Is PCOS an inflammatory process?

Abstract

PRO-- PCOS is associated with low-grade systemic inflammation as evidenced by elevation of multiple markers of inflammation such as C-reactive protein, interleukin-18, monocyte chemoattractant protein-1 and white blood count as well as endothelial dysfunction and increased oxidative stress. CON-- The evidence in support of the presence of chronic inflammatory state in the majority of women with PCOS is incontrovertible. It is apparent that PCOS is associated with a significant elevation of multiple markers of inflammation including CRP, IL-18, MCP-1, and white blood count. Furthermore, PCOS is associated with other derangements associated with inflammation such as increased oxidative stress and endothelial dysfunction. While the etiology of systemic inflammation in PCOS remains unclear, recent data raise the intriguing possibility of a link between PCOS, inflammation and chronic low grade infectious agents such as Chlamydia pneumoniae, Helicobacter pylori and pathogens inducing periodontal inflammation.

Evaluation of Oxidative Stress and hsCRP in Polycystic Ovarian Syndrome in a Tertiary Care Hospital

“…Oxidative stress and chronic inflammation are closely inter-related. A vicious cycle exists whereby inflammation induces generation of ROS, while oxidative stress promotes and aggravates inflammation [23].…”

The effect of serum and follicular fluid amyloid-associated protein levels on in vitro fertilization outcome in patients with polycystic ovary syndrome

“…Fat accumulation on the trunk and in visceral depots has been reported in women with PCOS regardless of BMI [20]. The visceral adipocytes exert these effects in a paracrine and endocrine manner via the secretion of adipokines into the circulation, many of which increase inflammation [4,6]. The link between inflammation and metabolic disorders was first recognized by Hotamisligil et al who demonstrated that adipocytes express the pro-inflammatory cytokine TNF-α and TNF-α expression is markedly increased in adipocytes of obese mice [21].…”

“…Adipose tissue is thought to play a key role in endocrine and metabolic control, creating a range of adipokines into the circulation, many of which increase inflammation [4]. Serum concentrations of high-sensitive C-reactive protein (hs-CRP), interleukin-18, monocyte chemoattractant protein-1 (MCP-1), and macrophage inflammatory protein-1a (MIP-1a) are found to be elevated in PCOS [5,6].…”

“…Cytokine function in the ovary has been demonstrated as promoting processes of follicular growth, steroidogenesis, recruitment, and activation of leukocytes necessary for ovulation and tissue remodeling during ovulation, luteinization, and luteolysis [6]. Some of the cytokines such as interleukin (IL)-12 influence oocyte fertilization and embryo quality, while others, such as IL-1, IL-8, and IL-18 were found to be correlated successfully with pregnancy rate in IVF treatment [7][8][9].…”

MECHANISMS IN ENDOCRINOLOGY: Nutrition as a mediator of oxidative stress in metabolic and reproductive disorders in women

“…Its etiopathophysiological core remains vague; however, gonadotropin-secretory alterations, androgen excess, insulin resistance and low-grade inflammation, in conjunction with the pivotal contribution of genetic and environmental parameters, are all involved in the interplay net of the syndrome (176,177). Recently, oxidative stress has also been highlighted as another potent modulator of PCOS (178,179).…”