Effects of Exercise Combined with Finasteride on Hormone and Ovarian Function in Polycystic Ovary Syndrome Rats

Combination therapy of curcumin and fecal microbiota transplant: Potential treatment of polycystic ovarian syndrome

Polycystic ovarian syndrome (PCOS) is a combination of various symptoms like anovulation, hirsutism, chronic amenorrhea, infertility, obesity and polycystic ovaries. It affects over 7 million women worldwide. The current strategy to treat this disorder is based on the use of drugs that provide symptomatic relief. Most of these, however, exhibit numerous side effects and are not able to ameliorate all the signs and symptoms of PCOS. As dysbiosis is considered as one of the prime underlying causes of PCOS, restoration of eubiosis was considered as a plausible way to treat it. Bacteriotherpeutics like probiotics, synbiotics and even fecal microbiota transplant (FMT) have shown considerable effectiveness in PCOS. Of these baceteriotherapeutic options, FMT is considered to be the most holistic as it encompasses the bacteriome, virome, fungome, archaeome and even parasitome while both probiotics as well as synbiotics mainly comprise bacteria. Repeated FMT, however, is not a pragmatic option because of its inconvenience, lack of standardization, involved risk and scepticism amongst patients and physicians. If the eubiosis ushered by FMT is sustained for a long time, the repeated administrations of FMT can be avoided and maintenance therapy with any agent that can maintain the eubiotic condition can be adopted. Role of curcumin on gut microbiota is widely known. It is largely attributed to the ability of certain microbes to consume polyphenols as substrates and its positive effect on bacterial consumption of nutrients such as sugars. Based on various mechanisms and studies, a new hypothesis is being proposed wherein FMT and curcumin combination is predicted to be an effective and sustained treatment of PCOS with much lower rates of remission.

Recent updates on animal models for understanding the etiopathogenesis of polycystic ovarian syndrome

Polycystic ovarian syndrome (PCOS) is the primary cause of female infertility affecting several women worldwide. Changes in hormonal functions such as hyperandrogenism are considered a significant factor in developing PCOS in women. In addition, many molecular pathways are involved in the pathogenesis of PCOS in women. To have better insights about PCOS, it is data from clinical studies carried on women suffering from PCOS should be collected. However, this approach has several implications, including ethical considerations, cost involved and availability of subject. Moreover, during the early drug development process, it is always advisable to use non-human models mimicking human physiology as they are less expensive, readily available, have a shorter gestation period and less risk involved. Many animal models have been reported that resemble the PCOS pathways in human subjects. However, the models developed on rats and mice are more preferred over other rodent/non-rodent models due to their closer resemblance with human PCOS development mechanism. The most extensively reported PCOS models for rats and mice include those induced by using testosterone, letrozole and estradiol valerate. As the pathophysiology of PCOS is complex, none of the explored models completely surrogates the PCOS related conditions occurring in women. Hence, there is a need to develop an animal model that can resemble the pathophysiology of PCOS in women. The review focuses on various animal models explored to understand the pathophysiology of PCOS. The article also highlights some environmental and food-related models that have been used to induce PCOS.

The role of 5-reduction in physiology and metabolic disease: evidence from cellular, pre-clinical and human studies

The 5-reductases (5α-reductase types 1, 2 and 3 [5αR1-3], 5β-reductase [5βR]) are steroid hormone metabolising enzymes that hold fundamental roles in human physiology and pathology. They possess broad substrate specificity converting many steroid hormones to their 5α- and 5β-reduced metabolites, as well as catalysing crucial steps in bile acid synthesis. 5αRs are fundamentally important in urogenital development by converting testosterone to the more potent androgen 5α-dihydrotestosterone (5αDHT); inactivating mutations in 5αR2 lead to disorders of sexual development. Due to the ability of the 5αRs to generate 5αDHT, they are an established drug target, and 5αR inhibitors are widely used for the treatment of androgen-dependent benign or malignant prostatic diseases. There is an emerging body of evidence to suggest that the 5-reductases can impact upon aspects of health and disease (other than urogenital development); alterations in their expression and activity have been associated with metabolic disease, polycystic ovarian syndrome, inflammation and bone metabolism. This review will outline the evidence base for the extra-urogenital role of 5-reductases from in vitro cell systems, pre-clinical models and human studies, and highlight the potential adverse effects of 5αR inhibition in human health and disease.

Predicting Risk of Insulin Resistance in a Chinese Population with Polycystic Ovary Syndrome: Designing and Testing a New Predictive Nomogram

BACKGROUND

This research is aimed at establishing and internally validating the risk nomogram of insulin resistance (IR) in a Chinese population of patients with polycystic ovary syndrome (PCOS).

METHODS

We developed a predictive model based on a training dataset of 145 PCOS patients, and data were collected between March 2018 and May 2019. The least absolute shrinkage and selection operator regression model was used to optimize function selection for the insulin resistance risk model. Multivariable logistic regression analysis was used to construct a prediction model integrating the function selected in the regression model of the least absolute shrinkage and selection operator. The predicting model's characteristics of prejudice, disease, and lifestyle were analyzed using the C-index, the calibration diagram, and the study of the decision curve. External validity was assessed using the validation of bootstrapping.

RESULTS

Predictors contained in the prediction nomogram included occupation, disease durations (years), BMI, current use of metformin, and activities. With a C-index of 0.739 (95 percent confidence interval: 0.644-0.830), the model showed good differentiation and proper calibration. In the interval validation, a high C-index value of 0.681 could still be achieved. Examination of the decision curve found that the IR nomogram was clinically useful when the intervention was determined at the 11 percent IR potential threshold.

CONCLUSION

This novel IR nomogram incorporates occupation, disease durations (years), BMI, current use of metformin, and activities. This nomogram could be used to promote the estimation of individual IR risk in patients with PCOS.