Gata4 est un facteur de transcription exprimé par les entérocytes. Nos études ont démontré que Gata4 pouvait réguler l'expression de Pap1 chez le rat. Ce gène encode pour une protéine sécrétoire de type lectine impliquée dans le contrôle de la prolifération bactérienne. Puisqu'il a été démontré que des lectines antibactériennes de la famille Pap sont sécrétées dans la lumière intestinale en réponse à des stimuli inflammatoires, le but de cette étude était de définir l'implication transcriptionnelle de Gata4 dans la réponse inflammatoire des cellules épithéliales intestinales. Afin de caractériser l'effet de Gata4 sur la régulation transcriptionnelle de Pap1 dans les cellules Caco-2/15, nous avons utilisé des essais luciférase et généré différents mutants de la protéine Gata4 et du promoteur Pap1 . Nous avons également utilisé des immunobuvardages et des analyses de gel de rétention afin de mesurer la quantité et l'affinité de Gata4 pour l'ADN dans les cellules IEC-6/Cdx2. Les essais luciférase ont démontré que Gata4, en combinaison avec Cdx2, amène un effet synergique important sur l'activité du promoteur de Pap1 de l'ordre d'environ 8 fois. Différents mutants de la protéine Gata4 ont montré une abolition du potentiel transcriptionnel, démontrant que l'effet observé est spécifique. Cependant, la cotransfection d'un mutant du domaine en doigt de zinc (Zn) localisé en N-terminal, en combinaison avec Cdx2, augmente radicalement l'activation du promoteur de 18 fois. Des résultats préliminaires ont également démontré que la surexpression de ce mutant dans les cellules IEC-6/Cdx2 augmente fortement l'expression endogène du gène Pap1 . Cet effet pourrait être médié par des interactions avec les cofacteurs Fog. En effet, la cotransfection de Fog1 réprime l'effet synergique observé avec Gata4 de type sauvage mais non avec le mutant du domaine en doigt de Zn en N-terminal. Les mutants générés du promoteur Pap1 ont permis d'identifier le site Cdx2 et le site Gata le plus proximal du site d'initiation de la transcription comme nécessaire à l'effet transcriptionnel de Gata4 et Cdx2. En utilisant comme modèle les cellules IEC-6/Cdx2, nous avons montré qu'une induction avec des LPS n'a pas d'effet significatif sur la quantité totale de la protéine Gata4 mais des résultats préliminaires montrent une modulation de la phosphorylation de Gata4 sur la sérine 105. Par gel de rétention, nous avons montré que GATA4 a une affinité pour plusieurs sites sur le promoteur du gène Pap1 et qu'elle est augmentée en condition de stress cellulaire induit par les LPS. Cette étude nous permet de mieux comprendre l'implication de Gata4 dans la réponse inflammatoire de la cellule épithéliale intestinale.

Barrett's metaplasia describes a condition in which the stratified squamous epithelium of the oesophagus switches to intestinal type columnar epithelium. The molecular mechanisms underlying the switch to intestinal epithelium is poorly understood but the transcription factor CDX2 has been implicated in the pathogenesis of Barrett's metaplasia and is sufficient to provoke an intestinal metaplasia in the stomach of transgenic mice. To address the molecular basis of Barrett’s, I developed an innovative explant system for adult mouse oesophageal epithelium in which the full repertoire of stratified squamous cell types is maintained for prolonged culture periods. In adult oesophageal cultures, cells expressing p63, K14, K4 and loricrin were detected. The ability of Cdx2 to induce intestinal genes in this model as well as in a human oesophageal cell line and foetal mouse oesophageal cultures was assessed. Cdx2 was sufficient to induce intestinal markers in Het-1A cells and foetal oesophageal epithelium but not in adult oesophageal explants. Following infection with Cdx2, Het-1A cells expressed four intestinal genes, Cdx1, Muc2, villin and K20. Embryonic oesophagus responds similarly and Muc2 and villin mRNA and Muc2 protein were detected. In contrast, infection of adult oesophageal explants did not provoke the expression of intestinal genes. These data suggest that additional factor(s) to Cdx2 are required in the conversion of adult oesophagus towards an intestinal phenotype as seen in Barrett's metaplasia. HNF4α is a candidate factor to cooperate with Cdx2 in intestinal development and therefore Barrett's metaplasia. Herein I demonstrate that HNF4α is sufficient to induce a columnar phenotype and the expression of intestinal genes within adult squamous oesophageal cells. The resultant phenotype is consistent with that seen in Barrett's metaplasia. Furthermore HNF4α and Cdx2 synergise to further enhance intestinalisation. This data suggests a hitherto unknown potential role for HNF4a in Barrett’s metaplasia.

