{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T08:27:38Z","timestamp":1786955258207,"version":"build-2736575974"},"reference-count":80,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Medical Science, Khalifa University","award":["RO1 ES028615"],"award-info":[{"award-number":["RO1 ES028615"]}]},{"name":"Department of Medical Science, Khalifa University","award":["RO1 HD094378"],"award-info":[{"award-number":["RO1 HD094378"]}]},{"name":"Department of Medical Science, Khalifa University","award":["U54 MD007602"],"award-info":[{"award-number":["U54 MD007602"]}]},{"name":"Department of Medical Science, Khalifa University","award":["RO1 HD087417"],"award-info":[{"award-number":["RO1 HD087417"]}]},{"name":"Department of Medical Science, Khalifa University","award":["RO1 HD106285 (AA)"],"award-info":[{"award-number":["RO1 HD106285 (AA)"]}]},{"award":["RO1 ES028615"],"award-info":[{"award-number":["RO1 ES028615"]}],"id":[{"id":"https:\/\/ror.org\/05hffr360","id-type":"ROR","asserted-by":"publisher"}]},{"award":["RO1 HD094378"],"award-info":[{"award-number":["RO1 HD094378"]}],"id":[{"id":"https:\/\/ror.org\/05hffr360","id-type":"ROR","asserted-by":"publisher"}]},{"award":["U54 MD007602"],"award-info":[{"award-number":["U54 MD007602"]}],"id":[{"id":"https:\/\/ror.org\/05hffr360","id-type":"ROR","asserted-by":"publisher"}]},{"award":["RO1 HD087417"],"award-info":[{"award-number":["RO1 HD087417"]}],"id":[{"id":"https:\/\/ror.org\/05hffr360","id-type":"ROR","asserted-by":"publisher"}]},{"award":["RO1 HD106285 (AA)"],"award-info":[{"award-number":["RO1 HD106285 (AA)"]}],"id":[{"id":"https:\/\/ror.org\/05hffr360","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Uterine fibroids, the most common tumors in reproductive-age women, remain without a defined precursor tissue state. Unlike cervical dysplasia preceding cervical cancer, or colonic polyps preceding colorectal malignancy, no equivalent \u201cat-risk\u201d tissue marker exists for fibroids, and diagnosis relies on radiological imaging only after tumors are already well-established and often symptomatic including excessive menstrual bleeding, pelvic pain, infertility and obstetric complications. In this narrative review, we propose that a subset of women with unexplained AUB may harbor a chronic, non-infectious inflammatory condition of the myometrium, which we term Chronic Aseptic Myometritis (CAM). We synthesize mechanistic and human tissue evidence suggesting that sterile inflammation driven by damage-associated molecular patterns, NLRP3 inflammasome activation, oxidative DNA damage, and TGF-\u03b2\u2013mediated extracellular-matrix remodeling may underlie the transition from normal myometrium (MyoN) to a pre-fibroid, inflamed and stiffened state (MyoF), and may contribute both to abnormal uterine bleeding (AUB) and to fibroid initiation. We propose a preliminary framework for future CAM research, including the identification of candidate biomarker categories and imaging correlates. We also discuss whether early mechanism-based interventions, such as vitamin D and epigallocatechin gallate (EGCG), may offer a potential pathway toward primary prevention. Because the components of this model derive largely from experimental and cross-sectional human studies, CAM is presented as a hypothesis-generating, myometrium-centered framework rather than a validated clinical entity, and prospective validation is required.<\/jats:p>","DOI":"10.3390\/cells15161469","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T08:05:41Z","timestamp":1786953941000},"page":"1469","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Chronic Aseptic Myometritis: A Mechanistic Framework Linking Sterile Myometrial Inflammation to Uterine Fibroid Initiation and a Roadmap for Primary Prevention"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4163-7293","authenticated-orcid":false,"given":"Saba","family":"Haq","sequence":"first","affiliation":[{"name":"Department of Medical Science, Khalifa University, Abu Dhabi 127788, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6952-0520","authenticated-orcid":false,"given":"Fatimah","family":"Hussein","sequence":"additional","affiliation":[{"name":"Department of Medical Science, Khalifa University, Abu Dhabi 127788, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Elamin","sequence":"additional","affiliation":[{"name":"Department of Medical Science, Khalifa University, Abu Dhabi 127788, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1643-0104","authenticated-orcid":false,"given":"Mervat M.","family":"Omran","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA"},{"name":"Cancer Biology Department, National Cancer Institute, Cairo University, Cairo 11769, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7959-3707","authenticated-orcid":false,"given":"Jakub","family":"Kociuba","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Obstetrics and Gynecological Endocrinology, 00-189 Warsaw, Poland"},{"name":"Warsaw Institute of Women\u2019s Health, 00-189 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5780-5983","authenticated-orcid":false,"given":"Michal","family":"Ciebiera","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Obstetrics and Gynecological Endocrinology, 00-189 Warsaw, Poland"},{"name":"Warsaw Institute of Women\u2019s Health, 00-189 Warsaw, Poland"},{"name":"Development and Research Center of Non-Invasive Therapies, Pro-Familia Hospital, 35-302 Rzeszow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahya","family":"Mohammadi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0979-8402","authenticated-orcid":false,"given":"Esra","family":"Cetin","sequence":"additional","affiliation":[{"name":"Hurley Medical Center, Michigan State University, East Lansing, MI 48503, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Everett","family":"Tate","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obianuju Sandra","family":"Madueke-Laveaux","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5676-3221","authenticated-orcid":false,"given":"Mira","family":"Mousa","sequence":"additional","affiliation":[{"name":"Department of Public Health and Epidemiology, College of Health and Medical Sciences, Khalifa University, Abu Dhabi 127788, United Arab Emirates"},{"name":"Center for Biotechnology, College of Health and Medical Sciences, Khalifa University, Abu Dhabi 127788, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0554-132X","authenticated-orcid":false,"given":"Mostafa","family":"Borahay","sequence":"additional","affiliation":[{"name":"Department of Gynecology & Obstetrics, Johns Hopkins University, Baltimore, MD 21287, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9675-6691","authenticated-orcid":false,"given":"Mohamed","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA"},{"name":"Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo 11566, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8778-4447","authenticated-orcid":false,"given":"Ayman","family":"Al-Hendy","sequence":"additional","affiliation":[{"name":"Department of Medical Science, Khalifa University, Abu Dhabi 127788, United Arab Emirates"},{"name":"Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Navarro, A., Bariani, M.V., Yang, Q., and Al-Hendy, A. 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