Evidence that tamoxifen is a histamine antagonist

The tumor-suppressor cholesterol metabolite, dendrogenin A, is a new class of LXR modulator activating lethal autophagy in cancers

Dendrogenin A (DDA) is a mammalian cholesterol metabolite recently identified that displays tumor suppressor properties. The discovery of DDA has revealed the existence in mammals of a new metabolic branch in the cholesterol pathway centered on 5,6α-epoxycholesterol and bridging cholesterol metabolism with histamine metabolism. Metabolic studies showed a drop in DDA levels in cancer cells and tumors compared to normal cells, suggesting a link between DDA metabolism deregulation and oncogenesis. Importantly, complementation of cancer cells with DDA induced 1) cancer cell re-differentiation, 2) blockade of 6-oxo-cholestan-3β,5α-diol (OCDO) production, an endogenous tumor promoter and 3) lethal autophagy in tumors. Importantly, by binding the liver X receptor (LXR), DDA activates the expression of genes controlling autophagy. These genes include NR4A1, NR4A3, LC3 and TFEB. The canonical LXR ligands 22(R)hydroxycholesterol, TO901317 and GW3965 did not induce these effects indicating that DDA delineates a new class of selective LXR modulator (SLiM). The induction of lethal autophagy by DDA was associated with the accumulation in cancer cells of lysosomes and of the pro-lysosomal cholesterol precursor zymostenol due to the inhibition of the 3β-hydroxysteroid-Δ⁸Δ⁷-isomerase enzyme (D8D7I). The anti-cancer efficacy of DDA was established on different mouse and human cancers such as breast cancers, melanoma and acute myeloid leukemia, including patient derived xenografts, and did not discriminate bulk cancer cells from cancer cell progenitors. Together these data highlight that the mammalian metabolite DDA is a promising anticancer compound with a broad range of anticancer applications. In addition, DDA and LXR are new actors in the transcriptional control of autophagy and DDA being a "first in line" driver of lethal autophagy in cancers via the LXR.

Response of patients with indolent systemic mastocytosis to tamoxifen citrate

We examined whether tamoxifen citrate at 20mg/day for 1 year had a beneficial effect on laboratory findings, bone marrow mastocytosis, common clinical symptoms, or quality-of-life assessment for 5 women and 2 men with indolent systemic mastocytosis. Tamoxifen was well tolerated. We found significant reductions in the platelet count, serum alkaline phosphatase, and 24-h urinary excretion of N-methylhistamine and significant increases in serum lactate dehydrogenase and (excluding 2 patients taking aspirin) in 24-h urinary excretion of 11β-prostaglandin F2α. Overall, no change occurred in percent involvement of bone marrow by mastocytosis. Symptom scores were mild and did not change during the treatment. The 36-Item Short Form Health Survey scores for quality of life physical and mental components showed no marked changes. Tamoxifen, an older, nonhematotoxic medication, has limited activity in systemic mastocytosis at the dosage used in this study.

Neonatal administration of tamoxifen causes disruption of myometrial development but not adenomyosis in the C57/BL6J mouse

We previously demonstrated that in the CD-1 mouse, which exhibits a high incidence of age-related adenomyosis, neonatal exposure to tamoxifen induced premature uterine adenomyosis and was associated with abnormal development particularly of the inner myometrium. In the present study, we examined the effect of neonatal tamoxifen administration upon uterine development in the C57/BL6J mouse strain that is not known to develop uterine adenomyosis. Female C57/BL6J pups (n=20) were treated with oral tamoxifen (1 mg/kg) from age 1 to 5 days. Uteri from control and treated mice were obtained on days 5, 10, 15 and 42 of age. We examined sections histologically using image analysis and immunohistochemistry for alpha-smooth muscle actin (ACTA2, alpha-SMA), desmin, vimentin, laminin, fibronectin and oestrogen receptor-alpha (ESR1). Following tamoxifen exposure, all uteri showed inner myometrium thinning, lack of continuity, disorganisation and bundling. However, adenomyosis was not seen in any uterus. ACTA2 immunostaining was less in the circular muscle layer of treated mice. The temporal pattern of desmin immunostaining found in control mice was absent in tamoxifen-treated mice. There was no difference in the localisation of laminin or fibronectin between control and tamoxifen-treated groups. However, laminin immunostaining was reduced in the circular muscle layer of treated mice. Vimentin could not be detected in either group. In conclusion, our results demonstrate that the development of the inner myometrium is particularly sensitive to oestrogen antagonism, and is affected by steroid receptor modulation. Although tamoxifen induces inner myometrial changes including that of ACTA2, desmin, ESR1 and laminin expression in C57/BL6J neonatal mice similar to those induced in CD-1 mice, C57/BL6J mice did not develop premature adenomyosis. Thus, disruption of the development and differentiation of the inner myometrium cannot alone explain the development of tamoxifen-associated adenomyosis, and this must be dependent upon its interaction with strain-dependent factors.

