O carcinoma epidermoide bucal (CEB) é uma malignidade epitelial que causa grande mortalidade. As metalotioneínas (MTs) são proteínas envolvidas na homeostasia de metais e eventos oxidativos. Estudos de expressão proteica a apontaram como marcadora de prognóstico e comportamento metastático para o CEB. A análise da expressão gênica das mesmas tem auxiliado no entendimento deste papel para outros tumores, mas ainda não foi estudada no CEB. O objetivo deste trabalho foi avaliar o perfil de expressão gênica das MTs no CEB e em fragmentos de mucosa oral (MOC), além de sua relação com dados clínicopatológicos, comportamento metastático e prognóstico. Para tal, foram utilizadas amostras armazenadas a -80º C no Banco Nacional de Tumores do Instituto Nacional de Câncer, constando de 35 casos de CEB de língua e/ou assoalho bucal e 35 MOC. Todos os fragmentos foram submetidos ao qRT-PCR com uso de TaqMan® para os genes: MT1A, MT1B, MT1E, MT1F, MT1G, MT1H, MT1X, MT2A, MT3 e MT4. A expressão dos genes MT1B e MT1H foi raramente detectada. Houve queda significativa de expressão dos genes MT1A, MT1X, MT3 e MT4 e aumento significativo de expressão de MT1F no CEB com relação à MOC. Casos de baixa expressão de MT1G tiveram pior prognóstico. A alta expressão de MT1X indicou casos não metastáticos e a alta expressão de MT3 indicou casos metastáticos. Em suma, foi demonstrado pela primeira vez o perfil gênico das MTs no CEB, indicando que a mesma pode fornecer informações sobre o prognóstico e comportamento metastático do CEB. / The oral squamous cell carcinoma (OSCC) is a malignancy that causes high mortality. Metallothioneins (MTs) are proteins involved in metal homeostasis and antioxidant events. Studies regarding its protein expression indicated its potential as marker of prognosis and metastatic behavior, also for OSCC. The analysis of its specific gene expression can clarify its importance in these aspects and no study has been done for OSCC. The aim of this work was to evaluate the profile of gene expression of MTs in OSCC and samples of non-neoplastic oral mucosa (OM), evaluating its relationship with clinic-pathologic characteristic, metastatic behavior and prognosis for OSCC. For this, tissue samples archived at -80º C at the National Bank of Tumors of the Brazilian National Institute of Cancer were collected, in a total of 35 cases of OSCC and 35 fragments of OM. All tissues were submitted to qRTPCR with TaqMan® for the genes: MT1A, MT1B, MT1E, MT1F, MT1G, MT1H, MT1X, MT2A, MT3 e MT4, besides the constitutive gene GAPDH. Expressions of MT1B and MT1H were rarely detected. There was significant loss of expression for MT1A, MT1X, MT3 and MT4 and gain of expression for MT1F comparing OSCC with OM. Cases with down-regulation of MT1G had the worst prognosis. Up-regulation of MT1X indicated non-metastatic cases whereas up-regulation of MT3 indicated metastatic ones. In conclusion, this study shows for the first time the profile of gene expression of MTs on OSCC indicating distinctive patterns of regulation for each, and giving associations with prognosis and metastatic behavior of cases.

