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ResearchIn-Press PreviewGastroenterologyImmunologyOncology Open Access | 10.1172/JCI199516

A CD138+ tumor-associated macrophage-Siglec-F+ neutrophil feedforward loop promotes immune evasion in pancreatic cancer

Chao Wang,1 Qi Zhang,2 Jinyan Huang,3 Fangyu Lin,2 Danyang Zhao,3 Youling Mu,3 Junshuo Tong,3 Jinping Li,3 Yingjiqiong Liang,3 Tao Zeng,3 Fukang Shi,2 Hang Shen,2 Tingting Lu,5 and Tingbo Liang2

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Wang, C. in: PubMed | Google Scholar

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Zhang, Q. in: PubMed | Google Scholar

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Huang, J. in: PubMed | Google Scholar |

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Lin, F. in: PubMed | Google Scholar

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Zhao, D. in: PubMed | Google Scholar |

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Mu, Y. in: PubMed | Google Scholar

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Tong, J. in: PubMed | Google Scholar

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Li, J. in: PubMed | Google Scholar

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Liang, Y. in: PubMed | Google Scholar

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Zeng, T. in: PubMed | Google Scholar

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Shi, F. in: PubMed | Google Scholar

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Shen, H. in: PubMed | Google Scholar

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Lu, T. in: PubMed | Google Scholar

1Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

2Department of Hepatobiliary and Pancreatic Surgery, Zhejiang University School of Medicine, Hangzhou, China

3Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, Hangzhou, China

4Zhejiang Provincial Key Laboratory of Pancreatic Disease, Zhejiang University School of Medicine, HangZhou, China

5Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disor, Shanghai Jiao Tong University, Shanghai, China

Find articles by Liang, T. in: PubMed | Google Scholar

Published March 12, 2026 - More info

J Clin Invest. https://doi.org/10.1172/JCI199516.
Copyright © 2026, Wang et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published March 12, 2026 - Version history
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Abstract

Immune evasion is a major obstacle ahead of pancreatic cancer therapy. Recent data implicate pro-inflammatory macrophages in the progression of pancreatic ductal adenocarcinoma (PDAC) and its therapeutic response. However, whether or which of the pro-inflammatory macrophage subtypes play a crucial role in the immune escape of PDAC remains unclear. Here we identify a population of CD138+ tumor-associated macrophages (TAMs), characterized by their pro-inflammatory and neutrophil-chemotactic activity, which undergo significant expansion in both PDAC patients and mouse models. These cells are elicited by a local synergy between IL-34-syndecan-1 and PGE2-EP2 signaling and are associated with immune evasion and poor clinical outcomes in patients, while also promoting immune escape and disease progression in mouse models. Mechanistically, CD138+ TAMs establish a feedforward loop with immunosuppressive Siglec-F+ neutrophils, which exhibit elevated PGE2 expression, via the secretion of Saa3 and Cxcl1. Targeting CD138+ TAMs by disrupting IL-34-syndecan-1 signaling with anti-IL-34 neutralizing antibodies significantly suppresses PDAC progression, especially when combined with anti-PD-1 antibodies. Together, our study elucidates a CD138+ TAM-Siglec-F+ neutrophil axis that drives immune escape in PDAC and proposes a therapeutic strategy that integrates IL-34-syndecan-1 signaling blockade with anti-PD-1 immunotherapy for the treatment of PDAC.

Graphical Abstract
graphical abstract
Supplemental material

View Unedited blot and gel images

View Supplemental Data file 1. Patient information for Cohort 3.

View Supplemental Data file 2. Marker genes of clusters of F4/80+ cells isolated from orthotopic tumors.

View Supplemental Data file 3. Marker genes of main clusters of live cells derived from the pancreas of both healthy and acute pancreatitis mice.

View Supplemental Data file 4. Signaling pathways enriched in Sdc1+ TAMs identified by GESA.

View Supplemental Data file 5. The DEGs and the KEGG enriched pathways associated with CD138+ macrophages derived from orthotopic tumors, in comparison to previously reported gene sets and pathways.

View Supplemental Data file 6. Common genes identified between the DEGs of the Sdc1+ (MM1) scRNA-seq cluster and CD138+ macrophages isolated from orthotopic tumors.

View Supplemental Data file 7. Marker genes of main clusters of live cells isolated from peripheral blood and tumor tissues of mice with KPC orthotopic tumors.

View Supplemental Data file 8. Synergized genes up-regulated by IL-34 and PGE2.

View Supplemental Data file 9. Marker genes of clusters of monocytes/macrophages derived from peripheral blood and tumor tissues of orthotopic KPC mice.

View Supplemental Data file 10. Driver genes of the monocyte-to-Sdc1+ TAM transition.

View Supplemental Data file 11. Signaling pathways enriched in Sdc1+ TAMs based on KEGG enrichment analysis.

View Supplemental Data file 12. Marker genes of CD8+ T cell clusters, DEGs of CD8+ T cells, and GSEA of pathways enriched in CD8+ T cells in orthotopic KPC mice following adoptive transfer.

View Supplemental Data file 13. Marker genes of CD8+ T cell clusters, DEGs of CD8+ T cells, and GSEA of pathways enriched in CD8+ T cells in control and Sdc1-cKO mice with orthotopic tumors.

View Supplemental Data file 14. Marker genes of clusters of neutrophils derived from tumor tissues of orthotopic KPC mice.

View Supplemental Data file 15. DEGs of Siglec-F+ neutrophils compared to Siglec-F- neutrophils and signaling pathways enriched in Siglec-F+ neutrophils as determined by KEGG enrichment analysis.

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