Melatonin has Synergistic Protective Effect with Ghrelin on Cisplatin-induced Ovarian Damage Via Regulation of FOXO3a Shuttling and p27Kip1 Expression in Primordial Follicl
Premature ovarian failure is an important problem for young women with cancer during chemotherapy. To preserve the fertility of young female cancer patients, it is necessary to find out proper methods and materials against chemotherapy-induced ovarian failure. In the previous study, we reported that melatonin treatment partially prevents the depletion of dormant follicle pool via repressing simultaneous activation of dormant primordial follicles by cisplatin. However, the protective effect of melatonin was partial, but not sufficient. Here, we found a hormone, ghrelin to maximize the protective effect of melatonin on ovarian failure in cisplatin-injected mice. Interestingly, co-administration of melatonin and ghrelin more effectively works against follicle disruption by cisplatin. Simultaneous treatment of melatonin and ghrelin almost restored the number of primordial follicles and corpus-luteum in cisplatin-treated ovaries, compared with the single administration group. We found that melatonin and ghrelin receptors were highly present in the cell membrane of premature oocytes of primordial follicles. In addition, both melatonin and ghrelin treatment decreased the phosphorylation of PTEN and FOXO3a resulting in inhibition of FOXO3a’s location in the nucleus and reduction of p27Kip1 expression in primordial follicles. Nuclear FOXO3a and p27Kip1 expression were critical for keeping dormant status of primordial follicles in cisplatin-treated ovary. In conclusion, these findings suggest that combination of melatonin and ghrelin is able to be used in clinics for fertoprotective adjuvant therapy during cisplatin-mediated chemotherapy in young female cancer patients.