242 10 21MB
English Pages 523 [533] Year 2019
Receptor Mediateci Antisteroid Action
Receptor Mediated Antisteroid Action Editor M. K Agarwal
W DE
G Walter de Gruyter • Berlin • New York 1987
Editor M. K. Agarwal, M. Sc.; Ph. D., M. D. Directeur de Recherche au CNRS Scientific Director: Laboratoire de Physio-Hormono-Réceptérologie Faculté de Médecine Broussais Hôtel-Dieu Université Pierre et Marie Curie 15, rue de l'Ecole de Médecine F-75270 Paris Cédex 06 France
Library of Congress Cataloging in Publication Data Receptor mediated antisteroid action / editor, M. K. Agarwal. p. cm. Includes bibliographies and indexes. ISBN 0-89925-374-1 (U.S.) 1. Steroid hormones-Receptors-Effect of drugs on. 2. Steroid hormones-Antagonists. I. Agarwal, M. K. [DNLM: 1. Estrones-pharmacodynamics. 2. Receptors, Steroid. 3. Steroids-antagonists & inhibitors. WK150 R2948] RM297.S74R43 1987 615'.36~dcl9 DNLM/DLC 87-27567
CIP-Kurztitelaufnahme der Deutschen Bibliothek Receptor mediated antisteroid action / ed. M. K. Agarwal. Berlin ; New York : de Gruyter, 1987. ISBN 3-11-011355-4 NE: Agarwal, Manjul K. [Hrsg.]
Copyright © 1987 by Walter de Gruyter & Co., Berlin 30. All rights reserved, including those of translation into foreign languages. No part of this book may be reproduced in any form - by photoprint, microfilm or any other means nor transmitted nor translated into a machine language without written permission from the publisher. Printing: Gerike GmbH, Berlin. Binding: Liideritz & Bauer GmbH, Berlin. - Printed in Germany.
PREFACE T h e last few y e a r s h a v e w i t n e s s e d a literal e x p l o s i o n of a d v a n c e s in the field of molecular e n d o c r i n o l o g y . T h e receptor g e n e for all g r o u p s of s t e r o i d hormone r e c e p t o r s has been c l o n e d . Chemical modifications in the s t e r o i d n u c l e u s h a v e p r o v i d e d a whole new a r r a y of materials with specific a g o n i s t / a n t a g o n i s t a c t i v i t y . T h e notion that the s t e r o i d hormone receptor is p r i m a r i l y cytoplasmic has been c h a l l e n g e d . New biochemical a n d immunocytochemical a p p r o a c h e s to p r o b e the receptor a p p r a i s a l of its s t e r e o s p e c i f i c
h a v e permitted f r e s h
configuration.
S t e r o i d hormone a n t a g o n i s t s not o n l y form excellent tools to s t u d y
various
a s p e c t s of the receptor s t r u c t u r e a n d f u n c t i o n b u t t h e y a r e also important in d i a g n o s t i c a n d clinical medicine. A n t a g o n i s t s for all c l a s s e s of s t e r o i d hormones a r e actually u s e d in the treatment of a wide a r r a y of d i s o r d e r s . Medical treatment has now become p o s s i b l e in c a s e s where s u r g e r y to be the o n l y available
used
therapy.
T h e p r e s e n t volume g r o u p s t o g e t h e r latest conceptual d e v e l o p m e n t s a n d o n g o i n g d e s i g n s for a n t a g o n i s t s in all g r o u p s of s t e r o i d h o r m o n e s b y some of the
leading a u t h o r i t i e s actually i n v o l v e d in their r e s p e c t i v e f i e l d s .
the biochemical a n d pharmacological level, v e r y dramatic a d v a n c e s been made in the area of a n t i m i n e r a l o c o r t i c o i d s .
At
have
For the f i r s t time, a
specific p r o b e for the m i n e r a l o - r e c e p t o r has been marketed a n d t h i s book p r e s e n t s the o n l y available review in t h i s a r e a .
D i s c o v e r e d b a r e l y a few y e a r s b a c k , R U 38486 has all b u t
revolutionized
c o n t r a c e p t i o n a n d medical treatment of g l u c o c o r t i c o i d hormone e x c e s s .
All
t h i s information has been r e v i e w e d here c o m p r e h e n s i v e l y . T h e u s e of t h i s antihormone to p r o b e g l u c o c o r t i c o i d
and progesterone receptors,
and
the newly d e v e l o p e d a p p r o a c h of idiotype selection, are also r e v i e w e d in t h i s book for the f i r s t time.
VI
A n t i e s t r o g e n s and antiandrogens have been reviewed both for the fundamentalist, and the clinician
interested in basic mechanisms.
The
influence of antisteroids on modification of behaviour, a n t a g o n i s t s for steroid hormones in insects, and the problem of receptor have also been included to stimulate f u r t h e r
localization
thought.
In this day and age of specialization and literature explosion, it is often a herculean task to keep abreast of developments even in one's own particular field. T h i s book may be used as a source of material that individuals involved constantly in their routine work would not otherwise read. Newcomers may use this volume as a s t a r t i n g point for the history and development of antisteroid research.
backtracking
It is hoped that
c r o s s fertilization of ideas developed in different areas
will
lead to
even greater p r o g r e s s when readily available under a single c o v e r .
Earlier volumes by this editor have covered v a r i o u s biological levels at which the action of hormones can be antagonized. T h i s book concentrates primarily on the antagonism mediated t h r o u g h the specific cellular receptor. The advances summarized here should be of interest to pharmacologists, biochemists, advanced g r a d u a t e s t u d e n t s , and clinicians.
Theoretical criticism of any u n d e r t a k i n g of this sort is within the reach of everyone who wishes to point out that which was not included and could or should have been p r o v i d e d . V a r i o u s degrees of commitment
by
leading authorities do not make it possible to provide a timely c o v e r a g e in every single field. T h a n k s are due to all c o n t r i b u t o r s who mailed their manuscripts in time for a publication rapid e n o u g h to be worthwhile before further research reduces it to a niche in the heap of h i s t o r y . July 1987, Paris
M. K . A g a r w a l ,
Editor
CONTENTS
S t r u c t u r a l D i f f e r e n c e s D i s t i n g u i s h i n g S t e r o i d A n t a g o n i s t s from A g o n i s t s W. L . D u a x a n d J. F . G r i f f i n
1
A n t i h o r m o n e A c t i o n of S t e r o i d s with Modified R i n g L. Starka,
R . Hampl a n d A .
Structure
Kasal
17
A n a l y s i s of the S t r u c t u r e a n d F u n c t i o n of S t e r o i d R e c e p t o r s with the A i d of the A n t i h o r m o n e R U 38486 M. K. Agarwal and G. Lazar Clinical A p p l i c a t i o n s of the Glucocorticoid a n d P r o g e s t i n R U 486
43 Antagonist
L . K . Nieman a n d D . L . L o r i a u x
77
R U 38486 ( M i f e p r i s t o n e ) R e v e r s e s P r o g e s t e r o n e - a n d H y d r o c o r t i s o n e Mediated I n h i b i t i o n of P r o s t a n o i d S y n t h e s i s in C u l t u r e d Myometrial, V a s c u l a r a n d Gut T i s s u e E x p l a n t s J. Y . Jeremy a n d P. D a n d o n a
99
Receptor Mediated A n t i p r o g e s t i n Action of R U 486 M . Kalimi
121
T h e A n t i g l u c o c o r t i c o i d Effects of C o r t e x o l o n e a n d R U 38486 in the Human Leukemic Cell Line C E M - C 7 T . J. Schmidt
139
T h e Mineralocorticoid Receptor a n d the A c t i v i t y of A l d o s t e r o n e Antagonists G . Wambach T h e A n t i m i n e r a l o c o r t i c o i d A c t i o n of T w o Newly D e v e l o p e d Derivatives M . K . A g a r w a l a n d M . Kalimi
169 Spirolactone 197
VIII New Molecular P r o b e s to A s s e s s E s t r o g e n a n d A n t i e s t r o g e n
Actions
E. M. Cormier and V . C. Jordan Antioestrogens and R . I. N i c h o l s o n ,
223
Cancer
K . J . Walker a n d P. D a v i e s
A n t i e s t r o g e n A c t i o n in M C F - 7 T . S . R u h , M. F. R u h ,
275
Cells
R . K . S i n g h a n d W. B . B u t l e r
D e s i g n a n d A c t i v i t y of N o n s t e r o i d
307
Antiandrogens
T . Ojasoo a n d J . P. R a y n a u d
329
Cellular a n d Molecular Effects of A n t i e s t r o g e n s a n d C. V.
Antiandrogens
Ramana M u r t y a n d A . K . R o y
S t e r o i d Hormone A n t a g o n i s t s ,
373
B r a i n Receptor Systems and
Behavior
A. M. Etgen
405
A n t i s t e r o i d A c t i o n in B r a i n a n d C h a n g e s in Animal
Behaviour
C. Fabre-Nys and E. A d k i n s - R e g a n
435
Localization of S t e r o i d Hormone R e c e p t o r s in the Cells b y Immunohistochemistry K . C . R a j e n d r a n a n d I. P a r i k h Antiecdysteroids and
469
Receptors
M. S p i n d l e r - B a r t h and K. D. Spindler
497
AUTHOR
513
SUBJECT
INDEX INDEX
517
STRUCTURAL DIFFERENCES DISTINGUISHING STEROID ANTAGONISTS FROM AGONISTS
W.L. Duax and J.F. Griffin Medical Foundation of Buffalo, Inc., 73 High Street, Buffalo, N.Y.
14203
Introduction Many characteristic hormonal responses of steroids are contingent upon their binding to specific receptors in target tissue (1).
While it is
known that response depends upon interaction of the receptor and nuclear chromatin (2-4), the precise details of this interaction and the role played by the steroid in this process remain undetermined.
Structural
details undoubtedly have a direct bearing upon receptor affinity and will directly or indirectly influence receptor activation, transport and nuclear interaction.
The existence of antagonists that compete for the
steroid binding site of the receptor with high affinity demonstrates that the phenomena of binding and activity are at least partially independent. X-Ray crystallographic data provide reliable information on the overall conformation of steroid hormone agonists and antagonists that may be used to gain insight into the conformational flexibility of these molecules, the structural similarities that might account for their binding to a common site and the structural differences that might account for varying degrees of hormonal response. On the basis of conformational analysis of the molecular structures of agonists and antagonists of estrogen, progesterone and corticoid hormones, we have proposed a model for receptor binding and hormonal activity.
The
model suggests that receptor binding is primarily controlled by the interaction of the steroid A ring with the receptor, and the nature and degree of the hormonal response is primarily controlled by the stereochemical features of the.D-ring region of the molecule (5). More recently, examination of the structural features of androgen agonists and antagonists has lead to the conclusion that for this class of
Receptor Mediated Antisteroid Action © 1987 Walter d e Gruyter & Co., Berlin • New York - Printed in Germany
2 hormones the D-ring may be the region critical to receptor interaction and that the stereochemistry of the A ring may control hormonal response (6). This review will summarize the salient features of these two models.
A.
Estrogen Agonists and Antagonists
Structures with high affinity for the estrogen receptor almost without exception contain a phenolic ring that appears to be essential to initiate receptor binding (7,8).
The potent synthetic estrogen diethylstilbestrol
(DES, I) has two phenol rings capable of initiating receptor binding.
In
addition DES is constrained by its central double bond to have an extended conformation with an overall shape and separation of its functional hydroxyl groups similar to that observed in the natural estrogen estradiol (Figure 1).
Fig. 1. A comparison of the observed structures of (a) estradiol and (b) DES. They have in common: overall shape, phenolic ring, and similar separation of hydroxyl groups by a hydrophobic mid region.
Metabolites of DES are of interest due to uncertainty concerning the form responsible for the carginogenic properties of DES and as additional probes of the structure-activity relationships of estrogens.
The low
affinity of indanesterol (Fig. 2b) for the estrogen receptor despite the presence of two phenolic rings indicates that the bent overall shape of the molecule (Fig. 2a) is incompatible with receptor binding (9).
It is
evident that the precise location of steric bulk and functional groups relative to the phenolic ring will govern binding and activity.
The
subtlety of the details of molecular control is exemplified by the case of the racemates of indenesterol A.
Korach finds that only one enantiomer of
indenesterol A (IA) has high affinity for the estrogen receptor (9,10).
3
a)
Fig. 2.
,O 5 H
Bent conformation of indanestrol observed in the solid state.
Model studies using X-ray crystallographically observed structures of IA suggest that it is the a-ring that mimics the estrogen A-ring (9) (Fig. 3) but it is difficult to identify the structural basis for the enantiomeric effect in IA.
It must be related to the topology of the molecule in the
region of the double bond.
In this regard IA has a high degree of
similarity to the crystallographically observed asymmetric form of DES in which the two methyl groups are on the same side of the plane of the double bond.
On the basis of a comparison of the crystallographically
observed structures of estradiol, DES and IA (Fig. 4), we suggested that the more active enantiomer would be the one with C(3)-R chirality (11).
Fig. 3. Comparison of the conformations of IA with estradiol reveal that the best fit is achieved when the a ring of IA is superimposed on the A ring of estradiol with the double bond in the 0 ring overlapping the C(8)C(9) bond in estradiol.
In order to test this hypothesis we undertook the crystal structure analysis of a bromobenzoate derivative of one of the enantiomers.
The
derivative of the inactive enantiomer was used in the X-ray analysis in order to spare the more active enantiomer for further biological testing. The X-ray crystal structure analysis unequivocally demonstrated that as we had postulated, the C(3)-R enantiomer of indenesterol A is more active than the C(3)-S enantiomer (unpublished results).
4 a)
b)
Fig. 4. Stereo views illustrating the best fit of the hydroxyl groups and the hydrophobic bulk of the structure of E (dark solid lines), DES (light solid lines), and IA (dashed lines).
When the phenol rings of a sample of the compounds that compete for binding to the estrogen receptor are superimposed significant differences in the D ring region of the molecules are observed (Fig. 5).
If there is
a close association between estrogens and the receptor it would appear to be limited to the A and B rings.
The receptor is either flexible in the D
ring region or insensitive to it (12,13).
Fig. 5. Superposition of the phenol rings of six compounds that bind to the estrogen receptor, suggests that variability in D-ring orientation is compatible with receptor binding and some degree of activity.
Estrogen antagonists such as trans tamoxifen compete for binding to estrogen receptors and elicit little or none of the characteristic hormonal response.
The clinical utility of the estrogen antagonists is a
result of their competition for the traditional Type I estrogen binding site (14).
5 The 4-hydroxy metabolite of trans tamoxifen (Fig. 6) has been shown to be the potent competitor for the estrogen receptor responsible for the antagonist properties useful in breast cancer therapy (15).
This
observation has led most investigators (16-18) to conclude that, at least in the case of the 4-hydroxy derivative of tamoxifen, it is the a ring that mimics the estradiol A ring in receptor interaction.
If the a' ring
of tamoxifen mimics the A-ring of estradiol when competing for the binding site on the receptor, then the X-ray crystallographic data on the conformation of these molecules can be used to identify the structural differences that may account for the failure of tamoxifen to elicit a significant response.
The atomic skeleton and the van der Vaals envelopes
of estradiol and trans tamoxifen are illustrated if Figs. 7 a and b,
observations
that
was
antiandrogenic
the
repor-
A-nor-5a-androstane
possess
relationships. According
It
estrogenic
found
even
(35)
17a-diethynyl-A-nor-5a-andro-
researchers
study
and
(Anordrin). also
were
and
several
Pincus
of
they
these
form
by
(18)
virtue
with
hormone.
compounds
incubation.
al.
antiestrogens
activity natural
et
One
of
is
appears
of
the
estrogen The high
such
and
to
fast
dis-
receptor
relative but
Mehta
it
compounds
binddecliwas
32 2-ethynyl-5a-A-nor-estrane-2,17B-diol forms
a fast-dissociating
similarly ceptors its
as
(18).
19-nor
17 R - d i o l the
cyproterone
(XXVI)
successfully China In
tation
to
(Dinordrin
have the
steroids
by
been
as
confirmed
by
re-
Anordrin, isomer
of
investigation
Anordrin
a post-coital
binding
has
on
been
contraceptive
between
some
of
to
in
interacted
considerably
sults
in g o o d
were
Moreover, ceptors. ments
some In
for
trogen A-nor
the
them
for
steroids
tested time
formed
receptors, misfit
findings
concerning
estrogen
viously
both
that
had
these
RBA
were
be
a basic
of
of
unexpected
those that
decreasing with
with that
the
rees-
pre-
all increathese
cytosolic
conformational In
fact,
some
these
compounds
as
was
the p h e n o l i c
re-
require-
either
to
fact
suggested
The
i_n v i v o .
androgen
with
components.
interaction
presence
the
similar
complexes
relati-
hydroxyl
structural
The
and
discrimina-
obtained
steroids
values
might
were
these
diffe-
receptors.
receptors.
with
the
hormones.
interacting the
of
to
Surprisingly,
a phenolic data
interacted
temperature
there
receptors the
the
their
enabling
estrogen
with
receptors
and
to
with
androgen
antagonists.
the
of
as
and
applied
and
with
short-lived
so t h a t
between
tested
estrogen
natural
incubation
compounds
were
approximation,
androgen
reported
activities
interact
A-nor
tried
A-nor-5a-androstane-
were
also
other have
Various
agreement
first
hormonal
not p o s s e s s i n g
interaction
and/or
viously
of
the
of
authors
antiimplan-
to
agonists
compounds
The
the
ability
the
conditions
potent
these
56
from
one, a number
(38).
derivatives
affinities
activity
potential their
receptors.
incubation
?)
examined
different
hormonal
tion
the
of
the 2 B - e t h i n y l
Recently,
estrogenic
measuring
A-nor-5a-estrane
sing
receptors, androgen
effectiveness
and
were
(37).
introduced separate
evaluate
Two
II)
baboons
I)
(= a n t i - p r o g e s t i o n a l
analogues
ve
the
(36) .
order
rent
estrogen
which
(2oc,17a-di e t h y n y l - A - n o r - 5 a - e s t r a n e - 2 R ,
(Dinordrin
female
with
does with
anti-fertility
analogue
latter
cycling
The
complex acetate
( X X V , RU 2 6 1 4 3 ) ,
it
hydroxy
with
assumed group
prewas
33 an
essential
the
2-OH
ding
to
prerequisite
group
seemed
estrogen
to
for be
receptors
binding.
an and
one
-hydroxygroup
in t h e
five-membered
play
of
3-hydroxy
the
role
hydrogen
bonding
interaction xy
group
in
that
since
in
equally the of
tors, to
the
3-phenolic
group
classes
those of
2a-
of
also
which
natural
were
stereochemistry
far
less
important.
the
1713-hydroxy
The
group
For of
results
for
the
the
forming
the
From
recep-
extent
receptors,
group the
de-
lies.
androgen
with
ste-
in
androgen
a similar
confirmed
a
surprising
molecule,
with to
the
2-hydro-
substituents
the
2-OH
interaction
by
active.
estrogens
bound
2-
partially
of
quite
and 2B-0H of
bin-
Interestingly,
is
interacted
receptors.
the
could
were
plane
series, for
that
estradiol
site.
effect
average
compounds
however,
of
stereochemistry
this
both
above
suggest
A-ring
group
2R-derivatives
the
the
requirement
might
receptor the
view
ring
from
including
both
of
A-nor
these
the upon
only
point
viate Some
with
depended
reochemical
which
the
In
absolute
seemed
to
be
importance
of
androgen
re-
ceptors. Rousseau stant ding
et
for
al.
rat
protein
vatives with
androgen (ABP)
including
se c o m p o u n d s ABP
with
were
and
the
receptor
nor
to
(estrane
series),
were
of
the
tors
group.
the
other
gesterone
receptor
and
19-A-nor
androstaneboth
the
androgen
to
ABP.
The
were
authors
CH RU X 3 H TA O'HB
£ T3 e a>
£ TJ e « 55 *
55 40
1
Antibody Dilution x 10
J
2
3
Antibody Dilution x 10*
Fig. 16. The Specificity of the Rabbit Idiotype for the Hapten. Antiserum from rabbit immunized with TA-BSA was incubated with various steroids to assess relative binding (see 40).
67 Data in Fig. 17 show that ^H-TA bound to the idiotype could not be displaced by either RU 38486 (the antagonist), RU 28362 (the ideal agonist), cortexolone, or aldosterone. In contrast, nonradioactive TA exhibited dose dependent displacement of 3 H-TA binding to the idiotype antibody. In rat liver cytosol, 3 displacement of bound H-TA was obtained with various cold steroids in the order: TA > RU 38486 > RU 28362 > Aldosterone > Cortexolone
(Fig. 17b). The most striking difference in
these steroid binding proteins is the total lack of binding of 3 H-RU 38486 to the antisteroid antibody as compared to the receptor, and the inability of this synthetic antihormone, 3 and of RU 28362 (the ideal agonist), to displace H-TA bound to the antibody, even at concentration ratios of 1000:1 (40). Antibody
Liver Cytosol
[Steroid] M
[Steroid] M
Fig. 17. The Polyclonal Anti-TA Antibody is Specific for TA, Contrary to the Steroid Binding Site on the Receptor. 3 10 nM H-TA was used to label either the rabbit idiotype or rat liver cytosol. Various nonradioactive steroids were used to displace the bound steroid, as described before (40). These differences were confirmed when
3 H-RU 38486 was used to
label 3GR in rat liver and kidney. Data in Fig. 18 show that 1 nM
H-RU 38486 could be displaced equally well with either
unlabelled TA or RU and less so by Cortexolone = Aldosterone.
68
Since 3h-ru 38486 has no affinity for the mineralocorticoid receptor in the kidney (reviews in 3), and since aldosterone was less effective than TA or RU 38486 in displacing bound 3 H-RU 38486, the renal binding site is quite obviously GR. Kidney Cytosol
Liver Cytosol
• X O •
Fig.
RU38486 TA Aldo Cortexolone
[j_ Comparative Studies on the Glucocorticoid Receptor in Two Target Organs.
3 1 nM H-RU 38486 was used alone, or in presence of various cold steroids, to label GR in hepatic and renal cytosol. For further details see (40). These results were supported by additional studies where
H-TA
was used to label renal GR (not shown). Under these conditions, the displacement of bound
H-TA was in the order: TA =
RU 38486 > Aldosterone > Cortexolone. These data imply strong topological homologies
(perhaps identity) between the steroid
binding sites of the hepatic and renal glucocorticoid receptor. In any event, it is clear from the foregoing that the idiotype appears to contain an active site strictly complementary to TA. The conformation and topology of the steroid binding domain on the receptor appears to be complex, contrary to the notion in vogue where all agonists and antagonists would saturate an identical configuration leading to differences in affinity
(1-5 for various reviews).
69 Further analysis of epitopes near the combining site of the liver glucocorticoid receptor was attempted by raising antiidiotype antibodies to
triamcinolone 6-ketohexanoyl
(TKH)
linked to thyroglobulin, as described previously in detail (39). Data in Table 5 show the influence of three variables on the interaction of the anti-idiotype 8G11-C6 with the Fab fragment of the anti-TA idiotype. Table 5. Interaction of anti-TA Fab with the anti-idiotype
TA. (1 mM) RU 38486 Well Dilution TA-RSA (2 mg/ml) (1 Mm)
Liver Cytosol (5%)
A
2x
0.808
B
4x
1.182
1. 760
1. 884
0.152
c
8x
1.177
1. 597
1. 669
0.149
D
16x
1.188
1. 647
1.899
0.186
E
32x
1. 172
1. 591
1.459
0.271
F
PBS
1. 628
1. 531
1.390
1. 547
G
PBS
1.574
1. 426
1. 737
1. 405
H
Blank
0.005
0. 005
0.007
0.007
-
-
0.119
For details of Eliza method see (39). It is clear from data in Table 5 that liver cytosol competes effectively with anti-TA antisteroid-anti-idiotype confirmed previously
interaction,
(39). Interestingly, both TA and TA-RSA,
used to obtain the antisteroid idiotype, are ineffective. The antihormone RU 38486, too, was totally ineffective in interfering with the anti-TA Fab-anti-idiotype
interaction.
Data in Table 6 show that cytosol from several organs was just as effective as liver cytosol in competing with the anti-TA Fab - 8G11-C6 interaction. It is quite clear that serum, too, competed equally well under these conditions. Thus, the antiidiotype was not very specific for the glucocorticoid receptor.
70
The behaviour of the anti-idiotype was contrary to that of TA which has no affinity for the corticosteroid binding globulin in the serum. In other words, the anti-idiotype was possibly recognizing epitopes adjacent to the active site on both the receptor and transcortin. Table 6. Influence of Various Cytosols and Serum on the Binding of Anti-idiotype to the Idiotype Fab. Well Dilution
Liver
Kidney
Thymus
Spleen
Serum
A
0
0. 076
0. 086
0.052
0..087
0.072
B
2x
0. 055
0. 068
0.047
0,,068
0.066
C
4x
0. 081
0. 056
0.045
0..066
0.075
D
8x
0. 088
0. 087
0.050
0..068
0.076
E
16x
0. 124
0. 121
0.088
0..072
0.074
F
PBS
0. 717
0. 664
0.948
0.. 809
0.755
G
PBS
0. 669
0. 622
0.656
H
Blank
0. Oil
0. Oil
0.014
0.651 0..010
0.010
For details of Eliza see (39). In the anti-idiotype network theory, the ligand for the receptor may provoke idiotype antibodies resembling the receptor and the anti-idiotypes of this subset should mimick the ligand
(39). The results described above indicate that ^both
the transcortin
and the receptor may share a comparable
domain close to the ligand binding sites. A whole family of anti-idiotype antibodies may be helpful in mapping various domains around the active site which, according to the idiotype described earlier, appears to be complex. It would be interesting to see whether a pure agonist antagonist
(RU 28362) and the
(RU 38486) conjugates would elicit a specific
anti-idiotype since neither recognizes the idiotype engendered by Triamcinolone-BSA.
Conclusions and Future Trends The most obvious message that emerges from the present review is the uniqueness of each system subjected to careful analysis No generalizations seem possible from in vitro to in vivo, from one tissue to the other, and from one steroid receptor class to another. To recapitulate just some of these variables, RU 38486 binds to the same population of the glucocorticoid receptor in all tissues studied. Yet, its affinity for rat liver GR is less than that of the agonist triamcinolone exactly in contrast to rat thymus and hepatoma
(12),
(29,30). The
activation of the GR-antagonist complex is complete in rat liver cytosol (27) but only partial in thymocytes
(3, 29, 30)
In the progesterone receptor system, the agonist and the antagonist compete for the same binding site in the calf uterus cytosol but two separate binders were clearly evident in the chick oviduct cytosol, one each specific for RU 38486 and progesterone
(28). The affinity of the antagonist for the
PR was higher than that of the agonist in calf uterus but the reverse was true in the chick oviduct (28). This recalls some of our earliest observations on receptor heterogeneity
(24)
and falls into the category of the estrogen (41) and the mineralocorticoid
(31, 42) receptor series where antagonist
specific binding populations have been reported
(see also
other chapters in this book). This sort of heterogeneity may be due to a combination of separate enhancer elements
(43)
and recent advances in receptor gene cloning may make this sort of reasoning amenable to experimental scrutiny. The most striking differences were noted when receptor stability was considered. At 37° C, GR-TA complexes were far more stable than GR-RU 38486 complexes from rat liver cytosol (27) Paradoxically, the antagonist actually stabilized the progesterone receptor in chick oviduct as compared to PR-progesterone complex at 37° C (28).
72 Like the receptor activation, which proceeds in presence of agonists and antagonists in the GR (27), MR (31), and PR (28) systems, the process of nuclear binding in vivo needs to be reassessed. Although both the GR and the PR receptor complexes are believed to bind to the same hexanucleotide in the promotor (33, 34), this sequence did not compete with the binding of the activated GR-receptor complex to DNA-cellulose which is believed to represent a valid model for in vivo behaviour of different receptors. This concept needs revision not only because receptor activation can not be assessed in presence of phosphate buffers that form the predominant cellular ion in vivo (31) but also because the estro-progestative hormones are now believed to be intranuclear
(see another paper in this
volume). If activation is a means for the transfer of cytosol based corticoid hormone receptor into the nucleus, what is the role of this process in the action of sex steroid hormone receptor that is nuclear based? The idiotype - antiidiotype approach has hitherto been used only in the GR system (39,40). The novelty of this procedure has permitted some cartography of the active site on the rat liver GR. Contrary to the notions in vogue, the steroid binding domain may be far more complex than is generally assumed by competition experiments. Similar studies with nuclear based receptors should prove valuable and this method may permit receptor purification solely by immune selection. Finally, RU 38486 has already proved its usefulness both in diagnostic
(44,45) and clinical
(46,47) medicine, as reviewed
in another chapter. The challenge in future would require dissociation of the antiprogestin from the antiglucocorticoid effects. As a word of caution, it is wrong to assume that all physiological effects of RU 38486 are receptor mediated
(23).
Future screening should be based on physiological action of the derivative in question even if its affinity for the receptor is lower than expected (48, 49).
References 1.
Agarwal, M. K. (ed), Antihormones, Elsevier/North Holland Biomedical Press, Amsterdam, New York, 1979.
2.
Agarwal, M. K. (ed), Hormone Antagonists, Walter de Gruyter, Berlin, New York, 1982.
3.
Agarwal, M. K. (ed), Adrenal Steroid Antagonism, Walter de Gruyter, Berlin, New York, 1984.
4.
Agarwal, M. K. (ed), Principles of Recepterology, Walter de Gruyter, Berlin, New York, 1983.
5.
Agarwal, M. K. (ed), FEBS Letters, 178: 1-5 (1984).
6.
Sakiz, E. in Pharmacology and Clinical Uses of Inhibitors of Hormone Secretion and Action (B. J. A. Furr and A. E. Wakeling, eds), Baillere Tindall, London, 1986.
7.
James, V. H. T. and Few J. D., Clinics in Endocrinol. Met 14: 867-892 (1985).
8.
Nedelec, L., Philibert, D. and Torelli, V. in Proc. 3rd SCI-RSC Medicinal Chemistry Symposium Suppl. 45, (R. W. Lambert ed), Royal Soc., London, 1986.
9.
Chrousos, G. P., Cutler Jr., G. B., Sauer, M., Simons Jr, S. S. and Loriaux, D. L., Pharm. Ther., 20: 263-281 (1983) .
10. Agarwal, M. K., Hainque, B., Moustaid, N. and Lazar, G. FEBS Letters 217: 221-226 (1987). 11. Adaikan,P. G. and Kottegoda, S. R., Drugs of the Future, 9: 755-757 (1984). 12. Lazar, G. and Agarwal, M. K., Biochem. Biophys. Res. Comm., 134: 44-50 (1986). 13. Gjerde, H., Morland, J. and Olsen, H., J. Steroid Biochem 23: 1091-1092 (1985). 14. Mercier, L., Miller, P. A. and Simons Jr, S. S., J. Steroid Biochem., 2J5 : 11-20 ( 1986). 15. Santana, M. A., Bolaz, S. C., Beck; G. and Pogson, C. I., Cancer Lett., 2 3 2 9 - 3 3 7 (1985). 16. Chobert, M. N., Barouki, R., Finidori, J., Ageerbeck, M. Hanoune, J., Philibert, D. and Draedt, R., Biochem. Pharmacol., 32: 3481-3483 (1983). 17. Bakke, 0., Cancer Res., 46: 1275-1279
(1986).
18. Cockayne, D., Sterling, K. M., Shull, S., Mintz, K. P., Illeyne, S. and Cutroneo, K. R. , Biochemistry, 2_5: 32023209 (1986) . 19. Dietrich, J. B., Golaz, S. C., Beck, G. and Bauer, G. J. Steroid Biochem., 24: 417-421 (1986).
74
20. Jeremy, J. Y. and Dandona, P., Endocrinology, 119/ 655-660 (1986) . 21. Grunfeld, J. P., Eloy, L., Moura, A. M., Ganeval, D., Frendo, B. R. and Worcel, M. , Hypertension, ]_: 292-299 (1985) . 22. Lassman, M. N. and Mudlow, P. J., Endocrinology, 94 : 1541-1546 (1974). 23. Lazar, G. and Agarwal, M. K., Biochem. Med., (1986) .
70-74
24. Agarwal, M. K. (ed) Multiple Molecular Forms of Steroid Hormone Receptors, Elsevier/North Holland Biomedical Press, Amsterdam, New York, 1977. 25. Agarwal, M. K. and Philippe, M. , Biochem. Med., 26^: 265276 (1981) . 26. Agarwal, M. K. (ed) Proteases and Hormones, Elsevier/ North Holland Biomedical Press, Amsterdam, New York, 1979. 27. Agarwal, M. K., Lombardo, G., Eliezer, N. and Moudgil, V. K., Biochem. Biophys. Res. Comm., 133 : 745-752 (1985). 28. Moudgil, V. K., Lombardo, G., Hurd, C., Eliezer, N. and Agarwal, M. K., Biochim. Biophys. Acta, 889 : 192-199 (1986). 29. Moguliewsky, M. and Philibert, D., J. Steroid Biochem., 20_: 271-276 (1984) . 30. Gagne, D., Pons M. and Philibert, D., J. Steroid Biochem., 23; 247-251 (1985) . 31. Agarwal, M. K. and Kalimi, M., Biochem. Biophys. Res. Comm., 143: 398-402 (1987). 32. Bourgeois, S., Pfhal, M. and Baulieu, E. E., EMBO J., 3: 751-755 (1984). 33. Dietmar, A., Janich, S., Scheidereit, C., Renkawitz, R., Schütz, G. and Beato, M. , Nature (London), 313 : 706-709 (1985) . 34. Scheidereit, C., Geisse, S., Westphal, H. M. and Beato, M. Nature (London) , 304 : 749-752 (1983) . 35. Miesfeld,R., Rusconi, S., Godowski, P. J., Maler, B. A., Okret, S., Wikström, A. C., Gustafsson, J. A. and Yamamoto K. R., Cell, 46: 389-399 (1986). 36. Hollenberg, S. M., Weinberger, C., Ong, E. S., Cerelli, G. Oro, A., Lebo, R., Thompson, E. B., Rosenfeld, M. G. and Evans, R. M., Nature (London), 318: 635-641 (1985). 37. Agarwal, M. K., FEBS Letters, £2: 25-29
(1976).
38. Giguère, V. , Hollenberg, S. M., Rosenfeld, M. G., and Evans, R. M. , Cell, ±6: 645-652 (1986).
75 39. Cayanis, E., Rajagopalan, R., Cleveland, W. L., Edelman, I. S. and Erlanger, B. F., J. Biol. Chem., 261: 50945103 (1986). 40. Agarwal, M. K. and Cayanis, E., Biochem. Biophys. Res. Comm., 136: 470-475 (1986). 41. Sutherland, R. L., Murphy, L. C., Foo, M. S., Green, M. D. Whybourne, A. M. and Krozowski, Z. S., Nature (Lond) 288: 273-275 (1980). 42. Lazar, G. and Agarwal, M. K., Biochem. Biophys. Res. Comm. 134: 261-265 (1986) . 43. Hammer, R. E., Krumlauf, R., Camper, S. A., Brinster, R. L. and Tilgham, S. M., Science, 235: 53-58 (1987). 44. Bertagna, X. , Bertagna, C., Luton, J.P., Husson, J. M. and Girard, F., J. Clin. Endocr. Metab., 59: 25-28 (1984). 45. Baulieu, E. E. and Segal, S. C. (eds) The Antiprogestin Steroid RU 486 and Human Fertility Control. Plenum Press, New York, London, 1985. 46. Healy, D. L., Chrousos, G. P., Schulte, H. M., Williams, R. F., Gold, P. W. , Baulieu, E. E. and Hodgen, G. D., J. Clin. Endocr. Metab., 863-865 (1983). 47. Nieman, L. L., Morin, Bardin, C. England J.
K., Choate, T. M., Chrousos, G. P., Healy, D. M., Renquist, D., Merriam, G. R., Spitz, I. M. W., Baulieu, E. E. and Loriaux, D. L., New Med., 316: 187-191 (1987).
48. Ottow, E., Beier, S., Elger, W., Henderson, D. A., Neef, G. and Wiechert, R. , Steroids, 4_4: 519-530 (1984). 49. Neef, G., Beier, S., Elger, W., Henderson, D. A. and Wiechert, R. , Steroids, 44: 349-372 (1984). Acknowledgments Some of the studies in this chapter were conducted during the sabbatical leave (MKA) from CNRS, Paris, at Oakland University, Michigan, and Columbia University, New York. G. L. Was the recipient of an International Fellowship from the INSERM. We wish to thank Roussel-Uclaf for the gift of 3 H-RU 38486 and litterature retrieval on this compound. The hexanucleotide sequence in the promotor was kindly supplied by Dr. G. Schiitz. Financial support was made available by the UER Broussais Hotel Dieu. We appreciate the preprints supplied by Drs. D. Philibert and E. Sakiz, Roussel-Uclaf. Dr. C. E. Sekeris, National Hellenic Cancer Institute, Athens, was most helpful with the technique on thymocytes.
CLINICAL APPLICATIONS OF THE GLUCOCORTICOID AND PROGESTIN ANTAGONIST RU 486
L.K. Nieman, D.L. Loriaux Developmental Endocrinology Branch, National Institutes of Child Health and Human Development, National Institutes of Health, Bethesda, MD
20892
Introduction
Clinically useful antagonists of mineralocorticoid, estrogen, and androgen action have been available for many years (1-3).
Despite efforts spanning
almost three decades, useful glucocorticoid and progestin antagonists were not available until 1981, when Roussel UCLAF introduced RU 486, [ 17 R -hydroxy-l
(4-dimethylaminophenyl )-17'i'-l-propynyl-estra-4 ,9-dien-
3-one] a compound with both antiprogestin and antiglucocorticoid activities (Fig 1) (4-7).
RU 486 bound to the rat glucocorticoid receptor with an
affinity greater than that of dexamethasone and to the rat progestin receptor with an affinity greater than that of progesterone (6).
It also
had a weak affinity for the rat androgen receptor (8) but had no affinity for the rat mineralocorticoid or estrogen receptors (9).
ch 3 CH;
\C = C-CH'3
RU 486 Figure 1.
The Structure of RU 486
Receptor Mediated Antisteroid Action © 1987 Walter de Gruyter & Co., Berlin • New York - Printed in Germany
78
Bioassays in rodents showed RU 486 to be a progesterone antagonist without any detectable agonist activity.
RU 486 blocked
progesterone-induced
rabbit uteroglobin raRNA (10), progesterone-induced giant mitochondria in rat endometrium (11), and progesterone-induced sex behavior in the guinea pig (12).
It caused abortion in rats (13), mice (13) and rabbits (14).
RU 486 also opposed glucocorticoid action in in vitro rodent cell systems. It antagonized glucocorticoid-induced cytolysis of lymphocytes
(15),
induction of tyrosine aminotransferase in hepatoma cells (16) and immunosuppression of in vitro antibody responses in mice (17).
It prevented the
suppression of plasma A.CTH levels, thymic weight and potassium excretion caused by glucocorticoid administration (13).
Plasma
adrenocorticotropin
(ACTH) and glucocorticoid levels increased after RU 486
administration,
presumably because of antiglucocorticoid activity at the level of the hypothalamus and pituitary gland (14). Studies in the dog (18), rabbit (14) and rhesus monkey (19-23) have confirmed the antiprogestin and antiglucocorticoid properties of RU 486. Tolerance and toxicity studies in cynomolgus monkeys have given preliminary assurance of the relative safety of the drug.
Signs of adrenal
insufficiency were seen only w i t h large daily doses (100 mg/kg) after one month of treatment (14). On the basis of these preclinical
studies,
investigations of the action of RU 486 in man were begun.
This paper will
review the subsequent studies of the pharmacokinetic properties and a n t i progestin and antiglucocorticoid actions of RU 486 in man.
Pharmacokinetics and Metabolism of RU 486
RU 486 is formulated for human use as a tablet containing micronized RU 486 powder.
The pharmacokinetics and metabolism of RU 486 administered as this
oral preparation have been studied using radioimmunoassay
(24), radio-
receptor assay (25), and high pressure liquid chromatography (26) techniques to measure plasma and urine RU 486 and its metabolites.
Unless a prepara-
tive separation method such as thin layer chromatography is used, the available radioreceptor and radioimmunoassay methods detect both RU 486 and its major metabolites. molecules
separately.
High pressure liquid chromatography measures
these
79 Peak plasma levels of RU 486 are reached within two hours of the administration of a single oral dose of 10 - 25 mg/kg (25,26).
to fasting men and women
The plasma half-life of RU 486 is long, 20 - 24 hours (24-26).
During chronic administration of doses of 15 - 20 mg/kg/day, plasma levels of receptor-reactive material were very stable, ranging between 500 - 1000 ug/dl (25).
RU 486 is metabolized by single or double demethylation of the dimethylamine group and/or hydroxylation of the 17 -propynyl chain (27).
This probably
occurs in the liver, as less than 0.5 percent of a daily dose is detected in the urine by radioreceptor assay.
The demethylated metabolites have been synthesized and tested for biologic activity in the rat.
The N-monodemethylated compound has about
one-third the antiprogestin and antiglucocorticoid activity as the parent compound, and the didemethylated analog is even less potent
(27).
In man, over 95% of circulating RU 486 is bound to plasma proteins. may account, in part, for the long plasma half-life of the compound RU 486 binds to albumin and/or a human
1 acid glycoprotein
(25,28) but not to Cortisol binding globulin (CBG) or binding globulin (TeBG) (29).
This (25,27).
(orosomucoid)
testosterone-estradiol
RU 486 is not bound to plasma proteins in
the rat, rabbit or guinea pig (27).
Antiglucocorticoid Properties of RU 486
The antiglucocorticoid properties of RU 486 have been studied in healthy men.
The morning concentrations of plasma ACTH, S-endorphin and Cortisol
increased after administration of RU 486 at a divided oral dose of 6 mg/kg for 24 hours (30).
