In vivo experiments were conducted using a syngeneic rat orthotopic CCA model. Coculturing CCA cells with myofibroblastic human primary hepatic stellate cells

or LX-2 cells significantly decreased TRAIL-induced apoptosis in CCA cells, a cytoprotective effect abrogated by neutralizing platelet-derived growth factor (PDGF)-BB antiserum. Cytoprotection by PDGF-BB was dependent upon Hedgehog (Hh) signaling, because it was abolished by the smoothened (SMO; the transducer of Hh signaling) inhibitor, cyclopamine. PDGF-BB induced cyclic adenosine monophosphate–dependent protein kinase–dependent trafficking of SMO to the plasma membrane, resulting in glioma-associated oncogene (GLI)2 nuclear translocation and Inhibitor Library manufacturer activation of a consensus GLI reporter gene-based luciferase assay. A genome-wide messenger RNA expression analysis identified

67 target genes to be commonly up- (50 genes) or down-regulated (17 genes) by both Sonic hedgehog and PDGF-BB in a cyclopamine-dependent manner in CCA cells. Finally, in a rodent CCA in vivo model, cyclopamine administration 5-Fluoracil cost increased apoptosis in CCA cells, resulting in tumor suppression. Conclusions: MFB-derived PDGF-BB protects CCA cells from TRAIL cytotoxicity by a Hh-signaling–dependent process. These results have therapeutical implications for the treatment of human CCA. (HEPATOLOGY 2011;) Cholangiocarcinoma (CCA) is a highly lethal malignancy with limited treatment options.1-3 It is the most common biliary cancer, and epidemiologic studies suggest that its incidence is increasing in several Western countries.4 Suplatast tosilate Human CCA in vivo paradoxically expresses the death ligand, tumor necrosis factor–related apoptosis-inducing ligand (TRAIL), and its cognate death receptors, 5 suggesting that these cancers are reliant on potent survival signals for tumor maintenance and progression. However, the mechanisms by which CCA evades apoptosis by

TRAIL and other proapoptotic stimuli is incompletely understood. CCAs are highly desmoplastic cancers, suggesting that cancer-associated fibroblasts within the tumor microenvironment contribute to their development and progression, as has been proposed for other cancers (e.g., breast cancer, prostate cancer, etc.).6, 7 Cancer-associated fibroblasts are perpetually “activated” and express alpha-smooth muscle actin (α-SMA); cells exhibiting this activated phenotype are often referred to as myofibroblasts (MFBs).8 In the liver, MFBs are derived from periportal fibroblasts, hepatic stellate cells (HSCs), and, perhaps, an epithelial-to-mesenchymal transition of cholangiocytes, hepatocytes, and/or the tumor itself.9, 10 A role for MFBs in carcinogenesis and tumor biology has only recently received attention.8, 11-13 Cross-talk between cancer and MFBs appears to be exploited by cancers as a tumor-promoting mechanism.