Defective
Gene Tied to Uterine Fibroids
Excerpt
By Nicolle Charbonneau, HealthScoutNews
(HealthScoutNews) -- The identification of a genetic mutation
could one day lead to new treatments for fibroids, a common gynecological
problem that can cause discomfort, bleeding and reduced fertility.
An international team of scientists has identified a gene mutation
linked to a condition called multiple cutaneous and uterine leiomyomatosis,
which causes non-cancerous but problematic fibroid tumors in the
uterus and skin. Uterine fibroids usually appear in women between
the ages of 20 and 35.
In the United States, roughly 30 percent of women develop uterine
fibroids during their lifetime, but not every woman will experience
the symptoms of pain and bleeding.
Current treatments include drugs that can temporarily shrink
the fibroids. But some women require surgical removal of the fibroids
or even a hysterectomy, although that procedure is usually a last
resort.
According to Dr. Ian P.M. Tomlinson, a researcher with London's
Imperial Cancer Research Fund, there had been little medical literature
on multiple cutaneous and uterine leiomyomatosis. But there were
some reports of fibroids running in families.
At the same time, it appears that some people with multiple
cutaneous and uterine leiomyomatosis are also at increased risk
of a rare but aggressive cancer called type II papillary renal
cell carcinoma.
"We thought that there was a good chance that this was
a genetic disorder," says Tomlinson. "We went out and
identified families, and it looked very much like it was genetic
once we'd done that."
A team led by Dr. Richard Houlston, an expert in cancer genetics
at the Institute of Cancer Research in Surrey, England, had narrowed
the search for the uterine fibroid gene to chromosome 1 by May
2001. But after learning that Tomlinson's group and another team
of researchers in Finland were looking for the same gene, the
scientists decided to pool their research and work together.
The result was the identification of the fumarate hydratase,
or FH gene, which they describe in the Feb. 25 issue of Nature
Genetics.
Normally, the fumarate hydratase gene plays a role in basic
cell energy production, and it's commonly referred to as a "housekeeping"
gene. Tomlinson says that their findings suggest that fibroid
cells have defective energy production.
But the exact mechanism of how mutations in the FH gene lead
to fibroids is not as clear, says Tomlinson.
"We know that these people have inherited one copy of the
gene that's faulty," he says. "The tumors start off
without any or very little function of this [gene]."
Houlston says that identifying the mutated FH gene could help
give researchers a better grasp of why uterine fibroids develop.
"It does actually provide a very good model as to why fibroids
may develop, and you could manipulate it in a cell system and
try and learn more about it," says Houlston.
"In terms of fibroids, if you have a good model system,
it's theoretically possible that you could produce therapies and
interventions which could have benefits," he adds.
Dr. William Foulkes, an assistant professor of human genetics
at McGill University in Montreal, Canada, is familiar with the
research, and says that, at first glance, the findings may seem
surprising.
"Fumarate hydratase is not exactly a gene you would have
immediately thought of as a candidate for diseases as varied as
uterine fibroids, skin leiomylomas and papillary renal cell cancer,"
says Foulkes.
But, he notes, genes located near the FH gene are linked to
some hereditary cancers.
He also cites case studies of infants who died quickly because
they lacked both copies of the FH gene. And their mothers were
found to have skin fibroids characteristic of multiple cutaneous
and uterine leiomyomatosis.
Tomlinson says that future studies will look into how the genetic
defect leads to fibroids, and study the role of the FH gene in
women with uterine fibroids.
"Fibroids are not intrinsically life-threatening,"
Tomlinson says. But "They're so common they're a very big
cause of not only illness [but some deaths], because of the inevitable
complications of surgery."
"To have some sort of medical therapy that would allow
you to treat these without having to have hysterectomy or removal
of the tumors by some other [method] would mean that it would
save people a lot of time off work, a lot of illness and also,
of course, a lot of expenditure from governments or individuals,"
Tomlinson adds.
What to Do: Find out more about uterine fibroids from
MEDLINEplus,
or Brigham
and Women's Hospital's Center for Uterine Fibroids.
Reference
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