Emerging concepts about prenatal genesis, aberrant metabolism and treatment paradigms in polycystic ovary syndrome

Witchel, Selma F.; Recabarren, Sergio E; González, Fidelina; Diamanti-Kandarakis, Evanthia; Cheang, Kai I.; Dulęba, Antoni J.; Legro, Richard S.; Homburg, Roy; Pasquali, Renato; Løbo, Rogerio A.; Zouboulis, Christos C.; Keleştimur, Fahrettin; Fruzzetti, Franca; Futterweit, Walter; Norman, Robert J.; Abbott, David H.

doi:10.1007/s12020-012-9701-4

Cited by 25 publications

(13 citation statements)

References 112 publications

(114 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Androgen suppression reduces CRP and IL-6 in lean controls as early as 3 months after GnRH agonist administration. In contrast, we have shown that 5 days of oral androgen administration to elevate circulating androgens to levels comparable to PCOS induces a proinflammatory response in lean healthy reproductive-age women, [36,37]. This androgen treatment interval is too short to alter adiposity, and is consistent with the unaltered weight in lean controls of our current study in the face of the reduced inflammatory load following androgen suppression.…”

Section: Discussionsupporting

confidence: 82%

Hyperandrogenism exerts an anti-inflammatory effect in obese women with polycystic ovary syndrome

et al. 2012

Self Cite

View full text Add to dashboard Cite

Purpose We determined the effect of chronic androgen suppression on inflammation in women with Polycystic Ovary Syndrome (PCOS) compared to weight-matched controls. Methods We performed a pilot project using samples from previous prospective, controlled studies. Nine women with PCOS (5 obese, 4 lean) and 9 ovulatory controls (5 obese, 4 lean) participated in the study. Androgens, C-reactive protein (CRP), interleukin-6 (IL-6), free fatty acids (FFA) and body weight were measured before and after 3 and 6 months of gonadotropin releasing hormone (GnRH) agonist administration. Results GnRH agonist treatment decreased estradiol, testosterone and androstenedione to similar levels in all subjects. CRP and IL-6 increased in obese women with PCOS, was unaltered in lean women with PCOS and obese controls, and decreased in lean controls after 6 months of treatment. FFA decreased and body weight increased in obese women with PCOS, but did not change significantly in lean women with PCOS and in either control group after 6 months of treatment. The testosterone reduction was related to increases in weight and IL-6. The fall in FFA was related to the rise in CRP. The increases in weight and IL-6 were related to the rise in CRP. Conclusion We propose that hyperandrogenism in PCOS may exert an anti-inflammatory effect when obesity is present, but may not promote inflammation in the disorder; and that circulating androgens have a pleiotropic effect on inflammation depending on the combination of PCOS and weight status in a given individual.

show abstract

Section: Discussionsupporting

confidence: 82%

Hyperandrogenism exerts an anti-inflammatory effect in obese women with polycystic ovary syndrome

et al. 2012

Self Cite

View full text Add to dashboard Cite

show abstract

“…The severity of acne in adolescence is associated with several factors, including a positive history of severe acne in first‐grade relatives, especially the mother; occurrence in boys in early puberty; and occurrence in girls with notably elevated dehydroepiandrosterone sulfate serum levels during the adrenarche . Severe acne is in most cases a chronic disease, and is often a component of systemic diseases or syndromes …”

mentioning

confidence: 99%

Management of severe acne

Zouboulis

Bettoli

2015

Br J Dermatol

View full text Add to dashboard Cite

SummaryAcne is the most common skin disease, affecting up to 95% of adolescents. Severe episodes of acne can cause considerable physical and psychological scarring, and overexpression of transforming growth factor-b can lead to formation of hypertrophic scars and keloids. The severity of acne in adolescence is associated with a positive history of severe acne in first-degree relatives, especially the mother. In most cases acne is a chronic disease, and it is often a component of systemic diseases or syndromes. All forms of severe acne require systemic treatment. The available options include oral antibiotics, hormonal antiandrogens for female patients and oral isotretinoin, as well as other combination treatments. Oral isotretinoin is the only drug available that affects all four pathogenic factors of acne. However, due to possible serious side-effects, a European directive states that oral isotretinoin should be used only as a second-line therapy in cases of severe, nodular and conglobate acne. The pharmaceutical quality of generic isotretinoin products and the obtainability of isotretinoin through e-pharmacies without prescription raise new therapeutic problems. New anti-inflammatory compounds, such as the 5-lipoxygenase inhibitor zileuton, may replace systemic antibiotics in the future, especially under the scope of antibiotic resistance prevention. This review looks into the various options and latest approaches, and factors to consider, when combating severe acne.

show abstract

“…Seborrhea, acne tarda and male-pattern baldness were very likely the results of the relative hyperandrogenism occurring in POI together with persisting amenorrhea, while the immunologic laboratory findings indicated the etiology of POI in our patient. Despite similar clinical signs, POI due to ovarian fibrosis is pathogenetically diverse from seborrhea-acne-hirsutism-androgenetic alopecia syndrome [8] and polycystic ovary syndrome [9], which are more familiar to dermatologists.…”

Section: Discussionmentioning

confidence: 99%

Acne Tarda and Male-Pattern Baldness Unmasking Primary Ovarian Insufficiency: A Case and Review

Zouboulis

Achenbach²,

Makrantonaki

2014

Dermatology

Self Cite

View full text Add to dashboard Cite

A 30-year-old woman presented with recurrent acne lesions and progressing male-pattern baldness. Furthermore, she reported amenorrhea, weight loss, mucosal xerosis and dyspareunia since discontinuation of hormonal contraception 6 months earlier in order to conceive. Acne tarda and androgenetic alopecia of female pattern were diagnosed. Hormonal and immunologic serological and ultrasound examinations revealed an autoimmune hypergonadotropic primary ovarian insufficiency (POI) with no ovarian cysts but ovarian fibrosis with marked reduced follicle pool. Immediate ovarian stimulation and in vitro fertilization led to pregnancy and the patient gave birth to a healthy child. Though presenting with clinical findings similar to menopause, 50% of patients with POI exhibit varying and unpredictable ovarian function, and only 5-10% are able to accomplish pregnancy. Genetic disorders affect the X chromosome. In 14-30% of cases POI has been associated with autoimmunity. POI may occur after discontinuation of hormonal contraception, like in our case.

show abstract

Emerging concepts about prenatal genesis, aberrant metabolism and treatment paradigms in polycystic ovary syndrome

Cited by 25 publications

References 112 publications

Hyperandrogenism exerts an anti-inflammatory effect in obese women with polycystic ovary syndrome

Hyperandrogenism exerts an anti-inflammatory effect in obese women with polycystic ovary syndrome

Management of severe acne

Acne Tarda and Male-Pattern Baldness Unmasking Primary Ovarian Insufficiency: A Case and Review

Contact Info

Product

Resources

About