Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

La protéine HBx du virus de l'hépatite B (VHB) potentialise la survenue du carcinome hépatocellulaire (CHC). Cependant, les mécanismes par lesquels, HBx favorise l'instabilité génétique lors de la prolifération hépatique restent flous. La polyploïdisation hépatocytaire participe à la diversité génétique dans le foie. La modulation de la polyploïdie par l'HBx contribuerait-elle au développement de la maladie hépatique ? Ainsi, la polyploïdisation au cours du développement et de la maladie hépatique induite par le tétrachlorure de carbone ou le diéthylnitrosamine, a été évaluée dans les souris transgéniques FL-HBx (forme complète). Au cours du développement postnatal et dans la maladie hépatique, FL-HBx inhibe la binucléation hépatique au profit de noyaux polyploïdes (? 4n) par la dérégulation des transitions G1/S et G2/M, et l'accumulation d'ADN altérés. Une polyploïdisation similaire a été observé dans des souris avec un foie humanisé et infecté par le VHB. Dans les souris FL-HBx, l'initiation du CHC est associée à l'inactivation de ChK1, l'inhibition de Mre11, Rad51 et de l'apoptose, et à la surexpression d'IL-6 tandis que dans la fibrose, l'augmentation d'?-sma, PdgfR-?, TGF-?, TNF-? et la perte de l'expression de la glutamine synthétase ont été observées. De plus, les hépatocytes FL-HBx traitées présentent une prolifération anormale avec une forte expression de Ly6D, GpC3 et AFP. En conclusion, nos résultats montrent que par la surexpression de PLK1 via p38/ERK, FL-HBx induit une polyploïdisation pathologique du foie conduisant à la propagation d'ADN altérés et à l'apparition de marqueurs tumoraux au cours de la fibrose hépatique et de l'initiation du CHC. / Hepatitis B virus X protein (HBx) is involved in the development of hepatocellular carcinoma (HCC). However, how HBx promotes genetic instability or DNA damage during liver proliferation remains unclear. For that, we used mice transgenic for the full-length HBx (FL-HBx) to investigated the impact of HBx expression on polyploidization during normal liver proliferation and in liver diseases (fibrosis : carbon tetrachloride and HCC : diethyl nitrosamine, treatments). During postnatal liver development as well as in liver diseases, FL-HBx inhibits liver binucleation and triggers early production of polyploid nuclei (≥ 4n). These features were associated with aberrant G1/S and G2/M transitions and the propagation of DNA damage. Furthermore, hepatitis B virus infection, in liver humanized mouse model, shows similar deregulation of hepatocytes polyploidization. In FL-HBx animals, HCC initiation was associated with impairment of ChK1 activation and Mre11 and Rad51 expression (DNA repair proteins), inhibited apoptosis and upregulated IL-6 transcription while in fibrosis, increased expression of α-sma, PdgfR-β, TGF-β, TNF-α as well as a defect in glutamine synthetase expression were observed. In addition, treated FL-HBx animals displayed marked alterations to the cell cycle associated with stronger expression of HCC progenitor cell markers (Ly6D, GpC3, AFP). Finally, we showed that FL-HBx protein induces pathological polyploidization of hepatocytes by upregulating PLK1 through p38/ERK Mapks pathways. That promotes a loss of genomic integrity and an increase of hepatocytes expressing tumor progenitor cell markers during liver fibrosis and HCC initiation.

