Cheung, Ka Yan. / "Aug 2010." / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 157-167). / Abstracts in English and Chinese. / Abstract --- p.i / 摘要 --- p.iii / Acknowledgments --- p.v / Table of Contents --- p.vi / List of Figures --- p.x / List of Tables --- p.xi / Abbreviations --- p.xii / Chapter Chapter1 --- General Introduction --- p.1 / Chapter 1.1 --- Cancer epidemiology and managements --- p.2 / Chapter 1.2 --- Photodynamic therapy (PDT) as cancer treatment --- p.7 / Chapter 1.3 --- Pheophorbide a (Pa) as a photosensitizer for PDT --- p.13 / Chapter 1.4 --- Aim of study --- p.15 / Chapter Chapter2 --- The anti-proliferative effect of pheophorbide a- mediated photodynamic therapy on human breast adenocarcinoma cell line MCF-7 --- p.17 / Chapter 2.1 --- Introduction / Chapter 2.1.1 --- Cell cycle regulation --- p.18 / Chapter 2.1.2 --- Growth arrest and DNA damage inducible (GADD) genes as cell cycle regulators --- p.22 / Chapter 2.2 --- Materials and Methods / Chapter 2.2.1 --- Materials / Chapter 2.2.1.1 --- Cell line --- p.29 / Chapter 2.2.1.2 --- "Cell culture medium, supplements and other reagents" --- p.29 / Chapter 2.2.1.3 --- Gene expression assay reagents --- p.30 / Chapter 2.2.1.4 --- Reagents and buffers for Western blotting --- p.32 / Chapter 2.2.1.5 --- Cell cycle analysis reagents --- p.35 / Chapter 2.2.2 --- Methods / Chapter 2.2.2.1 --- Cell line propagation and subculture --- p.36 / Chapter 2.2.2.2 --- Whole-transcript expression micro array analysis --- p.37 / Chapter 2.2.2.3 --- GADD genes expression assay- RT-PCR --- p.37 / Chapter 2.2.2.4 --- Cell cycle analysis --- p.40 / Chapter 2.2.2.5 --- Western Blotting --- p.41 / Chapter 2.2.2.6 --- Statistical analysis --- p.43 / Chapter 2.3 --- Results / Chapter 2.3.1 --- Effect of Pa-PDT on GADD genes expression by whole-transcript expression microarray analysis --- p.44 / Chapter 2.3.2 --- Effect of Pa-PDT on GADD genes expression by RT-PCR --- p.46 / Chapter 2.3.3 --- Temporal change in the cell cycle profile after Pa-PDT --- p.48 / Chapter 2.3.4 --- Effect of Pa-PDT on cell cycle associated proteins --- p.65 / Chapter 2.4 --- Discussion --- p.67 / Chapter Chapter3 --- Development of drug resistance in human breast adenocarcinoma cell line MDA and the circumvention by pheophorbide a-mediated photodynamic therapy --- p.77 / Chapter 3.1 --- Introduction / Chapter 3.1.1 --- Clinical Importance of multidrug resistance (MDR) --- p.78 / Chapter 3.1.2 --- Mechanisms of MDR --- p.78 / Chapter 3.1.3 --- Development of MDR cell lines --- p.82 / Chapter 3.1.4 --- Reversal of MDR by P-glycoprotein modulators --- p.83 / Chapter 3.1.5 --- Therapeutic potential of Pa-PDT in treating MDR cancers --- p.83 / Chapter 3.2 --- Materials and Methods / Chapter 3.2.1 --- Materials / Chapter 3.2.1.1 --- Cell line --- p.85 / Chapter 3.2.1.2 --- "Cell culture medium, supplements and other reagents" --- p.85 / Chapter 3.2.1.3 --- Cell viability assay reagents --- p.85 / Chapter 3.2.1.4 --- Gene expression assay reagents --- p.86 / Chapter 3.2.2 --- Methods / Chapter 3.2.2.1 --- Cell line propagation and subculture --- p.87 / Chapter 3.2.2.2 --- Drug-resistance development --- p.88 / Chapter 3.2.2.3 --- Measurement of cell viability - MTT reduction assay --- p.88 / Chapter 3.2.2.4 --- ABCB1 expression assay- RT-PCR --- p.89 / Chapter 3.2.2.5 --- Doxorubicin uptake assay --- p.91 / Chapter 3.2.2.6 --- Pheophorbide a uptake assay --- p.91 / Chapter 3.2.2.7 --- Statistical analysis --- p.92 / Chapter 3.3 --- Results / Chapter 3.3.1 --- Cytotoxicity of doxorubicin on MDA and MDA-R cells --- p.93 / Chapter 3.3.2 --- mRNA expression of ABCB1 (P-glycoprotein) in MDA and MDA-R cells --- p.96 / Chapter 3.3.3 --- Doxorubicin uptake by MDA and MDA-R cells --- p.98 / Chapter 3.3.4 --- Circumvention of drug resistance in MDA-R cells by Pa-PDT --- p.102 / Chapter 3.3.5 --- Pheophorbide a uptake by MDA and MDA-R cells --- p.104 / Chapter 3.4 --- Discussion --- p.106 / Chapter Chapter4 --- Synergistic anti-proliferation of pheophorbide a-mediated photodynamic therapy and doxorubicin on multidrug resistant uterine sarcoma cell line Dx5 --- p.113 / Chapter 4.1 --- Introduction / Chapter 4.1.1 --- Clinical limitations of doxorubicin as chemotherapeutic drug --- p.114 / Chapter 4.1.2 --- Clinical limitations of photodynamic therapy --- p.115 / Chapter 4.1.3 --- Combination therapy with Dox and Pa-PDT --- p.117 / Chapter 4.1.4 --- Uterine sarcoma cell line Dx5 as in vitro model for combination therapy --- p.118 / Chapter 4.2 --- Materials and Methods / Chapter 4.2.1 --- Materials / Chapter 4.2.1.1 --- Cell line --- p.120 / Chapter 4.2.1.2 --- "Cell culture medium, supplements and other reagents" --- p.120 / Chapter 4.2.1.3 --- Anti-cancer drugs --- p.121 / Chapter 4.2.1.4 --- "ROS inhibitor, α-tocopherol" --- p.121 / Chapter 4.2.1.5 --- Cell viability assay reagents --- p.122 / Chapter 4.2.1.6 --- P-glycoprotein activity assay reagents --- p.122 / Chapter 4.2.2 --- Methods - / Chapter 4.2.2.1 --- Cell line propagation and subculture --- p.123 / Chapter 4.2.2.2 --- Cell viability assay --- p.123 / Chapter 4.2.2.3 --- P-glycoprotein activity assay --- p.124 / Chapter 4.2.2.4 --- Statistical analysis --- p.125 / Chapter 4.3 --- Results / Chapter 4.3.1 --- Combination therapy of Pa-PDT and doxorubicin in Dx5 cells --- p.126 / Chapter 4.3.2 --- Effect of α-tocopherol on the synergism between Pa-PDT and doxorubicin in Dx5 cells --- p.129 / Chapter 4.3.3 --- Effect of Pa-PDT on P-glycoprotein activity in Dx5 cells --- p.132 / Chapter 4.3.4 --- Combination therapy of Pa-PDT and doxorubicin in SA cells --- p.138 / Chapter 4.4 --- Discussion --- p.141 / Chapter Chapter5 --- General Discussion --- p.148 / Chapter 5.1 --- Pa-PDT induced growth arrest and DNA fragmentation in breast cancer MCF-7 cells --- p.149 / Chapter 5.2 --- Circumvention of doxorubicin resistance by Pa-PDT in breast cancer MDA cells --- p.151 / Chapter 5.3 --- Synergistic anti-proliferation of Pa-PDT and doxorubicin on uterine sarcoma cell line Dx5 --- p.151 / Chapter 5.4 --- Clinical implication --- p.153 / Chapter 5.5 --- Conclusions and future perspectives --- p.153 / References --- p.157

A carcinogênese do córtex da supra-renal é um processo complexo que envolve alterações genéticas múltiplas e seqüenciais. Embora algumas dessas alterações já tenham sido caracterizadas, de modo geral estes mecanismos permanecem pouco compreendidos. Um conhecimento mais aprofundado dos mesmos não só levaria à descoberta de novos marcadores de prognóstico como também a alvos terapêuticos em potencial. A fim de melhor caracterizarmos os mecanismos envolvidos na progressão maligna do tumor e selecionarmos genes candidatos a serem marcadores de malignidade e alvos terapêuticos, nós estudamos os RNAs de uma linhagem celular derivada de um tumor adrenocortical maligno (NCI-H295A) e um espécime de tumor do córtex da supra-renal por \"Differential Display\" (DDRT-PCR). Foi selecionado um total de 317 transcritos únicos diferencialmente expressos, com base na análise densitométrica digital dos géis de DDRTPCR. A anotação funcional dos genes hiper-expressos mostrou relação com motilidade celular e proliferação. Entre os hipo-expressos foram identificados genes envolvidos na regulação de transcrição, síntese e processamento de RNA e remodelamento da cromatina. A expressão de dois genes entre os transcritos selecionados foi verificada por RT-PCR semi-quantitativa em 19 tumores adrenocorticais adultos e pediátricos, metastáticos e não metastáticos. Os genes da fucosiltransferase-11 e do supressor tumoral BCSC-1 (hiper- e hipo-regulado, respectivamente) encontraram-se diferencialmente expressos nos subgrupos específicos das 19 amostras tumorais. Em suma, o DDRT-PCR revelou-se uma ferramenta valiosa para uma análise global dos transcritomas do córtex da supra-renal e para selecionar genes com possível envolvimento na tumorigênese adrenocortical. Novos aspectos da biologia, progressão e possíveis alvos terapêuticos moleculares puderam ser vislumbrados. / There are important gaps in the present knowledge about adrenocortical tumorigenesis. For this reason we compared by Differential Display RNAs from a carcinoma-derived cell line (NCI-H295A) and a metastatic adrenocortical tumor and characterized 317 differentially expressed transcripts. The up-regulated genes are mainly related to cell motility and proliferation. Among the down-regulated genes, those involved in regulation of transcription, RNA synthesis and processing and chromatin remodeling were identified. Differential expression of FUTT11 and BCSC-1 tumor suppressor gene were confirmed in specific subsets of 19 adult and pediatric adrenocortical tumors and might serve as marker for malignancy. Our data revealed previously unknown aspects of adrenal tumorigenesis.

