Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

Le tamoxifène, un modulateur sélectif des récepteurs oestrogéniques, est un médicament largement utilisé depuis plus de vingt ans pour le traitement et la prévention du cancer du sein. Plusieurs études ont rapporté que l’administration aiguë du tamoxifène pouvait réduire certains courants K+ cardiaques. Cette observation suggère que les femmes traitées de façon chronique avec le tamoxifène risquent d’avoir une prolongation de leur intervalle QT, favorisant ainsi le développement de torsades de pointes. Puisque in vivo, le tamoxifène est largement métabolisé et son effet est attribué à celui du 4hydroxy-tamoxifène (4OH-tamoxifène), nous avons d'abord vérifié si les effets du tamoxifène sur la repolarisation pouvaient être dus au 4OH-tamoxifène. À l'aide de la méthode de patch-clamp, nous avons étudié l’effet aigu du 4OH-tamoxifène sur les courants K+ présents au niveau ventriculaire chez la souris femelle. En premier lieu, nous avons démontré que les souris traitées avec le 4OH-tamoxifène présentaient une diminution des courants K+ comparativement aux souris intactes. Fait intéressant, le prétraitement des myocytes avec l’antagoniste des récepteurs oestrogéniques, le ICI 182,780, ou l’inhibiteur de la synthèse protéique, l'actinomycine D, n’a pas modifié les effets du 4OH-tamoxifène. Ces résultats suggéraient que les effets du 4OH-tamoxifène sur les courants potassiques ne soient pas liés à la transcription génomique et n’implique pas les récepteurs aux œstrogènes. Bien que l’administration aiguë du 4OH-tamoxifène diminue les courants K+ cardiaques, l’absence de troubles au niveau du rythme cardiaque chez les femmes traitées à long terme exclu la possibilité de conclure que le traitement chronique avec le tamoxifène augmente la durée de l’intervalle QT. L'accès à des souris femelles et des cobayes nous a permis de démontrer que contrairement au traitement en aigu, les courants et les canaux K+ cardiaques sont augmentés en chronique. Les oestrogènes associés à une diminution des courants K+ d’une part et nos résultats obtenus avec le tamoxifène d’autre part suggèrent qu’en bloquant les récepteurs oestrogéniques, le tamoxifène puisse prévenir les effets inhibiteurs des oestrogènes sur les courants K+. Cette association œstrogènes- tamoxifène- récepteurs oestrogéniques et courants K+ nous a encouragées à approfondir encore nos études et vérifier l’influence des hormones sexuelles féminines sur la repolarisation ventriculaire. Une troisième étude a été ainsi réalisée chez des souris femelles ovariectomisées et des souris déficientes en récepteurs oestrogéniques α ou β afin de vérifier le rôle des oestrogènes et des récepteurs oestrogéniques sur la repolarisation ventriculaire. Nos résultats ont révélé clairement que l’absence des oestrogènes entraîne une augmentation de la densité du courant K+ transitoire indépendant du Ca2+ (Ito) et de l’expression du canal Kv4.3 et ces effets sont médiés par les REα. Ces données soutiennent davantage notre conclusion que l’inhibition des récepteurs oestrogéniques est responsable de l’augmentation des courants/canaux K+ et suggèrent fortement qu’ils jouent un rôle dans la régulation de la repolarisation ventriculaire. Elles soulignent aussi l'importance de vérifier le statut hormonal des animaux utilisés pour des études touchant l'électrophysiologie cardiaque. Dans la dernière partie de cette thèse nous avons vérifié les effets de la grossesse et du système nerveux autonome sur les différents paramètres électrocardiographiques et plus particulièrement sur le rythme cardiaque chez la souris. Nos données ont montré que, comme chez la femme enceinte, la grossesse est associée à une augmentation du rythme cardiaque. De plus, l'augmentation des niveaux des hormones féminines pourrait affecter l’automatisme et l’activité électrique cardiaque. Ces différentes études ont augmenté les connaissances sur la régulation hormonale de l'électrophysiologie cardiaque et aideront aux avancements des recherches chez les femmes. / Tamoxifen is a selective estrogen receptor modulator widely used in the treatment and prevention of breast cancer from more than 20 years. Other studies have reported that acute exposure to tamoxifen can reduce cardiac K+ currents. However, in vivo tamoxifen is largely metabolized and most of its activity is attributable to its major metabolite, 4- hydroxytamoxifen (4OH-tamoxifen). In our first study, we investigated the acute effects of 4OH-tamoxifen on cardiac K+ currents in mice. Using the patch-clamp technique, we found that, as with tamoxifen, short-term exposure to 4OH-tamoxifen reduced K+ currents in the mouse ventricle even in the presence