Pancreatic cancer is nowadays one of the neoplasms with worst prognosis, so research towards the discovery of new molecular targets for therapy and diagnosis is more than urgent. In this direction, we have deeply evaluated the role of Galectin-1 (Gal-1) - a protein that is highly overexpressed in the tumor stroma- in pancreatic tumor progression. Interestingly, we have found that Gal-1 interacts with tissue plasminogen activator (tPA) and that this interplay seems to be involved both in pancreatic tumor epithelial cells and fibroblasts migration, Erk1/2 activation and invasion, suggesting its importance in the tumor/stroma crosstalk in vitro. We have also focused on the biochemical identification of tPA/Gal-1 interaction domains. Furthermore, we have studied Gal-1 role in pancreatic tumor progression in vivo, using murine (xenografts and transgenics) and zebrafish models. We have found that Gal-1 participates in proliferation, angiogenesis, stroma formation and necrosis in Ela-1-myc pancreatic tumors, as well as in the acinar to ductal metaplasia. Importantly, these effects result in an overall significant increase in the survival of Ela-1-myc mice with reduced Gal-1 levels. We have also analyzed Gal-1 role in mouse embryonic pancreatic development, finding interesting parallelisms with tumors. Finally, the molecular mechanisms involved in Gal-1 driving tumor pancreatic progression have been addressed through a transcriptome analysis. All together, our data support Gal-1 as a new molecular target to fight against pancreatic cancer. / Avui en dia, el càncer de pàncrees representa un dels tumors amb més elevats índex de mortalitat, per la qual cosa la recerca dirigida a la identificació de molècules per teràpia i diagnosi són més que necessàries. Amb aquest objectiu, hem avaluat el paper que juga Galectina-1 (Gal-1) - una proteïna altament sobreexpressada en l’estroma tumoral- en la progressió tumoral pancreàtica. Hem trobat que Gal-1 interactua amb l’activador tissular del plasminògen (tPA), participant en la migració, l’activació de Erk1/2 i la invasió, tant en cèl4lules tumorals pancreàtiques com en fibroblasts in vitro, suggerint una importància caudal d’aquesta interacció en la comunicació entre el tumor i l’estroma. Així mateix, ens hem centrat en la identificació bioquímica dels dominis d’interacció entre Gal-1 i tPA. A més, el paper de Gal-1 en la progressió tumoral pancreàtica ha estat adreçat in vivo, utilitzant models murins (xenografts i transgènics) i el peix zebra. Així doncs hem trobat que Gal-1 participa en la proliferació, angiogènesi, formació de l’estroma i la necrosi dels tumors pancreàtics dels ratolins Ela- 1-myc, així com en la metaplasia acinar-ductal. De forma significativa, aquests efectes es tradueixen en un increment important en la supervivència dels ratolins Ela-1-myc amb nivells reduïts de Gal-1. Hem també analitzat el paper que juga Gal-1 en el desenvolupament pancreàtic embrionari murí, trobant paral4lelismes interessants amb els tumors. Finalment, hem volgut ocupar-nos dels mecanismes moleculars involucrats en els efectes produïts per Gal-1 durant la progressió tumoral pancreàtica mitjançant microarrays. Les nostres dades presenten Gal-1 com una nova diana terapèutica per lluitar contra el càncer de pàncrees.

