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1.
Genes Dev ; 35(1-2): 133-146, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33334822

RESUMO

The cJun NH2-terminal kinase (JNK) signaling pathway is activated by metabolic stress and promotes the development of metabolic syndrome, including hyperglycemia, hyperlipidemia, and insulin resistance. This integrated physiological response involves cross-talk between different organs. Here we demonstrate that JNK signaling in adipocytes causes an increased circulating concentration of the hepatokine fibroblast growth factor 21 (FGF21) that regulates systemic metabolism. The mechanism of organ crosstalk is mediated by a feed-forward regulatory loop caused by JNK-regulated FGF21 autocrine signaling in adipocytes that promotes increased expression of the adipokine adiponectin and subsequent hepatic expression of the hormone FGF21. The mechanism of organ cross-talk places circulating adiponectin downstream of autocrine FGF21 expressed by adipocytes and upstream of endocrine FGF21 expressed by hepatocytes. This regulatory loop represents a novel signaling paradigm that connects autocrine and endocrine signaling modes of the same hormone in different tissues.


Assuntos
Tecido Adiposo/fisiologia , Comunicação Autócrina/genética , Fatores de Crescimento de Fibroblastos/genética , Regulação da Expressão Gênica/genética , Transdução de Sinais/genética , Adipócitos/metabolismo , Adiponectina/metabolismo , Tecido Adiposo/fisiopatologia , Animais , Sistema Endócrino/metabolismo , Metabolismo Energético/genética , Retroalimentação Fisiológica/fisiologia , Fatores de Crescimento de Fibroblastos/sangue , Hepatócitos/metabolismo , Resistência à Insulina/genética , Fígado/metabolismo , MAP Quinase Quinase 4/deficiência , MAP Quinase Quinase 4/genética , MAP Quinase Quinase 4/metabolismo , Sistema de Sinalização das MAP Quinases/fisiologia , Camundongos
2.
Biosci Rep ; 39(7)2019 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-31270248

RESUMO

Cardiometabolic syndrome (CMS) describes the cluster of metabolic and cardiovascular diseases that are generally characterized by impaired glucose tolerance, intra-abdominal adiposity, dyslipidemia, and hypertension. CMS currently affects more than 25% of the world's population and the rates of diseases are rapidly rising. These CMS conditions represent critical risk factors for cardiovascular diseases including atherosclerosis, heart failure, myocardial infarction, and peripheral artery disease (PAD). Therefore, it is imperative to elucidate the underlying signaling involved in disease onset and progression. The c-Jun N-terminal Kinases (JNKs) are a family of stress signaling kinases that have been recently indicated in CMS. The purpose of this review is to examine the in vivo implications of JNK as a potential therapeutic target for CMS. As the constellation of diseases associated with CMS are complex and involve multiple tissues and environmental triggers, carefully examining what is known about the JNK pathway will be important for specificity in treatment strategies.


Assuntos
Dislipidemias/genética , Intolerância à Glucose/genética , Hipertensão/genética , Insulina/genética , MAP Quinase Quinase 4/genética , Tecido Adiposo/enzimologia , Tecido Adiposo/patologia , Adiposidade/genética , Animais , Citocinas/genética , Citocinas/metabolismo , Dislipidemias/enzimologia , Dislipidemias/patologia , Fatores de Crescimento de Fibroblastos/genética , Fatores de Crescimento de Fibroblastos/metabolismo , Regulação da Expressão Gênica , Intolerância à Glucose/enzimologia , Intolerância à Glucose/patologia , Humanos , Hipertensão/enzimologia , Hipertensão/patologia , Insulina/metabolismo , Isoenzimas/genética , Isoenzimas/metabolismo , Fígado/enzimologia , Fígado/patologia , MAP Quinase Quinase 4/deficiência , Camundongos , Camundongos Knockout , Músculo Esquelético/enzimologia , Músculo Esquelético/patologia , Transdução de Sinais , Síndrome
3.
J Am Heart Assoc ; 3(2): e000340, 2014 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-24721794