This amplification of the normal circadian pattern
persisted for two days.
Administration of RU 486 at different times of day
suggested that the antiglucocorticoid potency of RU 486 was influenced by the circadian rhythm of Cortisol secretion.
Subjects received RU 486
(6mg/kg) as a single dose at 2400h, and one week later, at lOOOh.
Plasma
levels of ACTH, R-endorphin and Cortisol rose only in the morning and were
80 not altered in the evening, regardless of the time of administration of RU 486.
Bertagna and co-workers found a similar increase in late morning
Cortisol levels after administration of the drug at 0200h while afternoon (1400h) administration did not affect evening Cortisol levels (31).
These
results suggest that the disinhibition of the pituitary-adrenal axis by RU 486 occurs only during the early morning hours.
The effect on Cortisol levels of RU 486 given at midnight was dosedependent.
No change was seen at a dose of 2.2 mg/kg, while doses of
4.5 and 6.6 mg/kg increased plasma Cortisol concentrations.
The ability of RU 486 to block dexamethasone action was evaluated to confirm that RU 486 acted via the glucocorticoid receptor.
RU 486 (6 mg/kg)
completely antagonized the inhibitory effect of 1 mg of dexamethasone at midnight (30).
This supports the concept that changes in ACTH and Cortisol
levels are mediated through the glucocorticoid receptor.
Conversely, 2 mg
of dexamethasone blocked the antiglucocorticoid effect of 4 mg/kg RU 486. This suggests that adrenal insufficiency resulting from RU 486 administration could be reversed by glucocorticoid administration.
RU 486 also antagonized the peripheral effects of glucocorticoids.
It
blocked the effects of pharmacologic doses of glucocorticoids on blood leukocytes (32) and antagonized cutaneous steroid-induced (33).
vasoconstriction
This latter phenomenon, produced by three different topical steroids
of differing potency in six normal men, was consistently attenuated or abolished by the oral administration of RU 486 (6mg/kg at 2400 and lOOOh). No peripheral antiglucocorticoid effects were observed after administration of RU 486 alone, presumably because the RU 486-induced increases in ACTH and Cortisol compensate at the target tissue for the antiglucocorticoid action of RU 486.
Generally, the dose of RU 486 required for antiglucocorticoid effect was higher than that required for antiprogestin effect.
For example, the
midluteal phase administration of RU 486 at a dose of ~1 mg/kg for four days induced menses within 48 hours (7).
Despite this antiprogestin
activity, no change in plasma B-LPH or Cortisol levels was observed,
81
suggesting that antiglucocorticoid effects were not significant at this dose.
Thus, in normal individuals, RU 486 blocks glucocorticoid negative feedback at the pituitary gland and induces a compensatory increase in plasma ACTH and Cortisol.
This antiglucocorticoid effect of RU 486 is only apparent
during the morning hours.
It is observed at doses exceeding those required
for an antiprogesterone effect, and can be reversed by administration of a glucocorticoid such as dexamethasone.
The dose-dependent dissociation of
antiglucocorticoid and antiprogestin activity and the homeostatic increase in Cortisol permit use of the drug as an antiprogestin without risking antiglucocorticoid
effects.
The pituitary and adrenal responses to short term administration of RU 486 have also been evaluated in patients with Cushing's syndrome (34). Urinary excretion of Cortisol increased by 50 to 1000%
in four patients
with Cushing's disease after three days of RU 486 administration (400mg/day).
17-Hydroxysteroid excretion and plasma LPH and Cortisol
levels also increased.
The parallel increase in LPH and glucocorticoid
levels suggested that the adrenal response resulted from RU 486 disinhibition of negative feedback at the pituitary gland. The activation of the pituitary-adrenal axis persisted for 3 - 4
days after RU 486 was stopped,
a finding consistent with the long plasma half-life of the compound.
In contrast, RU 486 did not alter the plasma or urinary glucocorticoid concentrations in two patients with nonpituitary-dependent Cushing's syndrome.
The discordant responses of the patients with pituitary and
nonpituitary dependent causes of Cushing's syndrome suggest that RU 486 administration may be useful in the differential diagnosis of Cushing's syndrome.
Further studies will be necessary to define the optimal regimen
for this use.
RU 486 in the Treatment of Cushing's Syndrome
When possible, surgical resection provides optimal therapy for ACTH and cortisol-secreting tumors (35).
Transsphenoidal microadenomectomy
82 remains the treatment of choice for Cushing's disease.
Surgical
treatment
of ectopic ACTH-secreting tumors is not feasible if the tumor is widely metastatic, or if it is occult at the time of presentation.
Patients w i t h
adrenal carcinoma also may have disseminated disease, rendering surgical extirpation unlikely.
For these individuals, an effective medical therapy
for hypercortisolism is desirable.
The medical therapy of Cushing's syndrome has traditionally been directed to the adrenal gland with adrenal enzyme inhibitors such as aminoglutethimide (36), metyrapone (37), ketoconazole (38) and trilostane (39), and with the adrenolytic agent o,p'DDD (40).
These drugs, however,
adequately reduce the hypercortisolism in all patients.
cannot
A further drawback
is the frequent incidence of toxic side-effects, especially at the large doses required for control of hypercortisolism.
RU 486 offers a new approach in the therapy of Cushing's syndrome We have administered this compound for 2 - 1 2
(29).
months to three patients
w i t h Cushing's syndrome caused by the ectopic secretion of ACTH. protocol for treatment was approved under an investigational
The
exemption
for new drugs by the National Center for Drugs and Biologies, DHHS and by the N1CHHD Research Subpanel.
All subjects gave their informed
consent and underwent baseline studies before beginning
treatment.
The assessment of the effectiveness of a glucocorticoid antagonist differs from that of other available medical agents.
With the latter
compounds,
successful inhibition of steroidogenesis can be monitored by measuring plasma Cortisol concentrations or urinary Cortisol or Cortisol metabolite excretion.
In contrast, RU 486 prevents the action of circulating
by occupying its receptor site.
corticoid antagonist can only be assessed indirectly by monitoring and biochemical glucocorticoid-sensitive
Clinical parameters used to follow weight and blood pressure. questionnaire.
Cortisol
Thus, successful treatment w i t h a glucoclinical
measures.
RU 486 treatment included body habitus,
Mood and libido were assessed by a self-report
Metabolic and hormonal measures included fasting and p o s t -
absorptive blood sugar, which are elevated by hypercortisolism, and plasma
83 concentrations of luteinizing hormone (LH), testosterone, testosteroneestradiol binding globulin (TeBG), Cortisol binding globulin (CBG), and TSH, which are suppressed by hypercortisolism. made on blood samples drawn RU 486 dose.
These measurements were
before therapy and prior to each increase in
Plasma ACTH and Cortisol and urinary Cortisol levels were
also measured before and during treatment.
RU 486 was given in divided daily doses beginning at 5 - 10 mg/kg and increasing in 5 mg/kg increments every two weeks to a maximum of 20 mg/kg/day. The first patient to be treated was a 25 year old white man with a widely metastatic carcinoid tumor. ectopic ACTH syndrome.
He presented with features typical of the
These included moon facies, truncal obesity,
muscle weakness, hypertension, diabetes mellitus, hypokalemic alkalosis, hypercortisolism and hyperpigmentation.
He was depressed and complained of
decreased libido.
The patient received RU 486 for nine weeks and showed marked improvement in Cushingoid features.
The physical stigmata of Cushing's syndrome, including
supraclavicular and dorsocervical fat pads and central obesity, regressed. Maximal systolic and diastolic blood pressure decreased steadily during treatment, from 200/120 mm Hg prior to therapy, to 140/90 at its conclusion. The hypokalemic alkalosis resolved as serum potassium levels increased from 1.9 mEq/L to 4.5 mEq/L.
Potassium supplements were discontinued after the
sixth week of therapy.
Both objective and subjective psychological measures improved during therapy with RU 486.
The patient's depression improved, and he reported increased
libido, attention span and sense of well-being.
These subjective improvements
were corroborated by self-rating questionnaire and psychiatric interviews.
Biochemical measures of glucococorticoid action also improved with RU 486 therapy, as shown in Figure 2.
Glucose tolerance improved and plasma
concentrations of testosterone, LH, TeBG, CBG and TSH all returned to the normal range.
No new serum chemistry (creatinine, BUN, SGOT, SGPT) or
chest radiography abnormality or abnormalities in urinalysis, EKG, or physical examination were found during or following therapy.
No signs or
84
A.
B.
Glucose 2 Hr OGTT (mg/dl)
LH (mlU/ml) 30
12 -I
140 -
I
Total Testosterone (ng/dl)
750
250
TeBG (ug/dl)
C B G (Mg/dl)
J
I
J
I
Free Testosterone (ng/dl)
Mean BP (mmHg) ISO
_L Dose RU486 (mg/kg/d) 20 r
10^
•
15
--r
Dose RU 486 (mg/kg/d) F
.
^
— r 45
r
DAY OF ADMISSION Figure 2. The effect of RU 486 treatment on glucocoticoid-sensitive measures. (All ordinate scales are linear.) Panel A: Two hour post-OGTT (normal • ) , h y d r o c o r t i s o n e (•——••), indomethacin (• W) and RU38486 (A A.) on P G I 2 (as 6 - o x o - P G F ^ a ) and PGE2 secretion by gastric explants following an 18 h culture. Untreated tissue release 0.86 ng 6-oxo-PGF]ci and 0.62 ng PGE2/mg wet tissue/l h. Each point represents mean + S.D. (n=6). IC50S in m o l . l - ! for PGI2: betamethasone, 1x10"^; hydrocortisone, l x l 0 ~ 6 ; indomethacin, l x l O - ® ; and RU38486, > l x l 0 - 4 ; for PGE2: betamethasone, l x l O - 7 ; hydrocortisone, l x l O - 6 ; indomethacin, 1 . 2 x l 0 - 6 ; and RU38486, > l x l 0 ~ 4 .
112
HYDROCORTISONE PGE„
PGI„ 0 20CO
co
40 -
I2 >-
60-
UJ X
CO
Q O z < Ico o CC CL
80 -
100-
I
2 3 4 5
|
2
3
4
5
4
5
BETAMETHASONE
o h CO X 2
PGI Q
0
PGE~
2040 60 -
80 •
100-
Figure
I
2
3
4
5
I
2
3
7.
Effect of RU38486 o n h y d r o c o r t i s o n e ( 1 x l 0 ~ 6 m o l . l - 1 ) - and b e t a m e t h a s o n e ( l x l O - ^ m o l . 1 - 1 ) - i n h i b i t e d P G I 2 (as 6-oxo-PGF^a) and PGE2 synthesis by duodenal explants f o l l o w i n g a n 18 h c u l t u r e . Each point represents mean + S.D. (n=6). C o d e : (1) u n t r e a t e d t i s s u e ; (2) g l u c o c o r t i c o i d a l o n e . T h e n same d o s e s of g l u c o c o r t i c o i d + v a r y i n g R U 3 8 4 8 6 , i n mol.l"1: (3) l x l O - ' ; (4) 5 x l 0 - 7 ; (5) 1 x l 0 - 6 . U n t r e a t e d t i s s u e r e l e a s e d 1.4 ng 6 - o x o - P G F ^ a and 0.98 ng PGE2/mg w e t tissue/1 h.
and
negate
Stress gastric
the
ulcerogenic
is a k n o w n
epidemiological
and duodenal
hypersecretion
of
properties
ulcer
adrenal
(47)
of
factor
and
hormones,
NSAIDs
(45,46).
in the g e n e s i s
is a l s o k n o w n including
to
of
elicit
corticosteroids
113
HYDROCORTISONE
PGI,
PGE„
20 •
ço to LU I I-
z >V)
g O z < f— w o
4060
"
80 •
100 .
1 2 3 4 5
1 2
3 4 5
BETAMETHASONE
(E
S
PGE„
PGL
Z o 20 •
40 • 6080 100 L
Figure
1
2 3 4 5
1
2 3 4
5
8.
Effect of RU38486 on hydrocortisone (1xl0 -6 mol.l - 1 )- and betamethasone (3xl0 - ^ mol.I -1 )-inhibited PGI2 (as 6-oxo-PGF^a) and PGE2 synthesis by gastric explants following an 18 h culture. Each point represents mean + S.D. (n=6). Code: (1) untreated tissue; (2) glucocorticoid alone. Then same doses of glucocorticoid + varying RU38486,in mol.l--'-: (3) lxlO - 7 ; (4) 5xl0 - 7 ; (5) 1xlO - 6 . Untreated tissue released 1.32 ng 6-oxo-PGF i a and 0.86 ng PGE 2 /mg wet tissue/l h.
(38).
In this context, the therapeutic administration of
corticosteroids is known sometimes to result in peptic and duodenal ulcers (48).
Since corticosteroids inhibit prosta-
noid synthesis (this paper), it is reasonable to propose that
114 corticosteroid-linked
ulcerogenesis
i n h i b i t i o n of the a n t i u l c e r o g e n s , RU38486 may prove beneficial stressed patients
Concluding
and
in o b v i a t i n g
in p a t i e n t s
potent antagonist
taking
in t h i s p a p e r
i n d u c t i o n of a b o r t i o n , not,
ulcerogenesis
but
earlier,
syndrome,
stressed patients
glucocorticoids)
that RU38486 in
(1,2,3)
in
excess
and patients
is a s s o c i a t e d
with
(as
in
in t h e s e
two major
and gastroduodenal
conditions.
influence many other glucose
diverse Thus
functions will
steroids
therapeutic
the effects
pathological
ulceration.
in the a e t i o l o g y to
the
of this
with Cushing's
novel effects
but
also
thank
Pamela Dale
for
immune
system
RU38486 on also on
these
may prove useful
syndrome.
for p r e p a r i n g
the
of
other
antiglucocorticoid.
Acknowledgement We
of
be
including, of
We
the
shed light not o n l y on the role
its a n t i g l u c o c o r t i c o i d
treating patients
was
Cushing's
Glucocorticoids
functions
in n o r m a l p h y s i o l o g y ,
applications
As
s u p p r e s s i o n of
and protein metabolism,
and brain excitation.
properties
taking
that RU38486 might prove
and
to
the
fully explored.
glucocorticoid
hypertension
and
might p l a y a role
Finally,
a
and
the a n t i g l u c o c o r t i c o i d
that glucocorticoid-induced
beneficial
is
has already been proved
these processes,
adrenal
in
intrauterine
relevant prostanoids
and other
the
corticosteroids.
in v a s c u l a r
as yet, b e e n
discussed
processes:
action
action
as a contraceptive
of RU38486 h a v e
example,
to
Furthermore,
tissue.
as an antiprogestagen,
be successful
confirm
of p r o g e s t e r o n e
tissue and of g l u c o r t i c o i d gastroduodenal
suggested
in p a r t
and PGE2•
Remarks
The data presented
RU38486,
may be due
PGI2
manuscript.
in
115
References 1.
Couzinet, B., N. Le Strat, A. Ulmann, E.-E. Baulieu and G. Schaison. 1986. Termination of early pregnancy by the progesterone antagonist RU38486 (Mifepristone). N. Engl. J. Med. 315, 1565-1570.
2.
Healy, D.L. and H.M. Fraser. 1985. The antiprogesterones are coming. Br. Med. J. 290, 580-582.
3.
Crowley, W.F. 1986. Progesterone antagonism. Science and Society. N. Eng. J. Med. 315, 1607-1608.
4.
Hermann, W., R. Wyss, A. Riondel, D. Philibert, G. Teutsch, E. Sakiz and E.-E. Baulieu. 1982. Effet d 1 u n steroide antiprogesterone chez la femme: interruption du cycle menstruel et de la grossesse au debut. C.R. Seances Acad. Sci. (iii) 295, 933-938.
5.
Kelly, R.W., D.L. Healy, M.J. Cameron, I.T. Cameron and D.T. Baird. 1986. The stimulation of prostaglandin production by two antiprogesterone steroids in human endometrial cells. J. Clin. Endo. Metab. 1986, 62, 1116-1123.
6.
Philibert, D. 1984. In: Adrenal Steroid Antagonism (M.K. Aggarwal, ed.) Walter de Gruyter, Berlin • New York, pp 77-101.
7.
Chobert, M.N., R. Barouki, J. Findori, J. Hanoume, D. Philibert and R. Deraedt. 1983. Antiglucorticoid properties of RU38486 in a differential hepatoma cell line. Biochem. Pharmacol. _32, 3481.
8.
Mogiulewsky, M. and D. Philibert. 1984. RU38486: Potent antiglucorticoid activity correlated with strong binding to the cytosolic glucocorticoid receptor followed by an impaired activation. J. Steroid Biochem. 20, 271-276.
9.
Csapo, A.I. 1977. In: The Fetus and Birth: Ciba Symposium 47 (J. Knight and M. O'Connor, eds.) Elsevier, Amsterdam, pp 159-210.
10.
Blackwell, G.J., R. Carnuccio, M. Di Rosa, R.F. Flower, L. Parente and P. Persico. 1980. Macrocortin: a polypeptide causing anti-lipase effects of glucocorticoids. Nature 287, 147-150.
11.
Jeremy, J.Y. and P. Dandona. 1986. Inhibition by hydrocortisone of prostacyclin synthesis by rat aorta and its reversal with RU486. J Endocrinol 119, 661-665.
116
12.
Jeremy, J.Y. and P. Dandona. 1986. RU486 antagonises the inhibitory action of progesterone on prostacyclin and thromboxane A2 synthesis in cultured rat myometrial explants. J Endocrinol 119, 655-660.
13.
Hirata, I.Y., M. Notsue, L. Iwata, M. Parente, M. Di Rosa and R.J. Flower. 1982. Identification of several species of phospholipase inhibitory proteins by radioimmunoassay for lipomodulin. Biochem. Biophys. Res. Comm. 109, 223-234.
14.
Danon, A. and G. Assouline. 1978. Inhibition of prostaglandin synthesis by corticosteroids requires RNA and protein synthesis. Nature 273, 552-554.
15.
Jeremy, J.Y., D.P. Mikhailidis and P. Dandona. 1984. Vascular trauma and prostacyclin release. Microcirc. Endothel. Lymph. 1, 629-642.
16.
Jeremy, J.Y., D.P. Mikhailidis and P. Dandona. 1985. Adrenergic modulation of vascular prostacyclin synthesis. Eur. J. Pharmacol. 115, 33-40.
17.
Jeremy, J.Y., D.P. Mikhailidis and P. Dandona. 1986. Prostanoid synthesis by the rat urinary bladder: evidence for stimulation through muscarine receptor linked calcium channels. Naunyn Schmied. Arch. Pharmacol. 334, 463-467.
18.
Jeremy, J.Y., D.P. Mikhailidis and P. Dandona. 1985. The thromboxane A2 analogue, U46619, stimulates vascular prostacyclin synthesis. Eur. J. Pharmacol. 107, 259-262.
19.
Jeremy, J.Y., D.P. Mikhailidis and P. Dandona. 1986. Muscarinic stimulation of prostacyclin synthesis by the rat penis. Eur. J. Pharmacol. 123, 67-71.
20.
Jeremy, J.Y., D.P. Mikhailidis and P. Dandona. 1985. A comparison of the effects of tiaprofenic acid and indomethacin on in vitro prostaglandin synthesis by rat, rabbit and human stomach tissue. Agents and Actions _12, 205-208.
21.
Ham, E.A., V.J. Cirillo, M.E. Zanetto and F.A. Keuhl, Jr. 1975. Estrogen directed synthesis of specific prostaglandins in uterus. Proc. Natl. Acad. Sci. 72, 1420-1427.
22.
Downie, J., N.L. Poyser and M. Wunderlich. 1974. Level of prostaglandins in human endometrium during the normal menstrual cycle. J. Physiol. 236, 465-472.
117
23.
Maathius, J.B. and R.W. Reilly. 1978. Concentration of prostaglandins F2ct and E2 in the endometrium throughout the human menstrual cycle after administration of clomiphene or an oestrogen-progesterone pill and in early pregnancy. J. Endocrinol. 7_7, 361-371.
24.
Liggins, G.C. and R.N. Howie. 1972. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome. Pediatrics 50, 515-525.
25.
Irvine, R.F. 1982. How is the level of free arachidonic acid controlled in mammalian cells Biochem. J. 204, 3-16.
26.
Anggard, E. and B. Samuelsson. 1965. Biosynthesis of prostaglandins from arachidonic acid in guinea pig lung. J. Biol. Chem. 240, 3518-3529.
27.
Bunting, S., R. Gryglewski, S. Moncada and J. Vane. 1976. Arterial walls generate from prostaglandin endoperoxides a substance (prostaglandin X) which relaxes strips of mesenteric and coeliac arteries and inhibits platelet aggregation. Prostaglandins 12, 897-913.
28.
Jeremy, J.Y., D.P. Mikhailidis and P. Dandona. 1986. The effect of nifedipine, nimodipine and nisoldipine on agonist- and trauma-stimulated vascular prostacyclin synthesis. Naunyn Schmied. Arch. Pharmacol. 332, 70-74.
29.
Baenzinger, M.L., F.J. Fogerty, L.F. Mertz and L.F. Chernuta. 1981. Regulation of histamine-mediated prostacyclin synthesis in cultured human vascular endothelial cells. Cell 24, 915-925.
30.
Boeynaems, V.M. and N. Galand. 1983. Stimulation of vascular prostacyclin synthesis by extracellular ADP and ATP. Biochem. Biophys. Res. Comm. 112, 200-212.
31.
Miller, R.L. and K.L. Melmon. 1972. In: Clinical Pharmacology. Basic Principles in Therapeutics. (K.L. Melmon and H.F. Moretti, eds.) MacMillan Co., New York, pp 382-405
32.
Krakoff, L.R., G. Nicholis and B. Amsel. 1975. Pathogenesis of hypertension in Cushing's syndrome. Am. J. Med. 58, 216-218.
33.
Moncada, S. and J.R. Vane. 1979. In: Chemistry and Pharmacological Activity of Prostanoids. (S.M. Roberts and F. Scheinmann, eds. Pergamon Press, Oxford, pp 258-273.
118
34.
Yard, A.C. and P.J. Kadowitz. 1972. Studies on the mechanism of hydrocortisone potentiation of vasoconstrictor responses to epinephrine in the anaesthetised animal. Eur. J. Pharmacol. 20_, 1-9.
35.
Hadhazy, P., L. Nagy, F. Juhasz, B. Malomvogyi and K. Magyar. 1983. Effects of indomethacin and prostaglandin on the tone of human isolated mesenteric arteries. Eur. J. Pharmacol. 91, 477-484.
36.
Kalsner, S. 1969. Mechanisms of hydrocortisone potentiation of responses to epinephrine and norepinephrine in rabbit aorta. Circulation Res. 24, 383-395.
37.
del Favero, A. 1985. In: Side Effects of Drugs Annual (M.N.G. Dukes and L. Beeley, eds.) Elsevier, Amsterdam, p 83.
38.
Liddle, G.W. and K.L. Melmon. 1974. Textbook of Endocrinology (R.H. Williams, ed.) W.B. Saunders Co., Philadelphia, pp 233-283.
39.
Ibels, E.S., J.H. Stewart, J.F. Mahony and A.G.R. Sheil. 1974. Deaths from occlusive arterial disease in renal allograft recipients. Br. Med. J. 552-554.
40.
Harker, L.A., S.M. Scwartz, R. Ross. 1981. In: Clinics in Haematology (C.R.M. Prentice, ed.) W.B. Saunders, London, pp 283-300
41.
Robert, A. 1984. In: Mechanisms of Mucosal Protection in the Upper Gastrointestinal Tract. (A. Allen and G. Felstrom, eds.) Raven Press, New York, p 377.
42.
Chaudury, M.L. and E.D. Jacobson. 1978. Prostaglandin cytroprotection of gastric mucosa. Gastroenterol 74, 59-63.
43.
Levy, M.W. 1974. Aspirin use in patients with major upper gastrointestinal bleeding and peptic ulcer disease. N. Eng. J. Med. 290, 1158-1162.
44.
Chapamn, M.L. 1978. Peptic ulcer: a medical perspective. Med. Clin. North Am. 6_3, 39-51.
45.
Cohen, M.M. and J.M. Pollett. 1976. Prostaglandin E2 prevents aspirin and indomethacin damage to human gastric mucosa. Surg. Forum 27^, 400-401.
46.
Konturek, S.J., T. Radecki and I. Brzozowski. 1981. Aspirin-induced gastric ulcers in cats - protection by prostacyclin. Dig. Dis. Sei. 26^, 1003-1012.
119 47.
48.
Silen, W., A. M e r h a n and J.N.L. Simson. 1981. The p a t h o p h y s i o l o g y of stress u l c e r s . W o r l d of S u r g e r y 165-175. Messer, J., D. R e i t m a n and H.S. S a c k s . 1983. A s s o c i a t i o n of a d r e n o c o r t i c o s t e r o i d t h e r a p y a n d ulcer disease. N. Engl. J. Med. 309, 21-24.
5,
peptic
RECEPTOR-MEDIATED ANTIPROGESTIN ACTION OF RU 486
Mohammed Kalimi Dept. of Physiology, Medical College of Virginia Virginia Commonwealth University, Richmond, VA
23298, USA
Introduction
Progesterone is known to play a prominent role in female reproductive physiology.
Progesterone can promote uterine growth,
inhibit uterine contraction and, depending on concentration, either potentiate or inhibit actions of estrogen.
The role of progesterone in
promotion and formation of a secretory endometrium is crucial for ovum implantation and pregnancy.
Progesterone is also known to stimulate the
secretory activity of the oviduct.
It also promotes viscosity of
cervical mucus and growth and development of the breast.
Many other
biochemical and physiological effects are attributed to progesterone. For example, it is well known that progesterone induces the secretion of avidin by hen oviduct and uteroglobulin in rabbit uterus.
In view of the
significant physiological and biochemical roles of progesterone in female reproductive physiology, it is natural that intense research efforts have been directed toward synthesizing compounds having biochemically and pharmacologically potent antiprogestin effects.
In 1980, researchers at
Roussel-Uclaf synthesized one of the most exciting antiprogestin compounds designated RU 486 (11 - (4-dimethyl amino phenyl)- 17 -hydroxy, 17 - (propyl-ynyl)- estra - 4, 9 - dien - 3-one). This compound showed both antiprogestin and antiglucocorticoid
Receptor Mediated Antisteroid Action © 1987 Walter de Gruyter & Co., Berlin • New York - Printed in Germany
122
properties
i n v i v o as w e l l as i n v i t r o .
devoid of any agonist activity
(1-5).
The R U 486
is r e p o r t e d to b e
The properties of this
pure
antagonist distinguish RU 486 from other antiprogestin compounds R 2 3 2 3 , R M I 1 2 9 3 6 , etc. w h i c h s h o w b o t h p a r t i a l activities 7).
such as
antagonist/agonist
in experimental animal model system a n d in clinical trials
The antiprogestin RU 486 has potential clinical
interest as
(6-
a
t e r m i n a t o r o f p r e g n a n c y a n d p o s s i b l y as a n a n t i c a n c e r a g e n t i n t h e treatment of advanced hormone-dependent breast cancer.
Indeed,
oral
a d m i n i s t r a t i o n o f t h i s c o m p o u n d is k n o w n to i n t e r r u p t the l u t e a l p h a s e the m e n s t r u a l c y c l e a n d e a r l y p r e g n a n c y i n w o m e n ( 8 - 1 0 ) .
The
aspects of R U 486 are r e v i e w e d elsewhere
Beside
clinical importance of this compound,
in this volume.
the r e c e n t a v a i l a b i l i t y
of
clinical obvious
of
t r i t i a t e d R U 4 8 6 m a y r e p r e s e n t a p o w e r f u l n e w t o o l to e x p l o r e t h e
precise
u n d e r s t a n d i n g o f the m e c h a n i s m o f s t e r o i d h o r m o n e a c t i o n a t t h e
molecular
level.
the
Overall,
the e l u c i d a t i o n o f v a r i o u s m e c h a n i s m s b y w h i c h
synthetic drug RU 486 exerts physiological
its p o t e n t a n t i g e s t i o n a l e f f e c t s
and biochemical actions of progesterone
significant scientific
on
is n o t o n l y
i n t e r e s t b u t m a y l e a d to t h e s y n t h e s i s o f
pharmacologically potent compounds with higher antiprogestional
of improved
activity.
T h e b i o l o g i c a l p o t e n c y o f R U 4 6 8 i n v a r i o u s m o d e l s y s t e m is s u m m a r i z e d Table
I.
in
123 TABLE I
Biological potency (in terms of progesterone action) of RU 486 in various model systems.
System
Biological potency
Observed biological effects
Rat uterus (11)
Pure antagonist
Antinidatory and abortive activity
Rabbit uterus(11,19)
Pure antagonist
Inhibition of endometrial proliferation Inhibition of progesterone induced uteroglobulin mRNA
Human endometrium (16)
Partial agonist antagonist
Given alone has some progestomimetic effects Given with progesterone has pure antagonistic effects
Guinea pig nervous (14)
Pure antagonist
Inhibition of sexual behavior system
Rat nervous system (15)
Pure antagonist
Antagonism of progesterone facilitation of estrous behavior
124
Biological potency
System
Observed biological effects
H u m a n b r e a s t tumor cells T47D (17)
Pure antagonist
Complete inhibition of progesterone
induction
of two proteins T47DCO
(22)
Partial agonist antagonist action
Agonist in terms of growth
inhibition
Antagonist in terms of insulin receptor stimulation H u m a n endometrial cancer cells
Pure antagonist
Antimitotic effects
(HEC-1
In this chapter, I will concisely review our current knowledge the receptor-mediated antiprogestin action of RU 486.
regarding
The m e c h a n i s m of
antiglucocorticoid action of RU 486 will be dealt w i t h in a separate chapter in this book.
Receptor binding!: studies In Vitro In order to u n d e r s t a n d the mechanism b y w h i c h RU 486 antagonizes p r o g e s t i n action, it is of fundamental importance to determine w h e t h e r RU 486 exerts its effect b y binding to the same receptor moiety as the agonist without generating any biological responses.
In contrast,
the
125
a n t a g o n i s t m a y b i n d to a n e n t i r e l y d i f f e r e n t p r o t e i n a n d s o m e h o w agonist-receptor
complex interaction or post-receptor
modulate
events.
E x c e p t for one report w h i c h will be m e n t i o n e d later,
current
findings from several laboratories suggest that RU 486 clearly acts b i n d i n g w i t h h i g h a f f i n i t y to the p r o g e s t e r o n e r e c e p t o r o f v a r i o u s tissues.
Philbert
(11) r e p o r t e d a v e r y h i g h r e l a t i v e b i n d i n g
(about 5 times) of R U 486 for rabbit uterine progesterone c o m p a r e d to p r o g e s t e r o n e .
The association constant of
target
affinity
receptor
[ H] R U 4 8 6
for
the r a t u t e r i n e p r o g e s t e r o n e
receptor was about 2 times higher than
of synthetic p r o g e s t i n R5020
(11).
in various target tissues
a f f i n i t y o f t h i s c o m p o u n d f o r the p r o g e s t e r o n e i n the d i s s o c i a t i o n r a t e a t 4 ° C o f progesterone
receptors.
is a l s o
[^H] R U 4 8 6 f r o m r a t
uterine
The half-time of d i s s o c i a t i o n of
higher
apparent
[^H] R U 4 8 6 ,
70 m i n . , a n d 10 m i n . ,
(MBH-PIA) cytosolic progesterone
receptors
b i n d i n g a f f i n i t y w a s c a l c u l a t e d to b e 50 c o m p a r e d to Etgen and Barfield
(15) o b s e r v e d t h a t R U 4 8 6
HPOA cytosols were
(relative
is a c o m p e t i t i v e
inhibitor
(HPOA).
incubated with various concentrations
When
(0.5-20 nM)
of
486 i n the p r e s e n c e or a b s e n c e o f u n l a b e l l e d p r o g e s t e r o n e ,
affinity,
limited capacity binding was detected kd=8.4 nM
injected)
and kd=l.7 nm
(in 8 y g E2 b e n z o a t e
a high
(in o i l
injected 48h before
P r o g e s t i n s w e r e f o u n d to b e the m o s t e f f e c t i v e c o m p e t i t o r binding,
of
progesterone).
[^H] R 5 0 2 0 b i n d i n g i n r a t h y p o t h a l a m u s p r e o p t i c a r e a
[3H] RU
The
B r o w n a n d B l a u s t e i n (14) r e p o r t e d h i g h a f f i n i t y b i n d i n g
R U 4 8 6 to n e u r a l
of
(12,13).
the
higher
receptor
R 5 0 2 0 a n d p r o g e s t e r o n e w e r e f o u n d to b e 16 h o u r s , respectively.
that
I t is n o t e w o r t h y to m e n t i o n t h a t
a s s o c i a t i o n c o n s t a n t o f R 5 0 2 0 w a s r e p o r t e d to b e a b o u t 7 t i m e s than that of progesterone
by
for
death).
[^H] R U 4 8 6
suggesting a n a n t i p r o g e s t i n effect of this c o m p o u n d rather
than
126
an antiglucocorticoid effect in the nervous system.
However, they have
not ruled out the binding of RU 486 to neural glucocorticoid receptor sites beside progesterone receptors.
Gravanis et al. (16) showed high
affinity binding of [ 3 H] RU 486 in cytosols of endometrium obtained from post-menopausal women.
The kd for [ 3 H] RU 486 and [ 3 H] progesterone
binding to the endometrium progesterone receptor was 0.8 nM and 1.2 nM, respectively.
Interestingly, the presence of 30% glycerol in the cytosol
resulted in a significant decrease in the affinity of RU 486 for the progesterone receptor, while the affinity of progesterone for the progesterone receptor remained unchanged. RU 486 (17) is known to suppress the growth of human breast cancer cells in vitro and also inhibits progesterone induction of a number of proteins.
These effects of RU 486 are shown to be mediated by its high
affinity binding to progestin receptors in breast cancer cell lines such as MCF7 and T47D (17).
It was further shown that this growth suppressing
effect was dose-dependent and its magnitude correlated well with the progesterone receptor concentration in these cell lines (17).
The
selective antiprogestronic effect of this compound was demonstrated by the fact that addition of dexamethasone, estradiol or testosterone were unable to reverse the growth inhibitory effect of RU 486, but cells readily responded to low concentration of progestin R5020. Moudgil et al. (18) carried out both competition and stability experiments and conc luded that [ 3 H] RU 486 and [ 3 H] progesterone bind to the
same receptor moiety in the calf uterus cytosol.
Finally, no
immunological differences were observed between [ 3 H] R5020 (agonist) and o [ H] RU 486 (antagonist) receptor complexes of rabbit endometrium cytosol when titrated against five monoclonal antibodies raised against purified
127
R5020-receptor
complex
(19).
T h i s f i n d i n g i n d i c a t e s t h a t t h e r e are
major structural differences between agonist and antagonist c o m p l e x e s to a c c o u n t for the o b s e r v e d d i f f e r e n c e s activity of these two
i n the
receptor
biological
compounds.
I t is a p p a r e n t f r o m the r e v i e w e d l i t e r a t u r e
that R U 486 brings
its a n t i p r o g e s t i n a c t i o n s b y b i n d i n g w i t h h i g h a f f i n i t y to progesterone receptor present in various m a m m a l i a n target Unlike
no
about
the tissues.
the m a m m a l i a n s y s t e m , r e c e n t c h a r a c t e r i z a t i o n o f R U 4 8 6 b i n d i n g
chick oviduct
(avian) cytosol
(20) s u g g e s t s a s e p a r a t e b i n d i n g s i t e
[3H] RU 486 and
[3H] progesterone.
oviduct cytosol
(20), it w a s o b s e r v e d t h a t l i k e
In b i n d i n g studies u s i n g
R U 4 8 6 w h e n a d d e d u p to 50 n M l e v e l w a s u n a b l e
for
chick
[3H] progesterone, to r e a c h the
in
[3H]
saturation.
o In this system,
[ H] R U 4 8 6 w a s n o t d i s p l a c e d b y l a r g e e x c e s s
unlabelled progesterone likewise
ineffective
of
a n d 1000 f o l d e x c e s s o f u n l a b e l l e d R U 4 8 6 o
in displacing
[ H] p r o g e s t e r o n e b i n d i n g .
addition,
d e n a t u r a t i o n s t u d i e s s h o w e d t h a t a l m o s t 40% o f c h i c k
cytosolic
[ H] p r o g e s t e r o n e - r e c e p t o r
incubation at 37°C, whereas
the
Further
[3H] progesterone
and
h e t e r o g e n i t y b e t w e e n t h e s e two c o m p o u n d s
(20).
exchange chromatography on DEAE-sephacel
columns and
physicochemical [ 3 H ] R U 486
labelled cytosol
receptor
binding
For example, b o t h
ion
sucrose-density
g r a d i e n t s a n a l y s i s s u g g e s t the p r e s e n c e o f two l a b e l l e d s p e c i e s [ H] p r o g e s t e r o n e
oviduct
[ 3 H ] R U 4 8 6 c o m p l e x w a s f o u n d to b e
complexes of chick oviduct again revealed macromolecular
case of
In
complex was inactivated within 5 min
s t a b l e u p to 60 m i n o f i n c u b a t i o n a t 37°C. characterization of cytosolic
was
i n the
(two r a d i o a c t i v i t y p e a k s
DEAE-sephacel columns and 4 S and 8 S moieties on sucrose
density
gradients).
(one
O n the o t h e r h a n d , a s i n g l e l a b e l l e d s p e c i e s
on
128
radioactivity peak on DEAE-sephacel column and 4 S
moiety on
sucrose[JH] RU
density gradients) was observed when cytosol was labelled with 486
(20).
R U 486 b i n d i n g
in vivo
Oral doses
( l - 1 0 m g / k g ) o f R U 4 8 6 w h e n a d m i n i s t e r e d to
rats resulted in a dose-dependent decrease of p r o g e s t e r o n e receptors
in rat uterus
overiectomized
in percent free binding
(11).
The total saturation
progesterone receptor b i n d i n g sites in vivo was a t t a i n e d at a dose.
A g o o d c o r r e l a t i o n was n o t e d b e t w e e n the amount of RU
486 induced
responses such as endometrial p r o l i f e r a t i o n and increased volume o f m i t o c h o n d r i a a n d c o m p l e t e o c c u p a n c y o f free p r o g e s t e r o n e (11).
This finding suggests that RU 486
of
lOmg/kg
( l O m g / k g ) r e q u i r e d f o r the c o m p l e t e a n t a g o n i s m o f p r o g e s t e r o n e
binding sites
sites
density
receptor
inhibits
p r o g e s t e r o n e a c t i o n b y b i n d i n g to the p r o g e s t e r o n e r e c e p t o r i n v i v o . R U 486 behaviour
injection
(5mg) w a s a b l e to i n h i b i t the e x p r e s s i o n o f
in o v a r i e c t o m i z e d estrogen-primed guinea pigs treated w i t h
0.lmg progesterone
(14).
This dose
(5mg) r e s u l t e d i n a 44% d e c r e a s e
the n u m b e r o f a v a i l a b l e p r o g e s t i n b i n d i n g s i t e s i n h y p o t h a l a m i c cytosol, w i t h no observable alteration in b i n d i n g affinity Similarly,
sexual
Etegen and Barfield
intracerebral
i n the
h y p o t h a l a m u s o f f e m a l e r a t s w a s a b l e to a n t a g o n i z e facilitated estrous behavior.
or
ventromedial progesterone
T h i s e f f e c t w a s f o u n d to b e m e d i a t e d b y
interference with progesterone receptor binding. present time w h y such a h i g h dose to a n t a g o n i z e the p r o g e s t e r o n e
(MBH-POA)
(14).
(15) d e m o n s t r a t e d t h a t s y s t e m a t i c
i n j e c t i o n o f the 5 m g o f R U 4 8 6
in
(5-10mg/kg)
I t is n o t c l e a r a t
the
o f R U 486 is n e e d e d i n v i v o
induced biological responses when
it
129
displays very potent affinity similar to progesterone and R5020 for the progesterone receptor in vitro (11-15).
For example, R5020 is known to
saturate the free progesterone receptor binding sites in vivo at doses lower than 50 Ug/kg.
One explanation for such a higher in vivo
requirement of RU 486 to obtain complete antiprogestional activity may be due to a higher level of binding of RU 486 to the plasma proteins. However, Mcguilewsky and Phibert (21) have reported that except for humans, other animal species such as rat, rabbit, pig, and monkey, had hardly any detectable specific binding of [^H] RU 486 to plasma proteins. Of course, it is likely that beside other factors, characteristic pharmokinetics and metabolism of RU 486 may account for higher dose requirements of RU 486 in vivo to interact with target tissue cytplasmic progesterone receptors.
Activation and nuclear bindinp studies In mammalian species studied so far, it is apparent that progesterone and RU 486 seem to reversibly compete for the same receptor unit with high affinity (11,14,16,17).
Therefore, it is natural to
presume that antiprogestinic properties of this compound, in spite of its high affinity binding to agonist receptor may reside at the steps beyond initial binding of hormone to the receptors, i.e. impairment at the level of either activation of [^H] RU 486-receptor complex or at the level of nuclear binding of the activated [^H] RU 486-receptor complex when compared with agonist-receptor complex. Moguilewsky and Philbert (21) found no defect in either in vitro o thermal activation or in binding of thermally activated [ H] RU 486receptor complex to the nuclei of rabbit uterus.
They reported that heat
130
treated cytoplasmic [^H] RU 486-progesterone receptor complex of rabbit uterus was bound readily to DNA-cellulose.
Also purified nuclei of
endometrial cells of rabbit uterus when incubated with [^H] RU 486 showed a rapid uptake of specific radioactivity (21).
Since both activation and
nuclear binding were found to be functional with antagonist bound receptor complex, they concluded that the probable reason of antagonistic properties of RU 486 may lie in a step beyond the thermal activation and nuclear binding states, i.e. at the regulatory region of the genes. Rauch et al. (19) studied progesterone induced inhibition of uteroglobin gene expression in the rabbit endometrium of RU 486.
