京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21447号 / 医博第4414号 / 新制||医||1032(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 武藤 学, 教授 平井 豊博, 教授 岩田 想 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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Les dernières décennies ont été marquées par une augmentation du nombre des cas de cancers, ce qui a subséquemment conduit à une augmentation dans la consommation des agents de chimiothérapie. La toxicité et le caractère cancérogène de ces molécules justifient l’intérêt crucial porté à leur égard. Quelques études ont fait l’objet de détection et de quantification des agents de chimiothérapie dans des matrices environnementales. Dans ce projet, une méthode utilisant la chromatographie liquide couplée à la spectrométrie de masse en tandem (LC-MS/MS) précédée d’une extraction sur phase solide (SPE) automatisée ou en ligne a été développée pour la détection et la quantification d’un groupe de six agents de chimiothérapie. Parmi ceux-ci figurent les plus utilisés au Québec (gemcitabine, méthotrexate, cyclophosphamide, ifosfamide, irinotécan, épirubicine) et présentant des propriétés physico-chimiques et des structures chimiques différentes. La méthode développée a été validée dans une matrice réelle représentant l’affluent d’une station d’épuration dans la région de Montréal. Deux des six composés cytotoxiques étudiés en l’occurrence (cyclophosphamide et méthotrexate) ont été détectés dans huit échantillons sur les neuf qui ont été recensés, essentiellement au niveau de l’affluent et l’effluent de quelques stations d’épuration de la région de Montréal. Les résultats des analyses effectuées sur les échantillons réels ont montré qu’il n’y avait pas de différence significative dans la concentration entre l’affluent et l’effluent, et donc que les systèmes d’épuration semblent inefficaces pour la dégradation de ces molécules. / The last few decades have been marked by an increase in the number of cancer cases, which subsequently led to an increase in the consumption of chemotherapeutic agents. The toxicity and the carcinogenicity of these molecules justify the increased interest. Few studies have been conducted to detect and quantify chemotherapeutic agents in environmental matrices. In this project, a method using liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) preceded by an online solid-phase extraction (SPE) has been developed for the detection and quantification of a group of six chemotherapeutic agents, which are among the most commonly used in Quebec (gemcitabine, methotrexate, cyclophosphamide, ifosfamide, irinotecan, epirubicin) and having different physico-chemical properties and different chemical structures. The developed method was validated in a real water matrix representing the influent of a sewage treatment plant in the Montreal area. Two of the six studied cytotoxic agents (cyclophosphamide and methotrexate) were detected in eight samples of the nine taken mainly at the influent and effluent of some treatment plants in the Montreal area. The results of the analysis of real samples showed that there was no significant difference in concentration between the influent and effluent. This also demonstrates the inadequacy of the current wastewater treatment approaches to remove those compounds.

Background: Cancer is the second leading cause of death in economically developed countries. The use and availability of oral treatment for cancer has increased dramatically in the past 10 years. Few studies have described the use of oral chemotherapy in non-traditional ambulatory settings by health care professionals across different specialties. Objective: The purpose of this study is to describe the usage of oral chemotherapeutic medications in ambulatory settings. Methods: Cross sectional study of 2007 NAMCS Survey analysis involving 21,761 subjects aged 18 years and above with cancer who participated in the 2007 National Ambulatory Medical Survey (NAMCS). Main Outcome Measure: Physician-reported use of oral chemotherapeutic medications (includes all major drug classes) as indicated on questionnaire for 2007 NAMCS survey. Results: Health care providers in non-traditional settings are less likely to prescribe oral chemotherapy than in traditional ambulatory settings (Adjusted odds ratio (AOR)=0.65{95% confidence interval: 0.61-0.69}). The study results suggest that oncologists are prescribing oral anti-cancer drugs the most as compared to other physician specialties. Conclusion: Health care providers in non-traditional settings are less likely to prescribe oral chemotherapy than in traditional ambulatory settings. Primary care physicians may have limited experience in monitoring and prescribing these potentially toxic medications. Clear guidelines are required for the use of oral chemotherapy medications, considering the potential for their use in non-traditional ambulatory settings and by non-oncologists.

