Mucin (Muc) expression during pancreatic cancer progression in spontaneous mouse model: potential implications for diagnosis and therapy
© Rachagani et al.; licensee BioMed Central Ltd. 2012
Received: 8 September 2012
Accepted: 15 October 2012
Published: 26 October 2012
Pancreatic cancer (PC) is a lethal malignancy primarily driven by activated Kras mutations and characterized by the deregulation of several genes including mucins. Previous studies on mucins have identified their significant role in both benign and malignant human diseases including PC progression and metastasis. However, the initiation of MUC expression during PC remains unknown because of lack of early stage tumor tissues from PC patients.
In the present study, we have evaluated stage specific expression patterns of mucins during mouse PC progression in (KrasG12D;Pdx1-Cre (KC)) murine PC model from pancreatic intraepithelial neoplasia (PanIN) to pancreatic ductal adenocarcinoma (PDAC) by immunohistochemistry and quantitative real-time PCR.
In agreement with previous studies on human PC, we observed a progressive increase in the expression of mucins particularly Muc1, Muc4 and Muc5AC in the pancreas of KC (as early as PanIN I) mice with advancement of PanIN lesions and PDAC both at mRNA and protein levels. Additionally, mucin expression correlated with the increased expression of inflammatory cytokines IFN-γ (p < 0.0062), CXCL1 (p < 0.00014) and CXCL2 (p < 0.08) in the pancreas of KC mice, which are known to induce mucin expression. Further, we also observed progressive increase in inflammation in pancreas of KC mice from 10 to 50 weeks of age as indicated by the increase in the macrophage infiltration. Overall, this study corroborates with previous human studies that indicated the aberrant overexpression of MUC1, MUC4 and MUC5AC mucins during the progression of PC.
Our study reinforces the potential utility of the KC murine model for determining the functional role of mucins in PC pathogenesis by crossing KC mice with corresponding mucin knockout mice and evaluating mucin based diagnostic and therapeutic approaches for lethal PC.
KeywordsMucins Inflammatory cytokines KrasG12D mouse model
Pancreatic cancer (PC) has an extremely poor prognosis with a five year survival rate of less than 6%  and a median survival of approximately 5-6 months after being diagnosed. This high mortality rate of PC is due to its late clinical presentation with approximately 80% of the patients having metastatic disease at the time of diagnosis . Further, PC exhibits an unusual resistance to current chemo- and radiotherapies, which are mainly directed for palliative care . Early detection of PC remains a clinical challenge because of its silent nature, retroperitoneal location, small size of precursor lesions and unavailability of early stage tissue and serum samples from PC patients.
Molecules that are specifically overexpressed in tumor tissues not only serve as useful diagnostic markers but also as potential targets for therapeutic intervention. Serum-based molecular markers such as cancer antigen 125 (CA125), antigen SC6 (SC6-Ag), pyruvate kinase isoenzyme type 2 (M2-PK), macrophage inhibitory cytokine 1 (MIC-1)  and the most commonly used PC marker CA19-9 lack sensitivity, specificity or reproducibility and hence cannot be used routinely for diagnosing PC. Due to unavailability of early stage PC tissues, genetically engineered mouse models of PC progression serve as a reliable source of early stage lesions and serum samples and can potentially help in understanding the molecular alterations at the earliest stages of the disease for identifying potential biomarkers and novel targets for therapeutic intervention.
Mucins are high molecular weight glycoproteins that form a physical barrier to protect the epithelial cells under normal physiological conditions. However, alterations in mucin expression, localization or glycosylation patterns have been associated with cancer development and contribute to enhanced transformation, cancer cell growth, and decreased immune surveillance [5, 6]. Further, due to their aberrant overexpression in several epithelial malignancies [7, 8], mucins are recognized as attractive targets for therapy and diagnosis . Our previous studies have established that human PC is characterized by an altered pattern of mucin expression at different stages of tumor progression [10, 11].
MUC1, MUC4, MUC5AC are the most differentially overexpressed mucins in human PC [8, 10, 11]. While MUC4 and MUC5AC are undetectable in benign pancreatic diseases and normal pancreas [10, 11], their expression increases progressively with the advancement of PC to an extent that both genes are among the top differentially overexpressed genes in PC . Importantly, overexpression of MUC1, MUC4 and MUC5AC are associated with poor survival [13, 14] and serve as potential tumor markers for PC . MUC1 is a transmembrane glycoprotein that is expressed in normal pancreas  but overexpressed and aberrantly glycosylated in >90% of metastatic PDAC and its aberrant expression has been associated with increased metastasis and poor prognosis of PC and other cancers [8, 17–19]. Knock-down of MUC1 and MUC4 expression decreases growth and metastatic potential of PC cells indicating that mucins play a functional role in PC progression [5, 20, 21].
