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Obstetrics and Gynecology International
Volume 2014 (2014), Article ID 783289, 12 pages
Review Article

The Extracellular Matrix Contributes to Mechanotransduction in Uterine Fibroids

1Duke University School of Medicine, Durham, NC 27710, USA
2Unit on Reproductive Endocrinology and Infertility, Program on Pediatric and Adult Endocrinology, NICHD, NIH, Bethesda, MD 20892-1109, USA

Received 21 January 2014; Revised 28 May 2014; Accepted 11 June 2014; Published 3 July 2014

Academic Editor: Peter E. Schwartz

Copyright © 2014 Phyllis C. Leppert 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.


The role of the extracellular matrix (ECM) and mechanotransduction as an important signaling factor in the human uterus is just beginning to be appreciated. The ECM is not only the substance that surrounds cells, but ECM stiffness will either compress cells or stretch them resulting in signals converted into chemical changes within the cell, depending on the amount of collagen, cross-linking, and hydration, as well as other ECM components. In this review we present evidence that the stiffness of fibroid tissue has a direct effect on the growth of the tumor through the induction of fibrosis. Fibrosis has two characteristics: (1) resistance to apoptosis leading to the persistence of cells and (2) secretion of collagen and other components of the ECM such a proteoglycans by those cells leading to abundant disposition of highly cross-linked, disoriented, and often widely dispersed collagen fibrils. Fibrosis affects cell growth by mechanotransduction, the dynamic signaling system whereby mechanical forces initiate chemical signaling in cells. Data indicate that the structurally disordered and abnormally formed ECM of uterine fibroids contributes to fibroid formation and growth. An appreciation of the critical role of ECM stiffness to fibroid growth may lead to new strategies for treatment of this common disease.