维甲酸在子宫内膜异位症中的研究进展

The Research Progress of Retinoic Acid in Endometriosis

子宫内膜异位症(EMs)是一种严重影响女性生活质量与生育能力的常见妇科良性疾病,其复杂的病理生理学机制尚未明确。尽管EMs的诊断标准与治疗方案在不断改进,但其高发病率与低治愈率却没有明显改善。维甲酸(RA)作为维生素A的活性代谢产物,参与各种细胞生长、分化与器官发生的过程。RA在EMs中因代谢缺陷而呈异常低水平,且大量研究显示RA信号缺陷可能通过提高局部内膜雌激素水平、抑制凋亡与自噬、促炎与异常免疫调节等方式参与EMs的发生、发展,因此RA及其衍生物有望成为EMs治疗的新药物。就EMs中RA异常代谢、RA信号缺陷促进EMs发生和发展的可能机制以及RA在EMs中的治疗潜力进行了综述,以期为EMs的发病机制与治疗提供新思路。

Endometriosis(EMs)is a common gynecological benign disease that seriously affects the quality of life and fertility of women.Its complex pathophysiological mechanism has not been clear.Despite the continuous improvement in diagnostic criteria and treatment protocols of EMs,the high incidence rate and low cure rate did not improve significantly.Retinoic acid(RA),as an active metabolite of vitamin A,is involved in various cell growth,differentiation and organogenesis processes.RA is abnormally low in EMs due to metabolic defects,and a large number of studies have shown that RA signal defects may participate in the occurrence of EMs by increasing local endometrial estrogen levels,inhibiting apoptosis and autophagy,pro-inflammatory and abnormal immune regulation,etc.Therefore,RA and its derivatives are expected to become new drugs for the treatment of EMs.The abnormal metabolism of RA in EMs,the possible mechanisms by which RA signal defects promote the occurrence and development of EMs,and the therapeutic potential of RA in EMs are reviewed in order to provide new ideas for the pathogenesis and treatment of EMs.