Vascular endothelial growth factor (VEGFA) gene variation in polycystic ovary syndrome in a Tunisian women population

Genetic and Epigenetic Landscape for Drug Development in Polycystic Ovary Syndrome

The treatment of polycystic ovary syndrome (PCOS) faces challenges as all known treatments are merely symptomatic. The US Food and Drug Administration has not approved any drug specifically for treating PCOS. As the significance of genetics and epigenetics rises in drug development, their pivotal insights have greatly enhanced the efficacy and success of drug target discovery and validation, offering promise for guiding the advancement of PCOS treatments. In this context, we outline the genetic and epigenetic advancement in PCOS, which provide novel insights into the pathogenesis of this complex disease. We also delve into the prospective method for harnessing genetic and epigenetic strategies to identify potential drug targets and ensure target safety. Additionally, we shed light on the preliminary evidence and distinctive challenges associated with gene and epigenetic therapies in the context of PCOS.

Prolactin in Polycystic Ovary Syndrome: Metabolic Effects and Therapeutic Prospects

Polycystic ovary syndrome (PCOS) is the most prevalent endocrine and metabolic disorder in premenopausal women, characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. Patients frequently present comorbidities, including obesity, insulin resistance, and impaired glucose and lipid metabolism. The diverse clinical presentation may mimic various endocrine disorders, making the diagnosis challenging in some clinical circumstances. Prolactin (PRL) is a recommended biomarker in the initial diagnostic workup to rule out hyperprolactinemia (HPRL). The traditional role of PRL is linked to lactation and the reproductive system. Recent research highlights PRL's emerging role in metabolic homeostasis. PRL influences metabolism directly by interacting with the pancreas, liver, hypothalamus, and adipose tissue. Its influence on an individual's metabolism is intricately tied to its serum concentration. While deficient and very high levels of PRL can negatively affect metabolism, intermediate-normal to moderately high levels may promote metabolic health. In women with PCOS, PRL levels may be altered. Research results on different aspects of the relationship between PCOS and the impact of various levels of PRL on metabolic homeostasis are limited and inconsistent. In this narrative literature review, we comprehensively examined data on serum PRL levels in PCOS patients. We investigated the correlation between a favorable metabolic profile and serum PRL levels in this population. Furthermore, we explored the concept of beneficial PRL effects on metabolism and discussed the potential therapeutic application of dopamine agonists in PCOS treatment. Lastly, we emphasized several promising avenues for future research in this field.

Polymorphisms rs2010963 and rs833061 of the VEGF gene in polycystic ovary syndrome

OBJECTIVE:

The polycystic ovary syndrome is the most common endocrine disorder, characterized by the dysregulation of ovarian angiogenesis. This alteration can be related to changes in the activities of the vascular endothelial growth factor (VEGF) gene. Single-nucleotide polymorphisms have been observed in the promoter, intronic, and untranslated regions of the VEGF gene, and several studies have suggested that these polymorphisms may be associated with the risk of polycystic ovary syndrome. This study aimed to investigate the association between rs2010963 and rs833061 polymorphisms and haplotypes of VEGF in the etiology of polycystic ovary syndrome.

METHODS:

A total of 210 women, 102 diagnosed with polycystic ovary syndrome and 108 controls, participated in this study. The genotyping of the samples was performed by PCR-RFLP and real-time PCR for rs2010963 and rs833061 polymorphisms, respectively. The statistical analyses were performed by the chi-square test and logistic regression model.

RESULTS:

The clinical characteristics of the patients showed that 75.8% of the patients did not become pregnant, 36.3% had a family history of polycystic ovary syndrome, 58.6% were obese, and about 60% had clinical characteristics of hyperandrogenism. There were no associations between the distribution of rs2010963 (OR 1.24; 95%CI 0.60–2.57; p=0.56) and rs833061 (OR 0.78; 95%CI 0.32–1.92; p=0.59) in patients and controls.

CONCLUSIONS:

The patients with polycystic ovary syndrome have similar rates of VEGF polymorphisms rs2010963 and rs833061 on the general population.

