切换至 "中华医学电子期刊资源库"

中华妇幼临床医学杂志(电子版) ›› 2022, Vol. 18 ›› Issue (05) : 506 -511. doi: 10.3877/cma.j.issn.1673-5250.2022.05.002

专题论坛

复发性流产与肠道微生物群失衡
孙环蕊1, 张若鹏2,3,()   
  1. 1大理大学临床医学院,大理 671000
    2大理大学第一附属医院生殖医学科,大理 671000
    3昆明市妇幼保健院,昆明 650000
  • 收稿日期:2022-02-03 修回日期:2022-09-09 出版日期:2022-10-01
  • 通信作者: 张若鹏

Recurrent spontaneous abortion and the imbalance of gut microbiota

Huanrui Sun1, Ruopeng Zhang2,3,()   

  1. 1Clinic School of Medicine, Dali University, Dali 671000, Yunnan Province, China
    2Department of Reproductive Medicine, The First Affiliated Hospital of Dali University, Dali 671000, Yunnan Province, China
    3Kunming Maternal and Child Health Hospital, Kunming 650000, Yunnan Province, China
  • Received:2022-02-03 Revised:2022-09-09 Published:2022-10-01
  • Corresponding author: Ruopeng Zhang
  • Supported by:
    National Natural Science Foundation of China(81860271); Famous Doctors and Masters Talents Project of " Ten Thousand Talents Program" in Yunnan Province([2019]35); Eighth Batch of Young and Middle-aged Academic Leaders Reserve Talents Project of Dali University([2017]2)
引用本文:

孙环蕊, 张若鹏. 复发性流产与肠道微生物群失衡[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(05): 506-511.

Huanrui Sun, Ruopeng Zhang. Recurrent spontaneous abortion and the imbalance of gut microbiota[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2022, 18(05): 506-511.

复发性流产(RSA)是一种多病因疾病。肠道微生物群失衡已被证实与多种疾病的发生、发展有关,包括肥胖、多囊卵巢综合征(PCOS)、糖尿病、自身免疫性甲状腺疾病(AITD)、抑郁症等,而上述疾病皆为导致RSA发生的病因,由此间接提示RSA可能与肠道微生物群失衡有关。肠道微生物群失衡导致RSA的发病机制迄今尚未完全阐明。笔者拟对①RSA的流行病学及病因;②肠道微生物群失衡对机体的影响;③RSA病因与肠道微生物群失衡的最新研究进展等进行阐述,旨在为RSA诊治提供新的方向。

Recurrent spontaneous abortion (RSA) is a multi-causal disease. The imbalance of gut microbiota has been confirmed to be related to the occurrence and development of various diseases, including obesity, polycystic ovary syndrome (PCOS), diabetes, autoimmune thyroid disease (AITD), depression, etc., all of which can lead to RSA. The etiological factors of RSA indirectly suggest that RSA may be related to gut microbiota imbalance. The pathogenesis of gut microbiota imbalance leading to RSA has not yet been fully elucidated. The author intends to elaborate on the latest researches of epidemiology and etiology of RSA, impacts of gut microbiota imbalance on the body, and etiology of RSA and gut microbiota imbalance, aiming to provide a new direction for diagnosis and treatment of RSA.

