Mutations in the tumor suppressor tuberin (TSC2) are a common factor in the development of lymphangioleiomyomatosis (LAM). LAM is a cystic lung disease that is characterized by the infiltration of smooth muscle-like cells into the pulmonary parenchyma. The mechanism by which the loss of tuberin promotes the development of LAM has yet to be elucidated, although several lines of evidence suggest it is due to the metastasis of tuberin-deficient cells. Here we show that tuberin-null cells become nonadherent and invasive. These nonadherent cells express cleaved forms of b-catenin. In reporter assays, the b-catenin products are transcriptionally active and promote MMP7 expression. Invasion by the tuberin-null cells is mediated by MMP7. Examination of LAM tissues shows the expression of cleaved b-catenin products and MMP7 consistent with a model that tuberin-deficient cells acquire invasive properties through a b-catenin-dependent mechanism, which may underlie the development of LAM.Keywords: caspase 3; MMP7; LAM; tuberous sclerosis complex Lymphangioleiomyomatosis (LAM) is a potentially fatal cystic lung disease that occurs almost exclusively in women. There are no proven medical therapies for the treatment of LAM, and the health of patients with LAM deteriorates over an average span of 10 years due to the progressive destruction of the lungs (1). LAM is predominantly caused by tuberin loss-of-function mutations, forming a genetic link with tuberous sclerosis complex (TSC) (2-4). Recent analyses estimate that 30 to 40% of women with TSC may also be affected with LAM (5).TSC is a multisystem disease that results in the growth of benign tumors in the brain, kidneys, heart, and skin. It commonly affects the central nervous system, resulting in any combination of disorders including seizures, mental retardation, and behavioral problems (6). One of the most common phenotypic factors for TSC is the development of renal angiomyolipomas (AMLs), which occur in approximately 70 to 80% of patients with TSC (7,8). AMLs are characterized by the abnormal proliferation of dysplastic vessels and adipose and smooth muscle-like cells. Up to 60% of patients with sporadic LAM are diagnosed with AMLs (9). Genetic analyses have demonstrated that LAM cells and AML cells isolated from patients with LAM contain identical TSC2 mutations, suggesting that tuberin-deficient AML smooth muscle-like cells may have the potential to migrate and infiltrate the lung (3).The benign metastasis hypothesis of LAM is further supported by two independent clinical observations. First, after lung transplantation, there have been several case reports in which LAM develops anew in the transplanted donor lung, with LAM cells expressing the same TSC2 mutation identified in the native lung (10-13). Second, LAM cells have recently been isolated from the circulatory system and other bodily fluids of patients with LAM, indicating that these migratory cells have the potential to invade a variety of host tissues (14). These lines of evidence strongly suggest that the dev...