L’infection par Helicobacter pylori touche environ la moitié de la population mondiale et est responsable de plusieurs pathologies gastro-intestinales incluant l’adénocarcinome gastrique. Les mécanismes de la carcinogénèse induite par H. pylori ne sont pas clairement élucidés. Mais, l’oncoprotéine CagA que possèdent certaines souches est très impliquée dans la carcinogénèse gastrique ; elle induit l’apparition d’un phénotype particulier, dit colibri, qui mime une transition épithélio-mésenchymateuse (EMT). De plus, CagA déstabilise les jonctions cellulaires en perturbant la E-cadhérine. Les objectifs de ces travaux ont été de déterminer si H. pylori induit une véritable EMT et si cette EMT est à l’origine de l’émergence de cellules souches cancéreuses (CSC). De plus, nous avons étudié le rôle joué par la protéine IQGAP1, protéine assurant le maintien des jonctions cellulaires, dans la carcinogénèse gastrique induite par H. pylori. Ces travaux ont montré que H. pylori induit une EMT in vitro. Cette EMT est à l’origine de l’émergence de cellules CD44high présentant les caractéristiques de CSC. L’étude du rôle de IQGAP1 au cours de la carcinogénèse gastrique liée à H. pylori a permis de déterminer son implication dans l’apparition de lésions néoplasiques dans un modèle de souris transgéniques hétérozygotes pour IQGAP1. En outre, IQGAP1 apparaît comme une protéine dont l’expression est modifiée par l’infection à H. pylori et par l’EMT induite par cette bactérie in vitro. Nos résultats permettent de mieux comprendre le mécanisme physiopathologique de l’adénocarcinome gastrique et seront potentiellement utiles au développement de nouvelles thérapeutiques anti-cancéreuses. / Helicobacter pylori infection is found in about half of the world population and is responsible for several gastrointestinal pathologies, including gastric adenocarcinoma. The mechanisms of the carcinogenesis due to H. pylori remain unclear. However, the link with gastric adenocarcinoma is partly due to the H. pylori CagA oncoprotein. CagA is responsible for a particular cell phenotype in vitro, the “hummingbird” phenotype which corresponds to an elongation of the cells, mimicking an epithelial to mesenchymal transition (EMT). EMT participates to carcinogenesis, and is involved in the generation of cancer stem cells (CSC). Moreover, CagA destabilize the cell junctions. This study aimed to determine wether H. pylori induces a true EMT, and if so, wether this EMT can generate CSCs. The role of IQGAP1, which is a scaffold protein involved in cell adhesion, was also studied in cases of gastric carcinogenesis due to H. pylori. We demonstrated that H. pylori induces an EMT in vitro. Moreover, we showed that this EMT is responsible for the emergence of CD44high cells which have the same characteristics as the CSCs. IQGAP1 has been identified as a protein implicated in neoplastic lesion development in a transgenic mouse model heterozygous for IQGAP1. Moreover, in vitro, the expression of IQGAP1 was modified by H. pylori infection and more specifically by the EMT induced by H. pylori. Our results allow a better understanding of gastric adenocarcinoma pathophysiology and will be helpful in developing new cancer chemotherapies.

