The prevalence of cardiovascular disease in the United States dramatically increases with age. A hallmark feature of the aged myocardium is increased fibrosis resulting in diastolic dysfunction. Moreover, the survival of patients subsequent to a myocardial infarction is inversely related to age because of a certain extent to maladaptive remodeling mediated by cardiac fibroblasts. Our hypothesis is that cardiac fibroblast (CF) dysfunction results in overexpressed TGF-β1 leading to increased cardiac collagen content in the aged population. TGF-β1 stimulates the synthesis of the extracellular matrix proteins, including collagen in the cardiac tissues. The RT-PCR analysis of mRNA expression of TGF-β1 of the CF was increased by 43% in the aged mice as compared to the younger. The stiffness of the left ventricle is expressed with the slope of the end-diastolic pressure-volume relationship parameter, β (mmHg/μL). In a mouse model, we demonstrated that β was 0.30 ± 0.05 in the young as compared to 0.52 ± 0.10 in the aged (p < .05). The ventricular stiffness was associated with the myocardial collagen content; namely, young versus the aged was 9.5 ± 4.0 as compared to 16.4 ± 2.3% of total protein, respectively (p < .05). In conclusion, the gene structure-function relationships support our hypothesis that cardiac fibroblast disregulation contributes to diastolic filling dysfunction in elderly persons. These data provide a potential contributory mechanism for diastolic dysfunction that may be vital in caring for the aged open-heart surgical patient.

Les phénomènes cicatriciels et de carcinogenèse partagent des points communs et peuvent être définis comme des processus complexes et adaptatif régulés par les interactions entre l'hôte et le microenvironnement tissulaire. Après la chirurgie, la radiothérapie est la seconde modalité la plus efficace dans le traitement du cancer et une approche thérapeutique multimodale impliquant chirurgie, radiothérapie et chimiothérapie est aujourd’hui classiquement utilisée. Des résultats récents suggèrent que, en plus des effets létaux sur les cellules tumorales, la radiothérapie modifie le microenvironnement tissulaire. Ces modifications affectent le phénotype cellulaire, le métabolisme des tissus, et les événements de signalisation entre les cellules.Les interactions complexes entre les cellules stromales et les cellules cancéreuses suscitent beaucoup d’intérêt et dans la première partie de ma thèse, j’ai exploré les interactions entre stroma et cellules de carcinome en réponse à la radiothérapie par modulation génétique du stroma après irradiation. J’ai constaté que les fibroblastes, indépendamment de leur statut RhoB, ne modulaient pas la radiosensibilité intrinsèque des TC- 1, mais produisaient des facteurs diffusibles capables de modifier le devenir des cellules tumorales. Ensuite, j’ai constaté que fibroblastes sauvages et RhoB déficients stimulaient la migration des TC-1 par des mécanismes distincts, impliquant respectivement TGF- β1 et MMP. J’ai également constaté que la co-irradiation, des fibroblastes et des TC- 1, abrogait le phénotype pro-migratoire des TC-1 par répression de la sécrétion du TGF- β et des MMP. Alors que le protocole de co-irradiation utilisé mime la situation clinique, mes résultats sont en désaccord avec les publications récentes et suggèrent que le stroma irradié ne renforce pas la migration des cellules tumorales mais au contraire pourrait être manipulé pour promouvoir une réponse immunitaire anti-tumorale.Deuxièmement, mes expériences in vivo, semblent confirmer les données obtenues in vitro et montrent que l’irradiation préalable du lit tumoral ne stimule ni croissance de la tumeur et ni sa dissemination. Nos résultats semblent montrer que l’irradiation du stroma ne favorise pas la migration des cellules de carcinome et ceci indépendamment de leur génotype. La Troisième Partie De Mon Projet, a été consacrée à l’étude des cellules tumorale circulantes (CTC) après la radiothérapie. En accord avec les résultats rapportés après la chirurgie, le nombre de CTC augmente dans la circulation sanguine après radiothérapie probablement à cause des lésions vasculaires radio-induites ou/et par induction d’EMT dans les cellules tumorales. Néanmoins ces CTC semblent être piégées dans la cavité cardiaque. La signification de la présence de ces CTC pour le développement métastatique n’est pas élucidée mais on peut suspecter un effet promoteur de métastase. Ainsi le microenvironnement pourrait avoir des effets antagonistes promoteurs ou inhibiteurs de malignité. / Wound healing and carcinogenesis are defined as complex, adaptive processes which are controlled by intricate communications between the host and the tissue microenvironment. A number of phenotypic similarities are shared by wounds and cancers in cellular signaling and gene expression. Radiotherapy is the second most effective modality of cancer treatment after surgery and can be used, either alone or in combination with chemotherapy. Recent findings suggest that