Chapter One - Targeting steroid hormone receptors for anti-cancer therapy

Cells as we know are the smallest unit of living system which is a highly ordered system whose main function is to maintain cellular growth, metabolism, programmed cell death and interaction with extracellular matrix and adjacent cells which creates a microenvironment necessary for cell viability. Any disturbances in the cellular mechanisms or information lead to disturbed cellular functions. The disturbances are created mainly through the changes in DNA sequence of a cell which makes it vulnerable to the circumstances in its microenvironment leading to cancer like condition (Hanselmann & Welter, 2016). Only 5–10 % cancers are due to mutations that are inherited and 90–95 % is due to acquired conditions such as smoking, drinking alcohol, eating junk food and stress etc (Anand et al., 2008). Cancer is a preventable disease that requires major lifestyle changes (Anand et al., 2008). There are multiple hallmarks of cancer which makes it a complex disease. Since long, several methods have been discovered; medical facilities have been made more advanced to cure this disease. Multiple different proteins are involved in cell growth, proliferation, migration, interaction, apoptosis and many more leading to normal cellular infrastructure. Aberrant nature of any one of the proteins responsible for the above functions may lead to cancer like conditions thus characterizing it as a multistep advanced disease and hence disturbing the entire balance of the cell. Therefore, targeting a single protein or a particular pathway responsible for cancer will not eradicate this completely. For now there is surgery, radiotherapy and chemotherapy for treating cancer but surgery generally works when the tumor is benign. Further, both chemotherapy and radiotherapy are done for treating cancer when it becomes aggressive but both of these techniques hamper the health and normal cells of the body (Moding et al., 2013). Therefore, these days targeted therapeutics have gained much importance where chances for targeting only cancer cells are maximum thus causing less harm to normal cells. Keeping in consideration to this aspect, new targeted therapeutics has gained a lot of attention where nuclear hormone receptors (NHRs) are being targeted. Among NHRs, steroid hormone receptors (SHRs) are creating a new epitome of research because of its unique property in cancer cells which can be easily explored to treat cancer. Common NHR/SHRs which has gained a lot of importance is estrogen receptor (ER), progesterone receptor (PR) and androgen receptor (AR) because it is well associated with sex-related malignancies. Now-a-days glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) are also coming into limelight but their ubiquitous expression (both in cancer and non-cancer cells) limits their usage in anti-cancer therapy (Mahadik et al., 2022). In here we will understand the efficacy of targeting SHRs among NHRs as a tool for developing anti-cancer therapy. Steroid hormones, both natural and synthetic, bind to SHRs. Upon hormone binding, SHRs translocate within nucleus and thus act as transcriptional activators or repressors which can transactivate or transrepress several effector genes that regulate tumorigenesis. One of the SHRs, PR has functional activity in both cancerous and normal mammary gland cells. PR is responsible for both activating and repressing gene transcription responsible for the mammary gland development. Still researchers are exploring the relationship between the role of SHRs and its relation with the hallmark of cancer. Apart from exploring the selectivity of SHRs in cancer cells, targeting NHRs or SHRs are now-a-days creating a new path for research to treat cancer with unique treatment modalities and strategies.

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