{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:30:29Z","timestamp":1787923829385,"version":"build-2784847793"},"reference-count":139,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p>When exploring the macro trend of declining global fertility rates, a pathological factor often hidden beneath individual suffering cannot be ignored: pelvic inflammatory disease (PID). Recurrent inflammation leads to tissue damage, adhesions, and scaring in the fallopian tubes, ovaries, and even the entire pelvic cavity, ultimately causing serious pelvic organ sequelae that severely affect female quality of life. The clinical diagnosis and treatment of PID are very challenging, with issues such as inappropriate treatment plan selection, insufficient treatment duration, and poor patient compliance. The role of microecological balance in maintaining human health has been increasingly recognized. Human tissues and organs form a dynamic, interactive system with microorganisms, playing an important role in female reproductive function. As an important microecological system of the body, the reproductive tract has a relatively complete natural defense function to resist infection. Previous research on the microbiome and female reproductive health has rarely focused on PID. The gut\u2013reproduction axis aims to construct an integrated regulatory model in which the homeostasis of the gut microbiota plays a crucial role in reproductive health. The microbiota affects the occurrence of PID by regulating core pathways, such as hormone secretion, inflammatory responses, and immune homeostasis. Examining the effects of microecologies in animal models and preliminary clinical studies will lay a solid theoretical foundation for developing microbiota-targeted innovative diagnostics and treatment strategies for PID, improving female reproductive health throughout their life course.<\/jats:p>","DOI":"10.3389\/fmicb.2026.1822640","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T08:02:27Z","timestamp":1786348947000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Gut-reproduction axis: a new perspective on understanding pelvic inflammatory disease"],"prefix":"10.3389","volume":"17","author":[{"given":"Shuai","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Second Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Wang","sequence":"additional","affiliation":[{"name":"The Reproductive Medical Center, China-Japan Union Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Tan","sequence":"additional","affiliation":[{"name":"Clinical Medicine Program, Xinjiang Medical University","place":["\u00dcr\u00fcmqi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caomeihui","family":"Shen","sequence":"additional","affiliation":[{"name":"College of Animal Science, Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaorui","family":"Tao","sequence":"additional","affiliation":[{"name":"Jilin Guojian Economic Development Obstetrics and Gynecology Hospital","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minjia","family":"Sheng","sequence":"additional","affiliation":[{"name":"The Reproductive Medical Center, China-Japan Union Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Second Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Second Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianwen","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Second Hospital of Jilin University","place":["Changchun, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1161\/CIRCRESAHA.122.322354","article-title":"Finding needles in the gut microbiota\u2019s haystack.","volume":"132","author":"Aljadah","year":"2023","journal-title":"Circ. Res"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1346035","DOI":"10.3389\/fimmu.2024.1346035","article-title":"Gut microbiota-gonadal axis: the impact of gut microbiota on reproductive functions.","volume":"15","author":"Ashonibare","year":"2024","journal-title":"Front. Immunol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.maturitas.2017.06.025","article-title":"Estrogen-gut microbiome axis: physiological and clinical implications.","volume":"103","author":"Baker","year":"2017","journal-title":"Maturitas"},{"key":"B4","doi-asserted-by":"publisher","first-page":"4696","DOI":"10.3748\/wjg.v25.i32.4696","article-title":"Effect of mild moxibustion on intestinal microbiota and NLRP6 inflammasome signaling in rats with post-inflammatory irritable bowel syndrome.","volume":"25","author":"Bao","year":"2019","journal-title":"World J. Gastroenterol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e71563","DOI":"10.1002\/fsn3.71563","article-title":"Association between dietary index for gut microbiota and the risk of pelvic inflammatory disease: mediating role of anti- and pro-inflammatory dietary patterns.","volume":"14","author":"Bao","year":"2026","journal-title":"Food Sci. Nutr"},{"key":"B6","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1186\/s40168-023-01584-0","article-title":"Gut barrier-microbiota imbalances in early life lead to higher sensitivity to inflammation in a murine model of C-section delivery.","volume":"11","author":"Barone","year":"2023","journal-title":"Microbiome"},{"key":"B7","doi-asserted-by":"publisher","first-page":"419","DOI":"10.3390\/nu12020419","article-title":"Reviewing the composition of vaginal microbiota: inclusion of nutrition and probiotic factors in the maintenance of eubiosis.","volume":"12","author":"Barrientos-Dur\u00e1n","year":"2020","journal-title":"Nutrients"},{"key":"B8","doi-asserted-by":"publisher","first-page":"f3189","DOI":"10.1136\/bmj.f3189","article-title":"Pelvic