Nuclear Receptors Flashcards

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1
Q

What are examples of ligands?

A
  • Hormones
  • Growth factors
  • Neurotransmitter sugars
  • Lipids
  • Ions
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2
Q

How do nuclear receptors differ from cell surface receptors?

A
  • Cell surface; act as sensors for extracellular molecules
  • Nuclear receptors; act as sensors for intracellular levels of small molecules/metabolities, potentially inducing a signal transduction cascade binding to DNA and activating gene transcription
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3
Q

What signals do nuclear receptors respond to?

A

(small) Lipid-soluble molecules (entering into the cell, into the nucleus binding in situ):
- hormones
- vitamins
- retinoids

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4
Q

What are the outcomes of nuclear receptor activation?

A
  • Activating gene transcription

- Repressing gene transcription

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5
Q

What forms do nuclear receptors exist in?

A
  • Homodimers; 2 molecules of the same NR protein
  • Heterodimers; 2 molecules of differing nuclear receptor protein
  • Monomers
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6
Q

What are orphan receptors?

A

Nuclear receptors that are thought not to have ligands (e.g. interaction w/another protein) or of which their ligands have not yet been discovered.

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7
Q

What does ligand binding do to a NR?

A

Induces a conformational change of the nuclear receptor protein e.g. in folding/shape, altering its ability to induce gene transcription switching it from an inactive form to an active form or vice versa.

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8
Q

What is a xenobiotic compound?

A

Compounds/foreign chemical substance not normally produced by the organism; e.g. PXR nuclear receptor can detect the xenobiotic and respond accordingly, drugs pollutants etc.

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9
Q

What do natural NR ligands all have in common?

A
  • Lipophilic

- Lipid solubility enables them to cross cell membranes with ease by passive diffusion

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10
Q

What are the different classes of natural NR ligands?

A
  • Sex steroids (cholesterol derivatives)
  • Reinoids; Vitamin A
  • Prostaglandins/fatty acids
  • Vitamin D
  • Thyroid hormone
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11
Q

Why do ligands have different affinities for their respective NRs?

A
  • Steroids, vitamins etc. have high affinity for their NR as there is a lower circulating concentration
  • Than metabolites etc. such as fatty acids where there is lots of availible
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12
Q

What effects can ligands have on their NRs?

A
  • Agonists
  • Partial agonist
  • Antagonist
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13
Q

What processes do NRs regulate in human physiology?

A
  • Cell growth, proliferation, apoptosis (death), homeostasis
  • Tissue differentiation
  • Development
  • Metabolism
  • Endocrine systems
  • Body clock/circadian rhythms
  • Reproduction
  • CNS function
  • Cardiovascular system
  • Respiratory system
  • Renal function
  • GI function
  • Immune system
  • Stem cell renewal
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14
Q

When are NRs important clinical targets?

A
  • Inflammatory disease
  • Solid tumours
  • Leukaemias and lymphomas
  • Developmental abnormalities
  • Metabolic diseases
  • Growth disorders
  • Diabetes
  • Kidney disease
  • Obesity
  • Liver disease
  • Endocrine disorders
  • Auto-immune disease
  • Retinopathies
  • Thyroid disorders
  • Behavioral disorders
  • Alzheimer’s disease
  • Parkinson’s disease
  • Stroke
  • CVD
  • Hypogonadism
  • Polycystic ovary disease
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15
Q

What are the top NR drug targets?

A
  • Estrogen receptor
  • Glucocorticoid receptor
  • Progesterone receptor
  • PPARs
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16
Q

What is the NR domain structure?

A
  • 2 main functional domains
  • DNA Binding Domain (DBD)
  • Ligand Binding Domain (LBD)
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17
Q

What enables the DBD of a NR to specifically recognise sequences?

A
  • 2 Zinc Fingers
  • 2-3 alpha helices arranged to read dsDNA
  • Helices interact w/bases and read sequences, allowing receptor to recognise specific sequences
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18
Q

What is the structure of the LBD and what does it contain?

A
  • Makes up most of the C-terminus
  • 10-12 alpha helices; NRs have conserved folding but differed enough in sequence to give specificity
  • Contains activation helix
  • Many contain a hydrophobic cavity known as the ligand binding pocket
  • Ligand binding changes conformation of LBD
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19
Q

What are the functions of the DBD NR Domain?

