The Relationship Between FTO and Female Reproduction System Diseases: Focusing on PCOS, Endometriosis and Cancer and Targeted Therapy Strategy

Fat mass and obesity-related (FTO) proteins are indispensable key enzymes in the dynamic regulation of RNA epigenetic transcriptome modification, which significantly affect the RNA life cycle process. In recent years, the involvement of RNA epigenetic modifications in the underlying mechanisms of female reproductive disorders has been extensively researched. Several m6A regulators, including METTL3, FTO are involved in the processes and development of reproduction. FTO-involved m6A modification has been implicated in endometriosis, polycystic ovary syndrome (PCOS), and frequent gynecological cancers include ovarian and endometrial cancer. The pleiotropic effect of FTO has been revealed to be involved in many female diseases, which exert tumor suppressive effects by affecting the IGF1/PI3K-AKT axis and EMT pathway. In ovarian cancer, FTO expression showed distinct associations with tumor growth, with pleiotropic effects. This paper summarizes the association between the m6A modification process of FTO and recent female reproductive diseases——endometriosis, PCOS and cancer, aiming to explore the clinical application and research direction of female reproduction and pathophysiology, increase the current understanding of the cellular mechanism of female reproductive system diseases, diagnostic biomarkers and explore the treatment plan of reproductive system diseases with FTO target as the core.