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Papadimitriou DT, Dermitzaki E, Christopoulos P, Livadas S, Grivea IN, Mastorakos G. Anastrozole monotherapy further improves near-adult height after the initial combined treatment with leuprorelin and anastrozole in early-maturing girls with compromised growth prediction: results from the second phase of the GAIL study. Front Endocrinol (Lausanne) 2024; 15:1366970. [PMID: 38628587 PMCID: PMC11019432 DOI: 10.3389/fendo.2024.1366970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/04/2024] [Indexed: 04/19/2024] Open
Abstract
Background The first phase of the GAIL study ("Girls treated with an Aromatase Inhibitor and Leuprorelin," ISRCTN11469487) has shown that the combination of anastrozole and leuprorelin for 24 months is safe and effective in improving the predicted adult height (PAH) in girls with early puberty and compromised growth prediction by +1.21 standard deviation score (SDS; +7.51 cm) compared to inhibition of puberty alone, +0.31 SDS (+1.92 cm). Objectives and hypotheses In the second phase of the GAIL study, we assessed the adult height (AH)/near-adult height (NAH) at the end of the first phase and, in addition, the efficacy of anastrozole monotherapy thereafter in further improving NAH. Methods We measured the AH (age 16.5 years)/NAH [bone age (BA), 15 years] of the 40 girls included, divided into two matched groups: group A (20 girls on anastrozole + leuprorelin) and group B (20 girls on leuprorelin alone). Group A was further randomized into two subgroups: A1 and A2. Group A1 (n = 10), after completion of the combined therapy, received anastrozole 1 mg/day as monotherapy until BA 14 years, with a 6-month follow-up. Group A2 (n = 10) and group B (n = 20), who received only the combined treatment and leuprorelin alone, respectively, were recalled for evaluation of AH/NAH. Results AH or NAH exceeded the PAH at the completion of the 2-year initial phase of the GAIL study in all groups, but the results were statistically significant only in group A1: NAH-PAH group A1, +3.85 cm (+0.62 SDS, p = 0.01); group A2, +1.6 cm (+0.26 SDS, p = 0.26); and group B, +1.7 cm (+0.3 SDS, p = 0.08). The gain in group A1 was significantly greater than that in group A2 (p = 0.04) and in group B (p = 0.03). Anastrozole was determined to be safe even as monotherapy in Group A1. Conclusions In early-maturing girls with compromised growth potential, the combined treatment with leuprorelin and anastrozole for 2 years or until the age of 11 years resulted in a total gain in height of +9.7 cm when continuing anastrozole monotherapy until the attainment of NAH, as opposed to +7.4 cm if they do not continue with the anastrozole monotherapy and +3.6 cm when treated with leuprorelin alone. Thus, the combined intervention ends at the shortest distance from the target height if continued with anastrozole monotherapy until BA 14 years.
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Affiliation(s)
- Dimitrios T. Papadimitriou
- Department of Pediatrics, Faculty of Medicine, University of Thessaly, Larisa, Greece
- Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Pediatric and Adolescent Endocrinology, Athens Medical Center, Marousi, Greece
- Hellenic Endocrine Network, Athens, Greece
| | - Eleni Dermitzaki
- Department of Pediatric and Adolescent Endocrinology, Athens Medical Center, Marousi, Greece
| | | | - Sarantis Livadas
- Department of Pediatric and Adolescent Endocrinology, Athens Medical Center, Marousi, Greece
- Hellenic Endocrine Network, Athens, Greece
| | - Ioanna N. Grivea
- Department of Pediatrics, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - George Mastorakos
- Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Tarçın G, Koç C, Turan H, Ercan O. The effect of anastrozole therapy on final height and sex hormone levels in pubertal boys receiving growth hormone therapy. Arch Endocrinol Metab 2023; 68:e220524. [PMID: 37988665 PMCID: PMC10916834 DOI: 10.20945/2359-4292-2022-0524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 06/19/2023] [Indexed: 11/23/2023]
Abstract
Objective This research aimed to evaluate retrospectively the effect of anastrozole on height gain and sex hormone levels in pubertal boys receiving growth hormone (GH). Materials and methods Pubertal boys who received both GH and anastrozole (GH+A) were one-to-one matched with boys who received only GH (GH-Only) for chronological and bone age, pubertal stage and height before the GH initiation, treatment duration and midparental height. Anthropometric measurements throughout treatment and adult heights were compared between the groups. Sex hormone levels were evaluated longitudinally in the GH+A group. Results Forty-eight cases (24 in each group) were included. There was no statistical difference in adult height between the GH+A and GH-Only (p = 0.071). However, when the analysis was limited to those receiving anastrozole for at least 2 years, mean adult height was higher in the GH+A than in the GH-Only group (173.1 ± 6.2/169.8 ± 5.6 cm, p = 0.044). Despite similar growth rates between the two groups, bone age advancement was slower in the GH+A than in the GH-Only in a mean anastrozole treatment period of 1.59 years (1.37 ± 0.80/1.81 ± 0.98 years, p = 0.001). The greatest increase for FSH, LH, total and free testosterone and decrease for estradiol levels were observed in the third month after anastrozole was started, albeit remaining within the normal ranges according to the actual pubertal stages. Conclusion Using anastrozole with GH for at least 2 years decelerates the bone age advancement resulting in adult height gain with no abnormality in sex hormone levels. These results suggest anastrozole can be used as an additional treatment to GH for further height gain in pubertal boys.
