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ResearchIn-Press PreviewGastroenterologyImmunologyOncology
Open Access |
10.1172/JCI199516
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
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Huang, J.
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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.
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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
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.
View Unedited blot and gel images
View Supplemental Data file 1. Patient information for Cohort 3.
View Supplemental Data file 4. Signaling pathways enriched in Sdc1+ TAMs identified by GESA.
View Supplemental Data file 8. Synergized genes up-regulated by IL-34 and PGE2.
View Supplemental Data file 10. Driver genes of the monocyte-to-Sdc1+ TAM transition.