HYAL-1 (hyaluronidase-1) appartient à la famille des hyaluronidases connues pour leur rôle dans la dégradation de l’acide hyaluronique. L’expression de HYAL-1 est élevée dans de nombreux type de cancers, notamment dans le cancer de la prostate, de la vessie, des reins et du sein où il est impliqué dans la croissance tumorale et les métastases. Récemment notre laboratoire a aussi démontré une expression élevée de HYAL-1 dans le cancer épithélial de l’ovaire (CEO) de type mucineux et à cellules claires, expression qui est inversement corrélée à celle du récepteur de l’oestrogène alpha (REα). Cependant, malgré le fait que le rôle de HYAL-1 dans le cancer soit bien établit, le mécanisme de sa régulation reste encore inconnu. Le REα est un facteur de transcription qui suite à sa liaison avec son ligand va réguler l’expression de plusieurs gènes. Le REα ainsi stimulé par l’hormone va activer la transcription de ces gènes cibles mais il est connu maintenant qu’une grande partie des gènes régulés par le REα sont en réalité réprimés par ce récepteur. Dans ce travail nous proposons d’étudier le mécanisme de la régulation du gène HYAL-1 par le REα dans le CEO à cellules claires et dans le cancer du sein. L’expression ectopique du REα dans la lignée TOV21G (RE-) de même que le traitement de la lignée MCF-7 (RE+) avec de l’oestrogène a induit une diminution du niveau d’expression de l’ARN m de HYAL-1. Ces résultats nous ont permis de confirmer que HYAL-1 est un gène cible du REα. Il est aussi connu que le REα peut exercer son action par différents mécanismes d’action, entre autres en interagissant avec une séquence d’ADN appelée élément de réponse à l’oestrogène (ERE), retrouvé sur le promoteur des gènes cibles ou bien indirectement par des interactions protéine-protéine en se liant à d’autres facteur de transcription tels que Sp1. Après avoir identifiés de telles séquences sur le promoteur proximal de HYAL-1, (1 ERE proximal à -900 pb, 3 distaux à -32350 pb, 48430, -50130 pb du site d’initiation de la transcription) en plus des 2 Sp1 connus (-60 et – 1020pb), nous avons démontrés par immunoprécipitation de la chromatine que le REα est recruté sur le promoteur de HYAL-1 au niveau de l’ERE proximal -900 pb et du distal -32350 pb de même que sur le site Sp1 -1020 pb. De plus, l’activité biologique de l’ERE -900 pb et du ii Sp1-1020pb à été confirmée par des essais de gènes rapporteurs à la luciférase. Avec son rôle connu dans la tumorigenèse, l’identification de HYAL-1 comme gène cible du REα pourrait être une avenue intéressante pour le traitement des cancers hormono-indépendants. / HYAL-1 (hyaluronidase-1) belongs to the hyaluronidase family of enzymes that degrade hyaluronic acid. HYAL-1 expression is elevated in many types of cancers including prostate, bladder, liver and breast cancer where it is involved in tumor growth and metastasis. In accordance to these observations, our group has also demonstrated high expression of HYAL-1 in clear cell and mucinous epithelial ovarian cancer (EOC) subtypes which was inversely correlated to that of estrogen receptor alpha (ERα). However, despite the fact that the role of HYAL-1 in cancer is well established, the mechanism of its regulation is still unknown. ERα is a transcriptional factor that regulates target-gene expression following ligand binding. Upon hormone stimulation, activated ERα will upregulate transcription of many target genes. However, it has been recently well documented that a large number of ERα responsive genes are in fact repressed. In this work we propose to study the mechanism by which ERα regulates HYAL-1 expression in clear cell EOC subtype as well as in breast cancer. The ectopic expression of ERα in TOV21G cell line (ERα -) and estrogen treatment of MCF-7 cells (ERα +) decreased HYAL-1 mRNA expression and allowed us to confirm that HYAL-1 is an ERα target gene. It is also known that ERα may exert its action through different mechanisms of action including interacting with a DNA sequence called estrogen response element (ERE) found in the promoter of target genes or indirectly by protein-protein interactions by binding to other transcription factor such as Sp1. Having identified such sequences in the proximal promoter of HYAL-1, (one proximal ERE -900 bp, 3 distals at -32350, -48430, -50130 bp from the start site of transcription) in addition to the two known Sp1 (-60 and -1020pb), we have demonstrated by chromatin immunoprecipitation that ERα is recruited at the HYAL-1 promoter at the ERE sites -900 pb and -32350 pb as well as at the Sp1 site -1020. Furthermore, the biological activity of the proximal ERE -900 and Sp1 -1020 sites were further confirmed by luciferase reporter gene assay. Given its known role in tumorigenesis, identification of HYAL-1 as an ERα target may provide an interesting approach for the treatment of hormono-independent cancer.

