Thesis (Ph.D.)--Memorial University of Newfoundland, Faculty of Medicine, 2001. / Typescript. Bibliography: leaves 188-241.

Made available in DSpace on 2014-12-17T15:32:23Z (GMT). No. of bitstreams: 1 AndreiaFC_DISSERT.pdf: 3035785 bytes, checksum: a9769f0a294924c551036d1a098b7d2a (MD5) Previous issue date: 2014-02-12 / A displasia epitelial (DE) oral ? uma desordem potencialmente maligna (DPM), cujo diagn?stico e grada??o histol?gica se baseiam nas suas altera??es arquiteturais e citol?gicas. Para avaliar o risco de transforma??o maligna dessas les?es de forma mais precisa ? fundamental entender e localizar altera??es gen?ticas e epigen?ticas nas c?lulas displ?sicas, as quais podem ajudar a compreender melhor a progress?o para a malignidade. Dessa forma, o presente estudo objetivou avaliar a imunoexpress?o de EGFR e PTEN nas DEs orais e relacionar esse aspecto com as caracter?sticas cl?nicas e grada??o histol?gica pelo sistema bin?rio (baixo e alto risco de transforma??o maligna). Para tanto, foram selecionados 20 casos de DE de alto risco e 20 de baixo risco para serem submetidos ? an?lise imunoistoqu?mica para os biomarcadores supracitados. A imunomarca??o de cada caso foi avaliada semiquantitativamente atrav?s de escores e quanto ? localiza??o nos estratos epiteliais. A an?lise estat?stica foi realizada atrav?s dos testes de Mann-Whitney, Qui-quadrado de Pearson, Exato de Fisher e de correla??o de Spearman com n?vel de signific?ncia estabelecido em 5%. Os resultados mostraram que 57,5% dos pacientes eram do g?nero feminino, a m?dia de idade foi de 57,5 anos, 42,5% foram diagnosticados clinicamente como leucoplasia e a maioria dos casos foi proveniente de les?es localizadas na l?ngua (32,5%). De forma geral, g?nero e idade n?o exerceram influ?ncia na imunoexpress?o do EGFR e PTEN. A express?o do EGFR foi observada em 100% dos casos, nos quais houve predom?nio do escore 3 (75%) e imunoreatividade em todas as camadas epiteliais (55%), independente da grada??o histol?gica (p = 0,453 e p = 0,204, respectivamente). O PTEN revelou positividade de marca??o em 87,5% dos casos, nos quais observou-se predom?nio do escore 0 (55%) e imunoreatividade limitada ? camada basal (40%), por?m sem diferen?as significativas entre os grupos histol?gicos (p = 0,904 e p = 0,915, respectivamente). Por fim, quando analisados, em conjunto, os 40 casos de DEs, foi observada uma fraca correla??o positiva, estatisticamente significativa, entre os padr?es de imunoexpress?o do EGFR e do PTEN (r = 0,317; p = 0,046). Com base nesses resultados, altera??es no padr?o de express?o do EGFR e PTEN sugerem que essas prote?nas participam de processos moleculares relacionados com a carcinog?nese em mucosa oral

INTRODUÇÃO: O câncer do pâncreas apresenta taxas anuais de mortalidade e incidência muito semelhantes, sendo uma das principais causas de morte por câncer no mundo. A agressividade do tumor e o retardo no seu diagnóstico são considerados responsáveis pela sua alta letalidade. O tratamento adjuvante convencional aumenta pouco a sobrevida a longo prazo e a terapia-alvo pode ser uma alternativa ao tratamento deste tipo de tumor. OBJETIVO: O objetivo do presente estudo é avaliar a expressão do receptor do fator de crescimento epitelial e seu eventual valor prognóstico em pacientes portadores de adenocarcinoma pancreático submetidos à ressecção cirúrgica. MÉTODO: Foram estudados retrospectivamente 88 pacientes portadores de adenocarcinoma pancreático operados no Serviço de Cirurgia de Vias Biliares e Pâncreas do HC-FMUSP e no Departamento de Cirurgia Abdominal Hospital A.C. Camargo no período de 1990 a 2006. RESULTADOS: Quarenta e sete (53,4%) pacientes do sexo feminino e 41 (46,6%) do masculino com idade mediana de 60 anos. As cirurgias realizadas foram duodenopancreatectomia com preservação do piloro (55,1%), gastroduodenopancreatectomia (34,8%), pancreatectomia corpo-caudal (6,8%) e gastroduodenopancreatectomia total (2,3%). A ressecção venosa portal foi realizada em 12 pacientes (13,5%). O tamanho tumoral médio foi de 3,75cm. Invasão vascular esteve presente em 31% dos casos e neural em 88,5%. A margem de ressecção estava comprometida em 33 pacientes (37,5%). Cinco (5,7%) pacientes eram do estádio IA, 15(17%) do IB, 19(21,6%) do