MODULATION OF THE TGF-β SIGNALING PATHWAY IN THE TREATMENT OF ENDOMETRIAL HYPERPLASIA WITH GESTAGENS

R.M. Sarkisyan
In: Laboratornaya i klinicheskaya meditsina. Farmatsiya · 2025 · pp. 23–33 · doi:10.14489/lcmp.2025.03.pp.023-033 · W4415527356
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Abstract

Objective. This study aimed to investigate the effect of progestogens on key components of the transforming growth factor beta (TGF-β) signaling pathway in the endometrial mucosa in cases of non-atypical endometrial hyperplasia, in order to determine the pathogenetic role of this pathway and to predict treatment outcomes. Materials and Methods. A comprehensive examination was conducted on 19 patients with non-atypical endometrial hyperplasia before and after 3 months of conservative treatment with progestogens. Endometrial samples were obtained by dilatation and curettage or Pipelle biopsy. Results. The study revealed that progestogens suppress the upregulated expression of TGF-β observed in endometrial hyperplasia and modulate the altered expression of other components of the TGF-β-dependent signaling pathway, particularly SMAD proteins ( From the name of the Drosophila MAD gene (mothers against decapentaplegic) and the Caenorhabditis elegans SMA gene (small worm phenotype), restoring them to levels typical of normal endometrium. Conclusion. These findings confirm that components of the TGF-β signaling pathway are altered in endometrial hyperplasia and are sensitive to modulation by progestogen therapy. This opens new perspectives for the treatment of this condition and for the prevention of malignant transformation of the endometrial lining leading to endometrial carcinoma.

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