Beatriz Lazcoz Calvo

Introduction: Uterine leiomyoma (uterine fibroids, UF) are benign myometrial tumors affecting up to 70% of women and may cause significant symptoms. Their pathogenesis involves cytokines, steroid hormones, growth factors, and increased extracellular matrix deposition and remodeling, though it is not fully understood. Recent evidence associates low vitamin D levels with higher prevalence and severity of myomas. This clinical trial evaluates the effect of nutritional supplement on UF. Material and Patients: Sixty (60) patients with uterine myoma received in a double-blind clinical trial for 16 weeks a nutritional formulation containing the omega 3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) 150 and 240 mg respectively, the selective pro resolving mediators (SPMs) 17-HDHA 180 µg, 18-HEPE 168 µg, 14-HDHA 90 µg, and vitamin D3 50 µg and vitamin B6 10 mg compared to placebo. The main outcomes were the development of bleeding, dysmenorrhea, volume reduction and quality of life assessment including female sexual desire. Results: The group receiving the nutritional showed a significant improvement in the parameters bleeding reduction, dysmenorrhea’s and female sexual function compared to placebo. No changes could be observed regarding the volume reduction and estradiol values between the groups. Conclusions: The nutritional containing Omega 3 fatty acid, SPMs, vitamin D and B6 represent a valid option for the symptomatic management of patients with uterine fibroids without comprising the hypothalamic pituitary axis of the women. Further research in grater groups of patients is needed to validate these first results.

Uterine leiomyoma (uterine fibroids, UF) are benign myometrium tumors that affect up to 70% of the female population and may lead to severe clinical symptoms. Despite the high prevalence, pathogenesis of UF is not understood and involves cytokines, steroid hormones, and growth factors. Additionally, an increased deposition and remodelling of the extracellular matrix is characteristic for UF. Vitamin D seems to play a new role in UF. Interestingly, hypovitaminosis D correlates with a higher prevalence of myomas and the severity of the myomas. Administration of vitamin D in women with insufficiency (serum level <30 ng/mL) restored the vitamin D status and reduced the mild symptoms of myomas. In addition, inflammatory processes may play a role. In the past years, it has become clear that cessation of inflammation is an active process driven by a class of lipid mediator molecules called specialized pro-resolving mediators (SPM). Inadequate resolution of inflammation is related to several chronic inflammatory diseases and several studies have proven the crucial role of SPMs in improving these diseases. In this review, we will give an overview on processes involved in UF growth and will give an overview on the modern view regarding the concept of inflammation and the role of SPMs in resolution of inflammation, especially in chronic inflammatory diseases.

Uterine leiomyoma (uterine fibroids, UF) are benign myometrium tumors, that affect up to 70% of the female population and may lead to severe clinical symptoms. Despite the high prevalence, pathogenesis of UF is not understood and involves cytokines, steroid hormones and growth factors. Additionally, an increased deposition and remodelling of the extracellular matrix is characteristic for UF. Vitamin D seems to play a new role in UF. Interestingly, hypovitaminosis D correlates with a higher prevalence of myomas and the severity of the myomas. Administration of vitamin D in insufficient women (serum level <30 ng/mL) proved to restore the vitamin D status and reduce the mild symptoms of myomas. In addition, inflammatory processes may play also a role. In the past years it has become clear, that cessation of inflammation is an active process driven by a class of lipid mediator molecules called specialized pro-resolving mediators (SPM). Inadequate resolution of inflammation is related to several chronic inflammatory diseases and several studies have proven the crucial role of SPMs in improving these diseases. In this review, we will give the overview on processes involved in UF growth and will give an overview on the modern view regarding the concept of inflammation and the role of SPMs in resolution of inflammation, especially in chronic inflammatory diseases.