Vascular endothelial growth factor A with two genetic variants for prediction of mixed microvascular diabetic complications

Background

Vascular endothelial growth factor (VEGF) is a signal protein, induces cell proliferation, and enhances the permeability of the endothelial cells. VEGF-A gene is highly polymorphic, with different near-gene variants at varied frequencies linked with altered VEGF protein expression, type 2 diabetes mellitus (T2DM) susceptibility, and associated microvascular complications. The present study aimed to investigate the role of two genetic variants of VEGF-A, − 583C > T (rs3025020) and + 936 C/T (rs3025039), for predicting mixed microvascular complications in T2DM. This case–control study was performed on 26 T2DM patients with mixed microvascular complications and 26 apparently healthy individuals, as a control group. Clinical, neurological, funds examinations, and biochemical laboratory investigations were conducted on all groups. The serum level of VEGF-A was measured using ELISA. Genotyping of VEGF-A was performed by real-time PCR allelic discrimination system.

Results

Serum level of VEGF-A was significantly increased in T2DM with mixed complications. T allele of VEGF-A rs3025020 showed higher frequency among T2DM patients with mixed complications than in control group [OR 2.67; 95% CI 1.03–6.91; p = 0.04], while CT genotype and T allele of VEGF-A rs3025039 had a high frequency in mixed complication group [OR 4.08; 95% CI 1.32–17.44; p = 0.01 and OR 4.02; 95% CI 1.52–10.63; p = 0.004, respectively].

Conclusion

VEGF-A increased the level contributed in the pathogenesis of mixed diabetic microvascular complications. T allele of VEGF-A rs3025020, CT genotype, and T allele of VEGF-A rs3025039 had the highest frequency in mixed diabetic microvascular complications, so they were considered risk genes for mixed diabetic microvascular complications.

Machine Learning Approaches for Predicting Bisphosphonate-Related Osteonecrosis in Women with Osteoporosis Using VEGFA Gene Polymorphisms

Objective: This nested case–control study aimed to investigate the effects of VEGFA polymorphisms on the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in women with osteoporosis. Methods: Eleven single nucleotide polymorphisms (SNPs) of the VEGFA were assessed in a total of 125 patients. Logistic regression was performed for multivariable analysis. Machine learning algorithms, namely, fivefold cross-validated multivariate logistic regression, elastic net, random forest, and support vector machine, were developed to predict risk factors for BRONJ occurrence. Area under the receiver-operating curve (AUROC) analysis was conducted to assess clinical performance. Results: The VEGFA rs881858 was significantly associated with BRONJ development. The odds of BRONJ development were 6.45 times (95% CI, 1.69–24.65) higher among carriers of the wild-type rs881858 allele compared with variant homozygote carriers after adjusting for covariates. Additionally, variant homozygote (GG) carriers of rs10434 had higher odds than those with wild-type allele (OR, 3.16). Age ≥ 65 years (OR, 16.05) and bisphosphonate exposure ≥ 36 months (OR, 3.67) were also significant risk factors for BRONJ occurrence. AUROC values were higher than 0.78 for all machine learning methods employed in this study. Conclusion: Our study showed that the BRONJ occurrence was associated with VEGFA polymorphisms in osteoporotic women.

VEGF gene rs35569394 polymorphism in patients with Polycystic Ovary Syndrome

OBJECTIVE

The relationship between the clinicopathological and sociodemographics characteristics of acral melanomas diagnosed at BACKGROUND: This study aimed to investigate the frequency of VEGF gene insertion (I) / deletion (D) polymorphism (rs35569394) in patients with Polycystic Ovarian Syndrome (PCOS) and to compare with a control population to verify its association with the pathology.

METHODS

206 women participated in this study, 103 with PCOS (group of patients) and 103 without the disease (control group). After extraction of genomic DNA from the samples, molecular analysis was performed by Polymerase Chain Reaction (PCR) and electrophoresis in polycrylamide. Descriptive analysis, univariate analysis and logistic regression model were used. Results were presented in odds ratio (OR) and 95% confidence interval (95% CI), considering the significance of p <0.05.

RESULTS

There were no statistical differences between patients and controls for allele frequencies (χ2 = 1.16, p = 0.56). The genotypic frequency distribution was in Hardy Weinberg equilibrium for the patients (χ2 = 2.42; p <0.05), but not for the control group (χ2 = 7.26; p <0.05). Regarding risk factors for the syndrome, a history of familial PCOS is more frequent among women with the syndrome.

CONCLUSIONS

In the present study, there is no association between VEGF gene I / D polymorphism and PCOS.

