McWilliams Michelle M, Chennathukuzhi Vargheese M
Department of Molecular and Integrative Physiology, Center for Reproductive Sciences, IRHRM, University of Kansas Medical Center, Kansas.
Semin Reprod Med. 2017 Mar;35(2):181-189. doi: 10.1055/s-0037-1599090. Epub 2017 Mar 9.
Uterine fibroids, also known as uterine leiomyoma (UL), are monoclonal tumors of the smooth muscle tissue layer (myometrium) of the uterus. Although ULs are considered benign, uterine fibroids are the source of major quality-of-life issues for approximately 25% of all women, who suffer from clinically significant symptoms of UL. Despite the prevalence of UL, there is no treatment option for UL which is long term, cost-effective, and leaves fertility intact. The lack of understanding about the etiology of UL contributes to the scarcity of medical therapies available. Studies have identified an important role for sex steroid hormones in the pathogenesis of UL, and have driven the use of hormonal treatment for fibroids, with mixed results. Dysregulation of cell signaling pathways, miRNA expression, and cytogenetic abnormalities have also been implicated in UL etiology. Recent discoveries on the etiology of UL and the development of relevant genetically modified rodent models of UL have started to revitalize UL research. This review outlines the major characteristics of fibroids; major contributors to UL etiology, including steroid hormones; and available preclinical animal models for UL.
子宫肌瘤，也称为子宫平滑肌瘤（UL），是子宫平滑肌组织层（肌层）的单克隆肿瘤。尽管UL被认为是良性的，但子宫肌瘤却是约25%的女性生活质量问题的主要根源，这些女性患有具有临床意义的UL症状。尽管UL很常见，但目前尚无长期、经济有效且不影响生育能力的UL治疗方案。对UL病因的认识不足导致可用药物治疗方法匮乏。研究已确定性类固醇激素在UL发病机制中起重要作用，并推动了子宫肌瘤激素治疗的应用，但结果不一。细胞信号通路失调、miRNA表达异常和细胞遗传学异常也与UL病因有关。最近关于UL病因的发现以及相关UL基因改造啮齿动物模型的开发已开始重振UL研究。本综述概述了肌瘤的主要特征；UL病因的主要促成因素，包括类固醇激素；以及现有的UL临床前动物模型。