A terapia antiangiogênica surgiu como uma alternativa promissora para o tratamento do câncer. No entanto, evidências recentes mostram que as células endoteliais isoladas diretamente de um tumor maligno são mais resistentes a diferentes drogas do que as células endoteliais presentes no mesmo tecido normal. Essas diferenças podem ser atribuídas em parte à adaptação das células endoteliais ao microambiente tumoral. Uma característica singular do microambiente tumoral é a consistente acidificação do meio extracelular, cujos efeitos nas células endoteliais não são conhecidos. Acidez extracelular pode alterar múltiplas funções biológicas, causar estresse do retículo endoplasmático (RE) e ativação da Unfolded Protein Response (UPR). Células endoteliais humanas primárias de derme (HDMEC) cultivadas em pH 6.4, ajustado tanto com ácido lático tanto com ácido clorídrico, apresentaram aumento da expressão de proteínas relacionadas à UPR, como GRP78, ATF4, elf2α fosforilada e aumento na clivagem do mRNA de XBP1. Nessas condições massiva morte celular ocorreu após 48 horas. Em contrapartida, quando as células endoteliais eram expostas à acidez crônica não-letal com pH 7.0 durante sete dias, essas foram capazes de se adaptar coincidentemente com um aumento da expressão da proteína GRP78 Após sete dias sob pH 7.0, as células HDMEC apresentaram maior resistência à morte celular quando tratadas com as drogas Etoposide, Adriamicina e Sunitinib em doses que variavam entre 0.0025μM a 100μM. O silenciamento do gene GRP78 com ShRNA reverteu esse fenótipo resistente. Para determinar os níveis de UPR in vivo utilizou-se captura por microdissecção à laser de células endoteliais em lâminas histológicas de 14 carcinomas espinocelulares bucais. Observou-se um aumento significativo dos níveis de mRNA de GRP78, ATF4 e CHOP em células endoteliais dos tumores quando comparadas a células endoteliais primárias (HDMEC). Além do mais, células endoteliais tumorais apresentaram intensa imunomarcação para GRP78 comparativamente a células endoteliais de mucosa bucal normal. A acidez, uma importante fonte de estresse no microambiente tumoral, pode ativar uma UPR adaptativa em células endoteliais. Aumento da expressão de GRP78 em células endoteliais é associado com maior resistência a drogas quimioterápicas. Os resultados sugerem que a resistência mediada pela UPR pode contribuir com o insucesso terapêutico na resposta a drogas antitumorais. / Antiangiogenic therapy has emerged as a promising alternative for cancer treatment. However, growing evidence has shown that endothelial cells isolated directly from malignant tumors are more resistant to different drugs than endothelial cells from normal tissues. These differences may due to the adaptation of endothelial cells to the tumor microenvironment. A unique feature of tumor microenvironment is the consistent acidification of the extracellular environment, whose effects on endothelial cells are not known. Extracellular acidity can alter multiple biological functions, including endoplasmic reticulum stress and activation of the Unfolded Protein Response (UPR). Primary human dermal microvascular endothelial cells (HDMEC) cultured at medium pH 6.4, adjusted with either lactic acid or either hydrochloric acid, showed strong up-regulation of the UPR-related proteins: GRP78, ATF4, phospho-elf2α and increased XBP1 mRNA splicing. However massive cell death occurred after 48 hours. In contrast, when endothelial cells were exposed to chronic nonlethal acidic stress at pH 7.0 for up to seven days, cells were able to adapt, coincidental with a marked increase in GRP78 protein expression. After 7 days at pH 7.0, HDMEC cells showed increased resistance to cell death when exposed to Etoposide, Adriamycin and Sunitinib at doses ranging from 0.0025μM to 100μM. Knockdown of GRP78 by shRNA reversed the resistance phenotype. To determine the levels of UPR in vivo, laser capture microdissection of endothelial cells from oral squamous cell carcinomas biopsies was done. There is a significant increase in mRNA levels of GRP78, ATF4 and CHOP on endothelial cells of tumors compared to untreated primary endothelial cells (HDMEC). Moreover, tumor 16 endothelial cells showed strong GRP78 immunostaining compared to endothelial cells from normal oral mucosa. Low pH, an important source of cellular stress in the tumor microenvironment, can activate an adaptive UPR response in endothelial cells. Increased expression of GRP78 in endothelial cells is associated with chemoresistance. The results suggest that UPR-mediated resistance may contribute to therapeutic failures in response to anticancer drugs.

