Atualmente os gliomas representam cerca de 81% dos tumores cerebrais malignos, com aumento na incidência tanto em crianças, como em adultos acima dos 45 anos. Um número elevado de receptores neuroquinina tipo 1 (NK-1) estão expressos em células de glioma, estando a ligação da Substância P (SP) a esses receptores, envolvida no desenvolvimento e progressão desse tipo de tumor. A SP quelada ao DOTA (SP-DOTA), radiomarcada, vem sendo testada para utilização na terapia de gliomas, sendo o lutécio-177 (177Lu), devido a seu menor alcance tecidual, o radioisótopo mais indicado para tumores localizados em áreas críticas do cérebro. No entanto, estudos indicam a necessidade da adição de um excesso de metionina para prevenção da oxidação peptídica da SP-DOTA-177Lu, visando aumentar a estabilidade e a capacidade de ligação às células tumorais. Para superar esse desafio, surge a perspectiva da utilização de um novo análogo da SP, com estrutura modificada, para prevenir a oxidação peptídica. Neste contexto, o objetivo desse trabalho foi estudar a marcação de um novo análogo da SP com 177Lu e caracterizar suas propriedades in vitro e in vivo, visando a obtenção de um radiofármaco inédito e com potencial aplicação na terapia de tumores cerebrais e realizar estudos preliminares de marcação deste novo análogo com Ítrio-90 (90Y). O novo análogo foi obtido pela troca do aminoácido metionina (Met) pelo aminoácido norleucina (Nle) na posição 11 da cadeia peptídica da SP, sendo esses peptídeos denominados respectivamente SP(Met11)-DOTA e SP(Nle11)-DOTA. Após análise da oxidação peptídica dos dois peptídeos, os parâmetros da radiomarcação da SP(Nle11)-DOTA, com 177LuCl3, foram estudados para determinar a melhor condição de marcação. As estabilidades in vitro da SP(Nle11)-DOTA-177Lu sob refrigeração (2-8°C), no freezer (-20°C) e em soro humano (37°C) foram determinadas após radiomarcação com alta atividade, quanto ao uso de agentes estabilizantes e após diluição. A SP(Nle11)-DOTA também foi radiomarcada com 90Y, utilizando-se a condição padrão determinada, sendo a estabilidade in vitro da SP(Nle11)-DOTA-90Y sob refrigeração (2-8°C) e em freezer (-20°C), avaliada após radiomarcação com alta atividade e quanto a utilização de agente estabilizante. A capacidade de ligação in vitro às células tumorais (U-87 MG e M059J) e a biodistribuição in vivo em camundongos BALB/c sadios foram determinadas para a SP(Nle11)-DOTA-177Lu e comparadas à SP(Met11)-DOTA-177Lu. A ligação às proteínas plasmáticas e a biodistribuição em camundongos Nude com modelo tumoral também foram avaliadas. Os resultados obtidos na análise da oxidação peptídica comprovaram a importância da adição de excesso de metionina para prevenção da oxidação peptídica e indicaram uma alta estabilidade da SP(Nle11)-DOTA, durante e após o processo de radiomarcação. A adição de 148 MBq (4 mCi) da solução de 177LuCl3 em HCl 0,05N à 10 μg de SP(Nle11)-DOTA diluída em tampão acetato de sódio 0,4 M pH 4,5 seguida pela incubação a uma temperatura de 90ºC por 30 minutos, sob agitação de 350 rpm foi definida com condição padrão de marcação. O congelamento (-20°C), o uso de agentes estabilizantes e a diluição apresentaram-se como métodos efetivos para garantir uma alta estabilidade in vitro da SP(Nle11)-DOTA-177Lu, após a marcação com alta atividade. Bons resultados também foram observados para a marcação da SP(Nle11)-DOTA com 90YCl3 e para a estabilidade in vitro da SP(Nle11)-DOTA-90Y, após congelamento (-20°C) e quando utilizado ácido gentísico como estabilizante. A SP(Nle11)-DOTA-177Lu apresentou uma boa especificidade pelas células tumorais, principalmente pelas células de glioma humano M059J, sugerindo que a substituição do aminoácido metionina por norleucina na posição 11 não compromete a capacidade de ligação da SP(Nle11) às células tumorais. Uma baixa porcentagem de ligação às proteínas plasmáticas e um rápido clareamento sanguíneo foram observados para a SP(Nle11)-DOTA-177Lu, sendo esse radiofármaco eliminado preferencialmente por via renal. A SP(Nle11)-DOTA-177Lu apresentou uma boa estabilidade in vivo e se mostrou incapaz de atravessar a barreira hematoencefálica, sendo seu uso indicado por injeção intratumoral ou intracavitária. O estudo de biodistribuição em animais com modelo tumoral, mostrou que esse radiofármaco se liga às células tumorais por ligações receptor específicas. Com base nesse dados conclui-se que a SP(Nle11)-DOTA-177Lu, apresenta-se como um radiofármaco inédito que devido às suas propriedades in vitro e in vivo favoráveis, apresenta potencial aplicação na terapia de tumores