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LH/FSH dysregulation an elevated LH-to-FSH ratio produced by abnormally rapid GnRH pulse frequency in the hypothalamus, creating a hormonal environment that stimulates androgen production while suppressing follicle maturation.[3] Chronic low-grade inflammation elevated CRP, IL-6, and TNF-, even in lean women with PCOS and in the absence of obesity, suggesting that inflammation is a core feature, not a secondary consequence of excess weight

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found that hypoxia can drive the production of CXCL4 in MS patients plasmacytoid dendritic cells by stabilizing HIF-2 through excessive production of mtROS ( P =0.0079) (166)