Orientador: Albina Messias de Almeida Milani Altemani / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-13T00:26:10Z (GMT). No. of bitstreams: 1 Neves_CatarinadeOliveira_D.pdf: 1050550 bytes, checksum: fc3ca7c67f2a52e8450896158a67f0d6 (MD5) Previous issue date: 2009 / Resumo: CD10 e Podoplanina (D2-40), além de expressos nas células mioepiteliais, estão envolvidos na progressão tumoral e podem ser utilizados como marcadores prognósticos. Em 79 neoplasias salivares com diferenciação mioepitelial (44 malignas e 35 benignas), analisamos a expressão dessas proteínas nas células neoplásicas, na reação desmoplásica tumoral e, nos carcinomas adenóides císticos (CAC), verificamos possível correlação com fatores prognósticos. CD10 foi negativo nas células epiteliais em 100% dos casos. Nas mioepiteliais, foi positivo em 25,71% das lesões benignas e em 27,27% das malignas, sendo esses resultados significantemente inferiores àqueles da a-SMA (60% e 88,64%, respectivamente). CD10 foi positivo em 83,33%, 30%, 27,7% e 40% dos carcinomas epiteliais-mioepiteliais (CEME), adenomas pleomórficos, mioepiteliomas e carcinomas mioepiteliais, respectivamente, e negativo em 100% dos CAC, adenocarcinomas polimórficos de baixo grau (APBG) e adenomas de células basais. No estroma tumoral, a expressão do CD10 (38,64%) foi significantemente maior (p=0.007) que a da a-SMA (11,36%). Entretanto, a expressão do CD10 não apresentou correlação com os fatores prognósticos do CAC. O D2-40 foi negativo, nas células epiteliais e estromais, e positivo nas mioepiteliais em 59% dos carcinomas e em 42,86% das lesões benignas. Concluímos que, ao contrário do D2-40, o CD10 tem pouca utilidade para identificar células mioepiteliais malignas, exceto no CEME onde pode ser útil no diagnóstico diferencial com a variante tubular do CAC. Sua expressão estromal ocorre em células de fenótipo distinto dos miofibroblastos, está associada com invasão tumoral e não se correlaciona com fatores prognósticos do CAC. / AbstrAct: CD10 and Podoplanin (D2-40) are expressed in myoepithelial cells and, in addition, are involved in tumoral progression and can be utilized as prognostic markers. In a series of 79 salivary neoplasias with myoepithelial differentiation (44 malignant and 35 benign), the expression of these proteins was analyzed in tumor cells as well as in tumor-associated stromal cells and it was correlated with prognostic factors in a select group of lesions (adenoid cystic carcinomas). In epithelial cells, CD10 was negative in 100% of the cases. In myoepithelial cells, CD10 was positive in 25.71% of the benign neoplasias and in 27.27% of the malignant ones and this expressions was significantly lower in comparison to that of a-smooth muscle actin (a-SMA) (60% and 88.64%, respectively). In neoplasias classified according to histological subtype, CD10 was positive in 83.33%, 30%, 27.27% and 40% of epithelial-myoepithelial carcinomas (EMC), pleomorphic adenomas, myoepitheliomas and myoepithelial carcinomas, respectively and negative in 100% of adenoid cystic carcinomas (ACC), polymorphic low-grade adenocarcinomas (PLGA) and basal adenomas. In tumor-associated stromal cells, CD10 expression was significantly higher (p=0.007) than that of a-SMA (38.64% versus 11.36%). However, no correlation was detected between CD10 expression and prognostic factors in ACC. D2-40 was negative in epithelial cells and in tumorassociated stromal cells as well and positive in myoepithelial cells of carcinomas (59%) and benign lesions (42.86%). This reactivity in myoepithelial cells did not differ significantly of that using a-SMA as a marker, except for PLGA where D2-40 was negative. In conclusion, CD10 differs of D2-40 once it shows low utility to detect neoplastic myoepithelial cells. However, EMC is an exception and in this tumor, CD10 could be useful to separate this lesion from tubular variant of ACC. In the tumor-associated stroma, CD10 expression in non-myofibroblast cells seems to be associated with tumor invasion but it does not show correlation with prognostic factors in ACC. / Doutorado / Anatomia Patologica / Doutor em Ciências Médicas

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / HematogÃnias sÃo cÃlulas jovens normais da medula Ãssea responsÃveis pela produÃÃo das cÃlulas de linhagem B do sistema imunolÃgico. A leucemia linfoblÃstica aguda de cÃlulas precursoras B representa um dos tipos de transformaÃÃo neoplÃsica das hematogÃnias. Devido a alta similaridade do ponto de vista citolÃgico dos dois tipos celulares, à possÃvel haver erros de interpretaÃÃo na anÃlise citolÃgica, fazendo-se necessÃrio em algumas circunstÃncias o uso de tÃcnicas complementares diagnÃsticas para diferenciar as cÃlulas benignas das malignas. O uso de marcadores imunolÃgicos atravÃs de anticorpos monoclonais marcados com fluorescÃncia tem grande aplicabilidade nos laboratÃrios especializados como rotina no estudo das leucemias. Os antÃgenos CD10 e CD19 estÃo expressos em ambos os tipos celulares de forma que se faz necessÃria