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.

Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS / Unfer, Vittorio; Dinicola, Simona; Laganà, Antonio Simone; Bizzarri, Mariano. - In: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES. - ISSN 1422-0067. - 21:19(2020), pp. 1-9. [10.3390/ijms21197157]

Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS

Unfer, Vittorio;Dinicola, Simona;Bizzarri, Mariano
Conceptualization
2020

Abstract

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.
2020
D-chiro-inositol; PCOS; myo-inositol; steroidogenesis
01 Pubblicazione su rivista::01a Articolo in rivista
Altered Ovarian Inositol Ratios May Account for Pathological Steroidogenesis in PCOS / Unfer, Vittorio; Dinicola, Simona; Laganà, Antonio Simone; Bizzarri, Mariano. - In: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES. - ISSN 1422-0067. - 21:19(2020), pp. 1-9. [10.3390/ijms21197157]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1682460
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