No / Inflammatory bowel diseases are associated with increased risk of developing colitis-associated colorectal cancer (CAC). Epidemiological data show that the consumption of ω-3 polyunsaturated fatty acids (ω-3 PUFAs) decreases the risk of sporadic colorectal cancer (CRC). Importantly, recent data have shown that eicosapentaenoic acid-free fatty acid (EPA-FFA) reduces polyp formation and growth in models of familial adenomatous polyposis. However, the effects of dietary EPA-FFA are unknown in CAC. We tested the effectiveness of substituting EPA-FFA, for other dietary fats, in preventing inflammation and cancer in the AOM-DSS model of CAC. The AOM-DSS protocols were designed to evaluate the effect of EPA-FFA on both initiation and promotion of carcinogenesis. We found that EPA-FFA diet strongly decreased tumor multiplicity, incidence and maximum tumor size in the promotion and initiation arms. Moreover EPA–FFA, in particular in the initiation arm, led to reduced cell proliferation and nuclear β-catenin expression, whilst it increased apoptosis. In both arms, EPA-FFA treatment led to increased membrane switch from ω-6 to ω-3 PUFAs and a concomitant reduction in PGE2 production. We observed no significant changes in intestinal inflammation between EPA-FFA treated arms and AOM-DSS controls. Importantly, we found that EPA-FFA treatment restored the loss of Notch signaling found in the AOM-DSS control and resulted in the enrichment of Lactobacillus species in the gut microbiota. Taken together, our data suggest that EPA-FFA is an excellent candidate for CRC chemoprevention in CAC.

Fusobacterium nucleatum is an anaerobic, Gram-negative, oral bacterium that disseminates from the mouth, and contributes to preterm birth, tissue infections, and acceleration of multiple cancers including colorectal and pancreatic. It is well-established that most Fusobacterium species exhibit genetic recalcitrance, which has led to hindrance in the understanding of their biology and molecular pathogenesis. Though the association of Fusobacterium in diseases is well-established, the majority of our experimental work stems from the strain F. nucleatum ATCC 23726 because it is genetically tractable. Here, in this dissertation, we show that we are able to enhance our existing molecular tools for genome editing to introduce the first mutants in a clinically relevant strain, F. nucleatum ATCC 25586, a feat that was never accomplished in decades of trying. Furthermore, we created a deletion library of genes predicted to be involved in host cellular invasion and survival. In this work, we identified a novel small adhesin, FadA2, that played a significant role in the invasive ability of F. nucleatum ATCC 25586 to colorectal cancer cells. This dissertation also sheds the first insight into the roles of the type 5a autotransporters. Using a deletion library of genes encoding for the type 5a autotransporter proteins in F. nucleatum ATCC 23726, we systemically characterized altogether 12 type 5a proteins with a focus on the invasion of colorectal cancer cells. Most notably, we found that a wide assortment of type 5a proteins contributing to binding and invasion of F. nucleatum to HCT116 cancer cells. Furthermore, we identified that RadD was not directly involved in inducing secretions of the cytokines IL-8 and CXCL1 while confirmed the specific association of Fap2 in bacterial-induced cytokine secretion. Thus, our findings provided the first comparative and functional analysis of Fusobacterium type 5a autotransporter proteins in colorectal cancer cells which will be crucial to the understanding of Fusobacterium involvement in cancer progression. Finally, this dissertation reported on the first ever observation on the survival strategy of Fusobacterium inside the host cells. We uncovered a novel protein that contributed to enhanced survival of Fusobacterium residing in colorectal cancer cells. This work undoubtedly helps expand the current Fusobacterium genetic toolkit to study proteins and mechanisms relevant to Fusobacterium-accelerated diseases. By identifying and characterizing novel virulence strategies that Fusobacterium can take advantage of, we can increase our comprehension on this opportunistic microbe while devising innovative therapeutic treatments. / Doctor of Philosophy / Fusobacterium, a member of the microbial community in our mouth, has been a captivating study target due to its association with human health and diseases. By nature, Fusobacterium lives in oxygen-free pockets between our teeth and gumline in which this organism has been correlated with a multitude of complications and diseases including periodontitis, inflammatory bowel disease, preterm birth, and most importantly colorectal cancer. Though the connection to human health is established, we still have to learn more about the mechanisms utilized by Fusobacterium to exacerbate diseases. This challenge is mainly hindered by the lack of efficient tools and resources to systematically investigate the relationship between the bacterium and its human host. Therefore, the work in this dissertation focuses on expanding the existing molecular toolkit to study clinically relevant Fusobacterium strain, which provides the power and convenience to discover novel mechanisms that Fusobacterium can take advantage of to be a successful pathogen. Accordingly, we first enhanced our ability to work with a wider range of Fusobacterium species. We successfully introduced exogenous genetic materials into a clinical strain of Fusobacterium, Fusobacterium nucleatum ATCC 25586. This breakthrough was built on the success of our current toolkit to make genetic modifications to a sister strain, Fusobacterium nucleatum ATCC 23726. With this newfound capacity to modify F. nucleatum ATCC 25586, we have described the importance of a novel protein aiding in the invasion of Fusobacterium to colorectal cancer. Furthermore, we have determined that certain proteins within the fusobacterial type 5a protein family can play a key role in governing binding and invasion of colorectal cancer cells in this study. Concurrently, for the first time, we provided the snapshot of a small protein and its role in fusobacterial long-term survival inside its targeted host cells. Altogether, the findings in this dissertation will bring forth an innovative framework to better the comprehension of current Fusobacterium-induced disease implications, while exploring alternative treatments for enhanced patient health.

