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The rising incidence of pancreatic cancer is largely driven by increased prevalence of obesity and type 2 diabetes (T2D). Hyperinsulinemia is a cardinal feature of obesity and T2D, and is associated with increased cancer incidence and mortality. Whether insulin alone plays a causal role in increasing cancer risk by directly affecting the tumor cell of origin remains unclear. Our previous studies demonstrated that genetically reducing production of insulin suppressed formation of pancreatic intraepithelial neoplasia (PanIN) pre-cancerous lesions in mice with mutant Kras. However, consistent with a role for insulin in modulating the immune system, we saw changes in fibrosis, as well as changes in the transcriptomes of immune cells in the pancreas in mice with reduced insulin. Thus, it remained unclear whether hyperinsulinemia exerted its effects directly on the cells that give rise to PanINs or indirectly on the tumor …