Salamonsen Lois A
Centre for Reproductive Health, Hudson Institute of Medical Research and Department of Molecular and Translational Science, Monash University, Clayton, VIC, Australia.
Front Reprod Health. 2021 Dec 21;3:779979. doi: 10.3389/frph.2021.779979. eCollection 2021.
Menstruation is a process whereby the outer functionalis layer of the endometrium is shed each month in response to falling progesterone and estrogen levels in a non-conception cycle. Simultaneously with the tissue breakdown, the surface is re-epithelialized, protecting the wound from infection. Once menstruation is complete and estrogen levels start to rise, regeneration progresses throughout the proliferative phase of the cycle, to fully restore endometrial thickness. Endometrial repair is unique compared to tissue repair elsewhere in the adult, in that it is rapid, scar-free and occurs around 400 times during each modern woman's reproductive life. The shedding tissue and that undergoing repair is bathed in menstrual fluid, which contains live cells, cellular debris, fragments of extracellular matrix, activated leukocytes and their products, soluble cellular components and extracellular vesicles. Proteomic and other analyses have revealed some detail of these components. Menstrual fluid, along with a number of individual proteins enhances epithelial cell migration to cover the wound. This is shown in endometrial epithelial and keratinocyte cell culture models, in an decellularized skin model and in pig wounds . Thus, the microenvironment provided by menstrual fluid, is likely responsible for the unique rapid and scar-free repair of this remarkable tissue. Insight gained from analysis of this fluid is likely to be of value not only for treating endometrial bleeding problems but also in providing potential new therapies for poorly repairing wounds such as those seen in the aged and in diabetics.
月经是一个过程，在非受孕周期中，随着孕酮和雌激素水平下降，子宫内膜的外层功能层每月都会脱落。在组织分解的同时，表面会重新上皮化，保护伤口免受感染。月经结束且雌激素水平开始上升后，在整个周期的增殖期进行再生，以完全恢复子宫内膜厚度。与成年人其他部位的组织修复相比，子宫内膜修复具有独特性，因为它快速、无疤痕，并且在每位现代女性的生殖生活中会发生约400次。脱落的组织和正在修复的组织浸泡在月经液中，月经液含有活细胞、细胞碎片、细胞外基质片段、活化的白细胞及其产物、可溶性细胞成分和细胞外囊泡。蛋白质组学和其他分析揭示了这些成分的一些细节。月经液以及一些单个蛋白质可增强上皮细胞迁移以覆盖伤口。这在子宫内膜上皮细胞和角质形成细胞培养模型、脱细胞皮肤模型以及猪伤口中得到了证实。因此，月经液提供的微环境可能是这种非凡组织独特的快速无疤痕修复的原因。对这种液体分析所获得的见解不仅可能对治疗子宫内膜出血问题有价值，而且在为诸如老年人和糖尿病患者中所见的难愈合伤口提供潜在新疗法方面也可能有价值。