cerebrais, representando uma nova possibilidade dentro do limitado arsenal terapêutico para esse tipo de tumor. / Currently gliomas represent about 81% of malignant brain tumors with increased incidence in children and in adults over 45 years. A large number of type 1 neurokinin receptor (NK-1) are expressed in glioma cells, being the binding of substance P (SP) to these receptors, involved in the development and progression of this tumor type. The SP conjugated at DOTA chelator (SP-DOTA), radiolabeled, have been tested for use in the treatment of gliomas, and the lutetium-177 (177 Lu), due to its lower tissue range, has been the most suitable radioisotope for tumors located in critical areas brain. However, studies indicate the necessity of adding an excess of methionine to prevent the peptide SP-DOTA-177Lu oxidation in order to increase the stability and capacity to bind to tumor cells. To overcome this challenge, there is the prospect of using a new analog of SP with a modified structure, to prevent peptide oxidation. In this context, the aim of this work was study the labeling of a new analog of SP with 177Lu and characterize their properties in vitro and in vivo, in order to obtain a novel radiopharmaceutical with potential application in brain tumor therapy, and perform preliminary studies labeling of this new analog with yttrium-90 (90Y). The new analog was obtained by replacement of the amino acid methionine (Met) by the amino acid norleucine (Nle) at position 11 of the peptide chain of SP, and these peptides were called SP(Met11)-DOTA and SP(Nle11)-DOTA respectively. After analysis of the oxidation for the two peptides, the radiolabeling parameters of the SP(Nle11)-DOTA with 177LuCl3 were studied to determine the best labeling condition. The SP(Nle11)-DOTA was also radiolabeled with 90Y, using standard condition, and the stability in vitro of the SP(Nle11)-DOTA-90Y assessed under refrigeration (2-8 °C) and under freezing (-20° C), after radiolabeling with high activity and use of stabilizing agent. The stabilities in vitro of the SP (Nle11)-DOTA-177Lu under refrigeration (2-8 °C), under freezing (-20 °C) and in human serum (37 °C) were determined after radiolabeling with high activity, with use of stabilizing agents and after dilution. The ability of in vitro binding to tumor cells (U-87 MG and M059J) and the biodistribution in vivo in healthy BALB/c mice were determined for the 177Lu-DOTA-SP(Nle11) and compared to 177Lu-DOTA-SP(Met11). The plasma protein binding and biodistribution in Nude mice with tumor model were also evaluated. The results obtained from analysis of oxidation for the two peptides confirmed the importance of adding excess methionine to prevent peptide oxidation and indicated a high stability of the DOTA- SP(Nle11), during and after the radiolabeling process. The addition of 148 MBq (4 mCi) of 177LuCl3 solution in 0.05N HCl at 10 μg DOTA-SP(Nle11) diluted in 0.4 M sodium acetate buffer pH 4.5 followed by incubation at a temperature of 90 °C for 30 minutes under constant agitation to 350 rpm was defined as standard labeling condition. The freezing (-20 °C), the use of stabilizing agents and the dilution were presented as effective methods to ensure high stability in vitro 177Lu-DOTA-SP(Nle11), after labeling with high activity. Good results were also observed for labeling DOTA-SP(Nle11) with 90YCl3 and for stability in vitro of the 90Y-DOTA-SP(Nle11) after freezing (-20 °C) and when gentisic acid was used as a stabilizer. The 177Lu-DOTA-SP(Nle11) showed good specificity to tumor cells, particularly human glioma cells (M059J), suggesting that substitution of the amino acid norleucine for methionine at position 11 does not compromise the capacity of SP(Nle11) binding to tumor cells. A low percentage of plasma protein binding and rapid blood clearance were observed for the 177Lu-DOTA-SP(Nle11), being this radiopharmaceutical preferably eliminated by the kidney. The 177Lu-DOTA-SP(Nle11) showed good stability in vivo and inability to cross the blood brain barrier, being its use indicated through intratumoral or intracavitary injection. The biodistribution studies in animals with tumor model showed that the radiopharmaceutical binds to the tumor cells by specific receptor binding. Based on this data was concluded that the 177Lu-DOTA-SP(Nle11), can be presented as a novel radiopharmaceutical that due to its favorable properties in vitro and in vivo, presents a potential application in the therapy of brain tumors, representing a new possibility within the limited therapeutic options for this type of tumor.

