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- W4387396623 abstract "Uterine leiomyomas are the most common tumor of reproductive-age women worldwide. Although benign, uterine fibroids cause significant morbidity and adversely impact the quality of life for affected women. Somatic mutations in the MED-12 gene represent the most common single gene mutation associated with uterine leiomyomas. The objective of this review was to evaluate the current understanding of the role of MED-12 mutation in the pathophysiology of uterine fibroids, to assess the prevalence of MED-12 mutation among different populations, and to identify the most common subtypes of MED-12 mutations found in uterine fibroids. A comprehensive search was conducted on Pubmed, Embase, Scopus, and Web of Science. English-language publications that evaluated MED-12 mutation and uterine fibroids in humans, whether experimental or clinical, were considered. Articles found to be case studies, case series, letters, comments, reviews, or editorials were excluded. We identified 380 studies, of which 23 were included, comprising 1353 patients and 1872 fibroid tumors. The overall average prevalence of MED-12 mutation in uterine fibroids was found to be 55.8% across the global population, ranging from 31.1% to 80% among the included studies. The most common type of MED-12 mutation was a heterozygous missense mutation affecting codon 44 of exon 2, specifically the nucleotide 131. In regard to the mechanism involved in altered fibroids signaling, studies reported that MED-12 mutation acts by increasing levels of AKT and disrupting the cyclin C-CDK8/19 kinase activity. This review confirmed the association between MED-12 mutation and fibroids, with an overall prevalence of 55.8%. However, it is not possible to determine whether the association between MED-12 mutation and leiomyoma is causative for this condition or arises during the pathogenesis of fibroid formation because almost 44% of fibroids lacked the mutation. The wide variation in the prevalence of MED-12 mutation in leiomyomas among different populations, ranging between 31.1% to 80%, might suggest that other genomic alterations may be present in women of different ethnicities. The low prevalence of MED-12 mutation of about 30% can suggest that in different populations, mechanisms other than MED-12 mutation may lead to fibroid formation. The mutation in the MED-12 gene acts through different pathways that culminate in the growth and proliferation of myometrial cells and the impairment of autophagy. Further research is needed to determine how MED-12 mutations may contribute to the pathophysiology of uterine fibroids." @default.
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- W4387396623 date "2023-10-01" @default.
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- W4387396623 title "THE MEDIATOR COMPLEX SUBUNIT 12 (MED-12) GENE AND UTERINE FIBROIDS: A SYSTEMATIC REVIEW" @default.
- W4387396623 doi "https://doi.org/10.1016/j.fertnstert.2023.08.238" @default.
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