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Bohsas H, Alibrahim H, Swed S, Abouainain Y, Aljabali A, Kazan L, Jabban YKE, Mehmood Q, Sawaf B, Eissa N, Alkasem M, Edrees Y, Cherrez-Ojeda I, Fathey S, Rashid G, Hafez W, AbdElrahim E, Osman H, Emran TB, Khan Pathan R, Khandaker MU. Prevalence and knowledge of polycystic ovary syndrome (PCOS) and health-related practices among women of Syria: a cross-sectional study. J Psychosom Obstet Gynaecol 2024; 45:2318194. [PMID: 38635351 DOI: 10.1080/0167482x.2024.2318194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/08/2024] [Indexed: 04/20/2024] Open
Abstract
Polycystic Ovarian Syndrome (PCOS) is a prevalent metabolic and hormonal disorder affecting women of reproductive age. Limited data exists on Syrian women's PCOS awareness and health behaviors. This study aimed to gauge PCOS prevalence, knowledge, awareness, and health-related practices among Syrian women. A cross-sectional online survey was conducted from 11 February to 27 October 2022, targeting Syrian women aged 18-45. Collaborators from specific medical universities distributed a questionnaire adapted from a Malaysian paper through social media platforms. Out of 1840 surveyed Syrian women, 64.2% were aged 21-29, and 69.6% held bachelor's degrees. Those with a bachelor's degree exhibited the highest mean knowledge score (12.86), and women previously diagnosed with PCOS had a higher mean knowledge score (13.74) than those without. Approximately 27.4% were confirmed PCOS cases, and 38.9% had possible cases. Women with PCOS were 3.41 times more likely to possess knowledge about the condition. The findings suggest a moderate level of PCOS knowledge and health-related practices among Syrian women, emphasizing the need for increased awareness. Consistent local PCOS screening programs, in collaboration with obstetrics and gynecology professionals, are crucial for improving understanding and clinical symptom recognition of this condition among Syrian women.
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Affiliation(s)
| | | | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | | | - Ahmed Aljabali
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Lazaward Kazan
- Faculty of Medicine, Altınbaş University, Istanbul, Turkey
| | | | | | - Bisher Sawaf
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Nourhan Eissa
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Meriam Alkasem
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Yasmine Edrees
- Faculty of Medicine, Damascus University, Damascus, Syria
| | | | | | - Gowhar Rashid
- Department of Amity Medical School, Amity University, Haryana, India
| | - Wael Hafez
- NMC Royal Hospital, Khalifa City, Abu Dhabi, United Arab Emirates
- Medical Research Division, Department of Internal Medicine, The National Research Centre, Cairo, Egypt
| | - Elrashed AbdElrahim
- Radiological Sciences Department, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Hamid Osman
- Radiological Sciences Department, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
| | - Refat Khan Pathan
- Department of Computing and Information Systems, School of Engineering and Technology, Sunway University, Bandar Sunway, Malaysia
| | - Mayeen Uddin Khandaker
- Faculty of Graduate Studies, Daffodil International University, Daffodil Smart City, Dhaka, Bangladesh
- Applied Physics and Radiation Technologies Group, CCDCU, School of Engineering and Technology, Sunway University, Bandar Sunway, Malaysia
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Wu HH, Zhu Q, Liang N, Xiang Y, Xu TY, Huang ZC, Cai JY, Weng LL, Ge HS. CISD2 regulates oxidative stress and mitophagy to maintain the balance of the follicular microenvironment in PCOS. Redox Rep 2024; 29:2377870. [PMID: 39010730 PMCID: PMC467114 DOI: 10.1080/13510002.2024.2377870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024] Open
Abstract
OBJECTIVES To observe the CISD2 expression among PCOS patients and to explore its profound impact on the follicular microenvironment. Moreover, we want to elucidate the intricate mechanistic contribution of CISD2 to the onset and progression of PCOS. METHODS Oxidase NOX2, mitophagy-related proteins, and CISD2 were detected by WB. The changes in mitochondrial structure and quantity were observed by transmission electron microscopy. Mitochondrial and lysosome colocalization was used to detect the changes of mitophagy. MDA kit, GSH and GSSG Assay kit and ROS probe were used to detect oxidative stress damage. RESULTS We found that CISD2, mitophagy and oxidase in the GCs of PCOS patients were significantly increased. Testosterone stimulation leads to the increase of oxidase, mitophagy, and CISD2 in KGN cells. CISD2 inhibition promoted the increase of mitophagy, and the activation of mitochondria-lysosome binding, while alleviating the oxidative stress. CONCLUSIONS Inhibition of CISD2 can improve the occurrence of oxidative stress by increasing the level of mitophagy, thus affecting the occurrence and development of PCOS diseases.
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Affiliation(s)
- Hong-Hui Wu
- Graduate School, Dalian Medical University, Liaoning, People’s Republic of China
- Reproduction Medicine Centre, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, People’s Republic of China
| | - Qi Zhu
- Reproduction Medicine Centre, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, People’s Republic of China
- Graduate School, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Na Liang
- Graduate School, Dalian Medical University, Liaoning, People’s Republic of China
- Reproduction Medicine Centre, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, People’s Republic of China
| | - Yu Xiang
- Reproduction Medicine Centre, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, People’s Republic of China
- Graduate School, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Tian-Yue Xu
- Reproduction Medicine Centre, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, People’s Republic of China
- Graduate School, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Zi-Chao Huang
- Reproduction Medicine Centre, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, People’s Republic of China
- Graduate School, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Jie-Yu Cai
- Reproduction Medicine Centre, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, People’s Republic of China
- Graduate School, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Ling-Lin Weng
- Reproduction Medicine Centre, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, People’s Republic of China
- Graduate School, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Hong-Shan Ge
- Graduate School, Dalian Medical University, Liaoning, People’s Republic of China
- Reproduction Medicine Centre, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, People’s Republic of China
- Graduate School, Nanjing Medical University, Nanjing, People’s Republic of China
- Graduate School, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
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Bao X, Yan D, Yang J, Zhang Z, Yuan B. Role of ERβ in the ovary and ovary related diseases. Gene 2024; 927:148678. [PMID: 38906392 DOI: 10.1016/j.gene.2024.148678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 06/01/2024] [Accepted: 06/07/2024] [Indexed: 06/23/2024]
Abstract
Estrogen and estrogen receptors (ERα and ERβ) regulate a multitude of complicated physiological and pathological processes. Jan-Ake Gustafsson's group discovered ERβ in 1996, this crucial finding gives us new insights into the understanding of estrogen signaling. ERβ is highly expressed in the ovary and particularly exists in granulosa cells (GCs). ERβ is a key transcription factor in the maintenance of ovarian granulosa cell growth, differentiation, and homeostasis, and the ovulation function of ovarian follicles and oocytes. Additionally, ERβ can modulate the steroidogenic transcriptional program through phosphorylation and regulate both gonadotropin response and FOXL2 expression within the ovary. In this review, we focus on the role of ERβ in regulating ovarian granulosa cell development and homeostasis, particularly its significance in ovarian cancer (OC), premature ovarian failure (POF), and polycystic ovary syndrome (PCOS). It also highlights the prospects of small molecule compounds targeting ERβ, providing a new strategy for the treatment of ovarian-related diseases.
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Affiliation(s)
- Xuewei Bao
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui 230032, People's Republic of China
| | - Di Yan
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui 230032, People's Republic of China; Second School of Clinical Medicine, Anhui Medical University, Hefei, Anhui 230032, People's Republic of China
| | - Jing Yang
- Experimental Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, People's Republic of China
| | - Zhen Zhang
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, People's Republic of China.
| | - Bin Yuan
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui 230032, People's Republic of China.
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Usulkar S, Sutar KP, Biradar P, Patil V, Jadhav V. Innovative berberine nanoethosomal vaginal in situ gel: Unraveling polycystic ovary syndrome treatment on female Wistar rats. Int J Pharm 2024; 663:124564. [PMID: 39117062 DOI: 10.1016/j.ijpharm.2024.124564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/22/2024] [Accepted: 08/05/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE The present work seeks to develop, assess and refine a nanoethosomal vaginal in situ gel containing Berberine, aimed at enhancing its efficacy in treating Poly Cystic Ovary Syndrome (PCOS). This formulation aims to augment drug permeation, enable controlled release kinetics, and mitigate oral adverse effects commonly associated with Berberine administration. METHOD Nanoethosomes formulated using diverse soya lecithin-ethanol concentrations within a 32 full-factorial-design, sought optimal formulations based on particle size and %entrapment-efficiency. Subsequent scrutiny involved PDI, Zeta potential and drug-content evaluation. TEM analysis authenticated morphology, while in vitro drug release from Nanoethosomes was examined. Pluronic F-127 concentrations (16%-21%w/v) were explored for the in situ gel, analyzing pH, gelation time and gelation temperature. The refined gel underwent evaluations for viscosity and in vitro diffusion. In vivo assessment covered pharmacokinetics, vaginal irritancy and Mifepristone-induced PCOS management, validated through histopathological and biochemical analysis, juxtaposing findings across normal, diseased, plain Berberine gel and standard metformin administered groups. RESULTS Optimized Nanoethosomal Formulation(F3) displayed particle size of 183.5 nm, 82.58 % as %entrapment-efficiency, PDI of 0.137, -50.34 mV as zeta potential and 81.64 ± 1.57 % drug-content. TEM analysis confirmed spherical, nano-sized particles. In vitro studies exhibited 80.45 % drug release over 24 h. The formulated gel with 18 % Pluronic F-127 showed viscosity ranging from 193.01 ± 0.16cps to 1817.08 ± 1.67cps with temperature changes from 25 ± 2.0 °C to 38 ± 2.0 °C. In vitro diffusion revealed 85.99 %drug release from optimized gel. In vivo animal studies demonstrated increased plasma drug concentration, non-irritating properties in vaginal tests, and efficacy in managing Mifepristone-induced PCOS compared to other treatments. Short-term stability evaluations confirmed thermodynamic stability at room-temperature.
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Affiliation(s)
- Siddarth Usulkar
- Department of Pharmaceutics, KLE College of Pharmacy, Belagavi, KLE Academy of Higher Education and Research (KAHER), Nehru Nagar, Belagavi 590010, Karnataka, India.
| | - Kishori P Sutar
- Department of Pharmaceutics, KLE College of Pharmacy, Belagavi, KLE Academy of Higher Education and Research (KAHER), Nehru Nagar, Belagavi 590010, Karnataka, India.
| | - Prakash Biradar
- Department of Pharmacology, KLE College of Pharmacy, Belagavi, KLE Academy of Higher Education and Research (KAHER), Nehru Nagar, Belagavi 590010, Karnataka, India
| | - Vinayak Patil
- Department of Pharmaceutics, KLE College of Pharmacy, Belagavi, KLE Academy of Higher Education and Research (KAHER), Nehru Nagar, Belagavi 590010, Karnataka, India
| | - Vishwanath Jadhav
- Department of Pharmaceutics, KLE College of Pharmacy, Belagavi, KLE Academy of Higher Education and Research (KAHER), Nehru Nagar, Belagavi 590010, Karnataka, India
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Nguyen NT, Le TTM. Factors predicting menstrual irregularity among university students in Ho Chi Minh City, Vietnam: A cross-sectional study. BELITUNG NURSING JOURNAL 2024; 10:424-429. [PMID: 39211466 PMCID: PMC11350349 DOI: 10.33546/bnj.3303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/29/2024] [Accepted: 07/09/2024] [Indexed: 09/04/2024] Open
Abstract
Background University students often face menstrual irregularities, particularly among healthcare students, due to rigorous study environments, such as night duties resembling professional staff responsibilities. Objective This study aimed to examine the prevalence of and factors predicting menstrual irregularities among female students in Ho Chi Minh City, Vietnam. Methods A cross-sectional study was conducted from April to July 2023 at the University of Medicine and Pharmacy at Ho Chi Minh City (UMP). Data were collected using self-administered questionnaires comprising sections on personal background, menstrual cycles, sleep duration, and academic stress. Descriptive statistics and multiple logistic regression were employed for data analysis. Results Approximately 48.3% of participants experienced menstrual irregularities. Overweight or obese students were more likely to experience irregularities compared to those of normal weight (AOR = 7.56, 95% CI = 1.34, 80.8). Nursing majors (including nursing, midwifery, and anesthesia resuscitation nursing) showed a higher likelihood of irregularities compared to other majors (AOR = 2.5, 95% CI = 1.35, 4.13). Conclusion This study highlights a significant prevalence of menstrual irregularities among female students. Interventions in nursing education should focus on promoting healthy lifestyles and regular physical activity to manage weight and mitigate menstrual irregularities.
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Affiliation(s)
- Nhan Thi Nguyen
- Department of Midwifery, Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| | - Trinh Thi My Le
- Department of Midwifery, Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
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Ge Y, Chen Y, Zhang Y, Hu Y, Jiang F, Lu X, Wu C. Shared genes of polycystic ovary syndrome and sedentary behavior as a novel immune landscape biomarker for endometrial cancer. Sci Rep 2024; 14:19111. [PMID: 39154063 PMCID: PMC11330454 DOI: 10.1038/s41598-024-69951-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 08/12/2024] [Indexed: 08/19/2024] Open
Abstract
Endometrial cancer (EC) is associated with significant risk factors such as polycystic ovarian syndrome (PCOS) and sedentary behavior. In our study, we aim to employ machine learning algorithms to investigate the potential molecular processes that underlie their interaction and explore their respective roles in the diagnosis and immunotherapy of EC. The GEO database provides access to microarray data, which was utilized in this study to identify gene expression modules associated with PCOS and sedentary behavior, using weighted gene expression network analysis (WGCNA). Cluego software was then employed to investigate the energy enrichment of shared pathways in both PCOS and sedentary individuals, and differential gene analysis was used to confirm another two databases. The miRNAs-mRNAs controlled network was constructed to verify the pathway. The immune-related factors of the shared pathway in EC were then analyzed. Finally, to validate our findings, we conducted cell experiments using EC cell lines (AN3CA, KLE, Ishikawa, RL95-2, and HEC-1A). We found that increased intracellular aromatic compound anabolism is a common feature of both PCOS and sedentary individuals. We then developed a disease pathway model that was based on the common genetic characteristics of PCOS and sedentary behavior. We utilized pathway typing in EC samples and found a significant survival difference between the two subgroups, with the upregulated expression type exhibiting an immune-hot phenotype. Finally, the experimental results confirmed the expression of the hub gene (NAA15) in EC. The findings of our study suggest that genes related to the intracellular aromatic compound metabolic pathway can be used for immunotherapy of EC.
