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Cortese N, Capretti G, Barbagallo M, Rigamonti A, Takis PG, Castino GF, Vignali D, Maggi G, Gavazzi F, Ridolfi C, Nappo G, Donisi G, Erreni M, Avigni R, Rahal D, Spaggiari P, Roncalli M, Cappello P, Novelli F, Monti P, Zerbi A, Allavena P, Mantovani A, Marchesi F. Metabolome of Pancreatic Juice Delineates Distinct Clinical Profiles of Pancreatic Cancer and Reveals a Link between Glucose Metabolism and PD-1 + Cells. Cancer Immunol Res 2020; 8:493-505. [PMID: 32019781 DOI: 10.1158/2326-6066.cir-19-0403] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 10/30/2019] [Accepted: 01/28/2020] [Indexed: 11/16/2022]
Abstract
Better understanding of pancreatic diseases, including pancreatic ductal adenocarcinoma (PDAC), is an urgent medical need, with little advances in preoperative differential diagnosis, preventing rational selection of therapeutic strategies. The clinical management of pancreatic cancer patients would benefit from the identification of variables distinctively associated with the multiplicity of pancreatic disorders. We investigated, by 1H nuclear magnetic resonance, the metabolomic fingerprint of pancreatic juice (the biofluid that collects pancreatic products) in 40 patients with different pancreatic diseases. Metabolic variables discriminated PDAC from other less aggressive pancreatic diseases and identified metabolic clusters of patients with distinct clinical behaviors. PDAC specimens were overtly glycolytic, with significant accumulation of lactate, which was probed as a disease-specific variable in pancreatic juice from a larger cohort of 106 patients. In human PDAC sections, high expression of the glucose transporter GLUT-1 correlated with tumor grade and a higher density of PD-1+ T cells, suggesting their accumulation in glycolytic tumors. In a preclinical model, PD-1+ CD8 tumor-infiltrating lymphocytes differentially infiltrated PDAC tumors obtained from cell lines with different metabolic consumption, and tumors metabolically rewired by knocking down the phosphofructokinase (Pfkm) gene displayed a decrease in PD-1+ cell infiltration. Collectively, we introduced pancreatic juice as a valuable source of metabolic variables that could contribute to differential diagnosis. The correlation of metabolic markers with immune infiltration suggests that upfront evaluation of the metabolic profile of PDAC patients could foster the introduction of immunotherapeutic approaches for pancreatic cancer.
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Affiliation(s)
- Nina Cortese
- Department of Immunology and Inflammation, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Giovanni Capretti
- Section of Pancreatic Surgery, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy.,Humanitas University, Department of Biomedical Sciences, Pieve Emanuele-Milan, Italy
| | - Marialuisa Barbagallo
- Department of Immunology and Inflammation, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Alessandra Rigamonti
- Department of Immunology and Inflammation, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy.,Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Panteleimon G Takis
- Giotto Biotech S.R.L., Sesto Fiorentino, Florence, Italy.,Department of Metabolism, Digestion and Reproduction, National Phenome Centre, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Giovanni F Castino
- Department of Immunology and Inflammation, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Debora Vignali
- San Raffaele Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giulia Maggi
- Department of Immunology and Inflammation, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy.,Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Francesca Gavazzi
- Section of Pancreatic Surgery, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Cristina Ridolfi
- Section of Pancreatic Surgery, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Gennaro Nappo
- Section of Pancreatic Surgery, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Greta Donisi
- Section of Pancreatic Surgery, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Marco Erreni
- Unit of Advanced Optical Microscopy, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Roberta Avigni
- Department of Immunology and Inflammation, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Daoud Rahal
- Department of Pathology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Paola Spaggiari
- Department of Pathology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Massimo Roncalli
- Humanitas University, Department of Biomedical Sciences, Pieve Emanuele-Milan, Italy.,Department of Pathology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Paola Cappello
- Center for Experimental Research and Medical Studies, Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Francesco Novelli
- Center for Experimental Research and Medical Studies, Città della Salute e della Scienza di Torino and Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Paolo Monti
- San Raffaele Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alessandro Zerbi
- Section of Pancreatic Surgery, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy.,Humanitas University, Department of Biomedical Sciences, Pieve Emanuele-Milan, Italy
| | - Paola Allavena
- Department of Immunology and Inflammation, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Alberto Mantovani
- Department of Immunology and Inflammation, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy.,Humanitas University, Department of Biomedical Sciences, Pieve Emanuele-Milan, Italy.,The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - Federica Marchesi
- Department of Immunology and Inflammation, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy. .,Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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