Most oral squamous cell carcinoma (OSCC) is believed to develop via a multistep process of cumulative gene damage in epithelial cells. Increasing incidence of OSCC and evidence that traditional risk factors may not be responsible directed us to investigate the prevalence of virus in pre- and malignant samples.The integration of the DNA from human papillomavirus (HPV), Epstein-Barr virus (EBV), and Herpes simplex (HSV) into the human genome is associated with the expression of oncogenes and the down-regulation of tumor-suppressor genes in OSCC carcinogenesis. This thesis compared samples from India and Sudan, two countries on two continents having a documented high incidence of oral cancer, with specimens from Sweden, with its known low incidence of oral cancer. Each region has, in addition to smoking, a unique non-smoked tobacco habits with documented carcinogenic effects. These countries also typify areas of low and high socioeconomic living conditions with their expected impact on disease development. The study populations were selected from tobacco users and nonusers with OSCC, oral sub-mucous fibrosis (India), oral lichen planus (Sweden), oral leukoplakia with and without dysplasia and snuff-induced lesions (Sweden and Sudan). An expedient method was developed for extracting DNA from old formalin-fixed and paraffin-embedded biopsies. The prevalence of HPV, EBV, and HSV was investigated using PCR/DNA sequencing and southern blot hybridization analysis. We found HPV and EBV to be most prevalent in samples of tissue characterized as normal, with decreasing prevalence in dysplastic and malignant lesions. This intriguing finding that prevalence decreases as neoplastic development proceeds warrants further investigation. Our data do not at first sight support the conclusion that viruses and tobacco use jointly interact with cell mechanisms in the development of oral cancer.

No description available.

A terapia antiangiogênica surgiu como uma alternativa promissora para o tratamento do câncer. No entanto, evidências recentes mostram que as células endoteliais isoladas diretamente de um tumor maligno são mais resistentes a diferentes drogas do que as células endoteliais presentes no mesmo tecido normal. Essas diferenças podem ser atribuídas em parte à adaptação das células endoteliais ao microambiente tumoral. Uma característica singular do microambiente tumoral é a consistente acidificação do meio extracelular, cujos efeitos nas células endoteliais não são conhecidos. Acidez extracelular pode alterar múltiplas funções biológicas, causar estresse do retículo endoplasmático (RE) e ativação da Unfolded Protein Response (UPR). Células endoteliais humanas primárias de derme (HDMEC) cultivadas em pH 6.4, ajustado tanto com ácido lático tanto com ácido clorídrico, apresentaram aumento da expressão de proteínas relacionadas à UPR, como GRP78, ATF4, elf2α fosforilada e aumento na clivagem do mRNA de XBP1. Nessas condições massiva morte celular ocorreu após 48 horas. Em contrapartida, quando as células endoteliais eram expostas à acidez crônica não-letal com pH 7.0 durante sete dias, essas foram capazes de se adaptar coincidentemente com um aumento da expressão da proteína GRP78 Após sete dias sob pH 7.0, as células HDMEC apresentaram maior resistência à morte celular quando tratadas com as drogas Etoposide, Adriamicina e Sunitinib em doses que variavam entre 0.0025μM a 100μM. O silenciamento do gene GRP78 com ShRNA reverteu esse fenótipo resistente. Para determinar os níveis de UPR in vivo utilizou-se captura por microdissecção à laser de células endoteliais em lâminas histológicas de 14 carcinomas espinocelulares bucais. Observou-se um aumento significativo dos níveis de mRNA de GRP78, ATF4 e CHOP em células endoteliais dos tumores quando comparadas a células endoteliais primárias (HDMEC). Além do mais, células endoteliais tumorais apresentaram intensa imunomarcação para GRP78 comparativamente a células endoteliais de mucosa bucal normal. A acidez, uma importante fonte de estresse no microambiente tumoral, pode ativar uma UPR adaptativa em células endoteliais. Aumento da expressão de GRP78 em células endoteliais é associado com maior resistência a drogas quimioterápicas. Os resultados sugerem que a resistência mediada pela UPR pode contribuir com o insucesso terapêutico na resposta a drogas antitumorais. / Antiangiogenic therapy has emerged as a promising alternative for cancer treatment. However, growing evidence has shown that endothelial cells isolated directly from malignant tumors are more resistant to different drugs than endothelial cells from normal tissues. These differences may due to the adaptation of endothelial cells to the tumor microenvironment. A unique feature of tumor microenvironment is the consistent acidification of the extracellular environment, whose effects on endothelial cells are not known. Extracellular acidity can alter multiple biological functions, including endoplasmic reticulum stress and activation of the Unfolded Protein Response (UPR). Primary human dermal microvascular endothelial cells (HDMEC) cultured at medium pH 6.4, adjusted with either lactic acid or either hydrochloric acid, showed strong up-regulation of the UPR-related proteins: GRP78, ATF4, phospho-elf2α and increased XBP1 mRNA splicing. However massive cell death occurred after 48 hours. In contrast, when endothelial cells were exposed to chronic nonlethal acidic stress at pH 7.0 for up to seven days, cells were able to adapt, coincidental with a marked increase in GRP78 protein expression. After 7 days at pH 7.0, HDMEC cells showed increased resistance to cell death when exposed to Etoposide, Adriamycin and Sunitinib at doses ranging from 0.0025μM to 100μM. Knockdown of GRP78 by shRNA reversed the resistance phenotype. To determine the levels of UPR in vivo, laser capture microdissection of endothelial cells from oral squamous cell carcinomas biopsies was done. There is a significant increase in mRNA levels of GRP78, ATF4 and CHOP on endothelial cells of tumors compared to untreated primary endothelial cells (HDMEC). Moreover, tumor 16 endothelial cells showed strong GRP78 immunostaining compared to endothelial cells from normal oral mucosa. Low pH, an important source of cellular stress in the tumor microenvironment, can activate an adaptive UPR response in endothelial cells. Increased expression of GRP78 in endothelial cells is associated with chemoresistance. The results suggest that UPR-mediated resistance may contribute to therapeutic failures in response to anticancer drugs.

