Androgen receptor structural and functional elements: role and regulation in prostate cancer

The androgen receptor (AR) is a nuclear receptor transcription factor that mediates the cellular actions of androgens, the male sex steroids. Androgen-dependent tissues, such as the prostate, rely on androgen action for their development as well as their maintenance in adulthood. This requirement is exploited during systemic therapy of prostate cancer, which is initially an androgen-dependent disease. Indeed, androgen ablation, which prevents the production or blocks the action of androgens, inhibits prostate cancer growth. Invariably, the disease recurs with a phenotype resistant to further hormonal manipulations. However, this so-called androgen depletion-independent prostate cancer remains dependent on a functional AR for growth. Many studies have focused on the mechanistic and structural basis of AR activation with the important goal of understanding how the AR is activated at this stage of the disease. In this review, we summarize how these studies have revealed important functional domains in the AR protein and have provided initial clues to their role in prostate cancer development and progression. A comprehensive understanding of the role and functional relationships between these AR domains could lead to the development of novel AR-directed therapies for prostate cancer.