D1.351 - The impact of Lactobacillus on the expression of NLRP3, IL-1β and HMGB1 in women with endometriosis associated infertility

Endometriosis-associated infertility is accompanied by increased levels of many proinflammatory factors, including NLRP3, IL-1β, HMGB1.  Despite the large number of anti-inflammatory agents, their use is limited in reproduction. Probiotics based on Lactobacillus  are potential factors to reduce the production of pro-inflammatory mediators and may be a promising approach for endometriosis treatment to increase the chances of successful pregnancy. This study assesses the feasibility of including probiotics containing Lactobacillus in the preparation program for assisted reproductive technologies (ART) in women with endometriosis-associated infertility.

88 women with endometriosis and infertility were studied who underwent ART. The first subgroup included 39 women who underwent traditional ART preparation. The second subgroup included 49 women who additionally received a probiotic containing Lactobacillus, 1 capsule twice a day for a month before the start of the ART program. The polymerase chain reaction method in real-time mode was used to analyze the expression of NLPP3 inflammasome, HMGB1, and IL1β genes. The study design was approved by the bioethics committee; all women gave written informed consent to participate in the study.

In the group without and with the use of Lactobacillus, the mRNA expression level of the NLRP3 inflammasome was 44.43±3.72 u.o. and 0.85±0.03 u.o., respectively (p˂ 0.001); The expression of the IL 1β gene in women in the group without Lactobacillus was 26.47±0.01 u.o. and 0.45±0.01 u.o. in the group using Lactobacillus (p˂ 0.001); mRNA expression of HMGB1 in the group without Lactobacillus was 11.91±0.01 u.o., while with it was 1.00±0.01 u.o. (p˂ 0.001).

The use of Lactobacillus in ART programs in women with endometriosis may positively affect reproductive outcomes by reducing systemic inflammation levels due to the ability to regulate immune responses by reducing the expression of NLRP3, IL-1β, and HMGB1.