Made available in DSpace on 2014-07-29T15:21:58Z (GMT). No. of bitstreams: 1 Dissertacao parte1 Larissa Santana Arantes Elias.pdf: 1237563 bytes, checksum: 572e0535bd8ddf8a3d9cd5c693a6aa5f (MD5) Previous issue date: 2010-03-19 / The RANK (receptor activator of nuclear factor Kappa-Beta)-RANKL (receptor activator of nuclear factor-kappa beta ligand)-OPG (osteoprotegerin) system is the principal means of differentiating and activating osteoclasts. Changes along this path have been associated with various bone related lesions (BRL), whether benign or malignant, such as osteosarcoma (OS). This system induces resorption when it is deregulated, and in the case of LROs, by replacing the bone tissue for fibrous tissue with the presence of various forms of ossification. And in this same context another protein, osteocalcin (OC), a marker of late ossification, plays a key role in the diagnosis of these lesions. This being so, the objective of this study was to identify, quantify and compare cell RANK+, RANKL+, OPG+ and OC+ in lesions of the jaw with bone involvement: ossifying fibroma (OF), fibrous dysplasia (FD), simple bone cysts (SBC), central giant cell lesions (CGCL) and osteosarcoma (OS) so as to contribute to understanding the pathogenesis and establishing the diagnosis of these lesions. RANK+, RANKL+, OPG+ and OC+ cells were identified by the technique of immunohistochemistry, a method of immunoperoxidase and polymer, in 10 samples of OF, FD, SBC, CGCL and 5 samples of OS. Our results showed that all samples were positive for RANK, RANKL, OPG and OC. In the stromal fibroblast-like cells, the OF (P<0.001), CGCL (P=0.007) and OS (P=0,058) presented a greater expression of RANKL than OPG, in contrast with both the SBC (P=0.003) and the FD (P<0.001). As for bone-matrix (cells around bone/osteoid-osteoblast and osteoclast), the OS (P=0.24) and OF (P=0.001) samples demonstrated a higher RANKL immunoreactivity and and a lower in FD (P=0.001) and SBC (P=0.4) samples. In terms of OC, a higher expression was shown in FD, SBC, and OS (P=0.008). Our results suggest that OF, CGCL and OS express bone metabolism regulators, which may be related to increased bone resorption in these lesions. In addition, osteoblastic involvement was seen in FD and OS. Note: The superscript + is where it appears. Programs to copy some formatting errors. / O sistema RANK (receptor activator of nuclear factor Kappa-Beta)-RANKL (receptor activator of nuclear factor-kappa beta ligand)-OPG (osteoprotegerin) constitui uma das principais vias de diferenciação e ativação dos osteoclastos e alterações nessa via tem sido associadas a diversas lesões relacionadas ao osso (LRO), benignas e maligna como no osteossarcoma (OS). Esse sistema quando desregulado induz reabsorção, e no caso das LROs, através da substituição do tecido ósseo por um tecido fibroso com a presença de várias formas de ossificação. E nesse contexto outra proteína, a osteocalcina (OC), que é um marcador tardio de ossificação, desempenha um papel fundamental no diagnóstico destas lesões. Portanto, o objetivo do presente estudo foi identificar, quantificar e comparar células RANK+, RANKL+, OPG+ e OC+ em lesões dos maxilares com envolvimento ósseo: fibroma ossificante (FO), displasia fibrosa (DF), cisto ósseo simples (COS), lesão central de células gigantes (LCCG) e osteossarcoma (OS). As células RANK+, RANKL+, OPG+ e OC+ foram identificadas pela técnica da imunoistoquímica, método da imunoperoxidase e do polímero, em 10 amostras de FO, DF, COS, LCCG e 5 amostras de OS. Quando comparado as lesões entre si, tanto nas células fibroblásticas estromais quanto da matriz óssea, nossos resultados demonstraram que os ativadores da reabsorção óssea (RANK/RANKL) apresentam uma maior expressão no FO e LCCG e, o inibidor da reabsorção (OPG) e a OC apresentaram maior na DF e COS. Em adição, nossos achados revelam que o OS apresenta alta expressão de todas as proteínas avaliadas, quando comparadas àquelas das LROs. Todavia, uma maior expressão de RANKL em relação à OPG e OC foi evidenciada nesta neoplasia. Nossos resultados sugerem que o FO, a LCCG e o OS expressam reguladores do metabolismo ósseo que podem estar relacionados com a reabsorção óssea aumentada nessas lesões, sendo que na DF e no OS foi observado envolvimento osteoblástico. OBS: A + está sobrescrita onde aparece. Programas copiam com erros certas formatações.

