O carcinoma de cabeça e pescoço é uma neoplasia maligna de origem epitelial que resulta em aproximadamente 500.000 novos casos por ano ao redor do mundo. Diversos estudos têm sido conduzidos de maneira a elucidar os mecanismos de proliferação e invasão desta doença, sendo a via de sinalização Akt/mTOR e proteínas relacionadas, apontada como uma das principais vias envolvidas em sua progressão. Sabe-se que células neoplásicas, bem como células de diferentes tecidos, podem ter seu comportamento modificado após terem sido irradiadas com laser em baixa intensidade (LLLT). Porém, os mecanismos de atuação da luz laser de baixa potência sobre estas células permanecem ainda não completamente esclarecidos. Portanto, o objetivo deste estudo foi o de analisar a viabilidade celular e expressão das proteínas Akt, pAkt, Hsp90, S6, pS6 e Ciclina D1 em duas linhagens celulares de carcinoma de boca (SCC9 e SCC25), bem como em uma linhagem de queratinócitos orais humanos com displasia (DOK) após irradiação com laser em baixa intensidade. O laser utilizado foi um diodo semicondutor de arseneto de Gálio e Alumínio (GaAlAs) operando nos comprimentos de onda vermelho (660nm) e infravermelho (780nm), com potência fixa em 40mW e três densidades de energia para cada comprimento de onda disponível: 2.05J/cm², 3.07J/cm² e 6.15J/cm². A análise de apoptose foi realizada por meio do teste de TUNEL e a expressão proteica foi obtida com imunofluorescência e western blotting. Após análise estatística por meio do método ANOVA dois critérios e testes de Tukey ou teste T de estudante, todos com nível de significância de 5%, pôde-se concluir que a LLLT induziu comportamentos distintos em cada uma das linhagens celulares utilizadas. Foi notado aumento, bem como diminuição da viabilidade celular, dependendo do comprimento de onda utilizado e das células irradiadas. A densidade de energia de 2.05J/cm² foi a que produziu efeitos mais significativos em SCC9. Para a linhagem celular SCC25, a dose mais relevante foi a de 3.07J/cm², enquanto que para a linhagem DOK, a dose de 6.15J/cm² causou efeitos mais proeminentes. Estas respectivas doses foram escolhidas para cada uma das linhagens para dar continuidade aos experimentos de Western Blotting e Imunofluorescência. Dentre os resultados mais relevantes obtidos com estas técnicas, pode-se citar a variação dos níveis de pS6 e Ciclina D1 para a linhagem DOK em determinados períodos. Já a linhagem SCC9 apresentou variação dos níveis de pAkt e Ciclina D1 nos períodos estudados. A linhagem SCC25 também teve as expressões de pAkt, pS6 e Ciclina D1 modificadas por LLLT. De maneira interessante, o aparecimento ou manutenção de uma isoforma de Hsp90 foi encontrado em SCC9 e SCC25 após irradiação laser. Por fim, a indução de apoptose foi detectada na linhagem SCC25. Em conclusão, pode-se dizer que a LLLT, como empregada neste estudo, foi capaz de aumentar a expressão de proteínas relacionadas à progressão e invasão em todas as linhagens estudadas. Além disso, a irradiação laser foi única, apesar de ter causado efeitos prolongados, algumas vezes até o último período estudado. / Head and neck squamous cell carcinoma (HNSCC) is an epithelial malignant neoplasm that accounts for approximately 500.000 new cases yearly around the world. Several studies have been conducted to elucidate the mechanisms of proliferation and invasion of this lesion, whereas the Akt/mTOR signaling pathway with its related proteins is being pointed out as one of the main pathways involved in HNSCC`s progression. Neoplastic cells, as well as cells that originate from different tissues may have their behavior modified by low level laser therapy (LLLT); however, the mechanisms through which the low level laser light interacts with these cells remain poorly understood. Thus, this study sought to evaluate the cell viability and the expression levels of Akt, pAkt, Hsp90, S6, pS6 and Cyclin D1 proteins in two oral squamous cell carcinoma cell lineages (SCC9 and SCC25) and in one oral dysplastic human keratinocyte cell line (DOK) after they had been treated with LLLT. The laser device was a semiconductor diode of Gallium and Aluminum Arsenate (GaAlAs), operating with wavelengths of 660nm (red) and 780nm (infrared), with a fixed power of 40mW and giving three different energy densities: 2.05J/cm², 3.07J/cm² and 6.15J/cm². Apoptosis was analyzed through TUNEL test and the protein expression was accessed with Immunofluorescence and Western blotting. After statistical analysis through two-way ANOVA and Tukey or Student`s T test, all of them with a level of significance of 5%, it was concluded that LLLT induced distinct behaviors to each of the studied cell lines. Increases and inhibitions in cell viabilities were detected depending on the wavelength and also on the irradiated cell line. The energy density of 2.05J/cm² produced the most significant findings over SCC9. On the other hand, in SCC25 the most relevant results were detected with 3.07J/cm², while the most prominent findings were seen with 6.15J/cm² when the cell line DOK was evaluated. In that way, these respective doses were chosen for each cell line to continue with Western blotting and Immunofluorescence. Among the most relevant findings, the variation of pS6 and Cyclin D1 levels can be cited for DOK in some evaluated periods. SCC9 presented both pAkt and Cyclin D1 variations in the studied periods. Besides that, SCC25 also had pAkt, pS6 and Cyclin D1 levels modified by LLLT. Interestingly, the appearance and maintenance of an Hsp90 isoform was found in SCC9 and SCC25 after laser irradiation. Moreover, the induction of apoptosis was detected for the SCC25 cell line. Finally, the LLLT employed herein was able to enhance the expression of proteins related to progression and invasion in all of the studied cell lines. In addition, there was a single laser irradiation, although it caused prolonged effects, sometimes through the latest evaluated period.

