Orientador: José Andrés Yunes / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T07:51:03Z (GMT). No. of bitstreams: 1 Ganazza_MonicaAparecida_D.pdf: 9547403 bytes, checksum: 7d821874cefad54cd4ae846262dbb09a (MD5) Previous issue date: 2014 / Resumo: A leucemia linfóide aguda (LLA) é o câncer mais comum da infância. Os atuais protocolos de tratamento da LLA levam à cura em até 80% dos casos e parte do sucesso se deve à aplicação de diferentes tratamentos para os pacientes estratificados em diferentes grupos de risco. Contudo, pacientes considerados em remissão podem apresentar conteúdo substancial de células neoplásicas, a chamada doença residual mínima (DRM), cuja proliferação está associada com a recaída da doença e que podem estar em níveis indetectáveis pelas técnicas convencionais de análise morfológica. O atual protocolo do Grupo Brasileiro de Tratamento da Leucemia Infantil (GBTLI-LLA-2009) utiliza as análises da DRM para estratificar os pacientes em grupos de risco e assim determinar seu tratamento. Desta maneira o presente estudo objetivou (1) estudar a DRM por método qualitativo e quantitativo (RQ-PCR) em amostras D35 de 120 pacientes prospectivos admitidos para tratamento com o protocolo GBTLI-LLA-2009 no Centro Boldrini entre dezembro de 2009 e julho de 2013 (2) determinar a freqüência e sensibilidade dos rearranjos gênicos de imunoglobulinas e receptores de células T (3) analisar a realocação dos pacientes em grupos de risco em três pontos do tratamento (D8, D15 e D35) (4) buscar associações entre resultados de DRM no D35 e variáveis clínico-biológicas dos pacientes (5) analisar a sobrevida global nos pacientes (6) analisar o grau de concordância entre os resultados obtidos por PCR qualitativo e RQ-PCR no D35. Para a DRM no D15 as análises foram realizadas por citometria de fluxo pela equipe multidisciplinar do Centro Boldrini, já para DRM no D35 as análises foram feitas por PCR qualitativo e RQ-PCR com o uso de primers para a região VDJ das imunoglobulinas e receptores de células T. Observou-se que pelo menos 1 rearranjo gênico foi detectado ao diagnóstico para 98% dos casos estudados através de PCR qualitativo. Os rearranjos mais frequentes ao diagnóstico foram IGH , IGK, TCRG e TCRD para os casos de LLA-B derivada e TCRG, TCRD e Sil-Tal e IGH para os casos de LLA-T. Os primers paciente específicos para RQ-PCR mais sensíveis (sensibilidade 1x10-4) foram aqueles envolvendo rearranjos IGH, TCRD, TCRG e IGK. Associação entre presença de DRM no D35 detectada por RQ-PCR e idade dos pacientes (grupo <1 e ?9 anos) foi observada. Presença de DRM ?10-3 no D35 se mostrou relacionada com sobrevida global em pacientes com LLA-B derivada classificados como BR após análises de DRM no D15. Casos de LLA-B derivada classificados como BR após o D15 em sua maioria não apresentaram DRM nos pontos analisados (D15 e D35) sugerindo que a análise da DRM nesses casos seja dispensável. Já para os casos LLA-B derivada classificados como AR após o D15, 7 pacientes considerados bons respondedores no D15 mostraram-se respondedores lentos no D35 ressaltando a importância da análise da DRM nesse ponto do tratamento. Para casos com LLA-T o número reduzido de pacientes impediu qualquer conclusão a respeito. As duas metodologias aplicadas para as análises da DRM no D35 obtiveram concordância de 80% e 100% para LLA-B derivada e LLA-T, respectivamente / Abstract: Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer. The recent ALL treatment protocols can achieve the complete remission in 80% of cases and this success is due to different treatments for patients stratified into different risk groups. Therefore, patients considered in remission may have substantial contents of neoplasic cells, the minimal residual disease (MRD). The proliferation of such neoplasic cells is associated with disease relapse and they can be undected by conventional methods. The current protocol of the Brazilian Childhood Leukemia Treatment (GBTLI-LLA-2009) uses the analysis of MRD to stratify patients into risk groups and thus determine their treatment. Thus this study aimed to (1) study the MRD for qualitative and quantitative method (RQ-PCR) at D35 from 120 prospective patients admitted for treatment with protocol GBTLI-LLA-2009 at Centro Boldrini between December 2009 and July 2013 (2) determine the frequency and sensitivity of immunoglobulin and T cell receptor gene rearrangements (3) analysis of the relocation of patients into risk groups in three points of treatment (D8, D15 and D35) (4) find associations between results of MRD at D35 and D15 and clinical-biological characteristics of patients (5) analyze the overall survival in patients (6) to analyze the degree of agreement between the results obtained by qualitative PCR and RQ-PCR in D35. MRD analyzes at D15 were performed by flow cytometry by the multidisciplinary team of the Centro Boldrini, MRD at D35 analyzes were performed by qualitative PCR and RQ-PCR using primers for the VDJ region of the immunoglobulin and T cell receptors. At least one gene rearrangement was detected at diagnosis to 98% of the cases studied by qualitative PCR. The most frequent rearrangements at diagnosis were IGH, IGK, TCRG and TCRD for cases of B-ALL derived and TCRG, TCRD and Sil-Tal and IGH in cases of T-ALL. The most sensitive RQ-PCR patient specific primers (sensitivity 1x10-4) were those involving IGH, TCRD, TCRD and IGK rearrangements. Association between presence of MRD in D35 detected by RQ-PCR and age group (<1 and ? 