Pancreatic ductal adenocarcinomas (PDACs) are highly aggressive malignancies, associated with poor clinical prognosis and limited therapeutic options. The KRAS oncogene is mutated in over 90% of PDACs and plays a pivotal role in tumor progression. Global gene expression profiling of PDAC reveals 3-4 major molecular subtypes with distinct phenotypic traits and pharmacological vulnerabilities, including variations in oncogenic KRAS pathway dependencies. PDAC cell lines of the aberrantly differentiated endocrine exocrine (ADEX) subtype are robustly KRAS-dependent for survival. The KRAS gene is located on chromosome 12p11-12p12, a region amplified in 5-10% of primary PDACs. Within this amplicon, we identified co-amplification of KRAS with the STK38L gene in a subset of primary human PDACs and PDAC cell lines. This provided rationale to determine whether PDAC cell lines are dependent on STK38L expression for proliferation and viability. STK38L (also known as NDR2) encodes a nuclear Dbf2-related (NDR) serine/threonine kinase, which shares homology with Hippo pathway LATS1/2 kinases. We show that STK38L expression levels are elevated in a subset of primary PDACs and PDAC cell lines that display ADEX subtype characteristics, including overexpression of mutant KRAS. RNAi-mediated depletion of STK38L in a subset of ADEX subtype cell lines results in decreased cellular proliferation and increased apoptotic cell death. Concomitant with cytostatic and cytotoxic effects, STK38L depletion causes increased expression of the LATS2 kinase and the cell cycle regulator p21. LATS2 depletion partially rescues the cell proliferation and viability effects of STK38L depletion. Lastly, high STK38L mRNA expression is associated with worse patient prognosis compared to low STK38L expression in PDACs. Taken together, our study uncovers STK38L as a candidate, targetable vulnerability in a subset of molecularly defined PDACs. / 2019-11-01T00:00:00Z

Introduction: Polymeric immunoglobulin receptor (pIgR) traffics Immunoglobulins (IgA and IgM) through epithelial cells in normal mucosae but neither are expressed in the normal pancreas. Recent work has demonstrated pIgR to be upregulated in hepatocellular carcinoma, even though it is not expressed in normal liver cells. High pIgR levels are associated with poor survival and distant metastases for a number of cancers such as nasopharyngeal cancers, lung and oesophageal cancers. Recent work from our laboratory suggested pIgR may be upregulated in pancreatic ductal adenocarcinoma (PDAC). My aim was to assess pIgR's role in PDAC by interrogating human PDAC tissue samples as well using cell biology experimental tools. Methods: pIgR expression was manipulated (siRNA and shRNA) in cell lines to evaluate its subsequent effect on cell behaviour in 2D assays as well as 3D organotypics models. Tissue Microarrays of patients with PDAC were analysed after pIgR, αSMA, E-Cadherin and Picrosirius Red staining to assess their role as a combined bio-marker panel. Results: Cytokines such as interleukin 4 (IL4) and Tumour Necrosis Factor (TNFα) could not modulate pIgR expression in PDAC cell lines despite this effect being seen in other studies using colorectal and nasopharyngeal cancer cell lines. Downregulation in pIgR expression in Capan1 cell line resulted in reduction of cellular proliferation (n= 3, P < 0.05, Friedman test), adhesion (n= 3, P < 0.05, Kruskal-Wallis) and migration (n= 3, P < 0.05, Kruskal-Wallis). In 3D organotypic models, pIgR downregulation resulted in reduced cancer cell invasion (n= 9, P < 0.05, Kruskal- Wallis) and diminished contraction of gels (n= 9, P < 0.05, Kruskal-Wallis). In human PDAC, decreased E-cadherin expression correlates with increased pIgR expression through pancreatic intra-epithelial neoplasia (PanIN) progression. There was no IgA expression in PDAC. pIgR expression had no clinical correlation with routine prognostic measures such as differentiation, lymph node metastasis (n= 88, P=0.5012, Kruskal-Wallis). Even in combination with stromal indices (α-smooth muscle action (SMA) and Picrosirius red), low pIgR scores had no statistically significant impact on prognosis but had a trend towards better survival (n= 88, P=0.2791, Mann-Whitney U test). Conclusion: pIgR may be involved in progression from pre-neoplastic lesions such as PanIN to PDAC. pIgR may have a biological impact on cellular motility and invasion due to yet to be deciphered signalling cascades with marked effect on cellular phenotype. Careful analysis is required to study the impact of pIgR on prognostic impact bearing in mind the histological sub-types of pancreatic cancer.

