Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls

Journal of the Endocrine Society, Год журнала: 2019, Номер 3(8), С. 1545 - 1573

Опубликована: Июнь 14, 2019

Abstract Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by hyperandrogenism and chronic anovulation. Depending on diagnostic criteria, 6% to 20% of reproductive aged women are affected. Symptoms PCOS arise during the early pubertal years. Both normal female development irregular menstrual cycles, anovulation, acne. Owing complicated interwoven pathophysiology, discerning inciting causes challenging. Most available clinical data communicate findings outcomes in adult women. Whereas Rotterdam criteria accepted for women, different adolescent girls have been delineated. Diagnostic features irregularity, hyperandrogenism, and/or hyperandrogenemia. Pelvic ultrasound not needed diagnosis girls. Even before definitive PCOS, adolescents with signs androgen excess oligomenorrhea/amenorrhea, can be regarded as being “at risk PCOS.” Management both those at confirmed includes education, healthy lifestyle interventions, therapeutic interventions targeting their symptoms. Interventions include metformin, combined oral contraceptive pills, spironolactone, local treatments hirsutism In addition ascertaining associated comorbidities, management should also regular follow-up visits planned transition care providers. Comprehensive knowledge regarding pathogenesis will enable earlier identification high propensity develop PCOS. Timely implementation individualized improve overall adolescence, prevent quality life.

Язык: Английский

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Semaglutide lowers body weight in rodents via distributed neural pathways

JCI Insight, Год журнала: 2020, Номер 5(6)

Опубликована: Март 25, 2020

Semaglutide, a glucagon-like peptide 1 (GLP-1) analog, induces weight loss, lowers glucose levels, and reduces cardiovascular risk in patients with diabetes. Mechanistic preclinical studies suggest loss is mediated through GLP-1 receptors (GLP-1Rs) the brain. The findings presented here show that semaglutide modulated food preference, reduced intake, caused without decreasing energy expenditure. Semaglutide directly accessed brainstem, septal nucleus, hypothalamus but did not cross blood-brain barrier; it interacted brain circumventricular organs several select sites adjacent to ventricles. induced central c-Fos activation 10 areas, including hindbrain areas targeted by semaglutide, secondary direct GLP-1R interaction, such as lateral parabrachial nucleus. Automated analysis of access, activity, distribution, connectivity revealed may involve meal termination controlled neurons Transcriptomic microdissected from semaglutide-treated rats showed upregulation prolactin-releasing hormone tyrosine hydroxylase area postrema. We body interaction diverse populations indirectly affecting activity neural pathways involved reward,

Язык: Английский

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Glucose transporters in brain in health and disease

Pflügers Archiv - European Journal of Physiology, Год журнала: 2020, Номер 472(9), С. 1299 - 1343

Опубликована: Авг. 13, 2020

Abstract Energy demand of neurons in brain that is covered by glucose supply from the blood ensured transporters capillaries and cells. In brain, facilitative diffusion GLUT1-6 GLUT8, Na + - d -glucose cotransporters SGLT1 are expressed. The mediate uptake across blood-brain barrier delivery to astrocytes neurons. They critically involved regulatory adaptations varying energy demands response differing neuronal activities supply. this review, a comprehensive overview about verified proposed roles cerebral during health diseases presented. Our current knowledge mainly based on experiments performed rodents. First, functional properties human expressed their locations described. Thereafter, physiological functions GLUT1, GLUT2, GLUT3, GLUT4, for neurons, sensing, central regulation glucohomeostasis, feeding behavior compiled, learning memory formation discussed. addition, described which changes relevant. These GLUT1 deficiency syndrome (GLUT1-SD), diabetes mellitus, Alzheimer’s disease (AD), stroke, traumatic injury (TBI). GLUT1-SD caused defect mutations GLUT1. Diabetes AD associated with changed expression transporter-related may contribute pathogenesis AD. Stroke TBI transporter influence clinical outcome.

Язык: Английский

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Elevated prenatal anti-Müllerian hormone reprograms the fetus and induces polycystic ovary syndrome in adulthood

Nature Medicine, Год журнала: 2018, Номер 24(6), С. 834 - 846

Опубликована: Май 11, 2018

Язык: Английский

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Astrocytes: Role and Functions in Brain Pathologies

Frontiers in Pharmacology, Год журнала: 2019, Номер 10

Опубликована: Сен. 27, 2019

Astrocytes are a population of cells with distinctive morphological and functional characteristics that differ within specific areas the brain. Postnatally, astrocytes progenitors migrate to reach their brain area related properties. They have regulatory role functions: implicated in neurogenesis, synaptogenesis, controlling blood-brain barrier permeability maintaining extracellular homeostasis. Mature also express some genes enriched cell progenitors, suggesting they can retain proliferative potential. Considering heterogeneity population, it is not surprising disorders wide range different neuro-pathologies. Brain diseases characterized by active inflammatory state astrocytes, which usually described as up-regulation glial fibrillary acidic protein (GFAP). In particular, loss function result cellular senescence could implications for neurodegenerative disorders, such Alzheimer disease Huntington disease, aging drive induction progression due Ca2+ signals strongly severity/state. Moreover, contribute altered neuronal activity several frontal cortex pathologies ischemic stroke epilepsy. There we describe current knowledge pertaining discuss possibilities target them approach toward pharmacological therapies

