Neurofibromatosis type 1 (NF1) is a hereditary disease caused by mutations of the NF1 gene at 17q11.2. Loss of the NF1 gene product in Schwann cells leads to the development of benign nerve sheath tumors. These neurofibromas may occur at any time but tend to arise during periods of hormonal imbalance, suggesting that hormones influence neurofibroma growth. As steroid hormone levels rise during these times, we hypothesized that progesterone has proliferative effects on neurofibroma-derived Schwann cells. We chose specific medium conditions for selective proliferation of NF (ϩ/Ϫ) and NF (Ϫ/Ϫ) cells from human neurofibromas. Genetic characterization was not performed, but former works have shown that under the conditions used (ϩ/Ϫ) and (Ϫ/Ϫ) cells can be selected. Different progesterone concentrations were added at different days with BrdU-staining was performed to investigate proliferation rates and DAB-staining to identify a progesterone receptor. We could demonstrate that Schwann cells from human neurofibromas express progesterone receptors. These cells show elevated proliferation rates (highest in NF(Ϫ/Ϫ) cells) under progesterone, whereas normal human Schwann cells were not affected. These data suggest that progesterone plays an important role in the development of neurofibromas in NF1. (1). Thus, NF1 represents one of the most frequent hereditary diseases. The disease is characterized by typical clinical symptoms that were summarized in a "diagnostic criteria list" at a National Institutes of Health consensus conference in 1988 (2). Despite a markedly variable clinical expression, the hallmark feature of the disease is benign peripheral nerve sheath tumors termed neurofibromas. These tumors consist of a mixed cellular population that mainly consists of Schwann cells and fibroblasts but also contains a significant proportion of mast cells, perineurial, and endothelial cells (3). All NF1 patients will inevitably develop neurofibromas during their lifetime (1) but the number, size, and age of onset of these tumors are entirely unpredictable.Homozygous inactivation of the NF1 gene and subsequent loss of its gene product neurofibromin in Schwann cells has been identified as the primary step in a pathogenetic process that ultimately results in the development of neurofibromas (4,5). Many investigators (6,7) have stressed the fact that apart from mutations at NF1, various additional factors are necessary to enable neurofibroma formation. However, still very little is known about these additional factors, which might affect tumor development and growth in NF1.From a clinical view, dermal neurofibromas tend to develop in adolescence as well as during pregnancy. These are times of increased hormonal influence and it has to be postulated that steroid hormones might affect neurofibroma development.In this context, it is intriguing that progesterone-as a steroid hormone with numerous functions in the human body-has been shown to play an important role in myelin synthesis of Schwann cells. Jung-Testas et al. (8)...