Impact of Aromatase Enzyme and its Altered Regulation on Polycystic Ovary Syndrome (PCOS): A Key Factor in Pathogenesis of PCOS

Abstract

Abstract Polycystic ovary syndrome (PCOS) is found to be a common endocrinopathy in a woman’s reproductive life. It is importantly characterized by hyperandrogenism. The enzyme aromatase prevents the accumulation of androgen by converting it into estrogens during the process of steroidogenesis. Down-regulation of this enzyme causes elevated levels of testosterone which leads to PCOS. This review is aims to explore the various factors and pathogenic pathways that influence the regulation of aromatase and steroidogenesis. The articles were selected from PUBMED, Google Scholar, Cross ref, and Research Gate. The results of the selected articles were analyzed and presented systematically. Polymorphism in the CYP19A1 gene specifically rs2414096 was found to be strongly associated with PCOS while other polymorphisms showed variable results. Micro RNAs such as miRNA1294 and lncRNAs exhibited an inhibitory role on CYP19A1 along with down-regulation of aromatase. In addition to this, the altered ratio between Inositol epimers and pathogenic activation of the JAK2/STAT3 pathway caused the down-regulation of aromatase and accumulation of testosterone. It was also observed that there was a direct effect of environmental toxins on endocrine balance which affected steroidogenesis that led to PCOS. In conclusion, Aromatase played a key role in steroidogenesis and it is the hotspot of research to investigate the pathophysiology of PCOS. Genetic polymorphism, microRNAs, pathogenic metabolism, and pollutants were significantly influenced the enzyme.