NLRP3 Inflammasome in Polycystic Ovary Syndrome: Pathogenic Mechanisms and Therapeutic Potential

Authors

  • Simin Yu Baise People's Hospital, Youjiang Medical University for Nationalities, Baise, China Author
  • Tongye Su Baise People's Hospital, Youjiang Medical University for Nationalities, Baise, China Author

DOI:

https://doi.org/10.70088/b5qj9931

Keywords:

NLRP3 inflammasome, polycystic ovary syndrome, inflammation, pathogenesis

Abstract

Polycystic ovary syndrome (PCOS) is a polygenic and multifactorial reproductive endocrine disorder, with chronic low-grade inflammation recognized as a contributing factor in its pathogenesis. The NOD-like receptor protein 3 (NLRP3) inflammasome is a multiprotein complex within the innate immune system whose activation leads to the production of inflammatory cytokines and inflammatory factors. A growing body of evidence indicates that the NLRP3 inflammasome plays a critical role in the pathophysiology of PCOS. This review summarizes the multifaceted roles of the NLRP3 inflammasome in the pathogenesis and treatment of PCOS, aiming to provide novel insights and directions for further investigation into the pathogenic mechanisms and clinical management of PCOS.

References

C. Vatier and S. Christin-Maitre, "Epigenetic/circadian clocks and PCOS," Human Reproduction (Oxford, England), vol. 39, no. 6, pp. 1167–1175, 2024.

C. Guan, S. Zahid, A. S. Minhas, et al., "Polycystic ovary syndrome: a 'risk-enhancing' factor for cardiovascular disease," Fertility and Sterility, vol. 117, no. 5, pp. 924–935, 2022.

A. T. Brinca, A. C. Ramalhinho, A. Sousa, et al., "Follicular fluid: a powerful tool for the understanding and diagnosis of polycystic ovary syndrome," Biomedicines, vol. 10, no. 6, p. 1254, 2022.

M. G. Da Broi, V. S. I. Giorgi, F. Wang, et al., "Influence of follicular fluid and cumulus cells on oocyte quality: clinical implications," Journal of Assisted Reproduction and Genetics, vol. 35, no. 5, pp. 735–751, 2018.

H. Deng, Y. Chen, J. Xing, et al., "Systematic low-grade chronic inflammation and intrinsic mechanisms in polycystic ovary syndrome," Frontiers in Immunology, vol. 15, p. 1470283, 2024.

M. Dadkhah and M. Sharifi, "The NLRP3 inflammasome: mechanisms of activation, regulation, and role in diseases," International Reviews of Immunology, pp. 1–14, 2024.

E. Irandoost, S. Najibi, S. Talebbeigi, et al., "Focus on the role of NLRP3 inflammasome in the pathology of endometriosis: a review on molecular mechanisms and possible medical applications," Naunyn-Schmiedeberg's Archives of Pharmacology, vol. 396, no. 4, pp. 621–631, 2023.

V. Lamantia, S. Bissonnette, M. Beaudry, et al., "EPA and DHA inhibit LDL-induced upregulation of human adipose tissue NLRP3 inflammasome/IL-1β pathway and its association with diabetes risk factors," Scientific Reports, vol. 14, no. 1, p. 27146, 2024.

Y. Yang, Y. Qiao, G. Liu, et al., "A novel synbiotic protects against DSS-induced colitis in mice via anti-inflammatory and microbiota-balancing properties," Probiotics and Antimicrobial Proteins, 2024.

D. T. Meier, J. De Paula Souza, and M. Y. Donath, "Targeting the NLRP3 inflammasome-IL-1β pathway in type 2 diabetes and obesity," Diabetologia, 2024.

Y. Kim, S. Lee, and Y. H. Park, "NLRP3 negative regulation mechanisms in the resting state and its implications for therapeutic development," International Journal of Molecular Sciences, vol. 25, no. 16, p. 9018, 2024.

L. Andreeva, L. David, S. Rawson, et al., "NLRP3 cages revealed by full-length mouse NLRP3 structure control pathway activation," Cell, vol. 184, no. 26, pp. 6299–6312.e22, 2021.

Q. Yuan, B. Tang, and C. Zhang, "Signaling pathways of chronic kidney diseases, implications for therapeutics," Signal Transduction and Targeted Therapy, vol. 7, no. 1, p. 182, 2022.

K. Shahzad, S. Fatima, H. Khawaja, et al., "Podocyte-specific NLRP3 inflammasome activation promotes diabetic kidney disease," Kidney International, vol. 102, no. 4, pp. 766–779, 2022.

R. C. Coll and K. Schroder, "Inflammasome components as new therapeutic targets in inflammatory disease," Nature Reviews Immunology, 2024.

H. Duez and B. Pourcet, "Nuclear receptors in the control of the NLRP3 inflammasome pathway," Frontiers in Endocrinology, vol. 12, p. 630536, 2021.

T. Mokhtari, M. Lu, and A. E.-M. El-Kenawy, "Potential anxiolytic and antidepressant-like effects of luteolin in a chronic constriction injury rat model of neuropathic pain: role of oxidative stress, neurotrophins, and inflammatory factors," International Immunopharmacology, vol. 122, p. 110520, 2023.

L. Xiao, M. Wang, Y. Shi, et al., "Neuroinflammation-mediated white matter injury in Parkinson's disease and potential therapeutic strategies targeting NLRP3 inflammasome," International Immunopharmacology, vol. 143, p. 113483, 2024.

Y. Huang, W. Xu, and R. Zhou, "NLRP3 inflammasome activation and cell death," Cellular & Molecular Immunology, vol. 18, no. 9, pp. 2114–2127, 2021, doi: 10.1038/s41423-021-00740-6.

J. M. Navarro-Pando, E. Alcocer-Gomez, B. Castejon-Vega, et al., "Inhibition of the NLRP3 inflammasome prevents ovarian aging," Science Advances, vol. 7, no. 1, p. eabc7409, 2021.

S. A. Alenezi, R. Khan, L. Snell, et al., "The role of NLRP3 inflammasome in obesity and PCOS—a systematic review and meta-analysis," International Journal of Molecular Sciences, vol. 24, no. 13, p. 10976, 2023.

B. Wang, M. Shi, C. Yu, et al., "NLRP3 inflammasome-dependent pathway is involved in the pathogenesis of polycystic ovary syndrome," Reproductive Sciences (Thousand Oaks, Calif.), vol. 31, no. 4, pp. 1017–1027, 2024.

M. Orisaka, T. Mizutani, Y. Miyazaki, et al., "Chronic low-grade inflammation and ovarian dysfunction in women with polycystic ovarian syndrome, endometriosis, and aging," Frontiers in Endocrinology, vol. 14, p. 1324429, 2023.

A. Salmassi, A. Fattahi, M. Nouri, et al., "Expression of mRNA and protein of IL-18 and its receptor in human follicular granulosa cells," Journal of Endocrinological Investigation, vol. 40, no. 4, pp. 447–454, 2017.

Y. Liu, H. Liu, Z. Li, et al., "The release of peripheral immune inflammatory cytokines promote an inflammatory cascade in PCOS patients via altering the follicular microenvironment," Frontiers in Immunology, vol. 12, p. 685724, 2021.

D. Wang, Y. Weng, Y. Zhang, et al., "Exposure to hyperandrogen drives ovarian dysfunction and fibrosis by activating the NLRP3 inflammasome in mice," The Science of the Total Environment, vol. 745, p. 141049, 2020.

J. Hou, Z. Lei, L. Cui, et al., "Polystyrene microplastics lead to pyroptosis and apoptosis of ovarian granulosa cells via NLRP3/caspase-1 signaling pathway in rats," Ecotoxicology and Environmental Safety, vol. 212, p. 112012, 2021.

H. Li, Y. Li, Y. Zhang, et al., "Rubus chingii Hu relieved the polycystic ovary syndrome with enhanced insulin sensitivity through inhibiting TNIP/NLRP3 inflammasome signaling," *Gynecological Endocrinology: The Official Journal of the International Society of Gynecological Endocrinology*, vol. 39, no. 1, p. 2237116, 2023.

