Nano carriers-A novel approach for efficient treatment of Uterine fibroids
Aishwarya Nagarajan, Srividya H., Dr. Manasa Nune*
Manipal Institute of Regenerative Medicine, Manipal Academy of Higher Education
Allalasandra, Yelahanka, Bangalore -560065
ABSTRACT
• treatment of many other diseases such as cancer, cardiac diseases, etc.
Background- Uterine fibroids are one of the commonly faced gynaecological problems in women today. By
the latest report released by the United Nations, in the world of 3.8 million women, more than 70% of them
have a lifetime risk of facing it. In India, approximately 60% of the women have uterine fibroids by the age of
50, and it is increasing exponentially year by year.
• Rationale- Despite being one of the major concerns faced by women today, the growth and pathogenesis of
these fibroids are not clearly understood. The idea is to focus on a new treatment approach which can not only
cure uterine fibroids permanently but also will have no side effects.
• Strategy- Research papers on Uterine fibroids were studied from the National Centre for Biotechnology
Information. Wide range of papers from 2010-2020 were taken to study all the developments and the progress
in the field of Uterine Fibroids from which we identified the research gaps and the scope of research.
• Results- There are advancements in the treatment of uterine fibroids past decade in both surgical and non-
surgical methods, yet there are lot of complications and unavoidable side effects that put women in both
physical and mental trauma. Therefore we came up with a hypothesis which can not only cure the fibroids
completely but can also avoid the side effects which prevail later. We plan on introducing nano carrier with
small molecules or drugs in the form of intrauterine implants or injectable products which can directly target
the fibroids in the uterus.
• Conclusion- Nano carrier can be a new prospect for treatment in uterine fibroids as it will focus on selective
eradication. Yet there is a broad range of research that has to go into it.
INTRODUCTION
• Uterine fibroids or leiomyomas are benign tumours which originate in the myometrium smooth muscles of the uterus
and one of the most frequently faced gynecological problem in women today.
• There are three types of uterine fibroids; intramural fibroids that grow within the uterus wall, submucosal fibroids
which are present in the uterine cavity and subserosal fibroids which are present outside the uterus.
• These tumors vary in size from a few millimetres to massive growth in the uterine wall. Symptoms of these uterine
fibroids depend on the region where the fibroids are present, but 80% of the women who have uterine fibroids
•
experience no symptoms and it is usually discovered only during pelvic examination or ultrasound [1].
Fibroids are related to the hormonal status in the body; therefore, occur in women in their reproductive age till
menopause is reached [4]. Uterine fibroids have shown similarity to the myometrial cells during pregnancy [5].
Studies have confirmed that myometrial stem cells have been found among the myometrial cells [3]. These stem cells
have been found to have characteristics of a tumour initiation, which causes cell proliferation and tumour growth in
fibroids [2].
Fig 1: Fibroid formation from the myometrium stem cells
Fig 2: Risk factors of uterine fibroids Fig 3: Symptoms of uterine
METHODOLOGY
Past decade there have been advancements in the treatment of uterine fibroids. Many
surgical and non-surgical methods have been introduced
Surgical methods:
Hysterectomy, hysteroscopic myomectomy, Magnetic Resonance Guided Focused
Ultrasound(MRgFUS),Laparoscopic myomectomy, Uterine artery embolization.
Non-surgical methods:
1. Gonadotropin-releasing hormone (GnRH)
2. Selective progesterone receptor modulator (SPRM)
Despite all the advancements in the treatments present today, they all cause severe side effects such as infertility, the
hormonal treatments if used more than 6 months cause hypoestrogenism and osteoporosis in women [6]. This brings
the need to develop a new treatment approach that can tackle all the side effects faced by the existing treatment
methodologies.
Fig 4: Different surgical methods available for uterine fibroids
fig 5: Non-surgical methods for the treatment of uterine fibroids
RESULTS
• Nanotechnology can be a possible approach for the treatment of uterine fibroids. Nanomedicine is used in the
• Using the same idea we came up with a hypothesis that is non-invasive. We know that uterine fibroids are related to
the secretion of excessive hormones such as progesterone and estrogen.
• We plan on introducing a nano carrier with a drug inside that can be inserted intra-vaginally or intravenous
injections. These nanocarriers that carry the drugs inside them which is used to stop the bleeding and also shrink the
fibroids.
• These drugs will be engineered to specifically bind to the receptors of the fibroids to which the hormones such as
progesterone and estrogen bind and lead to fibroids formation.
• These drugs inhibit the receptors and therefore the hormones can not bind to them. These drugs can stop the
bleeding and shrink the fibroids.
• This method focuses on selective eradication and will not cause any side effects like the hormonal treatments present
today for the treatment of uterine fibroids
Fig 6: Using Nano carriers for treating uterine fibroids
CONCLUSION
• The advancements in the research of uterine fibroids have expanded our knowledge on the biology of the fibroids to
an extent.
• Yet growth and pathogenesis are not completely understood. There has been a significant advancement in the
treatment procedure past decade in uterine fibroids which has introduced us to non-invasive procedures.
• Now we need to focus on the non-surgical treatments, which are effective in the long term and also can reduce the
side effects extensively. Further, there is a need for the determination of early intervention and also the risk factors.
• In addition, a new approach to the treatment of uterine fibroids is required. The use of nanomedicine can be a possible
approach for uterine fibroids
REFERENCES
1. Marsh EE, Lin Z, Yin P, Milad M, Chakravarti D, Bulun SE. Differential expression of microRNA
species in human uterine leiomyoma versus normal myometrium. Fertil Steril 2008;89:1771– 1776.
2. Ono M, Maruyama T, Masuda H, Kajitani T, Nagashima T, Arase T, Ito M, Ohta K,Uchida H, Asada H et
al. Side population in human uterine myometrium displays phenotypic and functional characteristics of
myometrial stem cells. Proc Natl Acad Sci USA 2007;104:18700 –18705.
3. Mas A, Cervello I, Gil-Sanchis C, Faus A, Ferro J, Pellicer A, Simon C. Identification and
characterization of the human leiomyoma side population as putative tumor-initiating cells. Fertil Steril
2012;98:741 –751 e746.
4. Baird DD, Newbold R. Prenatal diethylstilbestrol (DES) exposure is associated with uterine leiomyoma
development. Reprod Toxicol 2005;20:81–84.
5. Busnelli M, Rimoldi V, Vigano P, Persani L, Di Blasio AM, Chini B. Oxytocin-induced cell growth
proliferation in human myometrial cells and leiomyomas. Fertil Steril 2010;94:1869– 1874.
6. Manuela Farris,Carlo Bastianelli ,Elena Rosato,Ivo Brosens,Giuseppe Benagiano.Uterine Fiobroids:An
update on current and emerging treatmnt options.Dovepress 2019.
ACKNOWLEDGEMENT
• Dean of MIRM, MAHE- Dr. Gopal Pande to give me this great opportunity
• MIRM for the internship opportunity and providing infrastructural support
• DST-SERB grant for financial support