Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX 77030, USA
In several species, a family of nuclear receptors, the peroxisome proliferator-activated receptors (PPARs) composed of three isotypes, is expressed in somatic cells and germ cells of the ovary as well as the testis. Invalidation of these receptors in mice or stimulation of these receptors in vivo or in vitro showed that each receptor has physiological roles in the gamete maturation or the embryo development. In addition, synthetic PPAR ligands are recently used to induce ovulation in women with polycystic ovary disease. These results reveal the positive actions of PPAR in reproduction. On the other hand, xenobiotics molecules (in herbicides, plasticizers, or components of personal care products), capable of activating PPAR, may disrupt normal PPAR functions in the ovary or the testis and have consequences on the quality of the gametes and the embryos. Despite the recent data obtained on the biological actions of PPARs in reproduction, relatively little is known about PPARs in gametes and embryos. This review summarizes the current knowledge on the expression and the function of PPARs as well as their partners, retinoid X receptors (RXRs), in germ cells and preimplantation embryos. The effects of natural and synthetic PPAR ligands will also be discussed from the perspectives of reproductive toxicology and assisted reproductive technology.
1. Introduction
Peroxisomes are organelles in
eukaryotes that remove toxic substances and break down fatty acid. Peroxisome
proliferator-activated receptor (PPAR) was discovered during the search for a
compound that increases the proliferation of peroxisomes in mouse liver cells [1].
Subsequently, two additional isotypes, PPAR (also known as PPAR) and PPAR,
were discovered. The three PPARs are encoded by different genes. Variants arising
from alternative splicing and usage of different promoters have been reported
in all three PPARs [2]. Together they form a subfamily within
the steroid receptor superfamily. To date, PPARs have been identified in many
species, including Xenopus, sea
squirt, zebrafish, Aedes aegypti (yellow fever mosquito), Anopheles
gambiae (a species complex which contains six vectors of malaria), mouse, rat,
hamster, and human (http://www.ensembl.org/index.html).
Since their discovery, a great deal
has been learned about PPAR, PPAR, and, to a less extent, PPAR. The knowledge has been applied to clinical practice: synthetic PPAR
ligands (fibrates) and PPAR ligands (thiazolidinediones TZD), respectively, are widely used to treat lipid
and glucose disorders. In contrast, the use of PPARs to enhance fertility is
constrained by our relative meager knowledge regarding PPARs and reproduction.
PPAR activators have recently been used to induce ovulation in women with polycystic
ovary disease, a condition of ovulation dysfunction associated with insulin
resistance. This review will focus on the roles of PPARs in the development and
physiology of gametes and preimplantation embryos. Also included in the
discussion are potential impacts of natural or synthetic PPAR ligand on
reproduction and the promising benefits of synthetic PPAR ligands in enhancing the
success of assisted reproductive technology.
2. PPARs and RXRs
PPARs, similar to steroid and thyroid
hormone receptors, are ligand-activated nuclear transcription factors. Unlike
steroid and thyroid hormone receptors, PPARs were discovered before their
functions were fully understood. Over the years, tissue distribution and
synthetic ligands, which bind to specific PPAR, helped to elucidate the biological
functions of PPARs.
PPARs
form heterodimers with another nuclear receptor, retinoid X receptor (RXR).
This interaction occurs in the presence and absence of PPAR ligand. The PPAR-RXR
complex recruits other cofactors before binding to PPAR responsive element
(PPRE) at the promoter regions of PPAR-responsive genes. Besides PPARs, RXR
also forms heterodimers with other nuclear receptors. RXR has three isotypes:
RXR, RXR, and RXR, all of which are activated by 9-cis-retinoic acid (but not by all-trans retinoic acid) [3]. The 9-cis-retinoic acid was originally considered as the endogenous
ligand for RXRs in vivo; but recent reports [4, 5] cast considerable doubt that it is
the case. Although RXRs exist as three isotypes, they do not confer different
functions to PPAR-RXR complexes. The PPAR-RXR complexes are activated by either
PPAR or RXR ligand, but simultaneous binding by both ligands elicits more
potent activities [6]. A unique feature of PPAR, not
seen in PPAR or PPAR, is its ability to repress the transcriptional
activities of PPAR and PPAR. This activity is mediated by corepressors
recruited by PPAR [7].
