Abstract
The exact mechanism of selective progesterone receptor modulator action in leiomyoma still challenges researchers. The aim of the study was to assess the effects of ulipristal acetate (UPA) on immunoexpression of inflammatory markers and vascularization in fibroids. UPA-treated patients were divided into three groups: (1) good response (≥25% reduction in volume of fibroid), (2) weak response (insignificant volume reduction), (3) and no response to treatment (no decrease or increase in fibroid volume). The percentage of TGFβ, IL6, IL10, CD117, and CD68-positive cells were significantly lower in the group with a good response to treatment vs. the control group. Moreover, the percentage of IL10 and CD68-positive cells in the group with a good response to treatment were also significantly lower compared to the no response group. Additionally, a significant decrease in the percentage of IL10-positive cells was found in the good response group vs. the weak response group. There were no statistical differences in the percentage of TNFα-positive cells and vessel parameters between all compared groups. The results of the study indicate that a good response to UPA treatment may be associated with a decrease of inflammatory markers, but it does not influence myoma vascularization.
Highlights
Uterine fibroids (UFs) are the most common benign tumors of the female reproductive tract
The aim of the study was to assess the effects of ulipristal acetate (UPA) on the immunoexpression of inflammatory markers such as transforming growth factor β (TGFβ), tumor necrosis factor α (TNFα), IL6, IL10, CD117, and
In myomas taken from patients in the UPA-treated group with a good response to treatment, a significant decrease in volume was revealed (p = 0.039)
Summary
Uterine fibroids (UFs) are the most common benign tumors of the female reproductive tract They occur in approximately 70% of women up to 50 years of age. In patients at the reproductive age, UFs may cause miscarriages or infertility These monoclonal tumors are formed in smoothmuscle cells due to a variety of reasons. A combination of severe hypoxia and gonadal steroids stimulates the local expression of the angiogenic growth factor in fibroid tissue, as well as the production of cytokines and chemokines. This in turn impacts cell proliferation and extracellular matrix (ECM) deposition, providing a vascular support for growing leiomyoma [2]. Genetic factors may be associated with the uterine fibroid formation
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