Pediatric Surgical Research Laboratories, Massachusetts General Hospital, Boston.
Department of Surgery, Harvard Medical School, Cambridge.
Curr Opin Endocrinol Diabetes Obes. 2018 Dec;25(6):399-405. doi: 10.1097/MED.0000000000000442.
The nascent field of oncofertility is quickly gaining traction as novel experimental treatments are being developed, driving a renewed interest in Müllerian inhibiting substance (MIS) as an ovarian fertoprotectant.
MIS is unique in its mechanisms of ovarian protection by virtue of acting directly on granulosa cells of primordial follicles and for being a benign reproductive hormone, with few side effects. We will explore in this review how it may be utilized to protect the ovary from chemotherapy, or to enhance ovarian tissue cryopreservation therapy. We will also examine potential mechanisms of action of MIS across multiple cell types, as well as current limitations in our understanding of the pharmacology of recombinant MIS.
The usefulness of MIS as a fertoprotectant may be dependent on the mechanisms of gonadotoxicity of each chemotherapeutic. Further investigation is needed to determine how to best deliver and combine MIS treatment to existing fertility management strategies.
随着新的实验性治疗方法的发展，肿瘤生育力这一新兴领域迅速受到关注，人们对作为卵巢保护剂的 Müllerian 抑制物质（MIS）重新产生了兴趣。
MIS 通过直接作用于原始卵泡的颗粒细胞来保护卵巢，具有独特的作用机制，而且作为一种良性生殖激素，副作用很少。在这篇综述中，我们将探讨如何利用 MIS 来保护卵巢免受化疗的影响，或增强卵巢组织冷冻保存治疗。我们还将研究 MIS 在多种细胞类型中的潜在作用机制，以及我们对重组 MIS 药理学理解的当前局限性。
MIS 作为一种生育保护剂的效用可能取决于每种化疗药物的性腺毒性机制。需要进一步研究以确定如何最好地提供和结合 MIS 治疗与现有的生育力管理策略。
