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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Immunol.</journal-id>
<journal-title-group>
<journal-title>Frontiers in Immunology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Immunol.</abbrev-journal-title>
</journal-title-group>
<issn pub-type="epub">1664-3224</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fimmu.2026.1743187</article-id>
<article-version article-version-type="Version of Record" vocab="NISO-RP-8-2008"/>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Original Research</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Spatial transcriptomics reveals the mechanistic role of lactate metabolism in the pancreatic ductal adenocarcinoma microenvironment</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Gao</surname><given-names>Fan</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="author-notes" rid="fn003"><sup>&#x2020;</sup></xref>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Writing &#x2013; original draft" vocab-term-identifier="https://credit.niso.org/contributor-roles/writing-original-draft/">Writing &#x2013; original draft</role>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="conceptualization" vocab-term-identifier="https://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role>
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</contrib>
<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Tang</surname><given-names>Zhe</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="author-notes" rid="fn003"><sup>&#x2020;</sup></xref>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Writing &#x2013; original draft" vocab-term-identifier="https://credit.niso.org/contributor-roles/writing-original-draft/">Writing &#x2013; original draft</role>
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<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="software" vocab-term-identifier="https://credit.niso.org/contributor-roles/software/">Software</role>
</contrib>
<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Lian</surname><given-names>Jie</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="author-notes" rid="fn003"><sup>&#x2020;</sup></xref>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Writing &#x2013; original draft" vocab-term-identifier="https://credit.niso.org/contributor-roles/writing-original-draft/">Writing &#x2013; original draft</role>
<role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="conceptualization" vocab-term-identifier="https://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role>
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</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Zhang</surname><given-names>Luting</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>*</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/3273595/overview"/>
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<aff id="aff1"><label>1</label><institution>Department of Hepatobiliary and Pancreatic Surgery, Shangyu People&#x2019;s Hospital of Shaoxing, Shaoxing University</institution>, <city>Shaoxing</city>, <state>Zhejiang</state>,&#xa0;<country country="cn">China</country></aff>
<aff id="aff2"><label>2</label><institution>Department of Pathology, Shangyu People&#x2019;s Hospital of Shaoxing, Shaoxing University</institution>, <city>Shaoxing</city>, <state>Zhejiang</state>,&#xa0;<country country="cn">China</country></aff>
<author-notes>
<corresp id="c001"><label>*</label>Correspondence: Luting Zhang, <email xlink:href="mailto:b2418098@zju.edu.cn">b2418098@zju.edu.cn</email></corresp>
<fn fn-type="equal" id="fn003">
<p>&#x2020;These authors have contributed equally to this work</p></fn>
</author-notes>
<pub-date publication-format="electronic" date-type="pub" iso-8601-date="2026-02-13">
<day>13</day>
<month>02</month>
<year>2026</year>
</pub-date>
<pub-date publication-format="electronic" date-type="collection">
<year>2026</year>
</pub-date>
<volume>17</volume>
<elocation-id>1743187</elocation-id>
<history>
<date date-type="received">
<day>10</day>
<month>11</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>28</day>
<month>01</month>
<year>2026</year>
</date>
<date date-type="rev-recd">
<day>12</day>
<month>01</month>
<year>2026</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2026 Gao, Tang, Lian and Zhang.</copyright-statement>
<copyright-year>2026</copyright-year>
<copyright-holder>Gao, Tang, Lian and Zhang</copyright-holder>
<license>
<ali:license_ref start_date="2026-02-13">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
<license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License (CC BY)</ext-link>. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p>
</license>
</permissions>
<abstract>
<sec>
<title>Background</title>
<p>Pancreatic ductal adenocarcinoma (PDAC), an aggressive cancer with poor prognosis, poses major challenges owing to late diagnosis and limited response to current therapies. However, the identification of candidate drugs through multi-omics analyses and therapeutic peptides targeting key molecular pathways may provide improved outcomes. Although lactate metabolism is a critical factor in tumor progression, affecting cell proliferation, metastasis, and immune evasion, its role in PDAC&#x2014;particularly within the tumor microenvironment, remains underexplored.</p>
</sec>
<sec>
<title>Objectives</title>
<p>This study investigated lactate metabolism in PDAC using high-throughput transcriptomic sequencing and single-cell transcriptomic analysis.</p>
</sec>
<sec>
<title>Methods</title>
<p>Lactate metabolism&#x2013;related gene expression was analyzed in tumor cells and their microenvironment, and correlations with patient prognosis were determined. Additionally, a machine learning&#x2013;based prognostic model was established to identify lactate metabolism biomarkers for early diagnosis and personalized therapy.</p>
</sec>
<sec>
<title>Results</title>
<p>Lactate metabolism significantly impacted the survival of patients with PDAC (n = 92; log-rank test, <italic>p</italic> &lt; 0.05). Single-cell RNA and spatial transcriptomics analyses of 50, 795 cells from 8 PDAC samples revealed that 521 malignant cells exhibited hyperactive lactate metabolism (AUCell score comparison, <italic>p</italic> &lt; 0.001). A prognostic model constructed from lactate metabolism&#x2013;related genes using ensemble machine learning (StepCox + Enet, &#x3b1; = 0.5) effectively stratified patients into high- and low-risk groups across multiple cohorts (ICGC: n = 92; GSE28735: n = 45; GSE62452: n = 69; GSE183795: n = 139; all log-rank <italic>p</italic> &lt; 0.05). Key prognostic genes identified included lysozyme (<italic>LYZ</italic>) and polymeric immunoglobulin receptor, which were significantly associated with patient survival (univariate Cox regression, <italic>p</italic> &lt; 0.05). These genes may serve as clinical biomarkers of PDAC.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>This study provides insights into PDAC metabolic features and highlights lactate metabolism as a potential therapeutic target. The identified biomarkers could facilitate early diagnosis and improve treatment strategies, ultimately enhancing patient outcomes.</p>
</sec>
</abstract>
<kwd-group>
<kwd>biomarkers</kwd>
<kwd>lactatemetabolism</kwd>
<kwd>pancreatic ductaladenocarcinoma</kwd>
<kwd>prognostic model</kwd>
<kwd>spatialtranscriptomics</kwd>
</kwd-group>
<funding-group>
<funding-statement>The author(s) declared that financial support was not received for this work and/or its publication. This study was funded by the Medical and Health Science and Technology Program of Zhejiang Province [2025KY1708 to FG] and Health Science and Technology Project of Shaoxing City (Health Science and Technology Project) [2023SKY112 to LZ]. The funders did not have any role in paper design, data collection, interpretation and writing of the paper.</funding-statement>
</funding-group>
<counts>
<fig-count count="8"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="47"/>
<page-count count="18"/>
<word-count count="8646"/>
</counts>
<custom-meta-group>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Cancer Immunity and Immunotherapy</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<label>1</label>
<title>Introduction</title>
<p>Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest solid malignancies, with 5-year survival rates &lt;10% despite multimodal therapies (<xref ref-type="bibr" rid="B1">1</xref>). It is marked by poor prognosis and a substantial global economic burden on healthcare systems (<xref ref-type="bibr" rid="B2">2</xref>). PDAC&#x2019;s complexity arises from late diagnosis and resistance to conventional therapies, leading to limited treatment options and poor outcomes (<xref ref-type="bibr" rid="B3">3</xref>). Current diagnostic and therapeutic approaches, including surgery, chemotherapy, targeted therapy, and immunotherapy, remain only modestly effective, primarily due to tumor heterogeneity and a dense stromal microenvironment that restricts drug delivery (<xref ref-type="bibr" rid="B4">4</xref>&#x2013;<xref ref-type="bibr" rid="B9">9</xref>). Moreover, existing treatments fail to address the metabolic reprogramming and cellular interactions driving PDAC progression, leaving major gaps in our understanding of the disease&#x2019;s biology (<xref ref-type="bibr" rid="B10">10</xref>).</p>
<p>Studying lactate metabolism&#x2013;related targets in PDAC is essential because they play a central role in tumor progression. PDAC cells undergo extensive metabolic reprogramming, frequently upregulating glycolysis to generate excess lactate even under normoxic conditions, a phenomenon known as the Warburg effect (<xref ref-type="bibr" rid="B11">11</xref>). Lactate, a key metabolic byproduct, shapes the tumor microenvironment (TME) by promoting acidosis, suppressing immune cell function, and driving angiogenesis and extracellular matrix remodeling, which together support tumor growth, invasion, and metastasis (<xref ref-type="bibr" rid="B12">12</xref>). Intensive research on the core enzymes and transporters involved in lactate metabolism, such as lactate dehydrogenase A/B (LDH A/B) and monocarboxylate transporters (MCTs), has identified promising therapeutic targets. Inhibiting these enzymes can disrupt cancer cell energy supply and metabolic balance, thereby slowing tumor progression (<xref ref-type="bibr" rid="B13">13</xref>, <xref ref-type="bibr" rid="B14">14</xref>). Targeting lactate metabolism not only suppresses cancer cell proliferation but also enhances immunotherapy efficacy by reprogramming the TME. This strategy boosts immune cell antitumor activity, mitigates PDAC&#x2019;s resistance to chemotherapy and radiotherapy, and improves therapeutic outcomes (<xref ref-type="bibr" rid="B15">15</xref>). Additionally, the expression levels of lactate and related enzymes function as diagnostic and prognostic biomarkers, aiding clinicians in assessing disease progression and personalizing treatment strategies. In summary, investigating lactate metabolism elucidates key metabolic mechanisms in PDAC, reveals multiple therapeutic targets, and holds promise for improving patient prognosis, extending survival, and reducing mortality through novel clinical interventions.</p>
