Abstract
Background and Purpose: Sex differences in immune-mediated diseases are
linked to the activity of estrogens on innate immunity cells, including
macrophages. Tamoxifen (TAM) is a selective estrogen receptor modulator
(SERM) used in estrogen receptor-alpha (ERα)-dependent breast cancers
and off-target indications such as infections, although the immune
activity of TAM and its active metabolite, 4-OH tamoxifen (4HT), is
poorly characterized. Here, we aimed at investigating the endocrine and
immune activity of these SERMs in macrophages. Experimental Approach:
Using primary cultures of female mouse macrophages, we analyzed the
expression of immune mediators and activation of effectors functions in
competition experiments with SERMS and 17β-estradiol (E2) or the
bacterial endotoxin LPS. Key results: We observed that 4HT and TAM
induce estrogen antagonist effects when used at nanomolar
concentrations, while pharmacological concentrations that are reached by
TAM in clinical settings regulate the expression of VEGFα and other
immune activation genes by ERα- and G protein-coupled receptor 1
(GPER1)-independent mechanisms that involve NRF2 through
PI3K/Akt-dependent mechanisms. Importantly, we observed that SERMs
potentiate cell phagocytosis and modify the effects of LPS on the
expression of inflammatory cytokines, such as TNFα, IL-6 and IL1-β, with
an overall increase in cell inflammatory phenotype, further sustained by
potentiation of IL1-β secretion through caspase-1 activation. Conclusion
and Implications: Altogether, our data unravel a novel molecular
mechanism and immune functions for TAM and 4HT, sustaining their
repurposing in infective and other estrogen receptors-unrelated
pathologies.