While mucins have been studied extensively in late stage clinical samples and PC cell lines, limited information is available on early stage lesions of PC because precursor lesions observed in patient samples are in tandem with the aggressive form of the disease. Thus, mucin expression in these early lesions is suggestive but not definitive as an early event in PC. Due to the lack of availability of early-stage tissues and samples from patients, the expression profiles of mucins and their true potential as early biomarkers of PC remains to be tested. Since MUC1, MUC4 and MUC5AC have considerable homology with their murine counterparts [22–25], the present study was aimed to determine the expression profile of Muc1, Muc4 and Muc5ac in KrasG12D spontaneous mouse model for PC. This mouse model closely recapitulate the genetic and histopathological features of human PC, and therefore it can potentially help in understanding the molecular alterations at earliest stages of the malignant disease for identifying potential biomarkers and novel therapeutic targets. Hence, they serve as suitable preclinical models to evaluate therapeutic and preventive strategies and provide a rare opportunity to identify and validate mucin based early biomarkers for PC .
The B6.129-Krastm4Tyj (01XJ6) and B6. FVB-Tg (Ipf1-cre)1Tuv (01XL5) mice were obtained from the NCI Mouse Models of Human Cancers Consortium (MMHCC) (Frederick, MD, USA). These animals (LSL-KrasG12D and Pdx1-Cre) were crossed to remove the LSL cassette in order to activate Kras G12D (KrasG12D;Pdx1-Cre/floxed KrasG12D) allele in the pancreas of the mouse. The F1 progeny was genotyped for Kras as well as Pdx1-Cre by using specific primers for Kras and Pdx1-Cre by Polymerase chain reaction (PCR). Animals that were positive for Kras G12D and Pdx1-Cre expressed the mutated Kras G12D allele in the pancreas. The floxed Kras G12D animals (positive for both Kras and Pdx1-Cre) and their contemporary littermates positive for either LSLKras G12D or Pdx1-Cre were euthanized at 7, 10, 25, 30, 40 and 50 weeks of age (eight animals/group/time point). Throughout the experiment, animals were provided with food and water ad libitum and subjected to a 12-h dark/light cycle. Animal studies were performed in accordance with the U.S. Public Health Service “Guidelines for the Care and Use of Laboratory Animals” under an approved protocol by the University of Nebraska Medical Center Institutional Animal Care and Use Committee (IACUC).
DNA isolation and genotyping
Animals were tail clipped at 10-14 days of age and DNA was isolated using standard protocol (Maxwell 16 mouse tail DNA purification kit, Promega, Madison, WI, USA). The genotyping of Kras and Pdx1-Cre was performed by PCR using the following primer sequences Kras K006F-5’-CCT TTA CAA GCG CAC GCA GAC TGT AGA-3’, Kras K005R-5’- AGC TAG CCA CCA TGG CTT GAG TAA GTC TGC A-3’ and Pdx1-Cre F-5’-CTG GAC TAC ATC TTG AGT TGC -3’ and Pdx1-Cre R-5’-GGT GTA CGG TCA GTA AAT TTG -3’. The PCR amplification reaction contained 1 μl of genomic DNA (100 ng), 0.3 μl 10 pmol of each primer, 10 μl of 2X PCR master mix (DNA Polymerase, 400 μM each of dATP, dGTP, dCTP, dTTP and 3 mM MgCl2) and 8.4 μl of autoclaved water. PCR amplification was carried out in a programmable thermal cycler (MJ Research, Minnesota, USA) using the following program: denaturation for 5 min at 95°C, followed by 40 cycles of amplification by denaturation for 1 min at 94°C, annealing at 2 min at 59°C, elongation for 45 sec at 72°C and a final extension of 10 min at 72°C. The PCR products were resolved on 1.5% agarose gel to confirm the genotype of each animal based on the amplification of target regions.
Isolation of RNA
Total RNA was isolated from the pancreas of floxed Kras G12D (KrasG12D;Pdx1-Cre) and unfloxed Kras G12D (LSLKrasG12D) by using the mirVana™ miRNA Isolation Kit (Applied Biosystems/Ambion, Austin, TX, USA). RNA concentration was measured by using a NanoDropTM Spectrophotometer (NanoDrop Technologies Inc., Wilmington, DE, USA), and the quality was analyzed with a bioanalyzer (Agilent technologies, Waldbronn, Germany). Samples with good integrity were used for cDNA synthesis.
cDNA synthesis and real time PCR
Total RNA was isolated from the pancreas and the cDNA was synthesized by reverse transcription. Reverse transcription of RNA was performed by adding 10 μl of (2000 ng) total RNA, 1 μl of Oligo (dT) and 1 μl of 10 mM dNTP incubated at 65°C for 5 min and immediately chilled on ice. Then, the master mix containing the following components were added (4 μl of (5X) first strand RT buffer, 1 μl of 0.1 M DTT, 1 μl of RNaseOUT (RNase Inhibitor) and incubated at 42°C for 2 min. Finally, 1 μl (50 units) of SuperScript II RT was then added to each tube mix, and incubated at 42°C for 50 min followed by 70°C for 15 min in order to destroy the superscript II RT (Invitrogen, Carlsbad, CA, USA).
