Le cancer colorectal (CCR) demeure l'une des principales causes de décès par cancer dans le monde. Récemment, une nouvelle immunothérapie basée sur le ciblage du récepteur à activité tyrosine kinase (RTK) EGFR via l'anticorps cetuximab a montré une amélioration significative de la survie des patients atteints de CCR métastatique (CCRm). Cependant, une grande partie de ces patients présente une résistance qui est associée à la présence de mutations gains de fonction dans la voie de signalisation Ras. Dans ce contexte, l'identification de cibles thérapeutiques Ras-indépendantes pourrait avoir un intérêt particulier. Une analyse pharmacologique effectuée au laboratoire démontre que le nilotinib, un inhibiteur de la TK oncogénique BCR-ABL utilisée en clinique pour le traitement des leucémies myéloïdes chroniques, affecte également les propriétés invasives et métastatiques de cellules de CCR. Nous avons identifié la cible majoritaire de cet inhibiteur dans cette réponse tumorale : il s'agit de DDR1, un récepteur au collagène ayant une activité TK intrinsèque. Mon travail de thèse a mis en évidence que DDR1 est fréquemment et fortement activé dans les métastases de patients atteints de CCR. J'ai ensuite analysé la signalisation DDR1-dépendante dans ces cellules tumorales par phosphoprotéomique quantitative. Cette analyse montre la nature Ras-indépendante de cette signalisation et révèle la protéine de signalisation BCR comme un nouveau substrat essentiel de DDR1 pour induire l'invasion cellulaire. Enfin, je montre que l'inhibition de DDR1 par le nilotinib améliore la réponse au cetuximab y compris pour les cellules tumorales ayant une mutation oncogénique de K-Ras ou B-Raf. En conclusion, ces résultats suggèrent que le ciblage de DDR1 par le nilotinib pourrait avoir un intérêt thérapeutique dans le traitement des CCRm. / Colorectal cancer (CRC) is one of the leading causes of cancer-related death in the Western world. Cancer that metastasizes to distant sites is usually not curable, although chemotherapy can extend survival. Recently, a novel immunotherapy approach based on targeting the EGFR tyrosine kinase (TK) via the antibody cetuximab was shown to significantly improve the survival of patients with metastatic CRC (mCRC). However, only patients with wild-type KRAS may hope to gain from EGFR inhibition. The majority of patients expresses oncogenic K-Ras alleles and thus have hyperactive Ras cascade operating independently from EGFR. Therefore, there is an urgent need for discovery of a new Ras-independent target that regulates tumor cell invasion and metastasis in mCRC. A pharmacological approach in the lab revealed that the small inhibitor of the leukemic TK BCR-Abl also inhibits invasive and metastatic abilities of CRC cells. This effect was also observed in cells expressing deregulated KRAS signalling. We next identified the receptor for collagen and atypical TK DDR1 as that the main target of nilotinib in these cells. Accordingly, DDR1 was found frequently and strongly activated in metastatic nodules of CRC patients. I also characterized DDR1 signalling by quantitative phosphoproteomic. This analysis revealed the Ras-independent nature of DDR1 signalling but also the Rho GTPase regulator BCR as an essential DDR1 substrate that leads to cell invasion. Finally, I demonstrate that nilotinib potentiates cetuximab response in CRC cells expressing oncogenic K-Ras signaling. Overall, these results suggest that the targeting of DDR1 by nilotinib may be of therapeutic value in mCRC.

Le récepteur à neurotrophine TrkC a été identifié comme étant un récepteur à dépendance : en l'absence de son ligand NT-3, il déclenche l'apoptose. En effet, la survie des cellules qui expriment ces récepteurs dépend de la disponibilité en ligand, un mécanisme qui inhibe la prolifération incontrôlée et la migration des cellules tumorales. TrkC, en tant que récepteur à tyrosine kinase, est généralement considéré comme un proto-oncogène. Or nous montrons que l'expression TrkC est diminuée dans une grande fraction des cancers colorectaux humains, principalement par méthylation du promoteur de TrkC. En outre, ce mécanisme confère un avantage sélectif aux lignées cellulaires colorectales pour inhiber la mort des cellules tumorales. De plus, la réexpression de TrkC dans les lignées tumorales colorectales est associée à la mort des cellules tumorales et à l'inhibition in vitro des caractéristiques de transformation cellulaire, et in vivo de la croissance tumorale. Ensemble, ces données permettent de conclure que TrkC est un gène suppresseur de tumeur dans le cancer colorectal. Le mécanisme moléculaire par lequel TrkC déclenche l'apoptose implique le clivage de son domaine intracellulaire, ce qui libère un fragment pro-apoptotique (TrkC KF). Nous montrons que TrkC KF interagit avec Cobra1, un cofacteur de BRCA1, et que Cobra1 est nécessaire à l'apoptose induite par TrkC. Cobra1 conduit TrkC KF à la mitochondrie, où il favorise l'apoptose apoptosome-dépendante. Ainsi, nous proposons qu'en l'absence de NT-3, le clivage protéolytique de TrkC conduit à la libération d'un fragment tueur qui déclenche l'apoptose mitochondriale, via le recrutement de Cobra1 / The neurotrophin receptor TrkC was recently identified as a dependence receptor, and, as such, it triggers apoptosis in the absence of its ligand, NT-3. Indeed cells that express these receptors are thought to be dependent on ligand availability for their survival, a mechanism that inhibits uncontrolled tumor cell proliferation and migration. TrkC, as a classic tyrosine kinase receptor, is generally considered to be a proto-oncogene. We show that TrkC expression is down-regulated in a large fraction of human colorectal cancers, mainly through promoter methylation. Moreover, we show that TrkC silencing by promoter methylation is a selective advantage for colorectal cell lines to limit tumor cell death. Furthermore, reestablished TrkC expression in colorectal cancer cell lines is associated with tumor cell death and inhibition of in vitro characteristics of cell transformation, as well as in vivo tumor growth. Together, these data support the conclusion that TrkC is a colorectal cancer tumor suppressor. TrkC triggers apoptosis in the absence of its ligand NT-3 : the molecular mechanism for apoptotic engagement involves the double cleavage of the receptor's intracellular domain, leading to the formation of a proapoptotic fragment (TrkC KF). We show that TrkC KF interfacts with Cobra1, a putative cofactor of BRCA1, and that Cobra1 is required for TrkC-induced apoptosis. Cobra1 shuttles TrkC KF to the mitochondria, where it promotes apoptosome-dependent apoptosis. Thus, we propose that, in the absence of NT-3, the proteolytic cleavage of TrkC leads to the release of a killer fragment that triggers mitochondria-dependent apoptosis via the recruitment of Cobra1

