Purpose: The purpose of this study was to investigate the expression and localization of NAC1, a member of the BTB/POZ gene family in the human cyclic endometrium. Experimental Design: NAC1expression in normal cyclic endometrium was assessed by immunohistochemistry, and data on clinical variables were collected by retrospective chart review. To elucidate the molecular mechanisms of NAC1expression in the normal endometrium endometrial carcinoma cell lines (Ishikawa, HHUA; ER+, PR+) and primary cultured normal endometria were tested in a sex steroid induction assay and a NAC1knockdown assay using siRNA. Results: Expression of NAC1in glandular cells was significantly higher in the early and mid proliferative phases than in the other menstrual phases. Both NAC1RNA and protein expression were up-regulated by treatment with 10 nmol/L17h-Estradiol (E2) in Ishikawa, HHUA and primary cultured normal endometrial cells.The estrogen receptor antagonist ICI 182,780 significantly attenuated E2-induced NAC1 expression. NAC1 gene knockdown inhibited cell growth and induced apoptosis in Ishikawa, HHUA, and normal endometria, all of which expressed NAC1. Furthermore, NAC1siRNA significantly abrogated estrogen-driven cellular proliferation in Ishikawa, HHUA, and primary cultured normal endometrial cells, whereas the control siRNA had no effect on cell growth in any of these cells. Conclusions: These findings suggest that NAC1 is functionally involved in E2-induced cell growth of the normal endometrial glandular cells. Because NAC1 is thought to have oncogenic potential, the current findings may provide new insight into the mechanism of estrogen induced endometrial carcinogenesis.Proliferation and differentiation of the human endometrium are controlled by ovarian steroids via their receptors. Estrogen stimulates the proliferation of both glandular and stromal cells, whereas progesterone inhibits their growth. Various aspects of hormone-induced proliferation and differentiation of the endometrium have been investigated. Studies have examined up-and down-regulation of steroid receptors (1, 2) and the role of growth factors or cytokines (3). The sex steroidinduced events are generally believed to occur via estrogen receptors (ER) and progesterone receptors. The molecular pathways downstream of these receptors that eventually promote the transcription of target genes, however, have not been fully elucidated. Steroid receptor cofactors have recently been identified as important molecules intervening between the receptors and target genes. These cofactors are now functionally divided into two subclasses, i.e., coactivators and corepressors. Cofactors are either activators or repressors for other transcription factors and participate in a transcriptional factor cascade of positive and negative regulators. Only a few factors, however, are directly involved in normal endometrial cycles.The genes of the BTB/POZ family participate in several cellular functions including proliferation, apoptosis, transcription control, and cell morpho...