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[ES] Las células de los mamíferos secretan una gran variedad de vesículas extracelulares (EV) que participan activamente en la comunicación celular. Entre ellas, los exosomas son un tipo de EV cuyo tamaño está comprendido entre los 20 y 150 nanómetros que juegan un papel importante en la comunicación celular. De este modo, se ha descrito el papel de los exosomas en distintos procesos como la regeneración de tejidos, la respuesta inmunitaria o en la progresión de diferentes tipos de cánceres. Por otro lado, se ha observado que la actividad de la vía de señalización de Notch juega un papel importante en procesos de diferenciación celular, la angiogénesis o la proliferación, entre otros. Además, se ha relacionado con la aparición y progresión de un gran número de patologías, como el cáncer. Trabajos recientes han advertido que la actividad de la vía de Notch puede regularse mediante un nuevo mecanismo de señalización mediado por exosomas. En este trabajo se profundizó en este nuevo mecanismo de señalización de la vía de Notch en dos contextos diferentes como son las terapias regenerativas y el cáncer. Un trabajo previo de nuestro laboratorio demostró que las células madre mesenquimales (MSC) que mantenían una expresión aumentada del factor inducible por hipoxia 1α (HIF-1α; HIF-MSC) aumentaban el potencial terapéutico de las MSC nativas en un modelo de infarto agudo de miocardio (IAM) en rata a través de un aumento de la angiogénesis y una reducción de la fibrosis. Varios trabajos han estudiado la relación entre la vía de señalización de Notch y HIF-1α; así como la influencia de ambos en el proceso angiogénico. Por estos motivos, en este trabajo nos interesamos por evaluar la relación de ambas vías y su efecto sobre la angiogénesis a través de los exosomas liberados por las HIF-MSC y las MSC. Los resultados permitieron observar que la expresión de HIF-1α indujo un aumento en la secreción y la transferencia de exosomas de MSC a cultivos primarios de células endoteliales. Además, se observó que los exosomas derivados de HIF-MSC tenían un mayor potencial angiogénico tanto in vitro como in vivo en parte debido a una mayor incorporación del ligando de la vía de Notch Jagged1. Se ha observado que los exosomas derivados de células tumorales contribuyen a la progresión tumoral a través de mecanismos como la activación de la transición epitelio mesénquima (EMT), el establecimiento de nichos pre-metastáticos o la inmunomodulación. Así, se sabe que la vía de señalización de Notch es capaz de activar la EMT durante la progresión de distintos tipos de cánceres. Así mismo, los cánceres de mama de peor prognosis han sido relacionados con una desregulación de la vía de señalización de Notch. Por estas razones, nos inquietó la posibilidad de que la señalización de la vía de Notch a través de exosomas estuviera influyendo en la progresión del cáncer de mama. De este modo, estudiamos la presencia de componentes de la vía de señalización de Notch en los exosomas procedentes de dos líneas tumorales de cáncer de mama, una más agresiva (MDA-MB-231) y otra menos agresiva (MCF-7). Así, se observó que varios componentes de Notch se sobreexpresaron en los exosomas procedentes de MDA-MB-231 en comparación con los procedentes de MCF-7. Fue de particular interés la detección del dominio intracelular con actividad transcripcional de Notch1 (N1ICD) sobreexpresado en los exosomas procedentes de MDA-MB-231. Debido a que previamente había sido demostrado que una sobreexpresión de N1ICD en MCF-7 aumentaba su tumorigenicidad a través de una inducción de la EMT, se evaluó el efecto de los componentes de Notch incorporados en los exosomas procedentes de ambas líneas tumorales sobre cultivos de MCF-7. Nuestros resultados sugieren que los componentes de Notch incorporados en los exosomas procedentes de MDA-MB-231 son funcionales y contribuyen a la induc / [CA] Les cèl·lules dels mamífers secreten una gran varietat de vesícules extracel·lulars (EV) que participen activament en la comunicació celular. Entre elles, els exosomes són un tipus de EV amb una grandària compresa entre els 20 i 150 nanòmetres que juguen un paper important en la comunicació celular. D'aquesta manera, s'ha descrit el paper dels exosomes en diferents processos com la regeneració de teixits, la resposta immunitària o en la progressió de diferents tipus de càncers. D'altra