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Introdução: O diagnóstico precoce de câncer de próstata (CaP) é essencial para aumentar a sobrevida dos pacientes, mas os marcadores e métodos atuais não possuem sensibilidade e especificidade suficientes, tornando o diagnóstico ainda muito impreciso. Recentemente, as células tumorais circulantes (CTCs) têm surgido não como método de rastreio do CaP, mas sim como marcadores de prognóstico utilizando um arsenal de diversos alvos para a captura dessas células. Contudo, a busca por um método ou marcadores comuns para o rastreio, diagnóstico, prognóstico e monitoramento da doença ainda se apresenta com um dos principais objetivos técnico-científicos a ser alcançado. Objetivo: apresentar um novo marcador, o aptâmero A4 selecionado previamente por 3DCell SELEX na linhagem PC3, e avaliar sua capacidade de detectar CTCs por citometria de fluxo no sangue de pacientes com CaP virgens de tratamento e sob diferentes regimes terapêuticos. Material e métodos: o estudo avaliou 34 homens com CaP e 16 homens sem alterações prostáticas. Foi coletado o sangue em tubo com EDTA, e após proceder a lise de hemácias, as células nucleadas de cada paciente foram incubadas com o aptâmero A4 conjugado à biotina, e em seguida lavadas e incubadas com estreptoavidina-FITC para posterior análise em citometria de fluxo. Os percentuais de CTCs foram comparados entre os dois grupos de pacientes e correlacionados com idade, níveis de PSA, estadiamento e procedimentos terapêuticos adotados (bloqueio hormonal, radioterapia e cirurgia). O limite de detecção acima de 1% de CTCs foi considerado positivo, utilizando como base o percentual observado em todos os 16 controles negativos. Resultados: todos os pacientes foram diagnosticados como positivos independentemente do tempo de terapia ou do estadiamento, exceto um paciente sob bloqueio hormonal que não apresentou CTCs. O percentual de CTCs apresentou alta correlação com idade (R=0,75) e com os níveis de PSA (R=0,80) de forma exponencial, embora seis pacientes com altos índices de células circulantes apresentaram PSA<0,02ng/mL, considerados como falha bioquímica. Conclusão: nossos resultados preliminares indicam uma acurácia elevada de 98% e demonstra um grande potencial de aplicação dessa nova tecnologia diagnóstica tanto no rastreamento, quanto no monitoramento do tratamento do CaP, o qual deverá ser melhor investigado em população de risco. / Introduction: prostate cancer (PCa) early diagnosis is essential to boost patients’ life expectance. Although, current biomarkers and diagnosis methods do not present reliable sensibility and specificity, making the diagnosis rather imprecise. Recent methodologies have been using circulating tumor cells (CTCs), not for screening of PCa, but as prognosis indicators, employing a vast array of techniques to capture those cells. However, the search for a new biomarkers or diagnosis methods able to screen, diagnosis, assist in prognosis and in the disease monitoring still one of the major technical and scientific objectives to be achieved. Objective: To present a new biomarker for PCa, the aptamer A4, previous screened in the prostate cancer cell line PC3, using 3DCell SELEX. And to able to detect, by flow cytometry, CTCs in blood samples of PCa patients undergoing various treatment regimen. Material and methods: the study evaluated 34 PCa patients and 16 health controls. Blood samples were collected in EDTA tubes, and after erythrocytes lysis, nucleated cells were incubated with A4 aptamer conjugated with biotin, them the cells were washed and incubated with streptavidin-FITC for later flow cytometer analysis. Percentage of CTCs were compared between patient’s groups and correlated against age, PSA levels, staging and treatment regimen (hormonal blockade, radiotherapy and surgery). Detection limit above 1% of CTCs was considered positive, based on the percentage observed on all of the 16 negative controls. Results: all patients were positively diagnosed independently of therapy time or staging, except for one patient undergoing hormonal blockade therapy, which does not present detectable CTCs. CTCs percentage presented high correlation against age (R=0.75) and with PSA levels (R=0.80) with exponential behavior, although, six patients with high CTCs count presented PSA levels <0.02 ng/mL, and were considered was biochemical errors. Conclusion: Our preliminary results indicated high accuracy (98%) and demonstrate a potential application of this technology for diagnosis and screening, as well as in the monitoring of PCa evolution, which should be better investigated in the risk population. / Dissertação (Mestrado)

