La P-glycoprotéine (P-gp) est une protéine transmembranaire de la famille des ATP binding cassette transporteurs. Elle est impliquée dans l’efflux du milieu intracellulaire vers le milieu extracellulaire d’une grande variété de médicaments anticancéreux. Elle peut être responsable de la diminution de la biodisponibilité orale et de la concentration intra-tumorale des médicaments qui en sont substrats. Elle peut notamment être surexprimée par les cellules cancéreuses des adénocarcinomes du colon naïfs de tout traitement, suggérant une résistance naturelle de cette tumeur et également après une chimiothérapie. Notre premier travail in vivo a documenté le caractère substrat de la P-gp de l’evérolimus, inhibiteur de mTOR indiqué dans divers cancers (rein, tumeurs neuroendocrines d’oringine pancréatique et sein), jusqu’à maintenant uniquement étudié dans des modèles in vitro. Une augmentation significative de l’AUC de l’evérolimus administré par voie orale est observée chez des souris mdr1a-/b- comparées à des souris mdr1a+/1b+. Une amélioration significative de la biodisponibilité orale de l’evérolimus est aussi notée chez des souris prétraitées par le lapatinib (Tyverb®), inhibiteur des tyrosines kinases (EGFR et HER2) indiqué dans le cancer du sein, par rapport aux souris ayant reçu l’evérolimus seul. Ce résultat est accompagné d’une inhibition de l’expression de la P-gp intestinale par le lapatinib mesurée par la technique de Western Blot. Enfin, une étude préclinique menée chez des souris porteuses d’une xénogreffe colorectale mutée KRAS montre une activité anti-tumorale certaine des deux médicaments utilisés seuls et en schéma séquentiel. Notre seconde étude a montré pour la première fois que le cétuximab (Erbitux®), anticorps anti-EGFR, inhibe la fonctionnalité de la P-gp dans deux lignées cellulaires surexprimant la P-gp (les cellules IGROV-1 et les HEK P-gp) indépendamment de leur statut EGFR et entraîne chez des souris porteuses d’une xénogreffe colorectale une augmentation significative de la biodisponibilité orale et de la concentration intra-tumorale du SN-38, métabolite actif de l’irinotécan (Campto®) administré par voie orale. Le cétuximab étant prescrit en association avec l’irinotécan chez des patients atteints d’un cancer colorectal métastasé, initialement réfractaire à l’irinotécan, ces résultats pourraient en partie expliquer la réversion de la résistance à l’irinotécan par le cétuximab par une inhibition de l’efflux de la P-gp. Grâce à l’étude de deux associations de médicaments «lapatinib-evérolimus» et «cétuximab-irinotécan», nous avons démontré l’intérêt de l’étude de l’inhibition de la P-gp avec les traitements les plus récents, notamment son rôle dans l’amélioration de la biodisponibilité orale de chimiothérapies utilisées par voie orale. / P-glycoprotein (P-gp) is a membrane transporter and belongs to the ATP-binding cassette (ABC) transporter super family. P-gp decreases oral bioavailability of substrate drugs and can cause multidrug resistance in tumor cells by decreasing intracellular drug levels. P-gp is overexpressed in colorectal carcinoma naturally resistant to chemotherapy. The aim of our first study was to document the in vivo transport of everolimus (Afinitor®), a mTOR inhibitor, by P-gp. A significant increase of everolimus oral bioavaibility was observed in mdr1a-/1b- mice compared to the wild type. In addition, a significant increase of everolimus oral bioavaibility was showed in mice that received a lapatinib pre-treatment (a dual EGFR/HER2 tyrosine kinase inhibitor) compared to mice that received everolimus alone. These results were accompanied by a significant decrease of P-gp expression in duodenum segment in lapatinib pre-treated group as compared to control group. Finally, each drug given alone or in association showed a major antitumor activity in a xenograft model of human colorectal carcinoma with KRAS mutation. Our second study showed for the first time that cetuximab (Erbitux®), a monoclonal antibody directed towards EGFR, inhibits P-gp functionality in two cell lines overexpressing P-gp (IGROV-1 and HEK P-gp cells) independently of EGFR status and leads to significant increases of oral bioavailability and intratumoral concentration of SN-38, the active metabolite of irinotecan (Campto®) in mice bearing colorectal carcinoma xenograft. Cetuximab is used in combination with irinotecan in patients with metastatic colorectal cancer, initially refractory to irinotecan, our results may partly explain the reversion of resistance to irinotecan by inhibiting P-gp efflux by cetuximab. In conclusion, our results showed the interest to study the effect of recent anticancerous drugs on P-gp, including their ability to improve oral bioavailability of oral chemotherapy used.

