Recombinant Human Steryl-sulfatase (STS)

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Description

Introduction to Recombinant Human Steryl-sulfatase

Recombinant Human Steryl-sulfatase, commonly referred to as recombinant human steroid sulfatase (rhSTS), is an enzyme that plays a crucial role in the metabolism of steroids. It catalyzes the hydrolysis of sulfate esters of steroid precursors, converting them into their active forms, which are essential for various physiological processes. The enzyme is encoded by the STS gene located on the X chromosome and is primarily expressed in steroidogenic tissues such as the placenta, prostate, and adrenal glands.

Function and Mechanism of Action

The primary function of recombinant human steroid sulfatase is to hydrolyze sulfated steroids, such as estrone sulfate and dehydroepiandrosterone sulfate, into their unconjugated forms. This reaction is vital for regulating the levels of active steroids in the body, influencing numerous biological pathways including hormone signaling and metabolism.

Chemical Reaction

The enzymatic reaction facilitated by rhSTS can be summarized as follows:

3β-hydroxyandrost-5-en-17-one 3-sulfate+H2O3β-hydroxyandrost-5-en-17-one+sulfate\text{3β-hydroxyandrost-5-en-17-one 3-sulfate} + \text{H}_2\text{O} \rightleftharpoons \text{3β-hydroxyandrost-5-en-17-one} + \text{sulfate}

This reaction underscores the enzyme's role in converting inactive steroid forms into their biologically active counterparts, thereby affecting hormone availability and action.

Clinical Significance

The importance of recombinant human steroid sulfatase extends beyond basic biology; it has significant clinical implications, particularly in the context of hormone-dependent diseases such as breast and prostate cancers. Inhibition of STS activity can potentially reduce local levels of active estrogens and androgens, making it a target for therapeutic intervention.

Genetic Disorders

A deficiency in STS activity leads to X-linked ichthyosis, a genetic disorder characterized by dry, scaly skin due to impaired steroid metabolism. Approximately 90% of affected individuals exhibit large deletions at the STS locus on the X chromosome, emphasizing the enzyme's critical role in human health.

Research Findings

Recent studies have explored various aspects of recombinant human steroid sulfatase, including its expression regulation, inhibitors, and potential therapeutic applications.

Expression Regulation

Research indicates that tumor necrosis factor-alpha (TNF-α) can induce STS expression in cancer cells through the PI3K/Akt signaling pathway. This induction is both concentration- and time-dependent, highlighting a complex regulatory mechanism that may be exploited for therapeutic purposes .

Inhibitors

Novel inhibitors like KW-2581 have been identified as potent agents against rhSTS, with an IC50 value of 2.9 nM when using estrone sulfate as a substrate. These inhibitors can effectively block STS activity and may serve as potential treatments for estrogen-dependent cancers .

Product Specs

Form
Lyophilized powder
Note: While we prioritize shipping the format currently in stock, please specify your format preference in order remarks for customized preparation.
Lead Time
Delivery times vary depending on the purchasing method and location. Please consult your local distributor for precise delivery estimates.
Note: All proteins are shipped with standard blue ice packs. Dry ice shipping requires advance notice and incurs additional charges.
Notes
Avoid repeated freeze-thaw cycles. Store working aliquots at 4°C for up to one week.
Reconstitution
Centrifuge the vial briefly before opening to consolidate the contents. Reconstitute the protein in sterile, deionized water to a concentration of 0.1-1.0 mg/mL. For long-term storage, we recommend adding 5-50% glycerol (final concentration) and aliquoting at -20°C/-80°C. Our standard glycerol concentration is 50% and serves as a guideline.
Shelf Life
Shelf life depends on storage conditions, buffer composition, temperature, and protein stability. Generally, liquid formulations have a 6-month shelf life at -20°C/-80°C, while lyophilized forms have a 12-month shelf life at -20°C/-80°C.
Storage Condition
Upon receipt, store at -20°C/-80°C. Aliquot for multiple uses to prevent repeated freeze-thaw cycles.
Tag Info
Tag type is determined during manufacturing.
The tag type will be determined during the production process. If you require a specific tag, please inform us for preferential development.
Synonyms
STS; ARSC1; Steryl-sulfatase; Arylsulfatase C; ASC; Estrone sulfatase; Steroid sulfatase; Steryl-sulfate sulfohydrolase
Buffer Before Lyophilization
Tris/PBS-based buffer, 6% Trehalose.
Datasheet
Please contact us to get it.
Expression Region
22-583
Protein Length
Full Length of Mature Protein
Species
Homo sapiens (Human)
Target Names
STS
Target Protein Sequence
HAASRPNIILVMADDLGIGDPGCYGNKTIRTPNIDRLASGGVKLTQHLAASPLCTPSRAA FMTGRYPVRSGMASWSRTGVFLFTASSGGLPTDEITFAKLLKDQGYSTALIGKWHLGMSC HSKTDFCHHPLHHGFNYFYGISLTNLRDCKPGEGSVFTTGFKRLVFLPLQIVGVTLLTLA ALNCLGLLHVPLGVFFSLLFLAALILTLFLGFLHYFRPLNCFMMRNYEIIQQPMSYDNLT QRLTVEAAQFIQRNTETPFLLVLSYLHVHTALFSSKDFAGKSQHGVYGDAVEEMDWSVGQ ILNLLDELRLANDTLIYFTSDQGAHVEEVSSKGEIHGGSNGIYKGGKANNWEGGIRVPGI LRWPRVIQAGQKIDEPTSNMDIFPTVAKLAGAPLPEDRIIDGRDLMPLLEGKSQRSDHEF LFHYCNAYLNAVRWHPQNSTSIWKAFFFTPNFNPVGSNGCFATHVCFCFGSYVTHHDPPL LFDISKDPRERNPLTPASEPRFYEILKVMQEAADRHTQTLPEVPDQFSWNNFLWKPWLQL CCPSTGLSCQCDREKQDKRLSR
Uniprot No.

