铁死亡在子宫内膜异位症中的研究进展

子宫内膜异位症（endometriosis,EMs）虽为一种常见的妇科良性疾病,却有侵袭、浸润、远处转移等恶性行为。铁死亡（ferroptosis）是一种新发现的程序性细胞死亡,主要特征表现为细胞内游离二价铁（Fe²⁺）过量介导芬顿反应产生羟基自由基,细胞内抗氧化酶谷胱甘肽过氧化物酶4受抑制,细胞膜脂质发生过氧化导致细胞死亡。EMs病灶表现为铁死亡抵抗,这一特征导致异位内膜清除障碍并促进其增殖与迁移;而部分细胞又可通过铁死亡促进血管生成。铁死亡导致的精子和卵细胞损伤及胚胎毒性则进一步导致EMs相关性不孕。

Research Progress of Ferroptosis in Endometriosis

Endometriosis as a common gynecological benign disease, however, has malignant behaviors such as invasion, infiltration, and distant metastasis. Ferroptosis is a newly discovered form of programmed cell death mainly characterized by the excessive intracellular free Fe²⁺ that mediates the Fenton reaction to produce hydroxyl radicals, inhibition of the intracellular antioxidant enzyme glutathione peroxidase 4, and peroxidation of cell membrane lipids leading to cell death. Endometriosis lesions exhibit ferroptosis resistance, a feature that impairs ectopic endometrial clearance and promotes their proliferation and migration. And part of the cells in turn promotes angiogenesis through ferroptosis. Sperm and oocyte damage as well as embryotoxicity from ferroptosis contribute further to endometriosis related infertility.