Approximately 7000 rare disorders exist, affecting 2 percent of Canadians and millions of people worldwide. Given that for many rare diseases only one allele is mutated, we hypothesize inducing expression of the remaining wild-type allele may have a therapeutic effect. SMAD3 heterozygosity results in Aneurysms-Osteoarthritis Syndrome (AOS) – an aortic aneurysm disorder also known as Loeys-Dietz Syndrome Type 3. We conducted a screen of FDA-approved compounds and found that 13-cis-retinoic acid (13-CRA) induces SMAD3 in normal human fibroblast cultures. Treatment with therapeutic concentrations of 13-CRA increased SMAD3 mRNA in normal human fibroblasts, patient fibroblasts, wild-type murine vascular smooth muscle cells and Smad3+/- murine vascular smooth muscle cells. Increases in SMAD3 protein were also observed in normal human fibroblasts, patient fibroblasts, and wild-type murine vascular smooth muscle cells. Immunofluorescent imaging revealed the primary site of protein induction to be nuclear. We report here the in vitro induction of SMAD3 mRNA and protein by therapeutic levels of 13-CRA and suggest further investigation of this modality for the treatment of AOS.

Nos últimos anos, nós propusemos um modelo de duas etapas para a padronização antero-posterior do coração. Ácido retinóico (AR) produzido pela enzima RALDH2 induz o destino sino atrial nos precursores cardíacos posteriores. Subsequentemente, estes precursores adquirem a capacidade de expressar RALDH2, formando uma onda caudo-rostral desta enzima. A nossa hipótese é que esta onda surgiu nos para padronizar as células precursoras da bomba circulatória ancestral em regiões de influxo e efluxo, resultando na origem das câmaras cardíacas. Para testar se a onda cauro-rostral é ancestral nos vertebrados, nós mapeamos a expressão de RALDH2 em relação ao campo cardíaco em anfíbios, vertebrados basais e no cordado invertebrado anfioxo. Nossos dados sugerem que o modelo de duas etapas está presente em anfíbios e peixes. Clonagem do gene RALDH em lampréias indica presença de AR no campo cardíaco. Em anfioxo, a caracterização do padrão de expressão do ortólogo da RALDH2 revela ausência da onda caudo-rostral. Nossos resultados sugerem que a onda caudo-rostral de RALDH2 foi cooptada nos vertebrados para padronizar o campo cardíaco no eixo AP, o que corrobora a hipotése de que este mecanismo foi importante na origem evolutiva das câmaras cardíacas. / In the last years, we have proposed a 2-step model for the establishment of cardiac chamber identities. Retinoic acid (RA) produced by its synthetic enzyme RALDH2, induces an atrial fate in posterior cardiac precursors of amniote embryos. Subsequently, a RALDH2 caudorostral wave engulfs posterior precursors. Our hypothesis is that this wave evolved in vertebrates to pattern an ancestral circulatory pump into AP fields, which were later fashioned into cardiac chambers. To test whether the wave is an ancestral or derived feature of amniotes, we mapped expression of RALDH2 in relation to the cardiac field in amphibians, basal vertebrates and the amphioxus. Our data suggests RA signaling patterns amphibian and piscine hearts. Cloning of RALDH in lampreys shows that RA synthesis takes place in the heart field. In the amphioxus, cloning of RALDH reveals a vertebrate-like expression pattern, although the RALDH2 wave is absent. Our results support the hypothesis that the caudorostral wave of RALDH2 was coopted to pattern the vertebrate cardiac field. This supports the hypothesis that the caudorostral wave of RALDH2 was an important player in the evolutionary origin of the cardiac chambers.

