Authors:
Antonio Simone Laganà, Simone Garzon and Vittorio Unfer
Abstract
Introduction: Inositols have a key role in ovarian physiology and the literature reports a wealth of
studies about the major isomer, myo-inositol (MI). However, information about D-chiro-inositol (DCI) is
still scarce, despite the ratio MI:DCI is tissue-specific and actively maintained by an insulin-dependent
epimerase enzyme.
Areas covered: This expert opinion provides an overview of the physiological contribution of DCI in
regulating steroidogenesis. DCI indeed mediates the intracellular signaling of insulin, which induces the
biosynthesis of androgens. Studies on second messengers of insulin also revealed that DCI has a specific
role in modulating the activity of aromatase enzyme. Specifically, recent findings demonstrated that DCI
influences the enzyme gene expression, thus reducing the conversion of androgens into estrogens.
Expert opinion: Available evidence suggests that the effects of DCI administration may be similar to
those of aromatase inhibitors, but without causing hypo-estrogenic states. Therefore, DCI treatments
should be evaluated for either estrogen-dependent gynecological conditions or low testosterone states
in male subjects.
