Conversion of estrone to 17-beta-estradiol in human non-small-cell lung cancer cells in vitro

Conversion of estrone to 17-beta-estradiol in human non-small-cell lung cancer cells in vitro

Biomedicine & Pharmacotherapy 66 (2012) 530–534 Available online at www.sciencedirect.com Original article Conversion of estrone to 17-beta-estrad...

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Biomedicine & Pharmacotherapy 66 (2012) 530–534

Available online at

www.sciencedirect.com

Original article

Conversion of estrone to 17-beta-estradiol in human non-small-cell lung cancer cells in vitro Hanna Drzewiecka, Paweł P. Jagodzinski * Poznan´ University of Medical Sciences, Department of Biochemistry and Molecular Biology, 6 S´wie˛cickiego St., 60-781 Poznan´, Poland

A R T I C L E I N F O

A B S T R A C T

Article history: Received 5 January 2012 Accepted 29 February 2012

It has recently been suggested that, in addition to genetic and environmental factors and tobacco exposure, estrogens also may be an independent risk factor in the development of lung cancer. Therefore, we evaluated the transcript and protein levels of 17-beta-hydroxysteroid-dehydrogenase type 1 (HSD17B1), and the conversion of estrone (E1) to 17-beta-estradiol (E2) in human non-small cell lung cancer (NSCLC) Calu-6, Calu-1 and A549 cells. In our work, we established the presence of HSD17B1 transcripts and proteins in all examined NSCLC cells. Moreover, we demonstrated that human NSCLC Calu-6, Calu-1 and A549 cells are able to convert weak estrogen E1 to highly potent E2 in vitro. Our results indicate that NSCLC cells are able to produce E2 from E1. ß 2012 Elsevier Masson SAS. All rights reserved.

Keywords: HSD17B1 Lung cancer 17-beta-estradiol

1. Introduction Despite the development of new treatment methods, lung cancer continues to be the leading cause of death worldwide, with more than one million cases reported among men and women annually [1]. The overall prognosis for this cancer is poor because of late diagnosis, which disqualifies patients for surgical resection [2,3]. Primary lung cancer is derived from epithelial cells and can be distinguished into two major types: non-small cell lung cancer (NSCLC), and small cell lung cancer (SCLC). NSCLC accounts for approximately 80% of all lung cancers and includes the following histological types: squamous cell carcinoma, adenocarcinoma, large cell carcinoma, and other rare types [4]. Squamous cell carcinoma tends to occur more frequently in men and is connected to a history of smoking, whereas adenocarcinoma is the most common form in women [5,6]. Currently, an upward trend in NSCLC incidence is observed among women [7,8]. Lung cancer in young women exhibits rapid growth and a more aggressive biology than in postmenopausal women [9,10]. Furthermore, the longterm use of hormone replacement therapy (HRT) seems to be correlated with a poor survival rate of patients with lung cancer [11,12]. Therefore, gender may be an additional independent risk factor, apart from tobacco exposure and genetic and environmental factors, in carcinogenesis of the lung. This observation may place the estrogens to the fore of lung cancer risk factors, but the role of estrogens in the incidence of this disease remains elusive. * Corresponding author. E-mail address: [email protected] (P.P. Jagodzinski). 0753-3322/$ – see front matter ß 2012 Elsevier Masson SAS. All rights reserved. doi:10.1016/j.biopha.2012.02.006

Estrogen affects its target tissues by the classical, liganddependend activation of signaling pathways or via non-genomic actions using membrane-associated estrogen receptors ERs and/or a member of the G protein-coupled receptor superfamily, GPCR30 [13,14]. The classical pathway is mediated by estrogen receptors, ERa and ERb, which belong to the nuclear steroid hormone receptor superfamily. ERb is the predominant subtype present in normal lung tissue, and a great majority of NSCLC tumors are positive for ERb, regardless of gender [7,15–22]. Moreover, the non-genomic signalling pathway using the GPR30 receptor has also been identified in lung cancer cells [23]. Although 17-betaestradiol (E2) is mainly produced in the ovaries [24], this steroid hormone can be also locally synthesized from its precursors in various tissues in both women and men [25]. In peripheral tissue, estrone (E1) can be formed by the aromatase or steroid sulfatase (STS) pathways [26,27] and subsequently reduced by 17-betahydroxysteroid-dehydrogenase type 1 (HSD17B1) to E2 [28]. It has recently been demonstrated that HSD17B1 may exhibit a crucial role in the development of estrogen-dependent diseases [29–33]. To date, the metabolism of androgens and estrogens in the lungs has been focused on the aromatase and STS pathways and their pivotal role in intratumoral estrogen synthesis in NSCLC cells [18,34–37]. However, little is known about HSD17B1 expression in lung cancer cells and their ability to convert E1 to E2. Therefore, we evaluated the levels of HSD17B1 transcript and protein and the production of E2 from E1 in human NSCLC Calu-6, Calu-1 and A549 cells. In addition to being a precursor of E2, E1 can also exert an impact on NSCLC cells by acting through ERs [38], so we also explored the influence of both E1 and E2 on the proliferation of Calu-6, Calu-1 and A549 cells.

