Die Mehrzahl der Patienten mit einem duktalen Pankreaskarzinom weist bei Diagnosestellung ein fortgeschrittenes Tumorstadium auf. Da die Chemo- und die Strahlentherapie nur geringe Ansprechraten bei gleichzeitig starken Nebenwirkungen zeigen, ist die Entwicklung neuer nebenwirkungsarmer Therapiekonzepte erforderlich. Zur Evaluierung neuer medikamentöser Behandlungskonzepte etablierten wir das Tumordell eines N-Nitrosobis-2-oxopropylamin (BOP)-induzierten duktalen Pankreaskarzinoms des Syrischen Hamsters, welches morphologisch und biologisch dem humanen Pankreaskarzinom sehr ähnlich ist. Um fortgeschrittene Tumorstadien zu simulieren hoben wir die in diesem Tiermodell auftretende Lebermetastasierungsrate von 30-35% auf 90% durch eine diätetische Modifikation an, indem der Rohfettanteil von 3,5% im Hamsterstandardfutter auf 21,4% erhöht wurde. Die führenden Komponenten waren dabei Linolsäure und Linolensäure. Da die gesteigerte Lebermetastasierung durch die Anhebung des Rohfettanteils bedingt war und eine Steigerung des oxidativen Stresses durch Nitrosamine, wie BOP, bekannt ist, untersuchten wir ferner den Einfluß auf die intra- und extrametastatische Lipidperoxidation. Unter der Therapie mit dem Somatostatin-Analogon Octreotid und dem Östrogenantagonisten Tamoxifen zeigte sich, daß Tamoxifen keinen Einfluß auf das Wachstum und die Lebermetastasierung hat. Hingegen verringerte Octreotid in Einzel- und Kombinationstherapie gleichermaßen das Lebermetastasenwachstum. Darüberhinaus führte Octreotid bei gleichzeitiger Hochfetternährung zu einer Erniedrigung der extrametastatischen und einer Erhöhung der intrametastatischen hepatischen Lipidperoxidation. Über diese beiden Mechanismen führt Octreotid möglicherweise zu einer Inhibition des Wachstums der Lebermetastasen. Hierbei scheint es sich nicht um einen rezeptorvermittelten Effekt handeln, da in metastasenfreien Leberanteilen keine Somatostatinrezeptoren nachweisbar waren. Demgegenüber könnte es sich bei der Octreotid-bedingten intrametastatischen Steigerung der Lipidperoxidation um einen direkten, rezeptorvermittelten Effekt handeln, da intrametastatisch Somatostatinrezeptoren nachgewiesen wurden. Unter der Therapie mit Vitamin A und E wurde die Lebermetastasierung beim Pankreaskarzinom erniedrigt. Biochemisch war unter der Behandlung mit den Vitaminen A, C und E die Aktivität der antioxidativen Schutzenzyme GSHPX und SOD erhöht, sowie die hepatisch Lipidperoxidation (TBARS) intra- und extrametastatisch erniedrigt. Ferner untersuchten wir den Einfluß der hochselektiven Cyclooxigenase-II- (Celebrex) und der 5-Lipoxygenase-Inhibition (Zyflo) des Eicosanoidstoffwechsels auf das Tumorwachstum des Pankreaskarzinoms. Während die Einzeltherapie mit Celebrex oder Zyflo keinen Einfluß auf die Inzidenz, Anzahl oder Größe von Lebermetastasen hatte, wurden alle 3 Parameter durch die Kombinationstherapie erniedrigt. Darüberhinaus war die hepatische Aktivität der Lipidperoxidations-Schutzenzyme intrametastatisch unter der Kombinationstherapie nicht erhöht. Dies führte zu einer Steigerung der intrametastatischen Lipidperoxidation, die wahrscheinlich für Membranschäden von Metastasenzellen mitverantwortlich ist, und über einen Verlust von Zellintegrität zum Zelltod führt. / At the time of diagnosis the majority of patients with ductal pancreatic cancer suffers from advanced tumor stages. Since present adjuvant therapies show strong side-effects and only decrease tumour growth in very few patients, the development of new therapeutic concepts seems urgent. In order to evaluate