Laganà Antonio Simone, Garzon Simone, Unfer Vittorio
Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria , Varese, Italy.
The Experts Group on Inositol in Basic and Clinical Research (EGOI): https://www.inositolgroup.com.
Expert Opin Drug Metab Toxicol. 2020 Aug;16(8):703-710. doi: 10.1080/17425255.2020.1785429. Epub 2020 Jul 9.
Inositols have a key role in ovarian physiology and the literature reports a wealth of studies about the major isomer, myo-inositol (MI). However, information about d-chiro-inositol (DCI) is still scarce, despite the ratio MI:DCI is tissue-specific and actively maintained by an insulin-dependent epimerase enzyme.
This expert opinion provides an overview of the physiological contribution of DCI in regulating steroidogenesis. DCI indeed mediates the intracellular signaling of insulin, which induces the biosynthesis of androgens. Studies on second messengers of insulin also revealed that DCI has a specific role in modulating the activity of aromatase enzyme. Specifically, recent findings demonstrated that DCI influences the enzyme gene expression, thus reducing the conversion of androgens into estrogens.
Available evidence suggests that the effects of DCI administration may be similar to those of aromatase inhibitors, but without causing hypo-estrogenic states. Therefore, DCI treatments should be evaluated for either estrogen-dependent gynecological conditions or low testosterone states in male subjects.
肌醇在卵巢生理中起着关键作用，文献报道了大量关于主要异构体——肌醇（MI）的研究。然而，尽管MI与D-手性肌醇（DCI）的比例具有组织特异性且由一种胰岛素依赖性差向异构酶积极维持，但关于DCI的信息仍然很少。
本专家意见概述了DCI在调节类固醇生成中的生理作用。DCI确实介导胰岛素的细胞内信号传导，从而诱导雄激素的生物合成。对胰岛素第二信使的研究还表明，DCI在调节芳香化酶的活性方面具有特定作用。具体而言，最近的研究结果表明，DCI影响该酶的基因表达，从而减少雄激素向雌激素的转化。
现有证据表明，给予DCI的效果可能与芳香化酶抑制剂相似，但不会导致雌激素水平过低的状态。因此，对于雌激素依赖性妇科疾病或男性低睾酮状态，应评估DCI治疗。