Molecular characteristics of oocytes and somatic cells of follicles at different sizes that influence in vitro oocyte maturation and embryo production

During the last 10 to 15 yr, in vitro research to predict antral follicle growth and oocyte maturation has delivered interesting advances in the knowledge of processes regulating follicle growth and developmental competence of oocytes. This review discusses the contribution of cumulus and mural granulosa cells in the process of oocyte maturation and cumulus expansion in cumulus-oocyte complexes (COCs) from follicles of different sizes and shows that differences in gene expression in oocytes, granulosa, and theca cells of small and large follicles impact the success of in vitro blastocyst development. In addition, the molecular mechanisms by which COC metabolism and antioxidant defense provide oocyte competence are highlighted. Furthermore, new insights and perspectives on molecular and cellular regulation of in vitro oocyte maturation are emphasized.

The interaction between dietary inflammatory index and 6 P21 rs2010963 gene variants in metabolic syndrome

BACKGROUND

The Vascular endothelial growth factor (VEGF) regulates endothelial cell proliferation, migration and angiogenesis, promotes vascular and capillary permeability and also is involved in inflammation. VEGF gene has been suggested to play an important role in the pathogenesis of metabolic syndrome. The aim of this study was to investigate the association between inflammatory potential of a diet and + 405 VEGF C/G (rs2010963) polymorphism and metabolic components in patients with metabolic syndrome.

METHODS

One hundred fifty patients with metabolic syndrome and fifty healthy individuals were enrolled. A semi-quantitative food-frequency questionnaire (FFQ) was used for dietary assessments and dietary inflammatory index (DII) calculation. Biochemical assays including fasting serum glucose (FSG), serum insulin, matrix metalloproteinase-3 (MMP-3), liver enzymes and lipid profile were measured. Polymerase chain reaction-restriction fragments length polymorphism (PCR-RFLP) method was used for the determination of gene polymorphism.

RESULTS

In the current study, patients with metabolic syndrome had higher serum low density lipoprotein (LDL) and lower high density lipoprotein (HDL) concentrations compared with healthy subjects. Patients with lower DII quartiles and lower inflammatory potential of the diet had lower waist to hip ratio (WHR) and lower diastolic blood pressure (DBP) compared with patients in higher DII quartiles (P < 0.05). Moreover, patients and healthy subjects in second quartile of DII had significantly higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT) concentrations compared with subjects in the first quartile; also healthy subjects in third quartile had significantly higher triglyceride (TG) and total cholesterol (TC) concentrations compared with subjects in second quartile (P < 0.05). Among different genotypes of 6 P21 rs2010963 gene variants in patients with metabolic syndrome, CC genotype indicated the highest DII compared with other genotypes (P < 0.05).

CONCLUSION

The current study revealed the association between DII and metabolic risk factors of metabolic syndrome.

LEVEL OF EVIDENCE

Level III, case-control analytic study.

Diagnostic value of miR-199a and miR-21 in the plasma of infertile women with dysregulated AMH levels

This work aimed to explore the expression pattern of circulating miR-199a-3p, miR-21-5p and miR-let7i-3p in infertile women with dysregulated AMH levels. Quantitative real-time PCR was used to measure miR-199a-3p, miR-21-5p, and miR-let7i-3p expression levels in 60 plasma samples of infertile women with low or high AMH levels. Bioinformatic analyses for microRNAs predicting target genes and molecular pathways were performed according to gene ontology (GO) analysis and KEGG pathways. Only miR-199a-3p and miR-21-5p were significantly over and under-expressed, respectively, in the plasma samples of all infertile women with low or high AMH levels versus controls (p-value = 0.01). Furthermore, the diagnostic value miR-199a-3p yielded a receiver operating characteristic (ROC) curve with area under the curve (AUC) of 0.82 with a 95% CI [0.72-0.92] and an AUC of 0.81, for miR-21-5p, 95% CI [0.69-0.92]. The combined ROC curve of miR-21 and miR-199a provided an optimal combination with AUC = 0.98, 95% CI [0.96-1], and, a cut-off point (0.42) which provided 98% sensitivity and 87% specificity. In conclusion, circulating miR-199a-3p and miR-21-5p vary significantly whenever AMH levels of infertile women are disturbed and could potentially serve as non-invasive biomarkers in distinguishing infertile from fertile women.

