Research progress on the mechanism of vitamin D expression in the pathogenesis of endometriosis

doi:10.12092/j.issn.1009-2501.2026.05.017

Abstract

Abstract:

Endometriosis (EMT) is a gynecological disease with high clinical incidence, with dysmenorrhea and pelvic pain as the main symptoms. The pathogenesis is closely related to immune response, inflammation, cell proliferation and apoptosis. In recent years, studies have found that vitamin D has regulatory effects on bone metabolism, calcium and phosphorus balance, and apoptosis. It is also involved in the pathogenesis of chronic inflammatory diseases, immune diseases and tumor diseases. This article analyzes the mechanism of vitamin D in the pathogenesis of EMT and its clinical diagnosis and treatment application effect from immune response, inflammatory response, cell proliferation and apoptosis. The results showed that immune response, inflammatory response, cell proliferation and apoptosis were the main mechanisms of vitamin D involved in the occurrence and progression of EMT, which had certain predictive value for the occurrence, development and pregnancy outcome of EMT, which could be used as a new idea and target for non-invasive treatment for endometriosis.

Key words: vitamin D, endometriosis, pathogenesis, diagnosis, treatment, review

CLC Number:

R711.71

Qun ZHANG, Hui SHI, Lingling DAI, Jingjing GAO. Research progress on the mechanism of vitamin D expression in the pathogenesis of endometriosis[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(5): 716-720.