The effects of tamoxifen and estradiol on myometrial differentiation and organization during early uterine development in the CD1 mouse

We used a neonatal mouse model to examine the histogenesis of uterine adenomyosis, and to test whether adenomyosis is due to an abnormality in myometrial differentiation, or in extracellular matrix proteins expression. We also studied the effects of tamoxifen and estradiol on uterine development, myometrial differentiation, and organization. Female CD1 pups were treated with oral tamoxifen (1 mg/kg) (n=27) or estradiol (0.1 mg/kg) (n=24) from age 1 to 5 days. Uteri from control (n=27) and treated mice were obtained on days 2, 5, 10, 15, and 42 of age. We examined the sections histologically, using image analysis and immunohistochemistry for alpha-smooth muscle actin (alpha-SMA), desmin, vimentin, laminin, fibronectin, and estrogen receptor-alpha. Following tamoxifen exposure, all uteri showed adenomyosis by 6 weeks of age (seen as early as day 10). The inner myometrium showed thinning, lack of continuity, disorganization, and bundling. alpha-SMA expression was normal. Desmin expression normally showed a wave of maturation that was absent in tamoxifen-treated mice. In the estradiol group, adenomyosis was not observed. All uterine layers were normally developed, but hypertrophied. The inner myometrium retained its circular arrangement. There was no difference in the localization of laminin or fibronectin between groups (laminin expression was reduced in the tamoxifen treated uteri). Vimentin could not be detected in all groups. Our results suggest that the development of the inner myometrium is particularly sensitive to estrogen antagonism, and can be affected by steroid receptors modulation. Disruption of the inner myometrium may play a role in the development of uterine adenomyosis.

N,N-diethyl-2-[4-(phenylmethyl) phenoxy] ethanamine (DPPE; tesmilifene), a chemopotentiating agent with hormetic effects on DNA synthesis in vitro, may improve survival in patients with metastatic breast cancer

N,N-diethyl-2-[4-(phenylmethyl) phenoxy] ethanamine (DPPE; tesmilifene) is a novel anti-histaminic and chemopotentiating agent that has a hormetic effect on DNA synthesis in MCF (Michigan Cancer Foundation)-7 human breast cancer cells in vitro and stimulates the growth of experimental tumors in rodents. In a prospectively randomized phase three trial (NCIC MA.19), 152 patients who were co-administered DPPE and doxorubicin survived 50% longer (P < 0.03) than 153 patients who were administered the same dose and schedule of doxorubicin alone. At clinically relevant in vitro concentrations that do not inhibit the P-glycoprotein (P-gp) pump, DPPE selectively sensitizes the cancer cells that express the multiple drug resistance phenotype, making them more susceptible to the cytotoxic effects of chemotherapeutic agents, including anthracyclines and taxanes. Based on its previously demonstrated interaction with histamine at CYP3A4, a P450 that metabolizes arachidonic acid, and its induction of high levels of prostacyclin in the gut of rodents, modulation by DPPE of the intracellular concentration of arachidonate products, such as hydroxyeicosatetraeinoic acids, implicated in increased cancer cell proliferation and metastasis, is postulated.

Tesmilifene may enhance breast cancer chemotherapy by killing a clone of aggressive, multi-drug resistant cells through its action on the p-glycoprotein pump

Tesmilifene is a novel potentiator of chemotherapy which, when added to doxorubicin, achieved an unexpected and very large survival advantage over doxorubicin alone in a randomized trial in advanced breast cancer. This trial was unusual in that the early endpoints (response rate and median progression-free survival) were equivalent in the two arms, despite the ultimate survival difference. These aspects, coupled with the absence of a coherent molecular mechanism of action, and a pending confirmatory trial, have led oncologists to hold judgement on this drug. This paper reacts to this in three ways: firstly, a forensic subgroup analysis is presented with an explanation as to why it strongly supports the veracity of the survival difference; secondly a novel cellular explanation is provided for the decoupling of the early and late (survival) endpoints; finally, a molecular mechanism of action is proposed, for the first time, which reconciles the peculiarities of the trial with the laboratory data and background literature. This hypothesis explains how tesmilifene could meld two of the apparent strengths of the cancer cell (drug resistance pumps, and hypoxia-adapted energetics) into a potent weapon of self-destruction. Tesmilifene is proposed to allow chemotherapy (e.g. anthracycline or taxane) to additionally kill a small but critical population (clone) of aggressive, multi-drug resistant cells, the benefits of which cannot be appreciated until a period of time (about 6-8 months) has elapsed. These cells, present in women with more rapidly relapsing disease, very likely carry an energy-dependent extrusion pump which is paradoxically activated by tesmilifene plus the chemotherapy. The result is that, despite the chemotherapy's remaining extracellular, the cell dies from reactive oxygen species leaking from the electron chain transport in the abnormal mitochondria which characterize cancer. These mitochondria are activated in response to the ATP cost of this pump activation, in these predominantly glycolytic cells.