inflammatory disease.","volume":"346","author":"Bartlett","year":"2013","journal-title":"BMJ"},{"key":"B9","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.jsbmb.2005.02.018","article-title":"Effects of dehydroepiandrosterone, premarin and Acolbifene on histomorphology and sex steroid receptors in the rat vagina.","volume":"96","author":"Berger","year":"2005","journal-title":"J. Steroid Biochem. Mol. Biol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"I11","DOI":"10.1007\/s00394-002-1102-7","article-title":"Relationship of prebiotics and food to intestinal microflora.","volume":"41","author":"Blaut","year":"2002","journal-title":"Eur. J. Nutr"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.3390\/molecules25061340","article-title":"Resistance of gram-negative bacteria to current antibacterial agents and approaches to resolve it.","volume":"25","author":"Breijyeh","year":"2020","journal-title":"Molecules"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2039","DOI":"10.1056\/NEJMra1411426","article-title":"Pelvic inflammatory disease.","volume":"372","author":"Brunham","year":"2015","journal-title":"N. Engl. J. Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1136\/sextrans-2021-055242","article-title":"Hospitalisations for pelvic inflammatory disease in young Aboriginal women living in remote Australia: the role of chlamydia and gonorrhoea.","volume":"98","author":"Causer","year":"2022","journal-title":"Sex Transm. Infect"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e202101224","DOI":"10.26508\/lsa.202101224","article-title":"Gut microbiota-derived short-chain fatty acids protect against the progression of endometriosis.","volume":"4","author":"Chadchan","year":"2021","journal-title":"Life Sci. Alliance"},{"key":"B15","doi-asserted-by":"publisher","first-page":"R81","DOI":"10.1530\/JME-21-0238","article-title":"Female reproductive dysfunctions and the gut microbiota.","volume":"69","author":"Chadchan","year":"2022","journal-title":"J. Mol. Endocrinol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1038\/s41467-017-00901-0","article-title":"The microbiota continuum along the female reproductive tract and its relation to uterine-related diseases.","volume":"8","author":"Chen","year":"2017","journal-title":"Nat. Commun"},{"key":"B17","doi-asserted-by":"publisher","first-page":"625913","DOI":"10.3389\/fcimb.2021.625913","article-title":"Role and mechanism of gut microbiota in human disease.","volume":"11","author":"Chen","year":"2021","journal-title":"Front. Cell Infect. Microbiol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1430730","DOI":"10.3389\/fnut.2024.1430730","article-title":"Association between dietary magnesium intake and pelvic inflammatory disease in US women: a cross-sectional study of NHANES.","volume":"11","author":"Chen","year":"2024","journal-title":"Front. Nutr"},{"key":"B19","doi-asserted-by":"publisher","first-page":"2645","DOI":"10.3390\/ijms18122645","article-title":"Impact of omega-3 fatty acids on the gut microbiota.","volume":"18","author":"Costantini","year":"2017","journal-title":"Int. J. Mol. Sci"},{"key":"B20","doi-asserted-by":"publisher","first-page":"S39","DOI":"10.1093\/infdis\/jiab031","article-title":"Pelvic inflammatory disease due to Neisseria gonorrhoeae and Chlamydia trachomatis: immune evasion mechanisms and pathogenic disease pathways.","volume":"224","author":"Darville","year":"2021","journal-title":"J. Infect. Dis"},{"key":"B21","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1186\/s12879-018-3528-4","article-title":"Stably high azithromycin resistance and decreasing ceftriaxone susceptibility in Neisseria gonorrhoeae in 25 European countries, 2016.","volume":"18","author":"Day","year":"2018","journal-title":"BMC Infect. Dis"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1020","DOI":"10.1136\/gutjnl-2021-326789","article-title":"Gut microbiome and health: mechanistic insights.","volume":"71","author":"de Vos","year":"2022","journal-title":"Gut"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1002\/jobm.202100421","article-title":"Insights into the role of vaginal microbiome in women\u2019s health.","volume":"61","author":"Deka","year":"2021","journal-title":"J. Basic Microbiol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"2459","DOI":"10.1093\/cid\/ciz897","article-title":"Erratum to: Chlamydia trachomatis and the risk of pelvic inflammatory disease, ectopic pregnancy, and female infertility: a retrospective cohort study among primary care patients.","volume":"70","author":"Den Heijer","year":"2020","journal-title":"Clin. Infect. Dis"},{"key":"B25","doi-asserted-by":"publisher","first-page":"2617","DOI":"10.3390\/cells11162617","article-title":"A multi-strain probiotic formulation improves intestinal barrier function by the modulation of tight and adherent junction proteins.","volume":"11","author":"di Vito","year":"2022","journal-title":"Cells"},{"key":"B26","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/j.ncrna.2025.01.007","article-title":"Research progress on the interaction between intestinal flora and microRNA in pelvic inflammatory diseases.","volume":"11","author":"Dong","year":"2025","journal-title":"Noncoding RNA Res"},{"key":"B27","doi-asserted-by":"publisher","first-page":"791373","DOI":"10.3389\/fcimb.2021.791373","article-title":"Combined intestinal metabolomics and microbiota analysis for acute endometritis induced by lipopolysaccharide in mice.","volume":"11","author":"Dong","year":"2021","journal-title":"Front. Cell Infect. Microbiol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"18586","DOI":"10.1074\/jbc.RA119.010950","article-title":"Gut microbial \u03b2-glucuronidases reactivate estrogens as components of the estrobolome that reactivate estrogens.","volume":"294","author":"Ervin","year":"2019","journal-title":"J. Biol. Chem"},{"key":"B29","first-page":"1581","article-title":"Barcoded sequencing reveals diverse intrauterine microbiomes in patients suffering with endometrial polyps.","volume":"8","author":"Fang","year":"2016","journal-title":"Am. J. Transl. Res."