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La scoliose idiopathique de l’adolescent (SIA) est définie comme une courbure de la colonne vertébrale supérieure à 10 degrés, qui est de cause inconnue et qui affecte de façon prépondérante les adolescents. Des études précédentes sur des modèles murins ont démontré une inactivation partielle du gène Pitx1. Cette inactivation partielle provoque une déformation spinale sévère lors du développement des souris Pitx1+/-, ce qui est grandement similaire au phénotype de la SIA. En se basant sur ces observations, nous postulons que la perte de fonction de Pitx1 pourrait avoir un rôle dans la SIA et pourrait être régulée par des mécanismes moléculaires spécifiques. En effet, des études faites sur l’expression de Pitx1 révèlent une perte de son expression dans les ostéoblastes dérivés de patients SIA au niveau de l’ARNm. Nous émettons l’hypothèse que la perte de Pitx1 dans la SIA pourrait être déclenchée par des facteurs hypoxiques puisqu’il est connu que Pitx1 est réprimé par l’hypoxie et que HIF-2 alpha est surexprimés dans les ostéoblastes des patients SIA même dans des conditions normoxiques. De plus, nous avons découvert une mutation dans le domaine ODD des HIF-1 alpha chez certains patients SIA (3,1%). Une fonction connue de ce domaine est de stabiliser et d’augmenter l’activité transcriptionnelle de HIF-1 alpha dans des conditions normoxiques. Nous avons confirmé, par la technique EMSA, l’existence d’un élément de réponse fonctionnel à l’hypoxie au niveau du promoteur de Pitx1. Cependant, des co-transfections avec des vecteurs d’expression pour HIF-1 alpha et HIF-2 alpha, en présence de leur sous-unité beta ARNT, ont conduit à une activation du promoteur de Pitx1 dans la lignée cellulaire MG-63 ainsi que dans les ostéoblastes des sujets contrôles. Il est intéressant de constater qu’aucune activité du promoteur de Pitx1 dans les ostéoblastes SIA n’a été observée, même après la co-expression de HIF-2 alpha et ARNT, confirmant le fait que l’expression de Pitx1 est abrogée dans la SIA. Dans l’ensemble, nos résultats démontrent un rôle important de Pitx1 dans la SIA et une possible régulation par des facteurs hypoxiques. / Adolescent Idiopathic Scoliosis is a lateral curvature of the spine greater than 10 degrees, with an unknown cause, affecting primarily adolescents. Previous mouse model studies showed that partial inactivation of Pitx1 gene resulted in the development of severe spinal deformities in Pitx1 +/- mice, which is strikingly similar to the AIS phenotype. Based on this observation, we postulated that loss of Pitx1 function might have a role in AIS and could be regulated through specific molecular mechanisms. Indeed, expression studies revealed a loss of Pitx1 expression in osteoblasts derived from AIS patients, at the mRNA level. We hypothesized that the loss of Pitx1 in AIS could be triggered by hypoxic factors, since Pitx1 is known to be repressed by hypoxia and that HIF-2 alpha was up regulated in AIS osteoblasts even under normoxic conditions. Also, we found a mutation in the ODD domain of HIF-1 alpha in some AIS patients (3.1%), which is known to stabilize and enhance HIF-1 alpha transcriptional activity in normoxic conditions. We confirmed through EMSA the existence of a functional hypoxia response element on Pitx1 promoter. However, co-transfection assays with HIF-1 alpha and HIF-2 alpha expression vectors in the presence of their beta subunit ARNT led to the activation of Pitx1 promoter in human osteoblast cell line MG-63 cells and osteoblasts from control subjects. Interestingly, no Pitx1 promoter activity was observed in AIS osteoblasts, even after the co expression of HIF2 alpha and ARNT, consolidating the fact that Pitx1 expression is abrogated in AIS. Taken together, our findings show an important role for Pitx1 in AIS and hypoxic factors could be one of its regulators.

Objetivos: Determinar a expressão imunohistoquímica do fator indutor de hipóxia 1-alfa (HIF-1-alfa) e suas variáveis associadas em pacientes com câncer de mama localmente avançado. Pacientes e método: Vinte e sete mulheres foram biopsiadas para diagnóstico histopatológico do carcinoma mamário e submetidas a tratamento quimioterápico pré-cirúrgico. Analisou-se a associação do HIF-1-alfa com idade, tamanho tumoral, grau histológico, estadio clínico, status hormonal e axilar, resposta clínica e patológica após tratamento quimioterápico, expressão do receptor de estrogênio, progesterona e cerbB2. Resultados: A expressão de HIF-1-alfa foi presente em 66,7% das pacientes. O único fator associado à sua presença foi o status axilar positivo (p=0,02), tendo permanecido durante a análise univariada. As demais variáveis não apresentaram associação estatisticamente significante. Conclusão: Existe uma associação estatisticamente significante entre o acometimento linfonodal e a presença de HIF-1-alfa em pacientes com câncer de mama localmente avançado. / Objectives: To assess the expression of HIF-1 and its associated variables with locally advanced breast cancer (LABC) patients. Methods: Twenty-seven women were submitted to incisional biopsy for histopathological diagnosis of breast carcinoma and undertaken to neoadjuvant chemotherapy (NACT). It was studied the association of HIF-1 with age, tumoral size, histological grade, clinical stage, hormonal and axillary status, clinical and pathological response after NACT, expression of estrogen and progesterone receptors, as well as the presence of cerbB2 antigen. Results: HIF-1-alpha expression was found in 66.7% of patients. Only axillary status was the associated factor with its presence (p=0.02), and remained after univariate analysis. The others did not present any significant statistically difference. Conclusion: There is a significant statistically association between axillary status and HIF-1-alpha expression in LABC patients.

Chlamydien durch die Modulation spezifischer Wirtszellproteine verschiedene Wege der Apoptose verhindern können. Mcl-1 und cIAP-2 erwiesen sich als bedeutende Faktoren, die durch die Infektion hochreguliert und absolut notwendig für die Inhibierung der Apoptose durch Chlamydien waren. Hochregulation der Mcl-1 Expression führte zu einem Block im apoptotischen Weg oberhalb der Mitochondrien. cIAP-2 zusammen mit anderen Inhibitor of Apoptosis Proteins (IAP) verhinderten die Aktivierung von Caspase-3, denfinalen Schritt in der apoptotischen Kaskade. Weiterhin wurde beobachtet, dass die Aktivierung des MAPKinase-Signalweges durch die Infektion wichtig war für die Hochregulierung von Mcl-1 und cIAP-2. Ein Hochdurchsatz-Screen wurde durchgeführt, um andere Wirtszellfaktoren, die für die Apoptoseinhibierung durch die Chlamydien verantwortlich sind, zu identifizieren. Neben Mcl-1 waren die identifizierten Faktoren hauptsächlich Mitglieder des MAPKinase-Signalweges. Dabei wurde deren Rolle für die Apoptoseresistenz bestätigt. Eine weiterführende Analyse der im Screen ermittelten Faktoren identifizierte eine Funktion von HIF-1a bei der Modulation der Expression anti-apoptotischer Faktoren während der Infektion. Es wurde beobachtet, dass HIF-1a stabilisiert und zum Nukleus transloziert wird. Es ist bekannt, dass HIF-1a HIF-1a im Nukleus binden kann, um den funktionalen Transkriptionsfaktor HIF zu bilden. Dieser reguliert die Expression verschiedener Überlebensfaktoren, unter anderem Mcl-1. HIF-1a Knockdown inhibierte die Chlamydien-induzierte Hochregulation von Mcl-1 mRNA-Expression. / chlamydial infection blocked the apoptotic pathway at multiple levels by modulation of specific host cell proteins. Mcl-1 and cIAP-2 were two most prominent factors that were up-regulated during the infection, and absolutely required for apoptosis inhibition. Increased expression of Mcl-1 led to a block in the apoptotic pathway upstream of the mitochondria. cIAP-2, together with other inhibitor of apoptosis proteins (IAPs), blocked the activation of caspase-3 at the final step of the apoptosis cascade. Further, it was observed that the activation of the MAPK pathways during infection was needed for the up-regulation of Mcl-1 and cIAP-2. A high throughput RNAi screen was performed to identify other host factors required for the apoptosis resistance during the infection. Besides Mcl-1, the targets from the screen prominently included members of the MAPK pathways, confirming their role in the apoptosis resistance. Pathway analysis of the targets identified the role of HIF-1a in modulating the expression of the anti-apoptotic factors during infection. It was observed that during infection, HIF-1a gets stabilized and translocates to the nucleus. It is known that HIF-1a can bind to HIF-1a in the nucleus to form the functional transcription factor HIF, which can regulate the expression of survival factors like Mcl-1. This was seen to be the case, because knock down of HIF-1a abrogated the infection induced up-regulation of Mcl-1 at the mRNA levels.

