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      Distinct populations of inflammatory fibroblasts and myofibroblasts in pancreatic cancer

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          Abstract

          Öhlund et al. develop a three-dimensional co-culture platform of neoplastic pancreatic ductal organoids and pancreatic stellate cells (PSCs) to characterize the dynamic crosstalk between cancer cells and stromal cells, and to address stromal heterogeneity. The co-cultures reveal the co-existence of two phenotypically distinct populations of PSCs, providing insights into PDA biology and prompting a reconsideration of interventional strategies.

          Abstract

          Pancreatic stellate cells (PSCs) differentiate into cancer-associated fibroblasts (CAFs) that produce desmoplastic stroma, thereby modulating disease progression and therapeutic response in pancreatic ductal adenocarcinoma (PDA). However, it is unknown whether CAFs uniformly carry out these tasks or if subtypes of CAFs with distinct phenotypes in PDA exist. We identified a CAF subpopulation with elevated expression of α-smooth muscle actin (αSMA) located immediately adjacent to neoplastic cells in mouse and human PDA tissue. We recapitulated this finding in co-cultures of murine PSCs and PDA organoids, and demonstrated that organoid-activated CAFs produced desmoplastic stroma. The co-cultures showed cooperative interactions and revealed another distinct subpopulation of CAFs, located more distantly from neoplastic cells, which lacked elevated αSMA expression and instead secreted IL6 and additional inflammatory mediators. These findings were corroborated in mouse and human PDA tissue, providing direct evidence for CAF heterogeneity in PDA tumor biology with implications for disease etiology and therapeutic development.

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          Virtual microdissection identifies distinct tumor- and stroma-specific subtypes of pancreatic ductal adenocarcinoma

          Pancreatic ductal adenocarcinoma (PDAC) remains a lethal disease with a 5-year survival of 4%. A key hallmark of PDAC is extensive stromal involvement, which makes capturing precise tumor-specific molecular information difficult. Here, we have overcome this problem by applying blind source separation to a diverse collection of PDAC gene expression microarray data, which includes primary, metastatic, and normal samples. By digitally separating tumor, stroma, and normal gene expression, we have identified and validated two tumor-specific subtypes including a “basal-like” subtype which has worse outcome, and is molecularly similar to basal tumors in bladder and breast cancer. Furthermore, we define “normal” and “activated” stromal subtypes which are independently prognostic. Our results provide new insight into the molecular composition of PDAC which may be used to tailor therapies or provide decision support in a clinical setting where the choice and timing of therapies is critical.
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            Vitamin D receptor-mediated stromal reprogramming suppresses pancreatitis and enhances pancreatic cancer therapy.

            The poor clinical outcome in pancreatic ductal adenocarcinoma (PDA) is attributed to intrinsic chemoresistance and a growth-permissive tumor microenvironment. Conversion of quiescent to activated pancreatic stellate cells (PSCs) drives the severe stromal reaction that characterizes PDA. Here, we reveal that the vitamin D receptor (VDR) is expressed in stroma from human pancreatic tumors and that treatment with the VDR ligand calcipotriol markedly reduced markers of inflammation and fibrosis in pancreatitis and human tumor stroma. We show that VDR acts as a master transcriptional regulator of PSCs to reprise the quiescent state, resulting in induced stromal remodeling, increased intratumoral gemcitabine, reduced tumor volume, and a 57% increase in survival compared to chemotherapy alone. This work describes a molecular strategy through which transcriptional reprogramming of tumor stroma enables chemotherapeutic response and suggests vitamin D priming as an adjunct in PDA therapy. PAPERFLICK: Copyright © 2014 Elsevier Inc. All rights reserved.
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              Cancer-associated stromal fibroblasts promote pancreatic tumor progression.

              Pancreatic adenocarcinoma is characterized by a dense background of tumor associated stroma originating from abundant pancreatic stellate cells. The aim of this study was to determine the effect of human pancreatic stellate cells (HPSC) on pancreatic tumor progression. HPSCs were isolated from resected pancreatic adenocarcinoma samples and immortalized with telomerase and SV40 large T antigen. Effects of HPSC conditioned medium (HPSC-CM) on in vitro proliferation, migration, invasion, soft-agar colony formation, and survival in the presence of gemcitabine or radiation therapy were measured in two pancreatic cancer cell lines. The effects of HPSCs on tumors were examined in an orthotopic murine model of pancreatic cancer by co-injecting them with cancer cells and analyzing growth and metastasis. HPSC-CM dose-dependently increased BxPC3 and Panc1 tumor cell proliferation, migration, invasion, and colony formation. Furthermore, gemcitabine and radiation therapy were less effective in tumor cells treated with HPSC-CM. HPSC-CM activated the mitogen-activated protein kinase and Akt pathways in tumor cells. Co-injection of tumor cells with HPSCs in an orthotopic model resulted in increased primary tumor incidence, size, and metastasis, which corresponded with the proportion of HPSCs. HPSCs produce soluble factors that stimulate signaling pathways related to proliferation and survival of pancreatic cancer cells, and the presence of HPSCs in tumors increases the growth and metastasis of these cells. These data indicate that stellate cells have an important role in supporting and promoting pancreatic cancer. Identification of HPSC-derived factors may lead to novel stroma-targeted therapies for pancreatic cancer.
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                Author and article information