<p>The integration of single-cell RNA sequencing (scRNA-seq) with spatial transcriptomics and machine learning has deepened our understanding of the TME (<xref ref-type="bibr" rid="B16">16</xref>, <xref ref-type="bibr" rid="B17">17</xref>). This combined approach enables detailed characterization of cellular heterogeneity and complex intercellular interactions within the TME (<xref ref-type="bibr" rid="B18">18</xref>, <xref ref-type="bibr" rid="B19">19</xref>). Furthermore, spatial transcriptomics maps gene expression within tissue architecture, clarifying how spatial organization influences cell-cell communication and tumor behavior (<xref ref-type="bibr" rid="B20">20</xref>). This study aimed to analyze lactate metabolism&#x2013;associated cell subtypes in PDAC using single-cell and spatial transcriptomics, supported by evidence highlighting lactate&#x2019;s importance in PDAC progression. By investigating the roles of these subtypes within the TME and their prognostic relevance, we sought to identify potential biomarkers and therapeutic targets. The integration of single-cell and spatial transcriptomics enhances our understanding of PDAC heterogeneity and underscores lactate metabolism&#x2019;s pivotal role in tumor biology. Ultimately, this study provides novel insights into the mechanisms driving PDAC progression and identifies innovative strategies to improve patient outcomes (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;1</bold></xref>).</p>
</sec>
<sec id="s2" sec-type="materials|methods">
<label>2</label>
<title>Materials and methods</title>
<sec id="s2_1">
<label>2.1</label>
<title>Data acquisition and processing</title>
<p>Transcriptomic data were obtained from two publicly available databases: the International Cancer Genome Consortium (ICGC; <ext-link ext-link-type="uri" xlink:href="https://dcc.icgc.org/">https://dcc.icgc.org/</ext-link>) and the Gene Expression Omnibus (GEO; <ext-link ext-link-type="uri" xlink:href="https://www.ncbi.nlm.nih.gov/geo/">https://www.ncbi.nlm.nih.gov/geo/</ext-link>). Gene expression profiles and clinical data for PDAC were retrieved from ICGC, including 92 PDAC samples. Additional transcriptomic datasets were downloaded from GEO using the R package GEOquery. The included datasets were as follows: GSE28735 (45 PDAC tissue and 45 adjacent nontumor samples), GSE62452 (69 PDAC tissue and 61 adjacent nontumor samples), and GSE183795 (139 PDAC tissue, 102 adjacent nontumor samples, and 3 normal pancreatic ductal tissue samples). All datasets were processed according to the respective database access guidelines, ensuring compliance with ethical and data usage requirements. Through the Molecular Signatures Database (MSigDB) website (<ext-link ext-link-type="uri" xlink:href="https://www.gsea-msigdb.org/gsea/msigdb/index.jsp">https://www.gsea-msigdb.org/gsea/msigdb/index.jsp</ext-link>), 320 lactate metabolism&#x2013;related genes were identified (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Table S1</bold></xref>).</p>
</sec>
<sec id="s2_2">
<label>2.2</label>
<title>Download and processing of single-cell sequencing data</title>
<p>The GEO database was used to retrieve scRNA-seq data related to lactate metabolism. Specifically, dataset GSE205354, comprising eight PDAC samples, was used. Raw scRNA-seq data from GSE205354 were processed using the Seurat package (v4.2.0) in R. Data preprocessing followed these criteria: genes with undetected expression were excluded; cells expressing &gt;500 genes were retained; cells with &lt;10, 000 unique molecular identifiers (UMIs) were removed; and cells with &gt;25% mitochondrial gene expression were excluded. Data normalization was performed using the <italic>NormalizeData</italic> function in Seurat. After normalization, highly variable genes were identified by evaluating mean expression versus dispersion. Principal component analysis (PCA) was conducted, and significant principal components (PCs) were used for graph-based clustering.</p>
<p>To correct for batch effects, the Harmony method was applied for sample integration. Clustering was performed using the FindClusters function with the shared nearest neighbor modularity algorithm (resolution = 1.2) across the first 18 PCs. Clustering results were visualized using t-distributed stochastic neighbor embedding (t-SNE) via the RunTSNE function, and cell aggregation was visualized based on the t-SNE-1 and t-SNE-2 axes. Differentially expressed genes (DEGs) among clusters were identified using the FindAllMarkers function in Seurat with default settings. DEGs were selected based on expression in &gt;25% of cells within a cluster and a log-fold change (logFC) &gt;0.25, as recommended in Seurat documentation. The proportions of cell types were calculated using known cell type&#x2013;specific biomarkers.</p>
</sec>
<sec id="s2_3">
<label>2.3</label>
<title>Download and processing of spatial transcriptomic sequencing data</title>
<p>Spatial transcriptomic data related to PDAC were obtained from GEO. The GSE203612 dataset, including 31 cancer-related spatial transcriptomic samples generated using various sequencing methods, was retrieved. This study focused on GSM6177614, obtained using the 10X Genomics Visium platform. Raw spatial transcriptomic data from GSM6177614 were processed using Seurat in R. Data were loaded using the Load10X_Spatial function, retaining spots with at least 500 detected genes. Normalization was conducted using SCTransform, followed by PCA performed via RunPCA. The optimal number of PCs was determined using the ElbowPlot function, and FindNeighbors was applied to compute pairwise cell neighborhood relationships.</p>
<p>Spatial expression patterns were visualized using SpatialPlot. Expressed UMIs and genes (nGenes) per spot were examined to assess sequencing quality, focusing on detected genes per UMI and UMIs per cell. Clustering was performed using the first 18 PCs at a resolution of 0.4, yielding 5 clusters. Clusters were annotated based on hematoxylin and eosin (HE) staining images and known cell type&#x2013;specific biomarkers. DEGs among cell clusters were identified using the FindAllMarkers function based on normalized gene expression data.</p>
</sec>
<sec id="s2_4">
<label>2.4</label>
<title>AUCell-based screening of cells with active lactate metabolism</title>
<p>For single-cell analysis, each cell was scored using the AUCell R package (v1.24.0), which applies gene set enrichment analysis (GSEA). Gene expression ranking per cell was determined based on the area under the curve (AUC) values of 320 lactate metabolism&#x2013;related genes (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Table S1</bold></xref>). The AUC represents the proportion of highly expressed genes within a set, with higher AUC values indicating greater activity. The AUCell_exploreThresholds function was employed to establish thresholds for identifying lactate metabolism&#x2013;active cells.</p>
<p>AUC scores were visualized using t-SNE, implemented via the <italic>ggplot2</italic> R package (v3.3.5), to represent activated cell clusters and preserve local data structures. This method maps high-dimensional data to two or three dimensions, enabling visualization of underlying patterns. For spatial transcriptome analysis, the SPATA2 R package (v0.1) was used to visualize spatial expression of lactate metabolism&#x2013;associated gene sets. The plotSurface2 function in SPATA2 was employed with the parameters smooth = TRUE and smooth span = 0.2 to generate a smooth surface representation of the spatial gene expression.</p>
</sec>
<sec id="s2_5">
<label>2.5</label>
<title>InferCNV screening for malignant cells</title>
<p>The InferCNV R package (v1.10.1) was used to evaluate somatic large-scale chromosomal copy number variations (CNVs) in ductal cells based on single-cell gene expression data. This analysis aimed to identify potential malignant changes by comparing tumor and normal ductal cells through single-cell CNV profiling. Macrophages, endothelial cells, and stellate cells were selected as reference cell types. Iterative clustering analysis was conducted to distinguish malignant from nonmalignant cells. CNV scores were calculated to classify these populations by chromosomal alterations, an approach widely used in single-cell sequencing to differentiate tumor from normal cells and assess tumor heterogeneity.</p>
</sec>
<sec id="s2_6">
<label>2.6</label>
<title>Consensus clustering analysis</title>
<p>Consensus clustering, a robust unsupervised method, identifies stable and reproducible clusters in high-dimensional data through iterative similarity assessment. ConsensusClusterPlus (v1.58.0) was applied in R to classify PDAC samples based on lactate metabolism gene expression profiles. Samples were stratified into two clusters (Cluster 1 and Cluster 2) according to their consensus matrices and cumulative distribution function curves.</p>
</sec>
<sec id="s2_7">
<label>2.7</label>
<title>Building prognostic models using ensemble machine learning methods</title>
<p>To evaluate the prognostic value of lactate metabolism&#x2013;related DEGs in PDAC, the R package <italic>limma</italic> was employed to identify DEGs between two groups: 41 samples with low lactate metabolism scores and 51 samples with high scores (|logFC| &gt; 1.2, <italic>p</italic> &lt;.05). Additional DEG identification was conducted via single-cell analysis, comparing malignant and normal cells as well as high-risk malignant lactate metabolism cells and their counterparts. Genes common to all three DEG sets were defined as bidirectional expression genes associated with lactate metabolism in PDAC. Univariate Cox regression analysis was then performed to assess associations between these DEGs and overall survival (OS) in each tumor cohort. Genes with <italic>p</italic> &lt;.05 were considered significantly associated with OS and selected for further analysis, consistent with studies reporting improved PDAC survival for specific genetic profiles.</p>