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1016\/j.csbj.2022.03.017","article-title":"Microorganisms in the reproductive system and probiotic\u2019s regulatory effects on reproductive health.","volume":"20","author":"Feng","year":"2022","journal-title":"Comput. Struct. Biotechnol. J"},{"key":"B31","doi-asserted-by":"publisher","first-page":"321","DOI":"10.3389\/fcimb.2017.00321","article-title":"Diversity of cervical microbiota in asymptomatic Chlamydia trachomatis genital infection: a pilot study.","volume":"7","author":"Filardo","year":"2017","journal-title":"Front. Cell Infect. Microbiol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1186\/1479-5876-10-253","article-title":"Fecal microbial determinants of fecal and systemic estrogens and estrogen metabolites: a cross-sectional study.","volume":"10","author":"Flores","year":"2012","journal-title":"J. Transl. Med"},{"key":"B33","doi-asserted-by":"publisher","first-page":"132ra52","DOI":"10.1126\/scitranslmed.3003605","article-title":"Temporal dynamics of the human vaginal microbiota.","volume":"4","author":"Gajer","year":"2012","journal-title":"Sci. Transl. Med."},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000004066","article-title":"Global impact of pelvic inflammatory diseases attributable to sexually transmitted infections in women of childbearing age: a comprehensive analysis based on GBD 2021 data and bibliometric analysis.","author":"Gao","year":"2025","journal-title":"Int. J. Surg."},{"key":"B35","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1126\/science.aaa4972","article-title":"Cancer and the microbiota.","volume":"348","author":"Garrett","year":"2015","journal-title":"Science"},{"key":"B36","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1016\/j.cell.2017.01.022","article-title":"Mining the human gut microbiota for immunomodulatory organisms.","volume":"168","author":"Geva-Zatorsky","year":"2017","journal-title":"Cell"},{"key":"B37","doi-asserted-by":"publisher","first-page":"963752","DOI":"10.3389\/frph.2022.963752","article-title":"The female reproductive tract microbiotas, inflammation, and gynecological conditions.","volume":"4","author":"Gholiof","year":"2022","journal-title":"Front. Reprod. Health"},{"key":"B38","doi-asserted-by":"publisher","first-page":"101287","DOI":"10.1016\/j.disamonth.2021.101287","article-title":"Pelvic inflammatory disease in the adolescent and young adult: an update.","volume":"68","author":"Greydanus","year":"2022","journal-title":"Dis. Mon"},{"key":"B39","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1097\/MOP.0000000000000183","article-title":"Pelvic inflammatory disease in the adolescent: a poignant, perplexing, potentially preventable problem for patients and physicians.","volume":"27","author":"Greydanus","year":"2015","journal-title":"Curr. Opin. Pediatr"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1515\/ijamh-2018-0216","article-title":"Pelvic inflammatory disease: management requires a patient, prudent, prejudice-free provider.","volume":"32","author":"Greydanus","year":"2018","journal-title":"Int. J. Adolesc. Med. Health"},{"key":"B41","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1177\/0009922819852979","article-title":"Partner notification, treatment, and subsequent condom use after pelvic inflammatory disease: implications for dyadic intervention with urban youth.","volume":"58","author":"Ha","year":"2019","journal-title":"Clin. Pediatr"},{"key":"B42","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/s00404-017-4555-x","article-title":"The effect of prebiotic vaginal gel with adjuvant oral metronidazole tablets on treatment and recurrence of bacterial vaginosis: a triple-blind randomized controlled study.","volume":"297","author":"Hakimi","year":"2018","journal-title":"Arch. Gynecol. Obstet"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1336496","DOI":"10.3389\/fendo.2024.1336496","article-title":"High-fat diets promote peritoneal inflammation and augment endometriosis-associated abdominal hyperalgesia.","volume":"15","author":"Herup-Wheeler","year":"2024","journal-title":"Front. Endocrinol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1038\/nrgastro.2014.66","article-title":"Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic.","volume":"11","author":"Hill","year":"2014","journal-title":"Nat. Rev. Gastroenterol. Hepatol"},{"key":"B45","doi-asserted-by":"publisher","first-page":"1273509","DOI":"10.3389\/fnut.2023.1273509","article-title":"Association between dietary trace minerals and pelvic inflammatory disease: data from the 2015-2018 National Health and Nutrition Examination Surveys.","volume":"10","author":"Hu","year":"2023","journal-title":"Front. Nutr"},{"key":"B46","doi-asserted-by":"publisher","first-page":"3695","DOI":"10.1039\/c9fo02963j","article-title":"Gut microbiota mediate the protective effects on endometritis induced by Staphylococcus aureus in mice.","volume":"11","author":"Hu","year":"2020","journal-title":"Food Funct"},{"key":"B47","doi-asserted-by":"publisher","first-page":"926351","DOI":"10.3389\/fmed.2022.926351","article-title":"The severity of depression is associated with pelvic inflammatory diseases: a cross-sectional study of the United States National Health and Nutrition Examinations from 2013 to 2018.","volume":"9","author":"Huang","year":"2022","journal-title":"Front. Med."