Genetic and pharmacological inactivation of the purinergic P2RX7 receptor dampens inflammation but increases tumor incidence in a mouse model of colitis-associated cancer

Colitis-Associated Cancer (CAC), a complication of inflammatory bowel disease (IBD), is enhanced by chronic inflammation. Binding of extracellular ATP (eATP) to the purinergic P2X7 receptor (P2RX7) has recently emerged as a key signaling molecule in the control of intestinal inflammation by regulating cytokine production, regulatory T cell (Tregs) survival, mast cell-dependent intestinal inflammation and death of enteric neurons. In this study, we investigated the effect of P2RX7 blockade in a mouse model of dextran sodium sulfate-induced CAC. Using genetic and pharmacological tools, we demonstrated that while P2RX7 promoted an inflammatory response, it unexpectedly acted as a tumor suppressor during early CAC tumorigenesis. Indeed, we reported that the absence of P2RX7 activity enhanced proliferation of intestinal epithelial cells and protected them from apoptosis. Further, we demonstrated that P2RX7 blockade influenced immune cell infiltration and notably promoted Treg accumulation within lesions of the digestive system. Finally, we showed that P2RX7 inactivation increased TGFB1 (TGF-β1) production, which stimulated the proliferation of intestinal epithelial cells. Taken together, our findings define a novel and unexpected role for P2RX7 in protecting against CAC.