uma extensÃo no uso de outros marcadores para caracterizaÃÃo da natureza benigna ou maligna das cÃlulas. Testou-se possÃveis diferenÃas nas curvas de expressÃo de CD10 e CD19 dos dois tipos celulares. Foram colhidas 36 amostras de medula Ãssea de pacientes pediÃtricos nÃo neoplÃsicos como grupo controle. A idade variou de 24 dias de vida a 15 anos com uma mÃdia de 5 anos. Foram colhidas tambÃm 39 amostras de pacientes portadores de LLA de linhagem B por ocasiÃo do diagnÃstico. A idade variou de 4 meses a 14 anos com uma mÃdia de 6,6 anos. Analisou-se as diferenÃas nas distribuiÃÃes quanto a intensidade de fluorescÃncia pelas mÃdias, desvios-padrÃo, coeficientes de variaÃÃo, coeficientes de inclinaÃÃo e coeficiente de curtose para os dois marcadores CD10 e CD19 nos dois grupos. Os valores individuais de cada amostra foram comparados com os intervalos gerados pelos valores do grupo controle com os seguintes respectivos resultados de sensibilidade e especificidade: 89,7% e 75% para um cut-off de mÃdia+2DP; 79,5% e 100% para mÃdia+2,5DP; e 71,8% e 100% para mÃdia+3DP. ConclusÃo: A expressÃo de CD10 e CD19 em blastos e hematogÃnias à diferente podendo ser de utilidade prÃtica na distinÃÃo entre os dois tipos celulares. / Hematogones are normal immature cells from bone marrow that are responsible for the production of the immune systemâs B cell lineage. The acute lymphoblastic leukemia (ALL) of precursors B cells represents one type of neoplastic transformation of hematogones. Due to their high similarity there are risks of erroneous interpretation consequently making it necessary use to complementary diagnostic techniques. The CD10 and CD19 antigens are expressed on both types of cells so, it is necessary use other monoclonal antibodies to identify malign or benign nature. In attempt to avoid the use of different antibodies we investigate possible differences in the expression of CD10 and CD19 in both cell types. We collected 36 samples of bone marrow from non-neoplastic patients as a control group. The age raged from 0 to 15 years with an average of 5 years. It was also collected 39 samples from patients with ALL of B cells. The age ranged from 0 to 14 years with an average of 6.6 years. We analyzed the differences between the fluorescence intensity concerning average, standard deviation, variation, inclination and kurtosis coefficients for the two markers. The individual values of each sample were compared with the intervals generated by the values of the control group: MEÂ2SD; MEÂ2.5SD and MEÂ3SD. It was possible to distinguish the groups with 89.7% and 75%; 79.5% and 100% and 71.8% e 100% of sensibility and specificity, respectively for the intervals. In conclusion, the expression of CD10 and CD19 antigens on blasts and hematogones is significantly different and may be useful in the differentiation of both cell types

Dans différents types de cancers, notamment dans le cancer du sein, il existe une population cellulaire à l’origine des mécanismes de rechute de la maladie plusieurs années après la fin des traitements initiaux, caractérisée par des propriétés de cellules souches et une chimiorésistance unique dont le mécanisme est inconnu. Pour ces raisons il est important de comprendre les mécanismes et de connaître les acteurs physiologiques impliqués à la fois dans la régulation des cellules souches normales et cancéreuses. Le CD10 est une endopeptidase zinc-dépendante capable d’inactiver un certain nombre de peptides impliqués, entre autre, dans le développement de la glande mammaire. Nos recherches ont permis de montrer que la population cellulaire exprimant le CD10 dans la glande mammaire était enrichie en cellules souches/progéniteurs communs précoces/cellules myoépithéliales. Nos résultats suggèrent que l’adhérence des cellules souches au stroma via l’intégrine β1 et le clivage de certains peptides par le CD10 sont des éléments clés du micro-environnement permettant le maintien du réservoir de cellules souches et de progéniteurs précoces dans la glande mammaire. Le tissu adipeux est également un des constituants majeur de l’environnement de la glande mammaire et joue un rôle dans la sécrétion de facteurs de croissances également impliqués dans l’homéostasie du tissu mammaire. Nos résultats ont suggéré qu’en plus de son rôle nourricier, le tissu adipeux pouvait constituer une source potentielle de cellules souches épithéliales luminales pouvant ainsi être considérée comme une nouvelle source cellulaire à l’origine de certains cancers du sein. / In breast, the existence of cancer stem cells has been demonstrated and that explain a number of observations as tumour heterogeneity. Other studies have demonstrated the resistance of radio and chemotherapy by different innate or acquired stem cell specific mechanisms that could explain relapse few years after the traitment. For all these reasons, that is very important to understand these mechanisms and to know physiological actors both implicated in the regulation of normal or cancer stem cells. CD10 