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Breast cancer and steroid metabolizing enzymes: the role of progestogens.

Abstract
It is well documented that breast tissue, both normal and cancerous, contains all the enzymatic systems necessary for the bioformation and metabolic transformation of estrogens, androgens and progesterone. These include sulfatases, aromatase, hydroxysteroid-dehydrogenases, sulfotransferases, hydroxylases and glucuronidases. The control of these enzymes plays an important role in the development and pathogenesis of hormone-dependent breast cancer. As discussed in this review, various progestogens including dydrogesterone and its 20alpha-dihydro-derivative, medrogestone, promegestone, nomegestrol acetate and norelgestromin can reduce intratissular levels of estradiol in breast cancer by blocking sulfatase and 17beta-hydroxysteroid-dehydrogenase type 1 activities. A possible correlation has been postulated between breast cell proliferation and estrogen sulfotransferase activity. Progesterone is largely transformed in the breast; normal breast produces mainly 4-ene derivatives, whereas 5alpha-derivatives are most common in breast cancer tissue. It has been suggested that this specific conversion of progesterone may be involved in breast carcinogenesis. In conclusion, treatment with anti-aromatases combined with anti-sulfatase or 17beta-hydroxysteroid-dehydrogenase type 1 could provide new therapeutic possibilities in the treatment of patients with hormone-dependent breast cancer.
AuthorsJorge R Pasqualini
JournalMaturitas (Maturitas) Vol. 65 Suppl 1 Pg. S17-21 (Dec 2009) ISSN: 1873-4111 [Electronic] Ireland
PMID19962254 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
CopyrightCopyright 2009 Elsevier Ireland Ltd. All rights reserved.
Chemical References
  • Progestins
  • Progesterone
  • Estradiol
  • 17-Hydroxysteroid Dehydrogenases
  • 3 (or 17)-beta-hydroxysteroid dehydrogenase
  • Aromatase
  • Sulfotransferases
  • Sulfatases
Topics
  • 17-Hydroxysteroid Dehydrogenases (metabolism)
  • Aromatase (metabolism)
  • Breast (metabolism, pathology)
  • Breast Neoplasms (drug therapy, etiology)
  • Cell Proliferation
  • Estradiol (metabolism)
  • Female
  • Humans
  • Progesterone (metabolism)
  • Progestins (metabolism)
  • Sulfatases (metabolism)
  • Sulfotransferases (antagonists & inhibitors, metabolism)

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