The following is a summary of “Reduced endometrial expression of histone deacetylase 3 in women with adenomyosis who complained of heavy menstrual bleeding,” published in the December 2023  issue of Obstetrics and Gynecology by Mao, et al.

Histone deacetylase 3 (HDAC3): What part does it play in heavy menstrual bleeding (HMB) caused by adenomyosis? About 72 women with adenomyosis-related HMB were asked to take part. Out of these, 37 women said they were bleeding moderately to heavily (MHB), and the other 35 said they had excessive bleeding (EXB). Researchers used transvaginal elastosonography to measure the hardness of adenomyotic lesions and the endometrial–myometrial interface (EMI) next to them. They also processed full-thickness uterine tissue columns for Masson trichrome staining and immunohistochemistry studies. They looked at the levels of HDAC3 protein in uterine cells grown on substrates with varying levels of stiffness. 

They also looked at the NF-κB p65 subunit protein levels along with HDAC3 inhibition. Scientists used to study how adenomyosis affects HDAC3 levels, uterine repair, and bleeding. They also looked at how blocking HDAC3 affected endometrial healing. The amount of HDAC3 labeling in the endometrium was much lower in women with adenomyosis-associated HMB than normal. 

At the same time, there was more scarring. The EXB group had significantly stiffer lesions and nearby EMI than the MHB group. The EXB group also had significantly more collagen in the lesions, their nearby EMI, and the endometrium. When uterine epithelial cells were grown on stiff surfaces, their expression of HDAC3 dropped significantly. When HDAC3 was turned off, NF-κB stopped activating and sending signals. With caused adenomyosis had less Hdac3 spotting and more scarring in the uterus. Endometrial healing was also slowed down, and the bleeding worsened. Stopping Hdac3 caused inflammation to go wrong and more blood. There is less HDAC3 expression in the endometrium when there is lesional fibrosis. This disrupts NF-κB signaling and inflammation, which causes adenomyosis-associated HMB.

Source: sciencedirect.com/science/article/abs/pii/S1472648323003887