INTRODUÇÃO: O câncer de mama masculino é uma doença rara, apresentando uma baixa frequência, representando cerca de 0,2% de todos os cânceres, 1% dos cânceres de mama e 1,5% de todos os tumores malignos em homens. A etiologia e o prognóstico do câncer de mama masculino são pouco conhecidos. Estudos pareados de grupo controle foram realizados para melhor responder a estes questionamentos, porém o número limitado de casos de câncer de mama nos homens nos diversos serviços dificulta maiores estudos. O uso dos marcadores moleculares e técnicas imuno-histoquímicas têm sido muito úteis na compreensão do desenvolvimento e progressão desta patologia, e a relação destes marcadores moleculares com a sobrevida global e sobrevida livre de doença, bem como a sua relação entre o câncer de mama nos homens e nas mulheres não estão bem estabelecidos. O objetivo foi analisar as características clínicas, patológicas e imuno-histoquímicas do câncer de mama no sexo masculino observadas em uma coorte histórica, em comparação com aquelas observadas no sexo feminino, relacionando com a sobrevida global e sobrevida livre de doença destes grupos de pacientes. MÉTODOS: Estudo caso-controle retrospectivo de pacientes portadores de câncer de mama masculino, atendidos no período de 1983 a 2008, no Hospital de Câncer de Barretos e no Hospital A.C. Camargo. No grupo controle foram incluídas mulheres com câncer de mama, pareadas por década de diagnóstico, estádio clínico e faixa etária. Foram incluídos 44 pacientes do sexo masculino e 136 do sexo feminino e foram analisadas as variáveis clínicas (sexo, idade, história familiar de câncer, comorbidades associadas, tamanho do tumor, estado linfonodal da axila, estádio clínico/TNM e modalidades de tratamento realizado), patológicas (tipo e grau histológico, embolização linfática, embolização sanguínea, invasão perineural) e as expressas pela imuno-histoquímica (receptor de estrógeno, receptor de progesterona, receptor de andrógeno, bcl-2, Ki-67, ciclina D1, citoqueratinas 5, 6, 8, 14, 17,18 e HER2, confirmada por FISH). No presente estudo, a caracterização dos subtipos moleculares pelo método imuno-histoquímico foi baseada no modelo proposto por Carey et al. (2006), resultando nos grupos Luminal A, Luminal B, HER2 superexpresso, basal-like e não classificável. Avaliou-se a sobrevida global e livre de doença. RESULTADOS: O câncer de mama no homem apresentou-se mais frequentemente com histologia não lobular, receptores hormonais positivos e HER2 negativos, e maior expressão de bcl-2 e ciclina D1. O estádio clínico e o estado linfonodal tiveram influência na sobrevida, sendo de pior prognóstico os pacientes em estádios clínicos mais avançados e com linfonodos axilares positivos. O receptor de andrógeno positivo foi mais frequente nos homens, nos fenótipos luminais e não teve correlação com a sobrevida. Não houve diferença entre os fenótipos moleculares caracterizados pela imuno-histoquímica e o fenótipo basal-like teve pior prognóstico nos sexos masculino e feminino. Porém, o sexo não foi considerado fator prognóstico independente e não houve diferença na sobrevida entre os homens e mulheres. CONCLUSÕES: Apesar de apresentarem características clínicas, histológicas e expressão de marcadores pela imunohistoquímica diferentes, a sobrevida foi semelhante nos sexos masculino e feminino, não sendo o sexo um fator prognóstico independente no câncer de mama / INTRODUCTION: The male breast cancer is a rare disease, presenting a low frequency, representing about 0,2% of all the cancers, 1% of breast cancers and 1,5% of all the evil tumors in men. The etiology and the prognostic of the male breast cancer are little known. Group control studies they were accomplished for best to answer to these questions, however the limited number of cases of breast cancer in the men in the several services it hinders larger studies. The use of the molecular markers and immunohistochemistry have been very useful in the understanding of the development and progression of this pathology, and the relationship of these molecular markers with the overall survival and disease free survival, as well as your relationship among breast cancer in the men and in the women they are not very established. The objective was to analyze the clinical, pathological and immunohistochemical characteristics of breast cancer in the masculine sex observed in a historical cohort, in comparison with observed them in the feminine sex, relating with the overall survival and disease free survival of these groups of patients. METHODS: a retrospective case-control study of patient bearers of male breast cancer was accomplished, assisted in the period from 1983 to 2008, in the Hospital of Cancer of Barretos and in the Hospital A.C. Camargo. In the group control women were included with breast cancer, selected for decade of diagnosis, clinical stadium and age group. Forty four patients of the masculine sex were included and 136 of the feminine sex, and the clinical variables were analyzed (sex, age, family history of cancer, associated comorbidities, size of the tumor, nodal status, clinical stadium/TNM and treatment modalities accomplished), pathological (type and grade histological) and the expressed ones for the immunohistochemical (estrogen, progesterone and androgens receptors, bcl-2, Ki-67, ciclina D1,cytokeratins 5, 6, 8, 14, 17,18 and HER2, confirmed by FISH). In the present study, the immunohistochemical characterization of molecular subtypes was based on the model proposed by Carey et al. (2006), resulting in the groups Luminal A, Luminal B, HER2, basal-like and not classifiable. The overall survival and disease free survival was evaluated. RESULTS: Breast cancer in the man more frequently came with histology non lobular, positive hormonal receptor, negative HER2, and larger bcl2 and ciclina D1 expression. The clinical stadium and the state nodal had influence in the survival, being of worse prognostic the patients in stadiums more advanced and with positive axillary node. The positive androgen receptor was more frequent in the men, in the phenotype luminal and it didn\'t have correlation with the survival. There was not difference among the molecular phenotypes characterized by the immunohistochemistry and the phenotype basal-like had worse prognostic in the masculine and feminine sexes. However the sex was not considered factor independent prognostic and there was not difference in the survival between the men and women. CONCLUSION: In spite of they present different clinical, histological and immunohistochemical characteristics, the survival was similar in the masculine and feminine sexes, not being the sex a factor independent prognostic in breast cancer

Dietary factors may affect development and progression of prostate cancer. Experimental and epidemiological studies have suggested an effect of phytoestrogens on prostate cancer. Lignans are the predominant phytoestrogen in a Western diet. The effects of a diet rich in phytoestrogens and in particular lignans, as compared to a control diet, were assessed in several prostate cancer models. In paper I, 70 athymic nude mice with transplanted subcutaneous LNCaP tumours, an androgen sensitive human prostate cancer cell line, were fed one out of six phytoestrogen rich diets or a control diet after tumour injection. The rye diet, with high lignan content, decreased tumour take and growth, decreased secretion of prostate specific antigen and increased apoptosis. Addition of fat to the rye diet decreased the beneficial effects. In paper II, transgenic mice designed to develop prostate cancer (TRAMP) were fed rye bran or a control diet from the age of four weeks. Rye bran decreased prostate epithelial cell volume by 20%, and increased cell apoptosis by 31% as compared to the control diet. In paper III, we examined the effects of 7-hydroxymatairesinol (HMR), a purified lignan, in nude mice with subcutaneous LNCaP tumours in two different concentrations as compared to a control diet. Mice on the HMR diets had a reduced tumour take rate, lower total tumour volume, increased proportion of non-growing tumours, and increased apoptosis as compared to the control diet. Paper IV was a three week intervention study exploring the effects of rye bran bread vs. a control diet in men with prostate cancer. The men in the rye group had increased levels of plasma enterolactone and in biopsies from the prostate after the intervention an increase in apoptosis was observed in comparison with biopsies obtained before the intervention. In paper V, we examined the association between plasma levels of enterolactone, and risk of prostate cancer in a nested case control study. In the Northern Sweden Health and Disease Cohort, enterolactone concentrations were measured in plasma obtained at a mean time of 5 years before diagnosis from 265 cases of prostate cancer, and from 525 matched controls. We found no significant association between plasma enterolactone and risk of prostate cancer. Men with very low enterolactone levels (bottom decile) however, had significantly higher risk of prostate cancer. Phytoestrogen rich diet including soy, rye bran, substances purified from rye, and a purified lignan (HMR) all inhibited prostate tumour growth. However, it cannot be concluded that the effects observed were due solely to lignans as other components in rye grain such as tannins, phytic acid, ferulic acid, vitamins and minerals may have contributed to the beneficial effects. Thus, additional studies are needed to further elucidate the effects of phytoestrogens on prostate cancer development and progression.

