Endocrinology Vol. 138, No. 9 3711-3718
Copyright © 1997 by The Endocrine Society
1,25-Dihydroxyvitamin D3 Regulates Estrogen Metabolism in Cultured Keratinocytes1
Susan V. Hughes,
Elaine Robinson,
Rosemary Bland,
Helen M. Lewis,
Paul M. Stewart and
Martin Hewison
Department of Medicine, Queen Elizabeth Hospital, University of
Birmingham, Birmingham, United Kingdom B15 2TH; and the Department of
Dermatology, Selly Oak Hospital (H.M.L.), Birmingham, United Kingdom
B29 6JD
Address all correspondence and requests for reprints to: Dr. M. Hewison, Department of Medicine, Queen Elizabeth Hospital, University of Birmingham, Birmingham, United Kingdom B15 2TH. E-mail:
M.Hewison{at}bham.ac.uk
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Abstract
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Local estrogen metabolism may play an important role in modulating cell
development in peripheral tissues such as breast, adipose, and bone.
C19 androgens are converted to C18
estrogens by the enzyme aromatase, overexpression of which is
associated with breast cancer. Interconversion of active estradiol
(E2) to inactive estrone is controlled by various isoforms
of the enzyme 17ß-hydroxysteroid dehydrogenase (17ßHSD). We have
studied the expression of these two enzymes in human keratinocytes and
report rapid changes in 17ßHSD activity in response to treatment with
1,25-dihydroxyvitamin D3
[1,25-(OH)2D3]. Keratinocytes cultured in
serum-free medium showed aromatase activity of 2.5 fmol/h·mg cell
protein, which was unaffected by any culture treatment. A much higher
level of 17ßHSD activity was observed in the keratinocytes,
predominantly conversion of E2 to estrone (
120
pmol/h·mg cell protein). This inactivation of E2
increased in a dose-dependent fashion after treatment of the cells with
antiproliferative doses of
1,25-(OH)2D3 (0.1200
nM). The effect of
1,25-(OH)2D3 on 17ßHSD activity was
enhanced by simultaneous treatment with dexamethasone, which also
increased the antiproliferative action of
1,25-(OH)2D3. Reverse
transcription-PCR and Northern analysis showed that keratinocytes
expressed messenger RNA for three 17ßHSD isoenzymes (types I, II, and
IV). Treatment with 1,25-(OH)2D3 (10
nM for 20 h) resulted in the up-regulation of
messenger RNA levels for type 2 17ßHSD. Further RNA studies combined
with E2 binding experiments demonstrated the presence of
estrogen receptors in the cultured keratinocytes. These data indicate
that keratinocytes are potential targets for systemically or locally
produced estrogens, which may, in turn, play a key role in the
development of normal skin. In particular, we propose that 17ßHSD
isoenzymes are key target genes for
1,25-(OH)2D3 in keratinocytes and may
be an important feature of the antipsoriatic effects of vitamin D and
its analogs.
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Introduction
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THE ACTIVE form of vitamin D,
1,25-dihydroxyvitamin D3
[1,25-(OH)2D3], is a seco-steroid
that influences a wide variety of tissues and functions (1).
Classically, 1,25-(OH)2D3 modulates
calcium homeostasis by stimulating calcium transport across the gut and
calcium mobilization from bone (2). However, in recent years it has
become clear that 1,25-(OH)2D3 can
influence tissue and functions not immediately involved in calciotropic
activity (1). In part, this has stemmed from studies that have
described the ubiquitous nature of the receptor for
1,25-(OH)2D3 [vitamin D receptor
(VDR)] (3). Other groups have reported synthesis, via the enzyme
1
-hydroxylase, of 1,25-(OH)2D3 at
extrarenal sites (4). Key cell types that express both VDR and
1
-hydroxylase activity are keratinocytes and monocytes, highlighting
a possible paracrine or autocrine role for
1,25-(OH)2D3 in modulating the
functions of skin and the immune system (5, 6). The most important
action of 1,25-(OH)2D3 in these
tissues is its ability to act as an antiproliferative/differentiative
agent. This has raised the possibility of the clinical application of
1,25-(OH)2D3 as both an inhibitor of
keratinocyte proliferation and an immunosuppresive agent (7).
