La leucémie aiguë lymphoblastique (LAL) est une maladie complexe à l’étiologie multifactorielle. Elle représente la forme la plus commune de cancer pédiatrique et malgré une augmentation significative du taux de survie des patients, près de 15% d’entre eux ne répondent pas aux traitements classiques et plus de 2/3 subissent les effets du traitement à long terme. Réduire ces chiffres passe par une meilleure compréhension des causes sous-jacentes de la LAL. À travers l’analyse des données de séquençage de nouvelle génération (SNG) de la cohorte QcALL du CHU Sainte-Justine, je me suis intéressé aux déterminants génomiques contribuant aux différents aspects de la LAL (prédispositions, développement/progression et rechutes). Dans un premier temps, j’ai développé un outil d’analyse (SNooPer) basé sur un algorithme d’apprentissage intégrant les données SNG normales et tumorales des patients, permettant d’identifier les mutations somatiques au sein de données à faible couverture (low-pass). Cet outil, couplé aux analyses prédictives in silico et aux validations fonctionnelles adéquates, nous a permis de caractériser les événements rares ou récurrents impliqués dans le processus leucémogène. En analysant les données de LALs pré-B, j’ai pu mettre en évidence une série de mutations drivers rares au niveau de gènes (ACD, DOT1L, HCFC1) qui n’avaient jamais été associés à la LAL. L’étude fonctionnelle de la mutation identifiée au niveau d’ACD, membre du complexe shelterin, a démontré qu’elle conduit à une réduction de l’apoptose et une augmentation de la taille des télomères. Outre l’intérêt de la découverte de ces nouveaux drivers, je souhaitais démontrer l’importance des mutations somatiques rares afin d'établir la spécificité interindividuelle, généralement sous-estimée, et d’identifier l’ensemble des fonctions cellulaires impliquées. Au cours de ces travaux, j'ai également mis en évidence de nouveaux évènements récurrents de la LAL à cellules T (LAL-T), en particulier au niveau de patients présentant un phénotype immature encore mal caractérisé. J'ai démontré l’influence d'une mutation dans le gène codant pour U2AF1, membre de la machinerie d’épissage (spliceosome), sur l’épissage de gènes d’intérêt et ainsi confirmer l’importance du dysfonctionnement de l’épissage dans le développement de la leucémie. J'ai également identifié deux suppresseurs de tumeurs portés par le chromosome X, MED12 et USP9X, qui n’avaient jamais été associés à la LAL-T auparavant et qui représentent un intérêt particulier étant donné le débalancement de l'incidence en fonction du sexe (ratio garçon:fille =1.22). Enfin, grâce à l’étude longitudinale de patients LAL-B ayant subi une ou plusieurs rechutes, j'ai analysé l'architecture et l'évolution clonales des tumeurs. J’ai ainsi identifié 2 profils évolutifs distincts gouvernant les rechutes précoces et tardives: d'un côté, une dynamique élevée alimentée par un dysfonctionnement des mécanismes de réparation de l'ADN et conduisant à l'émergence rapide de clones mieux adaptés – de l'autre, une dynamique réduite, quasi-inerte, suggérant l'échappement de cellules en dormance épargnée par la chimiothérapie. De manière générale, cette thèse a permis de contribuer à la caractérisation des déterminants génomiques qui constituent la variabilité inter- et intra-tumorale, participent au processus leucémogène et/ou aux mécanismes de résistance au traitement. Ces nouvelles connaissances contribueront à un raffinement de la stratification des patients et leur prise en charge personnalisée. / Acute lymphoblastic leukemia (ALL) is a complex disease with a multi-factorial etiology. It represents the most frequent pediatric cancer and despite a significant increase of survival rate, about 15% of the patients still do not respond to current treatment protocols and over 2/3 of survivors experience long-term treatment related side effects. To reduce these numbers, a better understanding of the underlying causes of ALL is needed. Through the analysis of next-generation sequencing (NGS) data obtained from the established Quebec cALL (QcALL) cohort of the Sainte-Justine hospital, I have been particularly concerned about the genomic determinants that contribute to different phases of ALL (predispositions, onset/progress and relapses). First, I developed an analysis tool (SNooPer) based on a machine learning algorithm integrating both normal and tumor NGS data of the patient to identify somatic mutations from low-pass sequencing. This tool, combined to in silico predictive analysis and to adequate functional validations, allowed us to characterize rare or recurrent events involved in the leukemogenesis process. Through