{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:32:12Z","timestamp":1786987932669,"version":"build-2736575974"},"reference-count":48,"publisher":"Elsevier BV","issue":"10","license":[{"start":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T00:00:00Z","timestamp":1538352000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T00:00:00Z","timestamp":1538352000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T00:00:00Z","timestamp":1576195200000},"content-version":"vor","delay-in-days":438,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["R01 ES028615"],"award-info":[{"award-number":["R01 ES028615"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012127","name":"Augusta University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012127","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["F30 HD089585"],"award-info":[{"award-number":["F30 HD089585"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["ajp.amjpathol.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The American Journal of Pathology"],"published-print":{"date-parts":[[2018,10]]},"DOI":"10.1016\/j.ajpath.2018.06.023","type":"journal-article","created":{"date-parts":[[2018,7,31]],"date-time":"2018-07-31T22:21:20Z","timestamp":1533075680000},"page":"2293-2306","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":13,"title":["Expanding upon the Human Myometrial Stem Cell Hypothesis and the Role of Race, Hormones, Age, and Parity in a Profibroid Environment"],"prefix":"10.1016","volume":"188","author":[{"given":"Lauren E.","family":"Prusinski Fernung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8313-1695","authenticated-orcid":false,"given":"Kimya","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aymara","family":"Mas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kleven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Waller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"Al-Hendy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajpath.2018.06.023_bib1","first-page":"37","article-title":"Pregnancy with fibroids and its and its obstetric complication","volume":"21","author":"Noor","year":"2009","journal-title":"J Ayub Med Coll Abbottabad"},{"key":"10.1016\/j.ajpath.2018.06.023_bib2","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.ajog.2007.12.039","article-title":"Fibroids and reproductive outcomes: a systematic literature review from conception to delivery","volume":"198","author":"Klatsky","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajpath.2018.06.023_bib3","first-page":"593","article-title":"Complications of uterine leiomyomas in pregnancy","volume":"73","author":"Katz","year":"1989","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajpath.2018.06.023_bib4","doi-asserted-by":"crossref","first-page":"211.e1","DOI":"10.1016\/j.ajog.2011.12.002","article-title":"The estimated annual cost of uterine leiomyomata in the United States","volume":"206","author":"Cardozo","year":"2012","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajpath.2018.06.023_bib5","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.bpobgyn.2008.01.014","article-title":"Molecular genetics and racial disparities of uterine leiomyomas","volume":"22","author":"Othman","year":"2008","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"10.1016\/j.ajpath.2018.06.023_bib6","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1111\/1471-0528.14640","article-title":"Epidemiology of uterine fibroids: a systematic review","volume":"124","author":"Stewart","year":"2017","journal-title":"BJOG"},{"key":"10.1016\/j.ajpath.2018.06.023_bib7","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1089\/jwh.2013.4334","article-title":"The burden of uterine fibroids for African-American women: results of a national survey","volume":"22","author":"Stewart","year":"2013","journal-title":"J Womens Health"},{"key":"10.1016\/j.ajpath.2018.06.023_bib8","first-page":"757","article-title":"Hysterectomy and race","volume":"82","author":"Kjerulff","year":"1993","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajpath.2018.06.023_bib9","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1095\/biolreprod.105.048124","article-title":"Myometrial apoptosis: activation of the caspase cascade in the pregnant rat myometrium at midgestation","volume":"74","author":"Shynlova","year":"2006","journal-title":"Biol