Southern University of Science and Technology Yantian Hospital, Shenzhen, 518081, China.
Shenzhen Yantian District People's Hospital, Shenzhen, 518081, China.
Sci Rep. 2023 May 12;13(1):7721. doi: 10.1038/s41598-023-34746-z.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of childbearing age. The etiology of PCOS is multifactorial, and current treatments for PCOS are far from satisfactory. Recently, an imbalanced autonomic nervous system (ANS) with sympathetic hyperactivity and reduced parasympathetic nerve activity (vagal tone) has aroused increasing attention in the pathogenesis of PCOS. In this paper, we review an innovative therapy for the treatment of PCOS and related co-morbidities by targeting parasympathetic modulation based on non-invasive transcutaneous auricular vagal nerve stimulation (ta-VNS). In this work, we present the role of the ANS in the development of PCOS and describe a large number of experimental and clinical reports that support the favorable effects of VNS/ta-VNS in treating a variety of symptoms, including obesity, insulin resistance, type 2 diabetes mellitus, inflammation, microbiome dysregulation, cardiovascular disease, and depression, all of which are also commonly present in PCOS patients. We propose a model focusing on ta-VNS that may treat PCOS by (1) regulating energy metabolism via bidirectional vagal signaling; (2) reversing insulin resistance via its antidiabetic effect; (3) activating anti-inflammatory pathways; (4) restoring homeostasis of the microbiota-gut-brain axis; (5) restoring the sympatho-vagal balance to improve CVD outcomes; (6) and modulating mental disorders. ta-VNS is a safe clinical procedure and it might be a promising new treatment approach for PCOS, or at least a supplementary treatment for current therapeutics.
多囊卵巢综合征(PCOS)是育龄妇女常见的内分泌疾病。PCOS 的病因是多因素的,目前的治疗方法远不能令人满意。最近,自主神经系统(ANS)失衡,交感神经活性增加,副交感神经活性(迷走神经张力)降低,在 PCOS 的发病机制中引起了越来越多的关注。本文综述了一种基于非侵入性经皮耳迷走神经刺激(ta-VNS)的副交感神经调节的创新治疗方法,用于治疗 PCOS 及相关合并症。在这项工作中,我们介绍了 ANS 在 PCOS 发展中的作用,并描述了大量的实验和临床报告,支持 VNS/ta-VNS 在治疗多种症状方面的有益作用,包括肥胖、胰岛素抵抗、2 型糖尿病、炎症、微生物组失调、心血管疾病和抑郁症,所有这些症状在 PCOS 患者中也很常见。我们提出了一个以 ta-VNS 为重点的模型,该模型可能通过以下方式治疗 PCOS:(1)通过双向迷走神经信号调节能量代谢;(2)通过其抗糖尿病作用逆转胰岛素抵抗;(3)激活抗炎途径;(4)恢复微生物群-肠道-大脑轴的内稳态;(5)恢复交感神经-副交感神经平衡,改善心血管疾病结局;(6)调节精神障碍。ta-VNS 是一种安全的临床程序,它可能是 PCOS 的一种有前途的新治疗方法,或者至少是目前治疗方法的补充治疗方法。
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