of the selective oestrogen receptor antagonist, ICI-182,780, or the inhibitor of RNA synthesis, actinomycin D. These results suggest an inhibition independent of the intracellular oestrogen receptor and the protein synthesis. However, women receiving long-term tamoxifen therapy do not experience cardiac arrhythmias although acute perfusion of tamoxifen has been shown to inhibit cardiac K+ currents. This observation suggests that chronic tamoxifen treatment does not negatively modulate cardiac K+ currents. Therefore, in order to investigate the absence of cardiac arrhythmias in women, we examined the effects of long term tamoxifen therapy associated with low level of estrogen on ventricular K+ currents and channels expressed in mouse and guinea pig heart. Female mice and guinea pigs were treated with placebo or tamoxifen pellets for 60 days. Our results show an increase of the densities of K+ currents and the expression of their channels. Conditions with high oestrogen levels are associated with reduced K+ currents both in the heart and the uterus. Thus, conceivably, tamoxifen might prevent the inhibitory effects of oestrogen on K+ channels by blocking the oestrogen receptors, which would explain the reported increase in K+ currents. These findings could contribute to explain the absence of cardiac arrhythmia with long-term tamoxifen therapy. These association estrogen- tamoxifen and estrogen receptor lead us to study the influence of estrogens and estrogen receptors on ventricular repolarization. Accordingly, we assessed the involvement of estrogens and ER on K+ currents in mouse using ovariectomised (OVX), ER-knockout (ERKOα) or ERβ-knockout (ERKOβ) female mice. These experiments show that the absence of estrogen is associated with an increase of the density of the Ca2+-independent transient outward, Ito, the mRNA and protein expression of Kv4.3. These results vi obtained with ERKO mice suggest that estrogens regulate ventricular repolarization and ER mediates this effect. The last part of this thesis was to determine whether pregnancy elicits a change in the heart rate in mice and whether pregnancy-related changes are due to the cardiac conduction system rather than a change in autonomic tone. Our results revealed that pregnancy accelerates the resting heart rate and the AV node conduction time in the presence and absence of autonomic nervous system input suggesting an intrinsic mechanism. Moreover, Hormonal changes that occur during pregnancy are likely to be involved in these adaptations of the heart to pregnancy. These studies provide a new insight to understand the hormonal regulation of cardiac electrophysiology.

Le cancer du sein est le cancer qui a la plus forte fréquence au Canada. En 2012, on estime que 23 200 nouveaux cas de cancer du sein seront diagnostiqués. Deux tiers des tumeurs mammaires expriment ou surexpriment le récepteur des oestrogènes α (ERα). De même, les oestrogènes sont importants pour la croissance de ces tumeurs. La présence des récepteurs hormonaux est un critère qui détermine le choix de la thérapie; à cet égard, le ciblage des récepteurs des oestrogènes par les antioestrogènes a pour but d’inactiver ces récepteurs et diminuer leur contribution à la croissance tumorale. Les antioestrogènes sont des inhibiteurs compétitifs de ERα. Tamoxifene est le médicament le plus utilisé pour traiter les tumeurs mammaires ER+ de tous les stades, avant ou après la ménopause. Tamoxifene est antioestrogène partiel ou SERM qui a un profile mixte d’activités agonistes et antagonistes. Fulvestrant ou ICI 182, 780 est un antioestrogène de type total ou SERD dépourvu de toute activité agoniste. Ce composé est utilisé en clinique chez les femmes après la ménopause ayant des tumeurs mammaires avancées. Fulvestrant constitue, donc, une deuxième ligne thérapeutique en cas de rechute après à un traitement par Tamoxifene. Afin de comprendre le potentiel thérapeutique de Fulvestrant, il est primordial d’étudier son impact sur ERα. Actuellement, la polyubiquitination et la dégradation de ERα sont les mécanismes les plus connus pour expliquer l’inactivation de ERα par Fulvestrant. Par ailleurs, en utilisant des modèles cellulaires ER+ et ER-; nous avons montré que les antioestrogènes totaux induisent une insolubilité de ERα indépendamment de leur capacité à induire sa dégradation. L’insolubilité corrèle avec l’association de ERα avec la matrice nucléaire et avec l’inhibition de sa transactivation. L’hélice H12 du domaine de liaison du ligand joue un rôle important dans l’insolubilité et l’inactivation de ERα par les antioestrogènes totaux. Par ailleurs, les antioestrogènes totaux se distinguent par leur capacité à induire la SUMOylation