1.Isolation of functional human Leydig cells: A differential-adhesion approach with multi-modal phenotypic and steroidogenic validation
Yee Jia Heng ; Pooi Pooi Leong ; Omar Ahmed Fahmy Ahmed ; Waye Hann Kang
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):3-
Introduction:
Leydig cells (LCs) are the principal source of testosterone in males, underpinning male reproductive health and androgendependent physiology. Precise isolation of viable human LCs is essential for mechanistic steroidogenesis research and
cell-based therapeutic development. Existing protocols rely on density-gradient centrifugation, which is technically
demanding and often compromises yield and viability. Here, we describe a simplified density-gradient-free approach
using differential adhesion to enrich functional human LCs from testicular tissue.
Methodology:
Human testicular fragments (~5 mm³) were minced and enzymatically digested with collagenase IV (2 mg/mL) at 37°C for
20 min under gentle agitation (100 RPM). The suspension was filtered (45 µm) and plated onto poly-L-lysine-coated T25
flasks. After 24 hours, non-adherent cells were removed by PBS washing. Viability exceeded 90% by trypan blue exclusion.
Cells were maintained in DMEM/F12 with 10% FBS, 1% Antibiotic-Antimycotic, and 10 ng/mL luteinizing hormone
(LH) to preserve the mature LC phenotype. Characterization employed immunofluorescence and flow cytometry using
antibodies against SF-1, StAR, LHCGR, PDGFRA, and TEM-1. Testosterone secretion was quantified by ELISA under basal
conditions and LH-stimulated conditions (10 ng/mL).
Results:
The protocol yielded ~1.25 × 10⁶ LCs per gram of tissue with >80% purity. Adherent HLCs displayed dense cytoplasmic
lipid granules and intercellular networks consistent with active steroidogenesis. Flow cytometry confirmed 84.7% StAR⁺
cells, indicative of a robust steroidogenic population. A distinct progenitor subpopulation (PDGFRα⁺/TEM-1⁺) comprising
~28% of primary cultures, suggests retention of regenerative capacity. Basal testosterone secretion averaged 8.88 ng/mL
per 24 hours, confirming preserved functional activity post-isolation.
Conclusion
This differential-adhesion protocol efficiently isolates functional human LCs without density-gradient media. Multimodal validation integrating immunofluorescence, flow cytometry, and ELISA confirms both phenotypic identity and
steroidogenic competence, providing a reproducible and accessible platform for LC research and translational applications
in male hypogonadism and androgen replacement.
Leydig Cells
2.Pituitary-driven gonadal hyperstimulation: A rare presentation of functioning gonadotroph adenoma
Nurbadriah Jasmiad ; Wei Wei Ng ; Anilah Abdul Rahim ; Ijaz Hallaj Rahmatullah
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):17-
Introduction:
Functioning gonadotroph adenomas, also known as follicle-stimulating hormone (FSH)-secreting pituitary adenomas
(FSH-omas), are rare pituitary tumors characterized by the secretion of biologically active FSH. Unlike the more common
clinically nonfunctioning gonadotroph adenomas, these tumors produce endocrine manifestations due to excessive FSH
secretion. Clinical presentation may result from local mass effects such as headache, visual disturbances due to optic
chiasmal compression, or from hormonal activity affecting reproductive function. The endocrine manifestations vary
between males and females and can lead to diagnostic challenges.
Cases:
We report two patients with functioning gonadotroph adenomas presenting with distinct clinical manifestations.
The first case involved a 23-year-old female who presented with secondary amenorrhea for 4 years, accompanied by
personality changes. Abdominal ultrasound demonstrated bilaterally enlarged multicystic ovaries suggestive of ovarian
hyperstimulation, which subsequently regressed postoperatively. Biochemical evaluation revealed inappropriately
elevated FSH levels (3.5-fold increase), with suppressed luteinizing hormone (LH) and markedly elevated estradiol levels
(11-fold increase). Pituitary magnetic resonance imaging (MRI) identified a large sellar–suprasellar mass with mass effect,
consistent with a pituitary macroadenoma.