Apesar do excelente prognóstico dos tumores de Wilms (TW) localizados (estádios I e II) e de histologia favorável (HF), 10% deles recidivam. Em 122 pacientes com TW com essas características, diagnosticados de 1976 e 2001, analisamos alguns fatores clínicos, como a idade por ocasião do diagnóstico e peso do tumor, em todos os pacientes; fatores biológicos, como o TP53 e a glicoproteína-p, em 40 deles; e variáveis histológicas de microestadiamento (invasão de seio renal, cápsula tumoral, vasos intra-renais e pseudocápsula inflamatória) em 28 com TW em estádio I. Correlacionando todos esses fatores com a presença de recidiva, observamos que a chance maior de recidiva estatisticamente significativa somente foi verificada em pacientes com duas ou mais variáveis de microestadiamento e/ou peso tumoral maior que 550 g / In spite of the excellent prognosis of localized favorable histology (FH) of Wilms' tumor (WT), 10% of them will relapse. In 122 TW patients with these characteristics, diagnosed between 1976 and 2001, some clinical factors have been analyzed, such as age at diagnosis and tumor weight in all patients; biological factors, like TP53 and p-glycoprotein, in 40 of them; and microsubstaging histological variables (invasion of renal sinus, tumor capsule, intrarenal vessels, and inflammatory pseudocapsule). Correlating all of those factors with relapse, we have observed that only patients with the association of two or more microsubstaging variables and/or tumor weight over 550 g showed a statistically significant higher chance of relapse

Infectious bronchitis virus (IBV) is the causative agent of an economically important disease of poultry. In Brazil this disease causes respiratory, renal and reproductive problems in birds of all ages, despite constant vaccination with the Massachusetts strain H120. This lack of immunological protection is known to be due the genetic variation in the spike glycoprotein of IBV, which is involved in host cell attachment, neutralization and the induction of protective immunity. Brazilian IBV variants resulting of this genetic variation are present since the 80s and this study aimed to epidemiologicaly analyze and molecularly characterize the existing variants during 2010-2015 and perform a bioinformatics analysis of the available sequences of IBV variants in a 40 year period. Of the 453 samples tested, 61.4% were positive for IBV and 75.9% of them were considered variants and were detected in birds of all ages, distributed in all five Brazilian regions. A fragment of 559-566 bp was obtained from 12 isolates, where BR-I was the predominant variant while only one isolate belonged to the BR-II genotype. Bioinformatics analysis of the sequences of 40 years of Brazilian IBV variants was performed and the ratio of non-synonymous substitutions per non-synonymous site (dn) to synonymous substitutions per synonymous site (ds) dN/dS was calculated. It revealed a predominance of codons with non-synonymous substitutions in the first third of the S1 gene and a dN/dS ratio of 0.6757, indicating that this portion of the gene was under negative selection. Additionally prediction of N-glycosilation sites showed that most of the BR-I variants (from 2003 to early 2014) present an extra site at animoacid position 20, while the newest ones lack this feature.Together these results suggest that IBV Brazilian variants had probably suffered drastic mutations in some points between the years 1983 to 2003 and after achieving an antigenic structure effective enough for invasion and replication in their hosts, the selection processes became silent. / O vírus da bronquite infecciosa das galinhas (IBV) é o agente causador de uma doença aviária economicamente importante. No Brasil, esta doença ocasiona problemas respiratórios, renais e reprodutivos em aves de todas as idades, apesar da vacinação constante com a cepa Massachusetts H120. Esta falha na proteção conferida pela vacina é ocasionada por mutações nos nucleotídeos do gene