Les tumeurs épithéliales thymiques (TET) humaines sont rares (250 - 300 cas/an en France). On distingue les thymomes de type A, AB ou B d'évolution lente avec une survie actuarielle > 95% à 5 ans pour les stades précoces et les carcinomes thymiques d'évolution plus sévère avec une survie actuarielle à 5 ans < 20% pour les stades IV. La pierre angulaire du traitement des TET est l'exérèse chirurgicale complète, facteur pronostique le plus significatif identifié à ce jour. Les récidives des TET, essentiellement pleurales pour les thymomes et générales pour les carcinomes thymiques, sont de prise en charge complexe. Les avancées thérapeutiques sont limitées notamment par l'absence de modèles d'étude de la cellule épithéliale thymique tumorale. Dans le cadre d'une prise en charge multidisciplinaire des récidives pleurales métastatiques, nous avons développé la pleurectomie de cytoréduction associée à une chimio hyperthermie (cisplatine/ mitomycine ; 42°C) intra thoracique (CHIT) pour la prise en charge des métastases pleurales de thymome. Chez des patients sélectionnés (n=19), la médiane de survie sans récidive était de 53 mois et les survies actuarielles à 1 an et 5 ans étaient respectivement de 93% et 86%. Cette technique chirurgicale innovante a permis de développer une alternative à la morbide pleuro pneumonectomie. L'efficacité de la CHIT pose des questions sur le rôle de l'hyperthermie et sur le type de chimiothérapie à associer. Avec pour objectif d'améliorer la prise en charge des patients, la connaissance de la biologie tumorale thymique et l'identification de potentielles cibles thérapeutiques sont des voies de recherche importantes pour améliorer la survie des patients. Nous avons développé des cultures de cellules épithéliales thymiques dérivées in vitro de 12 TET (11 thymomes A, AB ou B et un carcinome thymique), caractérisées par leur potentiel prolifératif et leur expression de cytokératine. La voie PI3K / Akt / mTOR joue un rôle clé dans de nombreux cancers ; plusieurs études de phases I / II ont rapporté un effet positif des inhibiteurs de mTOR pour le contrôle de l'évolution du thymome chez les patients. Nous avons mis en évidence l'expression et l'activation des effecteurs mTOR, Akt et P70S6K dans les thymomes et dans les cellules épithéliales thymiques dérivées in vitro. Nous avons montré l'efficacité de la rapamycine, inhibiteur de mTOR, à réduire la prolifération cellulaire (30%) sans induire de mort cellulaire. Nos résultats suggèrent que l'activation de la voie Akt / mTOR participe à la prolifération cellulaire associée à la croissance tumorale. Nous avons établi un nouvel outil permettant l'étude de la dérégulation cellulaire au cours des thymomes. Dans un contexte de tumeurs rares, ces cellules permettront d'aborder des études mécanistiques in vitro et de tester l'efficacité de drogues anti tumorales / Human thymic epithelial tumors (TETs) are rare (250 – 300 cases/ year in France). We distinguish thymomas (A, AB and B subtypes) with indolent evolution (5 years actuarial survival in early stages >95%) and more aggressive thymic carcinomas (5 years actuarial survival <20% in stage IV). Surgical complete resection when feasible is the corner stone of a multimodal therapy and the most significant factor on survival. Relapse of TETs principally in pleura for thymomas (75%) and general for thymic carcinomas are difficult to treat. Therapeutics advances are limited given the lack of studies models of tumoral thymic epithelial cell. In a multidisciplinary approach for the treatment of metastatic pleural relapse of thymomas we developed an innovative surgical technique: cytoreductive pleurectomy associated with hyper thermic intra pleural chemotherapy (Cysplatin/ Mitomycin; 42°C) (ITCH). In selected patient (n=19), ITCH provides an efficient alternative to the morbid pleuro pneumonectomy. The median of free disease survival was 53 months, one year and five years actuarial survival were respectively 93% and 86%. However, the effectiveness of ITCH procedure questions on the played role ok hyperthermia, on the choice of chemotherapy association. With the aim to improve TETs therapies, the knowledge of TETs biology to identify potential target therapies is currently challenging. We developed an in vitro