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Debra
Cycle Diet Dietitian
| Joined: | Thu Sep 1st, 2005 |
| Location: | West Des Moines, Iowa, USA |
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Posted: Wed Jul 9th, 2008 08:11 pm |
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An interesting statement was made regarding PCOS not being autoimmune, but every indication is that it is according to these researchers:
Autoimmun Rev. 2007 Nov;7(1):42-5. Epub 2007 Jul 18.
Functional autoantibodies, a new paradigm in autoimmunity?
Gleicher N, Barad D, Weghofer A.
Center for Human Reproduction, New York, New York, USA. ngleicher@thechr.com
The recent detection of stimulatory autoantibodies as a characteristic feature of systemic sclerosis (scleroderma), established the presence of such autoantibodies as a characteristic pathophysiologic finding in a second classical autoimmune disease after autoimmune thyroid disease. This observation raises the possibility of a new paradigm in abnormal autoimmune function, the presence of stimulatory (and suppressive), functional autoantibodies as characteristic features of abnormal autoimmune function. The assumption of such a paradigm opens interesting new research avenues within rheumatology and in other medical specialty areas. Within reproductive medicine, and akin to the concept of hypo- and hyperthyroidism, the possible juxtaposition of polycystic ovarian syndrome (PCOS) and premature ovarian aging (POA), as opposite abnormalities of adrenal function, under control of autoimmune adrenal antibodies, deserves further investigation.
Eur J Endocrinol. 2004 Mar;150(3):363-9.
High prevalence of autoimmune thyroiditis in patients with polycystic ovary syndrome
OE Janssen, N Mehlmauer, S Hahn, AH Offner, and R Gartner
Division of Endocrinology, Department of Medicine, University of Essen, Essen, Germany.
Abstract
OBJECTIVE: To investigate the prevalence of autoimmune thyroiditis (AIT) in patients with polycystic ovary syndrome (PCOS). DESIGN: Over a period of 30 months, 175 patients with PCOS were recruited to a prospective multicenter study to evaluate thyroid function and morphology; 168 age-matched women without PCOS were studied as a control group. METHODS: PCOS was defined as a- or oligomenorrhea, hyperandrogenism and exclusion of other disturbances of estrogen or androgen synthesis. All laboratory parameters were determined with automated immunoassays. Thyroid morphology was assessed by ultrasound. RESULTS: PCOS patients were characterized by an increased LH/FSH ratio, low progesterone, elevated testosterone and a high prevalence of hirsutism (PCOS 83%, control 3%; mean hirsutism score 12+/-5 and 3+/-2 respectively), but no differences in estrogen levels were found. Thyroid function and thyroid-specific antibody tests revealed elevated thyroperoxidase (TPO) or thyroglobulin (TG) antibodies in 14 of 168 controls (8.3%), and in 47 of 175 patients with PCOS (26.9%; P<0.001). On thyroid ultrasound, 42.3% of PCOS patients, but only 6.5% of the controls (P<0.001) had a hypoechoic tissue typical of AIT; while thyroid hormone levels were normal in all subjects, PCOS patients had a higher mean TSH level (P<0.001) and a higher incidence of TSH levels above the upper limit of normal (PCOS 10.9%, controls 1.8%; P<0.001).
CONCLUSION: This prospective study demonstrates a threefold higher prevalence of AIT in patients with PCOS, correlated in part with an increased estrogen-to-progesterone ratio and characterized by early manifestation of the disease.
1: Am J Reprod Immunol. 2005 Nov;54(5):262-9.
IgG, IgA and IgM antibodies against FSH: serological markers of pathogenic autoimmunity or of normal immunoregulation?
Haller K, Mathieu C, Rull K, Matt K, Béné MC, Uibo R.
Department of Immunology, Institute of General and Molecular Pathology and Centre of Molecular and Clinical Medicine, University of Tartu, Estonia.
PROBLEM: Autoimmune mechanisms are often involved in causing infertility. Among the possible targets of autoantibodies, the follicle-stimulating hormone (FSH) which regulates the follicular maturation in human ovary is a promising candidate. We aimed to study whether anti-FSH-antibodies might be involved in different clinical types of infertility. METHOD OF STUDY: The study group consisted of 178 patients (75 with polycystic ovary syndrome (PCOS), 103 with endometriosis) and 75 pregnant women. Female blood donors formed the control group (n = 85). Indirect enzyme-linked immunosorbent assay tests were performed using purified FSH as antigens and a synthetic peptide corresponding to the 78-93 region (V14D) of the human FSH beta-chain.
CONCLUSION: We showed that anti-FSH-antibodies were present in controls and their production decreased during pregnancy. Endometriosis and PCOS were associated with higher values of anti-FSH-immunoglobulin (Ig)A, anti-V14D-IgA, and endometriosis with anti-V14D-IgG. Our data suggest that anti-FSH-IgA could be a marker of ovarian disorders that cause infertility.
