Central Laboratory, Jinan Central Hospital Affiliated to Shandong University, Jinan, China.
Wells Center for Pediatric Research, Department of Pediatrics, Indiana University school of Medicine, Indianapolis, IN, 46202, USA.
Oncogene. 2019 Mar;38(10):1764-1777. doi: 10.1038/s41388-018-0553-0. Epub 2018 Oct 31.
Pancreatic cancer, mostly pancreatic ductal adenocarcinomas (PDAC), is one of the most lethal cancers, with a dismal median survival around 8 months. PDAC is notoriously resistant to chemotherapy. Thus far, numerous attempts using novel targeted therapies and immunotherapies yielded limited clinical benefits for pancreatic cancer patients. It is hoped that delineating the molecular mechanisms underlying drug resistance in pancreatic cancer may provide novel therapeutic options. Using acquired gemcitabine resistant pancreatic cell lines, we revealed an important role of the GLI-SOX2 signaling axis for regulation of gemcitabine sensitivity in vitro and in animal models. Down-regulation of GLI transcriptional factors (GLI1 or GLI2), but not SMO signaling inhibition, reduces tumor sphere formation, a characteristics of tumor initiating cell (TIC). Down-regulation of GLI transcription factors also decreased expression of TIC marker CD24. Similarly, high SOX2 expression is associated with gemcitabine resistance whereas down-regulation of SOX2 sensitizes pancreatic cancer cells to gemcitabine treatment. We further revealed that elevated SOX2 expression is associated with an increase in GLI1 or GLI2 expression. Our ChIP assay revealed that GLI proteins are associated with a putative Gli binding site within the SOX2 promoter, suggesting a more direct regulation of SOX2 by GLI transcription factors. The relevance of our findings to human disease was revealed in human cancer specimens. We found that high SOX2 protein expression is associated with frequent tumor relapse and poor survival in stage II PDAC patients (all of them underwent gemcitabine treatment), indicating that reduced SOX2 expression or down-regulation of GLI transcription factors may be effective in sensitizing pancreatic cancer cells to gemcitabine treatment.
胰腺癌,主要是胰腺导管腺癌(PDAC),是最致命的癌症之一,中位生存期只有 8 个月左右。PDAC 对化疗具有明显的耐药性。迄今为止,使用新型靶向治疗和免疫疗法的众多尝试为胰腺癌患者带来的临床获益有限。人们希望阐明胰腺癌耐药的分子机制可能为提供新的治疗选择。通过使用获得性吉西他滨耐药胰腺细胞系,我们揭示了 GLI-SOX2 信号轴在体外和动物模型中调节吉西他滨敏感性的重要作用。下调 GLI 转录因子(GLI1 或 GLI2),而不是抑制 SMO 信号,可减少肿瘤球体形成,这是肿瘤起始细胞(TIC)的特征。下调 GLI 转录因子也降低了 TIC 标志物 CD24 的表达。同样,SOX2 高表达与吉西他滨耐药相关,而下调 SOX2 可使胰腺癌细胞对吉西他滨治疗敏感。我们进一步发现,SOX2 表达升高与 GLI1 或 GLI2 表达增加相关。我们的 ChIP 分析显示,GLI 蛋白与 SOX2 启动子内的一个假定 Gli 结合位点相关,这表明 GLI 转录因子更直接调节 SOX2。在人类癌症标本中发现了我们研究结果与人类疾病的相关性。我们发现,SOX2 蛋白高表达与 II 期 PDAC 患者(均接受吉西他滨治疗)的肿瘤频繁复发和生存不良相关,这表明降低 SOX2 表达或下调 GLI 转录因子可能有效使胰腺癌细胞对吉西他滨治疗敏感。