Utilising Human Myometrial and Uterine Fibroid Stem Cell-Derived Three Dimentional Organoids as a Robust Model System for Understanding the Pathophysiology of Uterine Fibroids

Mervat M. Omran , Somayeh Vafaei , Samar Alkhrait , Farzana Liakath Ali , Maria Victoria Bariani , Tao Bai , Winston E. Thompson , Qiwei Yang , Mohamed Ali , Ayman Al-Hendy

Cell Proliferation ›› 2025, Vol. 58 ›› Issue (9) : e70025

PDF
Cell Proliferation ›› 2025, Vol. 58 ›› Issue (9) : e70025 DOI: 10.1111/cpr.70025
ORIGINAL ARTICLE

Utilising Human Myometrial and Uterine Fibroid Stem Cell-Derived Three Dimentional Organoids as a Robust Model System for Understanding the Pathophysiology of Uterine Fibroids

Author information +
History +
PDF

Abstract

Uterine fibroids (UFs) are the most common benign gynecologic tumours affecting women of reproductive age. This study aims to deepen the understanding of UFs complex aetiology through harnessing the power of 3D organoid models derived from human myometrial stem cells to emulate the in vivo behaviour of these tumours. Isolated SCs were cultured over 7 days under a defined culture system. Immunohistochemistry, Immunofluorescence, organoid stiffness, RNA Sequencing was conducted, and differential gene expression was assessed using RT-PCR. The derived organoids exhibited diverse populations of cells, including stem cells, smooth muscle, and fibroblasts. Excessive ECM deposition was shown via Collagen and Fibronectin expression. We confirmed that our organoids expressed oestrogen receptor in a pattern similar to that in their corresponding tissue, as well as responded to steroid hormone. Interestingly, we revealed significant racial disparities in ECM accumulation within organoids derived from different racial groups. This augmented ECM deposition is theorised to enhance tissue stiffness, as assessed using Young's modulus. Additionally, our research demonstrated significant decreases in fibrotic markers upon treatment with Vitamin D3 and Doxercalciferol. Furthermore, the pro-fibroid effects of environmental phthalates further elucidate the potential factors contributing to UF pathology. The 3D organoid model can serve as a robust platform to study the underlying molecular mechanisms of UFs, besides offering invaluable insights for potential therapeutic interventions.

Keywords

3D organoids / extracellular matrix / racial disparities / uterine fibroid

Cite this article

Download citation ▾
Mervat M. Omran, Somayeh Vafaei, Samar Alkhrait, Farzana Liakath Ali, Maria Victoria Bariani, Tao Bai, Winston E. Thompson, Qiwei Yang, Mohamed Ali, Ayman Al-Hendy. Utilising Human Myometrial and Uterine Fibroid Stem Cell-Derived Three Dimentional Organoids as a Robust Model System for Understanding the Pathophysiology of Uterine Fibroids. Cell Proliferation, 2025, 58(9): e70025 DOI:10.1111/cpr.70025

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

L. A. Wise and S. K. Laughlin-Tommaso, “Epidemiology of Uterine Fibroids: From Menarche to Menopause,” Clinical Obstetrics and Gynecology 59, no. 1 (2016): 2-24.

[2]

A. Navarro, M. V. Bariani, Q. Yang, and A. al-Hendy, “Understanding the Impact of Uterine Fibroids on Human Endometrium Function,” Frontiers in Cell and Development Biology 9 (2021): 633180.

[3]

N. Sefah, S. Ndebele, L. Prince, et al., “Uterine Fibroids-Causes, Impact, Treatment, and Lens to the African Perspective,” Frontiers in Pharmacology 13 (2022): 1045783.

[4]

S. Vannuccini, S. Clemenza, E. Cassioli, et al., “Uterine Fibroids, Perceived Stress, and Menstrual Distress: A Key Role of Heavy Menstrual Bleeding,” Reproductive Sciences 30, no. 5 (2023): 1608-1615.

[5]

M. Ali, M. V. Bariani, S. Vafaei, et al., “Prevention of Uterine Fibroids: Molecular Mechanisms and Potential Clinical Application,” Journal of Endometriosis and Uterine Disorders 1 (2023): 100018, https://doi.org/10.1016/j.jeud.2023.100018.

[6]

A. Al-Hendy, A. S. Lukes, A. N. Poindexter, et al., “Long-Term Relugolix Combination Therapy for Symptomatic Uterine Leiomyomas,” Obstetrics and Gynecology 140, no. 6 (2022): 920-930.

