A resistência tubular renal tem sido estudada a fim de se ampliar a compreensão da fisiopatologia da Insuficiência renal aguda (IRA). A isquemia renal induz à resistência a um subseqüente insulto isquêmico sendo que os mecanismos de resistência parecem depender de alterações celulares. O p21 é um inibidor do ciclo celular, o qual pode ser induzido por radicais livres de oxigênio e parece ter um efeito protetor na IRA isquêmica. O objetivo deste estudo é avaliar o papel do p21 e do estresse oxidativo em modelo de resistência adquirida após episódio de IRA isquêmica, e em túbulos proximais isolados após isquemia. Ratos Wistar foram divididos em 3 grupos: grupo 1- sham, grupo 2- submetido a procedimento sham e após 2 dias submetido à isquemia de 45 min e grupo 3- submetido à isquemia de 45 min e após 2 dias submetido à segunda isquemia de 45 min. Os valores de uréia plasmática (114±60 vs. 136±44 mg/dL, n.s.), a creatinina sérica (0,86±0,2 vs. 0,98±0,1mg/dL, n.s.) e o clearance de creatinina (0,21±0,1vs. 0,24±0,1mL/min/100g, n.s.), avaliados 48 h após o segundo procedimento (Dia 4), foram semelhantes entre os grupos 2 e 3. O tempo de recuperação da IRA também foi semelhante entre os grupos 2 e 3. A histologia mostrou necrose tubular aguda aparentemente de grau semelhante entre os grupos 2 e 3. O infiltrado linfocitário foi semelhante entre os 3 grupos, entretanto houve aumento no infiltrado de macrófagos no grupo 3. Foi observado aumento na proliferação celular no grupo 2 e grupo 3, quando comparados ao grupo 1(125±28 cél./mm2, p<0,05), entretanto, a proliferação foi mais intensa no grupo 2 (1.262±440 cél /mm2) que no grupo 3 (653±300 cél /mm2, p<0,05 vs. group 2). O grau de apoptose encontrado foi semelhante entre o grupo 2 e o grupo 3. Houve aumento na expressão do p21 apenas no grupo 3 sendo que esta expressão foi semelhante nos grupos 1 e 2. Foi estudada também a resistência celular em túbulos proximais (TP) isolados de ratos normais (grupo Controle) e ratos submetidos à isquemia de 35 min, 24 h antes do estudo (grupo Isquemia). TP do grupo Isquemia foram susceptíveis à hipóxia, porém, resistentes à lesão de reoxigenação. Além disto, apresentaram menor produção de hidroperóxidos. Portanto, a resistência renal isquêmica aparentemente está associada a mecanismos celulares, o estresse oxidativo e o aumento na expressão do p21 são possíveis mediadores destes mecanismos. / Renal tubular resistance has been studied for the understanding of ischemic acute renal failure (ARF). Subsequent ischemic episodes may induce renal resistance whose mechanisms seem to be related to cell alterations. P21 is a cell cycle inhibitor that may be induced by oxygen free radicals and may have a protective effect in ischemic ARF. This study aimed at evaluating the role of oxidative stress and p21 on tubular resistance in isolated renal tubules and in a model of acquired resistance after renal ischemia. Wistar rats were divided into 3 groups: group 1 - sham; group 2 - submitted to sham procedure and after 2 days submitted to 45 min ischemia and group 3 - submitted to ischemia of 45 min followed by a second 45 min ischemia after 2 days. Plasma urea levels (114±60 vs. 136±44 mg/dL), serum creatinine (0.86±0.2 vs. 0.98±0.1mg/dL) and creatinine clearance (0.21±0.1vs. 0.24±0.1mL/min/100g.) evaluated at 48 hours after the second procedure were similar between groups 2 and 3 (all NS). ARF recovery time was also similar between groups 2 and 3. Histology disclosed the same degree of acute tubular necrosis between groups 2 and 3. Lymphocytes infiltrate was similar among all groups whereas macrophages infiltrate was greater in group 3. Enhanced cell proliferation was observed in groups 2 and 3 when compared with group 1 (125±28 cel/mm2, p<0.05), however it was greater in group 2 (1,262±440 cel/mm2) than group 3 (653±300 cel/mm2, p<0.05 vs. group 2). Degree of apoptosis was similar between groups 2 and 3. The p21 expression was increased only in group 3 whereas it was similar in groups 1 and 2. Cell resistance was also evaluated in isolated renal proximal tubules (PT) from control and ischemia groups. In the latter group, animals were submitted to 35 min ischemia and PT were isolated one day later. PT from the ischemia group were sensitive to hypoxia but resistant to reoxygenation injury which was followed by lower hydroperoxides production. In conclusion, renal resistance obtained by an ischemia was associated with cell mechanisms involving oxidative stress and increased p21 expression as mediators of this protection.