L'expression intracellulaire des anticorps (intracorps) est une approche qui permet l'étude et le ciblage des antigènes dans les compartiments intracellulaires. Néanmoins, l'expression d'anticorps entiers fonctionnels dans les cellules reste une tâche difficile en raison de leur grande taille et de leur structure, l'environnement réducteur du milieu intracellulaire étant défavorable à la formation des ponts disulfure. Notre groupe a une forte expertise dans le domaine de l'immunisation intracellulaire et son application pour l'identification de nouvelles cibles thérapeutiques. Pour cela, notre équipe a élaboré des banques de fragments d'anticorps scFv optimisés pour une meilleure expression intracellulaire. Nos travaux antérieurs ont démontré que ces intracorps peuvent cibler spécifiquement des domaines ou des modifications post-traductionnelles de protéines dans des cellules vivantes. Ceci est particulièrement important car il démontre l'un des avantages principaux des intracorps par rapport à l'approche basée sur l'ARNi. Cet avantage a été démontré par un criblage phénotypique dans un modèle d'allergie. En appliquant cette approche à l'étude de l'activation des mastocytes, nous avons pu identifier un nouvel acteur moléculaire impliqué dans la voie de signalisation mise en jeu. Ce travail a été protégé par un brevet européen en 2013 et est publié récemment. Dans le cadre de mon projet de thèse, j'ai construit une nouvelle banque synthétique (HUSCIv) optimisée pour la stabilité, la diversité et l'affinité des scFvs. Pour cela, le scFv 13R4 isolé dans notre équipe a servi de charpente pour le greffage des différentes boucles hypervariables, tout en respectant la diversité des régions CDR observée dans les anticorps naturels humains. Nous avons utilisé la protéine GFP en tant que rapporteur pour étudier le repliement et la solubilité des intracorps. Nos résultats ont clairement démontré que la plupart des intracorps issus de la banque HUSCIv sont soluble dans le cytoplasme des cellules mammifères. Mon projet de thèse décrit ici rapporte l'utilisation de la banque HUSCIv pour un criblage phénotypique dans des cellules de cancer colorectal portant une mutation du gène K-RAS et résistantes au traitement par l'anticorps chimérique Cetuximab. Le projet cherche à sélectionner des scFv capables de restaurer la sensibilité au Cetuximab, avec comme objectif l'identification des cibles intracellulaires impliquées.Pour ce criblage fonctionnel, la banque HUSCIv a été exprimée dans les cellules HCT116 par l'intermédiaire d'un système d'expression rétroviral. Le processus de sélection est basé sur la sélection directe de la prolifération des cellules en utilisant un colorant fluorescent (CMRA). Les cellules dont la prolifération est bloquée sont isolées et un séquençage à haut débit permet de suivre l'évolution des populations de scFv tout au long de l'expérience. Ainsi, ce projet a nécessité un séquençage profond d'un grand nombre de scFv afin de réaliser une analyse statistique. Nous avons réalisé à ce jour deux tours de sélection. Les tests de cytotoxicité réalisés sur les populations sélectionnées ont montré une inhibition significative de la prolifération en présence du Cetuximab d'environ 10%. Ces résultats indiquent l'évolution du phénotype qui tend vers une sélection de scFv inhibiteurs et suggèrent que nous devons réaliser au moins un ou plusieurs tours plus sélectifs avant de formuler des conclusions.L'approche introduite ici est différente de toutes les études existantes en ce qu'elle utilise des banques « naïves », et permet non seulement de répondre à la diversité du protéome, mais aussi d'étudier les messagers secondaires et le métabolisme des cellules. En tant que tel, et par rapport à d'autres approches à grande échelle, celle-ci représente une voie simple pour la découverte de molécules thérapeutiques potentielles. / Intracellular expression of antibodies (intrabodies) permitted the study and targeting of antigens in cellular compartments. However, the expression of functional intrabodies remains a difficult task due to their large size, structure, and the reducing intracellular environment. Our group has a strong expertise in the field of intracellular immunization and the identification of new therapeutic targets. For this purpose, we have developed an scFv library optimized for intracellular expression of scFv antibody fragments. Our previous works have shown the successful use of intrabodies for targeting specific domains or post-translational modifications in living cells. This is particularly important because it demonstrates one of the main advantages of intrabodies compared to the approaches using RNAi. This benefit was demonstrated by a phenotypic screen in a model of allergy. Applying this approach to the study of mast cell activation, we identified a new molecular player involved in the signaling pathway implemented. This work was protected by a European patent in 2013 and was recently published. As part of my thesis project, I designed a new synthetic library (HUSCIv) optimized for scFv stability, diversity and affinity. For this, a highly soluble and hyper-stable framework, scFv13R4 isolated in our group, was used as a scaffold for grafting different hypervariable loops, while respecting the diversity of CDRs observed in human natural antibodies. We used protein GFP as a reporter to study the folding and solubility of intrabodies. Our findings clearly demonstrated that most of the intrabodies from HUSCIv library are soluble in the cytoplasm of mammalian cells. My thesis project described here reports the use of HUSCIv in a phenotypic screen of colorectal cancer cells carrying a mutation in the K-RAS gene and resistant to the treatment with the chimeric antibody Cetuximab. The project seeks to select scFv fragments able to restore the sensitivity to Cetuximab, with the objective to identify the intracellular targets involved. For this functional screen, the HUSCIv library was expressed in HCT116 cells via a retroviral expression system. The selection process is based on the direct selection of cell proliferation using a fluorescent dye (CMRA). The cells whose proliferation is blocked are isolated and the evolution of scFv populations throughout the experiment are tracked via high-throughput sequencing. This sequencing requires a large number of scFvs to perform a statistical analysis. So far, we have achieved two rounds of selection. The cytotoxicity tests carried out on the selected populations showed a significant inhibition of proliferation (10%) in the presence of Cetuximab. These results indicate that the evolving phenotypes are tending towards a selection of scFv inhibitors and suggest that we need to perform at least one or more selective rounds before making conclusions. The approach introduced here is different from all existing studies in that it uses "naive" libraries not only to respond to the diversity of the proteome, but also to study secondary messengers and metabolism in cells. As such, and in comparison to other large-scale approaches, it is a simple way for the discovery of potential therapeutic molecules.

