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Review
. 2023 Dec 13:14:1324429.
doi: 10.3389/fendo.2023.1324429. eCollection 2023.

Chronic low-grade inflammation and ovarian dysfunction in women with polycystic ovarian syndrome, endometriosis, and aging

Makoto Orisaka  1 , Tetsuya Mizutani  2 , Yumiko Miyazaki  1 , Aya Shirafuji  1 , Chiyo Tamamura  1 , Masayuki Fujita  1 , Hideaki Tsuyoshi  1   3 , Yoshio Yoshida  1
Affiliations
Review

Chronic low-grade inflammation and ovarian dysfunction in women with polycystic ovarian syndrome, endometriosis, and aging

Makoto Orisaka et al. Front Endocrinol (Lausanne). .

Abstract

The ovarian microenvironment is critical for follicular development and oocyte maturation. Maternal conditions, including polycystic ovary syndrome (PCOS), endometriosis, and aging, may compromise the ovarian microenvironment, follicular development, and oocyte quality. Chronic low-grade inflammation can induce oxidative stress and tissue fibrosis in the ovary. In PCOS, endometriosis, and aging, pro-inflammatory cytokine levels are often elevated in follicular fluids. In women with obesity and PCOS, hyperandrogenemia and insulin resistance induce ovarian chronic low-grade inflammation, thereby disrupting follicular development by increasing oxidative stress. In endometriosis, ovarian endometrioma-derived iron overload can induce chronic inflammation and oxidative stress, leading to ovarian ferroptosis and fibrosis. In inflammatory aging (inflammaging), senescent cells may secrete senescence-associated secretory phenotype factors, causing chronic inflammation and oxidative stress in the ovary. Therefore, controlling chronic low-grade inflammation and fibrosis in the ovary would present a novel therapeutic strategy for improving the follicular microenvironment and minimizing ovarian dysfunction.

Keywords: aging; endometriosis; follicular microenvironment; inflammation; ovarian dysfunction; polycystic ovarian syndrome.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Hypothetical models illustrating chronic low-grade inflammation, oxidative stress, fibrosis, and ovarian dysfunction. (A) obesity and polycystic ovary syndrome (obese PCOS), (B) endometriosis, and (C) aging.
See this image and copyright information in PMC

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Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by JSPS KAKENHI (18K09224 and 22K09592).