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Effects of the levonorgestrel-releasing intrauterine system on cell proliferation, Fas expression and steroid receptors in endometriosis lesions and normal endometrium.
Hum Reprod. 2009 Nov; 24(11):2736-45.HR

Abstract

BACKGROUND

The objectives of this study were: (i) to evaluate the effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) on both proliferation and apoptosis markers and hormone receptors of the eutopic and ectopic endometrium of women experiencing pain related to endometriosis and (ii) to compare the results with those obtained with GnRH agonist (GnRHa) injections.

METHODS

Pre- and post-treatment endometrium and endometriosis specimens were obtained from 22 women experiencing pain related to endometriosis who were treated with LNG-IUS (n = 11) or GnRHa (n = 11) for 6 months. Changes in the expression of proliferating cell nuclear antigen, Fas, progesterone receptor (PRA) and estrogen receptor alpha (ER-alpha) were analyzed by immunohistochemistry.

RESULTS

The cell proliferation index was significantly reduced in the epithelium and stroma of both the eutopic and the ectopic endometrium after treatment with the LNG-IUS and GnRHa. Only LNG-IUS users showed an increased H-score for Fas in the epithelium of the eutopic and ectopic endometrium (P < 0.05). Expression of ER-alpha and PRA by the glandular epithelium was lower in the eutopic endometrium after both treatments, but this reduction was noted in the ectopic endometrium only after LNG-IUS treatments (P < 0.05). No difference was detected between groups for any of the markers.

CONCLUSIONS

LNG-IUS reduced both cell proliferation and the expression of PRA and ER-alpha and increased Fas expression in the eutopic and ectopic endometrium of patients with endometriosis. Some of these actions were not observed with GnRHa.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, School of Medicine of Ribeirão Preto, University of São Paulo, 14049-900 Ribeirão Preto, SP, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19661125

Citation

Gomes, M K O., et al. "Effects of the Levonorgestrel-releasing Intrauterine System On Cell Proliferation, Fas Expression and Steroid Receptors in Endometriosis Lesions and Normal Endometrium." Human Reproduction (Oxford, England), vol. 24, no. 11, 2009, pp. 2736-45.
Gomes MK, Rosa-e-Silva JC, Garcia SB, et al. Effects of the levonorgestrel-releasing intrauterine system on cell proliferation, Fas expression and steroid receptors in endometriosis lesions and normal endometrium. Hum Reprod. 2009;24(11):2736-45.
Gomes, M. K., Rosa-e-Silva, J. C., Garcia, S. B., de Sá Rosa-e-Silva, A. C., Turatti, A., Vieira, C. S., & Ferriani, R. A. (2009). Effects of the levonorgestrel-releasing intrauterine system on cell proliferation, Fas expression and steroid receptors in endometriosis lesions and normal endometrium. Human Reproduction (Oxford, England), 24(11), 2736-45. https://doi.org/10.1093/humrep/dep288
Gomes MK, et al. Effects of the Levonorgestrel-releasing Intrauterine System On Cell Proliferation, Fas Expression and Steroid Receptors in Endometriosis Lesions and Normal Endometrium. Hum Reprod. 2009;24(11):2736-45. PubMed PMID: 19661125.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of the levonorgestrel-releasing intrauterine system on cell proliferation, Fas expression and steroid receptors in endometriosis lesions and normal endometrium. AU - Gomes,M K O, AU - Rosa-e-Silva,J C, AU - Garcia,S B, AU - de Sá Rosa-e-Silva,A C Japur, AU - Turatti,A, AU - Vieira,C S, AU - Ferriani,R A, Y1 - 2009/08/06/ PY - 2009/8/8/entrez PY - 2009/8/8/pubmed PY - 2010/2/19/medline SP - 2736 EP - 45 JF - Human reproduction (Oxford, England) JO - Hum Reprod VL - 24 IS - 11 N2 - BACKGROUND: The objectives of this study were: (i) to evaluate the effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) on both proliferation and apoptosis markers and hormone receptors of the eutopic and ectopic endometrium of women experiencing pain related to endometriosis and (ii) to compare the results with those obtained with GnRH agonist (GnRHa) injections. METHODS: Pre- and post-treatment endometrium and endometriosis specimens were obtained from 22 women experiencing pain related to endometriosis who were treated with LNG-IUS (n = 11) or GnRHa (n = 11) for 6 months. Changes in the expression of proliferating cell nuclear antigen, Fas, progesterone receptor (PRA) and estrogen receptor alpha (ER-alpha) were analyzed by immunohistochemistry. RESULTS: The cell proliferation index was significantly reduced in the epithelium and stroma of both the eutopic and the ectopic endometrium after treatment with the LNG-IUS and GnRHa. Only LNG-IUS users showed an increased H-score for Fas in the epithelium of the eutopic and ectopic endometrium (P < 0.05). Expression of ER-alpha and PRA by the glandular epithelium was lower in the eutopic endometrium after both treatments, but this reduction was noted in the ectopic endometrium only after LNG-IUS treatments (P < 0.05). No difference was detected between groups for any of the markers. CONCLUSIONS: LNG-IUS reduced both cell proliferation and the expression of PRA and ER-alpha and increased Fas expression in the eutopic and ectopic endometrium of patients with endometriosis. Some of these actions were not observed with GnRHa. SN - 1460-2350 UR - https://www.unboundmedicine.com/medline/citation/19661125/Effects_of_the_levonorgestrel_releasing_intrauterine_system_on_cell_proliferation_Fas_expression_and_steroid_receptors_in_endometriosis_lesions_and_normal_endometrium_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/dep288 DB - PRIME DP - Unbound Medicine ER -