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Affiliation(s)
- Gürkan Tarçın
- Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Türkiye
| | - Cansu Koç
- Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Türkiye
| | - Hande Turan
- Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Türkiye
| | - Oya Ercan
- Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Türkiye,
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Tian X, Gao Z, Yin D, Hu Y, Fang B, Li C, Lou S, Rao Z, Shi R. 17beta-estradiol alleviates contusion-induced skeletal muscle injury by decreasing oxidative stress via SIRT1/PGC-1α/Nrf2 pathway. Steroids 2023; 191:109160. [PMID: 36574869 DOI: 10.1016/j.steroids.2022.109160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/28/2022] [Accepted: 12/18/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE This study aimed to investigate the role of 17β-estradiol (E2) in the repair of contusion-induced myoinjury in mice and to identify the underlying molecular mechanisms. METHODS In vivo, contusion protocol was performed for preparing mice myoinjury model, and Injection (i.p.) of 17β-estradiol (E2) or estrogen receptor antagonist ICI 182,780, or ovariectomy (OVX), was used to alter estrogen level of animal models. In vitro, C2C12 myoblasts were treated with H2O2 (oxidative stress inducer), SIRT1 inhibitor EX527, or aromatase inhibitor anastrozole. Serum E2 level was assessed by enzyme-linked immunosorbent assay (ELISA). Muscle damage repair was evaluated by H&E staining and the activities of serum creatine kinase (CK) and lactate dehydrogenase (LDH). The oxidative stress was estimated by the levels of catalase (CAT), superoxide dismutase (SOD), and malondialdehyde (MDA). Western blot was performed to measure the protein expressions of SIRT1, PGC-1α, Nrf2, and HO-1. RESULTS We observed the elevated serum E2 levels and the upregulated oxidative stress in damaged muscle in female mice after contusion-induction. The E2 administration in vivo alleviated contusion-induced myoinjury in OVX mice by reducing CK and LDH activities, suppressing oxidative stress, and enhancing the expression levels of SIRT1, PGC-1α, Nrf2, and HO-1. These effects were inhibited by treatment with an ERα/β antagonist. Moreover, EX527 or anastrozole treatment exacerbated H2O2-induced growth inhibition and oxidative stress, and expression downregulation of SIRT1, PGC-1α, Nrf2, and HO-1 in C2C12 cells in vitro. CONCLUSION Our results suggest that E2 is a positive intervention factor for muscle repair followed contusion-induced myoinjury, through its effects on suppressing oxidative stress via activating the SIRT1/PGC-1α/Nrf2 pathway.
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Affiliation(s)
- Xu Tian
- School of Kinesiology, Shanghai University of Sport, 188 Hengren Road, Yangpu District, Shanghai, China
| | - Zelin Gao
- School of Kinesiology, Shanghai University of Sport, 188 Hengren Road, Yangpu District, Shanghai, China
| | - Danyang Yin
- School of Kinesiology, Shanghai University of Sport, 188 Hengren Road, Yangpu District, Shanghai, China
| | - Yi Hu
- School of Kinesiology, Shanghai University of Sport, 188 Hengren Road, Yangpu District, Shanghai, China
| | - Biqing Fang
- School of Kinesiology, Shanghai University of Sport, 188 Hengren Road, Yangpu District, Shanghai, China
| | - Cong Li
- School of Kinesiology, Shanghai University of Sport, 188 Hengren Road, Yangpu District, Shanghai, China
| | - Shujie Lou
- School of Kinesiology, Shanghai University of Sport, 188 Hengren Road, Yangpu District, Shanghai, China
| | - Zhijian Rao
- College of Physical Education, Shanghai Normal University, Shanghai, China
| | - Rengfei Shi
- School of Kinesiology, Shanghai University of Sport, 188 Hengren Road, Yangpu District, Shanghai, China.