study model of tumoral thymic epithelial cells derived from 12 TETs (11 A, AB and B thymomas and one thymic carcinoma) characterized by their proliferative abilities and the cytokeratin expression. The PIK3 / Akt / mTOR pathway is implicated in numerous cancers. Several phase I, II studies advocate the potential role of mTOR inhibitors in the control of the metastatic disease. We highlighted the expression and the activation of mTOR, Akt and P70S6K effectors in TETs and in thymic epithelial cells in vitro derived. We showed the efficacy of rapamycin (mTOR inhibitor) in the inhibition (-30%) of in vitro cell proliferation without cell death induction. Our results suggest the implication of the PIK3 / Akt / mTOR pathway in the tumoral cell growth. We established a new tool to study cell dysregulation in TETs. In the context of rare tumors, these cells could allow in vitro mechanistic studies and test the efficacy of new anti tumoral therapies

Hepatocellular carcinoma (HCC) is the second most common cause of cancerrelated mortality worldwide. AKT pathway has been found activated in 50% of HCC cases, making it promising target. Therefore we assess efficacy of the allosteric AKT inhibitor or the combination of Sorafenib with AKT inhibitor compared to untreated control and to standard treatment, Sorafenib, in vitro and in vivo. AKT inhibitor blocked phosphorylation of AKT in vitro and strongly inhibited cell growth with significantly higher potency than Sorafenib. Similarly, apoptosis and cell migration were strongly reduced by AKT inhibitor in vitro. To mimic human advanced HCC, we used diethylnitrosamine-induced cirrhotic rat model with fully developed HCC. MRI analyses showed that AKT inhibitor significantly reduced overall tumor size. Furthermore, number of tumors was decreased by AKT inhibitor, which was associated with increased apoptosis and decreased proliferation. Tumor contrast enhancement was significantly decreased in the AKT inhibitor group. Moreover, on tumor tissue sections, we observed a vascular normalization and a significant decrease in fibrosis in surrounding liver of animals treated with AKT inhibitor. Finally, pAKT/AKT levels in AKT inhibitor treated tumors were reduced, followed by down regulation of actors of AKT downstream signalling pathway: pmTOR, pPRAS40, pPLCγ1 and pS6K1. In conclusion, we demonstrated that AKT inhibitor blocks AKT phosphorylation in vitro and in vivo. In HCC-rat model, AKT inhibitor was well tolerated, showed anti-fibrotic effect and had stronger antitumor effect than Sorafenib. Our results confirm the importance of targeting AKT in HCC. / Hepatocellular carcinoma (HCC) is the second most common cause of cancerrelated mortality worldwide. AKT pathway has been found activated in 50% of HCC cases, making it promising target. Therefore we assess efficacy of the allosteric AKT inhibitor or the combination of Sorafenib with AKT inhibitor compared to untreated control and to standard treatment, Sorafenib, in vitro and in vivo. AKT inhibitor blocked phosphorylation of AKT in vitro and strongly inhibited cell growth with significantly higher potency than Sorafenib. Similarly, apoptosis and cell migration were strongly reduced by AKT inhibitor in vitro. To mimic human advanced HCC, we used diethylnitrosamine-induced cirrhotic rat model with fully developed HCC. MRI analyses showed that AKT inhibitor significantly reduced overall tumor size. Furthermore, number of tumors was decreased by AKT inhibitor, which was associated with increased apoptosis and decreased proliferation. Tumor contrast enhancement was significantly decreased in the AKT inhibitor group. Moreover, on tumor tissue sections, we observed a vascular normalization and a significant decrease in fibrosis in surrounding liver of animals treated with AKT inhibitor. Finally, pAKT/AKT levels in AKT inhibitor treated tumors were reduced, followed by down regulation of actors of AKT downstream signalling pathway: pmTOR, pPRAS40, pPLCγ1 and pS6K1. In conclusion, we demonstrated that AKT inhibitor blocks AKT phosphorylation in vitro and in vivo. In HCC-rat model, AKT inhibitor was well tolerated, showed anti-fibrotic effect and had stronger antitumor effect than Sorafenib. Our results confirm the importance of targeting AKT in HCC.

