Introduction

Adenomyosis (AM) means to a type of estrogen-dependent disease in which active endometrial tissue (glandular and interstitial) appears in the myometrium1, accompanied by hypertrophy and hyperplasia of the surrounding myometrial tissues2, severe endometriosis is associated with adenomyosis with a deeper myometrial invasion3. The condition can present with debilitating symptoms (heavy menstrual flow, prolonged menstrual periods, progressive aggravation dysmenorrhea, large uterine) that have considerable adverse impacts on quality of life4, including an increased risk of secondary infertility5. Studies have shown that the incidence of AM is 10 to 15% and equating to 190 million women worldwide6, 7. At present, the pathogenesis of adenomyosis remains unclear. Adenomyosis is a benign disease, but it has some pathophysiological characteristics similar to the malignant tumor, such as regulating cytoskeleton inducing migration and invasion8. Therefore, the regulation of cytoskeleton, migration and invasion ability of the endometrium may be the critical factor in the occurrence of adenomyosis, but the exact mechanisms need further exploration.
Cell migration requires cytoskeletal reorganization, which plays a critical role in cancer metastasis9, 10. In particular, some classical signaling pathways are involved during cytoskeletal reorganization, such as Rho/ROCK signaling pathway11, 12. Guizhi can regulate the cytoskeleton through the Rho/ROCK signaling pathway. Therefore, the interactions among Guizhi, Rho/ROCK signaling, and the cytoskeleton underlie the ability of a cell to become motile, eventually leading to tumor migration13-16. Trans-cinnamaldehyde (TC) is the main active constituent of Guizhi which is a traditional Chinese herbal medicine17.however, their role and mechanism in AMDC remain unclear.
Our research group support the theory of AM derived from the invasion and migration of the endometrium and identified cell subcluster with tumour-associated characteristics18. What’s more, Traditional Chinese medicine prescription Guizhi Fuling Pills in the treatment of endometriosis is supported19. Even though the underlying mechanism is not known yet, based on this research basis, the current evidence does encourage us to dig out the role of TC to AMDC may relate to Rho/ROCK signaling pathway to regulate cytoskeleton-induced invasion and migration.