da glicoproteína da espícula, a qual está envolvida no processo de interação comas células do hospedeiro, a neutralização e a indução de imunidade protetora. As variantes brasileiras resultantes dessa mutação genética estão presentes desde os anos 80 e este estudo teve como objetivo analisar epidemiologicamente e caracterizar molecularmente os vírus variantes existentes durante 2010-2015 e realizar uma análise bioinformática das sequências disponíveis no GenBank em um período de 40 anos. Das 453 amostras analisadas, 61,4% foram positivas para IBV e 75,9% delas foram consideradas variantes e foram detectados em aves de todas as idades, distribuídos em todas as 5 regiões do Brasil. Um fragmento de 559-566 pb foi obtido a partir de 12 isolados, onde BR-I foi a variante predominante ao contrario que apenas um isolado pertencia ao genótipo BR-II. Análise bioinformática de 40 anos de variantes do IBV brasileiros revelou uma predominância de codões com as substituições não sinónimos no primeiro terço do gene S1 e uma relação dN / dS de 0,6757, indicando que esta porção do gene estava sob selecção negativa. Além disso a previsão de pontos de de N-glicosilação mostrou que a maioria das amostras variantes BR-I (entre o 2003 e início de 2014) apresentam um ponto adicional na posição 20, enquanto as variantes mais novas não apresentam esse ponto de nglicosilação. Estes resultados sugerem que as variantes brasileiras teriam sofrido mutações provavelmente drásticas em alguns pontos do genoma, entre os anos de 1983 a 2003 e depois de atingir uma estrutura antigênica eficaz o suficiente para a invasão e replicação em seus hospedeiros, o processo de seleção mudou para seleção negativa.

Blood-brain barrier (BBB) is a unique membranous barrier, which segregates brain from the circulating blood. It works as a physical and metabolic barrier between the central nervous system (CNS) and periphery. In mammals, endothelial cells were shown to be of BBB and are characterized by the tight junctions along with efflux system which are responsible for the restriction of movement of molecules within the cells. Efflux system consists of multidrug resistance proteins such as P-glycoprotein (P-gp). P-gp removes substances out back from the brain to the blood before they reach to the brain. So the barrier is impermeable to many compounds such as amino acids, ions, small peptides and proteins, making it the most challenging factor for the development of new drugs for targeting CNS. Curcumin is a bioactive compound that has a number of health promoting benefits such as anti-inflammatory, anticancer, anti-oxidant agent; as well as a role in neurodegenerative diseases, but low oral bioavailability is the major limiting factor. Low water solubility and rapid metabolism are the two important factors responsible for poor bioavailability of curcumin. Galaxolide is a musk compound and previously known for the bioaccumulation of toxic components in the aquatic animals by interference with the activity of multidrug/multixenobiotic resistance efflux transporters (MDR/MXR). The bioavailability of curcumin can be enhanced when administered with galaxolide. This study was carried out to investigate the effect of galaxolide on the permeation of curcumin through the epithelial cell monolayers. MDCKII-MDR1 cell monolayer is used an in vitro blood-brain barrier model while Caco-2 monolayer is used as an in vitro intestinal model, which also expresses the P-glycoprotein. The curcumin and galaxolide were separately solubilised in the DMSO and used in combination to perform permeation study, to determine the effect of galaxolide on curcumin permeation through epithelial cell monolayers. The galaxolide shows an efflux protein inhibition activity and this activity was used to enhance permeation of curcumin through the Caco-2 monolayer. In summary, galaxolide is a novel permeation enhancer molecule, which can be used for the improvement of drug delivery of other bioactive compounds in future.