RESUMO

BACKGROUND: Atrial fibrillation (AF), often associated with structural, fibrotic change in cardiac tissues involving regulatory signaling mediators, becomes increasingly common with age. In the present study, we explored the role of mitogen-activated protein kinase kinase 4 (Mkk4), a critical component of the stress-activated mitogen-activated protein kinase family, in age-associated AF. METHODS AND RESULTS: We developed a novel mouse model with a selective inactivation of atrial cardiomyocyte Mkk4 (Mkk4(ACKO)). We characterized and compared electrophysiological, histological, and molecular features of young (3- to 4-month), adult (6-month), and old (1-year) Mkk4(ACKO) mice with age-matched control littermates (Mkk4(F/F)). Aging Mkk4(ACKO) mice were more susceptible to atrial tachyarrhythmias than the corresponding Mkk4(F/F) mice, showing characteristic slow and dispersed atrial conduction, for which modeling studies demonstrated potential arrhythmic effects. These differences paralleled increased interstitial fibrosis, upregulated transforming growth factor beta 1 (TGF-ß1) signaling and dysregulation of matrix metalloproteinases in Mkk4(ACKO), compared to Mkk4(F/F), atria. Mkk4 inactivation increased the sensitivity of cultured cardiomyocytes to angiotensin II-induced activation of TGF-ß1 signaling. This, in turn, enhanced expression of profibrotic molecules in cultured cardiac fibroblasts, suggesting cross-talk between these two cell types in profibrotic signaling. Finally, human atrial tissues in AF showed a Mkk4 downregulation associated with increased production of profibrotic molecules, compared to findings in tissue from control subjects in sinus rhythm. CONCLUSIONS: These findings together demonstrate, for the first time, that Mkk4 is a negative regulator of the TGF-ß1 signaling associated with atrial remodeling and arrhythmogenesis with age, establishing Mkk4 as a new potential therapeutic target for treating AF.


Assuntos
Fibrilação Atrial/enzimologia , Remodelamento Atrial , Frequência Cardíaca , MAP Quinase Quinase 4/metabolismo , Miócitos Cardíacos/enzimologia , Transdução de Sinais , Fator de Crescimento Transformador beta1/metabolismo , Fatores Etários , Idoso , Angiotensina II/farmacologia , Animais , Fibrilação Atrial/genética , Fibrilação Atrial/patologia , Fibrilação Atrial/fisiopatologia , Remodelamento Atrial/efeitos dos fármacos , Estudos de Casos e Controles , Células Cultivadas , Simulação por Computador , Regulação para Baixo , Feminino , Fibrose , Humanos , MAP Quinase Quinase 4/deficiência , MAP Quinase Quinase 4/genética , Masculino , Camundongos , Camundongos Knockout , Miócitos Cardíacos/efeitos dos fármacos , Miócitos Cardíacos/patologia , Ratos , Ratos Sprague-Dawley , Transdução de Sinais/efeitos dos fármacos , Transfecção , Fator de Crescimento Transformador beta1/genética
4.
Cancer Res ; 70(14): 5797-806, 2010 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-20610622

RESUMO

The mitogen-activated protein kinase (MAPK) kinase 4 (MKK4) is a nonredundant component of stress-activated MAPK signaling modules. Its function in tumorigenesis remains highly controversial with some studies indicating that MKK4 is a tumor suppressor, whereas others have reported a pro-oncogenic role. To clarify the role of MKK4 in cancer, we have created a novel mouse model to test the effect of the specific loss of MKK4 in the epidermis on the formation of papillomas caused by activated ras mutation. We have discovered that skin-specific MKK4-deficient mice are resistant to carcinogen-induced tumorigenesis. One mechanism by which MKK4 promotes cell proliferation and the formation of tumors is by increasing epidermal growth factor receptor expression through the c-Jun NH(2)-terminal protein kinase/c-Jun signaling pathway. Together, our results provide the first genetic demonstration that MKK4 is essential to mediate the oncogenic effect of Ras in vivo, thereby validating MKK4 as a potential drug target for cancer therapy.


