Garmendia Jenny Valentina, De Sanctis Claudia Valentina, Hajdúch Marian, De Sanctis Juan Bautista
Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic.
Czech Advanced Technologies and Research Institute (CATRIN), Institute of Molecular and Translational Medicine, Palacky University, 779 00 Olomouc, Czech Republic.
Int J Mol Sci. 2025 May 28;26(11):5193. doi: 10.3390/ijms26115193.
Endometriosis, a complex inflammatory disease, affects a significant proportion of women of reproductive age, approximately 10-15%. The disease involves the growth of endometrial glands and stroma outside the uterine cavity, leading to tissue remodeling and fibrosis. Hormonal imbalances, accompanied by local and general inflammation and pain, are key features of endometriosis. Endometriotic lesions are associated with the overproduction of cytokines, metalloproteinases, prostaglandins, reactive oxygen radicals, and extracellular vesicles. Genetic predisposition and cytokine gene polymorphisms have been documented. Macrophages, dendritic cells, mast cells, Th1 in the early phase, Th2 in the late phase, and T regulatory cells play a crucial role in endometriosis. Reduced NK cell function and impaired immune vigilance contribute to endometrial growth. The strong inflammatory condition of the endometrium poses a barrier to the proper implantation of the zygote, contributing to the infertility of these patients. Cytokines from various cell types vary with the severity of the disease. The role of microbiota in endometriosis is still under study. Endometriosis is associated with autoimmunity and ovarian cancer. Hormonal treatments and surgery are commonly used; however, recent interest focuses on anti-inflammatory and immunomodulatory therapies, including cytokine and anti-cytokine antibodies. Modulating the immune response has proven critical; however, more research is needed to optimize treatment for these patients.
子宫内膜异位症是一种复杂的炎症性疾病，影响着相当比例的育龄女性，约为10 - 15%。该疾病涉及子宫腔外子宫内膜腺体和间质的生长，导致组织重塑和纤维化。激素失衡，伴有局部和全身炎症及疼痛，是子宫内膜异位症的关键特征。子宫内膜异位症病变与细胞因子、金属蛋白酶、前列腺素、活性氧自由基和细胞外囊泡的过度产生有关。遗传易感性和细胞因子基因多态性已有文献记载。巨噬细胞、树突状细胞、肥大细胞、早期的Th1、晚期的Th2以及调节性T细胞在子宫内膜异位症中起关键作用。自然杀伤细胞功能降低和免疫监视受损导致子宫内膜生长。子宫内膜的强烈炎症状态对受精卵的正常着床构成障碍，导致这些患者不孕。来自各种细胞类型的细胞因子随疾病严重程度而变化。微生物群在子宫内膜异位症中的作用仍在研究中。子宫内膜异位症与自身免疫和卵巢癌有关。激素治疗和手术是常用的治疗方法；然而，最近的研究兴趣集中在抗炎和免疫调节疗法，包括细胞因子和抗细胞因子抗体。调节免疫反应已被证明至关重要；然而，需要更多的研究来优化对这些患者的治疗。
