<p>To this day, cancer remains the leading cause of mortality worldwide1. A major contributor to cancer progression and metastasis is tumor angiogenesis. The formation of blood vessels around a tumor is facilitated by the complex interplay between cells in the tumor stroma and the surrounding microenvironment. Understanding this interplay and its dynamic interactions is crucial to identify promising targets for cancer therapy. Current methods in cancer research involve the use of two-dimensional (2D) monolayer cell culture. However, cell-cell and cell-ECM interactions that are important in vascularization and the three-dimensional (3D) tumor microenvironment cannot accurately be recapitulated in 2D. To obtain more biologically relevant information, it is essential to mimic the tumor microenvironment in a 3D culture system. To this end, we demonstrate the utility of poly(ethylene glycol) diacrylate (PEGDA) hydrogels modified for cell-mediated degradability and cell-adhesion to explore, in 3D, the effect of various tumor microenvironmental features such as cell-cell and cell-ECM interactions, and dimensionality on tumor vascularization and cancer cell phenotype. </p><p>In aim 1, PEG hydrogels were utilized to evaluate the effect of cells in the tumor stroma, specifically cancer associated fibroblasts (CAFs), on endothelial cells (ECs) and tumor vascularization. CAFs comprise a majority of the cells in the tumor stroma and secrete factors that may influence other cells in the vicinity such as ECs to promote the organization and formation of blood vessels. To investigate this theory, CAFs were isolated from tumors and co-cultured with HUVECs in PEG hydrogels. CAFs co-cultured with ECs organized into vessel-like structures as early as 7 days and were different in vessel morphology and density from co-cultures with normal lung fibroblasts. In contrast to normal lung fibroblasts (LF), CAFs and ECs organized into vessel-like networks that were structurally similar to vessels found in tumors. This work provides insight on the complex crosstalk between cells in the tumor stroma and their effect on tumor angiogenesis. Controlling this complex crosstalk can provide means for developing new therapies to treat cancer.</p><p>In aim 2, degradable PEG hydrogels were utilized to explore how extracellular matrix derived peptides modulate vessel formation and angiogenesis. Specifically, integrin-binding motifs derived from laminin such as IKVAV, a peptide derived from the α-chain of laminin and YIGSR, a peptide found in a cysteine-rich site of the laminin β chain, were examined along with RGDS. These peptides were conjugated to heterobifunctional PEG chains and covalently incorporated in hydrogels. The EC tubule formation in vitro and angiogenesis in vivo in response to the laminin-derived motifs were evaluated. </p><p>Based on these previous aims, in aim 3, PEG hydrogels were optimized to function as a 3D lung adenocarcinoma in vitro model with metastasis-prone lung tumor derived CAFs, HUVECs, and human lung adenocarcinoma derived A549 tumor cells. Similar to the complex tumor microenvironment consisting of interacting malignant and non-malignant cells, the PEG-based 3D lung adenocarcinoma model consists of both tumor and stromal cells that interact together to support vessel formation and tumor cell proliferation thereby more closely mimicking the functional properties of the tumor microenvironment. The utility of the PEG-based 3D lung adenocarcinoma model as a cancer drug screening platform is demonstrated with investigating the effects of doxorubicin, semaxanib, and cilengitide on cell apoptosis and proliferation. The results from drug screening studies using the PEG-based 3D in vitro lung adenocarcinoma model correlate with results reported from drug screening studies conducted in vivo. Thus, the PEG-based 3D in vitro lung adenocarcinoma model may serve as a better tool for identifying promising drug candidates than the conventional 2D monolayer culture method.</p> / Dissertation

When breast tumor cells encounter stress due to cancer therapies, they may enter a dormant state, escaping from treatment-induced apoptosis. Dormant cells may eventually regain proliferative capabilities and cause recurrent metastatic disease, which is the leading cause of mortality in breast cancer patients. We sought to determine if a high dose of radiation therapy (RT) or combined chemo-immunotherapy, with and without the blockade of autophagy by chloroquine (CQ), could overcome treatment-induced tumor dormancy or relapse. We found that autophagy contributes in part to treatment-induced tumor dormancy. We also found that three therapeutic strategies were successful in inhibiting or preventing tumor relapse. These include: 18Gy/day RT, chemotherapy combined with the blockade of autophagy, and combined chemo-immunotherapy. Follow-up studies are needed to determine the feasibility of preventing tumor relapse by prolonging tumor dormancy versus eliminating dormant tumor cells.

