Figure 1.

The role of autophagy in endometrium-related diseases. (a) The level of autophagy in normal menstrual cycle is in a dynamic state. In the proliferative phase, the autophagy activity is relatively low in endometrium cells. When entering into the secretive phase, it significantly increases to the peak in late secretive phase under the control of estrogen and progestogen. And during the menstrual phase, it remains a middle level with the withdrawal of estrogen and progestogen. (b) Autophagy is decreased in endometriosis. On the one hand, the downregulated autophagy can inhibit the activation of NK cells and induce the immune escape of ectopic endometrial stromal cells; on the other hand, the autophagy in endometrial cells may contribute to its migration and invasion. (c) In endometrial carcinoma, the upregulated autophagy is related to its resistance to several drugs, including sorafenib, cisplatin, paclitaxel and so on. Meanwhile, autophagy may also lead to apoptosis of tumor cells and is essential for some other treatment methods, such as metformin and suberoylanilide hydroxamic acid. Autophagy is a double-edged sword in endometrium-related diseases and need to be further explored.