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Genetic Polymorphisms of Estrogen Receptor-α

Possible Implications for Targeted Osteoporosis Therapy

  • Practical Pharmacogenomics
  • Published:
American Journal of Pharmacogenomics

Abstract

Genetic factors play an important role in the determination of bone mass and osteoporosis. A number of candidate genes have been implicated in osteoporosis, including genes encoding type 1 collagen, vitamin D receptor, estrogen receptor-α (ERα), and others. A number of association studies have been performed with single nucleotide polymorphisms in the ERα gene to assess their relation with bone mineral density in pre- and postmenopausal women, as well as the rate of bone loss after menopause and skeletal response to estrogen administration. The polymorphisms studied thus far mostly involved intronic polymorphisms in intron 1. Other less frequently studied polymorphisms include those in exons 1, 4, and 8. Although most studies demonstrated associations with various bone-related parameters, the results are still disputed.

Assessing genetic factors including ERα polymorphisms, if their significances are confirmed, can be helpful in targeting preventive measures to individuals with higher risk of developing osteoporosis and render the preventive effort more cost-effective. Moreover, pharmacogenetically, it may help identify postmenopausal women who tend to have better skeletal responses after estrogen replacement. It is not known, however, if patients who possess favorable polymorphisms in terms of skeletal responsiveness will also have an undesirably higher risk of adverse effects. This issue needs to be further investigated before clinical decisions based on the balance between benefits and risks can be made.

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References

  1. Sowers MR, Burns TL, Wallace RB. Familial resemblance of bone mass in adult women. Genet Epidemiol 1986; 3: 85–93

    Article  PubMed  CAS  Google Scholar 

  2. Lutz J. Bone mineral, serum calcium, and dietary intakes of mother/daughter pairs. Am J Clin Nutr 1986; 44: 99–106

    PubMed  CAS  Google Scholar 

  3. Pocock NA, Eisman JA, Hopper JL, et al. Genetic determinants of bone mass in adults: a twin study. J Clin Invest 1987; 80: 706–10

    Article  PubMed  CAS  Google Scholar 

  4. Slemenda CW, Christian JC, Williams CJ, et al. Genetic determinants of bone mass in adult women: a reevaluation of the twin model and the potential importance of gene interaction on heritability estimates. J Bone Miner Res 1991; 6: 561–7

    Article  PubMed  CAS  Google Scholar 

  5. Deng HW, Chen WM, Conway T, et al. Determination of bone mineral density of the hip and spine in human pedigrees by genetic and life-style factors. Genet Epidemiol 2000; 19: 160–77

    Article  PubMed  CAS  Google Scholar 

  6. Ferrari S, Rizzoli R, Slosman D, et al. Familial resemblance for bone mineral mass is expressed before puberty. J Clin Endocrinol Metab 1998; 83: 358–61

    Article  PubMed  CAS  Google Scholar 

  7. Gueguen R, Jouanny P, Guillemin F, et al. Segregation analysis and variance components analysis of bone mineral density in healthy families. J Bone Miner Res 1995; 10: 2017–22

    Article  PubMed  CAS  Google Scholar 

  8. Sowers MR, Boehnke M, Jannausch ML, et al. Familiality and partitioning the variability of femoral bone mineral density in women of child-bearing age. Calcif Tissue Int 1992; 50: 110–4

    Article  PubMed  CAS  Google Scholar 

  9. Niu T, Chen C, Cordell H, et al. A genome-wide scan for loci linked to forearm bone mineral density. Hum Genet 1999; 104: 226–33

    Article  PubMed  CAS  Google Scholar 

  10. Koller DL, Econs MJ, Morin PA, et al. Genome screen for QTLs contributing to normal variation in bone mineral density and osteoporosis. J Clin Endocrinol Metab 2000; 85: 3116–20

    Article  PubMed  CAS  Google Scholar 

  11. Recker RR, Deng HW. Role of genetics in osteoporosis. Endocrine 2002; 17: 55–66

    Article  PubMed  CAS  Google Scholar 

  12. Deng HW, Shen H, Xu FH, et al. Tests of linkage and/or association of genes for vitamin D receptor, osteocalcin, and parathyroid hormone with bone mineral density. J Bone Miner Res 2002; 17: 678–86

    Article  PubMed  CAS  Google Scholar 

  13. Deng HW, Mahaney MC, Williams JT, et al. Relevance of the genes for bone mass variation to susceptibility to osteoporotic fractures and its implications to gene search for complex human diseases. Genet Epidemiol 2002; 22: 12–25