A
  • Binds specific DNA sequence; normally 6 base pairs long
  • Normally AGGTCA
  • Or steroid receptors bind AGAACA
  • Dimer nature; recognise 2 copies of the sequence
  • Dimerisation (on the DNA)
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20
Q

What are the functions of the LBD NR Domain?

A
  • Ligand binding
  • DImerisation
  • Co-factor binding (needed for transcriptional activity)
  • Transcriptional activation or repression
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21
Q

Upon ligand-binding, how does the NR become repressed/activated?

A
  • NRs recruit respective co-factors; for an antagonist ligand/no ligand, co-repressor proteins are recruited which in turn represses gene transcription
  • With an agonist ligand, co-activator proteins are recruited which allow for transcription of the desired gene (facilitating RNA polymerase etc)
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22
Q

How do recruited co-factors interact with NRs?

A
  • Via conserved helical motifs, promoting NR/cofactor complexes
  • Ligand binding to NR = conformational change which accommodates binding to helical motifs of cofactors
  • Strong protein-protein interaction occurs
  • Co-activators: LXXLL motif (3 leucines + 2 other AAs)
  • Co-repressors: LXXXI/LXXXL (1 leucine 1 isoleucine + 3 AAs or 2 leucines and 3 AAs)
  • They form amphipathic alpha helices with respective hydrophobic and -philic ends, leucines pointing in the same direction
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23
Q

How do corepressors exert their suppressive effect?

A
  • DNA is packaged as chromatins; nucleosomes of 8 histone proteins w/200 bases of DNA wrapped around
  • Corepressors contain histone deacetylases
  • Enzyme removes acetyl groups from histones, which keep nucleosomes tightly packed and generates a compact chromatin structure
  • This blocks the recruitment of polymerases; transcription does not occur
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24
Q

How do coactivators exert their agonist activity?

A
  • DNA is packaged as chromatins; nucleosomes of 8 histone proteins w/200 bases of DNA wrapped around
  • Coactivators contain histone acetylases
  • These add acetyl groups to the histones; this occurs on the lysine residue which is positive - DNA is negative (normally enhancing the interaction), thus acetylating removes the positive charge relaxing interaction
  • This generates an open chromatin structure, making it easier to invade thus there is recruitment of polymerases and transcription of the gene can occur
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25
Q

What is different about steroid receptor dimerisation at the LBD?

A
  • Most NR LBDs function as dimers
  • Steroid receptors function as homodimers, binding inverted repeats (palindromes; reading the same forwards and backwards)
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26
Q

How does LBD heterodimer formation contribute to greater complexity of NR function?

A
  • Ligand-binding NRs (but not steroids) form heterodimers with RXR (retinoid X receptor; which binds 9-cis retinoic acid)
  • They bind direct repeats of AGGTCA (unlike palindromic nature of steroids)
  • But spacing between repeats ‘n’ differs giving rise to unique functionalities etc
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27
Q

How does the activation helix influence cofactor binding?

A
  • Activation helix normally is chillin’ and protrudes away when inactivated
  • Ligand binding at ligand binding pocket of LBD brings about conformational change due to molecular interactions with AAs etc
  • Activation helix moves (a lot)
  • This opens up a surface on the NR for the LXXLL motif of a coactivator (e.g.) to dock and bind
  • Intimate hydrophobic interaction established with leucine and ligand binding domain
28
Q

What is the activation helix also known as?

A
  • Helix 12

- AF2`

29
Q

What are the different gene mutations that can result in human disease?

A
  • Mutation
  • Deletion
  • Amplification
30
Q

What diseases can arise from PPAR Mutations?

A
  • Type II Diabetes
  • Insulin resistance
  • Obesity
  • Dyslipidemia
31
Q

What diseases can arise from thyroid hormone receptor mutations?

A
  • Thyroid disorders

- Graves disease

32
Q

What diseases can arise from mineralocorticoid receptor mutations?

A
  • Severe familial hypertension
33
Q

What diseases can arise from Retinoic Acid Receptor mutation?

A
  • Gene fusion PML-RAR in acute promyelocytic leukaemia (100% remission achieved by treatment with All Trans Retinoic Acid
34
Q

What diseases can arise from photoreceptor specific nuclear receptor mutations?