Association between VEGF gene polymorphisms (11 sites) and polycystic ovary syndrome risk

Vascular endothelial growth factor (VEGF) plays a critical role in ovarian folliculogenesis and normal reproductive function. So far, several studies focusing on association between VEGF gene polymorphisms and polycystic ovary syndrome (PCOS). However, above association between the VEGF gene polymorphisms and PCOS susceptibility is uncertain. Hence, we performed a timely meta-analysis containing all current publications to make clear this relationship. We searched articles from the PubMed, Embase and Chinese language (WanFang and CNKI) databases that were published up until May 10, 2019. Finally, we obtained 9 studies, containing 29 case-control studies and 11 different polymorphisms. The odds ratios (OR) and 95% confidence intervals (CI) were revealed association strengths. There were significantly decreased associations between rs2010963 (-634), +9812, +405 polymorphisms and PCOS risk. Nevertheless, there existed increased associations between rs699947 (-2578), rs833061, rs1570360 (-1154), rs3025020, rs3025039 polymorphisms and PCOS susceptibility. Our current analysis suggested VEGF gene polymorphisms may be associated with PCOS risk, which is possible to be expected to become biomarkers of early detection for women.

Dietary total antioxidant capacity significantly interacts with 6-P21 rs2010963 gene polymorphisms in terms of cardio-metabolic risk factors in patients with metabolic syndrome

OBJECTIVE

Gene- nutrient interaction might possibly be involved in the pathogenesis of metabolic syndrome and its components. In the current report, the association between antioxidant potential of the diet with 6P21 rs2010963 gene polymorphism in patients with metabolic syndrome has been evaluated. Two hundred fifty-four patients with metabolic syndrome were enrolled. Total dietary antioxidant capacity (TAC) has been estimated and anthropometric assessments were assessed. Biochemical assays including serum glucose, matrix metalloproteinase-3, liver enzymes and lipid profiles were also assessed. Polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) method was used for determination of 6P21 rs2010963 polymorphism.

RESULTS

Dietary vitamin E score was significantly higher in GC genotype compared with other genotypes (P = 0.035). Patients in CC genotype of 6P21 rs2010963 had significantly higher body mass index (BMI), fasting blood sugar and liver enzymes (P < 0.05). Being in the higher dietary TAC scores was also associated with lower liver enzymes. The interaction between 6P21 rs2010963 and dietary TAC significantly affected BMI, FBS and diastolic blood pressure (P < 0.05). According to our findings the CC genotype of 6P21 rs2010963 could be considered as the possible risk factor for obesity and metabolic disorders among patients with metabolic syndrome.

Association of vascular endothelial growth factor polymorphisms with polycystic ovarian syndrome risk: a meta-analysis

BACKGROUND

Polycystic ovarian syndrome (PCOS) is a multi-gene hereditary disorder caused by the interaction of certain gene variation with environmental factors. Previous studies have shown that vascular endothelial growth factor (VEGF) gene polymorphisms are associated with the risk of polycystic ovarian syndrome. However, the results of these studies remain controversial. We performed the present meta-analysis aiming to further investigate the potential relationship between VEGF polymorphisms and susceptibility to PCOS.

METHODS

The following databases were systematically searched: PubMed, EMBASE, Web of Science (WOS), China National Knowledge Infrastructure (CNKI), and Wanfang Databases. The correlation between VEGF polymorphisms and PCOS risk was assessed by calculating pooled odds ratios (ORs) and their 95% confidence intervals (95% CIs). Subgroup analyses stratified by ethnicity and source of control were also conducted. Besides, trial sequential analysis (TSA) was done to verify the reliability of the pooled results.

RESULTS

10 relevant case-control studies were incorporated in this meta-analysis, involving 1347 PCOS cases and 1378 controls. The VEGF rs2010963 polymorphism was associated with decreased PCOS risk in the whole population and the Asian populations. The VEGF rs3025039 polymorphism was associated with decreased PCOS susceptibility and the Asian populations, but increased risk of PCOS was observed among the Caucasian populations. In addition, the results of trial sequential analysis (TSA) showed the negative correlation between rs2010963 and PCOS risk, obtained by our meta-analysis, was stable and reliable.

CONCLUSION

Overall, different VEGF gene polymorphisms may exert different effects on PCOS susceptibility. The VEGF rs2010963 polymorphism decreases PCOS susceptibility in both the whole population and the Asian populations, and VEGF rs3025039 polymorphism causes lower PCOS susceptibility in the whole population and the Asian populations but higher in the Caucasian populations.

Identification of the Active Constituents and Significant Pathways of Cangfu Daotan Decoction for the Treatment of PCOS Based on Network Pharmacology

Background

Polycystic ovary syndrome (PCOS) is the most common female endocrine disease. Cangfu Daotan Decoction (CDD) can effectively relieve the clinical symptoms of PCOS patients.