new therapeutic strategies we established a tumour model of N-nitrosobis-2-oxopropylamin (BOP) induced ductal pancreatic cancer in Syrian Hamster, which is equal to human cancer in morphological and biological aspects. Accordingly we increased the incidence of liver metastasis from 30-35% to 90% by diatetic modification elevating raw fat content from 3,5% zu 21,4% with important components linolenic and linol acid. Furthermore we evaluated the impact of increased raw fat content and oxidative stress, caused by nitrosamines, on intra- and extrametastatic lipidperoxidation. Evaluating the effect of the somatostatin analogue Octreotide and the estrogen antagonist Tamoxifen we observed that Tamoxifen did neither influence tumour growth nor liver metastasis while Octreotide decreased liver metastasis in single and combined therapy. Moreover Octreotide significantly decreased extrametastatic lipidperoxidation and increased intrametastatic lipidperoxidation. Probably inhibition of growth of liver metastasis was caused by these mechanisms. This effect seems not to be mediated by somatostatin receptors since we did not detect any receptors in non-metastatic hepatic tissue. However, intrametastatic increase of lipidperoxidation might directly be receptor-mediated, since we proved somatostatin receptors in liver metastasis. Therapy with Vitamine A and E decreased liver metastasis in pancreatic cancer. Biochemically activity of lipidperoxidation protective enzymes GSHPX and SOD was increased by Vitamine A, C and E while hepatic lipidperoxidation was decreased intra- and extrametastically. Furthermore we analysed the impact of selective cyclooxigenase-II- (Celebrex) and 5-lipoxygenase-inhibition (Zyflo) of eicosanoid metabolism on tumor growth in. While single therapy with Celebrex or Zyflo did not influence incidence, number or size of liver metastasis, these parameters were decreased by combined therapy. Moreover hepatic activity of lipidperoxidation protective enzymes was not increased intrametastatically by combined therapy. Thus intrametastatic lipidperoxidation increased and probably caused damage of membranes and apoptosis of metastatic cells.

INTRODUÇÃO: Os microRNAs (miRNAs) são uma classe de pequenas moléculas não codificadoras de proteínas que regulam a expressão gênica durante a etapa de tradução. Esta regulação é feita pelo pareamento de bases com o mRNA-alvo (RNA mensageiro), resultando na supressão da tradução ou na clivagem do mRNA. A depender se os miRNAs têm como alvo genes supressores de tumor ou oncogenes, eles podem atuar como supressores tumorais ou oncogenes. A imunoistoquímica triplo negativa, no câncer de mama, é, comumente, utilizada como substituto clínico para identificação dos tumores basaloides, que se caracterizam pela expressão de genes epiteliais basais, sendo associados a menores taxas de sobrevida livre de doença e sobrevida global. O câncer de mama triplo negativo faz com que seja necessária a descoberta de marcadores moleculares que possam servir de alvos terapêuticos ou, pelo menos, que sirvam como marcadores preditivos da resposta aos quimioterápicos. OBJETIVO: avaliar a expressão de microRNAs, por PCR em tempo real, no carcinoma mamário ductal invasivo (CDI) triplo negativo. MÉTODOS: Foram avaliados materiais em parafina de tumor de 31 pacientes com as seguintes características: carcinoma invasivo de mama, receptores de estrogênio e de progesterona negativos e HER 2 negativo, bem como tecido mamário histologicamente normal. Foram utilizados kit para extração de RNA de amostras