Le cancer colorectal (CCR) reste encore aujourd'hui une cause majeure de mortalité dans le monde, avec une incidence annuelle d'environ 1 million de cas et une mortalité d'environ 700 000 personnes. La stratégie de dépistage du CCR se base sur la détection de sang occulte dans les selles par le test iFOBT. Malgré une spécificité acceptable, la sensibilité de détection reste toujours insuffisante dans une population asymptomatique (27% de sensibilité pour un adénome, 65% pour un CCR). Aujourd'hui, il existe un réel besoin de trouver de nouveaux biomarqueurs spécifiques du CCR ainsi que de développer des tests de diagnostic faciles à mettre en oeuvre dans les laboratoires de biologie médicale. Les progrès récents de l'analyse protéomique à haut débit permettent aujourd'hui d'identifier et de quantifier un nombre toujours plus grand de protéines. C'est pourquoi, nous avons développé des stratégies en protéomique quantitative pour la recherche et la validation de biomarqueurs du cancer colorectal. L'approche iTRAQ et Label-free ont permis l'identification d'environ 800 protéines et la quantification de 214 protéines. Nous avons entrepris avec succès, la validation de 4 protéines par des tests ELISA et de nouvelles technologie en protéomique quantitative ciblée (LC-SRM). Au Final, nous proposons un test multiplex de 3 protéines qui permettra d'affirmer ou d'infirmer les résultats obtenus par le test iFOBT. L'ajout du test pourrait réduire de manière significative le nombre de coloscopies inutiles, potentiellement dangereuses pour les patients et onéreuses pour les autorités de santé. / Colorectal cancer (CRC) remains a major cause of cancer mortality throughout the world with an annual incidence of approximately 1 million cases and an annual mortality around 700 000. CRC outcome is highly dependent upon the stage of detection. The 5-year survival rate of patients with metastases is less than 20% while patients with localized adenomatous polyps have an excellent outcome with 90% survival rate. Current screening methods of CRC include the iFOBT and colonoscopy. The iFOBT has an acceptable 95% specificity but always an unsatisfactory sensitivity of detection in the asymptomatic population (27% sensitivity for adenoma, 65% for carcinoma). That is why, there is a real need to find new biomarkers and develop new diagnostic test, specific and easy to implement in clinical research. Recent advances in the analysis of biological fluids by high throughput mass spectrometry allow us now to identify and quantify a large number of proteins. Due to these improvements of proteomic strategies, it seems to be a promising way to find new potential proteins markers in the CRC disease. The quantitative iTRAQ & Label-free approaches allowed the identification of 800 proteins and the quantification of 200 proteins. Therefore, we have successfully validated four proteins by targeted proteomics using mass spectrometry (LC-SRM) and ELISA assays. Finally, we suggest a multiplex test of 3 proteins which confirm or contradict the FOBT outcome. The addition of the test could significantly reduce the number of unnecessary colonoscopies which are potentially dangerous for patients and expensive for public health authorities.

A mitocôndria é a organela citoplasmática responsável pelo maior sistema produtor de energia, a fosforilação oxidativa (OXPHOS). Foi proposto que em células tumorais a hiper-regulação da glicólise em condições normais de oxigênio (Efeito Warburg), está associada a defeitos na OXPHOS e pode regular o fenótipo tumoral, por exemplo, o potencial metastático da célula por meio da indução de vias pseudohipóxicas durante a normóxia. Estudos recentes mostraram que vários tipos de tumores possuem mutações somáticas em seu genoma mitocondrial, o que pode alterar as funções da OXPHOS levando a troca de metabolismo energético nas células tumorais e induzindo a tumorigênese. Diante disto, o presente trabalho avaliou a instabilidade do genoma mitocondrial em etapas bem definidas da progressão do câncer colorretal. O DNA genômico foi extraído de amostras de adenoma, adenocarcinoma, tecido adjacente e sangue periférico de nove pacientes diagnosticados com Câncer colorretal. O genoma mitocondrial foi amplificado e sequenciado para que fossem feitas as buscas por mutações nas amostras de sangue periférico, adenomas e adenocarcinoma. Foi também medido o número de cópias relativas do mtDNA. Foram encontradas um total de 233 mutações, das quais 162 foram em comum entre os três tecidos avaliados. As amostras de adenocarcinoma foram as que apresentaram uma maior média de mutações por amostra (44,6), seguidas dos adenoma (40,2) e do sangue periférico (34). As amostras de adenocarcinoma apresentaram uma maior instabilidade do mtDNA refletidas a partir de um maior número de mutações somáticas (tanto do tipo InDel como mutações de uma única base), mutações não sinônimas com maior patogenicidade, maior número de mutações em heteroplasmia e com taxa de heteroplasmia elevada. Já as amostras de adenoma apresentaram instabilidade dos seus mtDNA intermediários entre o tecido não tumoral e tumoral, refletindo bem a etapa de modificação celular no qual esses tecidos se encontram. Na análise do número de cópias relativas, as amostras de adenocarcinoma tiveram diminuição no número de cópias relativas quando comparadas com tecido adjacente (p= 0,01) e com adenomas (p= 0,04). Em síntese, o presente trabalho sugere que a instabilidade do genoma mitocondrial parece ter um papel importante no desenvolvimento de tumores colorretais. / The mitochondrion is a cytoplasmic organelle responsible for the major energy producing system, which is the oxidative phosphorylation enzyme pathway (OXPHOS). It was proposed that glycolysis up-regulation during normal oxygen conditions (Warburg effect) may induce defects in the mitochondrial respiration and regulate tumoral phenotypes, for example, metastatic potential through the induction of pseudohipoxic pathways during normoxia. Recent