Nos mamíferos, a determinação sexual é governada pelo equilíbrio entre duas vias de sinalização paralelas e antagônicas: a via masculina SOX9/FGF9 e a via feminina RSPO1/beta-catenina/WNT4. A R-spondina 1 é uma importante reguladora do processo de diferenciação ovariana e atua modulando a via de sinalização Wnt canônica (Wnt/beta-catenina). Em humanos, mutações em RSPO1 causam uma rara síndrome genética autossômica recessiva caracterizada por Distúrbios do Desenvolvimento Sexual (DDS) 46,XX Testicular ou Ovotesticular, hiperceratose palmoplantar (HPP) e predisposição para o desenvolvimento de carcinoma de células escamosas (MIM 610644). Identificamos um paciente brasileiro, proveniente de uma grande família consanguínea, que apresentava a associação de HPP e DDS 46,XX Testicular SRY negativo. A avaliação da região codificadora do gene RSPO1 identificou a nova variante alélica c.305G>A (p.Cys102Tyr). O estudo de segregação realizado em 67 familiares demonstrou que a variante c.305G>A segrega em perfeita concordância com o fenótipo de HPP, exibindo um padrão de herança autossômico recessivo. Na família foram identificados 10 indivíduos afetados pelo fenótipo de HPP. As avaliações clínica e hormonal e os estudos molecular e citogenético nesses indivíduos resultou na caracterização de: (a) quatro indivíduos do sexo masculino 46,XX e/ou SRY negativo, com ambiguidade genital e perfil hormonal alterado; (b) cinco indivíduos do sexo masculino 46,XY e/ou SRY positivo, sem ambiguidade genital, com perfil hormonal normal e (c) uma mulher 46,XX, fértil. Experimentos de transfecção transitória in vitro demostraram que a proteína mutante tem menor capacidade de transativação do plasmídio reporter da via Wnt. As simulações de dinâmica molecular constataram que a troca p.Cys102Tyr aumenta a flexibilidade do backbone da R-spondina-1, diminuindo a energia de ligação da proteína ao complexo de receptores, LGR5 e RNF43. Em conjunto, nossos achados demonstram que a variante c.305G > A é patogênica, sendo responsável pela síndrome genética diagnosticada na família brasileira. As análises de expressão gênica e os estudos de imuno-histoquímica, por sua vez, detectaram um aumento da expressão do gene SOX9 e maior imonorreatividade para a proteína Sox9 no tecido testicular do caso índice. Esses resultados sugerem que o processo de reversão sexual nos indivíduos XX ocorra por uma hiperexpressão de SOX9 secundária à menor ativação da via Wnt/beta-catenina na gônada durante a embriogênese. No presente estudo também relatamos o primeiro caso de indivíduo de cariótipo 46,XX portador de mutação em homozigose no gene RSPO1 que não desenvolveu DDS. A variabilidade do fenótipo sexual não está associada com alterações no número de cópias dos genes WNT4 ou do SOX9 e região cis-regulatória. No entanto, a avaliação do exoma da família encontrou uma associação entre o polimorfismo do receptor LGR5 rs17109924 e a atenuação do fenótipo de DDS. Todavia, serão necessários estudos funcionais para esclarecer o impacto biológico da interação das variantes RSPO1 p.Cys102Tyr e LGR5 rs171099 / In mammals, sex determination is governed by the balance between two parallel and antagonic signaling pathways: the male SOX9/FGF9 and the female, RSPO1/beta-catenin/WNT4 pathways. R-spondin 1 regulates the ovarian differentiation process by its modulating action through the canonic Wnt pathway (Wnt/beta-catenin). In humans, patogenic mutations in RSPO1 cause a rare, autosomic recessive syndrome characterized by 46,XX Testicular or Ovotesticular disorders of sexual development (DSD), palmoplantar keratosis (PPK) and predisposition to squamous cell carcinoma (MIM 610644). We identified and studied a SRY-negative 46,XX DSD patient with PPK from a large, consaguineous, brazillian family. Through a \"candidate gene\" approach we identified in the proband a new allelic variant in the coding region of RSPO1, c.305G > A. This variant presented full concordance with the PPK phenotype by segregation analyses in 10 of 67 members of this family. Clinical, hormonal, cytogenetic and molecular genetic studies characterized three patterns in individuals with this variant: (a) four 46,XX and/or SRY-negative males with ambiguous genitalia and altered hormonal profile; (b) five 46,XY and/or SRY-positive males without ambiguous genitalia with normal hormonal profile; (c) one 46,XX fertile woman. In vitro experiments demonstrated that transient transfection of the mutant protein resulted in lower transactivation of the Wnt pathway-reporter plasmid. Moreover, molecular dinamic studies showed that p.Cys102Tyr increased the R-spondin-1 backbone flexibility, thus decreasing the interaction between this protein and its receptors, LGR5 and RNF43. Thus, both in vitro and in silico analysis demonstrate the pathogenicity of the RSPO1 variant c.305G > A. In addition, in the index case, a higher expression of SOX9, corroborated by a reactive immunohistochemistry in testicular tissue, suggested that the process of sexual reversal in the XX individual is driven by a higher SOX9 expression possibly due to a lower Wnt/beta-catenin signaling pathway activation during embriogenesis. In this study, we also reported the first 46,XX individual with RSPO1 mutation without DSD, in which no copy number abnormality was detected in WNT4, SOX9 and its cisregulatory regions. Whole exome sequencing of the affected individuals revealed, in turn, that the LGR5 rs17109924 polymorphism associates with a protacted DSD phenotype in the fertile woman with normal hormonal profile. Despite this evidence, future studies are nedded to address causality and biological impact between RSPO1 p.Cys102Tyr and LGR5 rs17109924 variants