},{"key":"B48","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1007\/s12602-022-10019-5","article-title":"Antimicrobial substances and mechanisms of Lactobacillus rhamnosus against Gardnerella vaginalis.","volume":"15","author":"Huang","year":"2023","journal-title":"Probiot. Antimicrob Proteins"},{"key":"B49","doi-asserted-by":"publisher","first-page":"531","DOI":"10.3390\/nu9060531","article-title":"Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14 attenuate Gardnerella vaginalis-infected bacterial vaginosis in mice.","volume":"9","author":"Jang","year":"2017","journal-title":"Nutrients"},{"key":"B50","volume-title":"Pelvic Inflammatory Disease.","author":"Jenkins","year":"2025"},{"key":"B51","doi-asserted-by":"publisher","first-page":"e1300","DOI":"10.1002\/iid3.1300","article-title":"Modified Hongteng Baijiang decoction enema improves sequelae of pelvic inflammatory disease by regulating the LIF\/JAK2\/STAT3 pathway and gut microbiota.","volume":"12","author":"Ji","year":"2024","journal-title":"Immun. Inflamm. Dis"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.7150\/ijbs.56933","article-title":"Enforced expression of miR-92b blunts E. coli lipopolysaccharide-mediated inflammatory injury by activating the PI3K\/AKT\/\u03b2-catenin pathway via targeting PTEN.","volume":"17","author":"Jiang","year":"2021","journal-title":"Int. J. Biol. Sci"},{"key":"B53","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1111\/jcmm.14744","article-title":"miR-148a suppresses inflammation in lipopolysaccharide-induced endometritis.","volume":"24","author":"Jiang","year":"2020","journal-title":"J. Cell Mol. Med"},{"key":"B54","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1186\/s12905-025-03911-z","article-title":"The association between dietary fiber intake and pelvic inflammatory disease in women: findings from the NHANES 2015-2018.","volume":"25","author":"Jin","year":"2025","journal-title":"BMC Womens Health"},{"key":"B55","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.repbio.2020.07.001","article-title":"Use of a vaginal probiotic suppository and antibiotics to influence the composition of the endometrial microbiota.","volume":"20","author":"Kadogami","year":"2020","journal-title":"Reprod. Biol"},{"key":"B56","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.4014\/jmb.2106.06022","article-title":"Changes in the microbiome of vaginal fluid after menopause in Korean women.","volume":"31","author":"Kim","year":"","journal-title":"J. Microbiol. Biotechnol"},{"key":"B57","doi-asserted-by":"publisher","first-page":"345","DOI":"10.33073\/pjm-2021-033","article-title":"Characteristics of vaginal microbiome in women with pelvic inflammatory disease in Korea.","volume":"70","author":"Kim","year":"","journal-title":"Pol. J. Microbiol"},{"key":"B58","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1093\/humupd\/dmy048","article-title":"Identification and evaluation of the microbiome in the female and male reproductive tracts.","volume":"25","author":"Koedooder","year":"2019","journal-title":"Hum. Reprod. Update"},{"key":"B59","doi-asserted-by":"publisher","first-page":"80","DOI":"10.15585\/mmwr.mm6603a3","article-title":"Prevalence of pelvic inflammatory disease in sexually experienced women of reproductive Age - United States, 2013-2014.","volume":"66","author":"Kreisel","year":"2017","journal-title":"MMWR Morb Mortal Wkly. Rep"},{"key":"B60","doi-asserted-by":"publisher","first-page":"S103","DOI":"10.1093\/infdis\/jiaa771","article-title":"The burden of and trends in pelvic inflammatory disease in the United States, 2006-2016.","volume":"224","author":"Kreisel","year":"2021","journal-title":"J. Infect. Dis"},{"key":"B61","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/s0165-0378(01)00109-7","article-title":"Induction of specific immune responses in the genital tract of women after oral or rectal immunization and rectal boosting with Salmonella typhi Ty 21a vaccine.","volume":"52","author":"Kutteh","year":"2001","journal-title":"J. Reprod. Immunol"},{"key":"B62","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1038\/s41585-020-0286-z","article-title":"The microbiome and gynaecological cancer development, prevention and therapy.","volume":"17","author":"\u0141aniewski","year":"2020","journal-title":"Nat. Rev. Urol"},{"key":"B63","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1515\/CCLM.2008.196","article-title":"Plasma interleukin-1beta, -6, -8 and tumor necrosis factor-alpha as highly informative markers of pelvic inflammatory disease.","volume":"46","author":"Lee","year":"2008","journal-title":"Clin. Chem. Lab. Med"},{"key":"B64","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.1038\/s41591-019-0600-6","article-title":"Vaginal microbiome transplantation in women with intractable bacterial vaginosis.","volume":"25","author":"Lev-Sagie","year":"2019","journal-title":"Nat. Med"},{"key":"B65","doi-asserted-by":"publisher","first-page":"1125640","DOI":"10.3389\/fcimb.2023.1125640","article-title":"Analysis of the microbiota composition in the genital