Regenerative gene therapy in the hypothalamus prolongs fertility in female rats

There is substantial evidence that age-related ovarian failure in rats is preceded by abnormal responsiveness of the neuroendocrine axis to estrogen positive feedback. In middle-aged (M-A) female rats, we have demonstrated that intrahypothalamic gene therapy for insulin-like growth factor-I (IGF-I) started at 6 months of age extends the regular cyclicity of the animals beyond 10 month (the age at which MA rats stop ovulating) and preserves the integrity of the ovarian structure. Here, we implemented long-term regenerative gene therapy in the hypothalamus of young females. The goal was to extend fertility in the treated animals. We constructed a helper-dependent adenovector that harbors the green fluorescent protein (GFP) reporter gene as well as a gene tandem, termed STEMCCA, which harbors the 4 Yamanaka genes (oct4, sox2, klf4, and c-myc, OSKM), both under the control of a Tet-Off bidirectional promoter. An adenovector that only carries the gene for GFP was used as control. At 4 months of age 12 female rats received an intrahypothalamic injection of our OSKM-GFP vector (treated rats); 12 control rats a vector expressing GFP only (control rats). At 9.3 months of age control and treated rats were mated with young males. A group of 12 young intact female rats was also mated. The rate of pregnancy recorded was 83%, 8.3% and 25% for young, M-A control and M-A treated animals, respectively. Average litter size was 9, 3 and 3 for the corresponding groups. Mean pup BW was slightly higher in the M-A rats. In a preliminary study we confirmed that ovulation in our M-A females ceases at 10 months of age. Our results are in line with the evidence that viral vector-mediated delivery of the Yamanaka genes in the brain has strong regenerative effects without adverse side effects. The particular significance of the present results is that, for the first time, they show that long-term OSKM gene therapy in the hypothalamus is able to extend the functionality of such a complex system as the hypothalamo-pituitary-ovarian axis. ### Competing Interest Statement The authors have declared no competing interest.