Abstract
Pancreatic ductal adenocarcinoma (PDAC) has one of the worst outcomes among cancers with a 5-years survival rate of below 10%. This is a result of late diagnosis and the lack of effective treatments. The tumor is characterized by a highly fibrotic stroma containing distinct cellular components, embedded within an extracellular matrix (ECM). This ECM-abundant tumor microenvironment (TME) in PDAC plays a pivotal role in tumor progression and resistance to treatment. Cancer-associated fibroblasts (CAFs), being a dominant cell type of the stroma, are in fact functionally heterogeneous populations of cells within the TME. Certain subtypes of CAFs are the main producer of the ECM components of the stroma, with the most abundant one being the collagen family of proteins. Collagens are large macromolecules that upon deposition into the ECM form supramolecular fibrillar structures which provide a mechanical framework to the TME. They not only bring structure to the tissue by being the main structural proteins but also contain binding domains that interact with surface receptors on the cancer cells. These interactions can induce various responses in the cancer cells and activate signaling pathways leading to epithelial-to-mesenchymal transition (EMT) and ultimately metastasis. In addition, collagens are one of the main contributors to building up mechanical forces in the tumor. These forces influence the signaling pathways that are involved in cell motility and tumor progression and affect tumor microstructure and tissue stiffness by exerting solid stress and interstitial fluid pressure on the cells. Taken together, the TME is subjected to various types of mechanical forces and interactions that affect tumor progression, metastasis, and drug response. In this review article, we aim to summarize and contextualize the recent knowledge of components of the PDAC stroma, especially the role of different collagens and mechanical traits on tumor progression. We furthermore discuss different experimental models available for studying tumor-stromal interactions and finally discuss potential therapeutic targets within the stroma.
Highlights
Pancreatic cancer is one of the most fatal malignancies with a 5years survival rate below 10% (Europe 2018) (Siegel et al, 2021)
An alternative study demonstrated that modulation of extracellular matrix (ECM) stiffness itself was a key factor in pancreatic stellate cells (PSCs) activation to Cancer-associated fibroblasts (CAFs) by means of culture on polyacrylamide gels of varying stiffnesses, where high stiffness matrices induced a myofibroblastic-like phenotype in the PSCs (Lachowski et al, 2017)
We described the current knowledge regarding the Pancreatic ductal adenocarcinoma (PDAC) stromal components with special reference to collagens and mentioned their multifaceted role in disease development even from early stages
Summary
Pancreatic cancer is one of the most fatal malignancies with a 5years survival rate below 10% (Europe 2018) (Siegel et al, 2021). A high amount of collagen deposition in the TME increases tumor density, altering its mechanical traits compared to normal pancreatic tissue. Since desmoplasia is one of the major stromal aberrations common to several precursor lesions as well as PDAC, it is prudent to study the formation of the desmoplastic stroma and its interaction with pancreatic cells in order to understand the role of stroma and changes thereof in the early stages of disease progression. The remodeling of the stroma starts early and is pronounced already in preinvasive precursor lesions (Erkan et al, 2012) which suggests that stromal fragments in the circulation might be easier to detect than biomarkers released from cancer cells themselves, which is an idea that has shown promising results in initial studies. We discuss different experimental models available for studying tumor-stromal interactions and discuss potential therapeutic targets within the stroma
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