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子宫内膜异位症和子宫腺肌病精准诊断与治疗中新兴的生物工程突破。

Emerging bioengineering breakthroughs in precision diagnosis and therapy for endometriosis and adenomyosis.

作者信息

Peng Yujie, Zhang Meng, Yan Jingjing, Wang Rong, Xin Yu, Zheng Xiaoling, Zhu Libo, Fei Weidong, Zhao Mengdan

机构信息

Research Center for Clinical Pharmacy, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China.

Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China.

出版信息

J Mater Chem B. 2025 Jan 15;13(3):742-762. doi: 10.1039/d4tb01755b.

Abstract

Endometriosis and adenomyosis are debilitating gynecological conditions that severely affect the quality of life of women. Traditional diagnostic and treatment methods, including laparoscopic surgery and hormonal therapy, face significant limitations such as incomplete lesion detection, high recurrence rates, and adverse side effects. Emerging bioengineering technologies offer promising solutions for precise diagnosis and therapy of these diseases. Advances in biomarker detection through electrochemical immunosensors, including specific molecular markers like cytokines and growth factors, have improved their early diagnosis. Innovative imaging techniques, such as near-infrared fluorescence imaging, magnetic resonance imaging, and photoacoustic imaging, enhance lesion visualization and surgical precision. In therapeutic applications, bioengineered drug delivery systems enable targeted therapy by modifying drug carriers with ligands targeting highly expressed receptors in endometriotic lesions. Such strategies could improve drug accumulation at target sites and reduce damage to healthy tissues. Integrating external energy (including lasers, focused ultrasound, and magnetic fields) with nanoplatforms offers key benefits for treating endometriosis and adenomyosis, allowing precise delivery of energy-responsive molecules to lesions and minimizing damage to healthy tissues. Additionally, novel approaches, such as immunotherapy, gene therapy, ferroptosis induction, and synthetic lethal activation, offer new avenues for effective treatment of endometriosis and adenomyosis. Significantly, this paper discusses the advantages of precision diagnosis and treatment of endometriosis in preserving the fertility of women of reproductive age. This review highlights the potential of bioengineering breakthroughs to transform the diagnosis and management of endometriosis and adenomyosis, emphasizing their role in advancing precision medicine and improving women's health.

摘要

子宫内膜异位症和子宫腺肌病是使人虚弱的妇科疾病,严重影响女性的生活质量。传统的诊断和治疗方法,包括腹腔镜手术和激素治疗,面临着诸如病变检测不完全、复发率高和副作用等重大局限性。新兴的生物工程技术为这些疾病的精确诊断和治疗提供了有前景的解决方案。通过电化学免疫传感器进行生物标志物检测的进展,包括细胞因子和生长因子等特定分子标志物,改善了它们的早期诊断。创新的成像技术,如近红外荧光成像、磁共振成像和光声成像,增强了病变可视化和手术精度。在治疗应用中,生物工程药物递送系统通过用靶向子宫内膜异位病变中高表达受体的配体修饰药物载体来实现靶向治疗。这种策略可以提高药物在靶位点的积累并减少对健康组织的损害。将外部能量(包括激光、聚焦超声和磁场)与纳米平台相结合,为治疗子宫内膜异位症和子宫腺肌病带来了关键益处,使能量响应分子能够精确递送至病变部位并将对健康组织的损害降至最低。此外,免疫疗法、基因疗法、铁死亡诱导和合成致死激活等新方法为有效治疗子宫内膜异位症和子宫腺肌病提供了新途径。重要的是,本文讨论了子宫内膜异位症精确诊断和治疗在保留育龄女性生育能力方面的优势。这篇综述强调了生物工程突破在改变子宫内膜异位症和子宫腺肌病的诊断和管理方面的潜力,强调了它们在推进精准医学和改善女性健康方面的作用。

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