by Lai Bo San Paul. / "April 1997." / "Revised May 1998." / Thesis (M.D.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (p. 175-228). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstract in Chinese.

Type 1 diabetes mellitus (T1D) is an autoimmune disease characterized by the inflammation of the insulin-producing pancreatic beta cells, eventually leading to beta cell loss and the inability to maintain glucose homeostasis. Understanding the mechanisms of beta cell-intrinsic factors that influence the maintenance of cellular defenses and contribute to cell death when deregulated will be crucial in efforts to treat or prevent beta cell loss in individuals who are prone to autoimmunity. Through my thesis work, I have investigated beta cell-specific etiologies of T1D through both a candidate-based approach using beta cell specific deletion of a susceptibility gene and an unbiased global exploration of beta cell factors that regulate the predisposition to insulitic injury. Protein tyrosine phosphatase N2 (PTPN2) is a T1D candidate gene that has been shown to be critical for modulating inflammation by regulating T cell activation. PTPN2 is also highly expressed in human and murine beta cells and it has been shown to be critical for beta cell function in vivo and inhibit inflammatory stimuli-mediated beta cell apoptosis in vitro, suggesting that PTPN2 mediated defense against inflammation is two pronged negative regulation of inflammatory immune cells and elevation of a beta cell intrinsic defense. To examine whether PTPN2 regulates beta cell loss upon cytotoxic stimuli by bolstering beta cell defense mechanisms in vivo, I deleted PTPN2 in the beta cells (Ptpn2 beta-KO) and subjected the mice to the diabetogenic agent streptozotocin (STZ). Animals deficient in beta cell PTPN2 are more susceptible to STZ induced diabetes and have poor survival due to hyperglycemia. While investigating the mechanism of PTPN2-mediated beta cell defense, I have discovered that PTPN2 interacts with pyruvate kinase M2 (PKM2), a key metabolic enzyme that normally resides in the cytosol. In response to STZ, PKM2 translocates to the nuclei of diabetic beta cells, and the lack of PTPN2 results in the hyper-accumulation of nuclear PKM2, suggesting that PTPN2 mediates nuclear export of PKM2 in stressed beta cells. In the nucleus, PKM2 mediates the transcriptional activation of key proapototic genes, which is attenuated when I modulate nuclear PKM2 ex vivo, in effect reconstituting the function of PTPN2. Together, deregulation of PTPN2 mediated nuclear export of PKM2 leading to excessive transcriptional activation of proapoptotic genes may be the mechanism for exacerbated diabetes in the Ptpn2 beta KO mice. To identify novel candidates that function in the beta cells to influence beta cell susceptibility to insulitic injury, I established RNA transcriptome and CpG dinucleotide methylome profiles of islets isolated from insulitis susceptible NOD and insulitis resistant NOR mice, prior to the onset of insulitis. Integrating these profiles with the genes nested in the human diabetic loci from the genome wide association studies, I identified several novel candidate genes that may be involved in T1D pathogenesis in a beta cell specific manner. Moreover, I also examined non CpG methylation, which appears to influence gene expression independently of CpG methylation. Collectively, my studies have expanded the understanding of beta cell-specific factors that regulate cellular defense to insulitis and may have expanded the therapeutic possibilities by implicating PKM2, inhibition of which is the focus of many cancer therapy research.