studies have shown that many kinds of tumors have mtDNA somatic mutations, which could alter the OXPHOS functions, leading to changes in glucose metabolismo and improvind tumorigenesis. This study analyzed the mitochondrial genome instability of well defined stages of colorectal cancer. Genomic DNA was extracted from adenoma, adenocarcinoma, adjacente tissue and peripheral blood of patients diagnosed with Colorectal cancer. The mitochondrial genome was amplified and sequenced for mutations screening in adenoma, adenocarcinoma e blood samples. It was also analyzed the relative mtDNA copy number. It was find a total of 233 mutations, which 162 were in common among the three analyzed tissues. The adenocarcinoma samples presented a greater mutation mean per sample (44.6) followed by adenomas samples (40.2) and blood samples (34). The adenocarcinoma samples also shown a greater mitochondrial genome instability refleted by increased of somatic mutations (InDels and single nucleotide variation), non sinonimous mutations with higher patogenicity, increased number of heteroplasmatic mutations and higher heteroplasmatic levels. The adenoma samples showed intermadiate instability of its mtDNA, which well reflects the intermediate stage of cellular modifications of this tissue. The mtDN copy number analysis shown that the adenocarcinoma samples presented decreased number of mtDNA content when compared with adjacente tissue (p= 0.01) and adenoma samples (p= 0.04). In summary the presente study suggests that the mitochondrial genomic instability seems to play an importante role in colorectal tumorigenesis.

La tyrosine kinase cytoplasmique Src est un régulateur essentiel de la croissance et de l’adhésion cellulaires induites par de nombreux stimuli extracellulaires, dont les facteurs de croissance et certains composants de la matrice extracellulaire. La dérégulation de son activité catalytique lui confère des propriétés oncogéniques importantes conduisant à la formation de tumeurs agressives chez l’Homme. La plupart des connaissances actuelles sur sa régulation catalytique repose sur des données structurales de cristallographie qui ont révélé l’importance des interactions intramoléculaires SH2 et SH3-dépendantes dans le contrôle des conformations ouvertes et actives de Src. Les domaines SH3, SH2 et kinase de Src sont associés au domaine SH4 N-terminal d'ancrage à la membrane plasmique via un domaine unique (DU) flexible. Le rôle du DU dans la régulation de Src reste obscur car il est intrinsèquement désordonné et par conséquent, cette région n'a pas été incluse dans les analyses structurales originelles. L'analyse par RMN de l'extrémité N-terminale de Src a révélé une conformation partiellement structurée du DU par le contact de séquences peptidiques spécifiques avec les lipides membranaires et le domaine SH3 (Perez et al, 2013; Maffei et al, 2015). De plus, cette interaction est régulée par phosphorylation des Ser69 et Ser75 localisées à proximité de ce domaine. L’objectif de ma thèse était d’adresser la relevance biologique de ces données structurales en me focalisant sur le rôle d’une partie du DU identifiée comme importante par RMN. J’ai montré que l’inactivation de cette région par des mutations perte de fonction, diminue fortement la signalisation de Src dans les cellules non transformées humaines ainsi que ses propriétés tumorales dans les cellules cancéreuses colorectales métastatiques révélant la pertinence biomédicale du système. Des analyses de protéomique m’ont permis de révéler un mécanisme original par lequel cette région contrôle la capacité de Src à phosphoryler ses substrats. En conclusion, ces données confirment un rôle important du DU sur l'activité et la signalisation de Src et révèlent un rôle critique des domaines désordonnés dans les tumeurs chez l’Homme. L’inhibition de cette région unique par de petites molécules devrait conduire à de nouvelles stratégies thérapeutiques dans le cancer. / The membrane-anchored non-receptor tyrosine kinase Src is involved in numerous signal transduction pathways and hyperactive Src is a potent oncogene and driver of human metastasis. Most of our knowledge on Src kinase regulation relies on structural data, which revealed SH2 and SH3-dependent intramolecular interactions to control active conformations of the protein. The kinase, SH3 and SH2 domains of Src are attached to the membrane-anchored SH4 domain through the flexible unique domain (UD). The role of this UD remains obscure due to its intrinsically disordered properties for which reason it was not included in original structural analyses. Interestingly, membrane-associated intrinsic disordered domains are more prevalent among signaling and cancer-related proteins and they are thought to play critical roles in human disease. NMR analysis of Src N-terminus in the presence of lipids revealed a partially structured conformation of the UD through the contact of a small peptide sequence with membrane lipids and the SH3 domain of the protein (Perez et al, 2013; Maffei et al, 2015). This interaction was regulated by phosphorylation of Ser69 and Ser75 surrounded this central region. The aim of my thesis project was to assess the biological relevance of this structural data. Interestingly, I showed that expression of Src mutants with UD loss of function drastically affected Src activity and signaling in human non-transformed cells as well as Src oncogenic properties in metastatic colorectal cancer cells. This highlights the biomedical relevance of the system. Further proteomic analysis revealed an unsuspected mechanism by which this region controls the Src capacity to phosphorylate specific substrates involved in cancer cell activity. These data support a previously unrecognized important role of the UD on Src activity and signaling and reveals a critical role of intrinsic disordered domains in the regulation of kinase signaling in human disease. Targeting this unique region by small molecules may be of therapeutic value in human cancer.