the analysis of pre-B ALLs, I have been able to identify several rare driver genes which had never been associated to ALL before (ACD, DOT1L, HCFC1). The functional study of the identified mutation in ACD, a member of the shelterin complex, showed a concomitant lengthening of the telomeres and decreased apoptosis levels in leukemia cells. Besides the interest aroused by the discovery of these new drivers, I wanted to demonstrate the importance of low-frequency somatic events to establish the generally underestimated interindividual specificity and identify all cellular functions involved. During this work, I also identified new recurrent driver events in T-cell ALL (T-ALL), particularly among poorly characterized immature T-ALL patients. For example, I demonstrated the impact of a recurrent mutation in U2AF1, member of the spliceosome, on alternative splicing of cancer-relevant genes, further suggesting the importance of aberrant splicing in leukemogenesis. I also identified two new X-linked tumor suppressors, MED12 and USP9X, never associated to T-ALL before and obtained results supporting a potential role for these genes in the male-biased sex ratio observed in T-ALL (ratio male:female =1.22). Finally, through the longitudinal study of pre-B cALLs who suffered one or multiple relapses, I analyzed the clonal architecture and evolution of the tumors. I identified two distinct evolution patterns governing either early or late relapses: on one hand a highly dynamic pattern, sustained by a defect of DNA repair processes, illustrating the quick emergence of fitter clones - and on the other hand, a quasi-inert evolution pattern suggesting the escape from dormancy of neoplastic stem cells likely spared from initial cytoreductive therapy. Overall, this thesis contributed to the characterization of genomic determinants that constitute the inter- and intra-tumor variability, participate in leukemogenesis and/or in resistance mechanisms. This new knowledge will contribute to refine patient stratification and treatment.

Pathogenic gain-of-function mutations associated with increased paternal age, albeit harmful to embryonic development, are paradoxically enriched in the normal testis. Evidence from previous studies indicates that these so-called paternal age-effect mutations confer a proliferative advantage to the spermatogonia in which they arise, leading to clonal expansion within the normal testis over time. Recently, spermatocytic seminoma (SS; a rare testicular germ cell tumour that occurs mainly in older men) has emerged as a key link between the processes of somatic and germline mutation (Goriely et al, Nat Genet. 41:1247-52, 2009), suggesting that the proposed clonal expansion events can in some cases lead to testicular tumourigenesis. In this thesis, I have used immunohistochemistry to seek evidence for putative clones of cells in the normal adult testis. To address this, a screening approach was developed using markers chosen from analysis of normal testicular tissues and SS. The ontogeny of OCT2 and SSX expression in human testis, from embryonic development to adulthood, identified distinct subpopulations of spermatogonia at different maturation stages. Together, these data reveal the potential of OCT2 as a novel marker of A_dark spermatogonia (human reserve spermatogonial stem cells). In parallel with these observations, two distinct types of SS characterised by differential OCT2 and SSX immunoexpression were identified, providing new evidence for heterogeneity of this tumour. This work provided the backdrop to the detailed immunohistochemical study of normal adult testis by characterising in serial sections the expression of five spermatogonial markers, MAGEA4, SSX, FGFR3, OCT2 and SAGE1, and a proliferation marker, Ki67. Independent sections were screened with predetermined criteria set to identify unusual positively-stained cellular clusters within the seminiferous tubules. Several antigenic combinations previously described in SS were observed in a subset of these clones, suggesting differing genetic origins and a possible link with early events of testicular tumourigenesis. The size (minimum number of cells) of each clonal event was estimated and its correlation with the staining pattern of the molecular markers was investigated. In summary, the data presented in this thesis convincingly identify for the first time the previously hypothesised clonal events in the testis using immunohistochemical markers. My research will pave the way for future work involving genetic analysis of microdissected cells from these putative clones, aimed at identifying the underlying mutational events thought to be present.

