Impact of therapy with a selective progesterone receptor modulator on the synthesis of factors that regulate apoptosis and proteolysis in the myomatous nodules of patients with large leiomyoma


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Objective. To determine the in vivo molecular mechanisms of action of ulipristal acetate on the cell apoptosis of myomatous nodules and on the proteolysis of extracellular matrix components and to identify the features of a tumor cell response to the drug during its therapy showing varying clinical efficacy. Subjects and methods. A total of 32 women with uterine leiomyoma (17 had not been preoperatively prepared and 15 women had preoperatively received ulipristal acetate 5 mg daily for 3 months) were examined. PCR was used to determine XIAP, PPARγ, PTEN, and MMP-2 mRNA expression levels in the biopsies of the myometrium and myomatous nodules. Results. The drug-untreated patients showed a higher XIAP, PPARγ, PTEN, and MMP-2 mRNA expression in the myomatous nodes than in the myometrium. The synthesis of XIAP and MMP-2 decreased and the expression of PPARγ mRNA increased in the leiomyomas of the treated women as compared to those of the untreated ones. The ulipristal acetate-induced reduction in nodular sizes was associated with the highest rates of PPARγ and PTEN synthesis in the tumor. Conclusion. The ulipristal acetate-induced reduction in uterine leiomyoma sizes occurs due to the induction of apoptosis in the tumor, by increasing the synthesis of the pro-apoptotic factors PPARγ and PTEN.

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作者简介

Anna Malyshkina

V.N. Gorodkov Ivanovo Research Institute of Maternity and Childhood, Ministry of Health of Russia

Email: ivniimid@mail.ru
MD, the director

Dmitry Voronin

V.N. Gorodkov Ivanovo Research Institute of Maternity and Childhood, Ministry of Health of Russia

Email: niimid.immune@mail.ru
PhD, scientific worker of the laboratory of clinical immunology

Yulia Antsiferova

V.N. Gorodkov Ivanovo Research Institute of Maternity and Childhood, Ministry of Health of Russia

Email: niimid.immune@mail.ru
BD, senior scientific worker of the laboratory of clinical immunology

Sergey Nagornyi

V.N. Gorodkov Ivanovo Research Institute of Maternity and Childhood, Ministry of Health of Russia

Email: nagornomu@gmail.com
radiologist of Radiology diagnostic Department

Aleksey Kirsanov

V.N. Gorodkov Ivanovo Research Institute of Maternity and Childhood, Ministry of Health of Russia

Email: drkirsanov@gmail.com
PhD, obstetrician-gynecologist of the 4th gynecological department

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