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AbuMadighem A, Shuchat S, Lunenfeld E, Yossifon G, Huleihel M. Testis on a chip - a microfluidic 3-dimensional culture system for the development of spermatogenesis in-vitro. Biofabrication 2022; 14. [PMID: 35334473 DOI: 10.1088/1758-5090/ac6126] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/25/2022] [Indexed: 11/12/2022]
Abstract
This research presents a novel Testis-on-a Chip- platform. Testicular cells are enzymatically isolated from the seminiferous tubules of sexually immature mice, seeded in a methylcellulose gel and cultured in a microfluidic chip. The unique design sandwiches the soft methylcellulose between stiffer agar support gels. The cells develop into organoids continuing to proliferate and differentiate. After seven weeks of culture the cells have over 95% viability. Confocal microscopy of the developed organoids reveals a structure containing the various stages of spermatogenesis up to and including meiosis II: premeiotic, meiotic and post-meiotic germ cells. The organoid structure also contains the supporting Sertoli and peritubular cells. The responsiveness of the system to the addition of testosterone and retinoic acid to the culture medium during the experiment are also investigated. As a benchmark, the Testis-on-a-Chip is compared to a conventional three-dimensional methylcellulose cell culture in a well plate. Analysis via FACS (Fluorescence-activated cell sorting) shows more haploid cells in the chip as compared to the plates. Immunofluorescence staining after seven weeks of culture shows more differentiated cells in the chip as compared to the well plate. This demonstrates the feasibility of our platform as well as its advantages. This research opens new horizons for the study and realization of spermatogenesis in-vitro. It can also enable the implementation of microfluidic technologies in future therapeutic strategies for pre pubertal male fertility preservation and adults with maturation arrest. Lastly, it can serve as a platform for drug and toxin testing.
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Affiliation(s)
- Ali AbuMadighem
- Ben-Gurion University of the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Southern, 84105, ISRAEL
| | - Sholom Shuchat
- Technion Israel Institute of Technology, Faculty of Mechanical Engineering, Haifa, Haifa, 3200003, ISRAEL
| | - Eitan Lunenfeld
- Ben-Gurion University of the Negev, Ben-Gurion University of the Negev, Beer-Sheva, Beer-Sheva, Southern, 84105, ISRAEL
| | - Gilad Yossifon
- Technion Israel Institute of Technology, Faculty of Mechanical Engineering, Haifa, Haifa, 3200003, ISRAEL
| | - Mahmoud Huleihel
- Ben-Gurion University of the Negev, Faculty of Health Sciences, Beer-Sheva, 84105, ISRAEL
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Michailov Y, AbuMadighem A, Lunenfeld E, Kapelushnik J, Huleihel M. Granulocyte Colony-Stimulating Factor Restored Impaired Spermatogenesis and Fertility in an AML-Chemotherapy Mice Model. Int J Mol Sci 2021; 22:ijms222011157. [PMID: 34681817 PMCID: PMC8538347 DOI: 10.3390/ijms222011157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/24/2022] Open
Abstract
Leukemia and treatment of male patients with anticancer therapy (aggressive chemotherapy and/or radiotherapy) may lead to infertility or even permanent male sterility. Their mechanisms of spermatogenesis impairment and the decrease in male fertility are not yet clear. We showed that under acute myeloid leukemia (AML) conditions, alone and in combination with cytarabine (CYT), there was significant damage in the histology of seminiferous tubules, a significant increase in apoptotic cells of the seminiferous tubules, and a reduction in spermatogonial cells (SALL and PLZF) and in meiotic (CREM) and post-meiotic (ACROSIN) cells. In addition, we showed a significant impairment in sperm parameters and fertilization rates and offspring compared to control. Our results showed a significant decrease in the expression of glial cell line-derived neurotrophic factor (GDNF), macrophage colony-stimulating factor (MCSF) and stem cell factor (SCF) under AML conditions, but not under cytarabine treatment compared to control. In addition, our results showed a significant increase in the pro-inflammatory cytokine interleukin-1 (IL-1) alpha in whole testis homogenates in all treatment groups compared to the control. Increase in IL-1 beta level was shown under AML conditions. We identified for the first time the expression of GCSF receptor (GCSFR) in sperm cells. We showed that GCSF injection in combination with AML and cytarabine (AML + CYT + GCSF) extended the survival of mice for a week (from 6.5 weeks to 7.5 weeks) compared to (AML + CYT). Injection of GCSF to all treated groups (post hoc), showed a significant impact on mice testis weight, improved testis histology, decreased apoptosis and increased expression of pre-meiotic, meiotic and post- meiotic markers, improved sperm parameters, fertility capacity and number of offspring compared to the controls (without GCSF). GCSF significantly improved the spermatogonial niche expressed by increased the expression levels of testicular GDNF, SCF and MCSF growth factors in AML-treated mice and (AML + CYT)-treated mice compared to those groups without GCSF. Furthermore, GCSF decreased the expression levels of the pro-inflammatory cytokine IL-12, but increased the expression of IL-10 in the interstitial compartment compared to the relevant groups without GCSF. Our results show for the first time the capacity of post injection of GCSF into AML- and CYT-treated mice to improve the cellular and biomolecular mechanisms that lead to improve/restore spermatogenesis and male fertility. Thus, post injection of GCSF may assist in the development of future therapeutic strategies to preserve/restore male fertility in cancer patients, specifically in AML patients under chemotherapy treatments.
