School of Medicine (E.C., R.B.M.), University of Washington, Seattle, Washington 98195; and Division of Clinical Research (E.A.M.), Fred Hutchinson Cancer Research Center, Seattle, Washington 98109.
Endocrinology. 2014 Nov;155(11):4124-32. doi: 10.1210/en.2014-1337. Epub 2014 Aug 22.
Androgens play a critical role in the development and progression of prostate cancer (PCa), and androgen deprivation therapy via surgical or medical castration is front-line therapy for patients with advanced PCa. However, intratumoral testosterone levels are elevated in metastases from patients with castration-resistant disease, and residual intratumoral androgens have been implicated in mediating ligand-dependent mechanisms of androgen receptor activation. The source of residual tissue androgens present despite castration has not been fully elucidated, but proposed mechanisms include uptake and conversion of adrenal androgens, such as dehdroepiandrosterone to testosterone and dihydrotestosterone, or de novo androgen synthesis from cholesterol or progesterone precursors. In this minireview, we discuss the emerging evidence that suggests a role for specific transporters in mediating transport of steroids into or out of prostate cells, thereby influencing intratumoral androgen levels and PCa development and progression. We focus on the solute carrier and ATP binding cassette gene families, which have the most published data for a role in PCa-related steroid transport, and review the potential impact of genetic variation on steroid transport activity and PCa outcomes. Continued assessment of transport activity in PCa models and human tumor tissue is needed to better delineate the different roles these transporters play in physiologic and neoplastic settings, and in order to determine whether targeting the uptake of steroid substrates by specific transporters may be a clinically feasible therapeutic strategy.
雄激素在前列腺癌 (PCa) 的发展和进展中起着关键作用,通过手术或医学去势进行雄激素剥夺疗法是晚期 PCa 患者的一线治疗方法。然而,在去势抵抗疾病患者的转移灶中,肿瘤内睾酮水平升高,并且残留的肿瘤内雄激素被认为介导雄激素受体激活的配体依赖性机制。尽管去势,但仍未完全阐明存在的残留组织雄激素的来源,但提出的机制包括摄取和转化肾上腺雄激素,如脱氢表雄酮转化为睾酮和二氢睾酮,或从头胆固醇或孕激素前体合成雄激素。在这篇综述中,我们讨论了越来越多的证据表明,特定转运蛋白在介导类固醇进入或离开前列腺细胞的转运中起作用,从而影响肿瘤内雄激素水平以及 PCa 的发展和进展。我们重点介绍溶质载体和 ATP 结合盒基因家族,这些家族在与 PCa 相关的类固醇转运中具有最多的发表数据,并回顾了遗传变异对类固醇转运活性和 PCa 结局的潜在影响。需要在 PCa 模型和人类肿瘤组织中继续评估转运活性,以更好地阐明这些转运蛋白在生理和肿瘤环境中发挥的不同作用,并确定是否通过特定转运蛋白摄取类固醇底物可能是一种可行的临床治疗策略。