Kit-positive Interstitial Cells Of Cajal Research Articles

LIX1 regulates YAP activity and controls gastrointestinal cancer cell plasticity.

Gastrointestinal stromal tumours (GISTs), the most common mesenchymal neoplasm of the gastrointestinal tract, result from deregulated proliferation of transformed KIT‐positive interstitial cells of Cajal that share mesenchymal progenitors with smooth muscle cells. Despite the identification of selective KIT inhibitors, primary resistance and relapse remain a major concern. Moreover, most patients develop resistance partly through reactivation of KIT and its downstream signalling pathways. We previously identified the Limb Expression 1 (LIX1) gene as a unique marker of digestive mesenchyme immaturity. We also demonstrated that LIX1 regulates mesenchymal progenitor proliferation and differentiation by controlling the Hippo effector YAP1, which is constitutively activated in many sarcomas. Therefore, we wanted to determine LIX1 role in GIST development. We found that LIX1 is strongly up‐regulated in GIST samples and this is associated with unfavourable prognosis. Moreover, LIX1 controls GIST cell proliferation in vitro and in vivo. Upon LIX1 inactivation in GIST cells, YAP1/TAZ activity is reduced, KIT (the GIST signature) is down‐regulated, and cells acquire smooth muscle lineage features. Our data highlight LIX1 role in digestive mesenchyme‐derived cell‐fate decisions and identify this novel regulator as a target for drug design for GIST treatment by influencing its differentiation status.

The effects of Glivec on the urinary bladder excitation of rats with suprasacral or sacral spinal cord transection

BackgroundTo investigate the effects of the c-kit blocker imatinib mesylate (Glivec) on the bladders of animals with suprasacral cord injury (SSCI) and sacral cord injury (SCI). Materials and methodsWe randomized 60 female Sprague-Dawley rats into control, sham, SSCI (T8/9 transection), and SCI (S1-3 transection) groups. Six weeks later, we evaluated the effects of stepwise Glivec administrations on urinary bladder contraction using cystometry and the detrusor strip stretch-test. We investigated spontaneous calcium transients of kit-positive interstitial cells of Cajal (ICCs) with the preloaded Ca2+ indicator fluo-3AM. The expression levels of c-kit and the number of ICCs in those bladders were determined using Western blot and fluorescence staining analyses, respectively. ResultsBladder capacity and compliance were decreased in SSCI bladders and increased in SCI bladders (P<0.05). The amplitude and frequency of spontaneous contractions of detrusor strips, the frequency and relative fluorescence intensity of the spontaneous Ca2+ waves, and c-kit expression in the bladder were significantly increased in the SSCI group and decreased in the SCI group compared with the control and sham groups (P<0.05). The dose-dependent effects of Glivec also confirmed consistent functional variations in bladder activity. ConclusionsThe expressions and effects of Glivec were enhanced in SSCI bladders and inhibited in SCI bladders, which may indicate potential roles of ICCs for the c-kit signaling pathway in the pathogenesis of SSCI and SCI bladder.

Inactivation of Patched1 in Mice Leads to Development of Gastrointestinal Stromal-Like Tumors That Express Pdgfrα but Not Kit

A fraction of gastrointestinal stromal tumor (GIST) cells overexpress the platelet-derived growth factor receptor (PDGFR)A, although most overexpress KIT. It is not known if this is because these receptor tyrosine kinases have complementary oncogenic potential, or because of heterogeneity in the cellular origin of GIST. Little also is known about why Hedgehog (HH) signaling is activated in some GIST. HH binds to and inactivates the receptor protein patched homolog (PTCH). Ptch was conditionally inactivated in mice (to achieve constitutive HH signaling) using a Cre recombinase regulated by the lysozyme M promoter. Cre-expressing cells were traced using R26R-LacZ reporter mice. Tumors were characterized by in situ hybridization, immunohistochemistry, immunoblot, and quantitative reverse-transcriptase polymerase chain reaction analyses. Cell transformation was assessed by soft agar assay. Loss of Ptch from lysozyme M-expressing cells resulted in the development of tumors of GIST-like localization and histology; these were reduced when mice were given imatinib, a drug that targets KIT and PDGFRA. The Hh signaling pathway was activated in the tumor cells, and Pdgfrα, but not Kit, was overexpressed and activated. Lineage tracing revealed that Cre-expressing intestinal cells were Kit-negative. These cells sometimes expressed Pdgfrα and were located near Kit-positive interstitial cells of Cajal. In contrast to KIT, activation of PDGFRA increased anchorage-independent proliferation and was required for tumor formation in mice by cells with activated HH signaling. Inactivation of Ptch in mice leads to formation of GIST-like tumors that express Pdgfrα, but not Kit. Activation of Pdgfrα signaling appears to facilitate tumorigenesis.