Orientadora: Mirela Tinucci Costa / Banca: Suely Nunes Esteves Beloni / Banca: José Jurandir Fagliari / Resumo: A erliquiose canina é uma doença de alta incidência na região nordeste do Estado de São Paulo, sendo responsável pela morte de muitos cães. O diagnóstico precoce favorece a pronta instituição do tratamento e melhora o prognóstico do animal. Estudos têm apontado que a determinação da concentração de proteínas de fase aguda (PFA) pode contribuir para detecção precoce de doenças e auxiliar na predição do prognóstico. O presente estudo objetivou avaliar o perfil de proteínas de fase aguda (PFA) em cães experimentalmente infectados com Ehrlichia canis, amostra Jaboticabal, no início da infecção e após o tratamento. Para tanto, foram utilizados 10 cães sem contato prévio com hemoparasitas. Deste, cinco foram infectados e cinco serviram de controle da infecção. Hemogramas, nested PCR, detecção de anticorpos anti-E. canis e eletroforetograma de proteínas séricas foram realizados em períodos pré-determinados. Os resultados mostraram que a proteína-C reativa, ceruplasmina e a α1-glicoproteína ácida tiveram suas concentrações aumentadas antes do aparecimento dos sinais clínicos e das alterações de hemograma nos cães infectados. Os sinais clínicos da doença tornaram-se evidentes por volta do 17º dia de infecção. Trombocitopenia foi registrada a partir do 3º dia de infecção. Mórulas intracitoplasmáticas foram detectadas a partir do 15º dia. Títulos sorológicos anti-E. canis, variando de 1:2560 a 1:5120, e nPCR positiva foram evidenciados no 18º dia. Nas avaliações após o tratamento os cães infectados estavam assintomáticos, com nPCR negativo e acentuada redução dos títulos de anticorpos específicos em quatro dos cinco cães. Todas as PFA estudadas reduziram suas concentrações a títulos próximos aos iniciais. Este estudo mostrou que as mensurações das PFA contribuem para o diagnóstico precoce e predição de cura... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Canine ehrlichiosis is an endemic disease, with high incidence in the Northwest area of Sao Paulo State - Brazil and it is responsible for the death of numerous dogs. The rapid and accurate diagnosis helps the prompt establishment of treatment and improves the prognosis of the animal. Evidence has shown that the measurement of acute phase proteins (APP) can contribute for the early detection of the disease and help to predict its prognosis. This study evaluated the profile of APP in dogs experimentally infected with Ehrlichia canis, Jaboticabal - SP - Brazil sample, at the onset of the infection and after its treatment. Ten dogs, with no previous hemoparasitosis, were randomly assigned in either the infected group (5 animals), which received the bacteria, or the control group (5 animals). In pre-determined intervals, their blood was colected and hemogram, nested PCR, anti-E. canis antibodies detection and tritation and eletrophoresis of serum proteins were performed. We showed that, in infected dogs, the concentration of C-reactive protein, ceruplasmin and α-1 acid glycoprotein were increased previous to the clinical signs forthcoming and hemogram alterations. The clinical signs were evident around the 17th day of infection. Thrombocytopenia was found on the 3th day of infection. Intra-cytosolic morules were detected on the 15th day of infection. Sorologic tritation of anti-E. canis, ranging from 1:2560 to 1:5120, and positive nPCR were found on the 18th day of infection. In the post-treatment evaluation, the infected dogs were asymptomatic with negative nPCR and decreased tritation of specific antibodies in four out of five dogs. All APP analyzed were similar to basal levels. This study showed that the measurement of APP can, indeed, contribute for the early diagnosis and prediction of cure, after treatment, of the experimental acute phase of canine Ehrlichiosis. / Mestre

Um dos principais limitantes ao desenvolvimento e aprovação para utilização em humanos das vacinas de DNA é a falta de um vetor ideal de entrega gênica, que seja ao mesmo tempo eficiente e seguro. Embora mais seguros, os vetores não virais enfrentam uma série de barreiras físicas, enzimáticas e difusionais que limitam a chegada do transgene ao núcleo das células alvo. Dando continuidade ao trabalho desenvolvido em nosso grupo de pesquisa, o principal objetivo desta dissertação de mestrado foi avaliar o desempenho do vetor não viral comercial Lipofectamina e da proteína multifuncional T-Rp3 na entrega do gene da glicoproteína do vírus da raiva (RVGP) a células BHK-21. Primeiramente, o gene RVGP foi inserido no plasmídeo modelo pVAX1. Foram então realizados estudos de transfecção em células BHK-21 (Baby Hamster Kidney), utilizando-se Lipofectamina como agente de transfecção, no sentido de constatar a correta expressão do gene RVGP contido no novo plasmídeo. Como controle positivo, foi utilizado o plasmídeo pCMV-RVGP. Os estudos de PCR quantitativo da transcrição reversa (qRT-PCR) e imunofluorescência indicaram a expressão da