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Departments of Physiology (X.L., L.S., A.K., I.H., M.P.) and Anatomy (R.S., S.M.), Institute of Biomedicine and Functional Foods Forum, University of Turku, FIN-20520 Turku, Finland; Anatomical Institute (A.M.), Ludwig-Maximilians-University, D-80802 Munich, Germany; and Institute of Reproductive and Developmental Biology (I.H.), Imperial College London, London W12 ONN, United Kingdom
Address all correspondence and requests for reprints to: Dr. Matti Poutanen, Department of Physiology, Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, FIN-20520 Turku, Finland. E-mail: matti.poutanen{at}utu.fi.
| Abstract |
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, indicating strong activation, presumably by estrogen exposure. The increased activity of the macrophages was associated with Leydig cell depletion (analyzed at the age of 9 and 15 months) and an increased number of mast cells and fibrosis in the testicular interstitium. Interestingly, similar findings have been made in testes of infertile men. Hence, the aging AROM+ males present with a phenocopy of inflammation-associated infertility in men, providing a model for further studies on the putative link among estrogens, orchitis, and infertility. | Introduction |
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Autoimmune orchitis is a common cause of male infertility. Studies on experimental autoimmune orchitis (EAO) have shown an increased number of macrophages in the testicular interstitium of rats (10). Recently estrogens have been proposed to act as immunomodulators with contradictory effects on autoimmune diseases. The incidence of autoimmune diseases, systemic lupus erythematosus, Sjögrens syndrome, and rheumatoid arthritis is significantly higher in females than males (11, 12), whereas estrogens seem to offer protection in multiple sclerosis (13) and experimental autoimmune encephalomyelitis (14). Interestingly, mice lacking the aromatase enzyme gene have been shown to spontaneously develop a lymphoproliferative autoimmune disease resembling Sjögrens syndrome (15). Although a subset of infertile men have significantly lower testosterone and higher estradiol concentrations in serum (16) and testicular macrophages have been shown to be involved in the pathogenesis or maintenance of states of infertility in the human testes (17), no connection between estrogens and idiopathic chronic orchitis has so far been demonstrated.
Leydig cells and macrophages are the two major cell types in the testicular interstitium. Testicular macrophages are divided into two different subpopulations with different functions. The CD68-expressing macrophages have been suggested to preserve the proinflammatory profile of circulating monocytes, whereas the CD163-expressing cells sensitive to the testicular microenvironment may have an antiinflammatory profile (18, 19). Testicular inflammation in vivo causes an influx of new monocytes and macrophages into the testis, drastically altering the composition of the macrophage population (20). Immunoactivated macrophages begin to secrete high amounts of proinflammatory cytokines, e.g. TNF
(21, 22). The macrophages are mainly derived from the circulating monocyte pool, but the resident testicular macrophages do not reenter the circulating pool (23). The number of the macrophages and their functions are largely determined by the local environment (24, 25). During testicular development, the increase in macrophage number closely follows the increase in adult-type Leydig cell number (26, 27). There is increasing evidence that these cells are closely associated with each other and form specialized junctions, suggesting a functional relationship between the two cell types (28, 29, 30). However, the physiological significance of this association has remained obscure.
We recently developed a transgenic mouse model, AROM+, for studying the role of estrogen excess in the male (31). These mice are characterized by the expression of human P450 aromatase (P450arom) in a variety of tissues under the human ubiquitin C-promoter, resulting in increased conversion of testosterone (T) to estradiol (E2). The increased serum E2 to T ratio detected in the AROM+ mice results in a multitude of abnormalities in the structure and function of male reproductive tissues, whereas no obvious phenotype exists in female reproduction. Interestingly, AROM+ males also develop mammary epithelial structures typically seen only in female mice (32), confirming a major role of estrogens in the development of gynecomastia in males. Another typical feature of the estrogen stimulus in these mice is the induction of pituitary lactotrope adenomas. We have also shown that AROM+ males have multiple disorders in testicular function at the age of 4 months, with arrested spermatogenesis and Leydig cell hyperplasia and hypertrophy (31). The present study was carried out to further characterize the testis phenotype and follow up the long-term consequences of increased estrogen to androgen ratio in the testis of aging mice.
| Materials and Methods |
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Hormone assays
For intratesticular T and E2 assays, whole testes were weighed and homogenized in 1.0 ml PBS. T concentrations were measured by RIA from diethyl ether-extracted testis homogenates as previously described (33). Intratesticular E2 concentrations were measured by immunofluorometric assay from diethyl ether-extracted testis homogenates, following the protocol for serum samples recommended by the manufacturer (Wallac Oy, Turku, Finland). The serum concentrations of LH and FSH were analyzed using immunofluorometric assays as described previously (34).
