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Active DHEA uptake in the prostate gland correlates with aggressive prostate cancer
Xuebin Zhang, … , Denglong Wu, Zhenfei Li
Xuebin Zhang, … , Denglong Wu, Zhenfei Li
Published December 15, 2023
Citation Information: J Clin Invest. 2023;133(24):e171199. https://doi.org/10.1172/JCI171199.
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Research Article Oncology

Active DHEA uptake in the prostate gland correlates with aggressive prostate cancer

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Abstract

Strategies for patient stratification and early intervention are required to improve clinical benefits for patients with prostate cancer. Here, we found that active DHEA utilization in the prostate gland correlated with tumor aggressiveness at early disease stages, and 3βHSD1 inhibitors were promising for early intervention. [3H]-labeled DHEA consumption was traced in fresh prostatic biopsies ex vivo. Active DHEA utilization was more frequently found in patients with metastatic disease or therapy-resistant disease. Genetic and transcriptomic features associated with the potency of prostatic DHEA utilization were analyzed to generate clinically accessible approaches for patient stratification. UBE3D, by regulating 3βHSD1 homeostasis, was discovered to be a regulator of patient metabolic heterogeneity. Equilin suppressed DHEA utilization and inhibited tumor growth as a potent 3βHSD1 antagonist, providing a promising strategy for the early treatment of aggressive prostate cancer. Overall, our findings indicate that patients with active prostatic DHEA utilization might benefit from 3βHSD1 inhibitors as early intervention.

Authors

Xuebin Zhang, Zengming Wang, Shengsong Huang, Dongyin He, Weiwei Yan, Qian Zhuang, Zixian Wang, Chenyang Wang, Qilong Tan, Ziqun Liu, Tao Yang, Ying Liu, Ruobing Ren, Jing Li, William Butler, Huiru Tang, Gong-Hong Wei, Xin Li, Denglong Wu, Zhenfei Li

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Figure 1

Correlations of prostatic DHEA utilization with tumor aggressiveness.

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Correlations of prostatic DHEA utilization with tumor aggressiveness.
(A...
(A) Schema of steroidogenesis in patient prostatic biopsies. (B) Intra- and interpatient heterogeneity in prostatic DHEA utilization. Multiple biopsies were collected from 239 patients for steroidogenesis tracing; x axis shows individual patients. Boxes show the interquartile range, and whiskers represent the minimum and maximum value. (C) Correlations of prostatic DHEA utilization activity with age. (D) Enhanced prostatic DHEA utilization in metastatic patients. All patients were naive to treatment. Prostatic 3βHSD1 activity is calculated as potent androgens/(DHEA + potent androgens) × 100%. Bars, median; lines, interquartile range. Two-tailed Student’s t test. (E) Association of prostatic DHEA utilization with duration of response to ADT. Biopsies were collected prior to ADT. Log-rank test. (F) Baseline PSA could not predict ADT response. Log-rank test. (G) Suppressed prostatic DHEA utilization in finasteride-treated patients. Two-way ANOVA. *P < 0.05; **P < 0.01.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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