Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Front Endocrinol (Lausanne). 2021 Feb 26;11:527592. doi: 10.3389/fendo.2020.527592. eCollection 2020.
Recently, a growing body of evidence has suggested that abnormal ovarian angiogenesis, secondary to the imbalance between various angiogenic markers, is involved in the pathogenesis of PCOS, and this has led to the use of various interventions (such as Diane-35) to restore the normal ovarian angiogenesis. Therefore, we conducted the current investigation to determine the role of such markers (endothelial growth factor (VEGF), endostatin (ES), and thrombospondin-1 (TSP-1)) in the pathogenesis of PCOS along with the associated changes in ovarian blood flow in patients with PCOS compared to healthy controls, both before and after a course of oral contraception. A total of 381 patients with PCOS and 98 healthy females of childbearing age were recruited from July 2014 to June 2017 at the Reproductive Center of the Second Affiliated Hospital of Harbin Medical University. The serum levels of VEGF, ES, and TSP-1 were determined by enzyme-linked immunosorbent assay, while ovarian perfusion was measured by the pulsatility index (PI) and resistance index (RI) by using transvaginal color Doppler ultrasound. Repeated analyses were carried out after 3 months of Diane-35 treatment. Post-treatment serum levels of luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio of patients with PCOS decreased significantly (P <0.05). The RI values of most PCOS patients increased after treatment (P<0.05), while PI was significantly increased in all patients (P<0.05). However, variable changes in the serum levels of TSP-1, VEGF, and ES after treatment were observed. Serum VEGF levels showed a negative correlation with serum LH/FSH ratio, T concentration, and ES (P <0.05), while ES levels were negatively correlated with serum T concentrations only (P<0.05). The markers of angiogenesis (VEGF, ES, and TSP-1) were expressed differently among PCOS patients, who also responded differently to the same course of Diane-35 treatment. This field still warrants further investigation to reach a more definitive conclusion.
最近,越来越多的证据表明,多囊卵巢综合征(PCOS)的发病机制与各种血管生成标志物的失衡有关,这导致了各种干预措施(如 Diane-35)的应用,以恢复正常的卵巢血管生成。因此,我们进行了当前的研究,以确定这些标志物(血管内皮生长因子(VEGF)、内皮抑素(ES)和血小板反应蛋白-1(TSP-1))在 PCOS 发病机制中的作用,以及 PCOS 患者与健康对照组相比,在口服避孕药治疗前后卵巢血流的相关变化。2014 年 7 月至 2017 年 6 月,我们在哈尔滨医科大学第二附属医院生殖中心招募了 381 名 PCOS 患者和 98 名生育期健康女性。通过酶联免疫吸附试验测定 VEGF、ES 和 TSP-1 的血清水平,通过经阴道彩色多普勒超声测定搏动指数(PI)和阻力指数(RI)来测量卵巢灌注。在服用 Diane-35 治疗 3 个月后进行了重复分析。PCOS 患者治疗后血清黄体生成素(LH)/卵泡刺激素(FSH)比值明显下降(P<0.05)。大多数 PCOS 患者治疗后 RI 值升高(P<0.05),而所有患者的 PI 均显著升高(P<0.05)。然而,治疗后 TSP-1、VEGF 和 ES 的血清水平变化不同。血清 VEGF 水平与血清 LH/FSH 比值、T 浓度和 ES 呈负相关(P<0.05),而 ES 水平仅与血清 T 浓度呈负相关(P<0.05)。PCOS 患者的血管生成标志物(VEGF、ES 和 TSP-1)表达不同,对相同的 Diane-35 治疗方案也有不同的反应。这一领域仍需要进一步研究,以得出更明确的结论。