Methods

To explore the active ingredients and related pathways of CDD for treating PCOS, a network pharmacology-based analysis was carried out. The active ingredients of CDD and their potential targets were obtained from the TCM system pharmacology analysis platform. The obtained PCOS-related genes from OMIM and GeneCards were imported to establish protein-protein interaction networks in STRING. Finally, GO analysis and significant pathway analysis were conducted with the RStudio (Bioconductor) database.

Results

A total of 111 active compounds were obtained from 1433 ingredients present in the CDD, related to 118 protein targets. In addition, 736 genes were found to be closely related to PCOS, of which 44 overlapped with CDD and were thus considered therapeutically relevant. Pathway enrichment analysis identified the AGE-RAGE signalling pathway in diabetic complications, endocrine resistance, the IL-17 signalling pathway, the prolactin signalling pathway, and the HIF-1 signalling pathway. Moreover, PI3K-Akt, insulin resistance, Toll-like receptor, MAPK, and AGE-RAGE were related to PCOS and treatment.

Conclusions

CDD can effectively improve the symptoms of PCOS, and our network pharmacological analysis lays the foundation for future clinical research.

The effect of prednisolone on endometrial VGEF concentrations, Gene polymorphisms and pregnancy outcome in women with polycystic ovary syndrome: A retrospective cohort study

PCOS (Polycystic Ovary Syndrome) occurs due to hyperandrogenism, excessive androgen, abnormal growth, steroidogenesis and seems to be associated with abnormal Vascular endothelial growth factor (VEGF) level in serum. The treatment is provided on the basis of body symptoms to mute the excess production of hormone. The study assessed the effect of prednisolone treatment on the concentration of VEGF, pregnancy outcomes and variants of VEGF SNPs. In the current retrospective study, the samples were collected from PCOS female patients who received prednisolone and those who did not received it, were compared along with control, in terms of pregnancy results and the association complications. The results inferred that the prednisolone made the concentration of VEGF significantly to normal levels along with other pregnancy-related and growth-related hormones. But the reduced normal limits were achieved only among few patients whereas no significant improvement found in the women who received prednisolone and control, in terms of pregnancy outcomes or complications. Further, there were no relations between the impact of treatment and the variants of VEGF SNPs. To conclude, there is no solid evidence found in the current study with regards to notable beneficial effect when the patients were treated with prednisolone, either in pregnancy outcomes or VEGF SNPs. The current study results should be considered only as a preliminary one since the genetic polymorphisms tend to exhibit different results based on population, ethnic groups etc. The results yielded may not be generalized due to differences in genetic background.

Association between vascular endothelial growth factor gene polymorphisms and PCOS risk: a meta-analysis

Vascular endothelial growth factor (VEGF) plays important roles in the pathogenesis of polycystic ovary syndrome (PCOS). Several single nucleotide polymorphisms (SNP) of the VEGF gene have been identified and are associated with the aberrant secretion of VEGF protein. This meta-analysis aimed to evaluate the impact of the VEGF +405G>C (rs2010963), -460C>T (rs833061) and -2578A>C (rs699947) polymorphisms on PCOS susceptibility. A systematic search of the Embase, PubMed, Web of Science and Wanfang databases was carried out to identify relevant studies published before 19 July 2019. Seven eligible studies were included in this meta-analysis involving 1100 patients with PCOS and 1141 control individuals. The pooled analysis revealed no significant association between PCOS risk and the +405G>C (rs2010963), -460C>T (rs833061) or -2578A>C (rs699947) polymorphisms in women. Subgroup analysis by ethnicity indicated that Asian women carrying the VEGF +405C allele had a lower risk of PCOS (C versus G: odds ratio [OR] 0.731, 95% confidence interval [CI] 0.544-0.982, P < 0.05, I² = 46.4%; CG versus GG: OR 0.667, 95% CI 0.469-0.948, P < 0.05, I² = 18.4%; CC versus GG: OR 0.611, 95% CI 0.390-0.958, P < 0.05, I² = 24.3%). The study demonstrates that for all women regardless of ethnicity, no significant associations between VEGF SNP and PCOS were observed; however, +405G>C (rs2010963) may protect Asian women from PCOS.

