SUMMARYHirschsprung disease is a serious disorder of enteric nervous system (ENS) development caused by the failure of ENS precursor migration into the distal bowel. We now demonstrate that retinoic acid (RA) is crucial for GDNF-induced ENS precursor migration, cell polarization and lamellipodia formation, and that vitamin A depletion causes distal bowel aganglionosis in serum retinolbinding-protein-deficient (Rbp4 -/-) mice. Ret heterozygosity increases the incidence and severity of distal bowel aganglionosis induced by vitamin A deficiency in Rbp4 -/-animals. Furthermore, RA reduces phosphatase and tensin homolog (Pten) accumulation in migrating cells, whereas Pten overexpression slows ENS precursor migration. Collectively, these data support the hypothesis that vitamin A deficiency is a non-genetic risk factor that increases Hirschsprung disease penetrance and expressivity, suggesting that some cases of Hirschsprung disease might be preventable by optimizing maternal nutrition.
MATERIALS AND METHODS
Mice
Rbp4-/- (Quadro et al., 2005) and Ret +/-mice (Enomoto et al., 2001) were bred >10 generations to C57BL/6. For timed breeding studies, the day of the vaginal plug was considered as embryonic day 0.5 (E0.5). Wild-type CF-1 mice were from Charles River. Mice were maintained on Purina PICO irradiated mouse diet 5058 until E7.5. Food was changed to synthetic chow (El Mel, St Charles, MO, USA) containing sufficient vitamin A (TestDiet 5755; 22.1 IU vitamin A/g) or to vitamin A deficient food (TestDiet 5822; <0.4 IU vitamin A/g) colored blue or yellow to avoid confusion. Mice were maintained on synthetic diets until analysis.
Retinoid measurementsRA was quantified using an API-4000 (Applied Biosystems) LC/MS/MS with atmospheric pressure chemical ionization in positive ion mode. Retinol and retinyl esters were quantified by HPLC/UV (Kane et al., 2008a). Tissues were harvested under yellow light, immediately frozen in liquid N 2 and kept at -80°C until assay. Samples were homogenized on ice, extracted and analyzed as described (Kane et al., 2005;Kane et al., 2008b). Total protein was determined by Bradford (Bio-Rad).
Slice cultureE12.5 CF-1 midgut sections (300-400 m length) from 400 m proximal to the cecum were cultured on fibronectin-coated (250 g/ml) dishes in Opti-MEM (Invitrogen), glutamine (2 mM), penicillin 100 IU/ml and streptomycin 100 g/ml. Immediately after plating, cells were treated with RA (10 -7 M, Sigma, St Louis, MO, USA) or BMS493 (10 -5 M, generously provided by Dr Chris Zusi at Bristol-Myers Squibb). GDNF (100 ng/ml) was added to cultures three hours later. Cultures were maintained for 16 hours before fixation [4% paraformaldehyde (PFA), 10 minutes, 25°C].
Boyden chamberTranswell supports (8.0 m pore size; 0.33 cm 2 area; Corning 3422; Fisher Scientific) were coated on both sides with 10% Matrigel (Fisher Scientific) in PBS (4°C, 18 hours) and rinsed with PBS. Neural crest medium [Dulbecco's modified Eagle medium (DMEM), 10% chick embryo extract, 1% N2 supplement, 2% B27 supplement, penicil...