Multifactorial activities of nonsteroidal antiestrogens against leukemia

The antileukemic activity of nonsteroidal antiestrogens was investigated. Tamoxifen, clomiphene and nafoxidine caused a decrease in viability of the estrogen receptor-negative T-lymphoblastic leukemia cell line CCRF/CEM, nafoxidine being the most active. A combination of clomiphene and genistein resulted in a synergistic cytotoxic effect when applied to Molt-3, another T-lymphblastic leukemic cell line. The antiestrogens arrested the cells at G(0)/G(1) phase and induced apoptosis. Using the CCRF/VCR(1000) cell line, which is resistant to vincristine, it was observed that the effect of nafoxidine on modulating drug resistance was manifested at a lower concentration than that causing a direct cytotoxic effect. Nafoxidine inhibited the Pgp pump activity as measured by rhodamine 123 efflux. Combination with verapamil was found to be more effective in abrogating the pump activity. This study points to the multifactorial activities of nonsteroidal antiestrogens against lymphoblastic leukemia and implies their potential use in clinical treatment as antileukemic drugs.

Tamoxifen and toremifene impair retrieval, but not acquisition, of spatial information processing in mice

The present study examines the effects of tamoxifen (TAM) or toremifene (TOR), two triphenylethylene antiestrogen agents, on spatial information in mice by using Morris water maze. In a 30-s free swim trial, the TAM- or TOR-treated mice (intraperitoneally, 30 min before test) spent shorter time than the blank control mice in target quadrant. Compared to saline control group, animals exposed to TAM (1-10 mg/kg i.p., once a day for 5 days) or TOR (3-30 mg/kg i.p., once a day for 5 days) did not show significant difference on the acquisition of place task in Morris water maze. These results suggest that TAM, at the doses of 1-10 mg/kg, and TOR, at the doses of 3-30 mg/kg, impair the retrieval, but not the acquisition, of spatial information task in Morris water maze. It seems, however, that TOR is more potent than TAM on impairing memory retrieval.

Tamoxifen and toremifene cause impairment of learning and memory function in mice

Tamoxifen (TAM) and toremifene (TOR) are two antiestrogen agents frequently used in the treatment of breast cancer. They are currently being assessed as the prophylactic for patients at high risk of developing tumors. However, the side effects of these drugs on memory function have drawn attention in clinical usage. In the present study, it is demonstrated in mice that TAM and TOR significantly shortened the escaping latency or increased the number of errors, respectively, by using the step-down and step-through passive avoidance tests. By using an appetitively motivated task in T-maze, it is demonstrated that TAM and TOR significantly delayed the latency of finding food in well-trained mice. TAM appeared to impair memory consolidation and retrieval processes, rather than acquisition of memory, whereas TOR appeared to impair acquisition, consolidation, and retrieval processes. These results provide experimental support for the clinical findings that have shown that these drugs impaired memory function in patients routinely taking the drugs and suggest that caution should be taken for using these drugs as the prophylactics for those at risk of developing tumors.

Tamoxifen activates smooth muscle BK channels through the regulatory beta 1 subunit

Estrogen (17beta-estradiol; 17betaE) and xenoestrogens, estrogenic compounds that are not steroid hormones, have non-genomic actions at plasma membrane receptors unrelated to the nuclear estrogen receptor. The open probability (P(o)) of large conductance Ca(2+)/voltage-sensitive k(+)(BK) channels is increased by 17betaE through the regulatory beta1 subunit. The pharmacological nature of the putative membrane binding site is unclear. We probed the site by determining whether tamoxifen ((Z)-1-(p-dimethylaminoethoxy-phenyl)-1,2-diphenyl-1-butene; Tx), a chemotherapeutic xenoestrogen, increased P(o) in clinically relevant concentrations (0.1-10 microm). In whole cell patch clamp recordings on canine colonic myocytes, which express the beta1 subunit, Tx activated charybdotoxin-sensitive K(+) current. In single channel experiments, Tx increased the NP(o) (P(o) x number channels; N) and decreased the unitary conductance (gamma) of BK channels. Tx increased NP(o) (EC(50) = 0.65 microm) in excised membrane patches independent of Ca(2+) changes. The Tx mechanism of action requires the beta1 subunit, as Tx increased the NP(o) of Slo alpha expressed in human embryonic kidney cells only in the presence of the beta1 subunit. Tx decreased gamma of the alpha subunit expressed alone, without effect on NP(o). Our data indicate that Tx increases BK channel activity in therapeutic concentrations and reveal novel pharmacological properties attributable to the alpha and beta1 subunits. These data shed light on BK channel structure and function, non-genomic mechanisms of regulation, and physiologically and therapeutically relevant effects of xenoestrogens.

