Abstract

Patients with inflammatory bowel disease (IBD) have an increased risk of colorectal cancer, particularly in ulcerative colitis (UC) when the majority of colon epithelial cells may be exposed to inflammation-associated mutagenesis. In addition to mutagenesis generated by oxidative stress, inflammation can induce activation-induced cytidine deaminase (Aicda), a mutator enzyme in the APOBEC family, within colon epithelial cells. This study tested the hypothesis that deletion of the Aicda gene could protect against the development of inflammation-associated colorectal cancers, using a model of UC-like colitis in “T/I” mice deficient in TNF and IL10. Results showed that T/I mice that were additionally Aicda-deficient (“TIA” mice) spontaneously developed moderate to severe UC-like colitis soon after weaning, with histologic features and colon inflammation severity scores similar those in T/I mice. Although the mean survival of TIA mice was decreased compared to T/I mice, multivariable analysis that adjusted for age when neoplasia was ascertained showed a decreased numbers of neoplastic colorectal lesions in TIA mice, with a trend toward decreased incidence of neoplasia. Aicda deficiency increased serum IL1α and slightly decreased IL12p40 and M-CSF, as compared with T/I mice, and led to undetectable levels of IgA, IgG1, IgG2a, IgG2b, and IgG3. Taken together, these studies show that Aicda deficiency can decrease the number of neoplastic lesions but is not sufficient to prevent the risk of inflammation-associated colorectal neoplasia in the setting of severe UC-like inflammation. The TIA model may also be useful for assessing the roles of antibody class-switch recombination deficiency and somatic hypermutation on regulation of microbiota and inflammation in the small intestine and colon, as well as the pathogenesis of colitis associated with hyper-IgM syndrome in humans. Further studies will be required to determine the mechanisms that drive early mortality in TIA mice.

Highlights

  • Cancer risk in inflammatory bowel disease (IBD) appears to be proportional to the area of colon that is inflamed, with a lower risk in Crohn disease (CD) where inflammation is typically focal and higher in ulcerative colitis (UC) where inflammation is characteristically geographically continuous such that more colon epithelial cells are potentially exposed to inflammation-associated mutagenesis [4]

  • We previously reported that Tnf -/- Il10-/- (T/I) mice spontaneously developed moderate to severe UC-like colitis soon after weaning [20]

  • The studies reported here show that TIA mice that are triply deficient in Il10, Tnf, and the APOBEC family mutator enzyme activation-induced cytidine deaminase (Aicda) develop severe UC-like colitis soon after weaning, similar to T/I mice that are deficient in Tnf and Il10 alone

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Summary

Introduction

A personal history of inflammatory bowel disease (IBD) further increases colorectal cancer risk beyond that of the general population, reported relative risks have varied widely depending on the populations studied [1,2,3,4]. Cancer risk in IBD appears to be proportional to the area of colon that is inflamed, with a lower risk in Crohn disease (CD) where inflammation is typically focal and higher in ulcerative colitis (UC) where inflammation is characteristically geographically continuous such that more colon epithelial cells are potentially exposed to inflammation-associated mutagenesis [4]. The oxidative stress generated by inflammation within the colon can clearly enhance the rate of mutation accumulation, this alone appears to be insufficient to explain the increased risk of colorectal cancer in IBD patients

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