Les gliomes diffus de bas grades sont des tumeurs qui affectent des régions fonctionnelles du cerveau chez des jeunes patients. Malgré leur faible taux de prolifération ces tumeurs peuvent dégénérer en des tumeurs plus agressives après leurs exérèses. Le gène IDH1 est très fréquemment muté dans les DLGG. Cette mutation confère à l’enzyme isocitratedeshydrogénase (IDH1) la propriété de produire du 2-OH-glutarate (2-HG) au lieu de l’α-cétoglutarate (α-KG). L’oncométabolite 2HG rentre alors en compétition avec l’α-KG pour les enzymes de déméthylation conduisant à une hyperméthylation de l’ADN et de l’histone H3 concourant à un blocage de la différenciation cellulaire. Mon projet de thèse consiste à la caractérisation des cellules tumorales et la compréhension des voies de signalisation impliquées dans la progression tumorale ainsi que l’identité du microenvironnement tumoral. Les récepteurs tyrosine kinase, PDGFRα et EGFR, sont abondamment exprimés par les cellules tumorales mais ne sont pas activés. En revanche, une forte phosphorylation de la protéine Erk p42/44 a été détectée dans les tumeurs. Cette phosphorylation a une double origine : les cellules tumorales et leur environnement. L’utilisation d’une série de marqueurs m’a permis de mieux définir l’état de différenciation des cellules tumorales et de mettre en évidence une préférence pour l’expression de Sox8 dans les oligodendrogliomes tandis que Sox9 est prédominant dans les astrocytomes. Dans une seconde partie, j’ai mis au point des méthodes pour la culture des gliomes diffus de bas grade et isolé cinq lignées de gliomes portant la mutation récurente IDH1 R132H. Récemment, la société Agios a identifié des inhibiteurs très spécifiques (notamment l’AGI-5198) de l’enzyme mutée IDH1 qui, utilisés dans un modèle de gliome murin, provoquent une déméthylation des histones H3K9me3 associées à une augmentation de l’expression de gènes de différenciation ainsi qu’à une réduction de la masse tumorale. A contrario, j’ai montré que l’AGI-5198 augmente la croissance cellulaire sur les lignée de patients, modifie la migration cellulaire ainsi que différentes voies de signalisation.Ces travaux apportent un nouvel éclairage sur le phénotype des cellules tumorales, leur diversité et les mécanismes moléculaires régissant leur prolifération. / Low grade gliomas are low proliferating tumors affecting functional regions of young patients. In most cases, they tend to transform into a more malignant state following surgery. These tumors carry a key mutation in isocitrate dehydrogenase (70-80% of DLGG). Gliomas with IDH1 mutation have improved prognosis compared togliomaswith wild type IDH1. IDH1 protein acquires the ability to convert α-Ketoglutarate (α-KG) to 2-OH-glutarate (2-HG). The new onco-metabolite can interfere with the normal function of α-KG, leading to a general hypermethylation of the genome, thus inducing a blockage of the cellular differentiation. Very good reviews on the molecular mechanisms underlying high grade glioma invasion already exist but little is known about the cellular and molecular mechanisms in diffuse low grade gliomas. To that end, I characterized the profile of IDH1 mutated cells in the different types of DLGG. I have demonstrated that the tyrosine kinase, PDGFRα and EGFR receptors are abundantly expressed by tumor cells eventhough they are not activated. In contrast, a strong phosphorylation of Erk p42 / 44 proteins was detected in these tumors. This phosphorylation has a dual origin: tumor cells and their environment. The use of a series of markers allowed me to better define the state of differentiation of cancerous cells and to demonstrate a preferential expression of Sox8 in oligodendrogliomas while Sox9 is predominant in astrocytomas. In a second time, I have developed a method for the culture of low-grade diffuse gliomas and isolated five cell lines carrying the recurrent mutation IDH1 R132H. Recently Agios has identified very specific inhibitors (particularly AGI-5198) of the mutated IDH1 enzyme which, used in a murine glioma model, contributed to the demethylation of H3K9me3 histones with an increased expression of differentiation related genes as well as a reduction of the tumor mass. On the contrary, I have shown that AGI-5198 increases cell growth of patient cell lines, modifies the cellular migration and various signaling pathways.These studies shed new light on the phenotype of tumor cells, their diversity and The molecular mechanisms governing their proliferation.

