Abstract
Problem: The increase in infertility worldwide is not only linked to the increase in maternal age but also to the impact of environmental factors associated to epigenetic changes in women’s health status, which have an impact on the origin of inflammatory disorders whose first symptom could be infertility. Method of study: A total of 301 women with multiple IVF-ET failures were recruited. The expression of specific microRNAs associated with microbiota imbalances was analyzed together with biomarkers in blood and saliva. All patients showed imbalances in at least one of the above-mentioned biomarkers and decided to continue with their usual treatment (n=23) or to customize dietary and probiotic supplementation for 75 days (n=278). Pregnancy rate was compared between both groups after 180 days of pregnancy search. Result(s): 84% of the infertile patients showed an increase in at least one of these microRNAs. Considering these parameters and peripheral blood and saliva biomarkers, the patients were supplemented with a combination of biomedical diets, probiotics and nutraceuticals. Pregnancy rate after another IVF-ET attempt was 75% for the group that customized supplementation and 30% for the group that did not supplement according tests results (*p<0.05). Conclusions: Appropriate dietary supplementation according to our novel microRNA diagnostic platform improved the pregnancy rate of patients with multiple IVF-ET failures.
References
Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clin Biochem. 2018;62:2-10. doi:10.1016/j. clinbiochem.2018.03.012
Inhorn MC, Patrizio P. Infertility around the globe: New thinking on gender, reproductive technologies and global movements in the 21st century. Hum Reprod Update. 2014;21(4):411-426. doi:10.1093/humupd/dmv016
Sadegui MR. Unexplained Infertility, the Controversial Matter in Management of Infertile Couples - PubMed.; 2015. doi:10.1093/humupd/dmv016. Epub 2015 Mar 22. PMID: 25801630
Kåhrström CT, Pariente N, Weiss U. Intestinal microbiota in health and disease. Nature. 2016;535(7610):47. doi:10.1038/535047a
Dinan TG, Cryan JF. The Microbiome-Gut-Brain Axis in Health and Disease. Gastroenterol Clin North Am. 2017;46(1):77-89. doi:10.1016/j.gtc.2016.09.007
Lynch S V., Pedersen O. The Human Intestinal Microbiome in Health and Disease. N Engl J Med. 2016;375(24):2369-2379. doi:10.1056/nejmra1600266
Fallucca F, Porrata C, Fallucca S, Pianesi M. Influence of diet on gut microbiota, inflammation and type 2 diabetes mellitus. First experience with macrobiotic Ma-Pi 2 diet. Diabetes Metab Res Rev. 2014;30(S1):48-54. doi:10.1002/dmrr.2518
Aagaard K, Riehle K, Ma J, et al. A metagenomic approach to characterization of the vaginal microbiome signature in pregnancy. PLoS One. 2012;7(6). doi:10.1371/journal. pone.0036466
Boers SA, Jansen R, Hays JP. Understanding and overcoming the pitfalls and biases of next-generation sequencing (NGS) methods for use in the routine clinical microbiological diagnostic laboratory. Eur J Clin Microbiol Infect Dis. 2019;38(6):1059-1070. doi:10.1007/s10096-019-03520-3
Degruttola AK, Low D, Mizoguchi A, Mizoguchi E. Current understanding of dysbiosis in disease in human and animal models. Inflamm Bowel Dis. 2016;22(5):1137-1150. doi:10.1097/MIB.0000000000000750
Campisciano G, Florian F, D’Eustacchio A, et al. Subclinical alteration of the cervical–vaginal microbiome in women with idiopathic infertility. J Cell Physiol. 2017;232(7):1681-1688. doi:10.1002/jcp.25806
Mor G, Aldo P, Alvero AB. The unique immunological and microbial aspects of pregnancy. Nat Rev Immunol. 2017;17(8):469-482. doi:10.1038/nri.2017.64
Fasano A, Shea-Donohue T. Mechanisms of disease: The role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases. Nat Clin Pract Gastroenterol Hepatol. 2005;2(9):416-422. doi:10.1038/ncpgasthep0259