Several difficulties are associated with the therapeutic use of
1,25-(OH)2D3, the most obvious being
its potent hypercalcemic side-effects. This has in part been addressed
by the development of vitamin D analogs that have low calciotropic
activity while retaining the antiproliferative effects of
1,25-(OH)2D3 (8). The use of these
analogs as therapy for immune proliferative disorders such as leukemia
has met with limited success. Indeed, recent studies of animal models
suggest that a more effective use for
1,25-(OH)2D3 may be as a T
cell-modulating immunosuppresive agent (7). However,
1,25-(OH)2D3-like analogs such as
calcipotriol (MC903) and tacalcitol are now widely and successfully
used in the topical treatment of psoriasis (9). Most studies have shown
a marked decrease in epidermal proliferation in response to vitamin D
treatment, albeit without any significant effect on the inflammatory
infiltrate associated with psoriasis (10).
Although there is much interest in the clinical use of vitamin D
analogs, it is clear that our understanding of the mechanisms by which
1,25-(OH)2D3 achieves its
antiproliferative effects is far from complete. In this study we have
investigated a possible role for novel steroid hormone interactions in
mediating nonclassical effects of
1,25-(OH)2D3. Specifically, we have
characterized local estrogen production by keratinocytes and have
sought to determine whether this is a target for the antiproliferative
agent, 1,25-(OH)2D3. Data indicate
that both aromatase and 17ß-hydroxysteroid dehydrogenase (17ßHSD)
enzymes are expressed by keratinocytes, with the predominant activity
being 17ßHSD-catalyzed conversion of estradiol (E2) to
estrone (E1). Further studies have shown that the
antiproliferative effect of
1,25-(OH)2D3 is associated with rapid
stimulation of 17ßHSD messenger RNA (mRNA) expression and activity.
As well as highlighting the potential importance of vitamin D-estrogen
interactions in regulating cell proliferation, these studies suggest
that both systemically and locally produced estrogens may play a key
role in directing keratinocyte development.
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Materials and Methods
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Cell culture
Purified human foreskin keratinocytes (Promocell, Heidelburg,
Germany) were cultured in phenol red-free, serum-free, defined medium
based on a modified MCDB 153 preparation with 28 mM HEPES
buffer and containing the following additives: calcium chloride (0.15
mM), epidermal growth factor (recombinant human; 0.1
ng/ml), insulin (bovine; 5.0 µg/ml), hydrocortisone (0.5 µg/ml),
gentamicin (50 µg/ml), and amphotericin B (2.5 µg/ml). Each batch
of keratinocytes was cultured for no more than five passages. Cells
were seeded at a density of 10,000 cell/cm2, and medium was
changed every 2 days. Experimental cultures were grown to approximately
70% confluency in 24-well plates before the addition of the various
treatments, including 1,25-(OH)2D3
(0.1200 nM; a gift from Dr. M. Uskukovic, Hoffman
LaRoche, Nutley, NJ), 9-cis-retinoic acid (10
nM), dexamethasone (DEXA; 100 nM),
E2 (100 nM), and E1 (100
nM; all from Sigma Chemical Co., St. Louis, MO).
Estrogen metabolic assays
Aromatase activity was assessed by a water release assay using
[1ß-3H]androstenedione ([3H]1ßA;
SA, 30 Ci/mmol; New England Nuclear, Boston, MA) as substrate. Assays
were carried out in 24-well plates using 0.5-ml aliquots of medium
supplemented with 40 nM [3H]1ßA. Monolayers
were incubated with substrate for 5 h, after which the culture
medium was removed, and steroids were extracted using chloroform. The
aqueous layer was retained and contained 3H2O
produced in a molar equivalent to E1 after
aromatase metabolism of [3H]1ßA. Residual substrate
contamination of the aqueous layer was further limited by addition of
dextran-activated charcoal and centrifugation at 1000 x
g for 15 min. Aliquots of the resulting supernatant were
then removed and added to 5 ml scintillant before scintillation
counting. Data were reported as femtomoles per h/mg cellular
protein.
