Efficiency of combination therapy with indole-3-carbinol in patients with hormone-dependent uterine diseases


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To evaluate the efficiency of combination therapy with indole-3-carbinol (I3C) in patients with hormone-dependent diseases, such as uterine fibroids, endometrial hyperplasia, endometriosis (adenomyosis). Materials and methods. The investigation enrolled 1217 patients aged 31-52 years with hormone-dependent uterine diseases (f ibroids, endometriosis, and endometrial hyperplasia). It was conducted using various therapeutic regimens and combinations. The results were processed using the SPSS 19.0 standard statistical software package. Results. The tolerability of treatment was similar in each of the subgroups. The efficiency evaluation showed the following: 1) the combination of a GnRH agonist and I3C was recorded to have an advantage over GnRH agonist monotherapy in the treatment of uterine fibroids; 2) the detection rate for positive changes during endometriosis in the use of combination therapy with dienogest and I3C) was higher than the baseline; 3) the efficiency of therapy using the combination regimen (a GnRH agonist/gestagen, I3C) for recurrent endometrial hyperplasia was higher than the basic regimen; 4) anti-relapse therapy after organ-sparing surgery was equally effective with the use of both a GnRH agonist and I3C. Conclusion. The addition of I3C to a drug treatment regimen for hormone-dependent uterine diseases enhances the efficiency of therapy, reduces the risk of recurrences and the need for re-operation, and improves quality of life.

Full Text

Restricted Access

About the authors

Alexander L. Tikhomirov

A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia

Email: pacificoff@mail.ru
MD, Professor of the Department of Obstetrics and Gynecology of the Medical Faculty