<p>To construct a prognostic model based on lactate metabolism scores with high accuracy and stability, 10 machine learning algorithms were integrated: Random Survival Forest (RSF), ElasticNet (Enet), Lasso, Ridge, StepCox, CoxBoost, Cox partial least squares regression (plsRcox), supervised principal components (SuperPCs), generalized boosted regression modeling (GBM), and survival support vector machine (survival-SVM). Model performance was evaluated using cross-validation and by calculating accuracy, precision, recall, and F1 score. Lasso, StepCox, CoxBoost, and RSF incorporated built-in feature selection.</p>
<p>The RSF model was implemented using the randomForestSRC package in R. Enet, Lasso, and Ridge were executed using glmnet, with the L1-L2 balance parameter (&#x3b1;) varied from 0 to 1 at 0.1 intervals. StepCox was performed using the survival package in R with the stepwise search modes &#x201c;both, &#x201c; &#x201c;backward, &#x201c; and &#x201c;forward.&#x201d; CoxBoost was implemented using the CoxBoost package (v1.4.0) in R, with the optimal penalty and optimal step number determined via the optimCoxBoostPenalty and cv.CoxBoost functions, respectively. To execute plsRcox, the plsRcox package (v1.8.0) was implemented in R, using cv.plsRcox to determine the number of extracted components. SuperPC was implemented through the superpc package in R, with the superpc.cv function selecting the best threshold. GBM was executed using the gbm package in R, with the cv.gbm function employed to select the model with the lowest cross-validation error. Finally, survival-SVM was implemented via the survivalsvm package in R.</p>
<p>Model training was conducted on the ICGC-PDAC cohort and validated on independent datasets (GSE28735, GSE62452, and GSE183795). The model exhibiting the highest average concordance index (C-index), i.e., StepCox [backward] + Enet [&#x3b1; = 0.5], was chosen as the final model, as it demonstrated superior predictive accuracy. Kaplan&#x2013;Meier analysis was used to evaluate this model&#x2019;s prognostic value. Immunohistochemical staining images of the gene protein products in head and neck squamous cell carcinoma samples were obtained from the Human Protein Atlas (HPA; <ext-link ext-link-type="uri" xlink:href="http://www.proteinatlas.org">http://www.proteinatlas.org</ext-link>).</p>
</sec>
<sec id="s2_8">
<label>2.8</label>
<title>Spatial transcriptome analysis by deconvolution</title>
<p>Spatial transcriptomics datasets generated by 10X Genomics VISIUM technology initially lacked single-cell resolution, a limitation addressed via Visium HD. In spatial transcriptomics, gene expression at each spatial spot represents multiple cells and can be analyzed similarly to small RNA-seq datasets. To estimate cell type proportions at each spatial location, deconvolution methods are necessary. The spatial coordinates of individual cells were obtained through joint analysis of scRNA-seq data and spatial transcriptomic data using the CellTrek package in R[35, 314, 812] with default parameters. The run_kdist function in CellTrek was employed to calculate spatial k-distances between cell types, and cell colocalization patterns were examined using the SColoc function within CellTrek.</p>
</sec>
<sec id="s2_9">
<label>2.9</label>
<title>Cell communication analysis with ligand&#x2013;receptor expression</title>
<p>Cell communication analysis was performed to identify signaling pathways by quantifying ligand&#x2013;receptor pair expression across cell types. The CellChat package (v1.1.3) was employed to detect afferent and efferent signaling patterns, measure communication probabilities, and calculate information flow for each pathway. In PDAC samples, CellChat analysis focused on how lactate metabolism modulates intercellular interactions within the TME. The strength of each signaling pathway was examined using multidimensional clinical proteomics, and key pathways were selected for visualization. Default CellChat parameters were applied with significance set at <italic>p</italic> &lt;.05, and multiple testing corrections were performed using the Benjamini&#x2013;Hochberg method.</p>
</sec>
<sec id="s2_10">
<label>2.10</label>
<title>Single-cell regulatory network inference and clustering analysis</title>
<p>Single-cell regulatory network inference and clustering (SCENIC) analysis was performed using the pySCENIC Python package (v0.12.0). Coexpression modules were first identified between transcription factors (TFs) and candidate target genes. The RcisTarget function was then used to detect enriched motifs in each module, defining TFs and their direct target genes. Subsequently, the AUCell function was employed to evaluate module activity in individual cells, and module cell type&#x2013;specificity was determined using the module specificity score.</p>
</sec>
<sec id="s2_11">
<label>2.11</label>
<title>Gene ontology and kyoto encyclopedia of genes and genomes pathway enrichment analysis</title>
<p>DEGs were identified between active and inactive lactate cells using the FindAllMarkers function with a threshold of |log2Fold Change| &gt; 0.25 and <italic>p</italic> &lt;.05. DEGs between PDAC and control samples were determined using the limma package with a screening threshold of |log2Fold Change| &gt; 2 and <italic>p</italic> &lt;.05. Two DEGs were further analyzed in PDAC. Gene Ontology (GO) enrichment analysis was used to assess biological process (BP), molecular function (MF), and cellular component (CC) enrichment. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis was employed to identify significantly enriched metabolic pathways in the DEG list. Both GO and KEGG analyses were conducted via the clusterProfiler package (v4.2.2) in R, using a significance threshold of <italic>p</italic> &lt;.05.</p>
</sec>
<sec id="s2_12">
<label>2.12</label>
<title>GSEA</title>
<p>GSEA was conducted to determine whether predefined gene sets displayed significant expression differences between biological states. The limma package was used to analyze the differential expression of prognosis-related genes and calculate log2FC. GSEA was performed in clusterProfiler using a ranked gene list based on log2FC values. Each analysis included 1, 000 gene set permutations. The c2.cp.kegg.v7.5.1.symbols gene set from MSigDB served as the reference. Gene sets with <italic>p</italic> &lt;.05 were considered significantly enriched.</p>
</sec>
<sec id="s2_13">
<label>2.13</label>
<title>Drug sensitivity analysis</title>
<p>Drug sensitivity data were obtained from the Genomics of Drug Sensitivity in Cancer database (<ext-link ext-link-type="uri" xlink:href="https://www.cancerrxgene.org/">https://www.cancerrxgene.org/</ext-link>), including half-maximal inhibitory concentration (IC50) values and corresponding gene expression profiles. IC50 values provide a quantitative measure of drug efficacy, representing the concentration required to inhibit 50% of cancer cell viability. To predict therapeutic sensitivity in PDAC patients, the R package oncoPredict (v0.2) was employed. This tool integrates gene expression and drug response data to estimate PDAC sample sensitivity to chemotherapeutic agents.</p>
</sec>
<sec id="s2_14">
<label>2.14</label>
<title>Immune checkpoint analysis</title>
<p>Immune checkpoints are regulatory molecules expressed on immune cells that modulate immune activation levels and prevent excessive immune responses. The expression profiles of immune checkpoint genes and their associations with prognosis-related genes were examined in clusters 1 and 2. The Wilcoxon rank-sum test, a nonparametric method for comparing medians between independent samples, was performed via the <italic>wilcox.test</italic> function in R&#x2019;s <italic>stats</italic> package.</p>
</sec>
<sec id="s2_15">
<label>2.15</label>
<title>Tumor immune dysfunction and exclusion analysis</title>
<p>To predict patient response to immunotherapy, the tumor immune dysfunction and exclusion (TIDE) algorithm (<ext-link ext-link-type="uri" xlink:href="http://tide.dfci.harvard.edu/">http://tide.dfci.harvard.edu/</ext-link>) was employed. Correlations among immune checkpoint genes, key genes, and TIDE scores were evaluated using Pearson correlation analysis, following the TIDE framework for assessing immune checkpoint blockade efficacy. Correlation coefficients and their statistical significance were computed using functions from the R package Hmisc.</p>
</sec>
<sec id="s2_16">
<label>2.16</label>
<title>Pan-cancer analysis</title>
<p>Pan-cancer analysis was performed to evaluate the expression, prognostic significance, and immune associations of key genes across 33 cancer types. This approach has previously been used to analyze tumor coagulome genes and their link to the TME, as well as 33 human cancers to assess the immunotherapeutic value of specific genes. Genome-wide expression and clinical data were obtained from The Cancer Genome Atlas using the R package <italic>TCGAbiolinks</italic> (v2.25.0). The expression differences of key genes across the 33 cancer types were analyzed. For survival analysis, a univariate Cox regression model was employed to assess the relationship between key gene expression and tumor prognosis. Immune infiltration scores for each tumor sample were calculated using the ssGSEA algorithm, and correlations between immune infiltration scores and key gene expression levels were determined.</p>
</sec>
<sec id="s2_17">
<label>2.17</label>
<title>Cell culture</title>
<p>The PDAC-representative cell lines ASPC-1, MIA-PACA2, and PANC-1 and the controls human pancreatic ductal epithelium (HPDE) and SW1990 were obtained from Pricella (Wuhan, China). Cells were cultured in RPMI-1640 medium supplemented with 10% fetal bovine serum at 37&#xb0;C in a humidified incubator with 5% CO<sub>2</sub>.</p>
</sec>
<sec id="s2_18">
<label>2.18</label>
<title>Reverse transcription polymerase chain reaction</title>