Tumor microenvironment is an area, where the local immunosuppressive effects dominate and prevents the immune system to perform its physiological functions. The cells infiltrating the microenvironment have an important function among many cell types since they produce a large quantity of factors suppressing the immune response. In our work, we monitored the immune changes in the microenvironment during tumor growth and chemotherapy. For these purposes, we utilized the methods for analysis of the proportion and phenotype of the distinct populations of immunocytes and for analysis of the total level of expressions of selected genes associated with immunosuppression or with distinct populations of immunocytes. The aim of our work was to discover, using two types of mouse tumors (TRAMP-C2 and TC-1/A9), how 5-azacytidine (5AC), a cytostatic drug with epigenetic activity, affects the proportion of leukocytes infiltrating the tumor microenvironment and, further, whether these changes are accompanied by decreased expression of immunosuppressing genes. In addition, we have also focused on the changes of relative expression of genes encoding markers of lymphoid lines and, on other immunoregulating genes, encoding IL-6, IL-10, IL-12, IL-4 and IFNγ cytokines, in the microenvironment of these tumors....

TNF wird zunächst als TypII-Transmembranprotein (mTNF) gebildet und erst anschließend durch spezifische Spaltung durch die Metalloprotease TACE zum löslichen Zytokin sTNF prozessiert. Da mTNF der alleinige Hauptaktivator des TNFR2 ist und sich bisherige Untersuchungen zum TNF-Signaling weitgehend auf sTNF konzentrierten, ist vergleichsweise wenig über TNFR2-vermittelte Signaltransduktion bekannt. An TNFR1 sind dagegen beide TNF-Varianten bioaktiv. Trotz intensiver Untersuchung des TNFR1-Signaling sind jedoch auch hier viele Fragen noch unbeantwortet. Derzeit existieren deshalb zum TNFR1-Signaling zwei verschiedene Modellvorstellungen nebeneinander. Im ersten Modell, dem Modell der Kompartmentalisation, bindet TRADD erst nach Rezeptorinternalisierung an TNFR1, genauso wie FADD und Caspase-8. Die Rezeptorinternalisierung nach Ligandenbindung gilt hier daher als Voraussetzung für die TRADD-Rekrutierung und für die Apoptoseinduktion. Im zweiten Modell, dem Modell zweier sequentiell arbeitender Signalkomplexe, bindet TRADD dagegen bereits im membrangebundenen Signalkomplex an TNFR1. Anschließend dissoziiert TRADD vom Rezeptor, um im Zytoplasma einen zweiten, apoptoseinduzierenden Komplex mit FADD und Caspase-8 zu formen. Um mehr über TNFR2 zu erfahren und um das TNFR1-Signaling besser zu verstehen, wurden in dieser Arbeit die Signaltransduktion und die Geninduktion über TNFR1 und TNFR2 nach Stimulation mit mTNF untersucht. Ziel war es letztlich, eine Methode zu etablieren, die es erlaubt, membrangebundene TNFR1- und TNFR2-Signalkomplexe getrennt zu isolieren. Dazu wurden zunächst nicht zu sTNF spaltbare TNFR1- bzw. TNFR2-spezifische mTNF-Varianten mit GST-Tag hinsichtlich Rezeptorbindung und Rezeptoraktivierung näher charakterisiert. Die selektive Bindung dieser mTNF-Varianten an TNFR1 bzw. TNFR2 konnte gezeigt werden. Auch der Nachweis ihre Funktionalität in Versuchen zur IL8-Induktion war möglich. Mit Hilfe der TNFR1-spezifischen mTNF-Variante gelang im GST-Fishing die Koimmunopräzipitation von TNFR1, TRADD und TRAF2 und damit die Isolierung des membrangebundenen Signalkomplexes des TNFR1. Mit Hilfe einer TNFR2-spezifischen Variante konnten dagegen TNFR2 und TRAF2 koimmunopräzipitiert werden, TRADD dagegen nicht. Somit ließen sich mit den rezeptorspezifischen Varianten von mTNF die Rezeptorsignalkomplexe des TNFR1 und TNFR2 getrennt isolieren. Interessant war dabei insbesondere die TRADD-Rekrutierung an TNFR1 im membrangebundenen TNFR1-Signalkomplex. Da die Internalisierung von TNFR1 nach mTNF-Stimulation schwer vorstellbar ist, bindet TRADD offensichtlich an TNFR1, ohne dass eine Rezeptorinternalisierung Voraussetzung wäre. Damit erscheint das Modell der Kompartmentalisation zumindest für mTNF wenig plausibel. Dagegen sind die bisher für mTNF erhobenen Daten mit einer TRADD-Dissoziation vom Rezeptor vereinbar, weshalb ein Modell zweier sequentiell arbeitender Signalkomplexe durchaus auch für mTNF Gültigkeit besitzen könnte. / In this dissertation, membrane bound TNF and its receptor selective muteins are shown to induce gene expression and to selectively bind to TNFR1 and TNFR2. Furthermore, in GST-Fishing experiments membrane bound TNF induced signal transduction leading to NFkB and apoptosis induction was further investigated. Two existing different models of TNFalpha induced apoptosis in the literature were compared, the model of two sequential signaling complexes and the model of compartmentalisation. In this dissertation, it was shown that the model of two sequential signaling complexes is more likely to be able to explain membrane bound TNF induced apoptosis.

