[HTML][HTML] Vitamin D receptor-mediated stromal reprogramming suppresses pancreatitis and enhances pancreatic cancer therapy

MH Sherman, TY Ruth, DD Engle, N Ding, AR Atkins… - Cell, 2014 - cell.com
MH Sherman, TY Ruth, DD Engle, N Ding, AR Atkins, H Tiriac, EA Collisson, F Connor…
Cell, 2014cell.com
The poor clinical outcome in pancreatic ductal adenocarcinoma (PDA) is attributed to
intrinsic chemoresistance and a growth-permissive tumor microenvironment. Conversion of
quiescent to activated pancreatic stellate cells (PSCs) drives the severe stromal reaction that
characterizes PDA. Here, we reveal that the vitamin D receptor (VDR) is expressed in stroma
from human pancreatic tumors and that treatment with the VDR ligand calcipotriol markedly
reduced markers of inflammation and fibrosis in pancreatitis and human tumor stroma. We …
Summary
The poor clinical outcome in pancreatic ductal adenocarcinoma (PDA) is attributed to intrinsic chemoresistance and a growth-permissive tumor microenvironment. Conversion of quiescent to activated pancreatic stellate cells (PSCs) drives the severe stromal reaction that characterizes PDA. Here, we reveal that the vitamin D receptor (VDR) is expressed in stroma from human pancreatic tumors and that treatment with the VDR ligand calcipotriol markedly reduced markers of inflammation and fibrosis in pancreatitis and human tumor stroma. We show that VDR acts as a master transcriptional regulator of PSCs to reprise the quiescent state, resulting in induced stromal remodeling, increased intratumoral gemcitabine, reduced tumor volume, and a 57% increase in survival compared to chemotherapy alone. This work describes a molecular strategy through which transcriptional reprogramming of tumor stroma enables chemotherapeutic response and suggests vitamin D priming as an adjunct in PDA therapy.
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