banda, s'ha observat que l'activitat de la via de senyalització de Notch juga un paper molt important en processos de diferenciació cel·lular, la angiogénesis o la proliferació, entre altres. A més, s'ha relacionat amb l'aparició i progressió d'un gran nombre de patologies, com el càncer. Treballs recents han advertit que l'activitat de la via de Notch pot regular-se mitjançant un nou mecanisme de senyalització mediat per exosomes. En aquest treball es va aprofundir en aquest nou de mecanisme de senyalització de la via de Notch en dos contextos diferents com són les teràpies regeneratives i el càncer. Un treball publicat pel nostre equip de treball va demostrar que les cèl·lules mare mesenquimals (MSC) que mantenien una expressió augmentada del factor inducible per hipòxia 1α (HIF-1α; HIF-MSC) augmentaven el potencial terapèutic de les MSC natives en un model d'infart agut de miocardi (IAM) en rata a través d'un augment de la angiogénesis i una reducció de la fibrosi. Diversos treballs han estudiat la relació entre la via de senyalització de Notch i HIF-1α; així com la influència de tots dos en el procés angiogénic. Per aquests motius, en aquest treball ens vam interessar en estudiar la relació de totes dues vies i el seu efecte sobre la angiogénesis a través dels exosomes alliberats per les HIF-MSC i les MSC. Els resultats van permetre observar que l'expressió de HIF-1α va induir un augment en la secreció i la transferència d'exosomes de MSC a cultius primaris de cèl·lules endotelials. A més, es va observar que els exosomes derivats de HIF-MSC tenien un major potencial angiogénic tant in vitro com in vivo en part a causa d'una major incorporació del lligant de la via de Notch Jagged1. S'ha observat que els exosomes procedents de cèl·lules tumorals contribueixen a la progressió tumoral a través de mecanismes com l'activació de la transició epiteli mesènquima (EMT), l'establiment de nínxols pre-metastàtics o la inmunomodulació. En aquest sentit, se sap que la via de senyalització de Notch és capaç d'activar l'EMT durant la progressió de diferents tipus de càncers. Així mateix, els càncers de mama de pitjor prognosi han sigut reiteradament relacionats amb una desregulació de la via de senyalització de Notch. Per açò, ens va inquietar la possibilitat que la senyalització de la via de Notch a través d'exosomes estiguera influint en la progressió del càncer de mama. D'aquesta manera, estudiem la presència de components de la via de senyalització de Notch en els exosomes procedents de dues línies tumorals de càncer de mama, una més agressiva (MDA-MB-231) i una altra menys agressiva (MCF-7). Així, es va observar que diversos components de Notch es sobreexpresaben en els exosomes procedents de MDA-MB-231 en comparació amb els procedents de MCF-7. Va ser de particular interés la detecció del domini intracel·lular amb activitat transcripcional de Notch1 (N1ICD) sobreexpresat en els exosomes procedents de MDA-MB-231. Debut a que havia sigut demostrat que una sobreexpressió de N1ICD en MCF-7 augmentava la seua tumorigenicidad a través d'una inducció de l'EMT, es va evaluar l'efecte dels components de Notch incorporats en els exosomes procedents de les dues línies tumorals sobre cultius de MCF-7. Els nostres resultats suggereixen que els components de Notch incorporats en els exosomes procedents de MDA-MB-231 eren funcionals i contribuïen a la / [EN] Mammal cells secrete a great variety of extracellular vesicles (EV) that actively participate in intercellular communication. Among them, exosomes are a type of EV whose size is between 20 and 150 nanometers and play an important role in intercellular communication. In this way, the role of exosomes in different processes such as tissue regeneration, the immune response or in the progression of different types of cancers has been described. On the other hand, it has been observed that the Notch signaling pathway plays a very important role in processes such as cell differentiation, angiogenesis or proliferation, among others. In addition, it has been related to the appearance and progression of a large number of pathologies, such as cancer. Recent works have shown that the activity of the Notch pathway can be regulated by a new signaling mechanism mediated by exosomes. In this work, we deepened this new signaling mechanism of the Notch signaling pathway in two different contexts: the regenerative therapies and cancer. A