Abstract

BackgroundTamoxifen (TAM) and fulvestrant (FUL) are the major drugs for patients with estrogen receptor-positive (ER+) breast cancers. However, the development of endocrine resistance is the impediment for successful treatment. We aimed to explore the mechanisms of endocrine resistance and therapeutic strategy for overcoming resistance against TAM and FUL.MethodsExperiments were performed in ER+ and estrogen/TAM-sensitive MCF7 cells and antiestrogen-resistant MCF7/LCC9 cells. The expression of miR-214 and uncoupling protein 2 (UCP2) was determined by RT-qPCR and Western blot in breast cancer cells and human breast cancer tissue specimens. Cell autophagy was examined by fluorescent probe monodansyl cadaverine (MDC) and GFP-LC3-II-positive punctate identified by confocal microscopy. Apoptotic cells were determined by Annexin V-FITC/PI staining. The potential regulatory target of miR-214 was determined by prediction tool, target protein expression and luciferase reporter assay.Results4-OHT/FUL treatment resulted in induction of apoptosis as well as autophagy in breast cancer cells. Autophagy might be the major cause of endocrine resistance to 4-OHT or FUL. MiR-214 increased the sensitivity of breast cancer cells to the 4-OHT/FUL-induced apoptosis through inhibition of autophagy. Importantly, a negative correlation was established between miR-214 and UCP2 in human breast cancer tissue specimens assayed by RT-qPCR. UCP2 was identified to be a direct target of miR-214. Further study in MCF7/LCC9 cells indicated that endocrine resistance might arise from activation of the PI3K-Akt-mTOR pathway, thereby inducing autophagy by overexpression of UCP2.ConclusionMiR-214 increased the sensitivity of breast cancer cells to TAM and FUL through inhibition of autophagy by targeting UCP2. MiR-214 shows potential as a novel therapeutic strategy for overcoming endocrine resistance in ER+ breast cancers.

Highlights

  • Tamoxifen (TAM) and fulvestrant (FUL) are the major drugs for patients with estrogen receptorpositive (ER+) breast cancers

  • We examined the effects of miR-214 on sensitivity of breast cancer cells to TAM and FUL in the ER+ and estrogen/TAM-sensitive MCF7 cells and antiestrogen-resistant MCF7/LCC9 cells

  • These results indicated that MCF7 cells transfected with miR-214 mimics exhibited higher sensitivity to 4- hydroxytamoxifen (4-OHT)/ FUL than the cells transfected with negative control miRNA

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Summary

Introduction

Tamoxifen (TAM) and fulvestrant (FUL) are the major drugs for patients with estrogen receptorpositive (ER+) breast cancers. Breast cancers are classified based on the expression of hormone receptors: estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth receptor 2 (HER2). Among those patients, about 70 % of cases express ER. Multiple mechanisms responsible for endocrine resistance are recognized, such as deregulation of the ER pathway itself, alterations in cell cycle and survival molecules, and altered expression of miRNAs [8, 9]. The noteworthy mechanism of endocrine resistance is the increase of autophagy and apoptosis in the ER+ breast cancers following TAM treatment [10]. Inhibition of autophagy might potentiate resensitization of previously antiestrogen resistant breast cancer cells [6]. The key point in the determination of cell fate appears to be affected by the status of cancer cells in autophagy or apoptosis [15]

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