IIA, 47(53,4) do IIB e dois (2,3%) do III.Observou-se diferença na expressão de EGFR na membrana celular entre o tecido tumoral e o tecido não tumoral (p=0,004); entre o tecido metastático linfonodal e o tecido não tumoral (p=0,02) mas não houve diferença quanto à sua expressão quando comparamos o tecido tumoral e o tecido metastático linfonodal (p=0,28). Dentre as variáveis clínicas e patológicas estudadas, observou-se diferença de expressão do EGFR entre os gêneros feminino e masculino (p=0,03), não havendo diferenças entre as outras variáveis. A sobrevida mediana global foi de 22,9 meses. A sobrevida cumulativa global em 1 ano, 3 anos e 5 anos foi de 48%, 20% e 18%, respectivamente. As sobrevidas cumulativas em 1 ano, 3 anos e 5 anos foram 77%, 30% e 8% no grupo sem expressão do EGFR na membrana tumoral versus 46%, 8% e 0% respectivamente no grupo com expressão do EGFR na membrana celular do tumor. Na análise univariada, as seguintes variáveis estiveram associadas a menor sobrevida: sexo masculino, ressecção venosa portal, invasão peri-neural, e vascular, invasão do tecido peri-pancreático, acometimento da margem de ressecção pancreática e expressão positiva de EGFR no tecido tumoral. Na análise multivariada, os fatores associados à sobrevida menor foram: gênero masculino, ressecção venosa portal, invasão vascular e invasão peri-neural. CONCLUSÃO: A expressão do EGFR na membrana celular é significativamente maior no tecido tumoral que no tecido pancreático não tumoral. A expressão do EGFR na membrana celular do tecido tumoral está associada a pior prognóstico (menor sobrevida). / INTRODUCTION: Pancreatic cancer is one of the main cancer related deaths in the world and its incidence is similar to its mortality. Biological aggressiveness and delayed diagnosis are a major concern. Adjuvant treatment has little impact on survival and the expression of potential target molecules has been undertaken in order to increase survival. OBJECTIVE: The aim of the present study is to study the expression of EGFR and its potential prognostic role in tumor, non-tumor and metastatic lymph node tissues of patient with pancreatic adenocarcinoma treated with surgical resection. MATHERIAL AND METHODS: Eighty eight patients with pancreatic adenocarcinoma operated at Serviço de Cirurgia de Vias Biliares e Pâncreas do HC-FMUSP and Departamento de Cirurgia Abdominal do Hospital A.C.Camargo were retrospectively studied between 1990 and 2003. RESULTS: Forty seven females (53,4%) and 41 males (46,6%) with median age of 60 years were studied. Pylorus preserving duodenopancreatectomy was performed in 55%, classical duodenopancreatectomy in 34,8%, distal pancreatectomy in 6,8% and total pancreatectomy in 2,3%. Portal vein resection was performed in 12 patients (13,5%). Mean tumor size was 3,75cm. Vascular and neural invasion were present in 31% and 88,5%, respectively. Positive surgical margin was present in 33 (37,5%) patients. Five (5,7%) patients were stage IA, 15(17%) stages IB, 19(21,6%) stages IIA, 47(53,4%) stages IIB and two (2,3%) stages III. There were difference in the membrane expression of EGFR between tumor and non tumor pancreatic tissue (p=0,004); between metastatic lymph node and non tumor pancreatic tissue (p=0,02); but there were no difference between tumor and metastatic lymph node tissue (p=0,28). Median survival time was 22,9 months. Cumulative one, three and five years survival were 48%, 20% and 18%. Cumulative survival at 1, 3 and 5 years were 77%, 30% and 8% in patients with negative expression of EGFR in tumor membrane and 46%, 8% and 0%, respectively in patients with positive EGFR expression in tumoral membrane. Univariate analysis showed that male gender, portal vein resection, neural, vascular and peri-pancreatic invasion invasion, positive surgical margin and positive membrane EGFR expression in tumoral tissue were correlated with poor survival. Multivariate analysis showed that male gender, portal vein resection, vascular invasion and peri-neural invasion are associated with lower survival after resection. CONCLUSION: EGFR membrane expression is different between tumor tissue and non tumor pancreatic tissue. EGFR membrane expression in tumoral tissue was associated with worst survival.

