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女性健康领域的铁疗法:过去、现在与未来。

Iron Therapeutics in Women's Health: Past, Present, and Future.

作者信息

Mintz Joel, Mirza Jackie, Young Eric, Bauckman Kyle

机构信息

Department of Academic Affairs, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Davie, FL 33314, USA.

出版信息

Pharmaceuticals (Basel). 2020 Dec 8;13(12):449. doi: 10.3390/ph13120449.

Abstract

Iron plays a unique physiological role in the maintenance of homeostasis and the pathological outcomes of the female reproductive tract. The dual nature of elemental iron has created an evolutionary need to tightly regulate its biological concentration. The female reproductive tract is particularly unique due to the constant cycle of endometrial growth and shedding, in addition to the potential need for iron transfer to a developing fetus. Here, iron regulation is explored in a number of physiologic states including the endometrial lining and placenta. While iron dysregulation is a common characteristic in many women's health pathologies there is currently a lack of targeted therapeutic options. Traditional iron therapies, including iron replacement and chelation, are common treatment options for gynecological diseases but pose long term negative health consequences; therefore, more targeted interventions directed towards iron regulation have been proposed. Recent findings show potential benefits in a therapeutic focus on ferritin-hepcidin regulation, modulation of reactive oxygen species (ROS), and iron mediated cell death (ferroptosis). These novel therapeutics are the direct result of previous research in iron's complex signaling pathway and show promise for improved therapy, diagnosis, and prognosis in women's health.

摘要

铁在维持内环境稳态以及女性生殖道的病理转归中发挥着独特的生理作用。元素铁的双重性质使得机体在进化过程中需要严格调控其生物学浓度。女性生殖道尤为独特,这是因为子宫内膜存在持续的生长和脱落周期,此外还可能需要将铁转运给发育中的胎儿。在此,我们探讨了包括子宫内膜和胎盘在内的多种生理状态下的铁调节。虽然铁调节异常是许多女性健康疾病的共同特征,但目前缺乏针对性的治疗选择。传统的铁疗法,包括铁补充和螯合疗法,是妇科疾病常见的治疗选择,但会带来长期的负面健康影响;因此,已有人提出针对铁调节的更具针对性的干预措施。最近的研究结果表明,聚焦于铁蛋白-铁调素调节、活性氧(ROS)调节以及铁介导的细胞死亡(铁死亡)的治疗具有潜在益处。这些新型疗法是先前对铁复杂信号通路研究的直接成果,有望改善女性健康领域的治疗、诊断和预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fbb/7762600/9cf7568e2a47/pharmaceuticals-13-00449-g001.jpg

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