OBJECTIVE: To determine the progesterone receptor (PR) specificity, PR activation, endometrial influence, and impact on proliferation and extracellular matrix (ECM) production of the novel non-steroidal selective progesterone receptor modulator (SPRM) CP8947 in human immortalized leiomyoma and patient-matched myometrial cells. DESIGN: Prospective human and rabbit model experiments. MATERIALS AND METHODS: Receptor binding assessed using LNCaP, Ishikawa, T-47D, and HeLa cells for AR, ER-alpha, PR, and GR, respectively. Progestational activity assessed by alkaline phosphatase assay in T47D cells and ER-alpha expression in human leiomyoma and myometrial cells. Endometrial progestational activity assessed by McPhail assay. Proliferation and gene expression studies (q RT-PCR and western blot) assessed in leiomyoma and myometrial cells. Wilcoxon sign rank test was used, with significance set at p<0.05. RESULTS: CP8947 is highly selective for PR, with an IC50 of 8nM compared with over 1000nM for ER-alpha, AR, and GR. It induced alkaline phosphatase comparably to progesterone, and induced ER-alpha in leiomyoma cells but not myometrial cells. CP8947 was progestational in rabbit endometrium. It inhibited human leiomyoma cell (but not myometrial cell) proliferation. The decreased proliferation correlated with increased TRAIL, caspase-3 and -7, suggesting induction of apoptosis in leiomyoma cells. ECM components were decreased in leiomyoma cells, including COL1A1, COL7A1, and CTGF at nanomolar concentrations. CONCLUSIONS: CP8947 is a potent novel SPRM that was selective for PR, with progestational activity in endometrium, and inhibition of both leiomyoma cell proliferation (via induction of apoptosis) and ECM component production, without disrupting myometrial cells. Unlike other SPRMs, the progestational activity of CP8947 in endometrium may prevent hyperplasia from an unopposed estrogen environment. Prospective human trials will determine if this novel compound is a specific and effective therapy for human leiomyomas.
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