title: Pancreatic duct glands are distinct ductal compartments that react to chronic injury and mediate Shh-induced metaplasia.
abstract: OBJECTIVE
  Pancreatic intraepithelial neoplasia (PanIN) are pancreatic cancer precursor lesions of unclear origin and significance. PanIN aberrantly express sonic hedgehog (Shh), an initiator of pancreatic cancer, and gastrointestinal mucins. A majority of PanIN are thought to arise from ducts. We identified a novel ductal compartment that is gathered in gland-like outpouches (pancreatic duct glands [PDG]) of major ducts and characterized its role in injury and metaplasia.
  
  
  METHODS
  The ductal system was analyzed in normal pancreata and chronic pancreatitis in humans and mice. Anatomy was assessed by serial hematoxylin and eosin sections and scanning electron microscopy of corrosion casts. Expression of mucins and developmental genes and proliferation were assessed by immunohistochemistry or real-time quantitative polymerase chain reaction. Effects of Shh on ductal cells were investigated by exposure to Shh in vitro and transgenic misexpression in vivo.
  
  
  RESULTS
  Three-dimensional analysis revealed blind-ending outpouches of ducts in murine and human pancreata. These PDG are morphologically and molecularly distinct from normal ducts; even in normal pancreata they display PanIN and metaplastic features, such as expression of Shh and gastric mucins. They express other developmental genes, such as Pdx-1 and Hes-1. In injury, Shh is up-regulated along with gastric mucins. Expansion of the PDG compartment results in a mucinous metaplasia. Shh promotes this transformation in vitro and in vivo.
  
  
  CONCLUSIONS
  PDG are distinct gland-like mucinous compartments with a distinct molecular signature. In response to injury, PDG undergo an Shh-mediated mucinous gastrointestinal metaplasia with PanIN-like features. PDG may provide a link between Shh, mucinous metaplasia, and neoplasia.
authors.affiliation: Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.
authors.forename: Oliver
authors.initials: O
authors.lastname: Strobel
authors.forename: David E
authors.initials: DE
authors.lastname: Rosow
authors.forename: Elena Y
authors.initials: EY
authors.lastname: Rakhlin
authors.forename: Gregory Y
authors.initials: GY
authors.lastname: Lauwers
authors.forename: Amanda G
authors.initials: AG
authors.lastname: Trainor
authors.forename: Janivette
authors.initials: J
authors.lastname: Alsina
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernández-Del Castillo
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Warshaw
authors.forename: Sarah P
authors.initials: SP
authors.lastname: Thayer
mesh_terms: D000818:Animals; D002278:Carcinoma in Situ / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D002478:Cells, Cultured; D002108:Ceruletide; D016319:Corrosion Casting; D004195:Disease Models, Animal; D004847:Epithelial Cells / Q000378:metabolism* / Q000648:ultrastructure; D005752:Gastric Mucins / Q000378:metabolism; D018507:Gene Expression Regulation, Developmental; D053823:Hedgehog Proteins / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008679:Metaplasia; D051379:Mice; D008822:Mice, Transgenic; D010183:Pancreatic Ducts / Q000378:metabolism* / Q000648:ultrastructure; D010190:Pancreatic Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D050500:Pancreatitis, Chronic / Q000139:chemically induced / Q000378:metabolism* / Q000473:pathology; D011230:Precancerous Conditions / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015398:Signal Transduction; D013997:Time Factors
chemical_list: D005752:Gastric Mucins; D053823:Hedgehog Proteins; C509239:SHH protein, human; C465570:Shh protein, mouse; D002108:Ceruletide