卵子激活缺陷:病理分子机制与诊断测试的研究进展

Oocyte activation deficiency:insights into molecular mechanisms and diagnostic tests

卵子激活是成功受精的关键,涉及复杂的分子与信号通路协调作用。目前卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)后完全受精失败的主要原因是卵子激活缺陷。卵子激活缺陷与精子和卵细胞异常因素均相关。过去大量的研究认为,精子因素异常导致Ca2+振荡诱导失败是卵子激活缺陷的主要机制。近年来,卵母细胞相关蛋白突变导致卵子激活缺陷被广泛报道。同时,越来越多的文献证明,遗传筛查、基因/蛋白表达检测以及磷脂酶C zeta(phospholipase C zeta,PLCζ)诱导Ca2+振荡等诊断实验在辅助明确卵子激活缺陷病因方面有重要意义。本文总结了卵子激活缺陷的分子机制,以及相关的诊断实验技术,旨在为卵子激活相关研究提供理论基础,给临床医生为受精失败的患者制定个体化诊治方案提供参考思路。

Oocyte activation is critical for successful fertilization and involves the coordinated action of complex molecular and signaling pathways.Complete fertilization failure undergoing intracytoplasmic sperm injection(ICSI)mainly due to oocyte activation deficiency.Oocyte activation deficiency is associated with both sperm and oocyte abnormalities.In the past,a large number of studies have neglected that the failure of induction of Calcium oscillations was the main mechanism of oocyte activation deficiency.In recent years,mutations in oocyte-associated proteins leading to oocyte activation deficiency have been widely reported.Meanwhile,a growing body of literature has demonstrated the importance of genetic screening,gene/protein expression assays,and PLCζ(phospholipase C zeta)-induced calcium oscillations in aiding the clarification of the etiology of oocyte activation deficiency.This paper summarizes the molecular mechanism of oocyte activation deficiency and the related diagnostic tests,aiming to provide a theoretical basis for oocyte activation-related research and reference for clinicians to develop individualized diagnostic and treatment plans for patients with fertilization failure.