O diabete melito é uma doença metabólica com alta prevalência na população e quando no estado descompensado pode causar diversas complicações metabólicas e clínicas, entre elas a osteoporose. Entretanto, ainda não foram completamente esclarecidos os mecanismos pelos quais o diabete diminui a densidade mineral óssea e aumenta o risco a fraturas. Recentemente foram descritos alguns genes que estão envolvidos no turnover ósseo: OPG, RANK e RANKL. Além disso, o uso de hipoglicemiantes orais como as tiazolidinedionas (TZD), pode influenciar negativamente o metabolismo ósseo. Com a finalidade de identificar marcadores sensíveis de alteração do metabolismo ósseo foram investigadas as relações entre a expressão dos genes OPG, RANK e RANKL em células do sangue periférico e a resposta a TZDs em pacientes com DM2. Foram selecionados 52 indivíduos (36 diabéticos e 16 normoglicêmicos), no Instituto Dante Pazzanese de Cardiologia. Os indivíduos diabéticos foram tratados com pioglitazona (15, 30 e 45 mg/ dia/ via oral) por 16 semanas. Foram colhidas amostras de sangue, antes e após o tratamento para determinação de exames laboratoriais e extração de RNA total. A expressão de mRNA dos genes OPG, RANK e RANKL foi quantificada e avaliada por RT-PCR em tempo real, empregando-se o GAPD como controle endógeno. Observou-se que nos pacientes DM2 após o tratamento com pioglitazona, houve diminuição da glicemia de jejum, glicemia pós-prandial, insulina, Hb1Ac, índices HOMA-IR e HOMA-&#946; e aumento nas concentrações séricas de HDL, demonstrando a eficácia do tratamento. Ao comparar a expressão dos genes entre o grupo DM2 (sem tratamento) e o grupo normoglicêmico (NG), foi evidenciado um aumento da expressão de OPG no grupo NG em relação ao grupo DM2, e ao analisar a expressão entre as mulheres, constatou-se aumento da expressão de RANK no grupo DM2 em relação ao grupo NG. Além disso, ao correlacionar a expressão dos genes com as dosagens dos parâmetros bioquímicos, constatou-se que o aumento da expressão de RANK e RANKL está relacionado com o aumento das concentrações de cálcio ionizado e diminuição da expressão de OPG. Esses dados sugerem que a atividade osteoclástica está aumentada nos pacientes DM2 e com o tratamento o quadro osteoporótico pode ser agravado. / The diabetes mellitus is a metabolic disease with high prevalence in the population and can cause various metabolic and clinic complications, including osteoporosis, when it is decompensated. However, the mechanisms by which diabetes decreases bone mineral density and increases the risk of fractures are not completely clarified. Recently some genes which are involved in bone turnover were described: OPG, RANK and RANKL. Moreover, the treatment using oral hypoglycemic drugs such as thiazolidinediones (TZD), may negatively affect the bone metabolism. In order to identify sensitive markers related to the bone metabolism, were investigated the relationship between the expression of genes OPG, RANK and RANKL in peripheral blood leukocytes and the response to TZDs treatment in patients with DM2. Fifty-two individuals were selected (36 diabetics and 16 normoglycemics) at Dante Pazzanese Institute of Cardiology. Diabetic patients were treated with pioglitazone (15, 30 and 45 mg I day I oral) during 16 weeks. Blood samples were collected for biochemical analyses and total RNA extraction, before and after treatment. Gene expression of the genes OPG, RANK and RANKL in peripheral blood mononuclear cells was evaluated by Real Time PCR, using the GAPD housekeeping gene as the endogenous reference. In DM2 patients after treatment with pioglitazone there was reduction in their fasting glycemia, postprandial glycemia, insulin, Hb1Ac, HOMA-IR and HOMA-&#946; indices, and their serum concentrations of HDL increased, which demonstrates the effectiveness of the treatment. The bone profile markers have not altered after treatment, suggesting an anabolic action of the insulin in bone metabolism of these patients. Normoglycemics (NG) group gene expression, when compared with DM2 group (with no treatment), had increased OPG expression. Besides, RANK expression in group DM2 was higher than NG group when it was analyzed among women. Furthermore, having correlated the expression of the genes with the biochemical parameters data, the increase on RANK and RANKL gene expression is related to increased concentrations of ionized calcium and to decreased expression of OPG gene. These results are suggestive that osteoclastic activity is higher in DM2 patients, the treatment can exacerbate osteoporosis severity and the bone markers does not have enough sensibility to differentiate changes in individuals with type 2 diabetes mellitus.

Paget’s disease (PDB) is the second most common metabolic bone disease after osteoporosis, affecting up to 3% of adults over age 55. It is characterized by focal lesions of bone resorbed by hyperactive osteoclasts coupled with rapid formation of highly disorganized, low quality bone formed by osteoblasts. Such lesions cause skeletal deformity, fractures, and other symptoms that significantly decrease quality of life. In 2001, mutations in the SQSTM1/p62 gene were found in a subset of Paget’s patients. The work summarized in this dissertation sought to answer two broad questions: what is the function of p62 in normal bone homeostasis and how do PDB-associated mutations alter it? These studies took advantage of two mouse models: p62 knock-out (KO) mice, and p62P394L “knock-in” (KI) mice carrying the most common PDB-associated mutation. KO, KI, and wildtype (WT) controls were aged to one year for skeletal-histological characterization. No differences were observed in a variety of bone parameters between WT and KO bones, while bones from age-matched KI mice exhibited a 33% decrease in bone volume and a 25% increase in osteoclast formation. In vivo, TNF-α caused a potent induction of osteoclastogenesis in calvariae of WT and KI, but not KO, mice. In vitro, RANKL induced osteoclast formation in a dose-dependent manner in WT and KI, but not KO, cultures. Gene expression profiling of RANKL-treated osteoclast progenitors from WT, KO, and KI mice was then performed to identify the changes in signaling pathways responsible for these effects. Surprisingly, gene expression patterns from all three groups were consistent with robust activation of NFκB signaling in RANKL-treated samples, indicating that p62 is dispensable for RANKL activation of NFκB. Interestingly, gene expression patterns in KO cells suggested impaired proliferation and response to reactive oxygen species (ROS), a finding which was confirmed in cell culture experiments. In contrast, KI cells displayed enrichment for genes associated with the unfolded protein response, consistent with p62’s role in ubiquitin-mediated protein degradation via proteolysis and autophagy. These studies have therefore generated several novel hypotheses concerning the role of p62 in both normal bone homeostasis and Paget’s disease of bone.