Язык: Английский

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Role of astrocytes, microglia, and tanycytes in brain control of systemic metabolism

Nature Neuroscience, Год журнала: 2018, Номер 22(1), С. 7 - 14

Опубликована: Ноя. 30, 2018

Язык: Английский

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Leptin as a key regulator of the adipose organ

Reviews in Endocrine and Metabolic Disorders, Год журнала: 2021, Номер 23(1), С. 13 - 30

Опубликована: Сен. 14, 2021

Abstract Leptin is a hormone primarily produced by the adipose tissue in proportion to size of fat stores, with primary function control lipid reserves. Besides tissue, leptin also other tissues, such as stomach, placenta, and mammary gland. Altogether, exerts broad spectrum short, medium, long-term regulatory actions at central peripheral levels, including metabolic programming effects that condition proper development organ, which are relevant for its main role energy homeostasis. Comprehending how regulates may provide important clues understand pathophysiology obesity related diseases, type 2 diabetes, well prevention treatment. This review focuses on physiological long-lasting mechanisms pathways involved, outcomes whole-body homeostasis, consequences chronic diseases.

Язык: Английский

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Radial glia in the zebrafish brain: Functional, structural, and physiological comparison with the mammalian glia

Glia, Год журнала: 2020, Номер 68(12), С. 2451 - 2470

Опубликована: Май 31, 2020

The neuroscience community has witnessed a tremendous expansion of glia research. Glial cells are now on center stage with leading roles in the development, maturation, and physiology brain circuits. Over course evolution, have highly diversified include radial glia, astroglia or astrocytes, microglia, oligodendrocytes, ependymal cells, each having dedicated functions brain. zebrafish, small teleost fish, is no exception to this recent evidences point evolutionarily conserved for development its nervous system. Due size, transparency, genetic amenability, zebrafish become an increasingly prominent animal model It enabled study neural circuits from individual entire brains, precision unmatched other vertebrate models. Moreover, high neurogenic regenerative potential attracted lot attention research focusing stem neurodegenerative diseases. Hence, studies using provide fundamental insights about function, also elucidate molecular mechanisms neurological We will discuss here discoveries diverse neurogenesis, modulating neuronal activity regulating homeostasis at barriers. By comparing made various models, particularly mammals our goal highlight similarities differences biology among species, which could set new paradigms relevant humans.

Язык: Английский

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Hypothalamic control of energy expenditure and thermogenesis

Experimental & Molecular Medicine, Год журнала: 2022, Номер 54(4), С. 358 - 369

Опубликована: Март 17, 2022

Abstract Energy expenditure and energy intake need to be balanced maintain proper homeostasis. homeostasis is tightly regulated by the central nervous system, hypothalamus primary center for regulation of balance. The exerts its effect through both humoral neuronal mechanisms, each hypothalamic area has a distinct role in expenditure. Recent studies have advanced understanding molecular thermogenesis with targeted manipulation techniques mouse genome function. In this review, we elucidate recent progress mechanism how affects basal metabolism, modulates physical activity, adapts environmental temperature food changes.

Язык: Английский

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The physiological control of eating: signals, neurons, and networks

Physiological Reviews, Год журнала: 2021, Номер 102(2), С. 689 - 813

Опубликована: Сен. 6, 2021

During the past 30 yr, investigating physiology of eating behaviors has generated a truly vast literature. This is fueled in part by dramatic increase obesity and its comorbidities that coincided with an ever increasing sophistication genetically based manipulations. These techniques have produced results remarkable degree cell specificity, particularly at signaling level, played lead role advancing field. However, putting these findings into brain-wide context connects physiological signals neurons to behavior somatic requires thorough consideration neuronal connections: field also seen extraordinary technological revolution. Our goal present comprehensive balanced assessment how associated energy homeostasis interact many brain levels control behaviors. A major theme engage sets interacting neural networks throughout are defined specific connections. We begin discussing some fundamental concepts, including ones still engender vigorous debate, provide necessary frameworks for understanding controls meal initiation termination. include key word definitions, ATP availability as pivotal regulated variable homeostasis, neuropeptide signaling, homeostatic hedonic eating, structure. Within this context, we discuss network models regions endbrain (or telencephalon), hypothalamus, hindbrain, medulla, vagus nerve, spinal cord work together gastrointestinal tract enable complex motor events permit animals eat diverse situations.

Язык: Английский

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