Gynecology Research Unit, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1200 Brussels, Belgium.
Society for Research into Infertility, 1150 Brussels, Belgium.
Int J Mol Sci. 2021 Jul 1;22(13):7138. doi: 10.3390/ijms22137138.
Endometriosis is a disease of reproductive age characterized by chronic pelvic pain and infertility. Its pathogenesis is complex and still partially unexplained. However, there is increasing evidence of the role of chronic inflammation, immune system dysregulation, and oxidative stress in its development and progression. The latter appears to be involved in multiple aspects of the disease. Indeed, disease progression sustained by a hyperproliferative phenotype can be related to reactive oxygen species (ROS) imbalance, as numerous experiments using drugs to counteract hyperproliferation have shown in recent years. Chronic pelvic pain is also associated with cell function dysregulation favoring chronic inflammation and oxidative stress, specifically involving macrophages and mast cell activation. Moreover, there is increasing evidence of a role for ROS and impaired mitochondrial function not only as deleterious effectors of the ovarian reserve in patients with endometriomas but also in terms of oocyte quality and, hence, embryo development impairment. Targeting oxidative stress looks to be a promising strategy to both curb endometriotic lesion progression and alleviate endometriosis-associated symptoms of chronic pain and infertility. More investigations are nevertheless needed to develop effective therapeutic strategies for clinical application.
子宫内膜异位症是一种以慢性盆腔痛和不孕为特征的育龄期疾病。其发病机制复杂，部分原因仍不清楚。然而，越来越多的证据表明慢性炎症、免疫系统失调和氧化应激在其发展和进展中起作用。后者似乎涉及疾病的多个方面。事实上，由过度增生表型维持的疾病进展可能与活性氧（ROS）失衡有关，近年来，许多使用药物来对抗过度增生的实验已经证明了这一点。慢性盆腔痛也与细胞功能失调有关，有利于慢性炎症和氧化应激，特别是涉及巨噬细胞和肥大细胞的激活。此外，越来越多的证据表明 ROS 和受损的线粒体功能不仅作为内异症患者卵巢储备的有害效应物，而且在卵母细胞质量方面，也会影响胚胎发育。针对氧化应激似乎是一种很有前途的策略，既能抑制子宫内膜异位症病变的进展，又能缓解与慢性疼痛和不孕相关的症状。然而，仍需要更多的研究来开发针对临床应用的有效治疗策略。