Introdução: Tumores adrenocorticais (TAC) são raros, correspondendo somente a 0,2% de todas as neoplasias pediátricas, sendo que a maioria dos casos são diagnosticados no Brasil e estão associados com a mutação TP53 p.R337H. A cirurgia é o único tratamento efetivo conhecido para os TAC, sendo os tumores em estadios avançados frequentemente fatais. A família das Aurora-quinases é formada por três membros (Aurora-A, -B e -C) os quais atuam em diversas fases do ciclo celular, como alinhamento dos cromossomos, formação do fuso mitótico e citocinese. Diferentes trabalhos mostraram a expressão alterada de membros desta família em vários tipos de tumores e a inibição da atividade destas proteínas tem sido considerada uma potencial abordagem para o tratamento do câncer. Objetivo: A partir da análise da expressão dos genes Aurora-A e Aurora-B em amostras de TAC pediátrico, foram investigados os efeitos do AMG 900, um pan-inibidor de aurora quinases, na proliferação, apoptose, síntese hormonal e perfil transcricional da linhagem H295A. Além disso, foram avaliados os efeitos do AMG 900 combinado com diferentes quimioterápicos. Metodologia: Os níveis de expressão dos genes Aurora-A e Aurora-B foram analisados em 60 crianças com TAC através das técnicas de RT-qPCR e imuno-histoquímica. A proliferação celular foi avaliada por coloração com Giemsa e a apoptose foi realizada por citometria de fluxo. A análise de combinação de drogas foi feita com base no método de Chou-Talalay e o ensaio de microarray foi realizado utilizando a plataforma da Agilent. Resultados: A expressão dos genes Aurora-A e Aurora-B foi associada com estadios avançados da doença e a expressão do Aurora-A foi associada com a presença da mutação TP53 p.R337H. O tratamento com o AMG900 causou a inibição da proliferação, aumento da apoptose e sensibilizou as células para os inibidores de topoisomerase II (doxorrubicina e etoposídeo). Adicionalmente, o AMG 900 levou à redução da síntese de hormônios bem como modulou a expressão de genes envolvidos com esta atividade. A inibição das aurora-quinases alterou a expressão de genes associados com a regulação da fase G1 do ciclo celular e afetou a expressão de genes da via de sinalização Notch. Conclusão: A inibição das aurora-quinases pelo AMG 900 pode ser uma alternativa para o tratamento dos tumores adrenocorticais. / Introduction: Pediatric adrenocortical tumors (ACT) are rare malignancies representing only 0.2 % of all pediatric cancers. Most cases are diagnosed in Brazil and are associated with TP53 p.R337H mutation. Surgery is the only effective treatment known for the ACT however this approach has a small impact on survival in advanced disease. The Aurora kinase family is comprised of three members (Aurora-A, -B and -C) which act at different phases of the cell cycle, such as chromosomes alignment, mitotic spindle formation and cytokinesis. Several studies have demonstrated altered expression of members of this family in various types of tumors and the functional inhibition of the aurora kinases have been considered as a potential approach to cancer treatment. Aim: On the basis of analysis of Aurora-A and Aurora-B gene expression in the samples from pediatric ACT, we investigated the effects of AMG 900, a pan-aurora kinase inhibitor, on proliferation, apoptosis rate, hormone synthesis and transcriptional profile of H295A cell line. Furthermore, we evaluated the effects of AMG 900 combined with different chemotherapeutic agents. Methods: The mRNA expression levels of Aurora-A and Aurora-B genes were analyzed in 60 children with ACT by RT-qPCR and immunohistochemistry. Cell proliferation was assessed by Giemsa staining and apoptosis was performed by flow cytometry. Drug combination analysis was made on the basis of Chou- Talalay method. Microarray experiments were carried out using the Agilent human microarray. Results: Aurora-A and Aurora-B overexpression was associated with advanced disease. Patients carrying the TP53 p.R337H mutation presented significantly higher expression values of Aurora-A. Treatment with AMG900 caused inhibition of proliferation, increased apoptosis and sensitized the cells to topoisomerase II inhibitors (doxorubicin and etoposide). Additionally, the AMG 900 led to decreased synthesis of hormones and modulated the expression of genes involved in this activity. Finally, Aurora kinases inhibition altered the expression of genes associated with G1 cell cycle phase regulation and affected the Notch signaling pathway target genes. Conclusion: These data suggest that Aurora kinase inhibition by AMG900 may be a new therapeutic approach to adrenocortical carcinoma treatment.