17ßHSD activity was assessed using [3H]E1
or [3H]E2 as substrate (SA for both,
80
Ci/mmol; Amersham, Aylesbury, UK). Assays were carried out in 24-well
plates using 0.5-ml aliquots of medium supplemented with 100
nM [3H]E1 or
[3H]E2. Cells were incubated with substrate
for 5 h, after which the culture medium was removed, and steroids
were extracted using chloroform. Vacuum-dried chloroform extracts were
then plated on silica TLC plates (Fluka), and estrogen metabolites were
separated using 80% chloroform-20% ethyl acetate as a running
solvent. Quantification of the conversion of
[3H]E1 to [3H]E2
and of [3H]E2 to
[3H]E1 was carried out by scanning
radioactive analysis using a Bioscan System 200 imaging scanner (Lab
Logic, Sheffield, UK). Data were reported as picomoles per h/mg
cellular protein.
Analysis of keratinocyte proliferation
Data for aromatase and 17ßHSD assays were normalized by
analyzing changes in the protein content of keratinocyte monolayers.
After removal of culture medium for enzyme assay, cell monolayers were
lysed in 1 ml water, and 0.2-ml aliquots were used for standard protein
assays (Bio-Rad, Richmond, CA). Enzyme activity values are shown per mg
cellular protein. Quantification of changes in keratinocyte
proliferation was carried out by measuring the incorporation of
[3H]thymidine (80 Ci/mmol; Amersham). Cell cultures were
supplemented with 1 µCi [3H]thymidine for 5 h and
then pulsed with 1 mmol unlabeled thymidine to eliminate nonspecific
incorporation of the nucleotide. Isolated keratinocyte nuclei were
dissolved in sodium hydroxide and added to scintillation fluid, and
radioactivity was counted by standard methods.
Analysis of mRNA expression
Total RNA was isolated from keratinocyte cultures using RNeasy
preparative minicolumns as described by the manufacturer (Qiagen,
Chatsworth, CA). An optional incubation step to reduce DNA
contamination was included using QiaShredder minicolumns (Qiagen).
Reverse transcription-PCR (RT-PCR) analysis was carried out using 1
µg total RNA, which was reverse transcribed using Promegas AMV
reverse transcriptase kit, at 42 C (1 h), according to the
manufacturers protocol. At the end of the reaction, samples were
heated to 95 C for 5 min. An aliquot of this RT reaction was then used
as template for subsequent PCR reactions. PCR analysis of complementary
DNAs (cDNAs) for 17ßHSD isoenzymes (types IIV) was carried out
as described previously (11). The following primers were used: 17ßHSD
I: 5'-primer, AGG CTT ATG CGA GAG TCT GG; 3'-primer, CAT GGC GGT GAC
GTA GTT GG; 17ßHSD II: 5'-primer, CTG AGG AAT TGC GAA GAA CC;
3'-primer, GAA GTC CTT GCT GGC TAA CG; 17ßHSD III: 5'-primer, ACA ATG
TCG GAA TGC; 3'-primer, AGG TTG AAG TGC TGG TCT GC; and 17ßHSD IV:
5'-primer CTA TTG GCC AGA AAC TCC CT; 3'-primer, GGA CCT TGG TTT GAA
AAT GA. PCR primers for estrogen receptor (ER) were as follows:
5'-primer, TGA CTA TGC TTC AGG CTA C; and 3'-primer, CTT TCA TCA TTC
CCA CTT C. PCR reactions (20 µl) were set up using 2-µl aliquots of
cDNA, primers at a final concentration of 0.5 µM, and 1 U
Taq polymerase (Promega). PCR buffer contained deoxy-NTPs
(0.2 mM), MgCl2 (1.5 mM), KCl (50
mM), Tris-HCl (10 mM; pH 8.3), and gelatin
(0.01%, wt/vol). Samples were amplified using an initial denaturation
cycle of 95 C for 3 min, followed by 30 cycles of 95 C (1 min), 55 C (1
min; ER and 17ßHSD IV) or 60 C (1 min; 17ßHSD IIII), and 72 C (2
min). A final elongation step of 72 C for 7 min was also included.
