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      LncRNA SRA1 may play a role in the uterine leiomyoma tumor growth regarding the MED12 mutation pattern

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          Abstract

          Background

          Uterine leiomyomas (ULMs) are benign uterine tumors that are estrogen-dependent. Recent studies suggest that the abnormal expression of the steroid receptor RNA activator 1 (SRA1) long non-coding RNA (lncRNA) might participate in the mechanisms of tumorigenesis of some hormone-dependent tumors including breast cancer. SRA1 is known to enhance the transcriptional activity of steroid receptors and also promotes steroidogenesis. The level of steroid hormones, such as estrogen and the progesterone, and their receptors play an important role in the development and growth of leiomyoma. The aim of the present study was to determine the expression level of lncRNA SRA1 in ULM tissues considering the MED12 mutation pattern.

          Methods

          Mutation screening was performed for MED12 exons 1 and 2 and the intronic flanking regions using Sanger sequencing in 60 ULM tissues. Quantitative real-time polymerase chain reaction (qRT-PCRs) was performed in order to estimate the expression of lncRNA SRA1 in leiomyoma samples with and without MED12 gene mutations. The expression results were analyzed by using LinReg and REST software.

          Results

          Mutations were detected in exon 2 of the MED12 in 28 (46.67%) ULM samples; including, 21 (75%) missense mutations and 7 (25%) in-frame deletions. No mutation was detected in the MED12 exon 1. LncRNA SRA1 was over-expressed in ULM samples without MED12 mutation compared with ULM samples harboring MED12 mutation (Expression ratio=2.5, P-value=0.004).

          Conclusion

          Present results suggest that lncRNA SRA1 may explain the phenotypic difference observed in the tumor size of ULM samples considering MED12 mutation pattern. Therefore, it serves as a good therapeutic target and provides new insight into understanding the disease molecular mechanism.

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          Most cited references21

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          Epidemiology of uterine fibroids: a systematic review

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            MED12, the mediator complex subunit 12 gene, is mutated at high frequency in uterine leiomyomas.

            Uterine leiomyomas, or fibroids, are benign tumors that affect millions of women worldwide and that can cause considerable morbidity. To study the genetic basis of this tumor type, we examined 18 uterine leiomyomas derived from 17 different patients by exome sequencing and identified tumor-specific mutations in the mediator complex subunit 12 (MED12) gene in 10. Through analysis of 207 additional tumors, we determined that MED12 is altered in 70% (159 of 225) of tumors from a total of 80 patients. The Mediator complex is a 26-subunit transcriptional regulator that bridges DNA regulatory sequences to the RNA polymerase II initiation complex. All mutations resided in exon 2, suggesting that aberrant function of this region of MED12 contributes to tumorigenesis.
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              Uterine fibroid management: from the present to the future

              Abstract Uterine fibroids (also known as leiomyomas or myomas) are the most common form of benign uterine tumors. Clinical presentations include abnormal bleeding, pelvic masses, pelvic pain, infertility, bulk symptoms and obstetric complications. Almost a third of women with leiomyomas will request treatment due to symptoms. Current management strategies mainly involve surgical interventions, but the choice of treatment is guided by patient's age and desire to preserve fertility or avoid ‘radical’ surgery such as hysterectomy. The management of uterine fibroids also depends on the number, size and location of the fibroids. Other surgical and non-surgical approaches include myomectomy by hysteroscopy, myomectomy by laparotomy or laparoscopy, uterine artery embolization and interventions performed under radiologic or ultrasound guidance to induce thermal ablation of the uterine fibroids. There are only a few randomized trials comparing various therapies for fibroids. Further investigations are required as there is a lack of concrete evidence of effectiveness and areas of uncertainty surrounding correct management according to symptoms. The economic impact of uterine fibroid management is significant and it is imperative that new treatments be developed to provide alternatives to surgical intervention. There is growing evidence of the crucial role of progesterone pathways in the pathophysiology of uterine fibroids due to the use of selective progesterone receptor modulators (SPRMs) such as ulipristal acetate (UPA). The efficacy of long-term intermittent use of UPA was recently demonstrated by randomized controlled studies. The need for alternatives to surgical intervention is very real, especially for women seeking to preserve their fertility. These options now exist, with SPRMs which are proven to treat fibroid symptoms effectively. Gynecologists now have new tools in their armamentarium, opening up novel strategies for the management of uterine fibroids.
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                Author and article information

                Journal
                Int J Womens Health
                Int J Womens Health
                IJWH
                intjwh
                International Journal of Women's Health
                Dove
                1179-1411
                29 August 2019
                2019
                : 11
                : 495-500
                Affiliations
                [1 ]Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical Sciences , Tehran, Iran
                [2 ]Department of Obstetrics and Gynecology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences , Tehran, Iran
                [3 ]GREB, Dental Faculty, Department of Regenerative Medicine, Faculty of Medicine, Laval University , Quebec, Canada
                [4 ]Department of Molecular Genetics, Genomic Research Center, Shahid Beheshti University of Medical Sciences , Tehran, Iran
                Author notes
                Correspondence: Reza MirfakhraieDepartment of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical Sciences , Koodakyar St, Velenjak Ave, Chamran highway, Tehran19395-4719, IranTel/Fax +98 212 387 2572Email reza_mirfakhraie@yahoo.com
                Fakhrolmolouk YassaeeDepartment of Obstetrics and Gynecology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences , PO Box 1985717413, Tehran, IranEmail Dr_fyass@yahoo.com
                Article
                211632
                10.2147/IJWH.S211632
                6718952
                31507331
                ccfea510-c636-4f7d-a3d3-22402ebbe9df
                © 2019 Akbari et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 12 April 2019
                : 01 August 2019
                Page count
                Figures: 3, Tables: 2, References: 21, Pages: 6
                Categories
                Original Research

                Obstetrics & Gynecology
                med12,mutation,sra1,lncrna,uterine leiomyoma
                Obstetrics & Gynecology
                med12, mutation, sra1, lncrna, uterine leiomyoma

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