Inositols: Guide to Practical Applications in Obstetrics and Gynecology

Vittorio Unfer (Editor)
A.G.UN.CO Obstetrics and Gynecology Center, Rome, Italy

Series: Therapeutic Approaches in Common Obstetrics and Gynecological Disorders
BISAC: MED033000

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This book offers a valuable mine of clinical information for health professionals and researchers. It gives an overview of the critical role played by Inositols in the therapeutic approach to common obstetrics and gynecological disorders. Inositols are a family of simple carbohydrates naturally found in several foods and human cells. There are potentially nine stereoisomers of Inositols, among them being myo-inositol (MI) and, to a lesser extent, D-chiro-inositol (DCI). These are the most important isoforms for the physiological processes in humans. They exert different actions in the control of glucose homeostasis: MI regulates the activation of glucose transporters and glucose utilization, while DCI modulates the glycogen synthesis.

Once incorporated into phosphoglycans, they act as second messengers involved in the signaling transduction cascade of insulin. The metabolism of Inositols is dysregulated in patients with Polycystic Ovary Syndrome (PCOS), highlighting the crucial link between insulin resistance and inositol deficiency in PCOS patients. Therefore, several pre-clinical and clinical studies have been carried out to evaluate their therapeutic usefulness in pathologies where there is an imbalance in MI and DCI levels (from PCOS and gestational diabetes mellitus to infertility). The clinical evidence has demonstrated that MI can be considered widely safe and well tolerated, giving prominence to this versatile molecule. In several trials, the beneficial effect of MI in improving the metabolic and endocrine profile of women with PCOS has been highlighted extensively.

Further analyses have shown that the physiological MI:DCI ratio (40:1) is the optimal approach for improving oocyte follicular development and oocyte maturation as well as ovary stimulation and pregnancy outcomes in in vitro fertilization (IVF) procedures. Furthermore, the reader is introduced to a broader area encompassing the Inositols scenery from the history to Inositols nutritional importance, the therapeutic use in preeclampsia, gynecologic oncology, fetal programming as well as their resistance and substance interaction. All these interesting topics will be discussed and deepened in the present book, giving the opportunity to explore in detail every aspect of this effective molecule, bringing the instructions from this guide to everyday practice.
(Imprint: Nova)

Foreward

Preface

Chapter 1. Use of Inositols in Gynecology and Obstetrics: A Historical Overview
(Beatrice Orrù, PhD, and Vittorio Unfer, MD, Medical Affairs Department, Lo.Li. Pharma, Rome, Italy, and others)

Chapter 2. Eating Extra Dietary Inositol: How Does It Counter the Impacts of Metabolic, Nutritional and Endocrine Imbalances?
(Robert H Michell, PhD, School of Biosciences, University of Birmingham, Birmingham, UK)

Chapter 3. Inositols in Polycystic Ovary Syndrome
(Morgan Vargo, MD, Stéphanie B. Mayer, John Nestler, MD, 1Virginia Commonwealth University, Division of Endocrinology, Diabetes and Metabolism. Richmond, VA, US and others)

Chapter 4. Inositols and Metabolic Syndrome
(Marine L. Croze, PhD, and Christophe O. Soulage, PhD, Montreal Diabetes Research Center and Research Center of the Montreal University Hospital Center, Montreal University, Montreal, Quebec, Canada, and others)

Chapter 5. Inositols and Gestational Diabetes
(Angelo Santamaria, MD, and Rosario D’Anna, MD, Department of Human Pathology, University of Messina, Italy)

Chapter 6. Inositol Resistance: A Problem and a Solution
(Zdravko Kamenov, MD, and Antoaneta Gateva, PhD, Clinic of Endocrinology, University Hospital Alexandrovska, Department of internal medicine, Medical University Sofia, Sofia, Bulgaria)

Chapter 7. Inositols vs. Metformin: Comparison between Insulin Sensitizers
(Pedro-Antonio Regidor, PhD, Exeltis Healthcare, Ismaning, Germany)

Chapter 8. Inositols in Assisted Reproductive Technologies (ART)
(Tony T. Chiu, PhD, IVF Centre, Hong Kong SAR, China)

Chapter 9. Inositols and Preeclampsia
(Marco Scioscia, Department of Obstetrics and Gynaecology, Policlinico Hospital, Abano Terme, Padua, Italy)

Chapter 10. Inositols and Fetal Programming
(Daniela Menichini, MD, and Fabio Facchinetti, MD, Mother Infant Department, University of Modena and Reggio Emilia, Modena, Italy)

Chapter 11. Inositols in Gynecologic Oncology
(Simona Dinicola, Ph.D, Alessandra Cucina, PhD, and Mariano Bizzarri, PhD, MD, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy, and others)

Chapter 12. Associations of Inositol with Other Substances: Opportunity or Risks?
(Fedele Manna, Associate Professor, Pharmaceutical and Toxicological Chemistry, Sapienza University of Rome, Rome, Italy)

Index

"This book provides a comprehensive overview on the use of Inositols in gynecology and obstetrics. From their discovery in 1850 to the most recent findings, the chapters thoroughly describe historical and current knowledge on the impact of Inositols, mainly Myo-inositol and D-chiro-inositol, upon management of Polycystic Ovary Syndrome, Metabolic syndrome, Preeclampsia, Fetal programming, Assisted Reproductive Technologies and Gynecologic oncology. Results from scientific investigations and clinical applications are presented in a rigorous although simple manner. Researchers and clinicians will certainly benefit from reading this book, and will find opportunities to expand current knowledge and applications of Inositols in this relevant field." - Mónica H. Vazquez-Levin, MSc., PhD. Senior Investigator. Consejo de Investigaciones Científicas y Técnicas de Argentina (CONICET). Director Laboratory of Cell-Cell Interaction en Reproduction and Cancer. Instituto de Biología y Medicina Experimental (IBYME-CONICET). Argentina.

"Inositol is a promising possible safe alternative treatment for amenorrhea and PCOS. This compendium outstandingly focus on new research and understanding of this alternative innovative therapy, both in metabolic and reproductive profile. I strongly recommend the reading of this book that is really unique and useful." - Professor Francesco Orio, MD, PhD, Professor of Endocrinology “Parthenope” University of Naples, Italy

"Accumulating evidence suggests that Inositols play a pivotal role in several biological processes, which are fundamental for endocrine and metabolic regulation as well as human reproduction. In this scenario, Inositols have paramount importance as potent and cost-effective compounds to counteract the underlying causes of different pathological conditions, such as metabolic syndrome, polycystic ovary syndrome, gestational diabetes and infertility. Although these insulin-sensitizer molecules have pleiotropic actions in different body microenvironments, the book provides a complete and updated summary for an evidence-based therapeutic approach with Inositols in the whole field of obstetrics and gynecology." - Antonio Simone Laganà, M.D., Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy.

"This exhaustive and very updated book guides us through the different therapeutic approaches to the obstetrics and gynecological disorders, from PCOS and GDM to infertility. A book of great scientific value written by the main worldwide experts on Inositol. It provides an overview of the critical role played by this natural molecule, from the early discovery up to nowadays researches. I recommend this publication to health professionals and researchers who want to explore in detail this area and bring the information displayed here to their everyday practice." - Giusy Porcaro, M.D., Department of Obstetrics and Gynecological, Hospital Santa Maria della Stella Orvieto USL Umbria 2, Orvieto, Umbria

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