Helicobacter pylori (H. pylori) is a human-specific gastric pathogen which is responsible for a spectrum of diseases ranging from superficial gastritis to gastric and duodenal ulceration, and which is also highly associated with gastric cancer. The pathogenesis of severe gastric disorders caused by H. pylori is multifactorial and involves complex interactions between the microbe and the gastric mucosa. H. pylori expresses several adhesion proteins. These molecules have important roles in the establishment of persistent infection and chronic inflammation, which cause tissue damage. The aim of this thesis was to study the attachment of this bacterium to human gastric epithelium, mediated by blood group antigens in both health and disease. One of the bestcharacterized H. pylori adhesins is the histo-blood group antigen binding adhesin (BabA), which binds specifically to the Lewis b antigen (Leb) in the gastric mucosa. A protective mucus layer lines the stomach. The mucosal glycosylation patterns (GPs) vary between different cell lineages, different locations along the gastrointestinal (GI) tract and different developmental stages. In addition, GPs undergo changes during malignant transformation. MUC5AC is a mucin molecule produced by the surface epithelium. Three distinctly different types of human gastrointestinal tissue were studied by bacterial adherence analysis in situ. MUC5AC is the most important carrier of Leb and the new results demonstrate that it forms major receptors for H. pylori adherence. By analysing an H. pylori babA-deletion mutant, a novel adhesin-receptor binding mode was found. Surprisingly, the mutant bound efficiently to both human gastric mucosa and to gastric mucosa of Leb transgenic mice. The sialylated and fucosylated blood group antigen, sialyl-dimeric-Lewis x (sdiLex), was structurally identified as the new receptor. A positive correlation was found between adherence of H. pylori to sialyl-Lewis x (sLex) and elevated levels of inflammation response in the human gastric mucosa. These results were supported by detailed analysis of sialylated and fucosylated blood group antigen glycosylation patterns and, in addition, in situ bacterial adherence to gastric mucosa of experimentally challenged Rhesus monkey. The cognate sialic acid-binding adhesin (SabA) was purified by the retagging technique, and the corresponding sabA-gene was identified. H. pylori lipopolysaccharide (LPS) contains various Lewis blood group antigens such as Lewis x (Lex) and Lewis y (Ley). Additional bacterial adherence modes, which are independent of the BabA and/or SabA adhesins, could possibly be mediated by Lex interactions. Adherence of a clinical isolate and its corresponding Lex mutant to human gastric mucosa with various gastric pathologies was studied in situ. The results suggest that H. pylori LPS plays a distinct but minor role in promotion of bacterial adhesion. Taken together, the results suggest mechanisms for continuous selection of H. pylori strains, involving capacity to adapt to changes in the local environment such as shifts in cell differentiation and associated glycosylation patterns. Adherence of H. pylori is dependent on both the BabA and the SabA adhesin. Multi-step dependent attachment mechanisms may direct the microbes to distinct ecological niches during persistent infections, driving the chronic inflammation processes further toward the development of peptic ulcer disease and/or malignant transformation. Key words: H. pylori, BabA, adhesin, Lewis b, MUC5AC, sialyl-dimeric-Lewis x, chronic inflammation, SabA, Lewis x, LPS.

The work presented in this thesis describes the determination of structures of peptides and proteins at atomic resolution. Nuclear Magnetic Resonance (NMR) spectroscopy was used as the principal method of investigation. The thesis is divided into three parts. Part I of the thesis consists of chapters 1 to 4, and deals with structural studies of two novel conotoxins. Part II of the thesis consists of chapter 5 and deals with structural studies of Small MutS Related (Smr) domain from Helicobacter pylori MutS2. Part III of the thesis consists of Appendices A to D. Appendix A describes implementation of a novel pulse sequence for determination of disulfide connectivity using long-range 13 C–13 C scalar couplings across disulfide bonds. Appendices B, C and D contain supplementary infor- mation (acquisition parameters and chemical shifts) for the structural studies presented in parts I and II of the thesis. Part I: Structural studies of novel conotoxins from Conus monile Chapter 1 gives a brief overview of the conotoxins and their structural studies. The first half of the chapter describes biosynthesis, classification schemes, nomenclature, com- monly observed post-translational modifications and applications of conotoxins. The latter half of this chapter summarizes the challenges involved in the structural studies of conotoxins in light of the recent developments in integrated transcriptomic and venomic studies of conotoxins. The key homonuclear and heteronuclear NMR experiments that are employed for structural studies of conotoxins are summarized. Emphasis was laid on describing the spectral features and the structural information that can be gleaned from these experiments. Finally, the current mass spectrometric and NMR methods available for determination of disulfide connectivity are discussed Chapter 2 describes sample preparation and preliminary biophysical characteriza- tion of a conotoxin Mo3964 that contains a hitherto uncharacterized cysteine framework (C–CC–C–C–C). The sequence of Mo3964 was identified at the nucleic acid level as a cDNA clone. Analysis of the signal sequence revealed that the toxin belongs to the M-superfamily, while the cysteine framework bears more resemblance to O- and K- super- family of conotoxins. Structural studies were initiated to determine the disulfide connec- tivity, tertiary structure and biological activity. The gene corresponding to the mature toxin sequence was cloned in a bacterial expression vector pET21a(+) as a C-terminal tag to the cytochrome b5 fusion protein host system. The fusion protein was obtained by recombinant expression using the bacterial expression host E. coli BL21(DE3) and the mature toxin was obtained by either enzymatic or chemical cleavage of the fusion protein followed by size exclusion chromatography and reverse phase HPLC. Proton 1D NMR spectra of the purified peptide exhibited sharp lines and good spec- tral dispersion indicating that molecule was well folded. Formation of disulfide bonds in the mature toxin was ascertained by high resolution mass spectra of intact and chemically modified Mo3964. The peptide toxin exhibited remarkable stability to chemical denatu- ration and proteolytic digestion. Spectroscopic studies clearly showed that Mo3964 pos- sesses a very stable and well defined structure as long as its disulfide bonds are intact. Analytical size exclusion chromatography and Multi Angle Light Scattering (MALS) studies showed that Mo3964 exists in solution as monomer albeit with a non-globular structure. Electrophysiological studies showed that Mo3964 inhibits outward potassium currents in rat Dorsal Root Ganglion (DRG) neurons and increases the reversal potential of rat voltage gated sodium channel rNav 1.2 stably expressed on Chinese Hamster Ovary (CHO) cells at peptide concentrations as low as 10 nM. Chapter 3 describes the determination of disulfide connectivity and tertiary stricture of Mo3964. Initial attempts to determine disulfide connectivity using direct fragmenta- tion of the intact peptide in the mass spectrometer failed due to the relatively large size of the molecule and its resistance to endoproteases. Partial reduction alkylation based methods failed as the first stage of partial reduction gave rise to a mixture of various single disulfide bond reduced species which could not be separated from each other. Subsequently, information about the disulfide connectivity was obtained using a method that does not necessitate separation of such a mixture of single disulfide bond reduced species. This method involves partial reduction, cyanylation of the reduced cysteines and alkali mediated cleavage of the peptide backbone on the N-terminus of cyanylated cysteines. Structural studies were carried out using homonuclear and heteronuclear NMR meth- ods. The hydrogen bond network and hence topology of the molecule was determined with high accuracy using the long-range HNCO-COSY experiment that correlates hydrogen- bond donor-acceptor pairs. This experiment utilizes the three bond heteronuclear scalar coupling, i.e., the h3JN C O′ coupling across the hydrogen bonds. All these restraints proved crucial to the assignment of the disulfide connectivity in Mo3964, given its novel cysteine framework. The structure of Mo3964 was calculated using a total of 549 NOE distance restraints, 84 dihedral angle restraints and 28 hydrogen bond distance restraints. The tertiary structure was constructed from the disulfide connectivity pattern 1–3, 2–5 and 4–6, that is hitherto undescribed for the M–superfamily conotoxins. The ensemble of structures showed a backbone Root Mean Square Deviation of 0.68 ± 0.18 Å, with 87% and 13% of the backbone dihedral (φ, ψ) angles lying in the most favored and additional allowed regions of the Ramachandran map. The remarkable stability and anomalous spectral properties exhibited by Mo3964 could be rationalized using the disulfide connectivity and the tertiary structure. The tertiary structural fold has not been described for any of the known Conus peptides. Further, a search for structures similar to that of Mo3964 using the web server DALI returned no hits indicating that the peptide scaffold of Mo3964 has no structural homologues. Hence, the conotoxin Mo3964 represents a new bioactive peptide fold that is stabilized by disulfide bonds and adds to the existing repertoire of scaffolds that can be used to design stable bioactive peptide molecules. The structure of Mo3964 was submitted to the Protein Data Bank (PDB ID: 2MW7)[1]. Chapter 4 describes the structural studies of a 17 residue, single disulfide containing conopeptide Mo1853. The samples for structural studies were obtained either by chemical synthesis or by recombinant expression methods. Structural studies using homonuclear solution NMR methods revealed that Mo1853 exists as two equally populated cis and trans X–Pro conformers which are in slow exchange regime, compared to the chemical shift timescale. Sequence specific assignments were obtained for both the conformers by analysis of homonuclear 2D 1 H,1H–DQF–COSY,1H,1 H–TOCSY, 1H,1 H–NOESY and 1H,1 H–ROESY spectra. Temperature dependence of chemical shifts was measured and coalescence was observed for two amide protons at 318 K. At this temperature, the rate of exchange and the free energy of activation were determined to be 59 Hz and ≈ 67.2 kJ mol−1 respectively. The evidence for this conformational equilibrium was also observed as exchange correlation peaks in the 2D- NOESY and ROESY spectra. Tertiary structures of both the cis and trans conformers were determined using distance restraints, backbone dihedral angle restraints, the disulfide bond restraint and the cis or trans conformation of the X–Pro peptide bond. Tertiary structures of both the conformers consist of a 29-membered macro-cyclic ring formed by 9 amino acid residues which are cyclized by side chain to side chain disulfide bond. The conformation of the X–Pro peptide bond which is located within this macro-cyclic ring causes the cis structure to be compact and the trans structure to be in an extended form. Analysis of the tertiary structures indicated that the trans conformer is stabilized by hydrogen bonds while the cis conformer is likely to be stabilized by hydrophobic interactions. This was further corroborated by the fact that at lower temperatures, the hydrophobic interactions became weaker reducing the population of the cis conformer with respect to that of the trans conformer. Preliminary electrophysiological studies carried out on rat DRG neurons indicate that Mo1853 transiently reduces late outward potassium currents. Part II: Structural studies of Small MutS Related (Smr) domain from Helicobacter pylori MutS2 Chapter 5 presents the solution NMR studies of the Smr domain from MutS2 of H. pylori , henceforth called as HpSmr. In H. pylori , MutS2 is involved in suppression of homologous recombination and its Smr domain was shown to be necessary for this activity. As of date, in spite of the availability of structural information for the Smr domain, unambiguous identification of the residues involved in metal binding, DNA binding and catalysis remains elusive. Structural studies were carried out on two different constructs of HpSmr viz., HpSmr– (His)6 and GSHM–HpSmr, with and without the hexahistidine tag respectively. Se- quence specific assignments of HpSmr–(His)6 were obtained at two different sample pH conditions viz., pH 8.0 and pH 5.35 using the standard suite of triple resonance NMR experiments. Since, valines and leucines constitute about 25% of the total number of amino acid residues in HpSmr–(His)6 , stereospecific assignments were obtained for di- astereotopic methyl groups of these residues by preparing a fractionally 13C labeled sample of HpSmr–(His)6 . Solution structure of HpSmr–(His)6 at pH 8.0 was determined using 766 NOE restraints, 170 backbone dihedral angle restraints and 70 hydrogen bond distance restraints. The tertiary structure exhibits the canonical α/β sandwich fold ex- hibited by all the other known structures of Smr domains. Further, NMR studies and analytical gel filtration studies indicated the presence of pH dependent conformational exchange in HpSmr that involves strand to coil transition in the C-terminal β-strand. In order ascertain that the conformational equilibrium is not at an artifact caused by the C-terminal hexa-histidine-tag, HpSmr protein construct GSHM–HpSmr, which does not have the hexa-histidine-tag, was prepared. Conformational exchange was observed in this construct as well. The preliminary NMR evidence suggests that the conformational exchange is caused by pH dependent cis–trans isomerization of a semi-conserved Proline residue Pro66 . We have hypothesized that the pH dependent modulation of the activity of Smr domain of MutS2 can be advantageous to H. pylori . Such a regulation could help the bacteria to achieve optimal rate of homologous recombination in response to changes in pH, which is necessary for maintaining homeostasis and tiding over stress conditions. Part III: Appendix Appendix A describes an NMR pulse program LRCC_CH2 that was designed with the aim of determining disulfide connectivity using long-range 13C–13 C (C β –C β ′ ) couplings across the disulfide bond. This experiment is a modification of an earlier experiment pub- lished by Bax and co-workers designed to measure the side-chain χ3 dihedral angle in me- thionines. The experiment described here is optimized for the detection of 3 bond scalar coupled methylene carbons. The details of modifications introduced in LRCC_CH2, its product operator analysis, a representative spectrum acquired on [U-13C,15 N]–Mo3964, short-comings and future directions are described. The C programming code that was used to implement the pulse program is also included in the appendix. Appendices B, C and D contain the supplementary information (acquisition pa- rameters for the NMR experiments and chemical shifts) for the structural studies carried out on Mo3964, Mo1853 and HpSmr.