[1]
张建平. 复发性流产诊治的专家共识[J]. 中华妇产科杂志2016, 51(1): 3-9. DOI: 10.3760/cma.j.issn.0529-567X.2016.01.002.
[2]
自然流产诊治中国专家共识编写组. 自然流产诊治中国专家共识(2020)[J]. 中国实用妇科与产科杂志2020, 36(11): 1082-1090. DOI: 10.19538/j.fk2020110113.
[3]
中国人体健康科技促进会生殖免疫专业委员会复发性流产病因检查专家共识编写组. 复发性流产病因检查专家共识[J]. 中国计划生育和妇产科2022, 14(2): 3-9. DOI: 10.3969/j.issn.1674-4020.2022.02.01.
[4]
柏文心,赵爱民. 不明原因复发性流产的免疫发病机制研究进展[J]. 上海交通大学学报(医学版), 2021, 41(10): 1371-1377. DOI: 10.3969/j.issn.1674-8115.2021.10.016.
[5]
张清华,潘静,姚丽艳. 复发性流产患者病因构成分析[J]. 中国全科医学2020, 23(14): 1760-1764. DOI: 10.12114/j.issn.1007-9572.2019.00.738.
[6]
Kolte AM, Olsen LR, Mikkelsen EM, et al. Depression and emotional stress is highly prevalent among women with recurrent pregnancy loss[J]. Hum Reprod, 2015, 30(4): 777-782. DOI: 10.1093/humrep/dev014.
[7]
He L, Wang T, Xu H, et al. Prevalence of depression and anxiety in women with recurrent pregnancy loss and the associated risk factors[J]. Arch Gynecol Obstet, 2019, 300(4): 1061-1066. DOI: 10.1007/s00404-019-05264-z.
[8]
Koert E, Malling G, Sylvest R, et al. Recurrent pregnancy loss: couples′ perspectives on their need for treatment, support and follow up[J]. Hum Reprod, 2019, 34(2): 291-296. DOI: 10.1093/humrep/dey362.
[9]
Lu D, Huang Y, Kong Y, et al. Gut microecology: why our microbes could be key to our health[J]. Biomed Pharmacother, 2020, 131: 110784. DOI: 10.1016/j.biopha.2020.110784.
[10]
Federici M. Gut microbiome and microbial metabolites: a new system affecting metabolic disorders[J]. J Endocrinol Invest, 2019, 42(9): 1011-1018. DOI: 10.1007/s40618-019-01022-9.
[11]
Browne HP, Neville BA, Forster SC, et al. Transmission of the gut microbiota: spreading of health[J]. Nat Rev Microbiol, 2017, 15(9): 531-543. DOI: 10.1038/nrmicro.2017.50.
[12]
El Aidy S, Dinan TG, Cryan JF. Gut microbiota: the conductor in the orchestra of immune-neuroendocrine communication[J]. Clin Ther, 2015, 37(5): 954-967. DOI: 10.1016/j.clinthera.2015.03.002.
[13]
Salah M, Azab M, Ramadan A, et al. New insights on obesity and diabetes from gut microbiome alterations in Egyptian adults[J]. Omics, 2019, 23(10): 477-485. DOI: 10.1089/omi.2019.0063.
[14]
Xu H, Liu M, Cao J, et al. The dynamic interplay between the gut microbiota and autoimmune diseases[J]. J Immunol Res, 2019, 2019: 7546047. DOI: 10.1155/2019/7546047.
[15]
Scheithauer T, Rampanelli E, Nieuwdorp M, et al. Gut microbiota as a trigger for metabolic inflammation in obesity and type 2 diabetes[J]. Front Immunol, 2020, 11: 571731. DOI: 10.3389/fimmu.2020.571731.
[16]
Cavalcante MB, Sarno M, Peixoto AB, et al. Obesity and recurrent miscarriage: a systematic review and Meta-analysis[J]. J Obstet Gynaecol Res, 2019, 45(1): 30-38. DOI: 10.1111/jog.13799.
[17]
Eapen A, Hayes ET, McQueen DB, et al. Mean differences in maternal body mass index and recurrent pregnancy loss: a systematic review and Meta-analysis of observational studies[J]. Fertil Steril, 2021, 116(5): 1341-1348. DOI: 10.1016/j.fertnstert.2021.06.019.
[18]
Lee CJ, Sears CL, Maruthur N. Gut microbiome and its role in obesity and insulin resistance[J]. Ann NY Acad Sci, 2020, 1461(1): 37-52. DOI: 10.1111/nyas.14107.
[19]
Lim YY, Lee YS, Ooi D. Engineering the gut microbiome for treatment of obesity: a review of current understanding and progress[J]. Biotechnol J, 2020, 15(10): e2000013. DOI: 10.1002/biot.202000013.
[20]
