Foram estudadas 20 pacientes na menacme portadoras de leiomioma uterino, sintomáticas, que utilizaram anastrozol na dose 1 mg/dia por três meses consecutivos. Durante o tratamento acompanhou-se o volume do conjunto úteroleiomiomas com ultra-sonografia, no momento inicial e após um mês e três meses do início do uso da medicação. Além disso, foi observada a evolução da sintomatologia relacionada ao leiomioma (hipermenorréia, dismenorréia e metrorragia), presença de sintomas ligados ao hipoestrogenismo e dosagens séricas de FSH, estradiol, colesterol total e frações, triglicérides e glicose. Obtivemos redução média do volume do conjunto útero-leiomiomas de 9,32% até 31%. Houve diminuição significante dos sintomas relacionados ao leiomioma do útero. Não ocorreram sintomas ligados ao hipoestrogenismo. Não se comprovou modificação significante dos demais parâmetros estudados. Concluiu-se que o inibidor da aromatase, o anastrozol, na dosagem utilizada, foi efetivo na redução volumétrica do conjunto útero-leiomiomas, além de proporcionar significativa melhora dos sintomas relacionados a essa doença, sem alterar, no entanto, os valores de FSH, estradiol, colesterol total e frações, triglicérides e glicose. / We studied 20 patients in menacme with leiomyoma in the uterus, referring symptoms, using anastrozol 1 mg per day for three months. During this treatment we monitored the uterus-leiomyoma volume using ultrasound, at the beginning, one month after and three months after the beginning of the use of the medication. We also observed the leiomyoma symptoms evolution, presence of usual symptoms of hipoestrogenism and seric values of FSH, estradiol, cholesterol and its fractions triglycerides and glicemia. We obtained reduction in uterus-leiomyoma volume of 9.32% in average, in maximum 31%. There was significative reduction in symptoms related with leiomyoma. There were not symptoms of hipoestrogenism. We not observed significative modifications in the other studied parameters. This study concluded that the aromatase inhibitor, anastrozol, in this dosage, is effective in uterus-leiomyomas reduction, cause significative reduction of the symptoms related with this illness, without change the seric dosage of FSH, estradiol, total cholesterol and fractions, triglycerides and glicemia.

Le léiomyome utérin est la pathologie utérine la plus fréquente chez les femmes en âges de procréer. Des résultats précédent obtenus avec les cellules ELT3, une lignée de cellules de léiomyomes de rat, ont montré que l’acide lysophosphatidique (LPA) activait les MAP kinases ERK1/2 via le récepteur LPA1 couplé à la protéine Gi et l’activation de Raf, Ras et de MEK. Durant ce travail, nous avons caractérisé l’activité phosphatase responsable de la dégradation du LPA dans cette lignée de cellules ELT3. Nous avons montré que le LPA était dégradé exclusivement par la lipide-phosphate phosphatase 1 (LPP1), seule isoforme exprimé dans les cellules ELT3. Dans un deuxième temps nous nous somme intéressés aux effets du diacylglycerol pyrophosphate (DGPP). Le DGPP est un médiateur lipidique qui, sous sa forme dioctanoyl (DGPP8:0), est décrit comme un antagoniste des récepteurs LPA1 et LPA3 chez les mammifères. Dans cette étude, nous montrons que le DGPP8:0 n’a pas d’effet antagoniste sur l’activation du module MAP kinase ERK1/2 par le LPA mais qu’il induit une activation de ERK1/2 dans plusieurs lignées de cellules de mammifères. En effet le DGPP active ERK1/2 à travers l’activation des PKC, Raf et MEK. De plus, nous montrons que l’activation induite par le DGPP repose sur sa déphosphorylation catalysée par une LPP. Nous montrons également que l’inhibition de LPP1 par le VPC32183 ou l’utilisation de siRNA dirigé contre la lipide phosphate-phosphatase 1 (LPP1) réduit l’activation ERK1/2 induite par le DGPP. Ceci montre que le DGPP active ERK1/2 via sa déphosphorylation en acide phosphatidique (PA8:0), catalysée par la LPP1. Enfin dans une dernière partie nous montrons que le myomètre sain, contrairement aux cellules ELT3, exprime à la fois la LPP1 et la LPP3. En étudiant l’effet de la surexpression de la LPP3 dans les cellules ELT3, nous avons observé que la LPP3 interagissait avec la LPP1 et qu’elle pourrait la séquestrer dans des compartiments membranaires internes. Cette séquestration entraine une diminution de l’actvité ecto-LPP au profit de l’activité intracellulaire qui pourrait réguler négativement la production de seconds messagers phospholipidiques. Ces résultats montrent l’importance des LPP dans la régulation des effets des phospholipides bioactifs et suggère un lien entre le caractère tumorale des cellules de léiomyomes et l’absence de la LPP3. / Leiomyoma is the most common uterine disease in women in age of procreation. Previous result have shown that in ELT3 cells, which is a rat leiomyoma-derived cell line, lysophosphatidic