[7]

M. Ali, M. Ciebiera, S. Vafaei, et al., “Progesterone Signaling and Uterine Fibroid Pathogenesis; Molecular Mechanisms and Potential Therapeutics,” Cells 12, no. 8 (2023): 1117.

[8]

J. Kim, B.-K. Koo, and J. A. Knoblich, “Human Organoids: Model Systems for Human Biology and Medicine,” Nature Reviews Molecular Cell Biology 21, no. 10 (2020): 571-584.

[9]

S. Yang, H. Hu, H. Kung, et al., “Organoids: The Current Status and Biomedical Applications,” MedComm 4, no. 3 (2020): e274.

[10]

B. X. Ho, N. M. Q. Pek, and B. S. Soh, “Disease Modeling Using 3D Organoids Derived From Human Induced Pluripotent Stem Cells,” International Journal of Molecular Sciences 19, no. 4 (2018): 936, https://doi.org/10.3390/ijms19040936.

[11]

L. Liu, L. Yu, Z. Li, W. Li, and W. R. Huang, “Patient-Derived Organoid (PDO) Platforms to Facilitate Clinical Decision Making,” Journal of Translational Medicine 19, no. 1 (2021): 40.

[12]

M. Kapałczyńska, T. Kolenda, W. Przybyła, et al., “2D and 3D Cell Cultures-A Comparison of Different Types of Cancer Cell Cultures,” Archives of Medical Science 14, no. 4 (2018): 910-919, https://doi.org/10.5114/aoms.2016.63743.

[13]

S. Banerjee, W. Xu, I. Chowdhury, et al., “Human Myometrial and Uterine Fibroid Stem Cell-Derived Organoids for Intervening the Pathophysiology of Uterine Fibroid,” Reproductive Sciences 29, no. 9 (2022): 2607-2619, https://doi.org/10.1007/s43032-022-00960-9.

[14]

J. A. Mather, “Ethics and Care: For Animals, Not Just Mammals,” Animals 9 (2019): 1018, https://doi.org/10.3390/ani9121018.

[15]

A. Mas, S. Nair, A. Laknaur, C. Simón, M. P. Diamond, and A. al-Hendy, “Stro-1/CD44 as Putative Human Myometrial and Fibroid Stem Cell Markers,” Fertility and Sterility 104, no. 1 (2015): 225.

[16]

Y. Chen, X. Yi, B. Huo, et al., “BRD4770 Functions as a Novel Ferroptosis Inhibitor to Protect Against Aortic Dissection,” Pharmacological Research 177 (2022): 106122, https://doi.org/10.1016/j.phrs.2022.106122.

[17]

R. V. Pandey, S. Pabinger, A. Kriegner, and A. Weinhäusel, “ClinQC: A Tool for Quality Control and Cleaning of Sanger and NGS Data in Clinical Research,” BMC Bioinformatics 17, no. 1 (2016): 56.

[18]

Y. Zhang, C. Park, C. Bennett, M. Thornton, and D. Kim, “Rapid and Accurate Alignment of Nucleotide Conversion Sequencing Reads With HISAT-3 N,” Genome Research 31, no. 7 (2021): 1290-1295, https://doi.org/10.1101/gr.275193.120.

[19]

Y. Zhao, M. C. Li, M. M. Konaté, et al., “TPM, FPKM, or Normalized Counts? A Comparative Study of Quantification Measures for the Analysis of RNA-Seq Data From the NCI Patient-Derived Models Repository,” Journal of Translational Medicine 19, no. 1 (2021): 269.

[20]

X. Ren and P. F. Kuan, “Negative Binomial Additive Model for RNA-Seq Data Analysis,” BMC Bioinformatics 21, no. 1 (2020): 171.

[21]

W. S. Noble, “How Does Multiple Testing Correction Work?,” Nature Biotechnology 27, no. 12 (2009): 1135-1137.

[22]

G. Yu, L. G. Wang, Y. Han, and Q. Y. He, “clusterProfiler: An R Package for Comparing Biological Themes Among Gene Clusters,” OMICS 16, no. 5 (2012): 284-287.

[23]

M. Kanehisa and S. Goto, “KEGG: Kyoto Encyclopedia of Genes and Genomes,” Nucleic Acids Research 28, no. 1 (2000): 27-30.

