Comparing the overlap of different transcription factors can be a powerful means of inferring functional relationships, particularly when combined with expression data. Our results indicate that RARα and RARγ binding sites frequently overlap in the human genome, and comparisons of gene expression in response to isoform-specific agonists indicate considerable redundant function. Previous models of gene regulation by these crucial physiological and developmental regulators have been restricted by the focus on binding to promoters or promoter-proximal gene regions (
Balmer and Blomhoff, 2002;
Niederreither and Dolle, 2008). However, we found that the majority of RAR binding sites occur distal to TSSs. These results are reminiscent of recent studies that have revealed a similar tendency for ERα to bind to distal elements (
Carroll et al., 2006;
Hua et al., 2008;
Lin et al., 2007). The co-factor FoxA1 has been implicated in this recruitment of ERα to distal sites (
Carroll et al., 2005;
Lupien et al., 2008), and our results indicate that FoxA1 is similarly required for RAR recruitment to genomic binding sites. Likewise, GATA3 binding frequently coincides with ERα and RAR binding, although it is not strictly required for RAR recruitment. Strikingly, many of the genomic regions bound by RARs overlapped with those previously identified to bind ERα. Subsequent transcriptional analysis demonstrated that RARs and ERα tend to exhibit antagonistic effects on the transcription of target genes.
This can occur either through independent cis-regulatory elements, or more frequently, via shared binding regions of ERα and RARs (). In specific instances we tested, ERα and RARs binding was mutually exclusive, indicating competitive binding of the two nuclear receptors to the same element or nearby cis-regulatory elements. Based on the known functions of their target genes in breast cancer, ERα and RARs appear to be “Yin and Yang” for the genetic regulation of proliferation and survival that are promoted by ERα and inhibited by RARs. The finding that binding sites of RARs and ERα are coincident within the same enhancers or located in different enhancers for the same target genes, along with the finding that these two nuclear receptor signalling systems antagonistically regulate their target genes, indicates that these regulatory elements are co-evolving to balance target gene expression. Interestingly, the ERα/RAR antagonism appears to regulate itself through cross-regulatory loops between ERα, RARs and their co-factors (). This balanced control of gene expression regulates fundamental cellular processes that when dysregulated can lead to cancer.
The identification of the genes regulated by RARs in breast cancer cells, and in particular the discovery of their extensive cross-talk with estrogen signalling, may benefit breast cancer diagnostics and therapeutic intervention. Specifically, RAR and ERα binding data can diagnostically differentiate tumor subtypes and patient outcome. Putative direct targets of ERα and RARs in MCF-7 cells are highly expressed in Luminal type breast tumors, indicating that their antagonistic effects may be relevant for primary ER-positive tumors. However, RARs appear to be important regulators of cancer-relevant genes that are not regulated by estrogen. We found such RAR targets expressed at high levels in Basal-like and HER2/ER− tumors that are typically highly aggressive and associated with poor prognosis. Importantly, we demonstrated that in breast tumor samples that the expression of RAR targets identified in MCF-7 cells predicts a positive clinical outcome. Some of these genes may be targets for diagnosis and/or therapeutic intervention. Based on these findings, there is a strong rationale for the use of RA agonists in breast cancer treatment. However, success of RA-based therapies has been limited to treatment of acute promyelocytic leukaemia (
Altucci et al., 2007;
Soprano et al., 2004), while clinical applications of RA in breast and other solid tumors have shown limited effects due to RA resistance (
Freemantle et al., 2003) (
Schug et al., 2007). To harness the RA-mediated anti-carcinogenic effects of RARs in breast cancer this resistance must be overcome, perhaps via inhibition of FAB{5 to block metabolism of RA into PPARδ agonists (
Schug et al., 2008). Another potential approach would be the use of selective agonists or combination therapy with anti-estrogens in ER+/RAR+ patients. Alternatively, RA resistance could be bypassed by targeting RA-regulated genes and pathways that mediate the anti-neoplastic effects of RA in breast cancer, whose framework we have uncovered in this study.