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Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 5 uppsatser.

La diffusion dans le sang des cellules tumorales circulantes (CTC) à partir de la tumeur primitive est un signe précoce d’invasivité tumorale et du risque de développer des métastases. Par conséquent, la capacité à les détecter de façon très sensible et spécifique est censée constituer un test cliniquement important pour le pronostic du cancer, le suivi des patients et la personnalisation de la thérapie. Les CTC sont des cellules rares, et plusieurs méthodes ont été proposées pour leur détection. La technique ISET (Isolation by Size of Epithelial/Tumor cells) se base sur la différence de taille des CTC par rapport aux cellules leucocytaires et a montré une très grande sensibilité d’isolement et spécificité d’identification des CTC. Elle permet l’analyse cytopathologique, immunologique et moléculaire des cellules isolées.Le cancer du rein représente 3% des cancers de l’adulte, dans 75% des cas il s’agit d’un carcinome rénal à cellules claires (RCC). Sur le plan génétique, il est un des rarissimes cancers solides caractérisé par des variations de l’ADN, il s’agit de mutations au niveau du gène VHL.Ce projet de recherche vise l’analyse comparative, moléculaire et cytopathologique, des CTC isolées à partir des patients avec RCC dans le but d’évaluer, par une approche moléculaire, les critères cytopathologiques diagnostiques des CTC. Notre étude a porté sur 29 patients ayant bénéficié de l’isolement des CTC par ISET avant toute intervention chirurgicale.L’analyse cytopathologique a été réalisée utilisant les critères décrits par l’équipe de P. Hofman pour définir les CTC (CNHC-MF) et les Cellules Atypiques Circulantes « CAC » (CNHC-UMF). L’analyse génétique par séquençage du gène VHL a été réalisée avec succès sur l’ADN de 205 cellules individuelles, sur l’ADN issu du tissu tumoral et sur l’ADN génomique de chaque patient.Sur les 29 tumeurs étudiées, 25 étaient caractérisées par des mutations du gène VHL. Cent soixante et une cellules, CTC et CAC, isolées à partir du sang de ces 25 patients, ont présenté des variations génétiques du gène VHL identiques à l’ADN issu du tissu tumoral. Il s’agit de 18 mutations différentes affectant les 3 exons de ce gène. Nous avons trouvé des CTC/CAC dans 29/30 des patients avec CCRC analysés. Des mutations VHL ont été trouvées dans 25 des 29 tumeurs CCRC correspondantes. Nous avons obtenu des résultats spécifiques VHL dans 205 des 327 CTC/CAC microdisséquées, comprenant 64 CTC et 141 CAC, selon l’analyse cytopathologique. Les mutations VHL ont été détectées en aveugle dans 57/64 CTC et dans 125/141 CAC. Cependant, nous avons observé que les 8 et 16 CTC et CAC restantes, respectivement, avaient été isolées de patients sans mutations VHL détectables dans le tissu tumoral.Conclusion : Ceci est la première étude comparative de diagnostic génétique et cytopathologique des CTC/CAC chez des patients avec un cancer solide, le CRCC. Nos résultats suggèrent que des critères cytopathologiques élargis pourraient être appliqués au diagnostic des CTC chez les patients avec CCRC. Bien que des études complémentaires et plus élargies soient maintenant nécessaires, cette méthode ouvre la voie à une approche génétique pour le diagnostic des Cellules Tumorales Circulantes / Dissemination in the circulating tumor cells (CTC) from the primary tumor is an early sign of tumor invasion and risk of metastases. Therefore, the ability to detect CTC through a very sensitive and specific test is expected to be clinically important for cancer prognosis, patient monitoring and customization of therapy. CTCs are rare cells, and several methods have been proposed for their detection. The ISET technique (Isolation by Size of Epithelial /Tumor cells) is based on the difference in size of CTC as compared to leucocytes and provides high sensitivity of CTC isolation and high specificity of CTC identification. This methods also allows cytopathological, immunological and molecular analyses of the isolated cellsKidney cancer accounts for 3% of adult cancers and is a clear cell renal cell carcinoma (RCC) in 75% of cases. RCC is one of very rare cancers characterized by a DNA mutations. IRCC tumor cells are in fact characterized by by mutations in the VHL gene. This research project aims at a comparative molecular and cytopathological analysis of, CTCs isolated from patients with RCC in order to evaluate, through a molecular approach, the diagnostic criteria used for cytopathological identification of CTC. Our study included 29 patients tested by the ISET technique before surgery.The cytopathological analysis was performed using the criteria described by the group of P. Hofman to define CTC (CNHC-MF) and Circulating Atypical Cells "CAC" (UMF-CNHC). Genetic analysis of the VHL gene was successfully performed by sequencing on DNA from 205 individual cells isolated by ISET, on DNA from tumor tissue and on genomic DNA from each patient. Of the 29 tumors studied, 25 were characterized by mutations in the VHL gene. One hundred and sixty-one cells, CTC and CAC, isolated from the blood of the 25 patients, with the tumor having VHL mutation, showed genetic variations in the VHL gene identical to those found in the DNA from the tumor tissue. We found 18 different mutations affecting the three exons of this gene.We found CTC/CAC in 29/30 analyzed patients with CCRC. VHL mutations were found in the tumor of 25 out of the corresponding 29 CCRC tumors. Among 327 microdissected CTC/CAC, we obtained VHL-specific results in 205 including 64 CTC and 141 CAC, according to the cytopathological analysis. VHL mutations were blindly detected in 57/64 CTC and in 125/141 CAC. However, we then observed that the 8 and 16 residual CTC and CAC, respectively, had been isolated from patients without detectable VHL mutations in the tumor tissue. Conclusion: This is the first study comparing genetic and cytopathological diagnosis of CTC/CAC in patients with a solid cancer, CRCC. Our results suggest that broaden cytopathological criteria could be applied to the diagnosis of CTC in patients with CCRC. Although further and larger studies are now needed, this approach opens the way to a genetic approach for the accurate diagnosis of Circulating Tumor Cells.

