Effects of mifepristone on proliferation and apoptosis of human endometrium in new users of medroxyprogesterone acetate. Hum Reprod 2006 Mar;21(3):798-809
Date
11/29/2005Pubmed ID
16311300DOI
10.1093/humrep/dei383Scopus ID
2-s2.0-33644858394 (requires institutional sign-in at Scopus site) 17 CitationsAbstract
BACKGROUND: Mifepristone has been demonstrated to decrease breakthrough bleeding (BTB) in users of progestin-only contraceptives.
METHODS: Endometrial biopsies were collected from 50 normal cycling women who were new users of depot medroxyprogesterone acetate (DMPA) randomized to receive either mifepristone or placebo before, during and after treatment. Proliferation, apoptosis and sex steroid receptors were evaluated by either immunohistochemistry or TUNEL assay.
RESULTS: Administration of mifepristone to DMPA-exposed endometrium for 1 week significantly increased endometrial expression of Ki-67 (MKI67), estrogen receptor (ER)alpha and progesterone receptors A and B (PRAB) and decreased the number of TUNEL-positive and caspase-3 (CASP3)-active cells in the endometrial stroma. However, after 10 weeks of mifepristone treatment, no significant difference in proliferation, apoptosis and the expression of ERalpha or PRAB could be detected between the endometrium treated with DMPA alone and endometrium treated with mifepristone and DMPA.
CONCLUSIONS: Administration of mifepristone to DMPA users significantly increases endometrial proliferation and decreases endometrial stromal apoptosis in the short term. Prolonged exposure to mifepristone does not counteract the inhibitory effects of progestin therapy on endometrial proliferation. Estrogen and progesterone receptors may play an important role in these effects.
Author List
Jain JK, Li A, Yang W, Minoo P, Felix JCAuthor
Juan Felix MD Vice Chair, Director, Professor in the Pathology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Aniline CompoundsApoptosis
Cell Division
Contraceptive Agents, Female
Double-Blind Method
Endometrium
Female
Humans
Medroxyprogesterone Acetate