Targeting Stem Cells and Dysplastic Features with Dual MEK/ERK and STAT3 Suppression in Gastric Carcinogenesis

Pre-cancerous metaplasia progression to dysplasiasignificantlyincreases the risk of gastriccancer, and effective targeting strategies forpre-cancerouslesions are currently lacking.Weaimed to identify key signaling pathways critical for stem cell survival and function in dysplasia.Usingmouse and humanmetaplastic and dysplastic organoids, we evaluated responsestoPyrvinium, a putative anti-cancer drug.WhilePyrvinium induced growth arrest in metaplasticorganoids, itinducedcell death in dysplastic organoidsthrough a dual blockade of MEK/ERKand STAT3 signaling pathways. Pyrvinium specifically targeted stem cells andproliferating cellsin dysplastic organoids.Pyrviniumarrestedmetaplasia progression andpromoted repopulationof themousestomach mucosawith normal lineages.Furthermore, Pyrvinium exhibitedsuppressive effects on the growth and survival of human organoids with dysplastic features, through simultaneous blockingthe MEK/ERK and STAT3 signaling pathways.Therefore, ourfindings suggest that Pyrvinium is a promising therapeutic agent for reprogramming the pre-cancerous milieu to prevent of gastric cancer development. Overall design: To evaluate transcriptomic alterations and identify subpopulations of dysplastic organoids affected by Pyrvinium treatment, we performed single-cell RNA-sequencing using cells from Meta4 organoids treated with either DMSO or Pyrvinium for 1 day before organoids exhibited morphological disruption.