Arvonen M, Berntson L, Pokka T, Karttunen TJ, Vähäsalo P, Stoll ML. Gut microbiota-host interactions and juvenile idiopathic arthritis. Pediatr Rheumatol. 2016;14(1). doi:10.1186/s12969-016-0104-6
Fahlén A, Engstrand L, Baker BS, Powles A, Fry L. Comparison of bacterial microbiota in skin biopsies from normal and psoriatic skin. Arch Dermatol Res. 2012;304(1):15-22. doi:10.1007/s00403-011-1189-x
Hold GL, Smith M, Grange C, Watt ER, El-Omar EM, Mukhopadhya I. Role of the gut microbiota in inflammatory bowel disease pathogenesis: What have we learnt in the past 10 years? World J Gastroenterol. 2014;20(5):1192-1210. doi:10.3748/wjg.v20.i5.1192
Huipeng W, Lifeng G, Chuang G, Jiaying Z, Yuankun C. The differences in colonic mucosal microbiota between normal individual and colon cancer patients by polymerase chain reaction-denaturing gradient gel electrophoresis. J Clin Gastroenterol. 2014;48(2):138-144. doi:10.1097/MCG.0b013e3182a26719
Maes M, Kubera M, Leuni J-C. The gut-brain barrier in major depression: Intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression. Neuro Endocrinol Lett. Published online
Pärtty A, Kalliomäki M, Wacklin P, Salminen S, Isolauri E. A possible link between early probiotic intervention and the risk of neuropsychiatric disorders later in childhood: A randomized trial. Pediatr Res. 2015;77(6):823-828. doi:10.1038/pr.2015.51
Peterson DA, Frank DN, Pace NR, Gordon JI. Metagenomic Approaches for Defining the Pathogenesis of Inflammatory Bowel Diseases. Cell Host Microbe. 2008;3(6):417-427. doi:10.1016/j.chom.2008.05.001
Jeon MK. Intestinal barrier: Molecular pathways and modifiers. World J Gastrointest Pathophysiol. 2013;4(4):94. doi:10.4291/wjgp.v4.i4.94
Catanzaro JR, Strauss JD, Bielecka A, et al. IgA-deficient humans exhibit gut microbiota dysbiosis despite secretion of compensatory IgM. Sci Rep. 2019;9(1). doi:10.1038/s41598-019-49923-2
Gulyaeva LF, Kushlinskiy NE. Regulatory mechanisms of microRNA expression. J Transl Med. 2016;14(1). doi:10.1186/s12967-016-0893-x
Mortha A, Chudnovskiy A, Hashimoto D, et al. Microbiota- dependent crosstalk between macrophages and ILC3 promotes intestinal homeostasis. Science (80- ). 2014;343(6178). doi:10.1126/science.1249288
Curtale G, Rubino M, Locati M. MicroRNAs as molecular switches in macrophage activation. Front Immunol. 2019;10(MAR). doi:10.3389/fimmu.2019.00799
Vojdani A. For the assessment of intestinal permeability, size matters. Altern Ther Health Med. 2013;19(1):12-24. Accessed January 12, 2021. https://pubmed.ncbi.nlm.nih. gov/23341423/
Gleicher N, El-Roeiy A. The reproductive autoimmune failure syndrome. Am J Obstet Gynecol. 1988;159(1):223-227. doi:10.1016/0002-9378(88)90525-X
Laschke MW, Menger MD. The gut microbiota: A puppet master in the pathogenesis of endometriosis? Am J Obstet Gynecol. 2016;215(1):68.e1-68.e4. doi:10.1016/j.ajog.2016.02.036
De Luca F, Shoenfeld Y. The microbiome in autoimmune diseases. Clin Exp Immunol. 2019;195(1):74-85. doi:10.1111/cei.13158
Yu LCH. Microbiota dysbiosis and barrier dysfunction in inflammatory bowel disease and colorectal cancers: exploring a common ground hypothesis. J Biomed Sci. 2018;25(1). doi:10.1186/s12929-018-0483-8
Flores R, Shi J, Fuhrman B, et al. Fecal microbial determinants of fecal and systemic estrogens and estrogen metabolites: A cross-sectional study. J Transl Med. 2012;10(1). doi:10.1186/1479-5876-10-253
Zeng B, Lai Z, Sun L, et al. Structural and functional profiles of the gut microbial community in polycystic ovary syndrome with insulin resistance (IR-PCOS): a pilot study. Res Microbiol. 2019;170(1):43-52. doi:10.1016/j.resmic.2018.09.002
Yurtdaş G, Akdevelioğlu Y. A New Approach to Polycystic Ovary Syndrome: The Gut Microbiota. J Am Coll Nutr. 2020;39(4):371-382. doi:10.1080/07315724.2019.1657515