<p>Reverse transcription polymerase chain reaction (RT-PCR) was conducted in four stages: cell seeding, RNA extraction, reverse transcription, and quantitative RT-PCR (qRT-PCR). PDAC cell lines (ASPC-1, HPDE, MIA-PACA2, PANC-1, and SW1990) were seeded in 6-well plates and cultured in drug-containing serum. RNA was extracted following standard protocols involving cell washing, lysis, centrifugation, and RNA precipitation. For reverse transcription, the HiScript III RT SuperMix Kit was used to eliminate genomic DNA. Subsequently, qRT-PCR was performed using ChamQ Universal SYBR qPCR Master Mix, with glyceraldehyde-3-phosphate dehydrogenase (GAPDH) as an internal reference. Relative expression levels were calculated using the 2<sup>-&#x25b3;&#x25b3;Ct</sup> method.</p>
</sec>
<sec id="s2_19">
<label>2.19</label>
<title>Western blot</title>
<p>Western blotting was performed through sequential steps: cell culture, protein extraction, gel preparation, electrophoresis, protein transfer, blocking, antibody incubation, and imaging. Total proteins from ASPC-1, HPDE, MIA-PACA2, PANC-1, and SW1990 cells were extracted using radioimmunoprecipitation assay (RIPA) lysis buffer. Protein lysates were separated via sodium dodecyl sulfate&#x2013;polyacrylamide gel electrophoresis, transferred onto polyvinylidene fluoride membranes, blocked, and incubated sequentially with primary and secondary antibodies. Protein bands were visualized using a fluorescence scanner.</p>
</sec>
<sec id="s2_20">
<label>2.20</label>
<title>Clinical sample collection</title>
<p>Paraffin-embedded tissue samples from patients with PDAC were collected from Shangyu People&#x2019;s Hospital of Shaoxing, Shaoxing University, during June 2020&#x2013;December 2024.</p>
</sec>
<sec id="s2_21">
<label>2.21</label>
<title>Immunohistochemical analysis</title>
<p>Immunohistochemistry was performed through standard steps of deparaffinization, hydration, antigen retrieval, and antibody incubation. Paraffin sections were deparaffinized in xylene and rehydrated through graded ethanol solutions. Antigen retrieval was performed using ethylenediaminetetraacetic acid (EDTA) or citrate buffer, with tissue sections heated in a microwave, maintained at boiling, and then cooled at room temperature. Endogenous peroxidase activity was blocked, followed by serum blocking. Sections were incubated with primary and secondary antibodies, and staining was visualized using 3, 3&#x2019;-diaminobenzidine (DAB). Staining intensity, indicative of antigen abundance, was monitored microscopically. Sections were counterstained, dehydrated, mounted, and imaged for analysis.</p>
<p>The expression levels of PIGR protein were independently evaluated in a semi-quantitative manner by two senior pathologists using a double-blinded approach (unaware of the sample grouping information). The assessment integrated staining intensity and the percentage of positive tumor cells, with results classified into four grades: &#x2013; (negative): no staining or positive cells &lt; 5%; + (weak positive): pale yellow staining and positive cells &#x2265; 5%; ++ (moderate positive): brownish-yellow staining and positive cells &#x2265; 25%; +++ (strong positive): brown staining and positive cells &#x2265; 50%. The results from the two evaluators showed a high degree of concordance. For the few discrepant cases, a consensus was reached through joint re-evaluation and discussion, and the agreed-upon result was used as the final determination for subsequent statistical analysis.</p>
</sec>
<sec id="s2_22">
<label>2.22</label>
<title>Statistical analysis</title>
<p>All analyses were performed using R (v4.1.2). Survival differences between groups were assessed using the Kaplan&#x2013;Meier method, with significance determined via the log-rank test. Survival curves were generated using the <italic>survminer</italic> package. Univariate and multivariate Cox regression analyses identified prognostic variables. Lasso regression was employed to select high-impact predictors of survival outcomes. Data visualization was performed using <italic>ggplot2</italic>, with risk and OS scores calculated using the <italic>survival</italic> package. Heatmaps were generated using <italic>pheatmap</italic>. Continuous variables were compared using two-tailed t-tests or one-way analysis of variance (ANOVA) for normally distributed data, with the Wilcoxon rank-sum test or Kruskal&#x2013;Wallis test employed for non-normal distributions. <italic>p</italic> &lt; 0.05 was considered statistically significant. All basic experiments were performed in triplicate, and results are presented as means &#xb1; standard deviations. Statistical analysis for these experiments was performed using GraphPad Prism 8. One-way ANOVA followed by Tukey&#x2019;s <italic>post hoc</italic> test was used to compare group means, with <italic>p</italic> &lt;.05 denoting statistical significance.</p>
</sec>
</sec>
<sec id="s3" sec-type="results">
<label>3</label>
<title>Results</title>
<sec id="s3_1">
<label>3.1</label>
<title>Single-cell dimensionality reduction, clustering, and annotation</title>
<p>We analyzed PDAC cell populations using the scRNA-seq dataset GSE205354. After quality control and doublet removal, 50, 795 cells were retained for downstream analysis. The dataset comprised eight samples, with a uniform distribution across these samples, indicating minimal batch effects and ensuring reliability for subsequent analysis. Clustering divided cells into 26 distinct clusters (<xref ref-type="fig" rid="f1"><bold>Figure&#xa0;1A</bold></xref>), which were annotated based on gene expression profiles and cell-specific biomarkers (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Table S2</bold></xref>). As shown in <xref ref-type="fig" rid="f1"><bold>Figure&#xa0;1B</bold></xref>, we identified 13 major cell types: T cells, B cells, fibroblasts, endothelial cells, macrophages, stellate cells, neutrophils, natural killer (NK) cells, mast cells, ductal cells 1, ductal cells 2, Schwann cells, and acinar cells. Marker genes for each cell type were visualized using tools from scPlantDB (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;2A</bold></xref>). The proportional distribution of these cell types across tumor and normal samples is shown in <xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figures&#xa0;2B, C</bold></xref>.</p>
<fig id="f1" position="float">
<label>Figure&#xa0;1</label>
<caption>
<p>Single-cell dimensional reduction clustering of PDAC and identification of malignant cells based on lactate metabolism. <bold>(A, B)</bold> t-SNE plots showing the cluster distribution of PDAC cells. <bold>(C)</bold> InferCNV heat map illustrating the cell CNV scores. <bold>(D)</bold> Bar graphs showing CNV score differences among cell populations. <bold>(E)</bold> Histogram depicting differences in AUCell scores between lactate metabolism&#x2013;active cell types. <bold>(F)</bold> t-SNE plot displaying the annotation results of lactate metabolism&#x2013;active cells. PDAC, pancreatic ductal adenocarcinoma; t-SNE, t-distributed stochastic neighbor embedding; CNV, copy number variation.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-17-1743187-g001.tif">
<alt-text content-type="machine-generated">Panel A shows a t-SNE plot of single cells colored by cluster number. Panel B presents a t-SNE plot labeled by specific cell types such as macrophages, ductal cells, and T cells. Panel C displays a heatmap representing inferred copy number variations by cell and cell type. Panel D provides a boxplot comparing CNV scores between cell types. Panel E illustrates a boxplot of AUCell scores between two ductal cell subtypes, highlighting a significant difference. Panel F features a t-SNE plot showing the distribution of two ductal cell subgroups distinguished by color.</alt-text>
</graphic></fig>
</sec>
<sec id="s3_2">
<label>3.2</label>
<title>InferCNV identification of malignant and lactate-metabolic malignant cells</title>
<p>As PDAC originates from ductal cells, we applied inferCNV analysis to single-cell gene expression data to distinguish malignant from nonmalignant cells, employing macrophages, endothelial cells, and stellate cells as references. Unsupervised clustering based on CNV profiles identified ductal 2 cells as malignant owing to their elevated CNV levels (<xref ref-type="fig" rid="f1"><bold>Figures&#xa0;1C, D</bold></xref>).</p>
<p>To identify malignant subsets with active lactate metabolism, we assessed gene expression patterns at the single-cell level. Based on the AUCell-determined threshold of lactate metabolic activity, ductal 2 cells were further classified, with cells exceeding this threshold categorized as active cells, showing 521 malignant cells with active lactate metabolism. The AUC scores of these cells were significantly higher than those of inactive cells (p &lt;.001; <xref ref-type="fig" rid="f1"><bold>Figure&#xa0;1E</bold></xref>). Dimensionality reduction using t-SNE further distinguished malignant cells by lactate-metabolic activity (<xref ref-type="fig" rid="f1"><bold>Figure&#xa0;1F</bold></xref>).</p>
<p>Comparison of active malignant and other cells yielded 382 DEGs with significant differences (corrected <italic>p</italic> &lt;.05, |log2FC| &gt; 1; <xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Table S3</bold></xref>). GO (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Table S4</bold></xref>) analyses revealed DEG enrichment in response to steroid hormones, positive regulation of cytokine production, and adenosine triphosphate (ATP) metabolic processes (all BP), along with localization to cytosolic ribosomes and secretory granule lumen (both CC), and cadherin binding and major histocompatibility complex class II protein complex binding (both MF) (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;2D</bold></xref>). KEGG pathway analysis (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Table S5</bold></xref>) identified enrichment in prion diseases, oxidative phosphorylation, and pancreatic secretion (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;2E</bold></xref>).</p>
</sec>
<sec id="s3_3">
<label>3.3</label>
<title>Consistent clustering identified lactate metabolism subgroups</title>
