Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital Affiliated to School of Medicine, Zhejiang University, Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, Zhejiang 310016, China.
Chin Med J (Engl). 2020 Nov 4;134(1):20-27. doi: 10.1097/CM9.0000000000001214.
The NOD-like receptor protein 3 (NLRP3) inflammasome is a key regulator of the host's immune response, and many immune and metabolic disorders are linked to its activation. This review aimed to investigate and clarify the relationship between this inflammasome and high-risk reproductive disorders. Papers cited here were retrieved from PubMed up to August 2020 using the keywords "NLRP3" or "NALP3", "caspase-1", "endometriosis", "gestational diabetes", "interleukin (IL)-18", "IL-1β", "pre-eclampsia (PE)", "preterm birth", "polycystic ovarian syndrome (PCOS)", "recurrent spontaneous abortion (RSA)", and combinations of these terms. The results show that NLRP3 inflammasome is associated with various high-risk reproductive disorders and many inflammatory factors are secreted during its activation, such as IL-1β induced during the development of endometriosis. PCOS is also associated with activation of the NLRP3 inflammasome, especially in overweight patients. It also participates in the pathogenesis of RSA and is activated in fetal membranes before preterm birth. The placentas of pregnant women with PE show higher expression of the NLRP3 inflammasome, and gestational diabetes mellitus occurs simultaneously with its activation. Current evidence suggest that the NLRP3 inflammasome plays an important role in female reproductive disorders. New treatment and management methods targeting it might help reduce the incidence of such disorders and improve neonatal outcomes.
NOD 样受体蛋白 3（NLRP3）炎性小体是宿主免疫反应的关键调节因子，许多免疫和代谢紊乱都与其激活有关。本综述旨在探讨和阐明该炎性小体与高风险生殖障碍之间的关系。本研究检索了 2020 年 8 月前在 PubMed 上发表的使用“NLRP3”或“NALP3”、“caspase-1”、“子宫内膜异位症”、“妊娠糖尿病”、“白细胞介素（IL）-18”、“IL-1β”、“先兆子痫（PE）”、“早产”、“多囊卵巢综合征（PCOS）”、“复发性自然流产（RSA）”和这些术语组合的关键词，共得到 31 篇文献。结果表明，NLRP3 炎性小体与各种高风险生殖障碍有关，其激活过程中会分泌许多炎症因子，如在子宫内膜异位症发展过程中诱导产生的 IL-1β。PCOS 也与 NLRP3 炎性小体的激活有关，尤其是在超重患者中。它还参与 RSA 的发病机制，并在早产前的胎膜中被激活。PE 孕妇的胎盘显示出更高的 NLRP3 炎性小体表达，而妊娠期糖尿病则伴随着其激活而发生。目前的证据表明，NLRP3 炎性小体在女性生殖障碍中发挥重要作用。针对它的新的治疗和管理方法可能有助于降低这些疾病的发生率，并改善新生儿结局。
