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Acta Biochim Biophys
Sin 2008, 40: 554-564
doi:10.1111/j.1745-7270.2008.00439.x
Roles of Kr?ppel-like factor 4 in normal
homeostasis, cancer and stem cells
Paul M Evans and Chunming Liu*
Department of Biochemistry and Molecular
Biology, Sealy Center for Cancer Cell Biology, University of Texas Medical Branch,
Galveston, Texas 77555-1448, USA
Received: April 20,
2008
Accepted: May 15,
2008
This work was
supported by the grants from the Sealy Center for Cancer Cell Biology, the National
Institutes of Health (No. T32CA117834), and the Charlotte Geyer Foundation
*Corresponding
author: Tel, 1-409-747-1909; E-mail, [email protected]
Kr?ppel-like factor 4 (KLF4) is a zinc
finger-type transcription factor expressed in a variety of tissues, including
the epithelium of the intestine and the skin, and it plays an important role in
differentiation and cell cycle arrest. Depending on the gene targeted, KLF4 can
both activate and repress transcription. Moreover, in certain cellular
contexts, KLF4 can function as a tumor suppressor or an oncogene. Finally, KLF4
is important in reprogramming differentiated fibroblasts into inducible
pluripotent stem cells, which highly resemble embryonic stem cells. This review
summarizes what is known about the diverse functions of KLF4 as well as their
molecular mechanisms.
Keywords Kr?ppel-like factor 4; colorectal cancer; stem cell
Kr?ppel-like factor 4 (KLF4) is a transcription factor expressed in
a wide variety of tissues in humans, including the intestine and the skin,
which is important for many different physiologic processes, including
development, differentiation, and maintenance of normal tissue homeostasis.
KLF4 is a bi-functional transcription factor that can either activate or
repress transcription using different mechanisms, depending on the target gene.
In addition, KLF4 can function as an oncogene or a tumor suppressor depending
on the type of cancer involved. In concert with three other transcription
factors, KLF4 can reprogram differentiated fibroblasts into a state resembling
embryonic stem cells in every possible manner tested so far. This review will
provide a detailed summary of what is currently known about KLF4 and its role
in the homeostasis of tissues, in cancer and in stem cell reprogramming.
The Kr?ppel-like Factor Family
Kr?ppel-like factors are a family of transcription factors that play
important roles in many fundamental biologic processes, including development,
proliferation, differentiation and apoptosis (Fig. 1). Kr?ppel-like
factor family members contain three C-terminal C2H2-type zinc fingers that bind DNA. They were named Kr?ppel-like due
to strong homology in this region with the Drosophila gene product
Kr?ppel, which is important in segmentation of the developing embryo. Genetic
deletion of Kr?ppel results in complete absence of the thoracic and anterior
abdominal segments [1]. KLF4 was cloned independently by two groups, and
given two different names: gut-enriched Kr?ppel-like factor due to the fact
that it was found to be highly expressed in the intestine [2], and epithelial
zinc finger due to its high expression in the skin epithelium [3]. It was later
renamed KLF4 to avoid confusion, as expression of KLF4 is also detectable in
the lung, skin, testis [2–5], thymus [6], cornea [7], cardiac myocytes [8], and lymphocytes
[9]. In addition, KLF4 is important in development, as it is detectable in the
mouse embryo, with the highest expression occurring in the later stages [3,4].
Roles of KLF4 in Homeostasis of the Colonic Epithelium
The colonic epithelium consists of three major types of
differentiated cells: enterocytes, goblet cells and enteroendocrine cells.
