Tesis por compendio / [ES] El melanoma es el tipo de cáncer de piel más mortífero y peligroso, ya que tumores de pequeño tamaño pueden generar metástasis. Hasta la fecha, se ha tratado de clasificar desde el punto de vista clínico, epidemiológico y molecular, empleándose actualmente el nivel de exposición solar y la localización del tumor como criterios principales para dividir en distintos grupos a los pacientes de melanoma. En 1998, David Whiteman y colaboradores propusieron un "modelo de vías divergentes" para el desarrollo del melanoma. Este presentaba dos vías: una vinculada a la proliferación melanocítica (nevogénica) y otra relacionada con la exposición solar crónica (CSD). Corroborado desde el punto de vista clínico y epidemiológico, todavía no se ha aportado una caracterización molecular en profundidad. A nivel general se habían identificado genes cuyas mutaciones eran relevantes para el desarrollo del melanoma, como por ejemplo KIT. Sin embargo, todavía se había de estudiar con más detalle la distribución de estas mutaciones entre los distintos subgrupos de melanoma, así como su posible valor pronóstico. En esta tesis se han empleado técnicas de secuenciación - masiva y tradicional - para caracterizar los perfiles mutacionales de las poblaciones del modelo de vías divergentes. Encontramos diferencias tanto en el número de mutaciones como en los genes afectados. También hemos visto cómo los melanomas con mutaciones en KIT parecen desarrollarse por una vía independiente de la etiopatogenia conocida, careciendo el estatus mutacional de este gen de valor pronóstico para la supervivencia de los pacientes. / [CA] El melanoma és el tipus de càncer de pell més mortífer i perillós, ja que fins els tumors de menor mida poden acabar generant metàstasi. Al llarg dels anys, s'ha tractat de classificar des del punt de vista clínic, epidemiològic i molecular. Les classificacions actuals utilitzen el nivell d'exposició solar i la localització tumoral per dividir en diferents grups als pacients de melanoma. Al 1998, David Whiteman i col·laboradors proposaren un model de desenvolupament del melanoma que anomenaren "model de vies divergents". Aquest presentava dos vies per la melanomagènesi: una vinculada a la proliferació melanocítica (nevogènica) i l'altra relacionada amb l'exposició solar crònica (CSD). Malgrat aquest model fou corroborat des del punt de vista clínic i epidemiològic, encara no s'ha aportat una caracterització molecular en profunditat. A nivell general s'havien identificat gens les mutacions dels quals eren rellevants per al desenvolupament del melanoma, com el gen KIT. Però, encara s'havia d'estudiar amb més cura la distribució d'estes mutacions entre els distints subgrups de melanoma, així com el seu possible valor pronòstic. En aquesta tesi s'han emprat tècniques de seqüenciació -massiva i tradicional- per caracteritzar els perfils mutacionals de les dues poblacions proposades pel model de vies divergents, trobant diferències tant al nombre de mutacions com als gens afectats. També hem vist com els melanomes mutats en KIT semblen desenvolupar-se per una via independent de l'etiopatogènia coneguda, mancant l'estatus mutacional d'aquest gen de valor pronòstic per la supervivència dels pacients. / [EN] Melanoma is the deadliest and most dangerous type of skin cancer, given that a small tumor can spread and result in metastasis. Over the years, classifications have been made either from a clinical, epidemiological or molecular point of view. Current classifications use the degree of solar exposure and tumoral location to divide into different melanoma groups. In 1998, David Whiteman and collaborators proposed the divergent pathway model for melanoma development. This presented two pathways to melanomagenesis: one related to melanocytic proliferation (nevogenic) and the other related to chronic sun exposure (CSD). Despite corroborations of this model from the clinic and epidemiology, it is yet to be molecularly characterized in depth. At a general level, different genes had been identified with relevant mutations for the development of melanoma, as is the gene KIT. However, there was a lack of knowledge on how these mutations were distributed among different melanoma subgroups, as well as the potential prognostic value. In this thesis we