Les syndromes myélodysplasiques (SMD) sont un ensemble d’hémopathies clonales de la cellule souche. Ils touchent les sujets âgés et se caractérisent par une hématopoïèse inefficace, une différenciation anormale et une transformation fréquente en leucémie aiguë myéloblastique (LAM). La prise en charge thérapeutique a considérablement évolué ces dix dernières années, principalement avec l’arrivée de la 5-azacytidine (Aza) dans les SMD de haut risque. Malheureusement, il existe fréquemment un échec ou une perte de réponse rapide au traitement responsable d’une survie médiane globale de seulement quelques mois. La compréhension des mécanismes d’action des agents hypométhylants, la mise en évidence des facteurs biologiques impliqués dans la résistance à l’Aza ou encore l’identification de nouvelles associations de molécules constitue donc un enjeu majeur. Plusieurs équipes, dont la nôtre, ont démontré que l’erlotinib (Erlo) (inhibiteur de l’activité kinase de l’EGFR (Epidermal Growth Factor Receptor)) possède des effets antinéoplasiques dans les SMD/LAM. Compte tenu de sa toxicité modérée, cet inhibiteur de tyrosine kinase est actuellement en essai clinique en France et aux États-Unis dans les SMD en échec d’Aza. Dans ce travail, nous avons tenté de comprendre les mécanismes d’action impliqués dans l’activité de l’Aza et de l’Erlo seuls ou en association. Nous avons observé que l’Aza et la décitabine (un autre agent hypométhylant) induisent la déphosphorylation et la translocation dans le noyau du facteur de transcription FOXO3A où il réactive l’expression de gènes cibles tels que les facteurs pro apoptotiques PUMA et BIM. Cet effet observé rapidement, suggère un effet « off target » non lié à une reprogrammation épigénétique. La phosphorylation constitutive de FOXO3A étant considérée comme un facteur de mauvais pronostic dans les LAM, cette observation soulève l’intérêt potentiel des agents hypométhylants dans cette pathologie. Nous avons également identifié deux nouvelles cibles de l’Erlo : les SRC-kinases et la voie mTOR/p70S6K dont l’inhibition par des inhibiteurs biochimiques induit un arrêt du cycle cellulaire en G0/G1 sans apoptose ni différenciation confirmant l’hypothèse d’une action « multikinase » de l’Erlo. Par ailleurs, nous avons mis en évidence une activité synergique sur l’apoptose de l’association Aza et Erlo sur des lignées cellulaires de SMD/LAM et sur des cellules de patients. Cet effet n’a pas été retrouvé avec la décitabine ni les autres inhibiteurs de tyrosine kinase testés. La potentialisation de l’apoptose semble liée à plusieurs mécanismes associant l’augmentation de la concentration intracellulaire d’Aza via l’inhibition des transporteurs ABC, un arrêt de la prolifération, une activation des voies apoptotiques caspases-dépendantes et indépendantes et une activation des dommages à l’ADN. En conclusion, ce travail a permis l’identification de nouvelles cibles de l’Erlo et de l’AZA et a révélé un effet synergique entre ces deux molécules. Ces résultats précliniques encourageants suggèrent que cette association pourrait apporter un potentiel bénéfice chez les patients atteints de SMD/LAM, notamment ceux devenus réfractaires à l’Aza. / Myelodysplasic syndromes (MDS) constitute a diverse group of malignant clonal disorders that typically occur in elderly people. MDS are characterized by ineffective hematopoiesis, refractory cytopenias, morphologic dysplasia and increased potential to transform into acute myeloid leukemia (AML). Treatment of MDS has progressed considerably in recent years with the emergence of new approval agents such as azacytidine (aza)(a hypomethylating agent (HMA)) in higher-risk MDS. However, there are still a significant proportion of patients who do not respond to therapy with aza. Therefore, understanding the mechanisms of action of HMAs, identifying predictive factors for aza resistance and combining HMAs with other active compounds in MDS represent a challenging area to improve MDS/AML treatment. Previous works showed that erlotinib (an inhibitor of the epidermal growth factor receptor (EGFR)) exhibits antineoplastic effects in MDS/AML. Due to its limited toxicity profile, this tyrosine kinase inhibitor is currently being evaluated after failure of aza in two clinical trials. In this project, we aimed at understanding the molecular mechanisms involved in the activity of aza and erlo alone or in combination. We observed that aza and decitabine (another HMA related to aza) induces dephosphorylation and translocation to nucleus of the transcriptional regulator FOXO3A promoting the upregulation of the pro-apoptotic factors PUMA and BIM. This effect could be an “off target” effect and could contribute the bebenfical role of HMA in AML as constitutive phosphorylation of FOXO3A has been shown to be an adverse prognostic factor. We discovered new target for erlo, Src-kinase kinases and mTOR that are implicated in the cell-cycle arrest but not in the induction of apoptosis or differentiation confirming the “multikinase” activity of erlo. We found that the combination of aza and erlo demonstrated synergistic induction of apoptosis in MDS/AML cell lines and in some patient cells. This effect was not observed with decitabine or other tyrosine kinase inhibitors frequently used in onco-hematology. We demonstrated that potentiation of cell death is associated with different mechanisms such as intracellular accumulation of aza (via inhibition of ABC transporters), cell cycle arrest with inhibition of leukemic cells growth, caspase-dependent and -independent induction of apoptosis and DNA damage level. In conclusion, this work identified new targets of aza and erlo and revealed a synergistic induction of apoptosis upon co-treatment suggesting that this drug combination might be promising for SMD/AML treatment SMD/AML, especially the resistant patients.

Non communiqué. / Non communiqué.

Canada is a global leader in flax production, but flax acreage in Canada remains limited since flax is not well adapted to the northern Prairies. Therefore, breeding early-flowering and early maturing flax cultivars that are adapted to the climate of the northern Prairies is one of the major strategies to expand flax acreage in Canada. The objective of this project is to understand flowering time in flax and generate early flowering genotypes that are adapted to the continental climate of the Canadian Prairies. This project examined photoperiod sensitivity in five Canadian flax cultivars (CDC Sorrel, CDC Bethune, Flanders, Prairie Thunder and Royal) and three M9 genotypes derived from 5-azacytidine (5-azaC) treatment (RE1, RE2 and RE3). To investigate how each cultivar or genotype responds to photoperiod changes, a reciprocal transfer experiment between long day and short day conditions was conducted. All cultivars and genotypes were photoperiod sensitive. However, the level of sensitivity and length of the sensitive phase varied among cultivars and genotypes. The five cultivars were more sensitive to photoperiod changes compared with the three mutant genotypes, while RE2, which was the earliest flowering genotype, was the least sensitive genotype. This project, in addition, examined the expression pattern of ELF4 (EARLY FLOWERING 4), a specific flowering-related gene. This experiment was conducted with three Canadian flax cultivars (CDC Sorrel, CDC Bethune and Royal) and one 5-azaC mutant genotype (RE2). GAPDH (Glyceraldehyde 3-phosphate dehydrogenase) was used as a reference gene in RT-qPCR. Results of RT-qPCR demonstrated that CDC Sorrel and CDC Bethune had a similar expression pattern, while Royal and RE2 had a similar expression pattern. This project also sought to generate early-flowering genotypes by treating CDC Sorrel with 5-azaC as well as to introgress the early-flowering trait from RE genotypes into CDC Sorrel via hybridization. Mutant populations (M2, M3, bulk M3) and hybrid populations (F2, F3, and bulk F3) were grown and evaluated for time to flowering, maturity and height under latitude (53° N) field conditions in 2012 and 2013. 5-azaC treatment did not induce significant differences in flowering or maturity in the CDC Sorrel background. However, the early flowering trait was successfully introgressed into CDC Sorrel background since selected progeny lines flowered significantly earlier than the later flowering CDC Sorrel parental line.

Spray application of 5­azacytidine on established plant seedlings was tested for its demethylating efficiency, as it represents a novel method for plant experimental demethylation with a potentially lower negative impact on plant development compared to the traditional application of the demethytaling agent through germination of seeds in its solution. Further, the 5­azacytidine spray application was used in practice to erase the epigenetic memory in offspring of Taraxacum brevicorniculatum plants from different competitive conditions. The impact of parental competition on the juvenile phenotype was estimated by measuring growth related traits, while the experimental demethylation allowed for evaluating the significance of DNA methylation marks in bioticaly induced transgenerational effects in T. brevirorniculatum.

Die heterogene Biologie der diffusen großzelligen B-Zell-Lymphome (DLBCL) und die daraus resultierenden Unterschiede in Therapieansprechen und Prognose stellen ein wesentliches Problem in der aktuellen Therapie von DLBCL dar. Anomalien im kanonischen Wnt-Signalweg und seinen natürlichen Antagonisten wie secreted frizzled-related proteins (SFRPs) sind für verschiedene solide und hämatologische Malignome als wichtige Bestandteile der Tumorgenese und Tumorprogression identifiziert worden. Vorarbeiten unserer Arbeitsgruppe lieferten Hinweise für die Bedeutung von Wnt3a und SFRP4 in der Regulation von DLBCL. Im Rahmen dieser Arbeit wurde untersucht, welche Rolle dem Protein SFRP4 in der Wachstumsregulation von diffusen großzelligen B-Zell-Lymphomen zukommt. Die Synthese von SFRP4 wurde in den als Modellzelllinien genutzten humanen DLBCL-Zelllinien nachgewiesen. Unter Verwendung von rekombinantem humanen SFRP4 sowie einer mittels lentiviraler shRNA erzeugten Expressionsreduktion von SFRP4 konnte gezeigt werden, dass SFRP4 zu einer Expansionshemmung sowie zu einer reduzierten Klonogenität bei DLBCL-Zellen führt. Als Ursache für diese Effekte konnte die Inhibition des kanonischen Wnt-Signalwegs durch SFRP4 identifiziert werden. SFRP4 wurde hinsichtlich seiner Bedeutung für die Ausprägung der Side Population (SP), einer Tumorzellsubpopulation mit repopulativem Potenzial, in DLBCL-Zellen untersucht. Dabei wurde sowohl durch exogene Zugabe als auch durch Reduktion von SFRP4 auf Transkriptebene die Bedeutsamkeit von SFRP4 für die SP-Regulation gezeigt. Untersuchungen zur differentiellen SFRP4-Expression sowie SFRP4-Promotormethylierung in Side Population versus non-Side Population wiesen epigenetische Mechanismen in der Regulation des SP-Phänotyps nach. Das DNA-demethylierende Medikament 5-Azacytidine reduzierte in DLBCL-Zelllinien Expansion sowie Klonogenität. Darüber hinaus beeinflusste 5-Azacytidine den kanonischen Wnt-Signalweg und den SFRP4-Gehalt der DLBCL-Zellen. Die Bedeutung von Exosomen als interzelluläre Kommunikatoren, die Wnt-Proteine transportieren, wurde unter besonderer Berücksichtigung von SFRP4 evaluiert. Sowohl SFRP4 als auch Wnt3a waren in der Exosomen- und der Mikrovesikelfraktion von DLBCL-Zellen nachweisbar. Die Exosomen waren in der Lage, den kanonischen Wnt-Signalweg an den Zielzellen zu aktivieren und Einfluss auf die Side Population zu nehmen. Insgesamt wurde für SFRP4 erstmalig eine hemmende Wirkung auf das Wachstum von DLBCL-Zellen demonstriert. Weiterführende Studien können adressieren, inwiefern die aufgezeigten Mechanismen der Wachstumsmodulation von DLBCL-Zellen durch SFRP4 in therapeutischen Anwendungen genutzt werden können.

Adipose tissue is not homogenous as individual fat depots display regional variation in their physiological properties. It follows that body fat distribution is increasingly being recognised as a major determinant of metabolic disease risk. At the cellular level, depot-specific properties are exhibited by adipocyte precursors during in vitro culture and persist for many generations, suggesting these cells retain an ‘intrinsic memory’ of their anatomical origin which is epigenetic in nature. A primary aim was to identify depot-specific genes whose expression may be regulated by DNA methylation in adipose precursors. Using two paired preadipocyte cell lines derived from human subcutaneous abdominal and gluteal adipose tissue - to represent upper and lower body fat with their opposing associations with cardiovascular disease and diabetes respectively - depot-specific gene expression and DNA methylation profiles were detected. Furthermore, the expression of certain genes in preadipocytes was found to change in response to treatment with the DNA demethylating agent 5-azacytidine, which suggests DNA methylation may regulate depot-specific gene expression. A secondary aim was to investigate whether glucocorticoids – which are important determinants of body fat distribution – exert their effects through DNA methylation. The synthetic glucocorticoid dexamethasone was found to modulate the expression of some of the differentially expressed genes in preadipocytes, with this effect possibly being mediated by DNA methylation. It has been postulated that depot-specific phenotypes in adipose tissue may arise from developmental differences. Several genes were found to be expressed in a depot-specific fashion during a differentiation time course, suggesting regional variation in adipogenesis may contribute to the generation of depot-specific phenotypes. Overall, the data presented suggests regional variation within subcutaneous white adipose tissue exists and supports the notion that DNA methylation patterns can, in part, determine adipose tissue heterogeneity.

Tumor microenvironment is an area, where the local immunosuppressive effects dominate and prevents the immune system to perform its physiological functions. The cells infiltrating the microenvironment have an important function among many cell types since they produce a large quantity of factors suppressing the immune response. In our work, we monitored the immune changes in the microenvironment during tumor growth and chemotherapy. For these purposes, we utilized the methods for analysis of the proportion and phenotype of the distinct populations of immunocytes and for analysis of the total level of expressions of selected genes associated with immunosuppression or with distinct populations of immunocytes. The aim of our work was to discover, using two types of mouse tumors (TRAMP-C2 and TC-1/A9), how 5-azacytidine (5AC), a cytostatic drug with epigenetic activity, affects the proportion of leukocytes infiltrating the tumor microenvironment and, further, whether these changes are accompanied by decreased expression of immunosuppressing genes. In addition, we have also focused on the changes of relative expression of genes encoding markers of lymphoid lines and, on other immunoregulating genes, encoding IL-6, IL-10, IL-12, IL-4 and IFNγ cytokines, in the microenvironment of these tumors....

<p>5-azacytidine and its derivatives are cytidine analogs used for leukemia chemotherapy. The primary effect of 5-azacytidine is the prohibition of cytosine methylation, which results in covalent DNA-methyltransferase crosslinks at cytosine methylation sites. These DNA-protein crosslinks have been suggested to cause chromosomal rearrangements and contribute to cytotoxicity, but the detailed mechanisms of DNA damage and the repair pathways of DNA-protein crosslinks have not been elucidated. </p><p>We used 2-dimensional agarose gel electrophoresis and electron microscopy to analyze plasmid pBR322 replication dynamics in Escherichia coli cells grown in the presence of 5-azacytidine. 2-dimensional gel analysis revealed the accumulation of specific bubble- and Y-molecules, dependent on overproduction of the cytosine methyltransferase EcoRII and treatment with 5-azacytidine. Furthermore, a point mutation that eliminates a particular EcoRII methylation site resulted in disappearance of the corresponding bubble- and Y-molecules. These results imply that 5-azacytidine-induced DNA-protein crosslinks block DNA replication in vivo. RecA-dependent X-structures were also observed after 5-azacytidine treatment. These molecules may be generated from blocked forks by recombinational repair and/or replication fork regression. In addition, electron microscopy analysis revealed both bubbles and rolling circles after 5-azacytidine treatment. These results suggest that replication can switch from theta to rolling circle mode after a replication fork is stalled by a DNA-methyltransferase crosslink. The simplest model for the conversion of theta to rolling-circle mode is that the blocked replication fork is cleaved by a branch-specific endonuclease. Such replication-dependent DNA breaks may represent an important pathway that contributes to genome rearrangement and/or cytotoxicity. </p><p>In addition, we performed a transposon mutagenesis screen and found that mutants defective in the tmRNA translational quality control system are hypersensitive to 5-azacytidine. The hypersensitivity of these mutants requires expression of active methyltransferase, indicating that hypersensitivity is dependent on DNA-methyltransferase crosslink formation. Furthermore, the tmRNA pathway is activated upon 5-azacytidine treatment in cells expressing methyltransferase, resulting in increased SsrA tagging of cellular proteins. These results support a "chain-reaction" model, in which transcription complexes blocked by 5-azacytidine-induced DNA-protein crosslinks result in ribosomes stalling on the attached nascent transcripts, and the tmRNA pathway is invoked for cleaning up the resulting pile-ups. In support of this model, an ssrA mutant is also hypersensitive to antibiotic streptolydigin, which blocks RNA polymerase elongation. These results reveal a novel role for the tmRNA system in clearance of coupled transcription/translation complexes in which RNA polymerase has become blocked.</p> / Dissertation

Orientador: Eliana Pereira de Araujo / Texto em português e inglês / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T05:27:47Z (GMT). No. of bitstreams: 1 Gomes_FabianadeSouza_M.pdf: 1469055 bytes, checksum: 01ebfd4043c839e80e30bebeeb9bef95 (MD5) Previous issue date: 2013 / Resumo: O desenvolvimento de métodos que tem por objetivo acelerar e melhorar a qualidade do processo de cicatrização de feridas tem impacto positivo na condução de distúrbios de cicatrização associados a inúmeras condições médicas. Neste estudo, avaliamos os efeitos moleculares, celulares e clínicos da aplicação tópica de 5-azacitidina na cicatrização de feridas em ratos. De acordo com estudos pregressos, a 5-azacitidina reduz a expressão de folistatina, que é um regulador negativo das ativinas. Estas, por sua vez, promovem o crescimento de células em diferentes tecidos, incluindo a pele. Ratos Wistar machos com oito semanas de vida foram submetidos a um ferimento cutâneo com punch de oito milímetros na região dorsal. A seguir os ratos foram aleatoriamente separados em grupo controle (veículo) ou submetidos à aplicação tópica de 5-azacitidina (10 mM), uma vez por dia por até 12 dias, iniciando-se no terceiro dia após a lesão. A documentação fotográfica e coleta de amostras ocorreram nos dias 5, 9 e 15. O emprego desta droga resultou em aceleração da cicatrização da ferida, (99,7±7,0% versus 71,2±2,8% no dia 15, p <0,01). Este resultado clínico foi acompanhado pela redução de aproximadamente três vezes na expressão protéica de folistatina. O exame histológico da pele revelou re-epitelização eficiente com aumento da expressão de queratinócitos e aumento significativo na expressão do gene de TGF-? além da diminuição significativa de citocinas, tais como TNF-? e IL-10. Analisamos também a proliferação celular na lesão de pele através do método de incorporação de BrdU. O número de células positivas para BrdU aumentou significativamente quando comparado ao controle. No entanto, quando folistatina exógena foi aplicada na pele em paralelo ao tratamento tópico de 5-azacitidina a maioria dos benefícios do medicamento foi perdida. Assim, 5-azacitidina atua, pelo menos em parte, através da via folistatina/ativina para melhorar a cicatrização de feridas em ratos. Este trabalho pertence à linha de pesquisa Processo de Cuidar em Saúde e Enfermagem / Abstract: The development of new methods aimed at improving wound healing may have an impact on the outcomes of a number of medical conditions. Here we evaluate the molecular and clinical effects of topical 5-azacytidine, a compound used in myelodysplasia, on the wound healing in rats. According to previous studies, 5-Azacytidine decreases the expression of follistatin 1, which is a negative regulator of activins. Activins, in turn, promote cell growth in different tissues, including the skin. Eight-week old male Wistar rats were submitted to an 8 mm punchwound in the dorsal region. After three days, rats were randomly assigned to either control or topical application of a solution containing 5-azacytidine (10mM), once a day. Photo documentation and collection of samples occurred at days 5, 9 and 15. Overall, 5-azacytidine resulted on a significant acceleration of complete wound healing (99.7% ±0.7.0 vs. 71.2%±2.8 on days 15; n=10; p<0,01). This was accompanied by an up to 3-fold reduction in follistatin expression. Histological examination of the skin revealed efficient reepithelization with increase in gene expression of TGF-? and keratinocytes markers, involucrin and citokeratin, besides the significant decrease of cytokines such as TNF-? and IL-10. In addition, we analyzed cell proliferation in injured skin employing the BrdU incorporation method. The treatment with 5-azacytidine led to a progressive increase of BrdU positive cells. Finally when recombinant follistatin was employed in the skin in parallel to topical 5-azacytidine most of the benefits of the drug were lost. Thus, 5-azacytidine acts, at least in part, through the follistatin/activin pathway to improve wound healing in rats. This study belongs to online research process Caring in Nursing and Health / Mestrado / Enfermagem e Trabalho / Mestra em Ciências da Saúde

Myelodysplastic syndrome (MDS) is a group of clonal bone marrow disorders characterized by bone marrow dysplasia with myeloblasts <20%, typically seen in older patients. MDS has a significant risk of transformation to Acute Myeloid Leukemia (AML). We report a case of MDS transformed to AML, with sustained Complete Remission and incomplete count recovery (CRi) with treatment. A 78-year-old male with a 2-year history of leukopenia had a workup including bone marrow biopsy (BMBX) revealing intermediate- risk MDS with 13% blasts (Refractory Anemia Excess Blasts II), deletion 20 on cytogenetics and normal MDS FISH panel. He was categorized as revised IPSS score 4.5 on risk stratification. Patient initiated treatment with hypomethylating agent Azacytidine with subsequent improved BMBX with 7% blasts. He continued Azacytidine with dose reductions due to cytopenia only to develop 14% blasts on another follow up BMBX. He continued successful treatment for over 3 years before developing with 40-50% CD 34+/CD117+ blasts in the bone marrow consistent with transformation to AML. He commenced salvage treatment with Venetoclax and full dose Azacytidine as advanced age and performance status precluded transplant options. Repeat BMBX 4 weeks following Venetoclax showed hypocellular marrow, blasts percentage less than 2% indicating a CRi. Two other subsequent marrow exams have demonstrated sustained CRi twelve months after transformation with continued Venetoclax and Azacytidine administration. Around 30% of MDS patients eventually transform to secondary AML. Azacytidine therapy has significantly improved survival and time to AML transformation in intermediate-2 and high-risk MDS patients. Venetoclax, a BCL-2 inhibitor, in treating AML. Based on the results of the VIALE-A trial, the incidence of CR (complete remission) was higher around 36.7% with Azacytidine-Venetoclax (A-V) compared to 17.9% with Azacytidine. The composite CR (CR+ Cri) was higher in the A-V group, 66.4% compared to 28.3% with Azacytidine group. The median overall survival was 14.7 months in the A-V group compared to 9.6 months in the Azacytidine group. Our patient achieved a CRi with A-V treatment and has demonstrated a durable response beyond 16 months in secondary AML which has a bleak prognosis indicating the promise of this new combination treatment.