Astaxanthin treatment alleviates ER stress in patients with polycystic ovary syndrome

Astaxanthin (ASX) is a natural carotenoid compound that is found in numerous seafood and microorganisms. It induces several possible advantageous therapeutic effects for patients with polycystic ovary syndrome (PCOS). These patients also suffer from endoplasmic reticulum (ER) stress. The present study hypothesized that ASX could improve ER stress in PCOS patients. 

The study obtained Granulosa cells (GCs) from 58 PCOS patients and classified them into those receiving ASX treatment (12 mg/day for 60 days) or those receiving a placebo. It gained follicular fluid (FF) from all patients to assess oxidative stress markers.

The study found-

• After the intervention, ASX substantially reduced the expression levels of 78-kDa glucose-regulated protein (GRP78), CCAAT/enhancer-binding protein homologous protein (CHOP), and X-box-binding protein-1 than the placebo group. 
• However, ASX did not cause a significant reduction in the messenger RNA (mRNA) expression level of activating transcription factor 6.
• ASX significantly increased the ATF4 expression level. 
• GRP78 and CHOP protein levels symbolized a marked reduction in the treatment group after the intervention. 
• The FF level significantly increased the total antioxidant capacity in the treatment group. 

Based on clinical outcomes, the study found no significant differences between the groups regarding the oocyte number, fertilization rate, and fertility rate. Still, the ASX group had higher rates of high-quality oocytes, high-quality embryos, and oocyte maturity than the placebo group. 

These findings exhibit that ASX could modulate ER stress in the GCs of PCOS patients by altering the expression of genes and proteins included in the unfolding protein response.

Jabarpour M, Aleyasin A, Nashtaei MS. et al. Astaxanthin treatment ameliorates ER stress in polycystic ovary syndrome patients: a randomized clinical trial. Sci Rep. 2023;13, 3376. https://doi.org/10.1038/s41598-023-28956-8