INTRODUÇÃO: Perda óssea é um achado comum em pacientes com Nefrite Lúpica (NL), mesmo naqueles com diagnóstico recente. Algumas evidências indicam um aumento na osteoclastogênese como um dos distúrbios principais no processo de remodelamento ósseo. O objetivo deste estudo foi investigar algumas vias de sinalização (RANKL/OPG, Wnt/Beta-catenin and Th17/IL-17) possivelmente envolvidas na osteoclastogênese anormal detectada em mulheres jovens ao diagnóstico de nefrite lúpica ativa, assim como avaliar a ação da vitamina D (VitD) nesse cenário e sua correlação com fatores inflamatórios. MÉTODOS: Realizamos culturas com a linhagem de células osteoblásticas humanas hFOB 1.19 (ATCC) e as dividimos em um grupo suplementado com soro de pacientes lúpicas (NL) (n=15) e em um grupo com soro de controles saudáveis (CS) (n=15) em vez de soro fetal bovino (SFB). Em seguida, adicionamos 1,25-dihidroxivitamina D3 (1,25(OH)2D3) em dois subgrupos nas concentrações 10-9M e 10-7M, resultando em 6 grupos: CS, CS+vitD 10-9M, CS+vitD 10-7M, NL, NL+vitD 10-9M, NL+vitD 10-7M). Após 48h da adição de 1,25(OH)2D3 ao meio de cultura, células hFOB foram tripsinizadas e separado o lisato celular de cada grupo. Ensaios de citometria de fluxo e multiplex foram realizados para quantificação das seguintes proteínas do lisato cellular: CD166, CD54, fosfatase alcalina, RANKL, OPG, CD14, TLR4, NF-KappaB, SOST, DKK-1, Beta-catenina, IL-1-beta, IL-2, IL-6, TNF-alfa, IL-17A, IL-17F, IL-21 and IL-22. RT-PCR foi empregado para quantificação de mRNA dos genes RANKL, SOST, OPG e Beta-catenina. RESULTADOS: Pacientes com NL evidenciaram maiores níveis séricos de DKK-1 (2802,04 ± 1380,06 x 696,30 ± 421,22pg/ml, p < 0,001), OPG (560,12 ± 333,56 x 340,24 ± 102,08pg/ml, p=0,0212), TNF-alfa (9,63 ± 14,49 x 1,27 ± 0,35pg/ml, p=0,0337), IL-6 (15,58±39,08 x 8,02±3,49, p= 0,0053) and IL-2 (3,36 ± 3,06 x 1,54 ± 0,9pg/ml, p=0,0353) do que CS. Após exposição ao meio enriquecido com soro de pacientes com NL, células hFOB 1.19 apresentaram maior nível de mRNA de RANKL (p=0,045)) e menor nível de proteína OPG (178,81 ± 66,40 x 298,76 ± 114,94pg/mg, p=0,0016). Suplementação com 1,25(OH)2D3 aumentou a diferença da expressão das proteínas DKK-1 (673,03 ± 171,93 x 456,69 ± 234,53pg/mg, p=0,0215), IL-6 (0,80 ± 0,25pg/mg x 0,66 ± 0,18, p=0,0417) and IL-2 (4,97 ± 2,2 x 3,90 ± 1,66pg/mg, p=0,042) entre hFOB NL comparados com hFOB CS, enquanto diminuiu o nível de mRNA de Beta-catenina em células do grupo NL. DISCUSSÃO: Dentro das limitações deste estudo, os resultados sugerem que os maiores níveis séricos de citocinas pró-inflamatórias, como TNF-alfa, IL-6 e talvez IL-2, detectadas em pacientes com NL pode ter induzido a maior expressão osteoblástica de RANKL, representada pelo maior nível de mRNA RANKL em células do grupo NL, e suprimido OPG, conforme a diminuição observada na quantificação proteica de OPG nos lisatos celulares, o que pode ter contribuído para a aumentada osteoclastogênese evidenciada pela biópsia óssea dessas pacientes. A adição de 1,25(OH)2D3 não preveniu os efeitos inflamatórios do soro de pacientes com NL ativa em células hFOB 1.19 neste estudo / INTRODUCTION: Bone loss is a common finding in Lupus Nephritis (LN) patients even in those recently diagnosed. Some evidences indicate an increased osteoclastogenesis as the main disturb of the bone remodeling process. The aim of this study was to investigate some pathways (RANK-L/OPG, Wnt/?-catenin and Th17/IL-17) possibly involved in the abnormal osteoclastogenesis detected in women at the diagnosis of proliferative LN as well as evaluating the action of vitamin D (vitD) in this scenario and their correlation with inflammatory factors. METHODS: We cultured the human osteoblastic cell line hFOB 1.19 (ATCC), and divided cultures into those supplemented with serum from healthy controls (HC) (n=15) and LN patients (n=15) instead of fetal bovine serum (FBS). Then 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] was added in two subgroups at the concentrations of 10-9M e 10-7M while vitD was absent in one subgroup in both HC and LN cultures (HC, HC+vitD 10-9M, HC+vitD 10-7M, LN, LN+vitD 10-9M, LN+vitD 10-7M) . After 48h of vitD addition, hFOB cultures were trypsinized. Flow cytometry and multiplex assays were performed to test CD166, CD54, alkaline phosphatase, RANKL, OPG, CD14, TLR4, NF-KappaB, SOST, DKK-1, ?-catenin, IL-1Beta, IL-2, IL-6, TNF-alfa, IL-17A, IL-17F, IL-21 and IL-22 concentrations in the cell lysates. Polymerase reaction chain (RT-PCR) assays analyzed the expression of RANKL, SOST, OPG and Beta-catenin mRNA. RESULTS: LN patients showed higher serum levels of DKK-1 (2802.04 ± 1380.06 x 696.3 ± 421.22pg/ml, p < 0.001), OPG (560.12 ± 333.56 x 340.24 ± 102.08pg/ml, p=0.0212), TNF-alfa (9.63 ± 14.49 x 1.27 ± 0.35pg/ml, p=0.0337), IL-6 (15.58±39.08 x 8.02±3.49, 0.0053) and IL-2 (3.36 ± 3.06 x 1.54 ± 0.9pg/ml, p=0.0353) than HCs. After exposure to medium enriched with LN serum, osteoblasts expressed higher RANKL mRNA (fold change 1.573, p=0.045) and lower OPG protein (178.81 ± 66.40 x 298.76 ± 114.94pg/mg, p=0.0016). 1,25(OH)2D3 supplementation increased the difference between LN and HC expression of DKK-1 (673.03 ± 171.93 x 456.69 ± 234.53pg/mg, p=0.0215), IL-6 (0.80 ± 0.25pg/mg x 0.66 ± 0.18, p=0.0417) and IL-2 (4.97 ± 2.2 x 3.90 ± 1,66pg/mg, p=0.042) proteins and diminished Beta-catenin mRNA in LN cells. DISCUSSION: Within the limitations of this study, the results suggest that the higher serum levels of proinflammatory cytokines, such as TNF-alfa, IL-6 and perhaps IL-2, detected in LN patients would possibly have induced RANKL genes, as demonstrated by an enhanced RANKL mRNA expression in LN osteoblasts, and suppressed OPG protein in cell lysates, which would have contributed to the increased osteoclastogenesis detected in bone biopsies of women with new onset of LN. 1,25(OH)2D3 addition to osteoblast cultures did not prevent the effects of inflammatory LN serum in vitro

L’échec thérapeutique des maladies cérébrales est lié, entre autres, à la présence de barrières entre le sang et le Système Nerveux Central (SNC), en particulier la Barrière Hémato-Encéphalique (BHE). La BHE est une structure neuro-vasculaire localisée au niveau des MicroVaisseaux Cérébraux (MVC) limitant l’entrée des molécules thérapeutiques dans le cerveau. Ce rôle barrière est dû à plusieurs facteurs, dont principalement, l’existence du côté luminal et/ou abluminal de la BHE de plusieurs transporteurs d’efflux, dont les transporteurs de type ABC (ATP Binding Casette) et SLC (SoLute Carrier) et qui sont à l’origine des phénomènes de résistance aux médicaments. Les études de recherche actuelles visent à identifier les voies de signalisation régulant l’activité de ces protéines d’efflux afin d’optimiser la pharmacothérapie cérébrale. Mais la majorité de ces études sont effectuées chez l’adulte. Très peu de données existent chez l’enfant.Cette étude a été réalisé dans la perspective de 1) Etudier l’ontogenèse des transporteurs ABC et SLC de la BHE au cours de la maturation cérébrale, 2) Elucider le rôle fonctionnel de quatre transporteurs d’efflux ((P-glycoproteine (P-gp), Breast Cancer Resistance Protein (bcrp), Organic Anion Transporter 3 (oat3), and Transporting Peptide 1a4 (oatp1a4) transporters) dans le cerveau des enfants et 3) Elucider les mécanismes qui régulent leur expression fonctionnelle dans des conditions normales et pathologiques, notamment inflammatoires, parce que des modifications dans les composantes structurales et fonctionnelles de l'unité neurovasculaire ont été rapportées dans une longue liste de pathologies du SNC chez les enfants et les adultes. Nos résultats ont montré l’existence de différences fonctionnelles, en terme de passage de molécules, entre la BHE pédiatrique et celle adulte. De plus, cette étude a mis en évidence une régulation différentielle liée à l'âge des transporteurs d'efflux de médicaments de la barrière dans des conditions normales et inflammatoires.Ces résultats fournissent des preuves sur l’intérêt de prendre en compte les propriétés spécifiques de la BHE pédiatrique et la distinguer de la BHE adulte lors des définitions des stratégies thérapeutiques destinées à traiter les maladies cérébrales chez les enfants. / One major reason of CNS pharmacotherapy’s impediment is the existence of “barriers” between blood and CNS, especially the Blood-Brain Barrier (BBB), a neurovascular structure localized at the level of brain microvasculature. Main factors responsible for this barrier function are drug efflux transporters type ABC (ATP-Binding Cassette) and SLC (SoLute Carrier) expressed at BBB level and known to be at the origin of multi-drug resistance phenomenon. Recent researches aim at unraveling the signaling mechanisms regulating these transporters in order to modulate their activity and improve pharmacotherapy in brain diseases. For years, these transporters have been studied in adult organism. But, there is a wide spread belief that the BBB in embryo, fetus, new born and infant is “immature”, implying caution in giving drugs to infants. However, current knowledge on the functional status of the BBB in immature organism remains very limited.This study was performed in the aim of understanding: 1) The ontogenesis of ABC and SLC transporters during brain maturation, 2) the functional role of four BBB drug efflux transporters (P-glycoprotein (P-gp), Breast Cancer Resistance Protein (bcrp), Organic Anion Transporter 3 (oat3), and Transporting Peptide 1a4 (oatp1a4) transporters) in children’s brain, and 3) the mechanisms that regulate their functional expression under normal and pathological conditions, mostly under inflammatory conditions, because indeed alterations in structural and functional components of the BBB have been reported in a long list of CNS pathologies in adults. Our results showed changing properties of the BBB during ontogenesis, as well as an age-related differential regulation of BBB drug efflux transporters under normal and inflammatory conditions.These findings highlight the importance of considering an age-related response of CNS to drugs and of taking into account the specific properties of juvenile BBB during definition of therapeutic strategies designed to treat childhood brain diseases, and this in the clinical perspective of developing new drugs with enhanced efficacy in children’s CNS.