9 years) was observed. Presence of MRD ? 10-3 in D35 showed to be related with overall survival in patients with B-ALL derived classified as BR after analysis of MRD in D15. Cases of B-ALL derived classified as low risk after the D15 mostly showed no MRD in the analyzed points (D15 and D35) suggesting that the analysis of these cases is dispensable. As for the B-ALL derived cases classified as AR after D15, 7 patients considered good responders in D15 proved to be slow responders in D35 emphasizing the importance of analyzing MRD at this point of treatment. For T-ALL cases the small number of patients did not allow any conclusion. Both methodologies for the analysis of DRM in D35 obtained 80% and 100% of agreement for B-ALL derived and T-ALL respectively / Doutorado / Ciencias Biomedicas / Doutora em Ciências Médicas

Orientador: Laura Sterian Ward, José Vassallo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T19:34:22Z (GMT). No. of bitstreams: 1 Cunha_LucasLeite_D.pdf: 3273726 bytes, checksum: 85653bdcc1b0fa91465a6ac9ed73359a (MD5) Previous issue date: 2015 / Resumo: O câncer de tiroide é a neoplasia maligna endócrina mais frequente. Muito embora a maioria destes pacientes apresente boa evolução clínica com as ferramentas terapêuticas atuais, 10-30% evoluirão com doença recorrente e contribuirão para as 1.890 mortes que são estimadas para 2014 nos Estados Unidos . As ciclooxigenases (COX) são um grupo de enzimas que catalisam a formação de prostaglandinas a partir do ácido aracdônico e a atividade de COX2 tem sido implicada na carcinogênese. Nosso grupo demonstrou anteriormente que diferentes células do sistema imunológico infiltram tecidos de cânceres de tiroide. O presente trabalho investigou a presença de marcadores de células do sistema imunológico, bem como marcadores tumorais de perfil inflamatório, procurando marcadores de prognóstico em pacientes com carcinoma diferenciado de tiroide. Foram investigados retrospectivamente 437 pacientes com carcinoma diferenciado da tiroide, cujas amostras de tecido previamente fixadas em formalina e incluidas em blocos de parafina eram mantidas no Banco de Tecidos do A.C.Camargo Cancer Center. Câncer bem diferenciado de tiroide foi diagnosticado em 305 pacientes: 252 com carcinoma papilífero e 53 com carcinoma folicular. Informações clínicas foram obtidas dos prontuários. Obtivemos tecidos de metástases linfonodais ao diagnóstico de 25 pacientes. Para estes casos, fizemos análise pareada entre tecido metastático e tumor primário. Foram investigados marcadores de células imunológicas em áreas intratumorais, incluindo macrófagos associados a tumores (CD68) e subpopulações de linfócitos infiltrantes de tumor, como CD3, CD4, CD8, CD16, CD20, CD45RO, GRANZIMA B, CD69 e CD25. Também foi investigada a expressão de COX2, IL-17A, IL-1'beta', IL-10, IL-6, CD134 e IL-23 nas células tumorais. Entre todos os parâmetros imunológicos avaliados, apenas o enriquecimento de linfócitos CD8+ e expressão de COX2 foram associados à recorrência. A análise multivariada, utilizando o modelo de riscos proporcionais de Cox ajustado para a presença de tiroidite crônica concomitante, identificou CD8+/COX2 como marcador independente de recidiva. Outros marcadores imunoistoquímicos não conseguiram prever o prognóstico dos pacientes. Notamos um aumento da densidade de linfócitos GRANZIMA B+ nas metástases linfonodais se comparado com os respectivos tumores primários. Metástases linfonodais apresentam menor expressão de COX2 e de IL-10. Isto sugere que mecanismos de evasão tumoral estejam diminuídos nos tecidos metastáticos, explicando, pelo menos em parte, por que a presença de metástases linfonodais não seria um excelente marcador de prognóstico nos pacientes com câncer diferenciado de tiroide. Nosso estudo mostrou que o câncer diferenciado de tiroide é infiltrado por múltiplas células do sistema imunológico e que o padrão de infiltração celular parece se associar a características clínicas e anatomopatológicas distintas. Este misto celular infiltrativo, juntamente com a produção de citocinas inflamatórias, cria um perfil de microambiente que é importante na determinação da agressividade tumoral. De fato, a presença de linfócitos T citotóxicos e a expressão de COX2 puderam prever o pior prognóstico dos pacientes estudados. Ainda, observamos que a metástase linfonodal é o sítio onde ocorreria uma resposta imunológica mais efetora e menos evasiva, de forma