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2. Materials and methods 2.1. Antibodies and reagents Rabbit polyclonal anti-HSD17B1 antibody (Ab) (H-158), rabbit polyclonal antiglyceraldehyde-3-phosphate (GAPDH) Ab (FL-335) and goat antirabbit horseradish peroxidase (HRP)-conjugated Ab were provided by Santa Cruz Biotechnology (Santa Cruz, CA). E1, E2 and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) were purchased from Sigma-Aldrich Co. (St.-Louis, MO). 2.2. Cell culture T47D breast cancer cells were used as a positive control for HSD17B1 transcript and protein identification [39]. The human NSCLC A549 and Calu-1 cells, as well as the T47D breast cancer cells, were purchased from the American Type Culture Collection (Rockville, MD). The NSCLC Calu-6 cell line was kindly provided by Dr. Marek Rusin from the Centre of Oncology Maria Sklodowska-Curie Memorial Institute (Gliwice, Poland). A549, Calu-1 and T47D cells were routinely maintained in DMEM medium, Sigma-Aldrich Co. (St.-Louis, MO), while Calu-6 cells were grown in RPMI-1640 medium, Sigma-Aldrich Co. (St.-Louis, MO) supplemented with 10% heat-inactivated fetal bovine serum (FBS), 2 mM glutamine and gentamicin sulfate salt (50 mg/ml) Sigma-Aldrich Co. (St.-Louis, MO) at 37 8C in humidified air with 5% CO2. Prior to all experiments, cells were maintained for 48 hours in an appropriate phenol red-free medium Sigma-Aldrich Co. (St.-Louis, MO) supplemented with 10% charcoal-dextran-stripped FBS Sigma-Aldrich Co. (St.-Louis, MO). 2.3. Conversion of E1 to E2 in Calu-6, Calu-1 and A549 cells To investigate the ability of NSCLC cells to convert E1 to E2, the Calu-6, Calu-1 and A549 cells were seeded in six-well plates (3.6  105 cells/well). After 24 hours, media were replaced and cells were cultured either in the absence or in the presence of E1 at a concentration of 5 mM for 2, 4, 6, 8, 10, and 12 hours. At the end of incubation periods, 1.0 ml of the medium was collected and the concentration of E2 was evaluated by electrochemiluminescence method using Cobas 6000 Roche Diagnostics GmbH (Mannheim, Germany). The results were presented as the concentration of E2 in culture medium in nM or pM per 1 mg of total cell protein. All experiments were performed in triplicate and the results represent mean  SE. 2.4. Reverse transcription (RT) and real-time quantitative PCR (RQPCR) analysis To determine the presence of the HSD17B1 transcript and its levels in Calu-6, Calu-1 and A549 cells we applied RT and RQ-PCR analysis. RNA was isolated by TRI Reagent1 Sigma-Aldrich Co. (St.Louis, MO) according to the method of Chomczynski and Sacchi [40]. RNA quality was determined by denaturing agarose gel electrophoresis, and the concentration was quantified by measuring the optical density (OD) at 260 nm. RNA samples were treated with DNase I and reverse-transcribed into cDNA using Moloney Murine Leukemia Virus (M-MLV) Reverse Transcriptase from Invitrogen (Carlsbad, CA). RQ-PCR was conducted in a Light Cycler1480 Real-Time PCR System, Roche Diagnostics GmbH (Mannheim, Germany), using SYBR Green I as detection dye. Target cDNA was quantified by the relative quantification method. The quantity of HSD17B1 transcript in each sample was standardized by the porphobilinogen deaminase (PBGD) transcript level. The PCR amplification efficiency for target and reference genes was determined by different standard curves created by consecutive

