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Yin D, Mao R, Wang D, Yu P, Zhou C, Liu J, Li S, Nie Y, Liao H, Peng C. Association of Plasma Metal Levels with Outcomes of Assisted Reproduction in Polycystic Ovary Syndrome. Biol Trace Elem Res 2024; 202:4961-4977. [PMID: 38441797 DOI: 10.1007/s12011-024-04085-9] [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: 11/23/2023] [Accepted: 01/28/2024] [Indexed: 10/01/2024]
Abstract
The objective of this study is to explore the correlation of metal levels with assisted reproductive technology (ART) outcomes in polycystic ovary syndrome (PCOS) patients. The individuals were recruited who met the research criteria, only tubal factor or male infertility served as the control group (n = 40) and patient group was PCOS patients (n = 35). Individuals (n = 75) were divided into PCOS group (n = 35) and control group (n = 40). The normal body mass index (BMI) group (control) includes women with BMI < 25 kg/m2 in PCOS group (n = 24) and control group (n = 33), and BMI ≥ 25 kg/m2 in PCOS group (n = 11) and control group (n = 7). We performed an analysis of insulin resistance (IR) (n = 15) group and without insulin resistance (NIR) group (n = 20) in PCOS patient and control patients. Comparing difference demographic data, ART outcomes and the metal levels in every group respectively, the correlation of metal levels and ART outcomes in control participants and PCOS patients were analyzed by the Spearman correlation analysis, and multiple linear regression model was used to examine the association between the concentration of 19 metals and ART outcomes in PCOS group and control group. Plasma manganese (Mn), titanium (Ti), sodium (Na), magnesium (Mg), copper (Cu), calcium (Ca)/Mg ratio, and Cu/zinc (Zn) ratio levels in PCOS patients were higher than that in control, while Zn and Ca levels were lower in PCOS patients than that in control. The Mg levels had a positive connection with the number of eggs recovered, and the iron (Fe) levels were positively associated with the number of transplanted embryos in PCOS-IR. In PCOS-NIR, Mn levels positively correlated with the number of follicles and the number of good embryos. Silver (Ag) levels were negatively correlated with the number of follicles, and aluminum (Al) levels were negatively related with the normal fertilization and the number of good embryos. The Spearman analysis in PCOS-BMI ≥ 25 group exhibited that nickel (Ni) levels were negatively associated with the number of follicles. The plasma metal levels seem to affect the clinical manifestations and in vitro fertilization outcomes in assisted reproduction.
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Affiliation(s)
- Dan Yin
- Department of Cell Biology and Genetics, Institute of Cytology and Genetics, School of Basic Medical Sciences, Hengyang Medical School, Key Laboratory of Ecological Environment and Critical Human Diseases Prevention of Hunan Province, Department of Education, Key Laboratory of Hengyang City On Biological Toxicology and Ecological Restoration, Key Laboratory of Typical Environmental Pollution and Health Hazards, University of South China, Hengyang, 421001, Hunan, China
| | - Rui Mao
- Department of Cell Biology and Genetics, Institute of Cytology and Genetics, School of Basic Medical Sciences, Hengyang Medical School, Key Laboratory of Ecological Environment and Critical Human Diseases Prevention of Hunan Province, Department of Education, Key Laboratory of Hengyang City On Biological Toxicology and Ecological Restoration, Key Laboratory of Typical Environmental Pollution and Health Hazards, University of South China, Hengyang, 421001, Hunan, China
| | - Die Wang
- Department of Cell Biology and Genetics, Institute of Cytology and Genetics, School of Basic Medical Sciences, Hengyang Medical School, Key Laboratory of Ecological Environment and Critical Human Diseases Prevention of Hunan Province, Department of Education, Key Laboratory of Hengyang City On Biological Toxicology and Ecological Restoration, Key Laboratory of Typical Environmental Pollution and Health Hazards, University of South China, Hengyang, 421001, Hunan, China
| | - Ping Yu
- Department of Cell Biology and Genetics, Institute of Cytology and Genetics, School of Basic Medical Sciences, Hengyang Medical School, Key Laboratory of Ecological Environment and Critical Human Diseases Prevention of Hunan Province, Department of Education, Key Laboratory of Hengyang City On Biological Toxicology and Ecological Restoration, Key Laboratory of Typical Environmental Pollution and Health Hazards, University of South China, Hengyang, 421001, Hunan, China
