Abstract：
Uterine leiomyomas, also known as fibroids or myomas, occur in an estimated 70-80% of reproductive aged women. Many experience debilitating symptoms including pelvic pain, abnormal uterine bleeding (AUB), dyspareunia, dysmenorrhea, and infertility. Current treatment options are limited in preserving fertility, with many opting for sterilizing hysterectomy as a form of treatment. Currently, surgical interventions include hysterectomy, myomectomy, and uterine artery embolization in addition to endometrial ablation to control AUB. Non-surgical hormonal interventions, including GnRH agonists, are connotated with negative side effects and are unacceptable for women desiring fertility. Periostin, a regulatory extra cellular matrix (ECM) protein, has been found to be expressed in various gynecological diseases including leiomyomas. We previously determined that periostin over-expression in immortalized myometrial cells led to the development of a leiomyoma-like cellular phenotype. Periostin is induced by TGF-β, signals through the PI3K/AKT pathway, induces collagen production, and mediates wound repair and fibrosis, all of which are implicated in leiomyoma pathology. Periostin has been linked to other gynecological diseases including ovarian cancer and endometriosis and is being investigated as pharmacological target for treating ovarian cancer, post-surgical scarring, and numerous other fibrotic conditions. In this review, we provide discussion linking pathological inflammation and wound repair, with a TGF-β-periostin-collagen signaling in the pathogenesis of leiomyomas, and ultimately the potential of periostin as a druggable target to treat leiomyomas.
摘要：
子宫平滑肌瘤，也被称为肌瘤或肌瘤，发生在估计70-80%的育龄妇女中。许多人经历衰弱的症状，包括骨盆疼痛，异常子宫出血（AUB），性交困难,痛经,和不孕症。目前的治疗选择在保持生育能力方面受到限制，许多人选择子宫切除术作为一种治疗形式。目前,外科手术包括子宫切除术，子宫肌瘤切除术,子宫动脉栓塞术除子宫内膜消融术外控制AUB。非手术激素干预，包括GnRH激动剂,带有负面副作用，对于渴望生育的女性来说是不可接受的。骨膜素,调节性细胞外基质（ECM）蛋白，已发现在包括平滑肌瘤在内的各种妇科疾病中表达。我们先前确定，永生化子宫肌层细胞中骨膜素的过度表达导致平滑肌瘤样细胞表型的发展。骨膜素由TGF-β诱导，信号通过PI3K/AKT通路，诱导胶原蛋白的产生，并介导伤口修复和纤维化，所有这些都与平滑肌瘤病理有关。骨膜素与其他妇科疾病有关，包括卵巢癌和子宫内膜异位症，正在研究作为治疗卵巢癌的药理靶点。手术后的疤痕,和许多其他纤维化条件。在这次审查中,我们提供联系病理性炎症和伤口修复的讨论，在平滑肌瘤的发病机理中与TGF-β-骨膜素-胶原信号传导，以及骨膜素作为治疗平滑肌瘤的药物靶点的潜力。
