子宫肌瘤 (UF) 是育龄妇女最常见的肿瘤，其特征是性类固醇依赖性生长和 UF 平滑肌细胞周围细胞外基质 (ECM) 过度沉积。患有症状性尿毒症的女性会经历大量月经出血并随之而来的缺铁性贫血。她们还存在反复流产、早产和剖腹产的风险，这表明UF会对生殖结果产生负面影响。在UF中观察到各种类型的免疫细胞，包括先天性和适应性细胞；然而，这些细胞对 UF 病理生理学的影响仍不清楚。炎症可能在 UF 的生长中发挥重要作用，并且促炎和炎症细胞因子的表达水平在 UF 中上调，例如白细胞介素 (IL)-1、IL-6、IL-10、TNF-α 和 TGF-β 。这些细胞因子在生长因子和 ECM 之间的相互作用中发挥着重要作用，而 ECM 受性类固醇雌激素和黄体酮的调节。此外，促炎介质在有UF的女性中上调，在有粘膜下和壁内UF的子宫内膜中表达水平高于没有UF的子宫内膜，表明这些促炎细胞因子可能损害子宫内膜容受性，导致体外受精计划中的着床失败。使用促性腺激素释放激素类似物和选择性黄体酮受体调节剂醋酸乌利司他的激素治疗可显着缩小 UF 并改善 UF 相关症状。这些化合物可以调节UF和邻近子宫肌层的局部炎症。控制和改善由 UF 引起的局部炎症可能代表了一种新的 UF 治疗策略，并有可能改善有症状的 UF 女性的生殖结果。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

Uterine fibroids (UFs), the most common tumors in women of reproductive age, are characterized by sex steroid-dependent growth and excessive deposition of extracellular matrix (ECM) surrounding UF smooth muscle cells. Women with symptomatic UFs experience heavy menstrual bleeding and consequent iron-deficiency anemia. They also have a risk of recurrent pregnancy loss, preterm birth, and cesarean delivery, indicating that UFs can negatively affect reproductive outcomes. Various types of immune cells, including innate and adaptive cells, are observed in UFs; however, the impact of these cells on the pathophysiology of UFs remains unclear. Inflammation may play important roles in the growth of UFs, and expression levels of proinflammatory and inflammatory cytokines, such as interleukin (IL)-1, IL-6, IL-10, TNF-α, and TGF-β, are upregulated in UFs. These cytokines play important roles in the interaction between growth factors and ECM that is regulated by the sex steroids estrogen and progesterone. Furthermore, proinflammatory mediators are upregulated in females with UFs, with higher expression levels in the endometrium with submucosal and intramural UFs than in the endometrium without UFs, indicating that these proinflammatory cytokines may impair endometrial receptivity, leading to implantation failure in in vitro fertilization programs. Hormonal treatments using gonadotropin releasing hormone analogs and the selective progesterone receptor modulator ulipristal acetate significantly shrink UFs and improve UF-related symptoms. These compounds can regulate local inflammation in UFs and adjacent myometrium. Controlling and improving local inflammation caused by UFs may represent a novel therapeutic strategy for UFs and potentially improve reproductive outcomes in women with symptomatic UFs.Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.