Orientador: Lúcia Helena Simões da Costa Paiva / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-11-07T13:42:39Z (GMT). No. of bitstreams: 1 Pinheiro_Anderson_M.pdf: 3122120 bytes, checksum: dced5efa50ee11a7d5554366020908bb (MD5) Previous issue date: 2012 / Resumo: Introdução: A prevalência de obesidade tem aumentado em todo o mundo e hoje já representa um problema de saúde pública. Na população feminina, seu aumento ocorre principalmente nos anos próximos da transição para menopausa. O aumento de peso representa um risco para diversas comorbidades, dentre elas um importante fator de risco para patologia endometrial. A etiologia e a patogênese dos pólipos não estão completamente esclarecidas. Estuda-se se o desenvolvimento dos pólipos endometriais está diretamente relacionado à presença de receptores hormonais, além de estar relacionado a mecanismos envolvidos à proliferação e à apoptose celular. Objetivos: Avaliar a imunoexpressão dos receptores de estrógeno (RE), progesterona (RP), Cox-2, Ki67 e Bcl-2 em pólipos endometriais benignos na pré e pós-menopausa e associação com a obesidade. Materiais e métodos: Dentre 1050 mulheres submetidas à histeroscopia cirúrgica no Hospital da Mulher Prof. Dr. Aristodemo Pinotti - CAISM/UNICAMP, de janeiro de 1998 a dezembro de 2008, 800 foram casos de polipectomia endometrial confirmados com exame anatomopatológico. Deste total, foram excluídas as usuárias de Tamoxifeno, as que faziam uso de terapia hormonal e os casos de pólipos malignos ou pré-malignos. Obteve-se uma amostra de 515 pólipos endometriais benignos em mulheres na pré e pós-menopausa. Foram avaliadas as expressões de RE, RP, Bcl-2, Ki67 e Cox-2, através de imuno-histoquímica, segundo a porcentagem de células coradas, intensidade da coloração e escore final. Os escores finais de RE, RP, Bcl-2, Cox-2 variam de 0 a 8 e o de Ki67 de 0 a 3. A mediana dos escores finais de RE, RP, Bcl-2, Cox-2 e Ki67 no epitélio glandular e no estroma dos pólipos foi comparada entre mulheres obesas e não obesas na pré e pós-menopausa, utilizando os testes qui-quadrado, exato de Fisher ou não paramétrico de Mann-Whitney. Resultados: A mediana do escore final de receptores hormonais mostrou maior expressão de RP no estroma e no epitélio glandular das mulheres obesas na pós-menopausa, sem diferença em relação à expressão dos RE. Em mulheres na pré-menopausa não houve diferença na expressão de RE e RP entre obesas e não obesas. Nos pólipos endometriais de mulheres pós-menopausadas houve maior expressão de Cox-2 e Bcl-2 no epitélio glandular das mulheres obesas do que em relação às mulheres não obesas. Não houve diferenças em relação ao estroma endometrial. Na pré-menopausa, houve maior expressão de Bcl-2 apenas no epitélio glandular das mulheres obesas. Não houve diferenças na expressão de Ki67 entre obesas e não obesas tanto na pós-menopausa quanto na pré-menopausa. Conclusões: Os pólipos de mulheres obesas apresentam, na pós-menopausa, maior expressão de RP glandular e estromal, Cox-2 glandular e Bcl-2 glandular, sem diferenças na expressão de Ki67. Estes dados sugerem que sua etiopatogênese dos pólipos em obesas parece estar mais relacionada aos receptores de progesterona, à inibição da apoptose e aos mecanismos relacionados à inflamação celular / Abstract: Introduction: The prevalence of obesity has increased worldwide and represents a public health problem nowadays. The female population, considerably presents its increase in the coming years of the transition to menopause. Weight gaining represents a risk for various comorbidities, but among them all, it is an important risk factor for the endometrial pathology. The polyps etiology and pathogenesis have not been completely clarified so far. It has been studied whether the endometrial polyps development is directly related to the presence of hormone receptors, besides being associated with mechanisms involved in the proliferation and cellular apoptosis.Objectives: To evaluate the immunoexpression of estrogen and progesterone receptors, Ki67, Bcl-2 and Cox-2 in benign endometrial polyps in pre and postmenopausal women and their association with obesity. Methods: It was observed that among 1050 women who underwent hysteroscopic surgery at the "Prof. Dr. José Aristodemo Pinotti" Women's Hospital-CAISM-UNICAMP from January 1998 to December 2008, 800 were confirmed with endometrial polyp anatomopathological diagnosis. Of this total amount, it was excluded tamoxifen users, those who used hormone therapy and cases of malignant or pre-malignant polyps. It was obtained a sample of 515 benign endometrial polyps in women before and after menopause. It was also assessed the expression of ER, PR, Bcl-2, COX-2 and Ki67 through immunohistochemistry according to stained cells percentage, staining intensity, and the final score. The ER, PR, Bcl-2, Cox-2 final score ranges from 0 to 8 and the Ki67 from 0 to 3). The ER, PR, Bcl-2, Cox-2 and Ki67 median final scores in the glandular epithelium and stroma of the polyps were compared among obese and nonobese women, in pre and postmenopausal condition, using the Chi-square Fisher's exact