Les accidents vasculaires cérébraux (AVC) sont considérés comme la pathologie neurologique la plus sévère en termes de mortalité et d’infirmité. Ils touchent plus de 140 000 personnes chaque année. L’AVC ischémique, qui représente 80% des AVC, est causé par l’occlusion localisée d’un vaisseau conduisant à un arrêt de l’apport en oxygène et en glucose au cerveau. Il est ainsi responsable de déficits moteurs, sensitifs et cognitifs qui peuvent gravement compromettre l’autonomie et la qualité de vie des patients. Les patients qui ont subi un AVC ischémique développent notamment une atrophie musculaire qui se produit principalement dans le membre parétique, mais aussi dans une moindre mesure dans le membre non parétique. Toutefois, les mécanismes moléculaires à l’origine de cette atrophie musculaire sont méconnus. Dans une première étude, l’objectif a été d’identifier les déterminants moléculaires mis en jeu dans l’atrophie musculaire induite par une ischémie cérébrale. Pour répondre à cet objectif, les travaux ont été menés sur un modèle d'ischémie cérébrale chez la souris qui consiste en l’occlusion de l'artère cérébrale moyenne par un monofilament en nylon. Nous avons montré que l’ischémie cérébrale entraînait, 3 jours après son induction, une atrophie musculaire des muscles quadriceps, soleus et tibialis anterior du côté parétique. Cette atrophie musculaire était associée à des déficits moteurs touchant l’équilibre, la coordination, la force musculaire, la posture ou la marche. Au niveau moléculaire, nous avons reporté un déséquilibre de la balance entre la synthèse et la dégradation des protéines musculaires en faveur d’une augmentation de la dégradation dans les muscles parétique et non parétique des souris ischémiées. Nous avons notamment montré que l’expression de la myostatine, un régulateur négatif majeur de la masse musculaire, était significativement augmentée. Dans une seconde étude, l’objectif a été d’identifier une cible d’intervention thérapeutique pour préserver la masse musculaire suite à une ischémie cérébrale. Au vu des résultats obtenus dans la première étude, nous avons ciblé la myostatine. Nous avons montré que l’inhibition de la myostatine entraînait, une meilleure récupération du poids de corps et du poids de divers muscles, 15 jours après une ischémie cérébrale. De plus, l’inhibition de la myostatine tendait à améliorer le comportement moteur des souris ischémiées (équilibre, coordination, force musculaire). En revanche, nous n’avons reporté aucune variation majeure des niveaux en ARNm ou protéines d’acteurs impliqués dans les voies de signalisation Akt/mTOR, Smad2/3, ubiquitine-protéasome et autophagie-lysosome, 15 jours après une ischémie cérébrale. Ces données préliminaires suggèrent que l’inhibition pharmacologique de la myostatine pourrait représenter une stratégie thérapeutique efficace pour limiter la perte de masse musculaire suite à une ischémie cérébrale / Strokes are considered as the most severe neurological disease in terms of mortality and disability. The incidence of stroke in France is estimated at 140 000. Ischemic stroke, which represents about 80% of strokes occur as a result of an obstruction of a blood vessel supplying blood to the brain. Motor, cognitive and sensory deficits are common impacts of stroke and can seriously compromise the autonomy and patient quality of life. Ischemic stroke leads to muscle atrophy, wich occurs primarily in the paretic limb, but also to a lesser extent in the nonparetic limb. However, the molecular mechanisms of muscle atrophy is unknown. In a first study, the purpose was to identify the molecular determinants involved in skeletal muscle atrophy following cerebral ischemia. To meet this objective, the work was carried out on a mouse model of cerebral ischemia, which involves the occlusion of the middle cerebral artery (MCAO) with a nylon monofilament. We have shown that cerebral ischemia leads to skeletal muscle atrophy of quadriceps, soleus and tibialis anterior muscles of the paretic side, 3 days after MCAO. This muscular atrophy was associated with motor deficits in the balance, coordination, muscle strength, posture and walking. From a molecular point of view, we reported an imbalance between the rates of synthesis and degradation of muscle protein, in favour of protein degradation in both paretic and nonparetic muscles. In particular, we showed that the expression of myostatin, a master negative regulator of skeletal muscle mass was significantly increased. In a second study, the purpose was to identify a target for therapeutic intervention in order to maintain muscle mass following cerebral ischemia. In view of the results obtained in the first study, we targeted the myostatin. Our results show that myostatin inhibition increases body weight and muscle mass recovery, 15 days after cerebral ischemia. In addition, myostatin inhibition tends to improve motor behavior (balance, coordination, strength). From a molecular point of view, we reported no major change in mRNA or protein level of actors involved in Akt/mTOR, Smad2/3, autophagy-lysosome and ubiquitin-proteasome pathways, involved in the control of muscle mass, 15 days after cerebral ischemia. These preliminary results strongly suggest that pharmacological inhibitors of myostatin may provide significant therapeutic benefit for muscle atrophy following cerebral ischemia

