{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:31:10Z","timestamp":1791549070146,"version":"4.3.4"},"reference-count":33,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The aim of this study is to investigate the characteristics and etiology of endometrial hyperemia in patients with polycystic ovary syndrome (PCOS) through two complementary approaches: clinical data analysis to characterize endometrial hyperemia and clinical trials to elucidate its underlying causes. ELISA was employed to quantify inflammatory mediators in endometrial tissue, while reverse transcription quantitative polymerase chain reaction (RT-qPCR) and Western blot analyses were conducted to assess the expression levels of molecules associated with endoplasmic reticulum stress (ERS). Additionally, RT-qPCR was used to determine the mRNA expression levels of HIF-1\u03b1, VEGF, and EPO. Compared with non-PCOS patients, those with PCOS exhibited a significantly higher prevalence of chronic endometritis (CE) (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.05) along with increased levels of inflammatory factors (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.05). Furthermore, the mRNA expression levels of HIF-1\u03b1, VEGF, and EPO, as well as ERS-related molecules, were significantly elevated in PCOS patients (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.05). These findings indicate that women with PCOS are more likely to suffer from CE and that endometrial hyperemia is the primary manifestation of CE in these patients. The results further suggest that endometrial hypoxia-induced ERS may contribute to the development of endometrial hyperemia in PCOS patients.\n                  <\/jats:p>","DOI":"10.1515\/biol-2025-1154","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T16:05:42Z","timestamp":1756742742000},"source":"Crossref","is-referenced-by-count":2,"title":["To explore the relationship between endometrial hyperemia and polycystic ovary syndrome"],"prefix":"10.1515","volume":"20","author":[{"given":"Shuang","family":"Wang","sequence":"first","affiliation":[{"name":"School of Medicine, Shandong University , Jinan , Shandong, 250000 , China"},{"name":"Reproductive Medicine Centre, Yantai Yuhuangding Hospital , Yantai , Shandong, 264000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng-Hua","family":"Li","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Centre, Yantai Yuhuangding Hospital , Yantai , Shandong, 264000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Centre, Yantai Yuhuangding Hospital , Yantai , Shandong, 264000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong-Chu","family":"Bao","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Centre, Yantai Yuhuangding Hospital , Yantai , Shandong, 264000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8169-044X","authenticated-orcid":false,"given":"Cui-Fang","family":"Hao","sequence":"additional","affiliation":[{"name":"School of Medicine, Shandong University , Jinan , Shandong, 250000 , China"},{"name":"Reproductive Medicine Centre, Qingdao Women and Children\u2019s Hospital , Qingdao , Shandong, 266000 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"2025122123391369237_j_biol-2025-1154_ref_001","doi-asserted-by":"crossref","unstructured":"Safiri S, Noori M, Nejadghaderi SA, Karamzad N, Carson-Chahhoud K, Sullman MJM, et al. Prevalence, incidence and years lived with disability due to polycystic ovary syndrome in 204 countries and territories, 1990\u20132019. Hum Reprod. 2022;37:1919\u201331. 10.1093\/humrep\/deac091.","DOI":"10.1093\/humrep\/deac091"},{"key":"2025122123391369237_j_biol-2025-1154_ref_002","doi-asserted-by":"crossref","unstructured":"Fatima Q, Amin S, Kawa IA, Jeelani H, Manzoor S, Rizvi SM, et al. Evaluation of antioxidant defense markers in relation to hormonal and insulin parameters in women with polycystic ovary syndrome (PCOS): A case-control study. Diabetes Metab Syndr. 