Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 2001 Aug;54(8):624–630. doi: 10.1136/jcp.54.8.624

Detection of progesterone receptor forms A and B by immunohistochemical analysis

P Mote 1, J Johnston 1, T Manninen 1, P Tuohimaa 1, C Clarke 1
PMCID: PMC1731503  PMID: 11477119

Abstract

Aim—The measurement of progesterone receptors (PR) is recommended as part of the clinical management of breast and endometrial cancers, and immunohistochemistry on formalin fixed tissue is now the method of choice. PR is expressed as two isoforms, PRA and PRB, and although both these proteins are expressed in hormone dependent cancers, there is evidence that a large proportion of tumours express a predominance of one isoform. Therefore, it is essential to document the individual detection of PRA and PRB by the presently available anti-PR antibodies. The aim of this study is to investigate the detection of PR isoforms A and B in formalin fixed, paraffin wax embedded cell lines and tissue sections by immunohistochemistry, using a panel of commercial and in house antibodies to human PR.

Methods—PR negative cell lines stably transfected to express only PRA (MCF-7Mll/PRA) or PRB (MDA-MB-231/PRB), and tissue sections of human breast carcinoma and normal endometrium were stained using an immunoperoxidase method. A panel of primary PR specific antibodies was evaluated for ability to detect both PRA and PRB proteins, and for intensity and distribution of positive staining under optimal conditions.

Results—Of the 11 antibodies assessed, only four recognised PRA and PRB similarly. Six recognised PRA proteins but were unable to detect PRB expression in the cell lines expressing only PRA or PRB. In tissues expressing high amounts of PRA and PRB, all antibodies tested demonstrated positive PR staining. However, in tissues expressing a predominance of PRB, differential staining patterns were observed, with variations in staining intensity and in the proportion of cells positive for PR.

Conclusions—Most PR specific antibodies tested failed to detect PRB in formalin fixed tissue by immunohistochemical techniques, despite their ability to do so by immunoblot analysis. These observations suggest that there are conformational differences between PRA and PRB that mask epitopes on the PRB protein recognised by most anti-PR antibodies. The selection of antibodies that recognise both PRB and PRA in formalin fixed tissue is essential for the accurate evaluation of PR positivity in clinical specimens.

Key Words: progesterone receptor isoforms • progesterone receptor antibodies • immunohistochemistry

Full Text

The Full Text of this article is available as a PDF (210.4 KB).

graphic file with name 00311.f1.jpg

Figure 1 Immunoperoxidase staining of progesterone receptor isoform A and B (PRA and PRB) proteins in a PR negative cell line transfected with PRA (MCF-7M11/PRA) (A, C, E, and G); a PR negative cell line transfected with PRB (MDA-MB-231/PRB) (B, D, F, and H); or midsecretory endometrium (I–L). The primary antibodies used are:- Cell Marque (A, B, and I); PR-86 (C, D, and J); Novocastra (E, F, and K); and hPRa6 (G, H, and L). Original magnification, x400.