have implemented sequencing techniques - both massive and traditional - to characterize the mutational profile of the two populations proposed by the divergent pathways model. We found differences both in the number of mutations and in the genes carrying the mutations. We have also seen how melanomas harboring KIT mutations seem to develop in a way which is independent from the known etiology, and how the mutational status of this gene lacks prognostic value on the outcome of the patients. / Millán Esteban, D. (2022). Next-Generation Sequencing in the Identification of Biomarkers in Cutaneous Melanoma According to the Etiopathogenic Development Pathway and their Potential Clinical Relevance [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/182977 / TESIS / Compendio

Rare diseases (RD) are a heterogeneous group of diseases that affect about 5% of the world population. RDs represent more than 7.000 different phenotypes and many of them are genetically determined. RDs provide unique biological models for understanding the basic principles of molecular and cellular organization and function of human tissues and organs. Results of studies focused at pathogenesis of RDs are often used to diagnose and treat the affected patients. Significant progress in molecular genetic techniques, specifically the use of the next generation sequencing (NGS) in clinical practice, substantially facilitated and improved efficiency of RD laboratory diagnostics. Moreover, these novel testing algorithms identified the previously unknown molecular causes of many RDs. This thesis demonstrates the utility of NGS techniques and bioinformatics processing of obtained data in studies aimed at understanding molecular basis of selected RDs. These methods led to identification and characterization of causative pathogenic variants in the NDUFAF6 and PLD1 genes among patients affected by the Acadian variant of Fanconi disease and patients with a rare congenital heart defect, respectively. This approach was further used to analyze exomes of a large cohort of patients with different types of...

Advances in DNA sequencing revolutionized the field of genomics over the last 5 years. New sequencing instruments make it possible to rapidly generate large amounts of sequence data at substantially lower cost. These high-throughput sequencing technologies (e.g. Roche 454 FLX, Life Technology SOLiD, Dover Polonator, Helicos HeliScope and Illumina Genome Analyzer) make whole genome sequencing and resequencing, transcript sequencing as well as quantification of gene expression, DNA-protein interactions and DNA methylation feasible at an unanticipated scale. In the field of evolutionary genomics, high-throughput sequencing permitted studies of whole genomes from ancient specimens of different hominin groups. Further, it allowed large-scale population genetics studies of present-day humans as well as different types of sequence-based comparative genomics studies in primates. Such comparisons of humans with closely related apes and hominins are important not only to better understand human origins and the biological background of what sets humans apart from other organisms, but also for understanding the molecular basis for diseases and disorders, particularly those that affect uniquely human traits, such as speech disorders, autism or schizophrenia. However, while the cost and time required to create comparative data sets have been greatly reduced, the error profiles and limitations of the new platforms differ significantly from those of previous approaches. This requires a specific experimental design in order to circumvent these issues, or to handle them during data analysis. During the course of my PhD, I analyzed and improved current protocols and algorithms for next generation sequencing data, taking into account the specific characteristics of these new sequencing technologies. The presented approaches and algorithms were applied in different projects and are widely used within the department of Evolutionary Genetics at the Max Planck Institute of Evolutionary Anthropology. In this thesis, I will present selected analyses from the whole genome shotgun sequencing of two ancient hominins and the quantification of gene expression from short-sequence tags in five tissues from three primates.

