{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:19:25Z","timestamp":1785410365488,"version":"3.56.0"},"reference-count":30,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Faculty Research Grant of Yonsei University College of Medicine","award":["6-2019-0097"],"award-info":[{"award-number":["6-2019-0097"]}]},{"name":"National Research Foundation of Korea (NRF), funded by the Korean government","award":["RS-2025-16070676, RS-2020-NR048467"],"award-info":[{"award-number":["RS-2025-16070676, RS-2020-NR048467"]}]},{"name":"National Research Foundation of Korea (NRF), funded by the Ministry of Science and ICT","award":["RS-2023-NR077137"],"award-info":[{"award-number":["RS-2023-NR077137"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,6,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Endometriosis (EMS) is a chronic inflammatory disorder affecting ~10% of reproductive-age women, with increasing evidence implicating the microbiome in its pathogenesis through immunomodulation and estrogen metabolism. This study investigated microbiome composition in the vagina, endometrium, and peritoneal fluid (PF) of women with and without EMS and further assessed the effects of\n                      <jats:italic toggle=\"yes\">Lactobacillus reuteri<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">L. reuteri<\/jats:italic>\n                      ) on endometrial (EM) cells\n                      <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                      . Samples from 41 patients were analyzed using 16S rRNA gene sequencing, targeting the V3\u2013V4 regions. Western blotting, ELISA, and LC-MS\/MS were employed to evaluate protein expression and estrogen metabolism during EM\u2013\n                      <jats:italic toggle=\"yes\">L<\/jats:italic>\n                      .\n                      <jats:italic toggle=\"yes\">reuteri<\/jats:italic>\n                      co-culture with or without estradiol-17-glucuronide (E2G). Microbiome analysis revealed no significant differences in alpha or beta diversity between EMS and controls across all compartments. However, LEfSe analysis identified several taxa with differential abundance, with\n                      <jats:italic toggle=\"yes\">L. reuteri<\/jats:italic>\n                      consistently altered in both vagina and EM. Across the menstrual cycle, EM and vaginal microbiomes were stable, whereas PF microbiota showed phase-dependent variation involving 60 genera and 76 species.\n                      <jats:italic toggle=\"yes\">In vitro<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">L. reuteri<\/jats:italic>\n                      alone did not alter endometriosis-related proteins, but in the presence of E2G, it reduced BAX\/Bcl-2 ratios and increased p-NF-\u03baB, suggesting anti-apoptotic and pro-inflammatory shifts. Progesterone receptor \u03b1\/\u03b2 expression decreased, while estrogen receptor levels remained unchanged.\n                      <jats:italic toggle=\"yes\">L. reuteri<\/jats:italic>\n                      increased \u03b2-glucuronidase activity but did not enhance E2G-to-estradiol conversion. These findings highlight\n                      <jats:italic toggle=\"yes\">L. reuteri<\/jats:italic>\n                      as a potentially important species in EMS, with\n                      <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                      evidence suggesting survival-promoting effects under estrogenic conditions. Further research should explore multi-species interactions and hormonal contexts to clarify microbial contributions to EMS pathogenesis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      Although\n                      <jats:italic toggle=\"yes\">Lactobacillus reuteri<\/jats:italic>\n                      appeared more abundant in the vagina and endometrium of controls, suggesting a protective role,\n                      <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                      findings paradoxically indicated anti-apoptotic and pro-inflammatory effects under estrogenic conditions, underscoring the need for further investigation of multi-species microbial interactions and hormonal contexts in endometriosis pathogenesis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.03689-25","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T13:00:40Z","timestamp":1778072440000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Microbiome in women with endometriosis and the\n                    <i>in vitro<\/i>\n                    effects of\n                    <i>Lactobacillus reuteri<\/i>\n                    on human endometrium"],"prefix":"10.1128","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4223-1395","authenticated-orcid":true,"given":"Jae Hoon","family":"Lee","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01wjejq96","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Gangnam Severance Hospital, Yonsei University College of Medicine","place":["Gangnam-gu, South 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