de ERα par SUMO1 et SUMO2/3. La SUMOylation est rapide et précède la dégradation de ERα dans cellules ER+. À l’aide de dérivés de l’antioestrogène total ICI 164, 384, nous avons montré que la chaine latérale des antioestrogènes totaux est à la base de l’induction de la SUMOylation et de l’inactivation de ERα. De plus, la SUMOylation semble être une marque d’inhibition, car la déSUMOylation restaure une activité de ERα en présence des antioestrogènes totaux. L’hélice H12 du LBD et le domaine de liaison à l’ADN sont requis pour l’induction de la SUMOylation. La recherche de protéines impliquées dans l’inactivation et dans la SUMOylation a permis d’identifier le facteur de remodelage de la chromatine ACF dans le même complexe que ERα. De manière similaire à la SUMOylation, le recrutement de ACF est précoce et constitue une propriété spécifique des antioestrogènes totaux. D’autre part, Fulvestrant induit le recrutement de ACF au niveau du promoteur du gène cible des oestrogènes pS2, ce qui suggère une contribution du remodelage de la chromatine dans les mécanismes d’action des antioestrogènes totaux. La surexpression de la DéSUMOylase SENP1 abolit le recrutement de ACF ce qui indique un rôle de la SUMOylation dans le recrutement de ACF. De même, l’hélice H12 du LBD de ERα constitue un lien entre l’inactivation de ERα et le recrutement de ACF. L’insolubilité, la SUMOylation et l'interaction du complexe ACF sont le reflet des mécanismes d’action des antioestrogènes totaux. Ces observations peuvent être utilisées comme des critères fonctionnels pour identifier d’autres composés avec de meilleures propriétés pharmacologiques que Fulvestrant. / Approximately 70% of breast tumors express or overexpress estrogen receptor alpha (ERα) and are treated with antiestrogens (AEs), which act as competitive inhibitors of this receptor. Tamoxifen has been widely used for the treatment of ERα-positive tumors, but intrinsic or acquired resistance can lead to tumor recurrence. Full AEs such as Fulvestrant (ICI182, 780) are currently used to treat postmenopausal women with ERα-positive breast cancers with disease progression following Tamoxifen therapy. Unlike Tamoxifen and other Selective estrogen receptor modulators (SERMs), full AEs (SERDs) are devoid of any agonistic activity. It is currently thought that the capacity of full AEs to induce rapid polyubiquitination and degradation of ERα underlies their complete suppression of ERα signalling. On the one hand, we show a correlation between ICI 182, 780 induced ERα inhibition and its association with the insoluble fraction. This insolubility corresponds to an immobilization within the nuclear matrix and takes place in the absence of an accelerated turn over. The helix 12 in the ligand binding domain is important in the induction of insolubility and inactivation. On the other hand, we identify ERα as a target for Small Ubiquitin-like Modifier (SUMO) posttranslational modification by SUMO1 and SUMO2/3 specifically when liganded with full AEs. Induction of SUMOylation is rapid and precedes receptor degradation in ERα-positive breast cancer cells. On the other hand, the SERMs do not induce SUMOylation. The helix 12 in the ligand binding domain and the DNA binding domain play a role in the induction of SUMOylation in the presence of full AEs. Structure activity relationship experiments with full AE derivatives showed that the induction of SUMOylation is correlated with the degree of inhibition of ERα-mediated transcription. In addition, preventing SUMOylation by overexpression of a SENP1 deSUMOylase abolished the inverse agonist properties of full AEs without increasing activity in the presence of agonists or of Tamoxifen. In our attempt to screen for factors with a possible role in SUMOylation and inactivation, we show that the treatment with SERDs but not SERMs, induces a rapid interaction between ERα and the human ATP-utilizing chromatin assembly and remodeling factor (ACF) in ERα-negative and ERα-positive cell lines. The helix 12 is important since introducing single point mutations in this helix lead to an increased solubility and abrogate ACF recruitment. Using ChIP, we find an increase of ACF1 subunit association with proximal promoter of estrogen target gene pS2 suggesting a possible role of ACF in remodeling in this promoter. ACF recruitment is SUMOylation dependant since the overexpression of DeSUMOylase SENP1 abolishes the interaction between ERα and ACF. Together, induction of insolubility, SUMOylation and ACF recruitment are characteristic properties of full antiestrogens that contribute to their specific activity profile. They can be used to screen for new compounds with an improved therapeutic potential.