No description available.

Growing evidence indicates that serine proteases known as kallikreins are associated with malignancy and may have potential diagnostic/prognostic applications in cancer. Kallikreins are the largest group of serine proteases. Kallikrein enzymes are often involved in proteolytic cascades through their function in degradation of extracellular matrix proteins and promotion of angiogenesis. Kallikrein 6 (KLK6) is a member of the family of fifteen highly conserved secreted trypsin- or chemotrypsin-like serine proteases. Over-expression of KLK6 has been observed in different pathophysiological states such as neurodegenerative diseases, inflammation and various cancers, including colorectal cancer. In Chapter 3 we elucidated the miRNA-based mechanism of regulation of invasion in metastatic colorectal cancer over-expressing KLK6. We developed HCT116 colon stable isogenic cell lines with knockdown of KLK6 expression using short-hairpin interference RNA (shKLK6 clones). The shKLK6 clones had decreased expression and secretion of KLK6 protein with a minimal effect on cell growth and viability in cell culture. SCID mice injected with shKLK6-3 clone 3 cells exhibited a statistically significant increase in the survival rates (P=0.005), decrease in the incidence of distant metastases and a shift in the location of the metastatic foci closer to the cell's injection site. Levels of KLK6 protein secreted into the bloodstream were significantly lower in animals injected with shKLK6-3 clone 3 compared to HCT116 control clone 1 (P < 0.04). Through bioinformatics analyses we identified and validated three miRNAs, which are important in post-translational modification of bioactive proteins, proliferation, migration and p38 MAPK signaling pathway. In Chapter 4 we developed Caco-2 colon stable isogenic cell lines with expressing enzymatically active or mutant KLK6 protein (Caco-2 stable clones). We employed these cell lines to investigate the importance of KLK6 enzymatic activity of initiation of cell invasion using in vitro and in vivo models.