Les cellules souches cancéreuses mammaires sont considérées d'initier et d'être responsable du développement des tumeurs. Un certain nombre de marqueurs ont été proposées, mais la question sur la définition de la CSC dans les cancers du sein RE+ reste ouverte. Nous avons utilisé les lignées MCF7 et T47D comme modèles RE+ et les SUM159 comme RE- pour rechercher les fractions cellulaires enrichies des CSC. Nous avons utilisé un panel de marqueurs tels qu'ALDH, CD44/CD24, combiné avec la formation de mammosphères. Les xénogreffes dérivées de patients (PDXs) de cancer du sein ont également été analysées. ALDH+ et/ou CD44+/CD24- définie des fractions cellulaires enrichies en cellules initiatrices de mammosphères et la capacité de différenciation dans les SUM159 et T47D, mais pas dans les MCF7. Nous avons demandé si cela pourrait être lié à différents statuts de p53. Dans ce but, nous avons généré des cellules MCF7shP53 et a montré une augmentation nette de fraction CD44+/CD24- dans ces cellules et une formation accrue de mammosphères. Cependant, les fractions triées ALDH+ ou CD44+/CD24- ont augmenté la formation de mammosphères d'un facteur 2 maximal. Nous voulions enrichir les CSC (basées sur l'initiation de mammosphères), les cellules en monocouche et en mammosphères sont exposées sous faible tension d'oxygène (<2%) pendant 7 jours, elles sont ensuite caractérisées sur la base de leur expression d'un certain nombre de marqueurs de différenciation soit par FACS soit par immunofluorescence. Dans les mammosphères des lignées RE+, les cellules ont passé à un phénotype bipotent CK5+/CK8+ et augmenté la fraction CD24+/CD44-. La même tendance a été observée parallèlement dans les cellules incubées en hypoxie. En outre, les sphères ne portent pas d'augmentation de la tumorigénicité. En conclusion, les cellules formant les mammosphères correspondent à un sous-ensemble avec un phénotype spécifique qui ne portent pas d'augmentation de la tumorigénicité. / Breast cancer stem cells (BCSCs) are believed to initiate and sustain tumor development. A number of markers have been proposed but open questions remain on the definition of CSC in ER+ breast cancer. We used MCF7 and T47D BCCL as ER+ models and the SUM159 BCCL for ER- to search for BCSC enriched subpopulations. We used a panel of markers such as ALDH, CD44/CD24, combined with mammosphere formation. Breast patient derived xenografts (PDX) were also analyzed. ALDH+ and/or CD44+/CD24- define fractions of cells enriched in mammosphere initiation and differentiation capacity in SUM159 and T47D, but not in MCF7. We asked whether this could be linked to different p53 statuses. To this aim, we generated MCF7-shp53 cells and showed a net increase in CD44+/CD24- in these cells and increased mammosphere formation. However, sorted ALDH+ or CD44+/CD24- cells increased mammosphere formation at most by a factor 2. We wanted to further enrich for CSC (based on mammosphere initiation), cultured 2D and mammosphere cells to low oxygen (<2%) for 7 days and characterized the cells on the basis of their expression of a number of differentiation markers by either FACS or immunofluorescence. In mammosphere of ER+ BCCL cells switched to a bipotent CK5+/CK8+ phenotype and increased the CD24+/CD44- fraction. Parallel findings were made with cells incubated under low O2. Furthermore, spheres do not bear increased tumorigenicity. In conclusion mammosphere forming cells correspond to a specific phenotypic subset of breast cancer cells that do not bear increased tumorigenicity.

L'électrochimiothérapie est un traitement anticancéreux utilisé en routine en Europe dans près de 130 centres de traitement du cancer. Le taux de réponse objective atteint 85 % pour le traitment de tumeurs cutanées et sous-cutanées et des études sont en cours afin d'appliquer ce traitement à des tumeurs profondes. Au cours de ce doctorat, les méchanismes sous-jacents à cette excellente efficacité antitumorale ont été étudiés. Dans un premier temps, l'objectif a été d'évaluer la capacité de l'électrochimiothérapie à induire la mort des cellules souches cancéreuses, considérées comme les racines du cancer. Ensuite, les mécanismes immunologiques à l'origine du développement d'une immunité antitumorale mise en place par le traitement ont été investigués. Cependant, malgré le haut taux de réponse observé, l'électrochimiothérapie reste un traitement local qui n'induit pas de réponse antitumorale à distance, sur les tumeurs non-traitées. Afin de pallier à cette absence d'activité systémique, une collaboration