is a zinc-dependant metallo-endopeptidase that inactivates a number of signalling peptides that could be implicated in mammary growth and differentiation. We have showed that CD10+ cell sorted population is enriched in Stem Cells/Early Common Progenitors/MyoEPithelial cells. We demonstrate that the protease activity of CD10 and the adhesion function of beta1-integrin are required to prevent differentiation of mammary stem cells/early progenitors. Taken together, our data suggest that integrin-mediated contact with the basement membrane and cleavage of signalling factors by CD10 are key elements in the microenvironment that maintains the progenitor and stem cell pools in the mammary gland. Adipose tissue is also a major component of the mammary microenvironment implicated in its homeostasis by the secretion of soluble factors. Our results suggested that the adipose tissue could be considered as a potential source of stem cells that differentiated into the luminal epithelial lineage involved in some breast cancers.

Dans différents types de cancers, notamment dans le cancer du sein, il existe une population cellulaire à l'origine des mécanismes de rechute de la maladie plusieurs années après la fin des traitements initiaux, caractérisée par des propriétés de cellules souches et une chimiorésistance unique dont le mécanisme est inconnu. Pour ces raisons il est important de comprendre les mécanismes et de connaître les acteurs physiologiques impliqués à la fois dans la régulation des cellules souches normales et cancéreuses. Le CD10 est une endopeptidase zinc-dépendante capable d'inactiver un certain nombre de peptides impliqués, entre autre, dans le développement de la glande mammaire. Nos recherches ont permis de montrer que la population cellulaire exprimant le CD10 dans la glande mammaire était enrichie en cellules souches/progéniteurs communs précoces/cellules myoépithéliales. Nos résultats suggèrent que l'adhérence des cellules souches au stroma via l'intégrine β1 et le clivage de certains peptides par le CD10 sont des éléments clés du micro-environnement permettant le maintien du réservoir de cellules souches et de progéniteurs précoces dans la glande mammaire. Le tissu adipeux est également un des constituants majeur de l'environnement de la glande mammaire et joue un rôle dans la sécrétion de facteurs de croissances également impliqués dans l'homéostasie du tissu mammaire. Nos résultats ont suggéré qu'en plus de son rôle nourricier, le tissu adipeux pouvait constituer une source potentielle de cellules souches épithéliales luminales pouvant ainsi être considérée comme une nouvelle source cellulaire à l'origine de certains cancers du sein.

Diffuse large B-cell lymphoma (DLBCL) is a genetically heterogeneous disease with multiple distinct molecular subtypes. Increased NF-κB activity and expression of the microRNA miR-155 (product of the BIC gene) are associated with one subtype, called the activated B-cell (ABC) subtype. It is shown here that induction of NF-κB activity leads to increased miR-155 expression, the levels of miR-155 in a panel of B-lymphoma cell lines correlate with increased NF-κB activity, and the NF-κB p50/p65 heterodimer binds to a specific DNA site in the BIC promoter. Also described is a regulatory network wherein NF-κB-dependent up-regulation of miR-155 leads to reduced PU.1 transcription factor expression and consequently reduced PU.1-driven expression of B-lymphoma marker CD10 in the human B-lymphoma cell line BJAB. Genetic variation in DLBCL can be used to explain the response of individual patients to chemotherapy. One cancer therapeutic approach currently in clinical trials uses histone deacetylase inhibitors (HDACi's) as a monotherapy or in combination with other vi agents. It is shown here that two pan-HDACi's, trichostatin A and vorinostat, induce apoptosis in seven of eight human DLBCL cell lines. Ectopic over-expression of antiapoptotic proteins BCL-2 and BCL-XL or the pro-apoptotic protein BIM in select DLBCL cell lines can confer further resistance or sensitivity, respectively, to HDACi treatment. Additionally, the BCL-2 family antagonist ABT-737 can increase the sensitivity of several DLBCL cell lines to vorinostat-induced apoptosis, including the HDACi-resistant SUDHL6 cell line. Moreover, one vorinostat-resistant variant of the HDACi-sensitive cell line SUDHL4 has increased expression of anti-apoptotic proteins BCL-XL and MCL-1 and decreased sensitivity to ABT-737, and a second such variant cell line has increased expression of anti-apoptotic protein MCL-1. These results suggest that the balance of anti- to pro-apoptotic BCL-2 family protein expression is important in determining the sensitivity of DLBCL cell lines to HDACi-induced apoptosis. Thus, the sensitivity of DLBCL cell lines to treatment with HDACi's appears to depend on the complex regulation of BCL-2 family members, suggesting that the response of a subset of DLBCL patients to HDACi treatment may benefit from co-treatment with BCL-2 antagonists.

