The epithelial stem cell of the stomach is poorly characterized, which is surprising given its role in many gastric diseases. High doses of the Selective Estrogen Receptor Modulator (SERM) tamoxifen (HD-Tam) kill parietal cells and causes a proliferative, metaplastic gastric response which follows the pattern seen in patients chronically infected with Helicobacter pylori, but in a more synchronous and controllable model, with the effect peaking at 3 days post injections. Published studies using HD-Tam show that this response is dependent on a ?-ERK?CD44??-STAT3 signaling axis and combines proliferation both from expansion of the isthmal stem cell (iSC) and contribution from mature zymogenic cells which reprogram to re-enter the cell cycle, termed recruited stem cells (rSCs). While these proliferating populations are inseparable in their response to any metaplasia-causing agent, we recently discovered that highly specific diphtheria toxin (DT)-mediated parietal cell death induces iSC expansion but no metaplasia or rSC generation. These two models now allow us to specifically characterize iSCs and rSCs to determine their relative mechanisms of proliferation.
Our Aims are: 1) Characterize mechanisms of iSC expansion/recovery and determine the specific role of CD44 in iSC expansion both in vivo and in human and murine gastric organoids (?gastroids?). We will also sort pure iSCs following DT and mixed iSCs+rSCs following HD-Tam and run RNA-Seq to characterize each population. 2) Examine new metabolic pathways governing each proliferative population using rapamycin and metformin, both of which are seen to decrease proliferation following HD-Tam. These drugs will be tested in vivo following HD-Tam and DT as well as in gastroids, along with a drug screen to identify other proteins involved in their signaling pathways. 3) We are now able to determine whether metaplastic rSC generation increases risk of gastric tumorigenesis over increased iSC proliferation alone. We will follow an established protocol using the carcinogen MNU to drive tumorigenesis in mice while treating with cycles of DT or HD-Tam while monitoring the entire course of tumorigenesis non-invasively with Near Infrared Fluorescence live imaging with novel probes found to track gastric cancer in vivo. We will track specific mutations and proteins necessary for this cancer progression and focus on any candidates found with our large biobank of human gastric cancer tissues. Our DT and HD-Tam models allow us to separate iSC and rSC proliferation in the stomach for the first time, finally allowing for detailed characterization of each population. Our experiments aim to use this opportunity to attribute our known proliferative axis more specifically to iSC and/or rSC expansion, define new metabolic pathways involved in governing proliferation in each population, and run unbiased screens to identify additional modulators of these pathways. Finally, our models allow us to test a new theory for how solid tissue cancers arise, investigating whether rounds of reprogramming and cell cycle re-entry of mature, post-mitotic cells (rSC generation) increase risk for tumorigenesis over increased iSC proliferation alone.

Public Health Relevance

During inflammation caused by infection with the bacteria Helicobacter pylori, many cells of the stomach die and need to be replaced. Cells are repopulated through proliferation of the stomach?s stem cells as well as by other mature cells which do not normally proliferate but can do so following injury. Our grant proposal aims to find how both cell types react to the damage, and also investigates whether this damage response can increase the risk of gastric cancer.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK094989-08
Application #
9899231
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Greenwel, Patricia
Project Start
2012-09-11
Project End
2023-04-30
Budget Start
2020-05-01
Budget End
2021-04-30
Support Year
8
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Washington University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
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Mills, Jason C; Samuelson, Linda C (2018) Past Questions and Current Understanding About Gastric Cancer. Gastroenterology 155:939-944
Sáenz, José B; Mills, Jason C (2018) Acid and the basis for cellular plasticity and reprogramming in gastric repair and cancer. Nat Rev Gastroenterol Hepatol 15:257-273
Brown, Jeffrey W; Badahdah, Arwa; Iticovici, Micah et al. (2018) A Role for Salivary Peptides in the Innate Defense Against Enterotoxigenic Escherichia coli. J Infect Dis 217:1435-1441
Burclaff, Joseph; Mills, Jason C (2018) Plasticity of differentiated cells in wound repair and tumorigenesis, part I: stomach and pancreas. Dis Model Mech 11:
Willet, Spencer G; Lewis, Mark A; Miao, Zhi-Feng et al. (2018) Regenerative proliferation of differentiated cells by mTORC1-dependent paligenosis. EMBO J 37:
Jin, Ramon U; Mills, Jason C (2018) Are Gastric and Esophageal Metaplasia Relatives? The Case for Barrett's Stemming from SPEM. Dig Dis Sci 63:2028-2041
Radyk, Megan D; Burclaff, Joseph; Willet, Spencer G et al. (2018) Metaplastic Cells in the Stomach Arise, Independently of Stem Cells, via Dedifferentiation or Transdifferentiation of Chief Cells. Gastroenterology 154:839-843.e2
Osaki, Luciana H; Bockerstett, Kevin A; Wong, Chun Fung et al. (2018) Interferon-? directly induces gastric epithelial cell death and is required for progression to metaplasia. J Pathol :
Bockerstett, Kevin A; Osaki, Luciana H; Petersen, Christine P et al. (2018) Interleukin-17A Promotes Parietal Cell Atrophy by Inducing Apoptosis. Cell Mol Gastroenterol Hepatol 5:678-690.e1

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