Northern blotting analysis was carried out using aliquots (15 µg) of
RNA from control and
1,25-(OH)2D3-treated keratinocytes.
RNA was separated by denaturing gel electrophoresis and blotted onto
Hybond N-plus nylon filters (Amersham). After fixation by UV
irradiation, filters were prehybridized for 3 h using a modified
phosphate buffer containing 0.78 M sodium phosphate (pH
7.2; 0.2 M
NaH2PO4·H2O and 0.58
M Na2HPO4), 5 mM EDTA,
7% SDS, and sonicated salmon sperm DNA (100 ng/ml). Radiolabeled
probes for 17ßHSD I, II, and IV were derived from the amplified cDNA
fragments produced in the RT-PCR studies. DNA bands were isolated from
low melting point agarose gels and used as templates (2550 ng) in
random priming labeling preparations (Multiprime, Amersham, UK). After
hybridization for 16 h at 65 C, filters were washed three times in
1 x standard sodium citrate (1 x SSC) with 0.1% SDS at
room temperature, followed by a 0.3 x SSC-0.1% SDS wash at 55 C
(30 min) and a 0.1 x SSC-0.1% SDS wash at 65 C. Washed filters
were then exposed to DuPont Cronex film (Wilmington, DE) for various
time periods before development of autoradiographs.
Analysis of nuclear binding of E2 and
E1
The number of intracellular receptors for
E2 was assessed by whole cell nuclear association
assays using [3H]E2 and
[3H]E1 as ligands (SA, 80100
Ci/mmol; Amersham). Assays were carried out as follows. Monolayers of
keratinocytes were trypsinized and washed twice with serum-free medium
to remove traces of trypsin. Cell pellets were resuspended in
serum-free medium to give 0.5 x 107 cells/ml.
Aliquots of this cell suspension (0.2 ml) were then added to glass
tubes containing increasing doses of [3H]E2
or [3H]E1 (0.210 nM) in the
presence or absence of a 200-fold excess of unlabeled E2 or
E1 (to determine nonspecific binding). Cells were then
incubated at 37 C for 1 h to allow association of ligand-ER
complexes with keratinocyte nuclei. Cells were washed three times with
0.5-ml aliquots of cold PBS including 5-min centrifugation steps at
500 x g. The final cell pellets were incubated with
0.5 ml lysis buffer (containing 0.25 M sucrose, 20
mM HCl, 1.1 mM magnesium chloride, and 0.5%
Triton X-100) and centrifuged for 5 min at 1000 x g to
isolate crude nuclear pellets. This step was repeated again, and the
resulting nuclei were resuspended in 0.1 ml PBS and 0.5 ml ethanol and
then transferred to 5 ml scintillation fluid before scintillation
counting.
Statistics
Assays for hormone metabolism and keratinocyte proliferation
were carried out in quadruplicate and reported as the mean ±
SD. Analysis of differences between values for various
treatments was carried out using unpaired Students t
tests.
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Results
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Preliminary investigations indicated that aromatase and 17ßHSD
activities were both detectable in monolayers of human keratinocytes
cultured in defined medium containing 0.15 mM calcium.
Enzyme assays were optimized for 5-h incubations using 20200
nM [3H]A (aromatase) and 20500
nM [3H]E1 and
[3H]E2 (17ßHSD; data not shown). Parallel
studies also indicated that substrate conversion was similar when using
either medium or cell monolayers (data not shown). However, additional
assays were carried out using only cell medium, as this contained
higher levels of both substrate and product, thereby providing more
reproducible data. Both aromatase and 17ßHSD showed a linear increase
in activity over respective concentration ranges, and subsequent assays
were carried out using 40 nM [3H]A and 100
nM [3H]E1 or -E2. At
these substrate concentrations, aromatase and 17ßHSD activities
remained linear for incubation periods up to 9 h. Subsequent
assays were routinely carried out using incubation periods of 5 h.
Results in Fig. 1
show typical TLC
analyses of 17ßHSD activity in control cultures and cells treated
with 10 nM 1,25-(OH)2D3
for 20 h. Control keratinocytes were able to metabolize both
[3H]E1 and [3H]E2.
