Forges T, Monnier-Barbarino P, Faure G C, Béné M C
Department of Reproductive Medicine, Maternité Universitaire A.Pinard, 10, rue du Dr Heydenreich, 54042 Nancy Cedex, France.
Hum Reprod Update. 2004 Mar-Apr;10(2):163-75. doi: 10.1093/humupd/dmh014.
The involvement of autoimmune mechanisms in premature ovarian failure has been put forward by numerous investigators. In various other ovarian pathologies, such as idiopathic infertility, polycystic ovary syndrome, or endometriosis, similar mechanisms have been suggested. However, the exact role of autoimmunity in the pathophysiology of these diseases still remains controversial. The diagnosis of autoimmune ovarian disease relies on several clinical, biological and histological findings, but special interest has been focused on antiovarian autoantibodies. The search for these antibodies has been undertaken by several authors and yielded somewhat conflicting results which might be conditioned by methodological differences and by the multiplicity of potential immune targets. These targets, which comprise various steroidogenic enzymes, gonadotrophins and their receptors, the corpus luteum, zona pellucida and oocyte, are reviewed. Further investigation of these targets is required to improve the diagnostic tools that will lead to a precocious and reliable diagnosis of autoimmune ovarian disease, an appropriate clinical surveillance as well as the selection of patients who may benefit from immune-modulating therapy and possibly recover ovarian function and fertility.
众多研究者提出自身免疫机制与卵巢早衰有关。在其他各种卵巢疾病中，如特发性不孕、多囊卵巢综合征或子宫内膜异位症，也有人提出了类似机制。然而，自身免疫在这些疾病病理生理过程中的确切作用仍存在争议。自身免疫性卵巢疾病的诊断依赖于多项临床、生物学和组织学检查结果，但特别关注的是抗卵巢自身抗体。多位作者对这些抗体进行了研究，结果有些相互矛盾，这可能受方法学差异以及潜在免疫靶点多样性的影响。本文综述了这些靶点，包括各种类固醇生成酶、促性腺激素及其受体、黄体、透明带和卵母细胞。需要对这些靶点进行进一步研究，以改进诊断工具，从而实现对自身免疫性卵巢疾病的早期、可靠诊断，进行适当的临床监测，并筛选出可能从免疫调节治疗中获益并恢复卵巢功能和生育能力的患者。