Made available in DSpace on 2014-06-11T19:32:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2003Bitstream added on 2014-06-13T18:42:59Z : No. of bitstreams: 1 bertao_jm_dr_aracadg.pdf: 985938 bytes, checksum: 1c8d92b84eb72a2ea991ee245bd8aadc (MD5) / Realizamos um estudo clínico, histopatológico e histoquímico utilizando a técnica de coloração pela prata, para evidenciação das regiões organizadoras de nucléolos (Agnor). Foram analisados 81 casos de biópsias incisionais de carcinoma espinocelular de boca de regiões diferentes, ou seja, lábio, língua, assoalho, palato e retromolar. Foram observados e analisados os dados com relação a sexo, cor, idade, grau de diferenciação, estadiamento e hábitos de fumar e beber. Esses dados analisados entre si revelaram que a maior incidência de carcinoma espinoceluar em nossos estudos foi de carcinoma de assoalho bucal em torno de 30% contrariando a literatura que se refere à língua como local de maior freqüência; os outros dados analisados foram todos concordantes com a literatura de vários autores. A análise quantitativa e morfométrica das Nors foram realizadas por um sistema computadorizado, Imagelab 2000 que analisa as imagens capturadas de um microscópio por uma câmera e transfere para o sistema computadorizado, onde são analisadas. Usando esse sistema analisamos lâminas coradas pela técnica Agnor para verificação do número de Nors, área das Nors, número de Núcleos e área dos Núcleos das células presentes em tecidos removidos por biópsia incisional de boca, em áreas diferentes. Pelos resultados obtidos na análise histoquímica podemos verificar que existe uma diferença significativa na proporção do número de Nors/Núcleo para as diferentes áreas analisadas, mas que são coerentes com a literatura em carcionoma bem diferenciado e moderadamente diferenciado. Notamos ainda diferenças significativas entre as áreas das Nors, área dos Núcleos e números dos Núcleos entre as regiões diferentes analisadas e não conclusiva, portanto necessitando de outros estudos com a técnica de Agnor para aprimoramento da mesma, elucidação de resultados e uso mais freqüente em laboratórios de Anatomia Patológica. / We have carried out a clinical, histopathological and histochemical study using silver staining technique, to evidence the nucleolar organizing regions (Agnor). Eighty-one cases of incisional biopsies of oral squamous cell carcinoma from different regions of de mouth (lip, tongue, floor, palate and retromolar) have been observed and analyzed with regard to sex, race, age, degree of differentiation, staging and habit to smoke and to drink. The compared analyses of the data in our study indicated a greater incidence of oral floor cell carcinoma (about 30%) in disagreement with the current literature with mentions the tongue as the local of greater occurrence. The other analyzed data were all in agreement with the literature. The quantitative and morphometric analyses of the Nors have been carried out by a computerized system, Imagelab 2000 that analyzes the captured images of a microscope for a camera and transfers to the computerized system, where are analyzed. Using this system we have analyzed slides stained by the Agnor technique for verification of the number of Nors, area of the Nors, number of nuclei and area of the nuclei of the cells present in tissue removed by incisional biopsy of mouth in different areas. By the results gotten in the histochemical analysis we can verify that there is a significant difference in the ratio of the number of Nors/Nuclei for the different analyzed areas, but they are coherent with the literature for well differentiated and moderately differentiated carcinoma. We notice too significant differences between the areas of the Nors, area and de numbers of the nuclei among the different regions analyzed and not conclusive, therefore needing other studies with the Agnor technique for better interpretation of the results.