Os tumores de cabeça e pescoço ocupam o sexto lugar no ranking de incidência mundial, e estão localizados na região da face, fossas nasais, seios paranasais, boca, faringe, laringe entre outros tecidos moles do pescoço. O tabagismo, o etilismo, a radiação solar e o vírus HPV, são fatores de risco associados a esse tipo de tumors. A terapia combinada de drogas antineoplásicas tem sido utilizada para amenizar os efeitos colaterais e potencializar o tratamento antitumoral. A combinação de paclitaxel e cisplatina tem se mostrado eficaz em tumores sólidos, como o HNSCC. A morte celular induzida pelo paclitaxel é mediada pela ruptura da dinâmica dos microtúbulos normais, já a cisplatina induz ligações cruzadas de DNA estes tratamentos induzem a célula à morte por apoptose. A apoptose é um processo de morte dividido, didaticamente, em via intrínseca (via mitocondrial) e via extrínseca (via receptor de morte). Entender por qual via essas células tumorais são induzidas a morte é fundamental para tentar evitar a resistência dessas células ao tratamento. Nosso objetivo é entender se células tumorais de HNSCC são resistentes ou sensíveis ao tratamento com paclitaxel e cisplatina sozinhos ou em associação. Para isso, realizamos o tratamento da linhagem celular FaDu por um período de 48 horas com as drogas e verificamos sua resistência a indução de morte por esses tratamentos. Os resultados mostraram que o tratamento com paclitaxel não potencializa a morte desta célula, sendo a linhagem FaDu mais sensível ao tratamento com cisplatina e a associação apresenta o mesmo perfil de quando tratada com cisplatina. A morte desta linhagem é dependente de caspases e possui uma preferência pela via extrínseca da apoptose que, consequentemente, induz a morte também pela via intrínseca. A modulação desta morte se dá pelo balanço das proteínas pró- e anti-apoptóticas da família BCL-2 que são responsáveis pela regulação da apoptose, o tratamento com cisplatina induz a expressão da proteína pró-apoptótica BAK e a diminuição das proteínas anti-apoptóticas BCL-2 e BCL-XL. Com os resultados obtidos, concluímos que a associação de paclitaxel e cisplatina não potencializa a morte da linhagem celular FaDu. Contudo, a cisplatina apresentou-se efetiva na indução de morte por apoptose através do aumento da expressão da proteína BAK e a diminuição da expressão das proteínas BCL-2 e BCL-XL. / Head and neck squamous cell carcinoma is the sixth most common cancer in the world, and are located in the region of the face, nasal fossas, sinuses, mouth, pharynx, larynx and other soft tissues of the neck. Tobacco smoke, etilism, solar radiation and HPV are risk factors associated with this type of tumors. Combination therapy of anticancer drugs has been used to alleviate the side effects and potentiate the antitumor treatment. The combination of paclitaxel and cisplatin has been shown to be effective in solid tumors such as HNSCC. The paclitaxel-induced cell death is mediated by disruption of the normal microtubule dynamics, and the cisplatin induced DNA cross-links, these treatments induce cell death by apoptosis. Apoptosis is a death process divided in, intrinsic pathway (mitochondrial pathway) and extrinsic pathway (death receptor pathway). Understand by what pathway those tumor cells which are induced death is important to try and avoid the resistance of these cells to treatment. Our aims understand if HNSCC tumor cells are resistant or sensitive to treatment with paclitaxel and cisplatin alone or in combination. We carried out the treatment of cell line FADU a period of 48 hours with the drug and we verify their resistance to death induction by these treatments. The results showed that treatment with paclitaxel did not potentiate the cell death, in the other hand, FADU cell line appeared to be more sensitive to cisplatin treatment, and the association has the same profile when treated with cisplatin. The death of this line is dependent on caspases and has a preference for the extrinsic pathway of apoptosis, consequently, also induces the death by the intrinsic pathway. The modulation of death is caused by the balance of pro-and anti-apoptotic proteins of BCL-2 family proteins that are responsible for regulation of apoptosis, treatment with cisplatin induces the expression of pro-apoptotic protein BAK and the decrease of anti-apoptotic proteins BCL -2 and BCL-XL. With these results, we conclude that the combination of paclitaxel and cisplatin did not potentiate the cell death of the cell line Fadu. However, cisplatin showed to be effective in induction of death by apoptosis through increased expression of BAK protein and decreased expression of BCL-2 and BCL-XL.

