Mandalà Maurizio
Department of Biology, Ecology & Earth Sciences, University of Calabria, 87036 Rende, Italy.
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont Larner College of Medicine, Burlington, VT 05405, USA.
Antioxidants (Basel). 2025 Aug 26;14(9):1051. doi: 10.3390/antiox14091051.
During pregnancy, uterine circulation undergoes profound structural and functional adaptations to accommodate the dramatically increased metabolic demands of the growing fetus. Oxidative stress (OS) and inflammation have emerged as central regulators both physiologically, to drive vascular remodeling and angiogenesis, and pathologically, when dysregulated, to promote endothelial dysfunction, maladaptive extracellular matrix (ECM) remodeling, and heightened arterial stiffness. This review synthesizes insights into the molecular sources of reactive oxygen species (ROS) in the uterine vasculature, endothelial and immune-mediated inflammatory pathways, the bidirectional crosstalk between OS and inflammation, and their combined impact on vascular stiffness. We further discuss clinical implications for conditions such as preeclampsia and intrauterine growth restriction (IUGR), highlight circulating and imaging biomarkers of redox-inflammatory imbalance, and evaluate antioxidant and anti-inflammatory therapeutic strategies. Finally, we identify critical knowledge gaps and propose future research directions aimed at translating mechanistic understanding into personalized maternal-fetal care. For this narrative review, we searched the PubMed and Web of Science databases to identify all human and animal studies investigating OS and inflammation on uterine vasculature remodeling during pregnancy.
在孕期，子宫循环会经历深刻的结构和功能适应性变化，以适应不断生长的胎儿急剧增加的代谢需求。氧化应激（OS）和炎症在生理上已成为驱动血管重塑和血管生成的核心调节因子，而在病理状态下，当调节失调时，会促进内皮功能障碍、适应性不良的细胞外基质（ECM）重塑以及动脉僵硬度增加。本综述综合了对子宫血管系统中活性氧（ROS）的分子来源、内皮和免疫介导的炎症途径、OS与炎症之间的双向相互作用及其对血管僵硬度的综合影响的见解。我们进一步讨论了子痫前期和宫内生长受限（IUGR）等病症的临床意义，强调了氧化还原炎症失衡的循环和成像生物标志物，并评估了抗氧化和抗炎治疗策略。最后，我们确定了关键的知识空白，并提出了未来的研究方向，旨在将机制理解转化为个性化的母婴护理。对于本叙述性综述，我们检索了PubMed和Web of Science数据库，以识别所有研究孕期氧化应激和炎症对子宫血管重塑影响的人类和动物研究。