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dilutions of the cDNA template mixture, as provided in Relative Quantification Manual Roche Diagnostics GmbH (Mannheim, Germany). The HSD17B1 cDNA 75 bp amplicon was amplified employing the primer pair: (50 TGA GGA GGT GGC GGA GGT CTT C 30 ) (forward, nt 702-723) and (50 CGC TCG GTG GTG AAG TAG 30 ) (reverse, nt 759-776). The PBGD cDNA 160 bp amplicon was amplified using the primer pair: (50 GCC AAG GAC CAG GAC ATC 30 ) (forward, nt 676-693) and (50 TCA GGT ACA GTT GCC CAT C 30 ) (reverse, nt 817-835). The HSD17B1 and PBGD cDNA primers were designed based on sequences ENST00000225929 and ENST00000278715, located in Ensembl Genome Browser (www.ensembl.org). For amplification, 1 ml of total (20 ml) cDNA solution was added to 9 ml of Light Cycler1480 SYBR Green I Master mix (1  concentrated) Roche Diagnostics GmbH (Mannheim, Germany), containing 2.5 mM MgCl2 and 0.5 mM primers. A sample of RNA that had not been reverse-transcribed and a notemplate control were included in each batch of samples to provide a negative control in subsequent PCR. Melting-curve analysis and sequencing were applied to confirm the specificity of the amplified products. All experiments were performed in triplicate and RQ-PCR results are expressed as averages of relative expression to control transcript levels in T47D cells. 2.5. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDSPAGE) and western blotting Cell lysates were prepared using RIPA buffer Sigma-Aldrich Co. (St.-Louis, MO) containing 50 mM Tris-HCl, pH 8.0, 150 mM sodium chloride, 1.0% Igepal, 0.5% sodium deoxycholate, 0.1% sodium dodecyl sulfate and protease inhibitor cocktail. Samples were incubated for 1 hour on ice and then centrifuged at 10,000  g for 10 min at 4 8C to remove cell debris. Supernatants were stored at 80 8C before use. The total protein concentration in cell extracts was determined by the Bradford assay. Subsequently, 30 mg of protein was resuspended in the loading buffer and boiled at 99 8C for 5 min. Next, all samples were loaded into each lane and separated on 10% Tris-glycine gel using SDS-PAGE. Gel proteins were transferred to polyvinylidene fluoride (PVDF) membrane, Roche Diagnostics GmbH (Mannheim, Germany), which was blocked with 5% non-fat dry milk in Tris buffered saline/Tween 20. Immunodetection was performed with rabbit polyclonal antiHSD17B1 Ab (H-158) at a dilution of 1:500, followed by incubation with goat anti-rabbit HRP-conjugated Ab (1:5000). Bands were revealed using Pierce ECL Plus Western Blotting Substrate, Thermo Fisher Scientific (Rockford, IL). The membranes were stripped and reblotted with rabbit polyclonal anti-GAPDH Ab (FL-335) at a dilution of 1:2500, followed by goat anti-rabbit HRP-conjugated Ab (1:10,000), to ensure equal protein loading of the lanes. 2.6. MTT cell proliferation assay To determine the effect of E1 and E2 on the proliferation of Calu6, Calu-1 and A549 cells we used MTT cell proliferation assay. The cells were either cultured in phenol red-free RPMI-1640 (Calu-6 cells) or phenol red-free DMEM (Calu-1 and A549 cells) supplemented with 10% charcoal-dextran-stripped FBS for 48 hours, then seeded into 24-well culture plates (6  104 cells/ well). Subsequently, cells were incubated either in the absence or in the presence of E1 (5 mM) and E2 (10 nM) for 24, 48 and 72 hours. After the incubation period, all culture media were removed and 50 ml of the MTT stock solution in phosphate buffered saline (PBS) (5 mg/ml), mixed with 450 ml of the appropriate phenol red-free medium, was added to each well. After 4 hours of incubation, the culture medium was discarded and the blue formazan crystals were dissolved by adding MTT solvent