a determinar de forma mais assertiva um ataque imunológico efetivo coerente com a pouca força da metástase linfonodal como um preditor de prognóstico / Abstract: Thyroid cancer is the most common endocrine malignancy. Although most of these patients experience clinical improvement with current therapeutic tools, 10-30% will develop recurrent disease and contribute to the 1,890 deaths that are estimated for 2014 in the United States. The cyclooxygenase (COX) are a group of enzymes that catalyze the formation of prostaglandins from arachidonic acid and COX2 activity has been implicated in carcinogenesis. Our group previously demonstrated that mixture of immune cells infiltrates tissue of thyroid cancers. The present study investigated the presence of immune cells markers and tumor markers of inflammatory profile, looking for prognostic markers in patients with differentiated thyroid carcinoma. We retrospectively investigated 437 patients with differentiated thyroid carcinoma, whose tissue samples previously fixed in formalin and included in paraffin blocks were kept in the Tissue Bank of the AC Camargo Cancer Center. Well-differentiated thyroid cancer was diagnosed in 305 patients: 252 with papillary carcinoma and 53 with follicular carcinoma. Clinical information was obtained from medical records. We obtained tissue of lymph node metastases at diagnosis of 25 patients. For these cases, we performed a paired analysis of metastatic tissue and primary tumor. Immunological cell markers were investigated in intratumoral areas, including tumor-associated macrophages (CD68) and subpopulations of tumor infiltrating lymphocytes, such as CD3, CD4, CD8, CD16, CD20, CD45RO, GRANZYME B, CD69 and CD25. We also investigated the expression of COX2, IL-17A, IL-1'beta', IL-10, IL-6, IL-23 and CD134 in the tumor cells. Among all the immunological parameters evaluated, only the enrichment of CD8+ lymphocytes and expression of COX2 were associated with recurrence. Multivariate analysis using the Cox model of proportional hazards adjusted for the presence of concurrent chronic lymphocytic thyroiditis, identified CD8+/COX2 as an independent marker for recurrence. Other immunohistochemical markers failed to predict the prognosis of patients. We notice an increase in the density of GRANZYME B + lymphocytes in lymph node metastases when compared with their primary tumors. Lymph node metastases have lower expression of COX2 and IL-10. This suggests that tumor evasion mechanisms are impaired in metastatic tissues, explaining, at least in part, why the presence of lymph node metastases would not be an excellent prognostic marker in patients with differentiated thyroid cancer. Our study showed that the differentiated thyroid cancer is infiltrated by multiple immune cells and that the pattern of cellular infiltration appears to be associated with distinct clinical and pathological characteristics. This infiltrative mixed cell along with the production of inflammatory cytokines, creates a microenvironment profile that is important in determining the tumor aggressiveness. In fact, the presence of cytotoxic T lymphocytes and COX2 expression could predict the worst prognosis of the patients. Still, we found that lymph node metastasis is the place where there would be a more productive immune response and less evasive, favoring and effective immune response. It is fairly coherent with the little strength of lymph node metastasis as a prognostic predictor / Doutorado / Clinica Medica / Doutor em Ciências

INTRODUÇÃO: A ressecção hepática é o único tratamento potencialmente curativo para as metástases hepáticas de câncer colorretal (MHCCR), porém com taxas de recidiva entre 60 e 70%. Desta forma, faz-se necessário um melhor entendimento das vias de disseminação e recidiva da doença. Os brotamentos tumorais (BT) e grupamentos pouco diferenciados (GPD), relacionados à transição epitélio-mesenquimal, são fatores prognósticos para o câncer colorretal; entretanto sua presença e importância nas MHCCR ainda não estão estabelecidas. Os objetivos deste trabalho foram avaliar a presença dos BT e GPD nas MHCCR, determinar sua importância prognóstica e sua relação com outros fatores patológicos conhecidos. MÉTODOS: Foram avaliados, retrospectivamente, 229 pacientes submetidos a ressecção de MHCCR com intuito curativo, entre janeiro de 2004 e junho de 2014. Nos espécimes cirúrgicos das MHCCR ressecadas, foi realizada análise anatomopatológica através de lâminas coradas em hematoxilina e eosina (HE), para avaliação dos BT, GPD, infiltrado inflamatório peritumoral, presença de pseudocápsula e tipo de borda; e por imuno-histoquímica, por meio de anticorpos anti-AE1/AE (BT e GPD), anti-D2-40 (invasão linfática) e anti-CD34 (invasão venosa portal). Também foram analisadas as variáveis clínicas relacionadas ao prognóstico. RESULTADOS: O seguimento médio após a hepatectomia foi de 43 meses. As taxas de sobrevida global e livre de doença em 1, 3 e 5 anos