Estudos epidemiológicos vêm demonstrando que quantidades apropriadas de atividade física regular estão associadas a significativa redução do risco para o desenvolvimento de câncer de cólon em até 40% entre os indivíduos mais fisicamente ativos. Por outro lado, tem sido observado que o exercício físico exaustivo aumenta a produção sistêmica de radicais livres, com concomitante aumento dos danos oxidativos ao DNA, além de deprimir a função imune global, eventos relacionados ao aumento do risco para o desenvolvimento de câncer. Relativamente, poucos estudos experimentais exploram essas relações, principalmente no que concerne ao exercício exaustivo e o câncer. A taxa de proliferação celular epitelial, os focos de criptas aberrantes (FCAs) e as criptas com acúmulo de beta-catenina (CABC) têm sido marcadores biológicos (biomarcadores) usados para a identificação precoce de fatores que poderiam influenciar a carcinogênese colônica em ratos. Através da aplicação do carcinógeno químico 1,2dimetilhidrazina (DMH), logo após os protocolos de exercício, foram estudados quatro grupos principais de ratos previamente sedentários (grupo-controle, e três grupos submetidos, respectivamente, ao treinamento crônico de natação, à natação até a exaustão, e à natação até a exaustão após treinamento crônico), sendo sacrificados quinze dias após a injeção da DMH. Após análise histológica e imunohistoquímica, os biomarcadores estudados mostraram resultados coerentes nas diferentes situações experimentais aferidas. Foi observada uma diminuição estatisticamente significante da resposta hiperproliferativa, do número de FCAs e de CABC no grupo que realizou o treinamento crônico, enquanto o grupo submetido ao exercício exaustivo apresentou aumento estatisticamente significante dos parâmetros citados, quando comparados ao grupo-controle. No grupo submetido à associação dos dois protocolos de exercício, quando comparado ao grupo-controle, não houve alterações significantes nos biomarcadores de transformação neoplásica estudados. Nesse estudo experimental, o treinamento físico crônico teve efeito protetor contra o desenvolvimento dos biomarcadores precoces de transformação neoplásica do cólon, enquanto o exercício físico exaustivo aumentou a prevalência destes em ratos sedentários. O treinamento físico crônico, quando associado ao exercício físico exaustivo, não alterou a prevalência dos biomarcadores estudados. Desse achado, acrescido do que se pode encontrar na literatura científica atual, levanta-se a hipótese de que, de maneira similar à relação entre exercício físico e infecções, também o exercício poderia ou proteger contra o desenvolvimento, ou aumentar o risco para o câncer, dependendo do tipo, intensidade e duração da atividade desenvolvida. / Ephitelial cell proliferation, aberrant crypt foci (ACF) and â-catenin-accumulated crypts (BCAC) have been used for early detection of factors that influence colorectal carcinogenesis in rats. It has been observed that moderate and regular physical activity may prevent colon cancer up to 40% in humans. However, exhaustive exercise increases free radical DNA oxidative damage and depresses immune function, events also related to the increased risk for cancer development. Fifteen days after either a single exhaustive swimming bout or a swimming physical training for 8 weeks, or both, in untrained rats treated with a colon carcinogen, we observed a statistically significant decreased number of those biomarkers in rats under training protocol, and a statistically significant increased number of them in rats under exhaustive protocol, when compared to the non-exercised group. For the rats under exhaustive protocol after being trained, data was not evident. Thus, we concluded that training protected against the biomakers development and exhaustive exercise improved colorectal carcinogenesis biomarkers development in sedentary rats. From our finding and literature data, we hypothesize that, similarly to the suggested relationship between exercise and infections, exercise could be protective against cancer or it could increase the risk for this disease depending on its type, dose and duration.

The phosphatidylinositol 3' kinase (PI3K) pathway is involved in many cellular processes including cell proliferation, survival, and glucose transport, and is implicated in various disease states such as cancer and diabetes. Though there have been numerous studies dissecting the role of PI3K signaling in different cell types and disease models, the mechanism by which PI3K signaling regulates embryonic stem (ES) cell fate remains unclear. It is believed that in addition to proliferation and tumorigenicity, PI3K activity might also be important for self-renewal of ES cells. Paling et al. (2004) reported that the inhibition of PI3K led to a reduction in the ability of leukemia inhibitory factor (LIF) to maintain self-renewal causing cells to differentiate. Studies in our lab have revealed that ES cells completely lacking GSK-3 remain undifferentiated compared to wildtype ES cells. GSK-3 is negatively regulated by PI3K suggesting that PI3K may play a vital role in maintaining pluripotency in ES cells through GSK-3. By using a modified Flp recombinase system, we expressed activated alleles of PDK-1 and PKB to create stable, isogenic ES cell lines to further study the role of the PI3K signaling pathway in stem cell fate determination. In vitro characterization of the transgenic cell lines revealed a strong tendency towards maintenance of pluripotency, and this phenotype was found to be independent of canonical Wnt signal transduction. To assess growth and differentiation capacity in vivo, the ES cell lines were grown as subcutaneous teratomas. The constitutively active PDK-1 and PKB ES cell lines were able to form all three germ layers when grown in this manner – in contrast to ES cells engineered to lack GSK-3. The resulting PI3K pathway activated cells exhibited a higher growth rate which resulted in large teratomas. In summary, PI3K signaling is sufficient to maintain self-renewal and survival of stem cells. Since this pathway is frequently mutationally activated in cancers, its effect on suppressing differentiation may contribute to its oncogenicity.

The phosphatidylinositol 3' kinase (PI3K) pathway is involved in many cellular processes including cell proliferation, survival, and glucose transport, and is implicated in various disease states such as cancer and diabetes. Though there have been numerous studies dissecting the role of PI3K signaling in different cell types and disease models, the mechanism by which PI3K signaling regulates embryonic stem (ES) cell fate remains unclear. It is believed that in addition to proliferation and tumorigenicity, PI3K activity might also be important for self-renewal of ES cells. Paling et al. (2004) reported that the inhibition of PI3K led to a reduction in the ability of leukemia inhibitory factor (LIF) to maintain self-renewal causing cells to differentiate. Studies in our lab have revealed that ES cells completely lacking GSK-3 remain undifferentiated compared to wildtype ES cells. GSK-3 is negatively regulated by PI3K suggesting that PI3K may play a vital role in maintaining pluripotency in ES cells through GSK-3. By using a modified Flp recombinase system, we expressed activated alleles of PDK-1 and PKB to create stable, isogenic ES cell lines to further study the role of the PI3K signaling pathway in stem cell fate determination. In vitro characterization of the transgenic cell lines revealed a strong tendency towards maintenance of pluripotency, and this phenotype was found to be independent of canonical Wnt signal transduction. To assess growth and differentiation capacity in vivo, the ES cell lines were grown as subcutaneous teratomas. The constitutively active PDK-1 and PKB ES cell lines were able to form all three germ layers when grown in this manner – in contrast to ES cells engineered to lack GSK-3. The resulting PI3K pathway activated cells exhibited a higher growth rate which resulted in large teratomas. In summary, PI3K signaling is sufficient to maintain self-renewal and survival of stem cells. Since this pathway is frequently mutationally activated in cancers, its effect on suppressing differentiation may contribute to its oncogenicity.

