A Síndrome de Noonan (SN) é caracterizada por baixa estatura proporcionada de início pós-natal, dismorfismos faciais, cardiopatia congênita e deformidade torácica. A frequência da SN é estimada entre 1:1000 e 1:2500 nascidos vivos, com distribuição semelhante em ambos os sexos. A herança é autossômica dominante com penetrância completa, porém a maioria dos casos é esporádica. Até o momento, mutações em genes da via RAS-MAPK (PTPN11, KRAS, SOS1, RAF1, MEK1, NRAS e SHOC2) foram identificadas em aproximadamente 70% dos pacientes. Uma das principais características fenotípicas da SN é a baixa estatura pós-natal, embora o mecanismo fisiopatológico do déficit de crescimento nesta síndrome ainda não esteja totalmente esclarecido. Estudos que avaliaram o padrão de crescimento linear em crianças com SN foram realizados anteriormente ao conhecimento do diagnóstico molecular dessa síndrome. No presente estudo, avaliamos a frequência de mutação nos genes PTPN11, SOS1, RAF1 e KRAS em 152 pacientes com SN e o padrão de crescimento linear (altura) e ponderal [índice de massa corpórea (IMC)] dos pacientes com mutação identificada. No total, mutações nos genes relacionados foram encontradas em 99 pacientes (65%) do nosso estudo, com predominância do gene PTPN11 (47%), seguido do SOS1 (9%), RAF1 (7%) e KRAS (3%). Foram construídas curvas específicas para SN de Altura e IMC para idade e sexo utilizando o método LMS. Os pacientes com SN apresentaram crescimento pré-natal preservado, porém o comprometimento do crescimento pós-natal foi observado desde o primeiro ano de vida, atingindo uma altura final de -2,5 e -2,2 desvios-padrão da média para população brasileira em homens e mulheres, respectivamente. O prejuízo da altura foi maior nos pacientes com mutação no gene RAF1 em comparação com os genes PTPN11 e SOS1. O IMC dos pacientes com SN apresentou queda de 1 desvio-padrão em relação à média da população brasileira normal. O comprometimento do IMC foi menor nos pacientes carreadores de mutação no RAF1. Pacientes com mutação nos genes PTPN11 e SOS1 apresentaram maior frequência de estenose de valva pulmonar, enquanto a miocardiopatia hipertrófica foi mais frequente nos pacientes com mutação no gene RAF1. A variabilidade fenotípica observada nos pacientes com mutação no PTPN11 não pode ser explicada pelo grau que estas mutações influenciam a atividade tirosina fosfatase da SHP-2 nem pela presença de polimorfismos no gene KRAS. Com a análise dos éxons 3, 8 e 13 do PTPN11, seguido dos éxons 6 e 10 do SOS1 e éxon 7 do RAF1 identificamos 86% dos pacientes carreadores de mutações nos genes relacionados, propondo uma forma mais eficiente de avaliação molecular na SN. Acreditamos que a variabilidade fenotípica presente nessa síndrome esteja diretamente ligada aos diferentes papéis exercidos pelas proteínas que participam da via RAS/MAPK. Entretanto, mais estudos em relação à via RAS/MAPK serão necessários para esclarecer as questões relacionadas ao crescimento e outras características fenotípicas da SN / Noonan Syndrome (NS) is characterized by distinctive facial features, short stature and congenital heart defects. The estimated prevalence is 1:1000 to 1:2500 live births, affecting equally both sexes. It is an autosomal dominant disorder with complete penetrance, but most cases are sporadic. To date, mutations in the RAS/MAPK pathway genes (PTPN11, KRAS, SOS1, RAF1, MEK1, NRAS and SHOC2) were identified in approximately 70% of patients. One of the cardinal signs of NS is proportional postnatal short stature although the physiopathological mechanism of growth impairment remains unclear. The current knowledge about the natural history of growth associated with NS was described before molecular diagnosis era. In this study, we performed PTPN11, SOS1, RAF1, and KRAS mutation analysis in a cohort of 152 NS patients and studied the natural linear (height) and ponderal growth [body mass index (BMI)] of NS patients with related mutations. Mutations in NS-causative genes were found in 99 patients (65%) of our cohort. The most common mutated gene was PTPN11 (47%), followed by SOS1 (9%), RAF1 (7%) and KRAS (3%). Sex-specific percentile curves for height and BMI were constructed using the LMS method. NS patients had birth weight and length within normal ranges but the postnatal growth impairment was observed during the first year of life, reaching a final height of -2.3 and -2.2 standard deviations from the mean for Brazilian healthy men and women, respectively. Postnatal growth impairment was higher in RAF1 mutation patients than in patients with SOS1 and PTPN11 mutations. BMI values in NS patients were lower in comparison with normal Brazilian population. BMI values were higher in patients with RAF1 mutations than in patients with other genotypes. Patients with mutations in PTPN11 and SOS1 genes were more likely to have pulmonary valve stenosis, whereas hypertrophic cardiomyopathy was more common in patients with mutations in the gene RAF1. The intensity of constitutive tyrosine phosphatase activity of SHP-2 due to PTPN11 mutations, as well as the presence of polymorphisms in KRAS gene did not influence the phenotype of NS patients with mutation in PTPN11 gene. Analysis of exons 3, 8 and 13 of PTPN11 gene, followed by exons 6 and 10 of SOS1 gene and exon 7of RAF1 gene identified 86% of patients harboring mutations in related genes, suggesting a more efficient evaluation of NS molecular diagnosis. We believe that the phenotypic variability in this syndrome is directly linked to the different roles played by proteins that participate in RAS/MAPK pathway. However, further studies in RAS/MAPK pathway are needed to clarify issues related to growth and other phenotypic characteristics of SN

