Uterine fibroids: The role of signaling pathways in the pathogenesis. A literature review

Abstract

Uterine fibroids are one of the most common benign tumors of the female reproductive system, originating from smooth muscle cells of the cervix or uterine body. The controversial issues of the pathogenesis of the disease make equal the various theories of its development and approaches to therapy. To date, there is no single and unambiguous opinion on the causes of the onset and recurrence of uterine fibroids, but thanks to the modern level of molecular medicine, much progress has been made in the study of hormonal and molecular genetic mechanisms of the initiation, formation and growth of the myoma node. The aim of this work was to review the modern aspects of the pathogenesis of uterine fibroids. We analyzed book chapters, original and review articles deposited in the PubMed database and related to the study of the pathogenesis of uterine fibroids from 2000 to 2019. This review presents modern data on the role of sex steroid hormones and their enzyme regulation, as well as growth factors and Vitamin D in the pathogenesis of the disease. Particular attention was paid to signaling pathways involved in the regulation of basic cellular processes, in the onset and progression of the disease. It was noted that the activation of signaling pathways such as Wnt/β-catenin, MAPK/ERK, and TGF-β/SMAD plays a significant role in the development of uterine fibroids. Further study of the pathogenesis of the disease is needed for new strategies to design targeted therapy of uterine leiomyoma.