慢性炎症及代谢与多囊卵巢综合征及其相关治疗的研究进展
Research Progress on Chronic Inflammation and Polycystic Ovary Syndrome and Related Treatments
DOI: 10.12677/acm.2024.1441190, PDF,   
作者: 王明伟:济宁医学院临床医学院,山东 济宁;姚红梅*:济宁医学院附属医院,山东 济宁
关键词: 多囊卵巢综合征炎症治疗Polycystic Ovary Syndrome Inflammation Therapy
摘要: 多囊卵巢综合征(Polycystic Ovary Syndrome, PCOS)是育龄期女性最常见的内分泌代谢紊乱疾病,以排卵障碍、高雄激素血症及卵巢多囊样改变为特征,主要临床表现为月经不规律、不孕、多毛和/或痤疮等。虽然PCOS的发病机制尚不清楚,但是其与低度慢性炎症密切相关。本研究对外周血炎症、卵巢炎症、子宫内膜炎症与PCOS的发病机制的关系,以及炎症因子、肥胖、胰岛素抵抗和高雄激素血症之间的相互作用和其相关的治疗方法进行总结。
Abstract: Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder in women of childbearing age, characterized by ovulation disorders, hyperandrogenism, and polycystic ovary like changes. The main clinical manifestations include irregular menstruation, infertility, hirsutism, and/or acne. Although the pathogenesis of PCOS is still unclear, it is closely related to low-grade chronic inflammation. This study summarizes the relationship between peripheral blood inflammation, ovarian inflammation, endometritis, and the pathogenesis of PCOS, as well as the interaction and related treatment methods between inflammatory factors, obesity, insulin resistance, and hyperandrogenism.
文章引用:王明伟, 姚红梅. 慢性炎症及代谢与多囊卵巢综合征及其相关治疗的研究进展[J]. 临床医学进展, 2024, 14(4): 1547-1554. https://doi.org/10.12677/acm.2024.1441190

参考文献

[1] Shrivastava, S. and Conigliaro, R.L. (2023) Polycystic Ovarian Syndrome. The Medical Clinics of North America, 107, 227-234. [Google Scholar] [CrossRef] [PubMed]
[2] Li, R., Zhang, Q., Yang, D., et al. (2013) Prevalence of Polycystic Ovary Syndrome in Women in China: A Large Community-Based Study. Human Reproduction, 28, 2562-2569. [Google Scholar] [CrossRef] [PubMed]
[3] Patel, S. (2018) Polycystic Ovary Syndrome (PCOS), an Inflammatory, Systemic, Lifestyle Endocrinopathy. The Journal of Steroid Biochemistry and Molecular Biology, 182, 27-36. [Google Scholar] [CrossRef] [PubMed]
[4] Dabravolski, S.A., Nikiforov, N.G., Eid, A.H., et al. (2021) Mitochondrial Dysfunction and Chronic Inflammation in Polycystic Ovary Syndrome. International Journal of Molecular Sciences, 22, Article 3923. [Google Scholar] [CrossRef] [PubMed]
[5] Pang, Y., Wu, L., Tang, C., et al. (2022) Autophagy-Inflammation Interplay during Infection: Balancing Pathogen Clearance and Host Inflammation. Frontiers in Pharmacology, 13, Article 832750. [Google Scholar] [CrossRef] [PubMed]
[6] Metsios, G.S., Moe, R.H. and Kitas, G.D. (2020) Exercise and Inflammation. Best Practice & Research. Clinical Rheumatology, 34, Article ID: 101504. [Google Scholar] [CrossRef] [PubMed]
[7] Shamsi, M., Ghazavi, A., Saeedifar, A.M., et al. (2022) The Immune System’s Role in PCOS. Molecular Biology Reports, 49, 10689-10702. [Google Scholar] [CrossRef] [PubMed]
[8] Kakoly, N.S., Khomami, M.B., Joham, A.E., et al. (2018) Ethnicity, Obesity and the Prevalence of Impaired Glucose Tolerance and Type 2 Diabetes in PCOS: A Systematic Review and Meta-Regression. Human Reproduction Update, 24, 455-467. [Google Scholar] [CrossRef] [PubMed]