glicoproteína pelo pVAX1RVGP, ainda que em valores de expressão menores se comparados com o plasmídeo controle pCMV-RVGP. Foi também desenvolvido com sucesso um método quantitativo de determinação da expressão da RVGP em células utilizando-se citometria de fluxo, que confirmou os resultados anteriores. Devido ao plasmídeo pVAX1RVGP ter apresentado baixa eficiência de expressão da RVGP, buscou-se a elevação da eficiência a partir da adição da sequência de KOZAK no plasmídeo pVAX1RVGP. Nesse caso, ainda que os resultados indiquem um aumento na expressão, não houve confirmação estatística (p<0,05). Os estudos de entrega com a proteína T-Rp3 foram realizados com um lote da T-Rp3 armazenada em ultrafreezer. A proteína demonstrou-se não ser estável após o congelamento em nitrogênio líquido e armazenamento em ultrafreezer pelo tempo de 10 meses. Apesar de ser capaz de complexar o pDNA após esse tempo, não foi eficiente em ensaios de transfecção, tendendo a agregar em relações molares altas e ausência de soro fetal bovino. / One of the major bottlenecks on the development and approval of DNA vaccines in humans is the lack of an ideal gene delivery vector, which must be safe and efficient at the same time. Although safer, the non-viral vectors face a series of physical, enzymatic and diffusion barriers that limits the arrival of the endogenous gene in the nuclei of the target cells. The main goal of this work was the evaluation of the performances of the commercial non-viral vector Lipofectamine, and the recombinant protein T-Rp3, a multifunctional protein, on the delivery of the rabies virus glycoprotein (RVGP) gene to BHK-21 cells. First, the RVGP gene was inserted into the pVAX1 plasmid, and transfections using BHK-21 (Baby Hamster Kidney) cells were performed using the Lipofectamine reagent to verify the correct expression of the RVGP gene present in the new plasmid. As a positive control, the plasmid pCMV-RVGP was used. The quantitative reverse transcription (qRT-PCR) and immunofluorescence studies indicated the expression of RVGP from pVAX1RVGP, although in lower expression values in comparison to the control plasmid. In addition, a flow cytometry quantitative method to quantify and compare the expression of the RVGP in the membrane of the transfected cells was developed, confirming the previous results. With the purpose of increase, the expression of RVGP, the KOZAK consensus sequence was added to the new pVAX1RVGP plasmid, and despite of the apparent increase of RVGP expression, this could not be confirmed statistically. The experiments of gene delivery using the T-Rp3 protein were performed using a protein batch storaged in ultrafreezer for 10 months. However, the protein has shown not being stable after storage for this long period. Moreover, despite of being capable to complex pDNA after this time, T-Rp3 was not efficient in the transfection assays and tended to aggregate in high molar ratios.

Apesar do excelente prognóstico dos tumores de Wilms (TW) localizados (estádios I e II) e de histologia favorável (HF), 10% deles recidivam. Em 122 pacientes com TW com essas características, diagnosticados de 1976 e 2001, analisamos alguns fatores clínicos, como a idade por ocasião do diagnóstico e peso do tumor, em todos os pacientes; fatores biológicos, como o TP53 e a glicoproteína-p, em 40 deles; e variáveis histológicas de microestadiamento (invasão de seio renal, cápsula tumoral, vasos intra-renais e pseudocápsula inflamatória) em 28 com TW em estádio I. Correlacionando todos esses fatores com a presença de recidiva, observamos que a chance maior de recidiva estatisticamente significativa somente foi verificada em pacientes com duas ou mais variáveis de microestadiamento e/ou peso tumoral maior que 550 g / In spite of the excellent prognosis of localized favorable histology (FH) of Wilms' tumor (WT), 10% of them will relapse. In 122 TW patients with these characteristics, diagnosed between 1976 and 2001, some clinical factors have been analyzed, such as age at diagnosis and tumor weight in all patients; biological factors, like TP53 and p-glycoprotein, in 40 of them; and microsubstaging histological variables (invasion of renal sinus, tumor capsule, intrarenal vessels, and inflammatory pseudocapsule). Correlating all of those factors with relapse, we have observed that only patients with the association of two or more microsubstaging variables and/or tumor weight over 550 g showed a statistically significant higher chance of relapse

Não consta resumo na publicação. / The &#945;-amylase inhibitor from Phaseolus vulgaris is a glucoprotein with a Molecular Weight of 53,000 daltons and an isoelectric point of 4.35. It can be dissociated by SDS or guanidin in three subunities having molecular weight of 17,500, 16,000 and 13,500. The molecule has 400 amino acid residues and no disulfide brigde. The C and N terminal amino acid are respectively: leucine and tyrosine and threonine, alanine, and glutamic acid. It is resistent to proteolysis in the native state.