Real time PCR primer sequences
Anti-mouse Muc1 (mouse monoclonal antibody recognizing the cytoplasmic tail of Muc1), and Anti-mouse Muc5AC (mouse monoclonal) antibody were purchased from Abcam® (Cambridge, MA, USA). The anti-Muc4 (4A-rabbit polyclonal) antibody used in this study was designed by us and developed by GenScript (Piscataway, NJ, USA). Rabbits were immunized with a 15 amino-acid peptide specific to the tandem repeat region of mouse Muc4 (CAGYRPPRPAWTFGD). Analysis of tissue sections pre-incubated with the blocking peptide was conducted in order to confirm the specificity of the antibody.
Hematoxylin and eosin staining (H&E)
The F1 progeny of (N=8) floxed Kras G12D (KrasG12D;Pdx1-Cre) and unfloxed Kras G12D (LSLKrasG12D) animals were sacrificed at 7, 10, 25, 30, 40 and 50 weeks of age. A section of the pancreas from these animals was fixed in 10% formalin (Fisher Scientific, Fair Lawn, NJ, USA). The tissues were then embedded in paraffin and serial tissue sections (4 μm thick) were cut. The sections were deparaffinized using EZ-DeWaxTM (Bio genex, San Roman CA, USA) and dehydrated gradually. Subsequently, the sections were stained with hematoxylin and eosin (H&E) stains and examined under a light microscope as described .
Immunohistochemistry (IHC) analysis
Pancreatic tissues isolated from transgenic mice of different ages were embedded in paraffin after being fixed in 10% formalin for at least 48 h. Subsequently, 4 μm sections of paraffin-embedded pancreas were sliced and prepared for histological analysis. After placing the slides in an oven at 56°C overnight, these were deparaffinized after washing several times in xylene (Fisher Scientific, Fair Lawn, NJ, USA). Tissues were then rehydrated with decreasing concentrations of ethanol. After incubating the tissues for 30 min in the presence of 5% H2O2 in methanol to block the endogenous peroxidase, tissue sections were blocked in 2.5% horse serum for 2 h. Without washing the tissue sections, the corresponding primary antibodies were added at the optimum concentrations, which were determined after standardization experiments. The corresponding dilutions used in these sections were: 1:200 anti-Muc1, 1:4000 anti-Muc4, 1:400 anti-Muc5AC. Following overnight incubation, sections were washed three times with PBST and the horseradish peroxidase-conjugated secondary antibody was added for 30 min. IHC staining of the respective mucins were developed after colorimetric detection with a 3,3’-diaminobenzidine (DAB) reagent kit (Vector Laboratories, Burlingame, CA, USA) followed by hematoxylin staining. Tissues were then dehydrated with increasing concentrations of ethanol followed by a xylene wash. IHC staining was evaluated by a pathologist after mounting with Permount mounting medium (Fisher Scientific, Fair Lawn, NJ, USA). Expression of each mucin was scored on a scale of 0–3 where 0-negative, 1-weak, 2-moderate and 3- represented strong immunoreactivity to the antibody used. Further the percentage of cells positive for the antibody was scored on a scale of 1–4 where 1: 0–25% cells positive; 2: 26–50% positive; 3: 51–75% positive; and 4: 76–100% positive. The composite score was then obtained by multiplying the staining intensity and the percentage of immunoreactive cells and it ranged from 0 to 12.
Fold change in the mRNA expression of various genes were calculated by ΔΔCt method. Mouse β-actin was used for normalization. A change of 2 fold or more (on the log scale 0.3 or more) was considered statistically significant. A Student’s t-test was used to calculate the significance in the staining pattern for each mucin at different stages of PC progression. All p- values <0.05 were considered statistically significant.
Pancreatic cancer progression
Upon microscopic examination of the H&E stained tissue sections, no lesions were observed in the pancreas of LSLKrasG12D mice (Figure 1B1-1B4), while KrasG12D;Pdx1-Cre mice pancreas showed the presence of PanIN lesions as early as 10 weeks of age, which progressively developed into PDAC by 50 weeks of age (Figure 1B5-1B8). Specifically, at 10 weeks of age, mostly PanIN-I lesions were observed (Figure 1B5), which progressed to PanIN-II and III lesions at 25 weeks of age, replacing the majority of pancreatic parenchyma (Figure 1B6). At 40 weeks of age, the majority of parenchyma was replaced by advanced PanIN III lesions and extensive desmoplasia (Figure 1B7), and at 50 weeks of age, the pancreas parenchyma was replaced with PDAC (Figure 1B8). Metastatic lesions involving liver, lung and small intestines were observed at 50 weeks of age in 60-70% of the KrasG12D;Pdx1-Cre mice (Figure 1C-1E).
Muc1 expression during pancreatic cancer progression in KrasG12D mouse model
Expression of Muc4 during pancreatic cancer progression in KrasG12D mouse model
Expression of Muc5ac during pancreatic cancer progression in KrasG12D mouse model
Inflammation during the progression of pancreatic cancer
Expression of inflammatory cytokines/chemokines such as IFN-γ, CXCL1 and CXCL2 were measured by performing real time-PCR using total RNA isolated from mouse pancreas collected at 50 weeks of age. We observed a significantly higher expression of CXCL1 (p < 0.00013), CXCL2 (p < 0.085) and IFN-γ (p < 0.0062) in KrasG12D;Pdx1-Cre animals compared to LSLKrasG12D control animals (Figure 5B). Correspondingly, an increased infiltration of lymphocytes in pancreatic tissues of KrasG12D;Pdx1-Cre mice correlated with the increased inflammation and increased inflammatory cytokines detected in the pancreas of KrasG12D;Pdx1-Cre mice (Figure 5C).