| | - Cuilan Zhou
- Department of Cell Biology and Genetics, Institute of Cytology and Genetics, School of Basic Medical Sciences, Hengyang Medical School, Key Laboratory of Ecological Environment and Critical Human Diseases Prevention of Hunan Province, Department of Education, Key Laboratory of Hengyang City On Biological Toxicology and Ecological Restoration, Key Laboratory of Typical Environmental Pollution and Health Hazards, University of South China, Hengyang, 421001, Hunan, China
| | - Jun Liu
- Department of Cell Biology and Genetics, Institute of Cytology and Genetics, School of Basic Medical Sciences, Hengyang Medical School, Key Laboratory of Ecological Environment and Critical Human Diseases Prevention of Hunan Province, Department of Education, Key Laboratory of Hengyang City On Biological Toxicology and Ecological Restoration, Key Laboratory of Typical Environmental Pollution and Health Hazards, University of South China, Hengyang, 421001, Hunan, China
| | - Suyun Li
- Department of Cell Biology and Genetics, Institute of Cytology and Genetics, School of Basic Medical Sciences, Hengyang Medical School, Key Laboratory of Ecological Environment and Critical Human Diseases Prevention of Hunan Province, Department of Education, Key Laboratory of Hengyang City On Biological Toxicology and Ecological Restoration, Key Laboratory of Typical Environmental Pollution and Health Hazards, University of South China, Hengyang, 421001, Hunan, China
| | - Yulin Nie
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital, University of South China, 30# Jiefang Road, Hengyang, 421001, Hunan, China
| | - Hongqing Liao
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital, University of South China, 30# Jiefang Road, Hengyang, 421001, Hunan, China.
| | - Cuiying Peng
- Department of Cell Biology and Genetics, Institute of Cytology and Genetics, School of Basic Medical Sciences, Hengyang Medical School, Key Laboratory of Ecological Environment and Critical Human Diseases Prevention of Hunan Province, Department of Education, Key Laboratory of Hengyang City On Biological Toxicology and Ecological Restoration, Key Laboratory of Typical Environmental Pollution and Health Hazards, University of South China, Hengyang, 421001, Hunan, China.
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Dinicola S, Unfer V, Soulage CO, Margarita Yap-Garcia MI, Bevilacqua A, Benvenga S, Barbaro D, Wdowiak A, Nordio M, Dewailly D, Appetecchia M, Aragona C, Bezerra Espinola MS, Bizzarri M, Cavalli P, Colao A, D’Anna R, Vazquez-Levin MH, Marin IH, Kamenov Z, Laganà AS, Monastra G, Oliva MM, Özay AC, Pintaudi B, Porcaro G, Pustotina O, Pkhaladze L, Prapas N, Roseff S, Salehpour S, Stringaro A, Tugushev M, Unfer V, Vucenik I, Facchinetti F. <sc>d</sc>-Chiro-Inositol in Clinical Practice: A Perspective from the Experts Group on Inositol in Basic and Clinical Research (EGOI). Gynecol Obstet Invest 2024; 89:284-294. [PMID: 38373412 PMCID: PMC11309080 DOI: 10.1159/000536081] [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: 11/16/2023] [Accepted: 01/02/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND d-Chiro-inositol is a natural molecule that, in association with its well-studied isomer myo-inositol, may play a role in treating various metabolic and gynecological disorders. OBJECTIVES This perspective seeks to explore the mechanisms and functions of d-chiro-inositol, laying the foundations to discuss its use in clinical practice, across dysmetabolism, obesity, and hormonal dysregulation. METHODS A narrative review of all the relevant papers known to the authors was conducted. OUTCOME d-Chiro-inositol acts through a variety of mechanisms, acting as an insulin sensitizer, inhibiting the transcription of aromatase, in addition to modulating white adipose tissue/brown adipose tissue transdifferentiation. These different modes of action have potential applications in a variety of therapeutic fields, including PCOS, dysmetabolism, obesity, hypoestrogenic/hyperandrogenic disorders, and bone health. CONCLUSIONS d-Chiro-inositol mode of action has been studied in detail in recent years, resulting in a clear differentiation between d-chiro-inositol and its isomer myo-inositol. The insulin-sensitizing activities of d-chiro-inositol are well understood; however, its potential applications in other fields, in particular obesity and hyperestrogenic/hypoandrogenic disorders in men and women, represent promising avenues of research that require further clinical study.