Pancreatic beta cell specification is a complex process, requiring proper function of numerous transcription factors. Nkx2.2 is a transcription factor that is crucial for beta cell formation, and is expressed early and throughout pancreatic development. Nkx2.2-/- mice display complete loss of the beta cell lineage and defects in the specification of other endocrine cell types, demonstrating the importance of Nkx2.2 in establishing proper endocrine cell ratios. Recent studies have also demonstrated a role for Nkx2.2 within the mature beta cell to maintain identity and function. This thesis work investigated the timing of pancreatic beta cell specification and the mechanism of this process. In these studies, Nkx2.2 was ablated specifically within the Ngn3-expressing endocrine progenitor population in vivo. These mice displayed defects similar to Nkx2.2-/- mice. Surprisingly, the disruption of endocrine cell specification did not require loss of expression of multiple essential transcription factors known to function downstream of Nkx2.2, including Ngn3, Rfx6, and NeuroD1. While these factors are all necessary for beta cell specification, their preserved expression did not rescue beta cell formation. ChIP-Seq analyses also revealed co-occupancy of Nkx2.2, Rfx6, and NeuroD1 near endocrine-related genes, suggesting Nkx2.2 may cooperate with its downstream targets to regulate beta cell fate. These results have revealed a unique requirement for Nkx2.2 during a critical window of beta cell development. In addition, the role of a conserved domain of Nkx2.2, the specific domain (SD), was assessed using Nkx2.2SDmutant mice. Transcriptional profiling of Nkx2.2SDmutant endocrine progenitors revealed a critical role for the SD domain in regulating the transcription of endocrine fate genes early in the process of endocrine differentiation. In addition, beta cell-specific deletion of the Nkx2.2 SD domain resulted in hyperglycemia, glucose intolerance and dysregulation of beta cell functional genes. This suggests the SD domain is important for mediating Nkx2.2 function within the beta cell to maintain glucose homeostasis. Together, these results have elucidated a critical developmental window for beta cell specification and demonstrated an essential role for Nkx2.2 and specifically its SD domain in this process. Furthermore, these studies suggest that beta cell transcription factors may also regulate endocrine fate in a combinatorial manner, and exert changes within the endocrine progenitor lineage. These findings have provided us with a better understanding of in vivo pancreatic development, and will improve current research efforts to differentiate beta cells in vitro from hPSCs.

The acquisition of beta cell identity and function is a multistage process that involves the sequential regulation of specific factors and signals. The maintenance of beta cell identity and function is a process of comparable importance that requires persistent and continuous regulation. Loss of beta cell identity and/or reprogramming represents an important feature of beta cell dysfunction in genetic models of diabetes, as well as in patients with type 1 and type 2 diabetes. The factors and mechanisms involved in the acquisition and maintenance of beta cell identity are still not well understood. Nevertheless, several beta cell developmental transcription factors have been found to be important in the maintenance of its functional identity during the postnatal stage. Nkx2.2 is a transcription factor that is critical for the development and differentiation of beta cells both in mice and humans. In adults, Nkx2.2 is expressed in the entire beta cell population. However, due to the perinatal lethality of the Nkx2.2 null mice, the study of its function in adult beta cells has remained elusive. For my dissertation work, I explored the function and mechanism of action of Nkx2.2 in the adult beta cell. I deleted Nkx2.2 specifically in beta cells during their maturation and in adults. Deletion of Nkx2.2 in beta cells caused rapid onset of diabetes due to the loss of insulin and the down-regulation of many beta cell functional genes. Concomitantly, Nkx2.2-deficient beta cells acquired non-beta cell endocrine features, resulting in populations of completely reprogrammed cells and bi-hormonal cells that have hybrid endocrine cell morphological characteristics. Molecular analysis in mouse and human islets revealed that Nkx2.2 is a conserved master regulatory protein that controls the acquisition and maintenance of a functional monohormonal beta cell identity by directly activating critical beta cell genes, and actively repressing genes that specify the alternative islet endocrine cell lineages. This study demonstrates the highly volatile nature of the beta cell; it is necessary to actively maintain expression of genes involved in beta cell function, but to also maintain repression of closely related endocrine gene programs. These findings have potential applications that include the optimization of iPS cell differentiation protocols that aim to differentiate functional beta cells that remain safely locked into that identity state; as well as in future therapies that attempt to restore beta cells into a functional state.