The predominant activity was conversion of E2 to
E1 (20% conversion of substrate). Metabolism of
E1 to E2 was approximately 4% of substrate
(27 ± 8 pmol/h·mg protein), which was unaffected by treatment
with 1,25-(OH)2D3 (25 ± 10
pmol/h·mg protein). In contrast, conversion of E2 to
E1 increased by approximately 2-fold after treatment with
10 nM 1,25-(OH)2D3 for
20 h.

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Figure 1. Effect of
1,25-(OH)2D3 on the interconversion
of E2 and E1 in cultured keratinocytes. Cells
were cultured in the absence or presence of
1,25-(OH)2D3 (10 nM) for
20 h and then incubated with either 100 nM
[3H]E2 or 100 nM
[3H]E1 for an additional 5 h.
Supernatants were chloroform extracted and separated by TLC. The data
shown are typical scanning analyses of TLC plates, showing conversion
of E2 to E1 and of E1 to
E2.
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Further studies of E2 inactivation by 17ßHSD showed that
conversion to E1 was stimulated in a dose-dependent fashion
after treatment with increasing concentrations of
1,25-(OH)2D3 (Fig. 2B
). This effect paralleled the
dose-dependent inhibition of keratinocyte proliferation induced by
1,25-(OH)2D3 (Fig. 2A
). The putative
relationship between keratinocyte proliferation and
E2 inactivation was assessed in more detail by
the data shown in Fig. 3
. Analysis of
17ßHSD activity (Fig. 3A
) indicated that conversion of E2
to E1 was unaffected by the addition of
9-cis-retinoic acid (10 nM), although the
retinoid produced a significant decrease in cell proliferation.
Cotreatment with 1,25-(OH)2D3 and
9-cis-retinoic acid did not enhance the effects of
1,25-(OH)2D3 on cell proliferation or
17ßHSD activity. In contrast, DEXA (100 nM) induced a
significant rise in 17ßHSD activity, which was additive when
1,25-(OH)2D3 and DEXA were used as
cotreatments. DEXA on its own had no effect on keratinocyte
proliferation, but significantly enhanced the antiproliferative effects
of 1,25-(OH)2D3 when the two hormones
were added together (Fig. 3B
).

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Figure 2. Dose-dependent changes in keratinocyte
proliferation and estrogen metabolism. Parallel cultures of
keratinocytes were treated with
1,25-(OH)2D3 (0.1200
nM) for 20 h. Cells were then assessed for
proliferation (A) and E2 to E1 conversion (B).
17ßHSD activity was normalized per h/mg cellular protein for each
assay replicate. Values are the mean ± SD of
quadruplicate samples from a single assay. Experiments were carried out
at least twice.
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Figure 3. Effects of modulators of keratinocyte
proliferation on E2 inactivation. Log-phase
cultures of keratinocytes were treated with the following agents in the
absence or presence of 10 nM
1,25-(OH)2D3: vehicle only (control
cells), 10 nM 9-cis-retinoic acid (9-CIS),
100 nM DEXA, 100 nM E1, and 100
nM E2. Each treatment was then assessed for
changes in proliferation (A) and E2 to
E1 inactivation (B). E1 and
E2 treatments were assessed for changes in proliferation
only (B). Values are the mean ± SD of quadruplicate
samples from a single assay. Each experiment was carried out at least
twice. *, Significantly different from untreated control
(P < 0.01); **, significantly different from
1,25-(OH)2D3-treated cells
(P < 0.01).
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Analysis of aromatase-catalyzed conversion of androstenedione to
E1 indicated a much lower level of activity
compared with 17ßHSD (2.1 ± 0.4 fmol/h·mg protein).
Furthermore, this activity was unaffected by 20-h exposure to
1,25-(OH)2D3 or any of the other
culture treatments. RT-PCR analysis indicated that keratinocytes
expressed several of the variable aromatase promoter mRNA species,
including the 1.4-III transcript, which has been shown to be enhanced
in breast cancer cell lines after treatment with glucocorticoids (data
not shown).