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was significance (P < 0.05) between the groups. The statistical analysis was performed with STATISTICA 6.0 software. 3. Results and discussion

Fig. 1. Identification of HSD17B1 transcript (A) and protein (B) in human NSCLC Calu-6, Calu-1 and A549 cells. The cells were used for total RNA isolation and reverse transcription. The HSD17B1 transcript levels were determined by RQ-PCR analysis. RQ-PCR results were standardized by PBGD cDNA levels. HSD17B1 transcripts levels in the investigated NSCLC cells are expressed as a multiplicity of the HSD17B1 cDNA levels in positive controls, T47D breast cancer cells. Each sample was determined in triplicate. Cell proteins were separated by 10% SDS-PAGE and transferred to a PVDF membrane that was then immunoblotted with rabbit polyclonal anti-HSD17B1 Ab and incubated with goat antirabbit HRP-conjugated Ab. To ensure equal protein loading of the lanes, the membrane was then reblotted with anti-GAPDH Ab, followed by goat antirabbit HRP-conjugated Ab.

(0.1 N HCl in isopropanol, 150 ml/well). Next, 100 ml of the solution was transferred into 96-well culture plates and the absorbance was measured at a wavelength of 570 nm with a background reading at 640 nm. All experiments were performed in triplicate and the results are presented as means  SE. 2.7. Statistical analysis The difference between control and treated cells was statistically analyzed by unpaired, two-tailed t-test to evaluate if there

Despite the fact that cigarette smoking is still a main cause of lung cancer, estrogens appear to be significant factors in this carcinoma. Clinical data demonstrates that individuals who have never smoked and are diagnosed with this disease are mostly females. Women also seem to be more susceptible to developing lung cancer among smokers, because women have been found to be more vulnerable to the carcinogens found in cigarette smoke [41,42]. The uptake of polycyclic aromatic hydrocarbons, formed as by-products during tobacco consumption, stimulates the activity of cytochrome P450 1B1 (CYP1B1). CYP1B1 is commonly expressed in the human lung and metabolizes E2 to 2- and 4-catechol estrogens, which generate DNA adducts when converted into semiquinones and quinines [43,44]. The formation of DNA adducts contributes to the inactivation of tumour suppressor genes and mutation in proto-oncogenes, which are often detected in lung cancer patients [45]. In our study, we found the presence of HSD17B1 transcript and protein in Calu-6, Calu-1 and A549 cells (Fig. 1). Moreover, we demonstrated that all examined NSCLC cells are able to convert the weak estrogen E1 to the highly potent E2 (Fig. 2). To date, increased HSD17B1 mRNA levels associated with an elevated E2/E1 ratio have been observed in breast cancer [29,30], ovarian tumor [31], endometriosis [32], endometrial hyperplasia [33], and uterine leiomyoma [46]. Recently, the clinical case study by Niikawa et al. reported that patients with NSCLC also have a higher E2 concentration in cancerous tissues as compared to the corresponding non-neoplastic lung tissues from the same patients [4]. Furthermore, high endogenous or exogenous estrogen levels were connected with a poorer clinical outcome for the patients. In addition to their influence on the reproductive system, sexsteroid hormones exert multidirectional action on other tissues. Estrogens promote the development and progression of estrogendepended cancers, as well as markedly affecting the immune system and contributing to some autoimmune diseases [47,48]. Results of experimental studies have indicated that estrogen treatment activates both genomic and non-genomic signaling in lung cancer cells [49,50]. Although previous studies with murine

Fig. 3. Effect of E1 and E2 on the proliferation of human NSCLC Calu-6 (A), Calu-1 (B) and A549 (C) cells. To determine the effect of E1 and E2 on the proliferation of Calu-6, Calu-1 and A549 cells we used the MTT cell proliferation assay. Cells were cultured in an appropriate phenol red-free medium for 48 hours, followed by seeding into 24-well culture plates. Subsequently, cells were incubated either in the absence or in the presence of and E1 (5 mM) and E2 (10 nM) for 24, 48 and 72 hours, respectively. After the incubation period, all culture media were removed and the MTT assay was carried out. All experiments were performed in triplicate and results are presented as the mean  SE from three independent experiments.