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Kumar S, Choudhary N, Faruq M, Kumar A, Saran RK, Indercanti PK, Singh V, Sait H, Jaitley S, Valis M, Kuca K, Polipalli SK, Kumar M, Singh T, Suravajhala P, Sharma R, Kapoor S. Anastrozole-mediated modulation of mitochondrial activity by inhibition of mitochondrial permeability transition pore opening: an initial perspective. J Biomol Struct Dyn 2023; 41:14063-14079. [PMID: 36815262 DOI: 10.1080/07391102.2023.2176927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/31/2023] [Indexed: 02/24/2023]
Abstract
The mitochondrial permeability transition pore (mtPTP) plays a vital role in altering the structure and function of mitochondria. Cyclophilin D (CypD) is a mitochondrial protein that regulates mtPTP function and a known drug target for therapeutic studies involving mitochondria. While the effect of aromatase inhibition on the mtPTP has been studied previously, the effect of anastrozole on the mtPTP has not been completely elucidated. The role of anastrozole in modulating the mtPTP was evaluated by docking, molecular dynamics and network-guided studies using human CypD data. The peripheral blood mononuclear cells (PBMCs) of patients with mitochondrial disorders and healthy controls were treated with anastrozole and evaluated for mitochondrial permeability transition pore (mtPTP) function and apoptosis using a flow cytometer. Spectrophotometry was employed for estimating total ATP levels. The anastrozole-CypD complex is more stable than cyclosporin A (CsA)-CypD. Anastrozole performed better than cyclosporine in inhibiting mtPTP. Additional effects included inducing mitochondrial membrane depolarization and a reduction in mitochondrial swelling and superoxide generation, intrinsic caspase-3 activity and cellular apoptosis, along with an increase in ATP levels. Anastrozole may serve as a potential therapeutic agent for mitochondrial disorders and ameliorate the clinical phenotype by regulating the activity of mtPTP. However, further studies are required to substantiate our preliminary findings.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Somesh Kumar
- Pediatrics Genetics & Research Laboratory, Department of Pediatrics, Maulana Azad Medical College & Associated LN Hospital, Delhi, India
| | - Neha Choudhary
- Centre for Computational Biology and Bioinformatics, Central University of Himachal Pradesh, Dharamsala, India
| | - Mohammed Faruq
- Institute of Genomics and Integrative Biology, Council of Scientific and Industrial Research (CSIR), Delhi, India
| | - Arun Kumar
- Department of Emergency Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
- Department of Zoology, Kirori Mal College, University of Delhi, Delhi, India
| | - Ravindra K Saran
- Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Delhi, India
| | | | - Vikram Singh
- Centre for Computational Biology and Bioinformatics, Central University of Himachal Pradesh, Dharamsala, India
| | - Haseena Sait
- Pediatrics Genetics & Research Laboratory, Department of Pediatrics, Maulana Azad Medical College & Associated LN Hospital, Delhi, India
| | - Sunita Jaitley
- Department of Biomedical Sciences, Acharya Narendra Dev College, University of Delhi, Delhi, India
| | - Martin Valis
- Department of Neurology of the Medical Faculty of Charles University and University Hospital in Hradec Králové, Hradec Králové, Czech Republic
| | - Kamil Kuca
- Department of Chemistry, Faculty of Science, University of Hradec Králové, Hradec Králové, Czech Republic
| | - Sunil K Polipalli
- Pediatrics Genetics & Research Laboratory, Department of Pediatrics, Maulana Azad Medical College & Associated LN Hospital, Delhi, India
| | - Manoj Kumar
- Department of Emergency Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
- Department of Microbiology, World College of Medical Science and Research, Jhajjar, Haryana, India
| | - Tejveer Singh
- Molecular Oncology Laboratory, Department of Zoology, University of Delhi, Delhi, India
| | | | - Rohit Sharma
- Department of Rasa Shastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Seema Kapoor
- Pediatrics Genetics & Research Laboratory, Department of Pediatrics, Maulana Azad Medical College & Associated LN Hospital, Delhi, India
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Augusto TV, Amaral C, Almeida CF, Teixeira N, Correia-da-Silva G. Differential biological effects of aromatase inhibitors: Apoptosis, autophagy, senescence and modulation of the hormonal status in breast cancer cells. Mol Cell Endocrinol 2021; 537:111426. [PMID: 34391846 DOI: 10.1016/j.mce.2021.111426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 08/09/2021] [Accepted: 08/12/2021] [Indexed: 01/10/2023]
Abstract
Estrogen receptor-positive (ER+) breast carcinomas are the most common subtype, corresponding to 60% of the cases in premenopausal and 75% in postmenopausal women. The third-generation of aromatase inhibitors (AIs), the non-steroidal Anastrozole (Ana) and Letrozole (Let) and the steroidal Exemestane (Exe), are considered a first-line endocrine therapy for postmenopausal women. Despite their clinical success, the development of resistance is the major setback in clinical practice. Nevertheless, the lack of cross-resistance between AIs hints that these drugs may act through distinct mechanisms. Therefore, this work studied the different effects induced by AIs on biological processes, such as cell proliferation, death, autophagy and senescence. Moreover, their effects on the regulation of the hormonal environment were also explored. The non-steroidal AIs induce senescence, through increased YPEL3 expression, on aromatase-overexpressing breast cancer cells (MCF-7aro), whereas Exe promotes a cytoprotective autophagy, thus blocking senescence induction. In addition, in a hormone-enriched environment, the non-steroidal AIs prevent estrogen signaling, despite up-regulating the estrogen receptor alpha (ERα), while Exe down-regulates ERα and maintains its activation. In these conditions, all AIs up-regulate the androgen receptor (AR) which blocks EGR3 transcription in Exe-treated cells. On the other hand, in hormone-depleted conditions, a crosstalk between AR and ERα occurs, enhancing the estrogenic effects of Exe. This indicates that Exe modulates both ERα and AR, while Ana and Let act as pure AIs. Thus, this study highlights the potential clinical benefit of combining AR antagonists with Exe and discourages the sequential use of Exe as second-line therapy in postmenopausal breast cancer.