L'incidence, le coût et l'issue fatale dans un nombre encore trop élevé de cas font du cancer un problème majeur en santé publique. Malgré les progrès réalisés dans le développement de thérapies ciblées, la plupart des cancers rechutent, vraisemblablement à cause de l'échappement des cellules souches cancéreuses (CSC) qui survivent et régénèrent la tumeur. L'enjeu clinique en cancérologie aujourd'hui est d'éliminer les cellules souches cancéreuses en épargnant les cellules souches normales. Pour atteindre cet objectif, il est primordial de comprendre leurs mécanismes spécifiques de transformation. Nous évaluons dans mon équipe de recherche l'implication du microenvironnement dans la transformation et la résistance des CSC épithéliales, à travers les effets de facteurs solubles et de contacts cellulaires : l'enzyme CD10, et la voie des BMPs (Bone Morphogenetic Proteins).Notre équipe étudie le rôle du dialogue permanent entre la CS normale et son microenvironnement qui régule la prolifération, et la survie des CS. Nous utilisons la glande mammaire et la prostate comme systèmes modèles car ces deux types d'épithélium présentent des similitudes, ce qui nous permet d'aborder la question de l'apparition et la résistance des CSC dans deux modèles tumoraux correspondants. Des dérégulations de la voie des BMPs, comme de l'enzyme CD10 sont observées dans ces tumeurs. Enfin, nous cherchons à comprendre comment les dérégulations de la voie des BMPs apparaissent, en s'intéressant principalement aux facteurs pouvant modifier directement le microenvironnement, tels que les polluants présents dans l'environnement (bisphénols, benzoapyrène) / It has been shown for a number of cancers that a cell population characterized by stem cell (SC) properties and therapeutic resistance is likely responsible for relapse several years after treatment. Current therapies kill most of the tumor cells, but fail to eradicate the so-called cancer stem cells (CSC). Therefore a complete cure of the disease will require the eradication of the tumor-sustaining CSC. We propose to study these CSC in the context of breast cancer as the existence of CSC as already been highlighted in this epithelia.CD10 is a membrane enzyme able to cleave several peptide of the microenvironment (such as oxytocin, bombesin, enkephalin.. ) that can also interact with intracellular signalling pathway through its direct interaction with PTEN. Our results, and those of the literature, indicate that CD10 enzyme controls the fate of SC and is deregulated in normal breast and cancerous tissues. We showed that CD10 membrane expression allows the maintenance of immature cells partly through its enzymatic function that inhibits mammary stem cells differentiation. As CD10 has been described in breast cancer initiation, progression and resistance, we then decided to test the role of CD10 in tumor context. Our strategy consists in flow cytometry cell sorting for CD10+/CD10- cells to compare the functional properties of both sub-population. Only CD10+ cells are able to regenerate both CD10+ and CD10- subpopulations, and CD10+ cells exhibit higher expression of immature genes. Interestingly, modulating CD10 using stable expression of CD10 in our models and Sh strategies do not mimick the normal functions of CD10, indicating that CD10 could be more a marker of a certain population with immature properties prone to transformation rather than a driver. To better characterize the role of CD10 in luminal breast transformation, we developed a new human mammary model, initiated from immature cells to obtain transformed luminal epithelial cells and their resistant counterpart. We observed a higher level of CD10 expression during mammary epithelial cell transformation process. We then performed a microarray on CD10+ and CD10- subpopulations. Preliminary analysis seems to confirm that CD10 is a potential marker for a stem cell population prone to transformation rather than a direct driver of the cell transformation