work previously published by our laboratory showed that mesenchymal stem cells (MSC) that maintained an increased expression of hypoxia-inducible factor 1α (HIF-1α; HIF-MSC) increased the therapeutic potential of native MSC in a model of acute myocardial infarction (AMI) in rats through an increase in angiogenesis and a reduction in fibrosis. Several studies have studied the relationship between the Notch signaling pathway and HIF-1α as well as the influence of both in the angiogenic process. For these reasons, in this work we were interested in evaluating the relationship of both pathways and their effect on angiogenesis through exosomes released by HIF-MSCs and MSCs. The results showed that the expression of HIF-1α induced an increase in the secretion and the transfer of exosomes of MSC to primary cultures of endothelial cells. In addition, it was observed that exosomes derived from HIF-MSC had a greater angiogenic potential both in vitro and in vivo in part due to a greater incorporation of the Notch ligand Jagged1. In the last decade, it has been observed that exosomes from tumor cells contribute to tumor progression through mechanisms such as the activation of epithelial to mesenchymal transition (EMT), the establishment of pre-metastatic niches orimmunomodulation. In this sense, it is known that the Notch signaling pathway is capable of activating EMT during the progression of different types of cancers. Likewise, breast cancers of bad prognosis have been repeatedly related to a deregulation of the Notch signaling pathway. For these reasons, we were concerned about the possibility that the signaling of the Notch pathway through exosomes was influencing the progression of breast cancers. In this way, we studied the presence of Notch signaling pathway components in exosomes from the metastatic and more aggressive MDA-MB-231 and the non-metastatic and less aggressive MCF-7 cell lines. It was observed that several Notch components were overexpressed in exosomes from MDA-MB-231 compared to those from MCF-7. Of particular interest was the detection of the intracellular domain with transcriptional activity of Notch1 (N1ICD) overexpressed in MDA-MB-231 exosomes. It has been previously demonstrated that an overexpression of N1ICD in MCF-7 increases its tumorigenicity through an induction of EMT. Because of this, we evaluated the effect of Notch components incorporated in exosomes from both tumoral cell lines on MCF-7 cultures. Our results suggested that Notch components incorporated into MDA-MB-231 exosomes were functional and contributed to the induction of EMT when added to MCF-7 cultures in part due to N1ICD activity. / González-King Garibotti, H. (2019). Estudio de las Implicaciones de la Via de Señalización de Notch en Cardioregeneración y Cáncer [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/124343

Conselho Nacional de Desenvolvimento Científico e Tecnológico / O carcinoma epidermoide de esôfago (CEE) representa 90% dos casos de câncer de esôfago no Brasil. O CEE tem detecção tardia, um comportamento extremamente agressivo e baixa sobrevida, sendo, portanto, um alvo interessante para o estudo dos mecanismos envolvidos em sua carcinogênese, a fim de se identificar possíveis alvos terapêuticos ou marcadores moleculares que ajudem na prática clínica. Mudanças no metabolismo energético da célula tumoral parecem ter papel de destaque na transformação maligna. Sabe-se que células tumorais consomem glicose avidamente produzindo ácido lático, mesmo em condições de normóxia. Dentre os fatores que podem contribuir para o estímulo da glicólise em células tumorais destacam-se as alterações em enzimas da via glicolítica tais como: as piruvato-cinases M1 e M2 (PKM1 e PKM2), a hexocinase II (HKII), isofoma 1 do transportador de glicose, GLUT-1, e o fator de transcrição induzido por hipóxia (HIF1α), responsável pela transcrição das proteínas citadas. O objetivo do estudo é avaliar a relação entre a expressão de HIF1α, HK2, PKM2, PKM1 e GLUT-1 e dados clínico-patológicos no CEE. Para tal, foram avaliados tumores conservados em parafina de 44 pacientes com CEE matriculados no INCA e no Hospital das Clínicas de Porto Alegre. Além disso, foram coletadas amostras de biópsia de esôfago em 67 pacientes sem doença esofágica, que foram submetidos à endoscopia no Hospital Universitário Pedro Ernesto (HUPE). A expressão das proteínas foi avaliada nos tecidos por imuno-histoquímica, enquanto que a expressão do mRNA de GLUT-1 também foi avaliada nas amostras controle. Foi observado que as amostras controle expressam HK2, PKM1, PKM2, HIF1α nas camadas do epitélio esofágico. Já GLUT-1 e Ki-67 são vistos apenas na camada basal. Além disso, a expressão do mRNA de GLUT-1 não teve correlação com fatores etiológicos da doença. Em CEE a expressão de HK2, PKM2 e GLUT-1 foi vista em todos os tumores, já a expressão de HIF1α e PKM1 foi variável. Além disso, observou-se que maior expressão de HIF-1α apresenta correlação com invasão linfonodal e diferenciação, enquanto que a expressão de HK2 tem relação com sobrevida e PKM1 com diferenciação. As correlações clínicas encontradas sugerem que alterações no metabolismo energético é um alvo de estudo interessante para desenvolvimento de marcadores moleculares que auxiliem a prática clínica. / The esophageal squamous cell carcinoma (ESCC) represents 90% of cases of esophageal cancer in Brazil. The ESCC has late diagnosis, highly aggressive behavior and poor survival. ESCC is an interesting target to the study of mechanism involved in its carcinogenesis, in order to identify potential drug targets or biomarkers to help clinical practice. Changes in tumor cell energy metabolism appear to have a prominent role in malignant transformation. Tumor cells consume glucose avidly and produce lactic acid, even under normoxia. Among the factors that may contribute to the stimulation of glycolysis in tumor cells, there are changes in the glycolytic pathway enzymes such as: pyruvate kinase M1 and M2 (PKM2 and PKM1), hexokinase II (HKII), glucose transporter isoform 1, GLUT-1, and transcription factor induced by hypoxia (HIF1α), responsible for the transcription of proteins cited. The goal of the study is to evaluate the relationship between the expression of HIF1α, HK2, PKM2, PKM1 and GLUT-1 and clinicopathological data in ESCC. Biopsy of the esophagus in patients without esophageal disease were collected, who underwent endoscopy at University Hospital Pedro Ernesto (HUPE). Tissue samples were collected from 44 patients with a histologically confirmed diagnosis of ESCC recruted from Hospital Universitário Pedro Ernesto (HUPE-UERJ), and Instituto Nacional de Câncer (INCA). Tissue samples from healthy individuals submitted to endoscopic routine examination, not related to cancer or esophageal disorders, at HUPE-UERJ were also included in this study. The expression of proteins in tissues was evaluated by immunohistochemistry, while mRNA expression of GLUT-1 was also evaluated in the control samples. It was observed that the control samples express HK2, PKM1, PKM2, HIF1α layers of the esophageal epithelium. GLUT-1 and Ki-67 are seen only in the basal layer. Furthermore, expression of GLUT-1 mRNA did not correlate with disease etiological factors. In ESCC expression of HK2, PKM2 and GLUT-1 was seen in all tumors, and the expression of HIF1α and PKM1 was variable. We found that increased expression of HIF-1α correlates with lymph node invasion and differentiation, whereas the expression of HK2 is related to survival, and differentiation with PKM1. The clinical correlations found suggest that alterations in energy metabolism are an interesting subject of study for development of biomarkers that help clinical practice.

Le syndrome d’apnées obstructives du sommeil (SAOS) est associé à une forte morbi-mortalité cardiovasculaire. L’hypoxie intermittente (HI), conséquence majeure des apnées, est à l’origine d’un stress oxydant, d’une activation de HIF-1 (hypoxia inducible factor 1) et d’une expression d’endothéline (ET-1), tous impliqués dans les complications cardiovasculaires liées à l’HI.Dans un premier temps, nous avons démontré que l’HI augmentait l’incidence des arythmies ventriculaires létales associées à l’ischémie myocardique. Parmi les mécanismes potentiels impliqués, l’analyse spectrale de la variabilité de la fréquence cardiaque et de la pression artérielle et le dosage des catécholamines ont mis en évidence une activation sympathique chez les animaux exposés à l’HI. L’HI est également à l’origine d’altérations de la repolarisation ventriculaire (allongement du QTc et du Tpeak-Tend) et d’une dispersion du gradient transmural (allongement de la durée du potentiel d’action endocardique) associées à une augmentation de l’expression de canaux calciques de type LTCC et TRPC dans l’endocarde.Dans la seconde