The DNA sequence of PPRE is typically
of a direct repeat 1 (DR1) nuclear receptor in that the PPRE DNA sequence consists of two repeats
of AGGTCA separated by one nucleotide (AGGTCA N AGGTCA). Detailed analyses of
native PPREs show that the consensus PPRE sequence is -AACTAGGNCA A AGGTCA-
[6]. The extended half site, the one
imperfect DR1 core, and the adenine as the spacing nucleotide may confer
additional selectivity to the binding of PPAR-RXR complex.
3. Distribution and Biological Functions of PPAR
The functions of PPARs can be extrapolated
from tissue(s) expressing the specific PPAR isotype or from the functions of genes
regulated by specific PPAR. PPAR is expressed most abundantly in brown adipose
tissue and liver, followed by the kidney, heart, and skeletal muscle. PPAR is
mainly expressed in adipose tissue and, to a less extent, in the colon, the
immune system, and the retina. Both PPAR and PPAR responsive genes are
involved in lipid homeostasis. Therefore, it is not surprising that the main
functions of PPAR and PPAR are in glucose and lipid homeostasis [6, 8].
On the other hand, the ubiquitous
distribution of PPAR (although gut, kidney, and heart express higher levels than
other tissues) makes it difficult to associate PPAR with specific biological
function [8]. The multiple functions of PPAR
are revealed by the diverse genes regulated by PPAR, such as ILK [9], 11 ß hydroxysteroid dehydrogenase II
[10], PTEN [9], and 14-3-3 [11]. It is worth noting that 14-3-3 functions
as a protein chaperone. Therefore, PPAR is indirectly associated with even
more diverse range of functions. Indeed, PPAR has been implicated in embryo
implantation [12], intestinal adenoma [13], colon cancer [14], skin wound healing [15], hair follicle development [16], and cytoprotection [11].
4. PPAR Ligands
Natural and synthetic PPAR ligands
relevant to this review are listed below. More extensive lists are available in
the literature [6, 17].
Unsaturated fatty acids are ligands to
all PPARs, with PPAR exhibiting the highest affinity; saturated fatty acids,
on the other hand, are not effective PPAR ligands. Eicosanoids derived from
arachidonic acid form a unique group of fatty acids that bind to PPARs. They
include leukotrienes, hydroxyeicosatetraenoic acids (HETEs) (both are formed via
the lipoxygenase pathway), and prostaglandins (PGs) (formed via the
cyclooxygenase pathway). Leukotriene B4 and 8(S)-HETE are PPAR ligand; and 15-deoxy-12, 14-PGJ2 (15d-PGJ2, a PGD2 derivative) is a PPAR ligand. Synthetic
PPAR (fibrates) and PPAR (TZD) ligands are used to lower blood lipid and
glucose, respectively. Prostacyclin (PGI2) is a natural PPAR
ligand, indeed the uterine PGI2 generated by cyclooxygenase-2 (COX-2)
mediates the implantation of embryos via PPAR [12]. Synthetic PGI2 analogs,
such as iloprost and carbaprostacyclin, may function as PGI2 receptor agonists or PPAR ligands. Although iloprost is used as a PGI2 receptor agonist to treat pulmonary hypertension and peripheral vascular
diseases, no PGI2 analog has been used as a PPAR ligand
clinically. A recent report indicates that retinoic acid, in cells with high
fatty acid binding protein 5 to retinoic acid binding protein-II ratio, may
function as a natural PPAR ligand [18]. This finding may have evolutional or
developmental significance in germ cell maturation, gamete function, or embryo
development. PGI2 and retinoic acid may provide functional redundancy
to ensure PPAR activation or they may compliment each other to activate PPAR
in a developmental stage-dependent manner based on the ratio of the two binding
proteins.
5. PPAR Ligands in The Reproductive Tract
Zygotes remain in the oviduct after fertilization
and develop to morula or early blastocyst stage embryos before entering into
the uterus. It is generally accepted that, compared with cultured embryos (derived
from fertilized eggs in vitro or
flushed from oviducts at earlier developmental stage), in vivo embryos develop better and have less cell death because
oviducts protect the embryos and promote their development [19]. The unique environment provided by
the oviduct includes oviduct-derived soluble factors and embryo-derived
autocrine factors. Both oviducts and embryos are sources of PPAR ligand(s).
