Gastrin is a hormone produced by G-cells in the normal gastric antrum. However, colorectal carcinoma cells may aberrantly produce gastrin and exhibit increased expression of cholecystokinin B (CCK-B)/gastrin receptors. Gastrin is trophic for the normal gastric oxyntic mucosa and exerts a growth-promoting action on gastrointestinal malignancy. Thus, gastrin may act as an autocrine/paracrine or endocrine factor in the initiation and progression of colorectal carcinoma. The molecular mechanisms involved have not been elucidated. Hypergastrinemia induced by Helicobacter pylori infection is associated with increased cyclooxygenase-2 (COX-2) expression in gastric and colorectal tissues, suggesting the possibility that gastrin up-regulates COX-2 expression in these tissues; this has not been confirmed. We report here that gastrin significantly increases the expression of COX-2 mRNA and protein, the activity of the COX-2 promoter, and the release of prostaglandin E 2 from a rat intestinal epithelial cell line transfected with the CCK-B receptor. These actions were dependent upon the activation of multiple MAPK signal pathways, including ERK5 kinase; transactivation of the epidermal growth factor receptor; and the increased expression and activities of transcription factors ELK-1, activating transcription factor-2, c-Fos, c-Jun, activator protein-1, and myocyte enhancer factor-2. Thus, our findings identify the signaling pathways coupling the CCK-B receptor with up-regulation of COX-2 expression. This effect may contribute to this hormone-dependent gastrointestinal carcinogenesis, especially in the colon.Cyclooxygenase-2 (COX-2) 1 is an inducible enzyme catalyzing the rate-limiting step in prostaglandin synthesis, converting arachidonic acid to prostaglandin H 2 (1). A large body of genetic and biochemical evidence supports the important role of COX-2 in tumorigenesis, particularly in colorectal cancer (1). COX-2 is overexpressed in cancer cells and is associated with enhanced invasiveness (1). However, the molecular mechanisms leading to up-regulation of COX-2 in intestinal cells are not completely understood.Gastrointestinal hormones regulate gastrointestinal homeostasis by affecting cell proliferation, differentiation, apoptosis, and gene expression. Aberrant control of these biological processes is thought to play an important role in establishment of intestinal neoplasia (2, 3).Gastrin is a gastrointestinal hormone that is produced by G-cells in the normal gastric antrum (4). We (5) and others (6) have shown that expression of cholecystokinin B/gastrin receptors is increased in most colon cancers. Gastrin is trophic for the normal gastric oxyntic mucosa and exerts a growth-promoting action on gastrointestinal malignancy (3,4,7,8). Ciccotosto et al. (9) reported that 69% of colon cancers contain fully processed gastrin and that 100% have detectable amounts of progastrin, reflecting aberrant production of both gastrin and progastrin by colon cancer. Watson et al. (10,11) showed that immune neutralization of gastrin ...