The collection of peripheral blood of POI patients and ovary granulosa cells of rats
The peripheral blood samples were collected from 20 pairs of POI patients and health people from The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), respectively. Serum was isolated from the peripheral blood to detect the concentration of miR-144. For the cell experiments, 8 female SD rats at the age of 23–25 days were purchased from Beijing Vital River Laboratory Animal Technology Co., Ltd (Certificate No. SCXK(Jing)2016-0006). The rats were kept in cages under the conditions with 12 h light and 12 h dark regime, temperature (22°C), humidity (65%), and fed ad libitum on rat cubes and tap water. The rats were injected subcutaneously with 40 U pregnant mare serum gonadotropins (PMSG). After 48 hours, the animals were anesthetized with 10% chloral hydrate, followed by striping the ovarian tissue and puncturing the follicle to isolate the granulosa cells. The cells were cultured with conditional DMEM medium containing 10% FBS. Approximately 5×105 cells/mL were seeded into the 96-well plates, which were identified utilizing the immunofluorescence assay with the antibody against follicle-stimulating hormone receptor (FSH-R) at the logarithmic phase.
Animals model: After adapting for a week, another 48 female SD rats at the age of 21 days were divided into 4 groups randomly: control, VCD, VCD + SC79, and VCD + miR-144 groups (n = 12 for each group). In the control group, the animals were administered intraperitoneally with 2.5 mL/kg/day sesame oil for consecutive 15 days. In the VCD group, the rats were administered intraperitoneally with 80 mg/kg VCD solution dissolved in 2.5 mL/kg/day sesame oil for consecutive 15 days. For the animals in the VCD + SC79 group, the schedule for the dosing of VCD is consistent with the rats in the VCD group, which was accompanied by subcutaneous injection of 10 mg/day SC79 (activator of AKT signal pathway) for consecutive 15 days. In the VCD + miR-144 groups, the rats were firstly transfected with lentivirus particles containing the miR-144 agomir (Genscript, Nanjing, China) to up-regulate the expression level of miR-144 in the rat, followed by administered intraperitoneally with 80 mg/kg VCD solution dissolved in 2.5 mL/kg/day sesame oil for consecutive 15 days. Part of the animals was anesthetized to collect the experimental tissues approximately 85 days post the treatment of VCD. The blood samples from orbital venous plexus of eight rats in each group were collected on non-estrus period under anesthesia, by intraperitoneally administering 10% chloralihydras (3 ml/kg), as well as oophorectomy. Then, the serum was obtained by centrifugation at 3000 rpm/ min for 15 min and stored at − 80°C for future use. Several ovarian tissues were immersed in 10% formaldehyde for histopathology, and the rest were frozen and preserved at-80°C for genes and proteins tests. In addition, the other four rats in each group were raised with the male rats at a ratio of 1:2 for 12h. The mixture of sperm and vaginal smears seen on the next morning indicated the success of pregnancy, and this morning was considered as the 0.5th day of the gestation. The pregnant rats were euthanized on the 15 th day of the gestation, and the embryos were isolated. The embryo resorption was defined as no embryo, residual placental tissue or observed clots. Then, the embryo resorption rate was calculated as dividing the total number of embryos with the number of absorbed embryos. Animal experiments were approved by the ethics committee of Zhejiang Chinese Medical University.
MTT assay
To select the optimized concentration of VCD in the medium of granulosa cells, the cells were incubated with 0, 0.5, 1, 1.5, 2, and 3 mM, respectively, and the cell viability of each group was determined by the MTT assay. The granulosa cells were seeded on the 96-well plates (3 × 103 cells per well) and incubated for 24 hours, followed by replacing the medium with new fresh medium containing MTT solution. After being incubated for additional 2 h at 37°C, the medium was replaced with DMSO to dissolve the MTT solution for 15 min, followed by observing the absorbance of 490 nm described previously [23].
ELISA assay
ELISA commercial kits (Nanjing Jin Yibai Biological Technology Co. Ltd., Nanjing, China) were used to detect the concentration of estradiol (E2), Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), and anti-Mullerian hormone (AMH) in the treated granulosa cells or the serum of each animal, the lysis sample of which was incubated with 5% BSA to remove the non-specific binding proteins for 1 hour at room temperature, followed by being incubated with the primary antibodies for 1 h. Subsequently, the samples were incubated with streptavidin-horseradish peroxidase (HRP) conjugated secondary antibodies for 20 min at room temperature, followed by being read at 450 nm with a microplate spectrophotometer (Thermo Fisher, Massachusetts, USA).
QRT-PCR
The total RNA in the treated granulosa cells were extracted using the RNA simple Total RNA kit (Beyotime, Shanghai, China), followed by transforming the RNA into cDNA with the Prime Script RT reagent Kit (Takara, Tokyo, Japan). In the present study, PCR procedure was performed using a SYBR Green PCR Kit (Takara, Tokyo, Japan). The relative expression of related genes was determined using a 2−△△Ct methods and GADPH was taken as a negative control. The forward sequence of miR-144 was 5′-GGGAGATCAGAAGGTGATT-3′ and the reverse sequence of miR-144 was 5′-GTGCAGGGTCCGAGGT-3′.