Analysis of pacemaker activity in the human stomach

Extracellular electrical recording and studies using animal models have helped establish important concepts of human gastric physiology. Accepted standards include electrical quiescence in the fundus, 3 cycles per minute (cpm) pacemaker activity in corpus and antrum, and a proximal-to-distal slow wave frequency gradient. We investigated slow wave pacemaker activity, contractions and distribution of interstitial cells of Cajal (ICC) in human gastric muscles. Muscles were obtained from patients undergoing gastric resection for cancer, and the anatomical locations of each specimen were mapped by the operating surgeon to 16 standardized regions of the stomach. Electrical slow waves were recorded with intracellular microelectrodes and contractions were recorded by isometric force techniques. Slow waves were routinely recorded from gastric fundus muscles. These events had similar waveforms as slow waves in more distal regions and were coupled to phasic contractions. Gastric slow wave frequency was significantly greater than 3 cpm in all regions of the stomach. Antral slow wave frequency often exceeded the highest frequency of pacemaker activity in the corpus. Chronotropic mechanisms such as muscarinic and prostaglandin receptor binding, stretch, extracelluar Ca(2+) and temperature were unable to explain the observed slow wave frequency that exceeded accepted normal levels. Muscles from all regions through the thickness of the muscularis demonstrated intrinsic pacemaker activity, and this corresponded with the widespread distribution in ICC we mapped throughout the tunica muscularis. Our findings suggest that extracellular electrical recording has underestimated human slow wave frequency and mechanisms of human gastric function may differ from standard laboratory animal models.

Immunoreactivity for Ano1 detects depletion of Kit-positive interstitial cells of Cajal in patients with slow transit constipation

Depletion of interstitial cells of Cajal (ICC) is associated with several gastrointestinal (GI) motility disorders. Changes in ICC networks are usually detected by immunolabeling for the receptor tyrosine kinase Kit. Ano1 (DOG1 or TMEM16A) was recently described as a marker of ICC in GI tract. Our aim was to determine whether Ano1 immunoreactivity can be used as a reliable marker for ICC in tissues from patients with motility disorders. Four tissues from patients with normal ICC numbers and four tissues from patients with slow transit constipation and loss of Kit-positive ICC were studied. Interstitial cells of Cajal were detected by double labeling using antisera to Kit and Ano1. Both the processes and cell bodies of ICC in tissue from controls and slow transit constipation were immunoreactive for Ano1. There was a near complete overlap between Kit and Ano1 immunoreactivity. Tissues from patients with slow transit constipation contained significantly fewer Ano1-positive ICC than control tissues. The numbers of ICC identified by Ano1 and Kit immunoreactivity were nearly identical across the range of ICC numbers from an average of 1.64 to 7.05 cells per field and correlated with an R(2) value of 0.99. Ano1 is a reliable and sensitive marker for detecting changes in ICC networks in humans. Labeling with antibodies selective for Ano1 reproducibly detects depletion of Kit-positive ICC in tissues from patients with slow transit constipation.

Role of KIT-Positive Interstitial Cells of Cajal in the Urinary Bladder and Possible Therapeutic Target for Overactive Bladder.

In the gastrointestinal tract, interstitial cells of Cajal (ICCs) act as pacemaker cells to generate slow wave activity. Interstitial cells that resemble ICCs in the gastrointestinal tract have been identified by their morphological characteristics in the bladder. KIT is used as an identification marker of ICCs. ICCs in the bladder may be involved in signal transmission between smooth muscle bundles, from efferent nerves to smooth muscles, and from the urothelium to afferent nerves. Recent research has suggested that not only the disturbance of spontaneous contractility caused by altered detrusor ICC signal transduction between nerves and smooth muscle cells but also the disturbance of signal transduction between urothelial cells and sensory nerves via suburothelial ICC may induce overactive bladder (OAB). Recent reports have suggested that KIT is not only a detection marker of these cells, but also may play a crucial role in the control of bladder function. Research into the effect of a c-kit receptor inhibitor, imatinib mesylate, on bladder function implies that KIT-positive ICCs may be therapeutic target cells to reduce bladder overactivity and that the blockage of c-kit receptor may offer a new therapeutic strategy for OAB treatment, although further study will be needed.