Actively proliferating cells reside at the base of the crypts and migrate
towards the luminal surface as they differentiate, eventually to be sloughed
off. KLF4 inhibits proliferation and promotes differentiation; consistent with
this role, expression of KLF4 is greatest near the luminal surface and
gradually decreases toward the base of the crypts [2,10]. Klf4–/– mice lack goblet cells, which does not affect the total number of
enterocytes, suggesting that KLF4 may be specifically required for goblet cell
differentiation [11]. In addition, KLF4 can interact with b-catenin and
antagonize Wnt signaling [10], a key pathway in driving proliferation of the
intestinal epithelium [12–14]. Thus, KLF4 may also be important in mediating the switch from
transit-amplifying cells to the various differentiated cell types in the
colonic crypts.Butyrate is constantly produced in the colon by bacterial
fermentation of dietary fiber in the intestine [15], and it can induce
expression of KLF4 [5,16]. In cell culture, butyrate stimulates expression of
the enterocyte-specific marker intestinal alkaline phosphatase [17], and
induces colon cancer cells to acquire a more differentiated, enterocyte-like
phenotype [18]. KLF4 positively regulates expression of intestinal alkaline
phosphatase [19,20], and overexpression of KLF4 in cell culture inhibits
proliferation [2,5]. KLF4 appears to have inhibitory effect on a wide variety of cellular
processes, including protein and cholesterol synthesis, transcription, cell
growth and DNA repair [21,22]. Consistent with its anti-proliferative role, KLF4
simultaneously induces the expression of cyclin-dependent kinase inhibitor
proteins p21Cip1/WAF1 and p57Kip2 [21,2325], and represses the expression of
Cyclin D1 [5,26,27], Cyclin D2 [28], Cyclin E [29], and
Cyclin B1 [30] (Fig. 2). In addition, KLF4 represses expression of
ornithine decarboxylase [7,31], an enzyme involved in the production of a class
of molecules known as polyamines, which are also important in proliferation.
KLF4 is required for both the G1/S-phase and G2/M-phase checkpoints [30,32,33]. Finally, KLF4 represses expression
of p53 and may be important in determining whether cells decide to undergo
apoptosis or cell cycle arrest [34].
Roles in
other Homeostasis of Other Tissues
Although the importance of KLF4 in the intestine is well characterized,
increasing evidence demonstrates its importance in other organs and tissues as
well. For example, KLF4–/– mice die of dehydration soon after birth due to defects in the
epidermal barrier of the skin [35], yet targeted overexpression of KLF4 results
in early formation of the epithelial permeability barrier [36]. These data
clearly implicate KLF4 as an important molecule in differentiation of the skin
epithelium. Furthermore, overexpressed KLF4 can synergize with maternally
injected corticosteroids in accelerating the formation of the skin barrier.
This is likely due to overlap between the genes targeted by KLF4 and the
glucocorticoid receptor [37]. The utility of glucocorticoids in lung maturation
of premature infants is well-established [38], thus it might be interesting to
determine whether KLF4 or possibly other Kr?ppel-like factors could synergize
with glucocorticoids in fetal lung maturation as well. Also, in the developing
fetus, KLF4 synergizes with Sp1 in up-regulating expression of PSG-5, a protein
secreted into the maternal circulation by the placenta [39]. PSG-5 is thought
be required for maintenance of a term pregnancy and may protect the fetus from
attack by the maternal immune system. In addition, KLF4 and PSG-5 have closely
overlapping patterns of expression in the placenta, suggesting an in vivo
role for KLF4 in the regulation of PSG-5 expression [40].Human KLF4 was isolated from an umbilical vein complementary DNA
library and is expressed in the vascular endothelium [41]. Expression of KLF4
is induced by shear stress in endothelial cells [42], whereas KLF4 appears to
block differentiation and is expressed at low levels in differentiated arterial
smooth muscle cells [43]. However, expression of KLF4 is rapidly up-regulated
in smooth muscle cells in response to vascular injury [44].Overexpression of KLF4 in a pro-myelocytic cell line increases the
expression of monocyte markers, whereas knockdown of KLF4 decreases TPA-induced
overexpression of these same markers. In addition, KLF4–/– hematopoietic stem cells less frequently differentiate into
monocytes [45]. When fetal liver cells from KLF4–/– mice were transplanted into lethally irradiated wild-type mice,
they had undetectable levels of circulating inflammatory monocytes [46]. Thus,
KLF4 appears to be important for both resident and inflammatory monocyte
differentiation.KLF4 is highly expressed in the corneal epithelium, where it is
important in differentiation. Targeted deletion of KLF4 in the eye results in
corneal fragility, edema and a lack of goblet cells in the conjunctiva [47]. In
a cell culture model of adipocyte differentiation using 3T3-L1 cells, short
interfering RNA-mediated knockdown of KLF4 completely blocked expression of
several phenotypic markers of differentiated adipocytes [48]. Collectively,
these data strongly implicate KLF4 as a factor involved in the differentiation
of many tissues. KLF4 is highly expressed in the corneal epithelium, where it is
important in differentiation. Targeted deletion of KLF4 in the eye results in
corneal fragility, edema and a lack of goblet cells in the conjunctiva [47]. In
a cell culture model of adipocyte differentiation using 3T3-L1 cells, short
interfering RNA-mediated knockdown of KLF4 completely blocked expression of
several phenotypic markers of differentiated adipocytes [48]. Collectively,
these data strongly implicate KLF4 as a factor involved in the differentiation
of many tissues.
