Involvement of immune cells in the pathogenesis of endometriosis
Involvement of immune cells in the pathogenesis of endometriosis
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DOI：
10.1111/jog.13559
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发表时间：
2018-02-01
影响因子：
1.6
通讯作者：
Osuga, Yutaka
中科院分区：
文献类型：
--
作者：
Izumi, Gentaro;Koga, Kaori;Osuga, Yutaka
子宫内膜异位症的特点是子宫外子宫内膜异位症组织的植入和生长。子宫内膜异位症被广泛接受的理论是由月经逆行引起的子宫内膜组织植入引起的；然而，几乎所有女性都有月经逆行，子宫内膜异位症的建立需要其他因素，如细胞存活、细胞侵袭、血管生成、细胞生长等。因此，局部环境中的免疫因素可能有助于子宫内膜异位症的形成和进展。目前的证据支持免疫细胞参与子宫内膜异位症的发病机制。腹膜中性粒细胞和巨噬细胞分泌生化因子，帮助子宫内膜异位症细胞生长、侵袭和血管生成。子宫内膜异位症的巨噬细胞和NK细胞对腹腔内子宫内膜细胞的清除能力有限。T细胞亚群的不平衡导致异常的细胞因子分泌和炎症，导致子宫内膜异位症病变的生长。目前尚不确定这些免疫细胞是否在最初的病因和/或刺激增强疾病的行为中起作用；然而，在任何一种情况下，调节这些细胞的行为都可能阻止疾病的发生或进展。需要进一步的研究来加深对子宫内膜异位症病理的理解，并开发新的治疗方法，使患有这种疾病的妇女受益。
Endometriosis is characterized by the implantation and growth of endometriotic tissues outside the uterus. It is widely accepted the theory that endometriosis is caused by the implantation of endometrial tissue from retrograde menstruation; however, retrograde menstruation occurs in almost all women and other factors are required for the establishment of endometriosis, such as cell survival, cell invasion, angiogenesis, and cell growth. Immune factors in the local environment may, therefore, contribute to the formation and progression of endometriosis. Current evidence supports the involvement of immune cells in the pathogenesis of endometriosis. Peritoneal neutrophils and macrophages secrete biochemical factors that help endometriotic cell growth and invasion, and angiogenesis. Peritoneal macrophages and NK cells in endometriosis have limited capability of eliminating endometrial cells in the peritoneal cavity. An imbalance of T cell subsets leads to aberrant cytokine secretions and inflammation that results in the growth of endometriosis lesions. It is still uncertain whether these immune cells have a role in the initial cause and/or stimulate actions that enhance disease; however, in either case, modulating the actions of these cells may prevent initiation or disease progression. Further studies are needed to deepen the understanding of the pathology of endometriosis and to develop novel management approaches of benefit to women suffering from this disease.