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Fig. 2. Conversion of E1 to E2 in human NSCLC Calu-6 (A), Calu-1 (B) and A549 (C) cells. Cells were cultured in phenol red-free RPMI-1640 (Calu-6 cells) or phenol red-free DMEM (Calu-1 and A549 cells) for 48 hours, followed by incubation either in the absence or in the presence of E1 at a concentration of 5 mM. After 2, 4, 6, 8, 10 and 12 hours, 1.0 ml of medium was collected and the concentration of E2 was determined by electrochemiluminescence method. The results were expressed as E2 concentration in culture medium in nM or pM per 1 mg of total cell protein. Each sample was determined in triplicate and results are presented as the mean  SE from three independent experiments.

knockout models showed the indispensability of ERb for normal lung structure and function [51,52], a higher expression of ERb was detected in lung adenocarcinoma [7,15] and provided a new line of evidence for estrogen involvement in lung cancer pathogenesis. Additionally, cross-signalling between ERs and an epidermal growth factor receptor in lung cancer has been established in recent years [16,18,53–55], highlighting the necessity of targeting both of these pathways. Several previous studies have confirmed the presence of estrogen-stimulated NSCLC cell growth and proliferation in vitro and in vivo and indicated that anti-estrogens were able to inhibit those events [16,19,54,56–58]. A549 is a lung adenocarcinoma cell line and Calu-1 is a squamous lung cancer cell line, both derived from males, whereas Calu-6 is an anaplastic lung carcinoma cell line derived from a female [59–61]. We observed that neither E2 at a concentration of 10 nM nor E1 at a concentration of 5 mM had an effect on cellular proliferation of Calu-6, Calu-1 and A549 cells (Fig. 3). Our results are consistent with Miki et al., who did not observe E2 mediated cell proliferation in A549 cells [62]. In contrast, Niikawa et al. used A549 cells transfected with either ERa or ERb expression vectors to demonstrate the positive effect of E2 on the proliferation of these cells [4]. Moreover, our observation that Calu-1 did not respond proliferatively to E2 and E1 may be secondary to findings that E2 has no impact on proliferation of lung adenocarcinoma cells derived from males [19,63]. However, we were not able to confirm growth stimulation of Calu-6 cells after estrogen exposure, and this observation is contrary to earlier studies [22]. This inconsistent result may be due to differences in the sensitivity of the tests used in our study compared to the tests used in earlier studies. We used the MTT proliferation assay, whereas the 5-bromo-2-deoxyuridine assay, which was applied in the above-mentioned study, is over 10 times more sensitive [64]. The results of our study demonstrated the presence of HSD17B1 and the conversion of E1 to E2 in human NSCLC Calu-6, Calu-1 and A549 cells. However, further studies are required to clarify the changes in expression of HSD17B1 during lung carcinogenesis and its role in converting E1 to E2.

Disclosure of interest The authors declare that they have no conflicts of interest concerning this article.