    Article  PubMed  Google Scholar 

  14. Grant SF, Reid DM, Blake G, et al. Reduced bone density and osteoporosis associated with a polymorphic Spl binding site in the collagen type I α 1 gene. Nat Genet 1996; 14: 203–5

    Article  PubMed  CAS  Google Scholar 

  15. Garnero P, Borel O, Grant SF, et al. Collagen Iα1 Spl polymorphism, bone mass, and bone turnover in healthy French premenopausal women: the OFELY study. J Bone Miner Res 1998; 13: 813–7

    Article  PubMed  CAS  Google Scholar 

  16. Efstathiadou Z, Tsatsoulis A, Loannidis JP. Association of collagen I alpha 1 Sp1 polymorphism with the risk of prevalent fractures: a meta-analysis. J Bone Miner Res 2001; 16: 1586–92

    Article  PubMed  CAS  Google Scholar 

  17. Uitterlinden AG, Burger H, Huang Q, et al. Relation of alleles of the collagen type Ialpha1 gene to bone density and the risk of osteoporotic fractures in postmenopausal women. N Engl J Med 1998; 338: 1016–21

    Article  PubMed  CAS  Google Scholar 

  18. Mann V, Hobson EE, Li B, et al. A COL1A1 Sp1 binding site polymorphism predisposes to osteoporotic fracture by affecting bone density and quality. J Clin Invest 2001; 107: 899–907

    Article  PubMed  CAS  Google Scholar 

  19. Han KO, Moon IG, Hwang CS, et al. Lack of an intronic Sp1 binding-site polymorphism at the collagen type I alpha1 gene in healthy Korean women. Bone 1999; 24: 135–7

    Article  PubMed  CAS  Google Scholar 

  20. Nakajima T, Ota N, Shirai Y, et al. Ethnic difference in contribution of Sp1 site variation of COLIA1 gene in genetic predisposition to osteoporosis. Calcif Tissue Int 1999; 65: 352–3

    Article  PubMed  CAS  Google Scholar 

  21. Lambrinoudaki I, Kung AW. Absence of high-risk “s” allele associated with osteoporosis at the intronic SP1 binding-site of collagen I alpha1 gene in Southern Chinese. J Endocrinol Invest 2001; 24: 499–502

    PubMed  CAS  Google Scholar 

  22. Green S, Walter P, Kumar V, et al. Human oestrogen receptor cDNA: sequence, expression and homology to v-erbA. Nature 1986; 320: 134–9

    Article  PubMed  CAS  Google Scholar 

  23. Enmark E, Pelto-Huikko M, Grandien K, et al. Human estrogen receptor β-gene structure, chromosomal localization and expression pattern. J Clin Endocrinol Metab 1997; 82: 4258–65

    Article  PubMed  CAS  Google Scholar 

  24. Eriksen EF, Colvard DS, Berg NJ, et al. Evidence of estrogen receptors in normal human osteoblast-like cells. Science 1988; 241: 84–6

    Article  PubMed  CAS  Google Scholar 

  25. Pensler JM, Langman CB, Radosevitch JA, et al. Sex steroid hormone receptors in normal and dysplastic bone disorders in children. J Bone Miner Res 1990; 5: 493–8

    Article  PubMed  CAS  Google Scholar 

  26. Braidman IP, Davenport LK, Carter DH, et al. Preliminary in situ identification of estrogen target cells in bone. J Bone Miner Res 1995; 10: 74–80

    Article  PubMed  CAS  Google Scholar 

  27. Smith EP, Boyd J, Frank GR, et al. Estrogen resistance caused by a mutation in the estrogen-receptor gene in a man. N Engl J Med 1994; 331: 1056–61

    Article  PubMed  CAS  Google Scholar 

  28. Couse JF, Korach KS. Estrogen receptor null mice: what have we learned and where will they lead us? Endocr Rev 1999; 20: 358–417

    Article  PubMed  CAS  Google Scholar 

  29. Sims NA, Dupont S, Krust A, et al. Deletion of estrogen receptors reveals a regulatory role for estrogen receptors-beta in bone remodeling in females but not in males. Bone 2002; 30: 18–25

    Article  PubMed  CAS  Google Scholar 

  30. Sano M, Inoue S, Hosoi T, et al. Association of estrogen receptor dinucleotide repeat polymorphism with osteoporosis. Biochem Biophys Res Commun 1995; 217: 378–83

