Mécanismes d'action des antioestrogènes totaux

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.

Keyphrases: Breast cancer, estrogen receptor, SUMOylation, Fulvestrant, chromatin remodeling, antiestrogens