Summary
The mutant form of the GTPase KRAS is a key driver of pancreatic cancer
but remains a challenging therapeutic target. Exosomes, extracellular vesicles
generated by all cells, are naturally present in the blood. Here we demonstrate
that enhanced retention of exosomes in circulation, compared to liposomes, is
due to CD47 mediated protection of exosomes from phagocytosis by monocytes and
macrophages. Exosomes derived from normal fibroblast-like mesenchymal cells were
engineered to carry siRNA or shRNA specific to oncogenic KRASG12D
(iExosomes), a common mutation in pancreatic cancer. Compared to liposomes,
iExosomes target oncogenic Kras with an enhanced efficacy that is dependent on
CD47, and is facilitated by macropinocytosis. iExosomes treatment suppressed
cancer in multiple mouse models of pancreatic cancer and significantly increased
their overall survival. Our results inform on a novel approach for direct and
specific targeting of oncogenic Kras in tumors using iExosomes.
Superoxide production contributes to osteoclastic bone resorption. Evidence strongly indicates that NADPH oxidase is an enzyme system responsible for superoxide generation in osteoclasts. A membranebound subunit, p91, is the catalytic domain of NADPH oxidase. However, osteoclasts from p91 knockout mice still produce superoxide at a rate similar to that observed in wild type mice. This unexpected phenomenon prompted us to examine the osteoclasts for an alternative to the p91-containing oxidase. In this study, the cloning of a NADPH oxidase subunit (Nox 4) with 578 amino acids is reported. Nox 4 has 58% similarity in amino acids with the known p91 subunit of NADPH oxidase. Nox 4 is present and active in osteoclasts. Antisense oligonucleotides of Nox 4 reduced osteoclastic superoxide generation as well as resorption pit formation by osteoclasts. This new oxidase complex was present and functional in osteoclasts from p91 knockout mice, explaining the normal resorptive activity seen in the osteoclasts where no p91 is present.
Pancreatic cancer presents with a dismal mortality rate and is in urgent need of methods for early detection with potential for timely intervention. All living cells, including cancer cells, generate exosomes. We previously discovered double stranded genomic DNA in exosomes derived from the circulation of pancreatic cancer patients, which enabled the detection of prevalent mutations associated with the disease. Here, we report a proof-of-concept study that demonstrates the potential clinical utility of circulating exosomal DNA for identification of KRAS and TP53 mutations in patients with pancreas-associated pathologies, including pancreatic ductal adenocarcinoma (PDAC), chronic pancreatitis (CP) and intraductal papillary mucinous neoplasm (IPMN), and in healthy human subjects. In 48 clinically annotated serum samples from PDAC patients, digital PCR analyses of exosomal DNA identified KRAS mutation in 39.6% of cases, and TP53 mutation in 4.2% of cases. KRAS and TP53 mutations were also detected in exosomal DNA from IPMN patients (2 out of 7 with KRAS, one of which also co-presented with TP53 mutation). Circulating exosomal DNA in 5 out of 9 CP patients enabled the detection of KRAS mutation. In 114 healthy subject-derived circulating exosomal DNA, 2.6% presented with KRAS mutation and none with TP53 mutation. This study highlights the value of circulating exosomal DNA for a rapid, low-cost identification of cancer driving mutations. The identification of mutations in IPMN patients and healthy subjects suggests that liquid biopsies may allow potential assessment of cancer risk but with a cautionary note that detection of clinical cancer cannot be assumed.
The tumor microenvironment in pancreatic ductal adenocarcinoma (PDAC) involves a significant accumulation of fibroblasts as part of the host response to cancer. Employing single-cell RNA-sequencing, multiplex immunostaining, and several genetic mouse models, we identify carcinoma-associated fibroblasts (CAFs) with opposing functions in PDAC progression. Depletion of fibroblast activation protein (FAP)+ CAFs results in increased survival, in contrast to depletion of alpha smooth muscle actin (aSMA)+ CAFs that leads to decreased survival. Tumor-promoting FAP+ CAFs (TP-CAFs) and tumor-restraining aSMA+ CAFs (TR-CAFs) differentially regulate cancer-associated pathways and accumulation of Tregs. Improved efficacy of gemcitabine is observed when IL-6 is deleted from aSMA+ CAFs but not from FAP+ CAFs employing dual-recombinase genetic PDAC models. Improved gemcitabine efficacy due to lack of IL-6 synergizes with anti-PD1 immunotherapy to significantly improve survival of PDAC mice. Our study identifies functional heterogeneity of CAFs in PDAC progression and their different roles in therapy response.
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