Résumé : L’adénocarcinome colorectal est parmi les plus importants cancers au Canada en terme de mortalité et morbidité. Cependant, nous n’en connaissons encore que peu, entres autres sur les voies cellulaires importantes et les protéines présentant un potentiel comme biomarqueur. Cette étude fut divisée en deux sous-projets. Sous-projet A. Il n’y a présentement aucun biomarqueur permettant de prédire la réponse à la radiothérapie comme modalité de traitement pour le cancer colorectal. Le but de ce sous-projet était de mettre au point les méthodes permettant d’effectuer une étude prospective ou rétrospective par spectrométrie de masse sur la réponse à la radiothérapie en utilisant des échantillons de tissu de patient. Des échantillons de tissu de souris et de tissu humains anonymisés ont été utilisés pour évaluer la faisabilité d’une telle étude. Différentes techniques d’extraction protéique ont été évaluées. Les extraits totaux et fractionnements subcellulaires de tissu frais ont permis une analyse appropriée des protéines cellulaires. Il en était de même pour l’extraction totale de tissus fixés. Cependant, les protéines extraites suite à microdissection au laser de tissu fixé étaient inadéquates et en nombre insuffisant. Sous-projet B. Afin d’investiguer l’importance de fonctions, voies ou protéines dans différents types de cancer colorectaux, neuf lignées cellulaires de cancer colorectal et de côlon normal ont été fractionnées en quatre compartiments subcellulaires et analysées par spectrométrie de masse. Aucun groupe de recherche n’avait analysé jusqu’à présent plus de cinq lignées et plus d’un compartiment subcellulaire à la fois. Les résultats montraient que certaines voies canoniques et fonctions cellulaires étaient de haute importance dans plusieurs des lignées analysées, dont la voie de signalisation par eIF2. De plus, les régulateurs de transcription TP53, MYC et TGFB1, pouvant être responsables des caractéristiques cellulaires observées, ont été identifiés. En conclusion, ce projet nous a permis d’améliorer nos connaissances sur les caractéristiques moléculaires d’importance dans le cancer colorectal et de mettre au point des techniques qui pourraient permettre la découverte de nouveaux biomarqueurs. / Abstract : Colorectal adenocarcinoma is one of the most important cancers in Canada in terms of mortality and morbidity. However, we still know very little on its molecular features. This study was divided into two sub-projects. Sub-project A. At this time, no biomarker has the capacity of predicting a patient’s response to radiotherapy, which is a commonly used treatment of colorectal cancer. The goal of this section was to develop the methods to conduct a prospective or retrospective mass spectrometry study on the patient response to radiotherapy, through the use of human tissues. Mouse tissues and tissues of an anonymous patient were obtained in order to evaluate the feasibility of such a study. Different protein extraction techniques were evaluated. Total lysates and subcellular fractionations of fresh tissues allowed for a successful analysis of the samples. The same was true of total lysates of fixed tissues. However, proteins extracted from cells isolated through laser capture microdissection were insufficient in numbers and their types were inconsistent with the expected results. Sub-project B. In order to study the importance of proteins and cellular functions or pathways in different types of colorectal cancers. nine cell lines originating from colorectal carcinoma and from normal colon were fractionated according to four subcellular compartments and analysed through mass spectrometry. Until now, no research group had analysed, in a single study more than 5 cell lines as well as more than one subcellular compartment at once. Some cellular functions and canonical pathways were shown to be of high importance in many of the studied cell lines, such as the signalling through eIF2 pathway. Furthermore, the transcription regulators TP53, MYC and TGFB1were identified as potentially responsible for the observed proteomic characteristics. In conclusion, this study allowed for a better understanding of important molecular caracteristics of colorectal cancer and allowed for the optimization of techniques that may serve in the discovery of new biomarkers relative to the use of radiotherapy as a treatment.

Despite significant advances in cancer treatment, clinical response remains suboptimal and there is a continued requirement for improved chemotherapeutics. The attrition rate for new therapies is high, due principally to lack of in vivo efficacy and poor pharmacodynamics. Consequently better systems are required to determine in vivo preclinical efficiency and drug-target interactions. Engineering of cancer cells to express fluorescent or bioluminescent proteins, either endogenously or under the control of specific gene promoters, and their detection by noninvasive optical imaging has the potential to improve preclinical drug development. In this study, a panel of colorectal cancer cell lines were engineered to express fluorescent and luminescent proteins either constitutively or under control of gene-promoters for the DNA damage response gene p53 or the cell cycle regulator p21, both important pharmacodynamic sensors. These cell lines were characterised for their potential as in vivo models of primary and metastatic tumour therapy response, several showing significant potential. In addition to the development of these models, this study also addressed the pharmacokinetics of different luciferase substrates and identified optimal temporal and dose characteristics for each. Furthermore, a new application for bioluminescent imaging was developed and validated for use in preclinical evaluation of vascular disrupting agents, a new generation of cancer therapeutic. This study demonstrates that despite the dynamic and variable nature of fluorescent and bioluminescent imaging, reproducible results can be obtained if appropriate precautions are taken. The models developed herein will expedite cancer drug development whilst reducing and refining the use of animals in research.