Acknowledgements Supported by grant No. 502-01-01124182-07474 and No. 50214-01124182-09698, Poznan´ University of Medical Sciences. The authors wish to acknowledge Dr. Margarita Lianeri for her assistance. References [1] Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005;55:74–108. [2] Ocak S, Sos ML, Thomas RK, Massion PP. High-throughput molecular analysis in lung cancer: insights into biology and potential clinical applications. Eur Respir J 2009;34:489–506. [3] Giaccone G. Clinical impact of novel treatment strategies. Oncogene 2002;21:6970–81. [4] Niikawa H, Suzuki T, Miki Y, Suzuki S, Nagasaki S, Akahira J, et al. Intratumoral estrogens and estrogen receptors in human non-small cell lung carcinoma. Clin Cancer Res 2008;14:4417–26. [5] Muscat JE, Wynder EL. Lung cancer pathology in smokers, ex-smokers and never smokers. Cancer Lett 1995;88:1–5. [6] Wakelee HA, Chang ET, Gomez SL, Keegan TH, Feskanich D, Clarke CA, et al. Lung cancer incidence in never smokers. J Clin Oncol 2007;25:472–8. [7] Raso MG, Behrens C, Herynk MH, Liu S, Prudkin L, Ozburn NC, et al. Immunohistochemical expression of estrogen and progesterone receptors identifies a subset of NSCLCs and correlates with EGFR mutation. Clin Cancer Res 2009;15:5359–68. [8] Brennan P, Bray I. Recent trends and future directions for lung cancer mortality in Europe. Br J Cancer 2002;87:43–8. [9] Siegfried JM, Hershberger PA, Stabile LP. Estrogen receptor signaling in lung cancer. Semin Oncol 2009;36:524–31. [10] Lienert T, Serke M, Scho¨nfeld N, Loddenkemper R. Lung cancer in young females. Eur Respir J 2000;16:986–90. [11] Ganti AK, Sahmoun AE, Panwalkar AW, Tendulkar KK, Potti A. Hormone replacement therapy is associated with decreased survival in women with lung cancer. J Clin Oncol 2006;24:59–63. [12] Chlebowski RT, Schwartz AG, Wakelee H, Anderson GL, Stefanick ML, Manson JE, et al. Oestrogen plus progestin and lung cancer in postmenopausal women (Women’s Health Initiative trial): a post hoc analysis of a randomised controlled trial. Lancet 2009;374:1243–51. [13] Le Romancer M, Poulard C, Cohen P, Sentis S, Renoir JM, Corbo L. Cracking the estrogen receptor’s posttranslational code in breast tumors. Endocr Rev 2011;32:597–622. [14] Barkhem T, Nilsson S, Gustafsson JA. Molecular mechanisms, physiological consequences and pharmacological implications of estrogen receptor action. Am J Pharmacogenomics 2004;4:19–28. [15] Omoto Y, Kobayashi Y, Nishida K, Tsuchiya E, Eguchi H, Nakagawa K, et al. Expression, function, and clinical implications of the estrogen receptor beta in human lung cancers. Biochem Biophys Res Commun 2001;285:340–7. [16] Stabile LP, Davis AL, Gubish CT, Hopkins TM, Luketich JD, Christie N, et al. Human non-small cell lung tumors and cells derived from normal lung express both estrogen receptor alpha and beta and show biological responses to estrogen. Cancer Res 2002;62:2141–50.

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H. Drzewiecka, P.P. Jagodzinski / Biomedicine & Pharmacotherapy 66 (2012) 530–534

