The purpose of this thesis was to evaluate and compare the peripheral dose associated with VMAT lung SABR treatments for 10X, 6X, and 10X-FFF beams. Flattening Filter Free (FFF) radiotherapy photon beams exhibit high dose rates as compared to standard flattened photon beams. The high dose rates available with FFF beams make them ideal for high dose treatments, such as Volumetric Modulated Arc Therapy (VMAT)-delivery lung Stereotactic Ablative Radiotherapy (SABR), where treatment delivery is longer than that of standard treatments. They are also known to show reductions in treatment head scatter, multi-leaf collimator (MLC) transmission and treatment head leakage radiation, compared to flattened beams. The use of FFF beams for VMAT lung SABR has been shown to significantly reduce treatment delivery time, while maintaining plan quality and accuracy. Another potential advantage of the use of FFF beams for VMAT lung SABR is the reduction in peripheral (out-of-field) dose, due mainly to the reduction in head scatter and treatment head leakage. The peripheral doses delivered by VMAT Lung SABR treatments using 10X-FFF, 10X and 6X were investigated for the Varian TrueBeam medical linear accelerator. There were three components to this investigation; (1) Ion chamber measurement of peripheral dose for static open, static MLC and dynamic MLC fields, (2) Validation of Monte Carlo, Acuros XB and AAA algorithms for peripheral dose prediction, and (3) Evaluation of peripheral doses for VMAT lung SABR treatments using the validated Monte Carlo model. Measurements of out-of field doses for static open, static MLC and dynamic MLC fields showed that 10X-FFF delivered peripheral doses in the range of 30% to 50%, 3% to 40% and 5% to 20% lower than the peripheral doses for flattened beams. Dose calculation algorithm validation showed that AAA and Acuros XB significantly under predicted the dose in the peripheral region. Monte Carlo was found to be the most accurate dose calculation algorithm for peripheral dose prediction. The VMAT lung SABR dose distributions were calculated for both static gantry delivery and arc delivery using the validated Monte Carlo model. For static gantry Monte Carlo simulation, 10X-FFF was found to show a reduction in peripheral dose in the range of 7% to 21% and 7% to 17% when compared to 6X and 10X. For arc delivery Monte Carlo simulation, 10X-FFF was found to deliver a statistically significant reduction in mean peripheral dose compared to 6X in four of the six cases, and was not found to deliver a statistically significant reduction in mean peripheral dose compared to 10X in any of the six cases. For this type of VMAT lung SABR treatment, 10X-FFF offers a reduction in peripheral dose over 6X. In terms of the benefits of using 10X-FFF for this type of treatment, the reduction in peripheral dose is added to the already-established reduction in treatment times. / Graduate / 0756 / 0574

Considerando que várias mutações gênicas estão envolvidas no estabelecimento dos tumores, surge a idéia de que o alcance da melhor eficiência no tratamento do câncer é dado pela entrega de múltiplos genes. Este trabalho apresenta a construção, produção e caracterização funcional in vitro e in vivo do vetor adenoviral bicistrônico Adp16IRESp53 e dos monocistrônicos Adp16 e Adp53 em modelo de câncer de pulmão. Nossos resultados indicam uma forte indução de morte celular nas células H358 transduzidas com Adp16IRESp53 em comparação com vetores monocistrônicos Adp16, Adp53 ou o reporter AdeGFP e/ou AdLacZ. Nos ensaios in vivo, utilizando modelo xenografico onde as células H358 foram implantadas no subcutâneo de camundongos atímicos Balb/C nude, pudemos confirmar também in vivo a significativa inibição do crescimentos dos tumores tratados com Adp16IRESp53. Em conclusão, a remediação simultânea de p16INK4a e p53, mediada pelo arranjo bicistrônico, pode ser considerada como uma estratégia promissora para terapia gênica do câncer de pulmão. / This work presents the construction, production and functional evaluation in vitro and in vivo of the bicistronic adenoviral vector Ap16IRESp53 as well as the monocistronic vectors Adp16 and Adp53 in a lung cancer model. Considering that several mutation events are involved in tumorigenesis, comes the idea that a greater efficiency in cancer treatment would be reached with delivery of multiples genes. Our data demonstrate a strong cell death effect in H358 cells transduced with Adp16IRESp53 when compared with Adp16, Adp53 or the reporter AdeGFP and/or AdLacZ. For the in vivo studies, we have used H358 cells implanted subcutaneously in athymic Balb/c nude mice. Our data show significant suppression of tumors treated with the therapeutic adenoviral vector, Adp16IRESp53. In conclusion, the simultaneous replacement of p16INK4a and p53, mediated by the bicistronic vector, may prove to be a promising strategy for gene therapy of lung cancer.

