Rossi Valerio, Lispi Monica, Longobardi Salvatore, Mattei Maurizio, Di Rella Francesca, Salustri Antonietta, De Felici Massimo, Klinger Francesca G
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
Medical Affair Department Fertility TA, Merck-Serono SAS, Rome, Italy.
Cell Death Differ. 2017 Jan;24(1):72-82. doi: 10.1038/cdd.2016.97. Epub 2016 Sep 30.
Premature ovarian failure and female infertility are frequent side effects of anticancer therapies, owing to the extreme sensitivity of the ovarian reserve oocytes to the damaging effects of irradiation and chemotherapy on DNA. We report here a robust protective effect of luteinizing hormone (LH) on the primordial follicle pool of prepubertal ovaries against the cisplatin (Cs)-induced apoptosis. In vitro LH treatment of prepubertal ovarian fragments generated anti-apoptotic signals by a subset of ovarian somatic cells expressing LH receptor (LHR) through cAMP/PKA and Akt pathways. Such signals, reducing the oocyte level of pro-apoptotic TAp63 protein and favoring the repair of the Cs-damaged DNA in the oocytes, prevented their apoptosis. Noteworthy, in vivo administration to prepubertal female mice of a single dose of LH together with Cs inhibited the depletion of the primordial follicle reserve caused by the drug and preserved their fertility in reproductive age, preventing significant alteration in the number of pregnancy and of delivered pups. In conclusion, these findings establish a novel ovoprotective role for LH and further support the very attracting prospective to use physiological 'fertoprotective' approaches for preventing premature infertility and risks linked to precocious menopause in young patients who survived cancer after chemotherapy.
卵巢早衰和女性不孕是抗癌治疗常见的副作用,这是由于卵巢储备卵母细胞对放疗和化疗对DNA的损伤作用极为敏感。我们在此报告,促黄体生成素(LH)对青春期前卵巢的原始卵泡库具有强大的保护作用,可抵抗顺铂(Cs)诱导的细胞凋亡。在体外,用LH处理青春期前的卵巢片段,表达LH受体(LHR)的一部分卵巢体细胞通过cAMP/PKA和Akt途径产生抗凋亡信号。这些信号降低了促凋亡TAp63蛋白在卵母细胞中的水平,并促进了卵母细胞中Cs损伤DNA的修复,从而防止了它们的凋亡。值得注意的是,在青春期前雌性小鼠体内单次注射LH并联合Cs,可抑制药物引起的原始卵泡储备的消耗,并在生殖年龄保留其生育能力,防止怀孕和产仔数量发生显著改变。总之,这些发现确立了LH新的卵巢保护作用,并进一步支持了采用生理性“生育保护”方法预防年轻癌症化疗幸存者过早不孕及与过早绝经相关风险这一极具吸引力的前景。