Expression of the neuropeptide neurotensin (NT) and its high affinity receptor (NTR1) is increased during the course of Clostridium difficile toxin A-induced acute colitis, and NTR1 antagonism attenuates the severity of toxin A-induced inflammation. We recently demonstrated in non-transformed human colonic epithelial NCM460 cells that NT treatment caused activation of a Ras-mediated MAP kinase pathway that significantly contributes to NT-induced interleukin-8 (IL-8) secretion. Here we used NCM460 cells, which normally express low levels of NTR1, and NCM460 cells stably transfected with NTR1 to identify the upstream signaling molecules involved in NT-NTR1-mediated MAP kinase activation. We found that inhibition of the epidermal growth factor receptor (EGFR) by either an EGFR neutralizing antibody or by its specific inhibitor AG1478 (0.2 M) blocked NT-induced MAP kinase activation. Moreover, NT stimulated tyrosine phosphorylation of the EGFR, and pretreatment with a broad spectrum metalloproteinase inhibitor batimastat reduced NT-induced MAP kinase activation. Using neutralizing antibodies against the EGFR ligands EGF, heparin-binding-EGF, transforming growth factor-␣ (TGF␣), or amphiregulin we have shown that only the anti-TGF␣ antibody significantly decreases NT-induced phosphorylation of EGFR and MAP kinases. Furthermore, inhibition of the EGF receptor by AG1478 significantly reduced NT-induced IL-8 promoter activity and IL-8 secretion. This is the first report demonstrating that NT binding to NTR1 transactivates the EGFR and that this response is linked to NT-mediated proinflammatory signaling. Our findings indicate that matrix metalloproteinase-mediated release of TGF␣ and subsequent EGFR transactivation triggers a NT-mediated MAP kinase pathway that leads to IL-8 gene expression in human colonic epithelial cells.Neurotensin (NT), 1 a 13-amino acid neuropeptide originally isolated by Carraway and Leeman (1) from bovine hypothalamus, is also localized in the gastrointestinal tract (2). In the small intestine NT is synthesized and secreted by specific mucosal endocrine cells in response to several different stimuli (3, 4). NT alters motility in the stomach, small bowel, and colon (5-7), stimulates secretion in the ileum (8), pancreas (9), and the biliary tract (10), and causes Cl Ϫ secretion from human colonic mucosa (11). NT also stimulates growth and regeneration of the intestinal mucosa (12, 13) and has been implicated in the pathophysiology of colon cancer (14, 15).Two G protein-coupled receptors (GPCRs) have been described for NT, a high affinity (NTR1) and a low affinity (NTR2) receptor (16). A third, non-G protein-coupled receptor has also been identified (17). Several studies underline the importance of NTR1 in several intestinal pathologic conditions. For example, administration of the specific NTR1 antagonist SR 48692 to rats inhibits colonic mucin and prostaglandin E2 secretion and mast cell activation in response to immobilization stress (18). NTR1 antagonism also reduces colonic secretion and infla...