The second case involved a 68-year-old male who presented with progressively worsening vision over 2 years. Hormonal
evaluation demonstrated elevated FSH levels (4.5-fold increase), with relatively normal LH and low testosterone levels.
Pituitary MRI revealed a sellar mass consistent with a pituitary adenoma. Both patients subsequently underwent pterional
craniotomy with tumor debulking. Histopathological examination confirmed gonadotroph adenomas, with positive
immunohistochemical staining for FSH.
Conclusion
Functioning gonadotroph adenomas are rare and may present with diverse clinical features related to gonadal
hyperstimulation or mass effects. Early recognition of the characteristic hormonal profile and radiological findings is crucial
for diagnosis and appropriate management. These cases highlight the importance of considering functioning gonadotroph
adenoma in patients presenting with unexplained gonadal hyperstimulation or atypical reproductive hormonal profiles.
Gonadotrophs
;
Adenoma
3.Determinants of Polycystic Ovarian Syndrome Among Adolescents with Overweight and Obesity: A Case-Control Study Protocol
Shazana Rifham Abdullah ; Nur Zati Iwani Ahmad Kamil ; Siti Sarah Hamzah ; Norhashimah Abu Seman ; Farah Huda Mohkiar ; Nur Azlin Zainal Abidin ; Ezarul Faradianna Lokman ; Azahadi Omar ; Liyana Ahmad Zamri ; Fatin Saparuddin ; Syarifah Nortasya Sayed Muhamad Kamarudin ; Puteri Sofia Nadira Megat Kamaruddin ; B. Vimala A/P R.M.T. Balasubramaniam ; Fazliana Mansor ; Nur Azurah Abdul Ghani ; Abqariyah Yahya ; Rahima Dahlan @Mohd Shafie ; Ahmad Ali Zainuddin ; Kimberly Yuin Y&rsquo ; ng Wong ; Janet Yeow Hua Hong ; Nik Sumayyah Nik Mhd Nor ; Mohd Fairulnizal Md Noh ; Muhammad Yazid Jalaludin
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):61-
Introduction:
Polycystic ovarian syndrome (PCOS) is a complex
endocrine disorder that significantly affects adolescent
girls, particularly those with overweight or obesity.
However, data examining the determinants and metabolic
profiles of PCOS among adolescents with overweight
and obesity remain limited, especially in Malaysia. This
protocol describes a case-control study investigating the
cardiometabolic, dietary, and psychosocial determinants of
PCOS among adolescents with overweight and obesity.
Methodology:
This study is designed as a case-control study involving
adolescent girls aged 13–16 years with a body mass
index z-score >+1 standard deviation. Cases are defined as adolescent girls with a confirmed diagnosis of PCOS
based on the recommendations of the 2017 International
Consortium of Paediatric Endocrinology (ICPE), while
controls are those who do not meet the diagnostic criteria
for PCOS. A total sample size of 440 participants is required.
Participants will be recruited from 22 secondary schools
selected from a list of schools in Kuala Lumpur. Data on
sociodemographic characteristics, psychosocial health,
physical activity, and dietary intake will be collected using
structured questionnaires. Blood samples will be obtained
and analyzed for diagnostic testing (free testosterone),
exclusion tests (thyroid-stimulating hormone, folliclestimulating hormone, luteinizing hormone, estradiol,
prolactin, and dehydroepiandrosterone sulfate), and
biochemical parameters (liver function tests, lipid profile,
hemoglobin A1c, fasting glucose, fasting insulin, and
inflammatory markers).
Results:
The study is expected to generate comprehensive data on
the cardiometabolic, dietary, and psychosocial determinants of PCOS among adolescents with overweight and
obesity. The findings will inform early screening strategies
and targeted interventions aimed at reducing long-term
reproductive and cardiometabolic complications.
Conclusion
This protocol outlines a structured approach to investigating PCOS in adolescence and addresses current gaps
in early identification and risk stratification among highrisk populations.