[17] Mollerup S, Jørgensen K, Berge G, Haugen A. Expression of estrogen receptors alpha and beta in human lung tissue and cell lines. Lung Cancer 2002;37:153– 9. [18] Pietras RJ, Ma´rquez DC, Chen HW, Tsai E, Weinberg O, Fishbein M. Estrogen and growth factor receptor interactions in human breast and non-small cell lung cancer cells. Steroids 2005;70:372–81. [19] Ivanova M, Abner S, Pierce Jr W, Klinge C. Ligand-dependent differences in estrogen receptor beta-interacting proteins identified in lung adenocarcinoma cells corresponds to estrogenic responses. Proteome Sci 2011;9:60. [20] Beattie CW, Hansen NW, Thomas PA. Steroid receptors in human lung cancer. Cancer Res 1985;45:4206–14. [21] Kawai H, Ishii A, Washiya K, Konno T, Kon H, Yamaya C, et al. Estrogen receptor alpha and beta are prognostic factors in non-small cell lung cancer. Clin Cancer Res 2005;11:5084–9. [22] Zhang G, Liu X, Farkas AM, Parwani AV, Lathrop KL, Lenzner D, et al. Estrogen receptor beta functions through nongenomic mechanisms in lung cancer cells. Mol Endocrinol 2009;23:146–56. [23] Maggiolini M, Picard D. The unfolding stories of GPR30, a new membranebound estrogen receptor. J Endocrinol 2010;204:105–14. [24] Simpson E, Rubin G, Clyne C, Robertson K, O’Donnell L, Davis S, et al. Local estrogen biosynthesis in males and females. Endocr Relat Cancer 1999;6:131– 7. [25] Simpson ER. Sources of estrogen and their importance. J Steroid Biochem Mol Biol 2003;86:225–30. [26] Penning TM. Hydroxysteroid dehydrogenases and pre-receptor regulation of steroid hormone action. Hum Reprod Update 2003;9:193–205. [27] Smuc T, Rizner TL. Expression of 17-beta-hydroxysteroid dehydrogenases and other estrogen-metabolizing enzymes in different cancer cell lines. Chem Biol Interact 2009;178:228–33. [28] Vihko P, Isomaa V, Ghosh D. Structure and function of 17-beta-hydroxysteroid dehydrogenase type 1 and type 2. Mol Cell Endocrinol 2001;171:71–6. [29] Miyoshi Y, Ando A, Shiba E, Taguchi T, Tamaki Y, Noguchi S. Involvement of upregulation of 17-beta-hydroxysteroid dehydrogenase type 1 in maintenance of intratumoral high estradiol levels in postmenopausal breast cancers. Int J Cancer 2001;94:685–9. [30] Jansson A. 17-beta-hydroxysteroid dehydrogenase enzymes and breast cancer. J Steroid Biochem Mol Biol 2009;114:64–7. [31] Blomquist CH, Bonenfant M, McGinley DM, Posalaky Z, Lakatua DJ, Tuli-Puri S, et al. Androgenic and estrogenic 17-beta-hydroxysteroid dehydrogenase/17ketosteroid reductase in human ovarian epithelial tumors: evidence for the type 1, 2 and 5 isoforms. J Steroid Biochem Mol Biol 2002;81:343–51. [32] Smuc T, Pucelj MR, Sinkovec J, Husen B, Thole H, Lanisnik Rizner T. Expression analysis of the genes involved in estradiol and progesterone action in human ovarian endometriosis. Gynecol Endocrinol 2007;23:105–11. [33] Saloniemi T, Ja¨rvensivu P, Koskimies P, Jokela H, Lamminen T, GhaemMaghami S, et al. Novel hydroxysteroid (17-beta) dehydrogenase 1 inhibitors reverse estrogen-induced endometrial hyperplasia in transgenic mice. Am J Pathol 2010;176:1443–51. [34] Milewich L, Parker PS, MacDonald PC. Testosterone metabolism by human lung tissue. J Steroid Biochem 1978;9:29–32. [35] Milewich L, Winters AJ, Stephens P, MacDonald PC. Metabolism of dehydroisoandrosterone and androstenedione by the human lung in vitro. J Steroid Biochem 1977;8:277–84. [36] Provost PR, Blomquist CH, Godin C, Huang XF, Flamand N, Luu-The V, et al. Androgen formation and metabolism in the pulmonary epithelial cell line A549: expression of 17-beta-hydroxysteroid dehydrogenase type 5 and 3alpha-hydroxysteroid dehydrogenase type 3. Endocrinology 2000;141:2786– 94. [37] Pezzi V, Mathis JM, Rainey WE, Carr BR. Profiling transcript levels for steroidogenic enzymes in fetal tissues. J Steroid Biochem Mol Biol 2003;87:181–9. [38] Kuiper GG, Carlsson B, Grandien K, Enmark E, Ha¨ggblad J, Nilsson S, et al. Comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors alpha and beta. Endocrinology 1997;138:863–70. [39] Aka JA, Mazumdar M, Lin SX. Reductive 17-beta-hydroxysteroid dehydrogenases in the sulfatase pathway: critical in the cell proliferation of breast cancer. Mol Cell Endocrinol 2009;301:183–90. [40] Chomczynski P, Sacchi N. Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction. Anal Biochem 1987;162:156–9. [41] Zang EA, Wynder EL. Differences in lung cancer risk between men and women: examination of the evidence. J Natl Cancer Inst 1996;88:183–92.