Master of Science / Biochemistry and Molecular Biophysics Interdepartmental Program / Anna Zolkiewska / Mitogen-activated protein kinase (MAPK) signaling plays an important role in the proliferation, survival, and therapy resistance of breast cancer cells. Two important protein kinases involved in the MAPK pathway are MEK and ERK. The MEK/ERK signaling cascade can be stimulated by activation of the epidermal growth factor receptor (EGFR) upon binding of EGF-like ligands, which are released from cells by ADAM proteases. EGFR is frequently overexpressed in triple-negative breast cancer (TNBC), a particularly aggressive form of breast cancer. Our analysis of clinical data revealed that high expression of ADAM12, but not other ADAMs, in TNBC is associated with poor patient survival. Thus, we hypothesized that ADAM12 plays a critical role in the progression of TNBC, possibly by stimulating MEK/ERK activity in an EGFR-dependent manner. To test this hypothesis, ADAM12 was knocked-down (KD) in SUM159PT TNBC cells, which express high levels of the endogenous ADAM12 protein. An antibody array assay indicated a significant decrease in the activation of the MAPK pathway in SUM159PT cells after ADAM12 KD. The decrease in MAPK activity was further confirmed by Western blotting using phospho-MEK and phospho-ERK specific antibodies. Additionally, conditioned media from ADAM12-deficient SUM159PT cells failed to support the survival of MCF10A cells, suggesting that ADAM12 KD reduced the release of pro-survival growth factors from SUM159PT cells. Based upon this data, we propose that ADAM12 is a novel regulator of the MAPK pathway and a potential therapeutic target in breast cancer.

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

La recherche porte sur les rapports entretenus par le sacré, par le sentiment religieux, et son instrumentalisation pour en faire des outils de territorialisation à Beyrouth. Elle étudie l’émergence des espaces sacrés dans la ville où dix-huit communautés confessionnelles libanaises sont chacune marquée par des idéologies politiques différentes. Nous partons de l’hypothèse qu’un espace religieux ne peut être limité aux seuls édifices religieux. Son impact sur l’espace se traduit par une appropriation de l’espace public, soit momentané soit permanent, transformant l’espace profane, ouvert à tout le monde, en un espace sacré qui impose des règles de jeu spécifiques, avec des codes à déchiffrer. Le Liban comprend dix huit communautés confessionnelles réparties sur tout le territoire dont chaque partie est marquée par une idéologie qui diffère de l’autre. Beyrouth en particulier, est un espace marqué de symboles idéologiques qui oscillent entre politique et religion pour toucher au sacré. Le paysage urbain de Beyrouth change selon les appartenances politiques et religieuses. Quant aux moyens et outils utilisés pour ces différentes expressions, ils sont lisibles par tous les moyens médiatiques possibles mis à la disposition des pouvoirs politiques et religieux liés à des enjeux d'affirmation identitaire. Chaque partie du territoire est marquée par une idéologie politique qui reflète l'identité religieuse de ses habitants à travers des codes et des signes qui s'expriment selon deux composantes qui sont le lieu et le temps. Un calendrier religieux propre à chaque communauté rend la géographie encore plus complexe. Le paysage urbain de Beyrouth subit des mutations selon les appartenances politiques et religieuses qui, toutes deux, sont à leur tour liées par des enjeux historiques et démographiques. Ainsi, un paysage sacré émerge et évolue selon le jeu complexe de composantes géographiques, sociales, ethnologiques, politiques et économiques qui s’entremêlent, et vont aboutir à une problématique à plusieurs facettes. La production du sens se fait à des niveaux très divers : nous assistons à un échafaudage à plusieurs niveaux et, nous avons à créer des liens à chaque palier, à expliquer comment ils vont se raccorder. Les questions majeures qui se posent dans ce contexte touchent la dimension de la religion dans l’espace urbain de Beyrouth, en tenant compte de la place structurante que tiennent les idéologies et les croyances. Cette place oscille entre espace communautaire et confessionnel marqués par des espaces religieux et parfois sacrés. / This thesis aims to analyze the various strategies of religious and secular actors in their process of production of sacred spaces in Beirut, Lebanon. The eighteen Lebanese religious communities present in the country each mark Beirut’s urban landscape with religious symbols and signs that are also very often politically charged. Our assumption is that religious space cannot be limited to just religious buildings; in Beirut, it is expressed by taking over public spaces, transforming easily accessible secular loci into sacred space that imposes rules and specific codes of behaviour.In the city, religious events are expressed through spiritual, cultural, social and architectural venues. Beirut is a marked space with ideological symbols merging politics and religion with both leading to the sacred. The use of religion by the media working for political parties is a common practice for each and every community; thus, each quarter of the city is marked by a particular political ideology that reflects the religious identity of its inhabitants through specific codes and signs. They vary according to their position and time-frame. The religious affiliations of the majority of the inhabitants of a particular region impose religious codes that mark particular public spaces. This geography is rendered more complex by the particular religious calendars observed by each religion. Sacredness begins and ends on specific dates for each religion, producing specific spaces produced, recognized and used differently by the various segments of the city’s population. These would lead to confirm that the city is a cleaved space observable at all scales.

Magister Public Health - MPH / Background: Antiretroviral therapy (ART) was rolled out in South Africa in the public sector in 2004 and the treatment coverage has increased over the years to 56% in 2016. The increased treatment coverage has the potential to increase the level of HIV drug resistance. Drug resistance presents a major challenge to the management of HIV infection through antiretroviral therapy at the population level. The aim of this study was to determine the impact of the public sector antiretroviral therapy rollout on the prevalence of HIV drug resistance in South Africa and the factors associated with drug resistance. Methodology: A cross-sectional analytical study was used to determine the prevalence of drug resistance before and after ART rollout. The study population was HIV infected South Africans (infected between 1996 and 2011) who were not on antiretroviral therapy. The study sample was therapy naïve HIV infected South Africans who participated in published studies conducted between 1996 and 2011. HIV DNA sequences and associated data (participants’ age, gender, geographic location and estimated year of HIV infection) were accessed through the Los Alamos HIV Database. The database contains all HIV DNA sequences and associated data from all published studies and the data was freely accessible. A descriptive analysis was carried out on the data to determine characteristics of the study sample. Drug resistance mutations were detected using Calibrated Population Resistance Program on the Stanford University HIV Drug Resistance database. The output from the Calibrated Population Resistance Program analysis were used to determine the prevalence of drug resistance mutations. Results: There were 1701 DNA sequences obtained from the Los Alamos HIV Database for the three gene regions targeted by ART (reverse transcriptase, protease and integrase). Of these, 604 (35,5%) were for reverse transcriptase, 794 (46,7%) were for protease and 303 (17,8%) were for integrase. There was overrepresentation of DNA sequences from female participants (91%). There was no significant difference in the prevalence of drug resistance mutations between 1996-2004 (before ART rollout) and 2005-2011 (after ART rollout) in all the drug classes. There was also no association between drug resistance and age as well as gender. Conclusion: The data from this study suggest that the public sector rollout of ART did not result in an increase in the prevalence of drug resistance mutations in therapy naïve HIVinfected South Africans. There is need for further studies, which have a wider coverage of the South African population.

Camundongos são modelos valiosos para o entendimento dos processos e mecanismos moleculares e fisiológicos em mamíferos. A maioria do nosso conhecimento sobre esses processos e mecanismos vem de experimentos realizados com camundongos de linhagens isogênicas. Essas linhagens, criadas normalmente por sucessivos cruzamentos irmão-irmã, surgiram no início do século XX visando reduzir a interferência da variabilidade genética, aumentando a reprodutibilidade dos experimentos. Caracterizar o background genético das linhagens isogênicas permite não só traçar possíveis relações de parentesco entre linhagens, mas também permite o controle genético oriundo de possíveis contaminações e mutações espontâneas que possam surgir na população. Além das linhagens isogênicas, os camundongos mutantes também são importantes como modelos para o estudo de doenças humanas. O uso desses modelos murinos permite a elucidação e associação de fatores genéticos a manifestações fenotípicas diversas, como síndromes hereditárias e predisposições a doenças. Esses mutantes podem ser gerados por uma abordagem de varredura de mutagênese pelo agente mutagênico ENU, que inclui a caracterização de fenótipos interessantes e a busca pelas mutações causativas induzidas. O presente trabalho teve como objetivo utilizar o sequenciamento completo de exomas para caracterizar o background genético das linhagens isogênicas C57BL/6ICBI e BALB/cICBI, mantidas há quase 20 anos no Brasil e distribuídas pelo ICB-USP a pesquisadores de todo país. O trabalho também usou o sequenciamento de nova geração (NGS) para a busca das mutações causadores de fenótipo em um grupo de sete mutantes induzidos por ENU oriundos de uma varredura prévia. Através da aplicação de uma estratégia de análise de dados e filtragem de mutações foi possível encontrar mutações candidatas com alto potencial de impacto para todos os mutantes avaliados, validadas por sequenciamento Sanger. Os genes afetados pelas mutações encontradas indicam que os mutantes possam se tornar interessantes modelos para o estudo de doenças neuromusculares e neurológicas. A avaliação do exoma das linhagens C57BL/6ICBI e BALB/cICBI descartou a possibilidade de contaminação das colônias com outras linhagens, e revelou similaridades relacionadas com o parentesco das sublinhagens brasileiras em relação a linhagens gold-standard. As informações obtidas serão uma fonte importante de informação no planejamento e análise dos resultados obtidos com o uso tanto dos mutantes quanto com as linhagens fornecidas pelo Biotério do Departamento de Imunologia ao ICB a instituições de todo o Brasil. / Mice are valuable models for the comprehension of molecular processes and underlying physiological mechanisms in mammals. Most of the knowledge about those processes came from experiments with isogenic mice. Those strains, arose in the 1900s by successive inbreeding, are very important as they reduce genetic variability across the experiments increasing reproducibility. Isogenic lineages are kept as isolated colonies in animal facilities and supplied to researchers, as they needed. Thus, is possible to trace relationships among strains all over the world using the characterization of their genetic backgrounds. It is also possible to detect putative contaminations and spontaneous mutations which can arise in the populations. Mutant mice are also important tools as human disease models, allowing associations between genetic factors and phenotypes. Those mutants could be generated in forward genetics approaches by screenings using mutagens as ENU. The aims of this work were to characterize the genetic background of two mouse strains used at ICB-USP C57BL/6ICBI and BALB/cICBI and to find causative mutations of seven mutants generated by a previous ENU-mutagenesis screening. We used whole-exome sequencing followed by resequencing data-analysis approaches to detect SNVs for both isogenic strains and mutants. Exome evaluation of isogenic strains C57BL/6ICBI and BALB/cICBI did not reveal any evidence for cross-contamination and provided insightful details related to other strains and substrains. A specific filtering strategy was applied to select candidates for phenotypecausative mutations in the seven ENU-induced mutants. We are able to select candidates for all mutants at a high global Sanger validation rate when considering only the main candidates for each mutant. Considering affected genes and phenotypes all mutants have potential to become interesting mouse models for human diseases. Taken together, our results are a reliable and confident source of genetic information for experimental analysis for researchers who use isogenic strains provided by animal facility at ICB-USP and research groups interested in further characterization of mutant study neuromuscular, neuronal or development processes using mice as animal models.

As manifestações bucais da AIDS têm sido relacionadas a diversas características clínicas da infecção pelo HIV como decréscimo de células T CD4+, aumento de carga viral e falha terapêutica, entre outras. Os avanços recentes da medicina mostram que a falha terapêutica, nesses pacientes, está diretamente vinculada a mutações na transcriptase reversa (TR) e na protease (PR). O objetivo deste estudo foi descrever, em pacientes HIV+ apresentando falha terapêutica, o perfil de mutações do vírus e o perfil de resistência a antirretrovirais, e correlacioná-los as manifestações bucais da imunodeficiência. Foram acessados prontuários, laudos de genotipagem e informações de bancos de dados digitais de pacientes com AIDS, que se submeteram a genotipagem no Centro de Referência e Treinamento em Doenças Sexualmente Transmissíveis e AIDS (CRT-DST/AIDS), entre 2003 e 2010. Os dados foram transferidos para o Epiinfo, onde foi construído um banco de dados informatizado para posterior análise estatística. O evento lesões orais foi escolhido como variável dependente. Calculou-se o odds ratio para cada variável independente, utilizando intervalo de confiança de 95%. Foram cruzados dados sobre mutações encontradas no vírus e resistência às medicações com a presença e tipo de manifestações bucais. O teste de Bartlett foi utilizado para testar a normalidade dos dados. Para variáveis sem distribuição normal foram aplicados os testes de Mann-Whitney ou Kruskal-Wallis. Para comparação entre frequências e proporções, foi utilizado o Teste de Exato de Fisher ou o Qui quadrado. O nível de significância foi estabelecido como 0,05 ou 5%. A análise de características sociocomportamentais e clínico laboratoriais permitiu verificar que a presença de lesões orais pode ser relacionada estatisticamente a baixas taxas de CD4 (p<0,05), faixa de carga viral (p=0,048) e ao uso prévio de mais de cinco esquemas antirretrovirais diferentes (p=0,021). Verificou-se maior prevalência de lesões virais (75%) e bacterianas (66,7%) do que de lesões fúngicas (37,3%) apenas em pacientes que apresentavam resistência a inibidores de protease (IP) (p=0,02). Foram encontradas 146 mutações diferentes nos pacientes que apresentavam lesões orais, dentre essas, quatro (101E, 20T, 188L, 93L) apresentaram correlação negativa com a presença de lesões orais (respectivamente, p=0,01, p=0,01, p=0,03, p=0,03) e oito (215Y, 118I, 20R, 44D, 71I, 82I E 84V) apresentaram correlação positiva (respectivamente p=0,04, p=0,05, p=0,03, p=0,01, p=0,01, p=0,04, p=0,0004). Subsequentemente, as mutações que apresentaram correlação positiva com a presença de lesões orais foram avaliadas para verificar se sua presença estaria realmente associada a resistência aos ARVs (aos quais seriam supostamente resistentes). Foram excluídas dessa avaliação as mutações 71I e 82I, por apresentarem uma quantidade extremamente pequena de ocorrências. Todas as mutações apresentaram correlação estatística positiva para a resistência aos respectivos antirretrovirais (p<0,05). Em pacientes HIV+, que apresentavam falha terapêutica e manifestações bucais, foram identificadas as mutações 84V e 20R na PR e as mutações 215Y, 44D e 118I na TR e a presença dessas mutações foi associada a resistência a inibidores de protease e inibidores de transcriptase reversa nucleosídeos, respectivamente. / Oral manifestation of AIDS have been associated with several clinical characteristics of HIV infection such as reduction in T CD4+ cells, increase in viral load and treatment failure, among others. Recent advances have shown that treatment failure in these patients is directly linked to mutations in reverse transcriptases (RT) and in proteases (PR). The objective of the present study was to describe the profile of virus mutations and of resistance to antiretroviral drugs in HIV+ patients in treatment failure, and to correlate mutations to the oral manifestations of the immunodeficiency. Patient charts, genotyping results and information from digital databases of AIDS patients, who underwent genotyping at the Sexually Transmissible Diseases and AIDS Training and Reference Center (CRT-DST/AIDS) between 2003 and 2010, were accessed. Data were transferred to the Epiinfo program, in which a computerized database was built for statistical analysis. The event oral lesions was chosen as a dependent variable. Odds ratio for each independent variable was calculated, using a 95% confidence interval. Data found on virus mutations and drug resistance was analyzed to check for correlation with presence and type of oral manifestations. The Bartlett test was used to test normality of data. Mann-Whitney or Kruskal-Wallis tests were used for variables without a normal distribution. The Fisher Exact or Chi-square Tests were used to compare frequencies and proportions. A 0.05 or 5% significance level was established. The analysis of socio-behavioral and clinical-laboratorial characteristics allowed concluding that the presence of oral lesions may be related to statistically low CD4 rates (p<0.05), viral load range (p=0.048) and previous use of more than five different antiretroviral regimens (p=0.021). A higher prevalence of viral (75%) and bacterial (66.7%) lesions in relation to fungal lesions (37.3%) was observed only in patients who were resistant to protease inhibitors (PI) (p=0.02). We found 146 different mutations in patients with oral lesions, among which, four (101E, 20T, 188L, 93L) with a negative correlation with the presence of oral lesions (p=0.01, p=0.01, p=0.03, p=0.03, respectively) and eight (215Y, 118I, 20R, 44D, 71I, 82I E 84V) with a positive correlation (p=0.04, p=0.05, p=0.03, p=0.01, p=0.01, p=0.04, p=0.0004, respectively). Subsequently, mutations with a positive correlation with the presence of oral lesions were assessed to check if their presence would really be associated with resistance to ARVs (to which they supposedly would be resistant to). Mutations 71I and 82I were excluded from this assessment because they had an extremely low frequency. All mutations had a statistically positive correlation for resistance to their respective antiretroviral drugs (p<0.05). Mutations 84V and 20R were identified in PR, and mutations 215Y, 44D and 118I in TR of HIV+ in patients undergoing treatment failure and presenting oral manifestations. Moreover, the presence of these mutations was associated with resistance to protease inhibitors and to nucleoside reverse transcriptase inhibitors, respectively.

As Mucopolissacaridoses (MPS) são um grupo de doenças de armazenamento lisossômico causadas por deficiência de enzimas que catalisam a degradação gradual das glicosaminoglicanas (GAGs). GAGs (anteriormente chamadas de mucopolissacarídeos) são produtos de degradação das proteoglicanas que existem na matriz extracelular e tem efeito proteolítico. A classificação das MPS é baseada na deficiência enzimática específica. A MPS IVA é causada por mutações no gene que codifica a enzima GALNS (Nacetilgalactosamina-6-sulfatase), a qual desempenha um papel crucial na degradação do sulfato de queratano e condroitina-6-sulfatase. As mutações na enzima se resumem em três categorias: interrupção do sítio ativo, alterações no núcleo hidrofóbico e exposição da superfície, onde mutações missense na estrutura podem afetar gravemente a atividade da proteína GALNS, alterando seu núcleo hidrofóbico ou modificando seu enovelamento (folding). Com a falta de tratamentos efetivos, sendo em sua maioria paliativos, e tendo como base a estrutura já resolvida da GLANS selvagem, este trabalho teve como objetivo modelar 3 variantes da enzima GALNs, sendo uma mutação no sítio ativo, uma no núcleo hidrofóbico e uma na superfície. Foi usado o software MODELLER 9.12 para a modelagem comparativa, os softwares Prochek, PROSA II, ERRATv2, Verify3d, ProQ para a avaliação dos modelos, o software NAND 2.10, para simulação de dinâmica molecular e o software Chimera 1.10.1 para cálculo de superfícies eletrostáticas e hidrofobicidade da superfície. Os modelos apresentaram bons resultados segundo os softwares de avaliação e análise visual. Apresentaram poucas diferenças estruturais em relação à estrutura da GALNS selvagem, demonstraram estabilidade em simulação de dinâmica molecular. Entretanto, algumas diferenças foram observadas com relação à distribuição de cargas e hidrofobicidade no sítio ativo do modelo da variante com mutação no sítio ativo. Pôde ser concluído que as 3 mutações analisadas não causaram alterações estruturais significativas, não interferiram na estabilidade estrutural em simulação de dinâmica molecular, entretanto, foi demonstrado que mutações na região do sítio ativo podem interferir na função da enzima. / The Mucopolysaccharidoses (MPS) are a group of lysosomal storage diseases caused by deficiencies in enzymes that catalyze the gradual glycosaminoglycans (GAGs) degradation. GAGs (formerly called mucopolysaccharides) are products of proteoglycan degradation that exist in the extracellular matrix and have proteolytic effect. The classification of MPS is based on the specific enzyme deficiency. MPS IVA is caused by mutations in the gene that encodes the GALNS enzyme (Nacetilgalactosamina-6-sulfatase), which plays a crucial role in the degradation of keratan sulfate and chondroitin-6-sulfatase. Mutations in the enzyme can be summarized in three categories: interruption of the active site, changes in the hydrophobic core and display surface, where missense mutations in the structure can seriously affect the activity of GALNS protein, changing its hydrophobic core or modifying its folding. With the lack of effective treatments, in its most palliative, and based on the wild GALNS structure already determined, this study aimed to model 3 variants of GALNS enzyme, a mutation in the active site, one in the hydrophobic core and a on the surface. 9.12 MODELLER was used for comparative modeling software, the software Prochek, Prose II, ERRATv2, Verify3d, ProQ models for the evaluation of the NAND 2.10 software, for molecular dynamics simulation and software Chimera 1.10.1 calculates electrostatic and hydrophobic surface. The models showed good results according to the evaluation software and visual analysis. Presented few structural differences from the wild GALNS structure and showed stability in molecular dynamics simulation. However, some differences were observed with respect to the charge distribution and hydrophobicity in the active site of the variants of the model with a mutation in the active site. It might be concluded that the three mutations analyzed did not cause significant structural changes and did not affect the structural stability in molecular dynamics simulation, however, it has been shown that mutations in the active site region may interfere with the function of this enzyme.