Hepatitis B virus (HBV) is a major etiologic agent of chronic liver disease (CLD) and hepatocellular carcinoma (HCC). The virally encoded X antigen, HBx, contributes importantly to the development of HCC through its trans-activating role in various signal transduction pathways. Pathways implicated in stem cell self-renewal also contribute to carcinogenesis. Thus, experiments were designed to test if HBx triggers malignant transformation by promoting properties that are characteristic of cancer stem cells (CSCs). To test this hypothesis, HBx expressing (HepG2X) and control (HepG2CAT) human cell lines were assayed for phenotypic and molecular characteristics of "stemness." Western blotting of protein extracts from HepG2X and HepG2CAT cells as well as immunohistochemical staining of HCC and adjacent liver tissue sections from HBV infected patients showed up-regulation of "stemness"-associated (EpCAM and beta-catenin) and "stemness" (Oct-4, Nanog, Klf-4) markers by HBx. Moreover, HBx stimulated cell migration and spheroid formation. HBx expression was also associated with depressed levels of E-cadherin and subsequent activation of beta-catenin and EpCAM. Results from ChIP-chip data performed previously in this lab suggest an associative link between HBx and the expression of epigenetic co-repressor, mSin3A, which is known to repress E-cadherin when complexed with histone deacetylases. Thus, experiments were also designed to test if HBx represses the E-cadherin gene (CDH1) through histone deacetylation by the mSin3A/HDAC complex. In HepG2X cells, decreased levels of E-cadherin and elevated levels of mSin3A were detected. Reciprocal immunoprecipitation with anti-HBx and anti-mSin3A demonstrated mutual binding. Further, HBx-mSin3A co-localization was showed by immunofluorescent staining. Chromatin immunoprecipitation revealed that HBx mediated the recruitment of the mSin3A/HDAC complex to the CDH1 promoter. HDAC inhibition by Trichostatin A treatment restored E-cadherin expression. Thus, HBx-associated epigenetic repression of E-cadherin and up-regulated expression of multiple "stemness" markers support the hypothesis that HBx contributes to hepatocarcinogenesis, at least in part, by promoting changes in gene expression that are characteristic of CSCs. This work is the first to propose that HBV promotes "stemness" in the pathogenesis of HCC. / Biology

Chronic infection with hepatitis B virus (HBV) is a primary risk factor for the development of hepatocellular carcinoma (HCC). HCC is the fifth most common cancer type worldwide with few treatment options. The hepatitis B encoded x antigen (HBx) plays a crucial role in the pathogenesis of HCC through several mechanisms. HBx alters signaling pathways shown to promote carcinogenesis and mediates epigenetic changes that silence tumor suppressor genes and activate host oncogenes. Short chain fatty acids (SCFAs) are made by selected gut bacteria with largely anti-inflammatory properties. They alter gene expression by functioning as histone deacetylase inhibitors (HDACi) and can bind to G protein coupled receptors (GCPR) to stimulate signaling pathways. Due to the documented anti-cancer properties of SCFAs, experiments were designed to test the hypothesis that SCFAs delay the development of HCC in HBx transgenic (HBxTg) mice. A diet of SCFAs was fed to HBxTg for three months prior to the expected appearance of dysplastic nodules and HCC. The results showed a statistically significant reduction in the number of dysplastic nodules as well as the presence and frequency of HCC. The effect of SCFAs on tumor growth was also evaluated in nude mice subcutaneously injected with human HCC cells. Tumor size in SCFA-treated mice was statistically smaller compared to the controls. The effect of SCFAs on cell viability of cancer and primary human hepatocytes was evaluated. SCFAs were shown to reduce cell viability in cancer cells only, with no effect on primary hepatocytes. Proteomics was performed on SCFA-treated compared to control livers from HBxTg to investigate changes on the molecular level that are associated with reduced preneoplastic and neoplastic nodule