Les estrogènes sont impliqués dans plusieurs aspects de la physiologie humaine en particulier, le développement, la croissance, la différenciation des tissus reproducteurs, la reproduction, et la grossesse. Les effets cellulaires des estrogènes sont transmis via l'interaction avec les récepteurs des estrogènes ERα et ERβ. L’activation de ERα et ERβ contrôle directement la transcription des gènes cibles nécessaires pour médier les effets physiologiques des estrogènes. L’effet des estrogènes peut aussi être mitogénique et devient la cause de plusieurs pathologies surtout dans les tissus qui présentent une sensibilité accrue à l’hormone tel que les tissus mammaires, les ovaires et l’utérus. De ce fait, une surexposition de ces tissus à l’estrogène augmente le risque de développer le cancer. Dans une lignée cellulaire qui coexprime les deux récepteurs, nous avons identifié la chimiokine SDF-1 qui interagit avec le récepteur CXCR4 et qui décrit une boucle de régulation autocrine/paracrine entre la voie des chimiokines et celle des estrogènes. Cette régulation induit une augmentation de l’expression des gènes cibles prolifératifs du cancer du sein. Cependant, les mécanismes exacts de cette régulation restent inconnus. Afin d'identifier les cibles exactes de cette régulation au niveau génomique, nous avons développé un modèle cellulaire pour discriminer le rôle respectif de ERα et ERβ au niveau du contrôle transcriptionnel de cette boucle de régulation des chimiokines. En partant d’une lignée cellulaire ER-, nous avons généré un système cellulaire qui exprime l’un ou l’autre des isoformes en plus du mutant ERβ-S87A. Nous avons construit le promoteur CXCR4bLuc qu’on a testé dans les lignées cellulaires générées. En utilisant la construction du promoteur CXCR4bLuc, nous avons démontré une voie de régulation des récepteurs des chimiokines par les récepteurs des estrogènes. L’activation membranaire de CXCR4 par SDF-1 implique l’activation directe du récepteur de l’estrogène ERβ par phosphorylation de la sérine 87. Cette phosphorylation active ERβ et favorise l’expression du gène de CXCR4. La transcription de CXCR4 passe par la liaison de ERβ au niveau d’un élément de liaison ERE que nous avons identifié dans ce travail par la technique de ChIP. Ainsi, nous avons identifié une cible exacte de la régulation des récepteurs des chimiokines CXCR4 par le récepteur des estrogènes ERβ qui peut constituer une approche prometteuse pour contrer les pathologies associées au cancer du sein et ses métastases. / Estrogens are involved in development, growth, differentiation, reproduction, and pregnancy. The cellular effects of estrogens are mediated through its interaction with estrogen receptors ERα and ERβ. The ERα and ERβ activation controls directly the transcription of target genes required to mediate the physiological effects of estrogen. The effect of estrogen may be mitogenic and becomes the cause of many diseases especially in tissues that have greater sensitivity to the hormone such as breast tissue, ovaries and uterus. Therefore, overexposure of these tissues to estrogen increases the risk of developing cancer. In a cell line that co-expresses both receptors, we identified the chemokine SDF-1 that interacts with the CXCR4 receptor and describes an autocrine / paracrine loop pathway between chemokines and estrogen. This control leads to an increase of the expression of proliferatives target genes in breast cancer. However, the exact mechanisms of this regulation remain unknown. To identify the exact target of this regulation at the genomic level, we have developed a cellular model to discriminate the respective role of ERα and ERβ level of transcriptional control of the loop chemokines. Starting from an ER- cell line, we generated a cell system that expresses one or other of isoforms in addition to the mutant ERβ-S87A. We built the promoter CXCR4bLuc that we have tested in the generated cell lines. Using the CXCR4bLuc promoter construct, we have demonstrated a regulatory pathway of chemokine receptors by estrogen receptors. The membrane activation of CXCR4 by SDF-1 involves the direct activation of estrogen receptor ERβ by phosphorylation of serine 87. This phosphorylation leads to activate ERβ and promotes the expression of CXCR4 gene. The transcription of CXCR4 involves the binding of ERβ at an ERE binding element that we have identified in this work by the ChIP technical. Thus the identification of a precise ERE target regulation of chemokine receptors CXCR4 by estrogen receptor ERβ, is a promising approach to counter the pathologies associated with breast cancer and its metastases.

Estrogens greatly affect the activity and connectivity of serotonergic neural cell populations, which extend from clusters of nuclei in the brainstem, termed the raphe nuclei, where estrogen receptor β is the most abundantly expressed estrogen receptor subtype. Estrogenic effects on the raphe nuclei are primarily important for influencing various neuropsychological behaviors, including depression, mood swings and anxiety behaviors. Because of this connection, phases of intense hormone fluctuations for instance during menopause are often associated with several mood disturbances that often reduce the quality of life of menopausal women. Accordingly, long-term use of hormone replacement therapy appeared to be the method of choice for many menopausal women to help alleviate vasomotor symptoms, which may include neuropsychological changes such as depression. However, given the limitations and number of serious health risks attributed