A icterícia por hiperbilirrubinemia indireta afeta mais de 60% dos recém-nascidos a termo. O tratamento, quando necessário, é realizado através da fototerapia. Não existem estudos na literatura avaliando os efeitos da fototerapia na função dos neutrófilos de recém-nascidos. O melhor entendimento da função dos neutrófilos nos recém-nascidos antes e após a fototerapia seria importante para avaliar as possíveis repercussões na expressão dos neutrófilos desencadeadas pelo tratamento fototerápico. O objetivo deste estudo foi avaliar e comparar a função dos neutrófilos, através da mensuração pela citometria de fluxo da expressão dos principais marcadores de superfície em recémnascidos ictéricos, antes e após 24 horas de fototerapia. Metodologia: Foram incluídos recém-nascidos com idade gestacional ≥ 35 semanas e peso de nascimento ≥ 2000g, que possuiam critérios da Academia Americana de Pediatria para tratamento fototerápico. Os critérios de exclusão foram: mal-formações congênitas, síndromes com alterações cromossômicas, erro inato do metabolismo, infecções do grupo STORCH, asfixia neonatal, sepse ou suspeita de sepse, exsanguineotransfusão, transfusão de hemocomponentes e uso de imunoglobulina. Foi realizada a avaliação de expressão da intensidade média de fluorescência (IMF) de CD10, CD11b, CD11c, CD15, CD16, CD18, CD62L, CD64 e CD66, antes do início e após 24 horas do início da fototerapia. Foram utilizados o teste T de Student para análise dos dados. Resultados: Foram incluídos 25 recém-nascidos no estudo, com idade mediana de 53 (27.5-75.5) horas de vida e bilirrubina média de 13.6±2.85 mg/dL. Não houve diferença estatística na expressão de CD11b, CD15, CD18, CD62L, CD64 e percentual de neutrófilos antes e após 24 horas de fototerapia. Ocorreu aumento da expressão de CD10 8 (p=0.038) e CD16 (p=0.017) e redução da expressão de CD11c (p=0.023) e CD66acde (p=0.004) após 24 horas de fototerapia. Conclusão: Os recém-nascidos submetidos ao tratamento fototerápico apresentaram aumento da expressão de CD10 e de CD16 e diminuição da expressão de CD11c e de CD66acde após 24 horas de exposição, que pode estar relacionado a um efeito antiinflamatório da fototerapia nos recém-nascidos expostos a este tratamento. / Jaundice due to indirect hyperbilirubinemia affects more than 60% of term neonates. The treatment when necessary is carried out using phototherapy. There are no studies in the literature evaluating the effect of phototherapy on the function of neonates' neutrophils. A better understanding of the function of neutrophils in neonates before and after phototherapy would be important in order to assess potential effects on the expression of neutrofils triggered by the phototherapy treatment. The aim of this study was to assess and compare the function of neutrophils by measuring the expression of the main surface markers in icteric neonates, using flow cytometry, before and after 24 hours of phototherapy. Methodology: Neonates at a gestational age ≥ 35 weeks and at a birth weight ≥ 2000g who met the criteria of the American Academy of Pediatrics for phototherapy were included. The exclusion criteria were: congenital malformations, syndromes with chromosomal alterations, inborn errors of metabolism, infections of the STORCH group, neonatal asphyxia, sepsis or suspicion of sepsis, exchange transfusion, transfusion of blood components, and use of immunoglobulin. The evaluation of the MFI expression of CD10, CD11b, CD11c, CD15, CD16, CD18, CD62L, CD64 and CD66 was performed before and 24 hours after the initiation of phototherapy. The chi-square and Student T tests were used for data analysis. Results: Twenty-five neonates were included in the study at the mean age of 53 (27.5- 75.5) hours of life and with a mean bilirubin level of 13.6±2.85 mg/dL. There was no statistical difference in the expression of CD11b, CD15, CD18, CD62L, CD64 and percentage of neutrophils before and after 24 hours of phototherapy. There was an increase in the expression of CD10 (p=0.038) and CD16 (p=0.017) and a reduction in 10 the expression of CD11c (p=0.023) and CD66acde (p=0.004) after 24 hours of phototherapy. Conclusion: The newborns submitted to phototherapy had increased expression of CD10 and CD16 and decreased expression of CD11c and CD66acde after 24 hours of exposure, which may be related to an anti-inflammatory effect of phototherapy on the neonates exposed to this treatment.

