Regulatory Mechanism and Drug Therapy of NLRP3 Inflammasome in Recurrent Pregnancy Loss: Research Status and Prospect.

Recurrent pregnancy loss (RPL) is a distressing reproductive system disease with complex underlying causes and difficult treatment, making it a common fertility challenge for women of childbearing age. In recent years, the role of inflammasomes in RPL has gradually been recognized. NOD-like receptor family pyrin domain-containing 3 (NLRP3) is a key component of the innate immune system and a central regulator of inflammatory signaling. Accumulating evidence links NLRP3 inflammasome activation to female reproduction. During pregnancy, the assembly and activation of the NLRP3 inflammasome generate pro-inflammatory cytokines and pyroptosis-associated factors that engage in extensive cross-talk with other inflammatory pathways, thereby contributing to RPL through diverse mechanisms, including inflammatory cascades, endometrial receptivity, immune cell differentiation and polarization, pyroptotic cell death, autophagy, and intestinal barrier permeability. A detailed understanding of these intricate interactions may unveil novel therapeutic targets and strategies to mitigate the physiological and psychological burden of RPL on affected couples. However, currently there are still limited RPL therapeutic drugs targeting NLRP3. Developing drugs that precisely target and regulate NLRP3 is expected to promote the development of RPL therapy research. This comprehensive review investigates the complex relationship between NLRP3 inflammasome and RPL, highlighting the central role of inflammation in disease progression. It also summarizes potential drugs targeting NLRP3 inflammasome for the treatment of RPL, providing theoretical basis for potential clinical therapeutic targets.