NorthWest Centre for Advanced Drug Delivery (NoWCADD), School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
AstraZeneca, Cambridge, UK.
Pharmacol Res Perspect. 2021 Apr;9(2):e00759. doi: 10.1002/prp2.759.
Endometriosis is a chronic disease, characterized by the growth of endometrial-like cells outside the uterine cavity. Due to its complex pathophysiology, a totally resolving cure is yet to be found. The aim of this study was to compare the therapeutic efficacy of AZD4547, a novel fibroblast growth factor receptor inhibitor (FGFRI), with a well-characterized progestin, etonogestrel (ENG) using a validated in vivo mouse model of endometriosis. Endometriosis was induced by transplanting uterine fragments from donor mice in proestrus into the peritoneal cavity of recipient mice, which then developed into cyst-like lesions. AZD4547 and ENG were administered systemically either from the day of endometriosis induction or 2-weeks post-surgery. After 20 days of treatment, the lesions were harvested; their size and weight were measured and analyzed histologically or by qRT-PCR. Stage of estrous cycle was monitored throughout. Compared to vehicle, AZD4547 (25 mg/kg) was most effective in counteracting lesion growth when treating from day of surgery and 2 weeks after; ENG (0.8 mg/kg) was similarly effective in reducing lesion growth but only when administered from day of surgery. Each downregulated FGFR gene expression (p < 0.05). AZD4547 at all doses and ENG (0.008 mg/kg) caused no disturbance to the estrous cycle. ENG at 0.08 and 0.8 mg/kg was associated with partial or complete estrous cycle disruption and hyperemia of the uteri. AZD4547 and ENG both attenuated endometriotic lesion size, but only AZD4547 did not disrupt the estrous cycle, suggesting that targeting of FGFR is worthy of further investigation as a novel treatment for endometriosis.
子宫内膜异位症是一种慢性疾病,其特征是在子宫腔外生长类似子宫内膜的细胞。由于其复杂的病理生理学,目前尚未找到完全根治的方法。本研究旨在比较新型成纤维细胞生长因子受体抑制剂(FGFRI)AZD4547 与经过充分验证的孕激素依托孕烯(ENG)在子宫内膜异位症的体内小鼠模型中的治疗效果。通过将来自发情前期供体小鼠的子宫片段移植到受体小鼠的腹腔中诱导子宫内膜异位症,从而形成囊状病变。从子宫内膜异位症诱导之日或手术后 2 周开始,通过系统给药给予 AZD4547 和 ENG。治疗 20 天后,收获病变;测量和分析其大小和重量,并通过组织学或 qRT-PCR 进行分析。整个过程中监测动情周期的阶段。与载体相比,AZD4547(25mg/kg)在从手术当天和手术后 2 周开始治疗时最有效地抑制病变生长;ENG(0.8mg/kg)在减少病变生长方面同样有效,但仅在手术当天给药时有效。每个下调 FGFR 基因表达(p<0.05)。AZD4547 在所有剂量和 ENG(0.008mg/kg)下均未引起动情周期紊乱。ENG 为 0.08 和 0.8mg/kg 与动情周期部分或完全紊乱以及子宫充血有关。AZD4547 和 ENG 均能减轻子宫内膜异位症病变的大小,但只有 AZD4547 不会破坏动情周期,这表明靶向 FGFR 作为子宫内膜异位症的一种新治疗方法值得进一步研究。