Quercetin as a multifaceted therapeutic agent in recurrent pregnancy loss: Mechanisms and clinical perspectives.

Abstract

In recent years, there has been an escalating incidence of recurrent pregnancy loss (RPL), imposing substantial psychosocial and economic burdens on families. Despite extensive investigations, approximately 50% of cases remain idiopathic, underscoring the intricate nature of potential pathogenic mechanisms. Quercetin (QUE), a prevalent flavonoid compound, exhibits potential in the therapeutic modulation of RPL by influencing endocrine, coagulation, oxidative stress, inflammation, and immune responses. This review aims to elucidate the potential role of QUE in RPL, explore its molecular mechanisms, and delineate its therapeutic significance. Herein, we synthesize existing evidence on the impact of QUE in RPL, particularly in traditional Chinese medicine, accentuating areas necessitating further exploration. QUE demonstrates regulatory prowess over RPL by modulating endocrine functions, encompassing thyroid functionality, diabetes, polycystic ovary syndrome, and luteal phase defects. It exhibits anti-inflammatory and antioxidant properties, influences coagulation functions, and affects immune cells such as T cells, T helper cells, macrophages, and natural killer cells. QUE also interacts with maternal-fetal interface cells, including myeloid-derived suppressor cells, stromal cells, and extravillous trophoblast cells, highlighting its multifaceted role in the modulation of RPL. Despite promising preclinical data, clinical trials directly targeting RPL remain limited. We emphasize the need for rigorous human studies to validate QUE's efficacy and safety in pregnancy. By elucidating the mechanistic underpinnings of QUE in treating RPL, this research may contribute to developing targeted interventions for RPL and other adverse pregnancy conditions, ultimately ameliorating reproductive health and well-being for affected individuals and families.