Reproductive Endocrinology And Infertility Clinical Trai

生殖内分泌学和不孕不育科由James Segars领导，研究各种临床生殖疾病的根本原因和治疗效果。我们的努力一直集中在子宫平滑肌瘤（俗称纤维瘤），子宫内膜异位症，和生殖疾病导致不孕症。该单位的使命是在生殖内分泌学和不孕症的多机构临床培训计划的背景下进行对生殖重要的基础，转化和临床研究。在过去的一年里，我们扩大了我们的观察，子宫肌瘤的细胞外基质是异常形成的。基于几项研究，我们的研究表明，纤维瘤的发展，瘢痕疙瘩的形成和组织修复的改变有着惊人的相似性。这导致了子宫肌瘤细胞外基质的改变可能有助于肌瘤生长的假设。我们计划检查是否有化合物，干扰过多的细胞外基质的形成类似于在纤维瘤中观察到的可能具有临床实用性。在过去的一年里，我们还完成了一项关于选择性雌激素受体模块（SERM）雷洛昔芬治疗子宫内膜异位症相关慢性盆腔疼痛的大型前瞻性、随机、安慰剂对照试验。这项由Stratton博士领导的研究表明，雷洛昔芬治疗实际上加速了子宫内膜异位症女性疼痛的恢复，这表明雷洛昔芬与预测相反，对该患者群体没有益处。我们与Chrousos和Kino博士合作的基础科学研究表明，在我们实验室克隆的原癌蛋白Brx在某些情况下是体内糖皮质激素作用所必需的。这一重要的观察结果表明，Brx的作用超出了雌激素的作用，如最初所理解的，并可能影响其他核受体的作用，这表明Brx在生殖道外的组织中对激素作用的可能重要性。

The Unit on Reproductive Endocrinology and Infertility, led by James Segars, investigates underlying causes and effectiveness of treatment for a variety of clinical reproductive disorders. Our efforts have been focused on uterine leiomyoma (commonly known as fibroids), endometriosis, and reproductive disorders leading to infertility. The unit has the mission to conduct basic, translational, and clinical studies of importance to reproduction in the context of the multi-institutional clinical training program in Reproductive Endocrinology and Infertility. In the past year, we expanded upon our observation that the extracellular matrix of uterine fibroids was abnormally-formed. Based on several studies, our research suggests striking similarities common to fibroid development, keloid formation and altered tissue repair. This has led to the hypothesis that the altered extracellular matrix of uterine fibroids may contribute to fibroid growth. We plan to examine whether compounds that interfere with formation of excessive extracellular matrix similar to that observed in fibroids may have clinical utility. Also in the past year we have concluded a large prospective, randomized, placebo-controlled trial of the selective estrogen receptor modular(SERM), raloxifene, for the treatment of endometriosis-related chronic pelvic pain. This study headed by Dr. Stratton revealed that treatment with raloxifene actually hastened the return to pain in women with endometriosis, indicating that raloxifene, contrary to predictions, was not beneficial in this patient group. Our basic science studies in collaboration with Drs. Chrousos and Kino have revealed that the proto-oncoprotein cloned in our laboratory, Brx, is required for glucocorticoid action in vivo in some instances. This important observation indicates that Brx has a role beyond estrogen action, as initially understood, and may influence the action of other nuclear receptors, suggesting a possible importance for Brx for hormone action in tissues outside the reproductive tract.