Recent Advances in Uterine Fibroid Etiology

Abstract

Uterine fibroids, also known as uterine leiomyoma (UL), are monoclonal tumors of the smooth muscle tissue layer (myometrium) of the uterus. Although ULs are considered benign, uterine fibroids are the source of major quality-of-life issues for approximately 25% of all women, who suffer from clinically significant symptoms of UL. Despite the prevalence of UL, there is no treatment option for UL which is long term, cost-effective, and leaves fertility intact. The lack of understanding about the etiology of UL contributes to the scarcity of medical therapies available. Studies have identified an important role for sex steroid hormones in the pathogenesis of UL, and have driven the use of hormonal treatment for fibroids, with mixed results. Dysregulation of cell signaling pathways, miRNA expression, and cytogenetic abnormalities have also been implicated in UL etiology. Recent discoveries on the etiology of UL and the development of relevant genetically modified rodent models of UL have started to revitalize UL research. This review outlines the major characteristics of fibroids; major contributors to UL etiology, including steroid hormones; and available preclinical animal models for UL.

Pregnancy outcomes in patients with uterine fibroids treated with ultrasound‐guided high‐intensity focused ultrasound

“…This retrospective study demonstrates a relation between infertility and miscarriage with uterine fibroids. Among the 78 patients in this study, 23 had an abnormal pregnancy, including nine cases of infertility and 13 cases of miscarriage; these results are in agreement with previous reports . Uterine fibroids cause infertility or miscarriage through the following mechanisms.…”

“…Evidence indicates that uterine fibroids, as an independent factor, are associated with infertility, causing 1–2.4% of cases of infertility and 7% of recurrent miscarriage . In addition, the rate of miscarriage of women with uterine fibroids is 20–30%, two to three times higher than that of women without such fibroids . The common factors leading to infertility or miscarriage are: fibroid‐induced anatomical changes in the uterus, high estrogen, uterine contraction and dysmotility, and the decline of receptivity of the endometrium and ovulation dysfunction.…”

Impact of reproductive evolutionary mismatch on women's health and the need for action and research

“…16 Uterine leiomyomas in vivo and leiomyoma cells in culture are dependent for growth and development on stimulation from hormones, especially estrogen. 17 The risk of endometriosis is consistent with the central importance of retrograde menstruation, a feature of the menstrual cycle in women and nonhuman primates. Pregnancy is protective not only by avoiding menstruation, but also the decidual reaction that occurs during pregnancy might make this tissue less vulnerable to growth.…”

“…Uterine leiomyomas in vivo and leiomyoma cells in culture are dependent for growth and development on stimulation from hormones, especially estrogen …”

Ginsenoside Rb1 inhibits proliferation and promotes apoptosis by regulating HMGB1 in uterine fibroid cells

“…Uterine fibroids are common benign tumors of the genital system in women of childbearing age. According to statistics, about 80% of women in childbearing age have uterine fibroids, which seriously endanger women's physical and mental health [1]. Ginsenoside is an effective chemical component of ginseng, with extensive pharmacological effects.…”