a été mise en place avec une entreprise innovante de biotechnologies, INVECTYS, dans le but de développer une stratégie de vaccination à ADN ciblant la télomérase et basée sur l'électrogènetransfert. Il est attendu que la combinaison de cette immunothérapie avec un traitement local par électrochimiothérapie, détruise non seulement la tumeur primaire, dont les cellules souches cancéreuses, mais également les cellules cancéreuses circulantes et les métastases. / Electrochemotherapy is an anticancer treatment used in routine in Europe in 130 cancer treatment centers. The objective response rate reaches 85 % for the treatment of cutaneous and subcutaneous tumors and studies are ongoing to spread the use of electrochemotherapy to deep-seated tumors. In the frame of this doctorate, the mechanisms underlying this excellent antitumor efficiency were investigated. First, the goal was to evaluate the ability of electrochemotherapy to induce the death of cancer stem cells, considered as the roots of cancer. Second, the immunological mechanisms responsible for the development of antitumor immune responses following the treatment were investigated. However, although a very high response rate is observed, electrochemotherapy remains a local treatment which does not induce antitumor responses in distant non-treated nodules. In order to circumvent this lack of systemic activity, a collaborative project was initiated with an innovating biotech company, INVECTYS, in order to develop a DNA vaccination strategy targeting the telomerase and based on electrogenetransfer. It is expected that the combination of this immunotherapy with a local treatment by electrochemotherapy could destroy not only the primary tumor, including cancer stem cells, but also circulating cancer cells and metastases.

O câncer de pulmão está entre os tipos de câncer com maiores índices de mortalidade no mundo. Na década de 90, houve a descoberta de populações de células tumorais com características de células-tronco e implicou na hipótese das células-tronco cancerosas (CTCs). Se a hipótese das CTCs for correta, a recorrência/recidiva dos cânceres é gerada por uma porcentagem de células (CTCs) que prolifera pouco e é resistente a quimioterapia convencional. Desta forma, a busca por novos alvos terapêuticos que tenham como alvo estas CTCs tem enorme implicação no desenvolvimento de novos fármacos ou modalidades terapêuticas contra o câncer. O guaraná (Paullinia cupana Mart var. sorbilis) tem demonstrado efeitos promissores sobre o câncer, em especial efeitos quimiopreventivos e antineoplásicos. Portanto, objetivando-se neste projeto avaliar a presença de CTCs a partir de células tumorais de pulmão de camundongo, onde se possa conseguir rapidamente uma alta porcentagem deste tipo celular para posteriores estudos, além de avaliar os efeitos do extrato etanólico do guaraná e de suas frações butanólica e aquosa, sobre as células tumorais e em especial verificar os efeitos sobre a população rica em CTCs, onde foi possível observar a presença de possíveis CTCs, a partir de cultivo de células tumorais de pulmão de camundongo, como também que o guaraná apresentou um efeito sobre estas possíveis CTCs devido a diminuição da expressão dos genes ABCG2 e ALDH1a1. / Lung cancer is among the cancers with the highest mortality rates in the world. In the 90\'s, there was the discovery of tumor cell populations with stem cell characteristics implied in the case of cancer stem cells (CSCs). If the hypothesis is correct CSCs of the recurrence / relapse of cancers is generated by a percentage of cells (CSCs) that growth low and are more resistant to conventional chemotherapy. Thus, the search for new therapeutic targets that target these CSCs has huge implications in developing new drugs or therapeutic approaches against cancer. Guarana (Paullinia cupana Mart var. Sorbilis) has shown promising effects on cancer, especially chemopreventive and anticancer effects. Therefore, the objective in this project is to evaluate the presence of CSCs from tumor cells of mouse lung, where it can quickly get a high percentage of this cell type for further studies and to evaluate the effects of ethanol extract of guarana and its butanol and aqueous fractions on tumor cells and in particular to verify the effect on the population rich in CSCs, where it was possible to observe the possible presence of CSCs from cultivation of tumor cells from mouse lung, as well as guarana presented an effect on these CSCs possible to decreased expression of ABCG2 and ALDH1a1 genes.

