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Emerging from potentially malignant disorders that in most cases will never become cancerous, head and neck squamous cell carcinoma (HNSCC) is a cancer that is extremely difficult to diagnose early. This late stage diagnosis has allowed limited improvements in overall survival (OS) as patients are prone to local recurrence, secondary primary tumors, and distant metastasis. As a result, it has become vitally important to assess the prognostic value of biological marker screening to provide an avenue for early diagnosis and identification of local recurrence or residual secondary tumor sites. Many characteristic markers such as EGFR, p16, p53 and VEGF that are constitutively mutated in HNSCC have been identified. However, the dysregulation of VEGF marks a landmark mutation that accelerates the diseases progression and spread. An angiogenic protein normally expressed in response to hypoxic conditions, VEGF allows the creation of new vasculature to remove catabolites and bestows resistance to normal cellular apoptotic signals; pathways often employed by chemotherapeutics. Therefore, early identification of VEGF poses a unique opportunity to employ aggressive therapeutic regimens in combination with precision surgical resection to eliminate the cancer before neovascualture invasion has occurred and the tumor has expanded significantly. For this reason, this review will examine the current literature available on VEGFs role in HNSCC, its value as a prognostic marker.

Abstract Bladder cancer when superficial has a good prognosis but it has a high recurrence risk and about 10–15% of the superficial carcinomas will progress into muscle invasive or metastatic type. The most powerful factor for predicting the behavior of bladder carcinoma is the stage of the tumor. Invasion to the lamina propria increases the risk of recurrence and progress to muscle-invasive tumor. Also grade of the tumor and tumor multiplicity associates with high risk for recurrence. New markers are still needed to find those patients who need more and better treatments to avoid the recurrence and progress. The need for new non-invasive markers to diminish the need for frequent cystoscopy in follow-up is also obvious. Gelatinases MMP-2 and MMP-9 are known to associate to tumor invasion and progression. Also their tissue inhibitors TIMP-1 and TIMP-2 take part in these diversified processes and metastasis formation. In the present work the expression and clinical value of gelatinases MMP-2 and MMP-9 and their tissue inhibitors TIMP-1 and TIMP-2 were evaluated in bladder carcinoma. Primary tissue samples of 121 patients were analyzed for expression of MMP-2 and/or MMP-9 using immunohistochemistry. The serum samples of 87 patients who were treated in the Oncology Department of Oulu University Hospital were collected and studied with ELISA. The control group consisted of 44 healthy volunteers. Overexperssion of MMP-2 protein correlated significantly to disease-specific survival and showed an independent prognostic value as a biomarker. High MMP-9 expression instead correlated to favorable overall survival of bladder cancer patients. Circulating proMMP-2, TIMP-2 and MMP-2:TIMP-2 complex levels were lower in cancer patients than in healthy volunteers in control group. High levels of all these three markers correlated with better prognosis in bladder cancer patients.

Abstract Traditional clinicopathological factors are not accurate enough to predict the behavior of head and neck squamous cell carcinoma (HNSCC). The most powerful indicator of prognosis is the stage of the disease. New prognostic markers have, however, been searched for in order to better identify patient groups in need of different treatments or follow-up. Gelatinases (MMP-2, -9) are endopeptidases associated with tumor invasion and angiogenesis, and their tissue inhibitors (TIMP-1, -2) are also linked to cancer cell invasion and metastasis formation. In some cancer types they are even prognostic and relate with a more aggressive clinical course of the disease. In the present work the expression and the clinical significance of tumor tissue and circulating immunoreactive proteins for MMP-2, -9, TIMP-1 and -2 were assessed in HNSCC. The study group included 74 patients with HNSCC and 44 healthy controls. The expression of immunoreactive proteins was examined in paraffin-embedded tumor sections by immunohistochemical staining using specific antibodies, and the pretreatment serum levels of those proteins were quantitatively measured by ELISA assay. Immunohistochemical overexpression of MMP-9 in tumor was for the first time found to predict the prognosis for shortened survival in HNSCC, the cause-specific survival rates being 45% and 92% and relapse-free survival being 42% and 79% in MMP-9 positive or negative cases, respectively. Additionally, tissue TIMP-1, MMP-2 and TIMP-2 positivity were all also linked with poorer survival of patients with HNSCC. However, these differences remained less distinct than with MMP-9. The expression of gelatinases and their inhibitors in tumor tissue was also an indicator for later lymph node or hematogenic relapses in HNSCC patients. Circulating MMP-9 and TIMP-1 levels were significantly higher in HNSCC patients than in healthy controls. Further, the cause-specific and relapse-free survival rates were lower among HNSCC patients with high MMP-9 and TIMP-1 serum levels compared to patients with low levels of circulating MMP-9 and TIMP-1. A significant correlation was shown between circulating MMP-9 and MMP-9 immunohistochemical staining in the corresponding tumors. No correlation was found between tissue or circulating levels of gelatinases or their inhibitors and the traditional clinical or histopathological factors, except for the association between tissue and circulating TIMP-1 and the size of the primary tumor. Taken together, these results suggest that tissue expression of gelatinases and their inhibitors as well as pretreatment circulating MMP-9 and TIMP-1 levels could be prognostic in estimation of the clinical course of HNSCC. The results indicate further studies are needed with larger patient materials.

