Bile acid induction of CSCs

The primary objective of the current investigation is to determine whether bile acids, specifically DCA and/or LCA, would induce CSCs in colonic epithelial cells.

In the first set of tests, we examined the changes in expression of a number of CSC markers as well as the proportion of CSCs in HCoEpiC following exposure to DCA or LCA for 72  they would. We observed that both DCA and LCA triggered a marked 2-fold to 40-fold increase in the mRNA levels of CSC markers CD44, CD166, and ALDHA1 within HCoEpiC when compared with the control (Fig.  

1a– c

). Nevertheless , LCA was found to be more effective than DCA within inducing the expression of these markers (Fig.  


). Additionally , the proportion of CD44-positive and CD166-positive populations had been found to be markedly higher in DCA-treated or LCA-treated cells, compared with the corresponding vehicle-treated control (Fig.  


). These observations suggest that DCA and LCA can cause CSCs in colonic epithelial cells. To further investigate this problem, we examined the ability of DCA and LCA in order to stimulate spheroid formation by HCoEpiC, a property common in order to both normal and CSCs. To conduct this analysis, we isolated the CD44



phenotype from HCoEpiC by flow cytometry. This CSC phenotype was found to be a predictor associated with colonic adenoma [




]. Cells were incubated right after 12  days in stem cell media in the lack or presence of DCA or LCA. Incubation within stem cell media is known to kill epithelial cells although not stem cells/CSCs. Indeed, after 5– 6 days of incubation, some cells began to form spheroids (surrogate tumors) within the absence or presence of bile acids. However , in late the 12-day incubation period, the size of the spheroids created by the CD44



CSC phenotype of HCoEpiC in the presence of DCA or LCA was found to be markedly greater than all those formed in the absence of bile acids (controls) (Fig.  


). At 12  days, the DCA-treated and LCA-treated spheroids also showed the required integrity of spheroids. These findings further suggest that bile acids induce stemness in regular human epithelial cells.

Fig. 1

DCA and LCA induce increases in CSC guns. Quantitative real-time PCR showed significantly increased mRNA appearance of CD44 ( a ), CD166 ( b ), plus ALDHA1 ( c ) within HCoEpiC following incubation with 100  μ M DCA or LCA for 72  h. Flow cytometric evaluation of HCoEpiC showing an increased proportion of CD44-positive plus CD166-positive cells following 12-day incubation in the absence (control) or presence of 100  μ M DCA or even LCA ( d ). DCA/LCA mediated the increase in spheroid formation by the CD44 + CD166 CSC phenotype of HCoEpiC ( e ); photomicrographs showing spheroids formed according to DCA or LCA at the end of the 12-day incubation time period. For spheroid formation, CD44 + CD166 cells had been sorted by flow cytometry and 200– 300 cellular material were seeded with B27 containing DMEM/F12 medium within 96-well low-attachment plates; 24  h after seeding, 100  μ M DCA or LCA was added to the particular incubation medium, and cells were incubated for an extra 12  days. 0 Day , cell size at the time of plating. The sizes of spheres were photographed and measured on a 100  μ mirielle scale at a magnification of 400× using an Olympus microscope. Data represent the mean  ±   standard change of 15 sphere determinations. ** G   <   0. 01, ** *P   <   0. 001, compared with control. Data were analyzed by ANOVA, Tukey HSD test for multiple comparisons ( e ). DCA deoxycholic acid, LCA lithocholic acid

Like normal come cells, CSCs exhibit self-renewal in a de-differentiated state, pluripotency, but form tumors with a very small number of cells [


]. Four key transcription factors, OCT4 (POU course 5 homeo box 1), KLF4 (Kruppel like aspect 4), SOX2 (SRY-box 2), and c-Myc (v-myc bird myelocytomatosis viral oncogene homolog) (OKSM), have been identified as pluripotency genes in CSCs. OKSM have been shown to induce dysplasia and tumorigenesis in vivo [



]. In view of the, we examined the expression of KLF4, Nanog, OCT4, and SOX2 in HCoEpiC in response to DCA/LCA. As continues to be observed for CSC surface epitopes, the expression associated with KLF4, Nanog, OCT4, and SOX2 was also significantly raised following incubation for 7  days with 100  μ M DCA or LCA, when compared with the corresponding manage (Fig.  


). These increases were accompanied by concomitant raises in the expression of N-cadherin, Slug, Twist, Vimentin, Zeb1, and Zeb2 (Fig.  


) which are considered to be markers associated with epithelial– mesenchymal transition (EMT), cells that are thought to stand for CSCs [



]. Taken together, the results suggest that DCA or even LCA is able to transform colonic epithelial cells into CSCs.