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Affiliation(s)
- Simona Dinicola
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Systems Biology Group Lab, Rome, Italy
| | - Vittorio Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- UniCamillus – Saint Camillus International University of Health Sciences, Rome, Italy
| | - Christophe O. Soulage
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- INSERM U1060, INSA de Lyon, University of Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Maria Isidora Margarita Yap-Garcia
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- St. Luke’s Medical Center College of Medicine, William H. Quasha Memorial, Quezon, Philippines
| | - Arturo Bevilacqua
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Department of Dynamic, Clinical Psychology and Health, Sapienza University of Rome, Rome, Italy
| | - Salvatore Benvenga
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Daniele Barbaro
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Director of U.O. Endocrinology in Livorno Hospital, Livorno, Italy
| | - Artur Wdowiak
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Faculty of Medicine and Dentistry, Medical University of Lublin, Lublin, Poland
| | - Maurizio Nordio
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- A.S.L. RMF, Civitavecchia, Italy
| | - Didier Dewailly
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Faculty of Medicine Henri Warembourg, University of Lille, Lille Cedex, France
| | - Marialuisa Appetecchia
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Oncological Endocrinology Unit, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Cesare Aragona
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Systems Biology Group Lab, Rome, Italy
| | - Maria Salomè Bezerra Espinola
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Systems Biology Group Lab, Rome, Italy
| | - Mariano Bizzarri
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Systems Biology Group Lab, Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Pietro Cavalli
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Annamaria Colao
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Department of Clinical Medicine and Surgery, Endocrinology, Diabetology and Andrology Unit, Italian Society of Endocrinology, Federico II University of Naples, Naples, Italy
| | - Rosario D’Anna
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Department of Human Pathology, University of Messina, Messina, Italy
| | - Mónica Hebe Vazquez-Levin
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- National Council of Scientific and Technical Research, Instituto de Biología y Medicina Experimental (IBYME), Buenos Aires, Argentina
| | - Imelda Hernàndez Marin
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Human Reproduction Department, Hospital Juárez de México, and Universidad Nacional Autónoma de México (UNAM), México, Mexico
| | - Zdravko Kamenov
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Department of Internal Medicine, University Hospital “Alexandrovska”, Clinic of Endocrinology and Metabolism, Medical University, Sofia, Bulgaria
| | - Antonio Simone Laganà
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Giovanni Monastra
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
| | - Mario Montanino Oliva
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Department of Obstetrics and Gynecology, Santo Spirito Hospital, Rome, Italy
| | - Ali Cenk Özay
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cyprus International University, Nicosia, Cyprus
| | - Basilio Pintaudi
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giuseppina Porcaro
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Women's Health Centre, USL UMBRIA 2, Terni, Italy
| | - Olga Pustotina
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Department of Obstetrics and Gynecology with Reproductive Medicine, F.I. Inozemtsev Academy of Medical Education, Saint Petersburg, Russia
| | - Lali Pkhaladze
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Zhordania and Khomasuridze Institute of Reproductology, Tbilisi, Georgia
| | - Nikos Prapas
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Third Department of OB-GYNAE, Aristotle University of Thessaloniki, and IVF Laboratory, IAKENTRO Fertility Centre, Thessaloniki, Greece
| | - Scott Roseff
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Reproductive Endocrinology and Infertility, South Florida Institute for Reproductive Medicine (IVFMD), Jupiter, FL, USA
| | - Saghar Salehpour
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Annarita Stringaro
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- National Center for Drug Research and Evaluation, Italian National Institute of Health, Rome, Italy
| | - Marat Tugushev
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Department of Reproductive Medicine, Clinical Embryology and Genetics of Samara State Medical University, Samara, Russia