Sabe-se que TRAIL é capaz de matar células tumorais de forma seletiva e que TRAIL tem sua expressão reduzida em diversos tumores, porém pouco se sabe sobre os mecanismos responsáveis pela sua inibição. Tendo em vista que a expressão de TRAIL pode ser regulada pelo Ácido Retinóico; que PRAME é capaz de inibir a via do ácido retinóico através da proteína EZH2 e que nós observamos anteriormente que a expressão de TRAIL esta diminuída em pacientes com LMC, nós decidimos investigar a associação entre PRAME, EZH2 e TRAIL na LMC. Nós demonstramos que PRAME, mas não EZH2, tem sua expressão aumentada em células BCR-ABL+ e sua expressão está associada com a progressão da LMC. Alem disto, existe uma correlação positiva entre PRAME e BCR-ABL e negativa entre PRAME e TRAIL nestes pacientes. A inibição da expressão de PRAME ou EZH2 por RNAi induziu um aumento da expressão de TRAIL. Estes dados revelam um novo mecanismo de regulação responsável por diminuir a expressão de TRAIL, e geram novos possíveis alvos para a terapia da LMC e, possivelmente, também para outros tumores. / TRAIL was shown to selectively kill tumor cells. Not surprisingly, TRAIL is down-regulated in a variety of tumor cells, but the mechanism responsible for TRAIL inhibition remains elusive. Because TRAIL can be regulate by retinoic acid; PRAME was shown to inhibit transcription of retinoic acid receptor target genes through the polycomb protein EZH2; and we have found that TRAIL is inversely correlated with BCR-ABL in CML patients, we decided to investigate the association of PRAME, EZH2 and TRAIL in BCR-ABL-positive leukemia. Here, we demonstrate that PRAME, but not EZH2, is up-regulated in BCR-ABL cells and is associated with the progression of disease in CML patients. In addition, PRAME expression is positively correlated with BCR-ABL and negatively with TRAIL in these patients. Importantly, knocking down of PRAME or EZH2 by RNA interference restores TRAIL expression. Our data reveal a novel regulatory mechanism responsible for lowering TRAIL expression and provide the basis of alternative targets for combined therapeutic strategies for CML.

O uso da LDE como veículo para quimioterápicos tem mostrado ser uma boa estratégia para aumentar a eficácia terapêutica dos mesmos. Nesse estudo, a LDE foi empregada como veículo para um derivado lipofílico do metotrexato (MTX), o di-dodecil metotrexato, que foi obtido com rendimento elevado através de reação de esterificação do MTX. O aumento na lipofilicidade do derivado possibilitou incorporação na LDE com rendimento e estabilidade elevados. O IC50 de LDE-di-dodecil MTX foi cerca de 100 vezes menor em relação ao MTX comercial, sua captação celular mais elevada nas linhagens leucêmicas estudadas e sua toxicidade animal reduzida, mostrando que a LDE é um veículo promissor para este fármaco. / The use of LDE as vehicle to drugs is a great strategy to improve the therapeutic index and reduce the side effects. In this study LDE was used as vehicle to di-dodecyl methotrexate, a lipophilic derivative of MTX, obtained through an esterification reaction with a high yield. The increased lipophilicity of the derivative allowed a high association to LDE and good stability. The IC50 of LDE-di-dodecyl MTX was lower than that of the MTX and the uptake was higher in leukemic cells. The MTX toxicity in mice was reduced after association to LDE, showing that LDE is a promising vehicle to this drug.

Hepatocarcinoma (HCC) é o mais comum tumor maligno primário do fígado. Aurora A é importante durante o ciclo celular, atuando na maturação centrossômica e sua separação, entrada em mitose, montagem de fuso bipolar, alinhamento dos cromossomos na placa metafásica e citocinese. Expressão alterada de Aurora A tem sido associada com o desenvolvimento do tumor e sua superexpressão ocorre em 60% dos HCCs. Inibidores de Aurora quinases têm sido desenvolvidos como drogas antitumorais. 4(4`-Benzamidoanilina)-6,7dimetoxiquizanoline, BADIM, é um recém desenvolvido inibidor da Aurora. Nosso estudo investigou os efeitos de BADIM na linhagem celular HepG2, derivada de HCC, quando tratada com 300, 600 e 1200nm de BADIM por 24 e 48h. Observamos inibição de proliferação, aumento de células tetraplóides, binucleadas e gigantes, bloqueio em G2/M do ciclo celular, alterações nos microtúbulos, mitoses atípicas e apoptose. Por conseguinte, este inibidor é um agente promissor para estudos em HCC, pois atua em pontos críticos relacionados com o processo de tumorigênese. / Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of liver. Aurora A is important during cell cycle, including centrosome maturation and separation, mitotic entry, bipolar-spindle assembly, chromosome alignment on metaphase plate and cytokinesis. Altered expression of Aurora A has been associated with tumor development and its overexpression occurs in 60% of HCC. Aurora kinases inhibitors have been developed as antitumoral drugs. 4(4`-Benzamidoanilino)-6,7-dimethoxiquizanolina, BADIM, is a new Aurora inhibitor. Our study aimed investigates the BADIM effects on HepG2 cell line, derivates of HCC, when treated in 300, 600 and 1200nM for 24 and 48h. We observed inhibition of cell proliferation, increase of tetraploids, binucleated and giant cells, arrest in G2/M cell cycle, microtubules alterations, aberrant cell divisions and apoptosis. Therefore this inhibitor is a promising agent for studies in HCC, since it acts at critical points related to tumorigenesis.