graphic file with name 00311.f2.jpg

Figure 2 Immunoblot analysis of human progesterone receptor isoforms A and B (PRA and PRB) with PR-86. Equal amounts of total protein from COS cells transfected with human PRA and PRB were analysed by immunoblot using PR-86. Lane 1, negative control (transfected with vector only); lane 2, COS cells transfected with PRB; lane 3, COS cells transfected with PRA.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arnett-Mansfield R. L., deFazio A., Wain G. V., Jaworski R. C., Byth K., Mote P. A., Clarke C. L. Relative expression of progesterone receptors A and B in endometrioid cancers of the endometrium. Cancer Res. 2001 Jun 1;61(11):4576–4582. [PubMed] [Google Scholar]
  2. Artvinli S. Biochemical aspects of aldehyde fixation and a new formaldehyde fixative. Histochem J. 1975 Sep;7(5):435–450. doi: 10.1007/BF01003881. [DOI] [PubMed] [Google Scholar]
  3. Bain D. L., Franden M. A., McManaman J. L., Takimoto G. S., Horwitz K. B. The N-terminal region of the human progesterone A-receptor. Structural analysis and the influence of the DNA binding domain. J Biol Chem. 2000 Mar 10;275(10):7313–7320. doi: 10.1074/jbc.275.10.7313. [DOI] [PubMed] [Google Scholar]
  4. Balleine R. L., Earl M. J., Greenberg M. L., Clarke C. L. Absence of progesterone receptor associated with secondary breast cancer in postmenopausal women. Br J Cancer. 1999 Mar;79(9-10):1564–1571. doi: 10.1038/sj.bjc.6690249. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bevitt D. J., Milton I. D., Piggot N., Henry L., Carter M. J., Toms G. L., Lennard T. W., Westley B., Angus B., Horne C. H. New monoclonal antibodies to oestrogen and progesterone receptors effective for paraffin section immunohistochemistry. J Pathol. 1997 Oct;183(2):228–232. doi: 10.1002/(SICI)1096-9896(199710)183:2<228::AID-PATH895>3.0.CO;2-X. [DOI] [PubMed] [Google Scholar]
  6. Cavaliere A., Bucciarelli E., Sidoni A., Bianchi G., Pietropaoli N., Ludovini V., Vitali R. Estrogen and progesterone receptors in breast cancer: comparison between enzyme immunoassay and computer-assisted image analysis of immunocytochemical assay. Cytometry. 1996 Sep 15;26(3):204–208. doi: 10.1002/(SICI)1097-0320(19960915)26:3<204::AID-CYTO4>3.0.CO;2-E. [DOI] [PubMed] [Google Scholar]
  7. Clark G. M., McGuire W. L. Progesterone receptors and human breast cancer. Breast Cancer Res Treat. 1983;3(2):157–163. doi: 10.1007/BF01803558. [DOI] [PubMed] [Google Scholar]
  8. Clark G. M., McGuire W. L. Steroid receptors and other prognostic factors in primary breast cancer. Semin Oncol. 1988 Apr;15(2 Suppl 1):20–25. [PubMed] [Google Scholar]
  9. Clarke C. L., Zaino R. J., Feil P. D., Miller J. V., Steck M. E., Ohlsson-Wilhelm B. M., Satyaswaroop P. G. Monoclonal antibodies to human progesterone receptor: characterization by biochemical and immunohistochemical techniques. Endocrinology. 1987 Sep;121(3):1123–1132. doi: 10.1210/endo-121-3-1123. [DOI] [PubMed] [Google Scholar]
  10. Clemm D. L., Sherman L., Boonyaratanakornkit V., Schrader W. T., Weigel N. L., Edwards D. P. Differential hormone-dependent phosphorylation of progesterone receptor A and B forms revealed by a phosphoserine site-specific monoclonal antibody. Mol Endocrinol. 2000 Jan;14(1):52–65. doi: 10.1210/mend.14.1.0413. [DOI] [PubMed] [Google Scholar]
  11. Dapson R. W. Fixation for the 1990's: a review of needs and accomplishments. Biotech Histochem. 1993 Mar;68(2):75–82. doi: 10.3109/10520299309104670. [DOI] [PubMed] [Google Scholar]
  12. Ehrlich C. E., Young P. C., Stehman F. B., Sutton G. P., Alford W. M. Steroid receptors and clinical outcome in patients with adenocarcinoma of the endometrium. Am J Obstet Gynecol. 1988 Apr;158(4):796–807. doi: 10.1016/0002-9378(88)90075-0. [DOI] [PubMed] [Google Scholar]
  13. Elashry-Stowers D., Zava D. T., Speers W. C., Edwards D. P. Immunocytochemical localization of progesterone receptors in breast cancer with anti-human receptor monoclonal antibodies. Cancer Res. 1988 Nov 15;48(22):6462–6474. [PubMed] [Google Scholar]
  14. Estes P. A., Suba E. J., Lawler-Heavner J., Elashry-Stowers D., Wei L. L., Toft D. O., Sullivan W. P., Horwitz K. B., Edwards D. P. Immunologic analysis of human breast cancer progesterone receptors. 1. Immunoaffinity purification of transformed receptors and production of monoclonal antibodies. Biochemistry. 1987 Sep 22;26(19):6250–6262. doi: 10.1021/bi00393a045. [DOI] [PubMed] [Google Scholar]