partie de ce travail de thèse, nous nous sommes intéressés aux perturbations de l’homéostasie du zinc en réponse au stress oxydant causé par l’ischémie-reperfusion (IR) ou par l’HI et aux propriétés cardioprotectives de la supplémentation en zinc dans ce contexte. Nous avons montré que l’IR et l’HI induisaient une diminution des concentrations de zinc myocardiques et plasmatiques, respectivement. Nous avons mis en évidence les effets bénéfiques de la supplémentation en zinc vis-à-vis des arythmies ventriculaires et des altérations myocardiques induites par l’IR. L’administration de zinc lors de la reperfusion a également permis d’abolir l’augmentation de la taille d’infarctus induite par l’exposition chronique à l’HI.Finalement, nous avons étudié les effets de la déplétion en zinc sur des cellules endothéliales à l’aide d’un chélateur spécifique du zinc, le TPEN. Nous avons observé que l’exposition des cellules au TPEN entraînait une translocation nucléaire de HIF-1α et une augmentation de la sécrétion d’ET-1 avec, comme conséquence, une augmentation de la capacité migratoire des cellules endothéliales. Ainsi, une déplétion en zinc semble conduire à une activation de l’axe HIF-1-ET-1 connu pour ses effets délétères lors de l’HI.En résumé, l’exposition chronique à l’HI exacerbe les arythmies et augmente la taille d’infarctus lors de l’IR. L’activation sympathique, le stress oxydant et l’altération de l’homéostasie du zinc pourraient être impliqués. L’utilisation d’outils pharmacologiques permettrait de confirmer leur rôle et potentiellement de prévenir les altérations cardiovasculaires liées à l’HI et au SAOS. / Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality. Intermittent hypoxia (IH), one of the major consequences of apneas, leads to oxidative stress, activation of HIF-1 (hypoxia inducible factor 1) and endothelin (ET-1) expression, all known to play an important role in the cardiovascular consequences of OSA.First, we have demonstrated that IH increases the incidence of ischemia-related lethal ventricular arrhythmias. Among the potential mechanisms involved, spectral analysis of heart rate and blood pressure variability and catecholamine assay, showed a sympathetic activation in animals exposed to IH. IH was also responsible for alterations in ventricular repolarisation (increased QTc and Tpeak-Tend intervals) and dispersion of the transmural gradient (increased endocardial action potential duration). These alterations were associated with increased expression of endocardial LTCC and TRPC calcium channels.The second part of the thesis aimed at investigating zinc homeostasis in response to the oxidative stress induced by ischemia-reperfusion (IR) or IH as well as the beneficial effects of zinc supplementation in this context. We observed that IR and IH induced a decrease in myocardial and plasma zinc concentrations, respectively. We also highlighted the protective effects of zinc supplementation during reperfusion against the ventricular arrhythmias and myocardial dysfunction induced by IR. Zinc administration during reperfusion also abolished the increase in infarct size induced by chronic IH exposure.Finally, we investigated the effects of zinc depletion in endothelial cells exposed to TPEN, a specific zinc chelator. We observed that TPEN induced a nuclear translocation of HIF-1α and an increase in ET-1 secretion with a resulting increase in endothelial cell migration. Thus, zinc depletion appears to promote activation of the HIF-1-ET-1 axis, known for its deleterious effects upon IH.In summary, chronic IH exposure enhances ventricular arrhythmias and increases infarct size upon myocardial I/R. Sympathetic activation, oxidative stress and alterations of zinc homeostasis appear to be contributing factors. Pharmacological targeting of these alterations should be performed in order to confirm their role as well as to potentially prevent the deleterious cardiovascular consequences of IH and OSA.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / O carcinoma epidermoide de esôfago (CEE) representa 90% dos casos de câncer de esôfago no Brasil. O CEE tem detecção tardia, um comportamento extremamente agressivo e baixa sobrevida, sendo, portanto, um alvo interessante para o estudo dos mecanismos envolvidos em sua carcinogênese, a fim de se identificar possíveis alvos terapêuticos ou marcadores moleculares que ajudem na prática clínica. Mudanças no metabolismo energético da célula tumoral parecem ter papel de destaque na transformação maligna. Sabe-se que células tumorais consomem glicose avidamente produzindo ácido lático, mesmo em condições de normóxia. Dentre os fatores que podem contribuir para o estímulo da glicólise em células tumorais destacam-se as alterações em enzimas da via glicolítica tais como: as piruvato-cinases M1 e M2 (PKM1 e PKM2), a hexocinase II (HKII), isofoma 1 do transportador de glicose, GLUT-1, e o fator de transcrição induzido por hipóxia (HIF1α), responsável pela transcrição das proteínas citadas. O objetivo do estudo é avaliar a relação entre a expressão de HIF1α, HK2, PKM2, PKM1 e GLUT-1 e dados clínico-patológicos no CEE. Para tal, foram avaliados tumores conservados em parafina de 44 pacientes com CEE matriculados no INCA e no Hospital das Clínicas de Porto Alegre. Além disso, foram coletadas amostras de biópsia de esôfago em 67 pacientes sem doença esofágica, que foram submetidos à endoscopia no Hospital Universitário Pedro Ernesto (HUPE). A expressão das proteínas foi avaliada nos tecidos por imuno-histoquímica, enquanto que a expressão do mRNA de GLUT-1 também foi avaliada nas amostras controle. Foi observado que as amostras controle expressam HK2, PKM1, PKM2, HIF1α nas camadas do epitélio esofágico. Já GLUT-1 e Ki-67 são vistos apenas na camada basal. Além disso, a expressão do mRNA de GLUT-1 não teve correlação com fatores etiológicos da doença. Em CEE a expressão de HK2, PKM2 e GLUT-1 foi vista em todos os tumores, já a expressão de HIF1α e PKM1 foi variável. Além disso, observou-se que maior expressão de HIF-1α apresenta correlação com invasão linfonodal e diferenciação, enquanto que a expressão de HK2 tem relação com sobrevida e PKM1 com diferenciação. As correlações clínicas encontradas sugerem que alterações no metabolismo energético é um alvo de estudo interessante para desenvolvimento de marcadores moleculares que auxiliem a prática clínica. / The esophageal squamous cell carcinoma (ESCC) represents 90% of cases of esophageal cancer in Brazil. The ESCC has late diagnosis, highly aggressive behavior and poor survival. ESCC is an interesting target to the study of mechanism involved in its carcinogenesis, in order to identify potential drug targets or biomarkers to help clinical practice. Changes in tumor cell energy metabolism appear to have a prominent role in malignant transformation. Tumor cells consume glucose avidly and produce lactic acid, even under normoxia. Among the factors that may contribute to the stimulation of glycolysis in tumor cells, there are changes in the glycolytic pathway enzymes such as: pyruvate kinase M1 and M2 (PKM2 and PKM1), hexokinase II (HKII), glucose transporter isoform 1, GLUT-1, and transcription factor induced by hypoxia (HIF1α), responsible for the transcription of proteins cited. The goal of the study is to evaluate the relationship between the expression of HIF1α, HK2, PKM2, PKM1 and GLUT-1 and clinicopathological data in ESCC. Biopsy of the esophagus in patients without esophageal disease were collected, who underwent endoscopy at University Hospital Pedro Ernesto (HUPE). Tissue samples were collected from 44 patients with a histologically confirmed diagnosis of ESCC recruted from Hospital Universitário Pedro Ernesto (HUPE-UERJ), and Instituto Nacional de Câncer (INCA). Tissue samples from healthy individuals submitted to endoscopic routine examination, not related to cancer or esophageal disorders, at HUPE-UERJ were also included in this study. The expression of proteins in tissues was evaluated by immunohistochemistry, while mRNA expression of GLUT-1 was also evaluated in the control samples. It was observed that the control samples express HK2, PKM1, PKM2, HIF1α layers of the esophageal epithelium. GLUT-1 and Ki-67 are seen only in the basal layer. Furthermore, expression of GLUT-1 mRNA did not correlate with disease etiological factors. In ESCC expression of HK2, PKM2 and GLUT-1 was seen in all tumors, and the expression of HIF1α and PKM1 was variable. We found that increased expression of HIF-1α correlates with lymph node invasion and differentiation, whereas the expression of HK2 is related to survival, and differentiation with PKM1. The clinical correlations found suggest that alterations in energy metabolism are an interesting subject of study for development of biomarkers that help clinical practice.

