Matrix metalloproteinases (MMPs) play an important role in the invasive behavior of a number of cancers including oral squamous cell cancer (OSCC), and increased expression of MMP-9 is correlated with invasive and metastatic OSCC. Because calcium is an important regulator of keratinocyte function, the effect of modulating extracellular calcium on MMP-9 expression in OSCC cell lines was evaluated. Increasing extracellular calcium induced a dose-dependent increase in MMP-9 expression in immortalized normal and premalignant oral keratinocytes, but not in two highly invasive OSCC cell lines. Differential activation of MAPK signaling was also induced by calcium. p38 MAPK activity was downregulated, whereas ERK1/2 activity was enhanced. Pharmacologic inhibition of p38 MAPK activity or expression of a catalytically inactive mutant of the upstream kinase MAPK kinase 3 (MKK3) increased the calcium induced MMP-9 gene expression, demonstrating that p38 MAPK activity negatively regulated this process. Interestingly blocking p38 MAPK activity enhanced ERK1/2 phosphorylation, suggesting reciprocal regulation between the ERK1/2 and p38 MAPK pathways. Together these data support a model wherein calcium-induced MMP-9 expression is differentially regulated by the ERK1/2 and p38 MAPK pathways in oral keratinocytes, and the data suggest that a loss of this regulatory mechanism accompanies malignant transformation of the oral epithelium.Oral squamous cell carcinoma (OSCC) 1 is the most common malignancy of the oral cavity causing more deaths than any other oral disease (1, 2). Although OSCC is characterized by local, regional, and distant spread, the biochemical factors that underlie dissemination are poorly understood (1, 3). OSCC tumors demonstrate a progressive lack of basement membrane staining, more diffuse invasion, and a higher frequency of lymph node metastasis, suggesting that basement membrane loss reflects metastatic potential (4 -7). This is consistent with immunohistochemical and in situ hybridization studies of human OSCC tumors that implicate enzymes belonging to the matrix metalloproteinase (MMP) family, including MMP-9 (92-kDa gelatinase B), in basement membrane proteolysis and tissue invasion. The presence of gelatinolytic activity attributable to activated MMP-9 in OSCC biopsy specimens correlates with immunohistochemical staining of frozen sections and is enhanced in both highly invasive and metastatic cases, suggesting a correlation between MMP-9 activity and metastatic potential (8,9). Additional studies of human tumors have shown that MMP-9 is up-regulated in diffuse invasive OSCC specimens, with predominant localization to the invasive front (4, 10). At the cellular level, modulation of MMP-9 expression via phorbol ester treatment leads to enhanced invasive behavior (8 -10), whereas blocking MMP-9 expression in vivo reduces invasion in an orthotopic murine model of OSCC (11). These data support the hypothesis that MMP-9 is an important determinant of the invasive phenotype in OSCC.Oral keratinocytes express a...