Tu1651 Indian Hedgehog Is Required for Intestinal Adenoma Formation

Abstract

Introduction: Activating mutations in the Hedgehog pathway are found in basal cell carcinomas and medulloblastomas. The role of Hedgehog signaling in intestinal tumorigenesis has not yet been clarified. Hedgehog is expressed by differentiated enterocytes and signals in a paracrine manner from the epithelium to the mesenchyme. Hedgehog controls mesenchymal factors such as Bone Morphogenetic Proteins and Activins which negatively regulate the proliferation of precursor cells. Since Indian Hedgehog (Ihh) is the major Hedgehog expressed in the intestinal epithelium we decided to study the potential role of Ihh signaling in intestinal adenoma formation.Methods: In order to study the effect of loss of Ihh signaling in sporadic tumorigenesis we conditionally deleted Ihh in adult mice in the intestinal epithelium using the Cyp1a1Cre promoter. These compound mice were crossed with conditional mutant Apc mice to generate Cyp1a1Cre-Ihh-Apc mice. At 4-7 weeks of age mice were intraperitoneally injected with 80 mg/kg β-naphthoflavone for 5 days. Cyp1a1Cre-IhhApc littermates served as controls. Four months after recombination, we sacrificed and analyzed the mice (n=15). Results: Ihh expression was upregulated in polyps of Cyp1a1CreIhh-Apc mice as assessed by in situ hybridization. Deletion of Ihh resulted in a marked reduction of 90.3% in the number of polyps (17.2 ± 13.65 polyps per mouse vs. 1.7 ± 1.5, P < 0.01). The average polyp size did not differ between groups. Neither did the number of proliferating or apoptotic cells in the polyps, as assessed by immunostaining for BrdU and cleaved caspase 3. Hh responsive cells in the adenomawere restricted to themesenchyme. In those adenomas that did develop in Ihh mutant mice, we observed a remarkable loss of α-sma/desmin double positive smooth muscle cells. COX2 is expressed early in adenoma to carcinoma transition and believed to play an important role in adenoma formation. Stromal cells are known to be a source of COX2. In accordance with this, examination of Cox2 expression by Q-PCR and immunostaining showed up regulation in polyps ofCyp1a1Cre-Ihh -Apc mice in compared to normal intestinal epithelium (P < 0.01, resp. P < 0.05). In contrast, Cox2 expression in the polyps of Cyp1a1Cre-Ihh-Apc mice was not significantly up regulated. Conclusion: Surprisingly, in contrast to its role as an anti-proliferative signal in the normal epithelium, Ihh acts as a tumor promoter. Our data show that Ihh signaling is increased during intestinal adenoma formation and as in the normal intestine Ihh signaling is exclusively from the epithelium to the mesenchyme. Loss of Ihh signaling is associated with major changes in the composition of the adenoma mesenchyme and decreased Cox2 expression, which significantly impairs adenoma formation.