test or nonparametric Mann-Whitney test. Results: The hormonal receptors median final score has showed an increased expression of progesterone receptors in the stroma and glandular epithelium of postmenopausal obese women but there was no difference in expression of ER estrogen receptors. In premenopausal women, there was no difference in expression of ER and PR among obese and nonobese women. The endometrial polyps in postmenopausal women have showed a higher expression of Cox-2 and Bcl-2 in glandular epithelium in obese women rather than in nonobese women. There were no differences in the endometrial stroma. In premenopausal women, there was a higher expression of Bcl-2 only in the obese women glandular epithelium. There were no differences in Ki67 expression among obese and nonobese both postmenopausal and premenopausal women. Conclusions: Obese women polyps, in postmenopausal condition, have increased expression of glandular and stromal PR, Cox-2 and Bcl-2 glandular. However, there are no differences in the Ki67 expression . These data suggest that its etiopathogenesis in obese women polyps, seem to be related to progesterone receptors, apoptosis inhibition and also to mechanisms associated with cellular inflammation / Mestrado / Fisiopatologia Ginecológica / Mestre em Ciências da Saúde

Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / IntroduÃÃo: O cloridrato de irinotecano (CPT-11) à um inibidor da topoisomerase I, clinicamente efetivo no tratamento de vÃrios tipos de cÃncer. Apesar da mucosite intestinal (MI) acompanhada de severa diarrÃia ser o efeito colateral mais limitante do uso terapÃutico do CPT-11, os exatos mecanismos que levam a estes efeitos nÃo sÃo estabelecidos. Objetivo: avaliar o envolvimento de mediadores inflamatÃrios (citocinas, Ãxido nÃtrico â NO e prostaglandinas â PGs) na patogÃnese dos eventos que acompanham a MI induzida pelo CPT-11; e estudar o efeito de inibidores da sÃntese e liberaÃÃo de citocinas, como pentoxifilina (PTX) e talidomida (TLD), e de um inibidor seletivo da ciclooxigenase-2 (COX-2), o celecoxibe (CLX), na lesÃo intestinal induzida pelo CPT-11. Material e MÃtodos: camundongos Swiss, machos, foram tratados durante quatro dias consecutivos com CPT-11 (50, 75 e 100 mg/kg, i.p.) ou veÃculo (0,5 mL, i.p.), a fim de se obter a melhor dose capaz de induzir injÃrias consistentes com o mÃnimo de letalidade. Os animais foram tratados com PTX (1,7, 5 e 15 mg/kg, s.c.), TLD (15, 30, 60 mg/kg, s.c), CLX (3, 10, 30 mg/kg, gavagem) ou veÃculo (0,5 mL, s.c. ou gavagem), um dia antes da primeira administraÃÃo do CPT-11 (75 mg/kg), e diariamente, atà o sacrifÃcio, no quinto ou sÃtimo dia. Os seguintes parÃmetros foram avaliados: diarrÃia, variaÃÃo de massa corpÃrea, leucograma, sobrevida, anÃlise histopatolÃgica, atividade de mieloperoxidase (MPO), dosagem de citocinas (TNF-α, IL-1β e KC) por ELISA e imunohistoquÃmica para TNF-α, IL-1β, iNOS e COX-2 nas mucosas duodenais. Resultados: CPT-11 induziu diarrÃia significante, acompanhada de perda acentuada de massa corpÃrea, leucopenia e reduÃÃo da sobrevida. As alteraÃÃes histopatolÃgicas intestinais induzidas pelo CPT-11 caracterizaram-se pela presenÃa de infiltrado inflamatÃrio nas cÃlulas da lÃmina prÃpria, perda da arquitetura das criptas e achatamento dos vilos. Observou-se ainda, aumento intestinal na atividade de MPO e dos nÃveis de TNF-α, IL-1β e KC, alÃm do aumento significativo na marcaÃÃo imunohistoquÃmica para TNF-α, IL-1β, iNOS e COX-2. O tratamento com PTX inibiu a diarrÃia tardia, reduziu as alteraÃÃes histopatolÃgicas, a atividade de MPO, e os nÃveis de TNF-α, IL-1β e KC, assim como a marcaÃÃo imunohistoquÃmica para TNF-α, IL-1β e iNOS na mucosa duodenal, entretanto, nÃo preveniu significativamente a perda de massa corpÃrea, a leucopenia e tampouco a mortalidade dos animais. O tratamento com TLD reduziu as lesÃes histopatolÃgicas induzidas pelo CPT-11 na mucosa intestinal, os nÃveis intestinais de MPO e TNF-α, bem como a marcaÃÃo imunohistoquÃmica de TNF-α, mas nÃo foi capaz de prevenir a diarrÃia, a perda de massa corpÃrea, a leucopenia e a sobrevida. O tratamento com CLX nÃo foi capaz de reduzir os parÃmetros inflamatÃrios e sistÃmicos observados nos animais tratados com CPT-11. ConclusÃo: Estes resultados sugerem o envolvimento de TNF-α, IL-1β, KC, NO e PGs na patogÃnese da MI induzida pelo CPT-11. PTX e TLD preveniram significativamente as alteraÃÃes histolÃgicas e inflamatÃrias induzidas pelo CPT-11, entretanto, somente PTX foi capaz de inibir o curso da diarrÃia / Introduction: Irinotecan (CPT-11) is an inhibitor of DNA topoisomerase I and clinically effective against several cancers. A major toxic effect of CPT-11 is delayed diarrhea; however, the exact mechanism by which the drug induces diarrhea has not been established. Purpose: The aim of the present study was to elucidate the involvement of cytokines (TNF-α, IL-1β and KC), nitric oxide (NO) and prostaglandins (PGs) in the pathogenesis of CPT-11-induced mucositis and the effects of the cytokine production inhibitors, pentoxifylline (PTX) and thalidomide (TLD), as well as the effects of