Les données existantes sur le rôle de l’autophagie dans la mort cellulaire radio-induite sont controversées et proviennent d’études pour lesquelles sont utilisées des drogues : l’action se produit donc de manière indirecte. Certains suggèrent que l’induction combinée de l’apoptose et de l’autophagie améliore le traitement par radiations ionisantes. D’autres indiquent que l’induction de l’autophagie favoriserait la radiorésistance des cellules tumorales et que l’utilisation d’inhibiteurs de l’autophagie augmenterait la réponse des tumeurs aux radiations ionisantes. L'autophagie, ou «self-eating», est un processus cellulaire activé par diverses conditions de stress, par lequel les cellules peuvent dégrader les protéines et les organites. Nous avons au cours de cette étude cherché à déterminer le rôle de l'autophagie dans la mort cellulaire radio-induite. Selon nos observations, l'autophagie est nécessaire pour la libération de l'ATP après un traitement par radiothérapie: en effet, le knockdown de gènes essentiels à l'autophagie limite la sécrétion d'ATP. Nous avons également constaté que des cellules déficientes pour l'autophagie traitées par radiothérapie sont incapables d’immuniser des souris contre une injection de cellules vivantes. En outre, les tumeurs déficientes pour l’autophagie répondent moins bien à un traitement par radiations ionisantes dans des souris immunocompétentes et continuent à proliférer, contrairement aux tumeurs “wild-type”. De plus, nous avons montré que les cellules déficientes pour l'autophagie ne sont pas en mesure de recruter des cellules dendritiques dans le lit tumoral. A l'inverse, l'inhibition des enzymes de dégradation de l’ATP extracellulaire accroît les concentrations d'ATP dans les tumeurs déficientes pour l'autophagie, ce qui rétablit le recrutement des cellules immunitaires dans le lit tumoral et restaure la réponse à la radiothérapie des cancers déficients pour l'autophagie. Ainsi, cette étude a montré l'importance de l'autophagie dans la réponse anti-tumorale spécifique, après traitement par radiations ionisantes. Ces résultats ouvrent de nouvelles perspectives pour comprendre la mort cellulaire radio-induite. Il reste cependant à découvrir les mécanismes moléculaires sous-jacents pour développer de nouvelles thérapies ciblées qui amélioreront l’efficacité de la radiothérapie. / Most of the available data on autophagy and tumor response to IR comes from indirect conclusions after concomitant drug-IR exposure. Some authors suggest that concurrent induction of apoptosis and autophagy enhances radiation therapy. Oppositely, others indicate that the induction of autophagy contributes to the radioresistance of tumor cells and suggest that autophagy inhibitors may be employed to increase the sensitivity radioresistant tumors cells to ionizing radiation. Autophagy literally ‘self-eating’ is a cellular process activated in response to various conditions of cellular stress, whereby cells can liberate energy resources via the degradation of proteins and organelles. In this project we aimed to determine the potential role of autophagy in IR –induced cell death. We found that autophagy is required for the release of ATP in response to radiotherapy, as we observed that the knockdown of essential autophagy-related genes abolished its secretion. Furthermore, autophagy deficient tumors growing on immunocompetent mice did not respond to radiotherapy and continued proliferating in contrast to autophagy proficient tumors. We showed that autophagy deficient cells were neither able to recruit DCs into the tumor bed. Conversely, the inhibition of extracellular ATP degrading enzymes increased extracellular ATP concentrations in autophagy deficient tumors, which reestablished the recruitment of immune cells into the tumor bed, and restored radiotherapeutic responses in autophagy-deficient cancers.Altogether, this study showed the importance of autophagy in tumor-specific immune response after radiotherapy. Thus giving new insights into the concept of IR-induced cell death. However, there is still much that is unknown about molecular mechanisms that undergo IR-induced cell death. Understand these molecular mechanisms will help to develop new targeted therapies that will improve the effectiveness of radiotherapy.

