Evaluation of the antiproliferative, proapoptotic, and antiangiogenic effects of a double- stranded RNA mimic complexed with polycations in an experimental mouse model of leiomyoma  Carmen Maria García-Pascual, Ph.D., Hortensia Ferrero, Ph.D., Irene Juarez, M.D., Jessica Martínez, Ph.D., Ana Villanueva, Ph.D., Mercedes Pozuelo-Rubio, Ph.D., Marisol Soengas, Ph.D., Damiá Tormo, Ph.D., Carlos Simón, MD., Raúl Gómez, Ph.D., Antonio Pellicer, M.D.  Fertility and Sterility  Volume 105, Issue 2, Pages 529-538 (February 2016) DOI: 10.1016/j.fertnstert.2015.10.037 Copyright © 2016 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Evaluation of the proapoptotic effects of [pICPEI] treatment on the survival of leiomyoma and myometrial cells cultured in vitro. Graph represents cell death, estimated by Trypan exclusion in primary leiomyoma or myometrial cells cultured in the presence of [pICPEI] (1 μg/mL) for 12, 24, or 48 hours. Note that no statistically significant differences in cell death are observed in untreated control cells during the time course. Mean ± standard error of the mean; *P<.05. Fertility and Sterility 2016 105, 529-538DOI: (10.1016/j.fertnstert.2015.10.037) Copyright © 2016 American Society for Reproductive Medicine Terms and Conditions

Figure 2 The effect of [pICPEI] on the macroscopic features of human leiomyoma implants in the peritoneal wall of mice. Examples show the appearance of leiomyoma implants observed in mice treated with vehicle (A, C) or 0.6 mg/kg [pICPEI] (B, D) at the end of the treatment. Note the reddish color of the control animal implants and the pale white color of the [pICPEI]-treated animal implants. The graph shows the average size of the implants (mm2) before and after treatment in mice administered vehicle or [pICPEI] over the study period. No statistically significant size reduction was detected in any group after treatment. Scale bars: 5 mm. Fertility and Sterility 2016 105, 529-538DOI: (10.1016/j.fertnstert.2015.10.037) Copyright © 2016 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Effect of [pICPEI] treatment on neoangiogenesis of leiomyoma implants. (A) Illustrative staining pattern for vascularization (PECAM staining, red color), and (B) quantitative analysis of the PECAM-stained area in leiomyoma implant sections from [pICPEI]-treated and control animals. Note the dramatic decrease in leiomyoma vascular density in the [pICPEI]-treated versus control animals. Mean ± standard error of the mean; *P<.05. Original magnification ×100. Scale bars: 150 μm. Fertility and Sterility 2016 105, 529-538DOI: (10.1016/j.fertnstert.2015.10.037) Copyright © 2016 American Society for Reproductive Medicine Terms and Conditions

Figure 4 Effect of [pICPEI] treatment on cell proliferation and apoptosis of leiomyoma implants. The images are representative staining of (A) proliferating cells (brown color) stained for the Ki67 proliferation marker and (B) apoptotic cells (red color) stained against cells with DNase I activity as a marker of apoptosis in leiomyoma implants from [pICPEI]-treated and control mice. Original magnification (A) ×400, scale bars: 60 μm; (B) ×100, scale bars: 150 μm. Graphs below the images show quantitative analysis (mean ± standard error of the mean) of (A) cellular proliferation and (B) apoptosis in both groups.*P<.05. Fertility and Sterility 2016 105, 529-538DOI: (10.1016/j.fertnstert.2015.10.037) Copyright © 2016 American Society for Reproductive Medicine Terms and Conditions