Introdução: Pearlman e colaboradores relacionou a presença de mutações ativadoras no gene MAP3K1 com o desenvolvimento testicular anormal em pacientes com disgenesia gonadal 46,XY familial, embora os estudos em camundongos tenham demonstrado que o gene Map3k1 não é essencial para a determinação testicular. No desenvolvimento gonadal masculino, a ligação do MAP3K1 à proteína RHOA promove uma fosforilação normal de p38 e ERK1/2, o que determina um bloqueio da via da beta-catenina pela MAP3K4. Já no desenvolvimento feminino, ocorre uma hiper fosforilação de p38 e ERK1/2, o que determina a ativação da via da beta-catenina e o bloqueio da via de retroalimentação positiva do SOX9 e o desenvolvimento testicular. Objetivos: Pesquisar a presença de variantes alélicas do gene MAP3K1 em pacientes portadores de distúrbios do desenvolvimento sexual (1) 46,XY por anormalidades do desenvolvimento gonadal e avaliar a repercussão funcional das variantes identificadas. Casuística e Métodos: Quarenta e sete pacientes com disgenesia gonadal 46,XY (17 com a forma completa e 29 com a forma parcial) e uma paciente com DDS 46,XY de causa etiológica não conhecida foram estudados. As regiões codificadoras do gene MAP3K1 foram amplificadas e sequenciadas pelo método de Sanger ou painel customizado de genes-alvo associados ao DDS. Estudo in vitro utilizando o método de detecção colorimétrica In-Cell ELISA com anticorpos específicos para detecção de ERK1/2 e AKT, fosforilado e não fosforilado foi realizado em fibroblastos obtidos por biópsia de pele e mantidos em cultura celular de 3 indivíduos portadores de variantes no MAP3K1. A quantificação da fosforilação de p38 e ERK por ensaio de citometria em células linfoblastóides mutadas foram realizados em amostras de 4 indivíduos portadores de variantes no MAP3K1 em estudo realizado em colaboração. Imunohistoquímica com anticorpos anti Caspase-3 foram realizadas em tecidos gonadais parafinados das pacientes portadoras de variantes alélicas nos genes MAP3K1 e FGFR2. Resultados: Vinte e uma variantes alélicas, sete das quais ainda não descritas na literatura, foram identificadas no gene MAP3K1. Quatro novas variantes alélicas exônicas e não sinônimas (p.Leu639Pro, p.Leu447Trp, p.Thr657Arg e p.Cys691Arg) foram identificadas em heterozigose; todas foram classificadas como deletérias para a proteína nos estudos de predição \"in silico\", não foram identificadas em indivíduos controles brasileiros estudados e não estão descritas nos bancos de dados populacionais. A variante p.Leu639Pro foi identificada em duas irmãs com disgenesia gonadal 46,XY portadoras da variante p.Ser453Leu no gene FGFR2 identificada previamente. A variante intrônica c.834+1G >T identificada em heterozigose foi classificada como deletéria à proteína na análise no site de predição para alteração de \"splicing\". Os ensaios colorimétricos para detecção de ERK1/2 e AKT, fosforilado e não fosforilado foram inconclusivos. Os estudos in vitro de avaliação dos níveis de fosforilação de p38 e ERK evidenciaram uma maior fosforilação nas culturas celulares mutantes para o MAP3K1 quando comparado com a linhagem celular selvagem, resultado estatisticamente significativo ( p < 0,001) e que corrobora com os dados publicados previamente. A imunohistoquímica com anticorpos anti Caspase-3 mostrou uma maior marcação em células germinativas nos tecidos gonadais das pacientes portadoras das variantes no MAP3K1 e FGFR2 do que no tecido testicular normal, porém marcações foram identificadas também em células germinativas de tecidos testiculares de indivíduos com DDS 46,XY de outras etiologias. Conclusões: Os achados sugerem fortemente a participação das mutações identificadas no MAP3K1 na etiologia dos distúrbios do desenvolvimento sexual dos pacientes estudados. Porém, uma melhor compreensão dos mecanismos de participação da via MAPK nas redes gênicas de regulação do processo de determinação testicular humano ainda é necessário / Introduction: Pearlman et al. associated the presence of activating mutations in MAP3K1 gene with abnormal testicular development in patients with familial 46,XY gonadal dysgenesis, although studies in mice have shown that the Map3k1 gene is not essential for testicular determination. In male gonadal development, the binding of MAP3K1 to the RHOA protein promotes a normal phosphorylation of p38 and ERK1/2, and a blockade of the beta- catenin pathway is determined by MAP3K4. In the female development, hyperphosphorylation of p38 and ERK1/2 occurs. p38 and ERK1/2 hyperphosphorylated determine the activation of the beta-catenin pathway, the blockade of the positive feedback pathway of SOX9 and the testicular development. Objectives: To investigate the presence of allelic variants of the MAP3K1 gene in patients with 46,XY disorders of sex development (DSD) due to abnormalities of gonadal development and to evaluate the functional repercussion of the identified variants. Patients and Methods: Forty-seven patients with 46,XY gonadal dysgenesis (17 patients with complete form and 29 with partial form) and one patient with 46,XY DSD of unknown cause were studied. The MAP3K1 coding regions were amplified and sequenced by Sanger method or by custom panel of target genes associated with DSD. In-Cell ELISA assay with specific antibodies for the detection of phosphorylated and non-phosphorylated ERK1/2 and AKT was performed on fibroblasts obtained by skin biopsy and kept in cell culture of 3 individuals with MAP3K1 variants. Quantification of p38 and ERK phosphorylation by cytometric assay on mutated lymphoblastoid cells were performed on samples from 4 subjects with MAP3K1 variants in a collaborative study. Immunohistochemistry with anti-Caspase-3 antibodies were performed on paraffinembedded gonadal tissues of patients with MAP3K1 and FGFR2 allelic variants. Results: Twenty-one allelic variants, seven of them have not yet been described in the literature, were identified in the MAP3K1. Four novel exonic and non-synonymous allelic variants (p.Leu639Pro, p.Leu447Trp, p.Thr657Arg and p.Cys691Arg) were identified in heterozygous state; all of them were classified as deleterious in silico prediction sites; they were not identified in Brazilian control subjects and they were not described in the human genetic variation databases. The p.Leu639Pro variant was identified in two sisters with 46,XY gonadal dysgenesis carrying the previously identified FGFR2 variant (p Ser453Leu). The intronic c.834+1G > T variant identified in heterozygous state was classified as deleterious in the prediction sites. Colorimetric assays for the detection of phosphorylated and nonphosphorylated ERK1/2 and AKT were not significant. In vitro studies to evaluate p38 and ERK phosphorylation levels evidenced increased phosphorylation in the MAP3K1 mutant cells when compared to the wild type cells line; a statistically significant result (p < 0.001) that confirmed previously published data. The immunohistochemistry study with anti-Caspase-3 antibodies showed that the gonadal tissues of patients with MAP3K1 and FGFR2 variants exhibited more apoptotic germ ceIls than normal testicular tissue, but stained germ cells were also identified in the testicular tissues of the 46,XY DSD controls.Conclusions: These findings strongly suggest the participation of MAP3K1 mutations in the etiology of the testicular abnormalities of the 46,XY DSD patients of this study. However, a better understanding of the mechanisms of MAPK pathway in the gene regulatory networks of the human testicular determination process is still necessary

