Made available in DSpace on 2016-08-29T15:34:27Z (GMT). No. of bitstreams: 1 tese_4971_Dissertação_Nahun Thiagor.pdf: 1844062 bytes, checksum: 8e3e54f1750887fb5387ffffb0103629 (MD5) Previous issue date: 2011-08-16 / No presente estudo é estabelecida uma correlação entre alguns tensoativos, um derivado de ciclodextrina, oligossacarídeo cíclicos originado da ação da ciclodextrina glicosiltransferase, a β-ciclodextrina metilada e as linhagens de câncer de ovário A 2780 e OVCAR 3, tentando abrir a possibilidade de utilização da ciclodextrina associada a medicamentos quimioterápicos padronizados à terapia contra o câncer de ovário, que é apontado como uma das principais causas de óbito entre as malignidades ginecológicas. O câncer de ovário apresenta alta taxa de mortalida, além de possuir vários subtipos histo-clínicos, a cada ano aumenta cada vez mais o número de pacientes diagnosticadas, assim, é indispensável à continuidade das pesquisas científicas relacionadas a este tipo de câncer, visto que os conhecimentos até então elaborados são de extrema significância, porém insuficientes para que seja estabelecida uma cura. Através da viabilidade celular pelo método do MTT, onde se utiliza o sal de tetrazol para expressar de forma quantitativa a proliferação e sobrevivência das células e o método de BRADFORD, para normalização de dados, tenta-se estabelecer a influência de alguns tensoativos e do derivado de ciclodextrina sobre e entre as linhagens de câncer de ovário. A metil-β-ciclodextrina e os tensoativos SDS, TX100 E TW20 induziram uma redução da atividade mitocondrial dose-dependente em cultura de células de câncer de ovário da linhagem A 2780 e OVCAR 3. O derivado de ciclodextrina demonstrou indução gradativa da redução da atividade mitocondrial para duas das oito concentrações testadas (0,2% e 0,4%) com viabilidade celular próxima a 60% na linhagem A 2780. Na linhagem OVCAR 3 a metil-β-ciclodextrina apresenta potencial citotóxico capaz de inviabilizar 25% do crescimento celular em concentrações superiores a 0,003125%, a viabilidade celular perante as mesmas condições de tratamento é menor nesta linhagem quando comparada a linhagem A 2780. Devido às propriedades da ciclodextrinas os resultados das análises comparativas de viabilidade celular, nas linhagens de câncer de ovário, estes resultados apontam para possibilidades maiores em futuros estudos, podendo a pesquisa aqui apresentada ser tomada como referência. / This study sets up a correlation between some surfactants, a derivate of cyclodextrin, cyclic oligosaccharide originated from the action of the glycosyltransferase cyclodextrin, a methyllated β-cyclodextrin and the lines of ovarian cancer A 2780 and OVCAR 3, trying to offering the possibility of using cyclodextrin associated with standard chemotherapy drugs in therapy against ovarian cancer, which is pointed as one of the main causes of death among gynecological ills. Ovarian cancer is connected with high mortality rate and has several histo-clinical subtypes, raising the number of patient diagnosed each year, therefore there are the needy of continuing the scientific research which this kind of cancer is related, once the knowledge developed so far are extremely significant, yet it still is insufficient to generate a cure. Through the cellular viability by MTT method, which uses salt of tetrazol to express quantitatively the proliferation and survival of cells, and Bradford method for standardization data, it attempts to establish the influence of surfactants and some of the derivate of cyclodextrin on and between the lines of ovarian cancer. The methyl-β-cyclodextrin and the surfactant SDS, TX100 and TW20 induced a reduction in dose-dependent mitochondrial activity in cell cultures of ovarian cancer line A 2780 and OVCAR 3. The cyclodextrin derivate has demonstrated induction of gradual reduction of the mitochondrial activity of two from eight concentrations tested (0,2% and 0,4%) with cell viability of approximately 60% in strain A 2780. In the line OVCAR 3 the methyl-β-cyclodextrin shows potential cytotoxic able to tamper 25% of cell growth in conditions of treatment is reduced in this strain when compared with strain A 2780. Due to the properties of cyclodextrins, results of comparative analyzes of cell viability, in the strains of ovarian cancer, indicates to greater possibilities in future studies, enabling the research presented here as a reference.