Considerando que várias mutações gênicas estão envolvidas no estabelecimento dos tumores, surge a idéia de que o alcance da melhor eficiência no tratamento do câncer é dado pela entrega de múltiplos genes. Este trabalho apresenta a construção, produção e caracterização funcional in vitro e in vivo do vetor adenoviral bicistrônico Adp16IRESp53 e dos monocistrônicos Adp16 e Adp53 em modelo de câncer de pulmão. Nossos resultados indicam uma forte indução de morte celular nas células H358 transduzidas com Adp16IRESp53 em comparação com vetores monocistrônicos Adp16, Adp53 ou o reporter AdeGFP e/ou AdLacZ. Nos ensaios in vivo, utilizando modelo xenografico onde as células H358 foram implantadas no subcutâneo de camundongos atímicos Balb/C nude, pudemos confirmar também in vivo a significativa inibição do crescimentos dos tumores tratados com Adp16IRESp53. Em conclusão, a remediação simultânea de p16INK4a e p53, mediada pelo arranjo bicistrônico, pode ser considerada como uma estratégia promissora para terapia gênica do câncer de pulmão. / This work presents the construction, production and functional evaluation in vitro and in vivo of the bicistronic adenoviral vector Ap16IRESp53 as well as the monocistronic vectors Adp16 and Adp53 in a lung cancer model. Considering that several mutation events are involved in tumorigenesis, comes the idea that a greater efficiency in cancer treatment would be reached with delivery of multiples genes. Our data demonstrate a strong cell death effect in H358 cells transduced with Adp16IRESp53 when compared with Adp16, Adp53 or the reporter AdeGFP and/or AdLacZ. For the in vivo studies, we have used H358 cells implanted subcutaneously in athymic Balb/c nude mice. Our data show significant suppression of tumors treated with the therapeutic adenoviral vector, Adp16IRESp53. In conclusion, the simultaneous replacement of p16INK4a and p53, mediated by the bicistronic vector, may prove to be a promising strategy for gene therapy of lung cancer.

Non-small cell lung carcinoma is a leading cause of cancer mortality worldwide. There are gender and smoking associated differences both in tumour types and clinical outcome. Squamous cell carcinomas (SCC) are more frequent among smoking men while females develop adenocarcinomas (ADCA). NSCLC among never smokers are mainly ADCA, and occurs mostly in females. The present thesis elucidates the role of estrogen receptor (ER) and epidermal growth factor receptor family (EGFR/HER2-4) in NSCLC in the perspective of gender and histology as well as the influence of smoking on those biomarkers. A recently developed technique, tissue micro array (TMA), was employed.The question of how much of a tumour tissue that needed to be included in a TMA for biomarker analysis was analyzed by a statistical approach. Data indicates a sample size of three cylinders of tumour tissue with a diameter of 0.6 mm each as being appropriate and cost-effective. In order to optimally use the up to thousands of different tumour samples within a TMA, it would be optimal to serially cut and store slides before performing in situ detection of proteins and nucleic acids. Applying up to date methodology, and by evaluation with image analysis, data are presented that shows that such handling of TMA slides would be possible without any loss of biomarker information. ERα is more frequently observed in ADCA and in females and a local estradiol synthesis is supported by the presence of aromatase. ERβ is identified as a positive prognostic marker in ADCA. Smoking is associated to increased levels of ERβ mRNA. EGFR over expression is associated with a ligand. Independent phosporylation of ERα. HER-4 intracellular domain may also act as a co-activator to ERα in ADCA, especially among neversmokers. The question of ER and EGFR family signalling crosstalk as a potential target for combined targeted therapy is raised.

Dissertation (Ph.D.) -- University of Texas Southwestern Medical Center at Dallas, 2008. / Vita. Bibliography: p. 174-213.

