Efficacy, safety and mechanism of new progestin and selective progesterone receptor modulator (SPRM) for treatment of endometriosis
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香港中文大學研究人員

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摘要Objective:
To compare therapeutic and side effects and anti‐endometriosis mechanisms of Esmya (a partial agonistic and antagonistic SPRM), Duphaston (a semi‐synthesized retroprogesterone group progestin) and Dienogest (a 19‐ortestosterone group progestin) in endometriosis.
Design:
Animal studies in mice.
Materials and methods:
Experimental endometriosis was induced by intraperitoneal endometrium transplantation. Mice were randomly administered with Esmya, Duphaston, Dienogest or vehicle for 4 weeks. Lesion size, weight and histology were compared. Adhesion, invasion, proliferation, angiogenesis and survival were examined. Body, uterus and ovary weights, endometrial glands and thickness, and follicle counts were monitored.
Results:
After Esmya, Duphaston, Dienogest treatment, lesion size and weight were significantly decreased and endometriotic gland and epithelium were degraded and underdeveloped. Amongst all, Dienogest had the smallest lesions. Adhesion Itgv3, proliferation Pcna and invasion Plau mRNA expression were significantly decreased in treatment groups. Apoptosis Mapk1 mRNA expression and TUNEL‐positive cells were significantly increased in Duphaston and Dienogest group only. Angiogenesis HIF1 and VEGFA mRNA expression were not significantly different from control. Peritoneal fluid PGE2 levels were not significant different but PGP9.5 nerve innervations in the lesions were significantly decreased in Duphaston and Dienogest. There were no significant changes in body, uterus and ovary weights; blood E2, P, FSH and LH levels; endometrial gland counts and thickness, but antral follicle counts were significantly lower in Esyma.
Conclusion:
Esmya, Duphaston and Dienogest are effective anti‐endometriosis drugs targeting adhesion, proliferation and invasion, but not angiogenesis. Duphaston and Dienogest can further induce apoptosis, may also reduce endometriotic pain. Esmya, Duphaston and Dienogest are all well tolerable, except ovarian reserve is reduced with Esyma. Recurrence after withdraw is unknown.
Keywords:
Esmya, Duphaston, Dienogest
著者Liang Bo , Wu Ling , Cheung Eva Chun Wai , Fung Linda Wen Ying , Wong Alysa Sze Wai , Wang Chi Chiu
會議名稱The 13th World Congress on Endometriosis
會議開始日17.05.2017
會議完結日20.05.2017
會議地點Vancouver
會議國家/地區加拿大
出版年份2017
語言美式英語
關鍵詞Esmya, Duphaston, Dienogest

上次更新時間 2018-18-01 於 03:06