International Business Department           Liu Bojia           June 17, 2023

  In 2015, Chinese scientist Tu Youyou was awarded the Nobel Prize in Physiology or Medicine for her discovery of artemisinin, a treatment for malaria. Artemisinin is a compound extracted from the plant Artemisia annua, which rapidly kills the malaria parasite early in the malaria infection, significantly reducing the mortality rate of malaria patients. Artemisinin has been a globally important antimalarial drug for half a century, and combination therapies based on artemisinin or its derivative artemether are now important first-line antimalarials.

  Surprisingly, artemisinin, a well-known antimalarial "old drug," has a new use. In the latest issue of the leading international academic journal Science, a research team led by Professor Tang Qiqun of the School of Basic Medical Sciences at Fudan University found that artemisinin can be used to treat a common endocrine disorder in women: polycystic ovary syndrome. This, says Science, is "a major advance in the field of reproductive medicine".

  According to the World Health Organisation, polycystic ovary syndrome (PCOS) affects 8-13% of women of reproductive age worldwide. Patients often suffer from excessive facial or body hair, acne, thinning hair, and irregular menstrual cycles due to excessive androgen production by the ovaries, and it can lead to impaired fertility and susceptibility to failed implantation or recurrent miscarriages. In addition, metabolic problems such as insulin resistance and diabetes, and psychiatric disorders such as anxiety and eating disorders, are among the more common long-term complications of polycystic ovary syndrome.

  Although millions of women around the world suffer from polycystic ovary syndrome, both the understanding of its pathogenesis and specific treatments are still limited, and clinical treatment is mainly focused on alleviating symptoms.

  In this new study, scientists have found that artemisinin-based compounds can inhibit ovarian androgen synthesis, improving the hormonal imbalance at its root, and achieving a "curative" effect.

  This is because, from the point of view of the female ovary androgen production process, testosterone and androstenedione mainly from cholesterol, by the ovarian membrane cells in the luteinising hormone (LH) stimulation of synthesis, and these conversion steps require several key enzymes, such as cytochrome P450 family of CYP11A1, etc., in the polycystic ovary syndrome patients with membrane cells with high activity, leading to an increase in the production of androgens. production increases.

  However, the new study found that artemisinin, by directly binding to a mitochondrial protease called LONP1, can promote the degradation of the key enzyme CYP11A1, thereby reducing ovarian androgen synthesis and alleviating polycystic ovary syndrome.

  To verify the potential of artemisinin in treating polycystic ovary syndrome (PCOS), the researchers first carried out experiments on mouse and rat models of PCOS with high androgen secretion. The results showed that injection of the artemisinin derivative artemether resulted in regular oestrous cycles and normal ovarian morphology, as well as improved embryo implantation rates and increased litter sizes.

  Building on the well-established and proven safety of artemether for malaria treatment, the team went on to conduct a small clinical trial to confirm the efficacy of artemisinin in patients with polycystic ovary syndrome (PCOS). 12 weeks of artemisinin administration in 19 patients resulted in a significant reduction in disease-related biomarkers in the blood, an improvement in the morphology of the polycystic ovaries, and a regularisation of the menstrual cycle. improved, and menstrual cycles became regular.

  The authors of the study concluded at the end of the paper's abstract: "Our data suggest that artemisinin application is a promising approach for the treatment of polycystic ovary syndrome."

  The journal Science also gave high marks to this "new use of an old drug" discovery, with an expert commentary published at the same time stating that the new strategy of treating polycystic ovary syndrome with artemisinin-based drugs not only emphasises the versatility of artemisinins, but also represents a promising improvement in the quality of life for the millions of women affected.