The Best PhD Thesis in the Faculties of Dentistry, Engineering, Medicine and Science (University of Hong Kong), Li Ka Shing Prize,2008-2009 / published_or_final_version / Pathology / Doctoral / Doctor of Philosophy

Résumé : Le “Suppressor of cytokine signaling -1” (SOCS1) est une protéine de 24 kD qui fonctionne principalement comme un régulateur négatif des voies de signalisation intracellulaires. SOCS1 inhibe l’axe JAK-STAT et induit l’ubiquitylation et la dégradation de certaines protéines cibles. L’expression de SOCS1 est diminuée par l’hyperméthylation de son promoteur dans plus de 65% des cas de carcinome hépatocellulaire. Les souris déficientes en SOCS1 ne survivent que trois semaines après la naissance à cause d’une hyperinflammation induite par IFN-[gamma]. Afin d’étudier le rôle anti tumoral de SOCS1 dans le foie, nous avons utilisé les souris Socs1[indice supérieur -/-]Ifng[indice supérieur -/-], Ifng[indice supérieur -/-] et les souris de type sauvage. Nous avons démontré que le taux de la régénération du foie après une hépatectomie partielle était augmenté chez les souris déficientes en SOCS1. De plus, les souris Socs1[indice supérieur -/]-Ifng[indice supérieur -/-] étaient plus susceptibles pour le développement des nodules hépatiques suite à un traitement avec diethylnitrosamine (DEN). Par contre, les souris déficientes en IFN-[gamma] ont démontré une résistance contre le cancer du foie. Néanmoins, au contraire de nos attentes préliminaires, nous n’avons pas observé une augmentation des taux sériques d’IL-6. Pourtant, la prolifération compensatoire et la synthèse de l’ADN étaient élevées chez les souris SOCS1 KO. Afin d’expliquer cette observation, nous avons étudié l’activation de p53. Nous n’avons pas trouvé une réponse différente de stabilisation ni de phosphorylation de p53 (Ser15) après traitement au cisplatin (in vitro) ou DEN (in vivo). Par contre, nous avons observé que l’expression du gène Cdkn1a était élevée chez les hépatocytes déficients en SOCS1. De plus, l’expression ectopique de SOCS1 pouvait supprimer l’expression de p21 chez les cellules HepG2 traitées au cisplatin. Nous avons aussi constaté que la stabilité de p21 était augmentée chez les hépatocytes primaires déficients en SOCS1. En effet, SOCS1 induisait l’ubiquitylation et la dégradation de p21. SOCS1 pouvait interagir avec p21 par son domaine SH2. De plus, SOCS1 pouvait contrôler la localisation cytoplasmique de p21 en régulant l’activité d’AKT. Bien que p21 soit connu comme un inhibiteur du cycle cellulaire, il peut également participer à l’assemblage des complexes CDK4-Cyclin D. Nous avons démontré que l’expression de p21 et des cyclines de type D était augmentée chez les souris déficientes en SOCS1 après l’hépatectomie partielle. En diminuant l’expression de p21 par shRNA, nous avons empêché la réponse proliférative des hépatocytes SOCS1 KO. Finalement, nous avons trouvé que l’expression élevée de p21 chez les hépatocytes déficients en SOCS1 rendait les cellules plus résistantes contre l’apoptose. En conclusion, nos résultats suggèrent que SOCS1 protège contre le cancer du foie par la régulation des activités oncogéniques de p21. // Abstract : Suppressor of cytokine signaling - 1 (SOCS1) is an inducible 24 kD protein that principally acts as a negative regulator of different intracellular signaling pathways. SOCS1 exerts its regulatory feedback by blocking the JAK - STAT axis and inducing ubiquitylation and subsequent proteasomal degradation of target proteins. The gene coding for Socs1 has a CpG - rich promoter and can be methylated by methyltransferases. SOCS1 is silenced due to hypermethylation of its promoter in almost 65% of hepatocellular carcinoma cases. SOCS1 deficient mice cannot survive more than three weeks of age because of enhanced IFN - [gamma] induced inflammation. To better understand the tumor suppressor role of SOCS1 in the liver we used Socs1[superscript - / -]Ifng[superscript - / -], while Ifng[superscript - / -] and wild type mice served as controls. We found that SOCS1 deficient mice showed accelerated liver regeneration following standard partial hepatectomy (PH). Moreover, Socs1 null mice were susceptible to development of hepatic nodules after treatment with diethylnitrosamine (DEN). Interestingly, the IFN - [gamma] deficient mice showed reduced number of liver tumors. In contrast to our preliminary expectations, we did not observe elevated IL - 6 serum levels in SOCS1 deficient mice compared to the controls. Nevertheless, loss of SOCS1 was associated with increased compensator y proliferation and DNA synthesis after PH and DEN treatment. To find an explanation for the increased tumorigeneis in the SOCS1 deficient liver, we examined the activation of p53 and its target genes. Although we observed neither a variable phosphorylation (Ser15), nor an impaired stabilization of p53 after cisplatin ( in vitro ) or DEN treatment ( in vivo ), Cdkn1a expression was increased in the absence of SOCS1. We also found that ectopic expression of SOCS1 could suppress the mRNA levels of p21 in HepG2 cells treated with cisplatin. In addition, we found that loss of SOCS1 increased p21 stability in hepatocytes and that SOCS1 could induce p21 ubiquitylation and subsequent proteasomal degradation. We showed that SOCS1 could bind directly to p21 via its SH2 domain. Furthermore, in SOCS1 deficient hepatocytes, p21 was retained in the cytosol in an AKT dependent fashion. While classically known as a cell cycle inhibitor, p21 can promote the assembly and kinase activity of CDK4 - cyclin D complexes. We showed that D - type cyclins and p21 levels were increased in the liver of SOCS1 deficient mice following PH. Suppression of p21 by transient shRNA transfection in SOCS1 deficient primary hepatocytes could reverse their increased proliferative response to mitogens. Finally, we found that increased p21 expression in SOCS1 deficient hepatocytes renders them resistant to apoptosis. In conclusion, our findings suggest that SOCS1 protects against liver cancer via inhibiting the oncogenic potential of p21.

Focal liver lesions are commonly encountered in clinical practice. To be able to differentiate potentially life-threatening lesions from clinically insignificant lesions, and to be able to treat them effectively are the two basic problems of a clinician who comes across such lesions. Percutaneous intervention of the liver with a needle enables a clinician to solve the above two problems in a minimally invasive manner. To date, there is a diversity of needle-related percutaneous interventional procedures that are applicable to the clinical management of patients with liver lesions, such as biopsy of focal lesions, drainage of abscesses, and ablation of tumors. Despite a reasonable safety and efficacy associated with these procedures, there are always grounds of further improvement in techniques and technology of needle-related percutaneous procedures to achieve an even better outcome. It was hypothesized that the application of needle-related interventional radiology to clinical management of focal liver lesions could be facilitated and extended with advancement and refinement in needle-related techniques and technology. This thesis was based on a series of nine studies that aimed to explore the potential of needle-related percutaneous interventions in the clinical management of focal liver lesions and to study the effect of the introduction of innovations in needle-related techniques and technology on such clinical applications. It was concluded that the hypothesis was confirmed. / Yu Chun Ho. / "April 2006." / Adviser: Anil Ahuja. / Source: Dissertation Abstracts International, Volume: 68-08, Section: B, page: 5176. / Thesis (M.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 219-235). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / School code: 1307.

Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the third most common cause of cancer-related deaths. Systemic therapies are the main treatment options for HCC patients with advanced disease (∼ 80% of all cases). However, only very moderate clinical responses are achieved with most of the conventional therapies. Thus, more effective therapeutic strategies are much needed. The PI3K/Akt/mTOR signaling pathway, which plays a critical role in controlling cell proliferation and survival, is aberrantly activated in ∼ 45% HCC, suggesting it to be a potential target for HCC treatment. Moreover, emerging evidences indicate that activation of the PI3K/Akt/mTOR pathway may be associated with resistance to many cytotoxic chemotherapies, including microtubule targeting agents. In this study, by gene expression profiling and gene ontology analysis, "microtubule-related cellular assembly" was identified to be the major biological/functional process involved in HCC development, suggesting that microtubule is also an important therapeutic target for HCC. With these understandings, it is hypothesize in this thesis that combined targeting of a key component ofthe PI3K/Akt/mTOR pathway, namely the mammalian target of rapamycin (mTOR) and the microtubule would be an effective therapeutic strategy for HCC. The objectives of the thesis are to examine the therapeutic potential of microtubule targeting, mTOR targeting, and combined targeting of the microtubule and mTOR in both in vitro and in vivo models of HCC. / In summary, the PI3K/Akt/mTOR pathway and the microtubule represent promising therapeutic targets for HCC treatment. The findings from this thesis offer a rationale for combining mTOR inhibitors with microtubule targeting agents for effective HCC treatment. / In the second part, the effect of mTOR inhibition, either alone or in combination with an additional microtubule targeting agent (vinblastine) was investigated in HCC. Temsirolimus, an mTOR inhibitor, suppressed HCC cell proliferation in as early as 24 hrs with an IC50 of 1.27+/-0.06muM (Huh7), 8.77+/-0.76muM (HepG2), and 52.95+/-17.14muM (Hep3B). Vinblastine (1nM) alone caused 30--50% growth inhibition in 3 HCC cell lines. In these HCC cell lines, it was found that temsirolimus/vinblastine combination resulted in an additive to synergistic effect (when compared to single agents alone) with maximum growth inhibition of 80--90% as early as 24 hrs upon treatment. This marked growth inhibition was accompanied with cell cycle arrest at both G1 and G2/M phases, and PARP cleavage (a hallmark for apoptosis). Moreover, the combination specifically caused concerted down-regulation of several important anti-apoptotic and survival proteins (survivin, Bcl-2 and Mcl-1), which was not observed in single agent treatments. It was hypothesized that inhibition of these key anti-apoptotic/survival proteins may represent a novel mechanistic action of this highly effective combination approach of dual targeting of mTOR and microtubule by temsirolimus/vinblastine in HCC cells. Indeed, transient over-expression of each of these genes (survivin, Bcl-2 or Mcl-1) in HCC cells did partially rescue the growth inhibitory effect of the temsirolimus/vinblastine combination. More importantly, this novel combination significantly suppressed the growth of HCC xenografts in nude mice (when compared with single agents alone). / In the third part, the anti-tumor effect of another mTOR inhibitor everolimus in combination with microtubule targeting agents, vinblastine and patupilone (a microtubule-stabilizing agent), was investigated in HCC cells. Everolimus/vinblastine combination resulted in an additive to synergistic effect accompanied with cell cycle arrest at both G1 and G2/M phases, and PARP cleavage. The combination also caused concerted down-regulation of anti-apoptotic and survival proteins (survivin, Bel-2 and Mel-1) as observed with the temsirolimus/vinblastine combination. However, everolimus only moderately enhanced the sensitivity of patupilone for reasons unknown. / Taxanes are the major chemotherapeutic agents that target the microtubule. In the first part of the thesis, the anti-tumor activity of two taxanes, paclitaxel and docetaxel (which are known to stabilize microtubules) was examined and compared with doxorubicin (a DNA intercalating agent). Across all three HCC cell lines tested, it was found that the microtubule targeting agents, taxanes, were more efficacious than doxorubicin. This supports the initial finding that microtubule assembly process is functionally important in HCC. Recent studies demonstrated that using nanoparticles for drug delivery can greatly enhance therapeutic efficacy and reduce side-effects. Therefore, the nanoparticle albumin-bound (nab)-paclitaxel was employed to further evaluate the therapeutic