Abstract
BACKGROUND: Apoptosis and autophagy play important roles in the development and maturation of the ovaries in women. Any abnormalities in these processes may lead to conditions such as polycystic ovary syndrome (PCOS); therefore, evaluating the synergistic effects of apoptosis and autophagy in PCOS patients may explain the complexity of this disease. METHODS: This study included 68 patients diagnosed with PCOS and 66 non-PCOS women as control subjects, with ages ranging from 20 to 45 years. The serum levels and gene expression of Beclin-1 and programmed cell death 1 (PD-1) were assessed using ELISA and RT-PCR, respectively. RESULTS: Serum Beclin-1 and PD-1 levels were considerably higher in women with PCOS compared to the control group (p<0.0001). Significant overexpression of Beclin-1 and PD-1 genes was observed in PCOS patients compared to the control group (p=0.019 and <0.0001). Higher Beclin-1 and PD-1 gene expression was observed in PCOS patients over 25 compared to controls over and under 25 (p<0.05) years of age. In obese PCOS patients (waist-hip ratio >0.8), gene expression of Beclin-1 and PD-1 was significantly higher than in controls (p<0.01). Beclin-1 gene overexpression was detected in PCOS patients with a family history of PCOS compared to those without such history (p<0.05). The statistical analysis demonstrated a positive association between hormonal profile, autophagy, and apoptosis in PCOS patients. CONCLUSION: These findings suggest that Beclin-1 and PD-1 may have a significant role in the development of PCOS. The study highlights the potential of targeting Beclin-1 and PD-1 as future directions for immunotherapeutic intervention in PCOS.