Studies On Means to Enhance the Effectiveness of Dienogest in the Therapy of Endometriosis

Endometriosis is an inflammatory disease that affects one in ten women, where ectopic endometrial cells grow outside of the uterus. Lesions are estrogen dependent but progesterone resistant due to decreased progesterone receptor activity. This study investigated whether a combination of dienogest, a synthetic progesterone, and calcitriol, vitamin D’s active form, had an additive or synergistic effect in the therapy of endometriosis. Experiments were conducted on immortalized endometriotic epithelial (12Z) and stromal (22B) cell lines. Results revealed that the combination therapy effectively inhibited cell viability in spheroids, limited proliferation, and reduced cell migration in cell monolayers of lipopolysaccharide- induced cells. Concentrations of prostaglandin E2, a key inflammatory cytokine, were measured from the supernatants of 12Z cells. The combination did not alter CD44 and progesterone receptor levels on the surface of 12Z cells. Further testing in a mouse model is necessary to determine the
efficacy of the combination in vivo.