O melanoma é uma forma de câncer com alto índice de morte devido, em parte, à sua tendência de formar metástases. Esse tipo tumoral apresenta deleção de CDKN2A e amplificação de HDM2 em aproximadamente 50 % dos casos, mas apenas 10 % apresentam mutação em p53. Aproveitando-se do fato de a maioria dos casos de melanoma retêm p53 selvagem, uma proteína supressora tumoral e fator de transcrição, utilizamos vetores adenovirais nos quais a expressão dos transgenes é controlada pelo p53 endógeno. Estes vetores foram aperfeiçoados com a inclusão de uma modificação na proteína fibra que permite a eficiente transdução de um amplo espectro de células. Utilizando estes vetores, nosso laboratório mostrou que o tratamento combinado, mas não individual, de vetores virais codificando p19Arf e IFNbeta (interferon-beta) induziu elevados níveis de morte em células de melanoma de camundongo, B16F10. Assim, iniciamos novos estudos que têm como alvo explorar os mecanismos de morte celular e identificar genes críticos cuja expressão é alterada frente o tratamento combinado e que agem como mediadores da resposta celular para a estratégia de transferência gênica. Com este projeto, transferimos a combinação gênica (p19Arf + IFNbeta) para células B16F10 e analisamos o tipo de morte celular induzido. Assim, detectamos o aumento da presença de marcadores de morte celular conhecidos, tais como de apoptose (atividade de caspases e exposição de fosfatidilserina) e de necroptose (expressão de RIPK3 e TNFR1), e a diminuição de um marcador de autofagia (expressão de LC3-II). Além disso, mostramos que a detecção dos três marcadores clássicos de morte imunogênica (ATP, calreticulina e HMGB1) foi possível somente quando as células B16F10 foram tratadas com a combinacao de p19Arf + IFNbeta. Por fim, a avaliação do perfil de expressão gênica através de microarray de cDNA das células B16F10 tratadas com p19Arf + IFNbeta revelou expressão diferenciada de 1054 genes em comparação com células que receberam apenas somente um ou outro transgene. Em seguida, a expressão dos genes Nr3c1, RanBP9, Sin3A, Wdr46, FoxO1, Phlda3 e tp73 foi validada por qPCR e estudos funcionais foram iniciados para revelar a participação destes na resposta celular. Dessa forma, desvendamos importantes aspectos da resposta de células B16F10 frente ao tratamento com p19Arf e IFNbeta / Melanoma is a form of cancer with a high death rate due, in part, to its tendency to generate metastasis. These tumors carry deletion of CDKN2A and amplification of HDM2 in nearly 50 % of cases, but only 10 % have mutations in p53. Taking advantage of the fact that most melanoma cases retain wild type p53, a transcription factor and tumor suppressor protein, we used adenoviral vectors in which transgene expression is controlled by endogenous p53. These vectors were improved with a modification of the fiber protein that allows efficient transduction of a broad spectrum of cells. Using these vectors, our laboratory showed that the combined treatment with viral vectors encoding p19Arf and IFNbeta (interferon-beta) induced high levels of B16F10 (mouse melanoma) cell death, but not when treated with these vectors individually. Thus, we initiated studies to explore the mechanisms of cell death and to identify critical genes involved in the response of B16F10 cells to treatment with p19Arf + IFNbeta. Here, we transferred p19Arf + IFNbeta genes to B16F10 cells and analyzed the type of cell death induced. In this regard, we detected an increase of cell death markers, such as apoptosis (caspase activity and exposure of phosphatidylserine) and necroptosis (RIPK3 and TNFR1 expression) and a decrease of an autophagy marker (LC3-II expression). Furthermore, we showed that the detection of three classic immunogenic cell death markers (ATP, calreticulin and HMGB1) was possible only when B16F10 cells were treated with p19Arf + IFNbeta combination. Lastly, assessment of gene expression profile using cDNA microarray analysis of B16F10 cells treated with p19Arf + IFNbeta revealed differential expression of 1054 genes compared to cells that received only one of the transgenes. Expression of Nr3c1, RanBP9, Sin3a, Wdr46, FoxO1, Phlda3 and TP73 genes was validated by qPCR and functional studies were started to reveal participation of these genes in the cellular response. Thus, we exposed important aspects of the B16F10 cellular response to treatment with p19Arf and IFNbeta

Chronic Myelogenous Leukemia (CML) is a blood cancer that arises when hematopoietic cells acquire an abnormal protein known as BCR-ABL. Current therapies for CML include drugs that inhibit BCR-ABL. However, these drugs only suppress the disease and do not cure it. One reason is that BCR-ABL drugs fail to kill the primitive population of CML cells, referred to as leukemia stem cells (LSCs), which are responsible for initiating and propagating CML. Since LSCs are not killed, the cancer is not cured and many affected patients eventually relapse. Recent studies suggest that LSCs are protected from current therapies by the bone marrow micro-environment where they reside. There, cytokine signaling molecules are present, which mediate processes that protect LSCs from BCR-ABL drugs. The stem cell factor (SCF) is one of these signaling molecules. It activates the receptor c-Kit located on the surface of LSCs, and this activation in turn allows proliferating LSCs to resist BCR-ABL drugs, even without prior exposure to these drugs, i.e., innate resistance is observed. In this thesis, the mechanism of this innate resistance is investigated, so that a suitable treatment strategy can be developed. To this end, a co-agent approach based on synthetic antibodies (sABs) is proposed to inhibit the receptor c-Kit, with the goal of disrupting its activation by the ligand SCF. This disruption should in turn block the SCF-mediated innate resistance, thus potentially restoring BCR-ABL drug apoptotic activity. The method for this disruption involves targeting the c-Kit structural susceptibility. Specifically, the sABs are designed via antibody phage display technology to target the D1–D2–D3 domains representing the SCF binding sites, hence preventing downstream pathway activation. The hypothesis is that, by blocking the SCF-mediated innate resistance, a suitable combination of such an sAB co-agent and a BCR-ABL drug should be conducive to suppressing LSCs, thereby providing a potential means to improve CML treatment. In addition, to assess the performance of the proposed treatment strategy, a set of in vitro tests is conducted, focusing on performance behaviors such as cell binding, cell death, and the progenitor inhibition. The experimental results support the hypothesis that the proposed combinatorial strategy is indeed a promising approach to mitigate the innate resistance, thus restoring BCR-ABL drug apoptotic activity.

Unter Verwendung eines mathematischen Hämatopoese-Modells werden verschiedene Fragen adressiert, die im Zusammenhang mit einer möglichen Optimierung der gegenwärtigen Therapie chronischer myeloischer Leukämie (CML) stehen. Es handelt sich um ein agentenbasiertes Modell, das heißt, jede Zelle wird als einzelnes Objekt repräsentiert und gemäß festgelegter Regeln im Computer simuliert. Es werden proliferative von ruhenden Stammzellen unterschieden, wobei sich der Proliferationszustand reversibel ändern kann. Das Modell basiert auf der Annahme, dass sich normale und maligne Stammzellen in einem Wettbewerb um gemeinsame Ressourcen befinden, wobei der CML-Klon einen kompetitiven Vorteil besitzt. Es ist ungeklärt, ob Tyrosinkinaseinhibitoren wie Imatinib (IM) in der Lage sind, die Erkrankung zu heilen. Es gibt Evidenz, dass residuale leukämische Stammzellen im Knochenmark persistieren, welche in einem Ruhezustand (G0-Phase des Zellzyklus) von IM nicht eradiziert werden können. Proliferativ aktive Zellen sind der IM-Wirkung hingegen ausgesetzt. Das Modell sagt voraus, unter welchen Bedingungen eine Kombinationsstrategie von IM mit stammzellaktivierenden Substanzen Synergieeffekte hervorbringen könnte. Ein verwandtes Problem ist die Frage, in welchen Fällen nach Reduktion der Tumorlast auf ein mittels hochsensitiver Messmethoden undetektierbares Niveau ein Therapieabbruch gerechtfertigt ist. Basierend auf dem dynamischen Modell wird in dieser Arbeit ein Prädiktor vorgeschlagen, der vorhersagt, ob ein Patient nach Abbruch der Therapie einen molekularen Rückfall zu erwarten hat. Zusätzlich wird approximativ ein modellunabhängiger Prädiktor angegeben, der die Vorhersage nur auf Basis klinisch messbarer Größen gestattet.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed Feb. 18, 2009). Includes bibliographical references.

