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International Journal of Endocrinology
Volume 2012 (2012), Article ID 436174, 6 pages
http://dx.doi.org/10.1155/2012/436174
Clinical Study

Effect of a Selective Progesterone Receptor Modulator on Induction of Apoptosis in Uterine Fibroids In Vivo

1Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University in Prague, Apolinarska 18, 128 00 Prague, Czech Republic
2Institute of Pathology, First Faculty of Medicine, Charles University in Prague, 128 00 Prague, Czech Republic
3Department of Obstetrics and Gynaecology, University Hospital Brno, 625 00 Brno, Czech Republic
4Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University in Prague, 150 06 Prague, Czech Republic

Received 7 March 2012; Revised 18 May 2012; Accepted 18 May 2012

Academic Editor: Faustino R. Pérez-López

Copyright © 2012 Petr Horak et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. To determine if hormonal treatment induces apoptosis in uterine fibroids. Methods. Immunohistochemical examination of fibroid tissue, using avidin-biotin complex and cleaved caspase-3 antibody for detecting apoptosis, was performed in premenopausal women who underwent 12-week treatment with oral SPRM (6 patients with 5 mg and 5 patients with 10 mg of ulipristal acetate per day) or gonadoliberin agonist (GnRHa, 17 patients) and subsequent myomectomy or hysterectomy for symptomatic uterine fibroids. Ten patients with no presurgical hormonal treatment were used as controls. Results. Apoptosis was present in a significantly higher proportion of patients treated with ulipristal acetate compared to GnRHa ( ) and to patients with no hormonal treatment ( ). In contrast to an AI of 158.9 in SPRM patients, the mean AI was 27.5 and 2.0 in GnRHa and control groups, respectively. No statistical difference in the AI was observed between the two groups of patients treated with ulipristal acetate (5 mg or 10 mg). Conclusion. Treatment with ulipristal acetate induces apoptosis in uterine fibroid cells. This effect of SPRM may contribute to their positive clinical effect on uterine fibroids.