HEF1 (Human Enhancer of Filamentation 1) est une protéine d’ancrage multi-domaine de la famille CAS. Ces protéines sont impliquées dans des modifications du cytosquelette et sont des médiateurs de l’activation par les intégrines des cascades de signalisation au niveau des adhérences focales. Des données récentes ont mis en évidence une expression élevée de HEF1 associée à une capacité de migration et d’invasion cellulaire accrue dans plusieurs types de cancer. Ainsi, un rôle de la protéine dans la progression tumorale et le développement métastatique a été suggéré. HEF1 est une phosphoprotéine. Outre sa phosphorylation sur résidus tyrosine par les kinases FAK et Src bien décrite, elle est également phosphorylée sur des sérines: la sérine 296 et la sérine 369 identifiée par notre laboratoire comme étant un régulateur de la dégradation protéosomale de la protéine. A ce jour, peu d’informations sont disponibles sur le rôle de HEF1 dans la progression tumorale colorectale, ou sur l’implication de sa phosphorylation sur sérine dans ses fonctions biologiques.Mon travail de thèse a permis de montrer une régulation positive de l’expression de HEF1 dans des échantillons du cancer de côlon, associée à une augmentation de la migration cellulaire dans des lignées tumorale colorectales. L’induction de la migration de la lignée HCT116 lors de la surexpression de HEF1 est corrélée à une augmentation de la phosphorylation sur tyrosine de FAK de manière dépendante de la kinase Src. Dans un deuxième temps, nous nous sommes intéressé à la phosphorylation sur sérine de HEF1, et avons montré que, comparativement à la protéine sauvage, la mutation sur la Sér-369 amplifie son effet pro-migratoire ainsi que la phosphorylation de FAK régulée par HEF1 consécutivement à une stabilisation de la protéine. Nous avons également caractérisé, pour la première fois, une mutation fonctionnelle de HEF1 sur l’Arg-367 qui mime l'effet de la mutation sur la Sér-369. Enfin, nous avons identifié des protéines adaptatrices de la famille BCAR3 comme partenaires de HEF1 et démontré que l’effet pro-migratoire de HEF1 est requiert son interaction avec BCAR3. En conclusion, ce travail nous a permis d’identifier une mutation de HEF1 (R367Q) qui stabilise la protéine, accroissant ainsi son effet pro-migratoire. Nous avons également associé la migration induite par HEF1 à son interaction avec BCAR3 et à une augmentation de la phosphorylation sur tyrosine de FAK. / Human Enhancer of Filamentation 1 (HEF1) is a member of the p130Cas family of docking proteins. HEF1 is present at focal adhesions and is involved in integrin-mediated cytoskeleton reorganization associated with cell migration. Elevated expression of HEF1 promotes invasion and metastasis in multiple cancer cell types. To date, little is known on the role of HEF1 in CRC tumor progression. HEF1 is phosphorylated on several Ser/Thr residues but the effects of these post-translational modifications on the functions of HEF1 are poorly understood. In this manuscript, we investigated the role of HEF1 in colorectal adeno-carcinoma migration capacities. First, we found that HEF1 expression was augmented in high stages CRC samples and then showed that overexpression of HEF1 in colo-carcinoma cell line HCT116 increases cell migration. Moreover, in these cells, HEF1 increases Src-mediated phosphorylation of FAK. We then showed that HEF1 mutation on Ser-369 enhances HEF1-induced migration and FAK phosphorylation as a result of protein stabilization. We also, for the first time characterized a functional mutation of HEF1 on Arg-367 which mimics the effect of Ser-369 to Ala mutation. Finally through mass spectrometry experiments, we identified BCAR3 as an essential interactor and mediator of HEF1-induced migration. We demonstrated that single amino acid mutations that prevent formation of the HEF1-BCAR3 complex impair HEF1-mediated migration. Therefore, amino-acid substitutions that prevent Ser-369 phosphorylation stabilize HEF1 which increases the migration of CRC cells and this requires the interaction of HEF1 with the NSP family adaptor protein BCAR3. Collectively, these data reveal the importance of HEF1 expression level in cancer cell motility and then support the utilization of HEF1 as a biomarker of tumor progression.

