Bowdoin Science Journal

Cancer Biology

Gut Viruses Might Be the Key to Life Saving Early Pancreatic Cancer Diagnosis

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New study links the community of viruses in our gut to early pancreatic cancer development – a potentially lifesaving discovery.

With a mortality-to-incidence ratio of over 90%, pancreatic cancer (PC) is among the most deadly forms of cancer. Since its early stages often bear no distinct symptoms, the disease grows stealthily until it’s too late. What’s more? Scientists foresee a near 100% increase in PC deaths, from 466 000 in 2020 to over 800 000 by 2040. To avert this grim future, researchers strive to develop methods for earlier detection, and subsequent earlier treatment. A 2022 study at the University of Tokyo linked PC to changes in gut microbiome composition. This has directed gastroenterologists’ focus to the microbiome in the search for new diagnostic tools.

The gut microbiome is often understood as the community of bacteria living in symbiosis with our digestive tract. Bacteria, like E. coli, break down our food in exchange for a safe habitat. However, bacteria do not aid our digestion for brownie points. As evolving creatures, they constantly test the limits of our gut ecosystems. As far as we understand, that’s where viruses come in; they regulate the bacterial population in our guts. The microbiome, therefore, consists of not only bacteria but also viruses. All viruses together make up our body’s virome.

An imbalance of bacteria and viruses has previously been observed in PC patients and is believed to be a factor in PC development. For example, the bacterium Roseburia intestinalis is significantly less abundant in the guts of PC patients compared to healthy individuals. This particular bacterium produces a cancer-inhibiting metabolite called butyrate, a substance that limits cancer development by suppressing inflammation and reducing the expression of genes involved in tumor cell growth. Other bacteria produce cancer promoting-metabolites, like lipopolysaccharide (LPS). This substance activates our immune system in the presence of pathogens, but also stimulates inflammation, and therefore, promotes cancer growth in the process. The balance of bacteria producing these two kinds of metabolites depends on the virome’s composition. Therefore, if we could identify the gut viruses causing imbalances, we might be able to diagnose patients earlier.

Researchers at Xi’an Jiaotong University took on this hypothesis when they performed a study that compared PC patient viromes to those of healthy individuals. They sequenced the DNA of 183 fecal samples from a Spanish and a German cohort with 101 PC patients and 82 healthy individuals. After sequencing the samples, they filtered out human DNA by comparing the sequenced DNA to an established human reference genome. They then used viral references to compare viral DNA from the samples to known viruses. After statistical analyses confirmed significant difference between the PC patient group and the healthy group, they identified which viruses were present in the PC patients’ guts, and how those differed from the ones found in healthy individuals. As pancreatic cancer severity increased, virome diversity decreased in PC patients. Additionally, the viruses present in the affected individuals targeted different bacteria compared to the gut viruses found in healthy individuals, offering a potential explanation for the relationship between unbalanced microbiomes and cancer growth.

Using their results, the researchers created models to differentiate PC patients from healthy individuals. These models succeeded with 87.9% accuracy. Though these findings do not offer the ultimate solution to late PC diagnoses, access to virome information could be used as a diagnostic tool in addition to the tools currently available. Namely, a viral DNA sequencing-based tool could identify the specific viral biomarkers linked to pancreatic cancer. In the future, at risk groups for PC might, therefore, be asked to supply fecal samples for gut virus analysis during routine check-ups. In the case that PC-linked biomarkers show up, these at-risk groups could be provided early treatment, potentially saving their lives.

Sources:

Miyabayashi, K., Ijichi, H., & Fujishiro, M. (2022). The Role of the Microbiome in Pancreatic Cancer. Cancers, 14(18), 4479. https://doi.org/10.3390/cancers14184479  

Zhang, P., Shi, H., Guo, R., Li, L., Guo, X., Yang, H., Chang, D., Cheng, Y., Zhao, G., Li, S., Zhong, Q., Zhang, H., Zhao, P., Fu, C., Song, Y., Yang, L., Wang, Y., Zhang, Y., Jiang, J., & Wang, T. (2024). Metagenomic analysis reveals altered gut virome and diagnostic potential in pancreatic cancer. Journal of Medical Virology, 96(7). https://doi.org/10.1002/jmv.29809

Cover image by magicmine, https://stock.adobe.com/search?k=pancreas+cancer&asset_id=343535067

From Milk to Malignancy – Breast Cancer and its Metabolic Implications 

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The annual rise of cancer cases has created a high demand for new innovative treatments and has made cancer a prominent topic in the scientific community. According to the American Cancer Society (ACS), approximately 20 million new cancer cases were diagnosed worldwide in 2022, leading to 9.7 million deaths [1]. It is expected that by 2050, cancer cases will reach 35 million, largely due to population growth [1]. While significant advancements have been made in cancer research, the complexity of different cancer types presents challenges. 

One of the most prevalent forms is breast cancer, which, in 2022, was the second most common cancer in the U.S., with 2.3 million new cases, predominantly affecting women [2]. Unlike many cancers, breast cancer is not a single disease but a collection of subtypes characterized by distinct clinical, morphological, and molecular features. This heterogeneity makes it challenging to study and treat effectively. A recent study published in Nature Metabolism explores the metabolic differences between normal mammary cells and breast cancer cells [4]. Understanding these metabolic processes could pave the way for new, targeted therapies. Researchers have identified specific metabolic vulnerabilities in mammary epithelial cells, which line the breast tissue.