Les gliomes sont les tumeurs primitives les plus fréquentes du cerveau et restent de mauvais pronostic en raison de l’inefficacité des traitements actuels. Des cellules souches cancéreuses ont été isolées à partir de gliomes de haut grade de l’adulte. Ces cellules souches de gliomes (GSC) peuvent fournir tous les sous-types cellulaires qui composent la tumeur. De nombreuses données indiquent que la résistance aux traitements est due en grande partie aux GSC. Cibler les GSC et leurs propriétés souches constitue donc un enjeu thérapeutique important. [...] Une solution pertinente de ciblage thérapeutique est de forcer les GSC à quitter leur état souche. Dans ce cadre, mes principaux travaux ont eu pour but de caractériser les changements épigénétiques des marques d’histones qui accompagnent la répression des propriétés des GSC par un groupe de micro-ARN, miR-302-367. [...] L’étude de cette plasticité par notre équipe a abouti à l’identification de miR-302-367. Son expression forcée, à l’aide de lentivirus, bloque de façon irréversible les propriétés souches et initiatrices de tumeur des GSC. L’effet suppresseur de tumeur exercé par miR offre la possibilité d’identifier les mécanismes qui régulent le maintien ou la perte des propriétés des GSC. A l’aide d’un modèle formé par une lignée de GSC et de sa contrepartie dépourvue des propriétés souches et tumorigènes GSC-miR-302-367, je me suis attachée à caractériser les méthylations de l’histone H3, qui font parties du code d’histone associé à une transcription génique respectivement active ou réprimée. Je me suis axée sur la triméthylation de la lysine 4 (H3K4me3) et de la lysine 27 (H3K27me3), respectivement permissive et répressive de la transcription. Une analyse par ChIP-seq (Immunoprécipitation de la chromatine-séquençage) des gènes associés à ces marques a été associée à la caractérisation des transcriptomes des cellules par exon-array. Nos résultats montrent que l’expression du groupe de miR-302-367 ne modifie pas de façon globale les taux des marques H3K4me3 et H3K27me3. Par contre, des changements dans des groupes de gènes circonscrits ont pu être identifiés. La corrélation positive observée entre les marques d’histones et les taux d’expression des gènes montre une conservation du code d’histone dans les cellules cancéreuses, au moins pour les marques étudiées. L’analyse des termes GO (Gene Ontology) indique que la perte des propriétés induites par miR-302-367 s’accompagne d’un engagement de GSC dans une voie de différenciation. Les gènes portant la marque répressive dans les GSC-miR-302-367 participent notamment à des catégories fonctionnelles associées à l’expression de propriétés souches et tumorigènes. L’analyse du groupe de gènes portant une marque permissive dans les GSC et répressive dans les GSC-miR-302-367, a révélé un réseau de facteurs de transcription susceptible de participer au contrôle des propriétés souches des GSC. La répression à l’aide de siRNA d’un des membres de ce réseau, le facteur de transcription ARNT2, nous a permis de révéler son rôle dans le maintien des capacités prolifératives des GSC issues de gliomes distincts et dans l’expression du facteur de transcription Nanog, connu pour son rôle central dans le contrôle des propriétés souches des GSC. Nos résultats montrent que l’analyse des changements de marques d’histone offre donc non seulement une vue d’ensemble des différents réseaux moléculaires associés au maintien ou au contraire à la répression des propriétés des GSC, mais permet d’identifier de nouveaux acteurs. L’effet stimulateur d’ARNT2 sur la croissance cellulaire et l’expression de Nanog, dans des GSC dérivées de gliomes différents aux altérations génomiques distinctes, indique que ce facteur de transcription tient une place centrale, insoupçonnée jusqu’à présent, dans la hiérarchie des gènes qui gouvernent les propriétés des GSC. / Gliomas, the most frequent primary brain tumors, are resistant to current therapies and the survival rate of patients is very low. Within high-grade gliomas, a cell sub-population bearing stem-like properties has been isolated. These cells, called glioma stem cell (GSC), are capable of generating all glioma cellular sub-types. Recent data indicates that resistance of these aggressive tumors to therapies is mostly due to GSCs. Thus, targeting the GSCs and their stem-like properties is imperative in order to improve current therapies. [...] Another effective solution to treat GSCs is to force them to lose their stem-like properties. In this context, the aims of my major project were to characterize the epigenetic modifications of histone marks accompanying the loss of GSC stem-like properties under the influence of a cluster of micro-RNA, miR-302-367. GSCs are endowed with an exceptional plasticity, allowing them to gain or lose their stem-like state in response to modifications in their micro-environment. Our results identified the implication of miR-302-367 in the regulation of GSC plasticity. Its stable expression using lentivirus inhibits in an irreversible manner the stem-like and tumorigenic properties of GSC. The tumor-suppressor effect of this miR offers the possibility to decipher the mechanisms responsible for the maintenance or the loss of GSC stem-like properties. Using the model of GSC and their counterparts, GSC-miR-302-367, who lost their stem-like and tumorigenic properties, my aim was to identify the methylation status of histone H3 of the histone code which is known to be associated either to an active or to a repressive gene transcription. I focused on the trimethylation of lysine 4 (H3K4me3) and lysine 27 (H3K27me3), which are associated with an activation or repression of gene transcription, respectively. We performed a ChIP-seq (Chromatin-immunoprecipitation-sequencing) analysis of the respective associated genes followed by a transcriptomic (exon-array) analysis of both cell lines. Our results show that miR-302-367 expression does not alter in a global manner the expression levels of H3K4me3 and H3K27me3. On the contrary, we were able to detect modifications in a discrete group of genes. At least for the studied marks, the positive correlation between the identified histone marks and the gene expression levels indicates that the histone code is well preserved in cancer. GO (Gene Ontology) analysis indicates that miR-302-367-induced loss of stem-like properties is accompanied with activation of the differentiation process in GSC. Genes implicated in the regulation of stem-like and tumorigenic properties were found to bear the repressive histone mark in GSC-miR-302-367. From our analysis of the group of genes bearing the active histone mark in GSC and the repressive one in GSC-miR-302-367, emerged a network of transcription factors that could possibly participate in the regulation of GSC stem-like properties. Down-regulation using siRNA of a member of this network, namely ARNT2, highlighted its role in the maintenance of the proliferative dynamic, as well as the expression of the transcription factor Nanog (a major regulator of GSC stem-like properties), in GSC derived from distinct gliomas. Our histone mark modification analysis, not only elucidated the molecular pathways implicated in the maintenance or, on the contrary, in the loss of GSC stem-like properties, but also, highlighted the implication of new actors in these processes. The activator effect of ARNT2 on GSC proliferation, as well as on the expression of Nanog, observed in GSC bearing distinct genetic alterations and derived from different glioma, indicates that this transcription factor plays a major role, not documented thus far, in the regulation of GSC stem-like properties.