Assuntos
Transformação Celular Neoplásica/metabolismo , MAP Quinase Quinase 4/metabolismo , Neoplasias Cutâneas/enzimologia , 9,10-Dimetil-1,2-benzantraceno , Animais , Carcinógenos , Transformação Celular Neoplásica/induzido quimicamente , Transformação Celular Neoplásica/genética , Ativação Enzimática , Feminino , Genes ras , Endogamia , MAP Quinase Quinase 4/deficiência , MAP Quinase Quinase 4/genética , Masculino , Camundongos , Pele/enzimologia , Neoplasias Cutâneas/induzido quimicamente , Neoplasias Cutâneas/genética
5.
Circ Res ; 104(7): 905-14, 2009 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-19265040

RESUMO

Mitogen-activated protein kinase kinase (MKK)4 is a critical member of the mitogen-activated protein kinase family. It is able to activate the c-Jun NH(2)-terminal protein kinase (JNK) and p38 mitogen-activated protein kinase in response to environmental stresses. JNK and p38 are strongly implicated in pathological cardiac hypertrophy and heart failure; however, the regulatory mechanism whereby the upstream kinase MKK4 activates these signaling cascades in the heart is unknown. To elucidate the biological function of MKK4, we generated mice with a cardiac myocyte-specific deletion of mkk4 (MKK4(cko) mice). In response to pressure overload or chronic beta-adrenergic stimulation, upregulated NFAT (nuclear factor of activated T-cell) transcriptional activity associated with exacerbated cardiac hypertrophy and the appearance of apoptotic cardiomyocytes were observed in MKK4(cko) mice. However, when subjected to swimming exercise, MKK4(cko) mice displayed a similar level of physiological cardiac hypertrophy compared to controls (MKK4(f/f)). In addition, we also discovered that MKK4 expression was significantly reduced in heart failure patients. In conclusion, this study demonstrates for the first time that MKK4 is a key mediator which prevents the transition from an adaptive response to maladaptive cardiac hypertrophy likely involving the regulation of the NFAT signaling pathway.


Assuntos
Cardiomegalia/enzimologia , Insuficiência Cardíaca/enzimologia , Coração/crescimento & desenvolvimento , MAP Quinase Quinase 4/metabolismo , Miocárdio/enzimologia , Transdução de Sinais , Adaptação Fisiológica , Animais , Apoptose , Pressão Sanguínea , Cardiomegalia/induzido quimicamente , Cardiomegalia/patologia , Cardiomegalia/fisiopatologia , Modelos Animais de Doenças , Coração/fisiopatologia , Insuficiência Cardíaca/patologia , Insuficiência Cardíaca/fisiopatologia , Isoproterenol , MAP Quinase Quinase 4/deficiência , MAP Quinase Quinase 4/genética , Masculino , Camundongos , Camundongos Knockout , Miocárdio/patologia , Fatores de Transcrição NFATC/metabolismo , Natação , Fatores de Tempo , Transcrição Gênica
6.
J Cell Biochem ; 104(5): 1771-80, 2008 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-18348256

RESUMO

JNK, a member of the mitogen-activated protein kinases (MAPKs), is activated by the MAPK kinases SEK1 and MKK7 in response to environmental stresses. In the present study, the effects of CdCl2 treatment on MAPK phosphorylation and HSP70 expression were examined in mouse embryonic stem (ES) cells lacking the sek1 gene, the mkk7 gene, or both. Following CdCl2 exposure, the phosphorylation of JNK, p38, and ERK was suppressed in sek1-/- mkk7-/- cells. When sek1-/- or mkk7-/- cells were treated with CdCl2, JNK phosphorylation, but not the phosphorylation of either p38 or ERK, was markedly reduced, while a weak reduction in p38 phosphorylation was observed in sek1-/- cells. Thus, both SEK1 and MKK7 are required for JNK phosphorylation, whereas their role in p38 and ERK phosphorylation could overlap with that of another kinase. We also observed that CdCl2-induced HSP70 expression was abolished in sek1-/- mkk7-/- cells, was reduced in sek1-/- cells, and was enhanced in mkk7-/- cells. Similarly, the phosphorylation of heat shock factor 1 (HSF1) was decreased in sek1-/- mkk7-/- and sek1-/- cells, but was increased in mkk7-/- cells. Transfection with siRNA specific for JNK1, JNK2, p38, ERK1, or ERK2 suppressed CdCl2-induced HSP70 expression. In contrast, silencing of p38 or p38 resulted in further accumulation of HSP70 protein. These results suggest that HSP70 expression is up-regulated by SEK1 and down-regulated by MKK7 through distinct MAPK isoforms in mouse ES cells treated with CdCl2.


