The Leucine-mTOR-Autophagy Axis in Granulosa Cells Mediates Circadian Disruption-Induced Anovulation.

Background: Ovulation disorders represent the most common cause of infertility in women. Previous studies have reported that continuous light exposure can induce anovulation. However, the underlying mechanisms remain unclear. Methods: We assessed the phenotypes of ovulation disorders by using vaginal smears, hormone levels, and ovarian morphology. Metabolomics and RNA sequencing were employed to identify key metabolites and explore potential underlying mechanisms. Additionally, we investigated the effects of a leucine-rich diet on the phenotypes of ovulation disorders and autophagy. Serum levels of branched-chain amino acids (BCAAs) in patients with polycystic ovary syndrome (PCOS) were also measured. Causality was explored by using Mendelian randomization (MR) methods based on GWAS summary data. Results: Female SD rats subjected to continuous light exhibited disrupted estrous cycles and polycystic ovaries, as well as increased anti-Müllerian hormone (AMH) levels. Metabolic profiling revealed that leucine was a pivotal metabolite. Specifically, a high-leucine diet induced anovulation and polycystic morphology, along with reducing autophagy, in rats under normal light conditions; additionally, leucine restriction alleviated these effects in recovered rats. Moreover, the mTOR-ULK1-LC3-II/I autophagy pathway was influenced both in vivo and in vitro by leucine. In patients with PCOS, elevated serum BCAA levels (especially leucine) were observed to be correlated with increased AMH levels, higher luteinizing hormone (LH)-to-follicle-stimulating hormone (FSH) ratios, and higher antral follicle counts. MR analysis indicated that night shift work may increase the risk of PCOS through elevated serum leucine levels. Conclusions: These results suggest that the disruption of the leucine-mTOR-autophagy axis in granulosa cells (GCs) mediates continuous light-induced ovulation disorders. The potential therapeutic targeting of leucine-mTOR pathways for managing PCOS should be investigated.