University of Macau / Faculty of Health Sciences

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Every year more than 10 million people develop cancers globally. Ovarian cancer, specifically, results in more than 22,000 new cases and 16,000 deaths from this disease yearly, more than any other cancer of the female reproductive system. In addition, because of non-specific symptoms and poor screening techniques, most ovarian cancer cases are discovered after the disease is in an advanced state. Consequently, aggressive and effective treatment options that incur minimal toxic effects to healthy tissue are in great need. In the present research, stealth biodegradable nanoparticles were developed as vehicles for the controlled and targeted delivery of chemotherapeutic agents for the treatment of ovarian cancer. The design of this delivery system consisted of nanoparticles of biodegradable polymers of the poly(lactic-co-glycolic acid) family loaded with the chemotherapeutic agent doxorubicin or the imaging agents rhodamine 6G, indocyanine green or gadopentetic acid. Nanoparticles were modified by incorporation of functional poly(ethylene glycol) on their surface to improve the stability of the colloidal suspension, increase their circulation lifetime in vivo, and provide a site for conjugation of targeting agents specific to ovarian tissue. Various methods were evaluated for this surface modification, including the use of polymer blends, the chemical conjugation of the polymers, and the polymerization of lactide and glycolide monomers initiated by heterofunctional poly(ethylene glycol). Nanoparticles incorporating poly(ethylene glycol) presented improved characteristics compared to unmodified particles including smaller size, higher stability and slower release of the chemotherapeutic agent doxorubicin The actual drug or agent content was decreased in the case of doxorubicin and rhodamine, but increased for indocyanine green as a result of improved agent-polymer interactions. Poly(ethylene glycol)-containing nanoparticles were conjugated to monoclonal antibody mAb106-105, which is specific to the extracellular domain of human folliclestimulating hormone (FSH) receptors. These receptors are only expressed in ovarian cells in women, thus providing a system that is highly specific to ovarian tissue. The interaction and therapeutic potential of nanoparticles with or without targeting antibodies were tested on OVCAR-3, Caov-3, and MDA-MB-231 cancer cells.

Purpose: Control of micrometastatic ovarian cancer in the peritoneal cavity remains a major objective in post-surgical treatment. The purpose of this project was to investigate the efficacy and toxicity of targeted alpha therapy (TAT) for ovarian cancer in vitro and in vivo in animal models and to select the optimal targeting vector for an ovarian cancer clinical trial. Animal models of ovarian, breast and prostate cancer were developed and for further TAT; a phase I melanoma clinical trial was supported, paving the way for an ovarian cancer clinical trial. Methods: The expression of the turnor-associated antigens (Her2, MUC1, uPAfuPAR) on cancer cell line, animal model xenografts and human ovarian cancer tissue was tested by immunostaining. MTS and TUNEL assays were used to evaluate cell killing of alpha conjugates in monolayer and spheroids. Toxicity and maximum tolerance doses for different vectors were tested and determined in vivo. Pharmacokinetics was studied for different time points and different parameters. The antiproliferative effect of 213Bi-C595 and 213Bi-PAI2 was tested at 9 days post-peritoneal cell inoculation of the ovarian cancer cell line OVCAR3. The treatment efficacy of 213Bi-Herceptin was tested at a 2 days post-subcutaneous breast cancer cell BT474 inoculation. Mice were injected (i.p) with various concentrations of alpha conjugates (AC). Changes in cancer progression were assessed by girth size and tumor size. Results: uPA/uPAR and MUCI are expressed on ovarian cancer cell lines and more than 45% ovarian cancer tissue, while HER2 was only positive in one cell line and was positive in less than 15% of ovarian cancer tissues. The ACs can target and kill cancer cells in vitro in a dose dependent fashion. TUNEL positive cells were found after incubation with the different ACs. PAI2 and C595 vectors were selected for in vivo ascites model study of OVCARJ cell with high expression. Delayed and acute toxicity in animal models showed that radiation nephropathy was the cause of body weight loss. Biodistribution studies showed that kidney was the major uptake organ. L-lysine can reduce kidney uptake for 213Bi-PAI2, but no significant differences were found. A single ip injection of 213Bi-C595 or 213Bi-PAI2 can inhibit ascites growth, whereas, 213Bi-Herceptin can inhibit breast cancer growth in a nude mice model. Conclusion: 213Bi labelled targeting vectors can specifically target ovarian cancer cells in vitro and inhibit tumor growth in vivo. These ACs may be useful agents for the treatment of ovarian cancer at the minimum residual disease stage.

