RANKL regulates male reproductive function
Martin Blomberg Jensen, Christine Hjorth Andreassen, Anne Jørgensen, John Erik Nielsen, Li Juel Mortensen, Ida Marie Boisen, Peter Schwarz, Jorma Toppari, Roland Baron, Beate Lanske, Anders Juul, Martin Blomberg Jensen, Christine Hjorth Andreassen, Anne Jørgensen, John Erik Nielsen, Li Juel Mortensen, Ida Marie Boisen, Peter Schwarz, Jorma Toppari, Roland Baron, Beate Lanske, Anders Juul
Abstract
Infertile men have few treatment options. Here, we demonstrate that the transmembrane receptor activator of NF-kB ligand (RANKL) signaling system is active in mouse and human testis. RANKL is highly expressed in Sertoli cells and signals through RANK, expressed in most germ cells, whereas the RANKL-inhibitor osteoprotegerin (OPG) is expressed in germ and peritubular cells. OPG treatment increases wild-type mouse sperm counts, and mice with global or Sertoli-specific genetic suppression of Rankl have increased male fertility and sperm counts. Moreover, RANKL levels in seminal fluid are high and distinguishes normal from infertile men with higher specificity than total sperm count. In infertile men, one dose of Denosumab decreases RANKL seminal fluid concentration and increases serum Inhibin-B and anti-Müllerian-hormone levels, but semen quality only in a subgroup. This translational study suggests that RANKL is a regulator of male reproductive function, however, predictive biomarkers for treatment-outcome requires further investigation in placebo-controlled studies.
Conflict of interest statement
All authors declare no competing interests except for M.B.J. who holds two patents on the use of RANKL inhibitors to treat male infertility. R.B. has been on the advisory Board of Amgen and B.L. is now employed by Radius Health. All other authors state no conflicts of interest.
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References
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Source: PubMed