Le glioblastome est la plus fréquente et la plus agressive des tumeurs cérébrales primaires.<p>Malgré un traitement standard pluridisciplinaire (chirurgie, radiothérapie et chimiothérapie),<p>la médiane de survie des patients atteints de ce type de tumeur est de 15 mois et aucun patient<p>n’a pu être guéri à ce jour. Ce pronostic très sombre est directement lié à la capacité<p>d’invasion diffuse du parenchyme cérébral par les cellules gliales tumorales, ce qui rend<p>impossible une résection chirurgicale totale. De plus, ces cellules sont particulièrement<p>résistantes aux traitements chimiothérapeutiques de type pro-apoptotique, entrainant une<p>récidive quasi inévitable de la tumeur. De nombreuses stratégies thérapeutiques telles que<p>l’immunothérapie ou les thérapies ciblées sont actuellement explorées pour tenter de<p>combattre ces tumeurs. Cependant, leur efficacité au niveau clinique s’est avérée décevante. Il<p>devient donc indispensable d’identifier de nouveaux agents thérapeutiques afin d’améliorer la<p>survie des patients atteints de glioblastome.<p>Dans ce travail, nous avons caractérisé les propriétés anticancéreuses in vitro et in vivo de<p>deux terpénoïdes extraits de champignons, la fusicoccine A et l’ophioboline A, puis nous<p>avons caractérisé en partie leur mécanisme d’action anti-tumoral dans des cellules de<p>glioblastome.<p>Tout d’abord, nous avons montré que l’activité inhibitrice de croissance in vitro de la<p>fusicoccine A et de l’ophioboline A n’était pas dépendante du degré de sensibilité ou de<p>résistance à l’apoptose des cellules gliales tumorales. Nous avons ensuite mis en évidence que<p>la fusicoccine A était capable de diminuer l’invasion des cellules de glioblastome in vitro en<p>ciblant la kinase focale d’adhérence (FAK). Dans le même temps, nous avons démontré que<p>l’ophioboline A était capable d’induire la mort de ces cellules par paraptose en inhibant<p>l’activité du canal ionique BKCa. Ces deux cibles sont intéressantes car en plus d’être<p>surexprimées dans les glioblastomes, elles interviennent dans de nombreux processus<p>cellulaires tels que la prolifération, la migration et la survie cellulaire.<p>Pour finir, nous avons analysé le pouvoir anti-tumoral in vivo de ces deux terpénoïdes en<p>utilisant un modèle murin de mélanome métastatique, couramment utilisé dans notre<p>laboratoire. Seule l’ophioboline A, injectée en intrapéritonéal à 10 mg/kg, augmentait de<p>manière significative la survie des souris traitées avec cette molécule par rapport aux souris<p>contrôles. Dans ce premier modèle, nous n’avions pas déterminé les conditions optimales<p>9<p>pour l’évaluation in vivo de la fusicoccine A et de l’ophioboline A. Lorsque celles-ci seront<p>définies, des modèles de xénogreffes orthotopiques de glioblastomes humains implantées dans<p>le cerveau de souris immunodéficientes seront utilisés.<p>En conclusion, l’ophioboline A, pouvant être produite en quantités industrielles par culture<p>du champignon qui la synthétise, possédant un mécanisme d’action original et montrant déjà<p>un début d’activité in vivo, pourrait représenter une molécule méritant des études plus<p>approfondies en termes d’agent thérapeutique susceptible de combattre les glioblastomes. / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished

Our aim was to determine the characteristics, treatments and outcomes of patients with primary spinal glioblastomas (GB) or gliosarcomas (GS) reported in literature until March 2015. PubMed and Web of Science were searched for peer-reviewed articles pertaining to cases of glioblastomas / gliosarcomas with primary spinal origin, using predefined search terms. Furthermore we performed hand searches tracking the references from the selected papers. Eighty-two articles published between 1938 and March 2015 were eligible. They reported on 157 patients. Median age at diagnosis was 22 years. The proportion of patients who received adjuvant chemo- or radiotherapy clearly increased from the time before 1980 until present. Median overall survival from diagnosis was 8.0 ± 0.9 months. On univariate analysis age influenced overall survival, whereas tumor location, gender and the extent of initial resection did not. Outcomes did not differ between children (< 18 years) and adults. However, the patients who were treated after 1980 achieved longer survival times than the patients treated before. On multivariable analysis only age (< 60 years) and the time period of treatment (>1980) were confirmed as positive independent prognostic factors. In conclusion, primary spinal GB / GS mainly affect younger patients and are associated with a dismal prognosis. However, most likely due to the increasing use of adjuvant treatment, modest therapeutic progress has been achieved over recent decades. The characteristics and treatments of primary spinal glioblastomas should be entered into a central registry in order to gain more information about the ideal treatment approach in the future.

