de Bruin C, Feelders R A, Waaijers A M, van Koetsveld P M, Sprij-Mooij D M, Lamberts S W J, Hofland L J
Division of Endocrinology, Department of Internal Medicine, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
J Mol Endocrinol. 2009 Jan;42(1):47-56. doi: 10.1677/JME-08-0110. Epub 2008 Oct 13.
Dopamine agonists (DA) and somatostatin (SS) analogues have been proposed in the treatment of ACTH-producing neuro-endocrine tumours that cause Cushing's syndrome. Inversely, glucocorticoids (GCs) can differentially influence DA receptor D(2) or SS receptor subtype (sst) expression in rodent models. If this also occurs in human neuro-endocrine cells, then cortisol-lowering therapy could directly affect the expression of these target receptors. In this study, we investigated the effects of the GC dexamethasone (DEX) on D(2) and sst expression in three human neuro-endocrine cell lines: BON (carcinoid) and TT (medullary thyroid carcinoma) versus DMS (small cell lung cancer), which is severely GC resistant. In BON and TT, sst(2) mRNA was strongly down-regulated in a dose-dependent manner (IC(50) 0.84 nM and 0.16 nM), whereas sst(5) and especially D(2) were much more resistant to DEX treatment. Sst(2) down-regulation was abrogated by a GC receptor antagonist and reversible in time upon GC withdrawal. At the protein level, DEX also induced a decrease in the total number of SS (-52%) and sst(2)-specific (-42%) binding sites. Pretreatment with DEX abrogated calcitonin inhibition by sst(2)-preferring analogue octreotide in TT. In DMS, DEX did not cause significant changes in the expression of these receptor subtypes. In conclusion, we show that GCs selectively down-regulate sst(2), but not D(2) and only to a minor degree sst(5) in human neuro-endocrine BON and TT cells. This mechanism may also be responsible for the low expression of sst(2) in corticotroph adenomas and underwrite the current interest in sst(5) and D(2) as possible therapeutic targets for a medical treatment of Cushing's disease.
多巴胺激动剂(DA)和生长抑素(SS)类似物已被用于治疗导致库欣综合征的促肾上腺皮质激素(ACTH)分泌性神经内分泌肿瘤。相反,在啮齿动物模型中,糖皮质激素(GCs)可不同程度地影响DA受体D(2)或SS受体亚型(sst)的表达。如果这一现象也发生在人类神经内分泌细胞中,那么降低皮质醇的治疗可能会直接影响这些靶受体的表达。在本研究中,我们研究了GC地塞米松(DEX)对三种人类神经内分泌细胞系中D(2)和sst表达的影响:BON(类癌)和TT(甲状腺髓样癌)与严重GC抵抗的DMS(小细胞肺癌)。在BON和TT细胞中,sst(2) mRNA以剂量依赖性方式强烈下调(IC(50)分别为0.84 nM和0.16 nM),而sst(5)尤其是D(2)对DEX治疗的抵抗性更强。GC受体拮抗剂可消除sst(2)的下调,且在撤去GC后可随时间逆转。在蛋白水平上,DEX还导致SS(-52%)和sst(2)特异性(-42%)结合位点总数减少。在TT细胞中,用DEX预处理可消除sst(2)选择性类似物奥曲肽对降钙素的抑制作用。在DMS细胞中,DEX对这些受体亚型的表达没有引起显著变化。总之,我们表明GCs在人类神经内分泌BON和TT细胞中选择性下调sst(2),而非D(2),对sst(5)的下调程度较小。这一机制可能也是促肾上腺皮质激素腺瘤中sst(2)低表达的原因,并支持目前将sst(5)和D(2)作为库欣病药物治疗可能的治疗靶点的研究兴趣。