Le facteur de transcription homéotique CDX2 est spécifiquement exprimé dans l’épithélium intestinal où il maintient l’identité, contrôle l’homéostasie et exerce une fonction suppresseur de tumeurs. Chez l’homme, une expression ectopique (hors de l’intestin) de CDX2 peut survenir, dans les métaplasies intestinales d’organes digestifs, considérées comme pré-cancéreuses. Ce travail de thèse visait à étudier les conséquences physiopathologiques de l’expression ectopique de CDX2. Nous avons développé et validé un modèle murin d’induction conditionnelle de CDX2 dans plusieurs organes digestifs. Nos résultats montrent que cette expression est dépendante du contexte cellulaire, et induit des métaplasies intestinales seulement dans l’estomac et le pancréas. Ces métaplasies n’évoluent pas spontanément en cancer. Cependant, CDX2 sensibilise ces lésions métaplasiques à l’apparition de tumeurs intestinales dans l’estomac placé dans un contexte où le gène Apc est muté. Globalement, ces résultats montrent que CDX2 est essentiel au développement de métaplasies intestinales mais n’exercerait pas de fonction oncogénique en situation ectopique. / The intestine-specific homeotic transcription factor CDX2 is required throughout life for intestinal homeostasis, the maintenance of intestinal identity and has tumor suppressor activity. In Human, ectopic expression of the gene Cdx2 is observed in several digestive organs as in intestinal metaplasia which is considered as pre-cancerous lesion. This work aimed to investigate the pathophysiological consequences and molecular mechanisms of ectopic expression of CDX2. We created and validated a conditional murine model of CDX2 induction in several digestive organs. Ectopic CDX2 causes intestinal metaplasias only in the stomach and the pancreas which do not spontaneously evolve to cancer, depending on cellular context. However, CDX2 promotes intestinal carcinogenesis in complete intestinal metaplasia of the stomach. Collectively, these results show that CDX2 is essential for the development of intestinal metaplasia but has no oncogenic function in ectopic situation.