Várias condições podem estar relacionadas com a atrofia muscular, tais como inatividade, envelhecimento, septicemia, diabetes, câncer e uso de glicocorticoides. Em tentativa prévia de prevenir tal condição catabólica secundário ao uso de glicocorticoide, através da suplementação de ômega-3 (N-3), observamos um agravamento da atrofia muscular, afetando mais tipos de fibras musculares, usualmente poupadas pelo glicocorticoide, fibras tipo 1 por exemplo. Entretanto, não foi possível determinar quais as propriedades dessa interação. Portanto, o objetivo deste estudo foi de avaliar a ação do Ômega-3 associada a dexametasona e de diferentes glicocorticoides em dose equipotente sobre o peso corporal; área de secção transversa muscular; perfil de ácidos graxos; expressão gênica de fatores de transcrição musculares e atrogenes (Atrogina 1 e MuRF-1); expressão proteica de componentes das vias do IGF-1/Akt/mTOR, Ras/Raf/MEK/ERK e Miostatina/Smad2/3; e expressão de receptores de glicocorticoides na musculatura esquelética de ratos. Metodologia: Ratos Wistar suplementados ou não com ômega-3 (100mg/kg/dia de EPA) por 40 dias receberam dexametasona (DX) subcutânea (2,5 e 1,25mg/kg/dia) nos últimos 10 dias de suplementação. Para estudo dos demais glicocorticoides, ratos sem suplementação receberam deflazacorte (DC), metilprednisolona (MP) em dose/volume equipotente ao de dexametasona (DC 10 e 20mg/kg/dia e MP6,7 e 13,3mg/kg/dia) por 10 dias. Constituindo 10 grupos: CT, N-3, DX1,25, DX2,5, DX1,25+N-3, DX2,5+N-3, MP6, MP13, DC10 e DC20. Através de estudo histológico, imuno-histoquímico, PCR em tempo real e Western blotting, foram avaliados a área transversa dos diferentes tipos de fibras musculares; a expressão de receptor de glicocorticoide na fibra muscular; a expressão gênica dos atrogenes e fatores de transcrição; expressão de proteínas das vias IGF-1, Miostatina e MEK/ERK. Resultados: A administração de N-3 influenciou a atrofia por DX causando maior atrofia em fibras do tipo 1 e 2A, aumento na expressão proteica de FoxO3a total, P-Smad3, LC3-II e gênica (mRNA) de REDD-1, Atrogina-1/MAFbx. De forma isolada o ômega-3 reduziu a expressão de P-FoxO3a, PGC1alfa, a quantidade de ácido araquidônico e a expressão de mRNA do IRS-1 com aumento na expressão de LC3-II. A comparação entre glicocorticoides mostrou que a MP (13mg/kg/dia) acarretou maior impacto no peso corporal e muscular; o DC (10mg/kg/dia) causou menor atrofia em fibras 2B em relação aos demais glicocorticoides. A DX causou maior impacto sobre o Akt total em comparação com os demais glicocorticoides, em P-Akt o grupo DX1,25 teve menor expressão em relação a outros glicocorticoides em dose equipotente. Todos os glicocorticoides afetaram a expressão de P-FOXO3a. Na expressão de ERK1/2 e P-ERK1/2, MP6 foi o grupo com maior prejuízo à fosforilação em relação aos demais em dose equipotente. Já na avaliação da via Miostatina/Smad2/3 os grupos MP 6, MP13 e DC20 mostraram maior expressão de Smad2/3 total e P-Smad3. A expressão gênica de REDD-1 e MYOD foi aumentada nos grupos MP6 e MP13 em relação aos demais grupos; REDD2 no grupo DC20 foi menor em relação ao grupo DX2,5. A expressão de Miostatina foi menor nos grupos DX2,5 e DC20, sendo o DC a droga com menor impacto sobre os atrogenes MuRF-1 e Atrogina-1. DX1,25 e DX2,5 causaram menor expressão de IRS-1 entre os grupos de glicocorticoides. Conclusões: Ômega-3 pode aumentar a atrofia muscular causada por DX em fibras 1 e 2A, possivelmente relacionado com aumento da expressão de FoxO3a, REDD-1 e Atrogina-1, diminuição na expressão de PGC1alfa e P-FoxO3a, nas quantidades de ácido araquidônico com aumento da atividade lisossomal. Comparando diferentes glicocorticoides, a MP tende a produzir maior impacto nos pesos corporal e muscular, o DC é menos prejudicial as fibras do tipo 2B, entretanto, afeta predominantemente fibras do tipo 1, da mesma forma que a DX na dosagem de 1,25mg/kg/dia. A DX tende a afetar mais a expressão de Akt total e fosforilado que os demais glicocorticoides. A MP afeta mais a via Ras/Raf/MEK/ERK e expressão de REDD-1 em relação aos demais glicocorticoides, e o DC e MP mostram maior expressão de Smad2/3 total e fosforilada em relação ao DX após 10 dias de administração / Several conditions may be related to muscle atrophy, such as inactivity, aging, septicemia, diabetes, cancer and use of glucocorticoids. In a previous attempt to prevent such glucocorticoid catabolic condition, through the supplementation of omega-3 (N-3), we observed a worsening of muscular atrophy, affecting more types of muscle fibers, usually spared by glucocorticoid, type 1 fibers for example. However, it was not possible to determine the properties of this interaction. Therefore, the objective of this study was to evaluate the action of omega-3 associated with dexamethasone and different glucocorticoids in equipotent dose on body weight; muscle cross-sectional area; fatty acid profile; gene expression of muscle transcription factors and atrogenes (Atrogin-1 and MuRF-1); protein expression of IGF-1/Akt/mTOR, Ras/Raf/MEK/ERK and Myostatin/Smad2/3 pathways components; and expression of glucocorticoid receptors in the skeletal musculature of rats. Methods: Wistar rats given orally or not with omega-3 (100mg/kg/day of EPA) for 40 days received subcutaneous dexamethasone (DX) (2.5 or 1.25mg/kg/day) during the last 10 days of supplementation. For the other glucocorticoids, rats without supplementation received deflazacorte (DC) or methylprednisolone (MP) in dose/volume equivalent to that of dexamethasone (DC 10 or 20mg/kg/day and MP6.7 or 13.3mg/kg/day) for 10 days. Comprising 10 groups: CT, N-3, DX1.25, DX2.5, DX1.25 + N-3, DX2.5 + N-3, MP6, MP13, DC10 and DC20. Through histological, immunohistochemical, real-time PCR and Western blotting, we evaluated the transverse area of the different muscle fibers; the expression of glucocorticoid receptor; the gene expression of atrogenes and transcription factors; protein expression of the IGF-1, Myostatin and MEK/ERK pathways. Results: N-3 administration influenced DEXA atrophy causing increased atrophy in type 1 and 2A fibers, increased protein expression of total FoxO3a, P-Smad3, LC3-II, and REDD-1 gene (mRNA), Atrogin-1/MAFbx isolated omega-3 reduced the expression of P-FoxO3a, PGC1alpha, the amount of arachidonic acid and the expression of IRS-1 