Table 2.
Mechanisms of chemoresistance in PDAC by the action of ECM and PCSCs.
| ECM-Related Factors | Point of Action | Mechanism |
|---|---|---|
| Abnormal vascularization/high fibrosis | Hypoxia | Affecting affect drug transport |
| pH | ||
| Matrix stiffness | ||
| ECM proteins | EMT | |
| MAPK signaling pathway | ||
| PI3K signaling pathway | ||
| YAP signaling pathway | ||
| ECM-PSCS interaction | HA-CD44 | Increase the stemness and MDR1 |
| Keap1-NRF2 | Up-regulation of glutathione pathway | |
| Regulating the expression of drug resistance-related genes | ||
| JNK | Up-regulation of ECM related genes | |