免疫细胞驱动子宫内膜异位症纤维化：机制与治疗意义

谭佳蓉; 欧阳祝青; 秦宏喆; 申复进

doi:10.14188/j.1671-8852.2026.1171

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免疫细胞驱动子宫内膜异位症纤维化：机制与治疗意义

更新时间：2026-10-15

- 免疫细胞驱动子宫内膜异位症纤维化：机制与治疗意义
- Immune cells driving fibrosis in endometriosis: mechanisms and therapeutic implications
- 武汉大学学报（医学版） 2026年页码：1-10
- 作者机构：
  
  武汉大学人民医院妇产科湖北武汉 430060
- 作者简介：
  
  谭佳蓉，女，2002—，医学硕士生，主要从事子宫内膜异位症机制研究，E⁃mail：2966991498@qq.com。
  申复进，E⁃mail：sfj296@163.com。
- 基金信息：
  
  湖北省卫生健康科技面上项目(WJ2025M071);白求恩·医学进阶科研基金(2023⁃YJ⁃152⁃J⁃048)
- DOI：10.14188/j.1671-8852.2026.1171
  中图分类号： R711.71
- 网络首发：2026-10-15，
- 稿件说明：
移动端阅览
谭佳蓉, 欧阳祝青, 秦宏喆, 等. 免疫细胞驱动子宫内膜异位症纤维化：机制与治疗意义[J/OL]. 武汉大学学报（医学版）, 2026,1-10.

TAN Jiarong, OUYANG Zhuqing, QIN Hongzhe, et al. Immune cells driving fibrosis in endometriosis: mechanisms and therapeutic implications[J/OL]. Medical Journal of Wuhan University, 2026, 1-10.
谭佳蓉, 欧阳祝青, 秦宏喆, 等. 免疫细胞驱动子宫内膜异位症纤维化：机制与治疗意义[J/OL]. 武汉大学学报（医学版）, 2026,1-10. DOI： 10.14188/j.1671-8852.2026.1171.

TAN Jiarong, OUYANG Zhuqing, QIN Hongzhe, et al. Immune cells driving fibrosis in endometriosis: mechanisms and therapeutic implications[J/OL]. Medical Journal of Wuhan University, 2026, 1-10. DOI： 10.14188/j.1671-8852.2026.1171.

摘要

子宫内膜异位症（EMs）是一种以慢性炎症、异常免疫应答及进行性纤维化为主要特征的雌激素依赖性疾病。近年来研究表明，纤维化不仅是EMs病灶成熟和疾病进展的重要病理特征，也是导致盆腔粘连、慢性盆腔痛及不孕等临床结局的重要基础。已有研究证实，免疫细胞异常活化及免疫微环境失衡贯穿EMs纤维化全过程。其中，巨噬细胞、肥大细胞、中性粒细胞、自然杀伤细胞及不同T细胞亚群通过分泌炎症及促纤维化因子，调控上皮⁃间质转化（EMT）、成纤维细胞⁃肌成纤维细胞转化（FMT）、细胞外基质（ECM）沉积及组织重塑等多种途径，共同促进病灶纤维化形成。随着单细胞转录组、空间转录组等新技术的发展，EMs免疫微环境及免疫细胞间相互作用机制得到进一步阐明，也为免疫调控治疗提供了新的理论基础。目前，靶向炎症因子、巨噬细胞重编程、免疫检查点及免疫耐受等策略已展现出一定的抗纤维化潜力。本文围绕EMs纤维化过程中不同免疫细胞的作用及其分子机制进行综述，并总结近年来免疫调控治疗的研究进展，以期为EMs抗纤维化治疗及精准免疫干预提供新的研究思路。

Abstract

Endometriosis (EMs) is an estrogen⁃dependent disease characterized primarily by chronic inflammation

abnormal immune responses

and progressive fibrosis. Recent studies have demonstrated that fibrosis not only serves as a critical pathological feature of lesion maturation and disease progression in EMs but also constitutes a fundamental basis for clinical outcomes such as pelvic adhesions

chronic pelvic pain

and infertility. Growing evidence suggests that abnormal activation of immune cells and dysregulation of the immune microenvironment persist throughout the entire fibrotic process of EMs. Macrophages

mast cells

neutrophils

natural killer cells

and various T⁃cell subsets contribute to fibrosis formation by secreting pro⁃inflammatory and pro⁃fibrotic factors

regulating multiple pathways

including epithelial⁃mesenchymal transition (EMT)

fibroblast⁃myofibroblast transformation (FMT)

extracellular matrix (ECM) deposition

and tissue remodeling. Advances in single⁃cell transcriptomics and spatial transcriptomics have further elucidated the mechanisms of immune microenvironment interactions and intercellular communication within EMs

providing novel theoretical foundations for immunomodulatory therapies. Current strategies targeting inflammatory cytokines

macrophage reprogramming

immune checkpoints

and immune tolerance have shown certain anti⁃fibrotic potential. This review examines the roles and molecular mechanisms of various immune cells during EMs fibrosis and summarizes recent progress in immunomodulatory therapies

aiming to offer new insights for anti⁃fibrotic treatment and precision immunotherapy in EMs.

关键词

Keywords

references

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