Akpang Nicole, Kwiatkowski Jakub, Zaborowska Lucja, Ludwin Artur
1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland.
Doctoral School of Medical and Health Sciences, Jagiellonian University Collegium Medicum, 31-530 Cracow, Poland.
Int J Mol Sci. 2025 Apr 26;26(9):4121. doi: 10.3390/ijms26094121.
Polycystic ovary syndrome (PCOS) is a common female endocrinopathy associated with reproductive and metabolic abnormalities. PCOS is characterized by complex pathogenesis and pathophysiology. Its multifactorial etiology and heterogeneous presentation make effective treatment difficult. Endocrine abnormalities in PCOS create a vicious cycle of overriding dysfunction involving the hypothalamic-pituitary-ovarian (HPO) axis. Most research has primarily focused on identifying genetic, epigenetic, or immunological factors underlying PCOS. In recent years, new reports have emerged on the possible involvement of antibodies directed against HPO axis components in the development of PCOS. Some of these have been shown to be able to interfere with hormone receptors or receptor binding by targeting the key domains for their function. However, the evidence is heterogeneous and challenging to interpret, given the overall predisposition to high levels of various autoantibodies found in women with PCOS. This review focuses on autoantibodies affecting the HPO axis in PCOS and their potential role in the pathogenesis of PCOS. The authors discuss PCOS as a potential antibody-mediated autoimmune disease in light of recent reports on its possible pathogenesis.
多囊卵巢综合征（PCOS）是一种常见的女性内分泌疾病，与生殖和代谢异常有关。PCOS的特点是发病机制和病理生理学复杂。其多因素病因和异质性表现使得有效治疗变得困难。PCOS中的内分泌异常会导致涉及下丘脑-垂体-卵巢（HPO）轴的功能障碍恶性循环。大多数研究主要集中在确定PCOS潜在的遗传、表观遗传或免疫因素。近年来，有新报道指出，针对HPO轴成分的抗体可能参与了PCOS的发病过程。其中一些抗体已被证明能够通过靶向其功能的关键结构域来干扰激素受体或受体结合。然而，鉴于PCOS女性中普遍存在各种自身抗体水平升高的倾向，相关证据具有异质性且难以解释。本综述重点关注影响PCOS中HPO轴的自身抗体及其在PCOS发病机制中的潜在作用。作者根据最近关于PCOS可能发病机制的报道，将其讨论为一种潜在的抗体介导的自身免疫性疾病。