Assuntos
Cloreto de Cádmio/toxicidade , Células-Tronco Embrionárias/efeitos dos fármacos , Células-Tronco Embrionárias/enzimologia , Proteínas de Choque Térmico HSP70/metabolismo , MAP Quinase Quinase 4/metabolismo , MAP Quinase Quinase 7/metabolismo , Animais , Linhagem Celular , Proteínas de Ligação a DNA/metabolismo , Fatores de Transcrição de Choque Térmico , Resposta ao Choque Térmico/efeitos dos fármacos , Isoenzimas/metabolismo , MAP Quinase Quinase 4/deficiência , MAP Quinase Quinase 7/deficiência , Camundongos , Fosforilação/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Fatores de Transcrição/metabolismo
7.
J Neurochem ; 104(3): 683-95, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18005001

RESUMO

Sequential cleavages of the beta-amyloid precursor protein cleaving enzyme 1 (BACE1) by beta-secretase and gamma-secretase generate the amyloid beta-peptides, believed to be responsible of synaptic dysfunction and neuronal cell death in Alzheimer's disease (AD). Levels of BACE1 are increased in vulnerable regions of the AD brain, but the underlying mechanism is unknown. Here we show that oxidative stress (OS) stimulates BACE1 expression by a mechanism requiring gamma-secretase activity involving the c-jun N-terminal kinase (JNK)/c-jun pathway. BACE1 levels are increased in response to OS in normal cells, but not in cells lacking presenilins or amyloid precursor protein. Moreover, BACE1 is induced in association with OS in the brains of mice subjected to cerebral ischaemia/reperfusion. The OS-induced BACE1 expression correlates with an activation of JNK and c-jun, but is absent in cultured cells or mice lacking JNK. Our findings suggest a mechanism by which OS induces BACE1 transcription, thereby promoting production of pathological levels of amyloid beta in AD.


Assuntos
Secretases da Proteína Precursora do Amiloide/farmacologia , Precursor de Proteína beta-Amiloide/metabolismo , Estresse Oxidativo/fisiologia , Secretases da Proteína Precursora do Amiloide/metabolismo , Precursor de Proteína beta-Amiloide/deficiência , Precursor de Proteína beta-Amiloide/efeitos dos fármacos , Animais , Ácido Aspártico Endopeptidases/metabolismo , Células Cultivadas , Embrião de Mamíferos , Inibidores Enzimáticos/farmacologia , Retroalimentação/efeitos dos fármacos , Retroalimentação/fisiologia , Regulação da Expressão Gênica/efeitos dos fármacos , Peróxido de Hidrogênio/farmacologia , Infarto da Artéria Cerebral Média/fisiopatologia , MAP Quinase Quinase 4/deficiência , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Knockout , Presenilinas/deficiência , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais/efeitos dos fármacos , Fatores de Tempo , Transfecção/métodos
8.
J Immunol ; 179(3): 1926-33, 2007 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-17641059