>Magister Scientiae - MSc / Aims DNA metabarcoding has recently emerged as a valuable supplementary tool to ensure food authenticity within the global food market. However, it is widely known that highly processed food samples are one of DNA metabarcoding’s greatest shortfalls due to high DNA degradation, presence of PCR inhibitors and the incomplete removal of several undesirable compounds (such as polysaccharides) that makes the amplification of desired DNA challenging. This project has two main aims, the first of which was to determine and develop a cost and time effective DNA metabarcoding system that could successfully describe to species level the ingredient composition of highly processed vegetarian food products. The DNA metabarcoding system was thoroughly evaluated and tested by combining well-researched primers with varying concentrations into a multiplex reaction. The combination of plant and animal primers selected that yielded the best results were used to determine the species composition in the samples. The second aim is to determine the possible presence of meat contaminants within the highly processed vegetarian food samples. Numerous studies have shown that food adulteration is a wide-spread phenomenon throughout the world due to the economic gains it can provide. Animal primers were introduced into the multiplex reaction to aid in the identification of any meat products that could have been inserted into the vegetarian products to lower the overall cost to company. Methodology Thirty-two highly processed vegetarian food samples were collected in the Cape Town area from local and franchised supermarkets. DNA was extracted using the Chloroform/Isoamyl alcohol method best suited for plant-based samples followed by amplification of the following mini-barcoding regions: the mitochondrial 16S ribosomal rRNA, cytochrome B, tRNALeu – trnL – UAA intron and the ribosomal internal transcribed spacer region – ITS2 for plant and fungi identification. The PCR products were purified using the Qiaquick kit and library preparation and building was conducted using the TruSeq DNA PCR-free Library kit. Final purification was completed using AMPure XP kit and the pooled libraries were sequenced on an Illumina Miseq using 300bp paired-end run. Statistical and bioinformatic analysis on the NGS raw sequence reads was performed in R version 3.6.3. Results The results of the data analysis showed that the cytochrome B primer couldn’t detect any animal DNA in the vegetarian samples, however animal-derived sequences were detected in the positives present, validating the efficacy of the multiplex reaction. Mitochondrial 16S ribosomal rRNA was only able to detect plant-based DNA due to the structural homology between chloroplast and mitochondrial DNA. The fungal ribosomal internal transcribed spacer region – ITS2 detected sequences deriving from “Viridiplantae”. This result could have been due to the fungal and plant ribosomal internal transcribed spacer region – ITS2 sharing a reverse primer during amplification. The trnL region was able to detect the presence of undeclared coriander, mustard and wheat in 8 (29%), 6 (21%) and 5 (18%) samples respectively. Additionally, trnL was able to detect the presence of tobacco in 11 (35%) samples. This could have been due to cross-contamination between samples being co-extracted and amplified at the same time for separate studies. The PITS2 region was able to detect the presence of undeclared barley, mustard and wheat in 8 (25%), 4 (14%) and 4 (14%) samples respectively. Our results show the possibility of DNA metabarcoding for the authentication of a wide range of species present in highly processed vegetarian samples using a single assay. However, further optimization of the technique for the identification of both plant and animal species within vegetarian samples needs to be performed before the wide-spread implementation of this technology would be both feasible and viable. Eliminating primer biases, decreasing the risk of homology between different primers in the same assay as well as preventing the amplification of sequencing of undesirable DNA need to be further explored and ultimately mitigated before DNA metabarcoding can be widely seen as an effective and cost-effective method for authentication and food control.

Indiana University-Purdue University Indianapolis (IUPUI) / Disturbances in membrane composition and protein folding in the endoplasmic reticulum (ER) trigger the unfolded protein response (UPR). Three UPR sensory proteins, PERK (PEK/EIF2AK3), IRE1, and ATF6 are each activated by ER stress. PERK phosphorylation of the alpha subunit of eIF2 represses global protein synthesis, lowering influx of nascent polypeptides into the stressed ER, coincident with the preferential translation of ATF4 (CREB2). Results from cultured cells demonstrate that ATF4 induces transcriptional expression of genes directed by the PERK arm of the UPR, including genes involved in amino acid metabolism, resistance to oxidative stress, and the proapoptotic transcription factor CHOP (GADD153/DDIT3). In this study, we characterized two ATF4 knockout mouse models and show in liver exposed to ER stress that ATF4 is not required for CHOP expression, but rather ATF6 is a primary inducer. RNA-sequence analysis indicated that ATF4 was responsible for a small portion of the PERK-dependent genes in the UPR. This smaller than expected subset of gene expression lends itself to the relevance of UPR crosstalk, with ATF6, XBP1, and CHOP being capable of upregulating UPR genes in the absence of ATF4. RNA-sequence analysis also revealed a requirement for expression of ATF4 for expression of a comparable number of genes basally, including those involved in oxidative stress response and cholesterol metabolism. Consistent with this pattern of gene expression, loss of ATF4 in our mouse model resulted in enhanced oxidative damage and increased free cholesterol in liver under stress accompanied by lowered cholesterol in sera. Taken together, this study highlights both an expansion of the role of ATF4 in transcriptional regulation of genes involved in metabolism in the basal state and a more specialized role during ER stress. These findings are important for understanding the variances of the UPR signaling between cell culture and in vivo and for a greater understanding of all the roles ATF4 plays within the cell.

