Metformin Inhibits Aromatase via an Extracellular Signal-Regulated Kinase-Mediated Pathway

Endocrinology - Tập 150 Số 10 - Trang 4794-4801 - 2009
Suman Rice1, Laura Pellatt1, Kumaran Ramanathan2, S. A. Whitehead1, Helen Mason1
1Division of Basic Medical Sciences (S.R., L.P., S.A.W., H.D.M.), St. George’s, University of London, London SW17 0RE, United Kingdom
2Bachelor of Medicine, Bachelor of Surgery (MBBS) Programme (K.R.), St. George’s, University of London, London SW17 0RE, United Kingdom

Tóm tắt

Abstract Metformin treatment, now widely prescribed in polycystic ovary syndrome, is aimed at correcting the associated insulin resistance, but it has also been shown to directly inhibit ovarian steroidogenesis. The mechanisms, however, by which metformin inhibits estradiol production in human granulosa cells remains unknown. Granulosa luteal cells were incubted with metformin, insulin, or combined metformin and insulin treatment, and aromatase mRNA expression was quantified using real-time RT-PCR. Enzyme activity was assessed by the conversion of 3H-androstenedione to estrone and estradiol. Metformin’s effect on the expression of specific untranslated first exon aromatase promoters was analyzed using semiquantitative PCR. The involvement of MAPK kinase (MEK)/ERK pathway was investigated by immunoblotting for aromatase, phosphorylated, and total ERK-1,2 from cells cultured as above with/without the MEK inhibitor PD98059. Metformin significantly inhibited basal and insulin-stimulated aromatase mRNA expression, with parallel results from the aromatase activity assay and protein assessment. This suppression was via down-regulation of aromatase promoter II, I.3, and 1.4 expression and was reversed by the addition of PD98059. Involvement of the ERK signaling pathway was demonstrated by the significant increase in phosphorylated ERK-1,2 with the combined metformin and insulin treatment. We have shown for the first time in human granulosa cells that metformin signficantly attenuated basal and insulin-stimulated P450 aromatase mRNA expression and activity, via silencing of key promoters. This occurred by activation of MEK/ERK pathway, which negatively regulated aromatase production. This is an important consideration given metformin’s widespread use in polycystic ovary syndrome and may further support a possible therapeutic indication in estrogen-dependent breast tumors.

Từ khóa


Tài liệu tham khảo

Nestler, 1998, Effects of metformin on spontaneous and clomiphene-induced ovulation in the polycystic ovary syndrome., N Engl J Med, 338, 1876, 10.1056/NEJM199806253382603

De Leo, 1999, Effects of metformin on gonadotropin-induced ovulation in women with polycystic ovary syndrome., Fertil Steril, 72, 282, 10.1016/S0015-0282(99)00208-3

Tang, 2006, Combined lifestyle modification and metformin in obese patients with polycystic ovary syndrome. A randomized, placebo-controlled, double-blind multicentre study., Hum Reprod, 21, 80, 10.1093/humrep/dei311

Moghetti, 2000, Metformin effects on clinical features, endocrine and metabolic profiles, and insulin sensitivity in polycystic ovary syndrome: a randomized, double-blind, placebo-controlled 6-month trial, followed by open, long-term clinical evaluation., J Clin Endocrinol Metab, 85, 139

Bailey, 1992, Biguanides and NIDDM., Diabetes Care, 15, 755, 10.2337/diacare.15.6.755

Mansfield, 2003, Metformin has direct effects on human ovarian steroidogenesis., Fertil Steril, 79, 956, 10.1016/S0015-0282(02)04925-7

Harborne, 2003, Descriptive review of the evidence for the use of metformin in polycystic ovary syndrome., Lancet, 361, 1894, 10.1016/S0140-6736(03)13493-9

Vrbíková, 2001, The effects of long-term metformin treatment on adrenal and ovarian steroidogenesis in women with polycystic ovary syndrome., Eur J Endocrinol, 144, 619, 10.1530/eje.0.1440619

Marca, 2000, Metformin treatment reduces ovarian cytochrome P-450c17α response to human chorionic gonadotrophin in women with insulin resistance-related polycystic ovary syndrome., Hum Reprod, 15, 21, 10.1093/humrep/15.1.21

Marca, 2002, Insulin-lowering treatment reduces aromatase activity in response to follicle-stimulating hormone in women with polycystic ovary syndrome., Fertil Steril, 78, 1234, 10.1016/S0015-0282(02)04346-7

Palomba, 2005, A randomized controlled trial evaluating metformin pre-treatment and co-administration in non-obese insulin-resistant women with polycystic ovary syndrome treated with controlled ovarian stimulation plus timed intercourse or intrauterine insemination., Hum Reprod, 20, 2879, 10.1093/humrep/dei130

Santbrink, 2005, Does metformin modify ovarian responsiveness during exogenous FSH ovulation induction in normogonadotrophic anovulation? A placebo-controlled double-blind assessment., Eur J Endocrinol, 152, 611, 10.1530/eje.1.01866

Simpson, 2004, Aromatase: biologic relevance of tissue-specific expression., Semin Reprod Med, 22, 11, 10.1055/s-2004-823023

Bréard, 1999, Presence of exon I. 4 mRNA from CYP19 gene in human granulosa cells., Mol Cell Endocrinol, 154, 187, 10.1016/S0303-7207(99)00083-0

Hunzicker-Dunn, 2006, FSH signaling pathways in immature granulosa cells that regulate target gene expression: branching out from protein kinase A., Cell Signal, 18, 1351, 10.1016/j.cellsig.2006.02.011

