17 beta-Estradiol suppresses proliferation of fibroblasts derived from cardinal ligaments in patients with or without pelvic organ prolapse

BACKGROUND: Estrogen replacement therapy (ERT) has been used in the treatment of pelvic organ prolapse (POP) but clinical results are inconclusive. The purpose of this study was to investigate the effect of 17 beta-estradiol (E-2) on the proliferation of fibroblasts derived from cardinal ligaments in women with or without POP. METHODS: Fibroblasts were derived from seven patients with POP and seven age-matched controls. The growth rate of POP fibroblasts was compared with that of control by 3-(4,5,-dimethyl thiazolyl-2)-2,5-diphenyl tetrazolium bromide (MTT) assay. Four cell strains from each patient and control group were treated with different concentrations of E-2 (10(-4), 10(-8), 10(-9) and 10(-10) mol/l). The effect of E-2 on cell proliferation was then measured by MTT assay. RESULTS: The overall growth rate of POP fibroblasts was significantly slower than that of controls under normal culture conditions. Addition of E-2 suppressed cell proliferation of all the fibroblasts, especially in POP fibroblasts. POP fibroblasts showed a significantly lower proliferative rate than that of controls at all E-2 concentrations, with the most prominent inhibitory effect at physiological concentration (10.83 +/- 34.41% versus 81.56 +/- 48.10% at 10(-8) mol/l). CONCLUSIONS: Our results suggest that decreased fibroblast turnover may contribute to the development of POP; and ERT may not be an effective POP treatment.