自噬在子宫内膜异位症发病机制中的研究新进展

doi:10.12280/gjfckx.20210782

摘要/Abstract

摘要：

子宫内膜异位症（endometriosis,EMs）是育龄期女性的常见良性疾病,严重影响患者的生活质量,且发病率呈逐年上升的趋势。自噬（autophagy）是一种不同于凋亡的程序性细胞死亡,其通过吞噬降解细胞内异常蛋白或细胞器产生能量,维持细胞生存和代谢,是细胞内成分降解和再循环的重要机制。近年来大量研究发现自噬可参与EMs的发生、发展。既往研究报道了EMs患者异位病灶中的自噬水平低于非EMs患者的正常子宫内膜组织的自噬水平,且EMs患者异位内膜组织自噬的周期性变化消失。然而,仍有少量研究证明EMs患者异位病灶中的自噬水平更高。EMs异位病灶的复杂环境中包括众多影响自噬水平的因素,如雌孕激素、缺氧和氧化应激,以及病原体感染和铁过载等。此外,自噬对EMs发生、发展有双重作用,既可以通过抑制炎症反应、增强免疫系统清除病灶能力和抑制病灶纤维化来阻碍EMs进展,又可以通过促进异位内膜间质细胞存活和迁移、侵袭来促进EMs进展。

关键词: 自噬, 子宫内膜异位症, 自噬相关蛋白质类, Beclin-1蛋白, 治疗

Abstract:

Endometriosis (EMs) is a common benign disease in women of childbearing age which seriously affects patients′ quality of life, and its incidence is increasing year by year. Autophagy is a kind of programmed cell death different from apoptosis, which supports cell survival and metabolism by degrading abnormal proteins or organelles within the cell to produce energy, which is an important mechanism for the degradation and recycling of intracellular components. In recent years, plenty of studies have found that autophagy participates in the occurrence and development of EMs. Previous studies reported that the level of autophagy in ectopic lesions of patients with EMs is lower than that in endometrial tissue of normal patients, and that the cyclical changes of autophagy in ectopic endometrial tissue of patients with EMs disappear. However, there are still a small number of studies demonstrate the higher levels of autophagy in ectopic lesions in patients with EMs. The complex environment of EMs ectopic lesion includes many factors that affect the level of autophagy, such as estrogen and progestin, hypoxia and oxidative stress, pathogen infection and iron overload, etc. In addition, autophagy plays a dual role in the occurrence development of EMs, it can not only hinder the progression of EMs by inhibiting the inflammatory response, promoting the immune system′s ability to clear lesions and inhibiting the fibrosis of the lesions, but also promote the progression of EMs by promoting the survival, migration and invasion of ectopic endometrial stromal cells.

Key words: Autophagy, Endometriosis, Autophagy-related proteins, Beclin-1 protein, Therapy

谈佳欢, 张宗峰. 自噬在子宫内膜异位症发病机制中的研究新进展[J]. 国际妇产科学杂志, 2022, 49(2): 156-160.

TAN Jia-huan, ZHANG Zong-feng. New Advances in Autophagy in the Pathogenesis of Endometriosis[J]. Journal of International Obstetrics and Gynecology, 2022, 49(2): 156-160.

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