En France, le cancer colorectal (CCR) est la 2ème cause de décès par cancer. Chez les patients, lorsque la tumeur est localisée, elle est réséquée par chirurgie. Toutefois, 50% des patients sont diagnostiqués à un stade métastatique, ces patients sont alors traités par chimiothérapie (FOLFOX/FOLFIRI), souvent en combinaison avec des thérapies ciblées incluant des anticorps tel que le Cetuximab (anti-EGFR) ou le Bevacizumab (anti-VEGF). Cependant, il reste encore environ 40% des patients qui ne répondent pas au traitement et l’une des causes les mieux établies est l'influence des mutations de la voie RAS en aval du récepteur à l'EGF sur la réponse au Cetuximab. C’est pourquoi l’identification de nouvelles cibles moléculaires accessibles aux anticorps permettrait le développement de nouveaux modèles de thérapie ciblée. Depuis peu, les Claudines ont suscité un intérêt pour le ciblage tumoral comme la claudin-4 dans les cancers de l’endomètre ou de la prostate. Très récemment, les résultats d'une étude clinique ont démontré que la combinaison d'un anticorps anti-Claudin-18.2, l'Acm IMAB362, avec la chimiothérapie prolongeait nettement la survie chez des patients atteints de cancer gastrique avancé.C’est dans cette optique que nous nous sommes focalisés sur les claudines dans le CCR. Tout d’abord en étudiant leur expression dans des échantillons de patients atteints de CCR métastatique. En analysant l’expression des claudines dans les nouveaux sous-types moléculaires, nous avons montré que certaines pouvaient avoir une valeur pronostique. Nous avons également identifié des claudines comme cibles thérapeutiques potentielles dans le CCR, parmi elles la CLDN1. En effet, nous avons montré que la forme membranaire de la CLDN1 était surexprimée dans les tumeurs primaires et métastases du CCR. Nous avons développé un anticorps monoclonal (Acm) ciblant les parties extracellulaires de la CLDN1. Nous avons montré que le ciblage thérapeutique de la CLDN1 par Acm provoquait un ralentissement significatif de la croissance, la migration et l'invasion des cellules tumorales aussi bien in vitro que in vivo. Afin d’améliorer l’efficacité du ciblage de la CLDN1 par Acm, nous avons couplé ce dernier avec une toxine, générant ainsi un Antibody Drug conjugated (ADC). Nous avons montré que le ciblage de la CLDN1 par un ADC diminuait la survie cellulaire in vitro en culture cellulaire 2D, mais également celle des sphéroïdes via un effet cytotoxique. Ce travail a permis d'établir la preuve de concept du ciblage de la CLDN1 aussi bien par Acm que par ADC. Afin de finaliser ce travail, ces résultats doivent être confirmés in vivo. A terme, nous espérons que ce ciblage puisse trouver sa place au sein de l’arsenal thérapeutique du CCR métastatique, en particulier chez les patients résistants aux traitements. / Colorectal cancer (CRC) is one of the major causes of cancer-related deaths in the Western world. When localized, CRC is often curable by surgery. However, 50% of patients are diagnosed at a metastatic stage, these patients are then treated with chemotherapy (FOLFOX / FOLFIRI), often in combination with targeted therapies including antibodies such as Cetuximab (anti-EGFR) or Bevacizumab (anti -VEGF). Despite these treatment, almost 40% of patients develop resistance. One of the most known resistance mechanisms of resistance is due to the RAS pathway downstream of the EGF receptor in response to Cetuximab. Therefore, more therapeutic options are required particularly by identifying new molecular targets that can be reached by antibodies. Recently, Claudines have generated interest as targets in cancer, such as claudin-4 in endometrial or prostate cancer. More recently, the results of a clinical study demonstrated that the combination of an anti-Claudin-18.2 antibody, IMAB362 mAb, with chemotherapy significantly prolonged survival in patients with advanced gastric cancer.Therefore, one of our aims was to focus on claudins in CCR. First, by studying their expression in metastatic CRC patient samples. We demonstrated the prognostic value of some claudins, after analyzing their gene expression in the new molecular subtype of CRC. Beside, we identified some claudins as potential therapeutic targets in CCR, among them claudin-1 (CLDN1). Indeed, we showed that the membrane form of CLDN1 is overexpressed in primary tumors and metastases of CRC. Therefore, we developed a monoclonal antibody (mAb) targeting the extracellular parts of CLDN1. We showed that therapeutic targeting of CLDN1 by mAb significantly decreased tumor cell growth, migration and invasion both in vitro and in vivo. In order to improve the efficiency of targeting CLDN1 by mAb, we conjugated it with a toxin, thus generating an Antibody Drug Conjugate (ADC). We showed that CLDN1 targeting by an ADC decreased cell survival in vitro in 2D cell culture, but also spheroids growth via a cytotoxic effect.This work demonstrated the proof of concept of CLDN1 targeting by both mAb and ADC. In order to achieve this work, the next steps remains on testing ADC affect in vivo models. CLDN1 is a good therapeutic target in the CCR. In the long term, we hope that its targeting can find its place within the therapeutic arsenal of metastatic CRC, particularly in treatment of resistant patients.

Submitted by Suzana Dias (suzana.dias@famerp.br) on 2018-10-29T17:01:35Z No. of bitstreams: 1 CarlaMariaMoraes_dissert.pdf: 4345886 bytes, checksum: 7c2b7d3028309208358698339e534111 (MD5) / Made available in DSpace on 2018-10-29T17:01:35Z (GMT). No. of bitstreams: 1 CarlaMariaMoraes_dissert.pdf: 4345886 bytes, checksum: 7c2b7d3028309208358698339e534111 (MD5) Previous issue date: 2017-07-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Colorectal cancer (CRC) is a prevalent disease in Brazil and worldwide. It is treated with surgical indication, neoadjuvant therapies such as Chemotherapy and / or Radiotherapy. Thus in elective surgeries, the approach of the multidisciplinary team to improve the clinical condition of surgical patients is required. Nutritional impairments to the side effects of cancer treatment prior to surgery are permanent. Therefore, the preoperative nutritional assessment, therapy and post-surgical nutritional monitoring are fundamental, since this nutritional impairment contributes to the increase of postoperative morbidity and mortality. Objective: To identify the status and preoperative nutritional