PC is an extremely lethal disease, with a five year survival rate of less than 5% and a median survival period of 5-6 months. At the time of diagnosis, PC metastasizes to regional lymph nodes and distant organs and responds poorly to current chemo- and radiation therapies resulting in a high recurrence rate [1–3]. The poor prognosis and weak therapeutic responses are a consequence of late diagnosis of the majority of PC patients, primarily due to lack of early symptoms and reliable early diagnostic markers . Therefore, there is an urgent need to identify specific early biomarkers for early diagnosis and molecular targets for effective treatment of PC.
Previous studies done in human tissues have indicated an aberrant overexpression of various mucins in several epithelial malignancies including pancreatic, ovarian and lung cancers [7, 10]. Thus, not surprisingly, their potential in the diagnosis and targeted treatment of PC has been suggested and tested over the last decades [35, 36]. In cancer cells, mucins play an important role in cell growth, differentiation, transformation, adhesion, invasion and immune evasion [5, 8, 20]. In human PC tissues, MUC1, MUC4, and MUC5AC are aberrantly upregulated and their expression has been linked to the progression and poor prognosis of the disease. However, due to the late diagnosis of PC, the status of mucin expression in the earliest stages of the disease remains unknown.
Genetically engineered mouse models can facilitate the discovery of tumor biomarkers in order to design powerful techniques to diagnose, treat, and monitor therapeutic efficacy in cancer patients more effectively . Mouse Muc1 shares 34% homology with human MUC1 in the tandem repeat region mainly sharing threonine, serine and O-linked sugars but it is 87% homologous at transmembrane and cytoplasmic regions. Due to high degree of conservation in the promoter region (74%), the patterns of expression of mouse Muc1 is quite similar to human MUC1 . Similarly, the mouse and human MUC4 have identical exon/intron structure . Further, human MUC4 homology analysis with mouse, dog, rat, and chicken Muc4 revealed that NIDOgen-like (NIDO), Adhesion associated domain of MUC4 and Other Proteins (AMOP), von Willebrand factor D (vWD), Epidermal Growth Factor (EGF), transmembrane (TM), and cytoplasmic tail (CT) domains are highly conserved across the species suggesting that individual domains evolved from common ancestral domains and share common functions . In the case of mouse Muc5AC (located on chromosome 7), it shares 52% homology with human MUC5AC (located on human chromosome 11) and TATA box regions in both the species are fully conserved . Because mucin genes are conserved between humans and mice, such mouse models provide a unique opportunity to examine the expression profile and possibly functional role of mucin genes at the earliest stages of the disease.
We used a well characterized KrasG12D;Pdx1-Cre spontaneous PDAC mouse model, which recapitulates human PC genetically, histologically and pathologically , to investigate if the expression pattern of murine mucins (i.e. Muc1, Muc4 and Muc5AC) mirrors the altered mucin profile of the human disease. The KrasG12D;Pdx1-Cre genetically engineered mouse PDAC model was chosen over other spontaneous PDAC models because it recapitulates the full spectrum of human PanIN lesions, which are recognized as early events in PC. Moreover, mass spectrometry proteomics analysis in this mouse model identified a distinct serum proteome having preinvasive PanIN lesions compared to healthy controls , emphasizing its utility as a suitable platform to understand early stages of PC that may lead to the optimization of diagnostic and therapeutic techniques against this malignancy.
MUC1 is a transmembrane mucin with basal level expression in normal epithelial cells lining various organs including the pancreas. It has been shown to be overexpressed and aberrantly glycosylated in PC and play a role in the invasion and metastasis of PC [6, 8, 19]. Overexpression of MUC1 has been observed during the early stages of PC development, with a subsequent increase in expression in invasive carcinoma, both in humans and p48; KrasG12D; MUC1.Tg mouse model [18, 41]. Similarly, IPMNs like lesions from KrasG12D;TGFÎ±;Pdx-1-Cre transgenic mice showed elevated Muc1 and Muc5AC expression at 3 months of age  and recent reports also revealed that KrasG12D;P48-Cre; Muc1KO mice had slower tumor progression and metastasis compared to both KrasG12D;P48-Cre and KrasG12D;P48-Cre; MUC1 transgenic animals . On the other hand, Muc1 null mice are phenotypically normal and exhibit normal reproduction and survival rate . Previous studies in human pancreatic tissues also reported an increase in MUC1 expression which correlated with grade of PanIN lesions and PDAC . In our study, mRNA and protein levels of Muc1 progressively increased from 10 weeks to 50 weeks of age in the pancreas of KrasG12D;Pdx1-Cre mice compared to unfloxed LSLKrasG12D mice, and correlated with the development of PDAC from PanIN precursor lesions (Figure 2). Thus, the expression of Muc1 in the KrasG12D;Pdx-1-Cre spontaneous PDAC progression model corroborates its resemblance with the human disease.