Haplotype analysis of VEGF gene polymorphisms in polycystic ovary syndrome

This study evaluated the association of polymorphisms of VEGF (endothelial vascular growth factor) gene + 936C/T (rs3025039), 1154 G/A (rs 1570360) and -2578 C/A (rs 699947) in patients with polycystic ovary syndrome (PCOS) and to perform the haplotypes formed by the alleles in the Brazilian population. A total of 110 women without PCOS and 112 women with PCOS were included in the study. Genotyping analyses were performed using the PCR-RFLP assays (rs 3025039 and rs 699947) and by allelic discrimination using the real-time PCR technique (rs 1570360). In the univariate analysis, we observed a significant difference between the groups for the polymorphism rs 1570360 and this polymorphism presented statistical differences between the groups for the recessive model (p = .04). The frequency of the T-G-C haplotype showed a statistically significant difference between women with PCOS and controls (p = .05). The -2578 A/C polymorphism was more frequent in the control group, which may be associated with a protective characteristic for the PCOS manifestation. In the sample analysis, polymorphism rs 1570360 is associated with PCOS and the T-G-C haplotype could be associated with protective factors.

Analysis of VEGF gene polymorphisms and serum VEGF protein levels contribution in polycystic ovary syndrome of patients

Vascular endothelial growth factor (VEGF) is a well-known factor in reproductive function and contributes to the pathogenesis of polycystic ovary syndrome (PCOS). Genetic variations in VEGFA gene were suggested to contribute alterations in VEGF secretion and PCOS. This study evaluated the association of VEGFA SNPs with altered VEGF secretion level and PCOS among ethnically-matched control women. This prospective case-control study was conducted from 2016 to 2018 and comprised of 55 women with PCOS and 52 control subjects. ELISA was used to measure VEGF levels; and various other related bio chemicals whereas the genotyping of VEGFA variants was performed through the analysis of nine SNPs of VEGF. PRL, E2, PRGE testosterone and glucose level were found to be insignificantly different. The levels of FSH, LH, LH/FSH, TT, insulin, SHBG and HOMA-IR were significantly higher in the study group. Among the nine tested variants of VEGF SNPs, two SNPs rs3025020 and rs833061, consisted of TT (Recessive and Dominant homozygous, respectively) which were marginally higher in test. The SNP rs1570360 had significantly higher GG allele (32.73%) which was recessive homozygous. There was no significant difference observed in genotype frequencies related to higher value of VEGF. The genotype frequencies for the studied SNPs were in alignment with Hardy-Weinberg equilibrium (HWE). The mean serum VEGF levels got significantly increased in PCOS group. No significant association was found between VEGF genotypes and its serum levels. VEGF levels in rs699947 (AA-major homozygous), rs3025039 (CC-major homozygous) and rs833061 (TT & CC-major & minor homozygous) genotypes were significantly higher in PCOS. The study results evidently proved that the allelic variants in genes may be a factor for PCOS and VEGF serum levels with respect to few SNP variants only. These findings indicated that VEGF may be involved in PCOS status and confirmed the previous association between genetic variants in VEGF, serum level of VEGF protein and PCOS.

Effects of resveratrol on VEGF & HIF1 genes expression in granulosa cells in the angiogenesis pathway and laboratory parameters of polycystic ovary syndrome: a triple-blind randomized clinical trial

OBJECTIVES

Management options for PCOS, as the most prevalent endocrine disorder in women of reproductive age, using natural supplements have a high priority for physicians, especially based on the etiological pathways. Therefore, this study was conducted to describe the effect of resveratrol on the angiogenesis pathway, for management of PCOS through assessing VEGF, HIF1 gene expression, and laboratory parameters.

METHODS

In this triple-blind RCT, PCOS was confirmed in ICSI candidates based on the Rotterdam criteria. Sixty-two patients that met the inclusion criteria were randomly assigned to two groups. All patients took resveratrol 800 mg/day or placebo for 40 days orally from the beginning of their previous menstruation cycle until the oocyte retrieval day. The serum levels of different hormones were measured, and the expression of HIF1 & VEGF genes was quantified by real-time PCR.

RESULTS

As for the laboratory hormone assay in 61 PCOS patients, a significant mean difference was seen in the FSH, LH, TSH, and testosterone between the two groups (P < 0.05). The results showed a reduction in the expression of VEGF & HIF1 genes under the effect of resveratrol in the granulosa cells (P = 0.0001). The number of mature oocytes, cleavage rate, fertilization rate, and fertility rate were not significantly different between the two groups (P > 0.05), but the high-quality oocyte rate and high-quality embryo rate were higher in the resveratrol group (P < 0.05).