MA A, L O, MI P, et al. Potential biomarkers of infertility associated with microbiome imbalances. Am J Reprod Immunol. Published online 2021. doi:10.1111/AJI.13438
Zhang L, Zhang F, He DK, Fan XM, Shen J. MicroRNA-21 is upregulated during intestinal barrier dysfunction induced by ischemia reperfusion. Kaohsiung J Med Sci. 2018;34(10):556-563. doi:10.1016/j.kjms.2018.05.006
Zhang L, Shen J, Cheng J, Fan X. MicroRNA-21 regulates intestinal epithelial tight junction permeability. Cell Biochem Funct. 2015;33(4):235-240. doi:10.1002/cbf.3109
Nakata K, Sugi Y, Narabayashi H, et al. Commensal Microbiota-induced microRNA modulates intestinal epithelial permeability through the small GTPase ARF4. J Biol Chem. 2017;292(37):15426-15433. doi:10.1074/jbc.M117.788596
Shi C, Liang Y, Yang J, et al. MicroRNA-21 Knockout Improve the Survival Rate in DSS Induced Fatal Colitis through Protectingagainst Inflammation and Tissue Injury. PLoS One.2013;8(6). doi:10.1371/journal.pone.0066814
Shi C, Yang Y, Xia Y, et al. Novel evidence for an oncogenic role of microRNA-21 in colitis-associated colorectal cancer. Gut. 2016;65(9):1470-1481. doi:10.1136/gutjnl-2014-308455
Jiang W, Li X. Molecular Analysis of Inflammatory Bowel Disease: Clinically Useful Tools for Diagnosis, Response Prediction, and Monitoring of Targeted Therapy. Mol Diagnosis Ther. 2015;19(3):141-158. doi:10.1007/s40291-015-0142-7
Xu WD, Pan HF, Li JH, Ye DQ. MicroRNA-21 with therapeutic potential in bl Sci. 2016;17(6). doi:10.3390/ijms17060864
Wang Z, Brandt S, Medeiros A, et al. MicroRNA 21 Is a homeostatic regulator of macrophage polarization and prevents prostaglandin e2 -mediated M2 generation. PLoS One. 2015;10(2). doi:10.1371/journal.pone.0115855
Croston TL, Lemons AR, Beezhold DH, Green BJ. MicroRNA regulation of host immune responses following fungal exposure. Front Immunol. 2018;9(FEB). doi:10.3389/fimmu. 2018.00170
Abdul-Maksoud RS, Sediq AM, Kattaia AAA, et al. Serum miR-210 and miR-155 expression levels as novel biomarkers for rheumatoid arthritis diagnosis. Br J Biomed Sci. 2017;74(4):209-213. doi:10.1080/09674845.2017.1343545
Bala S, Csak T, Saha B, et al. The pro-inflammatory effects of miR-155 promote liver fibrosis and alcohol-induced steatohepatitis. J Hepatol. 2016;64(6):1378-1387. doi:10.1016/j.jhep.2016.01.035
Saare M, Rekker K, Laisk-Podar T, et al. Challenges in endometriosis miRNA studies — From tissue heterogeneity to disease specific miRNAs. Biochim Biophys Acta - Mol Basis Dis. 2017;1863(9):2282-2292. doi:10.1016/j.bbadis.2017.06.018
Nisenblat V, Sharkey DJ, Wang Z, et al. Plasma miRNAs display limited potential as diagnostic tools for endometriosis. J Clin Endocrinol Metab. 2019;104(6):1999-2022. doi:10.1210/jc.2018-01464
Rotelli MT, Di Lena M, Cavallini A, et al. Fecal microRNA profile in patients with colorectal carcinoma before and after curative surgery. Int J Colorectal Dis. 2015;30(7):891-898. doi:10.1007/s00384-015-2248-0
Kulnigg-Dabsch S. Autoimmungastritis. Wiener Medizinische Wochenschrift. 2016;166(13-14):424-430. doi:10.1007/s10354-016-0515-5
Rodriguez-Castro KI, Franceschi M, Noto A, et al. Clinical manifestations of chronic atrophic gastritis. Acta Biomed. 2018;89(8-S):88-92. doi:10.23750/abm.v89i8-S.7921
Belizário JE, Faintuch J, Garay-Malpartida M. New frontiers for treatment of metabolic diseases. Mediators Inflamm. 2018;2018. doi:10.1155/2018/2037838
Kalinkovich A, Gabdulina G, Livshits G. Autoimmunity, inflammation, and dysbiosis mutually govern the transition from the preclinical to the clinical stage of rheumatoid arthritis. Immunol Res. 2018;66(6):696-709. doi:10.1007/s12026-018-9048-x
Vojdani A, Vojdani E, Herbert M, Kharrazian D. Correlation between antibodies to bacterial lipopolysaccharides and barrier proteins in sera positive for asca and anca. Int J Mol Sci. 2020;21(4). doi:10.3390/ijms21041381
Esta obra está bajo licencia internacional
