Progesterone is responsible for preparing the uterine lining for implantation of a fertilized ovum and to maintain pregnancy, eliciting its action through the nuclear progesterone receptor (PR). Mifepristone is a potent PR and glucocorticoid receptor (GR) antagonist with Ki values of approximately 1 nM.1 It is used in combination with misoprostol for the oral induction of first trimester abortions.1 Mifepristone promotes efficient binding of PR to hormone response elements (HRE) on DNA, but prevents transcriptional activation of the receptor.2,3,4 The IC50 of mifepristone for PR dimerization and activation is 0.6 nM; the IC50 for mifepristone-induced competitive binding of wild-type PR with a constitutively active PR for HRE is 0.01 nM.2 In anti-estrogen-resistant breast cancer cells, mifepristone induces growth arrest, caspase activation, and cell death, indicating the effectiveness of PR antagonism as a novel approach to treatment of select cancers.5
1
Cadepond, F., Ulmann, A., and Baulieu, E. RU486 (mifepristone): Mechanisms of action and clinical uses. Annu Rev Med48129-156(1997).
2
Delabre, K., Guiochon-Mantel, A., and Milgrom, E. In vivo evidence against the existence of antiprogestins disrupting receptor binding to DNA. Proc Natl Acad Sci USA904421-4425(1993).
3
Beck, C.A., Estes, P.A., Bona, B.J., et al. The steroid antagonist RU486 exerts different effects on the glucocorticoid and progesterone receptors. Endocrinology133(2)728-740(1993).
4
Edwards, D.P., Altmann, M., DeMarzo, A., et al. Progesterone receptor and the mechanism of action of progesterone antagonists. J Steroid Biochem Mol Biol53(1-6)449-458(1995).
5
Gaddy, V.T., Barrett, J.T., Delk, J.N., et al. Mifepristone induces growth arrest, caspase activation, and apoptosis of estrogen receptor-expressing, antiestrogen-resistant breast cancer cells. Clin Cancer Res105215-5225(2004).
Delabre, K., Guiochon-Mantel, A., and Milgrom, E. In vivo evidence against the existence of antiprogestins disrupting receptor binding to DNA. Proc Natl Acad Sci USA904421-4425(1993).
Edwards, D.P., Altmann, M., DeMarzo, A., et al. Progesterone receptor and the mechanism of action of progesterone antagonists. J Steroid Biochem Mol Biol53(1-6)449-458(1995).
Beck, C.A., Estes, P.A., Bona, B.J., et al. The steroid antagonist RU486 exerts different effects on the glucocorticoid and progesterone receptors. Endocrinology133(2)728-740(1993).
Cadepond, F., Ulmann, A., and Baulieu, E. RU486 (mifepristone): Mechanisms of action and clinical uses. Annu Rev Med48129-156(1997).
Gaddy, V.T., Barrett, J.T., Delk, J.N., et al. Mifepristone induces growth arrest, caspase activation, and apoptosis of estrogen receptor-expressing, antiestrogen-resistant breast cancer cells. Clin Cancer Res105215-5225(2004).