Harmful BRCA (breast cancer susceptibility genes 1 and 2) mutations greatly increase women's risks of breast and/or ovarian cancer but are found in less than 1 per cent of the general population. Thus, care is targeted at women with strong family histories of breast and/or ovarian cancer. Genetic testing can determine if these high-risk women carry harmful mutations; if so, they may pursue care that facilitates cancer prevention, detection, and/or treatment. In this thesis, I examine in which cases it is problematic that some British and American women do not access this potentially life-saving care. In recognition of the difficulty in measuring access, a view informed by preliminary interviews and a literature review, I use three complementary approaches to illustrate different aspects of access. First, a critical review surveys how British and American clinical guidelines, laws, policies, and legal rulings govern service availability. Second, a scoping study describes the US and UK literature on barriers and facilitators to access. Third, an empirical study involving focus groups with UK and US genetics professionals and support group members details how women provide and pursue care. Using Beauchamp and Childress's 'four principles' framework, I analyse how these approaches inform four elements of access: availability of services, barriers to care, relevance and effectiveness of services, and equity of access. I distinguish between cases in which women do not want and/or need care and cases in which women are denied care they want and need, and I propose strategies to redress current inequities in access. I further suggest that offering Ashkenazi Jewish population screening alongside family history-based screening may be appropriate. I conclude that whilst most problematic cases are country-neutral, only US women are problematically constrained by insurance and legal loopholes, and only UK women are problematically constrained by regional variations in health authority funding.

Introdução: O câncer de ovário é o mais prevalente e letal câncer ginecológico. A quimioterapia é um componente importante do tratamento sistêmico clássico com uma combinação de um agente platinado e um taxano, usualmente. Invariavelmente, câncer de ovário avançado torna-se resistente à quimioterapia. Objetivos: Com base em dados recentes que demonstram um possível papel das neurotrofinas na regulação de quimiosensibilidade, decidimos estudar o impacto do fator neurotrófico derivado de cérebro (BDNF) sobre a atividade antitumoral de diferentes classes de agentes antineoplásicos. Métodos: Para avaliar um possível efeito sinérgico entre BDNF e diferentes combinações de tratamento para câncer de ovário, as células foram expostas a cisplatina, etoposideo, doxorrubicina e paclitaxel concomitantemente com BDNF durante 48 horas. Administração sequencial de BDNF e quimioterapia foi realizada para avaliar o potencial de BDNF em modificar a resposta ao tratamento quimioterápico dependendo de qual agente é aplicado em primeiro lugar. Resultados: Houve uma redução da viabilidade de células OVCAR-3 quando expostas a cisplatina, doxorubicina e etoposideo concomitantemente com BDNF em 61,18% (SE±1.12, p=0.002), 38,96% (SE±1.08, p=0.001) e 49,63% (SE±1.17, p<0.001), respectivamente. BDNF também reduziu significativamente o efeito do paclitaxel e doxorrubicina quando usado antes da quimioterapia com uma redução de efeito de 53,46% (SE±3.48, p=0.001) e 48,25% (SE±1.25, p=0.018), respectivamente. Além disso, o BDNF utilizado sequencialmente à doxorrubicina foi capaz de reverter a quimiotoxicidade deste agente em 37,77% (SE±1.25, p=0.018). Conclusão: Utilizando a linhagem celular de câncer de ovário (OVCAR-3), BDNF exibiu um efeito sinérgico quando administrado concomitantemente com os agentes citotóxicos doxorrubicina, etoposideo e cisplatina. Observamos também um efeito protetor de BDNF quando aplicado 24 horas antes de doxorrubicina e paclitaxel. Notavelmente, quando BDNF foi administrado após a exposição a agentes antineoplásicos, uma reversão da citotoxicidade foi observada apenas para a doxorrubicina e não para os outros agentes. / Background: Ovarian cancer is the most prevalent and lethal of gynecological malignancies. Chemotherapy is an important component of the systemic treatment with a combination of a platinum complex and a taxane one of the classic treatments. Invariably, advanced ovarian cancer becomes resistant to chemotherapy. Objective: Based on recent data demonstrating a possible role of neurotrophins regulating chemosensitivity, we decided to study the impact of brain-derived neurotrophic factor (BDNF) on the antitumor activity of different classes of antineoplastic agents. Methods: Primarily, to evaluate a possible synergistic effect of BDNF and different ovarian cancer treatments combination, cells were exposed to cisplatin, etoposide, doxorubicin and paclitaxel concomitantly with BDNF for 48 hours. Sequential administration of BDNF and any of the agents was carried out to evaluate if BDNF has the potential of enhancing or protecting cells from the effects of treatment depending of each agent is applied first. Results: There were a reduction in viability of OVCAR-3 cells exposed to cisplatin, doxorubicin and etoposide when used concomitantly with BDNF in 61.18% (SE 1.12, p=0.002), 38.96% (SE 1.08, p=0.001) and 49.63% (SE 1.17, p<0.001) respectively. We also found that BDNF reduced significantly the effect of paclitaxel and doxorubicin when used before chemotherapy with a reduction of effect of 53.46% (SE±3.48, p=0.001) and 48.25% (SE±1.25, p=0.018), respectively. Furthermore, BDNF used sequentially to doxorubicin was able to reverse the chemotoxicity of this agent in 37.77% (SE 1.25, p=0.018). Conclusion: In conclusion, using the human ovarian carcinoma cell line OVCAR-3, BDNF exhibited a synergistic effect when administered concomitantly to the cytotoxic agents doxorubicin, etoposide and cisplatin. We have also observed a protective effect of BDNF when applied 24 hours before doxorubicin and paclitaxel. Notably, when BDNF was administered after the exposure to the antineoplastic agents, a reversal of cytotoxicity was observed only for doxorubicin and not for the other agents.