[42] Risch HA, Howe GR, Jain M, Burch JD, Holowaty EJ, Miller AB. Are female smokers at higher risk for lung cancer than male smokers?. A case-control analysis by histologic type. Am J Epidemiol 1993;138:281–93. [43] Spivack SD, Hurteau GJ, Reilly AA, Aldous KM, Ding X, Kaminsky LS. CYP1B1 expression in human lung. Drug Metab Dispos 2001;29:916–22. [44] Belous AR, Hachey DL, Dawling S, Roodi N, Parl FF. Cytochrome P450 1B1mediated estrogen metabolism results in estrogen-deoxyribonucleoside adduct formation. Cancer Res 2007;67:812–7. [45] Gasperino J. Gender is a risk factor for lung cancer. Med Hypotheses 2011;76:328–31. [46] Kasai T, Shozu M, Murakami K, Segawa T, Shinohara K, Nomura K, et al. Increased expression of type I 17-beta-hydroxysteroid dehydrogenase enhances in situ production of estradiol in uterine leiomyoma. J Clin Endocrinol Metab 2004;89:5661–8. [47] Rochefort H, Platet N, Hayashido Y, Derocq D, Lucas A, Cunat S, et al. Estrogen receptor mediated inhibition of cancer cell invasion and motility: an overview. J Steroid Biochem Mol Biol 1998;65:163–8. [48] Kassi E, Moutsatsou P. Estrogen receptor signaling and its relationship to cytokines in systemic lupus erythematosus. J Biomed Biotechnol 2010;2010:317452. [49] Hershberger PA, Stabile LP, Kanterewicz B, Rothstein ME, Gubish CT, Land S, et al. Estrogen receptor beta (ERbeta) subtype-specific ligands increase transcription, p44/p42 mitogen activated protein kinase (MAPK) activation and growth in human non-small cell lung cancer cells. J Steroid Biochem Mol Biol 2009;116:102–9. [50] Ivanova MM, Mazhawidza W, Dougherty SM, Minna JD, Klinge CM. Activity and intracellular location of estrogen receptors alpha and beta in human bronchial epithelial cells. Mol Cell Endocrinol 2009;305:12–21. [51] Patrone C, Cassel TN, Pettersson K, Piao YS, Cheng G, Ciana P, et al. Regulation of postnatal lung development and homeostasis by estrogen receptor beta. Mol Cell Biol 2003;23:8542–52. [52] Morani A, Barros RP, Imamov O, Hultenby K, Arner A, Warner M, et al. Lung dysfunction causes systemic hypoxia in estrogen receptor beta knockout (ERbeta-/-) mice. Proc Natl Acad Sci U S A 2006;103:7165–9. [53] Shen H, Yuan Y, Sun J, Gao W, Shu YQ. Combined tamoxifen and gefitinib in non-small cell lung cancer shows antiproliferative effects. Biomed Pharmacother 2010;64:88–92. [54] Stabile LP, Lyker JS, Gubish CT, Zhang W, Grandis JR, Siegfried JM. Combined targeting of the estrogen receptor and the epidermal growth factor receptor in non-small cell lung cancer shows enhanced antiproliferative effects. Cancer Res 2005;65:1459–70. [55] Stabile LP, Siegfried JM. Estrogen receptor pathways in lung cancer. Curr Oncol Rep 2004;6:259–67. [56] Ma´rquez-Garba´n DC, Chen HW, Fishbein MC, Goodglick L, Pietras RJ. Estrogen receptor signaling pathways in human non-small cell lung cancer. Steroids 2007;72:135–43. [57] Hershberger PA, Vasquez AC, Kanterewicz B, Land S, Siegfried JM, Nichols M. Regulation of endogenous gene expression in human non-small cell lung cancer cells by estrogen receptor ligands. Cancer Res 2005;65:1598–605. [58] Ivanova MM, Mazhawidza W, Dougherty SM, Klinge CM. Sex differences in estrogen receptor subcellular location and activity in lung adenocarcinoma cells. Am J Respir Cell Mol Biol 2010;42:320–30. [59] Caamano J, Ruggeri B, Momiki S, Sickler A, Zhang SY, Klein-Szanto AJ. Detection of p53 in primary lung tumors and nonsmall cell lung carcinoma cell lines. Am J Pathol 1991;139:839–45. [60] Giard DJ, Aaronson SA, Todaro GJ, Arnstein P, Kersey JH, Dosik H, et al. In vitro cultivation of human tumors: establishment of cell lines derived from a series of solid tumors. J Natl Cancer Inst 1973;51:1417–23. [61] www.lgcstandards-atcc.org/. [62] Miki Y, Suzuki T, Abe K, Suzuki S, Niikawa H, Iida S, et al. Intratumoral localization of aromatase and interaction between stromal and parenchymal cells in the non-small cell lung carcinoma microenvironment. Cancer Res 2010;70:6659–69. [63] Dougherty SM, Mazhawidza W, Bohn AR, Robinson KA, Mattingly KA, Blankenship KA, et al. Gender difference in the activity but not expression of estrogen receptors alpha and beta in human lung adenocarcinoma cells. Endocr Relat Cancer 2006;13:113–34. [64] Bergler W, Petroianu G, Schadel A. Feasibility of proliferation studies using the BrdU and MTT assays with a head and neck carcinoma cell line. ORL J Otorhinolaryngol Relat Spec 1993;55:230–5.