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Affiliation(s)
- Yulia Michailov
- The Center of Advanced Research and Education in Reproduction (CARER), The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel; (Y.M.); (A.A.)
- Barzilai University Medical Center, IVF Unit, Ashkelon 7830604, Israel
| | - Ali AbuMadighem
- The Center of Advanced Research and Education in Reproduction (CARER), The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel; (Y.M.); (A.A.)
| | - Eitan Lunenfeld
- The Center of Advanced Research and Education in Reproduction (CARER), Dep OB/GYN, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel;
| | - Joseph Kapelushnik
- Soroka Medical Center, Department of Pediatric Oncology and Hematology, Beer-Sheva, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel;
| | - Mahmoud Huleihel
- The Center of Advanced Research and Education in Reproduction (CARER), The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel; (Y.M.); (A.A.)
- Correspondence:
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Bagdadi N, Sawaied A, AbuMadighem A, Lunenfeld E, Huleihel M. The Expression Levels and Cellular Localization of Pigment Epithelium Derived Factor (PEDF) in Mouse Testis: Its Possible Involvement in the Differentiation of Spermatogonial Cells. Int J Mol Sci 2021; 22:1147. [PMID: 33498962 PMCID: PMC7865766 DOI: 10.3390/ijms22031147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/12/2021] [Accepted: 01/21/2021] [Indexed: 11/24/2022] Open
Abstract
Pigment epithelium derived factor (PEDF) is a multifunctional secretory soluble glycoprotein that belongs to the serine protease inhibitor (serpin) family. It was reported to have neurotrophic, anti-angiogenic and anti-tumorigenic activity. Recently, PEDF was found in testicular peritubular cells and it was assumed to be involved in the avascular nature of seminiferous tubules. The aim of this study was to determine the cellular origin, expression levels and target cells of PEDF in testicular tissue of immature and adult mice under physiological conditions, and to explore its possible role in the process of spermatogenesis in vitro. Using immunofluorescence staining, we showed that PEDF was localized in spermatogenic cells at different stages of development as well as in the somatic cells of the testis. Its protein levels in testicular homogenates and Sertoli cells supernatant showed a significant decrease with age. PEDF receptor (PEDF-R) was localized within the seminiferous tubule cells and in the interstitial cells compartment. Its RNA expression levels showed an increase with age until 8 weeks followed by a decrease. RNA levels of PEDF-R showed the opposite trend of the protein. Addition of PEDF to cultures of isolated cells from the seminiferous tubules did not changed their proliferation rate, however, a significant increase was observed in number of meiotic/post meiotic cells at 1000 ng/mL of PEDF; indicating an in vitro differentiation effect. This study may suggest a role for PEDF in the process of spermatogenesis.
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Affiliation(s)
- Noy Bagdadi
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel; (N.B.); (A.S.); (A.A.)
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel;
| | - Alaa Sawaied
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel; (N.B.); (A.S.); (A.A.)
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel;
| | - Ali AbuMadighem
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel; (N.B.); (A.S.); (A.A.)
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel;
| | - Eitan Lunenfeld
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel;
- Department of OB/GYN, Soroka Medical Center, Beer Sheva 8410501, Israel
| | - Mahmoud Huleihel
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel; (N.B.); (A.S.); (A.A.)
