Augoulea Areti, Mastorakos George, Lambrinoudaki Irene, Christodoulakos George, Creatsas George
2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Athens University Medical School, Athens, Greece.
Gynecol Endocrinol. 2009 Feb;25(2):75-81. doi: 10.1080/09513590802485012.
Endometriosis is a common gynecological disorder of the reproductive age characterised by pelvic pain, dysmenorrhea and infertility. Classic theories have failed to propose a precise pathogenetic mechanism. Recent studies have investigated the role of the immune system and oxidative stress in the development of endometriosis as well as the identification of biomarkers for a non-invasive diagnosis of the disease. At endometriotic sites, inflammatory cells including eosinophils, neutrophils and macrophages generate reactive oxygen species that contribute to the development of oxidative stress in the peritoneal cavity. Oxidative stress further augments immune response in affected sites. The oxidants exacerbate the development of endometriosis by inducing chemoattractants and endometrial cell growth-promoting activity. The oxidative proinflammatory state of the peritoneal fluid is an important mediator of endometriosis. Many studies investigate the correlation of endometriosis and oxidative stress but the results are discrepant. Furthermore, oxidative stress has been implicated in unexplained infertility and has been associated with some of its causative factors. Oxidative stress influences women's reproductive capacity. The association between endometriosis and infertility is described in several studies and still remains debated.
子宫内膜异位症是一种常见的育龄期妇科疾病,其特征为盆腔疼痛、痛经和不孕。经典理论未能提出精确的发病机制。最近的研究探讨了免疫系统和氧化应激在子宫内膜异位症发生发展中的作用,以及用于该疾病非侵入性诊断的生物标志物的鉴定。在子宫内膜异位症病灶处,包括嗜酸性粒细胞、中性粒细胞和巨噬细胞在内的炎症细胞会产生活性氧,这有助于腹腔内氧化应激的发展。氧化应激进一步增强了受影响部位的免疫反应。氧化剂通过诱导趋化因子和促进子宫内膜细胞生长的活性,加剧了子宫内膜异位症的发展。腹腔液的氧化促炎状态是子宫内膜异位症的重要介质。许多研究探讨了子宫内膜异位症与氧化应激的相关性,但结果并不一致。此外,氧化应激与不明原因的不孕有关,并与其一些致病因素相关。氧化应激会影响女性的生殖能力。多项研究描述了子宫内膜异位症与不孕之间的关联,但仍存在争议。