Kuznetsova Maria V, Tonoyan Narine M, Trubnikova Elena V, Zelensky Dmitry V, Svirepova Ksenia A, Adamyan Leila V, Trofimov Dmitry Y, Sukhikh Gennady T
Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, 117997 Moscow, Russia.
Genetics Research Laboratory, Kursk State University, 305000 Kursk, Russia.
Diseases. 2023 Nov 1;11(4):156. doi: 10.3390/diseases11040156.
Uterine leiomyomas are the most common benign tumors in women of childbearing age. They may lead to problems of conception or complications during the gestational period. The methods of treatment include surgical (myomectomy and hysterectomy, embolization of arteries) and therapeutic treatment (ulipristal acetate, leuprolide acetate, cetrorelix, goserelin, mifepristone). Both approaches are efficient but incompatible with pregnancy planning. Therefore, there is a call for medical practice to develop therapeutical means of preventing leiomyoma onset in patients planning on becoming pregnant. Based on the analysis of GWAS data on the search for mononucleotide polymorphisms associated with the risk of leiomyoma, in meta-transcriptomic and meta-methylomic studies, target proteins have been proposed. Prospective therapeutic treatments of leiomyoma may be based on chemical compounds, humanized recombinant antibodies, vaccines based on markers of the uterine leiomyoma cells that are absent in the adult organism, or DNA and RNA preparations. Three different nosological forms of the disease associated with driver mutations in the , and genes should be considered when developing or prescribing drugs. For example, synthetic inhibitors and vaccines based on matrix metalloproteinases and are expected to be effective only for the prevention of the occurrence of -dependent nodules.
子宫平滑肌瘤是育龄期女性最常见的良性肿瘤。它们可能导致受孕问题或妊娠期并发症。治疗方法包括手术治疗（肌瘤切除术和子宫切除术、动脉栓塞）和药物治疗（醋酸乌利司他、醋酸亮丙瑞林、西曲瑞克、戈舍瑞林、米非司酮）。这两种方法都有效，但都与妊娠计划不相容。因此，医疗实践需要开发预防计划怀孕患者发生平滑肌瘤的治疗方法。基于对全基因组关联研究（GWAS）数据的分析，以寻找与平滑肌瘤风险相关的单核苷酸多态性，在元转录组学和元甲基组学研究中，已经提出了靶蛋白。平滑肌瘤的前瞻性治疗可能基于化合物、人源化重组抗体、基于成年生物体中不存在的子宫平滑肌瘤细胞标志物的疫苗，或DNA和RNA制剂。在开发或开处方药物时，应考虑与 、 和 基因中的驱动突变相关的三种不同疾病分类形式的疾病。例如，基于基质金属蛋白酶 和 的合成抑制剂和疫苗预计仅对预防依赖 的结节的发生有效。