[24]

M. Gillespie, B. Jassal, R. Stephan, et al., “The Reactome Pathway Knowledgebase 2022,” Nucleic Acids Research 50, no. D1 (2021): D687-D692, https://doi.org/10.1093/nar/gkab1028.

[25]

S. Kanton, M. J. Boyle, Z. He, et al., “Organoid Single-Cell Genomic Atlas Uncovers Human-Specific Features of Brain Development,” Nature 574, no. 7778 (2019): 418-422, https://doi.org/10.1038/s41586-019-1654-9.

[26]

S. Velasco, A. J. Kedaigle, S. K. Simmons, et al., “Individual Brain Organoids Reproducibly Form Cell Diversity of the Human Cerebral Cortex,” Nature 570, no. 7762 (2019): 523-527.

[27]

S. J. Yoon, L. S. Elahi, A. M. Pașca, et al., “Reliability of Human Cortical Organoid Generation,” Nature Methods 16, no. 1 (2019): 75-78.

[28]

H. Cedraz de Oliveira, A. A. Pinto Garcia, J. G. Gonzaga Gromboni, R. Vasconcelos Farias Filho, C. Souza do Nascimento, and A. Arias Wenceslau, “Influence of Heat Stress, Sex and Genetic Groups on Reference Genes Stability in Muscle Tissue of Chicken,” PLoS One 12, no. 5 (2017): e0176402.

[29]

R. Bologna-Molina, A. Mosqueda-Taylor, N. Molina-Frechero, A. D. Mori-Estevez, and G. Sánchez-Acuña, “Comparison of the Value of PCNA and Ki-67 as Markers of Cell Proliferation in Ameloblastic Tumors,” Medicina Oral, Patología Oral y Cirugía Bucal 18, no. 2 (2013): e174-9, https://doi.org/10.4317/medoral.18573.

[30]

J. T. Saunders and J. E. Schwarzbauer, “Fibronectin Matrix as a Scaffold for Procollagen Proteinase Binding and Collagen Processing,” Molecular Biology of the Cell 30, no. 17 (2019): 2218-2226.

[31]

P. C. Leppert, F. L. Jayes, and J. H. Segars, “The Extracellular Matrix Contributes to Mechanotransduction in Uterine Fibroids,” Obstetrics and Gynecology International 2014 (2014): 783289.

[32]

R. A. Heuer, K. T. Nella, H.-T. Chang, et al., “Three-Dimensional Otic Neuronal Progenitor Spheroids Derived From Human Embryonic Stem Cells,” Tissue Engineering Part A 27, no. 3-4 (2021): 256-269.

[33]

M. Ali, S. M. Shahin, N. A. Sabri, A. Al-Hendy, and Q. Yang, “Activation of β-Catenin Signaling and Its Crosstalk With Estrogen and Histone Deacetylases in Human Uterine Fibroids,” Journal of Clinical Endocrinology and Metabolism 105, no. 4 (2020): e1517, https://doi.org/10.1210/clinem/dgz227.

[34]

T. Iizuka, P. Yin, A. Zuberi, et al., “Mono-(2-Ethyl-5-Hydroxyhexyl) Phthalate Promotes Uterine Leiomyoma Cell Survival Through Tryptophan-Kynurenine-AHR Pathway Activation,” Proceedings of the National Academy of Sciences of the United States of America 119, no. 47 (2022): e2208886119, https://doi.org/10.1073/pnas.2208886119.

[35]

E. Carrington, Y. Zhan, J. Brady, et al., “Anti-Apoptotic Proteins BCL-2, MCL-1 and A1 Summate Collectively to Maintain Survival of Immune Cell Populations Both In Vitro and In Vivo,” Cell Death and Differentiation 24, no. 5 (2017): 878-888, https://doi.org/10.1038/cdd.2017.30.

[36]

A. T. Khan, M. Shehmar, and J. K. Gupta, “Uterine Fbroids: Current Perspectives,” International Journal of Women's Health 6 (2014): 95-114, https://doi.org/10.2147/IJWH.S51083.

[37]

R. Sparic, L. Mirkovic, A. Malvasi, and A. Tinelli, “Epidemiology of Uterine Myomas: A Review,” International Journal of Fertility & Sterility 9, no. 4 (2016): 424-435, https://doi.org/10.22074/ijfs.2015.4599.

