Abstract
Uterine fibroids are the most common gynecologic benign tumors. Studies supporting a strong pregnancy-related growth of leiomyomas generally claimed a crucial role of sex steroid hormones. However, sex steroids are unlikely the unique actors involved as estrogen and progesterone achieve a pick serum concentration in the last trimester while leiomyomas show a typical increase during the first trimester. Given the rapid exponential raise in serum human Chorionic Gonadotrophin (hCG) at the beginning of gestation, we conducted a review to assess the potential role of hCG in the striking growth of leiomyomas during initial pregnancy. Fibroid growth during initial pregnancy seems to correlate to the similar increase of serum hCG levels until 12 weeks of gestation. The presence of functional Luteinizing Hormone/human Chorionic Gonadotropin (LH/hCG) receptors was demonstrated on leiomyomas. In vitro treatment of leiomyoma cells with hCG determines an up to 500% increase in cell number after three days. Expression of cyclin E and cyclin-dependent kinase 1 was significantly increased in leiomyoma cells by hCG treatment. Moreover, upon binding to the receptor, hCG stimulates prolactin secretion in leiomyoma cells, promoting cell proliferation via the mitogen-activated protein kinase cascade. Fibroid enlargement during initial pregnancy may be regulated by serum hCG.
Highlights
Introduction to Leiomyoma PathophysiologyLeiomyomas or fibroids represents the most common benign tumors of the genital tract in reproductive age women and are associated with significant morbidity and a decline of the quality of life [1]
Only 22% of uterine leiomyomas grew more than 10% of the initial volume, 19% shrank more than 10% of the initial volume and 59% changed in size by less than 10% of the initial volume supporting the idea that most fibroids change shape during pregnancy without changing their volume
Horiuchi and coworkers have investigated cell proliferation and the expression of cell cyclerelated proteins in normal uterine smooth muscle and uterine leiomyoma cells to assess the direct effect of human Chorionic Gonadotrophin (hCG) showing that, even at a low concentration, the molecule could exert a direct influence over the growth of uterine fibroids by promoting cell cycling [73]
Summary
Leiomyomas or fibroids represents the most common benign tumors of the genital tract in reproductive age women and are associated with significant morbidity and a decline of the quality of life [1] They mainly consist in collagen-rich masses of proliferating smooth muscle cells with a pseudocapsule but their histological appearance differs from the adjacent normal myometrium since, in most of cases, they demonstrate much more extracellular matrix (ECM) deposition (50% more collagen than normal myometrium with an increased proportion of type I–III). Data on epidemiologic factors associated with leiomyoma risk are only partly elucidated They include age, race, body mass index (BMI), parity, environmental factors, lifestyles including diet, caffeine and alcohol consumption, smoking, physical activity and stress and other pathologies such as hypertension and infections.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
