FEATURES OF CHANGES IN THE RATIO OF M1 AND M2 MACROPHAGE SUBPOPULATIONS IN THE ENDOMETRIUM DURING A NORMAL MENSTRUAL CYCLE

Endometrial macrophages are actively involved in various stages of endometrial remodeling, especially during decidualization and pregnancy development. Their role in the functioning of the endometrium is to precisely maintain the balance between pro- and anti-inflammatory reactions during low-intensity inflammation, remodeling and repair of its tissues.. M1 macrophages are characterized by the generation of high levels of proinflammatory cytokines, antimicrobial properties, increased production of reactive nitrogen and oxygen intermediates, and induction of a Th1 response. In contrast, M2 macrophages, by producing anti-inflammatory cytokines, are actively involved in tissue remodeling, immune regulation, tumor development, and efficient phagocytosis. Macrophages constitute 1–2% of all endometrial cells during the estrogen-dominant proliferative phase, and this number increases to 3–5% during the progesterone-dominant secretory phase, with the macrophage population peaking at 6–15% during the menstrual phase. Endocrine communication between macrophages and reproductive tissues is primarily mediated by estrogens, which control the function of endometrial macrophages. Impaired macrophage function and responsiveness may be associated with estrogen- and macrophage-dependent gynecological diseases such as uterine cancer and endometriosis. Nanodrugs using extracellular vesicles, nanoparticles, and non-coding RNAs have recently been applied to modulate macrophage polarization. Despite these advances, the functions of endometrial macrophages under physiological and pathophysiological conditions remain poorly understood, which complicates the development of targeted therapies. Downloads

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