Markers of Inflammation and Vascular Parameters in Selective Progesterone Receptor Modulator (Ulipristal Acetate)-Treated Uterine Fibroids

Abstract

The exact mechanism of selective progesterone receptor modulator action in leiomyoma still challenges researchers. The aim of the study was to assess the effects of ulipristal acetate (UPA) on immunoexpression of inflammatory markers and vascularization in fibroids. UPA-treated patients were divided into three groups: (1) good response (≥25% reduction in volume of fibroid), (2) weak response (insignificant volume reduction), (3) and no response to treatment (no decrease or increase in fibroid volume). The percentage of TGFβ, IL6, IL10, CD117, and CD68-positive cells were significantly lower in the group with a good response to treatment vs. the control group. Moreover, the percentage of IL10 and CD68-positive cells in the group with a good response to treatment were also significantly lower compared to the no response group. Additionally, a significant decrease in the percentage of IL10-positive cells was found in the good response group vs. the weak response group. There were no statistical differences in the percentage of TNFα-positive cells and vessel parameters between all compared groups. The results of the study indicate that a good response to UPA treatment may be associated with a decrease of inflammatory markers, but it does not influence myoma vascularization.

Keywords: CD31; interleukin 10; interleukin 6; macrophages; mast cells; transforming growth factor β; tumor necrosis factor α; ulipristal acetate; uterine myoma.

Figure 1

Representative light micrographs of immunoexpression (brown-stained cell cytoplasm indicated by black arrows) of inflammatory markers and vessel marker in fibroid cells in the control group and study groups after 3 months of treatment with ulipristal acetate (UPA): good, weak, and no response to treatment. Note: scale bar—100 µm. Abbreviations: CD31—marker of endothelial cells; CD68—marker of cells of the macrophage lineage; CD117—marker of mast cells; IL6—interleukin 6; IL10—interleukin 10; TGFβ 1—transforming growth factor β 1; and TNFα—tumor necrosis factor α.