mRNA with increased expression of LC3-II. The comparison between glucocorticoids showed that MP13 had a greater impact on body and muscle weight; the DC10 caused less atrophy in 2B fibers in relation to the other glucocorticoids. DX, caused greater impact on total Akt compared to the other glucocorticoids, in P-Akt the DX1,25 group had lower expression to other equipotent dose glucocorticoids. All glucocorticoids affect the expression of P-FOXO3a. In the of ERK1/2 and P-ERK1/2 protein expression, the MP6 was the group with the greatest damage to the phosphorylation in relation to the others in equipotent dose. In the evaluation of the Myostatin/Smad2/3 pathway MP 6, MP13 and DC20 showed higher expression of total Smad2/3 and P-Smad3. The gene expression of REDD-1 and MYOD was increased in the MP6 and MP13 groups compared to the other groups, REDD2 in the DC20 group was lower in relation to the DX2.5 group. Myostatin expression was lower in the DX2.5 and DC20 groups, with DC being the drug with less impact on atrogenes MuRF-1 and Atrogin-1. DX1.25 and DX2.5 caused lower IRS-1 expression among the glucocorticoid groups. Conclusions: Omega-3 may increase muscle atrophy caused by DX in fibers 1 and 2A, possibly related to increased expression of FoxO3a, REDD-1 and Atrogin-1, decreased expression of PGC1alpha and P-FoxO3a, in the amounts of acid arachidonic with increased lysosomal activity. Comparing different glucocorticoids, MP tends to produce a greater impact on body and muscular weights, DC is less harmful to type 2B fibers, however, it predominantly affects type 1 fibers, in the same way as DX in the dosage of 1.25mg/kg/day. DX tends to affect total and phosphorylated Akt expression more than other glucocorticoids. MP affects more the Ras/Raf/MEK/ERK pathway and REDD-1 expression in relation to the other glucocorticoids, and DC and MP show a higher expression of total and phosphorylated Smad2/3 compared to DX after 10 days of administration

O câncer de pele é um dos mais frequentes entre humanos, sendo o melanoma o tipo menos comum, mas com grande importância devido à agressividade que ele apresenta. Um dos principais agentes etiológicos deste tipo de tumor é a radiação ultravioleta proveniente da luz solar. A fração de radiação ultravioleta B (UVB) gera dano no DNA e induz alterações nas células da pele após a exposição prolongada e sem proteção. A resposta à luz UVB em melanócitos e melanomas é diferente, mostrando a importância do perfil celular. O efeito genotóxico da luz UVB pode alterar a expressão de moléculas como galectina-3 e MAPKs, desencadeando respostas UVB-dependentes. Galectina-3 é uma lectina que reconhece beta-galactosídeos e está envolvida na regulação de diversos processos celulares que modificam a viabilidade celular e a proliferação. Esta molécula é ubiquamente expressa apresentando um comportamento específico dependendo da sua localização subcelular. No presente trabalho mostramos que a distribuição de galectina-3 em melanoma e melanócitos é ampla, encontrando-se tanto no núcleo como no citoplasma, podendo ser modificada após irradiação UVB ou ainda secretada para o meio extracelular. Além disso, observamos que a luz UVB ativa a via de MAPKs, proteínas quinases ativadas por mitógenos envolvidas no crescimento, sobrevivência, diferenciação e resposta a estresse, em melanócitos e em melanomas poucos minutos após a exposição à UVB. Uma maior atividade de p38 e de ERK é evidenciada em melanomas, enquanto que em melanócitos a via de p38 é a mais ativa, corroborando a noção de que a resposta celular à luz UVB difere entre melanócitos e melanoma. As moléculas p38 e JNK são proteínas quinases ativada pelo estresse (SAPK). A via de JNK não é tão responsiva em alguns melanomas, mas ativação desta molécula parece estar envolvida com a sobrevivência celular e a translocação mitocondrial após UVB. Em adição, a inibição de JNK leva ao aumento de morte celular em linhagens melanocíticas irradiadas e não irradiadas, e em melanoma induz morte e aumenta autofagia após irradiação. Esta molécula parece interagir com galectina-3 em modelos murinos, mas não em melanomas humanos, enquanto que ERK interage fisicamente com galectina-3 em melanócitos e melanomas humanos, independente de UVB. Através do silenciamento de galectina-3 pela técnica de RNA de interferência, mostramos o aumento da ativação da via de ERK após irradiação e de proteínas downstream de ERK, promovendo a proliferação celular em melanomas nessas condições. Em melanócitos parece existir uma regulação negativa da via de ERK por galectina-3 acompanhada de uma diminuição da viabilidade celular após o silenciamento dessa lectina, independente de UVB. Estes resultados mostram que galectina-3 é uma importante reguladora de eventos associados com sobrevivência e morte celular em melanoma. Por outro lado, em melanomas a ausência de galectina-3 induz aumento da proliferação associada à ativação de ERK, evidenciando a importância do tipo celular na ação de galectina-3 / Skin cancer is the most common cancer among humans, melanoma being the least common type but very important due to its aggressive behavior. A major etiologic agent of this type of tumor is ultraviolet radiation from the sunlight. The ultraviolet B rays (UVB) cause DNA damage and induce alterations over the skin cells after prolonged exposition without protection. The UVB response in melanocytes and melanoma cells is different. This shows the importance of the cellular profile. The genotoxic effect of UVB light can alter the expression of molecules such as galectine-3 and MAPKs and also triggers multiple responses UVB-dependent. Galectin-3 is a lectin that recognizes beta-galactosides. It is involved in the regulation of many cellular processes that modify cellular viability and proliferation and presents specific behavior depending on its subcellular localization. In the present study we showed that galectine-3 distribution in melanoma cells and melanocytes is large, lying both in the nucleus and in the cytoplasm. After UVB irradiation this distribution could be modified or even galactine-3 secreted itself into the extracellular space. Moreover, we observed that UVB light activates the mitogen-activated protein kinase pathway (MAPK) involved in growth, survival, differentiation and stress-response in melanocytes and in melanoma cells just a few minutes after exposure. An increased activity of p38 and ERK was observed in melanomas, while in melanocytes just p38 pathway was highly active, supporting the notion that the cellular