Adolescent
;
Humans
;
Case-Control Studies
;
Overweight
;
Polycystic Ovary Syndrome
;
Obesity
4.Masking Andropause by a Functioning Gonadotroph Macroadenoma: Discordant Clinical and Hormonal Findings
Niken Febriharsari ; Mirza Adhyatma ; Hemi Sinorita
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):84-85
Introduction:
Functioning gonadotroph adenomas (FGPAs) in males
are rare and typically present with macroorchidism. In
elderly patients, the presentation can be confounding.
This case illustrates a unique scenario where a pituitary
tumor masked the physiological decline of testosterone,
maintaining the patient’s stamina despite Introduction
testicular involution.
Case:
A 65-year-old male was referred for a pituitary macroadenoma (10.7 × 10.6 × 11.4 mm) following progressive
headaches. Remarkably, the patient denied symptoms
of andropause; his stamina, mood, and libido were wellpreserved. Investigations revealed elevated folliclestimulating hormone (15.42 mIU/mL) and luteinizing hormone (12.1 mIU/mL) with normal testosterone levels.
Scrotal ultrasound showed bilateral testicular involution
(right: 8.66 mL, left: 7.21 mL), contradicting the expected
macroorchidism of FGPA. Although the patient felt his
vision was normal, a confrontation test revealed temporal
visual field defects, indicating chiasmatic compression. This
case presents a striking clinical discordance where tumorinduced gonadotropin hypersecretion provided a supraphysiological drive to the involuting testes, maintaining
testosterone levels and masking andropause. The primary
indication for transsphenoidal surgery is the Introduction
evidence of visual field defects. However, removing
the adenoma will abruptly eliminate this “hormonal
drive.” Postoperative management will focus on rigorous
hormonal monitoring. Testosterone replacement therapy
is not immediately indicated; rather, it will be carefully
planned only if postoperative evaluations demonstrate a
significant hormonal decline accompanied by symptomatic
hypogonadism. This tailored approach ensures that the
benefits of intervention outweigh the potential risks in
an elderly patient.
Conclusion
In elderly patients, FGPAs can mask age-related hormonal
decline. In this case, clinicians must treat the patient,
not just the tumor. Anticipating a potential decline in
postoperative stamina is as crucial as the surgery itself.
Comprehensive hormonal evaluation and a personalized
approach to therapy are essential to preserve quality of life
after the “masking” effect is removed.
Male
;
Andropause
;
Gonadotrophs
5.When Hyperprolactinemia Fails to Suppress: The Silent Gonadotroph in a Pituitary Macroadenoma
Min Jing Choo ; Liang Wei Wong
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):85-
Introduction:
Pituitary macroadenomas may present with mass effects,
hypopituitarism, or hormone hypersecretion. Hyperprolactinemia, resulting from a prolactin-secreting tumor
or stalk compression, typically suppresses gonadotropins.
Thus, elevated follicle-stimulating hormone (FSH) and
luteinizing hormone (LH) with low testosterone in this
context are unusual. We report a macroprolactinoma with
a clinically non-functioning gonadotroph adenoma.
Case:
A 69-year-old male presented with acute giddiness and
headache while in Vietnam. He reported reduced libido
but no visual symptoms or galactorrhea. Examination
showed no neurological deficits, normal visual fields, and
secondary sexual characteristics; bilateral testes volume of
25 mL. Magnetic resonance imaging (MRI) brain revealed
a 1.6 × 2.2 × 2.1 cm pituitary macroadenoma compressing
the optic chiasm and pituitary stalk.
Initial pituitary evaluation demonstrated hyperprolactinemia (prolactin >200 µg/L; normal 2.4–13.1), central hypothyroidism (T4 6.8 pmol/L [7.8–14.4], thyroid-stimulating
hormone 2.3 mIU/L [0.38–5.3]), elevated FSH (21.5 IU/L
[1.2–19.2]) and LH (191 IU/L [1.24–8.62]), low testosterone
(8.88 nmol/L), normal insulin-like growth factor 1 (IGF-1)
(68 µg/L [46.5–191.9]), and cortisol 237 nmol/L. Cabergoline
was initiated at 0.25 mg twice weekly and titrated to 1
mg twice weekly over 4 months, alongside levothyroxine
25 µg daily.
