Progesterone Actions and Resistance in Gynecological Disorders.
Progesterone Actions and Resistance in Gynecological Disorders.
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孕酮的作用和妇科疾病的抗性。
DOI：
10.3390/cells11040647
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发表时间：
2022-02-13
期刊：
影响因子：
6
通讯作者：
Hayashi K
中科院分区：
文献类型：
--
作者：
MacLean JA 2nd;Hayashi K
雌激素和孕激素及其信号传导机制受到严格调节，以维持正常的月经周期并支持成功怀孕。雌激素和孕激素的失衡破坏了它们复杂的调节机制，导致雌激素优势和孕激素抵抗。妇科疾病与类固醇激素失调密切相关，可引起慢性盆腔疼痛、痛经、性交困难、大出血和不孕症，严重影响妇女的生活质量。由于月经周期在生殖年龄期间反复发生，生殖相关组织发生动态变化和重塑，这些变化可能累积并诱导慢性和复发性疾病。本文综述了子宫内膜异位症、子宫腺肌病、子宫肌瘤、多囊卵巢综合征和子宫内膜增生症中孕酮信号传导机制和细胞对孕酮的反应。我们还总结了疾病进展中基因突变和类固醇激素调节的相关性，以及目前的激素治疗和孕酮抵抗的临床后果。
Estrogen and progesterone and their signaling mechanisms are tightly regulated to maintain a normal menstrual cycle and to support a successful pregnancy. The imbalance of estrogen and progesterone disrupts their complex regulatory mechanisms, leading to estrogen dominance and progesterone resistance. Gynecological diseases are heavily associated with dysregulated steroid hormones and can induce chronic pelvic pain, dysmenorrhea, dyspareunia, heavy bleeding, and infertility, which substantially impact the quality of women’s lives. Because the menstrual cycle repeatably occurs during reproductive ages with dynamic changes and remodeling of reproductive-related tissues, these alterations can accumulate and induce chronic and recurrent conditions. This review focuses on faulty progesterone signaling mechanisms and cellular responses to progesterone in endometriosis, adenomyosis, leiomyoma (uterine fibroids), polycystic ovary syndrome (PCOS), and endometrial hyperplasia. We also summarize the association with gene mutations and steroid hormone regulation in disease progression as well as current hormonal therapies and the clinical consequences of progesterone resistance.