acid (LPA) was able to activate ERK1/2 MAP kinases through the activation of the LPA1 receptor via the classical MAP kinase pathway involving Raf, Ras and MEK. We have observed that LPA was dephosphorylated in ELT3 cells by Lipid-phosphate phosphatase 1 (LPP1) which is the only LPP isoform expressed in these cells. In a second part, we investigated the effect of diacylglycerol pyrophosphate (DGPP). DGPP, in its octanoyl form (DGPP8:0), is described as an LPA1, 3-antognist. Here, we show that DGPP had no antagonistic effect on LPA-ERK activation, but was able to induce ERK activation by itself. This activation occurred through the activation of PKC, Raf and MEK. On the other hand, we show that DGPP-ERK activation required its dephosphorylation by LPP. Next we observed that the DGPP-ERK activation was inhibited by VPC32183, which we showed to inhibit LPP activity, and by siRNA treatment targeting LPP1. This results show that DGPP needs to be dephosphorylated into PA to induce ERK phosphorylation, and this dephosphorylation is catalyzed by LPP1. Finally, in the third part of this study, we were interested in the differential LPP expression between ELT3 cells and myometrium cells. Indeed, we have previously observed that ELT3 cell express only LPP1 while myometrial cells express LPP1 and LPP3. We observed that when LPP3 is expressed in ELT3 cells, it can interact with LPP1 and may restrain its plasma membrane localization reducing ectoLPP activity in favor of intracellular LPP activity. This may result in a negative regulation of intracellular phospholipidic second messengers. All these results show the significance of LPP in the regulation of bioactive phospholipid effects and suggest a relationship between the tumoral phenotype of leiomyoma cells and the absence of LPP3.

Background: Uterine fibriod (UF) or leiomyoma is the most frequent benign tumour upon lower genital tract and represents the most frequent indication for hysterectomy. The aetiology remains still unknown. The genetic factors contributing for the development of UF are being intensively investigated. The aim of our study was to look for possible genetic markers which could be used as prognostic tools for evaluation of an increased risk for development of UF. Methods: The study group enrolled 102 patients diagnosed with UF and 145 healthy controls. Ultrasonographic examination of the pelvis was performed and a single blood sample was taken in all women. Histological verification followed the surgery in the patient group. The principal of the cytokine gene polymorphisms detection is based on PCR reaction with sequence-specific primers. Results: A large spectrum of Th1/Th2 cytokine gene polymorphisms in patients with uterine fibroid was compared with control group. The frequencies of the majority of tested cytokine gene SNP in the patient cohort were not statistically different from the cytokine SNP in the control group. However, an intriguing association between polymorphisms of the IL-4 gene promotor at positions -590 C/T and -33 C/T, and the risk of leiomyoma was observed. The CC genotype of IL-4 at position...

Abstract Uterine leiomyomas are the most common benign tumours in females. They are myometrial neoplasms, may present single or multiple, and may be located in various sites of the uterus. Leiomyomas distort the uterine cavity and the uterus itself, causing abnormal vaginal bleeding, reduced fertility and also pelvic pressure and pain symptoms. The aim of this study was to elaborate current knowledge on familial uterine leiomyomas and to explore the possible association between uterine leiomyoma and cardiovascular disease risk factors, and also the association between leiomyomas and endometriosis. The natural history of familial uterine leiomyoma study showed significant differences between familial and non-familial leiomyoma cases, familial cases having more severe clinical characteristics. They presented with multiple uterine leiomyomas and were more often symptomatic. They were also diagnosed at a younger age. The prevalence study on uterine leiomyomas and endometriosis offered confirmation of an association between the diseases. Uterine leiomyomas and endometriosis seem to decrease female fertility independently of each other. Uterine leiomyomas related to the hereditary leiomyomatosis and renal cell cancer (HLRCC) tumour syndrome were studied in regard to their clinical characteristics and immunophenotype. The study provided evidence that women with HLRCC may be identified through distinct leiomyoma clinical characteristics, and routine-use IHC of CD34 and Bcl-2. Distinguishing these leiomyoma cases from sporadic ones may identify families affected by fumarate hydratase (fumarase, FH) mutation. Uterine leiomyoma and cardiovascular disease risk factors were studied in The Northern Finland Birth Cohort 1966 (NFBC1966). The study showed an association between leiomyomas and raised cardiovascular disease risk factors, serum lipids and metabolic syndrome in particular. These findings may suggest that there are shared predisposing factors underlying both uterine leiomyomas and adverse metabolic and cardiac disease risks, or that metabolic factors have a role in biological mechanisms underlying leiomyoma development. This study provides novel information on clinical characteristics of familial uterine leiomyomas and on the immunophenotype of HLRCC-related leiomyomas. The study also offers significant confirmation of associations between uterine leiomyomas and both endometriosis and several CVD risk factors. / Tiivistelmä Kohdun leiomyoomat ovat naisten yleisin hyvänlaatuinen kasvain. Ne ovat myometriumin neoplastisia muutoksia ja ne ilmenevät joko yksittäisinä tai monilukuisina, ja ne voivat sijaita missä tahansa kohdun myometriumia. Leiomyoomat muuttavat kohdun ja kohtuontelon säännöllistä muotoa. Lisäksi ne aiheuttavat vuotohäiriöitä, alentunutta hedelmällisyyttä, ja lantion alueen painetta ja kipua. Tämän tutkimuksen tavoitteena oli laajentaa nykyistä tietämystä suvuittain esiintyvistä kohdun leiomyoomista ja selvittää mahdollista leiomyoomien ja kardiovaskulaaritautiriskin assosiaatiota, ja lisäksi selvittää leiomyoomien ja endometrioosin assosiaatiota. Suvuittain esiintyvien kohdun leiomyoomien taudinkulkua selvittävässä tutkimuksessa osoitettiin merkittäviä eroja suvuittain ja ei-suvuittain esiintyvien leiomyoomien välillä. Suvuittain esiintyvien leiomyoomien kliininen taudinkuva oli vaikeampi, leiomyoomia oli kohdussa useampia ja ne aiheuttivat useammin oireita ja lisäksi ne diagnosoitiin nuoremmalla iällä. Kohdun leiomyoomien ja endometrioosin yleisyyttä selvittävä tutkimus antoi lisävahvistusta sille havainnolle, että nämä taudit assosioivat keskenään. Tutkimustuloksen mukaan leiomyoomat ja endometrioosi vähentävät naisen hedelmällisyyttä toisistaan riippumatta. Perinnöllinen kohdun leiomyomatoosi ja munuaissyöpä (hereditary leiomyomatosis and renal cell cancer, HLRCC) -kasvainoireyhtymään liittyvän kohdun leiomyoomia selvittävän tutkimuksen tuloksien mukaan HLRCC-naisten kohdun leiomyoomien kliiniset ominaisuudet poikkeavat satunnaisesti esiintyvien leiomyoomien ominaisuuksista. Naisella HLRCC voitaisiinkin tunnistaa näiden poikkeavien ominaisuuksien perusteella, sekä immunohistokemiallisilla värjäyksillä CD34 ja Bcl-2. Fumaraattihydrataasi (fumaraasi, FH) -geenin mutaatiota kantava suku voitaisiin siten tunnistaa yksittäisen HLRCC leiomyoomatapauksen avulla. Pohjois-Suomen syntymäkohortti 1966 (Northern Finland Birth Cohort 1966, NFBC1966) tutkittiin kohdun leiomyoomia ja kardiovaskulaarisairauden riskitekijöitä. Tutkimustuloksien perusteella kohdun leiomyoomat assosioivat koholla olevien kardiovaskulaarisairauden riskien kanssa, erityisesti seerumin lipidien ja metabolisen syndrooman suhteen. Näiden tutkimustulosten perusteella voidaan esittää, että leiomyoomien ja terveydelle epäedullisen metabolian ja kardiovaskulaaritaudin riskien taustalla on mahdollisesti joitain yhteisiä altistavia tekijöitä, tai että metabolisilla tekijöillä on rooli kohdun leiomyoomien tautimekanismissa. Tämä tutkimus on tuottanut uutta tietoa suvuittain esiintyvien kohdun leiomyoomien kliinisestä taudinkuvasta ja HLRCC:n liittyvien leiomyoomien immunofenotyypistä. Lisäksi tämä tutkimus esittää lisävahvistusta kohdun leiomyoomien ja endometrioosin assosiaatiolle sekä useille kardiovaskulaaririskitekijöille.

Background: Uterine fibriod (UF) or leiomyoma is the most frequent benign tumour upon lower genital tract and represents the most frequent indication for hysterectomy. The aetiology remains still unknown. The genetic factors contributing for the development of UF are being intensively investigated. The aim of our study was to look for possible genetic markers which could be used as prognostic tools for evaluation of an increased risk for development of UF. Methods: The study group enrolled 102 patients diagnosed with UF and 145 healthy controls. Ultrasonographic examination of the pelvis was performed and a single blood sample was taken in all women. Histological verification followed the surgery in the patient group. The principal of the cytokine gene polymorphisms detection is based on PCR reaction with sequence-specific primers. Results: A large spectrum of Th1/Th2 cytokine gene polymorphisms in patients with uterine fibroid was compared with control group. The frequencies of the majority of tested cytokine gene SNP in the patient cohort were not statistically different from the cytokine SNP in the control group. However, an intriguing association between polymorphisms of the IL-4 gene promotor at positions -590 C/T and -33 C/T, and the risk of leiomyoma was observed. The CC genotype of IL-4 at position...