La leucémie myéloïde aigüe (LMA) est la forme de leucémie la plus fréquente chez l’adulte au Canada. Bien que de nombreux réarrangements chromosomiques récurrents aient été identifiés chez les patients LMA, près de la moitié des cas présentent un caryotype normal (LMA-CN). L’étude de la LMA-CN in vitro est rendue difficile par le fait que la survie des cellules primaires de patients est défectueuse sur le long terme et que les lignées cellulaires leucémiques ont un caryotype hautement anormal. En 2009, Munker et son équipe ont établi une nouvelle lignée cellulaire, CG-SH, ayant la particularité d’avoir un caryotype normal. L’objectif principal de ce projet d’étude est de caractériser plus en détail ce nouveau modèle d’étude. Nous avons identifié l’ensemble des variants génétiques présents dans CG-SH grâce au séquençage du génome entier. Les variants susceptibles de participer à la leucémogénèse ont été isolés, tels que des insertions détectées dans EZH2 et GATA2, et de nombreux variants faux-sens détectés dans des gènes pertinents pour la LMA. Nous avons montré que les cellules CG-SH sont sensibles à l’effet prolifératif d’une combinaison de cytokines, qui agissent sur le comportement des cellules en modifiant l’expression des gènes associés à la régulation de la prolifération, de l’apoptose et de la différentiation. De plus, les cytokines diminuent le taux de nécrose des cellules en culture sur le court terme. La présente étude a permis d’approfondir notre connaissance sur les caractéristiques moléculaires de la lignée cellulaire CG-SH, un nouveau modèle d’étude in vitro de la LMA-CN. / Acute myeloid leukemia (AML) is the most frequent form of leukemia in the adult population in Canada. Although many recurrent chromosomal rearrangements have been identified in AML, almost half of all adult patients will present with a normal karyotype (NK-AML). The in vitro study of NK-AML is difficult because the long-term survival of primary patient samples is deficient and AML cell lines have a highly abnormal karyotype. In 2009, Munker and collegues established a new cell line, CG-SH, with the advantage of having a normal karyotype. The main goal of this research project is to further characterize this new model system. We identified all the genetic variants present in the CG-SH cells using whole genome sequencing. We also isolated the variants that are susceptible to participate to leukemogenesis, including the insertions detected in EZH2 and GATA2, and several missense mutations occurring in relevant genes for AML. We found that a combination of cytokines promotes the proliferation of CG-SH cells, and that cytokines act on the cells behavior through expression changes of the genes involved in the regulation of proliferation, apoptosis and differentiation. Moreover, cytokines trigger a decrease of the necrotic rate of CG-SH on the short-term. The current study allowed us to better appreciate molecular characteristics of the CG-SH cell line, a new model to study NK-AML in vitro.

