{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:41:54Z","timestamp":1783489314664,"version":"3.55.0"},"reference-count":79,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T00:00:00Z","timestamp":1759017600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["IJMS"],"abstract":"<jats:p>Polycystic ovary syndrome (PCOS), the most common endocrine disorder in reproductive-age women, is characterized by menstrual irregularities and polycystic ovarian morphology. It is also associated with insulin resistance, chronic inflammation, and oxidative stress, all of which may promote autoimmunity. Several studies have suggested a higher occurrence of antinuclear antibodies (ANA) in PCOS but the main challenge in this field is the inconsistency of findings due to heterogeneous study designs and assay methods. However, to date, no systematic review has synthesized this evidence. We conducted a systematic review to evaluate the prevalence and serum levels of ANA in women with PCOS. A comprehensive search was performed in PubMed, Embase, and Scopus, and 13 studies were ultimately included, comprising 924 women with PCOS and 1172 controls. ANA were elevated in about half of the studies, while the remainder found no significant differences between PCOS and controls. Anti-dsDNA antibodies were the most consistently investigated ANA subtype, with most studies reporting higher levels or prevalence in PCOS. For other ANA subtypes, the evidence was limited and inconclusive, largely due to methodological variability across studies. This systematic review suggests that ANA may be elevated in a subset of women with PCOS, but the current evidence remains inconsistent. These findings highlight the need for methodological standardization in ANA assessment to enable clearer conclusions and to clarify whether ANA positivity has clinical relevance in this population.<\/jats:p>","DOI":"10.3390\/ijms26199493","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T15:38:55Z","timestamp":1759246735000},"page":"9493","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Antinuclear Antibodies in Polycystic Ovary Syndrome: A Systematic Review of Observational Studies"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4442-8519","authenticated-orcid":false,"given":"Jakub","family":"Kwiatkowski","sequence":"first","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3150-1827","authenticated-orcid":false,"given":"Nicole","family":"Akpang","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucja","family":"Zaborowska","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"},{"name":"Doctoral School of Medical and Health Sciences, Jagiellonian University Collegium Medicum, 31-530 Cracow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5853-8661","authenticated-orcid":false,"given":"Artur","family":"Ludwin","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1210\/er.2015-1104","article-title":"The Pathogenesis of Polycystic Ovary Syndrome (PCOS): The Hypothesis of PCOS as Functional Ovarian Hyperandrogenism Revisited","volume":"37","author":"Rosenfield","year":"2016","journal-title":"Endocr. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2447","DOI":"10.1210\/clinem\/dgad463","article-title":"Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome","volume":"108","author":"Teede","year":"2023","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1093\/humrep\/dep399","article-title":"The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria","volume":"25","author":"March","year":"2010","journal-title":"Hum. Reprod."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Akpang, N., Kwiatkowski, J., Zaborowska, L., and Ludwin, A. (2025). Autoantibodies Targeting the Hypothalamic-Pituitary-Ovarian Axis in Polycystic Ovary Syndrome: Emerging Key Players in Pathogenesis?. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26094121"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2100","DOI":"10.1210\/jc.2005-1494","article-title":"Heritability of polycystic ovary syndrome in a Dutch twin-family study","volume":"91","author":"Vink","year":"2006","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Zhao, Y., Pang, J., Fang, X., Yan, Z., Yang, H., Deng, Q., Ma, T., Lv, M., Li, Y., and Tu, Z. (2024). Causal relationships between modifiable risk factors and polycystic ovary syndrome: A comprehensive Mendelian randomization study. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1348368"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1093\/humrep\/deaa099","article-title":"Polycystic ovary syndrome as an independent risk factor for gestational diabetes and hypertensive disorders of pregnancy: A population-based study on 9.1 million pregnancies","volume":"35","author":"Mills","year":"2020","journal-title":"Hum. Reprod."