Dados do Trabalho

Title

Unveiling the Role of lncRNAs in PCOS among Patients Undergoing Assisted Reproductive Cycles

Objective

To systematically review the potential roles of long non-coding RNAs (lncRNAs) in polycystic ovary syndrome (PCOS) among patients undergoing assisted reproductive technologies. In this scope, we aim to highlight the relevance of lncRNAs as promising prognostic biomarkers for assisted reproductive outcomes.

Methods

The literature search, study selection, and data extraction process adhered to the recommended review structure described in the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was conducted in the Science Direct, Scopus, and Embase databases to identify articles highlighting the relevance of lncRNAs in PCOS management within assisted reproduction. The inclusion criteria encompassed patients undergoing in vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI) diagnosed with PCOS based on the Revised Rotterdam Diagnostic Criteria. The search was limited to English articles published within the last 10 years (2013-2023). Studies conducted in species other than humans or outside the scope of the study were excluded. For each study, information regarding study design, publication date, sample size, analyzed lncRNA, and, if available, additional results were collected. Subsequently, categories were created based on the composition of the included articles and their main focus. These categories included parameters such as apoptosis rates, cell proliferation, patient characteristics, and relevant additional predictors.

Results

The search yielded 17 prospective articles, encompassing a total of 1,534 analyzed patients, of whom 821 were diagnosed with PCOS. All 17 studies included in this review reported variances in the expression of specific lncRNAs between patients with and without PCOS. In this context, five studies have linked specific lncRNAs to physiological characteristics of patients. AC095350.1 lncRNA was found to correlate with age, LINC-01572:28 expression was linked to basal testosterone levels, HCG26 upregulation was associated with antral follicle count (AFC), and MALAT1 was associated with BMI. Moreover, MALAT1 expression was also correlated with pregnancy outcomes in PCOS. The significantly elevated lncRNA named HUPCOS in GCs was positively correlated with follicular fluid testosterone of PCOS patients. Additionally, seven lncRNAs (NONHSAT101926.2, NONHSAT136825.2, NONHSAT227177.1, NONHSAT010538.2, NONHSAT191377.1, NONHSAT230904.1, ENST00000607307) were related to hormone levels and AFC. Six studies have reported an association between increased rates of apoptosis in granulosa cells (GCs) and the overexpression of LINC00173, HOTAIRM1, lnc-CCNL1-3:1, SRLR, HLA-F-AS1, and PLAC2. Additionally, three other studies have linked the inhibition of GCs proliferation with the expression levels of lncRNAs MAP3K13-7:1, MALAT1, and LINC-01572:28. Conversely, TUG1 expression may contribute to excessive follicular activation and growth, while the lncRNA H19 may play a role in regulating GC growth.

Conclusion

In conclusion, our systematic review highlights specific lncRNAs that are associated with physiological variables, such as patients' age, BMI, AFC, and testosterone levels, while also showing correlations with GCs proliferation and apoptosis rates. These findings underscore the emerging significance of lncRNAs as promising therapeutic targets and biomarkers, offering valuable insights into treatment prognosis for effectively managing PCOS within the field of assisted reproduction.

Keywords

lncRNAs; assisted reproductive technology; PCOS