Chronic expression of p16INK4a in the epidermis induces Wnt-mediated hyperplasia and promotes tumor initiation

Narmen Azazmeh, Benjamin Assouline, Eitan Winter, Shmuel Ruppo, Yuval Nevo, Alexander Maly, Karen Meir, Agnieszka K. Witkiewicz, Jonathan Cohen, Sophia V. Rizou, Eli Pikarsky, Chen Luxenburg, Vassilis G. Gorgoulis, Ittai Ben-Porath*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


p16INK4a (CDKN2A) is a central tumor suppressor, which induces cell-cycle arrest and senescence. Cells expressing p16INK4a accumulate in aging tissues and appear in premalignant lesions, yet their physiologic effects are poorly understood. We found that prolonged expression of transgenic p16INK4a in the mouse epidermis induces hyperplasia and dysplasia, involving high proliferation rates of keratinocytes not expressing the transgene. Continuous p16INK4a expression increases the number of epidermal papillomas formed after carcinogen treatment. Wnt-pathway ligands and targets are activated upon prolonged p16INK4a expression, and Wnt inhibition suppresses p16INK4a-induced hyperplasia. Senolytic treatment reduces p16INK4a-expressing cell numbers, and inhibits Wnt activation and hyperplasia. In human actinic keratosis, a precursor of squamous cell carcinoma, p16INK4a-expressing cells are found adjacent to dividing cells, consistent with paracrine interaction. These findings reveal that chronic p16INK4a expression is sufficient to induce hyperplasia through Wnt-mediated paracrine stimulation, and suggest that this tumor suppressor can promote early premalignant epidermal lesion formation.

Original languageAmerican English
Article number2711
JournalNature Communications
Issue number1
StatePublished - 1 Dec 2020

Bibliographical note

Funding Information:
We thank Safa Hirbawi for technical assistance, Norma E. Kidess-Bassir for histological preparation, Sharona Elgavish, and Hadar Benyamini for bioinformatics assistance, Dan Lehmann of the Core Research Facility at Hebrew University for FACS assistance, and Yaron Fuchs for advice. We thank Elaine Fuchs for the tet-Tcf3 mice. This study was supported by grants from the Israel Science Foundation (1009/13, 2092/18) and from the DKFZ-MOST Fund (CA-161) (I.B.), by a fellowship from the Israel Council for Higher Education (N.A.), and by the Welfare Foundation for Social & Cultural Sciences (KIKPE) Greece, and NKUA-SARG Greece, grants No 70/3/8916, 70/3/12128 (V.G.G.).

Publisher Copyright:
© 2020, The Author(s).


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