title: GR and ER Coactivation Alters the Expression of Differentiation Genes and Associates with Improved ER+ Breast Cancer Outcome.
abstract: In estrogen receptor (ER)-negative breast cancer, high tumor glucocorticoid receptor (GR) expression has been associated with a relatively poor outcome. In contrast, using a meta-analysis of several genomic datasets, here we find that tumor GR mRNA expression is associated with improved ER(+) relapse-free survival (RFS; independently of progesterone receptor expression). To understand the mechanism by which GR expression is associated with a better ER(+) breast cancer outcome, the global effect of GR-mediated transcriptional activation in ER(+) breast cancer cells was studied. Analysis of GR chromatin immunoprecipitation followed by high-throughput sequencing in ER(+)/GR(+) MCF-7 cells revealed that upon coactivation of GR and ER, GR chromatin association became enriched at proximal promoter regions. Furthermore, following ER activation, increased GR chromatin association was observed at ER, FOXO, and AP1 response elements. In addition, ER associated with GR response elements, suggesting that ER and GR interact in a complex. Coactivation of GR and ER resulted in increased expression (relative to ER activation alone) of transcripts that encode proteins promoting cellular differentiation (e.g., KDM4B, VDR) and inhibiting the Wnt signaling pathway (IGFBP4). Finally, expression of these individual prodifferentiation genes was associated with significantly improved RFS in ER(+) breast cancer patients. Together, these data suggest that the coexpression and subsequent activity of tumor cell GR and ER contribute to the less aggressive natural history of early-stage breast cancer by coordinating the altered expression of genes favoring differentiation.
  
  
  
  The interaction between ER and GR activity highlights the importance of context-dependent nuclear receptor function in cancer. Mol Cancer Res; 14(8); 707-19. ©2016 AACR.
authors.affiliation: Department of Medicine, The University of Chicago, Chicago, Illinois.
authors.forename: Diana C
authors.initials: DC
authors.lastname: West
authors.affiliation: Department of Medicine, The University of Chicago, Chicago, Illinois.
authors.forename: Deng
authors.initials: D
authors.lastname: Pan
authors.affiliation: Department of Medicine, The University of Chicago, Chicago, Illinois.
authors.forename: Eva Y
authors.initials: EY
authors.lastname: Tonsing-Carter
authors.affiliation: Center for Research Informatics, The University of Chicago, Chicago, Illinois.
authors.forename: Kyle M
authors.initials: KM
authors.lastname: Hernandez
authors.affiliation: Department of Medicine, The University of Chicago, Chicago, Illinois.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Pierce
authors.affiliation: Department of Medicine, The University of Chicago, Chicago, Illinois.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Styke
authors.affiliation: Department of Medicine, The University of Chicago, Chicago, Illinois.
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Bowie
authors.affiliation: Center for Research Informatics, The University of Chicago, Chicago, Illinois.
authors.forename: Tzintzuni I
authors.initials: TI
authors.lastname: Garcia
authors.affiliation: Department of Public Health Sciences, The University of Chicago, Chicago, Illinois.
authors.forename: Masha
authors.initials: M
authors.lastname: Kocherginsky
authors.affiliation: Department of Medicine, The University of Chicago, Chicago, Illinois. Ben May Department for Cancer Research, The University of Chicago, Chicago, Illinois. sconzen@medicine.bsd.uchicago.edu.
authors.forename: Suzanne D
authors.initials: SD
authors.lastname: Conzen
mesh_terms: D001943:Breast Neoplasms / Q000235:genetics* / Q000473:pathology; D002454:Cell Differentiation; D045744:Cell Line, Tumor; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D011960:Receptors, Estrogen / Q000235:genetics / Q000378:metabolism*; D011965:Receptors, Glucocorticoid / Q000235:genetics / Q000378:metabolism*; D020218:Response Elements; D015398:Signal Transduction; D014158:Transcription, Genetic
chemical_list: D011960:Receptors, Estrogen; D011965:Receptors, Glucocorticoid