Objective: We aimed to assess the prognostic value of circulating tumor cells (CTC) in patients with advanced gastric and gastroesophageal adenocarcinomas. Methods: The presence of CTC was evaluated in 62 patients with advanced gastric and gastroesophageal adenocarcinomas before systemic therapy and at follow-up through immunomagnetic enrichment for mucin 1- and epithelial cell adhesion molecule (EpCAM)-positive cells, followed by real-time RT-PCR of the tumor-associated genes KRT19 , MUC1 , EPCAM , CEACAM5 and BIRC5 . Results: The patients were stratified into groups according to CTC detection (CTC negative: with all marker genes negative; CTC positive: with at least 1 of the marker genes positive). Patients who were CTC positive at baseline had a significantly shorter median progression-free survival (PFS; 3.5 months, 95% CI: 2.9–4.2) and overall survival (OS; 5.8 months, 95% CI: 4.5–7.0) than patients lacking CTC (PFS 10.7 months, 95% CI: 6.9–14.4, p < 0.001; OS 13.3 months, 95% CI: 8.0–18.6, p = 0.003). Alterations in the marker profile during the course of chemotherapy were not predictive of clinical outcome or response to therapy. Yet, a favorable clinical response depended significantly on CTC negativity (p = 0.03). Conclusion: Our data suggest that the presence of CTC is a major predictor of outcome in patients with gastric and gastroesophageal malignancies.

Introduction: The presence of circulating tumor cells (CTC) in the peripheral blood has been associated with worse prognosis and early relapse in breast cancer patients. CTC determination in the peripheral blood has been considered as a liquid biopsy. The aim of this project was to analyze the presence of CTC followed by their molecular characterization with the potential use not only as a new biomarker for real-time monitoring of therapy efficacy but also as a suitable tool for patient's stratification and individualization of treatment for breast cancer. Methods: A total of 54 patients with diagnosed early breast cancer were enrolled into a prospective study. Ten millilitres of peripheral blood were sequentially collected to test for the presence and characterization of CTC during the follow-up of patients. CTC isolation and detection was performed by AdnaTest BreastCancer™ (AdnaGen AG, Germany), which is based on the detection of EpCAM, HER2 and MUC1 specific transcripts in enriched CTC- lysates. cDNA from isolated CTC has been further used for newly optimized qPCR assays for breast tumor and therapy resistance associated genes: TOP1, TOP2A, CSTD, ST6GAL, KRT19 and reference gene actin. qPCR results have been analyzed by Genex software (MultiD Analysis). Results: 195 blood samples have been...

Objective: The aim of this study was to develop an immunomagnetic/real-time reverse transcriptase polymerase chain reaction (RT-PCR) assay and assess its clinical value for the molecular detection of circulating tumor cells (CTCs) in peripheral blood of pancreatic cancer patients. Methods: The presence of CTCs was evaluated in 34 pancreatic cancer patients before systemic therapy and in 40 healthy controls, through immunomagnetic enrichment, using the antibodies BM7 and VU1D9 [targeting mucin 1 and epithelial cell adhesion molecule (EpCAM), respectively], followed by real-time RT-PCR analysis of the genes KRT19, MUC1, EPCAM, CEACAM5 and BIRC5. Results: The developed assay showed high specificity, as none of the healthy controls were found to be positive for the multimarker gene panel. CTCs were detected in 47.1% of the pancreatic cancer patients before the beginning of systemic treatment. Shorter median progression-free survival (PFS) was observed for patients who had at least one detectable tumor-associated transcript, compared with patients who were CTC negative. Median PFS time was 66.0 days [95% confidence interval (CI) 44.8–87.2] for patients with baseline CTC positivity and 138.0 days (95% CI 124.1–151.9) for CTC-negative patients (p = 0.01, log-rank test). Conclusion: Our results suggest that in addition to the current prognostic methods, CTC analysis represents a potential complementary tool for prediction of outcome in pancreatic cancer patients. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Aim: To develop an immunomagnetic assay for the isolation of circulating tumor cells (CTCs) followed by the analysis of a multimarker panel, which will enable the characterization of these malignant cells with high accuracy. Patients and Methods: Peripheral blood (PB) was collected from 32 metastatic breast cancer patients and 42 negative controls. The antibodies BM7 and VU1D9 were used for immunomagnetic tumor cell enrichment. A real-time reverse transcription-polymerase chain reaction (RT-PCR) approach for the markers KRT19, SCGB2A2, MUC1, EPCAM, BIRC5 and ERBB2 was used for CTC detection and characterization. Results: The positivity rates for each marker were as follows: 46.9% for KRT19, 25.0% for SCGB2A2, 28.1% for MUC1, 28.1% for EPCAM, 21.9% for BIRC5, and 15.6% for ERBB2. After the creation of individualized cutoffs, the sensitivity and specificity of the combined marker gene panel increased to 56.3% and 100%, respectively. Interestingly, 27.0% of the HER2-negative tumor patients showed ERBB2 mRNA-positive CTCs. Conclusions: The described technique can be used to measure CTCs with great accuracy. The use of a multimarker panel for the characterization of CTCs may provide real-time information and be of great value in therapy monitoring. / Ziel: Entwicklung eines immunomagnetischen Verfahrens zur Isolierung zirkulierender Tumorzellen (CTCs) in Kombination mit einer molekularen Multimarkeranalyse für die hochspezifische Identifizierung maligner Zellen. Patientinnen und Methoden: Peripheres Blut (PB) von 32 Patientinnen mit metastasiertem Mammakarzinom und von 42 gesunden Kontrollen wurde für die immunomagnetische Tumorzellanreicherung mit den Antikörpern BM7 und VU1D9 genutzt. Eine Real-Time Reverse Transkription Polymerase-Kettenreaktion (RT-PCR)-Methodik mit den Markern KRT19, SCGB2A2, MUC1, EPCAM, BIRC5 und ERBB2 wurde für den CTC-Nachweis und die Tumorzellcharakterisierung entwickelt. Ergebnisse: Für die einzelnen Marker wurden die folgenden Positivitätsraten ermittelt: 46,9% für KRT19, 25,0% für SCGB2A2, 28,1% für MUC1, 28,1% für EPCAM, 21,9% für BIRC5 und 15,6% für ERBB2. Nach der Bestimmung individualisierter Cut-off-Werte ergab sich für den kombinierten Multimarkernachweis eine Sensitivität und Spezifität von 56,3% bzw. 100%. Bemerkenswert war der Befund, dass 27,0% der HER2-tumornegativen Patientinnen ERBB2-mRNA-positive CTCs aufwiesen. Schlussfolgerung: Die hier beschriebene Methodik bestimmt CTCs mit hoher Spezifität. Die molekulare Multimarkeranalyse liefert wertvolle Real-Time-Informationen für personalisierte Behandlungsmodalitäten. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

STAUFEN1 (STAU1) est une protéine de liaison à l’acide ribonucléique (ARN) double brin jouant un rôle important dans le contrôle post-transcriptionnel de nombreux ARN messager (ARNm). Sa déplétion diminue la prolifération des cellules non cancéreuses en altérant les transitions G1/S et G2/M. En revanche, Ceci n’a aucun impact sur la prolifération des cellules tumorales. La déplétion de STAU1 module le niveau d’expression des transcrits et/ou des protéines impliquées dans la régulation des points de contrôle des transitions de phase. Notamment, STAU1 module le niveau d’expression de la protéine CDK4 ainsi que l’abondance de l’ARNm E2F1, deux régulateurs indispensables de la transition G1/S. Le transcrit de ces deux gènes possède un site de liaison à STAU1 ou STAU1 binding site (SBS) dans la région codante ou coding sequence (CDS) et dans la région non codante en 3’ (3’UTR), respectivement. Cependant, l’importance de la liaison de STAU1 à ces transcrits n’a pas encore été étudiée. Étonnamment, la sensibilité des cellules non tumorales et tumorales à l’expression de STAU1 est