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Article

Markers of Cellular Proliferation, Apoptosis, Estrogen/Progesterone Receptor Expression and Fibrosis in Selective Progesterone Receptor Modulator (Ulipristal Acetate)-Treated Uterine Fibroids

by
Iwona Szydłowska
1,*,
Marta Grabowska
2,
Jolanta Nawrocka-Rutkowska
1,
Małgorzata Piasecka
2 and
Andrzej Starczewski
1
1
Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland
2
Department of Histology and Developmental Biology, Pomeranian Medical University, Żołnierska 48 Street, 71-210 Szczecin, Poland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(4), 562; https://doi.org/10.3390/jcm10040562
Submission received: 19 December 2020 / Revised: 27 January 2021 / Accepted: 29 January 2021 / Published: 3 February 2021
(This article belongs to the Special Issue Diagnosis and Management of Endometriosis and Uterine Fibroids)
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Abstract

There appear to be very few data on the exact mechanisms of a selective progesterone receptor modulator action in myomas. The aim of the study was to assess the effects of ulipristal acetate (UPA) on fibroids, especially on estrogen receptor (ER) and progesterone receptor (PR) immunoexpression, proliferation, apoptosis and tissue fibrosis, and to compare the above parameters in untreated (surgical attention only) and UPA-treated leiomyomas. UPA-treated patients were divided into three groups: (1) good response (≥25% reduction in volume of fibroid), (2) weak response (insignificant volume reduction) and (3) no response to treatment (no decrease or increase in fibroid volume). The study observed a significant decrease in the percentage of collagen volume fraction and ER and PR immunoexpression in the good response group, in the percentage of proliferating cell nuclear antigen (PCNA)- and Ki67-positive cells in the groups with good and weak reactions vs. control group; significantly higher apoptotic index (terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL)-positive cells) in the good reaction group vs. control group. The results of the study indicate that a good response to UPA, manifested by a volume reduction of myoma, may be associated with a decrease in fibrosis, ER/PR and PCNA and Ki67 immunoexpression and an increase in cell apoptosis within the myoma.
Keywords: uterine myoma; ulipristal acetate; proliferation; apoptosis; fibrosis; estrogen receptor; progesterone receptor uterine myoma; ulipristal acetate; proliferation; apoptosis; fibrosis; estrogen receptor; progesterone receptor

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MDPI and ACS Style

Szydłowska, I.; Grabowska, M.; Nawrocka-Rutkowska, J.; Piasecka, M.; Starczewski, A. Markers of Cellular Proliferation, Apoptosis, Estrogen/Progesterone Receptor Expression and Fibrosis in Selective Progesterone Receptor Modulator (Ulipristal Acetate)-Treated Uterine Fibroids. J. Clin. Med. 2021, 10, 562. https://doi.org/10.3390/jcm10040562

AMA Style

Szydłowska I, Grabowska M, Nawrocka-Rutkowska J, Piasecka M, Starczewski A. Markers of Cellular Proliferation, Apoptosis, Estrogen/Progesterone Receptor Expression and Fibrosis in Selective Progesterone Receptor Modulator (Ulipristal Acetate)-Treated Uterine Fibroids. Journal of Clinical Medicine. 2021; 10(4):562. https://doi.org/10.3390/jcm10040562

Chicago/Turabian Style

Szydłowska, Iwona, Marta Grabowska, Jolanta Nawrocka-Rutkowska, Małgorzata Piasecka, and Andrzej Starczewski. 2021. "Markers of Cellular Proliferation, Apoptosis, Estrogen/Progesterone Receptor Expression and Fibrosis in Selective Progesterone Receptor Modulator (Ulipristal Acetate)-Treated Uterine Fibroids" Journal of Clinical Medicine 10, no. 4: 562. https://doi.org/10.3390/jcm10040562

APA Style

Szydłowska, I., Grabowska, M., Nawrocka-Rutkowska, J., Piasecka, M., & Starczewski, A. (2021). Markers of Cellular Proliferation, Apoptosis, Estrogen/Progesterone Receptor Expression and Fibrosis in Selective Progesterone Receptor Modulator (Ulipristal Acetate)-Treated Uterine Fibroids. Journal of Clinical Medicine, 10(4), 562. https://doi.org/10.3390/jcm10040562

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