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L’adénocarcinome pancréatique canalaire (PDAC) est un cancer de mauvais pronostic en partie en raison de la résistance aux traitements conventionnels de chimiothérapie ou de radiothérapie. Certaines substances bioactives issues de l’alimentation (BFCs), prooxydantes sont capables de potentialiser l’action cytotoxique des drogues conventionnelles dans le PDAC. Par ailleurs ces BFCs pourraient augmenter les cassures de l’ADN induites par les radiations ionisantes. Objectifs : évaluer l’action combinée de BFCs en association avec la chimiothérapie et la radiothérapie dans des modèles de PDAC et identifier les mécanismes impliqués dans la chimio/radiosensibilisation. Méthodes : La survie cellulaire a été évaluée in vitro en présence de BFCs en combinaison sur 4 lignées tumorales pancréatiques. La production d’espèces réactives de l'oxygène (ROS) a été mesurée par cytométrie en flux et par microscopie à fluorescence. Les mécanismes moléculaires ont été décryptés par western-blot (voies de signalisation) et cytométrie en flux (cycle cellulaire et apoptose). Enfin nous avons évalué l’association de BFCs en gavage avec la chimiothérapie par gemcitabine intrapéritonéale et avec la radiothérapie de 2 Gy par fraction in vivo, sur des greffes sous-cutanée de cellules CAPAN-2. Résultats : In vitro, le resvératrol (R), la capsaïcine (C) et le sulforaphane (S) étaient cytotoxiques avec effet inhibiteur significativement plus élevé en combinaison (R+C), (C+S) ou (R+C+S), sans effet sur les fibroblastes. Par ailleurs, les combinaisons potentialisaient l’action autrement limitée de la gemcitabine sur les cellules testées in vitro. In vivo, l’addition de R+C au traitement par gemcitabine à dose réduite a permis une régression tumorale équivalente à celle obtenue avec la gemcitabine à pleine dose. Par ailleurs, in vitro, l’ajout des BFCs seuls et combinés à la radiothérapie augmente de façon significative la toxicité cellulaire sur la lignée épithéliale CAPAN-2, comparé au traitement par radiothérapie seule comme aux traitements par BFCs seuls ou combinés. In vivo, la combinaison R+C associée à la radiothérapie a permis une diminution significative des volumes tumoraux comparée à la radiothérapie seule. L’étude des voies de signalisation a montré une augmentation de protéines pro-apoptotiques avec l’association R+C, en rapport avec une induction augmentée de ROS, mais aussi, de façon surprenante, une inhibition de la réparation de l’ADN par inhibition de la phosphorylation d’ATM. Ces deux effets combinés précipitaient la mort des cellules tumorales. Conclusions : Les combinaisons de R+C ont un effet chimiosensibilisant et radiosensibilisant dans un modèle préclinique de PDAC, avec des mécanismes moléculaires identifiés pertinents dans le contexte des thérapies testées. En associant les BFCs, à la chimioradiothérapie avec gemcitabine, on peut espérer une double potentialisation de la radiothérapie et de la chimiothérapie, en augmentant l’efficacité de la RT, et en diminuant la dose de gemcitabine associée pour une même efficacité et une meilleure tolérance du traitement.Mots clés : Cancer du pancréas, Substances bioactives issues de l’alimentation, radiothérapie, chimiothérapie, resvératrol, capsaïcine / Background: Pancreatic ductal adenocarcinoma (PDAC) is of poor prognosis in part because of resistance to conventional treatments such as chemotherapy or radiotherapy. Some naturally occurring bioactive food components (BFCs), with pro-oxidant properties are able to potentiate the cytotoxic action of conventional drugs in the PDAC. In addition, these BFCs could increase the DNA breaks induced by ionizing radiation. Objectives: To evaluate the combined action of several BFCs in combination with chemotherapy and radiotherapy in PDAC models and to identify mechanisms involved in chemo / radiosensitization at the cellular and molecular levels. Methods: Cell survival was evaluated in vitro in the presence of BFCs in combination on 4 pancreatic tumor cell lines. The production of reactive oxygen species (ROS) was measured by flow cytometry and fluorescence microscopy. Molecular mechanisms have been decrypted by western blot (signaling pathways) and flow cytometry (cell cycle and apoptosis). Finally, we evaluated the association of BFCs in gavage with intraperitoneal gemcitabine chemotherapy and with radiotherapy (2 Gy/fraction) in vivo, on subcutaneous CAPAN-2 cell xenografts. Results: In vitro, resveratrol (R), capsaicin (C) and sulforaphane (S) were cytotoxic with significantly higher inhibitory effect in combination (R + C), (C + S) or (R + C + S), without effect on fibroblasts. In addition, the combinations potentiated the otherwise limited action of gemcitabine on cells tested in vitro. In vivo, the addition of R + C to treatment with gemcitabine at reduced dose allowed tumor inhibition equivalent to that obtained with gemcitabine at full dose. Furthermore, in vitro, the addition of BFCs alone and in combination with radiotherapy significantly increases cellular toxicity on the CAPAN-2 epithelial line, compared to radiotherapy alone and BFCs alone or combined. In vivo, the combination R + C associated with radiotherapy allowed a significant decrease in tumor volumes compared to radiotherapy alone. The study of signaling pathways showed an increase of proapoptotic proteins with the association R + C and radiotherapy, in relation with an increased induction of ROS, but also, surprisingly, an inhibition of the repair of the DNA by inhibition of ATM phosphorylation. These two combined effects precipitated the death of the tumor cells. Conclusions: Combinations of R + C have a chemosensitizing and radiosensitizing effect in a preclinical model of PDAC, with identified molecular mechanisms relevant in the context of the therapies tested. By combining BFCs with radiochemotherapy with gemcitabine, we can hope for a double potentiation of radiotherapy and chemotherapy, by increasing the effectiveness of RT, and by reducing the dose of gemcitabine associated for similar efficiency and better tolerance treatment.