La chimiorésistance est un enjeu majeur dans la prise en charge des patients atteints de cancers digestifs et peut se manifester par l’efflux de molécules cytotoxiques via la surexpression des transporteurs ABC. Le facteur de transcription CDX2 est un régulateur important de l’identité intestinale et agit comme gène suppresseur de tumeur dans le côlon. Il pourrait être impliqué dans des phénomènes de chimiorésistance des cancers colorectaux (CCR) car le transporteur MDR1/ABCB1 correspond à un de ses gènes cibles. Nous avons confirmé le rôle de CDX2 dans la chimiorésistance des CCR. Nous avons montré par une approche translationnelle, que la surexpression de CDX2 était impliquée dans la résistance au 5-fluorouracile (5-FU) dans les CCR. Le transporteur du 5-FU ABCC11 a été identifié comme gène cible de CDX2 dont l’activité contribue à la résistance au 5-FU des cellules cancéreuses coliques. L’expression d’ABCC11 corrèle avec celle de CDX2 dans les CCR humains mais également avec celle de la DYPD, enzyme impliquée dans le catabolisme du 5-FU. Cette étude montre pour la première fois que CDX2 contribue à la chimiorésistance au 5-FU en impliquant des mécanismes régulant son métabolisme. / Chemoresistance represents a major drawback in digestive cancers’ management and may be achieved particularly through active efflux of the drug through overexpression of ABC transporters The transcription factor CDX2 is a master regulator of intestinal identity that acts as a tumor suppressor in the colon and may be important for drug resistance in colorectal cancer (CRC) as MDR1/ABCB1 was recently identified as one of its target genes. Here, we confirmed the role of CDX2 in the chemoresistance of CRC. We showed through a translational approach that CDX2 overexpression is implicated in 5-fluorouracil (5-FU) chemoresistance in CRC and described the molecular mechanisms implicated in this finding. We identified the 5-FU transporter ABCC11 as a new transcriptional target of CDX2 whose activity contributes to the 5-FU-chemoresistance of colon cancer cells. Remarkably, CDX2 expression correlates with the expression of ABCC11 in human colon tumors, but also with the one of the DPYD, enzyme involved in the 5-FU break down. Thus, our study links for the first time CDX2 to the 5-FU metabolism and provides a molecular mechanism for its impact on 5-FU-based chemotherapy.

Chez l’adulte, le facteur de transcription homéotique Cdx2 est spécifiquement exprimé dans l’intestin dont il maintient l’identité et contrôle l’homéostasie. Des études récentes menées chez l’homme ont identifié des formes de cancer colorectal de mauvais pronostic dans lesquelles l’expression de Cdx2 est très fortement réduite. Ce travail de thèse visait à étudier les conséquences physiopathologiques de la perte de fonction de Cdx2 dans l’intestin adulte. A partir d’un modèle murin d’invalidation conditionnelle et mosaïque de Cdx2, nos résultats montrent que la perte de Cdx2 conduit au développement de lésions caecales de type gastrique qui n’évoluent pas spontanément en cancer. Ces lésions créent cependant un microenvironnement inflammatoire qui favorise la transformation maligne de cellules épithéliales voisines intactes pour Cdx2 et prédisposées à la tumorigénèse. Globalement, ces résultats montrent que Cdx2 exerce une fonction suppresseur de tumeurs « cellule non-autonome » dans l’intestin. / The intestine-specific transcription factor Cdx2 is required throughout life for intestinal homeostasis and for the maintenance of intestinal identity. Several recent studies showed that Cdx2 expression is dramatically reduced in some human colon cancers of poor prognosis. This work aimed to investigate the pathophysiological consequences of the loss of Cdx2 in the adult gut. Conditional mosaic ablation of Cdx2 in mice causes gastric-type metaplasia in the cecum which do not spontaneously evolve to cancer. However, these lesions strongly modify the inflammatory microenvironment which facilitates the malignant transformation of adjacent Cdx2-intact and cancer-prone epithelial cells. Collectively, these results unravel a novel and original function of Cdx2, namely its non-cell autonomous tumor suppressor activity in the gut.

