Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder prevalent in females of reproductive age; insulin resistance (IR) is the major pathogenic driver. Pharmacology is a basic option for PCOS therapy; traditional Chinese medicine (TCM), as a significant part of complementary and alternative medicine, has a long history in the clinical management of PCOS. Cangfudaotan decoction (CFD) has been used clinically for gynaecological diseases especially PCOS. In this study, first, chemical components in CFD were clarified using UPLC-Q/TOF-MS analysis. Then, an animal model of PCOS was established, granular cells were also isolated from the rats with PCOS, and CFD was administrated at different dosages in PCOS rats and granular cells, to investigate the therapeutic effect and mechanisms of CFD for PCOS treatment. The result showed that CFD treatment is effective in PCOS rats and granulosa cells. CFD was able to improve IR, restore the serum hormone levels, inhibit the inflammatory cytokines in PCOS rat, and alleviate ovary morphological injury and apoptosis in PCOS rats. In granulosa cells of PCOS, the result showed that the cell viability was improved, and cell apoptosis was inhibited after CFD administration. Further experiments suggested that CDF improves IR, follicular development, cell apoptosis, and inflammatory microenvironment, and this was associated to the regulation of IGF-1-PI3K/Akt-Bax/Bcl-2 pathway-mediated gene expression. Given that CFD sufficiently suppresses insulin resistance and improves follicular development in this study, exploring these mechanisms might help to optimize the therapeutic treatment of CFD in PCOS patients.
Highlights
Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder prevalent in females of reproductive age
Nucleated epithelial cells were observed in proestrus; keratinocytes with irregular shape that interconnected into pieces were observed in estrus; nucleated epithelial cells, irregular epithelial keratinocytes, and leukocytes were observed in metestrus; and a large number of leukocytes were observed in diestrus
It showed that Cangfudaotan decoction (CFD) is able to improve insulin resistance (IR), restore the serum hormone levels in PCOS rats, and alleviate ovary morphological injury and apoptosis in PCOS rats
Summary
Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder prevalent in females of reproductive age. IR is the major pathogenic driver of PCOS; approximately 75% of PCOS patients have an impairment of insulin action [2]. In PCOS patients, ovarian cells are hyperresponsive to the stimulatory effects of insulin, causing ovarian hyperplasia; IR amplifies hyperandrogenism, resulting in a disruption in the hypothalamic-pituitary-ovarian axis and aggravating PCOS [3]. Case-control studies show that PCOS is associated with lower life quality and increased psychological distress; both PCOS and thereby induced infertility have negative impact on reproductive age women [6, 7]. It is necessary for PCOS patients to be cured of reproductive disorders
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