Made available in DSpace on 2015-03-03T11:52:48Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-02-24Bitstream added on 2015-03-03T12:07:01Z : No. of bitstreams: 1 000807311.pdf: 1576554 bytes, checksum: 8c98005febc992a7fec3f6de5d99dd6a (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo á Pesquisa do Estado de Minas Gerais (FAPEMIG) / Fundação Oswaldo Cruz (FIOCRUZ) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / O câncer epitelial de ovário representa um desafio para Oncologia Ginecológica, devido à sua natureza insidiosa e alta mortalidade. Há também uma compreensão limitada da etiologia da doença ao nível molecular, o que continua a dificultar o desenvolvimento de alvos terapêuticos. Estudos recentes de morfologia, imuno-histoquímica e de genética molecular têm levado ao desenvolvimento de um novo paradigma para a patogênese e a origem do câncer epitelial de ovário, baseado em um modelo dualista de carcinogênese que divide o câncer epitelial de ovário (CEO) em duas grandes categorias chamadas de tipos I e II. O objetivo deste estudo foi avaliar o padrão das citocinas e quimiocinas encontradas no tecido ovariano de mulheres saudáveis e mulheres com CEO tipo I e tipo II. Além disso, descrever a associação desses biomarcadores com os dados clínico-patológicos. Foram analisadas amostras de tecido ovariano e ascite obtidas de mulheres com CEO (n=26) e amostras de tecido ovariano e lavado peritoneal de mulheres sem evidências de malignidade (n=16 - grupo de controle). Nas amostras de tecido, a expressão gênica foi avaliada utilizando a metodologia de PCR quantitativo em tempo real (qPCR) para os genes IFNG, IL-10, TGFB1, CCL2, CCL3, CCL5, CXCL8, CXCL9 e CXCL10. A detecção dos níveis de citoquinas/quimioquinas nos fluidos peritoneais foi realizada através do método Cytometric Bead Array (CBA) os marcadores IL-12p70, TNF, IL-10, IL-6, IL-1--8, IL-17A, IFN-IL-4, IL-2, CCL2, CCL5, CXCL-9 e CXCL-10. No grupo das pacientes com CEO, 10 (38,5%) apresentavam estágios I/II e 16 (61,5%) estágios III/IV. Com relação ao tipo de tumor, de acordo com a nova classificação, 8 (30,8%) eram do tipo I e 18 (69,2 %) do tipo II. A citorredução ótima foi obtida em 15 (57,7%) das mulheres com CEO. Mulheres com CEO tipo II apresentaram maiores níveis séricos do marcador CA-125 quando comparado às do tipo I. Não houve óbito no grupo ... / The epithelial ovarian cancer represents a challenge to Gynecologic Oncology due to its insidious nature and high mortality. There is also a limited understanding of disease etiology at the molecular level, which continues to hamper targeted therapeutic development. Recent morphological, immunohistochemical, and molecular genetic studies have led to the development of a new paradigm for the pathogenesis and origin of epithelial ovarian cancer based on a dualistic model of carcinogenesis that divides epithelial ovarian cancer into 2 broad categories designated types I and II. The aim of this study was to evaluate the cytokines and chemokines pattern in ovarian tissue from healthy women and women with EOC type I and type II. Also, we described the association of these biomarkers with the clinicopathological data. Samples of ovarian tissue and ascite obtained from women with EOC (n=26), samples of ovarian tissue and peritoneal wash from women with no evidence of malignancy were analyzed (n=16 – control group). In the tissue samples, gene expression were evaluated by quantitative real time PCR (qPCR) IFNG, IL-10, TGFB1, CCL2, CCL3, CCL5, CXCL8, CXCL9 and CXCL10. The detection of cytokine/chemokine levels in peritoneal fluids was measured by cytometric bead array immunoassay (CBA), IL-12p70, TNF, IL-10, IL-6, IL-1--8, IL-17A, IFN--4, IL-2, CCL2, CCL5, CXCL-9 and CXCL-10. In the group of women with EOC, 10 (38.5 %) had stage I/II and 16 (61.5 %) were stage III/IV . Concerning tumor type , according to the new classification, 8 (30.8 %) were type I and type II were 18 ( 69.2 % ) . Optimal cytoreduction was achieved in 15 (57.7 %) women with EOC. The CA-125 showed higher serum levels in patients with EOC type II compared to type I. There were no deaths in women with type I tumor while 6 (33.3 %) of patients with type II tumor died . Increased expression of IL-10, CXCL8 and CXCL9 genes in the group of women

