肿瘤坏死因子-α与卵巢疾病的研究进展
Research Progress on Tumor Necrosis Factor-α and Ovarian Diseases
摘要: 卵巢疾病，包括多囊卵巢综合征(PCOS)、卵巢子宫内膜异位症(OEM)、卵巢癌(OC)等，通过炎症因子介导(如TNF-α)的发病机制影响患者生殖功能与内分泌稳态。TNF-α作为炎症反应的核心调控因子，通过激活NF-κB、MAPK及凋亡信号通路，在卵巢疾病进程中发挥重要作用。在PCOS的病理进程中，TNF-α参与并加剧胰岛素抵抗与慢性炎症状态，进而促进高雄激素血症，这些因素共同作用，可能最终对卵巢储备功能(OR)产生不利影响；而在OEM及OC等疾病进展中，TNF-α的增加改变了卵巢微环境，损伤卵泡，导致卵巢卵巢储备功能减退(DOR)。卵巢疾病对女性长期健康及生育力造成损害，从而显著降低女性的生活质量，近年来备受关注。基于此，TNF-α抑制剂及相关该通路的药物可用于治疗卵巢疾病，但相关药物属于超说明书用药，目前研究较少；这类药物长期使用对卵巢储备功能(OR)、生育力及潜在的母婴安全性影响尚不明确。本文将对TNF-α与卵巢疾病发病机制及目前针对该通路的药物疗效进行综述，为卵巢疾病临床治疗及卵巢功能保护提供新思路。
Abstract: Ovarian diseases, including polycystic ovary syndrome (PCOS), ovarian endometriosis (OEM), and ovarian cancer (OC), affect patients’ reproductive function and endocrine homeostasis through mechanisms mediated by inflammatory factors such as TNF-α. As a core regulatory factor of the inflammatory response, TNF-α plays a significant role in the progression of ovarian diseases by activating NF-κB, MAPK, and apoptotic signaling pathways. In the pathological process of PCOS, TNF-α is involved in and exacerbates insulin resistance and chronic inflammation, which in turn promotes hyperandrogenemia. These factors collectively may ultimately have an adverse effect on ovarian reserve (OR). In the progression of diseases such as OEM and OC, the increase of TNF-α alters the ovarian microenvironment, damaging follicles and leading to diminished ovarian reserve (DOR). Ovarian diseases damage long-term health and fertility in women, significantly reducing their quality of life, and have gained considerable attention in recent years. Based on this, TNF-α inhibitors and medications related to this pathway could be used to treat ovarian diseases; however, these medications fall under off-label use, and there is currently limited research on them. The long-term effects of such drugs on ovarian reserve (OR), fertility, and potential mother-infant safety remain unclear. This article will review the role of TNF-α in the pathogenesis of ovarian diseases and the efficacy of current medications targeting this pathway, providing new insights for clinical treatment and ovarian function preservation.
文章引用：潘慧聪, 李彤, 叶喜阳. 肿瘤坏死因子-α与卵巢疾病的研究进展[J]. 临床医学进展, 2025, 15(10): 2407-2414. https://doi.org/10.12677/acm.2025.15103026

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