Made available in DSpace on 2015-04-01T14:16:01Z (GMT). No. of bitstreams: 1 ArquivoTotal.pdf: 1987821 bytes, checksum: 0557f7c6083cf4200e6fc6542c383ea7 (MD5) Previous issue date: 2013-05-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Cancer is a disease with a high mortality rate in Brazil, including, stomach cancer is currently the fourth most common type of cancer worldwide, responsible for countless deaths. Its etiology is multifactorial, because studies suggest associations to various factors such as dietary habits, environmental factors, genetic and epigenetic factors and gastric infection by Helicobacter pylori. Epigenetic changes such as methylation of the promoter regions of genes involved in cellular homeostasis may contribute to gastric carcinogenesis. To verify the methylation status of THBS1, GPX3 and COX2 genes and to evaluate their association with H. pylori in gastric adenocarcinomas, Methylation-Sensitive Restriction Enzyme PCR (MSRE-PCR) assay was performed in 39 gastric carcinomas (intestinal and diffuse types) and 15 normal stomach tissue samples. The presence of H. pylori was performed by amplification of the fragment of the 16S rRNA. Statistical analysies were performed using Fisher s exact test. The hypermethylation of GPX3, THBS1 and COX2 occurred in 18% (n = 7), 5% (n = 2) 36% (n = 14) of gastric cancer samples, respectively, whereas in normal samples was found in 13%, 7% and 67%. The presence of H. pylori was detected in 67% of gastric cancer samples and 67% in normal gastric samples. No correlation was found between the methylation profile of the studied samples and clinicopathological variables and the presence of H. pylori (P ≥ 0,05). The presence of H. pylori in gastric cancer samples and normal was not associated with clinicopathologic variables analyzed (P> 0.05). / O câncer é uma doença com alta taxa de mortalidade no Brasil, dentre eles, o câncer de estômago constitui atualmente, o quarto tipo de câncer mais comum a nível mundial. No ano de 2012, estimam-se, para o Brasil, 12.670 casos novos de câncer do estômago em homens e 7.420 em mulheres. A sua etiologia é multifatorial, pois estudos sugerem associações a diversos fatores como: hábitos alimentares, fatores ambientais, fatores genéticos e epigenéticos e a infecção gástrica por Helicobacter pylori. Alterações epigenéticas tais como a metilação das regiões promotoras de genes envolvidos na homeostase celular podem contribuir para carcinogênese gástrica. Para verificar o estado de metilação de genes THBS1, GPX3 e COX2 e avaliar a sua associação com a Helicobacter pylori (H. pylori) em adenocarcinomas gástricos, Methylation-Sensitive Restriction Enzyme PCR (MSRE-PCR) foi realizada em 39 carcinomas gástricos (intestinal e tipo difusa) e 15 amostras de tecido normal do estômago. A presença de H. pylori foi realizada por amplificação de um fragmento de rRNA 16S. Analysies estatísticas foram realizadas utilizando o teste exato de Fisher. A hipermetilação de GPX3, THBS1 e COX2 ocorreu em 18% (n = 7), 5% (n = 2) 36% (n = 14) das amostras de câncer gástrico, respectivamente, ao passo que em amostras normais foi encontrada em 13%, 7 % e 67%. A presença de H. pylorifoi detectada em 67% das amostras de câncer gástrico e 67% em amostras gástricas normais. Não foi encontrada correlação entre o perfil de metilação das amostras estudadas com variáveis clínico-patológicas e com presença de H. pylori (P > 0,05). A presença de H. pylori nas amostras de câncer gástrico e normais não foi associada com as variáveis clínico-patológicas analisadas (P > 0.05).

Please read the abstract in the section front of this document / Dissertation (MSc)--University of Pretoria, 2007. / Chemical Pathology / unrestricted

Earlier ecological studies on the relation between H. pylori infection and stomach cancer have considered that the relation between these two variables, as estimated by the exposure coefficient, is constant. However, there is evidence to suggest that this relation changes geographically due to differences in strains of H. pylori. Since the prevalence of H. pylori varies with socio-economic status, the association between the latter and stomach cancer mortality may also vary geographically. This thesis studies stomach cancer by taking into account the geographical variability of the exposure coefficients. The study proposes the use of regression mixtures, clustering models and spatially varying regressions for the study of varying exposure coefficients. The effect of transformations of variables in these models appears to have been little considered. We provide new necessary conditions for invariance under transformations of variables for mixed effect models in general, and for the proposed models in particular. In addition, we show that varying exposure coefficients may induce a varying baseline risk. The regression mixtures and the clustering model are applied to a data set on stomach cancer incidence and H. pylori prevalence in 57 countries worldwide. We extend the clustering model to reflect any distance measure between the geographical units, including the Euclidean distance, in the formation of clusters. We also show that the clustering model performs better than the regression mixture model when the aim is to identify connected clusters and the observations present large variance. The results obtained with the clustering model supported the existence of three clusters where the interaction between the human and H. pylori populations have similar characteristics. Spatially varying regressions are applied to a data set of areal death counts of stomach cancer and spending power in 275 counties in continental Portugal. We provide an original strategy for implementing multivectorial intrinsic autoregressions as the distribution for the random effects. The results obtained with the application of this methodology were consistent with a varying exposure coefficient of spending power.

Background: Helicobacter pylori (H. pylori) infection is a significant risk factor for peptic ulcer (PU) and gastric cancer (GC). Apart from the virulent CagA genotype of H. pylori environmental and dietary factors influence disease outcomes. There have been no studies addressing these factors in Western India. Hence, we conducted a case control study enrolling PU, GC patients and controls at Pune, India. Methods: Risk factors for PU and H. pylori infection were assessed in participant interview. H. pylori status was assessed from stool by monoclonal antigen detection. To understand treatment effect, we followed 100 H. pylori positive patients. Results: We enrolled 190 PU patients, 125 Controls and 35 GU patients. Prevalence of H. pylori was 61% among symptomatic patients and 45% among controls. H. pylori infection (OR: 1.70, 95% CI: 1.03-2.89), meat (OR: 1.10, 95% CI: 1.02-1.75), fish (OR: 1.05, 95% CI: 1.02-1.89) consumption, and family history of ulcer (OR: 1.20, 95% CI: 1.08-1.60) were risk factors for PU. Consumption of snacks with alcohol (OR: 0.32, 95% CI: 0.13-0.78) and history of anti-parasite treatment (OR: 0.51, 95% CI: 0.30-0.86) were protective factors against PU. Lower socioeconomic status (SES) (OR: 1.10, 95% CI: 1.02-1.39), meat consumption (OR: 2.35, 95% CI: 1.30-4.23), smoking (OR: 2.23, 95% CI: 1.24-4.02), eating restaurant food thrice per week (OR: 3.77, 95% CI: 1.39-10.23) and drinking non-filtered or non-boiled water (OR: 1.05, 95% CI: 1.01-1.23) were risk factors for H. pylori infection. Consumption of chili peppers (OR: 0.20, 95% CI: 0.10-0.37) and concurrent parasite infestation (OR: 0.44, 95% CI: 0.24-0.80) were protective against H. pylori infection. H. pylori infection was eradicated only in 53% (40/75) of treated patients. Conclusion: This study indicates that H. pylori infection is associated PU. Consumption of meat, fish and family history of PU are risk factors for PU. Lower SES, consumption of restaurant food, meat, non filtered water and smoking are risk factors for H. pylori infection. Consumption of chili peppers and concurrent parasite infestation are protective against H. pylori infectionwhile history of anti parasite treatment protects against PU. H. pylori were eradicated only in 53% of patients.

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Made available in DSpace on 2014-06-11T19:32:14Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-10-09Bitstream added on 2014-06-13T18:43:20Z : No. of bitstreams: 1 duarte_mc_dr_sjrp.pdf: 1624040 bytes, checksum: 20ecff772fa883fe77038e593b4fc422 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A carcinogênese gástrica apresenta um modelo de múltiplas etapas, que pode iniciar a partir de uma gastrite crônica, frequentemente associada à infecção pela bactéria Helicobacter pylori, e progredir para atrofia gástrica, metaplasia intestinal, displasia e câncer gástrico. Outra via, trata do surgimento do câncer gástrico a partir de um sítio de úlcera péptica benigna. Há relatos de algumas alterações genéticas bem estabelecidas nos estágios iniciais e avançados da carcinogênese gástrica, mas em lesões benignas precursoras como a metaplasia intestinal e a úlcera gástrica, relativamente pouco é conhecido. Deste modo, estudos genéticos destas lesões poderão fornecer informações importantes sobre os eventos iniciais da carcinogênese do estômago e contribuir para estratégias de diagnóstico precoce e prevenção. A partir de dados da literatura foram selecionados genes envolvidos com a carcinogênese do estômago como TERT, COX-2, NOS2, HGF, MET, KRAS, TFF1 e CLDN18, que atuam na manutenção dos telômeros, processos celulares e proteção da mucosa gástrica. Diante do exposto, este trabalho teve por objetivos avaliar mudanças de expressão gênica e protéica destes genes selecionados, em metaplasia intestinal (MI - 37 casos) e úlcera gástrica (UG - 30 casos), comparadas com suas respectivas mucosas normais (MN) e com adenocarcinoma gástrico (CG - 22 casos) e verificar possíveis correlações entre a expressão destes genes nos três grupos estudados, bem como associações entre os níveis de expressão gênica e protéica e fatores como infecção pela H. pylori e tipo histológico de MI e CG. A expressão relativa do RNAm dos referidos genes foi analisada pela técnica de PCR em tempo real, enquanto a expressão das respectivas proteínas foi avaliada por imuno-histoquímica. A avaliação da expressão gênica revelou níveis médios relativos do RNAm... / Gastric carcinogenesis presents a model of multiple steps, which can be triggered by a chronic gastritis, often associated with infection caused by the bacterium Helicobacter pylori, and progress to gastric atrophy, intestinal metaplasia, dysplasia and gastric cancer. However, another pathway has attracted interest in recent decades and refers to origin of gastric cancer from one site of benign peptic ulcer. There are reports of some well-established genetic alterations in the early stages and advanced gastric carcinogenesis, however, in precursor benign lesions as intestinal metaplasia and gastric ulcer, relatively little is known. Thus, genetic studies of these lesions may provide important information regarding the initial events of carcinogenesis of the stomach and contribute to strategies for early diagnosis and prevention. The genes selected for this study TERT, COX-2, NOS2, HGF, MET, KRAS, TFF1 and CLDN18, act, usually, in cell cycle processes, telomere maintenance and protection of the gastric mucosa. So, this study aimed to evaluate changes in gene and protein expression of these genes, altered in intestinal metaplasia (IM- 37 cases) and gastric ulcer (GU- 30 cases), compared with their corresponding normal mucosa (NM) and gastric cancer (GC - 22 cases) and to verify possible correlations between the expressions of these genes among the three groups studied, and also examine associations between gene and protein expression levels and factors such as H. pylori infection and histological type of IM and GC. The relative mRNA expression of these genes was analyzed by real time PCR, while the expression of respective proteins was assessed by immunohistochemistry. Evaluation of gene expression showed mRNA relative mean levels, increased in GC compared to NM to TERT (17.3-fold), COX-2 (27.6-fold), NOS2 (12.8-fold), HGF (1.8-fold), MET (3.5-fold) and KRAS (1.7-fold). For TFF1, there was... (Complete abstract click electronic access below)

Orientador: Ana Elizabete Silva / Banca: Claudia Regina Bonini Domingos / Banca: Dorotéia Rossi Silva Souza / Banca: Eny Maria Goloni Bertollo / Banca: Cláudia Aparecida Rainho / Resumo: A carcinogênese gástrica apresenta um modelo de múltiplas etapas, que pode iniciar a partir de uma gastrite crônica, frequentemente associada à infecção pela bactéria Helicobacter pylori, e progredir para atrofia gástrica, metaplasia intestinal, displasia e câncer gástrico. Outra via, trata do surgimento do câncer gástrico a partir de um sítio de úlcera péptica benigna. Há relatos de algumas alterações genéticas bem estabelecidas nos estágios iniciais e avançados da carcinogênese gástrica, mas em lesões benignas precursoras como a metaplasia intestinal e a úlcera gástrica, relativamente pouco é conhecido. Deste modo, estudos genéticos destas lesões poderão fornecer informações importantes sobre os eventos iniciais da carcinogênese do estômago e contribuir para estratégias de diagnóstico precoce e prevenção. A partir de dados da literatura foram selecionados genes envolvidos com a carcinogênese do estômago como TERT, COX-2, NOS2, HGF, MET, KRAS, TFF1 e CLDN18, que atuam na manutenção dos telômeros, processos celulares e proteção da mucosa gástrica. Diante do exposto, este trabalho teve por objetivos avaliar mudanças de expressão gênica e protéica destes genes selecionados, em metaplasia intestinal (MI - 37 casos) e úlcera gástrica (UG - 30 casos), comparadas com suas respectivas mucosas normais (MN) e com adenocarcinoma gástrico (CG - 22 casos) e verificar possíveis correlações entre a expressão destes genes nos três grupos estudados, bem como associações entre os níveis de expressão gênica e protéica e fatores como infecção pela H. pylori e tipo histológico de MI e CG. A expressão relativa do RNAm dos referidos genes foi analisada pela técnica de PCR em tempo real, enquanto a expressão das respectivas proteínas foi avaliada por imuno-histoquímica. A avaliação da expressão gênica revelou níveis médios relativos do RNAm... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Gastric carcinogenesis presents a model of multiple steps, which can be triggered by a chronic gastritis, often associated with infection caused by the bacterium Helicobacter pylori, and progress to gastric atrophy, intestinal metaplasia, dysplasia and gastric cancer. However, another pathway has attracted interest in recent decades and refers to origin of gastric cancer from one site of benign peptic ulcer. There are reports of some well-established genetic alterations in the early stages and advanced gastric carcinogenesis, however, in precursor benign lesions as intestinal metaplasia and gastric ulcer, relatively little is known. Thus, genetic studies of these lesions may provide important information regarding the initial events of carcinogenesis of the stomach and contribute to strategies for early diagnosis and prevention. The genes selected for this study TERT, COX-2, NOS2, HGF, MET, KRAS, TFF1 and CLDN18, act, usually, in cell cycle processes, telomere maintenance and protection of the gastric mucosa. So, this study aimed to evaluate changes in gene and protein expression of these genes, altered in intestinal metaplasia (IM- 37 cases) and gastric ulcer (GU- 30 cases), compared with their corresponding normal mucosa (NM) and gastric cancer (GC - 22 cases) and to verify possible correlations between the expressions of these genes among the three groups studied, and also examine associations between gene and protein expression levels and factors such as H. pylori infection and histological type of IM and GC. The relative mRNA expression of these genes was analyzed by real time PCR, while the expression of respective proteins was assessed by immunohistochemistry. Evaluation of gene expression showed mRNA relative mean levels, increased in GC compared to NM to TERT (17.3-fold), COX-2 (27.6-fold), NOS2 (12.8-fold), HGF (1.8-fold), MET (3.5-fold) and KRAS (1.7-fold). For TFF1, there was... (Complete abstract click electronic access below) / Doutor