The main expansion of the discovery of genetic variants associated with complex diseases has occurred during the last decade. This expansion has been accompanied, and in some sense motivated, by the desire to use this information to improve the predictive capacity of many diseases with an unidentified familial component, including coronary heart disease (CHD), with the aim of translating this genetic knowledge into clinical practice. This doctoral thesis is structured in two lines of investigation that address distinct aspects of this issue, first to evaluate the possible role of genetic variation in a candidate gene in modulating CHD risk, and second to evaluate whether genetic information can be used to improve risk assessment tools used in clinical practice. In the first research line (described in Part I), we investigate the contribution of genetic variation in one of the most widely-studied genes in cardiovascular genetics, ESR1, which encodes the Oestrogen receptor α protein. We provide a solid meta-analysis of evidence regarding the most widely-studied variant in this gene and we further explore the role of a broad range of common and uncommon variants in this gene in CHD risk. Using these approaches, we find no evidence of association between the genetic variants studied and CHD risk. However, although we can confidently accept that common genetic polymorphisms are not associated with cardiovascular disease, we cannot discard the possibility that other types of variation in this gene (for instance epigenetic variation) could modify susceptibility to cardiovascular disease, or that other elements of this pathway are associated with an increased risk of CHD. In this research I have provided a reliable answer to this long running unanswered question in cardiovascular genetics, allowing research to re-focus on other elements of this system or other pathways. In the second line, we explored the possible utility of genetic information obtained from genome-wide association studies (GWAS) in prediction of 10-year risk of CHD events by adding this information to cardiovascular risk functions. We have followed the recommendations proposed by the American Heart Association for evaluating the utility of novel biomarkers in clinical practice, and have demonstrated that although the magnitudes of the effects of these genetic variants on CHD risk are modest, there is a tendency towards improvement in the capacity of the risk functions to predict future CHD events. The translation of genetic information into clinical practice was one of the main motivations for the investment in genome-wide association studies, and my research represents one of the first efforts to explore this possibility. / L’expansió principal pel que fa al descobriment de variants genètiques associades amb malalties complexes s’ha dut a terme durant la última dècada. Aquesta expansió ha estat acompanyada, i d’alguna forma motivada, pel desig d’usar aquesta informació per millorar la capacitat de predicció d’aquelles malalties on hi és present un cert component familiar però en les que no es coneixien les variants que conferien un major risc de patir la malaltia, entre elles la cardiopatia isquèmica (CI). La present tesis doctoral està estructurada en dues línies d’investigació que avaluen el possible rol d’un gen candidat en la susceptibilitat de la CI i també avalua la millora en la capacitat de predicció d’un esdeveniment coronari de les eines usades habitualment en la pràctica clínica mitjançant la inclusió d’informació genètica. Més concretament, la primera línea d’investigació es centra en la contribució de la variació genètica en un dels gens més estudiats en relació amb CI: el gen que codifica pel receptor d’estrogens alfa (ESR1). En aquesta línea hem proveït un sòlid meta-anàlisis entre la variant més àmpliament estudiada d’aquest gen i risc coronari i també hem explorat el paper de la majoria de les variants comunes descrites en aquest gen i risc de CI. Mitjançant cap dels anàlisis hem trobat evidència d’associació entre les variants genètiques en aquest gen i el risc de CI. No obstant això, i encara que podem acceptar que les variants genètiques comunes d’aquest gen no estan associades amb esdeveniments coronaris, no podem descartar que altres tipus de variació en aquest gen (com per exemple variació epigenètica) pugui estar modificant la susceptibilitat a patir un esdeveniment coronari, ni tampoc que altres elements de la mateixa cadena de senyalització estiguin associats amb la malaltia. En la segona línea d’investigació, hem explorat el possible paper de les variants genètiques, obtingudes mitjançant estudis d’associació global del genoma (GWAS), en la millora de la capacitat de predicció a 10 anys dels esdeveniments coronaris, mitjançant la seva addició en les funcions de risc cardiovascular clàssiques. Hem seguit les recomanacions proposades per la American Heart Association per l’avaluació en la pràctica clínica de nous biomarcadors, i hem demostrat que, tot i que la magnitud de l’associació d’aquestes variants és modesta, hi ha una tendència cap a la millora de la capacitat de predicció de les funcions de risc.