to hormone replacement therapy, natural compounds such as phytoestrogens are receiving widespread awareness due to their occurrence in medicinal plant extracts and a wide variety of food items including dietary supplements with respective health claims. Flavonoids, particularly the isoflavones and the naringenin-type flavanones, belong to a group of polyphenolic plant-derived secondary metabolites known to possess estrogen-like bioactivities. Nevertheless, little is known about their transactivational activity and their potential to regulate endogenous gene expression of estrogen responsive genes in the raphe nuclei due to the lack of suitable cellular models expressing sufficient amounts of functional estrogen receptor β. Hence, a raphe nuclei-derived cell line that expresses a functional estrogen receptor β was sought as a model to investigate effects of flavonoids in vitro. In this regard, RN46A-B14 cells derived from embryonic day 13 rat medullary raphe nuclei were primarily used in this study as the main cellular model. Nonetheless, expression of endogenous estrogen receptor β in these cells was not sufficient to pursue downstream investigations of estrogen-dependent activities. To overcome this deficit, a rat raphe nuclei-derived in vitro model that overexpresses a functional estrogen receptor β was initially established (herein termed RNDA cells) by stably transducing its parent cell line, RN46A-B14 cells, with a suitable lentiviral expression vector encoding a human estrogen receptor β gene. The stable expression and the functional characterization of the transgenic receptor was confirmed by Western blot analysis and luciferase reporter gene assays, respectively. The same reporter gene assay was used to scrutinize the transactivational activity of the flavonoids in RNDA cells. Key results revealed that Genistein, Daidzein, Equol, Naringenin and 8-Prenylnaringenin demonstrated high transactivational activity in a concentration-dependent manner by stimulating luciferase expression from an estrogen responsive element-regulated reporter gene construct transiently transfected in RNDA cells. Low transactivational activity was observed in RNDA cells in response to increasing concentrations of 7-(O-prenyl)naringenin-4'-acetate. However, no transactivational activity was noticed in response to 6-(1,1-Dimethylallyl)naringenin in the studied cell model. All effects elicited by the flavonoids were antagonized by the pure estrogen receptor antagonist, Fulvestrant, indicating that all substances act by binding to and activating the transgenic ERβ. Additional effects were observed in RNDA cells in response to a co-treatment of 1 µM of either Genistein or Daidzein, but not Equol, with 10 nM 17β-Estradiol. Slight antagonistic effects were observed in the same studied cell line when either 8-Prenylnaringenin or 7-(O-prenyl)naringenin-4'-acetate, but not Naringenin or 6-(1,1-Dimethylallyl)naringenin, were co-added with 17β-Estradiol. Results from the reporter gene assays were validated on the basis of regulation of mRNA expression of estrogen responsive genes following the global assessment of 17β-Estradiol-induced gene expression in this cell line using a DNA microarray technique. Out of 212 estrogen-regulated genes with at least two-fold change of expression, six were selected according to specific features of estrogenic regulation of expression. The expression of the six selected 17β-Estradiol-regulated genes was validated using quantitative real-time PCR analysis. The regulation of mRNA expression of the selected genes in response to the tested flavonoids was then investigated in RNDA cells. Additionally, because RNDA cells encode a temperature-sensitive mutant of the Simian Virus 40 large T-antigen, their neuronal differentiation is constitutive upon shifting them from conditions promoting proliferation (permissive temperature) to differentiation (non permissive temperature). Hence, the regulation of mRNA expression of the selected genes in response to the tested flavonoids was additionally investigated as RNDA cells differentiate. In RNDA cells grown under proliferative conditions, 17β-Estradiol up-regulated mRNA expression of camello-like 5, sex determining region Y-box 18 and keratin type I cytoskeletal 19. Similar effects were observed in response to 8-Prenylnaringenin, Genistein, Daidzein and Equol. In addition, 17β-Estradiol down-regulated mRNA expression of neurofilament medium polypeptide and zinc finger DHHC-type containing 2. Similar effects were observed in response to 8-Prenylnaringenin, Naringenin, Genistein, Daidzein and Equol. Yet, no effect was observed on the regulation of mRNA expression of solute carrier family 6 member 4 in response to 17β-Estradiol or the flavonoids in RNDA cells grown under proliferative conditions. When RNDA cells were shifted to conditions promoting differentiation, changes in cell morphology, in mRNA expression levels and in responsiveness towards 17β-Estradiol or the flavonoids were observed. These expression studies additionally highlighted some of the genes as indicator genes for RNDA cellular differentiation. The newly established RNDA cell line should prove useful to elucidate basic physiological properties of estrogen receptor β in the raphe nuclei. The present study should serve as the basis to help shed light on molecular and cellular mechanisms following the action of phytoestrogens, endocrine disruptors or other exogenous estrogen receptor ligands in neural cell populations, particularly the raphe nuclei, for further applications within the brain.