[9] Sadeghi, H.M., Adeli, I., Calina, D., et al. (2022) Polycystic Ovary Syndrome: A Comprehensive Review of Pathogenesis, Management, and Drug Repurposing. International Journal of Molecular Sciences, 23, Article 583. [Google Scholar] [CrossRef] [PubMed]
[10] Xing, C., Li, C. and He, B. (2020) Insulin Sensitizers for Improving the Endocrine and Metabolic Profile in Overweight Women with PCOS. The Journal of Clinical Endocrinology and Metabolism, 105, 2950-2963. [Google Scholar] [CrossRef] [PubMed]
[11] Garzia, E., Galiano, V., Marfia, G., et al. (2022) Hyperandrogenism and Menstrual Imbalance Are the Best Predictors of Metformin Response in PCOS Patients. Reproductive Biology and Endocrinology, 20, Article No. 6. [Google Scholar] [CrossRef] [PubMed]
[12] Khichar, A., Gupta, S., Mishra, S., et al. (2021) Assessment of Inflammatory Markers in Women with PCOS and Their Correlation with Insulin Resistance. Clinical Laboratory, 67, 2439-2446. [Google Scholar] [CrossRef
[13] Mohammadian Khonsari, N., Baygi, F., Tabatabaei-Malazy, O., et al (2023) Association of Normal Weight Obesity Phenotype with Inflammatory Markers: A Systematic Review and Meta-Analysis. Frontiers in Immunology, 14, Article 1044178. [Google Scholar] [CrossRef] [PubMed]
[14] Stokkeland, L., Giskeødegård, G.F., Ryssdal, M., et al. (2022) Changes in Serum Cytokines throughout Pregnancy in Women with Polycystic Ovary Syndrome. The Journal of Clinical Endocrinology and Metabolism, 107, 39-52. [Google Scholar] [CrossRef] [PubMed]
[15] Abraham Gnanadass, S., Divakar Prabhu, Y. and Valsala Gopalakrishnan, A. (2021) Association of Metabolic and Inflammatory Markers with Polycystic Ovarian Syndrome (PCOS): An Update. Archives of Gynecology and Obstetrics, 303, 631-643. [Google Scholar] [CrossRef] [PubMed]
[16] He, S., Mao, X., Lei, H., et al. (2020) Peripheral Blood Inflammatory-Immune Cells as a Predictor of Infertility in Women with Polycystic Ovary Syndrome. Journal of Inflammation Research, 13, 441-450. [Google Scholar] [CrossRef
[17] ALhabardi, N.A., Al-Wutayd, O., Eltayieb, K.M., et al. (2020) Peripheral Hematological Parameters in Women with Polycystic Ovary Syndrome. The Journal of International Medical Research, 48, 1-6. [Google Scholar] [CrossRef] [PubMed]
[18] Gonzalez, F., Thusu, K., Abdel-Rahman, E., et al. (1999) Elevated Serum Levels of Tumor Necrosis Factor α in Normal-Weight Women with Polycystic Ovary Syndrome. Metabolism: Clinical and Experimental, 48, 437-441. [Google Scholar] [CrossRef
[19] Rudnicka, E., Kunicki, M., Suchta, K., et al. (2020) Inflammatory Markers in Women with Polycystic Ovary Syndrome. BioMed Research International, 2020, Article ID: 4092470. [Google Scholar] [CrossRef] [PubMed]
[20] Velez, L., M., Seldin, M. and Motta, A.B. (2021) Inflammation and Reproductive Function in Women with Polycystic Ovary Syndrome. Biology of Reproduction, 104, 1205-1217. [Google Scholar] [CrossRef] [PubMed]
[21] Yu, Y., Li, G., He, X., et al. (2021) MicroRNA-21 Regulate the Cell Apoptosis and Cell Proliferation of Polycystic Ovary Syndrome (PCOS) Granulosa Cells through Target Toll Like Receptor TLR8. Bioengineered, 12, 5789-5796. [Google Scholar] [CrossRef] [PubMed]