A
  • Retinopathies

- Retinitis pigmentosa

35
Q

What diseases can arise from estrogen receptor mutation?

A
  • Metastatic breast cancer
36
Q

What diseases can arise from androgen receptor mutation?

A
  • Metastatic prostate cancer
37
Q

What are endocrine cancers?

A
  • Tumours arising in endocrine tissues (hormone producing)
  • Tumours of adrenals, pancreas, pituitary, thyroid, parathyroid glands
  • Poor outlook
38
Q

What are steroid hormone-related cancers?

A
  • Tumours of breast, prostate, ovary, endometrium, testis, osteosarcoma
  • Growth of tumour stimulated by sex (steroid) hormones
  • Treatable w/hormone therapies
39
Q

What are the potential origins of breast cancer?

A
  • Ductal
  • Lobular
  • Mucinous
  • Basal-type
  • Medullary
40
Q

What is the difference between benign and malignant breast cancer?

A
  • Benign; localised - DCIS (Ductal Carcinoma In Situ; contained within duct
  • Malignant; invasive - metastatic, spreading outside local origin
41
Q

How is breast cancer classified?

A
  • Tumour morphology
  • Biomarker staining (staining w/antibodies to determine if receptors present and genetic factors): ER (estrogen receptor), PR (progesterone receptor), EGFR2 (HER2), BRCA1, BRCA2
42
Q

What gene transcription signatures does breast cancer possess?

A
  • Luminal A
  • Luminal B
  • Basal
  • HER2-enriched
43
Q

When would breast cancer be treated with hormone therapies?

A
  • If they are ER+; estrogen receptor expressing
44
Q

When is herceptin used for breast cancer therapy?

A
  • If the patient is ER-, but HER2 (human epidermal growth factor receptor 2) enriched
  • No point using hormone therapy as ER-
45
Q

What is the outlook for a triple negative breast tumour?

A
  • Don’t express ER
  • Don’t express HER2
  • No approved targeted therapy; poor outcome
46
Q

What is available for breast cancer treatments?

A
  • Surgery
  • Radiotherapy (often following surgery)
  • Chemotherapy (pre and post surgery, shrinking tumour to cause minimal damage etc)
  • Hormone therapy
  • Targeted therapy
47
Q

What surgery is available for breast cancer treatment?

A
  • Lumpectomy,
  • Mastectomy - whole breast,
  • Lymph node biopsies
48
Q

What chemotherapy regimens are available for breast cancer treatment?

A
  • 5-FU,
  • epirubicin,
  • docetaxel,
  • cyclophosphamide,
  • methotrexate
49
Q

What hormone therapies are available for breast cancer treatment and what do they entail?

A
  • Antiestrogen (Tamoxifen); binds estrogen receptor as antagonist ligand
  • Aromatase inhibitors (Arimidex; Aromasin; Femara); block estrogen synthesis, so that it’s not available to stimulate cancer cell growth
  • Ovarian ablation (Zoladex); GnRH agonists (gonadotropin releasing hormone agonist, blocking the function of the ovaries - where the estrogen is produced)
50
Q

What targeted therapy is available for breast cancer treatment?

A
  • HER2+; herceptin (trastuzumab); monoclonal antibody
51
Q

How do tamoxifen and raloxifen exert their therapeutic activity?

A
  • Growth of many breast tumours is estrogen (estradiol)-dependent
  • Tamoxifen/raloxifen (SERMs - Selective Estrogen Modulators) are antagonists that block estrogen-dependent growth, mimicing estradiol (estrogen) and binding reversibly to ER LBD
  • Bulky nature pushes activation helix out of position; occupying position where cofactors normally bind
  • Co-activators are thus unable to form a complex with ER
52
Q

What are the other tissue-specific effects for the hormone therapies tamoxifen/raloxifen?

A

Tamoxifen/Raloxifen:

  • are ER antagonists in breast tissues
  • are partial ER agonists in bone (prevent osteoporosis - menopausal women lose bone density due to lack of estrogen productio)

Tamoxifen:
- ER partial agonist in endometrium ( inner mucous membrane of the mammalian uterus); increased risk of endometrial cancer over time

Raloxifen:
- increased risk of blood clots

53
Q

How do aromatase inhibitors exert their therapeutic effect?