    Article  PubMed  CAS  Google Scholar 

  31. Kobayashi S, Inoue S, Hosoi T, et al. Association of bone mineral density with polymorphism of the estrogen receptor gene. J Bone Miner Res 1996; 11: 306–11

    Article  PubMed  CAS  Google Scholar 

  32. Willing M, Sowers M, Aron D, et al. Bone mineral density and its change in white women: estrogen and vitamin D receptor genotypes and their interaction. J Bone Miner Res 1998; 13: 695–705

    Article  PubMed  CAS  Google Scholar 

  33. Mizunuma H, Hosoi T, Okano H, et al. Estrogen receptor gene polymorphism and bone mineral density at the lumbar spine of pre- and postmenopausal women. Bone 1997; 21: 379–83

    Article  PubMed  CAS  Google Scholar 

  34. Ongphiphadhanakul B, Rajatanavin R, Chanprasertyothin S, et al. Estrogen receptor gene polymorphism is associated with bone mineral density in premenopausal women but not in postmenopausal women. J Endocrinol Invest 1998; 21: 487–93

    PubMed  CAS  Google Scholar 

  35. Han K, Choi J, Moon I, et al. Non-association of estrogen receptor genotypes with bone mineral density and bone turnover in Korean pre-, peri-, and postmenopausal women. Osteoporos Int 1999; 9: 290–5

    Article  PubMed  CAS  Google Scholar 

  36. Ho AY, Yeung SS, Kung AW. PvuII polymorphisms of the estrogen receptor alpha and bone mineral density in healthy southern Chinese women. Calcif Tissue Int 2000; 66: 405–8

    Article  PubMed  CAS  Google Scholar 

  37. Han KO, Moon IG, Kang YS, et al. Nonassociation of estrogen receptor genotypes with bone mineral density and estrogen responsiveness to hormone replacement therapy in Korean postmenopausal women. J Clin Endocrinol Metab 1997; 82: 991–5

    Article  PubMed  CAS  Google Scholar 

  38. Gennari L, Becherini L, Masi L, et al. Vitamin D and estrogen receptor allelic variants in Italian postmenopausal women: evidence of multiple gene contribution to bone mineral density. J Clin Endocrinol Metab 1998; 83: 939–44

    Article  PubMed  CAS  Google Scholar 

  39. Bagger YZ, Jorgensen HL, Heegaard AM, et al. No major effect of estrogen receptor gene polymorphisms on bone mineral density or bone loss in postmenopausal Danish women. Bone 2000; 26: 111–6

    Article  PubMed  CAS  Google Scholar 

  40. Vandevyver C, Vanhoof J, Declerck K, et al. Lack of association between estrogen receptor genotypes and bone mineral density, fracture history, or muscle strength in elderly women. J Bone Miner Res 1999; 14: 1576–82

    Article  PubMed  CAS  Google Scholar 

  41. Becherini L, Gennari L, Masi L, et al. Evidence of a linkage disequilibrium between polymorphisms in the human estrogen receptor alpha gene and their relationship to bone mass variation in postmenopausal Italian women. Hum Mol Genet 2000; 9: 2043–50

    Article  PubMed  CAS  Google Scholar 

  42. Langdahl BL, Lokke E, Carstens M, et al. A TA repeat polymorphism in the estrogen receptor gene is associated with osteoporotic fractures but polymorphisms in the first exon and intron are not. J Bone Miner Res 2000; 15: 2222–30

    Article  PubMed  CAS  Google Scholar 

  43. Salmen T, Heikkinen AM, Mahonen A, et al. Early postmenopausal bone loss is associated with PvuII estrogen receptor gene polymorphism in Finnish women: effect of hormone replacement therapy. J Bone Miner Res 2000; 15: 315–21

    Article  PubMed  CAS  Google Scholar 

  44. Deng HW, Li J, Li JL, et al. Association of estrogen receptor-alpha genotypes with body mass index in normal healthy postmenopausal Caucasian women. J Clin Endocrinol Metab 2000; 85: 2748–51

    Article  PubMed  CAS  Google Scholar 

  45. Patel MS, Cole DE, Smith JD, et al. Alleles of the estrogen receptor alpha-gene and an estrogen receptor cotranscriptional activator gene, amplified in breast cancer-1 (AIB1), are associated with quantitative calcaneal ultrasound. J Bone Miner Res 2000; 15: 2231–9

    Article  PubMed  CAS  Google Scholar 

  46. Salmen T, Heikkinen AM, Mahonen A, et al. Relation of estrogen receptor-alpha gene polymorphism and hormone replacement therapy to fall risk and muscle strength in early postmenopausal women. Ann Med 2002; 34: 64–72