Interaction of histamine and other bioamines with cytochromes P450: implications for cell growth modulation and chemopotentiation by drugs

We have characterized microsomal and nuclear histamine sites, designated H(IC), through which this amine acts as an intracellular mediator of platelet aggregation and lymphocyte mitogenesis. A major proportion, at least, of the microsomal H(IC) sites are on cytochromes P450, an important family of microsomal enzymes that are present in all cells, but most abundant in the liver. These enzymes are involved in the metabolism of xenobiotics and natural substrates, including lipid hormones that modulate gene function and cell growth. We have shown that polyamines, hormones (including estrogen, testosterone and progesterone), antihormones (including tamoxifen and flutamide) and various antidepressants and antihistamines, all inhibit histamine binding to P450; we have postulated that, through binding to the heme moiety, intracellular histamine regulates cell function by modulating the catalytic activity of P450 enzymes, an action that may be perturbed by endogenous and exogenous substances. We now demonstrate that, in addition to histamine, melatonin and the biogenic amines dopamine, serotonin and noradrenaline bind to P450 isozymes and to cytochrome C. Thus, heme enzymes in general may represent common targets where multiple bioamines, hormones and drugs interact to influence cell function and growth.

Modifications of benzylphenoxy ethanamine antiestrogen molecules: influence affinity for antiestrogen binding site (AEBS) and cell cytotoxicity

The antiestrogen binding site (AEBS) is a membranous protein complex that has been shown to be intimately linked with the antiproliferative and antiretroviral effects of certain antiestrogenic compounds such as tamoxifen (Tx). Various specific ligands of AEBS derived from benzylphenoxy ethanamine and a new benzoyl structure were synthesized either by modification of the aminoether side chain or by halogen substitution at the meta-, ortho-, and para position on the benzoyl group. Using the MCF-7 cellular strain and its RTx6 variant (a clone selected for its antigrowth resistance to tamoxifen), it was shown that under high drug concentrations the cytotoxicity of the ligands was directly correlated with their affinity for AEBS. In agreement with previous observations made on triphenylethylenic ligands, modification of the basic ethanamine side chain modulated the ligand affinities. Chloride in meta increased ligand efficacy, whereas chloride substitution in ortho and para decreased it. Effects on AEBS-positive MCF-7 cells were drug concentration- and time-dependent, whereas they were unspecific on the AEBS-negative RTx6 cell line. These cytotoxic effects were confirmed in the absence of estrogen receptor on human AEBS-positive uterine cervix cell carcinoma HeLa cells, but were non-specific on rat fibroblastic AEBS-negative (low concentration) NRK cells. The cytotoxicities of these ligands are related to their affinities for AEBS.

Tamoxifen inhibits the release of arachidonic acid stimulated by thapsigargin in estrogen receptor-negative A549 cells

In pre-labelled A549 cells the tumour promoter thapsigargin (50 nM) stimulates the release of [5,6,8,9,11,12,14,15-3H(N)]-arachidonic acid (3H-AA) by ca. 300% above basal levels. A549 cells are estrogen receptor negative (ER-), yet this stimulation by thapsigargin is inhibited in a dose-dependent manner by a 3 h pre-treatment with the anti-estrogen tamoxifen (1-20 microM). Moreover, the presence of excess (100 microM) estradiol does not reverse this effect of tamoxifen. Thapsigargin stimulated 3H-AA release is not inhibited over the same concentration range by 4 hydroxy-tamoxifen nor by the steroidal anti-estrogen ICI 164384. However, the steroidal anti-estrogen ICI 182780 inhibits thapsigargin stimulated 3H-AA release in a similar manner to tamoxifen and this effect is also not reversed by the presence of excess estradiol. Stimulation of 3H-AA release by EGF (10 nM), IL-1beta (1 ng ml-1) and bradykinin (100 nM) was unaffected by these concentrations of tamoxifen. Ionomycin (10 microM) stimulates 3H-AA release by ca. 700% and A23187 (10 microM) by ca. 300% above basal levels. Pre-treatment with tamoxifen (1-20 microM) inhibits 3H-AA release stimulated by both these agents and again the presence of excess estradiol does not reverse this effect. Unlike the effects of glucocorticoids on 3H-AA release in A549 cells the effects of tamoxifen are not reversed by neutralizing anti-bodies to lipocortin 1. Arachidonic acid release is central to cell proliferation in A549 cells and we propose that this action of tamoxifen could explain the anti-proliferative effect seen in these cells and could have important implications for control of cell proliferation of ER- cells in general.

