A growing body of research demonstrates the potential benefits of the administration of inositol isomers in the treatment of many different disorders, from reproductive to metabolic diseases. A Clinical Guide to Inositols discusses scientific evidence of inositol-based treatments in different clinical fields to provide clinicians with a practical guide to use inositol supplementation within pathological conditions. Each chapter covers a specific disorder and describes aspects of the application of inositol in clinical practice, discussing the physio-pathologic features of the health condition and scientific evidences of the effects of inositol treatment.This book is a valuable resource to researchers and clinicians looking for a clear understanding of clinical effects of inositol supplementation and a practical guide on inositol-based treatments.

This book offers a valuable clinical resource for health professionals and researchers. It gives an overview about the pivotal role played by High Molecular Hyaluronic Acid (HMW-HA) during pregnancy and its applications in the gestational period. Hyaluronic acid is a critical component of the extracellular matrix (ECM) and one of the most interesting, versatile and useful natural molecules in almost all areas of biology. As widely reported, HA has a pivotal role in several phases of pregnancy, from fertilization to labour and it displays several regulatory activities and functional properties based on its different molecular weight. While low molecular weight hyaluronic acid (LMW-HA) is widely used in gynaecology for menopause-related symptoms or in association with physical treatments (e.g., radiation therapy) to counteract the onset of adverse events, HMW-HA has been poorly evaluated as clinical treatment. Its physiological presence in the extracellular matrix of all the main organs and tissues involved in pregnancy (uterus, cervix, placenta, decidua, chorion, amnios, ovarium etc..) suggests the importance of this molecule for a successful gestation. Several papers, in particular, shed light on its importance for blastocyst adhesion and implantation, for an efficient immune tolerance and for the correct development of haemo-lymphatic system. It has been demonstrated that HMW-HA has regulatory activity on the PGRMC1 expression, a specific progesterone receptor expressed in maternal and foetal-maternal interface tissues, involved in uterine quiescence. On these premises, the administration of HMW-HA may represent an interesting treatment opportunity for the prevention of recurrent miscarriage and pre-term birth (PTB) in patients with risk factors. The high safety profile of HMW-HA further supports its administration in pregnancy. All these interesting topics will be discussed and deepened in this book, giving the opportunity to explore in detail every aspect of this effective and attractive molecule, thus helping physicians to assess the state of connective tissues in pregnancy and to evaluate the risk for the onset of gestational complications.

This book offers a valuable mine of clinical information for health professionals and researchers. It gives an overview of the critical role played by Inositols in the therapeutic approach to common obstetrics and gynecological disorders. Inositols are a family of simple carbohydrates naturally found in several foods and human cells. There are potentially nine stereoisomers of Inositols, among them being myo-inositol (MI) and, to a lesser extent, D-chiro-inositol (DCI). These are the most important isoforms for the physiological processes in humans. They exert different actions in the control of glucose homeostasis: MI regulates the activation of glucose transporters and glucose utilization, while DCI modulates the glycogen synthesis. Once incorporated into phosphoglycans, they act as second messengers involved in the signaling transduction cascade of insulin. The metabolism of Inositols is dysregulated in patients with Polycystic Ovary Syndrome (PCOS), highlighting the crucial link between insulin resistance and inositol deficiency in PCOS patients. Therefore, several pre-clinical and clinical studies have been carried out to evaluate their therapeutic usefulness in pathologies where there is an imbalance in MI and DCI levels (from PCOS and gestational diabetes mellitus to infertility). The clinical evidence has demonstrated that MI can be considered widely safe and well tolerated, giving prominence to this versatile molecule. In several trials, the beneficial effect of MI in improving the metabolic and endocrine profile of women with PCOS has been highlighted extensively. Further analyses have shown that the physiological MI:DCI ratio (40:1) is the optimal approach for improving oocyte follicular development and oocyte maturation as well as ovary stimulation and pregnancy outcomes in in vitro fertilization (IVF) procedures. Furthermore, the reader is introduced to a broader area encompassing the Inositols scenery from the history to Inositols nutritional importance, the therapeutic use in preeclampsia, gynecologic oncology, fetal programming as well as their resistance and substance interaction. All these interesting topics will be discussed and deepened in the present book, giving the opportunity to explore in detail every aspect of this effective molecule, bringing the instructions from this guide to everyday practice.

Alpha Lipoic Acid: New Perspectives and Clinical Use in Obstetrics and Gynecology focuses on the rationale of Alpha-lipoic Acid (ALA) use in the field of maternal-fetal medicine and its clinical applications. So far, the use of ALA is promising in several conditions which involve inflammation, oxidation, and tissue damage in their pathophysiology. Indeed, several studies provide a reliable amount of data related to the therapeutic use of ALA in different disorders such as cancer, neurodegenerative diseases, diabetes, tissue regeneration, ischemiareperfusion injury, and aging. According to the multiple actions of ALA and its safe profile, the book provides valuable updates regarding the positive role of ALA supplementation from implantation to parturition, and includes research and information from newer published studies in this field. The rationale of ALA use in obstetrics, the current preclinical and clinical evidences on the administration of ALA to maintain the physiological state of pregnancy and treat pathological conditions such as threatened miscarriage, and preterm delivery represent the core of this composition. In addition, to contain the core science of ALA in pregnancy, this book is designed to serve both as a valuable clinical reference for the obstetricians and as a starting point for the development of new experimental and clinical studies on the use of ALA in pregnancy.