Impact of Microbiome in Endometriosis Development

Endometriosis is a chronic disease and its pathophysiology is still unknown. Several theories exist, the one of menstrual blood flow has been retained until now but does not fully explain it. The main symptoms are dysmenorrhea, dyspareunia and infertility. There is a large number of women with endometriosis without clinical manifestations, as well as those who suffer from it with an impact on their personal and professional lives. The estimation of prevalence is complicated since medical imagery is not conclusive in all cases and the gold-standard of diagnosis remains laparoscopy. The estimated overall prevalence is 10%. There is the notion that prevalence is higher in the Caribbean population. Recent studies have demonstrated the essential role of immunological factors and angiogenesis in the pathogenesis of endometriosis. Thus it has been shown the impact of pro-inflammatory cytokines (TNF-a, MCP-1, IL-6 IL 8) in the development and survival of endometriotic cells. The impact of the microbiome in the occurrence of certain pathologies (cancers...) and in the promotion of the carrying of infections (high risk HPV) is known. Candida albicans is a fungus widely present in normal human microbiome but its hyphae have a virulent potential that intensify the production of inflammatory cytokines via the MAPK/MKP1 /C-Fos regulatory route. This could cause endometriosis depending on the immune status of the host (pro-inflammatory context). We also speak of the "inflammasome" induced by C. albicans causing a local inflammatory reaction leading to a cascade of inflammation and the development of endometriosis The essential role of immunological factors and angiogenesis in the pathogenesis of endometriosis has been demonstrated with the impact of pro-inflammatory cytokines (TNF-a, MCP-1, IL-6 IL 8) on the development and survival of endometriotic cells. The interaction between the host genome and its microbiome is known. Candida albicans is a fungus widely present in normal human microbiome but its hyphae have a virulent potential that intensify the production of inflammatory cytokines via the MAPK/MKP1/C-Fos regulatory route. This is supposed to cause endometriosis depending on the immune status of the host (pro-inflammatory context). We also speak of the "inflammasome" induced by C. albicans causing a local inflammatory reaction leading to a cascade of inflammation and the development of endometriosis. The study will be proposed to patients during their gynecological consultation at the University Hospital of Guadeloupe. The participation to the study includes a questionnaire with epidemiological and medical data and a biospecimen collection containing a vaginal and oral swab and a saliva sample.

Inclusion criteria

For cases :

aged 18-50 years old With confirmed or highly suspected endometriosis Affiliated to a social security system For controls: -aged 18-50 years old No confirmed or highly suspected Affiliated to a social security system

Exclusion criteria

Minors; Pregnant women; Protected persons, or persons placed under the protection of justice; Refusal to participate