Roles of KLF4 in Cancers
As an anti-proliferative factor expressed in differentiated
epithelia, it seems logical that KLF4 might act as a tumor suppressor, and
indeed this appears to be the case in the gastrointestinal tract [49,50].
However, recent evidence suggests that KLF4 might also act as an oncogene in
certain contexts [51]. This section will investigate these two contrasting
roles.
KLF4 as a tumor suppressor
Increasing evidence implicates KLF4 as a tumor suppressor in the
intestinal epithelium. In human colorectal carcinoma, expression of KLF4 is
down-regulated, with evidence of both hypermethylation and loss of
heterozygosity [52–54]. However, no association has been found between down-regulation
of KLF4 and tumor staging or 5-year survival in patients with metastatic
carcinoma, suggesting that loss of KLF4 in colorectal cancer may be an early
event [53,54].Examination of KLF4 expression in mouse models of colorectal cancer
has yielded similar results. The APCmin/+ mouse develops hundred of intestinal adenomas early in life and is
a widely used model of intestinal tumorigenesis [55,56]. In adenomas from these
mice, KLF4 is down-regulated, with expression inversely related to the size of
the tumor [4,57]. As APC is a critical component of the Wnt/b-catenin pathway
and APCmin/+
mice express a truncated form of the APC protein, these
mice have deregulated Wnt signaling in their intestine [58,59]. Interestingly,
KLF4 can interact with b-catenin in the nucleus and repress Wnt signaling in vivo, as
well as inhibit tumor growth in tumor xenografts [10]. In addition, crossing
APCmin/+ mice with KLF4+/–
heterozygotes resulted in significantly more adenomas than in APCmin/+ mice alone [60]. Notably, this phenotype was similar to that found
with another double mutant, APCMin/+/TCF-1-/-. The most abundant isoform of TCF-1 expressed in the intestine is
also an antagonist of Wnt/b-catenin signaling, suggesting that an important effect of decreased
KLF4 expression during colorectal tumorigenesis may be de-repression of Wnt
signaling.In human colon cancer cell lines, several point mutations have been
found in the KLF4 gene. One mutation had a significant effect on the ability to
activate a p21Cip1/WAF1 reporter construct in NIH3T3 cells
[52]. However, an investigation to identify mutations in tissue samples of
human colorectal cancers has not yet been performed. In the HCT116 colorectal
cancer cell line, KLF4 is required to prevent centrosome amplification after
gamma-irradiation, and loss of KLF4 may promote chromosomal instability [29].
In addition, KLF4 represses expression of the enzyme ornithine decarboxylase
[31], a proto-oncogene that alone is sufficient to transform NIH3T3 cells
[61]. Collectively, these data strongly
implicate KLF4 as a tumor suppressor in the colon.Strong evidence also implicates KLF4 as a tumor suppressor in the
gastric epithelium. Similar to colorectal cancer, KLF4 is down-regulated in
gastric cancer, with evidence of hypermethylation and loss of heterozygosity
[62–64].
Moreover, targeted loss of the KLF4 gene in the gastric mucosa of mice results
in pre-cancerous changes in the stomach [65]. In examining both normal and
cancerous gastric mucosal tissue from humans, one study found an inverse
relationship between the expression of KLF4 and Sp1, a distantly related
Kr?ppel-like factor family member (Fig. 1) [62]. In addition, the same
study found that in gastric cancer cell lines, KLF4 can directly repress the
expression of Sp1. Given that strong expression of Sp1 is correlated with poor
survival in gastric cancer [66], loss of KLF4 may contribute to gastric cancer
progression.In addition to gastric and colorectal cancer, KLF4 is down-regulated
in esophageal cancer [67,68], bladder cancer [69], non-small-cell lung
carcinoma [70], and leukemia [71,72].