L’immunothérapie se présente aujourd’hui comme une alternative de choix dans le traitement des cancers. Son objectif est d’amplifier la réponse immunitaire contre les cellules tumorales tout en préservant les cellules normales. Les travaux antérieurs de mon équipe ont démontré qu'une réponse immunitaire antitumorale a lieu dans les carcinomes bronchiques non à petites cellules (CBNPC) et que des lymphocytes T cytotoxiques (CTL) spécifiques peuvent contribuer à la régression de la tumeur. Les travaux de mon équipe ont démontré aussi que l’interaction de l’intégrine CD103, souvent exprimée sur les lymphocytes infiltrant la tumeur (TIL), avec son ligand, le marqueur des cellules épithéliales E-Cadhérine, à la surface des cellules tumorales, est nécessaire à la polarisation des granules cytotoxiques et leur exocytose pour déclencher la lyse de la cellule cible. L’objectif principal de mon projet de thèse est de déterminer la contribution réelle des lymphocytes T CD8+/CD103+ infiltrant les tumeurs épithéliales dans la réponse CTL antitumorale et le rôle de CD103 dans la régulation de leurs fonctions effectrices in situ. Dans un premier temps, j’ai caractérisé, sur le plan transcriptionel et phénotypique, les TIL de CBNPC humains. Mes résultats ont montré que les lymphocytes T CD8+/CD103+ présentent une signature moléculaire caractéristique des cellules T mémoires résidentes dans les tissues (TRM), avec une expression des récepteurs CD69 et CD45RO. Mes résultats ont montré aussi que cette population lymphocytaire co-Exprime les récepteurs inhibiteurs PD-1 et Tim-3. Dans un deuxième temps, j’ai étudié la fonctionnalité des TIL CD8+/CD103+ et le rôle de CD103 dans leur activité cytotoxique anti-Tumorale. Mes résultats ont d’abord indiqué que les lymphocytes T CD103+ sont plus sensibles à la mort cellulaire induite par activation (AICD) que les TIL CD103-, et qu’ils expriment le granzyme B et CD107a suite à une activation spécifique. De plus, ils sont capables d’exercer une activité cytotoxique spécifique à l’encontre des cellules tumorales autologues suite à la neutralisation de l’interaction de PD-1 avec son PD-L1, et que des anticorps anti-CD103 bloquants inhibe cette fonction. Ensuite, j’ai analysé l’impact de l’expression de CD103 à la surface des TIL sur la survie de patients atteints de CBNPC de stade 1. Mes résultats ont révélé que cette intégrine favorise l’infiltration des TIL dans les régions tumorales épithéliales et qu’une forte expression de CD103 sur les TIL corrèle avec une amélioration de la survie des patients. Enfin, J’ai examiné le rôle de CD103 dans cette fonction et dans la réponse immunitaire antitumorale in vivo. Mes résultats préliminaires ont montré une croissance tumorale retardée des tumeurs LL2 transfectées avec l’E-Cadhérine et CCL5 greffées dans les souris CD103-WT. De plus l’inhibition de cette croissance corrèle avec une infiltration plus importante des tumeurs avec des lymphocytes T CD8+/CD103+. Ces résultats suggèrent un rôle important de la coexpression de CCL5 et d’E-Cadhérine par la tumeur dans le recrutement et la rétention des CTL au site tumoral. L’ensemble de ces travaux est en faveur du rôle important de CD103 dans la régulation de l’immunité T CD8 dans les tumeurs épithéliales et de l’utilité des anticorps neutralisants anti-PD-1 et anti-Tim-3 pour inverser l'épuisement de cette population lymphocytaires CD8+/CD103+. / Today Immunotherapy is clearly an alternative choice in the treatment of cancers. Its main objective is to enhance the cytotoxic immune response against tumor cells while preserving normal cells. We have previously demonstrated that there is an antitumor immune response in the Non-Small-Cell lung carcinoma (NSCLC) and cytotoxic T lymphocytes (CTL) contribute to NSCLC tumor regression. We further showed that the CD103 integrin interaction (oftenly expressed on tumor infiltrating lymphocytes (TIL)) with its ligand, the epithelial cell marker E-Cadherin, expressed at the surface of tumor cells, is necessary for the polarization and exocytosis of TIL cytotoxic granules and to trigger the lysis of the tumor target cells. The main purpose of my thesis project is to determine the actual role/ contribution of CD8+/CD103+ T lymphocytes (infiltrating the epithelial tumors) in the regulation of antitumor CTL response and to study the role of CD103 in the regulation of their in situ effector functions. Firstly, TIL infiltrating human NSCLC were characterized at transcriptional and phenotypic level. My results show that CD8+/CD103+ T lymphocytes have a molecular signature characteristic of memory T cells resident in tissues (MRT), with expression of CD69 receptors and CD45RO. My results also showed that this cell population co-Expresses the inhibitory receptors, PD-1 and Tim-3.In a second step, I studied the functionality of CD8+/CD103+ TIL and the role of CD103 in the regulation of anti-Tumor cytotoxic activity. My results have first indicated that CD103+ TIL are more sensitive to activation induced cell death (AICD) than TIL-CD103- and CD103+ TIL express granzyme B and CD107a after specific activation. Furthermore, CD103+ TIL are able to exert a specific cytotoxic activity against autologous tumor cells following the neutralization of PD-1- PD-L1 interaction, and that of anti-CD103 antibody inhibits this blocking function. After, I analyzed the impact of the expression of CD103 on the surface of TIL on the survival of patients with NSCLC stage 1. My results revealed that this integrin promotes the infiltration of TIL in epithelial tumor regions and a strong expression of CD103 on TIL correlates with improved patient survival. Finally, I examined the role of CD103 in this function and the antitumor immune response in vivo. My preliminary results showed a tumor growth delay of LL2 tumors transfected with E-Cadherin and CCL5 grafted in CD103-WT mice. Furthermore inhibition of growth correlates with a higher tumor infiltrating with CD8+/CD103+ T lymphocytes. These results suggest an important role of the coexpression of CCL5 and E-Cadherin by the tumor in the recruitment and retention of CTL at the tumor site. The whole work supports the role of CD103 in regulating the CD8 T cells-Mediated immune response in epithelial tumors and the usefulness of anti-PD-1 neutralizing and anti-Tim-3 for reversing the depletion of this lymphocyte population CD8+ / CD103+.

