Davidson Lien M, Coward Kevin
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Level 3, Women's Centre, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, United Kingdom.
Birth Defects Res C Embryo Today. 2016 Mar;108(1):19-32. doi: 10.1002/bdrc.21122. Epub 2016 Mar 10.
Successful pregnancy is dependent upon the implantation of a competent embryo into a receptive endometrium. Despite major advancement in our understanding of reproductive medicine over the last few decades, implantation failure still occurs in both normal pregnancies and those created artificially by assisted reproductive technology (ART). Consequently, there is significant interest in elucidating the etiology of implantation failure. The complex multistep process of implantation begins when the developing embryo first makes contact with the plasma membrane of epithelial cells within the uterine environment. However, although this biological interaction marks the beginning of a fundamental developmental process, our knowledge of the intricate physiological and molecular processes involved remains sparse. In this synopsis, we aim to provide an overview of our current understanding of the morphological changes which occur to the plasma membrane of the uterine endothelium, and the molecular mechanisms that control communication between the early embryo and the endometrium during implantation. A multitude of molecular factors have been implicated in this complex process, including endometrial integrins, extracellular matrix molecules, adhesion molecules, growth factors, and ion channels. We also explore the development of in vitro models for embryo implantation to help researchers investigate mechanisms which may underlie implantation failure. Understanding the precise molecular pathways associated with implantation failure could help us to generate new prognostic/diagnostic biomarkers, and may identify novel therapeutic targets.
成功妊娠依赖于一个有活力的胚胎植入一个具有接受性的子宫内膜。尽管在过去几十年里我们对生殖医学的理解取得了重大进展，但植入失败在正常妊娠以及辅助生殖技术（ART）创造的人工妊娠中仍然会发生。因此，阐明植入失败的病因引起了极大的关注。植入的复杂多步骤过程始于发育中的胚胎首次与子宫环境中的上皮细胞质膜接触。然而，尽管这种生物学相互作用标志着一个基本发育过程的开始，但我们对其中涉及的复杂生理和分子过程的了解仍然很少。在本综述中，我们旨在概述我们目前对子宫内膜质膜发生的形态学变化以及植入过程中控制早期胚胎与子宫内膜之间通讯的分子机制的理解。众多分子因素参与了这一复杂过程，包括子宫内膜整合素、细胞外基质分子、黏附分子、生长因子和离子通道。我们还探讨了用于胚胎植入的体外模型的发展，以帮助研究人员研究可能是植入失败基础的机制。了解与植入失败相关的精确分子途径可以帮助我们生成新的预后/诊断生物标志物，并可能识别新的治疗靶点。