This work focuses on the integration of microfluidics and dielectrophoresis(DEP) with the principles of field flow fractionation (FFF) to create a continuous-flow isolator for rare and viable circulating tumor cells (CTCs) from peripheral blood mononuclear cells (PBMNs) drawn from cancer patients. The method exploits differences in the plasma membrane capacitances of tumor and blood cells, which correspond to differences in the membrane surface areas of these cell types. DEP-FFF was first adapted to measure cell membrane capacitance, cell density and deformability profiles of cell populations. These properties of the NCI-60 panel of cancer cell types, which represents the wide functional diversity of cancers from 9 organs and leukemia, were compared with the normal cell subpopulations of peripheral blood. In every case, the NCI-60 cells exhibited membrane capacitance characteristics that were distinct from blood and, as a result, they could be isolated from blood by DEP. The heightened cancer cell membrane capacitances correlated strongly with membrane-rich morphological characteristics at their growth sites, including cell flattening, dendritic projections, and surface wrinkling. Following harvest from culture and maintenance in suspension, cancer cells were found to shed cytoplasm and membrane area over time and the suspended cell populations developed considerable morphological diversity. The shedding changed the cancer cell DEP properties but they could still be isolated from blood cells. A similar shedding process in the peripheral blood could account for the surprisingly wide morphological diversity seen among circulating cells isolated from clinical specimens. A continuous flow DEP-FFF method was devised to exploit these findings by allowing CTCs to be isolated from the nucleated cells of 10 mL clinical blood specimens in 40 minutes, an extremely high throughput rate for a microfluidic-based method. Cultured cancer cells could be isolated at 70-80% efficiency using this approach and the isolation of CTCs from clinical specimens was demonstrated. The results showed that the continuous DEP-FFF method delivers unmodified, viable CTCs for analysis, is perhaps universally applicable to isolation of CTCs from different cancer types and is independent of surface antigens - making it suitable for cells lacking the epithelial markers used in currently accepted CTC isolation methods. / text

No description available.

