Gravanis Achille, Makrigiannakis Antonis, Chatzaki Ekaterini, Zoumakis Emmanuel, Tsatsanis Christos, Margioris Andrew N
Department of Pharmacology, University of Crete, Medical School, 71110 Heraklion, Crete, Greece.
Hormones (Athens). 2002 Jul-Sep;1(3):139-48. doi: 10.14310/horm.2002.1161.
Human endometrium exhibits characteristics of a neuroendocrine-like stress organ in addition to its classical role as the main target of ovarian steroid hormones. Indeed, the epithelial cells of human endometrium express the stress-associated neuropeptide genes corticotropin-releasing hormone (CRH), proopiomelanocortin, proenkephalin and prodynorphin. Furthermore, endometrium stroma cells also express CRH when they differentiate into decidual cells. Multiple lines of evidence suggest that the stress-associated neuropeptides of human endometrium are under the endocrine control of gonadal steroids as well as under an autocrine/paracrine regulation by prostanoids and interleukins. Endometrial stress-associated neuropeptides appear to exert their biological effect locally, i.e. within the uterus since human endometrium and myometrium also express the relevant receptors. More specifically, recent data suggest that endometrial CRH participates in the regulation of intrauterine inflammatory processes taking place in early pregnancy including stroma decidualization, blastocyst implantation and early maternal tolerance. Similarly, endometrial opioids participate in the regulation of uterine tissue remodeling via their effect on endometrial cell apoptosis. Thus, endometrial stress neuropeptides act as paracrine regulators of uterine cell differentiation and tissue remodeling as well as modulators of local immune responses.
除了作为卵巢甾体激素的主要靶器官这一经典作用外，人类子宫内膜还表现出神经内分泌样应激器官的特征。事实上，人类子宫内膜的上皮细胞表达与应激相关的神经肽基因，如促肾上腺皮质激素释放激素（CRH）、阿片促黑皮质素原、前脑啡肽原和前强啡肽原。此外，子宫内膜基质细胞在分化为蜕膜细胞时也表达CRH。多条证据表明，人类子宫内膜中与应激相关的神经肽受性腺甾体激素的内分泌控制，也受前列腺素和白细胞介素的自分泌/旁分泌调节。子宫内膜应激相关神经肽似乎在局部发挥其生物学作用，即在子宫内，因为人类子宫内膜和子宫肌层也表达相关受体。更具体地说，最近的数据表明，子宫内膜CRH参与调节妊娠早期发生的子宫内炎症过程，包括基质蜕膜化、胚泡着床和早期母体耐受性。同样，子宫内膜阿片类物质通过对子宫内膜细胞凋亡的影响参与子宫组织重塑的调节。因此，子宫内膜应激神经肽作为子宫细胞分化和组织重塑的旁分泌调节因子以及局部免疫反应的调节剂。