fixadas e parafinadas - miRNeasy FFPE; kit para síntese de cDNA - miScript II RT; kit miScript SYBR Green PCR e miScript miRNA PCR Arrays para análise de 84 sequências de miRNA de câncer humano. Foram avaliados dados clínicos, como idade, paridade, amamentação, status menopausal; variáveis histológicas, como tamanho do tumor, status linfonodal, invasão linfática; características imunoistoquímicas, como expressão de Ki-67, EFGR e CK 5/6. O seguimento das pacientes buscou verificar a ocorrência e o tempo de aparecimento de recidiva loco regional, metástase à distância e óbito. Para análise estatística foi utilizado o software miScript miRNA PCR Array Data Analysis, que utiliza o método de quantificação relativa DeltaCt. RESULTADOS: A análise comparativa dos 31 casos de CDI triplo negativo com os 18 casos de parênquima mamário normal definiu microRNAs hiperexpressos, sendo eles: miR-96-5p (fold-regulation(FR) = 9,68, p = 0,000008), miR-21-5p (FR = 4,47, p = 0,00), miR-7-5p (FR = 5,8, p = 0,00137) , miR-182-5p (FR= 7,92, p = 0,000001), miR-210-3p (FR = 11,83, p = 0,000048), miR-18a-5p (FR = 9,51, p = 0,000034), miR-155-5p (FR= 4,40 , p = 0,00019) e miR-93-5p (FR= 4,15, p = 0,000023). Aponta, ainda, microRNAs com hipoexpressão, a saber: miR-204-5p (FR = -10,26, p = 0), miR-205-5p (FR= -4,07, p = 0,019822), miR-125b-5p (FR= -4,29, p=0) e let 7c-5p (FR= -4,91, p=0). CONCLUSÃO: a expressão de microRNAs no carcinoma ductal invasivo triplo negativo permite diferenciá-lo do tecido normal / INTRODUCTION: MicroRNAs (miRNAs) are a class of small non-coding protein molecules that regulate gene expression during the translation stage. This adjustment is made by base pairing with the mRNA (messenger RNA) target resulting in suppression of translation or cleavage of the mRNA. Depending on whether miRNAs target tumor suppressor genes or oncogenes, they can act as tumor suppressors or oncogenes. The triple negative immunohistochemistry in breast cancer is commonly used as a substitute for clinical identification of basaloid tumors, which are characterized by the expression of basal epithelial genes and are associated with lower rates of disease-free survival and overall survival. The triple negative breast cancer makes necessary the discovery of molecular markers that may serve as therapeutic targets or at least as predictive markers of response to chemotherapy. OBJECTIVE: evaluate the expression of microRNAs by RT-PCR in triple negative breast invasive ductal carcinoma (IDC). METHODS: Paraffin embedded tumor material from 31 patients with the following characteristics were evaluated: invasive breast carcinoma, negative estrogen and progesterone receptor, negative HER 2, and histologically normal breast tissue. Were used: Kit for RNA extraction from fixed and paraffin embedded samples - miRNeasy FFPE; cDNA synthesis kit - miScript II RT; miScript SYBR Green PCR Kit and miScript miRNA PCR Arrays for analysis of 84 miRNA sequences of human cancer. Clinical data such as age, parity, breastfeeding, menopausal status; histological variables such as tumor size, lymph node status, lymphatic invasion; immunohistochemical characteristics, such as expression of Ki-67, EFGR and CK 5/6 were evaluated. The follow-up of patients aimed to verify the occurrence and time of appearance of loco regional recurrence, distant metastasis and death. For statistical analysis the miScript miRNA PCR Array Data Analysis software, which uses the method of relative quantification DeltaCt, was used. RESULTS: A comparative analysis of 31 cases of triple negative