Meczekalski Blazej, Nowicka Agata, Bochynska Stefania, Szczesnowicz Aleksandra, Bala Gregory, Szeliga Anna
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland.
UCD School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland.
J Clin Med. 2024 Dec 17;13(24):7683. doi: 10.3390/jcm13247683.
This article presents a narrative review that explores the potential link between kisspeptin-a key regulator of the hypothalamic-pituitary-gonadal axis-and the pathogenesis of endometriosis. Kisspeptin plays a significant role in regulating reproductive functions by modulating the release of gonadotropin-releasing hormone (GnRH), which in turn stimulates the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Recent studies suggest that kisspeptin may also impact peripheral reproductive tissues and influence inflammatory processes involved in the development of endometriosis. Altered kisspeptin signaling has been associated with the abnormal hormonal environment observed in endometriosis, which affects menstrual cycles and ovarian function. Research indicates that women with endometriosis exhibit altered levels of kisspeptin and its receptor, KISS1R, in both eutopic and ectopic endometrial tissues, suggesting a role in disease progression, particularly in tissue invasion and lesion formation. Kisspeptin's role in regulating matrix metalloproteinases (MMPs), enzymes essential for tissue remodeling, further supports its potential contribution to the pathophysiology of endometriosis. Moreover, kisspeptin-based therapeutic strategies are currently under investigation, with the aim of providing targeted treatments that reduce the side effects commonly associated with existing therapies. Despite promising findings, further research is needed to fully understand the mechanisms by which kisspeptin influences endometriosis.
本文呈现了一篇叙述性综述，探讨了促性腺激素释放激素神经元肽（一种下丘脑 - 垂体 - 性腺轴的关键调节因子）与子宫内膜异位症发病机制之间的潜在联系。促性腺激素释放激素神经元肽通过调节促性腺激素释放激素（GnRH）的释放，在调节生殖功能中发挥重要作用，而促性腺激素释放激素又会刺激黄体生成素（LH）和卵泡刺激素（FSH）的分泌。最近的研究表明，促性腺激素释放激素神经元肽可能还会影响外周生殖组织，并影响子宫内膜异位症发展过程中涉及的炎症过程。促性腺激素释放激素神经元肽信号的改变与子宫内膜异位症中观察到的异常激素环境有关，这种异常激素环境会影响月经周期和卵巢功能。研究表明，患有子宫内膜异位症的女性在在位和异位子宫内膜组织中促性腺激素释放激素神经元肽及其受体KISS1R的水平均发生改变，这表明其在疾病进展中发挥作用，尤其是在组织侵袭和病变形成方面。促性腺激素释放激素神经元肽在调节基质金属蛋白酶（MMPs，组织重塑所必需的酶）方面的作用，进一步支持了其对子宫内膜异位症病理生理学的潜在贡献。此外，目前正在研究基于促性腺激素释放激素神经元肽的治疗策略，旨在提供针对性治疗，以减少现有疗法常见的副作用。尽管有一些有前景的发现，但仍需要进一步研究以充分了解促性腺激素释放激素神经元肽影响子宫内膜异位症的机制。