Τα αστροκυττώματα αποτελούν το συχνότερο τύπο πρωτοπαθών όγκων του κεντρικού νευρικού συστήματος (ΚΝΣ) και παραδοσιακά θεωρούνται ότι σχετίζονται με ιδιαίτερα δυσμενή πρόγνωση. Η Συστημική προσέγγιση της καρκινογένεσης, εστιάζοντας στην αποκρυπτογράφηση του τρόπου λειτουργίας και δυναμικής αλληλεπίδρασης πολύπλοκων παθοβιολογικών δικτύων, προσφέρει σήμερα καινούριες ερευνητικές προοπτικές και πιθανές εναλλακτικές, περισσότερο αποτελεσματικές θεραπευτικές στρατηγικές. Οι οιστρογονικοί υποδοχείς και οι συν – ρυθμιστές της μεταγραφής συνιστούν κομβικά σημεία “συνομιλίας” (cross – talk) πολύπλοκων μοριακών οδών του κυττάρου, διαμεσολαβώντας πλήθος κυτταρικών λειτουργιών φυσιολογικά αλλά και σε παθολογικές καταστάσεις, ανάμεσα στις οποίες και ο καρκίνος. Οι παράγοντες EZH2 και SOX2 θεωρούνται μόρια κλειδιά του ρυθμιστικού μεταγραφικού κυκλώματος που χαρακτηρίζει το stemness. Η αποσαφήνιση της συμπεριφοράς του συγκεκριμένου αυτού δικτύου στα διάφορα νεοπλάσματα και ρόλος του σε σχέση με την απόκτηση ιδιότητας καρκινικού stem κυττάρου, θεωρείται καθοριστικής σημασίας στην προσπάθεια ερμηνείας του φαινομένου του καρκίνου ως πολύπλοκο προσαρμόσιμο σύστημα, που θα αναδείξει εναλλακτικούς θεραπευτικούς στόχους και θα επιτρέψει περισσότερο αποτελεσματικές σε σχέση με τις υπάρχουσες παρεμβάσεις. Σκοπός. Υπό το πρίσμα της Συστημικής προσέγγισης της κατανόησης της κακοήθους ανάπτυξης και εξέλιξης των αστροκυτταρικών όγκων, η παρούσα μελέτη διερεύνησε τα επίπεδα έκφρασης του Οιστρογονικού υποδοχέα β (ERβ), και των συν – ρυθμιστών AIB1, TIF2 and PELP1, όπως και την έκφραση των παραγόντων EZH2 και SOX2 σε αστροκυττώματα grade II ως IV και τη συσχέτιση μεταξύ του προφίλ έκφρασης των συγκεκριμένων παραγόντων, με κλινικοπαθολογικά δεδομένα. Υλικό και μέθοδος. Η έκφραση των πρωτεϊνών ERβ, AIB1, TIF2, PELP1, EZH2 και SOX2 εκτιμήθηκε σε 86 περιπτώσεις αστροκυτταρικών όγκων χρησιμοποιώντας τη μέθοδο της ανοσοϊστοχημείας. Είκοσι grade II αστροκυττώματα, 22 grade III αναπλαστικά αστροκυττώματα και 46 grade IV πλειόμορφα γλοιοβλαστώματα (GBM) συμπεριλήφθησαν στη συγκεκριμένη μελέτη. Η μέθοδος με χρήση συστήματος ανίχνευσης EnVision (Envision, Dako, CA, USA) ή MACH4 Universal HRP-Polymer Detection (Biocare Medical, CA, USA) και πρωτογενή αντισώματα έναντι των ERβ (Biogenex, CA, USA), AIB1 (BD Biosciences, Ca, USA), TIF2 (BD Biosciences, Ca, USA), PELP-1/MNAR (Novus Biologicals, CO, USA) EZH2 (Novocastra, UK) και SOX2 (R&D Systems, Inc.) χρησιμοποιήθηκαν στην παρούσα μελέτη. Σε κάθε περιστατικό και για κάθε δείκτη εκτιμήθηκε το ποσοστό των καρκινικών κυττάρων που εμφάνιζαν θετική ανοσοχρώση. Αντιπροσωπευτικές περιοχές επιλέχθηκαν κατόπιν σάρωσης του πλακιδίου σε οπτικό πεδίο μικρής μεγέθυνσης (Χ100), ενώ η καταμέτρηση των θετικών κυττάρων πραγματοποιήθηκε σε μεγάλης μεγέθυνσης πεδίο (400X). Η στατιστική ανάλυση έγινε με τη χρήση του SPSS στατιστικού πακέτου (SPSS©, Release 17.0, Chicago, IL, USA). Τιμές p<0.05 θεωρήθηκαν ως στατιστικά σημαντικές. Αποτελέσματα. Σημαντική μείωση των επιπέδων του ERβ παρατηρήθηκε παράλληλα με την αύξηση του grade. Επιπλέον, η υψηλή ERβ έκφραση αναδείχθηκε ως ανεξάρτητος θετικός προγνωστικός παράγοντας της συνολικής επιβίωσης κατά την πολυπαραγοντική ανάλυση. Η έκφραση των AIB1, TIF2 και PELP1, δε συσχετίσθηκε με αυτή του ERβ, και ακολούθησε αντιστρόφως ανοδική τάση, παράλληλα με την αύξηση του grade. Η στατιστική ανάλυση περαιτέρω, ανέδειξε μία σημαντική αύξηση τόσο των επιπέδων EZH2 όσο και SOX2 στα grade III και IV σε σχέση με τα grade II αστροκυττώματα. Ισχυρή συσχέτιση παρατηρήθηκε ως προς την έκφραση των δύο δεικτών σε όλες τις κατά grade υποομάδες. Η Kaplan-Meier ανάλυση έδειξε ότι, η υψηλή EZH2 και SOX2 πρωτεϊνική έκφραση συνιστούν αρνητικό παράγοντα πρόγνωσης τόσο στο σύνολο των ασθενών όσο και κατόπιν διαστρωμάτωσης κατά grade. Τέλος, η πολυπαραγοντική Cox ανάλυση συνυπολογίζοντας την ηλικία, το φύλο, το grade και την έκφραση των δύο πρωτεϊνών έδειξε ότι μόνο η υψηλή EZH2 έκφραση μαζί με το υψηλό grade, αποτελούν ανεξάρτητους παράγοντες δυσμενούς πρόγνωσης. Συμπεράσματα. Οι παράγοντες ERβ, AIB1, TIF2 και PELP1 ενέχονται στους παθογενετικούς μηχανισμούς ανάπτυξης και εξέλιξης των αστροκυτταρικών όγκων, με τον ERβ να διαδραματίζει