KLF4 as an oncogene
Although these data clearly demonstrate that KLF4 can act as tumor
suppressor in multiple tissues, the possibility that KLF4 might be an oncogene
as well was first demonstrated in the late 1990s. Using E1A-immortalized rat
kidney epithelial cells to screen for factors that could induce transformation,
KLF4 was identified. Moreover, KLF4-transformed rat kidney epithelial cells
could produce tumors in xenografted mice [73]. KLF4 is overexpressed in
laryngeal squamous cell carcinoma as an early event in its progression [73].
Expression of KLF4 is increased in ductal carcinoma of the breast [74], and
increased nuclear staining is associated with a more aggressive phenotype and
poorer prognosis [75]. In the skin, overexpression of KLF4 results in
hyperplasia and dysplasia [76], eventually leading to squamous cell carcinoma
[77].Whether KLF4 acts as a tumor suppressor or an oncogene is likely due
to differences in cell context, expression patterns of other genes and the
chromatin environment of individual cells. However, the mechanism to explain these
differences fully is unknown. A recent study that found that KLF4 could
override RasV12-induced senescence in primary fibroblasts and induce transformation
provided some insight [34]. Additionally, this study demonstrated that the
status of p21Cip1/WAF1, a transcriptional target of KLF4,
determined whether overexpression of KLF4 induced transformation or resulted in
cell cycle arrest. Overexpression of KLF4 alone increases expression of p21Cip1/WAF1 and results in cell cycle arrest. However, the addition of RasV12 resulted in inhibition of p21Cip1/WAF1
expression, allowing KLF4s ability to repress p53 to predominate. Repression
of p53 effectively blocked apoptosis and, in concert with the decreased
expression of p21Cip1/WAF1, eventually led to transformation.
Thus, KLF4 can be added to a growing list of genes that have multiple,
context-dependent roles in cancer, including CDKN1A (p21), transforming growth
factor-b, Ras and NOTCH1 genes [51].
Roles of KLF4 in Stem Cell Renewal and
Reprogramming
Recently, it was found that overexpression of KLF4, in combination
with three other transcription factors, could transform mouse fibroblasts into
a state resembling embryonic stem cells (ES cells). These cells have been termed
inducible pluripotent stem cells (iPS cells) [78]. By replacing the open
reading frame of Fbx15, a non-essential marker of ES cells, with a
neomycin resistance gene, it was hypothesized that neomycin-resistant colonies
might have somehow reprogrammed themselves into ES cells. After screening a
short list of potential factors, it was found that the simultaneous infection
of retroviruses expressing Oct3/4, Sox2, c-Myc and KLF4
were able to produce resistant clones. These cells could form teratomas that
contained differentiated tissues from all three germ layers, confirming their
pluripotency. This approach was further refined by screening for neomycin
resistance based on Nanog or Oct4 expression instead of Fbx15
expression. Unlike Fbx15-iPS cells, Nanog and Oct4-iPS could produce
chimeric mice, and generate live late-term embryos when injected into
tetraploid blastocysts [79–81]. Thus, Nanog- and Oct4-iPS are even more stringent tests of
pluripotency than Fbx15-iPS cells.Researchers are currently trying to gain a better understanding of
the molecular events that occur during stem cell reprogramming as well as the
precise role of the four individual factors required. The importance of Oct3/4
and Sox2 in ES cell renewal is well established [82]. What is less clear is the
function of the other two factors that make up the “magic brew”:
c-Myc and KLF4. One possibility is that c-Myc and KLF4 confer increased
proliferative capacity on potential iPS cells, since both can function as
oncogenes [83]. Since c-Myc regulates a significant number of genes, its
function may be to affect global changes in the chromatin environment by
recruiting histone acetyl-transferase complexes. According this model, KLF4 may
then function to inhibit apoptosis induced by overexpression of c-Myc. KLF4
represses c-Myc expression in colon cancer cells by inhibiting Wnt signaling
[10]. While the role of Wnt signaling in iPS cells remains unresolved, c-Myc
may provide a balance for KLF4.Overexpression of KLF4 in ES cells inhibited differentiation