The paucity of well validated preclinical models is frequently cited as a contributing factor to the high attrition rates seen in clinical oncological trials. There remains a critical need to develop models which are accurately able to recapitulate the features of human disease. The aims of this study were to use genetically engineered mouse models (GEMMs) to explore the efficacy of novel treatment strategies in HER2 positive breast cancer and to further develop the model to facilitate the study of mechanisms underpinning drug resistance. Using the BLG--HER2KI-PTEN+/- model, we demonstrated that Src plays an important role in the early stages of tumour development. Chemopreventative treatment with dasatinib delayed tumour inititation (p= 0.046, Wilcoxon signed rank test) and prolonged overall survival (OS) (p=0.06, Wilcoxon signed rank test). Dasatinib treatment also induced squamous metaplasia in 66% of drug treated tumours. We used 2 cell lines derived from this model to further explore dasatinib’s mechanism of action and demonstrated reduced proliferation, migration and invasion following in vitro treatment. Due to the prolonged tumour latency and the low metastatic rate seen in this model, further studies were undertaken with the MMTV-NIC model. This model also allowed us to study the impact of PTEN loss on therapeutic response. We validated this model by treating a cohort of MMTV-NIC PTEN+/- mice with paclitaxel and demonstrated prolonged OS (p=0.035, Gehan Breslow Wilcoxon test). AZD8931 is an equipotent signalling inhibitor of HER2, HER3 and EGFR. We observed heterogeneity in tumour response but overall AZD8931 treatment prolonged OS in both MMTV-NIC PTEN FL/+ and MMTV-NIC PTEN+/- models. PTEN loss was associated with reduced sensitivity to AZD8931 and failure to suppress Src activity, suggesting these may be suitable predictive biomarkers of AZD8931 response. To facilitate further studies exploring resistance, we transplanted MMTV-NIC PTEN+/- fragments into syngeneic mice and generated 3 tumours with acquired resistance to AZD8931. These tumours displayed differing resistance strategies; 1 tumour continued to express HER2 whilst the remaining 2 underwent EMT and lost HER2 expression reflecting to a very limited degree some of the heterogeneity of resistance strategies seen in human disease. To further explore resistance to HER2 targeting tyrosine kinase inhibitors, we generated a panel of human cell lines with acquired resistance to AZD8931 and lapatinib. Western blotting demonstrated loss of HER2, HER3 and PTEN in all resistant lines. Acquisition of resistance was associated with a marked change in phenotype and western blotting confirmed all lines had undergone EMT. We used a combination of RPPA and mass spectrometry to further characterise the AZD8931 resistant lines and identified multiple potential novel proteins involved in the resistant phenotype, including several implicated in EMT. In conclusion, when coupled with appropriate in vitro techniques, the MMTV-NIC model is a valuable tool for selection of emerging drugs to carry forward into clinical trials of HER2 positive breast cancer.

Nutrient and growth factor receptors internalize through dathrin coated pits. The signal sequences which mediate the association between receptors and the coated pit reside in receptor cytoplasmic tail domains. These signal sequences have been extensively investigated in nutrient receptors, and a minimal functional sequence has been identified consisting of a tyrosine residue in an exposed b turn. Protein-protein contacts between internalization signal sequences and components of the coated pit machinery have been proposed to mediate rapid internalization. In vitro evidence suggests the AP-2 adaptor may be that protein component. The signal sequences of growth factor receptors are less well understood. However, a growth factor- and temperature- dependent binding between the epideimal growth factor receptor and the AP-2 adaptor has been observed. We identified Hsc70 as a cytosolic ligand for the cytoplasmic tail of the transferrin receptor. The binding was mapped to the internalization signal sequence of the receptor tail. Mutations within the signal sequence which inhibit internalization result in alteration of signal sequence secondary structure and reduction in stimulation of the Hsc70 ATPase. Co-immunoprecipitation analysis showed a population of transferrin receptors which are bound to Hsc70, suggesting an association in vivo. We also showed binding of Hsc70 to the epidermal growth factor receptor by co-immunoprecipitation analysis. This binding was increased by treatment with EGF. The binding was transient, and occured prior to the binding of the receptor to AP-2 adaptors. Other agents which induce EGF receptor clustering and internalization also stimulate the transient increase in Hsc70 binding and the later AP-2 binding, suggesting a role in early endocytosis. These data support the hypothesis that Hsc70 is associated with the receptors for transferrin and epidermal growth factor in vitro and in vivo. We propose a role for the 70 kD heat shock protein in the assembly/disassembly of protein complexes involved in receptor signalling and/or internalization.

