Obesity enriches for tumor protective microbial metabolites and treatment refractory cells to confer therapy resistance in PDAC

Abstract

Obesity causes chronic inflammation and changes in gut microbiome. However, how this contributes to poor survival and therapy resistance in patients with pancreatic cancer remain undetermined. Our current study shows that high fat diet-fed obese pancreatic tumor bearing mice do not respond to standard of care therapy with gemcitabine and paclitaxel when compared to corresponding control diet-fed mice. C57BL6 mice were put on control and high fat diet for 1 month following with pancreatic tumors were implanted in both groups. Microbiome of lean (control) and obese (high fat diet fed) mice was analyzed. Fecal matter transplant from control mice to obese mice sensitized tumors to chemotherapy and demonstrated extensive cell death. Analysis of gut microbiome showed an enrichment of queuosine (Q) producing bacteria in obese mice and an enrichment of S-adenosyl methionine (SAM) producing bacteria in control diet-fed mice. Further, supplementation of obese animals with SAM sensitized pancreatic tumors to chemotherapy. Treatment of pancreatic cancer cells with Q increased PRDX1 involved in oxidative stress protection. In parallel, tumors in obese mice showed increase in CD133 + treatment refractory tumor populations compared to control animals. These observations indicated that microbial metabolite Q accumulation in high fat diet-fed mice protected tumors from chemotherapy induced oxidative stress by upregulating PRDX1. This protection could be reversed by treatment with SAM. We conclude that relative concentration of SAM and queuosine in fecal samples of pancreatic cancer patients can be developed as a potential biomarker and therapeutic target in chemotherapy refractory pancreatic cancer.

Effects of dietary intervention on human diseases: molecular mechanisms and therapeutic potential

“…This resistance can be counteracted by SAM, which is typically produced by bacteria in lean diets, highlighting the influence of diet on chemotherapy effectiveness via gut microbiome adjustments. 307 Expanding on the theme of diet’s influence on chemotherapy effectiveness in pancreatic cancer, another study revealed that the microbiota-derived tryptophan metabolite indole-3-acetic acid (3-IAA) is enriched in patients responsive to chemotherapy. Through dietary manipulation of tryptophan, an increase in 3-IAA production enhances chemotherapy efficacy by disrupting cancer cell metabolic fitness via increased reactive oxygen species and reduced autophagy.…”

Functional Roles of CD133: More than Stemness Associated Factor Regulated by the Microenvironment

“…CD133 + cells tended to accumulate around adipocytes in pancreatic tumors. Kesh et al (2022) reported that conditioned media from patient-derived adipocytes increased CD133, Sox2, and Oct4 expression, which suggests that peritumoral adipocytes are part of the homing niche that maintains CD133 + population partially because of interleukins secretion such as IL6 [ 190 ].…”

Top advances of the year: Pancreatic cancer

“…In one study, the gut microbe‐derived metabolite trimethylamine N‐oxide (TMAO), the main source of which is dietary choline, enhanced antitumor immunity in mice bearing pancreas tumors through the type I interferon pathway 38 . In the other study, obese mice were found to be resistant to chemotherapy, driven by an enrichment of gut bacteria producing queuosine, which upregulates the expression of antioxidant protein PRDX1 39 …”