摘要
细胞凋亡是一种程序性细胞死亡方式,在妊娠生理和病理过程中扮演着关键角色。细胞异常凋亡,尤其是胎盘滋养细胞的过度凋亡,可能导致滋养细胞功能障碍、血管重塑异常、氧化应激增加和免疫失衡,进而引发复发性流产(recurrent spontaneous abortion,RSA)、子痫前期(preeclampsia,PE)、妊娠期糖尿病(gestational diabetes mellitus,GDM)和早产等不良妊娠结局。研究表明,细胞凋亡的调控对妊娠至关重要。在RSA中,p53介导的凋亡和微小RNA-184(miR-184)、mi R-27a的异常表达破坏滋养细胞的增殖与凋亡平衡。在PE中,miR-4531/CX3CL1信号通路通过调控血管内皮损伤参与PE发病机制。在GDM中,胃饥饿素通过下调内质网应激信号通路显示出潜在治疗价值。在早产中,内质网应激通过肌醇需求酶1α(inositol-requiring enzyme 1α,IRE1α)/c-Jun氨基端蛋白激酶(c-Jun N-terminal protein kinase,JNK)通路诱导早产儿肺上皮细胞凋亡。未来需深入研究细胞凋亡的机制及治疗靶点,为预防和治疗不良妊娠结局提供新思路。
Apoptosis is a programmed cell death that plays a crucial role in the physiological and pathological processes of pregnancy.Abnormal apoptosis,especially excessive apoptosis of trophoblast cells in the placenta,may lead to trophoblast dysfunction,abnormal vascular remodeling,increased oxidative stress,and immune imbalance,thereby cause adverse pregnancy outcomes such as recurrent spontaneous abortion(RSA),pre-eclampsia(PE),gestational diabetes mellitus(GDM),and preterm birth.The regulation of apoptosis is vital for pregnancy.In the RSA,p53-mediated apoptosis and abnormal expression of miR-184 and miR-27a disrupt the balance between trophoblast proliferation and apoptosis.In PE,the miR-4531/CX3CL1 signaling pathway is involved in the pathogenesis of PE by regulating vascular endothelial injury.In GDM,ghrelin shows potential therapeutic value by downregulating the endoplasmic reticulum stress signaling pathway.In preterm birth,endoplasmic reticulum stress induces apoptosis of alveolar epithelial cells via the inositol-requiring enzyme 1α(IRE1α)/c-Jun N-terminal protein kinase(JNK)pathway.Future research needs to further explore its mechanisms and therapeutic targets to provide new ideas for the prevention and treatment of adverse pregnancy outcomes.
作者
马玲
李亚西
赵敏
王静(审校)
李红丽
MA Ling;LI Ya-xi;ZHAO Min;WANG Jing;LI Hong-li(The First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,China;The First Hospital of Lanzhou University,Lanzhou 730000,China)
出处
《国际妇产科学杂志》
2025年第2期121-126,共6页
Journal of International Obstetrics and Gynecology
关键词
细胞凋亡
妊娠结局
流产
习惯性
先兆子痫
糖尿病
妊娠
早产
Apoptosis
Pregnancy outcome
Abortion,habitual
Pre-eclampsia
Diabetes,gestational
Premature birth