foram de, respectivamente, 94,1%, 66,7% e 45,5% e 53,6%, 31,5% e 29,6%. Os BT estiveram presentes em 61,1% dos pacientes na avaliação pelo AE1/AE3 e em 48,9% pelo HE, enquanto os GPD estiveram presentes em 42,8% dos pacientes na avaliação pelo AE1/AE3 e em 49,3% pelo HE. Na análise univariada, os BT e os GPD grau 3 ( > 9 GPD) mostraram significância prognóstica, tanto na avaliação pelo AE1/AE3 quanto pelo HE. Na análise múltipla, os fatores independentes para sobrevida global foram: a presença de GPD grau 3 (pelo HE), presença de pseudocápsula, invasão venosa portal e presença de 4 ou mais nódulos. Os fatores independentes para sobrevida livre de doença foram: GPD grau 3 (pelo HE), quimioterapia prévia, presença de 4 ou mais nódulos, infiltrado inflamatório peritumoral ausente ou leve, invasão venosa portal e borda infiltrativa. Os BT e GPD não estiveram associados à recidiva hepática. Os BT foram associados a: GPD, MHCCR sincrônicas, tumores de até 5 cm, ausência de pseudocápsula, borda infiltrativa, e presença de invasão venosa portal. Os GPD foram associados a: BT, infiltrado inflamatório peritumoral ausente ou leve, ausência de pseudocápsula e borda infiltrativa. CONCLUSÕES: Os BT e os GPD são frequentes nas MHCCR e ambos, na análise univariada, são fatores de pior prognóstico na sobrevida global e livre de doença, estando associados à recidiva extra-hepática. A presença de GPD grau 3 avaliada pelo HE é fator prognóstico independente na sobrevida global e livre de doença, sugerindo que este é um importante mecanismo de disseminação tumoral na MHCCR / INTRODUCTION: The only potentially curative treatment for colorectal liver metastases is surgical resection. However, about 60 to 70% of patients will recur, showing the necessity of a better knowledge regarding spread and disease recurrence pathways. Tumor budding and poorly differentiated clusters, markers related to epithelial-mesenchymal transition, are prognostic factors for colorectal cancer, but their presence and significance in colorectal liver metastases is not yet established. The aims of this study were to evaluate the presence of tumor budding and poorly differentiated clusters in colorectal liver metastases, to determine their prognostic value and to relate them to other known pathological factors. METHODS: A total of 229 patients that underwent hepatic resection for colorectal liver metastases between January 2004 and June 2014 were retrospectively evaluated. Resected specimens of colorectal liver metastases were submitted to pathological evaluation by hematoxilin and eosin staining, to analyze tumor budding, poorly differentiated clusters, peritumoral inflammatory infiltrate, presence of tumor pseudocapsule and tumor growth pattern; and by immunohistochemical staining with antibodies anti- AE1/AE3 (tumor budding and poorly differentiated clusters), anti-D2-40 (lymphatic invasion) and anti-CD-34 (portal vein invasion). Clinical variables related to prognosis were also evaluated. RESULTS: Mean follow up after hepatectomy was 43 months. Overall and disease-free survival rates at 1, 3 and 5 years were 94.1%, 66.7% and 45.5% and 53.6%, 31.5% and 29.6%, respectively. Tumor budding was present in 61.1% of patients in the evaluation by AE1/AE3 staining and in 48.9% by hematoxilin and eosin, while poorly differentiated clusters were present in 42.8% of patients by AE1/AE3 staining and 49.3% by hematoxilin and eosin. At univariate analysis, tumor budding and poorly differentiated clusters grade 3 ( > 9 poorly differentiated clusters) by AE1/AE3 and hematoxilin and eosin staining showed prognostic significance. On multiple analysis, independent factors for overall survival were: presence of poorly differentiated clusters grade 3 (by hematoxilin and eosin), presence of tumor pseudocapsule, portal vein invasion and presence of 4 or more nodules. Independent factors for disease-free survival were: poorly differentiated clusters grade 3 (by hematoxilin and eosin), preoperative chemotherapy, portal vein invasion, presence of 4 or more nodules, none/mild peritumoral inflammatory infiltrate and infiltrative tumor border. Tumor budding and poorly differentiated clusters were not related to hepatic recurrence. Tumor budding was associated with: presence of poorly differentiated clusters, synchronous colorectal liver metastases, tumor size up to 5 cm, absence of tumor pseudocapsule, infiltrative tumor border and presence of portal vein invasion. Poorly differentiated clusters were associated with: presence of tumor budding, none/mild peritumoral inflammatory infiltrate, absence of tumor pseudocapsule and infiltrative tumor border. CONCLUSIONS: Tumor budding and poorly differentiated clusters are frequent in colorectal liver metastases and, on univariate analysis, are prognostic factors for overall and disease-free survival, being associated to extrahepatic recurrence. Presence of poorly differentiated clusters grade 3 stained by hematoxilin and eosin is an independent prognostic factor for overall and disease-free survival, suggesting that it is an important spread pathway in colorectal liver metastases

