子宫内膜异位症免疫机制研究进展

Progress of Immunologic Mechanism in Endometriosis

子宫内膜异位症(EMs)是一种妇科常见病,在育龄妇女中的发生率约为1/7。其严重影响患病妇女的生活质量,危害其身心健康。目前,EMs发病机制的研究认为可能与多方面因素有关,但至今仍未完全阐明。经血逆流的普遍存在和EMs的相对少见,使学者们考虑到EMs的发病可能与腹腔内环境的不同有关。多年来通过对EMs患者腹腔内免疫细胞、细胞因子等变化的研究证实,EMs可能与机体免疫机制异常有关。研究表明,自然杀伤细胞、巨噬细胞、T淋巴细胞、肥大细胞及自然杀伤T细胞的数量和(或)功能异常可能导致异位子宫内膜的种植,整合素αvβ3、内膜细胞间黏附分子1(ICAM-1)、E-钙黏蛋白等多种黏附分子表达异常可能参与了EMs的定位及黏附,而各种因免疫机制异常而活化的免疫细胞释放出白细胞介素(IL)、肿瘤坏死因子α(TNF-α)、血管内皮生长因子(VEGF)等一系列细胞因子,又进一步加重了免疫机制的紊乱,形成恶性循环,导致EMs的增殖、发展。有研究认为EMs也可能是一种自身免疫性疾病。综述EMs免疫机制的研究进展。

Endometriosis is a common gynecological diseases,the incidence rate in women of reproductive age is about 1/7.It seriously impacts women′ s life and harm to their physical and mental health. After years of researches,the pathogenesis of endometriosis may be related with many factors,but remains unclear. Retrograde menstruation is widely accepted by most people,but it can not explain why most of women have menstrual blood reflux,but only a small number of women with endometriosis,and the present study reports that the immunologic mechanism may be related to the abnormality. Research shows that,the abnormal number and（or） dysfunction of natural killer cells,T lymphocytes, macrophages,mast cells and NKT cells may lead to ectopic endometrial planting,abnormal expression of integrin αvβ3、ICAM-1、E-cadherin and other adhesion molecules may be involved in the positioning and abnormal adhesion of EMs,and because of the abnormal immune mechanism,the activated immune cells release IL,TNF-α,VEGF and a series of cytokines,which further aggravate the disorder of immune mechanism. All those form a vicious circle,lead to the proliferation and development of EMs. The studies also show that EMs may be an autoimmune disease. This paper reviews the research progression of immunologic mechanisms in endometriosis.