2019;13:1957\u201361. 10.1016\/j.dsx.2019.04.032.","DOI":"10.1016\/j.dsx.2019.04.032"},{"key":"2025122123391369237_j_biol-2025-1154_ref_003","doi-asserted-by":"crossref","unstructured":"Li Y, Xu S, Yu S, Huang C, Lin S, Chen W, et al. Diagnosis of chronic endometritis: How many CD138(+) cells\/HPF in endometrial stroma affect pregnancy outcome of infertile women? Am J Reprod Immunol. 2021;85:e13369. 10.1111\/aji.13369.","DOI":"10.1111\/aji.13369"},{"key":"2025122123391369237_j_biol-2025-1154_ref_004","doi-asserted-by":"crossref","unstructured":"Liu H, Song J, Zhang F, Li J, Kong W, Lv S, et al. A new hysteroscopic scoring system for diagnosing chronic endometritis. J Minim Invasive Gynecol. 2020;27:1127\u201332. 10.1016\/j.jmig.2019.08.035.","DOI":"10.1016\/j.jmig.2019.08.035"},{"key":"2025122123391369237_j_biol-2025-1154_ref_005","doi-asserted-by":"crossref","unstructured":"Giulini S, Grisendi V, Sighinolfi G, Di Vinci P, Tagliasacchi D, Botticelli L, et al. Chronic endometritis in recurrent implantation failure: Use of prednisone and IVF outcome. J Reprod Immunol. 2022;153:103673. 10.1016\/j.jri.2022.103673.","DOI":"10.1016\/j.jri.2022.103673"},{"key":"2025122123391369237_j_biol-2025-1154_ref_006","doi-asserted-by":"crossref","unstructured":"Gay C, Hamdaoui N, Pauly V, Rojat Habib MC, Djemli A, Carmassi M, et al. Impact of antibiotic treatment for chronic endometritis on unexplained recurrent pregnancy loss. J Gynecol Obstet Hum Reprod. 2021;50:102034. 10.1016\/j.jogoh.2020.102034.","DOI":"10.1016\/j.jogoh.2020.102034"},{"key":"2025122123391369237_j_biol-2025-1154_ref_007","doi-asserted-by":"crossref","unstructured":"Sterling L, Liu J, Okun N, Sakhuja A, Sierra S, Greenblatt E. Pregnancy outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization. Fertil Steril. 2016;105:791\u20137.e792. 10.1016\/j.fertnstert.2015.11.019.","DOI":"10.1016\/j.fertnstert.2015.11.019"},{"key":"2025122123391369237_j_biol-2025-1154_ref_008","doi-asserted-by":"crossref","unstructured":"Gonzalez D, Thackeray H, Lewis PD, Mantani A, Brook N, Ahuja K, et al. Loss of WT1 expression in the endometrium of infertile PCOS patients: A hyperandrogenic effect? J Clin Endocrinol Metab. 2012;97:957\u201366. 10.1210\/jc.2011-2366.","DOI":"10.1210\/jc.2011-2366"},{"key":"2025122123391369237_j_biol-2025-1154_ref_009","doi-asserted-by":"crossref","unstructured":"Cassar S, Misso ML, Hopkins WG, Shaw CS, Teede HJ, Stepto NK. Insulin resistance in polycystic ovary syndrome: A systematic review and meta-analysis of euglycaemic-hyperinsulinaemic clamp studies. Hum Reprod. 2016;31:2619\u201331. 10.1093\/humrep\/dew243.","DOI":"10.1093\/humrep\/dew243"},{"key":"2025122123391369237_j_biol-2025-1154_ref_010","doi-asserted-by":"crossref","unstructured":"Marciniak SJ, Chambers JE, Ron D. Pharmacological targeting of endoplasmic reticulum stress in disease. Nat Rev Drug Discov. 2022;21:115\u201340. 10.1038\/s41573-021-00320-3.","DOI":"10.1038\/s41573-021-00320-3"},{"key":"2025122123391369237_j_biol-2025-1154_ref_011","unstructured":"Marinelli S, Napoletano G, Straccamore M, Basile G. Female obesity and infertility: outcomes and regulatory guidance. Acta Biomed. 2022;93:e2022278. 10.23750\/abm.v93i4.13466."},{"key":"2025122123391369237_j_biol-2025-1154_ref_012","doi-asserted-by":"crossref","unstructured":"Venkatesh SS, Ferreira T, Benonisdottir S, Rahmioglu N, Becker CM, Granne I, et al. Obesity and risk of female reproductive conditions: A Mendelian randomisation study. PLoS Med. 2022;19:e1003679. 10.1371\/journal.pmed.1003679.","DOI":"10.1371\/journal.pmed.1003679"},{"key":"2025122123391369237_j_biol-2025-1154_ref_013","unstructured":"Endocrinology Group and Guidelines Expert Group of the Chinese Medical Association Obstetrics and Gynecology Branch. Guidelines for diagnosis and treatment of polycystic ovary syndrome in China. Chin J Obstet Gynecol. 2018;53:2\u20136."