Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The present study employed a two-phased approach to investigate the possible mechanisms involved in the chemopreventive properties of rooibos (Aspalathus linearis) and different honeybush species (Cyclopia spp.) in vitro. In the first phase, the effect of unfermented methanol and aqueous herbal tea extracts against the growth parameters (cell viability, proliferation and apoptosis) of normal (CRL 7761); premalignant (HaCaT); and malignant (CRL 7762) skin cells was evaluated and compared to green tea extracts. The predictive potential of polyphenol content (total polyphenol and flavanol/proanthocyanidins) and antioxidant properties (ABTS; ORAC; FRAP and LPO) in the biological activity of extracts in cells was also assessed. Of the herbal teas, the methanol extract of rooibos was the most active and it inhibited the growth of skin cells presumably by inducing mitochondrial dysfunction via membrane depolarisation. At lower concentrations, this activity was associated with inhibition of cell proliferation that was selective for cancer cells whilst higher concentrations induced apoptosis that was more prominent in premalignant cells. The strong antioxidant properties of the extracts implicated the role of pro-oxidative polyphenol/iron interactions involving monomeric flavonoids and polymeric proanthocyanidins in the cytotoxic effects of rooibos. The strong relationship between total polyphenolic and flavanol/proanthocyanidins content, antioxidant properties and reduction of cell viability indicated that these parameters (polyphenols and antioxidant properties) can serve as predictive tools for the cytotoxic effects of rooibos in vitro. The aqueous extracts of honeybush species, although weaker, displayed similar effects to rooibos extracts in cells with C. genistoides being the most effective at selectively inhibiting the proliferation of cancer cells whilst the pro-apoptotic activity of C. subternata and C. intermedia was more prominent in premalignant cells. The underlying mechanisms are also likely to result from pro-oxidative mechanisms resulting from polyphenol/iron interactions that mainly involve polymeric flavanol-like proanthocyanidin compounds in honeybush. In contrast, the methanol extracts exhibited weaker cytotoxic effects and protected cancer cells from going into apoptosis. The cytoprotective effects of honeybush species are possibly mediated by the major monomeric compounds such as mangiferin and hesperidin through antioxidant mechanisms that result in reduction of oxidative stress. Due to the possible dual role of the monomeric and polymeric compounds in the honeybush extracts, the total polyphenolic content of these herbal teas may not be a good indicator of biological activity in vitro. However, as aqueous extracts displayed high flavanol/proanthocyanidins content and exceptional activity in the ABTS assay, these parameters may be considered as indicators of cytotoxicity. On the other hand, methanol extracts, particularly from the xanthone-rich species (C. genistoides and C. longifolia) which exhibited the weakest cytotoxic effects, were more active in the ORAC thus this assay may be a useful predictor for cytoprotective activity. In the second phase, an in vitro UVB/HaCaT model which used IL-1α as a biomarker for early inflammation was developed and validated with known anti-inflammatory compounds, dexamethasone and ibuprofen. It was used to determine the specific mechanisms involved in the modulatory effects of the herbal tea extracts against inflammation. Rooibos extracts and the aqueous extract of honeybush enhanced the cytotoxic effects of UVB in the model and exhibited indirect anti-inflammatory effects as they removed icIL-1α containing cells via apoptosis. In contrast, methanol extracts of honeybush exacerbated icIL-1α by protecting UVB stimulated cells from undergoing apoptosis. In conclusion, methanol extract of rooibos and aqueous extracts of honeybush species may be useful in protecting the skin after UVB exposure. These herbal tea extracts may block initiation and delay the promotion stage during skin carcinogenesis by removing premalignant cells via apoptosis and preventing onset of inflammation. In contrast, due to their cytoprotective effects, methanol extracts of honeybush may be more effective at preventing oxidative stress in skin before UVB exposure. Future studies should focus on the effects of extracts and polyphenolic fractions on the oxidative status of the cells and development of biomarkers of chemoprevention that can be utilised in vivo and in human skin. / AFRIKAANSE OPSOMMING: In hierdie studie word moontlike velkankerwerende eienskappe van rooibos (Aspalathus linearis) en ‘n aantal heuningbos (Cyclopia spp.) spesies deur twee afsonderlike benaderings bestudeer. Die eerste benadering ondersoek die effek van die kruietee op groeiparameters van velselle [lewensvatbaarheid, groei en dood van normale selle (CRL 7761), vroeë kankerselle (HaCaT) en kankerselle (CRL 7762)]. Tydens eksperimente is die moontlikheid om polifenoolinhoud (totale polifenole, en flavanol/proantosianidiene verhouding) en antioksidant-eienskappe te gebruik om die biologiese funksies van die ekstrakte in die selle te voorspel, geevalueer. Die metanolekstrak van rooibos het die groei van selle die effektiefste gestop, moontlik deur depolarisasie van die mitokondriale membraan. By lae konsentrasies van die ekstrak is die groei van kankerselle selektief gestop, terwyl vroeë kankerselle die sensitiefste by hoër konsentrasies was. Die hoë antioksidant-aktiwiteit