Localized drug delivery systems have been widely studied as potential replacements for conventional chemotherapy with the capability of providing sustained and controlled drug release in specific targeted sites. They offer numerous benefits over conventional chemotherapy such as enhancing the stability of embedded drugs and preserving their anticancer activity, providing sustained and controlled drug release in the tumor site, reducing toxicity and diminishing subsequent side effects, minimizing the drug loss, averting the need for frequent administrations, and minimizing the cost of therapy. The aim of this study is to develop a localized drug delivery system with niosomes embedded in a chitosan hydrogel with targeting capabilities. The incorporation of niosomes into a chitosan hydrogel has several advantages over each individually being used. First, embedding niosomes in a chitosan hydrogel can yield control over drug release especially for small molecule drugs. Second, chitosan hydrogel may improve the release time and dosage of drugs from niosomes by protecting them with an extra barrier, resulting in tunable release rates. Third, as a localized delivery system, chitosan hydrogels can prevent the migration of niosomes away from the targeted tumor sites. Finally, chitosan has mucoadhesive property which can be used in the targeting of the tumor cells with the mucin over expression. To enhance the specific targeting, the capacity of chitosan to target MUC1 overexpression in cancer cells will be analyzed. Similarly, the incorporation of chlorotoxin in this system will be achieved and evaluated. Chlorotoxin, a 36-amino acid peptide, is purified from Leiurus quinquestriatus scorpion venom with a distinct characteristic of binding preferentially to neuroectoderma tumors such as glioma, but not to normal tissue. The overexpression of MUC1, a mucin antigen, in certain cancer cells has been used as an attractive therapeutic target in the design of a drug delivery system consisting of chitosan with a distinct mucoadhesive property. To determine the level of MUC1expression in different cell lines, Cell based Enzyme Linked Immunosorbent Assay (Cell ELISA) was developed for the first time. Attenuated Total Reflectance- Fourier Transform Infra-Red (ATR-FTIR) Spectroscopy is used to investigate the possible molecular interaction between chlorotoxin and glioma cells. This study presents a new approach in monitoring the biochemical and biophysical changes in glioma cells after being exposed to CTX. In addition to characterizing the signature spectra of CTX and glioma cells, we evaluated the differences in biochemical compositions of the spectra of the glioma cells treated with and without CTX over different incubation time periods. The results indicate that the proposed localized drug delivery system with the distinct tumor targeting features and extended release profiles would tune and control the specific delivery of chemotherapeutics in tumor sites.

Glioblastoma Multiforme (GBM) is a primary malignant brain cancer, affecting children and adults and has a very poor prognosis. Up to 30% of the tumour mass consists of host derived immune cells, and a better understanding of how these cells affect tumour behaviour is required. These cells, called ‘Tumour Associated Macrophages’ (TAM) have been shown to occur in peripheral solid organ cancers, where they can cause local immune suppression, increase invasiveness and aid tumour growth. In the brain however, TAMs can consist of centrally derived microglia and peripherally derived macrophages, and although these cells could be exerting different effects on the tumour, there is currently no reliable way of distinguishing between the two. Cancer Stem Cells (CSC) are a subpopulation of cells within the tumour mass with stem-like features, are capable of self-renewal, and can recapitulate a tumour in an immunocompromised mouse host. It is thought that these cells play a role in disease recurrence and hence represent a potential target for anti-GBM therapies. In the first project we investigate the interaction between Cancer Stem Cells and TAMs. We first describe a method of culturing CSCs and TAMs from a single human patient sample, followed by an investigation into the functional properties of these cell types. We found functional differences between established cell line pairings of U87-MG and CHME3 versus primary patient derived CSCs and TAM cell line pairings. Polarisation of microglia/TAMs with lipopolysaccharide caused significant decrease in proliferative capacity of the GBM cell lines. Next we used a Non-Myeloablative Conditioning System (NMCS) to selectively replace the peripheral bone marrow compartment of wild type animals with labelled bone marrow cells, without disturbing brain homeostasis. We demonstrate that peripheral cells home exclusively to the orthotopically implanted tumour, and that some of these cells are CD11b+ and Gr1+, suggestive of myeloid derived suppressor cells (MDSC). We evaluate current CD45 based gating strategies for distinguishing peripheral and central cells and show them to be inadequate. Finally we compared the chemosensitivity profiles of different patient derived CSC lines using high throughput content screening (HTCS), against currently approved chemotherapeutic drugs and rank these drugs in a response space, based on HTCS parameters including 2D and 3D culture with and without irradiation. Differential chemosensitivities were noted between different patient derived cell lines. Drugs not currently used in the treatment of GBM such as Actinomycin D and Mitoxantrone were also identified using HTCS, suggesting the potential utility of such an approach to personalised treatments in GBM.

