di Clemente Nathalie, Racine Chrystèle, Rey Rodolfo A
Centre de Recherche Saint-Antoine (CRSA), Sorbonne Université-INSERM, 75012 Paris, France.
Institut Hospitalo-Universitaire ICAN, 75013 Paris, France.
Biomedicines. 2022 Oct 7;10(10):2506. doi: 10.3390/biomedicines10102506.
This article reviews the main findings on anti-Müllerian hormone (AMH) and its involvement in the pathogenesis of polycystic ovary syndrome (PCOS) and its male equivalent. In women, AMH is produced by granulosa cells from the mid-fetal life to menopause and is a reliable indirect marker of ovarian reserve. AMH protects follicles from atresia, inhibits their differentiation in the ovary, and stimulates gonadotrophin-releasing hormone neurons pulsatility. AMH overexpression in women with PCOS likely contributes to the increase of the follicle cohort and of androgen levels, leading to follicular arrest and anovulation. In the male, AMH is synthesized at high levels by Sertoli cells from fetal life to puberty when serum AMH falls to levels similar to those observed in women. AMH is involved in the differentiation of the genital tract during fetal life and plays a role in Sertoli and Leydig cells differentiation and function. Serum AMH is used to assess Sertoli cell function in children with disorders of sex development and various conditions affecting the hypothalamic-pituitary-testicular axis. Although the reproductive function of male relative of women with PCOS has been poorly investigated, adolescents have elevated levels of AMH which could play a detrimental role on their fertility.
本文综述了抗苗勒管激素(AMH)的主要研究结果及其在多囊卵巢综合征(PCOS)及其男性对应病症发病机制中的作用。在女性中,AMH由胎儿中期直至绝经期间的颗粒细胞产生,是卵巢储备功能的可靠间接标志物。AMH可保护卵泡免于闭锁,抑制其在卵巢中的分化,并刺激促性腺激素释放激素神经元的脉冲性。PCOS女性中AMH的过度表达可能导致卵泡群数量增加和雄激素水平升高,进而导致卵泡停滞和无排卵。在男性中,从胎儿期到青春期,支持细胞会高水平合成AMH,之后血清AMH水平降至与女性相似的水平。胎儿期,AMH参与生殖道的分化,并在支持细胞和间质细胞的分化及功能中发挥作用。血清AMH用于评估性发育障碍儿童以及影响下丘脑-垂体-睾丸轴的各种病症中支持细胞的功能。尽管对PCOS女性男性亲属的生殖功能研究较少,但青少年的AMH水平升高,这可能对其生育能力产生不利影响。