Attachment of circulating tumor cells in microfluidic devices functionalized with proper antibodies was studied. Under static experimental conditions, microchambers were utilized to study the parameters such as cell suspension concentration, incubation time or ambient temperature that may affect the binding of cell to the functionalized surfaces. Specific capture of cells from suspensions increases exponentially with incubation time and linearly with concentration within the tested range. Functionalizing a surface with counter-receptors enables capture of almost 100% of cells within 15 minutes incubation time at ambient temperature higher than 25°C. Suspending cells with different receptors, changing the counter receptors immobilized on the surface, or incubation the cell suspension at low ambient temperature result in a poor capture ratio. To illustrate the specific binding of target cells, various binary mixtures of target cancer and blood cells were incubated in the microchambers. The microsystem sensitivity, specificity and accuracy were determined as a function of the incubated cell concentrations. In general, the system specificity increases while the sensitivity decreases with increasing cell concentration; the accuracy of the system depends weakly on cell concentration within the tested range. The cell attachment dynamics in shear flow was studied by driving the MDA-MB- 231 or BT-20 cells through microchannels functionalized with EpCAM antibodies. The cell attachment ratio was experimentally determined at different flow rates. A modeling system based on Stokesian as well as cell-adhesive dynamics is adopted to analyze the cell motion. The cell motion is modeled as a rigid sphere, with receptors on its surface, moving under shear flow above a surface immobilized with ligands. The system is described mathematically by the Langevin equation, in which the receptor-ligand bonds are modeled as linear springs. Primarily depending on the applied flow rate, three distinct dynamic states of cell motion have been observed: free motion, rolling adhesion, and firm adhesion. The fraction of cells captured due to firm adhesion, defined as attachment ratio, depends on the applied flow rate with a characteristic value that increases with either cellreceptor or surface-ligand density. Utilizing this characteristic flow rate as a scaling parameter, all measured and calculated attachment ratios for different receptor and ligand densities collapse onto a single exponential curve. Binary mixtures of target MDA-MB-231 cells and non-target BT-20 cells were driven through anti-cadherin-11 functionalized microchannels to study the selective isoaltion of target cells from binary mixtures. The system sensitivity is very high, above 0.95, while the specificity is only moderately high, about 0.85, essentially independent of the relative concentration of the target and non-target cells in the binary mixture. An attachment/detachment flow field pattern is proposed to enhance the system specificity. Utilizing this flow pattern with a 1:1,000 MDA-MB-231:BT-20 binary cell mixture, the microfluidic system specificity increased to about 0.95 while the sensitivity remained above 0.95. In order to obtain high experimental throughput allowing lower relative concentration of target cells, a microchannel array which enables processing samples containing about 510⁵ cells with a minimum target cell concentration ratio of 1/100,000 was designed and fabricated. To demonstrate selective isolation of target cells, binary mixtures of BT-20 cells and MIA PaCa-2 cells were driven through microchannel arrays functionalized with EpCAM antibodies; the EpCAM positive BT-20 cells served as target cells and the EpCAM negative MIA PaCa-2 cells as non-target cells. The relative concentration ratio of target/non-target cells varied from 1:1 to 1:100,000. The sensitivity was close to 1.0 while the specificity was also high, about 0.95. The additional detachment step, with a faster flow rate, enhanced the specificity to about 0.985. Initial results of two sets of experiments are reported as preliminary studies for future work. In the first set of experiments, whole blood samples from healthy donors were spiked with a known number of BT-20 cells at a concentration of 500 CTCs per milliliter blood or 50 CTCs per milliliter blood. After a pretreatment to enrich the CTCs, the samples were driven through microchannel arrays functionalized with anti-EpCAM. For both samples, around 55% of the target CTCs were captured in the microchannel arrays. The second set of experiments was dedicated to characterization of target cells exposed to applied shear stress. BT-20 or MDA-MB-231 cells were driven through microchannels functionalized with EpCAM antibodies to allow target cell attachment; then, a high flow rate was applied to detach the captured cells. The detached cells were collected and cultured in an incubator to test their viability. For both cell lines, the majority of the captured CTCs collected from the microchannels were viable. The images taken after three and seven days of culture demonstrate continuous cell growth and division.