Le gène Cdx2 exerce de nombreuses fonctions au cours du développement embryonnaire. Son expression est maintenue spécifiquement dans l’épithélium intestinal adulte. Cdx2 est diminué dans les cancers colorectaux (CCR), favorisant la migration et la dissémination des cellules tumorales. Cette diminution de Cdx2 est réversible, suggérant une dérégulation du gène. Nous avons étudié d’une part les fonctions intestinales de Cdx2 au cours du développement et surtout chez l’adulte, et d’autre part les mécanismes moléculaires associés à la dérégulation de Cdx2 dans les CCR.Une approche d’invalidation conditionnelle de Cdx2 chez la souris a été choisie. Nous montrons que Cdx2 est nécessaire pour l’établissement de l’identité intestinale au cours du développement. De plus, dans l’intestin adulte il contribue au maintien de l’identité des cellules souches et intervient dans la différenciation terminale des cellules épithéliales. Le croisement du modèle murin transgénique pCdx2-9LacZ avec le modèle de cancérogénèse colique spontanée Apc∆14/+ indique que les éléments nécessaires à la diminution d’expression de Cdx2 dans les CCR sont sur le promoteur de 9kb de Cdx2. Par ailleurs, nous montrons une corrélation d’expression entre les protéines HNF4α, régulateur transcriptionnel de Cdx2, et Cdx2 dans des échantillons de tumeurs intestinales humaines et murines. L’invalidation conditionnelle de Hnf4α dans l’intestin est associée à une réduction d’expression de Cdx2 et à une plus grande susceptibilité des animaux à la tumorigenèse colique chimio-induite. HNF4α constitue un facteur important de la dérégulation de Cdx2 dans les CCR et exerce une fonction suppresseur de tumeur dans l’intestin / The Cdx2 gene exerts many functions during embryonic development. Its expression is maintained specifically in the adult intestinal epithelium. Cdx2 expression is reduced in colorectal cancers (CRC); moreover, this reduction promotes migration and the spread of colon tumor cells. The alteration of Cdx2 in CRC is reversible, suggesting a deregulation of the gene. The objectives of my project were to study the functions of Cdx2 during intestinal development and in adults and to study the molecular mechanisms associated with the deregulation of Cdx2 in CRC. An approach of conditional invalidation of Cdx2 in mice has been used. We show that Cdx2 plays a key role in establishing the intestinal identity during development. In addition, at the adult stage Cdx2 is involved in the maintaining of the intestinal stem cells identity and in the control of terminal differentiation of intestinal epithelial cells. Crossing the transgenic mouse model pCdx2-9LacZ with spontaneous colon carcinogenesis model ApcΔ14/+ indicates that the elements necessary for the decrease of Cdx2 expression are located on the Cdx2 promoter of 9kb. Earlier team works have highlighted HNF4α as a transcriptional regulator of Cdx2 expression. In this work, we have demonstrated a correlation between HNF4α and Cdx2 protein expression in samples of human and mouse intestinal tumors. The conditional invalidation of Hnf4α in the intestine is associated with a reduction of Cdx2 expression, and a greater susceptibility for mice to chemo-induced colonic tumorigenesis. HNF4α is an important factor in the deregulation of Cdx2 in CRC and it exerts itself a tumor suppressor function in the gut.

<p>Background. Immunohistochemistry is a useful method in the differential diagnosis between pleural mesotheliomas and metastatic adenocarcinomas in the pleura. Cytokeratin 20 and 7 have been used successfully as markers in studies determining primary location of adenocarcinomas from metastases. The current study is a complementary research of archived paraffininbedded material of cases with cancer origin. This study contributes a bigger statistical material that may facilitate the search for unknown primary site of adenocarcinoma by identification of metastatic cells in the pleura.</p><p>Methods. Cells from the pleura taken from fifteen patients with diagnosed cancer of different types and eleven patients with cancer of unknown origin, were stained with antibodies against the tumour markers: Ber EP 4, calretinin, cytokeratin 20 and 7, estrogen receptor α, thyroid transcription factor, prostate-specific antigen and Cdx2.The staining was conducted in an automated immunohistochemical system. The staining of each kind of antibody was confirmed by a control section staining.</p><p>Results. All control staining ended perfect The whole panel of antibodies used on mammary cancer showed the same pattern for every antibody. Of the patients with cancer of unknown origin there were four that gave the same pattern, two men and two women. The women are deceased. To make a more careful evaluation more information and clinic background is needed. The number of samples is too small to draw any statistical conclusions.</p><p>Comment. Although the control staining was perfect the negative result of CK20 in the cases of diagnosed colon cancer was unexpected. This staining should be performed again to confirm the result. In some cases the number of cells were to few for a certain evaluation. The slides and the results of this work will be archived for further research.</p>