Mon travail de thèse consistait à étudier la signalisation oncogénique de la tyrosine kinase (TyrK) cytoplasmique Src dans les cellules de cancer colorectal (CCR) à un stade avancé par une approche globale de phosphoprotéomique quantitative de type SILAC puis d'évaluer l'efficacité du Nilotinib, un inhibiteur de la Tyrk oncogénique BCR-Abl, sur les propriétés invasives des cellules de CCR. Dans un premier temps, nos résultats ont confirmé le rôle clé joué par Src dans l'acquisition des propriétés invasives de la tumeur. Puis, l'approche phosphoprotéomique de type SILAC a permis de mettre en évidence 136 protéines substrats de Src parmi lesquelles nous retrouvons des protéines de signalisation, des protéines associées au cytosquelette ou des protéines du trafic vésiculaire. De manière intéressante, j'ai révélé l'implication d'un réseau de TyrK dans les propriétés invasives Src-dépendantes. Nos résultats suggèrent qu'une thérapie multi-TyrK pourrait s'avérer intéressante pour traiter les CCR à un stade avancé. En complément de l'analyse SILAC, j'ai initié une approche pharmacologique pour caractériser les TyrK impliquées dans l'invasion des cellules de CCR. De manière surprenante, j'ai observé que le Nilotinib inhibe l'activité invasive des cellules de CCR avec une efficacité comparable à celle observée sur la croissance des cellules de LMC (IC50=20nM). Des approches d'invalidation génétique et de mutagénèse couplées à des tests d'invasion in vitro et in vivo ont permis de démontrer que le Nilotinib exerce son activité anti-invasive en ciblant le récepteur au collagène DDR1. Mes résultats laissent présager un intérêt thérapeutique potentiel du Nilotinib dans le traitement du cancer colorectal métastasant. / My thesis work was devoted to decipher the oncogenic signaling of the cytoplasmic tyrosine kinase (TyrK) Src in advanced colorectal cancer (CRC) cells using SILAC quantitative phosphoproteomics and to evaluate the efficiency of the oncogenic BCR-Abl inhibitor, Nilotinib, on the CRC cell invasive activity. Firstable, our results confirmed the key role of Src in the induction of cell invasion. Then, the SILAC phosphoproteomic approach revealed 136 Src substrates among which signaling proteins, cytoskeleton associated proteins or vesicular trafficking associated proteins. Interestingly, I have identified a TyrK network involved in Src-dependent invasive properties. Taken together, our results suggest that a multi-TyrK therapy may be interesting in clinic for the treatment of advanced CRC. In addition to the SILAC analysis, a pharmacological approach was set up to characterize TyrK involved in CRC cell invasion. Surprisingly, I found that Nilotinib inhibits CRC cell invasive activity with a similar efficiency to the one observed on the growth of CML (IC50 = 20nM). Knock down and mutagenesis experiments together with in vitro and in vivo invasion assay revealed the collagen receptor DDR1 as the main Nilotinib target in its anti-invasive activity. Our results suggest that Nilotinib could be of therapeutic value in metastatic CRC.

Colorectal cancer (CRC) is one of the most prevalent and deadly forms of cancer. Its high mortality rate is associated with difficulties in early detection, which is crucial to survival. The onset of CRC is marked by macroscopic changes in intestinal tissue, originating from a deviation in the healthy cell dynamics of glands known as the crypts of Lieberkuhn. It is believed that accumulated genetic alterations confer on mutated cells the ability to persist in the crypts, which can lead to the formation of a benign tumour through localised proliferation. Stress on the crypt walls can lead to buckling, or crypt fission, and the further spread of mutant cells. Elucidating the initial perturbations in crypt dynamics is not possible experimentally, but such investigations could be made using a predictive, computational model. This thesis proposes a new discrete crypt model, which focuses on the interaction between cell- and tissue-level behaviour, while incorporating key subcellular components. The model contains a novel description of the role of the surrounding tissue and musculature, which allows the shape of the crypt to evolve and deform. A two-dimensional (2D) cross-sectional geometry is considered. Simulation results reveal how the shape of the crypt base may contribute mechanically to the asymmetric division events typically associated with the stem cells in this region. The model predicts that epithelial cell migration may arise due to feedback between cell loss at the crypt collar and density-dependent cell division, an hypothesis which can be investigated in a wet lab. Further, in silico experiments illustrate how this framework can be used to investigate the spread of mutations, and conclude that a reduction in cell migration is key to confer persistence on mutant cell populations. A three-dimensional (3D) model is proposed to remove the spatial restrictions imposed on cell migration in 2D, and preliminary simulation results agree with the hypotheses generated in 2D. Computational limitations that currently restrict extension to a realistic 3D geometry are discussed. These models enable investigation of the role that mechanical forces play in regulating tissue homeostasis, and make a significant contribution to the theoretical study of the onset of crypt deformation under pre-cancerous conditions.