in erythroid progenitors and increased their capacity to generate secondary
embryoid bodies, suggesting a role for KLF4 in self-renewal [84]. In concert
with Oct3/4 and Sox2, KLF4 activates expression of Lefty1, a gene
expressed in ES cells but lost during differentiation [85]. In addition,
KLF4-null mice survive to term and have no detectable defects during
embryogenesis in their pluripotent stem cell population [11,35], suggesting
that KLF4 may be dispensable in normal ES cells. More recently, human iPS have
been produced using a slightly different mix of factors, substituting Nanog and
LIN28 for c-Myc and KLF4 [86], further calling into question the overall
importance of c-Myc and KLF4. It has even been suggested that c-Myc and KLF4
are merely molecular catalysts, in that they might accelerate or increase the
efficiency of the reprogramming process, but are otherwise not absolutely
required [87].However, a recent study has found that KLF4s function in ES cell
self-renewal is partially redundant; knockdown of KLF4, KLF2 and KLF5, but not
any one individually, resulted in spontaneous ES cell differentiation [88]. In
addition, significant overlap was found between genes regulated by Nanog and
the three Kr?ppel-like factors. Clearly, a complete understanding of the role
of KLF4 in ES cell self-renewal and iPS cell reprogramming awaits further study
Molecular
Mechanisms of KLF4
Human and mouse KLF4 are 470 and 483 amino acids in length,
respectively, and produce a 55 kDa protein. KLF4 can be roughly divided into
three separate domains: a N-terminal activation domain [3,41,89], a central
repressive domain [41], and a C-terminal DNA-binding domain (Fig. 3).
The DNA-binding domain consists of three successive zinc fingers, each
containing an anti-parallel b-sheet, followed by a short loop and an a-helix. Two cysteines
within the b-sheet and two histidines within the a-helix work together to
coordinate a single zinc ion, which stabilizes the fold. Each zinc finger
interacts with three consecutive nucleotides on a target DNA sequence, and the
sequence specificity of a zinc finger protein can be increased simply by adding
zinc fingers [90].In general, KLF4 interacts with GT-rich or CACCC elements on target
genes [41,91]. Although one report suggests that KLF4 prefers to bind a RRGGYGY
sequence (where R=A/G and Y=C/T) [92], it is still not clear whether this is a
true consensus in vivo. KLF4 is exclusively nuclear, like many other
transcription factors, and appears to contain two discrete nuclear localization
sequences: a basic hexapeptide sequence of a N-terminal to the three C-terminal
zinc fingers and a sequence contained within the first two zinc fingers
themselves [93].Given the large number of genes regulated by KLF4, it is not
surprising that the expression of KLF4 is highly regulated (Table 1). In
the colon cancer cell line HCT116, KLF4 has a half-life of only 2 h and is
quickly degraded by the proteasome [94]. However, a variety of stimuli can
induce KLF4 expression, including serum starvation, contact inhibition [3],
interferon-g [31,95], sodium butyrate [5,16], cAMP [48], gastrin [96], DNA
damage [24,33], and oxidative stress [8,25]. The precise mechanism of how the
majority these stimuli increase the expression of KLF4 is unclear, although
possibilities include increased transcription of the KLF4 gene, increased mRNA
stability and/or increased protein stability.
Although much remains to be known about how KLF4 expression is
regulated, several transcription factors have been found to regulate its promoter.
For example, p53 transactivates the KLF4 gene, and p53 is required for the
induction of KLF4 after DNA damage [24,33]. CDX2, another protein important in
differentiation of the intestinal epithelium, can activate a KLF4 reporter
construct [97]. This suggests that KLF4 may act downstream of CDX2, although
more work is necessary to demonstrate this in vivo. KLF4 up-regulates
its own expression by binding to its promoter, whereas KLF5 inhibits KLF4
expression and blocks the binding of KLF4 to its promoter [98]. Although KLF4
and KLF5 are closely related transcription factors, expression of KLF5 is in a
completely opposite pattern in the colonic intestine, with the strongest
expression found in the actively proliferating cells at the base of the crypts;
expression is absent in differentiated cells at the luminal surface [99,100].