MUC4 is a high molecular weight, type I transmembrane glycoprotein that is overexpressed in PC but absent in normal pancreas and chronic pancreatitis . Although previous studies in human specimens have shown an increased expression of MUC4 in PC progression and metastasis [10, 11], it remains unknown if MUC4 overexpression is an early event in PC. MUC4 expression has been observed in precursor PanIN lesions in clinical samples , which is suggestive of, but not a definitive proof of MUC4 overexpression as an early event in PC. In the present study, we observed that Muc4 mRNA and protein levels increased progressively from 10 weeks of age, which is when we observed the appearance of PanIN I lesions and continued to increase up to 40 weeks of age where we observed advanced PanIN III lesions (Figure 3). Our findings establish that Muc4 expression is indeed an early event in PC progression, which recapitulates the MUC4 expression profile in human PC. Future studies using Muc4 knock out and MUC4 transgenic animals on the KrasG12D murine background will help delineate the molecular mechanisms and contribution of Muc4 in PC progression and metastasis. Nonetheless, the present study establishes the suitability of KrasG12D model for evaluating the potential of Muc4 as an early diagnostic marker and therapeutic target.
The expression of the gel-forming secretory mucin MUC5AC in human PC increases progressively with the increase in grade of PanIN lesions and PDAC, whereas it is undetected in normal pancreas [19, 29]. Similar to the expression of the transmembrane mucins MUC1 and MUC4, MUC5AC expression has also been related to PC progression  and it is associated with a shorter survival period of PC patients . In the present study, Muc5AC expression in the pancreas of KrasG12D;Pdx1-Cre spontaneous PDAC mice increased progressively from 10 to 50 weeks of age (Figure 4) as compared to unfloxed LSLKrasG12D mice, corroborating studies of the human disease. It is important to emphasize the particular usefulness of the detection of Muc5AC in early lesions of PC, as its secretory nature is advantageous for non-invasive serum based diagnostics.
Previous studies with human tissues have implicated Kras activation in rigorous inflammatory responses in PC, mainly by activating the NF-κB pathway . In agreement with these studies, recent studies reported the observation of proinflammatory responses in the KrasG12D;PdxCre spontaneous PDAC mouse model, which suggested that chronic inflammation is indeed a precursor and potentially a key factor in promoting PC . These studies suggested that constitutive NF-κB activation and inflammatory responses induced by oncogenic Kras are one of the earliest events in PC development. Mucins are known to be transcriptionally regulated by inflammatory cytokines like IFN-γ (MUC4)  and neutrophil elastase (MUC1 and MUC5AC), which is a serine proteinase secreted by neutrophils during inflammation [33, 48]. Moreover, a recent study demonstrated that glycosylation of mucins can be altered in response to proinflammatory conditions in PC cells . Given the functional and pathological significance of MUC1, MUC4 and MUC5AC in PC progression and their regulation by inflammatory environment in the human disease, we analyzed the inflammation in the pancreas of KrasG12D;Pdx1-Cre mice. Increased inflammation in the pancreas of KrasG12D;Pdx1-Cre spontaneous PDAC mice correlated with an increase in inflammatory cytokines/chemokines such as INFγ (p < 0.0062), CXCL1 (p < 0.00014), CXCL2 (p < 0.08) and lymphocyte (Figure 5C) and macrophage infiltration (Figure 5D, G-H). These results correlate with an increase in the expression of Muc1, Muc4 and Muc5AC in the pancreas of KrasG12D;Pdx1-Cre spontaneous PDAC mouse model, suggesting a possible link between inflammation and mucin expression, which further recapitulates the studies done in the human disease.
Our studies are the first to establish that KrasG12D;Pdx1-Cre mouse model recapitulates the alterations in mucin expression observed during the progression of human PC. Although Kras was the first oncogene identified to play a critical role in PDAC development, its activity is involved in PanIN initiation but not sufficient to induce PDAC by itself . Inflammatory signaling pathways triggered by oncogenic Kras may synergize with other critical molecules to upregulate mucin expression during the early development of PC. The present study provides the basis to investigate the functional role of specific mucins in PC initiation and progression by generating corresponding transgenic and knockout animals and crossing them with spontaneous models of PC. It will also be interesting to study the fate of mucin expression in the mouse pancreas in response to inflammatory stimuli like smoking and alcohol that induce pancreatic pathologies. Our studies also establish that KrasG12D;Pdx1-Cre mouse model is ideally suited to investigate mucin-based biomarkers and targeted therapies for PC.
We thank Kavita Mallya and Erik Moore for technical support, the Molecular Biology and Tissue Core Facility at UNMC, and Kristi L.W. Berger for editorial assistance.
This work was supported in part by the grants from National Institutes of Health (RO1 CA133774, RO1 CA78590, UO1 CA111294, RO1 CA131944, P50 CA 127, R21 CA155175, R21 CA 156037, T32 CA009476, and U54 CA163120).