Side effects of current chemotherapeutics limit their use in cancer therapy. Although many current drugs are highly toxic and potent, the effects they have on non-cancerous tissue are unbearable for patients. Targeting these drugs may provide a means to restrict their toxic effects to only cancer tissue while leaving healthy tissue unaffected. This approach requires that the drug is only available in cancer tissue, which has been achieved here by encapsulating drugs into liposomal nano-capsules which are capable of passively accumulating in cancerous tissue via the enhanced permeability and retention effect (EPR). In addition to localisation, a threshold dose must be achieved to deliver the desired toxic effect to the target tumour tissue. Previous strategies have relied on passive 'leaching' of the drug from liposomes, however this 'leaching' does not necessarily achieve the threshold dose required. In the present work, a new generation of liposomes has been developed whereby release is solely achieved in the presence of ultrasound triggered cavitation. Instigation of such cavitation events would normally require the target tissue be exposed to high and possibly damaging ultrasound pressures. To remove the need for these high pressures, cavitation nuclei have been developed to lower the cavitation threshold of surrounding media. To allow for improved co-localisation and treatment deeper into cancer tissue, cavitation nuclei were developed to be in the nanoscale size range. Two types of novel cavitation nuclei were produced, a rough surfaced carbon nanoparticle (CNP, ~180 nm) and smooth shaped polymeric nano-cup particle (NC, ~150, 470, or 770 nm). Both types of particle are solid nanoparticles with gas entrapped on their surface which was capable of cavitating in response to ultrasound without greatly affecting the particle itself. These particles are classified as cavicatalytic nanoparticles due to their ability to reduce the cavitation threshold of their surrounding media without being destroyed themselves. Finally, an entirely nanoscale release system was developed and tested in vitro and in vivo. The drug carrier (the liposome) and effector agent (the cavicatalytic nanoparticle) were used to demonstrate ultrasound triggered drug release, specifically in response to the generation of cavitation events. These cavitation events could be non-invasively monitored and characterised, adding to the potential clinical utility of the technologies developed and described here.

Les dernières décennies ont été marquées par une augmentation du nombre des cas de cancers, ce qui a subséquemment conduit à une augmentation dans la consommation des agents de chimiothérapie. La toxicité et le caractère cancérogène de ces molécules justifient l’intérêt crucial porté à leur égard. Quelques études ont fait l’objet de détection et de quantification des agents de chimiothérapie dans des matrices environnementales. Dans ce projet, une méthode utilisant la chromatographie liquide couplée à la spectrométrie de masse en tandem (LC-MS/MS) précédée d’une extraction sur phase solide (SPE) automatisée ou en ligne a été développée pour la détection et la quantification d’un groupe de six agents de chimiothérapie. Parmi ceux-ci figurent les plus utilisés au Québec (gemcitabine, méthotrexate, cyclophosphamide, ifosfamide, irinotécan, épirubicine) et présentant des propriétés physico-chimiques et des structures chimiques différentes. La méthode développée a été validée dans une matrice réelle représentant l’affluent d’une station d’épuration dans la région de Montréal. Deux des six composés cytotoxiques étudiés en l’occurrence (cyclophosphamide et méthotrexate) ont été détectés dans huit échantillons sur les neuf qui ont été recensés, essentiellement au niveau de l’affluent et l’effluent de quelques stations d’épuration de la région de Montréal. Les résultats des analyses effectuées sur les échantillons réels ont montré qu’il n’y avait pas de différence significative dans la concentration entre l’affluent et l’effluent, et donc que les systèmes d’épuration semblent inefficaces pour la dégradation de ces molécules. / The last few decades have been marked by an increase in the number of cancer cases, which subsequently led to an increase in the consumption of chemotherapeutic agents. The toxicity and the carcinogenicity of these molecules justify the increased interest. Few studies have been conducted to detect and quantify chemotherapeutic agents in environmental matrices. In this project, a method using liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) preceded by an online solid-phase extraction (SPE) has been developed for the detection and quantification of a group of six chemotherapeutic agents, which are among the most commonly used in Quebec (gemcitabine, methotrexate, cyclophosphamide, ifosfamide, irinotecan, epirubicin) and having different physico-chemical properties and different chemical structures. The developed method was validated in a real water matrix representing the influent of a sewage treatment plant in the Montreal area. Two of the six studied cytotoxic agents (cyclophosphamide and methotrexate) were detected in eight samples of the nine taken mainly at the influent and effluent of some treatment plants in the Montreal area. The results of the analysis of real samples showed that there was no significant difference in concentration between the influent and effluent. This also demonstrates the inadequacy of the current wastewater treatment approaches to remove those compounds.