risk of patients eligible for colorectal surgery. Methods: We studied from February, 2014 to August, 2015, 22 patients (11 men and 11 women; 59.6± 12.4 years) hospitalized in the Coloproctology Department of Hospital de Base/ FAMERP candidates to the elective major abdominal surgery. Preoperative evaluation was performed by a protocol that comprised subjective global assessment (SGA), objective nutritional assessment (ONA), anthropometric parameters (weight, height, BMI, measures of circumferences and triceps skinfold), biochemical (hematocrit, hemoglobin and serum albumin) and dietary recall of the usual intake. Nutritional risk was calculated according to criteria combined according to the Nutritional Guidelines Nutritional Therapy (DITEN) and the Second National Consensus Oncology Nutrition (CNNO) based on parameters such as: weight loss (pp)>10% in 6 months, severe malnutrition according to SGA, BMI <18.5kg/m2 (adults) or 22 kg/m2 (elderly) and serum albumin <3.0g/dL. Results: In the study, 18 (81.8%) patients had cancer (50.0% colon cancer and 31.8% rectal cancer). All patients had major surgery indication, 8 (27.3%) reported having gastrointestinal symptoms, 20 (90.9%) reported no impairment in functional capacity and 8 (36.4%) showed depletion of adipose tissue and lean mass. Nine (40.9%) patients were considered malnourished or at nutritional risk according to SGA, and only 2 (9.1%) according to BMI (P=0.0339). Thirteen (59.1%) of them were overweighed according to BMI, 7 (31.8%) and 11 (50%) were classified with malnutrition / nutritional risk and overweight according to ONA, respectively. Regarding the anthropometric profile, the group of men towards women; higher weight median (77.8kg x 60.0 kg, P=0.0126), CMB (26.4 cm x 22.2 cm P=0.0372), DC (100 cm x 80 cm; P=0.0301) and WHR (0.99 x 0.88, P=0.0010) were observed. Regarding the PCT, there was a higher median in the female group compared to the group of men (23.0 mm x 10.0 mm; P=0.0065). In 10 (45.5%) patients and in 11 (50%) of them, the ingestion of calories and protein was smaller than 75% of the required. Only 2 (9.1%) patients had serum albumin levels between 3.5 and 3.0 g/dL. Thus, 4 (18.2%) patients were considered to have severe nutritional risk according to DITEN and II CNNO. Conclusions: Considering the results found in the study, it is concluded that the impaired nutritional status, either by depletion of lean body mass, as the overweight is a common finding in patients undergoing surgery for colorectal cancer. Severe nutritional risk is present in these patients, so the Preoperative Nutritional Therapy is fundamental and can provide better results in the elective surgeries. / O câncer colorretal (CCR), doença prevalente no Brasil e no mundo, a qual é tratada com cirúrgia, terapias neoadjuvantes e adjuvantes, como quimioterapia e/ou radioterapia vem ganhando mais atenção devido ao aumento da incidência. Assim, em cirurgias eletivas, a atuação da equipe multidisciplinar pode contribuir decisivamente para melhorar as condições clínicas dos pacientes cirúrgicos e o resultado do tratamento. Prejuízos nutricionais devido aos efeitos colaterais do tratamento oncológico anterior à cirurgia são evidentes. Portanto, a avaliação nutricional pré-cirúrgica, a terapia e o acompanhamento nutricional pós-cirúrgico são fundamentais, uma vez que o comprometimento nutricional contribui para o aumento da morbimortalidade pós-operatória. Objetivo: Identificar o estado e o risco nutricional pré-operatório de pacientes candidatos à cirurgia colorretal. Casuística e Método: Foram estudados, de Fevereiro/2014 à Agosto∕2015, 22 pacientes (11 homens e 11 mulheres; 59,6+ 12,4 anos), internados nas enfermarias da Disciplina de Coloproctologia do Hospital de Base/FAMERP, candidatos à cirurgia abdominal eletiva de grande porte. A avaliação pré-operatória foi realizada por protocolo composto de avaliação nutricional subjetiva global (ANSG), avaliação nutricional objetiva (ANO), parâmetros antropométricos (peso, altura, IMC, medidas de circunferências e prega cutânea do tríceps), bioquímicos (hematócrito, hemoglobina e albumina sérica) e recordatório alimentar da ingestão habitual. O risco nutricional foi calculado de acordo com critérios combinados segundo as Diretrizes Nutricionais de Terapia Nutricional (DITEN) e o II Consenso Nacional de Nutrição Oncológica (CNNO), baseado em parâmetros como: perda de peso (pp)>10% em 06 meses, desnutrição grave de acordo com ANSG, IMC<18,5Kg/m2 (adultos) ou 22Kg/m2 (idosos) e albumina sérica <3,0g/dL. Resultados: Na casuística, 18(81,8%) eram portadores de câncer (50,0%câncer de cólon e 31,8% câncer de reto) e 18,2 outras doenças do intestino. Todos os pacientes tinham indicação de cirurgia de grande porte, sendo que 6(27,3%) relataram apresentar sintomas gastrointestinais, 20(90,9%) referiram ausência de disfunção na capacidade funcional e 8(36,4%) apresentaram depleção de tecido adiposo e de massa magra. Nove (40,9%) pacientes foram considerados desnutridos ou de risco nutricional segundo a ANSG, e apenas 2(9,1%) segundo o IMC (P=0,0339). Treze (59,1%) deles tinham excesso de peso de acordo com o IMC, 7(31,8%) e 11(50%) classificaram-se com desnutrição/risco nutricional e com excesso de peso segundo a ANO, respectivamente. Em relação ao perfil antropométrico, no grupo dos homens em relação às mulheres, observaram-se maiores medianas de peso (77,8kg x 60,0kg; P=0,0126), CMB (26,4cm x 22,2cm; P=0,0372), CC (100 cm x 80 cm; P=0,0301) e RCQ (0,99 x 0,88; P=0,0010). Em relação ao PCT, verificou-se maior mediana no grupo das mulheres comparado ao grupo dos homens (23,0mm x 10,0mm; P=0,0065). Em 10(45,5%) pacientes e em 11(50%) deles, a ingestão de calorias e proteínas foi considerada menor que 75% das necessidades. Apenas 2(9,1%) pacientes apresentaram níveis séricos de albumina entre 3,5 a 3,0 g/dL. Sendo assim, 4 (18,2%) pacientes foram considerados com risco nutricional grave segundo o DITEN e o II CNNO. Conclusões: Considerando-se os resultados encontrados na casuística, conclui-se que o estado nutricional comprometido, tanto pela depleção de massa magra, como pelo excesso de peso, é um achado frequente em pacientes que realizam a cirurgia do câncer colorretal. O risco nutricional grave está presente nestes pacientes, de tal modo que a Terapia Nutricional pré-operatória, é fundamental, pois pode influenciar os melhores resultados em cirurgias eletivas.