[22] Yan, S., Ding, J., Zhang, Y., et al. (2021) C1QTNF6 Participates in the Pathogenesis of PCOS by Affecting the Inflammatory Response of Granulosa Cells. Biology of Reproduction, 105, 427-438. [Google Scholar] [CrossRef] [PubMed]
[23] Lai, Y., Ye, Z., Mu, L., et al. (2022) Elevated Levels of Follicular Fatty Acids Induce Ovarian Inflammation via ERK1/2 and Inflammasome Activation in PCOS. The Journal of Clinical Endocrinology and Metabolism, 107, 2307-2317. [Google Scholar] [CrossRef] [PubMed]
[24] Liu, Y., Liu, H., Li, Z., et al. (2021) The Release of Peripheral Immune Inflammatory Cytokines Promote an Inflammatory Cascade in PCOS Patients via Altering the Follicular Microenvironment. Frontiers in Immunology, 12, Article ID: 685724. [Google Scholar] [CrossRef] [PubMed]
[25] Liu, Y., Li, Z., Wang, Y., et al. (2022) IL-15 Participates in the Pathogenesis of Polycystic Ovary Syndrome by Affecting the Activity of Granulosa Cells. Frontiers in Endocrinology, 13, Article 787876. [Google Scholar] [CrossRef] [PubMed]
[26] Ullah, A., Wang, M.J., Yang, J.P., et al. (2022) Ovarian Inflammatory MRNA Profiles of a Dehydroepiandrosterone plus High-Fat Diet-Induced Polycystic Ovary Syndrome Mouse Model. Reproductive Biomedicine Online, 44, 791-802. [Google Scholar] [CrossRef] [PubMed]
[27] Critchley, H., Maybin, J.A., Armstrong, G.M., et al. (2020) Physiology of the Endometrium and Regulation of Menstruation. Physiological Reviews, 100, 1149-1179. [Google Scholar] [CrossRef] [PubMed]
[28] Aksak, T., Gümürdülü, D., Çetin, M.T., et al. (2021) Expression of Monocyte Chemotactic Protein 2 and Tumor Necrosis Factor α in Human Normal Endometrium and Endometriotic Tissues. Journal of Gynecology Obstetrics and Human Reproduction, 50, Article ID: 101971. [Google Scholar] [CrossRef] [PubMed]
[29] Long, X., Li, R., Yang, Y., et al. (2017) Overexpression of IL-18 in the Proliferative Phase Endometrium of Patients with Polycystic Ovary Syndrome. Reproductive Sciences, 24, 252-257. [Google Scholar] [CrossRef] [PubMed]
[30] Peng, F., Hu, Y., Peng, S., et al. (2022) Apigenin Exerts Protective Effect and Restores Ovarian Function in Dehydroepiandrosterone Induced Polycystic Ovary Syndrome Rats: A Biochemical and Histological Analysis. Annals of Medicine, 54, 578-587. [Google Scholar] [CrossRef] [PubMed]
[31] Mousavi, R., Alizadeh, M., Asghari Jafarabadi, M., et al. (2022) Effects of Melatonin and/or Magnesium Supplementation on Biomarkers of Inflammation and Oxidative Stress in Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial. Biological Trace Element Research, 200, 1010-1019. [Google Scholar] [CrossRef] [PubMed]
[32] Areloegbe, S.E., Peter, M.U., Oyeleke, M.B., et al. (2022) Low-Dose Spironolactone Ameliorates Adipose Tissue Inflammation and Apoptosis in Letrozole-Induced PCOS Rat Model. BMC Endocrine Disorders, 22, Article No. 224. [Google Scholar] [CrossRef] [PubMed]