Els tractaments actuals pel càncer de pàncreas presenten un eficàcia limitada de manera que es necessari el desenvolupament de noves teràpies antitumorals. La teràpia gènica pel càncer de pàncreas basada en l’ús d’adenovirus es troba limitada per la baixa capacitat dels virus d’arribar a les masses tumoral, de distribuir-se pel tumor i d’infectar les cèl·lules tumorals. Nosaltres hem observat que l’administració intraductal d’adenovirus al ducte biliar de ratolins Ela-myc permet arribar als tumors pancreàtics de manera més eficient que per la via sistèmica. A més a més permet transduir la majoria de la massa tumoral restringint l’expressió adenoviral al teixit pancreàtic. D’altre banda, l’administració intraductal del tractament AduPARTat8TK/GCV retarda significativament el creixement tumoral i disminueix la toxicitat associada al tumor. El nou adenovirus AdTATMMP és activat per les MMP2/9 restaurant la capacitat de transducció de l’AdYTGRE in vitro, i incrementant 7,3 vegades la infecció del tumor pancreàtic. El tractament combinat de l’AduPARTat8TK/GCV amb gemcitabina presenta un efecte sinèrgic in vitro, però no millora la eficàcia antitumoral de les teràpies simples. D’altre banda el tractament de l’electroporació irreversible presenta efectes antitumorals significatius en tumors ortotòpics de la línia cel·lular BxPC-3-Luc i allarga la supervivència dels ratolins provocant una toxicitat mínima. / Novel therapies are needed to overcome the limited efficacy of current treatments in pancreatic cancer. Adenoviral gene therapy against pancreatic tumors is challenged by the limitation of viruses to reach the tumor mass, poorly distribute within the tumor and inefficiently transduce tumor cells. We show that intraductal administration of adenoviruses into the common bile duct of Ela-myc mice targets pancreatic tumors more efficiently than systemic delivery with relevant transduction of the bulk of the tumor and restricts expression to pancreatic tissue. Moreover, intraductal administration of AduPARTat8TK/GCV treatment significantly delayed tumor growth ameliorating tumor-associated toxicity. Noticeable the new generated MMP-activatable adenovirus AdTATMMP was susceptible to MMP2/9 activation, restored the transduction capacity of AdYTRGE in vitro, and increased 7.3 times tumor pancreas transduction. The multimodal treatment AduPARTat8TK/GCV and gemcitabine showed synergistic effects in vitro; however, did not enhance the antitumoral efficacy of single therapies. Interestingly, IRE treatment exhibited significant antitumor effects in BxPC-3-Luc orthotopic tumors and prolonged mice survival with minimal toxicity.

Doctor of Philosophy / Introduction Cachexia is characterised by a marked weight loss and the presence of anorexia, anaemia, and asthenia. Although cachexia is often associated with the presence and growth of tumour and observed in solid tumours of the upper gastrointestinal tract, its presence is not unique to cancer and is often also present in most chronic, end-stage diseases processes. The loss of body fat, altered lipid metabolism, increase in the resting energy expenditure, and the increased loss of body protein the degree of which is associated with poor survival, are all hallmarks of this detrimental disease. The clinical aspects and consequences of cachexia can simply be summarised as morbidity, debilitating conditions, and mortality. The conditions such as loss of muscle mass, impaired muscle function, fatigue, reduced activity and functional capacity by themselves are enough to severely and significantly affect the patients’ QL. Although different interventional procedures and therapies are available for the treatment of cachexia and its symptoms, effective methods to evaluate their benefits and outcomes have not been tested or investigated. It was, therefore, the aim of this project to use body composition analysis as a clinical tool and evaluate the effectiveness and outcome of interventional and therapeutic procedures in three groups of patients with cancer. Methods Three patient groups were investigated: 1) patients with pancreatic cancer undergoing Whipple’s Procedure, 2) patients with pancreatic cancer undergoing cancer chemotherapy and receiving either EPA or placebo, and 3) patients with malignant mesothelioma undergoing cancer chemotherapy plus thalidomide or thalidomide alone. Body composition analysis techniques were used to assess the changes in TBN, TBF, TBK, and TBW. In addition, the body composition parameters together with clinical measures were also used to determine parameters influencing survival. The malignant mesothelioma patients were randomised into patients who received gemcitabine / cisplatin plus thalidomide and those who received thalidomide alone. The pancreatic cancer patients undergoing chemotherapy were randomised into the group who were receiving EPA and those who were receiving placebo. In addition, these patients were also investigated on the basis of their disease extent where they were separated into two groups of metastatic and locally advanced. Unpaired T-Test and ANOVA were used to determine differences between groups. Kaplan-Meier analysis and Cox’s Regression were used to assess survival in all three patient cohorts. The Whipple’s Procedure patients were separated into those who received a Clear Margin and those who received an Unclear Margin during their resection. Results 1) In the pancreatic cancer patients undergoing Whipple’s Procedure, compared to the base-line, there were highly significant changes in Weight (p=0.006), BMI (p=0.005), and FM (p=0.007) followed by significant changes in %BFat (p=0.016), TBK/Ht (p=0.021), LBM (By TBK) (p=0.023), LBM (Van Loan) (p=0.034), and LBM (Segal) (p=0.038) at the 14 week time-point. At the 26 weeks post-operative time point, the only significant changes were in the FM (p=0.012), %BFat (p=0.003), and BMI (p=0.027) parameters. There was also a deviation between the two groups in their TBN, LBM and TBW content observable in a long-term setting and fat content in the relatively shorter-term. Although the Unclear Margin group had lower body composition values, both groups seem to begin to gradually “equalise” around the 14 weeks post-operative time-point. The survival analysis results for the Whipple’s Procedure patients demonstrated that Margin Status (p=0.001), Fat Mass (p=0.003) and Age (p=0.081) were significant and could influence survival. 