Fig. 2

Exposure of DCA/LCA in HCoEpiC increased the expression of pluripotency genetics. Levels of mRNA encoding the pluripotency genes KLF-4, Nanog, OCT4 , and SOX2 was significantly higher within cells incubated with DCA or LCA than manage cells ( a ). Also, expression of EMT regulators N-Cadherin, Slug, Twist, Vimentin, Zeb1, and Zeb2 was also increased in response to 100  μ M DCA or LCA ( n ). Results expressed as mean  ±   standard deviation of three separate experiments. * P   <   0. 05, ** P   <   0. 01 and *** P   <   0. 001. DCA (deoxycholic acid), LCA (lithocholic acid)

To help determine whether DCA or LCA would indeed transform colonic epithelial cells to CSCs, the next set of experiments had been conducted. One of the primary properties of CSCs, as opposed to mature stem cells, is their ability to resist chemotherapy due to increased drug efflux capacity [


]. We noticed that the proportion of HCoEpiC that excluded Hoechst 33342 dye was greatly increased (2-fold to 3-fold) subsequent 30  days of exposure to 100  μ M of DCA or LCA, when compared with the control (Fig.  


). A primary reason for increased drug exclusion by cells is considered to be due to the elevated levels of ABC transporter proteins ABCB1 (ATP binding cassette subfamily B member 1) and ABCG2 (ATP binding cassette subfamily G member 2), users of the superfamily of ATP-binding cassette (ABC) transporters, in whose primary function is to transport various molecules across the intracellular and extracellular membranes [


]. In HCoEpiC tissue, we found LCA treatment for 18  days in order to cause a significant 1 . 5-fold to 2-fold increase in ABCB1 and ABCG2 mRNA levels when compared with the control (Fig.  

3b, c

). A similar phenomenon was also noted following 30-day exposure of HCoEpiC to DCA or LCA (data not shown). These results indicate the induction associated with CSCs in HCoEpiC following a prolonged exposure to the supplementary bile acids, DCA or LCA.

Fig. 3

DCA/LCA induction of drug exclusion within HCoEpiC. Ability of HCoEpiC cells to exclude Hoechst dye (H33342) was greatly increased following 30-day incubation with DCA or LCA ( the ). Likewise, the expression of ABCB1 plus ABCG2 was also increased in HCoEpiC cells following 18-day exposure to 50  μ M LCA ( b , c ). Controls contained the appropriate vehicle. Data represent the mean  ±   standard deviation of three separate determinations. ** P   <   0. 01 and *** P < 0. 001 Statistical significance determined by t test. DCA (deoxycholic acid), LCA (lithocholic acid)

To further determine whether the presence of CSCs in HCoEpiC would result in the processes of carcinogenesis, the following experiments were executed. Earlier studies have reported that secondary bile acids for example LCA activate M3R and that this activation is important just for colon cancer progression [




]. In view of this, all of us examined the expression of M3R in HCoEpiC subsequent exposure to DCA or LCA. We found DCA or even LCA to induce an 8-fold to 12-fold embrace M3R mRNA levels in HCoEpiC, when compared with the manage (Fig.  



Fig. 4

DCA/LCA induction of CSC phenotypic characters in HCoEpiC is certainly mediated by M3R and knockdown of M3R reduced ALDHA1, c-Myc, and TCF/LCF activity in cells given DCA. Induction of M3R in HCoEpiC following incubation with 100  μ M DCA or LCA right after 72  h ( a ). Downregulation of M3R in cells following transfection along with either of two siRNAs (si-M3RT2 and si-M3RT3) meant for M3R ( b ). ALDHA1 and c-Myc expression is reduced in M3R-downregulated tissues ( c ). Suppression associated with DCA-induced stimulation of ALDH1, CD166, and c-Myc appearance in M3R-downregulated cells ( d f ). Data signify the mean  ±   standard deviation of 3 separate determinations. * P   <   0. 05, ** G   <   0. 01, and *** P   <   zero. 001, compared with the control. DCA (deoxycholic acid), LCA (lithocholic acid)

To further determine the role of M3R in DCA/LCA regulation of CSCs, we downregulated the particular receptor in HCoEpiC by the corresponding siRNAs. Two various siRNAs for M3R (si-M3RT2 and si-M3RT3) were used. Transfection of HCoEpiC with either si-M3RT2 or si-M3RT3 resulted in a marked 80– 85% reduction of the receptor (Fig.   4b ), with a significant reduction in the expression of ALDHA1 and c-Myc, when compared with the corresponding control (Fig.   4c ). Additionally , we observed that while DCA caused a significant (100– 300%) increase in the expression associated with ALDHA1, CD166, and c-Myc in HCoEpiC, no this kind of increase by DCA could be observed in cells when M3R was downregulated (Fig.   4d– farrenheit ).

