Abstract. Pancreatic cancer (PaCa) is the fourth leading cause of cancer deaths in Western societies, with pancreatic ductal adenocarcinomas (PDACs) accounting for >90% of such cases. PDAC is a heterogeneous disease that includes a subset showing overexpression of the secreted glycoprotein Dickkopfrelated protein 3 (Dkk-3), a protein shown to be downregulated in various cancers of different tissues. The biological function of Dkk-3 in this subset was studied using the Dkk-3 expressing PANC-1 cell line as a model for PDACs. The influence of Dkk-3 overexpression and knockdown on cellular differentiation and proliferation of PANC-1 was investigated. Confocal microscopy showed that Dkk-3 was expressed in a fraction of PANC-1 cells. While lentiviral-mediated overexpression of DKK3 did not alter cellular proliferation, knockdown of DKK3 resulted in significant reduction of cellular proliferation and concomitant induction of cell cycle inhibitors CDKN2B (p15 ). In parallel, pancreatic epithelial cell differentiation markers AMY2A, CELA1, CTRB1, GCG, GLB1 and INS were significantly upregulated. PANC-1 cells differentiated using exendin-4showed analogous induction of cell cycle inhibitors and differentiation markers. Thus, we conclude that Dkk-3 is required to maintain a highly dedifferentiated and consequently proliferative state in PANC-1, indicating a similar function in the Dkk-3 overexpressing subset of PDACs. Therefore, Dkk-3 represents a potential target for the treatment of Dkk-3-positive subtypes of PaCa to drive cells into cell cycle arrest and differentiation.
IntroductionPancreatic cancer (PaCa) is the fourth leading cause of cancer deaths in Western societies. In 2008, there were an estimated 68,500 new cases and 70,200 deaths from the disease in the European Union (1), indicating incidence rates approximately equal to mortality. Clearly PaCa has an extremely poor prognosis, with a five-year relative survival rate of only 5% (2). Because PaCa-specific symptoms occur late in the course of the disease, for the majority of patients curative resections are not usually possible. Median survival from time of diagnosis is 3.5 months for patients who were not resected and 13.3 months for those who underwent resection (3). Thus, novel targets for early detection and therapy of PaCas are urgently needed. A better understanding of the underlying molecular and cellular changes associated with dedifferentiation and proliferation of pancreatic tumor cells is a prerequisite to achieve this purpose.The secreted glycoprotein Dickkopf-related protein 3 (Dkk-3) is the most divergent member of the human Dickkopf family (4,5) and, in contrast to other family members, does not modulate Wnt signaling (6,7). Dkk-3 has been proposed to represent a novel tumor suppressor since gene expression is downregulated in various tumor cells (8-12), and hypermethylation of its promoter correlates with cancer occurrence (13,14). However, overexpression of Dkk-3 does not influence proliferation of malignant and non-malignant prostate cells (15)....