Introduction. Uterine leiomyoma is the most common benign tumor in women, which is accompanied by the life quality decrease and infertility. Despite numerous studies, the etiology of uterine myoma is still unknown.The aim of the study was to determine the effects of a mixture of polyclonal activators on the interleukin production by dominant myomatous and myometrial tissue samples under treating by ulipristal acetate (UA), a selective modulator of progesterone receptors.Materials and methods. Surgical material of 35 reproductiveaged women with multiple uterine myoma (1st group – without hormone therapy, 2nd group – after UA) was studied using enzyme immunoassay analysis. After determining of cytokine production, being spontaneous and stimulated by polyclonal activators phytohemagglutinin, concanavalin A, and lipopolysaccharide, the cytokine production stimulation index (SIPA) was calculated, followed by statistical analysis.Results. In patients of the 1st group the SIPA of IL-1β, IL-6 and IL-10 in the myomatous nodes and myometrium did not differ; at the same time, SIPA of IL-18 and 17-OH-progesterone were statistically higher in the myometrium samples than in the nodes (p < 0.05). In patients of the 2nd group, who have been treated by UA before myomectomy, there was a significantly higher SIPA of the IL-6 (p < 0.001) and IL-10 (p = 0.002) in the myometrium samples, compared with the dominant nodes. When comparing the nodes and myometrium between two groups, it was revealed that, compared with the 1st group, in patients using UA in the supernatants of myomatous nodes, out of 5 studied markers, the SIPA of the pro-inflammatory cytokine Il-6 was down-regulated (p = 0.013). In the myometrial supernatants in the 2nd group, there were a higher SIPA of anti-inflammatory IL-10 (p < 0.001), as well as the lower levels of pro-inflammatory IL-18 (p < 0.001).Discussion. The results of study demonstrate the anti-inflammatory effect of UA on the cellular elements of the dominant myomatous nodes and perifocal myometrium, and also confirm the role of inflammation in the pathogenesis of uterine fibroids.Conclusion. Polyclonal activators during in vitro incubation, had multidirectional effects on the production of some interleukins and the content of the progesterone metabolite in the tissue of the dominant myomatous node and perifocal myometrium.

Лейомиома матки (миома, или фиброма)-доброкачественная опухоль, наиболее часто встречающаяся у женщин, в том числе репродуктивного возраста, значительно влияющая на детородную функцию и качество жизни [1-3]. Заболевание характеризуется вариабельной клинической картиной. Тактика ведения зависит от возраста и репродуктивных задач пациентки, а также анатомо-топографических особенностей миоматозных узлов [4]. До 50-70% пациенток с миомой подвергаются хирургическому лечению [5], и по-прежнему актуальны патогенетически обоснованные методы консервативного лечения. Высокая распространенность заболевания (до 80% у афроамериканских и 50% у европейских женщин) [6, 7] индуцировала многочисленные научные исследования, тем не менее этиопатогенез лейомиомы матки привлекает пристальное внимание. В настоящее время наряду с представлениями о моноклональной гиперплазии и циклической механотрансдукции гладких миоцитов [8, 9], о влиянии стероидных гормонов [10-12] признана роль патологической васкуляризации опухолевых узлов миометрия [13], что позволило разработать метод эмболизации маточных артерий и ФУЗ-аблацию, однако не решило про