Background: A compilation of high quality systematic reviews (SRs) on lifestyle factors associated with adult glioma and meningioma was developed. Methods and Materials: Phase 1 consisted of a systematic overview of existing SRs. For Phase 2, high quality SRs were incorporated in an update. Moderate or low quality SRs which had not been considered in a high quality review were eligible for a de-novo synthesis. Results: Phase 1 resulted in seven moderate to low quality reviews. From this, in Phase 2, smoking, mobile phone and hair dye use were subjected to de-novo reviews. For smoking, it was suggestive that past smokers had an increased risk. For mobile phone use, there was no overall association, however it was suggestive that ipsilateral and high cumulative call time were associated with slight increased risk. No association was observed for personal hair dye use. Conclusions: Despite these null associations, rigorous SR methods were used providing confidence in conveying these results.

Glioblastome représente la tumeur la plus courante du cerveau primaire avec une survie de moins de 2 ans. Ces tumeurs sont très infiltrantes et angiogéniques et contiennent une sous population de cellules souches cancéreuses. Nkx2.2 est un homéodomaine facteur de transcription, impliqué dans la formation d'oligodendrocytes au cours du développement. Nkx2.2 joue un rôle central dans la tumorogenèse de Ewing'sarcoma. L'utilisation de la QPCR et de la matrice du tissu de gliome, nous a permis de mettre en évidence la forte expression de Nkx2 dans le glioblastome. Nkx2.2 a également été détecté dans 3 cultures de cellules de gliomes où il est co-exprimé avec des marqueurs de cellules souches tels que CD133 et CD15. Il a été récemment proposé que la surexpression de Nkx2.2 pourrait induire à la différenciation oligodendrocytaire de la cellule du gliome tige-comme et au blocage de la formation des tumeurs dans la xénotransplantation (Cancer Res fév 2011 1; 71 (3): 1135-1145). Pour explorer cette possibilité, nous avons utilisé des rétrovirus pour surexprimer Nkx2.2 dans nos cultures cellulaires. De manière surprenante, nous avons trouvé que Nkx2.2, induit la prolifération des cellules souches du gliome et n'a en conséquent aucun effet de différenciation. Microarray analyses a confirmé que la surexpression de Nkx2.2 n'a en effet aucune influence sur la différenciation des oligodendrocytes. Cette analyse a également révélé que Nkx2.2 était capable d'induire une forte expression de YKL-40 40 dans le surnageant des cellules souches du gliome. YKL-40 est en fait, une glycoprotéine sécrétée et impliquée dans l'inflammation, l'angiogenèse et la prolifération. Elle est souvent associée à un mauvais pronostic dans plusieurs types de cancers. En outre, nous avons effectué une transplantation orthotopique afin d'explorer le rôle de Nkx2.2 dans la gliomagenèse in vivo et avons constaté que Nkx2.2 ne réduit pas l'agressivité du glioblastome.Dans l'autre partie de ma thèse, nous avons utilisé la gamme Taqman à basse densité et la validation des miRNA par la Qpcr afin de chercher ces derniers dans la culture cellulaire du glioblastome humain. Nous avons ensuite étudié le rôle des miARN dans la transcription de 3'UTR de Nkx2.2. Les résultats d'analyse de la mutagénèse dirigée (SDM) et de la double-luciférase ont montré que l'expression de Nkx2.2 est régulée par la diminution de mir-133b ainsi que celle de mir-202. / Glioblastoma represent the most common primary brain tumor with an overall survival of less than 2 years. These tumors are highly infiltrative and angiogenic and contain a sub population of cancer stem cells. Nkx2.2 is a homeodomain transcription factor which is implicated in the formation of oligodendrocytes during development. Nkx2.2 is central in tumorogenesis of Ewing'sarcoma. Using QPCR and glioma tissue array, we found that Nkx2.2 is highly expressed in glioblastoma. Nkx2.2 was also detected in 3 glioma stem-like cell cultures (neurospheres) where it is co-expressed with stem cell markers such as CD133 and CD15. It was recently proposed that overexpression of Nkx2.2 could induce terminal oligodendrocytic differentiation of glioma stem-like cell and inhibit tumor formation in xenotransplantation (Cancer Res. 2011 Feb 1;71(3):1135-45).To explore this possibility further, we used retroviruses to overexpress Nkx2.2 in our cell cultures. Surprisingly, we found that Nkx2.2, induce glioma stem cell proliferation and had no oligodendrocyte differentiating effect. Microarray analyses confirmed that Nkx2.2 overexpression had no influence in oligodendrocyte differentiation. This analysis further revealed that Nkx2.2 was able to induce a strong expression of YKL40 protein in the supernatant of glioma stem cells and increase YKL-40 promoter activity. YKL-40 is a secreted glycoprotein which is involved in inflammation, angiogenesis and proliferation and which is often associated with a bad prognosis in several cancers. In addition, we performed orthotopic transplantation to explore the role of Nkx2.2 in gliomagenesis in vivo and found that Nkx2.2 did not reduce the aggressiveness of glioblastoma. In the other part of my thesis we used Taqman low-density arrays (TLDA) and individual miRNA QPCR validation to find the microRNA (miRNA) signature in human glioblastoma cell cultures. Then we investigated the role of miRNA in the 3'UTR of Nkx2.2 transcript. Site directed mutagenesis (SDM) and dual-Luciferase reporter assay results showed that the Nkx2.2 expression is downregulated by mir-133b and mir-202.