Quantitative RT-PCR
Total RNA was isolated from testes using the RNeasy minikit (QIAGEN, Valencia, CA) according to the manufacturers protocol. The mRNA analysis was carried out by quantitative real-time RT-PCR by using the Engine Opticon system (MJ Research, Inc., Waltham, MA) for continuous fluorescent detection. Reactions were performed using QuantiTect SYBR Green RT-PCR kit (QIAGEN) according to the manufacturers instructions, using 50 ng total RNA from the testis. All samples and standards were amplified in triplicate. The expression level of L19 or ß-actin was used as a reference to adjust for an equal amount of sample RNA. The sequences of primers were: TNF
(GenBank accession no. NM_013693), 5'-GAACTGGCAGAAGAGGCACT-3' (forward primer) and 5'-AGGGTCTGGGCCATAGAACT-3' (reverse primer) and CD68 (GenBank accession no. NM_009853), 5'-CCAGCTGTTCACCTTGACCT-3' (forward primer) and 5'-AGAGGGGCTGGTAGGTTGAT-3' (reverse primer). The annealing temperatures were 60 and 58 C and the sizes of the products 205 and 208 bp, respectively.
Morphological and histological analyses
Wild-type (WT) and AROM+ mice were obtained at similar ages of 4, 9, and 15 months and were anesthetized by ip injection of 300600 µl of 2.5% Avertin. Blood was collected by cardiac puncture, and tissues were dissected out for macroscopic analyses. For histological evaluation, the testes were fixed in 4% paraformaldehyde. The tissues were then dehydrated, embedded in paraffin, and sectioned. Five-micrometer-thick sections were deparaffinized in xylene and stained with hematoxylin and eosin. For detecting collagen fibers, the sections were stained with Van Giesons solution. The Leydig cell adenomas were classified according to the criteria described by the National Toxicology Program (35) in which the adenoma classification is warranted if the tumor diameter exceeds one seminiferous tubule cross-section. An aggregation of Leydig cells smaller than the diameter of a seminiferous tubule was classified as focal hyperplasia. To visualize mast cells, deparaffinized sections were stained with Giemsa or toluidine blue.
Immunohistochemistry
Four-micrometer-thick sections were cut from paraffin-embedded testis tissues and mounted on slides. After deparaffinization and rehydration, they were placed in a 10-mM citrate buffer (pH 6.0), followed by heating in a microwave oven for antigen retrieval. For this, three periods of 5 min each were used, after which the sections were treated with 3% H2O2 in PBS (pH 7.6) for 20 min. The sections were then incubated overnight at 4 C in PBS containing 3% BSA and one of the following antibodies: 1) antibody against F4/80 (macrophage-specific marker; rat antimouse, Serotec, Oxford, UK) used at 1:20 dilution; 2) antibody against P450 side chain cleavage (P450scc) (rabbit antimouse) used at 1:1500 dilution (provided by Professor Anita Payne, Department of Gynecology and Obstetrics, School of Medicine, Stanford University, Stanford, CA); 3) antibody against TNF
(goat polyclonal IgG; Santa Cruz Biotechnology, Santa Cruz, CA) used at 1:50 dilution; 4) antibody against androgen receptor (rabbit polyclonal IgG; Santa Cruz Biotechnology) used at 1:400 dilution; 5) antibody against estrogen receptor (ER)-
(rabbit polyclonal IgG; sc-542; Santa Cruz Biotechnology) used at 1:500 dilution; and 6) antibody against ERß (chicken polyclonal IgG; provided by J. Å. Gustafsson, Department of Medical Nutrition, Karolinska Institute, Stockholm, Sweden). The bound primary antibody was detected by using biotinylated goat antirabbit, goat antirat, or horse antigoat IgG, followed by incubation with avidin-biotin-peroxidase complex (Vector Laboratories, Burlingame, CA), and visualized by using 3'-3' diaminobenzidine tetrahydrochloride. Sections were slightly counterstained with Mayers hematoxylin and mounted.
