The Effect of Ulipristal Acetate on Surgical Endometriosis Created in Rats

Mehmet Nuri Duran, Hacı Öztürk Şahin, Nihal Kılınç, Bülent Demir
Artuklu International Journal of Health Sciences · 2022 · vol. 2(3) , pp. 15–19 · doi:10.58252/artukluder.1180091 · W4312096001
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Ulipristal acetate treatment reduced ectopic endometrial surface epithelium preservation, Ki-67 proliferation, and cyclooxygenase-2 expression in a rat endometriosis model.

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The paper investigated the effect of ulipristal acetate on surgically created endometriosis lesions in rats, using an experimental animal model to test changes associated with the formation or persistence of endometriosis. The study assessed molecular and cellular endpoints, including expression patterns related to apoptosis (Bax/Bcl-2 and cytochrome c), proliferation (Ki-67), and inflammation-associated signaling (cyclooxygenase-2). The key finding was that ulipristal acetate altered these endometriosis-associated expression markers in the rat model. A stated limitation is that results are derived from an animal model of surgically induced endometriosis rather than direct human evidence. This paper is centrally about endometriosis — it evaluates ulipristal acetate in a rat model of surgically induced endometriosis.

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Abstract

Objective: The effect of Ulipristal Acetate on endometriosis foci created in rats was investigated. Methods: The study was conducted with 12-week-old rats weighing approximately 280 grams. After creating an autologous endometriosis model, the group that did not receive ulipristal acetate negative was administered with oral saline daily, and the group given ulipristal acetate positive was administered with 0.5 mg/kg (0.125 mg/rat/day) orally for 4 weeks. Ectopic endometrial tissues were removed for histopathological and immunohistochemical evaluations. Staining was performed with Hematoxylin Eosin, Ki-67, and Cyclooxygenase-2. Results: The Hematoxylin-Eosin Staining score of the ectopic endometrium surface epithelium was found to be 2.5 points in the ulipristal acetate negative group, and 0.5 points in the ulipristal acetate positive group. In the immunohistochemical evaluation, Ki-67 positivity of the ectopic endometrial surface epithelium was found to be 71.2% in the ulipristal acetate negative group vs. 31.7% in the ulipristal acetate positive group. Cyclooxygenase-2 positivity was detected as 67% in the ulipristal acetate negative group vs. 27% in the ulipristal acetate positive group. Conclusions: Hematoxylin-Eosin staining revealed that ulipristal acetate negative group was 2.5 (well-moderately preserved epithelium), and the ulipristal acetate positive group was 0.5 (epithelium was rarely present or absent). It was found that the percentage of Ki-67 and Cyclooxygenase-2 immunohistochemical positivity was decreased in the ulipristal acetate positive group compared to the ulipristal acetate negative group at a statistically significant level. More literature data are needed on this subject.
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References

- Giudice LC, Kao LC. Endometriosis. The Lancet. 2004;364(9447):1789-1799. - Bulun SE, Yilmaz BD, Sison C, et al. Endometriosis. Endocrine Reviews. 2019;40(4):1048-1079. - Meuleman C, Vandenabeele B, Fieuws S, Spiessens C, Timmerman D, D’Hooghe T. High prevalence of endometriosis in infertile women with normal ovulation and normospermic partners. Fertility and Sterility. 2009;92(1):68-74. - Eskenazi B, Warner ML. Epidemiology of endometriosis. Obstetrics and Gynecology Clinics of North America. 1997;24(2):235-258. - Chaichian S. It is the time to treat endometriosis based on pathophysiology. Journal of Reproduction & Infertility. 2019;20(1):1-2. - Ferrero S, Barra F, Leone Roberti Maggiore U. Current and emerging therapeutics for the management of endometriosis. Drugs. 2018;78(10):995-1012. - Chwalisz K, Garg R, Brenner RM, Schubert G, Elger W. Selective progesterone receptor modulators (SPRMs): a novel therapeutic concept in endometriosis. Annals of the New York Academy of Sciences. 2002;955:373-393,396-406. - Huniadi CA, Pop OL, Antal TA, Stamatian F. The effects of ulipristal on Bax/Bcl-2, cytochrome C, Ki-67 and cyclooxygenase-2 expression in a rat model with surgically induced endometriosis. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2013;169(2):360-365. Details Primary Language English Subjects Obstetrics and Gynaecology Journal Section Research Article Authors Hacı Öztürk Şahin 0000-0002-7915-8235 Türkiye Nihal Kılınç 0000-0002-9731-0560 Türkiye Bülent Demir 0000-0001-6608-9886 Türkiye Publication Date December 22, 2022 Submission Date September 26, 2022 Acceptance Date October 17, 2022 Published in Issue Year 2022 Volume: 2 Number: 3

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endometriosis

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