Department of Gynecology and Reproductive Medicine, Ms.Clinic MayOne, Kashihara, Nara 634‑0813, Japan.
Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634‑8522, Japan.
Int J Mol Med. 2024 Sep;54(3). doi: 10.3892/ijmm.2024.5402. Epub 2024 Jul 12.
It is considered that the etiology of endometriosis is retrograde menstruation of endometrial tissue. Although shed endometrial cells are constantly exposed to a challenging environment with iron overload, oxidative stress and hypoxia, a few cells are able to survive and continue to proliferate and invade. Ferroptosis, an iron‑dependent form of non‑apoptotic cell death, is known to play a major role in the development and course of endometriosis. However, few papers have concentrated on the dynamic interaction between autophagy and ferroptosis throughout the progression of diseases. The present review summarized the current understanding of the mechanisms underlying autophagy and ferroptosis in endometriosis and discuss their role in disease development and progression. For the present narrative review electronic databases including PubMed and Google Scholar were searched for literature published up to the October 31, 2023. Autophagy and ferroptosis may be activated at early stages in endometriosis development. On the other hand, excessive activation of intrinsic pathways (e.g., estrogen and mechanistic target of rapamycin) may promote disease progression through autophagy inhibition. Furthermore, suppression of ferroptosis may cause further progression of endometriotic lesions. In conclusion, the autophagy and ferroptosis pathways may play a dual role in disease initiation and progression. The present review discussed the temporal transition of non‑apoptotic cell death regulation during disease progression from retrograde endometrium to early lesions to established lesions.
人们认为子宫内膜异位症的病因是子宫内膜组织的逆行月经。尽管脱落的子宫内膜细胞不断暴露于富含铁、氧化应激和缺氧的挑战性环境中,但仍有少数细胞能够存活并继续增殖和侵袭。铁死亡是一种铁依赖性的非凋亡细胞死亡形式,已知其在子宫内膜异位症的发生和病程中起主要作用。然而,很少有论文集中研究自噬和铁死亡在疾病进展过程中的动态相互作用。本综述总结了目前对子宫内膜异位症中自噬和铁死亡机制的认识,并讨论了它们在疾病发展和进展中的作用。本叙述性综述的电子数据库包括 PubMed 和 Google Scholar,检索截至 2023 年 10 月 31 日发表的文献。自噬和铁死亡可能在子宫内膜异位症发展的早期阶段被激活。另一方面,内在途径(如雌激素和雷帕霉素靶蛋白)的过度激活可能通过自噬抑制促进疾病进展。此外,铁死亡的抑制可能导致子宫内膜异位病变的进一步进展。总之,自噬和铁死亡途径可能在疾病的起始和进展中发挥双重作用。本综述讨论了从逆行子宫内膜到早期病变再到已建立病变的疾病进展过程中非凋亡细胞死亡调控的时间转换。
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