Endostatina é um inibidor específico de proliferação de células endoteliais, migração e um potente inibidor de angiogênese. Foi demonstrado que a administração contínua de endostatina é mais efetiva na supressão tumoral do que a mesma dose administrada s.c. diariamente. Encontrar a concentração de endostatina para combater o crescimento tumoral é complicado pela pequena meia vida da proteína. O transplante de células encapsuladas em dispositivos de imunoisolamento é uma abordagem promissora para muitas doenças, pois permite uma liberação por longo tempo da proteína com propriedades terapêuticas. A membrana semipermeável pode proteger as células da rejeição do sistema imune, para evitar o problema de toxicidade, meia vida limitada e variação nos níveis circulantes. O dispositivo Theracyte® é um sistema de membranas semipermeáveis para macroencapsulamento que permite o implante de células geneticamente modificadas para liberação de proteínas terapêuticas in vivo sem a necessidade de imunosupressão do hospedeiro. Foi demonstrado neste estudo que fibroblastos murinos (células LM) expressando 0,4 µg de endostatina murina/106 células em 24 horas se apresentam como uma abordagem promissora para terapia tumoral. O sistema de liberação é composto de células LM produtoras de endostatina encapsuladas em macrocápsulas Theracyte para imunoisolamento de células. Para demonstrar a utilidade deste sistema, modelos de camundongos com tumores de Ehrlich e melanoma foram tratados com 107 células encapsuladas expressando endostatina. Foram analisados dois protocolos para o implante dos dispositivos: No primeiro, os dispositivos foram implantados nos animais e após 14 dias (cicatrização das feridas), as células expressando endostatina foram implantadas no interior destes dispositivos. Em um segundo, os dispositivos contendo as células foram implantados nos animais. O crescimento do tumor melanoma foi reduzido de 42% pela utilização do primeiro protocolo de implante e de 54% quando o segundo protocolo foi utilizado. O crescimento do tumor de Ehrlich foi reduzido de 25% utilizando o primeiro protocolo de implante. A imunohistoquímica utilizando anticorpo anti-endostatina demonstrou a liberação da endostatina para o estroma ao redor do dispositivo, mostrando que a endostatina, secretada pelas células recombinantes confinadas permeou através da membrana, atingindo os tecidos adjacentes. A efetividade da ação da endostatina na neovascularização de melanoma (B16-F10) foi determinada pela análise do número de estruturas vasculares, analisadas por imunohistoquímica utilizando anticorpo anti-CD34. Foi demonstrado um decréscimo de 41,5% no número de estruturas vasculares, 35,9% no número de vasos viáveis e de 33,5% na extensão da área vascular no grupo tratado. Os resultados descritos são promissores e podem oferecer uma alternativa para uma variedade te tipos de tumores. / Endostatin is a specific inhibitor of endothelial cell proliferation, migration and a potent angiogenesis inhibitor. It has been shown that continuous administration of endostatin is more effective in tumor suppression than the same dose administered s.c. daily. Achieving concentration of endostatin to combat tumor growth is complicated by the short life of the protein. Transplantation of encapsulated cells in immunoisolation devices is a promising approach for many diseases since it allows a long-term delivery of the therapeutic protein and the semi-permeable membrane can protect cell from host’s immune rejection, to circumvent the problem of toxicity, limited half life and variation in circulating levels. The Theracyte® device is a semi-permeable membrane macroencapsulation system for implantation of genetically engineered cells for therapeutic proteins delivery in vivo and which does not require host immunosuppression. It was shown in this study that encapsulated recombinant murine fibroblasts (LM) expressing 0.4µg of murine endostatina/106 cells in 24 hours presents a feasible approach to tumor therapy. The delivery system was composed of recombinant endostatin-producing LM murine cells encapsulated into Theracyte macrocapsule for immunoisolation of cells. To demonstrate the usefulness of this system, experimental mice models with Ehrlich and Melanoma tumors were treated with 107 encapsulated endostatin-expressing cells. Two protocols were used for the implant of the devices: 1) The devices were implanted in the animals and after 14 days (wound healing), the cells expressing endostatin were implanted into the device and 2) the devices were implanted in the animals containing the cells. Melanoma tumor growth was reduced by 42% using the first implant protocol