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Affiliation(s)
- Tiago V Augusto
- UCIBIO.REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo Ferreira N° 228, 4050-313, Porto, Portugal
| | - Cristina Amaral
- UCIBIO.REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo Ferreira N° 228, 4050-313, Porto, Portugal
| | - Cristina F Almeida
- UCIBIO.REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo Ferreira N° 228, 4050-313, Porto, Portugal
| | - Natércia Teixeira
- UCIBIO.REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo Ferreira N° 228, 4050-313, Porto, Portugal.
| | - Georgina Correia-da-Silva
- UCIBIO.REQUIMTE, Laboratory of Biochemistry, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Rua Jorge Viterbo Ferreira N° 228, 4050-313, Porto, Portugal.
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Binder G, Nakamura A, Schweizer R, Ogata T, Fukami M, Nagasaki K. Long-term Effect of Aromatase Inhibition in Aromatase Excess Syndrome. J Clin Endocrinol Metab 2021; 106:1491-1500. [PMID: 33513243 DOI: 10.1210/clinem/dgab054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Aromatase excess syndrome (AEXS) is a very rare disorder characterized by prepubertal gynecomastia, bone age acceleration, and early growth arrest. Heterozygote submicroscopic rearrangements within the promotor of CYP19A1 result in overexpression of aromatase and enhanced aromatization of androgens. OBJECTIVE The objective was to study long-term treatment effects of an aromatase inhibitor. METHODS Data from 7 boys with AEXS were retrospectively collected. Genetic analysis revealed upstream of CYP19A1 a 165 901 bp deletion in 4 German cousins, a 198 662 bp deletion in 2 Japanese brothers, and a 387 622 bp tandem duplication in a Japanese boy. RESULTS All boys developed prepubertal gynecomastia, at median 9.0 years of age (range: 7.0-11.0). Height was +1.20 standard deviation score (SDS) (-0.24 to +1.98); predicted adult height was -1.29 SDS (-3.29 to +1.09). Four boys were treated with 1.0 mg of anastrozole daily, while 3 reached adult height untreated. Treatment with anastrozole was stopped after 5.6 years (4.0-6.8). Three treated boys exceeded their prognosis by 2.4, 6.9, and 8.1 cm, while 1 untreated boy fell below the prognosis by 8.6 cm. One treated with a low dose and 2 untreated reached their prognosis. Adult heights were -0.91 SDS with anastrozole (-2.86 to -0.29) and -0.15 SDS without (-2.31 to -0.03). Distance to target height was -0.22 SDS with anastrozole (-1.72 to +0.52) and +0.54 SDS without (+0.23 to +1.30). CONCLUSION Spontaneous growth in AEXS varied, even in the same family. Our data suggest that early started, long-term inhibition by anastrozole promotes adult height in boys with AEXS.
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Affiliation(s)
- Gerhard Binder
- University Children's Hospital, Pediatric Endocrinology, Tübingen, Germany
| | - Akie Nakamura
- Hokkaido University School of Medicine, Department of Pediatrics, Kitaku, Sapporo, Japan
| | - Roland Schweizer
- University Children's Hospital, Pediatric Endocrinology, Tübingen, Germany
| | - Tsutomu Ogata
- Department of Pediatrics, Hamamatsu University of Medicine, Higashi-ku, Hamamatsu, Shizuoka, Japan
| | - Maki Fukami
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Keisuke Nagasaki
- Division of Pediatrics, Niigata University Graduate School of Medicine and Dental Science, Niigata, Japan
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Filip-Psurska B, Psurski M, Anisiewicz A, Libako P, Zbrojewicz E, Maciejewska M, Chodyński M, Kutner A, Wietrzyk J. Vitamin D Compounds PRI-2191 and PRI-2205 Enhance Anastrozole Activity in Human Breast Cancer Models. Int J Mol Sci 2021; 22:ijms22052781. [PMID: 33803480 PMCID: PMC7967212 DOI: 10.3390/ijms22052781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 01/01/2023] Open
Abstract
1,25-Dihydroxycholecalciferol, the hormonally active vitamin D3 metabolite, is known to exhibit therapeutic effects against breast cancer, mainly by lowering the expression of estrogen receptors and aromatase activity. Previously, the safety of the vitamin D active metabolite (24R)-1,24-dihydroxycholecalciferol (PRI-2191) and 1,25(OH)2D3 analog PRI-2205 was tested, and the in vitro activity of these analogs against different cancer cell lines was studied. We determined the effect of the two vitamin D compounds on anastrozole (An) activity against breast cancer based on antiproliferative activity, ELISA, flow cytometry, enzyme inhibition potency, PCR, and xenograft study. Both the vitamin D active metabolite and synthetic analog regulated the growth of not only estrogen receptor-positive cells (T47D and MCF-7, in vitro and in vivo), but also hormone-independent cancer cells such as SKBR-3 (HER-2-positive) and MDA-MB-231 (triple-negative), despite their relatively low VDR expression. Combined with An, PRI-2191 and PRI-2205 significantly inhibited the tumor growth of MCF-7 cells. Potentiation of the antitumor activity in combined treatment of MCF-7 tumor-bearing mice is related to the reduced activity of aromatase by both An (enzyme inhibition) and vitamin D compounds (switched off/decreased aromatase gene expression, decreased expression of other genes related to estrogen signaling) and by regulation of the expression of the estrogen receptor ERα and VDR.