2) When the second cohort pancreatic cancer patients undergoing chemotherapy were analysed, they were initially separated according to the extent of their disease The results of the analyses of body composition changes between measurement time-points for the each group separately, suggested that the patients with locally advanced disease maintain their Weight, FM, and TBN but are more likely to have a lower TBW by the end of the four month of chemotherapy. However, the patients with metastatic pancreatic cancer maintain their TBW but are more likely to have a decreased fat compartment and a higher FFM. The QL analysis showed that the metastatic group are performing “worse” than the locally advanced group especially in term of their Dyspnoea, Nausea & Vomiting, and Sexuality. In addition, the Karnofsky score showed that the metastatic group are not performing as well as the locally advanced group. Furthermore, for the metastatic group there was an increase in the patients’ pain with a decline in mood and general performance as well as increase in gastrointestinal symptoms. Pain Card scores also showed a general increase for the metastatic group and a general decrease for the locally advanced group. When the pancreatic cancer patients undergoing chemotherapy were separated according to whether they received EPA or placebo, the results demonstrated that firstly, due to the fact that the patients were well randomised, the two groups commenced the trial with similar and statistically non-significantly different body composition parameters. Secondly, the two groups were also found to be statistically not different at their corresponding measurement time-points. And thirdly, the patients receiving placebo compared to those receiving EPA lost more Weight, and FM but less TBW throughout the trial. The TBK/Ht (p=0.044), TBK (p=0.042), and LBM (By TBK) (p=0.042), however, showed statistically significant differences where in all three parameters the EPA showed an increase compared to the base-line (pre-chemotherapy). Results of the survival analysis demonstrated that the use of EPA in this group of pancreatic cancer patients did not provide any benefit. In fact, as it was shown in the Kaplan-Meier plot, the group of patients receiving the EPA had a “worse” survival than the group receiving the placebo. The QL results showed that placebo group improved in their functional scales, but increased their Altered Bowel Habit scores with an increase in the perception of pain and decrease in relief from pain. The EPA group, however, showed a decrease in the Loss of Appetite, Dyspnoea, Pain, Pancreatic Pain, and Fatigue, and improvements in Role Functioning and Sexuality. 3) Results of the malignant mesothelioma patients demonstrated that both study arms show similar weight changes. In addition, body composition measurements indicated that the gemcitabine / cisplatin chemotherapy plus thalidomide group had a greater TBN loss and a greater TBW gain than the thalidomide-alone group. This loss of TBN and gain in TBW looked to be “concealed” in the weight. The results of the survival analysis carried out on the mesothelioma patient group suggested that haemoglobin levels (p=0.001), Age (p=0.007), and NI (p=0.008) are the parameters that can influence the survival of patients with malignant mesothelioma undergoing chemotherapy. Conclusions 1) The trend in body composition changes in the Whipple’s Procedure group showed that, although both groups may start with non-significantly different body composition, they tended to grow closer around the 14 week point indicating that the Clear Margin group may lose more than Unclear Margin group. The implications of these findings, therefore, were that once the most appropriate surgical procedure is performed, an adjuvant therapy regimen (such as chemotherapy) at around 14 weeks may have the most impact on the patient’s overall treatment outcome. 2) When the pancreatic cancer patients were separated by the extent of their disease, the results lead to the conclusion that the patients with locally advanced disease maintain their Weight, FM, and TBN but are more likely to have a lower TBW by the end of the four month of chemotherapy. However, the patients with metastatic pancreatic cancer maintain their TBW but are more likely to have a decreased fat compartment and a higher FFM. The QL analysis concluded that the results may point to a worsening and/or progressing disease which is consistent with classic metastatic disease aetiology. From the results of the pancreatic cancer patients undergoing cancer chemotherapy it was concluded that the use of EPA in this group of pancreatic cancer patients undergoing cancer chemotherapy with gemcitabine results in a non-significant reduction in weight loss, FM loss, and TBW gain with a statistically significant increase in FFM. The results of the survival analysis was, however, contradictory suggesting that patients receiving EPA may have a worse survival than the placebo group. The QL analysis here concluded that that EPA does improve the QL of this group of pancreatic cancer patients. 3) From the malignant mesothelioma group it was concluded that provided that the overall anti-cancer potential of gemcitabine / cisplatin plus thalidomide is comparable with that of thalidomide-alone, then by looking purely from the body composition angle one may be able to suggest the use of thalidomide alone in the treatment of malignant mesothelioma in this group of patients. From the results of the survival analysis, the fact that the Study Arm parameter did not reach statistical significance could indicate that survival in these patients is not affected by the presence or absence of chemotherapy with gemcitabine and cisplatin. The body composition techniques were used here as a tool to monitor changes in various body composition parameters to assess the outcomes, including survival, of the administration of different therapies and interventional procedures in these three groups of cancer patients. For these purposes, these techniques were demonstrated to be an effective and invaluable tool.