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Affiliation(s)
- Yao Ge
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210029, China
| | - Yuan Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210029, China
| | - Yun Zhang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210029, China
| | - Yifang Hu
- Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Feng Jiang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China.
| | - Xiao Lu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210029, China.
| | - Chuyan Wu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210029, China.
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Abu-Zaid A, Baradwan S, Alyafi M, Al Baalharith M, Alsehaimi SO, Alsabban M, Alsharif SA, Alqarni SMS, Albelwi H, Jamjoom MZ, Saleh SAK, Adly HM, Alomar O, Salem H. Association between polycystic ovary syndrome and the risk of malignant gynecologic cancers (ovarian, endometrial, and cervical): A population-based study from the U.S.A. National Inpatient Sample 2016-2019. Eur J Obstet Gynecol Reprod Biol 2024; 299:283-288. [PMID: 38941743 DOI: 10.1016/j.ejogrb.2024.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 06/19/2024] [Accepted: 06/22/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE This study aimed to systematically examine the relationship between polycystic ovary syndrome and ovarian, endometrial, and cervical cancers using the National Inpatient Sample (NIS) database. METHODS We utilized the International Classification of Diseases (ICD-10) system to identify relevant codes from the NIS database (2016-2019). Univariate and multivariable regression analyses (adjusted age, race, hospital region, hospital teaching status, income Zip score, smoking, alcohol use, and hormonal replacement therapy) were conducted to evaluate association between PCOS and gynecologic cancers. Results were summarized as odds ratio (OR) with 95% confidence intervals (CI). RESULTS Overall, 15,024,965 patients were analyzed, of whom 56,183 and 14,968,782 patients were diagnosed with and without PCOS, respectively. Among the patients diagnosed with gynecologic cancers (n = 91,599), there were 286 with PCOS and 91,313 without PCOS. Univariate analysis revealed that PCOS was significantly associated with higher risk of endometrial cancer (OR = 1.39, 95 % CI [1.18-1.63], p < 0.0001), but lower risk of ovarian cancer (OR = 0.55, 95 % CI [0.45-0.67], p < 0.0001) and cervical cancer (OR = 0.68, 95 % CI [0.51-0.91], p = 0.009). In contrast, after Bonferroni correction, multivariable analysis depicted that PCOS remained significantly associated with higher risk of endometrial cancer (OR = 3.90, 95 % CI [4.32-4.59], p < 0.0001). There was no significant correlation between PCOS and risk of ovarian cancer (OR = 1.09, 95 % CI [0.89-1.34], p = 0.409) and cervical cancer (OR = 0.83, 95 % CI [0.62-1.11], p = 0.218). CONCLUSION This first-ever NIS analysis showed that patients with PCOS exhibited unique gynecologic cancer risk profiles, with higher risk for endometrial cancer, and no significant risk for ovarian or cervical cancers.
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Affiliation(s)
- Ahmed Abu-Zaid
- Department of Biochemistry and Molecular Medicine, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
| | - Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mohammad Alyafi
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maha Al Baalharith
- Department of Obstetrics and Gynecology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Saud Owaimer Alsehaimi
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohannad Alsabban
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Saud Abdullah Alsharif
- Department of Obstetrics and Gynecology, College of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Saad M S Alqarni
- Department of Obstetrics and Gynecology, King Faisal Armed Forces Hospital, Khamis Mushait, Saudi Arabia
| | - Hedaya Albelwi
- Department of Obstetrics and Gynecology, National Guard Hospital, Riyadh, Saudi Arabia
| | - Mohammed Ziad Jamjoom
- Department of Obstetrics and Gynecology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Saleh A K Saleh
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Heba M Adly
- Department of Community Medicine and Pilgrims Healthcare, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Osama Alomar
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hany Salem
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Zheng M, Zhao F. The IL-12 family of heterodimeric cytokines in polycystic ovarian syndrome: biological role in induction, regulation, and treatment. Immunol Res 2024; 72:583-591. [PMID: 38771486 DOI: 10.1007/s12026-024-09487-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/01/2024] [Indexed: 05/22/2024]
Abstract
Polycystic ovary syndrome (PCOS) is a diverse endocrine disorder widely recognized as the prevailing metabolic condition among women in their reproductive years. The precise pathophysiological mechanisms underlying PCOS remain incompletely understood. However, existing evidence suggests that the development of PCOS may be linked to factors such as abdominal obesity, hyperandrogenism, and insulin resistance (IR). Excessive central adiposity in women with PCOS may lead to the development of a chronic, low-grade inflammation characterized by the activation of proinflammatory cytokines. The cytokines that belong to the IL-12 family are a collection of distinct heterodimeric cytokines that include IL-12, IL-23, IL-27, and IL-35. Recent research has provided further evidence regarding the significance of IL-12 cytokines in influencing both innate and adaptive immune responses in different diseases. Additionally, these studies have discovered diverse roles for certain members of the IL-12 family, encompassing multiple immunological functions that can either act as effectors or regulators. In this discourse, we examine the distinctive and atypical structural and functional attributes of this particular cytokine family. This study aims to offer a comprehensive overview of the pathophysiological significance of the IL-12 family cytokines in PCOS patients. Additionally, the therapeutic potential of the cytokines as novel approaches for PCOS treatment will be proposed.
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Affiliation(s)
- Mingyan Zheng
- Gynaecology and Obstetrics, Weifang People's Hospital, Weifang, 261000, Shandong, China
| | - Feng Zhao
- Gynaecology and Obstetrics, Weifang People's Hospital, Weifang, 261000, Shandong, China.
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Busari KA, Tulay P. Polycystic ovary syndrome: emerging stem cell therapies. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20231436. [PMID: 39045951 PMCID: PMC11288272 DOI: 10.1590/1806-9282.20231436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/05/2024] [Indexed: 07/25/2024]
Affiliation(s)
- Karimat Adeola Busari
- Near East University, Faculty of Medicine, Department of Medical Genetics – Nicosia, Cyprus
| | - Pinar Tulay
- Near East University, Faculty of Medicine, Department of Medical Genetics – Nicosia, Cyprus
- Near East University, DESAM Research Institute – Nicosia, Cyprus
- Near East University, Center of Excellence, Genetics and Cancer Diagnosis-Research Center – Nicosia, Cyprus
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Mohamed RA, Taref NN, Osman NE, Keshta NHA, Alboghdady MA, Marzouk MM, Almowafy AA, Fadel EA. Effect of web-based health education on nursing students' knowledge, adaptive healthy measures and attitudes regarding polycystic ovary syndrome: a randomized controlled trial. BMC Nurs 2024; 23:479. [PMID: 39010089 PMCID: PMC11247781 DOI: 10.1186/s12912-024-02015-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/14/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting women of reproductive age, and it has emerged as a significant global public health issue. This study aimed to investigate the effects of web-based health education on nursing students' knowledge, adaptive healthy measures, and attitudes toward PCOS. METHODS A two-group randomized controlled trial (RCT) with pre-test and immediate post-test assessments was conducted. Study participants were recruited using a simple random sampling method from the Faculty of Nursing, Mansoura University, Egypt. A questionnaire consisting of six sections was developed to collect data, which was analyzed with the SPSS 23.0 using Student's t-test, Pearson's correlation test, and chi-square test analysis of variance. RESULTS The analysis revealed a significant increase in knowledge scores post-intervention, with the web-based learning groups (32.2 ± 10.5) outperforming the traditional learning group (22.1 ± 10.2), with (p < 0.05). Similarly, there was a notable improvement in adaptive healthy measures scores post-intervention, with the web-based learning group (8.9 ± 2.4) showing better results than the traditional group (6.5 ± 2.9), with (p < 0.05). In terms of attitudes toward PCOS, the web-based group (18.2 ± 4.9) displayed a significant improvement compared to the traditional group (11.7 ± 5.2), with (p < 0.05). CONCLUSIONS The findings suggest that web-based learning is more effective than traditional methods in enhancing nursing students' knowledge, adaptive healthy measures, and attitudes toward PCOS. TRIAL REGISTRATION This study was registered by Clinical Trials.gov Identifier: (NCT06192381|| https://www. CLINICALTRIALS gov/ ) on 5-1-2024.
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Affiliation(s)
- Rasha A Mohamed
- Community Health Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
- College of Applied Medical Sciences, University of Bisha, Bisha, Saudi Arabia
| | - Nagwa N Taref
- Community Health Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Nehmedo E Osman
- Woman's Health and Midwifery Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Nawal Hamdy Ahmed Keshta
- Department of Obstetrics and Gynecology, Faculty of Medicine, Girls Branch, Al Azhar University, Cairo, Egypt
| | - Mahmoud A Alboghdady
- Obstetrics and gynecology at ART unit, International Islamic institute Al-Azhar University, Cairo, Egypt
| | - Marzouk M Marzouk
- Public Health and Community Medicine, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Abeer A Almowafy
- International Islamic Center for Population Studies and Research, Al-Azhar University, Cairo, Egypt.
| | - Eman A Fadel
- Woman's Health and Midwifery Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
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11
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Kaur M, Singh S, Kaur A. Structural changes in amide I and amide II regions of PCOS women analyzed by ATR-FTIR spectroscopy. Heliyon 2024; 10:e33494. [PMID: 39040335 PMCID: PMC11261041 DOI: 10.1016/j.heliyon.2024.e33494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 07/24/2024] Open
Abstract
The etiology of PCOS is complex and frequently mis or undiagnosed, which may enhance morbidity and reduce the quality of life. Attenuated total reflection- Fourier transform infrared (ATR-FTIR) spectroscopy examines the structural fingerprints of the biochemical compounds and can provide distinct FTIR spectra of the PCOS cases and controls. The present study recruited 61 PCOS cases and 38 control women. The student's t-test was used to compare BMI, WHR, and lipid profile. The FTIR spectral region was compared among both groups using the Mann-Whitney U test and multivariate analysis involved principal component analysis (PCA) and hierarchical cluster analysis (HCA). FTIR spectra of different phenotypes of PCOS were also analyzed using multivariate analysis. In univariate analysis, PCOS women had significantly higher WHR (p = 0.007), BMI (p = 0.04), triglycerides (p = 0.04), and VLDL (p = 0.02) than the controls. The spectral regions of amide I (1700-1600 cm-1) and amide II (1580-1480 cm-1), were significantly greater in the PCOS group than in the controls (p < 0.01 and p < 0.001, respectively). The PCA and HCA revealed a distinct molecular fingerprint for phenotype A (PCOM + OA + HA) and phenotype B (HA + OA). Our study postulated that the spectral regions of amide I and amide II can distinguish between PCOS cases and control women and it may be used for the diagnosis of cases.
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Affiliation(s)
- Mandeep Kaur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, 143005, India
| | - Sukhjashanpreet Singh
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, 143005, India
| | - Anupam Kaur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, 143005, India
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12
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Rashid R, Shah IA, Makhdoomi MJ, Rashid A, Godha M, Ganai BA, Ganie MA. Association of TCF7L2 Gene Variant (rs12255372) with Polycystic Ovary Syndrome and its Effect Modification of the Disease Phenotype. Indian J Clin Biochem 2024; 39:373-379. [PMID: 39005872 PMCID: PMC11239628 DOI: 10.1007/s12291-023-01115-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/18/2023] [Indexed: 02/02/2023]
Abstract
Polycystic ovary syndrome (PCOS) and type-2 diabetes mellitus (T2DM) share common genetic features. Transcription factor 7-like-2 (TCF7L2) is consistently studied T2DM susceptibility locus. However, limited studies on TCF7L2 have failed to demonstrate any link with the PCOS risk. Therefore, we investigated the association of TCF7L2 polymorphic variant (rs12255372) with the PCOS risk. We recruited 120 PCOS cases, diagnosed as per Rotterdam 2003 criteria, and an equal number of age-matched controls. Besides a detailed clinical assessment, subjects underwent biochemical and hormonal profiling. Genotyping for rs12255372 was done by PCR-RFLP. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (95%CIs) of genotype-phenotype correlations. The PCOS cases reported fewer menstrual cycles per year and exhibited signs of hyperandrogenism. The heterozygous genotype of rs12255372 was strongly associated with the PCOS risk (OR = 2.00; 95%CI: 1.07-3.76). Unlike controls, only 3 cases harbored TT genotype, and the PCOS risk persisted in the dominant model (GT + TT) as well. Moreover, we found a synergistic effect modification by the variant genotype in the subjects who had family histories of T2DM, hirsutism, or menstrual irregularities. We report a significant association of the TCF7L2 polymorphic variant rs12255372 with the PCOS risk.