When Y-1 mouse adrenal tumor cells were treated with sodium orthovanadate, an intermediate filament (IF) inhibitor in BHK21-F cells, there was no change in the amount of 20α-dihydroprogesterone produced. A neurofilament inhibitor, β, β'-iminodipropionitrile (IDPN), enhanced the ability of Y-1 cells to produce steroid in response to ACTH by acting on the plasma membrane. Electron microscopy of Y-1 cells extracted with Triton X-100 revealed that both vanadate and IDPN caused the aggregation of cytoskeletal and granular structures in the perinuclear area. The steroidogenic effects of IDPN suggest that the perinuclear aggrergation of cytoskeletal structures may result from the detachment of IF from the plasma membrane, while the reason for the cytoskeletal changes by vanadate is unknown.

Telomerase, a ribonucleoprotein enzyme minimally composed of an RNA template (hTR) and a catalytically active protein subunit (hTERT), synthesizes telomeric repeats onto chromosome ends and is obligatory for continuous tumor cell proliferation, as well as malignant progression of breast cancer cells. Telomerase is an attractive anticancer therapeutic target because its activity is present in over 90% of human cancers, including more than 95% of breast carcinomas, but undetectable in most somatic cells. Traditions chemo- and radio-therapies lack the ability to effectively control and cure breast cancer, in part because residual cells are or become resistant to DNA damaging modalities.While various telomerase inhibition strategies cause cancer cells to undergo apoptosis car senescence, there is often a lag period between administration and biologic effect (Corey, 2002). Our goal in this study was to compare the efficacy of different telomerase inhibition strategies in concert with standard chemotherapeutic agents at triggering senescence and/or apoptosis in cultures of breast cancer cells. We hypothesized that telomerase inhibition strategies will sensitize breast cancer cells to traditional chemotherapies, potentially reducing the lag phase, allowing for more potent anti-tumor effects at lower doses, and therefore ultimately imparting less toxicity to the patient.We blocked telomerase by targeting hTR and hTERT, individually and collectively utilizing synthetic short interfering RNA (siRNA), short hairpin RNA (siRNA), and a dominant negative form of hTERT (DN-hTERT) in MCF-7 breast cancer cells. We analyzed the efficiency of telomerase inhibition for each strategy alone and then treated the cells with two mainstay chemotherapeutic agents, Adriamycin (AdR) and Taxol. The most effective telomerase inhibition strategies were synthetic siRNA and DN-hTERT, individually. After treatment with various concentrations of AdR or Taxol, breast cancer cells with inhibited telomerase grew significantly slower and exhibited widespread senescence or apoptosis within a much shorter time period and at a dose that is insufficient to trigger cytostasis. In addition, we provide evidence that cells in which telomerase was inhibited were more sensitive to anti-cancer agents, whether the drug inhibited topoisomerase II resulting in DNA damage (AdR) or blocked mitosis via protracted microtubule stabilization (Taxol). Collectively, our data indicate that alone, anti-telomerase inhibition strategies differ in their efficacy. However, when used in the adjuvant setting with diverse acting chemotherapeutic agents, there is a potent synergy resulting in chemotherapeutic sensitization characterized in part by widespread senescence and/or apoptosis.

Carbohydrates have an essentials role in wide range of biological phenomena. It is well known that most of the eukaryotic proteins are glycosylated and that their glycosylation undergoes dynamic changes, nevertheless the biological imperative for these modifications is still not fully understood. However, one area in which the importace of cell surface glycosylation has recently been the subject of active investigations is the tumor plasma membrane biology, where many changes in glycosylation have been found useful for diagnosis, and mostly recent, even for the therapies of malignant disease. Interestingly cell surface glycoconjugates, namely N-linked and O-linked oligosaccharides have been found therapeutically attractive for treatment of certain tumors. And although our understanding of the participation of these principal glycan classes in tumorigenesis is far from complete, there are already several examples of carbohydrate-based antitumor vaccines. Therefore, we decided to give this issue more attention, especially the molecular mechanisms responsible for identifying changes in glycosylation of the surface of tumor cells of the immune system. Although in the past in our laboratory identified a receptor-type lectin specific lectin receptors on natural killer cells, very little is yet known...

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.