Target Background

Function
This enzyme catalyzes the conversion of sulfated steroid precursors, such as dehydroepiandrosterone sulfate (DHEA-S) and estrone sulfate, into their free steroid forms.
Gene References Into Functions

Steryl-Sulfatase (STS) Gene References and Associated Functions:

  1. STS gene polymorphisms are linked to attention-deficit/hyperactivity disorder (ADHD). PMID: 28367959
  2. Elevated STS levels are observed in preeclamptic placentas and maternal whole blood. Research suggests STS may influence sFlt1 secretion by regulating sFlt1-i13 transcription, not through syncytialization changes. PMID: 27871476
  3. Studies indicate STS plays a crucial role in steroid biosynthesis by regulating circulating cholesterol availability. PMID: 27531568
  4. In healthy men, the G-allele at rs17268988 of STS is associated with improved cognition, unlike in males with ADHD. PMID: 28293481
  5. miR-661 overexpression sensitizes tumors to TRAIL or STS-induced apoptosis in a xenograft mouse model; this effect is reduced by CYC1 co-expression. PMID: 28391262
  6. STS point mutations demonstrate restricted localization, significantly impairing enzyme activity and are less likely to cause phenotypic heterogeneity in X-linked recessive ichthyosis (XLRI) subjects. PMID: 26387488
  7. While STS expression was observed in 27% of endometrial cancer patients, it wasn't significantly associated with disease-free survival (DFS) or overall survival (OS), warranting further investigation into its prognostic role. PMID: 26996578
  8. STS facilitates the conversion of inactive estrogen sulfates to active estrogens, attenuating NF-κB-mediated inflammation. PMID: 26220752
  9. The opposing effects of glucocorticoids and NF-κB on STS expression mirror the regulation of inflammatory response proteins. PMID: 26631368
  10. A novel nonsense mutation in the STS gene has been reported in a case of X-linked ichthyosis. PMID: 26421812
  11. High expression of both estrogen sulfatase (STS) and estrogen sulfotransferase (EST) is found in human umbilical vein endothelial cells (HUVECs). PMID: 26458420
  12. The influence of steroid hormones on estrogen sulfotransferase and steroid sulfatase expression in endometriosis tissue and stromal cells has been studied. PMID: 26723541
  13. STS represents a major pathway for regenerating biologically active steroids in steroidogenic and non-steroidogenic tissues. PMID: 26213785
  14. A genomic rearrangement involving the Kallmann syndrome 1 gene and a point mutation in the steryl-sulfatase gene were identified as independent causes of two phenotypes in a patient. PMID: 25726327
  15. Up-regulation of STS mRNA expression was observed in arm and subumbilical skin biopsies of patients with idiopathic hirsutism. PMID: 26194504
  16. Genetic variation in ARSC may be associated with changes in mammographic density after women stop using estrogen-progestin therapy. PMID: 25499601
  17. STS is present in human pre-osteoblastic bone cells and may influence bone cell growth. PMID: 25042472
  18. Complete deletion of STS has been reported in Pakistani families with X-linked ichthyosis. PMID: 24480088
  19. Studies suggest that steroid sulfatase expression may decrease during large intestinal carcinogenesis. PMID: 23916543
  20. Up-regulation of STS and 17β-hydroxysteroid dehydrogenase isoenzymes expression is observed in subcutaneous abdominal fat of morbidly obese women compared to men, potentially linked to in situ cytokine production (e.g., IL-1β). PMID: 24081738
  21. A microdeletion within Xp22.3, encompassing STS, was detected using array comparative genomic hybridization (aCGH) in an individual with suspected pre-Descemet corneal dystrophy and X-linked ichthyosis. PMID: 23807007
  22. IGF-II induces steroid sulfatase expression through a PI3-kinase/Akt-NF-κB signaling pathway in PC-3 cells, potentially leading to estrogen production and estrogen-mediated carcinogenesis. PMID: 24055520
  23. Genetic variants in SULT2A1, PAPSS2, and STS do not appear to increase the risk of polycystic ovary syndrome (PCOS). PMID: 23861462
  24. No significant difference in placental STS activity was found between women with PCOS and controls. PMID: 23122578
  25. Genetic variants affecting STS expression or activity might influence brain regions involved in ADHD. PMID: 21255266
  26. Filaggrin defects can worsen the ichthyosis phenotype in combination with steroid sulfatase deficiency. PMID: 21945601
  27. A summary of recent findings on STS and EST in several estrogen-dependent carcinomas is provided. PMID: 21073915
  28. This review focuses on recent advancements in steroid sulfatase research. PMID: 21693170
  29. A novel point mutation in the STS gene was reported in a patient with X-linked recessive ichthyosis. PMID: 21530180
  30. Genetic variation in the STS gene may be involved in ADHD susceptibility, with one polymorphism potentially associated with lower STS mRNA expression and higher prevalence in female ADHD homozygotes. PMID: 20862695
  31. X-linked recessive ichthyosis is caused by steroid sulfatase (STS) deficiency, with the gene located on the X chromosome. PMID: 20236202
  32. Six novel single nucleotide polymorphisms (SNPs) of the steroid sulfatase gene have been identified in a Japanese population. PMID: 20814163
  33. A significant increase in STS followed exemestane neoadjuvant therapy in postmenopausal ER-positive breast carcinoma, potentially representing a compensatory response to estrogen depletion. PMID: 20151319
  34. Both steroid sulfatase and filaggrin mutations are found in X-linked ichthyosis. PMID: 20149601
  35. Analysis of deletions suggests complex origins, beyond homologous recombination, for deletion mutants. PMID: 11844872
  36. In the human hair follicle, STS concentrates in the dermal papilla. PMID: 11886493
  37. The effect of IL-1β on steroid sulfatase activity in human endometrial stromal cells, relevant to estrogen activity regulation in the human endometrium, has been investigated. PMID: 11996939
  38. LNCaP prostate cancer cells contain a steryl sulfatase with properties similar to that found in human breast cancer cells. PMID: 12231117
  39. The structure of the enzyme, purified from the microsomal fraction of human placentas, was determined by X-ray crystallography. PMID: 12657638
  40. Levels of STS and estrogen sulfotransferase mRNA and activity may be associated with the severity of atherosclerotic changes in the female aorta, potentially related to in situ cytokine production (e.g., IL-1β). PMID: 14507642
  41. Estrogen-dependent cell growth in estrogen sulfatase-transfected cell clones was abolished due to enhanced estrogen sulfoconjugation. PMID: 14556660
  42. Steroid sulfatase increases steroid acute regulatory protein expression and stimulates steroid production. PMID: 14969586
  43. Steroid sulfatase (SSase) is concentrated in lamellar bodies (LBs) and secreted into the stratum corneum (SC) interstices along with other LBs-derived lipid hydrolases, where it degrades cholesterol sulfate (CSO4) to generate cholesterol for the skin barrier. PMID: 15009711
  44. High activity and mRNA expression of DHEA-S desulfating STS are observed in cerebral neocortex (twice as high as in subcortical white matter), resembling placental enzyme characteristics. PMID: 15056284
  45. Dehydroepiandrosterone (DHEA) blood levels are influenced by a steroid sulfatase polymorphism after acute resistance exercise. PMID: 15152080
  46. Gonadotropin-releasing hormone agonist (leuprolide) inhibits estrone sulfatase expression in ovarian cystic endometriosis. PMID: 15302278
  47. Increased steroid sulfatase expression is associated with estrogen-dependent endometrial carcinomas. PMID: 15355916
  48. STS localization in the cytoplasm of cumulus cells and STS mRNA expression suggest a local steroidal regulation mechanism in these cells. PMID: 16084891
  49. Studies on steroid sulfatase localization have been conducted. PMID: 16399357
  50. Corticotrophin-releasing hormone (CRH) increases, while α-helical CRH decreases, the mRNA levels of STS, CYP19A1, and HSD17B1, key enzymes in estrogen synthesis. PMID: 16467490
Database Links