    Article  PubMed  CAS  Google Scholar 

  47. Deng HW, Li J, Li JL, et al. Change of bone mass in postmenopausal Caucasian women with and without hormone replacement therapy is associated with vitamin D receptor and estrogen receptor genotypes. Hum Genet 1998; 103: 576–85

    Article  PubMed  CAS  Google Scholar 

  48. Maruyama H, Toji H, Harrington CR, et al. Lack of an association of estrogen receptor alpha gene polymorphisms and transcriptional activity with Alzheimer disease. Arch Neurol 2000; 57: 236–40

    Article  PubMed  CAS  Google Scholar 

  49. Ongphiphadhanakul B, Chanprasertyothin S, Payattikul P, et al. Association of a T262C transition in exon 1 of estrogen-receptor-alpha gene with skeletal responsiveness to estrogen in post-menopausal women. J Endocrinol Invest 2001; 24: 749–55

    PubMed  CAS  Google Scholar 

  50. Jurada S, Marc J, Prezelj J, et al. Codon 325 sequence polymorphism of the estrogen receptor alpha gene and bone mineral density in postmenopausal women. J Steroid Biochem Mol Biol 2001; 78: 15–20

    Article  PubMed  CAS  Google Scholar 

  51. Ongphiphadhanakul B, Chanprasertyothin S, Payattikul P, et al. Association of a G2014A transition in exon 8 of the estrogen receptor-alpha gene with postmenopausal osteoporosis. Osteoporos Int 2001; 12: 1015–9

    Article  PubMed  CAS  Google Scholar 

  52. Albagha OM, McGuigan FE, Reid DM, et al. Estrogen receptor alpha gene polymorphisms and bone mineral density: haplotype analysis in women from the United Kingdom. J Bone Miner Res 2001; 16: 128–34

    Article  PubMed  CAS  Google Scholar 

  53. Kenealy MR, Flouriot G, Sonntag-Buck V, et al. The 3′-untranslated region of the human estrogen receptor alpha gene mediates rapid messenger ribonucleic acid turnover. Endocrinology 2000; 141: 2805–13

    Article  PubMed  CAS  Google Scholar 

  54. Kalow W. Familial incidence of low pseudocholinesterase level. Lancet 1956; 211: 576–7

    Article  Google Scholar 

  55. Desmeules J, Gascon MP, Dayer P, et al. Impact of environmental and genetic factors on codeine analgesia. Eur J Clin Pharmacol 1991; 4: 23–6

    Article  Google Scholar 

  56. Evans WE, Johnson JA. Pharmacogenomics: the inherited basis of interindividual differences in drug response. Annu Rev Genomics Hum Genet 2001; 2: 9–39

    Article  PubMed  CAS  Google Scholar 

  57. Roper RJ, Griffith JS, Lyttle CR, et al. Interacting quantitative trait loci control phenotypic variation in murine estradiol-regulated response. Endocrinology 1999; 140: 556–61

    Article  PubMed  CAS  Google Scholar 

  58. Ongphiphadhanakul B, Chanprasertyothin S, Payatikul P, et al. Oestrogen-receptor-alpha gene polymorphism affects response in bone mineral density to oestrogen in post-menopausal women. Clin Endocrinol (Oxf) 2000; 52: 581–5

    Article  CAS  Google Scholar 

  59. Salmen T, Heikkinen AM, Mahonen A, et al. The protective effect of hormone-replacement therapy on fracture risk is modulated by estrogen receptor alpha genotype in early postmenopausal women. J Bone Miner Res 2000; 15: 2479–86

    Article  PubMed  CAS  Google Scholar 

  60. Ongphiphadhanakul B, Chanprasertyothin S, Payattikul P, et al. Association of a T262C transition in exon 1 of estrogen-receptor-alpha gene with skeletal responsiveness to estrogen in post-menopausal women. J Endocrinol Invest 2001; 24: 749–55

    PubMed  CAS  Google Scholar 

  61. Herrington DM, Howard TD, Hawkins GA, et al. Estrogen-receptor polymorphisms and effects of estrogen replacement on high-density lipoprotein cholesterol in women with coronary disease. N Engl J Med 2002; 346: 967–74

    Article  PubMed  CAS  Google Scholar 

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Ongphiphadhanakul, B. Genetic Polymorphisms of Estrogen Receptor-α. Am J Pharmacogenomics 3, 5–9 (2003). https://doi.org/10.2165/00129785-200303010-00002

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