<p>In the demyelinating autoimmune disease multiple sclerosis (MS) there is a great need for validated prognostic biomarkers that can give information about both prognosis and disease course. So far only clinical parameters have been shown to predict future outcome. CXCL13 is a potent B cell chemoattractant that has been suggested to be a potential biomarker candidate. The aim of this study was to investigate the usefulness of CXCL13 as a prognostic biomarker for MS.</p><p>Clinical, paraclinical, laboratory and MRI data about a large group of MS patients and controls were collected. CXCL13 levels in cerebrospinal fluid (CSF) samples from these patients were determined by standard enzymelinked immunosorbent assay (ELISA).</p><p>In general CXCL13 were increased in CSF in MS, especially in relapsing-remitting MS during relapses, i.e. with ongoing inflammations in the central nervous system. CXCL13 is a good candidate prognostic marker for MS, since newly diagnosed MS with high CXCL13 levels showed worsened disease course within five years. Most importantly, MS conversion occurred in higher rate in possible MS patients with high concentrations of CXCL13 in CSF, and in a shorter time point. This observation may support an early treatment decision in these patients.</p><p>In conclusion, this study provides support for an association between CXCL13 levels in the CSF and later development of disease severity in MS.</p>

Circulating tumor cells (CTCs) represent a systemic phase of the localised cancer disease. They can be distinguished and enriched from the peripheral blood and so from the surrounding leukocytes by either physical properties (e.g., density and size) or biological properties (e.g., expression of epithelial proteins such as EpCAM or cytokeratins) and are usually further characterized by immunostaining or RT-PCR assays. Selecting patients with the risk of disease relaps at the time of diagnosis is crucial for clinicians in deciding who should, and who should not, receive adjuvant chemotherapy. We know that CTCs are strong prognostic factor in patients with metastatic as well as localized breast cancer (BC). It is also known that the prognostic power of circulating tumor cells in women with BC is independent from the standard prognostic indicators. Testing of CTCs known recently as "liquid biopsy" could be informative not only as predictor of the disease relapse, but also as the predictor of therapy effectiveness. The clinical use of CTCs must be strictly encouraged by clinical trials results. Monitoring of CTCs in time could zoom in the mechanism of therapy resistance and/or may provide the identification of new druggable targets. The purpose of my work was therefore to assess the CTCs positivity rate...