A insuficiência cardíaca (IC) é a via final comum da maioria das cardiomiopatias e outras doenças do aparelho circulatório. Considerando a prevalência crescente e a morbimortalidade associada representa um importante problema de saúde pública. Em quadros mais avançados, além do comprometimento funcional, portadores de IC apresentam perda de massa muscular excessiva que pode culminar em caquexia cardíaca; condição que contribui para o mau prognóstico e a mortalidade aumentadas. A massa muscular é regulada pelo balanço entre estímulos anabólicos e catabólicos. A quinase Akt vêm sendo considerando uma importante quinase na regulação do crescimento muscular por controlar o anabolismo proteico. Dessa forma, ativadores da Akt (IGF-I e insulina), bem como proteínas alvo da sinalização da Akt (mTOR e GSK3) são importantes mediadores na manutenção da massa muscular e podem ser regulados por estímulos metabólicos, nutricionais e mecânicos. Assim, o objetivo desse estudo foi avaliar a contribuição da via de sinalização IGF-I/Akt/mTOR na atrofia muscular desencadeada pela IC tanto em humanos quanto em modelo experimental, bem como o efeito do treinamento físico aeróbico (TFA). Nossos resultados demonstraram que em biópsias do vasto lateral de pacientes portadores de IC classe II houve redução na expressão de mRNA de todas as isoformas de IGF-I e na expressão das proteínas IGFBP-3, Akt1, GSK3, pGSK3Ser9, mTOR e tendência a redução na pmTORSer2448 (p=0,08) e aumento na pAMPKThr172. Esses resultados foram acompanhados pela redução no VO2 pico desses pacientes. O TFA de 12 semanas levou a um aumento não significativo na expressão de mRNA da isoforma IGF-I Ea (p=0,07) e IGF-I PAM (p=0,06). Também observou-se aumento na pAMPKThr172 e tendência a aumento na Akt1 (p=0,07) e mTOR (p=0,06). Em modelo experimental de IC, no músculo sóleo observou-se redução na expressão das proteínas IGF-I, PI3K, pAktSer473,pGSK3Ser9 e aumento da pAMPKThr172. O TFA de 8 semanas promoveu aumento na expressão do mRNA das isoformas de IGF-I Ea, Eb e IGF-I PAM, bem como na expressão das proteínas IGFI, PI3K, pAktSer473, pmTORSer2448 e redução na pAMPKThr172. O conjunto de alterações promovido pelo TFA foi associado à maior tolerância ao esforço físico e ganho no desempenho motor em Rota Rod, além de prevenir a atrofia muscular. Quando esses animais foram tratados com rapamicina, um inibidor farmacológico da mTOR, o efeito do TFA na prevenção da atrofia muscular foi abolido. Juntos, esses resultados apoiam a hipótese de que a via de sinalização IGF-I/Akt/mTOR está envolvida no reestabelecimento muscular na IC induzida pelo TFA / Heart failure (HF) is a common ultimate consequence for the most cardiomyopathies and other diseases from circulatory system. Due its growing prevalence and morbimortality is an important public-health problem. In more advanced cases, besides functional impairment, HF patients present an excessive skeletal muscle loss which can lead to cardiac cachexia; a condition associated to a poor prognostic and increased mortality. Skeletal muscle mass is regulated by the balance between anabolic and catabolic stimuli. Akt kinase, although involved with the protein synthesis pathway, is able to regulates the skeletal muscle growth via anabolism and catabolism control. An importante role in the skeletal muscle growing has been attributed to the Akt kinase due its ability to control protein synthesis. Thus, activators (IGF-I and insulin) as well as target proteins in the Akt signaling pathway (mTOR and GSK3) are important mediators in the skeletal muscle mass homeostasis being regulated by anabolic, nutritional and mechanic stimuli. Therefore, the aim of the presente study was to evaluate the contribution of IGF-I/Akt/mTOR contribution to the muscle atrophy induced by HF in humans and mice. Additionally, the effect of aerobic exercise training were evaluated. Our data demonstrated that in biopsies obtained in the vastus lateral from class II IC patients occurred a reduction in the expression of all the forms of IGF investigated and in the expression of proteins such as IGFBP-3, Akt1, GSK3, pGSK3Ser9, mTOR, and tendency to reduce pmTORSer2448 (p=0.08) and to increase pAMPKThr172. These results were accompained by the reduction of peak VO2 in these patients. Twelve weeks of aerobic exercise training promoted a non-significant increase in the expression of the IGF-I Ea (p=0.07) and IGF-I PAM (p=0.06) mRNA