H. H. Freeze, J. X. Chong, M. J. Bamshad, et al., "Solving glycosylation disorders: fundamental approaches reveal complicated pathways," American Journal of Human Genetics, vol. 94, no. 2, pp. 161–175, 2014.

B. G. Ng and H. H. Freeze, "Perspectives on glycosylation and its congenital disorders," Trends in Genetics: TIG, vol. 34, no. 6, pp. 466–476, 2018.

K. S. Olaniyi and S. E. Arleoegbe, "Alleviation of adipose-hepatic glycolipid dysregulation by acetate in experimental PCOS model is associated with NF-κB/NLRP3 repression," Canadian Journal of Physiology and Pharmacology, vol. 101, no. 12, pp. 630–641, 2023.

L. Zhou, "Research on the pathogenesis and related progress of polycystic ovary syndrome," Chronic Disease Journal, vol. 25, no. 12, pp. 1798–1800, 2024.

J.-Y. Fan, T. Yi, C.-M. Sze-To, et al., "A systematic review of the botanical, phytochemical and pharmacological profile of Dracaena cochinchinensis, a plant source of the ethnomedicine 'dragon's blood'," Molecules (Basel, Switzerland), vol. 19, no. 7, pp. 10650–10669, 2014.

Q. Lang, X. Yidong, Z. Xueguang, et al., "ETA-mediated anti-TNF-α therapy ameliorates the phenotype of PCOS model induced by letrozole," PLoS One, vol. 14, no. 6, p. e0217495, 2019.

Y. Li, N. Yao, Y. Gao, et al., "MiR-1224-5p attenuates polycystic ovary syndrome through inhibiting NOD-like receptor protein 3 inflammasome activation via targeting forkhead box O 1," Bioengineered, vol. 12, no. 1, pp. 8555–8569, 2021.

M.-C. Huang, P.-L. Chen, and C.-L. Hsu, "Transcriptome analysis of mesenchymal progenitor cells revealed molecular insights into metabolic dysfunction and inflammation in polycystic ovary syndrome," International Journal of Molecular Sciences, vol. 25, no. 14, p. 7948, 2024.

M. Rostamtabar, S. Esmaeilzadeh, A. Karkhah, et al., "Elevated expression of IL-18 but not IL-1β gene is associated with NALP3 and AIM2 inflammasome in polycystic ovary syndrome," Gene, vol. 731, p. 144352, 2020.

D. Wang, Y. Weng, Y. Zhang, et al., "Exposure to hyperandrogen drives ovarian dysfunction and fibrosis by activating the NLRP3 inflammasome in mice," The Science of the Total Environment, vol. 745, p. 141049, 2020.

P. Moghetti and F. Tosi, "Insulin resistance and PCOS: chicken or egg?," Journal of Endocrinological Investigation, vol. 44, no. 2, pp. 233–244, 2021.

T. Viinikangas, E. Khosrowabadi, and S. Kellokumpu, "N-glycan biosynthesis: basic principles and factors affecting its outcome," Experientia Supplementum (2012), vol. 112, pp. 237–257, 2021.

R. Zhou, A. Tardivel, B. Thorens, et al., "Thioredoxin-interacting protein links oxidative stress to inflammasome activation," Nature Immunology, vol. 11, no. 2, pp. 136–140, 2010.

D. Gao, M. Madi, C. Ding, et al., "Interleukin-1β mediates macrophage-induced impairment of insulin signaling in human primary adipocytes," American Journal of Physiology. Endocrinology and Metabolism, vol. 307, no. 3, pp. E289–E304, 2014.

N. Esser, L. L'homme, A. De Roover, et al., "Obesity phenotype is related to NLRP3 inflammasome activity and immunological profile of visceral adipose tissue," Diabetologia, vol. 56, no. 11, pp. 2487–2497, 2013.