Hemolytic disease of fetus or newborn (HDFN) är en komplikation där foster eller nyföddas erytrocyter förstörs för tidigt. HDFN uppstår när det föreligger blodgruppsinkompatibilitet mellan moder och barnet. Komplikationerna/ symptomen kan variera allt från mildare symptom till fosterdöd. HDFN orsakas framförallt av antikropp D (RhD-immunisering) och på grund av detta utförs det typning av fetalt RhD i maternell plasma. Utöver RhD-immuniseringar kan svåra fall av HDFN ibland orsakas av andra blodgruppssystem som c (Rh) och K (Kell). Fetal RhD-typning görs idag som screening på alla RhD-negativa gravida mödrar och utförs i Stockholm och Lund. Metoden som används är baserad på realtids-PCR och har använts sedan 2009. Fetal typning av c och K görs när höga titrar av anti-c respektive anti-K påvisas i mammans plasma. För fetal typning av c och K skickas prover från Huddinge till Lund respektive Amsterdam. Motsvarande immunisering mot erytrocytantigen kan även bildas mot trombocytantigen främst Human Platelet Antigene (HPA-1a) som uttrycks hos fostret och leda till fetal neonatal alloimmun trombocytopeni (FNAIT). En next generation sequencing (NGS) baserad metod för genomisktypning av alla kliniskt relevanta blodgruppssystem finns idag på Karolinska universitetssjukhuset. Denna metod är dock inte anpassad för fetal blodgruppstypning där cell-fritt foster- DNA (cffDNA) analyseras. Syftet med det här projektet var att optimera designade oligonukleotider (oligos) anpassade för fetal blodgruppstypning med NGS-metodik. Design av oligos utfördes innan examensarbetet påbörjades. Dessa inkluderade primer- par som amplifierar upp alla blodgruppssystem som kan orsaka HDFN och FNAIT. Utöver det inkluderade designade oligos markörer som amelogenin-XY (Amel-XY) som är könsspecifika markörer och insertion/deletion markörer (Indel-markörer). Med Amel-XY markörerna kan könsspecifika Y-genen påvisas i provet, vilket kommer att fungera som en kontroll på att foster-DNA har analyserats (fungerar endast vid manligt foster). Designade Indel-markörer består av 2 - 3 bp insertioner/deletioner där olika markörerna används till att skilja DNA från foster och modern i framtiden. De designade oligonukleotiderna undersöktes för om de ger tillräckligt bra amplifiering av sökta sekvenser med NGS genom att analysera två slumpmässigt valda försöksprover (genomisk DNA 2 ng/ μL) från en man och en kvinna. Resultatet visade att tillräckligt bra amplifieringar/signaler erhålls från samtliga markörer som ingår i studien. Den totala signalen för samtliga markörer blev 114234 läsningar (”reads”) vilket gav ett medelvärde på 3939 läsningar. För att mäta amplifieringsförmågan hos varje enskild markör beräknades procent av medelvärdet på 3939 läsningar. En signal på 20 – 180 % av medelvärdet ansågs vara godkänt för varje markör. Alla undersökta primer-markörer uppvisade en signal på minst 45 % av medelvärdet vilket var godkänt (godkänt intervall 20 – 180 %). Efter optimering av oligos som ger tillräckligt bra amplifiering genotypades 32 slumpmässigt valda DNA prover från 21 män och 11 kvinnor med hjälp av NGS. Efter NGS-körning och analys av fastQ-filer med hjälp av mjukvaruprogrammet R erhölls resultat i form av signaler. Signaler för respektive markör över 50 läsningar ansågs vara en positiv signal det vill säga att den sökta genen har påvisats. Signal-värde under 50 innebar att det förekom bakgrundssignal då önskat signal-värde vid avsaknad av sökt gensekvens är 0 (åsatt gränsvärde <1 % av högst uppmätta positiva signalen för varje markör). Samtliga undersökta markörer visade låg bakgrundssignal (<1 % ). Bakgrundssignalen beräknades för att veta vilken tillförlitlig nivå varje markör ska ligga på för att kunna detektera känsligt foster-DNA i framtiden. Resultaten i denna studie visade att de optimerade oligos kan användas till genotypning av cffDNA i framtiden eftersom markörerna uppvisade låga bakgrundssignaler vilket indikerar att metoden är tillräckligt effektiv för att kunna detektera känsligt foster-DNA i framtiden.