A
  • Estrogen synthesis dependent on CYP19A aromatase
  • CYP19A converts testosterone to estradiol, and estrone to estradiol
  • Inhibiting this enzyme inhibits the synthesis of estrogen; tumour is starved
54
Q

What is the normal function of the prostate?

A
  • Sits just under bladder
  • Exocrine gland
  • Secretes alkaline fluid; part of ejaculate/sperm
  • Protectant for sperm
55
Q

What are the characteristics of prostate cancer?

A
  • May be symptomless; it’s a slow-growing cancer
  • Urinary problems; pressing on bladder etc
  • Pelvic pain (in more advanced carcinoma)
  • Stage I - IV (localised - invasive)
56
Q

How is prostate cancer diagnosed?

A
  • Digital rectal exam
  • PSA test
  • MRI or CT scan
  • Biopsy; ultrasound-guided
57
Q

What does the Gleason Score entail and how does it help diagnose prostate cancer?

A
  • Helps clinician decide how advanced tumour is
  • 10-12 samples scored
  • Most common grade + highest grade:
    1 = small, uniform glands (well differentiated)
    2 = more stroma between glands
    (moderately differentiated)
    3 = Distinctly infiltrative margins
    (poorly differentiated/anaplastic)
    4 = Irregular masses of neoplastic glands
    5 = Only occasional gland formation
  • 1 + 2 = not cancerous
  • 3 + 4 = intermediate grade
  • 5 + 5 = most aggressive
58
Q

What does the PSA test entail for prostate cancer diagnosis?

A

Blood test for prostate specific antigen (Pca biomarker):

- 20ng/ml; high risk

59
Q

What are androgens?

A

Male sex hormones:

  • testosterone
  • 5’-dihydrotesterone (DHT)
60
Q

How are androgens linked to prostate tumours?

A
  • Androgens mostly produced by testes (90%), but small amount (10%) produced by adrenal glands
  • Required for normal prostate growth & function BUT also stimulates prostate cancer cell growth
    1. ) Hypothalamus secreted GnRH/LHRH (gonadotropin releasing hormone)
    2. ) GnRH stimulates pituitary to secreted Luteinizing Hormone (LH)
    3. ) LH controls testosterone production in testes
    4. ) Testosterone converted to more active DHT in prostate
    5. ) DHT binds and activates androgen receptors which regulate gene expression
61
Q

What are the treatment for prostate cancer?

A
  • Active surveillance; watchful waiting (intervention postponed until/unless necessary)
  • Radical prostatectomy; if tumour is localised
  • Radiotherapy/chemotherapy (docetaxel - taxotere)
  • Seed brachytherapy; radioactive seed implants in the prostate
  • Cryotherapy; kill tumour cells by localised freezing
  • HIFU; High Intensity Focussed Ultrasound, killing tumour cells with heat
  • Antihormone therapy
  • Androgen deprivation therapy
62
Q

What are the potential side effect of antihormone/androgen deprivation therapy?

A
  • Erectile dysfunction, loss of libido
  • Weight gain, muscle loss, bone thinning, breast swelling, hair loss
  • Memory, mood, concentration effects
63
Q

What androgen deprivation therapies are available for prostate cancer?

A
  • GnRH Agonists
  • GnRH antagonists (medical castration); pituitary
  • CYP17A inhibition; block androgen synthesis
  • Antiandrogens; AR antagonists (at receptor level)
  • Bilateral orchidectomy (surgical castration)
64
Q

How can castration resistant prostate cancer develop?

A

Resistance to hormone therapies emerges after 1-2 years Androgen Deprivation Therapy treatment

65
Q

What differs in castration resistant prostate cancer to emerging prostate cancer?

A
  • Advanced metastatic disease
  • Incurable; no effective treatment
  • 60% of tumours have mutations/amplifications in AR gene
  • LBD mutations common
  • Mutant AR activated by antagonists such as flutamide, bicalutamide; disease worsens with previous ADT treatment driving cancer growth
  • Mutant AR no longer requires hormone
66
Q

What are the future therapies for castration resistant prostate cancer?

A
  • Epigenetic targets
  • HAT inhibitors
  • Bromodomain inhibitors
  • Demethylase inhibitors
  • Protein-protein interactions