Tese de mestrado integrado. Bioengenharia. Faculdade de Engenharia. Universidade do Porto. 2012

Despite significant advances in diagnosis and treatment, breast cancer remains the leading cause of cancer-related deaths in Australian women. Colorectal cancer is the second most common cancer in both males and females; after prostate and breast cancer, respectively, and excluding non-melanocytic skin cancer. Both breast cancer and colorectal cancer follow a common progressive course of illness; presenting (at least initially) with benign symptoms that can be treated by ablation (or removal) of the affected area. Cancer progression is associated with breakdown of tissue barriers (such as basement membranes), leading to the spread of cancer cells (via the vasculature or lymphatic system), and the establishment of secondary metastatic disease at green-field sites. Secondary tumours presenting in the lungs, ovaries, liver, bone, or brain are associated with chronic-debilitating symptoms that are difficult to treat, and will result in death. In the case of breast and colon cancer, effective early therapeutic intervention does have a significant impact upon patient survival. Tumour progression in breast and colon carcinomas is characterised by invasion of the surrounding stroma, and the acquisition of stromal characteristics, by previously epithelial cells. This progression is associated with the expression of extracellular proteases (ECPs) and increased motility. The process of mesenchymal transformation that tumour cells undergo is also referred to as the epithelial to mesenchymal transition (EMT). In general terms the aim of the study, presented in this thesis, was to investigate gene expression in cancer biology; and to characterise changes in breast cancer and colon cancer, with a focus on those genes, and gene products that may play a role in metastasis, including a family of ECPs, the matrix metalloproteinases (MMPs). In our laboratory, we have applied methods in microdissection, differential display polymerase chain reaction amplification (DD-PCR), and array hybridisation analysis to identify gene expression patterns in late stage archival formalin fixed paraffin embedded (FFPE) breast tumour biopsies that may be indicative of the EMT; or the response to the surrounding stroma/interstitium to the presence of the tumour.' The quality of nucleic acid obtainable from FFPE material presents a considerable challenge for gene expression studies. In order to identify tissue specific gene expression patterns, DD-PCR products, amplified from message obtained following segregation of tumour tissue from surrounding stroma, was hybridised to arrayed cDNA libraries created from stromal tumours, or sarcomas. In this way, 21 known genes, or expressed sequence tags (ESTs), were identified. These included the cytoskeletal element and EMT marker, vimentin, the mammary developmental factor and, signal transducer and activator of transcription (STAT)-3, and the cargo selection protein (TIP47). Seventeen genes showed differential expression in either the tumour, or stromal fractions. When applied to transformed breast cancer cell lines (MDA-MB-435 & T47D) DD-array analysis revealed a further 17 genes that were differentially regulated in invasive cells, compared with those displaying a less invasive phenotype. Six of the ESTs identified by DD-PCR array analysis, had no known (or predicted) function. For example, bcaf-2 was identified as the 3'-end of a putative open reading frame (ORF) localised to chromosome 6, while bcaf-10 showed homology with a known ORF. In order to analyse the expression of these bcafs further, a stromal cell culture model, representative of the original osteosarcoma cDNA libraries from which they were obtained, was used. In this model, CD14' (or adherent) peripheral blood mononuclear cells (PBMCs) treated with macrophage colony stimulating factor (M-CSF), can be allowed to differentiate into macrophage-like (ML) cells; while cells treated with M-CSF, and the receptor activator of NF-KB ligand (RANKL) will differentiate into multinucleate osteoclast-like (OCL) multinucleate giant cells. Uniquely, the stromal EST, bcaf-2 was expressed only by RANKL-treated (or OCL) cells. bcaf-2 and other ESTs, identified by DD-PCR analysis (and recently published) are the subject of on going research in our laboratory. The role of RANKL in mammary gland development and bone metastasis suggested that the identification of a RANKL-regulated stromal factor in breast tissue (bcaf-2) was not an artefact. RANKL is a membrane-bound, member of the tumour necrosis factor (TNF)-a cytokine super family. In order to test the hypothesis that RANKL might act as an inflammatory cytokine to regulate clinically significant stromal gene expression in the breast, we employed quantitative real time PCR analysis to examine the relative levels of selected members of a group of metal dependent ECPs, the matrix metalloproteinases (MMPs). RNA was extracted from ML cells and OCL cells, as well as RANK positive breast cancer cell lines (T47D, MDA-MB-435 & MCF-7). When the relative levels of protease mRNA were compared we demonstrated a significant (>20- fold) specific increase in collagenase (collagenase 2lMMP-8 and collagenase 3lMMP-13), and the tissue inhibitor of MMP (TIMP)-2 expression in M-CSF and RANKL treated PBMCs cells. When the assay was applied to RANKL treated breast cancer cell lines (MCF-7, T47D & MDAMB- 231), minor (40-fold) but potentially significant alterations in stromal protease gene expression were observed. The changes observed did not however, support the hypothesis that RANKL might act as an inflammatory cytokine to induce significant alterations in ECP expression in breast cancer cells. To investigate the role of RANKL as a driver of EMT in aberrant breast epithelium, total message (mRNNcDNA) from T47D, MCF-7, MDA-MB-231 cells, and message from the same cell lines treated with RANKL were compared by comparative fluorescent cDNA microarray analysis. Of the 1,700 targets available on the arrays, this study identified 160 that were differentially expressed in RANKL treated cells. The results suggest that RANKL may promote rather than suppress a mammary epithelial phenotype in breast cancer. In fact a putative mesenchymal to epithelial transition (MET) was observed following microscopic analysis, and this finding is the subject of on going research in our laboratory. Sporadic structural alterations in certain mitogenic factors represent important early events in cancer progression, while inherited mutations govern familial susceptibility to disease. In colon cancer, a close link exists between Winglessllnt (WNT) signalling, disease pathology, and the expression of MMPs. To examine the relationship between protease expression and structural genetic alterations in this EMT-linked signalling pathway, and others, we applied combined QPCR analysis of MMP expression and PCR-Single Strand Conformation Analysis (SSCA) to 26 colonic tumours, and patient-matched normal colonic mucosa. In this study, significant correlations between the expression of ECPs, and a key mediator of WNT signalling (p-catenin) were identified. While tumours possessing specific functional mutations in K-Ras, were found to group with phenotypic clustering based on protease gene expression. This result may be due to an interruption of normal interactions between RasIRaf signalling and transforming growth factor (TGF) P signalling, via Sma- and Mad- related protein (SMAD) signalling. These results demonstrate that the already identified link between mutations in kinase signalling, and aspects of gross colon tumour morphology (such as dysplasia) may be due to aberrant MMP expression patterning. The final aim of this research was to utilise methods developed in microdissection and specific Q-PCR analysis, to identify whether tumour-stroma differences in MMP gene expression might be used as markers of disease pathology. Total RNA from tumour, and biopsy-matched adjacent stromal tissue were segregated from 35 FFPE archival breast tumour biopsies. Comparison with stroma identified specific associations between TIMP-2 expression in the stroma and lymph node involvement, as well as stromelysin-3 (MMP-I I ) and TIMP-I expression and calcification of the tumour. Furthermore, a significant correlation was identified in the pattern of gelatinase (gelatinase AIMMP-2 & gelatinaseB1MMP-9) expression; while no significant correlation was identified in tumour-stroma MMP gene expression differences, and tumour grade, or hormone receptor status. These results suggest that coordinated changes within the tumour, and proximal stromal tissues (rather than tissue specific changes per se), regulate pathologically significant changes in breast carcinogenesis. In conclusion, this thesis describes the use of novel techniques in specific and global gene expression analysis that permitted examination of stromal gene expression changes in epithelial tumour progression. Microdissection facilitated localisation of expression to particular tissues, while cell culture models provided material with which to optimise and demonstrate the efficacy of techniques used (where tumour material itself was not abundant). Furthermore, we have identified significant and specific correlations between general stromal protease gene expression changes, a putative mammary epithelial differentiation factor (RANKL), alterations in growth factor signalling, and epithelial tumour pathology in the breast and colon. The combination of techniques developed in this study may assist in improvement of categorisation of tumours in clinical pathology. Specifically, the development of novel grading systems that link underlying molecular genetic changes with changes in tumour pathology. These processes may assist to improve diagnosis and provide more effective patient/tumour-specific drug therapies.