Abstract Breast carcinoma is a heterogeneous disease with a prognosis that varies from excellent to very poor. Traditional tumour parameters and biological factors that are also predictive for treatment response are used in determining breast carcinoma prognosis and selecting appropriate treatment. Gelatinases MMP-2 and MMP-9 have been shown to associate with tumour progression. Their tissue inhibitors TIMP-1 and -2 are multifunctional molecules that have been suggested as prognostic markers in some previous reports. In the present work, the expression and prognostic value of gelatinases MMP-2 and MMP-9 and their tissue inhibitors TIMP-1 and -2 were assessed in primary breast carcinoma. The material consisted of a total of 416 patients. Tissue expression of TIMP-1 and -2 was analysed in a population of 203 patients using immunohistochemistry. Circulating gelatinases and their inhibitors were studied using ELISA in two different populations of 71 at preoperative state and 213 patients at pre- and postoperative state. High expression of TIMP-1 immunoreactive protein positively correlated with high histological grade of the tumour and associated with aggressive disease course in grade 2–3 subpopulation. High preoperative plasma TIMP-1 was prognostic for relapse in a modern patient series after a median follow-up time of 18 months. TIMP-1 as a continuous variable was prognostic in Cox regression univariate analysis, and was an independent prognostic variable superior to nodal status in multivariate analysis. High preoperative serum TIMP-1 was an independent prognostic variable for poor disease-specific survival, and TIMP-1 was found to maintain its prognostic value when assessed independently with different ELISA analyses, and was not very sensitive for preanalytical conditions. In addition, low circulating preoperative serum MMP-2 was observed to associate with high stage and positive nodal status in breast carcinoma. These results indicate that circulating TIMP-1 may be a potential new marker of worsened prognosis in breast carcinoma, although careful validation of assay platforms and identification of the sources of physiological variation are needed before it can be adopted into clinical decision-making.

Charles University Faculty of Pharmacy in Hradec Králové Department of Biological and Medical Sciences Student: Zuzana Drobná Supervisor: PharmDr. Miroslav Kovařík, Ph.D. Title: Dynamometry as a prognostic and prediction marker Dynamometry is a method for measuring muscle strength. It is one of the methods of biomechanical motion analysis. There are two types of dynamometry. Isokinetic dynamometry is based on isokinetic muscle contraction. In this contraction, the muscles change their length. Isometric dynamometry is based on isometric muscle contraction. The length of the muscle does not change during the contraction. In my master thesis, 22 studies were included. Of this, 18 were engaged in a dynamometer, which measured muscle strength. Studies have been focused on prediction of short and long-term mortality, prognosis of hospitalized and severely ill patients, prediction of disease symptoms (cancer, chronic obstructive pulmonary disease, liver disease). I searched for studies according to the PubMed database. In 16 studies, it was confirmed that dynamometry can be used in the present time as a reliable diagnostic, predictive and prognostic method. Dynamometry is characterized as a simple, objective, non-invasive, easily transposable and reproducible method. Keywords: dynamometer, muscle...

Background: Glioblastoma multiforme (GBM) is the most common and aggressive brain tumor with poor clinical outcome. Identification and development of new markers could be beneficial for the diagnosis and prognosis of GBM patients. Deregulation of microRNAs (miRNAs or miRs) is involved in GBM. Therefore, we attempted to identify and develop specific miRNAs as prognostic and predictive markers for GBM patient survival.Methods: Expression profiles of miRNAs and genes and the corresponding clinical information of 480 GBM samples from The Cancer Genome Atlas (TCGA) dataset were downloaded and interested miRNAs were identified. Patients' overall survival (OS) and progression-free survival (PFS) associated with interested miRNAs and miRNA-interactions were performed by Kaplan-Meier survival analysis. The impacts of miRNA expressions and miRNA-interactions on survival were evaluated by Cox proportional hazard regression model. Biological processes and network of putative and validated targets of miRNAs were analyzed by bioinformatics.Results: In this study, 6 interested miRNAs were identified. Survival analysis showed that high levels of miR-326/miR-130a and low levels of miR-323/miR-329/miR-155/miR-210 were significantly associated with long OS of GBM patients, and also showed that high miR-326/miR-130a and low miR-155/miR-210 were related with extended PFS. Moreover, miRNA-323 and miRNA-329 were found to be increased in patients with no-recurrence or long time to progression (TTP). More notably, our analysis revealed miRNA-interactions were more specific and accurate to discriminate and predict OS and PFS. This interaction stratified OS and PFS related with different miRNA levels more detailed, and could obtain longer span of mean survival in comparison to that of one single miRNA. Moreover, miR-326, miR-130a, miR-155, miR-210 and 4 miRNA-interactions were confirmed for the first time as independent predictors for survival by Cox regression model together with clinicopathological factors: Age, Gender and Recurrence. Plus, the availability and rationality of the miRNA-interaction as predictors for survival were further supported by analysis of network, biological processes, KEGG pathway and correlation analysis with gene markers.Conclusions: Our results demonstrates that miR-326, miR-130a, miR-155, miR-210 and the 4 miRNA-interactions could serve as prognostic and predictive markers for survival of GBM patients, suggesting a potential application in improvement of prognostic tools and treatments.