The role of uterine microbiome and epithelial-mesenchymal transition in endometrial function

Reproductive period in woman is characterized by cyclic changes of endometrium and its regeneration. The factors important for proper function of the endometrium are anatomical structure, hormonal control and signalling pathways on molecular-genetic level. New knowledge on uterine microbiome, mutual epithelial-mesenchymal transition (EMT) and mesenchymal-epithelial transition (MET) of endometrial cells refine our conception of changes on cellular level, endometrial receptivity and possible causes of endometrial dysfunction. Substantial information on bacterial colonisation of endometrium were discovered by new diagnostic methods using analysis of ribosomal RNA in 16S subunit which are able to detect and exactly identify bacteria that are not detectable by classic cultivation methods. Endometrial microbiome prevents development of pathogenous microorganisms and modulates function of endometrial cells. It has been proven that stromal cells contribute to regeneration of not only the endometrial stroma, but also of the epithelium. Activity of ovarian steroids and other factors leads to EMT/MET, which ensures different functions of endometrium throughout the menstrual cycle and pregnancy. The endometrial microbiome and mutual transition of stromal and epithelial endometrial cells are necessary for physiological functions of uterine mucosa including implantation and development of an embryo.

Running title: Microbiome and cells transition in endometrial function