Inhibitor of differentiation 4 (ID4), a member of the helix-loop-helix family of transcriptional regulators has emerged as a tumor suppressor in prostate cancer (PCa). Recent studies have shown that Id4 is highly expressed in the normal prostate and decreases in prostate cancer due to epigenetic silencing. Id4 knockdown in androgen sensitive LNCaP cells has been shown to lead to castration resistant prostate cancer (CRPC) in vitro and in vivo. Id4-/- mice leads to underdeveloped prostate with PIN like lesions without the loss of Androgen Receptor (AR) expression. In this study we demonstrate that the loss of ID4 expression in PCa cell line LNCaP and DU145 may promote tumorigenesis by promoting stemness. LNCaP cells with stably silenced ID4 ((-)ID4) using retroviral based shRNA and LNCaP transfected with non-specific shRNA were used to perform colony forming assay and prostatosphere formation using matrigel. Expression of cancer stem cell markers was determined using western blotting and immunocytochemistry (ICC). FACS analysis was used to sort stem cells and determine the ID4 expression. Xenograft study was performed on SCID mice using CD133 positive LNCaP cells. LNCaP(-)ID4 and DU145 cells lacking ID4 showed increased holoclone as well as decreased paraclone formation, which are believed to be derived from stem cells and differentiated cells respectively, as compared to non-silencing control in the colony forming assay. There was also an increase in prostatosphere development in the LNCaP (-) ID4 cells indicating that the loss of ID4 is responsible for promoting the LNCaP cells towards cancer stem cells. The results were further validated via western blotting and ICC using known cancer stem cell markers on the holoclones and paraclones formed by these cells. Xenograft study showed that 10,000 cells from CD133 positive LNCaP cells developed tumor on SCID mice. This study reports for the first time that loss of ID4 increases holoclone and prostatosphere formation indicating that Id4 may contribute to promoting stemness in prostate cancer cells.

Dans les tumeurs hiérarchiques, les cellules souches du cancer (CSC), au sommet de la hiérarchie tumorale, peuvent s'auto-renouveler et se différencier en progéniteurs amplificateurs transitoires (TAP) avec un potentiel d'auto-renouvellement limité. Au cours du développement, les cellules souches neurales de Drosophile, appelées neuroblastes (NB), expriment en séquence deux protéines antagonistes se liant à l'ARN, Imp et Syncrip (Syp), qui respectivement favorise et réprime l'auto-renouvellement des NB. La perturbation de mécanismes de division asymétrique des NB peut générer leur amplification illimitée induisant de véritables tumeurs. À l’aide d’une analyse clonale et de modélisations mathématiques, nous avons démontré que les progéniteurs Imp+ dans les tumeurs agissent comme des cellules semblables aux CSC, capables de se renouveler indéfiniment et de se différencier en progéniteurs Syp+, qui, à l’instar des TAP, ont un potentiel d’auto-renouvellement limité et une forte tendance à entrer en quiescence. De plus, nous avons démontré que les tumeurs du NB suivent une organisation hiérarchique rigide dans laquelle la transition Imp-Syp est irréversible. Fait intéressant, en utilisant l’analyse transcriptomique, nous avons constaté que la transition Imp à Syp dans les NB de tumeurs induit une régulation négative des gènes glycolytiques et respiratoires, épuisant vraisemblablement la capacité de croissance et d’auto-renouvellement des progéniteurs Syp+. La conservation frappante de ces protéines de liaison à l'ARN ouvre la possibilité passionnante que des hiérarchies analogues puissent exister dans les cancers humain. / In hierarchical tumors, cancer stem cells (CSCs), at the top of the tumor hierarchy, can self-renew and differentiate in transient-amplifying progenitors (TAPs), with a limited self-renewal potential. Understanding the molecular mechanisms that drive tumor hierarchy and heterogeneity is crucial to develop effective therapies to eliminate CSCs. During development, Drosophila asymmetrically-dividing neural stem cells, called neuroblasts (NBs), sequentially express two antagonistic RNA-binding proteins, Imp and Syncrip (Syp), that respectively promote and repress NB self-renewal. Genetic perturbation of NB asymmetric division cause NB amplification and malignant tumors. By using lineage tracing, clonal analysis and stochastic mathematical modeling of tumor growth, we demonstrated that Imp+ progenitors act as CSCs. They are able to self-renew endlessly and differentiate in Syp+ progenitors, that have a limited self-renewal potential and the high tendency to undergo quiescence. NB tumors follow a rigid hierarchical organization, where the Imp-to-Syp transition is irreversible. Hence, Syp+ progenitors cannot revert to an Imp+ malignant state. Transcriptomic analysis revealed that the Imp-to-Syp transition in tumors induces a downregulation of glycolytic and respiratory genes that exhausts the growth and self-renewing potential of Syp+ progenitors. The striking conservation of these RNA-binding proteins opens the exciting possibility that analogous Imp-Syp hierarchies may exist in human cancers.