The enzymes CYP27A1 and CYP7B1 are widely expressed in various human tissues and perform catalytic reactions in cholesterol homeostasis and endocrine signaling. We have investigated the metabolism of a synthetic oxysterol. In this study, we show that CYP27A1 is the enzyme responsible for a 28-hydroxylation of this oxysterol and that the rate of CYP27A1-mediated metabolism is relatively slow. This may give an explanation for the prolonged inhibitory effects on cholesterol biosynthesis that have been shown for this oxysterol. The current study contributes to the knowledge of synthetically produced oxysterols and their potential use as cholesterol lowering drugs. In two studies we investigated CYP7B1-mediated metabolism of different sex hormones. Our data indicate that CYP7B1 may carry out a previously unknown catalytic reaction involving an androgen. Taken together the data suggest that varying steroid concentrations in cells and tissues may be important for CYP7B1-dependent metabolism of sex hormones and sex hormone precursors. CYP7B1-mediated hydroxylation of sex hormones may influence the cellular levels of these steroids and may be a potential pathway for elimination of the steroids from the cell. Some known CYP7B1 substrates are agonists for ERα and ERβ but the reported role(s) of CYP7B1 for ER action are not fully understood. In the last study we investigated the role(s) of CYP7B1-mediated metabolism for ER-mediated action. Our data indicate that CYP7B1-mediated conversion of steroids that affect ER-mediated response into their 7α-hydroxymetabolites will result in loss of action. This indicates that CYP7B1 may have an important role for regulation of ER-mediated processes in the body. In summary, results from this thesis contribute to the knowledge on the metabolism of synthetic oxysterols of potential use as cholesterol lowering drugs and the role(s) of CYP7B1-mediated metabolism for processes related to the functions of sex hormones. / Disputationsordförande;Professor Eva Brittebo, Inst. för Biovetenskap, Avd. för Toxikologi, Uppsala Universitet, UppsalaBetygsnämndens ledamöten; Docent Lena Ekström, Inst. för Laboratoriemedicin, Avd. för Klinisk Kemi, Karolinska Universitetssjukhuset, HuddingeDocent Ulf Diczfaluzy, Inst. för Laboratoriemedicin, Avd. för Klinisk Kemi, Karolinska Universitetssjukhuset, HuddingeProfessor Agneta Oskarsson, Inst. BVF, Avd. för farmakologi och toxikologi, SLU, Uppsala

Studies in Europe, Japan, and North America have reported that wild fish exposed to treated sewage effluents can exhibit significant physiological and reproductive abnormalities consistent with exposure to hormonally active chemicals. The main objective of this research project was to examine the estrogenic and androgenic activity in treated sewage to determine the risk associated with treated sewage discharges in Australia and New Zealand. Several bioassays, including a sheep estrogen receptor and a rainbow trout androgen receptor binding assay, were set up and validated with model compounds. The assays were then used to measure the estrogenic and androgenic activity in sewage samples from 15 municipal sewage treatment plants (STP) utilizing a variety of treatment technologies. Raw sewage samples contained high levels of both estrogenic and androgenic activity, up to 185 ng/L estradiol equivalents (EEq) and up to 9330 ng/L testosterone equivalents (TEq), respectively. Secondary treatment processes such as activated sludge had the greatest impact on removal of biological activity from the wastewater. The estrogenic and androgenic activity in final treated effluents were <1 to 4.2 ng/L EEq and <6.5 to 736 ng/L TEq, respectively. Based on lowest observable effective concentrations reported in the literature, these levels are unlikely to induce biological effects in exposed fish in the short term. To examine potential long-term effects, resident mosquitofish chronically exposed to undiluted treated sewage were sampled. Several morphological biomarkers indicative of endocrine disruption were measured and compared with mosquitofish captured at a reference site. Mosquitofish captured in a constructed wetland for tertiary treatment of secondary treated sewage exhibited morphological differences such as elongated anal fins consistent with exposure to androgenic chemicals, although this effect was not measurable in fish collected at sites further downstream or at any of the other sites. Based on these results, it is unlikely that mosquitofish populations would be significantly affected by exposure to final treated sewage. A reverse transcription real-time polymerase chain reaction (RT-PCR) method to measure the production of a female-specific protein (vitellogenin) mRNA in adult male mosquitofish was developed, and this could be used as a rapid test to detect early changes in individuals exposed to estrogenic activity.