They
have shown that in this system RU 486 was able to totally inhibit the progesterone induction of uteroglobin mRNA without demonstrating any agonistic activity.
High affinity binding of [^H] RU 486 with cytosolic
progesterone receptors has been identified in rabbit uterus previously (11).
Unfortunately, this binding was unable to enhance the
transcription of the uteroglobin gene.
Therefore detailed studies were
conducted by them (19) to characterize whether impairment in the thermal activation or subsequent nuclear binding of thermally activated receptor complex could account for the observed antagonist properties of this compound.
Rauch et al. (19) observed only a slight decrease in the
binding to DNA-cellulose between thermally activated agonist [ 3 H] R5020 receptor complex (47%) and antagonist [^H] RU 486-receptor complex (37%). This slight difference was found to be due to a decrease in thermal activation as well as decrease in affinity of activated complexes to bind to DNA.
This observed difference also persisted when [^H] RU 486 and
[ H] 5020 bound receptor complexes were characterized on phosphocellulose and DEAE cellulose column chromatography.
(These charged resins are
131
k n o w n to d i f f e r e n t i a l l y r e t a i n a n d e l u t e the a c t i v a t e d a n d receptor complexes.)
Decreased affinity of
[%]
nonactivated
RU 486-receptor
to D N A w a s a l s o a p p a r e n t w h e n D N A b o u n d a g o n i s t a n d a n t a g o n i s t were e l u t e d b y h i g h salt.
complexes
F r o m the o b t a i n e d d a t a t h e y c o n c l u d e d
relatively minor differences
in activation and DNA affinity data
n o t a c c o u n t f o r the c o m p l e t e a n t a g o n i s t a c t i o n o f R U 4 8 6 a n d a n t i p r o g e s t o n i c effects of R U 486 lies b e y o n d receptor
(22) r e p o r t e d t h a t b o t h
[3H] R5020 and
that could
therefore,
binding,
a c t i v a t i o n a n d n u c l e a r b i n d i n g o f the a c t i v a t e d r e c e p t o r - h o r m o n e Horowitz
complex
complex.
[ 3 H ] R U 4 8 6 a t 10 n M
c o n c e n t r a t i o n b o u n d e q u a l l y w e l l to two p r o g e s t e r o n e r e c e p t o r
subunits
(mol w t 1 0 8 , 0 0 0 a n d 8 4 , 0 0 0 ) p r e s e n t i n the n u c l e i o f T 4 7 D c o h u m a n b r e a s t c a n c e r ce lis.
The binding of
[3H] R5020
to b o t h p r o g e s t e r o n e
subunits was abolished by unlabeled R5020, progesterone Unlabelled dexamethasone,
receptor
or R U 486.
and hydrocortisone were unable
to
compete.
These results d e m o n s t r a t e d that in intact T47Dco h u m a n cancer cells, 486 binds
s p e c i f i c a l l y to p r o g e s t e r o n e
receptors.
T h e a f f i n i t y o f R U 4 8 6 for the p r o g e s t e r o n e i n t a c t c e l l s w a s f o u n d to b e K d = 2 n M a t 0 - 4 ° C
receptor in vitro and
(22).
In intact cells,
h o u r t r e a t m e n t w i t h 4 n M o f R U 486 w a s a b l e to t r a n s l o c a t e a l m o s t 80% progesterone
r e c e p t o r to h i g h a f f i n i t y n u c l e a r b i n d i n g s i t e s .
c o n c e n t r a t i o n of R U 486 m o b i l i z i n g more than 20,000 fmol r e c e p t o r / m g D N A i n d i c a t e s t h a t the h o r m o n e progesterone
receptor
in
one of
Such a
low
progesterone
is i n t e r a c t i n g d i r e c t l y
with
(22).
The observation of Horowitz activity of R U 486
RU
(22) s u g g e s t s t h a t the
antiprogestin
i n the T 4 7 D c o c e l l l i n e is n o t d u e to the
t r a n s l o c a t i o n o f the a c t i v a t e d R U 4 8 6 - r e c e p t o r c o m p l e x b u t s o m e w h e r e d i s t a l to n u c l e a r b i n d i n g .
However,
impaired
i n t o the
nuclei
the p o s s i b i l i t y
that
132
the binding sites of RU 486-nuclear complexes may differ from those of R5020 or that the fit of RU 486 into the active site of the receptor may differ from that of R5020 is not ruled out by her investigation. It is clear from the studies carried out with rabbit uterus (11,19) and a variant form of human breast cancer cell line (22) that at least in these systems, both agonist and antagonist showed high affinity receptor binding, almost normal activation and subsequent high affinity nuclear binding of the activated complexes.
This suggests that antagonist action
of RU 486 may reside at step distal to nuclear binding, or that there are some conformational changes in antagonist-receptor complex after activation in such a way that these complexes may bind at the nuclear site other than the active site. In contrast to rabbit uterus (19) and human breast cancer cell line (22), certain gross changes were noted between agonist and antagonist bound receptor complexes in some other systems.
For example, Mullick and
Katzenellenbogen (23) using sucrose density gradient technique, characterized the [ 3 H] RU 486 and [ 3 H] R5020 binding with progesterone receptors of MCF7 and T47D human breast cancer cells.
In high salt
o sucrose gradients, salt extracted nuc lear [ J H] 5020 -receptor complexes of both cell lines, sedimented with a single peak as a 4 S species. Interestingly, two distinct 6 S and 4 S species were detected under a similar condition when RU 486-receptor complexes were analyzed.
The [ 3 H]
RU 486 binding was specific to progesterone receptors, since excess of cold R5020, progesterone or RU 486 effectively displaced the [ 3 H] RU 486 binding, while excess cold dexamethasone or hydrocortisone were found to be ineffective.
They ruled out the possibility of association of DNA or
RNA with the 6 S complex, since digestion with either DNAse or RNAse was
133
unable to alter the 6 S form.
However, treatment with either 10 mM
thioglycerol or 3M urea resulted in conversion of 6 S to 4 S form, suggesting that the 6 S may represent an aggregate resulting from association between the two receptor units or between receptor and some other protein.
They speculated the possibility of defective chromatin
binding of this larger aggregate species.
This could explain the
antagonist effect of RU 486 at the molecular level.
Similarly, Hurd and
Moudgil (24) presented evidence showing the impaired transformation (from 8 S to 4 S) of antagonist [ 3 H] RU 486 bound cytosolic progesterone receptor of calf uterus as compared to agonist [ 3 H] R5020.
In 8-30%
linear glycerol gradients containing 0.15 M KC1 and 20 mM sodium molybdate they observed that both [ 3 H] RU 486 and [ 3 H] R5020 receptor complexes sedimented as 8 S species.
Interestingly, on incubation of
samples at 23°C for 10-60 min, in 1-10 mM ATP or with 0.3 M KC1 resulted in conversion of 8 S to 4 S in case of [ 3 H] progesterone bound progesterone-receptor complex whereas similarly treated samples containing [ H] RU 486 bound progesterone-receptor complex displayed only 8 S species and except for a decrease in the 8 S form, there was no conversion of 8 S to 4 S detected.
These results indicate that impaired
transformation of [-"H] RU 486-receptor complex could explain the observed antagonist actions of this compared.
Table II represents the summary
of our current understanding of receptor mediated antiprogestin action of RU 486.
134
TABLE II
Summary of receptor mediated antiprogestin action of RU 486
Model System
I. (i)
Rabbit uteroglobin gene expression (19)
(ii) Estrogen-insensitive T47Dco human breast cancer cells (22) (a)
High affinity receptor binding
(b)
Almost normal activation of the antagonist-receptor complex
(c)
Almost normal nuclear binding of the activated antagonistreceptor complex
(d)
Possible defect may be due to (i) altered conformation of the antagonist-receptor complex resulting in inadequate interaction with the regulatory regions of genes or (ii) steps further to nuclear binding
II. (i)
Calf uterus (24)
(ii) HCF7 cells (23) (a)
Impaired activation of antagonist-receptor complex (impaired conversion of 8 S or 6 S antagonist-receptor complex into 4 S).
It could be summarized from the 1 imited data available at the present time that the antagonistic properties of the RU 486 may reside in its impaired transformation ability as shown in the case of calf uterus
135 or human breast cancer cell lines (23,24) or at the site distal to initial binding, activation and nuclear binding of the activated receptor-steroid complex as shown in the case of rabbit uterus (19). More studies are needed both at the level of activation step and the interaction of the antagonistic receptor complex with the regulatory regions of discrete genes using state of the art techniques such as monoclonal antibodies, recombinant DNA, and immunohistochemical techniques, to precisely understand at the molecular level the antagonistic action of this potent and clinically useful antiprogestinic compound.
REFERENCES 1.
Philbert, D., R. Deraedt, G Teutsch, C. Tournemine, E. Sakiz, 1982. Endocrine society 64th annual meeting, San Francisco, Abstr. 668.
2.
Chobert, M., R. Barouki, J. Finidori, M. Aggerbeck, J. Hanoune, D. Philbert, R. Deraedt, 1983.
3.
Biochem. Pharmacol. 32, 3481-3483.
Healy, D., E. Baulieu, G. Hodgen, 1983.
Fertil. Steril. 40, 253-
257. 4.
Jung-Testas, I., E. Baulieu, 1984.
5.
Moguilewsky, M., D. Philbert, 1984.
J. Steroid Biochem. 20, 301-306. J. Steroid Biochemistry 20.
271-276. 6.
Kendle, K., 1979.
In antihormones (M.K. Agarwal Ed), Elsevier/North
Holland Biomedical Press, pp. 239-305. 7.
Kendle, K., 1982.
In hormone antagonists (M.K. Agarwal Ed), De
Gruyter, Berlin, New York, pp. 233-246.
136 8.
E l g e r , W . , S. B e i e r , K . C h w a l i s z , M . F ä h n r i c h , H e n d e r s o n , G. N e e f , a n d R. R o h d e , 1 9 8 6 . 25,
S. H a s a n ,
J. S t e r o i d
D.
Biochemistry,
835-845.
9.
R a y n a u d , J . , T. O j a s o o ,
10.
B a u l i e u , E., 1986.
11.
Philbert, D., 1984. Ed), pp.
1986.
J. S t e r o i d B i o c h e m i s t r y 25,
J. S t e r o i d B i o c h e m i s t r y
25,
811-833.
847-851.
In adrenal steroid antagonism
(M.K.
Agarwal.
77-101.
12.
P h i l b e r t , D., J. R a y n a u d ,
1973.
S t e r o i d s 22,
13.
P h i l b e r t , D . , T. O j a s o o , J. R a y n a u d ,
1977.
89-98.
Endocrinology
101,
1850-
1861. 14.
B r o w n , T. a n d J . B l a u s t e i n ,
15.
E t g e n , A. a n d R. B a r f i e l d ,
16.
G r a v a n i s , A . , G. S c h a i s o n , G. D e B r u x , P. S a t y a s w a r o o p ,
17.
1985.
B r a i n R e s e a r c h 301,
1986.
Endocrinology
a n d P.
Röbel,
Bordon,
S., F. V i g n o n , D. C h a l b o s ,
119,
J. C l i n . E n d o , a n d M e t a b . 60,
C l i n . E n d o , a n d M e t a b . 65, 18.
1984.
343-349.
1610-1617. E.
156-153.
a n d H. R o c h e f o r t ,
1985.
M o u d g i l , V . , N. E l i e z e r , C. L o m b a r d o ,
C. H u r d , a n d M . A g a r w a l ,
R a u c h , M . , H. L o o s f e l t , D. P h i l i b e r t , Biochem.
20.
148,
21.
of
1986.
1007.
1985.
Eur. J.
213-218.
B i o p h y s . A c t a 889,
Plenum Press, New York, pp. Horowitz, K., 1985.
and M. Agarwal,
1986.
192-199.
M c g u i l e w s k y , M. a n d D. P h i l b e r t , RU 486 and fertility control
22.
a n d E. M i l g r o m ,
M o u d g i l , V . , G. L o m b a r d o , C. Hurd, N. E l i e z e r Biochim.
J.
692-697.
Endocrine Society 68th Annual Meeting, Anaheim, Abstr. 19.
Baulieu,
1986.
(Segal,
I n the a n t i p r o g e s t i n
S. a n d E. B a u l i e u ,
99.
Endocrinology,
116,
2236-2245.
steroid
Eds.),
23.
M u l l i c k , A. a n d B. K a t z e n e l l e n b o g e n , Commun.
24.
25.
135.
1986.
Biochem. Biophy.
Res.
90-97.
H u r d , C. a n d V . M o u d g i l ,
1986.
Meeting, Anaheim, Abstr.
1008.
L i u , H. a n d Z. R o s e n w a k s , Meeting, Anaheim, Abstr.
1986. 1009.
Endocrine Society 68th Annual
Endocrine Society 68th Annual
THE ANTIGLUCOCORTICOID EFFECTS OF CORTEXOLONE AND R U 38486 IN THE H U M A N LEUKEMIC CELL LINE CEM-C7
Thomas J. Schmidt Department of Physiology and Biophysics College of Medicine The University of Iowa Iowa City, Iowa 52242
Introduction
Antiglucocorticoids,
by
definition,
are
compounds
which
antagonize or block the biological response to glucocorticoid agonists
in
various
target tissues and cell types.
In the
series
of experiments outlined in this chapter my laboratory
has
compared
the
antiglucocorticoids,
ability
cortexolone
glucocorticoid-mediated line,
CEM-C7.
of and
two
RU
steroidal
38486,
to
block
responses in the h u m a n leukemic cell
W e have utilized CEM-C7 for these comparative
studies because glucocorticoid agonists such as triamcinolone acetonide glutamine (cell
(TA)
elicit
synthetase
lysis)
both
an
activity)
response
anabolic
(1)
(induction
(2) in this cell line, and because of
the availability of a glucocorticoid-resistant subclone, In and
3R7.
addition to investigating the ability of both cortexolone RU
partial two
of
as well as a catabolic
38486 agonist
independent
characterized
to
function activity
agonist-mediated the
antiglucocorticoids CEM-C7.
as
pure antagonists
(elicit no
when given alone) and block these responses,
interaction
of
we
have also
these
two
with cytoplasmic receptors isolated from
W e have analyzed the specificity of this cytoplasmic
binding and have evaluated the potential ability of these two
Receptor Mediated Antisteroid Action © 1987 Walter de Gruyter & Co., Berlin • New York - Printed in Germany
140
steroids to promote in vitro receptor activation (conversion to a DNA-binding form) under a variety of experimental conditions. Subsequently, binding of activated agonist- or antagonist- receptor complexes to DNA has also been studied. The data which will be reviewed indicate that although both cortexolone and RU 38486 function as antiglucocorticoids via their ability to compete with agonists for the steroid binding site within the unactivated cytoplasmic receptor, they do differ significantly in regard to their ability to promote crucial post receptor-occupancy steps, such as activation and DNA binding, which are required if a steroid is to elicit a receptor-mediated biological response. As will be discussed, the experimental results which we have obtained with RU 38486 suggest that once the cytoplasmic receptor has undergone steroid-dependent activation and nuclear translocation, the ligand (agonist or antagonist) may continue to play a major role in terms of modulating the ability of the activated receptors to regulate gene expression.
Background
The cytotoxic effects of glucocorticoid hormones on sensitive lymphoid cells are mediated by intracellular receptors which bind these steroids with high affinity and specificity (for a review see Ref. 3). Once the glucocorticoid molecule has diffused into the target cell and bound to its cytoplasmic receptor, these complexes must undergo a two-step process in order to bind to nuclei and ultimately affect gene expression. The first temperature-dependent step, termed "activation" or "transformation", is thought to involve a conformational_change in the glucocorticoid-receptor complex, resulting in the exposure of positively charged amino acid residues on the surface of the protein (4, 5). These activated complexes exhibit an altered elution profile from
141
anion exchange resins such as DEAE-cellulose (6) and an increased affinity for nuclei and polyanions such as DNAcellulose (4, 7-9). Despite the present uncertainty concerning the underlying biochemical mechanism(s) of activation (for a review see ref. 10), this alteration represents a physiologically relevant step, since it occurs in vivo in a variety of cell and tissue types and is a prerequisite for nuclear binding (11-13). The second temperature-independent step is termed "translocation" and involves the movement of the previously activated complexes into the nucleus where they bind to acceptor sites within the chromatin (14), and, more specifically, to DNA sequences which flank genes whose expression is regulated by glucocorticoids (15-17). The net result of this nuclear interaction is the initiation of messenger RNA synthesis and ultimate translation into specific proteins whose activities constitute the phenotypic response. Glucocorticoid-induced
lymphocytolysis
has been studied for
many years, but the precise mechanism by which these steroids mediate
cell
laboratories
have
lymphocytes amino
death
not
been
elucidated.
Numerous
reported that glucocorticoid treatment of
reduces
acids,
has
and
the transmembrane transport of glucose, nucleosides,
as
well
as
decreases the
synthesis of proteins, lipids, and nucleic acids (for reviews see
refs.
inhibitors was
3,
by
Based on experiments which utilized
of RNA (20-22) and protein (20, 23) synthesis, it
suggested
induced
18, 19). that
specific
glucocorticoids
RNA(s)
and/or protein(s) are
(24, 25).
Although this concept
of glucocorticoid-mediated induction of a "killer" protein(s) received considerable support, other alternative theories for 2+ glucocorticoid-induced cytolysis included enhanced Ca uptake nuclear
(26) and release of free fatty acids which damage the membrane (27).
More recent experiments suggest that
glucocorticoids activate, via a receptor-mediated process, an endonuclease-like
activity
the
lymphocyte
DNA
fragmentation
in
lymphoid cells which cleaves
genome at internucleosomal sites (28). appears
to
precede
This
lymphocytolysis and
142
hence may represent the key triggering event in the steroid regulation of cell death. Consistent with this nuclease theory is the observation that low concentrations of benzamide, a potent inhibitor of poly(ADP-ribose) synthetase (an enzyme involved in DNA repair), enhances the cytotoxicity of glucocorticoids and shortens the interval between hormone addition and the onset of lymphoid cell death (29). A s previously defined, antiglucocorticoids are steroids w h i c h antagonize
or
block
the
biological
responses
to
glucocorticoid agonists (30). The antiglucocorticoid cortexolone has b e e n u s e d extensively for almost twenty years and
has
proven
analysis action.
to
be
an
extremely
useful
tool for the
of the mechanism(s) of glucocorticoid hormone Since early studies w h i c h demonstrated t h a t this
compound could block the inhibitory effects of glucocorticoids on rat thymus cells (31), cortexolone has b e e n reported to function as an antiglucocorticoid in a wide variety
of
target tissues and cell types including:
thymic
lymphocytes (32-36); leukemic lymphocytes and m y o b l a s t s (37); bone (38); chick retina (39); hepatoma tissue culture cells (40);
Hela
cells
the mouse brain block inhibition histamine
(41-43); and the locus ceruleus r e g i o n of (44) . Cortexolone has also b e e n shown to by dexamethasone of the stress response to
(45).
Despite
the
widespread
use
of
this
antiglucocorticoid, the results of experiments in w h i c h the 3 binding of [ H]cortexolone has been studied are somewhat conflicting, especially w i t h regard to nuclear binding. and
Munck
(46) concluded from their studies w i t h intact rat 3 cells that [ H]cortexolone-receptor complexes undergo
thymus
temperature-dependent despite
the
fact
glucocorticoid (36,
Wira
47)
translocation
that
these
and
complexes
response in these cells.
employed
sucrose
bind fail Other
to
nuclei,
to elicit a investigators
density gradient analyses which
indicated that cortexolone-receptor complexes exhibit altered physicochemical complexes.
properties
These
data
when
compared
w i t h TA-receptor
suggested that cortexolone-receptor
complexes either fail to translocate into the nucleus, or, if
143
they do translocate, exhibit a very low affinity for nuclear acceptor sites and hence fail to mediate a biological response. Finally, using autoradiographic procedures, Coutard and Osborne-Pellegrin (48) were unable to detect nuclear accumulation of radioactivity in the mouse brain 3 after injection of [ H]cortexolone. Taken collectively these published data have raised questions concerning the potential ability of cortexolone, once it has presumably bound to unactivated cytoplasmic receptors, to promote receptor activation and DNA binding. In the experiments to be subsequently described, my laboratory has attempted to clarify these discrepancies by analyzing the in vitro binding 3 of [ H]cortexolone to cytoplasmic CEM-C7 receptors (49). More specifically, we have performed a series of experiments which were designed to help us ascertain whether this antiglucocorticoid can promote in vitro activation. Most recently the synthetic steroid RU 38486 (17 3 -hydroxy116 -(4-dimethylaminophenyl)-17a-(l-propynyl) estra-4,9-dien3-one) has been utilized extensively as a pure antiglucocorticoid. Unlike cortexolone, which can be metabolized in the adrenals to a partial agonist (50), RU 38486 is capable of fully antagonizing the acute and chronic effects of glucocorticoids in vitro as well as in vivo without exhibiting partial agonist activity, even when administered at high doses (51, 52). For example, this potent new 19-norsteroid has been reported to: completely antagonize the ability of dexamethasone to inhibit uridine incorporation in isolated thymocytes as well as the ability of this agonist to suppress rat thymus weight when administered chronically (51) ; antagonize the glucocorticoidinduced cytolytic response of murine T-lymphoid cell lines (53); block the dexamethasone induction of hepatic tyrosine aminotransferase (51) and atrial natriuretic factor (54); antagonize dexamethasone-induced suppression of ACTH release by rat pituitary cells in vitro (52); and alleviate many of the symptoms of hypercortisolism in a patient with Cushing's syndrome (55). Several studies have attempted to explain why
144
RU 38486, when given alone, elicits no agonist activity despite the fact that it binds with high affinity to cytoplasmic receptors. As was also the case with cortexolone, the results of these experiments were somewhat conflicting, particularly with regard to nuclear binding of [ 3 H]RU 38486. Mougilewsky and Philibert (56) reported that 3 cytoplasmic rat thymic [ H]RU 38486-receptor complexes can be thermally activated in vitro to a less stable activated form from which the antiglucocorticoid rapidly dissociates. They speculated that this "impaired activation" of cytoplasmic 3 [ H]RU 38486-receptor complexes renders them unable to translocate properly into the nucleus and subsequently initiate a glucocorticoid response. Bourgeois et al. (53) also reported that activated [3H]RU 38486-receptor complexes from rat liver and murine T-lymphoid cells exhibit a lower 3 affinity, as compared to activated [ H]TA-receptor complexes, for both nonspecific DNA-cellulose and for a DNA fragment in the promotor region of MMTV proviral DNA which is known to contain high affinity sites for activated glucocorticoidreceptors. Consistent with these results was the observation that [3H]RU 38486 was less effective than [3H]TA in promoting nuclear translocation of receptors in these murine T-lymphoid cells. In contrast, Coutard and Duval (57) utilized 3 autoradiography to localize [ H]RU 38486 in various glucocorticoid target tissues and detected specific nuclear translocation in brain, liver and kidney. Once again these data have raised questions concerning the potential ability of RU 38486 to promote receptor activation and DNA binding. Again, in an attempt to clarify these discrepancies my laboratory has conducted a series 3 of experiments designed to characterize the interaction of [ H]RU 38486 with cytoplasmic CEM-C7 receptors and to evaluate the potential role of this relatively new antiglucocorticoid in promoting in vitro activation (58). In all of the experiments to be described we have compared the effects of the two antiglucocorticoids, cortexolone and RU 38486, with those of the potent synthetic agonist, triamcinolone acetonide.
145
HjCs, 'N
CHjOH
CH,OH B-
activity
in
16a-methyl-deri. vate
at
all.
and
its
denvates Spirortnont 30
d*rivat*s
100'/.
300
1000
Spironolactone
jog
¡-CM,
J
II
Spirortnont
[—r°
III
IV
MO (CHj^-OH
I
Fig.
5
I
rtlativ*
affinity
to MCf> in
rtlalivr
aniioldoittront
vitro
tfftcl
in
vtvo
A f f i n i t y f o r r a t r e n a l m i n e r a l o c o r t i c o i . d r e c e p t o r s in v i t r o a n d m a x i m a l r e l a t i v e a n t i a l d o s t e r o n e p o t e n c y in r a t s o f s p i r o r e n o n e a n d r e l a t e d c o m p o u n d s in c o m p a r i s o n to s p i r o n o l a c t o n e .
180
Spirorenone
related
30
derivotes
100%
300
1000
rtlative
affinity
to MCR in
rtlalivt
antialdosterone
Spironolactont I—
*-C-CM3
MB (CM,^OH
•Jair
] ig.
6
a
(Fig.
6).
5 , Fig.
new
was
8.6
higher
was
not
reflected
lative
binding
contrast,
showed
in
The
spironolactone
potent
only
50
tone
formation
%
of
mean
that
by
an
affinity ^^> ^2
potent
relative
of
in
in vivo
spirorenone
saturated
derivate
in
vivo
activity
averaged
its
affinity
doubled
than
deri. v a t e
in
being
as
of
vitro
to
its
7.5
was
receptor
spironolactone.
(17a-hydroxy-,
of
however,
binding,
the
re-
73 spirorenone
effects
that
spirorenone
spironolactone
compared
higher
antagonists spirorenone
This,
receptor
well
and
of
spironolactone.
increase of
aldosterone potency
as
17-spiroether
more
group
The
than
the
vivo
nolactone.
The
effect
Affinity for rat r e n a l u i n e r a l o c o r t i c o i d receptors in vitro and m a x i m a l r e l a t i v e a n t i a l d o s t e r o n e p o t e n c y in r a t s o f s p i r o r e n o n e r e l a t e d c o m p o u n d s in comparison to spironolactone.
Spirorenones,
In
vitro
than
times of
that
the
still
of
standard. 1.7
affinity
Modification
spiro-
of
times
being the
17g-hydroxypropyl-derivate
lacof
181
Table
1.
Compound
A f f i n i t y for r e n a l m i n e r a l o c o r t i c o i d r e c e p t o r s ( M C R ) o f r a t s in v i t r o a n d m a x i m a l r e l a t i v e a n t i a l d o s t e r o n e p o t e n c y ( M R P ) in r a t s o f s p i r o n o l a c t o n e d é r i v â t e s in c o m p a r i s o n to s p i r o n o l a c t o n e
Relevant modifications c o m p a r e d to spironolactone
17a-H ydroxypropy1 I
111
IV V VI
7
unsaturated
Uli VIII
IX
X
XI XII
at
184
< 1
No
activity
< 1
No
activity
24
46
( 28-83
)
< 1 54.4
32 34
( 21-45 ( 19-56
) )
152
141
(
98-221)
4. 0
71
(
21-157)
< 1
72
(
21-157)
37 . 1
114
(
51-268)
7. 9 < 1
47 No
(108-387)
compounds
63,73-Methylene (prorenone ) 63,73-Methylene; 17ot-hydroxypropyl, 17 3 - OH A1; 63,73-methylene; 17a-hydroxypropyl, 173-0H 63,73-Methylene17a-propi onate, K ( = K prorenoate)
Methylation
< 1
compounds
A6 (=canrenone) A6-17a-Hydroxyprop y 1, 1 7 3 - 0 H »6,15
6 3 , 7 3 - M e t h y 1ene
M a x i m a l MRP vs spironolactone ( = 100 % ) (95 % c o n f i dence limits) ( % )
compounds
17oi-Hydroxypropyl, 173-0H 17oi-(3-Hydroxy-3, 3-dimethylpropyl), 17 3 - O H 17ot-Hydroxybutyl, 17 3 - OH
II
c6/c
A f f i n i t y for M C R vs spironolactone ( = 100 % ) ( % )
the
D-ring
153-Methyl 16a-Methyl
( 19-153) activity
182
spirorenone) Ihe
in
vivo
resulted activity
spironolactone, very
low.
rolactone did
f)
not
Ihe
relative
tors
and
a
the
an
in
vitro
in
vivo
activity
only
is
no
( r
show
in
negligable
denvate
with
antialdosterone
higher vitro with
nor
affinity
is
in
in
).
vivo
receptor
binding.
receptor
binding
Table the
in
However,
similar
spi-
compound
action
between
< 0.025
activities
of
was
vitro.
and
summarized
that
reversed
mineralocorticoid
correlation p
than
Ihis
in
potency.
however
antialdosterone
= 0.309, vivo
in
included.
vivo
renal
compounds
significant
times
analogue
was in
vitro
relative
tone
vivo
in
rat
do
there
C^
to
compounds with
at
affinity
overall
1.3
antia 1dosterone
capacity
neither
between
spironolactone-like is
still
of
spirorenone
activity
Correlation
loss
binding
configuration
show
a
was
the
finally,
in
to On
and
activity recepof
all
I.
There
vivo
and
several
spironolacthe
other
without
hand,
in
activity.
3
H - dlhydrot*stest»ron* binding In human pros tat* cytoicl
• ».....,
Fig.
7
m3
H-OHT Ih-DHJ
. OUT f J.lSilO'* • OHT IIS x K'
90QQ
»000
7000
tooo 5000
4000
3000
2000
1000
Fig.
I n t e r a c t i o n o f d i f f e r e n t s t e r o i d s IAI11h t e s t o s t e r o n e at h u m a n p r o s t a t e b a n d i n g
8
II
Interaction
a)
Affinities
In a
a
with
for
preliminary
concentration
prostate
unlabelled
DHT
cant
binding
in
dose
a
No
2.5
and
x
alone
androgen
and
M was with
increasing
Gel
filtration
DHT
with
manner.
incubated
was
seen
rone,
hydrocortisone
and
progesterone
tions
(Fig.
renone-derivates (Fig.
for
of
^H-DHT
sites
after
was
only
incubation
sites
were
DHT
found
for
with
and
in
of
significold
with
100-fold
spironolactone
binding
a
by
together
in
(DHT) human
concentrations
revealed
Competition
when
Affinities
sites
with
displacement
displacement
8).
binding
incubated
7).
5a-DHT
binding
^H-dihydrotestosterone
10
labelled
dependent
testosterone DHT.
experiment,
(Fig.
of
prostate
^H-dihydrotestosterone
of
cytosol
human
^H-dihydrosites.
labelled aldoste-
concentrafour
spiro-
compared
9).
Unlabelled binding.
In
DHT
itself
contrast,
was
most
potent
spironolactone
in was
reducing a
weak
the
^H-DHT-
competitor
184 Affinity binding
af xpir»n»!mcHnt M* 5finrn«n»-4»rlrttn situ In humcn prtitat» cfttut
cr0
r r
9
with
^H-dihydrotestosterone
was
fold
reduced
however, binding
by
only
were
more A
centrations
b)
concentrations
sites.
obviously without
the
not
cytosol.
We,
for of
The in
the
four
and
great
is
binding
in
2000
the
most
with
with
binding
fold.
showed
with
Even
bound
The
"^H-DHT was
in
activity
the
binding ligand
the
incubated
for
found
lactone
since
a similar
specific
problem
therefore,
denvates
sites.
spi r o r e n o n e - c o m p o u n d s ,
importance
formation
the
four spirorenone-denin h u m a n p r o s t a t e
competing
reduction
600
»o.r«,i,-o«
spironolactone,
^H-methyltrienolone
avoiding
spirorenone
%
of
for
%.
active
50
lactone
Affinities
receptors
11
between
was
Methyltrienolone
the
n
Affinity o ^ spironolactone and v a t e s for H-DHT-bi.nding sites cytoso1 .
Fig.
000
'H-OHT-
.¿¿r^ xtr* oOT^
0
10
far
SHBG
the
in
con-
structure
compound (low)
affinity.
sites for
androgen
contamination
spironolactone
^H-methyltrienolone
and
and
of
four
cytosol
185
3
H
-mothyItrionolono-binding
sitos
in
human
p r o i t o t o
cytosol
methyllrienolon* cpm/1 roc lion methwltrienolone 2 5 1 IO'OM Spironolactone
•
• methyl
fraction»
Fig.
10
of 500
tnenoione
pi
A f f i n i t y of s p i r o n o l a c t o n e and spirorenone-denuates for H - m e t h y l t r i e n o l o n e b i n d i n g s a t e s in h u m a n p r o s t a t e c y t o s o l w h e n i n c u b a t e d an 1 0 - f o l d e x c e s s .
A f f i n i t y of 3
methyltr
spironolcctono
H-mothyttrionolono-binding
end
spiroronono s i f t
in
-dorivatos human
for
p r o s t c f o
cytosol
lenolort*
¡5
mothjrltritnolone * 10-4 ft
•
-
Spironolactone
•
methyltrienolone
• sptrotenones
fraction»
F ig.
11
0f 500
l-IV
jit
A f f i n i t y of s p i r o n o l a c t o n e and sp] r o r e n o n e - d e n v a t e s for H - m e t h y l t r i e n o l o n e b i n d i n g s i t e s in h u m a n p r o s t a t e c y t o s o l w h e n i n c u b a t e d in 1 0 0 - f o l d e x c e s s .
186
prepared from 10,
2.5 100
When
from
human
x
^ - 2.5
10
and
1000
prostate
spironolactone
bated
in
10
fold
seen
and
only
binding
by
Finally,
with
of
used,
and
in
(Fig.
the
ligand
was
tested
in
displaced
"^H-methyltrienoione
are
3
obviously
H-mfthyllritnolonr
methyl
trienolone
cpm /
fraction
less
- binding
10).
When
50
incu-
in
100
of
bound
fold %
was
methyltnenolone,
spironolactone 2 lowered the
however
active
were
reduction
^H-methyltnenolone
spirorenone-derivates
of
a
11). of
binding
fold
(Fig.
no
displacement
excess
ren ones
1000
representing
compounds
unlabelled
reduction
ranging
steroids.
spirorenone
spirorenones a
selected
cold
observed
were
a minimal
the
trienolone The
the
spironolactone
however
^ M were
Concentrations
concentrations,
was
concentrations
with
10
excess
higher
"^H-methyltrienolone higher
x
fold
tissue.
than
t i l t s
in
by
same
by
and
(Fig.
12).
concentrations,
only
40
%.
The
spironolactone
human
me thy 1 -
proitat*
spiro-
in
cytosot
A
iOOO-
•—• —o
3500-
3000-
'H - methyl trienolone 15 M 10-' M •
spironolactone
•
methyltrienolone
• spirorenones
2500-
2000-
15 00-
1000-
500-
fraction»
Fig.
12
of
250
pt
A f f i n i t y of s p i r o n o l a c t o n e and s p i r o r e n o n e - d e r i v a t e s for H - m e t h y l t r i e n o l o n e b i n d i n g s i t e s in h u m a n p r o s t a t e c y t o s o l w h e n i n c u b a t e d in 1 0 0 0 - f o l d e x c e s s .
I-IV
187
competing human
with
the
prostate
ligand
androgen
methyltrienolone
for
binding
at
the
receptors.
Discussion
The
observations,
tissues mone
is
receptors
competitive
and
a unique
ship
compounds
of
tion at
in
in
3)
less
since ties of
ty
data
these
were
and
independent under
was
with
in
with
ring
compared
the
toad
method
from
with
further and
allowing
(27,
a
and
receptor
data
binding
antagonistic
a
of
as
properties
of
The
unclear activi-
of in
seven vivo
the
of
activi-
shortbetween
the
system
the
compounds
a discrepancy
activity
well
relationship
differentiation Moreover,
to
compounds.
the
of
reduc-
the ^--lac-
biological
means
24
aldosterone
greater
The
of
comparison
activity
revealed
antagonistic
relation-
remained
28).
by
activity.
pharmacokinetic The
the
by
unsaturation
parent
studies
binding
bladder
in
show
their
target hor-
affinity
1)
unsaturation
affinities
antagonistic
affinity
higher
2)
or
the
cytoplasmic
in
In
inhibited
demonstrated
compound
investigated
investigation.
binding
renal
already
vitro
the
spironolactone
agonistic
to
not
is as
relation
antagonistic
circuit- current agonistic
in
at
cytoplasmic
structure-affinity
thej^-lactone
compounds.
studied
rat
They of
step
investigated
r i n g B, of
these
compounds
was
to
at
such
19-nor-spironolactones
of
agonistic,
these
in
affinities
the of
study
a potential
(26).
aldosterone
initial
a 1 . first
opening
significance
to
affinity
position
and
this
of
binding
antagonists
analogues
spironolactone. as
with
vitro
receptor
C^/Cy
tone
that
et
action
specific
chance
F"under
spironolactone receptors
the
by
aldosterone
offered
activity.
that
initiated
whereas
is
between compounds
manifested
significant
tremendous
dissociation
agonistic
activity. Recent the
studies
relative
confirmed
affinity
for
the
mineralocorticoid
receptor
between in
vitro
188
and of
the
in
vivo
pharmacological
antimineralocorticoid
more
potent
renal
vity med
by
the and
with
same
which
cannot
the
to
an
be
either
studies
low
again
structure
of
in
depending
on
observations et
al.
of
chain
a
the
ronolactone
series
while
appeared
its
to
antagonism,
It
is
have
in
takes
place
chain
at
that by
C-17
derivate
vivo
the
rat
aldosterone
and in
the
importance
for
the
complete
by
an
to
spirolactone
of
structure
at
et
of
binding
loss
f under
in
vivo
receptors.
the
for the
the
in
a 1.
17-spirolactone
in
one the
in
the
leads binding
C-17.
Simi-
(26)
and
ring,
the
a carboxyl
17a-hydroxypropyl
was
for
the
a
striking
higher
the
cytoplasma
is
implies active
conversion hydroxyl
group
and
of
to
its spire-
a blockade essential
that
this
of
for
compound
metabolites
mi n e r a l o c o r t i coi d
the
that
mineralocorticoid that
more
side
result:
than
Assuming
result or
vivo of
a
showed
vivo
this
to
oxidation to
in
a
prorenone,
group,
sites
vivo
affinity
likely
in
ring
binding
acid,
both
ring
and
^--lactone
or
negligable.
competitive
then
with
prorenone
of
affinity
be
binding
converted
for
containing
activity
aldosterone
is
prore-
to
aldosterone
remaining
acti-
that
vivo
Opening
made
without
17(B-hydroxy
pharmacological
ceptor
the
for
vivo
c a n re n o n e
almost
also
in
(30) .
compounds
prototype and
were
an
affinity an
be
hypothesis,
demonstrate
receptor.
to
vivo
perfor-
active
affinity
in
were
inactive was
spironolactone,
capacity,
the
was
clearly
or
Peterfalvi
for
found
and
studies
in
17-spirolactone
a partial
Among
the
groups
was
without despite
compounds
however,
to
lar
both
vitro
Further
affinity
lactonized
extremely
e.g.
almost
converted
certain
17-0-methyl-5,6-dihydrocanrenoic
mineralocorticoid
ring,
in
receptors
support
are
K+-canrenoate
despite Our
group
respectively,
(30).
vitro.
was
for
Prorenone
both
spironolactone.
a considerable
sites
intact
to
canrenoate
c a n re n o n e and
however
mi n e r a l o c o r t i c o i d
superior
noate
compounds.
spironolactone
K+-prorenoate
(29). rat
than
activity
which
receptors. active
group
further
of
substances the
side
a closure
to
189
the
spirolactone
Peterfalvi the
et
lactonic
They
found
a 1.
that
as
in
for
ring
already
C-17
cannot
the
closure
additional
at
be
is
other tion
side
compound of
the
affinity
but
also
this
to
their
the
the
side
vitro
and
-
chain the
to
the
is
one
of
in
the
case
did
a clear
The
double
bond
action The
in
vitro
second
group
76-methylene prorenone, in
vitro
the
groups but
by
as
as
only
in
of
to
C-16
vivo
for
The
the
affinity
et
the
al.
As
in
a minor
the
affinity
extent
the
of
Canre-
the
in
in vivo.
spironolac-
sites
vivo.
the in
of
for
receptor
in
moiety,
17a-hydroxypropyl
abolished
the
for
basis
17a-hydroxy-
slightly
compared
activity
(29).
of
the
to
compounds
6(3,7gmethylene
both
low
receptors
increased
when
only
B-ring
activity
effects
7a-dithioacetylated
pharmacological
practically
reduced
well
of
and
the
the
metabolites
affinity
not very
extent.
the
spironolactone
show
C-15
Claire
introduction
active
of
between
series.
the
the
oxida-
derivates
variable
antialdosterone
exthe
Nevertheless, on
at
its
for
an
by
is
17a-hy-
investigation.
features
a
antialdosterone
increases
and
extensively
not
to
vivo
two
of
Thus,
answered
affinity
- or
receptor
of
by the
formation
abolished. be
-
chain
closure.
affinity
sites
(31).
derivate
ring
is
only
the
compound
caused
a
structural
This
study
compound
pharmacological
reasonable
but
one
ring
vivo
and
a corresponding
As
and
in
tone
propyl
impede
group
receptor a
of
a
in
assumption
chain
17a-hydroxybutyl
of
activity. acid,
This
vitro.
present
influence
presented
importance
inactive
17a
however,
of
was
the
biochemical
aldosterone
in
mineralocorticoid
can,
Modifications
none
the
in
activity
spironolactone
to
antialdosterone
A branched
- seems
mechanism
additional
chain
hydroxyl
the
assay
supported
compounds.