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Affiliation(s)
- Rabiya Rashid
- Department of Life and Basic Sciences, Jaipur National University, Jaipur, India
- Multidisciplinary Research Unit, Department of Clinical Research, SKIMS, Srinagar, India
| | - Idrees A. Shah
- Multidisciplinary Research Unit, Department of Clinical Research, SKIMS, Srinagar, India
| | - Mudassir Jan Makhdoomi
- Department of Life and Basic Sciences, Jaipur National University, Jaipur, India
- Departments of Endocrinology, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
| | - Aafia Rashid
- Departments of Endocrinology, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
| | - Meena Godha
- Department of Life and Basic Sciences, Jaipur National University, Jaipur, India
| | - Bashir A. Ganai
- Centre for Research and Development, University of Kashmir, Srinagar, India
| | - Mohd Ashraf Ganie
- Multidisciplinary Research Unit, Department of Clinical Research, SKIMS, Srinagar, India
- Departments of Endocrinology, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
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13
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Tan K, Coster T, Mousa A, Mar A, Piltonen T, Boyle JA, Teede H, Joham A, Romualdi D, Tay CT. Laser and Light-Based Therapies for Hirsutism Management in Women With Polycystic Ovarian Syndrome: A Systematic Review. JAMA Dermatol 2024; 160:746-757. [PMID: 38630483 DOI: 10.1001/jamadermatol.2024.0623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
Importance Hirsutism represents a significant concern for women with polycystic ovary syndrome (PCOS), with deleterious psychological effects warranting acknowledgment and a clear imperative to provide effective management. To our knowledge, this is the first review to exclusively examine the effectiveness of laser and light-based therapies in addressing hirsutism in women with PCOS. Objective To synthesize the existing literature regarding the effectiveness of laser and light hair reduction therapies, either as stand-alone treatments or in combination with systemic agents, in treating hirsutism for women with PCOS. Evidence Review A systematic literature review was performed using MEDLINE, Embase, EMCARE, and CINAHL according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Articles written in English, reporting on patients who met pre-established inclusion criteria were selected. Objective and subjectively measured outcomes relating to the effect of laser or light-based hair reduction therapies on hirsutism were abstracted. Heterogeneity among included studies precluded a meta-analysis, necessitating a narrative synthesis. Findings Six studies reporting data on 423 individual patients with PCOS who underwent laser or light-based hair reduction therapies were included: 4 randomized clinical trials and 2 cohort studies. Alexandrite laser demonstrated significant improvements in hirsutism severity and psychological outcomes, particularly at high-fluence application. Alexandrite laser was also found to be more effective than intense pulsed light (IPL). The combination of diode laser with either metformin or combined oral contraceptive pill was superior to the application of diode laser alone, just as the addition of metformin to IPL demonstrated superior results to IPL treatment alone. Overall, most interventions were well tolerated. The overall certainty of evidence across all outcomes and comparisons was limited in part due to the observational nature of some studies. Conclusions and Relevance This systematic review highlights the potential of laser and light hair reduction therapies, both as stand-alone treatments and in combination with other pharmacological agents in PCOS. However, this review was limited by low certainty of the evidence, few studies evaluating effectiveness and safety in those with skin of color, and heterogeneity in outcome assessment. Future studies are needed to provide more robust evidence among diverse individuals with PCOS and hirsutism.
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Affiliation(s)
- Katrina Tan
- Monash Health, Department of Dermatology, Melbourne, Australia
| | - Thisara Coster
- Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine Nursing and Health Sciences, Monash University, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine Nursing and Health Sciences, Monash University, Australia
| | - Adrian Mar
- Monash Health, Department of Dermatology, Melbourne, Australia
| | - Terhi Piltonen
- Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Jacqueline A Boyle
- Eastern Health Clinical School, Monash University, Melbourne, 3128, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine Nursing and Health Sciences, Monash University, Australia
| | - Anju Joham
- Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine Nursing and Health Sciences, Monash University, Australia
| | - Daniela Romualdi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Chau Thien Tay
- Monash Centre for Health Research and Implementation (MCHRI), Faculty of Medicine Nursing and Health Sciences, Monash University, Australia
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14
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Myerson ML, Paparodis RD, Block RC, Karalis DG, Mintz G, Brinton EA, Wild R. Polycystic ovary syndrome: A review of diagnosis and management, with special focus on atherosclerotic cardiovascular disease prevention. J Clin Lipidol 2024; 18:e488-e500. [PMID: 38908968 DOI: 10.1016/j.jacl.2024.04.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 03/12/2024] [Accepted: 04/23/2024] [Indexed: 06/24/2024]
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrinopathy worldwide with a heterogeneous clinical presentation including reproductive, metabolic, and endocrine elements. However, the assessment and management of PCOS remains inconsistent, with many women undiagnosed and untreated. We now also understand that the management of PCOS should extend throughout a woman's lifespan as many elements of the syndrome persist after menopause. Management has traditionally focused on the treatment of hyperandrogenism and oligomenorrhea. Women with PCOS often have dyslipidemia, hypertension, obesity, and metabolic syndrome, which may be worsened by the hormonal abnormalities, and are therefore at higher risk for cardiovascular disease morbidity and mortality, a risk that increases after menopause. While treatment with hormonal therapy, in particular combined oral contraceptives, may improve cardiovascular risk factors, management plans should incorporate specific diagnosis and management of these factors, if present, because of the strong contribution to the risk for atherosclerotic cardiovascular disease. Given the complexities of the syndrome, optimal management often requires a multi-disciplinary approach including the lipid and cardiometabolic specialist to provide counseling and support for lifestyle modification along with pharmacologic therapy as indicated to address the full range of any reproductive, endocrine, and cardiometabolic abnormalities.
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Affiliation(s)
| | - Rodis D Paparodis
- Endocrinology, Diabetes and Metabolism Clinics, Private Practice, Patras, Greece and Center for Diabetes and Endocrine Research, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA (Dr. Paparodis)
| | - Robert C Block
- Department of Public Health Sciences, Cardiology Division of the Department of Medicine, and Center for Community Health and Prevention, at the University of Rochester, Rochester NY, USA (Dr. Block)
| | - Dean G Karalis
- Department of Cardiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA (Dr. Karalis)
| | - Guy Mintz
- Sandra Atlas Bass Heart Hospital, North Shore University Hospital and Zucker School of Medicine, Manhasset, NY, USA (Dr. Mintz)
| | - Eliot A Brinton
- Utah Lipid Center, Salt Lake City UT, and Family and Preventive Medicine, University of Utah, Salt Lake City, Utah, USA (Dr. Brinton)
| | - Robert Wild
- Department of Obstetrics and Gynecology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA (Dr. Wild)
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15
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Cao Y, Guo Y, Long Z, Wu Y, Pei B, Ye J, Zhang M, Yuan H, Jia Y, Liu X, Wang F, Zhao Y. The Global Burden of Gynecological Diseases from 1990 to 2019. Am J Prev Med 2024:S0749-3797(24)00222-8. [PMID: 38945179 DOI: 10.1016/j.amepre.2024.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 07/02/2024]
Abstract
INTRODUCTION Gynecological diseases ranked second among new cases of noncommunicable diseases in women of reproductive age in 1990 and 2019 globally. The aim of this study was to estimate the disease burden of gynecological diseases and describe their trends in women of all ages from 1990 to 2019. METHODS Using data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD 2019), authors examined the incidence, disability-adjusted life years, and deaths from gynecological diseases by age in 204 countries and territories worldwide from 1990 to 2019. Analyses were conducted in 2022. RESULTS Globally, the age-standardized incidence rate and age-standardized disability-adjusted life year rate (ASDR) of gynecological diseases decreased by -0.176% and -0.245%, respectively from 1990 to 2019. Low socioeconomic development index countries had the highest age-standardized incidence rate and ASDR in 2019. The age-specific incidence rate of gynecological diseases in women aged 15-29 years increased from 1990 to 2019, and the 20-24-year age group increased the greatest by 0.21%. Polycystic ovary syndrome and other types of benign disorders contributed to the major increase. CONCLUSIONS Although the disease burden of gynecological diseases decreased slightly between 1990 and 2019 globally, it remained highest in low socioeconomic development index countries. The disease burden in 20-24-year age group exhibited the fastest growth, with polycystic ovary syndrome and other types of benign disorders playing a significant role. Urgent and effective measures should be taken to target different age groups, types of gynecological disease, and regions with high disease burdens.
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Affiliation(s)
- Yukun Cao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yufeng Guo
- Department of Obstetrics and Gynecology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhiping Long
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yi Wu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Bing Pei
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jingyu Ye
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Min Zhang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Heli Yuan
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanjie Jia
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xiao Liu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Fan Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yashuang Zhao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China.
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16
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Sacca L, Okwaraji G, Densley S, Marciniak A, Knecht M, Wilson C, Pilitsis JG, Kimberly Hopkins D. Polycystic ovary syndrome and chronic pain among females and individuals of childbearing age: A scoping review. SAGE Open Med 2024; 12:20503121241262158. [PMID: 38903491 PMCID: PMC11189018 DOI: 10.1177/20503121241262158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 05/30/2024] [Indexed: 06/22/2024] Open
Abstract
Objectives The purpose of this scoping review is to explore research studies on the association between chronic pain and polycystic ovary syndrome to create local (U.S.-based) and global recommendations to improve access to and quality of affordable symptom management and treatment options for patients with polycystic ovary syndrome. Methods The study sections used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews as a checklist reference. The review followed the York methodology by Arksey and O'Malley for the extraction, analysis, and presentation of results in scoping reviews. Results Final analysis included two conference abstracts published in peer-reviewed journals and two peer-reviewed articles. The relationship between pain perception and health-related quality of life warrants further investigation in patients with polycystic ovary syndrome as the interconnected pathophysiology of symptoms renders exploring associations between the two factors difficult. A comprehensive understanding of the causes of polycystic ovary syndrome-associated symptoms, particularly those relating to pain perceptions can provide more insight into polycystic ovary syndrome pathophysiology and aid in the development of innovative therapeutic approaches for long-term polycystic ovary syndrome management and care. Conclusion Future studies are necessary to examine associations between the disease and pathophysiological symptoms for a better quality of life for patients with polycystic ovary syndrome.
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Affiliation(s)
- Lea Sacca
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Goodness Okwaraji
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Sebastian Densley
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Adeife Marciniak
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Michelle Knecht
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Candy Wilson
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Julie G Pilitsis
- Department of Neurosurgery, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Dawn Kimberly Hopkins
- Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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17
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Lyu W, Li DF, Li SY, Hu H, Zhou JY, Wang L. Gut microbiota modulation: a narrative review on a novel strategy for prevention and alleviation of ovarian aging. Crit Rev Food Sci Nutr 2024:1-13. [PMID: 38835159 DOI: 10.1080/10408398.2024.2361306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
The global rise in life expectancy corresponds with a delay in childbearing age among women. Ovaries, seen as the chronometers of female physiological aging, demonstrate features of sped up aging, evidenced by the steady decline in both the quality and quantity of ovarian follicles from birth. The multifaceted pathogenesis of ovarian aging has kindled intensive research interest from the biomedical and pharmaceutical sectors. Novel studies underscore the integral roles of gut microbiota in follicular development, lipid metabolism, and hormonal regulation, forging a nexus with ovarian aging. In this review, we outline the role of gut microbiota in ovarian function (follicular development, oocyte maturation, and ovulation), compile and present gut microbiota alterations associated with age-related ovarian aging. We also discuss potential strategies for alleviating ovarian aging from the perspective of gut microbiota, such as fecal microbiota transplantation and probiotics.
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Affiliation(s)
- Wei Lyu
- Clinical Medical Research Center, The Second Affiliated Hospital of Army Military Medical University, Chongqing, China
- Department of Pharmaceutical Chemistry, University of California-San Francisco, San Francisco, California, USA
| | - De-Feng Li
- Clinical Medical Research Center, The Second Affiliated Hospital of Army Military Medical University, Chongqing, China
| | - Shu-Ying Li
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Army Military Medical University, Chongqing, China
| | - Hua Hu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Army Military Medical University, Chongqing, China
| | - Jian-Yun Zhou
- Clinical Medical Research Center, The Second Affiliated Hospital of Army Military Medical University, Chongqing, China
| | - Ling Wang
- Clinical Medical Research Center, The Second Affiliated Hospital of Army Military Medical University, Chongqing, China
- Department of Pharmaceutical Chemistry, University of California-San Francisco, San Francisco, California, USA
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18
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Irmak E, Tunca Sanlier N, Sanlier N. Could polyphenols be an effective treatment in the management of polycystic ovary syndrome? INT J VITAM NUTR RES 2024; 94:422-433. [PMID: 38229476 DOI: 10.1024/0300-9831/a000802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Polycystic ovary syndrome (PCOS), is a health problem observed in women of reproductive age. Different diets, physical activity recommendations and lifestyle changes can be effective in dealing with the symptoms of PCOS. Nutrition is indeed an essential part of the treatment of the disease as it directly affects body weight loss, insulin resistance, lipid profile, hormones, and dermatological complaints such as acne. Polyphenols, simply classified as flavonoids and non-flavonoids, are bioactive components found in plant-based foods. The most common polyphenols in the diet are flavanols, flavonols, flavanone, anthocyanins. In particular, polyphenols which are compounds naturally found in foods, have antioxidant, anticancer, anti-inflammatory, antimutagenic benefits along with many other ones. In the treatment of PCOS, polyphenols may help reduce the symptoms, improve insulin resistance and poor lipid profile, and cure hormonal disorders. It has been reported that polyphenols are influential in menstrual cycle disorders and enable a decrease in body weight, hyperandrogenism, estrogen, testosterone, luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratios and LH. For adequate daily intake of polyphenols, which are found in high amounts in fruits and vegetables, at least 5 portions of fruits and vegetables should be consumed in addition to a healthy nutrition pattern. In this review, the effects of various polyphenols on polycystic ovary syndrome are discussed.
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Affiliation(s)
- Esra Irmak
- School of Health Sciences, Nutrition and Dietetics Department, Ankara Medipol University, Turkey
| | - Nazli Tunca Sanlier
- Department of Obstetrics and Gynecology, Ankara Bilkent City Hospital, Turkey
| | - Nevin Sanlier
- School of Health Sciences, Nutrition and Dietetics Department, Ankara Medipol University, Turkey
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19
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Simon SL, Phimphasone-Brady P, McKenney KM, Gulley LD, Bonny AE, Moore JM, Torres-Zegarra C, Cree MG. Comprehensive transition of care for polycystic ovary syndrome from adolescence to adulthood. THE LANCET. CHILD & ADOLESCENT HEALTH 2024; 8:443-455. [PMID: 38552655 DOI: 10.1016/s2352-4642(24)00019-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 05/18/2024]
Abstract
Polycystic ovary syndrome (PCOS) is a lifelong chronic condition that affects one in ten females and can be diagnosed in adolescence. As adolescents with PCOS transition to adulthood, counselling for lifestyle management and mental health concerns often transition from involving the family unit to increasingly individual-focused approaches. PCOS is associated with a large range of comorbidities affecting reproductive, metabolic, dermatological, and psychological health. The diagnosis and comorbidities of PCOS are influenced by pubertal hormones and need to be reassessed continuously to ensure that treatment remains appropriate for age and development. As young patients grow up, personal concerns often change, especially in relation to reproductive management. In this Review, we present prevalence rates, screening tools, and treatment recommendations for PCOS-related conditions, and we consider the diagnostic and clinical elements of optimal transition of care models that ensure continuity of comprehensive care for adolescents moving from the paediatric health-care system to the adult health-care system.