A icterícia por hiperbilirrubinemia indireta afeta mais de 60% dos recém-nascidos a termo. O tratamento, quando necessário, é realizado através da fototerapia. Não existem estudos na literatura avaliando os efeitos da fototerapia na função dos neutrófilos de recém-nascidos. O melhor entendimento da função dos neutrófilos nos recém-nascidos antes e após a fototerapia seria importante para avaliar as possíveis repercussões na expressão dos neutrófilos desencadeadas pelo tratamento fototerápico. O objetivo deste estudo foi avaliar e comparar a função dos neutrófilos, através da mensuração pela citometria de fluxo da expressão dos principais marcadores de superfície em recémnascidos ictéricos, antes e após 24 horas de fototerapia. Metodologia: Foram incluídos recém-nascidos com idade gestacional ≥ 35 semanas e peso de nascimento ≥ 2000g, que possuiam critérios da Academia Americana de Pediatria para tratamento fototerápico. Os critérios de exclusão foram: mal-formações congênitas, síndromes com alterações cromossômicas, erro inato do metabolismo, infecções do grupo STORCH, asfixia neonatal, sepse ou suspeita de sepse, exsanguineotransfusão, transfusão de hemocomponentes e uso de imunoglobulina. Foi realizada a avaliação de expressão da intensidade média de fluorescência (IMF) de CD10, CD11b, CD11c, CD15, CD16, CD18, CD62L, CD64 e CD66, antes do início e após 24 horas do início da fototerapia. Foram utilizados o teste T de Student para análise dos dados. Resultados: Foram incluídos 25 recém-nascidos no estudo, com idade mediana de 53 (27.5-75.5) horas de vida e bilirrubina média de 13.6±2.85 mg/dL. Não houve diferença estatística na expressão de CD11b, CD15, CD18, CD62L, CD64 e percentual de neutrófilos antes e após 24 horas de fototerapia. Ocorreu aumento da expressão de CD10 8 (p=0.038) e CD16 (p=0.017) e redução da expressão de CD11c (p=0.023) e CD66acde (p=0.004) após 24 horas de fototerapia. Conclusão: Os recém-nascidos submetidos ao tratamento fototerápico apresentaram aumento da expressão de CD10 e de CD16 e diminuição da expressão de CD11c e de CD66acde após 24 horas de exposição, que pode estar relacionado a um efeito antiinflamatório da fototerapia nos recém-nascidos expostos a este tratamento. / Jaundice due to indirect hyperbilirubinemia affects more than 60% of term neonates. The treatment when necessary is carried out using phototherapy. There are no studies in the literature evaluating the effect of phototherapy on the function of neonates' neutrophils. A better understanding of the function of neutrophils in neonates before and after phototherapy would be important in order to assess potential effects on the expression of neutrofils triggered by the phototherapy treatment. The aim of this study was to assess and compare the function of neutrophils by measuring the expression of the main surface markers in icteric neonates, using flow cytometry, before and after 24 hours of phototherapy. Methodology: Neonates at a gestational age ≥ 35 weeks and at a birth weight ≥ 2000g who met the criteria of the American Academy of Pediatrics for phototherapy were included. The exclusion criteria were: congenital malformations, syndromes with chromosomal alterations, inborn errors of metabolism, infections of the STORCH group, neonatal asphyxia, sepsis or suspicion of sepsis, exchange transfusion, transfusion of blood components, and use of immunoglobulin. The evaluation of the MFI expression of CD10, CD11b, CD11c, CD15, CD16, CD18, CD62L, CD64 and CD66 was performed before and 24 hours after the initiation of phototherapy. The chi-square and Student T tests were used for data analysis. Results: Twenty-five neonates were included in the study at the mean age of 53 (27.5- 75.5) hours of life and with a mean bilirubin level of 13.6±2.85 mg/dL. There was no statistical difference in the expression of CD11b, CD15, CD18, CD62L, CD64 and percentage of neutrophils before and after 24 hours of phototherapy. There was an increase in the expression of CD10 (p=0.038) and CD16 (p=0.017) and a reduction in 10 the expression of CD11c (p=0.023) and CD66acde (p=0.004) after 24 hours of phototherapy. Conclusion: The newborns submitted to phototherapy had increased expression of CD10 and CD16 and decreased expression of CD11c and CD66acde after 24 hours of exposure, which may be related to an anti-inflammatory effect of phototherapy on the neonates exposed to this treatment.