Earlier studies show that the oviduct
produces abundant PGE2 and PGF2, which regulate its
motility. We serendipitously discovered that human [20] and mouse [21] oviducts produce other eicosanoids
that activate PPARs. PGI2 (a PPAR ligand) is the most abundant
product, PGD2 (whose derivative, 15d-PGJ2, is a PPAR
ligand), and other products derived from the lipoxygenase pathway are also produced
in substantial amounts. PGI2 synthesis by mouse oviducts is synchronized
with estrus cycles (and, thus, the development of preimplantation embryos). Peak
PGI2 synthetic capacity coincides with the window of receptivity, that
is, between the eight-cell and morula stages [21, 22].
Recent reports indicate that human [23] and mouse [24, 25] preimplantation embryos express COX isoenzymes and
synthesize eicosanoids. PGI2 is the most abundant metabolite when radio-labeled
arachidonic acid is incubated with blastocyst-stage mouse embryos. Other
eicosanoids, such as HETEs and PGD2 are also produced by mouse
blastocysts [24].
6. RXR in Gametes and Preimplantation Embryos
Gametes and preimplantation embryos
express RXRs. Whereas RXR-null mice are normal [26], RXR- [27] and RXR-null mice [28] have distinctive phenotypes. Gene knockout studies show that spermatogenesis
requires RXR. Similarly, oocyte development may be modulated by RXR, which is
expressed in both granulosa-cumulus cells and oocytes. Finally, the quality of embryo
development may be associated with RXR expression.
6.1. RXR in Gametes
RXR
and RXR are expressed in human cumulus granulosa cells [29] and bovine oocytes [30]. Although the initial reports on RXR
[27] and RXR [28] null mice did not include a
description of female reproduction (such as follicular development and
ovulation), the localization of RXR and in the ovary supports their roles in
follicular maturation and oocyte function. RXR may regulate oocyte development
directly (via modulating steroidogenesis in the granulosa cells) or indirectly
(by affecting oocyte gene transcription) [31]. It is likely that female mice with
targeted RXR deletion may suffer subfertility.
The male
sterility observed in RXR-null mice [28] underscores the essential role of RXR
(and its functional partner) in spermatogenesis. In mouse testes, retinoic acid
receptors (RARs) and RXR are expressed in well-defined cell populations: RAR
and RXR in Sertoli cells, RAR, RXR, and RXR in steps 7 and 8 spermatids,
and RAR in spermatogonia. Mouse spermatocytes, however, do not express RARs [32]. Although RAR, RXR, and RXR are coexpressed in step 7
and 8 spermatids, RAR may not functionally couple with either RXR or RXR,
because RAR-, RXR-, and RAR/RXR-null mice do not display reproductive defects
[32]. On the other hand, RXR and RAR may
form heterodimer and control spermiation in
vivo because both are coexpressed in Sertoli cells and invalidation of
either gene in mice leads to similar phenotype [32]. RXR-null males are
sterile due to oligoasthenoteratozoospermia caused by failed spermatid release (from
the germinal epithelium) and abnormal sperm acrosomes and tails [27]. In Sertoli cells, the function of
RXR (coupled with RAR) may involve lipid metabolism or transport, because they
progressively accumulate lipids (which are unsaturated triglycerides) in RXR-null
mice. In older RXR-null males, germ cells degenerate completely and seminiferous
tubules are filled with lipid vacuoles [27]. RAR homozygous mutant [33] and mice with targeted RAR ablation
in Sertoli cells [34] display similar phenotype. Both have testicular
degeneration, failed spermiation, epithelial vacuolation, germ cell
desquamation, and apoptosis [34]. Although there is no report
concerning RXR expression in spermatozoa, it can be inferred that human sperm
express RXR because human sperm express PPAR (which forms functional complex
with RXR) and PPAR ligand enhances their activities [35].