Sharma M, Li Y, Stoll ML, et al. The epigenetic connection between the gut microbiome in obesity and diabetes[J]. Front Genet, 2019, 10: 1329. DOI: 10.3389/fgene.2019.01329.
[21]
Aoun A, Darwish F, Hamod N. The influence of the gut microbiome on obesity in adults and the role of probiotics, prebiotics, and synbiotics for weight loss[J]. Prev Nutr Food Sci, 2020, 25(2): 113-123. DOI: 10.3746/pnf.2020.25.2.113.
[22]
Insenser M, Murri M, Del Campo R, et al. Gut microbiota and the polycystic ovary syndrome: influence of sex, sex hormones, and obesity[J]. J Clin Endocrinol Metab, 2018, 103(7): 2552-2562. DOI: 10.1210/jc.2017-02799.
[23]
Shirvani RS, Nikkhah A, Orvatinia M, et al. Gut microbiota: a perspective of precision medicine in endocrine disorders[J]. J Diabetes Metab Disord, 2020, 19(2): 1827-1834. DOI: 10.1007/s40200-020-00593-2.
[24]
Zhao X, Jiang Y, Xi H, et al. Exploration of the relationship between gut microbiota and polycystic ovary syndrome (PCOS): a review[J]. Geburtshilfe Frauenheilkd, 2020, 80(2): 161-171. DOI: 10.1055/a-1081-2036.
[25]
Yurtdaş G, Akdevelioǧlu Y. A new approach to polycystic ovary syndrome: the gut microbiota[J]. J Am Coll Nutr, 2020, 39(4): 371-382. DOI: 10.1080/07315724.2019.1657515.
[26]
Corrie L, Gulati M, Vishwas S, et al. Combination therapy of curcumin and fecal microbiota transplant: potential treatment of polycystic ovarian syndrome[J]. Med Hypotheses, 2021, 154: 110644. DOI: 10.1016/j.mehy.2021.110644.
[27]
Darbandi M, Rezaeian S, Dianatinasab M, et al. Prevalence of gestational diabetes and its association with stillbirth, preterm birth, macrosomia, abortion and cesarean delivery: a national prevalence study of 11 provinces in Iran[J]. J Prev Med Hyg, 2021, 62(4): E885-E891. DOI: 10.15167/2421-4248/jpmh2021.62.4.1788.
[28]
Duan L, An X, Zhang Y, et al. Gut microbiota as the critical correlation of polycystic ovary syndrome and type 2 diabetes mellitus[J]. Biomed Pharmacother, 2021, 142: 112094. DOI: 10.1016/j.biopha.2021.112094.
[29]
Craciun CI, Neag MA, Catinean A, et al. The relationships between gut microbiota and diabetes mellitus, and treatments for diabetes mellitus[J]. Biomedicines, 2022, 10(2): 308. DOI: 10.3390/biomedicines10020308.
[30]
Salgaço MK, Oliveira L, Costa GN, et al. Relationship between gut microbiota, probiotics, and type 2 diabetes mellitus[J]. Appl Microbiol Biotechnol, 2019, 103(23-24): 9229-9238. DOI: 10.1007/s00253-019-10156-y.
[31]
Li WZ, Stirling K, Yang JJ, et al. Gut microbiota and diabetes: from correlation to causality and mechanism[J]. World J Diabet, 2020, 11(7): 293-308. DOI: 10.4239/wjd.v11.i7.293.
[32]
Docimo G, Cangiano A, Romano RM, et al. The human microbiota in endocrinology: implications for pathophysiology, treatment, and prognosis in thyroid diseases[J]. Front Endocrinol (Lausanne), 2020, 11: 586529. DOI: 10.3389/fendo.2020.586529.
[33]
Dong AC, Morgan J, Kane M, et al. Subclinical hypothyroidism and thyroid autoimmunity in recurrent pregnancy loss: a systematic review and Meta-analysis[J]. Fertil Steril, 2020, 113(3): 587.e1-600.e1. DOI: 10.1016/j.fertnstert.2019.11.003.
[34]
Zhou F, Wang X, Wang L, et al. Genetics, epigenetics, cellular immunology, and gut microbiota: emerging links with Graves′ disease[J]. Front Cell Dev Biol, 2021, 9: 794912. DOI: 10.3389/fcell.2021.794912.
[35]