RESUMO

MAPK kinase 4 (MKK4) is a dual-specificity kinase that activates both JNK and p38 MAPK. However, the mechanism by which MKK4 regulates TNF-induced apoptosis is not fully understood. Therefore, we used fibroblasts derived from MKK4 gene-deleted (MKK4-KO) mice to determine the role of this kinase in TNF signaling. We found that when compared with the wild-type cells, deletion of MKK4 gene enhanced TNF-induced apoptosis, and this correlated with down-regulation of TNF-induced cell-proliferative (COX-2 and cyclin D1) and antiapoptotic (survivin, IAP1, XIAP, Bcl-2, Bcl-x(L), and cFLIP) gene products, all regulated by NF-kappaB. Indeed we found that TNF-induced NF-kappaB activation was abrogated in MKK4 gene-deleted cells, as determined by DNA binding. Further investigation revealed that TNF-induced I kappaB alpha kinase activation, I kappaB alpha phosphorylation, I kappaB alpha degradation, and p65 nuclear translocation were all suppressed in MKK4-KO cells. NF-kappaB reporter assay revealed that NF-kappaB activation induced by TNF, TNFR1, TRADD, TRAF2, NIK, and I kappaB alpha kinase was modulated in gene-deleted cells. Overall, our results indicate that MKK4 plays a central role in TNF-induced apoptosis through the regulation of NF-kappaB-regulated gene products.


Assuntos
Proteínas Reguladoras de Apoptose/antagonistas & inibidores , Apoptose/imunologia , Regulação para Baixo/imunologia , Deleção de Genes , Marcação de Genes , MAP Quinase Quinase 4/genética , NF-kappa B/antagonistas & inibidores , Fator de Necrose Tumoral alfa/fisiologia , Animais , Apoptose/genética , Proteínas Reguladoras de Apoptose/biossíntese , Proteínas Reguladoras de Apoptose/genética , Linhagem Celular , Ciclina D1/biossíntese , Ciclina D1/genética , Ciclo-Oxigenase 2/biossíntese , Ciclo-Oxigenase 2/genética , Regulação para Baixo/genética , Fibroblastos/citologia , Fibroblastos/enzimologia , Fibroblastos/imunologia , MAP Quinase Quinase 4/deficiência , MAP Quinase Quinase 4/fisiologia , Metaloproteinase 9 da Matriz/biossíntese , Metaloproteinase 9 da Matriz/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , NF-kappa B/metabolismo , NF-kappa B/fisiologia , Receptores Tipo I de Fatores de Necrose Tumoral/biossíntese , Receptores Tipo I de Fatores de Necrose Tumoral/genética , Receptores Tipo II do Fator de Necrose Tumoral/biossíntese , Receptores Tipo II do Fator de Necrose Tumoral/genética
9.
J Biol Chem ; 282(6): 3507-19, 2007 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-17158870

RESUMO

Mitogen-activated protein kinase kinase-4 (MKK4/SEK1) cooperates with phosphatidylinositol 3-kinase to maintain the survival of non-small cell lung cancer (NSCLC) cells, but the biochemical basis of this phenomenon has not been elucidated. Here we used genetic approaches to modulate MKK4 expression in mouse embryo fibroblasts (MEF cells) and NSCLC cells to identify prosurvival signals downstream of MKK4. Relative to wild-type MEF cells, MKK4-null MEF cells were highly susceptible to apoptosis by LY294002, paclitaxel, or serum starvation. MKK4 promoted the survival of MEF cells by decreasing the expression of phosphatase and tensin homologue deleted from chromosome 10 (PTEN). MKK4 inhibited PTEN transcription by activating NFkappaB, a transcriptional suppressor of PTEN. MKK4 was required for nuclear translocation of RelA/p65 and processing of the NFkappaB2 precursor (p100) into the mature form (p52). Studies on a panel of NSCLC cell lines revealed a subset with high MKK4/high NFkappaB/low PTEN that was relatively resistant to apoptosis. Thus, MKK4 promotes cell survival by activating phosphatidylinositol 3-kinase through an NFkappaB/PTEN-dependent pathway.


Assuntos
MAP Quinase Quinase 4/fisiologia , NF-kappa B/fisiologia , PTEN Fosfo-Hidrolase/antagonistas & inibidores , PTEN Fosfo-Hidrolase/biossíntese , Transdução de Sinais/fisiologia , Animais , Apoptose/genética , Carcinoma Pulmonar de Células não Pequenas/enzimologia , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Linhagem Celular , Linhagem Celular Tumoral , Proliferação de Células , Sobrevivência Celular/fisiologia , Embrião de Mamíferos/citologia , Fibroblastos/enzimologia , Fibroblastos/metabolismo , Humanos , Neoplasias Pulmonares/enzimologia , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , MAP Quinase Quinase 4/deficiência , MAP Quinase Quinase 4/genética , Camundongos , Mutagênese Sítio-Dirigida , PTEN Fosfo-Hidrolase/genética , Fosfatidilinositol 3-Quinases/metabolismo , Fosfatidilinositol 3-Quinases/fisiologia , Transdução de Sinais/genética
10.
Biochim Biophys Acta ; 1773(8): 1349-57, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17157936