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Affiliation(s)
- Stacey L Simon
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Children's Hospital Colorado Aurora, CO, USA.
| | | | - Kathryn M McKenney
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lauren D Gulley
- Children's Hospital Colorado Aurora, CO, USA; Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - Andrea E Bonny
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jaime M Moore
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Children's Hospital Colorado Aurora, CO, USA
| | - Carla Torres-Zegarra
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Children's Hospital Colorado Aurora, CO, USA
| | - Melanie G Cree
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Ludeman Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Children's Hospital Colorado Aurora, CO, USA
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20
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Abdalla MA, Shah N, Deshmukh H, Sahebkar A, Östlundh L, Al-Rifai RH, Atkin SL, Sathyapalan T. The Effect of Thiazolidinediones in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Adv Ther 2024; 41:2168-2195. [PMID: 38683294 DOI: 10.1007/s12325-024-02848-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/18/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is a complex endocrine condition affecting women of reproductive age. It is characterised by insulin resistance and is a risk for type 2 diabetes mellitus (T2DM). The aim of this study was to review the literature on the effect of pioglitazone and rosiglitazone in women with PCOS. METHODS We searched PubMed, MEDLINE, Scopus, Embase, Cochrane Library and the Web of Science in April 2020 and updated in March 2023. Studies were deemed eligible if they were randomised controlled trials (RCTs) reporting the effect of pioglitazone and rosiglitazone in PCOS. The study follows the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two reviewers independently extracted data and assessed the risk of bias using the Cochrane risk of bias tool. RESULTS Out of 814 initially retrieved citations, 24 randomised clinical trials (RCTs) involving 976 participants were deemed eligible. Among women with PCOS, treatment with rosiglitazone compared to metformin resulted in a significant increase in the mean body weight (mean difference (MD) 1.95 kg; 95% CI 0.03-3.87, p = 0.05). Metformin treatment was associated with a reduction in mean body mass index (BMI) compared to pioglitazone (MD 0.85 kg/m2; 95% CI 0.13-1.57, p = 0.02). Both pioglitazone compared to placebo (MD 2.56 kg/m2; 95% CI 1.77-3.34, p < 0.00001) and rosiglitazone compared to metformin (MD 0.74 kg/m2; 95% CI 0.07-1.41, p = 0.03) were associated with a significant increase in BMI. Treatment with pioglitazone compared to placebo showed a significant reduction in triglycerides (MD - 0.20 mmol/L; 95% CI - 0.38 to - 0.03, p = 0.02) and fasting insulin levels (MD - 11.47 mmol/L; 95% CI - 20.20, - 2.27, p = 0.01). Rosiglitazone compared to metformin was marginally significantly associated with a reduction in the luteinising hormone (LH) (MD - 0.62; 95% CI - 1.25-0.00, p = 0.05). CONCLUSION Both pioglitazone and rosiglitazone were associated with significant increases in body weight and BMI when compared with metformin or placebo. Pioglitazone significantly reduced triglycerides and fasting insulin when compared with placebo while rosiglitazone showed a modest reduction of LH when compared with metformin. PROSPERO REGISTRATION NO CRD42020178783.
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Affiliation(s)
- Mohammed A Abdalla
- Allam Diabetes Centre, Academic Diabetes, Endocrinology and Metabolism, The University of Hull, Hull York Medical School (HYMS), Hull, UK.
- Dasman Diabetes Institute, Department of Translational Research, State of Kuwait, Kuwait City, Kuwait.
| | - Najeeb Shah
- Allam Diabetes Centre, Academic Diabetes, Endocrinology and Metabolism, The University of Hull, Hull York Medical School (HYMS), Hull, UK
| | - Harshal Deshmukh
- Allam Diabetes Centre, Academic Diabetes, Endocrinology and Metabolism, The University of Hull, Hull York Medical School (HYMS), Hull, UK
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Medicine, The University of Western Australia, Perth, Australia
| | - Linda Östlundh
- College of Medicine and Health Sciences, The National Medical Library, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Rami H Al-Rifai
- College of Medicine and Health Sciences, Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Stephen L Atkin
- School of Postgraduate Studies and Research, RCSI Medical University of Bahrain, Al Sayh, Kingdom of Bahrain
| | - Thozhukat Sathyapalan
- Allam Diabetes Centre, Academic Diabetes, Endocrinology and Metabolism, The University of Hull, Hull York Medical School (HYMS), Hull, UK
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21
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Harrison C, Tay CT, Busby MA, Mousa A, Teede H, Boivin J. Challenges experienced by those with polycystic ovary syndrome in healthcare interactions: a qualitative evidence synthesis. Reprod Biomed Online 2024; 49:104293. [PMID: 39067213 DOI: 10.1016/j.rbmo.2024.104293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/16/2024] [Accepted: 05/20/2024] [Indexed: 07/30/2024]
Abstract
Studies report interaction difficulties between patients with polycystic ovary syndrome (PCOS) and healthcare professionals (HCP). This systematic review and qualitative evidence synthesis aimed to collate and synthesize the existing peer-reviewed literature investigating challenges for people with PCOS when interacting with HCP. Medline, PsycInfo, EMBASE, All EBM and CINAHL were searched from 1990 to September 2022. Study risk of bias (RoB) was performed and all textual data relevant to challenging interactions between patients with PCOS and HCP were extracted and analysed using thematic synthesis. Of the 6353 studies identified, 28 were included. Two were appraised as high, four as moderate and 22 as low RoB. Four analytic themes were derived illustrating that interactions were challenging when: (i) medical information (PCOS, its management) was not shared in the best way; (ii) information provision and deliberation opportunities were insufficient to achieve outcomes that mattered to patients; (iii) interactions prompted but did not support patient activation; and (iv) health system-level barriers (e.g. policies and guidelines) were present or made worse by HCP behaviour. Future research should examine methods for the implementation and evaluation of established frameworks for sharing medical information and supporting patient agency in the context of PCOS care.
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Affiliation(s)
- China Harrison
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK; National Institute for Health Research, Health Protection Research Unit (HBU) in Behavioural Science and Evaluation, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Chau Thien Tay
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Clayton, Australia
| | | | - Aya Mousa
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Clayton, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Clayton, Australia
| | - Jacky Boivin
- Cardiff Fertility and Reproductive Research, School of Psychology, Cardiff University, Cardiff, Wales, UK..
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Yang M, Deng H, Zhou S, Lu D, Shen X, Huang L, Chen Y, Xu L. Irisin alleviated the reproductive endocrinal disorders of PCOS mice accompanied by changes in gut microbiota and metabolomic characteristics. Front Microbiol 2024; 15:1373077. [PMID: 38846566 PMCID: PMC11153696 DOI: 10.3389/fmicb.2024.1373077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/11/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Folliculogenesis and oligo/anovulation are common pathophysiological characteristics in polycystic ovary syndrome (PCOS) patients, and it is also accompanied by gut microbiota dysbiosis. It is known that physical activity has beneficial effects on improving metabolism and promoting ovulation and menstrual cycle disorder in PCOS patients, and it can also modulate the gastrointestinal microbiota in human beings. However, the mechanism remains vague. Irisin, a novel myokine, plays a positive role in the mediating effects of physical activity. Methods Mice were randomly divided into the control group, PCOS group and PCOS+irisin group. PCOS model was induced by dehydroepiandrosterone (DHEA) and high-fat diet (HFD). The PCOS+irisin group was given irisin 400μg/kg intraperitoneal injection every other day for 21 days. The serum sex hormones were measured by radioimmunoassay. Hematoxylin and Eosin (H&E) Staining and immunohistochemistry (IHC) were conducted on ovarian tissue. The feces microbiota and metabolomic characteristics were collected by 16S rRNA gene sequencing and liquid chromatography-mass spectrometry (LC-MS). Results In this study, we demonstrated that irisin supplementation alleviated reproductive endocrine disorders of PCOS mice, including estrous cycle disturbance, ovarian polycystic degeneration, and hyperandrogenemia. Irisin also improved the PCOS follicles dysplasia and ovulation disorders, while it had no significant effect on the quality of oocytes. Moreover, irisin could mitigate the decreased bacteria of Odoribacter and the increased bacteria of Eisenbergiella and Dubosiella in PCOS mice model. Moreover, irisin could alleviate the increased fecal metabolites: Methallenestril and PS (22:5(4Z,7Z,10Z,13Z,16Z)/ LTE4). Conclusion These results suggest that irisin may alleviate the status of PCOS mice model by modulating androgen-induced gut microbiota dysbiosis and fecal metabolites. Hence, our study provided evidence that irisin may be considered as a promising strategy for the treatment of PCOS.
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Affiliation(s)
- Meina Yang
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Hongxia Deng
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Siyu Zhou
- Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Danhua Lu
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Xiaoyang Shen
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Lu Huang
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Yan Chen
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Liangzhi Xu
- Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
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23
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Sha Y, Zhu J, Shen F. A meta-analysis of efficacy on dexamethasone and clomiphene in the treatment of polycystic ovary syndrome patients. BMC Womens Health 2024; 24:298. [PMID: 38769509 PMCID: PMC11103836 DOI: 10.1186/s12905-024-03141-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/10/2024] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is an endocrine gynecological disease affecting many women of reproductive age. Clomiphene is the first-line treatment for PCOS patients, but most individuals may be resistant to it. This study aims to assess the efficacy of dexamethasone and clomiphene in the treatment of PCOS patients, and to provide a theoretical basis for clinicians to study and treat PCOS. METHODS Chinese and English databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang Medical Network, and VIP Information Chinese Journal Service Platform (VIP) were searched from the inception to January 2023. Review Manager and Stata software were used for meta- analysis. The risk of bias of eligible studies were assessed using Cochrane's risk of bias tool. Publication bias was assessed by funnel plots, Begg's and Egger's tests. RESULTS A total of 12 literatures were finally included, with a total of 1270 PCOS patients. Compared with the control group, dexamethasone combined with clomiphene could significantly improve pregnancy (RR = 1.71, P < 0.00001), ovulation (RR = 1.30, P < 0.00001), luteinizing hormone level (SMD = -0.94, P < 0.00001), estradiol level (SMD = 0.99, P = 0.05), progesterone level (SMD = 5.08, P = 0.002) and testosterone level (SMD = -1.59, P < 0.00001). However, there were no significant effects on ovulation-stimulating hormone level (SMD = 0.15, P = 0.37), adverse reactions (RR = 1.30, P = 0.30), dizziness (RR = 1.50, P = 0.45), and vomiting (RR = 1.67, P = 0.48). CONCLUSION The treatment of dexamethasone combined with clomiphene is helpful to improve the ovulation and pregnancy rate in patients with PCOS, and improve the hormone levels of patients.
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Affiliation(s)
- Ying Sha
- Department of Obstetrics and Gynecology, Zhangjiagang Second People's Hospital, Zhangjiagang City, Jiangsu Province, China
| | - Jianfen Zhu
- Department of Obstetrics and Gynecology, Zhangjiagang Second People's Hospital, Zhangjiagang City, Jiangsu Province, China
| | - Fangrong Shen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Suzhou University, Suzhou City, Jiangsu Province, China.
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Lulseged BA, Ramaiyer MS, Michel R, Saad EE, Ozpolat B, Borahay MA. The Role of Nanomedicine in Benign Gynecologic Disorders. Molecules 2024; 29:2095. [PMID: 38731586 PMCID: PMC11085148 DOI: 10.3390/molecules29092095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/23/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024] Open
Abstract
Nanomedicine has revolutionized drug delivery in the last two decades. Nanoparticles appear to be a promising drug delivery platform in the treatment of various gynecological disorders including uterine leiomyoma, endometriosis, polycystic ovarian syndrome (PCOS), and menopause. Nanoparticles are tiny (mean size < 1000 nm), biodegradable, biocompatible, non-toxic, safe, and relatively inexpensive materials commonly used in imaging and the drug delivery of various therapeutics, such as chemotherapeutics, small molecule inhibitors, immune mediators, protein peptides and non-coding RNA. We performed a literature review of published studies to examine the role of nanoparticles in treating uterine leiomyoma, endometriosis, PCOS, and menopause. In uterine leiomyoma, nanoparticles containing 2-methoxyestradiole and simvastatin, promising uterine fibroid treatments, have been effective in significantly inhibiting tumor growth compared to controls in in vivo mouse models with patient-derived leiomyoma xenografts. Nanoparticles have also shown efficacy in delivering magnetic hyperthermia to ablate endometriotic tissue. Moreover, nanoparticles can be used to deliver hormones and have shown efficacy as a mechanism for transdermal hormone replacement therapy in individuals with menopause. In this review, we aim to summarize research findings and report the efficacy of nanoparticles and nanotherapeutics in the treatment of various benign gynecologic conditions.