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1089\/jwh.2014.5000","article-title":"Prevalence of infertility and use of fertility treatment in women with polycystic ovary syndrome: Data from a large community-based cohort study","volume":"24","author":"Joham","year":"2015","journal-title":"J. Womens Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2841","DOI":"10.1093\/humrep\/dew218","article-title":"The prevalence and phenotypic features of polycystic ovary syndrome: A systematic review and meta-analysis","volume":"31","author":"Bozdag","year":"2016","journal-title":"Hum. Reprod."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Pourahmad, B., Majidnia, M., Saniee, N., Riyahifar, S., and Moradi, Y. (2025). Polycystic ovary syndrome with stroke, hypertension, and cardiovascular diseases: A systematic review and meta-analysis. BMC Womens Health, 25.","DOI":"10.1186\/s12905-025-03927-5"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1093\/humrep\/dex044","article-title":"High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: A systematic review and meta-analysis","volume":"32","author":"Cooney","year":"2017","journal-title":"Hum. Reprod."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Kwiatkowski, J., Akpang, N., Ziemkiewicz, Z., Zaborowska, L., and Ludwin, A. (2025). Molecular Insights into Elevated Autoantibodies in Polycystic Ovary Syndrome: Mechanisms and Clinical Implications. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26178192"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1093\/humupd\/dms059","article-title":"Circulating markers of oxidative stress and polycystic ovary syndrome (PCOS): A systematic review and meta-analysis","volume":"19","author":"Murri","year":"2013","journal-title":"Hum. Reprod. Update"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"323","DOI":"10.4049\/immunohorizons.2200033","article-title":"Immune Dysfunction in Polycystic Ovary Syndrome","volume":"7","author":"Banerjee","year":"2023","journal-title":"Immunohorizons"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"104215","DOI":"10.1016\/j.jri.2024.104215","article-title":"Autoimmune thyroid disorders and polycystic ovary syndrome: Tracing links through systematic review and meta-analysis","volume":"163","author":"Bahreiny","year":"2024","journal-title":"J. Reprod. Immunol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1080\/09513590.2018.1469613","article-title":"Evaluation of serum anti-nuclear antibody among women with PCOS: A hospital based single center cross sectional study","volume":"34","author":"Rashid","year":"2018","journal-title":"Gynecol. Endocrinol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.21608\/ejhm.2020.113081","article-title":"The role of anti-ovarian autoantibodies in Polycystic Ovary Syndrome","volume":"81","author":"Shoukry","year":"2020","journal-title":"Egypt. J. Hosp. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S0165-0378(01)00075-4","article-title":"Autoantibody studies of female patients with reproductive failure","volume":"51","author":"Reimand","year":"2001","journal-title":"J. Reprod. Immunol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Mancini, A., Bruno, C., Vergani, E., d\u2019Abate, C., Giacchi, E., and Silvestrini, A. (2021). Oxidative Stress and Low-Grade Inflammation in Polycystic Ovary Syndrome: Controversies and New Insights. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22041667"},{"key":"ref_20","unstructured":"Nosal, R.S., Superville, S.S., Amraei, R., and Varacallo, M.A. (2025). Biochemistry, Antinuclear Antibodies (ANA), StatPearls."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Xue, H., Hu, Z., Liu, S., Zhang, S., Yang, W., Li, J., Yan, C., Zhang, J., Zhang, J., and Lei, X. (2024). The mechanism of NF-kappaB-TERT feedback regulation of granulosa cell apoptosis in PCOS rats. PLoS ONE, 19.","DOI":"10.21203\/rs.3.rs-4003002\/v1"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.4103\/0366-6999.235122","article-title":"Neutrophil Extracellular Traps in Autoimmune Diseases","volume":"131","author":"He","year":"2018","journal-title":"Chin. Med. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1038\/sj.cdd.4402239","article-title":"Autoantigens are translocated into small apoptotic bodies during early stages of apoptosis","volume":"15","author":"Schiller","year":"2008","journal-title":"Cell Death Differ."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Lin, S., Li, Y., Liu, W., Du, Y., and Tao, T. (2025). Metabolic Implications of Elevated Neutrophil Extracellular Traps in Polycystic Ovary Syndrome: A Focus on Hepatic Glycolysis. Biomolecules, 15.","DOI":"10.3390\/biom15040572"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1136\/annrheumdis-2013-203863","article-title":"International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies","volume":"73","author":"Damoiseaux","year":"2014","journal-title":"Ann. Rheum. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1038\/s41584-020-00522-w","article-title":"Understanding and interpreting antinuclear antibody tests in systemic rheumatic diseases","volume":"16","author":"Bossuyt","year":"2020","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"153","DOI":"10.3109\/s10165-008-0028-1","article-title":"Prevalence of disease-specific antinuclear antibodies in general population: Estimates from annual physical examinations of residents of a small town over a 5-year period","volume":"18","author":"Hayashi","year":"2008","journal-title":"Mod. Rheumatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s00296-021-05033-9","article-title":"Analysis of the impact of sex and age on the variation in the prevalence of antinuclear autoantibodies in Polish population: A nationwide observational, cross-sectional study","volume":"42","author":"Krzemien","year":"2022","journal-title":"Rheumatol. Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"417","DOI":"10.3904\/kjim.2022.352","article-title":"Clinical significance of antinuclear antibody positivity in patients with severe coronavirus disease 2019","volume":"38","author":"Park","year":"2023","journal-title":"Korean J. Intern. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1016\/0091-6749(84)90517-7","article-title":"Antinuclear antibodies in the serum of normal pregnant women: A prospective study","volume":"73","author":"Farnam","year":"1984","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_31","unstructured":"Solhjoo, M., Goyal, A., and Chauhan, K. (2025). Drug-Induced Lupus Erythematosus, StatPearls."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3935","DOI":"10.1007\/s10067-024-07180-3","article-title":"Mitigating overuse of antinuclear antibody (ANA) testing through educational intervention: A study in internal medicine and neurology departments","volume":"43","author":"Neumark","year":"2024","journal-title":"Clin. Rheumatol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Kwiatkowski, J., Akpang, N., Zaborowska, L., and Ludwin, A. (2025). Prevalence and Levels of Thyroid Autoantibodies in Polycystic Ovary Syndrome-Impact of TSH- and BMI-Matched Comparisons: A Systematic Review and Meta-Analysis. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26157525"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Palomba, S., Colombo, C., Busnelli, A., Caserta, D., and Vitale, G. (2023). Polycystic ovary syndrome and thyroid disorder: A comprehensive narrative review of the literature. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1251866"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3065","DOI":"10.1007\/s10067-022-06226-8","article-title":"Sex hormones, body mass index, and related comorbidities associated with developing Sj\u00f6gren\u2019s disease: A nested case-control study","volume":"41","author":"McCoy","year":"2022","journal-title":"Clin. Rheumatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/S0049-0172(03)00084-2","article-title":"Estrogen and other female reproductive risk factors are not strongly associated with the development of rheumatoid arthritis in elderly women","volume":"33","author":"Merlino","year":"2003","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"4837","DOI":"10.1007\/s10067-021-05850-0","article-title":"Polycystic ovary syndrome: Epidemiologic assessment of prevalence of systemic rheumatic and autoimmune diseases","volume":"40","author":"Sharmeen","year":"2021","journal-title":"Clin. Rheumatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.ejogrb.2013.03.003","article-title":"High prevalence of chronic thyroiditis in patients with polycystic ovary syndrome","volume":"169","author":"Garelli","year":"2013","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Page, M.J., McKenzie, J.E., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D., Shamseer, L., Tetzlaff, J.M., Akl, E.A., and Brennan, S.E. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372.","DOI":"10.1136\/bmj.n71"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"4071735","DOI":"10.1155\/2016\/4071735","article-title":"Polycystic Ovary Syndrome May Be an Autoimmune Disorder","volume":"2016","author":"Mobeen","year":"2016","journal-title":"Scientifica"},{"key":"ref_41","unstructured":"ClinicalTrials.gov (2025, August 28). The Role of Autoimmunity and Obesity in Polycystic Ovary Syndrome, Available online: https:\/\/clinicaltrials.gov\/study\/NCT05929950."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Carra, M.C., Romandini, P., and Romandini, M. (2025). Risk of Bias Evaluation of Cross-Sectional Studies: Adaptation of the Newcastle-Ottawa Scale. J. Periodontal Res., 1\u201310.","DOI":"10.1111\/jre.13405"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1016\/j.fertnstert.2005.01.085","article-title":"Diagnostic criteria for polycystic ovary syndrome: A reappraisal","volume":"83","author":"Azziz","year":"2005","journal-title":"Fertil. Steril."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.fertnstert.2008.06.035","article-title":"The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: The complete task force report","volume":"91","author":"Azziz","year":"2009","journal-title":"Fertil. Steril."