Made available in DSpace on 2014-12-17T15:32:33Z (GMT). No. of bitstreams: 1 MariaCFNC.pdf: 1259034 bytes, checksum: abf51afcd72b5241d217ca5d19610bd4 (MD5) Previous issue date: 2006-09-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The objective of this study was perform, by the streptoavidin-biotin technique, an immunohistochemical analysis of the E-cadherin and CD44v6 in 15 lower lip squamous cell carcinomas and 15 of tongue, with varied histologic gradation of malignidade, in order to establish a possible relation between the expression these proteins and the anatomical localization of the lesions, metastasis, as well as with the Bryne`s histolologic grading of malignancy system. It was not observed significant statistical association between the localization of the lesions and the malignancy score, however, had a significant correlation between the histologic parameters of malignancy gradation and the total score of malignancy, being that the parameter degree of keratinization presented the highest correlation (r = 0,844). Taking in consideration the anatomical localization of the lesions, it was not significant difference between the profile of expression and the amount of immunopositive cells for Ecaderina and CD44v6. To the metastasis variable, also it was not observed significant difference between the profile of expression and the amount of immunopositive cells for evaluated proteins. However, it was observed a statistical significant difference in relation to the scores of malignancy, being that the low score presented the highest values for the profile of expression and the amount of immunopositive cells for the E-caderina and the CD44v6. It was observed a statistically significant and negative correlation between the expression profile, the amount of E-cadherin and CD44v6 immunopositive cells and the total score of malignancy. Therefore, based in the results of this study, it was concluded that the expression of the immunohistochemical markers E-caderina and CD44v6 did not constitute histological indicator of aggressiveness for the patients with lower lip and tongue squamous cell carcinomas / Este trabalho teve como objetivo verificar, atrav?s da t?cnica da estreptoavidina-biotina, a express?o imuno-histoqu?mica das prote?nas E-caderina e CD44v6 em 15 esp?cimes de carcinoma epiderm?ide de l?bio inferior e 15 de l?ngua, com variada grada??o histol?gica de malignidade, a fim de estabelecer uma poss?vel rela??o entre a express?o das referidas prote?nas e a localiza??o anat?mica da les?o, met?stase, assim como com a grada??o histol?gica de malignidade proposta por Bryne (1998). A an?lise estat?stica demonstrou que n?o houve associa??o significativa entre a localiza??o da les?o e os escores de malignidade, entretanto, houve uma correla??o significativa entre os par?metros de grada??o histol?gica de malignidade e o escore total de malignidade, sendo que o par?metro grau de ceratiniza??o apresentou a maior correla??o (r = 0,844). Levando-se em considera??o a localiza??o anat?mica das les?es, n?o houve diferen?a significativa entre o padr?o de express?o e a quantidade de c?lulas imunopositivas para E-caderina e CD44v6. Em se tratando da vari?vel met?stase, tamb?m n?o houve diferen?a significativa entre o padr?o de express?o e a quantidade de c?lulas imunopositivas para as prote?nas avaliadas. Entretanto, ressalta-se que foi observada uma diferen?a estatisticamente significativa em rela??o aos escores de malignidade, sendo que o escore baixo apresentou os maiores valores para o padr?o de express?o e a quantidade de c?lulas imunopositivas para a E-caderina e o CD44v6. Uma correla??o estatisticamente significativa e negativa entre o padr?o de express?o e a quantidade de c?lulas imunopositivas para a E-caderina e o CD44v6 e o escore total de malignidade foi observada. Portanto, com base nestes resultados, conclui-se que a express?o dos marcadores imuno-histoqu?micos E-caderina e CD44v6 n?o constituiu fator indicativo de maior agressividade morfol?gica para os pacientes portadores de carcinomas epiderm?ides de l?bio inferior e de l?ngua