HGNC: 11425

OMIM: 300747

KEGG: hsa:412

STRING: 9606.ENSP00000217961

UniGene: Hs.522578

Involvement In Disease
Ichthyosis, X-linked (IXL)
Protein Families
Sulfatase family
Subcellular Location
Cytoplasmic vesicle, secretory vesicle, microneme membrane; Multi-pass membrane protein. Endoplasmic reticulum membrane; Multi-pass membrane protein.

Q&A

What is the enzymatic function of steroid sulfatase?

Steroid sulfatase catalyzes the hydrolysis of sulfate esters from a wide range of steroid substrates. It is primarily responsible for converting inactive sulfated steroids into their biologically active forms. STS mainly hydrolyzes estrone sulfate, dehydroepiandrosterone sulfate (DHEAS), pregnenolone sulfate, and cholesterol sulfate, representing one of the major pathways for regenerating biologically active steroids in both steroidogenic and non-steroidogenic tissues . The enzyme plays a crucial role in the regulation of steroid hormone homeostasis, particularly estrogens and androgens, which has significant implications for both physiological processes and pathological conditions like hormone-dependent cancers .

What are the structural characteristics of human STS?

Human STS is expressed as a membrane-associated precursor with a molecular mass of 63 kDa and asparagine-linked oligosaccharide chains. These chains undergo post-translational modification by endoglucosaminidase H, resulting in a final protein of approximately 61 kDa with a relatively long half-life of 4 days . The enzyme has four potential N-glycosylation sites, though research has demonstrated that only two sites (Asn47 and Asn259) are predominantly glycosylated and crucial for optimal enzyme activity . Another significant post-translational modification is the conversion of cysteine residue C75 to formylglycine (FGly), which undergoes further hydration to form gem-diol hydroxylformylglycine with a bound sulfate in the resting state . These structural features are critical for understanding the enzyme's functional mechanisms and for designing effective inhibitors.

How is recombinant human STS typically produced for research purposes?

Recombinant human STS can be produced using several expression systems. According to the provided information, common methods include:

  • Mammalian cell expression: COS-7 cells are frequently used for transient expression of human STS, as described in multiple studies . This approach allows for proper post-translational modifications.

  • Plant-based expression: Wheat germ expression systems have been successfully employed to produce full-length human STS protein (amino acids 1-583), yielding functional protein suitable for various analytical techniques including SDS-PAGE, ELISA, and Western blotting .

  • Purification methods: Following expression, recombinant STS is typically purified using chromatographic techniques appropriate for membrane-associated proteins, often employing detergent solubilization followed by affinity purification steps.

For optimal enzyme activity, expression systems that support proper glycosylation and other post-translational modifications are preferred, as these modifications are critical for STS functionality .

What substrates are commonly used to assess STS activity in vitro?

Several substrates are regularly employed to evaluate STS activity in research settings. The most common substrates include:

  • Estrone sulfate (E1S): This is the most frequently used substrate, with enzymatic hydrolysis yielding estrone. Studies report IC50 values for inhibitors using E1S as substrate, indicating its widespread use in STS activity assays .

  • Estradiol sulfate (E2S): Also commonly used in enzyme kinetic studies of STS .

  • Dehydroepiandrosterone sulfate (DHEAS): Important for assessing STS activity in the androgen pathway .

  • Pregnenolone sulfate: Used to evaluate STS activity related to neurosteroid production .

  • Cholesterol sulfate: Particularly relevant for studying STS in the context of skin disorders like X-linked ichthyosis .

Experimental protocols typically involve incubating the recombinant enzyme with the sulfated substrate under controlled conditions (temperature, pH, buffer composition) followed by measurement of the desulfated product. Detection methods include HPLC analysis, as described in the zebrafish Sts characterization study where desulfated estrone was separated on a Capcell Core ADME column and detected at 201 nm .

How do the enzymatic properties of recombinant human STS compare to orthologous enzymes from model organisms?

Comparative analysis between human STS and orthologous enzymes from model organisms provides valuable insights into conserved functional mechanisms. Research comparing zebrafish Sts with human STS revealed both similarities and differences in their enzymatic characteristics:

Substrate Specificity:
Both zebrafish Sts and human STS demonstrated highest activity toward estrone sulfate and estradiol sulfate among the tested steroid sulfates. This conservation of substrate preference suggests evolutionary preservation of the enzyme's core function in steroid hormone regulation .

Temperature Sensitivity:
Zebrafish Sts exhibited catalytic activity at both 28°C (physiological temperature for zebrafish) and 37°C (human physiological temperature), with higher activity observed at 37°C. Interestingly, the Km values remained similar at both temperatures, suggesting that temperature affects catalytic rate more than substrate binding .

Cation Effects:
Both enzymes showed similar responses to divalent cations, with Ca2+, Mg2+, and Mn2+ stimulating activity, while Zn2+ and Fe2+ inhibited activity . This conservation of cation response mechanisms indicates shared structural features in the active sites.

Inhibitor Sensitivity:
Established mammalian STS inhibitors, including EMATE and STX64, effectively inhibited zebrafish Sts activity . This cross-species inhibitor efficacy suggests conservation of active site architecture, which is valuable information for translational research and pre-clinical studies using zebrafish as a model organism.

These comparative findings support the use of zebrafish as a model for studying STS function and as a platform for screening potential STS inhibitors for human applications.

