ABSTRACT
Leiomyomas are believed to derive from the transformation of myometrial smooth muscle
cells/connective tissue fibroblasts. Although the identity of the molecule(s) that
initiate such cellular transformation and orchestrate subsequent growth is still unknown,
conventional evidence indicates that ovarian steroids are essential for leiomyoma
growth. Ovarian steroid action in their target cell/tissue is mediated in part through
local expression of various growth factors, cytokines, and chemokines. These autocrine/paracrine
molecules with proinflammatory and profibrotic activities serve as major contributing
factors in regulating cellular transformation, cell growth and apoptosis, angiogenesis,
cellular hypertrophy, and excess tissue turnover, events central to leiomyoma growth.
This review addresses the key regulatory functions of proinflammatory and profibrotic
mediators and their molecular mechanisms, downstream signaling that regulates cellular
events that result in transformation, and commitments of specific cells into forming
a cellular environment with a possible role in development and subsequent growth of
leiomyomas.
KEYWORDS
Inflammation - cytokines - chemokines - proteases - fibrosis - leiomyoma
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Nasser CheginiPh.D.
Professor, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics
and Gynecology
University of Florida, Gainesville, FL, 32610
Email: cheginin@ufl.edu