Polycystic Ovary Syndrome: A Comprehensive Review of Pathogenesis, Management, and Drug Repurposing

International Journal of Molecular Sciences, Journal Year: 2022, Volume and Issue: 23(2), P. 583 - 583

Published: Jan. 6, 2022

Polycystic ovary syndrome (PCOS) is an endocrine-gynecology disorder affecting many women of childbearing age. Although a part the involved mechanism in PCOS occurrence discovered, exact etiology and pathophysiology are not comprehensively understood yet. We searched PubMed for pathogenesis management this article ClinicalTrials.gov information on repurposed medications. All responsible factors behind were thoroughly evaluated. Furthermore, complete commonly prescribed medications summarized through tables. Epigenetics, environmental toxicants, stress, diet as external factors, insulin resistance, hyperandrogenism, inflammation, oxidative obesity internal investigated. Lifestyle modifications complementary alternative medicines preferred first-line therapy cases. Medications, including 3-hydroxy-3-methyl-3-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors, thiazolidinediones, sodium-glucose cotransporter-2 dipeptidyl peptidase-4 glucose-like peptide-1 receptor agonists, mucolytic agents, some supplements have supporting data being PCOS. Since there few completed clinical trials with low population mostly without results medications, it would be helpful to do further research run well-designed subject. Moreover, understanding more about beneficial find new implying effect via novel discovered routes.

Language: Английский

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Controversies in the Pathogenesis, Diagnosis and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism

International Journal of Molecular Sciences, Journal Year: 2022, Volume and Issue: 23(8), P. 4110 - 4110

Published: April 8, 2022

Polycystic ovary syndrome (PCOS) is a heterogeneous and extremely common disease with symptoms that vary the age of patient, typically characterized by hyperandrogenism, chronic oligo-anovulation, and/or several metabolic disorders. The includes various phenotypes, pathogenesis multifactorial, often involving insulin resistance. This feature closely related to ovarian dysfunction, inflammation, disorders, which characterize complicate syndrome. Therapy currently considers both lifestyle improvements medications, must be tailored on case-by-case basis. To date, published studies have not arrived at definition most suitable therapy for each individual case many drugs used are still off-label. In this review, we discuss some controversial diagnostic therapeutic aspects PCOS, such as role resistance, hyperandrogenism. We also evaluated advantages disadvantages contraceptive antiandrogens.

Language: Английский

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Biomechanical forces and signals operating in the ovary during folliculogenesis and their dysregulation: implications for fertility

Human Reproduction Update, Journal Year: 2022, Volume and Issue: 29(1), P. 1 - 23

Published: July 20, 2022

Abstract BACKGROUND Folliculogenesis occurs in the highly dynamic environment of ovary. Follicle cyclic recruitment, neo-angiogenesis, spatial displacement, follicle atresia and ovulation stand out as major events resulting from interplay between mechanical forces molecular signals. Morphological functional changes to growing surrounding tissue are required produce oocytes capable supporting preimplantation development blastocyst stage. OBJECTIVE AND RATIONALE This review will summarize ovarian morphological context that contributes growth ovulation, well acquisition oocyte developmental competence. We describe occurring during folliculogenesis extracellular matrix (ECM) vasculature, their influence on properties tissue, and, turn, regulation signal transduction. Also, we outline how dysregulation might be associated with pathologies such polycystic ovary syndrome (PCOS), endometriosis or premature insufficiency (POI). Finally, for each these three pathologies, highlight therapeutic strategies attempting correct altered biomechanical order restore fertility. SEARCH METHODS For area discussed, a systematic bibliographical search was performed, without temporal limits, using PubMed Central, Web Science Scopus engines employing keywords matrix, mechanobiology, biomechanics, angiogenesis signalling pathway combination with: ovary, oogenesis, oocyte, folliculogenesis, follicle, theca, granulosa, cumulus, follicular fluid, corpus luteum, meiosis, competence, preimplantation, syndrome, endometriosis. OUTCOMES Through queries, yielded total 37 368 papers were further selected based our focus mammals specifically, rodents, bovine, equine, ovine, primates human, also trimmed around specific topic review. After elimination duplicates, this selection process resulted 628 papers, which 287 cited manuscript. Among these, 89.2% published past 22 years, while remaining 8.0%, 2.4% 0.3% 1990s, 1980s before, respectively. During occur ECM composition organization that, together vasculature modelling aimed sustain its recruitment growth, maturation enclosed oocyte. These define scenario key cascades Alterations determine impaired decreased potential, observed pathological conditions causes infertility, PCOS, POI. WIDER IMPLICATIONS The knowledge mechanisms rules govern them lay sound basis explain follicles modulated, stimulate insights develop, clinical practice, improve particularly like