 

Figure 1. Non-tumorigenic Mammary Gland Components. A diagram of a non-tumorigenic mammary gland showing a cluster of alveoli containing luminal and basal cells. Luminal cells line the milk ducts and alveoli and are responsible for milk secretion during lactation. Basal cells are believed to play a role in transporting milk to the nipple during lactation. Source: Created in BioRender, [4], [10], [11].

In the normal mammary gland, various types of cells carry out specific functions, one of which is the progenitor cells. These progenitor cells generate distinct alveolar structures that continuously form in the adult breast, and their activity is crucial for maintaining normal mammary homeostasis [5]. Progenitor cells are located in the luminal compartment [6], which is also home to the luminal cells. The luminal cells play a key role in lactation by lining the milk ducts and alveoli, where they secrete milk (Figure 1)[7]. In contrast, basal cells are located around the luminal cells and are believed to function during lactation by helping to transport milk to the nipple (Figure 1)[7]. Although these mammalian epithelial cells (luminal and basal cells) are important to the function of normal mammary glands, these also serve as a tumour cell of origin [4].

In their study, Mahendralingam et al. used mass spectrometry to analyze the metabolic profiles of normal human mammary cells [8]. They discovered that luminal progenitor cells primarily rely on oxidative phosphorylation for energy, whereas basal cells depend more on glycolysis [4]. This distinction is crucial because oxidative phosphorylation is an efficient, oxygen-dependent process that generates substantial energy, while glycolysis, though faster, is less efficient and does not require oxygen — a pathway often favored by cancer cells to support rapid growth [9]. Targeting these distinct energy pathways could lead to more effective treatments for different breast cancer subtypes.

However, a new discovery was that breast cancer cells appear to adopt the metabolic programs of their cells of origin [4,9]. This complicates treatment since the cancer cells may still be vulnerable to metabolic pathways that are important for normal cell function. As a result, treatments designed to target specific metabolic pathways might not work as expected, since the cancer cells might behave similarly to the healthy cells from which they originated. 

The results from Mahendralingam et al. can form a basis for future metabolic studies that may lead to specific anti-tumoral drug therapies designed to treat specific breast cancer subtypes. This type of research lays a foundation for targeted approaches but further studies are needed to assess how findings, such as this one, can translate into clinical practice. As breast cancer continues to rise, understanding the complexity is more important than ever. 

 

Work Cited: 

  1. Global Cancer Facts & Figures. (n.d.). Retrieved October 27, 2024, from https://www.cancer.org/research/cancer-facts-statistics/global-cancer-facts-and-figures.html
  2. Global cancer burden growing, amidst mounting need for services. (n.d.). Retrieved October 27, 2024, from https://www.who.int/news/item/01-02-2024-global-cancer-burden-growing–amidst-mounting-need-for-services
  3. Sánchez López de Nava, A., & Raja, A. (2024). Physiology, Metabolism. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK546690/
  4. Alfonso-Pérez, T., Baonza, G., & Martin-Belmonte, F. (2021). Breast cancer has a new metabolic Achilles’ heel. Nature Metabolism, 3(5), 590–592. https://doi.org/10.1038/s42255-021-00394-8
  5. Tharmapalan, P., Mahendralingam, M., Berman, H. K., & Khokha, R. (2019). Mammary stem cells and progenitors: Targeting the roots of breast cancer for prevention. The EMBO Journal, 38(14), e100852. https://doi.org/10.15252/embj.2018100852
  6. Tornillo, G., & Smalley, M. J. (2015). ERrrr…Where are the Progenitors? Hormone Receptors and Mammary Cell Heterogeneity. Journal of Mammary Gland Biology and Neoplasia, 20(1–2), 63–73. https://doi.org/10.1007/s10911-015-9336-1
  7. New Paradigm for Mammary Glands. (n.d.). Massachusetts General Hospital. Retrieved December 8, 2024, from https://www.massgeneral.org/cancer-center/clinician-resources/advances/new-paradigm-for-mammary-glands
  8. Mahendralingam, M. J., Kim, H., McCloskey, C. W., Aliar, K., Casey, A. E., Tharmapalan, P., Pellacani, D., Ignatchenko, V., Garcia-Valero, M., Palomero, L., Sinha, A., Cruickshank, J., Shetty, R., Vellanki, R. N., Koritzinsky, M., Stambolic, V., Alam, M., Schimmer, A. D., Berman, H. K., … Khokha, R. (2021). Mammary epithelial cells have lineage-rooted metabolic identities. Nature Metabolism, 3(5), 665–681. https://doi.org/10.1038/s42255-021-00388-6
  9. ZHENG, J. (2012). Energy metabolism of cancer: Glycolysis versus oxidative phosphorylation (Review). Oncology Letters, 4(6), 1151–1157. https://doi.org/10.3892/ol.2012.928
  10. Fig. 3 Stem cell in glandular and stratified epithelia. A A schematic… (n.d.). ResearchGate. Retrieved December 7, 2024, from https://www.researchgate.net/figure/Stem-cell-in-glandular-and-stratified-epithelia-A-A-schematic-model-depicting-the_fig3_374804603
  11. Model of normal mammary gland structure. This tissue is composed of… (n.d.). ResearchGate. Retrieved December 8, 2024, from https://www.researchgate.net/figure/Model-of-normal-mammary-gland-structure-This-tissue-is-composed-of-ducts-which-are_fig1_357239665