Introdução: O câncer de ovário é o mais prevalente e letal câncer ginecológico. A quimioterapia é um componente importante do tratamento sistêmico clássico com uma combinação de um agente platinado e um taxano, usualmente. Invariavelmente, câncer de ovário avançado torna-se resistente à quimioterapia. Objetivos: Com base em dados recentes que demonstram um possível papel das neurotrofinas na regulação de quimiosensibilidade, decidimos estudar o impacto do fator neurotrófico derivado de cérebro (BDNF) sobre a atividade antitumoral de diferentes classes de agentes antineoplásicos. Métodos: Para avaliar um possível efeito sinérgico entre BDNF e diferentes combinações de tratamento para câncer de ovário, as células foram expostas a cisplatina, etoposideo, doxorrubicina e paclitaxel concomitantemente com BDNF durante 48 horas. Administração sequencial de BDNF e quimioterapia foi realizada para avaliar o potencial de BDNF em modificar a resposta ao tratamento quimioterápico dependendo de qual agente é aplicado em primeiro lugar. Resultados: Houve uma redução da viabilidade de células OVCAR-3 quando expostas a cisplatina, doxorubicina e etoposideo concomitantemente com BDNF em 61,18% (SE±1.12, p=0.002), 38,96% (SE±1.08, p=0.001) e 49,63% (SE±1.17, p<0.001), respectivamente. BDNF também reduziu significativamente o efeito do paclitaxel e doxorrubicina quando usado antes da quimioterapia com uma redução de efeito de 53,46% (SE±3.48, p=0.001) e 48,25% (SE±1.25, p=0.018), respectivamente. Além disso, o BDNF utilizado sequencialmente à doxorrubicina foi capaz de reverter a quimiotoxicidade deste agente em 37,77% (SE±1.25, p=0.018). Conclusão: Utilizando a linhagem celular de câncer de ovário (OVCAR-3), BDNF exibiu um efeito sinérgico quando administrado concomitantemente com os agentes citotóxicos doxorrubicina, etoposideo e cisplatina. Observamos também um efeito protetor de BDNF quando aplicado 24 horas antes de doxorrubicina e paclitaxel. Notavelmente, quando BDNF foi administrado após a exposição a agentes antineoplásicos, uma reversão da citotoxicidade foi observada apenas para a doxorrubicina e não para os outros agentes. / Background: Ovarian cancer is the most prevalent and lethal of gynecological malignancies. Chemotherapy is an important component of the systemic treatment with a combination of a platinum complex and a taxane one of the classic treatments. Invariably, advanced ovarian cancer becomes resistant to chemotherapy. Objective: Based on recent data demonstrating a possible role of neurotrophins regulating chemosensitivity, we decided to study the impact of brain-derived neurotrophic factor (BDNF) on the antitumor activity of different classes of antineoplastic agents. Methods: Primarily, to evaluate a possible synergistic effect of BDNF and different ovarian cancer treatments combination, cells were exposed to cisplatin, etoposide, doxorubicin and paclitaxel concomitantly with BDNF for 48 hours. Sequential administration of BDNF and any of the agents was carried out to evaluate if BDNF has the potential of enhancing or protecting cells from the effects of treatment depending of each agent is applied first. Results: There were a reduction in viability of OVCAR-3 cells exposed to cisplatin, doxorubicin and etoposide when used concomitantly with BDNF in 61.18% (SE 1.12, p=0.002), 38.96% (SE 1.08, p=0.001) and 49.63% (SE 1.17, p<0.001) respectively. We also found that BDNF reduced significantly the effect of paclitaxel and doxorubicin when used before chemotherapy with a reduction of effect of 53.46% (SE±3.48, p=0.001) and 48.25% (SE±1.25, p=0.018), respectively. Furthermore, BDNF used sequentially to doxorubicin was able to reverse the chemotoxicity of this agent in 37.77% (SE 1.25, p=0.018). Conclusion: In conclusion, using the human ovarian carcinoma cell line OVCAR-3, BDNF exhibited a synergistic effect when administered concomitantly to the cytotoxic agents doxorubicin, etoposide and cisplatin. We have also observed a protective effect of BDNF when applied 24 hours before doxorubicin and paclitaxel. Notably, when BDNF was administered after the exposure to the antineoplastic agents, a reversal of cytotoxicity was observed only for doxorubicin and not for the other agents.

