摘要
子宫内膜异位症(EMs)是一种雌激素依赖性的神经血管性疾病,子宫内膜异位性疼痛是EMs最主要的症状。然而,其机制至今仍不明确,治疗的效果欠佳且极易复发,是育龄期女性慢病管理的主要挑战。近年来,研究发现EMs疼痛与神经新生密切相关,EMs病灶中存在着密集的神经纤维网络,这些神经网络会促进EMs的发展和疼痛的发生。神经营养因子(NTFs)是神经发育和维持的重要调节因子,其能调控神经纤维的增殖、可塑性和敏感性。同时,EMs病灶中存在着复杂的免疫细胞群,这些免疫细胞群可以通过介导NTFs的无序表达为神经新生构建有益的免疫环境。其次,雌激素依赖和孕激素抵抗是EMs的病理特点,这些病理特点将有利于EMs复杂微环境中的神经和血管的共同募集,而神经和血管的共同募集有利于子宫内膜碎片的异位黏附、存活和生长。此外,慢性压力反应可以通过影响免疫细胞的募集来促进局部NTFs的表达,从而影响神经新生。神经新生是EMs病变和疼痛发生的关键过程,神经新生的局部破坏可能是EMs治疗的新靶点。本文就神经新生与EMs疼痛的作用进行阐述。
Endometriosis(EMs)is an estrogen-dependent neurovascular disease.EMs pain has become a major concern.However,the mechanism is still unclear,and the treatment effect is poor and easy to relapse,which is the main challenge in the management of chronic diseases.In recent years,studies have found that EMs pain is closely related to neurogenesis.There is a dense network of nerve fibers in EMs foci.It will promote the development of EMS and the occurrence of pain.Neurotrophic factors(NTFs)are an important regulatory factor for neurological development and maintenance,which can regulate the proliferation,plasticity,and sensitivity of nerve fibers.At the same time,there are complex immune cells in the EMs lesion.These immune cells can build a useful immune environment for neurogenesis by mediating the disorderly expression of NTFs.Secondly,estrogen dependencies and progesterone resistance are the pathological characteristics of EMs,which will be conducive to the joint raising of nerves and blood vessels.That has the benefit of ectopic adhesion,survival and growth of endometrial fragments.In addition,chronic stress reactions can promote the expression of local NTFs by affecting the recruitment of immune cells,thereby affecting neurological regeneration.Neurogenesis is closely associated with EMs pain mechanisms,and local disruption of neurogenesis may be a new target for EMs therapy.This article discusses the role of neurogenesis and EMs pain.
作者
罗喜
黄紫薇
张伶俐
LUO Xi;HUANG Ziwei;ZHANG Lingli(Hunan University of Chinese Medicine,Changsha,Hunan 410208,China;Hunan University of Chinese Medicine Affiliated Provincial Hospital of Traditional Chinese Medicine,Zhuzhou,Hunan 412000,China;The First Affiliated Hospital of Hunan Traditional Chinese Medical College,Hunan Province Directly Affiliated TCM Hospital,Zhuzhou,Hunan 412000,China)
出处
《中国优生与遗传杂志》
2023年第7期1512-1516,共5页
Chinese Journal of Birth Health & Heredity
基金
湖南省中医药科研计划项目(2015120)。
