Une dérégulation de la voie de signalisation Ras/Raf/MEK/ERK1/2 est observée dans plus de 30% des cancers et des mutations activatrices de RAS sont observées dans 30% à 50% des adénomes colorectaux. À la suite d’une analyse extensive de biopsies de tumeurs colorectales humaines par micromatrices tissulaires (TMA), nous avons observé que 44% des tissus cancéreux exprimaient MEK1/2 phosphorylés, contre 10% des tissus normaux. L'analyse des TMA a également révélé que 79% des tumeurs arboraient un marquage nucléaire de MEK1/2 phosphorylés, contre 4 % pour les tissus normaux. Bien que la voie MEK/ERK1/2 soit fréquemment activée dans les cancers, le rôle précis des isoformes de MEK1 et de MEK2 n'a jamais été clairement établie. De même, l'impact de cette localisation nucléaire aberrante de phospho-MEK1/2, dans l'initiation et la progression des cancers colorectaux, est inconnu. Lors d'un premier projet, nous avons démontré, que l’expression de MEK1 ou MEK2 activé est suffisante pour transformer in vitro des cellules intestinales épithéliales de rat (IEC-6). L'expression des mutants actifs de MEK1 ou MEK2 est suffisante pour induire une dérégulation de la prolifération cellulaire et engendrer la formation d'adénocarcinomes invasifs dans un modèle de greffe orthotopique du côlon chez la souris. Nous avons également démontré que l'inhibition de MEK2 par shRNA supprime complètement la prolifération des lignées humaines de cancer du côlon, alors que la suppression de MEK1 a peu d'effet sur la capacité de prolifération. Le deuxième projet, nous a permis d'observer que l'expression d'un mutant nucléaire de MEK1 dans les cellules IEC-6 transforme drastiquement les cellules. Une augmentation de prolifération, une résistance à l'anoikose, un dérèglement du cycle cellulaire, de l'instabilité chromosomique (CIN), de la tétra/aneuploïdie sont observés. La caractérisation des mécanismes responsables de cette localisation aberrante de MEK1/2 phosphorylés, a permis d'identifier la protéine Sef, un régulateur de la localisation cytoplasmique de MEK/ERK1/2. Nous avons démontré que l'expression d'une forme oncogénique de Ras (H-RasV12) inhibe l'expression de Sef, engendrant alors une accumulation nucléaire de MEK1/2 activés. Plus encore, la réexpression de Sef restaure la localisation cytoplasmique de MEK1/2 et renverse les propriétés tumorigéniques ainsi que l'aneuploïdie induite par Ras activé. Un troisième projet, visant la caractérisation des mécanismes associés à la CIN et à l'aneuploïde engendrés par l'activation aberrante de la voie de Ras-ERK1/2, a permis d'observer que l'hyperactivation de ERK1/2 induit des anomalies mitotiques menant à la binucléation. Une localisation erronée et une surexpression de la kinase Aurora A, de même que des protéines de passage du complexe chromosomique (CPC), Aurora B, Survivine et INCENP, sont observées. L'inhibition partielle de l'activation de ERK1/2 par de faible dose de PD184352, un inhibiteur de MEK1/2, est suffisante pour renverser la surexpression de ces régulateurs mitotiques, de même que corriger les anomalies de la mitose et réduire la tétra/aneuploïdie engendrée par Ras oncogénique. Ainsi, nous avons démontré, pour la première fois, que la voie des MAP kinases ERK1/2 est impliquée dans la CIN, la tétraploïdie et l'aneuploïdie. Nos résultats suggèrent que la perte de Sef est un événement oncogénique précoce, qui contribue à la localisation nucléaire aberrante de MEK1/2 qui est observée dans les tumeurs colorectales. Cette localisation anormale de MEK1/2 est associée à l'initiation de la transformation, la progression tumorale et la CIN, via l'activité soutenue de ERK1/2. Ces informations sont capitales et démontrent l’importance de la voie de signalisation Ras/Raf/MEK/ERK1/2 