Repeated MRI brain 2 months after cabergoline initiation
showed a persistent macroadenoma (1.7 × 2.2 × 2.2 cm) with
bilateral cavernous sinus extension. Prolactin decreased to
<170 µg/L, central hypothyroidism persisted; levothyroxine
was optimized, and hydrocortisone was initiated.
At the 5-month follow-up, prolactin further improved to
57 µg/L. Central hypothyroidism and borderline adrenal
function persisted, requiring continued replacement
therapy. Testosterone remained low-normal (10.2 nmol/L)
despite elevated FSH (15.4 IU/L) and LH (92 IU/L). Followup MRI and hormonal reassessment were planned in
May 2026.
Conclusion
Profoundly elevated prolactin level >200 µg/L and response
to cabergoline reflect true prolactinoma rather than stalk
effect. Persistently low testosterone with discordant high
FSH/LH suggests a non-functioning gonadotroph component producing biologically inactive gonadotropins. Definitive diagnosis requires histopathological confirmation,
while serial biochemical and radiological follow-up guides
management and clarifies tumor subtype.
Gonadotrophs
;
Hyperprolactinemia
6.Cushing Disease Masquerading as Polycystic Ovary Syndrome: A Diagnostic Pitfall in Severe Hyperandrogenism
Jean Mun Cheah ; Fei Bing Yong ; K.J. Lingeswary ; Jen Hoong Oon ; Sharifah Noor Adrilla binti Long Mohd Noor Affendi ; Gayathri Devi A/P Krishnan ; Shazatul Reza binti Mohd Redzuan ; Subashini Rajoo Rajoo
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):97-
Introduction:
Polycystic ovary syndrome (PCOS) is the most common
cause of hyperandrogenism in women of reproductive
age. However, several endocrine disorders, particularly
Cushing disease (CD), can closely mimic the clinical, biochemical, and radiological features of PCOS. This overlap
may lead to misdiagnosis and delayed recognition of
hypercortisolism, with significant metabolic and reproductive consequences.
Case:
We report a 24-year-old female with young-onset diabetes
mellitus who was referred for endocrine co-management
during admission for recurrent mons pubis and labial
abscesses with poorly controlled glycemia. She had a 5-year
history of progressive hirsutism, oligomenorrhoea, scalp
hair loss, significant weight gain, and insulin resistance,
and had previously been labelled as having PCOS during
adolescence, with subsequent default of follow-up. On
examination, she was obese (body mass index 33 kg/
m²) with plethoric facies, acanthosis nigricans, proximal
myopathy, and hirsutism (Ferriman–Gallwey score 10),
without overt virilization or acromegalic features.
Biochemical evaluation demonstrated severe hyperandrogenism with markedly elevated total testosterone
(7.05 nmol/L), suppressed gonadotropins, and adrenocorticotropic hormone (ACTH)-dependent hypercortisolism. Cortisol failed to suppress on low-dose dexamethasone testing, and 24-hour urinary free cortisol
was markedly elevated (>4,900 nmol/24 h). Pelvic ultrasonography and computed tomography imaging showed
polycystic ovarian morphology without evidence of an
ovarian mass. Pituitary magnetic resonance imaging
revealed a small right-sided pituitary microadenoma
measuring 2.6 × 3.7 mm. Inferior petrosal sinus sampling
demonstrated a central-to-peripheral ACTH gradient with
adequate prolactin ratios, confirming pituitary CD.
Conclusion
This case highlights how Cushing disease can closely
mimic PCOS, including polycystic ovarian morphology
and hyperandrogenism. Progressive symptoms, severe
biochemical androgen excess, and marked insulin
resistance should prompt evaluation for secondary causes
of hyperandrogenism, particularly hypercortisolism, to
avoid delayed diagnosis and prolonged morbidity.
