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多囊卵巢综合征中胰岛素抵抗与肿瘤坏死因子-α关系的研究进展
作者:沈晶晶  周羽西  李欣  凌秀凤  赵纯 
单位:南京医科大学附属妇产医院/南京市妇幼保健院 生殖医学中心, 江苏 南京 210004
关键词:多囊卵巢综合征 胰岛素抵抗 肿瘤坏死因子-α 肿瘤坏死因子-α拮抗剂 反复种植失败 综述 
分类号:R715.2
出版年·卷·期(页码):2024·43·第五期(789-794)
摘要:

多囊卵巢综合征(PCOS)是育龄女性中最常见的内分泌紊乱疾病,其主要特征为月经不调(月经过少或闭经)、排卵异常以及卵巢多囊样改变,是不孕症患者最常见的原因之一。有半数以上的PCOS患者合并有胰岛素抵抗(IR),且伴有IR的PCOS患者体内炎症因子水平更高,提示IR与PCOS慢性炎症的产生相关。炎性细胞因子会损害胰岛素信号并引发IR。抑制慢性炎症是改善IR的一种很有前途的治疗策略。在诱导IR的促炎细胞因子中,肿瘤坏死因子-α(TNF-α)是最具代表性的一种。本文作者将综述IR与TNF-α的关系,回顾TNF-α在辅助生殖领域的研究进展,探讨改变TNF-α水平是否可以成为PCOS患者改善IR从而获得更好的辅助生殖结局的有效策略。

参考文献:

[1] 刘音,鲁娣,宋殿荣.胰岛素抵抗对多囊卵巢综合征生殖内分泌及代谢的影响[J].国际妇产科学杂志,2023,50(2):190-195.
[2] 罗蓉,王宇,缪阿风,等.正常体质指数的多囊卵巢综合征患者发生胰岛素抵抗的影响因素研究[J].中国全科医学,2023,26(17):2102-2107.
[3] ARMANINI D,BOSCARO M,BORDIN L,et al.Controversies in the pathogenesis,diagnosis and treatment of PCOS:focus on insulin resistance,inflammation,and hyperandrogenism[J].Int J Mol Sci,2022,23(8):4110.
[4] 葛畅,高玥,陈娇,等.慢性炎症与多囊卵巢综合征伴随胰岛素抵抗的研究进展[J].生殖医学杂志,2023,32(8):1270-1274.
[5] ALIJOTAS-REIG J,ESTEVE-VALVERDE E,FERRER-OLIVERAS R,et al.Tumor necrosis factor-alpha and pregnancy:focus on biologics.An updated and comprehensive review[J].Clin Rev Allergy Immunol,2017,53(1):40-53.
[6] 张燕,杨玉清,包俊华,等.核因子-κB和肿瘤坏死因子-α 与多囊卵巢综合征患者糖脂代谢指标相关性研究[J].中华生殖与避孕杂志,2018,38(6):485-489.
[7] 高海杰,苏志英,邓冰冰,等.多囊卵巢综合征患者卵泡液中肿瘤坏死因子水平对临床结局的影响[J].中国妇幼保健,2021,36(1):117-120.
[8] TU Y A,CHOU C H,YANG P K,et al.Intentional endometrial injury enhances angiogenesis through increased production and activation of MMP-9 by TNF-α and MMP-3 in a mouse model[J].Mol Hum Reprod,2021,27(10):gaab055.
[9] FONSECA B M,CUNHA S C,GONÇALVES D,et al.Decidual NK cell-derived conditioned medium from miscarriages affects endometrial stromal cell decidualisation:endocannabinoid anandamide and tumour necrosis factor-α crosstalk[J].Hum Reprod,2020,35(2):265-274.
[10] YOU Y,STELZL P,JOSEPH D N,et al.TNF-α regulated endometrial stroma secretome promotes trophoblast invasion[J].Front Immunol,2021,12:737401.
[11] DANG X,FANG L,JIA Q,et al.TGF-β1 upregulates secreted protein acidic and rich in cysteine expression in human granulosa-lutein cells:a potential mechanism for the pathogenesis of ovarian hyperstimulation syndrome[J].Cell Commun Signal,2023,21(1):101.
[12] ROMANOWSKA-PRÓCHNICKA K,FELIS-GIEMZA A,OLESISKA M,et al.The role of TNF-α and anti-TNF-α agents during preconception,pregnancy,and breastfeeding[J].Int J Mol Sci,2021,22(6):2922.
[13] FISHER A L,SANGKHAE V,BALUŠÍKOVÁ K,et al.Iron-dependent apoptosis causes embryotoxicity in inflamed and obese pregnancy[J].Nat Commun,2021,12(1):4026.
[14] ZAVATTA A,PARISI F,MANDÒ C,et al.Role of inflammaging on the reproductive function and pregnancy[J].Clin Rev Allergy Immunol,2023,64(2):145-160.