προστατευτικό ρόλο και τους AIB1, TIF2 και PELP1 να εμφανίζουν ογκο – προαγωγό δράση. Το ογκογενετικό δυναμικό των παραγόντων AIB1, TIF2 και PELP1 φαίνεται πως διαμεσολαβείται μέσω ανεξάρτητων του οιστρογονικού υποδοχέα μηχανισμών. Η έκφραση του ERβ, διαχωρίζοντας κλινικές εκβάσεις σε ασθενείς ιδίου grade, θα μπορούσε να αποτελέσει ένα χρήσιμο εργαλείο κατά τη λήψη εξατομικευμένων κλινικών αποφάσεων. Οι παράγοντες EZH2 και SOX2, θα μπορούσαν να χρησιμοποιηθούν ως εν δυνάμει δείκτες καρκινικών stem κυττάρων σε αστροκυτταρικούς όγκους, να βοηθήσουν τη βελτιστοποίηση τόσο διαγνωστικών όσο και προγνωστικών διαδικασιών στην κλινική πράξη, και να κατευθύνουν την ανάπτυξη εξατομικευμένων στρατηγικών θεραπείας. / Astrocytic tumors are the most common primary neoplasms of the central nervous system (CNS) and have traditionally been associated with disappointing clinical outcomes. The current challenge is to develop more efficacious and targeted therapeutic paradigms, exploiting the knowledge derived from the systems approach of understanding the complex networks underlying tumor formation and progression. Estrogen receptor beta (ERβ) and co-regulators of transcription AIB1, TIF2 and PELP1, are key components of complex cellular networks and integrate diverse signaling afferents with transcription programs controlling various physiological cellular processes and a variety of disease states including cancer. SOX2 and EZH2 represent crucial components of the reciprocal regulatory circuit that controls stemness. Elucidating the behavior of this particular network in cancer and its role in the formation of putative cancer stem cells is considered essential for the understanding of cancer as an adaptive complex system and subsequently allowing the discovery of more successful therapeutic designs. Purpose. In the context of the systems approach of comprehending tumorigenesis in astrocytomas, we sought to investigate the expression of ERβ and co – regulatory proteins AIB1, TIF1 and PELP1, as well as parallel expression of SOX2 and EZH2 in astrocytomas of various grades, and correlate the protein expression profiles with clinicopathological parameters and patients’ prognosis. Materials and methods. Expression of ERβ, AIB1, TIF2, PELP1, EZH2 and SOX2 was evaluated in 86 cases of astrocytic tumors, using Immunohistochemistry, on formalin-fixed paraffin-embedded tissue sections. Twenty grade II astrocytomas, 22 grade III anaplastic astrocytomas and 46 grade IV glioblastomas multiforme (GBM) were included in this study. Polymer based technique (Envision, Dako, CA, USA) or MACH4 Universal HRP-Polymer Detection (Biocare Medical, CA, USA) and primary antibodies against ERβ1 (Biogenex, CA, USA), AIB1 (BD Biosciences, Ca, USA), TIF2 (BD Biosciences, Ca, USA), PELP-1/MNAR (Novus Biologicals, CO, USA) EZH2 (Novocastra, UK) and SOX2 (R&D Systems, Inc.) were used. In each case, the percentage of cells exhibiting positive staining was determined. Representative areas were selected at low power (x100) magnification. Cell counts were performed at a 400X magnification. Data were analyzed using the SPSS statistical package (SPSS©, Release 17.0, Chicago, IL, USA). The level of significance was set at p-value <0.05. Results. ERβ levels were significantly decreased with the progression of tumors’ grade. High expression of ERβ was an independent favorable prognostic factor on multivariate analysis. Expression of AIB1, TIF2 and PELP1, was not correlated to ERβ expression and followed an opposite trend, with increasing levels in grade III and IV relative to grade II tumors. Univariate survival analysis revealed that high AIB1, TIF2 and PELP1 expression was associated with worse prognosis. Statistical analysis further revealed significantly higher expression of EZH2 and SOX2 in high grade III and IV astrocytomas, compared to low grade II astrocytomas. Strong correlation between EZH2 and SOX2 was also detected within all subgroups according to grade. Kaplan-Meier showed that EZH2 and SOX2 high expression was predictive of worse overall survival in the whole cohort as well as after subgroup analysis by grade. Finally, multivariate Cox analysis that included age, gender, grade, and