L’adénocarcinome canalaire du pancréas (ACP) est un problème majeur de santé publique. L’ACP se développe principalement à partir de deux lésions précurseurs : les néoplasies intra-épithéliales pancréatiques et les tumeurs intracanalaires papillaires et mucineuses du pancréas (TIPMP). Les mécanismes moléculaires sous-tendant l’oncogenèse pancréatique sont nombreux. Nous avons étudié le mécanisme de cancérogenèse MSI (MicroSatellite Instability) où il existe une déficience dans le système de réparation des erreurs de réplication de l’ADN ou système MMR (Mismatch Repair). Ce mécanisme de cancérogenèse original est caractérisé par une instabilité génétique de l’ADN affectant les séquences répétées microsatellites du génome. Le phénotype MSI a été décrit dans le syndrome de Lynch (SL), dans lequel il existe une mutation germinale d’un des gènes du système MMR (MLH1, MSH2, MSH6 et PMS2). L’intérêt de l’étude des cancers MSI s’est accru de façon considérable avec le développement des immunothérapies dirigées contre les checkpoints immunitaires (ICK), en particulier PD-1/PD-L1. Nous avons confirmé que la fréquence du phénotype MSI se situe entre 1-2%. Nous avons montré que l’immunohistochimie est la méthode de screening plus adaptée pour l’identification de l’ACP MSI en comparaison avec les techniques de biologie moléculaire. Le phénotype MSI a été plus fréquemment observé dans un contexte de TIPMP. Les cas MSI identifiés présentaient des caractéristiques biologiques évocatrices du SL. Egalement, nos résultats confirment la présence d’un processus de carcinogenèse MSI immunogénique, mais suggèrent des évènements somatiques spécifiques à l’organe d’origine du cancer. Par ailleurs, les ACP MSI étaient caractérisés par un infiltrat inflammatoire riche en lymphocytes cytotoxiques T CD8+ et surexprimaient l’ICK PD-L1 permettant de supposer une probable réponse clinique de l’ACP MSI à l’immunothérapie anti-PD1/PD-L1. / Pancreatic ductal adenocarcinoma (PDAC) is a major health problem in France and around the world. PDAC is developed mainly from two precursor lesions: pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasm (IPMN). There are several molecular mechanisms underlying pancreatic oncogenesis. Particularly, we were interested in the MSI (MicroSatellite Instability) which is due to a defective DNA Mismatch Repair (MMR) system, which normally functions to recognize and repair erroneous insertions, deletions, and mis-incorporation of bases that can arise during DNA replication and recombination. The MSI phenotype was first described in the familial cancer condition known as Lynch syndrome (LS), where the MMR genes MLH1, MSH2, MSH6 or PMS2 harbor germline mutations. Interest in MSI tumors has recently increased after studies have highlighted the concomitant expression of multiple active immune checkpoint (ICK) markers including PD-1 and PD-L1 and the role of the MSI status to predict clinical benefit from immune checkpoint blockade. A Our results indicate that the MSI phenotype occurs in PDAC with a frequency of 1-2%. Our data showed that IHC using antibodies against the four MMR proteins was more sensitive for the assessment of MSI status than PCR-based methods. In addition, we demonstrate for the first time a statistically significant positive association between MSI and IPMNs in PDAC. MSI PDAC, including IPMN, are unlikely to be sporadic since they display molecular features that are usually observed in LS-related neoplasms. Also, our results highlight that an MSI-driven immunogenic pathway to cancer is active in MSI PDACs but suggest that MSI-driven somatic events may be tissue-specific. We observed a stronger lymphocytic tumor infiltration by activated TCD8 cells in MSI PDAC compared to MSS PDAC and found a positive association between PD-L1 expression and MSI status, suggesting that MSI PDAC could be responsive to ICK blockade therapy.