Female
;
Hyperandrogenism
;
Pituitary ACTH Hypersecretion
;
Polycystic Ovary Syndrome
7.Live Birth from a Primary Ovarian Pregnancy: A Rare Pathologically Confirmed Case
Denn Saudi J. Hayudini ; Randell S. Arias
Philippine Journal of Pathology 2026;(75th PSP Research Competition Abstracts):1-
Introduction:
Primary ovarian pregnancy is a rare ectopic gestation (<1% of ectopic
pregnancies), usually presenting with first-trimester rupture. Progression to term with
live birth is exceedingly rare and requires pathologic confirmation to exclude secondary
implantation.
Case Presentation:
A 32-year-old multigravida underwent exploratory laparotomy
for suspected ectopic pregnancy at term. A placenta-bearing mass involving the right
ovary was identified, with a grossly normal ipsilateral fallopian tube. Right oophorectomy
was performed, delivering a live female infant weighing 3,060 grams with Apgar scores
of 8 and 9.
Gross examination showed a large hemorrhagic placenta-like mass replacing the ovary
with peripheral residual ovarian tissue. Histology revealed mature chorionic villi
with syncytial knots, stromal fibrosis, calcifications, and abundant intervillous blood,
directly implanted within ovarian stroma containing luteinized cells and corpus albicans
remnants, with no tubal or endometrial tissue identified.
Discussion:
Advanced primary ovarian pregnancy is extremely rare and may mimic
secondary abdominal or tubal implantation. Diagnosis relies on the Spiegelberg
criteria, including an intact ipsilateral fallopian tube, ovarian location of the gestation,
attachment through the ovarian ligament, and histologic demonstration of chorionic
villi within ovarian stroma, confirming true ovarian implantation.
Conclusion
Clinical, gross, and microscopic findings fulfill the Spiegelberg criteria,
confirming primary ovarian pregnancy. This rare term pregnancy highlights the
crucial role of surgical pathology in establishing the definitive diagnosis and excluding
secondary implantation.
Female
;
Pregnancy
;
Ovary
;
Pregnancy, Ovarian
8.Effect of "Zhibian" (BL54)-toward-"Shuidao" (ST28) acupuncture on reproductive function in mice with asthenozoospermia based on mitochondrial apoptosis.
Jianheng HAO ; Boya CHANG ; Jia REN ; Zhen GAO ; Yanlin ZHANG ; Haijun WANG ; Laixi JI
Chinese Acupuncture & Moxibustion 2025;45(1):71-81
OBJECTIVE:
To observe the effects of the "Zhibian" (BL54)-toward-"Shuidao" (ST28) acupuncture on key regulatory factors during mitochondrial apoptosis of testicular tissue in asthenozoospermia mice, and explore the potential mechanism of the protective effect of acupuncture on reproductive function.
METHODS:
Thirty C57BL/6 male mice were randomly divided into a blank group, a model group and an acupuncture group, 10 mice in each group. In the model and the acupuncture groups, the intraperitoneal injection of cyclophosphamide (30 mg•kg-1•d-1) was delivered for 7 days to prepare the asthenozoospermia model. After the success of modeling, the modeled mice in the acupuncture group were intervened with "Zhibian" (BL54)-toward-"Shuidao" (ST28) acupuncture, once daily and the needles were retained for 20 min. The duration of the intervention was 2 weeks. The general condition of each mouse was observed, and the body mass was recorded before modeling, after modeling and after intervention completion. After intervention, the testicular mass was recorded and the weight coefficient was calculated, and the mouse sperm quality was examined; the serum contents of testosterone (T), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were detected using ELISA, the morphology of testicular tissue was observed using HE, the mitochondrial ultra-microstructure of testicular tissue was observed under transmission electrone microscopy, the mitochondrial membrane potential level of testicular tissue was detected using JC-1 staining, the positive rate of apoptosis cell of testicular tissue was observed using TUNEL; and the mRNA and protein expression of b-cell lymphocytoma-2 (Bcl-2), Bcl-2 associated X protein (Bax), cytochrome c (Cyt C), apoptotic protease-activating factor1 (Apaf-1), Caspase-9 and Caspase-3 of testicular tissue was detected using real-time quantitative fluorescence PCR and Western blot methods separately; and the positive expression of Cleaved Caspase-3 of the testicular tissue was detected using immunohistochemistry.
