title: Sertoli cell inactivation by cytotoxic damage to the human testis after cancer chemotherapy.
abstract: OBJECTIVE
  To assess Sertoli cell involvement in postchemotherapy azoospermia.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Teaching hospital.
  
  
  METHODS
  A 31-year-old azoospermic man who underwent cancer cytotoxic chemotherapy for non-Hodgkin's lymphoma at 13 years of age.
  
  
  METHODS
  Testicular biopsy specimens were obtained for sperm recovery in preparation for intracytoplasmic sperm injection. The biopsy specimens were evaluated by quantitative immunohistochemistry for the immature Sertoli cell markers cytokeratin 18 (CK-18) and D2-40.
  
  
  METHODS
  Extent of immature Sertoli cells.
  
  
  RESULTS
  A fraction of Sertoli cells (13%) in the atrophic tubules of this patient reexpressed the intermediate filament protein CK-18, which is normally absent after puberty, but not the D2-40 antigen, an Mr 40,000 a-linked membrane glycoprotein, whose loss of expression at puberty marks an irreversible step in Sertoli cell maturation. Tubules with normal spermatogenic progression lined by Sertoli cells negative for CK-18 were also observed.
  
  
  CONCLUSIONS
  A fraction of Sertoli cells of this patient initially progressed to full maturation at puberty and reverted to a dedifferentiated state marked by reexpression of CK-18 as a consequence of chemotherapy. This inactivation of Sertoli cells caused by the cytotoxicity of the chemotherapeutic drugs may have contributed to the spermatogenic impairment and resulting infertility.
authors.affiliation: Institute for the Study of Fertility, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Batia
authors.initials: B
authors.lastname: Bar-Shira Maymon
authors.forename: Leah
authors.initials: L
authors.lastname: Yogev
authors.forename: Alexander
authors.initials: A
authors.lastname: Marks
authors.forename: Ron
authors.initials: R
authors.lastname: Hauser
authors.forename: Amnon
authors.initials: A
authors.lastname: Botchan
authors.forename: Haim
authors.initials: H
authors.lastname: Yavetz
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002454:Cell Differentiation / Q000187:drug effects; D006801:Humans; D007150:Immunohistochemistry; D007248:Infertility, Male / Q000139:chemically induced*; D007633:Keratins / Q000032:analysis; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D012708:Sertoli Cells / Q000187:drug effects* / Q000473:pathology; D013737:Testis / Q000187:drug effects* / Q000473:pathology; D014746:Vimentin / Q000032:analysis
chemical_list: D000970:Antineoplastic Agents; D014746:Vimentin; D007633:Keratins