Tamoxifen is used widely in the treatment of endocrine-responsive breast cancers in humans. Studies were undertaken to examine the biological character (estrogenic-antiestrogenic properties) and estrogen receptor (ER) interaction of the cis- and trans-isomers of tamoxifen and hydroxytamoxifen in MCF-7 human breast cancer cells. For each compound,the following parameters were monitored: affinity for ER and effects on cellular ER levels; stimulation-inhibition of cell growth,plasminogen activator activity,and cellular progesterone receptor levels; and isomer interconversion and metabolism in vitro. The relative binding affinities of the compounds cis-tamoxifen,trans-tamoxifen,cis-hydroxytamoxifen,and trans-hydroxytamoxifen for cytosol ER were 0.3,2.5,1.8,and 310%,respectively,in which the affinity of estradiol is considered 100%. cis-Tamoxifen behaved as a weak estrogen agonist in all assays,while trans-tamoxifen was an effective estrogen antagonist. cis-Tamoxifen behaved like estradiol in stimulating MCF-7 cell growth and increasing plasminogen activator activity and cellular progesterone receptor content,although very much higher concentrations of cis-tamoxifen (10(-6) M) were needed to achieve the levels of stimulation observed with 10(-10) M estradiol. trans-Tamoxifen and trans-hydroxytamoxifen suppressed cell growth,inhibited plasminogen activator activity of control cells,and suppressed estradiol-stimulation of plasminogen activator activity,and they evoked minimal increases in cellular progesterone receptor levels. trans-Hydroxytamoxifen had a 100-fold increased affinity for ER and was approximately 100-times more potent than was trans-tamoxifen in suppressing cell growth and plasminogen activator activity. cis-Hydroxytamoxifen behaved as an estrogen antagonist,suppressing cell growth and plasminogen activator activity,and it elicited submaximal increases in progesterone receptor levels. This apparently paradoxical behavior of cis-hydroxytamoxifen was shown to be due to the fact that the cis- and trans-hydroxytamoxifens readily undergo isomeric interconversion upon exposure to our cell culture conditions,resulting in substantial accumulation of the higher-affinity trans-hydroxytamoxifen in the nuclear ER fraction of cells. In contrast to the facile interconversion of the hydroxytamoxifen isomers,there is no metabolism or interconversion of the parent compounds cis- and trans-tamoxifen in vitro. Hence,by the criteria we have used,the biological characters of trans-tamoxifen and trans-hydroxytamoxifen are similar,the major difference being the approximately 100-fold enhanced potency of the hydroxylated form. In contrast,cis-t
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