Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Andrology. 2019 Mar;7(2):257-265. doi: 10.1111/andr.12571. Epub 2018 Nov 23.
Cytotoxic cancer treatments, such as irradiation, can cause permanent sterility in male mammals owing to the loss of spermatogonial stem cells. In animal models, spermatogenesis could be restored from transplanted spermatogonial stem cells. Previously, we showed that transient suppression of FSH, LH, and testosterone in the recipient with a gonadotropin-releasing hormone antagonist (GnRH-ant), given immediately after irradiation, enhanced spermatogenesis from transplanted spermatogonial stem cells in mice and monkeys.
To explore improvements in the preparation of the recipient for efficient and reliable spermatogenic recovery from spermatogonial stem cell transplantation, so that it can be used effectively in clinical practice.
In mouse recipients, we evaluated the effects of hormone suppression given after germ cell depletion was complete, which is a more clinically relevant model, and also the importance of total androgen ablation and maintenance of FSH levels. Three regimens, GnRH-ant, GnRH-ant plus flutamide (androgen receptor antagonist), and GnRH-ant plus FSH, were administered prior to and around the time of transplantation of testis cells from immature mice or from prepubertal monkeys.
Treatment with GnRH-ant resulted in a fourfold increase in spermatogenic recovery from GFP-marked transplanted mouse cells. Total androgen ablation with the addition of flutamide, started two weeks before transplantation, did not further enhance recovery. Surprisingly, FSH supplementation, started around the time of transplantation, actually reduced spermatogenic recovery from transplanted spermatogonial stem cells in GnRH-ant-treated mice. When prepubertal monkey testicular cells were transplanted into nude mice that were given the same hormone treatments, the numbers of donor-derived colonies were independent of hormone treatment.
The enhancements in spermatogenic recovery may only occur when syngeneic or closely related donor-recipient pairs are used. These results are useful in further investigations in choosing a hormone suppression regimen in combination with spermatogonial transplantation as a treatment to restore fertility in primates after cytotoxic therapy.
细胞毒性癌症治疗,如放疗,会导致雄性哺乳动物的永久性不育,因为其精原干细胞的丧失。在动物模型中,移植精原干细胞可以恢复生殖。以前,我们表明,在接受促性腺激素释放激素拮抗剂(GnRH-ant)的受体中,立即在照射后短暂抑制 FSH、LH 和睾酮,可以增强小鼠和猴子的移植精原干细胞的生殖。
探索改善受体的准备,以从精原干细胞移植中获得有效的和可靠的生殖恢复,使其可以有效地用于临床实践。
在小鼠受体中,我们评估了在生殖细胞耗竭完成后给予激素抑制的效果,这是一种更具临床相关性的模型,还评估了总雄激素剥夺和 FSH 水平维持的重要性。在从未成熟小鼠或青春期前猴子的睾丸细胞移植之前和移植时,给予 GnRH-ant、GnRH-ant 加氟他胺(雄激素受体拮抗剂)和 GnRH-ant 加 FSH 三种方案。
用 GnRH-ant 治疗导致 GFP 标记的移植小鼠细胞的生殖恢复增加了四倍。从移植前两周开始,加用氟他胺的总雄激素剥夺并没有进一步增强恢复。令人惊讶的是,FSH 补充剂,在移植时开始,实际上降低了 GnRH-ant 处理的小鼠中移植精原干细胞的生殖恢复。当将青春期前猴睾丸细胞移植到接受相同激素处理的裸鼠中时,供体衍生的集落数量与激素处理无关。
生殖恢复的增强可能仅在使用同基因或密切相关的供体-受体对时发生。这些结果有助于进一步研究选择激素抑制方案与精原干细胞移植相结合,作为治疗细胞毒性治疗后灵长类动物生育力的方法。