京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19560号 / 医博第4067号 / 新制||医||1013(附属図書館) / 32596 / 京都大学大学院医学研究科医学専攻 / (主査)教授 川口 義弥, 教授 小川 修, 教授 長澤 丘司 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Osteoactivin (OA) is a glycoprotein required for the differentiation of osteoblasts. In osteoblasts, Bone Morphogenetic Protein-2 (BMP-2) activated Smad1 signaling enhances OA expression. However, the transcriptional regulation of OA gene expression by BMP-2 is still unknown. The aim of this study was to characterize BMP-2-induced transcription factors that regulate OA gene expression during osteoblast differentiation. The stimulatory effects of BMP-2 on OA transcription were established by cloning the proximal 0.96kb of rat OA promoter region in a luciferase reporter vector in various osteogenic cell types. Further, by deletion and mutagenesis analyses of the cloned OA promoter, key binding sites for osteogenic transcription factors namely, Runx2, Smad1, Smad4 and homeodomain proteins (Dlx3, Dlx5 and Msx2) were identified and characterized. Utilizing specific siRNAs to knock down Runx2, Smad1, Smad4, Dlx3, Dlx5 or Msx2 proteins in osteoblasts, we found that Runx2, Smad1, Smad4, Dlx3 and Dlx5 proteins up-regulate OA transcription, whereas, Msx2 down-regulated OA gene expression. These specific effects of transcription factors on OA promoter regulation were confirmed by forced expression of transcription factors. Most notably, BMP-2-stimulated cooperative and synergistic interactions between Runx2-Smad1 proteins and Dlx3-Dlx5 proteins that up-regulate OA promoter activity. Electrophoretic mobility shift and supershift assays demonstrated that BMP-2 stimulates interactions between Runx2, Smad1 and Smad4 and homeodomain transcription factors with the OA promoter regions flanking the -585 Runx2 binding site, the -248 Smad binding site and the region between the -852 and the -843 homeodomain binding sites relative to transcription start site. The OA promoter region was occupied by Runx2 and also Dlx3 transcription factors during proliferation stages of osteoblast differentiation. As the osteoblasts progress from proliferation to matrix maturation stages of differentiation, the OA promoter was predominantly occupied by Runx2 and to a lesser extent Dlx5 in response to BMP-2. Finally, during matrix mineralization stages of osteoblast differentiation, BMP-2-induced a robust recruitment of Dlx5, Smad1, Dlx3 and Msx2 proteins with simultaneous dissociation of Runx2 from the OA promoter region. In conclusion, the BMP-2-induced osteogenic transcription factors Runx2, Smad1, Smad4, Dlx3, Dlx5 and Msx2 provide key molecular switches that regulate OA transcription during osteoblast differentiation. / Cell Biology

Hintergrund: Karzinoid-Tumoren des embryonalen Mitteldarms sind seltene intestinale neuroendokrine Tumoren, bei denen zum Zeitpunkt der Diagnose häufig Metastasen vorliegen. Im Gegensatz zu Karzinoiden des Vorderdarms und Respirationstraktes sind sie nicht mit der Multiplen Endokrinen Neoplasie Typ 1 (MEN1) vergesellschaftet. Die Mechanismen ihrer Tumorigenesis sind weitgehend unbekannt. Methoden: Tumorgewebe acht sporadischer, maligner Dünndarm-Karzinoide war Objekt dieser Studie über Verlust der Heterozygotie ("Loss Of Heterozygosity" (LOH)) mit 131 fluoreszierenden Mikrosatelliten. DNA Sequenz-Analyse mit Oligonucleotid Primern, die Exon 8-11 des SMAD4/DPC4 Gens flankieren sowie immunhistochemische Färbung mit Smad4/DPC4 antikörpern wurde durchgeführt. Ergebnis: Chromosom 18 wies Deletionen in 88% der Tumoren auf. Alle außer einem Tumor hatten sowohl 18p als auch 18q verloren, in einem der Tumoren war eine kleine Region telomer zu den SMAD4/DPC4/DCC Genen auf 18q21 verloren. Andere Chromosomen waren nur in drei Tumoren betroffen. LOH auf Chromosom 11q13, dem MEN1 Lokus, wurde nicht gefunden.Sequenzierung der DNA und immunhistochemische Färbung für das SMAD4/DPC4 Gen