The present study describes a new model of metastatic gastric cancer that is dependent on the tumor promoting activity of PPAR
δ agonist GW510516 following carcinogen administration. In contrast to a previous study reporting a low percentage of squamous cell carcinomas of the forestomach by DMBA [
43], our DMBA regimen produced only forestomach hyperplasia without signs of dysplasia up to five months after treatment ((B)). This suggests a high sensitivity of mouse forestomach squamous epithelium to dysplasia, and the predilection of GW501516 to promote tumors of this histotype [
19]. This model differs from N-methyl-N-nitrosourea-induced gastric tumors in wild-type and APC
Min transgenic mice [
44,
45] in that it is dependent on both DMBA-induced mutagenesis and the tumor-promoting effects of GW501516. A feature of this model is its short latency of approximately three weeks in comparison to 10 to 20 weeks for NMU-treated wild-type and APC
Min mice. An important histopathological distinction, and perhaps disadvantage of the GW501516 tumor model, is that it produces squamous cell carcinomas from the nonglandular forestomach rather than adenocarcinomas from the glandular tissue that comprises the majority of human gastric cancer [
46]. Since this model was dependent on the selective PPAR
δ agonist GW501516 [
47], it is important to note that the dose of GW501516 used in the present and previous studies [
19] is equivalent to daily oral doses of 3–10

mg/kg that were previously shown to specifically enhance PPAR
δ-dependent fatty acid oxidation in mice [
48]. In addition, PPAR
δ agonist GW7042, which is almost identical to GW501516 in structure, potency, and specificity, was inactive in inducing gene expression in PPAR
δ knockout mice [
49], suggesting that the tumor promoting effects of GW501516 and GW7042 are not due to off-target effects.
Tumors induced by GW501516 exhibited a distinct inflammatory gene expression signature comprised predominantly of chemokine, MMP, and S100 genes (Table S2). This was unexpected in view of the lack of a similar signature after treatment with GW501516 (Table S3), and the fact that GW501516 induces an anti-inflammatory response in macrophages [
50] and protects the heart against oxidative stress [
51,
52]. Gene ontology analysis of gene expression in the gastric tumors indicates that PPAR
δ, MMP12, MMP13, Cxcl1, Cxcl5, S100A8, and S100A9 share both common and disparate pathway interactions that likely contributed to the tumorigenic phenotype (). PPAR
δ is associated with activation of genes related to proliferation (EGFR, Akt1) and adhesion (Itgb2), whereas S100A9 is associated with angiogenesis (Fgf2) and inflammation (Ager). Cxcl1 activates proliferation (Mapk3, Mapk14, and Akt1), angiogenesis (Fgf2), and invasion (MMP2, MMP9), and Cxcl5 activates other chemokines (Cxcl1, Cxcl2, and Cxcl3) and Ptgs2/Cox2. This scheme reiterates the ability of S100A8 and S100A9 to act as ligands for Ager (advanced glycation end-product receptor), which mediates acute and chronic inflammation, tumor development, and metastasis [
53,
54]. This paradigm is also consistent with GW501516-induced activation of Ptges and Ptgs2/Cox-2 expression [
55,
56], which initiate the production of prostacyclins [
14] and arachidonic acid metabolites [
29] that serve as PPAR
δ ligands [
57]. Since Cox-2 inhibitors reduce inflammation-related gastrointestinal carcinogenesis [
58], and overexpression or deletion of Ptgs2 increases or suppresses tumorigenesis, respectively [
59,
60]; this suggests cooperativity between PPAR
δ and inflammatory signaling pathways in gastric tumorigenesis. The ability of PPAR
δ to have an anti-inflammatory effect in normal cells [
51,
52] and a proinflammatory effect in tumors is reminiscent of the dual roles of TGF-
β in tumor cells [
61,
62]. TGF
β can function as a proinflammatory cytokine to activate S100A8 and S100A9 expression in the presence of activated Ras [
63] but acts as a repressor of inflammation-induced PPAR
δ expression in normal cells [
64,
65]. The increased expression of the PPAR
δ target gene, Agptl4, the TGF
β-activated genes Runx1 and Runx2, and S100A8 and S100A9 in the gastric tumors indeed suggests a duality of function of both PPAR
δ and TGF
β signaling in gastric tumorigenesis.
PPAR
δ is ubiquitously expressed in gastrointestinal tissue and gastric tumors [
27], and GW501516 elicited increased PPAR
δ nuclear staining and elevated pAkt in gastric epithelium and tumors. PPAR
δ-dependant activation of Akt is required for the growth-promoting and antiapoptotic effects of PPAR
δ [
66–
68], as shown by the delayed wound-healing response of PPAR
δ-deficient keratinocytes [
57,
69]. Enhanced Krt6a and Krt16 expression in tumors further suggests that PPAR
δ plays an important role in gastric squamous cell differentiation and tissue renewal.
Tumors also exhibited reduced PPAR
γ and PPAR
α expression that may have resulted, in part, from the negative regulation of PPAR
γ by PPAR
δ [
70]. PPAR
γ suppresses the growth and invasion of human colon [
71] and gastric [
72,
73] and esophageal carcinoma cells [
74], and both PPAR
γ [
75] and PPAR
α have anti-inflammatory actions [
76]. Thus, reduction of PPAR
α and PPAR
γ expression may be an additional mechanism for facilitating the proinflammatory and tumor-promoting effects of GW501516.
In summary, we describe a rapidly developing metastatic gastric cancer model dependent on the tumor-promoting effects of GW501516 following carcinogen treatment, which suggests a proinflammatory switch in PPARδ function. This animal model will therefore be useful to delineate the role of PPARδ in tumor initiation and progression and as a possible target for early intervention.