title: The effect of cytostatic drug treatment on intestine-specific transcription factors Cdx2, GATA-4 and HNF-1alpha in mice.
abstract: Chemotherapy-induced intestinal damage is a very important dose-limiting side effect for which there is no definitive prophylaxis or treatment. This is in part due to the lack of understanding of its pathophysiology and impact on intestinal differentiation. The objective of this study was to investigate the gene expression of the small intestinal transcription factors HNF-1alpha, Cdx2, GATA-4 in an experimental model of methotrexate (MTX)-induced intestinal damage, and to correlate these alterations with histological damage, epithelial proliferation and differentiation. HNF-1alpha, Cdx2 and GATA-4 are critical transcription factors in epithelial differentiation, and in combination they act as promoting factors of the sucrase-isomaltase (SI) gene, an enterocyte-specific differentiation marker which is distinctly downregulated after MTX treatment. Mice received two doses of MTX i.v. on two consecutive days and were sacrificed 1, 3 and 7 or 9 days after final injection. Segments of the jejunum were taken for morphological, immunohistochemical and quantitative analyses. Intestinal damage was most severe at day 3 and was associated with decreased expression of the transcriptional factors HNF-1alpha, Cdx2 and GATA-4, which correlated well with decreased expression of SI, and seemed inversely correlated with enhanced proliferation of epithelial crypt cells. During severe damage, the epithelium was preferentially concerned with proliferation rather than differentiation, most likely in order to restore the small intestinal barrier function rather than maintaining its absorptive function. Since HNF-1alpha, Cdx2 and GATA-4 are critical for intestine-specific gene expression and therefore crucial in epithelial differentiation, these results may explain, at least in part, why intestinal differentiation is compromised during MTX treatment.
authors.affiliation: Laboratory of Pediatrics, Division of Pediatric Gastro-enterology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands. b.dekoning@erasmusmc.nl
authors.forename: Barbara A E
authors.initials: BA
authors.lastname: de Koning
authors.forename: Dicky J
authors.initials: DJ
authors.lastname: Lindenbergh-Kortleve
authors.forename: Rob
authors.initials: R
authors.lastname: Pieters
authors.forename: Edmond H H M
authors.initials: EH
authors.lastname: Rings
authors.forename: Hans A
authors.initials: HA
authors.lastname: Büller
authors.forename: Ingrid B
authors.initials: IB
authors.lastname: Renes
authors.forename: Alexandra W C
authors.initials: AW
authors.lastname: Einerhand
mesh_terms: D000818:Animals; D000964:Antimetabolites, Antineoplastic / Q000494:pharmacology*; D000071616:CDX2 Transcription Factor; D050991:GATA4 Transcription Factor / Q000378:metabolism; D051538:Hepatocyte Nuclear Factor 1-alpha / Q000378:metabolism; D018398:Homeodomain Proteins / Q000378:metabolism; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D007583:Jejunum / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000494:pharmacology*; D051379:Mice; D008807:Mice, Inbred BALB C; D013394:Sucrase-Isomaltase Complex / Q000378:metabolism; D015534:Trans-Activators / Q000378:metabolism
chemical_list: D000964:Antimetabolites, Antineoplastic; D000071616:CDX2 Transcription Factor; D050991:GATA4 Transcription Factor; D051538:Hepatocyte Nuclear Factor 1-alpha; D018398:Homeodomain Proteins; D015534:Trans-Activators; D013394:Sucrase-Isomaltase Complex; D008727:Methotrexate