Progesterone: A critical role in the pathogenesis of uterine myomas

Rein, Mitchell S.; Barbieri, Robert L.; Friedman, Andrew J.

doi:10.1016/0002-9378(95)90077-2

Cited by 309 publications

(161 citation statements)

References 19 publications

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“…There is significant evidence in the literature supporting a progesterone-and TGFB-mediated role in the proliferation of uterine fibroids (reviewed by Rein et al (1995), Ciarmela et al (2011) and Kim & Sefton (2012)). TGFBR2 gene expression was decreased in fibroidderived A K C C SMC relative to myometrium.…”

Section: Discussionmentioning

confidence: 99%

Common fibroid-associated genes are differentially expressed in phenotypically dissimilar cell populations isolated from within human fibroids and myometrium

Holdsworth-Carson¹,

Zaitseva²,

Girling³

et al. 2014

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Uterine fibroids are a prevalent gynaecological condition in reproductive-aged women and are the commonest reason for hysterectomy. The cellular composition of clonal fibroids are heterogeneous, with phenotypically dissimilar cells that include smooth muscle cells (SMC), vascular SMC (VSMC) and fibroblasts. The aim of our study was to investigate genes that are commonly differentially expressed between fibroid and myometrial whole tissues in phenotypically different sub-populations of cells isolated from fibroid and myometrium. Genes to be investigated by fluorescence-activated cell sorting, quantitative real-time PCR and immunocytochemistry include transforming growth factor b (TGFB) and retinoic acid (RA) signalling families and steroid hormone receptors. We hypothesised that each cell population isolated from fibroid and myometrium would differ in the expression of fibroid-associated genes. We demonstrated that phenotypically different cellular constituents of uterine fibroids differentially express cellular RA-binding protein 2 (CRABP2), progesterone receptor B (PRB) and TGFB receptor 2 mRNA in fibroid-derived cells of VSMC and SMC phenotype. CRABP2 mRNA was also differentially expressed in fibroblasts and VSMC sub-populations from within clonal fibroid tumours. We conclude that differential regulation of RA, TGFB and PR pathway transcription occurs in fibroid-associated SMC and -fibroblasts and that investigation of paracrine interactions between different cell types within the fibroid microenvironment provides an important new paradigm for understanding the pathophysiology of this common disease.

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Section: Discussionmentioning

confidence: 99%

Common fibroid-associated genes are differentially expressed in phenotypically dissimilar cell populations isolated from within human fibroids and myometrium

Holdsworth-Carson¹,

Zaitseva²,

Girling³

et al. 2014

Reproduction

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“…The estrogen hypothesis has also been supported by clinical trials evaluating the medical treatment of myomas with GnRH agonists, the effective result of which is hypoestrogenism accompanied by regression of the fibroids (Friedman et al 1989). As noted by Rein, however, distinguishing the relative importance of estrogen versus progesterone is difficult, as progesterone levels, in a manner similar to those of estrogen, are also cyclically elevated during the reproductive years, are significantly elevated during pregnancy, and are suppressed after menopause (Rein et al 1995). Furthermore, regression of uterine leiomyomata has been induced by treatment with the antiprogesterone drug RU 486, accompanied by reduction in the progesterone receptor (PR) but not the ER in the tumors, suggesting that the regression was attained through a direct antiprogesterone effect (Murphy et al 1993).…”

Section: Clinical Observationsmentioning

confidence: 99%

Etiology and pathogenesis of uterine leiomyomas: a review.

Flake

Andersen

Dixon

2003

Environ Health Perspect

490

392

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Uterine leiomyomas, or fibroids, represent a major public health problem. It is believed that these tumors develop in the majority of American women and become symptomatic in one-third of these women. They are the most frequent indication for hysterectomy in the United States. Although the initiator or initiators of fibroids are unknown, several predisposing factors have been identified, including age (late reproductive years), African-American ethnicity, nulliparity, and obesity. Nonrandom cytogenetic abnormalities have been found in about 40% of tumors examined. Estrogen and progesterone are recognized as promoters of tumor growth, and the potential role of environmental estrogens has only recently been explored. Growth factors with mitogenic activity, such as transforming growth factor-β 3, basic fibroblast growth factor, epidermal growth factor, and insulin-like growth factor-I, are elevated in fibroids and may be the effectors of estrogen and progesterone promotion. These data offer clues to the etiology and pathogenesis of this common condition, which we have analyzed and summarized in this review.

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“…1,2 The cause of the fibroids is unknown, but however, it is estimated to be caused by estrogens and progestrones which proliferate tumor growth. 3,4 Fibroids are seen to rarely occur before menarche and reduce after menopause. The may be single or multiple and have a negative impact on the reproductive system, and are capable of causing severe morbidity among the women with deterioration of quality of life.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of fibroids: a study in a semiurban area in Telangana, India

Srilatha

Verabelly

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Uterine fibroids, also known as Leiomyoma, are the most common benign neoplasm in the female genital tract and originate from the myometrium´s smooth muscle. Although the uterine fibroids are diagnosed frequently, the prevalence of it in the local populations is unknown. Therefore, this study was done to observe the prevalence of the fibroids in our geographic area. Methods: 4487 women aged between 18-50 years who came to our gynec OPD out of which 522 were positive for the presence of fibroids, were included into the study. Ultrasound examination was done for all the patients. During this examination, the uterine dimensions and the structure were assessed. The number of the fibroids were counted and noted. Biopsy sample was taken from the fibroids and sent to pathology lab for further histological examination. Results: Out of the 4487 patients included into the study, 11.6% had fibroids. The predominant age group which was positive the presence of fiberoids was 40-59 years. 59.8% of them were married while 40.2% were either unmarried or divorced or widowed. The body mass index for most of them was within the normal range (60.3%), while some were slightly overweight. The most common cause of the patients to seek medical advice was menstrual disorder (37.7%) which included heavy, irregular or no periods. Conclusions: Fibroids was significantly associated with age, married marital status, overweight, pregnancy, menopause, childbirth and the presence of menorrhagia. Early detection would help in early management and thereby reduce the morbidity.

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Progesterone: A critical role in the pathogenesis of uterine myomas

Cited by 309 publications

References 19 publications

Common fibroid-associated genes are differentially expressed in phenotypically dissimilar cell populations isolated from within human fibroids and myometrium

Common fibroid-associated genes are differentially expressed in phenotypically dissimilar cell populations isolated from within human fibroids and myometrium

Etiology and pathogenesis of uterine leiomyomas: a review.

Prevalence of fibroids: a study in a semiurban area in Telangana, India

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