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. Author manuscript; available in PMC: 2021 Jun 1.
Published in final edited form as: Gastroenterology. 2020 Mar 19;158(8):2072–2081. doi: 10.1053/j.gastro.2020.02.059

Figure 1. Cells of origin for PDA.

Figure 1.

There is evidence that PDAs develop from acinar and/or duct cells. In 3-dimensional organoid culture, duct cells that express oncogenic KRAS can develop into PanIN-like cells; when these are transplanted into mice they form low-grade dysplasias. After additional disruption of Brg1, duct cells with a KRAS mutation can progress to IPMN. Acinar cells are highly plastic and, in crosstalk with inflammatory macrophages, can transdifferentiate to a ductal phenotype (acinar to ductal metaplasia). With an oncogenic KRAS mutation these ADM cells stay locked in a ductal stage, show increased EGFR signaling, and progress to PanIN and PDA.