radiotherapy apart from tumor cell death also rapidly and persistently modifies the tissue microenvironment. These modifications affect cell phenotype, tissue metabolism, bidirectional exchanges and signaling events between cells. The complex interactions between stromal cells and cancer cells are of immense interest and in The First Part of My Thesis, I tried to explore the crosstalk between stromal and carcinoma cells in response to radiotherapy by genetic modulation of the stroma and irradiation. We found that fibroblasts, irrespective of their RhoB status, do not modulate intrinsic radiosensitivity of TC-1 but produce diffusible factors able to modify tumor cell fate. Then we found that Wt and RhoB deficient fibroblasts stimulated TC-1 migration through distinct mechanisms respectively, TGF-β1 and MMP-mediated. We also found that co-irradiation of fibroblasts and TC-1 abrogated the pro-migratory phenotype by repression of TGF-β and MMP secretion. This result is highly relevant to the clinical situation and suggests that conversely to, the current view; irradiated stroma would not enhance carcinoma migration and could be manipulated to promote anti-tumor immune response. Secondly, our in vivo experiments, tends to confirm the in vitro data showing that irradiated tumor bed does not stimulate tumor growth and escape. Our results also challenges the view that irradiated stroma would promote migration of carcinoma cells as we show that independently from their genotype co-irradiation of fibroblasts and carcinoma cells repressed carcinoma cell migration and confirmations studies are currently performed in vivo. The Third Part of My Project, was dedicated to investigate the effect on CTC release after radiotherapy. Consistently with the results reported after surgery , the number of CTC increases in the blood stream after radiotherapy probably due to radiation-induced vascular injury induced or/and by EMT induction in tumor cells but these cells seemed to be entrapped into the cardiac cavity. The significance of these CTC to metastatic development is still under investigation but there is evidence for a metastasis-promoting effect of RT from animal studies.Thus the microenvironment can exert antagonist stimulatory or inhibitory effects on malignant cells.

Wound healing and carcinogenesis are defined as complex, adaptive processes which are controlled by intricate communications between the host and the tissue microenvironment. A number of phenotypic similarities are shared by wounds and cancers in cellular signaling and gene expression. Radiotherapy is the second most effective modality of cancer treatment after surgery and can be used, either alone or in combination with chemotherapy. Recent findings suggest that radiotherapy apart from tumor cell death also rapidly and persistently modifies the tissue microenvironment. These modifications affect cell phenotype, tissue metabolism, bidirectional exchanges and signaling events between cells. The complex interactions between stromal cells and cancer cells are of immense interest and in The First Part of My Thesis, I tried to explore the crosstalk between stromal and carcinoma cells in response to radiotherapy by genetic modulation of the stroma and irradiation. We found that fibroblasts, irrespective of their RhoB status, do not modulate intrinsic radiosensitivity of TC-1 but produce diffusible factors able to modify tumor cell fate. Then we found that Wt and RhoB deficient fibroblasts stimulated TC-1 migration through distinct mechanisms respectively, TGF-β1 and MMP-mediated. We also found that co-irradiation of fibroblasts and TC-1 abrogated the pro-migratory phenotype by repression of TGF-β and MMP secretion. This result is highly relevant to the clinical situation and suggests that conversely to, the current view; irradiated stroma would not enhance carcinoma migration and could be manipulated to promote anti-tumor immune response. Secondly, our in vivo experiments, tends to confirm the in vitro data showing that irradiated tumor bed does not stimulate tumor growth and escape. Our results also challenges the view that irradiated stroma would promote migration of carcinoma cells as we show that independently from their genotype co-irradiation of fibroblasts and carcinoma cells repressed carcinoma cell migration and confirmations studies are currently performed in vivo. The Third Part of My Project, was dedicated to investigate the effect on CTC release after radiotherapy. Consistently with the results reported after surgery , the number of CTC increases in the blood stream after radiotherapy probably due to radiation-induced vascular injury induced or/and by EMT induction in tumor cells but these cells seemed to be entrapped into the cardiac cavity. The significance of these CTC to metastatic development is still under investigation but there is evidence for a metastasis-promoting effect of RT from animal studies.Thus the microenvironment can exert antagonist stimulatory or inhibitory effects on malignant cells.