| | - Virginia Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- A.G.Un.Co. Obstetrics and Gynecology Center, Rome, Italy
| | - Ivana Vucenik
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- Department of Medical and Research Technology and Pathology, University of Maryland School of Medicine in Baltimore, Baltimore, MD, USA
| | - Fabio Facchinetti
- The Experts Group on Inositol in Basic and Clinical Research (EGOI) Rome, Italy
- University of Modena and Reggio Emilia, Modena, Italy
- President Italian Society of Perinatal Medicine (SIMP), Modena, Italy
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3
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Capece U, Moffa S, Improta I, Di Giuseppe G, Nista EC, Cefalo CMA, Cinti F, Pontecorvi A, Gasbarrini A, Giaccari A, Mezza T. Alpha-Lipoic Acid and Glucose Metabolism: A Comprehensive Update on Biochemical and Therapeutic Features. Nutrients 2022; 15:nu15010018. [PMID: 36615676 PMCID: PMC9824456 DOI: 10.3390/nu15010018] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Alpha-lipoic acid (ALA) is a natural compound with antioxidant and pro-oxidant properties which has effects on the regulation of insulin sensitivity and insulin secretion. ALA is widely prescribed in patients with diabetic polyneuropathy due to its positive effects on nerve conduction and alleviation of symptoms. It is, moreover, also prescribed in other insulin resistance conditions such as metabolic syndrome (SM), polycystic ovary syndrome (PCOS) and obesity. However, several cases of Insulin Autoimmune Syndrome (IAS) have been reported in subjects taking ALA. The aim of the present review is to describe the main chemical and biological functions of ALA in glucose metabolism, focusing on its antioxidant activity, its role in modulating insulin sensitivity and secretion and in symptomatic peripheral diabetic polyneuropathy. We also provide a potential explanation for increased risk for the development of IAS.
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Affiliation(s)
- Umberto Capece
- Endocrinology and Diabetology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Simona Moffa
- Endocrinology and Diabetology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ilaria Improta
- Endocrinology and Diabetology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gianfranco Di Giuseppe
- Endocrinology and Diabetology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Enrico Celestino Nista
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Chiara M. A. Cefalo
- Endocrinology and Diabetology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesca Cinti
- Endocrinology and Diabetology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Alfredo Pontecorvi
- Endocrinology and Diabetology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Andrea Giaccari
- Endocrinology and Diabetology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence:
| | - Teresa Mezza
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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Simic D, Nikolic Turnic T, Dimitrijevic A, Zivadinovic A, Milosevic Stevanovic J, Djuric D, Zivkovic VI, Jakovljevic V. POTENTIAL ROLE OF D-CHIRO-INOSITOL IN REDUCING OF OXIDATIVE STRESS IN BLOOD OF NON-OBESE WOMEN WITH POLYCYSTIC OVARY SYNDROME. Can J Physiol Pharmacol 2022; 100:629-636. [PMID: 35413205 DOI: 10.1139/cjpp-2021-0766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE D-chiro inositol (DCI), an isomer of inositol, possesses anti-oxidative and endothelial protective properties. Possibly due to a deficiency of insulin mediators, polycystic ovary syndrome (PCOS) is often associated with insulin resistance (IR) and hyperinsulinemia, likely responsible for an elevated production of reactive oxygen species. We investigated oxidative-related alterations in blood of inositol in women with PCOS before and after treatment with DCI. METHODS Thirty eight normal-weight PCOS women were investigated before and after DCI administration (500 mg/day for 12 weeks; n=38) by evaluating serum testosterone, serum androstenedione, fasting serum insulin, fasting serum glucose, and parameters of insulin resistance, From blood, we determined biomarkers of oxidative stress: superoxide anion radical, hydrogen peroxide, nitric oxide and index of lipid peroxidation. In hemolysate, activity of catalase and superoxide dismutase, glutathione (GSH) content, were also assessed. RESULTS Data show that PCOS patients' plasma underwent oxidative stress as indicated by higher level of prooxidants and reduced cytosolic GSH content. DCI treatment significantly improved metabolic parameters. Also, serum values of testosterone were reduced. CONCLUSIONS PCOS patients suffer from a systemic oxidative stress that induces endothelial dysfunction. Treatment with DCI is effective in reducing hormonal, metabolic, and oxidative abnormalities in PCOS patients by improving IR.