[15] DEMIR M B,CAM S D.Hydrosalpingeal fluid leads to subfertility via endometrial TNF-α and IL-7 and NF-κB signaling pathways[J].Eur Rev Med Pharmacol Sci,2023,27(7):2980-2986.
[16] KALI Z,CAGIRAN F T.Surgical removal of intramural fibroids improves the TNF-α induced inflammatory events in endometrium[J].Eur Rev Med Pharmaco Sci,2022,26(24):9180-9186.
[17] HE Y,LI R,YIN J,et al.Influencing of serum inflammatory factors on IVF/ICSI outcomes among PCOS patients with different BMI[J].Front Endocrinol(Lausanne),2023,14:1204623.
[18] SALAMA K M,ALLOUSH M K,AL HUSSINI R M.Are the cytokines TNF alpha and IL 1Beta early predictors of embryo implantation? Cross sectional study[J].J Reprod Immunol,2020,137:102618.
[19] LUO Z,WANG L,WANG Y,et al.Impact of insulin resistance on ovarian sensitivity and pregnancy outcomes in patients with polycystic ovary syndrome undergoing IVF[J].J Clin Med,2023,12(3):818.
[20] LI Y,WANG Y,LIU H,et al.Association between HOMA-IR and ovarian sensitivity index in women with PCOS undergoing ART:a retrospective cohort study[J].Front Endocrinol,2023,14:1117996.
[21] GE H S,LI X H,ZHANG F,et al.[Suppression of mitochondrial oxidative phosphorylation on in vitro maturation,fertilization and developmental competence of oocytes][J].Beijing Da Xue Xue Bao Yi Xue Ban,2013,45(6):864-868.
[22] BAI X,ZHENG L,LI D,et al.Research progress of endometrial receptivity in patients with polycystic ovary syndrome:a systematic review[J].Reprod Biol Endocrin,2021,19(1):122.
[23] GUO J,CHEN Y,JIANG Y,et al.Effects of body mass index and insulin resistance on first-time assisted conception and perinatal outcomes in young polycystic ovary syndrome patients[J].Front Endocrinol,2023,14:1170816.
[24] DEFRONZO R A,TOBIN J D,ANDRES R.Glucose clamp technique:a method for quantifying insulin secretion and resistance[J].Am J Physiol,1979,237(3):E214-E223.
[25] JEELANI H,GANIE M A,MASOOD A,et al.Assessment of PON1 activity and circulating TF levels in relation to BMI,testosterone,HOMA-IR,HDL-C,LDL-C,CHO,SOD activity and TAC in women with PCOS:an observational study[J].Diabetes Metab Syndr,2019,13(5):2907-2915.
[26] CHEN Y,GUO J,ZHANG Q,et al.Insulin resistance is a risk factor for early miscarriage and macrosomia in patients with polycystic ovary syndrome from the first embryo transfer cycle:a retrospective cohort study[J].Front Endocrinol,2022,13:853473.
[27] YANG T,YANG Y,ZHANG Q,et al.Homeostatic model assessment for insulin resistance is associated with late miscarriage in non-dyslipidemic women undergoing fresh IVF/ICSI embryo transfer[J].Front Endocrinol,2022,13:880518.
[28] CHOUBEY A,GIRDHAR K,KAR A K,et al.Low-dose naltrexone rescues inflammation and insulin resistance associated with hyperinsulinemia[J].J Biol Chem,2020,295(48):16359-16369.
[29] ORÓSTICA L,POBLETE C,ROMERO C,et al.Pro-inflammatory markers negatively regulate IRS1 in endometrial cells and endometrium from women with obesity and PCOS[J].Reprod Sci,2020,27(1):290-300.
[30] HA L X,WU Y Y,YIN T,et al.Effect of TNF-alpha on endometrial glucose transporter-4 expression in patients with polycystic ovary syndrome through nuclear factor-kappa B signaling pathway activation[J].J Physiol Pharmacol,2021,72(6):965-973.
[31] ORÓSTICA L,GARCÍA P,VERA C,et al.Effect of TNF-α on molecules related to the insulin action in endometrial cells exposed to hyperandrogenic and hyperinsulinic conditions characteristics of polycystic ovary syndrome[J].Reprod Sci,2018,25(7):1000-1009.
[32] 郝松莉,侯丽辉,徐芳,等.慢性低度炎症与多囊卵巢综合征胰岛素抵抗的研究进展[J].医学研究杂志,2021,50(1):152-155,148.
[33] RUDNICKA E,SUCHTA K,GRYMOWICZ M,et al.Chronic low grade inflammation in pathogenesis of PCOS[J].Int J Mol Sci,2021,22(7):3789.
[34] SHUKLA P,MUKHERJEE S.Mitochondrial dysfunction:an emerging link in the pathophysiology of polycystic ovary syndrome[J].Mitochondrion,2020,52:24-39.
