Wu Yan, Guo Sun-Wei
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226-0509, USA.
Gynecol Obstet Invest. 2006;62(4):193-205. doi: 10.1159/000093975. Epub 2006 Jun 16.
All current major medications in treating endometriosis are effective in treating pain, most likely through suppression of proliferation of the implants, yet their effectiveness is relatively short term and they all have many undesirable, and sometimes severe, side effects. There is pressing need for novel, more effective medications in treating endometriosis with less and/or milder side effects.
Using a recently established immortalized endometrial stromal cell line, we carried out cell proliferation assays for cells treated with trichostatin A (TSA), RU486, CDB-2914, and N-acetylcysteine, and ICI 182780. Gene expression levels for PR-A, PR-B, AR, Fas and FasL were measured. Protein expression levels for ERalpha, ERbeta, and AR were also measured.
Cell proliferation assay results for NAC, H2O2, CDB, and RU486 were nearly identical or similar to what have been reported based on primary cell cultures or in vivo studies. TSA, CDB, RU486 and NAC all had various antiproliferative effects. TSA had a more potent and longer lasting antiproliferative effect than CDB and NAC, even in the presence of an oxidant, H2O2. Its antiproliferative effect was concentration-dependent. ICI did not have a significant antiproliferative effect. PR-A, PR-B, AR, and FasL expression were all increased as compared with untreated cells.
The cell line appears to be an adequate model for stromal components of endometriotic implants. That ICI has no inhibitory effect on endometrial proliferation may explain why a phase II clinical trial on its use to treat endometriosis did not advance to later stages. The upregulation of PR-B and AR may be responsible for antiproliferative effects induced by TSA, a histone deacetylase inhibitor (HDACI). HDACIs may be promising therapeutics in treating endometriosis due to their antiproliferative effects as well as the potential to restore gene dysregulation through chromatin remodeling.
目前治疗子宫内膜异位症的所有主要药物在治疗疼痛方面均有效,很可能是通过抑制植入物的增殖来实现的,然而它们的疗效相对较短,并且都有许多不良的,有时甚至是严重的副作用。迫切需要新型、更有效的药物来治疗子宫内膜异位症,且副作用更少和/或更轻微。
使用最近建立的永生化子宫内膜基质细胞系,我们对用曲古抑菌素A(TSA)、米非司酮、CDB - 2914、N - 乙酰半胱氨酸和ICI 182780处理的细胞进行了细胞增殖测定。测量了PR - A、PR - B、AR、Fas和FasL的基因表达水平。还测量了ERα、ERβ和AR的蛋白质表达水平。
NAC、H2O2、CDB和米非司酮的细胞增殖测定结果与基于原代细胞培养或体内研究报道的结果几乎相同或相似。TSA、CDB、米非司酮和NAC都有各种抗增殖作用。即使在存在氧化剂H2O2的情况下,TSA也比CDB和NAC具有更强且持续时间更长的抗增殖作用。其抗增殖作用是浓度依赖性的。ICI没有显著的抗增殖作用。与未处理的细胞相比,PR - A、PR - B、AR和FasL的表达均增加。
该细胞系似乎是子宫内膜异位症植入物基质成分的合适模型。ICI对子宫内膜增殖没有抑制作用,这可能解释了为何其用于治疗子宫内膜异位症的II期临床试验未进入后期阶段。PR - B和AR的上调可能是组蛋白去乙酰化酶抑制剂(HDACI)TSA诱导抗增殖作用的原因。由于HDACIs具有抗增殖作用以及通过染色质重塑恢复基因失调的潜力,它们可能是治疗子宫内膜异位症的有前景的疗法。