The results presented in Fig. 4
indicated
that keratinocytes expressed mRNA for several 17ßHSD isoforms. RT-PCR
analysis identified keratinocyte transcripts for 17ßHSD types I, II,
and IV, which were also present in appropriate positive controls (Fig. 4A
). All three transcripts were detectable in control and
1,25-(OH)2D3-treated keratinocytes.
Type III 17ßHSD mRNA was undetectable in keratinocytes, but was
faintly expressed in rat testis and more strongly in SW620 colonic
cancer cells (routinely used by our laboratory as a control for this
isoenzyme). Changes in the levels of mRNA expression for the 17ßHSD
isoforms were assessed by Northern analysis using radiolabeled PCR
fragments. The results in Fig. 4B
indicated that treatment with
1,25-(OH)2D3 for 20 h stimulated
expression of type I and II 17ßHSD mRNA. Relative densitometry
analysis (corrected for 18S ribosomal RNA expression) indicated that
1,25-(OH)2D3 increased type I
expression by a mean of 45% and increased type II expression by a mean
of 105% (data not shown).

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Figure 4. RT-PCR and Northern analysis of 17ßHSD
isoenzymes in keratinocytes. A, RNA was reverse transcribed using
oligo(deoxythymidine) primers, and cDNAs were amplified using primers
specific for 17ßHSD isoforms 14. Sample organization for each set
of PCR reactions was as follows: 1) DNA markers; 2 and 4) control
keratinocytes (-); 3 and 5) keratinocytes plus 10 nM
1,25-(OH)2D3 (+); 6) placenta; 7)
testis; and 8) water blank. Analysis of 17ßHSD type III also included
RNA from SW620 colonic cancer cells as a positive control. B, Northern
analysis of RNA from control and
1,25-(OH)2D3-treated keratinocytes
was carried out using radiolabeled probes for 17ßHSD types I, II, and
IV generated from the RT-PCR fragments shown in A. Sample loading was
normalized by probing for 18S ribosomal RNA.
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Further proliferation studies suggested that estrogens themselves may
influence keratinocyte development. Cells treated with 100
nM E1 or 100 nM E2
showed a small, but significant, decrease in proliferation (Fig. 3B
).
In particular, the effect of E1 (22% inhibition of
proliferation) was similar to that observed with 10 nM
1,25-(OH)2D3. E1 and
1,25-(OH)2D3 did not have an additive
effect when used as cotreatments. To investigate further the impact of
estrogens on keratinocytes, we assessed ER mRNA expression and
E1 and E2 binding in untreated cells (Fig. 5
). RT-PCR analysis (Fig. 5A
) revealed
the presence of an ER transcript similar in size to that found in human
placenta. Whole cell nuclear association assays using radiolabeled
E2 (the preferred ligand for ER) indicated that there was
specific estrogen binding in keratinocytes. The mean Kd
value derived from Scatchard plots (2.1 nM) was similar to
that previously described for ER, as were the numbers of receptors per
cell (mean, 40,200). Parallel studies indicated that keratinocytes were
also able to bind radiolabeled E1, although this was at a
lower affinity as reflected by the higher mean Kd value
(4.1 nM). The maximal binding capacity for E1
was slightly higher than that for E2 (mean, 45,900
ER/cell).

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Figure 5. ER expression in keratinocytes. A, RNA from
untreated keratinocytes (-) and cells treated with 10 nM
1,25-(OH)2D3 (+) was reverse
transcribed using oligo(deoxythymidine) primers. The resulting cDNA was
amplified using ER-specific primers. The positive control was placental
RNA (plac). B, Binding of [3H]E2 or
[3H]E1 was determined by whole cell
nuclear association assay using ligand concentrations of 0.120
nM in the presence or absence of a 200-fold excess of
unlabeled E2 or E1. Data
were assessed by Scatchard analysis.
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Discussion
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As the largest organ in the human body, the skin may make a
significant contribution to both local and systemic hormone production.