Alterações no mecanismo de transporte de oxigênio (O2) frequentes em inflamações, infecções, tumores, transplantes e isquemia, levam a hipóxia tecidual. Espécies reativas do O2 são produzidas e citocinas inflamatórias são liberadas engatilhando uma série de eventos, os quais são amplificados após a restituição do fluxo sanguíneo resultando em inflamação sistêmica. No presente estudo, caracterizamos a regulação da Resposta Inflamatória Aguda (AIR) após indução de isquemia e reperfusão intestinal (I/Ri) e a participação do HIF-1α neste fenótipo. Camundongos selecionados para alta (AIRmax) e baixa (AIRmin) AIR foram submetidos a I/Ri e avaliados em diferentes períodos de reperfusão (0, 1, 4 e 24h). Nossos resultados demonstraram maior sensibilidade da linhagem AIRmax frente a I/Ri, confirmada por: 1) maior mobilização de neutrófilos para circulação periférica; 2) maior adesão celular e aumento da migração granulocítica no intestino e pulmão; 3) aumento da expressão de genes de citocinas e daqueles expressos em hipóxia (Tnfa, Il1, Il6 e Hif1a); 4) Translocação Bacteriana (TB); 5) maior expressão pulmonar da proteína HIF-1α e de proteínas envolvidas em processos inflamatórios tais como S100A9, Anexina 1, Profilina 1, Tropomiosina. Por outro lado, a linhagem AIRmin foi considerada pouco responsiva aos efeitos da I/Ri. Diante do exposto, nós concluímos que a sensibilidade dos camundongos AIRmax à injuria após indução de IRi está associada ao agravamento da inflamação sistemica, a qual foi determinada pela indução de HIF-1α atrelada à expressão de proteínas pró- inflamatórias e TB, indicando o compartilhamento ou a co- segregação entre os genes envolvidos na AIR e na hipóxia. / Changes in oxygen transport mechanism (O2) frequent in inflammation, infection, tumors, transplantation and ischemia, lead to tissue hypoxia. Reactive species of O2 are produced and inflammatory cytokines are released triggering a series of events, which are amplified after blood flow refund resulting in systemic inflammation. In the present study, we characterized the regulation of Acute Inflammatory Response (AIR) after intestinal ischemia and reperfusion (I/Ri) induction and the involvement of HIF-1α in this phenotype. Mice selected for high (AIRmax) and low (AIRmin) AIR were subjected to I/Ri and evaluated in different periods of reperfusion (0, 1, 4 and 24h). Our results show sensitivity of AIRmax front line I/Ri, confirmed by: 1) higher neutrophils mobilization to peripheral circulation; 2) increase in cell adhesion and granulocyte migration in lung and intestine; 3) higher expression of cytokine genes and those expressed in hypoxia (TNFa, IL-1, IL-6 and HIF1a); 4) Bacterial Translocation (BT), 5) increase in HIF-1α pulmonary protein expression and those involved in inflammatory processes such as S100A9, Annexin 1, profilin 1 Tropomyosin. On the other hand, the AIRmin line was considered unresponsive to effects of I/Ri. We concluded that the I/Ri sensitivity of the AIRmax mice were associated with worsening of systemic inflammation, which was determined by HIF-1α induction linked to the expression of pro- inflammatory proteins and TB, indicating the share and/or co-segregation of the genes involved in AIR.