expression of both proteins, revealed that high EZH2 together with higher grade were strong negative prognostic factors. Conclusions. ERβ, AIB1, TIF2 and PELP1 appear to play an important role in the pathogenesis of astrocytic tumors, with ERβ exhibiting a protective effect, whereas AIB1, TIF2 and PELP1 facilitate malignant progression. AIB1, TIF2 και PELP1 contribution in tumor progression is speculated to be achieved through ERβ independent pathways. Moreover, the expression status of ERβ, by distinguish patient subpopulations with different prognosis within the same grade, could be a useful tool accommodating personalized clinical decision-making. EZH2 and SOX2 may serve as potential cancer stem cell markers in astrocytomas and as such help optimizing diagnostic and prognostic assessments and devising novel individually tailored treatment strategies.

Os mecanismos etiopatogênicos que levam ao desenvolvimento dos nódulos e tumores da tireoide ainda não são bem conhecidos. É fato estabelecido que a prevalência dessas lesões é maior nas mulheres. Dessa forma, o que nos motivou a realizar esta Tese foi avaliar se os hormônios sexuais femininos tem efeito direto sobre as células de tireoide humanas normais podendo contribuir para a sua etiopatogenia. Este estudo teve como objetivos padronizar um modelo de cultura primária de células foliculares de tireoide humana normal e nesse modelo validar um gene normalizador após tratamento com estradiol e progesterona, avaliar os efeitos da progesterona na expressão dos genes NIS, TG e TPO bem como avaliar a expressão gênica e proteíca e a possível localização intracelular do receptor de membrana GPR30 nestas células. Em nosso modelo de cultura primária em monocamada, as células foliculares mantiveram sua morfologia cubóide característica e permaneceram diferenciadas o que foi evidenciado pela dosagem de tireoglobulina e T4 livre, no sobrenadante do meio de cultura, e pela identificação das proteínas TG e TPO por imunocitoquímica. A estimulação com progesterona aumentou a expressão dos genes NIS, TG e TPO, respectivamente, 1.78 (p=0.003), 1.50 (p=0.034) e 1.64 (p=0.018) vezes, quando comparadas ao grupo tratado somente com TSH. Essa estimulação da progesterona foi inibida por mifepristona sugerindo que a progesterona tem efeito direto nas células foliculares da tireoide e que esse efeito é mediado por seu receptor nuclear. A normalização da expressão gênica foi realizada pelo gene β-actina, o qual demonstrou uma maior estabilidade entre os grupos analisados. Demonstramos também que as células normais da tireoide expressam tanto o gene como a proteína do receptor de membrana GPR30 com possível localização na membrana celular e no espaço perinuclear. / The mechanisms leading to the development of thyroid nodules and tumors are not well established. As these lesions are more common in women, female sex hormones could be involved in the pathogenesis of these disorders. The objectives of this study were to establish a model of primary culture of normal human thyroid follicular cells, to validate a normalizing gene for qRT-PCR after treatment with estradiol and progesterone, to evaluate the effects of progesterone on the expression of genes NIS, TG and TPO, and to evaluate the GPR30 gene and protein expression as well as its possible intracellular location, in these cells. In our model of primary monolayer culture, follicular cells maintained their characteristic cuboid differentiated morphology; and had evidence of differentiated thyroid function: the production of thyroglobulin and free T4, and identification of TG and TPO proteins by immunocytochemistry . Adding progesterone to TSH increased NIS, TG and TPO mRNA, respectively, 1.78 (p=0.003), 1.50 (p=0.034) and 1.64 (p=0.018) folds, compared to the group treated with only TSH. This stimulation was inhibited by mifepristone, suggesting that progesterone has a direct effect on the thyroid follicular cells. Normalization of gene expression was performed using β-actin as reference gene. We have also demonstrated that normal thyroid cells expressed GPR30 gene and protein, which is possibly localized in the plasma membrane and the perinuclear region.