The products of the Cdx genes, Cdx1, Cdx2 and Cdx4, are known to play essential roles in many developmental processes including neural tube closure, axial elongation and patterning the anterior-posterior axis of the developing embryo. Cdx1 and Cdx2 are both expressed in the endoderm of the embryo and persist throughout adulthood in the intestinal epithelium, but their functions and mechanisms of action in this lineage are poorly understood, in part due to the peri-implantation lethality of Cdx2-/- mice. To circumvent this limitation, a conditional loss of function strategy was used to inactivate Cdx2 in the intestinal epithelium. These conditional mutants were also crossed to Cdx1-/- mice, which are viable and fertile, to examine potential functional compensation between these family members. The major findings of this study are that Cdx2 regulates patterning and differentiation of the small intestinal epithelium, while Cdx1 does not appear to make a contribution to either process. Furthermore, Cdx operates upstream of Notch ligand Delta-like 1 (Dll1) in endoderm and mesoderm derivatives, demonstrating that Cdx function is similar in different lineages. Finally, Cdx2 cannot fulfill the requirement for Cdx1 in regulation of its own promoter in the intestine. This is the first in vivo evidence that these two family members have context-dependent functional specificity. Altogether, this study underscores critical roles and mechanisms of action for Cdx members in the developing intestine and mesoderm.

The products of the Cdx genes, Cdx1, Cdx2 and Cdx4, are known to play essential roles in many developmental processes including neural tube closure, axial elongation and patterning the anterior-posterior axis of the developing embryo. Cdx1 and Cdx2 are both expressed in the endoderm of the embryo and persist throughout adulthood in the intestinal epithelium, but their functions and mechanisms of action in this lineage are poorly understood, in part due to the peri-implantation lethality of Cdx2-/- mice. To circumvent this limitation, a conditional loss of function strategy was used to inactivate Cdx2 in the intestinal epithelium. These conditional mutants were also crossed to Cdx1-/- mice, which are viable and fertile, to examine potential functional compensation between these family members. The major findings of this study are that Cdx2 regulates patterning and differentiation of the small intestinal epithelium, while Cdx1 does not appear to make a contribution to either process. Furthermore, Cdx operates upstream of Notch ligand Delta-like 1 (Dll1) in endoderm and mesoderm derivatives, demonstrating that Cdx function is similar in different lineages. Finally, Cdx2 cannot fulfill the requirement for Cdx1 in regulation of its own promoter in the intestine. This is the first in vivo evidence that these two family members have context-dependent functional specificity. Altogether, this study underscores critical roles and mechanisms of action for Cdx members in the developing intestine and mesoderm.

The products of the Cdx genes, Cdx1, Cdx2 and Cdx4, are known to play essential roles in many developmental processes including neural tube closure, axial elongation and patterning the anterior-posterior axis of the developing embryo. Cdx1 and Cdx2 are both expressed in the endoderm of the embryo and persist throughout adulthood in the intestinal epithelium, but their functions and mechanisms of action in this lineage are poorly understood, in part due to the peri-implantation lethality of Cdx2-/- mice. To circumvent this limitation, a conditional loss of function strategy was used to inactivate Cdx2 in the intestinal epithelium. These conditional mutants were also crossed to Cdx1-/- mice, which are viable and fertile, to examine potential functional compensation between these family members. The major findings of this study are that Cdx2 regulates patterning and differentiation of the small intestinal epithelium, while Cdx1 does not appear to make a contribution to either process. Furthermore, Cdx operates upstream of Notch ligand Delta-like 1 (Dll1) in endoderm and mesoderm derivatives, demonstrating that Cdx function is similar in different lineages. Finally, Cdx2 cannot fulfill the requirement for Cdx1 in regulation of its own promoter in the intestine. This is the first in vivo evidence that these two family members have context-dependent functional specificity. Altogether, this study underscores critical roles and mechanisms of action for Cdx members in the developing intestine and mesoderm.