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Savelieva GM, Breusenko VG, Kareva EN, Golukhov GN, Gutorova DS, Ovchinnikova AV, Ivanovskaya TN, Shcherbatyuk KV. A new strategy in selection of hormone therapy for endometrial proliferative process in postmenopausal patients. BULLETIN OF RUSSIAN STATE MEDICAL UNIVERSITY 2022. [DOI: 10.24075/brsmu.2022.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The limited efficacy of hormone therapy for endometrial proliferative process (EPP) in postmenopausal patients and its side effects on the immune system functionalities have not been studied in detail. Here we assess the feasibility of hormone therapy for EPP in postmenopausal patients through evaluation of estradiol and progesterone receptor gene expression in endometrial tissue and peripheral blood mononuclear cells (PBMC). The study enrolled 92 postmenopausal patients with EPP, including 37 pts with glandular-fibrous polyps, 7 pts with non-atypical endometrial hyperplasia (EH), 8 pts with atypical endometrial hyperplasia (AEH), 31 pts with moderately differentiated adenocarcinoma and 9 pts with highly differentiated adenocarcinoma. The PBMC isolates and endometrial samples were tested for ER⍺, ERβ, mER, PRA, PRB, mPR and PGRmC1 expression by reverse real time polymerase chain reaction (RT–PCR). Differential changes in PBMC receptor profiles upon in vitro exposure to progesterone or mifepristone were determined for patients with endometrial polyps and healthy women. The results indicate elevated expression of ERα, ERβ, PRA, PRB, mPR and PGRmC1 by endometrial tissues in EH and elevated expression of mER, ER⍺ and PRA by PBMC in AEH, apparently reflecting suppressed functionalities of monocytes, macrophages, Т-cells and natural killer cells. Unaltered expression of the studied genes by PBMC in endometrial adenocarcinoma may reflect the incrementing tumor autonomy. In vitro, mifepristone inhibited ER⍺, ERβ, mPR, PGRmC1, PRA and PRB expression in PBMC isolated from patients with endometrial polyps. We suppose that such effects can mitigate the negative influence of sex steroid hormones on immunocompetent cells.
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Affiliation(s)
- GM Savelieva
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - VG Breusenko
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - EN Kareva
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - GN Golukhov
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - DS Gutorova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - AV Ovchinnikova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - TN Ivanovskaya
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - KV Shcherbatyuk
- Pirogov Russian National Research Medical University, Moscow, Russia
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Zhang L, Li Y, Dong YC, Guan CY, Tian S, Lv XD, Li JH, Su X, Xia HF, Ma X. Transplantation of umbilical cord-derived mesenchymal stem cells promotes the recovery of thin endometrium in rats. Sci Rep 2022; 12:412. [PMID: 35013490 PMCID: PMC8748676 DOI: 10.1038/s41598-021-04454-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/20/2021] [Indexed: 12/25/2022] Open
Abstract
The endometrium plays a critical role in embryo implantation and pregnancy, and a thin uterus is recognized as a key factor in embryo implantation failure. Umbilical cord mesenchymal stem cells (UC-MSCs) have attracted interest for the repair of intrauterine adhesions. The current study investigated the repair of thin endometrium in rats using the UC-MSCs and the mechanisms involved. Rats were injected with 95% ethanol to establish a model of thin endometrium. The rats were randomly divided into normal, sham, model, and UC-MSCs groups. Endometrial morphological alterations were observed by hematoxylin-eosin staining and Masson staining, and functional restoration was assessed by testing embryo implantation. The interaction between UC-MSCs and rat endometrial stromal cells (ESCs) was evaluated using a transwell 3D model and immunocytochemistry. Microarray mRNA and miRNA platforms were used for miRNA-mRNA expression profiling. Gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) analyses were performed to identify the biological processes, molecular functions, cellular components, and pathways of endometrial injury and UC-MSCs transplantation repair and real-time quantitative reverse transcription PCR (qRT-PCR) was performed to further identify the expression changes of key molecules in the pathways. Endometrium thickness, number of glands, and the embryo implantation numbers were improved, and the degree of fibrosis was significantly alleviated by UC-MSCs treatment in the rat model of thin endometrium. In vitro cell experiments showed that UC-MSCs migrated to injured ESCs and enhanced their proliferation. miRNA microarray chip results showed that expression of 45 miRNAs was downregulated in the injured endometrium and upregulated after UC-MSCs transplantation. Likewise, expression of 39 miRNAs was upregulated in the injured endometrium and downregulated after UC-MSCs transplantation. The miRNA-mRNA interactions showed the changes in the miRNA and mRNA network during the processes of endometrial injury and repair. GO and KEGG analyses showed that the process of endometrial injury was mainly attributed to the decomposition of the extracellular matrix (ECM), protein degradation and absorption, and accompanying inflammation. The process of UC-MSCs transplantation and repair were accompanied by the reconstruction of the ECM, regulation of chemokines and inflammation, and cell proliferation and apoptosis. The key molecules involved in ECM-receptor interaction pathways were further verified by qRT-PCR. Itga1 and Thbs expression decreased in the model group and increased by UC-MSCs transplantation, while Laminin and Collagen expression increased in both the model group and MSCs group, with greater expression observed in the latter. This study showed that UC-MSCs transplantation could promote recovery of thin endometrial morphology and function. Furthermore, it revealed the expression changes of miRNA and mRNA after endometrial injury and UC-MSCs transplantation repair processed, and signaling pathways that may be involved in endometrial injury and repair.
