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休眠卵泡激活治疗卵巢早衰的研究进展

The Research Progression in the Treatment of Premature Ovarian Failure with Dormant Follicle Activation

  • 摘要: 卵巢早衰(premature ovarian failure, POF)发病因素复杂,临床表现多样,治疗方法棘手。近年来该病发病率逐渐上升,特别是患者人群有年轻化趋势,对女性患者造成难以估量的身心损害,受到国内外学者广泛关注。目前国内大部分地区治疗POF的主要方法是中医针灸和激素诱导,治疗效果很难达到预期目的,而激活休眠卵泡在国外已经作为治疗POF的最新方法被研究和推广。利用药物、人第10号染色体缺失的磷酸酶及张力蛋白同源物(phosphatase and tensin homolog deleted on chromosome 10, PTEN)抑制剂、表皮细胞生长因子(epidermal growth factor, EGF)等激活休眠卵泡的技术主要是通过磷脂酰肌醇激酶(phosphatidylinositide 3-kinases, PI3K)-PTEN-蛋白激酶B (protein kinase B, AKT)-叉头蛋白O3a(forkhead protein O3a, FOXO3a)、哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin, mTOR)和Hippo等细胞通路或信号轴使休眠卵泡激活而发挥治疗作用。随着激活休眠卵泡的基础研究不断发展,未来更多研究必将逐渐转移到临床应用层面,因此本文回顾了近年来激活休眠卵泡的有关治疗机制和治疗方法的基础研究进展,以期为临床诊疗POF提供理论依据。

     

    Abstract: Premature ovarian failure(POF) has complex pathogenic factors, diverse clinical manifestations and challenging treatment methods. In recent years, the incidence rate of the disease has gradually increased, especially the younger patient population. This disease has caused incalculable physical and mental damage to female patients, and has attracted extensive attention from scholars at home and abroad. Currently, the treatment methods for POF in most parts of the country are mainly traditional Chinese medicine, acupuncture, and hormone induction. The effects of these therapies are difficult to achieve the purpose of expected treatment, and the activation of dormant follicles abroad has started research and promotion as the latest method for the treatment of POF. The techniques of activating dormant follicles using drugs, phosphatase and tensin homolog deleted on chromosome 10(PTEN) inhibitors, epidermal growth factor(EGF) are mainly to activate dormant follicles through cellular pathways or signaling axes such as phosphatidylinositide 3-kinases(PI3K)-PTEN-protein kinase B(AKT)-forkhead protein O3a(FOXO3a), mammalian target of rapamycin(mTOR) and Hippo to play a therapeutic role. With the continuous development of the basic research on the activation of dormant follicles, more research will be gradually transferred to the clinical application level in the future. Therefore, this article reviews the basic research progress on the mechanisms and methods of activating dormant follicles in recent years, which provides a prospective theoretical guidance for the clinical diagnosis and treatment of chronic POF.

     

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