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 arrayTM 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.
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