expression. Moreover, it was observed an increase to pAMPKThr172, and tendency of increase for Akt1 (p=0.07) and mTOR (p=0.06) mRNA expression. In a experimental model of IC, it was observed a reduction in the expression of IGF I, PI3K, pAktSer473, pGSK3Ser9 and increase of pAMPKThr172. Eight weeks of aerobic exercise training increased the mRNA of IGF-I Ea, Eb and IGF-I PAM isoforms, as well as in the expression of IGF-I, PI3K, pAktSer473, pmTORSer2448 and pAMPKThr172 reduction. The changes induced by aerobic exercise training were associated with a higher tolerance to exercise and motor performance in rota rod besides prevent muscular atrophy. When treated with a inhibitor of mTOR, rapamycin, the adaptations induced by aerobic exercise training were blunted, supporting the hypothesis that the IGF-I/Akt/mTOR signaling pathway is involved in the recovering of muscle mass induced by physical training

Bcl-xL et Mcl-1 sont deux protéines anti-apoptotiques de la famille Bcl-2 dont dépendent les cancers de l’ovaire pour leur survie, leur inhibition semble donc être une stratégie pertinente. La molécule BH3-mimétique ABT 737 (ou son analogue oral, l’ABT-263), est un puissant inhibiteur de Bcl-xL mais l’inhibition de Mcl-1 reste problématique. Les voies de signalisation PI3K/Akt/mTOR et MAPK/ERK régulent l’expression et l’activité de cette dernière protéine et de ses partenaires BH3-only (Bim, Puma, Noxa). Nous nous sommes donc intéressés à l’intérêt de leur inhibition pour sensibiliser les cellules cancéreuses ovariennes à l’ABT-737. La première étude menée avec le BEZ235, double inhibiteur PI3K/mTOR développé par le laboratoire Novartis, montre qu’il inhibe l’expression de Mcl-1 et induit celle de Puma, et qu’il sensibilise les cellules cancéreuses ovariennes à l’ABT-737 à condition que l’expression de Bim soit également induite. La deuxième étude a évalué les effets de l’AZD8055, inhibiteur du site actif de mTOR développé par le laboratoire AstraZeneca, et du trametinib, inhibiteur allostérique de MEK développé par le laboratoire GlaxoSmithKline et actuellement en clinique, sur trois lignées cancéreuses ovariennes. L’inhibition de l’expression de Mcl-1 et l’induction de celle de Puma par l’AZD8055 ne permettent pas de diminuer suffisamment le ratio [Mcl-1/protéines BH3-only] pour sensibiliser les cellules à l’ABT-737. En revanche, la forte induction de Bim sous forme active déphosphorylée par le trametinib permet de diminuer suffisamment ce ratio pour sensibiliser deux des trois lignées testées à l’ABT-737. C’est cependant la triple combinaison AZD8055/trametinib/ABT-737 qui est la plus efficace pour induire une apoptose massive dans les trois lignées. Par ailleurs, de façon intéressante, l’association de l’AZD8055 et du trametinib est cytotoxique sans ABT 737 dans une des lignées testées. Ces résultats mettent en évidence l’efficacité de différentes stratégies thérapeutiques multi-cibles et la nécessité de définir des marqueurs prédictifs de la réponse afin d’évoluer vers un traitement personnalisé pour améliorer la prise en charge des cancers de l’ovaire. / Ovarian cancers depend on Bcl-xL and Mcl-1, two anti-apoptotic protein of the Bcl-2 family, for their survival and their inhibition seems to by a relevant strategy. The BH3-mimetic molecule ABT-737 (or its oral form, ABT-263), is a strong Bcl-xL inhibitor, but Mcl-1 inhibition remains problematic. Signaling pathways PI3K/Akt/mTOR and MAPK/ERK regulate expression and activity of Mcl-1 and its BH3-only partners (Bim, Puma, Noxa). We focused on the interest of their inhibition to sensitize ovarian cancer cells to ABT-737. The first study with BEZ235, a PI3K/mTOR dual inhibitor developed by Novartis, inhibits Mcl-1 expression and induces the one of Puma, and sensitizes ovarian cancer cells to ABT-737 provided that Bim expression is induced. The second study evaluated the effects of AZD8055, mTOR active site inhibitor developed by AstraZeneca, and of trametinib, MEK allosteric inhibitor developed by GlaxoSmithKline and currently in clinic, on three ovarian cancer cell lines. Mcl-1 expression inhibition and Puma expression induction by AZD8055 does not sufficiently reduce [Mcl-1/BH3-only proteins] ratio to sensitize cells to ABT-737. On the other hand, strong Bim induction in its active dephosphorylated form by trametinib sufficiently reduce this ratio to sensitize two of the three cell lines tested to ABT-737. Nevertheless, the triple combination AZD8055/trametinib/ABT-737 is the most efficient to induce massive apoptosis in the three cell lines. Besides, interestingly, AZD8055 and trametinib association is cytotoxic without ABT-737 in one of the tested cell lines. These results highlight the efficacy of different multi-targets therapeutic strategies and the need of predictive marker definition of the response to develop personalized treatment and to improve ovarian cancer management.

