akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2026.724akusherstvo-2803Research ArticleREVIEW ARTICLESНАУЧНЫЕ ОБЗОРЫClinical perspectives for D-chiroinositol dose-dependent supplementation in estrogen-dependent hyperproliferative gynecological diseasesКлинические перспективы дозозависимой дотации D-хироинозитола при эстрогензависимых гиперпролиферативных заболеваниях женской репродуктивной системыhttps://orcid.org/0000-0002-7663-710XГромоваО. А.GromovaO. A.

Громова Ольга Алексеевна, д.м.н., проф.

Scopus Author ID: 7003589812

119333 Москва, ул. Вавилова, д. 44, корп. 2

Olga A. Gromova, MD, Dr Sci Med, Prof.

Scopus Author ID: 7003589812

44 bldg. 2, Vavilova Str., Moscow 119333

unesco.gromova@gmail.comhttps://orcid.org/0000-0002-2659-7998ТоршинИ. Ю.TorshinI. Yu.

Торшин Иван Юрьевич, к.ф.-м.н., к.х.н.

Scopus Author ID: 7003300274. WoS ResearcherID: C-7683-2018

119333 Москва, ул. Вавилова, д. 44, корп. 2

Ivan Yu. Torshin, MD, PhD in Physics and Mathematics, PhD in Chemistry

Scopus Author ID: 7003300274. WoS ResearcherID: C-7683-2018

44 bldg. 2, Vavilova Str., Moscow 119333

https://orcid.org/0000-0001-9524-8962ДиккеГ. Б.DikkeG. B.

Дикке Галина Борисовна, д.м.н., проф.

190013 Санкт-Петербург, Московский проспект, д. 22, литера М

Galina B. Dikke, MD, Dr Sci Med, Prof.

22 Litera M, Moskovskiy Prospekt, Saint Petersburg 190013

ФГУ «Федеральный исследовательский центр "Информатика и управление" Российской академии наук»РоссияFederal Research Center «Computer Science and Control», Russian Academy of SciencesRussian FederationЧОУ ДПО «Академия медицинского образования имени Ф.И. Иноземцева»РоссияInozemtsev Academy of Medical EducationRussian Federation202610052026202335351Copyright © Gromova O.A., Torshin I.Y., Dikke G.B., 20262026Громова О.А., Торшин И.Ю., Дикке Г.Б.Gromova O.A., Torshin I.Y., Dikke G.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/2803

D-chiroinositol (D-CI) is an endogenous molecule that plays a key role in the insulin signaling cascade. Insulin promotes the release of inositolphosphoglycans, which contain D-CI so that D-CI deficiency in cells and tissues is directly related to insulin resistance. The mechanism of action of all insulin sensitizers is linked to increasing free D-CI concentration. However, the role of D-CI in vivo is not limited to mediating insulin signal transduction, as it is also involved in the dose-dependent regulation of various other essential physiological processes. This enables D-CI-level-based modulation of distinct physiological functions. D-CI dose-dependently modulates the activity of key steroidogenic enzymes, including 17α-hydroxylase, 3β-hydroxysteroid dehydrogenase, and aromatase. It also exhibits anti-inflammatory and anti-tumor properties by downmodulating levels of tumor necrosis factor-alpha (TNF-α) and nuclear factor kappa B (NF-κB), as well as suppressing integrin β3 (protein that in humans is encoded by the ITGB3 gene) gene expression. These effects underpin potential D-CI therapeutic efficacy in managing a broad spectrum of reproductive system disorders. D-CI-related multifaceted effects on insulin resistance, steroidogenesis regulation, and inflammation position this molecule as a promising pharmaconutrient for correcting a wide range of conditions – spanning from insulin resistance syndrome with hyperandrogenism in polycystic ovary syndrome to hyperproliferative, estrogen-dependent diseases such as endometriosis, uterine fibroids, endometrial hyperplasia, and fibrocystic breast disease. The selection of appropriate D-CI daily dosage is a critical determinant underlying its full clinical efficacy.

D-хироинозитол (D-ХИ) представляет собой эндогенную молекулу, играющую ключевую роль в инсулиновом каскаде. Инсулин способствует высвобождению сигнальных молекул – инозитолфосфогликанов, в состав которых входит D-ХИ, поэтому дефицит D-XИ в клетках и тканях напрямую ассоциирован с инсулинорезистентностью, а механизм действия всех инсулиносенситайзеров связан с повышением концентрации свободного D-ХИ. Однако роль D-XИ в организме не ограничивается только участием в передаче сигналов инсулина, так как он дозозависимо участвует в регуляции и ряда других важных физиологических процессов. Это позволяет управлять различными физиологическими процессами в зависимости от концентрации D-ХИ. D-XИ дозозависимо модулирует активность ключевых ферментов стероидогенеза, таких как 17α-гидроксилаза, 3β-гидроксистероиддегидрогеназа и ароматаза. Также он демонстрирует противовоспалительные и противоопухолевые свойства, снижая уровень фактора некроза опухоли альфа (англ. tumor necrosis factor-alpha, TNF-α), ядерного фактора каппа B (англ. nuclear factor kappa B, NF-κB) и экспрессию гена интегрина β3 (ITGB3; бета-субъединица рецептора фибриногена тромбоцитов, тромбоцитарный гликопротеин IIIa). Данные эффекты лежат в основе потенциальной терапевтической эффективности D-XИ для коррекции различного спектра патологий репродуктивной системы. Комплексное влияние D-XИ на инсулинорезистентность, регуляцию стероидогенеза и его противовоспалительные свойства делают эту молекулу перспективным фармаконутриентом для коррекции широкого спектра состояний: от синдрома инсулинорезистентности с гиперандрогенией при синдроме поликистозных яичников до гиперпролиферативных эстрогензависимых заболеваний, таких как эндометриоз, фибромиома матки, гиперплазия эндометрия и фиброзно-кистозная мастопатия. Подбор адекватной суточной дозировки D-XИ является ключевым фактором для реализации всех его клинических эффектов.

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