Orientador: Carlos Alberto de Souza Costa / Resumo: A fixação do tecido conjuntivo à superfície dos abutments de implantes dentários impede a migração apical do epitélio juncional e previne a reabsorção da crista óssea normalmente ocasionada pela inflamação peri-implantar, o qual promove comprometimento estético e o sucesso do procedimento reabilitador. O uso de terapias para favorecer a adesão celular, a fim de induzir um selamento biológico efetivo, pode melhorar as condições estéticas e funcionais nas reabilitações protéticas. O objetivo desta pesquisa foi avaliar o efeito da laserterapia de baixa potência (LBP) e do recobrimento de superfícies de titânio (Ti) e zircônia (ZrO2) com fator de crescimento epidérmico (EGF), sobre a adesão e metabolismo de células da mucosa oral humana expostas ao estímulo inflamatório com o fator de necrose tumoral α (TNF-α). Fibroblastos de gengiva e células epiteliais foram isolados e cultivados sobre discos de Ti e ZrO2, simulando o selamento biológico in vitro. Nos grupos com EGF, este fator de crescimento foi aplicado sobre as superfícies de Ti e ZrO2 previamente ao cultivo celular. Após a semeadura das células, estas foram irradiadas 3 vezes com LBP (LaserTABLE, InGaAsP, 780±3nm), em intervalos de 24 h, nas doses de 0,5 J/cm2; 1,5 J/cm2 e 3,0 J/cm2, de acordo os grupos estabelecidos e então, o TNF-α foi aplicado sobre as mesmas por 24 h. Foram realizadas as análises de rugosidade da superfície dos discos por Microscopia Confocal (n=8) e de liberação do EGF dos substratos recobertos, além ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The attachment of the connective tissue to abutment surface of dental implants prevents the apical migration of the junctional epithelium and the bone crest reabsorption, normally caused by the peri-implant inflammation, which compromises the aesthetics and the success of the rehabilitation procedure. The use of therapies to promote cell adhesion in order to induce effective biological sealing can improve aesthetic and functional conditions in prosthetic rehabilitation. The aim of this study was to evaluate the effects of low-level laser therapy (LLLT) and surfaces coating of titanium (Ti) and zirconia (ZrO2) with epidermal growth factor (EGF) on adhesion and metabolism of oral mucosa cells exposed or not to tumor necrosis alpha (TNF-α) inflammatory stimuli. Gingival fibroblasts and epithelial cells were isolated and seeded on surface Ti or ZrO2 surfaces, simulating the in vitro biological sealing. In EGF-coated groups, this growth factor was applied to Ti and ZrO2 surfaces prior to cell culture. After seeding cells, they were irradiated 3 times with LLLT (LaserTABLE, InGaAsP, 780 ± 3 nm) at 24 h intervals at doses of 0.5 J/cm2, 1.5 J/cm2 and 3.0 J/cm2, according to the established groups and then, TNF-α was applied to them for 24 h. Discs surface roughness analyzes were performed by confocal microscopy (n=8), EGF release of the coated substrates and cell adhesion by direct fluorescence. Cell viability (AlamarBlue, n=8), IL-6, IL-8 and VEGF (qPCR, n=5) gene expression, IL-6, ... (Complete abstract click electronic access below) / Doutor

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A variety of soybean oils (SOs) were developed with improved functional properties. Some of the modified SOs contain altered fatty acid (FA) composition by selective breeding methods. Currently, low α- linolenic acid soybean oil (LLSO) and low α- linolenic acid and mid oleic acid soybean oil (LLMOSO) are available FA modified SOs in the market. The consumption of FA modified SOs has been increased because the United States Food and Drug Administration required listing trans fat content in food products sold in U.S. as an effort to reduce