Molecular effects of chemotherapeutic drugs and their modulation by antioxidants in the testis

Cisplatin-based chemotherapy regimens are preferred in the treatment of a variety of cancers. The present study investigated early cumulative molecular effects of therapeutic dose-levels of bleomycin, etoposide and cisplatin (BEP) in the testis and their modulation by an antioxidant cocktail (AO). Adult male Sprague-Dawley rats (N = 7/group [G]) were treated with BEP as follows: G1 - control; G2 - AO (α-tocopherol [100 mg/kg], l-ascorbic acid [50 mg/kg], Zn [40 mg/l] and Se [100 μg/l]); G3 - B, 1.5 mg/kg on day 2; E, 15 mg/kg and P, 3 mg/kg for 4 days, and G4 - similar to G3 but also treated with AO for 4 days. In G3, the testis weight, sperm count and motility, and activities of enzymatic antioxidants decreased and lipid peroxidation increased compared to that in G1 (P < 0.05). Seminiferous epithelial sloughing and degeneration were observed. In G3, mRNA levels of p53, Bcl-2 and Bax were unaltered but protein expression of p53 and Bax was up-regulated and that of Bcl-2 was down-regulated (P < 0.05). These changes led to an increase in terminal deoxynucleotidyl transferase-mediated nick-end labeling (TUNEL) positive germ cells indicating cell death (P < 0.05). The AO recovered the BEP-induced molecular alterations to control levels. The mechanism of BEP-induced early testicular damage involves the initiation of oxidative stress, up-regulation of pro-apoptotic proteins and induction of cell death. Further, the induced testicular structural changes are negligible and less than those observed in single drug exposure studies reported in literature. The AO significantly ameliorates the BEP-induced pathogenesis of testicular damage suggesting its potential therapeutic uses.