van die rooibosekstrak kan moontlik ‘n rol speel in die indusering van sitotoksiese effekte in die selle en kan toegeskryf word aan die pro-antioksidant aktiwiteit van die polifenole weens hul interaksie met yster. ‘n Spesifieke funksie word vir die monomeriese flavonoïede en die polimeriese proantosianidiene geïmpliseer. Die sterk verwantskap tussen die totale polifenoolinhoud, flavanol/proantosianidien inhoud en antioksidant aktiwiteit met die verlaging in selgroei, maak hul relevante parameters van die voorspellingsmodel. Die waterekstrakte van heuningbos induseer ook soortgelyke maar swakker effekte met die induksie van kankersel dood, met C. genistoides die selektiefste en C. subternata en C. intermedia die aktiefste spesies wat die groei van die vroeë kanker selle inhibeer. Die onderliggende meganismes betrokke blyk ook aan ‘n pro-oksidant effek toe geskryf te wees, waartydens spesifieke polifenool/yster interaksies betrokke is. In teenstelling met rooibos, beskerm die metanolekstrak van heuningbos kankerselle teen seldood, wat moontlik verband hou met die antioksidant-eienskappe van die hoof monomeriese polifenole, mangiferien/isomangiferien en hesperidien. Vanweë die dubbele rol van die monomeriese polifenole en polimeriese verbindings in heuninghbosekstrakte is die totale polifenol inhoud nie ‘n goeie indikator van die biologiese aktiwiteit in vitro nie. Daarenteen is die flavanol/proantosianien inhoud en die hoë aktiwiteit in die ABTS antioksidanttoets goeie indikators om seldood te voorspel. In teenstelling hiermee het die metanolekstrakte van die xantoon-ryke spesies (C. genistoides en C. longifolia) ‘n baie lae effek op seldood, maar ‘n hoë aktiwitiet in die ORAC toets getoon, wat ‘n goeie rigtingwyser is om die beskermende effek in selle te voorspel. Met die tweede benadering is die anti-inflammatoriese eienskappe en die onderliggende meganismes van die kruietee ondersoek in ‘n UVB/HaCaT selmodel. Intrasellulêre interleukin 1α (IL-1α) is as merker gebruik en die model is geëvalueer deur bekende anti-inflammatoriese verbindings soos dexamethasone en ibuprofin te gebruik. Die metanolekstrak van rooibos en die waterekstrak van heuningbos het die toksiese effek van UVB in die model verhoog deur selle met verhoogde vlakke,van icIL-1α te verwyder deur middel van die induksie van seldood. Die metanolekstrak beskerm die selle teen die oksidatiewe skade wat deur UVB geïnduseer word en verwyder nie selle met hoë IL-1α vlakke nie. Ter opsomming blyk dit dat die metanolekstrak van rooibos en die waterekstrak van heuningbos moontlik gebuik kan word om die vel te beskerm teen die induksie van icIL-1α en sodoende die inisiëring van kanker te blokkeer en ook die promosie van kanker te vertraag. Die beskermende effek van die metanolekstrak kan moontlik aangewend word om die oksidatiewe skade wat deur UVB veroorsaak word teen te werk deur dit aan te wend voordat blootstelling plaasvind. Toekomstige studies behoort verdere karakterisering van die polifenoolsamestelling van die ekstrakte in te sluit en hul effek op die oksidatiewe status en anti-inflammoriese effekte van selle te bepaal ten einde sekere merkers te identifiseer vir vel studies in vivo.

published_or_final_version / Surgery / Master / Master of Philosophy

Optical coherence tomography (OCT) is a minimally-invasive imaging modality that generates high resolution cross-sectional images of tissue. The present study employed a 2 mm diameter endoscopic spectral domain OCT system in the in vivo evaluation of the drugs α-Difluoromethylornithine and Sulindac as chemopreventive and chemotherapeutic agents in a mouse model of sporadic colorectal cancer. 30 mm lateral images of each colon at eight different rotations were obtained at five different time points. Visual analysis of the images was performed to determine the number and size of discrete adenomas, with gross photos and histology serving as gold standard confirmation of the final imaging time point. When applied for chemoprevention, DFMO and Sulindac both significantly reduced the incidence of adenoma, appearing to interact additively in the prevention of tumorigenesis. For chemotherapy, however, only Sulindac had a significant effect on the number of adenoma and neither DFMO nor Sulindac significantly affected tumor growth.

The use of food supplements containing natural chemopreventive compounds increased in recent years. Some of the most popular chemopreventive compounds are flavonoids. Due to their natural origin, flavonoids are generally accepted as safe compounds. They exert antioxidant, anti-cancer and anti-inflammatory properties. However, flavonoids should be considered as foreign compounds (xenobiotics). Flavonoids interact with many enzymes, among the most important belong cytochromes P450 (CYPs), key enzymes of the first phase of biotransformation of xenobiotics (e.g. drugs, carcinogens). CYPs catalyze reactions leading mainly to detoxification of xenobiotics. However, some CYPs are involved in the activation of carcinogens, particularly CYP1A1 and CYP1A2 activate e.g. heterocyclic amines. Flavonoids might enhance the activation of carcinogens via induction of these CYPs or stimulation of their activities and hence, increase the risk of a cancer development. The thesis is focused on the influence of flavonoids and food carcinogens on the induction and activity of CYP1A1 and CYP1A2 in liver and small intestine of rats. For the purpose of this study, the small intestine was dissected into three parts: proximal (nearest to stomach), middle and distal. Western blotting was used for the evaluation of CYP...