No processo de metástase os movimentos de migração e invasão tem um papel essencial e em ambos a função dos microfilamentos é de grande importância. Neste contexto, o presente trabalho buscoui analisar os efeitos da droga jaspamídeo e após a determinação das concentrações de IC50 para as linhagens HT144 e NGM foram estudados os efeitos da droga. Os tratamentos mostraram que o fármaco atua desorganizando o citoesqueleto de modo dependente de sua concentração. Os ensaios de ferida mostraram diminuição da taxa de fechamento da área livre após os tratamentos e os ensaios de migração com placas de transwell mostraram que os grupos tratados sofrem aumento desse parâmetro. Nos ensaios de invasão com câmara de Boyden o tratamento mostrou-se efetivo apenas para a célula NGM quando tratadas com 75 nM de jaspamídeo e 30 <font face=\"Symbol\">mM de Y-27632. Quanto à migração, a linhagem NGM não completava este processo quando tratada com as concentrações do IC50 e do IC50/2 acrescido de Y-27632 e a linhagem HT144 apresenta aumento deste parâmetro quando tratado com jaspamídeo e 200 <font face=\"Symbol\">mM de NSC23766. / Many signaling ways are involved in metastasis and the cellular migration and invasion are important in this context. The role of microfilaments is essential in mesenchymal and amoeboid migration. In this context, the present work aimed to analyze the effects of the drug jaspamide and. after the determination of the IC50 concentrations for the HT144 and NGM cell lines, the effects of the treatment with jaspamide were studied. The wound assays indicated a decrease in the free area after the treatments, and the migration assays with transwell showed that, after the inoculation with the drug, the cells increased the process of migration. In the invasion assays with Boydens chamber, the treatment with jaspamide was effective only in NGM cells, when they are treated with 75 nM of the drug plus 30 <font face=\"Symbol\">mM of Y-27632. Regarding the migration process, the NGM cell line did not show movement when treated with the IC50 concentration and the IC50/2 concentration plus Y-27632, and the HT144 cell line increases this parameter when treated with jaspamide and 200 <font face=\"Symbol\">mM of NSC23766.

O melanoma maligno é uma forma de câncer com alto índice de morte devido, em parte, à falta de tratamentos eficazes e à sua tendência de formar metástases. Nosso grupo tem desenvolvido vetores virais para a transferência gênica de fatores anti-tumorais e, inicialmente, foi construído um vetor adenoviral, AdPG, no qual a expressão do transgene é controlada por p53, um supressor de tumor e fator de transcrição. Sendo que aproximadamente 90% dos casos de melanoma retêm p53 selvagem, foi proposto que isto pudesse ser utilizado como uma ferramenta para dirigir a expressão do transgene codificado pelo vetor AdPG, um mecanismo apoiado por resultados anteriores de nosso grupo. Por exemplo, a transdução de células B16 (melanoma de camundongo, p53-selvagem, deleção de p19Arf) com vetores AdPG portadores de p19Arf ou interferon-<font face=\"Symbol\">b (IFN<font face=\"Symbol\">b) resultou em morte celular maciça enquanto a transferência de apenas um destes fatores isolados não causou o mesmo efeito. O trabalho descrito aqui inclui dois avanços tecnológicos críticos em comparação com trabalhos anteriores do grupo. Primeiramente, os transgenes de interesse (eGFP, p19Arf e IFN<font face=\"Symbol\">b) foram inseridos num vetor adenoviral que apresenta o tripetídeo RGD na sua proteína fibra. Essa modificação no vetor permite a eficiente transdução de um amplo espectro de células alvos sem a dependência do receptor viral do adenovírus selvagem, CAR. Além disso, foi construído um vetor bicistrônico, que contém a combinação de ambos os genes terapêuticos, como forma de garantir a transferência dos dois fatores ao mesmo tempo para as células-alvo. A inclusão de p19Arf, um supressor de tumor e inibidor de MDM2, como um gene terapêutico deve complementar as atividades do p53 celular endógeno e, como consequência, atuar na promoção da expressão a partir do vetor e também na inibição da proliferação das células tumorais. Porém, a transferência de p19Arf sozinho acarretaria efeito somente nas células que foram transduzidas e, então, seu efeito seria limitado. Por este motivo, descreve-se, além do p19Arf, a utilização de IFN<font face=\"Symbol\">b, uma proteína secretada com funções anti-tumorais, incluindo inibição de angiogênese, indução de apoptose e ativação da resposta imunológica. A estratégia do projeto contemplou vários níveis relacionados ao mecanismo do processo de transferência, incluindo a eficiência da transdução, o mecanismo de controle da expressão dos transgenes e as atividades dos transgenes. Assim, foi proposto que a combinação de p19Arf e IFN<font