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Exosomes in Pancreatic Cancer: from Early Detection to Treatment

Journal of Gastrointestinal Surgery volume 22, pages 737–750 (2018)Cite this article

Abstract

Background

Pancreatic cancer (PC) remains one of the most fatal forms of cancer worldwide with incidence nearly equal to mortality. This is often attributed to the fact that diagnosis is often not made until later disease stages when treatment proves difficult. Efforts have been made to reduce the mortality of PC through improvements in early screening techniques and treatments of late-stage disease. Exosomes, small extracellular vesicles involved in cellular communication, have shown promise in helping understand PC disease biology.

Methods

In this review, we discuss current studies of the role of exosomes in PC physiology, and their potential use as diagnostic and treatment tools.

Results

Exosomes have a role in diagnosing pancreatic cancer and in understanding tumor biology including migration, proliferation, chemoresistance, immunosuppression, cachexia and diabetes, and have a potential role in therapy for pancreatic cancer.

Conclusions

Exosomal analysis is beneficial in demonstrating mechanisms behind PC growth and metastasis, immunosuppression, drug resistance, and paraneoplastic conditions. Furthermore, the use of exosomes can be beneficial in detecting early-stage PC and exosomes have potential applications as therapeutic targets.

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Abbreviations

AM:

Adrenomedullin

ABCG2:

ATP-binding cassette sub-family G member 2

Ca 19-9:

Carbohydrate antigen 19-9

CAF:

Cancer-associated fibroblast cells

cfDNA:

Cell-free deoxyribonucleic acid

cfRNA:

Cell-free ribonucleic acid

DCs:

Dendritic cells

DNA:

Deoxyribonucleic acid

EVs:

Extracellular vesicles

FDA:

Federal Drug Administration

GIPC:

GAIP-interacting protein C terminus

GEM:

Gemcitabine

hStCs:

Hepatic stellate cells

IL-12:

Interleukin-12

IPMN:

Intraductal papillary mucinous neoplasm

MHC:

Major histocompatibility complex

MIF:

Macrophage inhibitory factor

miRNA:

Microribonucleic acid

NK:

Natural killer

PC:

Pancreatic cancer

PCIC:

Pancreatic cancer-initiating cell

PDAC:

Pancreatic ductal adenocarcinoma

PSCs:

Pancreatic stellate cells

RFXAP:

Regulatory factor X-associated protein

RNA:

Ribonucleic acid

UPR:

Unfolded protein response

TAMs:

Tumor-associated macrophages

TLR-4:

Toll-like receptor-4

TNF-α:

Tumor necrosis factor-alpha

TGF-β:

Tumor growth factor-beta

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Authorship

Emily Armstrong, Eliza Beal, Jeffery Chakedis, Anghela Paredes, Demetrios Moris, Timothy Pawlik, Carl Schmidt, and Mary Dillhoff conceived the idea for the project. Eliza Beal and Emily Armstrong performed the literature review. Emily Armstrong, Eliza Beal, Jeffery Chakedis, Anghela Paredes, Demetrios Moris, Timothy Pawlik, Carl Schmidt, and Mary Dillhoff prepared the manuscript, provided critical review and revision, approved the final version to be submitted, and agree to be accountable for all aspects of the work.

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Affiliations

  1. The Ohio State University College of Medicine, Columbus, OH, 43210, USA

    Emily A. Armstrong

  2. Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, 320 W 10th Ave. M256 Starling Loving Hall, Columbus, OH, 43210, USA

    Eliza W. Beal, Jeffery Chakedis, Anghela Z. Paredes, Demetrios Moris, Timothy M. Pawlik, Carl R. Schmidt & Mary E. Dillhoff

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  1. Emily A. Armstrong
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  2. Eliza W. Beal
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Correspondence to Eliza W. Beal.

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Armstrong, E.A., Beal, E.W., Chakedis, J. et al. Exosomes in Pancreatic Cancer: from Early Detection to Treatment. J Gastrointest Surg 22, 737–750 (2018). https://doi.org/10.1007/s11605-018-3693-1

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  • DOI: https://doi.org/10.1007/s11605-018-3693-1

Keywords

  • Exosomes
  • Pancreatic cancer
  • Early detection of cancer