ously, we showed that ACh-induced proliferation of human colon cancer cells is mediated by transactivation of epidermal growth factor (EGF) receptors (EGFRs). In the present study, we elucidate the molecular mechanism underlying this action. ACh-induced proliferation of H508 colon cancer cells, which express exclusively M3 muscarinic receptors (M3Rs), was attenuated by anti-EGFR ligand binding domain antibody, a broad-spectrum matrix metalloproteinase (MMP) inhibitor, anti-MMP7 antibody, a diphtheria toxin analog that blocks release of an EGFR ligand [heparin-binding EGF-like growth factor (HBEGF)], and anti-HBEGF antibody. Conditioned media from ACh-treated H508 cells induced proliferation of SNU-C4 colon cancer cells that express EGFR but not M3R. These actions were attenuated by an EGFR inhibitor and by anti-EGFR and anti-HBEGF antibodies. In H508, but not SNU-C4, colon cancer cells, ACh caused a striking dose-and time-dependent increase in levels of MMP7 mRNA and MMP7 protein. Similarly, ACh induced robust MMP1 and MMP10 gene transcription. ACh-induced MMP1, MMP7, and MMP10 gene transcription was attenuated by atropine, anti-EGFR antibody, and chemical inhibitors of EGFR and ERK activation. In contrast, inhibitors of phosphatidylinositol 3-kinase and NF-B activation did not alter MMP gene transcription. Collectively, these findings indicate that MMP7-catalyzed release of HBEGF mediates ACh-induced transactivation of EGFR and consequent proliferation of colon cancer cells. ACh-induced activation of EGFR and downstream ERK signaling also regulates transcriptional activation of MMP7, thereby identifying a novel feed-forward mechanism for neoplastic cell proliferation. epidermal growth factor receptor; gene transcription; heparin-binding epidermal growth factor-like growth factor COLON CANCER, A COMMON and frequently lethal disease, progresses in a multistep process that involves tumor initiation and promotion. Therapeutic strategies directed at interfering with tumor promotion are of particular interest, because this is generally a reversible, long-term process (13). Hence, there is great interest in identifying key colon cancer growth factors and their receptors. Increasing evidence indicates that muscarinic receptors and ligands play key roles in intestinal neoplasia (8,9,14,15,17,27). The muscarinic cholinergic family of G proteincoupled receptors (GPCRs) consists of five muscarinic receptor subtypes designated M 1 R, M 2 R, M 3 R, M 4 R, and M 5 R (for reviews see Refs. 34 and 35). Using RT-PCR with primers specific for muscarinic receptor subtypes, Frucht and colleagues (14, 15) reported that 60% of colon cancer cell lines tested express M 3 R. Follow-up studies revealed that normal colon epithelial cells uniformly express M 3 R, and in 62% of colon cancers, M 3 R expression was increased up to eightfold compared with adjacent normal colon epithelium (37).Work from our laboratory extended these observations by showing that cholinergic ligand-induced proliferation of H508 human colon cancer cells, which exp...