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Zhankina R, Zhanbyrbekuly U, Askarov M, Zare A, Jafari N, Saipiyeva D, Sherkhanov R, Akhmetov D, Hashemi A, Farjam M, Tanideh N, Aflatoonian B, Mussin NM, Kaliyev AA, Sultangereyev Y, Baneshi H, Shirazi R, Mahdipour M, Bakhshalizadeh S, Rahmanifar F, Tamadon A. Improving Fertility in Non-obstructive Azoospermia: Results from an Autologous Bone Mar-row-Derived Mesenchymal Stromal/Stem Cell Phase I Clinical Trial. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2024; 18:60-70. [PMID: 39033372 PMCID: PMC11263852 DOI: 10.22074/ijfs.2023.2005045.1480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 10/25/2023] [Accepted: 11/07/2023] [Indexed: 07/23/2024]
Abstract
BACKGROUND In this phase I clinical trial, our primary objective was to develop an innovative therapeutic approach utilizing autologous bone marrow-derived mesenchymal stromal/stem cells (BM-MSCs) for the treatment of nonobstructive azoospermia (NOA). Additionally, we aimed to assess the feasibility and safety of this approach. MATERIALS AND METHODS We recruited 80 participants in this non-randomized, open-label clinical trial, including patients undergoing NOA treatment using autologous BM-MSCs (n=40) and those receiving hormone therapy as a control group (n=40). Detailed participant characteristics, such as age, baseline hormonal profiles, etiology of NOA, and medical history, were thoroughly documented. Autotransplantation of BM-MSCs into the testicular network was achieved using microsurgical testicular sperm extraction (microTESE). Semen analysis and hormonal assessments were performed both before and six months after treatment. Additionally, we conducted an in-silico analysis to explore potential protein-protein interactions between exosomes secreted from BM-MSCs and receptors present in human seminiferous tubule cells. RESULTS Our results revealed significant improvements following treatment, including increased testosterone and inhibin B levels, elevated sperm concentration, and reduced levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin. Notably, in nine patients (22.5%) previously diagnosed with secondary infertility and exhibiting azoospermia before treatment, the proposed approach yielded successful outcomes, as indicated by hormonal profile changes over six months. Importantly, these improvements were achieved without complications. Additionally, our in-silico analysis identified potential binding interactions between the protein content of BM-MSC-derived exosomes and receptors integral to spermatogenesis. CONCLUSION Autotransplantation of BM-MSCs into the testicular network using microTESE in NOA patients led to the regeneration of seminiferous tubules and the regulation of hormonal profiles governing spermatogenesis. Our findings support the safety and effectiveness of autologous BM-MSCs as a promising treatment modality for NOA, with a particular focus on the achieved outcomes in patients with secondary infertility (registration number: IRCT20190519043634N1).
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Affiliation(s)
- Rano Zhankina
- Department of Urology and Andrology, Astana Medical University, Astana, Kazakhstan
| | | | | | - Afshin Zare
- Department of R&D Research, PerciaVista R&D Co., Shiraz, Iran
| | - Nazanin Jafari
- Department of R&D Research, PerciaVista R&D Co., Shiraz, Iran
| | - Dana Saipiyeva
- Department of Urology and Andrology, Astana Medical University, Astana, Kazakhstan
| | - Ravil Sherkhanov
- Department of Urology and Andrology, Astana Medical University, Astana, Kazakhstan
| | - Daniyar Akhmetov
- Department of Urology and Andrology, Astana Medical University, Astana, Kazakhstan
| | - Alireza Hashemi
- Department of R&D Research, PerciaVista R&D Co., Shiraz, Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Nader Tanideh
- Department of R&D Research, PerciaVista R&D Co., Shiraz, Iran
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmacology, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behrouz Aflatoonian
- Stem Cell Biology Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Reproductive Biology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Advanced Medical Sciences and Technologies, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nadiar Maratovich Mussin
- Department of General Surgery, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Asset Askerovich Kaliyev
- Department of General Surgery, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Yerlan Sultangereyev
- Department of General Surgery, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
- Department of Surgery and Transplantation, Aktobe Medical Center, Aktobe, Kazakhstan
| | - Hanieh Baneshi
- Department of R&D Research, PerciaVista R&D Co., Shiraz, Iran
| | - Reza Shirazi
- Department of Anatomy, School of Biomedical Sciences, Medicine & Health, UNSW Sydney, Sydney, Australia
| | - Mahdi Mahdipour
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shabnam Bakhshalizadeh
- Reproductive Development, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Farhad Rahmanifar
- Department of Basic Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Amin Tamadon
- Department of R&D Research, PerciaVista R&D Co., Shiraz, Iran
- Department of Natural Sciences, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.