17a
pointed the
lactonized,
receptor
droxy-3,3-dimethylpropyl tended
for
17-0-methyl-5,6-di.hydrocanrenoic
which
as
(30)
ring
derivative well
ring.
as
canrenone.
is
the
shown
receptor
vivo,
the
as
previous
6(3, by sites
shown group,
and
176-hydroxyl
for
the
receptor
antialdosterone
acti-
190
vity. of
In
the
case
prorenone,
was
lost
but
comparison The
to
the
vates
methylated
in
receptor
their
affinity
spirorenone
lites
markedly
than
the
to
v ivo
form
the was
receptor kept
(twice
that
of
derivate for
The the
the
in
spirorenone
transformed
probably
the
C^/C2
for
this
of
be
the
might
accorderi-
strong
be,
that
saturated result
finding
similar
activity of
(0.73
into
of
times
the that
a more
acitve
antimineralocorticoid one
of
these
compound.
active
Another
be
a slower
than
of
the
C^/C^
the
spironolac-
indicates,
would
spirorenone
a
mineralocorticoid
binding
must
It
in
showed
affinity
This
achieve
was
spironolactone
spironolactone).
to
elimination
different.
derivate
vivo.
is
open
D-nng.
but
higher
planation
the
for
vivo
was
in
at
activity
saturated
tone)
vity
vivo
C^/C^
of
in
receptors
its
war
capacity
power
and
saturated
metabolite
binding
mi.neralocorticoid
in
C^/C2
affinity
the
the
prorenone.
with
potency
of
prorenoate,
anti.aldosterone
for
dance
Spirorenone
potassium
a part the
affinity
of
acti-
metabo-
possible
ex-
iriactivati.on saturated
and
com-
pound. It
has
been
essential
postulated
for
the
activity
(30,32).
was
less
active
and
in
Thus,
vitro, from
spirolactone aldosterone The
and
a
ronolactone
in
its
vitro
this
activity
(markedly
was
compound
has
to
aldosterone
but
still
potent
than
concluded,
spiroether
containing group, in
lower
be
the
be
derivate
ring
at
C^
is
antagonistic of
spirorenone
active
in
vivo
spironolactone. that
ring
not
lead
only to
the
active
compounds.
capacity
practically
more
can
also
derivate
binding
of
congener,
it
173-hydroxy
pharmacological
while
the
moreover,
but
spirolactone
17-spiroether
antagonistic
spirorenone
chain
The
result
form
the
development
than
and
that
that
showed
vivo in for
a
was
17a-hydroxypropyl a
striking
higher
comparison the
result:
its
that
spi-
in
of
spirorenone)
mineralocorticoid
negligable. converted
to
than
side
This
result
vivo
to
an
receptor
implies active
that
meta-
191
b o 1 i t e . It active group ther has
is
likely,
substance of
the
been
form) (33,
34).
vates or
of
The
loss
of
ceptor
the
droxyl
of
C ^
the
at
the
the
as
results
were
found In
of
aldosterone
teers
been
at
use
the
gestagen
In
of
these
taken
the
steroids
into
investigation and
in
in
vivo
with
active
by
deri.-
shortening complete
of
the due
of
reto
the
a hy-
(unpublished).
activity
vitro.
in
Similar
spirolactone is
which
limited
et
configuration
a potent
series
studies
also
is
aldosterone
their
of
aldo-
compounds
possesses
a
higher
spironolactone.
(35), in
this
new
healthy
However, their
type
volun-
the
clini-
affinity
there
consideration.
In
is
the
confined
vitro
for
to
binding
affinity
antagonistic
relative
receptor,
^H-aldosterone
However,
in
spironolactone.
compounds
mineralocorticoid be
is
for
for
receptors.
comparing
various
than
chain
classical
preliminary
doses
a new
a
probably
spirorenone
the
(open form
C^
oxydation
MCR
properties
antagonists
lower
cal
in
and
vivo is
pharmacological
represents
than
at
in
the
the
step
Peterfalvi
in
diastereomers
conclusion, and
by
spirolactone
for
other
potency
shown
the
latter
branching,
17a-si.de
the
ring
results
This
after
the of
blocking
aldosterone
pharmacological has
of
affinity for
antagonist
As
closure
end
the
(32).
activity vitro.
fur-
17a-hydroxypropyl
the
chain
and
lactonic
pointed with
The
an
hydroxyl
canrenoate
its
lactonic
also
senes,
completely
well
with
in
the
to
group
ring.
with
experience
reversion
abolished
sterone
the
of
a carboxyl
potassium
17a-side
ring
as
compounds
own
activity
the
group
Finally, at
of was
antialdosterone
binding
hindrance
vivo
of
u i. v o c o n v e r s i o n
oxydation to
for
spironolactone
lengthening
by
C ^
equilibrates
activity our
in
17-sp1ro 1 actone
importance
From the
at
demonstrated
rapidly
antialdosterone a 1 . (30).
the
this
place
chain
to
well
which
takes
side
a closure
that
for
affinities
are
the
a number
receptor
to the
the
of
of renal
aspects
to
system,
between
cytoplasmic receptor
for of
assay
competition
effect
a
receptor a given
the
steroid sites. com-
192
pound 37).
could In
rences
the in
ween
which
tance. with
high
tone
^H-DHT
Fig.
9).
The
TEBG
compared
Competition contrast,
tone
in
state
by
does
the
these
in
of
bind
bet-
prostate
critical
of
prostate
transport
androgen to
are
For
principal
the
less
in
imporbind binding
spironolaccytosol
protein
might
(see
obviously
more
to
methyltrienolone,
in
affinity
cannot
therefore
present
studying
the
affinity,
compounds
is
discussed
studies for
with
the
antagonistic
understanding
of
the
metabolism
action
compounds.
of
search
well
receptor
vivo
is
the
modula-
compound.
one
cannot
a given the
receptors
more
and
for
the
and
compound.
usefulness
for
as
expect
sites
mineralocorticoid
steroids, as
pro-
into
receptor
mineralocorticoid
in
androgen
in
the
for
vivo
human
necessary.
demonstrate
expected
activity
of
above,
affinity in
to
in
site
spironolac-
transferee!
activity
vivo
activity
the
be
receptor
than
binding
binding
between
antimineralocorticoid
androgen active
protein
reasons
However,
mineralocorticoid
lower
Anti.androgenic
agreement
mineralocorticoid
a
results
and
effect
new
human
tested
binding
suggesting
the
of
in
this
synthetic
derivates
condition.
of
is
interaction
competition
^H-methyltnenolone
Testing
vitro,
and
-antago-
testosteron-estradiol
the
at
the
receptors
chosen
serum
binding
or
5a-dihydrotestosterone
spiroreriones
metabolism
the
ligand
reflect
However,
a complete
considering
and
diffe-
metabolism
with.spironolactone.
with
reducing
vivo
are
(36,
vivo.
androgen
binding
four
cytosol
sites.
ted
for
Spirorenone
(38).
in
Therefore,
reflect
there
action
aldosterone-agonisti.c
the
the
hand,
distribution,
and
to
antagonistic
other
when
testosterone
(IEBG).
with
the
emerge
affinity
partially
the
substance
addition,
Both,
globulin
in
a
spironolactones In
on
or
absorption,
effect
of
problems
tissue.
agonistic
bioassay,
action
Similar
an
intestinal
excretion nistic
induce
or
of in anti-
specific a
better
mechanism
of
193
Summary
We
tested
to
spironolactone
at
rat
renal
sterone son
the
in
group
of
in
and
the a
steroids
compete
with
vivo.
showed
17-spirolactone
a
to
a
group
reduced
activity
the
7a-thi.oacetyl
the
in
by
41
and
at
the
52
%
D-ring vivo
were
receptor
vivo
3-8
in
in
as
more
was
receptor
activity
affinity
for
androgen The
of
potent
in
as
for
however,
than
binding
of
and
in
of
vitro
not
activity
in
(prore-
activity group
activity
of
its
Taken
replace
of
comvivo.
a methyl
two
new
deriTheir together,
testing
compounds. receptors
provides
into
insights
re-
action
mineralocorti.coid
sites
in
did
binding
and
four
human
the
the Comand meta-
spirorenone-derivates
prostate
compete
spirorenones the
suggesting c y t o s o l ic
a
cytosol
significantly
reflecting
spironolactone
for
loss
spironolactone.
Using
more
lower
androgen
was
with
competition
showed
compounds
in
increased.
does
a
B-positi.on
and
lone
four
compari-
antimineralocorticoids.
spirorenones
ligand,
in
vitro in
globulin.
four
in
unsaturated
the
testosterone-estradiol-binding
the
antialdo-
17a-hydroxypro-
reduction
slightly
spironolactone
dihydrotestosterone
as
vivo
a
C , /C 6 /
group
well
affinity
affinity
potential
The
tested.
binding
the
antialdosterone
Spirorenone
only
by
Introduction
antimineralocorticoid
of
in
a similar
vitro.
times
between
biological bolism
resulted and
the
vivo
respectively.
affinity
measuring in
in
similar
for
and
resulted
both
of
parison
rats
spironolactone,
increased
vates
structures
vitro
ring
reduction
none)
in
in
adrenalectomized
without
Compared
Substitution
both
with
^H-aldosterone
receptors
176-hydroxyl
affinity
pounds
to
17
spironolactone.
Replacement
ceptor
of
cytoplasmic
activity
with
pyl
ability
for
also ^H-
the
methyltneno-
displacement
affinity
of
receptor.
than
these
194 Re f e r e n c e s 1.
Kagawa,
C.M.:
Endocrinology
2. C o r v o l , P . , C l a i r e , B . : K i d n e y Int. 2 0 ,
67,
125-132
(1960)
M. , 0 b 1 i n, M . E . , G e e r i n g , 1-6 (1980)
3. F u n d e r , J . W . , F e l d m a n n , D . , H i g h l a n d , E . , Biochem. Pharmacol. 23: 1493-1501 (1974)
K.,
Rossier,
Edelman,
1.5.:
4. M a r v e r , D . , S t e w a r t , J . , F u n d e r , J . W . , F e l d m a n n , D . , E d e l man, I.S.: Proc. Nat. Acad. Sei. (USA) 71, 1 4 3 1 - 1 4 3 5 (1974) 5. C l a i r e , M . , R a f e s t i n - O b 1 i n , M . E . , M i c h a u d , A . , R o t h - M e y e r , C., C o r v o l , P.: E n d o c r i n o l o g y 104, 1 1 9 4 - 1 2 0 0 (1979) 6. E r b l e r , 366-372
H.C.: Naunyn-Schmiedeberg ' s Arch. (1972)
7. C h e n g , S . C . , S u z u k i , K., S a d e e , c r i n o l o g y 99, 1 0 9 7 - 1 1 0 6 (1976) 8. E r b l e r , 395-401
H.C.: Naunyn-Schmiedeberg's (1974)
9. C o n n , J. W . , (1977) 10.
Hinerman,
D.L.:
Harding, Arch.
Metabolism
A b s h a g e n , U., S p o r e , S . , S c h ö n e s h o f e r , R e n n e k a m p , M., O e l k e r s , W. : Clin. Sei. 310s (1976)
11. L o r i a u x , R.: Ann. 12.
W.,
Schaue, 691-694
D.L., Menrad, Int. M e d . 8 5 , H.P., Potts, (1978)
13. M e n a r d , R . A . , 94, 1628-1636
R., T a y l o r , A., 630-636 (1976)
G.O.:
Stripp, (1974)
B.,
A.A., Mitchell, A (1976)
J.
Clin.
Gillette,
B.W.:
26,
Pita,
J.R.:
J.C.,
16.
Stalman, S.L., Brooks, 449-450 (1969)
17.
Bonne, (1974)
18.
C o r v o l , P . , M i c h a u d , A . , M e n a r d , J., F r e i f e l d , deau, J.: E n d o c r i n o l o g y 97, 52-58 (1975)
19.
Pita, J.C., Lippmann, M.E., E n d o c r i n o l o g y 97, 1521-1527
20.
R i f k a , S.M., Pita, J.C., V i g e r s k y , A., W i l s o n , L o r i a u x , D . C . : J. C l i n . E n d o c r i n o l . M e t a b . 4 6 ,
J.P.:
Mol.
Cell.
Thompson, (1975)
47,
Endocrinology
Rose, L.I., Underwood, R.H., Newmark, S.R., Kisch, W i l l i a m s , G.H.: Ann. Int. Med. 87, 3 9 8 - 4 0 3 (1977)
Raynaud,
Santen,
Metab.
15.
Morgan,
285:
M., L'Age, M., M o l . M e d . 51 , 3 0 7 s -
Taylor, 24, 279
J.R.,
Endo-
1293-1307
Endocrinol.
Rollins,
273,
Pharmacol.
14.
C.,
J.R.,
Pharmacol.
D.E.:
E.R.:
Clin.
E.S.,
Steroids
Endocrinol.
E.R.,
Res.
14,
2,
M.,
59-67 Mahou-
Loriaux,
D.C.:
Y.A., 338-344
195
(1977) 21.
Cutler, G.B., Pita, J.C., Rifka, S.M., Menard, R.H., Sauer, M.A., Loriaux, D.C.: J . Clin. Endocrinol. M etab . 4 7, 171-173 (1978)
22.
R o u s s e a u , G., B a x t e r , J.D., F u n d e r , T o m k i n s , G . M . : J. S t e r o i d . B i o c h e m .
23.
Wambach, (1978)
24.
W a m b a c h , G . , H i g g i n s , J . R . : In A n t i h o r m o n e s ( E d . M . Agariwal) p. 1 6 7 , E l s e v i e r / N o r t h H o l l a n d B i o c h e m i c a l Amsterdam (1979)
25.
Casa 1 s - S t e n z e 1 , J., Buse, col. 80, 37-41 (1982)
26.
Funder, J.W., Feldman, D., Highland, E., Edelman, B i o c h e m . P h a r m a c o l . 23, 1 4 9 3 - 1 5 0 7 (1974)
27.
Sakauye, (1976)
C.,
28.
Feldman, Addison, ( 1978 )
D . : In A n t a g o n i s t s i n C l i n i c a l M e d i c i n e (Eds. G.M. et a l . ) p. 18, E x c e r p t a M e d i c a A m s t e r d a m
29.
C l a i r e , M., R a f e s t i n - O b 1 in, M . E . , M i c h a u d , A., Meyer, C., Cor vol, P.: E n d o c r i n o l o g y 104, 1194
30.
Peterfalvi, M., Torelli, C l a i r e , M. , M i c h a u d , A., 29, 3 5 3 - 3 5 7 (1980)
31.
Kar im, A., Pharmacol.
32.
Kagama, C.M.: R e s e a r c h , ed.
33.
Sadee, W., Abshagen, Schmiedeberg's Arch.
34.
Ramsay, L.E., Shelton, J.R., Wilkinson, B r . J. C l i n . P h a r m a c o l . 3, 6 0 7 (1976)
35.
C a s a l s - S t e n z e l , J., Brown, J.J., L o s e r t , W.: N a u n y n S c h m i e d e b e r g ' s A r c h . P h a r m a c o l . S u p p l . 316, R 49 (1981)
36.
S h e r m a n , M . R . : In A l d o s t e r o n e A n t a g o n i s t s M e d i c i n e ( e d s . G . M . A d d i s o n et a l . ) p. 1, Amsterdam (1978)
37.
Raynaud, J.P., Bouton, M.M., M o g u i l e w s k y , M., Ojasoo, P h i l i b e r t , D., Beck, G., Labrie, F., M o r n u n , J.P.: J. S t e r o i d B i o c h e m . 1 2 , 143 (1980)
38.
N o r i s , J . S . , S m i t h , R . G . : A n d r o g e n R e c e p t o r s in " P r i n c i p les of R e c e p t e r o l o g y " (edt. M . K . A g a r w a l ) W a l t e r de G r u y t e r B e r l i n - N e w Y o r k , p. 2 0 7 - 2 7 1 (1983)
G.,
Higgins,
Feldman,
J.R.:
D.:
J.W., Edelman, I.S., 3, 2 1 9 - 2 2 9 (1972)
Endocrinology
M.,
Am.
Losert,
J.
W.:
Physiol.
102,
Eur.
231,
1686
J.
K. Press
PharmaI.S.:
93-97
Roth( 1979 )
V., F o u r n e x , R., R o u s s e a u , G., Corvol, P.: Biochem. Pharmacol.
Z a g a r e l l a , J., H r i b a r , J., Ther. 19, 1 5 8 - 1 6 4 (1976) A n t i - A l d o s t e r o n e s , in: R.J. Dorfman, Academic
Dooley,
M.:
Clin.
M e t h o d s in H o r m o n e P r e s s New York (1964)
U., F i n n , C., R i e t b r o c k , N.: P h a r m a c o l . 283, 303 (1974) D.,
Tidd,
NaunynM.J.:
in C l i n i c a l Excerpta Medica T.,
196 Acknowledgements W e w o u l d l i k e to e x p r e s s o u r g r a t i t u d e to P r o f e s s o r R. W i e c h e r t , D r . W . E d e r a n d D r . U. K e r b , S c h e r i n g A k t i e n g e s e l l s c h a f t B e r l i n a n d B e r g k a m e n , W - G e r m a n y , for the g e n e r o u s s u p p l y of the s t e r o i d s u s e d in t h i s w o r k . W e t h a n k M r . M. B u s e a n d M r s . G. S u c k a u for e x c e l l e n t a s s i s t a n c e . P a r t of the d a t a a r e p u b l i s h e d in a c o n t r i b u t i o n to B i o c h e m i c a l P h a r m a c o l o g y , 32, 1 4 7 9 - 1 4 8 5 ( 1 9 8 3 ) . T h e s e s t u d i e s w e r e s u p p o r t e d by g r a n t s f r o m M i n i s t e r i u m für W i s s e n s c h a f t u n d F o r s c h u n g d e s Landes Nordrhein-Westfalen.
THE A N T I M I N E R A L O C O R T I C O I D
ACTION OF TWO NEWLY
SP I R O L A C T O N E
DEVELOPED
DERIVATIVES
M . K. A g a rwa1 Centre
U n i v e r s i t a i r e d e s C o r d e l i e r s , 15 rue E c o l e de 7 5 2 7 0 P a r i s C e d e x 06, F r a n c e
Médecine,
M. Kai imi Department
of P h y s i o l o g y ,
M i n e r a l o c o r t icoi d h o r m o n e s mammals w h o s e
dysfunction
Medical
regulate
the
syndromes
(l- »). A l t h o u g h
aldosterone
corticoid
hormone, minute
amounts
in p a t h o l o g y to the o n e
accepted
and
appropriate
the
target
chemical
analysis
revealed
that
molecular various only
organ of the
becomes
these
the mi n e r a l o c o r t icoid
agonists may
s u c h that
for
subsequent
transfer
(9).
by p r o g e s t i n s reviewed
receptor receptor
occupancy activation
(MR)
Physicoexhibits action
saturation
of
of
to c o m p e t e
(5-6) and/or to
to
impede
impaired
at the
level
of the c e l l u l a r
in an e a r l i e r
volume
receptor in t h i s
The a n t i m i n e r a l o c o r t icoid a c t i o n of s p i r o l a c t o n e to
an
with with
nuclear
i n h i b i t i o n of the mi n e r a l o c o r t i co id a c t i o n
by o n e of us
in r e l a t i o n
bind of
reviews).
shown
leading
It
however
physiological
was
noxious
steroids
has
receptor
an a n t a g o n i s t
also
reviews).
(5-6).
binder
C 7 — 8 for
are
cytoplasm
proceed via preferential
model
The
kidney
the
a s u b s p e c i e s of the MR s y s t e m
the a g o n i s t
hormonal
intracellular
mineralo-
particularly
C+ for
in
related
steroids
in the cell
s u c h as the
balance
and
is the m a i n
syndrome
receptor
Virginia
hydrosodic
of o t h e r
that
t h a t all
same
heterogeneity
In the c l a s s i c a l the
property
s u c h as the C o n n ' s
was generally
of
leads to h y p e r t e n s i o n
1
endowed with similar
College
receptor
conformations
will
be
Receptor Mediated Antisteroid Action © 1987 Walter de Gruyter & Co., Berlin • New York - Printed in Germany
has
been
series
(3).
derivatives
reviewed
here.
198 Experimental
Procedures
Male,
Wistar
rats
mized
5-7 d a y s
and water
ad
(200-250
prior
to o r g a n
libitum
were
sacrificed
n a t ion,
the o r g a n w a s
l ipid f r e e
cytosol
105,000
g.
60 m i n ,
followed
under
Blood was
allowed
by
60 m i n
g to o b t a i n
a clear
serum.
For
and c o m p e t i t i o n
binding
M Tris-HCl C) w i t h
pH
in p r e s e n c e Free C)
7.4),
of
steroids
an e x c e s s were
in p r e s e n c e
0.25%
dextran
(3000
g,
10 ml
of
vector the
quantitated
and
kinetics,
using
as d e s c r i b e d
the
left
before
studies,
also
cytosol
in t h e T r i s 35°
C for
and
processed
protein
various
as b e f o r e . T h e
(12).
for
of
or
choice. min,
charcoal
+
fluid
in p r e s e n c e
of
spectrometer.
(10) and
dependent
the
steroid-
concentration under
was
similar
of condi-
(11).
was
buffer.
at
radioactivity
studied
steroid
as a b o v e ,
method
a single
min
centrifugation
in a P a c k a r d
in d e t a i l
radioactive
(2.5%
0.01
alone
(10
supernatant
Time
(60
steroid
by
10,000
(in
material
incubation
Bradford
saturation
then
CPM/mg
the
was
incubated
and counted
protein.
10 n M of
treated
vials
at
cytosol
charcoal
as C P M / m g
hormone,
for
sedimented
resulting
and
room temperature
radioinert
(Amersham)
by
buffer,
at
0.2 ml
further
expressed
sodium molybdate were
the
The
exsanguiat
tritiated
activated
cocktail
For d e n a t u r a t i o n with
the
by
to s c i n t i l l a t i o n
radioactive
tions,
0.2 ml 4° C ) .
the ACS
Protein was results
of
of
removed
initial
food
u1tracentrifugation
serum, was
of
T-70) which was
10 m i n ,
transferred
amount
by
on
house.
C, a n d c e n t r i f u g e d
studies,
or w h o l e
the d e s i r e d
the
by
to c l o t
at
animal
anesthesia
with
prepared
adrenalecto-
and m a i n t a i n e d
controlled
ether
perfused was
bilaterally
ablation
in a c l i m a t e
Animals a
g) were
incubated with
Samples periods
(2 h,
or w i t h o u t
are
mM
in tripl i c a t e of
time,
determination
results
C) 10
of
expressed
charcoal protein as
199 To a s s e s s
receptor
following
the
of
at
choice
molybdate.
activation,
2 h equlibration 4° C,
( 1 . 4 mg
incubated
for
of
prior
45 m i n
to c o u n t i n g gradient
sucrose
gradients
30 m M
KC1
buffer
Clow
was
steroid.
finally were
40,000
rpm.
Charcoal 5 ml
estimate
was
in 10 m M
gradients).
incubated
(2 h at
treated
of
10 m M
the
Fractions
of
sedimentation
Double
labelled
ion e x c h a n g e
cytosol, tritiated powder/ml with
prepared
incubated
0.2
M sodium and
this
20°
at
a Gilford
gradients.
assessed (4.6
by
was
Samples
rotor with
C)
cytosol
0.4 ml
S)
in
and
references
on
procedures
for
4° C ) w i t h
of c h o i c e
as
coefficients
by
(MKA)
in 0 . 0 0 2
(2 h at
steroid
us
employed
chromatography
performed of
thereafter
same
tritiated
4° C.
the
serum albumin
Bovine S) w e r e
(14).
was
t o p of
plus
at
the
and
collected
the
fluid.
and Ames
by o n e
from
7.5
in the
SW
was
(7.1
pH
at
radioactivity
globulin
DE-52) was
precooled
the
5-20%
10 n M
in a S p i n c o
The
fluid
(45 m i n
as a b o v e ,
8 drops were
starting
buffer
sodium molybdate,
4° C
and
(13).
prepared
4° C ) w i t h
gradients
18 h at
and
linear,
incubation
and c e n t r i f u g e d
for
buffer
on
Tris
Cytosol
an a d d i t i o n a l
Martin
(Whatman
performed
DNA-
agitation.
in d e t a i l
resistant
established
ug
cellulose)
occasional Tris
100
sodium
before
prepared
receptor
DNA/ml
C,
steroid
10 m M
as d e s c r i b e d
apparatus,
gamma
of
scintillation
scintillation
human
tritiated
1 ml
layered onto
Densiflow
25°
in t h e
salt
centrifuged
at
overnight
or a b s e n c e
charcoal
left
mixed with
thymus
4° C w i t h
analysis
first
the
or a b s e n c e
ul w e r e
calf
was
thrice with
Following
in p r e s e n c e was
at
suspended
Density
200
native
samples were washed was
with
in p r e s e n c e
Aliquots
cellulose
pellet
cytosol
to
the m e t h o d
of
DEAE-ce11u1ose
originally
purpose
phosphate
the d e s i r e d then charcoal
(15-18).
buffer amount
pH of
treated
The 7.5, the
(50
mg
c y t o s o l ) . Rat b l o o d s e r u m w a s s i m i l a r l y incubated 14 C - c o r t i sol a n d t h e n c h a r c o a l t r e a t e d as a b o v e , MCi
separately.
The
serum
and
the c y t o s o l
were
then mixed
and
200 loaded onto initial
a DE-52
0.002
this
low s a l t
ient
(begun
e a c h of flow
rate
buffer, the
0.002
of
processed
M phosphate
at
the
column
buffer.
arrow
in t h e
M and 0.2
determination A1iquots
ACS
radioactivity
fluid
for
described
sodium
(1
x 130 c m ) ,
separation.
3
30 m l / h
H-RU
filtration,
phosphate
activity
Uclaf,
with
of
a
of
2 ml
pH
7.5,
were
absorbance
measurements spectral
of
at
30 ml
4°C,
10 ml
taking
a
for
of
into
as
at
and
280 m u a n d
overlap,
of
grad-
collected
at
the
20 ml
linear
figures) consisting
were mixed with
the
account
previously
equilibrated
mixture
at
C and
2 ml
Roma invi11e.
3
as a b o v e
processed
H-ZK
0.01
charged
for
ion
collected
for
with
Sweden) M
with
the
exchange
at a f l o w
absorbance
rate
and
radio-
the
corres-
(15-18).
reference
steroid
and eluted 7.5, w e r e
were
as a b o v e
Ci/mM,
radioinert
pH
prepared of
determination
(50
U 1 t r o g e 1-ACA-'+'t ( P h a r m a c i a ,
+ 0.1 M N a C l ,
Fractions
26752
ponding
of
1 ml
and
passage
eluted
in
(15-18).
cytosol-serum of
of
background,
For m o l e c u l a r columns
After
equilibrated
M phosphate,
Fractions
conductivity. quenching,
x 25 c m )
protein was
30 m l / h .
for
CO.5
(lot 9 1587
X 3025 A),
and
7) w e r e
obtained
(lot
2 0 9 6 - 2 ; 87 C i / m M )
ES
from
Rousseland
the c o r r e s p o n d i n g c o l d m a t e r i a l w e r e p r o c u r e d f r o m S c h e r i n g , 3 14 1 , 2 , 3 , H - a 1 d o s t e r o n e C+5 C i / m M ; b a t c h 3 4 ) a n d 4 C-
Germany. cortisol The
(55 m C i / m M ;
radiochemical
layer c h r o m a t o g r a p h y . Reagent We w i s h Losert
grade to
thank
Broussais
provided
All
for
D.
other and
Dieu,
Virginia by
of
aided and
Affiliate.
Schering,
in all
from
Amersham.
cases
were
in
high
thin
purity
Sigma.
gift
Paris,
purchased
97%
chemicals
Philibert
the
This work was
Hotel
Association, also
Dr.
57) w e r e
exceeded
from Merck
(Schering)
respectively.
batch
purity
(Rousse 1-Uc 1 af) and RU
26752
by g r a n t s by
ZK
from
the A m e r i c a n
Some
Germany.
and
financial
Dr.
W.
91587, the
UER
Heart support
was
201 Results Data
presented
kidney,
ZK
in F i g .
91 587
- MR
formation
reached
remained
unaltered
renal
MR could
steroid
began
labelled then
a more
since
in b o t h
( m i n e r a l o c o r t icoid
for
at
least
be m a x i m a l l y to d i s s o c i a t e
progressive
specific
that,
a maximum within
the M R w i t h i n
the o r g a n this
1 show
the
receptor)
first
only
soon after. followed with
RU
time,
both
antagonists
were
they
show
no a f f i n i t y
for o t h e r
the
26752
labelling
MR
classes
RU
2 h and heart,
first
the
and
With
after
and
complex
60 m i n
In t h e by
decl ine. A l t h o u g h
differences
heart
8 h thereafter.
labelled
30 m i n
the
RU
26752, the 26752
a rapid
and
reasonCs)
for
are
not
clear
at
specifically of
receptors
C19-20).
Fig.
1. T e m p o r a l S a t u r a t i o n of By T w o A n t a g o n i s t s .
the Mi n e r a l o c o r t ico i d
Receptor
Renal c y t o s o l w a s i n c u b a t e d w i t h 100 nM of e i t h e r 3 H RU 2 6 7 5 2 ( x - - - x ) or 3 H ZK 9 1587 (x x). C n r d i a c c y t o s o l w a s similarly i n c u b a t e d w i t h e i t h e r 3 H RU 2 6 7 5 2 ( 0 ) o r 3 H ZK 9 1 5 8 7 C • ). A l i q u o t s of 200 u1 w e r e c h a r c o a l t r e a t e d at t h e i n d i c a t e d t i m e p e r i o d s f o r d e t e r m i n a t i o n of r a d i o a c t i v i t y . All p o i n t s a r e a v e r a g e of t h r e e s e p a r a t e d e t e r m i n a t i o n s . S i m i l a r r e s u l t s h a v e b e e n d e s c r i b e d by o n e of us in a n e a r l i e r p u b l i c a t i o n us i ng o n 1y RU 2 6 7 5 2 ( 1 1) .
202 Data
shown
in F i g .
antagonist
binding.
ZK
91587-MR
by
the
Similar
used with site
kidney
specififc
the a g o n i s t
since the
did
a more
any
attest
(Fig.
two
and
ZK
(11)
a 1dosterone-MR
10 nM
further
aldosterone
abundant
range
site
to t h e
target 91587
at a l l , w h e r e a s
RU
at
did
not
26752
for
heart bind was
of
fact
the
and
of
concenwas of
affinity
the
kidney.
ZK
91587
the
liver
antagonists Furthermore,
serum
only
a
for
plateau
that
lung o r
to b l o o d
bound
^H-
26752
a
MR-
followed
the e x i s t e n c e reached
The
specificity
organs
of
100 nM
^H-RU
little
complex all
slope
until
when
with
(2,3,11).
affinity
initial
suggest
antagonists
specificity
10 n M s t e r o i d w a s
and
the
exhibit
cortin
an
until
cytosol
not
in the
the
obtained
cytosol for M R
organs,
formation
of
confirm
results were
for
well
before
In b o t h
complex
saturation
tration.
2a f u r t h e r
trans-
minimally
2b).
0)
o Q-2 O)
E
X 50
nM STEROID Fig.
Q_ O 0
2. ZK 9 1 5 8 7 B i n d s t h e M i n e r a l o c o r t i c o i d Target Organs only.
_
•
Receptor
_ in
the
200 u1 c y t o s o l , in t r i p l i c a t e , f r o m v a r i o u s o r g a n s w a s i n c u b a t e d f o r 60 m i n at 4° C w i t h the i n d i c a t e d c o n c e n t r a t i o n of the r a d i o a c t i v e s t e r o i d a l o n e or in p r e s e n c e of o n e t h o u s a n d f o l d e x c e s s of the c o l d m a t e r i a l w h i c h w a s s u b t r a c t e d f r o m the f o r m e r to a c c o u n t for the n o n - s p e c i f i c b i n d i n g . F o r F i g . 2b, 200 y1 s e r u m w a s u s e d in p l a c e of c y t o s o l . F o r f u r t h e r d e t a i l s s e e the s e c t i o n o n m e t h o d s . l t m u s t be n o t e d t h a t in all o u r s t u d i e s u n d i l u t e d s e r u m w a s u s e d , c o n t r a r y to s o m e l a b o r a t o r i e s w h e r e a s e r u m d i l u t i o n of 1:20 w a s u s e d l e a d i n g to e r r o n e o u s c o n c l u s i o n s ( 2 1 ) .
203
V
1
c 2 e O )
E
-9
u
-8
-7
M
Fig.
3•
RU
26752
Does
Not
-6
-5
STEROID
Displace
Aldosterone
in Rat
Kidney.
Renal c y t o s o l w a s i n c u b a t e d a l o n e w i t h ^ H - R U 2 6 7 5 2 ( O ) , and in p r e s e n c e of e i t h e r c o l d RU 2 6 7 5 2 ( £ D ) or c o l d a l d o s t e r o n e ( # ) , at the i n d i c a t e d c o n c e n t r a t i o n s of t h e c o m p e t i t o r . All s a m p l e s w e r e run in tripl icate and c a l c u l a t e d as C P M / m g prote i n (11).
The
specificity
several could
other
not
easily
be
of
displaced
competed
Similar
out
results
26752.
Independent specififc
26752
available for
the
suitable
for
however,
that
established be
kept
various
the
in m i n d means
binder, Thus,
in the
all
with
of
in t h e
receptor. has
physicochemica1 in the
of
makes
steroid
arsenal
was
in p l a c e
bind
of
ZK
91587
It
is
already
of
RU
an
anta-
>
is RU
clear, been
(7),
analysis
of
the
was
particularly
hormones
of
but used.
agonists,
them
by
^ H - R U 26752
aldosterone
existence
not
specificity
this
of
the
organs
confirmed that
material
91587
does
heterogeneity
classes
currently
for
that the
ZK
was
3 show
homologous
target
analysis
to MR
in F i g .
non-radioactive the
obtained
receptor
for
binding
Data
confirmation
MR
(22). MR
by
when
were
gonist also
antagonist
experiments.
MR
well and by
biochemist.
must
204 Denaturation upto
60 m i n
MR, more
studies at
so
C
if
were
absence
100%
had been stable
of m o l y b d a t e
35°
C and
was
90%
in the heat first more
studies 30 m i n .
of M R .
tion
than
of M R - ^ H - R U
With
these
the
and
differences
further
the
confirmed
again
that
species,
label
exhibits
in p l a c e protected only
was
reported (not
the
even at all.
popula10-100
both
the
range. (22)
and
shown).
a
MIN 35° C
10 nM
against
denatura-
for
1-10 nM s t e r o i d cytosol
of
effect
to h e a t
affinity
almost
within
during
labelled with
been
even 26752
this was
two d i s t i n c t
sensitive
cardiac
H-RU
complete
protective
suggest
in the
3
of
denaturation
no
previously
with
(12)
complex
heat
is m o r e
antagonists have
used
molybdate
26752
91587,
abundant
population
Similar
was
exhibited
studies
antagonist,
agonist were
^H-ZK
The more
n M of e i t h e r
26752
In a d d i t i o n ,
and m o l y b d a t e
Collectively, tions
H-RU
here.
denaturation rapid
3
30 m i n
to
incubation.
100 n M a l d o s t e r o n e
at
60 m i n . nM
with
complexes
used
during
The d i s s o c i a t i o n
from MR within 100
was
included
(12).
stable
40%
complete
10 m i n w h e n
4 reveal
Nearly
dissociated by
in F i g .
10 n M a l d o s t e r o n e
if m o l y b d a t e
The c o m p l e x e s in the
35°
shown
205
b
c
MIN 35° C
Fig,
h. D e n a t u r a t ion K i n e t i c s of t h e Renal M i n e r a 1 o c o r t i c o i d R e c e p t o r in P r e s e n c e of A g o n i s t s a n d A n t a g o n i s t s .
For e x p e r i m e n t a l d e t a i l s s e e M e t h o d s s e c t i o n a n d ( 1 2 ) . All v a l u e s a r e a v e r a g e of t h r e e s e p a r a t e e x p e r i m e n t s d o n e o n separate cytosols. N o molybdate C • ); w i t h 10 m M m o l y b d a t e ( 0 ).
206 Data
in
Fig.5a
underwent
show
heat
did
not
obtained
cal
just
confirming permit when
derivatives
MR
as
as
earlier
cardiac
action
at
the
2 67 5 2 - r e c e p t o r
at
did the
assessed
by
complex
binding
to
a 1 dosterone-receptor
studies
(12).
all.
cytosol
spirolactone of
3h - R U
act¡vat i on,
well
activation
rat
of
mechanism
renal
dependent
DNA-ce11u1ose, complex,
that
was
not level
However,
Similar
used (5b).
appear of
the
^H-ZK
results
to
Thus,
the
possess
cellular
91587
were two
identireceptor.
a ALDOSTERONE
Fig.
5.
RU 2675!
ZK 91587
T h e r m a l A c t i v a t i o n of the M i n e r a l o c o r t icoid in p r e s e n c e o f A g o n i s t a n d A n t a g o n i s t s .
For d e t a i l s 4° C ( Q );
see 25°
Methods and (12). Incubations C w i t h (£77] ) or w i t h o u t ( ^ 1 )
Receptor
as f o l l o w s : 10 m M m o l y b d a t e .
207 Data
in
Fig.
6 present
activated
and
Molybdate
stabilized
the
7 S
vation,
the
region
^H-RU
26752,
predominant the
4 S
in
of
in
7 S to
7 S
region
with
peaks
of
thermal
equal
Under
these
^H-ZK
91587-MR
magnitude
activation
Similar
results
used
place
of
were
a
of
MR
the
the
seen
antagonists receptor
(see
With as
a in
26752-MR
with
the
nonactivated, buffer 4 S
this
cardiac
showed
regions
profile.
cytosol
was
cytosol.
steroid earlier
mechanism
m i nera1ocorticoids.
rat
as
the
alter
the
shoulder
^H-RU
salt
7 S and
further when
low
in
acti-
of
region.
smaller the
S form,
in
shift
sedimented
conditions,
in t h e
not
obtained
renal
confirm
did
4
MR
gradients.
sedimented
h S
the
the
Thermal
in a
kidney
in t h e
two
the
the
both
density
buffer.
largely
and
terone
from
salt
resulted
revealed
stabilized
and
low
of
complex
activation,
aldosterone.
dissociate
sucrose
thermal
agonist
activation
of
stabilized
the
molybdate
data
on
analysis
Upon
was
These
MR
molybdate,
complex
peak
ever
a 1dosterone-MR
presence
complex
in
the
molybdate
region.
first
nonactivated
in a b s e n c e
a 1dosterone-MR
the
of
Similar have
also
another
dependent on
DNA-ce11u1ose
action
of
the
differences been
two
in
and
this
with
6
E a o
FRACTION
8 NOS
the
volume).
ALDOSTERONE
12
thermal
further
the
CM
k
in
synthetic
between
observed
chapter
i
.15 E
differences
a n t i-
agonists proges-
208
_
E
1-
eg
6
E a
o
A
FRACTION
BSA
I
12
8
NOS
IK 9158?
1 Globulin
I
CM
O
E a. o
U
FRACTION
Fig.
6.
8
12
NOS
Sucrose Density Gradient Analysis Minera1ocortIcoid Receptor.
of
the
Renal
F o r e x p e r i m e n t a l d e t a i l s s e e thn s e c t i o n o n M e t h o d s . I n c u b a t i o n s w i t h o u t C • ) o r w i t h ( 0 ) 10 m M m o l y b d a t e .
Receptor depends system
heterogeneity upon
(7
matography 3
H-RU
vity
range
0.006
M
100 nM
H-ZK
again
995-1675
H-ZK
nM
in t h e 9 1587,
H-ZK
studies two
the
either
one
Transcortin
both
0.002
of
3
that
(Fig.
of
the
two
or
the
(MR^)
With
slope
that
the
the
10 nM
of
first
is q u i t e
of
distinct.
E a o
20
FRACTION NOS
30
U0
MR^
of
(Fig.
in F i g .
mechanism
With
radioacti
and
populations
the
and
(15-18). bound
labelled
and
elution
7c),
MR.
It
1
(10-
slope
antagonist) corresponds
antiminera 1ocorticoids
10
7a)
prewash
whereas
of
(conducti-
( T ) and
7b). be
chro-
peak
(Fig.
position
second
as M R ^
confirm
single
MR^
and
fractionation
phosphate
26752,
MR^
MR ^ c o u l d
existence
M
fact
exchange
respectively H-RU
in the
prewash
only
agonist
further
the
ion
- 0.02!+ M
in the
91587) eluted
nM of
confirmed
in p l a c e
ionic
and
labelled
Siemens) called
both
to c o n c l u d e
(1-10
the
low
established
steroid,
(MR,,) r e g i o n s ,
however,
These of
from
obtained
confirming
3
micro
91587
be
the
Double
in 0 . 020
aldosterone
is t e m p t i n g 100
nM)
phosphate 3
a well
DEAE-ce11ulose
C100
of
could
region 3
tissue,
reviews).
distinct
position
vity
on
267 52
clearly
the
for
is n o w
to
MR^
action
b
210
c
Fig.
7.
Ion E x c h a n g e C h r o m a t o g r a p h y C o r t ico id R e c e p t o r .
of
the
Renal
Mineralo-
2 ml renal c y t o s o l w a s i n c u b a t e d w i t h the a n t a g o n i s t in e a c h c a s e a n d 1 ml b l o o d s e r u m e q u i l i b r a t e d w i t h 0.1 mC i o f l i + C C o r t i s o l w a s u s e d as a p o s i t i o n m a r k e r . 100 n M s t e r o i d w a s u s e d for F i g u r e s a a n d b but o n l y 10 nM ^ h - Z K 9 1 5 8 7 w a s u s e d for F i g . 7c. . . 3 H C • ); C ( 0 ); A280.
211
Data
in
this
Figure exchange
for
the
ion
The
use
of
of
us
nearly
two
entity
the
since
almost
as
decades
peak
or
well
even
Tissue
with
corticoid (25).
with
be
10
is
any
time
but
was
H-ZK
that
in
the have
relevant
been
to
ask
antagonists
would
renal
replaced
another
cytosol
few
The
organs
Data
in
3
that
Fig.
population With
H-ZK
in
the
the
relative to
MR^
be
kidney dance
the
contrasted
a
(Fig.
receptor
to
the
maintained
is
of
Further
required
The
to
as
in nM
>
MR^
the 3
as
in
< MR^
to
constitute
studies,
to
a
a given could
target the
the
7a). the
(Fig.
in
mechanism stimulus
to
receptor
8b)
abun-
the drug.
of is
possibly
unequivocally.
MR ^
the
relative
equally
MR^
However,
explain
not
the
of
pharmacological
the
respond
one
heart
the
well
particularly
these
if
both
8b).
the
words,
homeostasis
whether
(Fig.