the selective cyclooxygenase (COX-2) inhibitor, celecoxib (CLX), in the CPT-11 induced intestinal mucositis, in mice. Materials and methods: the animals were treated with CPT-11 (50, 75 or 100 mg/kg, i.p.) or vehicle (0,5 ml, i.p.) daily for four days, in order to investigate the best dose able to induce intestinal mucositis without important mortality. In another set of experiments, the animals received PTX (1.7, 5, 15 mg/kg, s.c.), TLD (15, 30, 60 mg/kg, s.c.), CLX (3, 10, 30 mg/kg, oral gavage) or vehicle (0,5 ml, s.c. or oral gavage) one day before the 1st administration of CPT-11 (75 mg/kg; i.p.) and daily until the sacrifice, on the 5th or 7th day. The systemic parameters evaluated were: diarrhea, body mass variation, survival curve and leucogram. In addition, it was also performed histological analysis, myeloperoxidase (MPO) activity assay, duodenum levels of TNF-α, IL-1β and KC by ELISA and immunohistochemistry for TNF-α, IL-1β, iNOS and COX-2 in the duodenal segments. Results: CPT-11 induced an important diarrhea, weight loss, leucopenia and mortality increase. It was also observed histopathological changes, such as shortened villi, loss of the crypt architecture and inflammatory cells infiltration, observed in the lamina propria, as well as, an increase in MPO activity, TNF-α, IL-1β and KC tissue levels and a marked immuno-staining for TNF-α, IL-1β, iNOS and COX-2. The treatment with PTX inhibited the delayed diarrhea and reduced the following parameters: histopathological alterations, MPO activity, tissue levels of TNF-α, IL-1β and KC, and the immuno-staining for TNF-α, IL-1β and iNOS, however, did not prevent leucopenia, weight loss and mortality. TLD significantly reduced all the inflammatory parameters evaluated, but was not able to prevent diarrhea, leucopenia, weight loss and mortality. On the other hand, CLX did not inhibit the inflammatory nor the systemic alterations induced by CPT-11. Conclusion: These results suggest an important role of TNF-α, IL-1β, KC, NO and PGs in the pathogenesis of intestinal mucositis induced by CPT-11. PTX and TLD showed a protector effect in intestinal structures, however, only PTX reduced the severity of CPT-11-induced diarrhea

Includes list of publications arising from this thesis / Erratum attached to inside back cover. / "25/03/2004." / Includes bibliographical references (leaves 185-257) / xii, 257 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Medicine and Royal Adelaide Hospital, Rheumatology Unit, 2004

[Truncated abstract] Hepatocellular carcinoma (HCC) is the major malignancy complicating chronic liver disease. New therapies for the prevention of HCC are required due to the limited success and high tumour recurrence rates of existing treatments. Emerging evidence suggests that HCC arise from the transformation of adult liver progenitor cells (LPCs), which have the capacity to differentiate into hepatocytes and biliary cells during liver regeneration. LPC activation precedes neoplasia in experimental hepatocarcinogenesis. LPCs share antigenic epitopes with HCCs, including α-fetoprotein (AFP) and M2- pyruvate kinase (M2PK). In animal models of hepatocarcinogenesis, attenuation of the LPC response reduces the incidence of HCC following prolonged liver injury via a tumour necrosis factor (TNF) dependent mechanism. As TNF is a pro-inflammatory cytokine, these data suggest that anti-inflammatory agents may be effective in inhibiting LPC activation and hepatocarcinogenesis. Cyclo-oxygenase-2 (COX-2) is an inducible enzyme that mediates the production of many prostaglandins during inflammation and carcinogenesis. Recent investigations show that the administration of selective COX-2 inhibitors (SC2Is) may reduce the incidence of a variety of tumours including breast, colon and skin. The broad aim of this thesis was to conduct a series of detailed studies on the effects of a SC2I on LPC activation and the hepatic pathologies associated with hepatocarcinogenesis in order to test the hypothesis that S2CIs may be a beneficial therapy that can reduce liver injury and pre-neoplastic changes in the choline-deficient, ethionine supplemented (CDE) murine model of hepatocarcinogenesis. Administration of a SC2I (SC-236) significantly inhibited a variety of hepatic cell populations that expand during the first month of the CDE mouse model of hepatocarcinogenesis (a choline deficient, ethionine supplemented diet). Numbers of M2PK-positive LPCs (which are more hepatocytic in morphology and are also COX-2 positive) and inflammatory cells were all significantly reduced by SC-236. In contrast, numbers of A6-positive LPCs (which are more biliary cell-like in morphology and do not express COX-2) were unchanged. ... In summary, these data suggest that COX-2 inhibitors such as SC-236 inhibit LPC activation and a variety of pre-neoplastic liver pathologies as a result of COX-2 dependent and independent mechanisms that may be mediated through inhibition of Akt phosphorylation and induction of apoptosis. Moreover, SC2Is may be useful as preventative treatment strategies for HCC in patients with chronic liver disease.

Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, Biyokimya Anabilim Dalı, 2006. / Bibliyografya var.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most used drugs in veterinary medicine. Most of the original NSAIDs inhibit primarily cyclooxygenase-1 (COX-1) and cause adverse effects such as gastrointestinal ulcers, kidney and liver damage. When the formerly supposed anti-inflammatory COX-2 enzyme was discovered, NSAIDs were developed to selectively inhibit this enzyme. Today it is known that COX-2 is not exclusively expressed in inflammatory conditions; it also has physiologic functions in tissues such as brain, male and female reproductive tracts. Several horses, such as stallions, are treated with some NSAID, and many times these treatments are prolonged as in osteoarthritis and laminitis. In horses, there is still little information about the effects of COX-1 and COX-2 selective NSAIDs on the reproductive and cardiovascular systems. Pharmacokinetic information of NSAIDs, like meloxicam, in different health conditions and horse breeds may explain differences in efficiency and/or toxicity. This study evaluated meloxicam pharmacokinetics on 3 groups with 3 animals each: a group of ponies with induced synovitis, a group of healthy ponies and a group of healthy horses. All animals were treated with the recommended dosage (0.06 mg/kg, PO) of meloxicam. Plasma was obtained from blood samples collected before (time 0), 15 and 30 minutes, and 1, 2, 4, 8, 12 and 24 hours after medication. The time to reach the maximum plasma concentration (Tmax) was longest (P<0.05) in horses and the maximum concentration (Cmax) was highest (P<0.05) in healthy ponies. The initial plasma concentrations were achieved more quickly (P<0.05) in both ponies groups. In a second study, the effect of meloxicam (preferential COX-2 NSAID) and ketoprofen (unspecific NSAID) was evaluated on hematological and biochemical variables, on the gastric mucosa and on semen quality of 6 healthy pony stallions. The ponies were treated for 30 days and then the experiment was repeated a second time changing the ponies group in a latin square design. The stallions were distributed equally into 3 groups; one was treated with meloxicam (0.6 mg/kg oral administration, PO; n=6), another with ketoprofen (2.2 mg/kg, PO; n=6, positive control) and the negative control group (n=6) received no treatment. Blood samples were obtained once a week for six weeks, beginning before treatment and extending until 1 week after the treatment ended to evaluate hematologic, coagulation and biochemical (AP, AST and GGT) profiles. Gastroscopic evaluation was determined 1 week before and 1 week after the treatment ended. Semen was collected and evaluated twice a week for 16 weeks: before treatment began (week 0), during 4 weeks of treatment (weeks 1-4), and 10 weeks after the treatment ended (weeks 5-15). Concentration of total prostaglandins (PGs) was measured in the seminal plasma of ejaculates collected before (week 0), during (1 to 4 weeks) and after treatment (week 5 and week 15). The treatments did not alter any evaluated hematological and biochemical parameter as well as on the gastric mucosa, but there was a time effect on fibrinogen, pro-thrombin time and activated partial thromboplastin time. Meloxicam treatment caused more (P<0.05) damage to the sperm membrane integrity and decreased (P<0.05) membrane function and total PGs concentration. A significant increase (P<0.05) in tail defects also was observed 2 weeks after treatment ended. In summary, pharmacokinetics differed between healthy ponies and those with synovitis. This may be the result of drug migration to the injury site. Meloxicam absorption was faster in ponies. No influence of the treatments was observed on the hematological or biochemical parameters as well as on gastric mucosa. Thirty day long meloxicam treatment lowered PGs in seminal plasma and affected semen quality. This suggests a physiological function of COX-2 in the stallion s reproductive tract. / Os anti-inflamatórios não esteroidais (AINEs) estão entre os fármacos mais utilizados na medicina veterinária. A maioria deles produz efeitos colaterais, como úlceras gastrointestinais, lesões renais e hepáticas, por inibirem a ciclooxigenase-1 (COX-1). Com a descoberta da COX-2, passaram a ser desenvolvidos AINEs para inibir seletivamente esta enzima, tida até pouco tempo como inflamatória. Porém, hoje se sabe que a COX-2 não é expressa exclusivamente em condições inflamatórias, mas também em funções fisiológicas em vários tecidos, como o cerebral, reprodutivo feminino e masculino. Vários eqüinos, como garanhões, são freqüentemente tratados com algum AINE, e muitas vezes esses tratamentos são prolongados como nos casos de osteoartrite e laminite. Além disto, são escassas as informações sobre os efeitos causados tanto pelos AINEs com inibição inespecífica de COX, como pelos ditos seletivos para a COX-2, especialmente sobre o sistema reprodutivo e cardiovascular de eqüinos. O conhecimento da farmacocinética de novos AINEs, como o meloxicam em diferentes condições de saúde e tamanho de eqüinos poderia explicar a sua eficácia ou efeito tóxico diversos. Desta forma, o estudo da farmacocinética do meloxicam oral foi realizado com três grupos distintos de eqüinos com três animais cada. Um grupo formado por pôneis com sinovite induzida, um grupo com pôneis saudáveis e outro grupo com cavalos saudáveis. Todos os animais foram tratados com a dose indicada (0,6 mg/kg via oral). As amostras de sangue para obtenção do plasma foram coletadas antes (tempo 0), 15, 30 minutos e 1, 2, 4, 8, 12 e 24 horas pós-medicação. O tempo da concentração máxima do fármaco (Tmax) foi mais tardio (P<0,05) nos cavalos e a concentração plasmática máxima (Cmax) foi maior (P<0,05) nos pôneis saudáveis. As primeiras concentrações plasmáticas foram atingidas mais rapidamente (P<0,05) nos grupos de pôneis. Para avaliar o efeito do meloxicam (AINE com ação preferencial sobre a COX-2) sobre os parâmetros hematológicos, bioquímicos, na mucosa gástrica, e sobre a qualidade do sêmen eqüino foram utilizados seis garanhões pôneis. Estes foram distribuídos em três grupos, sendo um tratado com meloxicam (0,6 mg/kg via oral), outro com cetoprofeno como controle positivo (2,2 mg/kg via oral; inibidor inespecífico de COX) durante 30 dias e um terceiro grupo não recebeu nenhum tratamento constituindo o grupo controle negativo. O experimento foi repetido três vezes alternando-se os pôneis de grupos num delineamento quadrado latino. Amostras de sangue foram coletadas antes (semana zero), durante (semanas um a quatro) e uma semana após o fim do tratamento (semana cinco) para determinação dos parâmetros hematológicos (hemograma e coagulograma) e bioquímicos (fosfatase alcalina - AP, aspartato aminotransferase - AST e gama-glutamil transferase - GGT). Também foram realizadas gastroscopias antes (semana zero) e após o final do tratamento (semana cinco). O sêmen foi coletado e avaliado duas vezes por semana antes (semana zero), durante (semanas um a quatro) e por 11 semanas após o final do tratamento (semanas cinco a 15). A concentração de prostaglandinas totais no plasma seminal foi avaliada nas semanas zero a cinco e na semana 15. Os tratamentos não modificaram nenhum parâmetro hematológico, bioquímico e gástrico avaliado, mas o tempo de coleta influenciou o fibrinogênio, tempo de pró-trombina e tempo de tromboplastina parcial ativada. O grupo tratado com meloxicam apresentou mais (P<0,05) espermatozóides com lesões de membrana e com diminuição da funcionalidade da membrana, bem como aumento significativo (P<0,05) de defeitos de cauda e diminuição (P<0,05) na concentração de prostaglandinas totais no plasma seminal, comparado aos grupos cetoprofeno e controle. Os parâmetros da farmacocinética diferiram entre os pôneis saudáveis e com sinovite. Isto pode ser atribuído a uma possível migração do fármaco para o local da lesão. A absorção do meloxicam foi mais rápida nos pôneis. Os tratamentos não influenciaram os parâmetros hematológicos, de coagulação, bioquímicos e na mucosa gástrica. O tratamento por 30 dias com meloxicam diminui a concentração de prostaglandinas totais no plasma seminal e interfere negativamente na qualidade do sêmen, sugerindo uma ação fisiológica da COX-2 no tecido reprodutivo de garanhões.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The cyclooxygenase 2 (Cox 2) is a molecular indicator of prognosis marker and its expression is associated with progression of mammary tumors in dogs. The purpose of this study was to investigate breast tumors of bitches Cox 2 expression by immunohistochemistry and correlated with the clinical stage, tumor size, lymph node involvement, the classification and the histological grade of carcinomas. We included in this study, 100 female dogs with mammary tumors and 131 samples were analyzed. Histological and COX 2 immunostaining evaluation were conducted. The streptavidin-biotinaperoxidase technique was used in order to do the immunohistochemistry (IHC). The IHC analysis was performaced counting the number of positive-staining cells in ten fields and the staining intensity. The COX 2 staining index was obtained by multiplying the COX 2 staining distribution and intensity scores. This gave a range of COX 2 staining indices of 0 12.Carcinoma complex was the most common histological type that we were diagnosed. The COX 2 expression was observed in the benign and malignant tumors. The weak score is more frequent, and strong score was observed in carcinomas. Simple carcinomas demonstraded a higher number of positive staining cells. There was no positive correlation between the histological type, size and lymph node involvement and the Cox 2 immunostaining. Therefore, COX 2 immunostaining is not a good prognostic factor. / A ciclooxigenase 2 (Cox 2) é um marcador molecular indicador de prognóstico e sua expressão está relacionada com a progressão do tumor mamário na cadela. Tendo isso em vista, o objetivo deste trabalho foi investigar tumores mamários de cadelas a expressão de Cox 2 por meio de imunohistoquímica e correlacionar com o estadiamento clínico, o tamanho tumoral, o envolvimento linfonodal, a classificação e o grau histológico dos carcinomas. Foram incluídas neste estudo, 100 cadelas com neoplasia mamária e dessas, 131 amostras foram analisadas. A avaliação histológica e da imunomarcação de Cox 2 foram conduzidas. Para a imunohistoquímica (IHQ), utilizou-se a técnica de estreptoavidina-biotinaperoxidase. Para análise das lâminas de IHQ contou-se o número de células marcadas em dez campos e verificou-se a intensidade de marcação. O escore de marcação foi obtido pelo produto do número de células marcadas e a intensidade de marcação. O tipo histológico mais frequente diagnosticado foi o carcinoma complexo mamário. A expressão de Cox 2 foi observada nos tumores benignos e malignos. A marcação fraca é mais frequente, sendo a marcação forte observada nos carcinomas. Os carcinomas simples apresentaram maior número de células marcadas. Não houve correlação positiva entre o tipo histológico, tamanho e o envolvimento linfonodal e a imunomarcação de Cox 2. Sendo assim, a imunomarcação de Cox 2 não demonstrou ser um bom fator de prognóstico. / Mestre em Ciências Veterinárias

A População brasileira apresenta elevada diversidade genética devido à multietnicidade, que têm implicações clínicas/genéticas importantes. O estudo de genes polimórficos pode auxiliar na detecção de pessoas com maior risco de desenvolver câncer, caracterização de evolução diferenciada, resposta distinta ao tratamento quimioterápico ou radioterápico e prognóstico. A ciclooxigenase-2 (COX-2) é induzida em resposta ao fator de crescimento e citocinas, sendo expressa nas doenças inflamatórias, lesões pré-malignas e tumores colorretais. Este trabalho teve como objetivos avaliar a influência dos polimorfismos 1195A > G e 8473T > C do gene COX-2 como fatores de risco para o desenvolvimento de câncer colorretal e investigar o impacto dos polimorfismos na progressão e sobrevida de pacientes submetidos ao tratamento cirúrgico por câncer colorretal. Avaliaram-se SNPs (polimorfismos de nucleotídeo único) em 230 pacientes submetidos à ressecção cirúrgica no Hospital das Clínicas (SP), seguidos por 5 anos e 196 controles, operados por doença benigna na mesma instituição, pareados quanto ao sexo e idade, sem histórico individual ou familial de câncer. Isolou-se o DNA dos leucócitos utilizando-se do kit de extração e purificação PureLink DNA Minikit, seguido de amplificação pela