Les lésions surrénaliennes surviennent dans la population générale à une fréquence d’environ 2-3%. Parmi les anomalies génétiques identifiées jusqu’à présent dans les tumeurs surrénaliennes, les mutations somatiques de β-caténine sont les plus prévalentes. Elles sont présentes dans environ 20% des adénomes et carcinomes cortico-surrénaliens. β-caténine est l’élément central de la voie canonique de WNT qui joue un rôle crucial dans le développement embryonnaire, l’homéostase et la tumourigenèse. Les mutations activatrices de β-caténine conduisent à l’accumulation nucléaire de β- caténine qui interagit avec les TCF/LEF-1 qui active la transcription des gènes cibles. Les gènes cibles de β-caténine, varient et dépendent du contexte cellulaire. Dans la glande surrénale, les gènes cibles de β-caténine sont inconnus. Nous avons effectué des études de microarray qui nous ont permis d’identifier 490 transcrits dérégulés dans les adénomes corticosurrénaliens porteurs de mutations ponctuelles de β-caténine. L’expression aberrante d’ISM1, RALBP1, PDE2A, CDH12, ENC1, PHYHIP et CITED2 dans les adénomes porteurs de mutations de β-caténine a été confirmée par PCR en temps réel. Le traitement des cellules humaines de carcinome cortico-surrénalien H295R (mutation de CTNNB1, Ser45Prol) avec les inhibiteurs de β-caténine/TCF (PKF115-584 et PNU74654) ont confirmé l'implication de β-caténine dans la régulation transcriptionelle d’ISM1, RALBP1, PDE2A, ENC1 et CITED2. En conclusion, nos travaux ont conduit à l’identification de nouveaux gènes cibles de β-catenin impliqués dans la tumourigenèse cortico-surrénalienne. / Adrenal lesions occur in the general population at a prevalence of about 2-3%. Several mutations have been identified in adrenocortical tumours. β-catenin mutations were recently found to be the most frequent genetic alteration in both sporadic adrenocortical adenomas and carcinomas (20-30%). β-catenin is the central player in canonical Wnt signaling which plays a key role in organ/ gland development, maintenance of homeostasis and tumourigenesis. Activation of Wnt signaling by altered regulation of β-catenin levels evokes -catenin accumulation in the nucleus, and interaction with the TCF/LEF-1 proteins that activates the transcription of target genes. These target genes are believed to be highly cell and context specific and are linked to developmental and cell cycling functions. β-catenin target genes in adrenocortical tumours are unknown. Using microarray technology, we found 490 transcripts that are deregulated in adrenocortical adenomas harbouring β-catenin activating mutations in comparison to non mutated adenomas and normal adrenal glands. These genes differ highly in function and many are poorly characterized genes. Differential expression of ISM1, RALBP1, PDE2A, CDH12, ENC1, PHYHIP and CITED2 in adenomas with activating β-catenin mutations was confirmed by real-time PCR. Treatment of human adrenocortical carcinoma cells, H295R (CTNNB1 Ser45Prol), with β-catenin/TCF inhibitors (PKF115-584 and PNU74654) further confirmed the implication of β-catenin on the transcriptional regulation of ISM1, RALBP1, PDE2A, ENC1 and CITED2. In conclusion, we have found new potential β-catenin target genes that may be involved in adrenocortical tumourigenesis.

Introdução: A incidência de tumores adrenocorticais em crianças é particularmente elevada nas regiões sudeste e sul do Brasil, correlacionandose com a ocorrência da mutação germinativa p.R337H do supressor tumoral p53, entretanto, o carcinoma adrenocortical é uma neoplasia endócrina maligna rara em todo o mundo com uma incidência aproximada de 0,5 - 2 casos por milhão por ano. Esta condição é uma doença heterogênea, apresentando frequentemente comportamento clínico agressivo e letal. A cascata de sinalização Wnt é uma via importante de transdução de sinal em cânceres humanos e tem sido implicada na tumorigênese adrenocortical. A atividade desta via de sinalização é dependente da quantidade de beta-catenina citoplasmática e nuclear. Mutações ativadoras no gene da beta-catenina (CTNNB1) foram relatadas em diversas neoplasias humanas. Estudos demonstraram que mutações no gene CTNNB1 são os defeitos genéticos mais frequentemente encontrados em adenomas e em carcinomas adrenocorticais. O estudo destas mutações demonstrou que as alterações no gene CTNNB1 localizam-se principalmente exon 3, que codifica a porção amino terminal da beta- catenina. Objetivos: determinar a ocorrência e a frequência das mutações somáticas no exon 3 do gene CTNNB1. Adicionalmente, determinar a imunorreatividade de beta-catenina e de p53 em tumores adrenocorticais benignos e malignos de crianças e adultos. Correlacionar os resultados da análise de mutações gênicas e os dados de imunorreatividade com as características hormonais, a mutação p.R337H do p53, o diagnóstico histológico e a evolução dos tumores adrenocorticais de crianças e adultos. Métodos: Neste estudo, a análise de imunohistoquímica para beta-catenina e p53 foi realizada em 103 tumores adrenocorticais benignos e malignos (40 crianças e 63 adultos), estando as amostras histológicas alocadas em micromatriz tecidual (TMA). A pesquisa de mutações no exon 3 do gene CTNNB1 foi determinada por seqüenciamento automático em 64 tumores adrenocorticais. Resultados: a imunorreatividade para beta-catenina em citoplasma e/ou núcleo foi evidenciada de maneira similar nos tumores adrenocorticais benignos e malignos de crianças e de adultos (15% e 23,8%, respectivamente). O percentual das células neoplásicas imunorreativas para beta-catenina em citoplasma e/ou núcleo não foi significativamente diferente entre os tumores clinicamente benignos e malignos pediátricos (15,6% vs. 12,5%, respectivamente; p=0,93) e entre adenomas e carcinomas adrenocorticais de adultos (28,5% vs. 17,8%, respectivamente; p=0,38). A síndrome endócrina causada pelo perfil de secreção hormonal foi similar entre os tumores adrenocorticais com presença ou ausência de acúmulo citoplasmático e/ou nuclear de beta-catenina em crianças e adultos. A associação entre acúmulo anormal de beta-catenina e diminuição de sobrevida foi avaliada nos pacientes adultos portadores de carcinomas adrenocorticais isoladamente (n=25), sendo observada na curva de Kaplan- Meier uma tendência de significância (log-rank p=0,07). A análise do gene CTNNB1 revelou mutações somáticas em heterozigose em 10 tumores adrenocorticais (4 crianças e 6 adultos). As mutações encontradas no gene CTNNB1 foram, sobretudo do tipo missense (p.Ser45Pro, p.Ser45Phe, p.Asp32Asn, p.Pro44Ala_Ser45Pro; p.His36Gln_Ser37Lys). Outras mutações encontradas compreenderam: a inserção de um único nucleotídeo (p.E9GfsX14), dando origem a uma desvio de leitura do exon 3; além da deleção dos três nucleotídeos do códon 45 (p.Ser45del). Todos os tumores com mutações somáticas no gene CTNNB1 mostraram acúmulo anormal para ?-catenina, com exceção de um caso. A presença de alterações no gene CTNNB1 não se associou ao tamanho do tumor (Teste de Mann-Whitney: p=0,75), desfecho desfavorável tanto no grupo pediátrico (log-rank p=0,29) como no grupo de pacientes adultos (log-rank p=0,77). Todos os pacientes portadores da mutação germinativa do gene TP53 apresentaram imunorreatividade nuclear de p53 nas células tumorais. Não foi encontrada correlação entre a presença de acúmulo anormal de beta-catenina e imunorreatividade nuclear de p53, considerando os grupos de crianças e de adultos portadores de tumores adrenocorticais. Adicionalmente, não foi observada correlação entre mutações no gene CTNNB1, bem como acúmulo anormal de beta-catenina, com a imunorreatividade nuclear de p53 no grupo de tumores adrenocorticais de pacientes adultos, porém, interessantemente, avaliando isoladamente o grupo de tumores adrenocorticais pediátricos, foi observada relação entre a presença de mutações no gene CTNNB1 e a presença de acúmulo nuclear de p53 (X2: p=0,009). Conclusões: Estes dados confirmam a participação da via Wnt na tumorigênese adrenocortical de crianças e de adultos, que apresenta uma prevalência de ativação semelhante entre crianças e adultos. O acúmulo citoplasmático e/ou nuclear de beta-catenina provavelmente é um marcador biológico de mau prognóstico do carcinoma de adrenocortical de adultos. Adicionalmente, observamos evidências de uma correlação positiva entre mutações no gene CTNNB1 e acúmulo nuclear de p53 em tumores adrenocorticais pediátricos, confirmando uma possível relação destas duas vias na tumorigênese do córtex da glândula suprarrenal / Introduction: The incidence of adrenocortical tumors in children is particularly high in the southeastern and southern regions of Brazil, correlating with the occurrence of p.R337H p53 tumor suppressor germline mutation. However, adrenocortical carcinoma is a worldwide rare endocrine malignancy with an approximate incidence of 0.5 to 2 cases per million per year. This condition is a heterogeneous disease and is often lethal. The Wnt signaling pathway is an important signal transduction pathway in human cancers and has been implicated in adrenocortical tumorigenesis. The activity of this signaling pathway is dependent on the amount of nuclear and cytoplasmic beta-catenin. Activating mutations of ?-catenin (CTNNB1) gene have been reported in several human malignancies. Studies have shown that CTNNB1 mutations are the most common genetic defect found in adrenocortical adenomas and carcinomas. The study of these mutations demonstrated that the changes in CTNNB1 gene are mainly located in exon 3, which encodes the amino terminal portion of the beta- catenin. Objectives: to determine the occurrence and frequency of CTNNB1 somatic mutations and the abnormal beta-catenin and p53 accumulation in benign and malignant adrenocortical tumors in both children and adults. We also evaluated the correlation of the gene mutations analysis and immunohistochemistry data with the hormonal characteristics, the p.R337H germline mutation, the histological diagnosis and the prognosis of adrenocortical tumors in children and adults. Methods: In this study, immunohistochemistry for beta-catenin and p53 was performed in 103 benign and malignant (40 children and 63 adults) adrenocortical tumors. The histological samples were allocated in a tissue microarray (TMA). The study of the CTNNB1 gene was performed by direct sequencing of 64 adrenocortical tumors. Results: The beta-catenin abnormal accumulation was similar in benign and malignant adrenocortical tumors of children and adults (15 % and 23.8 %, respectively). The percentage of cells with beta-catenin abnormal accumulation was not significantly different between benign and malignant pediatric adrenocortical tumors (15.6% vs. 12.5 %, respectively; P=0.93) and between adrenocortical adenomas and carcinomas in adults (28.5% vs 17.8 %, respectively; p=0.38). The endocrine syndrome caused by hormonal tumor secretion was similar in patients with and without beta-catenin abnormal accumulation both in pediatric and adult patients. The association between beta-catenin abnormal accumulation and decreased survival was evaluated in adult patients with adrenocortical carcinomas (n=25) and a trend toward significance was observed (log-rank p=0,07). The analysis of the CTNNB1 gene revealed heterozygous somatic mutations in 10 adrenocortical tumors (6 adults and 4 children). The mutations found in CTNNB1 gene were mainly missense (p.Ser45Pro, p.Ser45Phe, p.Asp32Asn, p.Pro44Ala_Ser45Pro; p.His36Gln_Ser37Lys). Other mutations found included: a single nucleotide insertion (p.E9GfsX14) and a deletion within codon 45 of exon 3 of CTNNB1 gene, (p.Ser45del). All tumors with somatic mutations in the CTNNB1 gene showed abnormal beta -catenin accumulation, except for one case. The mutations in CTNNB1 gene was not associated with tumor size (Mann - Whitney: p=0.75), unfavorable outcome in both pediatric (log -rank p=0.29) and adult group of patients (log-rank p=0.77). All patients with TP53 germline mutation showed p53 nuclear accumulation in the tumor cells. No correlation was found between the presence of beta-catenin abnormal accumulation and p53 nuclear accumulation in adrenocortical tumor cells of children and adults. In addition, no correlation was observed between CTNNB1 mutations, as well as beta-catenin abnormal accumulation, with p53 nuclear accumulation in adults adrenocortical tumors. Interestingly, the evaluation of pediatric adrenocortical tumors revealed a relationship between the occurrence of CTNNB1 mutations and the presence of p53 nuclear accumulation (X2: p=0.009). Conclusions: These data confirm the involvement of the Wnt pathway in adrenocortical tumorigenesis of children and adults, which has a prevalence similar activation between children and adults. We observed that abnormal beta-catenin accumulation in adults adrenocortical carcinoma is probably associated with a dismal prognosis. Additionally, we found evidence of a positive relationship between CTNNB1 mutations and p53 nuclear accumulation in pediatric adrenocortical tumors, confirming a possible connection of these two pathways in the pediatric adrenocortical tumorigenesis

Nos mamíferos, a determinação sexual é governada pelo equilíbrio entre duas vias de sinalização paralelas e antagônicas: a via masculina SOX9/FGF9 e a via feminina RSPO1/beta-catenina/WNT4. A R-spondina 1 é uma importante reguladora do processo de diferenciação ovariana e atua modulando a via de sinalização Wnt canônica (Wnt/beta-catenina). Em humanos, mutações em RSPO1 causam uma rara síndrome genética autossômica recessiva caracterizada por Distúrbios do Desenvolvimento Sexual (DDS) 46,XX Testicular ou Ovotesticular, hiperceratose palmoplantar (HPP) e predisposição para o desenvolvimento de carcinoma de células escamosas (MIM 610644). Identificamos um paciente brasileiro, proveniente de uma grande família consanguínea, que apresentava a associação de HPP e DDS 46,XX Testicular SRY negativo. A avaliação da região codificadora do gene RSPO1 identificou a nova variante alélica c.305G>A (p.Cys102Tyr). O estudo de segregação realizado em 67 familiares demonstrou que a variante c.305G>A segrega em perfeita concordância com o fenótipo de HPP, exibindo um padrão de herança autossômico recessivo. Na família foram identificados 10 indivíduos afetados pelo fenótipo de HPP. As avaliações clínica e hormonal e os estudos molecular e citogenético nesses indivíduos resultou na caracterização de: (a) quatro indivíduos do sexo masculino 46,XX e/ou SRY negativo, com ambiguidade genital e perfil hormonal alterado; (b) cinco indivíduos do sexo masculino 46,XY e/ou SRY positivo, sem ambiguidade genital, com perfil hormonal normal e (c) uma mulher 46,XX, fértil. Experimentos de transfecção transitória in vitro demostraram que a proteína mutante tem menor capacidade de transativação do plasmídio reporter da via Wnt. As simulações de dinâmica molecular constataram que a troca p.Cys102Tyr aumenta a flexibilidade do backbone da R-spondina-1, diminuindo a energia de ligação da proteína ao complexo de receptores, LGR5 e RNF43. Em conjunto, nossos achados demonstram que a variante c.305G > A é patogênica, sendo responsável pela síndrome genética diagnosticada na família brasileira. As análises de expressão gênica e os estudos de imuno-histoquímica, por sua vez, detectaram um aumento da expressão do gene SOX9 e maior imonorreatividade para a proteína Sox9 no tecido testicular do caso índice. Esses resultados sugerem que o processo de reversão sexual nos indivíduos XX ocorra por uma hiperexpressão de SOX9 secundária à menor ativação da via Wnt/beta-catenina na gônada durante a embriogênese. No presente estudo também relatamos o primeiro caso de indivíduo de cariótipo 46,XX portador de mutação em homozigose no gene RSPO1 que não desenvolveu DDS. A variabilidade do fenótipo sexual não está associada com alterações no número de cópias dos genes WNT4 ou do SOX9 e região cis-regulatória. No entanto, a avaliação do exoma da família encontrou uma associação entre o polimorfismo do receptor LGR5 rs17109924 e a atenuação do fenótipo de DDS. Todavia, serão necessários estudos funcionais para esclarecer o impacto biológico da interação das variantes RSPO1 p.Cys102Tyr e LGR5 rs171099 / In mammals, sex determination is governed by the balance between two parallel and antagonic signaling pathways: the male SOX9/FGF9 and the female, RSPO1/beta-catenin/WNT4 pathways. R-spondin 1 regulates the ovarian differentiation process by its modulating action through the canonic Wnt pathway (Wnt/beta-catenin). In humans, patogenic mutations in RSPO1 cause a rare, autosomic recessive syndrome characterized by 46,XX Testicular or Ovotesticular disorders of sexual development (DSD), palmoplantar keratosis (PPK) and predisposition to squamous cell carcinoma (MIM 610644). We identified and studied a SRY-negative 46,XX DSD patient with PPK from a large, consaguineous, brazillian family. Through a \"candidate gene\" approach we identified in the proband a new allelic variant in the coding region of RSPO1, c.305G > A. This variant presented full concordance with the PPK phenotype by segregation analyses in 10 of 67 members of this family. Clinical, hormonal, cytogenetic and molecular genetic studies characterized three patterns in individuals with this variant: (a) four 46,XX and/or SRY-negative males with ambiguous genitalia and altered hormonal profile; (b) five 46,XY and/or SRY-positive males without ambiguous genitalia with normal hormonal profile; (c) one 46,XX fertile woman. In vitro experiments demonstrated that transient transfection of the mutant protein resulted in lower transactivation of the Wnt pathway-reporter plasmid. Moreover, molecular dinamic studies showed that p.Cys102Tyr increased the R-spondin-1 backbone flexibility, thus decreasing the interaction between this protein and its receptors, LGR5 and RNF43. Thus, both in vitro and in silico analysis demonstrate the pathogenicity of the RSPO1 variant c.305G > A. In addition, in the index case, a higher expression of SOX9, corroborated by a reactive immunohistochemistry in testicular tissue, suggested that the process of sexual reversal in the XX individual is driven by a higher SOX9 expression possibly due to a lower Wnt/beta-catenin signaling pathway activation during embriogenesis. In this study, we also reported the first 46,XX individual with RSPO1 mutation without DSD, in which no copy number abnormality was detected in WNT4, SOX9 and its cisregulatory regions. Whole exome sequencing of the affected individuals revealed, in turn, that the LGR5 rs17109924 polymorphism associates with a protacted DSD phenotype in the fertile woman with normal hormonal profile. Despite this evidence, future studies are nedded to address causality and biological impact between RSPO1 p.Cys102Tyr and LGR5 rs17109924 variants

La formation de la gaine de myéline est un processus complexe et finement régulé. Une altération de l’expression des gènes codant pour les protéines structurales de cette gaine entraine de graves neuropathies démyélinisantes. Notre objectif est d’identifier de nouvelles voies de signalisation capables de moduler l’expression de ces gènes. Les cellules de Schwann et les oligodendrocytes contiennent et synthétisent de grande quantité de dérivés oxydés du cholestérol : les oxystérols. Ces molécules sont connues pour leurs rôles dans le maintien de l’homéostasie du cholestérol et dans la progression des maladies neurodégénératives. Les oxystérols peuvent être classés en deux groupes : ceux dont l’oxydation a lieu sur la chaine carbonée latérale (25OH) et ceux qui portent une oxydation sur l’un des cycles du cholestérol (7KC). Nous nous sommes tout d’abord intéressés à la première catégorie d’oxystérols. Nous avons montré que le 25OH, réprimait l’expression des gènes de la myéline périphérique P0 et PMP22. Cette activité répressive était le fruit d’un mécanisme direct conduisant à une augmentation de la quantité des LXRs liés à leurs éléments de réponse sur les promoteurs des gènes de la myéline, et d’un mécanisme indirect provoquant une diminution de l’activité de la voie Wnt/β-caténine. En revanche, dans le SNC, nos résultats indiquent que le 25OH active l’expression des gènes de la myéline PLP et MBP. Le traitement, par ces oxystérols, de cultures organotypiques de cervelet démyélinisées par la lysolécithine permet une remyélinisation des axones des cellules de Purkinje. Nous nous sommes ensuite penchés sur le rôle du corégulateur transcriptionnel RIP140. Ce dernier peut soit agir comme un corépresseur soit comme un coactivateur. Il peut interagir avec le LXR. L’invalidation de RIP140 dans le poisson zèbre altère les gaines de myéline. Nous avons montré que RIP140 possédait des rôles bivalents dans la régulation de la myélinisation. En effet, il est capable d’activer mais aussi de réprimer l’activité transcriptionnelle de P0 et de PMP22. Enfin, nous nous sommes intéressés à la seconde catégorie d’oxystérols. Le 7KC est l’oxystérol majoritairement présent dans le SNP et la CS. Il est connu pour moduler l’action du récepteur aux dioxines : le AhR. Ce récepteur a été très largement étudié dans un cadre toxicologique. Cependant ses rôles et ses ligands endogènes restent à ce jour encore assez méconnus. Nos résultats indiquent que le AhR est impliqué dans le contrôle de l’expression des gènes de la myéline périphérique. L’invalidation du AhR, chez la souris, provoque des anomalies structurales de la gaine de myéline conduisant à des déficits moteurs. Cette étude a permis de mieux comprendre les dialogues entre les voies de signalisation gouvernant le processus de myélinisation. Ce travail apporte également de nouvelles perspectives thérapeutiques des maladies neurodégénératives comme la CMT1A ou la sclérose en plaques. / The myelination of axons is a complex process performed by Schwann cells (SC) and by oligodendrocytes (OL) respectively in the peripheral nervous system (PNS) and in the central nervous system (CNS). A slight change in expression of myelin structural proteins has a deep impact on the development and preservation of nerve fibers and their myelin sheaths, as observed for example in Charcot-Marie-Tooth disease or in Pelizaeus-Merzbacher disease. Our aim is to identify new signaling pathways able to control the expression of these structural proteins. SC and OL contain and synthesize high amount of reactive molecules generated from the oxidation of cholesterol: the oxysterols. Their implication in cholesterol homeostasis and in the progression of neurodegenerative disorders is well known but few data are available for their functions in myelination of PNS and CNS. Firstly, we demonstrate that oxysterols inhibit peripheral myelin gene expression: MPZ and PMP22. This downregulation is mediated by two mechanisms: by increasing the binding of LXRs to myelin genes promoters and by inhibiting the Wnt/β-catenin pathway leading to a decrease of b-catenin recruitment at the levels of the MPZ and PMP22 promoters. However, in the CNS, our data demonstrate that activation of LXRS by oxysterols stimulate myelin genes expression (PLP and MBP). Interestingly, by using demyelinated organotipc culture of cerebellum, we show that oxysterols enhance OL differentiation and promote remyelination, via LXRs. Then, we studied the role of the transcriptional coregulatory, RIP140, in myelination. RIP140 is able to act as a corepressor or as a coactivator and can interact with LXRs. In Zebrafish, the knocked down of the orthologue of RIP140 led to a decrease of peripheral and central myelin gene expression and to a defect in myelin sheath ultrastructure. Finally, we focused on impact of AhR in myelination process. AhR is a ligand activated transcription factor mostly known to interact with environmental pollutant like dioxins to mediate their toxic and carcinogenic effect. However, its detoxifying activity is posterior to the apparition of the gene and its physiological roles and endogenous ligands remain elusive. We show that the main oxysterol in the nervous system is 7-ketocholesterol which is an endogenous modulator of AhR. We report that the constitutive absence of AhR in mice leads to defects in locomotion behaviors. We studied the impact of this invalidation on the myelin of sciatic nerve. We observed a severe demyelinating phenotype and deregulation of myelin genes expression. Moreover, we demonstrated a cross-talk between AhR and Wnt/β-catenin pathways. Our data reveal a new endogenous role of AhR in myelination process.