Introduction: Derangement of systemic and mucosal immunity, which are the integral components of the immune system, increases the risk of septic complications in patients postoperatively. The aims of this study were to investigate the integrity of systemic immunity as well as the mucosal immune system in patients with pancreatic cancer (PC), chronic pancreatitis (CP) and obstructive jaundice (OJ).Method: Healthy controls, as well as four groups of patients were studied. These included; jaundiced patients with PC, jaundiced patients secondary to benign disease (choledocholithiasis), non-jaundiced patients with PC and non-jaundiced patients with CP. The study evaluated the nutritional status including anthropometric measurements and the serum proteins: retinal binding protein (RBP), transferrin (TRF) and prealbumin (PALB). This study also evaluated systemic immunity in terms of total lymphocyte count, lymphocyte subsets (CD4+, CD8+, CD25+and CD56+), tumour necrosis factor alpha (TNF- alpha), interleukin-1alpha (IL-1 alpha) and complement components; and mucosal immunity in terms of CD3+, CD4+, CD8+, CD20+, CD57+, CD68+ and mast cells. Results: 78 patients were recruited (including 39 males) as follows: normal controls (n=17), benign OJ (n=9), patients with PC with jaundice (n=23), non-jaundiced patients with PC (n=20) and CP (n=9). Circulating CD25+ and CD4+ were significantly lower in the PC group whereas CD8+ showed increased levels in the same patients with a significant decrease in OJ patients when compared with controls. Circulating CD56+ showed no statistically significant difference between all four groups. In addition, IL-1 and TNF-alpha showed no statistically significant difference in all groups when compared with the control group. Also, C3 and CH50 showed significantly raised levels in PC with jaundice when compared with the control group. On the other hand mucosal lymphocyte subsets showed no statistically significant difference among all groups in comparison with the control group. As for prealbumin and transferrin, both showed significantly low levels in OJ, PC with jaundice and with PC when compared to healthy controls. Survival analysis for both PC groups was carried out and showed no difference in terms of age, however PC patients who survived over 13 months showed increased levels of prealbumin as well as low levels of CH50.Conclusion: Patients with PC both with and without jaundice showed some signs of altered and dysfunctional systemic immunity as well as a reduction in serum proteins. These findings may have implications on the disease progression and postoperative complications. This may warrant therapeutic interventions to restore nutrition and improve immunity before major surgical intervention is planned which could result in improving prognosis.