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Piechka A, Sparanese S, Witherspoon L, Hach F, Flannigan R. Molecular mechanisms of cellular dysfunction in testes from men with non-obstructive azoospermia. Nat Rev Urol 2024; 21:67-90. [PMID: 38110528 DOI: 10.1038/s41585-023-00837-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/20/2023]
Abstract
Male factor infertility affects 50% of infertile couples worldwide; the most severe form, non-obstructive azoospermia (NOA), affects 10-15% of infertile males. Treatment for individuals with NOA is limited to microsurgical sperm extraction paired with in vitro fertilization intracytoplasmic sperm injection. Unfortunately, spermatozoa are only retrieved in ~50% of patients, resulting in live birth rates of 21-46%. Regenerative therapies could provide a solution; however, understanding the cell-type-specific mechanisms of cellular dysfunction is a fundamental necessity to develop precision medicine strategies that could overcome these abnormalities and promote regeneration of spermatogenesis. A number of mechanisms of cellular dysfunction have been elucidated in NOA testicular cells. These mechanisms include abnormalities in both somatic cells and germ cells in NOA testes, such as somatic cell immaturity, aberrant growth factor signalling, increased inflammation, increased apoptosis and abnormal extracellular matrix regulation. Future cell-type-specific investigations in identifying modulators of cellular transcription and translation will be key to understanding upstream dysregulation, and these studies will require development of in vitro models to functionally interrogate spermatogenic niche dysfunction in both somatic and germ cells.
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Affiliation(s)
- Arina Piechka
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- Vancouver Prostate Centre, Vancouver, British Columbia, Canada
| | - Sydney Sparanese
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Luke Witherspoon
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- Division of Urology, Department of Surgery, University of Ottawa, Ontario, Canada
| | - Faraz Hach
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- Vancouver Prostate Centre, Vancouver, British Columbia, Canada
| | - Ryan Flannigan
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
- Vancouver Prostate Centre, Vancouver, British Columbia, Canada.
- Department of Urology, Weill Cornell Medicine, New York, NY, USA.
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Liguori G, Tafuri S, Pelagalli A, Ali’ S, Russo M, Mirabella N, Squillacioti C. G Protein-Coupled Estrogen Receptor (GPER) and ERs Are Modulated in the Testis-Epididymal Complex in the Normal and Cryptorchid Dog. Vet Sci 2024; 11:21. [PMID: 38250927 PMCID: PMC10820011 DOI: 10.3390/vetsci11010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/17/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
There is growing evidence by the literature that the unbalance between androgens and estrogens is a relevant condition associated with a common canine reproductive disorder known as cryptorchidism. The role of estrogens in regulating testicular cell function and reproductive events is supposedly due to the wide expression of two nuclear estrogen receptors (ERs), ER-alpha and ER-beta and a trans-membrane G protein-coupled estrogen receptor (GPER) in the testis. In this study, immunohistochemistry, Western blotting and qRT-PCR were used to assess the distribution and expression of GPER in the testis-epididymal complex in the normal and cryptorchid dog. ER-alpha and ER-beta were also evaluated to better characterize the relative abundances of all three receptors. In addition, in these tissues, the expression level of two proteins as SOD1 and Nrf2 normally associated with oxidative stress was investigated to evaluate a possible relationship with ERs. Our data revealed changes in the distribution and expression of the GPER between the normal and cryptorchid dog. In particular, dogs affected by cryptorchidism showed an upregulation of GPER at level of the examined reproductive tract. Also considering the obtained result of a modulation of SOD1 and Nrf2 expression, we could hypothesize the involvement of GPER in the cryptorchid condition. Further studies are, however, necessary to characterize the role of GPER and its specific signaling mechanisms.
