Uterine fibroids: a new insight into an old problem

Abstract

With the development of molecular methods in cancer biology, the etiopathogenesis of commonly occurring uterine myomas is constantly subject to amendment. It was found that ovarian steroid hormones are involved in the development of these benign tumors, hence the development of new therapies using selective progesterone receptor modulators (uliprystal acetate, UPA), especially in combination with vitamin D3 supplementation. Genetic changes associated with the pathogenesis of myomas, especially mutations in MED12 and related signaling via Wnt / β catenin, may be precursors to the development of aggressive forms of these benign tumors and therefore be influential regarding treatment options. Studies have also revealed the role of microRNA overexpression and angiogenesis in the development of uterine myomas, the inhibition of which may be associated with future therapy of these tumors. In recent years, the role of stem cells (SCs) in myomas and pathways involved in their activation have been described, which may also have clinical implications in the future.