face=\"Symbol\">b pudesse ser uma estratégia interessante para induzir morte no tumor primário e uma resposta imunológica contra as células metastáticas. Com este projeto, foi iniciada a construção destes novos vetores aprimorados para transferência gênica nas células de melanoma. / Malignant melanoma is a type of cancer with high death rates, in part, because of a lack of efficient treatments and its tendency to generate metastases. Our group has developed viral vectors for the gene transfer of anticancer factors and, initially, we constructed an adenoviral vector, AdPG, in which transgene expression is controlled by p53, a tumor suppressor and transcription factor. As 90% of melanoma cases maintain wild-type p53, it was proposed that this could be used as a tool to drive transgene expression encoded by the AdPG vector, as evidenced by previous studies from our group. For example, transduction of B16 cells (mouse melanoma, wild-type p53, p19Arf-null) with vectors encoding p19Arf or interferon-<font face=\"Symbol\">b (IFN<font face=\"Symbol\">b) resulted in massive death cell, while transfer of just one of these factors alone did not cause the same effect. The work described here includes two critical technologic advances in comparison with our previous work. First, transgenes of interest (eGFP, p19Arf and IFN<font face=\"Symbol\">b) were inserted into an adenoviral vector which presents the RGD tripeptide in its fiber. This vector modification allows efficient transduction in a wide range of target cells without dependence on the wild type adenovirus receptor, CAR. In addition, a bicistronic vector was constructed which contains the combination of both therapeutic genes, ensuring the transfer of both factors to the target cells at the same time. Use of p19Arf, a tumor suppressor and MDM2 inhibitor, as a therapeutic gene should complement endogenous p53 activities and, as a consequence, promote expression from the AdPG vector and inhibit tumor cell proliferation. However, p19Arf gene transfer alone should have an effect only in transduced cells and, therefore, its effect would be limited. For this reason, we describe, in addition to p19Arf, the application IFN<font face=\"Symbol\">b, a secreted protein with antitumor functions, including inhibition of angiogenesis, induction of apoptosis and activation of immunologic response. This strategy involves several mechanistic levels related with the gene transfer process, including transduction efficiency, control over transgene expression and transgene activity. Therefore, it was proposed that the combination of p19Arf and IFN<font face=\"Symbol\">b could be an interesting strategy to induce primary tumor death and an immunologic response against metastatic cells. In this project, the construction of new vectors optimized for gene transfer in melanoma cells was initiated.

A utilização do vírus adeno-associado recombinante (AAVr) como vetor de transferência gênica em células tumorais está crescendo. Neste trabalho, o promotor gênico de E2F-1, um promotor ativo durante a divisão celular, foi inserido no AAVr e utilizado para dirigir a expressão do HSV-tk ou luciferase e, simultaneamente, eGFP afim de direcionar a expressão viral para células em proliferação. Em paralelo, foram construídos vetores portadores do promotor constitutivo CMV para servir como controles. O promotor gênico de E2F-1 não foi eficiente em dirigir a expressão dos transgenes na linhagem celular HT1080, enquanto o promotor CMV apresentou uma alta expressão dos repórteres e do gene terapêutico. A baixa eficiência do promotor E2F-1 ainda não foi explorada, mas poderia ser relacionada com o desempenho intrínseco deste promotor, a biologia do vetor AAVr e especificidade celular. Contudo, o bom desempenho do vetor AAVr contendo o promotor CMV abre a possibilidade de realizar novos ensaios de transferência gênica para tratamento e visualização de células tumorais / The utilization of recombinant adeno-associated virus (AAVr) as a gene transfer vector in tumor cells is increasing. In this work, the promoter of the E2F-1 gene, active during cell division, was inserted in an AAVr vector and used to drive the expression of HSV-tk or luciferase and, simultaneously, eGFP with the intent of limiting viral expression to proliferating cells. Also, vectors with the constitutive CMV promoter were constructed to be used as controls. The E2F-1 promoter was not efficient in driving the expression of the transgenes in the HT1080 cell line, while the CMV promoter shows high level expression of the reporter and the therapeutic genes. The low efficiency of E2F promoter has not yet been explored, though this problem could be related to the intrinsic performance of this promoter, the biology of the vector AAV and cell-specific factors. However, the performance of the AAVr containing the CMV promoter creates the possibility of performing new gene transfer protocols for the treatment and visualization of tumor cells.

