The collective view of extranuclear ER
α signaling suggests that its transduction pathways and its interaction with IGF-IR/MAPK pathways may connect the nongenomic actions of estrogen to genomic responses, since many of them interact and regulate the phosphorylation status and activities of multiple transcription factors, which affect gene expression [
14,
27–
30]. Therefore, in this study we first investigated the gene profile involved in the MAPK pathway to explore the effects of E
2 treatment on IGF-IR/MAPK pathway related gene expression using siIGF-IR and real-time PCR array technology. As shown in and , UtLM cells treated with E
2 in the presence of an intact IGF-IR had a high induction of 27 genes including genes encoding Cyclins, Cyclin Kinases, MAPKs, MAPK kinases, and transcription factors all involved in the cell proliferation, differentiation and survival. However, by silencing the IGF-IR the effects induced by E
2 were diminished in UtLM cells and further indicated that E
2-mediated MAPK pathway activation requires the presence of the IGF-IR in UtLM cells.
A cascade of MAPKs can be induced by a variety of signaling molecules [
31,
32]. Transduction of the signals is achieved by a sequential series of phosphorylation reactions, wherein each downstream kinase serves as a substrate for the upstream activator. For example, in the mitogenic extracellular signal regulated kinase (ERK1/2) cascade, the two related mammalian MAPKs, ERK1 and ERK2 (p44mapk and p42mapk), are phosphorylated by MAP kinase/ERK kinase (MEK), which is activated primarily by the protein kinase Raf-1 after having been recruited to the plasma membrane by Ras [
33,
34]. In our previous studies, the MAPKp44/42 cascade, preferentially regulating cell growth and differentiation, was upregulated in leiomyomas [
9,
22]. The MAPK-related gene profiling RT-PCR array applied in this study further proves that the expression of genes involved in MAPK pathway, such as MAPK1, MAPK3, and GRB2, and the genes encoding transcriptional factors, ELK1, E2F1, MYC, and MAX are mediated by E
2, and their expression levels are elevated when UtLM cells are exposed to E
2 in the presence of a functional IGF-IR.
In the highly conserved cyclin family, whose members are characterized by a dramatic periodicity in protein abundance throughout the cell cycle, cyclin D1 can complex with and function as a regulatory subunit of CDK4 or CDK6, which is required for cell cycle G1/S progression [
35]. In this study, cyclin D1 and CDK4 expression levels were increased, which further indicates that E
2 not only upregulates the MAPK/ERK1/2 pathway, but can also induce cyclin family proteins leading to cell cycle progression from G1 to S phase, thereby increasing cell proliferation. It was interesting to note that some genes encoding cyclin kinase inhibitors, such as CDKN2B, were also increased following E
2 exposure and may have been increased to counterbalance the extremely high expression of CDK4. These findings are consistent with the concept of different cyclins and their kinases exhibiting distinct expression and degradation patterns which contribute to the temporal coordination of each mitotic event [
35].
The abrogation of upregulation of genes by E
2 in the presence of siIGF-IR in UtLM cells further strengthened our hypothesis that IGF-IR plays an important role in the crosstalk between the estrogen/ER
α and IGF-I/MAPKp44/42 pathways. However, other genes were differentially expressed by E
2 treatment in UtLM cells with and without siIGF-IR, which indicates that with silencing of the IGF-IR, other mechanisms compensated in response to E
2 exposure, resulting in differential gene expression. The increased EGFR, EGR1, CCND2, and CCND3 gene expression pattern with siIGF-IR suggests that E
2 treatment promotes alternative pathways for growth and survival when IGF-IR levels are decreased in UtLM cells. In other genes, such as DLK-1, involved in fibrosis [
36], the expression level was increased, and COL1A1, a gene involved in collagen synthesis and fibrosis, which is typically increased in the presence of a functional IGF-IR [
37,
38], was decreased after siIGF-IR further indicating that IGF-IR may play an important role in fibrosis in uterine leiomyomas.
