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2016 ; 157
(9
): 3374-83
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Minireview: Lymphangioleiomyomatosis (LAM): The "Other" Steroid-Sensitive Cancer
#MMPMID27409646
Prizant H
; Hammes SR
Endocrinology
2016[Sep]; 157
(9
): 3374-83
PMID27409646
show ga
Lymphangioleiomyomatosis (LAM) is a devastating rare lung disease affecting
primarily childbearing age women in which tumors consisting of abnormal
smooth-muscle-like cells grow within the lungs and progressively lead to loss of
pulmonary function. LAM cells metastasize to the lungs, predominantly through the
lymphatics; however, the source of the LAM cell is still unknown. LAM cells
contain inactivating mutations in genes encoding tuberous sclerosis 1 or 2,
proteins that normally limit cell growth through suppression of mammalian target
of rapamycin complex 1. As of today, sirolimus (an mammalian target of rapamycin
complex 1 inhibitor) is the only treatment, available for LAM patients that is
approved by the Food and Drug Administration; however, this drug and others in
its class provide stabilization but not remission of LAM. One of the biggest
problems in treating LAM is that both the origin of the LAM cells and the
mechanism of the sexual dimorphism in LAM are still not understood. LAM cells
express estrogen and progesterone receptors, and lung function declines during
periods of high circulating estrogen levels. Moreover, numerous basic research
studies find that estrogen is a key driving force in LAM cell proliferation,
migration, and metastasis. In this review, we highlight recent insights regarding
the role of steroid hormones in LAM and discuss possible explanations for the
profound female sexual dimorphism of LAM.