The Interrelationship of Polycystic Ovarian Syndrome and the Gut Microbiome
Introduction
Polycystic Ovarian Syndrome (PCOS), alternatively referred to as polycystic ovary syndrome, is a hormonal disorder that occurs when ovaries create and secrete excessive androgen. PCOS has a variety of defining characteristics, including hormonal imbalance, ovarian cysts, infertility, and irregular menstrual cycles.[1] These characteristics may be accompanied by complications such as obesity, insulin resistance, dyslipidemia or dysbiosis (an imbalance in the microbiome or lipids), impaired glucose metabolism, miscarriages, cardiovascular disease, sleep apnea, and cancer.[1][2] When left untreated, complications such as these are more likely to arise, causing a significant burden on many afflicted women and people assigned female at birth (AFAB).
PCOS affects an estimated 8–13% of women and people AFAB within reproductive age, accounting for 50%~70% of anovulatory infertility; in addition, an estimated 70% of PCOS cases are undiagnosed worldwide.[3][2][4] PCOS’s general symptoms usually arise during early to late puberty and can last through menopause; they include acne or oily skin, excessive hair on the face or body, irregular periods, infertility, irregular hair growth/loss, and abdominal weight gain.[5] Just as there is no singular symptom for PCOS, there is no singular test to diagnose it; therefore, many different variables are taken into account in order to make a diagnosis. Most commonly, a PCOS diagnosis is made during early reproductive years through a consideration of symptoms, followed by blood tests, pelvic exams, and/or ultrasounds.[4]
Despite PCOS's widespread occurrence and impact, its precise etiology and pathology are still not fully understood. It is known that there is a significant genetic component to the acquisition of PCOS. It is considered to be a polygenic complex genetic trait, as it is believed that PCOS inheritance occurs from multiple genes.[6] However, recent studies have begun to shed light on additional factors that impact the development and interworkings of PCOS. For example, new research has begun to reveal a connection between PCOS and the human gut microbiome.
PCOS Microbial Research and Discovery
The human gastrointestinal tract hosts a robust and complex population of organisms: the gut microbiota.[7] This population assists in food digestion, nutrient absorption, metabolism, and immune regulation, which can influence the development of various diseases and disorders, including PCOS.[2] In fact, dysbiosis is a common characteristic of PCOS. A recent theory suggests that this dysbiosis activates the immune system, increasing serum insulin levels, thus interfering with insulin receptor function and normal follicular development, then increasing ovarian androgen deprivation.[7] To explore this, one study by BMC Microbiology transplanted fecal matter from PCOS patients and healthy controls into female mice. The results showed that mice with transplanted controls underwent no significant difference in biological profiles, whereas those with PCOS transplants underwent significant deviation, inducing dysbiosis in the mice.[7] Additionally, the mice with PCOS transplants were occasionally found to have damage to their gut barrier tissue as well as PCOS-like symptoms.[7] Therefore, it can be reasonably inferred that a correlation lies between the gut microbiome and PCOS.
To further explore this theory, subsequent research has been conducted to compare human biological makeup in healthy vs. PCOS subjects. Various metrics and testing have been used to analyze these comparisons. Using Shannon and Chao1 diversity indices, it was determined that there is no statistically significant difference in alpha diversity between people with or without PCOS.4 However, while there is no decrease in the amount of bacteria, the type of bacteria has been found to have varying significance. Statistical analysis of taxonomic and functional profiles (STAMP) and Wilcoxon non-parametric testing, both of which are used to analyze genera, found that the most significant differences were in the increased genera of Ruminococcus, UCG-002, the Christensenellaceae_R-7_group, and Clostridia_UCG-014 and the decreased genera of Bifidobacterium, Blautia, and Bacteroides in individuals with PCOS.4
Given the difference in gut microbial diversity between PCOS patients and healthy individuals, the significance of the interrelationship between PCOS and the gut microbiome is beginning to be studied. Ideally, new treatments will be explored that could harness this connection.
Call out each figure by number (Fig. 1).
Sample citations: [8]
[9]
A citation code consists of a hyperlinked reference within "ref" begin and end codes.
For multiple use of the same inline citation or footnote, you can use the named references feature, choosing a name to identify the inline citation, and typing [11]
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Here we cite April Murphy's paper on microbiomes of the Kokosing river. [12]
Section 2 Microbiome
Include some current research, with a second image.
Here we cite Murphy's microbiome research again.[12]
Conclusion
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References
- ↑ 1.0 1.1 Cleveland Clinic. Polycystic ovary syndrome (PCOS) & treatment [Internet. Cleveland Clinic. 2023.]
- ↑ 2.0 2.1 2.2 Sun Y, Gao S, Ye C, Zhao W. Gut microbiota dysbiosis in polycystic ovary syndrome: Mechanisms of progression and clinical applications. Frontiers in Cellular and Infection Microbiology. 2023 Feb 24;13.
- ↑ Thursby E, Juge N. Introduction to the Human Gut Microbiota. Biochemical Journal [Internet. 2017 May 16;474(11):1823–36.]
- ↑ 4.0 4.1 WHO. Polycystic ovary syndrome [Internet. World Health Organization. 2023.]
- ↑ Yang Y, Cheng J, Liu C, Zhang X, Ma N, Zhou Z, et al. Gut microbiota in women with polycystic ovary syndrome: an individual based analysis of publicly available data. EClinicalMedicine [Internet. 2024 Oct 18;77:102884–4.]
- ↑ Prapas N, Karkanaki A, Prapas I, Kalogiannidis I, Katsikis I, Panidis D. Genetics of Polycystic Ovary Syndrome. Hippokratia [Internet. 2020;13(4):216.]
- ↑ 7.0 7.1 7.2 7.3 Huang F, Deng Y, Zhou M, Tang R, Zhang P, Chen R. Fecal microbiota transplantation from patients with polycystic ovary syndrome induces metabolic disorders and ovarian dysfunction in germ-free mice. BMC Microbiology. 2024 Sep 28;24(1).
- ↑ 8.0 8.1 Zigli DD, Brew L, Obeng-Denteh W, Kwofie S. On the Application of Homeomorphism on Amoeba Proteus. Ghana Journal of Technology. 2021 Mar 31;5(2):43-7.
- ↑ Bartlett et al.: Oncolytic viruses as therapeutic cancer vaccines. Molecular Cancer 2013 12:103.
- ↑ Lee G, Low RI, Amsterdam EA, Demaria AN, Huber PW, Mason DT. Hemodynamic effects of morphine and nalbuphine in acute myocardial infarction. Clinical Pharmacology & Therapeutics. 1981 May;29(5):576-81.
- ↑ 11.0 11.1 text of the citation
- ↑ 12.0 12.1 Murphy A, Barich D, Fennessy MS, Slonczewski JL. An Ohio State Scenic River Shows Elevated Antibiotic Resistance Genes, Including Acinetobacter Tetracycline and Macrolide Resistance, Downstream of Wastewater Treatment Plant Effluent. Microbiology Spectrum. 2021 Sep 1;9(2):e00941-21.
Edited by [Lauren Karg], student of Joan Slonczewski for BIOL 116, 2024, Kenyon College.