Research Paper Volume 11, Issue 21 pp 9500—9529

Figure 5. ERβ/Ptgds signalling pathway imbalance disrupting renal lipid metabolism and continues influencing ‘hypothalamus-uterus-kidney axis’ (HUK axis) function. During ovary failure, a significant downregulation of ERβ (green bubble) leads to PTGDS overexpression (green helix shape) due to persistent releasing ‘estrogen secretion’ instruction from hypothalamus after ovary failure. We call this ‘fake – immunity’. This would further activate the generation of PGD₂ and its derivatives (orange bubbles, each compound represent by blue hexagon shape) in renal cells (yellow cell structure), and inhibit them exert into body fluid circulation through the autocrine and paracrine pathways to reach other intracellular targets (serum: light pink colour; urine: light yellow colour). Therefore, extensively accumulation of these Ptgds regulated metabolites promote kidney lipid toxicity progression (cytoskeleton destruction, grey blue colour part in left panel), then kidney microenvironments disturbance occurs; consequently, inhibition of Ptgds transmission along the ‘hypothalamus-uterus-kidney axis’ result in its decreased expression in hypothalamus neurocyte (green cell structure). The artwork material from SMART SERVIER MEDICAL ART (Free download, https://smart.servier.com).