Le VEGF-A joue un rôle clé au cours de l’angiogenèse physiologique mais aussi de la néo-vascularisation tumorale essentielle à la croissance des tumeurs malignes. Le VEGF-A et ses récepteurs (VEGFR1/2) représentent une cible de première importance pour le développement de thérapies anti-tumorales, et un certain nombre de médicaments anti-angiogéniques (AAG) inhibant le VEGF-A ou ses récepteurs sont actuellement utilisés en clinique dans le traitement des carcinomes pulmonaires. Parmi les thérapies anti-angiogéniques ciblant le VEGF-A, on peut lister soit l’anticorps monoclonal anti-VEGF Bevacizumab (BVZ) ou bien les inhibiteurs pharmacologiques du domaine tyrosine kinase des VEGFR: les VEGFR-TKI. Seuls les patients porteurs d’adénocarcinomes pulmonaires peuvent bénéficier de thérapies AAG, les patients porteurs de carcinomes squameux présentant de sévères complications (hémorragies pulmonaires). Le sVEGFR1, est un variant tronqué du VEGFR1 qui ne contient que les premiers six motifs N-terminaux extracellulaires de type Ig du domaine extracellulaire et il est dépourvu des domaines transmembranaire et tyrosine kinase. Le sVEGFR1 a éte initialement considéré comme un facteur anti-angiogénique qui neutralise les fonctions du VEGF-A dans les cellules endothéliales. Les hauts niveaux ont été corrélés avec un mauvais pronostic et une mauvaise réponse aux thérapies dans plusieurs types de cancer. Nous avons montré in vitro dans 4 lignées cellulaires de SCC que le bevacizumab, ainsi que les inhibiteurs VEGF-TKI (Semaxanib, KI8751) augmentent les niveaux intra- et extra-cellulaires du sVEGFR1. Nous avons confirmé ces résultats in vivo dans des modèles murins de xénogreffes squameux induits par NCTU. De façon intérssante, l’augmentation du sVEGFR1 en réponse aux thérapies anti-angiogénique est spécifique aux modèles squameux et n’a pas été observée dans les modèles d’adénocarcinomes in vitro et in vivo. Sur le plan moléculaire, nous avons montré que le VEGF165 par l’intermédiaire de SOX2 régule l’expression du sVEGFR1 en réponse aux thérapiesAAG. De plus, nous avons identifié une boucle autocrine 1 intégrine / VEGFR1 / VEGFR2 par laquelle sVEGFR1 contrôle différentiellement la prolifération cellulaire et la survie, permettant notamment de distinguer les cellules SCC sensibles ou résistantes aux thérapies AAG. Enfin, dans une série de 77 cancers bronchiques non à petites cellules, nous avons montré que 11% et 44% des patients SCC expriment de bas ou de hauts nivaux de sVEGFR1 respectivement. Les hauts niveaux ont été corrélés avec des stades pTNM avancés. Dans l'ensemble, nos résultats sont la première preuve que les thérapies AAG augmentent l'expression du sVEGFR1 dans les cellules SCC. En outre, nos données mettent en évidence une fonction pro-tumorale inattendue de sVEGFR1 grâce à l'activation d'une boucle autocrine VEGFR/ β1 intégrine. Ces résultats pourraient aider à comprendre pourquoi les SCC répondent différemment aux AAG que les ADC et d'identifier les patients SCC qui pourraient etre éligibles à ces thérapies. / Vascular endothelial growth factors (VEGFs) and their receptors are regulators of physiological and pathological angiogenesis. In patients with squamous cell lung carcinoma (SCC), clinical trials evaluating anti-angiogenic therapies (AAG) have failed to identify strong benefits. Rather, these patients are at higher risk of bleeding complications when exposed to Bevacizumab (BVZ), a humanized monoclonal anti-VEGF-A antibody. The soluble VEGF receptor-1, namely sVEGFR1, is a truncated version of the cell membrane-spanning VEGFR1 that only retains the first six N-terminal Ig-like extracellular motifs of VEGFR1 owing to alternative splicing of its pre-mRNA. As a consequence, sVEGFR1 is mainly viewed as an anti-angiogenic factor that counteracts VEGF-A functions on endothelial cells. Moreover, high levels of sVEGFR1 were correlated with bad prognosis and bad response to therapies in many cancer types. Using various SCC cell lines, we showed that Bevacizumab as well as VEGFR-Tyrosine Kinase Inhibitors (Semaxanib, KI8751) increase the intra- and extra-cellular levels of sVEGFR1. We confirmed this up-regulation in NCTU-induced SCC murine tumorgrafts models treated with VEGFR-TKI (sunitinib) or anti-VEGFR2 (DC101). Of note, this effect was never observed in the lung adenocarcinoma histological sub-type (ADC), using either cell lines or a mouse model treated in the same conditions. At the molecular level, we identified the VEGF165 and SOX2 proteins as crucial upstream regulators of sVEGFR1 in response to AAG. Moreover, we unraveled an original and SOX2 proteins as crucial upstream regulators of sVEGFR1 in response to AAG. Moreover, we unraveled an original ines or a mouse model treato discriminate between AAG-sensitive or -resistant SCC cells. Finally, in a series of 77 Non Small Cell Lung Carcinoma, we provided the first description of a differential pattern of sVEGFR1 expression with 11% and 44% of SCC exhibiting no or high expression respectively, high levels of sVEGFR1 being correlated with advanced pTNM stages. As a whole, our results provide the first evidence that AAG therapies upregulate sVEGFR1 expression in SCC cells. In addition, our data highlight an unexpected pro-tumoral function of sVEGFR1 through the activation of a beta 1 integrin-dependent VEGFR autocrine loop. These results might help to understand why SCC are less responsive to anti-angiogenic drugs than ADC and to identify SCC patients eligible to these therapies.