26752,
situation
could
when
gluco-
earlier
labelled
(Fig.
18).
(26).
kidney
H-RU
MR^
response
were
answer
various
similarly
26752
observed
organs
organs
of
(4,
mineralo-specific
H-RU
In o t h e r
also
action
described
100
MR^
the
7b).
3
subpopu1 ation
between
if all
vicissitude. tion,
of
were
with
could
organism.
nM
just
place
physiological
differences
discrimination ted
heart, in
(15-18)
question
behave
been
confirm
minera 1ocorticoids
100
proportions
cytosol of
to
that
populations
differential Such
8 show
by
previously
responds
9 1587
and
is
was
heart h a s
These
described
the
either
agonists
MR
elution
with
labelled
91587.
antagonize
of
when
receptor
at
3
one
assessment
26752,
nM
by
addition,
a distinct
mineralocorticoid
organ.
In
mineralocorticoid
populations
therefore
permits
ideal
species.
perfected
columns.
H-RU
just
with
24),
are
receptor
marker,
observed 3
nM
conditions
various
(23,
differences
receptor
It w a s
of
prewash
not
these
position
back
progestins
dependent
that
different
100
observations as
a
in t h e
exclusively
earliest
as
between
it c o u l d
transcortin,
show
separation
transcortin
r e p r o d u c i b i 1 ity observed,
also
any
presenbe one
purifica-
212 a
FRACTION
Fig.
8.
NOS
Ion E x c h a n g e C h r o m a t o g r a p h y R e c e p t o r from Rat H e a r t .
of
the
Mineralocorticoid
2 ml c a r d i a c c y t o s o l w a s i n c u b a t e d w i t h the a n t a g o n i s t in e a c h c a s e a n d 1 ml b l o o d s e r u m w a s e q u i l i b r a t e d w i t h 0.1 uCi of - C o r t i s o l w a s u s e d as a p o s i t i o n m a r k e r . 100 n M 3 H - s t e r o i d w a s u s e d in all c a s e s . 3
H
C •
);
C 0 );
A00n.
213 Molecular
filtration
antagonists dalton daltons quite
labelled
region CFig.
from
In p r e v i o u s
studies, and
Despite
91587 on
peak
these has
been
regions,
in m o l e c u l a r whereas
50,000 region.
to e l u t e
these
in
conditions RU
density
aldosterone
in c h a r g e
were .
dalton
weights,
charge
both
110,000
about
shown
under
identical differ
that
populations
similarity
populations
of
65,000
carry
near
in t h e
entity
in t h e
aldosterone dalton
revealed
component
b o t h of
on D E A E - c e 1 1 u 1 o s e )
bound MR
columns
lighter
transcortin
65,000
bound components single
by a
9). A g a i n ,
the
C15-18).
a heavier
followed
distinct
110,000
on Ultrogel
as well
26752 Cone
and
ZK
(two
peaks
DEAE-ce11ulose).
FRACTION NOS Fig.
9. M o l e c u l a r F i l t r a t i o n R e c e p t o r on Ultrogel
of the Renal Columns.
Mineralocort i coid
100 n M t r i t i a t e d s t e r o i d w a s u s e d to s a t u r a t e k ml c y t o s o l ; 2 ml s e r u m w i t h 0.2 uCi ^ ^ C - C o r t i s o 1 w a s u s e d as a p o s i t i o n m a r k e r . For f u r t h e r d e t a i l s see M e t h o d s and ( 1 5 - 1 8 ) . ltf ' « ( • ) ; C C 0 ); Aosn.
214 Data MR
in F i g .
labelled
could more
be
with
abundant was
26752
kidney, CFigs.
9b vs vs
the m o l e c u l a r less
abundant
lighter,
component when
10b).
the
organs
when
tissue
specific
gave
^H-RU
the
elution relative
component
26752
was
differences
10a),
91587 was to the
similar
However,
1 ighter
Whereas heavier,
CFig.
^H-ZK
10b). As c o m p a r e d 91587
filtration
two a n t a g o n i s t s .
as a
reversed
CFig. ^H-ZK
heavier
the
resolved
abundance RU
10 s h o w
was
noted
rat
H-RU
26752
followed
by
the
relative in p l a c e
situation profile
in of
in t h e these
the two
confirm
above.
16
x
E
Q. O
•15
50
25
FRACTION
NOS
E a o
FRACTION Fig.
10. M o l e c u l a r Receptor.
Filtration
of
NOS Cardiac
of
heart
24i
to
a
the
in t h e
abundance
Again,
cardiac
used
reversed
employed.
of 3
Minera 1 ocorticoid
215
Discussion
The
results
ces
in t h e
described mechanisms
derivatives finally
of
known
side
effects
side
properties,
The
and
is
that
molecule
was
reviews
The
^H-RU
by
higher
dependent
the
effects
3
more
hormones, 3
26752
or
these
new
receptor. inferred
H-ZK
abundant,
The by
abundant
a
cold
presence
authors
estrogen
has
the
by
derivatives
site
that
1 ittle than
are of
using
studies
receptor is
of
are
two
in
RU
binding
to
a
rather for
target
classical
ZK
all
for
the MR
estrogen
(11).
range
was
10-100
nM
confirmed
9 1587,
which
serum
carriers,
for
the of
suggest
time
mineralo^H-RU
that
both
mi n e r a l o c o r t i c o i d has
also
spiro1actones aldosterone
for
agonist,
binding
in
sites
similarly
specific
(for
26752
displacement
tritiated
the
nM
largely
than
26752,
receptor
kidney
between
n o n - r a d i o a c t ive
has
RU
the
possibly
- MR
1-10
of
material
rat
numbered
possible
with
was
26752
were
MR
of
another
position
latter
the
steroids,
specific
(see
molecule,
denominated
site
not
lack
system
affinity
the
for
absence that
and
91587
competition
contain
The
7a
which
H-RU
in
the noxious
antigestationa1
in w o m e n
the
the
observations
affinity
organs
in
sites
supremacy
to
a n t imi n o r a l o c o r t icoi d .
and
of
of
These
minera1ocorticoid
of
receptor
devoid
action,
substance,
for
kinetics
overall
from
corticoid
that
residue
in a
of
These
kinetics.
cytosol
The
The
are
important
spirolactone
ideal
differen-
synthesized are
molecule.
like
spirolactone
binding
(11).
an
propyl
classes
that
parent
native
being
side
newly
analogues
methoxy-carbony 1 derivative,
showed
cross
in
the
another,
26752
the
a
two
important
i rregular i t i es The
resulted
2-4).
two
aldosterone
followed
to
for
see
suggested
the
specificity
lacking
responsible
from
of
of
Such
antiandrogen
volume).
reveal
compounds
of
menstrual
far
increased
which
action
those
include
introduction
parent
by
at
effects
in t h i s
therefore,
of
paper
spiro1actone.
arriving
many
chapter
in t h i s
been the and
receptor
shown
been in
(22). to
antagonist, that (27).
is
more
216 The
importance
spirolactone Most
of c h e m i c a l
molecule
dramatic
t i o n of mitted
the
hormone
process
whether
this
these
is o b v i o u s l y
processes
receptor
is n o t
possible on the
l a c k of
activation explanation
latter was
this
glucocorticoid
just
as well
acetonide
or
the
contrary
of
of
compartment
sort
are
receptor
antig1ucocorticoid permit
The
influence
in t h i s
for
to
the
in v i v o very
so c a l l e d lose or
same
antagonist
Furthermore,
longer
suggestions
be
the
considered
action
where
inhibiting
the
of
the
transfer
is g e n e r a l l y
Thus,
either RU with
on
only
the
been
p r e c e d e d by
It c a n
(28)
subject
safely
situations,
or
between
nuclei,
is
by
be
time
binding
in n o w a y
activated
activity
(29
for
and of
in vivo,
reviews).
the
glucocorti-
separate here
either
that
from target
to e i t h e r or
DNA
no
in organs
In a d d i t i o n ,
target
on
triamcinolone
various
system.
work
cortexolone,
be s a i d
this
judged
but
limited
at all
at
hormone-receptor
recent
GR c a n
progestin
the
by
the a g o n i s t
38486
possible
activation,
isolated
s p e c i f i c.
has
volume.
seem
f r o m an
supported
activation
38486
systems
extrapolations vitro
thermal
also (GR).
of
not
RU
it
(9).
in p r e s e n c e
of
In o t h e r w o r d s ,
can no
that
proby
activation.
by
due
interfere
adopted
an a g o n i s t
to p r e v i o u s
91587)
in v i v o
the a c t i v a t i o n
agonist.
to be a c t i v e
CZK
determined
that
antiminera1ocorticoid
the a n t a g o n i s t
receptor
ions
per-
natural
to be
be o p e r a t i v e
event,
receptor
did
chapters
the
the
another
coid
It r e m a i n s
activa-
26752)
the
to the c o n f o r m a t i o n
receptor
for
believed
Conclusions the
of
activation
(RU
the
studies.
thermal
as
phosphate
In a n y
unique
of
to t h e n u c l e a r
receptor
as well
also
of
to d i s t i n g u i s h
a valid
7 of
subsequent
in t h e
antihormone
just
would
(12).
not
basis
spirolactone,
one
completely.
in p r e s e n c e
merely
in all
observed
predominance
cess
in p o s i t i o n
the m e t h o x y - c a r b o n y 1 d e r i v a t i v e
differences
to t h e
with
of M R
Whereas
process
these
primarily
confirmed were
to p r o c e e d
aldosterone,
inhibited
the
was
differences
receptor.
this
substitution
the
cellu-
hormone
217
In
the
first
receptor buffer as
but
with
this
ever
complex
disaggregated
other
was
not
permit
forms. the
did
above
on
total
further
either
aldosterone
ZK
91587
-
Rather
stabilized the
protection as
an
ting
the
whatever
liver
60
min
for
against receptor
specific
known. alter
C or
35°
C
so
in
the
for
data
lacking
values.
had
no
these
was with
Similarly, in
presence
influence
on
differences
were
antiprogestin
RU
actually
receptor
system
(30).
totally
Such
not
This
(GR)
comparisons
in
cytosol
the is
Such
organism
The
were
and
reason(s)
with
differences
where
a
continuously.
at
any
38486, protecthe
stable
underscore
stability endowed
RU in
whereas
complexes
cytosol
afford
same
characterization
stability.
almost
oviduct
did
ineffective
receptor - GR
38486
in c h i c k
progesterone,
was
(28).
whole
protection
populations.
acetonide
tissue
prevails
inactive
cortexolone
denaturation
but
extrapolations.
receptor
and
did
receptor
differences
Perhaps
activa-
confirm
altogether
Again,
receptor
generalized
importance 37°
at
individual
largely
intermediate
glucocorticoid
need
almost
these
thermal
active
the
heterogeneous
in t h i s
upto
divided
4 S units
with
just
26752,
under
upon
receptor
26752
hormone,
triamcinolone
that
the
C,
against
RU
progesetrone
native
and
and
complex.
agonist
not
or
antig1ucocorticoid, rat
35°
gave
suggesting
paradoxically,
whereas
at
protected
receptor
dependent
(31)
salt
Whereas
RU
was
into
reported
low
cellulose.
26752
of
(1-4).
complex
further
the
activation,
antagonist
h o r m o n a l 1y
were
aldosterone
H-RU
molybdate
dose
between
studies
with 3
91587;
thermal
dissociation
aldosterone-
in
4 S populations,
change
receptor DNA
region
receptors the
receptor the
conclusions
denaturation
H-ZK
-
gradients,
7 S
4 S after
with
mere
distinction
the
hormone
not
words,
glucocorticoid
almost 3
which
Similar
obtained
In
91587 7 S and
sucrose
in
to
of
the
In o t h e r
on
confirmed
^H-ZK
into
conditions, tion.
classes
largely
unactivated equally
analysis sedimented
the
caution for
these
35°
C
are
factors
may
temperature
assume of
218 Ion e x c h a n g e
chromatography
on D E A E - c e 1 1 u 1 o s e
the mi n e r a l o c o r t icoi d r e c e p t o r forms whose Both the
genesis
aldosterone low
^H-RU
ionic
26752
consisted H-RU
bound MR.
of M R £
phosphate.
organ
1 i ver
C 18) .
these
kidney
evidence
for
and
the
with
is u n c l e a r
molecular
all
classes (32-34). ting
a mixture
of
two
In o t h e r
from
two
M and with
the
nontarget
ionic
forms
Here,
the
populations words,
these
the
MR^
molecular
ionic c o m p o n e n t s
receptor
the
resin
largely
columns.
of
and
transcortin.
in the
these
gave
in
progesterone
M phosphate
a r e of
of
the
homogeneous
populations
litterature of
steroid
How
then
in the c e l l .
To
actually
hormones.
hormone
receptors
to u n d e r s t a n d coded
in an e a r l i e r
the
these
of
extend
some
abounds The
of gene
has now
two
observed
the
the
(35).
earl¡est
receptor
new
various
been
receptor
back
receptor
for
relationships,
publ i c a t i o n
our
decades
in e v e r
appearannce
by a s i n g l e
modifications
understand
and
heterogeneity
steroid
species
post-trans1 ationa1
confirm
heterogeneity
of m o l e c u l a r
classes
receptor
advanced
bound
91587,
coeluted
both
two
the
ZK
serum
both
within
of
91587
receptor
24-). The
of
consists
on
in 0 . 0 2 0 - 0 . 0 2 4
lacking
alike
the
ZK
and
on Ultrogel
whether
chromatography
of
demonstrations for
or
data with
23,
of 0 . 0 6 totally
tissue.
columns.
demonstration (7,
conditions, aldosterone,
the
that ionic
transcortin
blood
to M R ^
heterogeneity
26752
the
sizes
on Ultrogel
These
RU
or
from
of
region
with
into
component
retained
very
ant¡hormones
forms.
aldosterone
lacking
distinct
and
the M R ^
1 0 0 - 1 2 0, 00 0 d a l t o n s .
component It
steroid
aldosterone
filtration
two
5 0 - 6 5 , 00 0 a n d
the
populations
but w e r e
from molecular
hormone of
was
confirmed
be s e p a r a t e d
labelled
exclusively
in the M R ^
target
Further
quite
antagonists
transcortin
came
The
bound
Under
two
upon
91587
and MR^, with
both
267 5 2 w a s
R-5020,
ZK
prewash which
respective1y, 3
depends
and
could
cloned
of
isoaccep-
gene? are
Perhaps
operative
a model
was
219
Persepectives
and
Conclusion
Mineralocorticoid substances and
including
other
most
means
promising
already
hormone
in
attempted
in o r d e r
increase in t h i s the in
the
the
native
It
duction
of
a
a molecule receptor species
the
called
(9). was
nM
hormone.
Type
bind
1-10
in
The of
existence
confirmed
and
of
an
specificity
for
both
These
antagonist (22)
in
mineralocorticoid
to
resolve
possible
receptor
protein.
It for
is
however
MR
vectors
since in
that
neither
non-target
specificity,
both
is
receptor
intro-
produced specific
abundant affinity
for
increased
of
to
such of
with
was
system makes
derivatives
action
with
(27). it
and in
are
are
1 iver. quite
a
Gene
even
transcortin,
the
so
affinity
heterogeneity
serum
the
minera1oreceptor
keeping
modifications
as
in
supposed
variable
in
receptor
these
bind
theirmechanisms
the
sites
that
specific
and
appearnce
organs
increase
derivative.
variance
with
p o s t - t r a n s l a t ional
clear they
estrogen
the
at
receptor
vector
to
are
antagonists
of
point
an
for
methoxy-carbony 1 derivative
similar
difficult
the
to
more
little
cloning
the
another,
and
chapter
aldosterone
had
independently
been
that
which
the
subs-
effects
c o n f i g u a r t ion the
the
affinity
lead
demonstrate 7a
(18)
far
another the
spirolactone
and
range
91587).
agonists
in
the
range,
nM
have
side
(see
saturated
I mineralocorticoid
all
The
(ZK
that
molecule
action
chapter
By
Chemical
increase
the
various
Spiro1actones,
(2-4).
necessarily
of
residue
introduction
7 position
not
are
by
progestins
(2-4).
undesirable
that
action
10-100
(36,37), before
spirolactone
does
antagonized
context
ant i hormone
26752)
the the
natural
the
to
in in
be
decades
attenuate
in t h i s
propyl
(RU
in t h i s since
is c l e a r
physiological
described
the
to
receptor
Results
with
use
the specific book).
cellular
repeatedly
materials
titutions
can
glucocorticoids
reviewed
in c l i n i c a l
action
more may
the
specific nor
Despite
to this
distinct.
220 ^H-RU
26752
receptor
- MR c o m p l e x
complex
activation. activation RU
26752
similar vated
35°
C but
underwent
^H-ZK
91587
to a l d o s t e r o n e
ZK
ZK
was
when
studies
action
differ
of
RU
reveal
guration. any one
in the
Thus,
is
addition, elution
of
the
new
activation
desired
receptor
the MR
by
quite
nonacti7 S and
heat.
S
In
DEAE-ce11ulose but
only
one
in the
could
imposed
unique
and
be e x p l o i t e d
generating may
be
in t h e
upon
the
dictates in the
receptor
resins
7a
that confi
receptor
by
subsequent screening
of
variants
function
fruitfully
from affinity
mechanism
derivatives
substitution
physiological
derivatives
on
differences
of
This may of
even
in t h e
altered
observed
C.
in a m a n n e r
however,
Spirolactone
nature
capable
the
such
sucrose
employed.
inherently
behaviour.
new derivatives endowed with
35°
the c o n f o r m a t i o n
steroid
receptor
at on
further
important
two,
thermal
receptor
to s a t u r a t e
26752 was
these
solely
not
hormone thermal
permit
was centrifuged
forms were
used
comparable
the
- MR complex;
this was
ionic
91587
be e l u t e d These
and
two
the
7 S to 4 S s h i f t
thermal
- MR complex
91 587
compartments
of
of
than
did not
destabilized underwent
as a result
addition, when
greatly
- MR c o m p l e x
gradients
unstable
Contrarily, and
at
was more
in v i v o .
utilized for
In
in
the
eventual
pur i f i cat i on. Note:
The
trivial
follows:
RU
names
are
as
21,
1 7-carbo 1 actone;
of
the
two a n t a g o n i s t s
employed
here
267 5 2 ; 7 a p r o p y 1 - 3 - o x o - 1 7 a - p r e g n - ' t - e n e ZK
16 8 - m e t h y 1 e n e - 3 - o x o - 1 7
91 5 8 7 ;
7 a - m e t h o x y - c a r b o n y 1 - 1 5 £3,
a-pregn-^-ene
21,
17-carbo 1actone.
221
References
1.
A g a r w a l , M. de G r u y t e r ,
2.
A g a r w a l , M . K. ( e d ) A n t i h o r m o n e s , El s e v i e r / N o r t h Biomedical Press, Amsterdam, New York, 1979.
3.
A g a r w a l , M. B e r i in, N e w
4.
Agarwal, Gruyter,
M . K. ( e d ) A d r e n a l S t e r o i d Berlin, New York, 1984.
Antagonism,
5.
Sakauye, (1976).
C.
Physiol.,
6.
F a n e s t i l , D. D. and 637-649 (1981).
7.
A g a r w a l , M . K. ( e d ) M u l t i p l e M o l e c u l a r F o r m s o f S t e r o i d Hormone Receptors, Elsevier/North Holland Biomedical Press, A m s t e r d a m , New York, 1977. M.
K. ( e d ) Berlin,
P r i n c i p l e s of R e c e p t e r o l o g y , New York, 1983.
K. ( e d ) H o r m o n e York, 1982.
and
K.,
Feldman,
D.,
Am.
J.
C.
S.,
Ann.
Park,
Walter
231:
de
93-97
Physiol.,
43:
Agarwal,
10.
Bradford,
11.
L a z a r , G. and A g a r w a l , 134: 2 6 1 - 2 6 5 ( 1 9 8 6 ) .
12.
A g a r w a l , M. C o m m . , 143:
13.
Ka1 i m i , M . , C o l m a n , P. a n d 2 5 0 : 1 0 8 0 - 1 0 8 6 ( 197 5 ) .
F e igei s o n ,
14.
Martin, R . (1961) .
Biol.
15.
Agarwal,
16.
Agarwal,
17.
Agarwal,
18.
A g a r w a l , M. K. a n d P a i l l a r d , C o m m . , 89: 7 7 - 8 4 ( 1 9 7 9 ) .
19.
G r i l l , H. J . , N i c k i s h , K., S c h u l z e , Elger, W., Heubner, A., and Pollow, 23: 19S ( 1 9 8 5 ) .
20.
P o l l o w , K . , G r i l l , H . J . , S c h u l z e , P. E . , N i c k i s c h , K . , H e u b n e r , A . , L a u r e n t , H., E l g e r , W. and M a n z , B., Intnl. Study G r o u p for Steroid H o r m o n e s , Rome, (Abstract), December, 1985.
Biochem., M.
72:
K.,
Ames,
B.,
K.,
Nature,
M.
K.,
Biochem.
M.
K.,
FEBS
J.
254: J.,
Letters,
(1978).
J. W., F e l d m a n , Sci. (USA), 71: 248-256
Biochem.
K. a n d Kal i m i , M . , 398-402 (1987).
and
1-8
Gruyter
M a r v e r , D., Stewart, J., Funder, E d e l m a n , I. S . , P r o c . N a t . A c a d . 1435 (1974).
M.
85:
Rev.
de
9.
Anal.
Letters,
Walter
Holland,
8.
D.,
FEBS
Antagonists,
Walter
Res.
Biophys.
P.,
Chem.,
623-625
(1976).
Biophys.
Biochem.
D. a n d 1431-
J.
236:
Res.
Biol.
Chem.,
1372-1379
(1975).
154:
567-575
(1976).
67:
260-263
(1976).
J.,
Comm.
Biochem. P. E., K., J.
Biophys.
Res.
Laurent, H., S t e r o i d Biochem
222 21.
B a l l a r d , P. L . , B a x t e r , J . D . , H i g g i n s , S . J . , R o u s s e a u , G. G. a n d T o m k i n s , G. M., E n d o c r i n o l o g y , 94: 9 9 8 - 1 0 0 2 (1974).
22.
L u z z a n i , F. a n d G l a s s e r , 2277-228 1 ( 198*0.
23.
S n a r t , R. S . , S a n y a l , N . N . a n d c r i n o l . , 47: 149-158 ( 1 9 7 0 ) .
24.
S n a r t , R. Hormones,
25.
Agarwal, Biophys.
26.
A g a r w a l , M. K. a n d P h i l i p p e , 1 1: 1 1 5 - 1 2 6 ( 1 9 7 9 ) .
27.
S u t h e r l a n d , R. L . , M u r p h y , L. C . , F o o , W h y b o u r n e , A. M. a n d K r o z o w s k i , Z. S., 288: 273-275 (1980).
28.
A g a r w a l , M . K. , L o m b a r d o , G . , E l i e z e r , N . a n d M o u d g i 1 , V. K., B i o c h e m . B i o p h y s . Res. C o m m . , 133: 7 4 5 - 7 5 2 (1985).
29.
A g a r w a l , M. K., H a i n q u e , B., M o u s t a i d , FEBS Letters 217: 221-226 (1987).
30.
Moudgil, Agarwal, ( 1986) .
31.
K a i s e r , N . , M i l h o l l a n d , R. F., B i o c h e m . B i o p h y s . R e s .
32.
H o l l e n b e r g , S. M . , W e i n b e r g e r , C . , O n g , E. S . , C e r e l l i , G . , O r o , A . , L e b o , R . , T h o m p s o n , E. B . , R o s e n f e l d , M . G . a n d E v a n s , R. M . , N a t u r e ( L o n d ) , 3 1 8 : 6 3 5 - 6 4 1 (1985).
33.
M i s e f e l d , R . , R u s c o n i , S . , G o d o w s k i , P. J . , M a l e r , B . A . , O k r e t , S., W i k s t r o m , A. C, G u s t a f s s o n , J. A. a n d Y a m a m o t o , K. R . , C e l l , 4 6 : 3 8 9 - 3 9 9 ( 1 9 8 6 ) .
34.
Green,
S.
A.,
S . , S h e p h e r d , R . E. 3: 2 9 3 - 3 1 2 (1972).
Biochem.
Pharmacol.,
Agarwal,
and
M.
Agarwal,
K., M.
M . K . , C o u p r y , F. a n d P h i l i p p e , M . , Res. C o m m . , 78: 7 4 7 - 7 5 3 ( 1 9 7 7 ) .
V. M.
K., K.,
and M.
Eliezer, Biochim.
Chambon,
K.,
FEBS
M.,
J.
Endo-
K., Biochem.
Mo 1 . Cell. M. S., Nature
N.
J.
33:
and
Cardiol., G r e e n , M. (Lond),
Lazar,
D.
G.,
N., L o m b a r d o , G., H u r d , C. a n d Biophys. Acta, 889: 192-199
P.,
J . , T u r n e l l , R. W. C o m m . , 49: 5 1 6 - 5 2 1
Nature,
Letters,
178:
325:
(1987).
35.
Agarwal,
36.
S t o c k i g t , J . R. a n d S c o g g i n s , M e t a b . , 64: 22-26 ( 1 9 8 7 ) .
37.
G r u n f e l d , J. P., E l o y , L., M o u r a , A. M., G a n e v a l , D., F r e n d o , B. R. a n d W o r c e l , M . , H y p e r t e n s i o n , 7: 2 9 2 - 2 9 9 (1985).
B.
1-5
75-78
and Rosen, (1972).
A.,
J.
(1984). Clin.
Endocr.
N E W M O L E C U L A R PROBES TO ASSESS ESTROGEN A N D A N T I E S T R O G E N ACTIONS
E t h e l M. Cormier and V. Craig
Jordan
D e p a r t m e n t of H u m a n O n c o l o g y , University of W i s c o n s i n , M a d i s o n , W i s c o n s i n 53792
Introduction M a n y b r e a s t c a n c e r s grow in direct response to e s t r o g e n stimulation
(1, 2).
As early as 1896, B e a t s o n
demonstrated
that o o p h o r e c t o m y of premenopausal w o m e n w i t h breast r e s u l t e d in tumor regression in some p a t i e n t s
(3).
cancer The
for this o b s e r v a t i o n was unknown until more than fifty later.
The synthesis and use of t r i t i u m - l a b e l e d
reason years
estrogens,
w i t h h i g h s p e c i f i c activity, led to the discovery of a receptor p r o t e i n w i t h both a high binding affinity and specificity
(4-7).
ligand
The m e a s u r e m e n t of e s t r o g e n receptors
b i o p s i e s of breast cancer patients
in
(8-12) indicated a m e c h a n -
ism of h o r m o n e - s t i m u l a t e d growth and p r o m p t e d d e v e l o p m e n t
of
e s t r o g e n a n t a g o n i s t s for breast cancer therapy
The
(13, 14).
c o r r e l a t i o n b e t w e e n response to endocrine therapy and
the
p r e s e n c e of e s t r o g e n receptors in human breast cancer
(15-17)
has f o c u s e d m u c h a t t e n t i o n on the molecular m e c h a n i s m s of estrogen action.
The ultimate aim is to u n d e r s t a n d the
role
of e s t r o g e n in the development of breast cancer, so that i n f o r m a t i o n can be used for the d e s i g n of e f f e c t i v e a n d u l t i m a t e l y the p r e v e n t i o n of the d i s e a s e .
this
treatments
It is c l e a r ,
h o w e v e r , that a complete understanding of the mode of
estrogen
a c t i o n t h r o u g h its receptor must be p u r s u e d since each s t e p m a y lend itself to m a n i p u l a t i o n or d i s r u p t i o n by natural or s y n t h e t i c agents.
This review will focus on the c h a n g i n g
Receptor Mediated Antisteroid Action © 1987 Walter de Gruyter & Co., Berlin • New York - Printed in Germany
224 c o n c e p t s concerning the d e v e l o p m e n t of breast cancer w i t h a n o v e r v i e w on new probes to assess estrogen a c t i o n a n d new t h e r a p i e s for
A.
treatment.
M o d e l s for steroid receptor
1) C l a s s i c a l m o d e l . cell m e m b r a n e s
action
Steroids appear to diffuse freely
(18, 19).
through
R e t e n t i o n of the s t e r o i d is a c c o m -
p l i s h e d by high affinity binding to receptor sites.
In a
f u n c t i o n a l sense, a receptor must display a dual role, that of r e c o g n i t i o n and a c t i v a t i o n .
The receptor p r o t e i n m i g h t
p l i s h b o t h roles by either possessing two f u n c t i o n a l or two c o n f o r m a t i o n a l states
accom-
domains
(see Figure 1).
The c l a s s i c a l m o d e l of e s t r o g e n receptor a c t i v a t i o n has
been
a c c e p t e d as the p a r a d i g m to explain e s t r o g e n a c t i o n a n d the a c t i o n of m o s t steroid hormones
(20).
In the a b s e n c e of
h o r m o n e , the e s t r o g e n receptor is located in the c y t o p l a s m of the cell
(see Figure IB).
W h e n hormone is bound, an
estrogen-
receptor complex is formed w h i c h then becomes t r a n s f o r m e d an a c t i v e state.
Receptor
transformation has b e e n
ized by the change in the c o n f o r m a t i o n of the complex.
This c o n f o r m a t i o n a l change causes a shift in the (20).
cell g r o w t h are
trans-
including
stimulated.
The e x i s t e n c e of d i f f e r e n t binding and a c t i v a t i o n tions has been well d o c u m e n t e d for the e s t r o g e n
conforma-
receptor
A c t i v a t i o n of the e s t r o g e n receptor m o d i f i e s
r e c e p t o r ' s intrinsic activity as well as the value.
gradient
The resulting a c t i v a t e d complex then
l o c a t e s to the nucleus where biological responses
(21-23).
character-
ligand-receptor
s e d i m e n t a t i o n c o e f f i c i e n t from 4S to 5S in sucrose analysis
into
sedimentation
Receptor a c t i v a t i o n is d e p e n d e n t upon both
b i n d i n g a n d temperature
(21).
the
estrogen
A u t o r a d i o g r a p h i c and cell
225
F i g u r e 1. S c h e m a t i c representation of ligand-receptor r e c o g nition and activation. A) The m e m b r a n e - b o u n d e p i d e r m a l g r o w t h factor receptor p o s s e s s e s two structural domains. An epid e r m a l g r o w t h factor (EGF) binding d o m a i n a n d a c a t a l y t i c k i n a s e d o m a i n w h i c h is a c t i v a t e d by E G F binding and w h i c h c a u s e s the p h o s p h o r y l a t i o n and a c t i v a t i o n of a number of enzymes. B) In the classical e s t r o g e n receptor m o d e l , e s t r o g e n (E 2 ) freely diffuses through the cell m e m b r a n e and b i n d s to a c y t o p l a s m i c receptor. A n e s t r o g e n - e s t r o g e n receptor complex with a s e d i m e n t a t i o n value of 4S is f o r m e d . A c t i v a t i o n of this complex is a c c o m p a n i e d by a change in the s e d i m e n t a t i o n value to 5S. The 5S complex interacts w i t h nuclear acceptor sites to switch on DNA synthesis and m R N A production. f r a c t i o n a t i o n studies show that at 4°C, uterine
tissue
i n c u b a t e d w i t h t r i t i u m - l a b e l e d estradiol retains most of label in the c y t o p l a s m i c fraction
(21).
At a higher
the
tempera-
ture of 37°C, m o s t of the estradiol is a s s o c i a t e d w i t h the nuclear
fraction.
Estrogen treatment both _in vitro a n d
226 in v i v o leads to receptor decrease in the cytosol, by an increase in nuclear receptor levels
paralleled
(22, 23).
The
s e d i m e n t a t i o n coefficient of the e s t r a d i o l - e s t r o g e n complex in salt-containing
receptor
sucrose g r a d i e n t s c h a n g e s w i t h
nuclear uptake from 4S to 5S (24, 25).
Activated
estrogen
receptor increases mRNA pools and p r o t e i n synthesis as a result of DNA acceptor site interactions 2) Nuclear e s t r o g e n receptors.
(26-31).
The current e s t r o g e n
receptor
m o d e l c o n t e n d s that the u n o c c u p i e d e s t r o g e n receptor is a l m o s t e x c l u s i v e l y nuclear
(see Figure 2).
As early as 1977, a small
number of reports had q u e s t i o n e d the dogma that the receptor was c y t o p l a s m i c
( 32-36).
unoccupied
Studies by Linkie et al.
s h o w e d that the 4S s e d i m e n t a t i o n form of the e s t r o g e n
receptor
c o u l d be t r a n s f o r m e d to the 5S form w i t h i n the nucleus 33).
These d a t a q u e s t i o n e d if the classical m o d e l of
a c t i v a t i o n p r e c e d i n g nuclear translocation was
(32, receptor
correct.
S h e r i d a n a n d coworkers found receptor l o c a l i z a t i o n to be highly d e p e n d e n t upon tissue p r e p a r a t i o n
(34-36).
These
a u t h o r s s u g g e s t e d that receptors were in e q u i l i b r i u m
between
the n u c l e u s and cytoplasm and that p r e p a r a t i o n of cells
in
h y p o t o n i c buffers caused a receptor
that
redistribution such
nuclear receptors relocated into the fraction c o n t a i n i n g higher buffer
the
volume.
E n u c l e a t i o n studies in GH3 rat p i t u i t a r y tumor and M C F - 7 breast cancer cell lines, using differential
centrifugation
and c y t o c h a l a s i n - B to extrude the nucleus, showed that b i n d i n g of tritiated estradiol o c c u r r e d mostly in those tions containing the n u c l e o p l a s t s
the frac-
(an intact nucleus w i t h a
small perimeter of t r y p a n - b l u e - e x c l u d i n g c y t o p l a s m i c m e m b r a n e ) (37, 38).
Similar results were also o b t a i n e d in GH3 c e l l s
the a b s e n c e of c y t o c h a l a s i n - B e x p e r i m e n t s , a cytoplast membrane)
(38).
In the GH3 cell
(cytoplasm in a
in
line
trypan-blue-excluding
layer virtually free of contaminating nuclei
was
227 IGFR
k:
TGFIi
39KD
protein inT
•»«. •TGF-O
CELL PROLIFERATION Figure 2. Schematic representation of unoccupied nuclear estrogen receptors and a nuclear estrogen-estrogen receptor transformation. Receptor activation by estrogen may cause a decrease in the activation and secretion of transforming growth factor beta (TGF-6) and the 39 KD protein concurrently with the activation and increased secretion of transforming growth factor alpha (TGF-a), epidermal growth factor (EGF), and insulin-like growth factor I (IGF-I). Each of these hormones may then interact with their receptors (EGFR and IGFR, respectively) in an autocrine or paracrine fashion to enhance cell proliferation. obtained; nucleoplast fractions contained both nucleoplast and whole cells.
Nucleoplasts which are between 80 to 95% pure
were obtained from MCF-7 breast cancer cells (39) in preliminary studies done in this laboratory
(see Table 1).
Again,
the majority of the unoccupied receptor remained nuclear Table 2).
(see
Enucleation studies on cells from other estrogen
228
Estrogen receptor (ER) fmol ER/ pmol ER/ Protein/DNA mg protein mg DNA W e cells
17.6
124
2.2
12.5 3.1
159 706
2.0 2.2
Fractions: Mixed Nucleoplasts
T a b l e 1. MCF-7 cells were e n u c l e a t e d by a p r o c e d u r e that u s e d a c o n t i n u o u s Percoll gradient (37) w i t h p a r t i a l s e p a r a t i o n of fractions. The m i x e d fraction was h e t e r o g e n e o u s a n d c o n t a i n e d n u c l e o p l a s t s , cytoplasts, and partially e n u c l e a t e d cells, w h i l e the n u c l e o p l a s t fraction was a p p r o x i m a t e l y 90% p u r e . E s t r o g e n receptor, p r o t e i n and DNA were m e a s u r e d in e a c h f r a c tion. The results show that the c o n c e n t r a t i o n of e s t r o g e n receptor per mg DNA remains constant b e t w e e n w h o l e cells a n d n u c l e o p l a s t s , but the c o n c e n t r a t i o n of e s t r o g e n receptor per mg p r o t e i n increases dramatically in n u c l e o p l a s t s c o m p a r e d to w h o l e cells. P r o t e i n per DNA ratio d e c r e a s e s b e t w e e n w h o l e cells and nucleoplasts. target tissue have also concluded that u n o c c u p i e d receptor resides in the nucleus
estrogen
(40).
A l t h o u g h e n u c l e a t i o n studies cannot c o n c l u s i v e l y e x c l u d e p o s s i b i l i t y that the estrogen receptor remains in the v o l u m e of c y t o p l a s m surrounding the nucleus,
the
small
immunocyto-
c h e m i c a l studies using highly specific m o n o c l o n a l
antibodies
to the e s t r o g e n receptor have also indicated that
unoccupied
e s t r o g e n receptors are p r e d o m i n a n t l y localized in the
nucleus
of a number of target tissues including h u m a n breast
tumor
s a m p l e s , MCF-7 breast cancer cells, h u m a n and rabbit
uterine
229
Number of estrogen receptors per cell or nucleoplast Experiment I
II
Whole cells
24,200
26,600
Nucleoplasts
20,300
18,700
T a b l e 2. In two e n u c l e a t i o n experiments of MCF-7 cells, up to 84% of the u n o c c u p i e d estrogen receptor is r e c o v e r e d in the n u c l e o p l a s t fraction. t i s s u e as well as rabbit oviduct, corpus luteum, m a m m a r y g l a n d , p i t u i t a r y , and liver
(41).
The u n i f o r m
staining o b s e r v e d suggests that receptors are
nuclear distributed
t h r o u g h o u t the nucleus and are not c l u s t e r e d a r o u n d the nuclear membrane.
Furthermore, treatment of cells or a n i m a l s
w i t h e s t r o g e n does not increase the nuclear intensity.
Together the enucleation and
staining
immuno-staining
t e c h n i q u e s p r o v i d e strong evidence for a nuclear
receptor.
In further support of a nuclear receptor, the binding
kinetics
for the e s t r o g e n receptor in vivo appear similar to that of receptor i m m o b i l i z e d on hydroxylapatite
(42-44).
Since
230
r e c e p t o r s behave as if they are immobilized a n d since
estrogen
a c t i o n is targetted for the nucleus then these k i n e t i c
studies
suggest that e s t r o g e n receptors may be nuclear a n d a l s o a s s o c i a t e d w i t h nuclear
acceptors.
S t u d i e s in immature rats injected w i t h
low-affinity,
n o n s t e r o i d a l estrogens also imply the p o s s i b i l i t y of a n u c l e a r e s t r o g e n receptor
(45).
Experiments in this laboratory
an e x c h a n g e assay o b s e r v e d that c y t o s o l i c e s t r o g e n
using
receptors
d i d not d e c r e a s e w h e n immature rats were t r e a t e d w i t h
low-
a f f i n i t y , n o n s t e r o i d a l estrogens a l t h o u g h u t e r i n e w e i g h t progesterone
receptor levels increased
(45).
We
hypothesized
that tissue h o m o g e n i z a t i o n caused u n o c c u p i e d nuclear to b e c o m e c y t o p l a s m i c .
and
receptor
T h e r e f o r e , treatment of target
tissues
w i t h l o w - a f f i n i t y compounds, which readily d i s s o c i a t e f r o m the r e c e p t o r , w o u l d follow the d i s t r i b u t i o n p a t t e r n of receptor.
The n u c l e a r - a s s o c i a t e d receptor is
unoccupied
therefore
b e l i e v e d to bind estrogen and undergo t r a n s f o r m a t i o n into a n active complex.
Once activated, the r e c e p t o r - l i g a n d
complex
m a y then interact with DNA acceptor sites w h i c h lead to biological 3.
response.
B i o l o g i c a l l y active u n o c c u p i e d receptor.
A third p o s s i b l e
m o d e l is that u n o c c u p i e d receptors are not only located in the n u c l e u s but are also active.
Significant a m o u n t s of
u n o c c u p i e d nuclear estrogen receptor can be found in h u m a n b r e a s t tumor b i o p s i e s and cultured breast cancer cell (46-49).
A nuclear location of receptor in MCF-7
cancer cells has been p r o p o s e d
(48).
lines
breast
H o w e v e r , this c l a i m w a s
later r e t r a c t e d since major c y t o p l a s m i c c o n t a m i n a t i o n found in the MCF-7 cell nuclear p r e p a r a t i o n s
(50).
was
But,
light of the recent finding that phenol red, a pH dye
in
indi-
cator in high c o n c e n t r a t i o n s in tissue culture m e d i a , is a weak e s t r o g e n
(51, 52), the concept of active
unoccupied
e s t r o g e n receptor should be reconsidered for several
reasons.
231 E x p e r i m e n t s done by K a t z e n e l l e n b o g e n et a^.
(personal
communi-
cation) a n d in this laboratory demonstrate that the c o n t r o l g r o w t h rate of MCF-7 cells in the absence of phenol red is initially slower than in the presence of p h e n o l red, but a d a p t s w i t h time to that of the original phenol red g r o w t h response
(53).
This a d a p t i o n to a
nonestrogen-containing
e n v i r o n m e n t has a strong correlation w i t h an increase e s t r o g e n receptors, a l t h o u g h progesterone receptor remain very low.
It can therefore be a r g u e d whether or not
the increase in g r o w t h is stimulated by the i n c r e a s e d of u n o c c u p i e d
in
levels number
receptor.
Interestingly,
it is well d o c u m e n t e d that p o s t m e n o p a u s a l
have higher e s t r o g e n receptors in their breast tumors premenopausal women
(54).
women
than
This o b s e r v a t i o n m a y e x p l a i n the
m e c h a n i s m of tumor growth in postmenopausal w o m e n in the a b s e n c e of m e a s u r a b l e estrogens.