What methods are most effective for evaluating the time-dependent inactivation of STS by irreversible inhibitors?

Evaluating time-dependent inactivation of STS by irreversible inhibitors requires specialized methodological approaches to accurately determine inactivation kinetics. Based on research with inhibitors like KW-2581, the following methods are most effective:

When designing such experiments, careful consideration must be given to reaction conditions (buffer composition, pH, temperature), enzyme concentration, and analytical methods for detecting both enzyme activity and chemical reaction products.

How does STS interact with other proteins in the steroidogenic pathway, and what methods can be used to study these interactions?

STS functions within a complex network of steroidogenic enzymes and regulatory proteins. Understanding these interactions is crucial for comprehending steroid hormone regulation. Research has revealed several key interactions and methodologies for their study:

Interaction with StAR Protein:
The steroidogenic acute regulatory (StAR) protein plays a crucial role in the intramitochondrial movement of cholesterol, the first step in steroid hormone biosynthesis. Research has demonstrated that STS significantly affects StAR protein synthesis and stability . This interaction can be studied through:

  • Co-transfection experiments:

    • COS-1 cells co-transfected with StAR expression vector (pStAR), STS expression vector (pSTS), and cholesterol P450scc system vector (F2)

    • Measurement of pregnenolone synthesis showed 2-fold increase when STS was co-expressed

  • Western blot analysis:

    • Analysis of protein levels in co-transfected cells revealed increased StAR protein levels when STS was present, while STS and P450scc protein levels remained unchanged

  • In vitro transcription-translation assays:

    • Addition of pSTS to reaction mixtures increased StAR protein translation products

  • Pulse-chase experiments:

    • Demonstrated that the 37 kDa StAR pre-protein disappeared significantly slower in cells transfected with pSTS

    • This indicates STS increases StAR protein stability by extending its half-life

Methods for Studying Broader Protein Interactions:

  • Co-immunoprecipitation:

    • Immunoprecipitate STS and identify interacting proteins by mass spectrometry

    • This approach can reveal previously unknown protein associations

  • Proximity-dependent biotin labeling (BioID or TurboID):

    • Fusion of STS with a biotin ligase to label nearby proteins

    • Allows identification of the proximal proteome in living cells

  • Fluorescence resonance energy transfer (FRET):

    • Tag STS and potential interaction partners with appropriate fluorophores

    • Measure energy transfer to detect interactions in real-time

  • Surface plasmon resonance:

    • Determine binding kinetics and affinity between STS and partner proteins

    • Provides quantitative data on protein-protein interactions

Understanding these interactions provides insights into how STS activity is regulated within the steroidogenic pathway and how it influences the synthesis of bioactive steroids.

What factors regulate STS expression and activity in different tissue types, and how can these be experimentally manipulated?

STS expression and activity exhibit tissue-specific regulation through various mechanisms. Understanding and manipulating these regulatory factors is essential for research into steroid hormone metabolism and related disorders:

Estrogen-Dependent Regulation:
In breast cancer cells (MCF7), STS transcription is upregulated by estradiol (E2) through direct binding to estrogen receptors (ERs) and activation of estrogen response elements in the STS promoter regions . This creates a potential positive feedback loop in estrogen-responsive tissues.

Experimental approaches to study and manipulate this regulation include:

  • Hormone treatment studies:

    • Treatment of cells with E2 increases STS mRNA expression

    • Anti-estrogen compounds like ICI182780 reduce both basal and E2-stimulated STS expression

  • Proteasomal degradation manipulation:

    • E2 induces ERα degradation through an autoregulatory feedback loop

    • Proteasomal inhibitors (e.g., MG132) prevent this degradation

    • Combined E2 and MG132 treatment increases STS mRNA levels

    • MG132 alone reduces STS mRNA, indicating complex regulatory mechanisms

  • Promoter analysis:

    • Luciferase reporter assays with STS promoter constructs can identify specific regulatory elements

    • Chromatin immunoprecipitation (ChIP) assays can confirm direct ER binding to these elements

Tissue-Specific Regulation:
The ubiquitous expression of STS across tissues with varying levels suggests tissue-specific regulatory mechanisms . Experimental approaches include:

  • Tissue-specific knockout models:

    • Conditional STS knockout in specific tissues using Cre-lox technology

    • Allows investigation of tissue-specific functions without systemic effects

  • Comparative expression analysis:

    • RNA-seq or qPCR analysis of STS expression across tissues

    • Identification of tissue-specific transcription factors correlating with STS expression

  • Epigenetic regulation studies:

    • DNA methylation analysis of the STS promoter in different tissues

    • Histone modification profiles at the STS locus

    • Use of epigenetic modifiers (HDAC inhibitors, DNA methyltransferase inhibitors) to manipulate expression

  • Post-translational modification analysis:

    • Mass spectrometry to identify tissue-specific patterns of STS post-translational modifications

    • Site-directed mutagenesis of modification sites to assess functional impact

Understanding these regulatory mechanisms is particularly relevant for hormone-dependent cancers, where STS expression is increased and has prognostic significance .

What are the most sensitive methods for detecting and quantifying STS activity in complex biological samples?

Detecting and quantifying STS activity in complex biological samples such as tissue homogenates, cell lysates, or serum presents technical challenges that require sensitive and specific analytical approaches. The following methods represent current best practices:

Radiochemical Assays:

  • [35S]-Labeled Substrate Method:

    • Incubate samples with [35S]-labeled steroid sulfates

    • Separate and quantify released [35S]-sulfate

    • Provides high sensitivity but requires radioactive handling precautions

  • [3H]-Labeled Substrate Method:

    • Incubate samples with tritium-labeled steroid sulfates (e.g., [3H]-E1S)

    • Extract and quantify desulfated products

    • Widely used due to high sensitivity and specificity

Chromatographic Methods:

  • HPLC with UV Detection:

    • Incubate samples with steroid sulfate substrate

    • Separate desulfated products using methods such as:

      • Capcell Core ADME column (2.7 μm, 4.6 mm ID × 100 mm)

      • Mobile phase: 0.05% TFA in 60% methanol

      • Isocratic elution at 1 mL/min

      • Detection at 201 nm

    • Moderate sensitivity but excellent for purified enzyme preparations

  • LC-MS/MS Method:

    • Higher sensitivity and specificity than HPLC-UV

    • Can simultaneously quantify multiple steroids

    • Allows absolute quantification without radiolabeled substrates

    • Requires sophisticated instrumentation

Sample Preparation Techniques:

  • Solid-Phase Extraction (SPE):

    • Two-step approach for complex samples:

      • First step: C18 cartridge loading, 20% methanol wash, 80% methanol elution

      • Second step: Reconstitution in 20% methanol/2% formic acid, loading onto Oasis WAX column

      • Sequential washing with 2% formic acid solution and 100% methanol

      • Elution with 1% NH4OH/methanol

    • Enhances sensitivity by removing interfering compounds

  • Immunoprecipitation:

    • Use of STS-specific antibodies to isolate enzyme from complex samples

    • Followed by activity assay using methods described above

    • Useful for samples with very low STS concentrations

Data Analysis Considerations:

  • Include appropriate enzyme kinetics calculations (Km, Vmax)

  • Use internal standards for quantification

  • Implement proper controls including:

    • Heat-inactivated samples

    • Known STS inhibitor treatment (e.g., EMATE or STX64)

    • Substrate-only controls

The choice of method depends on available equipment, required sensitivity, and nature of the biological sample. For clinical samples or tissues with low STS expression, radiochemical or LC-MS/MS methods offer the highest sensitivity, while HPLC methods may be sufficient for recombinant enzyme characterization.

How can recombinant STS be used to screen and evaluate potential enzyme inhibitors?

Recombinant STS serves as an essential tool for the development and evaluation of potential inhibitors with therapeutic applications. The following methodological approach outlines a comprehensive strategy for inhibitor screening and evaluation:

Primary Screening Assays:

  • Concentration-Response Analysis:

    • Incubate recombinant STS with estrone sulfate (typically 5 μM) in the presence of varying inhibitor concentrations

    • Measure residual enzyme activity to determine IC50 values

    • As demonstrated with KW-2581, which exhibited an IC50 of 2.9 nM against recombinant human STS

    • This allows rapid comparison and ranking of inhibitor potency

  • Multi-Substrate Testing:

    • Evaluate inhibitory effects against multiple physiologically relevant substrates (E1S, DHEAS, pregnenolone sulfate)

    • KW-2581 was shown to equally inhibit rhSTS activity when DHEAS was used as a substrate, indicating a non-substrate-specific mechanism

    • This approach identifies inhibitors with broad or selective substrate inhibition profiles

Mechanism of Action Studies:

  • Time-Dependent Inhibition Analysis:

    • Pre-incubate STS with inhibitor for varying time periods before substrate addition

    • Plot remaining activity versus pre-incubation time

    • Irreversible inhibitors like KW-2581 show time-dependent inactivation

    • Calculate kinact and Ki,app values to characterize inactivation kinetics

  • Chemical Modification Detection:

    • Monitor chemical changes to both inhibitor and enzyme

    • For example, measuring the formation of des-sulfamoylated derivatives during STS inactivation by KW-2581

    • Employ HPLC or LC-MS methods to track these chemical changes

Comparative Assessment:

  • Benchmark Against Known Inhibitors:

    • Compare new compounds with established inhibitors under identical conditions

    • KW-2581 was compared to 667 COUMATE, showing approximately 5-fold higher potency

    • EMATE and STX64 can serve as reference compounds for irreversible inhibition

  • Structure-Activity Relationship Studies:

    • Test structural analogs to identify critical pharmacophore features

    • Correlate structural modifications with changes in inhibitory potency

    • The phenol sulfamate ester moiety has been identified as an active pharmacophore for irreversible STS inhibitors

Advanced Characterization:

  • X-ray Crystallography:

    • Co-crystallize STS with inhibitors to determine binding modes

    • The resolution of the STS crystal structure has enabled structure-based inhibitor design

  • Computational Modeling:

    • Molecular docking and dynamics simulations to predict inhibitor binding

    • Virtual screening of compound libraries to identify novel inhibitor scaffolds

This systematic approach has facilitated the development of various steroidal and nonsteroidal STS inhibitors, leading to clinical candidates like 667 COUMATE for breast cancer treatment .

What experimental models are most appropriate for studying STS function in the context of hormone-dependent cancers?

Investigating STS function in hormone-dependent cancers requires carefully selected experimental models that accurately recapitulate the complex interactions between STS activity and tumor biology. The following models provide complementary approaches for comprehensive research:

In Vitro Cellular Models:

  • Established Cancer Cell Lines:

    • MCF-7 breast cancer cells: Widely used for studying estrogen-responsive breast cancer, these cells express STS and show correlation between STS and estrogen receptor expression

    • Additional relevant cell lines include T-47D, ZR-75-1 (breast cancer) and LNCaP, PC-3 (prostate cancer)

    • These models allow for fundamental mechanistic studies of STS in cancer cells

  • Primary Cancer Cells:

    • Patient-derived primary cancer cells provide greater clinical relevance

    • Can be used to correlate STS expression/activity with patient clinical parameters

    • Allow for personalized approaches to STS inhibitor testing

  • 3D Organoid Cultures:

    • More physiologically relevant than 2D cultures

    • Better recapitulate tumor microenvironment and cell-cell interactions

    • Can be established from patient samples for personalized medicine applications

In Vivo Models:

  • Xenograft Models:

    • MCF-7 xenografts in immunodeficient mice have been used to study STS inhibitors like KW-2581

    • These models allow evaluation of tumor growth inhibition in response to STS inhibitors

    • The study using KW-2581 demonstrated this compound could inhibit the ability of androstenediol sulfate to stimulate the in vivo growth of MCF-7 breast cancer

  • Patient-Derived Xenograft (PDX) Models:

    • Higher clinical relevance than cell line xenografts

    • Maintain tumor heterogeneity and microenvironment characteristics

    • Useful for testing STS inhibitors in diverse tumor types

  • Genetically Engineered Mouse Models (GEMMs):

    • STS overexpression in mammary tissue to study its role in tumor initiation/progression

    • Conditional STS knockout in specific tissues to evaluate its contribution to cancer development

    • Combination with established cancer models (e.g., MMTV-PyMT for breast cancer)

Ex Vivo Models:

  • Tissue Slice Cultures:

    • Maintain tissue architecture and cellular complexity

    • Allow short-term studies of STS inhibitors on intact tumor tissue

    • Useful for direct testing of patient samples

Methodological Considerations:

  • Hormone Supplementation:

    • Models should account for the relevant hormone environment

    • For postmenopausal breast cancer models, low estrogen background is appropriate

    • Supplementation with sulfated steroid precursors (E1S, DHEAS) to evaluate STS-dependent growth

  • Combined Pathway Inhibition:

    • Models evaluating STS inhibitors in combination with other therapeutic approaches

    • Examples include aromatase inhibitors, estrogen receptor modulators, or androgen receptor antagonists

    • Addresses the clinical reality of multiple steroidogenic pathways in cancer

  • Biomarker Analysis:

    • Implementation of methods to measure STS expression, activity, and downstream effects

    • Correlation of these parameters with treatment response

    • Development of predictive biomarkers for STS inhibitor efficacy

These diverse experimental models provide a comprehensive toolkit for investigating STS function in hormone-dependent cancers, from basic mechanistic studies to preclinical evaluation of novel therapeutic approaches.