In questa tesi di Dottorato, l’obiettivo era valutare l’impatto di diversi ingredienti alimentari sul metabolismo di alcuni batteri intestinali e viceversa, mediante l’applicazione di tecniche omiche. Utilizzando le tecniche di metabolomica e trascrittomica, è stata studiata la risposta all’acido linoleico del ceppo Bifidobacterium breve DSM 20213. Utilizzando un approccio combinato di metagenomica e metabolomica, è stato possibile studiare le modifiche a carico del microbiota intestinale, del profilo fenolico e degli acidi grassi, in biscotti senza glutine (a base di erba medica) durante digestione e fermentazione in vitro. Inoltre, è stato valutato come alcuni batteri potessero interferire negativamente su una terapia farmacologica a base di Diclofenac, un farmaco usato per alcune patologie intestinali. Per questo tipo di studio è stata utilizzata la spettrometria di massa ad alta risoluzione, che ha consentito di ipotizzare un coinvolgimento dell’enzima batterico β-glucuronidasi. Una sola tecnica omica, seppure di ultima generazione, non permette di valutare tutte le modificazioni del microbiota intestinale data la complessità dei fattori coinvolti. Per questa ragione, integrare più approcci omici potrebbe risultare una buona strategia per analizzare il reale impatto del microbiota sulla salute dell’ospite. Questo permetterebbe di valutare le interazioni microbiota-ospite, i principali metabolismi e le interconnessioni tra gruppi batterici coinvolti nella risposta ad uno stimolo esterno come l’assunzione di particolari ingredienti con l’alimentazione. / The aim of the present PhD thesis was to explore the metabolic response of intestinal bacteria to food components by using ‘omics’ approaches. In particular, the first part of this thesis was focused on the effect of linoleic acid on Bifidobacterium breve DSM 20213 strain. Firstly, an untargeted metabolomics-based approach was used to explore the primary changes in metabolic profile of this strain grown in presence of linoleic acid. Secondly, the gene expression of B. breve DSM 20213 induced by linoleic acid exposure was investigated. Integrated use of metabolomics/transcriptomics was applied to better understand the response mechanisms to linoleic acid stress. In the third part of the thesis, using a combination of metagenomics and metabolomics, the in vitro large intestine fermentation of gluten-free rice cookies containing alfalfa seed was investigated. In the last part of my PhD, the negative effect of β-glucuronidase producing bacteria was evaluated by means of qualitative high-resolution mass spectrometry. Based on my experience there is not a gold standard approach for evaluating a complex environment such as the gastrointestinal tract. For this reason, an integrated use of different techniques should be mandatory to have an accurate framework of gut microbiota composition, its potential metabolic network and the impact on the host physiology and health.

Diploma thesis deals with the creation and use of worksheets in the subject of Health Education. The worksheets are focused on a nutritional behavior of students in the second grade. In the theoretical part there is defined how the worksheets are created and what sort of requirements they have. The practical part contains a research conducted among pedagogues of Health education, three specific worksheets for students and three specific teachers methodology. The survey was conducted by quantitative method, where thirty teachers responded in the questionnaire to determine their view on the use of worksheets in the classroom and on the necessity of making comprehensive set of worksheets in the teaching of Health education. The worksheets are made for the students of the second degree with a focus on a nutritional behavior and methodology for teachers, how to work with the worksheets in the classroom. The worksheets contain learning tasks with a focus on food components, determinants of health and eating disorders. The practical part also includes supplementary material for teachers with information about topics that worksheets contain. KEYWORDS worksheets, Health education, nutritional behavior of students, food components, factors affecting health, eating disorders, obesity