NDRG4, an early detection marker for colorectal cancer, is specifically expressed in enteric neurons

N. Vaes, M. H. F. M. Lentjes, M. J. Gijbels, G. Rademakers, K. L. Daenen, W. Boesmans, K. A. D. Wouters, A. Geuzens, X. Qu, H. P. J. Steinbusch, B. P. F. Rutten, S. H. Baldwin, K. A. Sharkey, R. M. W. Hofstra, M. van Engeland, P. Vanden Berghe, V. Melotte*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Promoter methylation of N-myc Downstream-Regulated Gene 4 (NDRG4) in fecal DNA is an established early detection marker for colorectal cancer (CRC). Despite its connection to CRC, NDRG4 is predominantly studied in brain and heart, with little to no knowledge about its expression or role in other organs. In this study, we aimed to determine the whole-body expression of NDRG4, with a focus on the intestinal tract.

Methods: We investigated NDRG4 expression throughout the body by immunohistochemistry, Western Blotting and in situ mRNA hybridization using tissues from NDRG4 wild-type, heterozygous and knockout mice and humans. In addition, we explored cell-specific expression of NDRG4 in murine whole-mount gut preparations using immunofluorescence and confocal microscopy.

Key Results: NDRG4 is specifically expressed within nervous system structures throughout the body. In the intestinal tract of both mouse and man, NDRG4 immunoreactivity was restricted to the enteric nervous system (ENS), where it labeled cell bodies of the myenteric and submucosal plexuses and interconnecting nerve fibers. More precisely, NDRG4 expression was limited to neurons, as NDRG4 always co-localized with HuC/D (pan-neuronal marker) but never with GFAP (an enteric glial cell marker). Furthermore, NDRG4 was expressed in various neuropeptide Y positive neurons, but was only found in a minority (similar to 10%) of neurons expressing neuronal nitric oxide synthase.

Conclusions and Inferences :NDRG4 is exclusively expressed by central, peripheral and enteric neurons/nerves, suggesting a neuronal-specific role of this protein. Our findings raise the question whether NDRG4, via the ENS, an understudied component of the tumor microenvironment, supports CRC development and/or progression.

Original languageEnglish
Article number13095
Number of pages10
JournalNeurogastroenterology and Motility
Issue number9
Publication statusPublished - Sept 2017


  • biomarker
  • colorectal cancer
  • enteric nervous system
  • myenteric plexus
  • NDRG4


Dive into the research topics of 'NDRG4, an early detection marker for colorectal cancer, is specifically expressed in enteric neurons'. Together they form a unique fingerprint.

Cite this