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Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS

The presence of abnormal ovarian ratios of myo-inositol (MI) to D-chiro-inositol (DCI) is a recurrent feature in PCOS. Available evidence suggests that MI and DCI may modulate steroid biosynthesis, likely in an opposite manner. Specifically, MI seems to induce estrogen production, while DCI has a ro...

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Autores principales: Unfer, Vittorio, Dinicola, Simona, Laganà, Antonio Simone, Bizzarri, Mariano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7582282/
https://www.ncbi.nlm.nih.gov/pubmed/32998310
http://dx.doi.org/10.3390/ijms21197157
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author Unfer, Vittorio
Dinicola, Simona
Laganà, Antonio Simone
Bizzarri, Mariano
author_facet Unfer, Vittorio
Dinicola, Simona
Laganà, Antonio Simone
Bizzarri, Mariano
author_sort Unfer, Vittorio
collection PubMed
description The presence of abnormal ovarian ratios of myo-inositol (MI) to D-chiro-inositol (DCI) is a recurrent feature in PCOS. Available evidence suggests that MI and DCI may modulate steroid biosynthesis, likely in an opposite manner. Specifically, MI seems to induce estrogen production, while DCI has a role in the synthesis of androgens. Elevated insulin levels, generally associated with PCOS, alter the physiological MI/DCI ratio, increasing MI-to-DCI conversion through activation of a specific epimerase enzyme. DCI directly increases testosterone biosynthesis in thecal cells and reduces its conversion to estradiol by downregulating aromatase enzyme in granulosa cells. This manuscript reviews the literature that supports the connection between altered MI/DCI ratios and pathological steroidogenesis observed in PCOS women. Furthermore, it discusses the application of inositol-based treatment protocols in managing PCOS symptoms and improving the quality of patients’ life.
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spelling pubmed-75822822020-10-28 Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS Unfer, Vittorio Dinicola, Simona Laganà, Antonio Simone Bizzarri, Mariano Int J Mol Sci Review The presence of abnormal ovarian ratios of myo-inositol (MI) to D-chiro-inositol (DCI) is a recurrent feature in PCOS. Available evidence suggests that MI and DCI may modulate steroid biosynthesis, likely in an opposite manner. Specifically, MI seems to induce estrogen production, while DCI has a role in the synthesis of androgens. Elevated insulin levels, generally associated with PCOS, alter the physiological MI/DCI ratio, increasing MI-to-DCI conversion through activation of a specific epimerase enzyme. DCI directly increases testosterone biosynthesis in thecal cells and reduces its conversion to estradiol by downregulating aromatase enzyme in granulosa cells. This manuscript reviews the literature that supports the connection between altered MI/DCI ratios and pathological steroidogenesis observed in PCOS women. Furthermore, it discusses the application of inositol-based treatment protocols in managing PCOS symptoms and improving the quality of patients’ life. MDPI 2020-09-28 /pmc/articles/PMC7582282/ /pubmed/32998310 http://dx.doi.org/10.3390/ijms21197157 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Unfer, Vittorio
Dinicola, Simona
Laganà, Antonio Simone
Bizzarri, Mariano
Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS
title Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS
title_full Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS
title_fullStr Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS
title_full_unstemmed Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS
title_short Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS
title_sort altered ovarian inositol ratios may account for pathological steroidogenesis in pcos
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7582282/
https://www.ncbi.nlm.nih.gov/pubmed/32998310
http://dx.doi.org/10.3390/ijms21197157
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