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The uterus is a complex, pear-shaped reproductive organ composed of three primary layers: the innermost endometrium, the muscular middle myometrium, and the outer serosal perimetrium [4, 7]. Biologically, it serves as the site for embryo implantation, fetal development during gestation, and the muscular contractions required for parturition [2, 9]. While uterine tissue itself is an anatomical structure rather than a single molecular target, it contains a high density of therapeutic targets, including the estrogen receptor (ER), progesterone receptor (PR), and oxytocin receptor (OXTR), which regulate the menstrual cycle and pregnancy [1, 12]. Pathologies such as uterine fibroids and endometriosis are managed through the modulation of these hormonal pathways using drugs like elagolix and levonorgestrel [16, 18]. Furthermore, uterine malignancies like endometrial cancer are increasingly treated with targeted therapies against HER2/neu, VEGF, or components of the PI3K/AKT/mTOR pathway [11, 13, 17].
Drugs affecting the uterine tissue act through diverse mechanisms including agonism or antagonism of hormone receptors (Estrogen and Progesterone receptors), modulation of the oxytocin receptor to control contractility, inhibition of prostaglandin synthesis, and targeted inhibition of oncogenic pathways like HER2/neu or VEGF in malignant contexts.
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