Histological analysis of the small intestine shows that as villus formation is well on its way in wild type fetuses at 15.5 dpc, while this process has barely been initiated in Foxl1 deficient mice (Fig. 1A,B). Even two days later, at 17.5 dpc, villification is abnormal in mutant mice, with apparent bridging of nascent villi across the gut lumen, likely reflecting persistent epithelial ridges (Fig. 1C, D), a phenotype that persists at 18.5 dpc (Fig. 1E,F). In order to investigate this phenotype in three dimensions, we performed scanning electron microscopy. As shown in Fig. 1G-L, in control mice villification occurs through the formation of regularly spaced short invaginations into the gut lumen, which by 18.5 dpc have progressed to form elongated villi. This process is dramatically altered by loss of Foxl1, with absence of the regularly spaced nascent villi and presence instead of long epithelial ridges at 15.5 dpc (yellow arrow in Fig. 1H), which persist until late gestation (Fig. 1J, red arrow). The presence of epithelial ridges instead of villi is reminiscent of the phenotype seen in small intestinal explants treated with the pan-BMP inhibitor dorsomorphin6, a connection we explore further below.
Fetal gut telocytes progenitors exist in two subpopulations
The inclusion of tdTomato in the recently developed Foxl1 mutant allele employed here13 enabled us to follow the fate and determine the molecular properties of Foxl1-positive cells embryos heterozygous and homozygous for this Foxl1 null allele. Of note, the Foxl1 phenotype is recessive, as Foxl1 heterozygous mice are indistinguishable from wild type controls10, 14–16. We performed scRNAseq on the proximal half of the small intestine of 15.5 dpc FoxL1CreER-tdTom/+ fetuses (Fig. 2A,B). As shown in the UMAP analysis in Fig. 2C and D, Foxl1+ cells segregate into two closely related cell clusters, which we termed ‘telocyte progenitors 1 and 2’. A list of marker genes for all cell populations shown in Fig. 2C is given in Supplementary Table 1. Telocyte progenitors 1 express high levels of Pdgfra and multiple Bmp mRNAs (Fig. 1E), and thus most likely correspond to ‘villus cluster cells’, i.e the PDGFRa positive cells important in villus formation originally identified by Karlsson and colleagues3. By exclusion, the telocyte progenitor 2 population likely represents Foxl1+ cells directly adjacent to the intervillus epithelium, i.e. the presumptive future crypt cells. Interestingly, we identified Glp2r, encoding the GLP2 receptor, as another gene predominantly expressed in telocyte progenitor 1 cells, and confirm the localization of the Glp2r mRNA to villus cluster cells by RNAscope analysis (Fig. 2F,G). A further telocyte progenitor 1 marker is the Zinc-finger transcription factor Spalt like transcription factor 1 (Sall1), which is part of the NuRD transcriptional repressor complex (Fig. 2H,I). Sall1/Foxl1 double positive cells can be seen to also mark a cluster of cells that appears to be in the process of initiating a new villus (Fig. 2I). Importantly, this single cell analysis clearly shows that Foxl1+ cells are distinct from myofibroblast, interstitial cells of Cajal, and pericytes, identified by the expression of Acta2med/Myh11med/Desmed/Taglnmed, Etv1+/Kit+/Actalow, and Cspg4+/Pdgfrb+/Abcc9+ or Abcc9+/Ndufa4l2+, respectively (Fig. 2C). Major hallmarks of the telocyte progenitor 1 and 2 populations are summarized in the graphic shown in Fig. 2J.
Expression of PDGFRa in telocyte progenitors is dependent on Foxl1
Next, we analyzed the expression profile of the fetal small intestine of Foxl1 null (FoxL1CreER-tdTom/CreER-tdTom) mice and compared them to those of heterozygous fetuses. Note that in both control and Foxl1 null fetuses, Foxl1-expressing cells are localized to the mesodermal cell layer that is directly juxtaposed to the developing epithelium, and loss of Foxl1 does not affect telocyte progenitor number (Fig. 3A). The UMAP plot shown in Fig. 3B clearly demonstrates that the telocyte progenitor 1 population is dramatically reduced in abundance in the Foxl1 null intestine. As mentioned above, among the markers of the telocyte progenitor 1 cells is PDGFRa. The scRNAseq data shown in Fig. 3C as well as the immunofluorescence staining presented in Fig. 3D demonstrate that PDGFRa expression is Foxl1 dependent. To determine if Pdgfra is a direct target of Foxl1, we performed Cut-and-Run assays on telocytes from 15.5 dpc fetal gut. However, we found no Foxl1 binding event within 10 kb of the Pdgfra promoter (data not shown).
It was previously reported that the winged helix transcription factor Foxo3 is a transcriptional activator of Pdgfra, which binds to an evolutionarily conserved cis-regulatory element in its proximal promoter17. Therefore, we hypothesized that Foxl1 might indirectly control Pdgfra via activation of Foxo3. Using Cut-and-Run of sorted fetal telocytes, we indeed found several Foxl1 binding sites in the Foxo3 promoter (Fig. 3E). In addition, our scRNAseq data show a reduction of Foxo3 transcript levels in the telocyte progenitor 1 population of Foxl1 null fetuses (Fig. 3F). These data suggest indirect regulation of the Pdgfra gene by Foxl1 through a transcription factor cascade via Foxo3.
Foxl1 controls multiple Bmp genes in telocyte progenitor cells
Next, we focused on BMP proteins, as BMP signaling from the mesoderm to the epithelium is critical for villus cluster formation6. Telocyte-produced BMPs enriched in the villus cluster cells signal to the overlaying endoderm to inhibit Wnt signaling and limit proliferation (Fig. 4A). High expression of several BMP genes was present in particular in villus custer telocyte-progenitor 1 cells (Fig. 4B). In case of BMP4, expression also extends to Foxl1 negative GPX3 + FLCs; however, its levels are clearly reduced specifically in Foxl1-deficient telocytes (Fig. 4B). To determine if BMP signaling to the epithelium is impaired by this reduction in telocyte BMP expression, we performed immunostaining for phosphorylated SMAD1/5 (Fig. 4C). Nuclear pSMAD1/5 is clearly detectable in epithelial cells in the villus tip but not intervillus regions in control embryos. In contrast, epithelial cells in Foxl1 null mice are devoid of signal, confirming loss of active BMP signaling to the epithelium.
When analyzing the pSMAD1/5 staining, we also noticed signal in nuclei of mesenchymal cells within the invaginating villi, with most of them negative for the Foxl1-tdTomato signal. These findings suggest unexpected bi-directional signaling of villus tip telocytes to both epithelium and neighboring mesenchymal cells. At present, the significance of this observation is unknown; however, the pSMAD1/5 signal in mesenchymal cells is also Foxl1-dependent (Fig. 4C).
Loss of mesenchymal BMP signals is expected to result in de-inhibition of Wnt signaling in the epithelium overlying villus cluster telocytes. Indeed, we found expression of the Wnt target gene Sox9 expanded from the developing crypts to nascent villi in the Foxl1 null fetal intestine (Fig. 4D). Likewise, epithelial proliferation was not confined to the nascent crypts but extended to the villus epithelium in mutant mice (Fig. 4D). Thus, Foxl1 is a critical factor required for the demarcation of the postmitotic villus from the mitotic intervillus epithelium. The schema in Fig. 4E summarizes these findings.
Foxl1 is required for mesenchymal expression of planar cell polarity genes
Patterning of the developing gut epithelium is clearly perturbed in the absence of Foxl1, and the hyperproliferation of the epithelium due to lack of BMP signaling documented above regionally leads to an apparent multilayered epithelium, in which mesenchyme-distal cells undergo apoptosis as indicated by cleaved caspase 3 staining (Fig. 5A). Recently, planar cell polarity genes were identified among the mesenchymal Gli targets in the fetal gut, and it was demonstrated further that the GLI2 target gene Fat4 is required for villus development during the epithelial transition18. The discovery that the PCP pathway acts within the mesenchymal compartment to structure stromal cells was surprising, as typically PCP pathway function has been reported within epithelial cell layers19. As documented above, before the epithelial transition, Foxl1 + cells form a uniform cell layer with a depth of only one to two cells surrounding the primitive gut tube, which is then patterned into the telocyte progenitor 1 (villus cluster) and telocyte progenitor 2 (crypt base) cells, possibly with the involvement of the PCP system. We found that several PCP genes (Fat4, Wnt5a, Vangl1 and 2) exhibit reduced expression in the absence of Foxl1 (Fig. 5B). Using our Cut and Run data, we found Foxl1 binding in the promoter of Fat4, suggesting a direct regulatory relationship (Fig. 5C).
Rao-Bhatia and colleagues had found villification defects in mice with mutations in the PCP gene Fat4, which were worsened by simultaneous heterozygous loss of Vangl2 18. This defect was preceded by a reduction in the number of epithelial T-folds, characteristic invaginations of the epithelium that form the boundaries of developing villi and that can be visualized by staining with the apical membrane marker Ezrin. In order to evaluate if the reduced expression of PCP genes in Foxl1 null mice impacts epithelial remodeling, we stained small intestinal sections from fetuses at developmental stages spanning villification (13.5 to 15.5 dpc) for Ezrin to identify T-folds and PDGFRa to label villus cluster cells. As shown in Fig. 5D-F, the number of T-folds is clearly reduced in the Foxl1-deficient intestine, coinciding with the loss of PDGFRa expression in telocyte progenitors. Next, we employed staining for F-actin to assess the orientation of stromal cells in the developing intestine. As shown in Fig. 5G, while mesenchymal cells in the control fetal gut reorient their major axis to be parallel to the invaginating villi, this process fails to occur in Foxl1 null mice, supporting the notion of failed planar cell polarity in stromal cells.
Loss of Foxl1 impacts epithelial gene expression profiles
As shown above, Foxl1 deficiency impacts the patterning of the overlying epithelium, with many villus tip epithelial cells remaining in the cell cycle (Fig. 4D). We had also noted a shift in the UMAP pattern of epithelial cells between control and Foxl1 null cells in 15.5 dpc embryos (green box in Fig. 3B). To address this issue further, we reclustered the epithelial cells via UMAP. Figure 6A shows that fetal gut epithelial cells of control embryos partition into two major groups, which we identified as ‘secretory progenitors’ and ‘undifferentiated epithelial cells’ based on their expression profile. The heatmap in Fig. 6B shows the 225 most differentially expressed genes between these two clusters (false discovery rate < 10%; absolute fold-change > 2), while Fig. 6C indicates selected markers genes for each cell type. Fetal secretory progenitors are characterized by high levels of the mRNAs for transcription factors Klf4, Spdef, and Sox4, known to be critical for secretory cell differentiation20–22. Undifferentiated epithelial cells in contrast exhibit strong expression of Sox9 (which marks them as proliferating intervilllus cells as seen in Fig. 4D) as well as markers of the absorptive enterocyte lineage (Alpi, the gene for intestinal alkaline phosphatase, Fabp1, encoding fatty acid binding protein 1, Apoa4, encoding Apolipoprotein A4 which is important in intestinal cholesterol absorption, and Slc16a1, encoding the monocarboxylic acid transporter for lactate).
Next, we added epithelial cells from Foxl1 null embryos to the UMAP plot and found that they are largely confined to the undifferentiated epithelial cell cluster (Fig. 6D). When we quantified the proportion of cells in each cluster, we found a striking loss of secretory progenitor cells in Foxl1 null embryos (Fig. 6E). Finally, we performed gene set enrichment analysis to search for pathways that are differentially regulated in the absence of Foxl1. As shown in Fig. 6F, the response to BMP signaling, negative regulation of epithelial proliferation, and establishment of planar cell polarity were all strongly enriched among the genes more highly expressed in the control gut epithelium, confirming that loss of telocyte Foxl1 has a major impact on the development of the fetal intestinal epithelium. Finally, we confirmed these findings by immunofluorescent staining for markers of the secretory cell lineage. Staining for Agr2 (Anterior gradient protein 2 homolog), a protein disulfide isomerase required for the formation of mixed disulfides in intestinal mucins (Fig. 6G), and its substrate Muc2 (Mucin2), the major mucin of intestinal goblet cells (Fig. 6H), are both expressed in the embryonic day 15.5 control intestine in secretory cell progenitors, but completely absent from the Foxl1 null gut, confirming the findings from our single cell RNAseq analysis.