formation. Pathway analysis showed a decrease in important cancer-promoting pathways altered by HBx in HCC, including inflammation, oxidative stress, PI3K, VEGF, EGF, and Ras. These pathways are involved in biological processes central to carcinogenesis such as cell proliferation, survival, and angiogenesis. The ability of SCFAs to decrease these pathways has never been demonstrated. Further investigation confirmed that Ras activity was decreased in 12-month old livers treated with SCFAs. Taken together, these results show that SCFAs are capable of delaying the rate of tumor growth and tumor frequency in two mouse models of HBV-associated HCC, as well as reduce cell viability in cancer cells specifically. This data suggests that SCFAs may be a novel treatment option for HBV-associated HCC. / Biology

Contexte: Le carcinome hépatocellulaire (CHC) est la plus fréquent des tumeurs primitives du foie. Près de 50% des CHC sont causés par une infection par le virus de l'hépatite B (VHB). Au cours des différents stades de l’infection par le VHB, des multiples altérations génétiques et/ou chromosomiques s'accumulent et favorisent ainsi le développement tumoral. Objectives: a) étudier, in vitro et in vivo, le rôle potentiel d’un nouveau gène susceptible d’être impliqué dans la carcinogénèse hépatique : IRF-2 (Interferon regulatory factor 2). Ce gène a été identifié comme fréquemment délété par analyse CGH-SNP dans les CHC liés à l’infection par le VHB. b) caractériser une série de CHC liés au VHB en étudiant le statut viral, les altérations génétiques et l’expression de différents gènes afin de mieux comprendre le rôle du VHB dans l’hépato-carcinogenèse et comparer ces différents paramètres avec une série de CHC non liés au VHB. Résultats : a) Dans une série de 125 CHC, Sandrine Imbeaud, au sein du laboratoire, a effectué une analyse CGH-SNP microarray et a identifié une région commune de délétion homozygote localisée en 4q34.3-35 comprenant le gène IRF-2 dans 4 échantillons. Nous avons ensuite mis en évidence par séquençage des mutations somatiques inactivatrices dans 2 autres tumeurs. In vitro, la sousexpression d’IRF-2 a entrainé une augmentation de la prolifération cellulaire et sa sur-expression a induit une promotion de l'apoptose cellulaire. In vivo, l’extinction d’IRF-2 était responsable de la formation de tumeurs de grande taille. Les 6 tumeurs inactivées pour IRF-2 étaient associées au VHB (p = 0.0003), et les mutations de TP53 et d’IRF-2 étaient mutuellement exclusives. La sousexpression de IRF-2 induisait une sous-expression de TP53 et une forte corrélation entre les expressions protéiques de p53 et de IRF-2 a été observée (r2 = 0,72, p = 0,004). En plus, on a observé que l’expression des gènes cibles directs de TP53 était modulée par le niveau d‘expression d’IRF-2. Nous avons émise l'hypothèse que IRF-2 pourrait altérer la fonction de p53 car IRF-2 est connue pour se lier à MDM2, un régulateur négatif de l’expression de p53. Le traitement des cellules inactivées pour IRF-2 avec MG132, un inhibiteur du protéasome, a induit la restauration de l'expression de p53. In vivo, le traitement avec bortézomib, un inhibiteur du proteasome utilisé en oncologie, a entrainé une régression des tumeurs inactivées pour IRF-2. b) Nous avons caractérisé sur le plan clinique et moléculaire une série de CHC liés au VHB et, ensuite, nous avons comparé nos résultats avec ceux d’une série de CHC liés à autres étiologies. Nous avons montré que les CHC liés au VHB présentaient des caractéristiques cliniques et pathologiques différentes de celles des CHC non liés au VHB : ils survenaient chez des patients plus jeunes (P < 0.0001), d'origine Africaine ou Asiatique (P < 0.0001), avec un taux sérique d'alpha-foeto protéine élevé (P = 0.008) et étaient sur le plan histologique des tumeurs peu différenciés (P = 0.04). Nous avons identifié des mutations inactivatrices du gène HBX dans 71% des tumeurs et dans 33% des tissus non tumoraux adjacents (P < 0.0001). Dans 63% des cas, le nombre de copies virales dans les tumeurs était plus faible que dans les tissus non tumoraux adjacents (P < 0.0001). Le gène TP53 était le gène le plus