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Affiliation(s)
- Dusan Simic
- University of Nis, Department of Gynecology and Obstetrics, Nis, Serbia;
| | - Tamara Nikolic Turnic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia;
| | - Aleksandra Dimitrijevic
- University of Kragujevac, 127740, Department of Gynecology and Obstetrics, Kragujevac, Serbia;
| | | | | | - Dusan Djuric
- Faculty of Medical Sciences, University of Kragujevac, Department of Pharmacy, Kragujevac, Serbia;
| | - Vladimir I Zivkovic
- Faculty of Medicine, Department of Physiology, Svetozara Markovica 69, Kragujevac, Serbia, 34000;
| | - Vladimir Jakovljevic
- University of Kragujevac, 127740, Department of Physiology, Kragujevac, Serbia.,5Department of Human Pathology, 1st Moscow State Medical, University IM Sechenov, , Moscow, Russian Federation;
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5
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Gullo G, Etrusco A, Cucinella G, Perino A, Chiantera V, Laganà AS, Tomaiuolo R, Vitagliano A, Giampaolino P, Noventa M, Andrisani A, Buzzaccarini G. Fertility-Sparing Approach in Women Affected by Stage I and Low-Grade Endometrial Carcinoma: An Updated Overview. Int J Mol Sci 2021; 22:11825. [PMID: 34769256 PMCID: PMC8583899 DOI: 10.3390/ijms222111825] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 12/21/2022] Open
Abstract
Endometrial cancer (EC) is a deleterious condition which strongly affects a woman's quality of life. Although aggressive interventions should be considered to treat high-grade EC, a conservative approach should be taken into consideration for women wishing to conceive. In this scenario, we present an overview about the EC fertility-sparing approach state of art. Type I EC at low stage is the only histological type which can be addressed with a fertility-sparing approach. Moreover, no myometrium and/or adnexal invasion should be seen, and lymph-vascular space should not be involved. Regarding the pharmaceutical target, progestins, in particular medroxyprogesterone acetate (MPA) or megestrol acetate (MA), are the most employed agent in conservative treatment of early-stage EC. The metformin usage and hysteroscopic assessment is still under debate, despite promising results. Particularly strict and imperious attention should be given to the follow-up and psychological wellbeing of women, especially because of the double detrimental impairment: both EC and EC-related infertility consequences.
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Affiliation(s)
- Giuseppe Gullo
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.)
| | - Andrea Etrusco
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, University of Palermo, 90146 Palermo, Italy;
| | - Gaspare Cucinella
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.)
| | - Antonino Perino
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.)
| | - Vito Chiantera
- Department of Gynecology Oncology, University of Palermo, 90146 Palermo, Italy;
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, 21100 Varese, Italy;
| | | | - Amerigo Vitagliano
- Department of Women’s and Children’s Health, Gynaecological Clinic, University of Padova, 35128 Padova, Italy; (A.V.); (M.N.); (A.A.)
| | | | - Marco Noventa
- Department of Women’s and Children’s Health, Gynaecological Clinic, University of Padova, 35128 Padova, Italy; (A.V.); (M.N.); (A.A.)
| | - Alessandra Andrisani
- Department of Women’s and Children’s Health, Gynaecological Clinic, University of Padova, 35128 Padova, Italy; (A.V.); (M.N.); (A.A.)
| | - Giovanni Buzzaccarini
- Department of Women’s and Children’s Health, Gynaecological Clinic, University of Padova, 35128 Padova, Italy; (A.V.); (M.N.); (A.A.)