A terapia antiangiogênica surgiu como uma alternativa promissora para o tratamento do câncer. No entanto, evidências recentes mostram que as células endoteliais isoladas diretamente de um tumor maligno são mais resistentes a diferentes drogas do que as células endoteliais presentes no mesmo tecido normal. Essas diferenças podem ser atribuídas em parte à adaptação das células endoteliais ao microambiente tumoral. Uma característica singular do microambiente tumoral é a consistente acidificação do meio extracelular, cujos efeitos nas células endoteliais não são conhecidos. Acidez extracelular pode alterar múltiplas funções biológicas, causar estresse do retículo endoplasmático (RE) e ativação da Unfolded Protein Response (UPR). Células endoteliais humanas primárias de derme (HDMEC) cultivadas em pH 6.4, ajustado tanto com ácido lático tanto com ácido clorídrico, apresentaram aumento da expressão de proteínas relacionadas à UPR, como GRP78, ATF4, elf2α fosforilada e aumento na clivagem do mRNA de XBP1. Nessas condições massiva morte celular ocorreu após 48 horas. Em contrapartida, quando as células endoteliais eram expostas à acidez crônica não-letal com pH 7.0 durante sete dias, essas foram capazes de se adaptar coincidentemente com um aumento da expressão da proteína GRP78 Após sete dias sob pH 7.0, as células HDMEC apresentaram maior resistência à morte celular quando tratadas com as drogas Etoposide, Adriamicina e Sunitinib em doses que variavam entre 0.0025μM a 100μM. O silenciamento do gene GRP78 com ShRNA reverteu esse fenótipo resistente. Para determinar os níveis de UPR in vivo utilizou-se captura por microdissecção à laser de células endoteliais em lâminas histológicas de 14 carcinomas espinocelulares bucais. Observou-se um aumento significativo dos níveis de mRNA de GRP78, ATF4 e CHOP em células endoteliais dos tumores quando comparadas a células endoteliais primárias (HDMEC). Além do mais, células endoteliais tumorais apresentaram intensa imunomarcação para GRP78 comparativamente a células endoteliais de mucosa bucal normal. A acidez, uma importante fonte de estresse no microambiente tumoral, pode ativar uma UPR adaptativa em células endoteliais. Aumento da expressão de GRP78 em células endoteliais é associado com maior resistência a drogas quimioterápicas. Os resultados sugerem que a resistência mediada pela UPR pode contribuir com o insucesso terapêutico na resposta a drogas antitumorais. / Antiangiogenic therapy has emerged as a promising alternative for cancer treatment. However, growing evidence has shown that endothelial cells isolated directly from malignant tumors are more resistant to different drugs than endothelial cells from normal tissues. These differences may due to the adaptation of endothelial cells to the tumor microenvironment. A unique feature of tumor microenvironment is the consistent acidification of the extracellular environment, whose effects on endothelial cells are not known. Extracellular acidity can alter multiple biological functions, including endoplasmic reticulum stress and activation of the Unfolded Protein Response (UPR). Primary human dermal microvascular endothelial cells (HDMEC) cultured at medium pH 6.4, adjusted with either lactic acid or either hydrochloric acid, showed strong up-regulation of the UPR-related proteins: GRP78, ATF4, phospho-elf2α and increased XBP1 mRNA splicing. However massive cell death occurred after 48 hours. In contrast, when endothelial cells were exposed to chronic nonlethal acidic stress at pH 7.0 for up to seven days, cells were able to adapt, coincidental with a marked increase in GRP78 protein expression. After 7 days at pH 7.0, HDMEC cells showed increased resistance to cell death when exposed to Etoposide, Adriamycin and Sunitinib at doses ranging from 0.0025μM to 100μM. Knockdown of GRP78 by shRNA reversed the resistance phenotype. To determine the levels of UPR in vivo, laser capture microdissection of endothelial cells from oral squamous cell carcinomas biopsies was done. There is a significant increase in mRNA levels of GRP78, ATF4 and CHOP on endothelial cells of tumors compared to untreated primary endothelial cells (HDMEC). Moreover, tumor 16 endothelial cells showed strong GRP78 immunostaining compared to endothelial cells from normal oral mucosa. Low pH, an important source of cellular stress in the tumor microenvironment, can activate an adaptive UPR response in endothelial cells. Increased expression of GRP78 in endothelial cells is associated with chemoresistance. The results suggest that UPR-mediated resistance may contribute to therapeutic failures in response to anticancer drugs.