IDC with 18 cases of normal breast parenchyma defined microRNAs overexpressed, as follows: miR-96-5p (fold-regulation (FR) = 9.68, p = 0.000008), miR -21-5p (FR = 4.47, p = 0.00), 5p, miR-7 (FR = 5.8, p = 0.00137), miR-182-5p (FR = 7.92, p = 0.000001), miR-210-3p (FR = 11.83, p = 0.000048), miR-18a-5p (FR = 9.51, p = 0.000034), miR-155-5p (FR = 4.40, p = 0.00019) and miR-93-5p (FR = 4.15, p = 0.000023). Furthermore, microRNAs with reduced expression, as follows: miR-204-5p (FR = -10.26, p = 0), miR-205-5p (FR = -4.07, p = 0.019822), miR -125b-5p (FR = -4.29, p = 0) and Let-7c 5p (FR = -4.91, p = 0). CONCLUSION: the expression of microRNAs in triple negative invasive ductal carcinoma allows to differentiate it from normal tissue

O adenocarcinoma pancreático (PDAC) é uma neoplasia de difícil diagnóstico precoce e cujo tratamento não tem apresentado avanços expressivos desde a última década. As tecnologias de sequenciamento de nova geração (next generation sequencing - NGS) podem trazer importantes avanços para a busca de novos marcadores para diagnóstico de PDACs, podendo também contribuir para o desenvolvimento de terapias individualizadas. Bancos de dados são ferramentas poderosas para integração, padronização e armazenamento de grandes volumes de informação. O objetivo do presente estudo foi modelar e implementar um banco de dados relacional (CaRDIGAn - Cancer Relational Database for Integration and Genomic Analysis) que integra dados disponíveis publicamente, provenientes de experimentos de NGS de amostras de diferentes tipos histopatológicos de PDAC, com dados gerados por nosso grupo no IQ-USP, facilitando a comparação entre os mesmos. A funcionalidade do CaRDIGAn foi demonstrada através da recuperação de dados clínicos e dados de expressão gênica de pacientes a partir de listas de genes candidatos, associados com mutação no oncogene KRAS ou diferencialmente expressos em tumores identificados em dados de RNAseq gerados em nosso grupo. Os dados recuperados foram utilizados para a análise de curvas de sobrevida que resultou na identificação de 11 genes com potencial prognóstico no câncer de pâncreas, ilustrando o potencial da ferramenta para facilitar a análise, organização e priorização de novos alvos biomarcadores para o diagnóstico molecular do PDAC. / Pancreatic Ductal Adenocarcinoma (PDAC) is a type of cancer difficult to diagnose early on and treatment has not improved over the last decade. Next Generation Sequencing (NGS) technology may contribute to discover new biomarkers, develop diagnose strategies and personalised therapy applications. Databases are powerfull tools for data integration, normalization and storage of large data volumes. The main objective of this study was the design and implementation of a relational database to integrate publicly available data of NGS experiments of PDAC pacients with data generated in by our group at IQ-USP, alowing comparisson between both data sources. The database was called CaRDIGAn (Cancer Relational Database for Integration and Genomic Analysis) and its funcionalities were tested by retrieving clinical and expression data of public data of genes differencially expressed genes in our samples or genes associated with KRAS mutation. The output of those queries were used to fit survival curves of patients, which led to the identification of 11 genes potencially usefull for PDAC prognosis. Thus, CaRDIGAn is a tool for data storage and analysis, with promissing applications to identification and priorization of new biomarkers for molecular diagnosis in PDAC.

