Marshall Sarah A, Senadheera Sevvandi N, Parry Laura J, Girling Jane E
1 School of Biosciences, University of Melbourne, Melbourne, Victoria, Australia.
2 Department of Obstetrics and Gynaecology, Gynaecology Research Centre, The University of Melbourne and Royal Women's Hospital, Melbourne, Victoria, Australia.
Reprod Sci. 2017 Mar;24(3):342-354. doi: 10.1177/1933719116657189. Epub 2016 Sep 27.
The hormone relaxin is a 6-kDa peptide with high structural similarity to insulin. It is primarily produced by the corpus luteum during pregnancy but is also synthesized by other reproductive organs such as the uterus, decidua, and placenta. Relaxin binds to its receptor RXFP1, which has been localized to a wide variety of reproductive and nonreproductive tissues. The peptide's many uterotropic effects include stimulating uterine growth and vascularization, remodeling extracellular matrix components, and regulating vascular endothelial growth factor in preparation for implantation. Evidence also supports a role for relaxin in the systemic maternal vascular adaptations required for a healthy pregnancy. Diminished relaxin levels in early pregnancy are linked with increased risks of miscarriage and the development of preeclampsia. In addition to pregnancy, relaxin may also play a functional role in the uterus during the menstrual cycle, and modified relaxin activity may contribute to gynecological disorders such as uterine fibrosis and endometriosis. Despite over 75 years of research, we still have a limited understanding of relaxin's broad roles in the uterus, particularly as there are significant species differences in its synthesis and activity, which restricts the use of animal models for human-centric questions. Here, we review current knowledge regarding relaxin actions in the human uterus during the menstrual cycle and in early pregnancy, with a focus on its potential roles in various gynecological disorders, as well as the pregnancy disorders such as preeclampsia, recurrent miscarriage, and early pregnancy loss.
松弛素是一种与胰岛素具有高度结构相似性的6千道尔顿肽。它主要由孕期的黄体产生，但也由其他生殖器官合成，如子宫、蜕膜和胎盘。松弛素与其受体RXFP1结合，RXFP1已定位在多种生殖和非生殖组织中。该肽的许多促子宫生长作用包括刺激子宫生长和血管形成、重塑细胞外基质成分以及调节血管内皮生长因子以准备着床。有证据还支持松弛素在健康妊娠所需的母体全身血管适应性变化中发挥作用。妊娠早期松弛素水平降低与流产风险增加和子痫前期的发生有关。除了妊娠，松弛素在月经周期中子宫内也可能发挥功能作用，而松弛素活性的改变可能导致妇科疾病，如子宫纤维化和子宫内膜异位症。尽管经过了75年多的研究，但我们对松弛素在子宫中的广泛作用仍了解有限，特别是因为其合成和活性存在显著的物种差异，这限制了以人类为中心的问题使用动物模型进行研究。在此，我们综述了关于月经周期和妊娠早期松弛素在人子宫中作用的现有知识，重点关注其在各种妇科疾病以及子痫前期、复发性流产和早期妊娠丢失等妊娠疾病中的潜在作用。