Il est connu aujourd'hui qu'une petite sous-population de cellules au sein des tumeurs possède une puissante capacité d'auto-renouvellement et est impliquée dans la progression tumorale, l'agressivité et la résistance à la fois à la chimiothérapie et la radiothérapie. Ces cellules, nommées cellules souches cancéreuses(CSC), sont connues pour exprimer les facteurs de souchitude Oct4 et Nanog, quand elles sont pluripotentes. Le but de ma thèse était d'analyser les effets de petites molécules pharmacologiques en mesure de cibler chez les SCCces régulateurs d'auto-renouvellement, afin d'apporter de nouvelles thérapies efficaces contre le cancer. Plus précisément, ma thèse avait pour but d'étudier l'activité anticancéreuse sélective d'une flavagline synthétique, à savoir FL3, sur un modèle de SCC peu différencié et très malin (tératocarcinome) qui exprime les facteurs de souchitude. Nous avons également utilisé un modèle de cellules souches normales restreintes (NSC) (de type fibroblastique), pour évaluer l'effet sélectif de ce médicament. Nous avons constaté que, contrairement aux NSCs, FL3 était capable de déclencher un processus pro-apoptotique mitochondriale dans les CSCs, via l'activation dep38 MAPK et de la cas pase 3, suivie par une régulation négative de Oct4 et Nanog. Nous avons ensuite étudié le mécanisme moléculaire impliqué dans la protection des NSCs contre les effets cytotoxiques de la drogue. Nous avons constaté que FL3 active sélectivement les protéines pro-survie Akt et Bad dans les NSCs. En effet, l'inhibition de la sur-expression de ces protéines a déclenché un processus pro-apoptotique lié à la caspase-3 dans les NSCs traitées par FL3. Dans une deuxième étape, nous avons montré que FL3 à faible concentration, était capable d'induire la différenciation des CSCs par la régulation négative de l'expression d'Oct4 et de Nanog, tant au niveau de la traduction que de la transcription. Cet effet a coïncidé avec une régulation à la hausse de l'expression de plusieurs marqueurs neuronaux. Pris dans leur ensemble, les résultats présentés dans ma thèse démontrent clairement que la flavagline synthétique FL3 est un composé anticancéreux puissant, agissant comme un agent sélectif pro-apoptotique et pro-différenciation sur les cellules souches cancéreuses, sans effets sur les cellules souche normales. / It is believed that small subpopulation of cells within the tumor, with powerful self-renewal capacity, are involved in tumor progression, aggressiveness and resistance to both chemo- and radio-therapy. These cells, named cancer stem cells (CSCs), are known to express the stemness factors Oct4 and Nanog, when they are highly pluripotent. The aim of my thesis was therefore to analyze the effects of small pharmacological molecules which are able to target in CSCs these self-renewal regulators, in order to bring new effective therapies for cancer. More specifically, this thesis was aimed to study the selective anticancer activity of a synthetic flavagline, namely FL3,on a poorly differentiated and highly malignant CSC model (i.e. the teratocarcinomal stem-like cell) that expresses the stemness factors. Here in we also used a model of very restricted normal stem cell (NSC) (i.e. the fibroblasticstem-like cell), to evaluate the selective effect of this drug. We found that, unlike in NSCS, FL3 was able to trigger a mitochondrial pro-apoptotic process in CSCS, via the activation of p38 MAPK and caspase3, followed by a downregulation of Oct4 and Nanog. We newt investigated the molecular mechanism involved in the protection ofNSCS against the cytotoxic effects of the drug. We found that FL3 selectively activated the prosurvival proteins Akt and Bad in NSCS. Indeed, forced inhibition of the expression of these proteins triggered a caspase-3 proapoptotic process in FL3-treated NSCS. In a next step, we showed that the drug, at low concentration, was able to induce the differentiation of CSCS, by downregulating the expression of Oct4 and Nanog at both transcriptionand translation levels. This effect coincided with an upregulation of the expression of several neural markers. Taken as a whole, the results reported in my thesis clearly demonstrate that the synthetic flavagline FL3 is a powerful anticancer compound, since it acts as a selective proapoptotic and pro-differentiating agent on cancer stem-like cells, without having any effect on normal stem-like cells.

