Effect of Guizhi Fuling Pill combined with GnRH analog on cell proliferation and invasion as well as MEK/ERK pathway in endometriosis lesions

Objective: To study the effect of Guizhi Fuling Pill combined with gonadotropin-releasing \nhormone analog (GnRH-a) on cell proliferation and invasion as well as MEK/ERK pathway \nin endometriosis lesions. Methods: Patients who were diagnosed with endometriosis in \nBazhong Hospital of Traditional Chinese Medicine between November 2014 and March 2017 \nwere selected as the research subjects and randomly divided into two groups, observation \ngroup received preoperative Guizhi Fuling Pill combined with GnRH analog therapy, and \ncontrol group received preoperative GnRH analog monotherapy. After surgical resection, the \nendometriosis lesion was collected to determine the mRNA expression of proliferation and \ninvasion-related genes as well as the protein expression of MEK/ERK pathway molecules. \nResults: Id-1, Sema3A, c-IAP1, OPN and uPA mRNA expression as well as p-MEK, \np-EKR1/2, caspase-3 and MMP2 protein expression in endometriosis lesion of observation \ngroup were significantly lower than those of control group while Bak, Smac, PAI-1, TIMP1 \nand TIMP2 mRNA expression as well as caspase-3 protein expression were significantly \nhigher than those of control group. Conclusion: Guizhi Fuling Pill combined with GnRH \nanalog can inhibit the cell proliferation and invasion as well as the MEK/ERK pathway \nactivation in endometriosis lesions.