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Affiliation(s)
- Bethlehem A. Lulseged
- School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA; (B.A.L.); (M.S.R.)
| | - Malini S. Ramaiyer
- School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA; (B.A.L.); (M.S.R.)
| | - Rachel Michel
- Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Eslam E. Saad
- Department of Gynecology and Obstetrics, Johns Hopkins University, 720 Rutland Ave, Baltimore, MD 21205, USA;
| | - Bulent Ozpolat
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX 77030, USA;
| | - Mostafa A. Borahay
- Department of Gynecology and Obstetrics, Johns Hopkins University, 720 Rutland Ave, Baltimore, MD 21205, USA;
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25
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Tan H, Long P, Xiao H. Dissecting the shared genetic architecture between endometriosis and polycystic ovary syndrome. Front Endocrinol (Lausanne) 2024; 15:1359236. [PMID: 38742190 PMCID: PMC11089172 DOI: 10.3389/fendo.2024.1359236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Abstract
Background Previous study suggested evidence for coexistence and similarities between endometriosis and polycystic ovary syndrome (PCOS), but it is unclear regarding the shared genetic architecture and causality underlying the phenotypic similarities observed for endometriosis and PCOS. Methods By leveraging summary statistics from public genome-wide association studies regarding endometriosis (European-based: N=470,866) and PCOS (European-based: N=210,870), we explored the genetic correlation that shared between endometriosis and PCOS using linkage disequilibrium score regression. Shared risk SNPs were derived using PLACO (Pleiotropic analysis under composite null hypothesis) and FUMA (Functional Mapping and Annotation of Genetic Associations). The potential causal association between endometriosis and PCOS was investigated using two-sample Mendelian randomization (MR). Linkage disequilibrium score for the specific expression of genes analysis (LDSC-SEG) were performed for tissue enrichment analysis. The expression profiles of the risk gene in tissues were further examined. Results A positive genetic association was observed between endometriosis and PCOS. 12 significant pleiotropic loci shared between endometriosis and PCOS were identified. Genetic associations between endometriosis and PCOS were particularly enriched in uterus, endometrium and fallopian tube. Two-sample MR analysis further indicated a potential causative effect of endometriosis on PCOS, and vice versa. Microarray and RNA-seq verified the expressions of SYNE1 and DNM3 were significantly altered in the endometrium of patients with endometriosis or PCOS compared to those of control subjects. Conclusion Our study indicates the genetic correlation and shared risk genes between PCOS and endometriosis. These findings provide insights into the potential mechanisms behind their comorbidity and the future development of therapeutics.
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Affiliation(s)
- Hangjing Tan
- Institute of Reproductive & Stem Cell Engineering, Center of Reproductive Health, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - Panpan Long
- Institute of Reproductive & Stem Cell Engineering, Center of Reproductive Health, School of Basic Medical Science, Central South University, Changsha, Hunan, China
- Center of Genetics, Changsha Jiangwan Maternity Hospital, Changsha, Hunan, China
| | - Hongmei Xiao
- Institute of Reproductive & Stem Cell Engineering, Center of Reproductive Health, School of Basic Medical Science, Central South University, Changsha, Hunan, China
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26
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Kong FS, Huang P, Chen JH, Ma Y. The Novel Insight of Gut Microbiota from Mouse Model to Clinical Patients and the Role of NF-κB Pathway in Polycystic Ovary Syndrome. Reprod Sci 2024:10.1007/s43032-024-01562-3. [PMID: 38653859 DOI: 10.1007/s43032-024-01562-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
Polycystic Ovary Syndrome (PCOS) is a metabolic disorder characterized by hyperandrogenism and related symptoms in women of reproductive age. Emerging evidence suggests that chronic low-grade inflammation plays a significant role in the development of PCOS. The gut microbiota, a complex bacterial ecosystem, has been extensively studied for various diseases, including PCOS, while the underlying mechanisms are not fully understood. This review comprehensively summarizes the changes in gut microbiota and metabolites observed in PCOS and their potential association with the condition. Additionally, we discuss the role of abnormal nuclear factor κB signaling in the pathogenesis of PCOS. These findings offer valuable insights into the mechanisms of PCOS and may pave the way for the development of control and therapeutic strategies for this condition in clinical practice. By bridging the gap between mouse models and clinical patients, this review contributes to a better understanding of the interplay between gut microbiota and inflammation in PCOS, thus paving new ways for future investigations and interventions.
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Affiliation(s)
- Fan-Sheng Kong
- Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, 214122, Jiangsu, China
- Laboratory of Genomic and Precision Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Panwang Huang
- Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, 214122, Jiangsu, China
- Laboratory of Genomic and Precision Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Jian-Huan Chen
- Laboratory of Genomic and Precision Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China.
- Joint Primate Research Center for Chronic Diseases, Institute of Zoology of Guangdong Academy of Science, Jiangnan University, Wuxi, Jiangsu, China.
- Jiangnan University Brain Institute, Wuxi, Jiangsu, China.
| | - Yaping Ma
- Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, 214122, Jiangsu, China.
- Laboratory of Genomic and Precision Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China.
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27
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Kar TK, Sil S, Ghosh A, Barman A, Chattopadhyay S. Mitigation of letrozole induced polycystic ovarian syndrome associated inflammatory response and endocrinal dysfunction by Vitex negundo seeds. J Ovarian Res 2024; 17:76. [PMID: 38589892 PMCID: PMC11000293 DOI: 10.1186/s13048-024-01378-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/21/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a complex endocrine disorder in women that necessitates effective and safe treatment alternatives. This study aimed to evaluate the therapeutic efficacy of Vitex negundo seed in a letrozole-induced PCOS rat model. RESULTS Findings of the present study demonstrated that administration of hydro-ethanolic extract of Vitex negundo (VNE) effectively restored endocrino-metabolic imbalances associated with PCOS, along with correction of antioxidant enzymes level, proinflammatory cytokines, and apoptotic bio-markers. LC-MS analysis confirmed the presence of cinnamic acid, plumbagin and nigundin B as the prominent phytochemicals in VNE. The observed beneficial effects could be attributed to the active compounds in Vitex negundo extract, which exhibited hypoglycemic, hypolipidemic, and catabolic effects on body weight. Additionally, the extract contributed to hormonal balance regulation by modulating the steroidogenic enzymes, specifically by tuning gonadotropins level and correcting the LH:FSH ratio, through the modulation of ERα signalling and downregulation of NR3C4 expression. The antioxidant properties of phytochemicals in Vitex negundo seed were apparent through the correction of SOD and catalase activity. While it's anti-inflammatory and antiapoptotic action were associated with the regulation of mRNA expression of TNF-α, IL-6, BAX, Bcl2. Molecular docking study further indicated the molecular interaction of above mentioned active phytocompounds of VNE with ERα, NR3C4 and with TNFα that plays a critical mechanistic gateway to the regulation of hormone signalling as well as synchronizing the inflammation cascade. Furthermore, the histomorphological improvement of the ovaries supported the ameliorative action of Vitex negundo extract in the letrozole-induced PCOS model. CONCLUSIONS This study indicates the potential of Vitex negundo seed as a multifaceted therapeutic option for PCOS. VNE offers a holistic strategy for PCOS with antiandrogenic, anti-inflammatory, and antioxidant properties, driven by its major compounds like cinnamic acid, plumbagine, and nigundin B.
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Affiliation(s)
- Tarun Kumar Kar
- Department of Biomedical Laboratory Science & Management, Vidyasagar University, Midnapore, West Bengal, India
| | - Sananda Sil
- Department of Biomedical Laboratory Science & Management, Vidyasagar University, Midnapore, West Bengal, India
| | - Angshita Ghosh
- Department of Biomedical Laboratory Science & Management, Vidyasagar University, Midnapore, West Bengal, India
| | - Ananya Barman
- Department of Biomedical Laboratory Science & Management, Vidyasagar University, Midnapore, West Bengal, India
| | - Sandip Chattopadhyay
- Department of Biomedical Laboratory Science & Management, Vidyasagar University, Midnapore, West Bengal, India.
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28
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Choudhari R, Tayade S, Tiwari A, Satone P. Diagnosis, Management, and Associated Comorbidities of Polycystic Ovary Syndrome: A Narrative Review. Cureus 2024; 16:e58733. [PMID: 38779261 PMCID: PMC11110474 DOI: 10.7759/cureus.58733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most widespread and diverse endocrine health issue affecting many adolescent-aged women globally. It is the most frequent illness in reproductive-aged women. According to the Rotterdam criteria, two out of three elements: oligo-anovulation, hyperandrogenism, and polycystic ovaries (defined as having at least one ovary with an ovarian volume > 10 mL and/or 12 or more follicles measuring 2 to 9 mm in diameter) are present in PCOS. Conducted studies show epigenetics, environmental toxins, stress, and food as external factors as well as inflammation, oxidative stress, hyperandrogenism, insulin resistance, and obesity as internal factors related to PCOS. Although a portion of the mechanism associated with the occurrence of PCOS has been identified, there is still much to learn about the exact etiology and pathophysiology. The main debate covers the best ways to diagnose and treat this disease in adolescents. Early detection is crucial because of the disease's long-term effects on metabolic and reproductive health. Before beginning treatment for this group of young women, a firm diagnosis may not be made. Various criteria are used to diagnose PCOS patients. A person with PCOS has a chance of developing several comorbidities and health effects. PCOS patients are at risk of cardiac diseases, metabolic syndromes, resistance to insulin, infertility, and many more. There are numerous medications available for PCOS therapy that need a methodical approach. However, changing one's lifestyle should come first. There is proof in the support of the usage of several medications for PCOS, including mucolytic agents, Hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors, gliptins (oral diabetic medication), glucose-like peptide-1 receptor analogues, glitazones, and sodium-glucose cotransporter protein-2 (SGLT2) inhibitors. A comprehensive, systematic, schematic therapy approach is crucial for the treatment of PCOS.
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Affiliation(s)
- Rutuja Choudhari
- Department of Obstetrics and Gynaecology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Surekha Tayade
- Department of Obstetrics and Gynaecology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aakriti Tiwari
- Department of Obstetrics and Gynaecology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Prasiddhi Satone
- Department of Obstetrics and Gynaecology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Vaziripour M, Faghihi M, Ranjbaran M, Asadi B, Abdi A, Kianian F, Hajiaqaei M, Seifi B. Exploring the Therapeutic Potential of Sodium Hydrosulfide in Alleviating Oxidative Stress and Ovarian Dysfunction in a Rat Model of Polycystic Ovary Syndrome. J Reprod Infertil 2024; 25:133-139. [PMID: 39157798 PMCID: PMC11327425 DOI: 10.18502/jri.v25i2.16007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/07/2024] [Indexed: 08/20/2024] Open
Abstract
Background Oxidative stress is known to play a key role in the occurrence of polycystic ovary syndrome (PCOS) as the most common cause of anovulatory infertility. The purpose of the current study was to investigate whether diminished activity of ovarian enzymes responsible for hydrogen sulfide (H2S) production, cystathionine β-synthase (CBS), and cystathionine γ-lyase (CSE) contributes to oxidative stress in PCOS. The study also explored whether administration of sodium hydrosulfide (NaSH), an H2S donor, could ameliorate PCOS symptoms by reducing oxidative stress. Methods The total eighteen rats were randomly assigned into three groups (n=6): control, PCOS, and PCOS+NaSH. PCOS was induced by intramuscular injection of estradiol valerate to induce PCOS in the PCOS and PCOS+NaSH groups. The PCOS+NaSH group received 30 μmol/L of NaSH in drinking water for 27 days after PCOS induction. Ovarian tissue samples were analyzed for oxidative stress indices including malondialdehyde (MDA) levels and superoxide dismutase (SOD) activity. Additional analyses measured H2S levels, CBS, and CSE activity. Results PCOS induction led to a significant decrease in SOD activity, H2S levels, and CBS and CSE activity, accompanied by a significant increase in MDA levels (p<0.0001). Furthermore, PCOS caused severe histological alterations in the ovaries. However, administration of NaSH effectively restored all measured parameters to pre-PCOS induction levels (p<0.0001). Conclusion This study showed that the decrease in the activity of H2S-producing enzymes and H2S levels may contribute to oxidative stress in PCOS. Therefore, administration of NaSH as a H2S donor can be considered as a potential therapeutic strategy for PCOS patients.
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Affiliation(s)
- Maryam Vaziripour
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdieh Faghihi
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Ranjbaran
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Asadi
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Abdi
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Kianian
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Hajiaqaei
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Behjat Seifi
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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30
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Wang Y, Chen J, Dong H, Ma RL, Zou Y, Wang W, Zheng Q, Feng Y, Tan Z, Zeng X, Zhao Y, Deng Y, Wang Y, Gu B, Sun A. Effect of Consultation Number on the Assessment and Treatment of Polycystic Ovary Syndrome. Int J Womens Health 2024; 16:527-541. [PMID: 38558831 PMCID: PMC10979685 DOI: 10.2147/ijwh.s445568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
Background The basic medical education stage is not enough to support physicians to fully diagnose and evaluate polycystic ovary syndrome (PCOS). The study aims to discover the difference in treatment choice between participants with different annual consultation number of PCOS, to promote lifelong learning, and drive balanced development within healthcare. Methods This is a multicenter cross-sectional survey. Participants' basic information, knowledge of PCOS and treatment options were collected online. According to the annual consultation number of patients with PCOS, physicians were divided into three groups: 0-50 people/yr, 50-200 people/yr, and >200 people/yr, and the results were derived from χ2 test, Fisher exact test, and multivariate logistic regression analysis. Results The study analyzed 1689 questionnaires, and 1206 physicians (71.4%) received less than 50 women per year, 388 physicians (30.0%) with an annual number of 50-200 women, and 95 physicians (5.6%) with patient turnover for more than 200 people. Reproductive endocrinologists generally have higher access to the clinic. As the number of visits increases, more and more physicians would perceive patients as more likely to have abnormal blood glucose and heavy weight. Physicians with large numbers of consultations are more likely to use Asian or Chinese standards to assess obesity. The multivariate analysis involved variables such as age, hospital level, specialty, and patient turnover annually, and more young doctors actively assessed lipid profile (odds ratio (OR) 1.56, 95% confidence interval (CI) (1.16, 2.16)), and primary hospitals (OR 0.65 CI (0.44, 0.89)) chose OGTT for blood glucose assessment less than tertiary hospitals. Physicians in secondary hospitals are more aggressive in evaluating androgens. Conclusion Our survey found differences in endocrine assessment, metabolic screening, and treatment in PCOS women in terms of the number of obstetrician-gynecologists who received different patient consultation numbers. The importance of continuing education for physicians is emphasized, to promote lifelong learning.