RESULTS:
Compared with the blank group, the mice were in listless spirits, had shaggy hairs, the reduced appetite and movement, and weight loss in the model group (P<0.01); the testicular mass and the weight coefficient decreased (P<0.01); the total number of sperms, sperm motility, and sperm viability were declined (P<0.01); while the levels of serum T, FSH, and LH were dropped (P<0.01). The morphology of seminiferous tubules in testicular tissue was abnormal, the number of spermatogenic cells and the number of mitochondria decreased, the inner mitochondrial crest was fractured and lost, and vacuoles appeared. The level of mitochondrial membrane potential was reduced (P<0.01); and the positive rate of apoptosis cell in testicular tissue increased (P<0.01). The mRNA and protein expression of Bax, Cyt C, Apaf-1, Caspase-9 and Caspase-3 was elevated (P<0.01, P<0.05), the mRNA and protein expression of Bcl-2 was dropped (P<0.01), and the average absorbance value of Cleaved Caspase-3 increased (P<0.01). When compared with the model group, in the acupuncture group, the general condition of mice was improved, the testicular mass and the weight coefficient elevated (P<0.01); the total number of sperms, sperm motility, and sperm viability increased (P<0.01); while the levels of serum T, FSH, and LH rose (P<0.01). The pathological morphology of testicular tissue and the inner mitochondrial ultra-microstructure were ameliorated, the level of mitochondrial membrane potential was elevated (P<0.01); the positive rate of apoptosis cell was reduced (P<0.01). The mRNA and protein expression of Bax, Cyt C, Apaf-1, Caspase-9 and Caspase-3 was dropped (P<0.01, P<0.05), the mRNA and protein expression of Bcl-2 elevated (P<0.05), and the average absorbance value of Cleaved Caspase-3 declined (P<0.01).
CONCLUSION
"Zhibian" (BL54)-toward- "Shuidao" (ST28) acupuncture may ameliorate mouse reproductive function by inhibiting mitochondrial apoptosis pathway, alleviating testicular tissue damage in the asthenospermia mice induced by cyclophosphamide.
Animals
;
Male
;
Mice
;
Apoptosis
;
Acupuncture Therapy
;
Mitochondria/metabolism*
;
Asthenozoospermia/genetics*
;
Humans
;
Testis/metabolism*
;
Mice, Inbred C57BL
;
Spermatozoa/metabolism*
;
Acupuncture Points
;
Sperm Motility
;
Testosterone/blood*
;
Proto-Oncogene Proteins c-bcl-2/genetics*
;
Caspase 3/genetics*
;
Follicle Stimulating Hormone/blood*
;
Reproduction
;
Cytochromes c/genetics*
;
bcl-2-Associated X Protein/genetics*
;
Apoptotic Protease-Activating Factor 1/genetics*
9.Effects of acupuncture on the hypothalamic-pituitary-ovarian axis and FSH/cAMP signaling pathway in aged rats.
Yaoyao ZHU ; Yaqian YIN ; Huanfang XU ; Li YANG ; Weixin LI ; Chenchen SU ; Rong ZHANG ; Yigong FANG
Chinese Acupuncture & Moxibustion 2025;45(2):200-208
OBJECTIVE:
To explore the mechanism of acupuncture on improving ovarian hypofunction in aged rats from two perspectives: the overall regulation of the hypothalamic-pituitary-ovarian (HPO) axis and the local ovarian follicle stimulating hormone (FSH)/cyclic adenosine monophosphate (cAMP) signaling pathway.