Dois peptídeos, designados Let#1 e Let#2, foram delineados do segundo laço extracelular da proteína NaPi2b. Após conjugação, os peptídeos induziram produção de anticorpos específicos em coelhos e camundongos. Os anticorpos com maiores títulos foram selecionados para ensaios complementares. Estes anticorpos reconheceram os peptídeos conjugados aos carreadores pelos métodos de ELISA e WB, não havendo reação cruzada quando testados com a proteína carreadora livre e com antígeno sintético inespecífico. Após a completa validação, foi possível observar que os anticorpos anti-peptídeos reconhecem NaPi2b nativa, presente na superfície de células OV-CAR, bem como mostraram reconhecimento de um alvo comum em todos os soros analisados, mesmo quando o soro era considerado negativo para COV pelo teste comercial. Este reconhecimento não foi observado quando as amostras foram analisadas pelo soro pré-imune dos animais teste, sugerindo um reconhecimento específico dos anticorpos produzidos. / Two peptides, designated Let#1 and Let#2, were outlined from the second extracellular loop of the NaPi2b protein. After conjugation, the peptides induced the production of specific antibodies in rabbits and mice. Antibodies with higher titers were selected for complementary tests. These antibodies recognized peptides conjugated to the carrier by ELISA and WB, with no cross-reaction when tested with the free carrier protein and nonspecific synthetic antigen. After complete validation, it was observed that the anti-peptide antibodies recognize native NaPi2b protein present on the OV-CAR cell surface and showed recognizing a common target in all sera tested, even when the serum was considered negative for ovarian carcinonoma by commercial test. This recognition was not observed when the samples were analyzed by pre-immune serum of test animals, suggesting specific recognition of antibodies produced.

The initiating events of ovarian cancer remain unknown, but an established risk factor is use of estrogen therapy by post-menopausal women where there is a positive correlation between duration of use and risk for disease. Mouse models of ovarian cancer have shown that exposure to exogenous 17β-estradiol (E2) accelerates tumour onset so this study aims to investigate the E2 signalling mechanisms responsible for sensitizing ovarian epithelial cells to transformation. By developing model systems that are responsive to E2 manipulation, we showed that E2 induces the formation of epithelial dysplasias both in vitro and in vivo. microRNA microarray was used to discover that E2 up-regulates microRNA-378 via the ESR1 pathway, resulting in the down-regulation of a tumour suppressor gene called Disabled-2 (Dab2). E2 suppression of Dab2 was found to result in increased proliferation, loss of contact inhibition, epithelial dysplasia, and increased sensitivity to transformation. This mechanism was also found to be active in mouse fallopian tube epithelium and human ovarian cancer cells. Single-cell RNA sequencing and trajectory analysis was subsequently used to explore additional signalling mechanisms that might contribute to the emergence of dysplastic lesions induced by E2. Multiple molecular signalling pathways dysregulated by E2 were identified and this revealed several possible biomarkers to be investigated for early detection of ovarian cancer. In the context of a current lack of strategies for ovarian cancer prevention or early detection, this work represents a significant advance in our understanding of how E2 promotes ovarian cancer initiation.

Purpose: Women at familial/genetic ovarian cancer risk often undergo screening despite unproven efficacy. Research suggests each woman has her own CA125 baseline; significant increases above this level may identify cancers earlier than standard 6-12 monthly CA125>35U/mL. Experimental Design: Data from prospective Cancer Genetics Network and Gynecologic Oncology Group trials, which screened 3,692 women (13,080 woman-screening years) with a strong breast/ovarian cancer family history or BRCA1/2 mutations, were combined to assess a novel screening strategy. Specifically, serum CA125 q3 months, evaluated using a risk of ovarian cancer algorithm (ROCA), detected significant increases above each subject’s baseline, which triggered transvaginal ultrasound. Specificity and PPV were compared with levels derived from general population screening (specificity 90%, PPV 10%), and stage-at-detection was compared with historical high-risk controls.

