Geburtshilfe Frauenheilkd 2014; 74 - FV_02_06
DOI: 10.1055/s-0034-1388550

Ulipristalacetate treatment of endometriosis and normal endometrial stromal cells inhibits cell proliferation

SP Renner 1, PA Fasching 1, J Lermann 1, S Burghaus 1, J Hackl 1, R Strick 1, PL Strissel 1, MW Beckmann 1
  • 1Universitätsklinikum Erlangen, Frauenklinik, Erlangen, Germany

Question: Ulipristalacetate (UPA) has been previously demonstrated to inhibit the estradiol and progesterone induced proliferative response of normal endometrial cells in culture. We predicted that UPA would inhibit proliferation of endometriosis cells.

Methodology: Stromal cells were isolated from a deep infiltrating endometriosis lesion and matched normal endometrium. Since the progesterone receptor (PGR) is the target of UPA, both primary cell lines were tested for gene expression of steroid hormone receptors using semi-quantitative real time PCR. For proliferation assays, cells were seeded at 50,000 cells per 6-well culture dish. The following day UPA (10 – 100mM) was added and the cells were counted at 48hr and 72hr.

Results: Both stromal cell lines were > 90% vimentin and 15% cytokeratin-7 positive using immunoflourescence microscopy and expressed steroid hormone receptors. Endometriosis stromal cells were only 30% estrogen receptor (ERa) and 10% PGR positive by gene expression compared to matched endometrial cells. Compared to untreated cells, 50mM UPA treatment at 48hr showed the highest decrease of cell proliferation for both normal endometrial (2.5-fold) and endometriosis cells (2.3-fold).

Conclusions: PGR as the target gene of UPA is highly expressed in normal and lowly expressed in endometriosis stromal cells. UPA at 50µM inhibits cell proliferation > 2-fold for both normal and endometriosis cells in culture. However, considering the major difference in PGR expression of control endometrium and endometriosis cells a similar cell proliferation inhibition was found.