Molecular basis of pregnancy-induced breast cancer prevention

Reduction in breast cancer risk is associated with elevated circulating levels of human chorionic gonadotropin (hCG) during the first trimester of gestation. The knowledge that hCG also modifies the genomic signature of breast epithelial cells, from highly susceptible to refractory, to undergo neoplastic transformation, and also exerts both preventive and therapeutic effects on chemically induced mammary cancer, lead us to select this hormone for inducing chromatin remodeling in breast epithelial cells as a surrogate end point of complete differentiation and cancer prevention. We have found that chromatin remodeling is the driving force of the differences between the nulliparous and parous breast. In the parous breast, the epithelial cells have a condensed chromatin and increased reactivity with anti-H3K9me2 [di-methyl histone 3 (H3) (Lysine 9)] and H3K27me3 antibodies. This is accompanied by upregulation of noncoding RNA (ncRNA) elements including X2-inactive specific transcript (XIST) and chromatin remodeling genes, such as chromodomain helicase DNA-binding protein 2 (CHD2) and the chromobox homolog 3 (CBX3), whose products are required for controlling recruitment of protein/protein or DNA/protein interactions Another important gene upregulated in the parous breast epithelial cells is the histone-lysine N-methyltransferase or enhancer of zeste homolog 2 (EZH2), a member of the polycomb group (PcG) forming multimeric protein complexes that maintains the transcriptional repressive state of genes over successive cell generations. The fact that recent studies indicate that ncRNAs recruit PcG complexes to the locus of transcription or to sites located elsewhere in the genome cause us to postulate that the increased chromatin condensation in the parous breast has been initiated by ncRNAs, a postulate supported by the observed upregulation of several ncRNAs that included the XIST. The identification of a specific genomic signature of pregnancy has uncovered a novel tool that will serve as a surrogate biomarker for testing new chemopreventive agents and will significantly advance the field of cancer prevention. The clinical impact of this work is that it validates in an experimental system the genomic signature of prevention identified in the human parous breast and establish the bases for the use of the hormone hCG in the prevention of breast cancer, an approach that has not been fully developed until now.