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Affiliation(s)
- Beata Filip-Psurska
- Department of Experimental Oncology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 12 Weigl, 53-114 Wroclaw, Poland; (M.P.); (A.A.); (P.L.); (E.Z.); (M.M.); (J.W.)
- Correspondence:
| | - Mateusz Psurski
- Department of Experimental Oncology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 12 Weigl, 53-114 Wroclaw, Poland; (M.P.); (A.A.); (P.L.); (E.Z.); (M.M.); (J.W.)
| | - Artur Anisiewicz
- Department of Experimental Oncology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 12 Weigl, 53-114 Wroclaw, Poland; (M.P.); (A.A.); (P.L.); (E.Z.); (M.M.); (J.W.)
| | - Patrycja Libako
- Department of Experimental Oncology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 12 Weigl, 53-114 Wroclaw, Poland; (M.P.); (A.A.); (P.L.); (E.Z.); (M.M.); (J.W.)
| | - Ewa Zbrojewicz
- Department of Experimental Oncology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 12 Weigl, 53-114 Wroclaw, Poland; (M.P.); (A.A.); (P.L.); (E.Z.); (M.M.); (J.W.)
| | - Magdalena Maciejewska
- Department of Experimental Oncology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 12 Weigl, 53-114 Wroclaw, Poland; (M.P.); (A.A.); (P.L.); (E.Z.); (M.M.); (J.W.)
| | - Michał Chodyński
- Łukasiewicz Research Network-Industrial Chemistry Institute, 8 Rydygiera, 01-793 Warsaw, Poland;
| | - Andrzej Kutner
- Department of Bioanalysis and Drug Analysis, Faculty of Pharmacy, Medical University of Warsaw, 1 Banacha, 02-097 Warsaw, Poland;
| | - Joanna Wietrzyk
- Department of Experimental Oncology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 12 Weigl, 53-114 Wroclaw, Poland; (M.P.); (A.A.); (P.L.); (E.Z.); (M.M.); (J.W.)
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Kazi A, Goloubeva O, Schech A, Yu S, Sabnis GJ. Efficacy of a novel orally active SERD AZD9496 against hormone dependent post-menopausal breast cancer depends on inhibition of cellular aromatase activity. J Steroid Biochem Mol Biol 2020; 202:105697. [PMID: 32461092 DOI: 10.1016/j.jsbmb.2020.105697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 11/26/2022]
Abstract
Treatment of hormone sensitive breast cancer tumors with endocrine therapy such as antiestrogens or aromatase inhibitors has improved the outcome significantly. Studies including our own have shown that downregulation of ERα with pure antiestrogen fulvestrant in combination with aromatase inhibitors may prolong responsiveness of the tumors to endocrine therapy. Fulvestrant has been studied as second line or first line treatment for post-menopausal hormone receptor positive breast cancers as a single agent or in combination with AIs. Studies have also suggested that further escalation of dose may improve benefit. However, dose escalation of fulvestrant, which is administered via intramuscular injection, is difficult due to its poor solubility. To overcome this shortcoming of an injectable drug, a novel orally active antiestrogen, AZD9496 was developed. In addition to being orally active, AZD9496 is designed as a selective ERα downregulator (SERD). In the current study, we compared the effect of AZD9496 and fulvestrant on the growth of MCF-7Ca (human estrogen receptor positive MCF-7 cells stably transfected with human placental aromatase gene) xenografts grown in ovariectomized athymic nude mice. AZD9496 was also compared to fulvestrant in vitro as a single agent or in combination with anastrozole. Our current study shows that AZD9496 is equally effective as fulvestrant at controlling the growth of hormone sensitive human breast cancer tumors. Similar to fulvestrant, AZD9496 inhibits cellular aromatase activity through ERα mediated signaling. However, unlike fulvestrant, combination of AZD9496 with anastrozole did not produce increased tumor inhibition. Our results show that AZD9496 was significantly better at inhibiting cellular aromatase which contributed to its anticancer activity. Next, we measured the effect of AZD9496 on the mouse uterus. Uterine weight of mice treated with AZD9496 was significantly lower than that for mice treated with androstenedione. This reduction in uterine weight was due to AZD9496 mediated inhibition of aromatase activity and not a direct effect on uterine ERα expression. We also observed that anti-cancer efficacy of AZD9496 depended on its ability to inhibit cellular aromatase. These results suggest that AZD9496 may be a better alternative to fulvestrant due to its selectivity for mammary ER and ability to inhibit aromatase in addition of downregulating ERα that can be obtained upon oral administration. As such, AZD9496 may prove to be a better option than fulvestrant for the treatment of hormone sensitive human breast cancer.
