Li Yangshuo, He Yalun, Cheng Wen, Zhou Zhihao, Ni Zhexin, Yu Chaoqin
Department of Gynecology of Traditional Chinese Medicine, the First Affiliated Hospital of Naval Medical University, 200433, Shanghai, China.
Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, 100850, Beijing, China.
Cell Death Discov. 2023 Aug 22;9(1):306. doi: 10.1038/s41420-023-01606-8.
Endometriosis is strongly associated with infertility. Several mechanisms have been reported in an attempt to elucidate the pathophysiological effects that lead to reduced fertility in women with endometriosis. However, the mechanisms by which endometriosis affects fertility have not been fully elucidated. Ferroptosis is a novel form of nonapoptotic cell death that is characterized by iron-dependent lipid peroxidation membrane damage. In past reports, elevated iron levels in ectopic lesions, peritoneal fluid and follicular fluid have been reported in patients with endometriosis. The high-iron environment is closely associated with ferroptosis, which appears to exhibit a double-edged effect on endometriosis. Ferroptosis can cause damage to ovarian granulosa cells, oocytes, and embryos, leading to endometriosis-related infertility. This article summarizes the main pathways and regulatory mechanisms of ferroptosis and explores the possible mechanisms of the formation of an iron-overloaded environment in endometriotic ectopic lesions, peritoneal fluid and follicular fluid. Finally, we reviewed recent studies on the main and potential mechanisms of ferroptosis in endometriosis and endometriosis-related infertility.
子宫内膜异位症与不孕症密切相关。为了阐明导致子宫内膜异位症女性生育力降低的病理生理效应，已有多种机制被报道。然而，子宫内膜异位症影响生育力的机制尚未完全阐明。铁死亡是一种新型的非凋亡性细胞死亡形式，其特征是铁依赖性脂质过氧化膜损伤。在过去的报道中，子宫内膜异位症患者的异位病灶、腹腔液和卵泡液中铁水平升高。高铁环境与铁死亡密切相关，铁死亡似乎对子宫内膜异位症具有双刃剑效应。铁死亡可导致卵巢颗粒细胞、卵母细胞和胚胎受损，从而导致与子宫内膜异位症相关的不孕症。本文总结了铁死亡的主要途径和调控机制，探讨了子宫内膜异位症异位病灶、腹腔液和卵泡液中铁过载环境形成的可能机制。最后，我们综述了近年来关于铁死亡在子宫内膜异位症及与子宫内膜异位症相关不孕症中的主要和潜在机制的研究。
