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CAFs, in particular, are vital contributors to ECM remodeling, secreting collagen I and fibronectin that increase ECM stiffness and activate tumor-promoting signaling pathways, including the YAP/TAZ pathway

25,26 ADAMTS-3 has been proposed as the major type II procollagen-processing enzyme, but it is also highly expressed in many Col1a1 -expressing tissues during mouse embryonic development and might be responsible for some of the type I procollagen N-endopeptidase activity, 26,27 and ADAMTS-14 has been shown to have type I procollagen I N-endopeptidase activity in vitro

Since they are also fundamentally important in energy metabolism, immune balance, and gastrointestinal function, optimizing hormones in women with fibroids may additionally improve inflammation, gut dysbiosis, sleep, and overall quality of life