zeigten keine Aberrationen. Diskussion: Die Funde der Chromosom 18 Deletionen weisen eindeutig auf ein entscheidendes Ereignis in der Tumorigenese von Karzinoiden des Mitteldarms hin. An der Entstehung dieser Tumoren könnte ein mutmaßliches Tumor Suppressor Gen beteiligt sein, welches auf Chromosom 18 lokalisiert ist. Dahingegen ist SMAD4/DPC4 wahrscheinlich nicht in die Tumorneogenese von Carcinois Tumoren involviert. / Background: Midgut carcinoid tumors are rare malignant tumors with origin in the neuroendocrine cells of the small intestine. Due to secretion of a variety of peptide hormones and biogenic amines they cause the carcinoid syndrome. Metastases are often present at first diagnosis. Despite this, patients have a realistic chance to survive for a prolonged period (30% (unresectable/metastatic disease) -79% (non-metastatic disease) 5-year survival rate) if treated by a combination of surgery and medication. Unlike their foregut counterparts, midgut carcinoid tumors are not or rarely associated with the multiple endocrine neoplasia type 1 (MEN1) syndrome. The genetic back-ground to tumorigenesis of these neoplasms is unknown. In contrast, the events involved in tumorigenesis of gastroenteropancreatic adenocarcinomas are better characterized with frequent mutations e.g. of the Smad4/DPC4, Smad2/MADR2/JV18-1 and DCC genes on chromosome 18. Methods: Eight metastatic midgut carcinoids were analysed by a genome-wide screening for loss of heterozygosity using 131 PCR-amplified fluorescent-labelled microsatellite markers. DNA sequence analysis using oligonucleotide primers flanking exons 8-11 of the Smad4/DPC4 gene and immunohistochemical staining with Smad4/DPC4 antibodies was performed. Results: Chromosome 18 was deleted in seven out of eight tumors (88%). All but one of these tumors had lost both 18p and 18q, the remaining tumor had lost the long arm but retained the short arm. Several other chromosomal alleles were lost in a subset of the tumors. Loss of heterozygosity (LOH) on chromosome 11q13, the MEN 1 locus, was not found. Smad4/DPC4 wild-type sequence and normal immunohistochemical staining for Smad4/DPC4 protein was found for all analysed tumors. Conclusions: Our finding of a high frequency of chromosome 18 deletions in 88% of the tumors strongly suggests that midgut carcinoid tumorigenesis might involve inactivation of a candidate tumor suppressor gene located in that region while Smad4/DPC4 is unlikely to be involved in that process. A more detailed analysis of the genetic events in midgut carcinoid tumors is warranted to clarify their neogenetic origin.

Pancreatic cancer is one of the deadliest types of malignant diseases. Asymptomatic early tumour stages, tumour heterogeneity, cancer cell plasticity and unusually dense pancreatic stroma are responsible for the poor prognosis attributed to late diagnosis and therapy resistance. Therefore, targeting of a pivotal element common for any cell type within the tumour, e.g. mitochondria, may bring significant improvement. In this work, we demonstrate mitochondrial targeting of metformin, an anti-diabetic drug associated with reduced risk of developing pancreatic cancer, substantially increases accumulation of the compound in mitochondria. In consequence, we show that mitochondrially targeted metformin, MitoMet, eliminates pancreatic cancer cells in more than 1000-fold lower concentration than used for its parental compound. Following interaction with respiratory complex I (CI), MitoMet inhibits mitochondrial respiration, activates AMP-activated protein kinase pathway and causes depolarization of mitochondrial membrane potential in pancreatic cancer cells. Moreover, MitoMet induces cell cycle arrest and apoptosis, which is partially mediated via increased level of reactive oxygen species (ROS), and suppresses pancreatic tumour growth in vivo. Interestingly, SMAD4-deficient pancreatic cancer cells manifest...