fréquemment muté dans les CHC liés au VHB (41%, P = 0.0002), avec des mutations R249S présentes dans 14 échantillons (16%, p < 0.0001). Ce type de mutation est classiquement associé à l'aflatoxine B1. Nous avons observé que les mutations de TP53 étaient un prédicteur indépendant de survie uniquement pour les patients infectés par le VHB. Enfin, ... / Pas de résumé en anglais / Introduzione: Il carcinoma epatocellulare (HCC) è il tumore primitivo più comune del fegato. Nel mondo, quasi il 50% di tutti gli HCC sono causati dal virus dell'epatite B (HBV). Durante le fasi dell’ infezione da HBV, si possono accumulare alterazioni genetiche e / o cromosomiche e quindi promuovere lo sviluppo del tumore. Obiettivi: a) analizzare in vitro e in vivo il ruolo potenziale di un nuovo gene potenzialmente coinvolto nella carcinogenesi epatica: IRF-2 (Interferon regulatory factor 2). Questo gene è stato identificato mediante l’analisi CGH-SNP come frequentemente deleto negli HCC correlati all’ HBV. b) caratterizzare una cohorte di HCC correlati all’HBV studiandone lo stato virale, le alterazioni genetiche e l’espressione di differenti geni al fine di comprendere meglio il ruolo di HBV nella carcinogenesis epatocellulare e confrontare questi parametri con una cohorte di HCC a diversa eziologia. Risultati: a) In laboratorio, Sandrine Imbeaud ha condotto un'analisi SNP-CGH microarray su una cohorte di 125 HCC che ha evidenziato una regione deleta in maniera omozigote localizzata sul braccio lungo del cromosoma 4 (4q34.3-35) in 4 campioni tumorali. La regione comprende un unico gene: IRF2. In altri due campioni sono state identificate mutazioni somatiche inattivatrici mediante sequenziamento della regione codante di IRF-2. In vitro, la soppressione di IRF-2 ha indotto un aumento della proliferazione cellulare, al contrario, la sua sovra-espressione ha causato un aumento dell’apoptosi cellulare. In vivo, la soppressione di IRF-2 è responsabile della formazione di tumori più grandi nei topi nude. I 6 tumori mutati per IRF2 sono tutti correlati all’ HBV (p = 0,0003. Nella cohorte di tumori studiati, le mutazioni di TP53 e di IRF-2 erano vicendevolmente esclusive. Inoltre, la soppressione dell’espressione della proteina IRF-2 induceva una riduzione dell’espressione della proteina p53 ed una stretta correlazione tra l’espressione delle due proteine è stata osservata (r2 = 0,72, p = 0,004). Inoltre, abbiamo dimostrato che il livello di espressione di IRF-2 è in grado di modulare l'espressione di alcuni geni target di TP53. Abbiamo, quindi, ipotizzato che IRF2 possa alterare la funzione di p53. Come è noto IRF2 può legarsi a MDM2, un regolatore negativo di p53 che induce la sua degradazione proteasomica. Il trattamento di cellule inattivate per IRF2 con MG132, un inibitore del proteasoma, induceva il restauro dell’espressione di p53. In vivo, il trattamento con bortezomib, chemioterapico inibitore del proteasoma, ha determinato la regressione del tumore inattivato per IRF2. b) 86 HCC correlati all’HBV sono stati caratterizzati dal punto di vista clinico e molecolare ed in seguito sono stati confrontati una serie di 90 HCC correlati ad altre eziologie. Gli HCC correlati all’HBV hanno delle caratteristiche cliniche e patologiche diverse da quelle degli HCC d’altra eziologia: insorgenza in pazienti più giovani (p <0,0001), di origine africana o asiatica (P <0.0001), alfa-fetoproteina sierica elevata (P = 0.008) e scarsa differenziazione istologica (P = 0,04). Mutazioni inattivatrici del gene HBX sono state identificate nel 71% dei tumori e il 33% dei tessuti non tumorali adiacenti (P <0.0001). Nel 63% dei casi, il numero di copie virali nel tessuto tumorale era inferiore rispetto al tessuto non tumorale adiacente (p <0,0001). Il gene TP53 è stato il gene più frequentemente mutato nella serie di HCC correlati a HBV (41%, p = 0,0002), con una considerevole presenza di mutazioni al codone 249 (R249S) (16%, p <0,0001). Questo tipo di mutazione è associate classicamente all’ aflatossina B1. Abbiamo osservato, inoltre, che TP53 mutato era un predittore indipendente di sopravvivenza solo per i pazienti infetti da HBV. Infine, ...