In vivo mechanisms of uterine myoma volume reduction with ulipristal acetate treatment

Courtoy, Guillaume E.; Donnez, Jacques; Marbaix, Étienne; Dolmans, Marie-Madeleine

doi:10.1016/j.fertnstert.2015.04.025

Cited by 82 publications

(75 citation statements)

References 58 publications

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“…Patient baselines and treatment groups were described in a previous study [27]. In brief, myoma samples were obtained from women who had taken part in clinical studies (PEARL-II [18, 19] and PEARL-III [15]).…”

Section: Methodsmentioning

confidence: 99%

“…In order to allow for sample heterogeneity, multiple samples were taken from different parts of the biopsies. All samples were subsequently embedded in tissue microarray paraffin blocks, as previously described [27]. The blocks were cut into 5-µm-thick sections and placed on SuperFrost slides for hematoxylin and eosin staining or for immunohistochemistry (IHC).…”

Section: Methodsmentioning

confidence: 99%

“…IHC was performed as described in a previous study [27]. Antibody sources and dilutions are listed in Table 1.…”

Section: Methodsmentioning

confidence: 99%

“…Comprehensive image acquisition from stained sections was performed as formerly reported [27] using the Mirax Slide Scanner (3DHistech). The percentage of immunostained cells (from 0 to 100% ascending in 10% increments) was evaluated at 20× magnification.…”

Section: Methodsmentioning

confidence: 99%

“…We previously reported that UPA-induced reduction of uterine myoma volume involves multifactorial events, including control of proliferation, induction of apoptosis, and extracellular matrix remodeling [27]. However, the molecular signaling pathways triggered by UPA remain to be elucidated.…”

Section: Introductionmentioning

confidence: 99%

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Progesterone Receptor Isoforms, Nuclear Corepressor-1 and Steroid Receptor Coactivator-1 and B-Cell Lymphoma 2 and Akt and Akt Phosphorylation Status in Uterine Myomas after Ulipristal Acetate Treatment: A Systematic Immunohistochemical Evaluation

Courtoy

Donnez

Marbaix

et al. 2017

Gynecol Obstet Invest

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Objective: To investigate whether ulipristal acetate (UPA) treatment modifies the expression of progesterone receptor (PR), its nuclear cofactors steroid receptor coactivator-1 (SRC1) and nuclear corepressor-1 (NCoR1), prosurvival factor B-cell lymphoma 2 (Bcl-2), and Akt in uterine myomas. Patients: Prospective study of 59 women with symptomatic myomas undergoing myomectomy. Forty-two patients were treated preoperatively with UPA; the remaining 17 were not and they served as controls. Method: Tissue microarrays were obtained from surgical specimens and immunohistochemistry was performed. Blinded quantification of expression of PR (PR-A vs. PR-B), coactivator SRC1 and corepressor NCoR1, and prosurvival factor Bcl-2, and Akt and evaluation of Akt phosphorylation levels. Results: Compared with the control group, UPA does not alter PR protein levels or expression patterns in myomas, and the PR-A/PR-B ratio was similar, as well as cytoplasmic or nuclear expression of cofactors SRC1 and NCoR1. Bcl-2 was heterogeneously expressed throughout the samples and no significant modification in expression was evidenced. No significant difference was found in Akt expression and phosphorylation between treated and untreated myomas. Conclusion: This study did not find any significant change in the expression of the studied factors in myomas after UPA exposure. In conclusion, various theories on myomas cells proposed on the basis of in vitro studies are not supported in vivo.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…IHC was performed as described in a previous study [27]. Antibody sources and dilutions are listed in Table 1.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Progesterone Receptor Isoforms, Nuclear Corepressor-1 and Steroid Receptor Coactivator-1 and B-Cell Lymphoma 2 and Akt and Akt Phosphorylation Status in Uterine Myomas after Ulipristal Acetate Treatment: A Systematic Immunohistochemical Evaluation

Courtoy

Donnez

Marbaix

et al. 2017

Gynecol Obstet Invest

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A systematic review and meta‐analysis of ulipristal acetate for symptomatic uterine fibroids

Ghonim

Magdy

Sabbour

et al. 2019

Intl J Gynecology & Obste

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Background Uterine fibroids cause menorrhagia and adversely affect quality of life. Ulipristal acetate (UPA) can improve fibroid symptoms. Objectives To assess the effectiveness of UPA in women with symptomatic uterine fibroids. Search strategy We searched CENTRAL, MEDLINE, Embase, and CINHAL on December 31, 2018, using relevant search terms. Clinical trials registries were searched for ongoing trials and there were no language restrictions. Selection criteria We included randomized controlled trials (RCTs) comparing UPA with placebo/no treatment/any pharmacological intervention for symptomatic uterine fibroids. Data collection and analysis Two authors independently screened trials, extracted data, and assessed the risk of bias in included studies. We used risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, plus their 95% confidence intervals (CIs). Main results We identified six RCTs (1121 participants). Five studies (882 participants) compared UPA with placebo. UPA significantly achieved amenorrhea (RR 24.54; 95% CI, 10.82–55.64), reduced blood loss, and improved quality of life with insufficient evidence from RCTs for adverse events. There was insufficient evidence for improved outcomes when UPA was compared with leuprolide acetate. Conclusion Compared with placebo, oral UPA significantly induces amenorrhea, reduces heavy menses, and improves quality‐of‐life in women with uterine fibroids.

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Influence of Ulipristal Acetate Therapy on Uterine Fibroid‐Related Symptoms and on Uterine and Fibroid Volumes and Vascularity Indices Assessed by Ultrasound

Baggio

Pomini

Galeone

et al. 2018

J of Ultrasound Medicine

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In vivo mechanisms of uterine myoma volume reduction with ulipristal acetate treatment

Cited by 82 publications

References 58 publications

Progesterone Receptor Isoforms, Nuclear Corepressor-1 and Steroid Receptor Coactivator-1 and B-Cell Lymphoma 2 and Akt and Akt Phosphorylation Status in Uterine Myomas after Ulipristal Acetate Treatment: A Systematic Immunohistochemical Evaluation

Progesterone Receptor Isoforms, Nuclear Corepressor-1 and Steroid Receptor Coactivator-1 and B-Cell Lymphoma 2 and Akt and Akt Phosphorylation Status in Uterine Myomas after Ulipristal Acetate Treatment: A Systematic Immunohistochemical Evaluation

A systematic review and meta‐analysis of ulipristal acetate for symptomatic uterine fibroids

Influence of Ulipristal Acetate Therapy on Uterine Fibroid‐Related Symptoms and on Uterine and Fibroid Volumes and Vascularity Indices Assessed by Ultrasound

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