METHODS:
Six 3-month-old female SPF-grade Sprague-Dawley (SD) rats were selected as the blank group. Another twelve 9-month-old female SD rats were randomly divided into a model group and an acupuncture group, with six rats in each. The acupuncture group received acupuncture at "Baihui" (GV20), "Guanyuan" (CV4), and bilateral "Ciliao" (BL32) for 20 min per session, once every other day, for a total of 10 sessions. Vaginal smear tests were performed daily to observe the estrous cycle of the rats. Ovarian morphology was observed using HE staining, and follicles at various stages were counted. ELISA was used to detect levels of serum FSH, luteinizing hormone (LH), estradiol (E2), anti-müllerian hormone (AMH), hypothalamic gonadotropin-releasing hormone (GnRH), pituitary FSH and LH, and ovarian cAMP. Immunohistochemistry and Western blot were used to detect the protein expression of ovarian cAMP protein kinase catalytic subunit, FSH receptor (FSHR), and P450. Real-time quantitative PCR was used to measure mRNA expression levels of FSHR and P450 in ovarian tissue.
RESULTS:
Compared with the blank group, the model group showed an increased rate of estrous cycle disorder (P<0.01), reduced granulosa cell layers with blurred boundaries and disordered arrangement, decreased numbers of developing follicles at all stages, and increased numbers of atretic follicles (P<0.01); the serum levels of FSH and LH were increased (P<0.01), while E2 and AMH levels were decreased (P<0.01); the hypothalamic GnRH and pituitary FSH and LH levels were elevated (P<0.01), and ovarian cAMP level was decreased (P<0.01); the positive expression and protein expression of ovarian P450, cAMP protein kinase catalytic subunit, and FSHR were reduced (P<0.01), and ovarian FSHR and P450 mRNA expression was decreased (P<0.01). Compared with the model group, the acupuncture group showed a reduced rate of estrous cycle disorder (P<0.01), clear granulosa cell margins, increased numbers of primordial and secondary follicles, and decreased numbers of atretic follicles (P<0.01); the serum FSH and LH levels were decreased (P<0.01, P<0.05), while E2 and AMH levels were increased (P<0.05, P<0.01); the hypothalamic GnRH and pituitary FSH and LH levels were decreased (P<0.01, P<0.05), and ovarian cAMP level was increased (P<0.01); the positive expression and protein expression of ovarian P450, cAMP protein kinase catalytic subunit, and FSHR were elevated (P<0.01), and ovarian FSHR and P450 mRNA expression was increased (P<0.01).
CONCLUSION
Acupuncture could delay ovarian hypofunction in aged rats, possibly through regulating the HPO axis and the FSH/cAMP signaling pathway.
Animals
;
Female
;
Rats
;
Rats, Sprague-Dawley
;
Follicle Stimulating Hormone/genetics*
;
Acupuncture Therapy
;
Ovary/metabolism*
;
Signal Transduction
;
Humans
;
Cyclic AMP/metabolism*
;
Hypothalamo-Hypophyseal System/metabolism*
;
Aging/metabolism*
;
Hypothalamus/metabolism*
;
Pituitary Gland/metabolism*
;
Gonadotropin-Releasing Hormone/metabolism*
10.Mechanism research of "Zhibian" (BL54)-toward-"Shuidao" (ST28) acupuncture technique for improving reproductive function in mice with asthenospermia based on the ferroptosis pathway.
Jianheng HAO ; Boya CHANG ; Qingkai JIN ; Jia REN ; Haijun WANG ; Laixi JI
Chinese Acupuncture & Moxibustion 2025;45(3):351-360
OBJECTIVE:
To investigate the underlying mechanism of "Zhibian" (BL54)-toward-"Shuidao" (ST28) acupuncture technique for improving reproductive function in mice with asthenospermia by regulating ferroptosis pathway.