Shp-1 (Src homology 2 domain-containing phosphatase 1) est une tyrosine phosphatase retrouvée principalement chez les cellules hématopoïétiques, mais également chez les cellules épithéliales. Bien que Shp-1 soit reconnue comme étant un régulateur négatif de plusieurs voies de signalisation intracellulaire chez les cellules hématopoïétiques, son rôle dans les cellules épithéliales a été jusqu’ici très peu étudié. Afin de mieux comprendre son rôle dans les cellules épithéliales intestinales, nous avons généré un modèle murin de délétion conditionnelle de Shp-1 spécifiquement dans l’épithélium intestinal (Shp-1CEI-KO). De manière intéressante, dès l’âge de 6 semaines, les souris expérimentales présentent une intestinalomégalie associée à une légère augmentation de la prolifération cryptale. La taille des cellules épithéliales est également augmentée, suggérant de l’hypertrophie cellulaire chez les souris invalidées pour Shp-1. Parallèlement, la voie de signalisation PI3K/Akt/mTor est activée dans l’épithélium des souris mutantes. Nous avons également noté une production accrue de cellules caliciformes et de leurs précurseures, les cellules intermédiaires, en absence de Shp-1. Par contre, la maturation des cellules de Paneth semble grandement compromise vu la baisse importante d’expression du lysozyme et des RegIIIβ et RegIIIγ, de même que la faible densité de leurs granules de sécrétion. La comparaison du phénotype intestinal des souris Shp-1CEI-KO avec celui des souris PtenCEI-KO suggère que l’hyperactivation de la voie PI3K/Akt/mTor est responsable en partie des altérations phénotypiques observées chez la souris invalidée pour Shp-1. En conclusion, nos résultats montrent que la tyrosine phosphatase Shp-1 est un régulateur important de l’homéostasie de l’épithélium intestinal en contrôlant notamment la croissance cellulaire et la différenciation des cellules de la lignée sécrétrice.

Producing competent and fertilizable oocytes from in vitro grown primordial follicles could revolutionize female infertility treatment, particularly using fertility preservation approaches that use cryopreserved ovarian tissue. However, the protracted length of folliculogenesis in humans makes follicular culture complex, and the mechanisms controlling the tightly-regulated activation of primordial follicles remain largely unknown. The delicate balance between follicular recruitment and quiescence might be affected by preservation procedures, such as ovarian fragmentation or in vitro culture, that disrupt crucial pathways, such as the Hippo and PI3K/Akt/mTOR signaling pathways, that are involved in this process. When activated, these pathways induce massive recruitment of primordial follicles and accelerate follicular growth in vitro, with potential negative consequences on future oocyte developmental competence. Therefore, we hypothesized that the inhibition of the PI3K/Akt/mTOR pathway might improve follicular growth by slowing down the activation process.In the first part of this thesis, we explored the potential benefit of inhibiting PI3K/Akt/mTOR signaling on the regulation of in vitro follicular activation and growth, as well as its impact on the Hippo pathway. The effect of everolimus (EVE), a specific mTORC1 inhibitor, was compared to the PI3K/Akt activators recently used to reinitiate the growth of residual follicles in the ovarian tissue of patients with premature ovarian insufficiency. We showed that short-term incubation of ovarian cortex with EVE partially delayed follicular recruitment while supporting follicle survival and steroidogenesis. However, morphological abnormalities were observed in all conditions, suggesting that EVE failed to protect follicles from accelerated in vitro growth-related defects.Our findings also provided evidence that ovarian fragmentation, which disrupts the Hippo pathway, contributes to the triggering of primordial follicle recruitment and early development of quiescent human follicles. Moreover, our data suggested that both PI3K/Akt and Hippo signaling could act synergistically to promote follicular activation and growth.In the second part of the project, we further investigated the integrity of EVE-treated follicles based on their ultrastructural and functional status. Our observations indicate that the integrity of oocyte and granulosa cells, as well as their physical contacts, were preserved in EVE and control conditions, although some in vitro grown follicles sustained cryopreservation- and culture- induced damage. We also found that short exposure to EVE allowed the maintenance