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Affiliation(s)
- Yue Wang
- National Clinical Research Center for Obstetric & Gynecologic Diseases Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Jie Chen
- National Clinical Research Center for Obstetric & Gynecologic Diseases Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Han Dong
- Department of Obstetrics and Gynecology, Women and Children’s Hospital of Jinzhou, Jinzhou, Liaoning, 121000, People’s Republic of China
| | - Rui-Lin Ma
- National Clinical Research Center for Obstetric & Gynecologic Diseases Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Ying Zou
- Department of Obstetrics and Gynecology, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, 410008, People’s Republic of China
| | - Wei Wang
- Department of Reproductive Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050000, People’s Republic of China
| | - Qingmei Zheng
- Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266500, People’s Republic of China
| | - Ying Feng
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Zhangyun Tan
- Department of Obstetrics and Gynecology, Xinhui Maternity and Children’s Hospital, Nanning, Guangxi, 529100, People’s Republic of China
| | - Xiaoqin Zeng
- Department of Gynecology, Guangzhou Women and Children’s Medical Center, Guangzhou, Guangdong, 510000, People’s Republic of China
| | - Yinqing Zhao
- Department of Obstetrics and Gynecology, Xinhui Maternity and Children’s Hospital, Nanning, Guangxi, 529100, People’s Republic of China
| | - Yan Deng
- National Clinical Research Center for Obstetric & Gynecologic Diseases Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Yanfang Wang
- National Clinical Research Center for Obstetric & Gynecologic Diseases Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Bei Gu
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Peking University Ninth School of Clinical Medicine, Beijing, 100038, People’s Republic of China
| | - Aijun Sun
- National Clinical Research Center for Obstetric & Gynecologic Diseases Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, 100010, People’s Republic of China
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Cross AS, Moustafa M, Elder CJ. Fifteen-minute consultation: Approach to the adolescent presenting with hirsutism. Arch Dis Child Educ Pract Ed 2024; 109:66-72. [PMID: 36657811 DOI: 10.1136/archdischild-2022-324465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/01/2023] [Indexed: 01/21/2023]
Abstract
Hirsutism, unwanted terminal hair growth in androgen-dependent areas, is a common presentation to general paediatricians, dermatologists and endocrinologists. Polycystic ovarian syndrome is the most common cause but can be challenging to diagnose in young people due to the significant overlap of features with the healthy adolescent population. There are other rare, but important, causes to consider such as non-classic congenital adrenal hyperplasia and androgen-secreting tumours. Hirsutism carries a significant psychological burden for those living with it. This 15 min consultation piece describes the causes of hirsutism, introduces a novel assessment tool and suggests an approach to investigations and management, including signposting to psychological support.
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Affiliation(s)
- Alexandra Selina Cross
- Paediatric Endocrinology, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
| | - Manar Moustafa
- Paediatric Dermatology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Charlotte Jane Elder
- Paediatric Endocrinology, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
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32
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Quiroz-Aldave JE, Gamarra-Osorio ER, Durand-Vásquez MDC, Rafael-Robles LDP, Gonzáles-Yovera JG, Quispe-Flores MA, Concepción-Urteaga LA, Román-González A, Paz-Ibarra J, Concepción-Zavaleta MJ. From liver to hormones: The endocrine consequences of cirrhosis. World J Gastroenterol 2024; 30:1073-1095. [PMID: 38577191 PMCID: PMC10989500 DOI: 10.3748/wjg.v30.i9.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/02/2024] [Accepted: 02/06/2024] [Indexed: 03/06/2024] Open
Abstract
Hepatocrinology explores the intricate relationship between liver function and the endocrine system. Chronic liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis disruption. Despite its importance, assessing endocrine issues in cirrhotic patients is frequently neglected. This article provides a comprehensive review of the epidemiology, pathophysiology, diagnosis, and treatment of endocrine disturbances in liver cirrhosis. The review was conducted using the PubMed/Medline, EMBASE, and Scielo databases, encompassing 172 articles. Liver cirrhosis is associated with endocrine disturbances, including diabetes, hypoglycemia, sarcopenia, thyroid dysfunction, hypogonadotropic hypogonadism, bone disease, adrenal insufficiency, growth hormone dysfunction, and secondary hyperaldosteronism. The optimal tools for diagnosing diabetes and detecting hypoglycemia are the oral glucose tolerance test and continuous glucose monitoring system, respectively. Sarcopenia can be assessed through imaging and functional tests, while other endocrine disorders are evaluated using hormonal assays and imaging studies. Treatment options include metformin, glucagon-like peptide-1 analogs, sodium-glucose co-transporter-2 inhibitors, and insulin, which are effective and safe for diabetes control. Established standards are followed for managing hypoglycemia, and hormone replacement therapy is often necessary for other endocrine dysfunctions. Liver transplantation can address some of these problems.
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Affiliation(s)
| | | | | | | | | | | | | | - Alejandro Román-González
- Department of Endocrinology, Hospital Universitario de San Vicente Fundación, Medellin 050010, Colombia
- Internal Medicine, Universidad de Antioquia, Medellín 050010, Colombia
| | - José Paz-Ibarra
- School of Medicine, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
- Department of Endocrinology, Hospital Nacional Edgardo Rebagliati Martins, Lima 15072, Peru
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Kumari N, Kumari R, Dua A, Singh M, Kumar R, Singh P, Duyar-Ayerdi S, Pradeep S, Ojesina AI, Kumar R. From Gut to Hormones: Unraveling the Role of Gut Microbiota in (Phyto)Estrogen Modulation in Health and Disease. Mol Nutr Food Res 2024; 68:e2300688. [PMID: 38342595 DOI: 10.1002/mnfr.202300688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/28/2023] [Indexed: 02/13/2024]
Abstract
The human gut microbiota regulates estrogen metabolism through the "estrobolome," the collection of bacterial genes that encode enzymes like β-glucuronidases and β-glucosidases. These enzymes deconjugate and reactivate estrogen, influencing circulating levels. The estrobolome mediates the enterohepatic circulation and bioavailability of estrogen. Alterations in gut microbiota composition and estrobolome function have been associated with estrogen-related diseases like breast cancer, enometrial cancer, and polycystic ovarian syndrome (PCOS). This is likely due to dysregulated estrogen signaling partly contributed by the microbial impacts on estrogen metabolism. Dietary phytoestrogens also undergo bacterial metabolism into active metabolites like equol, which binds estrogen receptors and exhibits higher estrogenic potency than its precursor daidzein. However, the ability to produce equol varies across populations, depending on the presence of specific gut microbes. Characterizing the estrobolome and equol-producing genes across populations can provide microbiome-based biomarkers. Further research is needed to investigate specific components of the estrobolome, phytoestrogen-microbiota interactions, and mechanisms linking dysbiosis to estrogen-related pathology. However, current evidence suggests that the gut microbiota is an integral regulator of estrogen status with clinical relevance to women's health and hormonal disorders.
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Affiliation(s)
- Nikki Kumari
- Post-Graduate Department of Zoology, Magadh University, Bodh Gaya, Bihar, 824234, India
| | - Rashmi Kumari
- Department of Zoology, College of Commerce, Arts & Science, Patliputra University, Patna, Bihar, 800020, India
| | - Ankita Dua
- Department of Zoology, Shivaji College, University of Delhi, New Delhi, 110027, India
| | - Mona Singh
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Roushan Kumar
- Post-Graduate Department of Zoology, Magadh University, Bodh Gaya, Bihar, 824234, India
| | - Poonam Singh
- Post-Graduate Department of Zoology, Magadh University, Bodh Gaya, Bihar, 824234, India
| | - Susan Duyar-Ayerdi
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Sunila Pradeep
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Akinyemi I Ojesina
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Roshan Kumar
- Post-Graduate Department of Zoology, Magadh University, Bodh Gaya, Bihar, 824234, India
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
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Cuda S. Special considerations for the adolescent with obesity: An obesity medicine association (OMA) clinical practice statement (CPS) 2024. OBESITY PILLARS (ONLINE) 2024; 9:100096. [PMID: 38186667 PMCID: PMC10770754 DOI: 10.1016/j.obpill.2023.100096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) details special considerations for the management of the adolescent with obesity. The information in this CPS is based on scientific evidence, supported by medical literature, and derived from the clinical experiences of members of the OMA. Methods The scientific information and clinical guidance in this CPS are based on scientific evidence, supported by the medical literature, and derived from the clinical perspectives of the authors. Results This OMA Clinical Practice Statement addresses special considerations in the management and treatment of adolescents with overweight and obesity. Conclusions This OMA Clinical Practice Statement on the adolescent with obesity is an overview of current recommendations. These recommendations provide a roadmap to the improvement of the health of adolescents with obesity, especially those with metabolic, physiological, and psychological complications. This CPS also addresses treatment recommendations and is designed to help the provider with clinical decision making.
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Affiliation(s)
- Suzanne Cuda
- Alamo City Healthy Kids and Families, 1919 Oakwell Farms Parkway, Ste 145, San Antonio, TX, 78218, USA
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35
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Vadan RL, Varela N, Zhuravko N, Ogidan NO, Adedara VO, Keku E. Comparative Management Methods for Adolescents With Polycystic Ovarian Syndrome: A Systemic Review. Cureus 2024; 16:e55876. [PMID: 38595887 PMCID: PMC11003559 DOI: 10.7759/cureus.55876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2024] [Indexed: 04/11/2024] Open
Abstract
Polycystic ovarian syndrome (PCOS) is a common endocrinological disorder affecting many adolescents and women of reproductive age worldwide. A diagnosis of PCOS in adolescence relies upon investigating each medical history independently and noting commonly associated symptoms, including obesity, insulin resistance, acne, menstrual abnormalities, and hirsutism. Many researchers are aiming to discover a methodology to help manage the symptoms associated with PCOS, especially in adolescents. This review will investigate management methods possible for adolescents with PCOS. Although the most preferred way to help reduce symptoms is through lifestyle modifications such as vigorous exercise and dietary regimens low in carbohydrates, pharmaceuticals are also offering promising results to adolescents with PCOS. Metformin, oral contraceptives, gonadotropin-releasing hormone (GnRH) antagonists, and other alternatives, including finasteride, eflornithine, fibroblast growth factors (FGFs), and vitamin D, are all shown to help improve insulin sensitivity and regulate menstrual cycles and reduce hirsutism. Epilatory and surgical measurements are also available; however, they are reserved for when all other methods fail and once adulthood or an appropriate age is reached. Although there are many pharmaceuticals available, it is necessary to evaluate each adolescent with PCOS uniquely and prescribe the appropriate pharmacotherapy regarding their symptoms.
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Affiliation(s)
- Roberta L Vadan
- Medicine, St. George's University School of Medicine, St. George's, GRD
| | - Nanette Varela
- Medicine, St. George's University School of Medicine, St. George's, GRD
| | - Nikita Zhuravko
- Medicine, St. George's University School of Medicine, St. George's, GRD
| | - Noreena O Ogidan
- Medicine, St. George's University School of Medicine, St. George's, GRD
| | - Victor O Adedara
- Medicine, St. George's University School of Medicine, St. George's, GRD
| | - Emmanuel Keku
- Public Health & Preventive Medicine, St. George's University School of Medicine, St. George's, GRD
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36
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Chen Z, Zeng H, Huang Q, Lin C, Li X, Sun S, Liu JP. Increased GPC4 and clusterin associated with insulin resistance in patients with PCOS. Endocr Connect 2024; 13:e230428. [PMID: 38251963 PMCID: PMC10959037 DOI: 10.1530/ec-23-0428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/22/2024] [Indexed: 01/23/2024]
Abstract
The aim of the study was to investigate the changes in serum glypican 4 (GPC4) and clusterin (CLU) levels in patients with polycystic ovary syndrome (PCOS) as well as their correlation with sex hormones and metabolic parameters. A total of 40 PCOS patients and 40 age-matched healthy women were selected. Serum GPC4 and CLU levels were compared between the PCOS and control groups, and binary logistic regression was used to analyze the relative risk of PCOS at different tertiles of serum GPC4 and CLU concentrations. Stepwise linear regression was used to identify the factors influencing serum GPC4 and CLU levels in PCOS patients. Serum GPC4 (1.82 ± 0.49 vs 1.30 ± 0.61 ng/mL, P < 0.001) and CLU (468.79 ± 92.85 vs 228.59 ± 82.42 µg/mL, P < 0.001) were significantly higher in PCOS patients than in healthy women after adjustment for body mass index (BMI). In the PCOS group, serum GPC4 was positively correlated with follicle-stimulating hormone, fasting plasma glucose (FPG), fasting insulin (FINS), homeostatic model assessment of insulin resistance (HOMA-IR), triglyceride, and CLU (P < 0.05), whereas serum CLU was positively correlated with BMI, FPG, FINS, and HOMA-IR (P < 0.05). Multiple stepwise linear regression analysis showed that HOMA-IR was independently associated with serum GPC4, and BMI and HOMA-IR were independently associated with CLU (P < 0.05). Serum GPC4 and CLU levels were significantly higher in PCOS patients than in healthy women, suggesting that GPC4 and CLU may be markers associated with insulin resistance in women with PCOS.
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Affiliation(s)
- Zheng Chen
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Haixia Zeng
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qiulan Huang
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Cuiping Lin
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xuan Li
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shaohua Sun
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jian-ping Liu
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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Liaghatdar A, Mazaheri-Tehrani S, Fakhrolmobasheri M. Management of Hypertension in Patients With Polycystic Ovarian Syndrome: A Mini-Review. Cardiol Rev 2024:00045415-990000000-00199. [PMID: 38305409 DOI: 10.1097/crd.0000000000000635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Polycystic ovarian syndrome (PCOS) is a common problem among young women. It is characterized mainly by hyperandrogenism features, such as hirsutism, menstrual problems, and anovulation. Diagnosis is based on the existence of 2 items out of, oligo-ovulation, hyperandrogenism features, and ultrasounds findings. Cardiovascular complications such as hypertension are a prevalent serious condition in these patients which is mainly predisposed by the high levels of androgens, and insulin resistance. High blood pressure should be controlled well to prevent the progression of other serious conditions. Various antihypertensive drugs could be prescribed. However, in selecting an antihypertensive medication, other therapeutic properties of the drug should also be considered. Up to now, many clinicians do not differ between PCOS patients with hypertension and other hypertensive patients. However, being aware of the potential effects of each hypertension drug could help to choose better options for the patient. Here is a brief review of how each antihypertensive drug could affect PCOS women and if they cause any improvement in the disorder progression.