Statistical analyses
Statistical analyses were performed by the SigmaStat program (version 3.1 for Windows 2000 and XP; SPSS Inc., Chicago, IL). For real-time RT-PCR results, Students t test or the Mann-Whitney rank sum test was performed for analyzing the statistical significance (P < 0.05) between WT and AROM+ mice, whereas one-way ANOVA or Kruskal-Wallis one-way ANOVA on ranks was used for analyzing different age groups. For intratesticular E2 and T levels, the Mann-Whitney rank sum test was used for analyzing statistical significance between the 15-month-old AROM+ and WT mice.
| Results |
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We have previously reported that intratesticular E2 levels are markedly elevated, and T levels reduced in AROM+ males at 5 months of age (36). Similarly, there was a significant increase in intratesticular E2 and reduction in T level in 15-month-old AROM+ mice (Table 1
). The serum gonadotrophin levels were also in line with the results reported at 4 months of age (31), showing no significant differences in the average LH concentrations between 15-month-old AROM+ and WT mice, whereas the level of FSH was significantly reduced in the AROM+ mice, compared with WT (Table 1
). Both ERß (Fig. 2
, AC) and ER
(Fig. 2
, DH) were present in AROM+ testes, confirming that the estrogen-dependent signal transduction pathway was functional. Staining for androgen receptor (AR) revealed positive staining of the nuclei of Leydig, Sertoli, and myoid cells at the ages of 4, 9, and 15 months (Fig. 2
, IM). This, together with the measurable levels of T present, indicated that the Leydig and Sertoli cells were not devoid of androgen action.
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in the testes. Immunohistochemical analyses showed a low level of TNF
expression in the Leydig cells of WT mice at 15 months of age (Fig. 3K
-positive cells during the aging of AROM+ mice (Fig. 3
mRNA was detected in AROM+ males (Fig. 4A
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| Discussion |
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In the present study, the AROM+ males had an elevated amount of intratesticular E2, combined with reduced amount of T at the age of 15 months, similar to males we described previously at 5 months of age (36). Whereas there were no significant differences in LH levels between AROM+ and WT groups, the reduced intratesticular androgen concentrations indicate testicular failure independent of feedback inhibition through the hypothalamus-pituitary axis. In fact, estrogen has been shown to directly affect steroidogenesis in the rat testis via accumulation of estrogen-regulated protein (molecular weight 27,000) and consequential desensitization of 17
-hydroxylase and 1720 desmolase (37, 38). Likewise, recent studies with mouse Leydig cells isolated from estrogen sulfotransferase knockout mice showed that accumulation of estrogen leads to decreased expression of P450 17
-hydroxylase (39). Whereas ER
and AR were expressed in the AROM+ Leydig cells in all age groups, we hypothesize that E2 is the driving force behind the testicular phenotype and that mouse Leydig cells are a target of estrogen action. This hypothesis is supported by previous findings showing that estrogen excess stimulates Leydig cell hyperplasia in rodents and has been associated with cryptorchidism, testicular cancer, and impaired spermatogenesis (40).
It is well established that estradiol plays an important role in regulating gonadotrophin secretion in both male rodents and men. The studies have also demonstrated that, compared with LH, the circulating FSH concentration is more effectively reduced by estradiol (41, 42). Our study with significantly decreased FSH levels and unaltered LH levels in AROM+ males is in line with these previous observations. The data, furthermore, suggest that a constitutive exposure to increased estrogens effectively inhibits FSH secretion in male mice, also in the presence of severely suppressed spermatogenesis.