reação em cadeia da polimerase (PCR). Utilizou-se a análise do PCR em Tempo Real para determinar os genoótipos os polimorfismos através dos ensaios TaqMan ® SNP Genotyping Assay. Os resultados encontrados foram associados aos dados epidemiológicos e clinicopatológicos dos pacientes. Determinaram-se as frequências genotípicas, alélicas e estimaram-se as frequências de haplótipos dos polimorfismos do COX-2 -1195A > G e 8473T > C. As populações estão em equilíbrio de Hardy-Weinberg, a exceção do grupo controle para o polimorfismo 8473T > C (p=0,02). As frequências foram similares nos grupos caso e controle para genótipos e haplótipos, portanto, não há associação entre esses polimorfismos e risco de CCR. Em relação às variáveis epidemiológicas e anatomopatológicas do grupo caso, demonstraram-se associação das mesmas com alguns perfis genotípicos. Encontrou-se frequência elevada do genótipo polimórfico -1195GG na população oriental, grupo constituído em sua maioria por japoneses, e dos genótipos 8473TC e CC em afrodescendentes (p < 0,05). Neste grupo, o genótipo -1195GG é ausente. Foi encontrada. Encontrou-se associação entre invasão angiolinfática e genótipo polimórfico 8473 CC (p < 0,05). Na análise de sobrevida, houve associação, no modelo codominante e dominante, do genótipo COX-2 -1195GG com menor sobrevida global (AAxGG: RR = 2,78; IC95% = 1,13-6,84; p < 0,020 e AA/AG x GG: RR = 2,59; IC95% = 1,07-6,27; p < 0,04), utilizando o modelo de regressão múltipla, ajustado para as variáveis de confusão. Assim, pode-se concluir que as variantes -1195A > G e 8473T > C não participam da suscetibilidade genética ao CCR na população brasileira. O polimorfismo -1195A > G, associado à menor sobrevida, pode atuar como marcador prognóstico nestes pacientes / Brazilian population displays very high levels of genomic diversity due to the multi-ethnicity, which have important clinical/genomic implications. Polymorphic genes\' study may aid in the detection of people at higher risk of developing cancer, characterization of differentiated outcome, distinctive response to chemotherapy or radiotherapy and prognosis. Cyclooxygenase-2 (COX-2) is induced in response to growth factor and cytokines, and it is expressed in inflammatory diseases, precancerous lesions and colorectal tumors. This study aimed to evaluate the influence of COX-2 -1195A> G and 8473T> C gene polymorphisms as a risk factor for developing colorectal cancer and to investigate the impact of polymorphisms on progression and survival in patients who have undergone surgical treatment for colorectal cancer. We evaluated SNPs (Single nucleotide Polymorphism) of 230 colorectal cancer resected patients admitted at the Hospital das Clinicas (SP), followed by 5 years, and 196 controls, operated for benign disease at the same institution, matched for age and sex, and no individual or familial history of cancer. DNA was isolated from leukocyte using PureLink (TM) Genomic DNA Mini Kit, followed by amplification by polymerase chain reaction (PCR). Real-time analysis was used for genotyping of polymorphisms, through the TaqMan ® SNP Genotyping Assay. The results of the polymorphisms were associated to epidemiological, clinicopathological and immunohistochemical features of the patients. Were determined genotype and allelic frequencies, and were estimated the haplotype frequencies of COX-2 -1195A > G and 8473T > C polymorphisms. The populations are in Hardy-Weinberg equilibrium, except for the control group to the 8473T > C polymorphism (p = 0,02). The frequencies were similar in case and control groups for genotypes and haplotypes, therefore, there is no association between these polymorphisms and risk of CCR. Regarding the epidemiological and pathological variables in the case group, we demonstrate their association with some genotypic profiles. A high frequency of the polymorphic genotype -1195GG was found in an Asiatic population, group composed in its majority by Japaneses, and 8473TC and CC genotypes in African descent (p < 0,05). In this group, the 1195GG genotype is absent. Association was found between angiolymphatic invasion and polymorphic genotype 8473 CC (p < 0,05). In survival analysis, there was an association, in co-dominant and dominant model, of the COX-2 genotype -1195GG with decreased overall survival (AAxGG: RR = 2,78, 95% CI 1,13-6,84; p < 0,020 and AA / AG x GG: RR = 2,59, 95% CI 1,07-6,27; p < 0,04), using the multiple regression model, adjusted for confounding variables. Therefore, -1195A variants > G and 8473T > C does not appear participate in genetic susceptibility to CCR in the Brazilian population, but the polymorphism -1195A > G, associated with decreased survival, may act as a prognostic marker in these patients

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-03-29T13:30:24Z No. of bitstreams: 1 carolinadelourdesjuliaovieirarocha.pdf: 438849 bytes, checksum: 0e5f838b152a2294e48909758b185709 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-03-30T11:20:43Z (GMT) No. of bitstreams: 1 carolinadelourdesjuliaovieirarocha.pdf: 438849 bytes, checksum: 0e5f838b152a2294e48909758b185709 (MD5) / Made available in DSpace on 2017-03-30T11:20:43Z (GMT). No. of bitstreams: 1 carolinadelourdesjuliaovieirarocha.pdf: 438849 bytes, checksum: 0e5f838b152a2294e48909758b185709 (MD5) Previous issue date: 2010-01-01 / O Diabetes Mellitus é um problema mundial de saúde pública, de incidência elevada, em termos de pessoas afetadas e mortalidade prematura. As ulcerações em membros inferiores são a maior causa de morbidade entre os diabéticos, tendo como conseqüência a amputação. Na presença desta doença, o processo cicatricial é mais dificultado. Diversos estudos estão sendo realizados com a utilização da Terapia Laser de Baixa Intensidade no processo de cicatrização e reparo tecidual. A terapia laser de baixa intensidade tem sido relatada como importante moduladora da cicatrização de feridas cutâneas. No presente estudo, nós avaliamos os efeitos da terapia laser de baixa intensidade sobre a intensidade do infiltrado inflamatório e quantidade de vasos sangüíneos em feridas cutâneas de camundongos diabéticos não obesos (NOD), adicionalmente, analisamos a expressão da enzima ciclooxigenase 2 no sítio do reparo tecidual utilizando o modelo experimental camundongos