Abstract

Incidents of breast cancer (BC) are on the rise on a daily basis and have proven to be the most prevelant cause of death for women in both developed and developing countries. Among total BC cases diagnosed after menopause, 70% of cases are Estrogen Receptor (ER) positive (ER-positive or ER+). Mutations in the LBD (ligand-binding domain) of the ER have recently been reported to be the major cause of resistance to potent antagonists. In this study, the experimentally reported mutations K303R, E380Q, V392I, S463P, V524E, P535H, P536H, Y537C, Y537N, Y537S, and D538G were analyzed, and the most significant mutations were shortlisted based on multiple analyses. Initial analyses, such as mCSM stability, occluded depth analysis, mCSM-binding affinity, and FoldX energy changes shortlisted only six mutations as being highly resistant. Finally, simulations of force field-based molecular dynamics (MD on wild type (WT) ERα) on six mERα variants (E380Q, S463P, Y537S, Y537C, Y537N, and D538G) were carried out to justify mechanism of the resistance. It was observed that these mutations increased the flexibility of the H12. A bonding analysis suggested that previously reported important residue His524 lost bonding upon mutation. Other parameters, such as PCA (principal component analysis), DCCM (dynamics cross-correlation), and FEL (free energy landscape), verified that the shortlisted mutations affect the H12 helix, which opens up the co-activator binding conformation. These results provide deep insight into the mechanism of relative resistance posed to fulvestrant due to mutations in breast cancer. This study will facilitate further understanding of the important aspects of designing specific and more effective drugs.

Highlights

  • Breast cancer (BC) is the primary contributor to a rise in global female mortality rates

  • Estrogen Receptor (ER) proved to be the prime target for breast cancer (BC) therapy, but poor response or complete resistance developes during the course of treatment, making treatment a grim challenge and BC lethal

  • The resistance to fulvestrant, caused by genetic aberrations in ESR1, has been reported (Shi et al, 2014; Akhmetova et al, 2015; Khan et al, 2018), but the molecular mechanism subsequently leading to resistance has not yet been elucidated

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Summary

INTRODUCTION

Breast cancer (BC) is the primary contributor to a rise in global female mortality rates. Robinson et al (2013), Toy et al (2013), Merenbakh-Lamin et al (2013), and Jeselsohn et al (2014) reported ERα polymorphisms (mERαs) in the LBD between H9 and H10 (S463P), close to the estrogen binding site (i.e., E380Q) and in the loop that connects H11 and H12 (i.e., L536Q, L536R, Y537C, Y537N, Y537S, and D538G). These polymorphisms occur at a significant rate in relapsed metastatic patients. To cure all types of metastatic BC types, this detailed investigation advocates advancement in precision medicine

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DATA AVAILABILITY STATEMENT
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