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6
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Monastra G, Vazquez-Levin M, Bezerra Espinola MS, Bilotta G, Laganà AS, Unfer V. D-chiro-inositol, an aromatase down-modulator, increases androgens and reduces estrogens in male volunteers: a pilot study. Basic Clin Androl 2021; 31:13. [PMID: 34078260 PMCID: PMC8173878 DOI: 10.1186/s12610-021-00131-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/11/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Androgen deficiency affects men in the adulthood, causing several harmful effects at the reproductive and behavioural levels. Since aromatase is an enzyme that catalyses the conversion of androgens to estrogens, and it is responsible for an adequate balance of both sex hormones in males and females, the administration of molecules acting as down modulators may contribute to restore an abnormal enzymatic activity. A prospective pilot study was carried out to investigate the effect of D-chiro-inositol, a putative aromatase down-modulator, on serum levels of testosterone, estradiol, estrone, dehydroepiandrosterone and epiandrosterone from a group of adult male volunteers. Glucose, insulin, follicle-stimulating hormone, luteinizing hormone, inhibin B, D-chiro-inositol and myo-inositol serum levels were also measured. RESULTS Male volunteers were selected according to age and body mass index. Subjects with altered glycemia and/or hormonal status, due to advanced age or abnormal weight, were enrolled in the study. Each of the 10 volunteers enrolled took oral D-chiro-inositol (1 g/day) for 1 month. Serum assays of selected markers were performed at baseline (control) and after treatment. D-chiro-inositol administration was associated to reduced serum levels of estrone (- 85.0%) and estradiol (- 14.4%), and increased serum levels of testosterone (+ 23.4%) and dehydroepiandrosterone (+ 13.8%). In addition, epiandrosterone levels were higher (+39%) after treatment. On the other hand, follicle-stimulating hormone, luteinizing hormone and inhibin B did not change. A trend toward a decrease of glycemia, insulinemia and Homeostatic Model Assessment index was observed after D-chiro-inositol treatment, although differences did not reach statistical significance. D-chiro-inositol treatment did not cause any noticeable adverse effect. CONCLUSIONS Increased androgens and decreased estrogens seem to confirm that D-chiro-inositol acts as an aromatase down-modulator, but with a still unknown mechanism of action. This pilot study opens up new perspectives of research and therapeutic applications for D-chiro-inositol at different dosages and length of treatment. Authorization number 005/2020 released by the Local Ethics Committee of Alma Res Fertility Center, Rome. TRIAL REGISTRATION NUMBER NCT04615767 (registry: ClinicalTrials.gov) Date of registration: November 3, 2020.
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Affiliation(s)
- Giovanni Monastra
- Systems Biology Group Lab, Rome, Italy
- Experts Group on Inositols in Basic and Clinical Research (EGOI), Rome, Italy
| | - Mónica Vazquez-Levin
- Experts Group on Inositols in Basic and Clinical Research (EGOI), Rome, Italy
- Instituto de Biología y Medicina Experimental (IBYME, CONICET-FIBYME). Consejo Nacional de Investigaciones Científicas y Técnicas de Argentina (CONICET), Buenos Aires, Argentina
| | - Maria Salome Bezerra Espinola
- Systems Biology Group Lab, Rome, Italy
- Experts Group on Inositols in Basic and Clinical Research (EGOI), Rome, Italy
- Alma Res Fertility Center, Rome, Italy
| | | | - Antonio Simone Laganà
- Experts Group on Inositols in Basic and Clinical Research (EGOI), Rome, Italy
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Vittorio Unfer
- Systems Biology Group Lab, Rome, Italy.
- Experts Group on Inositols in Basic and Clinical Research (EGOI), Rome, Italy.