Les rétinoïdes sont utilisés dans le traitement d’une variété de tumeurs malignes et lésions précancéreuses. Leurs effets dans des lignées cellulaires dérivées de tumeurs solides tel que le cancer du sein ont été étudiés extensivement. Cependant, les bénéfices dans le cancer du sein restent à date peu clairs. Ceci est probablement du à l’hétérogénéité des tumeurs mammaires et la réponse très variable aux effets antiprolifératifs de l’acide rétinoïque. Dans les lignées cellulaires cancéreuses mammaires, la réponse l’AR est fortement corrélée au niveau d’expression du récepteur aux estrogènes alpha (ERα), qui régule l’expression du gène qui encode le récepteur à l’acide rétinoïque alpha, RARA. Malgré cela, certaines lignées cellulaires ER-négatives, comme la lignée HER2-positive SK-BR-3, ont été décrites comme étant sensibles à l’AR. Dans le Chapter 2: de cette thèse, nous avons étudié les mécanismes de la signalisation ER-dépendante et ER-indépendante dans les cellules cancéreuses mammaires. Nous avons utilisé des lignées ER-négatives et ER-positives pour démontrer qu’une partie de la réponse à l’AR est indépendante de la signalisation par ER. Nous avons identifié plusieurs gènes cibles primaires de l’AR qui ont des effets similaires à l’AR quand ils sont surexprimés dans des cellules mammaires cancéreuses. Cette étude apporte une meilleure compréhension des mécanismes complexes qui mènent à l’arrêt de croissance induit par l’AR dans les cellules cancéreuses mammaires. Dans le Chapitre 3, nous avons regardé plus en détails la signalisation ER-indépendante par l’AR dans des cellules ayant une amplification des gènes HER2 et RARA et nous avons identifié une synergie entre l’AR et le Herceptin dans ces cellules. Nous proposons que les gènes FOXO jouent une rôle dans cette synergie. Les cellules SK BR 3, ayant une coamplification HER2/RARA, pourraient représenter une classe de tumeurs qui pourraient bénéficier d’un traitement avec des rétinoïdes, en augmentent la réponse au Herceptin et potentiellement en réduisant la résistance au Herceptin. En conclusion, les données présentées dans cette thèse aident à mieux comprendre les mécanismes menant à l’arrêt de croissance induit par l’AR dans les cellules cancéreuses mammaires et fournissent une application potentielle pour l’utilisation de l’AR dans le traitement du cancer du sein. / Retinoids are being used in the treatment of several malignancies and precancerous lesions. Their effects on cell lines derived from solid tumors, such as breast cancer, have also been described extensively. Their benefit in breast cancer, however, remains unclear. This might be because of the high levels of heterogeneity of breast tumors and the very variable response to the antiproliferative effects of retinoic acid. In mammary tumor cell lines, the response to retinoic acid is highly correlated with the expression of the estrogen receptor alpha (ERα), which regulates the expression of the retinoic acid receptor alpha gene RARA. However, some ER-negative cell lines, such as the HER2 positive SK-BR-3 cell line, have been reported to be RA-sensitive. In Chapter 2: of this thesis we have investigated the mechanisms of ER-dependent and ER-independent RA signaling in breast cancer cells. Using ER-positive and ER-negative cell lines, we show that part of the response to RA is independent of ER signaling. Several direct retinoic acid targets were identified that could mimic antiproliferative effects of retinoic acid when overexpressed in breast cancer cells. This study has provided better insight in the complex mechanisms that lead to RA-induced growth arrest in breast cancer cells. In Chapter 3: we looked further into the ER-independent RA signaling in HER2/RARA-amplified cells and identified a synergy between RA and Herceptin in these cells. We propose a role for FOXOs in mediating this synergy. HER2/RARA coamplified breast tumors might represent a subclass of tumors that could benefit from retinoid treatment, both increase antitumor effects of Herceptin, as well as in potentially reducing Herceptin resistance. In conclusion, data presented in this thesis give better insight in the mechanisms of RA induced growth arrest in breast cancer cells and provide a potential application of retinoids in a subset of breast tumors.

Une perturbation de la signalisation dopaminergique dans le striatum est à l’origine de troubles moteurs tels que la maladie de Parkinson (MP) ou de Huntington (MH). Une diminution de la signalisation par l’AR a été observée chez les patients atteints de troubles de la voie nigro-striée et dans des modèles de MH et MP. Nos données indiquent que l’AR synthétisé par RALDH1 et se liant au récepteur RARβ dans le striatum est nécessaire au maintien du système nigro-strié. Une perturbation de cette signalisation entraîne une diminution de l’activité mitochondriale qui conduit à une augmentation du stress oxydatif puis à l’entrée en apoptose de la cellule. Il en résulte des troubles moteurs de type MH et MP. Le rétablissement du niveau striatal de l’AR et la stimulation de RARβ par un agoniste spécifique permettent de prévenir ces phénotypes. Nos travaux nous permettent de proposer RARβ comme une nouvelle cible thérapeutique potentielle dans le cadre des neurodégénérescences de type MH et MP. / A disturbed dopaminergic signaling in the striatum leads to motor disorders such as Huntington’s (HD) and Parkinson’s (PD) diseases. A decrease of the retinoic acid (RA) signaling is observed in patients presenting disorders of the nogro-striatal pathway as well as in HD and PD models. Our data indicate that RALDH1-synthesized RA that binds the receptor RARβ in the striatum is essential to maintain the nigro-striatal system. A disturbance in this RA signaling leads to a decreased mitochondrial respiration, an increased oxidative stress and an increased apoptosis in the dorso-lateral striatum. This cellular alterations lead to HD-like and PD-like motor disorders A rescue of the striatal RA level or the stimulation of RARβ by a specific agonist prevent this phenotypes. Our work allow us to point at RARβ as a new potential therapeutic target for neurodegenerescences like HD and PD.

