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Medical Research Council Human Reproductive Sciences Unit (H.M.S., G.R.H., I.K.M., N.H., M.W., R.M.S.), Centre for Reproductive Biology, The Queens Medical Research Institute, Edinburgh EH16 4TJ, United Kingdom; Division of Biochemistry (K.D.G., G.V.), Catholic University of Leuven, B-300 Leuven, Belgium; and Institute of Comparative Medicine (P.O.), University of Glasgow Veterinary School, Glasgow G61 1QH, United Kingdom
Address all correspondence and requests for reprints to: Richard M. Sharpe, Medical Research Council Human Reproductive Sciences Unit, Centre for Reproductive Biology, The Queens Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom. E-mail: r.sharpe{at}hrsu.mrc.ac.uk.
| Abstract |
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| Introduction |
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Testis formation and early development are hormone independent (3, 4), but impaired testosterone production/action resulting from dysgenesis may contribute to, or exacerbate, testicular maldevelopment. This is evident in patients with complete androgen insensitivity syndrome who may exhibit focal areas of testicular dysgenesis (5) and are at considerably increased risk of testicular germ cell cancer (6, 7). Similarly, testicular feminized mice (8) and mice with complete knockout of the androgen receptor (AR) (9), both equivalent to complete androgen insensitivity syndrome in the human, display a 3275% decrease in Sertoli cell number, suggesting that androgens play an important role in Sertoli cell proliferation in perinatal life. Because the Sertoli cells do not express AR in fetal life in the human or rat (10, 11, 12), it is assumed that androgen effects on Sertoli cell number occur indirectly, via the AR-positive peritubular myoid cells (9, 10). Because Sertoli cell number in adulthood is the primary determinant of sperm count in humans (10), impaired androgen production/action within the fetal testis is one mechanism via which fetal events could lead to low sperm counts in adulthood. In this regard, studies have shown that maternal smoking results in a 2049% reduction in testis size and sperm count in the resulting male offspring, probably via a reduction in Sertoli cell number (13, 14). The mechanism behind this is unclear, but cigarette smoke contains polycyclic aromatic hydrocarbons (PAHs), which bind to the aryl hydrocarbon receptor, and activation of the aryl hydrocarbon receptor can antagonize androgen action in cell transfection systems (15, 16). Others have suggested that maternal smoking could be a cause of TDS disorders in human males (17).
We and others have shown that in utero exposure of rats to certain phthalate esters, such as di(n-butyl) phthalate (DBP), can induce a TDS-like spectrum of disorders in the male offspring (18, 19, 20, 21, 22, 23, 24). In this model, DBP induces a marked reduction in Leydig cell hormone (testosterone and insulin-like factor 3) production, widespread occurrence of multinucleated fetal germ cells (21, 25, 26, 27, 28), and focal dysgenesis of seminiferous cords/tubules due to abnormal migration/aggregation of fetal Leydig cells (21, 29, 30). Whether reduced androgen levels contribute causally to the latter two end points and/or cause a reduction in Sertoli cell proliferation/numbers in fetal life in DBP-exposed animals is unknown. The primary aim of the present studies was to address this question together with the wider issue of the role that androgens might play in disorders of testis development relevant to TDS. To achieve this, pregnant rats were treated with the AR antagonist flutamide; a candidate PAH [7,12-dimethyl-benz[a]anthracene (DMBA)]; DBP, alone or in combination with flutamide or DMBA; or DBP plus testosterone or testosterone alone. Fetal testicular end points relevant to the origins of TDS (listed above) were evaluated and related to testicular testosterone levels and peripheral androgen action (anogenital distance). Where possible, AR knockout (ARKO) (d 2) mice and testicular feminized mice (tfm) [embryonic day (E) 18.5] were analyzed as positive controls.
| Materials and Methods |
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The chosen dose of DBP was shown previously to result in a high incidence of TDS-like disorders together with changes in Leydig cell aggregation in fetal testes/dysgenetic areas in adulthood and to induce widespread occurrence of multinucleated gonocytes (MNG) in the fetal testis (21, 22, 29, 30). The DBP was 99% pure according to the supplier and treatment commenced at E13.5, around the time of seminiferous cord formation. Administration of more than 24 mg/kg flutamide, to pregnant rats, has been shown to induce major reproductive tract abnormalities in the male including complete prevention of masculinization of the external genitalia and anogenital distance (31, 32). We chose a dose of 100 mg/kg with the aim of maximally antagonizing testosterone action within the testis, without producing a toxic effect in the dam. Flutamide treatment commenced at E15.5, the point at which androgens are first produced by the fetal rat testis (4). Previous publications have shown that a single dose of 120 mg/kg DMBA induces DNA damage and mammary tumors in adult rats (33, 34); consequently, we chose a lower dose to avoid inducing overt DNA damage but to reflect the chronic lower level exposure that would typify PAH exposure from smoking. Based on the evidence that suggests that DMBA has antiandrogenic properties, treatment started at the onset of steroidogenesis, at E15.5. Exposure to 20 mg/kg TP, from E14.520.5 (in accordance with Ref. 35) has been shown to rescue the Wolffian ducts in 100% of female pups, with minimal toxic effects (our unpublished data). In preliminary studies lower doses of flutamide (50 mg/kg), DMBA (200 µg/kg), and TP (5 mg/kg) were used, but all were found to have no significant effect on Sertoli cell number. Consequently, we increased the doses to those administered in the present study to increase the likelihood of inducing effects.
Control and treated pregnant dams were killed by inhalation of carbon dioxide on E21.5. Fetuses were removed, weighed, decapitated, and then placed in ice-cold PBS (Sigma-Aldrich). Anogenital distance (AGD) was measured using digital calipers. Testes were removed via microdissection and either snap frozen and stored at 70 C or fixed for 1 h in Bouins before being transferred to 70% ethanol. Testes were weighed before processing into paraffin wax using standard methods. Representative fetuses from the aforementioned litters were subsequently used for the quantitative and immunohistochemical studies detailed below. A minimum of three litters was analyzed for each of the treatment groups.
Generation of ARKO mice and testicular feminized mice
The ARKO mice were generated using Cre recombinase (Cre)/loxP technology. ARflox/+ female animals (129/Swiss) with exon 2 of the AR floxed were crossed with phosphoglycerate kinase-1-Cre+/+ male animals (C57BL/6) expressing Cre ubiquitously. Full details are provided elsewhere (36). These mice were killed on postnatal d 2. All animals were treated according to the National Institutes of Health guide for the care and use of laboratory animals, and all experiments were approved by the local ethical committee of Leuven University. The testicular feminized male (tfm) mice were bred at the University of Glasgow on a C3H/HeH-101/H genetic background from stock animals obtained originally from the Medical Research Council Radiobiology Unit (now the Medical Research Council, Mammalian Genetics Unit, Harwell, UK). These mice were killed on E18.5. Appropriate wild-type (WT) controls for ARKO and tfm mice were included in the various analyses.
Testicular testosterone analysis
Testicular testosterone levels in E21.5 control pups (n = 15) and pups in each of the treatment groups [DBP (n = 14), flutamide (n = 5), DBP + flutamide (n = 6), DMBA (n = 5), DBP + DMBA (n = 5), TP (n = 5), and DBP + TP (n = 5)] were measured by RIA, as described previously (21). The limit of detection of the assay was 40 pg/testis. Testicular extracts were not all assayed together. To avoid consequent interassay errors, testosterone levels for testes from treated animals were expressed as a percentage of the mean value for control testes run in the same assay. A similar magnitude of reduction in testicular testosterone levels in DBP-exposed animals was found in each assay run.
Immunohistochemistry
Specific proteins were detected by immunohistochemistry using methods that have been detailed previously (21, 29). Sections of 5 µm were mounted onto coated slides (BDH Chemicals, Poole, UK), dewaxed, and rehydrated. Slides were incubated in 3% (vol/vol) hydrogen peroxidase in methanol to block endogenous peroxidase activity and washed in Tris-buffered saline [0.05 M Tris, 0.85% NaCl (pH 7.4)]. Immunohistochemistry for Wilms tumor gene 1 (WT-1; Dako, Cambridgeshire, UK) but not 3ß-hydroxysteroid dehydrogenase (3ß-HSD; gift from Ian Mason) required antigen retrieval by pressure cooking slides for 5 min in 0.01 m citrate buffer (pH 6.0). Nonspecific binding sites were blocked with an appropriate normal serum diluted 1:5 in Tris-buffered saline containing 5% BSA (Sigma) before the addition of the primary antibody (WT-1 used at 1:500, 3ß-HSD used at 1:4000) and overnight incubation at 4 C.
Slides were incubated for 30 min with the appropriate secondary antibody conjugated to biotin at a dilution of 1:500 (rabbit antimouse for WT-1; goat antirabbit for 3ß-HSD; Dako). The biotinylated antibody was linked to horseradish peroxidase by 30 min incubation with avidin-biotin-horseradish peroxidase complex (Dako). Antibody localization was determined by application of diaminobenzidine (liquid DAB+; Dako) until staining in control sections was optimal, and the reaction was stopped by immersing slides in distilled water. Slides were counterstained with hematoxylin, dehydrated, and mounted using Pertex mounting medium (Cell Path, Hemel Hampstead, UK).
Determination of Sertoli number per testis
Standard stereological methods were used to determine Sertoli cell nuclear volume and number per testis at E21.5 in control males (n = 19) and males exposed in utero to DBP (n = 9), flutamide (n = 6), DBP + flutamide (n = 6), DMBA (n = 6), DBP + DMBA (n = 6), TP (n = 8), and DBP + TP (n = 6). Testes from d 2 postnatal WT and ARKO males (n = 5) were also assessed. Animals in each group were derived from at least three litters and were analyzed using methods detailed elsewhere (37, 38, 39). In brief, cross-sections of testes immunostained for WT-1 to stain Sertoli cell nuclei were examined under oil immersion using a x63 plan apo objective fitted to an Olympus BH-2 microscope (Olympus, London, UK) and a 121-point eyepiece graticule. Fifteen fields were selected and counted using a systematic clock-face sampling pattern from a random starting point; points falling over Sertoli cell nuclei were scored and expressed as a percentage of the total points counted. For each animal, the values for percentage nuclear volume were converted to absolute nuclear volumes per testis by multiplying by testis weight (equivalent to volume) because shrinkage was minimal. Sertoli cell nuclear volume in each animal was also determined using methods similar to those described previously (37, 39). Briefly, images were captured from an BH2 microscope (Olympus, Tokyo, Japan) fitted with an automatic stage (Prior Scientific Instruments Ltd., Cambridge, UK) using a video camera (HV-C20; Hitachi, Tokyo, Japan) and were analyzed with Image-Pro Plus 4.5.1 software with a Stereology 5.0 plug-in (Media Cybernetics, Wokingham, Berkshire, UK). An area of interest was created by drawing around the Sertoli cell nucleus, within which the computer program then determined the average length of several diameters measured at 2° intervals, which passed through the center of the nucleus. This was measured for a minimum of 90 Sertoli cell nuclei per testis and mean nuclear volume then determined. Data for Sertoli cell nuclear volume per testis was then converted to absolute numbers of Sertoli cell per testis by dividing by the average Sertoli cell nuclear volume.
Leydig cell aggregation analysis
To determine whether the distribution of Leydig cells throughout the fetal testis was altered by treatment, Leydig cell aggregation was quantified by analyzing the number and size of Leydig cell clusters using methods previously described (29). Testes from at least five pups from each of the treatment groups [control (n = 5), DBP (n = 5), flutamide (n = 5), DBP + flutamide (n = 5), DMBA (n = 5), DBP + DMBA (n = 5), TP (n = 6), DBP + TP (n = 8), and WT and tfm mice (n = 3) for each] were serially sectioned and three representative sections from each testis then selected and immunostained for 3ß-HSD. The three sections chosen were those corresponding to approximately 25, 50, and 75% intervals through the serially sectioned testis; at E21.5 in rats this corresponded to sections that were 2030 sections apart from each other. Sections from at least three separate litters from each treatment group were used for analysis. Quantification of Leydig cell cluster number and area in these sections was undertaken using Image-Pro Plus 4.5.1 software and equipment as described above. Specimens immunostained for 3ß-HSD were of sufficient homogeneity, high contrast, and low background to allow computer-assisted thresholding and subsequent computer-assisted counting of Leydig cell (3ß-HSD immunopositive) clusters and determination of Leydig cell cluster area. Digital images of complete testis sections were captured at x4 magnification. The software was used to trace around each section, creating an area of interest, allowing the area of each section to be calculated. Computer-assisted thresholding was then used to identify and analyze clusters of 3ß-HSD-immunopositive cells, generating data on cluster number, area, and the proportion of each section occupied by each Leydig cell cluster. Each cluster was then expressed as a percentage of the total Leydig cell cluster area in that animal and was then assigned to one of three groups: small clusters, which accounted for 5% or less of the total Leydig cell cluster area per testis; medium clusters, which accounted for 5.114.9%; and large clusters, which accounted for 15% or more of the total Leydig cell cluster area per testis. This approach was necessary to take account of the reduction in total Leydig cell area per testis in DBP-exposed animals due to reduction in Leydig cell size (29).
Multinucleated gonocyte analysis
Testes from control (n = 24), DBP (n = 10), flutamide (n = 9), DBP + flutamide (n = 15), DMBA (n = 7), DBP + DMBA (n = 9), TP (n = 6), and DBP + TP (n = 8) exposed animals were assessed (animals were from at least three separate litters) as well as WT and tfm mice (n = 3). They were sectioned and a representative section stained with toluidine blue to enable clear visualization of the gonocytes. Slides were dewaxed and rehydrated as outlined above. The toluidine blue stain (BDH Chemicals) was filtered and applied to slides at a 50% dilution with distilled water. Once staining was optimal, the slides were immersed in distilled water and then dehydrated and mounted as normal. Stereological analysis of the occurrence of MNG was performed using Image-Pro Plus software and equipment as described above. Each testis section was analyzed to determine the percentage of tubules containing one or more MNG.
Image capture
Images were examined and photographed using a Provis microscope (Olympus Optical, London, UK) fitted with a DCS330 digital camera (Eastman Kodak, Rochester, NY). Images were compiled using Photoshop 7.0 (Adobe Systems Inc., Mountain View, CA).
Statistical analysis
Values are expressed as means ± SEM, and data were analyzed using Students unpaired t test or one-way ANOVA followed by the Bonferroni post-test, comparing all single and combined treatments with controls and with each other, using GraphPad Prism (version 4; GraphPad Software Inc., San Diego, CA).
| Results |
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Sertoli cell number per testis
Sertoli cell nuclei were identified by immunostaining for WT-1 (Fig. 2A
) and then enumerated using standard stereological techniques. ARKO mice exhibited a 50% reduction in Sertoli cell number when compared with phosphoglycerate kinase-1-Cre (control) mice (Fig. 2B
), and tfm mice have previously been shown to exhibit a reduction of similar magnitude at birth (8). Sertoli cell number per testis was reduced by 49% in animals exposed to DBP alone (Fig. 2B
). Animals exposed to TP alone also exhibited a significant reduction (33%) in Sertoli cell number, and when DBP + TP treatments were combined, a 59% reduction in Sertoli cell number was evident. Exposure to flutamide alone had no effect on Sertoli cell number, but animals exposed to both DBP + flutamide exhibited a slightly larger reduction in Sertoli cell number (56%) than did DBP treatment alone (49% reduction; Fig. 2B
). Exposure to DMBA alone had no significant effect on Sertoli cell number and combined treatment with DBP + DMBA did not result in any greater reduction in Sertoli cell number than after treatment with DBP alone (Fig. 2B
).
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| Discussion |
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It was initially hoped that exposing animals to flutamide would be the most straightforward way of determining what role, if any, androgens play in the intratesticular changes seen in DBP-exposed animals, and in particular their involvement in Sertoli cell proliferation/number. It became apparent, however, that although flutamide had very pronounced effects at peripheral sites of androgen action, namely reduction of the male AGD to that of a typical female, it had no obvious effect on the testis when administered on its own. There are two possible, and opposing, explanations for this. The first is that flutamide does not cause any changes to the end points evaluated because none of them are androgen dependent. The second is that levels of testosterone within the testis are too high for flutamide to effectively antagonize them. Whereas the former possibility cannot be ruled out, there are two pieces of data that support the latter interpretation. First, this dose of flutamide fails to induce regression of the Wolffian duct in exposed males (40), consistent with the higher local testosterone levels in this duct, compared with peripheral sites (e.g. prostate, perineum), and testosterone levels within the testis are presumably higher than in the Wolffian duct. Second, combined exposure to DBP + flutamide induced a 17% larger decrease in Sertoli cell number than did exposure to DBP alone, which may mean that flutamide is marginally effective when intratesticular testosterone levels are markedly subnormal due to DBP treatment. An additional possibility is that flutamide exposure elevates endogenous FSH levels in male fetuses, as it does in neonatal male rats (38), which would increase Sertoli cell proliferation and thus counteract any antiandrogenic effect on this parameter.
It has already been well established that exposure to DBP results in a reduction in intratesticular testosterone (21, 22, 23, 24) and, in postnatal life, a reduced AGD (41), and our present data confirmed this, although the reduction in AGD evident at E21.5 in the present studies was slight and nonsignificant. All of the groups exposed to either DBP alone, or with a cotreatment, showed a reduction in intratesticular testosterone and a concurrent and equivalent reduction in Sertoli cell number. It cannot be excluded that DBP gave rise to this reduction in Sertoli cell number via a non-testosterone-dependent mechanism. However, if this were the case, it would fail to account for the reduction in Sertoli cell number observed in ARKO and tfm mice (this study and Refs. 8 , 9), and there is also evidence supporting a role for androgens in increasing Sertoli cell number in immature monkeys (42, 43, 44) and neonatal rats (38). Consequently, the present findings on changes in Sertoli cell number in rats are most plausibly explained by the change in intratesticular testosterone levels. Studies involving DBP administration to normal and ARKO mice could clarify this more definitively, but this may be difficult in practice because it has been shown previously that mice are less sensitive to DBP exposure, at least postnatally (45).