Made available in DSpace on 2016-12-23T13:49:04Z (GMT). No. of bitstreams: 1 Naidilene Aguilar.pdf: 1193572 bytes, checksum: 7f22fc898dd29c394190df17d986794b (MD5) Previous issue date: 2011-08-15 / The Lung Carcinoma (LG) represents the major challenge to the global health, becoming the leading cause of death by cancer among men and women in Brazil. The natural history of the disease includes high mortality rates and aggressive evolution, often with the patient coming to the doctor when the disease is already advanced. The incidence of this disease has its peak between the ages of 55 and 65 years old. The occurrence of lung cancer is intrinsically linked to the exposure to carcinogens, so that 90% of the cases are associated with active smoking. Thus, this study evaluated the feasibility of tumor lines through tests with four types of drugs of different classes. Recently, several experiments were performed with drugs that selectively inhibit the spread of tumor cells but have no effect on primary growth (Ross et al., 1969). This communication is in agreement with experiments performed to study the effect anti-metastatic of some drugs on the tumor spread. Thus, our study experiments to use the surfactants, Triton® X-100 (Sigma), Tween® 20 (BioAgency), SDS (Vetec) and CDs (Sigma) in varying concentrations, in order to evaluate cell viability. In this study we used two tumor cell lines, the H460 and A549, respectively classified as large cell carcinoma and adenocarcinoma. The screening of the substances with potential cytotoxic effect was done by the colorimetric test using MTT (3 - (4, 5-dimethyl-2-y1) 2, 5-diphenyl tetrazolium bromide), as described by Mosmann (1983). The results showed variations in cell viability shown by the strains under study when treated with different types of drugs resulting in a viability proportional to the type and concentration of the drug. He was taken into consideration the different classes and chemical structures of the substances tested to discuss the different results and different strains. The SDS showed greater cytotoxic effect and the CD with the lowest or no effect under the same 8 conditions, Tween 20 and Triton X-100 had similar effects, with Triton X-100 getting a greater reduction in cell viability / O carcinoma de pulmão (CP) representa um grande desafio à saúde mundial, configurando-se como a principal causa mortis por câncer entre homens e mulheres no Brasil. A história natural da doença inclui elevada letalidade e evolução agressiva, quase sempre com o paciente chegando ao médico quando a doença já se encontra em fase avançada. A incidência desta doença tem o seu auge entre as idades de 55 e 65 anos. A ocorrência do câncer de pulmão está intrinsecamente associada à exposição a agentes carcinogênicos, de forma que 90% dos casos estão associados ao fumo ativo. Neste sentido, este trabalho avaliou a viabilidade de linhagens tumorais frente a testes com quatro tipos de drogas diferentes. Recentemente, várias experiências foram realizadas com fármacos que inibem seletivamente a disseminação de células tumorais, mas não têm nenhum efeito sobre o crescimento primário (ROSSO et al.,1969). A presente comunicação esta de acordo com experimentos realizados para estudar o efeito anti metastático de algumas drogas na disseminação do tumor. Sendo assim, nosso estudo experimenta utilizar os tensoativos, Triton® X-100 (Sigma), Tween® 20 (BioAgency), SDS (Vetec) e CDs (Sigma) em concentrações variadas, com objetivo de avaliar a viabilidade celular. Nesse estudo utilizamos duas linhagens celulares tumorais a H460 e A549, classificadas respectivamente como carcinoma de células grandes e adenocarcinoma. A triagem das substâncias com potencial efeito citotóxico foi feita através do teste colorimétrico