Sphingosine 1 phosphate suppresses cyclophosphamide induced follicle apoptosis in human fetal ovarian xenografts in nude mice

Antiapoptotic drug sphingosine-1-phosphate suppresses follicular depletion associated with chemotherapeutic agent cyclophosphamide treatment in human fetal ovarian xenografts, potentially providing a new option to prevent infertility associated with cancer treatments.

Yuanyuan Meng, M.D., Zhihui Xu, M.D., Fangfang Wu, M.D., Wenming Chen, M.D., Shuangshuang Xie, M.D., Jun Liu, Ph.D., Xuefeng Huang, M.D., Ying Zhou, M.D.

Volume 102, Issue 3, Pages 871-877


To investigate the antiapoptosis effect of sphingosine-1-phosphate (S1P) on human fetal ovarian tissue treated by cyclophosphamide (CTX).

Experimental animal study.

University center for reproductive medicine and IVF unit.

Female immunodeficient BALB/c nude mice, 6 to 8 weeks old.

Human fetal ovarian tissue slowly cryopreserved then subcutaneously transplanted in immunodeficient mice.

Main Outcome Measure(s):
Follicle survival assessed qualitatively and quantitatively using H&E staining, and cellular apoptosis of the ovarian grafts evaluated using transmission electron microscopy and DNA nick end labeling in situ (TUNEL assay).

The alkylating agent CTX caused a substantial follicle loss and apoptotic DNA fragmentation in the ovarian grafts in a period of 2 weeks of transplantation. The S1P treatment significantly prevented follicular apoptosis and maintained primordial follicle population in the grafts.

This study shows for the first time that S1P protects primordial follicles in human ovarian grafts from a chemotherapy drug treatment via suppressing follicle apoptosis.

  • Amanda N. Kallen

    This is a fascinating study – I like the idea of exploring the use of an anti-apoptotic drug to prevent cyclophosphamide-induced ovarian toxicity. I do have two comments: one being that, at the very end of the paper, the authors mention that increased activation of the quiescent primordial follicle population has also been implicated in the mechanism of CTX toxicity. If this were the case, I would expect S1P (which induces growth and proliferation, as the authors pointed out) to be ineffective or even harmful to primordial follicle populations. This is not observed which I think lends support to the authors’ hypothesis. My other comment/question is regarding the tissue levels / dose of S1P. In a human patient population, this mode of delivery of S1P would not be feasible (at least with ovaries in situ). Has any equivalent systemic dose been tried in mouse or human populations, and if so, how was it tolerated? Thank you again for this great work.

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