Tatyana A. Sonina

SM Clinic Medical Holding

obstetrician-gynecologist

Elena A. Osetskaya

SM Clinic Medical Holding

doctor of ultrasound diagnostics

References

  1. Киселев В.И., Сидорова И.С., Унанян А.Л., Муйжнек Е.Л. Гиперпластические процессы органов женской репродуктивной системы: теория и практика. М.: Медпрактика-М; 2011.
  2. Altman D., Granath F., Cnattingius S., Falconer C. Hysterectomy and risk of stress-urinary-incontinence surgery: nationwide cohort study. Lancet. 2007; 370(9597): 1494-9. https://dx.doi.org/10.1016/S0140-6736(07)61635-3.
  3. Гинзбург Е.Б., Соснова Е.А. Гистерэктомия как фактор риска развития метаболического синдрома. Материалы XXVII Международного конгресса с курсом эндоскопии «Новые технологии в диагностике и лечении гинекологических заболеваний». Москва, 2-5 июня, 2014; 142-3.
  4. Laughlin-Tommaso S.K., Khan Z., Weaver A.L., Schleck C.D., Rocca W.A., Stewart E.A. Cardiovascular risk factors and diseases in women undergoing hysterectomy with ovarian conservation. Menopause. 2016; 23(2): 121-8. https://dx.doi.org/10.1097/gme.0000000000000506.
  5. Atsma F., Bartelink M.-L.E.L., Grobbee D.E., van der Schouw Y.T. Postmenopausal status and early menopause as independent risk factors for cardiovascular disease: a meta-analysis. Menopause. 2006; 13(2): 265-79. https://dx.doi.org/10.1097/01.gme.0000218683.97338.ea.
  6. Ingelsson E., Lundholm C., Johansson A.L.V., Altman D. Hysterectomy and risk of cardiovascular disease: a population-based cohort study. Eur Heart J. 2011; 32(6): 745-50. https://dx.doi.org/10.1093/eurheartj/ehq477.
  7. Altman D., Yin L., Johansson A., Lundholm C., Gronberg H. Risk of renal cell carcinoma after hysterectomy. Arch Intern Med. 2010; 170(22): 2011-6. https://dx.doi.org/10.1001/archinternmed.2010.425.
  8. Karami S., Daugherty S.E., Purdue M.P. Hysterectomy and kidney cancer risk: A meta analysis. Int J. Cancer 2014; 134(2): 405-10. https://dx.doi.org/10.1002/ijc.28352.
  9. Zucchetto A., Talamini R., Dal Maso L., Negri E., Polesel J. et al. Reproductive, menstrual, and other hormone-related factors and risk of renal cell cancer. Int J. Cancer. 2008; 123(9): 2213-6. https://dx.doi.org/10.1002/ijc.23750.
  10. Boland R. Depression in Medical Illness/Secondary Depression. In: Stein D.J., Kupfer D.J., Schatzberg A.F., ed. Textbook of Mood Disorders. American Psychiatric Pablishing, Inc. Washington DC, 2006; 639-52.
  11. Sozeri-Varma G., Kalkan-Oguzhanoglu N., Karadag F., Ozdel O. The effect of hysterectomy and/or oophorectomy on sexual satisfaction. Climacteric. 2011; 14(2): 275-81. https://dx.doi.org/10.3109/13697137.2010.532251.
  12. Zeydan B., Tosakulwong N., Schwarz C.G., Senjem M.L., Gunter J.L. et al. Association of Bilateral Salpingo-Oophorectomy Before Menopause Onset With Medial Temporal Lobe Neurodegeneration. JAMA Neurol. 2019; 76(1): 95-100. https://dx.doi.org/10.1001/jamaneurol.2018.3057.
  13. Доброхотова Ю.Э. Гистерэктомия в репродуктивном возрасте: авто-реф. дис. д-ра мед. наук. М., 2000.
  14. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Эндометриоз. 2020.
  15. Sanderson P.A., Critchley H.O., Williams A.R., Arends M.J., Saunders P.T. New concepts for an old problem: the diagnosis of endometrial hyperplasia. Hum Reprod Update. 2017; 23(2): 232-54. https://dx.doi.org/10.1093/humupd/dmw042.
  16. Ishikawa H., Reierstad S., Demura M., Rademaker A.W., Kasai T. et al. High aromatase expression in uterine leiomyoma tissues of African-American women. J. Clin Endocrinol Metab. 2009; 94(5): 1752-6. https://dx.doi.org/10.1210/jc.2008-2327.
  17. Ашрафян Л.А., Бабаева Н.А., Антонова И.Б., Овчинникова О.А., Алешикова О.И., Моцкобили Т.А., Кузнецов И.Н. Уровень баланса эстрогенных метаболитов при раке молочной железы и пути его коррекции. Опухоли репродуктивной системы. 2015; 3: 22-9.
  18. Памфамиров Ю.К. Самойленко А.В., Волох А.А. Органосохраняющее лечение миомы матки у пациенток репродуктивного возраста. Вестник науки и образования. 2017; 2(26): 97-9.
  19. Auclair M.H., Yong P.J., Salvador S., Thurston J., Colgan T.T.J., Sebastianelli A. Guideline No. 392 - Classification and Management of Endometrial Hyperplasia. J. Obstet Gynaecol Can. 2019; 41(12): 1789-1800. https://dx.doi.org/10.1016/j.jogc.2019.03.025.
  20. Management of Endometrial Hyperplasia. Green-top Guideline No. 67. RCOG/ BSGE Joint Guideline. February, 2016.
  21. Capuano E., Dekker M., Verkerk R., Oliviero T. Food as Pharma? The Case of Glucosinolates. Curr Pharm Des. 2017; 23(19): 2697-2721. https://dx.doi.org/10.2174/1381612823666170120160832.
  22. Liu X., Lv K. Cruciferous vegetables intake is inversely associated with risk of breast cancer: a meta-analysis. Breast. 2013; 22(3): 309-13. https://dx.doi.org/10.1016/j.breast.2012.07.013.
  23. Rogan E.G. The natural chemopreventive compound indole-3-carbinol: state of the science. In Vivo. 2006; 20(2): 221-8.
  24. Riby J.E., Feng C., Chang Y.C., Schaldach C.M., Firestone G.L., Bjeldanes L.F. The major cyclic trimeric product of indole-3-carbinol is a strong agonist of the estrogen receptor signaling pathway. Biochemistry. 2000; 39(5): 910-8. https://dx.doi.org/10.1021/bi9919706.
  25. Зулькарнаева Э.Т., Хакимова Р.Х., Лапан Е.И., Благодетелев И.Л. Индол-3-карбинол в лечении доброкачественных заболеваний молочной железы. Опухоли женской репродуктивной системы. 2008; 3: 50-4.
  26. Смирнова Т.А., Павшук Л.И. Современные подходы к лечению миомы матки у молодых женщин с целью сохранения репродуктивной функции. Медицинский журнал. 2007; 20(2): 105-7.
  27. Краснопольский В.И., Логутова Л.С., Буянова С.Н. Репродуктивные проблемы оперированной матки. М.: Миклош; 2006. 159 c.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies