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Thiopurines exert harmful effects on spermatogenesis in Nudt15R138C knock-in mice

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Abstract

Background

The association between thiopurine use and testicular reproductive functions remains unclear. In this study, we investigated whether thiopurines affect testicular functions based on the NUDT15 genotypes using Nudt15R138C knock-in mice.

Methods

The male Nudt15R138C knock-in mice (9–12 weeks) were treated with mercaptopurine (MP: 0.5 mg/kg/day) for 4 or 12 weeks. To examine reversibility, some mice were maintained for a further 12 weeks under MP-free condition.

Results

After MP treatment for 4 weeks, Nudt15R138C/R138C mice exhibited a significant reduction of testis weight compared to Nudt15+/+ mice and Nudt15+/R138C mice. The epithelial height and diameter of seminiferous tubules were significantly reduced in Nudt15R138C/R138C mice compared to Nudt15+/+ and Nudt15+/R138C mice. Apoptotic cells were significantly increased in Nudt15R138C/R138C mice, and most of apoptotic cells were spermatogonia. There were no significant changes in sperm counts and sperm morphology in MP-treated Nudt15R138C/R138C mice after 4-week MP treatment. On the other hand, after MP treatment for 12 weeks, the Nudt15+/R138C mice, but not Nudt15+/+ mice, exhibited a significant reduction in the testis weight and atrophic changes of seminiferous tubules, but these changes disappeared after 12-week rearing under MP-free condition. Despite a significant increase in abnormal sperm rate, there were no changes in the ability to conceive. No differences in serum levels of follicle-stimulating hormone or testosterone were observed between MP-treated Nudt15+/R138C and Nudt15+/+ mice after 12-week MP treatment.

Conclusions

Thiopurines exert harmful effects on testicular reproductive function according to host NUDT15 genotypes.

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References

  1. Amin J, Huang B, Yoon J, et al. Update 2014: advances to optimize 6-mercaptopurine and azathioprine to reduce toxicity and improve efficacy in the management of IBD. Inflamm Bowel Dis. 2015;21:445–52.

    Article  PubMed  Google Scholar 

  2. Lee MN, Kang B, Choi SY, et al. Relationship between azathioprine dosage, 6-thioguanine nucleotide levels, and therapeutic response in pediatric patients with IBD treated with azathioprine. Inflamm Bowel Dis. 2015;21:1054–62.

    Article  CAS  PubMed  Google Scholar 

  3. Timmer A, McDonald JW, Tsoulis DJ, et al. Azathioprine and 6-mercaptopurine for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev. 2012;9:CD000478.

    Google Scholar 

  4. Chande N, Patton PH, Tsoulis DJ, et al. Azathioprine or 6-mercaptopurine for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev. 2015;10:CD000067.

  5. Torres J, Bonovas S, Doherty G, et al. ECCO guidelines on therapeutics in Crohn’s disease: medical treatment. J Crohns Colitis. 2020;14:4–22.

    Article  PubMed  Google Scholar 

  6. van Gennep S, de Boer NK, D’Haens GR, et al. Thiopurine treatment in ulcerative colitis: a critical review of the evidence for current clinical practice. inflamm Bowel Dis. 2017;24:67–77.

    Article  PubMed  Google Scholar 

  7. Gearry RB, Barclay ML, Burt MJ, et al. Thiopurine drug adverse effects in a population of New Zealand patients with inflammatory bowel disease. Pharmacoepidemiol Drug Saf. 2004;13:563–7.

    Article  CAS  PubMed  Google Scholar 

  8. Van Dieren JM, Hansen BE, Kuipers EJ, et al. Meta-analysis: inosine triphosphate pyrophosphatase polymorphisms and thiopurine toxicity in the treatment of inflammatory bowel disease. Aliment Pharmacol Ther. 2007;26:643–52.

    Article  PubMed  Google Scholar 

  9. Chaparro M, Ordas I, Cabre E, et al. Safety of thiopurine therapy in inflammatory bowel disease: long-term follow-up study of 3931 patients. Inflamm Bowel Dis. 2013;19:1404–10.

    Article  PubMed  Google Scholar 

  10. Chang JY, Cheon JH. Thiopurine therapy in patients with inflammatory bowel disease: a focus on metabolism and pharmacogenetics. Dig Dis Sci. 2019;64:2395–403.

    Article  PubMed  Google Scholar 

  11. Yang SK, Hong M, Baek J, et al. A common missense variant in NUDT15 confers susceptibility to thiopurine-induced leukopenia. Nat Genet. 2014;46:1017–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Moriyama T, Nishii R, Perez-Andreu V, et al. NUDT15 polymorphisms alter thiopurine metabolism and hematopoietic toxicity. Nat Genet. 2016;48:367–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Relling MV, Schwab M, Whirl-Carrillo M, et al. Clinical pharmacogenetics implementation consortium guideline for thiopurine dosing based on TPMT and NUDT15 genotypes: 2018 update. Clin Pharmacol Ther. 2019;105:1095–105.

    Article  CAS  PubMed  Google Scholar 

  14. Kakuta Y, Kawai Y, Okamoto D, et al. NUDT15 codon 139 is the best pharmacogenetic marker for predicting thiopurine-induced severe adverse events in Japanese patients with inflammatory bowel disease: a multicenter study. J Gastroenterol. 2018;53:1065–78.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Yang JJ, Landier W, Yang W, et al. Inherited NUDT15 variant is a genetic determinant of mercaptopurine intolerance in children with acute lymphoblastic leukemia. J Clin Oncol. 2015;33:1235–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Chang JY, Park SJ, Jung ES, et al. Genotype-based treatment with thiopurine reduces incidence of myelosuppression in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. 2020;18(2010–8): e2.

    Google Scholar 

  17. Asada A, Nishida A, Shioya M, et al. NUDT15 R139C-related thiopurine leukocytopenia is mediated by 6-thioguanine nucleotide-independent mechanism in Japanese patients with inflammatory bowel disease. J Gastroenterol. 2016;51:22–9.

    Article  CAS  PubMed  Google Scholar 

  18. Kakuta Y, Naito T, Onodera M, et al. NUDT15 R139C causes thiopurine-induced early severe hair loss and leukopenia in Japanese patients with IBD. Pharmacogenomics J. 2016;16:280–5.

    Article  CAS  PubMed  Google Scholar 

  19. Warner B, Johnston E, Arenas-Hernandez M, et al. A practical guide to thiopurine prescribing and monitoring in IBD. Frontline Gastroenterol. 2018;9:10–5.

    Article  CAS  PubMed  Google Scholar 

  20. Nakase H, Uchino M, Shinzaki S, et al. Evidence-based clinical practice guidelines for inflammatory bowel disease 2020. J Gastroenterol. 2021;56:489–526.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Imai T, Kawahara M, Tatsumi G, et al. Thiopurine use during pregnancy has deleterious effects on offspring in Nudt 15(R138C) knock-in mice. Cell Mol Gastroenterol Hepatol. 2021;12:335–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Tatsumi G, Kawahara M, Imai T, et al. Thiopurine-mediated impairment of hematopoietic stem and leukemia cells in Nudt 15(R138C) knock-in mice. Leukemia. 2020;34:882–94.

    Article  CAS  PubMed  Google Scholar 

  23. Yang L, Boyd K, Kaste SC, et al. A mouse model for glucocorticoid-induced osteonecrosis: effect of a steroid holiday. J Orthop Res. 2009;27:169–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Shin SC, Kang YM, Jin YW, et al. Relative morphological abnormalities of sperm in the caudal epididymis of high- and low-dose-rate gamma-irradiated ICR mice. J Radiat Res. 2009;50:261–6.

    Article  PubMed  Google Scholar 

  25. Takeda N, Yoshinaga K, Furushima K, et al. Viable offspring obtained from Prm1-deficient sperm in mice. Sci Rep. 2016;6:27409. https://doi.org/10.1038/srep27409.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Yoshida S. From cyst to tubule: innovations in vertebrate spermatogenesis. Wiley Interdiscip Rev Dev Biol. 2016;5:119–31.

    Article  PubMed  Google Scholar 

  27. Weinbauer GF, Nieschlag E. Gonadotrophin control of testicular germ cell development. Adv Exp Med Biol. 1995;377:55–65.

    Article  CAS  PubMed  Google Scholar 

  28. Migrenne S, Moreau E, Pakarinen P, et al. Mouse testis development and function are differently regulated by follicle-stimulating hormone receptors signaling during fetal and prepubertal life. PLoS ONE. 2012;7: e53257. https://doi.org/10.1371/journal.pone.0053257.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Patel H, Bhartiya D. Direct action of FSH on testicular stem cells. Stem Cell Res Ther. 2019;10:261.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Kaplan GG. The global burden of IBD: from 2015 to 2025. Nat Rev Gastroenterol Hepatol. 2015;12:720–7.

    Article  PubMed  Google Scholar 

  31. van den Heuvel TR, Wintjens DS, Jeuring SF, et al. Inflammatory bowel disease, cancer and medication: cancer risk in the Dutch population-based IBDSL cohort. Int J Cancer. 2016;139:1270–80.