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Le fer est un oligo-élément nécessaire pour le fonctionnement normal de toutes les cellules de l'organisme et joue un rôle essentiel dans de nombreuses fonctions biologiques. Cependant, le niveau de fer dans le corps doit être bien réglé, sinon la carence en fer entraine des divers états pathologiques tels que l'anémie et la diminution de l’immunité. D'autre part, une surcharge en fer potentialise la multiplication des germes, aggrave l’infection et la formation de radicaux libres ayant des effets toxiques sur les cellules et leurs composants, ce qui favorise les maladies cardio-vasculaires, l'inflammation et le cancer. L'hepcidine (HAMP), un régulateur négatif de l'absorption du fer, induit la dégradation de la ferroportine (FPN), le seul exportateur connu de fer ce qui réduit sa libération par les macrophages et inhibe son absorption gastro-intestinale. HAMP est synthétisé principalement par les hépatocytes, mais aussi par les macrophages. Cependant, il y a très peu de données sur la façon dont HAMP est régulé au niveau des macrophages. Plus récemment, nous avons constaté que l’induction de l’hepcidin dans le foie par le polysaccharide (LPS) est dépendante de la voie de signalisation médiée par « Toll-like receptor 4 » (TLR4). Grâce au TLR4, le LPS induit l'activation des macrophages qui sécrètent de nombreuses différentes cytokines inflammatoires, y compris Interleukine 6 (IL-6), responsable de l'expression de HAMP hépatique. Dans le premier chapitre de la présente étude, nous avons étudié la régulation de HAMP dans la lignée cellulaire macrophagique RAW264.7 et dans les macrophages péritonéaux murins stimulés par différents ligands des TLRs. Nous avons constaté que TLR2 et TLR4 par l'intermédiaire de la protéine adaptatrice « myeloid differentiation primary response gene 88 » (MyD88) activent l'expression de HAMP dans les cellules RAW264.7 et les macrophages péritonéaux sauvages murins, tandis que cette expression a été supprimée dans les macrophages isolés des souris TLR2-/-, TLR4-déficiente ou MyD88-/-. En outre, nous avons constaté que la production d'IL-6 par les cellules RAW264.7 stimulées avec du LPS a été renforcée par l’ajout des quantités élevées de fer dans le milieu de culture. Au cours de l’inflammation, le niveau de HAMP est fortement augmenté. Ainsi, lorsque l'inflammation persiste, l’expression de HAMP continue à être activée par des cytokines pro-inflammatoires conduisant à une hyposidérémie. Malgré que cette dernière soit considérée comme une défense de l'hôte pour priver les micro-organismes de fer, celle ci cause un développement d'anémies nommées anémies des maladies chroniques. Ainsi, dans le deuxième chapitre de la présente étude, nous avons étudié l'implication des TLRs et leurs protéines adaptatrices MyD88 et TIR-domain-containing adapter-inducing interferon-β (TRIF) dans le développement des hyposidérémies. En utilisant des souris déficientes en MyD88 et TRIF, nous avons montré que les voies de signalisations MyD88 et TRIF sont essentielles pour l’induction de HAMP par le LPS. Malgré l'absence de HAMP, les souris déficientes ont été capables de développer une hyposidérémie, mais la réponse des souris déficientes en MyD88 a été très légère, ce qui indique l'exigence de cette protéine pour assurer une réponse maximale au LPS. En outre, nous avons constaté que la signalisation MyD88 est nécessaire pour le stockage du fer au niveau de la rate, ainsi que l'induction de lipocaline 2 (LCN2), qui est une protéine impliquée dans la fixation du fer pour limiter la croissance bactérienne. Indépendamment de MyD88 ou TRIF, l'activation de TLR4 et TLR3 a conduit, au niveau de la rate, à une diminution rapide de l’expression de FPN et du « Human hemochromatosis protein » (HFE) qui est une protéine qui limite la séquestration du fer cellulaire à partir de la circulation. Cependant, malgré cette baisse d’expression, le manque de la signalisation MyD88 a altéré de manière significative la réponse hyposidérémique. En établissant le rôle des TLRs et de la protéine adaptatrice MyD88 dans la diminution du taux du fer sérique au cours de la réponse inflammatoire, nous avons remarqué qu’en réponse au surcharge en fer les souris déficientes en MyD88 accumulent de manière significative plus de fer hépatique par rapport aux souris sauvages, et cela indépendamment des TLRs. Ainsi, dans le troisième chapitre de la présente étude, nous avons étudié le phénotype observé chez les souris déficientes en MyD88. Nous avons trouvé que l'expression de HAMP chez ces souris a été plus faible que celle des souris de type sauvage. Pour cela, nous avons exploré la signalisation à travers la voie du « Bone Morphogenetic Proteins 6 » (BMP6) qui est considérée comme étant la voie fondamentale de la régulation de HAMP en réponse aux concentrations du fer intracellulaires et extracellulaires et nous avons trouvé que l'expression protéique de Smad4, un régulateur positif de l'expression de HAMP, est significativement plus faible chez les souris MyD88-/- par rapport aux souris sauvages. En outre, on a montré que MyD88 interagit avec « mothers against decapentaplegic, Drosophila, homolog 4 » (Smad4) et que cette interaction est essentielle pour l’induction de HAMP à travers la voie BMP6. En conclusion, notre étude montre que l'expression de HAMP dans les macrophages est régulée principalement par TLR2 et TLR4 à travers la voie MyD88 et que l'accumulation du fer dans les macrophages peut affecter les niveaux des cytokines pro-inflammatoires. En outre, nos analyses démontrent que le développement d’hyposidérémie en réponse au LPS se produit par l'intermédiaire d’un mécanisme dépendant de MyD88 qui est dissociée de la production de cytokines et de HAMP. En plus, nos