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Vincristine sulphate is antitumor agent widely used in small animal clinical oncology; therefore it can cause a number of adverse effects including marrow and neuronal cytotoxicity. Nandrolone decanoate, an anabolic-androgenic steroid (AAS), has been used in association with vincristine in order to ease effects such as moderate myelosuppression. The present dissertation presents data related to the isolated or associated employment of vincristine sulphate and nandrolone decanoate, as well as their effects on the cholinergic system and oxidative profile of Wistar rats. The animals were submitted to four different doses of AAS for three weeks and its action on acetylcholinesterase (AChE) activity in four different structures of brain tissue (cerebellum, hippocampus, striatum and cerebral cortex) was studied. The second experiment shows the effects of vincristine and/or nandrolone decanoate in the brain (same parts studied previously) and blood through measurement of brain and red blood cell AChE (RBC-AChE) enzyme activity as well as brain and blood serum lipid peroxidation of rats treated for two weeks. Results show that the two highest doses used in the first experiment increased enzyme activity, suggesting interference in the cholinergical system of the striatum and cerebellum. The results obtained in the latter experiment demonstrate that the isolated use of this AAS and its association with vincristine sulphate altered brain and RBC-AChE action, both in a stimulatory and inhibitory fashion. Lipid peroxidation, in the brain and blood, increased due to the isolated use of both vincristine and nandrolone decanoate, as well as to their associated use at the highest dose of ester used. Furthermore, the data show that the association between the therapeutic dose of nandrolone decanoate and vincristine is capable of neutralizing the free radical production induced by their isolated use in brain and blood serum. Serum RBC-AChE activity and the oxidative profile presented in this study are similar to those exhibited for brain tissue. Based on these data, it can be concluded that nandrolone decanoate is capable of interfering in AChE activity, affecting the cholinergic system, which could cause an alteration of its neurotransmitter, as well as a low or high stimulation of post-synaptic receptors. Therefore, the use of the therapeutic dose of AAS studied here in association with vincristine has been shown to be beneficial, as it could protect the organism from damaging processes caused by the production of free radicals. / O sulfato de vincristina é um agente anti-tumoral bastante usado na oncologia clínica de pequenos animais, porém seus efeitos colaterais incluem citotoxicidade medular e neuronal. O decanoato de nandrolona, um esteróide anabólico androgênico (EAA), tem sido usado em associação a este medicamento para amenizar alguns de seus efeitos, como a mielossupressão moderada. Esta dissertação apresenta dados referentes ao uso isolado ou associado do sulfato de vincristina e do decanoato de nandrolona, seus efeitos no sistema colinérgico e no perfil oxidativo de ratos Wistar. Primeiramente, verificou-se quatro diferentes doses do EAA, por três semanas, e sua ação sobre a atividade da acetilcolinesterase (AChE) em quatro partes do tecido cerebral (cerebelo, estriado, hipocampo e córtex cerebral). O segundo experimento apresenta grupos tratados durante duas semanas com sulfato de vincristina e/ou decanoato de nandrolona e as ações destes no cérebro (mesmas partes pesquisadas anteriormente) e no sangue, através da mensuração da atividade enzimática da AChE cerebral e eritrocitária (RBC-AChE) e peroxidação lipídica cerebral e sérica. As duas doses mais altas utilizadas no primeiro trabalho aumentam a atividade da enzima, sugerindo que haja interferência no sistema colinérgico, no estriado e no cerebelo. Os resultados obtidos, no estudo posterior, demonstram que o uso isolado deste EAA e suas associações com o sulfato de vincristina alteram a ação da AChE cerebral e RBC-AChE, tanto de forma estimulatória quanto inibitória. A peroxidação lipídica, cerebral e sangüínea, aumenta devido ao uso isolado da vincristina e do decanoato de nandrolona, e na associação do quimioterápico com a dose mais alta usada do éster. A dose terapêutica do decanoato de nandrolona e a vincristina utilizadas são capazes de neutralizar a produção de radicais livres tanto no cérebro quanto no soro sangüíneo. A atividade da RBC-AChE e o valor do perfil oxidativo do soro apresentados nesta pesquisa são similares àqueles exibidos pelo tecido cerebral. Diante destes dados, pode-se concluir que o decanoato de nandrolona é capaz de influenciar a atividade da AChE, afetando o sistema colinérgico, o que poderia ocasionar em uma ação alterada do seu neurotransmissor, além de uma baixa ou alta estimulação dos receptores póssinápticos. Entretanto, o uso da dose terapêutica estudada deste EAA associada à vincristina mostra-se benéfico, pois poderia proteger o organismo de processos prejudiciais relacionados a produção de radicais livres.