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Affiliation(s)
- Lu Zhang
- National Research Institute for Family Planning, Beijing, 100081, China
- Graduate School, Peking Union Medical College, Beijing, China
| | - Ying Li
- National Research Institute for Family Planning, Beijing, 100081, China
- Graduate School, Peking Union Medical College, Beijing, China
| | - Yi-Chao Dong
- National Research Institute for Family Planning, Beijing, 100081, China
- Graduate School, Peking Union Medical College, Beijing, China
| | - Chun-Yi Guan
- National Research Institute for Family Planning, Beijing, 100081, China
- Graduate School, Peking Union Medical College, Beijing, China
| | - Shi Tian
- Haidian Maternal and Child Health Hospital, Beijing, China
| | - Xiao-Dan Lv
- National Research Institute for Family Planning, Beijing, 100081, China
- Graduate School, Peking Union Medical College, Beijing, China
| | - Jian-Hui Li
- National Research Institute for Family Planning, Beijing, 100081, China
- Graduate School, Peking Union Medical College, Beijing, China
| | - Xing Su
- National Research Institute for Family Planning, Beijing, 100081, China
- Graduate School, Peking Union Medical College, Beijing, China
| | - Hong-Fei Xia
- National Research Institute for Family Planning, Beijing, 100081, China.
- Graduate School, Peking Union Medical College, Beijing, China.
| | - Xu Ma
- National Research Institute for Family Planning, Beijing, 100081, China.
- Graduate School, Peking Union Medical College, Beijing, China.
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Islam MS, Chen LW, Segars JH. Selective Progesterone Receptor Modulators (SPRMs) and Androgen Receptor Modulators (SARMs) as Treatment for Benign Gynecologic Diseases. Clin Obstet Gynecol 2021; 64:813-836. [PMID: 34524172 DOI: 10.1097/grf.0000000000000659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Common benign gynecologic conditions such as uterine fibroids and endometriosis are linked to chronic pelvic pain, abnormal and heavy uterine bleeding, and infertility. Effective medical management of these diseases is an unmet need. The steroid hormones progesterone (P4), estrogen (E2), and testosterone play a major role in reproductive physiology and uterine pathologies. Notably, selective progesterone receptor modulators have shown considerable promise as treatment options for some hormone-dependent conditions. More limited data are available regarding the safety and efficacy of selective androgen receptor modulators. In this report we review current evidence for selective progesterone receptor modulators and selective androgen receptor modulators as treatment options for benign gynecologic conditions.
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Affiliation(s)
- Md Soriful Islam
- Division of Reproductive Sciences and Women's Health Research, Department of Gynecology and Obstetrics, Johns Hopkins Medicine, Baltimore, Maryland
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Strzałkowska B, Dawidowicz M, Ochman B, Świętochowska E. The role of adipokines in leiomyomas development. Exp Mol Pathol 2021; 123:104693. [PMID: 34637783 DOI: 10.1016/j.yexmp.2021.104693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/06/2021] [Accepted: 09/28/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Many women of premenopausal age suffer from uterine leiomyomas, which are benign tumors of the uterus. Despite the high prevalence of uterine leiomyomas underlying pathogenesis mechanisms are not fully elucidated. Early data showed a positive correlation between increased levels of adipose tissue and leiomyomas prevalence. Adipose tissue cells-adipocytes can play a potential role in leiomyomas formation by producing and secreting adipokines. AIM The aim of this study is to summarize the current knowledge on the potential relation between adipokines and leiomyomas basing on current data analyze, and justify future research directions. METHODOLOGY This review is based on pertinent articles searched using PubMed, encompassing all available literature. The key search words were as follows: adipokines, leiomyoma, TNFα, leptin, adiponectin, visfatin, resistin, omentin, lipocalin, apelin, adipsin, chemerin. Time was not an exclusion criterium due to few available studies on this subject. SUMMARY The results of the studies are inconclusive, but the vast majority indicates a significant connection between the adipokines and the leiomyomas. According to the majority of studies, TNFα contributes to the development of leiomyomas by inhibiting apoptosis, increasing migration of leiomyomas, and increasing fibrosis of leiomyomas. Most of the studies on the effects of leptin also indicate the relation between leptin and leiomyomas development. In the case of adiponectin released from mast cells' granularity, it is possible that adiponectin increases angiogenesis in leiomyomas. Under physiological conditions, adiponectin has the potential to inhibit the development of leiomyomas. The authors suggested that adiponectin affects leiomyomas via an insulin-dependent pathway or via an estrogen-dependent pathway. Most probably leptin contributes to the formation of myomas and adiponectin prevents this. More research is needed to understand better the influence of these molecules on the pathogenesis of leiomyomas.
