Research Progress of Caspase in Endometriosis

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This review examines caspase family proteases, their role in apoptosis and pyroptosis, and their potential involvement in endometriosis pathogenesis and treatment strategies.

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This paper is a narrative review examining recent research on caspases and their roles in endometriosis pathogenesis, focusing on apoptosis and inflammatory cell death (including pyroptosis) alongside broader processes such as estrogen dependence, inflammation, and ectopic lesion behavior. Drawing together evidence from molecular pathways, immune/inflammatory mediators, and cell-death mechanisms, the authors highlight that caspase-family proteases act as key initiators linking apoptotic dysregulation and inflammatory signaling in endometriosis. A major caveat is that the work is a review, not an original study, so it synthesizes existing findings without providing new experimental data and includes the heterogeneity of underlying studies as an implicit limitation. This paper is centrally about endometriosis — it reviews caspase function and proposes how caspases may contribute to endometriosis development through apoptosis and pyroptosis-related inflammation.

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Abstract

Endometriosis, a common chronic gynecological disease, refers to the presence and proliferation of endometrial tissue in locations other than the uterine cavity. Approximately 6 to 10% of the population of women of childbearing age are known to have endometriosis; the most common clinical signs are pelvic pain and infertility. Although endometriosis is a benign disease, it exhibits some typical features of malignant tumors, such as proliferation, invasion, metastasis, and recurrence. Endometriosis is considered a chronic, inflammatory, and estrogen-dependent disease, and multiple factors contribute to its occurrence and development. In recent years, increasing attention has been given to the role of apoptosis in the pathogenesis of this disease. Some researchers believe that spontaneous apoptosis of the endometrium is critical in maintaining its normal structure and function, and abnormal apoptosis can promote the occurrence and development of endometriosis. Inflammation is another likely process in the pathogenesis of endometriosis. Inflammation mediates the adhesion, proliferation, differentiation, and invasion of ectopic lesions of endometriosis, primarily by regulating the function of immune cells and increasing the level of proinflammatory cytokines in body fluids. The ultimate initiators of apoptosis and inflammatory cell death (pyroptosis) are the caspase family proteases. In this article, we review the progress in recent years in caspase function as well as the possible role of these enzymes in the pathogenesis of endometriosis, indicating potential treatment strategies.
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Abstract

Endometriosis, a common chronic gynecological disease, refers to the presence and proliferation of endometrial tissue in locations other than the uterine cavity. Approximately 6 to 10% of the population of women of childbearing age are known to have endometriosis; the most common clinical signs are pelvic pain and infertility. Although endometriosis is a benign disease, it exhibits some typical features of malignant tumors, such as proliferation, invasion, metastasis, and recurrence. Endometriosis is considered a chronic, inflammatory, and estrogen-dependent disease, and multiple factors contribute to its occurrence and development. In recent years, increasing attention has been given to the role of apoptosis in the pathogenesis of this disease. Some researchers believe that spontaneous apoptosis of the endometrium is critical in maintaining its normal structure and function, and abnormal apoptosis can promote the occurrence and development of endometriosis. Inflammation is another likely process in the pathogenesis of endometriosis. Inflammation mediates the adhesion, proliferation, differentiation, and invasion of ectopic lesions of endometriosis, primarily by regulating the function of immune cells and increasing the level of proinflammatory cytokines in body fluids. The ultimate initiators of apoptosis and inflammatory cell death (pyroptosis) are the caspase family proteases. In this article, we review the progress in recent years in caspase function as well as the possible role of these enzymes in the pathogenesis of endometriosis, indicating potential treatment strategies. Similar content being viewed by others Data Availability Any of the information can be obtained from the authors on request. Code Availability Not applicable. Abbreviations - EMS: - Endometriosis - GnRH-a: - Gonadotropin-releasing hormone agonist - IL-1β: - Interleukin-1 beta - IL-16: - Interleukin-16 - GSDMD: - Gasdermin-D - SOCS-3: - Suppressor of cytokine signaling-3 - CESCs: - Endometrial stromal cells from non-endometriotic controls - ESC: - Endometrial stromal cell - APEX1: - Apurinic-apyrimidinic endonuclease-1 - NF-κB/iNOS: - NF-kappaB/inducible nitric oxide synthase - MALAT1: - Metastasis-associated lung adenocarcinoma transcript 1 - COX-2: - Cyclooxygenase-2 - H2O2 : - Hydrogen peroxide - NK: - Natural killer - NLRP3: - NOD-like receptor family pyrin domain–containing protein 3 - PRR: - Pattern recognition receptor - ASC: - Apoptosis-associated speck-like protein containing a CARD - TRIM24: - Tripartite motif–containing protein 24 - SRC-1: - Steroid receptor coactivator-1 - AEG-1: - Astrocyte elevated gene-1 - TNF-α: - Tumor necrosis factor-alpha - NALP3: - NACHT-LRRPYD-containing protein 3 - KS: - Kallistatin - MIS: - Mullerian inhibiting substance - RES: - Resveratrol - RSG: - Rosiglitazone - CNYP: - Neiyi prescription - UA: - Ursolic acid - PARP: - Poly ADP-ribose polymerase - MMP-3: - Matrix metalloproteinase-3

References

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Acknowledgements

We would like to thank Yi Huang for her help in developing the search literature and for her assistance in the completion of the manuscript. Funding The study received financial support from the National Natural Science Foundation of China 82260305 and 81960275, the Health Industry Research Program of Gansu Province (GSWSKY2022-60), and the Key Research and Development Plan of Gansu Province (21YF5A119). Author information Authors and Affiliations Contributions YY, LLL, and YXQ were mainly responsible for conception and design, data collection, and manuscript drafting. DJL supervised the whole project from conception and design, draft of the manuscript, rigorous revision of the manuscript, final review and submission for publication, and consideration of corresponding authors. All authors have read and agreed to publish the manuscript. Corresponding author Ethics declarations Ethics Approval Not applicable. Consent to Participate Not applicable. Consent for Publication Not applicable. Competing Interests Not applicable. Additional information Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary information ESM 1 (download PDF ) (PDF 288 kb) ESM 2 (download PDF ) (PDF 577 kb) ESM 3 (download PDF ) (PDF 534 kb) ESM 4 (download PDF ) (PDF 172 kb) Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Yang, Y., Li, LL., Qi, YX. et al. Research Progress of Caspase in Endometriosis. Reprod. Sci. 31, 1496–1507 (2024). https://doi.org/10.1007/s43032-023-01425-3 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-023-01425-3

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