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1136\/bmj.293.6543.355","article-title":"Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism","volume":"293","author":"Adams","year":"1986","journal-title":"Br. Med. J. (Clin. Res. Ed.)"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"21","DOI":"10.2174\/1871522214666140422234234","article-title":"Evaluation of ANA-related serologic autoantibodies in polycystic ovary syndrome","volume":"14","author":"Hamedi","year":"2014","journal-title":"Immunol. Endocr. Metab. Agents Med. Chem."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2291","DOI":"10.1016\/j.fertnstert.2009.01.056","article-title":"Serologic markers of autoimmunity in women with polycystic ovary syndrome","volume":"93","author":"Walch","year":"2010","journal-title":"Fertil. Steril."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.26452\/ijrps.v10i3.1366","article-title":"Serological markers of autoimmunity in women with polycystic ovary syndrome","volume":"10","author":"Ibrahim","year":"2019","journal-title":"Int. J. Res. Pharm. Sci."},{"key":"ref_49","first-page":"103","article-title":"Role of vitamin D and some immunological markers in polycystic ovarian syndrome","volume":"35","author":"Kakoo","year":"2023","journal-title":"Zanco J. Pure Appl. Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.mefs.2014.05.006","article-title":"Serologic markers of autoimmunity in women with polycystic ovary syndrome","volume":"20","author":"Makled","year":"2015","journal-title":"Middle East. Fertil. Soc. J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"302","DOI":"10.5507\/bp.2014.062","article-title":"The prevalence of non organ specific and thyroid autoimmunity in patients with polycystic ovary syndrome","volume":"159","author":"Petrikova","year":"2015","journal-title":"Biomed. Pap. Med. Fac. Univ. Palacky Olomouc Czechoslov."},{"key":"ref_52","first-page":"187","article-title":"Anti-nuclear antibodies in patients with polycystic ovary syndrome before and after laparoscopic electrocauterization","volume":"38","author":"Karimaghaei","year":"2013","journal-title":"Iran. J. Med. Sci."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s13224-013-0451-x","article-title":"Serum levels of anti-histone and anti-double-strand DNA antibodies before and after laparoscopic ovarian drilling in women with polycystic ovarian syndrome","volume":"64","author":"Samsami","year":"2014","journal-title":"J. Obstet. Gynecol. India"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"3171","DOI":"10.5958\/0974-360X.2020.00561.2","article-title":"Studying some novel biochemical and immunological markers in a sample of Iraqi women with polycystic ovarian syndrome","volume":"13","author":"Shaheed","year":"2020","journal-title":"Res. J. Pharm. Technol."},{"key":"ref_55","first-page":"e75224","article-title":"Association Between Serum Antinuclear Antibody and Polycystic Ovarian Syndrome in Reproductive Women Aged 18 to 35 Years: A Quest for an Autoimmune Marker","volume":"16","author":"Shrivastava","year":"2024","journal-title":"Cureus"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Deng, H., Chen, Y., Xing, J., Zhang, N., and Xu, L. (2024). Systematic low-grade chronic inflammation and intrinsic mechanisms in polycystic ovary syndrome. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1470283"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"393","DOI":"10.37349\/ei.2022.00058","article-title":"Polycystic ovary syndrome and immune deregulation: What do hormones want to say?","volume":"2","author":"Johnson","year":"2022","journal-title":"Explor. Immunol."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Zeber-Lubecka, N., Ciebiera, M., and Hennig, E.E. (2023). Polycystic Ovary Syndrome and Oxidative Stress-From Bench to Bedside. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241814126"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Vale-Fernandes, E., Moreira, M.V., Rodrigues, B., Pereira, S.S., Leal, C., Barreiro, M., Tome, A., and Monteiro, M.P. (2024). Anti-Mullerian hormone a surrogate of follicular fluid oxidative stress in polycystic ovary syndrome?. Front. Cell Dev. Biol., 12.","DOI":"10.3389\/fcell.2024.1408879"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"4617","DOI":"10.18632\/aging.202421","article-title":"LNK promotes granulosa cell apoptosis in PCOS via negatively regulating insulin-stimulated AKT-FOXO3 pathway","volume":"13","author":"Tan","year":"2021","journal-title":"Aging"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.jri.2016.07.006","article-title":"Distribution of HLA DRB1 and DQB1 alleles and DRB1-DQB1 haplotypes among Bahraini women with polycystic ovary syndrome","volume":"117","author":"Messadi","year":"2016","journal-title":"J. Reprod. Immunol."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Aru, N., Yang, C., Chen, Y., and Liu, J. (2023). Causal association of immune cells and polycystic ovarian syndrome: A Mendelian randomization study. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1326344"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"6603","DOI":"10.18632\/oncotarget.2224","article-title":"Genome-wide DNA methylation and gene expression patterns provide insight into polycystic ovary syndrome development","volume":"5","author":"Wang","year":"2014","journal-title":"Oncotarget"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s40744-018-0100-z","article-title":"Role of Human Leukocyte Antigens (HLA) in Autoimmune Diseases","volume":"5","author":"Bodis","year":"2018","journal-title":"Rheumatol. Ther."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"152794","DOI":"10.1016\/j.semarthrit.2025.152794","article-title":"Genome-wide association study for loci associated with positive antinuclear antibodies","volume":"74","author":"Cui","year":"2025","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Wang, J., Yin, T., and Liu, S. (2023). Dysregulation of immune response in PCOS organ system. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1169232"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Kem, D.C., Li, H., Yu, X., Weedin, E., Reynolds, A.C., Forsythe, E., Beel, M., Fischer, H., Hines, B., and Guo, Y. (2020). The Role of GnRH Receptor Autoantibodies in Polycystic Ovary Syndrome. J. Endocr. Soc., 4.","DOI":"10.1210\/jendso\/bvaa078"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"A471","DOI":"10.1016\/j.autrev.2011.11.010","article-title":"Ovarian failure and polycystic ovary syndrome","volume":"11","author":"Petrikova","year":"2012","journal-title":"Autoimmun. Rev."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1080\/09513590.2019.1581759","article-title":"Plasmatic free light chains in polycystic ovary syndrome","volume":"35","author":"Mancini","year":"2019","journal-title":"Gynecol. Endocrinol."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Ascani, A., Torstensson, S., Risal, S., Lu, H., Eriksson, G., Li, C., Teschl, S., Menezes, J., Sandor, K., and Ohlsson, C. (2023). The role of B cells in immune cell activation in polycystic ovary syndrome. eLife, 12.","DOI":"10.7554\/eLife.86454"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.1016\/j.jaci.2019.01.007","article-title":"Altered subsets and activities of B lymphocytes in polycystic ovary syndrome","volume":"143","author":"Xiao","year":"2019","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_72","first-page":"175","article-title":"T Helper Cells Profile and CD4+CD25+Foxp3+Regulatory T Cells in Polycystic Ovary Syndrome","volume":"15","author":"Nasri","year":"2018","journal-title":"Iran. J. Immunol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"441","DOI":"10.2147\/JIR.S260770","article-title":"Peripheral Blood Inflammatory-Immune Cells as a Predictor of Infertility in Women with Polycystic Ovary Syndrome","volume":"13","author":"He","year":"2020","journal-title":"J. Inflamm. Res."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Feng, Y., Tang, Z., and Zhang, W. (2023). The role of macrophages in polycystic ovarian syndrome and its typical pathological features: A narrative review. Biomed. Pharmacother., 167.","DOI":"10.1016\/j.biopha.2023.115470"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.humimm.2021.10.001","article-title":"Antinuclear antibodies in patients with endometriosis: A cross-sectional study in 94 patients","volume":"83","author":"Rahal","year":"2022","journal-title":"Hum. Immunol."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Wu, M., Wan, Y., Zhao, L., Kang, S., Hao, G., Guo, M., Wang, S., Dong, J., and Song, J. (2024). Association between thyroid autoimmunity and antinuclear antibody prevalence among pregnant women: A cross-sectional study in Qingdao, China. Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1403917"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Fang, Q., Qiao, Z., Luo, L., Bai, S., Chen, M., Zhang, X., Zong, L., Tong, X.H., and Wu, L.M. (2024). Predictive models of recurrent implantation failure in patients receiving ART treatment based on clinical features and routine laboratory data. Reprod. Biol. Endocrinol., 22.","DOI":"10.1186\/s12958-024-01203-z"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s12016-016-8586-z","article-title":"Female Infertility and Serum Auto-antibodies: A Systematic Review","volume":"53","author":"Deroux","year":"2017","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e13285","DOI":"10.1111\/sji.13285","article-title":"Association between antinuclear antibody and female infertility: A meta-analysis","volume":"98","author":"Chen","year":"2023","journal-title":"Scand. J. Immunol."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/19\/9493\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T15:43:37Z","timestamp":1759247017000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/19\/9493"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,28]]},"references-count":79,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["ijms26199493"],"URL":"https:\/\/doi.org\/10.3390\/ijms26199493","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,28]]}}}