Editorial 1: The link between endometriosis and an infectious bacterium
Context
- A study has found a correlation between the presence of Fusobacterium and endometriosis, opening the door for researchers to potentially develop non-invasive tests for the condition as well as treat its severity with antibiotics. Endometriosis currently affects one in 10 women worldwide.
Endometriosis and the study
- Endometriosis, a reproductive disease affecting one in 10 women worldwide, involves the growth of lesions on pelvic organs such as the ovaries.
- These lesions are composed of endometrium, a layer of tissue lining the uterus. It causes infertility, chronic pain during periods, pelvic pain, bloating, nausea and fatigue and is also associated with depression and anxiety.
- A new study points to a link between a bacterium associated with infections in the oral cavity, and endometriosis.
- The experiment was conducted with a cohort of 155 women in Japan, of which 79 were diagnosed with endometriosis while 76 were healthy.
- To assess the direct effect of the bacteria on the disease, the scientists transplanted endometrial tissue inside the abdominal cavity of two sets of mice, one infected with Fusobacterium and another without it.
- They found that the bacteria triggered the growth of larger lesions of endometriosis in the former set, relative to the latter.
- The study concluded that the bacteria had a role in the formation and aggravation of endometrial lesions.
Retrograde menstruation
- Scientists worldwide have come up with different ideas of the disease’s cause.
- One is retrograde menstruation – when some part of the menstrual blood flows backwards, into the abdominal region, instead of flowing out of the vagina.
- Another possibility: The inability of the immune system to detect and eliminate blood cells from retrograde menstruation, allowing it to persist in the pelvic region, points to some dysfunction in the immune system.
- Researchers have also linked endocrine-disrupting substances to the endometriosis as they interfere with the signalling, production, transport and metabolism of hormones such as oestrogen and progesterone, which are causal factors of endometriosis.
- The condition has also been linked to genetic and metabolic factors.
- But for all their efforts, scientists are yet to identify the root cause of endometriosis.
- So treatment options are limited to hormone therapies, contraceptive pills and laparoscopic surgery to remove the lesions.
Link to gut microbes
- A paper reported that people with endometriosis had gut dysbiosis – an imbalance in the various microbe populations in the gut.
- It said that the altered microbiota (range of microorganisms) could help endometriosis progress, but also that more research will be required on this front.
- Fusobacterium already has known links to infections of the gum, vagina, and rectum – yet it isn’t commonly found in meaningful quantities in the gut.
- While the new study is compelling and shows the bacteria’s role in aggravating the disease but researchers are yet to prove that the bacteria is present in all those who have this condition.
Importance of the findings
- Endometriosis currently takes six years on average to be diagnosed. And even after a diagnosis, few treatment options are available.
- A common response to bacterial infections is antibiotics; the new study considered it as well – and in doing so, opened up potentially new ways to diagnose and treat endometriosis.
- For example, a 2019 study investigating the relationship between gut dysbiosis and endometriosis found that treating mice with metronidazole, an antibiotic that targets certain microbes, instead of broad-spectrum antibiotics slowed the rate at which the condition progressed.
- Researchers found that fibrous food can help manage the condition because, while metabolites released by certain microbes can aggravate endometrial lesions, other metabolites produced by the fermentation of certain types of food can protect from the condition.
- This is because the latter can decrease the abundance of Fusobacterium and other infectious bacterial species.
- This is why the consumption of food with high amounts of antioxidants, probiotic foods (with Lactobacillus gasseri bacteria), and food rich in omega-3 fatty acids have also been found to help suppress the development of endometriosis.
Conclusion
- In elucidating an inherent connection between gut health and endometriosis, the studies also pave the way for a future in which researchers can devise personalised treatment options.
Editorial 2: How are cheetahs faring in India?
Context
- As more deaths of cheetahs have been reported last week from the Kuno National Park (KNP), Madhya Pradesh, an expert committee charged with managing the Project Cheetah programme has recommended that all animals undergo a thorough medical review.
Project Cheetah
- Project Cheetah is India’s cheetah relocation programme and is perhaps among the most ambitious of its kind in the world.
- The attempt is to, over the next decade, bring in 5-10 animals every year until a self-sustaining population of about 35 cheetahs is established.
- Unlike cheetahs in South Africa and Namibia that are living in fenced reserves, India’s plan is to have them grow in natural, unfenced, wild conditions.
- As of today, 11 of the translocated cheetahs are in the true wild with four in specially designed one-square-kilometre enclosures called ‘bomas,’ to help the animals acclimatise to Indian conditions.
- Five of the translocated animals and three of four cubs born in India have died.
The need of Medical Review
- One of the cheetahs, nicknamed Surya, was found dead in KNP last week.
- Veterinarians examining the animal saw a wound on its neck, infected with maggots.
- The larvae of the maggots were also found on the radio-collar fitted onto the cheetah’s neck.
- There was a chance that chafing from the collar may have indirectly sickened the cheetah.
- The collars that the cheetahs wear are made from polystyrene and equipped with a radio-frequency tracking chip that helps monitor the animals.
- Coupled with the moisture from the monsoon season — something that South African cheetahs aren’t acclimatised too — the animal may have been unable to lick itself clean which allowed parasites to fatally lodge inside the wound.
- There is also a hypothesis that via the wound the African animal may have been exposed to parasites that Indian big-cats are usually resistant too.
- However, the Environment Ministry in a note on July 16 dismissed these suggestions as hearsay…in the absence of scientific evidence.
- To investigate these points, the expert committee has recommended that all surviving animals be subject to a thorough physical examination.
Success rate of Project Cheetah
- In September 2023, it will be one year since a batch of eight cheetahs from Namibia arrived in India.
- They were followed by 12 others from South Africa in February 2023. While conceived as an experiment that is susceptible to failure in the initial years, independent critics have argued that there are some basic flaws in the project.
- For one, it is a mistake to have had all 20 cheetahs in KNP as it’s too little space and prey, given that the animal is a courser and needs large distances.
- Moreover, having cheetahs for extended periods in quarantine have affected their adaptive capabilities and caused them to have psychological adjustment problems, making them more vulnerable.
- Unlike tigers and leopards, cheetahs are relatively delicate animals and are more likely to be fatally injured in the wild.
- Currently, Indian cheetahs face no competition from other comparable predators such as lions and leopards. So, it remains to be seen if the animals can successfully establish themselves in India, over time.
Way forward
- While officials say that there is enough space and prey in the Kuno reserve, there are plans to develop a second reserve in Gandhisagar, Madhya Pradesh and also establish a cheetah rehabilitation centre.