efficacy of such a delivery strategy in HCC models. In all three HCC cell lines tested, nab-paclitaxel was found to be the most effective agent, with an average IC50 value of 0.16--10.42nM, when compared to non-conjugated taxanes (paclitaxel, docetaxel) and doxorubicin. In vitro analysis showed that nab-paclitaxel was able to induce cell cycle arrest at G2/M phase and apoptosis in HCC cells. In vivo study demonstrated that nab-paclitaxel readily inhibited the growth of HCC xenografts with lower toxicity when compared to paclitaxel, docetaxel and doxorubicin. Moreover, specific silencing of a key regulatory protein for microtubule dynamics, Stathmin 1, by siRNA significantly enhanced the effect of nab-paclitaxel in HCC cells, resulting in synergistic growth inhibition in vitro. / Zhou, Qian. / Advisers: Winnie Yeo; Vivian Lui; Nathalie Wong. / Source: Dissertation Abstracts International, Volume: 73-06, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 148-164). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Zhang, Zhiyi. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves ). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Hepatocellular carcmoma (HCC) is the third most common cause of cancer-related deaths worldwide, with a gender prevalence observed in men. Recent studies have suggested that elevated activity of the androgen axis is one major host factor underlying this disparity between genders. The androgen receptor (AR) mediates function of androgen in vital developmental and oncogenic pathways by binding to genomic androgen response elements, which influence the transcription of downstream target genes. AR is overexpressed in 60-80% of human HCCs. Genetic studies further established the pivotal role ofAR in hepatocarcinogenesis, where liver-specific knockout of AR significantly reduced tumorigenicity in carcinogen- and HBV-induced HCC mouse models. However, AR-inducedhepatocarcinogenesis is far from fully understood, in part because little is known about the identity and role of direct AR-dependent targeted genes in hepatocytes. / In this study, we used genome-wide location and functional analyses to identify a critical mediator of AR signaling, cell cycle-related kinase (CCRK), in driving beta-cateninl T-cell factor (TCF)-dependent hepatocarcinogenesis. Using chromatin immunoprecipitation followed by promoter array analysis of AR-overexpressing HCC cell lines, we found a number of cell cycle-related genes that are likely under the direct modulation of AR. Cell cycle-related kinase (CCRK), previously shown to promote glioblastoma tumorigenesis, was found to be the most significantly-bound AR target ( p<0.0001). CCRK was directly up-regulated by ligand-activated AR through promoter binding and required for AR-induced G1-S cell cycle progression because (1) CCRK overexpression attenuated cell cycle blockage by AR knockdown and (2) CCRK inhibition counteracted AR-mediated cell cycle progression. Ectopic CCRK expression induced immortalized liver cell proliferation, malignant transformation and tumor formation in immunodeficient mice, whereas CCRK inhibition decreased HCC cell growth in vitro and in vivo. These functional assays demonstrated that CCRK is a potential oncogene in HCC. Mechanistically, CCRK activated beta-catenin/TCF-dependent transcription through phosphorylation of glycogen synthase kinase-3beta and induced the expressions of beta-catenin target genes, cyclin D1 (CCND1) and epidermal growth factor receptor (EGFR). Inhibition of beta-catenin/TCF signaling attenuated CCRK-induced cell cycle progression, colony formation and tumorigenicity. Conversely, HCC cell growth inhibition by CCRK knockdown was rescued by constitutively active beta-catenin or TCF. In agreement with these findings, activation of the AR/CCRK/beta-catenin axis was frequently observed in primary HCCs. More importantly, CCRK over-expression was correlated with tumor staging and poor overall survival in a cohort ofhuman HCC tissues. / Together, our data reveal a new cascade for AR function in hepatocarcinogenesis via the activation of beta-catenin/TCF signaling. This study also reveals that CCRK is a novel focal link between two prominent signaling pathways vital for HCC growth and thus represents a new therapeutic target for HCC treatment. / Feng, Hai. / Adviser: Sung Jao Yiu. / Source: Dissertation Abstracts International, Volume: 73-04, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 161-177). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Amplification of chr.1 q21-22 is also an aberration frequently detected in HCC. Copy number gains of the GEF-H1 gene ranked the most frequent event from array-CGH. GEF-H1 up-regulation was significant correlated in patients with advanced HCC staging (P = 0.048), presence of micro-vascular invasion (P = 0.049) and shorter overall and disease free survival of patients (P < 0.03). Similar to BOP1, functional examinations of GEF-H1 suggested profound inhibitory effects on cell motility ( P < 0.035) and invasiveness (P < 0.003) in cell lines studied. Upon GEF-H1 depletion, re-expression of epithelial markers (E-cadherin, cytokeratin 18, alpha-catenin and gamma-catenin) and down-regulations of mesenchymal markers (N-cadherin, fibronectin and vimentin) were also readily observed. In addition, reduced active form of GTP-RhoA together with its downstream effectors including cleaved ROCK 1 and phosphorylated MLC2 were also found in GEF-H1 depleted cells. / Array-CGH also defined candidate proto-oncogenes within 2 causal amplified regions in HCC, chr.8q24 and chr.1q21-q22. In resolving affected genes at chr.8q24, distinctive gains of BOP1 was further established in primary HCC tumors, where frequent BOP1 up-regulations in tumors compared to adjacent non-tumoral liver (P < 0.0001) was identified. Increased BOP1 expression correlated with advanced HCC staging (P = 0.004), micro-vascular invasion (P = 0.006) and shorter overall and disease free survival of patients (P < 0.02). siRNA-mediated suppression of BOP1 in HCC cell lines showed significant inhibition on cell invasion (P < 0.003) and migration (P < 0.05), whereas overexpression of BOP1 in immortalized hepatocyte cell line, L02, showed increase cellular invasiveness and cell migratory rate (P < 0.0001). Evident regression of the Epithelial-to-Mesenchymal Transition (EMT) phenotype was readily identified in BOP1 knockdown cells, where re-expressions of epithelial markers (E-cadherin, cytokeratin 18 and gamma-catenin) and down-regulation of mesenchymal markers (fibronectin and vimentin) were found. It was found that BOP1 likely stimulates actin stress fibers assembly through RhoA activation. / Hepatocellular carcinoma (HCC) is a highly malignant tumor that is associated with a high incidence of cancer morbidity and mortality. Elucidation of genomic aberrations of HCC holds much importance in understanding the molecular basis that underlies the disease causation and progression. Extensive research on HCC has by now revealed a number of key genomic aberrations but, for most of these loci, the underlying cancer-related gene(s) remains unknown. / In this thesis, array-based comparative genomic hybridization (array-CGH) was deployed to define target genes within HCC-associated chromosomal regions. The first part of my study focused on mapping the homozygous deletions (HDs) in HCC. Though infrequent, HD screening has been widely utilized to define tumor suppressor genes (TSGs) in cancers. A panel of HCC cell lines was systematically examined for the presence of HDs. Array-CGH identified 6 HD regions, amongst which CRYL1 (located on chr.13q12.11) displayed most common down-regulations in primary HCC tumors. Significant associations could also be drawn between repressed CRYL1 and advanced tumor staging, increased tumor size and shorter disease-free patient survival (P ≤ 0.037). Moreover, HD on CRYL1 could be detected in 36% of HCC cases with CRYL1 down-regulations. Examination of other inactivating mechanisms suggested histone deacetylation and promoter hypermethylation to be likely inactivating events as well. Re-expression of CRYL1 in SK-HEP1 cell line induced profound inhibition on cellular proliferation and cell growth (P ≤ 0.002). By Annexin V staining, CRYL1 restoration readily increased pro-apoptotic cells with an induction of P ARP cleavage. Flow cytometry further revealed CRYL1 could prolong the G2-M phase, possibly through interrupting the Cdc2/cyclin B path. / The similarities in functional behaviours of BOP1 and GEF-H1 might have implications in the fundamental biology of HCC tumorigenesis. It is known that HCC is a highly aggressive tumor often associated with intra- and extra-hepatic metastasis. The finding of 2 causal changes to be closely associated with cell migration and invasiveness may have implications in the metastatic potentials of HCC cells being predisposed earlier on from genomic events. / Cheng, Kit Chong Ibis. / Adviser: Nathalie Wong. / Source: Dissertation Abstracts International, Volume: 73-06, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 177-190). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Ng, Chor Fung. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 156-169). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Chan, Ho Ching. / Thesis M.Phil. Chinese University of Hong Kong 2016. / Includes bibliographical references (leaves 159-166). / Abstracts also in Chinese. / Title from PDF title page (viewed on 15, September, 2016).

Zhang, Bin. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 154-187). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.