},{"key":"2025122123391369237_j_biol-2025-1154_ref_014","doi-asserted-by":"crossref","unstructured":"Mirza FG, Tahlak MA, Rjeili RB, Hazari K, Ennab F, Hodgman C, et al. Polycystic ovarian syndrome (PCOS): Does the challenge end at conception? Int J Environ Res Public Health. 2022;19(22):14914. 10.3390\/ijerph192214914.","DOI":"10.3390\/ijerph192214914"},{"key":"2025122123391369237_j_biol-2025-1154_ref_015","doi-asserted-by":"crossref","unstructured":"Bahri Khomami M, Shorakae S, Hashemi S, Harrison CL, Piltonen TT, Romualdi D, et al. Systematic review and meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Nat Commun. 2024;15(1):5591. 10.1038\/s41467-024-49749-1.","DOI":"10.1038\/s41467-024-49749-1"},{"key":"2025122123391369237_j_biol-2025-1154_ref_016","doi-asserted-by":"crossref","unstructured":"Bril F, Ezeh U, Amiri M, Hatoum S, Pace L, Chen YH, et al. Adipose tissue dysfunction in polycystic ovary syndrome. J Clin Endocrinol Metab. 2023;109:10\u201324. 10.1210\/clinem\/dgad356.","DOI":"10.1210\/clinem\/dgad356"},{"key":"2025122123391369237_j_biol-2025-1154_ref_017","doi-asserted-by":"crossref","unstructured":"Zhang Z, Shi C, Wang Z. Therapeutic effects and molecular mechanism of chlorogenic acid on polycystic ovarian syndrome: Role of HIF-1alpha. Nutrients. 2023;15:2833. 10.3390\/nu15132833.","DOI":"10.3390\/nu15132833"},{"key":"2025122123391369237_j_biol-2025-1154_ref_018","doi-asserted-by":"crossref","unstructured":"Qian H, Xu W, Cui L, Wang R, Wang J, Tang M, et al. Efficacy of Bushen Huatan Decoction combined with Baduanjin in the treatment of polycystic ovary syndrome with insulin resistance (IR-PCOS), kidney deficiency and phlegm dampness: Study protocol for a randomized controlled trial. Trials. 2021;22:781. 10.1186\/s13063-021-05770-z.","DOI":"10.1186\/s13063-021-05770-z"},{"key":"2025122123391369237_j_biol-2025-1154_ref_019","doi-asserted-by":"crossref","unstructured":"Shirazi FKH, Khodamoradi Z, Jeddi M. Insulin resistance and high molecular weight adiponectin in obese and non-obese patients with Polycystic Ovarian Syndrome (PCOS). BMC Endocr Disord. 2021;21:45. 10.1186\/s12902-021-00710-z.","DOI":"10.1186\/s12902-021-00710-z"},{"key":"2025122123391369237_j_biol-2025-1154_ref_020","doi-asserted-by":"crossref","unstructured":"Orisaka M, Mizutani T, Miyazaki Y, Shirafuji A, Tamamura C, Fujita M, et al. Chronic low-grade inflammation and ovarian dysfunction in women with polycystic ovarian syndrome, endometriosis, and aging. Front Endocrinol. 2023;14:1324429. 10.3389\/fendo.2023.1324429.","DOI":"10.3389\/fendo.2023.1324429"},{"key":"2025122123391369237_j_biol-2025-1154_ref_021","doi-asserted-by":"crossref","unstructured":"Apparao KB, Lovely LP, Gui Y, Lininger RA, Lessey BA. Elevated endometrial androgen receptor expression in women with polycystic ovarian syndrome. Biol Reprod. 2002;66:297\u2013304. 10.1095\/biolreprod66.2.297.","DOI":"10.1095\/biolreprod66.2.297"},{"key":"2025122123391369237_j_biol-2025-1154_ref_022","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez F. Nutrient-induced inflammation in polycystic ovary syndrome: Role in the development of metabolic aberration and ovarian dysfunction. Semin Reprod Med. 2015;33:276\u201386. 10.1055\/s-0035-1554918.","DOI":"10.1055\/s-0035-1554918"},{"key":"2025122123391369237_j_biol-2025-1154_ref_023","doi-asserted-by":"crossref","unstructured":"Spritzer PM, Lecke SB, Satler F, Morsch DM. Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome. Reproduction. 2015;149:R219\u201327. 10.1530\/rep-14-0435.","DOI":"10.1530\/REP-14-0435"},{"key":"2025122123391369237_j_biol-2025-1154_ref_024","doi-asserted-by":"crossref","unstructured":"Schatz F, Guzeloglu-Kayisli O, Arlier S, Kayisli UA, Lockwood CJ. The role of decidual cells in uterine hemostasis, menstruation, inflammation, adverse pregnancy outcomes and abnormal uterine bleeding. Hum Reprod Update. 2016;22:497\u2013515. 