What are the key considerations for designing recombinant STS constructs for different expression systems?

Designing optimal recombinant STS constructs requires careful consideration of multiple factors to ensure proper expression, folding, post-translational modification, and enzymatic activity. The following are key considerations for different expression systems:

General Design Considerations:

  • Codon Optimization:

    • Adapt coding sequence to preferred codon usage of the expression host

    • Particularly important for high-level expression in heterologous systems

    • Avoid rare codons that might cause translational pausing or premature termination

  • Signal Peptide and Targeting Sequences:

    • Human STS is naturally targeted to the endoplasmic reticulum membrane

    • Retain native signal sequence for mammalian expression systems

    • For other systems, consider replacing with host-specific targeting sequences

  • Affinity Tags:

    • N- or C-terminal tags for purification and detection (His, FLAG, GST)

    • Consider placement carefully to avoid interference with enzyme activity

    • Include protease cleavage sites for tag removal when necessary

  • Post-Translational Modification Sites:

    • Preserve critical N-glycosylation sites (Asn47 and Asn259) that are essential for activity

    • Maintain the cysteine residue (C75) that undergoes conversion to formylglycine

    • Consider the expression system's capacity to perform these modifications

System-Specific Considerations:

  • Mammalian Expression Systems (e.g., COS-7 cells):

    • Advantages: Proper glycosylation and post-translational modifications

    • Design: Full-length construct including membrane-anchoring domain

    • Vectors: CMV promoter-driven expression vectors work well for STS expression

    • Special considerations: Co-transfection with other steroidogenic enzymes possible for pathway studies

  • Plant-Based Systems (e.g., Wheat Germ):

    • Advantages: High yields of full-length protein, fewer endogenous interfering proteins

    • Design: Complete coding sequence (amino acids 1-583)

    • Special considerations: May have different glycosylation patterns than mammalian cells

  • Insect Cell Systems (Baculovirus):

    • Advantages: Higher expression levels than mammalian systems, some mammalian-like PTMs

    • Design: Full-length construct with native signal sequence

    • Special considerations: Sf9 or High Five cells typically used; consider adding secretion signal for soluble variants

  • Bacterial Systems (E. coli):

    • Limitations: Lack glycosylation capability, difficulty with membrane proteins

    • Design: Consider truncated constructs lacking transmembrane domains

    • Special considerations: Fusion with solubility-enhancing partners (MBP, SUMO); may require refolding from inclusion bodies

  • Cell-Free Expression Systems:

    • Advantages: Rapid expression, control over reaction environment

    • Design: Optimization of 5' and 3' untranslated regions

    • Special considerations: Limited post-translational modifications

Functional Validation Approaches:

  • Activity Assays:

    • Verify enzymatic function using standard substrates (E1S, DHEAS)

    • Compare kinetic parameters with native enzyme

  • Structural Characterization:

    • Glycosylation analysis by endoglycosidase treatment

    • Mass spectrometry to confirm post-translational modifications

  • Subcellular Localization:

    • Immunofluorescence or fractionation studies to confirm proper targeting

    • Particularly important for membrane-associated forms

  • Stability Assessment:

    • Thermal stability assays to ensure proper folding

    • Half-life determination in relevant conditions

The choice of expression system should be guided by the specific research needs, whether focused on high-throughput screening, structural studies, or physiological investigations. For inhibitor development and kinetic studies, systems that maintain native-like post-translational modifications and activity are preferable, while structural studies might prioritize yield and homogeneity.

How have advances in structural biology contributed to our understanding of STS function and inhibitor design?

Advances in structural biology have significantly enhanced our understanding of STS structure-function relationships and revolutionized inhibitor design approaches. The resolution of the STS crystal structure has been particularly transformative for the field:

Structural Insights into STS:

The crystal structure of STS has revealed several key features that are critical for understanding its function:

  • Active Site Architecture:

    • The active site contains a formylglycine (FGly) residue, formed by post-translational modification of a cysteine

    • In the resting state, this exists as gem-diol hydroxylformylglycine with a bound sulfate

    • This structural feature is essential for the catalytic mechanism

  • Substrate Binding Pocket:

    • The structure revealed a hydrophobic pocket that accommodates the steroid scaffold

    • This explains the enzyme's preference for steroid sulfates as substrates

    • The positioning of the sulfate group relative to the catalytic residues illuminates the hydrolysis mechanism

  • Membrane Association:

    • Structural studies have elucidated how STS associates with the endoplasmic reticulum membrane

    • This positioning is important for accessing lipophilic steroid substrates

Impact on Inhibitor Design:

Structural knowledge has dramatically advanced inhibitor development through several approaches:

  • Structure-Based Drug Design:

    • Virtual screening of compound libraries against the STS active site

    • Rational design of inhibitors that complement the active site geometry

    • This has led to the development of both steroidal and non-steroidal inhibitors

  • Pharmacophore Identification:

    • The crystal structure confirmed the importance of the phenol sulfamate ester as an active pharmacophore for irreversible inhibitors

    • This knowledge guided the development of potent inhibitors like 667 COUMATE, EMATE, and STX64

  • Mechanism-Based Inhibitor Design:

    • Understanding of the catalytic mechanism involving the FGly residue

    • Design of inhibitors that covalently modify this residue, creating irreversible inhibition

    • KW-2581 exemplifies this approach, with time-dependent, irreversible inactivation of STS

  • Optimization of Inhibitor Properties:

    • Structure-guided modifications to improve pharmacokinetic properties

    • Development of inhibitors with enhanced tissue specificity

    • Addressing potential off-target effects by comparing structural homology with other sulfatases

Future Directions in Structural Biology of STS:

  • Dynamic Structural Studies:

    • Application of cryo-electron microscopy to capture different conformational states

    • Hydrogen-deuterium exchange mass spectrometry to map protein dynamics

    • These approaches could reveal transient states important for catalysis

  • Complex Structures:

    • Co-crystal structures with various substrates and inhibitors

    • Structures of STS in complex with interacting proteins like StAR

    • These would illuminate both catalytic mechanisms and regulatory interactions

  • Computational Approaches:

    • Molecular dynamics simulations to understand protein flexibility and substrate recognition

    • Quantum mechanical/molecular mechanical (QM/MM) calculations to model the reaction mechanism in detail

    • These computational methods can address questions difficult to answer experimentally

The continued advancement of structural biology techniques promises to further refine our understanding of STS function and facilitate the development of even more effective inhibitors for clinical applications in hormone-dependent cancers.