Attenuation of bladder overactivity in KIT mutant rats

To investigate morphological and physiological findings in the bladder of KIT mutant (WsRCWs/Ws) rats to clarify whether the disturbance of KIT pathways affects bladder activity. To discuss the potential role of KIT-positive interstitial cells of Cajal (ICC)-like cells in the urinary bladder. Reverse transcriptase-polymerase chain reaction and western blotting was used to confirm the absence of c-kit mRNA and protein in the bladders of 12-week-old WsRCWs/Ws rats. Light and transmission electron microscopy was used to identify the differences in morphological and ultrastructural characteristics of the bladder between WsRCWs/Ws and wild-type (WsRC+/+) rats. The voiding pattern of WsRCWs/Ws rats and the effects of cyclophosphamide (CYP) and protamine sulphate on bladder function were examined using cystometry. In WsRC+/+ rats, c-kit mRNA and KIT protein expression were observed in the urinary bladder, while they were not detectable in WsRCWs/Ws rats. Deformation of ICC-like cells with the collapse of the organelle was not observed in the bladders of WsRCWs/Ws rats. Each cystometry variable in WsRCWs/Ws rats was similar to that in WsRC+/+ rats. The reduction in the intercontraction intervals in WsRCWs/Ws rats with chemically (CYP and protamine sulphate) induced cystitis was significantly lower than in WsRC+/+ rats (P < 0.05). Certain voiding disturbances might be associated with impaired KIT signalling in ICC-like cells, therefore, KIT could be a candidate target for medical therapy in the future.

The Role of Capsaicin in Spontaneous Pacemaking Activity in Gastrointestinal Tract

Interstitial cells of Cajal (ICCs) are the pacemaking cells in the gastrointestinal (GI) tracts that generate the rhythmic oscillations in the membrane potential which were known as slow waves recorded in native smooth muscle tissue preparations in the past. Auto-rhythmicity in GI tracts is an exclusive property of ICCs and the spread of slow waves through GI tracts occurs electrically, and not by the active regeneration properties of ICCs and smooth muscles. Pacemaking ICCs are organized into electrically coupled networks within discrete areas of the stomach, small intestine, and colon.1,2 ICCs were originally identified by Santiago Ramon y Cajal and were characterized by morphological criteria until the discovery that these cells express the receptor tyrosine kinase Kit.3 Subsequent studies determined that Kit immunoreactivity in the muscularis propria of the GI tract is restricted to 2 cell types: mast cells4 and ICCs. Kit-positive ICCs are distributed throughout the GI tract as well as in other smooth muscle tissues.5 All regions of the GI tract contain ICCs but the location within the muscularis propria varies according to region or species.6 In the myenteric plexus region, ICCs form a network between the muscle layers forming a mesh around the ganglia and are considered as major pacemaker cells. A network of deep muscular plexus ICCs is present in the small intestine between the inner and outer circular muscle layers.6 In the colon and parts of the gastric antrum, submuscular ICCs are located outside the circular muscle layer.7 Intramuscular ICCs are distributed through the longitudinal and circular muscle layers and are considered to be involved in neurotransmission from nerve terminals. Septal ICCs are found between the fascicles of muscle in humans and other large species. These can be considered as one type of intramuscular ICCs.8 Stellate, subserosal ICCs are observed on the boundary between the longitudinal muscle and the serosa in the colon of mice.9 Capsaicin (8-methyl-N-vanillyl-6-ninenamide) activates afferent fiber endings and capsaicin sensitive primary afferent neurons participate in the regulation of GI motility.10 Furthermore, capsaicin induces contraction in the guinea-pig ileum11 and relaxation in human small and large intestines.10 Namely, it is known that capsaicin may have excitatory action on animal GI motility but inhibitory on human. However, information about the effect of capsaicin on human GI motility is somewhat controversial. Some reports showed the oral administration of capsaicin to fail in showing a significant effect on GI motility in human12-14 but there are reports that capsaicin could contribute to protection of the esophagus and could promote retention of the irritant in the stomach and faster transit through the small bowel.15 However, there are no reports on the direct effect of the capsaicin on ICCs that have important roles for regulation of GI motility as pacemaker cells. In this issue of the Journal of Neurogastroenterology and Motility, Choi et al examined the role of capsaicin on ICC in mouse small intestine. They showed that capsaicin inhibited the pacemaker activity of ICC dose-dependently. The effect of capsaicin, however, is not through the transient receptor potential of the vanilloid type 1 (TRPV1) channel because capsazepine did not block the effect of capsaicin. Consistently with this result, they also showed in their previous study that TRPV1-immunopositive cells were not co-localized with c-Kit positive tissue layer.16 The effect of capsaicin was not through nitric oxide release from ICCs, because there was no influence on capsaicin-induced action by L-NAME, an inhibitor of nitric oxide synthase in their study. Choi et al. proposed that further studies are needed to investigate the direct effect of capsaicin on pacemaker ion channels like TRPC4 or TRPM7 responsible for pacemaking activity in ICCs.17 Interestingly, when the action of capsaicin was examined in the intracellular calcium oscillation, capsaicin completely abolished the calcium oscillation in ICCs. Recently, 3 research groups showed simultaneously the calcium activated Cl channels to be required for pacemaking activity using TMEM16A knockout mice.18-20 Capsaicin might inhibit pacemaking activity of ICCs through the decreased activity of calcium activated Cl channels due to completely abolished calcium oscillations by application of capsaicin to ICCs. The effect of capsaicin seems more complicated because capsaicin acts on ICCs as well as afferent nerve endings of GI tract. In the future, more sophisticated studies are needed to clarify the role of capsaicin in GI tract considering ICCs and species differences.

