Role of Cystic Fluid Growth Factors and Inflammatory Mediators in Pathogenesis of Polycystic Ovary Syndrome

Abstract

Havagiray R Chitme, Eman Al Azawi, Hend Abdallah Humaid Al Manwari, Azhar Amur Nasser Al Saadi and Rand Mohammed Abbas Al Dulaimi

Objective: Present study was carried out to investigate whether there is any localized growth factor/s involved and mediated by inflammatory cytokines through measuring their level in fluid aspirated from ovarian cyst.

Study Design: Data was collected from 62 infertile female patients having PCOS and without PCOS. The cystic and follicular fluid obtained from consented patients was used in estimating inflammatory and growth factors. Further, these values were analyzed and interpreted with respect to number, size, length and depth of cysts.

Results: Indicates that there is a low level of inflammatory reaction centralized to IL-18 triggering the release of MMP-2 to degrade the extracellular matrix followed by release of ANG-1, VEGF, IGF-1 and EGF to maintain the growth of ovarian cysts. Our findings support the prominent role of IL-18, MMP-2 and ANG-1 in pathogenesis of severe PCOS.

Conclusion: In conclusion, the levels of inflammatory mediators in follicular fluid are significantly higher in women having PCOS than compared to cystic fluid of Non-PCOS patients. Despite the promising results of present study we recommend the readers to consider these results as preliminary. Further larger cohort studies are recommended by including more number of heterogeneous population, for extended period of time and more number of cytokines and growth factors with higher accuracy to understand how local inflammatory and growth factors are inter-related in development of ovarian cysts in PCOS patients.

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