One of the most striking features of the AROM+ testes was the presence of a high number of yellow multinucleated giant cells in the interstitium. These cells were identified as macrophages by immunohistochemical analysis of a macrophage-specific marker (F4/80). Similar histological findings (i.e. the presence of multinucleated giant cells in the interstitium) have been reported in old mice with chronic estrogen stimulation caused by targeted disruption of the estrogen sulfotransferase gene (43). This together with the present data suggests a role for estrogen stimulus in the macrophage activation of the testis. Accordingly, the increased size and number of macrophages observed at 9 and 15 months of age were accompanied by an increase in E2 concentrations. Because of the high background staining with the antibody used, we could not conclude whether the macrophages in AROM+ testes expressed ER
. However, previous studies have demonstrated the expression of ER
(44, 45, 46), but not ERß (46), in murine macrophages, giving a possibility for direct effect of estrogens on macrophages. Furthermore, Guo et al. (47) reported that E2 is able to induce the activation of RAW-fos13 macrophages (RAW 264.7 macrophage cell line stable transfected with c-fos promoter) via the nongenomic Ca2+ signaling pathway. However, the mechanisms behind the E2-associated increase in testicular macrophages still remain open. One such mechanism could be that E2-induced proliferation of Leydig cells stimulates macrophage proliferation and activation, and the activated macrophages control the number of Leydig cells. There is a connection between the numbers of Leydig cells and testicular macrophages. Previous studies have namely shown that Leydig cells regenerate more slowly if the testis is depleted of macrophages, and T production is decreased after macrophage depletion (48, 49). The fact that in rats the total number of testicular macrophages declines if Leydig cells are ablated by treatment with the specific Leydig cell cytotoxin ethane dimethane sulfonate (18) further supports our finding of a strong association between the numbers of Leydig cells and testicular macrophages.
Our results indicate signs of severe inflammation in the testis of aging AROM+ mice. The high expression of CD68 indicates the presence of recently arrived monocyte-macrophages (18). This, together with increased expression of the proinflammatory cytokine, TNF
, demonstrates that the macrophages in AROM+ testis are immunoactivated. Testicular macrophages produce undetectable levels of TNF
under nonimmune conditions (50), whereas the studies with an experimental model for EAO have proposed a role for TNF
in the pathogenesis of the disease (22, 21). The main target of the immunological attack in EAO are the germ cells that undergo apoptosis and sloughing, probably through an activated Fas-Fas ligand system (51). However, we could not detect an increased rate of apoptosis by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling staining or caspase-3 immunohistochemistry in the seminiferous tubules of AROM+ testis at any ages studied (data not shown). Nevertheless, severe fibrosis and an increased number of mast cells, in particular in the older groups of transgenic mice, was observed, providing further evidence for chronic inflammation reactions. Based on the elongated form of most of the mast cells, it can be concluded that they are activated, i.e. releasing their secretory products into the surrounding interstitial space. Although the precise nature of the putative mast cell products is not known, interaction between mast cells and macrophages have been shown to lead directly or indirectly to proliferation of fibroblast and collagen formation (52, 53), a likely response in the AROM+ mice as well. Interestingly, very similar inflammation-related changes have been reported in the testes of infertile men. Interstitial fibrosis, together with increased number of activated, degranulated mast cells, secreting proteases and histamine (54), and CD68-positive macrophages expressing TNF
and IL-1 (17), has been observed in the human testes in connection with infertility.
The connection among estrogens, orchitis, and infertility still remains unknown, although the interaction of estrogens and the immune system has recently been discussed extensively (55). The AROM+ transgenic mouse model is a novel tool for analysis of the role of estrogens in testicular function, and it provides a useful model to better understand the interaction between macrophages and Leydig cells in vivo. Taken together, our data suggest that the elevated testicular E2 in AROM+ males results in disrupted spermatogenesis, a marked increase in the number of immunoactive macrophages and Leydig cell hyperplasia. Furthermore, an interaction between macrophages and Leydig cells in the interstitium was shown. Further studies are needed to clarify the exact mechanisms causing the disruption of spermatogenesis associated with E2-induced chronic inflammation in the testes of AROM+ mice.
| Acknowledgments |
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| Footnotes |
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The authors have no conflict of interest.
First Published Online November 23, 2005
1 X.L. and L.S. contributed equally to this work. ![]()
Abbreviations: AR, Androgen receptor; AROM+, human P450 aromatase; E2, estradiol; EAO, experimental autoimmune orchitis; ER, estrogen receptor; P450arom, P450 aromatase; P450scc, P450 side chain cleavage; T, testosterone; WT, wild type.
Received June 1, 2005.
Accepted for publication November 17, 2005.
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production in activated mouse macrophages by progesterone. J Immunol 160:50985104
deficiency promotes increased TNF-
secretion and bacterial killing by murine macrophages in response to microbial stimuli in vitro. J Leukoc Biol 75:11661172This article has been cited by other articles:
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