The Italian team established a link between the two nutrients and a decrease in tumour volume along with improvements in Quality of Life (QoL) assessments in women undergoing the regimen.
“This simple, nonsurgical, approach seems appropriate to improve QoL, in a condition where the health-related condition is considerably impaired,” states the team, led by Dr Giusy Porcaro, who is based at the Hospital Santa Maria della Stella in Italy.
“This novel combination could be administered along with other pharmacological therapy, or as pre-treatment before surgery, reducing the side effects on patients.”
Uterine myomas are tumours of the smooth muscle cells located in the myometrium and consisting of collagen, fibronectin and/or proteoglycan. They may form in or on the uterus developing in women of childbearing age.
Their development varies according to age, heredity, obesity, hormonal and environmental factors. Environmental factors, such as vitamin D deficiency and toxins, are the subjects of ongoing research.
Recently, vitamin D deficiency has been linked to a higher prevalence and severity of myomas, with the administration of the vitamin in affected women (serum level less than 30 nanograms per millilitre (ng/mL)) able to restore normal vitamin D status and to reduce the mild symptoms of myomas.
In this latest study, the team enrolled 30 women with myomas and divided them into two groups: one group (15 patients) was given 25 micrograms (μg) of vitamin D and 150 milligrams (mg) EGCG + 5 mg vitamin B6 twice a day for 4 months. Meanwhile, the second group (15 patients) received no treatment (control) for 4 months.
One of the primary outcomes was the change of myoma volume with secondary outcomes including the variation of the number of myomas, sense of fatigue, QoL and the severity of symptoms (SS), which was assessed via a questionnaire.
Findings revealed a total myoma volume decrease of 34.7% in the treated group compared to a 6.9% increase in the control group after four months.
Additionally, an improvement of women’s QoL after intervention with vitamin D, EGCG and vitamin B6 along with a reduction of the SS.
“The combined supplementation of vitamin D and EGCG seems to be an optimal approach for the management of myomas and correlated symptoms,” the team concludes.
“For the first time, we showed the cooperative effectiveness as a promising and novel treatment for myomas.”
Mechanisms of action
In commenting on the observations, the team pointed to a few mechanisms of action that could be responsible for vitamin D and EGCG’s efficacious actions.
These include vitamin D’s ability to inhibits the growth of benign uterine tumour cells in vitro via the down-regulation of proteins involved in DNA replication, cell cycle regulation and regulation of cell death.
Other suggestions include vitamin D’s inhibition of myometrial and myoma cell growth as well as a potential oestrogen blocking agent in tumours.
Meanwhile, EGCG’s rich catechin content are also implicated, particularly their antioxidant and anti-inflammatory activity.
“Different pathways were reported, from the modulation of the expression of several gene through multiple signalling pathways such as BCL2, BCL2A1 and cyclin D1 (inhibition),” the team writes.
Other pathways include cyclin dependent kinase inhibitor 1A and 2B (CDKN1A, CDKN2B), and tumour protein p53 (enhancement) and inhibited expression of PCNA and CDK4.
Source: European Review for Medical and Pharmacological Sciences
Published online: doi: 10.26355/eurrev_202003_20702
“Vitamin D plus epigallocatechin gallate: a novel promising approach for uterine myomas.”
Authors: G. Porcaro et al.