L’adénocarcinome canalaire pancréatique (ADKP) est l’une des tumeurs solides avec le pronostic le plus sombre. Le stroma de ces tumeurs, très abondant, est composé de matrice extra cellulaire ainsi que de cellules stromales (incluant des fibroblastes activés associés au cancer ou des cellules immunitaires). Les fibres nerveuses infiltrant ce stroma tumoral sont considérées comme une caractéristique des ADKP, impliquées dans le phénomène de remodelage nerveux, qui participent aux douleurs neuropathiques, à la dissémination des cellules tumorales, ainsi qu’à la rechute de la maladie après chirurgie. Le remodelage nerveux associé aux ADKP est régulé par un réseau fonctionnel, impliquant des interactions physiques et moléculaires entre cellules tumorales, cellules nerveuses dont les cellules de Schwann et les autres cellules stromales. Dans cette étude, nous avons démontré que les cellules de Schwann (cellules gliales, soutient des neurones périphériques) stimulent l’agressivité (migration, invasion, tumorigénicité) des cellules pancréatiques tumorales de façon dépendante du TGFβ (Transforming Growth Factor beta). En effet, nous révélons que le milieu conditionné des cellules de Schwann est enrichi en nombreuses molécules de signalisation, incluant de grandes quantités de TGFβ capable d’activer sa voie de signalisation dépendante des protéines SMAD, au sein des cellules cancéreuses. Des analyses de spectrométrie de masse des sécrétomes des cellules de Schwann et des cellules tumorales pancréatiques, cultivées seules ou ensemble, soulignent le rôle central du TGFβ dans les interactions neuro-épithéliales, comme illustré par la signature protéomique relative aux mécanismes d’adhésion et de motilité cellulaires. Ainsi, ces résultats démontrent que les cellules de Schwann sont une source de TGFβ dans les ADKP, et jouent un rôle crucial dans l’acquisition de propriétés agressives par les cellules tumorales / Pancreatic ductal adenocarcinoma (PDAC) is one of the solid tumors with the poorest prognosis. The stroma of this tumor is abundant and composed of extracellular matrix and stromal cells (including cancer-associated fibroblasts and immune cells). Nerve fibers invading this stroma represent a hallmark of PDAC, involved in neural remodeling, which participates in neuropathic pain, cancer cells dissemination and tumor relapse after surgery. Pancreatic cancer-associated neural remodeling is regulated through functional interplays mediated by physical and molecular interactions between cancer cells, nerve cells and surrounding Schwann cells, and other stromal cells. In the present study, we show that Schwann cells (glial cells supporting peripheral neurons) can enhance aggressiveness (migration, invasion, tumorigenicity) of pancreatic cancer cells in a transforming growth factor beta (TGFβ)-dependent manner. Indeed, we reveal that conditioned medium from Schwann cells contains various signaling cues, including high amounts of TGFβ able to activate the TGFβ-SMAD signaling pathway in cancer cells. Secretome analyses by mass spectrometry of Schwann cells and pancreatic cancer cells cultured alone or in combination highlighted the central role of TGFβ in neuro-epithelial interactions, as illustrated by proteomic signatures related to cell adhesion and motility. Altogether, these results demonstrate that Schwann cells are a meaningful source of TGFβ in PDAC, which plays a crucial role in the acquisition of aggressive properties by pancreatic cancer cells