utilizando MTT (3 - (4, 5-dimetil-2-y1) 2, 5-difenil brometo de tetrazólium), descrito por Mosmann (1983). Os resultados demonstraram variações na viabilidade celular apresentadas pelas linhagens em estudo quando tratadas com os diferentes tipos de drogas, resultando numa viabilidade proporcional ao tipo e concentração da droga. Foi levado em consideração as diferentes classes e estruturas químicas das 6 substâncias testadas para discutir os diferentes resultados encontrados bem como as diferentes linhagens. O SDS destacou se com maior efeito citotóxico e a CD com o menor ou nenhum efeito nas mesmas condições, o Tween 20 e o Triton X-100 obtiveram efeitos semelhantes com o Triton X-100 acarretando maior redução da viabilidade celular

Abstract Lung cancers and chronic obstructive pulmonary disease (COPD) are the most common smoking-related lung diseases and both have high mortality rate. Tight junctions (TJ) are apical junctions between epithelial cells that regulate the permeability of epithelium and form the tight junction along with occludin. Dysfunction of the TJ and dysregulation of TJ proteins leads to a loss of cell-cell adhesion and a loss of cohesion as well as epitheliomesenchymal transition. These increase invasion of lung carcinomas and possibly predispose to the exacerbations in COPD. Therefore, the aim of this thesis was to study expression and regulation of claudins in different lung carcinomas and COPD. Carcinomas expressed claudins 1, 2, 3, 4, 5 and 7 in different variations. Claudin 5 expression was weak in all carcinoma types. Strong claudin 1, 4 and 7 expression was associated with better survival in squamous cell carcinoma and adenocarcinoma. Claudin 3 expression was associated with COPD in large airways. Claudins 3 and 4 was found to be stronger in small airways of smokers and COPD patients than in non-smokers. Transcription factor snail had prognostic value in lung carcinomas. Negative snail expression was associated with longer life expectancy in lung carcinoma patients. Negative snail expression was associated with up-regulated claudin 5 and 7 expression, while strong expression was associated with low claudin 1 and 3 expression. Transcription factors slug and twist were inversely associated with claudins 3 and 4 in small and large airways. Slug expression was higher in non-smokers than in COPD patients and smokers. Transcription factor knockdown increased claudin expression in normal bronchial cell line. Except for claudin 2 and 7, which were decreased. Adenocarcinoma-like cell line was not affected by snail knockdown and in squamous cell carcinoma-like cell line claudin 3, 4 and 7 expression was increased. Transcription factor snail knockdown inhibited invasion of cell lines. Twist knockdown increased transepithelial resistance in normal bronchial cell line indicating higher barrier function in cell layer. / Tiivistelmä Keuhkosyöpä ja keuhkoahtaumatauti ovat yleisiä tupakoinnin aiheuttamia keuhkosairauksia, joissa on korkea kuolleisuus. Tupakointi aiheuttaa muutoksia keuhkojen epiteelisoluissa ja solujen välisissä liitoksissa. Tiivisliitokset solujen välillä säätelevät epiteelin rakennetta ja läpäisevyyttä. Klaudiinit ovat proteiineja, jotka muodostavat tiivisliitoksen yhdessä okkludiinin kanssa. Tiivisliitos proteiinien toimintahäiriöt voivat johtaa solujen välisten liitosten katoamiseen ja epiteelin hajoamiseen sekä epiteelisolujen muuntumiseen mesenkymaalisten solujan kaltaisiksi. Nämä seikat lisäävät invaasiota keuhkosyövissä ja saattavat altistaa pahenemisvaiheisiin keuhkoahtaumataudissa. Väitöskirjassa tutkittiin klaudiinien ilmentymistä ja säätelyä keuhkosyövässä ja keuhkoahtaumataudissa. Klaudiinien1, 2, 3, 4, 5 ja 7 esiintyminen keuhkosyövän histologisissa alatyypeissä vaihteli. Klaudiinien 1, 4 ja 