S. Bando, D. Fukuda, T. Soeki, et al., "Expression of NLRP3 in subcutaneous adipose tissue is associated with coronary atherosclerosis," Atherosclerosis, vol. 242, no. 2, pp. 407–414, 2015.

J. R. Lukens, V. D. Dixit, and T.-D. Kanneganti, "Inflammasome activation in obesity-related inflammatory diseases and autoimmunity," Discovery Medicine, vol. 12, no. 62, pp. 65–74, 2011.

N. Veličković, B. Mićić, A. Teofilović, et al., "Overfeeding in the early postnatal period aggravates inflammation and hepatic insulin sensitivity in the 5α-dihydrotestosterone-induced animal model of PCOS," Frontiers in Endocrinology, vol. 15, p. 1402905, 2024.

M. Rostamtabar, S. Esmaeilzadeh, A. Karkhah, et al., "Elevated expression of IL-18 but not IL-1β gene is associated with NALP3 and AIM2 inflammasome in polycystic ovary syndrome," Gene, vol. 731, p. 144352, 2020.

Y. Shi, Q. Lv, M. Zheng, et al., "NLRP3 inflammasome inhibitor INF39 attenuated NLRP3 assembly in macrophages," International Immunopharmacology, vol. 92, p. 107358, 2021.

Y. Chen, C. Miao, Y. Zhao, et al., "Inflammasomes in human reproductive diseases," Molecular Human Reproduction, vol. 29, no. 10, p. gaad035, 2023.

K.-J. Chang, J.-H. Chen, and K.-H. Chen, "The pathophysiological mechanism and clinical treatment of polycystic ovary syndrome: a molecular and cellular review of the literature," International Journal of Molecular Sciences, vol. 25, no. 16, p. 9037, 2024.

L.-H. Zhou, H. Zou, J.-Y. Hao, et al., "Metformin inhibits ovarian granular cell pyroptosis through the miR-670-3p/NOX2/ROS pathway," Aging, vol. 15, no. 10, pp. 4429–4443, 2023.

L.-H. Zhou, H. Zou, J.-Y. Hao, et al., "Metformin inhibits ovarian granular cell pyroptosis through the miR-670-3p/NOX2/ROS pathway," Aging, vol. 15, no. 10, pp. 4429–4443, 2023.

Q.-J. Guo, J. Shan, Y.-F. Xu, et al., "Pioglitazone metformin complex improves polycystic ovary syndrome comorbid psychological distress via inhibiting NLRP3 inflammasome activation: a prospective clinical study," Mediators of Inflammation, vol. 2020, p. 3050487, 2020.

Y. Xiang, S. Liu, S. Wan, et al., "Interleukin-1 increases SERPINE1 expression in human granulosa-lutein cell via p50/p52 signaling pathways," Molecular and Cellular Endocrinology, vol. 591, p. 112274, 2024.

S. A. Khodir, E. Sweed, S. M. Motawaa, et al., "Diacerein and myo-inositol alleviate letrozole-induced PCOS via modulation of HMGB1, SIRT1, and NF-κB: a comparative study," Naunyn-Schmiedeberg's Archives of Pharmacology, 2024.

M. Z. U. H. Shah, V. K. Shrivastava, S. Muzamil, et al., "Diacerein mitigates endocrine and cardio-metabolic disruptions in experimental PCOS mice model by modulating AdipoR1/PON 1," BMC Endocrine Disorders, vol. 24, no. 1, p. 109, 2024.

Y. F. Ibrahim, M. Alorabi, W. Y. Abdelzaher, et al., "Diacerein ameliorates letrozole-induced polycystic ovarian syndrome in rats," Biomedicine & Pharmacotherapy, vol. 149, p. 112870, 2022.

Downloads

Published

08 October 2026

Issue

Section

Article

How to Cite

Yu, S. and Su, T. (2026) “NLRP3 Inflammasome in Polycystic Ovary Syndrome: Pathogenic Mechanisms and Therapeutic Potential”, Medicine Insights, 3(5), pp. 46–52. doi:10.70088/b5qj9931.