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Evidence for acid‐induced loss of Cdx2 expression in duodenal gastric metaplasia
Author(s) -
Faller Gerhard,
Dimmler Arno,
Rau Tilman,
Spaderna Simone,
Hlubek Falk,
Jung Andreas,
Kirchner Thomas,
Brabletz Thomas
Publication year - 2004
Publication title -
the journal of pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.964
H-Index - 184
eISSN - 1096-9896
pISSN - 0022-3417
DOI - 10.1002/path.1590
Subject(s) - cdx2 , intestinal metaplasia , duodenum , medicine , homeobox , biology , foveolar cell , gastric mucosa , transcription factor , immunohistochemistry , endocrinology , cancer research , stomach , biochemistry , gene
Gastric metaplasia in the duodenum (GMD) is characterized by transdifferentiation of intestinal epithelial cells into gastric foveolar cells within the duodenal mucosa. GMD is often associated with duodenal ulceration. Higher duodenal acidity due to increased gastric acid output into the duodenum has been implicated in the development of GMD. Intestinal development and homeostasis are controlled by the homeobox transcription factor Cdx2, which is considered to be the master regulator of intestinal differentiation. Using immunohistochemistry, the present study shows that GMD is associated with loss of expression of Cdx2 and its target gene product sucrase‐isomaltase. Quantitative RT‐PCR experiments using the intestinal cell line Caco2 revealed that Cdx2 and sucrase‐isomaltase were down‐regulated and gastric mucins MUC5AC and MUC6 were up‐regulated under acidic culture conditions. Thus, it is suggested that increased acid exposure leads to GMD by impairing the transcription of Cdx2 and subsequently that of its intestine‐specific target genes. Copyright © 2004 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.