Abstract

Tamoxifen (Tam) is the only FDA-approved chemoprevention agent for pre-menopausal women at high risk for developing breast cancer. While Tam reduces a woman's risk of developing estrogen receptor positive (ER+) breast cancer, the molecular mechanisms associated with risk reduction are poorly understood. Prior studies have shown that cytoplasmic proline, glutamic acid and leucine rich protein 1 (PELP1) promotes Tam resistance in breast cancer cell lines. Herein, we tested for PELP1 localization in breast epithelial cells from women at high risk for developing breast cancer and found that PELP1 was localized to the cytoplasm in 36% of samples. In vitro, immortalized HMECs expressing a nuclear localization signal (NLS) mutant of PELP1 (PELP1-cyto) were resistant to Tam-induced death. Furthermore, PELP1-cyto signaling through estrogen-related receptor gamma (ERRγ) promoted cell survival in the presence of Tam. Overexpression of ERRγ in immortalized HMECs protected cells from Tam-induced death, while knockdown of ERRγ sensitized PELP1-cyto expressing HMECs to Tam. Moreover, Tam-induced HMEC cell death was independent of apoptosis and involved accumulation of the autophagy marker LC3-II. Expression of PELP1-cyto and ERRγ reduced Tam-induced LC3-II accumulation, and knockdown of ERRγ increased LC3-II levels in response to Tam. Additionally, PELP1-cyto expression led to the upregulation of MMP-3 and MAOB, known PELP1 and ERRγ target genes, respectively. Our data indicate that cytoplasmic PELP1 induces signaling pathways that converge on ERRγ to promote cell survival in the presence of Tam. These data suggest that PELP1 localization and/or ERRγ activation could be developed as tissue biomarkers for Tam responsiveness.

Highlights

  • Progress in breast cancer prevention is currently limited by our lack of biological markers to identify which women will respond to prevention therapies

  • To determine whether PELP1 localization is altered during early mammary carcinogenesis, we examined PELP1 localization in 11 randomly selected random periaeriolar fine needle aspiration (RPFNA) samples from asymptomatic women at high risk for developing breast cancer

  • We found that 4/11 (36%) RPFNA samples were positive for cytoplasmic PELP1 staining

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Summary

Methods

The study was approved by the Human Subjects Committee and Institutional Review Board at Duke University Medical Center in accordance with assurances filed with and approved by the Department of Health and Human Services. Subjects were recruited on entry to the Duke University High-Risk Clinic and were required to have one of the following: (a) a 5-year Gail model risk score 1.7%, (b) a prior biopsy exhibiting atypia, LCIS, or DCIS, or (c) known or suspected BRCA1/2 mutation. The Duke High-Risk Research Cohort was established in 2003. There are 1027 women participating in the Duke High-Risk Research Cohort (defined as all women participating in research studies). The protocol and consent has undergone yearly review and all investigators have completed full Duke human subjects, ethics, and compliance training

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