Les gliomes ont des conséquences dévastatrices. La morbidité et la mortalité sont élevées. Les gliomes représentent un groupe hétérogène complexe d'entités pathologiques et aucune cause n'a été identifiée pour la majorité des gliomes. Les données épidémiologiques varient d'une étude à l'autre. Le nombre de chaque sous-type histologique est trop petit, même pour un grand centre de neurochirurgie, pour permettre une bonne recherche sur chaque sous-type de gliome. Les spécificités oncologiques et cliniques (épilepsie, troubles cognitifs, troubles moteurs, etc.) nécessitent une prise en charge et une analyse spécifique. De plus, il est important de recueillir et d'enregistrer tous les nouveaux cas et le suivi sur une grande région ou un pays entier pour permettre des études fondamentales et cliniques de qualité. En effet, les études en population sont la seule façon de connaitre l'impact en pratique des différentes thérapeutiques effectuées. Les sociétés françaises impliquées en neuro-oncologie (Société Française de Neurochirurgie, Société Française de Neuropathologie, Association des Neuro-Oncologues d'Expression Française) ont récemment créé le Recensement national histologique des tumeurs primitives du système nerveux central (RnhTPSNC) ou French Brain Tumor DataBase (FBTDB) en anglais. L'objectif principal du RnhTPSNC est d'enregistrer de manière prospective tous les cas incidents de tumeur primitive du système nerveux central (TPSNC), en France, pour lesquels le diagnostic histologique est confirmé (1-3). Les objectifs à long terme du RnhTPSNC sont de créer un registre histologique et un réseau national pour : (1) réaliser des études épidémiologiques, (2) mettre en place une base de données pour favoriser toute étude clinique ou fondamentale à grande échelle, (3) permettre l'évaluation des pratiques médicales d'une région ou du pays tout entier, (4) harmoniser et optimiser la prise en charge médicale des patients atteints de TPSNC. La présente étudiante en thèse, Sonia Zouaoui, concentrera son travail sur les gliomes. D'abord, elle devra recueillir les données des patients, puis analyser les facteurs pronostiques, la survie et les prises en charges oncologiques. Deuxièmement, elle participera à l'étude de la répartition géographique des principaux types de gliomes et à la recherche de facteurs de causaux. Troisièmement, elle procédera à un inventaire du matériel cryopréservé disponible pour la réalisation d'études translationnelles. / Gliomas have devastating consequences. Morbidity and mortality are high. Gliomas represent a complex heterogeneous group of pathologic entities and no underlying cause has been identified for the majority of them. Epidemiologic data vary from study to study. The number of each histological subtype is too small, even for a big neurosurgical center, to allow a good research on each subtype of glioma. Oncological and clinical specificities (epilepsy, cognitive disorders, motor impairments, etc) require a specific care and analysis. Indeed, we need to collect and record all new cases and follow up in large area, to allow good basic and clinical studies. Furthermore, population study is the only way to know what clinicians do to the patients, and make possible evaluating the medical care. The French societies involved in Neuro-Oncology (Société Française de Neurochirurgie, Société Française de Neuropathologie, Association des Neuro-Oncologues d'Expression Française) have recently created the French Brain Tumor DataBase (FBTDB). The main objective of the FBTDB is to prospectively record all primary central nervous system tumors (PCNST), in France, for which histological diagnosis is available (1-3). The long-term goals of the FBTDB are to create a histological national registry and a national network to (1) perform epidemiological studies, (2) implement a new database and use it for setting up both clinical and basic research protocols, (3) allow the evaluation of the medical practices of an area or of the entire country, and (4) harmonize the healthcare of patients affected by PCNST at the higher level. The present PhD student, Sonia Zouaoui, will focus her work on gliomas. First, she will collect data, and will analyze prognostic factors, survival and oncological patterns of care for patients with newly diagnosed glioma in France. Secondly, she will participate in the study of geographical distribution of the main types of glioma and in search of causal factors. Thirdly, she will conduct an inventory of cryopreserved material available for translational research.

