Semin Reprod Med 2017; 35(06): 487-493
DOI: 10.1055/s-0037-1607268
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Mechanical Signaling and Extracellular Matrix in Uterine Fibroids

Saima Rafique
1  Department of Obstetrics and Gynecology, Howard University Hospital, Washington, District of Columbia
James H. Segars
2  Howard W. and Georgeanna Seegar Jones Laboratory of Reproductive Sciences and Women's Health Research, Department of Obstetrics and Gynecology, Johns Hopkins Medical University, Baltimore, Maryland
Phyllis C. Leppert
3  Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina
› Author Affiliations
Further Information

Publication History

Publication Date:
03 November 2017 (online)


Fibroids (uterine leiomyomas) are the most common benign tumors of the female reproductive tract. Steroid hormones, growth factors, and cytokines have long been implicated in fibroid growth; however, research suggests that changes in the extracellular matrix and mechanical signaling play a critical role in fibroid growth and differentiation. Studies have shown that growth of fibroids is related to the change in the volume and composition of extracellular matrix with increased deposition of abnormal collagen, glycoproteins, laminins, fibronectins, and an increased osmotic stress. These changes generate mechanical stress which is converted to chemical signals in the cells through mechanotransduction and eventually affects gene expression and protein synthesis. Current studies also suggest that mechanical signaling in fibroid cells is abnormal as evidenced by decreased apoptosis of abnormal cells and deposition of a stiff extracellular matrix promoting fibrosis. Understanding and defining these mechanisms could help design new therapies for the treatment of fibroids.