[Regression of retroperitoneal fibrosis by combination therapy with tamoxifen and steroids]

BACKGROUND

Idiopathic retroperitoneal fibrosis is characterised by proliferation and fibrosis of retroperitoneal tissue. It is complicated by obstruction and encasement of retroperitoneal structures.

CASE REPORT

We describe two female patients with idiopathic retroperitoneal fibrosis. Both had to undergo lateralization of the ureter because of ureteral obstruction. Also both patients developed thrombosis of the inferior vena cava resp. the common iliac vein. Because of the eventful course of the disease a combined tamoxifen and steroid therapy was started. Hereafter there was a marked regression of the retroperitoneal fibrotic masses and the previous inflammatory signs disappeared.

CONCLUSION

Tamoxifen seems to be effective in the treatment of idiopathic retroperitoneal fibrosis by inducing a regression of the fibrotic masses. Especially in patients with continuous activity of the disease we recommend an additional steroid therapy to prevent a regeneration of the fibrosis.

Potent inhibition by tamoxifen of spontaneous and agonist-induced contractions of the human myometrium and intramyometrial arteries

OBJECTIVE

Our purpose was to elucidate the mechanism of direct (nongenomic) action of antiestrogens on spontaneous and agonist-induced contractions of the human myometrium and uterine arteries.

STUDY DESIGN

Myometrial strips and pieces of uterine arteries were obtained from nonpregnant premenopausal women undergoing hysterectomy. Spontaneous activity of myometrium and responses of myometrium and artery to K(+)-depolarization and vasopressin were recorded under isometric conditions. Quantification of the responses was done by planimetry.

RESULTS

The 50% inhibitory concentration values for tamoxifen, clomiphene, and cyclofenil in the case of myometrial spontaneous activity were 2.8, 43, and 331 nmol/L, respectively. Vasopressin-induced contractions in both the myometrium and arteries were potently inhibited by tamoxifen, and the 50% inhibitory concentration for the myometrium (1.4 nmol/L) was significantly lower (p < 0.05) than that for the arteries (11 nmol/L). Although tamoxifen caused no inhibition of responses induced by high potassium chloride (80 mmol/L), responses induced by low potassium chloride (20 mmol/L) were inhibited by 40% to 50% in both the myometrium and arteries. Glibenclamide reversed the inhibition by tamoxifen of spontaneous myometrial activity.

CONCLUSIONS

Tamoxifen is a highly potent inhibitor of the contractile activity of the human nonpregnant myometrium and uterine arteries. It is suggested that tamoxifen could have strong potential in the treatment of dysmenorrhea.

Tamoxifen inhibits nitrobenzylthioinosine-sensitive equilibrative uridine transport in human MCF-7 breast cancer cells

Tamoxifen inhibits the binding of [3H]nitrobenzylthioinosine ([3H]NBMPR) to human MCF-7 breast cancer cells with an IC50 of 8 microM. Tamoxifen at 30 microM changed the apparent Kd for [3H]NBMPR binding from 0.63 +/- 0.12 to 4.75 +/- 0.58 nM, with little effect on the Bmax (311000 +/- 76000 and 263000 +/- 46000 sites per cell for untreated and tamoxifen-treated cells respectively). Corresponding to this decrease in binding of [3H]NBMPR in the presence of tamoxifen was an inhibition of NBMPR-sensitive equilibrative transport of 50 microM [3H]uridine (IC50 7-10 microM). In the presence of 15 microM tamoxifen, the apparent K(m) for [3H]uridine transport was increased from 390 +/- 30 to 1500 +/- 250 microM, with no change in Vmax (12.0 +/- 0.1 and 11.3 +/- 4.3 microM/s for untreated and tamoxifen-treated cells respectively). The inhibitory effect of tamoxifen on NBMPR-sensitive equilibrative uridine transport was specific, as similar results were also observed in HL-60 leukaemia and EL4 lymphoma cells. Furthermore a similar concentration of tamoxifen had no effect on the NBMPR-insensitive equilibrative transport of uridine in MCF-7, HL-60 and Morris 7777 hepatoma cells, and on the Na(+)-dependent transport of uridine in murine splenocytes. In this paper we demonstrate that tamoxifen by itself might have some antiproliferative effects through inhibition of DNA synthesis by blocking the nucleoside salvage pathway.

Riedel's thyroiditis: treatment with tamoxifen

BACKGROUND

Riedel's thyroiditis is an often disabling disease with clinical and histologic similarity to several other fibrous inflammatory disorders. Surgical treatment alone is often unsatisfactory in permanently alleviating airway compression, dysphagia, neck immobility, pain, or chronic fatigue syndrome. Investigation of drugs shown to be of benefit in the treatment of related fibrous disorders in which hormonal factors or inflammatory deregulation appear to be important is indicated. Tamoxifen has not been previously used in the treatment of Riedel's thyroiditis.