Amplification of the receptor tyrosine kinase ErbB-2 has been linked to the proliferation of breast cancer cells.1,2 Trastuzumab targets the extracellular domain of ErbB-2, leading to growth inhibition of approximately 15% of the breast cancers with genomic amplification of the ERBB2 gene.3 Clinical studies have demonstrated its efficacy in both early4 and metastatic breast cancers. 5,6 However, many tumors with ERBB2 amplification are not responsive to treatment.7 Moreover, the ones that initially respond, eventually progress and acquire drug resistance.8 An in vitro model for this acquired resistance was established by Chan & al.9 The breast cancer cell line, BT474, containing amplified ERBB2, was grown in the presence of trastuzumab for several months until subclones outgrew. Gene expression profiling was performed on these clones to determine differentially expressed genes between the parental and resistant cells. DARPP-32 (Dopamine and cAMP regulated phosphoprotein of 32kDa) was, by far, the most overexpressed transcript. DARPP-32 is coamplified with ERBB2 on the same amplicon of chromosome 17.10 This protein has been mostly described in neurobiology, but DARPP-32 overexpression was recently reported in gastrointestinal, esophageal, prostate and breast cancer.11 Therefore, we suggest that overexpression of DARPP-32 can cause acquired resistance of breast cancer cells to trastuzumab. The in vitro knockout of DARPP-32, using stable shRNA transfection, abolishes the resistance to trastuzumab in the clones, while overexpression of DARPP-32 in the parental cells results in de novo resistance. Overall, our results suggest that DARPP-32 may be a potential therapeutic target in breast cancer patients who develop acquired trastuzumab resistance.

<p>Hematopoiesis is the continual process of blood cell generation that primarily occurs in the bone marrow of adult animals. Hematologic neoplasms can also occur in the bone marrow and often result from dysregulation of signal transduction pathways. One example is the activation of the Ras oncogene, which has been linked to a variety of different cancers, including hematologic neoplasms. Ras is located proximal to the cell membrane and can activate many downstream effector pathways, thus it is difficult to determine which downstream pathway is mediating oncogenic Ras function. My thesis work focused on the effect of inappropriate activation of MEK/ERK, a downstream Ras effector pathway, in the hematopoietic system.</p><p>Using a retroviral transduction system, we expressed a constitutively active form of MEK1 in hematopoietic stem cells (HSCs). Mice transplanted with HSCs expressing active MEK developed a lethal myelodysplastic syndrome/myeloproliferative disease (MDS/MPN) characterized by the expansion of granulocytes/macrophages (GM) at the expense of lymphoid cell development. Transplantation of active MEK-induced MDS/MPNs into naïve mice did not result in further disease, suggesting that the MDS/MPN is not a frank leukemia.</p><p>Bcl-2 is an anti-apoptotic molecule that has been shown to play a role in leukemia development and maintenance. Coupling expression of active MEK and Bcl-2 resulted in MDS/MPNs that were phenotypically identical and had very similar disease onset compared to active MEK-induced MDS/MPNs. However, transplantation of Bcl-2/active MEK-induced MDS/MPNs did not result in a myeloid disease; rather, it resulted in the development of T-acute lymphoblastic leukemia (T-ALL) that was marked by activated Notch signaling. </p><p>These results led us to conclude that activation of MEK/ERK was sufficient to cause a pre-leukemic myeloid disease; however, additional oncogenic factors, such as Bcl-2 and Notch, were necessary for frank leukemia development. Moreover, additional oncogenic factors can alter the disease phenotype and disease course. Future analysis of the interplay between oncogenic factors will help shed light on disease development and aid in the development of more effective cancer treatments.</p> / Dissertation

Thesis (Ph. D.)--University of Virginia, 2008. / Includes bibliographical references. Also available online through Digital Dissertations.

Diss. (sammanfattning) Linköping : Univ., 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Linköping : Univ., 2002. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.