<p>The incidence of breast cancer is rising steadily in Sweden and the proportion of carcinoma in situ (CIS) has increased appreciably, most likely due to mammography screening. The aim of this study was twofold: (1) to examine risk factors for subsequent invasive breast carcinoma and breast cancer death after primary ductal carcinoma in situ (DCIS) and (2) to study the biology in the progress between in situ and invasive carcinoma.</p><p> In a cohort-study based on 3,398 women with a primary CIS reported to the Swedish Cancer Registry (SCR) 1980-1992, women diagnosed in 1989-1992 ran a relative risk of 0.1 (CI 95%, 0.0-0.9) from dying of breast cancer as compared with women diagnosed in 1980-1982. Women in counties with mammography screening ran a relative risk of 0.2 (CI 95%, 0.0-2.1) for breast cancer death in comparison with women in non-screening counties.</p><p> In a case-control study derived from all 4,661 women with primary CIS reported to the SCR 1960-1992, we investigated risk factors for subsequent invasive breast carcinoma (n=118) and breast cancer death (n=39). Large size and multifocality were found to increase the risk for breast cancer death. Postoperative radiotherapy and mastectomy lowered the risk for ipsilateral invasive cancer.</p><p> The standardised incidence rates (SIR) for invasive breast cancer were estimated in the cohort from 1980-1992. The SIR after primary DCIS and primary lobular carcinoma in situ (LCIS) was 4.5 (CI 95%, 3.7-5.5) and 4.0 (CI 95%, 2.1-7.5), respectively.</p><p> New histopathological classification systems for DCIS were evaluated in 195 women consecutively diagnosed with primary DCIS between 1986-1994. One group with highly differentiated lesions was defined with the EORTC classification system and had an excellent prognosis.</p><p> Histopathological grade and expression of p53, c-erbB-2, Ki 67, hormone receptors, Bcl-2 and angiogenesis were compared in 626 women with either a pure DCIS, a small invasive carcinoma or a lesion with both an invasive and in situ component. When grade was taken into account, no change in tumour markers could be detected that signalled the progression from an in situ stage to invasiveness. All tumour markers correlated to grade and their distribution was very similar in the two components of mixed lesions.</p>

The incidence of breast cancer is rising steadily in Sweden and the proportion of carcinoma in situ (CIS) has increased appreciably, most likely due to mammography screening. The aim of this study was twofold: (1) to examine risk factors for subsequent invasive breast carcinoma and breast cancer death after primary ductal carcinoma in situ (DCIS) and (2) to study the biology in the progress between in situ and invasive carcinoma. In a cohort-study based on 3,398 women with a primary CIS reported to the Swedish Cancer Registry (SCR) 1980-1992, women diagnosed in 1989-1992 ran a relative risk of 0.1 (CI 95%, 0.0-0.9) from dying of breast cancer as compared with women diagnosed in 1980-1982. Women in counties with mammography screening ran a relative risk of 0.2 (CI 95%, 0.0-2.1) for breast cancer death in comparison with women in non-screening counties. In a case-control study derived from all 4,661 women with primary CIS reported to the SCR 1960-1992, we investigated risk factors for subsequent invasive breast carcinoma (n=118) and breast cancer death (n=39). Large size and multifocality were found to increase the risk for breast cancer death. Postoperative radiotherapy and mastectomy lowered the risk for ipsilateral invasive cancer. The standardised incidence rates (SIR) for invasive breast cancer were estimated in the cohort from 1980-1992. The SIR after primary DCIS and primary lobular carcinoma in situ (LCIS) was 4.5 (CI 95%, 3.7-5.5) and 4.0 (CI 95%, 2.1-7.5), respectively. New histopathological classification systems for DCIS were evaluated in 195 women consecutively diagnosed with primary DCIS between 1986-1994. One group with highly differentiated lesions was defined with the EORTC classification system and had an excellent prognosis. Histopathological grade and expression of p53, c-erbB-2, Ki 67, hormone receptors, Bcl-2 and angiogenesis were compared in 626 women with either a pure DCIS, a small invasive carcinoma or a lesion with both an invasive and in situ component. When grade was taken into account, no change in tumour markers could be detected that signalled the progression from an in situ stage to invasiveness. All tumour markers correlated to grade and their distribution was very similar in the two components of mixed lesions.