Les œstrogènes, et en particulier l’œstradiol E2, régulent un nombre considérable de fonctions physiologiques au sein de l’organisme et permettent notamment l’établissement et le maintien des fonctions reproductives chez tous les vertébrés. L’E2 agit localement dans de multiples organes cibles via l’intermédiaire de ses récepteurs : ERα et ERβ. Par son action proliférative contribuant au renouvellement de l’épithélium mammaire, l’E2 ainsi que son récepteur ERα ont été associés au développement pathologique de tumeurs mammaires. Celles-ci sont qualifiées d’hormono-dépendantes car elles répondent pour la majorité d’entre elles à l’utilisation de l’hormonothérapie visant à bloquer leur croissance. Malheureusement, on estime que 30 à 40% des tumeurs mammaires finissent par présenter une résistance aux traitements anti-oestrogéniques, par des mécanismes extrêmement complexes. Les travaux présentés dans ce manuscrit ont pour objectifs de mieux comprendre les mécanismes moléculaires et cellulaires impliqués dans le phénomène d’échappement des cellules tumorales mammaires au contrôle hormonal. Dans le cadre de cette thèse, nous nous sommes intéressés à deux facteurs capables de moduler l’activité d’ERα : l’hypoxie, qui désigne l’appauvrissement en oxygène du microenvironnement cellulaire, et la voie RhoA/MKL1 fréquemment mise en place au cours de la transition épithélio-mésenchymateuse. L’hypoxie est une caractéristique majeure des tumeurs solides, et des études lui suggèrent un rôle dans l’apparition de résistance endocrine. Nous montrons que le stress hypoxique inhibe fortement l’expression d’ERα, principalement au niveau protéique, et qu’il abolit la prolifération et la survie cellulaire induites par l’E2. L’analyse transcriptomique démontre qu’un certain nombre de gènes cibles d’ERα sont également régulés par l’hypoxie, qui peut soit réprimer (CXCL12…) ou bien augmenter leur expression (AREG…). Par ailleurs, l’analyse du cistrome d’ERα démontre une perte massive du nombre d’ERBSs (Estrogen Receptor Binding Site) par l’hypoxie, mais également une apparition d’ERBSs hypoxie-spécifiques. Nos résultats suggèrent que le fort recouvrement de régulation entre ERα et l’hypoxie puisse moduler l’efficacité des thérapies antihormonales. Enfin, l’équipe a démontré que l’activation de la voie RhoA/MKL1 provoque une forte inhibition de la fonction AF1 d’ERα. Afin de mieux appréhender les effets de cette voie de signalisation sur l’activité d’ERα, une lignée cellulaire MCF7 exprimant stablement un mutant constitutivement actif du facteur MKL1 a été générée. Nous montrons que son expression modifie profondément le contexte cellulaire en provoquant le basculement d’un phénotype luminal vers un phénotype basal-like. L’analyse transcriptomique de la réponse à l’E2 montre que le changement d’orientation cellulaire induit par MKL1 abolit toute régulation transcriptionnelle des gènes cibles d’ERα. Ce changement d’orientation cellulaire s’accompagne d’une reprogrammation massive du cistrome d’ERα avec une perte importante de ses sites de fixation à la chromatine, mais également de façon inattendue, un enrichissement en nouveaux ERBSs. Enfin, nous montrons une forte augmentation des interactions « non-génomiques » d’ERα avec des partenaires cytoplasmiques tels que PI3K, MSK1 et Src. Ces données suggèrent que dans des cellules agressives de type mésenchymal exprimant ERα, l’activité du récepteur repose majoritairement sur son action « non-génomique ». De façon intéressante, l’utilisation de l’anti-œstrogène pur ICI 182 780 n’a aucun effet inhibiteur sur ces interactions, pour lesquelles un rôle fonctionnel reste à établir. / Estrogens, and in particular estradiol E2, regulate a considerable number of physiological functions in the body and allow the establishment and maintenance of reproductive functions in all vertebrates. E2 acts locally in multiple target organs via its receptors: ERα and ERβ. By its proliferative action contributing to the renewal of the mammary epithelium, E2 as well as its ERα receptor have been associated with the pathological development of mammary tumors. These are qualified as hormone-dependent because they, for the majority of them, respond to the use of hormone therapy to block their growth. Unfortunately, it is estimated that 30-40% of mammary tumors end up with resistance to anti-estrogen treatments, through extremely complex mechanisms. The work presented in this manuscript aims to better understand the molecular and cellular mechanisms involved in the escape of mammary tumor cells to hormonal control. In this thesis, we looked at two factors that can modulate the ERα activity: hypoxia, which refers to oxygen depletion in the cellular microenvironment, and the RhoA/MKL1 pathway that is frequently activated during the epithelial-mesenchymal transition. Hypoxia is a major feature of solid tumors, and studies suggest a role in the development of endocrine resistance in breast cancer. We show that hypoxic stress strongly inhibits the expression of ERα, mainly at the protein level, and that it abolishes E2-induced cell proliferation and survival. Transcriptomic analysis shows that a certain number of ERα target genes are also regulated by hypoxia, which can either repress (CXCL12) or increase their expression (AREG ...). Moreover, the analysis of the ERα cistrome demonstrates a massive loss of the number of ERBSs (Estrogen Receptor Binding Site) by hypoxia, but also an appearance of hypoxia-specific ERBSs. Our results suggest that the strong regulatory overlap between ERα and hypoxia may modulate the efficacy of anti-hormonal therapies. Finally, the team demonstrated that the activation of the RhoA/MKL1 pathway causes a strong inhibition of the ERα AF1 function. In order to better understand the effects of this signaling pathway on ERα activity, an MCF7 cell line stably expressing a constitutively active mutant of the MKL1 factor was generated. We show that its expression profoundly modifies the cellular context by causing the switch from a luminal phenotype to a basal-like phenotype. The transcriptomic analysis of the E2 response shows that the MKL1 induced change in cell fate abolishes any transcriptional regulation of ERα target genes. This change in cellular orientation is accompanied by massive reprogramming of the ERα cistrome with a significant loss of its chromatin binding sites, but also unexpectedly, an enrichment of new ERBSs. Finally, we show a strong increase of "non-genomic" ERα interactions with cytoplasmic partners such as PI3K, MSK1 and Src. These data suggest that in aggressive mesenchymal cells expressing ERα, the receptor activity is mainly based on its "non-genomic" action. Interestingly, the use of pure anti-estrogen ICI 182 780 has no inhibitory effect on these interactions, for which a functional role remains to be established.