possible health risks caused by trans fat beginning 2006. However, the effects of these FA modified SOs on human chronic diseases including breast cancer (BC) have not been studied. BC has become the most frequently diagnosed cancer and is the second leading cause of cancer death among American women. The type of dietary fat, FA composition, and n-6/n-3 ratio are known to influence BC development. Therefore, it is possible that the changed FA composition and n-6/n-3 ratio in the FA modified SOs may affect BC progression, and its critical health concern needs to be investigated. Increased human epithelial growth factor receptor 2 (Her-2/neu) and fatty acid synthase (FAS) are associated with BC progression. In fact, FAS activity and expression are affected by dietary FA composition and FA metabolism. Hypothesis of this research is that LLSO and LLMOSO may affect Her-2/neu and FAS expressing human BC (SK-Br3) cell growth in vitro and in vivo. To test our hypothesis, we investigated the potential adverse or beneficial effects of LLSO and LLMOSO in comparison with conventional SO and lard on human BC cells and then examined the possible mechanisms of action by evaluating the expression level of genes markers involved in growth factor mediated signal transduction pathway, specifically Her-2/neu PI 3-kinase (phophoinositide 3- kinase)-FAS signal transduction pathway. In vitro study demonstrated that all the tested oils at 0-2 μl/ml level have cytotoxic effects. LLMOSO had less cytotoxic effects on the growth of SK-Br3 cells compared to SO. However, there was no difference in SK-Br3 cell growth between LLSO and SO. The apoptotic protein markers (mutant p53 and caspase-3) analysis revealed that the cell growth inhibition by oil treatments was cytotoxic by triggering apoptosis. Western blot analysis demonstrated that LLSO- and LLMOSO- induced changes on cell growth involve Her-2/neu and FAS signaling transduction pathway and sterol regulatory element binding protein-1 (SREBP-1), mitogen activated protein kinase (MAPK), and phosphatidylinositol 3-kinase (PI 3-kinase) are possible down-stream effectors of Her-2/neu signaling pathway. We also evaluated the dietary effects of LLSO (20% fat of total calorie), SO (20%), and lard (20%) on the growth of SK-Br3 tumors implanted in athymic mice. Changes in tumor surface area, body weight, and food intake were monitored during the 6 months feeding study. After termination, tumor net weight, Her-2/neu and FAS mRNA expression in tumors, FAS protein expression in liver, lipid composition in diets, abdominal fat, and serum, as well as plasma total cholesterol and triglyceride levels were analyzed. In vivo study showed that there were no statistical differences in tumor size and tumor net weight among SO, LLSO, and lard groups. No differences in FAS mRNA and protein expression levels between the LLSO and SO groups were observed. Tumors from the lard group expressed higher Her-2/neu and FAS mRNA than those from the LLSO and SO group. The lipid analysis demonstrated that LLSO was not significantly distinct from SO in trans fat concentration after metabolism. Serum cholesterol and triglyceride levels were unchanged in LLSO fed compared to SO fed mice. In summary, LLSO which contained modification in αLA concentration showed similar effects on SK-Br3 as SO in both in vitro and in vivo. However, LLMOSO which contained more drastic modifications on FA composition exhibited less cytotoxicity compared to SO in vitro. / Master of Science

