Department of Obstetrics and Gynecology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
Laboratory of Obstetrics and Gynecology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China.
Am J Reprod Immunol. 2024 Apr;91(4):e13841. doi: 10.1111/aji.13841.
Adenomyosis (AM) is a common gynecological disorder characterized by the presence of endometrial glands and stroma within the uterine myometrium. It is associated with abnormal uterine bleeding (AUB), dysmenorrhea, and infertility. Although several mechanisms have been proposed to elucidate AM, the exact cause and development of the condition remain unclear. Recent studies have highlighted the significance of macrophage polarization in the microenvironment, which plays a crucial role in AM initiation and progression. However, a comprehensive review regarding the role and regulatory mechanism of macrophage polarization in AM is currently lacking. Therefore, this review aims to summarize the phenotype and function of macrophage polarization and the phenomenon of the polarization of adenomyosis-associated macrophages (AAMs). It also elaborates on the role and regulatory mechanism of AAM polarization in invasion/migration, fibrosis, angiogenesis, dysmenorrhea, and infertility. Furthermore, this review explores the underlying molecular mechanisms of AAM polarization and suggests future research directions. In conclusion, this review provides a new perspective on understanding the pathogenesis of AM and provides a theoretical foundation for developing targeted drugs through the regulation of AAM polarization.
腺肌病（AM）是一种常见的妇科疾病，其特征是子宫内膜腺体和基质存在于子宫平滑肌中。它与异常子宫出血（AUB）、痛经和不孕有关。尽管已经提出了几种机制来阐明 AM，但该病的确切原因和发展仍不清楚。最近的研究强调了巨噬细胞极化在微环境中的重要性，它在 AM 的发生和发展中起着关键作用。然而，目前缺乏关于巨噬细胞极化在 AM 中的作用和调控机制的全面综述。因此，本综述旨在总结巨噬细胞极化的表型和功能以及与腺肌病相关的巨噬细胞（AAM）的极化现象。它还阐述了 AAM 极化在侵袭/迁移、纤维化、血管生成、痛经和不孕中的作用和调控机制。此外，本综述探讨了 AAM 极化的潜在分子机制，并提出了未来的研究方向。总之，本综述为理解 AM 的发病机制提供了新的视角，并为通过调节 AAM 极化来开发靶向药物提供了理论基础。
