Inhibition of MAPK and VEGFR by Sorafenib Controls the Progression of Endometriosis

Reprod Sci. 2015 Sep;22(9):1171-80. doi: 10.1177/1933719115592708. Epub 2015 Jul 12.

Abstract

Introduction: Sorafenib is a strong multikinase inhibitor targeting 2 different pathways of endometriosis pathogenesis: RAF kinase and vascular endothelial growth factor receptor (VEGFR). We investigate whether Sorafenib could control the growth of endometriotic lesions both in vitro and in vivo.

Methods: Stromal primary cells were extracted from endometrial and endometriotic biopsies from patients with (n = 10) and without (n = 10) endometriosis. Proliferation, apoptosis, mitogen-activated protein kinases, and VEGFR-2 autophosphorylation were explored with and without Sorafenib treatment. Human endometriotic lesions were implanted in 30 nude mice randomized according to Sorafenib or placebo treatment.

Results: Treating endometriotic cells with Sorafenib abrogated the phosphorylation of extracellular signal-regulated kinase in stromal cells of women with endometriosis compared to controls. In addition, this study highlights the antiangiogenic role of Sorafenib which translates as a decreased phosphorylated VEGFR-2-VEGFR-2 ratio in endometriosis. Using a xenogenic mouse model of endometriosis, we confirmed that Sorafenib regulates the endometriosis activity in vivo by targeting endometriosis-related proliferation and inflammation.

Conclusion: Our data suggest that Sorafenib controls the growth of endometriotic lesions in vitro and in vivo.

Keywords: MAPK; RAF kinase; VEGFR-2; endometriosis; sorafenib.

MeSH terms

  • Adult
  • Animals
  • Apoptosis / drug effects
  • Case-Control Studies
  • Cell Proliferation / drug effects*
  • Cells, Cultured
  • Disease Models, Animal
  • Disease Progression
  • Dose-Response Relationship, Drug
  • Endometriosis / drug therapy*
  • Endometriosis / enzymology
  • Endometriosis / pathology
  • Endometrium / blood supply
  • Endometrium / drug effects*
  • Endometrium / enzymology
  • Endometrium / pathology
  • Endometrium / transplantation
  • Extracellular Signal-Regulated MAP Kinases / antagonists & inhibitors*
  • Extracellular Signal-Regulated MAP Kinases / metabolism
  • Female
  • Heterografts
  • Humans
  • Mice, Nude
  • Neovascularization, Pathologic
  • Niacinamide / analogs & derivatives*
  • Niacinamide / pharmacology
  • Phenylurea Compounds / pharmacology*
  • Phosphorylation
  • Protein Kinase Inhibitors / pharmacology*
  • Signal Transduction / drug effects
  • Sorafenib
  • Stromal Cells / drug effects*
  • Stromal Cells / enzymology
  • Stromal Cells / pathology
  • Stromal Cells / transplantation
  • Time Factors
  • Vascular Endothelial Growth Factor Receptor-2 / antagonists & inhibitors*
  • Vascular Endothelial Growth Factor Receptor-2 / metabolism

Substances

  • Phenylurea Compounds
  • Protein Kinase Inhibitors
  • Niacinamide
  • Sorafenib
  • KDR protein, human
  • Vascular Endothelial Growth Factor Receptor-2
  • Extracellular Signal-Regulated MAP Kinases