10.1093\/humupd\/dmw004.","DOI":"10.1093\/humupd\/dmw004"},{"key":"2025122123391369237_j_biol-2025-1154_ref_025","doi-asserted-by":"crossref","unstructured":"Wang WJ, Zhang H, Chen ZQ, Zhang W, Liu XM, Fang JY, et al. Endometrial TGF-\u03b2, IL-10, IL-17 and autophagy are dysregulated in women with recurrent implantation failure with chronic endometritis. Reprod Biol Endocrinol. 2019;17:2. 10.1186\/s12958-018-0444-9.","DOI":"10.1186\/s12958-018-0444-9"},{"key":"2025122123391369237_j_biol-2025-1154_ref_026","doi-asserted-by":"crossref","unstructured":"Cicinelli E, De Ziegler D, Nicoletti R, Colafiglio G, Saliani N, Resta L, et al. Chronic endometritis: Correlation among hysteroscopic, histologic, and bacteriologic findings in a prospective trial with 2190 consecutive office hysteroscopies. Fertil Steril. 2008;89:677\u201384. 10.1016\/j.fertnstert.2007.03.074.","DOI":"10.1016\/j.fertnstert.2007.03.074"},{"key":"2025122123391369237_j_biol-2025-1154_ref_027","doi-asserted-by":"crossref","unstructured":"Cicinelli E, Resta L, Nicoletti R, Zappimbulso V, Tartagni M, Saliani N. Endometrial micropolyps at fluid hysteroscopy suggest the existence of chronic endometritis. Hum Reprod. 2005;20:1386\u20139. 10.1093\/humrep\/deh779.","DOI":"10.1093\/humrep\/deh779"},{"key":"2025122123391369237_j_biol-2025-1154_ref_028","doi-asserted-by":"crossref","unstructured":"Cicinelli E, Matteo M, Tinelli R, Lepera A, Alfonso R, Indraccolo U, et al. Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy. Hum Reprod. 2015;30:323\u201330. 10.1093\/humrep\/deu292.","DOI":"10.1093\/humrep\/deu292"},{"key":"2025122123391369237_j_biol-2025-1154_ref_029","doi-asserted-by":"crossref","unstructured":"Rudnicka E, Suchta K, Grymowicz M, Calik-Ksepka A, Smolarczyk K, Duszewska AM, et al. Chronic low grade inflammation in pathogenesis of PCOS. Int J Mol Sci. 2021;22:3789. 10.3390\/ijms22073789.","DOI":"10.3390\/ijms22073789"},{"key":"2025122123391369237_j_biol-2025-1154_ref_030","doi-asserted-by":"crossref","unstructured":"Petrillo T, Semprini E, Tomatis V, Arnesano M, Ambrosetti F, Battipaglia C, et al. Putative complementary compounds to counteract insulin-resistance in PCOS patients. Biomedicines. 2022;10:1924. 10.3390\/biomedicines10081924.","DOI":"10.3390\/biomedicines10081924"},{"key":"2025122123391369237_j_biol-2025-1154_ref_031","doi-asserted-by":"crossref","unstructured":"Bettigole SE, Glimcher LH. Endoplasmic reticulum stress in immunity. Annu Rev Immunol. 2015;33:107\u201338. 10.1146\/annurev-immunol-032414-112116.","DOI":"10.1146\/annurev-immunol-032414-112116"},{"key":"2025122123391369237_j_biol-2025-1154_ref_032","doi-asserted-by":"crossref","unstructured":"Tang Y, Zhou X, Cao T, Chen E, Li Y, Lei W, et al. Endoplasmic reticulum stress and oxidative stress in inflammatory diseases. DNA Cell Biol. 2022;41:924\u201334. 10.1089\/dna.2022.0353.","DOI":"10.1089\/dna.2022.0353"},{"key":"2025122123391369237_j_biol-2025-1154_ref_033","doi-asserted-by":"crossref","unstructured":"Koike H, Harada M, Kusamoto A, Xu Z, Tanaka T, Sakaguchi N, et al. Roles of endoplasmic reticulum stress in the pathophysiology of polycystic ovary syndrome. Front Endocrinol (Lausanne). 2023;14:1124405. 10.3389\/fendo.2023.1124405.","DOI":"10.3389\/fendo.2023.1124405"}],"container-title":["Open Life Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/biol-2025-1154\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/biol-2025-1154\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T23:42:34Z","timestamp":1766360554000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/biol-2025-1154\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,1]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,8,20]]},"published-print":{"date-parts":[[2025,8,20]]}},"alternative-id":["10.1515\/biol-2025-1154"],"URL":"https:\/\/doi.org\/10.1515\/biol-2025-1154","relation":{},"ISSN":["2391-5412"],"issn-type":[{"value":"2391-5412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,1]]},"article-number":"20251154"}}