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-21T19:57:35Z No. of bitstreams: 1 FatimaDuarteFreire_TESE.pdf: 3248766 bytes, checksum: 8e2bf08690970bd4823d71ff58b8c29f (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-23T17:44:50Z (GMT) No. of bitstreams: 1 FatimaDuarteFreire_TESE.pdf: 3248766 bytes, checksum: 8e2bf08690970bd4823d71ff58b8c29f (MD5) / Made available in DSpace on 2016-06-23T17:44:50Z (GMT). No. of bitstreams: 1 FatimaDuarteFreire_TESE.pdf: 3248766 bytes, checksum: 8e2bf08690970bd4823d71ff58b8c29f (MD5) Previous issue date: 2015-03-30 / A infec??o causada pelo Helicobacter pylori tem sido associado a v?rias doen?as g?stricas, inclusive o c?ncer g?strico. Esta bact?ria coloniza a mucosa g?strica de metade da popula??o do mundo, e os tratamentos dispon?veis s?o mal sucedidos em praticamente um em cada cinco pacientes. Pol?meros mucoadesivos, tais como quitosana, s?o usados como sistemas de libera??o g?stricos para uma melhor libera??o do f?rmaco nos locais de atua??o. Neste trabalho, part?culas de quitosana contendo amoxicilina foram obtidas pelo m?todo de coacerva??o/precipita??o visando uma libera??o controlada do f?rmaco no ambiente do est?mago, no intuito de melhorar a efic?cia terap?utica da amoxicilina no tratamento do Helicobacter pylori. A incorpora??o da amoxicilina foi feita utilizando duas t?cnicas diferentes: durante a forma??o das part?culas e por adsor??o das part?culas formadas .As part?culas foram caracterizadas quanto ao tamanho m?dio, potencial zeta, DSC, FTIR, efici?ncia de encapsula??o e libera??o in vitro em HCl 0,1N. As part?culas apresentaram uma efici?ncia de encapsula??o de 83%, tamanho m?dio de part?cula nanom?trica e potencial zeta positivo (20 mV). A amoxicilina encapsulada nas micropart?culas teve libera??o in vitro de apenas 40 % em 120 minutos. / The infection caused by Helicobacter pylori (H. pylori) is associated with gastroduodenal inflammation can lead to the development of gastritis, gastric or duodenal ulcer and gastric cancer (type 1 carcinogen for stomach cancer). Amoxicillin is used as first-line therapy in the treatment of H. pylori associated to metronidazole or clarithromycin, and a proton pump inhibitor. However, the scheme is not fully effective due to inadequate accumulation of antibiotics in gastric tissue, inadequate efficacy of ecological niche of H. pylori, and other factors. In this context, this study aimed to obtaining and characterization of particulate systems gastrorretentivos chitosan - amoxicillin aiming its use for treatment of H. pylori infections. The particles were obtained by the coacervation method / precipitation using sodium sulfate as precipitating agent and crosslinking and two techniques: addition of amoxicillin during preparation in a single step and the sorption particles prior to amoxycillin prepared by coacervation / precipitation and spray drying. The physicochemical characterization of the particles was performed by SEM, FTIR, DSC, TG and XRD. The in vitro release profile of amoxycillin free and incorporated in the particles was obtained in 0.1 N HCl (pH = 1.2). The particles have higher encapsulation efficiency to 80% spherical shape with interconnected particles or adhered to each other, the nanometric diameter to the systems obtained by coacervation / precipitation and fine for the particles obtained by spray drying. The characterization by FTIR, DSC and XRD showed that the drug was incorporated into the nanoparticles dispersed in the polymeric matrix. Thermal analysis (TG and DSC) indicated that encapsulation provides greater heat stability to the drug. Amoxicillin encapsulated in nanoparticles had slower release compared to free drug. The particles showed release profile with a faster initial stage (burst effect) reaching a maximum at 30 minutes 35% of amoxicillin for the system in 1: 1 ratio relative to the polymer and 80% for the system in the ratio 2: 1. Although simple and provide high encapsulation efficiency of amoxicillin, the process of coacervation, precipitation in one step using sodium sulfate as precipitant / cross-linker must be optimized in order to adjust the release kinetics according to the intended application.