[33] Ullah, A., Pervaz, S., Adu-Gyamfi, E.A,, et al. (2022) CXCL13, and, CXCR5, Are, Upregulated, in, PCOS, Mice, Ovaries, But, Downregulated Following Metformin Administration. Molecular and Cellular Endocrinology, 556, Article ID: 111730. [Google Scholar] [CrossRef] [PubMed]
[34] Ryssdal, M., Vanky, E., Stokkeland, L., et al. (2023) Immunomodulatory Effects of Metformin Treatment in Pregnant Women with PCOS. The Journal of Clinical Endocrinology and Metabolism, 108, e743-e753. [Google Scholar] [CrossRef] [PubMed]
[35] Liang, Y., Xu, M.L., Gao, X., et al. (2023) Resveratrol Improves Ovarian State by Inhibiting Apoptosis of Granulosa Cells. Gynecological Endocrinology, 39, 2181652. [Google Scholar] [CrossRef] [PubMed]
[36] Ji, X., Ye, Y., Wang, L., et al. (2023) PDE4 Inhibitor Roflumilast Modulates Inflammation and Lipid Accumulation in PCOS Mice to Improve Ovarian Function and Reduce DHEA-Induced Granulosa Cell Apoptosis in Vitro. Drug Development Research, 84, 226-237. [Google Scholar] [CrossRef] [PubMed]
[37] Izadi, M., Rezvani, M.E., Aliabadi, A., et al. (2022) Mesenchymal Stem Cells-Derived Exosomes as a Promising New Approach for the Treatment of Infertility Caused by Polycystic Ovary Syndrome. Frontiers in Pharmacology, 13, Article 1021581. [Google Scholar] [CrossRef] [PubMed]
[38] Ibrahim, M., Sadek, M.T. and Sharaf Eldin, H. (2022) Role of Pomegranate Extract in Restoring Endometrial Androgen Receptor Expression, Proliferation, and Pinopodes in a Rat Model of Polycystic Ovary Syndrome. Morphologie, 106, 145-154. [Google Scholar] [CrossRef] [PubMed]
[39] Dokuzeylül, Güngör, N., Güngör, K., Yurci, A., et al. (2022) Ovarian Drilling Down-Regulates Endometrial Nuclear Factor-κB P65 Expression in Women with PCOS: A Prospective Case-Control Study. Turkish Journal of Obstetrics and Gynecology, 19, 45-50. [Google Scholar] [CrossRef] [PubMed]
[40] Escobar-Morreale, H.F. (2012) Surgical Management of Metabolic Dysfunction in PCOS. Steroids, 77, 312-316. [Google Scholar] [CrossRef] [PubMed]
[41] Hu, L., Ma, L., Xia, X., et al. (2022) Efficacy of Bariatric Surgery in the Treatment of Women with Obesity and Polycystic Ovary Syndrome. The Journal of Clinical Endocrinology and Metabolism, 107, e3217-e3229. [Google Scholar] [CrossRef] [PubMed]
[42] Wang, X., Xu, T., Liu, R., et al. (2022) High-Fiber Diet Or Combined with Acarbose Alleviates Heterogeneous Phenotypes of Polycystic Ovary Syndrome by Regulating Gut Microbiota. Frontiers in Endocrinology, 12, Article 806331. [Google Scholar] [CrossRef] [PubMed]
[43] Elbandrawy, A.M., Yousef, A.M., Morgan, E.N., et al. (2022) Effect of Aerobic Exercise on Inflammatory Markers in Polycystic Ovary Syndrome: A Randomized Controlled Trial. European Review for Medical and Pharmacological Sciences, 26, 3506-3513.
[44] Pandit, U., Singh, M., Ranjan, R., et al. (2022) The Effect of Exercise Training on Body Composition, Insulin Resistance and High Sensitivity C-Reactive Protein (Hs-CRP) in Women with Polycystic Ovary Syndrome: A Pilot Study from North India. Cureus, 14, e23994. [Google Scholar] [CrossRef] [PubMed]