Another recent
report
involving g l u c o c o r t i c o i d receptors has indicated that
the
i n t e r a c t i o n of u n o c c u p i e d g l u c o c o r t i c o i d receptors w i t h nuclear c o m p o n e n t s may be able to turn on steroid genes
(55).
responsive
Thus, MCF-7 growth in p h e n o l - r e d - f r e e
media
a f f o r d s a unique system to look at the induction of g r o w t h in the a b s e n c e of
B.
estrogens.
E s t r o g e n s and phenol
red
It is a p p a r e n t , in hindsight, that m u c h of the d i f f i c u l t y
in
d e m o n s t r a t i n g an e s t r o g e n - s t i m u l a t e d g r o w t h in MCF-7
breast
cancer cells was due to the presence of phenol red.
We
c u r r e n t l y find that there is a very potent
growth-promoting
response e v o k e d in MCF-7 cells at very low c o n c e n t r a t i o n s estradiol
(see Figure 3A).
of
Half-maximal s t i m u l a t i o n is m e a -
s u r e d at 1 0 - 1 2 M to 1 0 - 1 3 M in a 5-day g r o w t h assay.
At
these
232
B 30
20
25 I5
a>
^ 20 15
ED=n « 5XI0"I3M
10
o» 10
5
Contri
•13 -12 -II -10 Log Cone (M)
>> Ll_ Ll. _ -I O O + T * UJ UJ
F i g u r e 3. A) G r o w t h curve of MCF-7 cells g r o w n in 24-well tissue culture plates and treated w i t h v a r i o u s c o n c e n t r a t i o n s of e s t r a d i o l - 1 7 6 . G r o w t h is m e a s u r e d as yg of DNA. B) G r o w t h of MCF-7 cells m e a s u r e d as ug of DNA after 7 days of t r e a t m e n t 8 w i t h L Y 1 5 6 7 5 8 (LY, 10 ) , epidermal g r o w t h factor (EGF, 10 M) or a c o m b i n a t i o n of both and c o m p a r e d w i t h no t r e a t m e n t (C). e s t r a d i o l c o n c e n t r a t i o n s , cell p r o l i f e r a t i o n is more to e s t r o g e n s t i m u l a t i o n than p r o g e s t e r o n e receptor G r o w t h s t i m u l a t i o n of MCF-7 cells at e s t r o g e n
sensitive
synthesis.
concentrations
u n d e t e c t a b l e by radioimmunoassay d e m o n s t r a t e the p o s s i b l e s e n s i t i v i t y of breast cancer to e s t r o g e n s t i m u l a t i o n .
This
s y s t e m p r o v i d e s a model to evaluate agents useful in the p r e v e n t i o n of breast cancer and also the o p p o r t u n i t y r e e v a l u a t e the current concepts concerning e s t r o g e n
to action.
233 C.
E s t r o g e n s and growth
factors
G r o w t h factor induction by estrogen has been p o s t u l a t e d to be a p o s s i b l e m e c h a n i s m by w h i c h the steroid p r o m o t e s g r o w t h h u m a n breast cancer
(56-59).
in
Breast cancer cell lines have
b e e n s h o w n to synthesize insulin-like g r o w t h factor I and II a n d the e s t r o g e n - i n d u c i b l e transforming g r o w t h factor (56, 58, 60).
alpha
F u r t h e r m o r e , injecting a t h y m i c mice w i t h a c i d -
e x t r a c t e d m e d i a , c o n d i t i o n e d by e s t r o g e n - s t i m u l a t e d
MCF-7
c e l l s a n d charcoal stripped to remove free e s t r o g e n ,
causes
the g r o w t h of implanted MCF-7 tumors (56).
condi-
Whereas,
t i o n e d m e d i a from u n t r e a t e d cells only weakly growth.
stimulated
T h e r e f o r e , if a n t i e s t r o g e n binding to the
receptor
i n h i b i t s the a c t i v a t i o n of positive g r o w t h factors, then the a d d i t i o n of a g r o w t h factor back into the m e d i a should the inhibitory effect.
strate that epidermal growth factor
(EGF) can o v e r c o m e
g r o w t h i n h i b i t i o n of MCF-7 cells caused by the LY156758
reverse
Studies done in this laboratory
(see Figure 3b) (61).
demonthe
antiestrogen,
However, the reversal of
g r o w t h i n h i b i t i o n by E G F was no greater than the sum of g r o w t h f o u n d in the E G F - t r e a t e d and a n t i e s t r o g e n - t r e a t e d
groups.
T h i s a d d i t i v e effect suggests that E G F - i n d u c e d cell
prolifera-
tion is i n d e p e n d e n t of the estrogen receptor system. e x p e r i m e n t s strongly support the concept that other can replace e s t r o g e n in supporting tumor
These factors
growth.
S e v e r a l lines of evidence point toward an important
relation-
s h i p b e t w e e n e s t r o g e n and epidermal g r o w t h factor receptors the p r o g r e s s i o n of breast cancer
(62-66).
Binding
in
studies
p e r f o r m e d on cell cultures and breast tumor b i o p s i e s
have
d e m o n s t r a t e d that a negative c o r r e l a t i o n exists b e t w e e n
the
levels of e s t r o g e n receptor and the levels of e p i d e r m a l
growth
factor
(EGF) receptor
(60-64).
In a d d i t i o n , greater
numbers
of E G F receptors are found in m e t a s t a t i c tumors than in the p r i m a r y tumor
(62).
These o b s e r v a t i o n s imply a p o s s i b l e
234 m e c h a n i s m for e n d o c r i n e therapy failure as the cancer more hormonally
becomes
independent.
E n c o m p a s s i n g the o l d and new concepts of e s t r o g e n
receptor
m e c h a n i s m s and its role in the d e v e l o p m e n t and c o n t r o l of breast cancer, a series of a p p r o a c h e s to the t r e a t m e n t of h o r m o n e - d e p e n d e n t breast cancer can be formulated.
These
s h o u l d focus on the p r e v e n t i o n of 1) e s t r o g e n b i o s y n t h e s i s e s t r o g e n receptor binding, 2) a c t i v a t i o n and/or
of the receptor, 3) acceptor site binding, 4) m R N A a n d / o r t r a n s l a t i o n , a n d 5) growth-factor receptor b i n d i n g .
and
transformation synthesis
induction a n d
A l t e r n a t e strategies to regulate g r o w t h of
b r e a s t cancer will be d i s c u s s e d later in this a r t i c l e .
Antiestrogens E n d o c r i n e m a n i p u l a t i o n , especially in the form of
antiestrogen
therapy, has become an important a l t e r n a t i v e to the use of c h e m o t h e r a p e u t i c agents in the treatment of b r e a s t cancer
(67-71).
hormone-dependent
The reason for this is the
target
t i s s u e - s p e c i f i c activity and lack of side effects of antiestrogens
(13, 14).
To date, four major classes of
e s t r o g e n s have been reported (see Figure 4). substituted triphenylethylenes, hydroxylated
T h e s e are
the
triphenylethyl-
enes, b i c y c l i c a n t i e s t r o g e n s and s u b s t i t u t e d s t e r o i d s 73).
anti-
(13, 72,
Since the literature pertaining to these c o m p o u n d s
been extensively
reviewed
has
(13, 14), this chapter will focus o n
those a n t i e s t r o g e n s w h i c h have current interest for c l i n i c a l use or as new probes for experimental
future
research.
W i t h few e x c e p t i o n s , none of the present n o n s t e r o i d a l p o u n d s are true e s t r o g e n a n t a g o n i s t s since none appear block receptor a c t i v a t i o n completely
(74, 75).
For
a n t i e s t r o g e n s may have either agonist or a n t a g o n i s t
comto
example, action
235
0(CH,),N, 501-509.
3.
MacLaughlin, D.T., Richardson, J.S. and Sylvan, P.E. (1983). Analysis of human endometrial protein secretion in vivo and in vitro. Effects of estrogens and progesterone. In: Progress in Cancer Research and Therapy: Steroids and Endometrial Cancer. (Jasonni, V.M., Nenci, I. and Flamigni, E., eds.) Raven Press, New York, pp93- 104.
4.
Baulieu, E.E., Röbel, P., Mörtel, R. and Levy, C. (1983). Endometrial Carcinoma: The potential of a dynamic test using tamoxifen. In: Progress in Cancer Research and Therapy: Steroids and Endometrial Cancer (Jasonni, V.M., Nenci, I. and Flamigni, E., eds.) Raven Press, New York, pp6 1-68.
5.
Jackson, I.M. and Lowery, C. (1987). Clinical uses of antioestrogens. In: Pharmacology and Clinical Uses of Inhibitors of Hormone Secretion and Action. (B.J.A. Furr and A.E. Wakeling, Eds.) Balliere Tindall, pp37-105.
6.
Swenerton, K.D., Chrumka, K . , Paterson, A.H. and Jackson, G.C. (1984). Efficacy of tamoxifen in endometrial cancer. Prog. Cancer Res. Ther. 3_[, 417-424.
7.
Haid, I., Salimtschik, M. and Mouridsen, H.T. (1983). Tamoxifen treatment of advanced endometrial carcinoma. A phase II study.
294
Eur. J. Gynaecol. Oncol. 4(2), 83-7. 8.
Swenerton, K.D. (1983). Experience with tamoxifen in endometrial cancer. Rev. Endocrin. Rel. Cancer, Suppl. 11, 47-49.
9.
Edmonson, J.H., Krook, J.E., Hilton, J.F., Long, H.J., Cullinan, S.A., Everson, L.K. and Malkasian, G.D. (1986). Ineffectiveness of tamoxifen in advanced endometrial carcinoma after failure of progestin treatment. Cancer Treat. Rep. 70(8) 1019-20.
10.
Luciani, L., Oriana, S., Spatti, G., Secreto, G. , Recchione, C., Grignoglio, E., Andreola, S., Coradini, D., Ronchi, E. and Di Fronzo, G. (1984). Hormonal and receptor status in postmenopausal women with endometrial carcinoma before and after treatment with tamoxifen. T u m o r i 7 0 ( 2 ) , 189-192.
11.
Kato, J. (1985). Hormonal therapy of endometrial cancer. Cancer Clin. 3_1_, 1182-1188.
12.
Carlson, J.A., Allegra, J.C., Day, T.G. and Wittliff, J.L. (1984). Tamoxifen and endometrial carcinoma. Alterations in oestrogen and progesterone receptors in untreated patients and combination hormonal therapy in advanced neoplasia. Am. J. Obst. Gynaecol. 149 (2), 149-153.
13.
Lattimer, J.K. (1942).
14.
Ludden, J.B., 28, 619.
15.
Kirkman, H. (1957).
16.
Kochakian, C.D., Tomana, M. and Strickland, B. (1974). Role of cytosol and polysomes in the stimulation by androgen of protein biosynthesis in the mouse kidney. Mol . Cell. Endocrinol. 1, 129-138.
17.
Selye, H. (1940).
18.
Matthews, V.S., Kirkman, H. and Bacon, R.L. (1947). Kidney damage in the Golden Hamster following chronic administration of diethylstilboestrol and sesame oil. Proc. Soc. Exp. Biol, and Med. 66, 195-196.
19.
Richardson, F.L. (1957). Incidence of mammary and pituitary tumours in hybrid mice treated with stilboestrol for varying periods. J. Natl. Can. Inst. J8, 813-829.
20.
Noronha, R.F. (1975). The inhibition of dimethylnitrosamine-induced renal tumorogenesis in NZO/B 1 mice by orchiectomy. Invest. Urol. 13, 136-141.
21.
Takizawa,
S.
Jap. J.
Urology 4_[, 778.
Kreuger, E. and Wright, I.S. (194 1).
Steroid Tumorigenesis.
Endocrinology
Cancer JO, 757-764.
Can. Med. Assoc. J. 42, 188.
(1976).
Influence of sex hormones on kidney tumours
295
induced
in r a t s w i t h N - b u t y l n i t r o s o u r e a .
G a n n . 6_7,(1),
33-40.
22.
K i r k m a n , H. ( 1 9 5 9 ) . O e s t r o g e n - i n d u c e d t u m o u r s of the k i d n e y in the Syrian hamster. P a r t s III a n d IV. N a t l . C a n c e r Inst. M o n o g r a p h 1-139.
23.
Riviere, M., Chourailinkov, I. and Gueriol, M. (1961). Actione H o r m o n a l e s E x p e r i m e n t a l e s de L o n g u e D u r e e c h e z les h a m s t e r d u P o i n t de V u e de L e u r E f f e c t C a n c e r i g e n e . Bull. Assoc. Frano. Cancer 48, 499-503.
24.
Bloom, H.J.G., Roe, F.J.C. and Mitchley, B.C.V. (1967). Sex I n h i b i t i o n of t u m o u r of h a m s t e r hormones and renal neoplasia. kidney b y a n e s t r o g e n a n t a g o n i s t , an a g e n t o f p o s s i b l e t h e r a p e u t i c v a l u e in m a n . C a n c e r 20, 2 1 1 8 - 2 1 2 4 .
25.
Matsuda, clinical
26.
Bullock, L.P. and Bardin, C.W. (1975). T h e p r e s e n c e of e s t r o g e n receptor in k i d n e y s from normal and a n d r o g e n - i n s e n s i t i v e t f m / y mice. E n d o c r i n o l o g y 97_, 1106-1111.
27.
King, R.J.B. (1967). F i x a t i o n of s t e r o i d s to r e c e p t o r s . A n a t . M i c r o s c o p . M o r p h o l . 56, ( S u p p l . 3 - 4 ) 5 7 0 - 5 7 5 .
28.
Li, J.J., Talley, D.J., Li, S.A. and Villee, C.A. (1976). Receptor characteristics of specific estrogen binding in the renal a d e n o c a r c i n o m a of the G o l d e n H a m s t e r . C a n c e r R e s . 36, 1127-1132.
29.
Pasqualini, J.R., Sumida, C . , G e l l y , C. a n d N g u y e n , B . L . ( 1 9 7 3 ) . 3 Formation des Complexes H-oestradiol-macromolecules dans les fractione cytosoliques et N u c l e a i r e s d u T i s s u e R e n a l d u foetus de Cabaye. Compt. Rend. 2J6, 3359-3362.
30.
Bojar, H., Wittliff, J.L., Balzer, K. , Dreyfurst, R., Boeminghans, F. and Staib, W. (1975). P r o p e r t i e s of s p e c i f i c e s t r o g e n b i n d i n g components in h u m a n kidney and renal c a r c i n o m a (abstract). Acta E n d o c r i n o l . (Kbh) s u p p l . _[93, 5 1.
31.
Concolino, G., Marocchi, A., Concolino, F., Sciarra, F., Di Silveno, F . a n d C o n t i , C. ( 1 9 7 6 ) . Human kidney steroid receptors. J. S t e r o i d B i o c h e m . ]_, 83 1-835.
32.
Concolino, G., Marocchi, A., M a r t e l l i , M . L . , Gugliardi, V. and Di Silverro, F. (1977). In: R e s e a r c h o n S t e r o i d s V o l . 7 (A. V e r m e u l e n , P. Jungblutt, A. Klopper and F. Sciarra, eds.) North Holland Publishing Co., Amsterdam, pp309-323.
33.
Fanestil, D.D., Vaughn, D.A. and Hormone Receptors in H u m a n Renal S t e r o i d B i o c h e m . 5, 3 3 8 .
M., Osafune, M., Kotake, T. a n d S o n o d a , T . ( 1976). A s t u d y on r e n a l c e l l c a r c i n o m a . J a p . J. U r o l . 67, 5 3 5 - 5 3 9 .
Arch.
Ludens, J.H. (1974). Steroid Cell Carcinoma. ( A b s t . ) J.
296 34.
Concolino, G., Marocchi, C . , C o n t i , R . , T e n a g l i a , F . , Di S i l v e r i o F., Bracci, U. (1978). Human renal c e l l carcinoma as a hormone dependent tumour. Cancer Res. 38, 4340-4344.
35.
Bloom, H.J.G. (1973). Hormone-induced and spontaneous of m e t a s t a t i c renal c a n c e r . Cancer 32, 1066-107 1.
36.
Legha, S. and Muggia, F.M. ( 1 9 7 6 ) . Antioestrogens of c a n c e r . Ann. I n t e r n . Med. JM, 751-756.
37.
L a n t e r i , V . J . , Dragone, N . , Choudhury, M . , B e c k l e y , S . , Wajsman, Z. and P o n t e s , J.E. (1982). High dose tamoxifen in m e t a s t a t i c renal c e l l carcinoma. U r o l o g y _[9(6) , 623-625.
38.
A l - S a r r a f , M. , E y r e , H . , Bonnet, J . , S a i k i , J . , G a g l i a n o , R . , Pugh, R., Lehane, D . , Dixon, D. and Bottomley, R. (198 1). Study of tamoxifen in m e t a s t a t i c renal c e l l carcinoma and the i n f l u e n c e of certain prognostic factors. A Southwest Oncology Group Study. Cancer T r e a t . Rep. 65, 447-451.
39.
Ferrazi, G., Salvagno, L., Fomasiero, A., Cartei, G. F i o r e n t i n o , M. ( 1 9 8 0 ) . Tamoxifen treatment f o r advanced renal cancer. Tumori 66^(5) , 601-605.
40.
(1979). Tamoxifen in Mulder, J.H. and A l e x i e v a - F i g u s c h , I. metastatic renal c e l l carcinoma. Cancer T r e a t . Rep. 6 3 ( 7 ) , 1222, Abst.406.
4 1.
Glick, J., Wein, A . , Negandank, W., H a r r i s , D . , Brodovsky, H . , Padavic, K. and T o r r i , S. (1979). Tamoxifen in m e t a s t a t i c and renal c a n c e r . P r o c . Amer. Ass. Cancer Res. 20, 311 A b s t . c - 8 1.
42.
Fuki, J.K., A i s n e r , J . , Van-Echo, D.A. and W i e r n i i k , P.H. ( 1 9 8 2 ) . Phase II study of medroxyprogesterone a c e t a t e with tamoxifen in advanced renal c e l l c a n c e r . Cancer T r e a t . Rep. 6 6 ( 9 ) , 1773-1774.
43.
Fuks, J.Z., Van Echo, D . A . , A i s n e r , J . , Ostrow, S. and W i e r n i k , P.H. ( 1 9 8 2 ) . Medroxyprogesterone plus tamoxifen f o r advanced renal c e l l carcinoma. P r o c . Am. Assoc. Cancer Res. 23, 154, A b s t . 606.
44.
B e l l , D . R . , A r o n e y , R . S . , F i s h e r , R . J . and L e v i , J . A . ( 1 9 8 4 ) . High dose m e t h o t r e x a t e with l e u c o v o r i n r e s c u e , v i n b l a s t i n e and bleomycin with or without tamoxifen in m e t a s t a t i c r e n a l c e l l carcinoma. Cancer T r e a t . Rep. 68, 587-590.
45.
Johnson, P.J. and C o r b i s h l e y , T . P . ( 1 9 8 7 ) . Sex-steroid receptors and antisteroidal agents in the treatment of pancreatic adenocarcinoma. In: Hormonal Manipulation of Cancer: P e p t i d e s , Growth F a c t o r s , and new ( a n t i ) s t e r o i d a l a g e n t s . (J.G.M. K l i j n , R. P a r i d a e n s , J . A . F o e k e r s , e d s . ) Raven p r e s s , New York pp99-104.
46.
Davidoff, F., hyperlipidemia
in the
regression
treatment
and cell
Tischler, S. and R o s o f f , C. (1973). Marked and p a n c r e a t i t i s a s s o c i a t e d with o r a l c o n t r a c e p t i v e
297 therapy.
N e w E n g . J. M e d .
289,
552-555.
47.
Glueck, C.J. Scheel, D., Fishback, J. a n d S t e i n e r , P. ( 1 9 7 2 ) . Estrogen-induced pancreatitis in p a t i e n t s w i t h p r e v i o u s l y c o v e r t familial type hyperlipo-proteinemia. Met. Clin. a n d E x p . 21 , 657-666.
48.
Greenberger, N.J., Hatch, F.T., Drummey, G.D. and Isselbacher, K.J. (1966). Pancreatitis in h y p e r l i p i d e m i a . A s t u d y of s e r u m l i p i d alterations in 25 patients with acute pancreatitis. Medicine ( B a l t i m o r e ) 4 5 , 161-174.
49.
Corbishley, T.P., Iqbal, M.J., W i l k i n s o n , M . L . a n d W i l l i a m s , R. (1986). A n d r o g e n r e c e p t o r in h u m a n n o r m a l a n d m a l i g n a n t p a n c r e a t i c tissue and cell lines. C a n c e r 57, 1992-1995.
50.
Satake, K., Yoshimoto, T., Mukai, R. and Umeyama, K. (1982). Estrogen receptors in 7,12.dimethylbenzanthracene (DMBA) induced pancreatic carcinoma in rats a n d in h u m a n p a n c r e a t i c c a r c i n o m a . C l i n . O n c o l . 8^, 4 9 - 5 4 .
51.
Greenway, B., I q b a l , M . J . , J o h n s o n , P . J . a n d W i l l i a m s , R. ( 1 9 8 1 ) . O e s t r o g e n r e c e p t o r p r o t e i n s in m a l i g n a n t a n d fetal p a n c r e a s . Brit. M e d . J. 2 8 3 , 7 5 1 - 7 5 3 .
52.
Ullberg, S. and Bengtsson, G. ( 1 9 6 3 ) . Autoradiographic with natural oestrogens. A c t a Endocr. Copenh. 43, 75-86.
53.
Band, P., Richardson, S.B., Boctor, A.M. and Grossman, A. (1983). Somatostatin enhances binding of 3 H - o e s t r a d i o l to a cytosolic p r o t e i n in rat p a n c r e a s . J. B i o l . C h e m . 258, 7 2 8 4 - 7 2 8 7 .
54.
Poisette, A., Fernstad, R., Theve, N.O., Skoldefors, H. and Carlstrom, K. (1985). F u r t h e r c h a r a c t e r i z a t i o n of the o e s t r o g e n binding macromolecule in h u m a n p a n c r e a s . J. S t e r o i d B i o c h e m . 22, 1 15-1 19.
55.
Wilking, N., Appelgren, L.E., Carlstrom, K., Pousette, A. Theve, N.O. (1982). The distribution and m e t a b o l i s m of t a m o x i f e n in s p a y e d female m i c e . A c t a P h a r m . T o x . 50, 16 1-168.
56.
T h e v e , N . O . , P o u s e t t e , A. a n d C a r l s t r o m , K. ( 1 9 8 3 ) . Adenocarcinoma of the p a n c r e a s - a h o r m o n e - s e n s i t i v e t u m o u r ? A preliminary report on Nolvadex treatment. C l i n . O n c o l . 9, 193-197.
57.
AntioeStrogen therapy Tonneson, K. and Kamp-Jensen, M. (1986). pancreatic carcinoma. A preliminary report (Nolvadex). Eur. S u r g . O n c o l . _12(1), 6 9 - 7 0 .
58.
Crowson, M.C., Dorrell, A., Rolfe, E.B. and Fielding, J.W.L. ( 1986) . A phase II study to e v a l u a t e t a m o x i f e n in p a n c r e a t i c adenocarcinoma. E u r . J. S u r g . O n c o l . 12, 3 3 5 - 3 3 6 .
studies
w d C
in J.
298 59.
Stedman, receptor 244-248.
K.E., Moore, G.E. and Morgan, R.T. (1980). Estrogen proteins in diverse human tumors. Arch. Surg. 115,
60.
Kirdani, R.Y., Emrich, L.J., Pontes, E., Priore, R.L. and Murphy, G.P. (1985). A comparison of estrogen and androgen receptor levels in human prostatic tissue from patients with non-metastatic and metastatic carcinoma and benign prostatic hyperplasia. J. Steroid Biochem. 22, 569-576.
61.
Wolf, R.M., Schneider, S.L., Pontes, J.E., Englander, L., Karr, J.P., Murphy, G.P. and Sandberg, A.A. (1985). Estrogen and progestin receptors in human prostatic carcinoma. Cancer 55, 2477-248 1.
62.
Relationships between Ghanadian, R. and Puah, C.M. (198 1). oestradiol-17 , testosterone, dihydrotestosterone and 5 -androstane-3 ,17 -diol in human benign hypertrophy and carcinoma of the prostate. J. Endocr. 88, 255-262.
63.
Bouton, M.M. , Pornin, C. and Grandadam, J.A. (198 1). Estrogen regulation of rat prostate androgen receptor. J. Steroid Biochem. J5, 403-408.
64.
Moore, R.J., Gazak, J.M. and Wilson, J.D. (1979). Regulation of cytoplasmic dihydrotestosterone binding in dog prostate by 17 -estradiol. J. Clin. Invest. 63^, 351-357.
65.
Mobbs, B.G., Johnson, I.E., Connolly, J.G. and Thompson, J. (1983). Concentration and cellular distribution of androgen receptor in human prostatic neoplasia: can estrogen treatment increase androgen receptor content? J. Steroid Biochem. _I9, 1279-1290.
66.
Albert, J.D., Geller, J., Liu, J. and Faber, L.E. (1984). Tamoxifen decreases progesterone and nuclear androgen receptors in the human prostate. J. Steroid Biochem. 2J_, 659-662.
67.
Willis, K.J., London, D.R., Bevis, M.A., Butt, W.R., Lynch, S.S. and Holder, G. (1977). Hormonal effects of tamoxifen in Oligospermie men. J. Endocr. _73> 17 1-178.
68.
De Gezelle, H., Vandekerckhove, D. and Dhont, tl. (1979). tamoxifen on gonadotrophin secretion in the normal male. Sei. Clin. Pharmacol. Ther. ]_, 314.
69.
Vermeulen, A. and Comhaire, F. (1978). Hormonal effects of an antiestrogen, tamoxifen, in normal and Oligospermie men. Fertil. Steril. 29_, 320-327.
70.
Leinonen, P., Bolton, N.J., Kontturi, M. and Vihko, R. (1982). Rapid endocrine effects of tamoxifen and testolactone in prostate carcinoma patients. The Prostate J3, 589-597.
Effect of IRCS Med.
299 71.
Bolton, N.J., Vihko, P., Leinonen, P., Kontturi, M. and Vihko, R. (1982). Effects of long-term administration of tamoxifen on steroid metabolism in prostatic carcinoma patients. The Prostate 6, 4 17-422.
72.
Martikainen, H., Leinonen, P. and Vihko, R. (1981). Effect of clomiphene treatment on the human testicular response to a single dose of hCG. Int. J. Androl. 628-638.
73.
Habib, F.K., Robinson, M.R.G. and Stitch, S.R. (1979). The effect of endocrine treatment on plasma steroids and SHBG in BPH and carcinoma of the prostate patients. Cancer Treatment Rep. 63, 1192.
74.
Glick, J.H. , Wein, A., Padavic, K. , Negendank, W. , Harris, D. and Brodovsky, H. (1980). Tamoxifen in refractory meetastatic carcinoma of the prostate. Cancer Treat. Rep. 64, 813-818.
75.
Glick, J.H., Wein, A., Padavic, K., Negendank, W., Harris, D. and Brodovsky, H. (1982). Phase II trial of tamoxifen in metastatic carcinoma of the prostate. Cancer 49, 1367-1372.
76.
Arnold, D.J., Hallbridge, E., Rosen, N. and Usher, S. (1981). Tamoxifen therapy for metastatic prostate cancer. Proc. Am. Assoc. Cancer Res. 22, Abst. C-529.
77.
Morgan, L.R., Posey, L.E. and Lanasa, J. (1978). Therapeutic use of Nolvadex (tamoxifen, ICI-46474) in advanced prostate cancer. 12th Int. Congr. Cancer, Abst. 111.
78.
Denis, L. and DeClercq, G. (1980). Anti-estrogens in the treatment of prostatic cancer. Acta Urol. Belg. 48, 106-109.
79.
Spremul1i, E., Desimone, P. and Durant, J. (1982). A phase II study of 'Nolvadex' tamoxifen citrate in the treatment of advanced prostatic adenocarcinoma. Am. J. Clin. Oncol. _5, 149-153.
80.
Torti, F.M., Lum, B.L., Lo, R., Freiha, F. and Shortliffe, L. (1984). Tamoxifen in advanced prostatic carcinoma. A dose escalation study. Cancer 54, 739-743.
81.
Geller, J., Liu, J., Albert, J.D., Fay, W. and Berry, C.C. (1986). Effect of antiandrogen and/or antiestrogen blockade on human prostate epithelial and stromal cell protein synthesis. J. Steroid Biochem. _25, 759-763.
82.
Liu, J., Albert, J.D., Geller, J. and Faber, L.E. (1984). Effect of tamoxifen on stromal protein synthesis in the human prostate. J. Clin. Endocrinol. Metab. 55, 710-713.
83.
Geller, J., Albert, J.D., Kirshner, M. and Liu, J. (1985). Tamoxifen decreases human prostate CPK concentration. The Prostate 7, 283-285.
300
84.
T r a c h t e n b e r g , J . , H i c k s , L . L . and Walsh, P.C. ( 1 9 8 0 ) . Androgen and e s t r o g e n - r e c e p t o r content in spontaneous and e x p e r i m e n t a l l y induced canine p r o s t a t i c h y p e r p l a s i a . J . C l i n . I n v e s t . 65, 105 1-1059.
85.
Donnelly, receptor 183-187.
86.
Chaisiri, N. and P i e r r e p o i n t , C.G. (1980). Examination of the distribution of oestrogen receptor between the stromal and epithelial compartments of the canine p r o s t a t e . The P r o s t a t e 1, 357-366. ~
87.
Krieg, M., Bartsch, W., Thomsen, M. and V o i g t , K.D. ( 1 9 8 3 ) . stroma and Androgens and estrogens: their i n t e r a c t i o n with epithelium of human benign p r o s t a t i c hyperplasia and normal prostate. J. S t e r o i d Biochem. J_9, 155-161.
88.
Kozak, I., Bartsch, W., K r i e g , M. and V o i g t , K.D. ( 1 9 8 2 ) . Nuclei of stroma: s i t e of h i g h e s t e s t r o g e n c o n c e n t r a t i o n in human benign prostatic hyperplasia. The P r o s t a t e 433-438.
89.
Bartsch, G., D a x e n b i c h l e r , G. and Rohr, H.P. ( 1 9 8 3 ) . Correlative morphological and biochemical i n v e s t i g a t i o n s on the stromal t i s s u e o f the human p r o s t a t e . J . S t e r o i d Biochem. 19, 147-154.
90.
Leake, R.E., Laing, L., Calman, K.C. andMacBeth, F . R . ( 1 9 8 0 ) . Estrogen receptors and a n t i o e s t r o g e n therapy in s e l e c t e d human s o l i d tumours. Cancer T r e a t . Rep. 64_, 797-799.
91.
Kitaoka, H. (1983). Sex hormone dependency and endocrine for patients with d i f f u s e carcinoma of the stomach. Kagakuryoho _10, 2453-2460.
92.
Kitaoka, H. ( 1 9 8 5 ) . Chemo-endocrine therapy f o r d i f f u s e carcinoma of the stomach and i t s c l i n i c a l e v a l u a t i o n . Jap. J. Cancer C l i n . 32, 1189-1194.
93a.
Kojuma, 0. and Takahashi, T. (1986). scirrhous carcinoma of the stomach. 2526-253 1.
93b.
' N o l v a d e x ' Adjuvant T r i a l O r g a n i s a t i o n ( 1 9 8 5 ) . C o n t r o l l e d t r i a l of tamoxifen as single adjuvant agent in management o f e a r l y b r e a s t cancer. The Lancet 836.
94.
Mclendon, J.E., Appleby, D., Claudon, D.B., Donegan, W.L. and DeCosse, J.J. (1977). Colonic neoplasms. Tissue estrogen r e c e p t o r s and carcinoembryonic a n t i g e n . Arch. Surg. 1 12, 240-24 1.
95.
Alford, T.C., Do, H.M., Geelhoed, G.W., Tsangaris, N.T. and Lippman, M.E. (1979). S t e r o i d hormone r e c e p t o r s in human c o l o n cancers. Cancer 43, 980-984.
B.J., Lakey, W.H. a n d M c B l a i n , W.A. ( 1 9 8 3 ) . Estrogen in human benign p r o s t a t i c hyperplasia. J . U r o l . 130,
therapy Gan To
Endocrine therapy Gan To Kagakuryoho
of 13,
301
96.
Heim, M.E., Bojar, H . , Saeger, H.D. and Queisser, W. (1983). Steroid hormone receptor analysis and antioestrogenic therapy with tamoxifen in advanced colorectal cancer. 13th Internat. Congr. Chemotherapy Pt. J270, I l — 13.
97.
Myers, A . M . , Moore, G.E., Major, F.J. and Myers, J.A. (1983). Tamoxifen therapy in diverse human tumors. 13th Internat. Congr. chemotherapy Pt. 270, 5-10.
98.
Panettiere, F.J., Groppe, C.W., Athens, J.W., Costanzi, J.J., Bonnet, J.D., Saiki, J.H. and Chen, T.T. (1985). Tamoxifen therapy and colorectal adenocarcinomas: A Southwest Oncology Group study. Cancer Treat. Rep. 69, 113-114.
99.
Goedert, biogenic 13-20.
100.
Myers, C.F., Ershler, W.B., Tannenbaum, M.A. and Barth, R. (1982). Tamoxifen and carcinoid tumor. Ann. Internal. Med. 96, 383.
101.
Stathopoulos, G.P., Karvountzis, G.G. and Yiotis, J. (1981). Tamoxifen in carcinoid syndrome. New Engl. J. Med. 305, 52.
102.
Moertel, C.G., Engstrom, P.F. and Schutt, A.J. (1984). Tamoxifen therapy for metastatic carcinoid tumor: A negative study. Ann. Internal. Med. _I00, 531-532.
103.
Antony, H.M. (1976). Age-specific incidence of cancer of the endometrium, ovary and breast in the United Kingdom and the United States. Intern. J. Epid. _5, (3) 231-236.
104.
Greenwald, E.F. 2 8 ( 4 ) , 61-87.
105.
Hamilton, T.C. ovarian cancer.
106.
Holt, J.A. and Bolanos, J. (1986). Enzyme-linked immunochemical measurement of estrogen receptor in gynaecological tumors, and an overview of steroid receptors in ovarian carcinoma. Clin. Chem. 32, 1836-1843.
107.
Soutter, W.P. and Leake, R.E. (1987). Steroid hormone receptors in gynaecological cancers. Rec. Adv. Obst. Gynacol. 15, 175-194.
108.
Holt, J.A., Caputo, T.A., Kelly, K.M., Greenwald, P. and Chorest, S. (1979). Estrogen and progestin binding in cytosols of ovarian adenocarcinomas. Obst. Gynecol. 53, 50-58.
109.
Hamilton, T.C., Davies, P. and Griffiths, K. (1983). Steroid-hormone receptor status of the normal and neoplastic ovarian surface germinal epithelium. In: Factors Regulating
M . , Otten, U. and Heitz, P.U. (1980). Carcinoid tumours, amines and cancer. Rev. Endocrine-Related Cancer 7,
(1975).
Ovarian
tumors.
Clin. Obst. Gynecol.
and Davies, P. (1983). Hormonal relationships in Rev. Endocrine-Related Cancer 19-22.
302 ovarian Function (G.S. Greenwald and P.F. Terranova, eds.) Raven press, New York, pp8l-85. 110.
Holt, J.A., Lorincz, M.A. and King, W.J. (1983). Antibody-recognized [ 1 2 5 l]-estradiol-receptor complex in ovarian epithelial carcinoma. Obst. Gynecol. 62, 231-235.
111.
Holt, J.A., Jordan, V.C., Tate, A.C. and Lorincz, M.A. (1983). Binding of [ 3 H]-monohydroxytamoxifen in ovarian carcinoma. Br. J. Obst. Gynaecol. 90, 751-758.
112.
Myers, A.M. Moore, G.E. and Major, F.J. (1981). Advanced ovarian carcinoma: response to antioestrogen therapy. Cancer 48, 2368-2370.
113.
Landoni, F., Regallo, M., Vassena, L. Bonazzi, C., Scalambrino and Mangioni, C. (1985). Antiestrogen as last-line treatment in epithelial ovarian cancer. Chemioterapie 4, 1059-1060.
114.
Pagel, J., Rose, C., Thorpe, S. and Haid, I. (1983). Treatment of advanced ovarian carcinoma with tamoxifen. J. Steroid Biochem. _[9( Suppl.) , Abst. 2 16.
115.
Hamerlynck, J.V.T.H., Vermoken, J.B., van der Burg, M.E., ten Bokkel-Huinin, W.W., Neijt, J.P., Camino, F., Mangioni, C., Rotmensz, N. and Veenhorr, C.H. (1985). Tamoxifen therapy in advanced ovarian cancer: a phase IX study. Proc. Am. Soc. Clin. Oncol. 4_, 115.
116.
Shirey, D.R., Kavanagh, J.J., Gershenson, D.M., Freedman, R.S., Copeland, L.J. and Jones, L.A. (1985). Tamoxifen therapy of epithelial ovarian cancer. Obst. Gynecol, (rt, 575-578.
117.
Runge, H.M., Teufel, G., Neulen, J., Geyer, H. and Pfleiderer, A. (1986). In vitro responsiveness of ovarian epithelial carcinomas to endocrine therapy. Cancer Chemother. Pharmacol. _[6, 58-63.
118.
Nicholson, R.I. (1987). Antioestrogens and breast cancer therapy. In: Pharmacology and Clinical Uses of Inhibitors of Hormone Secretion and Action (B.J.A. Furr and A.E. Wakeling, eds.) Bail1iere Tindall, pp60-86.
119.
Sanborn, B.M., Held, binding proteins in 1107-1112.
120.
Soutter, W.P., Pegoraro, R.J., Green-Thompson, R.W., Naidoo, D.V., Joubert, S.M. and Philpott, R.H. (198 1). Nuclear and cytoplasmic oestrogen receptors in squamous carcinoma of the cervix. Brit. J. Cancer 44, 154-159.
121.
Toppila, M., Willcocks, D., Tyler, J.P.P., Fischer Dillenbeck, C., Baird, R.J. and Crandon, A.J. (1983). Sex steroid receptors in
B. and Kuo, H.S. (1975). Specific estrogen human cervix. J. Steroid Biochem. 6,
303
gynaecological malignancy.
J. Obst. Gynaecol.
53-59.
122.
Kavanagh, J.J., Wharton, J.T. and Rutledge, F. (1986). Tamoxifen in the treatment of refractory adenocarcinomas of the cervix. Cancer Treat. Rep. _70, 923-924.
123.
Bodenham, D.C. and Hale, B. (1972). Malignant Melanoma. In: Endocrine Therapy in Malignant Disease (B.A. Stoll, ed.) H.B. Saunders, London, pp377-383.
124.
Fisher, R.I., Neifeld, J.P. and Lippman, M.E. (1976). receptors in malignant melanoma. Lancet JJ^, 337-339.
125.
Chaudhuri, P.K., Walker, M.J., Briele, H.A., Beattie, C.W. and Das Gupta, T.K. (1978). Incidence of oestrogen receptors in benign naevi and human malignant melanoma. JAMA, 244, 791-793.
126.
Creagan, E.T., Ingle, J.N., Woods, J.E., Prichard, D.J. and Jiang, N.S. (1980). Estrogen receptors in patients with malignant melanoma. Cancer 46, 1785-1786.
127.
McCarty, K.S. Jr. and eleven others (1986). Use of monoclonal anti-estrogen receptor antibody in the immunohistochemical evaluation of human tumours. Cancer Res. 4_6, 4244-4248.
128.
Wagenknecht, L. and Hunziker, N. (198 1). Mirimanoff, R.O., Long-term complete remission of malignant melanoma with tamoxifen. Lancet J., June 20th, 1368-1369.
129.
Nesbit, R.A., Woods, R.L., Tatterstall, M.H., Fox, R.M., Forbes, J.F., MacKay, I.R. and Goodyear, M. (1979). Tamoxifen in malignant melanoma. New Eng. J. Med. 301, (22), 124 1-1242.
130.
Quencez, E., Blanc, D., Adessi, G., Agache, P. and Laurent, R. (1985). Role of an anti-estrogen, tamoxifen, in the treatment of metastatic melanoma. Ann. Dermatol. Venereol. 112(4), 34 1-346.
131.
Karakousis, C.P., Lopez, R. , Bhakoo, M.S., Rosen, F. and Moore, R. (1980). Steroid hormone receptors and tamoxifen treatment in malignant melanoma. Proc. Am. Assoc. Cancer Res. 21, 345.
132.
Creagan, E.T., Ingle, J.N., Ahmann, D.L. and Green, S.J. (1982). Phase II study of high dose tamoxifen in patients with disseminated malignant melanoma. Cancer 49, 1353-1354.
133.
Meyskin, F.L. Jr. (1981). The endocrinology of malignant melanoma. Reviews on Endocrine-Related Cancer 9, 5-13.
134.
Narasimhan, P. (1981). Estrogen receptor activity in Hodgkin's Disease. Ann. Intern. Med. 95, 63-67.
135.
Malacarne, P., Piffanelli, A., Indelli, M. , Pumero, S., Mondino, A., Gionchiglia, E. and Silvestri, S. (1980). Estradiol binding in
Oestrogen
304 rat thymus cells.
Hormone Res. VI, 224-232.
136.
Atanassor, B., Astaldi, G., Raitcher, B. and Blagoeva, P. (1973). Hormonal factors in pregnancy and their relationship to lymphocyte transformation in vitro. Acta Europ. Fertil. 4 , 97.
137.
Stimson, W.H. and Junter, I.e. (1976). A n investigation into the immuno-suppressive properties of oestrogens. J. Endocr. 69, 42P.
138.
Rosen, S.T., Maciorowski, Z., Wifflin, F., Epstein, A.L., Gordon, L.I., Kres, M.S., Kucuk, 0., Kwaan, H.C., Vriesendorp, H . , Winter, J.N., Fors, E. and Molteni, A. (1983). Estrogen receptor analysis in chronic lymphocytic leukaemia. Blood j>0, (5), 996-999.
139.
