Gene Expression Analysis of Extracellular Matrix and Cytokines after Uterine Artery Embolization

André Bernardo^*, Tatiana Carvalho de Souza Bonetti, Ismael Dale Cotrim Guerreiro da Silva, Mariano Tamura Vieira Gomes, Rodrigo Aquino Castro, Manoel João Batista Castello Girão, Claudio Emilio Bonduki

Gynecology Department, Paulista School of Medicine, Federal University of Sao Paulo (EPM-UNIFESP), Sao Paulo, Brazil.

DOI: 10.4236/ojog.2014.415132                

Abstract

Arterial embolization of myomas (AEM) is an established option for the conservative treatment of uterine leio-myomas; it treats all present uterine nodules at once, is less invasive than other procedures and effective in controlling symptoms, and does not require long term hospitalizations. Nevertheless, the potential impact on endometrial morphological and functional outcomes after the procedure is still controversial based on reports of endometritis or eventual transient ischemia. This study evaluated endometrial reorganization in uterine leiomyoma patients, before and after AEM, through gene expression analyses of extracellular matrix and cytokines genes in theendometrial tissue. Eight patients with leiomyomas were evaluated before AEM and 6 months after. The examinations included transvaginal pelvic ultrasonography, dosing of the follicle-stimulating hormone, and endometrial biopsy during the second phase of the menstrual cycle. RNA was extracted from endometrial samples, cDNA was synthesized, and applied on PCR array^TM plates to evaluate the expression of extracellular matrix (ECM) genes and cytokines and their receptors’ genes (CYT). The ECM overexpressed genes were MMP (1, 3, 10, 11, and 14), CTGF1, ICAM1, TBHS1, ITGA2, ITGA3, ITGB3, COL7A1, COL12A, SPP1, and TNC; ADAMTS8 was underexpressed. The CYT overexpressed genes were SPP1, BCL6, CXCL12, IL-8, and CEBPB; CXCL13 and CCL21 were underexpressed. The ECM results showed overexpression of proteases that are responsible for dysfunctions in the ECM, and of genes responsible for adhesion and membrane components. The CYT results showed overexpression of chemokines responsible for endometrial repair, and underexpression of cytokines involved in inflammatory processes in the endometrial tissue. AEM treatment did not negatively affect the endometrial function at 6 months after embolization. This study broadens the knowledge about using a procedure that is relevant to the treatment of leiomyomas and contributes to the establishment of future guidelines for the decision making process for physicians and patients.

Keywords

Component, Myoma, Arterial Embolization of Myomas, Extracellular Matrix, Cytokines

Conflicts of Interest

The authors declare no conflicts of interest.

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