Stocco, 2008, Aromatase expression in the ovary: hormonal and molecular regulation., Steroids, 73, 473, 10.1016/j.steroids.2008.01.017

Yu, 2005, Activation of p38 MAPK pathway by FSH regulates steroidogenesis in granulosa cells differentially., J Endocrinol, 186, 85, 10.1677/joe.1.05955

Moore, 2001, Role of ERK1/2 in the differential synthesis of progesterone and estradiol by granulosa cells., Biochem Biophys Res Commun, 289, 796, 10.1006/bbrc.2001.6052

Seger, 2001, The ERK signalling cascade inhibits gonadotropin-stimulated steroidogenesis., J Biol Chem, 276, 13957, 10.1074/jbc.M006852200

Andric, 2006, A delayed gonadotrophin-dependent and growth factor mediated activation of the extracellular signal-regulated kinase 1/2 cascade negatively regulates aromatase expression in granulosa cells., Mol Endocrinol, 20, 3308, 10.1210/me.2006-0241

Silva, 2006, Control of oestradiol secretion and of cytochrome P450 aromatase messenger ribonucleic acid accumulation by FSH involves different intracellular pathways in oestrogenic bovine granulose cells in vitro., Reproduction, 132, 909, 10.1530/REP-06-0058

Wright, 2002, Insulin-like growth factor (IGF)-independent effects of IGF binding protein-4 on human granulosa cell steroidogenesis., Biol Reprod, 67, 776, 10.1095/biolreprod.101.001511

Willis, 1996, Modulation by insulin of follicle-stimulating hormone and luteinizing hormone actions in human granulosa cells of normal and polycystic ovaries., J Clin Endocrinol Metab, 81, 302

Rice, 2006, Phytoestrogens and their low dose combinations inhibit mRNA expression and activity of aromatase in human granulosa-luteal cells., J Steroid Biochem Mol Biol, 101, 216, 10.1016/j.jsbmb.2006.06.021

Enjuanes, 2003, Regulation of CYP19 gene expression in primary human osteoblasts: effects of vitamin D and other treatments., Eur J Endocrinol, 148, 519, 10.1530/eje.0.1480519

Garzo, 1984, Aromatase activity in human granulosa cells during follicular development and the modulation by follicle-stimulating hormone and insulin., Am J Obstet Gynecol, 148, 657, 10.1016/0002-9378(84)90769-5

Erickson, 1990, The effects of insulin and insulin-like growth factors-I and -II on estradiol production by granulosa cells of polycystic ovaries., J Clin Endocrinol Metab, 70, 894, 10.1210/jcem-70-4-894

Franks, 1999, Insulin action in the normal and polycystic ovary., Endocrinol Metab Clin North Am, 28, 361, 10.1016/S0889-8529(05)70074-8

Wiernsperger, 1999, Membrane physiology as a basis for the cellular effects of metformin in insulin resistance and diabetes., Diabetes Metab, 25, 110

Greisen, 2001, Effects of androstenedione, insulin and luteinizing hormone on steroidogenesis in human granulosa luteal cells., Hum Reprod, 16, 2061, 10.1093/humrep/16.10.2061

Takemura, 2007, Metformin suppresses interleukin (IL)-1β-induced IL-8 production, aromatase activation, and proliferation of endometriotic stromal cells., J Clin Endocrinol Metab, 92, 3213, 10.1210/jc.2006-2486

Bulun, 2007, Aromatase excess in cancers of breast, endometrium and ovary., J Steroid Biochem Mol Biol, 106, 81, 10.1016/j.jsbmb.2007.05.027

Larsson, 2007, Diabetes mellitus, risk of breast cancer. A meta-analysis., Int J Cancer, 121, 856, 10.1002/ijc.22717

Evans, 2005, Metformin, reduced risk of cancer in diabetic patients., BMJ, 330, 1304, 10.1136/bmj.38415.708634.F7

Bowker, 2006, Increased cancer-related mortality for patients with type 2 diabetes who use sulfonylureas or insulin., Diabetes Care, 29, 254, 10.2337/diacare.29.02.06.dc05-1558

Hadad, 2008, Targeting AMPK: a new therapeutic opportunity in breast cancer., Crit Rev Oncol Hematol, 67, 1, 10.1016/j.critrevonc.2008.01.007

Cazzaniga, 2009, Is it time to test metformin in breast cancer clinical trials?, Cancer Epidemiol Biomarkers Prev, 18, 701, 10.1158/1055-9965.EPI-08-0871

McDonald, 2006, Follicle-stimulating hormone-induced aromatase in immature rat Sertoli cells requires an active phosphatidylinositol 3-kinase pathway and is inhibited via the mitogen-activated protein kinase signaling pathway., Mol Endocrinol, 20, 608, 10.1210/me.2005-0245

Dunaif, 2008, Drug insight: insulin-sensitizing drugs in the treatment of polycystic ovary syndrome—a reappraisal., Nat Clin Pract Endocrinol Metab, 4, 272, 10.1038/ncpendmet0787

Mason, 1994, Estradiol production by granulosa cells of normal and polycystic ovaries: relationship to menstrual cycle history and concentrations of gonadotropins and sex steroids in follicular fluid., J Clin Endocrinol Metab, 79, 1355

Willis, 1998, Premature response to luteinizing hormone of granulosa cells from anovulatory women with polycystic ovary syndrome: relevance to mechanism of anovulation., J Clin Endocrinol Metab, 83, 3984