Bone mineral density (BMD) is a reflection of the action of osteoblasts compared to osteoclasts. An imbalance in the activity of osteoblasts or osteoclasts, results in bone disease such as osteoporosis caused by overactive osteoclasts. BMD is influenced by genetic and environmental factors as demonstrated through twin studies, association studies and linkage analysis (Ralston, 1999). Several polymorphisms involved in the determination of BMD have been identified, with Vitamin D receptor and Collagen Type 1 showing reproducible associations. To identify genes influencing BMD two distinct strategies have been employed: 1) To determine if DNA polymorphism within the runt related transcription factor (RUNX2) gene is a determinant of BMD and fracture in women. 2) The identification of RANKL target genes in osteoclastogenesis. RUNX2 is a runt domain transcription factor (Werner et al., 1999) essential for osteoblast differentiation (Lee et al., 1997). RUNX2 gene knock-out mice have no osteoblasts due to a failure in osteoblast differentiation and consequently unmineralised skeletons, (Komori et al., 1997; Otto et al., 1997). In humans, mutations in RUNX2 cause cleidocranial dysplasia (CCD), a disorder characterised by hypoplasia or aplasia of the clavicles, short stature, supernumerary teeth, patent fontanelles and other changes in skeletal patterning and growth (Mundlos et al., 1997). RUNX2 contains a poly-glutamine poly-alanine (polyQ/polyA) repeat where mutations causing cleidocranial dysplasia have been observed. BMD has not been routinely examined in CCD, two studies have identified CCD patients with lower BMD with one fracture case identified (Quack et al., 1999; Bergwitz et al., 2001). The central role of RUNX2 in determining osteoblast differentiation makes RUNX2 a prime candidate gene for regulating adult bone density. To determine if polymorphism was present in the polyQ/polyA tract the repeat was amplified within the upper and lower deciles of femoral neck (FN) BMD in the Geelong Osteoporosis study (GOS). The upper and lower deciles of FN BMD acted as a surrogate for genotyping the entire cohort. This study identified two common variants within the polyA repeat: an 18 base pair deletion (11Ala) and a synonymous alanine codon polymorphism with alleles, GCA and GCG (noted as A and G alleles, respectively). The 11Ala and SNP polymorphism are found on codon 64 and 66 respectively (RUNX2 MRIPV variant). A allele frequencies were significantly different in a comparison of the upper and lower deciles of FN BMD (p=0.019). In 495 randomly selected women of the Geelong Osteoporosis Study (GOS), the A allele was associated with higher BMD at all sites tested. The association was maximal at the ultra-distal radius (p=0.001). In a separate fracture study, the A allele was significantly protective against Colles' fracture in elderly women but not spine and hip fracture. The 11Ala polymorphism was not related to BMD in GOS. To further decipher the role of the RUNX2 A allele we genotyped 992 women from a Scottish cohort. The alleles of RUNX2 within the glutamine/alanine repeat were determined by MspA1I restriction digest. To examine the possible influence on estrogen related therapies or estrogen status on the potential genetic effect conferred by RUNX2, we divided the cohort by menopausal and hormone replacement therapy status. Within postmenopausal Scottish women the RUNX2 A allele was associated with significantly higher FN BMD (p=0.028, n=312) but not lumbar spine (LS) BMD. The A allele was associated with higher FN BMD (p=0.035) within a postmenopausal subgroup of the population (n=312). To investigate the effect of weight on the RUNX2 alleles the Scottish cohort was segregated into thin/normal (BMI ≥ 25 kg/m2) and overweight /obese (BMI > 25 kg/m2). RUNX2 A allele showed a stronger effect on FN BMD in postmenopausal women above the median BMI. The 11Ala RUNX2 deletion allele was significantly associated with decreased LS BMD (p=0.018) within overweight/obese women (n=546). The 11Ala allele was significantly associated with increased levels of pyridinoline (p=0.014) and deoxypyridinoline (p=0.038) in the HRT treated subgroup of the population (n=492). Glutamine variants and an alanine insertion were identified within the group. These data suggest that the RUNX2 11Ala and A alleles exert differing affects on BMD showing preference for different skeletal sites in a weight dependent manner. We genotyped 78 individuals from an osteoarthritic population to elucidate the role of the RUNX2 alleles on markers of bone turnover and inflammation. The RUNX2 11Ala allele was significantly associated with decreased osteocalcin (OC) serum levels (p = 0.01). The RUNX2 A allele was significantly related to reduced tumor necrosis factor alpha (TNF-alpha) serum levels (p = 0.004). RUNX2 is known to bind to the OC promoter. An OC promoter polymorphism is found 7bp upstream from a putative RUNX2 binding site. We hypothesized that OC polymorphism may effect the RUNX2 transactivation of the OC gene and thus affect OC serum levels. OC promoter polymorphism was not related to OC serum levels (n=78). These data present a novel link between RUNX2 alleles and OC and TNF serum levels, providing putative mechanisms of action for the RUNX2 alleles. Further studies in larger populations are required to confirm these findings. Ten individuals within the GOS and the Scottish cohort were found to carry rare mutations of the polyQ/polyA repeat. All polyQ variants had a normal polyA repeat (17 amino acids) and were heterozygous for a normal 23Q/17A allele. Variants observed were 15, 16, 24 and 30Q. One individual was observed with an extended polyA repeat (24A). Patient records indicated otherwise unremarkable clinical history except for fracture in 4/10 individuals from GOS (hip and spine). BMD data from the LS and the FN were expressed as T-scores, a measure that relates BMD in terms of standard deviations below the young normal value. In addition, BMD data were also expressed as Z-scores around the age-mean. Under the null hypothesis, where RUNX2 Q repeat variation has no effect on BMD, Z scores would be expected to be distributed around a mean of zero. However, when all variants were pooled the BMD was significantly lower than expected. This effect persisted when deletion variants were considered alone. The effect was stronger on FN BMD (p=0.001) rather than LS BMD (p=0.096), reflecting either difference in precision of BMD measurements at these sites or perhaps a differential genetic effect on different skeletal sites. These data suggest that polyQ and polyA variants are associated with significantly lower BMD, and may be an important determinant for fracture. Glutamine variants exist at high frequency (~0.7%): this rate of mutation could be important when considering large populations at risk of age related osteoporosis. Considering that these subjects are heterozygous for a normal allele, it suggests that a more severe phenotype might be expected in rare subjects homozygous for glutamine repeat variants. In summary, this study investigated the role of novel polymorphisms and rare variants of the RUNX2 gene in influencing BMD, fracture and markers of bone turnover. Two common polymorphisms were identified within the polyA repeat: an 18 base pair deletion and a synonymous alanine codon polymorphism with alleles, A and G. The A allele was associated with increased BMD and was protective against a common form of osteoporotic fracture within a Geelong population. To verify these findings the RUNX2 alleles were genotyped in 992 women from a Scottish cohort. The magnitude and the direction of the effect of the A allele was maintained in the Scottish cohort. Interestingly, the A allele was shown to exert a menopause specific effect, with postmenopausal women showing the strongest effect. On re-analysis of the GOS data the post-menopausal women were found to drive the significance identified in the cohort. The magnitude of the effect of the A allele on BMD was greater in overweight/obese postmenopausal women indicating a gene-weight interaction for RUNX2. The RUNX2 11Ala allele showed a significant relationship with decreased LS BMD in overweight/obese Scottish women. The 11Ala allele was also associated with higher levels of urinary PYD and DPD in women treated with HRT, indicating higher levels of bone turnover in carriers of the 11Ala allele. In contrast to the Scottish cohort, no significant association with heterozygous carriers of 11Ala was observed in GOS, although a significant association was detected for homozygous carriers and LS BMAD. The 11 Ala RUNX2 allele was significantly associated with decreased serum osteocalcin levels and the A allele was significantly associated with TNF in OA patients. Glutamine variants and an alanine insertion were identified within Geelong and Scottish cohorts, which showed low Z and T scores suggesting that RUNX2 variants may be related to genetic effects on BMD and osteoporosis. Polymorphism of the polyQ/polyA region of RUNX2 were identified within this study were shown to associate with significant differences in BMD. The A allele showed a significant association with increased BMD in postmenopausal women from a Geelong and Scottish cohort, with a decreased frequency of the A allele observed in Colles' fracture patients from Geelong. The 11Ala deletion allele was significantly associated with decreased LS BMD and increases in markers of bone turnover in the Scottish cohort. A significant decrease in OC serum levels was observed in OA patients suggesting a direct effect of the allele on the transactivation of the RUNX2 gene. Rare variants of RUNX2 were identified which showed low BMD. These studies have provided insight into the role of RUNX2 in influencing BMD, further studies are required to verify the role of the A allele on BMD and fracture, the role of the rare variants and to identify the precise mechanisms behind the observed changes in BMD. - 2) The identification of RANKL target genes in osteoclastogenesis. Osteoclastogenesis is regulated in vivo by the action of osteoblast/stromal cells that express membrane bound, receptor activator of NF-kB ligand (RANKL). Monocytes treated in vitro with a soluble form of RANKL and macrophage colony stimulating factor (M-CSF) differentiate to osteoclasts, whereas monocytes treated with M-CSF alone differentiate to macrophage-like cells. The gene expression profile of human osteoclasts has not been extensively explored. Genes highly expressed by rabbit osteoclasts were identified through random sequencing of an osteoclast cDNA library (Sakai et al., 1995). Differential gene expression of mouse osteoclastogenesis was elucidated by array analysis (Cappellen et al., 2002). To identify genes important for human osteoclastogenesis, total RNA was isolated from monocytes treated for three weeks with either M-CSF alone or with RANKL and M-CSF. RANKL treatment for 3 weeks and 12 hours was investigated in this study, to complement previous data. Differential display was performed on RNA (12 hour treatment with RANKL) and differential gene expression profiles examined. The differential display products were pooled to generate a probe for screening a gene array system derived from a human osteoclast cDNA library. cDNA (3 week treatment with RANKL) hybridisation experiments against the array revealed additional regulated genes. Gene clones that showed significant regulation in M-CSF and RANKL treated cells compared M-CSF treated cells represent genes that are targets for RANKL-specific regulation. Osteopontin, creatine kinase and various mitochondrial genes were up regulated by the treatment of RANKL. Changes in gene expression observed in the array data were confirmed with real-time PCR using mRNA derived from in vitro induced osteoclasts. Cathepsin K gene expression was more than 300 fold greater in osteoclasts compared to macrophage-like cells after one week treatment with RANKL and M-CSF. Cystatin C expression showed a six-fold induction at two weeks of RANKL and M-CSF treatment and cystatin B showed a steady increase in expression. Some of these regulated genes may provide useful targets for influencing BMD.

Σκοπός: Πρόσφατα δεδομένα, υποδεικνύουν ότι διαταραχή της ισορροπίας του λιπιδικού μεταβολισμού επηρεάζει τη λειτουργία των κυττάρων του οστού, με αποτέλεσμα την ανάπτυξη εκφυλιστικών και μεταβολικών νόσων, όπως η οστεοπόρωση. Στην παρούσα εργασία, μελετήσαμε τον ρόλου της απολιποπρωτεΐνης Ε (apoE), βασικού συστατικού του συστήματος μεταβολισμού των χυλομικρών και της VLDL (Very Low-Density Lipoprotein), στη ρύθμιση της οστικής ανακατασκευής και στην παθογένεια της οστεοπόρωσης, σε πειραματικά μοντέλα ποντικιών που έλαβαν δίαιτα πλούσια σε λιπαρά. Υλικά και μέθοδοι: Για τον λόγο αυτό, χρησιμοποιήσαμε μοντέλα ποντικών με έλλειψη του γονιδίου της apoE (apoE-/-) και αγρίου τύπου (C57BL/6) (ομάδα ελέγχου) που τους χορηγήθηκε για 24 εβδομάδες δίαιτα δυτικού τύπου (WTD) πλούσια σε λιπαρά (10 ζώα/ομάδα). Επιλέχθηκε η δίαιτα δυτικού τύπου διότι προσομοιάζει τις διατροφικές συνήθειες του σύγχρονου δυτικού κόσμου. Κάθε 6 εβδομάδες γινόταν μέτρηση σωματικού βάρους. Δύο και επτά ημέρες προ της ευθανασίας πραγματοποιήθηκε ενδοπεριτοναϊκή ένεση καλσεΐνης. Την 24η εβδομάδα τα ζώα θυσιάστηκαν, απομονώθηκαν χειρουργικά το μηριαίο οστό και οι οσφυϊκοί σπόνδυλοι και έγιναν ιστολογικές και ιστομορφομετρικές αναλύσεις. Με τη χρήση microCT scanner (στατική ιστομορφομετρία) εκτιμήθηκε η ποιότητα και η ποσότητα του σπογγώδους και του φλοιώδους οστού. Με τη χρώση TRAP και την εναπόθεση καλσεΐνης (δυναμική ιστομορφομετρία) ελέγχθηκε η οστική αποδόμηση και ο ρυθμός σύνθεσης νεοσχηματιζόμενου οστού, αντίστοιχα. Με τη χρήση φασματοσκοπίας Raman, αξιολογήθηκε η κατάσταση του δικτύου κολλαγόνου των μηριαίων οστών. Επιπλέον, μεσεγχυματικά κύτταρα του μυελού των οστών (BMMSC) απομονώθηκαν από το μηριαίο οστό των πειραματόζωων και καλλιεργήθηκαν με σκοπό την εκτίμηση των επιπέδων έκφρασης, τόσο σε επίπεδο πρωτεΐνης όσο και σε επίπεδο mRNA, μορίων που εμπλέκονται στην οστεοβλαστική λειτουργία [(Runx2, Osterix (Osx), Κολλαγόνο I τύπου 1a (Col1a1)], στην οστεοκλαστική λειτουργία [osteprotegerin (OPG), RANK-Ligand (RANKL), λόγος OPG/RANKL, RANK, TRAP, cathepsin Κ] καθώς και στην λιπογένεση [Peroxisome-Proliferator-Activated receptor γ (PPARγ)]. Για την εκτίμηση των επιπέδων έκφρασης των πρωτεϊνών, χρησιμοποιήσαμε τις μοριακές τεχνικές Western Blot και κυτταρομετρία ροής ενώ για την αξιολόγηση των επιπέδων έκφρασης του mRNA χρησιμοποιήσαμε τη RT-PCR. Αποτελέσματα: 1) Τα apoE-/- πειραματόζωα που έλαβαν WTD δεν ανέπτυξαν παχυσαρκία σε αντίθεση με τα C57BL/6 WTD. 2) Στον μυελό των οστών των apoE-/- WTD ποντικιών παρατηρήθηκε πλήρης απουσία λιποκυττάρων, σε αντίθεση με τα C57BL/6 WTD ζώα των οποίων ο μυελός των οστών ήταν πλούσιος σε λιποκύτταρα. 3) Ο αριθμός των οστεοκλαστών ήταν σημαντικά αυξημένος, ενώ των οστεοβλαστών σημαντικά ελαττωμένος στα apoE-/- WTD πειραματόζωα σε σύγκριση με τα C57BL/6 WTD. 4) Η στατική και η δυναμική ιστομορφομετρία έδειξαν ότι τα apoE-/- ποντίκια, σε δίαιτα δυτικού τύπου, εμφάνισαν σημαντική ελάττωση της οστικής τους μάζας. 5) Το δίκτυο του κολλαγόνου στα apoE-/- WTD ποντίκια εμφανίστηκε σημαντικά πιο σκληρό, πιο άκαμπτο και κατά συνέπεια λιγότερο ελαστικό συγκρινόμενο με αυτό των C57BL/6 WTD. 6) Τα apoE-/- WTD ποντίκια, εμφάνισαν σημαντικά μειωμένα επίπεδα έκφρασης του ρυθμιστή της οστεοβλαστογένεσης Runx2, τόσο σε επίπεδο πρωτεΐνης όσο και σε επίπεδο mRNA, συγκρινόμενα με τα C57BL/6 WTD ζώα. 7) Τα επίπεδα έκφρασης των ρυθμιστών της οστικής ανακατασκευής RANK και RANKL, ήταν σημαντικά αυξημένα στα apoE-/- WTD ποντίκια σε σχέση με τα C57BL/6 WTD ποντίκια. Αντίθετα, τα επίπεδα έκφρασης του γονιδίου της OPG καθώς και η αναλογία OPG/RANKL, ήταν σημαντικά μειωμένα στα apoE-/- WTD ποντίκια. Δεν παρατηρήθηκαν σημαντικές διαφορές στην έκφραση των οστεοκλαστικών ρυθμιστών cathepsin K και TRAP μεταξύ των δύο υπό εξέταση ομάδων ζώων. 8) Ο ρυθμιστής της λιπογένεσης PPARγ, τόσο σε επίπεδο πρωτεΐνης όσο και σε επίπεδο mRNA, ήταν σημαντικά μειωμένος στα apoE-/- WTD ποντίκια σε σχέση με τα C57BL/6 WTD. Συμπεράσματα: 1) Η έλλειψη της apoE εμπλέκεται στην ελάττωση της οστικής μάζας σε ποντίκια υπό δίαιτα δυτικού τύπου 2) Η apoE φαίνεται ότι διαδραματίζει σημαντικό ρόλο στη ρύθμιση της λειτουργίας των οστεοβλαστών, ενώ δεν είναι σαφής ο ρόλος της στη λειτουργία των οστεοκλαστών 3) Η έλλειψη της apoE, προστατεύει από την παχυσαρκία αλλά και την εναπόθεση λιποκυττάρων στον μυελό των οστών, κατόπιν λήψεως δίαιτας πλούσιας σε λιπαρά. 4) Η apoE ρυθμίζει τη διαφοροποίηση των MSC’s σε ερχόμενο στάδιο, καθώς η έλλειψή της επηρεάζει τόσο την οστεοβλαστική όσο και τη λιποβλαστική διαφοροποίηση, μετά από κατανάλωση δίαιτας δυτικού τύπου, πλούσιας σε λιπαρά. / Introduction: Recent data suggest that lipid metabolism imbalances affect bone cell function and therefore may result in the development of metabolic diseases such as osteoporosis. In the present study, we investigated the role of apoE, a plasma protein playing cardinal role in lipoprotein metabolism, in the regulation of osteoblasts, osteoclasts and lipoblasts and in the pathogenesis of osteoporosis. Material and Methods: We used apoE deficient (apoE-/-) and wild type (C57BL/6) mice (10 animals/ group). Mice were fed with standard western-type diet (WTD) for 24 weeks. Body weight measurements were obtained every 6 weeks. Two and seven days before euthanasia calcein was injected intraperitonealy for the determination of new bone formation rate. Following sacrifice, lumbar vertebrae and femora were removed and quantitative/qualitative study of the cortical and cancellous bone was performed using microCT scanner. In the tissue sections we perfomed histological (H&E) and histochemical (TRAP) analyses. Static and dynamic histomorphometry were employed for the determination of bone quality and bone cell function. Using Raman spectroscopy, the quality and biochemical composition of the collagen fibers of the examined femora were evaluated. Bone marrow mesenchymal stem cells (BMMSC) were isolated from mice femora and then assessed for the expression of the osteoblastic (Runx2, OSX, Col1a1), osteoclastic (OPG, RANKL, OPG/RANKL, RANK, TRAP, cathepsin K) and lipoblastic (PPARγ) regulators using Western Blotting, Flow Cytometry and RT-PCR. Results: 1) apoE-/- mice under WTD did not develop obesity and their BM was devoid of adipocytes, in contrast to the control mice. 2) Osteoclast number was significantly increased, while bone synthesis was significantly reduced in apoE-/- compared to the C57BL/6 mice that consumed WTD. 3) Static and dynamic histomorphometry showed that apoE-/- mice had sugnificantly reduced bone mass and impared bone architecture. 4) The collagen network in apoE-/- WTD mice was significantly stiffer and more rigid compared to the C57BL/6 WTD mice. 5) BMMSCs from apoE-/- WTD mice displayed significantly reduced Runx2 expression at both protein and mRNA levels compared to the control group. 6) The expression levels of RANK and RANKL, were significantly elevated in apoE-/- WTD mice compared to C57BL/6 WTD mice. In contrast, the gene expression levels of OPG and the ratio OPG / RANKL, were statistically significantly reduced in apoE-/- WTD mice. No significant differences were observed in the expression of cathepsin K and TRAP genes between the two test groups of animals. 7) The expression of the major lipoblastic regulator PPARγ was significantly reduced in apoE-/- WTD compared to their WT counterparts. Conclusions: 1) Low levels of apoE result in reduced bone mass following WTD. 2) apoE is implicated in the regulation of osteoblast function; nevertheless, its role in osteoclast function warrants further investigation. 3) The absence of apoE prevents obesity and BM adipocity after the consumption of WT (high-fat) diet. 4) apoE deficiency, regulates MSC differentiation at early stages, since its absence affects both the osteoblastic and lipoblastic differentiation, after the consumption of high fat diet.

During our lifetime, our bones constantly go through remodelling to maintain the skeletal system. This is done by osteoblasts that deposit new bone tissue, osteoclasts that remove the bone matrix and mechanosensing osteocytes. In case of bone implants, increased resorption by osteoclasts due to inflammation (inflammatory osteolysis) leads to aseptic implant loosening. This study focuses on how to detect these inflammatory resorbing cells at an early stage and prevent their activity with appropriate medication. To achieve this, we differentiated classical monocytes into macrophage-like cells, osteoclasts(OCs) and foreign body giant cells (FBGC) and their secretome was studied to identify specific biomarkers. Previously, tartrate resistant acid phosphatase (TRAP) was studied as an important biomarker for OCs and macrophages. An ELISA to separate and quantitate the two TRAP isoforms was used to distinguish the resorbing OCs from inflammatory FBGCs on the basis of the isoform ratio. This assay gave high levels of 5b isoform for osteoclastic stimulation and high 5a levels for the inflammatory stimulation. Also, different aminothiazole inhibitors were tested which were shown to be efficient drugs in inhibiting inflammatory osteolysis by reducing osteoclast formation and resorption in sub-micromolar concentration. Further to apply this study to patient samples, an immunoassay panel can be developed which will help detect TRAP and multiple biomarkers like CTX specific to aseptic loosening simultaneously. This will help in early, efficient and accurate diagnosis of inflammatory osteolytic bone loss and provide us with an accurate diagnosis and sufficient time for appropriate treatment.

Orientador: Carlos Rossa Junior / Banca: Luis Carlos Spolidório / Banca: Silvana Regina Perez Orrico / Banca: Dagmar Ruth Stach Machado / Banca: Paula Cristina Trevilatto / Resumo: Embora a doença periodontal tenha origem infecciosa, ela se caracteriza por uma complexa resposta imune-inflamatória, com a participação de células residentes e não-residentes, produzindo diversas citocinas e mediadores biológicos. A principal característica da doença periodontal destrutiva é a reabsorção do osso alveolar, a qual é uma consequência frequentemente irreversível do processo patológico e das citocinas produzidas pela resposta do hospedeiro. Citocinas específicas atuam diretamente no controle da remodelação óssea, denominadas RANKL (Receptor activator of NF-kB ligand) e OPG (Osteoprotegerin,). RANKL é uma proteína produzida por fibroblastos, osteoblastos, condrócitos, células mesenquimais e células T e B ativadas e sua ligação com o seu receptor RANK (Receptor activator of NF-kB) em células precursoras de osteoclastos é necessário e suficiente para a ativação, diferenciação e sobrevivência de osteoclastos maduros. OPG, a outra proteína envolvida nesta modulação, serve como um falso receptor para RANKL, impedindo dessa forma a ligação RANKL-RANK e levando a uma menor ativação de osteoclastos. Assim, o balanço entre RANKL e OPG é o atual paradigma para a modulação da remodelação óssea. FK-506 (tacrolimo) é uma droga imunossupressora usada para prevenir rejeição de enxertos afetando a ativação de linfócitos T por meio da modulação da via da calcineurina, inibindo a ativação de NFAT e de NF-kB. Estudos prévios demonstraram que o uso de tacrolimo em ratos diminui a resposta inflamatória e reabsorção óssea em modelo experimental de indução de doença periodontal. A proposta deste estudo foi avaliar os efeitos da administração sistêmica do tacrolimo sobre a expressão de RANKL e OPG na doença periodontal induzida em ratos e determinar in vitro, se o tratamento de células residentes do periodonto com tacrolimo... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Periodontitis is a well-characterized infectious disease with a complex immune-inflammatory response. In response to the bacterial presence, many resident and non-resident cells into the peridontium produce many cytokines and biologic mediators, causing tissue destruction and alveolar bone loss. These cytokines are the key-factor in osteoclast-mediated bone resorption. The expression ratio between two cytokines is fundamental to bone resorption process: RANKL (Receptor activator of NF-kB ligand) that is necessary to osteoclast differentiation, activation and survival, and OPG (Osteoprotegerin) that acts as the endogenous inhibitor of RANKL by functioning as its decoy receptor. RANKL is expressed by fibroblasts, osteoblasts, chondrocytes, mesenchymal cells and T and B lymphocytes. OPG is secreted primarily by osteoblastic cells, bone marrow stromal celss and fibroblasts and it counter regulates the excessive bone loss antagonizing the RANKL-binding to its receptor RANK in osteoclast precursor cells. The ratio between RANKL and OPG is the current paradigm for modulation of coupled bone turnover. FK-506 is an immunossupressive drug used to reduce and to prevent the risk of organ transplant rejections. It acts affecting T lymphocyte activation by calcinaurin pathway modulation inhibiting NFAT and NF-kB translocation to the nucleus. Previous studies showed that animals with experimental periodontitis treated with FK-506 exhibited less bone resorption and inflammatory infiltrate. The purpose of this study was evaluated effects of FK-506 systemic administration over RANKL and OPG expression in animals with experimental periodontitis; and determines if FK-506-treated periodontium resident cells can affect IL-1- and LPS-induced RANKL and OPG expression. In the in vivo study, two experimental periodontitis models were used (LPS and ligature) in rats. In the test group the animals received dail... (Complete abstract click electronic access below) / Doutor

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2015-12-02T00:27:28Z No. of bitstreams: 1 MelinaBezerraLoureiro_TESE.pdf: 1135185 bytes, checksum: e5cac7360be06d23b952396e9adfcb1d (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2015-12-08T23:49:46Z (GMT) No. of bitstreams: 1 MelinaBezerraLoureiro_TESE.pdf: 1135185 bytes, checksum: e5cac7360be06d23b952396e9adfcb1d (MD5) / Made available in DSpace on 2015-12-08T23:49:46Z (GMT). No. of bitstreams: 1 MelinaBezerraLoureiro_TESE.pdf: 1135185 bytes, checksum: e5cac7360be06d23b952396e9adfcb1d (MD5) Previous issue date: 2014-03-31 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico - CNPq / O objetivo do presente trabalho foi avaliar a express?o de RNAm e os polimorfismos dos genes RANK, RANKL e OPG de crian?as, adolescentes e adultos jovens com DM1, bem como estudar a associa??o dos mesmos com o desenvolvimento de altera??es no metabolismo ?sseo.No total, foram inclu?dos no estudo 119 crian?as e adolescentes com DM1 e 161 indiv?duos normoglic?micos (NG) da mesma faixa et?ria. Foram pesquisados os polimorfismos dos genes OPG (1181 G>C e 163 A>G), RANK (575 C>T e 3'UTR C>A) e RANKL (?ntron A>G) e determinadas as express?es g?nicas de OPG, RANK e RANKL. Al?m disso, foram avaliados o controle glic?mico e par?metros laboratoriais de fun??o ?ssea, al?m da densitometria ?ssea. Os indiv?duos com DM1 apresentaram um controle glic?mico insatisfat?rio e valores diminuidos de c?lcio total, propept?deo do col?geno tipo 1 (CTX), como tamb?m baixa densidade mineral ?ssea, quando comparados com os NG (p<0,05). O polimorfismo OPG 1181 G>C pode estar associado com susceptibilidade ao DM1 (p=0,054). Estudando apenas os indiv?duos com DM1, foi observado que os carreadores do gen?tipo OPG 1181 GG apresentaram maiores concentra??es de c?lcio ionizado no modelo recessivo (p<0,05). Esses resultados sugerem que o polimorfismo OPG 1181 G>C pode contribuir para o desenvolvimento do DM1 e da osteopatia diab?tica.