Regulated cell death in endometrial diseases: from molecular mechanisms to targeted therapies.

Abstract

Regulated cell death (RCD) is a fundamental biological process essential for tissue homeostasis and disease regulation. Increasing evidence has demonstrated that RCD plays a pivotal role in the pathogenesis of uterine endometrial diseases, including endometriosis, abnormal decidualization, endometrial receptivity defects, and intrauterine adhesions. However, a comprehensive synthesis centered on the roles of RCD in endometrial diseases is still lacking. This review systematically summarizes the roles of various RCD pathways-apoptosis, autophagy, ferroptosis, pyroptosis, and cuproptosis-in endometrial diseases, emphasizing their interactions with hormonal signaling, molecular mechanisms in different endometrial cells, and cell-cell communication. It also evaluates therapeutic strategies targeting RCD, offering insights into potential interventions for diseases, such as endometriosis, intrauterine adhesion, and embryo implantation failure.