{"id":177,"title":"Research progress of extracellular vesicles in PMOS: molecular mechanisms, diagnostic value, and therapeutic strategies","title_zh":"细胞外囊泡在多内分泌代谢性卵巢综合征（PMOS）中的研究进展：分子机制、诊断价值与治疗策略","url":"https://pubmed.ncbi.nlm.nih.gov/42979244","doi":"10.3389/fendo.2026.1976561","pmid":"42979244","journal":"Front Endocrinol (Lausanne)","kind":"paper","lang":"en","published_at":"2026-10-20T00:00:00+00:00","fetched_at":"2026-11-08T03:43:57+00:00","authors":["Qi L","Jiang Y","Han Y","Feng C","Jia L","Zhang Y"],"primary_topic":"oocyte","topics":[{"slug":"oocyte","score":5.0,"hits":["follicular","granulosa","oocyte maturation","ovarian","ovary"]},{"slug":"repro-endo","score":2.0,"hits":["polycystic ovary","premature ovarian insufficiency"]},{"slug":"endometrium","score":1.0,"hits":["stromal cell"]},{"slug":"repro-aging","score":1.0,"hits":["mitochondrial"]}],"topic_score":5.0,"preference_score":5.0,"preference_labels":["可转化到 ART 实验室的发现"],"llm_score":68.0,"final_score":73.0,"score_dims":{"novelty":65,"rigor":65,"impact":66,"relevance":80,"translation":58},"recommend_reason":"系统梳理PMOS中EV的机制、诊断与治疗证据，并明确强调临床转化限制，对生殖内分泌和卵泡微环境研究有参考价值；但属叙述性综述、无原始数据，直接指导ART实验室的价值有限。","keywords":["细胞外囊泡","多内分泌代谢性卵巢综合征","PCOS","卵泡液","颗粒细胞","生物标志物"],"selected":1,"story_id":366,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-gametes","source_name":"PubMed · 配子与性腺","source_tier":1,"mention_count":3,"has_interpretation":false,"journal_key":"front-endo","journal_tier":"standard","journal_if":3.9,"is_mock":false,"summary_zh":"本文为叙述性综述，梳理细胞外囊泡（EVs）在PMOS（原PCOS）中的分子机制、诊断潜力与实验性治疗。卵泡液EV货物随表型和肥胖变化，但尚无临床验证的诊断方法，且采集具侵入性。临床前研究显示间充质基质细胞及脂肪来源EV可调节颗粒细胞存活、线粒体质量控制与内分泌功能，工程化小EV可在小鼠递送PI3K激动剂；疾病相关EV可能影响卵母细胞成熟。总体证据以临床前为主，EV表征、剂量、分布及长期生殖安全性不足，不能直接外推临床。","summary":"Extracellular vesicles (EVs) carry proteins, lipids and nucleic acids that can influence ovarian and systemic metabolic function. This narrative review examines their molecular mechanisms, biomarker potential and experimental therapeutic applications in polyendocrine metabolic ovarian syndrome (PMOS), previously termed polycystic ovary syndrome. Follicular fluid EV cargo varies with disease phenotype and adiposity, but these associations have not established clinically validated diagnostic tests. Follicular fluid collection also requires an invasive procedure and should not be described as a non-invasive screening approach. Experimental studies indicate that selected mesenchymal stromal cell-derived EV preparations can modulate granulosa cell survival, mitochondrial quality control and endocrine function. Adipose stromal cell- and brown adipose tissue-derived preparations additionally affect metabolic pathways, while engineered small EVs can improve delivery of a PI3K agonist in mice. Disease-associated follicular fluid EVs may impair oocyte maturation or promote abnormal granulosa cell proliferation; their effects depend on source, cargo and recipient context. We distinguish PMOS-specific evidence from chemotherapy-related ovarian injury and premature ovarian insufficiency, summarize treatment models, administration and endpoints, and evaluate reporting in selected studies against MISEV2023 recommendations. The evidence remains predominantly preclinical. Incomplete EV characterization, heterogeneous doses and models, limited biodistribution data and uncertain long-term reproductive safety prevent direct extrapolation to patient care.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}