recherches montrent que MyD88 est nécessaire pour l'expression de Smad4 et cela pour garantir une réponse optimale à travers la signalisation BMP6, conduisant ainsi à une expression adéquate de HAMP. Enfin, la protéine MyD88 joue un rôle crucial dans, la régulation de HAMP au niveau des macrophages, la diminution du taux du fer sérique en réponse au LPS et le maintien de l'homéostasie du fer. / Iron is an oligoelement necessary for normal functioning of all body cells and plays an essential role in many biological functions. However, the level of iron in the body must be well regulated, otherwise iron deficiency results in various pathological conditions such as anemia and decreased immunity. On the other hand, iron overload potentiates the multiplication of germs and infection worsens, and the formation of free radicals with toxic effects on cells and their components, thus promoting cardiovascular diseases, inflammation and cancer. Hepcidin (HAMP), a negative regulator of iron absorption, induces the degradation of the only known iron exporter ferroportin (FPN) resulting in the reduction of iron release by macrophages and in the inhibition of its gastrointestinal uptake. HAMP is synthesized mainly by hepatocytes but also by macrophages. However, there are very little data about how HAMP is regulated in macrophages. More recently, we found that HAMP induction in the liver by polysaccharide (LPS) is dependent on the signaling pathway mediated by Toll-like receptor 4 (TLR4). Through TLR4, LPS induces the activation of macrophages which will secrete many different inflammatory cytokines, including Interleukine 6 (IL-6), responsible of hepatic HAMP expression. In the first chapter of the present study, we investigated HAMP regulation in the RAW264.7 macrophage cell line and in murine peritoneal macrophages stimulated with different TLR ligands. We found that TLR2 and TLR4 signaling through the myeloid differentiation primary response gene 88 (MyD88) adaptor protein activate hepcidin expression in RAW264.7 cells and in wild-type murine peritoneal macrophages, while this expression was abolished in TLR2−/−, TLR4-deficient or MyD88−/− isolated macrophages. Moreover, we found that IL-6 production by RAW264.7 cells stimulated with LPS was enhanced by high amounts of iron present in the culture medium. During inflammation, the level of HAMP is greatly increased. Thus, when inflammation persists, HAMP expression continues to be activated by proinflammatory cytokines leading to hypoferremia. Despite that the latter is considered as host defence to deprive microorganisms of iron, this will cause the development of anemia of chronic disease. Thus, in the second chapter of the present study, we investigated the involvement of TLRs signaling through their adaptor proteins MyD88 and TIR-domain-containing adapter-inducing interferon-β (TRIF) in the development of hypoferremia. Using MyD88-deficient and TRIF-deficient mice, we show that MyD88 and TRIF signaling pathways are critical for HAMP up-regulation by LPS. Despite the lack of HAMP, both deficient mice were able to develop hypoferremia; however the response in MyD88 deficient mice was very mild, indicating the requirement of MyD88 adaptor protein for the acute hypoferremic response to LPS. Furthermore, we found that MyD88 signaling is required for iron sequestration in the spleen and the induction of lipocalin 2 (LCN2) which is a protein involved in iron sequestration that in turn limits bacterial growth. Independently of MyD88 or TRIF, the activation of TLR4 and TLR3 signaling resulted in rapid down-regulation of splenic FPN and the Human hemochromatosis protein (HFE) which is a protein that limit cellular iron uptake from the circulation. However, despite the latter down-regulation, the lack of MyD88 signaling significantly impaired the hypoferremic response. While establishing the role of TLRs signaling through MyD88 adaptor protein in the acute phase of hypoferemia, we noticed that MyD88-deficient mice accumulate significantly more iron in their livers than wild-type mice in response to iron loading, and this independently of TLRs. Thus, in this third chapter of the present study, we studied the phenotype observed in MyD88-deficient mice. We found that HAMP expression in MyD88-deficient mice was lower than wild-type mice. Regarding this result, we explored the Bone Morphogenetic Proteins 6 (BMP6) signaling which is considered to be the fundamental pathway regulating HAMP levels in response to intracellular and extracellular iron concentrations and we found by western blot that Smad4 expression is significantly lower in MyD88-/- mice when compared to wild-type mice. We further show that MyD88 interacts with the mothers against decapentaplegic, Drosophila, homolog 4 (Smad4), a positive regulator of HAMP expression, and that this interaction is critical for HAMP induction through the Smad4 iron-sensing pathway. In conclusion, our study shows that HAMP expression in macrophages is regulated mainly through TLR2 and TLR4 receptors via the MyD88-dependent signaling pathway and that autocrine regulation of iron accumulation in macrophages by HAMP may affect the levels of proinflammatory cytokine production. Furthermore, our analysis shows that the development of hypoferremia during LPS response occur via a MyD88-dependent mechanism that is dissociated from peripheral cytokine production and hepatic HAMP induction. This work shows that MyD88 is required for Smad4 expression to guarantee an optimum response to BMP6 signaling, leading to adequate HAMP expression. Finally, the MyD88 adopter protein plays a crucial role in the regulation of HAMP expression by macrophages, the development of the hypoferremic response by LPS and the maintenance of iron homeostasis.