Zamiboni, A . , Simoncini, E., Marpicati, P., Gorni, F., Di-Lorenzo, D., Marini, G. (1986). Ineffectiveness of tamoxifen in chronic lymphocytic leukaemia: a study using oestrogen and progesterone assay on peripheral lymphocytes. Proc. Am. Soc. Clin. Oncol. 5, 154.
140.
Markwalder, T.M. Seiler, R.W. and Antiestrogenic therapy of meningiomas Neurol. 24, 245-249.
Zava, D.T. (1985). a pilot study. Surg.
14 1.
Vaguero, J. meningiomas.
Hormonal
142.
Cahill, D.W. (1985). Neurosurg. 62, 162-163.
143.
Bickerstaff, E.R., Small, J.M. and Guest, I.A. (1958). The relapsing course of certain meningiomas in relation to pregnancy and menstruation. J. Neurol. Neurosurg. Psychiatry 2J_, 89-91.
144.
Schoenberg, B.S., Christine, B.W. and Whisnant, J.P. (1975). Nervous system neoplasms and primary malignancies of other sites: the unique association between meningiomas and breast cancer. Neurology 25, 705-7 12.
145.
Donnell, M.S., Glenn, B.A., Meyer, A. and Donegan, W.L. (1979). Estrogen receptor protein in intracranial meningiomas. J. Neurosurg. 50, 499-502.
146.
Blankenstein, M . A . , Blaauw, G., Lamberts, S.W.J, and Mulder, E. (1983). Presence of progesterone receptors and absence of oestrogen receptors in human cranial meningioma cytosols. Eur. J. Cancer Clin, oncol. J 9 , 365-370.
147.
Blaauw, G.,, Blankenstein, M.A. and Lamberts, S.W.J. (1986). Sex steroid receptors in human meningiomas. Acta Neurochir. _79> 42-47.
148.
Blankenstein, M.A. , Berns, Thijssen, J.H.H. (1986).
and Martinez, R. (1985). J. Neurosurg. 62, 162-164. Hormone
Receptors
in
receptors in
Meningiomas.
J.
P.M.J.J., Blaauw, G., Mulder,, E. and Search to estrogen receptors in human
305 meningioma tissue sections with a monoclonal antibody against human estrogen receptor. Cancer Res. 4268-4270. 149.
Blankenstein, M . A . , Blaau, G., van't Verlaat, J.W., van der Meulen-Dijk, C. and Thijssen, J.H.H. (1987). Steroid receptors in cerebral tumours, possible consequences for endocrine treatment? In: Hormonal Manipulation of Cancer: Peptides, Growth Factors, and New (anti) Steroidal Agents (Ed. J.G.M. K l i j n et al.) Raven Press, New York pp61-70.
ANTIESTROGEN ACTION IN MCF-7 CELLS
T.S. Rah, M.F. Ruh, R.K. Singh Department of Physiology, St. Louis University School of Medicine, St. Louis, MO 63104 W.B. Butler Michigan Cancer Foundation and Department of Biochemistry, Wayne State University, Detroit, MI 48201
INTRODUCTION Non-steroidal antiestrogens inhibit estrogen stimulated cellular functions by competing with estrogens for the estrogen receptor (1,2).
However, the antiestrogen-receptor
complex is inefficient and does not promote maximal cell stimulation.
In fact, the estrogen receptor when bound by
antiestrogen may itself produce specific inhibitory actions (3,4).
In order to better understand the mechanisms whereby
antiestrogens inhibit estrogenic responses recent studies have utilized high affinity radiolabeled antiestrogens (5,7) which have allowed a much more accurate assessment of the physicochemical characteristics of antiestrogen-receptor complexes as well as their interaction with nuclear acceptor sites.
However, the cellular mechanisms whereby these
non-steroidal antiestrogens provoke both agonist and antagonist responses is still not clear. Multiple chromatin acceptor sites in mammalian chromatin have been demonstrated which indicate different degrees of estrogen receptor binding capacity and affinity for estrogenversus antiestrogen-receptor complexes (8-10).
Antiestrogen
interaction with the estrogen receptor appears to alter the receptor such that its physicochemical characteristics differ
Receptor Mediated Antisteroid Action © 1987 Walter de Gruyter & Co., Berlin • New York - Printed in Germany
308 f r o m t h a t of the e s t r a d i o l - r e c e p t o r the b i o l o g i c a l
complex
Thus,
r e s p o n s e s of a n t i e s t r o g e n s m a y be the
result of s u c h a l t e r e d r e c e p t o r p r o p e r t i e s binding.
(11-13).
end
induced by
ligand
T h e r e f o r e , the d i s t i n c t i o n b e t w e e n e s t r o g e n -
antiestrogen-receptor chromatin acceptor differences
b i n d i n g to m u l t i p l e sets of
s i t e s m a y be a result of m o r e
in initial l i g a n d - r e c e p t o r
and
different fundamental
interaction,
i.e.,
proper a c t i v a t i o n of r e c e p t o r s m a y o n l y be p e r m i t t e d w h e n p r o p e r l i g a n d b i n d s to the r e c e p t o r .
Since
the
antiestrogens
compete w i t h e s t r o g e n s for the e s t r o g e n r e c e p t o r , t h e r e
would
not be s u f f i c i e n t e s t r o g e n - r e c e p t o r
with
the s p e c i f i c a c c e p t o r specific cellular
c o m p l e x to i n t e r a c t
s i t e s to e l i c i t m a x i m a l
responses.
In a d d i t i o n ,
estrogen-
antiestrogen-
receptor c o m p l e x e s m a y e x e r t an e f f e c t of t h e i r o w n b y interacting with different acceptor
sites
(9).
This
review
will s u m m a r i z e the r e s u l t s f r o m our l a b o r a t o r y w h i c h the h y p o t h e s i s t h a t a n t i e s t r o g e n - r e c e p t o r altered
complexes
interaction with chromatin acceptor
have
s i t e s in M C F - 7
cells, a well established human breast cancer cell Our l a b o r a t o r y uses the t r i p h e n y l e t h y l e n e H1285
support
line.
antiestrogen,
[4-(N,N-diethylaminoethoxy)4'-methoxy-a-(p-
hydroxyphenyl)a'-ethylstilbene] affinity
(14), w h i c h h a s a h i g h
(Kd 0.23 nM) for the e s t r o g e n
receptor
in M C F - 7
cells
(Kd for e s t r a d i o l = 0.25 nM) and h a s b e e n d e m o n s t r a t e d to have very potent antiestrogen activity
in MCF-7
H1285 w a s d e t e r m i n e d to be a m o r e p o t e n t
cells.
i n h i b i t o r of
p r o l i f e r a t i o n t h a n the w i d e l y s t u d i e d a n t i e s t r o g e n
tamoxifen,
but H 1 2 8 5 w a s e q u i p o t e n t w i t h t r a n s - h y d r o x y t a m o x i f e n H1285 evoked minimal receptor
increases
in c e l l u l a r
l e v e l s and no i n c r e a s e
suppressed plasminogen activator
(15).
progesterone
in p l a s m i n o g e n
a c t i v i t y over a b r o a d range of c o n c e n t r a t i o n s , estrogens.
cell
activator and
it
activity stimulated
by
In a d d i t i o n , H 1 2 8 5 h a s a v e r y low a f f i n i t y
estrogen-noncompetible
antiestrogen binding
sites.
for
309 CHROMATIN ACCEPTOR
SITES
It is g e n e r a l l y a c c e p t e d t h a t an i n t e r a c t i o n steroid hormone required
receptors and nuclear "acceptor
between sites"
in o r d e r for s t e r o i d h o r m o n e s to r e g u l a t e
expression.
H o w e v e r , there
is some c o n t r o v e r s y c o n c e r n i n g
nature of s p e c i f i c n u c l e a r b i n d i n g s i t e s steroid hormone
receptors.
(acceptor
sites)
T h e r e have b e e n n u m e r o u s
interaction with target cell
receptor
components,
s u c h as b i n d i n g to n u c l e a r m e m b r a n e s , R N A ,
m a t r i x , D N A s e q u e n c e s and a c c e p t o r p r o t e i n - D N A
nuclear
another.
chromosomal
a c c e p t o r p r o t e i n s as c a n d i d a t e c o m p o n e n t s of a c c e p t o r receptors.
The term "acceptor
which confer specific high affinity binding receptor c o m p l e x e s .
sites
s i t e " as used
this chapter will signify nonhistone protein-DNA w i t h the s t e r o i d
nuclear
complexes.
N o n e of t h e s e m o d e l s are m u t u a l l y e x c l u s i v e of one Our l a b o r a t o r y h a s c h o s e n to s t u d y n o n h i s t o n e
the for
models
for s t e r o i d
for s t e r o i d
is
gene
in
complexes
in the
interaction
In our a p p r o a c h to the
study of the m e c h a n i s m s of a c t i o n of s t e r o i d h o r m o n e s , we have used r e c e p t o r b i n d i n g to a c c e p t o r p r o t e i n - D N A nucleoacidic protein
(NAP).
NAP
is d e f i n e d
sites
termed
(16,17) as e i t h e r
that partially deproteinized chromatin fraction with acceptor activity
(native NAP) or c e r t a i n
nonhistone proteins
chromosomal
r e c o n s t i t u t e d to DNA f o r m i n g an
protein-DNA complex with enhanced acceptor (reconstituted
receptor-acceptor
is to s e l e c t i v e l y s t r i p n o n h i s t o n e p r o t e i n s
chromatin with chaotropic agents i n t e r a c t i o n of s t e r o i d - r e c e p t o r fractions
acceptor
activity
NAP).
One a p p r o a c h we use to study s t e r o i d sites
enhanced
(native N A P ) .
from
(18) and to s t u d y the c o m p l e x e s w i t h the
residual
This chromatin preparation serves
functions;
r e m o v a l of s p e c i f i c p r o t e i n s w h i c h m a s k
sites a n d ,
if n e e d e d , the e x t r a c t i o n of the a c c e p t o r
c o m p o n e n t s of t h o s e same s i t e s . "acceptor a c t i v i t y "
Thus,
"acceptor
two
acceptor protein
sites" or
(high a f f i n i t y , s p e c i f i c b i n d i n g
of
310 r e c e p t o r s to c h r o m a t i n )
c a n be u n m a s k e d and m e a s u r e d
A n o t h e r a p p r o a c h to the s t u d y of a c c e p t o r
sites
(Fig.
involves
d e t e c t i o n of s p e c i f i c a c c e p t o r p r o t e i n s w h i c h d i s p l a y a c t i v i t y w h e n r e c o n s t i t u t e d to D N A . proteins
hydrochloride and receptor (Fig.
chromatin
( G d n » H C l ) , r e c o n s t i t u t e d to h o m o l o g o u s
1).
the
acceptor
guanidine
interaction with these nucleoacidic
(reconstituted NAP) assay
The nonhistone
(CP) are r e m o v e d b y s t e p - e l u t i o n w i t h
1).
DNA,
proteins
is m e a s u r e d using a s t r e p t o m y c i n
filter
T h i s a s s a y c o u p l e d w i t h v a r i o u s CP
p u r i f i c a t i o n t e c h n i q u e s w i l l a l l o w us to c h a r a c t e r i z e p r o t e i n c o m p o n e n t of a c c e p t o r
s i t e s , and u l t i m a t e l y
the
to
c h a r a c t e r i z e the DNA s e q u e n c e s w h i c h are c o n s t i t u e n t s of
the
sites.
STUDIES UTILIZING NATIVE NAP Experiments
utilizing partially deproteinized
chromatin
f r a c t i o n s f r o m a v a r i e t y of s y s t e m s h a v e d e m o n s t r a t e d
the
s p e c i f i c i n t e r a c t i o n of s t e r o i d r e c e p t o r s w i t h a c c e p t o r (8,16-25).
S t u d i e s of the b i n d i n g of v a r i o u s s t e r o i d
receptors to c h r o m a t i n a c c e p t o r
sites revealed that
sites
hormone
certain
nonhistone nuclear proteins may mask specific steroid
receptor
b i n d i n g s i t e s on c h r o m a t i n and r e m o v a l of t h e s e p r o t e i n s the c h a o t r o p i c salt g u a n i d i n e h y d r o c h l o r i d e f a c i l i t a t e the in vitro b i n d i n g of s t e r o i d to s p e c i f i c a c c e p t o r
e x t r a c t e d by 2 M Gdn-HC1 molarity.
1%-2%
After
receptor
s i t e s on the c h r o m a t i n .
of the h i s t o n e s and 80%-85% approximately
(Gdn-HC1)
all
are
extracts
s e l e c t i v e e x t r a c t i o n of t h e s e
p u r i f i e d s t e r o i d receptor
b i n d i n g of
nonhistone fractions
S e v e r a l p a r a m e t e r s of
s p e c i f i c i n t e r a c t i o n of receptor w i t h a c c e p t o r
in
partially
to the r e s i d u a l c h r o m a t i n
can m e a s u r e a c c e p t o r a c t i v i t y . determined.
Essentially
n o n h i s t o n e p r o t e i n s w i t h e a c h increase
p r o t e i n s from c h r o m a t i n - c e l l u l o s e ,
be
complexes
of the n o n h i s t o n e p r o t e i n s
and 3-8 M Gdn-HG1
with
may
the
s i t e s can
then
311
NUCLEI
CYTOSOL
PURIFICATION
Fig. 1. O u t l i n e for the a s s a y of n u c l e a r a c c e p t o r sites. T h i s figure p r e s e n t s the a p p r o a c h used in our l a b o r a t o r y for the c e l l - f r e e b i n d i n g a s s a y s for nuclear acceptor sites. The p r e p a r a t i o n s of p a r t i a l l y deproteinized chromatin-cellulose, reconstituted n u c l e o a c i d i c p r o t e i n s (NAP) as w e l l as p a r t i a l l y p u r i f i e d e s t r o g e n receptor are o u t l i n e d .
312 We have acceptor
r e c e n t l y r e p o r t e d the c h a r a c t e r i s t i c s
s i t e s for e s t r o g e n - a n d
complexes
MCF-7 cells
(9).
Triphenylethylene
and
antiestrogen-resistant
T w o s u b l i n e s of M C F - 7 c e l l s , E - 3 a n d antiestrogens
culture.
T h u s , E - 3 c e l l s are t e r m e d
are e s t r o g e n - s e n s i t i v e . antiestrogen-sensitive
H1285(10~7
antiestrogen-sensitive Both
Chromatin was prepared
by 1-8 M G d n - H C 1
and antiestrogen-resistant
to unmask acceptor
sites.
[ 3 H ] e s t r a d i o l - and
(30-fold)
sublines
from MCF-7
l i n k e d c o v a l e n t l y to c e l l u l o s e , a n d d e p r o t e i n i z e d
used for c h r o m a t i n b i n d i n g The following
assays
Partially
[3H]H1285-receptor
activity for
(acceptor
(residual chromatin
results were obtained:
from antiestrogen-sensitive sites)
cells
(1)
revealed maximal
unmasked by
receptor complexes acceptor
activity
and 4 M G d n - H C 1
(E-3 or R R ) . from either
(Fig. 2 A ) .
complexes from either increased binding
By c o n t r a s t ,
[ H]H1285-
cell type demonstrated
(2) For the c h r o m a t i n cells,
1 M
prepared
[3H]estradiol-receptor
for c h r o m a t i n p r e p a r e d f r o m
cells. However,
unmasked fraction
[3h]H1285-receptor
an
in b i n d i n g to the 4 M G d n * H C 1
(Fig. 2 B ) .
required
antiestrogen-
complexes
(3) T h e s e a c c e p t o r
undenatured estrogen
sites
receptor and
competitively
inhibited by radioinert estrogen
demonstrating
the s p e c i f i c i t y a n d s a t u r a b i l i t y of
sites.
maximal
s e n s i t i v e or r e s i s t a n t c e l l s s h o w e d
showed a drastic decrease
acceptor
either
3
activity unmasked at 1 M and 6 M G d n - H C 1 ,
as w a s d e m o n s t r a t e d
chromatin
Chromatin binding
in t h e c h r o m a t i n f r a c t i o n s u n m a s k e d b y
from antiestrogen-resistant
sensitive
were acceptor
1 M and 6 M Gdn-HCl
[3H]estradiol-receptor complexes prepared from
type of M C F - 7 c e l l s
cells,
sequentially
complexes prepared by step-elution from DEAE-cellulose sites).
growth
i n h i b i t i o n of E - 3 c e l l g r o w t h at 9 - 1 2 d a y s of
w h e r e a s R R c e l l s are a n t i e s t r o g e n - r e s i s t a n t .
purified
RR,
inhibit the
of E - 3 b u t h a v e no e f f e c t on the g r o w t h of R R . M) c a u s e d 80%
chromatin
antiestrogen-receptor
in a n t i e s t r o g e n - s e n s i t i v e
were used.
of
B i n d i n g of
receptor complexes
[ 3 H ] e s t r a d i o l - or
on
were
receptor these
[3H]H1 285-
in the p r e s e n c e of u n l a b e l e d
ligand-
313
receptor complexes was determined for those subtractions of deproteinized chromatin demonstrating the greatest acceptor activity (1 M, 4 M and 6 M Gdn-HC1).
A 2-fold excess of
radioinert estradiol- or H1285-receptor complexes was able to compete with and displace [^Hjestradiol-receptor
complexes
from the 1 M acceptor site with a respective binding decrease of 75% and 70% which compares well to a theoretical maximum of
GdnHCI(M)
Gdn-HCI(M)
Fig. 2. Comparison of binding of [3HJestradiol- and [3h]H1285-receptor complexes to chromatin subfractions from antiestrogen-sensitive (A) and antiestrogen-resistant (B) MCF-7 cells. MCF-7 cytosol from antiestrogensensitive (E-3) (Panel A) and antiestrogen-resistant (RR) (Panel B) cells was charged with 10 nM [^h]estradiol or 30 nM [ 3 H]H1285 for 2 hr at 4C. after charcoal-treatment the cytosol was loaded onto a pre-equilibrated DEAEcellulose column (9 ml). After washing with 50 ml of buffer containing 0.1 M KC1, the receptor complexes were eluted with 0.3 M KC1. Chromatin-cellulose (40u g DNA) from E-3 cells (A) or RR cells (B) was extracted with 0-8 M Gdn•HC1, washed to remove the Gdn»HCl and incubated with an aliquot (0.12 pmol) of [ 3 HJestradiol- (• •) or [3H]H1285- (O o) receptor complexes for 60 min at 4C. Radioactivity was extracted with absolute ethanol and counted. Each value was corrected for intact chromatin binding. (Reprinted from ref. 9).
314
(B)
(A) 1M Gdn-HCI
(C)
4M Gdn-HCI
100 £ (0 a>
6 M GkkrHCI X
80
x ® a
E
o
60
a a> o
40
o
a> DC •o c 3
o
I
20
CD
+ dR
+
+
+
E2R
HR
dR
[3H]E 2 R
• • E2R
HR
[3H]H1285R
4. dR
>
•
E2R
HR
[3H]E2R
Fig. 3. Specificity and saturability of binding of [^Hlestradiol- and [^h]H128 5-receptor complexes to chromatin acceptor sites. Chromatin-cellulose prepared from E-3 cells (40 u g DNA) was extracted with Gdn-HC1 and then washed to remove the Gdn-HCI. Partially purified radiolabeled receptor complexes (0.14 p m o l / a s s a y ) from E-3 cells were used to determine chromatin binding activity in the presence of 2-fold excess unlabeled estradiol-receptor complexes (E2R) and unlabeled H1285-receptor complexes (HR). The 100% value (control) was obtained with 2-fold excess heat-denatured receptors (dR) to keep the protein content constant (700 v g / a s s a y ) . (Reprinted from ref. 9).
315
67% for a two-fold excess radioinert receptor
(Fig. 3A) .
However, with the 6 M site (Fig. 3C), the binding of [^H]estradiol-receptor complexes was reduced more (76%) by 2-fold excess estradiol-receptor but reduced only 46% by the H1285-receptor, again corresponding to the direct binding data shown in Fig. 2.
In addition, binding to the 4 M site by
[3H]H1285- receptor complexes
(Fig. 3B) was reduced more
(68%) by Hl285-receptor and reduced less (30%) by estradiolreceptor, which is similar to the binding affinity in Fig. 2.
indicated
These results indicate not only that the receptor
binding to E-3 chromatin acceptor sites -is competable but also that these sites can be quite specific for a particular ligand-receptor complex, i.e., estradiol- or Hl285-receptor complexes. Thus, the different binding characteristics of antiestrogen-receptor complexes (compared with estrogenreceptor complexes) to chromatin acceptor sites from antiestrogen-sensitive cells may be responsible for the inhibitory effects of antiestrogens on cell growth.
In
addition, the acquisition of antiestrogen resistance to certain sublines of MCF-7 cells appears to result from alterations in the state of chromatin rather than the receptor itself since estrogen receptors from E-3 or RR sublines exhibited very similar chromatin binding
profiles.
STUDIES UTILIZING RECONSTITUTED NAP The chromatin-cellulose assay described in the previous section suggests that certain salt concentrations
remove
masking proteins, which allows for increased acceptor activity, and the next subsequent higher salt concentrations remove these exposed acceptor site proteins.
Support for
these results requires characterization of the removed acceptor proteins.
To do this, the chromosomal proteins
(CP)
316 conferring
a c c e p t o r a c t i v i t y m u s t be e x t r a c t e d using the
next
h i g h e r c o n c e n t r a t i o n s of a c h a o t r o p i c a g e n t , the p r o t e i n s be f r a c t i o n a t e d , and t h e s e p r o t e i n s m u s t be a s s a y e d acceptor activity by reconstituting
onto D N A .
The latter
a l l o w s t h e s e h i g h l y h y d r o p h o b i c p r o t e i n s to be s o l u b l e salt b u f f e r s a n d , t h e r e f o r e a l l o w s for r e c e p t o r assays.
the i n t e r p r e t a t i o n of the c h r o m a t i n - c e l l u l o s e
binding
studies
proteins from antiestrogen-sensitive
cells.
We
d e t e c t i o n of s p e c i f i c a c c e p t o r p r o t e i n s w h i c h ,
chromatin refined
differences
by
A f t e r o b t a i n i n g MCF-7
c h r o m a t i n w h i c h was t h e n b o u n d to h y d r o x y l a p a t i t e , first r e m o v e d w i t h 3 M NaCl
chromatin proteins
(CP) w e r e
The
reconstitution
to DNA w e r e p e r f o r m e d using the m e t h o d s d e s c r i b e d (16-18).
the
complexes.
p r e p a r a t i o n of the n o n h i s t o n e p r o t e i n s a n d the
histones were
is
when
r e c o n s t i t u t e d to D N A , d i s p l a y a c c e p t o r a c t i v i t y b e t w e e n e s t r o g e n - and a n t i e s t r o g e n - r e c e p t o r
laboratory
that
studies.
W e i n v e s t i g a t e d the c h a r a c t e r i s t i c s of MCF-7
Spelsberg's
step
in low
R e s u l t s f r o m our l a b o r a t o r y h a v e d e m o n s t r a t e d
supported by reconstitution
must
for
and the
(E-3)
the nonhistone
r e m o v e d w i t h a s e r i e s of
s t e p - e l u t i o n s b y 1-8 M Gdn»HC1
a n d t e r m e d CP1 to CP8 on the
b a s i s of m o l a r i t i e s of the salt.
S a m p l e s of
nonhistone
p r o t e i n f r a c t i o n s w e r e t h e n r e c o n s t i t u t e d to h u m a n DNA to nucleoacidic protein
(NAP)
fractions.
The
reconstituted
form NAP
f r a c t i o n s w e r e a s s a y e d for t h e i r a b i l i t y to b i n d [^Hjestradiol- and
[3H]Hl285-receptor
using the s t r e p t o m y c i n a s s a y [^Hjestradiol-receptor
(16).
complexes
Results
b i n d i n g to p r o t e i n - D N A
r e c o n s t i t u t e d w i t h CP2 and C P 7 .
However,
receptor c o m p l e x e s b o u n d not o n l y to the
(Fig. 4)
revealed
enhanced
complexes
3
[ H ] H 1285reconstituted
site b u t in a d d i t i o n b o u n d to a new CP5 s i t e , w h e r e a s to the CP7 site w a s n e a r l y a b s e n t as c o m p a r e d to estradiol-receptors.
These
r e s u l t s s u p p o r t our
f i n d i n g s of u n m a s k e d a c c e p t o r subfractions
(Fig. 2).
were s a t u r a b l e
The
sites
in r e s i d u a l respective
binding
[^H] previous chromatin
r e c o n s t i t u t e d CP5 and CP7
(Fig. 5) for t h e i r
CP2
receptor
sites
317
1
\E 0 . 4 o E o. 0.3 OC
o
I-
CL LU O
111
cr
Z> O m
J
I
I
I
I
I
I
I—
I
2
3
4
5
6
7
8
G d n H C I (M)
Fig. 4. Binding of [ 3 HJestradiol- and [ 3 H]H1 285receptor complexes to chromatin acceptor sites in MCF-7 antiestrogen-sensitive cells. For these reconstitution studies, histones were removed by 3 M NaC1 and MCF-7 chromatin nonhistone proteins were fractionated from chromatin-hydroxylapatite by step-elution using Gdn-HC1 (1-8 M). Samples of the extracted proteins were reconstituted to human DNA by reverse gradient dialysis. The receptor complexes were then incubated for 60 min with each reconstituted nucleoacidic protein (NAP) (70u g DNA) or DNA. Acceptor activity for [ 3 H ] estradiol- or [3h]H128 5-receptor complexes was then assayed using the streptomycin filter assay. Binding to DNA was subtracted from these values.
318 c o m p l e x e s w i t h K d s of 0.17 and 0.35 nM, r e s p e c t i v e l y The c o n c e n t r a t i o n of a c c e p t o r sites/cell.
(Fig.
sites was approximately
In a d d i t i o n a 2 - f o l d e x c e s s of
(Fig. 7). total
with
for the CP7 site w h e r e a s a 2 - f o l d
e x c e s s u n l a b e l e d H 1 2 8 5 - r e c e p t o r s , b u t not competed with
4000
unlabeled
e s t r a d i o l - r e c e p t o r s , b u t not H 1 2 8 5 - r e c e p t o r s , c o m p e t e d [^Hlestradiol-receptors
6).
[^H]H1285-receptor
Specific binding
estradiol-receptors,
c o m p l e x e s for the CP5
site
is e s t i m a t e d to be a b o u t 50%
of
binding.
These d i s t i n c t c h r o m a t i n a c c e p t o r p r o t e i n s m a y h a v e a role in the d i f f e r e n t b i o l o g i c a l
responses
induced b y
estrogens
Fig. 5. S a t u r a t i o n k i n e t i c s for b i n d i n g of [^H] e s t r a d i o l - and [ ^ h ] H 1 2 8 5 - r e c e p t o r c o m p l e x e s to N A P f r o m c h r o m a t i n p r o t e i n f r a c t i o n CP7 and C P 5 , r e s p e c t i v e l y . MCF-7 n o n h i s t o n e p r o t e i n s f r a c t i o n a t e d f r o m c h r o m a t i n b e t w e e n 4M and 5M Gdn-HC1 and b e t w e e n 6M a n d 7M Gdn-HC1 were r e c o n s t i t u t e d to D N A by reverse g r a d i e n t dialysis. I n c r e a s i n g c o n c e n t r a t i o n s of [ ^ H j e s t r a d i o l or ['h]H 1 2 8 5 - r e c e p t o r c o m p l e x e s were i n c u b a t e d w i t h r e c o n s t i t u t e d N A P from CP7 ( [ ^ H ] e s t r a d i o l - r e c e p t o r s ) or CP5 ( [ 3 h ] H 1 2 8 5 - r e c e p t o r s ) and b i n d i n g a s s a y e d .
319
.BOUND RECEPTOR ( p m o l / m g DNA) Fig. 6. The d a t a in F i g . 5 w e r e a n a l y z e d using p l o t s (see t e x t ) .
versus a n t i e s t r o g e n s , e s p e c i a l l y since the CP5 p r o t e i n s s e e m to be a b s e n t
(or m o d i f i e d )
in
acceptor
antiestrogen-
resistant MCF-7 c e l l s since b i n d i n g by r e c e p t o r s measurable.
sites
responses.
is not
In a d d i t i o n , our d a t a using v a r i a n t s of MCF-7
cells s u p p o r t our h y p o t h e s i s t h a t m u l t i p l e acceptor
Scatchard
regulate v a r i o u s d i f f e r e n t
Thus,
sets of
chromatin
biological
in a r e s i s t a n t line o n l y one a c c e p t o r
site
m a y be a f f e c t e d a l t e r i n g o n l y one g r o u p of r e s p o n s e s .
MCF-7
antiestrogen-resistant
growth
RR cells fail to r e s p o n d to the
inhibiting e f f e c t s of a n t i e s t r o g e n s b u t a n t i e s t r o g e n s
can
320 still i n h i b i t the e s t r o g e n (9).
In the a n t i e s t r o g e n
i n d u c t i o n of p l a s m i n o g e n r e s i s t a n t MCF-7 v a r i a n t
activator
R27,
a n t i e s t r o g e n s , w h i l e not i n h i b i t i n g c e l l g r o w t h , not o n l y induce p r o g e s t e r o n e
r e c e p t o r w h i c h t h e y do in n o r m a l
c e l l s , b u t also g a i n the a b i l i t y to induce the sensitive
52K p r o t e i n
CO llJ X UJ
o o
oc
o
H Q. UJ
Ul CC O
Z
(26,27).
NAP-5
120
MCF-7
estrogen
NAP-7
1.
100 80 60 40 20
o
CD
+ dR
+ ER [3h]hr
+ HR
+ dR
+ ER
+ HR
[3h]er
Fig. 7. C o m p e t i t i v e b i n d i n g of e s t r o g e n - r e c e p t o r c o m p l e x e s to r e c o n s t i t u t e d N A P f r o m CP5 and C P 7 . P a r t i a l l y p u r i f i e d [ 3 H ] e s t r a d i o l - or [ 3 H ] H 1 2 8 5 receptor c o m p l e x e s w e r e used to d e t e r m i n e b i n d i n g to NAP from CP7 and C P 5 , r e s p e c t i v e l y , in the a b s e n c e of (100%) or in the p r e s e n c e of 2 - f o l d e x c e s s u n l a b e l l e d e s t r a d i o l - r e c e p t o r c o m p l e x e s (F,R) or H l 2 8 5 - r e c e p t o r c o m p l e x e s (HR). P r o t e i n c o n t e n t w a s k e p t c o n s t a n t w i t h h e a t - d e n a t u r e d r e c e p t o r p r e p a r a t i o n s (dR). Receptor b i n d i n g w a s a s s a y e d using the s t r e p t o m y c i n filter a s s a y .
321 DISCUSSION We have demonstrated that estrogen- and receptor c o m p l e x e s d i f f e r characteristics.
antiestrogen-
in their c h r o m a t i n
binding
T h e s e r e s u l t s w e r e o b t a i n e d using
different approaches;
i.e., b i n d i n g of r e c e p t o r to
d e p r o t e i n i z e d c h r o m a t i n f r a c t i o n s and to nucleoacidic protein fractions.
two partially
reconstituted
W e as w e l l as o t h e r s
have
d e m o n s t r a t e d m a n y p r o p e r t i e s of the s p e c i f i c i n t e r a c t i o n of steroid 28-30).
receptors with chromatin acceptor Steroid receptors
sites
(8,9,17,22,
i n t e r a c t in a s a t u r a b l e m a n n e r
intact or p a r t i a l l y d e p r o t e i n i z e d c h r o m a t i n
with
subfractions.
S p e c i f i c c h r o m o s o m a l p r o t e i n s a p p e a r to be a s s o c i a t e d
with
a c c e p t o r site a c t i v i t y , since r e m o v a l of t h e s e p r o t e i n s b y salt or p r o n a s e d e c r e a s e s
receptor b i n d i n g
(8,16,31), and
s p e c i f i c p r o t e i n f r a c t i o n s w h e n r e c o n s t i t u t e d to D N A acceptor activity that there
(16,30-32).
We have recently
is b o t h t a r g e t t i s s u e , s p e c i e s , a n d
s p e c i f i c i t y for c h r o m a t i n a c c e p t o r chromatin acceptor conformational
sites
sites c a n d i s t i n g u i s h
changes
determined receptor
(8,24,25,30).
That
structural/
i n d u c e d in the e s t r o g e n receptor
e s t r o g e n s v e r s u s a n t i e s t r o g e n s u p p o r t s our p r e v i o u s (33) w h i c h s u g g e s t e d t h a t e s t r o g e n
only
enhance
by
findings
receptor b o u n d b y
estrogen
u n d e r g o e s a c t i v a t i o n to a d i f f e r e n t d e g r e e w h e n c o m p a r e d
with
estrogen receptor bound by antiestrogen.
that
activation/transformation
It is p o s s i b l e
is a m u l t i s t e p p r o c e s s .
l a b o r a t o r y as w e l l as o t h e r s
Our
(11-15,34) have s u g g e s t e d
a n t i e s t r o g e n b i n d i n g m a y a f f e c t the m o n o m e r - d i m e r
that
equilibrium.
W e h a v e s u g g e s t e d t h a t the e s t r o g e n r e c e p t o r e x i s t s as a d i m e r w h i c h can r e a d i l y d i s s o c i a t e
into m o n o m e r s .
Estradiol
to the r e c e p t o r w o u l d not impede d i m e r d i s s o c i a t i o n . a n t i e s t r o g e n b i n d i n g to the receptor m a y inhibit
binding However,
full
d i s s o c i a t i o n and the c o m p l e x w o u l d remain as a m o d i f i e d (12,13,32).
Therefore, antiestrogen binding would
receptor c o n f o r m a t i o n t h a t is d i f f e r e n t t h a n that
dimer
induce induced
a by
322 estrogen binding (32,35).
Recently, a monoclonal antibody was
developed which discriminates between receptor bound by estrogen and receptor bound by antiestrogen complexes (36,37), a further indication that antiestrogens induce a structural change in the receptor.
These receptor alterations could at
least explain the observed differences in salt-resistant nuclear binding between estrogens and antiestrogens and the inability of antiestrogen-receptor complexes to bind the total complement of estrogen receptor-acceptor sites.
Ultimately,
these conformational differences are manifested in the antagonist actions of antiestrogen. Estrogen receptors bound by estradiol interact with several classes of nuclear binding sites to provoke maximal cellular responses.
Although antiestrogen-receptor
complexes
bind well to some sites, these complexes appear to bind poorly to other nuclear sites which may explain the antiestrogen effects of these compounds.
In addition, our results lend
support to the idea that antiestrogens have effects of their own on cells in addition to acting as estrogen antagonists and, in some cases, agonists.
It had previously been
suggested by one of us (3) that the estrogen receptor bound by antiestrogen could specifically act in the nucleus to alter gene expression such that cell division or tumor growth is inhibited.
Our current chromatin binding data demonstrate
that antiestrogen-receptor complexes bind MCF-7 E-3 chromatin in a way that is similar to estrogen-receptor complexes, such as the 1 M site (CP 2), but also in ways that are different, such as less binding to a 6 M site (CP 7) and new binding to a 4 M site (CP 5).
Clone RR is resistant to growth inhibition
by antiestrogens but is still sensitive to estrogens, which induce plasminogen activator and the 52K protein.
The RR
appears to lack that portion of the chromatin binding (4 M site or CP 5) which is unique for antiestrogen-receptor complexes. Lippman's group has recently demonstrated that MCF-7 cells
323 produce both growth stimulating factors as well as a growth inhibiting factor.
Whereas estrogens stimulate growth
stimulating factors, antiestrogens increase the production of a tumor growth inhibiting factor, TGF-g(4).
Could the 4 M
site, i.e., CP 5 in association with specific DNA sequences, be somehow responsible for the production of TGF-(5 by antiestrogen?
Antiestrogen-resistance
(lacks of inhibition of
cell growth) may be correlated with lack of binding by estrogen receptor to the antiestrogen-specific acceptor sites as well as lack of TGF- ¡3 production.
The MCF-7 clone RR,
however, retains the ability for antiestrogens to inhibit estrogen induced plasminogen activator.
Could the 6 M site
(CP 7) which binds estrogen receptor bound by estrogen be responsible for stimulation of plasminogen activator?
Since
antiestrogens compete with estrogens for the estrogen receptor, there would not be sufficient estrogen receptor to interact with the specific acceptor sites to elicit the response, e.g. plasminogen activator production. Although we used a chaotropic agent, Gdn-HC1, as an in vitro tool to expose certain chromatin acceptor sites, it is quite possible that _in vivo some acceptor sites are made available (unmasked) at different times during the several hours of a response to estrogens by subtle but specific alterations in nonhistone masking proteins.
These alterations
may be enzymatic, may include changes in the degree of phosphorylation, acetylation, peptide cleavage, or subunit loss or may be the result of other conformational changes in nonhistone proteins induced by estrogen receptor binding to a few initially open sites.
Thus, both the masking and
unmasking of acceptor sites in vivo would be envisioned as physiological events.
Such continual exposure of new classes
of acceptor sites _iri vivo is consistent with the "sequential" (38) or "ratchet" (39) model of steroid hormone action. laboratory has speculated that _in_ vivo nuclear acceptor sites would be sequentially unmasked and masked with time
Our
324 UNMASKING a MASKING OF NUCLEAR A C C E P T O R S I T E S ESTROGEN
EARLY TERM ER
J
ER
J Mort«d Acceptor Sit»
VS A N T I E S T R O G E N
INTERMEDIATE TERM ER
J
ER .
ER
X
I
CIXpcS
1
UNMASK Cap
EARLY MASK RESPONSES
|
I Matkad Acceptor Slut
•
t
UNMASK cap MASK B
EARLY RESPONSES
L A T E TERM ER
ER
ER
I
ER
ER
I I I
G D ^ d b o D C D C D | I
I|UNMASK E 8F
B
AER AER
ACTION
|
|
STIMUf LATION OF GROWTH
AER
T I
|
AER
|I
AER .
|
MASK MASK AA
INHIBITION OF GROWTH
STIMULATION OF GROWTH
AER
AER •
|
I LACK OF GROWTH
Fig. 8. Model suggesting the effects of unmasking and masking of nuclear acceptor sites _in vivo. Acceptor proteins A-F would be sequentially unmasked and masked with time of exposure of target tissue to estrogen or antiestrogen. Receptor complexes initially bind to available unmasked sites which initiate early responses. With time some of these sites may become masked while others become unmasked to initiate other sets of responses. Antiestrogen-receptor complexes would be unable to bind certain acceptor sites (i.e., D) thus preventing completion of agonist responses, resulting in "antiestrogencity". It is also possible that antiestrogens initiate inhibitory responses of their own by interacting with different sites (i.e., C) .
325 after exposure to hormone bound receptor.
The ability of
antiestrogens to elicit some agonist responses, inhibit some estrogen-induced responses and possibly to have unique actions can be explained by this model (Fig. 8).
Both estrogen- and
antiestrogen-receptor complexes could elicit early responses by binding unmasked acceptor sites in intact chromatin. However, only estrogens would allow complete stimulation upon continued exposure to estrogen by binding of receptor to newly unmasked acceptor sites.
In addition, antiestrogen could
initiate inhibitory responses of their own by interacting with different sites. The receptor/acceptor interactions described in our studies fulfill many of the criteria of a physiologically significant binding system.
What is unknown is the exact
nature of the protein and DNA components of the acceptor site. Does the estrogen receptor bind to a nonhistone protein-DNA complex, to a nonhistone protein alone or to a DNA sequence alone?
Nonetheless, from previous and current evidence, it is
clear that certain nonhistone proteins are implicated in the specificity of acceptor sites for steroid receptors. Ultimately the acceptor site components will have to be isolated and highly purified to determine the role these sites may have in steroid hormone action. In summary, what is beginning to emerge is a picture of steroid receptor action in which the effect of a ligand on a cell depends on at least three things; the ligand (agonist or antagonist), the nature of the receptor (ligand specificity, chromatin affinity and other properties when a ligand is bound), and the state of the available chromatin acceptor sites (unmasked or masked, present or absent).
Changes in any
one of these can affect the range of responses of a cell to a steroid hormone or related ligand.
326
Acknowledgement This work was supported by grants HD-13425, RR-05388 and CA-43868 awarded by the National Institutes of Health.
References 1. Jensen, E.V., E.R. DeSombre. 2. Ruh, T.S., M.F. Ruh.
1974.
1973.
Science 182, 126.
Steroids 24^ 209.
3. Butler, W.B., W.H. Kelsey, N. Goran. 42, 82.
1981.
Cancer Res.
4. Knabbe, C., M.E. Lippman, L.M. Wakefield, K.C. Flanders, A. Kasid, R. Derynck, R. Dickson. 1 987 . Cell 48_, 417. 5. Borgna, J.L., H. Rochefort. 71 .
1980.
Mol. Cell. Endo. 20,
6. Katzenellenbogen, B.S., E.J. Pavlik, D.W. Robertson, J.A. Katzenellenbogen. 1981. J. Biol. Chem. 256, 2908. 7. Keene, J.L., F. Sweet, M.F. Ruh, T.S. Ruh. Biochem. J. 217, 817. 8. Singh, R.K., M.F. Ruh, T.S. Ruh. Biochim. Biophys. Acta 800, 33.
1984.
1984.
9. Singh, R.K., M.F. Ruh, W.B. Butler, T.S. Ruh. Endocrinology 118, 1087.
1986.
10. Ruh, T.S., D.M. Wood, P. Ross, Jr., J.L. Keene. 1981. In: Non-steroidal Antiestrogens (R.L. Sutherland and V.C. Jordan, eds.). Academic Press, p. 231. 11. Ruh, M.F., R.G. Brzyski, L. Strange, T.S. Ruh. Endocrinology 112, 2203. 12. Keene, J.L. M.F. Ruh., T.S. Ruh. Biochem. 2_1_r 6 2 5 • 13. Jasper, T.W., M.F. Ruh, T.S. Ruh. Biochem. 23_, 537 . 14. Ruh, T.S., M.F. Ruh.
1983.
