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Ulipristal acetate, a selective progesterone receptor modulator, induces cell death via inhibition of STAT3/CCL2 signaling pathway in uterine sarcoma - 11/11/23

Doi : 10.1016/j.biopha.2023.115792 
Jae Ryoung Hwang a, Young-Jae Cho a, Ji-Yoon Ryu a, Ju-Yeon Choi a, Jung-Joo Choi b, Jason K. Sa c, Hyun-Soo Kim d, Jeong-Won Lee a, b, e,
a Research Institute for Future Medicine, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea 
b Department of Obstetrics and Gynecology, Gynecologic Cancer Center, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea 
c Department of Biomedical Sciences, Korea University College of Medicine, Seoul, South Korea 
d Department of Pathology, Gynecologic Cancer Center, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea 
e Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, School of Medicine, Seoul, South Korea 

Correspondence to: Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, South Korea.Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine81, Irwon-ro, Gangnam-guSeoulSouth Korea

Abstract

Ulipristal acetate (UPA) is a selective progesterone receptor modulator and is used for the treatment of uterine leiomyoma (a benign tumor). Uterine sarcoma which is highly malignant cancer with a poor prognosis is clinically resembled with uterine leiomyoma. There has been no experimental research on the effect of UPA on uterine sarcoma. In this study, we examined the efficacy of UPA in uterine sarcoma with in vitro and in vivo animal models. Cytotoxicity of UPA was determined in uterine sarcoma cell lines (MES-SA, SK-UT-1, and SK-LMS-1). Apoptotic genes and signaling pathways affected by UPA were analyzed by complementary DNA (cDNA) microarray of uterine sarcoma cell lines and western blot, respectively. An in vivo efficacy of UPA was examined with uterine sarcoma cell line- and patient-derived xenograft (PDX) mice models. UPA inhibited cell growth in uterine sarcoma cell lines and primary culture cells from a PDX mouse (PDX-C). cDNA microarray analysis revealed that CCL2 was highly down-regulated by UPA. Phosphorylation and the total expression of STAT3 were inhibited by UPA. UPA also inhibited CCL2 and STAT3 in PDX-C. The inhibitory effect of UPA had not changed in the overexpression of PR and treatment of progesterone. In vivo efficacy studies with cell line-derived xenografts and a PDX model with leiomyosarcoma, a typical uterine sarcoma, demonstrated that UPA significantly decreased tumor growth. UPA had significant anti-tumor effects in uterine sarcoma through the inhibition of STAT3/CCL2 signaling pathway and might be a potential therapeutic agent to treat this disease.

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Highlights

Uterine leiomyosarcoma (uLMS) is highly aggressive malignant cancer.
Ulipristal acetate (UPA) has been used to reduce the growth of uterine leiomyoma.
Uterine leiomyoma is hardly discriminated against uLMS without myomectomy.
UPA inhibits cell proliferation by targeting the STAT3/CCL2 signaling pathway.
UPA inhibits tumor growth in uLMS cell lines xenograft and PDX mouse models.

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Abbreviations : UPA, uLMS, CCL2, STAT3, PDX, PDX-C, P4, PR

Keywords : Uterine leiomyosarcoma, Selective progesterone receptor modulators, Ulipristal acetate (UPA), Patient-derived xenograft model (PDX), STAT3/CCL2


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Vol 168

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