Impaired transforming growth factor β signalling in Barrett’s carcinogenesis due to frequent SMAD4 inactivation

Background and aims: Transforming growth factor β (TGF-β) is frequently involved in gastrointestinal carcinogenesis although its contribution to oesophageal adenocarcinoma (AC) and its precursor Barrett’s oesophageal epithelium (BE) metaplasia are unclear. Methods: Expression of TGF-β signalling components was assessed by reverse transcription-polymerase chain reaction (PCR), western blot, and immunohistochemistry in oesophageal endoscopic biopsies and cell lines. Genomic alterations in SMAD4 were characterised by fluorescence in situ hybridisation, methylation specific PCR, and sequencing. Functional integrity of TGF-β signalling was assessed by characterisation of p21 and proliferation status. Smad4 negative BIC-1 cells were transiently transfected with smad4 and TGF-β responsiveness evaluated. Results:smad4 mRNA expression was progressively reduced in the metaplasia-dysplasia-adenocarcinoma sequence (p80% of BE and AC. TGF-β failed to inhibit proliferation in 5/8 oesophageal cell lines. In BIC-1, the antiproliferative response was restored following transient transfection of smad4 cDNA. Conclusions: In BE carcinogenesis, downregulation of Smad4 occurs due to several different mechanisms, including methylation, deletion, and protein modification. Frequent alterations in TGF-β signalling lead to a functionally significant impairment of TGF-β mediated growth suppression.