inversée lors de la surexpression de STAU1. En effet, sa surexpression altère l’entrée en mitose des cellules cancéreuses et diminue leur prolifération, alors qu’elle n’a aucun effet sur la prolifération des cellules non tumorales. Lors de la mitose, STAU1 s’associe au fuseau mitotique (FM), ce qui lui permet de localiser des ARNm et de contrôler leur séquestration et/ou leur traduction locale. Cependant, le mécanisme qui permet à STAU1 de lier le FM est encore inconnu. Pour ce mémoire, nous avons donc poursuivi deux objectifs. Le premier but est de comprendre la régulation post-transcriptionnelle médiée par STAU1 des transcrits essentiels à la transition G1/S chez les cellules non tumorales. Notre hypothèse est que STAU1 par sa liaison directe à ses transcrits cibles via le SBS module leur expression. Pour ce faire, des cellules de type sauvage ou déplétées en STAU1 étaient transfectées par des plasmides exprimant les transcrits de CDK4 et d’E2F1 contenant un SBS endogène ou muté de telle sorte qu’il ne reconnait plus STAU1. L’expression des protéines CDK4 et E2F1 est dosée par un essai luciférase ou un immunobuvardage de type western ou western blot (WB). Nous avons observé que STAU1 régule négativement et positivement l’expression endogène de CDK4 et d’E2F1, respectivement, ce qui contribue au passage de la transition G1/S, donc à la prolifération cellulaire non tumorale. Les essais luciférases ont confirmé le rôle de STAU1 dans la régulation positive d’E2F1 lorsque liée au SBS dans le 3’UTR du transcrit E2F1. Malheureusement, les plasmides utilisés pour l’expression de CDK4 se sont avérés non fonctionnels, ce qui nous a forcés à mettre de côté cette expérience. Le deuxième but est d’étudier les déterminants qui régulent la localisation de STAU1 au FM chez les cellules tumorales. Pour ce faire, la localisation de STAU1 ou des mutants au FM est détectée par WB à partir de préparations des FM purifiés. Nos données montrent que le déterminant est composé de plusieurs acides aminés (aa) situés entre le 26ème et 37ème aa du côté N-terminal de la protéine STAU1. En somme, nos résultats montrent les différents rôles de STAU1 dans les cellules tumorales vs cellules non tumorales. De ce fait, STAU1 pourrait être une cible thérapeutique spécifique potentielle dans le traitement du cancer. / STAUFEN1 (STAU1) is a double stranded RNA binding protein that plays an important role in the post-transcriptional control of many mRNAs. Its depletion decreases the proliferation of non-cancer cells by altering G1/S and G2/M transitions. In contrast, this has no impact on the proliferation of tumor cells. The decrease of STAU1 expression modulates the level of transcripts/proteins of several genes involved in phase transition checkpoints, including CDK4 and E2F1, two essential regulators in G1/S transition. In addition, CDK4 and E2F1 transcripts have a STAU1 binding site (SBS) in the coding sequence (CDS) and the non-coding region in 3’ (3’UTR), respectively. However, the molecular consequence of STAU1 association with the SBS is not yet studied. Surprisingly, the sensibility of non-cancer and cancer cells to STAU1 expression is reversed following STAU1 overexpression. Indeed, its overexpression alters the entry into mitosis of cancer cells and decreases their proliferation, while it has no effect on non-cancer cells. During mitosis, STAU1 associates with the mitotic spindle, which allows it to localize mRNAs and other non-coding RNAs. STAU1 likely controls their sequestration and/or local translation during mitosis. However, the molecular determinant involved in STAU1-spindle association is still not known. Therefore, for this master thesis, we had two objectives. The first goal is to understand the post-transcriptional regulation mediated by STAU1 on transcripts that are essential for G1/S transition in non-tumor cells. Our hypothesis is that STAU1, by its direct binding to the SBS of its target transcripts, modulates their expression. To do this, plasmids coding for CDK4 and E2F1 containing a wild-type or mutated SBS that does not recognized STAU1 were transfected in wild-type and STAU1-depleted cells. Expression of CDK4 and E2F1 was detected by dual luciferase assay and western blot (WB). Our results first indicate that STAU1 negatively and positively regulates the endogenous expression of CDK4 and E2F1, respectively, which contributes to the passage of G1/S transition, and therefore to the proliferation non-tumor cells. Then, the luciferase assays confirm the role of STAU1 in E2F1 expression, depending on STAU1 binding to E2F1 SBS in its 3’UTR. Unfortunately, the plasmids used for CDK4 expression turned out to be non-functional. The second goal is to identify the molecular determinants responsible for the localization of STAU1 to the mitotic spindle in tumor cells. To this end, the localization of STAU1 or of several mutants was measured by WB using purified spindle preparations. Our data show that the determinant is composed of several amino acids (aa) located between the 26th and 37th aa at the N-terminal end of STAU1. In summary, our results show the different roles of STAU1 in tumor and non-tumor cells. Therefore, STAU1 could be a potential specific therapeutic target in cancer treatments.