Since its introduction, contrast-enhanced ultrasonography (CEUS) has significantly extended the value of ultrasonography (US). CEUS can be used to more accurately determine pancreatic lesions compared to conventional US or to characterize lesions already detectable by US. Thus, CEUS can aid in the differential diagnosis of pancreatic tumors. Using US contrast media, it is possible to visually detect microvessels in the majority of pancreatic ductal adenocarcinomas. Thus, the use of quantitatively evaluated transabdominal CEUS can help in the differentiation of patients with mass-forming pancreatitis from patients with pancreatic adenocarcinomas. In neuroendocrine pancreatic tumors, different enhancement patterns can be observed in relation to the tumor mass: larger ones show a rapid early enhancement sometimes combined with necrotic central structures, and smaller ones disclose a capillary-blush enhancement. Pseudocysts, the most widespread cystic lesions of the pancreas, are not vascularized. They do not show any signal in CEUS and remain entirely anechoic in all phases, while true cystic pancreatic tumors usually have vascularized septa and parietal nodules. In summary, CEUS is effective for differentiating solid pancreatic tumors in most cases. CEUS is safe and cost effective and can better discriminate solid from cystic pancreatic lesions, thereby directing further imaging modalities. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Pancreatic acinar cells display plasticity to acquire distinct differentiation programs, being involved in diseases as chronic pancreatitis and pancreatic ductal adenocarcinoma. This work shows that acinar cells cultured in suspension undergo dedifferentiation, acquiring a pancreatic embryonic progenitor phenotype. Dedifferentiated cells turn on a senescent program, associated with activation of p53 and Ras pathways. A similar progenitor‐like phenotype with activation of senescence is present in experimental chronic pancreatitis. Acinar cultures lacking p53 overcome growth arrest and lose the pancreatic phenotype, undergoing an epithelial‐mesenchymal transition, while maintaining the expression of pre‐pancreatic endoderm and stem cell markers. In experimental acute pancreatitis, absence of p53 results in increased acinar cell proliferation and delayed regeneration. Our findings support a role for acinar cell dedifferentiation in the initiation of pancreatic diseases. A p53‐ dependent control of cell growth and epithelial differentiation constitutes a tumor suppressive mechanism that may limit PDAC development. / Las células pancreáticas acinares poseen plasticidad que les permite adquirir distintos programas de diferenciación, estando implicadas en enfermedades como la pancreatitis crónica y el adenocarcinoma ductal pancreático. En este trabajo hemos demostrado que las células acinares cultivadas en suspensión se desdiferencian, adquiriendo un fenotipo de progenitores pancreáticos embrionarios. En estas células se induce un programa de senescencia asociado con la activación de las vías de p53 y Ras. Un fenotipo similar se evidencia en modelos de pancreatitis crónica experimental. Cultivos acinares en los que se ha inactivado p53 sobrepasan el bloqueo de crecimiento y pierden el fenotipo pancreático, presentando una transición epitelio‐mesenquimal y manteniendo la expresión de marcadores de endodermo pre‐pancreático y de células madre. Durante la inducción de una pancreatitis aguda experimental, la ausencia de p53 resulta en un incremento de la proliferación acinar y en un retraso en la regeneración. Nuestros resultados demuestran que la desdiferenciación de las células acinares participa en el desarrollo de enfermedades pancreáticas. El control del crecimiento celular y de la diferenciación pancreática epitelial dependiente de p53 constituye un mecanismo de supresión tumoral que puede limitar el desarrollo del PDAC.

L’adénocarcinome canalaire du pancréas (PDAC) est un des cancers les plus agressifs avec un taux de survie à 5 ans de moins de 5 %. Une des raisons est l’absence de traitement thérapeutique efficace. Des efforts afin d’identifier de nouvelles cibles pour le traitement du PDAC sont donc nécessaires. Il a été démontré que la dénervation du pancréas régule la progression des PDAC dans des modèles murins. De plus, on a rapporté que les axones du système nerveux périphérique (SNP) innervent les tumeurs pancréatiques, mais l'identité précise des fibres infiltrant la tumeur est inconnue.Ici, nous avons caractérisé le remodelage des principales divisions du SNP, y compris les systèmes autonomes et sensoriels, dans des modèles murins qui récapitulent la maladie humaine. Nous avons aussi commencé à caractériser l'innervation des PDAC dans des échantillons humains. Nous avons observé une augmentation de la densité des fibres sympathiques positives pour la tyrosine hydroxylase (TH) dans