dans le processus de tumorigénèse colorectale. / The Ras-dependent Raf/MEK/ERK1/2 signaling pathway is frequently hyperactivated in human cancer as a result of receptor tyrosine kinase overexpression or gain-of-function mutations in RAS or RAF genes. More specificaly, activating mutation in RAS genes are found in ~ 30-50% of colorectal adenomas and phosphorylation of ERK1/2 is frequently observed in human colorectal cancer cells and tumor specimens. In a large TMA analysis, we found that MEK1/MEK2 are aberrantly activated in 44% of human colorectal cancers. In addition, our analysis revealed that 79% of colorectal cancers exhibit aberrant phospho-MEK1/2 staining in the nucleus, as compared to 4% of normal tissue. How dysregulation and mislocalization of MEK1/2 contribute to tumor initiation and progression is not well understood. In order to determine the exact contribution of MEK1 and MEK2 to the pathogenesis of colorectal cancer, wild type and constitutively active forms of MEK1 and MEK2 were ectopically expressed by retroviral gene transfer in the normal intestinal epithelial cell line IEC-6. We found that the expression of activated MEK1 or MEK2 is sufficient to morphologically transform intestinal epithelial cells, dysregulate cell proliferation and induce the formation of high-grade adenocarcinomas after orthotopic transplantation in mice. A large proportion of these intestinal tumors metastasize to the liver and lung. Importantly, we show that silencing of MEK2 expression completely suppresses the proliferation of human colon carcinoma cell lines, whereas inactivation of MEK1 has a much weaker effect. In a second project, we have investigated the impact of the nuclear mislocalization of phosphorylated MEK1/2 observed in colorectal tumors. We show that oncogenic activation of Ras is sufficient to induce the nuclear accumulation of phosphorylated MEK1/2 and ERK1/2 in intestinal epithelial cells. To evaluate the biological impact of the mislocalization of MEK1/2, we have forced the localization of MEK1 in the nucleus of epithelial cells. We found that sustained nuclear MEK1 signaling leads to hyperactivation of ERK1/2 and to enhanced cell proliferation. Nuclear localization of MEK1 also leads to tetraploidization, chromosomal instability (CIN) and tumorigenesis. Importantly, we show that oncogenic Ras downregulates the spatial regulator Sef, concomitant to nuclear accumulation of activated MEK1/2. Moreover, re-expression of Sef is sufficient to restore the normal localization of MEK1/2 and to revert the cell cycle defects and tumorigenesis induced by oncogenic Ras. Another project was initiated to characterize the tetraploidy and CIN observed upon hyperactivation of the Ras-ERK1/2 pathway. Aneuploidy and CIN are observed in the majority of colorectal cancers and are associated with a poorer prognosis. We show that hyperactivation of ERK1/2 by oncogenic Ras or sustained nuclear MEK-ERK1/2 signaling induces mitotic defects that lead to tetraploidy, aneuploidy and CIN. We also found that dysregulation of Ras-ERK1/2 signaling alters the expression and localization of Aurora A and the Chromosomal passenger complex proteins. In conclusion, we show for the first time that the MEK/ERK1/2 signaling pathway is implicated in aneuploidy and CIN. Our results suggest that sustained nuclear ERK1/2 signaling may contribute to the initiation and progression of colorectal cancer by rapidly inducing aneuploidy and CIN. We suggest that loss of Sef is an early oncogenic event that contributes to genetic instability and tumor progression by sustaining nuclear ERK1/2 signaling. These observations are significant and highlight the importance of the Ras-ERK1/2 signaling pathway in colorectal tumorigenesis.

