Glucocorticoids can promote androgen-independent growth of prostate cancer cells through a mutated androgen receptor

XY Zhao, PJ Malloy, AV Krishnan, S Swami… - Nature medicine, 2000 - nature.com
XY Zhao, PJ Malloy, AV Krishnan, S Swami, NM Navone, DM Peehl, D Feldman
Nature medicine, 2000nature.com
The androgen receptor (AR) is involved in the development, growth and progression of
prostate cancer 1 (CaP). CaP often progresses from an androgen-dependent to an
androgen-independent tumor, making androgen ablation therapy ineffective. However, the
mechanisms for the development of androgen-independent CaP are unclear. More than
80% of clinically androgen-independent prostate tumors show high levels of AR expression
1. In some CaPs, AR levels are increased because of gene amplification 2 and/or …
Abstract
The androgen receptor (AR) is involved in the development, growth and progression of prostate cancer 1 (CaP). CaP often progresses from an androgen-dependent to an androgen-independent tumor, making androgen ablation therapy ineffective. However, the mechanisms for the development of androgen-independent CaP are unclear. More than 80% of clinically androgen-independent prostate tumors show high levels of AR expression 1. In some CaPs, AR levels are increased because of gene amplification 2 and/or overexpression, whereas in others, the AR is mutated 3, 4, 5. Nonetheless, the involvement of the AR in the transition of CaP to androgen-independent growth and the subsequent failure of endocrine therapy are not fully understood. Here we show that in CaP cells from a patient who failed androgen ablation therapy, a doubly mutated AR functioned as a high-affinity cortisol/cortisone receptor (AR ccr). Cortisol, the main circulating glucocorticoid, and its metabolite, cortisone, both equally stimulate the growth of these CaP cells and increase the secretion of prostate-specific antigen in the absence of androgens. The physiological concentrations of free cortisol and total cortisone in men 6, 7 greatly exceed the binding affinity of the AR ccr and would activate the receptor, promoting CaP cell proliferation. Our data demonstrate a previously unknown mechanism for the androgen-independent growth of advanced CaP. Understanding this mechanism and recognizing the presence of glucocorticoid-responsive AR mutants are important for the development of new forms of therapy for the treatment of this subset of CaP.
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