Pancreatic cancer is the fourth most lethal cancer and ranks as the eighth most commonly diagnosed cancer worldwide. This is due to its rapid proliferation, strong metastatic potential and its delayed detection. One major risk factor for developing pancreatic cancer is the aggressive inflammatory disease chronic pancreatitis. Chronic inflammation frequently precedes the development of certain pancreatic cancers. Inflammation is a protective and necessary process by which the body can alert the immune system of the existence of a wound or infection and mount an immune response to remove the harmful stimuli and start wound healing. The cross-talking of cells of the immune system and infected cells happens through cytokines, soluble proteins that activate and recruit other immune cells to increase the system’s response to the pathogen. Failure to resolve the injury can result in persistent cytokine production that in turn allows a cell that is damaged or altered to survive when in normal conditions it would be killed. Inflammation is thought to create a microenvironment that facilitates the initiation and/or growth of pancreatic cancer cells. Cytokines use two important kinases for their signaling: Janus Kinases (JAKs) and Signal Transducers and Activators of Transcription (STATs). The JAKs are activated upon the binding of cytokines to their corresponding receptors. When activated, the JAKs activate STATs through tyrosine phosphorylation. The STATs transduce signals to the nucleus of the cells to induce expression of critical genes essential in normal physiological cellular events such as differentiation, proliferation, cell survival, apoptosis and angiogenesis. STAT3 (a member of the STAT family) is constitutively activated in some pancreatic cancers, promoting cell cycle progression, cellular transformations and preventing apoptosis. Therefore, STAT3 is a promising target for cancer treatment. Novel therapies that inhibit STAT3 activity in cancers are urgently needed. Natural products are a very good resource for the discovery of new drugs against pancreatic cancer. Covering more than 70% of the Earths surface, The Ocean is an excellent source of bioactive natural products. Harbor Branch Oceanographic Institute’s Center for Marine Biomedical and Biotechnology Research (HBOI-CMBBR) situated in Florida, aims to find new marine natural products useful in disease prevention and drug therapy. Their current focus is to look for novel treatments for preventing both the formation of new pancreatic tumors and the metastasis of existing tumors. The hypothesis of this degree project was that novel inhibitors of STAT3 useful in the treatment of pancreatitis and/or pancreatic cancer could be found from marine-natural products. The first specific aim of this degree project was to set up an assay to identify bioactive marine natural products as inhibitors of inflammation. Furthermore the assay was validated using a commercially available inhibitor of inflammation (Cucurbitacin I). The last aim was to further validate the assay by screening pure compounds and peak library material from the HBOI marine specimen collection. At the end of the experimentation time, the assay still was not set-up as there were difficulties in proper cell culture techniques and the cell line did not respond as advertised. While the results were not as expected, the work performed resulted in familiarization with research laboratory practices and increased laboratory skills. Moreover, the results from the assays point to future directions to accomplish this project. / Development of a screening assay for inhibitors of inflammation useful against pancreatic cancer

Problématique. L’étiologie du cancer pancréatique est encore peu caractérisée, notamment quant au rôle des expositions environnementales modifiables. L’objectif de cette étude est d’examiner si les expositions chimiques dans les milieux de travail sont des facteurs de risques pour ce cancer le plus souvent mortel. Méthodes. Une étude cas-témoin populationnelle à Montréal incluant 19 types de cancer a été réalisée entre 1979 et 1985. Pour chaque participant, un historique de travail détaillé a été obtenu ainsi que des données sur des variables sociodémographiques et des habitudes de vie. Les antécédents de travail ont été examinés par des chimistes et hygiénistes de travail afin de déterminer le statut d’exposition de chaque participant pour environ 300 substances d’intérêt. Pour ce rapport, les 116 cas participants de cancer pancréatique ont été comparés avec les autres cas de cancers et des témoins populationnelles. Des analyses préliminaires ont été effectuées pour repérer les substances qui démontraient des indices d’association avec le cancer du pancréas. Celles-ci, en plus des substances qui sont réputées être associées avec le cancer du pancréas dans la littérature, ont été retenues pour des analyses statistiques plus approfondies. Pour chaque substance, deux catégories d’exposition ont été établies : « exposé » et « substantiellement exposé ». Les ratios de cotes entre le cancer pancréatique et chaque substance ont été estimés par régression logistique tout en contrôlant pour des facteurs de confusion possibles. Des analyses semblables ont été réalisées pour des catégories industrielles et occupationnelles. Résultats. Parmi toutes les expositions étudiées, la majorité d’entre eux n’ont pas démontré une association avec le cancer du pancréas. Cependant, des associations positives ont été repérées pour quelques substances, notamment pour les produits de combustion du charbon (RC 2,6, IC 95 % [1,3- 5,3]), la suie (RC 3,4, IC 95 % [1,3-8,6]), les cires et agents de polissage (RC 2,7, 95 % [1,1-4,1]), les produits de nettoyage (RC 1,9, IC 95 % [1,1-3,2]) et pour la catégorie des concierges et nettoyeurs (RC 2,8, IC 95 % [1,5-5,1]). Conclusion. Malgré que plusieurs des associations observées dans cette étude ne sont pas suffisamment appuyées directement par la littérature existante, nos résultats représentent une ressource utile pour diriger les futurs projets de recherche et notamment pour les éventuelles méta- analyses. / Background. Pancreatic cancer is a fatal disease in most cases. Unfortunately, little is known about the etiology of pancreatic cancer and whether modifiable environmental chemical exposures may play an important role. The purpose of this study is to explore whether chemical exposures in the workplace may be risk factors for pancreatic cancer. Methods. A population-based case-control study including 19 types of cancer was conducted in Montreal between 1979 and 1985. Detailed occupational histories were obtained from all subjects as well as information on several socio-demographic and lifestyle variables. Occupational histories were assessed by industrial hygienists and chemists to determine whether exposure had occurred to any of nearly 300 substances from a checklist. For this report, the participating 116 pancreatic cancer cases were compared with other cancer controls and population controls. Preliminary analyses were conducted to identify agents from the checklist showing evidence of an association with pancreatic cancer. These were selected for more in-depth statistical analyses together with agents reported in the literature as being potentially associated with pancreatic cancer. For each agent, “any” and “substantial” exposure metrics were defined. Unconditional logistic regression methods were used to estimate odds ratios between pancreatic cancer and each of the selected exposures while controlling for potential confounders. Similar analyses were conducted for occupation and industry groups. Results. Of all the exposures assessed, the majority did not reveal an association with pancreatic cancer. However, suggestive positive associations were found for several agents including coal combustion products (OR 2.6, 95% CI [1.3-5.3]), soot (OR 3.4, 95% [1.3-8.6]), waxes and polishes (OR 2.7, 95% [1.1-4.1]), cleaning agents (OR 1.9, 95% [1.1-3.2]) and for the occupational category “janitors and cleaners” (OR 2.8, 95% CI [1.5-5.1]). Conclusion. For most of the agents revealing an association with pancreatic cancer in our study, there is a paucity of direct evidence published by other authors to corroborate our findings. However, parallels can be made with previously observed excesses in occupational groups making our findings useful for guiding future research efforts, notably for meta-analyses, to uncover the specific chemical exposures that may account for these excesses.