Os mecanismos etiopatogênicos que levam ao desenvolvimento dos nódulos e tumores da tireoide ainda não são bem conhecidos. É fato estabelecido que a prevalência dessas lesões é maior nas mulheres. Dessa forma, o que nos motivou a realizar esta Tese foi avaliar se os hormônios sexuais femininos tem efeito direto sobre as células de tireoide humanas normais podendo contribuir para a sua etiopatogenia. Este estudo teve como objetivos padronizar um modelo de cultura primária de células foliculares de tireoide humana normal e nesse modelo validar um gene normalizador após tratamento com estradiol e progesterona, avaliar os efeitos da progesterona na expressão dos genes NIS, TG e TPO bem como avaliar a expressão gênica e proteíca e a possível localização intracelular do receptor de membrana GPR30 nestas células. Em nosso modelo de cultura primária em monocamada, as células foliculares mantiveram sua morfologia cubóide característica e permaneceram diferenciadas o que foi evidenciado pela dosagem de tireoglobulina e T4 livre, no sobrenadante do meio de cultura, e pela identificação das proteínas TG e TPO por imunocitoquímica. A estimulação com progesterona aumentou a expressão dos genes NIS, TG e TPO, respectivamente, 1.78 (p=0.003), 1.50 (p=0.034) e 1.64 (p=0.018) vezes, quando comparadas ao grupo tratado somente com TSH. Essa estimulação da progesterona foi inibida por mifepristona sugerindo que a progesterona tem efeito direto nas células foliculares da tireoide e que esse efeito é mediado por seu receptor nuclear. A normalização da expressão gênica foi realizada pelo gene β-actina, o qual demonstrou uma maior estabilidade entre os grupos analisados. Demonstramos também que as células normais da tireoide expressam tanto o gene como a proteína do receptor de membrana GPR30 com possível localização na membrana celular e no espaço perinuclear. / The mechanisms leading to the development of thyroid nodules and tumors are not well established. As these lesions are more common in women, female sex hormones could be involved in the pathogenesis of these disorders. The objectives of this study were to establish a model of primary culture of normal human thyroid follicular cells, to validate a normalizing gene for qRT-PCR after treatment with estradiol and progesterone, to evaluate the effects of progesterone on the expression of genes NIS, TG and TPO, and to evaluate the GPR30 gene and protein expression as well as its possible intracellular location, in these cells. In our model of primary monolayer culture, follicular cells maintained their characteristic cuboid differentiated morphology; and had evidence of differentiated thyroid function: the production of thyroglobulin and free T4, and identification of TG and TPO proteins by immunocytochemistry . Adding progesterone to TSH increased NIS, TG and TPO mRNA, respectively, 1.78 (p=0.003), 1.50 (p=0.034) and 1.64 (p=0.018) folds, compared to the group treated with only TSH. This stimulation was inhibited by mifepristone, suggesting that progesterone has a direct effect on the thyroid follicular cells. Normalization of gene expression was performed using β-actin as reference gene. We have also demonstrated that normal thyroid cells expressed GPR30 gene and protein, which is possibly localized in the plasma membrane and the perinuclear region.