Western blot assay: The granulosa cells were lysed using a RIPA lysis buffer (Thermo, Mississippi, USA) to obtain the total proteins, the concentration of which was quantified with a BCA protein assay kit (Beyotime, Shanghai, China). Approximately 50 µg proteins for each sample was added and separated by the 12% SDS-PAGE, which were further transferred to the PVDF membrane (Thermo, Mississippi, USA). Subsequently, the membrane was incubated with primary antibodies against AKT (1:1000, Cell Signaling Technology, Boston, USA), p-AKT (1:1000, Cell Signaling Technology, Boston, USA), p-mTOR (1:1000, Cell Signaling Technology, Boston, USA), mTOR (1:1000, Cell Signaling Technology, Boston, USA), PTEN (1:1000, Cell Signaling Technology, Boston, USA), S6K (1:1000, Cell Signaling Technology, Boston, USA), p-S6K (1:1000, Cell Signaling Technology, Boston, USA), ULK1 (1:1000, Cell Signaling Technology, Boston, USA), p-ULK1 (1:1000, Cell Signaling Technology, Boston, USA), Beclin-1 (1:1000, Cell Signaling Technology, Boston, USA), Bcl-2 (1:1000, Cell Signaling Technology, Boston, USA), LC3-II (1:1000, Cell Signaling Technology, Boston, USA), LC3-I (1:1000, Cell Signaling Technology, Boston, USA), P62 (1:1000, Cell Signaling Technology, Boston, USA), Caspase3 (1:1000, Cell Signaling Technology, Boston, USA) or GAPDH (1:1000, Cell Signaling Technology, Boston, USA), followed by incubated with the secondary antibodies for 60 minutes. Afterwards, the membranes were washed and the blots were visualized with an infrared imaging system (Tanon, Shanghai, China), which was quantified using the ImageJ software (Tanon, Shanghai, China).
Transmission electron microscope
The granulosa cells in logarithmic growth phase were seeded in 24-well plates at a density of 1×105 cells/well to be incubated for 48 hours. Cells or tissues were digested with trypsin, followed by being collected by centrifugation to remove the supernatant. Subsequently, 3% glutaraldehyde and 1% citric acid were used to fix the samples, which were gradually dehydrated by acetone and embedded with dipropylene dicarboxylate. The samples were cut into ultrathin sections. A transmission electron microscopy (Olympus, Tokyo, Japan) was used to observe and image the autophagosomes within the cells or the tissues.
Analysis of autophagic flux
LC3 was marked and tracked by transfecting the mRFP-GFP-LC3 lentivirus (Hanbio, Shanghai, China) into the granulosa cells. Briefly, tandem fluorescent mRFP-GFP-tagged adenovirus was transfected into the cells for 48 hours according to the instruction of the manufacturer, followed by taking images with the confocal fluorescence microscopy (Olympus, Tokyo, Japan). The early autophagosomes were represented by the yellow puncta (merge of GFP and RFP signal) and the late autophagosomes were represented by the red puncta.
Hematoxylin and eosin (HE) staining
The ovarian tissue of each rat was collected and washed over by sterile water for a couple of hours, followed by being dehydrated with 70%, 80% and 90% ethanol solution successively. Subsequently, the samples were incubated with equal quality of ethanol and xylene for 15 min, which were then incubated with equal quality of xylene for another 15 min. The incubation procedure was repeated until the samples looked transparent. Finally, the tissues were embedded in paraffin, followed by being sectioned and stained with hematoxylin and eosin (H&E) staining. Finally, the images selected randomly from 5 fields at 40× and 100× magnification were captured and all phases of follicles and corpora lutea were count by using an inverted microscope (Olympus, Tokyo, Japan).
Immunohistochemistry: The ovarian tissues were separated and incubated with pre-dolled saline, which was subsequently embedded in paraffin. After being sectioned, the tissues were incubated with p-AKT, P62, or caspase-3 antibody (1:1000, CST, Cell Signaling Technology, Boston, USA) at 4℃ overnight, followed by being washed and incubated with goat anti-rabbit antibody at 37℃ for 30 min. DAB agent was used to dye the slides for 5–10 min, which was re-dyed with hematoxylin for 30 min. The images were taken using an inverted microscope (Olympus, Tokyo, Japan).
The calculation of pregnancy rate and embryo resorption rate
The pregnancy rate was calculated dividing the total number of rats with the number of pregnant rats. On day 15 of the gestation period, the animals were anesthetized and the embryos were isolated. The surrounding tissues were separated, the embryo resorption was defined as no embryo, residual placental tissue or observed clots. The embryo resorption rate was calculated as dividing the total number of embryos with the number of absorbed embryos.
Statistical Analysis
All results are presented as the mean ± SEM and analyzed using Graphpad prism software. Comparisons between two groups were performed using an unpaired Student's t-test. One-way ANOVA was used for comparisons among three or more groups. A value of P < 0.05 was regarded as statistically significant.