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Three hundred and four women with mild dyskaryosis were recruited into this study. They were examined using cervical cytology, HPV 16 & HPV 18 detection and colposcopic assessment, and the histological outcome was diagnosed by Large Loop Excision of the Transformation Zone. The resulting statistical analysis of this data showed that a secondary screening programme that combines HPV 16 & HPV 18 level with repeat cytology would not be a very efficient screening programme for the management of women with a mildly dyskaryotic smear. The study women were also examined for the presence of a specific P4501A1 polymorphism. When considering the women who had high grade disease, it was discovered that the mean age of the women with the normal genotype was 29 years, whereas the mean age of the women with the 'high' risk genotype was 25 years. This difference was significant and could not be accounted for by years the women with the 'high' risk genotype have smoked, or how many cigarettes these women smoked a day. CIN is commonly treated by excisional surgical procedures. Chemotherapy, however, would represent a new, less invasive and potentially less expensive alternative for the prevention of cervical cancer. There are a number of anticancer drugs available, daunorubicin and doxorubicin being the 2 most commonly used antracyclines. However, the use of such drugs is strongly limited by their lack of selectivity for cancer cells. A method has thus been adapted to test whether DaunoXomes (daunorubicin encapsulated liposomes) could be used to kill cervical cancer cells. The long term aim of this is to achieve specific targeting of DaunoXomes to cancer cells using antibody-enzyme conjugates. Preliminary results appear promising as death of cancer cells was achieved by release of the DaunoXomes contents in the close proximity of the cancer cells.

Recently a whole cell based biosensor has been developed in our laboratory that consists of a monolayer of human umbilical vein endothelial cells (HUVECs) on the asymmetric cellulose triacetate (CTA) membrane of an ion selective electrode (ISE). When a confluent cell monolayer is formed across the membrane, response from the sensor is inhibited due to inhibited ion transport across the membrane. When the cell based biosensor is exposed to permeability modifying agents, the permeability across the cell monolayer is altered facilitating more ion transport and as a result the response from the sensor increases. This sensor response can be related to the concentration of these agents. One objective of this research was to investigate the ability of the sensor to detect a physiological toxin, alpha toxin from Staphylococcus aureus. Studies demonstrated that the biosensor can detect 0.1ng/ml alpha toxin. Considering the fact that the concentration of this toxin is 100-250 ng/ml in whole blood in humans, this biosensor has the ability to act as the diagnostic tool for staphylococcal diseases. Another part of this research was to investigate the ability of the biosensor to measure angiogenesis by measuring the changes in permeability induced by cytokines such as vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), hepatocyte growth factor (HGF) and tumor necrosis factor andamp;aacute; (TNF- andamp;aacute;) individually and in combination. The sensor response was then compared with the common in vitro assays for angiogenesis. The study demonstrated that at the concentrations studied the sensor response in the presence of cytokines was much higher than that observed for other angiogenesis assays, thereby bolstering the potential of the biosensor to act as a quick screening tool for angiogenesis. Furthermore, epithelial cell based sensor responses to the same cytokines were compared with the responses from endothelial cell based sensor and the mechanisms behind the increased sensor response were elucidated. Finally, to investigate the ability of the sensor to screen cancer, the biosensor was exposed to the serum from healthy individuals and cancer patients. The results showed that the sensor can distinguish between healthy individuals and cancer patients and the results correlate with the stages of cancer.

Thesis (Ph. D.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Dissertation Abstracts International, Volume: 69-02, Section: B, page: 0972. Adviser: Benjamn C. Amick, III. Includes bibliographical references.

Thesis (M.A.)--Northern Kentucky University, 2008. / Made available through ProQuest. Publication number: AAT 1459939. ProQuest document ID: 1622198781. Includes bibliographical references (p. 30-31)

Glioblastoma Multiforme (GBM) is a primary malignant brain cancer, affecting children and adults and has a very poor prognosis. Up to 30% of the tumour mass consists of host derived immune cells, and a better understanding of how these cells affect tumour behaviour is required. These cells, called ‘Tumour Associated Macrophages’ (TAM) have been shown to occur in peripheral solid organ cancers, where they can cause local immune suppression, increase invasiveness and aid tumour growth. In the brain however, TAMs can consist of centrally derived microglia and peripherally derived macrophages, and although these cells could be exerting different effects on the tumour, there is currently no reliable way of distinguishing between the two. Cancer Stem Cells (CSC) are a subpopulation of cells within the tumour mass with stem-like features, are capable of self-renewal, and can recapitulate a tumour in an immunocompromised mouse host. It is thought that these cells play a role in disease recurrence and hence represent a potential target for anti-GBM therapies. In the first project we investigate the interaction between Cancer Stem Cells and TAMs. We first describe a method of culturing CSCs and TAMs from a single human patient sample, followed by an investigation into the functional properties of these cell types. We found functional differences between established cell line pairings of U87-MG and CHME3 versus primary patient derived CSCs and TAM cell line pairings. Polarisation of microglia/TAMs with lipopolysaccharide caused significant decrease in proliferative capacity of the GBM cell lines. Next we used a Non-Myeloablative Conditioning System (NMCS) to selectively replace the peripheral bone marrow compartment of wild type animals with labelled bone marrow cells, without disturbing brain homeostasis. We demonstrate that peripheral cells home exclusively to the orthotopically implanted tumour, and that some of these cells are CD11b+ and Gr1+, suggestive of myeloid derived suppressor cells (MDSC). We evaluate current CD45 based gating strategies for distinguishing peripheral and central cells and show them to be inadequate. Finally we compared the chemosensitivity profiles of different patient derived CSC lines using high throughput content screening (HTCS), against currently approved chemotherapeutic drugs and rank these drugs in a response space, based on HTCS parameters including 2D and 3D culture with and without irradiation. Differential chemosensitivities were noted between different patient derived cell lines. Drugs not currently used in the treatment of GBM such as Actinomycin D and Mitoxantrone were also identified using HTCS, suggesting the potential utility of such an approach to personalised treatments in GBM.

The thesis provides a comprehensive overview of key issues affecting practice, policy and patients, in current efforts for colorectal cancer (CRC) disease control. The global burden of CRC is expected to increase by 60% to more than 2.2 million new cases and 1.1 million deaths by 2030. CRC incidence and mortality rates vary up to 10-fold worldwide, which is thought to reflect variation in lifestyles, especially diet. Better primary prevention, and more effective early detection, in screening and surveillance, are needed to reduce the number of patients with CRC in future1. The risk factors for CRC development include genetic, behavioural, environmental and socio-economic factors. Changes to surveillance, which offer non-invasive testing and provide primary prevention interventions represent promising opportunities to improve outcomes and personalise care in those at risk of CRC. By systematic review of the literature, I highlight the gaps in comparative effectiveness analyses of post-polypectomy surveillance. Using micro-simulation methods I assess the role of non-invasive, faecal immunochemical testing in surveillance programmes, to optimise post-polypectomy surveillance programmes, and in an accompanying sub-study, I explore the value of adding an adjunct diet and lifestyle intervention. The acceptability of such revisions is exposed to patient preference evaluation by discrete choice experiment methods. These preferences are accompanied by evidence generated from the prospective evaluation of the health literacy, numeracy, sedentary behaviour levels, body mass index (BMI) and information provision about cancer risk factors, to highlight the potential opportunities for personalisation and optimisation of surveillance. Additional analysis examines the optimisation of a screening programme facing colonoscopy constraints, highlighting the attendant potential to reduce costs and save lives within current capacity.