El adenocarcinoma ductal pancreático (PDAC) es la quinta causa de muerte por cáncer en los países desarrollados y uno de los tumores humanos más agresivos. A pesar del papel clave de la angiogénesis -la formación de nuevos vasos a partir de otros preexistentes- en la progresión y metástasis de muchos tumores, su papel en PDAC ha sido poco caracterizado. El activador tisular del plasminógeno (tPA), una proteína multifuncional que regula numerosas funciones celulares, ejerce efectos proangiogénicos en modelos in vivo de PDAC, aunque no se han analizado los mecanismos moleculares responsables de estos efectos. Esta tesis trata de identificar el papel de tPA en la angiogénesis del PDAC, así como de descubrir los factores responsables de la sobreexpresión de tPA en cáncer de páncreas. En primer lugar, hemos demostrado que los efectos pro-angiogénicos de tPA pueden ser tanto directos como indirectos. Por un lado, aunque tPA no cambia los niveles de moléculas pro-angiogénicas como VEGF, TGF-b, IL-1 o IL-8 producidas por las células tumorales o endoteliales, sí que induce la sobreexpresión y activación de MMP-9, una metaloproteasa implicada en promover angiogénesis, sugiriendo por tanto que esta proteína puede mediar de forma indirecta los efectos proangiogénicos de tPA. Por otro lado, hemos encontrado que tPA, de forma independiente de su actividad catalítica, promueve directamente la proliferación, migración y tubulogénesis de las células endoteliales. Estos efectos son mediados por la activación en estas células de las rutas de señalización ERK1/2, AKT y JNK. Además, mediante siRNA o inhibidores químicos, hemos encontrado que Annexina A2, Galectina-1 y EGFR son necesarios para la activación de la señalización inducida por tPA en células endoteliales. Finalmente, hemos visto que citoquinas inflamatorias e hipoxia, dos eventos asociados a PDAC y además inductores de angiogénesis, dan lugar a un fuerte incremento de los niveles de tPA en células tumorales pancreáticos. Todos estos datos apoyan un mecanismo de retroalimentación positiva entre estímulos proangiogénicos presentes en las células tumorales y el estroma, y el incremento de la molécula proangiogénica tPA. / Pancreatic ductal adenocarcinoma (PDAC) is the fifth leading cause of cancer death in the developed countries and one of the most aggressive human tumors. Despite the key contribution of angiogenesis – the growth of new vessels from pre-existing ones- to the progression and spread of many cancers, its role in PDAC has been poorly characterized. Tissue plasminogen activator (tPA), a multifunctional protein regulating a broad range of cellular functions, has been reported to exert pro-angiogenic effects in in vivo models of PDAC, although the underlying molecular mechanism has not been analyzed. This work aims to elucidate the role of tPA in the angiogenesis of PDAC as well as to identify the factors responsible for tPA increase in pancreatic cancer. First, we demonstrated that tPA pro-angiogenic effects are both indirect and direct. On the one hand, tPA does not change the levels of the pro-angiogenic molecules VEGF, TGF-b, IL-1 or IL-8 produced by pancreatic tumoral cells or endothelial cells, but it is involved in MMP-9 –a potent stimulator of angiogenesis- upregulation and activation in pancreatic and endothelial cells, suggesting that this matrix metalloproteinase can indirectly mediate tPA angiogenic effects. On the other hand, we found that tPA, in a catalytic-independent way, directly promotes endothelial cell proliferation, migration and tubulogenesis. These direct effects of tPA are mediated by activation of ERK1/2, AKT and JNK signaling pathways in endothelial cells. In addition, using siRNA technology or chemical inhibitors, we found that AnnexinA2, Galectin-1 and EGFR are required for tPA-mediated signaling activation in endothelium. Finally, we found that inflammatory cytokines and hypoxia, two hallmarks of PDAC and also angiogenic stimuli, lead to a sharp increase in tPA levels in pancreatic tumoral cells. These data support a feed-back loop between proangiogenic stimuli present in both tumoral and stromal cells and the increase of the proangiogenic molecule tPA.

