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ResearchIn-Press PreviewGastroenterologyInflammation Open Access | 10.1172/JCI196712

A missense mutation in Muc2 promotes gut microbiome- and metabolome-dependent colitis-associated tumorigenesis

Giulio Verna,1 Stefania De Santis,2 Bianca N. Islam,1 Eduardo M. Sommella,3 Danilo Licastro,4 Liangliang Zhang,5 Fabiano De Almelda Celio,1 Emily N. Miller,1 Fabrizio Merciai,3 Vicky Caponigro,3 Wei Xin,6 Pietro Campiglia,3 Theresa T. Pizarro,2 Marcello Chieppa,7 and Fabio Cominelli1

1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

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1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

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1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

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1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

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1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

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1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

Find articles by Zhang, L. in: PubMed | Google Scholar |

1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

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1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

Find articles by Miller, E. in: PubMed | Google Scholar

1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

Find articles by Merciai, F. in: PubMed | Google Scholar |

1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

Find articles by Caponigro, V. in: PubMed | Google Scholar

1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

Find articles by Xin, W. in: PubMed | Google Scholar

1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

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1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

Find articles by Pizarro, T. in: PubMed | Google Scholar |

1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

Find articles by Chieppa, M. in: PubMed | Google Scholar

1Department of Medicine, Digestive Health Research Institute, Case Western Reserve University School of Medicine, Cleveland, United States of America

2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, United States of America

3Department of Pharmacy, University of Salerno, Fisciano, Italy

4AREA Science Park, Trieste, Italy

5Department of Population & Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, United States of America

6Department of Pathology, University of South Alabama, Mobile, United States of America

7Department of Experimental Medicine (DiMeS), University of Salento, Lecce, Italy

Find articles by Cominelli, F. in: PubMed | Google Scholar |

Published November 6, 2025 - More info

J Clin Invest. https://doi.org/10.1172/JCI196712.
Copyright © 2025, Verna et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published November 6, 2025 - Version history
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Abstract

Colitis-associated cancer (CAC) arises from a complex interplay between host and environmental factors. In this report, we investigated the role of the gut microbiome using Winnie mice, a UC-like model with a missense mutation in the Muc2 gene. Upon rederivation from a conventional (CONV) to a specific-pathogen-free (SPF) facility, Winnie mice developed severe colitis and, notably, spontaneous CAC that progressively worsened over time. In contrast, CONV Winnie showed only mild colitis but no tumorigenesis. By comparison, when rederived into germ-free (GF) conditions, SPF Winnie mice were protected from colitis and colon tumors, indicating an essential role for the gut microbiome in the development of CAC in these mice. Using shotgun metagenomics, metabolomics, and lipidomics, we identified a distinct pro-inflammatory microbial and metabolic signature that potentially drives the transition from colitis to CAC. Fecal microbiota transplantation (FMT), using either SPF Winnie or WT (Bl/6) donors into GF Winnie recipients, demonstrated that while colitis developed regardless of the donor, only FMT from SPF Winnie donors resulted in CAC. Our studies present a relevant model of CAC, providing strong evidence that the microbiome plays a key role in its pathogenesis, thereby challenging the concept of colon cancer as a strictly non-transmissible disease.

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