- Siegel R, Naishadham D, Jemal A: Cancer statistics, 2012. CA Cancer J Clin. 2012, 62: 10-29. 10.3322/caac.20138.View ArticlePubMed
- Matsuno S, Egawa S, Fukuyama S, Motoi F, Sunamura M, Isaji S: Pancreatic cancer registry in Japan: 20years of experience. Pancreas. 2004, 28: 219-230. 10.1097/00006676-200404000-00002.View ArticlePubMed
- Sultana A, Tudur SC, Cunningham D, Starling N, Neoptolemos JP, Ghaneh P: Meta-analyses of chemotherapy for locally advanced and metastatic pancreatic cancer: results of secondary end points analyses. Br J Cancer. 2008, 99: 6-13. 10.1038/sj.bjc.6604436.PubMed CentralView ArticlePubMed
- Fry LC, Monkemuller K, Malfertheiner P: Molecular markers of pancreatic cancer: development and clinical relevance. Langenbecks Arch Surg. 2008, 393: 883-890. 10.1007/s00423-007-0276-0.View ArticlePubMed
- Chaturvedi P, Singh AP, Moniaux N, Senapati S, Chakraborty S, Meza JL: MUC4 mucin potentiates pancreatic tumor cell proliferation, survival, and invasive properties and interferes with its interaction to extracellular matrix proteins. Mol Cancer Res. 2007, 5: 309-320. 10.1158/1541-7786.MCR-06-0353.View ArticlePubMed
- Moniaux N, Andrianifahanana M, Brand RE, Batra SK: Multiple roles of mucins in pancreatic cancer, a lethal and challenging malignancy. Br J Cancer. 2004, 91: 1633-1638.PubMed CentralPubMed
- Chauhan SC, Singh AP, Ruiz F, Johansson SL, Jain M, Smith LM: Aberrant expression of MUC4 in ovarian carcinoma: diagnostic significance alone and in combination with MUC1 and MUC16 (CA125). Mod Pathol. 2006, 19: 1386-1394. 10.1038/modpathol.3800646.View ArticlePubMed
- Hollingsworth MA, Swanson BJ: Mucins in cancer: protection and control of the cell surface. Nat Rev Cancer. 2004, 4: 45-60. 10.1038/nrc1251.View ArticlePubMed
- Torres MP, Chakraborty S, Souchek J, Batra SK: Mucin-based targeted pancreatic Cancer Therapy. Curr Pharm Des. 2012, 18 (17): 2472-2481. 10.2174/13816128112092472.PubMed CentralView ArticlePubMed
- Andrianifahanana M, Moniaux N, Schmied BM, Ringel J, Friess H, Hollingsworth MA: Mucin (MUC) gene expression in human pancreatic adenocarcinoma and chronic pancreatitis: a potential role of MUC4 as a tumor marker of diagnostic significance. Clin Cancer Res. 2001, 7: 4033-4040.PubMed
- Jhala N, Jhala D, Vickers SM, Eltoum I, Batra SK, Manne U: Biomarkers in Diagnosis of pancreatic carcinoma in fine-needle aspirates. Am J Clin Pathol. 2006, 126: 572-579. 10.1309/CEV30BE088CBDQD9.View ArticlePubMed
- Iacobuzio-Donahue CA, Ashfaq R, Maitra A, Adsay NV, Shen-Ong GL, Berg K: Highly expressed genes in pancreatic ductal adenocarcinomas: a comprehensive characterization and comparison of the transcription profiles obtained from three major technologies. Cancer Res. 2003, 63: 8614-8622.PubMed
- Takikita M, Altekruse S, Lynch CF, Goodman MT, Hernandez BY, Green M: Associations between selected biomarkers and prognosis in a population-based pancreatic cancer tissue microarray. Cancer Res. 2009, 69: 2950-2955. 10.1158/0008-5472.CAN-08-3879.PubMed CentralView ArticlePubMed
- Westgaard A, Schjolberg AR, Cvancarova M, Eide TJ, Clausen OP, Gladhaug IP: Differentiation markers in pancreatic head adenocarcinomas: MUC1 and MUC4 expression indicates poor prognosis in pancreatobiliary differentiated tumours. Histopathology. 2009, 54: 337-347. 10.1111/j.1365-2559.2009.03227.x.PubMed CentralView ArticlePubMed
- Tamada S, Shibahara H, Higashi M, Goto M, Batra SK, Imai K: MUC4 is a novel prognostic factor of extrahepatic bile duct carcinoma. Clin Cancer Res. 2006, 12: 4257-4264. 10.1158/1078-0432.CCR-05-2814.View ArticlePubMed
- Lan MS, Batra SK, Qi WN, Metzgar RS, Hollingsworth MA: Cloning and sequencing of a human pancreatic tumor mucin cDNA. J Biol Chem. 1990, 265: 15294-15299.PubMed
- Spicer AP, Rowse GJ, Lidner TK, Gendler SJ: Delayed mammary tumor progression in Muc-1 null mice. J Biol Chem. 1995, 270: 30093-30101. 10.1074/jbc.270.50.30093.View ArticlePubMed