<p>Unsupervised clustering of 320 key lactate metabolism&#x2013;related genes defined two distinct PDAC subtypes (<xref ref-type="fig" rid="f2"><bold>Figure&#xa0;2A</bold></xref>). The optimal clustering solution (k = 2) produced two stable and well-separated subgroups representing active lactate metabolism profiles (<xref ref-type="fig" rid="f2"><bold>Figure&#xa0;2B</bold></xref>). Kaplan&#x2013;Meier survival analysis revealed significant prognostic differences between the subtypes: patients in Cluster 2 demonstrated significantly improved survival rates compared with those in Cluster 1 (<xref ref-type="fig" rid="f2"><bold>Figure&#xa0;2C</bold></xref>). Similarly, in a multiple myeloma study, Cluster 1 showed significantly lower lactate metabolism scores compared with Cluster 2 (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;3A</bold></xref>).</p>
<fig id="f2" position="float">
<label>Figure&#xa0;2</label>
<caption>
<p>Differential analysis of lactate metabolism subtypes in patients with PDAC and corresponding changes in cell abundance. <bold>(A)</bold> Consensus clustering at <italic>k</italic> = 2. <bold>(B)</bold> CDF plot showing the consistency of cluster distribution in patients with PDAC. <bold>(C)</bold> Kaplan&#x2013;Meier survival analysis comparing the estimated survival probabilities of different lactate metabolism subtypes. <bold>(D)</bold> Chord diagram showing GO enrichment of DEGs among subtypes. <bold>(E)</bold> Circular plot displaying significantly enriched GO pathways, along with a corresponding table of pathway numbers and pathway names. CDF, cumulative distribution function; PDAC, pancreatic ductal adenocarcinoma.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-17-1743187-g002.tif">
<alt-text content-type="machine-generated">Panel A shows a heatmap representing a consensus matrix for k equals 2 clusters with two distinct blue blocks. Panel B contains a line graph of cumulative distribution functions for consensus indices across cluster numbers, with lines in different colors. Panel C presents a Kaplan-Meier survival curve comparing two clusters with shaded confidence intervals and a p-value of 0.0085 indicating statistical significance. Panel D displays a circular chord diagram linking genes and GO terms, color-coded by log fold change. Panel E has a circular bar plot of gene ontology terms and a table listing GO IDs, descriptions, and categories, highlighting biological processes, cellular components, and molecular functions.</alt-text>
</graphic></fig>
<p>Differential expression analysis identified 69 DEGs between the two subgroups (corrected <italic>p</italic> &lt;.05, |log2FC| &gt; 1.2), with 26 upregulated and 43 downregulated in Cluster 1 (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Table S6</bold></xref>). olcano plots and heatmaps illustrated these differences (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figures&#xa0;3B, C</bold></xref>): the top five upregulated genes (RNVU 1-6, RNVU 1-1-3, RNVU 1-2, SNORA27, and RN7SL451P) and top five downregulated genes (JCHAIN, SLC4A4, LYZ, SLC40A1, and CLDN2) are shown in these plots (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;3B</bold></xref>). GO enrichment analysis (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Table S7</bold></xref>) indicated that DEGs were enriched in phagocytosis, recognition, complement activation (classical pathway), and humoral immune response (all BP). In terms of cellular localization, enriched components included the immunoglobulin complex, circulating immunoglobulin complex, and blood microparticles (all CC). Enriched functions included antigen binding, immunoglobulin receptor binding, and peptidoglycan binding (all MF) (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figures&#xa0;3D, E</bold></xref>).</p>
</sec>
<sec id="s3_4">
<label>3.4</label>
<title>Construction and validation of a prognostic model for lactate metabolism&#x2013;related genes</title>
<p>To identify key genes associated with lactate metabolism, we conducted screening by integrating single&#x2212;cell data and transcriptomic data. The key genes were obtained from the intersection of three gene sets. The first set was derived from the comparison between PDAC and control groups in the transcriptomic data, representing the major genes identified at the transcriptome level that are associated with PDAC development (LAM subgroup DEGs, n=69). The second set came from differential analysis between ductal2 and all other cell types in the single&#x2212;cell data, as ductal2 is considered malignant; this set represents the main genes related to tumorigenesis in ductal cells (LAM Malignant Cells DEGs, n=382). The third set of genes was obtained from the comparison between LAMrisk_high cells and all other cells; this set is defined as closely associated with the activation of lactate metabolism (Malignant Cell DEGs, n=418). Ultimately, seven overlapping genes were identified (<xref ref-type="fig" rid="f3"><bold>Figure&#xa0;3B</bold></xref>).</p>
<fig id="f3" position="float">
<label>Figure&#xa0;3</label>
<caption>
<p>Construction of a prognostic model using machine learning. <bold>(A)</bold> Venn diagram showing the final key genes identified from multiple differential gene analyses. <bold>(B)</bold> Univariate Cox regression showing the association between key genes and prognosis. <bold>(C)</bold> Heatmap of the concordance index (C-index) values of 101 combined machine-learning algorithms across datasets, with the adjacent bar graph displaying the mean C-index values in the validation cohort. <bold>(D&#x2013;G)</bold> Kaplan&#x2013;Meier survival curves showing the relationship between risk score and overall survival in the International Cancer Genome Consortium cohort <bold>(D)</bold>, GSE28735 <bold>(E)</bold>, GSE62452 <bold>(F)</bold>, and GSE183795 <bold>(G)</bold> datasets. <bold>(H)</bold> Boxplot illustrating differences in risk scores among PDAC lactate-metabolism subtypes. PDAC, pancreatic ductal adenocarcinoma.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-17-1743187-g003.tif">
<alt-text content-type="machine-generated">Scientific figure with eight panels: A) Venn diagram showing overlaps in differentially expressed genes among three groups; B) Table and forest plot of hazard ratios with confidence intervals for seven genes; C) Heatmap ranking statistical models with mean c-index values across datasets; D-G) Four Kaplan-Meier survival curves comparing high versus low risk with shaded confidence intervals; H) Boxplot displaying risk scores between two clusters, Cluster 1 and Cluster 2, with a significant difference indicated.</alt-text>
</graphic></fig>
<p>A prognostic model was built using 10 machine learning algorithms applied to the ICGC-PDAC cohort and validated across three external datasets (GSE28735, GSE62452, and GSE183795). The model with the highest mean C-index across three validation cohorts was selected as optimal, as the C-index (ranging from 0 to 1) quantifies concordance between predicted and actual outcomes. The final StepCox [backward] + Enet [&#x3b1; = 0.5] model identified two signature genes, namely lysozyme (LYZ) and polymeric immunoglobulin receptor (PIGR), which were used to construct the prognostic model (<xref ref-type="fig" rid="f3"><bold>Figure&#xa0;3C</bold></xref>; <xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Table S9</bold></xref>). Survival analyses of the ICGC-PDAC and GSE28735, GSE62452, and GSE183795 validation datasets showed that higher risk scores were significantly associated with shorter survival times (<xref ref-type="fig" rid="f3"><bold>Figures&#xa0;3D&#x2013;G</bold></xref>). Moreover, risk scores differed significantly between Cluster 1 and Cluster 2 (<italic>p</italic> = .01; <xref ref-type="fig" rid="f3"><bold>Figure&#xa0;3H</bold></xref>).</p>
</sec>
<sec id="s3_5">
<label>3.5</label>
<title>Screening of prognostic-related genes as lactate metabolism biomarkers</title>
<p>The expression levels of prognostic genes across lactate metabolism subtypes are shown in <xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;4A</bold></xref>. All prognostic genes displayed significant differential expression among the lactate metabolism subtypes. We further examined the correlations between prognostic genes and corresponding cell types, as shown in scatter plots (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;4B</bold></xref>). LYZ exhibited a significant positive correlation with B cells (R = 0.700, <italic>p</italic> &lt;.001), ductal malignant hyperlactate metabolism cells (ductal 2, LAMrisk_high; R = 0.700, <italic>p</italic> &lt;.001), and macrophages (R = 0.642, <italic>p</italic> &lt;.001). Similarly, PIGR showed significant positive correlations with ductal 2 cells (LAMrisk_high: R = 0.717, <italic>p</italic> &lt;.001; LAMrisk_low: R = 0.656, <italic>p</italic> &lt;.001) and fibroblasts (R = 0.615, <italic>p</italic> &lt;.001) (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;4B</bold></xref>). These findings highlight LYZ and PIGR as potential prognostic biomarkers for PDAC.</p>
<p>To further elucidate their mechanisms in PDAC, we performed survival analysis and single-gene GSEA on PDAC-associated tumor markers (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figures&#xa0;4C&#x2013;E</bold></xref>). Survival analysis revealed that higher LYZ and PIGR expression levels were associated with improved survival outcomes (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figures&#xa0;4C, E</bold></xref>). GSEA showed that LYZ-associated genes were primarily enriched in the hallmark kirsten rat sarcoma viral oncogene homolog (KRAS) signaling up, hallmark IL2 STAT5 signaling, and hallmark adipogenesis pathways (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;4D</bold></xref>). In contrast, PIGR-associated genes were mainly enriched in the epithelial&#x2013;mesenchymal transition, KRAS signaling up, and interferon gamma response pathways (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;4F</bold></xref>).</p>
<p>LYZ and PIGR protein expression levels were further validated using immunohistochemistry staining images obtained from the HPA database, confirming high-expression levels of both proteins in PDAC tissues at the translational level (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figures&#xa0;4G, H</bold></xref>). Additional single-gene analysis results are provided in <xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Table S10</bold></xref>.</p>
</sec>
<sec id="s3_6">
<label>3.6</label>
<title>Spatial transcriptomic heterogeneity analysis in PDAC</title>
