Gene therapy and uterine leiomyoma: A review

Ayman Al-Hendy, Salama Salama

Research output: Contribution to journalReview article

50 Citations (Scopus)

Abstract

Leiomyomas (fibroids) are common estrogen-dependent uterine tumours that cause significant morbidity for women and a substantial economic impact on health delivery systems. Currently, there is no effective medical treatment option for this condition - hysterectomy is the mainstay of management. This is not an attractive choice for many women, especially patients desiring to preserve their fertility potential. Gene therapy is becoming a clinical reality, with more than 600 clinical trials worldwide. Researchers have recently attempted to develop a gene-therapy-based approach for the ablation of uterine fibroids. The localized nature of this condition and its accessibility using different imaging or endoscopic techniques make it an attractive target for direct delivery of gene-based vectors. Recent work from our laboratory suggests the potential use of a dominant-negative form of estrogen receptor (ER) to inactivate estrogen signalling in leiomyoma cells and induce apoptosis. Our in vivo data in a mouse model demonstrate the ability of an adenovirus-expressing dominant-negative ER to arrest leiomyoma growth. We and others also have described the utility of the herpes simplex virus-thymidine kinase (HSV-TK) plus ganciclovir (GCV) suicide gene-therapy system to effectively eradicate leiomyoma cells by utilizing the bystandard effect phenomena and the high expression of gap-junction protein in these tumours. Further work on rat models will pave the way for future leiomyoma gene-therapy clinical trials and allow the realization of gene therapy as a viable non-surgical option for this common problem in women's health.

Original languageEnglish (US)
Pages (from-to)385-400
Number of pages16
JournalHuman Reproduction Update
Volume12
Issue number4
DOIs
StatePublished - Jul 1 2006

Fingerprint

Leiomyoma
Genetic Therapy
Estrogen Receptors
Estrogens
Clinical Trials
Ganciclovir
Connexins
Aptitude
Thymidine Kinase
Women's Health
Simplexvirus
Hysterectomy
Adenoviridae
Suicide
Fertility
Neoplasms
Economics
Research Personnel
Apoptosis
Morbidity

Keywords

  • Animal model
  • Dominant-negative estrogen receptor
  • Fibroids
  • Gene therapy
  • Uterine leiomyoma

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Gene therapy and uterine leiomyoma : A review. / Al-Hendy, Ayman; Salama, Salama.

In: Human Reproduction Update, Vol. 12, No. 4, 01.07.2006, p. 385-400.

Research output: Contribution to journalReview article

Al-Hendy, Ayman ; Salama, Salama. / Gene therapy and uterine leiomyoma : A review. In: Human Reproduction Update. 2006 ; Vol. 12, No. 4. pp. 385-400.
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