Objective: Two chromosomal instability (CIN) pathways are described in glioblastoma multiforme (GBM), type 1 and type 2, which can be observed in up to 70% of the cases. Microsatellite instability (MSI) plays a pathogenic role in sporadic cancers such as colon, gastric and endometrial carcinomas with deficient mismatch repair (MMR). We aimed to perform a comprehensive analysis of the relationship between CIN and MSI mechanisms in sporadic glioblastomas. Methods: 129 GBMs were examined (109 newly diagnosed and 20 relapses) investigating MSI, immunohistochemical expression of MMR proteins as well as sequencing and promoter methylation of hMLH1. We characterized the molecular changes frequently correlated with CIN in MSI+ GBMs and compared them with 26 microsatellite-stable tumors. Results: Low-level MSI was observed in 11 of 129 (8.5%) cases and was higher in relapses than in primary GBMs (25 vs. 5.5%, p = 0.027). High-level MSI was not found in any case. A deficient expression of MLH1 and PMS2 without hMLH1 inactivation was observed only in one giant cell GBM. 55% of the MSI+ GBMs showed a profile which did not correspond to one of the known CIN pathways. An inverse association was observed between MSI and mutations of both p53 and PTEN. Conclusions: Our data suggest that CIN and MSI contribute to the genomic instability in GBMs via independent pathways. Since MSI was significantly more frequent in relapses, it might play a role in the malignant progression of GBM. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

In dieser Arbeit wurde die Rolle der L-Aminosäureoxidase IL4I1 für die Progression von Glioblastomen analysiert. IL4I1 wird in diesem Hirntumor erhöht exprimiert und führt dadurch zu einem Abbau der drei aromatischen Aminosäuren Tryptophan (Trp), Phenylalanin und Tyrosin zu ihren entsprechenden α-Ketosäuren (Pyruvaten). In-vitro-Versuche mit IL4I1-überexprimierenden Glioblastomzelllinien zeigen, dass nur das aus Trp-gebildete Indol-3-pyruvat (I3P) bzw. dessen nachgeschaltete Abbauprodukte eine Aktivierung des Arylhydrocarbon Rezeptors (AHR) und seiner Signaltransduktion in Glioblastomen bewirkt. Des Weiteren wurde der Einfluss von IL4I1 in der Tumor-Mikroumgebung auf die Kompetenz von T-Zellen charakterisiert. Das von den Tumorzellen gebildete und sezernierte I3P vermittelt eine Aktivierung des AHR in beiden T-Zellsubpopulationen. Damit einhergehend werden zwei Mechanismen ausgelöst, die die Tumorprogression fördern: eine Proliferationsinhibierung CD8+ zytotoxischer T-Zellen und eine vermehrte Differenzierung immunsuppressiver Treg.

Personalized treatment strategies for oncological patient management can improve outcomes of patient populations with heterogeneous treatment response. The implementation of such a concept requires the identification of biomarkers that can precisely predict treatment outcome. In the context of this thesis, we develop and validate biomarkers from multimodal imaging data for the outcome prediction after treatment in patients with locally advanced rectal cancer (LARC) and in patients with newly diagnosed glioblastoma multiforme (GBM), using conventional feature-based radiomics and deep-learning (DL) based radiomics. For LARC patients, we identify promising radiomics signatures combining computed tomography (CT) and T2-weighted (T2-w) magnetic resonance imaging (MRI) with clinical parameters to predict tumour response to neoadjuvant chemoradiotherapy (nCRT). Further, the analyses of externally available radiomics models for LARC reveal a lack of reproducibility and the need for standardization of the radiomics process. For patients with GBM, we use postoperative [11C] methionine positron emission tomography (MET-PET) and gadolinium-enhanced T1-w MRI for the detection of the residual tumour status and to prognosticate time-to-recurrence (TTR) and overall survival (OS). We show that DL models built on MET-PET have an improved diagnostic and prognostic value as compared to MRI.

Les gliomes malins constituent les tumeurs cérébrales primaires les plus agressives et le glioblastome (GBM) est la plus fréquente et agressive d’entre elles. La survie médiane associée n’est que de 14,6 mois. Dû au caractère hautement invasif de ces tumeurs, la résection maximale de la tumeur doit impérativement être suivie de traitement de radio- et/ou chimiothérapie. Cependant, la présence de la barrière hématoencéphalique et des mécanismes de chimiorésistance, tels que les pompes à efflux, limitent l’acheminement et l’efficacité des composés aux cellules tumorales. L’ouverture osmotique de la barrière hématoencéphalique (OBHE) a été développée afin d’améliorer l’acheminement d’agents anti-néoplasiques au cerveau et à la tumeur. Bien que plusieurs études aient été effectuées afin de caractériser son processus, beaucoup d’informations restent à découvrir afin d’approfondir nos connaissances sur l’OBHE et améliorer son application en clinique. Avec l’objectif ultime de contourner ces deux obstacles, j’ai caractérisé le processus dynamique de l’OBHE pour deux molécules de tailles différentes par imagerie par résonance magnétique dynamique, ainsi que pour une molécule étant un substrat des pompes à efflux par tomographie d’émission par positron dans le modèle murin Fischer-F98. J’ai également étudié l’expression et la localisation de différentes pompes à efflux par PCR quantitative et immunohistochimie dans des spécimens de gliomes malins. Les résultats obtenus démontrent que la barrière hémato-tumorale limite l’acheminement à la tumeur de composés de différent poids moléculaire. L’acheminement au parenchyme cérébral et à la tumeur suite à une procédure d’OBHE est aussi dépendant du poids moléculaire et de la taille de la molécule à acheminer. L’OBHE à moins d’être de qualité excellente, ne semble pas suffisante pour acheminer au parenchyme cérébral des substrats des pompes à efflux. Les GBM expriment la MRP1, MRP3 et BCRP à différents niveaux. La PGP, MRP1 et BCRP sont exprimées par les cellules endothéliales des microvaisseaux cérébraux. L’ensemble de ces résultats suggère que l’administration d’agents thérapeutiques suite à la procédure d’OBHE doit être optimisée selon l’agent administré et que l’inhibition de pompes à efflux ou une autre stratégie rendant les agents de chimiothérapie invisibles aux pompes à efflux sera bénéfique pour améliorer leur acheminement au système nerveux central et aux cellules tumorales.

Glioblastoma multiforme (GBM) is an aggressive central nervous system (CNS) cancer characterized by enhanced tumor cell motility, pernicious invasion into the normal brain, extensive tumor-induced angiogenesis, and adaptive resistance to current therapeutic paradigms. One of the difficulties associated with GBM is the ability of the tumor cells to infiltrate normal CNS tissue. Neurosurgeons can remove the primary tumor mass, but peripheral cells that are inaccessible will ultimately result in a secondary lesion that can lead to death. The matrix metalloproteinases (MMP) are well known for their abilities to facilitate processes of cellular motility and invasion through their clearance of extracellular matrix (ECM). A specific member of this family, MMP-1, is not observed in normal brain, yet its expression is a common characteristic of GBM. The various causes of MMP-1 expression, and its consequences in GBM cells are unknown. As such, functional studies were conducted related to the induction of MMP-1 expression via another molecule intrinsic to GBM, nitric oxide (NO). The exposure of GBM cell lines to nanomolar concentrations of NO produced significant inductions of MMP-1 expression and GBM cell motility. The specific removal of MMP-1 with siRNA elicited an abrogation of NO-stimulated motility, suggesting a pathological contribution by this enzyme. Furthermore, recent accumulating evidence suggests that MMP-1 contributes to tumor cell survival and related angiogenesis in other cancer settings. To investigate these capabilities in GBM, cell lines were stably engineered to have either MMP-1 over-expression or knock-down. Both tumor formation and size were significantly reduced with MMP-1 knock-down and significantly increased with over-expression. In a model of GBM cell-induced angiogenesis, the presence of MMP-1 contributed to an angiogenic phenotype. Further angiogenesis studies revealed a significant recruitment of host endothelium to the tumor interstitium in vivo. Proteomic studies suggest that one mechanism by which MMP-1 could influence angiogenesis is through the easement of the anti-angiogenic tissue inhibitor of metalloproteinases-4 (TIMP-4), since the removal of MMP-1 elicits a significant increase in TIMP-4 detection. Altogether, these functional data present MMP-1 as a promising target for future therapeutic investigation, because it is unique to the GBM environment and contributes to key overlapping GBM pathologies.

Glioblastoma multiforme (GBM) is the most common and malignant brain tumor in adults, affecting thousands of people worldwide every year, with a life expectancy, post diagnosis of 12 months. Surgery, radiotherapy and chemotherapy together, result in an overall mean survival not exceeding 15 months. Targeted therapeutic agents sorafenib, an oral multi kinase inhibitor, and lapatinib, an epidermal growth factor receptor (EGFR) inhibitor, used in combination have been shown to kill GBM cells be through inhibition of major growth mediating signaling pathways that are frequently over expressed in gliomas, including mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase/ protein kinase B (PI3K/AKT). Sorafenib can restore lapatinib induced cytotoxicity by down regulation of myeloid cell leukaemia-1 (Mcl-1) expression. Prior studies have shown Mcl-1 to play an important role in resistance to lapatinib. Furthermore, data indicated that this drug combination is able to trigger activation of autophagic and apoptotic pathways and induce endoplasmic reticulum (ER) stress response in GBM cells, collectively resulting in cell death. In conclusion, data presented here demonstrates that the combination of sorafenib and lapatinib can kill GBM cells in a greater than additive fashion, through induction of autophagy, apoptotic events (extrinsic and intrinsic) and ER stress.

DHEA has been determined to have medically significant activity and is the parent compound to the more active metabolites; 17α-AED, 17β-AED and 17β-AET, which exhibit strong biological activity that has been attributed to androgenic, estrogenic or anti-glucocorticoid activity in vivo and in vitro. This study compared DHEA, 17α-AED, 17β-AED and 17β-AET for their ability to activate the human AR, ER and GR receptors and determine the relative androgenicity, estrogenicity and glucocorticoid activity. The results show that, at the receptor level, these androstene hormones are weak AR and even weaker ER activators. Direct androstene hormone activation of the human AR, ERα, and ERβ may not be essential for their biological function. Similarly, these hormones indirectly activated the human GR receptor; only in the presence of high dexamethasone concentrations. These results underscore the major difference between androstene hormone interactions with these nuclear receptors. 17β-AED and 17α-AED, androstene epimers that produce either survival or death, were utilized to treat T98G Glioblastoma cells. We identified 26 genes oppositely regulated by 17β-AED and 17α-AED to directly affect the cellular life or death decision. Network analysis demonstrated that these 26 genes are essential to regulating three critical Glioblastoma pathways. This report, for the first time, demonstrates that naturally occurring, chemically identical adrenal hormones (17β-AED or 17α-AED) direct a cellular life or death decision through contrasting modulation of identical signaling pathways and core regulators. Chronic pressure ulcers represent a significant health problem and are characterized by hypoxia, bacterial infection, repetitive ischemia/reperfusion and altered cellular and systemic stress responses. Whole genome microarray analysis was utilized in conjunction with IPA® premiere networking software to analyze chronic wound edge tissue. IPA® network analysis identified Ubiquitin C (UBC) as the most significant network. Sixteen (16) ubiquitin C associated genes were identified to be different in the chronic pressure ulcer and normal skin control. Targeted network analysis associated core regulators to 8 UBC associated genes that are unique to chronic pressure ulcers. The identification of these genes will allow the establishment of more effective treatments for Spinal Cord Injury (SCI) patients with chronic pressure ulcers.

O glioblastoma multiforme (GBM) é uma neoplasia do sistema nervoso central (SNC), caracterizada por uma elevada capacidade proliferativa e migratória. O desenvolvimento do tumor provoca uma remodelação da matriz extracelular (MEC) que facilita a migração tumoral. Eicosanóides são moléculas lipídicas importantes na carcinogênese e a sua síntese está correlacionada com o grau de desenvolvimento do tumor. As prostaglandinas são eicosanóides envolvidas na estimulação da angiogênese, na adesão celular e proliferação celular. Este estudo tem por objetivo avaliar in vitro o efeito da PGE2 na expressão moléculas da MEC e das moléculas de adesão envolvidas na migração, em células U87MG e U251MG. As células U251MG e U87MG foram tratadas com PGE2 (10&#181;M) e Ibuprofeno (25&#181;M), por um período 48hs. As proteínas da MEC foram analisadas por RT-qPCR após o tratamento. Foram realizadas reações de imunohistoquímica para as moléculas da MEC. As alterações foram encontradas na expressão de laminina, fibronectina, colágeno tipo IV e as integrinas &alpha;v , &alpha;3 e &alpha;5 para células U87MG . Observamos imunomarcação nas linhas celulares para colágeno tipo IV, laminina e fibronectina. Concluímos que o tratamento com IBU e PGE2, afeta a expressão gênica de moléculas de MEC. / Glioblastoma Multiforme (GBM) is a neoplasm of the central nervous system (CNS), characterized by a high proliferative and migratory capacity. Tumor development leads to extracellular matrix (ECM) remodeling and facilitating the migration of these cells. Eicosanoids are important lipid molecules in carcinogenesis, and their synthesis often correlates with the degree of tumor development. Prostaglandins are eicosanoids involved in the stimulation of angiogenesis, cell adhesion and cell proliferation. This study is aimed to evaluate the expression of several ECM molecules involved in migration after altering the concentration of prostaglandins, using human glioma cell lines as an in vitro model. The cell lines U87MG and U251MG were treated with PGE2 (10&#181;M) and Ibuprofen (25&#181;M), for a predetermined period of 48hs. Proteins involved in extracellular matrix were analyzed by RT-qPCR after treatment in vitro. Immunohistochemical reactions were also performed for the ECM molecules. Changes were found in the expression of laminin, fibronectin, type IV collagen and &alpha;v, &alpha;3 and &alpha;5 integrins in cells U87MG. We observed immunostaining in cell lines to type IV collagen, laminin and fibronectin. In conclusion, Ibuprofen and PGE2, affects gene expression of ECM molecules.