CONCLUSIONS

Based on the results, resveratrol may improve some outcomes of PCOS patients, probably through changing the serum levels of some sex hormones and expression of VEGF & HIF1 genes in the angiogenesis pathway of granulosa cells.

Association between VEGFA gene polymorphisms and bleeding complications in patients maintaining therapeutic international normalized ratio

Aim: This study was designed to identify the possible effects of VEGFA polymorphisms on the occurrence of bleeding complications in patients with mechanical heart valves who have achieved therapeutic international normalized ratio (INR). Materials & methods: 13 SNPs of VEGFA were analyzed. Uni- and multi-variate analyses were conducted to identify associations between polymorphisms and bleeding complications. Results & conclusion: Patients with the CC genotype of rs35410204 had an approximately tenfold higher bleeding complication than those with the T allele. For rs866236, patients who had wild-type homozygotes showed an approximately 2.9-fold higher bleeding complication than C allele carriers. This study demonstrated that bleeding complications during warfarin therapy are associated with VEGFA polymorphisms in patients with mechanical heart valves.

Effects of melatonin on the synthesis of estradiol and gene expression in pig granulosa cells

The interaction of granulosa cells (GCs) with oocytes is important to regulate follicle development. The exogenous melatonin promoting the maturation of oocytes by GCs has been approved in pig, however, the transcriptome profile and the functions of the genes regulated by melatonin in GCs have not yet to be fully characterized. In this study, we found melatonin could stimulate the synthesis of estradiol in pig GCs. The RNA-seq was used to explore the effects of melatonin on gene expression, a total of 89 differentially expressed genes (DEGs) were identified. Gene ontology analysis showed DEGs which associated with regulation of cell proliferation, cell cycle, and anti-apoptosis were significantly enriched. The functions of two DEGs, NOTCH2 and FILIP1L, were studied in pig GCs. The results showed that NOTCH2 inhibited the synthesis of estradiol, but FILIP1L promoted the synthesis of estradiol. Furthermore, inhibiting NOTCH2 in granulosa cells cocultured with cumulus-oocyte-complexes had no obvious effect on the maturation of pig oocyte, but could upregulate the cleavage rate of oocyte. We proved that FILIP1L had no effect on the maturation and cleavage of pig oocytes. Our work deepens the understanding of melatonin's effects on GCs and oocyte. The DEGs we found will be beneficial to reveal mechanisms of melatonin acting on GCs and oocytes and design the pharmacological interventions.

PORTABILITY OF GWAS RESULTS BETWEEN ETHNIC POPULATIONS: GENETIC MARKERS FOR POLYCYSTIC OVARY SYNDROME (PCOS) IN MEDITERRANEAN AREA

Genome Wide Association Studies (GWAS) are excellent opportunities to define culprit genes in complex disorders such as the polycystic ovary syndrome (PCOS). PCOS is a prevalent disorder characterized by anovulation, hyperandrogenism and polycystic ovaries, which benefitted from several GWASs in Asians and Europeans revealing more than 20 potential culprit genes near associated single nucleotide variations (SNV). Translation of these findings into the clinical practice raises difficulties since positive hits are surrogate SNVs linked with causative mutations by linkage disequilibrium (LD). Studies in Mediterranean populations (e.g. Southern Europe and North Africa) raise supplementary problems because of a different LD-pattern, which may disrupt the link with causative mutations. Our experience in MEDIGENE program between Tunisia and France enforces the necessity of genetic anthropology studies before translating GWAS data. Tunisians are a heterogeneous population with ancestral Berbers, European, Arab and Sub-Saharan African components while South Europeans display a high level of genetic diversity, partially explained by gene flow from North Africa. Human diversity studies require sampling from Middle East and North Africa (MENA) region that will help to understand genetic factors in complex diseases.

