Cholangiocarcinoma cell proliferation is enhanced in primary sclerosing cholangitis: A role for IL-17A

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Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease of the biliary tree and a risk factor for development of cholangiocarcinoma (CCA). The pathogenesis of PSC-related CCA is largely unclear, although it is assumed that chronic inflammatory environment plays a pivotal role. We aimed to investigate the effect of inflammation-related cytokines in PSC on the proliferation rate of cancer cells. For this, the proliferation index in PSC-CCA and sporadic CCA was determined by Ki-67 immunohistochemistry. The percentage of Ki-67 positivity in cancer cells was significantly higher in PSC-CCA than in sporadic CCA (41.3% ± 5.7% vs 25.8% ± 4.1%; P =.038). To assess which cytokines in the inflammatory environment have the potential to stimulate cancer cell proliferation, patient-derived CCA organoids (CCAOs) were exposed to five cytokines related to PSC (Interleukin (IL)-1β, IL-6, IL-17A, interferon gamma and tumor necrosis factor alpha). Only IL-17A showed a significant stimulatory effect on cell proliferation in CCAOs, increasing organoid size by 45.9% ± 16.4% (P <.01) and proliferation rate by 38% ± 16% (P <.05). IL-17A immunohistochemistry demonstrated that PSC-CCA might express more IL-17A than sporadic CCA. Moreover, correlation analysis in sporadic CCA and PSC-CCA found a significant correlation between IL-17A expression and proliferation. In conclusion, tumor cell proliferation is increased in PSC-CCA cells compared with sporadic CCA cells. IL-17A increases CCA cell proliferation in vitro and may contribute to the high proliferation rate in PSC-CCA in situ. Therefore, IL-17A represents a new potential therapeutic target in (PSC-)CCA, to be tested in future trials.

Original languageEnglish
Pages (from-to)2607-2614
Number of pages8
JournalInternational Journal of Cancer
Issue number12
Early online date8 Nov 2022
Publication statusPublished - 15 Jun 2023

Bibliographical note

Investigators in this study received financial support from the Erasmus MC Human Disease Model Award (HDMA grant-380801), the Netherlands Organization for Health Research and Development (ZonMw) (InnoSysTox grant 114027003), the Dutch Digestive Foundation (MLDS-Diagnostics project number D16-26) and the Dutch Cancer Society (KWF) (project number 10496).

Erasmus MC Human Disease Model Award,
Grant/Award Number: 380801; KWF
Kankerbestrijding, Grant/Award Number:
10496; Maag Lever Darm Stichting,
Grant/Award Number: D16-26; ZonMw
(InnoSysTox), Grant/Award Number:

© 2022 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.


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