<p>We next mapped the spatial distribution of pancreatic cells within the originating tissue. In the spatial transcriptomics sequencing (ST-seq) data, mitochondrial RNA accounted for &lt;20% of total reads, indicating high data quality. More than 3, 000 genes were detected via ST-seq (<xref ref-type="fig" rid="f4"><bold>Figures&#xa0;4A&#x2013;C</bold></xref>). Clustering analysis grouped cells into five clusters (<xref ref-type="fig" rid="f4"><bold>Figure&#xa0;4B</bold></xref>). Each cluster was annotated using gene expression features, cell-specific biomarkers, and HE staining. In differential analysis (<xref ref-type="fig" rid="f4"><bold>Figure&#xa0;4E</bold></xref>), Cluster 2 predominantly expressed B2M, CD24, LGALS3, and TM4SF1, genes overexpressed in tumor and epithelial cells, particularly in ovarian cancer, and linked to tumor progression and metastasis. Thus, Cluster 2 was annotated as cancer cells of epithelial origin. Clusters 0 and 5 mainly expressed TGM2, IGFBP4, and HLA-DRB1 as well as fibrous markers, such as CD74, characteristic of epithelial cells and adipocytes, and were annotated as normal cells. Clusters 1, 3, and 4 were primarily enriched in the genes NUPRI, TPM3, SERPINE1, and SLC2A1, biomarkers of pre-existing tumor and normal cells, and were classified as intermixed cells. Ultimately, the dataset was categorized into three groups: tumor, normal, and intermixed cells (<xref ref-type="fig" rid="f4"><bold>Figures&#xa0;4C, D</bold></xref>).</p>
<fig id="f4" position="float">
<label>Figure&#xa0;4</label>
<caption>
<p>Spatial transcriptomic quality control and annotation. <bold>(A)</bold> HE-stained image and spatial maps showing the distribution of UMIs and gene spatial density. <bold>(B)</bold> t-SNE cluster plot. <bold>(C)</bold> Annotation of t-SNE dimensional reduction clustering. <bold>(D)</bold> Spatial distribution maps of different cell types. <bold>(E)</bold> Heatmap showing the 10 most significantly differentially expressed genes among clusters. HE, hematoxylin and eosin; UMI, unique molecular identifier; t-SNE, t-distributed stochastic neighbor embedding.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-17-1743187-g004.tif">
<alt-text content-type="machine-generated">Multipanel scientific figure showing spatial transcriptomics and gene expression analysis of tissue. Panel A displays a tissue section with two colored hexbin maps quantifying gene and transcript counts. Panels B and C show tSNE plots depicting cellular clusters and cell identity (normal, malignant, or both). Panel D overlays cell identity on the tissue map with color coding. Panel E presents a heatmap of gene expression across cellular clusters, labeled by gene names and colorbars.</alt-text>
</graphic></fig>
<p>Using CellTrek analysis, we inferred the single-cell composition of each spatial spot to map all scRNA-seq clusters. The identified cell types, i.e., fibroblasts, endothelial cells, stellate cells, NK cells, mast cells, donor cells, acinar cells, and bile duct cells with hyperlactate metabolism, served as key indicators of malignancy. Notably, cells with hypolactate metabolism reflected the tumor&#x2019;s metabolic and oxygenation state. Immune cells, including macrophages, neutrophils, NK cells, T lymphocytes, and B lymphocytes, were primarily distributed in intermixed clusters (<xref ref-type="fig" rid="f5"><bold>Figure&#xa0;5A</bold></xref>). The colocalization patterns of different cell types are shown in <xref ref-type="fig" rid="f5"><bold>Figures&#xa0;5B, C</bold></xref>, revealing that malignant bile duct cells with elevated lactate metabolism primarily colocalized with <underline>acinar</underline> and T cells.</p>
<fig id="f5" position="float">
<label>Figure&#xa0;5</label>
<caption>
<p>Integrated analysis of single-cell and spatial transcriptomic data. <bold>(A)</bold> Spatial transcriptome map showing the localization of different cell types. <bold>(B)</bold> Spatial mapping comparing malignant bile duct hyperlactate cells and malignant cells in the spatial transcriptome. <bold>(C)</bold> Network plots illustrating colocalization relationships among different cell types in spatial context. <bold>(D)</bold> Spatial variation of the lactate metabolism score. <bold>(E)</bold> Spatial mapping of <italic>LYZ</italic> gene expression. <bold>(F)</bold> Spatial mapping of <italic>PIGR</italic> gene expression. LYZ, lysozyme; PIGR, polymeric immunoglobulin receptor.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-17-1743187-g005.tif">
<alt-text content-type="machine-generated">Panel A shows a tissue section with colored dots representing various cell types, indicated by a legend. Panel B presents a similar tissue map with focus on lactic acid metabolism, showing a color gradient. Panel C includes a network diagram illustrating connections and relative abundance among cell types, with node sizes reflecting cell numbers. Panel D displays a hexagonal grid map of cell types distributed across the tissue. Panel E shows expression levels of the LYZ marker using a red-to-blue scale on the tissue map. Panel F depicts expression of the PIGR marker as colored dots over a purple-stained tissue background.</alt-text>
</graphic></fig>
<p>We calculated the lactate metabolism score for each cell type using the AddModuleScore function with 320 characteristic lactate metabolism&#x2013;related genes, enabling estimation of lactate metabolism levels across tissues. As shown in <xref ref-type="fig" rid="f5"><bold>Figure&#xa0;5D</bold></xref>, cells with high lactate metabolism were localized in regions corresponding to malignant bile duct cells with elevated metabolic activity. Furthermore, we investigated the expression patterns of prognostic genes across various tissue types and found that LYZ expression was predominantly enriched in tumor tissues (<xref ref-type="fig" rid="f5"><bold>Figures&#xa0;5E, F</bold></xref>).</p>
</sec>
<sec id="s3_7">
<label>3.7</label>
<title>Cell communication analysis</title>
<p>We applied the CellChat algorithm to analyze intercellular signaling networks based on single-cell transcriptomic data, aiming to predict pathological changes in cell-to-cell communication in PDAC. This analysis revealed that malignant cells with low lactate metabolism exhibited an increase in communication events and higher interaction intensities compared with other cell types (<xref ref-type="fig" rid="f6"><bold>Figure&#xa0;6A</bold></xref>).</p>
<fig id="f6" position="float">
<label>Figure&#xa0;6</label>
<caption>
<p>Results of cell-to-cell communication analysis. <bold>(A)</bold> Network plots showing the number and strength of interactions among cell types. <bold>(B)</bold> Heatmap visualizations of potential afferent and efferent signaling pathways between cells. Ductal 2-LH refers to malignant bile duct cells with high lactate metabolism, and Ductal 2-LL refers to those with low lactate metabolism. <bold>(C)</bold> Heatmap showing cell population interactions mediated by the NRG signaling pathway. <bold>(D)</bold> Chord diagram illustrating cell population interactions mediated by NRG signaling across different cell types. <bold>(E)</bold> Heatmap showing the roles of individual cell populations within the signaling pathway.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-17-1743187-g006.tif">
<alt-text content-type="machine-generated">Panel A contains two circular network diagrams mapping cell-cell interactions by number (top) and interaction strength (bottom) among labeled pancreatic cell types. Panel B presents two heatmaps showing outgoing (left) and incoming (right) signaling patterns for multiple genes across the same cell types, with relative strength indicated by color intensity. Panel C provides a heatmap summarizing NRG signaling network communication probabilities between each cell type pair. Panel D displays a chord diagram illustrating the direction and strength of the NRG signaling between cell types. Panel E shows a bar graph representing the importance of each cell type as sender, receiver, mediator, or influencer within the NRG signaling pathway network.</alt-text>
</graphic></fig>
<p>To further quantify intercellular communication, we calculated the information flow for each signaling pathway across cell-type pairs, enabling assessment of communication probabilities and differences in information flow between cells with high and low lactate metabolism levels (<xref ref-type="fig" rid="f6"><bold>Figure&#xa0;6B</bold></xref>). Compared with Ductal 2-LL cells, Ductal 2-LH cells show increased MIF, NRG, and HGF pathways, while pathways such as BTLA, CD40, and LIGHT are decreased.</p>
<p>The neuregulin (NRG) signaling pathway exhibited marked heterogeneity. It showed minimal expression in malignant cells with low lactate metabolism but significantly higher expression in malignant bile duct cells with high lactate metabolism (ductal 2 LL). Given this variation, we focused on the NRG pathway for further analysis, examining communication dynamics among malignant cells with different metabolic states and interactions involving hyperlactate metabolic malignant cells (<xref ref-type="fig" rid="f6"><bold>Figure&#xa0;6C</bold></xref>). We found that malignant cells with high lactate metabolism act as central mediators in the NRG pathway, closely communicating with Schwann cells and Ductal 2-LL, contributing to intercellular communication within the PDAC microenvironment (<xref ref-type="fig" rid="f6"><bold>Figures&#xa0;6D, E</bold></xref>). These results highlight the potential importance of NRG signaling in PDAC metabolic reprogramming and progression, suggesting a metabolic-neural-immune tripartite interaction network and providing new evidence for key nodes that link metabolic reprogramming with neural invasion during PDAC development.</p>
</sec>
<sec id="s3_8">
<label>3.8</label>
<title>TF analysis in PDAC</title>
<p>We employed SCENIC analysis to identify key TF modules and examine differences in TF expression between malignant cholangiocytes with distinct lactate-metabolic activity. Malignant bile duct cells with hyperlactate metabolism were predominantly associated with the following TF modules: FOXA2 (+), MNX1 (+), EHF (+), IRF6 (+), GATA4 (+), POU2F3 (+), and SOX21 (+) (<xref ref-type="fig" rid="f7"><bold>Figures&#xa0;7A, B</bold></xref>). Conversely, bile duct cells with hypolactate metabolism were linked to the following TF modules: TBX21 (+), HOXA10 (+), EOMES (+), and HOXC (+) (<xref ref-type="fig" rid="f7"><bold>Figures&#xa0;7A, B</bold></xref>). Additionally, FOXA2 (+), MNX1 (+), GATA4 (+), POU2F3 (+), and SOX21 (+) were enriched in malignant bile duct cells with hyperlactate metabolism (<xref ref-type="fig" rid="f7"><bold>Figures&#xa0;7C&#x2013;G</bold></xref>).</p>