and by 54% when the second protocol was used. Ehrlich tumor growth was reduced by 25% using the first device implant protocol. As revealed by anti-endostatin immunostaining, there was a release of endostatin to the tissue outside the devices, demonstrating that endostatin, secreted by the confined recombinant cells, permeated trough the membrane, reaching the surrounding tissues. The effectiveness of endostatin delivery on the neovascularization of melanoma (B16-F10) was determined by analysis of the number of vascular structures, accessed by immunohistochemistry using anti-CD-34 antibody. It was shown that there was a decrease of 41.5% in the number of vascular structures, 35.9% in the number of viable vessels and 33.5% in the extension of vascular area in the treated group. The results described are quite promising and may offer an alternative for the treatment of a variety of tumor types. LISTA

Neste trabalho foram pesquisados os efeitos in vitro da metaloproteinase jararagina, em modelo de células de tumores de mama humana MCF7, T47D e murina (Tumor de Ehrlich), além de células normais, avaliando-se a viabilidade celular, morfologia, modificações nas fases do ciclo celular e tipo de morte celular; como os efeitos no modelo murino nas formas ascítica e sólido-ortotópica de Ehrlich. Os resultados obtidos mostraram que a jararagina diminui significativamente a viabilidade e adesão de maneira dose dependente, formação de agregados e estruturas tipo esferoides com formação túbulo-acinar. Os parâmetros antitumorais in vivo, não mostraram diminuição no volume tumoral ascítico, entretanto, no modelo ortotópico, a jararagina induz resposta inflamatória e remodelação da matriz extracelular e resulta em alterações na distribuição e organização do colágeno. Conclui-se que a jararagina induz citotoxicidade nas linhagens de células tumorais de mama e normais, e foi capaz de induzir infiltrado inflamatório durante o crescimento e disseminação das células tumorais. / The present study investigated the in vitro effects of metalloproteinase jararhagin in human breast tumor cells model MCF7 and T47D, murine tumor cells (Ehrlich\'s tumor), and normal cells, assessing cell viability, morphological alterations, changes in the cell cycle phases and death cell, as the effects on ascitic and solid orthotopic murin Ehrlich tumor. The results showed that jararhagin significantly decreases adhesion and cell viability in a dose dependent, with cells aggregates and spheroids with tubulo-acinar formation. The in vivo parameters showed no decrease in ascites tumor volume, however, the orthotopic model, jararhagin induces the inflammatory response and extracellular matrix remodeling with changes in the collagen distribution and organization. It is concluded that jararhagin induces cytotoxicity in breast tumor and normal cell lines, and was able to induce inflammatory infiltrate during the growth and dissemination of tumor cells.

Tumores carcinoides (neoplasias bem diferenciadas) são tumores neuroendócrinos que podem surgir em diferentes locais anatômicos. Na população a prevalência dos tumores carcinoides é de aproximadamente 10 casos para um milhão de habitantes e sua incidência é maior na quinta e sexta década de vida. Este trabalho propõe um modelo cinético baseado na teoria da análise compartimental em humanos com tumores carcinoides que se submeterão ao tratamento com o radiofármaco [177Lu-DOTA0,Tyr3]Octreotato. Imagens cintilográficas dinâmicas planares, obtidas imediatamente à injeção de 370 MBq (10 mCi) do radiofármaco, foram obtidas com o tomógrafo SPECT (Single Photon Emission Computed Tomography). Por meio da seleção de regiões de interesse (ROI) os resultados foram digitalizados e aplicados ao modelo cinético aqui proposto. A primeira fase do estudo (atividade de 370 MBq) teve como objetivo conhecer os parâmetros cinéticos e subsequentemente, o paciente foi submetido ao protocolo de tratamento radioterápico, a critério médico, aos quatro ciclos de 7,4 GBq (200 mCi) do radiofármaco. Desta forma, foi possível estimar previamente as constantes cinéticas ki,j da biodistribuição do 177Lu-DOTATATO no corpo, sendo ki,j a fração de transferência do i-ésimo compartimento (tecido ou órgão) para o j-ésimo compartimento a partir das ROI demarcadoras dos órgãos de maior captação, a saber: fígado, rins, região vascularizada e tumores carcinoides. A partir das constantes cinéticas ki,j a estimativa de dose absorvida em 26 órgãos foi estimada pelo método MIRD. Os resultados dosimétricos foram compatíveis com outras metodologias descritas na literatura. Para um paciente adulto de 73,6 kg, em termos médios seus rins (sem os