[35] SUN Y,NIE Q,ZHANG S,et al.Parabacteroides distasonis ameliorates insulin resistance via activation of intestinal GPR109a[J].Nat Commun,2023,14(1):7740.
[36] DE BAAT A,TRINH B,ELLINGSGAARD H,et al.Physiological role of cytokines in the regulation of mammalian metabolism[J].Trends Immunol,2023,44(8):613-627.
[37] DANTAS W S,NEVES W D,GIL S,et al.Exercise-induced anti-inflammatory effects in overweight/obese women with polycystic ovary syndrome[J].Cytokine,2019,120:66-70.
[38] HASEGAWA Y,PEI R,RAGHUVANSHI R,et al.Yogurt supplementation attenuates insulin resistance in obese mice by reducing metabolic endotoxemia and inflammation[J].J Nutr,2023,153(3):703-712.
[39] LI Y,CHEN X,CHEN Y,et al.Berberine improves TNF-α-induced hepatic insulin resistance by targeting MEKK1/MEK pathway[J].Inflammation,2022,45(5):2016-2026.
[40] SHEN H R,XU X,LI X L.Berberine exerts a protective effect on rats with polycystic ovary syndrome by inhibiting the inflammatory response and cell apoptosis[J].Reprod Biol Endocrinol,2021,19(1):3.
[41] HOU L,JIANG F,HUANG B,et al.Dihydromyricetin ameliorates inflammation-induced insulin resistance via phospholipase C-CaMKK-AMPK signal pathway[J].Oxid Med Cell Longev,2021,2021:8542809.
[42] PARK J E,KANG E,HAN J S.HM-chromanone attenuates TNF-α-mediated inflammation and insulin resistance by controlling JNK activation and NF-κB pathway in 3T3-L1 adipocytes[J].Eur J Pharmacol,2022,921:174884.
[43] ORÓSTICA M L,ASTORGA I,PLAZA-PARROCHIA F,et al.Metformin treatment regulates the expression of molecules involved in adiponectin and insulin signaling pathways in endometria from women with obesity-associated insulin resistance and PCOS[J].Int J Mol Sci,2022,23(7):3922.
[44] GUO C,LIU J,LI H.Metformin ameliorates olanzapine-induced insulin resistance via suppressing macrophage infiltration and inflammatory responses in rats[J].Biomed Pharmacother,2021,133:110912.
[45] NAM S W,HWANG J W,HAN Y H.A novel berberine derivative targeting adipocyte differentiation to alleviate TNF-α-induced inflammatory effects and insulin resistance in OP9 cells[J].Biomed Pharmacother,2023,167:115433.
[46] GUO X,YIN T,CHEN D,et al.Astragaloside IV regulates insulin resistance and inflammatory response of adipocytes via modulating MIR-21/PTEN/PI3K/AKT signaling[J].Endocr Metab Immune Disord Drug Targets,2023,23(12):1538-1547.
[47] EWORUKE E,PANUCCI G,GOULDING M,et al.Use of tumor necrosis factor-alpha inhibitors during pregnancy among women who delivered live born infants[J].Pharmacoepidemiol Drug Saf,2019,28(3):296-304.
[48] ANDREESCU M.The impact of the use of immunosuppressive treatment after an embryo transfer in increasing the rate of live birth[J].Front Med(Lausanne),2023,10:1167876.
[49] FU J,LI L,QI L,et al.A randomized controlled trial of etanercept in the treatment of refractory recurrent spontaneous abortion with innate immune disorders[J].Taiwan J Obstet Gynecol,2019,58(5):621-625.
[50] WU H,YOU Q,JIANG Y,et al.Tumor necrosis factor inhibitors as therapeutic agents for recurrent spontaneous abortion(Review)[J].Mol Med Rep,2021,24(6):847.
[51] 陈思琦,刘佳佳,崔鲂.富血小板血浆治疗对胚胎反复植入失败患者外周血Th1、Th2型细胞因子水平及妊娠结局的影响[J].中国医刊,2023,58(7):806-809.
[52] SANTIAGO K Y,PORCHIA L M,LÓPEZ-BAYGHEN E.Endometrial preparation with etanercept increased embryo implantation and live birth rates in women suffering from recurrent implantation failure during IVF[J].Reprod Biol,2021,21(1):100480.
[53] WINGER E E,REED J L,ASHOUSH S,et al.Treatment with adalimumab(Humira) and intravenous immunoglobulin improves pregnancy rates in women undergoing IVF[J].Am J Reprod Immunol,2009,61(2):113-120.
[54] LIANG J X,ZHANG Y,XIAO C H,et al.Application value of tumor necrosis factor inhibitors in in vitro fertilization-embryo transfer in infertile women with polycystic ovary syndrome[J].BMC Pregnancy Childbirth,2023,23(1):247.

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