7 voimakas ilmentyminen voitiin yhdistää pidempään elinikään potilailla, joilla oli levyepiteeli- tai adenokarsinooma. Klaudiini 3:n ilmentyminen liittyi keuhkoahtaumatautiin suurissa hengitysteissä. Klaudiinien 3 ja 4 voimakas ilmeneminen pienissä ilmateissä oli yleisempää keuhkoahtaumatautipotilailla ja tupakoitsijoilla kuin tupakoimattomilla henkilöillä. Transkriptiotekijä snailin puuttuminen keuhkosyövässä liittyi potilaiden pidempään elinaikaan. Klaudiinien 5 ja 7 ilmeneminen oli voimakkaampaa, kun snailin määrä oli vähäinen. Klaudiinien 1 ja 3 ilmeneminen väheni snail:in ollessa voimakas keuhkosyövässä. Traskriptiotekijöiden (slug ja twist) ilmeneminen liittyi käänteisesti klaudiinien ilmentymiseen pienissä ja suurissa ilmateissä. Slugin ilmeneminen oli voimakkaampaa tupakoimattomilla henkilöillä kuin tupakoivilla tai keuhkoahtaumatautia sairastavilla. Transkriptiotekijöiden snail, slug ja twist toiminnan estäminen lisäsi klaudiinien määrää normaaleissa keuhkon epiteelisoluissa. Poikkeuksen muodostivat klaudiinit 2 ja 7, joiden määrä väheni kun snail:in toiminta oli estetty. Adenokarsinooma-soluissa snailin estolla ei ollut vaikutusta, ja levyepiteelisyövän soluissa klaudiinien 3, 4 ja 7 määrä kasvoi. Snail myös vähensi solujen invaasiota. Transkriptiotekijä twistin toiminnan esto normaaleissa keuhkoepiteelisoluissa nosti solumaton läpi kulkevan sähkön resistenssiä, mikä on osoitus tiiviistä solujen välisistä liitoksista.

Με την εργασία έγινε μελέτη του σηματοδοτικού μονοπατιού Sonic Hedgehog σε 96 περιστατικά καρκίνου πνεύμονα με τη μέθοδο της ανοσοϊστοχημείας. Επίσης μελετήσαμε την πιθανή συμμετοχή του μεταγραφικού παράγοντα FoxM1 στο καρκίνωμα του πνεύμονα και την πιθανή συσχέτισή του με το μονπάτι του Hedgehog. Έγινε μελέτη της έκφρασης των μορίων Shh, Ptch1, Smo, Gli1, Gli2 και FoxM1. Τα αποτελέσματα αποκάλυψαν μια έντονη έκφραση των μορίων του μονοπατιού και αυξημένα ποσοστά ενεργοποίησής του. Επίσης βρέθηκε στατιστικά σημαντική συσχέτιση με τα πλακώδη καρκινώματα και με τα χαμηλού grade καρκινώματα. Ανάλογη σημαντική συσχέτιση βρέθηκε και με το φύλο,συχνότερα ενεργοποιημένο μονοπάτι στους άντρες. Ακόμα ανιχνεύτηκε μια συσχέτιση της έκφρασης του FoxM1 με το ενεργοποιημένο μονοπάτι. / The hedgehog (HH)-signaling pathway is implicated in developmental processes and its aberrant activation in adult tissues has been associated with malignancy. The aim of this study was to determine the expression pattern of HH-signaling molecules in lung carcinomas, as well as the involvement of the transcription factor FOXM1, that controls cell proliferation, in this process. Paraffin-embedded tissue sections of 96 lung cancer cases and adjacent non-neoplastic lung parenchyma were immunohistochemically analyzed with anti-SHH, anti-Patched1 (PTCH1), anti-Smoothened (SMO), anti-GLI1, anti-GLI2 and anti-FOXM1 antibodies. Correlations of HH molecules with clinicopathological parameters and FOXM1 expression were evaluated. All the HH-signaling molecules examined were overexpressed in lung cancer compared with the adjacent non-neoplastic lung parenchyma. HH pathway activity and expression of PTCH1 and SMO were significantly higher in squamous cell carcinomas compared to other histological types. Activation of HH pathway and PTCH1 expression were correlated with tumor grade being higher in low grade tumors. There was a significant correlation of lymph node metastases with expression of SMO in all histological types and with the gender higher in men. Overexpression of FOXM1 in lung cancer was also significantly correlated with PTCH1, SMO and GLI1 expression. In conclusion, HH-signaling pathway is activated in lung cancer and correlates with histological type, prognostic parameters of the tumors as well as with the increased expression of FOXM1.