<p>Pancreatic endocrine tumors (PETs) may cause typical syndromes of hormone excess, or appear clinically non-functioning without hormonal symptoms. PETs occur sporadically, in association with the multiple endocrine neoplasia type 1 (MEN1) syndrome, or rarely the von Hippel-Lindau syndrome. Molecular genetic investigations may reveal pathways important for tumor development, and be of clinical use.</p><p>The aim of this thesis was to investigate regulation of different genes involved in cell proliferation, and relate findings to signs of malignancy in PETs.</p><p>The MEN1 gene on chromosome 11q13 was mutated in three out of eleven sporadic malignant PETs. Two nonsense mutations, causing truncation of the protein, and one missense mutation were found.</p><p>Relation of allelic loss at 11q13 and 3p25 to malignant behavior was observed in sporadic PETs. Allelic loss at 18q21 was found in a subset of sporadic and MEN1-associated PETs, and mutation analysis of Smad4 excluded a tumor suppressor gene function.</p><p>In PETs with allelic loss on chromosome 3p25, mutation analysis of WNT7A and HDAC11 excluded function as tumor suppressor genes.</p><p>Menin, encoded by the MEN1 gene, was reported to regulate expression of the cyclin-dependent kinase inhibitors CDKN2C/p18, CDKN1B/p27, and CDKN2B/p15 in mouse pancreatic islet tumor models. Here, the mRNA expression of these genes was not related to MEN1 gene mutations in human PETs.</p><p>Cyclin-dependent kinase 4 (CDK4) and the protooncogene c-Myc were found to be overexpressed regardless of MEN1 gene mutational status of the PETs. The CDK4 gene was neither amplified nor mutated. Targeting of CDK4 may present an alternative to traditional chemotherapy of PETs in the future.</p>

Pancreatic endocrine tumors (PETs) may cause typical syndromes of hormone excess, or appear clinically non-functioning without hormonal symptoms. PETs occur sporadically, in association with the multiple endocrine neoplasia type 1 (MEN1) syndrome, or rarely the von Hippel-Lindau syndrome. Molecular genetic investigations may reveal pathways important for tumor development, and be of clinical use. The aim of this thesis was to investigate regulation of different genes involved in cell proliferation, and relate findings to signs of malignancy in PETs. The MEN1 gene on chromosome 11q13 was mutated in three out of eleven sporadic malignant PETs. Two nonsense mutations, causing truncation of the protein, and one missense mutation were found. Relation of allelic loss at 11q13 and 3p25 to malignant behavior was observed in sporadic PETs. Allelic loss at 18q21 was found in a subset of sporadic and MEN1-associated PETs, and mutation analysis of Smad4 excluded a tumor suppressor gene function. In PETs with allelic loss on chromosome 3p25, mutation analysis of WNT7A and HDAC11 excluded function as tumor suppressor genes. Menin, encoded by the MEN1 gene, was reported to regulate expression of the cyclin-dependent kinase inhibitors CDKN2C/p18, CDKN1B/p27, and CDKN2B/p15 in mouse pancreatic islet tumor models. Here, the mRNA expression of these genes was not related to MEN1 gene mutations in human PETs. Cyclin-dependent kinase 4 (CDK4) and the protooncogene c-Myc were found to be overexpressed regardless of MEN1 gene mutational status of the PETs. The CDK4 gene was neither amplified nor mutated. Targeting of CDK4 may present an alternative to traditional chemotherapy of PETs in the future.

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