- Tinder TL, Subramani DB, Basu GD, Bradley JM, Schettini J, Million A: MUC1 enhances tumor progression and contributes toward immunosuppression in a mouse model of spontaneous pancreatic adenocarcinoma. J Immunol. 2008, 181: 3116-3125.PubMed CentralView ArticlePubMed
- Yonezawa S, Higashi M, Yamada N, Yokoyama S, Goto M: Significance of mucin expression in pancreatobiliary neoplasms. J Hepatobiliary Pancreat Sci. 2010, 17: 108-124. 10.1007/s00534-009-0174-7.View ArticlePubMed
- Chaturvedi P, Singh AP, Chakraborty S, Chauhan SC, Bafna S, Meza JL: MUC4 mucin interacts with and stabilizes the HER2 oncoprotein in human pancreatic cancer cells. Cancer Res. 2008, 68: 2065-2070. 10.1158/0008-5472.CAN-07-6041.PubMed CentralView ArticlePubMed
- Tsutsumida H, Swanson BJ, Singh PK, Caffrey TC, Kitajima S, Goto M: RNA interference suppression of MUC1 reduces the growth rate and metastatic phenotype of human pancreatic cancer cells. Clin Cancer Res. 2006, 12: 2976-2987. 10.1158/1078-0432.CCR-05-1197.View ArticlePubMed
- Chaturvedi P, Singh AP, Batra SK: Structure, evolution, and biology of the MUC4 mucin. FASEB J. 2008, 22: 966-981.PubMed CentralView ArticlePubMed
- Inatomi T, Tisdale AS, Zhan Q, Spurr-Michaud S, Gipson IK: Cloning of rat Muc5AC mucin gene: comparison of its structure and tissue distribution to that of human and mouse homologues. Biochem Biophys Res Commun. 1997, 236: 789-797. 10.1006/bbrc.1997.7051.View ArticlePubMed
- Moniaux N, Nollet S, Porchet N, Degand P, Laine A, Aubert JP: Complete sequence of the human mucin MUC4: a putative cell membrane-associated mucin. Biochem J. 1999, 338 (Pt 2): 325-333.PubMed CentralView ArticlePubMed
- Spicer AP, Parry G, Patton S, Gendler SJ: Molecular cloning and analysis of the mouse homologue of the tumor-associated mucin, MUC1, reveals conservation of potential O-glycosylation sites, transmembrane, and cytoplasmic domains and a loss of minisatellite-like polymorphism. J Biol Chem. 1991, 266: 15099-15109.PubMed
- Hezel AF, Kimmelman AC, Stanger BZ, Bardeesy N, DePinho RA: Genetics and biology of pancreatic ductal adenocarcinoma. Genes Dev. 2006, 20: 1218-1249. 10.1101/gad.1415606.View ArticlePubMed
- Torres MP, Rachagani S, Purohit V, Pandey P, Joshi S, Moore ED: Graviola: A novel promising natural-derived drug that inhibits tumorigenicity and metastasis of pancreatic cancer cells in vitro and in vivo through altering cell metabolism. Cancer Lett. 2012, 323 (1): 29-40. 10.1016/j.canlet.2012.03.031.PubMed CentralView ArticlePubMed
- Moniaux N, Chaturvedi P, Varshney GC, Meza JL, Rodriguez-Sierra JF, Aubert JP: Human MUC4 mucin induces ultra-structural changes and tumorigenicity in pancreatic cancer cells. Br J Cancer. 2007, 97: 345-357. 10.1038/sj.bjc.6603868.PubMed CentralView ArticlePubMed
- Nagata K, Horinouchi M, Saitou M, Higashi M, Nomoto M, Goto M: Mucin expression profile in pancreatic cancer and the precursor lesions. J Hepatobiliary Pancreat Surg. 2007, 14: 243-254. 10.1007/s00534-006-1169-2.View ArticlePubMed
- Sclabas GM, Fujioka S, Schmidt C, Evans DB, Chiao PJ: NF-kappaB in pancreatic cancer. Int J Gastrointest Cancer. 2003, 33: 15-26. 10.1385/IJGC:33:1:15.View ArticlePubMed
- Ji H, Houghton AM, Mariani TJ, Perera S, Kim CB, Padera R: K-ras activation generates an inflammatory response in lung tumors. Oncogene. 2006, 25: 2105-2112. 10.1038/sj.onc.1209237.View ArticlePubMed
- Andrianifahanana M, Singh AP, Nemos C, Ponnusamy MP, Moniaux N, Mehta PP: IFN-gamma-induced expression of MUC4 in pancreatic cancer cells is mediated by STAT-1 upregulation: a novel mechanism for IFN-gamma response. Oncogene. 2007, 26: 7251-7261. 10.1038/sj.onc.1210532.View ArticlePubMed
- Voynow JA, Young LR, Wang Y, Horger T, Rose MC, Fischer BM: Neutrophil elastase increases MUC5AC mRNA and protein expression in respiratory epithelial cells. Am J Physiol. 1999, 276: L835-L843.PubMed