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Affiliation(s)
- Bogumiła Strzałkowska
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland.
| | - Miriam Dawidowicz
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Błażej Ochman
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Elżbieta Świętochowska
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
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Shen X, Wang X. The function role and synergic effect of syndecan-1 for mifepristone in uterine leiomyoma. Cytotechnology 2021; 73:179-187. [PMID: 33927475 DOI: 10.1007/s10616-021-00455-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/17/2021] [Indexed: 02/05/2023] Open
Abstract
The study intends to investigate the regulation of syndecan-1 in human uterine leiomyoma cells. Human syndecan-1 levels were detected by Western blot in uterus leimyoma's tissue. The efficacy of syndecan-1 silencing on the cell proliferation, metalloproteinases and extracellular matrix were determined through Cell Counting Kit (CCK8) assay and Western blot assay, respectively. We compared the respective and combined effect of mifepristone and syndecan-1 on cell proliferation and the expression of metalloproteinases and extracellular matrix (ECM) in human uterine leiomyoma cells. The inhibitory effects of Syndecan-1 silencing on proliferation, ECM and Matrix Metalloproteinase (MMP) were observed in human uterine leiomyoma cells. Furthermore, syndecan-1 inhibition enhanced the effects of mifepristone against uterine leiomyoma cell proliferation. The expression of MMPs and ECM components in human uterine leiomyoma cells was decreased dramatically after syndecan-1 silencing, which was promoted after mifepristone treatment. Altogether, syndecan-1 silencing enhanced the efficacy of mifepristone on the uterine leiomyoma cell proliferation and ECM formation. Therefore, targeting syndecan-1 represents a novel therapeutic strategy to treat uterine leiomyoma.
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Affiliation(s)
- Xiaoyan Shen
- Department of Gynecology, Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong, 226018 Jiangsu China
| | - Xiaoxu Wang
- Five Departments of Recuperation in Dalian Rehabilitation and Recuperation Center, No.30, Binhai West Road, Xigang District, Dalian City, 116013 Liaoning province China
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Ledezma-Gallegos F, Jurado R, Mir R, Medina LA, Mondragon-Fuentes L, Garcia-Lopez P. Liposomes Co-Encapsulating Cisplatin/Mifepristone Improve the Effect on Cervical Cancer: In Vitro and In Vivo Assessment. Pharmaceutics 2020; 12:E897. [PMID: 32971785 PMCID: PMC7558205 DOI: 10.3390/pharmaceutics12090897] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/12/2020] [Accepted: 09/16/2020] [Indexed: 01/24/2023] Open
Abstract
Cervical cancer is usually diagnosed in the later stages despite many campaigns for early detection and continues to be a major public health problem. The standard treatment is cisplatin-based chemotherapy plus radiotherapy, but patient response is far from ideal. In the research for new drugs that enhance the activity of cisplatin, different therapeutic agents have been tested, among them the antiprogestin mifepristone. Nevertheless, the efficacy of cisplatin is limited by its low specificity for tumor tissue, which causes severe side effects. Additionally, cervical tumors often become drug resistant. These problems could possibly be addressed by the use of liposome nanoparticles to encapsulate drugs and deliver them to the target. The aim of this study was to prepare liposome nanoparticles that co-encapsulate cisplatin and mifepristone, evaluate their cytotoxicity against HeLa cells and in vivo with subcutaneous inoculations of xenografts in nu/nu mice, and examine some plausible mechanisms of action. The liposomes were elaborated by the reverse-phase method and characterized by physicochemical tests. The nanoparticles had a mean particle size of 109 ± 5.4 nm and a Zeta potential of -38.7 ± 1.2 mV, the latter parameter indicating a stable formulation. These drug-loaded liposomes significantly decreased cell viability in vitro and tumor size in vivo, without generating systemic toxicity in the animals. There was evidence of cell cycle arrest and increased apoptosis. The promising results with the co-encapsulation of cisplatin/mifepristone warrant further research.