This project set out to examine the possibility that by acquiring Raman spectra and performing multi-photon imaging we can get better diagnosis and understanding of the biochemistry of an individual cancerous tumour and distinguish it from the healthy tissue. Within the frame of this study, colorectal primary and secondary cancer cells are examined with Raman spectroscopy in order to (i) study and distinguish them according to their chemical composition by applying multivariate methods and (ii) determine whether Raman spectroscopy can identify the cells which are the link between primary and secondary colorectal cancer cells, the so-called Cancer Stem Cells. The second part of this thesis is based on tissue studies. Human colorectal tissue sections are examined in a label-free manner with the use of multi-photon imaging modes (i) Two photon excitation fluorescence, (ii) stimulated Raman scattering and (iii) second harmonic generation, in order to determine whether these can provide fast and accurate diagnosis of colorectal cancer. These techniques were able to distinguish between healthy and cancerous tissue regions, based on the chemically-specific images of the tissue microenvironment and architecture. The hypothesis of Cancer stem cell is examined with the use of Raman spectroscopy shown that the CSCs have some small differences according to their tissue origin.

O carcinoma mucoepidermoide (CME) representa a neoplasia maligna de glândula salivar mais comum. Tumores com alto grau histológico e casos avançados, com metástase regional ou a distância, apresentam taxas de sobrevida extremamente baixas em decorrência da falta de terapias eficazes. A radioterapia é usualmente aplicada como terapia adjuvante ou primeira linha de tratamento de tumores inoperáveis, entretanto o perfil de resistência do CME à radioterapia permanece não elucidado. Outra abordagem em tumores avançados é a quimioterapia, usualmente a base de cisplatina, aplicada como tratamento meramente paliativo. Um dos principais pontos chave envolvidos na resistência tumoral às terapias convencionais é a manutenção de uma população celular com alto potencial tumorigênico, chamadas de células tronco tumorais (CTT). Estas células apresentam capacidade de evadir terapias convencionais e são responsáveis pelo aparecimento de metástases e recidivas. Evidências recentes sugerem que a utilização de terapias combinadas possuem maior potencial de reduzir a resistência tumoral. Desta forma, no primeiro estudo nosso objetivo foi identificar o perfil de resistência à radioterapia de linhagens celulares de CME, vias associadas com a radio-resistência adquirida e formas de sensibilizar farmacologicamente as células de CME, incluindo as CTT, à radiação ionizante. Os resultados demonstraram que as linhagens de CME apresentam diferentes perfis de resistência à radiação ionizante, sendo a linhagem mais resistente capaz de ativar intrinsicamente o NFκB frente a baixas doses de radiação. Além disso, a resistência das linhagens mais sensíveis foi estimulada quando a vida do NFκB foi excitada. A inibição farmacológica do NFκB com Emetine foi realizada com sucesso através da inibição do eixo IKK-β/IκBα/NFκB. A utilização de Emetine previamente a radiação ionizante foi capaz de aumentar a sensibilidade das células de CME assim como diminuir o percentual de CTT. No segundo estudo nosso objetivo foi identificar a resposta tumoral, incluindo das CTT, à terapia única ou combinada utilizando dois alvos terapêuticos distintos: NFκB (tratamento com Emetine) e acetilação de histonas (tratamento com SAHA). Os resultados mostraram que uma dose de Emetine é capaz de inibir a proliferação celular em todas as linhagens de CME analisadas, enquanto que o SAHA apresentou este efeito em apenas 50% das linhagens. Por outro lado, o SAHA foi mais eficaz em reduzir a população de CTT que o Emetine. A terapia combinada foi