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Είναι ευρέως αποδεκτό και καλά τεκμηριωμένο ότι ο υποδοχέας του επιδερμικού αυξητικού παράγοντα (epidermal growth factor receptor, EGFR) ελέγχει σημαντικές λειτουργίες των καρκινικών κυττάρων, όπως τον πολλαπλασιασμό και την απόπτωση, αλλά και διαδικασίες όπου συμμετέχουν περισσότεροι του ενός τύποι κυττάρων, όπως τη διήθηση και την αγγειογένεση. Μεταξύ των τύπων καρκίνου, στην ανάπτυξη των οποίων συμμετέχει ο EGFR, είναι και ο μη μικροκυτταρικός καρκίνος του πνεύμονα (ΜΜΚΠ). Πολύ πρόσφατα δεδομένα δείχνουν ότι ένα άλλο μόριο που εμπλέκεται στην ανάπτυξη του καρκίνου του πνεύμονα είναι το Notch. Ο ρόλος του είναι περίπλοκος και διττός: Έχει προταθεί ότι το Notch επάγει την ανάπτυξη του ΜΜΚΠ και αναστέλλει την ανάπτυξη του μικροκυτταρικού καρκίνου του πνεύμονα (ΜΚΠ). Επιπλέον, έχει βρεθεί ότι το μονοπάτι μεταγωγής σήματος του Notch επηρεάζει, αλλά και επηρεάζεται από άλλα μόρια. Στην παρούσα μεταπτυχιακή εργασία διερευνήθηκε ο ρόλος του EGFR και του Notch στην ανάπτυξη κυττάρων ΜΜΚΠ χρησιμοποιώντας τον προσδέτη του EGFR, EGF και τον αναστολέα της γ-σεκρετάσης DAPT. Για τη διεξαγωγή των πειραμάτων χρησιμοποιήθηκαν οι ανθρώπινες καρκινικές κυτταρικές σειρές ΜΜΚΠ Η23, Α549, Η661 και ΗCC827. Οι κυτταρικές σειρές Η23, Α549 και Η661 εκφράζουν τον αγρίου τύπου (wild type, wt) EGFR και η κυτταρική σειρά HCC827 εκφράζει EGFR που φέρει τη μετάλλαξη (mutation) (DE746- A750). Αρχικά με ανάλυση κατά western μελετήθηκε το προφίλ των κυττάρων ως προς τα επίπεδα έκφρασης του ενδοκυττάριου τμήματος του Notch (Notch Intracellular Domain, NICD). Βρέθηκε ότι τα κύτταρα Η23 εκφράζουν τα υψηλότερα επίπεδα Notch ICD, τα κύτταρα Η661 και HCC827 μέτρια επίπεδα και τα κύτταρα Α549 τα χαμηλότερα. Στη συνέχεια με τη μέθοδο του ΜΤΤ έγινε έλεγχος του DAPT στον πολλαπλασιασμό των κυττάρων και βρέθηκε ότι τα κύτταρα Η661 είχαν τη μεγαλύτερη αναστολή, παρόμοια συμπεριφορά έδειξαν και τα Α549. Τα κύτταρα Η23 εμφάνισαν μικρότερη ανταπόκριση σε σχέση με τα Η661 ενώ τα κύτταρα HCC827 εμφανίστηκαν ανθεκτικά στο DAPT. Η ανασταλτική δράση του DAPT στα κύτταρα Η661 συνοδεύτηκε με επαγωγή της απόπτωσης η οποία προσδιορίστηκε με τη μέθοδο αννεξίνης V καθώς και με επαγωγή της αυτοφαγίας η οποία ανιχνεύτηκε κάνοντας ανάλυση κατά western για τα πρωτεϊνικά επίπεδα της beclin-1. Περαιτέρω τα κύτταρα ενεργοποιήθηκαν με EGF και εν συνεχεία προστέθηκε DAPT. Παρατηρήθηκε ότι στα κύτταρα Η23 η προσθήκη του EGF δεν επέτρεψε να δράσει ανασταλτικά το DAPT ενώ στα Η661 εν μέρει ο EGF αντέστρεψε την ανασταλτική δράση του DAPT. Επιλέγοντας τις κυτταρικές σειρές Η23 και Η661, μελετήθηκε η δράση του DAPT και του EGF στα επίπεδα του Notch ICD. Παρατηρήθηκε ότι στα κύτταρα Η23, το DAPT μείωσε με χρονοεξαρτώμενο τρόπο τα πρωτεϊνικά επίπεδα του Notch ICD μέχρι και 6 ώρες μετά την προσθήκη του στα κύτταρα ενώ 24 ώρες μετά το φαινόμενο αντιστράφηκε. Η προσθήκη του EGF δεν επηρέασε τα επίπεδα του Notch ICD σε καμία από τις χρονικές στιγμές που μελετήθηκαν. Στα Η661 κύτταρα το DAPT προκάλεσε χρονοεξαρτώμενη μείωση των επιπέδων Notch ICD η οποία διήρκησε μέχρι και 24 ώρες μετά τη προσθήκη του DAPT. Ο EGF όπως και προηγουμένως δεν επηρέασε τα επίπεδα του Notch ICD. Παρατηρώντας ότι στα Η661 το DAPT ασκεί δράση με μεγαλύτερη διάρκεια σε σχέση με τα κύτταρα Η23, τα κύτταρα Η661 ενεργοποιήθηκαν με EGF και στη συνέχεια προστέθηκε το DAPT προκειμένου να δούμε τη δράση του συνδυασμού στα επίπεδα του Notch ICD. Βρέθηκε ότι ο EGF αντέστρεψε την μείωση των Notch ICD επιπέδων που προκαλεί μόνο του το DAPT. Τα αποτελέσματα αναδεικνύουν ότι τα μονοπάτια του EGFR και του Notch, συνηγορούν προς την ίδια κατεύθυνση για τη μείωση του όγκου και αυτό υποδηλώνει έναν ελκυστικό δρόμο συνδυαστικών προσεγγίσεων για τη θεραπεία του ΜΜΚΠ, που μπορεί να ενισχύσει τη δράση των ανασταλτικών παραγόντων του EGFR σε όγκους. Συμπερασματικά, θα μπορούσαμε να υποθέσουμε ότι στο ΜΜΚΠ: α) τα δύο μονοπάτια EGFR και Notch συνεπικουρούν για την ανάπτυξη του όγκου, β) η αναστολή του Notch