4 Discussion
endometriosis, desaturation, kidney qi deficiency, γ-linolenic acid, malignancy, kidney yin deficiency, M-Arginine, premature ovarian failure, kidney-qi
PREMATURE OVARIAN FAILURE, ENDOMETRIOSIS, INFLAMMATORY RESPONSES, DISORDERS, OXIDATIVE STRESS, PATHOGENESIS
Older women with poor ovarian response due to kidney-qi deficiency have decreased ovarian function and ovum mass, decreased oxidative stress and DNA repair damage in the body with age, and changes in autophagy and glycosylation levels, which are accompanied by aging-induced conditions that may cause inflammatory responses in neutrophils. Modern pharmacological studies have found that the traditional Chinese medicine components in Guilu Erxian ointment can improve the above disorders. Tortoise shell glue alleviates renal histopathological changes and has antioxidant activity in rats with kidney yin deficiency to some extent (In this study, 228 metabolites were identified in the follicular fluid of older patients with poor ovarian response of kidney-qi deficiency type and normal women, and 55 differential metabolites were found, of which 43 were up-regulated: L-Aspartic acid, L-Alanine, Sarcanine, Beta-Alosine, Aminoadipic acid, L-Asparagine, L-Arginine, L-Serine, etc. There were 12 kinds of downward adjustments: Pyroglutamic acid, Acetylglycine, 11Z-Eicosenoic Acid, Erucic Acid, etc. It can be divided into seven categories, which are amino acids, fatty acids, bile acids, indoles, hydroxyl acids, binary carboxylic acids, and others, mainly involving metabolic pathways such as Protein metabolism and absorption, Glycine, serine and threonine metabolism acids, Biosynthesis of amino acids digestion, Nicotinate and nicotinamide. Combined with previous studies that found a large correlation between L-aspartic acid, Alanine, Aminoadipic acid, L-asparagine, Arginine, L-serine, γ-linolenic acid, pentadecanoic acid, α-linolenic acid and poor ovarian response in advanced age, we speculated that these substances may be biomarkers for poor ovarian response in advanced age patients with kidney qi deficiency.L-Aspartic acid is a non-essential amino acid. In 2020, Ichikawa (The 2013 study demonstrated that indirectly confirmed its role in the pathogenesis of premature ovarian failure in women by replacing positively selected amino acids with L-Alanine or the most representative residue in other investigated species is important for the normal function of the protein as well as fertility in women (Aminoadipic acid accumulates in large amounts with aging (Previous studies have found significant differences between L-Asparagine in endometriosis and malignancy (M-Arginine is a non-essential amino acid that plays a critical role in various biological processes including immune responses (As one of the most important signaling pathways, the Hippo signaling pathway plays an important role in regulating female reproductive system development (Gamma-Linolenic acid is synthesized from linoleic acid (Among fatty acids, odd-chain saturated fatty acids (mainly pentadecanoic acid and heptadecanoic acid), conjugated linoleic acid, and palmitoleic acid can be acquired from diet, specific metabolic pathways, or intestinal bacteria (The level of Alpha-Linolenic Acid in follicular fluid is inversely related to the ability of oocytes to develop to metaphase, and researchers have also found that as follicles grow α-linolenic acid levels decrease, suggesting that the latter fatty acid is converted to long-chain counterparts by sequential elongation and desaturation reactions, and have also demonstrated that supplementation of bovine COC with α-linolenic acid eliminates the lipotoxic effects of non-esterified fatty acids on oocyte developmental ability (