  15. Giangrande P. H., Kimbrel E. A., Edwards D. P., McDonnell D. P. The opposing transcriptional activities of the two isoforms of the human progesterone receptor are due to differential cofactor binding. Mol Cell Biol. 2000 May;20(9):3102–3115. doi: 10.1128/mcb.20.9.3102-3115.2000. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Graham J. D., Yeates C., Balleine R. L., Harvey S. S., Milliken J. S., Bilous A. M., Clarke C. L. Characterization of progesterone receptor A and B expression in human breast cancer. Cancer Res. 1995 Nov 1;55(21):5063–5068. [PubMed] [Google Scholar]
  17. Graham J. D., Yeates C., Balleine R. L., Harvey S. S., Milliken J. S., Bilous A. M., Clarke C. L. Progesterone receptor A and B protein expression in human breast cancer. J Steroid Biochem Mol Biol. 1996 Jan;56(1-6):93–98. doi: 10.1016/0960-0760(95)00226-x. [DOI] [PubMed] [Google Scholar]
  18. Hovland A. R., Powell R. L., Takimoto G. S., Tung L., Horwitz K. B. An N-terminal inhibitory function, IF, suppresses transcription by the A-isoform but not the B-isoform of human progesterone receptors. J Biol Chem. 1998 Mar 6;273(10):5455–5460. doi: 10.1074/jbc.273.10.5455. [DOI] [PubMed] [Google Scholar]
  19. Kastner P., Krust A., Turcotte B., Stropp U., Tora L., Gronemeyer H., Chambon P. Two distinct estrogen-regulated promoters generate transcripts encoding the two functionally different human progesterone receptor forms A and B. EMBO J. 1990 May;9(5):1603–1614. doi: 10.1002/j.1460-2075.1990.tb08280.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Katoh A. K., Stemmler N., Specht S., D'Amico F. Immunoperoxidase staining for estrogen and progesterone receptors in archival formalin fixed, paraffin embedded breast carcinomas after microwave antigen retrieval. Biotech Histochem. 1997 Nov;72(6):291–298. doi: 10.3109/10520299709096524. [DOI] [PubMed] [Google Scholar]
  21. Kazmi S. M., Visconti V., Plante R. K., Ishaque A., Lau C. Differential regulation of human progesterone receptor A and B form-mediated trans-activation by phosphorylation. Endocrinology. 1993 Sep;133(3):1230–1238. doi: 10.1210/endo.133.3.8365365. [DOI] [PubMed] [Google Scholar]
  22. Mason J. T., O'Leary T. J. Effects of formaldehyde fixation on protein secondary structure: a calorimetric and infrared spectroscopic investigation. J Histochem Cytochem. 1991 Feb;39(2):225–229. doi: 10.1177/39.2.1987266. [DOI] [PubMed] [Google Scholar]
  23. McDonnell D. P., Goldman M. E. RU486 exerts antiestrogenic activities through a novel progesterone receptor A form-mediated mechanism. J Biol Chem. 1994 Apr 22;269(16):11945–11949. [PubMed] [Google Scholar]
  24. McDonnell D. P., Shahbaz M. M., Vegeto E., Goldman M. E. The human progesterone receptor A-form functions as a transcriptional modulator of mineralocorticoid receptor transcriptional activity. J Steroid Biochem Mol Biol. 1994 Apr;48(5-6):425–432. doi: 10.1016/0960-0760(94)90190-2. [DOI] [PubMed] [Google Scholar]
  25. Meyer M. E., Quirin-Stricker C., Lerouge T., Bocquel M. T., Gronemeyer H. A limiting factor mediates the differential activation of promoters by the human progesterone receptor isoforms. J Biol Chem. 1992 May 25;267(15):10882–10887. [PubMed] [Google Scholar]
  26. Misrahi M., Venencie P. Y., Saugier-Veber P., Sar S., Dessen P., Milgrom E. Structure of the human progesterone receptor gene. Biochim Biophys Acta. 1993 Nov 16;1216(2):289–292. doi: 10.1016/0167-4781(93)90156-8. [DOI] [PubMed] [Google Scholar]
  27. Mohamed M. K., Tung L., Takimoto G. S., Horwitz K. B. The leucine zippers of c-fos and c-jun for progesterone receptor dimerization: A-dominance in the A/B heterodimer. J Steroid Biochem Mol Biol. 1994 Dec;51(5-6):241–250. doi: 10.1016/0960-0760(94)90036-1. [DOI] [PubMed] [Google Scholar]
  28. Mote P. A., Balleine R. L., McGowan E. M., Clarke C. L. Colocalization of progesterone receptors A and B by dual immunofluorescent histochemistry in human endometrium during the menstrual cycle. J Clin Endocrinol Metab. 1999 Aug;84(8):2963–2971. doi: 10.1210/jcem.84.8.5928. [DOI] [PubMed] [Google Scholar]