Pancreatic cancer is relatively uncommon. Despite its relative scarcity, it is the fourth-ranked cancer killer in the Western world with less than a 5% 5-year survival rate. The high mortality rate is due to the asymptomatic nature of the disease and the advanced stage at which it is usually diagnosed. S100P is a calcium-binding protein that has been shown to be highly expressed in the early stages of pancreatic cancer and has been proposed as a potential therapeutic target via the blocking of its interaction with its receptor RAGE, the receptor for advanced glycation end-products. In this thesis, computational techniques were employed on the NMR ensemble of S100P (PDB Accession code 1OZO) to identify potential inhibitors of the S100P-RAGE interaction in the hope of identifying a series of novel leads that could be developed into clinical candidates for the treatment of pancreatic cancer. In silico studies identified putative binding sites at the S100P dimeric interface capable of accommodating cromolyn, an anti-allergy drug shown to bind to the protein both in vitro and in vivo. Virtual screening of >1 million lead-like compounds using 3D pharmacophore models derived from the predicted binding interactions between S100P and cromolyn, identified 9,408 'hits'. These were hierarchically clustered according to similarities between chemical structures into 299 clusters and 77 singletons. Biological screening of 17 of the 'hits' identified from virtual screening stuidies, 4 of which were synthesised in-house, against pancreatic cancer cell lines identified five compounds that demonstrated an equal or greater capacity to reduce BxPC-3 S100P-expressing pancreatic cells' metastatic potential in vitro relative to cromolyn. Compound 24 in particular, showed significant (p<0.05) inhibition of invasion of these cells at a concentration of 100 μM that was comparable to cromolyn at the same concentration. This compound, structurally distinct from cromolyn, was successfully synthesised, purified and characterised in-house alongside 39 of its analogues. Biological screening of compound 24 and four of its analogues for anti-proliferative activity against BxPC-3 and Panc-1 pancreatic cancer cell lines showed all five compounds significantly (p < 0.0001) inhibiting proliferation in both cell lines at a concentration of 1 μM relative to the non-treated control. Hence, structurally distinct compounds that show promising inhibitory activity on the metastasis and proliferation of pancreatic cancer cells have been identified using a structure-based drug design methodology. These compounds, with further optimisation, could provide good starting points as therapeutic lead candidates for the treatment of pancreatic cancer.

Background Pancreatic heterotopia (PH) is defined as ectopic pancreatic tissue outside the normal pancreas and its vasculature and duct system. Most frequently, PH is detected incidentally by histopathological examination. The aim of the present study was to analyze a large single-center series of duodenal PH with respect to the clinical presentation. Methods A prospective pancreatic database was retrospectively analyzed for cases of PH of the duodenum. All pancreatic and duodenal resections performed between January 2000 and October 2015 were included and screened for histopathologically proven duodenal PH. PH was classified according to Heinrich’s classification (Type I acini, ducts, and islet cells; Type II acini and ducts; Type III only ducts). Results A total of 1274 pancreatic and duodenal resections were performed within the study period, and 67 cases of PH (5.3%) were identified. The respective patients were predominantly male (72%) and either underwent pancreatoduodenectomy (n = 60); a limited pancreas resection with partial duodenal resection (n = 4); distal pancreatectomy with partial duodenal resection (n = 1); total pancreatectomy (n = 1); or enucleation (n = 1). Whereas 65 patients (83.5%) were asymptomatic, 11 patients (18.4%) presented with symptoms related to PH (most frequently with abdominal pain [72%] and duodenal obstruction [55%]). Of those, seven patients (63.6%) had chronic pancreatitis in the heterotopic pancreas. The risk of malignant transformation into adenocarcinoma was 2.9%. Conclusions PH is found in approximately 5% of pancreatic or duodenal resections and is generally asymptomatic. Chronic pancreatitis is not uncommon in heterotopic pancreatic tissue, and even there is a risk of malignant transformation. PH should be considered for the differential diagnosis of duodenal lesions and surgery should be considered, especially in symptomatic cases.