<fig id="f7" position="float">
<label>Figure&#xa0;7</label>
<caption>
<p>TF analysis in PDAC. <bold>(A)</bold> Bubble plot showing TFs specific to each cell type. <bold>(B)</bold> Heatmap illustrating expression patterns of cell type&#x2013;specific TFs. <bold>(C&#x2013;G)</bold> Representative expression patterns of FOXA2(+), MNX1(+), GATA4(+), POU2F3(+), and SOX21(+) in patients with PDAC. TF, transcription factor; PDAC, pancreatic ductal adenocarcinoma.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-17-1743187-g007.tif">
<alt-text content-type="machine-generated">Multipanel scientific figure showing transcription factor activity across cell types. Panel A is a dot plot where dot size and color indicate relative specificity score and z-score for transcription factors in different cell types. Panel B is a heatmap showing regulon activity scores across cell types, with clustering of both genes and cell types. Panels C through G present tSNE plots with color gradients illustrating the activity of FOXA2, MNX1, SOX21, POU2F3, and GATA4 regulons in single cells.</alt-text>
</graphic></fig>
</sec>
<sec id="s3_9">
<label>3.9</label>
<title>Drug sensitivity analysis</title>
<p>We also assessed the predictive value of the risk score for chemosensitivity in patients with PDAC. The clinical efficacy of several drugs, including dasatinib (1079), BI-2536 (1086), AZD8055 (1059), sepantronium bromide (1941), AZ6102 (2109), and bortezomib (1191), was evaluated for PDAC treatment potential. Patients with low-risk scores showed higher sensitivity to dasatinib (1079) (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;5A</bold></xref>), BI-2536 (1086) (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;5B</bold></xref>), and sepantronium bromide (1941) (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;5D</bold></xref>). In contrast, those with high risk were more sensitive to AZD8055 (1059) (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;5E</bold></xref>), AZ6102 (2109) (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;5C</bold></xref>), and bortezomib (1191) (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;5F</bold></xref>), a proteasome inhibitor with clinical efficacy in multiple myeloma treatment, as evidenced by improved progression-free survival and OS rates.</p>
<p>Additionally, LYZ expression correlated positively with sensitivity to dasatinib (1079) (R = 0.62, <italic>p</italic> &lt;.001), BI-2536 (1086) (R = 0.55, <italic>p</italic> &lt;.001), and sepantronium bromide (1941) (R = 0.37, <italic>p</italic> &lt;.001) (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figures&#xa0;5G&#x2013;I</bold></xref>). Similarly, PIGR expression was positively correlated with sepantronium bromide (1941) (R = 0.58, <italic>p</italic> &lt;.001) and BI-2536 (1086) (R = 0.66, <italic>p</italic> &lt;.001) but negatively correlated with AZ6102 (2109) (R = 0.25, <italic>p</italic> = .01) (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figures&#xa0;5J&#x2013;L</bold></xref>).</p>
</sec>
<sec id="s3_10">
<label>3.10</label>
<title>Association of immune checkpoints and immune escape with biomarker genes</title>
<p>We analyzed the relationships between prognostic genes and immune checkpoints by comparing immune checkpoint expression levels in high- and low-expression groups for prognostic genes. BTLA, CD96, HHLA2, ILRB4, and TIGIT were significantly upregulated in the LYZ high-expression group (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;6A</bold></xref>). Similarly, HHLA2 and ILRB4 were significantly upregulated in the PIGR high-expression group (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;6B</bold></xref>). Tumor immune microenvironment heterogeneity critically influences tumor progression and patient prognosis, as evidenced in prior studies. To assess immune status between high- and low-risk groups, we compared TIDE and risk scores (<xref ref-type="fig" rid="f8"><bold>Figure&#xa0;8A</bold></xref>). Results revealed higher TIDE and immune rejection scores in the high-risk group, suggesting an increased likelihood of immune escape (<xref ref-type="fig" rid="f8"><bold>Figure&#xa0;8B</bold></xref>).</p>
<fig id="f8" position="float">
<label>Figure&#xa0;8</label>
<caption>
<p>Immunocheckpoint, TIDE, and experimental validation analyses. <bold>(A)</bold> Bar chart showing differential TIDE scores between risk groups. <bold>(B)</bold> Sankey plot illustrating the relationship between risk score and immune response. <bold>(C)</bold> mRNA expression levels of <italic>PIGR</italic> and <italic>LYZ</italic> in ASPC-1, HPDE, MIA-PaCa-2, PANC-1, and SW1990 cell lines. <bold>(D, E)</bold> Protein expression of PIGR and LYZ in the same cell lines determined via western blot. <bold>(F)</bold> IHC showing high PIGR expression in PDAC tissues and low expression in adjacent normal tissues. Scale bars = 50 &#x3bc;m. TIDE, tumor immune dysfunction and exclusion; PDAC, pancreatic ductal adenocarcinoma; IHC, immunohistochemistry.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-17-1743187-g008.tif">
<alt-text content-type="machine-generated">Panel A presents boxplots comparing expression levels across four categories labeled high and low with statistically significant differences indicated. Panel B shows a Sankey diagram linking high and low values to corresponding true or false categories. Panel C contains two bar graphs displaying relative mRNA expression of PIGR and LYZ in five cell lines. Panel D shows a western blot depicting LYZ, PIGR, and GAPDH expression across the same cell lines. Panel E contains two bar graphs displaying relative protein expression of PIGR and LYZ. Panel F consists of immunohistochemistry images for PDAC, with stronger brown staining in tumor tissues compared to weaker staining in normal tissues.</alt-text>
</graphic></fig>
</sec>
<sec id="s3_11">
<label>3.11</label>
<title>Pan-cancer analysis of prognostic genes</title>
<p>We examined PIGR mRNA expression across multiple cancer types compared with paired normal tissues. Consistent with previous studies on differential gene expression in sarcoma and endometrial carcinoma, PIGR expression was significantly elevated in these cancers, as well as in rectal adenocarcinoma, lung adenocarcinoma (LUAD), lung squamous cell carcinoma (LUSC), squamous cell carcinoma of the head and neck (HNSC), renal chromophobe carcinoma, renal clear cell carcinoma (KIRC), renal papillary cell carcinoma (KIRP), breast cancer (BRCA), and colon cancer (COAD) relative to normal tissues (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;7A</bold></xref>).</p>
<p>Conversely, LYZ expression was significantly elevated in BRCA, cholangiocarcinoma, COAD, glioblastoma, HNSC, KIRC, KIRP, and hepatocellular carcinoma but notably reduced in LUAD and LUSC (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figure&#xa0;8A</bold></xref>). Furthermore, LYZ and PIGR expression levels were positively correlated with immune cell scores in most analyzed cancer types (<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Figures&#xa0;7B</bold></xref>, <xref ref-type="supplementary-material" rid="SM1"><bold>8B</bold></xref>).</p>
</sec>
<sec id="s3_12">
<label>3.12</label>
<title>Cell and tissue verification</title>
<p>We used five different cell lines to verify the expression of LYZ and PIGR, among which ASPC-1, MIA-PACA2, and PANC-1 are PDAC cell lines, while HPDE and SW1990 are control cell lines. RT-PCR analysis showed that PIGR mRNA expression was significantly higher in ASPC-1 cells compared with the other four cell lines, with highly significant pairwise differences detected (<italic>p</italic> &lt;.001). LYZ mRNA expression was also significantly higher in ASPC-1 and PANC-1 cells compared with the other three cell types (<italic>p</italic> = .01), consistent with bioinformatics findings (<xref ref-type="fig" rid="f8"><bold>Figure&#xa0;8C</bold></xref>).</p>
<p>Western blot analysis confirmed that PIGR expression was significantly elevated in ASPC-1 cells relative to the other cell types (<italic>p</italic> = .002). Similarly, LYZ expression was significantly higher in PANC-1 cells compared with the other cell types (<italic>p</italic> = .01). The concordance between experimental and computational results further validated the findings (<xref ref-type="fig" rid="f8"><bold>Figures&#xa0;8D, E</bold></xref>). Additionally, immunohistochemical staining of paraffin-embedded PDAC tissue sections revealed minimal differences in LYZ expression between cancerous and adjacent normal tissues; however, PIGR expression was notably higher in cancerous tissues (<xref ref-type="fig" rid="f8"><bold>Figure&#xa0;8F</bold></xref>).</p>
</sec>
</sec>
<sec id="s4" sec-type="discussion">
<label>4</label>
<title>Discussion</title>
<p>PDAC is a highly aggressive cancer, typically diagnosed at advanced stages and associated with poor prognosis, contributing substantially to global cancer mortality (<xref ref-type="bibr" rid="B21">21</xref>, <xref ref-type="bibr" rid="B22">22</xref>). The complexity of its TME and pronounced genetic heterogeneity hinder effective therapy development (<xref ref-type="bibr" rid="B23">23</xref>). Advances in scRNA-seq have provided critical insights into PDAC&#x2019;s cellular diversity and molecular mechanisms (<xref ref-type="bibr" rid="B24">24</xref>). Understanding metabolic alterations, particularly those involving lactate metabolism, is crucial for developing targeted treatments that improve prognosis (<xref ref-type="bibr" rid="B25">25</xref>). This study investigated PDAC cellular heterogeneity, emphasizing lactate metabolism, and identified potential biomarkers for prognosis and therapy.</p>
<p>We integrated single-cell transcriptomics, bulk RNA-seq, spatial transcriptomics, and experimental validation to analyze the PDAC TME. Accordingly, we identified two lactate-associated cell subtypes with distinct roles in disease progression and therapeutic response. Using advanced computational methods, we mapped dynamic interactions between these subtypes, suggesting novel TME-focused therapeutic strategies to improve prognosis.</p>