    Article  PubMed  Google Scholar 

  32. Oatley JM, Reeves JJ, McLean DJ. Biological activity of cryopreserved bovine spermatogonial stem cells during in vitro culture. Biol Reprod. 2004;71:942–7.

    Article  CAS  PubMed  Google Scholar 

  33. Habas K, Brinkworth MH, Anderson D. In vitro responses to known in vivo genotoxic agents in mouse germ cells. Environ Mol Mutagen. 2017;58:99–107.

    Article  CAS  PubMed  Google Scholar 

  34. Kotaja N, De Cesare D, Macho B, et al. Abnormal sperm in mice with targeted deletion of the act (activator of cAMP-responsive element modulator in testis) gene. Proc Natl Acad Sci U S A. 2004;101:10620–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Simsek M, Lambalk CB, Wilschut JA, et al. The associations of thiopurines with male fertility and paternally exposed offspring: a systematic review and meta-analysis. Hum Reprod Update. 2018;24:192–206.

    Article  CAS  PubMed  Google Scholar 

  36. Ligumsky M, Badaan S, Lewis H, et al. Effects of 6-mercaptopurine treatment on sperm production and reproductive performance: a study in male mice. Scand J Gastroenterol. 2005;40:444–9.

    Article  CAS  PubMed  Google Scholar 

  37. Karl PI, Katz R, Daum F, et al. 6-Mercaptopurine and spermatogenesis in the young rat. Dig Dis Sci. 1991;36:1569–73.

    Article  CAS  PubMed  Google Scholar 

  38. de Boer NK, de Meij T, van Bodegraven AA. Thiopurines during pregnancy in inflammatory bowel disease: is there a risk for the (unborn) child? Expert Rev Gastroenterol Hepatol. 2013;7:669–71.

    Article  PubMed  Google Scholar 

  39. Coelho J, Beaugerie L, Colombel JF, et al. Pregnancy outcome in patients with inflammatory bowel disease treated with thiopurines: cohort from the CESAME Study. Gut. 2011;60:198–203.

    Article  PubMed  Google Scholar 

  40. Andoh A, Kawahara M, Imai T, et al. Thiopurine pharmacogenomics and pregnancy in inflammatory bowel disease. J Gastroenterol. 2021;56:881–90.

    Article  CAS  PubMed  Google Scholar 

  41. Akbari M, Shah S, Velayos FS, et al. Systematic review and meta-analysis on the effects of thiopurines on birth outcomes from female and male patients with inflammatory bowel disease. Inflamm Bowel Dis. 2013;19:15–22.

    Article  PubMed  Google Scholar 

  42. Gubatan J, Barber GE, Nielsen OH, et al. Paternal medications in inflammatory bowel disease and male fertility and reproductive outcomes: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2023;21:2222–38.

    Article  CAS  PubMed  Google Scholar 

  43. Friedman S, Larsen MD, Magnussen B, et al. Paternal use of azathioprine/6-mercaptopurine or methotrexate within 3 months before conception and long-term health outcomes in the offspring-A nationwide cohort study. Reprod Toxicol. 2017;73:196–200.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors wish to thank DR. Keiji Tomita, Prof. Susumu Kageyama and Prof. Akihiro Kawauchi (Department of Urology, Shiga University of Medical Science) for professional opinions and helpful discussion.

Funding

This work was supported by the Japan Agency for Medical Research and Development (AMED) under grant number JP23ek0410091 (YK), and in part by a Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan under grant number 22K08054 (AA), and in part by Grants from the Japan Sciences Research Grant for Research on Intractable Diseases (Japanese Inflammatory Bowel Disease Research Group) affiliated with the Japan Ministry of Health, Labour and Welfare under grant number 20FC1027.

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Authors

Contributions

All authors contributed to the study conception and design. Material preparation, performing experiments, data collection and analysis were performed by YY and TI. The first draft of the manuscript was written by YY and AA, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Akira Andoh.

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Conflict of interest

AA receiving lecture fee from Takeda Pharmaceutical Co. Ltd., AbbVie GK, and Miyarisan Pharmaceutical Co. Ltd. YK received patent royalties from Medical & Biological Laboratories Co., Ltd, and lecture fee from Takeda Pharmaceutical Co. Ltd., AbbVie GK, and Janssen Pharmaceutical K.K. All other authors declare that they have no conflict of interest in this study.

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Yokota, Y., Imai, T., Kawahara, M. et al. Thiopurines exert harmful effects on spermatogenesis in Nudt15R138C knock-in mice. J Gastroenterol 59, 109–118 (2024). https://doi.org/10.1007/s00535-023-02059-7

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  • DOI: https://doi.org/10.1007/s00535-023-02059-7

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