Endometrial microbiota composition, α-defensin and transforming growth factor β1 levels in women with viral infection-driven infertility

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A viral infection can interfere with implantation processes, affecting angiogenesis and endometrial receptivity, invasive trophoblast activity, and disrupting the balance of immune factors. The aim of the study was to assess endometrial microbiota composition, to measure the levels of α-defensin, growth factors in infertile women with viral infection. Materials and methods. 80 female infertile patients aged 26–46 years were examined divided into two groups: main group — women with endometrium-bearing viruses found in their (25 patients), and comparison group — 55 women without endometrium-bearing viruses. The endometrial microbiota was studied using molecular biological tests. α-Defensin (DEFa1), fibroblast growth factor 2 (FGF2), and transforming growth factor beta 1 (TGF-β1) in the endometrium were determined by ELISA. Results. Viruses were detected in endometrium 31.3% of the examined women. Herpesviridae viruses accounted for 34%, while Human Papillomavirus — 66%. Lactobacillus spp. most often dominated in endometrial microbiota in both groups (group 1–68% (17/25), group 2–78% (43/55)). The second most common microbial community types were Gardnerella vaginalis and Atopobium vaginae (Fannyhessea vaginae), which accounted for 20% and 15% in groups 1 and 2, respectively. In group 1, the highest viral load was found in endometrial samples with a high concentration of L. iners, as well as upon a decline or absence of Lactobacillus spp. (p 0.05). The concentration of L. crispatus and L. jensenii was significantly higher in group 2 (p 0.05). Patients with endometrium-bearing viruses had increased DEFα levels comprising 4.32 ng/ml (0.497; 16.1) compared with patients without endometrium-bearing viruses (0.7 ng/ml (0.7; 20)), as well as decreased levels of TGFb — 2 ng/ml (0.2; 9.8) and 4.54 ng/ml (0;16), respectively (p 0.05). Conclusions. Viral damage to the endometrium is associated with an increased concentration of L. iners, or with a deficiency or absence of Lactobacillus spp., as well as with an increased level of DEFα, active against viruses, and a decrease in TGF β1, indicating a violation of endometrial tissue homeostasis.

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