<p>In total, we identified 50, 795 cells divided into 26 clusters representing 13 major cell types, illustrating the TME&#x2019;s complexity. InferCNV analysis distinguished malignant from nonmalignant cells, revealing 521 malignant cells with elevated lactate metabolism consistent with the Warburg effect (<xref ref-type="bibr" rid="B26">26</xref>, <xref ref-type="bibr" rid="B27">27</xref>). Two lactate metabolism&#x2013;related subtypes were defined: Cluster 1, characterized by NUPR1, TPM3, SERPINE1, and SLC2A1, expressed in both tumor and normal cells; and Cluster 2, characterized by B2M, CD24, LGALS3, and TM4SF1, mainly expressed in tumor and epithelial cells. Cluster 1 correlated with significantly better survival compared to Cluster 2, underscoring lactate metabolism&#x2019;s role in PDAC progression.</p>
<p>Consensus clustering analysis revealed a differentiation continuum between subtypes, driven by metabolic activity and signaling pathways. Cluster 2, with higher lactate metabolism, exhibited greater tumor aggressiveness and a more inflammatory microenvironment conducive to invasion and metastasis. Patients in Cluster 2, with high lactate metabolism, had worse prognosis, reinforcing metabolic reprogramming as a driver of PDAC progression.</p>
<p>The PDAC immune microenvironment, strongly shaped by lactate metabolism, critically influences intercellular communication and immune regulation. The malignant ductal cell subset with high lactate metabolism identified in this study establishes paracrine communication with Schwann cells through the NRG signaling pathway, revealing a coupling mechanism between metabolic reprogramming and neural interactions in PDAC perineural invasion (PNI). The high-lactate phenotype reflects enhanced glycolysis driven by the Warburg effect, wherein lactate not only acidifies the microenvironment but also functions as a signaling molecule regulating gene expression through protein lactylation modifications (<xref ref-type="bibr" rid="B28">28</xref>). NRG1, secreted by cancer-associated fibroblasts (CAFs) and Schwann cells within the tumor microenvironment, activates the ErbB3 receptor on tumor cell surfaces and its downstream PI3K/AKT pathway, promoting proliferation and invasion (<xref ref-type="bibr" rid="B29">29</xref>). Upon tumor &#x201c;hijacking, &#x201c; Schwann cells form tumor-activated Schwann cell tracks (TASTs), inducing tumor cell transition to basal-like subtypes through secretion of MDK and IL-1&#x3b1;, while establishing a bFGF/IL-33 positive feedback loop with tumor-associated macrophages (TAMs) (<xref ref-type="bibr" rid="B30">30</xref>, <xref ref-type="bibr" rid="B31">31</xref>). This tripartite metabolic-neural-immune interaction network provides multidimensional support for PNI, suggesting that combinatorial targeting of lactate metabolism (e.g., LDHA/MCT inhibitors) and the NRG pathway (e.g., zenocutuzumab) may represent a therapeutic strategy for blocking perineural invasion.</p>
<p>SCENIC analysis identified key TFs (FOXA2, GATA4, and MNX1) as regulators of high lactate metabolism. Although FOXA2&#x2019;s metabolic role in PDAC was previously described, we uniquely demonstrate its coregulation with lactate transporters (MCT1/4) and immune checkpoints (PD-L1) (<xref ref-type="bibr" rid="B32">32</xref>&#x2013;<xref ref-type="bibr" rid="B34">34</xref>). Conversely, low-lactate-associated TFs (TBX21 and HOXA10) showed enrichment patterns similar to the &#x201c;immune-hot&#x201d; PDAC subtype described by Ma et&#xa0;al.; however, our study is the first to link these TFs to metabolic suppression (<xref ref-type="bibr" rid="B35">35</xref>&#x2013;<xref ref-type="bibr" rid="B37">37</xref>).</p>
<p>PIGR emerged as a novel lactate-modulated target in PDAC. Although its immunosuppressive function was reported in colorectal cancer, our study provides the first comprehensive evidence of its importance in PDAC. We validated its marked overexpression in PDAC compared with normal tissues (<italic>p</italic> &lt;.001), noting a difference greater than that observed in colorectal cancer, and confirmed its association with NF-&#x3ba;B activation, a pathway implicated in PDAC chemoresistance (<xref ref-type="bibr" rid="B38">38</xref>&#x2013;<xref ref-type="bibr" rid="B40">40</xref>). Our findings suggest that PIGR is associated with pathways such as NF-&#x3ba;B activation and EMT, but functional studies are needed to determine causality.</p>
<p>For LYZ, beyond its known immune functions, pathway analysis revealed novel associations with KRAS signaling, supporting evidence of KRAS-driven metabolic reprogramming in PDAC (<xref ref-type="bibr" rid="B41">41</xref>). LYZ expression is enriched in gene sets associated with KRAS signaling and IL2&#x2013;STAT5 pathways (<xref ref-type="bibr" rid="B42">42</xref>).</p>
<p>This study represents a fundamental advance in PDAC research: spatial transcriptomics, for the first time, revealed spatial colocalization between lactate metabolism&#x2013;associated TFs and immune checkpoint molecules, a finding not achievable through bulk RNA-seq (<xref ref-type="bibr" rid="B43">43</xref>). The PIGR&#x2013;NF-&#x3ba;B&#x2013;EMT axis described in this study provides a mechanistic connection between the &#x201c;fibro-inflammatory&#x201d; PDAC subtype and metabolic heterogeneity (<xref ref-type="bibr" rid="B44">44</xref>).</p>
<p>Finally, lactate metabolism&#x2013;related genes emerged as markers of malignant cell behavior, with high lactate&#x2013;producing cells correlating with poorer clinical outcomes (<xref ref-type="bibr" rid="B45">45</xref>). Targeting lactate metabolism may offer a new therapeutic strategy by disrupting tumor-supportive metabolic adaptations. Our pharmacogenomic analysis showed that patients with low-risk scores are more sensitive to dasatinib and BI-2536, whereas high-risk patients responded better to AZD8055 and bortezomib. Expression levels of LYZ and PIGR were linked to drug sensitivity, highlighting their potential as biomarkers for PDAC treatment.</p>
<p>Despite these insights, this study has several limitations. These include potential bias from public datasets and the relatively small experimental validation cohort. Larger, more uniform patient cohorts with detailed clinical data are required to refine and confirm these findings. Moreover, machine learning models must be validated on independent cohorts to ensure prognostic accuracy (<xref ref-type="bibr" rid="B46">46</xref>, <xref ref-type="bibr" rid="B47">47</xref>).</p>
</sec>
<sec id="s5" sec-type="conclusions">
<label>5</label>
<title>Conclusion</title>
<p>In summary, we identified two genes, PIGR and LYZ, closely associated with lactate metabolism in PDAC through integrated bioinformatics analysis. Validation confirmed significant PIGR overexpression in PDAC compared with adjacent normal tissues, establishing it as a key biomarker for lactate metabolism. These genes appear to regulate PDAC progression, making PIGR and LYZ promising therapeutic targets. Our findings provide a foundation for future clinical strategies targeting lactate metabolism and offer potential new directions for PDAC treatment.</p>
</sec>
</body>
<back>
<sec id="s6" sec-type="data-availability">
<title>Data availability statement</title>
<p>The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found in the article/<xref ref-type="supplementary-material" rid="SM1"><bold>Supplementary Material</bold></xref>.</p></sec>
<sec id="s7" sec-type="ethics-statement">
<title>Ethics statement</title>
<p>Ethical approval was not required for the studies on humans in accordance with the local legislation and institutional requirements because only commercially available established cell lines were used.</p></sec>
<sec id="s8" sec-type="author-contributions">
<title>Author contributions</title>
<p>FG: Writing &#x2013; original draft, Conceptualization, Data curation, Formal Analysis, Funding acquisition, Investigation, Methodology, Project administration. ZT: Writing &#x2013; original draft, Formal Analysis, Investigation, Software. JL: Writing &#x2013; original draft, Conceptualization, Investigation. LZ: Writing &#x2013; review &amp; editing, Conceptualization, Funding acquisition, Investigation, Methodology, Project administration.</p></sec>
<ack>
<title>Acknowledgments</title>
<p>We extend our appreciation to all authors for their contribution in making their valuable research data publicly accessible.</p>
</ack>
<sec id="s10" sec-type="COI-statement">
<title>Conflict of interest</title>
<p>The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p></sec>
<sec id="s11" sec-type="ai-statement">
<title>Generative AI statement</title>
<p>The author(s) declared that generative AI was not used in the creation of this manuscript.</p>
<p>Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.</p></sec>
<sec id="s12" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p></sec>
<sec id="s13" sec-type="supplementary-material">
<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fimmu.2026.1743187/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fimmu.2026.1743187/full#supplementary-material</ext-link></p>
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<p><ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/657619">Yanjun Lu</ext-link>, Huazhong University of Science and Technology, China</p></fn>
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<fn fn-type="abbr" id="abbrev1">
<label>Abbreviations:</label>
<p>ANOVA, analysis of variance; AUC,area under the curve; BP, biological process; CC, cellular components; CHOL, cholangiocarcinoma; Index, concordance index; DEGs, differentially expressed genes; Enet, Elastic Net; FC, fold change; GBM, generalized boosted regression modelling; GEO, Gene Expression Omnibus; GSEA, gene set enrichment analysis; HE, hematoxylin and eosin; HNSC, squamous cell carcinoma of the head and neck; ICGC, International Cancer Genome Consortium; KEGG, Kyoto Encyclopedia of Genes and Genomes; KRAS, kirsten rat sarcoma viral oncogene homolog; log2FC, log2 fold change; LYZ, Lysozyme; MF, molecular functions; NRG, Neuregulin; OS, overall survival; PCA, principal component analysis; PCs, principal components; PDAC, pancreatic ductal adenocarcinoma; HPDE, human pancreatic ductal epithelium; PIGR, polymeric immunoglobulin receptor; RSF, random survival forest; SCENIC, single-cell regulatory network inference and clustering; scRNA-seq, single-cell RNA sequencing; ssGSEA, single-sample gene set enrichment analysis; TFs, transcription factors; TIDE, tumor immune dysfunction and exclusion; TME, tumor microenvironment; t-SNE, t-distributed stochastic neighbor embedding; UMIs, unique molecular identifiers.</p>
</fn>
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