  29. Mote P. A., Leary J. A., Clarke C. L. Immunohistochemical detection of progesterone receptors in archival breast cancer. Biotech Histochem. 1998 May;73(3):117–127. doi: 10.3109/10520299809140517. [DOI] [PubMed] [Google Scholar]
  30. Osborne C. K. Steroid hormone receptors in breast cancer management. Breast Cancer Res Treat. 1998;51(3):227–238. doi: 10.1023/a:1006132427948. [DOI] [PubMed] [Google Scholar]
  31. Pertschuk L. P., Feldman J. G., Kim D. S., Nayeri K., Eisenberg K. B., Carter A. C., Thelmo W. T., Rhong Z. T., Benn P., Grossman A. Steroid hormone receptor immunohistochemistry and amplification of c-myc protooncogene. Relationship to disease-free survival in breast cancer. Cancer. 1993 Jan 1;71(1):162–171. doi: 10.1002/1097-0142(19930101)71:1<162::aid-cncr2820710126>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  32. Pichon M. F., Pallud C., Brunet M., Milgrom E. Relationship of presence of progesterone receptors to prognosis in early breast cancer. Cancer Res. 1980 Sep;40(9):3357–3360. [PubMed] [Google Scholar]
  33. Richardson G. S., MacLaughlin D. T. The status of receptors in the management of endometrial cancer. Clin Obstet Gynecol. 1986 Sep;29(3):628–637. [PubMed] [Google Scholar]
  34. Rose P. G. Endometrial carcinoma. N Engl J Med. 1996 Aug 29;335(9):640–649. doi: 10.1056/NEJM199608293350907. [DOI] [PubMed] [Google Scholar]
  35. Sartorius C. A., Melville M. Y., Hovland A. R., Tung L., Takimoto G. S., Horwitz K. B. A third transactivation function (AF3) of human progesterone receptors located in the unique N-terminal segment of the B-isoform. Mol Endocrinol. 1994 Oct;8(10):1347–1360. doi: 10.1210/mend.8.10.7854352. [DOI] [PubMed] [Google Scholar]
  36. Slotman B. J., Kühnel R., Rao B. R., Dijkhuizen G. H., de Graaff J., Stolk J. G. Importance of steroid receptors and aromatase activity in the prognosis of ovarian cancer: high tumor progesterone receptor levels correlate with longer survival. Gynecol Oncol. 1989 Apr;33(1):76–81. doi: 10.1016/0090-8258(89)90607-0. [DOI] [PubMed] [Google Scholar]
  37. Taylor C. R. An exaltation of experts: concerted efforts in the standardization of immunohistochemistry. Hum Pathol. 1994 Jan;25(1):2–11. doi: 10.1016/0046-8177(94)90164-3. [DOI] [PubMed] [Google Scholar]
  38. Tetel M. J., Giangrande P. H., Leonhardt S. A., McDonnell D. P., Edwards D. P. Hormone-dependent interaction between the amino- and carboxyl-terminal domains of progesterone receptor in vitro and in vivo. Mol Endocrinol. 1999 Jun;13(6):910–924. doi: 10.1210/mend.13.6.0300. [DOI] [PubMed] [Google Scholar]
  39. Tora L., Gronemeyer H., Turcotte B., Gaub M. P., Chambon P. The N-terminal region of the chicken progesterone receptor specifies target gene activation. Nature. 1988 May 12;333(6169):185–188. doi: 10.1038/333185a0. [DOI] [PubMed] [Google Scholar]
  40. Tung L., Mohamed M. K., Hoeffler J. P., Takimoto G. S., Horwitz K. B. Antagonist-occupied human progesterone B-receptors activate transcription without binding to progesterone response elements and are dominantly inhibited by A-receptors. Mol Endocrinol. 1993 Oct;7(10):1256–1265. doi: 10.1210/mend.7.10.8123133. [DOI] [PubMed] [Google Scholar]
  41. Uotinen N., Puustinen R., Pasanen S., Manninen T., Kivineva M., Syvälä H., Tuohimaa P., Ylikomi T. Distribution of progesterone receptor in female mouse tissues. Gen Comp Endocrinol. 1999 Sep;115(3):429–441. doi: 10.1006/gcen.1999.7333. [DOI] [PubMed] [Google Scholar]
  42. Vegeto E., Shahbaz M. M., Wen D. X., Goldman M. E., O'Malley B. W., McDonnell D. P. Human progesterone receptor A form is a cell- and promoter-specific repressor of human progesterone receptor B function. Mol Endocrinol. 1993 Oct;7(10):1244–1255. doi: 10.1210/mend.7.10.8264658. [DOI] [PubMed] [Google Scholar]
  43. Vu Hai M. T., Jolivet A., Ravet V., Lorenzo F., Perrot-Applanat M., Citerne M., Milgrom E. Novel monoclonal antibodies against human uterine progesterone receptor. Mapping of receptor immunogenic domains. Biochem J. 1989 Jun 1;260(2):371–376. doi: 10.1042/bj2600371. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Wen D. X., Xu Y. F., Mais D. E., Goldman M. E., McDonnell D. P. The A and B isoforms of the human progesterone receptor operate through distinct signaling pathways within target cells. Mol Cell Biol. 1994 Dec;14(12):8356–8364. doi: 10.1128/mcb.14.12.8356. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES