子宫内膜异位症中类似瓦伯格效应的代谢重编程:从分子机制到治疗方法

Warburg-like Metabolic Reprogramming in Endometriosis: From Molecular Mechanisms to Therapeutic Approaches.

作者信息

Kim Bo-Sung, Kim Bosung, Yoon Seyeong, Park Wonyoung, Bae Sung-Jin, Joo Jongkil, Kim Wonnam, Ha Ki-Tae

机构信息

Research Institute for Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea.

Department of Korean Medical Science, School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea.

出版信息

Pharmaceuticals (Basel). 2025 May 28;18(6):813. doi: 10.3390/ph18060813.

Abstract

Endometriosis is a chronic gynecological disorder characterized by the presence of endometrial-like tissue outside the uterus, leading to inflammation, pain, and infertility. Emerging evidence indicates that endometriotic lesions exhibit cancer-like properties, including metabolic reprogramming marked by increased glucose uptake, enhanced Warburg's effect, and altered mitochondrial function. These metabolic adaptations support cell survival under hypoxic conditions and contribute to immune evasion and sustained proliferation. This review summarizes current findings on the molecular mechanisms driving metabolic reprogramming in endometriosis, including the roles of mitochondrial dysfunction, hypoxia-inducible factor (HIF) signaling, the PI3K/AKT/mTOR pathway, inflammatory cytokines, and genetic and epigenetic regulators. In addition, we discuss therapeutic strategies targeting glycolytic pathways using both synthetic inhibitors and natural compounds, which represent promising non-hormonal options. Finally, we highlight the need for further preclinical and clinical studies to validate metabolic interventions and improve outcomes for patients with endometriosis.

摘要

子宫内膜异位症是一种慢性妇科疾病,其特征是子宫外存在类似子宫内膜的组织,导致炎症、疼痛和不孕。新出现的证据表明,子宫内膜异位症病变具有类似癌症的特性,包括以葡萄糖摄取增加、沃伯格效应增强和线粒体功能改变为特征的代谢重编程。这些代谢适应支持细胞在缺氧条件下存活,并有助于免疫逃逸和持续增殖。本综述总结了目前关于子宫内膜异位症中驱动代谢重编程的分子机制的研究结果,包括线粒体功能障碍、缺氧诱导因子(HIF)信号传导、PI3K/AKT/mTOR途径、炎性细胞因子以及遗传和表观遗传调节因子的作用。此外,我们讨论了使用合成抑制剂和天然化合物靶向糖酵解途径的治疗策略,这些策略代表了有前景的非激素选择。最后,我们强调需要进一步的临床前和临床研究来验证代谢干预措施并改善子宫内膜异位症患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae47/12195805/e2223c4a73d4/pharmaceuticals-18-00813-g001.jpg

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