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New clinical targets of d-chiro-inositol: rationale and potential applications
Antonio Simone Laganà1,2, Simone Garzon1, Vittorio Unfer2,3
1Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria , Varese, Italy.
Introduction:
Inositols have a key role in ovarian physiology and the literature reports a wealth of studies about the major isomer, myo-inositol (MI). However, information about d-chiro-inositol (DCI) is still scarce, despite the ratio MI:DCI is tissue-specific and actively maintained by an insulin-dependent epimerase enzyme.
Areas Covered:
This expert opinion provides an overview of the physiological contribution of DCI in regulating steroidogenesis. DCI indeed mediates the intracellular signaling of insulin, which induces the biosynthesis of androgens. Studies on second messengers of insulin also revealed that DCI has a specific role in modulating the activity of aromatase enzyme. Specifically, recent findings demonstrated that DCI influences the enzyme gene expression, thus reducing the conversion of androgens into estrogens.
Expert Opinion:
Available evidence suggests that the effects of DCI administration may be similar to those of aromatase inhibitors, but without causing hypo-estrogenic states. Therefore, DCI treatments should be evaluated for either estrogen-dependent gynecological conditions or low testosterone states in male subjects.
Insights
D-chiro-inositol (DCI) plays a crucial role in regulating steroidogenesis by mediating insulin signaling and influencing aromatase activity. DCI may offer therapeutic benefits for gynecological conditions and low testosterone without causing hypo-estrogenic states.
Area of Science:
- Endocrinology
- Reproductive Physiology
Background:
- Inositols, particularly myo-inositol (MI), are vital in ovarian physiology.
- Information on d-chiro-inositol (DCI) is limited, despite its crucial role and insulin-dependent regulation.
- The MI:DCI ratio is tissue-specific and essential for physiological balance.
Purpose of the Study:
- To provide an expert overview of d-chiro-inositol's (DCI) physiological role in steroidogenesis.
- To elucidate DCI's function in mediating insulin signaling and androgen biosynthesis.
- To explore DCI's specific modulation of aromatase enzyme activity.
Main Methods:
- Expert opinion synthesis of existing literature.
- Analysis of DCI's role as an intracellular insulin second messenger.
- Review of studies on DCI's influence on aromatase gene expression.
Main Results:
- DCI mediates insulin's intracellular signaling pathway, promoting androgen biosynthesis.
- DCI specifically modulates aromatase activity, reducing androgen conversion to estrogens.
- DCI influences aromatase enzyme gene expression.
Conclusions:
- DCI administration may mimic aromatase inhibitors without inducing hypo-estrogenism.
- DCI treatment warrants investigation for estrogen-dependent gynecological conditions.
- DCI evaluation is recommended for managing low testosterone states in males.
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