                Journal
                J Exp Med
                J. Exp. Med
                jem
                jem
                The Journal of Experimental Medicine
                The Rockefeller University Press
                0022-1007
                1540-9538
                6 March 2017
                6 March 2017
                : 214
                : 3
                : 579-596
                Affiliations
                [1 ]Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724
                [2 ]Lustgarten Foundation Pancreatic Cancer Research Laboratory, Cold Spring Harbor, NY 11724
                [3 ]Department of Surgical and Perioperative Sciences, Surgery, Umeå University, 901 85 Umeå, Sweden
                [4 ]APC Microbiome Institute and School of Microbiology, University College Cork, Cork, Ireland
                [5 ]Department of Oncology, Clinica Universidad de Navarra, CIMA, IDISNA, Pamplona 31008, Spain
                [6 ]ARC-Net centre for applied research on cancer, University and Hospital Trust of Verona, 37134 Verona, Italy
                [7 ]Department of Diagnostic and Public Health, University and Hospital Trust of Verona, 37134 Verona, Italy
                [8 ]Graduate Program in Molecular and Cellular Biology, Stony Brook University, Stony Brook, NY 11794
                [9 ]University of Cambridge, Cancer Research UK, Cambridge Institute, Cambridge, UK
                [10 ]Hofstra Northwell School of Medicine, Hempstead, NY 11550
                [11 ]Hubrecht Institute, Royal Netherlands Academy of Arts and Sciences (KNAW), University Medical Centre Utrecht and CancerGenomics.nl, 3584 CT Utrecht, Netherlands
                Author notes
                Correspondence to David A. Tuveson: dtuveson@ 123456cshl.edu
                [*]

                D. Öhlund, A. Handly-Santana, G. Biffi, and E. Elyada contributed equally to this paper.

                Author information
                http://orcid.org/0000-0002-5847-2778
                http://orcid.org/0000-0001-8997-2639
                http://orcid.org/0000-0002-6340-8009
                http://orcid.org/0000-0002-6916-3380
                http://orcid.org/0000-0002-2489-2424
                http://orcid.org/0000-0002-5710-7672
                http://orcid.org/0000-0002-3098-2231
                http://orcid.org/0000-0003-1876-7675
                http://orcid.org/0000-0002-3371-1445
                http://orcid.org/0000-0003-0612-0495
                http://orcid.org/0000-0002-8017-2712
                Article
                20162024
                10.1084/jem.20162024
                5339682
                28232471
                42e3a2a3-8e27-489e-bdd4-90af5aa42470
                © 2017 Öhlund et al.

                This article is available under a Creative Commons License (Attribution 4.0 International, as described at https://creativecommons.org/licenses/by/4.0/).

                History
                : 01 December 2016
                : 22 December 2016
                : 12 January 2017
                Funding
                Funded by: Lustgarten Foundation, DOI https://doi.org/10.13039/100005979;
                Funded by: National Institutes of Health, DOI https://doi.org/10.13039/100000002;
                Award ID: 5P30CA45508-26
                Award ID: 5P50CA101955-07
                Award ID: 1U10CA180944-02
                Award ID: 5U01CA168409-5
                Award ID: 1R01CA188134
                Award ID: 1R01CA190092-03
                Award ID: R50CA311506-01
                Award ID: CA101955 UAB/UMN SPORE
                Award ID: 5T32CA148056
                Award ID: F32CA192904
                Funded by: Stand Up to Cancer, DOI https://doi.org/10.13039/100009730;
                Funded by: STARR foundation, DOI https://doi.org/10.13039/100009784;
                Award ID: I7-A718
                Funded by: DOD, DOI https://doi.org/10.13039/100000005;
                Award ID: W81XWH-13-PRCRP-IA
                Funded by: Swedish Research Council, DOI https://doi.org/10.13039/501100004359;
                Award ID: 537-2013-7277
                Funded by: Kempe Foundations, DOI https://doi.org/10.13039/501100007067;
                Award ID: JCK-1301
                Funded by: Swedish Society of Medicine, DOI https://doi.org/10.13039/501100007687;
                Award ID: SLS-326921
                Award ID: SLS-250831
                Award ID: SLS-175991
                Award ID: SLS-591551
                Funded by: Cancer Research Foundation in Northern Sweden, DOI https://doi.org/10.13039/501100004886;
                Award ID: AMP15-793
                Award ID: LP11-1927
                Funded by: Human Frontiers Science Program, DOI https://doi.org/10.13039/501100000854;
                Award ID: LT000403/2014
                Award ID: LT000195/2015-L
                Award ID: LT000190/2013
                Funded by: Weizmann Institute of Science, DOI https://doi.org/10.13039/501100001735;
                Funded by: EMBO, DOI https://doi.og/10.13039/100004410;
                Award ID: ALTF 1203-2014
                Funded by: Italian Ministry of Health, DOI https://doi.org/10.13039/501100003196;
                Award ID: FIRB - RBAP10AHJ
                Funded by: Associazione Italiana Ricerca Cancro, DOI https://doi.org/10.13039/501100005010;
                Award ID: 18718
                Funded by: Damon Runyon Cancer Research Foundation, DOI https://doi.org/10.13039/100001021;
                Award ID: DRG-2165-13
                Funded by: National Cancer Institute, DOI https://doi.org/10.13039/100000054;
                Award ID: 1K99CA204725-01A1
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