Submitted by biblioteca unifenas (biblioteca@unifenas.br) on 2017-09-18T20:18:02Z No. of bitstreams: 1 Roberta Soares Terra Dissertação.pdf: 5586714 bytes, checksum: b90d918d9ac7cb880dcc55847cd8c5fd (MD5) / Made available in DSpace on 2017-09-18T20:18:02Z (GMT). No. of bitstreams: 1 Roberta Soares Terra Dissertação.pdf: 5586714 bytes, checksum: b90d918d9ac7cb880dcc55847cd8c5fd (MD5) Previous issue date: 2017-03-31 / Fundação de Amparo à Pesquisa do Estado de Minas Gerais - FAPEMIG / Salvia officinalis has been widely used in culinary and traditional medicine, and studies have identified numerous chemical compounds and potential therapeutic actions. This study evaluated the genotoxicity of lyophilized hydroalcoholic extract of S. officinalis L. (SO) leaves using the micronucleus assay in mouse bone marrow. The interaction between SO and the genotoxic effects induced by doxorubicin (DXR) was also analyzed – antigenotoxicity assay. Experimental groups consisting of male and female Swiss albinus mice (Unib: SW) were evaluated after 24-48h treatment with cyclophosphamide (CP; 50 mg/kg), DXR (5 mg/kg), NaCl 0.5-2 g/kg) and SO (0.5 g/kg) + DXR (5 mg/kg). The PCEMN analyzes showed differences (p0.05) between SO (1-2 g/kg) and NaCl treatments, regardless of gender and time. DXR induced EPCMNs significantly in both genders and treatment times. Groups of mice treated with DXR showed lower frequencies (p0.05) of PCEMNs when compared to CP control groups (50 mg/kg). Associative treatment (500 mg/kg SO + 5 mg/kg DXR) did not reduce the frequency of DXR-induced PCEMNs (p0.05). The PCE/NCE ratio between control (NaCl, CP and DXR) and experimental genotoxic and antigenotoxic (SO; SO + DXR) treatments were insignificant (p0.05). The results suggest moderately genotoxic effects (clastogeny and/or aneugeny) of S. officinalis L. leaves, dose-dependent (i.e., from 1 g/kg) and gender- and time-independent. However, S. officinalis has no systemic toxicity and antigenotoxic effects (SO + DXR) under the conditions established in the present micronucleus test in mouse bone marrow. / Salvia officinalis tem sido amplamente utilizada na culinária e na medicina tradicional, e estudos têm identificado inúmeros compostos químicos e potenciais ações terapêuticas. Esta pesquisa avaliou a genotoxicidade do extrato hidroalcoólico liofilizado de folhas de S. officinalis L. (SO) usando o ensaio do micronúcleo em medula óssea de camundongos. A interação entre SO e os efeitos genotóxicos induzidos pela doxorrubicina (DXR) também foi analisada – ensaio de antigenotoxicidade. Grupos experimentais constituídos de camundongos machos e fêmeas Swiss albinus (Unib: SW) foram avaliados após 24-48h de tratamento com ciclofosfamida (CP; 50 mg/Kg), DXR (5 mg/Kg), NaCl (150 mM), SO (0,5–2 g/Kg) e SO (0,5 g/Kg) + DXR (5 mg/Kg). As análises de EPCMNs mostraram diferenças (p0,05) entre os tratamentos de SO (1–2 g/Kg) e NaCl, independentemente do gênero e do tempo. DXR induziu EPCMNs significativamente em ambos os gêneros e tempos de tratamento. Grupos de camundongos tratados com DXR mostraram frequências menores (p<0,05) de EPCMNs quando comparados com os grupos controles CP (50 mg/Kg). O tratamento associativo (500 mg/Kg de SO + 5 mg/Kg de DXR) não reduziu a frequência de EPCMNs (p<0,05) induzida por DXR. As proporções de EPC/ENC entre tratamentos controles (NaCl, CP e DXR) e experimentais genotóxicos e antigenotóxicos (SO; SO + DXR) foram insignificantes (p0,05). Os resultados sugerem efeitos moderadamente genotóxicos (clastogenia e/ou aneugenia) de folhas de S. officinalis L., dose-dependente (i.e., a partir de 1 g/Kg) e gênero- e tempo-independentes. Contudo, S. officinalis não apresenta toxicidade sistêmica e efeitos antigenotóxicos (SO + DXR) nas condições estabelecidas no presente teste do micronúcleo em medula óssea de camundongos.

<div>Biological dynamics have been studied by many methods. Fluorescence dynamic microscopy and optical coherence tomography provided fundamental understandings of biological systems. However, their high NA optics only represent local characteristics. Biodynamic imaging (BDI) technique implements a low NA optics and acquires the statistical average of Doppler shifts that occurred by dynamic light scattering with biological dynamic subsystems provided globally averaged dynamic characteristics. </div><div>BDI is used for this study to investigate biomedical applications. The chemotherapy efficacy measurement by BDI demonstrated a good agreement between the Doppler spectral phenotypes and the preclinical outcomes. Also, dynamic responses of microbiomes by chemical stimuli demonstrated featured Doppler characteristics. The bacterial infection of epithelial spheroids showed consistent spectral responses and antibiotic-resistant E. coli infection treatment with a sensitive and resistive antibiotic showed a dramatic contrast. Furthermore, the phase-sensitive characteristics of BDI provided a clue to understanding the characteristics of the random process of biological systems. Levy-like heavy-tailed probability density functions are demonstrated and </div><div>the shape changed by infection will be discussed. </div>