Abstract. The Leydig cell tumor, derived from interstitial cells, is a rare neoplasm. In most cases, Leydig cell tumors are benign, however, if the tumor is malignant, no effective treatments are currently available. In this study, we aimed to evaluate the effects of icariin on the growth of the mouse Leydig tumor cell line MLTC-1 and to examine its underlying mechanism. Icariin caused a dose-dependent decrease in the viability of MLTC-1 cells, which coincided with an increase in cell apoptosis through regulation of the expression of Bcl-2/Bax and cytochrome c, activation of caspase-9 and -3. Moreover, the pro-apoptotic effect of icariin on MLTC-1 cells is related to piwil4, since icariin induced a decrease in piwil4 protein expression and piwil4 silencing significantly enhanced the cytotoxic effects of icariin in MLTC-1 cells. These findings suggest a novel anticancer effect of icariin in Leydig cell tumor through activation of the mitochondrial pathway and down-regulation of the expression of piwil4.
IntroductionTesticular neoplasms include germ cell tumors and sex cord-stromal tumors. Germ cell tumors comprise 95% of all testicular neoplasms, while the remaining 5% of testicular tumors are sex cord-stromal tumors, which are derived from somatic cells, Sertoli and Leydig cells. The Leydig cell tumor is classified as an interstitial cell tumor, which are commonly benign; however, in adults, ~10% of cases are malignant (1-4). The etiology of Leydig cell tumor in humans remains unknown. Currently, in most cases, the standard therapy for benign Leydig cell tumors is considered to be orchiectomy. Recently, by retrospectively analyzing the long-term follow-up of a series of patients with Leydig cell tumors electively treated with testis sparing surgery, Glannarin et al (5) demonstrated that testis sparing surgery with frozen section examination has an excellent long-term oncological outcome. Therefore, testis-sparing surgery may be chosen for treating benign Leydig cell tumors to maintain fertility, especially in boys and young men (5-9). If the tumor is malignant, orchiectomy with retroperitoneal lymph node dissection is recommended, since chemotherapy and radiation therapy show limited efficacy in the treatment of malignant Leydig cell tumors. Survival time of patients with this malignancy range from 2 months to 17 years, and the mean survival time is 2 years (10,11). To improve the survival time of patients with malignant Leydig cell tumor, and to decrease the serious consequences, such as testicular dysfunction and infertility that is caused by the current treatment for benign Leydig cell tumors, alternative treatments need to be explored.Icariin (C 33 H 40 O 15 ; molecular weight, 676.67), a flavonoid isolated from Herba Epimedii, is considered to be the main active component responsible for the actions of Herba Epimedii. Many studies have shown that it has a wide range of pharmacological and biological activities on endocrine, cardiovascular, genital, bronchial, urinary and immune systems (12)(13)(14)(15). In ...