La tétraploïdie – cellule contenant le double du génome d’une cellule diploïde – est considérée comme un état métastable, à l’origine de l’aneuploïdie des cancers. Présentes dans les lésions précancéreuses, les cellules tétraploïdes sont associées à la progression tumorale. Etant donné le rôle clé de la tétraploïdie au cours de l’oncogenèse, le développement d’agents pharmacologiques éliminant spécifiquement les cellules tétraploïdes pourrait permettre de prévenir et limiter l’évolution vers un état cancéreux. Afin d'identifier des composés délétères pour les cellules tétraploïdes, nous avons développé une méthode de criblage basée sur la vidéomicroscopie à fluorescence automatisée. La chimiothèque de l'Institute of Chemistry and Cell Biology (ICCB) a été criblée, et nous avons mis en évidence plusieurs hits aux effets cytostatiques et/ou cytotoxiques préférentiels pour les cellules tétraploïdes. En raison de ses propriétés chimiopréventives, le resvératrol est le premier composé dont nous avons choisi de poursuivre la caractérisation. Sa sélectivité pour les cellules tétraploïdes a été confirmée sur différents types cellulaires, stables ou en cours de polyploïdisation. L’étude du mécanisme d’action anti-tétraploïde du resvératrol a permis d’identifier le senseur de la charge énergétique 5’-adenosine monophosphate-activated kinase (AMPK), comme une cible moléculaire responsable de la mort sélective des cellules tétraploïdes. Une série d’agents pharmacologiques activant directement ou indirectement AMPK – parmi lesquels l’aspirine et son métabolite le salicylate, dont l’action chimiopréventive a été établie par plusieurs études épidémiologiques et essais cliniques – a montré une toxicité préférentielle pour les cellules tétraploïdes. De la même manière que le resvératrol, ces agents éliminent les cellules tétraploïdes stables et limitent la polyploïdisation. Finalement, l’effet anti-tétraploïde du resvératrol et de l’aspirine a été évalué in vivo. L’administration orale de ces deux composés aux doses décrites comme chimiopréventives, réduit le développement des cellules épithéliales tétraploïdes et aneuploïdes des cryptes intestinales des souris ApcMin/+, le modèle murin de la polypose adénomateuse familiale. Collectivement les résultats de cette étude suggèrent que l’action chimiopréventive du resvératrol et de l’aspirine est associée à l’élimination des cellules tétraploïdes précurseur de tumeurs. / Tetraploidy – cells that contain twice the normal amount of chromosomes – is a metastable state leading to aneuploidy in cancer. Tetraploid cells have been observed in precancerous lesions and constitute a step toward tumor progression. Given the importance of tetraploidization for oncogenesis, developing drugs that selectively target tetraploid cells should prevent cancer.To discover compounds toxic to tetraploid cells, we developed an assay-system based on automatic fluorescence videomicroscopy. We screened the Institute of Chemistry and Cell Biology (ICCB) chemical library and identified several hits exerting a selective cytostatic and/or cytotoxic effect on tetraploid cells. Due to its well known chemopreventive properties, resveratrol was the first compound we further characterized. Its selectivity for tetraploid cells was confirmed on various stable or polyploidizing cancer cell lines, as well as primary epithelial cells. The mechanism accounting for the preferential killing of tetraploid cells involves the 5’-adenosine monophosphate-activated kinase (AMPK) signaling pathway. A series of additional agents that stimulate AMPK – including aspirin and salicylate whose chemopreventive action have been established by several epidemiological studies and clinical trials – display a selective toxicity toward tetraploid cells. Similar to resveratrol, these drugs eliminate stable tetraploid cells and reduce polyploidization. Finally, we validated the anti-tetraploid effect of resveratrol and aspirin in vivo. Oral treatment with either of these two compounds at chemopreventive doses, repressed the accumulation of tetraploid and subsequently aneuploid intestinal epithelial cells from the crypts of the ApcMin/+ mouse model of familial adenomatous polyposis.Collectively, our results suggest that the chemopreventive action of resveratrol and aspirin involves the elimination of tetraploid cancer cell precursors.

O carcinoma hepatocelular (HCC) é a 3ª causa de morte por neoplasias no mundo, sendo também o 5º tipo de neoplasia mais frequente. Seu tratamento limitado juntamente com o mau prognóstico tornam importante a adoção de medidas preventivas. A prevenção das etapas iniciais da hepatocarcinogênese pela administração de compostos bioativos de alimentos (CBAs) atualmente vem sendo observada em diversos estudos. Sugere-se que o processo de carcinogênese envolva alterações genéticas e epigenéticas, como a hipometilação do DNA e a desacetilação de histonas. Nesse sentido, o tratamento com ácido fólico (AF), precursor indireto de grupamento metil, e tributirina (TB), inibidora de enzimas desacetilases de histonas, quando em associação, poderia agir em adição potencializando os efeitos quimiopreventivos dos mesmos comparados às suas ações isoladas. A eventual atividade quimiopreventiva da TB (100mg/100g de peso corpóreo), do AF (0,08mg/100g de peso corpóreo), ambos com a metade da dose utilizada na literatura, e da associação entre os mesmos (AS) foi analisada durante a etapa de promoção da hepatocarcinogênese em ratos Wistar submetidos ao modelo do hepatócito resistente (HR). Para avaliação de GST-P, da proliferação celular, da apoptose, bem como a localização da histona H3K9 foi utilizada a técnica de imunohistoquímica; para a quantificação de H3K9, western blot. Em relação à análise macroscópica, os grupos tratados apresentaram menor número de nódulos em relação a MD (sem significância estatística), além de menor porcentagem de LPN menores do que 1mm nos grupos TB e AS. Na análise microscópica foi observado que os grupos TB, AF e AS apresentaram menor número de lesões pré neoplásicas persistentes (pLPN) em relação ao grupo controle isocalórico (MD, maltodextrina), assim como menor porcentagem de área ocupada por pLPN e por lesões em remodelação (rLPN). Quanto a proliferação celular, os grupos AF e AS apresentaram menor número de núcleos em fase S/mm2 quando comparados aos grupos MD e TB. Em relação à apoptose, os grupos TB e AS apresentaram maior número de hepatócitos em apoptose e corpúsculos apoptóticos/mm2 quando comparados aos grupos MD e AF. No resultado da metilação global do DNA não houve diferença entre os grupos. Em adição, os grupos AF e AS apresentaram maiores concentrações séricas de folato; o mesmo não ocorrendo para B12. No que diz respeito à acetilação de H3K9, os grupos TB e AS apresentaram maior porcentagem de acetilação quando comparados aos grupos N, MD e AF. Em conclusão, os grupos tratados com TB, AF e a associação entre eles apresentaram quimioprevenção pronunciada, sendo que o grupo AS apresentou mecanismos aditivos dos tratamentos isolados. / The hepatocellular carcinoma (HCC) is the third leading cause of death by cancer in the world, and the fifth most frequent type of neoplasm. Its limited treatment along with poor prognosis make it important to adopt preventive measures. The prevention of the initial stages of hepatocarcinogenesis by the administration of bioactive food compounds (BFCs) is currently being observed in several studies. It is suggested that the process of carcinogenesis involves genetic and epigenetic modifications, such as DNA hypomethylation and deacetylation of histones. Accordingly, treatment with folic acid (FA), indirect precursor of methyl grouping, and tributyrin (TB), a histone deacetylases inhibiting enzyme, when associated could act in addition to enhance the chemopreventive effects compared to their isolated actions. The possible chemopreventive activity of TB (100mg/100g body weight), FA (0.08 mg/100 g body weight) and the association between them (AS) were studied during the promotion stage of hepatocarcinogenesis in Wistar rats submitted to resistant hepatocyte model (RH).For evaluation of GST-P, cell proliferation, apoptosis, and the location of histone H3K9 was used immunohistochemistry, to quantify H3K9, western blot. Regarding the macroscopic analysis, the treated groups showed a lower number of nodules compared to MD (not statistically significant), and a lower percentage smaller than 1mm in groups TB and AS. Under microscopic examination the groups TB, FA and AS showed a lower number of persistent pre-neoplastic lesions (pLPN) compared to the isocaloric control group (MD, maltodextrin), as well as a lower percentage of the area occupied by pLPN and remodeling lesions (rLPN). As cell proliferation, FA and AS groups had fewer S phase nuclei/mm2 compared to MD and TB groups. Regarding apoptosis, TB and AS groups showed higher numbers of hepatocytes in apoptosis and apoptotic corpuscles/mm2 compared to MD and FA groups. Global DNA methylation did not differ between groups. In addition, AF and AS groups had higher serum concentrations of folate, which did not occur for B12.Concerning the H3K9 acetylation, the groups TB and AS showed higher percentage of acetylation when compared with the groups N, MD and FA. In conclusion, the groups treated with TB, FA and the association of both showed pronounced chemoprevention, and the AS group showed additive mechanisms compared with isolated treatments.

