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文献詳細

雑誌文献

臨床婦人科産科60巻9号

2006年09月発行

文献概要

今月の臨床 PCOS─新たな視点 PCOSの病因

2.高アンドロゲン血症

著者: 田嶋公久1 小辻文和1

所属機関: 1福井大学医学部産科婦人科学教室

ページ範囲:P.1167 - P.1171

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はじめに

 多嚢胞性卵巣症候群(polycystic ovary syndrome : PCOS)の定義は,時代,地域により必ずしも一致をみないが,近年,特に欧米では高アンドロゲン血症が病態の指標として重視されている.

 PCOSでは,副腎と卵巣の両方でアンドロゲン産生の増加を認めるが,本稿では卵巣のアンドロゲン産生細胞である莢膜細胞に焦点を置き,莢膜細胞の機能異常の観点からPCOSの病態生理を概説する.まず正常卵巣における莢膜細胞とアンドロゲンの働きを示したのち,PCOSにおけるアンドロゲン産生異常について最近の知見を述べる.

参考文献

1)Kotsuji F, Kamitani N, Goto K, et al:Bovine theca and granulosa cell interactions modulate their growth, morphology and function. Biol Reprod 43:726-732, 1990
2)Tajima K, Orisaka M, Hosokawa K, et al:Effects of ovarian theca cells on apoptosis and proliferation of granulosa cells:changes during bovine follicular maturation. Biol Reprod 66:1635-1639, 2002
3)Kotsuji F, Kubo M, Tominaga T:Effect of interactions between granulosa and thecal cells on meiotic arrest in bovine oocytes. J Reprod Fertil 100:151-156, 1994
4)Vendola KA, Zhou J, Adesanya OO, et al:Androgens stimulate early stages of follicular growth in the primate ovary. J Clin Invest 101:2622-2629, 1998
5)Gill A, Jamnongjit M, Hammes SR:Androgens promote maturation and signaling in mouse oocytes independent of transcription ; a release of inhibition model for mammalian oocyte meiosis. Mol Endocrinol 18:97-104, 2004
6)Agarwal SK, Judd HL, Magoffin DA:A mechanism for the suppression of estrogen production in polycystic ovary syndrome. J Clin Endocrinol Metab 81:3686-3691, 1996
7)Xia P, Younglai EV:Relationship between steroid concentrations in ovarian follicular fluid and oocyte morphology in patients undergoing intracytoplasmic sperm injection(ICSI)treatment. J Reprod Fertil 118:229-233, 2000
8)Eagleson CA, Gingrich MB, Pastor CL, et al:Polycystic ovarian syndrome:evidence that flutamide restores sensitivity of the gonadotropin-releasing hormone pulse generator to inhibition by estradiol and progesterone. J Clin Endocrinol Metab 85:4047-4052, 2000
9)San Roman GA, Magoffin DA:Insulin-like growth factor binding proteins in ovarian follicles from women with polycystic ovarian disease:cellular source and levels in follicular fluid. J Clin Endocrinol Metab 75:1010-1016, 1992
10)Tajima K, Yoshii K, Fukuda S, et al:Luteinizing hormone-induced extracellular-signal regulated kinase activation differently modulates progesterone and androstenedione production in bovine theca cells. Endocrinology 146:2903-2910, 2005

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1294

印刷版ISSN:0386-9865

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