Os mecanismos etiopatogênicos que levam ao desenvolvimento dos nódulos e tumores da tireoide ainda não são bem conhecidos. É fato estabelecido que a prevalência dessas lesões é maior nas mulheres. Dessa forma, o que nos motivou a realizar esta Tese foi avaliar se os hormônios sexuais femininos tem efeito direto sobre as células de tireoide humanas normais podendo contribuir para a sua etiopatogenia. Este estudo teve como objetivos padronizar um modelo de cultura primária de células foliculares de tireoide humana normal e nesse modelo validar um gene normalizador após tratamento com estradiol e progesterona, avaliar os efeitos da progesterona na expressão dos genes NIS, TG e TPO bem como avaliar a expressão gênica e proteíca e a possível localização intracelular do receptor de membrana GPR30 nestas células. Em nosso modelo de cultura primária em monocamada, as células foliculares mantiveram sua morfologia cubóide característica e permaneceram diferenciadas o que foi evidenciado pela dosagem de tireoglobulina e T4 livre, no sobrenadante do meio de cultura, e pela identificação das proteínas TG e TPO por imunocitoquímica. A estimulação com progesterona aumentou a expressão dos genes NIS, TG e TPO, respectivamente, 1.78 (p=0.003), 1.50 (p=0.034) e 1.64 (p=0.018) vezes, quando comparadas ao grupo tratado somente com TSH. Essa estimulação da progesterona foi inibida por mifepristona sugerindo que a progesterona tem efeito direto nas células foliculares da tireoide e que esse efeito é mediado por seu receptor nuclear. A normalização da expressão gênica foi realizada pelo gene β-actina, o qual demonstrou uma maior estabilidade entre os grupos analisados. Demonstramos também que as células normais da tireoide expressam tanto o gene como a proteína do receptor de membrana GPR30 com possível localização na membrana celular e no espaço perinuclear. / The mechanisms leading to the development of thyroid nodules and tumors are not well established. As these lesions are more common in women, female sex hormones could be involved in the pathogenesis of these disorders. The objectives of this study were to establish a model of primary culture of normal human thyroid follicular cells, to validate a normalizing gene for qRT-PCR after treatment with estradiol and progesterone, to evaluate the effects of progesterone on the expression of genes NIS, TG and TPO, and to evaluate the GPR30 gene and protein expression as well as its possible intracellular location, in these cells. In our model of primary monolayer culture, follicular cells maintained their characteristic cuboid differentiated morphology; and had evidence of differentiated thyroid function: the production of thyroglobulin and free T4, and identification of TG and TPO proteins by immunocytochemistry . Adding progesterone to TSH increased NIS, TG and TPO mRNA, respectively, 1.78 (p=0.003), 1.50 (p=0.034) and 1.64 (p=0.018) folds, compared to the group treated with only TSH. This stimulation was inhibited by mifepristone, suggesting that progesterone has a direct effect on the thyroid follicular cells. Normalization of gene expression was performed using β-actin as reference gene. We have also demonstrated that normal thyroid cells expressed GPR30 gene and protein, which is possibly localized in the plasma membrane and the perinuclear region.

Deux tiers des cancers du sein expriment le récepteur des œstrogènes alpha (ERα), un facteur de transcription ligand dépendant responsable de la prolifération oncogénique de ces cellules. Ces tumeurs, dites ER positives (ER+), bénéficient de thérapies endocrines comme les antiœstrogènes (AE). Les AE sont des ligands compétitifs de ERα qui inhibent son activité transcriptionnelle. Le tamoxifène est l’antiœstrogène le plus utilisé en première ligne de traitement chez les patientes ayant un cancer du sein ER+. Malgré un bon pronostique initial, plus du tiers d’entre elles finiront par développer une résistance, parfois après de nombreuses années. L’absence de résistance croisée avec le tamoxifène place le fulvestrant comme seul dé-régulateur sélectif de ER (SERD) autorisé en clinique contre les tumeurs mammaires avancées résistantes. Malgré son profil antagoniste pur, le fulvestrant ne s’est pas révélé supérieur au tamoxifène en première ligne de traitement, cela étant attribué à sa faible biodisponibilité. D’autres SERD oralement disponibles sont en cours d’évaluation clinique. Des mutations du gène ESR1 (ERα) sont retrouvées dans environ 20% des tumeurs avancées résistantes à l’hormonothérapie et contribuent à la résistance au fulvestrant. Les mutations sont toutes retrouvées dans le domaine de liaison au ligand. La maladie progressera éventuellement avec le développement de métastases qui sont incurables. Il est donc crucial de (1) comprendre les mécanismes moléculaires médiant l’antiestrogénicité pure et l’impact des altérations génétiques impliquées dans la résistance aux AE pour (2) développer