Can vildagliptin protect against radiation-induced premature ovarian failure? Insights into the AMPK and AKT signaling pathways.

Abstract

Background: Among the detrimental side effects caused by radiotherapy in young females is the ovarian damage, eventually causing premature ovarian failure (POF). While many signaling pathways contribute to the pathogenesis of POF, to date no sufficient data exist on the AMPK and AKT signaling pathways in irradiated ovaries. Both AMPK and AKT play crucial roles in the process of folliculogenesis. Vildagliptin (vilda) is a dipeptidyl peptidase-4 inhibitor with modulatory effect on both AMPK and AKT. Therefore, our study aimed to investigate the biochemical changes that occur in the AMPK/AKT signaling pathway, and the effect of co-administration of vildagliptin in radiation-induced POF.

Methods: Female Sprague-dawley rats were randomly divided into four groups: control, radiation, radiation + vilda, or vilda alone groups. Vilda was administered orally once/day, and on the 10th day of the experiment, radiation and radiation + vilda group rats were subjected to 3.2 Gy of whole-body gamma irradiation. Behavioral activity was assessed on the 13th day of the experiment. On day 14 of the experiment, all rats were euthanized. Serum samples were collected, and ovaries were dissected for histological and biochemical analyses.

Results: Irradiation of female rats resulted in increased locomotor hyperactivity, impaired memory, and ovarian damage as evidenced by the marked histopathological deterioration. Additionally, irradiation led to a significant decrease in body weight gain, gonadosomatic index, and serum estradiol level. Further, it caused a significant increase in serum AMH, phosphorylated AMPK, phosphorylated AKT, cytoplasmic Nrf2 expression and phosphorylated CREB levels. Co-administration of vilda exhibited neuroprotective effects, preserved the ovarian histological architecture but failed to preserve the primordial follicle pool in irradiated rats.

Conclusion: In conclusion, AMPK/AKT signaling pathway is upregulated in radiation-induced POF. It possibly contributes to POF pathogenesis by accelerating the activation of primordial follicles, hence leading to their premature depletion. Coadministration of vilda can protect the ovaries and temporarily preserve its endocrine function; however, it does not sustain the ovarian reproductive capacity due to the early depletion of the pool of primordial follicles. Women undergoing radiotherapy should be cautious with the use of AKT-activating drugs.