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Some recent work aimed to develop tamoxifen analogues that can bypass CYP2D6 metabolism and use the esterase enzymes to produce the active metabolites to ensure equal clinical outcomes for all patients [66,67,68]

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Upon activation, caspase-1 enzymatically processes the precursor pro-interleukin-1 (pro-IL-1) into its biologically active form, mature IL-1, which is then secreted into the extracellular milieu, triggering a robust inflammatory response ( Moreover, MSU triggers the release of pro-inflammatory cytokines, such as interleukin-6 (IL-6), through the NF-B and Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling cascades, consequently amplifying the infiltration of inflammatory cells ( Figure 1 )

Conversely, defective autophagy exacerbates inflammatory responses, further aggravating insulin resistance in women with PCOS ( 3.3 Ferroptosis Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, may play a key role in the pathogenesis of PCOS

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