Luz Angela Torres-de la Roche1, Sven Becker2, Cristina Cezar3, Anja Hermann3, Angelika Larbig1, Lasse Leicher1, Attilio Di Spiezio Sardo4, Vasilis Tanos5, Markus Wallwiener6, Hugo Verhoeven1, Rudy Leon De Wilde7. 1. Clinic for Gynecology, Obstetrics and Gynecological Oncology, Pius Hospital, University Hospital for Gynecology, Carl von Ossietzky University Medical School, Georgstrasse 12, 26121, Oldenburg, Germany. 2. Clinic of Gynecology and Obstetrics, Universitäts Klinikum Frankfurt, Frankfurt, Germany. 3. Clinic for Gynecology and Obstetrics, Carl von Ossietzky University Medical School, Oldenburg, Germany. 4. Clinic of Gynecology and Obstetrics, University of Naples Federico II, Naples, Italy. 5. Department of Surgery, Aretaeio Hospital, St. Georges Medical School, Nicosia University, Nicosia, Cyprus. 6. Clinic of Gynecology and Obstetrics and Gynecological Oncology, University of Heidelberg, Heidelberg, Germany. 7. Clinic for Gynecology, Obstetrics and Gynecological Oncology, Pius Hospital, University Hospital for Gynecology, Carl von Ossietzky University Medical School, Georgstrasse 12, 26121, Oldenburg, Germany. rudy-leon.dewilde@pius-hospital.de.
Abstract
INTRODUCTION: Uterine myomatosis, a benign condition, is the most common indication for hysterectomies worldwide, affecting the reproductive goals and quality of health of women. However, gynecologists have been provided with interesting insights on its pathobiology, which are the basis for uterine-preserving therapies. The aim of this paper is to discuss the latest evidence on these mechanisms and its importance in the clinical practice. METHOD: A comprehensive literature search was made in Pubmed, Medline, the Cochrane Library, Orbis plus and Google Scholar for articles related to the epidemiological, biological, and genetic bases. RESULTS: There is extensive evidence that genetic, epigenetic, hormonal, environmental, proinflamatory, angiogenetic, and growing factors are involved in the biology of myomatosis. Such factors are capable of activating and promoting inhibitory signaling pathways leading to initiation, development, and regression of myomata through changes in myometrial cells and myomata fibers, such as cellular proliferation, differentiation, apoptosis, angiogenesis, and changes in the surrounding environment. CONCLUSION: A good understanding of the pathobiologic mechanisms of myomatosis gives reasons to physicians to elect conservative or combined therapies, and allow affected women to receive an individualized management, according to age, reproduction desire, and clinical condition.
INTRODUCTION: Uterine myomatosis, a benign condition, is the most common indication for hysterectomies worldwide, affecting the reproductive goals and quality of health of women. However, gynecologists have been provided with interesting insights on its pathobiology, which are the basis for uterine-preserving therapies. The aim of this paper is to discuss the latest evidence on these mechanisms and its importance in the clinical practice. METHOD: A comprehensive literature search was made in Pubmed, Medline, the Cochrane Library, Orbis plus and Google Scholar for articles related to the epidemiological, biological, and genetic bases. RESULTS: There is extensive evidence that genetic, epigenetic, hormonal, environmental, proinflamatory, angiogenetic, and growing factors are involved in the biology of myomatosis. Such factors are capable of activating and promoting inhibitory signaling pathways leading to initiation, development, and regression of myomata through changes in myometrial cells and myomata fibers, such as cellular proliferation, differentiation, apoptosis, angiogenesis, and changes in the surrounding environment. CONCLUSION: A good understanding of the pathobiologic mechanisms of myomatosis gives reasons to physicians to elect conservative or combined therapies, and allow affected women to receive an individualized management, according to age, reproduction desire, and clinical condition.
Authors: Luz Angela Torres-de la Roche; Sarah Rafiq; Rajesh Devassy; Hugo Christian Verhoeven; Sven Becker; Rudy Leon De Wilde Journal: J Clin Med Date: 2022-02-05 Impact factor: 4.241
Authors: Narine M Tonoyan; Vitaliy V Chagovets; Natalia L Starodubtseva; Alisa O Tokareva; Konstantin Chingin; Irena F Kozachenko; Leyla V Adamyan; Vladimir E Frankevich Journal: Sci Rep Date: 2021-06-01 Impact factor: 4.379