Reprod"},{"key":"10.1016\/j.ajpath.2018.06.023_bib10","series-title":"Anatomy of the human uterus. The Uterus","first-page":"18","author":"Ramsey","year":"1994"},{"key":"10.1016\/j.ajpath.2018.06.023_bib11","doi-asserted-by":"crossref","first-page":"18700","DOI":"10.1073\/pnas.0704472104","article-title":"Side population in human uterine myometrium displays phenotypic and functional characteristics of myometrial stem cells","volume":"104","author":"Ono","year":"2007","journal-title":"Proc Natl Acad Sci U S A"},{"key":"10.1016\/j.ajpath.2018.06.023_bib12","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/j.fertnstert.2012.04.044","article-title":"Identification and characterization of the human leiomyoma side population as putative tumor-initiating cells","volume":"98","author":"Mas","year":"2012","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ajpath.2018.06.023_bib13","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.fertnstert.2015.04.021","article-title":"Stro-1\/CD44 as putative human myometrial and fibroid stem cell markers","volume":"104","author":"Mas","year":"2015","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ajpath.2018.06.023_bib14","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1095\/biolreprod.116.143461","article-title":"Role of Stro1+\/CD44+stem cells in myometrial physiology and uterine remodeling during pregnancy","volume":"96","author":"Mas","year":"2017","journal-title":"Biol Reprod"},{"key":"10.1016\/j.ajpath.2018.06.023_bib15","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1002\/stem.2519","article-title":"Developmental exposure to endocrine disruptors expands the murine myometrial stem cell compartment as a prerequisite to leiomyoma tumorigenesis","volume":"35","author":"Mas","year":"2016","journal-title":"Stem Cells"},{"key":"10.1016\/j.ajpath.2018.06.023_bib16","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1095\/biolreprod.114.123794","article-title":"Tissue-specific stem cells in the myometrium and tumor-initiating cells in leiomyoma","volume":"91","author":"Ono","year":"2014","journal-title":"Biol Reprod"},{"key":"10.1016\/j.ajpath.2018.06.023_bib17","doi-asserted-by":"crossref","first-page":"242","DOI":"10.2119\/molmed.2014.00053","article-title":"Signaling pathways in leiomyoma: understanding pathobiology and implications for therapy","volume":"21","author":"Borahay","year":"2015","journal-title":"Mol Med"},{"key":"10.1016\/j.ajpath.2018.06.023_bib18","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1177\/1933719115584449","article-title":"The mechanism and function of epigenetics in uterine leiomyoma development","volume":"23","author":"Yang","year":"2016","journal-title":"Reprod Sci"},{"key":"10.1016\/j.ajpath.2018.06.023_bib19","doi-asserted-by":"crossref","first-page":"40","DOI":"10.3389\/fphar.2016.00040","article-title":"Early life adverse environmental exposures increase the risk of uterine fibroid development: role of epigenetic regulation","volume":"7","author":"Yang","year":"2016","journal-title":"Front Pharmacol"},{"key":"10.1016\/j.ajpath.2018.06.023_bib20","doi-asserted-by":"crossref","first-page":"8644","DOI":"10.1073\/pnas.0503218102","article-title":"Interaction between genetic susceptibility and early-life environmental exposure determines tumor-suppressor-gene penetrance","volume":"102","author":"Cook","year":"2005","journal-title":"Proc Natl Acad Sci U S A"},{"key":"10.1016\/j.ajpath.2018.06.023_bib21","doi-asserted-by":"crossref","first-page":"2433","DOI":"10.1210\/en.2009-1225","article-title":"Progesterone is essential for maintenance and growth of uterine leiomyoma","volume":"151","author":"Ishikawa","year":"2010","journal-title":"Endocrinology"},{"key":"10.1016\/j.ajpath.2018.06.023_bib22","doi-asserted-by":"crossref","first-page":"e36935","DOI":"10.1371\/journal.pone.0036935","article-title":"Role of stem cells in human uterine leiomyoma growth","volume":"7","author":"Ono","year":"2012","journal-title":"PLoS One"},{"key":"10.1016\/j.ajpath.2018.06.023_bib23","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1097\/00006250-198812000-00008","article-title":"Epidemiologic characteristics of women with uterine fibroids: a case-control study","volume":"72","author":"Parazzini","year":"1988","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajpath.2018.06.023_bib24","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1097\/01.EDE.0000054360.61254.27","article-title":"Why is parity protective for uterine fibroids?","volume":"14","author":"Baird","year":"2003","journal-title":"Epidemiology"},{"key":"10.1016\/j.ajpath.2018.06.023_bib25","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1136\/bmj.293.6543.359","article-title":"Risk factors for uterine fibroids: reduced risk associated with oral contraceptives","volume":"293","author":"Ross","year":"1986","journal-title":"Br Med J (Clin Res Ed)"},{"key":"10.1016\/j.ajpath.2018.06.023_bib26","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1530\/REP-09-0438","article-title":"Human uterine stem\/progenitor cells: their possible role in uterine physiology and pathology","volume":"140","author":"Maruyama","year":"2010","journal-title":"Reproduction"},{"key":"10.1016\/j.ajpath.2018.06.023_bib27","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1126\/science.1260825","article-title":"Variation in cancer risk among tissues can be explained by the number of stem cell divisions","volume":"347","author":"Tomasetti","year":"2015","journal-title":"Science"},{"key":"10.1016\/j.ajpath.2018.06.023_bib28","doi-asserted-by":"crossref","first-page":"djv213","DOI":"10.1093\/jnci\/djv213","article-title":"Strategies to prevent \u201cbad luck\u201d in cancer","volume":"107","author":"Albini","year":"2015","journal-title":"J Natl Cancer Inst"},{"key":"10.1016\/j.ajpath.2018.06.023_bib29","doi-asserted-by":"crossref","first-page":"9","DOI":"10.3747\/co.19.1003","article-title":"A model for breast cancer risk based on stem-cell theory","volume":"19","author":"Narod","year":"2012","journal-title":"Curr Oncol"},{"key":"10.1016\/j.ajpath.2018.06.023_bib30","doi-asserted-by":"crossref","DOI":"10.1093\/biolre\/ioy097","article-title":"Endocrine disruptor exposure during development increases incidence of uterine fibroids by altering DNA repair in myometrial stem cells","author":"Prusinski Fernung","year":"2018","journal-title":"Biol Reprod"},{"key":"10.1016\/j.ajpath.2018.06.023_bib31","article-title":"A preliminary study: human fibroid Stro-1+\/CD44+ stem cells isolated from uterine fibroids demonstrate decreased DNA repair and genomic integrity compared to adjacent myometrial Stro-1+\/CD44+ cells","author":"Prusinski Fernung","year":"2018","journal-title":"Reprod Sci"},{"issue":"5 Suppl","key":"10.1016\/j.ajpath.2018.06.023_bib32","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1016\/j.ajog.2004.06.117","article-title":"Environmental exposures, toxicologic mechanisms, and adverse pregnancy outcomes","volume":"192","author":"Silbergeld","year":"2005","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajpath.2018.06.023_bib33","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.envres.2008.03.001","article-title":"Catfish consumption as a contributor to elevated PCB levels in a non-Hispanic black subpopulation","volume":"107","author":"Weintraub","year":"2008","journal-title":"Environ Res"},{"key":"10.1016\/j.ajpath.2018.06.023_bib34","first-page":"21","article-title":"Heading off hair-care disasters. Use caution with relaxers and dyes","volume":"35","author":"Meadows","year":"2001","journal-title":"FDA Consum"},{"key":"10.1016\/j.ajpath.2018.06.023_bib35","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1136\/jech.2006.054130","article-title":"Children at risk: measuring racial\/ethnic disparities in potential exposure to air pollution at school and home","volume":"61","author":"Chakraborty","year":"2007","journal-title":"J Epidemiol Community Health"},{"key":"10.1016\/j.ajpath.2018.06.023_bib36","series-title":"The Third National Report on Human Exposure to Environmental Chemicals","year":"2005"},{"key":"10.1016\/j.ajpath.2018.06.023_bib37","series-title":"Toward Environmental Justice: Research, Education, and Health Policy Needs","article-title":"The National Academies Collection: Reports Funded by National Institutes of Health","year":"1999"},{"key":"10.1016\/j.ajpath.2018.06.023_bib38","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1289\/ehp.8930","article-title":"The environmental \u201criskscape\u201d and social inequality: implications","volume":"114","author":"Morello-Frosch","year":"2006","journal-title":"Environ Health Perspect"},{"key":"10.1016\/j.ajpath.2018.06.023_bib39","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1111\/jsm.12425","article-title":"Examining the relationship between uterine fibroids and dyspareunia among premenopausal women in the United States","volume":"11","author":"Moshesh","year":"2014","journal-title":"J Sex Med"},{"key":"10.1016\/j.ajpath.2018.06.023_bib40","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1093\/humrep\/17.5.1244","article-title":"The effect on IVF outcome of small intramural fibroids not compressing the uterine cavity as determined by a prospective matched control study","volume":"17","author":"Check","year":"2002","journal-title":"Hum Reprod"},{"key":"10.1016\/j.ajpath.2018.06.023_bib41","doi-asserted-by":"crossref","first-page":"1878","DOI":"10.1016\/j.fertnstert.2007.09.019","article-title":"Estrogen receptor alpha and beta in uterine fibroids: a basis for altered estrogen responsiveness","volume":"90","author":"Bakas","year":"2008","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ajpath.2018.06.023_bib42","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/S0015-0282(16)57679-1","article-title":"Fibroid growth in response to high-dose progestogen","volume":"64","author":"Harrison-Woolrych","year":"1995","journal-title":"Fertil Steril"},{"key":"10.1016\/j.ajpath.2018.06.023_bib43","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1159\/000029983","article-title":"Expression of progesterone receptor form A and B mRNAs in uterine leiomyoma","volume":"19","author":"Fujimoto","year":"1998","journal-title":"Tumor Biol"},{"key":"10.1016\/j.ajpath.2018.06.023_bib44","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1002\/1097-4652(2000)9999:999<000::AID-JCP1040>3.0.CO;2-E","article-title":"17-B estradiol elicits an autocrine leiomyoma cell proliferation: evidence for a stimulation of protein kinase-dependent pathway","volume":"186","author":"Barbarisi","year":"2001","journal-title":"J Cell Physiol"},{"key":"10.1016\/j.ajpath.2018.06.023_bib45","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1210\/jc.2010-0501","article-title":"Activin-A and myostatin response and steroid regulation in human myometrium: disruption of their signalling in uterine fibroid","volume":"96","author":"Ciarmela","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.ajpath.2018.06.023_bib46","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1095\/biolreprod.114.127126","article-title":"CD34 and CD49f double-positive and lineage marker-negative cells isolated from human myometrium exhibit stem cell-like properties involved in pregnancy-induced uterine remodeling","volume":"93","author":"Ono","year":"2015","journal-title":"Biol Reprod"},{"key":"10.1016\/j.ajpath.2018.06.023_bib47","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.5858\/2000-124-1448-ROMCSA","article-title":"Relationship of myoma cell size and menopausal status in small uterine leiomyomas","volume":"124","author":"Cramer","year":"2000","journal-title":"Arch Pathol Lab Med"},{"key":"10.1016\/j.ajpath.2018.06.023_bib48","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1080\/019262301301418900","article-title":"Uterine leiomyomas: mechanisms of tumorigenesis","volume":"29","author":"Houston","year":"2001","journal-title":"Toxicol Pathol"}],"container-title":["The American Journal of Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002944018303717?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002944018303717?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T11:05:27Z","timestamp":1762081527000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002944018303717"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10]]},"references-count":48,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["S0002944018303717"],"URL":"https:\/\/doi.org\/10.1016\/j.ajpath.2018.06.023","relation":{},"ISSN":["0002-9440"],"issn-type":[{"value":"0002-9440","type":"print"}],"subject":[],"published":{"date-parts":[[2018,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Expanding upon the Human Myometrial Stem Cell Hypothesis and the Role of Race, Hormones, Age, and Parity in a Profibroid Environment","name":"articletitle","label":"Article Title"},{"value":"The American Journal of Pathology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajpath.2018.06.023","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2018 American Society for Investigative Pathology. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}