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Affiliation(s)
- Amin Liaghatdar
- From the Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sadegh Mazaheri-Tehrani
- From the Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Fakhrolmobasheri
- From the Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Abdelrahman A, Mahmoud AA, Lamie Fanous Y, Abd Elhaliem NG, Elalaf H. Impact of erythropoietin and myoinositol versus metformin on insulin resistance in a rat model of polycystic ovary syndrome. Arch Physiol Biochem 2024; 130:1-12. [PMID: 34297646 DOI: 10.1080/13813455.2021.1949023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
This study aimed to evaluate the therapeutic role of erythropoietin (EPO) or myoinositol versus metformin (MET) in improving the reproductive functions and glucose tolerance in a rat model of polycystic ovary (PCOS). Oral letrozole (LTZ) was used for induction of PCOS in wester rats for 21 days, after that, MET, EPO and myoinositol were administered for the following 21 days. The LTZ-induced PCOS rats have lost their oestrous cyclicity and become fixed at the diestrus phase, developed insulin resistance, abnormal sex and gonadotrophin hormone serum levels, increased cystic follicles, decreased number of the growing follicles and very little or no corpora lutea on microscopic examination, which were reversed by the three drugs, MET, EPO and myoinositol. MET and myoinositol were mostly equally effective in improving the reproductive manifestations of the disease. However, EPO was most effective in decreasing the insulin level observed in this LTZ-induced model of PCOS.
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Affiliation(s)
- Amany Abdelrahman
- Physiology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Aida Abdeen Mahmoud
- Biochemistry Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | | | | | - Hassan Elalaf
- Physiology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
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Sharkesh EZ, Keshavarz SA, Nazari L, Abbasi B. Empirical Dietary Inflammatory Pattern is positively associated with polycystic ovary syndrome: A case control study. Nutr Res 2024; 122:123-129. [PMID: 38219291 DOI: 10.1016/j.nutres.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 01/16/2024]
Abstract
Polycystic ovary syndrome (PCOS), as the most common endocrine disorder in women of reproductive age, is influenced by various factors. Because there is evidence linking inflammation with chronic diseases, we hypothesized that there is a relationship between an empirical dietary inflammatory pattern score (EDIP) with odds of PCOS among the adult population. This case control study was conducted on Tehranian women in Iran. A total of 494 participants (203 women with PCOS in the case group and 291 healthy people in the control group), aged 18 to 45 years, were recruited for the study. Demographic information, anthropometric indices, physical activity level, and dietary intake were collected by a trained nutritionist. EDIP score was calculated to estimate overall dietary inflammatory potential based on 18 food groups. Statistical analysis was performed with SPSS version 19. Based on the results, the mean age of participants in the case and control groups were 28.98 ± 5.43 and 30.15 ± 6.21 years, respectively. Individuals with PCOS had a significantly higher difference in EDIP score compared with healthy participants (2.03 ± 1.13 vs 1.70 ± 0.93, P < .001). Also, the odds ratio and 95% confidence interval for the risk of PCOS across quartiles of EDIP showed a significant direct relationship (P = .003). In conclusion, our study showed that there was a direct association between PCOS risk and EDIP score. Findings suggest that inflammatory index might be a potential mechanism linking diet and PCOS development.
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Affiliation(s)
- Elnaz Zirak Sharkesh
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Seyed Ali Keshavarz
- Department of Nutrition and Biochemistry, Faculty of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Leila Nazari
- Department of Obstetrics and Gynecology, Preventative Gynecology Research Center (PGRC), Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Behnood Abbasi
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran.
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Liu H, Tu M, Yin Z, Zhang D, Ma J, He F. Unraveling the complexity of polycystic ovary syndrome with animal models. J Genet Genomics 2024; 51:144-158. [PMID: 37777062 DOI: 10.1016/j.jgg.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/02/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a highly familial and heritable endocrine disorder. Over half of the daughters born to women with PCOS may eventually develop their own PCOS-related symptoms. Progress in the treatment of PCOS is currently hindered by the complexity of its clinical manifestations and incomplete knowledge of its etiopathogenesis. Various animal models, including experimentally induced, naturally occurring, and spontaneously arising ones, have been established to emulate a wide range of phenotypical and pathological traits of human PCOS. These studies have led to a paradigm shift in understanding the genetic, developmental, and evolutionary origins of this disorder. Furthermore, emerging evidence suggests that animal models are useful in evaluating state-of-the-art drugs and treatments for PCOS. This review aims to provide a comprehensive summary of recent studies of PCOS in animal models, highlighting the power of these disease models in understanding the biology of PCOS and aiding high-throughput approaches.
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Affiliation(s)
- Huanju Liu
- Center for Genetic Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Mixue Tu
- Key Laboratory of Women's Reproductive Health of Zhejiang Province and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, China
| | - Zhiyong Yin
- Center for Genetic Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Dan Zhang
- Key Laboratory of Women's Reproductive Health of Zhejiang Province and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, China; Zhejiang Provincial Clinical Research Center for Child Health, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, China; Clinical Research Center on Birth Defect Prevention and Intervention of Zhejiang Province, Hangzhou, Zhejiang 310006, China.
| | - Jun Ma
- Center for Genetic Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China; Key Laboratory of Women's Reproductive Health of Zhejiang Province and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, China; Institute of Genetics, Zhejiang University International School of Medicine, Hangzhou, Zhejiang 310058, China; Zhejiang Provincial Key Laboratory of Genetic and Developmental Disorder, Hangzhou, Zhejiang 310058, China.
| | - Feng He
- Center for Genetic Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China; Key Laboratory of Women's Reproductive Health of Zhejiang Province and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, China; Institute of Genetics, Zhejiang University International School of Medicine, Hangzhou, Zhejiang 310058, China; Zhejiang Provincial Key Laboratory of Genetic and Developmental Disorder, Hangzhou, Zhejiang 310058, China.
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41
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Athar F, Karmani M, Templeman N. Metabolic hormones are integral regulators of female reproductive health and function. Biosci Rep 2024; 44:BSR20231916. [PMID: 38131197 PMCID: PMC10830447 DOI: 10.1042/bsr20231916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 11/29/2023] [Accepted: 12/21/2023] [Indexed: 12/23/2023] Open
Abstract
The female reproductive system is strongly influenced by nutrition and energy balance. It is well known that food restriction or energy depletion can induce suppression of reproductive processes, while overnutrition is associated with reproductive dysfunction. However, the intricate mechanisms through which nutritional inputs and metabolic health are integrated into the coordination of reproduction are still being defined. In this review, we describe evidence for essential contributions by hormones that are responsive to food intake or fuel stores. Key metabolic hormones-including insulin, the incretins (glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1), growth hormone, ghrelin, leptin, and adiponectin-signal throughout the hypothalamic-pituitary-gonadal axis to support or suppress reproduction. We synthesize current knowledge on how these multifaceted hormones interact with the brain, pituitary, and ovaries to regulate functioning of the female reproductive system, incorporating in vitro and in vivo data from animal models and humans. Metabolic hormones are involved in orchestrating reproductive processes in healthy states, but some also play a significant role in the pathophysiology or treatment strategies of female reproductive disorders. Further understanding of the complex interrelationships between metabolic health and female reproductive function has important implications for improving women's health overall.
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Affiliation(s)
- Faria Athar
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Muskan Karmani
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Nicole M. Templeman
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
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42
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Wahid S, Ramli MDC, Fazleen NE, Naim RM, Mokhtar MH. Exploring the Therapeutic Potential of Natural Products in Polycystic Ovarian Syndrome (PCOS): A Mini-Review of Lipid Profile, Blood Glucose, and Ovarian Histological Improvements. Life (Basel) 2024; 14:150. [PMID: 38276279 PMCID: PMC10817691 DOI: 10.3390/life14010150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 01/27/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women that is characterized by fluid-filled sacs in the ovaries and various symptoms, including high androgen levels, endometrial irregularities, and cysts. Although the main cause of PCOS remains unknown, it has been linked to genetic, endocrine, and metabolic factors, and there are several treatment options, including lifestyle modifications, medications, and surgery. Natural products such as medicinal plants and fruits are being explored as potential treatments for PCOS because of their bioactive compounds with pharmacological effects related to antioxidant, antimicrobial, anticancer, and antidiabetic properties. Some of these compounds improve insulin sensitivity, reduce inflammation, and enhance glucose metabolism, thereby benefiting patients with PCOS. This mini-review examined the effects of natural products on PCOS, including their effects on ovarian histological changes, blood glucose, sex hormones, and lipid profiles, based on animal and human studies. This study suggests that the use of natural products as complementary medicines can be a promising resource for the development of effective therapeutics for PCOS; however, further research is needed to fully understand their benefits.
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Affiliation(s)
- Syawany Wahid
- School of Graduate Studies, Management and Science University, Shah Alam 40100, Malaysia; (S.W.)
| | | | - Nur Ezza Fazleen
- International Medical School, Management and Science University, Shah Alam 40100, Malaysia
| | - Rosli Muhammad Naim
- School of Graduate Studies, Management and Science University, Shah Alam 40100, Malaysia; (S.W.)
| | - Mohd Helmy Mokhtar
- Department of Physiology, Faculty of Medicine, University Kebangsaan Malaysia, Bangi 43600, Malaysia
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Chen LJ, Liu Y, Zhang L, Li JY, Xiong WQ, Li T, Ding H, Li BJ. Sequential 2.5 mg letrozole/FSH therapy is more effective for promoting pregnancy in infertile women with PCOS: a pragmatic randomized controlled trial. Front Endocrinol (Lausanne) 2024; 14:1294339. [PMID: 38283747 PMCID: PMC10811237 DOI: 10.3389/fendo.2023.1294339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/26/2023] [Indexed: 01/30/2024] Open
Abstract
Study question In infertile women with polycystic ovary syndrome (PCOS), is the sequential use of letrozole 2.5 mg/follicle stimulating hormone(FSH) more effective than letrozole 5 mg/FSH in stimulating ovulation and promoting pregnancy? Research design and methods The study was designed as a prospective, single-center, randomized, controlled pragmatic clinical trial. 220 infertile women between the ages of 20 and 40, who matched the Rotterdam criteria for PCOS and had no other identified reasons for infertility were enrolled from April 2023 to July 2023.The participants were randomly assigned to two groups in a 1:1 ratio. One group received 2.5 mg of letrozole on cycle days 3-7 with a sequential injection of 75 IU FSH on cycle days 8-10 (n = 110), while the other group received 5 mg of letrozole on cycle days 3-7 with a sequential injection of 75 IU FSH on cycle days 8-10 (n = 110). The duration of FSH treatment varied depending on the follicular development stage. Each participant underwent one to three treatment cycles until achieving pregnancy.The primary outcome was the cumulative pregnancy rate of all the participants. Secondary outcomes included characteristics and clinical pregnancy rates of all the intervention cycles. Results For all 220 participants, the sequential letrozole 2.5 mg/FSH treatment group had a significantly higher cumulative pregnancy rate compared to the letrozole 5 mg/FSH treatment group (72.7% versus 59.1%, RR (95%CI) = 1.23 (1.02, 1.49), P-value = 0.033). For all 468 intervention cycles, letrozole 2.5 mg/FSH group had a significantly higher clinical pregnancy rate than the letrozole 5 mg/FSH group (36.2% versus 26.3%, P-value = 0.021), no statistically significant differences were observed in ovulation rates or adverse effects. Conclusions The data indicate that the sequential letrozole 2.5mg/FSH protocol may be more effective than the sequential letrozole 5mg/FSH protocol for promoting pregnancy in infertile women with PCOS. Clinical trial registration www.chictr.org.cn, identifier ChiCTR2300069638.
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Affiliation(s)
- Li-Juan Chen
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yi Liu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ling Zhang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing-Yi Li
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wen-Qian Xiong
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tao Li
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hui Ding
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bing-Jie Li
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Nasser JS, Altahoo N, Almosawi S, Alhermi A, Butler AE. The Role of MicroRNA, Long Non-Coding RNA and Circular RNA in the Pathogenesis of Polycystic Ovary Syndrome: A Literature Review. Int J Mol Sci 2024; 25:903. [PMID: 38255975 PMCID: PMC10815174 DOI: 10.3390/ijms25020903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/24/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic disease in females of reproductive age, affecting 4-20% of pre-menopausal women worldwide. MicroRNAs (miRNAs) are endogenous, single-stranded, non-coding, regulatory ribonucleic acid molecules found in eukaryotic cells. Abnormal miRNA expression has been associated with several diseases and could possibly explain their underlying pathophysiology. MiRNAs have been extensively studied for their potential diagnostic, prognostic, and therapeutic uses in many diseases, such as type 2 diabetes, obesity, cardiovascular disease, PCOS, and endometriosis. In women with PCOS, miRNAs were found to be abnormally expressed in theca cells, follicular fluid, granulosa cells, peripheral blood leukocytes, serum, and adipose tissue when compared to those without PCOS, making miRNAs a useful potential biomarker for the disease. Key pathways involved in PCOS, such as folliculogenesis, steroidogenesis, and cellular adhesion, are regulated by miRNA. This also highlights their importance as potential prognostic markers. In addition, recent evidence suggests a role for miRNAs in regulating the circadian rhythm (CR). CR is crucial for regulating reproduction through the various functions of the hypothalamic-pituitary-gonadal (HPG) axis and the ovaries. A disordered CR affects reproductive outcomes by inducing insulin resistance, oxidative stress, and systemic inflammation. Moreover, miRNAs were demonstrated to interact with lncRNA and circRNAs, which are thought to play a role in the pathogenesis of PCOS. This review discusses what is currently understood about miRNAs in PCOS, the cellular pathways involved, and their potential role as biomarkers and therapeutic targets.