Submitted by Adriana Martinez (amartinez@unoeste.br) on 2017-05-31T21:00:12Z No. of bitstreams: 1 Fernanda Freire Marin Soares.pdf: 704573 bytes, checksum: bf544d5550ee825719abaa7a01a5e94c (MD5) / Made available in DSpace on 2017-05-31T21:00:12Z (GMT). No. of bitstreams: 1 Fernanda Freire Marin Soares.pdf: 704573 bytes, checksum: bf544d5550ee825719abaa7a01a5e94c (MD5) Previous issue date: 2017-03-20 / Cadmium is a metal that is widely used in industry. Cadmium exposure may result in a variety of pulmonary diseases. No studies have evaluated tracheal damage or even whether cadmium intake can damage the respiratory tract. The aim of this study was to investigate the histopathological changes caused by cadmium poisoning via intake into the respiratory tract and the possible effects of water pH in the genesis of these changes. Ninety male Wistar rats were used and were divided into six groups (n=15): Group A received 400 mg/l cadmium chloride (CdCl2) in the drinking water at a pH of 7.0; group B received CdCl2 (400 mg/l) in the drinking water at a pH of 5.0; group C received CdCl2 (400 mg/l) in the drinking water at a pH of 8.0; group D received water at a pH of 5.0; group E received water at a pH of 8.0; and group F received water at a pH of 7.0. Animals were euthanized after 6 months. Samples of the lung and trachea were removed. The histopathological analysis was performed to evaluate the presence or not of the following parameters: 1. Trachea: inflammatory infiltrate and type of inflammatory cell; tissue congestion; muscle hypertrophy; non-neoplastic lesions of the mucosa; dysplastic lesions; benign and malignant neoplastic lesions; mucus type (acid or basic); and the number of goblet cells; 2. Lung: interstitial inflammatory infiltrate, inflammatory cell type and location; tissue congestion; interstitial fibrosis; emphysema; necrosis of the parenchyma; dysplastic lesions and the presence of benign and malignant neoplastic lesions. Animals exposed to cadmium had a mean of goblet cells in the trachea of 65.83 cells / 6 high-power fields (HPF), while the animals exposed to cadmium had 85.16 cells / 6 HPF (p = 0.012). Pulmonary emphysema occurred in 71.43 to 100% of the cases, while the non-exposed had emphysema in 6.66% to 15.38% of the cases (p <0.001). The respiratory tract is a target for cadmium-related deficits after intake; however, the pH of the water did not influence the development of these lesions. / O cádmio é um metal muito utilizado na indústria. A exposição ao cádmio pode desenvolver uma variedade de doenças pulmonares. Não há na literatura avaliação do dano traqueal ou mesmo se a ingestão de cádmio pode também provocar danos ao trato respiratório. O objetivo do estudo é investigar as alterações histopatológicas causadas por intoxicação por cádmio via ingestão no trato respiratório e os possíveis efeitos do pH da água na gênese destas alterações. Utilizaram-se 90 ratos Wistar, divididos em 6 grupos (n=15): A – solução de cloreto de cádmio (CdCl2 - 400mg/L) na água de beber com pH 7,0; B – CdCl2 (400mg/L) na água de beber com pH 5,0; C – CdCl2 (400mg/L) na água com pH 8,0. D – água com pH 5,0; E – água com pH 8,0; F – água com pH 7,0. Todos os animais foram eutanasiados após 6 meses após o início do experimento. Retiraram-se fragmentos do pulmão e traquéia. A análise histopatológica foi realizada para avaliar presença ou não dos seguintes parâmetros: 1. Traquéia: infiltrado inflamatório e tipo de célula inflamatória; congestão tecidual; hipertrofia da musculatura; lesões não neoplásicas da mucosa; lesões displásicas; lesões neoplásicas benignas e malignas; tipo de muco (ácido ou básico); e o número de células caliciformes; 2. Pulmão: infiltrado inflamatório intersticial, tipo de célula inflamatória e localização; congestão tecidual; fibrose intersticial; enfisema; necrose do parênquima; lesões displásicas e presença de lesões neoplásicas benignas e malignas. Observou-se que os animais expostos ao cádmio apresentarem média de células caliciformes na traquéia de 65,83 células/6 campos de grande aumento (CGA), enquanto que os animais não expostos apresentaram 85,16 células/6CGA (p=0,012). Enfisema pulmonar ocorreu em 71,43 a 100% dos casos, enquanto os não expostos apresentaram enfisema em 6,66 a 15,38% dos casos (p<0,001). Concluiu-se que o trato respiratório é alvo do cádmio também na intoxicação via ingestão, porém o pH da água não influenciou no desenvolvimento das lesões.