NOD para estudar a cicatrização de feridas cutâneas. Foram utilizados 30 camundongos NOD. Destes, 14 ficaram diabéticos e foram divididos em dois grupos: grupo I (n = 7), controle, composto por camundongos NOD não submetidos à terapia laser de baixa intensidade e grupo II (n = 7), tratado, composto por camundongos NOD submetidos à terapia laser de baixa intensidade nos seguintes parâmetros: 15 mW de potência, dose de 3,8 J/cm2, e tempo de aplicação de 20 segundos. Após sete dias do ato cirúrgico e após aplicação do laser, os animais foram eutanasiados com sobredose de anestesia e foram colhidas amostras das feridas para posterior análise histopatológica, histomorfométrica e imunohistoquímica. Os resultados em conjunto sugeriram que a terapia laser de baixa intensidade é capaz de modular negativamente a expressão da enzima ciclooxigenase 2 contribuindo para o controle da resposta inflamatória em feridas cutâneas de camundongos NOD. / Diabetes Mellitus is a worldwide problem of public health, the high incidence, in terms of people affected and premature mortality. Ulcers of the lower limbs are the leading cause of morbidity among diabetic patients, which resulted in amputation. In this disease, the healing process is hampered. Several studies are being conducted with the use of low-level laser therapy in the process of healing and tissue repair. The low-level laser therapy has been reported as an important modulator of healing of skin wounds. In this study we evaluated the effects of low-level laser therapy intensity of the inflammatory infiltrate and number of blood vessels in wounds of non-obese diabetic mice (NOD), in addition, we analyzed the expression of cyclooxygenase 2 enzyme at the site of repair tissue using the NOD mice experimental model to study the healing of skin wounds. Were used thirty NOD mice, these fourteen were diabetic and were divided into two groups: group I (n = 7) underwent a surgical procedure of skin wounds and group II (n = 7) underwent a surgical procedure of skin wounds and treated with LLLT. Group II was submitted to LLLT in the following parameters: 15 mW of power, dose of 3.8 J/cm2 and exposure time of 20 seconds. Seven days after surgery and after laser application, animals were euthanized with an overdose of anesthesia and were submitted colleted tissue samples for subsequent histological analysis, histomorphometry and immunohistochemistry. A low-level laser therapy has promoted the inhibition of cyclooxygenase 2 expression in skin wounds in mice diabetic. The results together suggested that low-level laser therapy is able to negatively modulate the expression of cyclooxygenase 2 enzyme contributing to the inflammatory response in cutaneous wounds in NOD mice.

Mycobacteria are multifaceted pathogens capable of causing both acute disease as well as an asymptomatic latent infection. Protective immunity against pathogenic mycobacteria depends principally on cell-mediated immunity executed by efficient anti-infectious functions of type 1 T helper (Th1) subset of CD4+ T cells. The polarization of Th1 responses is orchestrated by IL-12 secreted by antigen presenting cells (APCs) such as macrophages and dendritic cells (DCs). A hallmark of Th1 type CD4+ T cells is the production of IFN-γ that activates plethora of innate cell-mediated immunity. It is well known that cytokines such as IFN-γ, IL-12 and TNF-α are required for control of mycobacterial infection in humans as well as in mice. However, it remains unclear that why the immune response controls mycobacteria, but does not eradicate infection suggesting critical roles for series of survival strategies employed by pathogenic mycobacteria. In general, these evasion strategies include blockade of phagosome-lysosome fusion, secretion of ROI antagonistic proteins like superoxide dismutase & catalase, inhibition of processing of its antigens for presentation to T cells, induced secretion of immunosuppressive cytokines like IL-10 and TGF-β etc. that ultimately suppress the secretion of IL-12 and IFN-γ from APCs and T cells respectively, culminating in a skewed Th1/Th2 balance towards unprotective Th2 responses. Th2 cells secrete IL-4, IL-5, IL-9, IL-10 and IL-13 but are deficient in clearing intracellular infections including pathogenic mycobacteria. This eventually leads to inhibition of host’s immuno-protective responses with concomitant increase in the vulnerability to chronic mycobacterial infection. In this intricate process, modulation of cyclooxygenase-2 (COX-2) levels, a key enzyme catalyzing the rate-limiting step in the inducible production of prostaglandin E2 (PGE2), by mycobacteria like Mycobacterium bovis BCG assumes critical importance in influencing the overall host immune response. PGE2, an immunosuppressive member of prostaglandin family, is known to restrain production of IL-12, as well as reactive oxygen intermediates. PGE2-mediated inhibition of IL-12R, diminishes IL-12 responsiveness of macrophages and dendritic cells. PGE2 also inhibits the secretion of IFN-γ, which is important in activating T cells and macrophages. In contrast, PGE2 promotes IL-10 production by macrophages, dendritic cells and Th1-to-Th2 shift of acquired immune responses by inhibiting IL-2 and enhancing IL-4 production. Albeit, mitogen-activated protein kinase (MAPK) and nuclear factor-kappa B (NF-κB) signaling pathways are generally believed to be involved, little is known about the signaling molecules playing significant roles upstream of MAPK and NF-κB pathways during mycobacteria triggered COX-2 expression. Further, information on early receptor proximal signaling mechanisms essential during mycobacteria mediated induction of COX-2 remains scanty. In this regard, signaling cascade triggered upon recognition of mycobacterial components by pattern recognition receptors (PRR) signify as critical event in overall regulation of cell fate decisions. PRR like Toll like receptor (TLR2) and nucleotide-binding oligomerization domain 2 (NOD2) are two nonredundant recognition mechanisms of pathogenic mycobacteria. Several components of mycobacteria have been identified as being responsible for TLR2-dependent activation including 19-kDa lipoprotein, lipomannan etc.; while NOD2 recognizes mycobacterial peptidoglycans through its interaction