Department of Hangzhou Normal University, Hangzhou, Zhejiang Province, China.
Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, Zhejiang Province, China.
Medicine (Baltimore). 2024 Mar 15;103(11):e37421. doi: 10.1097/MD.0000000000037421.
BACKGROUND: Endometriosis (EMT) a common gynecological condition in women, an inflammatory disease characterized by the presence of endometrial tissue on organs and tissues in the pelvis, and is mainly associated with chronic pelvic pain and infertility. As the etiology has not been fully elucidated, current treatment is limited to surgery, hormones and painkillers, with more side effects and difficulty in achieving long-term relief. Oxidative stress manifests itself as an overproduction of reactive oxygen species, which has an integral impact in the pathology of female reproductive disorders. In this review, we evaluate the mechanisms of iron overload-induced oxidative stress and ferroptosis in EMT and their pathophysiological implications. METHODS: Because the etiology has not been fully elucidated, current treatments are limited to surgery, hormones, and painkillers, which have many side effects and are difficult to achieve long-term relief. RESULTS: We interpreted that antioxidants as well as ferroptosis inducers show promising results in the treatment of EMT, but their application in this population needs to be further investigated. CONCLUSION: In combination with the interpretation of previous studies, it was shown that iron overload is present in the peritoneal fluid, endometriotic lesions, peritoneum and macrophages in the abdominal cavity. However, the programmed cellular ferroptosis associated with iron overload is resisted by endometriotic foci, which is critical to the pathophysiology of EMT with local iron overload and inflammation.
背景:子宫内膜异位症(EMT)是一种常见的妇科疾病,是一种以子宫内膜组织出现在盆腔器官和组织为特征的炎症性疾病,主要与慢性盆腔疼痛和不孕有关。由于病因尚未完全阐明,目前的治疗方法仅限于手术、激素和止痛药,副作用更多,难以实现长期缓解。氧化应激表现为活性氧的过度产生,这对女性生殖系统疾病的病理生理学有重要影响。在这篇综述中,我们评估了铁过载诱导的氧化应激和铁死亡在 EMT 中的机制及其病理生理学意义。
方法:由于病因尚未完全阐明,目前的治疗方法仅限于手术、激素和止痛药,这些方法有许多副作用,难以实现长期缓解。
结果:我们发现抗氧化剂和铁死亡诱导剂在 EMT 的治疗中显示出有希望的结果,但它们在这一人群中的应用需要进一步研究。
结论:结合以往研究的解释,表明铁过载存在于腹腔液、子宫内膜异位病灶、腹膜和腹腔巨噬细胞中。然而,与铁过载相关的程序性细胞铁死亡被子宫内膜异位病灶所抵抗,这对于局部铁过载和炎症引起的 EMT 的病理生理学至关重要。
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