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Davezac M, Meneur C, Buscato M, Zahreddine R, Arnal JF, Dalenc F, Lenfant F, Fontaine C. The beneficial effects of tamoxifen on arteries: a key player for cardiovascular health of breast cancer patient. Biochem Pharmacol 2023:115677. [PMID: 37419371 DOI: 10.1016/j.bcp.2023.115677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/09/2023]
Abstract
Breast cancer is the most common cancer in women. Over the past few decades, advances in cancer detection and treatment have significantly improved survival rate of breast cancer patients. However, due to the cardiovascular toxicity of cancer treatments (chemotherapy, anti-HER2 antibodies and radiotherapy), cardiovascular diseases (CVD) have become an increasingly important cause of long-term morbidity and mortality in breast cancer survivors. Endocrine therapies are prescribed to reduce the risk of recurrence and specific death in estrogen receptor-positive (ER+) early breast cancer patients, but their impact on CVD is a matter of debate. Whereas aromatase inhibitors and luteinizing hormone-releasing hormone (LHRH) analogs inhibit estrogen synthesis, tamoxifen acts as a selective estrogen receptor modulator (SERM), opposing estrogen action in the breast but mimicking their actions in other tissues, including arteries. This review aims to summarize the main clinical and experimental studies reporting the effects of tamoxifen on CVD. In addition, we will discuss how recent findings on the mechanisms of action of these therapies may contribute to a better understanding and anticipation of CVD risk in breast cancer patients.
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Affiliation(s)
- Morgane Davezac
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) U1297, University of Toulouse 3, Toulouse, France
| | - Cecile Meneur
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) U1297, University of Toulouse 3, Toulouse, France; PhysioStim, 10 rue Henri Regnault, 81100, Castres, France
| | - Melissa Buscato
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) U1297, University of Toulouse 3, Toulouse, France
| | - Rana Zahreddine
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) U1297, University of Toulouse 3, Toulouse, France; CREFRE-Anexplo, Service de Microchirurgie Experimentale, UMS006, INSERM, Université de Toulouse, UT3, ENVT, 31062 Toulouse, France
| | - Jean-François Arnal
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) U1297, University of Toulouse 3, Toulouse, France
| | - Florence Dalenc
- Department of Medical Oncology, Claudius Regaud Institute, IUCT-Oncopole, Toulouse, France
| | - Françoise Lenfant
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) U1297, University of Toulouse 3, Toulouse, France
| | - Coralie Fontaine
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) U1297, University of Toulouse 3, Toulouse, France.
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Zahreddine R, Davezac M, Buscato M, Smirnova N, Laffargue M, Henrion D, Adlanmerini M, Lenfant F, Arnal JF, Fontaine C. A historical view of estrogen effect on arterial endothelial healing: From animal models to medical implication. Atherosclerosis 2021; 338:30-38. [PMID: 34785429 DOI: 10.1016/j.atherosclerosis.2021.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/18/2021] [Accepted: 10/29/2021] [Indexed: 12/11/2022]
Abstract
Endothelial barrier integrity is required for maintaining vascular homeostasis and fluid balance between the circulation and surrounding tissues. In contrast, abnormalities of endothelial cell function and loss of the integrity of the endothelial monolayer constitute a key step in the onset of atherosclerosis. Endothelial erosion is directly responsible for thrombus formation and cardiovascular events in about one-third of the cases of acute coronary syndromes. Thus, after endothelial injury, the vascular repair process is crucial to restore endothelial junctions and rehabilitate a semipermeable barrier, preventing the development of vascular diseases. Endothelial healing can be modulated by several factors. In particular, 17β-estradiol (E2), the main estrogen, improves endothelial healing, reduces neointimal accumulation of smooth muscle cells and atherosclerosis in several animal models. The aim of this review is to highlight how various experimental models enabled the progress in the cellular and molecular mechanisms underlying the accelerative E2 effect on arterial endothelial healing through the estrogen receptor (ER) α, the main receptor mediating the physiological effects of estrogens. We first summarize the different experimental procedures used to reproduce vascular injury. We then provide an overview of how the combination of transgenic mouse models impacting ERα signalling with pharmacological tools demonstrated the pivotal role of non-genomic actions of ERα in E2-induced endothelial repair. Finally, we describe recent advances in the action of selective estrogen receptor modulators (SERMs) on this beneficial vascular effect, which surprisingly involves different cell types and activates different ERα subfunctions compared to E2.