<p>The subject of this thesis was to study two intestinal barriers to oral drug bioavailability, drug efflux proteins of the ABC-transporter family, and in particular ABCB1/P-glycoprotein (Pgp), and the drug metabolizing enzyme cytochrome P450 (CYP) 3A4. At the onset of this thesis, similarities between CYP3A4 and Pgp in terms of their tissue distribution and gene regulation, along with overlapping substrate specificities, had generated the hypothesis that CYP3A4 and Pgp may have a complementary function and thus form a coordinated intestinal barrier to drug absorption and gut wall metabolism.</p><p>In the first part of this thesis, a cell culture model of the intestinal epithelium that expressed both functional Pgp and CYP3A4 was developed. This model was then used to investigate the steroselective drug efflux and metabolism of R/S-verapamil. In summary, the results indicated that the two barriers in the cell culture model were in agreement with those in the human intestine.</p><p>Both ABC-transporters and CYPs are regulated by drugs that interact with nuclear receptors. However, while the regulation of CYPs is quite well understood, less is known about how repeated drug administration regulates the most abundantly expressed ABC-transporters. Therefore, in the second part of this thesis, the effects of repeated drug administration on the gene regulation of four ABC-transporters and CYP3A4 were studied in intestinal epithelial cell lines in vitro and in the perfused human jejunum in vivo. The in vitro studies revealed that the ABC-transporters are induced by drugs that interact with slightly different sets of nuclear receptors. The in vivo study showed that repeated oral administration of St John’s wort decreased the bioavailability of verapamil, predominantly by induction of intestinal CYP3A4. This part of the thesis provides new information about the regulation of ABC-transporters, shows that the intestinal metabolism is the most significant barrier to oral bioavailability of verapamil and provides evidence for a clinically significant interaction between verapamil and St John’s wort in vivo.</p>

<p>The main objective of this thesis was to investigate the in vivo relevance of membrane transporters and cytochrome P450 (CYP) 3A4-mediated metabolism in the intestine and liver for the bioavailability of drugs in humans after oral administration.</p><p>In the first part of the thesis, the main transport mechanisms involved in the intestinal absorption and bioavailability were investigated for fexofenadine, a minimally metabolized drug, which is a substrate for P-glycoprotein (P-gp) and members of organic anion transporting polypeptide (OATP) family. Jejunal perfusion studies revealed that co-perfusion with verapamil increased the bioavailability of fexofenadine by decreasing the first-pass liver extraction as the low intestinal permeability was unchanged by the transport inhibitors studied. The mechanism behind the interaction probably involves inhibition of OATP-mediated sinusoidal uptake and/or P-gp-mediated canalicular secretion of fexofenadine. Results from the Caco-2 model supported that the intestinal absorption of fexofenadine is mainly determined by the low passive permeability of the drug, even though fexofenadine clearly is a P-gp substrate. </p><p>In the second part of the thesis, the effect of repeated oral administration of the P-gp and CYP3A4 inducer St. John’s wort on the in vivo intestinal permeability and presystemic metabolism of the dual P-gp and CYP3A4 substrate verapamil was investigated in a jejunal perfusion study. St. John’s wort decreased the bioavailability of the enantiomers of verapamil by inducing the CYP3A4-mediated presystemic metabolism, probably mainly in the gut. It was also concluded that induction of efflux transporters, such as P-gp, does not affect the intestinal transport or the gut wall extraction of high permeability substrates like verapamil. Data from Caco-2 cells with induced CYP3A4-activity supported these findings. The plasma levels of the enantiomers of norverapamil also decreased despite an increased formation, which was attributed to induction of CYP3A4 and/or other metabolic routes. </p>