tract of infertile patients with chronic endometritis or endometrial polyps.","volume":"13","author":"Liang","year":"2023","journal-title":"Front. Cell Infect. Microbiol"},{"key":"B66","doi-asserted-by":"publisher","first-page":"e270","DOI":"10.1002\/imt2.270","article-title":"Gut-X axis.","volume":"4","author":"Lin","year":"2025","journal-title":"Imeta"},{"key":"B67","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s13073-016-0307-y","article-title":"The healthy human microbiome.","volume":"8","author":"Lloyd-Price","year":"2016","journal-title":"Genome Med"},{"key":"B68","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1016\/j.micinf.2018.02.003","article-title":"Microbiota changes impact on sexually transmitted infections and the development of pelvic inflammatory disease.","volume":"20","author":"Loeper","year":"2018","journal-title":"Microbes Infect"},{"key":"B69","doi-asserted-by":"publisher","first-page":"90","DOI":"10.3390\/pathogens10020090","article-title":"Vaginal, cervical and uterine pH in women with normal and abnormal vaginal microbiota.","volume":"10","author":"Lykke","year":"2021","journal-title":"Pathogens"},{"key":"B70","doi-asserted-by":"publisher","first-page":"CD001067","DOI":"10.1002\/14651858.CD001067.pub3","article-title":"Antibiotic regimens for postpartum endometritis.","volume":"2015","author":"Mackeen","year":"2015","journal-title":"Cochrane Database Syst. Rev"},{"key":"B71","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1016\/j.chom.2018.05.012","article-title":"The impact of dietary fiber on gut microbiota in host health and disease.","volume":"23","author":"Makki","year":"2018","journal-title":"Cell Host Microbe"},{"key":"B72","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1038\/s41579-022-00768-z","article-title":"Microbiota succession throughout life from the cradle to the grave.","volume":"20","author":"Martino","year":"2022","journal-title":"Nat. Rev. Microbiol"},{"key":"B73","doi-asserted-by":"publisher","first-page":"963868","DOI":"10.3389\/fcimb.2022.963868","article-title":"The role of probiotics in vaginal health.","volume":"12","author":"Mei","year":"2022","journal-title":"Front. Cell Infect. Microbiol"},{"key":"B74","doi-asserted-by":"publisher","first-page":"101","DOI":"10.4103\/2045-9912.260652","article-title":"Ozone therapy: a potential therapeutic adjunct for improving female reproductive health.","volume":"9","author":"Merhi","year":"2019","journal-title":"Med. Gas Res"},{"key":"B75","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1016\/j.idc.2013.08.004","article-title":"Pelvic inflammatory disease: current concepts in pathogenesis, diagnosis and treatment.","volume":"27","author":"Mitchell","year":"2013","journal-title":"Infect. Dis. Clin. North Am"},{"key":"B76","doi-asserted-by":"publisher","first-page":"878","DOI":"10.1080\/14767058.2020.1733517","article-title":"Vaginal Ureaplasma urealyticum or Mycoplasma hominis and preterm delivery in women with threatened preterm labor.","volume":"35","author":"Miyoshi","year":"2022","journal-title":"J. Matern Fetal Neonatal Med"},{"key":"B77","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1002\/hep.30349","article-title":"Intestinal immune dysregulation driven by dysbiosis promotes barrier disruption and bacterial translocation in rats with cirrhosis.","volume":"70","author":"Mu\u00f1oz","year":"2019","journal-title":"Hepatology"},{"key":"B78","doi-asserted-by":"publisher","first-page":"e043960","DOI":"10.1136\/bmjopen-2020-043960","article-title":"Barriers to shared decision-making with women of reproductive age affected by a chronic inflammatory disease: a mixed-methods needs assessment of dermatologists and rheumatologists.","volume":"11","author":"Murray","year":"2021","journal-title":"BMJ Open"},{"key":"B79","doi-asserted-by":"publisher","first-page":"43","DOI":"10.4322\/acr.2017.001","article-title":"Abdominal and pelvic actinomycosis due to longstanding intrauterine device: a slow and devastating infection.","volume":"7","author":"Nakahira","year":"2017","journal-title":"Autops Case Rep"},{"key":"B80","doi-asserted-by":"publisher","first-page":"502","DOI":"10.3390\/cimb47070502","article-title":"Unraveling the contribution of estrobolome alterations to endometriosis pathogenesis.","volume":"47","author":"Nannini","year":"2025","journal-title":"Curr. Issues Mol. Biol"},{"key":"B81","doi-asserted-by":"publisher","first-page":"29024","DOI":"10.1038\/srep29024","article-title":"Lactobacillus crispatus inhibits the infectivity of Chlamydia trachomatis elementary bodies, in vitro study.","volume":"6","author":"Nardini","year":"2016","journal-title":"Sci. Rep"},{"key":"B82","first-page":"87","article-title":"Acute pelvic inflammatory disease in cameroon: a cross sectional descriptive study.","volume":"19","author":"Nkwabong","year":"2015","journal-title":"Afr. J. Reprod. Health"},{"key":"B83","doi-asserted-by":"publisher","first-page":"e0191625","DOI":"10.1371\/journal.pone.0191625","article-title":"Associations between sexual habits, menstrual hygiene practices, demographics and the vaginal microbiome as revealed by Bayesian network analysis.","volume":"13","author":"Noyes","year":"2018","journal-title":"PLoS One"},{"key":"B84","doi-asserted-by":"publisher","first-page":"1613334","DOI":"10.3389\/fendo.2025.1613334","article-title":"Endometriosis-associated infertility: multi-omics insights into pathogenesis and precision