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Affiliation(s)
- Armina Kazi
- Department of Pharmacology, United States; Biology Department, Loyola University, Baltimore, MD, 21210, United States
| | - Olga Goloubeva
- Division of Biostatistics, University of Maryland School of Medicine and University of Maryland Marlene and Stewart Greenebaum Cancer Center, Baltimore, MD, 21201, United States
| | | | - Stephen Yu
- Department of Pharmacology, United States
| | - Gauri J Sabnis
- Department of Pharmaceutical Sciences, West Coast University, Los Angeles, CA, 90004, United States; Department of Pharmacology, United States.
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9
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Xulu K, Duarte R, Augustine T. Combined Anastrozole and Antiplatelet Therapy Treatment Differentially Promotes Breast Cancer Cell Survival. Microsc Microanal 2020; 26:497-508. [PMID: 32241309 DOI: 10.1017/s1431927620001324] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Thromboembolic disorders are the second leading cause of death in breast cancer. Antiplatelet therapy combined with cancer therapy is a potential treatment strategy against cancer-associated thromboembolic disorders; however, the efficacy of such dual treatment has not been established. This study reports novel findings on the response of hormone-dependent breast cancer cell lines (MCF7/T47D) following 24 h treatment with Anastrozole, combined with Aspirin and Clopidogrel cocktail; and Atopaxar. Neutral red and lactate dehydrogenase assays were conducted to assess viability and cytotoxicity respectively. Flow cytometric Annexin-V/PI assay was used to assess the mode of cell death. Morphological alterations were studied using scanning electron microscopy. Statistical analysis was conducted using Statistica V13. Definitive outcomes were established with flow cytometric detection of phosphatidylserine exposure and propidium iodide staining, complemented with ultrastructural analysis. Results showed that a few cells were undergoing death mainly through secondary necrosis. Morphological features suggesting induced cell motility (pseudopodia/ruffled membranes) were observed in both cell lines; notably, T47D cells presented pronounced features than MCF7 cells. Overall, these findings suggest that such combined treatment may differentially promote cell survival, inducing a more aggressive breast cancer phenotype.
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Affiliation(s)
- Kutlwano Xulu
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193Johannesburg, South Africa
| | - Raquel Duarte
- Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193Johannesburg, South Africa
| | - Tanya Augustine
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193Johannesburg, South Africa
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10
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Gelsomino L, Giordano C, La Camera G, Sisci D, Marsico S, Campana A, Tarallo R, Rinaldi A, Fuqua S, Leggio A, Grande F, Bonofiglio D, Andò S, Barone I, Catalano S. Leptin Signaling Contributes to Aromatase Inhibitor Resistant Breast Cancer Cell Growth and Activation of Macrophages. Biomolecules 2020; 10:biom10040543. [PMID: 32260113 PMCID: PMC7226081 DOI: 10.3390/biom10040543] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/23/2020] [Accepted: 04/01/2020] [Indexed: 12/22/2022] Open
Abstract
Obesity represents a risk factor for breast cancer development and therapy resistance, but the molecular players underling these links are unclear. Here, we identify a role for the obesity-cytokine leptin in sustaining aromatase inhibitor (AI) resistant growth and progression in breast cancer. Using as experimental models MCF-7 breast cancer cells surviving long-term treatment with the AI anastrozole (AnaR) and Ana-sensitive counterparts, we found that AnaR cells expressed higher levels of leptin and its receptors (ObR) along with a constitutive activation of downstream effectors. Accordingly, leptin signaling inhibition reduced only AnaR cell growth and motility, highlighting the existence of an autocrine loop in mechanisms governing drug-resistant phenotypes. In agreement with ObR overexpression, increasing doses of leptin were able to stimulate to a greater extent growth and migration in AnaR than sensitive cells. Moreover, leptin contributed to enhanced crosstalk between AnaR cells and macrophages within the tumor microenvironment. Indeed, AnaR, through leptin secretion, modulated macrophage profiles and increased macrophage motility through CXCR4 signaling, as evidenced by RNA-sequencing, real-time PCR, and immunoblotting. Reciprocally, activated macrophages increased AnaR cell growth and motility in coculture systems. In conclusion, acquired AI resistance is accompanied by the development of a leptin-driven phenotype, highlighting the potential clinical benefit of targeting this cytokine network in hormone-resistant breast cancers, especially in obese women.