Exocrine pancreatic cancer is the fifth leading cause of death from malignant disease in Western society and it is one of the most aggressive human tumors. Once diagnosed, the 12-month patient survival is less than 5%. More than 90% of human exocrine tumors are classified as "ductal adenocarcinomas" on the basis of their microscopic appearance. The plasminogen system plays a critical role in intravascular thrombolysis as well as in other biological processes that require cellular migration, such as angiogenesis, inflammatory reactions, tissue remodelling, and tumor progression. There are two types of plasminogen activators that catalyze plasmin generation from plasminogen: tissue-type (tPA) and urokinase-type (uPA). Activation of plasminogen to plasmin results in progressive degradation of fibrin and other extracellular matrix components and may also lead to activation of metalloproteases, latent growth factors, and proteolysis of membrane glycoproteins. All these processes may contribute to tumor development and metastasis. There is extensive evidence supporting the notion that the uPA system, including its receptor and plasminogen activator inhibitor PAI-1, can contribute to tumorigenesis in a variety of tissue types but there is less evidence for such a role regarding tPA and annexin A2 (AnxA2), a putative tPA receptor. Previous studies of our group have shown that tPA is commonly expressed in pancreas cancer tissues and cell lines and appears to be selectively associated with the neoplastic phenotype. Using neutralizing antibodies or chemical inhibitors leads to reduced in vitro tumor invasion. Our results support that - in the pancreas - the tPA system plays an important role in tumor development and/or progression whereas the uPA system may play a more dominant role in pancreatitis. More recent studies have shown that tPA stimulates cell proliferation and angiogenesis in exocrine pancreatic tumors. These results allow new approaches to improve the treatment of this disease, but to do so it is necessary to use of mouse models of disease. In attempt to explore the role of tPA and its receptor, annexin A2, in pancreatic tumorigenesis, we have taken advantage of two well established transgenic mouse models: Ela1-TAg (1-127) and Ela1-myc. In these mice, transgenes are targeted to acinar cells using the Elastase-1 enhancer/promoter. We have also analyzed the pancreas of Ela1-CCK2 and MT-TGFa transgenic mice, as models of acinar-ductal transdifferentiation and ductal complex formation. Our results show that expression of tPA is undetectable in the non-neoplastic pancreatic epithelium and in metaplastic ducts and in acinar tumors. By contrast, tPA is overexpressed in neoplastic pancreatic ducts. This pattern expression is in agreement with the results described in humans, indicating that mouse models of pancreatic cancer may be useful for the study of human pathology. On the other hand, AnxA2 is undetectable in acinar tumors but it is detected in the apical membrane of normal and metaplastic duct epithelium. In addition, AnxA2 is strongly expressed in ductal tumor cells where it shows a non-polarized distribution. These results suggest that different molecular events may participate in the activation of tPA and its receptor, AnxA2, in non-neoplastic ducts. In order to analyze the role of tPA in the progression of pancreatic tumors, we mated Ela1-TAg and Ela1-myc transgenic mice to tPA-deficient mice. The proportion of tumors displaying pure acinar differentiation or mixed acinar/ductal components was similar in both mouse strains, indicating that tPA is not required for in acinar-ductal transdifferentiation. However, it was observed an increased survival in hybrid mice Ela1-myc:tPA-/- supporting a critical role for tPA in the progression of pancreatic ductal tumors. To get insight into the mechanism by wich tPA participates in this process we have analyzed factors related to tumor progression: tumors arising in a tPA-/- genetic background show a lesser vessel density and proliferation rate than those arising in wild type mice. These results indicate that tPA could play a role in angiogenesis stimulation and cell proliferation and suggest that the increase in survival observed in Ela1-myc tPA-/- mice could be a consequence of the inhibition of tumor angiogenesis and cell proliferation. In addition, we have analyzed the differential gene expression between Ela1-myc and Ela1-myc tPA-/- mice by microarrays. This analysis has led to the identification of related genes with tumor progression and invasion that can be a target for the action of tPA, although more work is necessary to determined their role. Finally, we have studied the direct effects of the expression of tPA in the pancreas, by the generation of two transgenic mice which tPA expression is targeted to acinar cells, using the Elastase-1 enhancer/promoter (Ela1-tPA), or to ductal cells using the Citokeratin 19 promoter (CK19-tPA). The results in Ela1-tPA mice show that overexpression of tPA in acinar cells does not affect normal mouse development. The effects on the pancreas analysed are currently being analyzed in greater detail. Altogether, the data described here support the relevant role of tPA in pancreas cancer progression and indicate that mouse models of pancreatic cancer may be useful for the preclinical evaluation of drugs targeting the tPA system.