L’hypoxie tumorale par l’intermédiaire d’une de ses cibles HIF-1α, est associée à la transition épithélio-mésenchymateuse (TEM) dans de nombreuses tumeurs solides. La TEM a été associée aux résistances à la chimiothérapie et aux métastases dans de nombreux cancers. Dans ce travail, nous avons montré que l’hypoxie tumorale définit un pronostic péjoratif après chirurgie d’un cancer bronchique non à petites cellules (CBNPC). Nous avons également montré sur des lignées cellulaires de CBNPC présentant des mutations activatrices de l’EGFR, que l’hypoxie via HIF-1α, induit la TEM, avec activation de différents facteurs de transcription dépendant du statut mutationnel des lignées : induction de SNAIL-1/SNAIL-2 dans la lignée H1650 ayant une deletion de l’exon 19 et induction de SNAIL-1/ZEB-1 dans la lignée H1975 ayant la mutation L858R de l’exon 21 et T790M de l’exon 20. En considérant l’ensemble de ces données, il apparaît que HIF-1α peut être une nouvelle cible thérapeutique. / Tumoral hypoxia, and his target HIF-1α, are linked to the epithelial to mesenchymal transition (EMT) in various solid tumors. EMT has been linked to chemotherapy resistance and metastases in many cancers. In this work, we have shown that tumoral hypoxia may help to define a worst prognosis in case of hypoxia after non-small cell lung cancer surgery (NSCLC). We have also shown that on NSCLC cell lines harboring activating EGFR mutations, hypoxia trough expression of HIF-1α, was able to induce EMT, with activation of different transcription factors according to cell mutational status: induction of SNAIL-1/SNAIL-2 in H1650 cell line harboring exon 19 deletion, induction of SNAIL-1/ZEB-1 in H1975 cell line harboring both exon 21 L858R and exon 20 T790M mutations. Considering all these data, it appears that HIF-1α may be considered a a new therapeutic target.

Les adénocarcinomes rénaux à cellules claires (ccRCC), qui représentent 70% des tumeurs rénales, sont fortement mais irrégulièrement vascularisés, ce qui les rend hypoxiques et donc résistants aux chimiothérapies. L'hypoxie favorise l'agressivité tumorale via l'activation des facteurs de transcription HIF-1alpha et HIF-2alpha (Hypoxia-Inducible Factors). Pour cette raison, le ciblage de l'hypoxie intratumorale et des facteurs HIF dans les ccRCC constitue une stratégie thérapeutique pertinente. Dans ce projet, nous montrons pour la première fois que la voie sphingosine kinase 1/sphingosine 1-phosphate (SphK1/S1P) régule HIF-2alpha in vitro et in vivo. Nos résultats indiquent que la SphK1 régule le taux intracellulaire et l'activité transcriptionnelle de HIF-2alpha dans des lignées de ccRCC représentatives de certains sous-groupes retrouvés en clinique humaine ; et impliquent la S1P extracellulaire, via le récepteur S1P1, dans la régulation de HIF-1alpha et HIF-2alpha. D'autre part, nous avons évalué l'impact de l'inhibition des récepteurs à S1P et de la SphK1 par le FTY720 dans un modèle de ccRCC in vivo. Nos résultats indiquent que le FTY720 entraine une diminution transitoire du taux intratumoral de HIF-1alpha et HIF-2alpha ainsi qu'un remodelage du réseau vasculaire tumoral. En effet, le FTY720 induit une normalisation vasculaire qui aboutit à une oxygénation tumorale transitoire. Enfin, nous montrons que ce traitement permet de sensibiliser un modèle murin de ccRCC à la chimiothérapie. Ces résultats valident le rôle de la voie SphK1/S1P comme régulateur de l'adaptation à l'hypoxie dans les ccRCC. Ils constituent une étape indispensable à la transposition en clinique humaine du concept selon lequel la voie SphK1/S1P peut être ciblée afin de diminuer l'hypoxie intratumorale et de chimiosensibiliser certains cancers, le FTY720 étant déjà sur le marché. / Clear cell renal cell carcinomas (ccRCC) represent 70% of renal tumors. Because of their dense and irregular vascular network, ccRCC become hypoxic and therefore resistant to chemotherapies. Hypoxia promotes tumor aggressiveness via the activation of HIF-1alpha and HIF-2alpha (Hypoxia-Inducible Factors). For this reason, the control of intratumoral hypoxia and HIF in ccRCC could be a relevant therapeutic strategy to improve the efficacy of current treatments. In this study, we show for the first time that the sphingosine kinase 1/sphingosine 1-phosphate (SphK1/S1P) pathway regulates HIF-2alpha in vitro and in vivo. Our results indicate that SphK1 regulates HIF-2alpha intracellular