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Affiliation(s)
- Jenan Sh. Nasser
- School of Medicine, Royal College of Surgeons of Ireland, Busaiteen, Adliya 15503, Bahrain; (J.S.N.); (N.A.); (S.A.); (A.A.)
| | - Noor Altahoo
- School of Medicine, Royal College of Surgeons of Ireland, Busaiteen, Adliya 15503, Bahrain; (J.S.N.); (N.A.); (S.A.); (A.A.)
| | - Sayed Almosawi
- School of Medicine, Royal College of Surgeons of Ireland, Busaiteen, Adliya 15503, Bahrain; (J.S.N.); (N.A.); (S.A.); (A.A.)
| | - Abrar Alhermi
- School of Medicine, Royal College of Surgeons of Ireland, Busaiteen, Adliya 15503, Bahrain; (J.S.N.); (N.A.); (S.A.); (A.A.)
| | - Alexandra E. Butler
- Research Department, Royal College of Surgeons of Ireland, Busaiteen, Adliya 15503, Bahrain
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Yang X, A M, Gegen T, Daoerji B, Zheng Y, Wang A. PHLPP1 inhibits the growth and aerobic glycolysis activity of human ovarian granular cells through inactivating AKT pathway. BMC Womens Health 2024; 24:25. [PMID: 38184561 PMCID: PMC10771674 DOI: 10.1186/s12905-023-02872-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 12/28/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a disorder characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphologic features, and PCOS is associated with infertility. PH domain Leucine-rich repeat Protein Phosphatase 1 (PHLPP1) has been shown to regulate AKT. The aim of present study is to investigate the role of PHLPP1 in PCOS. METHODS The expression levels of PHLPP1 in dihydrotestosterone (DHT)-treated human ovarian granular KGN cells were determined by qRT-PCR and Western blot. PHLPP1 was silenced or overexpressed using lentivirus. Cell proliferation was detected by CCK-8. Apoptosis and ROS generation were analyzed by flow cytometry. Glycolysis was analyzed by measuring extracellular acidification rate (ECAR). RESULTS DHT treatment suppressed proliferation, promoted apoptosis, enhanced ROS, and inhibited glycolysis in KGN cells. PHLPP1 silencing alleviated the DHT-induced suppression of proliferation and glycolysis, and promotion of apoptosis and ROS in KGN cells. PHLPP1 regulated cell proliferation and glycolysis in human KGN cells via the AKT signaling pathway. CONCLUSIONS Our results showed that PHLPP1 mediates the proliferation and aerobic glycolysis activity of human ovarian granular cells through regulating AKT signaling.
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Affiliation(s)
- Xiaoyan Yang
- Reproductive Medicine Center, Affiliated Hospital of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, 028000, China
- Clinical Medical (Mongolian Medical) College of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, 028000, China
| | - Min A
- Clinical Medical (Mongolian Medical) College of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, 028000, China
- Department of Urology, Affiliated Hospital of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, 028000, China
| | - Tana Gegen
- Reproductive Medicine Center, Affiliated Hospital of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, 028000, China
- Clinical Medical (Mongolian Medical) College of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, 028000, China
| | - Badema Daoerji
- Reproductive Medicine Center, Affiliated Hospital of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, 028000, China
- Clinical Medical (Mongolian Medical) College of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, 028000, China
| | - Yue Zheng
- Reproductive Medicine Center, Affiliated Hospital of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, 028000, China
- Clinical Medical (Mongolian Medical) College of Inner Mongolia Minzu University, Tongliao, Inner Mongolia, 028000, China
| | - Aiming Wang
- Department of Obstetrics and Gynaecology, Sixth Medical Center, Chinese PLA General Hospital, No.6 Fucheng Road, Haidian District, Beijing, 100048, China.
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Gautam R, Prambil AM, Patel AK, Arora T. Emerging pollutants in etiology and pathophysiology of polycystic ovary syndrome. Reprod Toxicol 2024; 123:108515. [PMID: 38000646 DOI: 10.1016/j.reprotox.2023.108515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/24/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder affecting reproductive-aged women worldwide. Although genetic and lifestyle factors have been implicated in its etiology, emerging evidence suggests that exposure to environmental pollutants may also contribute significantly to the development and pathophysiology of PCOS. This review article aims to provide a comprehensive overview of the potential role of emerging pollutants, including pharmaceuticals and personal care products (PPCPs), microplastics, endocrine disruptors, and nanoparticles, in PCOS development. The article summarizes the current understanding of PCOS pathogenesis and its clinical manifestations. Subsequently, it delves into the mechanisms of action of the emerging pollutants, exploring how they may disrupt the endocrine system, interfere with hormonal regulation, and contribute to the manifestation of PCOS symptoms. Moreover, the potential for cumulative effects and synergistic interactions between these pollutants demands a cautious approach when considering their role in PCOS etiology.
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Affiliation(s)
- Rohit Gautam
- Division of Reproductive, Child Health & Nutrition, Indian Council of Medical Research, New Delhi 110029, India
| | - Ajith Manayil Prambil
- School of Environmental Sciences, Jawaharlal Nehru University, New Delhi 110067, India
| | - Arbind Kumar Patel
- School of Environmental Sciences, Jawaharlal Nehru University, New Delhi 110067, India
| | - Taruna Arora
- Division of Reproductive, Child Health & Nutrition, Indian Council of Medical Research, New Delhi 110029, India.
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Chamanara S, Hozouri V, Irandoost E. Inhibition of NLRP3 inflammasome-A potential mechanistic therapeutic for treatment of polycystic ovary syndrome? J Biochem Mol Toxicol 2024; 38:e23592. [PMID: 38054794 DOI: 10.1002/jbt.23592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 11/05/2023] [Accepted: 11/20/2023] [Indexed: 12/07/2023]
Abstract
This review article explores the relationship between the NOD-like receptor protein 3 (NLRP3) inflammasome and the risk of developing polycystic ovary syndrome (PCOS). The NLRP3 inflammasome, a fundamental element of the innate immune system, plays a crucial role in the production of proinflammatory mediators and pyroptosis, a type inflammatory cell death. We conducted a thorough search on scientific databases to gather relevant information on this topic, utilizing relevant keywords. The reviewed studies indicated a correlation between PCOS and a higher incidence of granulosa cell (GC) death and the presence of ovarian tissue fibrosis. NLRP3 inflammasome stimulation and subsequent pyroptosis in GCs play a significant role in the pathophysiology of PCOS. Active NLRP3 inflammasome is involved in the production of inflammatory mediators like interleukin-1β (IL-1β) and IL-18, contributing to the development of PCOS, particularly in overweight patients. Therefore, inhibiting NLRP3 activation and pyroptosis could potentially offer novel therapeutic strategies for PCOS. Some limited studies have explored the use of agents with antioxidant and anti-inflammatory properties, as well as gene therapy approaches, to target the NLRP3 and pyroptosis signaling pathways. This study overview the understanding of the relationship between NLRP3 inflammasome activation, pyroptosis, and PCOS. It highlights the potential of targeting the NLRP3 inflammasome as an approach for treating PCOS. Nonetheless, further research and clinical trials are imperative to validate these results and explore the effectiveness of NLRP3 inflammasome inhibition in the management of PCOS.
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Affiliation(s)
- Solmaz Chamanara
- Department of Gynecology and Obstetrics, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Vahid Hozouri
- Internal Medicine Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Elnaz Irandoost
- Department of Gynecology and Obstetrics, Tehran University of Medical Sciences, Tehran, Iran
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Rosato E, Sciarra F, Minnetti M, Degjoni A, Venneri MA. Clinical management of androgen excess and defect in women. Expert Rev Endocrinol Metab 2024; 19:21-35. [PMID: 37953607 DOI: 10.1080/17446651.2023.2279537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Hyperandrogenism and hypoandrogenism are complex disorders involving multiple-organ systems. While androgen excess is a well-characterized condition, androgen deficiency still needs diagnostic criteria, as there are no specific cutoffs. AREAS COVERED We highlight the most recent findings on the role of androgens in female pathophysiology, investigating clinically relevant conditions of androgen insufficiency or excess throughout a woman's life, and their possible therapeutic management. EXPERT OPINION Combined oral contraceptives (COCs) should be considered as first-line therapy for the management of menstrual irregularity and/or clinical hyperandrogenism in adolescents with a clear diagnosis of polycystic ovary syndrome (PCOS). There are limited evidence-based data regarding specific types or doses of COCs for management of PCOS in women; however, the lowest effective estrogen dose should be considered for treatment. Despite evidence regarding safety, efficacy, and clinical use, testosterone therapy has not been approved for women by most regulatory agencies for treatment of hypoactive sexual desire disorder (HSDD). The long-term safety for treatments with testosterone is still to be evaluated, and this review highlights the need for more research in this area.
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Affiliation(s)
- Elena Rosato
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesca Sciarra
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Marianna Minnetti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Anisa Degjoni
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Mary Anna Venneri
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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Khatun M, Lundin K, Naillat F, Loog L, Saarela U, Tuuri T, Salumets A, Piltonen TT, Tapanainen JS. Induced Pluripotent Stem Cells as a Possible Approach for Exploring the Pathophysiology of Polycystic Ovary Syndrome (PCOS). Stem Cell Rev Rep 2024; 20:67-87. [PMID: 37768523 PMCID: PMC10799779 DOI: 10.1007/s12015-023-10627-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 09/29/2023]
Abstract
Polycystic ovary syndrome (PCOS) is the most prevalent endocrine condition among women with pleiotropic sequelae possessing reproductive, metabolic, and psychological characteristics. Although the exact origin of PCOS is elusive, it is known to be a complex multigenic disorder with a genetic, epigenetic, and environmental background. However, the pathogenesis of PCOS, and the role of genetic variants in increasing the risk of the condition, are still unknown due to the lack of an appropriate study model. Since the debut of induced pluripotent stem cell (iPSC) technology, the ability of reprogrammed somatic cells to self-renew and their potential for multidirectional differentiation have made them excellent tools to study different disease mechanisms. Recently, researchers have succeeded in establishing human in vitro PCOS disease models utilizing iPSC lines from heterogeneous PCOS patient groups (iPSCPCOS). The current review sets out to summarize, for the first time, our current knowledge of the implications and challenges of iPSC technology in comprehending PCOS pathogenesis and tissue-specific disease mechanisms. Additionally, we suggest that the analysis of polygenic risk prediction based on genome-wide association studies (GWAS) could, theoretically, be utilized when creating iPSC lines as an additional research tool to identify women who are genetically susceptible to PCOS. Taken together, iPSCPCOS may provide a new paradigm for the exploration of PCOS tissue-specific disease mechanisms.
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Affiliation(s)
- Masuma Khatun
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, 00029 HUS, Finland.
| | - Karolina Lundin
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, 00029 HUS, Finland
| | - Florence Naillat
- Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
| | - Liisa Loog
- Institute of Genomics, University of Tartu, Tartu, 51010, Estonia
- Department of Genetics, University of Cambridge, Cambridge, CB2 3EH, UK
| | - Ulla Saarela
- Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Timo Tuuri
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, 00029 HUS, Finland
| | - Andres Salumets
- Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tartu, Tartu, 50406, Estonia
- Competence Centre of Health Technologies, Tartu, 50411, Estonia
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Huddinge, Stockholm, 14186, Sweden
| | - Terhi T Piltonen
- Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Central Hospital, Haartmaninkatu 8, Helsinki, 00029 HUS, Finland
- Department of Obstetrics and Gynecology, HFR - Cantonal Hospital of Fribourg and University of Fribourg, Fribourg, Switzerland
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Xing L, Xu J, Wei Y, Chen Y, Zhuang H, Tang W, Yu S, Zhang J, Yin G, Wang R, Zhao R, Qin D. Depression in Polycystic Ovary Syndrome: Focusing on Pathogenesis and Treatment. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2024; 22:109-119. [PMID: 38694155 PMCID: PMC11058923 DOI: 10.1176/appi.focus.23021032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
Polycystic ovary syndrome (PCOS) is one of the most prevalent gynecological endocrine conditions affecting reproductive women. It can feature a variety of symptoms, such as obesity, insulin resistance, skin conditions, and infertility. Women with PCOS are susceptible to illnesses including mood disorders, diabetes, hypertension, and dyslipidemia. Among them, depression is the most common in PCOS and has a detrimental effect on quality of life. Depression may occasionally develop due to the pathological traits of PCOS, but its exact pathogenesis in PCOS have eluded researchers to date. Therefore, there is an urgent need to explore the pathogenesis and treatments of depression in PCOS. The present review discusses the epidemiology of depression in PCOS, potential pathogenic mechanisms underlying PCOS and depression, as well as some potential factors causing depression in PCOS, including obesity, insulin resistance, hyperandrogenism, inflammation, and infertility. Meanwhile, some common treatment strategies for depression in PCOS, such as lifestyle intervention, acupuncture, oral contraceptive pills, psychological intervention, and insulin-sensitizer, are also reviewed. To fully understand the pathogenesis and treatment of depression in PCOS, a need remains for future large-scale multi-center randomized controlled trials and in-depth mechanism studies. Appeared originally in Front Psychiatry 2022; 13:1001484.
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Affiliation(s)
- Liwei Xing
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Jinlong Xu
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Yuanyuan Wei
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Yang Chen
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Haina Zhuang
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Wei Tang
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Shun Yu
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Junbao Zhang
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Guochen Yin
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Ruirui Wang
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Rong Zhao
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
| | - Dongdong Qin
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Xing, Xu, Zhao), Department of TCM, Yunnan Maternal and Child Health Care Hospital, Kunming, China (Xu), School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China (Wei, Qin), Department of TCM, Hainan Women and Children's Medical Center (Women and Children's Health Care Center of Hainan Province, Hainan Children's Hospital, Children's Hospital of Fudan University at Hainan, Hainan Obstetrics and Gynecology Hospital), Haikou, China (Chen), Department of Journal Editorial, Yunnan University of Chinese Medicine, Kunming, China (Zhuang), Department of Acupuncture and Moxibustion, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China (Tang), The Second School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China (Yu, Zhang, Yin), School of Chinese Materia Medica, Yunnan University of Chinese Medicine, Kunming, China (Wang)
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