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Weiye Zhao Department of Biology, University of York, York, UK

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Susanna F Rose Department of Biology, University of York, York, UK

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Ryan Blake CRUK Cambridge Institute, University of Cambridge, Cambridge, UK

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Aňze Godicelj Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Smith Building, Boston, Massachusetts, USA

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Amy E Cullen CRUK Cambridge Institute, University of Cambridge, Cambridge, UK

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Jack Stenning Department of Biology, University of York, York, UK

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Lucy Beevors The Institute of Metabolism and Systems Research (IMSR), University of Birmingham, College of Medical and Dental Sciences, Birmingham, UK

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Marcel Gehrung CRUK Cambridge Institute, University of Cambridge, Cambridge, UK

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Sanjeev Kumar Chris O’Brien Lifehouse, Sydney, New South Wales, Australia

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Kamal Kishore CRUK Cambridge Institute, University of Cambridge, Cambridge, UK

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Ashley Sawle CRUK Cambridge Institute, University of Cambridge, Cambridge, UK

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Matthew Eldridge CRUK Cambridge Institute, University of Cambridge, Cambridge, UK

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Federico M Giorgi Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy

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Katherine S Bridge Department of Biology, University of York, York, UK
York Biomedical Research Institute, University of York, York, UK

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Florian Markowetz CRUK Cambridge Institute, University of Cambridge, Cambridge, UK

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Andrew N Holding Department of Biology, University of York, York, UK
York Biomedical Research Institute, University of York, York, UK
The Alan Turing Institute, Kings Cross, London, UK

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The estrogen receptor-α (ER) drives 75% of breast cancers. On activation, the ER recruits and assembles a 1–2 MDa transcriptionally active complex. These complexes can modulate tumour growth, and understanding the roles of individual proteins within these complexes can help identify new therapeutic targets. Here, we present the discovery of ER and ZMIZ1 within the same multi-protein assembly by quantitative proteomics, and validated by proximity ligation assay. We characterise ZMIZ1 function by demonstrating a significant decrease in the proliferation of ER-positive cancer cell lines. To establish a role for the ER-ZMIZ1 interaction, we measured the transcriptional changes in the estrogen response post-ZMIZ1 knockdown using an RNA-seq time-course over 24 h. Gene set enrichment analysis of the ZMIZ1-knockdown data identified a specific delay in the response of estradiol-induced cell cycle genes. Integration of ENCODE data with our RNA-seq results identified that ER and ZMIZ1 both bind the promoter of E2F2. We therefore propose that ER and ZMIZ1 interact to enable the efficient estrogenic response at subset of cell cycle genes via a novel ZMIZ1–ER–E2F2 signalling axis. Finally, we show that high ZMIZ1 expression is predictive of worse patient outcome, ER and ZMIZ1 are co-expressed in breast cancer patients in TCGA and METABRIC, and the proteins are co-localised within the nuclei of tumour cell in patient biopsies. In conclusion, we establish that ZMIZ1 is a regulator of the estrogenic cell cycle response and provide evidence of the biological importance of the ER–ZMIZ1 interaction in ER-positive patient tumours, supporting potential clinical relevance.

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