A icterícia por hiperbilirrubinemia indireta afeta mais de 60% dos recém-nascidos a termo. O tratamento, quando necessário, é realizado através da fototerapia. Não existem estudos na literatura avaliando os efeitos da fototerapia na função dos neutrófilos de recém-nascidos. O melhor entendimento da função dos neutrófilos nos recém-nascidos antes e após a fototerapia seria importante para avaliar as possíveis repercussões na expressão dos neutrófilos desencadeadas pelo tratamento fototerápico. O objetivo deste estudo foi avaliar e comparar a função dos neutrófilos, através da mensuração pela citometria de fluxo da expressão dos principais marcadores de superfície em recémnascidos ictéricos, antes e após 24 horas de fototerapia. Metodologia: Foram incluídos recém-nascidos com idade gestacional ≥ 35 semanas e peso de nascimento ≥ 2000g, que possuiam critérios da Academia Americana de Pediatria para tratamento fototerápico. Os critérios de exclusão foram: mal-formações congênitas, síndromes com alterações cromossômicas, erro inato do metabolismo, infecções do grupo STORCH, asfixia neonatal, sepse ou suspeita de sepse, exsanguineotransfusão, transfusão de hemocomponentes e uso de imunoglobulina. Foi realizada a avaliação de expressão da intensidade média de fluorescência (IMF) de CD10, CD11b, CD11c, CD15, CD16, CD18, CD62L, CD64 e CD66, antes do início e após 24 horas do início da fototerapia. Foram utilizados o teste T de Student para análise dos dados. Resultados: Foram incluídos 25 recém-nascidos no estudo, com idade mediana de 53 (27.5-75.5) horas de vida e bilirrubina média de 13.6±2.85 mg/dL. Não houve diferença estatística na expressão de CD11b, CD15, CD18, CD62L, CD64 e percentual de neutrófilos antes e após 24 horas de fototerapia. Ocorreu aumento da expressão de CD10 8 (p=0.038) e CD16 (p=0.017) e redução da expressão de CD11c (p=0.023) e CD66acde (p=0.004) após 24 horas de fototerapia. Conclusão: Os recém-nascidos submetidos ao tratamento fototerápico apresentaram aumento da expressão de CD10 e de CD16 e diminuição da expressão de CD11c e de CD66acde após 24 horas de exposição, que pode estar relacionado a um efeito antiinflamatório da fototerapia nos recém-nascidos expostos a este tratamento. / Jaundice due to indirect hyperbilirubinemia affects more than 60% of term neonates. The treatment when necessary is carried out using phototherapy. There are no studies in the literature evaluating the effect of phototherapy on the function of neonates' neutrophils. A better understanding of the function of neutrophils in neonates before and after phototherapy would be important in order to assess potential effects on the expression of neutrofils triggered by the phototherapy treatment. The aim of this study was to assess and compare the function of neutrophils by measuring the expression of the main surface markers in icteric neonates, using flow cytometry, before and after 24 hours of phototherapy. Methodology: Neonates at a gestational age ≥ 35 weeks and at a birth weight ≥ 2000g who met the criteria of the American Academy of Pediatrics for phototherapy were included. The exclusion criteria were: congenital malformations, syndromes with chromosomal alterations, inborn errors of metabolism, infections of the STORCH group, neonatal asphyxia, sepsis or suspicion of sepsis, exchange transfusion, transfusion of blood components, and use of immunoglobulin. The evaluation of the MFI expression of CD10, CD11b, CD11c, CD15, CD16, CD18, CD62L, CD64 and CD66 was performed before and 24 hours after the initiation of phototherapy. The chi-square and Student T tests were used for data analysis. Results: Twenty-five neonates were included in the study at the mean age of 53 (27.5- 75.5) hours of life and with a mean bilirubin level of 13.6±2.85 mg/dL. There was no statistical difference in the expression of CD11b, CD15, CD18, CD62L, CD64 and percentage of neutrophils before and after 24 hours of phototherapy. There was an increase in the expression of CD10 (p=0.038) and CD16 (p=0.017) and a reduction in 10 the expression of CD11c (p=0.023) and CD66acde (p=0.004) after 24 hours of phototherapy. Conclusion: The newborns submitted to phototherapy had increased expression of CD10 and CD16 and decreased expression of CD11c and CD66acde after 24 hours of exposure, which may be related to an anti-inflammatory effect of phototherapy on the neonates exposed to this treatment.