des thérapies ciblées plus efficaces qui pourraient lutter contre les tumeurs avancées résistantes. Les résultats prometteurs de plusieurs études in vitro et en clinique combinant un AE avec un inhibiteur d’histones désacétylases (HDACi) ont mené à la création de molécules hybrides combinant les deux fonctionnalités en une seule molécule. Nos travaux montrent que ces molécules hybrides dérivées du tamoxifène démontrent des propriétés inhibitrices améliorées par l’ajout d’un groupe fonctionnel inhibiteur des HDAC sur le squelette du tamoxifène. Ces composés sont antagonistes contre ERα et plusieurs HDAC et l’un d’eux possède une activité antiproliférative accrue par rapport aux composés parentaux dans les cellules de cancer du sein ER+ MCF-7. Notre étude fournit une preuve de concept que la combinaison d’une fonction pharmacologique HDACi sur le noyau d’un AE est prometteuse. Afin de mieux comprendre les déterminants moléculaires liés à l’induction de la SUMOylation de ERα et l’inhibition de son activité transcriptionnelle par le fulvestrant, nous avons testé l’impact de différentes mutations sur l’activité de plusieurs SERD, comprenant le fulvestrant. Nos résultats valident l’importance du résidu L536 dans la SUMOylation et la répression transcriptionnelle de ERα en réponse aux SERD. Les mutations ponctuelles L536P, Q et R, trouvées en clinique, compromettent la réponse au fulvestrant et à une sélection de SERD oraux in vitro. En résumé, nos résultats participent à une meilleure compréhension des caractéristiques moléculaires liées au mécanisme d’action du fulvestrant et de plusieurs SERD oraux de nouvelle génération. L’ensemble de nos résultats devraient aider au développement de nouvelles molécules plus efficaces contre les tumeurs résistantes, y compris des composés avec une double fonction inhibitrice AE-HDACi. / Two thirds of breast tumors are classified as positive for estrogen receptor alpha (ERα), a ligand-dependent transcription factor driving breast cancer cell proliferation. ER-positive (ER+) tumors benefit from endocrine therapies such as antiestrogens (AE). AE compete with ERα natural ligands and inhibit its transcriptional activity. Tamoxifen is the gold-standard for antiestrogenic therapy in patients with primary ER+ breast cancer. Despite a good initial prognosis, more than one-third will eventually develop resistance, sometimes after long periods of latency. Fulvestrant, known as a “pure” AE, is the only selective ER deregulator (SERD) approved in advanced breast cancer even after development of resistance to tamoxifen. Despite its pure antagonistic profile, fulvestrant has not proven superior to tamoxifen in first-line treatment, which is attributed to poor pharmacological properties. New generation SERDs with orally bioavailable properties are currently tested in the clinic. Mutations of ERα are found in about 20% of hormone-resistant advanced tumors and contribute to resistance to fulvestrant. The mutations are all located in the ligand binding domain. Resistant tumors will eventually progress and develop metastases which are deadly. It is therefore crucial to (1) understand the molecular determinants of pure antiestrogenicity and the impact of genetic alterations involved in AE resistance to (2) develop treatments with improved cytotoxic activities to achieve a more efficient suppression of advanced tumors. Promising results from several in vitro and clinical studies combining an AE with a histone deacetylase inhibitor (HDACi) have led to the design of hybrid molecules combining both functionalities into a single molecule. Our work shows that tamoxifen-derived hybrids display properties by the addition of an HDAC inhibitory functional group (HDACi) on the tamoxifen backbone. These compounds have inhibitory activities against ERα and several HDACs. One hybrid exhibits an improved cytotoxic activity against ER+ MCF-7 breast cancer cells compared to parental molecules. Our study provides proof of concept that combining HDACi function to the core of an AE is promising. To better understand the molecular determinants related to the induction of ERα SUMOylation and transcriptional repression by fulvestrant, we evaluated the impact of different mutations on the activity of several SERDs, including fulvestrant. Our results validate the importance of residue L536 in SUMOylation and transcriptional repression of ERα in response to SERDs. L536P, Q, and R point mutations are found in the clinic compromise the response to fulvestrant and to several oral SERDs in vitro. In summary, our results give better insights into the mechanism of action of fulvestrant and new generation oral SERDs and on the impact of naturally occurring mutations on transcriptional responses to these AE. Taken together, our results should help in the design of more efficient molecules, including compounds with dual AE-HDACi inhibitory function.

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