Azaz Ahmad^1,2, Nihar Bhoi², Manoj Kumar³, Sueba Salmani⁴, Akanksha Jangid⁵, Ramanand Sharma⁶, Vinod Kumar Patel⁷, Mohd Ajmal¹, Juber Akhtar⁸and Mohammad Ahmad¹*

¹Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow, India
²Department of Reproductive Medicine, Indira IVF Hospital Pvt. Ltd. Udaipur, India
³Department of Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
⁴Department of Reproductive Medicine, Indira IVF Hospital Pvt. Ltd. Prayagraj, India
⁵Department of Reproductive Medicine, Indira IVF Hospital Pvt. Ltd. Kolkata, India
⁶Department of Pharmacy, Shyam University, Dausa, India
⁷Department of Pharmacology, Alwar Pharmacy College, Alwar, India
⁸Department of Pharmaceutics, Faculty of Pharmacy, Integral University, Lucknow, India

*Corresponding Author: Mohammad Ahmad, Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow, India.

Received: March 25, 2024; Published: April 18, 2024

Abstract

Background: Uterine fibroids are high-prevalence benign tumors originating from the smooth muscles of the uterus, noticed in approximately 70% of women of reproductive age. Prolactin is a hormone secreted from the anterior pituitary gland involved in various physiological functions, including lactogenesis and the regulation of reproductive functions. High serum prolactin levels may cause infertility and other reproductive disorders in women. Increasing evidence has focused on the critical pathogenetic role of prolactin in uterine fibroid diseases, as well as premalignant and malignant conditions. Subsequently, the objective of this current systematic review is to determine the status of serum prolactin in women of uterine fibroids.

Methods: In this systematic review, we comprehensively searched several databases, including PubMed, Google Scholar, and the Cochrane Library. A critical assessment has been conducted on articles related to the epidemiological and biological correlation of prolactin with uterine fibroids. Both observational and clinical trial studies were included from inception to March 15, 2024. The quality of the eligible studies was independently evaluated, retrieved, and assessed.

Results: Out of 275 studies, a total of 5 studies (1 Clinical Trial, 3 Case-Control, and 1 Cross-sectional) were included in this review. The 3 case-control studies concluded that serum prolactin levels are significantly higher in leiomyoma patients compared to healthy controls. Serum total protein and prolactin can be used as adjuvant biomarkers to confirm the diagnosis of uterine fibroids. Similarly, one cross-sectional study found a highly significant difference between prolactin levels in leiomyomas and in patients' myometrium. Additionally, a clinical trial revealed that patients' serum prolactin levels prior to surgery were significantly higher than post-surgery levels and higher than those in healthy, normal women. Furthermore, this clinical trial demonstrated a highly significant correlation between serum prolactin levels and their ratio with serum total protein. These results ensure and support the relationship between patients' serum prolactin and serum total protein levels with their fibroid numbers.

Conclusion: The evidence from available clinical studies suggests that uterine fibroids synthesize prolactin, and the ectopic production of prolactin from fibroid tissue results in a rise in serum prolactin levels, leading to infertility and other reproductive disorders that affect the quality of life. Hence, serum prolactin analysis should be taken into consideration in patients with uterine fibroids and infertility disorders. Furthermore diagnostic studies are required to validate the increased serum level of prolactin in women with uterine fibroids.

 Keywords: Prolactin; Uterine Fibroid; Leiomyomas; Myomas; Infertility; Biomarkers