είναι πιο αποτελεσματική σε κύτταρα με ενδιάμεσα επίπεδα ενεργού Notch 1, προκαλώντας τόσο απόπτωση όσο και αυτοφαγία, και γ) η μετάλλαξη του EGFR προσφέρει αντίσταση στη δράση αναστολέα της γ-σεκρετάσης. / It is widely accepted and well established that the epidermal growth factor receptor (EGFR) controls important processes of tumor cells, such as proliferation and apoptosis, but also processes involving more than one type of cells such as invasion and angiogenesis. It has been found that the EGFR has an important role in the development of several types of cancer including non-small cell lung cancer (NSCLC). Very recent data indicate that another molecule, which is involved in the development of lung cancer, is Notch. Its role is complicated and is under investigation. It is suspected that Notch has a growth promoting function in NSCLC, whereas exerts an inhibitory effect in small cell lung cancer (SCLC). Furthermore it has been found that the signaling pathway of Notch can affect/ can be affected by other molecules. This thesis investigated the role of EGFR and Notch in cell growth of NSCLC cells using the ligand of EGFR, EGF and gamma-secretase inhibitor, DAPT. To conduct the experiments the human NSCLC cell lines H23, A549, H661 and HCC827 were used. The cell lines H23, A549 and H661 express the wild type (wt) EGFR and the cell line HCC827 expresses EGFR bearing the mutation (mt) DE746-A750. Initially, we studied the profile of NSCLC cells regarding the protein levels of Notch intracellular domain (Notch ICD) using western blot analysis. It was found that H23 cells express the higher levels Notch ICD, H661 and HCC827 cells express intermediate levels and A549 cells express the lowest levels of Notch ICD. The next step was the evaluation of DAPT effect in cell proliferation using the MTT assay. We found that DAPT caused the greatest inhibition to H661 and A549 cells. DAPT was less effective to H23 cells while had no effect to HCC827 cells. The inhibitory effect of DAPT in H661 cells was in line with the induction of apoptosis and autophagy, as was detected using annexin V assay and western blot analysis for beclin-1, respectively. Furthermore, cells were stimulated with EGF and subsequently DAPT was added. We found that the stimulatory effect of EGF was not reversed by DAPT in H23 cells. However a partial reverse of EGF stimulation was observed in H661 cells. The next step was to study the effect of DAPT and EGF at Notch ICD protein levels, in H23 and H661 cells. We found that DAPT reduced the protein levels of Notch ICD in H23 cells, with a time-dependent manner, up to 6 hours after DAPT addition and this effect reversed 24 hour later. The addition of EGF did not affect the levels of Notch ICD at any time point tested. In H661 cells, DAPT caused a time-dependent reduction of Notch ICD protein levels up to 24 hours after DAPT addition to cells. EGF as previously, did not affect the levels of Notch ICD in these cells. Since DAPT was more effective to H661 cells, these cells stimulated with EGF and then DAPT was added in order to study the effect of the combination at the levels of Notch ICD. We found that EGF reversed the decrease of Notch ICD protein levels caused by DAPT alone. These results indicate that the pathways of EGFR and Notch might act with a synergistic fashion and this could be an attractive approach for the treatment of NSCLC. Summarizing our results, we might assume that in NSCLC: a) both pathways of EGFR and Notch exert a significant role in tumor growth, b) the inhibition of Notch is more effective in cells with intermediate levels of activated Notch 1, causing both apoptosis and autophagy, and c) the EGFR mutation confers resistance to the effect of γ- secretase inhibitor.