METHODS:
Sixty male C57BL/6 mice were randomly divided into a blank group, a model group, an acupuncture group and a Fer-1 group, 15 mice in each one. Except the blank group, the intraperitoneal injection with cyclophosphamide (50·kg-1·d-1) was administered to establish the asthenospermia model in the mice of the rest 3 groups for 5 consecutive days. In the acupuncture group, "Zhibian" (BL54)-toward-"Shuidao" (ST28) acupuncture technique was operated in the mice, for 20 min each time; and in the Fer-1 group, Fer-1 solution (1 mg/kg) was injected intraperitoneally. The interventions of these two groups were delivered once daily and for 2 consecutive weeks. The testicular wet weight was measured and the testicular coefficient was calculated. Using sperm quality detection system, the sperm quality was detected. With ELISA used, the contents of testosterone (T), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in the serum were detected. With HE staining, testicular and epididymal morphology was observed. Immunofluorescence was used to detect the expression of reactive oxygen species (ROS) in the testes. Biochemical assay was conducted to determine the contents of malondialdehyde (MDA), reduced glutathione (GSH), and total iron ion (TFe) in the testicular tissue. Transmission electron microscopy was used to examine mitochondrial structure of the testis, while JC-1 staining was used to assess mitochondrial membrane potential in the testicular tissue. Fluorescence quantitative PCR and Western blot analyses were employed to measure the mRNA and protein expression of solute carrier family 7 member 11 (SLC7A11), glutathione peroxidase 4 (GPX4), ferritin heavy chain 1 (FTH1), and acyl-CoA synthetase long-chain family member 4 (ACSL4) in the testicular tissue.
RESULTS:
Compared with the blank group, in the model group, the testicular wet weight and testicular coefficient decreased (P<0.01); the sperm concentration and sperm motility reduced (P<0.01), and the contents of T, FSH, and LH decreased in the serum (P<0.01); and the seminiferous tubules in the testis showed loose structure and deformed lumen, sperm cells were disorganized and the sperm numbers reduced; the tubular walls became thinner, and sperm numbers in the lumen less; the expression of ROS in testicular tissue, as well as the contents of MDA and TFe increased (P<0.01), and the content of GSH decreased (P<0.01); and the numbers of mitochondria reduced, the structure of cristae was serious damaged, and mitochondrial membrane potential level declined (P<0.01); the mRNA and protein expression of SLC7A11, GPX4, and FTH1 decreased (P<0.01), while the mRNA and protein expression of ACSL4 increased (P<0.01). In comparison with the model group, the acupuncture and Fer-1 groups showed the increase of testicular wet weight and coefficient (P<0.01), sperm concentration and motility (P<0.01), and the serum contents of T, FSH, and LH (P<0.01); and the improvements in testicular and epididymal histopathology; ROS expression and the contents of MDA and TFe decreased (P<0.01), and the content of GSH elevated (P<0.05); the mitochondrial structure and numbers were ameliorated and mitochondrial membrane potential rose (P<0.01). Besides, in comparison with the model group, the mRNA expression of SLC7A11 was higher (P<0.05, P<0.01), the mRNA and protein expression of GPX4 and FTH1 increased (P<0.01, P<0.05), and the mRNA and protein expression of ACSL4 decreased (P<0.01) in the acupuncture and the Fer-1 groups; and the protein expression of SLC7A11 was higher in the Fer-1 group (P<0.05).
CONCLUSION
"Zhibian" (BL54)-toward-"Shuidao" (ST28) acupuncture technique may improve the reproductive capacity in the mice with asthenospermia by alleviating ferroptosis-induced cellular damage and ameliorating testicular function.
Animals
;
Male
;
Ferroptosis
;
Mice
;
Acupuncture Therapy
;
Mice, Inbred C57BL
;
Asthenozoospermia/metabolism*
;
Humans
;
Acupuncture Points
;
Testis/metabolism*
;
Luteinizing Hormone/metabolism*
;
Malondialdehyde/metabolism*
;
Reproduction
;
Testosterone/metabolism*


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