Les anatomopathologistes disposent d’outils permettant d’assister leurs décisions cliniques et d’évaluer les risques de récidive des patientes atteintes d’un cancer du sein. Parmi ceux-ci, le grade histologique du cancer du sein divise les patientes en trois sous-groupes pour lesquels le grade histologique 1 et 3 sont respectivement associés à de bons et mauvais pronostics. Cependant, cet outil est loin d’être parfait, dû au manque de reproductibilité de ce système et du risque de récurrence intermédiaire, peu informatif, des patients classés dans la catégorie « grade 2 ».<p>Afin de mieux caractériser ces tumeurs de risque intermédiaire, notre laboratoire a introduit un score appelé « Gene expression Grade Index (GGI) », basé sur l’expression de 97 gènes définis par microarrays. De façon intéressante, ce GGI permet de diviser les patientes de grade histologique 2, sur base de leur profil d’expression, en 2 groupes correspondant aux tumeurs de grade 1 ou aux tumeurs de grade 3. Cependant, bien que le GGI apporte une information importante, son applicabilité clinique est limitée par son prix et la nécessité d’utiliser du matériel congelé.<p>Durant ce travail de thèse, nous avons transposé la signature microarrays en un test RT-PCR, appelé PCR-GGI, basé sur l’expression de 8 gènes qui permet de reproduire les performances du GGI à partir de tissus congelés ou conservés dans de la paraffine. Cette amélioration permet de faciliter son utilisation en routine clinique. <p>De plus, nous avons approfondi notre connaissance du grade histologique, au niveau génomique et transcriptomique, et montré que les tumeurs mammaires (ER-positives) peuvent être divisées en deux groupes :un premier groupe de faible instabilité génomique, exprimant faiblement les gènes de prolifération et présentant un faible risque de récurrence ;et un deuxième groupe de haute instabilité génomique (impliquant principalement des amplifications localisées dans les régions 8q et 20q), une expression importante de gènes de prolifération et un mauvais pronostic.<p>D’autre part, les carcinomes canalaires in situ (DCIS) présentant des similarités avec les tumeurs invasives, nous avons voulu mieux comprendre le comportement du grade tumoral parmi ces tumeurs pré-invasives. Nous avons donc intégré le PCR-GGI au VNPI et défini le VNPI-GGI. Comparé au VNPI classique, le VNPI-GGI identifie mieux les patientes qui vont récidiver tôt dans les groupes de risque intermédiaire et haut, et permet donc d’éviter le sur-traitement.<p>Cependant, le calcul du VNPI est un travail fastidieux et le PCR-GGI seul ne permet pas de prédire les risques de récidives des DCIS. Nous avons donc cherché un nouveau marqueur pronostique. Alors, qu’il existe des preuves de plus en plus nombreuses supportant l’importance du rôle anti-tumoral des cellules myoépithéliales, nous avons montré qu’une diminution de l’expression de CD10 – un marqueur des cellules myoépithéliale – était hautement corrélée au risque de récidive. Ces résultats soulignent l’importance tant de l’agressivité de la tumeur que de son environnement directe, dans la progression tumorale.<p><p>En terme d’applications, les résultats obtenus durant ce travail de thèse nous ont permis de développer des outils utilisables par les cliniciens afin d’améliorer la prise en charge des patientes.<p><p><p><p>Traditional histopathological tools routinely used to evaluate breast cancer prognosis are designed to assist physicians in their evaluation of clinical outcome. The histological grade of invasive breast cancer, that assigns patients to one of 3 groups for which histological grade 1 and 3 tumors are respectively associated with lower and higher rate of recurrence, has long provided clinically important prognostic information. However, this tool is far from perfect due to concern over reproducibility and intermediate risk of recurrence of the histological grade 2 that is not informative for clinical decision. <p>To better characterize tumors classified as histological grade 2, our group has introduced a score called Gene expression Grade Index (GGI) based on a cassette of 97 genes defined by Microarrays. Interestingly, the GGI was able to reclassify patients with histological grade 2 tumors into 2 groups with distinct clinical outcomes similar to those of histological grade 1 and 3, respectively. However, its clinical applicability still remains expensive and often requires frozen tissue.<p>During this thesis work, we have transposed the GGI onto a qRT-PCR assay, called PCR-GGI, based on a set of 8 genes that could recapitulate in an accurate and reproducible manner the prognostic performance of GGI using both frozen and paraffin-embedded (FFPE) tumor samples, to facilitate its use in clinical practice. <p>Moreover, we have explored histological grade of invasive breast cancer at genomic and transcriptomic level and we have shown that two classes of ER-positive invasive breast cancer are observed: a first of low genomic instability, low proliferation gene expression and low risk of recurrence; and a second of high genomic instability (implying a major role for amplification of region located on chromosome arms 8q and 20q), high proliferation gene expression and worse prognosis.<p>In addition, since Ductal Carcinoma in situ (DCIS) and invasive breast cancer show concordant biologic behavior, we attempted to better understand the molecular basis of grade in pre-invasive breast cancer. We have then incorporated the PCR-GGI in the VNPI and defined the VNPI-GGI to improve its prognostic value. Compared to the classic VNPI, the VNPI-GGI had a better potential to identify early relapsing patients in the intermediate and high score group, and avoid under treatment in high-risk DCIS patients.<p>However, VNPI scoring is a tedious work and PCR-GGI alone can’t predict recurrence in pre-invasive breast cancer. We aimed then to find news prognosis marker in the field of DCIS. As there is now growing body of evidence supporting the role of myoepithelial cells (MECs) as natural tumor suppressors, we have showed that a decrease of CD10 expression- a surface biomarker of MECs – was significantly associated with an increased risk of relapse. <p>These results highlight the importance of assessing intrinsic DCIS properties as well as juxta-tumoral stroma, both seems to have a major role in DCIS progression.<p><p>In terms of applications, from these results obtained during this thesis work, we developed methods applicable into clinical practice to improve patients management.<p> / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished