BEST4/CA7+ cells of the human intestine were recently identified by single-cell RNA sequencing. While their gene expression profile predicts a role in electrolyte balance, BEST4/CA7+ cell function has not been explored experimentally owing to the absence of BEST4/CA7+ cells in mice and the paucity of human in vitro models. Here, we establish a protocol that allows the emergence of BEST4/CA7+ cells in human intestinal organoids. Differentiation of BEST4/CA7+ cells requires activation of Notch signaling and the transcription factor SPIB. BEST4/CA7+ cell numbers strongly increase in response to the cytokine interferon-γ, supporting a role in immunity. Indeed, we demonstrate that BEST4/CA7+ cells generate robust CFTR-mediated fluid efflux when stimulated with bacterial diarrhea-causing toxins and find the norepinephrine-ADRA2A axis as a potential mechanism in blocking BEST4/CA7+ cell-mediated fluid secretion. Our observations identify a central role of BEST4/CA7+ cells in fluid homeostasis in response to bacterial infections.

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The Netherlands Organisation for Scientific Research (NWO)
Elsevier/ Cell Press
doi.org/10.1016/j.stem.2025.02.003
Cell Stem Cell
Biophysics

Wang, D., Spoelstra, W. K., Lin, L., Akkerman, N., Krueger, D., Dayton, T., … Clevers, H. (2025). Interferon-responsive intestinal BEST4/CA7+ cells are targets of bacterial diarrheal toxins. Cell Stem Cell, 32(4), 598–612.e5. doi:10.1016/j.stem.2025.02.003