- Wu YM, Nowack DD, Omenn GS, Haab BB: Mucin glycosylation is altered by pro-inflammatory signaling in pancreatic-cancer cells. J Proteome Res. 2009, 8: 1876-1886. 10.1021/pr8008379.PubMed CentralView ArticlePubMed
- Rachagani S, Torres MP, Moniaux N, Batra SK: Current status of mucins in the diagnosis and therapy of cancer. Biofactors. 2009, 35: 509-527. 10.1002/biof.64.PubMed CentralView ArticlePubMed
- Chakraborty S, Baine MJ, Sasson AR, Batra SK: Current status of molecular markers for early detection of sporadic pancreatic cancer. Biochim Biophys Acta. 2011, 1815: 44-64.PubMed CentralPubMed
- Singh M, Johnson L: Using genetically engineered mouse models of cancer to aid drug development: an industry perspective. Clin Cancer Res. 2006, 12: 5312-5328. 10.1158/1078-0432.CCR-06-0437.View ArticlePubMed
- Desseyn JL, Clavereau I, Laine A: Cloning, chromosomal localization and characterization of the murine mucin gene” orthologous to human MUC4. Eur J Biochem. 2002, 269: 3150-3159. 10.1046/j.1432-1033.2002.02988.x.View ArticlePubMed
- Jonckheere N, Van Der Sluis M, Velghe A, Buisine MP, Sutmuller M, Ducourouble MP: Transcriptional activation of the murine Muc5ac mucin gene in epithelial cancer cells by TGF-beta/Smad4 signalling pathway is potentiated by Sp1. Biochem J. 2004, 377: 797-808.PubMed CentralView ArticlePubMed
- Hingorani SR, Petricoin EF, Maitra A, Rajapakse V, King C, Jacobetz MA: Preinvasive and invasive ductal pancreatic cancer and its early detection in the mouse. Cancer Cell. 2003, 4: 437-450. 10.1016/S1535-6108(03)00309-X.View ArticlePubMed
- Acres B, Limacher JM: MUC1 as a target antigen for cancer immunotherapy. Expert Rev Vaccines. 2005, 4: 493-502. 10.1586/147605188.8.131.523.View ArticlePubMed
- Siveke JT, Einwachter H, Sipos B, Lubeseder-Martellato C, Kloppel G, Schmid RM: Concomitant pancreatic activation of Kras(G12D) and Tgfa results in cystic papillary neoplasms reminiscent of human IPMN. Cancer Cell. 2007, 12: 266-279. 10.1016/j.ccr.2007.08.002.View ArticlePubMed
- Besmer DM, Curry JM, Roy LD, Tinder TL, Sahraei M, Schettini J: Pancreatic ductal adenocarcinoma mice lacking mucin 1 have a profound defect in tumor growth and metastasis. Cancer Res. 2011, 71: 4432-4442. 10.1158/0008-5472.CAN-10-4439.PubMed CentralView ArticlePubMed
- Yonezawa S, Higashi M, Yamada N, Yokoyama S, Kitamoto S, Kitajima S: Mucins in human neoplasms: Clinical pathology, gene expression and diagnostic application. Pathol Int. 2011, 61: 697-716. 10.1111/j.1440-1827.2011.02734.x.View ArticlePubMed
- Swartz MJ, Batra SK, Varshney GC, Hollingsworth MA, Yeo CJ, Cameron JL: MUC4 expression increases progressively in pancreatic intraepithelial neoplasia. Am J Clin Pathol. 2002, 117: 791-796. 10.1309/7Y7N-M1WM-R0YK-M2VA.View ArticlePubMed
- Yamazoe S, Tanaka H, Sawada T, Amano R, Yamada N, Ohira M: RNA interference suppression of mucin 5AC (MUC5AC) reduces the adhesive and invasive capacity of human pancreatic cancer cells. J Exp Clin Cancer Res. 2010, 29: 53-53. 10.1186/1756-9966-29-53.PubMed CentralView ArticlePubMed
- Ling J, Kang Y, Zhao R, Xia Q, Lee DF, Chang Z: Kras(G12D)-induced IKK2/beta/NF-kappaB activation by IL-1alpha and p62 feedforward loops is required for development of pancreatic ductal adenocarcinoma. Cancer Cell. 2012, 21: 105-120. 10.1016/j.ccr.2011.12.006.PubMed CentralView ArticlePubMed
- Kuwahara I, Lillehoj EP, Hisatsune A, Lu W, Isohama Y, Miyata T: Neutrophil elastase stimulates MUC1 gene expression through increased Sp1 binding to the MUC1 promoter. Am J Physiol Lung Cell Mol Physiol. 2005, 289: L355-L362. 10.1152/ajplung.00040.2005.View ArticlePubMed
- Rhim AD, Stanger BZ: Molecular biology of pancreatic ductal adenocarcinoma progression: aberrant activation of developmental pathways. Prog Mol Biol Transl Sci. 2010, 97: 41-78.PubMed CentralView ArticlePubMed
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.