Obeagu Emmanuel Ifeanyi
Department of Biomedical Laboratory Science, Africa University, Mutare, Zimbabwe.
Medicine (Baltimore). 2025 Jun 20;104(25):e42995. doi: 10.1097/MD.0000000000042995.
Uterine fibroids, also known as leiomyomas, are benign tumors of the uterus that disproportionately affect women of reproductive age, often leading to significant clinical symptoms such as abnormal bleeding, pelvic pain, and infertility. Although hormones like estrogen and progesterone have long been established as major contributors to fibroid development, recent advances have shed light on the critical role of growth factors in modulating tumor growth and fibrosis. Among these, platelet-derived growth factor (PDGF) has emerged as a key mediator of cellular proliferation, extracellular matrix deposition, and angiogenesis within fibroid tissues. PDGF exists in several isoforms (AA, BB, AB, CC, DD) and signals through PDGF receptors α and β, activating downstream pathways such as PI3K/AKT, RAS/MAPK, and JAK/STAT. These signaling events promote not only smooth muscle cell proliferation but also fibrotic remodeling by stimulating collagen and fibronectin production. PDGF also interacts with other pathways (particularly transforming growth factor-beta and sex hormones) to amplify fibroid growth and resistance to apoptosis, reinforcing a fibrotic, hormone-responsive microenvironment. Elevated expression of PDGF and its receptors in fibroids compared to normal myometrium supports its central role in pathogenesis.
子宫肌瘤，也被称为平滑肌瘤，是子宫的良性肿瘤，对育龄女性的影响尤为显著，常常导致诸如异常出血、盆腔疼痛和不孕等严重临床症状。尽管长期以来雌激素和孕激素等激素被确认为肌瘤发生的主要促成因素，但最近的研究进展揭示了生长因子在调节肿瘤生长和纤维化过程中的关键作用。其中，血小板衍生生长因子（PDGF）已成为肌瘤组织中细胞增殖、细胞外基质沉积和血管生成的关键介质。PDGF 以几种异构体（AA、BB、AB、CC、DD）形式存在，并通过 PDGF 受体α和β发出信号，激活下游通路，如 PI3K/AKT、RAS/MAPK 和 JAK/STAT。这些信号事件不仅促进平滑肌细胞增殖，还通过刺激胶原蛋白和纤连蛋白的产生促进纤维化重塑。PDGF 还与其他通路（特别是转化生长因子-β和性激素）相互作用，以放大肌瘤生长并增强对细胞凋亡的抵抗，强化纤维化、激素反应性微环境。与正常子宫肌层相比，肌瘤中 PDGF 及其受体的表达升高，支持了其在发病机制中的核心作用。