RESUMO

c-Jun NH2-terminal protein kinase (JNK) is a mitogen-activated protein kinase (MAPK) involved in the regulation of numerous physiological processes during development and in response to stress. Its activity is increased upon phosphorylation by the MAPK kinases, MKK4 and MKK7. Similar to the early embryonic death of mice caused by the targeted deletion of the jnk genes, mice lacking mkk4 or mkk7 die before birth. The inability of MKK4 and MKK7 to compensate for each other's functions in vivo is consistent with their synergistic effect in mediating JNK activation. However, the phenotypic analysis of the mutant mouse embryos indicates that MKK4 and MKK7 have specific roles that may be due to their selective regulation by extracellular stimuli and their distinct tissue distribution. MKK4 and MKK7 also have different biochemical properties. For example, whereas MKK4 can activate p38 MAPK, MKK7 functions as a specific activator of JNK. Here we summarize the studies that have shed light on the mechanism of activation of MKK4 and MKK7 and on their physiological functions.


Assuntos
MAP Quinase Quinase 4/fisiologia , MAP Quinase Quinase 7/fisiologia , Sequência de Aminoácidos , Animais , Apoptose , Clonagem Molecular , Feminino , Cardiopatias/enzimologia , Sistema Imunitário/enzimologia , Fígado/enzimologia , MAP Quinase Quinase 4/deficiência , MAP Quinase Quinase 4/genética , MAP Quinase Quinase 7/deficiência , MAP Quinase Quinase 7/genética , Camundongos , Camundongos Knockout , Modelos Animais , Dados de Sequência Molecular , Neoplasias/enzimologia , Neurônios/citologia , Neurônios/enzimologia , Gravidez , Distribuição Tecidual
11.
Cancer Res ; 66(11): 5560-4, 2006 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-16740690

RESUMO

Tumor-suppressors have commanded attention due to the selection for their inactivating mutations in human tumors. However, relatively little is understood about the inverse, namely, that tumors do not select for a large proportion of seemingly favorable mutations in tumor-suppressor genes. This could be explained by a detrimental phenotype accruing in a cell type-specific manner to most cells experiencing a biallelic loss. For example, MKK4, a tumor suppressor gene distinguished by a remarkably consistent mutational rate across diverse tumor types and an unusually high rate of loss of heterozygosity, has the surprisingly low rate of genetic inactivation of only approximately 5%. To explore this incongruity, we engineered a somatic gene knockout of MKK4 in human cancer cells. Although the null cells resembled the wild-type cells regarding in vitro viability and proliferation in plastic dishes, there was a marked difference in a more relevant in vivo model of experimental metastasis and tumorigenesis. MKK4(-/-) clones injected i.v. produced fewer lung metastases than syngeneic MKK4-competent cells (P = 0.0034). These findings show how cell type-specific detrimental phenotypes can offer a paradoxical and yet key counterweight to the selective advantage attained by cells as they experiment with genetic null states during tumorigenesis, the resultant balance then determining the observed biallelic mutation rate for a given tumor-suppressor gene.


Assuntos
Genes Supressores de Tumor , MAP Quinase Quinase 4/deficiência , MAP Quinase Quinase 4/genética , Neoplasias Pancreáticas/enzimologia , Neoplasias Pancreáticas/genética , Animais , Processos de Crescimento Celular/genética , Linhagem Celular Tumoral , Ativação Enzimática , Éxons , Feminino , Deleção de Genes , Humanos , MAP Quinase Quinase 4/metabolismo , Sistema de Sinalização das MAP Quinases , Camundongos , Camundongos Nus , Metástase Neoplásica , Neoplasias Pancreáticas/patologia , Fenótipo , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo
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