Introduction : Le traitement des cancers bronchiques non à petites cellules (CBNPC) EGFR mutés repose sur les inhibiteurs de tyrosine kinase (ITK) du récepteur de l’Epidermal Growth Factor (EGFR). Cependant tous les patients traités par ITK EGFR finissent par présenter une progression tumorale, du fait de mécanismes de résistance comme l’amplification du gène codant pour le récepteur tyrosine kinase MET. Il n’existe actuellement aucune donnée sur les modifications phénotypiques induites par l’activation de MET dans ce contexte. L’objectif de cette thèse est de déterminer si l’amplification de MET, lors de la résistance aux ITK EGFR dans les CBNPC EGFR mutés, confère aux cellules tumorales un phénotype plus agressif et modifie l’histoire naturelle de la maladie.Méthodes : Les capacités de prolifération, de croissance sans ancrage, de formation de sphéroïdes, de résistance à l’anoïkis et de migration ont été étudiées in vitro dans la lignée HCC827, dérivée d’un CBNPC EGFR muté, et dans sa lignée fille HCC827-GR6 (GR6) devenue résistante aux ITK EGFR via une amplification du gène MET. L’expression de la vimentine, de ZEB1, et de la E-cadherine a également été étudiée dans les deux lignées cellulaires afin d’évaluer l’impact de l’amplification de MET sur la transition épithélio-mésenchymateuse (TEM). In vivo la croissance tumorale et le potentiel métastatique ont respectivement été analysés dans des modèles murins de xénogreffe ectopique et d’injection intracardiaque. Enfin les données cliniques de patients issus de 15 centres avec un CBNPC EGFR muté métastatique, présentant une forte surexpression de MET en immunohistochimie (score 3+) ou une amplification de MET en FISH sur une re-biopsie réalisée après la progression sous ITK EGFR ont été analysées rétrospectivement. Résultats : In vitro, l’amplification de MET induisait une augmentation significative de la prolifération, de la croissance sans ancrage, de la formation de sphéroïdes, de la résistance à l’anoïkis et de la migration. En présence d’un inhibiteur de MET, le PHA-665752, ces différentes propriétés biologiques étaient réduites de façon significative dans les cellules GR6 porteuses de l’amplification de MET. Il était également mis en évidence dans les cellules GR6 une augmentation de l’expression de la vimentine et de ZEB1. In vivo, l’amplification de MET augmentait significativement la croissance tumorale et le potentiel métastatique. Un traitement par crizotinib, ITK ciblant MET, diminuait de façon significative le potentiel métastatique des cellules porteuses de l’amplification de MET. Enfin les patients atteints d’un CBNPC EGFR muté, porteur d’une amplification de MET à la résistance à l’ITK EGFR, présentaient une durée jusqu’à apparition de nouvelles métastases plus courte après progression sous ITK EGFR que les patients avec une forte surexpression de MET sans amplification génique. Conclusion L’amplification de MET dans un contexte de résistance aux ITK EGFR est associée à un phénotype tumoral plus agressif. Ces résultats plaident en faveur d’une utilisation précoce d’inhibiteurs de MET en association avec les ITK EGFR afin d’éviter l’émergence d’un clone tumoral résistant plus agressif. / Introduction: Treatment of Epidermal Growth Factor Receptor (EGFR) mutated non-small cell lung cancers (NSCLC) relies on EGFR tyrosine kinase inhibitors (TKI). However, all patients treated with EGFR TKI eventually present tumor progression, due to mechanisms of resistance such as the MET amplification. There is currently no data on phenotypic changes induced by MET activation in this context. The objective of this thesis is to determine whether the MET amplification during EGFR TKI resistance in the EGFR mutated NSCLC induces a more aggressive phenotype in tumor cells and alters the natural history of the disease.Methods: Proliferation, anchorage independent growth, spheroid formation, anoïkis resistance and migration were studied in vitro in the HCC827 cell line, derived from an EGFR mutated NSCLC, and in its daughter cell line HCC827-GR6 (GR6) which became resistant to EGFR TKI through MET amplification. The expression of vimentin, ZEB1, and E-cadherin was evaluated in these cellular models in order to investigate an epithelial to mesenchymal transition (EMT) process induced by the MET amplification. In vivo, the tumor growth and the metastatic potential were analyzed by subcutaneous xenograft and intracardiac injection in mouse models. Finally, the clinical data of patients from 15 centers with a metastatic EGFR mutated NSCLC, exhibiting high MET overexpression in immunohistochemistry (score 3+) or MET amplification assessed by FISH on a re-biopsy performed after TKI EGFR progression were analyzed retrospectively.Results: In vitro, the MET amplification induced a significant increase in proliferation, anchorage independent growth, spheroid formation, anoïkis resistance and migration. Treatment with PHA-665752, a MET TKI, significantly reduced these biological properties in the GR6 cells harboring the MET amplification. An increase in the expression of vimentin and ZEB1 was also observed in the GR6 cells. In vivo, the MET amplification significantly increased the tumor growth and the metastatic potential. Treatment with crizotinib, another MET TKI, significantly decreased the metastatic potential of cells carrying MET amplification. Finally, patients with an EGFR mutated NSCLC, displayed a time to new metastases after TKI EGFR progression shorter than patients with high MET overexpression without MET amplification.Conclusion: The MET amplification during EGFR TKI resistance is associated in EGFR muted NSCLC with a more aggressive tumor phenotype. These results argue for the early use of MET inhibitors in combination with EGFR TKIs to avoid the emergence of a more aggressive resistant tumor clone.

A leucemia mielóide crônica (LMC) é uma doença mieloproliferativa clonal caracterizada pela presença do cromossomo Philadelphia e o oncogene BCR-ABL1. Este oncogene codifica a oncoproteína Bcr-Abl com atividade tirosina-quinase constitutiva. A proteína Bcr-Abl é responsável pela resistência das células leucêmicas a apoptose. Atualmente, os pacientes com LMC são tratados com os inibidores de tirosina-quinase - mesilato de imatinibe, dasatinibe e nilotinibe. Apesar de o tratamento ser eficiente, pacientes em fases avançadas e mesmo na fase crônica da doença, apresentam resistência à terapia. Desta forma, novos fármacos devem ser investigados para melhorar o tratamento da LMC. As L-aminoácido oxidases (LAAOs) têm sido descritas como substâncias citotóxicas e indutoras de apoptose. Assim, o principal objetivo do presente estudo foi investigar o potencial antitumoral da LAAO isolada da serpente Calloselasma rhodostoma (CR-LAAO) nas células Bcr-Abl positivas. Avaliou-se a citotoxicidade da CR-LAAO nas linhagens HL-60 (linhagem Bcr-Abl negativa), HL-60.Bcr-Abl, K562 e KCL22 (linhagens Bcr-Abl positivas) e nas células mononucleares (MNC) de sangue periférico de indivíduos saudáveis, na presença ou ausência da catalase. Para investigar os mecanismos da ação citotóxica da CR-LAAO, realizou-se os ensaios de indução de apoptose por meio da quantificação das percentagens de núcleos hipodiplóides e anexina V-FITC, nas linhagens celulares e nas células MNC de indivíduos saudáveis e pacientes com LMC. Avaliou-se também os níveis de expressão das caspases 3, 8 e 9, o potencial de membrana mitocondrial, danos no DNA e o efeito apoptótico da toxina combinada com os inibidores de tirosina-quinase nas linhagens Bcr-Abl positivas. Além disso, investigamos se a CR-LAAO foi capaz de modular a expressão dos apoptomiRs miR-15a, miR-16, miR-145, miR-26a, hsa-let-7d, miR-142-3p, miR-29c, miR-146a, miR-21, miR-130a e miR-130b, assim como das proteínas pro- e anti-apoptóticas Bak, Bax, Bid, Bim, A1, Bcl-2, c-Flip, Ciap-2 e Mcl-1 nas linhagens Bcr-Abl positivas. Nossos resultados mostraram que o efeito citotóxico da CR-LAAO foi mais potente nas linhagens Bcr-Abl positivas em relação às células MNC de indivíduos saudáveis, e está associado ao peróxido de hidrogênio produzido durante a reação enzimática da CR-LAAO. Demonstrou-se também que a CR-LAAO induziu apoptose nas linhagens Bcr-Abl postivas testadas e nas células MNC de pacientes com LMC na fase crônica da doença. Em todas as linhagens celulares detectou-se danos no DNA, perda do potencial de membrana e ativação das caspases 3, 8 e 9. A percentagem de apoptose aumentou quando as células HL-60.Bcr-Abl foram tratadas com a CR-LAAO combinada com os inibidores de tirosina-quinase. A CR-LAAO modulou a expressão dos apoptomiRs miR-15a, miR-16, miR-145, miR-26a, hsa-let-7d, miR-142-3p, miR-29c, miR-21, miR-130a e miR-130b e de possíveis proteínas alvos nas linhagens Bcr-Abl positivas. Sendo assim, os resultados obtidos sugerem que a CR-LAAO apresenta uma ação antitumoral capaz de destruir as células leucêmicas / Chronic myeloid leukemia (CML) is a clonal myeloproliferative disease characterized by the presence of Philadelphia chromosome and BCR-ABL1 oncogene. This oncogene encodes the Bcr-Abl tyrosine kinase (TK) which presents a constitutive activity. The Bcr-Abl is responsible for leukemic cells resistance to apoptosis. The CML patients are currently treated with tyrosine kinase inhibitors (TKI) - imatinib mesylate, dasatinib and nilotinib. Although TKI are efficient for CML treatment, patients in advanced phases and even in chronic phase of the disease present resistance to therapy. Thus, potential new drugs must be investigated to improve the CML treatment. The L-amino acid oxidases (LAAOs) have been described as cytotoxic and apoptosis-inducing substances. Here, we investigated the LAAO from Calloselasma rhodostoma (CR-LAAO) antitumoral potential against Bcr-Abl positive cells. We evaluated the CR-LAAO cytotoxic effect against HL-60 (Bcr-Abl negative cell line), HL-60.Bcr-Abl, K562, KCL22 (Bcr-Abl positive cell lines) and the peripheral blood mononuclear cells (PBMC) from healthy subjects, in the presence or absence of catalase. To investigate the mechanisms underlying the CR-LAAO cytotoxic