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Volume 22
Issue 5
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Review
Peer-Review Record

The Role of Chronic Inflammation in Polycystic Ovarian Syndrome—A Systematic Review and Meta-Analysis

Int. J. Mol. Sci. 2021, 22(5), 2734; https://doi.org/10.3390/ijms22052734
by Shaimaa Aboeldalyl 1,2, Cathryn James 3, Emaduldin Seyam 2, Emad Moussa Ibrahim 2, Hossam El-Din Shawki 2 and Saad Amer 1,*
Reviewer 1: Anonymous
Reviewer 2: Anonymous
Int. J. Mol. Sci. 2021, 22(5), 2734; https://doi.org/10.3390/ijms22052734
Submission received: 18 February 2021 / Revised: 3 March 2021 / Accepted: 4 March 2021 / Published: 8 March 2021
(This article belongs to the Special Issue Polycystic Ovary Syndrome: From Molecular Mechanisms to Therapies)

Round 1

Reviewer 1 Report

This study was about the significance in chronic inflammatory markers in PCOS by meta-analysis and showed that circulating CRP could be indicative of low-grade chronic inflammation in PCOS. This reviewer agrees with the author's opinions. The typo at line 183 should be corrected.

Author Response

We would like to thank the reviewer for the positive comment and for spotting the typographical errors. We have now carefully checked the manuscript and identified few typos, which have all been corrected as highlighted in the text.

here is a list of corrections:

Line 183: White cell count (WCC) - changed to adiponectin

Line 240: repeated word "women" deleted

Line 259: "Escobar et al"  changed to "Escobar-Morreale et al"

Line 340 :Pro-inflammatory - changed to proinflammatory (for consistency) 

Line 408:".. in addition other .." changed to "in addition to other.."

Line 421: ".. according to a systematic review by [147]".  - changed to "according to a recent systematic review [146]."   

Line 494: BMI >30 - added kg/m2

 

Reviewer 2 Report

This meta-analysis by Aboeldalyl et al. seeks to disentangle the chronic inflammation often observed in PCOS patients from obesity, which is a frequent co-morbidity of PCOS and a source of chronic inflammation as well. The authors update a previous meta-analysis examining this question through the addition of many recent studies that have used high-quality methods to measure the inflammation marker C-reactive protein (CRP). Additionally, the authors used more robust selection criteria than the previous study. They find that CRP levels are significantly higher in PCOS patients, even in a subset of studies that included non-obese PCOS and control women. Their analysis is strong evidence that PCOS is associated with chronic inflammation independently of obesity. This is supported by smaller analyses of several other pro- or anti-inflammation markers. Overall, this is a very well done analysis that should help guide future PCOS research. I only have one small comment: 

The heading for 2.2.5 seems to be a copy/paste error--should refer to adiponectin? 

Author Response

We would like to thank the reviewer for the positive feedback and for spotting the error, which we have now corrected as highlighted in the revised manuscript.

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