Abstract
Abstract Content:
Pancreatic ductal
adenocarcinoma (PDAC), is the leading histological type of pancreatic cancer
with incidence rising and a very high mortality within one year of diagnosis.
We have pioneered the concept that the highly coordinated hyperactivity of
pancreatic cancer stem cell self-renewal, cell proliferation, angiogenesis,
metastatic potential and drug resistance is regulated by neurotransmitter
receptors that are the recipients of signals from the autonomic nervous system.
We as well as others have thus shown that either stress or drug-induced
hyperactivity of the sympathetic branch of the autonomic nervous system,
resulting in systemic increases of the catecholamine neurotransmitters
epinephrine and norepinephrine, significantly stimulated the growth of PDAC in
mouse xenografts via hyperactive cAMP-dependent signaling downstream of Gs-coupled
beta-adrenergic receptors. Treatment of the animals with g-aminobutyric acid
(GABA) completely reversed this effect via inhibition of cAMP formation in
response to binding of GABA to Gi-coupled GABAB receptors. The general
beta-blocker propranolol had similar effects via inhibition of cAMP formation
downstream of Gs-coupled beta-adrenergic receptors. Using a hamster model of
pancreatitis-associated PDAC, we additionally showed that treatment of the
animals with GABA effectively prevented the development of PDAC. Stress
reduction via environmental enrichment also significantly reduced the
development and progression of PDAC xenografts in mice. In each of these animal
models, the observed inhibition of PDAC growth and progression was accompanied
by decreases in cAMP-dependent signaling of multiple proteins associated
with cell proliferation, cell migration, stem cell self-renewal and
angiogenesis. In vitro investigations with human PDAC cell lines confirmed the
central role of cAMP hyperactivity downstream of Gs-coupled receptors as the
driving force of PDAC growth suggested by the animal experiments. Collectively,
these findings identify the opposing roles of PDAC stimulating Gs-coupled
neurotransmitter receptors and PDAC inhibiting Gi-coupled neurotransmitter
receptors as promising novel targets that can be successfully used for the
prevention and therapy of PDAC by restoration of cAMP homeostasis via
psychological as well as pharmacological agents that are already widely used
for the therapy of several non-neoplastic diseases.
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