Grâce à la production de nanoparticules lipidiques, les SELN (Synthetic Exosomes-Like Nanoparticles), mimant la composition des exosomes produits par les cellules tumorales pancréatiques humaines SOJ-6, nous avons démontré que les effets apoptotiques des exosomes naturels étaient dus aux lipides. En effet, nous avons montré que les SELN dont le rapport rafts/phospholipides est le plus élevé, interagissent avec les cellules SOJ-6 au niveau des rafts et perturbent la voie Notch. Cela conduit à la diminution de l'expression du facteur de survie Hes-1, qui est accentuée par la perte d'activité du complexe PTEN-GSK-3β. Ces dérégulations induisent l'apoptose dépendante de la mitochondrie des cellules SOJ-6, caractérisée par l'augmentation du ratio Bax/Bcl-2, l'activation de la caspase 9 et la dégradation de l'ADN. En revanche, les cellules MiaPaCa-2 résistent aux SELN, ce qui s'explique par leur caractère indifférencié. Ainsi la surexpression de marqueurs de cellules souches tels que l'ALDH et CXCR4 leur confèrent une grande résistance. Elles sont toutefois sensibles à la cyclopamine un inhibiteur de la voie Hedgehog, dont les effets sont atténués si les cellules MiaPaCa-2 sont préincubées avec les SELN, prouvant que ces cellules mettent en place des voies de survie leur permettant d'échapper à l'apoptose. Nos investigations ont montré que dans les cellules MiaPaCa-2, sous l'effet des SELN, l'activation de la voie canonique NF-кB permet d'induire la transcription du gène codant SDF-1α, seul ligand connu du récepteur CXCR4. Le facteur produit et sécrété active de manière auto et paracrine une voie de survie Akt-dépendante. / It has been previously reported that exosomes released by the human pancreatic tumoral cell line SOJ-6 could induce their own apoptosis. Thanks to the production of lipid nanoparticles, SELN (Synthetic Exosomes-Like Nanoparticles) mimicking the lipid composition of natural exosomes, we have shown that lipids were responsible for the observed effects. Indeed, we showed that SELN with the higher ratio rafts/phospholipids could interact with SOJ-6 cells at the level of the rafts to perturb the Notch pathway, preferentially localized in these lipid microdomains. This induces a decreased expression of the main target of this pathway, the survival factor Hes-1. This decrease is intensified by the activation of the complex PTEN-GSK-3β. These deregulations drive cells towards the mitochondria-dependent apoptosis as shown by the increase of the ratio Bax/Bcl-2, the caspase 9 activity and the DNA fragmentation. Whereas MiaPaCa-2 cells are resistant to SELN, which is explained by their stem-like cell phenotype, contrarily to the well-differentiated SOJ-6 cell line. Although the over-expression of some stem cell markers, such as ALDH and CXCR4 is responsible for their resistance, they remain sensitive to the cyclopamine, a Hedgehog inhibitor. We found out that MiaPaCa-2 cells pre-incubation with SELN could protect them from the inhibitory effect of the cyclopamine, meaning that upon SELN incubation, a survival pathway is triggered in MiaPaCa-2 cells. So we showed that, upon SELN incubation, the canonical NF-кB pathway is activated in MiaPaCa-2 cells to promote SDF-1α expression. Once released, SDF-1α interacts with its receptor CXCR4 to activate an Akt-dependent survival pathway.

Background Pancreatic heterotopia (PH) is defined as ectopic pancreatic tissue outside the normal pancreas and its vasculature and duct system. Most frequently, PH is detected incidentally by histopathological examination. The aim of the present study was to analyze a large single-center series of duodenal PH with respect to the clinical presentation. Methods A prospective pancreatic database was retrospectively analyzed for cases of PH of the duodenum. All pancreatic and duodenal resections performed between January 2000 and October 2015 were included and screened for histopathologically proven duodenal PH. PH was classified according to Heinrich’s classification (Type I acini, ducts, and islet cells; Type II acini and ducts; Type III only ducts). Results A total of 1274 pancreatic and duodenal resections were performed within the study period, and 67 cases of PH (5.3%) were identified. The respective patients were predominantly male (72%) and either underwent pancreatoduodenectomy (n = 60); a limited pancreas resection with partial duodenal resection (n = 4); distal pancreatectomy with partial duodenal resection (n = 1); total pancreatectomy (n = 1); or enucleation (n = 1). Whereas 65 patients (83.5%) were asymptomatic, 11 patients (18.4%) presented with symptoms related to PH (most frequently with abdominal pain [72%] and duodenal obstruction [55%]). Of those, seven patients (63.6%) had chronic pancreatitis in the heterotopic pancreas. The risk of malignant transformation into adenocarcinoma was 2.9%. Conclusions PH is found in approximately 5% of pancreatic or duodenal resections and is generally asymptomatic. Chronic pancreatitis is not uncommon in heterotopic pancreatic tissue, and even there is a risk of malignant transformation. PH should be considered for the differential diagnosis of duodenal lesions and surgery should be considered, especially in symptomatic cases.