Endogenous Ovarian Angiogenesis in Polycystic Ovary Syndrome-Like Rats Induced by Low-Frequency Electro-Acupuncture: The CLARITY Three-Dimensional Approach

We sought to determine the role of ovarian vascularity and neo-angiogenesis in the development of mature follicles in polycystic ovary syndrome (PCOS) and to identify any changes induced by low-frequency electro-acupuncture (EA). Twenty-eight 21-day-old female Wistar rats were randomly divided into four groups—Control, Obesity, PCOS-like, and PCOS-like-EA (n = 7/group). Rats in the Obesity group were fed a high-fat diet throughout the experiment. Rats in the PCOS-like and PCOS-like-EA groups were implanted with a sustained-release tube containing 5α-dihydrotestosterone (DHT) beneath the skin of the neck. Rats in the PCOS-like-EA group received low-frequency EA treatment starting at 70 days for 30 min five times a week for four weeks. At the end of the experiment, all rats were euthanized and perfused with hydrogel. The ovaries were collected for clarification and imaging, and ovarian vascularity and neo-angiogenesis were analyzed. Compared with Control and Obesity rats, the ovaries in DHT-induced PCOS-like rats were smaller in size and had fewer mature follicles and corpora lutea. EA increased angiogenesis in the antral follicles of PCOS-like rats, which in turn promoted follicle maturation, ovulation, and CL formation. Therefore, endogenous ovarian angiogenesis plays a very important role in follicular maturation and might be one of the peripheral and direct mechanisms of EA on PCOS.

Variant Alleles of the ESR1, PPARG, HMGA2, and MTHFR Genes Are Associated With Polycystic Ovary Syndrome Risk in a Chinese Population: A Case-Control Study

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, with a prevalence of 6-8%. Although the etiology of PCOS has been investigated extensively, the association between genetic predisposition and PCOS risk is largely unknown. In this study, we genotyped 63 SNPs in 10 genes among 361 PCOS patients and 331 healthy controls in a Chinese Han population. The following variant alleles were significantly associated with decreased PCOS risk: ESR1 rs9340799 (P = 0.000), PPARG rs709154 (P = 0.013), and rs1151996 (P = 0.013), HMGA2 rs2272046 (P = 0.000), MTHFR rs1801133 (P = 0.000). Accordingly, the following genotypes at various loci were associated with reduced PCOS risk: GA genotype at rs9340799 (P < 0.0001) in ESR1, TA genotype at rs709154(P < 0.0001) in PPARG and CA genotype at rs2272046 (P < 0.0001) in HMGA2. Moreover, GA genotype at rs1999805 (P = 0.013) in ESR1 and TT genotype at rs1801133 in MTHFR (P < 0.0001) correlated with elevated PCOS risk. Furthermore, haplotype analysis revealed significant differences in haplotype distributions of CYP11A1, ESR2 and PPARG gene between cases and controls. In addition to confirming that ESR1 rs9340799, HMGA2 rs2272046 and MTHFR rs1801133 are related to the risk of PCOS, these findings also provide the first evidence that PPARG rs709154 and ESR1 rs1999805 are significantly associated with PCOS risk in a Chinese population. Further functional studies are warranted to elucidate the underlying biological mechanisms.

Association between vascular endothelial growth factor promoter polymorphisms and the risk of recurrent implantation failure

The objective of the present study was to investigate the association between recurrent implantation failure (RIF) and vascular endothelial growth factor (VEGF) gene polymorphisms that are associated with various female infertility disorders. A total of 116 women diagnosed with RIF and 218 control subjects were genotyped for the VEGF -2578C>A, -1154G>A, -634C>G and 936C>T polymorphisms using a polymerase chain reaction-restriction fragment length polymorphism assay. The VEGF -2578AA genotype was associated with an increased prevalence (≥4) of RIF [adjusted odds ratio (AOR)=2.77; 95% confidence interval (CI)=1.10-7.02; P=0.031], whereas the VEGF -634CG+GG genotype was associated with an increased incidence of total RIF (AOR=2.03; 95% CI=1.02-4.05; P=0.044) and ≥4 RIF (AOR=3.16; 95% CI=1.19-8.37; P=0.021). The results of the haplotype analysis indicated that -2578A/-1154A/-634G/936C (AOR=1.76; 95% CI=1.03-3.00; P=0.040 for total RIF and AOR=2.11; 95% CI=1.12-3.97; P=0.021 for ≥4 RIF) was associated with the occurrence of RIF. In addition, it was revealed that there was a significant difference in serum prolactin level associated with the VEGF -634C>G polymorphism (P=0.013). Therefore the findings of the present study indicate that the VEGF -2578AA genotype, -634G allele and -2578A/-1154A/-634G/936C haplotype may be genetic markers for susceptibility to RIF. However, further studies on VEGF promoter polymorphisms that include an independent randomized-controlled population are required to confirm these results.