References 31

1	Kalaitzopoulos DR, Lempesis IG, Athanasaki F, et al. Association between vitamin D and endometriosis: a systematic review[J]. Hormones (Athens), 2020, 19 (2): 109- 121. doi: 10.1007/s42000-019-00166-w
2	濮义福, 栗雅楠. 一项25-羟维生素D水平与子宫内膜异位症的两样本孟德尔随机化研究[J]. 中国优生与遗传杂志, 2023, 31 (10): 1980- 1986.
3	Qiu Y, Yuan S, Wang H. Vitamin D status in endometriosis: a systematic review and meta-analysis[J]. Arch Gynecol Obstet, 2020, 302 (1): 141- 152. doi: 10.1007/s00404-020-05576-5
4	Yarmolinskaya M, Denisova A, Tkachenko N, et al. Vitamin D significance in pathogenesis of endometriosis[J]. Gynecol Endocrinol, 2021, 37 (sup1): 40- 43. doi: 10.1080/09513590.2021.2006516
5	廖琪, 徐芳, 冯晓玲, 等. 维生素D调控子宫内膜异位症免疫学发病机制的研究进展[J]. 中华生殖与避孕杂志, 2024, 44 (10): 1002- 1008.
6	Carlberg C, Raczyk M, Zawrotna N. Vitamin D: a master example of nutrigenomics[J]. Redox Biol, 2023, 62 (4): 102695. doi: 10.1016/j.redox.2023.102695
7	田中秋, 李慧, 欧阳青. 1, 25-二羟维生素D(1, 25-(OH)2D)和CYP27A1 mRNA表达与肺结核的相关性研究[J]. 中国病原生物学杂志, 2024, 19 (12): 1408- 1412+1419.
8	Lopez A, Cruz ML, Chompre G, et al. Influence of stress on the vitamin D-Vitamin D receptor system, macrophages, and the local inflammatory milieu in endometriosis[J]. Reprod Sci, 2020, 27 (12): 2175- 2186. doi: 10.1007/s43032-020-00235-1
9	Le NXH, Loret de Mola JR, Bremer P, et al. Alteration of systemic and uterine endometrial immune populations in patients with endometriosis[J]. Am J Reprod Immunol, 2021, 85 (3): e13362. doi: 10.1111/aji.13362
10	Olkowska-Truchanowicz J, Białoszewska A, Zwierzchowska A, et al. Peritoneal fluid from patients with ovarian endometriosis displays immunosuppressive potential and stimulates Th2 response[J]. Int J Mol Sci, 2021, 22 (15): 8134. doi: 10.3390/ijms22158134
11	Adur MK, Braundmeier-Fleming AG, Lessey BA, et al. Altered eutopic endometrial T-regulatory and T-helper 17 lymphocyte ratio in women with unexplained subfertility[J]. J Endometr Pelvic Pain Disord, 2021, 13 (3): 185- 194. doi: 10.1177/22840265211018544
12	Ingles SA, Wu L, Liu BT, et al. Differential gene expression by 1, 25(OH)₂ D₃ in an endometriosis stromal cell line[J]. J Steroid Biochem Mol Biol, 2017, 173 (10): 223- 227.
13	Pashizeh F, Mansouri R, Davari-Tanha F, et al. Alterations of CD4+T cell subsets in blood and peritoneal fluid in different stages of endometriosis[J]. Int J Fertil Steril, 2020, 14 (3): 201- 208.
14	刘洋, 王宇, 丛晶, 等. 中药调控NF-κB信号通路防治子宫内膜异位症作用机制的研究进展[J]. 上海中医药杂志, 2023, 57 (8): 89- 95.
15	刘雅倩, 徐胜前, 杨小珂. 1, 25-二羟维生素D₃通过NF-κB通路改善骨关节炎软骨细胞模型的炎症反应及细胞凋亡[J]. 临床和实验医学杂志, 2021, 20 (23): 2497- 2500.
16	韦成厚, 韩立薇, 张婧, 等. 维生素D在子宫内膜异位症免疫发病机制中的作用研究[J]. 中国现代医药杂志, 2022, 24 (8): 19- 22. doi: 10.3969/j.issn.1672-9463.2022.08.004
17	Liu Y, Wang J, Zhang X. An update on the multifaceted role of NF-kappaB in endometriosis[J]. Int J Biol Sci, 2022, 18 (11): 4400- 4413.
18	Ilchovska DD, Barrow DM. An overview of the NF-kB mechanism of pathophysiology in rheumatoid arthritis, investigation of the NF-kB ligand RANKL and related nutritional interventions[J]. Autoimmun Rev, 2021, 20 (2): 102741.
19	奚晓雪, 陈婷, 侯顺玉, 等. 子宫内膜异位症病人卵巢储备功能与维生素D的关系研究[J]. 安徽医药, 2021, 25 (10): 1985- 1989.
20	邹巧瑜. 血清维生素D水平对子宫内膜异位症患者病情发展的预测价值[J]. 中国医学创新, 2020, 17 (17): 148- 152.
21	吴椒虹, 陈新艳, 郭敏, 等. 血清1, 25-(OH)₂D₃水平与盆腔子宫内膜异位症的相关性研究[J]. 中国性科学, 2021, 30 (4): 55- 57.
22	张倩, 李娟娟, 贾丽华. 血清维生素D、糖类抗原125及高迁移率簇蛋白B1水平与子宫内膜异位症患者临床分期的相关性分析[J]. 实用医院临床杂志, 2021, 18 (4): 23- 26.
23	Moolhuijsen LME, Visser JA. Anti-müllerian hormone and ovarian reserve: update on assessing ovarian function[J]. J Clin Endocrinol Metab, 2020, 105 (11): 3361- 3373.
24	王秋艳, 张夏璐. 血清25(OH)D、AMH、IGF-1、IGFBP-3在PCOS患者中的水平及意义[J]. 检验医学与临床, 2023, 20 (9): 1255- 1258.
25	Bednarska-Czerwińska A, Olszak-Wąsik K, Olejek A, et al. Vitamin D and anti-müllerian hormone levels in infertility treatment: The change-point problem[J]. Nutrients, 2019, 11 (5): 1053.
26	孙希雅, 陈艺璐, 曾琳, 等. 不孕女性维生素D水平与抗苗勒氏管激素的相关性及对妊娠结局的预测[J]. 北京大学学报(医学版), 2023, 55 (1): 167- 173.
27	李彦秋, 迟洪滨. 维生素D与子宫内膜异位症的研究进展[J]. 中国微创外科杂志, 2013, 23 (11): 865- 868.
28	Pazhohan A, Danaei-Mehrabad S, Mohamad-Rezaeii Z, et al. The modulating effects of vitamin D on the activity of β-catenin in the endometrium of women with endometriosis: a randomized exploratory trial[J]. Gynecol Endocrinol, 2021, 37 (3): 278- 282.
29	Mehdizadehkashi A, Rokhgireh S, Tahermanesh K, et al. The effect of vitamin D supplementation on clinical symptoms and metabolic profiles in patients with endometriosis[J]. Gynecol Endocrinol, 2021, 37 (7): 640- 645.
30	Kalaitzopoulos DR, Samartzis N, Daniilidis A, et al. Effect of Vitamin D supplementation in endometriosis: a systematic review[J]. Report Bio Endocirnol, 2022, 20 (1): 176.
31	Abdullah UH, Lalani S, Syed F, et al. Association of vitamin D with outcome after intra cytoplasmic sperm injection[J]. J Matern Fetal Neonatal Med, 2017, 30 (1): 117- 120.

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