Study on distribution of interstitial cells of Cajal in the sigmoid colon of patients with slow transit constipation

Slow transit constipation (STC) is a colonic motor disorder whose etiology remains unclear. Recent studies have demonstrated a crucial role for interstitial cells of Cajal (ICC) in regulation of intestinal motility. The aim of this study was to examine the distribution of ICC within the normal sigmoid colon and STC patients. Twelve patients with STC and eight age-matched controls were studied. ICC were identified with a monoclonal antibody to c-kit by an indirect immunofluorescence method. Immunostained tissues were examined with a laser scanning confocal microscope and the area occupied by ICC was calculated with image analysis software. ICC were located in the external muscle layers including longitudinal muscle (LM), myenteric plexus (MP), circular muscle (CM) and submucosal border (SMB). Two types of Kit-positive ICC were observed: bipolar cells characterized by one or two long processes, and multipolar cells with long stellate processes extending in various directions. A higher percentage of ICC was present in the MP regions and CM layers compared with the SMB and LM layers. Tissues from STC patients showed considerably decreased in number of ICC located in the four regions (ICC-LM, ICC-MP, ICC-CM, ICC-SMP), especially for ICC-SMP, almost completely disappeared. Decreased c-kit + ICC in number may play an important role in the pathophysiology of STC. It remains to be determined whether loss of ICC is primary or secondary to another lesion.

Electrical rhythmicity and spread of action potentials in longitudinal muscle of guinea pig distal colon.

Using simultaneous intracellular recordings, we have characterized 1) electrical activity in the longitudinal muscle (LM) of isolated segments of guinea pig distal colon free to contract spontaneously and 2) extent of propagation of spontaneous action potentials around the circumference of the colon. In all animals, rhythmical spontaneous depolarizations (SDs) were recorded that are usually associated with the generation of action potentials. Recordings from pairs of LM cells, separated by 100 microm in the circumferential axis, revealed that each action potential was phase locked at the two electrodes (mean propagation velocity: 3 mm/s). However, at an increased electrode separation distance of 1 mm circumferentially, action potentials and SDs became increasingly uncoordinated at the two recording sites. No SDs or action potentials ever propagated from one circumferential edge to the other (i.e., 13 mm apart). When LM strips were separated from the myenteric plexus and circular muscle, rhythmically firing SDs and action potentials were still recorded. Atropine (1 microM) or tetrodotoxin (1 microM) either reduced the frequency of SDs or temporarily abolished activity, whereas nifedipine (1 microM) always abolished SDs and action potentials. Kit-positive interstitial cells of Cajal were present at the level of the myenteric plexus and circular and longitudinal muscle. In summary, SDs and action potentials in LM propagate over discrete localized zones, usually <1 mm around the circumference of the colon. Furthermore, in contrast to the classic slow wave, rhythmic depolarizations in LM appear to be generated by an intrinsic property of the smooth muscle itself and are critically dependent on opening of L-type Ca(2+) channels.

Abnormal colonic interstitial cells of Cajal in children with anorectal malformations

Background/Purpose: Constipation is a frequent functional problem in children after operation for all types of anorectal malformations. Although this has been assumed to be caused by hypomotility of the rectosigmoid colon, recent studies have demonstrated generalized colonic hypomotility in children with high or intermediate anomalies. The cause of this disorder is unknown. The aim of this study was to determine whether the observed colonic hypomotility seen in patients with anorectal malformations was caused by defects in distribution or density of interstitial cells of Cajal (ICC), recently identified as ‘intestinal pacemaker cells’. Methods: Colostomy specimens from 12 patients with high anorectal anomalies (ARM group; age 0 to 14 months) were compared with colostomy specimens from five control patients with nonmotility-related gastrointestinal pathology (age, 1 to 4 months). Specimens were immunohistochemically labelled with antibodies to PGP9.5, a marker for neural tissue, and antibodies to c- kit, a recently characterized marker for interstitial cells of Cajal (ICC). Results: Ganglion cells were present in all histological specimens. Abnormalities in distribution and density of c- kit-positive ICC were present in 7 of 12 ARM patients. In two ARM patients, ICC were completely absent, and in five patients, ICC density was markedly reduced in circular muscle and at the submucosal border of circular muscle. Only five ARM patients had a distribution of ICC similar to that of control patients. Conclusion: Defects in the population of intestinal pacemaker cells may underlie the colonic hypomotility seen in high anorectal malformations and hence may contribute to refractory constipation.