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Updated: May 31, 2026

Systems Biology of Metabolic Regulation by Estrogen Receptor Signaling in Breast Cancer
Published on: March 17, 2016
Steroid hormone modulation of RET through two estrogen responsive enhancers in breast cancer
Zachary E Stine1, David M McGaughey, Seneca L Bessling
1McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205, USA.
Abstract:
RET, a gene causatively mutated in Hirschsprung disease and cancer, has recently been implicated in breast cancer estrogen (E2) independence and tamoxifen resistance. RET displays both E2 and retinoic acid (RA)-dependent transcriptional modulation in E2-responsive breast cancers. However, the regulatory elements through which the steroid hormone transcriptional regulation of RET is mediated are poorly defined. Recent genome-wide chromatin immunoprecipitation-based studies have identified 10 putative E2 receptor-alpha (ESR1) and RA receptor alpha-binding sites at the RET locus, of which we demonstrate only two (RET -49.8 and RET +32.8) display significant E2 regulatory response when assayed independently in MCF-7 breast cancer cells. We demonstrate that endogenous RET expression and RET -49.8 regulatory activity are cooperatively regulated by E2 and RA in breast cancer cells. We identify key sequences that are required for RET -49.8 and RET +32.8 E2 responsiveness, including motifs known to be bound by ESR1, FOXA1 and TFAP2C. We also report that both RET -49.8 regulatory activity and endogenous RET expression are completely dependent on ESR1 for their (E2)-induction and that ESR1 is sufficient to mediate the E2-induced enhancer activity of RET -49.8 and RET +32.8. Finally, using zebrafish transgenesis, we also demonstrate that RET -49.8 directs reporter expression in the central nervous system and peripheral nervous system consistent with the endogenous ret expression. Taken collectively, these data suggest that RET transcription in breast cancer cells is modulated by E2 via ESR1 acting on multiple elements collectively.
Insights
Estrogen (E2) and retinoic acid (RA) cooperatively regulate RET gene expression in breast cancer. Estrogen receptor-alpha (ESR1) is crucial for E2-induced RET transcription, acting on specific regulatory elements.
Area of Science:
- Molecular biology
- Genetics
- Endocrinology
Background:
- The RET gene is implicated in breast cancer progression, specifically estrogen independence and tamoxifen resistance.
- RET gene expression is modulated by both estrogen (E2) and retinoic acid (RA) in breast cancer cells.
- The precise regulatory elements mediating steroid hormone transcriptional control of RET are not well understood.
Purpose of the Study:
- To identify and characterize the regulatory elements controlling RET gene transcription in response to E2 and RA.
- To elucidate the role of estrogen receptor-alpha (ESR1) in mediating E2-dependent RET regulation.
- To investigate the functional significance of identified regulatory elements in vivo.
Main Methods:
- Chromatin immunoprecipitation (ChIP) assays to identify potential ESR1 and RA receptor binding sites at the RET locus.
- Reporter gene assays in MCF-7 breast cancer cells to assess the regulatory activity of RET gene promoter/enhancer regions.
- Site-directed mutagenesis to identify key sequences within regulatory elements responsible for E2 responsiveness.
- Zebrafish transgenesis to evaluate the in vivo expression pattern directed by RET regulatory elements.
Main Results:
- Two specific regulatory elements, RET -49.8 and RET +32.8, were identified as significantly responsive to E2.
- Endogenous RET expression and the activity of the RET -49.8 element are cooperatively regulated by E2 and RA.
- Key sequences within RET -49.8 and RET +32.8, including ESR1, FOXA1, and TFAP2C binding motifs, are essential for E2 responsiveness.
- ESR1 is indispensable for E2-induced RET expression and enhancer activity, demonstrating its sufficiency in mediating this regulation.
- Zebrafish studies confirmed that RET -49.8 directs reporter expression in the central and peripheral nervous systems.
Conclusions:
- RET transcription in breast cancer is modulated by E2 through ESR1 acting on multiple regulatory elements.
- The identified regulatory elements and the role of ESR1 provide novel insights into the mechanisms of RET gene control in breast cancer.
- These findings highlight potential therapeutic targets for managing breast cancer driven by RET signaling.
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