Our primary intention in treating with TP was to ascertain which, if any, of the DBP effects could be prevented if the DBP-induced reduction in intratesticular testosterone levels were attenuated, thus confirming that they were testosterone dependent. Surprisingly, TP did not reverse any of the DBP-induced effects, although it was able to successfully masculinize AGD, induce prostate formation, and stabilize the Wolffian duct in females, and to some extent increase AGD in males, when administered alone or with DBP. Therefore, whereas this dose of TP was clearly biologically active at more peripheral sites, it was unable to restore intratesticular testosterone levels in DBP-exposed animals to normal. In fact, animals exposed to DBP + TP had lower intratesticular testosterone levels than did those exposed to DBP alone and treatment with TP alone also resulted in a (nonsignificant) reduction in intratesticular testosterone levels. The most logical interpretation of these findings is that TP treatment caused a reduction in LH levels via increased negative feedback at the hypothalamic-pituitary axis (46, 47, 48), and thus reduced LH drive to testosterone production, and consequently this exacerbated the reduction in intratesticular testosterone caused by DBP alone. The reduction in Sertoli cell number observed in animals exposed to TP alone could be explained by this suppression of androgen action, or it could be due to a reduction in FSH stimulation because neonatal rats treated with testosterone have been shown to have reduced levels of FSH and reduced Sertoli cell number (38). Exposure to DBP + TP resulted in the greatest reduction in Sertoli cell number, the biggest increase in occurrence of MNG and one of the largest increases in large Leydig cell clusters. However, because treatment with TP ± DBP also caused quite marked decreases in fetal body weight, consistent with previous reports (35), it is also possible that growth restriction may have contributed to the effect on Sertoli cell number.
DMBA treatment was undertaken in response to earlier in vitro evidence that suggested that it could antagonize testosterone action distal to AR binding, thus providing a credible explanation for the presumed reduction in Sertoli cell number in men whose mothers smoked during pregnancy and who display a pronounced decrease in testis size and sperm count (13, 14). However, in the present studies, DMBA exposure did not induce any significant effects on measured parameters, including Sertoli cell number, when administered on its own, and cotreatment with DBP + DMBA did not obviously exacerbate any of these parameters, compared with DBP treatment alone. Therefore, at the dose used in this study, no evidence was obtained to support the hypothesis that DMBA antagonizes androgen action either peripherally or intratesticularly.
The data from this study have provided strong evidence that androgens are involved in the regulation of fetal Sertoli cell proliferation, consistent with present and earlier observations in ARKO mice (9). Our findings also provide evidence that reduced intratesticular testosterone levels could be involved in the etiology of MNG formation and fetal Leydig cell aggregation, although this evidence is not as convincing as the data for Sertoli cell number because it is not supported by parallel findings from the ARKO and tfm mice because neither of these end points were identified as being affected in these animals. Irrespective of which of the measured effects are testosterone dependent, they probably all occur via indirect mechanisms because neither the Sertoli cells nor germ cells express AR during fetal life (10, 11) and only a proportion of the fetal Leydig cells express AR. These indirect pathways have yet to be explored, but any effects that androgens have on Sertoli cells are expected to involve the AR-positive peritubular myoid cells (10, 11). It is important to note that any studies undertaken to identify these pathways will have to take into account lessons from the present study on how best to manipulate intratesticular androgen action without compromising steroid production/action essential to pregnancy and other fetal functions. For certain, our findings emphasize that the intratesticular and peripheral effects of androgen action are differentially susceptible to treatments that are designed to manipulate androgen levels/action, and the present study demonstrates that it is vital to measure intratesticular testosterone levels to make sense of results regarding testicular changes.
| Acknowledgments |
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| Footnotes |
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Disclosure Summary: The authors have nothing to disclose.
First Published Online February 8, 2007
Abbreviations: AGD, Anogenital distance; AR, androgen receptor; ARKO, AR knockout; Cre, Cre recombinase; DBP, di(n-butyl) phthalate; DMBA, 7,12-dimethyl-benz[a]anthracene; E, embryonic day; 3ß-HSD, 3ß-hydroxysteroid dehydrogenase; MNG, multinucleated gonocytes; PAH, polycyclic aromatic hydrocarbon; TDS, testicular dysgenesis syndrome; tfm, testicular feminized male; TP, testosterone propionate; WT, wild type.
Received December 5, 2006.
Accepted for publication January 26, 2007.
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-reductase inhibitor finasteride and the antiandrogen flutamide on prostate and genital differentiation: dose-response studies. Endocrinology 131:11491156This article has been cited by other articles:
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