O glioblastoma multiforme (GBM) é uma neoplasia do sistema nervoso central (SNC), caracterizada por uma elevada capacidade proliferativa e migratória. O desenvolvimento do tumor provoca uma remodelação da matriz extracelular (MEC) que facilita a migração tumoral. Eicosanóides são moléculas lipídicas importantes na carcinogênese e a sua síntese está correlacionada com o grau de desenvolvimento do tumor. As prostaglandinas são eicosanóides envolvidas na estimulação da angiogênese, na adesão celular e proliferação celular. Este estudo tem por objetivo avaliar in vitro o efeito da PGE2 na expressão moléculas da MEC e das moléculas de adesão envolvidas na migração, em células U87MG e U251MG. As células U251MG e U87MG foram tratadas com PGE2 (10µM) e Ibuprofeno (25µM), por um período 48hs. As proteínas da MEC foram analisadas por RT-qPCR após o tratamento. Foram realizadas reações de imunohistoquímica para as moléculas da MEC. As alterações foram encontradas na expressão de laminina, fibronectina, colágeno tipo IV e as integrinas αv , α3 e α5 para células U87MG . Observamos imunomarcação nas linhas celulares para colágeno tipo IV, laminina e fibronectina. Concluímos que o tratamento com IBU e PGE2, afeta a expressão gênica de moléculas de MEC. / Glioblastoma Multiforme (GBM) is a neoplasm of the central nervous system (CNS), characterized by a high proliferative and migratory capacity. Tumor development leads to extracellular matrix (ECM) remodeling and facilitating the migration of these cells. Eicosanoids are important lipid molecules in carcinogenesis, and their synthesis often correlates with the degree of tumor development. Prostaglandins are eicosanoids involved in the stimulation of angiogenesis, cell adhesion and cell proliferation. This study is aimed to evaluate the expression of several ECM molecules involved in migration after altering the concentration of prostaglandins, using human glioma cell lines as an in vitro model. The cell lines U87MG and U251MG were treated with PGE2 (10µM) and Ibuprofen (25µM), for a predetermined period of 48hs. Proteins involved in extracellular matrix were analyzed by RT-qPCR after treatment in vitro. Immunohistochemical reactions were also performed for the ECM molecules. Changes were found in the expression of laminin, fibronectin, type IV collagen and αv, α3 and α5 integrins in cells U87MG. We observed immunostaining in cell lines to type IV collagen, laminin and fibronectin. In conclusion, Ibuprofen and PGE2, affects gene expression of ECM molecules.

Os hormônios glicocorticóides (GCs) têm sido amplamente empregados como agentes antiinflamatórios e anti-tumorais. Sua ação ocorre via receptores nucleares (GR) sendo dependente da remodelação da estrutura da cromatina. As proteínas Brm e BRG1, componentes essenciais de um complexo regulador global da transcrição (SWI/SNF), por remodelamento da cromatina, exercem um papel-chave na ação de GR. Para estudar o mecanismo de ação de GCs, foram utilizadas as linhagens celulares ST1 e P7, derivadas da linhagem celular C6, de glioma de rato. P7 é insensível ao tratamento com GC, enquanto ST1 apresenta reversão fenotípica tumoral→normal, gerando um bloqueio específico na fase G1. Um anti-soro policlonal específico para Brm e BRG1, foi gerado através da inoculaçâo de coelha com a proteína hBRG1 recombinante. Este antisoro foi utilizado para análisar os níveis destas proteínas nas duas linhagens celulares, sob ação de GC. Enquanto em ST1, Brm é induzida por GC, em células P7, o nível basal de Brm é relativamente alto, mantendo-se inalterado na presença de GC. A possíbilidade de existirem mutações no gene brm de células P7, foi investigada através de amplificação do DNA, por PCR, e seqüenciamento. A superexpressão de brm e BRG1 em células P7 mostrou que clones isolados apresentavam, de um modo geral, achatamento celular, diminuição da taxa de crescimento e da eficiência de plaqueamento em substrato sólido e semi-sólido. Alguns destes clones passaram a responder ao tratamento com GC, porém não tão drasticamente como as células ST1. Co-imunonoprecipitação mostrou algumas diferenças entre os complexos SWI/SNF de células ST1 e P7. / Glucocorticoid hormones (GCs) have been used as anti-inflammatory and anti-tumor agents, acting via nuclear receptors (GR) and being dependent on remodeling of the chromatin structure. As components of the global chromatin remodeling transcription complex (SWI/SNF), Brm and BRG-1 proteins play a key role in the action of GR. In order to study the mechanisms of action of GCs, we have been using the ST1 and P7 cell lines, derived from the C6, a rat glioma cell line. P7 is insensitive to the GC treatment, while ST1 displays a complete phenotypic reversion from tumoral to normal, including a G1-specific block in the cell cycle. A Brm and BRG1-specific polyclonal antiserum was generated, in rabbit, using recombinant hBRG1 protein as antigen. This antiserum was used to analyze the levels of Brm and BRG1 in these two cell lines, under GC treatment. While Brm is induced by GC, in ST1 cells, the basal level of Brm, in P7 cells, is relatively high, remaining unchanged under GC treatment. The possibility of brm mutations occurring in the P7 cells, was analyzed by DNA sequencing. Overexpression of brm and BRG1 in P7 cells led to morphological alterations (cell flattening) and decreased colony formation in agarose suspension and in solid substrate. Some of these clones became partially responsive to GC, when compared to the ST1 cell line. Co-immunoprecipitation assays revealed some differences in the SWI/SNF complex between ST1 and P7 cells.