Gellersen B, Brosens J
IHF Institute for Hormone and Fertility Research, University of Hamburg, Hamburg, Germany.
J Endocrinol. 2003 Sep;178(3):357-72. doi: 10.1677/joe.0.1780357.
During the menstrual cycle, the ovarian hormones oestradiol and progesterone control the ordered growth and differentiation of uterine cells. This remodelling process is critical for implantation of the developing embryo, the formation of the placenta, and maintenance of pregnancy. Failure of uterine tIssues to respond appropriately to ovarian hormone signalling results in defective placentation, associated with a spectrum of pregnancy disorders such as recurrent miscarriages and preeclampsia. These obstetrical disorders are a major cause of maternal and perinatal morbidity and mortality. Progesterone exerts its action on target cells, at least in part, through binding to the progesterone receptor (PR), a member of the steroid/thyroid hormone receptor superfamily of ligand-activated transcription factors. The mechanism by which progesterone controls the differentiation of human endometrial stromal cells, a process termed decidualization, in the secretory phase of the menstrual cycle is not well understood. Emerging evidence indicates that locally expressed factors and activation of the cAMP second messenger pathway integrate hormonal inputs and confer cellular specificity to progesterone action through the induction of diverse transcription factors capable of modulating PR function.
在月经周期中，卵巢激素雌二醇和孕酮控制着子宫细胞的有序生长和分化。这一重塑过程对于发育中胚胎的着床、胎盘的形成以及妊娠的维持至关重要。子宫组织若无法对卵巢激素信号做出适当反应，会导致胎盘形成缺陷，进而引发一系列妊娠疾病，如复发性流产和先兆子痫。这些产科疾病是孕产妇和围产期发病及死亡的主要原因。孕酮至少部分地通过与孕酮受体（PR）结合来对靶细胞发挥作用，PR是配体激活转录因子的类固醇/甲状腺激素受体超家族的成员。在月经周期的分泌期，孕酮控制人子宫内膜基质细胞分化（即蜕膜化过程）的机制尚不清楚。新出现的证据表明，局部表达的因子和cAMP第二信使途径的激活整合了激素输入，并通过诱导能够调节PR功能的多种转录因子，赋予孕酮作用细胞特异性。