O câncer colorretal (CCR) é importante causa de morte no Brasil, representando a segunda causa de morbimortalidade por câncer nas regiões Sudeste e Sul. Foi uma das primeiras neoplasias malignas a ter modelo de carcinogênese identificado. Os objetivos deste trabalho foram avaliar a expressão do NF-KB e da survivina na progressão do CCR, sua relação com alvos moleculares envolvidos na sobrevivência celular [proibitina, fator de necrose tumoral (TNFR1), p53, B- catenina]; invasão (metaloproteinases 2 e 9 - MMP), angiogênese (fator de crescimento endotelial vascular VEGF) e apoptose (caspase 3 e método do Túnel). Trata-se de estudo retrospectivo baseado na análise histopatológica de dezoito casos de adenomas com displasia de alto (AG) e baixo grau (BG), respectivamente; dez casos de adenocarcinoma bem, moderado e pouco diferenciado, respectivamente, nove casos de lesões serrilhadas e nove biópsias colorretais (controle) selecionados aleatoriamente no Serviço de Patologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, no período de 2000 a 2009. Foram construídos arranjos de matriz tecidual para representar os casos de adenocarcinomas e cinco casos de adenomas >1 cm de diâmetro. A detecção do NF-KB foi realizada pelo método de Southwestern imunoistoquímica. Avaliou-se a expressão imunoistoquímica da survivina, proibitina, TNFR1, p53, B-catenina, MMPs 2 e 9, VEGF, caspase 3 e Túnel. Não observamos expressão imunoistoquímica do NF-KB em 70% dos casos de adenocarcinomas, em 72% dos adenomas AG e em 89% das lesões serrilhadas; a marcação foi positiva em 66% e 56% dos casos de adenoma do BG e controle, respectivamente. Expressões da survivina, proibitina citoplasmática, TNFR1, p53, MMP 2 e 9 foram crescentes na seqüência adenoma-carcinoma, sem aparente modulação pelo NF-KB. A survivina suprimiu ação da caspase 3, exceto nos adenomas BG e controle, com baixos níveis de apoptose ao túnel. Lesões serrilhadas e controle apresentaram baixa expressão do TNFR1 e da proibitina citoplasmática, ausência de marcação da p53 e MMPs 2 e 9, exceto um caso controle. Identificou-se marcação nuclear da proibitina nos adenocarcinomas pouco diferenciados, adenomas AG e BG. A expressão da p53 relacionou-se ao grau de displasia nos adenomas e à desregulação da survivina. Observou-se expressão citoplasmática e nuclear da B- catenina nos adenocarcinomas, adenomas AG e BG. As lesões serrilhadas exibiram expressão citoplasmática em 44% dos casos. O grupo controle exibiu expressão preservada da B-catenina. Identificou-se expressão do VEGF nos adenocarcinomas, relacionada à perda de diferenciação celular, presença de metástases, não correlacionada ao NF-KB. Com base nos nossos resultados, sugerimos a desregulação da B- catenina como possível responsável pela inibição do NF-KB; além de sua participação na desregulação da survivina juntamente com a p53. As lesões serrilhadas não exibiram indícios sugestivos de inibição do NF- KB pela B-catenina.A survivina, devido propriedades anti-apoptóticas, emerge como potencial alvo terapêutico no tratamento do CCR, confirmando estudos anteriores. / Colorectal cancer (CRC) is an important cause of death in Brazil, representing the second leading cause of cancer mortality in the Southeast and South. It was among the first malignancies that have the carcinogenesis model identified.The aim of this study was to evaluate the expression of NF-KB and survivin in the progression of CRC, its relationship with molecular targets involved in cell survival [prohibitin, tumor necrosis factor (TNFR1), p53,B-catenina], invasion (metalloproteinases 2 and 9 - MMP), angiogenesis (vascular endothelial growth factor VEGF) and apoptosis (caspase 3 and method Tunnel). This is a retrospective study based on the histopathological analyses of eighteen cases of high- (HG) and low- grade dysplastic (LG) adenomas, respectively; ten cases of adenocarcinoma well, moderately and poorly differentiated, respectively, nine cases of serrated lesions e nine biopsies (control); randomly selected in the Pathology Service of the University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo from 2000 to 2009. Tissue microarray were constructed to represent the cases of adenocarcinomas and five cases of adenomas > 1cm in diameter. Detection of NF-KB was performed by the Southwestern immunohistochemistry method. We evaluated immunohistochemical expression of survivin, prohibitin, TNFR1, p53, B- catenin, MMPs 2 and 9, VEGF, caspase 3 and method Tunnel. We did not observe immunohistochemical expression of NF-KB in 70% of cases of adenocarcinomas, in 72% of HG adenomas and 89% of lesions serrated; staining was positive in 66% and 56% of cases of LG adenoma and control, respectively. Expressions of survivin, cytoplasmic prohibitin, TNFR1, p53, MMPs 2 and 9 were increasing in adenoma-carcinoma sequence, without apparent modulation by NF-KB. Survivin suppressed action of caspase 3, except in BG adenomas and control, with low levels of apoptosis to the tunnel. Serrated lesions and control showed low expression of TNFR1 and cytoplasmic prohibitin, the absence of staining of p53 and MMPs2 and 9, except for one control. We identified nuclear staining of prohibitin in poorly differentiated adenocarcinomas, HG and LG adenomas. Expression of p53 was related to the grade of dysplasia in adenomas and deregulation of survivin.The expression of the cytoplasmic and nuclear B-catenin was observed in adenocarcinoma, HG and LG adenoma. Serrated lesions exhibited cytoplasmic expression in 44% of cases. Control group exhibited preserved expression of B-catenin. It was identified VEGF expression in adenocarcinomas, related to the loss of cellular differentiation, metastasis, not correlated with NF-KB. According to our results, we suggest that deregulation of catenin is possible responsible for the inhibition of NF-KB besides their participation in the deregulation of survivin with p53.Serrated lesions exhibited no evidence suggestive of inhibition of NF-KB by B-catenin. Survivin emerges as a potential therapeutic target in the treatment of CRC due to their anti-apoptotic properties, confirming previous studies.