Development of mortality from malignant neoplasm of bronchus and lung in the Czech Republic Abstract Malignant neoplasm of bronchus and lung is one of the most common causes of death in the Czech Republic and this diploma thesis aims to evaluate and describe the development of mortality from this disease since the mid-nineties to the present time in the Czech Republic compared to other European countries and on district level. The main goal of this thesis is to analyze the indicators evaluating the structure and intensity of mortality on this common cause of death. The theoretical part describes the selected disease, all the important risk factors, possibilities of prevention, diagnosis, treatment and prognosis of the disease. There are some other theoretical concepts described especially the tobacco epidemic, as smoking is without a doubt the most important risk factor for this disease. Throughout the study period, mortality rates have been converging in the Czech Republic and other selected European countries for malignant neoplasm of bronchus and lung by sex when mortality has decreased significantly for men population, while for women it is slightly increasing. Keywords: mortality, cause of death, malignant neoplasm, bronchus, lung, Czech Republic

The nuclear matrix (NM) is a fibrogranular network of ribonucleoproteins upon which transcriptional complexes and regulatory genomic sequences are organized. A hallmark of cancer is the disorganization of nuclear architecture; however, the extent to which the NM is involved in malignancy is not well studied. The RUNX1 and RUNX2 proteins form complexes within the NM to promote hematopoiesis and osteoblastogenesis, respectively at the transcriptional level. RUNX1 and RUNX2 are both expressed in breast cancer cells (BrCCs); however, their genome-wide BrCC functions are unknown. RUNX1 and RUNX2 activate many tumor suppressor pathways in blood and bone lineages, respectively, including attenuation of protein synthesis and cell growth via suppression of ribosomal RNA (rRNA) transcription, which appears contrary to Runx-expression in highly proliferative BrCCs. To define roles for RUNX1 and RUNX2 in BrCC phenotype, we examined the involvement of RUNX1 and RUNX2 in rRNA transcription and generated a genome-wide model for RUNX1 and RUNX2-binding and transcriptional regulation. To validate gene expression patterns identified in our screen, we developed a Real-Time qPCR primer design program, which allows rapid, high-throughput design of primer pairs (FoxPrimer). In BrCCs, RUNX1 and RUNX2 regulate genes that promote invasiveness and do not affect rRNA transcription, protein synthesis, or cell growth. We have characterized in vitro functions of Runx proteins in BrCCs; however, the relationships between Runx expression and diagnostic/prognostic markers of breast cancer (BrCa) in patients are not well studied. Immunohistochemical detection of RUNX1 and RUNX2 in BrCa tissue microarrays reveals RUNX1 expression is associated with early, smaller tumors that are ER+ (estrogen receptor), HER2+, p53-, and correlated with androgen receptor (AR) expression; RUNX2 expression is associated with late-stage, larger tumors that are HER2+. These results show that the functions and expression patterns of NM-associated RUNX1 and RUNX2 are context-sensitive, which suggests potential disease-specific roles. Two functionally disparate genomic sequence types bind to the NM: matrix associated regions (MARs) are functionally associated with transcriptional repression and scaffold associated regions (SARs) are functionally associated with actively expressed genes. It is unknown whether malignant nuclear disorganization affects the functions of MARs/SARs in BrCC. We have refined a method to isolate nuclear matrix associated DNA (NM-DNA) from a structurally preserved NM and applied this protocol to normal mammary epithelial cells and BrCCs. To define transcriptional functions for NM-DNA, we developed a computational algorithm (PeaksToGenes), which statistically tests the associations of experimentally-defined NM-DNA regions and ChIP-seq-defined positional enrichment of several histone marks with transcriptome-wide gene expression data. In normal mammary epithelial cells, NM-DNA is enriched in both MARs and SARs, and the positional enrichment patterns of MARs and SARs are strongly associated with gene expression patterns, suggesting functional roles. In contrast, the BrCCs are significantly enriched in the silencing mark H3K27me3, and the NM-DNA is enriched in MARs and depleted of SARs. The MARs/SARs in the BrCCs are only weakly associated with gene expression patterns, suggesting that loss of normal DNA-matrix associations accompanies the disease state. Our results show that structural preservation of the in situ NM allows isolation of both MARs and SARs, and further demonstrate that in a disorganized, cancerous nucleus, normal transcriptional functions of NM-DNA are disrupted. Our studies on nuclear organization in BrCC, show that the disorganized phenotype of the cancer cell nucleus is accompanied by deregulated transcriptional functions of two constituents of the NM. These results reinforce the role of the NM as an important structure-function component of gene expression regulation.

MicroRNAs (miRNAs) represent a class of small noncoding RNAs that regulate gene expression. Recent studies have shown that miRNAs are mis-expressed in various human cancers and that some miRNAs have the potential to act as tumor suppressors or oncogenes. MiR-10b is one miRNA that has been shown to be deregulated in breast cancer. However, current findings regarding miR-10b’s role in breast cancer are controversial. MiR-10b was originally reported to be downregulated in breast cancer compared to normal breast tissue. Subsequently, miR-10b was argued to be upregulated in metastatic breast cancer cell lines, acting as a potent pro-metastatic agent via regulation of HOXD10. This report was soon challenged by another group who reported that miR-10b expression in a large patient cohort correlated inversely and significantly with tumor size, grade, and vascular invasion, but did not correlate with development of distant metastases or survival. These latter data suggest that miR-10b may impede specific functions associated with breast cancer progression. In this thesis, I present my analysis of miR-10b function in breast carcinoma cells, which revealed that it suppresses their migration and invasion. To define a mechanism that accounts for this suppressive function, I identified T-lymphoma invasion and metastasis 1 (TIAM1), a guanine nucleotide exchange factor for Rac1, as a miR-10b target and demonstrated that miR-10b inhibits TIAM1-dependent Rac1 activation, migration, and invasion. In addition, I identified the VEGF receptor fms-related tyrosine kinase 1 (FLT-1) as a second target of miR-10b and discovered a novel function for FLT-1 in promoting breast carcinoma cell migration and invasion. My results show, for the first time, that Rac activation can be regulated by a specific miRNA and provide a novel mechanism for the regulation of TIAM1 and FLT-1 in breast cancer. These data support the conclusion from clinical data that miR-10b expression correlates inversely with breast cancer progression, and suggest that miR-10b functions to impede breast carcinoma progression by regulating key target genes involved in cell motility.