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel;
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Wormser O, Levy Y, Bakhrat A, Bonaccorsi S, Graziadio L, Gatti M, AbuMadighem A, McKenney RJ, Okada K, El Riati S, Har-Vardi I, Huleihel M, Levitas E, Birk OS, Abdu U. Absence of SCAPER causes male infertility in humans and Drosophila by modulating microtubule dynamics during meiosis. J Med Genet 2020; 58:254-263. [PMID: 32527956 PMCID: PMC10405349 DOI: 10.1136/jmedgenet-2020-106946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/22/2020] [Accepted: 04/25/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Mutation in S-phase cyclin A-associated protein rin the endoplasmic reticulum (SCAPER) have been found across ethnicities and have been shown to cause variable penetrance of an array of pathological traits, including intellectual disability, retinitis pigmentosa and ciliopathies. METHODS Human clinical phenotyping, surgical testicular sperm extraction and testicular tissue staining. Generation and analysis of short spindle 3 (ssp3) (SCAPER orthologue) Drosophila CAS9-knockout lines. In vitro microtubule (MT) binding assayed by total internal reflection fluorescence microscopy. RESULTS We show that patients homozygous for a SCAPER mutation lack SCAPER expression in spermatogonia (SPG) and are azoospermic due to early defects in spermatogenesis, leading to the complete absence of meiotic cells. Interestingly, Drosophila null mutants for the ubiquitously expressed ssp3 gene are viable and female fertile but male sterile. We further show that male sterility in ssp3 null mutants is due to failure in both chromosome segregation and cytokinesis. In cells undergoing male meiosis, the MTs emanating from the centrosomes do not appear to interact properly with the chromosomes, which remain dispersed within dividing spermatocytes (SPCs). In addition, mutant SPCs are unable to assemble a normal central spindle and undergo cytokinesis. Consistent with these results, an in vitro assay demonstrated that both SCAPER and Ssp3 directly bind MTs. CONCLUSIONS Our results show that SCAPER null mutations block the entry into meiosis of SPG, causing azoospermia. Null mutations in ssp3 specifically disrupt MT dynamics during male meiosis, leading to sterility. Moreover, both SCAPER and Ssp3 bind MTs in vitro. These results raise the intriguing possibility of a common feature between human and Drosophila meiosis.
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Affiliation(s)
- Ohad Wormser
- The Morris Kahn Laboratory of Human Genetics, National Institute for Biotechnology in the Negev and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ygal Levy
- Department of Life Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Anna Bakhrat
- Department of Life Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Silvia Bonaccorsi
- Dipartimento di Biologia e Biotecnologie "C. Darwin", Sapienza University of Rome, Rome, Italy
| | - Lucia Graziadio
- Dipartimento di Biologia e Biotecnologie "C. Darwin", Sapienza University of Rome, Rome, Italy
| | - Maurizio Gatti
- Dipartimento di Biologia e Biotecnologie "C. Darwin", Sapienza University of Rome, Rome, Italy.,Istituto di Biologia e Patologia Molecolari Consiglio Nazionale delle Ricerche, Roma, Italy
| | - Ali AbuMadighem
- Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev Faculty of Health Sciences, Beer-Sheva, Israel.,The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev Faculty of Health Sciences, Beer-Sheva, Israel
| | - Richard J McKenney
- Department of Molecular and Cellular Biology, UC Davis, Davis, California, USA
| | - Kyoko Okada
- Department of Molecular and Cellular Biology, UC Davis, Davis, California, USA
| | - Saad El Riati
- Southern District, Clalit Health Services, Beer-Sheva, Israel
| | - Iris Har-Vardi
- The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev Faculty of Health Sciences, Beer-Sheva, Israel.,Fertility and IVF Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Mahmoud Huleihel
- Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev Faculty of Health Sciences, Beer-Sheva, Israel.,The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev Faculty of Health Sciences, Beer-Sheva, Israel
| | - Eliahu Levitas
- The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev Faculty of Health Sciences, Beer-Sheva, Israel.,Fertility and IVF Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Ohad S Birk
- The Morris Kahn Laboratory of Human Genetics, National Institute for Biotechnology in the Negev and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel .,Genetics Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Uri Abdu
- Department of Life Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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AbuMadighem A, Solomon R, Stepanovsky A, Kapelushnik J, Shi Q, Meese E, Lunenfeld E, Huleihel M. Development of Spermatogenesis In Vitro in Three-Dimensional Culture from Spermatogonial Cells of Busulfan-Treated Immature Mice. Int J Mol Sci 2018; 19:ijms19123804. [PMID: 30501072 PMCID: PMC6321353 DOI: 10.3390/ijms19123804] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 11/20/2018] [Accepted: 11/24/2018] [Indexed: 01/22/2023] Open
Abstract
Aggressive chemotherapy may lead to permanent male infertility. Prepubertal males do not generate sperm, but their testes do contain spermatogonial cells (SPGCs) that could be used for fertility preservation. In the present study, we examined the effect of busulfan (BU) on the SPGCs of immature mice, and the possible induction of the survivor SPGCs to develop spermatogenesis in 3D in-vitro culture. Immature mice were injected with BU, and after 0.5⁻12 weeks, their testes were weighed and evaluated histologically compared to the control mice. The spermatogonial cells [Sal-like protein 4 (SALL4) and VASA (a member of the DEAD box protein family) in the testicular tissue were counted/seminiferous tubule (ST). The cells from the STs were enzymatically isolated and cultured in vitro. Our results showed a significant decrease in the testicular weight of the BU-treated mice compared to the control. This was in parallel to a significant increase in the number of severely damaged STs, and a decrease in the number of SALL4 and VASA/STs compared to the control. The cultures of the isolated cells from the STs of the BU-treated mice showed a development of colonies and meiotic and post-meiotic cells after four weeks of culture. The addition of homogenates from adult GFP mice to those cultures induced the development of sperm-like cells after four weeks of culture. This is the first study demonstrating the presence of biologically active spermatogonial cells in the testicular tissue of BU-treated immature mice, and their capacity to develop sperm-like cells in vitro.
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Affiliation(s)
- Ali AbuMadighem
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Beer-Sheva 84105, Israel.
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Beer-Sheva 8410501, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
| | - Ronnie Solomon
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Beer-Sheva 84105, Israel.
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Beer-Sheva 8410501, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
| | - Alina Stepanovsky
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Beer-Sheva 84105, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
| | - Joseph Kapelushnik
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Beer-Sheva 8410501, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
- Department of Pediatric Oncology and Department of Hematology, Soroka University Medical Center, Beer-Sheva 8410501, Israel.
| | - QingHua Shi
- Molecular and Cell Genetics Laboratory, The CAS Key Laboratory of Innate Immunity and Chronic Disease, Hefei National Laboratory for Physical Sciences at Microscale and School of Life Sciences, University of Science and Technology of China, Hefei 230000, China.
| | - Eckart Meese
- Institute of Human Genetics, Saarland University, Homburg/Saar, 66421 Homburg, Germany.
| | - Eitan Lunenfeld
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Beer-Sheva 8410501, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
- Fertility and IVF Unit and Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva 8410501, Israel.
| | - Mahmoud Huleihel
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Beer-Sheva 84105, Israel.
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Beer-Sheva 8410501, Israel.
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Abofoul-Azab M, AbuMadighem A, Lunenfeld E, Kapelushnik J, Shi Q, Pinkas H, Huleihel M. Development of Postmeiotic Cells In Vitro from Spermatogonial Cells of Prepubertal Cancer Patients. Stem Cells Dev 2018; 27:1007-1020. [PMID: 29779447 DOI: 10.1089/scd.2017.0301] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Aggressive chemotherapy in childhood often results in testicular damage and consequently jeopardizes future fertility. The presence of spermatogonial cells (SPGCs) in the testes of prepubertal cancer patient boys (PCPBs) can be used to develop future strategies for male fertility preservation. In the present study, we examined the presence of SPGCs in testes of chemotherapy-treated PCPBs and their ability to develop spermatogenesis in vitro using a three-dimensional culture system. Seven testicular biopsies were obtained from chemotherapy-treated PCPBs and one from a patient with β-thalassemia major. Isolated testicular cells were cultured in a methylcellulose culture system (MCS)-containing StemPro enriched with growth factors for 5-15 weeks. The presence of premeiotic, meiotic, and postmeiotic cells was examined by immunofluorescence staining and/or reverse transcription-polymerase chain reaction (RT-PCR) analysis. We observed SPGCs in the examined testicular biopsies. Isolated testicular cells cultured in MCS developed into colonies and contained premeiotic, meiotic, and postmeiotic cells. Furthermore, we identified sperm-like cells that had developed from testicular cells of a PCPB. Our results demonstrate, for the first time, the presence of biologically active SPGCs in testicular biopsies of chemotherapy-treated PCPBs and their capacity to develop in vitro to different stages of spermatogenesis, including the generation of sperm-like cells. This study may open the way for new therapeutic strategies for fertility preservation of PCPBs and for azoospermic patients.
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Affiliation(s)
- Maram Abofoul-Azab
- 1 The Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev , Beer-Sheva, Israel .,2 The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev , Beer-Sheva, Israel .,3 Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel
| | - Ali AbuMadighem
- 1 The Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev , Beer-Sheva, Israel .,2 The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev , Beer-Sheva, Israel .,3 Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel
| | - Eitan Lunenfeld
- 2 The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev , Beer-Sheva, Israel .,3 Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel .,4 Fertility and IVF Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center , Beer-Sheva, Israel
| | - Joseph Kapelushnik
- 2 The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev , Beer-Sheva, Israel .,3 Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel .,5 Department of Pediatric Oncology, Soroka University Medical Center , Beer-Sheva, Israel .,6 Department of Hematology, Soroka University Medical Center , Beer-Sheva, Israel
| | - QingHua Shi
- 7 Molecular and Cell Genetics Laboratory, The CAS Key Laboratory of Innate Immunity and Chronic Disease, Hefei National Laboratory for Physical Sciences at Microscale and School of Life Sciences, University of Science and Technology of China , Hefei, China
| | - Haim Pinkas
- 8 Male Infertility and Sperm Bank, Helen Schneider Hospital for Women, Rabin Medical Center , Beilinson Hospital, Petach Tikva, Israel
| | - Mahmoud Huleihel
- 1 The Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev , Beer-Sheva, Israel .,2 The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev , Beer-Sheva, Israel .,3 Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel
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