response to UVB light differs between melanocytes and melanoma cells. The molecules p38 and JNK are stress-activated protein kinases (SAPK). The JNK pathway is not responsive in some melanoma cells, but the activation of this molecule appears to be involved in cell survival and mitochondrial translocation after being exposed to UVB. Inhibition of JNK leads to increased cell death in irradiated and non-irradiated melanocytic lineage, but in melanoma cells induces cell death and increased autophagy only after irradiation. This molecule seems to interact with galectin-3 in mouse models but not in human melanomas, whereas ERK physically interacts with galectin-3 in human melanocytes and melanoma cells, regardless of UVB exposure. Through the knockdown of galectin-3 by siRNA, we showed increased activation of the ERK and its downstream pathway after irradiation, thus inducing cell proliferation. In melanocytes seems to be a negative regulation of the ERK pathway by galectin-3 accompanied by a decrease in cell viability after its knockdown regardless of UVB exposure. These results show that galectin-3 is an important regulatory molecule of events associated with cell death and survival in melanoma, which has different behavior depending on the cell type

Les patients décrits initialement par J. Noonan se ressemblent et ont une cardiopathie congénitale :soit une sténose valvulaire pulmonaire (SVP), soit une persistance du canal artériel. Avant la découverte du premier gène responsable de ce qui est devenu le syndrome de Noonan, cinq études de cohortes décrivant ces patients ont répertorié la prévalence de SVP mais le spectre des cardiopathies semble large, n’a pas été décrit de manière exhautive et aucune hypothèse n’est émise ou ne fait de lien entre ces différentes manifestations cardiaques et une compréhension intégrée du développement embryonnaire. Le gène PTPN11 est le premier gène identifié chez 40% de ces patients. Une corrélation existe entre la présence d’une mutation et la survenue de SVP de même qu’entre l’absence de mutation et la présence d’une cardiomyopathie hypertrophique. Six études de cohortes ont repris la description des mutations identifiées au sein du gène PTPN11 et les phénotypes associés, mais les cardiopathies n’ont pas été systématiquement ou spécifiquement analysées (tant au sein des groupes de patients porteurs de mutation que de ceux sans mutation). Le syndrome LEOPARD est allélique du syndrome de Noonan depuis que des mutations spécifiques au sein des exons 7,12 et 13 du gène PTPN11 ont été identifiées chez 95% des patients. <p><p>Afin d’appréhender les implications possibles du gène PTPN11 dans la survenue des cardiopathies chez les patients porteurs de ces deux syndromes, nous avons conduit une étude chez 272 patients au syndrome de Noonan et une étude chez 19 patients porteurs du syndrome LEOPARD. Parmi la cohorte de patients atteints du syndrome de Noonan, 104 ont été diagnostiqués porteurs d’une mutation du gène (38%). Une prévalence de survenue de cardiopathies affectant les structures droites du cœur se dégage chez les patients identifiés porteurs d’une mutation avec une différence significative pour la SVP, une tendance est relevée pour le canal atrio-ventriculaire et la communication inter-auriculaire de type Ostium Secundum. L’absence de mutation est corrélée avec la survenue de cardiomyopathie hypertrophique et de cardiopathies du cœur gauche. Parmi les patients atteints du syndrome LEOPARD, il n’existe pas de différence statistiquement significative pour les patients porteurs d’une mutation ou non et/ou pour une cardiopathie particulière. <p><p>Toutes les mutations identifiées du gène PTPN11 sont des mutations ‘faux-sens’. Ce gène appartient à la famille des gènes codant pour une protéine tyrosyl phosphatase, SHP-2, ne possédant pas de récepteur trans-membranaire. Cette phosphatase est impliquée dans la voie de signalisation cellulaire des MAP (‘Mitogen-activated protein’) kinases dont l’expression est ubiquitaire et inclut le coeur. Depuis nos travaux, le concept de syndrome « neuro-cardio-facio-cutané » est établi puisque, à ce jour, 9 gènes (SOS1, RAF1, BRAF, KRAS, NRAS, HRAS, NF1, SPRED1 et SHOC2), tous impliqués dans la voie de signalisation RAS (voie des MAP kinases) sont identifiés. Un spectre phénotypique existe avec des signes communs mais aussi distinctifs chez les patients présentant le syndrome de Noonan, le syndrome LEOPARD, le syndrome de Costello, le syndrome Cardio-Facio-Cutané (CFC), le syndrome « Noonan-NF1 », le syndrome de Legius et le syndrome « Noonan/Multiple Giant Cell Lesion ». Nous rapportons enfin l’observation d’une patiente atteinte du syndrome CFC et porteuse d’une mutation (p.R257Q) au sein du gène BRAF ayant développé une cardiomyopathie hypertrophique. <p><p>Ces travaux de cohortes de patients au phénotype du syndrome de Noonan, du syndrome LEOPARD et cette dernière description d’une patiente au syndrome CFC ont permis de participer à la découverte de l’implication d’une voie de signalisation cellulaire dont l’origine génétique est maintenant démontrée. Les résultats de nos travaux réalisés depuis 2002 auront permis, avec les équipes travaillant sur le même sujet, d’orienter les investigations et les nouveaux projets de recherche qui étudient spécifiquement le rôle du gène PTPN11 dans l’embryologie du cœur. Les études des orthologues (zebrafish, murin et Drosophila) porteurs à l’état hétérozygote d’une mutation du gène PTPN11 permettent d’intégrer les anomalies phénotypiques et cardiaques observées. Ces études permettent de postuler les effets cellulaires produits par les mutations chez les patients atteints du syndrome de Noonan et chez les patients atteints du syndrome LEOPARD engendrant in vitro une activation de la phosphatase (effet « gain de fonction ») pour les premiers ou une réduction de l’activité phosphatase (« dominant négatif ») mais engendrant un effet gain de fonction in vivo. Nous discutons les connaissances acquises, les compréhensions obtenues et intégrées et traçons enfin les perspectives offertes par ces travaux.<p> / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished

Human obesity is increasing globally at an impressive rate. The rise in obesity has led to an increase in diseases associated with obesity, such as type 2 diabetes. A major prerequisite for this disease is the development of insulin resistance in the muscle and adipose tissues. Interestingly, experiments in rodent models suggest that adipocytes and macrophages can profoundly influence the development of insulin resistance. Accordingly, the number of adipose tissue macrophages increases substantially during the development of obesity. Numerous research models have demonstrated that macrophages promote insulin resistance by secreting cytokines, like TNFα, which impair whole body insulin sensitivity and adipose tissue function. Additionally, enhancements of murine adipose function, particularly glucose disposal, prevent the development of insulin resistance in mice on a high fat diet. Thus, mechanisms which enhance adipose function or attenuate macrophage inflammation are of interest. Our lab previously identified mitogen activated protein kinase kinase kinase kinase 4 (MAP4K4) as a potent negative regulator of adipocyte function. In these studies, TNFα treatment increased the expression of adipocyte MAP4K4. Furthermore, the use of small interfering RNAs (siRNA) to block the increase in MAP4K4 expression protected adipocytes from some of the adverse effects of TNFα. Because MAP4K4 is a potent negative regulator of adipocyte function, an understanding of the mechanisms by which TNFα regulates MAP4K4 expression is of interest. Thus, for the first part of this thesis, I characterized the signaling pathways utilized by TNFα to regulate MAP4K4 expression in cultured adipocytes. Here I show that TNFα increases MAP4K4 expression through a pathway requiring the transcription factors activating transcription factor 2 (ATF2) and the JUN oncogene (cJUN). Through TNFα receptor 1 (TNFR1), but not TNFR2, TNFα increases MAP4K4 expression. This increase is highly specific to TNFα, as the inflammatory agents IL-1β, IL-6 and LPS did not affect MAP4K4 expression. In agreement, the activation of cJUN and ATF2 by TNFα is sustained over a longer period of time than by IL-1β in adipocytes. Finally, MAP4K4 is unique as the expression of other MAP kinases tested fails to change substantially with TNFα treatment. For the second part of this thesis, I assessed the role of MAP4K4 in macrophage inflammation in vitro and in vivo. To accomplish this task, pure β1,3-D-glucan shells were used to encapsulate siRNA. Glucan shells were utilized because they are effectively taken up by macrophages which express the dectin-1 receptor and they survive oral delivery. I demonstrate that these β1,3-D-glucan encapsulated RNAi particles (GeRPs) are efficiently phagocytosed and capable of mediating the silencing of multiple macrophage genes in vitro and in vivo. Importantly, oral treatment of mice with GeRPs fails to increase plasma IFNγ and TNFα or alter serum AST and ALT levels. Orally administered GeRPs are found in macrophages isolated from the spleen, liver, lung and peritoneal cavity and mediate macrophage gene silencing in these tissues. Utilizing this technology, I reveal that MAP4K4 augments the expression of TNFα in macrophages following LPS treatment. Oral delivery of MAP4K4 siRNA in GeRPs silences MAP4K4 expression by 70% and reduces basal TNFα and IL-1β expression significantly. The depletion of MAP4K4 in macrophages protects 40% of mice from death in the LPS/D- galactosamine (D-GalN) model of septicemia, compared to less than 10% in the control groups. This protection associates with significant decreases in serum TNFα concentrations following LPS/D-GalN challenge. Consistent with reduced macrophage inflammation, hepatocytes from mice treated orally with GeRPs targeting MAP4K4 present less apoptosis following LPS/D-GalN treatment. Thus, MAP4K4 is an important regulator of macrophage TNFα production in response to LPS. The results presented here add to the knowledge of MAP4K4 action in adipocyte and macrophage inflammation substantially. Prior to these studies, the mechanism by which TNFα controlled MAP4K4 expression in adipocytes remained unknown. Considering that MAP4K4 is a negative regulator of adipocyte function, identifying the mechanisms that control MAP4K4 expression was of interest. Furthermore, the role of macrophage MAP4K4 in LPS stimulated TNFα production was also unknown. To address this question in vivo, new technology specifically targeting macrophages was needed. Thus, we developed a technology for non toxic and highly specific macrophage gene silencing in vivo. Considering that macrophages mediate numerous diseases, the application of GeRPs to these disease models is an exciting new possibility.

Indiana University-Purdue University Indianapolis (IUPUI). / Tumor necrosis factor-induced protein 6 (TSG-6) has been shown to mitigate inflammation. Its presence in the secretome of adipose stem / stromal cells (ASC) and its role in activities of ASC have been overlooked. This thesis described for the first time the release of TSG-6 from ASC, and its modulation by endothelial cells. It also revealed that protection of endothelial barrier function was a novel mechanism underlying the anti-inflammatory activity of both ASC and TSG-6. Moreover, TSG-6 was found to inhibit mitogen-activated lymphocyte proliferation, extending the understanding of its pleiotropic effects on major cell populations involved in inflammation. Next, enzyme-linked immunosorbent assays (ELISA) were established to quantify secretion of TSG-6 from human and murine ASC. To study the importance of TSG-6 to specific activities of ASC, TSG-6 was knocked down in human ASC by siRNA. Murine ASC from TSG-6-/- mice were isolated and the down-regulation of TSG-6 was verified by ELISA. The subsequent attempt to determine the efficacy of ASC in ameliorating ischemic limb necrosis and the role of TSG-6, however, was hampered by the highly variable ischemic tissue necrosis in the BALB/c mouse strain. Afterwards in a mouse model of cigarette smoking (CS), in which inflammation also plays an important role, it was observed, for the first time, that 3-day CS exposure caused an acute functional exhaustion and cell cycle arrest of hematopoietic progenitor cells; and that 7-week CS exposure led to marked depletion of phenotypic bone marrow stem and progenitor cells (HSPC). Moreover, a dynamic crosstalk between human ASC and murine host inflammatory signals was described, and specifically TSG-6 was identified as a necessary and sufficient mediator accounting for the activity of the ASC secretome to ameliorate CS-induced myelotoxicity. These results implicate TSG-6 as a key mediator for activities of ASC in mitigation of inflammation and protection of HSPC from the myelotoxicity of cigarette smoke. They also prompt the notion that ASC and TSG-6 might potentially play therapeutic roles in other scenarios involving myelotoxicity.

Les performances reproductrices des espèces d’intérêt agronomique sont dépendantes d’une régulation minutieuse de la folliculogenèse ovarienne. Parmi les régulateurs impliqués, il y a les facteurs de croissance fibroblastiques (FGFs), stimulant notamment la phosphorylation des protéines kinases activées par des agents mitogènes (MAPKs), afin de contrôler le devenir du follicule mais aussi les évènements qui y sont associés tels que la stéroïdogenèse, l’angiogenèse, la formation du corps jaune. Dans plusieurs types cellulaires non ovariens, des phosphatases à double spécificité (DUSPs), dont l’expression est induite en réponse à des facteurs de croissance, déphosphorylent les MAPKs. La présence et la régulation des DUSPs dans l’ovaire des mammifères est cependant peu documentée. Ces travaux de thèse avaient ainsi pour objectifs, (1) de déterminer la présence des DUSPs, (2) leur régulation par les FGFs et (3) leur rôle dans les cellules de granulosa de vache et de brebis. Dans la première étude effectuée chez la brebis, les ARNm codant pour 16 DUSPs ont été détectés, et leur profil d’expression a été dressé dans des cellules de granulosa issues de follicules antraux. Puis, les niveaux d’ARNm pour DUSP1, DUSP2, DUSP5 et DUSP6, ainsi que les niveaux de protéines pour DUSP1 et DUSP6 ont été augmentés par FGF2 mais pas par FGF8 ou FGF18. L’inhibition de DUSP1/6 et DUSP1 a également suggéré un rôle pour DUSP6 dans la déphosphorylation de MAPK8 chez la brebis. Avec la deuxième étude chez la vache, il ressort que la régulation de ces trois DUSPs semble bien conservée car les niveaux d’ARNm pour DUSP1, DUSP5 et DUSP6 et de protéines pour DUSP5 et DUSP6 ont été augmentés en réponse à FGF2. De plus, en s’intéressant au contrôle de l’expression de DUSP1, DUSP5 et DUSP6, il est ressorti que l’accumulation d’ARNm pour DUSP5 et DUSP6 nécessitait l’activation de MAPK3/1, et la signalisation calcique pour les ARNm pour DUSP6. D’après l’ensemble de ces données, DUSP1, DUSP5 et DUSP6 sont régulées de manière complexe dans les cellules de granulosa, et peuvent être désignées comme des phosphatases participant à la signalisation des FGFs ; cela contribue ainsi à une meilleure compréhension des mécanismes régulatoires de la folliculogenèse chez les ruminants. / The reproductive performance of species of agronomic interest is dependent on the careful regulation of ovarian folliculogenesis. Among the regulators involved are fibroblast growth factors (FGFs) that stimulate the phosphorylation of mitogen-activated protein kinases (MAPKs) to control the fate of the follicle and associated events such as steroidogenesis, angiogenesis and corpus luteum formation. In several non-ovarian cell types, dual specificity phosphatases (DUSPs), whose expression is induced in response to growth factors, dephosphorylate MAPKs. However, the presence and regulation of DUSPs in the mammalian ovary are poorly documented. The objectives of this thesis were (1) to determine the presence of DUSPs, (2) their regulation by FGFs and (3) their role in cow and sheep granulosa cells. In the first study in sheep, mRNAs encoding 16 DUSPs were detected and profiled in granulosa cells from antral follicles. Subsequently, DUSP1, DUSP2, DUSP5 and DUSP6 mRNA levels, as well as proteins for DUSP1 and DUSP6, were increased by FGF2 but not FGF8 or FGF18. Inhibition of DUSP1/6 and DUSP1 also suggested a role for DUSP6 in the dephosphorylation of MAPK8 in sheep. In the second study in the cow, the regulation of these three DUSPs appeared to be well conserved as DUSP1, DUSP5 and DUSP6 mRNA levels and DUSP5, DUSP6 protein levels were increased in response to FGF2. In addition, by focusing on the control of DUSP1, DUSP5 and DUSP6 expression, it was found that the accumulation of DUSP5 and DUSP6 mRNAs required the activation of MAPK3/1, and calcium signaling for DUSP6 mRNA. Taken together, these data suggest that DUSP1, DUSP5 and DUSP6 are regulated in a complex manner in granulosa cells, and can be designated as phosphatases involved in FGF signaling, thus contributing to a better understanding of the regulatory mechanisms of folliculogenesis in ruminants.

No / Fibroblast growth factor receptors (FGFR) play key roles in proliferation, differentiation, and tumorigenesis. Many urothelial carcinomas contain activating point mutations or increased expression of FGFR3. However, little is known about the role of other FGFRs. We examined FGFR expression in telomerase-immortalized normal human urothelial cells, urothelial carcinoma cell lines, and tumor samples and showed that FGFR1 expression is increased in a high proportion of cell lines and tumors independent of stage and grade. To determine the role of FGFR1 in low-stage bladder cancer, we overexpressed FGFR1 in telomerase-immortalized normal human urothelial cells and examined changes in proliferation and cell survival in response to FGF2. FGFR1 stimulation increased proliferation and reduced apoptosis. To elucidate the mechanistic basis for these alterations, we examined the signaling cascades activated by FGFR1. FRS2alpha and PLCgamma were activated in response to FGF2, leading to activation of the mitogen-activated protein kinase pathway. The level of mitogen-activated protein kinase activation correlated with the level of cyclin D1, MCL1, and phospho-BAD, which also correlated with FGFR-induced proliferation and survival. Knockdown of FGFR1 in urothelial carcinoma cell lines revealed differential FGFR1 dependence. JMSU1 cells were dependent on FGFR1 expression for survival but three other cell lines were not. Two cell lines (JMSU1 and UMUC3) were dependent on FGFR1 for growth in soft agar. Only one of the cell lines tested (UMUC3) was frankly tumorigenic; here, FGFR1 knockdown inhibited tumor growth. Our results indicate that FGFR1 has significant effects on urothelial cell phenotype and may represent a useful therapeutic target in some cases of urothelial carcinoma.

