The intestinal epithelial cells proliferate and turn over at an extraordinary rate, outpacing all other tissues in the vertebrate body 2,3. The dividing cells including intestinal stem cells (ISC) and transit-amplifying cells differentiate into either secretory (goblet, Paneth and enteroendocrine) cells or enterocytes 3. The ISC is located at the base of the crypt. Paneth cells move down to the bottom of crypts and are long-lived, whereas other lineages migrate upwards to the villi 3,4. Here the cells are exposed to the gut contents including microbiota and are shed from the villus tips through an anoikis-induced apoptotic mechanism. Although the colon lacks villi and Paneth cells, the mechanism for maintaining homeostasis is similar 4.
The Wnt signaling pathway has been implicated in playing a crucial role in intestinal proliferation and ISC maintenance 4. Deletion of the transcription factor TCF4, a downstream effector of Wnt signaling, leads to loss of intestinal stem cells and subsequent breakdown of the tissue 5. Similarly, transgenic expression of the Wnt inhibitor DKK1 reduces the epithelial proliferation and depletes secretory cell lineages 6. Conversely, overexpression of the Wnt agonist R-spondin-1 induces potent and rapid proliferation of intestinal crypt cells 7.
Given the importance of Wnt signaling for intestinal homeostasis, Wnt pathway mutations are frequently observed in colon cancer 8. Colon cancer is the third leading cause of death from cancer in United States 9. Excess dietary intake with red meat and alcohol, reduced physical activity, and inherited and somatic mutations are considered to be risk factors of colon cancer 10,11. The adenomatous polyposis coli (Apc) gene, a key Wnt signaling factor, is mutated in a majority of patients with familial, sporadic, and colitis-associated colon cancer 12,13. Mutations of other factors involved in Wnt signaling pathway including Axin2 and β-catenin are also observed in colon cancer 14,15. However, the precise mechanism and effective therapy for colon cancer are still lacking. To facilitate the investigation of the molecular mechanisms for colon cancer, human colon cancer cell lines representing different stages of cancer progression from a benign to an aggressive cell type have been established 16-18. Mouse colon carcinoma cell lines with different metastatic properties are also available 19,20. Nevertheless, primary cells or organoid cultures are preferred over transformed cell lines because they closely mimic the in vivo state and generate more physiologically relevant data 21. Most colon-cancer derived cell lines grow as monolayer attached to the plate or as cell suspensions, lacking of apical-basolateral orientation and tight junctions between cells. Also, normal and tumor intestinal epithelial cells in vivo undergo a spontaneous form of apoptosis termed anoikis as the differentiated cells reach the villus tips and are shed 22. These features are difficult to recapitulate in cell lines but are important in the developmental process of colon cancer 23. These features are maintained in primary organoids. In addition, the tumor organoid cultures provide an efficient system to assess tumor autonomous functions of genes compared to in vivo studies. Genetic manipulation in vivo of the intestine is a time-consuming process mainly through creating transgenic and/or knockout mice using intestine-specific drivers. However, the tumor organoids are readily amenable to viral mediated genetic manipulations and thus a great tool for assessing precise molecular mechanisms. Primary intestinal tumor organoid cultures have been demonstrated to be a feasible and powerful technique. Primary intestinal cell culture can establish functional intestinal organoids with crypt-villi structure in vitro from a single adult Lgr5+ stem cell 24. These organoids can be transplanted and engrafted into damaged colon tissue for regeneration 25. Further adaption of the culture conditions had made similar epithelial organoids from mouse colon and human small intestine and colon feasible 1. For primary normal colon epithelium culture, basal culture medium as well as growth factors including EGF, Noggin, R-spondin and Wnt3a are essential, whereas basal culture medium and EGF is sufficient for growing primary mouse colon tumor organoids 1. Here we describe a detailed protocol to isolate, culture, and generate colon tumor organoids.