Huo D, Cen C, Chang H, et al. Probiotic bifidobacterium longum supplied with methimazole improved the thyroid function of Graves′ disease patients through the gut-thyroid axis[J]. Commun Biol, 2021, 4(1): 1046. DOI: 10.1038/s42003-021-02587-z.
[36]
Liu S, An Y, Cao B, et al. The composition of gut microbiota in patients bearing Hashimoto′s thyroiditis with euthyroidism and hypothyroidism[J]. Int J Endocrinol, 2020, 2020: 5036959. DOI: 10.1155/2020/5036959.
[37]
Zhao F, Feng J, Li J, et al. Alterations of the gut microbiota in Hashimoto′s thyroiditis patients[J]. Thyroid, 2018, 28(2): 175-186. DOI: 10.1089/thy.2017.0395.
[38]
Wang Y, Meng Z, Pei J, et al. Anxiety and depression are risk factors for recurrent pregnancy loss: a nested case-control study[J]. Health Qual Life Outcom, 2021, 19(1): 78. DOI: 10.1186/s12955-021-01703-1.
[39]
Barandouzi ZA, Starkweather AR, Henderson WA, et al. Altered composition of gut microbiota in depression: a systematic review[J]. Front Psychiat, 2020, 11: 541. DOI: 10.3389/fpsyt.2020.00541.
[40]
Mynarska E, Gadzinowska J, Tokarek J, et al. The role of the microbiome-brain-gut axis in the pathogenesis of depressive disorder[J]. Nutrients, 2022, 14(9): 1921. DOI: 10.3390/nu14091921.
[41]
Evrensel A, Tarhan KN. Emerging role of gut-microbiota-brain axis in depression and therapeutic implication[J]. Prog Neuropsychopharmacol Biol Psychiatry, 2021, 106: 110138. DOI: 10.1016/j.pnpbp.2020.110138.
[42]
Nikolova V, Zaidi SY, Young AH, et al. Gut feeling: randomized controlled trials of probiotics for the treatment of clinical depression: systematic review and Meta-analysis[J]. Ther Adv Psychopharmacol, 2019, 9: 2045125319859963. DOI: 10.1177/2045125319859963.
[43]
夏美艳,朱敏,黄亚雄. 子宫内膜微生物群及肠道菌群与复发性流产的相关性分析[J].中国妇幼健康研究2021, 32(10): 1519-1523. DOI: 10.3969/j.issn.1673-5293.2021.10.023.
[1] 何金梅, 尹立雪, 谭静, 张文军, 王锐, 任梅, 廖明娇. 超声心肌做功技术对2型糖尿病患者潜在左心室心肌收缩功能损伤的评价[J]. 中华医学超声杂志(电子版), 2023, 20(10): 1029-1035.
[2] 王珏, 陈赛君, 贲志飞, 詹锦勇, 徐开颖. 剪切波弹性成像联合极速脉搏波技术评估颈动脉弹性对糖尿病性视网膜病变的预测价值[J]. 中华医学超声杂志(电子版), 2023, 20(06): 636-641.
[3] 王洁, 丁泊文, 尹健. 糖尿病性乳腺病52例临床分析[J]. 中华乳腺病杂志(电子版), 2023, 17(05): 285-289.
[4] 马敏榕, 李聪, 周勤. 宫颈癌治疗研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 497-504.
[5] 林昌盛, 战军, 肖雪. 上皮性卵巢癌患者诊疗中基因检测及分子靶向药物治疗[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 505-510.
[6] 顾娟, 孙擎擎, 胡方方, 曹义娟, 祁玉娟. 子宫内膜容受性检测改善胚胎反复种植失败患者妊娠结局的临床应用[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 582-587.
[7] 陈絮, 詹玉茹, 王纯华. 孕妇ABO血型联合甲状腺功能检测对预测妊娠期糖尿病的临床价值[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 604-610.
[8] 张健, 刘小龙, 查天建, 姚俊杰, 王傑. 富含血小板血浆联合异种脱细胞真皮基质修复糖尿病足缺血性创面的临床效果[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 503-506.
[9] 李琛, 张惟佳, 潘亚萍. 牙周炎与系统性疾病之间关系的应用思考:2022年EFP和WONCA欧洲分部联合研讨会共识报告的解读及启示[J]. 中华口腔医学研究杂志(电子版), 2023, 17(05): 322-327.
[10] 李晓晖, 上官昌盛, 向英, 裴芝皆, 车俊志, 谢飞. 3D腹腔镜袖状胃切除术后机体能量代谢与多囊卵巢综合征患者性激素水平关系[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 538-541.
[11] 黄岩, 刘晓巍, 杨春玲, 兰烨. 急性胰腺炎合并糖尿病患者的临床特征及血糖代谢与病情严重度的相关性[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 439-442.
[12] 张政赢, 鞠阳, 刘晓宁. 二甲双胍对2型糖尿病患者大肠腺瘤术后复发的影响[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 485-488.
[13] 薛念余, 张盛敏, 吴凌恒, 沙蕾, 童揽月, 沈崔琴, 李朝军, 杜联芳. 研究血清胆红素对2型糖尿病患者心脏结构发生改变前心肌功能的影响[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1004-1009.
[14] 潘惠, 王明, 杨忠, 杜向东. 低频重复经颅磁刺激辅助治疗伴不同特征抑郁症的对照研究[J]. 中华临床医师杂志(电子版), 2023, 17(05): 562-568.
[15] 谢国晓, 赵凌霞, 薛雪花. 慢性病管理模式在糖尿病社区管理中的应用[J]. 中华临床医师杂志(电子版), 2023, 17(05): 587-590.
阅读次数
全文


摘要