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Stress hormones, adrenaline and noradrenaline, have been shown to be critical for heart development. Mice lacking dopamine greek lower case letter beta]-hydroxylase (Dbh), an enzyme responsible for synthesis of these adrenergic hormones, die during mid-gestation due to cardiac failure. Prior research showed that adrenergic cells are found within the electrical conduction system of the heart, and adrenergic deficiency leads to slowed cardiac conduction during embryogenesis. Microarray analysis of wild-type (Dbh+/+) and knockout (Dbh-/-) mouse hearts revealed significant differences in expression of retinoic acid (RA) signaling genes. RA signaling has also been shown to be critical for heart development. These data suggest that heart failure due to adrenergic deficiency may be dependent upon RA signaling. This led to the hypothesis that adrenergic hormones promote the development of the electrical conduction system through modulation of RA signaling. To test this, embryonic mouse hearts were cultured with LE 135, a RA receptor blocker. Heart rate, arrhythmic index (AI) and conduction time were measured. Under these conditions there was a marked increase in arrhythmias. Hearts treated with LE 135 showed a mean AI of 0.232±0.057 after 24 hours of treatment while when untreated had an AI of 0.083±0.028 (p<0.05;n=15). In contrast, there was no significant change in heart rate or conduction speed after 24 hours with or without the retinoic acid receptor blocker. To determine if adrenergic stimulus influences retinoic acid response, an established RA-sensitive reporter cell line was employed. These F9-RARE-LacZ cells were treated with forskolin (cAMP regulator) and isoproterenol (greek lower case letter beta]-agonist) to measure changes in RA signaling. Evaluation of RA signaling showed an increase in retinoic acid responsiveness when treated with an adrenergic signaling agonist.; These results suggest that proper retinoic acid signaling is essential for maintaining cardiac rhythmicity during embryonic development and adrenergic stimulation can influence this response.

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All-trans retinoic acid (atRA) mediated growth inhibition results in the arrest of the cell cycle during the G1 phase in CAOV3 cells but not SKOV3 ovarian carcinoma cells. The G1 checkpoint is regulated by a multitude of molecules such as the retinoblastoma family of proteins, cyclins, cyclin dependent kinases (CDKs) and cyclin dependent kinase inhibitors (CDKis). CAOV3 cells, which are atRA sensitive, have been shown to express p16INK4a (p16), a cyclin dependent kinase inhibitor regulating the G1 checkpoint. However, atRA resistant SKOV3 cells do not express p16. In these studies, we investigated the role of p16 in mediating atRA induced growth arrest. Our results show that overexpression of p16 in SKOV3 cells leads to growth inhibition following atRA treatment. However, the inhibition is short-term due to the loss of p16 expression. Nevertheless, these results show that p16 plays a role in atRA mediated growth inhibition in ovarian carcinoma cells and that modulation of p16 expression can determine the growth response to atRA. Additionally, we also examined the effect of atRA treatment on the expression of homeobox genes in the CAOV3 cells and SKOV3 cells model system. Homeobox genes comprise a family of transcription factors which function during embryonic development to control pattern formation, differentiation and proliferation. Besides their dominant role during embryogenesis, they are also expressed in adults. In human tumors, an association between the deregulation of the expression of homeobox genes and oncogenic transformation has been reported. It is known that some homeobox genes are atRA targets due to the presence of retinoic acid response element (RARE) either in their promoter region or in their 3' region. In these studies we examined the expression of 13 homeobox genes in CAOV3 cells and SKOV3 cells following ethanol or atRA treatment. The 13 homeobox genes were analyzed because previous studies done by our laboratory observed differences in expression of these homeobox genes when comparing atRA sensitive oral squamous carcinoma cells (SCC) to atRA resistant oral squamous cell carcinoma cells. Of the 13 homeobox genes analyzed in the ovarian carcinoma cell model system, we found HOXA1 and HOXB4 to be upregulated by atRA in CAOV3 cells but not in SKOV3 cells. We also found that the induction of HOXA1 and HOXB4 mRNA expression in CAOV3 cells occurred as a respond to atRA treatment and is not due to a generalized response because of overall growth reduction. Interestingly, HOXA1 has two alternatively spliced forms. The mRNA expression of the truncated form of HOXA1 is highly induced by atRA when compared to its full length form. HOXB1, which is HOXA1 target gene, was not upregulated following atRA treatment. These results suggest that: 1) expression of p16 plays a role in mediating atRA growth inhibition; 2) HOXA1 and HOXB4 also play a role in mediating growth suppression by atRA; and 3) the truncated form of HOXA1 is induced by atRA treatment and may play a role in mediating growth inhibition by atRA, perhaps by acting in a dominant negative fashion. / Microbiology and Immunology