母胎界面氧化应激与复发性流产

Recurrent Spontaneous Abortion Related to Oxidative Stress at Maternal-Fetal Interface

复发性流产(recurrent spontaneous abortion,RSA)病因复杂多样,病理生理机制仍存在许多未知。女性生殖系统中,活性氧在激素信号传导、卵母细胞成熟、卵巢类固醇生成、排卵、黄体溶解、妊娠期黄体维持、着床、囊胚发育、生殖细胞功能和黄体形成中发挥着重要的作用。低氧诱导因子-1α表达异常、铁死亡、微量元素及重金属暴露等原因直接或间接诱发的氧化应激(oxidative stress,OS),使体内氧化与抗氧化机制失衡,对细胞增殖和凋亡产生负面影响,出现细胞功能障碍、生物活性降低、免疫和炎症激活等病理现象。母胎界面在妊娠过程中起到交换气体、营养物质、代谢物的作用,同时产生各种激素和生长因子,支持胎儿正常发育和维持妊娠。因此,母胎界面OS与RSA发生发展相关。

Recurrent spontaneous abortion(RSA)has a complex and diverse etiology,and many pathophysiological mechanisms of RSA remain unknown.In the reproductive system of women,reactive oxygen species(ROS)play an important role in hormone signaling,oocyte maturation,ovarian steroidogenesis,ovulation,luteal dissolution,luteal maintenance during pregnancy,embryo implantation,blastocyst development,reproductive cell function,and luteal formation.The abnormal expression of hypoxia inducible factor-1α,iron death,exposure to trace elements and heavy metals,and other factors directly or indirectly induce oxidative stress(OS).The imbalance between oxidative and antioxidant mechanisms has a negative impact on cell proliferation and apoptosis,leading to pathological phenomena such as cellular dysfunction,decreased biological activity,immune and inflammatory activation.The maternal-fetal interface plays a role in the exchange of gases,nutrients and metabolites during pregnancy,while producing various hormones and growth factors to support the normal development of the fetus and to maintain pregnancy.Therefore,OS in maternal-fetal interface is related to the occurrence and progression of RSA.