A variação do número de cópias (CNV) de genes e cromossomos é uma característica comum do genoma plástico de Leishmania major, que pode estar associada à resistência do parasita à quimioterapia das leishmanioses. Em outros eucariotos, alterações na replicação do DNA ou na resposta a danos no DNA (DDR) pode levar à CNV. Nestes organismos, o complexo de checkpoint 9-1-1 (RAD9, RAD1 e HUS1) é essencial para a detecção e a sinalização do estresse de replicação e para o recrutamento de uma apropriada DDR. Já demonstramos que L. major expressa um homólogo 9-1-1 funcional. Aqui, avaliamos a deficiência de subunidades de 9-1-1 na variação do número de cópias em células selecionadas em metotrexato (MTX), um inibidor da enzima diidrofolato redutase timidilato sintetase (DHFR-TS). A seleção em MTX facilita o isolamento de células que carregam amplificações contendo o locus da DHFR-TS. Assim, selecionamos células deficientes de HUS1 ou RAD9 para resistência ao MTX sem e com exposição previa a hidroxiureia (HU), uma droga que causa estresse de replicação por inibição da ribonucleotídeo redutase, e avaliamos o efeito da deficiência destas proteínas na CNV e no tipo de amplificação gerada. Avaliamos também o efeito da deficiência destas proteínas no processo de síntese do DNA medido pela incorporação de IdU e observamos que a deficiência destas proteínas levou a um incremento na síntese do DNA na ausência de estresse de replicação e a perfis opostos de síntese do DNA após a remoção do estresse replicativo. Análises da detecção de simples fita do DNA (ssDNA) e da histona H2A fosforilada (?H2A) como indicadores do processo de estresse de replicação e dano no DNA também foram conduzidas. Em conjunto, nossos resultados indicam que (i) os níveis alterados das proteínas HUS1 e RAD9 afetam o padrão da CNV após a seleção no MTX, assim como a natureza da amplificação; (ii) HUS1 e RAD9 parecem possuir mecanismos distintos para mediar a CNV; (iii) a função destas proteínas na CNV deve envolver o processo de replicação e (iv) HUS1 e RAD9 são requeridas para a manutenção da estabilidade genômica em Leishmania. Estes resultados contribuem para uma melhor compreensão não só da evolução da via de sinalização mediada pelo complexo de checkpoint 9-1-1 nos eucariotos, mas também da bases moleculares da plasticidade genômica e do fenômeno de amplificação gênica em Leishmania. / The copy number variation (CNV) of genes and chromosomes is a common feature of the plastic genome of Leishmania major, which is normally associated with resistance of the parasite to the chemotherapy of leishmaniasis. In other eukaryotes, alteration in DNA replication and DNA damage response (DDR) causes CNV. In these organisms, the RAD9-RAD1-HUS1 (9-1-1) checkpoint complex is essential for detection and signaling of replication stress and recruitment of an appropriate DDR. We have already demonstrated that L. major expresses a functional 9-1-1 homolog. Here we evaluated the effect of 9-1-1 subunit deficiency in CNV of cells selected in methotrexate (MTX), an inhibitor of the dihydrofolate reductase thymidylate synthetase (DHFR-TS) enzyme. Selection in MTX facilitates the isolation of cells that carry amplicons containing the DHFR-TS locus. Thus, we selected HUS1 or RAD9 deficient cells for MTX resistance without and prior exposure to hydroxyurea (HU), a drug that causes replication stress due to inhibition of ribonucleotide reductase, and evaluated not only CNV, but also the nature of the amplification generated. We also evaluated the effect of deficiency of these proteins in the DNA synthesis process measured by IdU incorporation and observed that the deficiency of these proteins led to an increase in DNA synthesis in the absence of replication stress, and to opposite profiles of DNA synthesis after removal of replicative stress. Analyzes of single-stranded DNA (ssDNA) and phosphorylated histone H2A (?H2A) as indicators of replication stress and DNA damage were also conducted in both presence and absence of replicative stress. Taken together, our results indicate that (i) altered levels of HUS1 and RAD9 proteins affect the CNV pattern after selection in MTX, as well as the nature of amplification; (ii) HUS1 and RAD9 possibly have different mechanisms to mediate CNV; (iii) the function of these proteins in CNV seems to involve replication process and (iv) HUS1 and RAD9 are required for the maintenance of genomic stability in Leishmania. These findings contribute to a better understanding not only of the evolution of the signaling pathway mediated by 9-1-1 checkpoint complex in eukaryotes, but also of the molecular basis of the genome plasticity and the gene amplification phenomenon in Leishmania.

Prenatal assessment of fetal health is routinely offered throughout pregnancy to ensure that the most effective management can be provided to maintain fetal and maternal well-being. Currently, invasive testing is used for definitive diagnosis of fetal aneuploidy, which is associated with a 1% risk of iatrogenic fetal loss. Developing non-invasive prenatal testing (NIPT) is a key area of research and methods to increase the level of cell-free fetal DNA (cffDNA) within the maternal circulation have been discussed to improve accuracy of such tests. In this study, three strategies; co-amplification at lower denaturation temperature polymerase chain reaction (COLD-PCR), inverse-PCR and Pippin Prep™ gel electrophoresis, were analysed to identify a novel approach to selectively enrich shorter cffDNA fragments from larger maternal cell-free DNA (cfDNA). The sensitivity of droplet digital PCR (ddPCR) against real-time PCR (qPCR) was compared for fetal sex and RHD genotyping. In addition RHD zygosity testing was carried out for non-maternal samples. Consequently, Pippin Prep™ gel electrophoresis was combined with ddPCR analysis for the NIPD of Down Syndrome (DS) in pseudo-maternal samples. The results revealed that the Pippin Prep™ gel electrophoresis enrichment approach successfully demonstrated 2-fold to 5-fold increases in the cffDNA fraction. However, further optimisation assays of COLD-PCR and inverse-PCR using actual maternal samples were required. The spike experiments for DS detection revealed that with the present assay IV overrepresentation of the chromosome 21 target could be significantly detected for samples with ≥15% ‘cffDNA fraction’. In conjunction with the Pippin Prep™ enrichment method, this would have enabled assessment of all 10 maternal samples. Alternatively, fetal sex and RHD genotyping results determined that ddPCR provides a more sensitive platform compared to qPCR approaches, particularly for samples that express low cffDNA fractions (<2%). The ddPCR platform also proved to be a rapid and accurate system for the determination of RHD zygosity. This study highlights that ddPCR could be used as opposed to qPCR for accurate determination of fetal sex and RHD status. While sequencing approaches currently provide the most sensitive platforms for NIPT of fetal aneuploidy, high costs (>£400) prevent universal application. The combination of cffDNA enrichment with ddPCR analysis could provide a cheaper and more widely available platform for NIPD. However, further large scale validation studies using actual maternal samples are required.

Ce mémoire examine la pratique du dépistage prénatal et du diagnostic prénatal (désormais les tests prénataux ) en deux temps. D’abord, et après une brève mise en contexte, je présente une analyse des facteurs qui ont influencé la mise en place du Programme québécois de dépistage prénatal de la trisomie 21 (PQDPT21). En me basant sur la littérature gouvernementale, je démontre comment un ensemble de pressions politiques, éthiques et sociales a mené à l’impératif d’PQDPT21. Ensuite, je présente une revue de la recherche qualitative à propos de l’expérience de poursuivre une grossesse affectée par l’aneuploïdie fœtale, y compris la trisomie 21. Les principaux résultats de cette revue suggèrent que la ‘rhétorique’ du choix n’est pas toujours démontrée lorsque les parents amènent à terme un fœtus diagnostiqué avec aneuploïdie. Ensuite, je discuterai de l’ensemble de ces travaux selon le concept foucaldien de biopolitique, où les normes et la normalisation agissent sur la régulation politique et sociale. En conclusion, des recommandations pour la recherche et la pratique sont proposées, principalement la nécessité de documenter l’expérience vécue des personnes qui participent aux tests prénataux et d’intégrer ces constatations dans les décisions politiques et dans l’éducation des professionnels de la santé. / This thesis examines the practice of prenatal screening and prenatal diagnosis (henceforth “prenatal testing”) from two angles. Firstly, following a brief introduction to provide context, I present a framework analysis of the factors that influenced the implementation of the Trisomy 21 Prenatal Screening Program of Québec (T21PSPQ). Using governmental literature, I demonstrate how a combination of political, ethical and social pressures led to the imperative of the T21PSPQ. I then present a scoping review of primary empirical qualitative research regarding the experiences of continuing a pregnancy affected by fetal aneuploidy, including trisomy 21. The main findings of this review suggest the ‘rhetoric’ of choice is not always demonstrated in cases where prospective parents bring to term a fetus diagnosed with aneuploidy. The results of this work are then discussed through the Foucauldian concept of biopolitics, where norms and normalization are the principal forms of social and political regulation. Finally, recommendations for research and practice are offered, mainly the need to document the lived experience of those participating in prenatal testing and to incorporate those findings into policy making and into education for health care professionals.

Es wird allgemein angenommen, dass Proteine exponentiell degradiert werden. Das bedeutet, dass neu synthetisierte als auch alte Proteine mit gleicher Wahrscheinlichkeit degradiert werden. Es tauchen jedoch immer mehr Hinweise dafür auf, dass das nicht immer der Fall sein muss. Um diese Fragestellung systematisch anzugehen, haben wir eine Methode zur metabolischen Pulsmarkierung mit der nichtkanonischen Aminosäure Azidohomoalanine (AHA) entwickelt. AHA ermöglicht die Anreicherung von neu synthetisierten Proteinen direkt nach einem Puls oder nach einer „chase“ (Nachverfolgung) Periode in AHA freiem Medium. Wir kombinierten diese Methode mit SILAC und Shotgun Proteomik um zu quantifizieren wieviel Protein nach verschiedenen chase-Perioden übrig bleibt. Damit konnten wir Degradationsprofile für tausende von Proteinen erstellen. Unsere Daten zeigen, dass mehr als 10 % der Proteine nicht exponentiell degradiert werden (NED). Diese Proteine werden mit fortschreitendem Alter ausschließlich stabiler. Proteasomale Degradation von überschüssigen Proteinkomplexuntereinheiten scheint einen Großteil der NEDs zu erklären. Beim Vergleich zwischen murinen und humanen Zellen stellte sich heraus, dass NED teilweise konserviert ist. Das liegt scheinbar daran, dass diese Zellen trotz unterschiedlichem Ursprungs einheitlich bestimmte Untereinheiten überproduzieren. Da überschüssige NED Proteine bereits unter Standardbedingungen degradiert werden, nahmen wir an, dass die zusätzliche Überproduktion eines NED Proteins seine Level im stationären Zustand nicht verändern sollte. Um dies zu zeigen, quantifizierten wir Degradationskinetiken von Proteinen einer aneuploidenZelllinie. Wir fanden, dass NED Proteine, die auf trisomischen Chromosomen codiert sind, nicht in gleichem Maße ihr stationäres Level steigerten wie exponentiell degradierte Proteine. In Übereinstimmung mit unserer Hypothese verzeichneten wir stattdessen eine Zunahme der anfänglichen Degradationsraten dieser NED Proteine. / Proteins are thought to be degraded exponentially. That means that newly synthesized proteins have the same probability to be degraded as old proteins. However, evidence has accumulated showing that this is not true in all cases. To analyze this more systematically, we developed a method employing metabolic pulse-labeling by the non-canonical amino acid azidohomoalanine (AHA). AHA enables enrichment of newly synthesized proteins directly after pulse or after chase in AHA-free medium. We used SILAC and shotgun proteomics to quantify how much protein remains after different lengths of chase to create degradation profiles for thousands of proteins. Importantly, these degradation profiles allowed us to detect changes in degradation kinetics as the proteins age. We found that more than 10 % of proteins are non-exponentially degraded (NED). These protein are exclusively stabilized by age. Proteasomal degradation of excess protein complex subunits seems to explain a large fraction of NED. Comparing NED in mouse and human cells, we found that NED is at least partially conserved, seemingly due to cells consistently making too much of certain subunits. These overproduced subunits are on average shorter and more structured than the exponentially degraded proteins within the same complex. Finally, since excess NED proteins are degraded during baseline conditions, we hypothesized that making more of a NED protein would not increase its steady state levels. We employed an aneuploidy cell model and found that indeed NED proteins encoded on trisomic chromosomes did not increase in steady state levels to the same extent as exponentially degraded proteins. Instead, we recorded an increase in initial degradation of these proteins. In summary, we present a method for global pule-chase experiments allowing the detection of age-dependent protein degradation with possible implications for the understanding of aneuploidy and cancer.