Abstract

BackgroundDiabetes mellitus is linked to pancreatic cancer. We hypothesized a role for pancreatic stellate cells (PSC) in the hyperglycemia induced deterioration of pancreatic cancer and therefore studied two human cell lines (RLT-PSC, T3M4) in hyperglycemic environment.Methodology/Principal FindingsThe effect of chronic hyperglycemia (CHG) on PSCs was studied using mRNA expression array with real-time PCR validation and bioinformatic pathway analysis, and confirmatory protein studies. The stress fiber formation (IC: αSMA) indicated that PSCs tend to transdifferentiate to a myofibroblast-like state after exposure to CHG. The phosphorylation of p38 and ERK1/2 was increased with a consecutive upregulation of CDC25, SP1, cFOS and p21, and with downregulation of PPARγ after PSCs were exposed to chronic hyperglycemia. CXCL12 levels increased significantly in PSC supernatant after CHG exposure independently from TGF-β1 treatment (3.09-fold with a 2.73-fold without TGF-β1, p<0.05). The upregualtion of the SP1 transcription factor in PSCs after CHG exposure may be implicated in the increased CXCL12 and IGFBP2 production. In cancer cells, hyperglycemia induced an increased expression of CXCR4, a CXCL12 receptor that was also induced by PSC’s conditioned medium. The receptor-ligand interaction increased the phosphorylation of ERK1/2 and p38 resulting in activation of MAP kinase pathway, one of the most powerful stimuli for cell proliferation. Certainly, conditioned medium of PSC increased pancreatic cancer cell proliferation and this effect could be partially inhibited by a CXCR4 inhibitor. As the PSC conditioned medium (normal glucose concentration) increased the ERK1/2 and p38 phosphorylation, we concluded that PSCs produce other factor(s) that influence(s) pancreatic cancer behaviour.ConclusionsHyperglycemia induces increased CXCL12 production by the PSCs, and its receptor, CXCR4 on cancer cells. The ligand-receptor interaction activates MAP kinase signaling that causes increased cancer cell proliferation and migration.

Highlights

  • Epidemiologic studies and their meta-analyses established a clear evidence for the association between diabetes mellitus (DM) and pancreatic cancer (PaC) and concluded that DM is an early manifestation, and an etiologic factor of PaC.[1]

  • Types-1, -2 and -3 GLUTs, but not GLUT-4 were detected in RLT-pancreatic stellate cells (PSC) and T3M4 PaC cell lysates by WB. (Fig 1)

  • Increased α-SMA and type-1 collagen protein expression was detected by immunostaining after PSCs were exposed both to chronic hyperglycemia (CHG) and TGF-β1

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Summary

Introduction

Epidemiologic studies and their meta-analyses established a clear evidence for the association between diabetes mellitus (DM) and pancreatic cancer (PaC) and concluded that DM is an early manifestation, and an etiologic factor of PaC.[1]. A dose-response meta-analysis of data obtained from 2408 PaC patients confirmed that every single mmol/L increase in FPG already above 4.1 mmol/L is associated with a 25% increase in the rate of pancreatic cancer [5]. Pancreatic cancer, of which 90% of cases are ductal adenocarcinoma, means a miserable prognosis with a 5 years survival of 7% [7]. This means a uniquely high need for a better understanding of its molecular pathology. We hypothesized a role for pancreatic stellate cells (PSC) in the hyperglycemia induced deterioration of pancreatic cancer and studied two human cell lines (RLT-PSC, T3M4) in hyperglycemic environment.

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