therapeutics.","volume":"16","author":"Ou","year":"2025","journal-title":"Front. Endocrinol"},{"key":"B85","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1016\/S2468-1253(24)00311-X","article-title":"International consensus statement on microbiome testing in clinical practice.","volume":"10","author":"Porcari","year":"2025","journal-title":"Lancet Gastroenterol. Hepatol"},{"key":"B86","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/19490976.2021.1894070","article-title":"The impact of the gut microbiota on the reproductive and metabolic endocrine system.","volume":"13","author":"Qi","year":"2021","journal-title":"Gut Microbes"},{"key":"B87","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1038\/nature08821","article-title":"A human gut microbial gene catalogue established by metagenomic sequencing.","volume":"464","author":"Qin","year":"2010","journal-title":"Nature"},{"key":"B88","doi-asserted-by":"publisher","first-page":"4680","DOI":"10.1073\/pnas.1002611107","article-title":"Vaginal microbiome of reproductive-age women.","volume":"108","author":"Ravel","year":"2011","journal-title":"Proc. Natl. Acad. Sci. U. S. A"},{"key":"B89","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.ajog.2020.10.019","article-title":"Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease.","volume":"224","author":"Ravel","year":"2021","journal-title":"Am. J. Obstet Gynecol"},{"key":"B90","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1097\/LGT.0000000000000518","article-title":"Oral intake of lactobacilli can be helpful in symptomatic bacterial vaginosis: a randomized clinical study.","volume":"24","author":"Reznichenko","year":"2020","journal-title":"J. Low Genit. Tract. Dis"},{"key":"B91","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1177\/0956462417744099","article-title":"2017 European guideline for the management of pelvic inflammatory disease.","volume":"29","author":"Ross","year":"2018","journal-title":"Int. J. Std. AIDS"},{"key":"B92","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/0956462413498714","article-title":"2012 European guideline for the management of pelvic inflammatory disease.","volume":"25","author":"Ross","year":"2014","journal-title":"Int. J. Std. AIDS"},{"key":"B93","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1016\/j.cmet.2020.03.003","article-title":"Microbiota-derived metabolites suppress arthritis by amplifying aryl-hydrocarbon receptor activation in regulatory B Cells.","volume":"31","author":"Rosser","year":"2020","journal-title":"Cell Metab."},{"key":"B94","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1152\/physiol.00041.2015","article-title":"Linking gut microbiota and inflammation to obesity and insulin resistance.","volume":"31","author":"Saad","year":"2016","journal-title":"Physiology"},{"key":"B95","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.ejogrb.2019.11.004","article-title":"Risk factors for recurrent Pelvic inflammatory disease.","volume":"244","author":"Safrai","year":"2020","journal-title":"Eur. J. Obstet Gynecol. Reprod. Biol"},{"key":"B96","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1093\/humupd\/dmab035","article-title":"The role of gut and genital microbiota and the estrobolome in endometriosis, infertility and chronic pelvic pain.","volume":"28","author":"Salliss","year":"2021","journal-title":"Hum. Reprod. Update"},{"key":"B97","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1136\/sextrans-2018-053693","article-title":"Antibiotic therapy for pelvic inflammatory disease: an abridged version of a Cochrane systematic review and meta-analysis of randomised controlled trials.","volume":"95","author":"Savaris","year":"2019","journal-title":"Sex Transm. Infect"},{"key":"B98","doi-asserted-by":"publisher","first-page":"CD010285","DOI":"10.1002\/14651858.CD010285.pub3","article-title":"Antibiotic therapy for pelvic inflammatory disease.","volume":"8","author":"Savaris","year":"2020","journal-title":"Cochrane Database Syst. Rev"},{"key":"B99","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1016\/j.molmed.2021.07.004","article-title":"Microbiota and sleep: awakening the gut feeling.","volume":"27","author":"Sen","year":"2021","journal-title":"Trends Mol. Med"},{"key":"B100","doi-asserted-by":"publisher","first-page":"6","DOI":"10.3109\/0167482X.2015.1124852","article-title":"Risk of psychiatric disorders following pelvic inflammatory disease: a nationwide population-based retrospective cohort study.","volume":"37","author":"Shen","year":"2016","journal-title":"J. Psychosom. Obstet. Gynaecol"},{"key":"B101","doi-asserted-by":"publisher","first-page":"e225012","DOI":"10.1001\/jamanetworkopen.2022.5012","article-title":"Intake and sources of dietary fiber, inflammation, and cardiovascular disease in older US Adults.","volume":"5","author":"Shivakoti","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"B102","doi-asserted-by":"publisher","first-page":"3066","DOI":"10.1016\/j.clnu.2020.01.011","article-title":"Dietary macronutrient intake and molecular-bacterial vaginosis: role of fiber.","volume":"39","author":"Shivakoti","year":"2020","journal-title":"Clin. Nutr"},{"key":"B103","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1024\/0040-5930\/a001171","article-title":"[Management of pelvic inflammatory disease].","volume":"77","author":"Siegenthaler","year":"2020","journal-title":"Ther Umsch"},{"key":"B104","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1258\/ijsa.2009.009525","article-title":"Toll-like receptors and genital tract infection.","volume":"21","author":"Sonnex","year":"2010","journal-title":"Int. J. STD