Background: Currently, participation in the NHS Bowel Cancer Screening Programme (NHSBCSP) is poor, with around half of all people invited returning their (FOBT) kits. The research programme aimed to investigate whether a general practitioner’s (GP) letter encouraging participation and a detailed leaflet explaining how to complete the (FOBT) included with the invitation materials would improve uptake. Methods: The research programme was divided into three phases which were designed to sequentially develop and evaluate the two interventions. The initial and second phases developed and refined the two interventions and the trial outcome measures with previous participants and stakeholder representatives. The final phase was a randomised 2x2 factorial trial conducted with people invited to screening in October 2009. Participants were randomised to either a GP’s endorsement letter and/or a detailed procedural leaflet with their FOBT kit. The primary outcome was verified participation in the NHSBCSP. Questionnaires were also used to evaluate participant perceptions of CRC screening and GPs views on involvement with the NHSBCSP. Results: The factorial trial demonstrated both the GP’s endorsement letter and the detailed procedural leaflet increased participation in the NHSBCSP. In the intention-to-treat analysis, participation improved by 6% for the detailed procedural leaflet and 5.8% for the GP endorsement letter 20 weeks after receipt of the FOBT kit. The random effects logistic regression model confirmed that there was no important interaction between the two interventions, and estimated an adjusted rate ratio of 1.11 (P=0.038) for the GP’s letter and 1.12 (P=0.029) for the leaflet. The per protocol analysis indicated that the insertion of an electronic GP’s signature on the endorsement letter was associated with increased participation (P=0.039). Conclusions: Including both an endorsement letter from each patient’s GP and a detailed procedural leaflet could increase participation in the NHSBCSP by around 10%, a relative improvement of 20% on the current participation rate. Both interventions were well-received by participants and there was minimal impact on GP workload.

The estimation of probability density functions (PDF) of intensity values plays an important role in medical image analysis. Non-parametric PDF estimation methods have the advantage of generality in their application. The two most popular estimators in image analysis methods to perform the non-parametric PDF estimation task are the histogram and the kernel density estimator. But these popular estimators crucially need to be ‘tuned’ by setting a number of parameters and may be either computationally inefficient or need a large amount of training data. In this thesis, we critically analyse and further develop a recently proposed non-parametric PDF estimation method for signals, called the NP windows method. We propose three new algorithms to compute PDF estimates using the NP windows method. One of these algorithms, called the log-basis algorithm, provides an easier and faster way to compute the NP windows estimate, and allows us to compare the NP windows method with the two existing popular estimators. Results show that the NP windows method is fast and can estimate PDFs with a significantly smaller amount of training data. Moreover, it does not require any additional parameter settings. To demonstrate utility of the NP windows method in image analysis we consider its application to image segmentation. To do this, we first describe the distribution of intensity values in the image with a mixture of non-parametric distributions. We estimate these distributions using the NP windows method. We then use this novel mixture model to evolve curves with the well-known level set framework for image segmentation. We also take into account the partial volume effect that assumes importance in medical image analysis methods. In the final part of the thesis, we apply our non-parametric mixture model (NPMM) based level set segmentation framework to segment colorectal MR images. The segmentation of colorectal MR images is made challenging due to sparsity and ambiguity of features, presence of various artifacts, and complex anatomy of the region. We propose to use the monogenic signal (local energy, phase, and orientation) to overcome the first difficulty, and the NPMM to overcome the remaining two. Results are improved substantially on those that have been reported previously. We also present various ways to visualise clinically useful information obtained with our segmentations in a 3-dimensional manner.