les lésions pré-tumorales du pancréas, alors qu'une forte densité de fibres sensorielles positives pour le peptide lié au gène de la calcitonine (CGRP) a été observée dans les PDAC. Fait intéressant, alors que dans tissus normaux les axones sympathiques et sensoriels sont principalement associés aux vaisseaux sanguins, ils sont majoritairement isolés dans les lésions pré-tumorales et les PDAC. Ces données suggèrent que la plasticité axonale survient aux stades précoces du développement tumoral pour les fibres sympathiques et à un stade plus tardif pour les fibres sensorielles. Ce travail suggère de nouvelles cibles potentielles pour le traitement des PDAC. / Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with 5-year survival rate of less than 5%. One reason to explain this poor outcome is that there has been no effective therapeutic treatment for PDAC patients. Thus, efforts to identify novel targets for PDAC treatment are required. Denervation of the pancreas has been shown to regulate PDAC progression in murine models. In addition, axons of the peripheral nervous system (PNS) have been reported to innervate pancreatic tumors, but the precise identity of the tumor-infiltrating fibers is unknown. Here we characterized the remodeling of the main divisions of the PNS, including autonomic and sensory systems, in mouse models, which recapitulate the human disease. We also started to characterize the innervation of human PDAC samples. We observed an increased density of tyrosine hydroxylase (TH)-positive sympathetic fibers in pre-tumoral lesions of the pancreas, while a high density of calcitonin gene-related peptide (CGRP)-positive sensory fibers was seen within PDAC. Interestingly, whereas in the normal tissues TH+ and CGRP+ axons were mostly associated to blood vessels, they were mainly isolated in lesions and PDAC. These data suggest that axonal plasticity occurs at the early stage of tumor development for sympathetic fibers and at the late stage for sensory fibers. This work suggests potential novel targets for the treatment of PDAC.

O adenocarcinoma pancreático (PDAC) é uma neoplasia de difícil diagnóstico precoce e cujo tratamento não tem apresentado avanços expressivos desde a última década. As tecnologias de sequenciamento de nova geração (next generation sequencing - NGS) podem trazer importantes avanços para a busca de novos marcadores para diagnóstico de PDACs, podendo também contribuir para o desenvolvimento de terapias individualizadas. Bancos de dados são ferramentas poderosas para integração, padronização e armazenamento de grandes volumes de informação. O objetivo do presente estudo foi modelar e implementar um banco de dados relacional (CaRDIGAn - Cancer Relational Database for Integration and Genomic Analysis) que integra dados disponíveis publicamente, provenientes de experimentos de NGS de amostras de diferentes tipos histopatológicos de PDAC, com dados gerados por nosso grupo no IQ-USP, facilitando a comparação entre os mesmos. A funcionalidade do CaRDIGAn foi demonstrada através da recuperação de dados clínicos e dados de expressão gênica de pacientes a partir de listas de genes candidatos, associados com mutação no oncogene KRAS ou diferencialmente expressos em tumores identificados em dados de RNAseq gerados em nosso grupo. Os dados recuperados foram utilizados para a análise de curvas de sobrevida que resultou na identificação de 11 genes com potencial prognóstico no câncer de pâncreas, ilustrando o potencial da ferramenta para facilitar a análise, organização e priorização de novos alvos biomarcadores para o diagnóstico molecular do PDAC. / Pancreatic Ductal Adenocarcinoma (PDAC) is a type of cancer difficult to diagnose early on and treatment has not improved over the last decade. Next Generation Sequencing (NGS) technology may contribute to discover new biomarkers, develop diagnose strategies and personalised therapy applications. Databases are powerfull tools for data integration, normalization and storage of large data volumes. The main objective of this study was the design and implementation of a relational database to integrate publicly available data of NGS experiments of PDAC pacients with data generated in by our group at IQ-USP, alowing comparisson between both data sources. The database was called CaRDIGAn (Cancer Relational Database for Integration and Genomic Analysis) and its funcionalities were tested by retrieving clinical and expression data of public data of genes differencially expressed genes in our samples or genes associated with KRAS mutation. The output of those queries were used to fit survival curves of patients, which led to the identification of 11 genes potencially usefull for PDAC prognosis. Thus, CaRDIGAn is a tool for data storage and analysis, with promissing applications to identification and priorization of new biomarkers for molecular diagnosis in PDAC.