with muramyl dipeptide (MDP). Interestingly, although mycobacteria reside within phagolysosomes of the infected macrophages, many cell wall antigens like lipoarabinomannan (LAM), phosphatidyl-myo-inositol mannosides (PIM), trehalose 6,6′-dimycolate (TDM; cord factor), PE/PPE family proteins etc., are released and traffic out of the mycobacterial phagosome platform into endocytic compartments. Importantly, these antigens could gain access to the extracellular environment in the form of exocytosed vesicles. In this perspective, PIM represents a variety of phosphatidyl-myo-inositol mannosides (PIM) 1-6 containing molecules and are integral component of the mycobacterial envelope. Further, PIM2 is a known TLR2 agonist and reported to activate NF-κB, AP-1, and MAPK suggesting that mycobacterial envelope antigen PIM2 could modulate the inflammatory responses similar to mycobacteria bacilli. In this context, we explored the signaling events modulated by M. bovis BCG, and role for TLR2 and NOD2 in this intricate process, to trigger the expression of COX-2 in macrophages. Our studies demonstrated that M. bovis BCG triggered TLR2-dependent signaling leads to COX-2 expression and PGE2 secretion in vitro in macrophages and in vivo in mice. Further, the presence of PGE2 could be demonstrated in sera or CSF of tuberculosis patients. Similarly, mycobacterial TLR2 agonist PIM2 and NOD2 ligand MDP triggered COX-2 expression in macrophages. The induced COX-2 expression in macrophages either by M. bovis BCG or PIM2 or MDP was dependent on NF-κB activation, which was in turn mediated by iNOS/NO and Wnt-β-Catenin dependent participation of the members of Notch1-PI3K signaling cascade. Importantly, loss of iNOS activity either in iNOS null macrophages or by pharmacological intervention in wild type macrophages severely abrogated M. bovis BCG ability to trigger the generation of Notch1 intracellular domain (NICD) as well as activation of PI3K signaling cascade. On contrary, treatment of macrophages with SIN-1, an NO donor, resulted in a rapid increase in generation of NICD, activation of PI3K pathway as well as the expression of COX-2. Interestingly, pharmacological inhibition as well as siRNA mediated knockdown of Wnt-β-Catenin signaling compromised ability of M. bovis BCG to induce activation of Notch1-PI3K signaling and drive COX-2 expression. Concomitantly, activation of Wnt-β-Catenin signaling by LiCl triggered activation of Notch1 and PI3K pathway as well as COX-2 expression. Stable expression of NICD in RAW 264.7 macrophages resulted in augmented expression of COX-2. Further, signaling perturbation experiments suggested involvement of the cross-talk of Notch1 with PI3K signaling cascade. In this perspective, we propose TLR2 and NOD2 as two major receptors involved in mycobacteria mediated activation of Notch1PI3K signaling, and the activation of iNOS/NO and Wnt-β-Catenin signaling axis as obligatory early receptor proximal signaling events during mycobacteria induced COX-2 expression in macrophages. Functional characterization of mycobacterial antigens that are potent modulators of host immune responses to pathogens by virtue of induced expression of COX-2 assumes critical importance for deciphering pathogenesis of mycobacterial diseases as well as to identify novel therapeutic targets to combat the disease. In this context, a group of novel antigens carried by M. tuberculosis that are expressed upon infection of macrophages belong to PE and PPE family of proteins. Ten percent of the coding capacity of M. tuberculosis genome is devoted to the PE and PPE gene family members, exemplified by the presence of Pro-Glu (PE) and Pro-Pro-Glu (PPE) motifs near the N-terminus of their gene products. Many members of the PE family exhibit multiple copies of polymorphic guanine-cytosine– rich sequences (PGRS) at the C-terminal end, which are designated as the PE_PGRS family of proteins. A number of PE/PPE proteins associate with the cell wall and are known to induce strong T & B cell responses in humans. However information related to effects of PE/PPE antigens on the maturation and functions of human dendritic cells and eventual modulation of T cell responses as well as underlying signaling events remains obscure. Our results demonstrated that two cell wall associated/secretory PE_PGRS proteins PE_PGRS 17, PE_PGRS 11 and PPE family protein PPE 34 recognize TLR2, induce maturation and activation of human dendritic cells and enhance the ability of dendritic cells to stimulate CD4+ T cells. In addition, tuberculosis patients were found to have a high frequency of T cells specific to PE_PGRS and PPE antigens. We further found that PE/PPE proteins-mediated activation of dendritic cells involves participation of ERK1/2, p38 MAPK and NF-κB signaling pathways. While, PE_PGRS antigens-matured dendritic cells secreted high amounts of inflammatory cytokine IL-12, PPE 34 triggered maturation of dendritic cells was associated with secretion of high amounts of anti-inflammatory cytokine IL-10 but not the Th1-polarizing cytokine IL-12. Consistent with these results, PPE 34-matured dendritic cells favored secretion of IL-4, IL-5 and IL-10 from CD4+ T cells and contributed to Th2 skewed cytokine balance ex vivo in healthy individuals and in patients with pulmonary tuberculosis. Interestingly, PPE 34-skewed Th2 immune response involved induced expression of COX-2 in dendritic cells. Our results suggest that by inducing differential maturation and activation of human dendritic cells, PE/PPE proteins could potentially modulate the initiation of host immune responses against mycobacteria. Taken together, our observations clearly signify the potential role for TLR2 and NOD2 triggering by M. bovis BCG in activating receptor proximal Notch1-PI3K signaling during induced COX-2/PGE2 expression which represents a crucial immune subversion mechanism employed by mycobacteria in order to suppress or attenuate host immune responses. Further, differential maturation of human dendritic cells by PE_PGRS and PPE antigens as well as their ability to stimulate CD4+ T cells towards Th1 and Th2 phenotype respectively, improves our understanding about host-mycobacteria interactions and clearly paves a way towards the development of novel combinatorial therapeutics.