Estrogen receptor alpha (ERñ), also known as NR3A1 (nuclear receptor subfamily 3, group A, member 1), is one of two main types of estrogen receptor, a nuclear receptor (mainly found as a chromatin-binding protein) that is activated by the sex hormone estrogen. In humans, ERñ is encoded by the gene ESR1 (EStrogen Receptor 1).
The estrogen receptor (ER) is a ligand-activated transcription factor composed of several domains important for hormone binding, DNA binding, and activation of transcription. Alternative splicing results in several ESR1 mRNA transcripts, which differ primarily in their 5-prime untranslated regions. The translated receptors show less variability.
Agonists of ERñ selective over ERò include:
Antagonists of ERñ selective over ERò include:
ERñ plays a role in the physiological development and function of a variety of organ systems to varying degrees, including the reproductive, central nervous, skeletal, and cardiovascular systems. Accordingly, ERñ is widely expressed throughout the body, including the uterus and ovary, male reproductive organs, mammary gland, bone, heart, hypothalamus, pituitary gland, liver, lung, kidney, spleen, and adipose tissue. The development and function of these tissues is disrupted in animal models lacking active ERñ genes, such as the ERñ knockout mouse (ERKO), providing a preliminary understanding of ERñ function at specific target organs.
ERñ is essential in the maturation of the female reproductive phenotype. In the absence of ERñ, the ERKO mouse develops an adult uterus, indicating that ERñ may not mediate the initial growth of the uterus. However, ERñ plays a role in the completion of this development, and the subsequent function of the tissue. Activation of ERñ is known to trigger cell proliferation in the uterus. The uterus of female ERKO mice is hypoplastic, suggesting that ERñ mediates mitosis and differentiation in the uterus in response to estrogen stimulation.
Similarly, prepubertal female ERKO mice develop ovaries that are nearly indistinguishable from those of their wildtype counterparts. However, as the ERKO mice mature they progressively present an abnormal ovarian phenotype in both physiology and function. Specifically, female ERKO mice develop enlarged ovaries containing hemorrhagic follicular cysts, which also lack the corpus luteum, and therefore do not ovulate. This adult ovarian phenotype suggests that in the absence of ERñ, estrogen is no longer able to perform negative feedback on the hypothalamus, resulting in chronically elevated LH levels and constant ovarian stimulation. These results identify a pivotal role for ERñ in the hypothalamus, in addition to its role in the estrogen-driven maturation through theca and interstitial cells of the ovary.
ERñ is similarly essential in the maturation and maintenance of the male reproductive phenotype, as male ERKO mice are infertile and present undersized testes. The integrity of testicular structures of ERKO mice, such as the seminiferous tubules of the testes and the seminiferous epithelium, declines over time. Furthermore, the reproductive performance of male ERKO mice is hindered by abnormalities in sexual physiology and behavior, such as impaired spermatogenesis and loss of intromission and ejaculatory responses.
Estrogen stimulation of ERñ is known to stimulate cell proliferation in breast tissue. ERñ is thought to be responsible for pubertal development of the adult phenotype, through mediation of mammary gland response to estrogens. This role is consistent with the abnormalities of female ERKO mice: the epithelial ducts of female ERKO mice fail to grow beyond their pre-pubertal length, and lactational structures do not develop. As a result, the functions of the mammary glandâÂÂincluding both lactation and release of prolactinâÂÂare greatly impaired in ERKO mice.
Though its expression in bone is moderate, ERñ is known to be responsible for maintenance of bone integrity. It is hypothesized that estrogen stimulation of ERñ may trigger the release of growth factors, such as epidermal growth factor or insulin-like growth factor-1, which in turn regulate bone development and maintenance. Accordingly, male and female ERKO mice exhibit decreased bone length and size.
Estrogen signaling through ERñ appears to be responsible for various aspects of central nervous development, such as synaptogenesis and synaptic remodeling. In the brain, ERñ is found in hypothalamus, and preoptic area, and arcuate nucleus, all three of which have been linked to reproductive behavior, and the masculinization of the mouse brain appears to take place through ERñ function. Furthermore, studies in models of psychopathology and neurodegenerative disease states suggest that estrogen receptors mediate the neuroprotective role of estrogen in the brain. Finally, ERñ appears to mediate positive feedback effects of estrogen on the brain's secretion of GnRH and LH, by way increasing expression of kisspeptin in neurons of the arcuate nucleus and anteroventral periventricular nucleus. Although classical studies have suggested that negative feedback effects of estrogen also operate through ERñ, female mice lacking ERñ in kisspeptin-expressing neurons continue to demonstrate a degree of negative feedback response.
Estrogen insensitivity syndrome is a very rare condition characterized by a defective ERñ that is insensitive to estrogens. The clinical presentation of a female was observed to include absence of breast development and other female secondary sexual characteristics at puberty, hypoplastic uterus, primary amenorrhea, enlarged multicystic ovaries and associated lower abdominal pain, mild hyperandrogenism (manifested as cystic acne), and delayed bone maturation as well as an increased rate of bone turnover. The clinical presentation in a male was reported to include lack of epiphyseal closure, tall stature, osteoporosis, and poor sperm viability. Both individuals were completely insensitive to exogenous estrogen treatment, even with high doses.
Genetic polymorphisms in the gene encoding the ERñ have been associated with breast cancer in women, gynecomastia in men and dysmenorrhea.
In patients with breast cancer, mutations in the gene encoding ERñ (ESR1) have been associated with resistance to endocrine therapy, especially aromatase inhibitors.
Coactivators of ER-ñ include:
Estrogen receptor alpha has been shown to interact with: