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京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22115号 / 医博第4528号 / 新制||医||1039(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 松田 道行, 教授 武藤 学, 教授 小川 誠司 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Danial Alaei Faradonbeh, Natural drugs in the treatment and prevention of prostate diseases, Charles University in Prague, faculty of pharmacy in Hradec Králové, 2015, 86 pages. "Natural drugs in the treatment and prevention of prostate diseases" deals with prostate diseases which are some of the common ailments affecting men in different parts of the world. The etiology of prostate diseases has been identified but little progress has been witnessed as far as treatment is concerned. Of all prostate diseases identified so far, prostate cancer is the most common and affect me aged 40 and above. Prostate cancer affects the prostate gland and affects the normal function of other genitourinary tissues. Conventional prostate disease therapies have yielded minimal results, leading to increased calls for further research. Successful application of plants in the management of other conditions has attracted the interests of cancer researchers. Focus on a number of plants can provide the much needed reprieve and therapy against prostate cancer. Previous studies have identified a number of plants whose active component can act against cancer cells. Ficus pseudopalma, Nelumbo nuficera, Camptotheca acuminata, Rauvolfa vomitoria and Viscum album are some of the plants which have been identified to act against...

Prostate Cancer is one of the leading causes of male cancer related deaths. African American men who are diagnosed with this disease are over two times more likely to die from it than any other ethnic group. Even with this being a proven fact there are little to know studies that investigate why nor how to remedy the disparity. When a man begins the screening process and all the way until the beginning of treatment, the same guidelines are followed regardless of the patients’ ethnic background. This tactic has led to the developed of the disparity that: African American, even when diagnosed with prostate cancer of similar aggressiveness and receive the same treatments as other non-African American patients, are continuously found to have a less likely chance of survival. Despite all the research and the recurring disparity treatments are continued in the same manner. While the exact reasoning as to why African American males do not respond similarly to treatments as other ethnic groups remains unexplained. It could stem from internal differences, screening process, diagnosing methods, or the treatments themselves. Internal differences, like melanin levels, cannot be changed, but there are ways to circumvent these inevitable differences. Existing studies allow for parallels to be drawn about what effect these inevitable differences may have on the African American response to treatment methods; but clinical trials will need to be completed in order to determine if the parallels drawn hold any merit and if they have the ability to fix the disparity. Once those differences are understood, it will be time to conduct new research to determine if those changes are sufficient enough to eliminate the over two percent chance that African American men are more likely to die from a disease when compared to others.

acase@tulane.edu / 1 / Adedoyin Johnson

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Canagliflozin (CANA) is a sodium-glucose co-transporter 2 (SGLT2) inhibitor used for the treatment of type II diabetes. There is recent evidence suggesting that Canagliflozin has antiproliferative effects against malignant tumours. Canagliflozin is able to inhibit cell growth and cancer progression by inhibiting mitochondrial complex I leading to a reduction in cellular ATP levels. This alteration in the energy status of the cell leads to AMP-activated kinase (AMPK) activation, which in turn downregulates protein synthesis, lipogenesis and induces cell cycle arrest. The aim of this thesis is to explore whether Canagliflozin can be combined with radiation to enhance the outcome of radiation therapy in the treatment of prostate cancer and to further our knowledge on the cellular pathways impacted by Canagliflozin. Proliferation and clonogenic survival assays were used to establish the antiproliferative effect of Canagliflozin in vitro alone and when combined with radiation. Prostate cancer cell lines with different mutation profiles were used to assess the effectiveness of the drug under different radiation doses. A xenograft model was then used to test Canagliflozin’s effects in vivo. PC-3 cells were injected in the flank of balb/c nude mice. Mice were treated with Canagliflozin, radiation or a combined treatment and tumour growth was monitored. Furthermore, a western blot analysis of cells treated with Canagliflozin and radiation was performed to deepen our understanding of the cellular pathways affected by Canagliflozin. Our results show that Canagliflozin has an additive effect when combined with radiation. Canagliflozin was able to effectively downregulate the mTOR pathway, blocking mitosis and leading to cell cycle arrest. These findings provide evidence that Canagliflozin could be used as an adjunct to radiation therapy in clinical settings. / Thesis / Master of Science in Medical Sciences (MSMS) / Radiation therapy is a key therapy for prostate cancer. Although it is very effective at treating early stages of prostate cancer, prostate cancer cells develop resistance to radiation therapy rendering it less effective. One way to overcome this obstacle is by delivering higher doses of radiotherapy. However, this leads to increased side effects caused by radiation on normal tissues surrounding the prostate. An additional potential solution to this problem is administering a drug that can make cancer cells more sensitive to radiotherapy. This way we can deliver lower doses of radiation to avoid side effects while treating the disease. This study focuses on using a drug called Canagliflozin in combination with radiation in order to improve the outcomes of radiotherapy in prostate cancer.

The Gleason Score (GS) is a powerful predictor of outcome among prostate cancer patients. Patients with tumours graded with a GS of 2 to 6 have a much greater chance of survival compared to those with a GS of 8 to 10. A significant proportion (~40%) of men present with early stage GS 7 tumours (indicating intermediate risk) for whom prognosis is highly variable. Three gene signatures were derived from publicly available gene expression profiles of prostate cancers from the Swedish Watchful Waiting cohort: 1) The Genomic Grade Index consisted of the top 24 genes discriminating between high (8, 9 & 10) and low (≤ 6) GS tumours, 2) The Lethal Gene Score consisted of the top 24 genes discriminating between lethal and indolent disease within GS 7 tumours only, and 3) The network-based gene signature consisted of 88 genes. When these gene signatures were tested in silico on the gene expression profiles of GS 7 patients in both the SWW and the Mayo cohort, patients were stratified into high and low risk for recurrence. These results demonstrate that gene signatures are capable of differentiating low risk and high risk patients within GS 7 tumours. The prognostic capacity of our gene signature will be tested prospectively in a retrospective collection of archived prostate cancer tissue blocks from a phase 3 clinical trial, and it is hypothesized that the patients can be stratified into good and poor outcome groups. NanoString Technology will be used to quantify mRNA values for the signature genes on selected paraffin blocks. Expression values of candidate genes will be correlated with patients’ long-term follow-up information to derive a clinically meaningful signature. Outcome will be defined as biochemical recurrence or metastatic event. The goal of this study is to identify multiple genes whose expression could be formulated into a clinically applicable assay, the implementation of which could serve to better stratify intermediate risk prostate cancer patients for appropriate treatment. / Thesis / Master of Science (MSc) / The over-treatment of prostate cancer patients is a significant concern, as recent clinical trials has shown that it can lead to significant patient morbidity. Although the Gleason Scoring system is a powerful predictor of lethal or indolent disease, a significant proportion of men who present with early stage Gleason Score 7 tumours experience poorer prognosis than expected. The goal of this study is to develop and optimize a gene signature that can be utilized on Gleason Score 7, intermediate risk prostate cancer patients to differentiate them into good and poor outcome groups. We hypothesize that this signature will be able to accurately predict outcome in a separate retrospective cohort of prostate cancer patients. In short, our study hopes to provide proof-of-principle that through the use of gene signatures, it is possible to better differentiate prostate cancer patients into different outcome groups so that they may receive more appropriate treatment specific to their disease type.

Les antigènes testiculaires du cancer sont des cibles idéales pour l’immunothérapie du cancer car ce sont des protéines immunogéniques dont l’expression est restreinte aux cellules germinales et au cancer. Le but de cette étude est d’évaluer le potentiel de MAGE-A11, un antigène testiculaire du cancer, comme cible pour développer un vaccin contre le cancer de la prostate. Pour ce faire, l’anticorps monoclonal 5C4 qui a la capacité de reconnaître la présence de MAGE-A11 dans les tissus fixés et inclus en paraffine a été produit. De plus, l’expression de MAGE-A11 a été analysée sur plusieurs lignées de cellules cancéreuses. Il a été démontré que MAGE-A11 est exprimé dans plusieurs types de cancers notamment dans le cancer du côlon et du cerveau. Finalement, nous avons identifié trois épitopes du CMH classe II HLA-DR1 dans la protéine MAGE-A11 confirmant ainsi l’immunogénicité de cet antigène et son potentiel comme cible pour l’immunothérapie du cancer. / Cancer/testis antigens are ideal targets for cancer immunotherapy because of their limited expression in normal tissues, aberrant expression in malignancies and their immunogenic properties. The aim of this study was to evaluate the potential of cancer/testis antigen, MAGE-A11, as an immunotherapeutic target for development of a prostate cancer vaccine. To accomplish this, we produced the monoclonal antibody 5C4 that is capable of recognizing MAGE-A11 in formalin-fixed paraffin-embedded tissues. We also investigated the expression of MAGE-A11 in a wide variety of cancer cell lines to determine the scope of its expression in cancer. It was shown that MAGE-A11 is widely expressed in malignancies. The highest MAGE-A11 expression was observed in colon cancer and astrocytoma brain tumors. Finally, we identified three naturally processed MHC class II HLA-DR1 epitopes in MAGE-A11 protein, thus confirming its immunogenicity and its potential as a target for cancer immunotherapy.

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