What emerging technologies are improving our ability to study STS regulation and function at the cellular level?

Emerging technologies are transforming our ability to investigate STS regulation and function with unprecedented precision and insight at the cellular level. These advanced approaches are opening new avenues for understanding this enzyme's complex role in steroid hormone metabolism:

Single-Cell Analysis Technologies:

  • Single-Cell RNA Sequencing (scRNA-seq):

    • Enables analysis of STS expression heterogeneity within tissues

    • Identifies cell populations with differential STS expression

    • Allows correlation with expression of other steroidogenic enzymes at single-cell resolution

  • Single-Cell Proteomics:

    • Mass cytometry (CyTOF) or microfluidic-based approaches to quantify STS protein levels in individual cells

    • Correlates STS protein abundance with other signaling molecules

    • Provides insights into post-transcriptional regulation mechanisms

Advanced Imaging Techniques:

  • Super-Resolution Microscopy:

    • Techniques like STORM, PALM, or SIM provide nanoscale visualization of STS localization

    • Reveals co-localization with other steroidogenic enzymes and potential interaction partners

    • Offers insights into subcellular compartmentalization of steroid metabolism

  • Live-Cell Imaging with Fluorescent Biosensors:

    • Development of activity-based probes for STS

    • Real-time monitoring of enzymatic activity in living cells

    • Visualization of spatial and temporal regulation of STS function

Genome Editing and Screening Technologies:

  • CRISPR-Cas9 Applications:

    • Precise gene editing to create STS knockouts, knock-ins, or point mutations

    • CRISPRi/CRISPRa systems for controlled modulation of STS expression

    • Base editing for studying specific post-translational modification sites

  • CRISPR Screening:

    • Genome-wide or targeted CRISPR screens to identify regulators of STS expression or activity

    • Screens in the presence of STS inhibitors to identify resistance mechanisms

    • Synthetic lethality screens to identify potential combination therapeutic targets

Proximity Labeling Proteomics:

  • BioID or TurboID Approaches:

    • Fusion of STS with promiscuous biotin ligases to label proximal proteins

    • Identification of the STS proximity interactome under various conditions

    • Discovery of novel regulatory proteins and interaction partners

  • APEX2 Proximity Labeling:

    • Higher temporal resolution than BioID for capturing dynamic interactions

    • Subcellular mapping of STS-proximal proteins

    • Identification of transient interactions during steroid hormone signaling

Microfluidics and Organ-on-Chip Technology:

  • Microfluidic Culture Systems:

    • Precise control of cellular microenvironment for studying STS regulation

    • Integration with real-time analytical methods for monitoring steroid metabolism

    • High-throughput screening of STS modulators in physiologically relevant conditions

  • Multi-Cellular Organ-on-Chip Models:

    • Recapitulation of tissue-level organization and cell-cell interactions

    • Investigation of STS function in complex tissue architectures

    • Models of steroid-dependent tissues like breast or prostate for inhibitor testing

Metabolomic Approaches:

  • Stable Isotope Tracing:

    • Use of isotopically labeled steroid sulfates to track metabolic fates

    • Quantification of STS contribution to intracellular steroid pools

    • Integration with computational modeling for pathway flux analysis

  • Mass Spectrometry Imaging:

    • Spatial mapping of steroid distribution in tissues and cells

    • Correlation of steroid metabolites with STS expression and activity

    • Direct visualization of inhibitor effects on steroid metabolism in situ

These emerging technologies provide complementary approaches for investigating STS function and regulation across multiple scales—from molecular interactions to cellular heterogeneity to tissue-level effects. Integration of data from these diverse methodologies promises to yield a more comprehensive understanding of STS biology and its therapeutic targeting.

What are the current challenges and limitations in working with recombinant STS, and how might these be addressed?

Despite significant advances in STS research, several challenges and limitations remain when working with recombinant forms of this enzyme. Addressing these issues is crucial for advancing our understanding of STS biology and developing effective therapeutics:

Structural and Biochemical Challenges:

  • Membrane Association:

    • Challenge: STS is naturally membrane-associated, making expression and purification difficult

    • Current approaches: Detergent solubilization, truncated constructs lacking transmembrane domains

    • Future solutions: Nanodiscs or amphipols for membrane protein stabilization; optimized membrane-mimetic systems

  • Post-Translational Modifications:

    • Challenge: Critical modifications like N-glycosylation at Asn47/Asn259 and conversion of Cys75 to formylglycine are essential for activity

    • Current approaches: Use of mammalian expression systems that can perform these modifications

    • Future solutions: Engineered expression systems with enhanced post-translational modification capabilities; chemoenzymatic approaches for in vitro modification

  • Protein Stability:

    • Challenge: Purified recombinant STS may have limited stability

    • Current approaches: Buffer optimization, addition of stabilizing agents

    • Future solutions: Computational design of stabilizing mutations; fusion with stability-enhancing partners that don't compromise activity

Methodological Limitations:

  • Activity Assay Sensitivity and Throughput:

    • Challenge: Current methods often involve chromatographic separation or radiochemical detection, limiting throughput

    • Current approaches: HPLC methods with UV detection at 201 nm

    • Future solutions: Development of homogeneous, fluorescence-based assays; bioluminescent substrates for high-throughput screening

  • Recombinant Protein Yield:

    • Challenge: Expression levels of active STS can be low

    • Current approaches: Optimization of expression conditions; testing multiple expression systems

    • Future solutions: Directed evolution approaches to enhance expression; improved secretion signals for non-membrane-bound variants

  • Structural Heterogeneity:

    • Challenge: Varying degrees of glycosylation create heterogeneous protein preparations

