Madeleine M. Jordan, Emmanuel Amabebe, Kamil Khanipov, Brandie DePaoli Taylor
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引用次数: 0
摘要
关于微生物群在妊娠高血压疾病(HDP)中的作用,尤其是经常导致早产的先兆子痫中的作用的研究很有限。我们评估了 23 项探讨肠道、阴道、口腔或胎盘微生物群与 HDP 之间关系的研究。我们检索了 Scopus、ProQuest Health Research Premium Collection、ProQuest Nursing & Allied Health Database、EBSCO 和 Ovid,以查找相关文献。大多数研究(18 项)侧重于肠道微生物群,而研究口腔(3 项)、阴道(3 项)和胎盘(1 项)的研究则少得多。有一项研究考察了肠道、口腔和阴道微生物群。共识强调了微生物群失调在子痫前期和 HDP 中的潜在作用。特别是在妊娠三个月时,子痫前期与肠道菌群失调有关--缺乏有益的 Akkermansia、双歧杆菌和 Coprococcus,但富含致病的弯曲杆菌和酵母菌,群落 α-多样性较低。同样,先兆子痫患者的阴道和口腔微生物群分别富含细菌性阴道病和牙周病相关物种。在胎盘中也观察到了这种趋势,胎盘中定植有胃肠道、呼吸道和牙周炎相关病原体。因此,慢性促炎状态会对胎盘产生不利影响。然而,这些观察结果需要更多的机理研究,以确定之前免疫功能紊乱的时间和任何因果关系。
Scoping Review of Microbiota Dysbiosis and Risk of Preeclampsia
Limited studies have investigated the role of the microbiota in hypertensive disorders of pregnancy (HDP), particularly preeclampsia, which often results in preterm birth. We evaluated 23 studies that explored the relationship between gut, vaginal, oral, or placental microbiotas and HDP. Scopus, ProQuest Health Research Premium Collection, ProQuest Nursing & Allied Health Database, EBSCO, and Ovid were searched for relevant literature. Majority (18) of studies focused on the gut microbiota, and far fewer examined the oral cavity (3), vagina (3), and placenta (1). One study examined the gut, oral, and vaginal microbiotas. The consensus highlights a potential role for microbiota dysbiosis in preeclampsia and HDP. Especially in the third trimester, preeclampsia is associated with gut dysbiosis—deficient in beneficial species of Akkermansia, Bifidobacterium, and Coprococcus but enriched with pathogenic Campylobacterota and Candidatus Saccharibacteria, with low community α-diversity. Similarly, the preeclamptic vaginal and oral microbiotas are enriched with bacterial vaginosis and periodontal disease-associated species, respectively. The trend is also observed in the placenta, which is colonized by gastrointestinal, respiratory tract, and periodontitis-related pathogens. Consequently, a chronic proinflammatory state that adversely impacts placentation is implicated. These observations however require more mechanistic studies to establish the timing of the preceding immune dysfunction and any causality.
期刊介绍:
The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.