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CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O câncer de mama é a neoplasia que mais acomete mulheres no mundo. Dentre os fatores prognósticos levados em consideração estão os receptores hormonais. O receptor de estrógeno beta (ERβ) é um dos receptores hormonais que pode ser encontrado na mama, mas que até então não é utilizado como um marcador preditivo de prognóstico tumoral por conta da sua ação paradoxal. Células tumorais de mama da linhagem MCF-7 foram utilizadas neste trabalho para averiguar a função dicotômica do ERβ no processo tumoral. De tal forma que foi avaliado alguns dos processos que são observados nas etapas do desenvolvimento do câncer de mama, como proliferação, transição epitélio-mesênquima (EMT) e investigação das células -tronco cancerosas (CSCs) . Para isso, foram utilizados o agonista de ERβ, Diarilpropionitrilo (DPN), o agonista ambíguo (ERα e ERβ) estradiol (E2) e o fator de crescimento transformante beta (TGF-β), indutor de EMT. As células que receberam tratamento com DPN obtiveram maior número de CSCs comparadas às que não foram cultivadas com esse agonista, resultado encontrado pela técnica de citometria de fluxo. As células que tiveram um tratamento prévio com TGF-β demonstraram menor taxa de proliferação e aumento na expressão de p21, uma proteína com ação bloqueadora de ciclina D1, cuja expressão ficou inalterada nos tratamentos com TGF-β e agonista de ERβ. A respeito dos genes relacionados a EMT (SLUG, SNAIL,VIMENTINA, ZEB1,TWIST1,RBFOX2,CICLINAD1 e p21), ERβ inibiu a expressão dos mesmos, sugerindo que esse receptor induza o fenômeno denominado transição mesenquimal epitelial (MET). Nesse cenário, DPN causou a diminuição da expressão de SLUG, SNAIL, TWIST, contrastando com a expressão obtida no tratamento com TGF-β que, além desses genes, também demonstrou aumento na expressão de ZEB1, RBFOX2 e vimentina. O efeito do TGF-β na EMT foi revertido ao associá-lo com DPN. Os dados corroboram com a literatura acerca do possível papel pró tumoral de ERβ no aumento da proliferação celular e da geração das células-tronco cancerígenas de mama (BSCs), além de ir ao encontro do fenótipo relacionado a MET nos tratamentos com DPN sozinho ou associado ao TGF-β. Com esses resultados, torna-se claro no nosso trabalho que dependendo o que é avaliado em relação a ação do ERβ, previamente tratado ou não com TGF-β, o seu efeito dicotômico ainda é observado. / Breast cancer is the most common neoplasm of women in the world. Among the prognostic factors taken into consideration are the hormonal receptors. The estrogen receptor beta (ERβ) is one of the hormone receptors that can be found in the breast, but is not used as a predictive marker of tumor prognosis due to its paradoxical action. Tumor cells of the MCF-7 lineage were used in this work to ascertain the dichotomic function of ERβ in the tumor process. Thus, we evaluated some of the processes that are observed in the stages of breast cancer development, such as proliferation, epithelial-mesenchymal transition (EMT) and cancer stem cell research (CSCs). For this, ERβ agonist Diarilpropionitrile (DPN), ambiguous agonist (ERα and ERβ) estradiol (E2) and transforming growth factor beta (TGF-β), inducer of EMT, were used. Cells receiving TGF- β treatment obtained a higher number of CSCs compared to those that were not cultured with this agonist, a result found by the flow cytometry technique. Cells that were pretreated with TGF-β demonstrated a lower rate of proliferation and increased expression of p21, a protein with cyclin D1 blocking action, whose expression was unchanged in TGF-β and ERβ agonist treatments. Regarding the EMT-related genes (SLUG, SNAIL, VIMENTINA, ZEB1, TWIST1, RBFOX2, CYCLINAD1 and p21), ERβ inhibited their expression, suggesting that this receptor induces the phenomenon called epithelial mesenchymal transition (MET). In this scenario, DPN caused a decrease in the expression of SLUG, SNAIL, TWIST, in contrast to TGF-β expression, which, in addition to these genes, also showed increased expression of ZEB1, RBFOX2 and VIMENTIN. The effect of TGF-β on EMT was reversed by associating it with DPN. The data corroborate with the literature about the possible ERβ pro-tumor role in increasing cell proliferation and the generation of breast cancer stem cells (BSCs), in addition to the MET related phenotype in treatments with DPN alone or associated to TGF-β. With these results, it becomes clear in our work that depending on what is evaluated in relation to the action of ERβ, previously treated or not with TGF-β, its dichotomous effect is still observed. / Dissertação (Mestrado)