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Affiliation(s)
- Rana Zahreddine
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1297, University of Toulouse3, Toulouse, France
| | - Morgane Davezac
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1297, University of Toulouse3, Toulouse, France
| | - Melissa Buscato
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1297, University of Toulouse3, Toulouse, France
| | - Natalia Smirnova
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1297, University of Toulouse3, Toulouse, France
| | - Muriel Laffargue
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1297, University of Toulouse3, Toulouse, France
| | - Daniel Henrion
- MITOVASC Institute, CARFI Facility, INSERM U1083, UMR CNRS 6015, University of Angers, France
| | - Marine Adlanmerini
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1297, University of Toulouse3, Toulouse, France
| | - Françoise Lenfant
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1297, University of Toulouse3, Toulouse, France
| | - Jean-François Arnal
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1297, University of Toulouse3, Toulouse, France
| | - Coralie Fontaine
- I2MC, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR1297, University of Toulouse3, Toulouse, France.
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Hu JH, Wei H, Jaffe M, Airhart N, Du L, Angelov SN, Yan J, Allen JK, Kang I, Wight TN, Fox K, Smith A, Enstrom R, Dichek DA. Postnatal Deletion of the Type II Transforming Growth Factor-β Receptor in Smooth Muscle Cells Causes Severe Aortopathy in Mice. Arterioscler Thromb Vasc Biol 2015; 35:2647-56. [PMID: 26494233 DOI: 10.1161/atvbaha.115.306573] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 10/14/2015] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Prenatal deletion of the type II transforming growth factor-β (TGF-β) receptor (TBRII) prevents normal vascular morphogenesis and smooth muscle cell (SMC) differentiation, causing embryonic death. The role of TBRII in adult SMC is less well studied. Clarification of this role has important clinical implications because TBRII deletion should ablate TGF-β signaling, and blockade of TGF-β signaling is envisioned as a treatment for human aortopathies. We hypothesized that postnatal loss of SMC TBRII would cause aortopathy. APPROACH AND RESULTS We generated mice with either of 2 tamoxifen-inducible SMC-specific Cre (SMC-CreER(T2)) alleles and homozygous floxed Tgfbr2 alleles. Mice were injected with tamoxifen, and their aortas examined 4 and 14 weeks later. Both SMC-CreER(T2) alleles efficiently and specifically rearranged a floxed reporter gene and efficiently rearranged a floxed Tgfbr2 allele, resulting in loss of aortic medial TBRII protein. Loss of SMC TBRII caused severe aortopathy, including hemorrhage, ulceration, dissection, dilation, accumulation of macrophage markers, elastolysis, abnormal proteoglycan accumulation, and aberrant SMC gene expression. All areas of the aorta were affected, with the most severe pathology in the ascending aorta. Cre-mediated loss of SMC TBRII in vitro ablated both canonical and noncanonical TGF-β signaling and reproduced some of the gene expression abnormalities detected in vivo. CONCLUSIONS SMC TBRII plays a critical role in maintaining postnatal aortic homeostasis. Loss of SMC TBRII disrupts TGF-β signaling, acutely alters SMC gene expression, and rapidly results in severe and durable aortopathy. These results suggest that pharmacological blockade of TGF-β signaling in humans could cause aortic disease rather than prevent it.
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Affiliation(s)
- Jie Hong Hu
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.)
| | - Hao Wei
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.)
| | - Mia Jaffe
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.)
| | - Nathan Airhart
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.)
| | - Liang Du
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.)
| | - Stoyan N Angelov
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.)
| | - James Yan
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.)
| | - Julie K Allen
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.)
| | - Inkyung Kang
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.)
| | - Thomas N Wight
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.)
| | - Kate Fox
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.)
| | - Alexandra Smith
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.)
| | - Rachel Enstrom
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.)
| | - David A Dichek
- From the Department of Medicine, University of Washington School of Medicine, Seattle, WA (J.H.H., H.W., M.J., N.A., L.D., S.N.A., J.Y., J.K.A., K.F., A.S., R.E., D.A.D); and the Matrix Biology Program at the Benaroya Research Institute, Seattle, WA (I.K., T.N.W.).
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