Yu Zhiheng, Liu Wei, Wang Ziyu, Chen Yidong, Yan Jie, Benet Leslie Z, Zhai Suodi
Pharmacy Department, Peking University Third Hospital, Beijing, China.
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Clin Transl Sci. 2024 Oct;17(10):e70027. doi: 10.1111/cts.70027.
In traditional understanding, P-glycoprotein (P-gp) and Breast Cancer Resistance Protein (BCRP) are regarded as efflux transporters that can decrease the concentration of their substrates in the testis, thereby reducing reproductive toxicity in males (RTM) and protecting spermatogenesis. However, there is currently no direct pharmacological evidence demonstrating that P-gp and BCRP can reduce the occurrence of drug-induced RTM. In this study, we chose small molecule targeted anti-tumor agents as model drugs and systematically retrieved and collected information on the transporters and RTM for these drugs, followed by correlation analysis. The results showed a lower incidence of RTM for P-gp substrate drugs, which aligns with previous knowledge. Surprisingly, BCRP substrate drugs exhibited higher rates of RTM in various dimensions, contradicting previous notions. This discrepancy may be attributed to the differential distribution and transport directions of P-gp and BCRP on the blood-testis barrier (BTB). For the first time, this study may provide clues that BCRP may facilitate the passage of exogenous compounds across the BTB, increasing the occurrence of RTM, rather than protecting spermatogenesis as traditionally believed. Furthermore, this study provides the first direct verification of the role of P-gp in reducing RTM and protecting spermatogenesis.
在传统认知中,P-糖蛋白(P-gp)和乳腺癌耐药蛋白(BCRP)被视为外排转运体,它们能够降低睾丸中其底物的浓度,从而降低男性生殖毒性(RTM)并保护精子发生。然而,目前尚无直接的药理学证据表明P-gp和BCRP能够减少药物诱导的RTM的发生。在本研究中,我们选择小分子靶向抗肿瘤药物作为模型药物,系统地检索并收集了这些药物的转运体和RTM相关信息,随后进行相关性分析。结果显示,P-gp底物药物的RTM发生率较低,这与先前的认知相符。令人惊讶的是,BCRP底物药物在各个维度上均表现出较高的RTM发生率,这与先前的观念相悖。这种差异可能归因于P-gp和BCRP在血睾屏障(BTB)上的分布和转运方向不同。本研究首次可能提供线索表明,BCRP可能促进外源性化合物穿过BTB,增加RTM的发生,而不是像传统认为的那样保护精子发生。此外,本研究首次直接验证了P-gp在降低RTM和保护精子发生中的作用。