PURPOSE:To investigate the changes in the metabolome of fibroid tissue after high-intensity focused ultrasound (HIFU) treatment, providing insights into its potential mechanisms of action.
MATERIALS AND METHODS:Thirty patients with uterine fibroids who scheduled for hysterectomy were included. Among them, 15 patients had HIFU previously (HIFU group), and 15 patients did not receive HIFU (Control group). The tissues of treated fibroid, myometrium, endometrium, and new-emerging fibroids were collected. Gas chromatography-mass spectrometry (GC-MS) was applied for metabolomic analysis.
RESULTS:GC-MS metabolomics analysis identified 94 metabolites. There was no significant difference in metabolite profile between the newly emerged fibroid tissue in the HIFU group and fibroid tissue in the Control group, and also no significant difference in the myometrial tissue and endometrial tissue between the two groups. In contrast, a significant difference was observed in metabolites between the treated fibroid tissue and the myometrial tissue in HIFU group. The levels of malus pumila acid, dimethyl fumarate, fumaric acid, methylphenylacetic acid, benzoic acid, and phosphoenolpyruvic acid were significantly higher (p < 0.05), and acetophenone, hexanoic acid, and idketoglutaric acid monoamide exhibited significantly decreased levels in the HIFU group (p < 0.05). Biomarker analysis revealed that malus pumila acid and nicotinic acid were elevated in the HIFU group, whereas erketoglutaric acid monoamide, hexanoic acid, and acetophenone were significantly reduced (p < 0.05).
CONCLUSION:HIFU ablation may have a reprogramming effect on energy metabolism in the treated fibroids. The findings of this study provide a new direction for exploring the future development of biomarkers for combined metabolic regulation therapy.