title: Angiopoietin-2 drives lymphatic metastasis of pancreatic cancer.
abstract: Lymphatic metastasis constitutes a critical route of disease dissemination, which limits the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC). As lymphangiogenesis has been implicated in stimulation of lymphatic metastasis by vascular endothelial growth factor-C (VEGF-C) and VEGF-D, we studied the effect of the angioregulatory growth factor angiopoietin-2 (Ang-2) on PDAC progression. Ang-2 was found to be expressed in transformed cells of human PDAC specimens, with corresponding Tie-2 receptors present on blood and lymphatic endothelium. In vitro in PDAC cells, Ang-2 was subject to autocrine/paracrine TGF-β stimulation (2-fold induction, P=0.0106) acting on the -61- to +476-bp element of the human Ang-2 promoter. In turn, Ang-2 regulated the expression of genes involved in cell motility and tumor suppression. Orthotopic PDAC xenografts with forced expression of Ang-2, but not Ang-1, displayed increased blood and lymphatic vessel density, and an enhanced rate of lymphatic metastasis (6.7- to 9.1-fold, P<0.01), which was prevented by sequestration of Ang-2 via coexpression of soluble Tie-2. Notably, elevated circulating Ang-2 in patients with PDAC correlated with the extent of lymphatic metastasis. Furthermore, median survival was reduced from 28.4 to 7.7 mo in patients with circulating Ang-2 ≥ 75th percentile (P=0.0005). These findings indicate that Ang-2 participates in the control of lymphatic metastasis, constitutes a noninvasive prognostic biomarker, and may provide an accessible therapeutic target in PDAC.
authors.affiliation: Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Schulz
authors.forename: Christian
authors.initials: C
authors.lastname: Fischer
authors.forename: Katharina M
authors.initials: KM
authors.lastname: Detjen
authors.forename: Svenja
authors.initials: S
authors.lastname: Rieke
authors.forename: Georg
authors.initials: G
authors.lastname: Hilfenhaus
authors.forename: Zofia
authors.initials: Z
authors.lastname: von Marschall
authors.forename: Michael
authors.initials: M
authors.lastname: Böhmig
authors.forename: Inga
authors.initials: I
authors.lastname: Koch
authors.forename: Jenny
authors.initials: J
authors.lastname: Kehrberger
authors.forename: Peter
authors.initials: P
authors.lastname: Hauff
authors.forename: Karl Heinz
authors.initials: KH
authors.lastname: Thierauch
authors.forename: Frauke
authors.initials: F
authors.lastname: Alves
authors.forename: Bertram
authors.initials: B
authors.lastname: Wiedenmann
authors.forename: Arne
authors.initials: A
authors.lastname: Scholz
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology* / Q000556:secondary; D000368:Aged; D042702:Angiopoietin-2 / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D000818:Animals; D015415:Biomarkers; D045744:Cell Line, Tumor; D005260:Female; D015972:Gene Expression Regulation, Neoplastic / Q000502:physiology; D006801:Humans; D042583:Lymphangiogenesis / Q000502:physiology; D008207:Lymphatic Metastasis / Q000503:physiopathology*; D008297:Male; D051379:Mice; D016513:Mice, SCID; D009374:Neoplasms, Experimental; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000473:pathology*; D011401:Promoter Regions, Genetic; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D042787:Receptor, TIE-2 / Q000235:genetics / Q000378:metabolism
chemical_list: D042702:Angiopoietin-2; D015415:Biomarkers; D012333:RNA, Messenger; D042787:Receptor, TIE-2