1984. 1985.
1983.
J. Steroid J. Steroid
Pharmac. Ther. 21, 247.
327 15. S h e e n , Y . Y . , T . S . R u h , W . F . M a n g e l , B.S. 1985. C a n c e r R e s . 45_, 4 1 9 2 .
Katzenellenbogen.
16. S p e i s b e r g , T. 1982. In: B i o c h e m i c a l A c t i o n s of H o r m o n e s , V o l . 9 (G. L i t w a c k , e d . ) . Academic Press, Y o r k , p. 141.
New
17. S p e i s b e r g , T . C . , B . A . L i t t l e f i e l d , R. S e e l k e , G . M a r t i n - D a n i , H. T o y o d a , P . B o y d - L e i n e n , C. T h r a l l , 0. Kon. 1983 . R e e . P r o g . H o r m . R e s . J39_, 464. 18. W e b s t e r , R . , G . P i k l e r , T. S p e l s b e r q . 156, 409.
1976.
Biochem.
19. K l y z s e j k o - S t e f a n o w i c z , L . , J. C h u i , Y . T s a i , L . 1976 . P r o c . N a t ' l . A c a d . S e i . USA 7_3_, 1 954 .
Hnilica.
20. P e r r y , B., A. L o p e z .
1978.
B i o c h e m . J.
176, 873.
21. H a m a n a , K . , K. I w a i .
1978.
J. B i o c h e m .
(Tokyo) £ 3 ,
22. R u h , T . S . a n d T . C . S p e l s b e r g . 905.
1983.
23. L o p e z , A . , J. B u r g o s , J . V e n t a n a s . J . B i o c h e m . J_7_, 1207 .
Biochem. J. 1985.
1986.
1981.
27. V i g n o n , F., M . E . L i p p m a n , H. N a w a t a , D . D e r o c q , Rochefort. 1984. C a n c e r R e s . _44_, 2 0 8 4 . 28. S u n , H . K . , E . G . P f e n d n e r , M . B . S e n i o r , F.R. 1983. M o l . C e l l . E n d o c r i n o l . _30.» 2 6 7 1980.
210,
1986.
25. S h y a m a l a , G . , R . K . S i n g h , M . F . R u h , T . S . R u h . E n d o c r i n o l o g y 119, 819.
29. T h r a l l , C., T . C . S p e l s b e r g . 4130.
279.
Internal
24. R u h , M . F . , R . K . S i n g h , P . M a k , G . V . C a l l a r d . E n d o c r i n o l o g y 118, 811.
26. N a w a t a , H., D. B r o n z e r t , M.E. L i p p m a n . J. B i o l . C h e m . 256, 5 0 1 6 .
J.
H.
Frankel.
Biochemistry
19,
30. R u h , M . F . , T . S . R u h . 1987. In: Steroid Receptors and Disease: C a n c e r , Bone and C i r c u l a t o r y D i s o r d e r s (P.J. S h e r i d a n , K. B l u m and M . C . T r a c h t e n b e r g , eds.) M a r c e l Dekker, Inc., New York. In P r e s s . 31. R o s s , J r . , P . , T . S . R u h . 7 8 2 , 18.
1984.
Biochim. Biophys.
Acta.
328 32. R u h , M . F . , T . S . R u h . 1987. In: M o l e c u l a r M e c h a n i s m s of S t e r o i d H o r m o n e A c t i o n (V.K. M o u d g i l , ed) W a l t e r de Gruyter, Berlin. In P r e s s . 33. S i n g h , R . K . , M . F . , R u h , T . S . R u h . B i o c h e m . 2J_f 2 0 5 •
1984.
J.
Steroid
34. K a t z e n e l l e n b o g e n , B . S . , M . A . M i l l e r , A. M a l l i c k , Y . Y . Sheen. 1 985 . B r e a s t . C a n . R e s . and T r e a t . 4^, 231. 35. E v a n s , E., P . P . B a s k e v i t c h , H. R o c h e f o r t . F,ur. J. B i o c h e m . 1 28, 185. 36. B o r g n a , J . L . , J. F a u q u e , H. R o c h e f o r t . B i o c h e m i s t r y 23^, 2 1 6 2 .
1982.
1984.
37. T a t e , A . C . , G . L . G r e e n e , E . R . D e S o m b r e , E . V . J e n s e n , V . C . Jordan. 1984 . C a n c e r R e s . _44, 1012. 38. G o r s k i , J . , B. R a k e r .
1974.
G y n e c o l . O n c o l . 2,
249.
39. S t a c k , G . , J . G o r s k i .
1985.
Endocrinology
2017.
117,
DESIGN AND ACTIVITY OF NONSTEROID ANTIANDROGENS T. Ojasoo, J.P. Raynaud Roussel-Uclaf, 75007 Paris, France Introduction Anti-androgens block the production, transport and/or action of active endogenous androgens and, as such, may be (a) inhibitors of testosterone synthesis or secretion by the testes, (b) competitive inhibitors of enzymes involved in the formation and metabolism of testosterone, (c) inhibitors of androgen uptake by target organs and of androgen binding to receptor proteins. Category "a" comprises inhibitors of gonadotropin release by the hypothalamopituitary unit and is represented by estrogens and LHRH-superagonists and antagonists ; category "b" Includes Inhibitors of the formation of adrenal androgens and of the cytochrome-Pi 5o dependent 5a-reductase and aromatase systems, that influence the in situ formation of dihydrotestosterone (DHT) and of estrogen in target tissues ; compounds of category "c" block the direct effect of androgen and therefore can be considered antineoplastic agents acting to directly inhibit androgen-promoted cell growth. Some might even exert such activity by Interference with protein targets other than the hormone binding site of the androgen receptor. A single compound may belong to more than one category. Table 1 broadly classifies the major antiandrogens of disclosed chemical structure that are presently in clinical development or use for the treatment of androgen-sensitive benign and malignant diseases. The first pituitary hormone inhibitors used as antiprostatic cancer agents were estrogens, in particular diethylstilbestrol and its diphosphate, dienestrol, ethynyl estradiol and conjugated estrogens. These, however, have fallen into disfavour because of the associated cardiovascular complications [1, 2]. High doses of
Receptor Mediated Antisteroid Action © 1987 Walter de Gruyter & Co., Berlin • New York - Printed in Germany
330 estrogen are cytotoxic [3] but are also carcinogenic [4], Weaker estrogens such as bifluranol [5] or lower dose schedules are now promulgated but they may Induce androgen receptor (AR) [6] and consequently increase the androgen-sensitlvlty of the prostate [7, 8]. A recent report, however, suggests that estrogens downregulate AR in cultured human mammary cancer cells [9]. Some estrogens also inhibit 5o-reductase activity [10]. Continuous administration of LHRH-analogs reputedly castrates as effectively as estrogens [11] but the down-regulation of pituitary receptors only occurs after an initial early increase in LH and testosterone. The design and activity of these compounds have been the subject of excellent reviews [12-15]. The longer-acting forms available as biodegradable implants [16-18] may well supercede less convenient administration forms (subcutaneous injections or nasal sprays). The pituitary inhibitory activity of ant1androgenic progestins will be discussed below. Ehzyme inhibitors used to obtain an antiandrogenlc action should be specific. In prostate cancer patients who have relapsed after a first-line endocrine therapy, compounds like aminoglutethimlde, ketoconazole and other imidazole derivatives [19] have led to regression or stabilization of disease in about 30% of cases [20-24]. These compounds also act to inhibit Cortisol as well as adrenal androgens and the aromatase complex of enzymes. Patients therefore require corticosteroid replacement therapy and this may well affect the efficacy of the treatment. The design of new compounds has been directed towards specific inhibitors of the NADPH-dependent enzyme, 5a-reductase, which converts testosterone to DHT and of aromatase, also a microsomal P4 5 o enzyme, that converts androgens into estrogens. Older men have higher plasma estrogen levels than younger men [25] and elevated 5a-reductase activities have been reported in BPH stroma [26, 27] and in the skin of hirsute women [28, 29], Several progestins, in particular the much studied 6-methylene progesterone, are inhibitors of 5a-reductase [30, 31] and there now exists a new generation of inhibitors belonging to the 4-azasteroid family. Excellent
331
TABLE 1 .
Antiandrogens In Clinical Development and Use. COMPOUND
ACTIVITY
PROPOSED INDICATIONS
Estrogens QHS
Potent estrogen
Prostate cancer
Weak estrogen
Benign prostatic hypertrophy
Estrogen Antineoplastic
Prostate cancer
LHRH-receptor desensitizor
Prostate cancer
Initially anticonvulsant Adrenal inhibitor
Second-line prostate cancer therapy
Antifungal Adrenal inhibitor
Second-line prostate cancer therapy
H5C2 Diethylstilbestrol and its diphosphate
H0
CH CH
~ ~\ V"0H
\ / /
HsC
CiHs
p
Bifluranol (Biorex, UK)
(CICH 2 CH 2 ) 2 N C O O
JK
J
M
Estramustine (Leo, S) LHRH - analoqs ;
D-Trpß D-Leu&, Pro-NH Et?
Decapeptyl (Ipsen F )
: Leuprolide
6
( Abbott USA )
D - S e r ( t Bu) ,Pro-NH Et9 : Buserelin
(Hoechst FRG )
D-Ser (t BU)6, AZ Gly
( ICI UK )
: Zoladex
Inhibitors of adrenal steroid biosynthesis and of aromatase C2HS
0
Aminoglutethimide (Ciba, CH)
»^Ä
C H j C - N^
N—y\
\ ) - O C H 2 - 4F,
= /
O r5"0-cl I
0
ci
>
—'
Ketoconazole (Janssen, NL)
332 TABLE 1 . Contd. COMPOUND
ACTIVITY
PROPOSED INDICATIONS
Competitive inhibitors of 5d -reductase H3c
CH,
k A
Keratolytic
Acne
Antiandrogen
Benign prostatic hypertrophy
Progestin Antiandrogen
Acne Hypersexuality Prostate cancer
Antiandrogen
Benign prostatic hypertrophy
Antiandrogen
Benign prostatic hypertrophy
Progestin Antiandrogen
Prostate cancer
COOH
C H j
Retinoic acid (Hoffmann-La Roche, CH)
oXX; CH3
4-aza 3-oxo steroids
: MK906
(Merck Sharp and Dohme, USA)
Pituitary inhibitors that are also competitive inhibitors of androqen receptor bindina and of adrenal steroid biosvnthesis
^
Jl
Cyproterone acetate (Schering, FRG)
Pituitary inhibitors that are also competitive inhibitors of androqen receptor bindina and of 5a -reductase
QI^+^SS^
Oxendolone (Takeda, Japan) TSAA - 291
Lipido-steroid complex extracted from the plant Serenoa repens Permixon (Pierre Fabre. F)
Pituitary inhibitors that are also competitive inhibitors of androqen receptor bindina
„c
H— 285. 66. Keeping, H.S., Lyttle, C.R. 1982. Endocrinology 111, 2046. 67. Charaness, G.C., Bannayan, G.A., Laudry, Jr. L.A., Sheridan, P.J., McGuire, W.L. 1979. Biol. Reprod. 21_, 1087. 68. Nguyen, G.L., Giambiagi, N., Mayrand, C., Lecerf, F., Pasqualini, J.R. 1986. Endocrinology V\9_, 978. 69. Hsue, A.J.W., Ericksson, G.F., Yeu, S.S.C. 1978. Nature 273, 37. 70. Bichon, M., Bayard, F. 1979. J. Steroid Biochem. 10, 105. 71. Kniefei, M.A., Katzenellenbogen, B.S. 1981. Endocrinology 108, 545. 72. Huppert, L.C. 1979. Fertil. Steril. 31, 1. 73. Sakai, F., Chiex, F., Clavel, M., Colon, J., Mayer, M., Pommatau, E., Saey, S. 1978. J. Endocrinol. 76, 219. 74. Amara, J.F., Dannies, P.A. 1983. Endocrinology 112, 1141. 75. Amara, J.F., Dannies, P.A. 1986. Mol. Cell Endocrinol. 47, 183. 76. Martinez, A.C., Anara, J.F., Dannies, P.S. 1986. Mol. CeTl Endocrinol 48, 127. 77. Blue, M.L., Williams, D.L. 1981. Biochem. Biophys Res. Commun.98, 785. 78. Canopy, F., Williams, D.L. 1980. Biochemistry 19, 221979. Sutherland, R.L., Jordan, V.C. 1981. In: Non-Steroid anti-estrogens: Molecular Pharmacology and antitumor Actions. Academic Press, Sydney. 80. Riegel, A.T., Jordan, V.C., Bain, R.R., Schoenberg, D.R. 1986. J. Steroid. Biochem. 24, 1141. 81. Tata, J.R. 1976. CeTl 9, 1. 82. Aitken, S.C., Lippman, M.E., Kasid, A., Schoenberg, D.R. 1985. Cancer Res. 45, 2608. 83. Bronzert, D.A., Monaco, M.E., Pinkus, L., Aitken, S.C., Lipman, M.E. 1981. Cancer Res. 41_, 604. 84. Kasid, A., Davidson, N.E., Gelman, E.P., Lipman, M.E. 1986. J. Biol. Chem. 261_, 5562. 85. McGuire, W.L., Carbone, P.P., Vollmar, E.P. 1975. In: Estrogen Receptors in human breast, cancer. Raven Press, New York. 86. Leung, B.S., Sasaki, G.H. 1975. Endocrinology 97, 564. 87. Leung, B.S., Mosley, S., Davenport, C.E., Krippaehne, W.W., Fletcher, W.S. 1975. In: Estrogen Receptor in prediction of clinical responses to endocrine ablation. McGuire, W.L., Carbone, P.P. and Vollmer, E.P. (eds.) Raven Press, New York. 88. Leung, B.S. 1978. In: Hormones, Receptors and Breast Cancer. (McGuire, W.L. ed.) Raven Press, New York, pp. 219. 89. Edwards, D.P., Murthy, S.R., McGuire, W.L. 1980. Cancer Res. 40, 1722. 90. DeSombre, E.R., Argoblast, L.V. 1974. Cancer Res. 34, 1971. 91. Horwitz, K.B., McGuire, W.L. 1978. In: Breast Cancer: Advances in Research and Treatment Vol. 2, (McGuire ed.) Plenum Publishing Corp., New York, pp. 155. 92. Patterson, J.S., Battersby, L.A. 1980. Cancer Treat. Rep. 64, 775.
403 93. Tsai, T.L.S., KatzenelInbogen, B.S. 1977. Cancer Res. 37, 1537 94. Jordan, V.C. 1982. In: Hormones and Cancer. Leavilt, W7W. (ed.) Plenum Press, New York, pp. 165. 95. Kelley, P.A., Asselin, J., Carón, M.G., Raynand, J.P., Labrie, F., 1977. Cancer Res. 37, 76. 96. Soule, H.D., Vazquez, J., Long, A., Albert, S., Brennan, M. 1973. J. Natl. Cancer. Inst. 51_, 1409. 97. Osborne, C.K., Monaco, M.E., Lipman, M.E., Kahn, C.R. 1978. Cancer Res. 38, 94. 98. Bulter, W.B., Kelsey, W.H., Goran, N. 1981. Cancer Res. 41_, 82. 99. DePhilip, R., Leguch, W.E., Lieberman, I. 1977. Cancer Res. 37,
702.
100. McGuire, W.L., Edwards, D.P., Adams, D.J., Savage, N., 1981. In: Non-Steroidal Anti estrogens: Molecular Pharmacology and Antitamor Activity (Sutherland, R.L. and Jordan, V.C., eds.) Academic Press, New York, pp. 339. 101. Katzenellenbogen, B.S., Norman, M.J., Eckert, R.L., Peltz, S.W., Mangel, W.F. 1984. Cancer Res. 44, 112. 102. Westley, B., Rochefort, H. 1980. Cell 20, 353. 103. Sheen, Y.Y., Katzenellenbogen, B.S. 19$7. Endocrinology 120, 1140. 104. Westley, B., May, F.E., Brown, A.M., Knust, A., Chambón, P., Lippman, M.E., Rochefort, H. 1984. J. Biol. Chem. 259, 10030. 105. Vignon, F., Lippman, M., Newala, H., DeRocq, D., Rochefort, H. 1984. Cancer Res. 44, 2084. 106. Sheen, Y.Y., Katzenellenbogen, B.S. 1987. Endocrinology 120, 1140. 107. Wang, J.L., Hsu, Y.M. 1986. Trends Biochem. Sei. JJ_> 23* 108. Geller, J., McCoy, K. 1974. Acta Endocrinol. (Copenhagen) 75, 385. 109. Liao, S. 1974. Biochem., Ser. One 8, 154. 110. Tezon, G.G., Vazquez, M.H., Blaquier, J.A. 1982. Endocrinology 111, 2039. 111. Bullock, L.P., Barthe, P.L., Mowszowicz, I., Orth, D.N., Bardin, C.W. 1975. Endocrinology 97, 189. 112. Mowszowicz, I., Bieber, D.E., Chung, K.W., Bullock, L.P., Bardin, C.W. 1974. Endocrinology 95, 1589. 113. Sundaram, K., Cao, Y.Q., Wang, N.G., Bardin, C.W., River, J., Vale, W. 1981. Life Sei 28, 83114. Lecompte, P., Wang, N.G., Sundaram, K., River, J., Vale, W., Bardin, C.W. 1982. Endocrinology 111, 1. 115. Imperto-McGinley, J., Guerrero, L., Guatier, T., Peterson, R.E. 1974. Science _186, 1213. 116. Brooks, J.R., Bapista, E.M., Berman, C., Ham, E.A., Hichens, M., Johnston, D.B.R., Primka, R.L., Rasmusson, G.H., Reynolds, G.F., Schmitt, S.M., Arth, G.E. 1981. Endocrinology 109, 830. 117. Brooks, J.R., Berman, C., Glitzer, M.S., Gordon, L.R., Primka, R.L., Reynolds, G.F., Rasmusson, G.H. 1982. Prostate, 35. 118. Wenderoth, U.K., George, F.W., Wilson, J.D. 1983. Endocrinology 113, 569. 119. Liang, T., Brady, E.J., Cheung, E.H., Saperstein, R. 1984. Endocrinology 115, 2311. 120. Liang, T., Cascieri, M.A., Cheung, A.H., Reynolds, G.F., Rasmusson, G.H. 1985. Endocrinology 117, 571.
404
121. Hudson, R.W., Mofitt, P.M., Owens, W.A. 1983. Can. J. Biochem. Cell Biol. _61_, 750. 122. Rasmusson, G.H., Liang, T., Brooks, J.R. 1983. In: Gene Regulation by Steroid Hormones II (Roy, A.K. & Clark, J.H. eds.) SpringerVerlag, New York, pp. 311. 123. Pajunen, A.E.I., Isomaa, V.V., Janne, O.A., Bardin, C.W. 1982. J. Biol. Chem. 257, 8190. 124. Swank, R.T., Paigen, K., Granschow, R.E. 1973. J. Mol. Biol. 81, 225. 125. Toole, J.J., Hastie, N.D., Held, W.A. 1979. Cell J7, 441. 126. Catterall, J.F., Watson, C.S., Kontula, K.K., Janne, O.A., Bardin, C.W. 1986. Adv. Exp. Med. Biol. 196, 213. 127. Catterall, J.F., Kontula, K.K., Watson, C.S., Seppanen, P.J., Funkenstein, B., Melanitou, E., Hickock, N.J., Bardin, C.W., Janne, O.A. 1986. Ree. Prog. Horm. Res. 42, 71. 128. Kontula, K.K., Seppanen, P.J., Van Duyne, P., Bardin, C.W., Janne, O.A. 1985. Endocrinology J_1_6, 226. 129. Newmann, F., Wallrabe, R.B., Elger, W., Steinbeck, H., Han, J.D., Kramer, M. 1970. Ree. Prog. Horm. Res. 26, 337. 130. Mowszowicz, I., Bieber, D.E., Chung, K.W., Bullock, L.P., Bardin, C.W. 1974. Endocrinology 95, 1589. 131. Gupta, C., Bullock, L.P., Bardin, C.W. 1978. Endocrinology 102, 736. 132. Bullock, L.P., Barthe, P.L., Mowszowicz, I., Orth, D.N., Bardin, C.W. 1975. Endocrinology 97, 189. 133. Bardin, C.W., Bullock, L.P., Shenins, R., Mowszowicz, I., Blackburn, W.R. 1973. Ree. Prog. Horm. Res. 29, 65. 134. Coffey, D.S. 1974. In: Male Accessory Sex Organs, Structure and Function in Marwnals (Brandes, D. ed.) Academic Press, New York, pp. 307. 135. Böhmer, T., Hansson, V. 1975. Mol. Cell. Endocrinol. 103. 136. Lasnitzki, I., Röbel, P. 1976. Adv. Bio Sei. 3, 175. 137. Kitamura, Y., Uehida, N., Odaguchi, K., Yamaguchi, K., Okamoto, S., Matsumoto, K. 1980. J. Steroid Biochem. .13, 333. 138. Kitamura, Y., Okamoto, S., Hayata, I., Uehida, N., Yamaguchi, K.. Matsumoto, K. 1979. Cancer Res. 39, 4713. 139. Cambray, G.J., King, R.J. 1976. J. Endocrinol. 71., 43. 140. Schroeder, F.H., Richards, B. 1985. In: Progress in Clinical and Biological Research - Therapeutic Principles in Metastatic Prostatie Cancer (Riss, A.R. ed.) New York, 185A. 141. Newmann, F., Steinbeck, H. 1974. In: Handbook of Experimental Pharmacology (Eichler, 0., Fareh, A., Herken, H. & Welch, A.D., eds.) Springer, Berlin, 35, pp. 235. 142. Newmann, F., Humpel, M., Senge, Th, Schenek, B., TUnn, U. 1982. In: Prostate Cancer (Jacobi, G.H. and Hohenfeilner, R.F. eds.) Williams & Wilkins, Baltimore, pp. 269. 143. Luderschmidt, Chr., Plewig, G. 1977. Archs. Derm. Res. 258, 185. 144. Steinbeck, H., Newmann, F. 1971. J. Reprod. Fert. 26, 59.
STEROID HORMONE ANTAGONISTS, BRAIN RECEPTOR SYSTEMS AND BEHAVIOR
A.M. Etgen Departments of Psychiatry and Neuroscience, Albert Einstein College of Medicine, Bronx, N.Y. 10461
Introduction The antiestrogenic properties of the first nonsteroidal estrogen antagonist MER-25 were described by Lerner et al. (1) almost thirty years ago. In the ensuing three decades dozens of additional agents which antagonize the physiological effects of steroid hormones have been developed and characterized. The reasons for this intensive research effort are at least twofold. First, steroid hormone antagonists have potential therapeutic utility, e.g., in the treatment of acne, hirsutism, steroid-dependent breast and prostate cancers, and as fertility and antifertility agents. The clinical uses of antisteroids are discussed in several of the other chapters in this volume. Second, such compounds are potentially powerful tools for elucidating the cellular and molecular mechanisms of steroid hormone action. This chapter will focus on the use of such antagonists to identify the sites and mechanisms of steroid hormone regulation of animal behavior. The generally accepted model for the molecular mechanism of steroid action originated from early studies of estrogen action in the uterus (2,3). Briefly, steroids enter both target and nontarget cells by passive diffusion. Target cells contain intracellular macromolecules ("receptors") which bind the steroid with high affinity, limited capacity, and relative stereospecificity. Binding of steroid to the receptor
Receptor Mediated Antisteroid Action © 1987 Walter de Gruyter & Co., Berlin • New York - Printed in Germany
406
initiates conformational alterations in the steroid-receptor complex, converting it to a form with enhanced affinity for intranuclear chromatin "acceptor" sites. Interaction of steroid-receptor complexes with chromatin initiates changes in gene transcription (i.e., RNA synthesis), and these alterations in gene expression are believed to mediate the physiological responses of target tissues to steroid hormones (for reviews see 4-7). There is still some disagreement regarding the subcellular compartmentation of steroid receptors (i.e., cytosolic vs. nuclear) in the absence of hormone (8-11). For purposes of the present discussion, the term "cytosol receptor" is used to designate the state of the receptor with lower affinity for nuclear components, and "nuclear receptor" refers to cytosol receptors that have translocated to the cell nucleus and/or converted to a state with increased affinity for cell nuclear components. As reviewed below, the availability of steroid antagonists has allowed researchers to ask whether receptor-mediated modulation of gene expression in brain cells can account for the behavioral effects of steroids. To date most investigations have used antisteroids to study the neural sites and mechanisms of steroid regulation of reproductive (sexual) behavior. Thus most of this chapter will review experiments in which the interactions of antiandrogens, antiprogestins, or antiestrogens with brain steroid receptor systems have been correlated with changes in sexual behavior. The handful of studies that have examined other behaviors will also be described.
Antiandrogens The growth and function of male secondary sex structures (especially the seminal vesicles and ventral prostate) and, in most species, the display of male sexual behavior are
407
androgen-dependent processes. By the mid-197 0s a variety of steroidal (e.g., cyproterone acetate) and nonsteroidal (e.g., flutamide) antagonists of androgen-receptor binding in peripheral tissues had been reported to inhibit androgen action in the prostate and seminal vesicles (see 12-14). Until recently, however, attempts to modify androgen-dependent male reproductive behavior with such antiandrogens have proven relatively unsuccessful. Administration of peripherally potent antiandrogens, even in doses that induced sterility or decreased seminal vesicle and prostate weights, failed to alter sexual behavior in adult male rats or guinea pigs (1520). Similarly, flutamide had no effect on intermale aggression in male mice even though prostate weights were decreased (21). There is one early report that cyproterone acetate reversibly reduced sexual activity in male rats (22) and Sodersten et al. (20) found that flutamide partially inhibited testosterone-induced ejaculatory behavior in castrated male rats. The latter authors suggested that the observed ejaculatory failure probably resulted from flutamideinduced alterations in penile morphology rather than actions of the compound in the brain since the animals showed normal mounting and intromission behavior. Similar interpretations of flutamide's effects of male sexual behavior were made by Gray (23). Moreover, one laboratory (24) reported that both systemic injections of cyproterone acetate and intrahypothalamic implants of the free alcohol cyproterone actually enhanced sexual behavior in adult male rats. A likely explanation for these negative results is provided by studies of the cellular actions of antiandrogens in the brain. Whalen et al. (25) demonstrated that cyproterone acetate administration did not alter the uptake of radiolabeled testosterone by the pituitary, hypothalamus, preoptic area or cortex even in doses which significantly reduced hormone uptake by the seminal vesicles and penis. In vitro competition studies also found that flutamide and BOMT,
408 another potent antiandrogen in the periphery, were poor competitors for 3 H-androgen binding sites in brain cytosols from male mice (21,26) and rats (27,28).
These results
suggest that most antiandrogens fail to modify androgendependent behaviors because they fail to interact with brain androgen receptor systems.
The data also support the proposal
of Sheridan (29) that the brain may have as many as three distinct receptors for androgens which differ in some ways from peripheral androgen receptors. One recent study successfully correlated the behavioral effects and brain androgen receptor binding properties of the potent antiandrogen Sch 16423, a hydroxylated metabolite of flutamide (28) .
At a dose of 15 mg/day, Sch 16423 reversibly
depressed the restoration of male sexual behavior in castrated rats receiving testosterone replacement via Silastic capsules. In vivo injections of the compound reduced cell nuclear binding of radiolabeled androgen in the brain
(hypothalamus-
preoptic area-amygdala-septum) and pituitary; at concentrations of 10 uM or greater Sch 16423 also competed for binding of the synthetic androgen pituitary cytosols.
3
H-R1881 in brain and
Thus Sch 16423 may be the first useful
antagonist for studying the role of brain androgen receptor systems as mediators of the behavioral effects of androgens.
Antiprogestins In most female mammals ovarian estrogens and progestins synergize to control the onset, quality and duration of female reproductive behavior (for reviews see 30,31).
The most
effective treatment for inducing sexual behavior in ovariectomized rodents is sequential treatment with estrogen followed 36-48 hours later by progestin
(32,33).
A number of
laboratories have shown that estrogen treatments which facilitate female reproductive behavior also induce the
409
synthesis of progestin receptors in the hypothalamus and preoptic area, leading to the hypothesis that progestin receptors may mediate the behavioral effects of progesterone in the brain (for reviews see 31,34-36). For many years the search for agents which specifically antagonize the physiological effects of progestins was relatively unfruitful (see 37,38). However, a recently developed synthetic steroid, RU 38486, has been reported to antagonize a number of progestational responses in peripheral reproductive tissues, presumably because it acts as a competitive inhibitor of intracellular progesterone-receptor binding (39-44). Although RU 38486 has some progestin agonist activity (45,46) and is also a potent glucocorticoid receptor antagonist (47-49), the compound has already proven to be an effective tool for evaluating the neuroanatomical sites and molecular mechanisms of progestin regulation of female reproductive behavior. The first behavioral study with RU 38486 (50) showed that the drug inhibits progesterone activation of sexual behavior in ovariectomized, estrogen-primed female guinea pigs. This inhibitory action can be prevented by giving very high doses of progesterone but not Cortisol (36,51), suggesting that the behavioral effects of RU 38486 involve antagonism of progestin rather than of glucocorticoid action. The behavioral antagonism was correlated with the capacity of in vivo drug injections to reduce the concentration of progestin receptors in cytosols of hypothalamus-preoptic area from estrogen-primed guinea pigs. In addition, RU 38486 competed in vitro for progestin but not estrogen binding sites in brain cytosols (50). Etgen and Barfield (52) subsequently demonstrated that the compound competes for progestin binding sites in female rat brain cytosols and that injections of RU 38486 inhibit female reproductive behavior in estrogen-primed rats a$ well. They also showed that 3H-RU 38486 binding in rat brain
410
cytosols is increased by estrogen priming and is displaced by progestins (and to a lesser extent by glucocorticoids). These experiments all support the hypothesis that intracellular progestin receptors in the hypothalamus and/or preoptic area mediate progesterone facilitation of female sexual behavior in rodents. Interestingly, Richmond and Clemens (53) recently reported that RU 38486 does not antagonize the activation of sexual receptivity by cholinergic drugs in estrogen-primed female rats, suggesting that brain progestin receptors do not mediate the cholinergic facilitation of female reproductive behavior. In addition to the evidence cited above that RU 38486 competes for brain cytosol progestin receptors, Brown and Blaustein (51) have shown that the compound induces accumulation of progestin-receptor complexes in guinea pig hypothalamic cell nuclei. However, nuclear accumulation of brain progestin receptors following RU 38486 administration is detectable only when exchange assays are conducted at elevated temperatures. Thus RU 38486 may dissociate more slowly from brain progestin receptors than does progesterone itself. These slow dissociation kinetics may explain the observation that RU 38486 given alone makes animals unable to respond behaviorally to progesterone given 24 hours later (50,53; Vathy, Etgen and Barfield, unpublished observations). Blaustein and colleagues have also proposed that the termination of female sexual behavior is attributable to the loss of progestin receptor complexes from hypothalamic cell nuclei (50,54,55). This hypothesis was tested using RU 38486 in estrogen-primed guinea pigs (51). Injection of the drug 4 hours after progesterone had no effect on the latency of lordosis responses, but the display of sexual behavior in treated animals terminated several hours earlier than in animals given vehicle injections. This shortened period of behavioral receptivity in RU 38486-treated guinea pigs was
411
correlated with reductions in the concentration of progestin receptors in hypothalamic cell nuclei 2 and 6 hours after drug administration. Thus studies using RU 38486 are also consistent with the hypothesis that the loss of progestin receptors from hypothalamic cell nuclei may be a mechanism whereby the period of sexual behavior is terminated, at least in female guinea pigs. RU 38486 has also been utilized to examine the neural sites of progesterone stimulation of female sexual behavior (lordosis). Etgen and Barfield (52) applied the drug in bilateral intracerebral implants to the preoptic area, ventromedial hypothalamus, habenula and interpeduncular region of estrogenprimed rats 1 hour prior to systemic progesterone injections. Implants of RU 38486 into the ventromedial hypothalamus but not the preoptic area or interpeduncular region of the midbrain suppressed lordosis in a significant percentage of animals. These data confirm the results of recent progestin implant studies which point to the ventromedial nucleus of the hypothalamus as the primary neural locus of progesterone facilitation of female sexual behavior (56,57). Moreover, some RU 38486 implants in the habenula also inhibited progesterone-dependent lordosis, suggesting that progestinreceptor interactions in the habenula may also play a role in behavioral regulation. In summary, the steroidal antiprogestin RU 38486 antagonizes progesterone facilitation of female sexual behavior in estrogen-primed rodents when administered either systemically or intracerebrally. It is also clear that this progestin antagonist binds directly to brain progestin receptors, and the evidence presented to date is consistent with the interpretation that RU 38486 exerts its effects on reproductive behavior by interfering with progesteronereceptor interactions in neural tissues. Thus further studies with this compound should yield new insights into the cellular
412
and molecular mechanisms underlying progestin modulation of sexual and other behaviors.
Antiestrogens By far the most extensively characaterized steroid antagonists in both neural and peripheral tissues are the antiestrogens. Historically, analyses of antiestrogen action in the uterus provided some of the first direct evidence that modulation of gene expression by intracellular steroid receptors is a critical molecular event underlying target tissue responses to hormones (e.g., 5,58-61). More recent work has suggested that relatively antiestrogen-specific binding sites exist ubiquitously in vertebrate tissues (see 62-64) and that there may be an endogenous ligand for these binding sites (65). However, the physiological function of the antiestrogen binding sites is still undetermined; this issue and a variety of the clinical and basic research uses of estrogen antagonists in peripheral tissues are reviewed in other chapters of this volume. While studies of the effects of estrogen antagonists on neural estrogen binding and behavior are neither as numerous nor as systematic as those on the uterus and on breast cancer, antiestrogen modulation of both female sexual behavior and eating behavior has been reported (for earlier reviews see 66,67). In addition, a substantial amount of information regarding antiestrogen interaction with brain estrogen receptors is also available. The remainder of this chapter will review these data in some detail since they provide the best example of the use of steroid antagonists as probes of the sites and molecular mechanisms of hormonal regulation of behavior.
413
Effects of antiestrogens on female sexual behavior Arai and Gorski (68) were the first to report that the nonsteroidal antiestrogen CI-628 inhibited female rat sexual behavior when administered concurrently with estrogen. Delaying CI-628 treatment until 24 hours after the estrogen injection or until the time of progesterone injection (48 hours post-estrogen) did not attenuate sexual receptivity. Additional experiments in a variety of laboratories subsequently showed that a large number of estrogen antagonists, including MER-25, CI-628, clomiphene, nafoxidine, and tamoxifen, are effective inhibitors of estrogen-stimulated female sexual behavior in rats, hamsters and guinea pigs (for reviews, see 69 and chapter in this volume by Fabre-Nys). These behavioral studies also established some important general characteristics of antiestrogen action. First, the degree of behavioral inhibition is dependent on the dose of both estrogen and antiestrogen. Second, the temporal sequence of estrogen and antiestrogen administration is a critical variable; with the possible exception of guinea pigs (70,71) antiestrogens are effective behavioral antagonists only when given at or near the time of estrogen injection. Thus the behavioral inhibition exerted by estrogen antagonists is likely to be due to antagonism of estrogen rather than of progesterone action and is unlikely to reflect nonspecific or toxic effects of the compounds. Komisaruk and Beyer (72) demonstrated further that MER-25 does not block lordosis responses induced by cervical probing plus flank-perineum stimulation. This observation suggests further that antiestrogens act directly on the brain rather than by altering peripheral sensory input. The latter conclusion has been confirmed by experiments showing that implants of antiestrogens directly into the brain can block the activation of female rat sexual behavior by systemic estrogen priming (73-75). In fact the latter two studies have provided
414
c o n v i n c i n g e v i d e n c e t h a t e s t r o g e n a c t i o n in t h e
ventromedial
hypothalamus
(see 76)
is n e c e s s a r y a s w e l l a s s u f f i c i e n t
p r i m e f e m a l e s e x u a l b e h a v i o r in o v a r i e c t o m i z e d r a t s . in c o n t r a s t w i t h t h e m i x e d e s t r o g e n activity of antiestrogens
to
Finally,
agonist/antagonist
in m o s t t a r g e t t i s s u e s ,
these
compounds appear to be almost pure antagonists w i t h regard to e s t r o g e n f a c i l i t a t i o n of f e m a l e r e p r o d u c t i v e b e h a v i o r . enclomiphene has b e e n reported to have very w e a k
Only
estrogen
a g o n i s t e f f e c t s o n f e m a l e s e x u a l b e h a v i o r in g u i n e a p i g s 79) a n d i n r a t s
(80).
Hence in-depth examination of
(77-
estrogen-
antiestrogen interactions with brain estrogen receptors may a n ideal s y s t e m i n w h i c h t o e l u c i d a t e t h e m o l e c u l a r of s t e r o i d r e g u l a t i o n of b e h a v i o r .
However,
it m u s t b e
recognized that the major estrogen receptor-containing of t h e b r a i n
be
mechanisms
(hypothalamus, preoptic area, amygdala)
s i t e s o f e s t r o g e n r e g u l a t i o n of g o n a d o t r o p i n
regions
are also
release,
aggression, maternal behavior and eating behavior. o n e m u s t b e c a u t i o u s in i n t e r p r e t i n g r e p o r t s of
Therefore,
antiestrogen
a c t i o n in t h e h y p o t h a l a m u s a s b e i n g u n i q u e l y r e l a t e d t o t h e c o n t r o l of f e m a l e s e x u a l
behavior.
Effects of antiestrogens on brain uptake and retention
of
estrogen There are positive and negative reports of r e d u c t i o n o f h y p o t h a l a m i c u p t a k e of
3
antiestrogen
H-estradiol.
Several
i n v e s t i g a t o r s d e t e c t e d n o s i g n i f i c a n t i n h i b i t i o n of in v i v o 3
H - e s t r a d i o l u p t a k e i n t o w h o l e h o m o g e n a t e s of r a t
by nafoxidine
(81), M E R - 2 5
(82) o r C I - 6 2 8
hypothalamus
(83), e v e n w h e n t h e
l a t t e r a n t a g o n i s t w a s a d m i n i s t e r e d in a p a r a d i g m in w h i c h female sexual behavior was inhibited (85)
(84).
Walker and
found similarly that CI-628 did not reduce
u p t a k e of
3
H - e s t r a d i o l benzoate by guinea pig
Feder
cellular
hypothalamus;
however, CI-628 does not block female reproductive behavior this species Powers
(77).
Since Meyerson and Lindstrom
(87) r e p o r t e d t h a t C I - 6 2 8 a n t a g o n i z e d
(86)
estradiol
and
in
415
benzoate- but not estradiol-induced lordosis behavior, the reported failure of antiestrogens to reduce hypothalamic estradiol uptake might not be unexpected. Landau (88), however, also found that CI-628 did not effect in vivo uptake and retention of 3H-estradiol benzoate by hypothalamic whole homogenates. In spite of the observations cited above, many laboratories have demonstrated that antiestrogens can inhibit cellular uptake and retention of radiolabeled estradiol by the hypothalamus in vivo. Four studies reported that clomiphene depressed hypothalamic uptake of 3H-estradiol (81,89,90) or 3 H-estradiol benzoate (85) in rats and guinea pigs, respectively. The first three studies must be interpreted cautiously because racemic clomiphene was administered, and the trans isomer is an estrogen agonist (see 91,92). Both CI628 (82,93) and nafoxidine (82,94) are also capable of decreasing 3H-estradiol uptake and retention by whole homogenates of female rat hypothalamus. There are no positive reports of MER-25 inhibition of brain estradiol uptake or retention. There is no obvious explanation for the differences in the reported effects of estrogen antagonists on neural uptake of estradiol. The discrepancies cannot be attributed to simple differences in doses, temporal sequence, or route of administration of estrogen and antiestrogen. One can only conclude that some antiestrogens can, under some conditions, interfere with cellular uptake and retention of estradiol by the hypothalamus; therefore, neural uptake and retention are probably prerequisites for estrogen activation of female sexual behavior.
416
Antiestrogen interactions with cytosol receptors in vitro The hypothalamus, preoptic area and amygdala, like other estrogen target tissues, contain specific, high affinity, saturable cytosol estrogen receptors (e.g., 95-97). If behavioral responses to estrogen are, like uterine growth, mediated by a receptor system, one would predict that antiestrogens can compete with estradiol for receptor binding in brain cytosols. Indeed several laboratories have reported that nonsteroidal antiestrogens compete for specific estradiol binding in hypothalamus-preoptic area cytosols (97-102). Moreover, the relative affinities of estrogen antagonists for hypothalamic cytosol receptors correlates well with their potency as inhibitors of estrogen-stimulated female sexual behavior. These data are consistent with the hypothesis that brain estrogen receptors mediate estrogenic activation of female reproductive behavior. The precise manner in which antiestrogens interact with estrogen receptors is still unclear. It is widely accepted that antiestrogens operate by competing directly for the estradiol binding site on the receptor, i.e., by competitive inhibition. This notion is supported both by kinetic studies of estrogen-antiestrogen competition for uterine cytosol binding sites (e.g., 61,103) and by the observation that 3 Hantiestrogens can bind directly to estrogen receptors in a variety of tissues (104-108), including brain (109; Etgen, unpublished observations). However, the results of other kinetic studies suggested that many nonsteroidal antiestrogens, including tamoxifen, were allosteric rather than simple competitive inhibitors of estradiol binding (110). Our studies of antiestrogen interactions with neural estradiol receptors support the view that one cannot explain all of the influences of antiestrogens, at least on brain receptor systems, by competitive inhibition. We examined the competition by unlabeled estradiol, tamoxifen and nafoxidine
417
for 3H-estradiol binding sites in female rat hypothalamuspreoptic area cytosols when the concentrations of both the 3 Hestradiol and the competitors were varied over a large range (100). When these data were analyzed by the method of Scatchard (111), we found evidence of mixed competitivenoncompetitive inhibition of 3H-estradiol binding by both antiestrogens, i.e., either or both the apparent K