A systems biology approach was adopted in order to assess various aspects of the disease oral squamous cell carcinoma. Three main aims were addressed; assess the ability of CoCl2 to mimic the hypoxic response in a eukaryotic cell line, assess the role of PDE4D in oral squamous cell carcinoma (OSCC) and the construction of a normoxic/hypoxic mathematical model to identify therapeutic targets.Cancer cells often acquire a revised metabolism which aids in initiation, survival and progression of the tumour. This is predominantly due to the transcription factor HIF-1 which is activated under hypoxic conditions. Certain compounds such as cobalt chloride (CoCl2) have been used extensively to inhibit the degradation of HIF-1α and simulate hypoxia. CoCl2 is likely to have off-target effects on metabolism; these effects were examined when exposing human telomerase reverse transcriptase (hTERT) cells to 100μM CoCl2. Gas chromatography-mass spectrometry (GC-MS), liquid chromatography-mass spectrometry (LC-MS) based metabolomics were utilised in combination with ELISA assays for HIF-1α and ATP. Central metabolism was accurately mimicked when hTERT cells were subjected to 100μM CoCl2, however; it was apparent that this concentration of CoCl2 does not induce an equal extent of hypoxia as 1% oxygen. A number of off-target effects of CoCl2 were observed in secondary metabolism, specifically in lipids and fatty acids. In conclusion, CoCl2 should be used with caution as a hypoxic mimicker with the caveat that interpretation of results should be restricted to its effects on central metabolism.The transcription factor CREB has the ability to regulate approximately 4000 genes, a number of which are associated with cancer initiation and progression. Cyclic adenosine monophosphate (cAMP) is required to activate CREB and is partially regulated through its degradation via the enzyme phosphodiesterase type 4D (PDE4D). A homozygous deletion of PDE4D has been associated with OSCC; however; the exact consequence of this deletion has not been fully elucidated. PDE4D was knocked down in the OSCC cell line BicR16 and cellular proliferation, migration, resistance to ionising radiation and central metabolism was investigated using MTT, scratch, clonogenic and GC-MS, respectively. The knockdown resulted in an increase in proliferation, migration and radiation resistance suggesting the role of PDE4D as a TSG. Amino acids, cholesterol, fatty acids, carbohydrates and TCA intermediates were found to be altered in concentration.A mathematical model of glycolysis, TCA and glutaminolysis under normoxia and hypoxia was constructed through the amalgamation of two established models from the literature. New reactions, parameters and metabolite concentrations were added and unnecessary entities were deleted. COmplex PAthway SImulator (COPASI) was utilised to construct the model before validating the model using experimental data from the literature and steady state and flux analyses. Sensitivity analysis and a reduction in external glucose and glutamine were mimicked and the alterations in hypoxic and normoxic metabolism analysed. The reactions vCSII, vGS, vPGK and vGII were identified as potential therapeutic targets which may affect metabolism in hypoxia only. However, certain validation methods proved unsuccessful and hence the model requires further work before attempting the analyses again.

Magister Scientiae Dentium - MSc(Dent) / Oral epithelial dysplasia (OED) is a growth anomaly which occurs as a result of atypical, abnormal proliferation and a change in the architecture and cytological features of cells of epithelial origin, which ultimately results in the formation of a lesion with disturbed differentiation and maturation The purpose of this study was to describe the OED cases diagnosed at Tygerberg Oral health centre in a 7-year period between 2012 and 2019. The patients’ medical records from Tygerberg Oral Health Centre and National Health Laboratory Service (NHLS) were reviewed. All diagnosed cases of OED were identified and the data retrieved for further assessment and comparison. The individual medical records and follow up data were assessed. Seventy cases of OED were diagnosed in the period assessed. Of those 70 cases, the median age was 58 and the interquartile range was from 48 – 62. Thirty-six of the diagnosed patients were female and thirty-four were males. The majority of lesions diagnosed with OED were found on the tongue, floor of the mouth (FOM) and buccal mucosa. Majority of the lesions were found in non-smokers and non-alcohol consumers. These two categories both presented with mild cases of OED. From the results, it was derived that OED has no intra-oral location predilection. Moreover, OED is not directly associated with smoking.