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As the most common type of human cancer, basal cell carcinoma (BCC) affects about 2 million Americans per year 1. Accumulating evidence indicate that abnormal activation of hedgehog (Hh) signaling is the driving force underlying BCC development (Reviewed in 2,3). Alterations of Hh signaling in BCCs include inactivating mutations of PTCH1 4-6, gain-of-function mutations of SMO 7-9, and aberrant expression of Hh pathway transcription factors GLI1 10 and GLI2 11 or rare inactivated mutations of negative regulator Su(Fu)12. Through all these and other studies, Federal Drug Administration (FDA) has recently approved the use of Hh signaling inhibitor Vismodegib to treat metastatic and locally advanced BCCs13-15.
Despite all these achievements 16, we still do not understand the molecular and cellular mechanisms by which Hh signaling drives carcinogenesis. Establishing animal models using tissue-specific activation of Hh signaling is still important for these studies and for our understanding of drug resistance. In mice, wild-type mice do not develop BCCs, even under heavy doses of carcinogens, UV or ionizing radiation. In contrast, Ptch1+/- mice are susceptible to BCC development 17,18. The penetrance of BCC development in Ptch1+/- mice is over 50% 18,19 although Ptch1+/- mice rarely develop full-grown BCCs if kept under normal conditions. Due to the embryonic lethality of Ptch1-/-, tissue-specific knockout of PTCH1 is generally used for the study 20. In addition, conditional skin-specific expression of oncogenic SmoM2YFP (Krt14-creER:R26-SmoM2YFP or Krt14-cre:R26-SmoM2YFP) leads to formation of multiple microscopic BCCs at a very early age, providing an easy genetic assay for Hh signaling downstream of SMO 21.
There are three major issues in our knowledge of BCC biology. First, the cellular origin of BCCs is not entirely clear. While some studies support the budge of hair follicle as the stem cell site 22-24, Youssef et al. 25 localized the murine cell of origin of cutaneous Hh-driven tumors to be in the inter-follicular epidermis region, not in the hair follicle, by using cell-specific Cre to activate expression of a ROSA26-driven transgenic mutant SMO. Second, cellular interactions during BCC development are not well understood. It is known that keratinocytes with activated Hh signaling can lead to formation of BCCs, but other cellular changes are not well-understood. Furthermore, treatment of Smo antagonists in mice can lead to drug resistance 26-28. Thus novel targets for BCC are greatly needed. Understanding these three issues requires analyses of cellular changes in mice during carcinogenesis. While several methods have been published for keratinocyte culture, flow cytometry and skin stem cell isolation 29-31, there are currently no comprehensive procedures for cell analyses in mouse BCCs. By combining methods for mouse model of BCCs, separation of epidermis, generation of single cells from tissue and cell analyses, we will provide readers with a set of procedures to study cell signaling, cellular and molecular interactions during BCC development. We believe that this protocol will allow readers to see how each procedure is accomplished. In addition, we provided some data to illustrate what the results should look like, and troubleshooting to help readers to overcome difficulties during performing these procedures.