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.