PMID: 16212648 [PubMed - indexed for MEDLINE]
1: Clin Exp Immunol. 2006 May;144(2):217-22.
The presence of antibodies to oxidative modified proteins in serum from polycystic ovary syndrome patients.
Palacio JR, Iborra A, Ulcova-Gallova Z, Badia R, Martínez P.
Unidad de Inmunología, Instituto de Biotecnología y Biomedicina, Universidad Autónoma de Barcelona, 08193 Barcelona, Spain. joseramon.palacio@uab.es
Polycystic ovary syndrome (PCOS) affects 5-10% of women of reproductive age. Free radicals, as a product of oxidative stress, impair cells and tissue properties related to human fertility. These free radicals, together with the oxidized molecules, may have a cytotoxic or deleterious effects on sperm and oocytes, on early embryo development or on the endometrium. Aldehyde-modified proteins are highly immunogenic and circulating autoantibodies to new epitopes, such as malondialdehyde (MDA), may affect the reproductive system. Autoantibodies or elevated reactive oxygen species (ROS) in serum are often associated with inflammatory response. The purpose of this work is to investigate whether PCOS women show increased levels of oxidized proteins (protein-MDA) and anti-endometrial antibodies (AEA) in their sera, compared with control patients, and to determine whether AEA specificity is related to oxidized protein derivatives. Sera from 31 women [10 patients with PCOS (PCOS group) and 21 women with male factor of infertility (control group)] were chosen from patients attending for infertility. Anti-endometrial antibodies were determined by enzyme-linked immunosorbent assay (ELISA) with an endometrial cell line (RL-95). Antibodies against MDA modified human serum albumin (HSA-MDA) were also determined by ELISA. Oxidized proteins (protein-MDA) in serum were determined by a colorimetric assay. Patients with PCOS have significantly higher levels of AEA and anti-HSA-MDA, as well as oxidized proteins (protein-MDA) in serum than control patients. For the first time, we describe an autoimmune response in PCOS patients, in terms of AEA. The evidence of protein-MDA in the serum of these patients, together with the increased antibody reactivity to MDA-modified proteins (HSA-MDA) in vitro, supports the conclusion that oxidative stress may be one of the important causes for abnormal endometrial environment with poor embryo receptivity in PCOS patients.
J Reprod Immunol. 1999 Jan;42(1):79-84
Polycystic ovary syndrome and ovarian autoimmunity--assessment of ovarian antibodies by EIA.
Luborsky JL, Shatavi S, Adamczyk P, Chiong C, Llanes B, Lafniztzegger J, Soltes B, McGovern P, Santoro N.
Department of Obstetrics and Gynecology, Rush Medical College, Chicago, IL 60612, USA. jluborsk@rush.edu
There are conflicting reports of an association of ovarian antibodies, detected by immunofluorescence, with polycystic ovary syndrome (PCOS). The objective of this study was to evaluate the association of ovarian autoimmunity with PCOS. A validated immunoassay for ovarian antibodies was used to assess serum from women with PCOS and with menopause and normal cycling women as controls. The frequency of ovarian antibodies was similar (25%) among the controls and PCOS. Thus, unlike the association of ovarian antibodies detected with this test in patients with unexplained infertility and premature menopause, the prevalence of ovarian antibody in patients with PCOS is not significantly different to controls.
Ovarian autoimmune disease and ovarian autoantibodies.
Luborsky J.
Reproductive Immunology, Department of Obstetrics and Gynecology, Rush Medical College, 1653 W. Congress Parkway, Chicago, IL 60612, USA.
Detection of specific autoantibodies remains the most practical clinical and research marker of autoimmune disease. The lack of consensus on ovary specific antibodies as a marker for ovarian autoimmunity has clinical and research consequences. The objective of this review is to summarize the evidence for ovarian autoimmunity and the detection of ovary specific autoantibodies in humans. Evidence favors the presence of an autoimmune disease of the ovary. Ovarian autoantibodies are associated primarily with premature ovarian failure (POF) and unexplained infertility. Variations in detection of ovarian autoantibodies are likely to be due to study design elements such as antibody test format, antigen preparation, and criteria for study and comparison groups. In addition, multiple targets appear to be involved in ovarian autoimmunity including ovarian cellular elements and oocyte related antigens. Many studies only assess one target antigen, leaving individuals with ovarian autoimmunity unidentified. The next most significant advance in characterizing ovarian autoimmunity will be definitive identification of the specific antigens and development of standardized tests based on use of specific antigens.
PMID: 12396892 [PubMed - indexed for MEDLINE]Last edited on Sat Apr 17th, 2010 01:55 pm by Debra
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One woman's nutrient is another woman's toxin.