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Affiliation(s)
- Luca Gelsomino
- Department of Pharmacy, Health and Nutritional Sciences, Via P Bucci, University of Calabria, 87036 Arcavacata di Rende (CS), Italy; (L.G.); (C.G.); (G.L.C.); (D.S.); (S.M.); (A.C.); (A.L.); (F.G.); (D.B.); (S.A.)
| | - Cinzia Giordano
- Department of Pharmacy, Health and Nutritional Sciences, Via P Bucci, University of Calabria, 87036 Arcavacata di Rende (CS), Italy; (L.G.); (C.G.); (G.L.C.); (D.S.); (S.M.); (A.C.); (A.L.); (F.G.); (D.B.); (S.A.)
| | - Giusi La Camera
- Department of Pharmacy, Health and Nutritional Sciences, Via P Bucci, University of Calabria, 87036 Arcavacata di Rende (CS), Italy; (L.G.); (C.G.); (G.L.C.); (D.S.); (S.M.); (A.C.); (A.L.); (F.G.); (D.B.); (S.A.)
| | - Diego Sisci
- Department of Pharmacy, Health and Nutritional Sciences, Via P Bucci, University of Calabria, 87036 Arcavacata di Rende (CS), Italy; (L.G.); (C.G.); (G.L.C.); (D.S.); (S.M.); (A.C.); (A.L.); (F.G.); (D.B.); (S.A.)
| | - Stefania Marsico
- Department of Pharmacy, Health and Nutritional Sciences, Via P Bucci, University of Calabria, 87036 Arcavacata di Rende (CS), Italy; (L.G.); (C.G.); (G.L.C.); (D.S.); (S.M.); (A.C.); (A.L.); (F.G.); (D.B.); (S.A.)
| | - Antonella Campana
- Department of Pharmacy, Health and Nutritional Sciences, Via P Bucci, University of Calabria, 87036 Arcavacata di Rende (CS), Italy; (L.G.); (C.G.); (G.L.C.); (D.S.); (S.M.); (A.C.); (A.L.); (F.G.); (D.B.); (S.A.)
| | - Roberta Tarallo
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi (SA), Italy; (R.T.); (A.R.)
| | - Antonio Rinaldi
- Laboratory of Molecular Medicine and Genomics, Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi (SA), Italy; (R.T.); (A.R.)
| | - Suzanne Fuqua
- Lester and Sue Smith Breast Center, Baylor College of Medicine, One Baylor Plaza, MS: 600 N1220.01 Alkek Building, Houston, TX 77030, USA;
| | - Antonella Leggio
- Department of Pharmacy, Health and Nutritional Sciences, Via P Bucci, University of Calabria, 87036 Arcavacata di Rende (CS), Italy; (L.G.); (C.G.); (G.L.C.); (D.S.); (S.M.); (A.C.); (A.L.); (F.G.); (D.B.); (S.A.)
| | - Fedora Grande
- Department of Pharmacy, Health and Nutritional Sciences, Via P Bucci, University of Calabria, 87036 Arcavacata di Rende (CS), Italy; (L.G.); (C.G.); (G.L.C.); (D.S.); (S.M.); (A.C.); (A.L.); (F.G.); (D.B.); (S.A.)
| | - Daniela Bonofiglio
- Department of Pharmacy, Health and Nutritional Sciences, Via P Bucci, University of Calabria, 87036 Arcavacata di Rende (CS), Italy; (L.G.); (C.G.); (G.L.C.); (D.S.); (S.M.); (A.C.); (A.L.); (F.G.); (D.B.); (S.A.)
| | - Sebastiano Andò
- Department of Pharmacy, Health and Nutritional Sciences, Via P Bucci, University of Calabria, 87036 Arcavacata di Rende (CS), Italy; (L.G.); (C.G.); (G.L.C.); (D.S.); (S.M.); (A.C.); (A.L.); (F.G.); (D.B.); (S.A.)
| | - Ines Barone
- Department of Pharmacy, Health and Nutritional Sciences, Via P Bucci, University of Calabria, 87036 Arcavacata di Rende (CS), Italy; (L.G.); (C.G.); (G.L.C.); (D.S.); (S.M.); (A.C.); (A.L.); (F.G.); (D.B.); (S.A.)
- Correspondence: (I.B.); (S.C.); Tel.: +39-0984-496216 (I.B.); +39-0984-496207 (S.C.)
| | - Stefania Catalano
- Department of Pharmacy, Health and Nutritional Sciences, Via P Bucci, University of Calabria, 87036 Arcavacata di Rende (CS), Italy; (L.G.); (C.G.); (G.L.C.); (D.S.); (S.M.); (A.C.); (A.L.); (F.G.); (D.B.); (S.A.)
- Correspondence: (I.B.); (S.C.); Tel.: +39-0984-496216 (I.B.); +39-0984-496207 (S.C.)
