Chronic inflammation of mucosae is associated with an increased cancer risk. Tumorigenesis in these tissues is associated with the activity of some proteinases, cyclooxygenase-2 (COX-2), and â¤-catenin. Serine proteinases participate in both inflammation and tumorigenesis through the activation of proteinase-activated receptor-2 (PAR 2 ), which up-regulates COX-2 by an unknown mechanism. We sought to determine whether â¤-catenin participated in PAR 2 -induced COX-2 expression and through what cellular mechanism. In A549 epithelial cells, we showed that PAR 2 activation increased COX-2 expression through the â¤-catenin/T cell factor transcription pathway. This effect was dependent upon ERK1/2 MAPK, which inhibited the â¤-catenin-regulating protein, glycogen synthase kinase-3â¤, and induced the activity of the cAMP-response element-binding protein (CREB). Knockdown of CREB by small interfering RNA revealed that PAR 2 -induced â¤-catenin transcriptional activity and COX-2 expression were CREB-dependent. A co-immunoprecipitation assay revealed a physical interaction between CREB and â¤-catenin. Thus, PAR 2 up-regulated COX-2 expression via an ERK1/2-mediated activation of the â¤-catenin/Tcf-4 and CREB pathways. These findings reveal new cellular mechanisms by which serine proteinases may participate in tumor development and are particularly relevant to cancers associated with chronic mucosal inflammation, where serine proteinases are abundant and COX-2 overexpression is a common feature.Patients with chronic inflammatory diseases of mucosae, including those of the airway and intestine, have an increased risk for the development of cancer. Serine proteinases have been implicated as key factors in mucosal inflammation and the formation and metastasis of tumors. These proteinases trigger specific cellular responses through proteinase-activated receptors (PARs), 3 G-protein-coupled receptors that are activated by proteolytic cleavage of the extracellular N terminus at a specific amino acid sequence, revealing a new N-terminal "tethered ligand" that binds to and activates the receptor (1, 2). PAR 2 , one of the four members of this receptor family, can be activated by trypsin (3), tryptase (4), and the tumor-derived proteinase matriptase (5) to stimulate processes ranging from inflammation and pain perception to tumorigenesis (3, 7-9). Tumor cells, especially those of epithelial origin, express a high level of PAR 2 (10, 11). Trypsin and matriptase are commonly overexpressed in tumor cells and in their microenvironment at concentrations compatible with PAR 2 activation (12, 13).We have shown previously that the activation of PAR 2 stimulates COX-2 expression (14). COX-2 is expressed early in carcinogenesis and very likely plays a role in the development of cancer (15-17), as it correlates with tumor invasion and poor clinical outcome (18). The mechanisms by which PAR 2 activation induces the expression of COX-2 are still unclear. However, it is known that the cox2 gene can be induced by the transcriptional activity of â¤-catenin....