of intra-follicular communication while preserving follicular developmental potential. Importantly, results obtained suggested that, at a similar developmental stage, cell coupling and oocyte growth may be improved in EVE-treated follicles.Altogether, these data provide better insight into the regulation of the follicular activation process and emphasize the importance of getting closer to physiological conditions to preserve follicle integrity. They also provide proof-of-concept evidence that reducing the initiation of growth is feasible, and suggest that mTORC1 inhibitors are a potentially useful pharmacological tool to regulate in vitro follicular growth. / La production d'ovocytes compétents et fécondables à partir de follicules primordiaux développés in vitro pourrait révolutionner les traitements liés à l'infertilité féminine, en particulier les approches de préservation de la fertilité à partir du tissu ovarien cryopréservé. Cependant, la longue durée de la folliculogenèse chez l'Homme rend la culture folliculaire complexe, et les mécanismes contrôlant l'activation des follicules primordiaux restent largement inconnus. L’équilibre fragile entre quiescence folliculaire et entrée en croissance pourrait être affecté par la fragmentation ovarienne ou la culture in vitro elle-même, qui perturbent deux voies de signalisation cruciales: les voies Hippo et PI3K/Akt/mTOR, respectivement. Lorsqu'elles sont activées, elles induisent un recrutement massif de follicules primordiaux et accélèrent la croissance folliculaire in vitro, avec des conséquences potentiellement néfastes sur la capacité future des ovocytes à devenir compétents. Par conséquent, nous avons émis l’hypothèse que l’inhibition de la voie PI3K/Akt/mTOR pourrait améliorer la croissance folliculaire via un ralentissement du processus d’activation.Dans la première partie de cette thèse, nous avons exploré le potentiel bénéfice d’une inhibition de la voie PI3K/Akt/mTOR sur la régulation de l'activation et de la croissance folliculaire in vitro, ainsi que son impact sur la voie Hippo. L’effet de l’évérolimus (EVE), un inhibiteur spécifique de mTORC1, a été comparé à ceux d’activateurs de PI3K/Akt, récemment utilisés afin d’initier la croissance des follicules résiduels au sein de tissus ovarien de patientes en insuffisance ovarienne précoce. Nous avons montré que l'exposition à court terme de cortex ovarien à l'EVE retardait partiellement le recrutement folliculaire tout en préservant la survie et la stéroidogenèse des follicules. Toutefois, des anomalies morphologiques ont été observées dans toutes les conditions, ce qui suggère que l’EVE ne préserve pas les follicules de défauts liés à une croissance accélérée.Nos résultats ont également prouvé que la fragmentation ovarienne, en perturbant la voie Hippo, contribue au recrutement et au développement précoce des follicules primordiaux. De plus, les données obtenues suggèrent que les voies PI3K/Akt/mTOR et Hippo pourraient agir de manière synergique pour promouvoir l'activation et la croissance folliculaire.Dans la deuxième partie du projet, nous avons étudié la qualité des follicules traités avec de l’EVE en se basant sur des critères ultrastructural et fonctionnel. Nos observations ont indiqué que l'intégrité des ovocytes et des cellules de la granulosa ainsi que leurs contacts physiques était préservée dans les conditions EVE et contrôle, bien que certains follicules en croissance présentent des signes de dommages induits par la cryopréservation et la culture. Nous avons également constaté qu'une courte exposition à l’EVE permettait de maintenir les communications intra-folliculaires tout en préservant le potentiel de développement des follicules. De façon importante, les résultats obtenus suggèrent qu’à un stade de développement similaire, le couplage cellulaire et la croissance des ovocytes pourraient être améliorés dans les follicules traités à l’EVE.En conclusion, ces données contribuent à une meilleure compréhension de la régulation de l'activation folliculaire in vitro, et soulignent l'importance de mimer les conditions physiologiques pour préserver l'intégrité des follicules. Elles apportent également la preuve qu’un ralentissement de l’initiation de la croissance est réalisable, et suggèrent que l’utilisation d’inhibiteurs de mTORC1 pourrait représenter un outil pharmacologique efficace pour réguler la croissance folliculaire in vitro. / Doctorat en Sciences biomédicales et pharmaceutiques (Médecine) / info:eu-repo/semantics/nonPublished

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