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7
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Dabravolski SA, Nikiforov NG, Eid AH, Nedosugova LV, Starodubova AV, Popkova TV, Bezsonov EE, Orekhov AN. Mitochondrial Dysfunction and Chronic Inflammation in Polycystic Ovary Syndrome. Int J Mol Sci 2021; 22:3923. [PMID: 33920227 PMCID: PMC8070512 DOI: 10.3390/ijms22083923] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 12/20/2022] Open
Abstract
Polycystic ovarian syndrome (PCOS) is the most common endocrine-metabolic disorder affecting a vast population worldwide; it is linked with anovulation, mitochondrial dysfunctions and hormonal disbalance. Mutations in mtDNA have been identified in PCOS patients and likely play an important role in PCOS aetiology and pathogenesis; however, their causative role in PCOS development requires further investigation. As a low-grade chronic inflammation disease, PCOS patients have permanently elevated levels of inflammatory markers (TNF-α, CRP, IL-6, IL-8, IL-18). In this review, we summarise recent data regarding the role of mtDNA mutations and mitochondrial malfunctions in PCOS pathogenesis. Furthermore, we discuss recent papers dedicated to the identification of novel biomarkers for early PCOS diagnosis. Finally, traditional and new mitochondria-targeted treatments are discussed. This review intends to emphasise the key role of oxidative stress and chronic inflammation in PCOS pathogenesis; however, the exact molecular mechanism is mostly unknown and requires further investigation.
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Affiliation(s)
- Siarhei A. Dabravolski
- Department of Clinical Diagnostics, Vitebsk State Academy of Veterinary Medicine [UO VGAVM], 7/11 Dovatora str., 210026 Vitebsk, Belarus
| | - Nikita G. Nikiforov
- Center of Collective Usage, Institute of Gene Biology, Russian Academy of Sciences, 34/5 Vavilova Street, 119334 Moscow, Russia;
- Laboratory of Medical Genetics, Institute of Experimental Cardiology, National Medical Research Center of Cardiology, 121552 Moscow, Russia
- Laboratory of Cellular and Molecular Pathology of Cardiovascular System, Institute of Human Morphology, 3 Tsyurupa Street, 117418 Moscow, Russia; (E.E.B.); (A.N.O.)
| | - Ali H. Eid
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha 2713, Qatar;
- Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University, Doha 2713, Qatar
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut P.O. Box 11-0236, Lebanon
| | - Ludmila V. Nedosugova
- Federal State Autonomous Educational Institution of Higher Education, I. M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubenskaya Street, 119991 Moscow, Russia;
| | - Antonina V. Starodubova
- Federal Research Centre for Nutrition, Biotechnology and Food Safety, 2/14 Ustinsky Passage, 109240 Moscow, Russia;
- Pirogov Russian National Research Medical University, 1 Ostrovitianov Street, 117997 Moscow, Russia
| | - Tatyana V. Popkova
- V.A. Nasonova Institute of Rheumatology, 34A Kashirskoye Shosse, 115522 Moscow, Russia;
| | - Evgeny E. Bezsonov
- Laboratory of Cellular and Molecular Pathology of Cardiovascular System, Institute of Human Morphology, 3 Tsyurupa Street, 117418 Moscow, Russia; (E.E.B.); (A.N.O.)
- Laboratory of Angiopathology, The Institute of General Pathology and Pathophysiology, 8 Baltiyskaya Street, 125315 Moscow, Russia
| | - Alexander N. Orekhov
- Laboratory of Cellular and Molecular Pathology of Cardiovascular System, Institute of Human Morphology, 3 Tsyurupa Street, 117418 Moscow, Russia; (E.E.B.); (A.N.O.)
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8
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Abstract
(1) Background: Myoinositol (MI) and D-chiro-inositol (DCI) are involved in a number of biochemical pathways within oocytes having a role in oocyte maturation, fertilization, implantation, and post-implantation development. Both inositols have a role in insulin signaling and hormonal synthesis in the ovaries. (2) Methods: Literature search (with key words: inositols, myo-inositol, d-chiro-inositol, PCOS) was done in PubMed until Sept. 2020 and 197 articles were identified, of which 47 were of clinical trials (35 randomized controlled trials). (3) Results: Many studies have demonstrated that in patients with polycystic ovarian syndrome (PCOS) MI treatment improved ovarian function and fertility, decreased the severity of hyperandrogenism including acne and hirsutism, positively affected metabolic aspects, and modulated various hormonal parameters deeply involved in the reproductive axis function and ovulation. Thus treating with MI has become a novel method to ameliorate PCOS symptoms, improve spontaneous ovulation, or induce ovulation. The current review is focused on the effects of MI and DCI alone or in combination with other agents on the pathological features of PCOS with focus on insulin resistance and adverse metabolic outcomes. (4) Conclusions: The available clinical data suggest that MI, DCI, and their combination in physiological ratio 40:1 with or without other compound could be beneficial for improving metabolic, hormonal, and reproductive aspects of PCOS.
