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抗基质治疗联合化疗可靶向胰腺癌中的多种信号通路。

Anti-stromal treatment together with chemotherapy targets multiple signalling pathways in pancreatic adenocarcinoma.

作者信息

Carapuça Elisabete F, Gemenetzidis Emilios, Feig Christine, Bapiro Tashinga E, Williams Michael D, Wilson Abigail S, Delvecchio Francesca R, Arumugam Prabhu, Grose Richard P, Lemoine Nicholas R, Richards Frances M, Kocher Hemant M

机构信息

Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, London, UK.

The University of Cambridge Cancer Research-UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge, UK.

出版信息

J Pathol. 2016 Jul;239(3):286-96. doi: 10.1002/path.4727. Epub 2016 May 25.

Abstract

Stromal targeting for pancreatic ductal adenocarcinoma (PDAC) is rapidly becoming an attractive option, due to the lack of efficacy of standard chemotherapy and increased knowledge about PDAC stroma. We postulated that the addition of stromal therapy may enhance the anti-tumour efficacy of chemotherapy. Gemcitabine and all-trans retinoic acid (ATRA) were combined in a clinically applicable regimen, to target cancer cells and pancreatic stellate cells (PSCs) respectively, in 3D organotypic culture models and genetically engineered mice (LSL-Kras(G12D) (/+) ;LSL-Trp53(R172H) (/+) ;Pdx-1-Cre: KPC mice) representing the spectrum of PDAC. In two distinct sets of organotypic models as well as KPC mice, we demonstrate a reduction in cancer cell proliferation and invasion together with enhanced cancer cell apoptosis when ATRA is combined with gemcitabine, compared to vehicle or either agent alone. Simultaneously, PSC activity (as measured by deposition of extracellular matrix proteins such as collagen and fibronectin) and PSC invasive ability were both diminished in response to combination therapy. These effects were mediated through a range of signalling cascades (Wnt, hedgehog, retinoid, and FGF) in cancer as well as stellate cells, affecting epithelial cellular functions such as epithelial-mesenchymal transition, cellular polarity, and lumen formation. At the tissue level, this resulted in enhanced tumour necrosis, increased vascularity, and diminished hypoxia. Consequently, there was an overall reduction in tumour size. The enhanced effect of stromal co-targeting (ATRA) alongside chemotherapy (gemcitabine) appears to be mediated by dampening multiple signalling cascades in the tumour-stroma cross-talk, rather than ablating stroma or targeting a single pathway. © 2016 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.

摘要

由于标准化疗效果不佳以及对胰腺导管腺癌(PDAC)基质的认识增加,针对PDAC的基质靶向治疗正迅速成为一个有吸引力的选择。我们推测,添加基质疗法可能会增强化疗的抗肿瘤疗效。在3D器官型培养模型和代表PDAC谱系的基因工程小鼠(LSL-Kras(G12D) (/+) ;LSL-Trp53(R172H) (/+) ;Pdx-1-Cre: KPC小鼠)中,吉西他滨和全反式维甲酸(ATRA)以临床适用方案联合使用,分别靶向癌细胞和胰腺星状细胞(PSC)。在两组不同的器官型模型以及KPC小鼠中,我们证明,与单独使用载体或任何一种药物相比,当ATRA与吉西他滨联合使用时,癌细胞增殖和侵袭减少,同时癌细胞凋亡增加。同时,联合治疗使PSC活性(通过胶原蛋白和纤连蛋白等细胞外基质蛋白的沉积来衡量)和PSC侵袭能力均降低。这些作用是通过癌症以及星状细胞中的一系列信号级联反应(Wnt、刺猬蛋白、视黄酸和FGF)介导的,影响上皮细胞功能,如上皮-间质转化、细胞极性和管腔形成。在组织水平上,这导致肿瘤坏死增加、血管生成增加和缺氧减少。因此,肿瘤大小总体减小。基质共靶向(ATRA)与化疗(吉西他滨)联合使用的增强效果似乎是通过抑制肿瘤-基质相互作用中的多个信号级联反应来介导的,而不是通过消除基质或靶向单一途径。© 2016作者。《病理学杂志》由John Wiley & Sons Ltd代表大不列颠及爱尔兰病理学会出版。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4200/5025731/35d93c2d4b14/PATH-239-286-g005.jpg

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