Our data indicate that the Notch pathway plays a critical role in esophageal squamous differentiation involving the canonical CSL-mediated transcriptional network (–). A novel functional interplay between N1 and N3 appears to be essential as N1 transcriptionally activates
N3 to drive squamous differentiation ( and ). In mouse, Notch inhibition not only impaired esophageal squamous differentiation, but caused basal cell hyperplasia and dysplasia (). These findings establish a novel model whereby crosstalk between N1 and N3 regulates squamous differentiation (
Supplementary Figure 14).
To our knowledge, this is the first demonstration of functionally active Notch signaling in normal esophageal epithelial cell biology. Both primary and immortalized human esophageal keratinocytes underwent terminal differentiation and formed stratified squamous epithelium in 3D culture in a CSL-dependent manner. Notch inhibition abrogated early and late differentiation in culture as well as in mice. GSI induces goblet cell metaplasia in the rat intestine without affecting normal esophageal squamous epithelium after five daily intraperitoneal injections
25. However, long-term GSI treatment may be required before GSI takes effect in the esophagus, given slower epithelial turnover (> 14 days)
26. DNMAML1 did not affect basal cell proliferation in 3D culture (). Thus, esophageal hyperplasia and dysplasia in mice may be explained by non-cell autonomous effects of Notch inhibition
9.
Loss of Notch signaling in the skin leads to barrier defects and squamous cell carcinoma
9 as well as atopic dermatitis-like disease
27. Thus, our mouse model may have implication in esophageal diseases such as cancer and eosinophilic esophagitis. Interestingly, focal inflammation was noted in a few
K14Cre;DNMAML1 esophagi (Shinya Ohashi
et al. unpublished data). Only forty percent of the
K14Cre;DNMAML1 mice displayed esophageal phenotypes at three months after birth although hair loss occurred with 100% penetrance rate, implying hair follicle dysfunction (John T. Seykora, manuscript in preparation). We suspect mosaicism in the
K14Cre;DNMAML1 mouse esophagus as a possible explanation. Such a difference in
Cre-mediated recombination efficiency between the esophagus and the epidermis may be accounted for by the fact that CK14 is induced postnatally in the esophagus
28.
Induction of
CK13, an esophageal-specific cytokeratin, implies tissue-specific differentiation while other markers such as
IVL and
FLG are shared with other squamous epithelia including that in the epidermis. Lack of Ivl and Flg expression in the
K14Cre;DNMAML1 mouse is in concordance with impaired differentiation by embryonic
K14Cre-mediated
Csl loss in the mouse epidermis
7. Similar to CK13 expression in esophageal cells, Ca
2+ induces skin-specific suprabasal cytokeratins
CK1 and
CK10 in a Csl-dependent fashion
7. However, there may be certain differences in the modes of Notch signaling during squamous differentiation between the esophagus and the skin, which includes hair follicle and interfollicular keratinocytes that are regulated differentially.
First,
Ivl can be induced in a
Csl-independent manner in mouse skin keratinocytes
29. By contrast, our data point to CSL-dependent
IVL transcription in esophageal keratinocytes. Second, Hes1 is induced most predominantly amongst the HES/HEY family of transcription factors upon Notch activation in epidermal keratinocytes
7 where Hes1 regulates Hey1/Hey2 and other Notch downstream target molecules such as p21 and Wnt4
30. In human esophageal cells, Ca
2+ induced
HES5 most robustly ( and
Supplementary Figure 2) with
HES1 induction only to a modest extent (data not shown). Functional redundancy of
Hes1 and
Hes5 has been implicated in neuronal differentiation
31. However, Hes5 determines T-cell fate depending upon the ligand density while Hes1 is indispensible for T-cell differentiation
32. Our data imply N3 serving an important functional role in HES5 induction.
ICN3, a weak transcriptional activator
10, failed to stimulate the
IVL promoter by itself, but enhanced ICN1-mediated
IVL transactivation (). Our data suggest a novel modulatory role of N3 upon N1-mediated
IVL induction. Although ICN and CSL binding was not validated in this study, four potential CSL-binding
cis-elements exist within the 2.5 kb promoter sequence in
IVL-luc construct. It is tempting to speculate that ICN1-ICN3 heterodimers may be formed on the
IVL promoter to recruit histone acetyltransferases, chromatin remodeling factors and other transcription factors as proposed previously
33. AP-1 and SP1 also regulate
IVL34. Thus, further study will be needed to identify factors cooperating with ICN1, ICN3 and CSL to regulate
IVL.
N1-mediated CSL-dependent
N3 transcription agrees with
N3 mRNA induction by
ICN135. Our ChIP assay data establish a direct link between ICN1 and
N3. N3 downregulation in the
K14Cre;DNMAML1 mouse esophagus supports this notion. What is the biological role of N3 in the esophagus? Reminiscent of our
K14Cre;DNMAML1 mouse phenotypes, esophageal hyperplasia has been noted when
N3 was deleted in the
N1N2 compound knockout mice, phenocopying the γ-secretase deficient skin
11. We did not observe apoptosis upon
N3 knockdown or
DNMAML1 expression (data not shown). However, N3 may inhibit apoptosis through AKT
36 and the mitogen-activated protein kinase pathways
37. AKT activation by epidermal growth factor receptor (EGFR) leads to esophageal hyperplasia suppressing late differentiation in organotypic 3D culture
38. Since EGFR signaling negatively regulates
N139, it will be of great interest to explore the role of N3 in this context.
In conclusions, our innovative approaches reveal novel functional crosstalk between N1 and N3 during differentiation, providing mechanistic insights into the role of Notch signaling in esophageal squamous epithelial biology.