protetores renais) recebem a maior intensidade de dose (2,39 mGy/MBq) seguido do fígado (0,70 mGy/MBq). Observou-se que tumores com aproximadamente 100g recebem dose da ordem de 0,52 mGy/MBq independentemente da posição a que se encontram no corpo. Este achado se deve à predominância do dano devido às partículas beta quando comparado à radiação gama que possui pouco rendimento de emissão no processo de decaimento do 177Lu. Portanto, os parâmetros cinéticos que promovem a captação do 177Lu nas células são os principais responsáveis pela composição da dose no tumor e demais órgãos. / Carcinoid tumors (well differentiated neoplasms) are neuroendocrine tumors that may arise in different anatomical locations. The population prevalence of carcinoid tumors is approximately 10 cases per one million inhabitants. Its incidence is higher in the fifth and sixth decade of life. This paper proposes a kinetic model in humans with carcinoid tumors who will underwent treatment with the radiopharmaceutical [177Lu-DOTA0,Tyr3 ]OCTREOTATE based on the theory of compartmental analysis. Dynamic planar scintigraphic images acquired immediately upon injection of 370 MBq (10 mCi) of the radiopharmaceutical were obtained with the SPECT (Single Photon Emission Computed Tomography) tomography. Samples from regions of interest (ROI) were used for the kinetic study applying the kinetic proposed model. The first phase of the study (activity 370 MBq) was aimed to evaluate the kinetic parameters. Subsequently, the patient underwent the [177Lu-DOTA0,Tyr3 ]OCTREOTATE radiotherapy protocol, under the physician\'s prescription (up to four cycles of 7.4 GBq (200 mCi)). Thus, it was possible to previously estimate the kinetic constants ki,j relative to biodistribution of [177Lu-DOTA0,Tyr3 ]OCTREOTATE in the body. The ki,j is the transfer fraction from the ith compartment (a tissue or an organ) to the jth compartment. Only few organs showed significant ROI radioactivity count level, among them: the liver, kidney, blood and carcinoid tumors. The MIRD method and the kinetic constants ki,j were used to estimate the absorbed dose in 26 body organs. The absorbed dose D(mGy/MBq) was comparable to other methods described in the literature. For an adult patient of 73.6 kg, on average, the kidneys (without amino acid protectors) showed the highest dose (2.39 mGy/MBq) followed by liver (0.70 mGy / MBq) and tumor (0.52 mGy/MBq) with a tissue size of approximately 100 g. It was observed that tumors receive the same absorbed dose D(mGy/MBq) regardless their position in the body. This finding is due to the predominance of the tissue radiation damage of beta particles compared to gamma radiation that has little yield emission in the 177Lu decay scheme. Therefore, the kinetic parameters ki,j that promote the uptake of 177Lu in cells are primarily responsible for the absorbed D dose in the tumor and other organs.

O câncer de mama é a doença maligna que mais acomete as mulheres no mundo. Apesar dos inúmeros tratamentos, o óbito se deve principalmente à doença metastática que pode se desenvolver a partir do tumor primário. Esta progressão tumoral decorre da dificuldade de se estabelecer um prognóstico mais preciso. Atualmente, a teoria de células iniciadoras de tumor vem sendo estudada para tentar explicar a biologia do câncer e descrever novos alvos para prognósticos e terapias. O carcinoma mamário foi o primeiro tumor sólido para o qual foi identificada uma subpopulação celular, definida como CD44+/CD24-, apresentando as características de células iniciadoras tumorais. Embora este fenótipo venha sendo muito utilizado para descrever as células iniciadoras tumorais de mama, muitos trabalhos tem questionado a relevância clínica desses marcadores, enfatizando que outros marcadores devem ser identificados. Assim, o objetivo deste trabalho é analisar e caracterizar marcadores de células-tronco que possam estar relacionados com o grau de malignidade no modelo de câncer de mama. Inicialmente, analisou-se a expressão de 10 marcadores de células-tronco em diferentes linhagens de câncer de mama que apresentam graus crescentes de malignidade. O CD90 foi selecionado devido à alta expressão desse marcador na linhagem mais agressiva Hs578T. Para a caracterização deste marcador, realizou-se ensaios funcionais, através do silenciamento do CD90 na linhagem tumorigênica Hs579T e sua superexpressão na linhagem não-tumorigênica MCF10A. As linhagens celulares geradas foram caracterizadas quanto ao crescimento celular, potencial invasivo e metastático. Foi possível observar que houve uma alteração da morfologia nas linhagens transformadas com o CD90 e, também, um maior tempo de