METHODS

Four patients with clinical and histologic diagnoses of Riedel's thyroiditis were evaluated before and after treatment with tamoxifen. Each had progressive symptomatic disease of 3 to 16 years' duration despite one or more surgical procedures and steroid therapy. Subjective improvement was noted in all cases, and objective changes were confirmed by periodic physical and computed tomographic examinations.

RESULTS

Patients have been monitored for 1 to 4 years with subjective improvement in 100% and objective disease regression ranging from 50% to 100% in all patients. One patient had complete regression within 6 months, and another had more than 50% regression within 3 months. All have returned to predisease activity levels. There were no significant side effects of the therapy.

CONCLUSIONS

Tamoxifen has proved to be the most effective drug therapy available for managing Riedel's thyroiditis. Our studies suggest that this is unrelated to antiestrogen activity. Tamoxifen's effectiveness may be caused by a mechanism by which it stimulates the release of transforming growth factor-beta, which may inhibit the fibroblastic proliferation characteristic of Riedel's thyroiditis.

Enhancement of tumor growth by drugs with some common molecular actions

A group of structurally related drugs representing diverse therapeutic classes share, among a number of pharmacological properties, enhancement of tumor growth in several rodent models of malignancy. One common action, the inhibition of histamine binding to and catalytic activity of cytochrome P450 monooxygenases, is highly correlated with potency to enhance tumor growth. Among members of this drug ensemble, the antiestrogen tamoxifen has been shown in controlled clinical studies to increase the incidence of uterine and gastrointestinal cancer and to accelerate the course of gastric cancer, and the tamoxifen analogue clomiphene has been linked to neuroblastoma and the tricyclic group of antidepressants to ovarian cancer. The determination of drug affinities for protein modulators of cell growth, proliferation, and transformation suggests a strategy for identifying at least some classes of chemicals that impart oncologic risks to humans.

Evaluation of estrogen receptor, antiestrogen binding sites and calmodulin for antiestrogen resistance of two clones derived from the MCF-7 breast cancer cell line

Estrogen receptor (ER), antiestrogen binding sites (AEBS) and calmodulin (CaM) are potential targets of antiestrogen (AE) action. To analyse further which of these targets are primarily involved in the antiproliferative activity of these drugs against human breast cancers, two cell clones, namely the RTx6 and LY-2 variants, selected from MCF-7 cells for their resistance to high doses of tamoxifen (TAM) and the Keoxifen (KEO) analog LY 117018, respectively, were studied for their sensitivity to hydroxytamoxifen (OH-TAM) and KEO as well as the strong calmodulin antagonist calmidazolium. The effects of these drugs on both cell growth and progesterone receptor (PgR) concentration were assessed. Binding properties for ER, AEBS and CaM of each compound were also measured. Our results confirmed that basal growth of RTx6 and LY-2 cells was more resistant to OH-TAM and KEO than parent MCF-7 cells, although both displayed a significant inhibition at the highest doses assessed. In regard to calmidazolium inhibition, each variant behaved as did the MCF-7 line indicating that a modification at the CaM level was not responsible for their lower sensitivity to AEs. Nor could the association of CaM to ER which did not differ among all cell lines. Resistance of these variants was not related to AEBS in view of the total lack of such sites in RTx6 cells. However, under estrogenic growth stimulation such sites may play some role, since LY-2 cells in the presence of estradiol displayed a real antiestrogen-resistant pattern while RTx6 cells were more sensitive than MCF-7 cells to OH-TAM. This property was not found in the antagonism against estradiol-induced PgR synthesis which was observed with each variant. Thus the PgR concentration of RTx6 cells was strongly down-regulated by OH-TAM and KEO and reduced in LY-2 cells to the same extent as in MCF-7 cells. All these observations show that AE resistance is not entirely related to ER mediated events and that alterations at the ER and CaM levels are unlikely to account for the lower AE sensitivity of the variants investigated.

Tamoxifen inhibits growth of oestrogen receptor-negative A549 cells

The non-steroidal anti-oestrogen tamoxifen inhibits proliferation of the A549 human lung adenocarcinoma cell line (EC50 congruent to 10 nM) yet there was no evidence of oestrogen receptor expression as determined by ligand binding assay and northern blotting. 17-beta-Oestradiol had no effect on A549 cell proliferation (1 pM-1 microM) and moreover a 100-fold excess failed to reverse the effect of 10 nM tamoxifen as did a 100-fold excess of the steroidal anti-oestrogens ICI 164384 and ICI 182780. However, 4-hydroxytamoxifen which had no significant effect on A549 cell growth (1 pM-1 microM) completely antagonized the effect of 10 nM tamoxifen when used at a 100-fold excess. In the presence of oleic acid and stearic acid (10 microM) the growth inhibitory effect of tamoxifen in A549 cells was greatly enhanced, unlike effects mediated by the anti-oestrogen binding protein described in other cells where these fatty acids had no effect. These results indicate the presence of a unique and highly sensitive mechanism in A549 cells whereby concentrations of tamoxifen relevant to classical receptor binding can inhibit cell growth in the absence of the oestrogen receptor.

