Orientador: Carmen Silvia Bertuzzo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T19:05:10Z (GMT). No. of bitstreams: 1 Rossanese_LillianBarbosadeQueiroz_D.pdf: 6549748 bytes, checksum: 054df2cab96a347008ff6d310b9dcfa9 (MD5) Previous issue date: 2012 / Resumo: Mutações germinativas no gene APC (Polipose adenomatosa coli) são responsáveis pela ocorrência de polipose adenomatosa familiar (PAF). Mutações somáticas levam à transformação maligna de adenomas. O objetivo desse trabalho foi identificar mutações germinativas no gene APC. No presente estudo, 20 pacientes com PAF foram estudados. A determinação das mutações germinativas no APC foi realizada por meio de sequenciamento, e as mutações foram comparadas com marcadores clínicos (sexo, idade no momento do diagnóstico, tabagismo, estádio TNM, classificação Coller-Astler e o grau de diferenciação do adenocarcinoma). Os dados foram comparados por meio do programa SPSS , com o teste de Fisher e teste de ?2 , considerando ? = 0,05. De acordo com os principais resultados da nossa amostra, 16 alelos com mutações deletérias (80 % dos pacientes) foram identificados, enquanto 7 (35%) pacientes não tinham mutações deletérias. Houve um predomínio de mutações nonsense (45% dos pacientes) e de mutações frameshift (20% dos pacientes). Não houve significância estatística entre as mutações germinativas identificadas e as variáveis clínicas consideradas em nosso estudo. Apenas a fase TNM foi associada com a presença de mutações deletérias. Os portadores com mutações deletérias tinha uma OR , 0,086 ( IC = 0,001-0,984 ); TNM I + II em comparação com III + IV , quando comparado com os pacientes sem mutações deletérias identificados. Neste estudo, demonstramos a heterogeneidade molecular de mutações germinativas no APC em portadores de PAF e a dificuldade para realizar diagnóstico molecular em uma população brasileira / Abstract: Adenomatous polyposis coli (APC) germline mutations are responsible for the occurrence of familial adenomatous polyposis (FAP). Somatic mutations lead to malignant transformation of adenomas. In this context, considering the significance of APC germline mutations in FAP, we aimed to identify APC germline mutations. In the present study, 20 FAP patients were enrolled. The determination of APC germline mutations was performed using sequencing, and the mutations were compared with clinical markers (gender, age at diagnosis, smoking habits, TNM stage, Astler-Coller stage, degree of differentiation of adenocarcinoma). The data were compared using the SPSS program, with the Fisher's exact test and ?2 test, considering ?=0.05. According to the main results in our sample, 16 alleles with deleterious mutations (80% of the patients) were identified while 7 (35%) patients had no deleterious mutations. There was a predominance of nonsense (45% of the patients) and frameshift (20% of the patients) mutations. There was no statistical significance between the APC germline mutations identified and the clinical variables considered in our study. Only TNM stage was associated with the presence of deleterious mutations. Patients with deleterious mutations had an OR, 0.086 (IC=0.001-0.984); TNM stage I + II in comparison with III + IV, when compared with the patients with no deleterious mutations identified. In this context, as a conclusion, we demonstrated the molecular heterogeneity of APC germline mutations in FAP and the difficulty to perform molecular diagnostics in a Brazilian population, considering the admixed population analyzed / Doutorado / Clinica Medica / Doutora em Ciências

Orientador: Oslei Paes de Almeida / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-07-25T08:18:42Z (GMT). No. of bitstreams: 1 DellaColetta_Ricardo_D.pdf: 6321143 bytes, checksum: fee6575189b6054e21beeaa54cc06f5a (MD5) Previous issue date: 1999 / Resumo: Fibromatose gengival hereditária (FGH) é uma condição rara caracterizada por um aumento gengival generalizado com crescimento lento e progressivo. Para elucidar algumas das características regulatórias que resultam nesta condição, quatro linhagens celulares de fibroblastos provenientes de indivíduos de uma mesma família com FGH foram isoladas e caracterizadas em relação ao comportamento prol proliferativo, produção, e expressão de colágeno e suas proteínas chaperones, expressão de MMPs e TIMPs e produção de citocinas. Fibroblastos de gengiva normal (GN) e FGH em condições de subconfluência celular apresentaram típicas características morfológicas, mas em condições de saturação da densidade, os fibroblastos de FGH apresentaram dimensões menores que as células controle. Cinco diferentes ensaios de proliferação celular mostraram que a relação de proliferação foi significantemente maior em fibroblastos de FGH. A produção e expressão de Hsp47 é também aumentada em fibroblastos de FGH em paralelo com o aumento na produção de colágeno. Em adição, a expressão de Hsp47 é regulada por estresse celular e pró-peptídeos correspondendo as regiões da porção N-terminal das cadeias 'alfa'1 (I). A produção de citocinas foi detectada por ELlSA utilizando anticorpos específicos para TGF-' beta '31, IL-6, IL-1 ' beta ' e TNF- 'alfa '. Em fibroblastos de FGH a produção de TGF-' beta ' 1 e IL-6 foi estatisticamente maior que em fibroblastos normais (p<0,013 e p< 0,0035 respectivamente), enquanto que IL-' beta ' 1 e TNF- 'alfa ' não foram detectadas em todos as linhagens celulares. A expressão e produção de MMP-1 e MMP-2, como revelada por RT -PCR e zimografia, foram significantemente menores em fibroblastos de FGH comparando com células de GN. Por outro lado, a expressão de TIMP-1 e TIMP-2 foi ligeiramente maior em fibroblastos de GN. A neutralização de TGF- ' beta ' 1 com anticorpos específicos elevou os níveis de expressão e produção de MMP-1 e dramaticamente reduziu os níveis de MMP-2, enquanto que os de níveis de TIMPs não foram alterados. Estes resultados sugerem que a pato gênese do aumento gengival de indivíduos com FGH é possivelmente resultado de uma associação de fatores incluindo alterado comportamento proliferativo, exacerbada síntese de colágeno e Hsp47, desregulação no balanço proteolítico e elevada produção de citocinas / Abstract: Characterization of cellular proliferation and expression of collagen and its molecular chaperones, cytokines and matrix metalloproteinases and its tissue inhibitors in gingival fibroblasts from pacients with hereditary gingival fibromatosis Hereditary gingival fibromatosis (HGF) is a rare oral condition characterized by a slow and progressive enlargement of the gingiva, involving both the maxillaand mandible. To further elucidate some of the regulatory features resulting in this condition, the culture characteristics of the four cell lines of gingival fibroblasts derived from patients of the some family with HGF were isolated and characterized on proliferation index, collagen and its molecular chaperones production and expression, MMPs and TIMPs expression, and cytokines production. HGF and normal gingiva (NG) fibroblasts in subcofluent culture densities showed typical morphologic characteristics, but in saturation density, HGF fibroblasts were shorter than NG cells. Five different cell proliferation assays showed that the cell proliferation rate was significantly higher in HGF fibroblasts. The production and expression of Hsp47 were significantly higher in HGF fibroblasts than in NG fibroblasts, along with increased producto?n of collagen. In addition, Hsp47 is coordinately regulated by stress and by feedback mechanism mediated by N-terminal procollagen propeptides corresponding to residues of a1 (I)-chains. The cytokines production was detected by ELlSA using specific antibodies for TGF-' beta ' 1 , IL-6, IL-1 ' beta ' and