New Players in Pancreatic Cancer: Microbiome and Metabolic Syndrome Signalling

Dear Colleagues,

Pancreatic ductal adenocarcinoma (PDA), accounting for over 85% of all pancreatic malignancies, constitutes the 3rd deadliest cancer in the USA, with a still dismaying prognosis and that is increasing in incidence throughout the world. The pathophysiological mechanisms leading to PDA represent a hugely intricated arena are still yet to be properly unveiled. Nevertheless, more recently oral and gastrointestinal microbial dysbiosis has been increasingly recognized for its role in affecting normal cells while promoting cancer-related processes such as increased cell signaling, immune system evasion and invasion. Indeed, the dysbiosis-linked activation of pattern recognition receptors, a process which fosters inflammation in response to microbial pathogens, accelerates tumorigenesis. This may assist in identifying an associated distinct stage-specific gut and pancreatic microbiome and may be amenable to future use in early diagnosis and risk stratification as well as to tailoring strategies of risk in reduction pre-invasive disease or enhanced anti-tumor immunity and susceptibility to immunotherapy. This context is still very complex, especially when considering that while the cancerous pancreas has an abnormal expansion of Proteobacteria, associated with gut dysbiosis (Proteobacteria, Actinobacteria, Fusobacteria, and Verrucomicrobia), the oncogenic Kras expression itself conversely may affect the composition and diversity of the gut and intra-pancreatic flora. Metabolic syndrome is a spreading new threat worldwide and dysbiosis is a common associated feature of the condition. It is not surprising that this entity, which is accompanied by dysregulated inflammatory response, has also been recently associated with fatty pancreas and pancreas tumorigenesis. This Special Issue aims to gather top expertise in the above interrelated areas in order to enlighten researchers in the field while also providing enormous advantages to clinical practice.

Prof. Dr. Francesco Marotta
Guest Editor

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• pancreatic adenocarcinoma
• microbioma
• metabolic sybdrome
• early biomarkers to diagnose and follow up
• risk facto