Stimulation of in vivo tumor growth and phorbol ester-induced inflammation by N,N-diethyl-2-[4-(phenylmethyl)phenoxy] ethanamine HCl, a potent ligand for intracellular histamine receptors

We have implicated histamine as a mediator of proliferation through its binding to novel intracellular receptors (HIC), closely associated with antiestrogen binding sites (AEBS) in microsomes and nuclei. N,N-diethyl-2-[4-(phenylmethyl)phenoxy]ethanamine HCl (DPPE), is a potent ligand for AEBS/HIC. We now demonstrate that DPPE stimulates in vivo tumor growth (DMBA-induced mammary cancer in Sprague-Dawley rats and L5178Y leukemia in DBA/2 mice) and synergizes with phorbol-12-myristate-13-acetate (PMA) to induce inflammation and mitotic activity in mouse epidermis. Thus, ligands for intracellular histamine receptors may represent a new class of tumor promoting agents; this finding lends new credence to an important role for histamine in growth.

Effect of calcium and calcium antagonists on 45Ca influx and cellular growth of human prostatic tumor cells

Calcium and calmodulin play significant roles in DNA synthesis and cell proliferation. In this work the effects of verapamil, trifluoperazine, and tamoxifen on 45Ca uptake and cell growth in human prostatic tumor cells (DU 145) and human fibroblast cells (1 BR) were studied. Although the maximum proliferation was achieved at a concentration of around 2 mM CaCl2 in both DU 145 and 1 BR, growth of DU 145 cells was considerably greater than 1 BR at all calcium concentrations (0.1-4 mM). Calcium uptake experiments, using 45Ca, revealed that the unstimulated 45Ca uptake in 1 BR fibroblasts was 4-5 times higher than in DU 145 cancer cells. Depolarization with high extracellular K caused a 2-3-fold increase in 45Ca influx in 1 BR but only 25-55% increase in DU 145 cells. Verapamil caused a significant inhibition of cell growth with an IC50 value of 55 microM. Verapamil paradoxically increased 45Ca uptake in both unstimulated and K-stimulated DU 145 cells. Whereas unstimulated 45Ca uptake could be blocked by very low concentrations of lathanum (10 microM), much higher concentrations (1-10 mM) were required to completely block uptake in K-depolarized cells. Both trifluoperazine and tamoxifen also inhibited cell proliferation with an IC50 concentration of approximately 5 microM. These drugs, had, however, no effect on 45Ca uptake either in unstimulated or depolarized cells. The results suggest that voltage-gated calcium channels exist in both DU 145 cancer cells and fibroblasts. However, verapamil, in contrast to 1 BR, failed to block these channels in DU 145 cells. The mechanism of antiproliferative action of verapamil may be related to the observed, although paradoxical, increase in cellular calcium. The effect of trifluoperazine and tamoxifen does not involve changes in transmembrane calcium movements but could be mediated by their inhibition of calmodulin-mediated reactions within the cell.

Interaction of antiestrogens with binding sites for muscarinic cholinergic drugs and calcium channel blockers in cell membranes

The interaction of tamoxifen and clomifene with membrane binding sites for the cholinergic ligand quinuclidinyl benzilate (QNB) and the dihydropyridine calcium antagonist nitrendipine was studied. Both tamoxifen and clomifene competed with [3H]-QNB and [3H]-nitrendipine for their binding to the receptor in the membrane fractions from the urinary bladder and myometrium. The extent of inhibition as judged by the Ki values for both antiestrogens was similar at both receptor sites. The data suggest that the antiproliferative effects of tamoxifen may involve not only the intracellular estrogen-receptor system but also receptors for neurotransmitters and membrane calcium channels.

Histamine receptors: subclasses and specific ligands

In this review the three main types of histamine receptors are discussed together with their specific ligands. For the classical H1-receptors much emphasis is put on the mechanism by which the receptor is stimulated. For the H1- and H2-receptor the review includes information on the several models available for establishing agonistic or antagonistic activity. In the section on the H3-receptor the ligands are discussed as well as the possible physiological role of this receptor. In the final paragraphs some less well defined activities are presented.

Effect of embryonic and neonatal administration of tamoxifen on adiposity in the broiler chicken

1. The effect of early exposure of heavy breed (HB) chicks to an anti-oestrogen (tamoxifen--TAM) on later adiposity was studied. 2. TAM administration at the embryonic stage, but not at the day of hatching, reduced adiposity in females but not in males, at 8 to 9 weeks of age. This reduction in adiposity in females minimised or even alleviated the excess of fat in females compared to males.

Anti-oestrogens in the treatment of breast and gynaecological cancers

Tamoxifen is an effective therapy for advanced breast cancer and is well tolerated. In elderly patients or in those with inoperable primary disease tamoxifen is as effective as surgery or radiotherapy. In early breast cancer tamoxifen is associated with a prolongation of disease-free and overall survival, at least in women over the age of 50 with nodal involvement. Major trials now suggest that the effectiveness of tamoxifen may, however, be independent of age, menopausal status and of nodal status, but this remains the subject of substantial controversy. These trials also suggest that longer periods of tamoxifen treatment (more than 2 years) are better than shorter treatments and, therefore, adjuvant tamoxifen until recurrence may be the final treatment of choice for such patients. Tamoxifen is also effective in the treatment of endometrial cancer; however, there seems little advantage in combining the drug with progestogens, either concurrently or sequentially. Modest clinical benefit has been seen in patients with ovarian cancer treated with tamoxifen but the majority of patients have been heavily pretreated. Clinical trials of tamoxifen as primary therapy for this disease are warranted. Tamoxifen has probably been the most widely studied endocrine therapy for breast cancer and the subject of some of the longest and best controlled studies. Although there is no doubt that tamoxifen is effective in adjuvant therapy of breast cancer, the precise position and duration of treatment remains to be defined unequivocally. Future use in the treatment of women at high risk of developing breast cancer--so-called prophylactic therapy--depends on improvements in risk factor determination and a continuing evaluation of the possible clinical relevance of findings in animals given long-term treatment with high doses of the drug.

The antiproliferative properties of tamoxifen and phenothiazines may be mediated by a unique histamine receptor (?H3) distinct from the calmodulin-binding site

N,N-diethyl-2-[(4-phenylmethyl)-phenoxy]-ethanamine HCl (DPPE), a novel histamine antagonist (?H3), which selectively binds with high affinity to the antiestrogen-binding site (AEBS/?H3), inhibits the activity of calmodulin-dependent myosin light chain kinase (MLCK) only at concentrations greater than 1 mM, as opposed to tamoxifen (TAM), which has an IC50 = 4 microM in the same assay. This suggests that the antiestrogen-binding site is distinct from the site on calmodulin which binds TAM and phenothiazines. However, at an in vitro concentration of 1 X 10(-6) M, the antiproliferative effects of DPPE and several phenothiazines, which also compete for binding to AEBS/?H3, are about equal; this suggests that affinity for AEBS/?H3 rather than that for the calmodulin-binding site may correlate with clinically relevant antigrowth effects of these compounds.

Effect of in vivo antiestrogen pretreatment on rabbit atrial chronotropic response to histamine

The chronotropic response (delta rate) to histamine (1.4 to 18 X 10(-6) M) of isolated atria from antiestrogen (tamoxifen)-pretreated immature female rabbit was investigated. Tamoxifen treatment (1.0 and 10.0 mg/kg/day for 14 days) had no significant effect on the delta rate. The Rmax and D1/2max were not significantly different in the two tamoxifen-treated groups compared to the oil-treated (1.0 ml/kg/day for 14 days) control group. Cimetidine (2.8 X 10(-7) M) inhibited the delta rate to histamine in all groups: control, 27%; tamoxifen (1.0 mg/kg), 38%; and tamoxifen (10.0 mg/kg), 28%. Only the low dose of tamoxifen was found to be estrogenic (uterotropic). We conclude that tamoxifen pretreatment, both at estrogen-agonist and estrogen-antagonist doses, is without effect on atrial chronotropic response to histamine.

New evidence that the antiestrogen binding site may be a novel growth-promoting histamine receptor (?H3) which mediates the antiestrogenic and antiproliferative effects of tamoxifen

Using as a probe [3H]-DPPE (N,N-diethyl-2-[(4-phenylmethyl)phenoxy]ethanamine HCl), a novel compound selective for the antiestrogen binding site (AEBS), new evidence is presented that this site could be a growth-promoting histamine receptor of a type not previously described (?H3). In the rat uterus, DPPE alone at a concentration of 4 mg/kg acts as an estrogen antagonist, unlike TAM alone which is a partial estrogen agonist. In the presence of exogenous estradiol, both TAM and DPPE are partial antagonists. This suggests that the "antiestrogenic" effects of tamoxifen are mediated through AEBS/?H3 while the estrogenic effects are mediated through ER.