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Affiliation(s)
- Fabricio Ledezma-Gallegos
- Laboratorio de Farmacologia, Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Cd. México 14080, Mexico; (F.L.-G.); (R.J.); (R.M.)
- Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Coyacán, Cd. México 04510, Mexico
| | - Rafael Jurado
- Laboratorio de Farmacologia, Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Cd. México 14080, Mexico; (F.L.-G.); (R.J.); (R.M.)
| | - Roser Mir
- Laboratorio de Farmacologia, Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Cd. México 14080, Mexico; (F.L.-G.); (R.J.); (R.M.)
| | - Luis Alberto Medina
- Unidad de Investigación Biomédica en Cáncer INCan-UNAM, Instituto Nacional de Cancerología, Cd. México 14080, Mexico; (L.A.M); (L.M.-F.)
- Instituto de Física, Universidad Nacional Autónoma de México, Coyoacán, Cd. México 04510, Mexico
| | - Laura Mondragon-Fuentes
- Unidad de Investigación Biomédica en Cáncer INCan-UNAM, Instituto Nacional de Cancerología, Cd. México 14080, Mexico; (L.A.M); (L.M.-F.)
| | - Patricia Garcia-Lopez
- Laboratorio de Farmacologia, Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Cd. México 14080, Mexico; (F.L.-G.); (R.J.); (R.M.)
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Xu W, Song Y, Li K, Zhang B, Zhu X. Quercetin Inhibits Adenomyosis by Attenuating Cell Proliferation, Migration and Invasion of Ectopic Endometrial Stromal Cells. DRUG DESIGN DEVELOPMENT AND THERAPY 2020; 14:3815-3826. [PMID: 33061289 PMCID: PMC7519414 DOI: 10.2147/dddt.s265066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 09/02/2020] [Indexed: 11/23/2022]
Abstract
Purpose To evaluate the effects of quercetin on proliferation, invasion and migration of endometrial stromal cells (ESCs) from adenomyosis patients. Methods Primary ectopic ESCs (EESCs) and eutopic ESCs (EuESCs) were obtained and purified from patients undergoing total hysterectomy for adenomyosis and identified by immunocytochemistry staining. The cytotoxicity and inhibition rate were determined by CCK-8 assay to obtain the IC50 value. Cell proliferative, migratory, and invasive abilities were detected by BrdU, wound scratch, transwell assays, respectively. Western blot analysis was employed to explore the effects of quercetin on the expression of MMP-2, MMP-9, Ezrin and Fascin proteins in cells. Results Both EESCs and EuESCs were characterized with strongly positive staining for vimentin and almost negative for cytokeratin. Quercetin inhibited the viability of EESCs and EuESCs in a dose- and time-dependent manner, with an IC50 = 33.00 μM for EuESCs and IC50 = 74.88 μM for EESCs at 72 h. Thus, the final concentrations and action time of quercetin in EuESCs (0, 20, 40, and 80 μM for 72 h) and EESCs (0, 40, 80, and 160 μM for 72 h) were selected. BrdU assay showed that quercetin dose-dependently suppressed the proliferation of EESCs and EuESCs, while the inhibition rate in EESCs was higher. Similarly, administration of quercetin in EESCs and EuESCs significantly decreased the motility and invasiveness in a dose-dependent fashion, with stronger inhibitory effects on EESCs. Finally, Western blot analysis demonstrated that invasion- and migration-related proteins (MMP-2, MMP-9, Erzin, and Fascin) were significantly downregulated with the quercetin concentration increasing. Moreover, the decreased level of these proteins in EESCs under quercetin exposure was greater than that in EuESCs. Conclusion Quercetin can inhibit the proliferation of EESCs in adenomyosis and reduce their mobility and invasiveness. These inhibitory effects may be related to the downregulation of MMP-2, MMP-9, Fascin, and Erzin proteins.
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Affiliation(s)
- Wenbin Xu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, People's Republic of China
| | - Yizuo Song
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, People's Republic of China
| | - Kehan Li
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, People's Republic of China
| | - Biyun Zhang
- Department of Obstetrics and Gynecology, Cixi Maternity and Child Health Hospital, Ningbo 315300, Zhejiang, People's Republic of China
| | - Xueqiong Zhu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, People's Republic of China
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