Language: Английский

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Dysregulation of immune response in PCOS organ system

Frontiers in Immunology, Journal Year: 2023, Volume and Issue: 14

Published: May 5, 2023

Polycystic ovary syndrome (PCOS) is the most common reproductive endocrine disorder affecting women, which can lead to infertility. Infertility, obesity, hirsutism, acne, and irregular menstruation are just a few of issues that PCOS be linked to. has complicated pathophysiology range clinical symptoms. Chronic low-grade inflammation one features PCOS. The inflammatory environment involves immune metabolic disturbances. Numerous organ systems across body, in addition female system, have been affected by pathogenic role immunological dysregulation recent years. Insulin resistance hyperandrogenism associated with cell dysfunction cytokine imbalance. More importantly, obesity also involved PCOS, leading an women Hormone, interactions contribute pathogenesis Hormone imbalance may development autoimmune diseases. aim this review summarize pathophysiological various patients provide new ideas for systemic treatment future.

Language: Английский

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Activation and modulation of the AGEs-RAGE axis: Implications for inflammatory pathologies and therapeutic interventions – A review

Pharmacological Research, Journal Year: 2024, Volume and Issue: 206, P. 107282 - 107282

Published: June 22, 2024

Chronic inflammation is a common foundation for the development of many non-communicable diseases, particularly diabetes, atherosclerosis, and tumors. The activation axis involving Advanced Glycation End products (AGEs) their receptor RAGE key promotive factor in chronic process, influencing pathological progression these diseases. accumulation AGEs body results from an increase glycation reactions oxidative stress, especially pronounced individuals with diabetes. By binding to RAGE, activate signaling pathways such as NF-κB, promoting release inflammatory factors, exacerbating cell damage inflammation, further advancing formation atherosclerotic plaques tumor development. This review will delve into molecular mechanisms by which AGEs-RAGE activates aforementioned well strategies inhibit axis, aiming slow or halt related includes inhibitors, antagonists, interventions targeting upstream downstream pathways. Additionally, early detection levels expression biomarkers provides new avenues prevention treatment

Language: Английский

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Hypothalamic-Ovarian axis and Adiposity Relationship in Polycystic Ovary Syndrome: Physiopathology and Therapeutic Options for the Management of Metabolic and Inflammatory Aspects

Current Obesity Reports, Journal Year: 2024, Volume and Issue: 13(1), P. 51 - 70

Published: Jan. 3, 2024

Abstract Purpose of Review The goal the present review is to address main adiposity-related alterations in Polycystic Ovary Syndrome (PCOS) focusing on hypothalamic-pituitary-ovarian (H-P-O) axis and provide an overview nutraceutical pharmacological therapeutic strategies. Recent Findings Female reproduction a complex delicate interplay between neuroendocrine signals involving H-P-O axis. Elements that disrupt balance these interactions can lead metabolic reproductive disorders, such as PCOS. This disorder includes menstrual, metabolic, biochemical abnormalities well hyperandrogenism, oligo-anovulatory menstrual cycles, insulin resistance, hyperleptinemia which share inflammatory state with other chronic diseases. Moreover, self-feeding cycle, high androgen levels PCOS visceral fat deposition, resulting resistance hyperinsulinemia, further stimulating ovarian adrenal production. In fact, regardless age BMI, women have more adipose tissue less lean mass than healthy women. Excessive adiposity, especially capable affecting female through direct mechanisms compromising luteal phase, indirect able affect function Summary intricate crosstalk status contributes PCOS, alongside currently available hormonal treatments, strategies be exploited treat alterations, order enable comprehensive synergistic tailored treatment.