6.2. RXR in Preimplantation Embryos
The
development of preimplantation embryos was not described in the initial reports
describing RXR- [27] and RXR- [28] null mice. However, available information in the literature shows that preimplantation
embryos express RXRs. Transcripts of RXR, RXR, and RXR
are expressed in zebrafish embryos at 1.5 hour postfertilization [36]. RXR,
RXR, and RALDH2 (one of the two enzymes oxidizing retinol to
retinoic acid) are detected in all stages of preimplantation bovine embryos,
including blastocysts which express RXR protein in the inner cell mass and the
trophectoderm [30]. RXR, , and transcripts in preimplantation
bovine embryos are likely of maternal origin because eight-cell stage and
earlier embryos have significantly higher RXR levels than later stage embryos [37]. Furthermore, RXRs may be essential
for optimal embryo development because “good-quality” embryos express
significantly higher levels of RXR transcripts than “bad-quality” embryos [37]. It can be summarized that RXR
expression in preimplantation embryos described above is corroborated by the expression
of its partner, PPAR (discussed later). Furthermore, RXR (partners with PPAR or
RAR) is crucial to normal embryo development because (1) early stage embryos
contain high levels of maternal RXR mRNA, and (2) “good-quality” embryos
express higher RXR mRNA levels.
7. PPAR in Gametes and Preimplantation Embryos
Compared
with their role in postimplantation embryo development, the roles of PPARs in
fertilization, implantation, and embryo development are less well defined.
Available information does suggest that gametes and preimplantation embryos
express functional PPARs and that PPAR activation optimizes their functions.
7.1. PPAR
and Gametes
All three PPAR isotypes are expressed
in somatic and germ cells of the testis. In rat, PPAR and
are expressed in Leydig cells and Sertoli cells [38].
In human, PPAR1
message is detected in the testis [39].
In mouse, both PPAR
and are
expressed in Sertoli cells [40],
and PPAR
is expressed in spermatids and spermatocytes [41].
The expression of PPAR
in mouse spermatids and spermatocytes is further supported by the expression of Ssm,
a novel PPAR target gene, in mouse
testis [42]. The functionality
of PPAR in Sertoli cells is confirmed by its nuclear
translocation in response to a selective PPAR ligand, Wy-14,643 [40].
These findings suggest that PPARs (in Sertoli cells and Leydig cells) provide an
environment for spermatogenesis and may be directly involved in germ cell maturation.
PPAR may regulate germ cell maturation in a stage-dependent fashion. In
zebrafish, PPAR
is expressed in spermatogonia but not in spermatocytes [43].
PPAR ligand affects spermatogenesis and
sperm activities. Di(n-butyl) phthalate, a PPAR activator,
modulates the expression of genes related to spermatogenesis and steroidogenesis
and causes testicular atrophy in rats [44]. In contrast, the capacitation,
acrosome reaction, and motility of ejaculated human sperm are enhanced by a
treatment with rosiglitazone (a synthetic PPAR ligand) or 15d-PGJ2 (a natural
PPAR ligand) [35]. Since germ cells express
all three PPAR isotypes, the
expression and function of two other PPAR isotypes, PPAR and ,
in mature spermatozoa warrant further investigation.
In several species
including rat, all three PPAR isotypes are detected in the ovary [2]. PPAR, which has been studied
more extensively than the other two isotypes, is detected in the mouse, rat,
pig, sheep, cow, and human ovary. PPAR is expressed strongly in
the granulosa cells of rat [2], mouse [41], and sheep [45], as well as in oocytes from cattle [30], zebrafish [43], Xenopus [46], and human [47]. PPAR is detected in different
classes of follicles (primary/secondary to preovulatory follicles) and its
expression increases with the development of follicles. After the LH surge,
PPAR mRNA expression is downregulated
[2]. Activation of PPAR by
natural and synthetic ligands in the granulosa cells appears to regulate the
synthesis of steroid hormones. Thus, PPAR may be
indirectly involved in oocyte maturation via the granulosa cells. Indeed, disruption
of PPAR gene in the ovary using cre/loxP technology led to female subfertility
[48]. On the other hand, PPARs may be directly involved
in oocyte maturation. Indeed, it has been reported that rosiglitazone, a
synthetic PPAR ligand, at 100 µM stimulates AMP-activated protein kinase (AMPK)
and enhances the meiotic resumption of mouse oocytes [42].
7.2. PPAR
and Preimplantation Embryos
Preimplantation bovine and mouse embryos
express PPAR and PPAR, respectively. Beginning at two-cell stage and throughout
the preimplantation period, bovine embryos express PPAR. Blastocyst stage
bovine embryos express PPAR in the inner cell mass and the trophectoderm [30]. Mouse embryos express PPAR
detectable by immunohistochemistry at two-cell stage [25] or eight-cell stage [22] and throughout the preimplantation
period. Mouse blastocysts also express PPAR in the inner cell mass and the
trophectoderm [22].