action, we performed the apoptosis induction assays through the hypodiploid nuclei and annexin-V quantification in the cell lines and PBMC from healthy subjects and CML patients. We also evaluated the levels of caspases 3, 8 and 9 expression, the mitochondrial membrane potential, DNA damage and the apoptotic effect of CR-LAAO combined with TKI on Bcr-Abl positive cells. In addition we investigated if CR-LAAO was capable of modulating the apoptomiRs miR-15a, miR-16, miR-29c, hsa-let-7d, miR-145, miR-146a, miR-21, miR-130a, miR-130b, miR-142-3p and miR-26a, the pro- and anti-apoptotic proteins (Bak, Bax, Bid, Bim, A1, Bcl-2, c-Flip, Ciap-2 and Mcl-1 expression in HL-60, HL-60.Bcr-Abl, K562 and KCL22 cells. Our results showed that the CR-LAAO cytotoxic effect was more potent in Bcr-Abl positive cell lines than in PBMC from healthy subjects and it is linked to hydrogen peroxide produced during the enzymatic action of CR-LAAO. It was also demonstrated that CR-LAAO was capable of inducing apoptosis in Bcr-Abl positive cell lines and CML patient\'s cells in chronic phase of the disease. In all tested cell lines, the loss of mitochondrial membrane potential, DNA damage and caspases 3, 8 and 9 activation were detected. The apoptosis percentage was improved when HL-60.Bcr-Abl cells were treated with CR-LAAO combined with TKI. The CR-LAAO modulated the apoptomiRs miR-15a, miR-16, miR-145, miR-26a, hsa-let-7d, miR-142-3p, miR-29c, miR-21, miR-130a and miR-130b expression as well the predict target proteins levels on Bcr-Abl positive cells. Thus, our results suggest that CR-LAAO presents an antitumoral action capable of destroying the CML cells.

A resistência tubular renal tem sido estudada a fim de se ampliar a compreensão da fisiopatologia da Insuficiência renal aguda (IRA). A isquemia renal induz à resistência a um subseqüente insulto isquêmico sendo que os mecanismos de resistência parecem depender de alterações celulares. O p21 é um inibidor do ciclo celular, o qual pode ser induzido por radicais livres de oxigênio e parece ter um efeito protetor na IRA isquêmica. O objetivo deste estudo é avaliar o papel do p21 e do estresse oxidativo em modelo de resistência adquirida após episódio de IRA isquêmica, e em túbulos proximais isolados após isquemia. Ratos Wistar foram divididos em 3 grupos: grupo 1- sham, grupo 2- submetido a procedimento sham e após 2 dias submetido à isquemia de 45 min e grupo 3- submetido à isquemia de 45 min e após 2 dias submetido à segunda isquemia de 45 min. Os valores de uréia plasmática (114±60 vs. 136±44 mg/dL, n.s.), a creatinina sérica (0,86±0,2 vs. 0,98±0,1mg/dL, n.s.) e o clearance de creatinina (0,21±0,1vs. 0,24±0,1mL/min/100g, n.s.), avaliados 48 h após o segundo procedimento (Dia 4), foram semelhantes entre os grupos 2 e 3. O tempo de recuperação da IRA também foi semelhante entre os grupos 2 e 3. A histologia mostrou necrose tubular aguda aparentemente de grau semelhante entre os grupos 2 e 3. O infiltrado linfocitário foi semelhante entre os 3 grupos, entretanto houve aumento no infiltrado de macrófagos no grupo 3. Foi observado aumento na proliferação celular no grupo 2 e grupo 3, quando comparados ao grupo 1(125±28 cél./mm2, p<0,05), entretanto, a proliferação foi mais intensa no grupo 2 (1.262±440 cél /mm2) que no grupo 3 (653±300 cél /mm2, p<0,05 vs. group 2). O grau de apoptose encontrado foi semelhante entre o grupo 2 e o grupo 3. Houve aumento na expressão do p21 apenas no grupo 3 sendo que esta expressão foi semelhante nos grupos 1 e 2. Foi estudada também a resistência celular em túbulos proximais (TP) isolados de ratos normais (grupo Controle) e ratos submetidos à isquemia de 35 min, 24 h antes do estudo (grupo Isquemia). TP do grupo Isquemia foram susceptíveis à hipóxia, porém, resistentes à lesão de reoxigenação. Além disto, apresentaram menor produção de hidroperóxidos. Portanto, a resistência renal isquêmica aparentemente está associada a mecanismos celulares, o estresse oxidativo e o aumento na expressão do p21 são possíveis mediadores destes mecanismos. / Renal tubular resistance has been studied for the understanding of ischemic acute renal failure (ARF). Subsequent ischemic episodes may induce renal resistance whose mechanisms seem to be related to cell alterations. P21 is a cell cycle inhibitor that may be induced by oxygen free radicals and may have a protective effect in ischemic ARF. This study aimed at evaluating the role of oxidative stress and p21 on tubular resistance in isolated renal tubules and in a model of acquired resistance after renal ischemia. Wistar rats were divided into 3 groups: group 1 - sham; group 2 - submitted to sham procedure and after 2 days submitted to 45 min ischemia and group 3 - submitted to ischemia of 45 min followed by a second 45 min ischemia after 2 days. Plasma urea levels (114±60 vs. 136±44 mg/dL), serum creatinine (0.86±0.2 vs. 0.98±0.1mg/dL) and creatinine clearance (0.21±0.1vs. 0.24±0.1mL/min/100g.) evaluated at 48 hours after the second procedure were similar between groups 2 and 3 (all NS). ARF recovery time was also similar between groups 2 and 3. Histology disclosed the same degree of acute tubular necrosis between groups 2 and 3. Lymphocytes infiltrate was similar among all groups whereas macrophages infiltrate was greater in group 3. Enhanced cell proliferation was observed in groups 2 and 3 when compared with group 1 (125±28 cel/mm2, p<0.05), however it was greater in group 2 (1,262±440 cel/mm2) than group 3 (653±300 cel/mm2, p<0.05 vs. group 2). Degree of apoptosis was similar between groups 2 and 3. The p21 expression was increased only in group 3 whereas it was similar in groups 1 and 2. Cell resistance was also evaluated in isolated renal proximal tubules (PT) from control and ischemia groups. In the latter group, animals were submitted to 35 min ischemia and PT were isolated one day later. PT from the ischemia group were sensitive to hypoxia but resistant to reoxygenation injury which was followed by lower hydroperoxides production. In conclusion, renal resistance obtained by an ischemia was associated with cell mechanisms involving oxidative stress and increased p21 expression as mediators of this protection.

O melanoma é uma forma de câncer com alto índice de morte devido, em parte, à sua tendência de formar metástases. Esse tipo tumoral apresenta deleção de CDKN2A e amplificação de HDM2 em aproximadamente 50 % dos casos, mas apenas 10 % apresentam mutação em p53. Aproveitando-se do fato de a maioria dos casos de melanoma retêm p53 selvagem, uma proteína supressora tumoral e fator de transcrição, utilizamos vetores adenovirais nos quais a expressão dos transgenes é controlada pelo p53 endógeno. Estes vetores foram aperfeiçoados com a inclusão de uma modificação na proteína fibra que permite a eficiente transdução de um amplo espectro de células. Utilizando estes vetores, nosso laboratório mostrou que o tratamento combinado, mas não individual, de vetores virais codificando p19Arf e IFNbeta (interferon-beta) induziu elevados níveis de morte em células de melanoma de camundongo, B16F10. Assim, iniciamos novos estudos que têm como alvo explorar os mecanismos de morte celular e identificar genes críticos cuja expressão é alterada frente o tratamento combinado e que agem como mediadores da resposta celular para a estratégia de transferência gênica. Com este projeto, transferimos a combinação gênica (p19Arf + IFNbeta) para células B16F10 e analisamos o tipo de morte celular induzido. Assim, detectamos o aumento da presença de marcadores de morte celular conhecidos, tais como de apoptose (atividade de caspases e exposição de fosfatidilserina) e de necroptose (expressão de RIPK3 e TNFR1), e a diminuição de um marcador de autofagia (expressão de LC3-II). Além disso, mostramos que a detecção dos três marcadores clássicos de morte imunogênica (ATP, calreticulina e HMGB1) foi possível somente quando as células B16F10 foram tratadas com a combinacao de p19Arf + IFNbeta. Por fim, a avaliação do perfil de expressão gênica através de microarray de cDNA das células B16F10 tratadas com p19Arf + IFNbeta revelou expressão diferenciada de 1054 genes em comparação com células que receberam apenas somente um ou outro transgene. Em seguida, a expressão dos genes Nr3c1, RanBP9, Sin3A, Wdr46, FoxO1, Phlda3 e tp73 foi validada por qPCR e estudos funcionais foram iniciados para revelar a participação destes na resposta celular. Dessa forma, desvendamos importantes aspectos da resposta de células B16F10 frente ao tratamento com p19Arf e IFNbeta / Melanoma is a form of cancer with a high death rate due, in part, to its tendency to generate metastasis. These tumors carry deletion of CDKN2A and amplification of HDM2 in nearly 50 % of cases, but only 10 % have mutations in p53. Taking advantage of the fact that most melanoma cases retain wild type p53, a transcription factor and tumor suppressor protein, we used adenoviral vectors in which transgene expression is controlled by endogenous p53. These vectors were improved with a modification of the fiber protein that allows efficient transduction of a broad spectrum of cells. Using these vectors, our laboratory showed that the combined treatment with viral vectors encoding p19Arf and IFNbeta (interferon-beta) induced high levels of B16F10 (mouse melanoma) cell death, but not when treated with these vectors individually. Thus, we initiated studies to explore the mechanisms of cell death and to identify critical genes involved in the response of B16F10 cells to treatment with p19Arf + IFNbeta. Here, we transferred p19Arf + IFNbeta genes to B16F10 cells and analyzed the type of cell death induced. In this regard, we detected an increase of cell death markers, such as apoptosis (caspase activity and exposure of phosphatidylserine) and necroptosis (RIPK3 and TNFR1 expression) and a decrease of an autophagy marker (LC3-II expression). Furthermore, we showed that the detection of three classic immunogenic cell death markers (ATP, calreticulin and HMGB1) was possible only when B16F10 cells were treated with p19Arf + IFNbeta combination. Lastly, assessment of gene expression profile using cDNA microarray analysis of B16F10 cells treated with p19Arf + IFNbeta revealed differential expression of 1054 genes compared to cells that received only one of the transgenes. Expression of Nr3c1, RanBP9, Sin3a, Wdr46, FoxO1, Phlda3 and TP73 genes was validated by qPCR and functional studies were started to reveal participation of these genes in the cellular response. Thus, we exposed important aspects of the B16F10 cellular response to treatment with p19Arf and IFNbeta

Non-small-cell lung cancer (NSCLC) accounts for 80–85% of all lung cancers and is associated with significant mortality. As epidermal-growth-factor receptor (EGFR) is over-expressed in 80-90% of NSCLC, its inhibition via EGFR-Tyrosine Kinase inhibitors (EGFR-TKIs) is a main therapeutic strategy. However, patients with mutations in KRAS are resistant to EGFR-TKIs. A study in mutant KRAS-driven lung cancer in transgenic mice showed that tumor growth was dependent on the activity of focal adhesion kinase (FAK). Therefore, we hypothesized that KRAS-mutant NSCLC will be sensitive to FAK-TKIs and, given known FAK-EGFR cross-talk, FAK inhibition will sensitize KRAS-mutant NSCLC to EGFR-TKIs. We performed cell viability assays of WT versus mutant KRAS NSCLC cell lines following treatment with FAK-TKI alone or in combination with a clinically relevant EGFR-TKI. We found that KRAS-mutant cells were more sensitive to FAK-TKI than KRAS-WT NSCLC. In addition, we found that the combination treatment including FAK and EGFR TKIs resulted in reduced tumor cell viability as compared to treatment with either drug alone. This enhanced anti-tumor response could be due to FAK-TKI’s ability to down-regulate EGFR downstream targets. Our preliminary data suggests that in KRAS-mutant cells the drug combination appears to more effectively inhibit Akt activity than single drug treatment alone. This suggests an enhanced ability to impair cell survival following treatment with the drug combination. We also found that treatment with FAK TKI in KRAS mutant NSCLC cells resulted in increased activation of EGFR which was due in part to modulation of EGFR recycling and production of endogenous EGFR ligands. Thus, the combination of FAK- and EGFR-TKIs may be more effective in KRAS mutant NSCLC as treatment with EGFR-TKI overcomes the unexpected ‘side effect’ of treatment with FAK-TKI, namely activation of the EGFR pathway by this drug. The findings of our study are novel and have uncovered previously unrecognized outcomes of FAK inhibition on EGFR activity. Moreover, our data support the notion that the combination of FAK- and EGFR-TKIs could be an effective treatment for KRAS mutant NSCLC patients.