The roal of prostaglandin E2 (PGE 2) in toll-like receptor 4 (TLR4)-mediated colitis-associated neoplasia

Background: We have previously found that TLR4-deficient (TLR4-/-) mice demonstrate decreased expression of mucosal PGE (2) and are protected against colitis-associated neoplasia. However, it is still unclear whether PGE (2) is the central factor downstream of TLR4 signaling that promotes intestinal tumorigenesis. To further elucidate critical downstream pathways involving TLR4-mediated intestinal tumorigenesis, we examined the effects of exogenously administered PGE (2) in TLR4-/-mice to see if PGE (2) bypasses the protection from colitis-associated tumorigenesis. Method: Mouse colitis-associated neoplasia was induced by azoxymethane (AOM) injection followed by two cycles of dextran sodium sulfate (DSS) treatment. Two different doses of PGE (2) (high dose group, 200 mu g, n = 8; and low dose group, 100 mu g, n = 6) were administered daily during recovery period of colitis by gavage feeding. Another group was given PGE (2) during DSS treatment (200 mu g, n = 5). Inflammation and dysplasia were assessed histologically. Mucosal Cox-2 and amphiregulin (AR) expression, prostanoid synthesis, and EGFR activation were analyzed. Results: In control mice treated with PBS, the average number of tumors was greater in WT mice (n = 13) than in TLR4-/-mice (n = 7). High dose but not low dose PGE (2) treatment caused an increase in epithelial proliferation. 28.6% of PBS-treated TLR4-/-mice developed dysplasia (tumors/animal: 0.4 +/- 0.2). By contrast, 75.0% (tumors/animal: 1.5 +/- 1.2, P < 0.05) of the high dose group and 33.3% (tumors/animal: 0.3 +/- 0.5) of the low dose group developed dysplasia in TLR4-/-mice. Tumor size was also increased by high dose PGE (2) treatment. Endogenous prostanoid synthesis was differentially affected by PGE (2) treatment during acute and recovery phases of colitis. Exogenous administration of PGE (2) increased colitis-associated tumorigenesis but this only occurred during the recovery phase. Lastly, PGE 2 treatment increased mucosal expression of AR and Cox-2, thus inducing EGFR activation and forming a positive feedback mechanism to amplify mucosal Cox-2. Conclusions: These results highlight the importance of PGE (2) as a central downstream molecule involving TLR4-mediated intestinal tumorigenesis.