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Huss L, Gulz-Haake I, Nilsson E, Tryggvadottir H, Nilsson L, Nodin B, Jirström K, Isaksson K, Jernström H. The Vitamin D Receptor as a Prognostic Marker in Breast Cancer-A Cohort Study. Nutrients 2024; 16:931. [PMID: 38612962 PMCID: PMC11013402 DOI: 10.3390/nu16070931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/15/2024] [Accepted: 03/17/2024] [Indexed: 04/14/2024] Open
Abstract
Previous research has indicated an association between the presence of the vitamin D receptor (VDR) in breast cancer tissue and a favorable prognosis. This study aimed to further evaluate the prognostic potential of VDR located in the nuclear membrane or nucleus (liganded). The VDR protein levels were analyzed using immunohistochemistry in tumor samples from 878 breast cancer patients from Lund, Sweden, included in the Breast Cancer and Blood Study (BCBlood) from October 2002 to June 2012. The follow-up for breast cancer events and overall survival was recorded until 30 June 2019. Univariable and multivariable survival analyses were conducted, both with complete case data and with missing data imputed using multiple imputation by chained equations (MICE). Tumor-specific positive nuclear membrane VDR(num) staining was associated with favorable tumor characteristics and a longer breast cancer free interval (BCFI; HR: 0.64; 95% CI: 0.44-0.95) and overall survival (OS; HR: 0.52; 95% CI: 0.34-0.78). Further analyses indicated that VDRnum status also was predictive of overall survival when investigated in relation to ER status. There were significant interactions between VDR and invasive tumor size (Pinteraction = 0.047), as well as mode of detection (Pinteraction = 0.049). VDRnum was associated with a longer BCFI in patients with larger tumors (HR: 0.36; 95% CI: 0.14-0.93) or clinically detected tumors (HR: 0.28; 95% CI: 0.09-0.83), while no association was found for smaller tumors and screening-detected tumors. Further studies are suggested to confirm our results and to evaluate whether VDR should and could be used as a prognostic and targetable marker in breast cancer diagnostics.
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Affiliation(s)
- Linnea Huss
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
- Department of Surgery, Helsingborg Hospital, 251 87 Helsingborg, Sweden
| | - Igis Gulz-Haake
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
| | - Emma Nilsson
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
| | - Helga Tryggvadottir
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
- Department of Hematology, Oncology, and Radiation Physics, Skåne University Hospital, 221 85 Lund, Sweden
| | - Linn Nilsson
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
- Department of Medical Physics and Engineering, Växjö Central Hospital and Department of Research and Development, Region Kronoberg, 352 34 Växjö, Sweden
| | - Björn Nodin
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
| | - Karin Jirström
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
| | - Karolin Isaksson
- Department of Clinical Sciences, Division of Surgery, Lund University, 221 85 Lund, Sweden;
- Department of Surgery, Kristianstad Hospital, 291 85 Kristianstad, Sweden
| | - Helena Jernström
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
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Huss L, Butt ST, Borgquist S, Elebro K, Sandsveden M, Rosendahl A, Manjer J. Vitamin D receptor expression in invasive breast tumors and breast cancer survival. Breast Cancer Res 2019; 21:84. [PMID: 31358030 PMCID: PMC6664551 DOI: 10.1186/s13058-019-1169-1] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 07/15/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Vitamin D has been suggested to prevent and improve the prognosis of several cancers, including breast cancer. We have previously shown a U-shaped association between pre-diagnostic serum levels of vitamin D and risk of breast cancer-related death, with poor survival in patients with the lowest and the highest levels respectively, as compared to the intermediate group. Vitamin D exerts its functions through the vitamin D receptor (VDR), and the aim of the current study was to investigate if the expression of VDR in invasive breast tumors is associated with breast cancer prognosis. METHODS VDR expression was evaluated in a tissue microarray of 718 invasive breast tumors. Covariation between VDR expression and established prognostic factors for breast cancer was analyzed, as well as associations between VDR expression and breast cancer mortality. RESULTS We found that positive VDR expression in the nuclei and cytoplasm of breast cancer cells was associated with favorable tumor characteristics such as smaller size, lower grade, estrogen receptor positivity and progesterone receptor positivity, and lower expression of Ki67. In addition, both intranuclear and cytoplasmic VDR expression were associated with a low risk of breast cancer mortality, hazard ratios 0.56 (95% CI 0.34-0.91) and 0.59 (0.30-1.16) respectively. CONCLUSIONS This study found that high expression of VDR in invasive breast tumors is associated with favorable prognostic factors and a low risk of breast cancer death. Hence, a high VDR expression is a positive prognostic factor.