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Affiliation(s)
- Giovanna Liguori
- Department of Veterinary Medicine and Animal Production, University of Napoli Federico II, 80137 Naples, Italy; (G.L.); (S.T.); (S.A.); (M.R.); (N.M.); (C.S.)
- Department of Prevention, ASL FG, Piazza Pavoncelli 11, 71121 Foggia, Italy
| | - Simona Tafuri
- Department of Veterinary Medicine and Animal Production, University of Napoli Federico II, 80137 Naples, Italy; (G.L.); (S.T.); (S.A.); (M.R.); (N.M.); (C.S.)
| | - Alessandra Pelagalli
- Department of Advanced Biomedical Sciences, University of Napoli Federico II, 80137 Naples, Italy
- Institute of Biostructures and Bioimages, National Research Council, Via De Amicis 95, 80131 Naples, Italy
| | - Sabrina Ali’
- Department of Veterinary Medicine and Animal Production, University of Napoli Federico II, 80137 Naples, Italy; (G.L.); (S.T.); (S.A.); (M.R.); (N.M.); (C.S.)
| | - Marco Russo
- Department of Veterinary Medicine and Animal Production, University of Napoli Federico II, 80137 Naples, Italy; (G.L.); (S.T.); (S.A.); (M.R.); (N.M.); (C.S.)
| | - Nicola Mirabella
- Department of Veterinary Medicine and Animal Production, University of Napoli Federico II, 80137 Naples, Italy; (G.L.); (S.T.); (S.A.); (M.R.); (N.M.); (C.S.)
| | - Caterina Squillacioti
- Department of Veterinary Medicine and Animal Production, University of Napoli Federico II, 80137 Naples, Italy; (G.L.); (S.T.); (S.A.); (M.R.); (N.M.); (C.S.)
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Kawate N. Insulin-like peptide 3 in domestic animals with normal and abnormal reproductive functions, in comparison to rodents and humans. Reprod Med Biol 2022; 21:e12485. [PMID: 36310659 PMCID: PMC9601793 DOI: 10.1002/rmb2.12485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 11/07/2022] Open
Abstract
Background Insulin-like peptide 3 (INSL3) is a circulating hormone secreted from only testis and ovaries in mammals. Findings on INSL3 have been gathered from subjects with normal and abnormal reproductive statuses, especially rodents and humans. However, little to no review articles focusing on INSL3 in domestic animals exist. Methods The author reviewed the past and recent literature regarding the structure, expression, roles of INSL3 in the reproductive organs, and its circulation under normal and aberrant reproductive conditions in domestic animals in comparison with rodents and humans. Main findings As with humans and rodents, blood INSL3 concentrations rise around puberty in normal male domestic animals and are associated with testicular size. INSL3 levels are acutely upregulated by luteinizing hormone (LH), and the increase is smaller than that of testosterone in male ruminants, whereas the acute regulation of INSL3 by LH does not occur in human men. Dogs with cryptorchidism and bulls with abnormal semen have lowered INSL3 levels. Conclusion The findings regarding INSL3 secretions in male domestic animals with normal and aberrant reproductive functions illustrate similar or dissimilar points to humans and rodents. Data on blood INSL3 levels in normal and abnormal female domestic species are still limited and require further investigation.
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Affiliation(s)
- Noritoshi Kawate
- Graduate School of Veterinary ScienceOsaka Metropolitan UniversityIzumisanoJapan
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