level and transcriptional activity in ccRCC cell lines that are representative of some clinical ccRCC subgroups. Our data also involve extracellular S1P, via its receptor S1P1, in the regulation of HIF-1alpha and HIF-2alpha. In addition, in a ccRCC mouse model, we show that FTY720 - an inhibitor of the SphK1/S1P pathway- transiently decreases HIF-1alpha and HIF-2alpha intratumoral level. This is associated with a transient remodeling of the tumor vascular network indicating that FTY720 induces a vascular normalization that leads to transient tumor oxygenation. Finally, we show that this treatment sensitizes a ccRCC mouse model to chemotherapy. Overall, these results validate the key role of the SphK1/S1P pathway in the adaptation to hypoxia in ccRCC cell and animal models. Our results provide a mechanistic basis to target the SphK1/S1P pathway with FTY720 by increasing the efficacy of chemotherapy in ccRCC. They are a prerequisite for clinical transposition as FTY720 is a drug approved used in human clinic.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21257号 / 医博第4375号 / 新制||医||1029(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 増永 慎一郎, 教授 妹尾 浩, 教授 松田 道行 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 新制・課程博士 / 博士(生命科学) / 甲第25455号 / 生博第526号 / 京都大学大学院生命科学研究科高次生命科学専攻 / (主査)教授 原田 浩, 教授 永尾 雅哉, 教授 松本 智裕 / 学位規則第4条第1項該当 / Doctor of Philosophy in Life Sciences / Kyoto University / DFAM

Hypoxia Inducible Factors (HIF) functions are master regulators of oxygen homeostasis and have a key role in the physiological responses to hypoxia including angiogenesis and erythropoiesis. Under hypoxia, levels of HIF-α subunits increase, they hetereodimerise with HIF-1β sub unit and promote the initiation of transcription of target genes. Under normoxia, oxygen dependent HIF-α degradation is promoted by hydroxylation of either of two proline residues (Pro402 and Pro564). The interaction of prolylhydroxylated HIF-α with the Von Hippel-Lindau protein (pVHL) promotes hydrolytic degradation of HIFα through an E3 ubiquitin ligase proteasomal pathway. HIF prolyl hydroxylation is catalysed by three 2-oxoglutarate (2OG)-dependent oxygenases known as prolyl hydroxylase domain (PHD 1-3) proteins, through an Fe(II) mediated catalytic process using 2OG, and oxygen. The PHDs are part of the family of Fe(II) bound 2OG dependent oxygenases. There are approximately 70 human 2OG oxygenases many of which have biologically important roles. Small-molecule inhibitors have reached advanced clinical trials; however, many clinical candidates inhibit other structurally similar 2OG oxygenases (OGFOD1 and vCPH) potentially altering the therapeutic effect. This thesis describes the design and synthesis of potent and 2OG oxygenase selective inhibitors for the PHDs. The 1,3,8-triazaspiro[4.5]decane-2,4-dione and 4-hydroxy-2-(pyrazole)pyrimidine-5-amide series were chosen as initial 'hits' (reported in the patent literature). The main analogues of the series were characterised in vitro and in cells as potent and selective PHD inhibitors over structurally similar 2OG oxygenases (Chapter 2). Broad structure activity relationship (SAR) of both initial series demonstrated the sensitivity for PHD2 inhibition (Chapter 3). Combination of SAR work described in Chapters 2 and 3 lead to the development of the novel 4-hydroxy pyridine series. In-depth SAR resulted in optimised analogues including 1 (IC50 69 nM) and highly selective over structurally similar 2OG oxygenases including OGFOD1. The completed SAR work led to the development of two novel pharmacophores 2 and 3. Both pharmacophores displayed potent PHD inhibition and selectivity over OGFOD1. Analogues including 1 and 3 displayed on target cellular activity stabilising HIF-1α at 20 μM (Chapter 4). The 4-dimethylamine pyridine analogue displayed an increase in substrate hydroxylation on PHD2 in contrast to the DMSO control (Chapter 3). SAR and cellular characterisation indicated that the effect observed was not an assay artifact (Chapter 5). Fenofibrate was used as a starting point for the development of novel inhibitors of the oxygen consumption rate (OCR) via mitochondrial inhibition (Chapter 6). Analogues were synthesised in order to conduct broad SAR and on-target cellular activity was observed in a Seahorse XF assay (50% reduction in the OCR at 1 μM). A selection of amino and amide analogues warrant further investigation.