[38]

C. Fujisawa and J. J. Castellot, “Matrix Production and Remodeling as Therapeutic Targets for Uterine Leiomyoma,” Journal of Cell Communication and Signaling 8 (2014): 179-194, https://doi.org/10.1007/s12079-014-0234-x.

[39]

M. S. Islam, A. Ciavattini, F. Petraglia, M. Castellucci, and P. Ciarmela, “Extracellular Matrix in Uterine Leiomyoma Pathogenesis: A Potential Target for Future Therapeutics,” Human Reproduction Update 24 (2018): 59-85, https://doi.org/10.1093/humupd/dmx032.

[40]

J. J. Kim, T. Kurita, and S. E. Bulun, “Progesterone Action in Endometrial Cancer, Endometriosis, Uterine Fbroids, and Breast Cancer,” Endocrine Reviews 34 (2013): 130-162, https://doi.org/10.1210/er.2012-1043.

[41]

M. M. Carneiro, “Stem Cells and Uterine Leiomyomas: What Is the Evidence?,” JBRA Assisted Reproduction 20 (2016): 33-37 10., https://doi.org/10.5935/1518-0557.20160008.

[42]

P. Ciarmela, M. S. Islam, F. M. Reis, et al., “Growth Factors and Myometrium: Biological Effects in Uterine Fibroid and Possible Clinical Implications,” Human Reproduction Update 17, no. 6 (2011): 772-790, https://doi.org/10.1093/humupd/dmr031.

[43]

A. E. Commandeur, A. K. Styer, and J. M. Teixeira, “Epidemiological and Genetic Clues for Molecular Mechanisms Involved in Uterine Leiomyoma Development and Growth,” Human Reproduction Update 21 (2015): 593-615, https://doi.org/10.1093/humupd/dmv030.

[44]

Q. Yang, A. Mas, M. P. Diamond, and A. al-Hendy, “The Mechanism and Function of Epigenetics in Uterine Leiomyoma Development,” Reproductive Sciences 23 (2016): 163-175, https://doi.org/10.1177/1933719115584449.

[45]

V. Jain, R. R. Chodankar, J. A. Maybin, et al., “Uterine Bleeding: How Understanding Endometrial Physiology Underpins Menstrual Health,” Nature Reviews Endocrinology 18, no. 5 (2022): 290.

[46]

Q. Yang, M. Ali, L. S. Treviño, A. Mas, N. Ismail, and A. Al-Hendy, “Epigenetic Modulation of Inflammatory Pathways in Myometrial Stem Cells and Risk of Uterine Fibroids,” International Journal of Molecular Sciences 24, no. 14 (2023): 11641.

[47]

M. Malik and W. H. Catherino, “Development and Validation of a Three-Dimensional In Vitro Model for Uterine Leiomyoma and Patient-Matched Myometrium,” Fertility and Sterility 97, no. 6 (2012): 1287-1293, https://doi.org/10.1016/j.fertnstert.2012.02.037.

[48]

M. Malik, J. Britten, J. Segars, and W. H. Catherino, “Leiomyoma Cells in 3-Dimensional Cultures Demonstrate an Attenuated Response to Fasudil, a Rho-Kinase Inhibitor, When Compared to 2-Dimensional Cultures,” Reproductive Sciences 21, no. 9 (2014): 1126-1138, https://doi.org/10.1177/1933719114545240.

[49]

T. Maruyama, H. Masuda, M. Ono, T. Kajitani, and Y. Yoshimura, “Human Uterine Stem/Progenitor Cells: Their Possible Role in Uterine Physiology and Pathology,” Reproduction 140 (2010): 11-22, https://doi.org/10.1530/REP-09-0438.

[50]

A. Mas, I. Cervello, A. Fernandez-Alvarez, et al., “Overexpression of the Truncated Form of High Mobility Group A Proteins (HMGA2) in Human Myometrial Cells Induces Leiomyoma-Like Tissue Formation,” Molecular Human Reproduction 21 (2015): 330-338, https://doi.org/10.1093/molehr/gau114.

[51]

M. B. Moravek and S. E. Bulun, “Endocrinology of Uterine Fbroids: Steroid Hormones, Stem Cells, and Genetic Contribution,” Current Opinion in Obstetrics & Gynecology 27 (2015): 276-283, https://doi.org/10.1097/GCO.0000000000000185.

[52]

M. Ono and T. Maruyama, “Stem Cells in Myometrial Physiology,” Seminars in Reproductive Medicine 33 (2015): 350-356, https://doi.org/10.1055/s-0035-1563602.