O câncer é um dos principais problemas de saúde pública no mundo. Dentre as neoplasias primárias que acometem o fígado, o carcinoma hepatocelular (HCC) é a mais frequente. Diversos fatores de risco predispõem ao HCC, entre eles a doença hepática gordurosa não-alcoólica (NAFLD). Segundo estudos prévios do grupo, a &#946;-ionona (BI), presente em uvas e aromatizantes de vinho, apresenta potencial quimiopreventivo da hepatocarcinogênese. Além disso, a &#946;I parece atuar na redução da colesterolemia podendo, assim, influenciar a NAFLD. Desta forma pretendeu-se, neste projeto, avaliar o desenvolvimento da NAFLD e sua influência nas etapas de iniciação e seleção/promoção da hepatocarcinogênese em ratos Wistar submetidos ao modelo do hepatócito resistente (RH), além da atividade quimiopreventiva da &#946;I, nessas condições experimentais em ratos. Para isso, os animais foram alocados em 6 grupos experimentais: RH iniciação (n=11), NAFLD iniciação (n=15), BI iniciação (n=15), RH seleção/promoção (n=11), NAFLD seleção promoção (n=15) e BI seleção/promoção (n=15). Na fase de iniciação os animais do grupo NAFLD receberam, diariamente, emulsão hipercalórica até a sexta semana do experimento um dia antes da administração de DEN. Já na fase de seleção/promoção os animais do grupo NAFLD receberam a emulsão hipercalórica, a partir de um dia após a DEN. Os animais dos grupos RH da iniciação e da seleção/promoção servem como controles e receberam, diariamente, 1mL/100g peso corpóreo de água até a sexta semana do experimento e um dia após a DEN, respectivamente. Na fase de iniciação, após 13 semanas os animais do grupo NAFLD não demonstraram sinais de esteatose, apresentaram maiores níveis séricos de triacilglicerol, colesterol total e LDL comparados ao grupo RH (P<0,05). O grupo NAFLD apresentou maior porcentagem de nódulos macroscópicos, bem como maior número e porcentagem de área hepática de lesões pré neoplásicas persistentes (pLPN) comparado ao grupo RH (P<0,05). Já o grupo BI apresentou menor número de pLPN e maior número de lesões em remodelação e uma maior porcentagem de área hepática de rLPN (p<0,05). Em relação a proliferação celular, o grupo NAFLD apresentou maior número de células em sourrounding, pLPN e rLPN comparada ao grupo RH e o grupo BI menor número em pLPN comparada a NAFLD. Já na fase de seleção/promoção foi possível observar o grupo NAFLD tem maiores valores de focos de inflamação, hepatócitos balonizados e grau de esteatose hepática em relação ao grupo BI, assim como maiores níveis séricos de triacilgliceróis, colesterol total e LDL (p<0,05). O grupo NAFLD apresentou maior porcentagem de nódulos macroscópicos <1, maior número, menor tamanho médio de pLPN comparados ao grupo RH (p<0,05). O grupo BI apresentou menor número e menor porcentagem de área em pLPN e maior porcentagem de área em rLPN (p<0,05). Em relação a proliferação celular, o grupo NAFLD apresentou maior número de células em sourrounding, pLPN e rLPN comparada ao grupo RH (p<0,05). Na expressão gênica, o grupo BI apresentou maior expressão de HMGCR em relação grupo NAFLD (p<0,05), O grupo NAFLD apresentou maior expressão de INSIG1 em relação ao grupo RH (p<0,05) e tendência na expressão de INSIG 2. / Cancer is a major public health problems in the world. Among the primary neoplasm affecting the liver, hepatocellular carcinoma (HCC) is the most frequent. Several risk factors predispose to HCC, including the non-alcoholic fatty liver disease (NAFLD). According to previous studies of the group, &#946;-ionone (BI), present in grapes and flavors of wine, it presents potential chemopreventive of hepatocarcinogenesis. Furthermore, &#946;I appears to act in reducing blood cholesterol and may thus influence NAFLD. In this way it was intended in this project, evaluate the development of NAFLD and its influence on the steps of initiation and selection/promotion of hepatocarcinogenesis in Wistar rats resistant hepatocyte model (HR), and the chemopreventive activity of &#946;I, these experimental conditions in rats. For this, the animals were divided into 6 groups: RH initiation (n = 11), NAFLD initiation (n = 15), BI initiation (n = 15), HR selection / promotion (n = 11), NAFLD selection promotion ( n = 15) and BI selection / promotion (n = 15). In the inception phase of the NAFLD group animals received daily calorie emulsion until the sixth week of the experiment one day prior to DEN administration. In the selection / promotion stage NAFLD group of animals received hypercaloric emulsion, from one day after the DEN. The animals of groups HR and selection of initiation / promotion serve as controls and received daily 1mL / 100g body weight of water until the sixth week of the experiment, and one day after DEN respectively. In the initiation phase, after 13 weeks the animals of group NAFLD showed no signs steatosis, had higher serum levels of triglyceride, total cholesterol and LDL compared to the HR group (P <0.05). The NAFLD showed higher prevalence of macroscopic nodules as well as higher number and percentage of liver area of persistent pre-neoplastic lesions (pLPN) compared to the HR group (P <0.05). But the BI group had fewer pLPN and higher number of lesions in remodeling and a higher percentage of liver area rLPN (p <0.05). In relation to cell proliferation, the NAFLD group had a higher number of cells in sourrounding, pLPN and rLPN compared to the RH group and the lowest number in pLPN BI group compared to NAFLD. In the selection / promotion layer was observed NAFLD group has the highest values of inflammation foci, balonizados hepatocytes and hepatic steatosis grade in relation to BI group as well as higher serum levels of triglyceride, total cholesterol and LDL (p <0 , 05). The NAFLD showed higher prevalence of macroscopic nodules <1, more, smaller average size pLPN compared to the HR group (p <0.05). The BI group had fewer and smaller percentage area in pLPN and higher percentage of area rLPN (p <0.05). In relation to cell proliferation, the NAFLD group had a higher number of cells in sourrounding, pLPN and rLPN compared to the HR group (p <0.05). In gene expression, the BI group showed higher expression of HMGCR regarding NAFLD group (p <0.05), the NAFLD group had higher expression of INSIG1 against the RH group (p <0.05) and a tendency in the expression of INSIG 2.

