Medical Residency Program in Ginecology and Obstetric, Hospital Regional Dr. Homero Miranda Gomes, São José 88103-901, Brazil.
Department Curso de Medicina, Campus Pedra Branca, Undergraduate Medical School, Universidade Sul de Santa Catarina-UNISUL, Palhoça 88137-272, Brazil.
Int J Mol Sci. 2021 Apr 22;22(9):4370. doi: 10.3390/ijms22094370.
The pathogenesis of endometriosis is still controversial, although it is known that the inflammatory immune response plays a critical role in this process. The resolution of inflammation is an active process where the activation of endogenous factors allows the host tissue to maintain homeostasis. The mechanisms by which pro-resolving mediators (PRM) act in endometriosis are still little explored. Thus, this integrative review aims to synthesize the available content regarding the role of PRM in endometriosis. Experimental and in vitro studies with Lipoxin A4 demonstrate a potential inhibitory effect on endometrial lesions' progression, attenuating pro-inflammatory and angiogenic signals, inhibiting proliferative and invasive action suppressing intracellular signaling induced by cytokines and estradiol, mainly through the FPR2/ALX. Investigations with Resolvin D1 demonstrated the inhibition of endometrial lesions and decreased pro-inflammatory factors. Annexin A1 is expressed in the endometrium and is specifically present in women with endometriosis, although the available studies are still inconsistent. Thus, we believe there is a gap in knowledge regarding the PRM pathways in patients with endometriosis. It is important to note that these substances' therapeutic potential is evident since the immune and abnormal inflammatory responses play an essential role in endometriosis development and progression.
内异症的发病机制仍存在争议，尽管已知炎症免疫反应在这一过程中起着关键作用。炎症的消退是一个主动的过程，其中内源性因素的激活使宿主组织能够维持内稳态。在子宫内膜异位症中，促解决介质（PRM）发挥作用的机制仍在探索之中。因此，本综述旨在综合现有关于 PRM 在子宫内膜异位症中的作用的内容。关于脂氧素 A4 的实验和体外研究表明，它可能对子宫内膜病变的进展具有抑制作用，可减弱促炎和血管生成信号，抑制增殖和侵袭作用，抑制细胞因子和雌二醇诱导的细胞内信号，主要通过 FPR2/ALX。关于分辨率 D1 的研究表明，它可以抑制子宫内膜病变和减少促炎因子。膜联蛋白 A1 在子宫内膜中表达，并且在子宫内膜异位症患者中特异性存在，尽管现有研究仍然不一致。因此，我们认为在子宫内膜异位症患者的 PRM 途径方面存在知识差距。需要注意的是，这些物质的治疗潜力是显而易见的，因为免疫和异常炎症反应在子宫内膜异位症的发展和进展中起着重要作用。