In fact, KLF4 and KLF5 have several antagonizing roles in the intestinal
epithelium [49].
Mechanisms of activation
A major function of KLF4 is to activate transcription of target
genes (Table 2). Consistent with this function, the N-terminus of KLF4
contains a strong transactivation domain [3,41,89]. This domain alone, when
directly fused to its three C-terminal zinc fingers, is sufficient to activate
a synthetic reporter construct [89]. In addition, the N-terminal domain
interacts with the transcriptional co-activators p300/CBP, which is required
for its function, as point mutations that block interactions with CBP also
completely abrogate its ability to activate transcription [20,89]. p300/CBP are
histone acetyltransferase proteins, and recruitment of p300/CBP results in an
increase in localized histone acetylation at the promoter. Acetylation of
histones facilitates the recruitment of other transcription factors as well as
the basal transcriptional machinery. In addition, KLF4 itself is acetylated by
p300/CBP at lysine residues 225 and 229. Mutation of these two lysines to
arginine significantly decreases the ability of KLF4 to transactivate target
genes and to inhibit proliferation [20], suggesting that acetylation of KLF4 is
important for its function.One report found that KLF4 can interact with Tip60, a bi-functional
cofactor that contains intrinsic histone acetyltransferase activity, but it can
also recruit HDAC7 [96]. Tip60 is a co-activator for several nuclear hormone
receptors and APP [101,102], but appears to function as a co-repressor for
STAT3 by recruiting HDAC7 [103].
Krox20, another zinc finger protein, can directly interact with KLF4 and
synergistically activate the C/EBPb gene in 3T3-L1 cells [48]. KLF4 interacts
with the NF-kB subunit p65/RelA and synergistically activates expression of
inducible nitric oxide synthase [104]. Thus, the mechanisms of transactivation
mediated by KLF4 may be gene dependent.
Mechanism of repression
One mechanism for repression by a transcription factor is to simple
competition with an activator for binding to a target DNA sequence. This
mechanism is known as a form of passive repression. On the CYP1A1, HDC, and Sp1
genes, KLF4 binds to a sequence overlapping that recognized by the
activator Sp1, displacing Sp1 from the promoter and resulting in repression of
the target gene [62,105,106]. Since Sp1 is ubiquitously expressed and
positively regulates many genes [107], it is likely this mechanism is used by
KLF4 to repress many of its target genes.GAL4 fusion assays demonstrate that KLF4 contains central repressive
domain in addition to its more fully characterized transactivation domain [41].
This suggests that KLF might actively repress expression of some genes, in
addition to or instead of passive repression via competition with a
transcriptional activator. In KLF4-mediated repression of the CD11d gene, KLF4
interacts with and recruits HDAC1 and HDAC2 [108], whereas KLF4 represses
Cyclin B1 by specifically recruiting HDAC3 [20]. On the TP53 gene, MUC1-C
recruits KLF4, as well as HDAC1 and HDAC3, to mediate repression [109]. KLF4
inhibits Smad3-mediated activation of PAI-1 by directly competing with Smad3
for p300 binding [104]. Finally, KLF4 represses transcriptional targets of Wnt
signaling by directly interacting with b-catenin/TCF-4 [10]. These
data strongly suggest that KLF4-mediated activation and repression is complex
and gene-dependent.
Final Thoughts
KLF4 is complex transcription factor that,
depending on the context, can act as a transcriptional activator, a
transcriptional repressor, an oncogene, and a tumor suppressor. In considering
such a transcription factor, questions arise as to how it can switch between
these modes and what molecular mechanisms govern its function in normal cells,
in cancer and in stem cell reprogramming. Although this review discusses much
of what is already known in regard to these issues, more work is needed to
fully understand them. Attaining a greater understanding of the molecular
function of KLF4 will ultimately provide a deeper insight into these many
different fundamental processes.
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