Key result
Blocking the APLN/APJ axis with the antagonist ML221 significantly restored blood-testis barrier integrity and improved functional spermatogenesis, increasing blastocyst developmental rates from 3.2% to 29.9% in diabetic db/db mice.
Why the study?
The molecular mechanisms contributing to spermatogenesis dysfunction in male patients with type 2 diabetes mellitus have not been fully elucidated.
Does blocking APLN/APJ improve blood-testis barrier integrity and spermatogenesis in diabetic models?
Does blocking APLN/APJ improve blood-testis barrier integrity and spermatogenesis in diabetic models?
Targeting the APLN/APJ axis with ML221 restores blood-testis barrier integrity and improves spermatogenesis in diabetic models, highlighting a potential therapeutic target for diabetes-associated male infertility.
Answers are grounded in this paper and cite their sources.
May support APLN/APJ blockade for diabetic male infertility; animal data leave open human efficacy and safety.
Type 2 diabetes mellitus is one of the most prevalent metabolic diseases presenting with systemic pathologies, including reproductive disorders in male diabetic patients. However, the molecular mechanisms that contributing to spermatogenesis dysfunction in diabetic patients have not yet been fully elucidated. Here, we perform STRT-seq to examine the transcriptome of diabetic patients' testes at single-cell resolution including all major cell types of the testis. Intriguingly, whereas spermatogenesis appears largely preserved, the gene expression profiles of Sertoli cells and the blood-testis barrier (BTB) structure are dramatically impaired. Among these deregulate pathways, the Apelin (APLN) peptide/Apelin-receptor (APJ) axis is hyper-activated in diabetic patients' testes. Mechanistically, APLN is produced locally by Sertoli cells upon high glucose treatment, which subsequently suppress the production of carnitine and repress the expression of cell adhesion genes in Sertoli cells. Together, these effects culminate in BTB structural dysfunction. Finally, using the small molecule APLN receptor antagonist, ML221, we show that blocking APLN/APJ significantly ameliorate the BTB damage and, importantly, improve functional spermatogenesis in diabetic db/db mice. We also translate and validate these findings in cultured human testes. Our findings identify the APLN/APJ axis as a promising therapeutic target to improve reproduction capacity in male diabetic patients.
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Song et al. (2022) studied Type 2 diabetes mellitus associated spermatogenesis dysfunction (n=11). ML221 (APLN receptor antagonist) vs. Vehicle was evaluated on Blastocyst developmental rate in vitro fertilization (db/db mice). Blocking the APLN/APJ axis with the antagonist ML221 significantly restored blood-testis barrier integrity and improved functional spermatogenesis, increasing blastocyst developmental rates from 3.2% to 29.9% in diabetic db/db mice.
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