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Affiliation(s)
- Zdravko Kamenov
- Department of Internal Medicine, Clinic of Endocrinology University Hospital Alexandrovska, Medical University—Sofia, 1431 Sofia, Bulgaria;
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9
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Canosa S, Paschero C, Carosso A, Leoncini S, Mercaldo N, Gennarelli G, Benedetto C, Revelli A. Effect of a Combination of Myo-Inositol, Alpha-Lipoic Acid, and Folic Acid on Oocyte Morphology and Embryo Morphokinetics in non-PCOS Overweight/Obese Patients Undergoing IVF: A Pilot, Prospective, Randomized Study. J Clin Med 2020; 9:jcm9092949. [PMID: 32932604 PMCID: PMC7564928 DOI: 10.3390/jcm9092949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/28/2020] [Accepted: 09/07/2020] [Indexed: 12/11/2022] Open
Abstract
Herein we aimed at assessing whether Myo-Inositol (MI), Alpha–Lipoic acid (ALA), and Folic acid (FA) could improve oocyte quality and embryo development in non-PCOS overweight/obese women undergoing IVF. Three hundred and twenty-four mature oocytes were obtained from non-PCOS overweight/obese patients, randomized to receive either MI, ALA, and FA (MI + ALA + FA group, n = 155 oocytes) or FA alone (FA-only group, n = 169 oocytes). Oocytes were examined using Polarized Light Microscopy to assess morphological features of zona pellucida (ZP) and meiotic spindle (MS). One hundred and seventy-six embryos (n = 84 in the MI + ALA + FA group, n = 92 in the FA-only group) were assessed by conventional morphology on days 2 and 5, as well as using the Time-Lapse System morphokinetic analysis. A significantly higher ZP retardance, area, and thickness (p < 0.05), and a shorter MS axis (p < 0.05) were observed in the MI + ALA + FA group, suggesting a positive effect on oocyte quality. Conventional morphology evaluation on day 2 showed a higher mean embryo score in the MI + ALA + FA group, whereas embryo morphokinetic was comparable in the two groups. Overall, our data show a possible beneficial effect of the combination of MI, ALA, and FA on oocyte and embryo morphology, encouraging testing of this combination in adequately powered randomized trials to assess their impact of clinical IVF results.
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10
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Laganà AS, Garzon S, Unfer V. New clinical targets of d-chiro-inositol: rationale and potential applications. Expert Opin Drug Metab Toxicol 2020; 16:703-710. [PMID: 32552009 DOI: 10.1080/17425255.2020.1785429] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Inositols have a key role in ovarian physiology and the literature reports a wealth of studies about the major isomer, myo-inositol (MI). However, information about d-chiro-inositol (DCI) is still scarce, despite the ratio MI:DCI is tissue-specific and actively maintained by an insulin-dependent epimerase enzyme. AREAS COVERED This expert opinion provides an overview of the physiological contribution of DCI in regulating steroidogenesis. DCI indeed mediates the intracellular signaling of insulin, which induces the biosynthesis of androgens. Studies on second messengers of insulin also revealed that DCI has a specific role in modulating the activity of aromatase enzyme. Specifically, recent findings demonstrated that DCI influences the enzyme gene expression, thus reducing the conversion of androgens into estrogens. EXPERT OPINION Available evidence suggests that the effects of DCI administration may be similar to those of aromatase inhibitors, but without causing hypo-estrogenic states. Therefore, DCI treatments should be evaluated for either estrogen-dependent gynecological conditions or low testosterone states in male subjects.
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Affiliation(s)
- Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria , Varese, Italy.,The Experts Group on Inositol in Basic and Clinical Research (EGOI): https://www.inositolgroup.com
| | - Simone Garzon
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria , Varese, Italy
| | - Vittorio Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI): https://www.inositolgroup.com.,Systems Biology Group Lab, "Sapienza" University , Piazza Biroldi 1, 21100 Varese, Italy
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