FOR EMBARGOED RELEASE: 5:00 p.m. Jan. 31, 2006
GALVESTON, Texas — Women facing invasive surgery to remove fibroid tumors — particularly black women — may soon have a new option that will not only allow them to avoid the knife but lessen the danger for future pregnancies, according to researchers at the University of Texas Medical Branch at Galveston.
Fibroid tumors of the uterus are the most common tumors found in the female genital tract. The non-cancerous growths affect 20 to 40 percent of women over age 35 and can cause pelvic pain, complications for pregnancy and heavy menstrual bleeding. For unknown reasons, the tumors are about four times more common in black women. Of the 600,000 hysterectomies performed each year in the United States, one-third are due to uterine fibroid tumors. Such surgeries require long recovery times and can endanger future pregnancies.
The study, published in the February issue of the Journal of the Society for Gynecologic Investigation, monitored the frequency of a genetic alteration (polymorphism) in the catechol-O-methyltransferase (COMT) gene, an essential enzyme in estrogen metabolism, in 328 women. Of the women, 186 had fibroid tumors and 142 did not. The researchers found that women with high activity COMT were more likely to have fibroid tumors. The prevalence of this high activity COMT genotype was highest in black women at 47 percent compared to white women at 19 percent and Hispanic women at 30 percent. In addition, the researchers found that introducing COMT inhibitor drugs decreased the activity of certain estrogen-dependent genes causing the fibroid cells to stop growing and may cause the tumors to shrink.
“In this work, we provide for the first time, a genetic explanation for this interesting observation that uterine fibroids are much more common in black women,” said Dr. Ayman Al-Hendy, UTMB assistant professor of obstetrics and gynecology and lead investigator of the study. “Now, by inhibiting the COMT enzyme, we are creating an environment inside the tumor cells that is low in estrogen bioactivity. Once the tumor cells are deprived of their estrogen, they cannot grow and they become unhealthy and eventually die, which may lead to shrinkage of the tumor.”
Al-Hendy said that this research could eventually lead to safe medical treatment of fibroid tumors, which he hopes will decrease the need for hysterectomy or other invasive surgical intervention to treat this benign disease.
“Our goal is to develop non-surgical alternatives for women who do not desire to have a hysterectomy,” he said. “It is also important that we are aware of the ethnic disparities seen with fibroid tumors so we can provide the best possible care for our patients.”
Dr. Salama A. Salama, instructor of obstetrics and gynecology at UTMB, was the co-investigator of the study.
The University of Texas Medical Branch at Galveston
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Jennifer Reynolds-Sanchez: jareynol@utmb.edu