Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Department of Pathology, University of Illinois at Chicago, Chicago, IL, USA.
Cancer Lett. 2021 Nov 1;520:255-266. doi: 10.1016/j.canlet.2021.07.034. Epub 2021 Jul 27.
Pharmacological approaches to breast cancer risk-reduction for BRCA1 mutation carriers would provide an alternative to mastectomy. BRCA1-deficiency dysregulates progesterone signaling, promoting tumorigenesis. Selective progesterone receptor (PR) modulators (SPRMs) are therefore candidate prevention agents. However, their efficacy varies in different BRCA1-deficient mouse models. We examined chemopreventive efficacy of telapristone acetate (TPA), ulipristal acetate (UPA) and mifepristone (MFP) in mice with a conditional knockout of the Brca1 C-terminal domain. The SPRMs displayed a spectrum of efficacy: UPA was most effective, TPA less, and MFP ineffective. Compared to no-treatment controls, UPA reduced tumorigenesis (p = 0.04), and increased tumor latency (p = 0.03). In benign mammary glands, UPA decreased Ki67 (p < 0.001) and increased PR expression (p < 0.0001). RNA sequencing analysis revealed distinct gene expression in response to UPA and MFP. UPA downregulated glycolysis and extracellular matrix-inflammation genes (Fn1, Ptgs2, Tgfb2, Tgfb3) whereas MFP downregulated claudin genes and upregulated amino acid metabolism and inflammation genes. The anti-glucocorticoid effects of MFP appeared not to be tumor-protective, while altering estrogen receptor signaling and NF-kB activation. Our study points to an important role of epithelial PR and its paracrine action on the microenvironment in BRCA1-deficient mammary tumorigenesis, and prevention.
针对 BRCA1 基因突变携带者的乳腺癌风险降低的药物治疗方法将为乳房切除术提供替代方案。BRCA1 缺陷会扰乱孕激素信号,促进肿瘤发生。因此,选择性孕激素受体(PR)调节剂(SPRMs)是候选预防药物。然而,它们在不同的 BRCA1 缺陷型小鼠模型中的疗效存在差异。我们研究了 telapristone 乙酸盐(TPA)、ulipristal 乙酸盐(UPA)和米非司酮(MFP)在 BRCA1 C 端结构域条件敲除小鼠中的化学预防效果。SPRMs 显示出不同的疗效:UPA 最有效,TPA 效果次之,MFP 无效。与未治疗对照组相比,UPA 降低了肿瘤发生率(p=0.04),并延长了肿瘤潜伏期(p=0.03)。在良性乳腺中,UPA 降低了 Ki67(p<0.001)并增加了 PR 表达(p<0.0001)。RNA 测序分析显示,UPA 和 MFP 对基因表达的反应不同。UPA 下调糖酵解和细胞外基质-炎症基因(Fn1、Ptgs2、Tgfb2、Tgfb3),而 MFP 下调紧密连接基因,上调氨基酸代谢和炎症基因。MFP 的抗糖皮质激素作用似乎对肿瘤没有保护作用,同时改变了雌激素受体信号和 NF-kB 激活。我们的研究表明,上皮 PR 及其旁分泌作用对 BRCA1 缺陷型乳腺肿瘤发生和预防中的微环境具有重要作用。
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