AIDS"},{"key":"B105","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1097\/AOG.0b013e3181e92c54","article-title":"Pelvic inflammatory disease.","volume":"116","author":"Soper","year":"2010","journal-title":"Obstet. Gynecol"},{"key":"B106","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1161\/01.RES.0000082334.17947.11","article-title":"Modulation of antioxidant enzyme expression and function by estrogen.","volume":"93","author":"Strehlow","year":"2003","journal-title":"Circ. Res"},{"key":"B107","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1038\/s41575-020-0344-2","article-title":"The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of synbiotics.","volume":"17","author":"Swanson","year":"2020","journal-title":"Nat. Rev. Gastroenterol. Hepatol"},{"key":"B108","doi-asserted-by":"publisher","first-page":"17455057221112263","DOI":"10.1177\/17455057221112263","article-title":"Factors associated with pelvic inflammatory disease: a case series analysis of family planning clinic data.","volume":"18","author":"Sweeney","year":"2022","journal-title":"Womens Health"},{"key":"B109","first-page":"1","article-title":"Pelvic inflammatory disease: diagnosis and treatment in the emergency department.","volume":"24","author":"Taira","year":"2022","journal-title":"Emerg. Med. Pract."},{"key":"B110","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.cmi.2018.04.019","article-title":"The vaginal microbiota and its association with human papillomavirus, Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium infections: a systematic review and meta-analysis.","volume":"25","author":"Tamarelle","year":"2019","journal-title":"Clin. Microbiol. Infect"},{"key":"B111","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1093\/infdis\/jis922","article-title":"Racial variation in toll-like receptor variants among women with pelvic inflammatory disease.","volume":"207","author":"Taylor","year":"2013","journal-title":"J. Infect. Dis"},{"key":"B112","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1097\/OLQ.0b013e3181ffa7c7","article-title":"Microbial correlates of delayed care for pelvic inflammatory disease.","volume":"38","author":"Taylor","year":"2011","journal-title":"Sex. Transm. Dis"},{"key":"B113","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1016\/j.contraception.2012.08.011","article-title":"Retention of intrauterine devices in women who acquire pelvic inflammatory disease: a systematic review.","volume":"87","author":"Tepper","year":"2013","journal-title":"Contraception"},{"key":"B114","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.2147\/JIR.S447098","article-title":"Intestinal flora imbalance induced by antibiotic use in rats.","volume":"17","author":"Tong","year":"2024","journal-title":"J. Inflamm. Res"},{"key":"B115","doi-asserted-by":"publisher","first-page":"266","DOI":"10.3390\/ijms20020266","article-title":"Interplay among vaginal microbiome, immune response and sexually transmitted viral infections.","volume":"20","author":"Torcia","year":"2019","journal-title":"Int. J. Mol. Sci"},{"key":"B116","doi-asserted-by":"publisher","first-page":"S137","DOI":"10.1093\/infdis\/jiab103","article-title":"Bacterial vaginosis and behavioral factors associated with incident pelvic inflammatory disease in the longitudinal study of vaginal flora.","volume":"224","author":"Turpin","year":"2021","journal-title":"J. Infect. Dis"},{"key":"B117","doi-asserted-by":"publisher","first-page":"e105998","DOI":"10.1371\/journal.pone.0105998","article-title":"The vaginal microbiota: what have we learned after a decade of molecular characterization?","volume":"9","author":"van de Wijgert","year":"2014","journal-title":"PLoS One"},{"key":"B118","doi-asserted-by":"publisher","first-page":"e0328622","DOI":"10.1128\/spectrum.03286-22","article-title":"Protective effect of Clostridium butyricum on Escherichia coli-induced endometritis in mice via ameliorating endometrial barrier and inhibiting inflammatory response.","volume":"10","author":"Wang","year":"2022","journal-title":"Microbiol. Spectr"},{"key":"B119","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1186\/s40168-022-01397-7","article-title":"Zearalenone disturbs the reproductive-immune axis in pigs: the role of gut microbial metabolites.","volume":"10","author":"Wang","year":"2022","journal-title":"Microbiome"},{"key":"B120","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1111\/ajo.12754","article-title":"A retrospective pilot study to determine whether the reproductive tract microbiota differs between women with a history of infertility and fertile women.","volume":"58","author":"Wee","year":"2018","journal-title":"Aust. N. Z. J. Obstet Gynaecol"},{"key":"B121","doi-asserted-by":"publisher","first-page":"1418","DOI":"10.1016\/j.biopha.2018.07.137","article-title":"Ozone therapy ameliorates inflammation and endometrial injury in rats with pelvic inflammatory disease.","volume":"107","author":"Wei","year":"2018","journal-title":"Biomed. Pharmacother"},{"key":"B122","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.tem.2011.06.001","article-title":"The vaginal microbiome in health and disease.","volume":"22","author":"White","year":"2011","journal-title":"Trends Endocrinol. Metab"},{"key":"B123","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1093\/cid\/ciaa101","article-title":"A randomized controlled trial of ceftriaxone and doxycycline, with or without metronidazole, for the treatment of acute pelvic inflammatory