Archives of Gynecology and Obstetrics

, Volume 298, Issue 5, pp 961–969 | Cite as

Roles of SIRT1/FoxO1/SREBP-1 in the development of progestin resistance in endometrial cancer

  • Yilin Wang
  • Lili Zhang
  • Xiaoxia Che
  • Wenzhi Li
  • Zhiming Liu
  • Jie JiangEmail author
Gynecologic Oncology



The prevalence of endometrial cancer (EC) is increasing worldwide. Progestin therapy is effective for both early stage EC patients who require preserving fertility and advanced or recurrent patients. Progestin resistance resulting from downregulation of progesterone receptor (PR) remains a major problem, and its mechanism is currently unclear. It was demonstrated that Sirtuin 1 (SIRT1), forkhead transcription factor 1 (FoxO1) and sterol regulatory element binding protein-1 (SREBP-1) may act as a pathway and play crucial roles in the development of EC in our previous studies. In the present study, we investigated the effect on the development of progestin resistance and the relationship with PR of SIRT1/FoxO1/SREBP-1.


A progestin-resistant Ishikawa cell line was established in the stimulation and selection of medroxyprogesterone acetate (MPA), and the resistance was analyzed by MTT assay, flow cytometry, and Transwell invasion assay. qRT-PCR and western blotting were conducted to detect the expression of SIRT1, FoxO1, SREBP-1 and PR. SIRT1 knockdown progestin-resistant cells were established by lentiviral transduction.


The new progestin-resistant cell line presented sufficient resistance to MPA in aspects of proliferation, distribution of cell cycle and apoptosis compared with original Ishikawa cells. Besides, the invasion capability of progestin-resistant cells was observably increased. In both protein and mRNA levels, SIRT1 and SREBP-1 were upregulated in progestin-resistant cells, while PR and FoxO1 were downregulated. SIRT1 was knocked down by lentivirus transfection in progestin-resistant cells, resulting in upregulation of PR, FoxO1 and downregulation of SREBP-1, thereby SIRT1 knockdown cells were more sensitive to MPA compared with progestin-resistant cells.


SIRT1/FoxO1/SREBP-1 act as a pathway targeting PR and involve in the development of progestin resistance in Ishikawa cells.


Endometrial cancer Progestin resistance SIRT1 FoxO1 SREBP-1 



The present study was conducted at Qilu Hospital, Shandong University, and was supported by the National Natural Science Foundation of China (81372808 to J.J.), National Clinical Research Center for Gynecological Oncology (2015BAI13B05 to Xing Sheng Yang, 2015BAI13B04 to J.J.) and Fundamental Research Funds of Qilu Hospital of Shandong University (2082015QLMS44 to J.J.).

Author contribution

JJ: Project development. YW: Data collection, Data analysis, Manuscript writing/editing. LZ: Data collection, Data analysis, Manuscript writing/editing. XC: Data collection. WL: Data collection. ZL: Data collection.


This study was funded by National Natural Science Foundation of China (81372808 to J.J.), National Clinical Research Center for Gynecological Oncology (2015BAI13B05 to Xing Sheng Yang, 2015BAI13B04 to J.J.) and Fundamental Research Funds of Qilu Hospital of Shandong University (2082015QLMS44 to J.J.).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Qilu Hospital of Shandong UniversityJinanChina
  2. 2.Jinan Central Hospital of Shandong UniversityJinanChina

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