Inositols in the ovaries: activities and potential therapeutic applications

Laganà A.S. Forte G. Bizzarri M. Kamenov Z.A. Bianco B. Kaya C. Gitas G. Alkatout I. Terzic M. Unfer V.
2022 Taylor and Francis Ltd.

Expert Opinion on Drug Metabolism and Toxicology
2022 #18 Issue 2 123 - 133 pp.

Introduction: Myo-inositol (MI) and d-chiro-inositol (DCI) play a key role in ovarian physiology, as they are second messengers of insulin and gonadotropins. Ex-vivo and in-vitro experiments demonstrate that both isomers are deeply involved in steroid biosynthesis, and that reduced MI-to-DCI ratios are associated with pathological imbalance of sex hormones. Areas covered: This expert opinion provides an overview of the physiological distribution of MI and DCI in the ovarian tissues, and a thorough insight of their involvement into ovarian steroidogenesis. Insulin resistance and compensatory hyperinsulinemia dramatically reduce the MI-to-DCI ratio in the ovaries, leading to gynecological disorders characterized by hyperandrogenism, altered menstrual cycle and infertility. Expert opinion: Available evidence indicates that MI and DCI have very specific physiological roles and, seemingly, physiological MI-to-DCI ratios in the ovaries are crucial to maintain the correct homeostasis of steroids. Inositol treatments should be evaluated on the patients’ specific conditions and needs, as long-term supplementation of high doses of DCI may cause detrimental effects on the ovarian functionality. In addition, the effects of inositol therapy on the different PCOS phenotypes should be further investigated in order to better tailor the supplementation.

d-chiro-inositol , Epimerase , Insulin Resistance , Myo-inositol , Ovarian Steroidogenesis , Polycystic Ovary Syndrome

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The Experts Group on Inositols in Basic and Clinical Research (EGOI), Rome, Italy
Unit of Gynecologic Oncology, ARNAS Civico – Di Cristina – Benfratelli, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
RD Department, Lo.Li. Pharma S.r.l, Rome, Italy
Department of Experimental Medicine, Systems Biology Group Lab, Sapienza University of Rome, Rome, Italy
Department of Internal Medicine, Medical University of Sofia, Sofia, Bulgaria
Discipline of Sexual and Reproductive Health, Populational Genetics - Department of Collective Health, Faculdade de Medicina do ABC/Centro Universitário FMABC, Santo André, Brazil
Department of Obstetrics and Gynaecology, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
Department of Obstetrics and Gynecology, Charité Campus, Berlin, Germany
Department of Obstetrics and Gynecology, University Hospital Schleswig Holstein, Kiel, Germany
Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
National Research Center for Maternal and Child Health, Clinical Academic Department of Women’s Health, University Medical Center, Nur-Sultan, Kazakhstan
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA, United States
Systems Biology Group Lab, Rome, Italy

The Experts Group on Inositols in Basic and Clinical Research (EGOI)
Unit of Gynecologic Oncology
RD Department
Department of Experimental Medicine
Department of Internal Medicine
Discipline of Sexual and Reproductive Health
Department of Obstetrics and Gynaecology
Department of Obstetrics and Gynecology
Department of Obstetrics and Gynecology
Department of Medicine
National Research Center for Maternal and Child Health
Department of Obstetrics
Systems Biology Group Lab

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