Cell Biology Unit, de Duve Institute, Université catholique de Louvain, avenue Hippocrate, 75, B-1200 Bruxelles, Belgium.
Mol Cell Endocrinol. 2012 Jul 25;358(2):197-207. doi: 10.1016/j.mce.2011.07.042. Epub 2011 Jul 27.
During the reproductive life, the human endometrium undergoes cycles of substantial remodeling including, at menstruation, a massive but delimited tissue breakdown immediately followed by scarless repair. The present review aims at summarizing the current knowledge on the endocrine and paracrine control of menstruation in the light of recent observations that undermine obsolete dogmas. Menstruation can be globally considered as a response to falling progesterone concentration. However, tissue breakdown is heterogeneous and tightly controlled in space and time by a complex network of regulators and effectors, including cytokines, chemokines, proteases and various components of an inflammatory response. Moreover, menstruation must be regarded as part of a complex and integrated mechanism of tissue remodeling including features that precede and follow tissue lysis, i.e. decidualization and immediate post-menstrual regeneration. The understanding of the regulation of menstruation is of major basic and clinical interest. Indeed, these mechanisms largely overlap with those controlling other histopathological occurrences of tissue remodeling, such as development and cancer, and inappropriate control of menstrual features is a major potential cause of two frequent endometrial pathologies (i.e. abnormal uterine bleeding and endometriosis).
在生殖生命期间，人类子宫内膜经历了大量的重塑周期，包括在月经期间，大量但有限的组织崩解，随后立即无疤痕修复。本综述旨在根据最近的观察结果，总结目前关于月经内分泌和旁分泌控制的知识，这些观察结果颠覆了过时的教条。可以整体上认为，月经是对孕激素浓度下降的反应。然而，组织崩解在空间和时间上是不均匀的，受到包括细胞因子、趋化因子、蛋白酶和炎症反应的各种成分在内的复杂调节网络的严格控制。此外，月经必须被视为组织重塑复杂综合机制的一部分，包括组织溶解之前和之后的特征，即蜕膜化和月经后立即的再生。对月经调节的理解具有重要的基础和临床意义。事实上，这些机制与控制其他组织重塑的组织病理学发生的机制大部分重叠，如发育和癌症，而月经特征的不当控制是两种常见子宫内膜病理（即异常子宫出血和子宫内膜异位症）的主要潜在原因。
