G0S2 drives lipid metabolism disorders and oxidative stress to promote M1 macrophage polarization and inflammation in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is characterized by lipid metabolism disorders and oxidative stress. Dysregulated lipid metabolism and oxidative stress are key drivers of chronic inflammation, notably through M1 macrophage polarization within the ovarian microenvironment. The aim of our study was to identify key metabolic regulators involved in PCOS pathogenesis. We analyzed the intersection of lipid metabolism-related genes and significantly upregulated genes from two GEO datasets (GSE226146 and GSE54520). The G0/G1 Switch Gene 2 (G0S2) was identified as a relevant candidate. Gene and protein expression levels of G0S2 were validated in granulosa cells from PCOS patients and healthy controls via qRT-PCR and western blotting. We further validated in vitro results using a dehydroepiandrosterone (DHEA)-induced PCOS mouse model, which exhibited increased cystic follicles and reduced corpora lutea, consistent with PCOS-like morphology. G0S2 encodes a protein that inhibits adipose triglyceride Lipase. It was significantly upregulated in granulosa cells from PCOS patients, suggesting a potential role in disease pathophysiology. Functional studies in KGN cells demonstrated that G0S2 mediates DHEA-induced lipid accumulation and promotes oxidative stress via NOX4, leading to NF-κB activation and inflammatory signaling. G0S2 further facilitates M1 macrophage recruitment through CCL5 secretion and drives M0 to M1 polarization via NF-κB pathway activation. Importantly, G0S2 knockdown ameliorated PCOS-like phenotypes, improved fertility outcomes, and alleviated metabolic dysfunction and inflammation in DHEA-treated mice. Our findings infer that G0S2 is a key mediator that links lipid dysregulation and immune activation in PCOS and offer a potential therapeutic target for restoring metabolic and reproductive homeostasis.