However, despite the similarities that exist between teratoma and EB as ES progeny, a major distinction is their stage of differentiation. Since EB represent the early stage of ES differentiation and may contain undifferentiated ES cells, an enlarged size of EB should reflect an outcome of enhanced growth of ES cells by over3-Bromo-7-nitroindazole expression of p18. In contrast, the size of teratoma was measured 30 days after the inoculation of ES cells. At that time point, the teratoma formed would be in the late stage of ES cell differentiation, and should mainly be composed of more differentiated somatic cells. Therefore, the differential effects of p18 on teratoma and EB can be explained by stage-specific effects of p18 during ES differentiation. Like the effect of p18 on ES proliferation, a recent report also demonstrated a positive role of p18 in the proliferation of hematopoietic progenitor cells. In contrast, data from our previous studies, demonstrated that self-renewal of HSC is inhibited by p18. Taken A 286982 together, p18 may function in cell type-specific and differentiation-specific manners. Proper control of cell cycle progression is of critical importance for regulating all the cell types. Interestingly, cell cycle control in ES cells has been shown to be independent of the regulatory effects of the Rb and p53 pathways. For example, ectopic expression of p16, another prominent CDK4/6 cyclin D inhibitor, does not inhibit the proliferative capacity of mouse ES cells. In addition, ES cells do not exhibit growth arrest in the G1 phase. Based on the results of the present study where ectopic expression of p18 in mouse ES cells enhanced the cell growth and stemness by up-regulating self-renewal genes and down-regulating differentiation genes, it further reinforces the notion that cell cycle regulation in ES cells is distinct from that in somatic cells and cell cycle regulators have distinct effects on ES cells vs. somatic cells including adult stem cells and tumor cells. Ectopic expression of p18 in mouse ES cells was associated with the up-regulation of CDK4, and enhanced binding of p18 to CDK4. However, because of the absence of evidence concerning how p18 directly induces up-regulation of CDK4, we hypothesize that a feedback mechanism exists among cell cycle regulators. In fact, several studies have demonstrated that feedback among CKIs can affect CDKs based on a reassortment of cyclin-CDK-CKIs complexes. Moreover, previous studies have confirmed that p18 directly interacts with CDK4 based on a comparison of p18 and CDK4 double knockout, and single knockout mouse models. While CDK4 and CDK2 share a role in the G1/S transition of somatic cells, the role of CDK4 in ES cells has not been elucidated. Based on our current data and previous studies by others, a molecular paradigm concerning how p18 affects ES cells is proposed. Due to the resulted up-regulation of CDK4 by p18, p21 and p27 preferentially bind CDK4 rather than CDK2. As a result, the inhibition of CDK2 by p21 and p27 is reduced. Since CDK2, and not CDK4 or CDK6, is the major driving force for cell cycle progression in ES cells, decreased inhibition of CDK2 by p21 and p27 should accelerate cell proliferation. Thus, this model explains why overexpression of p18 enhances ES cell growth.