Abstract 1520: CDX2 regulates Multidrug Resistance 1 gene expression in malignant intestinal epithelium

Abstract

Abstract The intestine-specific caudal-related homeobox transcription factor CDX2 is important for intestinal development and differentiation. CDX2 heterozygous mice form colonic polyps, and loss of CDX2 expression is seen in some poorly differentiated colon carcinoma in humans. Conversely, ectopic CDX2 expression in the stomach of transgenic mice promotes intestinal metaplasia, and CDX2 expression is often seen in stomach and esophageal metaplasia. We sought to define CDX2-regulated genes to enhance the knowledge of CDX2 function. HT-29 colorectal cancer cells with minimal endogenous CDX2 expression were generated to express exogenous CDX2, and the gene expression changes were assessed by microarrays. Activation of CDX2 rapidly induced Multidrug Resistance 1 (MDR1/P-glycoprotein/ABCB1) gene expression in HT-29 cells, even in the presence of protein synthesis inhibitor, and RNA interference-mediated inhibition of CDX2 decreased MDR1 expression. In other colorectal cancer cell lines and human tissues, endogenous MDR1 expression was well correlated to CDX2 expression. Analysis with MDR1 reporter gene constructs and chromatin-immunoprecipitation assays suggested that CDX2 directly regulates MDR1 transcription. Overexpression of CDX2 in HT-29 cells revealed increased resistance to MDR1's known substrate, vincristine and paclitaxel, which was reversed by an MDR1 inhibitor, verapamil. These data indicate that CDX2 directly regulates MDR1 gene expression via binding to elements in the promoter region. Thus, CDX2 is probably important for basal expression of MDR1, regulating drug excretion and absorption in the lower gastrointestinal tract, as well as for multidrug resistance to chemotherapy reagent in CDX2-positive gastrointestinal cancers. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1520.