[53]

M. Ono, T. Maruyama, H. Masuda, et al., “Side Population in Human Uterine Myometrium Displays Phenotypic and Functional Characteristics of Myometrial Stem Cells,” Proceedings of the National Academy of Sciences of the United States of America 104 (2007): 18700-18705, https://doi.org/10.1073/pnas.0704472104.

[54]

N. Makinen, P. Vahteristo, K. Kampjarvi, et al., “MED12 Exon 2 Mutations in Histopathological Uterine Leiomyoma Variants,” European Journal of Human Genetics 21 (2013): 1300-1303, https://doi.org/10.1038/ejhg.2013.33.

[55]

X. Santamaria, A. Mas, I. Cervello, et al., “Uterine Stem Cells: From Basic Research to Advanced Cell Therapies,” Human Reproduction Update 24 (2018): 673-693, https://doi.org/10.1093/humupd/dmy028.

[56]

M. Ono, T. Kajitani, H. Uchida, et al., “OCT4 Expression in Human Uterine Myometrial Stem/Progenitor Cells,” Human Reproduction 25 (2010): 2059-2067, https://doi.org/10.1093/humrep/deq163.

[57]

M. Ono, T. Kajitani, H. Uchida, et al., “CD34 and CD49f Double-Positive and Lineage Marker-Negative Cells Isolated From Human Myometrium Exhibit Stem Cell-Like Properties Involved in Pregnancy-Induced Uterine Remodeling1,” Biology of Reproduction 93, no. 2 (2015): 37, https://doi.org/10.1095/biolreprod.114.127126.

[58]

A. L. Patterson, J. W. George, A. Chatterjee, et al., “Putative Human Myometrial and Fibroid Stem-Like Cells Have Mesenchymal Stem Cell and Endometrial Stromal Cell Properties,” Human Reproduction 35 (2020): 44-57, https://doi.org/10.1093/humrep/dez247.

[59]

P. Yin, M. Ono, M. B. Moravek, et al., “Human Uterine Leiomyoma Stem/Progenitor Cells Expressing CD34 and CD49b Initiate Tumors In Vivo,” Journal of Clinical Endocrinology and Metabolism 100, no. 4 (2015): E601-606, https://doi.org/10.1210/jc.2014-2134.

[60]

A. Mas, L. Stone, P. M. O'Connor, et al., “Developmental Exposure to Endocrine Disruptors Expands Murine Myometrial Stem Cell Compartment as a Prerequisite to Leiomyoma Tumorigenesis,” Stem Cells 35, no. 3 (2017): 666-678, https://doi.org/10.1002/stem.2519.

[61]

H. Elkafas, M. Ali, E. Elmorsy, et al., “Vitamin D3 Ameliorates DNA Damage Caused by Developmental Exposure to Endocrine Disruptors in the Uterine Myometrial Stem Cells of Eker Rats,” Cells 9, no. 6 (2020): 1459, https://doi.org/10.3390/cells9061459.

[62]

S. J. Holdsworth-Carson, M. Zaitseva, B. J. Vollenhoven, and P. A. W. Rogers, “Clonality of Smooth Muscle and Fibroblast Cell Populations Isolated From Human Fibroid and Myometrial Tissues,” MHR: Basic Science of Reproductive Medicine 20, no. 3 (2014): 250-259, https://doi.org/10.1093/molehr/gat083.

[63]

M. F. B. Jamaluddin, P. Nahar, and P. S. Tanwar, “Proteomic Characterization of the Extracellular Matrix of Human Uterine Fibroids,” Endocrinology 159 (2018): 2656-2669, https://doi.org/10.1210/en.2018-00151.

[64]

M. Malik, J. Norian, D. McCarthy-Keith, J. Britten, and W. H. Catherino, “Why Leiomyomas Are Called Fibroids: The Central Role of Extracellular Matrix in Symptomatic Women,” Seminars in Reproductive Medicine 28, no. 3 (2010): 169-179, https://doi.org/10.1055/s-0030-1251475.

[65]

A. B. Moore, L. Yu, C. D. Swartz, et al., “Human Uterine Leiomyoma- Derived Fibroblasts Stimulate Uterine Leiomyoma Cell Proliferation and Collagen Type I Production, and Activate RTKs and TGF Beta Receptor Signaling in Coculture,” Cell Communication and Signaling: CCS 8 (2010): 10, https://doi.org/10.1186/1478-811X-8-10.

[66]

C. L. Walker and E. A. Stewart, “Uterine Fibroids: The Elephant in the Room,” Science 308 (2005): 1589-1592, https://doi.org/10.1126/science.1112063.

[67]

N. Chegini, “Proinflammatory and Profibrotic Mediators: Principal Effectors of Leiomyoma Development as a Fibrotic Disorder,” Seminars in Reproductive Medicine 28 (2010): 180-203, https://doi.org/10.1055/s-0030-1251476.

[68]

R. Tal and J. H. Segars, “The Role of Angiogenic Factors in Fibroid Patho-Genesis: Potential Implications for Future Therapy,” Human Reproduction Update 20 (2014): 194-216, https://doi.org/10.1093/humupd/dmt042.

[69]

R. H. Grantab and I. F. Tannock, “Penetration of Anticancer Drugs Through Tumor Tissue as a Function of Cellular Packing Density and Interstitial Fluid Pressure and Its Modification by Bortezomib,” BMC Cancer 12 (2012): 214, https://doi.org/10.1186/1471-2407-12-214.

[70]

R. Rogers, J. Norian, M. Malik, et al., “Mechanical Homeostasis Is Altered in Uterine Leiomyoma,” American Journal of Obstetrics and Gynecology 198, no. 4 (2008): 474.e1-474.e11, https://doi.org/10.1016/j.ajog.2007.11.057.

[71]

S. K. Halder, K. G. Osteen, and A. Al-Hendy, “1,25-Dihydroxyvitamin D3 Reduces Extracellular Matrix-Associated Protein Expression in Human Uterine Fibroid Cells,” Biology of Reproduction 89 (2013): 150, https://doi.org/10.1095/biolreprod.113.107714.

[72]

H. B. Zeyneloglu, I. Esinler, B. H. Ozdemir, B. Haydardedeoglu, M. Oktem, and S. Batioglu, “Immunohistochemical Characteristics of Intramural Leiomyomata That Enlarge During Controlled Ovarian Hyperstimulation for In Vitro Fertilization,” Gynecologic and Obstetric Investigation 65 (2008): 252-257, https://doi.org/10.1159/000113049.

[73]

M. A. Borahay, A. Al-Hendy, G. S. Kilic, and D. Boehning, “Signaling Pathways in Leiomyoma: Understanding Pathobiology and Implications for Therapy,” Molecular Medicine 21 (2015): 242-256, https://doi.org/10.2119/molmed.2014.00053.

[74]

M. V. Bariani, S. L. Grimm, C. Coarfa, et al., “Altered Extracellular Matrix-Related Pathways Accelerate the Transition From Normal to Prefibroid Myometrium in Black Women,” American Journal of Obstetrics and Gynecology 231, no. 3 (2024): 324.e1-324.e12, https://doi.org/10.1016/j.ajog.2024.05.048.

[75]

N. W. Bateman, T. Abulez, C. M. Tarney, et al., “Multiomic Analysis of Uterine Leiomyomas in Self-Described Black and White Women: Molecular Insights Into Health Disparities,” American Journal of Obstetrics and Gynecology 231, no. 3 (2024): 321.e1-321.e11, https://doi.org/10.1016/j.ajog.2024.04.051.

[76]

J. T. Thorne, T. R. Segal, S. Chang, S. Jorge, J. H. Segars, and P. C. Leppert, “Dynamic Reciprocity Between Cells and Their Microenvironment in Reproduction1,” Biology of Reproduction 92, no. 1 (2015): 25, https://doi.org/10.1095/biolreprod.114.121368.

[77]

J. Wang, S. A. Xie, N. Li, et al., “Matrix Stiffness Exacerbates the Proinflammatory Responses of Vascular Smooth Muscle Cell Through the DDR1-DNMT1 Mechanotransduction Axis,” Bioactive Materials 17 (2022): 406-424.

[78]

W. Tiskratok, M. Yamada, J. Watanabe, N. Kartikasari, T. Kimura, and H. Egusa, “Substrate Stiffness Controls Proinflammatory Responses in Human Gingival Fibroblasts,” Scientific Reports 13, no. 1 (2023): 1358.

[79]

I. Chimenti, S. Sattler, G. del Monte-Nieto, and E. Forte, “Editorial: Fibrosis and Inflammation in Tissue Pathophysiology,” Frontiers in Physiology 12 (2022): 830683, https://doi.org/10.3389/fphys.2021.830683.

[80]

M. Kim and J. Costello, “DNA Methylation: An Epigenetic Mark of Cellular Memory,” Experimental & Molecular Medicine 49, no. 4 (2017): e322, https://doi.org/10.1038/emm.2017.10.

[81]

G. Auclair and M. Weber, “Mechanisms of DNA Methylation and Demethylation in Mammals,” Biochimie 94, no. 11 (2012): 2202-2211, https://doi.org/10.1016/j.biochi.2012.05.016.

[82]

S. Li, T. C. Chiang, G. Richard-Davis, J. C. Barrett, and J. A. McLachlan, “DNA Hypomethylation and Imbalanced 380 Expression of DNA Methyltransferases (DNMT1, 3A, and 3B) in Human Uterine Leiomyoma,” Gynecologic Oncology 90, no. 1 (2003): 123-130.

[83]

Y. Yamagata, R. Maekawa, H. Asada, et al., “Aberrant DNA Methylation 383 Status in Human Uterine Leiomyoma,” Molecular Human Reproduction 15, no. 4 (2009): 259-267, https://doi.org/10.1093/molehr/gap010.

[84]

J. J. Kim and E. C. Sefton, “The Role of Progesterone Signaling in the Pathogenesis of Uterine Leiomyoma,” Molecular and Cellular Endocrinology 358 (2012): 223-231, https://doi.org/10.1016/j.mce.2011.05.044.

[85]

D. Cermik, A. Arici, and H. S. Taylor, “Coordinated Regulation of HOX Gene Expression in Myometrium and Uterine Leiomyoma,” Fertility and Sterility 78 (2002): 979-984, https://doi.org/10.1016/s0015-0282(02)03366-6.

[86]

D. Voronin, N. Sotnikova, K. Rukavishnikov, A. Malyshkina, S. Nagornii, and Y. Antsiferova, “Differential Regulatory Effect of Progesterone on the Proliferation and Apoptosis of Uterine Leiomyoma Tissue Explants and Primary Leiomyoma Cell Cultures,” JBRA Assisted Reproduction 25, no. 4 (2021): 540-548, https://doi.org/10.5935/1518-0557.20210017.

[87]

M. S. Islam, M. Parish, J. T. Brennan, B. L. Winer, and J. H. Segars, “Targeting Fibrotic Signaling Pathways by EGCG as a Therapeutic Strategy for Uterine Fibroids,” Scientific Reports 13 (2023): 8492, https://doi.org/10.1038/s41598-023-35212-6.

[88]

L. Costabile, M. Burratti, G. Biovi, R. Pajalich, and V. Unfer, “Epigallocatechin Gallate in Combination With Vitamin D3 and Vitamin B6 as a Promising Alternative in Uterine Fibroids Management,” IJMDAT 4 (2021): e313, https://doi.org/10.32113/ijmdat_20214_313.

[89]

M. Hajhashemi, M. Ansari, F. Haghollahi, and B. Eslami, “The Effect of Vitamin D Supplementation on the Size of Uterine Leiomyoma in Women With Vitamin D Deficiency. Caspian,” Journal of Internal Medicine 10, no. 2 (2019): 125-131, https://doi.org/10.22088/cjim.10.2.125.

[90]

A. R. Zota, R. J. Geller, A. M. Calafat, C. Q. Marfori, A. A. Baccarelli, and G. N. Moawad, “Phthalates Exposure and Uterine Fibroid Burden Among Women Undergoing Surgical Treatment for Fibroids: A Preliminary Study,” Fertility and Sterility 111, no. 1 (2019): 112-121, https://doi.org/10.1016/j.fertnstert.2018.09.009.

[91]

J. G. Katon, T. C. Plowden, and E. E. Marsh, “Racial Disparities in Uterine Fibroids and Endometriosis: A Systematic Review and Application of Social, Structural, and Political Context,” Fertility and Sterility 119, no. 3 (2023): 355-363, https://doi.org/10.1016/j.fertnstert.2023.01.022.

RIGHTS & PERMISSIONS

2025 The Author(s). Cell Proliferation published by Beijing Institute for Stem Cell and Regenerative Medicine and John Wiley & Sons Ltd.

AI Summary AI Mindmap
PDF

7

Accesses

0

Citation

Detail

Sections
Recommended

AI思维导图

/