Yadav N, Heemers H V
Department of Urology, Roswell Park Cancer Institute, Buffalo, NY, USA.
Minerva Urol Nefrol. 2012 Mar;64(1):35-49.
The embryonic development, growth and maturation of the prostate relies on androgens, the male sex steroids, acting through their cognate receptor, the androgen receptor (AR). This dependence on androgens continues in adult life, where AR signaling remains necessary for the maintenance of the structural and functional integrity of the prostate gland. Moreover, AR action contributes to the development and progression of prostate cancer (PCa), which is the most common malignancy in Western men. Androgen deprivation therapies (ADTs) that interfere with ligand activation of AR to prevent expression of AR target genes and androgen action on target cells have been the standard therapy for locally advanced or recurrent PCa for 7 decades. While they initially induce remission, ADTs are not curative and eventually PCa recurs as castration-recurrent (CR) disease, which is invariably lethal. Despite low levels of circulating androgens, CR PCa cell proliferation still relies on a functional AR. Recently, new insights into the cellular processes and determinants that regulate AR action, including intraprostatic androgen metabolism, AR structure and function, a novel role for well-known tumor suppressors and oncogenes in the control of AR transcriptional output, unexpected non-transcriptional roles for AR, and the identification of distinct modes of androgen-dependent gene expression, have enhanced markedly our understanding of the AR-dependent events that contribute to progression to the lethal stage of PCa. Here, we provide a general overview of androgen action in prostate (cancer), summarize these novel concepts in AR action and discuss their implications for the optimization of therapeutic intervention in PCa.
前列腺的胚胎发育、生长和成熟依赖于雄激素,即男性甾体激素,它们通过其同源受体雄激素受体(AR)发挥作用。在成年期,这种对雄激素的依赖依然存在,AR信号传导对于维持前列腺的结构和功能完整性仍然是必需的。此外,AR作用促进前列腺癌(PCa)的发生和进展,前列腺癌是西方男性中最常见的恶性肿瘤。干扰AR配体激活以阻止AR靶基因表达以及雄激素对靶细胞作用的雄激素剥夺疗法(ADTs)在过去70年里一直是局部晚期或复发性PCa的标准治疗方法。虽然它们最初能诱导缓解,但ADTs并非治愈性疗法,最终PCa会复发为去势抵抗性(CR)疾病,这种疾病通常是致命的。尽管循环雄激素水平较低,但CR PCa细胞的增殖仍然依赖于功能性AR。最近,对调节AR作用的细胞过程和决定因素有了新的认识,包括前列腺内雄激素代谢、AR结构和功能、著名肿瘤抑制因子和癌基因在控制AR转录输出中的新作用、AR意外的非转录作用以及雄激素依赖性基因表达不同模式的鉴定,这些显著增强了我们对导致PCa进展到致命阶段的AR依赖性事件的理解。在此,我们对雄激素在前列腺(癌)中的作用进行总体概述,总结AR作用中的这些新概念,并讨论它们对优化PCa治疗干预的意义。
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