- Fu, Ting;
- Coulter, Sally;
- Yoshihara, Eiji;
- Oh, Tae Gyu;
- Fang, Sungsoon;
- Cayabyab, Fritz;
- Zhu, Qiyun;
- Zhang, Tong;
- Leblanc, Mathias;
- Liu, Sihao;
- He, Mingxiao;
- Waizenegger, Wanda;
- Gasser, Emanuel;
- Schnabl, Bernd;
- Atkins, Annette R;
- Yu, Ruth T;
- Knight, Rob;
- Liddle, Christopher;
- Downes, Michael;
- Evans, Ronald M
Increased levels of intestinal bile acids (BAs) are a risk factor for colorectal cancer (CRC). Here, we show that the convergence of dietary factors (high-fat diet) and dysregulated WNT signaling (APC mutation) alters BA profiles to drive malignant transformations in Lgr5-expressing (Lgr5+) cancer stem cells and promote an adenoma-to-adenocarcinoma progression. Mechanistically, we show that BAs that antagonize intestinal farnesoid X receptor (FXR) function, including tauro-β-muricholic acid (T-βMCA) and deoxycholic acid (DCA), induce proliferation and DNA damage in Lgr5+ cells. Conversely, selective activation of intestinal FXR can restrict abnormal Lgr5+ cell growth and curtail CRC progression. This unexpected role for FXR in coordinating intestinal self-renewal with BA levels implicates FXR as a potential therapeutic target for CRC.