Infectious Pancreatic Necrosis (IPN), due to infection with the IPN virus (IPNv), continues to cause heavy mortalities and is endemic across the major Atlantic salmon farming regions of the world. Prevalances of 0.3-0.8 or more at the freshwater stage and 0.05 to 0.3 in the seawater phase of production are typical. Partially effective injectable vaccines are available against seawater IPN but biosecurity measures remain the main methods of control. To explore the feasibility of selecting salmon for resistance to IPN, a selective breeding program was initiated in 1996, including a series of field and experimental trials challenging known full-sib families with IPNv. A total of 404,723 fish faced IPNv challenge (376,541 seawater and 28,182 freshwater) covering 14 years and 17 separate locations across 7 sites. Mortalities and survivors following IPN challenge were counted by full-sib family and analysed as binomial data (alive / dead). Initial heritabilities were obtained from expressions based on the variance and covariance of full-sib family means for the 2001 year-group, indicating heritabilities (h2) of 0.16, range 0.08 to 0.24, and genetic correlations (rg) between replicate families of 0.71 to 0.78. These results were then confirmed by residual maximum likelihood across all seawater challenged data (year-groups 1997-2003), indicating a h2 of 0.43 (s.e.0.02) across all sites, range 0.06 to 0.40 for individual sites, and a range of rg between replicates of 0.70 to 0.87 (s.e. approx 0.05). To accommodate datasets and pedigrees approaching half a million individually identified fish, an implementation of the Reduced Animal model (RAM) was used to obtain these estimates. A similar level of genetic variation for resistance to freshwater IPN (year-groups 2005-2009) was confirmed with a h2 of 0.49, (s.e. 0.03), range 0.31 to 0.59, and rg between replicates ( 0.80 to 0.95, s.e. approx 0.05), using an Individual Animal Model. When all the data were analysed together, assuming seawater and freshwater survival to be the same trait, the heritability increased to 0.67, (s.e. 0.02). On testing this assumption, the genetic correlation between freshwater and seawater survival was found to be 0.68 s.e. 0.09. Both these pooled estimates account better than those for the individual site estimates, for the known selection of superior families that was incorporated at the earliest opportunity (2001) into the selective breeding program. To further investigate if there were favourable or antagonistic relationships operating between traits under active selection, genetic correlations between IPN mortality and a range of performance and harvest traits were obtained. When restricting the harvest data to year-groups where the harvested fish had not experienced an IPN event (2003 for seawater IPN, 2005 for freshwater IPN) : fish length and flesh colour just reached significance with seawater IPN (0.27 to 0.53. s.e. 0.14), while only harvest weight (0.30 s.e 0.11) attained significance with freshwater IPN mortality. All these correlations were antagonistic. When all the data were combined, (ie both IPN and harvest events taken from all yeargroups) these became non-significant. Taken as a whole, these results indicate that selecting salmon for resistance to both seawater and freshwater IPN challenge certainly is feasible, and that adverse effects on selection for other important production traits is not expected. How these medium to high heritabilities relate to the discovery of a major QTL for IPN resistance segregating in these populations, reported in a parallel scheme of work but based on a sub-set of the same families, is discussed.

Des études montrent que l’accumulation de lipides dans l’hypothalamus serait responsable de l’installation d’une lipotoxicité centrale : phénomène qui pourrait jouer un rôle dans l’apparition d’une insulino-résistance périphérique et du diabète de type II en dérégulant le contrôle nerveux de l’homéostasie glucidique. Il est connu que l'accumulation des céramides est impliquée dans le développement d’une lipotoxicité des tissus périphériques. L’objectif de cette étude est de déterminer le rôle du métabolisme des céramides au niveau hypothalamique dans l’installation d’une insulino-résistance centrale et d'en étudier les mécanismes impliqués. Nous avons également déterminé le rôle du métabolisme des céramides hypothalamiques dans la dérégulation de l’homéostasie glucidique induite par l’obésité.L’installation d'une insulino-résistance centrale est étudiée à l'aide d'approches in vitro, en utilisant des cellules hypothalamiques de souris GT1-7 traitées avec du palmitate pendant 24h. L'action de l’insuline est mesurée par la quantification d’Akt phosphorylée (western blot). Les céramides sont quantifiées par lipidomique, l'expression d’ARNm des gènes codant pour les enzymes de la voie