The Gut-Reproductive-Immune Axis in OB/GYN Disease: Bridging Barrier Immunity and Women’s Health

The immune system is a central regulator of reproductive health, orchestrating implantation, placental development, and maternal-fetal tolerance. While much research has focused on localized uterine immunity, systemic factors—particularly those originating from the gut—are now recognized as critical contributors to reproductive outcomes. Gut barrier integrity and microbiota composition influence systemic immune responses and inflammatory tone. Disruption of these processes, through dysbiosis or increased intestinal permeability, can heighten systemic inflammation and skew immune regulation, potentially impacting conditions like endometriosis, infertility, recurrent pregnancy loss, and obstetric complications such as preeclampsia. The emerging understanding of how gut-derived immune signals interact with reproductive tissues, including the placenta, highlights a critical area for investigation in women’s health. This Research Topic aims to explore the mechanistic interplay between gut barrier function, microbiota dynamics, and systemic immune regulation in reproductive health and disease. Microbial products such as lipopolysaccharides (LPS) and short-chain fatty acids (SCFAs) shape immune cell differentiation and function, influencing regulatory T cells (Tregs), Th17 cells, and other critical players in the reproductive tract and placenta. Additionally, metabolic cues—particularly glucose availability—have been shown to directly impact the function of decidual natural killer (NK) cells, key regulators of placental development and vascular remodeling. These findings highlight a complex metabolic–immune axis with significant implications for maternal-fetal tolerance and pregnancy success.Alterations in these immune and metabolic pathways may contribute to diseases such as endometriosis, characterized by chronic inflammation and immune dysregulation, as well as pregnancy complications like preeclampsia and fetal growth restriction. We seek research that bridges gut microbiota, systemic immune modulation, and placental immunology to better understand how these interconnected systems influence reproductive health and disease. This collection encourages mechanistic, translational, and clinical contributions that integrate microbiome science with reproductive immunology and maternal-fetal medicine. We invite original research articles, reviews, perspectives, and clinical studies that investigate the complex interactions between the gut microbiota, systemic immunity, and reproductive health. This Research Topic is particularly interested in uncovering how gut-derived immune signals influence reproductive tract immunity, placental function, and the pathogenesis of gynecologic diseases. Studies that explore the immune-mediated mechanisms linking gut dysbiosis, systemic inflammation, and reproductive disorders are highly encouraged. We are also seeking contributions that examine the role of the gut-immune axis in obstetric complications, including how systemic immune perturbations affect placental development, maternal-fetal tolerance, and pregnancy outcomes.Specific themes of interest include, but are not limited to:• Gut barrier dysfunction and systemic inflammation in gynecologic and obstetric diseases• Microbiome-immune interactions in endometriosis pathogenesis• Placental immune responses shaped by gut-derived signals and systemic immunity• Mechanistic insights into maternal-fetal tolerance and immune dysregulation• Systems biology and multi-omics studies on gut-reproductive immune interactions• Translational and clinical research linking microbiota alterations with reproductive health outcomes Topic editors: Silvia Giugliano, Louise Glover Source: https://www.frontiersin.org/research-topics/73458/the-gut-reproductive-immune-axis-in-obgyn-disease-bridging-barrier-immunity-and-womens-health