Orientador: Agnaldo Lopes da Silva Filho / Coorientador: Andréa Teixeira de Carvalho / Resumo: O câncer epitelial de ovário representa um desafio para Oncologia Ginecológica, devido à sua natureza insidiosa e alta mortalidade. Há também uma compreensão limitada da etiologia da doença ao nível molecular, o que continua a dificultar o desenvolvimento de alvos terapêuticos. Estudos recentes de morfologia, imuno-histoquímica e de genética molecular têm levado ao desenvolvimento de um novo paradigma para a patogênese e a origem do câncer epitelial de ovário, baseado em um modelo dualista de carcinogênese que divide o câncer epitelial de ovário (CEO) em duas grandes categorias chamadas de tipos I e II. O objetivo deste estudo foi avaliar o padrão das citocinas e quimiocinas encontradas no tecido ovariano de mulheres saudáveis e mulheres com CEO tipo I e tipo II. Além disso, descrever a associação desses biomarcadores com os dados clínico-patológicos. Foram analisadas amostras de tecido ovariano e ascite obtidas de mulheres com CEO (n=26) e amostras de tecido ovariano e lavado peritoneal de mulheres sem evidências de malignidade (n=16 - grupo de controle). Nas amostras de tecido, a expressão gênica foi avaliada utilizando a metodologia de PCR quantitativo em tempo real (qPCR) para os genes IFNG, IL-10, TGFB1, CCL2, CCL3, CCL5, CXCL8, CXCL9 e CXCL10. A detecção dos níveis de citoquinas/quimioquinas nos fluidos peritoneais foi realizada através do método Cytometric Bead Array (CBA) os marcadores IL-12p70, TNF, IL-10, IL-6, IL-1--8, IL-17A, IFN-IL-4, IL-2, CCL2, CCL5, CXCL-9 e CXCL-10. No grupo das pacientes com CEO, 10 (38,5%) apresentavam estágios I/II e 16 (61,5%) estágios III/IV. Com relação ao tipo de tumor, de acordo com a nova classificação, 8 (30,8%) eram do tipo I e 18 (69,2 %) do tipo II. A citorredução ótima foi obtida em 15 (57,7%) das mulheres com CEO. Mulheres com CEO tipo II apresentaram maiores níveis séricos do marcador CA-125 quando comparado às do tipo I. Não houve óbito no grupo... / Abstract: The epithelial ovarian cancer represents a challenge to Gynecologic Oncology due to its insidious nature and high mortality. There is also a limited understanding of disease etiology at the molecular level, which continues to hamper targeted therapeutic development. Recent morphological, immunohistochemical, and molecular genetic studies have led to the development of a new paradigm for the pathogenesis and origin of epithelial ovarian cancer based on a dualistic model of carcinogenesis that divides epithelial ovarian cancer into 2 broad categories designated types I and II. The aim of this study was to evaluate the cytokines and chemokines pattern in ovarian tissue from healthy women and women with EOC type I and type II. Also, we described the association of these biomarkers with the clinicopathological data. Samples of ovarian tissue and ascite obtained from women with EOC (n=26), samples of ovarian tissue and peritoneal wash from women with no evidence of malignancy were analyzed (n=16 - control group). In the tissue samples, gene expression were evaluated by quantitative real time PCR (qPCR) IFNG, IL-10, TGFB1, CCL2, CCL3, CCL5, CXCL8, CXCL9 and CXCL10. The detection of cytokine/chemokine levels in peritoneal fluids was measured by cytometric bead array immunoassay (CBA), IL-12p70, TNF, IL-10, IL-6, IL-1--8, IL-17A, IFN--4, IL-2, CCL2, CCL5, CXCL-9 and CXCL-10. In the group of women with EOC, 10 (38.5 %) had stage I/II and 16 (61.5 %) were stage III/IV . Concerning tumor type, according to the new classification, 8 (30.8 %) were type I and type II were 18 ( 69.2 % ) . Optimal cytoreduction was achieved in 15 (57.7 %) women with EOC. The CA-125 showed higher serum levels in patients with EOC type II compared to type I. There were no deaths in women with type I tumor while 6 (33.3 %) of patients with type II tumor died . Increased expression of IL-10, CXCL8 and CXCL9 genes in the group of women / Doutor

[Truncated abstract] Ovarian cancer is currently the leading cause of death from gynaecological malignancies in women from developed countries. Serous ovarian cancer is the most prevalent type of all ovarian cancers, with the majority diagnosed in an advanced stage where treatment efficacy is reduced and patient survival is poor. Because of this fact, the development of improved detection and treatment strategies are necessary, with much research focussing on the complex molecular pathways involved in ovarian tumour growth as one potential avenue for intervention. Apoptosis, or programmed cell death, is one such area of investigation because currently successful cancer treatments induce apoptosis in tumour cells. Molecular analysis of apoptosis in both normal tissue and tumours has established a positive relationship between increased expression of secreted frizzled-related protein 4 (SFRP4) and apoptosis, however to date, very little research has focussed on the role of this gene in the ovary . . . An examination of SFRP4 and β-catenin expression in 163 primary serous ovarian carcinomas revealed high SFRP4 expression was associated with low β-catenin expression and conversely, low SFRP4 was associated with high β-catenin expression in the majority of the ovarian tumours analysed, reinforcing the inverse relationship observed in the ovarian cell lines. A positive trend was observed between cancer stage and the expression level of these proteins, with increased SFRP4 expression and reduced β-catenin expression as cancer stage increased. Additionally, patient survival revealed a trend towards increased survival among ovarian cancer patients who had tumours expressing low levels of SFRP4. Taken together, the novel findings of this study indicate that the increased expression of SFRP4 observed in a large proportion of serous ovarian cancers is a cellular response to down-regulate the level of β-catenin, and thus an attempt to maintain cellular homeostasis by counteracting the excessive proliferating signals present in these tumour cells.