No presente estudo avaliou-se a atividade quimiopreventiva do farnesol (FR) e geraniol (GR), isoprenóides presentes em frutas e ervas, quando administrados a ratos Wistar durante as etapas de iniciação e/ou seleção/promoção do modelo de hepatocarcinogênese do \"hepatócito resistente\" (RH). No Protocolo Experimental 1, os animais receberam durante 8 semanas consecutivas, continuamente durante as etapas de iniciação e seleção/promoção, por entubação gástrica e dissolvido em óleo de milho (OM): FR (25 mg/100 g de peso corpóreo [p.c.]; grupo FR) ou GR (25 mg/100 g de p.c.; grupo GR). Além disso, 1 grupo recebeu durante o mesmo período, por entubação gástrica, apenas OM (0,25 mL/100 g de p.c.; grupo OM; controle). Duas semanas após o início dos tratamentos, todos os grupos foram submetidos ao modelo do RH. Esse consistiu na aplicação intraperitoneal de uma dose do agente iniciante dietilnitrosamina (DEN, 20 mg/100 g de p.c.), seguida, 2 semanas após, da aplicação de 4 doses consecutivas de 2-acetilaminofluoreno (2-AAF; 2,5 mg/100 g de p.c.) e de uma hepatectomia parcial (HP) a 70%, acrescida de 2 doses de 2-AAF (2 mg/100 g de p.c.) 2 e 4 dias após a cirurgia. Decorridas 6 semanas após a iniciação com DEN, os animais foram sacrificados administrando-se, entretanto, 2 h. antes desse procedimento 5-bromo-2-desoxiuridina (BrdU) (10 mg/100 g de p.c.). De acordo com a análise macroscópica dos fígados, e em comparação ao grupo OM, verificou-se que o FR inibiu a incidência (p<0,05) e número médio (p<0,05) de lesões pré-neoplásicas (LPN) hepáticas visíveis à macroscopia. No caso do grupo GR, observou-se apenas sugestão de redução da incidência e número médio dessas LPN visíveis à macroscopia. Em relação à análise morfométrica das LPN hepáticas positivas para a enzima glutationa S-transferase forma placentária (GST-P) totais (persistentes + em remodelação), observou-se que em comparação ao grupo OM, o FR reduziu o tamanho (p<0,05) e área do corte ocupada (p<0,05) por essas lesões. O GR, por sua vez, reduziu o tamanho (p<0,05) das LPN GST-P positivas totais, observando-se, também, sugestão de redução pelo isoprenóide da área do corte ocupada pelas mesmas. Em comparação ao grupo OM, o FR e o GR foram capazes de inibir (p<0,05) a proliferação celular nas LPN, enquanto apenas o GR induziu (p<0,05) a apoptose nas mesmas. Além disso, danos no DNA hepático foram menores (p<0,05) nos animais tratados com FR ou GR, em comparação aos tratados com OM (controles). O tratamento com FR, mas não com GR, resultou em inibição (p<0,05) das concentrações plasmáticas de colesterol total. A análise, por \"western blot\", da expressão hepática do receptor nuclear ativado pelo farnesóide X (FXR) não revelou diferenças (p>0,05) entre os diferentes grupos. No Protocolo Experimental 2, os ratos receberam apenas durante 2 semanas consecutivas na fase de iniciação, e por entubação gástrica, FR (25 mg/100 g p.c.; grupo FRi), GR (25 mg/100 g p.c.; grupo GRi) ou OM (0,25 mL/00 g p.c.; grupo OMi, controle), sendo então submetidos ao modelo do RH, conforme descrito para o Protocolo Experimental 1. O sacrifício dos animais ocorreu 6 semanas após iniciação com DEN. De acordo com a análise macroscópica dos fígados, não foram constatadas diferenças entre os diferentes grupos (p>0,05) quanto à incidência de LPN hepáticas visíveis à macroscopia. Em comparação ao grupo OMi (controle), observou-se nos grupos FRi e GRi sugestão de maior número de LPN hepáticas visíveis à macroscopia. Também em comparação ao grupo OMi (controle), observou-se no grupo GRi menor (p<0,05) número de LPN hepáticas GST-P positivas totais (persistentes + em remodelação), e no grupo FRi sugestão de menor número dessas LPN GST-P positivas totais. Além disso, foram observadas nos grupos FRi e GRi, em comparação ao grupo OMi, LPN hepáticas GST-P positivas totais (persistentes + em remodelação) maiores (p<0,05), bem como sugestão de maior área do corte ocupada por essas LPN GST-P positivas. Não foram observadas diferenças (p>0,05) entre os diferentes grupos quanto à concentração hepática de DNA. No Protocolo Experimental 3, os ratos receberam inicialmente uma dose de DEN (20 mg/100 g de p.c.). Duas semanas após, os animais passaram a receber por entubação gástrica, durante 6 semanas consecutivas em período compreendendo a etapa de seleção/promoção: FR (25 mg/100 g p.c.; grupo FRs/p), GR (25 mg/100 g p.c.; grupo GRs/p) ou OM (0,25 mL/100 g p.c.; grupo Oms/p; controle). Nesse experimento, as administrações de 2-AAF e a realização da HP ocorreram 4 semanas após a iniciação com DEN. O sacrifício dos animais ocorreu após 8 semanas da iniciação com DEN. Em comparação ao grupo OMs/p (controle), observou-se nos grupos FRs/p e GRs/p sugestão de menor número médio de LPN hepáticas visíveis à macroscopia. Não foram constatadas diferenças (p>O,05) entre os diferentes grupos quanto à incidência de LPN hepáticas visíveis à macroscopia; quanto ao número, tamanho e área do corte ocupada por LPN hepáticas GST-P positivas totais (persistentes + em remodelação); e quanto à concentração hepática de DNA. De acordo com os resultados do estudo, considerou-se pronunciada a atividade quimiopreventiva do FR quando administrado a ratos Wistar continuamente durante as etapas de iniciação e seleção/promoção do modelo de hepatocarcinogênese do RH (Protocolo Experimenta! 