An established endocrine role for skin is in the photochemical
conversion of 7-dehydrocholesterol to the parental vitamin
D3 molecule. However, it now clear that the skin has much
wider steroidogenic activity. In particular, skin cells have been
reported to express a range of enzymes involved in the synthesis of
androgens (12). Previous studies have shown that keratinocytes and
fibroblasts are able to convert inactive androgens such as
dehydroepiandrosterone to active androgens such as dihydrotestosterone
via the enzymes 3ßHSD and 5
-reductase (13, 14). More recent
reports indicate that components of the pilosebaceous unit, including
keratinocytes from the inner and outer root sheaths, express mRNA for
several steroidogenic enzymes, with 17ßHSD type II present in
particularly high levels (15). These data suggest a possible role for
local androgen metabolism in fetal sebaceous gland development as well
as the pathogenesis of acne and androgen-dependent hair loss.
The presence of aromatase and 17ßHSD in skin components represents
additional potential steps in the synthesis of active sex hormones.
17ßHSD modulates the activity of both estrogens and androgens by
catalyzing the metabolism of 17-ketosteroids and their
17ß-hydroxysteroid counterparts. This includes the interconversion of
androstenedione and testosterone and that of E1
and E2. In both of these cases reduction to the
17ß-hydroxysteroid (e.g. testosterone and
E2) produces the more active configuration (16).
Four different human 17ßHSD isoforms have been cloned to date, each
of which may play a specific role in modulating estrogen and androgen
levels (17, 18, 19, 20). Previous studies have shown that antiproliferative and
differentiative agents may have modulatory effects on 17ßHSD enzymes.
Glucocorticoids have been shown to increase 17ßHSD IV in THP-1
leukemic monocytes (21), whereas retinoic acid appears to stimulate
17ßHSD I in breast cancer cells (22, 23). In this study we have
characterized estrogen metabolism in keratinocytes, a key target tissue
for the antiproliferative agent
1,25-(OH)2D3. Our data indicate that
regulation of 17ßHSD (primarily type II) is associated with the
antiproliferative effects of
1,25-(OH)2D3, highlighting a possible
role for estrogens as modulators of keratinocyte proliferation.
The observed aromatase and 17ß-dehydrogenase activities in
keratinocytes show for the first time that keratinocytes have a
capacity for estrogen metabolism similar to that of more well
characterized peripheral tissue such as breast. Furthermore, the
predominant oxidative activity of 17ßHSD is in agreement with other
estrogen target tissues, in which regulation of E2
availability may influence the mitogenic impact of the hormone. The
relationship among peripheral 17ßHSD activity, ER expression, and
E2 concentrations has been studied extensively in breast
tissue (24, 25, 26). Oxidative pathways tend to be dominant in ER-negative,
nonresponsive cells, whereas reductive activity is higher in
ER-positive, estrogen-responsive cells (27). The situation in
keratinocytes is clearly different in view of the significant numbers
of ER detected in these cells. This may be a feature of primary
keratinocyte cultures per se. However, our data were derived
using serum- and phenol red-free medium, which allowed us to quantify
17ßHSD activity in cultured intact cells rather than tissue
homogenates. This approach appears to provide a more accurate
representation of estrogen/androgen metabolism in vivo (27).
With this is mind, we can perhaps speculate that the role of 17ßHSD
activity in keratinocytes is a protective one, modulating the
potentially mitogenic effects of E2.
Overall, our findings support the idea of skin being an
estrogen-responsive tissue, in which effects of the hormone are tightly
regulated by local 17ßHSD activity. Furthermore, the rapid
stimulation of 17ßHSD activity after treatment with antiproliferative
doses of 1,25-(OH)2D3 raises the
possibility of a new nonclassical function for this pleiotropic
hormone. Significant changes in 17ßHSD activity were observed with
concentrations as low as 1 nM, suggesting physiological
importance. This is emphasized by previous reports that have suggested
that endogenously produced
1,25-(OH)2D3 may play a key role in
regulating keratinocyte development in vivo (28).
Cotreatment studies indicate that a mechanism linking
1,25-(OH)2D3, keratinocyte
proliferation, and estrogen metabolism is likely to be very complex.
