The bimodal role of matrix metalloproteinases and their inhibitors in etiology and pathogenesis of endometriosis (Review).
The bimodal role of matrix metalloproteinases and their inhibitors in etiology and pathogenesis of endometriosis (Review).
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DOI：
10.3892/mmr.2018.9303
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发表时间：
2018-09
影响因子：
3.4
通讯作者：
Włodarski PK
中科院分区：
文献类型：
--
作者：
Bałkowiec M;Maksym RB;Włodarski PK
基质金属蛋白酶（MMPs）的异常调节可能是一组易感妇女子宫内膜病变形成的主要原因。子宫内膜异位症的真正起源的前景正在进行中，因为逆行性月经导致许多未经历子宫内膜异位症的妇女的腹膜腔中存在子宫内膜碎片。组织重塑是由MMPs及其抑制剂的平衡精确调节的。在灵长类动物生理学中，促进和抑制基质更新的因素之间的相互作用对于子宫内膜的周期性准备、胚胎着床以及子宫内膜的脱落和更新至关重要。基质重塑调节的紊乱导致异位子宫内膜组织的种植增加和侵袭性生长。此外，子宫内膜异位症引起的基质平衡变化会导致粘连形成、排卵功能障碍和生育能力损害。综述总结了目前关于细胞外基质周转调节的子宫内膜周期的生理学和子宫内膜异位症的发展，以及排卵功能障碍的病理生理学在子宫内膜异位症妇女的知识。利用调制组织重塑的治疗方式进行了讨论。
Aberrant regulation of matrix metalloproteinases (MMPs) may be the primary cause of endometrial lesion formation in a group of predisposed women. Prospect for the genuine origin of endometriosis is ongoing, since retrograde menstruation leads to presence of endometrial debris in peritoneal cavity of many women, which do not experience endometriosis. Tissue remodeling is regulated precisely by a balance of MMPs and their inhibitors. Interplay between factors enhancing and suppressing matrix turnover is crucial for cyclic preparation of endometrium for embryo implantation, and endometrial shedding and renewal in physiology of primates. Disorders of the regulation of matrix remodeling leads to augmentation of implantation and invasive growth of ectopic endometrial tissue. Moreover, endometriosis-induced changes in the matrix balance leads to adhesion formation, ovulatory dysfunction and fertility impairment. The review summarizes the current knowledge regarding the regulation of extracellular matrix turnover in the physiology of the endometrial cycle and in the development of endometriosis, as well as the pathophysiology of ovulatory dysfunction in endometriotic women. Therapeutic modalities utilizing modulation of tissue remodeling were discussed.
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