References

1. Ahmad Azaz., et al. "Low Serum Vitamin D3 Levels among Premenopausal Women with Uterine Fibroids: A Cross-Sectional Study”. International Journal of Nutrition, Pharmacology, Neurological Diseases1 (2024): 103-110.
2. Hajhashemi Maryam., et al. "The effect of vitamin D supplementation on the size of uterine leiomyoma in women with vitamin D deficiency”. Caspian Journal of Internal Medicine2 (2019): 125.
3. Ahmad Azaz., et al. "Diagnosis and management of uterine fibroids: current trends and future strategies”. Journal of Basic and Clinical Physiology and Pharmacology3 (2023): 291-310.
4. Ciebiera Michał., et al. "Vitamin D and uterine fibroids—review of the literature and novel concepts”. International Journal of Molecular Sciences7 (2018): 2051.
5. Baird Donna Day., et al. "Vitamin D and the risk of uterine fibroids”. Epidemiology3 (2013): 447-453.
6. Khan Aamir T., et al. "Uterine fibroids: current perspectives”. International Journal of Women's Health (2014): 95-114.
7. Jukic Anne Marie Z., et al. "Lower plasma 25-hydroxyvitamin D is associated with irregular menstrual cycles in a cross-sectional study”. Reproductive Biology and Endocrinology13 (2015): 1-6.
8. Islam Md Soriful., et al. "Growth factors and pathogenesis”. Best Practice and Research Clinical Obstetrics and Gynaecology34 (2016): 25-36.
9. Ahmed Abd Al Azim Mohamed., et al. "Serum protein and prolactin in evaluation of uterine fibroids”. The Egyptian Journal of Hospital Medicine3 (2019): 3653-3658.
10. Ciavattini Andrea., et al. "Hypovitaminosis D and “small burden” uterine fibroids: Opportunity for a vitamin D supplementation”. Medicine52 (2016): e5698.
11. Sabry Mohamed., et al. "Serum vitamin D3 level inversely correlates with uterine fibroid volume in different ethnic groups: a cross-sectional observational study”. International journal of women's health (2013): 93-100.
12. Protic Olga., et al. "Possible involvement of inflammatory/reparative processes in the development of uterine fibroids”. Cell and Tissue Research2 (2016): 415-427.
13. De La Cruz Maria Syl D and Edward M Buchanan. "Uterine fibroids: diagnosis and treatment”. American Family Physician2 (2017): 100-107.
14. Oskovi Kaplan Zeynep Aslı., et al. "25-Hydroxy vitamin D levels in premenopausal Turkish women with uterine leiomyoma”. Gynecological Endocrinology3 (2018): 261-264.
15. Singh Vinita., et al. "Vitamin D 3 level in women with uterine fibroid: an observational study in eastern Indian population”. The Journal of Obstetrics and Gynecology of India69 (2019): 161-165.
16. Freeman Marc E., et al. "Prolactin: structure, function, and regulation of secretion”. Physiological Reviews (2000).
17. Sendur Suleyman Nahit., et al. "Hyperprolactinaemia associated with giant uterine myoma, description of a case and review of literature”. Journal of Obstetrics and Gynaecology7 (2019): 1034-1036.
18. Upreti Rita., et al. "Uterine fibroid causing hyperprolactinemia and paradoxical prolactin rise with dopamine agonist: case report and systematic review”. SN Comprehensive Clinical Medicine4 (2020): 464-467.
19. Levy Gary., et al. "Biomarkers in uterine leiomyoma”. Fertility and Sterility4 (2013): 1146-1152.
20. Chapitis Jane., et al. "Physicochemical characterization and functional activity of fibroid prolactin produced in cell culture”. American Journal of Obstetrics and Gynecology4 (1988): 846-853.
21. Ben-Jonathan Nira., et al. "Prolactin as an autocrine/paracrine growth factor in human cancer”. Trends in Endocrinology and Metabolism6 (2002): 245-250.
22. Abdulla Maysaloun M., et al. "Role of Ectopic Prolactin on Thyroid Hormones Level in a Sample of Iraqi Infertile Women with Uterine Fibroids”. Iraqi Journal of Medical Sciences 4 (2012): 334-338.
23. Nohara Ataru., et al. "Prolactin stimulates mitogen-activated protein kinase in human leiomyoma cells”. Biochemical and Biophysical Research Communications2 (1997): 473-477.
24. Levina Vera V., et al. "Biological significance of prolactin in gynecologic cancers”. Cancer Research12 (2009): 5226-5233.
25. ElSokary Hanan Abdelhalim., et al. "Assessing the role of serum prolactin levels and coding region somatic mutations of the prolactin gene in Saudi uterine leiomyoma patients”. Archives of Medical Sciences10 (2020).
26. Baban Rayah S., et al. "Prolactin receptors in uterine leiomyomas”. Saudi Medical Journal11 (2008): 1593-1596.
27. Abdulla Maysaloun Muhammad. "A study of prolactin hormone and other factors in relation to uterine leiomyomas among a group of Iraqi Women”. Iraqi Journal of Community Medicine2 (2008): 104-108.
28. Ali Mohamed., et al. "Vitamin D and uterine fibroids: preclinical evidence is in; time for an overdue clinical study!”. Fertility and Sterility1 (2020): 89-90.
29. Auriemma Renata S.., et al. "The interplay between prolactin and reproductive system: focus on uterine pathophysiology”. Frontiers in Endocrinology11 (2020): 594370.
30. Baban Rayah S. "Serum protein and prolactin as diagnostic markers”. Saudi Medical Journal11 (2009): 1411-1415.

Citation

Citation: Azaz Ahmad., et al. “A Systematic Review of Clinical Studies Investigates the Role of Serum Prolactin Levels in Women with Uterine Fibroids”.Acta Scientific Medical Sciences 8.5 (2024): 54-62.

Copyright

Copyright: © 2024 Azaz Ahmad., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.