These data demonstrate that although the intestinal mucosa of the
Apc1638N/+ mouse exhibits normal histology and function, the complex reprogramming of intestinal epithelial cells as they migrate from the progenitor cell compartment in the crypt is perturbed. This was determined by altered patterns of transcriptional activation along the CVA of key genes in the Notch pathway (Hes1 and Math1), and two genes (cyclin D1 and c-myc) that drive proliferation in the progenitor cell compartment regulated by Wnt and Notch signaling, fundamental developmental pathways that cooperate in maintaining the crypt progenitor cell compartment. Expression profiling then showed that although general patterns of reprogramming were maintained in villus compared to crypt cells in the mucosa of
Apc1638N/+ mice, there was a significant compromise in the reprogramming in the mutant mice compared to their WT littermates. These changes in the mutant mice encompassed perturbed profiles of lineage specific markers and altered expression of sequences that govern metabolic patterns. Changes are modest, consistent with the fact that the tissue continues to appear morphologically and functionally normal, but overall patterns of change indicate that it is significantly perturbed in comparison with the mucosa in wild-type mice. It has been reported that enterocyte migration along the crypt-villus axis is decreased in
ApcMin+ mice (
38), consistent with the dampened maturation of cells in the villi. Although this was not detected in the
Apc1638N/+ mouse (
39), this may be related to the much more modest tumor phenotype in
Apc1638N/+ compared to
ApcMin/+.
In the
Apc1638N/+ mouse, loss of the mutant allele is not detected until development of frank tumors (
40), an observation we confirmed ((
41), and additional data not shown). Moreover, we determined that the expression of the wild-type allele
Apc is reduced in the histologically normal mucosa by 40–60%, coupled with a 25% reduction in APC protein of 25% (not shown). In addition, the
Apc1638N/+ mice do not accumulate significant levels of a truncated APC protein encoded by the mutant allele. Therefore, we conclude that the changes in the underlying molecular biology of the mucosa are due to haploinsufficiency of the wild-type allele.
The shift of cells exhibiting active cyclinD1 and c-myc transcription, and Notch signaling, along the CVA in the mucosa is important because these genes and pathways likely drive the expanded proliferative compartment that characterizes the mucosa at genetic and/or nutritional risk for tumor development (
11). Continued proliferation of cells with a progenitor cell phenotype into zones where cell cycling is normally repressed can contribute to hyperplastic growth and expand the stem-like cell compartment which must be targeted by the loss of the second
Apc allele for tumors to form (
42). Affects on apoptosis may be less important: rates in the intestinal mucosa are very low and a mutation affecting short-chain fatty acid metabolism that reduce this >90% does not cause tumor development (
43). Further, targeted inactivation of Tcf4 in the mouse, which, in complex with β-catenin, is a major effector of intestinal Wnt signaling regulated by
Apc, leads to post-partum lethality as the mucosa deteriorates and cannot be regenerated due to premature differentiation, but not apoptosis, of intestinal progenitor cells (
44).
Math1 drives secretory cell differentiation of intestinal epithelial cells, and in its absence there is default to the enterocyte lineage (
35). Thus, the decrease in 9 of 10 secretory cell markers and the complementary increase in 6 of 6 enterocyte markers was consistent with that predicted by the repression of Math1 transcription sites in the mutant mice. However, altered expression of these markers likely reflects perturbed coordination of differentiation programs, rather than significant shifts in overall lineage allocation, since the mucosa appears normal until focal loss of the second
Apc allele and tumor initiation.
A novel finding was decreased expression of genes that encode enzymes of every step of the TCA cycle in crypt cells in
Apc1638N/+ mice compared to
Apc+/+ mice, in contrast to the lack of such changes in the villus cells of the same mice. This is similar to alterations we reported in the mucosa of both the small and large intestine of mice at nutritional risk for tumor formation (
27), which we recently found is also enriched in the crypt (not shown). Here we have shown association of these changes with perturbed expression of Hif1α, and its targets, VEGF and hexokinase 2. We hypothesize that these data reflect a shift in the tissue towards glycolytic metabolism, and generation of a (pseudo)hypoxic state that promotes tumorigenesis. It has been suggested that a shift towards glycolysis favors proliferation, higher in the crypt, by providing biochemical intermediates for synthesis of macromolecules and increase in biomass (
45). In regards to the potentially greater shift in the crypts of mutant compared to wild-type mice, it is important that hypoxia and Hif1α expression are characteristics of stem cell niches (
46–
50), and that genes encoding enzymes of the TCA cycle are
bona fide proto-oncogenes that, when mutated, lead to accumulation of TCA cycle intermediates (
51–
53) that can trigger Hif1α expression either by succinate inhibition of prolyl hydroxylase activity, and/or by generating increases in reactive oxygen species (
54). Moreover, elevated Hif1α expression has been shown to be a direct cause of intestinal polyp formation in Peutz-Jaeghers syndrome, mediating a metabolic shift that drives tumorigenesis (
55). Down regulation of the TCA cycle, a shift towards glycolytic metabolism, and a hypoxic response contributing to higher probability of tumor development in the intestinal mucosa by either genetic or environmental influences can be important in both screening strategies for early detection and as targets for chemoprevention.
Wnt signaling may contribute to intestinal tumorigenesis as a continuum of effects related to extent of altered signaling (
56), increases in Wnt signaling beyond those sufficient for initiation are necessary for intestinal tumor progression, (
57), and embryonic stem cell differentiation is modulated as a function of extent of β-catenin signaling levels (
58). Thus, it is tempting to speculate that the inherited
Apc1638 mutation causes modest changes in Wnt signaling that drive the altered transcriptional and expression patterns. While steady state levels of expression of several Wnt target genes (c-myc, cyclin D1, Sox9, Lgr5 and jagged1) were, as expected, higher at the bottom of the crypt of both normal and mutant mice, these steady state levels were not significantly different at any position along the crypt-villus axis of
Apc1638N/+ compared to WT mice (data not shown). However, whether Wnt signaling is functionally altered in the mucosa of
Apc1638N/+ mice is not easily resolved. For example, if inactivation of one
Apc allele decreases
Apc expression, modestly increasing Wnt activity, this would greatly increase the probability that stochastic variations in expression of the wild-type allele could transiently exceed a threshold sufficient to significantly alter steady state levels of direct Wnt targets (
59). This also applies to the variation in VEGF and HEK2 levels that are seen (), although these changes in
Apc1638N/+ compared to
Apc+/+ mice reach statistical significance. While such focal and transient changes might not be detected in cell populations isolated from the mucosa, the important effect of these stochastic variations in tumor suppressor gene expression has been discussed in detail (
59). Alternatively, the alterations in the mucosa of
Apc1638N/+ mice may depend on perturbation of one of the many other functions that have been reported for APC, rather than changes in Wnt signaling.
In summary, in
Apc1638N/+ mice few tumors develop over an extended period and the histologically normal intestinal mucosa can be readily investigated. We have found that in this histologically normal mucosa, there are significant alterations in the dynamics of cell reprogramming along the crypt-villus axis and of markers of normal cell maturation. We have previously shown that some of these changes are present in the mucosa at dietary risk (
27). Thus, just as alterations at distant tissue sites contribute to tumor metastasis by generating receptive environments, probability of tumor development at the primary site may be modulated by alterations that precede the reduction of the inherited mutation to homozygosity, or the generation of initiating mutations. Therefore these findings have important implications for understanding the mechanism of risk and tumor formation in this tissue, and for clinical approaches to early detection and prevention.