Institute of Basic Medical Sciences, National Cheng Kung University, Tainan, Taiwan.
Department of Physiology, National Cheng Kung University, Tainan, Taiwan.
Reproduction. 2021 Jan;161(1):F19-F31. doi: 10.1530/REP-20-0267.
Endometriosis is a benign gynecological disease that affects about 10% of women of reproductive age. Patients with endometriosis suffer from long-term coexistence with dysmenorrhea, dyspareunia, and even infertility, which severely reduces quality of life. So far, surgical removal and hormonal medication are the major treatment options; however, high recurrence and severe adverse effects hamper the therapeutic efficacy. Hypoxia is an inevitable cellular stress in many diseases that regulates the expression of a significant subset of genes involved in pathophysiological processes. A growing body of evidence demonstrates that hypoxia plays critical role in controlling the disease phenotypes of endometriosis, such as increasing adhesion ability, causing dysregulation of estrogen biosynthesis, aberrant production of proinflammatory cytokines, increasing angiogenic ability, and suppression of immune functions. In this review, we summarize the findings of the most recent studies in exploring the underlying mechanisms of hypoxia involved in endometriosis. Potential therapeutic options for targeting HIF and downstream effectors will also be discussed.
子宫内膜异位症是一种良性妇科疾病，影响约 10%的育龄妇女。患有子宫内膜异位症的患者长期伴有痛经、性交困难，甚至不孕，严重降低了生活质量。迄今为止，手术切除和激素药物治疗是主要的治疗选择；然而，高复发率和严重的不良反应阻碍了治疗效果。缺氧是许多疾病中不可避免的细胞应激，调节参与病理生理过程的大量基因的表达。越来越多的证据表明，缺氧在控制子宫内膜异位症的疾病表型中起着关键作用，例如增加粘连能力、导致雌激素生物合成失调、异常产生促炎细胞因子、增加血管生成能力和抑制免疫功能。在这篇综述中，我们总结了最近研究中关于缺氧在子宫内膜异位症中的潜在作用机制的发现。还将讨论针对 HIF 和下游效应物的潜在治疗选择。
