高雄激素相关的慢性炎症与多囊卵巢综合征的研究进展

Advances in Hyperandrogen-associated Chronic Inflammation and Polycystic Ovary Syndrome

多囊卵巢综合征是育龄妇女常见的慢性炎症代谢性疾病,70%以上患者出现高雄激素血症。下丘脑-垂体-性腺相关激素是月经周期和卵巢活动的调节器,脑神经元分泌的Kisspeptin、褪黑素通过下丘脑-垂体-卵巢轴调节Gn RH神经元AMH、Gn RH的表达,卵巢促性腺激素、雄激素水平增高,有利于慢性炎症的形成,促进多囊卵巢综合征的发生发展。本文综述了近几年多囊卵巢综合征中雄激素相关的慢性炎症研究,并根据相关研究提出了一些见解,希望能为多囊卵巢综合征的研究提供一些新的思路。

Polycystic ovary syndrome(PCOS)is a common chronic inflammatory metabolic disease in women of reproductive age,and is considered as a potential risk factor for infertility because it is often characterized by insufficient or non-ovulation,and over 70%of patients suffer from hyperandrogenemia.High androgen levels not only inhibit follicular growth,promote premature luteinization of follicles,hinder the selection of dominant follicles,but also induce the formation of inflammation,which is an important factor for PCOS to maintain chronic inflammatory state.Abnormally high LH pulses reflect the overactivity of GnRH neural circuit,reflecting the neuroendocrine basis of the etiology or phenotype of PCOS.Kisspeptin secreted by brain neurons not only promotes androgen-related chronic inflammation by activating GnRH,but also directly inhibits the production of NK cells,such as IL-4,IL-10,and IFN.Melatonin reduces androgen levels,inhibits inflammatory factors and improves oocyte quality through the extracellular signal-regulated kinase pathway of granulosa cells.C1QTNF6,a newly identified inflammatory adiponectin byproduct,affects inflammatory responses through the AKT/NF-κB signaling pathway and may be a good new diagnostic target of PCOS.This paper reviewed the relationship between neuro-endocrine regulation and inflammatory factors,and found that the upstream nerve of hypothalamus can promote the formation of hyperandrogenemia by regulating the hypothalamic-pituitary-gonad axis,which leads to the occurrence of inflammation and participate in the occurrence and development of PCOS.Meanwhile,melatonin,GNRH-AAB and C1QTNF6 may be new targets for the treatment or diagnosis of PCOS.It is hoped that this can provide some new ideas for the research of PCOS.