Your body is talking to you....take a little time and listen to what it's trying to tell you.
Debra Hope-Riedesel RD/LD
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Debra
Cycle Diet Dietitian
| Joined: | Thu Sep 1st, 2005 |
| Location: | West Des Moines, Iowa, USA |
| Posts: | 3673 |
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Posted: Sat Apr 17th, 2010 01:52 pm |
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A new study related to autoimmune, PCOS and thyroiditis
Eur J Endocrinol. 2010 Mar 23. [Epub ahead of print]
High prevalence of polycystic ovary syndrome (PCOS) characteristics in girls with euthyroid chronic lymphocytic thyroiditis: A case-control study.
Ganie MA, Marwaha R, Aggarwal R, Singh S.
M Ganie, ENDOCRINOLOGY, SKIMS, SRINAGAR, 190014, India.
Abstract
Objective: The aim was to find the prevalence of PCOS phenotype in adolescent euthyroid girls with chronic lymphocytic thyroiditis (CLT). Design: This was a prospective case-control study as part of an ongoing community-wide thyroid survey in Indian schools.
Methods: One hundred and seventy five girls with euthyroid CLT and 46 age-matched non-CLT girls underwent clinical, biochemical, hormonal and ultrasonographic evaluation for diagnosis of PCOS by Rotterdam 2003 criteria. All subjects underwent serum sampling for LH, FSH, Testosterone, DHEAS, FT4, TSH and anti-TPO antibodies. OGTT was undertaken for plasma glucose and insulin. Results: Significantly higher prevalence of PCOS was noted in girls with euthyroid CLT when compared to their control counterparts (46.8% vs. 4.3%, p=0.001). The CLT girls had higher BMI, waist circumference and systolic blood pressure (p=0.001). Mean number of menstrual cycles/ yr were 8.4 +/- 3.5 vs. 10.1 +/- 1.4 and mean Ferriman-Gallwey score was 11.9 +/- 3.5 vs. 3.0 +/-2.4 (p= 0.001) in cases vs. controls respectively. The fasting and post-prandial glucose and serum cholesterol were also higher in the cases (p=0.001). HOMA-IR was 4.4 +/- 4.2 vs. 2.3 +/- 2.7 in the cases vs. controls (p=0.001).
Conclusion: Higher prevalence of PCOS characteristics in euthyroid CLT girls when compared to controls, suggest possible role of autoimmune phenomenon in the etiopathogenesis of PCOS. Further studies are required to understand the pathogenic link between these two disorders.
PMID: 20332127 [PubMed - as supplied by publisher]
A study related to liver disease & PCOS (note: gluten sensitivity also associated with autoimmune liver disease)
J Hepatol. 2007 Sep;47(3):412-7. Epub 2007 May 24.
Nonalcoholic fatty liver disease in women with polycystic ovary syndrome.
Cerda C, Pérez-Ayuso RM, Riquelme A, Soza A, Villaseca P, Sir-Petermann T, Espinoza M, Pizarro M, Solis N, Miquel JF, Arrese M.
Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Comment in:
- J Hepatol. 2007 Sep;47(3):313-5.
BACKGROUND/AIMS: Insulin resistance is a common feature of both nonalcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS), therefore, we hypothesize that PCOS and NAFLD may coexist. The aim of the present study was to determine the frequency and characteristics of NAFLD in women with PCOS. METHODS: A prospective study of patients with PCOS and no current pharmacological treatment was conducted. NAFLD was diagnosed by abdominal ultrasound following exclusion of alcohol consumption, viral, or autoimmune liver disease. Anthropometric variables, serum levels of glucose, insulin, lipids and aminotransferases, and HOMA index were determined. RESULTS: Forty-one PCOS patients (mean age: 24.6+/-7.2yr, mean body mass index [BMI]: 30.3+/-7.0kg/m(2)) were included; 26 of 41 PCOS patients (63.4%) had insulin resistance and 17 (41.5%) had NAFLD. Nine of the NAFLD patients (64%) also had abnormal aminotransferases. Women with NAFLD and PCOS had a higher HOMA index and a higher waist-hip ratio than those with normal ultrasound. Patients with PCOS showed a higher frequency of NAFLD (41% vs. 19%) and insulin resistance (63% vs. 35.5%) than a control group.
CONCLUSIONS: NAFLD is frequent in patients with PCOS confirming a relevant clinical association between these two conditions. Women with PCOS should be screened for liver disease.
PMID: 17560682 [PubMed - indexed for MEDLINE]
____________________
One woman's nutrient is another woman's toxin.
Your body is talking to you....take a little time and listen to what it's trying to tell you.
Debra Hope-Riedesel RD/LD
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