How to rejuvenate the prostate damaged by cancer

Prostate cancer causes damage to the stromal compartment of smooth muscle cells. These cells control epithelial differentiation through secreted signaling factors and cell contact in development as well as renewal and repair. Stromal cells are depleted by programmed cell death induced by the cancer-secreted anterior gradient 2 protein. In their place, a less differentiated version of cancer-associated stromal cells, which are functionally defective, emerge. Without proper stromal influence, cancer cells can become dedifferentiated to more stem-like with expression of stem cell transcription factors. The importance of identified secreted stromal factors is shown by their induction of cancer cell differentiation with down-regulation of stem cell transcription factors. To maintain prostate function, stromal cells are generated ex vivo through stromal induced differentiation of patient-derived induced pluripotent stem cells. These are then injected into the prostate to restore the pool of stromal cells.