نقش التهاب و استرس اکسیداتیو در سبب‌شناسی سندرم تخمدان پلی‌کیستیک: مطالعه مروری

نوع مقاله : مروری

نویسندگان

1 دکتری تخصصی مهندسی بافت، گروه جنین‌شناسی، مرکز تحقیقات پزشکی تولید مثل، پژوهشکده زیست‌شناسی و علوم پزشکی تولید مثل جهاد دانشگاهی، پژوهشگاه رویان، تهران، ایران.

2 کارشناس ارشد مامایی، گروه اندوکرینولوژی و ناباروری زنان، مرکز تحقیقات پزشکی تولید مثل، پژوهشکده زیست‌شناسی و علوم پزشکی تولید مثل جهاد دانشگاهی، پژوهشگاه رویان، تهران، ایران.

3 دکتری تخصصی آناتومی، گروه جنین‌شناسی، مرکز تحقیقات پزشکی تولید مثل، پژوهشکده زیست‌شناسی و علوم پزشکی تولید مثل جهاد دانشگاهی، پژوهشگاه رویان، تهران، ایران.

چکیده

مقدمه: در سال‌های اخیر نقش التهاب و استرس اکسیداتیو در سبب‌شناسی بیماری سندرم تخمدان پلی‌کیستیک بیش از پیش مورد توجه قرار گرفته است. بررسی مطالعات موجود در رابطه با اثرات واسطه‌های التهابی و استرس اکسیداتیو بر عملکرد تخمدان در بیماران مبتلا به PCOS، حاکی از نقش کلیدی این عوامل در پیشرفت و توسعه عوارض بیماری است. مطالعه مروری حاضر با هدف جمع‌بندی حضور و نقش واسطه‌های التهابی مذکور و همچنین تأثیر رویکردهای درمانی اخیر شامل استفاده از مکمل‌های آنتی‌اکسیدانی و عوامل ضدالتهابی در بهبود نتایج چرخه‌های درمان ناباروری در این بیماران انجام شد.
روش‌کار: در این مطالعه مروری جهت یافتن مقالات مرتبط، پایگاه‌های اطلاعاتی PubMed، Science Direct، Scopus و Google Scholar با استفاده از کلمات کلیدی: سندرم تخمدان پلی‌کیستیک، التهاب، استرس اکسیداتیو، رادیکال‌های آزاد اکسیژن، مکمل‌های آنتی‌اکسیدانی، درمان ناباروری، آندروژن‌ها، سیتوکین‌ها و مقاومت به انسولین با استفاده از عملگرهای "AND" و "OR" از ژانویه 1991 تا دسامبر 2020 مورد جستجو قرار گرفتند.
یافته ­ها: پس از بررسی تمامی مقالات در این زمینه مشخص شد PCOS به‌عنوان یک بیماری ژنتیکی و خودایمنی با درجاتی از التهاب همراه است که نقش مهمی در سبب‌شناسی، پیشرفت و بروز بیماری دارد. اختلال در تخمک‌گذاری بیمار، افزایش غلظت رادیکال­ های آزاد اکسیژن در سلول­ های گرانولوزا و همچنین مایع فولیکولی در بیماران PCOS نابارور تحت درمان با تکنیک­ های کمک باروری گزارش شده است.
نتیجه ­گیری: به‌نظر می‌رسد هماهنگی بین سه عامل اصلی دریافت کربوهیدرات بالا از طریق رژیم غذایی، مقاومت به انسولین و هیپرآندروژنیسم را می‌توان آغازگر فرآیند القای التهاب و استرس اکسیداتیو در بیماران PCOS دانست. مکمل­ های آنتی‌اکسیدانی و عوامل ضدالتهابی می‌تواند در بهبود نتایج سیکل‌های درمان ناباروری در این بیماران مفید باشد. با این‌حال، جمع‌بندی نتایج هنوز به مطالعات بیشتری نیاز دارد.

کلیدواژه‌ها

عنوان مقاله [English]

The Role of Inflammation and Oxidative Stress in the Etiology of Polycystic Ovary Syndrome: A Review Article

نویسندگان [English]

  • Nahid Nasiri 1
  • Arezoo Arabipoor 2
  • Poopak Eftekhari-Yazdi 3
1 PhD in Tissue Engineering, Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
2 M.Sc. of Midwifery, Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
3 PhD in Anatomy, Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
چکیده [English]

Introduction: In recent years, the role of inflammation and oxidative stress in the etiology of polycystic ovary syndrome has received more attention. Evaluation of the existing studies regarding the effects of inflammatory mediators and oxidative stress on ovarian function in patients with polycystic ovary syndrome (PCOS) indicates the key role of these factors in the progress and development of disease complications. The current review study was conducted with aim to summarize the presence and role of the aforementioned inflammatory mediators as well as the effect of recent treatment approaches including the use of antioxidant supplements and anti-inflammatory agents in improving the results of infertility treatment cycles in these patients.
Methods: In the present review article, to find the related articles, databases of PubMed, Science Direct, Scopus, and Google Scholar databases were searched with the keywords of polycystic ovary syndrome, inflammation, oxidative stress, oxygen-free radicals, antioxidant supplementation, infertility treatment, androgens, cytokines, and insulin resistance using the "AND" and "OR" operators from January 1991 to December 2020.
Results: After reviewing all the articles in this field, it was found that PCOS, as a genetic and autoimmune disease, is associated with low degrees of inflammation, which plays an important role in the etiology, progression and occurrence of the disease. Moreover, ovulatory dysfunction, increased concentrations of oxygen free radicals in granulosa cells, as well as the follicular fluid of infertile PCOS patients under ART treatment, have been reported.
Conclusion: It seems that the coordination between three main factors, namely high dietary carbohydrate intake, insulin resistance, and hyperandrogenism, can be considered as the initiator for inflammation induction and oxidative stress in PCOS patients. The antioxidant supplements and anti-inflammatory agents can be useful to improve the results of infertility treatment cycles in these patients; however, concluding the results still requires further studies.

کلیدواژه‌ها [English]

  • Antioxidant
  • Assisted reproductive technique
  • Inflammation
  • Oxidative stress
  • Polycystic ovary syndrome

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مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 11
بهمن 1401
صفحه 73-87

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