Natural Killer Cells in Uterine Adenomyosis: Immunological Mechanisms and Therapeutic Perspectives.

Uterine adenomyosis (AM), a common gynecological disorder, is characterized by the invasion of endometrial glands and stroma into the myometrium, resulting in chronic pelvic inflammation and severe pain. This condition not only adversely affects patients' quality of life but also correlates with diminished fertility. Recent findings underscore the critical role of natural killer (NK) cells in the pathophysiology of AM. As a vital component of innate immunity, NK cells are responsible for identifying and eliminating abnormal cells, and functional alterations of NK cells may contribute to the progression of this disease. Although existing research has suggested preliminary associations between NK-cell dysfunction and AM, the exact mechanistic pathways and their clinical implications are still not fully elucidated. This review comprehensively explores the involvement of NK cells in AM, emphasizing their functional adaptability within the immune microenvironment, interactions with cytokine networks, and potential for therapeutic targeting. Furthermore, we critically assess the translational hurdles and propose a strategic framework for implementing NK cell-based immunomodulatory approaches in clinical practice.