https://doi.org/10.1200/JCO.2007.14.2968 [PubMed] [Google Scholar] 61. therapy. Our results suggest a collaboration of ER and p53 tumor suppressor activity in breast malignancy cells that indicates the importance of ligand-regulated ER as a tool to target p53 activity and improve the clinical management of resistant disease. and acquired resistance to endocrine therapy is usually developed in 50% of the cases . Only part of the mechanism that links estrogen signaling to therapy resistance has been elucidated including the altered expression and/or post-translational modification of ER that results in aberrant activity . The discovery of ER indicated the complexity of estrogen signaling and suggested the possibility of the second ER to interfere with the Piperidolate pathways that contribute to resistant phenotypes. Both ER and ER are transcription factors that regulate a plethora of genes by acting on estrogen-response-elements (ERE) or by interacting with other transcription factors [5, 6]. Despite similarities in the structure and the mechanism of action, the two ER subtypes elicit distinct transcriptional responses and differentially affect cancer cellular processes which may imply separate roles in therapy resistance. In addition to estrogen receptor activity, other factors that regulate cell survival have been associated with therapy resistance in breast cancer. Among these, the p53 protein that is expressed in its wild-type form in approximately 80% of ER-positive breast cancers [8, 9]. As a tumor suppressor, p53 regulates cell-cycle arrest, DNA repair, apoptosis and senescence through induction of downstream effectors including cyclin-dependent kinase inhibitor 1 (p21WAF1), growth arrest and DNA-damage-inducible alpha (GADD45A), p53 upregulated modulator of Piperidolate apoptosis (PUMA), BCL-2-like protein 4 (BAX), plasminogen activator inhibitor-1 (PAI-1), and NOXA [10C13]. In response to stress, p21 promotes G1/S cell cycle arrest  and the BCL-2 family member PUMA induces apoptosis by primarily activating the pro-apoptotic proteins BAX and/or BAK in mitochondria . Upon genotoxic stress, GADD45A induces growth arrest and apoptosis by interacting with p21 and CDC2 and PAI-1 is essential for replicative senescence [16C20]. In addition to downstream effectors, regulators of p53 expression and activity affect its tumor Mouse monoclonal to TYRO3 suppressor function. In response to DNA damage, ATM and ATR upregulate p53 through phosphorylation that disturbs its interaction with the ubiquitin ligase MDM2. Upregulation of MDM2 in breast carcinomas results in accelerated p53 degradation and is associated with worse prognosis [21C24]. Similar to MDM2, the Piperidolate ubiquitin ligase MDMX directly impedes p53 transcriptional activity or heterodimerizes with MDM2 to induce p53 degradation . Consequently, due to its pivotal impact on cell survival signaling, deregulation of the p53 pathway is an important step in the process that leads to resistant tumor phenotypes [26, 27]. Altered activity of this pathway has been associated with resistance to ER-targeted therapies and chemotherapies . However, what signaling mitigates wild-type p53 activity in ER-positive tumors is still poorly understood. Activation of the p53 pathway has been inversely associated with ER activity in breast cancer. While ER levels increase during the development of breast cancer, p53 expression is lower in luminal tumors compared with the normal mammary gland . The inverse association between the two proteins reflects their opposite roles during malignant transformation and may account for the early onset breast tumors that are induced by exogenous estrogen in absence of p53 . At the molecular level, despite the proposed involvement of ER in regulation of p53 expression , the receptor is likely to act on p53 transcriptional activity. ER was indeed found to bind to and repress p53-depedent transcription and its associated tumor suppressor function [32C34] and disruption of this interaction by radiation restores p53 function [35, 36]. In contrast to ER and similar to p53 downregulation, ER expression decreases in breast cancer [37, 38]. The reduced levels of the two proteins in human tumors may explain the observed collaboration of ER and p53 inactivation in mouse breast tumor development . This may imply an ER-p53 transcriptional cooperation that inhibits Piperidolate tumor-associated phenotypes. ER has so far been shown to interact with and inhibit the pro-invasive properties of mutant p53 . Thus, the p53 tumor suppressor activity.
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