dobramento na linhagem Hs578T-CD90- e um menor na MCF10A-CD90+. Além disso, a linhagem MCF10-CD90+ foi capaz de crescer independentemente de EGF. Através da análise da via EGF, foi possível observar que houve um aumento da expressão da forma fosforilada do receptor e dos fatores Erk, c-Jun, e Jnk na linhagem MCF10A-CD90+ e uma diminuição dos mesmos na linhagem Hs578T-CD90-. A análise da atividade do elemento responsivo do fator de transcrição AP1 comprovou que a via de EGF é funcional na linhagem MCF10-CD90+. Também foram analisados os marcadores de transição epitélio-mesenquimal, verificando-se aumento da expressão dos marcadores mesenquimais na linhagem MCF10A-CD90+ e diminuição na linhagem Hs578T-CD90-. Os ensaios in vitro de invasão mostraram que as células MCF10-CD90+ são capazes de migrar e invadir e as células Hs578T-CD90- apresentam diminuição significativa da habilidade de migração e invasão. Além disso, os ensaios de metástase in vitro e in vivo, mostraram que a superexpressão de CD90 levou à malignização das células MCF10A. Por outro lado, a linhagem Hs578T-CD90- apresentou menor potencial metastático in vitro. Portanto, neste trabalho, pela primeira vez, o CD 90 foi caracterizado funcionalmente como um marcador envolvido na transformação maligna do carcinoma mamário, contribuindo, assim, para melhor entendimento da biologia do câncer de mama e para que se possa desenvolver novas ferramentas de diagnóstico/prognóstico e novos protocolos clínicos e terapêuticos. / Breast cancer is the malignant disease which affects the highest number of women in the world. In spite of the numerous treatments available, death is primarily due to the metastatic disease that may develop from the primary tumor. This tumor progression occurs because of the difficulty in establishing an accurate diagnosis/prognosis. Currently, the tumor initiating cells theory is being applied in an attempt to explain cancer biology and to unveil new diagnostic and therapeutic targets. Mammary carcinoma was the first solid tumor in which a cellular subpopulation, defined as CD44+/CD24-, was associated with tumor initiating cells. Although this phenotype has been widely used to describe breast tumor initiating cells, several studies have questioned the clinical relevance of these markers, emphasizing that additional markers should be identified. The objective of the present study is to analyze and characterize stem cell markers that may be related to malignancy stages in the breast cancer model. Initially, the expression of 10 stem cell markers was analyzed in different breast cancer cell lines displaying different malignancy grades. CD90 was selected due to its high expression levels in the most aggressive cell line, namely: Hs578T. In order to further characterize this marker, a functional study was performed in which CD90 was silenced in the Hs578T tumorigenic cell line and overexpressed in the non-tumorigenic MCF10A cell line. The resulting cell lines were characterized relative to growth rate and invasive and metastatic potential. A change in morphology readily was observed in the cell lines overexpressing CD90. In addition, the Hs578T-CD90-cell line presented an increased doubling time (DT), while the MCF10A-CD90+ cell line displayed a lower DT.. Furthermore, MC10-CD90+ cells were able to grow in the absence of EGF. Analysis of components of the EGF pathwayrevealed increased expression levels of the phosphorylated form of Erk, c-Jun and Jnk receptors in the MCF10-CD90+ cell line, while Hs578T-CD90- cells presented decreased expression of the same factors and receptors. Analysis of the activity of the AP1 responsive element allowed confirmation that the EGF pathway is functional in the MCF10-CD90+. . Epithelial-mesenquimal transition markers presented increased expression levels in the MCF10A-CD90+ cell line, accompanied by decreased expression levels in Hs578T-CD90- cells. In vitro invasion assays showed that MCF10A-CD90+ cells are capable of migrating and invading, while Hs578T-CD90- cells presented a significant decrease in their ability to migrate and invade. Additionally, in vitro and in vivo metastasis assays showed that malignization ensued upon overexpression of CD90 in MCF10A cells and a lower tendency to form metastasis in vitro was observed for the Hs578T-CD90- cell line. Therefore, the present study presents, for the first time in the literature, the functional characterization of CD90 as a genetic marker involved in the malignant transformation of mammary carcinoma, leading to a better understanding of the breast cancer biology, which may, in turn, lead to the development of new clinical and therapeutic protocols.