1). Nessas mesmas condições, considerou-se moderada a atividade quimiopreventiva do GR. Inibições da proliferação celular e de danos no DNA parecem estar envolvidas com as ações anticarcinogênicas do FR e GR, enquanto que a indução da apoptose parece ser mecanismo de ação específico do GR. Além disso, as ações protetoras do FR e GR não parecem envolver alterações na expressão do receptor nuclear FXR. Finalmente, quando administrados especificamente durante a etapa de iniciação (Protocolo Experimental 2) ou de seleção/promoção (Protocolo Experimental 3), ambos os isoprenóides não foram capazes de apresentar atividades quimiopreventivas efetivas. Dessa forma, em ratos Wistar submetidos ao modelo do RH, é necessária a administração contínua de FR ou GR durante as etapas de iniciação e seleção/promoção para a ocorrência de atividades quimiopreventivas. / In the present study, the chemopreventive activity of farnesol (FR) and geraniol (GR), isoprenoids present in fruits and herbs, was evaluated when administered to Wistar rats during the initiation and/or selection/promotion phases of the \"resistant hepatocyte\" (RH) model of hepatocarcinogenesis. In Experimental Protocol 1, animals received during 8 consecutive weeks, continuously during the initiation and selection/promotion phases, by gavage and dissolved in corn oil (CO): FR (25 mg/100g9 body weight [b.w.]; FR group) or GR (25 mg/100 g de b.w.; GR group). Moreover, 1 group received during the same period, by gavage, only CO (0,25 mL/100 g de b.w.; CO group; controls). Two weeks after the beginning of the treatments, all groups were submitted to the RH model. Initiation was obtained by administration of a single intraperitoneal dose of diethylnitrosamine (DEN; 20 mg/100 g b.w.) followed, 2 weeks after, by the administration of 4 consecutive doses of 2-acetylaminofluorene (2-AAF; .2.5 mg/100 b.w.) and by a partial (70%) hepatectomy (PH). Finally, 2 and 4 days after PH, 2 additional 2-AAF doses (2 mg/100 g b.w.) were administered. Six weeks after initiation with DEN, the animals were anesthetized and sacrificed by exsanguination. Two hours before sacrifice, the rats received 5-bromo-2\'-deoxyuridine (10 mg/100 g b.w.). According to the macroscopic examination of the livers, and compared to CO group, FR inhibited the incidence (P<0.05) and mean number (P<0.05) of visible hepatic preneoplastic lesions (PNL). Regarding GR group, only a suggestion of inhibition of visible PNL incidence and mean number was observed. Morphometrical analysis of total (persitent and remodeling) glutathione S-transferase (GST-P) positive PNL showed that compared to CO group, FR group presented with smaller total GST-P positive PNL (p<0.05) that occupied a smaller area of the liver section (p<0.05). Also compared to CO group, GR group presented with smaller total GST-P positive PNL (p<0.05) and a suggestion of reduction of the liver section area occupied by these LPN was observed. Compared to CO group, FR and GR inhibited (p<0.05) PNL cell proliferation, whereas only GR induced (p<0.05) apoptosis in these PNL. Furthermore, hepatic DNA damage was lower (p<0.05) in FR or GR treated animals, compared to CO treated ones (controls). Animal treatment with FR, but not with GR, inhibited (p<0,05) total plasma cholesterol levels. Farnesoid X activated receptor (FXR) expression analysis by western blot did not reveal differences (p>0,05) between the different groups. In the Experimental Protocol 2, rats received only for 2 consecutive weeks during the initiation phase, and by gavage: FR (25 mg/100 g body weight b.w.; FRi group), GR (25 mg/100 g de b.w.; GRi group) or CO (0,25 mL/100 g de b.w.; COi group; controls) being submitted to the RH model as described for Experimental Protocol 1. Six weeks after initiation with DEN, the animals were sacrificed. According to the macroscopic examination of the livers, no differences (p>0.05) were observed among the different groups regarding the incidence of visible PNL. In FRi and GRi groups a suggestion of higher number of visible PNL was observed, when compared to COi group (controls). Also compared to COi group, GRi group presented with smaller (p<0.05) number of total (persistente + remodeling) GST-P positive PNL, whereas in FRi group a suggestion of smaller number of these visible PNL was observed. Moreover, compared to COi group, FRi and GRi groups presented with total (persistent + remodelling) GST-P positive PNL with greater (p<0,05) size, and a suggestion of greater area of the liver section occupied by these GST -P positive PNL was observed. No differences (p>0.05) among the different groups were observed regarding hepatic DNA concentration. In Experimental Protocol 3, rats were first initiated with DEN (20 mg/100 g de b.w.). After 2 weeks, animals received by gavage for 6 consecutive weeks during the selection/promotion phase: FR (25 mg/100 g body weight b.w.; FRs/p group), GR (25 mg/100 g de b.w.; GRs/p group) or CO (0,25 Ml/100 g de b.w.; COs/p group; controls). In this experiment animals received 2-AAF doses and were submitted to PH 4 weeks after initiation with DEN. Six weeks after initiation with DEN, the animals were sacrificed. Compared to COs/p group (controls), a suggestion of smaller visible PNL mean number was observed in FRs/p e GRs/p groups. No differences (p>0.05) among the different groups were observed regarding visible PNL incidence; regarding number, size and liver section occupied by total (persistent + remodeling) GST-P positive PNL; and regarding hepatic DNA concentration. According to the results of the study, FR chemopreventive activity was considered pronounced when administered to Wistar rats continuously during the initiation and selection/promotion phases of the RH model of hepatocarcinogenesis (Experimental Protocol 1). In these same conditions, GR chemopreventive activity was considered moderate. Cell proliferation and DNA damage inhibition seem to be involved with FR and GR anticarcinogenic actions, whereas apoptosis induction seems to represent a GR specific mechanism. Furthermore, FR and GR protective actions do not seem to involve alterations in FXR expression. Finally, when administered specifically during the initiation (Experimental Protocol 2) or selection/promotion (Experimental Protocol 3) phase, both isoprenoids did not present effective chemopreventive activity. Thus, in Wistar rats submitted to the RH model, FR or GR should be administered continuously during the initiation and selection/promotion phases in order to obtain chemopreventive activities.

O câncer é um dos principais problemas de saúde pública no mundo. Dentre as neoplasias primárias que acometem o fígado, o carcinoma hepatocelular (HCC) é a mais frequente. Diversos fatores de risco predispõem ao HCC, entre eles a doença hepática gordurosa não alcóolica (NAFLD). Segundo estudos prévios do grupo, a &#946-ionona (BI), apresenta potencial quimiopreventivo na hepatocarcinogênese, promovendo redução de lesões preneoplásicas (LPN). Assim pretendeu-se investigar se a NAFLD potencializaria o desenvolvimento de LPN em ratos Wistar submetidos ao modelo do hepatócito resistente (RH) na etapa de iniciação/promoção inicial da hepatocarcinogênese e se a BI apresenta efeito quimiopreventivo nesse contexto. Para tanto, os animais foram distribuídos em 4 grupos experimentais: grupo não-tratado (NT), grupo submetido ao RH (RH), grupo submetido ao RH e ao modelo de NAFLD, que consiste na administração de emulsão hiperlipídica, (AS) e grupo AS tratado com BI (AS + BI). Em uma primeira instância, 5 animais pertencentes aos grupos NT, AS,AS + BI foram eutanasiados após 6 semanas de administração de emulsão hiperlipídica, antes da aplicação do modelo RH, para se confirmar o desenvolvimento da NAFLD. Foi possível observar que a administração de emulsão hiperlipídica durante 6 semanas foi suficiente para o desenvolvimento de esteatose hepática. Após as 6 semanas foi introduzido o modelo do RH concomitante à administração da emulsão hipercalipídica até o fim do experimento na 13a semana . Após 13 semanas o grupo AS apresentou maiores (p<0,05) valores de focos de inflamação, hepatócitos balonizados e grau de esteatose hepática em relação ao grupo AS+BI, assim como maiores (p<0,05) níveis séricos de triacilgliceróis, colesterol, HDL, LDL, VLDL, e maior (p<0,05) valor de MDA em relação ao grupo RH embora sem diferença estatística. O grupo AS também apresentou maior (p<0,05) incidência, número total e multiplicidade de nódulos, além de maior (p<0,05) número e tamanho de LPN persistentes (pLPN) e índice de proliferação quando comparado aos grupos RH e AS+BI. O grupo AS + BI, por sua vez, demonstrou menores (p<0,05) valores de escore de células ovais e menores valores de comprimentos de cometa e danos no DNA quando comparado ao grupo AS, embora sem diferença estatista para este último parâmetro. Em relação à expressão gênica, o grupo AS apresentou menores (p<0,05) valores de expressão do gene Hmgcr em relação ao grupo RH e maiores (p<0,05) valores dos genes Insig 1 e Thy 1 quando comparados ao grupo AS+BI. Portanto, no contexto de esteatose hepática associada ao modelo do RH, a administração de BI durante a etapa de iniciação/promoção em ratos Wistar resultou em atividade quimiopreventiva que se deu pela diminuição de pLNP, redução da proliferação celular e do número de células ovais, consideradas potenciais alvos para o desenvolvimento da hepatocarcinogênese, entretanto os genes analisados parecem não serem modulados pela BI. / Cancer is a major public health problem in the world. Among the primary neoplasms affecting the liver, hepatocellular carcinoma (HCC) is the most frequent. Several risk factors predispose to HCC, including the nonalcoholic fatty liver disease (NAFLD). According to previous studies of the group, the &#946-ionone (BI), has potential chemopreventive in hepatocarcinogenesis, promoting reduction of preneoplastic lesions (LPN). Thus we investigated whether NAFLD would increase the development of LPN in Wistar rats resistant hepatocyte model (RH) at the stage of initiation / promotion of hepatocarcinogenesis and if BI has chemopreventive effect in this context. Therefore, the animals were divided into 4 groups: non-treated group (NT), the group submitted to HR (HR), the group submitted to HR and NAFLD model, consisting of the fatty emulsion administration (AS) and AS group treated with BI (AS + BI). In a first point, 5 animals belonging to the groups NT, AS, AS + BI were euthanized after 6 weeks of administration of fat emulsion prior to application of the HR model, to confirm the development of NAFLD. It was observed that the administration of fatty emulsion for 6 weeks was sufficient to the development of hepatic steatosis. After 6 weeks it was introduced into the model HR the concomitant administration of fatty emulsion until the end of the experiment at 13 weeks. In the endpoint, the AS group had higher (p <0.05) of serum triacylglycerols, cholesterol, HDL, LDL, VLDL although no statistical difference inrelation to RH group, and increased (p <0.05) amount of MDA in relation to the group RH. The AS group also had higher (p <0.05) incidence, multiplicity and total number of nodes and greater (p <0.05) number and size of persistent LPN (pLPN) and proliferation index when compared to HR groups and AS + BI. AS + BI group. It was observed in AS+BI group lower (p <0.05) cell oval score values compared to AS group. In addition the AS+BI group showed lower values of the comet length and DNA damage compared to the AS group, although no statistical differences. In relation to gene expression, the AS group showed lower(p <0.05) HMGCR gene expression values in relation to HR group and higher (p <0.05) expression of Insig genes 1 and Thy 1 compared to group AS + BI.Therefore, in the context of hepatic steatosis associated with HR model BI for administration to the stage of initiation / promotion in rats resulted in chemopreventive activity was due to decrease in area of pLNP, reducing cell proliferation, and the number of oval cells, as potential targets for the development of hepatocarcinogenesis, however the genes do not seem to be modulated analyzed by BI.

Introdução: Nas atividades exercidas pelos profissionais da área da saúde, há exposições a diversos riscos, tais como riscos físicos, biológicos, químicos, ergonômicos, mecânicos e de acidentes. O risco biológico representa uma grande ameaça à saúde dos profissionais dessa área, em especial aos da enfermagem, por manterem contato direto com fluidos orgânicos potencialmente contaminados. Objetivo: Avaliar a adesão ao seguimento clínico, caracterizar as exposições ocupacionais e identificar o perfil das fontes envolvidas nos acidentes ocupacionais com material biológico potencialmente contaminado sofrido por profissionais e estudantes da área da saúde. Metodologia: Estudo descritivo, retrospectivo com abordagem quantitativa. Desenvolvido no Centro de Referência em Moléstias Infecto Contagiosas \"Dr. José Roberto Campi\". A população do estudo foi composta por profissionais e estudantes da área da saúde que sofreram exposição ocupacional a material biológico potencialmente contaminado no período de 2005 a 2010. Para caraterização da adesão foram estabelecidos conceitos e definições. Foi utilizado um instrumento adaptado da ficha utilizada pelo Ministério da Saúde para a coleta de dados, e os dados foram organizados em planilhas do Excel e exportados para o Statistical Package for the Social Sciences, versão 15.0. Utilizou-se estatística descritiva para realizar a caracterização dos sujeitos quanto às variáveis coletadas. Aplicou-se o Teste Qui-quadrado para verificar a associação entre as variáveis do estudo e a regressão logística univariada e multivariada para quantificar a associação, onde se calculou o odds ratio com intervalos de confiança de 95%. Valores menores que 0,05 foram considerados significativos. Resultados: encontrou-se o registro de 521 acidentes envolvendo 461 profissionais e estudantes da área da saúde, sendo que 449 (86,2%) eram profissionais e 72 (13,8%) estudantes. Destaca-se o ano de 2006 com o maior número de ocorrências de acidente, com 98 (21,3%) casos. A categoria mais acometida foi a equipe de enfermagem com 218 (47,3%) casos, seguida pela equipe odontológica, com 103 (22,3%) e os estudantes, com 72 (15,6%). Houve o predomínio do sexo feminino 375 (81,3%), e a faixa etária predominante foi entre 20 e 29 anos (36,2%); Em 400 (86,8%) casos a fonte era conhecida, e em 42 (9,1%) apresentaram sorologia positiva. Em 202 (43,8%) deles, houve a procura por atendimento pós- exposição ocupacional em até duas horas ocorrido a exposição. Em 289 (62,7%) dos acidentes foi utilizado algum tipo de equipamento de proteção individual; o instrumento perfurocortante envolveu 370 (80,3%) dos acidentes. Em 118 (25,6%) exposições foi recomendado o uso de antirretrovirais, como quimioprofilaxia. Destes, em 50 (42,4%) casos constatou-se a adesão ao uso. Foi identificada a adesão ao seguimento clínico em 307 (66,6%). O indivíduo com fonte conhecida e positiva apresentou 29 vezes chance de aderir ao seguimento clínico, e o que possuía vacina contra hepatite B foi 5 vezes maior em relação ao que não possuía. Conclusão: Faz necessários programas de educação para que os profissionais sejam orientados quanto à importância ao seguimento clínico pós-exposição ocupacional / Introduction: Health workers\' activities imply exposure to several risks, which may be physical, biological, chemical, ergonomic, mechanic, as well as accidents. Biological risks are a threat to health workers, particularly nurses, as they are constantly handling potentially contaminated organic fluids. Objective: To evaluate clinical treatment adherence, characterize the occupational exposures and identify the profile of the sources involved in occupational accidents with potentially contaminated biological material suffered by health workers and students. Method: This descriptive, retrospective study was performed using a quantitative approach. The study was developed at the \"Dr. José Roberto Campi\" Reference Center for Communicable Diseases, and the study population was composed by health workers and students who had undergone occupation exposure to potentially contaminated biological material in the period between 2005 and 2010. Adherence was characterized according to pre-established concepts and definitions. An instrument adapted from the form used by the Brazilian Ministry of Health was used for data collection. The data were organized into Excel spreadsheets and exported to Statistical Package for the Social Sciences version 15.0. Descriptive analysis was used to characterize subjects according to the variables collected. The Chi-Square Test was applied to verify associations between variables and univariate and multivariate logistic regression was used to quantify the association, obtaining the odds ratio with confidence intervals of 95%. Values below 0.05 were considered significant. Results: a total of 521 records were found for accidents involving health workers and students, involving 461 subjects; 449 (86.2%) workers and 72 (13.8%) students. The year of 2006 is highlighted as the one with the highest incidence for accidents, with a total of 98 (21.3%). The most affected category was the nursing team (218 or 47.3%), followed by dentists (103 or 22.3%) and students (72 or 15.6%). Most subjects were female (375 or 81.3%), the predominant age group was 20 to 29 years (36.2%); In 400 subjects (86.8%) the source was known, and 42 (9.1%) presented a positive serologic test. There were 202 (43.8%) subjects who sought health care within two hours following the occupational exposure. In 289 (62.7%) of the accidents, some kind of personal protection equipment was used; sharp materials were involved in 370 (80.3%) accidents. In 118 (25.6%) exposures there was a prescription for antiretroviral agents such as chemoprophylaxis, and adherence was observed in 50 (42.4%); clinical treatment adherence was observed in 307 (66.6%). The individual with a known and positive source was 29 times more likely to comply with the clinical treatment, and there were five times more subjects who had taken vaccination against hepatitis B that those who had not been immunized. Conclusion: There is a need for education programs to guide workers regarding the importance of following clinical treatment after an occupational exposure