For example, the actions of
1,25-(OH)2D3 were unaffected by
simultaneous treatment with 9-cis-retinoic acid (the ligand
for VDRs heterodimer partner, retinoid X receptor). In contrast,
combined treatment with DEXA enhanced the estrogenic and
antiproliferative effects of
1,25-(OH)2D3. A precise mechanism for
this action remains to be determined, but it is likely that this will
involve other steroidogenic processes known to be influenced by
glucocorticoids. It was particularly important to note that although
treatment with DEXA alone up-regulated 17ßHSD activity, there was no
parallel change in cell proliferation. This would suggest that the link
between E2 inactivation and keratinocyte
proliferation is not direct, although clearly this requires further
investigation.
The Northern analyses shown in this study indicate that keratinocytes
express inducible 1.3-kilobase (kb) mRNAs for both 17ßHSD I and II;
increased expression of these transcripts provides the first direct
evidence for regulation of estrogen metabolism by
1,25-(OH)2D3. These findings are in
agreement with previous studies that have shown that the 1.3-kb mRNA
for 17ßHSD I is up-regulated by retinoic acid, whereas the 2.3-kb
transcript remains uninduced (22, 23). The likely gene target for the
estrogenic effects of 1,25-(OH)2D3 is
17ßHSD II, which showed the most significant increase in expression
after vitamin D treatment. A small change in 17ßHSD I was also
observed in keratinocytes after treatment with
1,25-(OH)2D3, but there was no
parallel up-regulation of reductive activity. Disparity between changes
in mRNA expression and actual activity may, of course, simply reflect
the relative abundance of one cofactor vs. another. In other
words, although type I activity is NADPH dependent, type II activity is
NAD dependent. Keratinocytes cultured as described in this system may
thus be predisposed toward estrogen inactivation via more efficient NAD
utilization.
The data presented here have extended the original concept of skin as a
key source of steroid hormones, and in particular, we have highlighted
the sensitive control of estrogen metabolism in keratinocytes. Recent
studies of the effects of exogenously added estrogen and progesterone
on keratinocyte proliferation suggested a biphasic effect, in which low
doses of hormone (<0.1 nM) were stimulatory and higher
doses (up to 100 nM) were inhibitory (29). The doses of
E2 and E1 used in our study were relatively
high (100 nM) and were growth inhibitory. Interestingly,
the effect of E2 on keratinocyte proliferation was only
marginal, whereas E1 was as potent as 10 nM
1,25-(OH)2D3. This is perhaps
surprising in view of the established role of E1 as an
inactive estrogen. Scatchard analyses of ER binding characteristics
suggest that in keratinocytes, the receptor has a 2-fold greater
affinity for E2 compared with E1, although
maximal binding values were similar. This difference in Kd
values agrees with the findings of recent studies that examined ligand
binding specificity for ER
and ER ß (30). Our data, therefore,
suggest that the product of estrogen metabolism in keratinocytes,
E1, can itself have cell modulatory effects. These may be
mediated via either classical or nonclassical estrogenic pathways.
These findings are clearly important when considering the development
of normal skin function in vivo. The proliferation (and
differentiation) of keratinocytes is likely to be heavily influenced by
estrogenic activity. Thus, naturally occurring variations in estrogen
and androgen levels may have a substantial impact on keratinocyte
function in both the normal and the psoriatic epidermis. Previous
studies have reported peaks of psoriasis at puberty and the menopause
or improvement in psoriasis during pregnancy, followed by deterioration
postpartum (31, 32). Regulation of local 17ßHSD and aromatase
activity may also play a role in the homeostasis of hair follicles and
sebaceous glands; disorders such as acne and androgen-dependent hair
loss are known to involve abnormal control of androgen function.
Furthermore, an established feature of the inherited disorder vitamin
D-resistant rickets is partial or total alopecia (33). In summary, the
data presented here confirm that there is considerable potential for
local estrogen metabolism in skin. We have also shown that the
expression and activity of estrogenic enzymes are regulated by
1,25-(OH)2D3, a known antipsoriasis
agent. Future studies will seek to clarify the contributions of both
aromatase and 17ßHSD activities to the development of normal skin as
well as diseases such as psoriasis.
 |
Acknowledgments
|
|---|
We thank Drs. E. R. Simpson and W. E. Rainey for their
help in initiating the RT-PCR studies.
 |
Footnotes
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1 This work was supported by a project grant from the Psoriasis
Association. 
Received February 24, 1997.
 |
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