Although preimplantation embryo development
and implantation were not specifically examined in the initial report regarding
PPAR-null mouse, the report provides a hint of the impacts of PPAR
deficiency [49]. The genotypic distribution of
embryos on gestation day 9.5 shows that PPAR embryos are underrepresented:
PPAR embryos represent 16% (3/19) and 38% (3/8) of embryos from PPAR x PPAR and PPAR x PPAR mating, respectively. This
represents a 36% (i.e., 25% versus 16%) and a 24% (i.e., 50% versus 38%) deviation
from the expected Mendelian frequency. Loss of PPAR embryos prior to
gestation day 9.5 may occur at any stage including ovulation, fertilization, preimplantation
period, implantation, and postimplantation period up to gestation day 9.5. The results
of our study show that PPAR ablation adversely affects preimplantation
embryo development and, consequently, implantation [22]. Compared with wild-type embryos, PPAR embryos show developmental delay as early as 48 hours after two-cell stage
embryos are harvested. The gap widens in the subsequent 48 hours. At 96 hours
after the harvest of two-cell embryos, 100% of wild-type embryos have reached or
passed the blastocyst stage (versus 65% PPAR embryos), and 85% of wild-type
embryos have undergone hatching or hatched completely (versus 28% PPAR
embryos). Consequently, PPAR embryos implant less effectively than wild-type
embryos (28% versus 44%). We also found that PPAR embryos have decreased
embryonic cell proliferation compared with that observed in wild-type embryos. These
results suggest that PPAR activation via endogenous PPAR ligand, such as
PGI2 [24] and/or retinoic acid [18], confers the “basal” momentum
(including cell proliferation and possibly other functions) to preimplantation
embryos and propels
them through various stages of development.
In addition to providing a “basal” momentum
of embryo development via endogenous PPAR ligand, PPAR activation by synthetic
ligand further enhances the development and the implantation of cultured embryos.
Both L-165041 (a synthetic PPAR ligand) and iloprost (a stable PGI2 analog) enhance complete embryo hatching in a concentration-dependent manner [22, 50, 51]. Embryos preconditioned with L-165041
or iloprost show higher implantation rates when transferred to gestational
carriers [22, 52]. These results suggest that cultured embryos do not
reach their full developmental potential due to insufficient endogenous PPAR
ligands or lack of exogenous PPAR ligands normally provided by the oviduct. Embryos
exposed to PPAR ligand have increased embryonic cell proliferation compared
with controlled embryos [22].
8. PPAR and Reproductive Toxicology
PPAR activators are found in
herbicides, industrial plasticizers (for a brief review see [53]), and personal care products such as
hair spray and solvent for perfumes [54]. Di(n-butyl) phthalate, a PPAR activator found in plasticizers and
personal care products, may cause male infertility by altering hormones
involved in steroidogenesis and spermatogenesis [44]. Other potential PPAR activators posing
reproductive toxicology concerns are pharmaceutical agents used to lower lipids
and blood glucose. Rosiglitazone (a TZD for diabetes) may activate PPAR ligand
and enhance sperm activities in men [35] or, depending on its concentration,
may enhance meiosis resumption of oocytes or induce oocyte degeneration in
women [55].
Nonsteroidal anti-inflammatory drugs, such as Motrin, which blocks PG synthesis,
pose reproductive hazards through a different mechanism. Decreased PG (such as PGI2)
production may adversely affect embryo development and implantation.
On the other hand, PPARs may be exploited
to enhance the success of assisted reproductive technology. The fertilization potentials
of human sperm in in vitro fertilization (IVF) or other assisted reproductive
technologies, such as artificial insemination, may be enhanced by incubating
sperm with synthetic PPAR ligands. The development and implantation of IVF
embryos may be augmented by supplementing culture media with PGI2 analogs, synthetic PPAR ligand, or retinoic acid. However, potential long-term
adverse effects are unknown. Large-scale clinical trials of sufficient power
are needed to validate the benefits and to assess the harms.
9. Conclusion
The literature on PPARs in gametes and
preimplantation embryos is relatively limited. Nonetheless, the consensus is that
PPAR serves to optimize gamete function and embryo development. Further studies
are needed to shed more light on the physiological roles of PPARs in reproduction.
The knowledge gained will help us avoid potential reproductive hazards and
augment the success of assisted reproductive technologies.