Kinase-independent inhibition of cyclophosphamide-induced pathways protects the ovarian reserve and prolongs fertility

Cell Death Dis. 2019 Sep 27;10(10):726. doi: 10.1038/s41419-019-1961-y.

Abstract

Premature ovarian failure and infertility are adverse effects of cancer therapies. The mechanism underlying chemotherapy-mediated depletion of the ovarian reserve remains unclear. Here, we aim to identify the signaling pathways involved in the loss of the ovarian reserve to prevent the damaging effects of chemotherapy. We evaluated the effects of cyclophosphamide, one of the most damaging chemotherapeutic drugs, against follicle reserve. In vivo studies showed that the cyclophosphamide-induced loss of ovarian reserve occurred through a sequential mechanism. Cyclophosphamide exposure induced the activation of both DNAPK-γH2AX-checkpoint kinase 2 (CHK2)-p53/TAp63α isoform and protein kinase B (AKT)-forkhead box O3 (FOXO3a) signaling axes in the nucleus of oocytes. Concomitant administration of an allosteric ABL inhibitor and cyclophosphamide modulated both pathways while protecting the ovarian reserve from chemotherapy assaults. As a consequence, the fertility of the treated mice was prolonged. On the contrary, the administration of an allosteric ABL activator enhanced the lethal effects of cyclophosphamide while shortening mouse fertility. Therefore, kinase-independent inhibition may serve as an effective ovarian-protective strategy in women under chemotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antineoplastic Agents, Alkylating / pharmacology
  • Cyclophosphamide / antagonists & inhibitors*
  • Cyclophosphamide / toxicity*
  • Drug Interactions
  • Female
  • Fertility / drug effects*
  • Mice
  • Ovarian Follicle / drug effects
  • Ovarian Reserve / drug effects*
  • Primary Ovarian Insufficiency / chemically induced
  • Primary Ovarian Insufficiency / prevention & control*
  • Protein Kinase Inhibitors / pharmacology*
  • Signal Transduction / drug effects
  • Small Molecule Libraries / pharmacology

Substances

  • Antineoplastic Agents, Alkylating
  • Protein Kinase Inhibitors
  • Small Molecule Libraries
  • Cyclophosphamide