Research progress of macrophage metabolic reprogramming in recurrent spontaneous abortion

doi:10.3969/j.issn.1674-8115.2026.04.014

Abstract

Abstract:

The mechanisms underlying recurrent spontaneous abortion (RSA) remain unclear, as its pathogenesis is complex and involves multiple immune and metabolic factors. In recent years, increasing attention has been directed toward the mechanisms by which macrophages influence embryo implantation and pregnancy maintenance through metabolic pathways. Macrophage metabolism primarily encompasses glucose metabolism, lipid metabolism, and amino acid metabolism. Glucose metabolism drives M1 macrophage polarization primarily through glycolysis, while reduced fatty acid oxidation is associated with impaired anti-inflammatory functions of macrophages. Cholesterol accumulation exacerbates local inflammatory responses, and lipid metabolism imbalances may also affect decidual angiogenesis and placental development. Current research has confirmed that metabolic disturbances in the local decidual microenvironment, such as hypoxia and oxidative stress, can directly induce metabolic reprogramming of macrophages, subsequently affecting their pro-inflammatory or anti-inflammatory conversion. However, the specific mechanisms of key metabolic nodes of macrophages of pregnancy immune regulation, as well as the feasibility of targeted intervention through metabolic pathways, still require further investigation. This article reviews the role of macrophages in recurrent spontaneous abortion, focusing on metabolic reprogramming as a core regulatory node. It delves into how imbalances in glucose, lipid, and amino acid metabolism drive macrophage dysfunction, thereby affecting the establishment and maintenance of the immune-tolerant microenvironment at the maternal-fetal interface, aiming to provide new perspectives for the prevention and treatment of RSA.

Key words: recurrent spontaneous abortion, macrophages, metabolic pathways, embryo implantation, pregnancy stability

CLC Number:

R714.21

Du Xin, Li Xuebing, Li Yongwei. Research progress of macrophage metabolic reprogramming in recurrent spontaneous abortion[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026, 46(4): 537-544.

Figures/Tables 1

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References 59

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