Background & aims: Considering the role of the P2X7 receptor in intestinal inflammation, we examined its potential involvement in fibrosis development.
Methods: Colonic biopsies from patients with inflammatory bowel disease (IBD) were analyzed via double immunofluorescence under confocal microscopy. Colon fibroblasts were used to analyze P2X7 receptor modulation and chemotaxis. Experimental chronic colitis was induced with 3 cycles of oral dextran sodium sulfate (DSS) treatment in P2X7+/+ and P2X7-/- mice. The mice were evaluated via follow-up video endoscopy with an endoluminal ultrasound biomicroscopic (eUBM) system, histological scoring, immunohistochemistry, cytokine measurement in colon explants, gene expression analysis of P2X7 signaling targets via quantitative real-time polymerase chain reaction (qRT-PCR), and microbiome composition analysis.
Results: Colocalization studies revealed a greater density of P2X7+/alpha smooth muscle actin (α-SMA)+ cells in colon sections from patients than in those from controls, especially in patients with Crohn's disease (P < .05). Activation of the adenosine triphosphate (ATP)-P2X7 pathway in human fibroblasts increased cell migration, calcium influx, and collagen production. Video colonoscopy with the eUBM system revealed significantly more inflammation, with greater wall thickness and stiffness, in P2X7+/+ mice than in P2X7-/- and P2X7+/+ mice treated with A740003 (a P2X7-selective inhibitor). P2X7+/+ mice exhibited increased caspase-1 and NLRP3 expression, as well as nuclear factor κB (NF-κB) and extracellular signal-regulated kinase (ERK) activation, accompanied by decreased peroxisome proliferator-activated receptor gamma (PPARγ) expression. In the supernatants of colon explants, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, interferon (IFN)-γ, transforming growth factor (TGF)-β, IL-10, and collagen production were increased in P2X7+/+ mice. Various microbial changes were observed in P2X7-/- and P2X7+/+ mice.
Conclusions: Regulatory mechanisms downstream of P2X7, combined with signals from a dysbiotic microbiota, activate intracellular signaling pathways and the inflammasome, leading to intestinal inflammation and promoting fibrogenesis.
Background & aims: In response to injury, pancreatic acinar cells undergo acinar-to-ductal metaplasia (ADM), marked by loss of acinar identity and acquisition of ductal features. Although ADM can resolve to support tissue repair, it may also persist and serve as a precursor to pancreatic cancer. Whether diverse pancreatic stressors drive a shared or context-specific ADM program remains unclear. We sought to comprehensively define metaplastic responses to clinically relevant exocrine pancreas diseases known to increase cancer risk.
Methods: We profiled ADM and the surrounding microenvironment across mouse models of exocrine disease-including acute, recurrent, and chronic pancreatitis, as well as in the setting of oncogenic Kras-capturing over 300,000 single cells. To enable high-quality transcriptomic profiling in enzyme-rich tissue, we leveraged FixNCut, a method that preserves RNA integrity in the exocrine pancreas. Findings were validated in human pancreas tissue using CosMx spatial transcriptomics.
Results: We identify a conserved acinar response across disease contexts that gives rise to previously unrecognized distinct metaplastic states, including a "gateway" ADM population that precedes more advanced metaplastic states marked by complete loss of acinar identity. In pancreatic intraepithelial neoplasia (PanIN) precancerous lesions, we detect classical-like and basal-like states, suggesting that pancreatic cancer subtypes are specified much earlier than previously appreciated. In Kras-mutant tissue, we identify a second wave of inflammation and the emergence of an immunosuppressive niche, coinciding with PanIN formation.
Conclusions: Our findings define a conserved program of acinar plasticity across exocrine pancreas diseases. We further link unresolved ADM to immune remodeling during precursor lesion formation and observe the emergence of pancreatic cancer subtypes in early PanIN lesions.