Les cancers du foie et du pancréas sont classés parmi les cancers les plus fréquents et agressifs à travers le monde et présentent une résistance à la chimiothérapie. L'efficacité des médicaments anticancéreux est affectée par les activités des enzymes métaboliques, transporteurs membranaires et par l’environnement tumoral. Le but de notre thèse est 1) de développer un modèle cellulaire hépatique et caractériser les mécanismes sous-jacents de la modulation de l’expression et de la fonctionnalité des transporteurs membranaires et des enzymes clés qui régissent le métabolisme des médicaments et 2) d’évaluer in vitro, dans différents modèles cellulaires (hépatique et pancréatique) en 2D et 3D, l’effet apoptotique de médicaments anticancéreux associés à des polyphénols en vue d’optimiser leur activité. Dans une première partie, nous avons mis en place une nouvelle lignée cellulaire hépatique humaine dérivée des HepG2, stable, exprimant suffisamment et significativement les enzymes CYP450 et les transporteurs hépatiques (MRP2, MDR1 et OATP1B1). Ce modèle pourrait être un outil de choix pour des études précliniques de métabolisme et de prédiction d’hépatotoxicité. Dans une deuxième partie, nous avons pu voir que les cellules pancréatiques et hépatiques dans un environnement 3D sont plus prédictives d’une tumeur in vivo et peuvent être un modèle de choix pour des études pharmacologiques de criblage de nouveaux médicaments anticancéreux ou des stratégies de combinaisons de molécules (avec des PP). Ainsi, nous avons montré que la quercétine, dans les cellules 3D, était capable d’augmenter l’activité de la gemcitabine et de la doxorubicine, en augmentant le taux des cellules mortes jusqu’à 60 %, par modulation des protéines MDR1 et par diminution significative du facteur HIF-1 alpha dans les cellules cancéreuses. En conclusion, les polyphénols peuvent être des molécules d’intérêt en combinaison avec des médicaments anticancéreux pour diminuer la résistance à ces traitements et servir d’outil pharmacologique pour mieux comprendre les mécanismes de résistance des cellules tumorales. / Liver and pancreatic cancers are among the most common and aggressive cancers worldwide that are resistant to chemotherapy. The efficacy of anticancer drugs is affected by the activities of metabolic enzymes, transporters and the tumor environment. The aim of my thesis was based on to main objectives: 1) developement of a hepatic cellular model and characterize the underlying mechanisms of modulation of the expression and functionality of transporters and key enzymes involved in the regulation of drug metabolism 2) study the effect of new strategies in vitro by combining anti-cancer drugs with polyphenols in these processes in order to optimize their activities on different cellular models (hepatic and pancreatic) in 2D and 3D cultures. Our results showed that we have developed a new human hepatic cell line derived from HepG2 cells. The novel cell line is a good in vitro model with a capacity of predicting hepatotoxicity of novel drugs with significant differences for chromosomes 5, 17 and 20 and high expression level of CYP450 and transporters (MRP2, MDR1 and OATP1B1). Secondly, our results indicate that the combination of anticancer drugs and polyphenols increased the rate of apoptosis in cancer cells by up regulation of the expression levels of cleaved caspase-3 and the regulator of apoptosis p53. Moreover, our results demonstrated that polyphenols inhibit the efflux activity of MDR1. In addition, our results indicate that the combination of anti-cancer drugs and quercetin down regulated the expression of HIF-1α and increased the expression levels of the cleaved caspase-3 and p53 on human pancreatic and liver cell line cultured in 3D culture. In conclusion, polyphenols may be promising agents for novel combination therapy since they potentialize the cytotoxic activity of anticancer drugs to eradicate cancer and therefore the cellular resistance.

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