Blanco Luz P, Salmeri Noemi, Temkin Sarah M, Shanmugam Victoria K, Stratton Pamela
National Institute of Arthritis, and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, United States of America.
Office of Research on Women's Health, Office of the Director, National Institutes of Health, Bethesda, MD, United States of America.
Autoimmun Rev. 2025 Mar 26;24(4):103752. doi: 10.1016/j.autrev.2025.103752. Epub 2025 Jan 17.
Endometriosis is a female-specific chronic condition that affects 1 in 10 women and other individuals with a uterus worldwide with common symptoms that include pelvic pain and infertility. Reliable and effective non-invasive biomarkers for endometriosis do not exist, and therefore currently a diagnosis of endometriosis requires direct visualization of lesions at surgery. Similarly, few safe and effective management strategies exist for endometriosis, with hormonal interventions and surgery only providing temporary symptom control. The development of endometriosis involves the implantation and proliferation of ectopic endometrial cells which triggers local and systemic inflammation and fibrosis. While multiple genetic, environmental, and lifestyle factors appear to influence the natural history of endometriosis, chronic inflammation is a hallmark feature associated with development and progression of the disease. Data further shows that endometriosis commonly co-occurs with autoimmune diseases, adding evidence that immune dysfunction likely contributes to the pathogenesis of this disorder. Specific innate and adaptive immune system drivers of endometriosis remain to be identified and additional research is needed to elucidate the mechanistic underpinnings of this debilitating disease. In this narrative review, we discuss the shared biological mechanisms and plausible immune-related connections between endometriosis and autoimmunity.
子宫内膜异位症是一种女性特有的慢性疾病，全球每10名女性及其他子宫性个体中就有1人受其影响，常见症状包括盆腔疼痛和不孕。目前不存在可靠且有效的子宫内膜异位症非侵入性生物标志物，因此目前子宫内膜异位症的诊断需要在手术中直接观察病变。同样，针对子宫内膜异位症的安全有效管理策略也很少，激素干预和手术只能暂时控制症状。子宫内膜异位症的发展涉及异位子宫内膜细胞的植入和增殖，这会引发局部和全身炎症及纤维化。虽然多种遗传、环境和生活方式因素似乎会影响子宫内膜异位症的自然病程，但慢性炎症是与该疾病发展和进展相关的标志性特征。数据进一步表明，子宫内膜异位症常与自身免疫性疾病同时出现，这进一步证明免疫功能障碍可能导致了这种疾病的发病机制。子宫内膜异位症具体的先天性和适应性免疫系统驱动因素仍有待确定，需要更多研究来阐明这种使人衰弱的疾病的机制基础。在这篇叙述性综述中，我们讨论了子宫内膜异位症与自身免疫之间共同的生物学机制以及可能的免疫相关联系。