de synthèse de novo des céramides par qRT-PCR. Des rats Zucker obèses sont perfusés avec la myriocine (inhibiteur de la synthèse de novo des céramides) en ICV pendant 21 jours. Des tests de sensibilité à l'insuline et de tolérance au glucose sont réalisés. A la fin du traitement, ils reçoivent une injection ICV d'insuline, la sensibilité à l’insuline ainsi que les taux de céramides sont quantifiés dans l’hypothalamus. Les îlots de Langerhans sont isolés pour des tests de sécrétion d'insuline.Nous avons mis en évidence une insulino-résistance dans la lignée hypothalamique GT1-7 traitées avec le palmitate qui s’accompagne d’une accumulation de céramides. En présence de myriocine, les céramides ne sont plus accumulés et le l’insulino-résistance induite par le palmitate est contre-carrée. En utilisant un inhibiteur de la PKCζ et un adénovirus codant pour un dominant-négatif de la PKCζ, nous avons montré que le palmitate n'est plus capable d'induire une insulino-résistance et ce malgré la présence d'une accumulation de céramides. Chez le rat Zucker obèse, nous avons mis en évidence une accumulation de céramides hypothalamiques qui est contre-carrée par la myriocine. Ceci est associé avec une amélioration de la sensibilité à l’insuline dans l’hypothalamus. De façon, intéressante, ces animaux améliorent leur tolérance au glucose qui est associée à une augmentation du tonus parasympathique conduisant à une augmentation de la sécrétion d’insuline. Les îlots de Langerhans isolés à partir de ces rats présentent une capacité sécrétoire augmentée lors du traitement avec la myriocine.Au final, notre étude révèle que la lipotoxicité hypothalamique est associée à une accumulation de céramides dans cette structure, responsable de l’installation d’une insulino-résistance. Ces résultats mettent également en évidence le rôle clé du métabolisme des céramides au niveau de l’hypothalamus dans la dérégulation du contrôle nerveux de l’homéostasie glucidique induit par l’obésité / Studies show that hypothalamic lipid accumulation is responsible for the development of central lipotoxicity, a phenomenon that could play a role in the installation of peripheral insulin resistance and type II diabetes by deregulating the nervous control of glucose homeostasis. It is known that the accumulation of ceramides is involved in the development of lipotoxicity of peripheral tissues. The objective of this study is to determine the role of the hypothalamic ceramide metabolism on the installation of a central insulin resistance and to study the mechanisms involved on this phenomenon. We also determined the role of hypothalamic ceramide metabolism in the deregulation of obesity-induced glucose homeostasis.The installation of a central insulin resistance is studied using in vitro approaches using hypothalamic GT1-7 mouse cells treated with palmitate for 24 hours. The action of insulin is measured by the quantification of phosphorylated Akt (western blot). The ceramides are quantified by lipidomic assay, mRNA expression of genes encoding enzymes of de novo synthesis pathway of ceramides by qRT-PCR. Obese Zucker rats were perfused with myriocin (an inhibitor of de novo synthesis of ceramides) in ICV for 21 days. Insulin sensitivity and glucose tolerance tests are performed. At the end of treatment, they receive an ICV injection of insulin, insulin sensitivity and ceramide levels are quantified in the hypothalamus. Islets of Langerhans are isolated for insulin secretion tests.We have demonstrated that palmitate is able to induce insulin resistance in the hypothalamic GT1-7, which is accompanied by an accumulation of ceramides. In the presence of myriocin, ceramides are no longer accumulated and the insulin resistance induced by palmitate is counteract. Using an inhibitor of PKCζ and an adenovirus encoding a dominant-negative of PKCζ, we have shown that palmitate is no longer able to induce insulin resistance despite the presence of an accumulation of ceramides. In the obese Zucker rat, we have demonstrated an accumulation of hypothalamic ceramides which is counteract by myriocin. This is associated with an improvement in insulin sensitivity in the hypothalamus. Interestingly, these animals improve their glucose tolerance which is associated with an increase in parasympathetic tone leading to an increase in insulin secretion. Islets of Langerhans isolated from these rats have increased secretory capacity when treated with myriocin.In conclusion, our study reveals that hypothalamic lipotoxicity is associated with an accumulation of ceramides in this structure, responsible for the installation of insulin resistance. These results also highlight the key role of ceramide metabolism at the hypothalamus level in the deregulation of nervous control of obesity-induced carbohydrate homeostasis

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