Wnt/β -catenin signaling plays a critical role not only in maintaining homeostasis of intestinal crypt but additionally in regulating proliferation of colon CSCs [



]. We have observed that in HCoEpiC, DCA, and LCA not only stimulated the expression of β -catenin, but additionally the Wnt/β -catenin signaling, as evidenced by the induction of transcriptional activity of TCF/LEF (Fig.  

5a, b


Fig. five

Bile acids induce Wnt-β -catenin signaling pathways and increase the expression of the focus on gene c-Myc in HCoEpiC. Real-time qPCR showing a greater expression of β -catenin mRNA in HCoEpiC tissues following 72-h incubation in the presence of 100  μ M DCA or LCA ( the ). Induction of transcriptional activity of TCF/LEF within HCoEpiC in response to 100  μ M DCA or LCA treatments for 72  h ( w ). Photomicrographs showing increased nuclear localization associated with β -catenin in HCoEpiC following 72  h incubation with 100  μ M DCA or LCA; settings were incubated with an equivalent volume of the vehicle ( c ): remaining panel , β -catenin immunostained cells; right panel , merged photograph associated with β -catenin and nucleus stained with DAPI; arrow , nuclear localization of β -catenin in cells. Increased expression of c-Myc within HCoEpiC following 72-h exposure to 100  μ M DCA or LCA ( d ). DCA/LCA-mediated induction of transcriptional activity of TCF/LEF is significantly suppressed in M3R-downregulated HCoEpiC ( electronic ). Cells were photographed on a 100  μ m scale at a magnification of 400×. Results portrayed as mean  ±   standard deviation of 3 separate experiments. * P   <   0. 05, ** L   <   0. 01 and *** P   <   zero. 001. DCA (deoxycholic acid), LCA (lithocholic acid), TCF/LEF (T-cell factor/lymphoid-enhancing factor). Diamonds represent significant reduction in M3R down-regulated cells in response to DCA compared to those without siM3R transfected cells

The particular Wnt/β catenin signaling pathway leads to de-phosphorylation, stabilization, and nuclear translocation associated with β -catenin. Nuclear β : catenin forms a complex with TCF/LEF loved ones transcription factors and acts as a coactivator to express target genetics in canonical Wnt signaling pathway such as CCND1 plus MYC [ 46 , 47 ]. We found in HCoEpiC that contact with DCA/LCA resulted in a marked 2-fold to 3-fold embrace the expression of β -catenin, accompanied by a marked induction of transcriptional activity of TCF/LEF, when compared with the corresponding settings (Fig.   5a, b ). We have also observed increased nuclear localization of β -catenin in HCoEpiC following exposure to DCA or LCA (Fig.   5c ). These types of increases were also accompanied by a 12-fold to 15-fold embrace the level of c-Myc (Fig.   5d ), one of the downstream effectors protein of Wnt/β -catenin signaling [ 47 49 ]. c-Myc also regulates stemness within CSCs [ 31 ]. In the presence of si-M3R-RNA, DCA-mediated stimulation of transcriptional activity of TCF/LEF was decreased can be 45% (Fig.   5e ), indicating a role for M3R in regulating bile acidity induction of carcinogenesis in colonic epithelial cells.

Muscarinic agonist-induced cell proliferation is mediated by cross-talk in between high expression of M3R and EGFRs in human being colon cancer cells and M3R activation causes a designated enhancement in MMPs [




]. We also found an identical phenomenon in HCoEpiC; DCA and LCA not only created a marked increase in the expression of EGFR but additionally greatly activated EGFR, as determined by tyrosine phosphorylation (activated form; measured using


992EGFR antibody) (Fig.  

6a, b

). This particular increase was associated with a marked rise in MMP mRNAs, MMP1, MMP3, and MMP10 mRNA in HCoEpiC (Fig.  



Fig. 6

DCA/LCA increased the particular expression and activation of EGFR in HCoEpiC. Current qPCR showing increased expression of EGFR mRNA within cells in response to DCA and LCA ( a ). Western blot analysis indicates improved tyrosine phosphorylation (Y992) of EGFR in response to DCA ( b ). Real-time qPCR displaying changes in the expression of the MMPs in cells in response to DCA or LCA ( c ). Results represent the mean of three separate determinations  ±   standard deviation. *** L < 0. 001, compared with control. DCA (deoxycholic acid), EGFR (epidermal growth aspect receptor), LCA (lithocholic acid), MMP (matrix metallopeptidase)