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Updated: Jun 30, 2025

Author Spotlight: Investigating the Mechanisms and Inducing Models of Polycystic Ovary Syndrome
Published on: July 5, 2024
Discovering therapeutic possibilities for polycystic ovary syndrome by targeting XIST and its associated ceRNA
Elahe Berenji1,2, Ali Valipour Motlagh2, Marziyeh Fathi1,2
1ACECR Institute of Higher Education (Isfahan Branch), Isfahan, Iran.
Abstract:
Long non-coding RNA (lncRNA) regulates many physiological processes by acting as competitive endogenous RNA (ceRNA). The dysregulation of lncRNA X-inactive specific transcript (XIST) has been shown in various human disorders. However, its role in the pathogenesis of polycystic ovary syndrome (PCOS) is yet to be explored. This study aimed to explore the underlying mechanism of XIST in the pathogenesis of PCOS, specifically through dataset functional analysis. GEO PCOS datasets including RNA-seq, microarray, and miRNA-seq in granulosa cells (GCs) and blood, were examined and comprehensively analyzed. Enrichment analysis, ROC curve constructions, lncRNA-miRNA-mRNA interaction network analyses, and qRT-PCR validation were performed followed by a series of drug signature screenings. Our results revealed significant dysregulation in the expression of 1131 mRNAs, 30 miRNAs, and XIST in GCs of PCOS patients compared to healthy individuals. Of the120 XIST-correlated upregulated genes, 25 were enriched in inflammation-related pathways. Additionally, 5 miRNAs were identified as negative regulators of XIST-correlated genes. Accordingly, a ceRNA network containing XIST-miRNAs-mRNAs interactions was constructed. Furthermore, 6 genes, including AQP9, ETS2, PLAU, PLEK, SOCS3, and TNFRSF1B served as both GCs and blood-based biomarkers. By analyzing the number of interactions among XIST, miRNAs, and mRNAs, we pinpointed ETS2 as the pivotal gene within the ceRNA network. Our findings reveal a novel XIST- hsa-miR-146a-5p, hsa-miR-144-3p, and hsa-miR-1271-5p-ETS2 axis that comprehensively elucidates the XIST-associated mechanism underlying PCOS onset. qRT-PCR analysis further confirmed the, overexpression of both XIST and ETS2 . Furthermore, our results demonstrated that XIST and ETS2 were correlated with some assisted reproductive technologies outcomes. Finally, we identified two novel compounds including, methotrexate/folate and threonine using drug-gene interaction databases for PCOS management. These findings provide novel insights into the molecular etiology, diagnosis, and potential therapeutic interventions for PCOS.
Insights
Long non-coding RNA XIST is dysregulated in polycystic ovary syndrome (PCOS), potentially driving inflammation via a ceRNA network. This study identifies XIST and ETS2 as biomarkers and suggests methotrexate/folate and threonine for PCOS management.
Area of Science:
- Molecular Biology
- Genetics
- Endocrinology
Background:
- Long non-coding RNAs (lncRNAs) regulate physiological processes as competitive endogenous RNAs (ceRNAs).
- Dysregulation of lncRNA X-inactive specific transcript (XIST) is implicated in various human disorders.
- The role of XIST in the pathogenesis of polycystic ovary syndrome (PCOS) remains largely unexplored.
Purpose of the Study:
- To investigate the underlying mechanism of XIST in PCOS pathogenesis.
- To identify potential diagnostic biomarkers and therapeutic targets for PCOS.
Main Methods:
- Analysis of publicly available PCOS datasets (RNA-seq, microarray, miRNA-seq) from granulosa cells and blood.
- Functional enrichment analysis, ROC curve construction, and lncRNA-miRNA-mRNA interaction network analysis.
- Validation using qRT-PCR and drug signature screening.
Main Results:
- Significant differential expression of 1131 mRNAs, 30 miRNAs, and XIST in PCOS granulosa cells.
- Identification of a novel ceRNA network involving XIST, specific miRNAs (hsa-miR-146a-5p, hsa-miR-144-3p, hsa-miR-1271-5p), and ETS2.
- ETS2 identified as a pivotal gene; XIST and ETS2 validated as biomarkers, correlating with assisted reproductive technologies outcomes.
- Identification of methotrexate/folate and threonine as potential therapeutic compounds for PCOS.
Conclusions:
- A novel XIST-miRNA-ETS2 axis contributes to PCOS pathogenesis, highlighting XIST's role in inflammation.
- XIST and ETS2 show potential as diagnostic biomarkers for PCOS and may influence assisted reproduction outcomes.
- Methotrexate/folate and threonine represent promising therapeutic avenues for PCOS management.

