Objective and Design

The purpose of the review was to gather information on the role and possibilities of using lipoxin in the treatment of infertility and maintaining a normal pregnancy. Ovulation, menstruation, embryo implantation, and childbirth are reactions representing short-term inflammatory events involving lipoxin activities. Lipoxin A4 (LXA4) is an arachidonic acid metabolite, and in cooperation with its positional isomer lipoxin B4 (LXB4), it is a major lipoxin in mammals. Biosynthesis process occurs in two stages: in the first step, the donor cell releases the eicosanoid intermediate; secondarily, the acceptor cell gets and converts the intermediate product into LXA4 (leukocyte/platelet interaction).

Results

Generating lipoxin synthesis may also be triggered by salicylic acid, which acetylates cyclooxygenase-2. Lipoxin A4 and its analogues are considered as specialized pro-resolving mediators. LXA4 is an important component for a proper menstrual cycle, embryo implantation, pregnancy, and delivery. Its level in the luteal phase is high, while in the follicular phase, it decreases, which coincides with an increase in estradiol concentration with which it competes for the receptor. LXA4 inhibits the progression of endometriosis. However, during the peri-implantation period, before pregnancy is confirmed clinically, high levels of LXA4 can contribute to early pregnancy loss and may cause miscarriage. After implantation, insufficient LXA4 levels contribute to incorrect maternal vessel remodeling; decreased, shallow trophoblastic invasion; and the immuno-energetic abnormality of the placenta, which negatively affects fetal growth and the maintenance of pregnancy. Moreover, the level of LXA4 increases in the final stages of pregnancy, allowing vessel remodeling and placental separation.

Methods

The review evaluates the literature published in the PubMed and Embase database up to 31 December 2019. The passwords were checked on terms: lipoxin and pregnancy with combined endometriosis, menstrual cycle, implantation, pre-eclampsia, fetal growth restriction, and preterm labor.

Conclusions

Although no human studies have been performed so far, the cell and animal model study results suggest that LXA4 will be used in obstetrics and gynecology soon.

中文翻译：

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怀孕期间和每月周期中脂氧素水平的变化，决定了怀孕或病理的正常过程。

目标与设计

审查的目的是收集有关使用脂氧素治疗不孕症和维持正常妊娠的作用和可能性的信息。排卵、月经、胚胎植入和分娩是代表涉及脂氧素活性的短期炎症事件的反应。脂氧素 A4 (LXA4) 是一种花生四烯酸代谢物，与其位置异构体脂氧素 B4 (LXB4) 共同作用，是哺乳动物体内的主要脂氧素。生物合成过程分两个阶段进行：第一步，供体细胞释放类花生酸中间体；其次，受体细胞获得中间产物并将其转化为 LXA4（白细胞/血小板相互作用）。

结果

生成脂氧素合成也可能由水杨酸触发，水杨酸乙酰化 cyclooxygenase-2。脂氧素 A4 及其类似物被认为是专门的促分解介质。LXA4 是正常月经周期、胚胎植入、怀孕和分娩的重要组成部分。它在黄体期的水平很高，而在卵泡期，它会降低，这与它竞争受体的雌二醇浓度的增加相吻合。LXA4 抑制子宫内膜异位症的进展。然而，在临床证实妊娠之前的围着床期，高水平的 LXA4 会导致早期妊娠丢失并可能导致流产。植入后，LXA4 水平不足会导致母体血管重塑不正确；减少，浅滋养细胞侵袭；以及胎盘的免疫能量异常，这对胎儿的生长和妊娠的维持产生负面影响。此外，LXA4 水平在妊娠的最后阶段增加，允许血管重塑和胎盘分离。

方法

该评论评估了截至 2019 年 12 月 31 日在 PubMed 和 Embase 数据库中发表的文献。密码检查的术语有：脂氧素和妊娠合并子宫内膜异位症、月经周期、植入、先兆子痫、胎儿生长受限和早产。

结论

虽然到目前为止还没有进行人体研究，但细胞和动物模型研究结果表明，LXA4 将很快用于妇产科。