We next investigated whether E
2 upregulates IGF-I and IGF-IR, and their target proteins in leiomyoma cells, and what mechanisms are involved in the interaction between E
2/ER
α and IGF-I/IGF-IR pathways. We found that IGF-I gene and protein expression levels increased during the course of E
2 exposure with a peak fold-change at 48 hours in UtLM cells; this prolonged response indicates a possible mechanism of IGF-I gene expression mediated by E
2 at a genomic level. We also found that phosphorylated ER
αser118, IGF-IR
β, and their target protein MAPKp44/42 were all increased within minutes after E
2 treatment. The rapid activation of IGF-IR and its target downstream proteins indicates that the interaction between E
2 and IGF-IR is mediated by nongenotropic signaling, that is, by kinase-initiated events that do not involve estrogen receptor binding to canonical steroid response elements on DNA [
18,
28]. Furthermore, increased colocalization of phospho-MAPKp44/42 and ER
αser118 occurred in UtLM cells 10 minutes after E
2 treatment. These results are consistent with the findings that several mechanisms are associated with E
2 exposure, including rapid activation of IGF-IR and MAP kinase, a nongenomic process observed in estrogen-responsive breast cancer cell lines [
39], which could lead to ER
α activation at serine 118 [
14,
28].
The molecules involved in the nongenomic signaling process have been identified. More recently, it has been shown that a pool of ERs resides in or is associated with the plasma membrane. These ERs utilize the membrane IGF-IR to rapidly signal through various kinase cascades that influence both transcriptional and nontranscriptional actions of estrogen [
28]. In this study, UtLM cells treated with E
2, showed upregulation of RAC1, a Rho GTPase involved in the regulation of several cellular processes that is often activated following stimulation of RTKs [
24]. This gene expression of RAC1 was decreased upon IGF-IR silencing. These data indicate that E
2 can directly, or through the involvement of the ER
α, activate IGF-IR and MAPK signaling. The IGF-IR may serve as an anchor for the plasma membrane-associated ER
α. Estradiol causes rapid phosphorylation of IGF-IR and Shc. It has been reported that activated Shc, after binding to ER
α, serves as a transporter, which carries ER
α to Shc-binding sites on the activated IGF-I receptors [
39], which subsequently signals to MAPKs and other pathways. Our immunoprecipitation results also show that these three proteins, ER
α, IGF-IR, and Shc, are associated with each other when UtLM cells are treated with E
2. Therefore, we proposed that IGF-IR should be a key mediator in this interaction, and applied siIGF-IR methodology to knockdown the IGF-IR gene to block the E
2 effect on the interaction of these two pathways through their respective receptors. We found that siIGF-IR decreased the phosphorylation of IGF-IR
β and the activation of MAPKp44/42 induced by E
2. At same time, ER
α phosphorylation at the serine118 site was also attenuated. These findings indicate that IGF-IR
β activation is required in the rapid nongenomic response of ER
α following E
2 exposure in UtLM cells. Silencing of IGF-IR abrogated the ER
α activity at the serine118 site induced by E
2 confirming a potential relationship between membrane-related signals and intracellular ER
α, in agreement with the findings that E
2 binds to cell membrane-associated ER
α, which physically associates with the adaptor protein Shc through IGF-IR activation and induces its phosphorylation [
39]. In turn, Shc binds GRB2 and Sos, which also results in the rapid activation of MAP kinase, and we have shown an association between IGF-IR and Grb2 and MAP kinase activation in fibroid tissue samples taken from women in the proliferative phase of the menstrual cycle [
9,
40].
Therefore, the possible convergence of distinct ER
α-mediated genomic and/or nongenomic actions at multiple response elements provides an extremely fine control system in the regulation of target gene transcript [
14] leading to the alternation of gene expression profiles found in this study. In conclusion, the results obtained in this study indicate that the two growth regulatory pathways, E
2/ER
α and IGF-I/IGF-IR, are tightly linked in UtLM cells. The E
2 effects can occur through both genomic and nongenomic events, which involve IGF-IR activation of MAP kinase cascades mediated by the association between ER
αser118 and MAPKp44/42 (). The observations that: (1) IGF-IR is required for the interaction and the differential expression of MAPK pathway-related genes mediated by E
2; (2) IGF-I gene expression is responsive to E
2; (3) the activation of alternative pathways induced by E
2 when IGF-IR is silenced enhances our understanding of IGF-I/IGF-IR and E
2/ER
α interactions and may suggest a multipronged or cocktail approach to fibroid treatment. Considering that the pure antiestrogen or anti-IGF-IR agents may only be partially effective in antagonizing E
2-induced IGF-I/MAPK pathway activation and because other alternative pathways (EGFR) could compensate, it suggests that inhibitors of small downstream molecules, such as Src and ERKs, or transcription factors may better block these effects and could possibly serve as noninvasive adjuvant therapies for fibroids.