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Of the 423 analysed tumour samples, 32.4% were defined as being ER β-negative and 67.6% as ER β-positive (including both moderate and high level of ER β expression).
We have developed a spontaneous mammary tumor model with high level of ER expression along with high levels of serum estrogen.
Interestingly, at high level of ER stress the transient peak of autophagy inducer is followed by a gradual increase in the average level of apoptosis inducer, right panel).
To verify experimentally the irreversibility of apoptosis induction with respect to high level of ER stress we performed inhibitor washout experiments in which cells were treated with high level of ER stressor for certain time interval and the inhibitor was washed out to study the effect on cell viability.
Most cells underwent autophagy when the high level of ER stressor was washed out after short treatment, while the washout after long treatment results in apoptosis on 95% of the population.
Recently, Nahta and O'Regan suggested that a subset of HER2+ER+ breast cancers could be driven primarily by high level of ER expression, and may show a response more like HER2−ER+ breast cancers 27.
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These results again suggest that high level of ER-α36 expression may confer resistance to tamoxifen.
This high level of ER-α expression parallels the threefold higher risk of breast cancer in Australian as compared with Japanese women.
ER expression levels in individual mammary epithelial cells are inversely correlated to circulating oestrogen levels [ 38, 39], and thus we hypothesise that the low-oestrogen environment promotes high levels of ER expression and skews the LP pool from an ER- state to an ER+ state.
However, high levels of ER stress or ER dysfunction may also impair cell survival by triggering apoptotic pathways (review by [27].
It has been suggested that chronic and high levels of ER stress have a function in β-cell dysfunction and glucose toxicity.
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