disease.","volume":"72","author":"Wiesenfeld","year":"2021","journal-title":"Clin. Infect. Dis"},{"key":"B124","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.coviro.2020.08.005","article-title":"Microbiota-immune system interactions and enteric virus infection.","volume":"46","author":"Woods Acevedo","year":"2021","journal-title":"Curr. Opin. Virol"},{"key":"B125","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1007\/s00404-013-3094-3","article-title":"Seasonal trend of acute pelvic inflammatory disease.","volume":"289","author":"Xholli","year":"2014","journal-title":"Arch. Gynecol. Obstet"},{"key":"B126","doi-asserted-by":"publisher","first-page":"119066","DOI":"10.1016\/j.jep.2024.119066","article-title":"New idea of Fuke Qianjin capsule in treating sequelae of pelvic inflammatory disease: anti-inflammatory in the early stage and reparative in the later stage.","volume":"338","author":"Xu","year":"2025","journal-title":"J. Ethnopharmacol"},{"key":"B127","doi-asserted-by":"publisher","first-page":"e0040923","DOI":"10.1128\/spectrum.00409-23","article-title":"Uterine tissue metabonomics combined with 16S rRNA gene sequencing to analyze the changes of gut microbiota in mice with endometritis and the intervention effect of tau interferon.","volume":"11","author":"Xue","year":"2023","journal-title":"Microbiol. Spectr"},{"key":"B128","doi-asserted-by":"publisher","first-page":"102176","DOI":"10.1016\/j.jogoh.2021.102176","article-title":"Characteristics of pelvic inflammatory disease caused by sexually transmitted disease - An epidemiologic study.","volume":"50","author":"Yagur","year":"2021","journal-title":"J. Gynecol. Obstet Hum. Reprod"},{"key":"B129","doi-asserted-by":"publisher","first-page":"749125","DOI":"10.3389\/fendo.2021.749125","article-title":"Gut microbiota in adipose tissue dysfunction induced cardiovascular disease: role as a metabolic organ.","volume":"12","author":"Yang","year":"2021","journal-title":"Front. Endocrinol"},{"key":"B130","first-page":"220","article-title":"Red snappers and red herrings: pelvic tuberculosis causing elevated CA 125 and mimicking advanced ovarian cancer. a case report and literature review.","volume":"76","author":"Yates","year":"2017","journal-title":"Hawaii J. Med. Public Health"},{"key":"B131","doi-asserted-by":"publisher","first-page":"102918","DOI":"10.1016\/j.tice.2025.102918","article-title":"Yi-Qi-Qing-Shi-Hua-Yu method improves uterine inflammation in rats with sequelae of pelvic inflammatory disease through the TLR4\/NF-\u03baB signaling pathway and regulates intestinal flora.","volume":"95","author":"Yin","year":"2025","journal-title":"Tissue Cell"},{"key":"B132","doi-asserted-by":"publisher","first-page":"753","DOI":"10.3349\/ymj.2012.53.4.753","article-title":"Clinical features of Fitz-Hugh-Curtis Syndrome in the emergency department.","volume":"53","author":"You","year":"2012","journal-title":"Yonsei Med. J"},{"key":"B133","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1067\/mob.2003.105","article-title":"Vaginal polymorphonuclear leukocytes and bacterial vaginosis as markers for histologic endometritis among women without symptoms of pelvic inflammatory disease.","volume":"188","author":"Yudin","year":"2003","journal-title":"Am. J. Obstet. Gynecol"},{"key":"B134","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1186\/s40104-023-00904-6","article-title":"Rosemary extract improves egg quality by altering gut barrier function, intestinal microbiota and oviductal gene expressions in late-phase laying hens.","volume":"14","author":"Zhang","year":"2023","journal-title":"J. Anim. Sci. Biotechnol"},{"key":"B135","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1016\/j.molmed.2020.04.001","article-title":"The gut microbiota: emerging evidence in autoimmune diseases.","volume":"26","author":"Zhang","year":"2020","journal-title":"Trends Mol. Med"},{"key":"B136","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1039\/d1fo02171k","article-title":"Enteromorpha prolifera polysaccharide-zinc complex modulates the immune response and alleviates LPS-induced intestinal inflammation via inhibiting the TLR4\/NF-\u03baB signaling pathway.","volume":"13","author":"Zhang","year":"2022","journal-title":"Food Funct"},{"key":"B137","doi-asserted-by":"publisher","first-page":"e0081122","DOI":"10.1128\/spectrum.00811-22","article-title":"Dietary tryptophan-mediated aryl hydrocarbon receptor activation by the gut microbiota alleviates Escherichia coli-induced endometritis in mice.","volume":"10","author":"Zhao","year":"2022","journal-title":"Microbiol. Spectr"},{"key":"B138","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1038\/s41392-023-01619-w","article-title":"Drug-microbiota interactions: an emerging priority for precision medicine.","volume":"8","author":"Zhao","year":"2023","journal-title":"Signal Transduct. Target Ther"},{"key":"B139","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1016\/j.trecan.2021.01.010","article-title":"Gut microbiota in cancer immune response and immunotherapy.","volume":"7","author":"Zhou","year":"2021","journal-title":"Trends Cancer"}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1822640\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:52:42Z","timestamp":1787921562000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1822640\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,10]]},"references-count":139,"alternative-id":["10.3389\/fmicb.2026.1822640"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2026.1822640","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,10]]},"article-number":"1822640"}}