mais eficaz do que as terapias individuais em relação a proliferação celular e a depleção de CTT. Através da analise dos resultados dos dois estudos, podemos concluir que a resistência tumoral do CME é superada com maior êxito quando mais de uma forma de tratamento é empregada. A associação de Emetine com a irradiação ou de SAHA com Emetine se mostrou eficaz no controle do tumor através da erradicação da população de CTT. / Mucoepidermoid carcinoma (MEC) represents the most common salivary gland cancer. High-grade tumors and advanced cases, presenting regional or distant metastasis, exhibit extremely low survival rates due to a lack of effective therapies. Radiotherapy is frequently applied as adjuvant therapy or as first-line treatment in inoperable cases. Nevertheless, the resistance profile of MEC to radiotherapy remains unclear. Chemotherapy, most commonly cisplatin, used for advanced cases is considered merely palliative. A key point involved in tumor resistance to conventional therapies is the maintenance of a cell population with high tumorigenic potential, called cancer stem cells (CSC). These cells have the ability to evade conventional therapies and are responsible for metastases and recurrences. Recent evidences support that combined therapies are more effective in reducing tumor resistance. Therefore, in the first study our objective was to identify the resistance profile of MEC cell lines to ionizing radiation, pathways associated with acquired resistance and ways to sensitize pharmacologically MEC cells, including CSC, to ionizing radiation. The results demonstrated that MEC cell lines present different resistance profile to ionizing radiation and the most resistant cell line is capable to activate intrinsically NFκB after low doses of irradiation. Moreover, resistance of sensitive cell lines can be triggered by NFκB activation. Pharmacological inhibition of NFκB with Emetine was achieved through IKK-β/IκBα/NFκB axis inhibition. The use of Emetine prior to irradiation was efficient in increasing cell sensibility as well as decrease the percentage of CSC. In the second study, our aim was to identify the tumor response, including of CSC, to single or combined therapy using two distinc therapeutic targets: NFκB (treated with Emetine) and histone acetylation (treated with SAHA). The results demonstrated that a single dose of Emetine was capable to inhibit cell proliferation in all MEC cell lines, while SAHA achieved this result in only 50% of cell lines analyzed. On the other side, SAHA was more efficient than Emetine in disrupting CSC population. The combined therapy was more effective than both single agent therapies regarding cell proliferation and CSC depletion. By analysing both studies results, we can conclude that the tumor resistance of MEC is overcome with greater success when more than one form of treatment is employed. The association of Emetine with irradiation or SAHA with Emetine is effective in tumor control by eradicating the CSC population.

Colony-stimulating factor 1 receptor (CSF1R, Fms) is an integral transmembrane glycoprotein with tyrosine specific protein kinase activity that it is found on the mononuclear phagocytes to promote their survival, proliferation and differentiation. Colony-stimulating factor 1 (CSF-1), also known as M-CSF, is a protein ligand that acts on the CSF1R. There is a variable association of Fms with the stem cell marker CD34 on acute myeloid leukemia (AML) cells and this suggests different structures of the AML hierarchy in different patients. Mouse stromal cells (MS-5) were transduced with a plasmid containing human CSF-1 because mouse CSF-1 is inactive on human CSF1R. Results show that AML cells cultured with CSF-1-expressing stroma had a much better growth and survival than the control stroma, suggesting that CSF-1 might be a stimulating factor for the growth of leukemic stem cells.