Access to bevacizumab, an important component of oncology treatment regimens, may be limited. This survey of oncologists in the US (n = 150), Europe (n = 230), and emerging markets (EM: Brazil, Mexico, and Turkey; n = 130) examined use of and barriers to accessing bevacizumab as treatment of advanced solid tumors. We also assessed the likelihood that physicians would prescribe a bevacizumab biosimilar, if available. Bevacizumab was frequently used as early-line therapy in metastatic colorectal cancer, metastatic non-squamous non-small-cell lung cancer, and metastatic ovarian cancer (all markets), and as a second-line therapy in glioblastoma multiforme (US, EM). A greater percentage of EM-based physicians cited access-related issues as a barrier to prescribing bevacizumab versus US and EU physicians. Lack of reimbursement and high out-of-pocket costs were cited as predominant barriers to prescribing and common reasons for reducing the number of planned cycles. Overall, similar to 50% of physicians reported they "definitely" or "probably" would prescribe a bevacizumab biosimilar, if available. Efficacy and safety data in specific tumor types and lower cost were factors cited that would increase likelihood to prescribe a bevacizumab biosimilar. A lower cost bevacizumab biosimilar could address the unmet needs of patients and physicians worldwide, and may have the greatest impact on patient outcomes in EM.

Background: The biological mechanisms underlying early-and advanced-stage epithelial ovarian cancers (EOCs) are still poorly understood. This study explored kinase-driven metabolic signalling in early and advanced EOCs, and its role in tumour progression and response to carboplatin-paclitaxel treatment. Methods: Tumour epithelia were isolated from two independent sets of primary EOC (n-72 and 30 for the discovery and the validation sets, respectively) via laser capture microdissection. Reverse phase protein microarrays were used to broadly profile the kinase-driven metabolic signalling of EOC with particular emphasis on the LBK1-AMPK and AKT-mTOR axes. Signalling activation was compared between early and advanced lesions, and carboplatin-paclitaxel-sensitive and -resistant tumours. Results: Advanced EOCs were characterised by a heterogeneous kinase-driven metabolic signature and decreased phosphorylation of the AMPK-AKT-mTOR axis compared to early EOC (P<0.05 for AMPK alpha T172, AMPK alpha 1 S485, AMPK beta 1 S108, AKT S473 and T308, mTOR S2448, p70S6 S371, 4EBP1 S65, GSK-3 alpha/beta S21/9, FOXO1 T24/FOXO3 T32, and FOXO1 S256). Advanced tumours with low relative activation of the metabolic signature and increased FOXO1 T24/FOXO3 T32 phosphorylation (P=0.041) were associated with carboplatin-paclitaxel resistance. Conclusions: If validated in a larger cohort of patients, the decreased AMPK-AKT-mTOR activation and phosphorylation of FOXO1 T24/FOXO3 T32 may help identify carboplatin-paclitaxel-resistant EOC patients.

The infrequency of known T cell targets in high grade serous ovarian carcinoma (HSGC) is a substantial barrier to the development of targeted immunotherapies. Due to their infrequency, antigen discovery is a crucial component of immunotherapeutic design. In our cohort of HGSC cases, the cancer testis (CT) antigen lactate dehydrogenase C (LDHC) is expressed in 76% of tumours (22/29). As LDHC presents with tumour specificity in women, I hypothesize that LDHC is an immunogenic target in HGSC patients, and that LDHC-specific T cells can be activated and expanded for therapeutic purposes. As such, I sought to examine whether endogenous LDHC-specific T cells were present in the ascites of HGSC patients. A standard Rapid Expansion Protocol was used to expand CD8 T cell cultures from patient ascites. These cultures were screened for reactivity to a peptide library encompassing all possible epitopes of the LDHC protein by interferon-γ ELISpot. With this approach, T cell clones from one of five patients were identified that were reactive to minimal peptides contained within LDHC. In this patient, the antigenic LDHC peptide differentiated from LDHA by a single amino acid at its C-terminus (YTSWAIGLSVM versus YTSWAIGLSVA). In recognition assays, tumour cell lines expressing endogenous LDHC, autologous ascites, or autologous B cells transfected with LDHC were unable to elicit T cell responses. Although this study suggests that LDHC is not immunogenic, continued screening of LDHC and other CT proteins will likely provide additional immunotherapeutic targets. / Graduate