[ES] La enfermedad de Wilson (EW) es un trastorno hereditario del metabolismo del cobre causado por mutaciones en ATP7B, que codifica una proteína transportadora de cobre en el hígado. Su mal funcionamiento provoca un fallo en la excreción biliar de cobre y una acumulación progresiva de este metal en el organismo, especialmente en hígado y cerebro. En este trabajo, se explora la posible utilidad de miRNAs circulantes en plasma para identificar biomarcadores que sirvan para controlar la progresión de la enfermedad en pacientes con EW bajo tratamiento. Los modelos desarrollados para cada miRNA mostraron un buen rendimiento al clasificar a los pacientes con factores de evolución desfavorable, por lo que estos tres miRNAs se proponen como candidatos para mejorar el seguimiento clínico o para respaldar la eficacia de nuevas terapias en la EW. / [CA] La malaltia de Wilson és un trastorn hereditari del metabolisme del coure causat per mutacions en ATP7B, que codifica per a una proteïna transportadora del coure al fetge. El seu mal funcionament produeix alteracions en l'excreció biliar i l'acumulació progressiva de coure, especialment en fetge i cervell. Es va explorar la possible utilitat del perfil de miRNAs circulants com biomarcadors de progressió de la patologia hepàtica. L'avaluació dels models obtinguts per a cadascun dels tres miRNAs va mostrar un bon rendiment per a classificar al grup de pacients amb factors d’evolució desfavorable, en conseqüència, es proposen com a candidats per tal de millorar el seguiment clínic o comprovar l’efectivitat de noves teràpies en la malaltia de Wilson. / [EN] Wilson disease (WD) is an inherited disorder of copper metabolism caused by mutations in ATP7B, which encodes for a liver copper-transporting protein. Its dysfunction causes a deficit in biliary copper excretion and a progressive accumulation of this metal in the organism, mainly in liver and brain. In this work, circulating miRNAs profiling in plasma has been accomplished to identify biomarkers that could serve to monitor disease progression in WD patients under chelation therapy. Developed models for each miRNA exhibited good performance classifying patients with poor outcome factors, consequently, these three miRNAs are proposed as candidates to improve clinical follow-up or to support efficacy of novel therapies in WD. / Esta Tesis Doctoral ha sido financiada por los siguientes proyectos de investigación: “Avanzar en el diagnóstico y la prognosis de la enfermedad de Wilson” Duración: 2016-2019, Fundació Per Amor a l’Art (FPAA) IP: C. Espinós; “Bases genéticas y biomarcadores pronóstico de la enfermedad de Wilson y Wilson-like” 2020-2022, Fundació Per Amor a l’Art (FPAA) IP: C. Espinós; “Estudios clínicos, bases genéticas y biomarcadores pronóstico en enfermedades raras neurodegenerativas” 2019-2021, Instituto de Salud Carlos III (Expediente: PI18/00147) IP: C. Espinós; “De genes a terapia en enfermedades neurodegenerativas y neuromusculares” 2018-2021, Generalitat Valenciana, Programa Prometeo para grupos de investigación de excelencia (Expediente: PROMETEO/2018/135) Consorcio de investigadores formado por F. V. Pallardó (coordinador), J.M. Millán, I. Galindo, P. Sanz, T. Sevilla y C. Espinós. / Sánchez Monteagudo, A. (2021). Genética molecular y biomarcadores de la enfermedad de Wilson [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/171454

Background: Rare genetic mutations cause familial early-onset stroke disorders, known as “Mendelian strokes”. The broader relevance of rare mutations in unrelated young stroke patients is uncertain. We hypothesize that rare mutations in known and novel genes are important risk factors for stroke. Methods: Exome sequencing was used to characterize rare disruptive protein-altering mutations in 185 young cases and 185 matched controls from INTERSTROKE, a large and globally representative stroke study. The major objectives were: 1) to precisely define the role of known Mendelian stroke genes and 2) to discover novel gene and pathway associations. Results: A focused assessment of known Mendelian stroke genes revealed a significant contribution from NOTCH3, the causal gene for Cerebral Autosomal Dominant Arteriopathies with Subcortical Infarcts and Leucoencephalopathies (CADASIL). CADASIL mutations were identified in six cases and no controls (P=0.03). The clinical presentation of CADASIL mutation carriers deviated from known symptomatology, consisting of small-vessel ischemic strokes (SVIS) accompanied by secondary features including migraine and depression. A novel role for non-CADASIL NOTCH3 mutations in ICH was also elucidated (OR=2.86; 95% CI, 1.13 to 7.93, P=0.02). Such mutations were present in 22% of ICH cases and 8% of matching controls. An agnostic evaluation of all genes did not reveal any genome-wide significant associations. However, NOTCH3 was among the top ICH genes out of 13,706 tested, and many others were also biologically relevant, notably, AARS2 and NBEAL2. A protective association was identified for the renin angiotensin system (P=8.1x10-4), whereas type II diabetes mellitus was associated with increased risk (P=1.9x10-2). Conclusion: Rare mutations influence risk of early-onset stroke. CADASIL mutations play an important role in unrelated stroke patients. Beyond CADASIL, a novel role was uncovered for other NOTCH3 mutations as common and significant risk factors for ICH. Novel biologically relevant genes and pathways may also affect stroke susceptibility. / Thesis / Master of Science in Medical Sciences (MSMS)

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