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11
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He T, Yang W, Zhang X, Li P, Yang D, Wu Y, Fan Y, Xiang M, Huang Q, Chen J, Zhou R, Lv Q, Chen J. Comparative effectiveness of tamoxifen, toremifene, letrozole, anastrozole, and exemestane on lipid profiles in breast cancer patients: A network meta-analysis. Medicine (Baltimore) 2020; 99:e18550. [PMID: 31914031 PMCID: PMC6959941 DOI: 10.1097/md.0000000000018550] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Adjuvant endocrine therapy is a vital portion of postoperative comprehensive treatment for breast cancer patients. In recent years, studies have shown that endocrine therapy has a certain impact on the serum lipids of breast cancer patients, and the changes of lipid profiles may bring a series of problems. However, very few studies focus on this issue to date. The results of these studies are inconsistent, and the influence of different adjuvant endocrine modalities on lipid profiles still remains controversial. In order to better explore this issue, we conduct this network meta-analysis. METHOD The protocol followed preferred reporting items for systematic reviews and meta-analyses protocols. Three main databases (PubMed, Embase, and the Cochrane Library) will be searched systematically for eligible randomized controlled trials without language restriction. In addition, a manual search of the references of relevant published studies will also be considered. Two reviewers will conduct studies selection, data extraction, and risk of bias assessment independently. The primary outcome is the variation of biochemical parameters - the serum lipid profiles (cholesterol, triglyceride, high-density lipoprotein, low low-density lipoprotein). RESULTS The results will provide useful information about the side effects of different adjuvant endocrine drugs on lipid profiles in postoperative breast cancer patients (estrogen receptor-positive and/or progesterone receptor-positive). CONCLUSION The findings of this study will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42019129850.
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Affiliation(s)
- Tao He
- Department of Breast Surgery, West China Hospital/West China School of Medicine
| | - Wenhao Yang
- Department of Pediatrics, West China Second Hospital/West China School of Medicine
| | - Xinyi Zhang
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Ping Li
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Dandan Yang
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Yunhao Wu
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Yuan Fan
- Department of Breast Surgery, West China Hospital/West China School of Medicine
| | - Mengya Xiang
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Qianqian Huang
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Jing Chen
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Runke Zhou
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Qing Lv
- Department of Breast Surgery, West China Hospital/West China School of Medicine
| | - Jie Chen
- Department of Breast Surgery, West China Hospital/West China School of Medicine
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12
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Chagas DC, da Conceição Barros-Oliveira M, Lopes-Costa PV, de Oliveira Pereira R, de Almeida Melo M, Costa-Silva DR, Borges CS, Viana JL, dos Santos AR, Facina G, da Silva BB. Effects of anastrozole on Ki-67 antigen expression in the vaginal epithelium of female rats in persistent estrus. Clinics (Sao Paulo) 2020; 75:e1643. [PMID: 32267395 PMCID: PMC7098419 DOI: 10.6061/clinics/2020/e1643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 01/17/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Aromatase inhibitors are the first-choice drugs for the treatment of hormone sensitive breast cancer. However, in addition to the scarcity of studies, there are controversies about their effects on vaginal epithelial cell proliferation in rats, especially those in persistent estrus. METHODS To investigate vaginal epithelial cell proliferation by Ki-67 antigen expression, persistent estrus was induced in 42 randomly selected rats. These rats were randomly divided into 2 groups: group I (control, n=21), which received 0.1 mL of propylene glycol (vehicle) daily, and group II (experimental, n=21), which received 0.5 mg/kg or 0.125 mg/day of anastrozole diluted with 0.1 mL of propylene glycol. RESULTS Light microscopy showed a higher concentration of cells with brown Ki-67 stained nuclei in the control compared to the experimental group. The mean percentage of Ki-67 stained nuclei per 500 cells in the vaginal epithelium was 68.64±2.64 and 30.46±2.00 [mean±standard error of the mean (SEM)] in the control and experimental groups, respectively (p<0.003). CONCLUSION This study showed that anastrozole, at the dose and treatment duration selected, significantly decreased cell proliferation in the vaginal mucosa of the rats in persistent estrus.
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Affiliation(s)
- Diego Cipriano Chagas
- Programa de Pos Graduacao em Ciencias da Saude, Universidade Federal do Piaui, Teresina, PI, BR
| | | | - Pedro Vitor Lopes-Costa
- Programa de Pos Graduacao em Ciencias da Saude, Universidade Federal do Piaui, Teresina, PI, BR
| | | | | | - Danylo Rafhael Costa-Silva
- Programa de Pos Graduacao, Rede Nordeste de Biotecnologia (RENORBIO), Universidade Federal do Piaui, Teresina, PI, BR
| | | | | | - Alesse Ribeiro dos Santos
- Programa de Pos Graduacao, Rede Nordeste de Biotecnologia (RENORBIO), Universidade Federal do Piaui, Teresina, PI, BR
| | - Gil Facina
- Departamento Ginecologia, Universidade Federal de Sao Paulo, Sao Paulo, SP, BR
| | - Benedito Borges da Silva
- Programa de Pos Graduacao em Ciencias da Saude, Universidade Federal do Piaui, Teresina, PI, BR
- Hospital Getulio Vargas, Universidade Federal do Piaui, Teresina, PI, BR
- *Corresponding author. E-mail:
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