Les peroxyrédoxines sont des enzymes essentielles de la cellule. Outre leur rôle d’antioxydant, elles sont aussi des régulateurs de la signalisation cellulaire et des suppresseurs de tumeurs. La péroxiredoxine 1 (Prx1) est la plus abondante parmi les six isoformes de peroxyrédoxines humaines. Elle est fréquemment surexprimée dans plusieurs types de cellules cancéreuses, et on a pu associer Prx1 aux processus de carcinogenèse et de métastase, ainsi qu’à la résistance à la radiothérapie ou la chimiothérapie. Ainsi, Prx1 pourrait donc être une cible anticancéreuse intéressante. Au cours de ce travail de thèse, nous avons d’abord évalué l'impact d’une diminution de Prx1 (Prx1 knockdown (Prx1–)) sur la sensibilité cellulaire à des dizaines de médicaments anticancéreux dont la vinblastine, le taxol, la doxorubicine, la daunorubicine, l’actinomycine D, et le 5-fluorouracile, et d’agents connus pour provoquer la production d’espèces réactives de l’oxygène (ROS), dont le peroxyde d'hydrogène, le 2-phényléthyle isothiocyanate, le β-lapachone (β-lap) et la ménadione. Nous avons mis en évidence qu’une diminution de Prx1 augmente significativement la sensibilité des cellules à l'effet cytotoxique de la β-lap et de la ménadione, deux naphtoquinones possédant une activité anti-tumorale.Nous avons étudié les mécanismes responsables de l'augmentation de la cytotoxicité de la β-lap dans un contexte Prx1–. Nous montrons que la toxicité accrue de la β-lap dans des cellules Prx1– est due à une accumulation intracellulaire de ROS. Cet effet est dépendant de l’activité NADPH quinone oxydoréductase (NQO1) et s’accompagne d’une phosphorylation de c-Jun N-terminal kinases (JNK), protein 38 (p38), extracellular signal-regulated kinases (Erk) et des mitogen-activated protein kinases (MAPK), mais aussi d’une diminution des niveaux protéiques de la thiorédoxine 1. En se basant sur le fait que Prx1 est une enzyme antioxydante et un partenaire d'au moins ASK1 et JNK, deux éléments clés de la voie MAPK, nous proposons que la sensibilisation à la β-lap, observée après diminution de Prx1, est provoquée par une action synergique entre l'accumulation de ROS et l'induction de la voie MAPK, conduisant ainsi à l'apoptose.Nous avons ensuite étudié les mécanismes responsables de l'augmentation de la cytotoxicité de la ménadione dans le contexte Prx1–. La sensibilité accrue des cellules à l'effet cytotoxique de la ménadione et également associée à l'accumulation rapide et massive des ROS intracellulaire et à une mort cellulaire ressemblant à la nécrose programmée (necroptosis). L’accumulation de ROS induite par la ménadione et très rapidement détectée dans le cytosol, le noyau, et de façon encore plus importante, dans la matrice mitochondriale. Ce phénomène est en corrélation avec l'oxydation importante des thiorédoxine 2 et peroxiredoxine 3, deux protéines antioxydantes localisées dans la mitochondrie. La diminution de l’expression de Prx1 s’accompagne d’une augmentation des quantités tant de l’ARNm que de la protéine NRH: quinone oxydoréductase 2 (NQO2). Cette augmentation de l'activité de NQO2 est en grande partie responsable de l'accumulation intracellulaire de ROS et de la mort cellulaire après le traitement à la ménadione. Nos données révèlent que l’accumulation de ROS dans les cellules Prx1– provient de la résultante entre l’augmentation de leur production par NQO2 au cours du métabolisme de la ménadione et la diminution de leur élimination par Prx1. Enfin et de façon surprenante, selon la nature des naptoquinones (β-lap ou ménadione), les voies métaboliques qui conduisent à l'accumulation des ROS, ou les voies de signalisation et les mécanismes de mort cellulaire impliqués semblent être distincts. / Peroxiredoxins have multiple cellular functions as major antioxidants, signaling regulators, molecular chaperones and tumor suppressors. Peroxiredoxin 1 (Prx1) is the most abundant among the six isoforms of human peroxiredoxins. It is frequently over-expressed in various cancer cells, which is known associated with carcinogenesis, metastasis and resistance to radiotherapy or chemotherapy. Prx1 could thus be an interesting anticancer target. In this study, we first evaluated the impact of Prx1 knockdown (Prx1–) on cellular sensitivity to dozens of anticancer drugs including vinblastine, taxol, doxorubicin, daunorubicin, actinomycin D, and 5-fluorouracil, and of reactive oxygen species (ROS)-generating agents, including hydrogen peroxide, 2-phenylethyl isothiocyanate, β-lapachone (β-lap) and menadione. We observed that Prx1 knockdown significantly enhanced cancer cell sensitivity to β-lap and menadione, two naphthoquinones with anti-cancer activity.We first investigated the underlying mechanisms responsible for the specifically enhanced cytotoxicity to β-lap in a Prx1 knockdown context. Prx1 knockdown markedly potentiated β-lap-induced cytotoxicity through ROS accumulation. This effect was largely NAD(P)H:quinone oxidoreductase 1 (NQO1)-dependent and associated with the phosphorylation of c-Jun N-terminal kinases (JNK), protein 38 (p38) and extracellular signal-regulated kinases (Erk) proteins in mitogen-activated protein kinase (MAPK) pathways, and a decrease in thioredoxin 1 protein levels. Based on the fact that Prx1 is a major ROS scavenger and a partner of apoptosis signaling kinase 1 (ASK1) and JNK, two key components of MAPK pathways, we propose that Prx1 knockdown-induced sensitization to β-lap is achieved through the combined action of ROS accumulation and MAPK pathway activation, leading to cell apoptosis.We then investigated the underlying mechanisms responsible for the specifically enhanced cytotoxicity to menadione in Prx1– cells. Enhanced sensitivity to menadione was associated with a rapid and significant intracellular ROS accumulation and necroptotic-like cell death. Menadione-induced ROS accumulation occurred immediately in the cytosol, the nucleus, and even more noticeably in the mitochondrial matrix, correlated with significant oxidation of both mitochondria-localized thioredoxin 2 and peroxiredoxin 3. Prx1 knockdown significantly up-regulated mRNA and protein levels of NRH: quinone oxidoreductase 2 (NQO2). Increased activity of NQO2 was largely responsible for menadione-induced ROS accumulation and consequent cell death. Our data indicate that massive ROS accumulation results from the combined effect of increased ROS generation by higher NQO2 activity during menadione metabolism, and diminished Prx1 scavenging activity. Finally and noteworthy, the metabolic pathways that lead to ROS accumulation, downstream signaling pathways and cell death mechanisms appear to be distinct for β-lap and menadione.