Effects of the levonorgestrel-releasing intrauterine system on cell proliferation, Fas expression and steroid receptors in endometriosis lesions and normal endometrium
Abstract
BACKGROUND: The objectives of this study were: (i) to evaluate the effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) on both proliferation and apoptosis markers and hormone receptors of the eutopic and ectopic endometrium of women experiencing pain related to endometriosis and (ii) to compare the results with those obtained with GnRH agonist (GnRHa) injections. METHODS: Pre- and post-treatment endometrium and endometriosis specimens were obtained from 22 women experiencing pain related to endometriosis who were treated with LNG-IUS (n = 11) or GnRHa (n = 11) for 6 months. Changes in the expression of proliferating cell nuclear antigen, Fas, progesterone receptor (PRA) and estrogen receptor alpha (ER-alpha) were analyzed by immunohistochemistry. RESULTS: The cell proliferation index was significantly reduced in the epithelium and stroma of both the eutopic and the ectopic endometrium after treatment with the LNG-IUS and GnRHa. Only LNG-IUS users showed an increased H-score for Fas in the epithelium of the eutopic and ectopic endometrium (P < 0.05). Expression of ER-alpha and PRA by the glandular epithelium was lower in the eutopic endometrium after both treatments, but this reduction was noted in the ectopic endometrium only after LNG-IUS treatments (P < 0.05). No difference was detected between groups for any of the markers. CONCLUSIONS: LNG-IUS reduced both cell proliferation and the expression of PRA and ER-alpha and increased Fas expression in the eutopic and ectopic endometrium of patients with endometriosis. Some of these actions were not observed with GnRHa.
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The ameliorative effects of LNG-IUS on endometriosis symptoms are likely modulated through a decrease in expression of glandular and stromal estrogen (α and β) and progesterone receptors in the ectopic endometrium.
“Moreover, the ameliorative effects of LNG-IUS on endometriosis' symptoms are likely modulated through a decrease in the expression of glandular and stromal estrogen ( α and β ) and progesterone receptors in the ectopic endometrium [76, 77].”
From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [76]
LNG-IUS increases Fas expression in both eutopic and ectopic endometrium of patients with endometriosis.
“In addition, LNG-IUS increased Fas expression in both eutopic and ectopic endometrium of patients with endometriosis [76].”
From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [76]
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- Authors
- Gomes, M. K. O., Rosa-e-Silva, J. C., Garcia, S. B., de Sa Rosa-e-Silva, A. C. J., Turatti, A., Vieira, C. S., & Ferriani, R. A.
- Affiliations
- Universidade de São Paulo (BR)
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-08-06
- Volume
- 24
- Issue
- 11
- Pages
- 2736-2745
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2033897915
- Cited by
- 54
- References
- 50
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 4 · 2021: 3 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 4 · 2015: 2 · 2014: 3 · 2013: 3 · 2012: 3
- FWCI
- 5.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- levonorgestrel-releasing intrauterine system, endometriosis, GnRH agonist, cell proliferation, apoptosis, Fas expression, progesterone receptor, estrogen receptor alpha, eutopic endometrium, ectopic endometrium, proliferating cell nuclear antigen, endometriosis-associated pain
- MeSH terms
- Adolescent, Adult, Endometriosis, Endometrium, Female, Humans, Gonadotropin-Releasing Hormone, Pain, Receptors, Progesterone, Levonorgestrel, Apoptosis, fas Receptor, Estrogen Receptor alpha, Cell Proliferation
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