    • Current approaches: Extensive purification; characterization of glycoforms

    • Future solutions: Engineered cell lines with uniform glycosylation patterns; glycosylation-independent STS variants

Translational Research Challenges:

  • Species Differences:

    • Challenge: Differences in kinetic parameters between human STS and orthologs from model organisms

    • Current approaches: Comparative analysis of enzyme properties; use of humanized animal models

    • Future solutions: Development of "humanized" STS enzymes in model organisms; better computational models to predict cross-species differences

  • Tissue-Specific Regulation:

    • Challenge: Difficulty in replicating tissue-specific regulatory mechanisms in recombinant systems

    • Current approaches: Use of tissue-derived cell lines; co-expression of tissue-specific factors

    • Future solutions: Organoid culture systems; tissue-specific reporters for STS activity

  • Physiological Relevance:

    • Challenge: Connecting in vitro enzymatic properties to in vivo physiological roles

    • Current approaches: Correlation of in vitro inhibition with cellular and in vivo effects

    • Future solutions: Development of biomarkers that reflect STS activity in vivo; systems biology approaches to model steroid metabolism networks

Emerging Solutions:

  • Cryo-EM for Structural Analysis:

    • Could overcome challenges in crystallizing membrane-associated forms of STS

    • Would enable visualization of STS in more native-like membrane environments

  • Cell-Free Expression Systems:

    • Rapid production of STS variants for structure-function studies

    • Control over reaction environment to optimize folding and modification

  • Artificial Intelligence for Protein Engineering:

    • Machine learning approaches to design STS variants with enhanced stability and activity

    • Prediction of mutations that maintain activity while improving expression

  • Microfluidic Enzyme Assays:

    • Miniaturized assay formats requiring minimal enzyme and substrate

    • Integration with detection systems for real-time activity monitoring

By addressing these challenges through innovative technological approaches, researchers can overcome current limitations in working with recombinant STS, leading to enhanced understanding of this enzyme's biology and more effective therapeutic targeting strategies.

How might STS inhibitors be integrated into combination therapy approaches for hormone-dependent cancers?

The strategic integration of STS inhibitors into combination therapy regimens represents a promising approach for addressing hormone-dependent cancers. Based on current research and clinical development, several combination strategies warrant consideration:

Combination with Established Hormone Therapies:

  • STS Inhibitors + Aromatase Inhibitors:

    • Rationale: Simultaneous blocking of both sulfatase and aromatase pathways for estrogen production

    • Target population: Postmenopausal women with ER+ breast cancer

    • Expected benefits: More complete estrogen deprivation than either approach alone

    • Evidence: Preclinical studies show enhanced anti-tumor effects with dual inhibition

    • Considerations: Monitoring for side effects related to profound estrogen depletion

  • STS Inhibitors + Selective Estrogen Receptor Modulators/Degraders (SERMs/SERDs):

    • Rationale: Blocking both estrogen production and receptor signaling

    • Target population: Patients with ER+ breast cancer, including those resistant to single-agent therapy

    • Expected benefits: Overcoming resistance mechanisms; enhanced anti-proliferative effects

    • Evidence: The inhibitor 667 COUMATE has entered phase I clinical trials for postmenopausal women with breast cancer

    • Considerations: Sequencing of therapies; biomarkers for patient selection

  • STS Inhibitors + Androgen Deprivation Therapy:

    • Rationale: STS contributes to androgen production via DHEAS desulfation

    • Target population: Prostate cancer patients, particularly with castration-resistant disease

    • Expected benefits: More complete androgen blockade; delaying resistance development

    • Considerations: Monitoring for side effects of complete androgen deprivation

Combination with Targeted Therapies:

  • STS Inhibitors + CDK4/6 Inhibitors:

    • Rationale: Combining endocrine modulation with cell cycle inhibition

    • Target population: ER+ breast cancer patients eligible for CDK4/6 inhibition

    • Expected benefits: Enhanced growth inhibition; potential to overcome resistance

    • Considerations: Determining optimal sequencing and dosing schedules

  • STS Inhibitors + PI3K/AKT/mTOR Pathway Inhibitors:

    • Rationale: Targeting both hormone production and growth factor signaling

    • Target population: Patients with activation of PI3K pathway plus hormone dependence

    • Expected benefits: Addressing multiple drivers of tumor growth; overcoming resistance mechanisms

    • Considerations: Managing toxicities from multiple pathway inhibition

Combination with Immunotherapies:

  • STS Inhibitors + Immune Checkpoint Inhibitors:

    • Rationale: Modulation of the tumor microenvironment by altering steroid levels, potentially enhancing immune recognition

    • Target population: Patients with hormone-dependent cancers showing immune infiltration

    • Expected benefits: Converting "cold" tumors to "hot" immunogenic tumors

    • Considerations: Limited current evidence; need for biomarker development

Biomarker-Guided Approaches:

The development of predictive biomarkers is critical for optimizing STS inhibitor combination strategies:

  • Expression-Based Biomarkers:

    • STS expression levels by immunohistochemistry or gene expression

    • Expression of estrogen/androgen receptors and related signaling molecules

    • Expression levels of other steroidogenic enzymes

  • Functional Biomarkers:

    • Tissue or serum steroid profiling to assess active steroidogenesis

    • Measurement of tumor steroid levels before and after treatment

    • Pharmacodynamic markers of STS inhibition

  • Genetic Biomarkers:

    • Mutations in steroid receptor genes or co-regulators

    • Alterations in steroidogenic enzyme pathways

    • Genomic signatures of endocrine sensitivity/resistance

Clinical Implementation Considerations:

  • Sequencing vs. Concurrent Administration:

    • Determining whether sequential or simultaneous administration is optimal

    • Potential for using STS inhibitors to resensitize tumors to endocrine therapies

  • Dosing Schedules:

    • Optimizing dosing to maintain STS inhibition while minimizing toxicity

    • Investigation of intermittent scheduling to manage side effects

  • Patient Selection:

    • Identifying patient subgroups most likely to benefit from STS inhibitor combinations

    • Development of companion diagnostics for STS activity

  • Long-term Safety Monitoring:

    • Assessing effects of prolonged steroid deprivation on bone health, cognitive function, and cardiovascular parameters

    • Designing appropriate supportive care strategies

The integration of STS inhibitors into combination therapy approaches represents a promising direction for improving outcomes in hormone-dependent cancers. Ongoing clinical trials with compounds like 667 COUMATE will provide valuable insights into optimal combination strategies and patient selection criteria.

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