Language: Английский

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A review on critical appraisal and pathogenesis of polycystic ovarian syndrome

Endocrine and Metabolic Science, Journal Year: 2024, Volume and Issue: 14, P. 100162 - 100162

Published: Jan. 30, 2024

Polycystic Ovarian Syndrome (PCOS) is a complex endocrine disorder affecting reproductive-aged women, characterized by clinical manifestations such as hyperandrogenism, menstrual irregularities, and polycystic ovaries. Despite its prevalence impact on women's health, the pathogenesis of PCOS remains incompletely understood. This review provides comprehensive critical appraisal existing literature pathogenesis, addressing knowledge gaps highlighting multifactorial nature. A systematic identified relevant articles published up to cutoff date in 2023, focusing molecular, genetic, hormonal, environmental factors contributing pathogenesis. Electronic databases, including PubMed, MEDLINE, Embase, were systematically searched using predefined terms. Eligible studies investigated associated with The revealed diverse enriching our understanding PCOS. Molecular genetic highlighted alterations signaling pathways, hormonal dysregulation, role insulin resistance. Environmental factors, lifestyle exposure endocrine-disrupting chemicals, implicated. Heterogeneity study designs methodologies underscored need for standardized approaches enhance comparability. synthesizes current evidence emphasizing multifaceted Standardization will facilitate future comparisons, enabling development targeted therapeutic interventions personalized management strategies women affected

Language: Английский

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Advances in the study of the correlation between insulin resistance and infertility

Frontiers in Endocrinology, Journal Year: 2024, Volume and Issue: 15

Published: Jan. 26, 2024

This is a narrative review of the progress research on correlation between insulin resistance and infertility. Insulin (IR) not only involved in development various metabolic diseases, but also affects female reproductive function, to some extent closely related IR may increase risk infertility by activating oxidative stress, interfering with energy metabolism, affecting oocyte development, embryo quality endometrial tolerance, hormone secretion implantation, as well assisted conception outcomes infertile populations reducing success rate technology treatment populations. In addition, associated spontaneous abortion, gestational diabetes other adverse pregnancies, if corrected time, obesity diseases offspring long term. article provides relationship provide new ideas for

Language: Английский

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Ovarian microenvironment: challenges and opportunities in protecting against chemotherapy-associated ovarian damage

Human Reproduction Update, Journal Year: 2024, Volume and Issue: 30(5), P. 614 - 647

Published: June 28, 2024

Chemotherapy-associated ovarian damage (CAOD) is one of the most feared short- and long-term side effects anticancer treatment in premenopausal women. Accumulating detailed data show that different chemotherapy regimens can lead to disturbance hormone levels, reduced or lost fertility, an increased risk early menopause. Previous studies have often focused on direct chemotherapeutic drugs follicles, such as DNA damage-mediated apoptotic death primordial follicle burnout. Emerging evidence has revealed imbalance microenvironment during chemotherapy. The provides nutritional support transportation signals stimulate growth development ovulation, corpus luteum formation. close interaction between follicles determine function. Therefore, designing novel precise strategies manipulate may be a new strategy protect function

Language: Английский

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The Role of Lifestyle Interventions in PCOS Management: A Systematic Review

Nutrients, Journal Year: 2025, Volume and Issue: 17(2), P. 310 - 310

Published: Jan. 16, 2025

Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine disorders among reproductive-aged women. It characterized by hyperandrogenism, anovulation, and polycystic ovaries. Lifestyle changes are suggested as first-line interventions in managing PCOS. This systematic review aims to assess scientific evidence regarding role lifestyle modifications (dietary changes, physical activity, behavioral changes) improving reproductive, anthropometric, metabolic, psychological outcomes women with Dietary such foods low glycemic index scores; caloric restrictions; high-fiber, omega three fatty acid-rich diets; ketogenic Mediterranean antioxidant-rich food; anti-inflammatory diets improve insulin sensitivity hormonal balance Physical like aerobic resistance exercise, enhances sensitivity, helps weight loss, improves metabolic reproductive Further, education modules can also be used awareness, adherence, effectiveness conventional treatment manage mental health issues related Collectively, not only biochemical, hormonal, anthropometric parameters PCOS patients but reduce long-term risks cardiovascular diseases.

Language: Английский

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