{
  "abstract": "Pancreatic ductal adenocarcinoma has an extremely poor prognosis. Pancreatic ductal adenocarcinoma harbors a multidomain intratumoral microbial community dominated by bacteria and also containing fungi; its composition differs fundamentally from that of normal pancreatic tissue and drives malignant progression through three major axes: inflammatory-immune signaling, metabolic-epigenetic regulation, and stromal remodeling. Gammaproteobacterial lipopolysaccharide establishes a chronic proinflammatory microenvironment through the Toll-like receptor 4-nuclear factor kappa B axis, whereas in situ gemcitabine inactivation by the long isoform of bacterial cytidine deaminase represents the best-supported microbiome-mediated mechanism of drug resistance to date. In experimental systems, Fusobacterium nucleatum has been linked to tumor-cell invasion and alternatively activated macrophage polarization. In mouse and cell models, intratumoral fungi have been implicated in immunosuppressive signaling through the C-type lectin receptor dectin-1-interleukin 33 axis and the mannose-binding lectin-complement pathway; their relevance to human pancreatic ductal adenocarcinoma remains debated. These three axes may converge on stromal activation and epithelial-mesenchymal transition and contribute to invasion and treatment resistance. Antimicrobial strategies targeting drug-resistance-associated bacteria can restore gemcitabine efficacy in animal experiments and have been explored experimentally alongside programmed cell death protein 1 blockade; the clinically appropriate patient populations and optimal sequencing of such combinations remain to be defined in prospective trials.",
  "abstract_shown": true,
  "affiliations": [
    "Gansu University of Chinese Medicine",
    "Affiliated Hospital of Gansu University of Chinese Medicine"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhonghua Qi"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Miaolei Wang"
    },
    {
      "affs": [
        1
      ],
      "name": "Yajing Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Lina Tian"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Junhong Liu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cr8xamcmjj2q0.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1970900",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13736042/",
  "id": "cr8xamcmjj2q0",
  "issns": [
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  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1970900/full",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review"
    ],
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      "openalex",
      "2730|Pancreatic and Hepatic Oncology Research"
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  "pdf_url": "https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1970900/pdf",
  "pmcid": "PMC13736042",
  "pmid": "42991517",
  "published": "2026-10-22",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/cr8xamcmjj2q0.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:17Z",
      "native_id": "10.3389/fimmu.2026.1970900",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1970900/full"
    },
    {
      "first_seen": "2026-11-09T12:21:35Z",
      "native_id": "PMC13736042",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fimmu.2026.1970900"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Pancreatic and Hepatic Oncology Research",
      "subfield": "oncology"
    }
  ],
  "title": "Molecular mechanisms by which the intratumoral microbiome drives pancreatic ductal adenocarcinoma progression and therapeutic response",
  "title_text": "Molecular mechanisms by which the intratumoral microbiome drives pancreatic ductal adenocarcinoma progression and therapeutic response",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:21:35Z",
  "url": "https://research.draconitic.com/paper/cr8xamcmjj2q0",
  "venue": "Frontiers in Immunology",
  "versions": []
}