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Affiliation(s)
- Linnea Huss
- Department of Surgery, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden.
| | - Salma Tunå Butt
- Department of Surgery, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden
| | - Signe Borgquist
- Department of Oncology, Aarhus University, Aarhus University Hospital, DE-8000, Aarhus C, Denmark
| | - Karin Elebro
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85, Lund, Sweden
| | - Malte Sandsveden
- Department of Surgery, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden
| | - Ann Rosendahl
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85, Lund, Sweden
| | - Jonas Manjer
- Department of Surgery, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden
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Costa PLF, França MM, Katayama ML, Carneiro ET, Martin RM, Folgueira MAK, Latronico AC, Ferraz-de-Souza B. Transcriptomic Response to 1,25-Dihydroxyvitamin D in Human Fibroblasts with or without a Functional Vitamin D Receptor (VDR): Novel Target Genes and Insights into VDR Basal Transcriptional Activity. Cells 2019; 8:cells8040318. [PMID: 30959822 PMCID: PMC6523947 DOI: 10.3390/cells8040318] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/29/2019] [Accepted: 04/03/2019] [Indexed: 01/30/2023] Open
Abstract
The vitamin D receptor (VDR) mediates vitamin D actions beyond bone health. While VDR activation by 1,25-dihydroxyvitamin D (1,25D) leads to robust transcriptional regulation, less is known about VDR actions in the absence of 1,25D. We analyzed the transcriptomic response to 1,25D in fibroblasts bearing a severe homozygous hereditary vitamin D resistant rickets-related p.Arg30* VDR mutation (MUT) and in control fibroblasts (CO). Roughly 4.5% of the transcriptome was regulated by 1,25D in CO fibroblasts, while MUT cells without a functional VDR were insensitive to 1,25D. Novel VDR target genes identified in human fibroblasts included bone and cartilage factors CILP, EFNB2, and GALNT12. Vehicle-treated CO and MUT fibroblasts had strikingly different transcriptomes, suggesting basal VDR activity. Indeed, oppositional transcriptional effects in basal conditions versus after 1,25D activation were implied for a subset of target genes mostly involved with cell cycle. Cell proliferation assays corroborated this conjectured oppositional basal VDR activity, indicating that precise 1,25D dosage in target tissues might be essential for modulating vitamin D actions in human health.
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Affiliation(s)
- Pedro L F Costa
- Laboratorio de Endocrinologia Celular e Molecular LIM-25 e Unidade de Doencas Osteometabolicas, Divisao de Endocrinologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-903, SP, Brazil.
| | - Monica M França
- Laboratorio de Endocrinologia Celular e Molecular LIM-25 e Unidade de Doencas Osteometabolicas, Divisao de Endocrinologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-903, SP, Brazil.
- Laboratorio de Hormonios e Genetica Molecular LIM-42, Divisao de Endocrinologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil.
| | - Maria L Katayama
- Departamento de Radiologia e Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo 01246-000, SP, Brazil.
| | - Eduardo T Carneiro
- Laboratorio de Endocrinologia Celular e Molecular LIM-25 e Unidade de Doencas Osteometabolicas, Divisao de Endocrinologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-903, SP, Brazil.
| | - Regina M Martin
- Laboratorio de Hormonios e Genetica Molecular LIM-42, Divisao de Endocrinologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil.
| | - Maria A K Folgueira
- Departamento de Radiologia e Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo 01246-000, SP, Brazil.
| | - Ana C Latronico
- Laboratorio de Hormonios e Genetica Molecular LIM-42, Divisao de Endocrinologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil.
| | - Bruno Ferraz-de-Souza
- Laboratorio de Endocrinologia Celular e Molecular LIM-25 e Unidade de Doencas Osteometabolicas, Divisao de Endocrinologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-903, SP, Brazil.
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