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Inflammatory macrophage derived TNFα downregulates estrogen receptor α via FOXO3a inactivation in human breast cancer
Frida Björk Gunnarsdóttir1, Catharina Hagerling2, Caroline Bergenfelz1
1Cancer Immunology, Department of Translational Medicine, 214 28, Malmö, Lund University, Sweden.
Abstract:
Patients with estrogen receptor α positive (ERα+) breast cancer can respond to endocrine therapy, but treatment resistance is common and associated with downregulation of ERα expression in the dormant residual cells. Here we show, using long-term NSG xenograft models of human breast cancer and primary human monocytes, in vitro primary cell cultures and tumors from breast cancer patients, that macrophage derived tumor necrosis factor alpha (TNFα) downregulates ERα in breast cancer cells via inactivation of the transcription factor Forkhead box O transcription factor 3a (FOXO3a). Moreover, presence of tumor associated macrophages in the primary tumor of breast cancer patients, was associated with ERα negativity, and with worse prognosis in patients with ERα+ tumors. We propose that pro-inflammatory macrophages, despite being tumoricidal, may have direct effects on tumor progression and endocrine resistance in breast cancer patients. Our findings suggest that TNFα antagonists should be evaluated for treatment of ERα+ breast cancer.
Insights
Tumor-associated macrophages secrete tumor necrosis factor alpha (TNFα), which reduces estrogen receptor alpha (ERα) in breast cancer cells, potentially causing endocrine resistance. TNFα inhibitors may help treat ERα-positive breast cancer.
Area of Science:
- Oncology
- Immunology
- Endocrinology
Background:
- Estrogen receptor alpha-positive (ERα+) breast cancer often develops resistance to endocrine therapy.
- This resistance is linked to decreased ERα expression in residual cancer cells.
Purpose of the Study:
- To investigate the mechanism by which macrophages influence ERα expression and endocrine resistance in breast cancer.
- To explore the role of tumor necrosis factor alpha (TNFα) in ERα downregulation.
Main Methods:
- Utilized long-term NSG xenograft models of human breast cancer.
- Employed in vitro primary cell cultures of human monocytes and breast cancer cells.
- Analyzed primary tumors from breast cancer patients.
Main Results:
- Macrophage-derived TNFα was found to downregulate ERα in breast cancer cells by inactivating the transcription factor FOXO3a.
- Tumor-associated macrophages in patient tumors correlated with ERα negativity.
- Presence of tumor-associated macrophages indicated a worse prognosis in ERα+ breast cancer patients.
Conclusions:
- Pro-inflammatory macrophages can promote breast cancer progression and endocrine resistance.
- Targeting TNFα with antagonists may be a viable strategy for treating ERα+ breast cancer.
- Further evaluation of TNFα antagonists in clinical settings is warranted.
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