TNF- 'alfa '. In HGF fibroblasts, the production of TGF-' beta ' 1 and IL-6 was higher than fibroblasts from normal tissues (p<0.013 and p<0.0035 respectively), whereas IL-1' beta ' and TNF-'alfa ' were not detected in ali cell lines. RT-PCR and enzymographic analysis clearly demonstrated that the expression and production of MMP-1 and MMP-2 were significantly lower in fibroblasts from HGF than from NG. Interestingly, TIMP-1 and TIMP-2 expression from NG cells was shown to be slightly higher than those from HGF. The use of neutralizing antibodies to TGF-' beta ' 1 caused a slight increase in MMP-1 and a decrease in MMP-2 expression, whereas that no change TIMPs levels. These results suggest that the pathogenesis of gingival outgrowth in HGF patients is possibly resulted of a association of factors such as increased proliferative potential, altered synthesis of collagen and Hsp47, dysregulated proteolytic balance and increased cytokines production / Doutorado / Biologia e Patologia Buco-Dental / Doutor em Odontologia

Abstract Human mitochondria contain a circular genome called mitochondrial DNA (mtDNA). It encodes subunits of the respiratory chain enzymes involved in energy conservation in oxidative phosphorylation and the necessary RNA needed for their expression. Errors in these genes have been shown to cause diseases, called mitochondrial diseases, which mainly affect tissues with high energy-demand, such as brain, heart, and skeletal muscle, or to lead to the production of harmful by-products in the form of reactive oxygen species (ROS) during cellular respiration. ROS damage lipids, proteins, and DNA, especially mtDNA. Accumulation of mtDNA mutations has also been associated with aging. Mitochondrial complex I is located in the inner mitochondrial membrane and catalyzes NADH-ubiquinone oxidoreduction coupled to the translocation of four protons from the inside of the mitochondrion to the intermembranous space. Bacteria contain a homologous but simpler enzyme, NDH-1, with the same catalytic mechanism and which is therefore considered the catalytical core of mitochondrial complex I. Seven of the conserved membranous subunits in complex I are encoded in the mtDNA and are targets for mutations causing mitochondrial diseases, like MELAS syndrome or Leber hereditary optic neuropathy (LHON). We used Paracoccus denitrificans and Escherichia coli NDH-1 enzymes to reveal the role of selected conserved charged residues and MELAS or LHON amino acid substitutions in enzyme catalysis. The growth phenotypes and NDH-1-dependent activities in mutant bacterial membranes were characterized, in addition to the sensitivity to selected complex I inhibitors. In order to enable ROS production measurements in the bacterial model of human mitochondrial diseases, we evaluated the reliability of two superoxide detecting probes, lucigenin and coelenterazine. Elimination of the acidic residue in ND1 (position E228) previously found to cause MELAS, was found detrimental for NDH-1 assembly and activity. Also, elimination of the acidic residue at position E36 in ND4L resulted in an inactive enzyme. ND1-E216A, ND4L-E72Q and -E36Q/I39D/A69D/E72Q substitutions decreased NDH-1 activity somewhat (normal activity in the last mutant), but displayed a negative growth phenotype under NDH-1 dependent conditions, suggestive of impaired energy conservation in these mutants. ND1-Y229, whose substitution causes MELAS, charged residues in loop five of ND1, and ND1-E157, whose substitution causes LHON, were also found important for the enzyme activity. Coelenterazine was found a reliable probe for quantitative superoxide production measurement in mitochondrial or bacterial membranes, and its sensitivity is not affected by the reduction level of the respiratory chain. Therefore, coelenterazine is suitable for quantitative superoxide production measurements.

Abstract Sensorineural hearing impairment (SNHI) is a well-recognized manifestation of mitochondrial diseases and occurs either in a non-syndromic form or as a part of a syndrome. Mitochondrial deafness is bilateral, usually progressive and is inherited maternally. Approximately 70% of patients with the most common syndromes, Kearns-Sayre, MELAS or MERRF, have SNHI. Several mutations in mitochondrial DNA (mtDNA) have been found to cause non-syndromic SNHI, including 1555A>G, 7445T>C, 7472insC and 7511T>C. In order to estimate prevalences of pathogenic mtDNA mutations in population-based cohorts of patients with SNHI, we obtained samples from 133 patients with SNHI, reportedly representing 117 separate maternal lineages. We found five patients with the 3243A>G mutation and three with the 1555A>G mutation, whereas the other point mutations associated with SNHI were absent. The frequencies of the mutations in the cohort were thus 4.3 % for 3243A>G and 2.6 % for 1555A>G, suggesting a total frequency of 6.9 % for mtDNA mutations known to be associated with hearing impairment. We found a mutation 10044A>G, which has been reported as pathogenic, in our patients with SNHI, but we also found it among the controls. Our results show it to be a homoplasmic polymorphism associated with a fairly rare haplotype within mtDNA haplogroup H which has recently been confirmed as subcluster H4. These results highlight the difficulty in determining the pathogenicity of a mtDNA mutation when it is identified only in one family. Therefore, in addition to the previously published criteria, we suggest that a sufficient number of haplotype-specific controls should be screened before the pathogenic nature of a mtDNA mutation can be verified. We determined the complete mtDNA sequences for 121 Finns, and after complementing our recent data, for a total of 192 Finns, and were able to construct a phylogenetic network based on complete mtDNA sequences, the largest set of complete sequences available at that time. These mtDNAs provide a rich source of information for studies in population genetics and a potential tool for analysing new substitutions and genotypes that entail a risk of mitochondrial disease. We used the phylogenetic network to find new pathogenic mutations or risk genotypes for SNHI. The entire coding region sequences of mtDNA were determined in 32 patients with SNHI and compared with the network. The patients were found to harbour more rare polymorphisms and haplotypes than the controls and to show increased variation in their mtDNA sequences, suggesting mildly deleterious effects for these substitutions. Two of the new mutations were suggested as putatively pathogenic.

In normal cranial suture development, the cranial sutures close at predetermined periods of development to allow the brain the capability to grow in a malleable environment. However, in craniosynostosis, cranial sutures prematurely fuse before birth which can lead to a wide range of developmental issues and complications. Craniosynostosis can be categorized as nonsyndromic which involves the sole fusion of one or more of the cranial sutures, or syndromic in which cranial sutures fuse as well as other abnormalities associated with a genetic disorder. Past research has identified three candidate genes that could be possible disease causing mutations in nonsyndromic sagittal craniosynostosis. The mutations were found were in ITGAV, SLC30A9, and BAMBI. Using zebrafish as a model organism, we assessed the phenotypic effects of mutating itgav, slc30a9, and bambia associated with craniosynostosis. Phenotypic analysis of heterozygous itgav mutants showed when itgav is mutated there is increased bone formation and abnormal suture development. Due to the phenotype seen in zebrafish, it is proposed when mutated, ITGAV can help produce craniosynostosis.

Les fièvres récurrentes héréditaires (FRH) sont des maladies auto-inflammatoires transmises selon un mode mendélien. Elles se caractérisent par des accès fébriles récurrents spontanément résolutifs accompagnés d'une inflammation systémique et d'une atteinte des séreuses. La complication la plus grave réside dans le risque de survenue d'une amylose inflammatoire, essentiellement rénale. Le diagnostic clinique des FRH est difficile à établir du fait d'une part d'une grande variabilité inter et intra familiale des phénotypes complexes qui peuvent combiner des signes évocateurs de plusieurs FRH, et d'autre part de l'absence, dans la majorité des cas, de critères objectifs de diagnostic. Alors que le diagnostic de certitude repose essentiellement sur l'identification de défauts moléculaires dans des gènes de l'immunité innée (comme NLRP3, NLRP12, ou MEFV), ces mutations ne rendent compte de la pathologie que chez moins de 30% des cas. Le retentissement fonctionnel de ces variations de séquence, qui sont essentiellement des mutations faux-sens, souvent conservatives, n'a été étudié que dans des lignées cellulaires qui n'expriment pas plusieurs acteurs clés de l'inflammasome, un complexe multiprotéique activé chez les patients présentant une FRH. Au cours de cette thèse, nous avons développé un modèle cellulaire pertinent des FRH à partir de cultures primaires de macrophages humains, dans le but d'étudier les conséquences fonctionnelles des mutations identifiées dans les gènes de FRH et de caractériser les réseaux moléculaires auxquels appartiennent les protéines codées par ces gènes. En parallèle, nous avons cherché à identifier de nouveaux gènes impliqués dans les FRH. / Hereditary recurrent fevers (HRF) define a group of auto-inflammatory diseases transmitted in a Mendelian fashion. They are characterized by recurrent episodes of fever spontaneously resolved, accompanied by systemic inflammation, usually revealed by sterile arthritis, peritonitis, and/or pleurisy. The most serious complication in HRFs is the risk of inflammatory amyloidosis, mainly renal. The clinical diagnosis of HRF is challenging due on the one hand to the inter- and intra- family variability and to complex phenotypes, which combine signs suggestive of different HRFs, and on the other hand, to the absence of objective diagnostic criteria in the majority of cases. While definitive diagnosis is mainly based on the identification of molecular defects in genes of innate immunity (as NLRP3, NLRP12 or MEFV), mutations in these genes account for the pathology in a limited number of patients (30% of cases in our experience). The functional impact of these sequence variations, which are mainly conserved missense mutations, has been studied mainly in heterologous cell lines that do not express several key players of the inflammasome, a multiprotein complex active in patients with HRF. In this thesis, we developed a physiologically relevant cell model of HRF using primary human macrophages in order to assess the functional consequences of the disease-causing mutations and to characterize the molecular networks to which the involved proteins belong. In parallel, we sought to identify novel genes involved in HRF.

Bakgrund: Mutation i BRCA-generna innebär kraftigt ökad risk att utveckla bröst- och ovarialcancer. Vetskap om att bära på denna genmutation innebär påfrestningar och psykosociala förändringar hos individen. Sjuksköterskor behöver insikt i hur detta tillstånd påverkar individen för att kunna tillfredsställa vårdbehovet på ett personcentrerat sätt. Syfte: Skildra kvinnors upplevelse av att bära på mutation i gen BRCA 1 eller BRCA 2. Metod: Allmän litteraturstudie med deskriptiv design. Resultatet baserades på tio originalartiklar med kvalitativ ansats från databaserna PubMed och Cinahl. Resultat: Upplevelsen varierade mellan kvinnor, och känslomönster identifierades mellan individer i liknande livssituationer. Många uppgav en initial känsla av chock, samt känslor av osäkerhet kring den upplevda hälsan. De beskrev ett informationsbehov och en upplevd brist på kunskap hos vårdgivaren. Detta resulterade i rädsla att bli vilseledd samt känslor av ensamhet, tomhet och isolering. Undersökningsgruppen beskrev en oro och rädsla inför en eventuell framtida cancerdiagnos och hur detta skulle komma att påverka dem och deras familj. De beskrev även att denna vetskap tvingade dem in i en beslutsprocess gällande framtida livshändelser, såsom profylaktisk kirurgi och familjeplanering. Slutsats: Kvinnorna upplevde mycket oro, ångest, rädsla och osäkerhet inför framtiden. De upplevde ett informationsbehov som inte tillfredsställdes samt ett stort behov av stöd.  Vårdpersonalen behöver mer kunskap om hur vetskapen om genmutation i BRCA 1 eller BRCA 2 kan påverka patienten. Strategier behöver utformas för att tillfredsställa kvinnornas behov av stöd och information. Detta i syfte att främja hälsa lindra lidande. / Background: Mutation in the BRCA genes involves a significantly increased risk of developing breast- and ovarian cancer. Knowledge about carrying this gene mutation lead to stress and resulted in psychosocial changes. Nurses needs insight into how this situation affects the individual in order to satisfy the care needs with a person-centered approach. Purpose: The aim of the study was to investigate and depict women’s experience of carrying a mutation in the BRCA 1 or BRCA 2 gene. Method: General literature review with descriptive design. Results was based on ten qualitative original research articles from the databases PubMed and Cinahl.  Results: The experience varied woman to women, and emotional patterns were identified between individuals in similar life situations. Many expressed an initial feeling of shock, and uncertainty about the perceived health. They described a need for information, and experienced a lack of knowledge among the caregivers, which resulted in fear of being misled. The study group described feelings of fear and worry for a future cancer diagnosis and how that would affect their families and themselves. They also described that it forced them into a decision making process regarding risk reducing surgery and family planning. Conclusion: These women experienced great levels of worry, anxiety, fear and uncertainty regarding the future. They experienced a need for information that was not satisfied, and also a great need for support. Caregivers need more knowledge about how awareness of gene mutation in BRCA 1 or BRCA 2 can affect the patient. Strategies need to be designed to meet women´s need of information and support. This in order to promote health and ease suffering.

Identifying individuals with hereditary cancer predisposition can improve health outcomes for patients and their family members through early cancer detection and prevention strategies. Prior research about family sharing of genetic test results among those with hereditary breast cancer has overwhelmingly been limited to the BRCA1 and BRCA2 genes. The present study sought to compare family sharing behaviors in women with pathogenic BRCA variants to women with pathogenic variants in the more recently identified and characterized PALB2 gene. A total of 18 BRCA carriers and 13 PALB2 carriers were interviewed about family sharing practices using a semi-structured guide based on the Integrated Behavioral Model. Barriers and facilitators to family sharing were similar for both BRCA and PALB2 carriers, with logistical difficulties and emotional struggles related to anticipated negative reactions from relatives being the most salient barriers. The most important facilitators were: attitude that sharing enables health protection, provider recommendation, strong family relationships, confidence in sharing basic information, knowledge of what to share and how to share, and belief that sharing is highly important. Given similar attitudes, norms, and control beliefs related to family sharing, similar, but tailored interventions may be effective at increasing family disclosures among both groups. Such interventions should involve a discussion of patients’ attitudes towards sharing with healthcare providers to strengthen motivations and address barriers and provision of informational resources to increase confidence and knowledge. Family sharing resources should clearly specify which relatives need to be informed, why sharing is important, and how at-risk relatives may benefit.

Cancer the second most common causes of death in the Czech Republic. Carriers of mutations in genes predisposing to hereditary cancers represent a small but clinically significant group of high risk individuals. Today, dozens of predisposing genes for hereditary tumor syndromes are known and targeted next generation sequencing (NGS) has become a standard approach for their analysis. NGS allows rapid acceleration diagnostics of causal mutation in high-risk individuals. To identify mutations in genes predisposing to hereditary cancers, we designed a panel NGS analysis including subsequent bioinformatics analysis allowing a reliable identification of single nucleotide variants, insertions/deletions, and large intragenic rearrangements. The bioinformatics procedures described in this thesis were used for panel NGS validation, but also for identification of alterations associating with so far undescribed hereditary tumor types. Bioinformatics analyzes have become the basis for the unified processing of large datasets from the CZECANCA consortium and enable the construction of a population-specific database of genotypes that serve to improve clinical diagnostics of cancer predisposition in Czech patients. The versatility of NGS also allows its use for RNA (cDNA-based) analyzes of splicing variants in the...

Hereditary Titles - Legal Regulation in the Czech Republic and in France Aim of this thesis is to present legal regulation of hereditary titles in the Czech Republic and in France. Within five chapter, the thesis provides analysis of the current legal framework of the particular hereditary titles in the Czech and French jurisdiction. Each hereditary title, which is a legal reason for inheritance, is presented in a separate chapter. Each chapter is then - for clarity reasons - further divided into subsections: firstly stating the Czech legal framework, followed by the French one. For easier understanding of the topic, the first chapter is dedicated to introduction into inheritance law and is followed by presenting the particular requirements of inheritance, which are conditions for realization of inheritance law. Second chapter talks about the inheritance contract and shows its legal regulation in the Czech Republic. Besides the general provisions, it also discusses the specific regulation of inheritance contract concluded between spouses. In connection to that, the French regulation of inheritance contract is displayed, whose state is set into the historical context. Third chapter is focused on introducing into the problematic of testament, legal requirements for its obtaining as well as legal...