Objetivos do Estudo: O aumento do crescimento de melanoma foi avaliado em camundongos expostos a hipóxia intermitente. As proteínas que caracterizam a agressividade do tumor ainda não foram investigadas. O estudo teve como objetivo verificar se a hipóxia intermitente simulada pela apneia do sono afeta marcadores de melanoma na progressão tumoral. Desenho: Estudo prospectivo controlado em animais. Senário: Hospital Universitário. Participantes: Doze camundongos C57BL/6. Intervenções: Camundongos foram expostos a hipóxia intermitente ou simulada. Durante 8 horas por dia, o grupo hipóxia foi submetido a um total de 480 ciclos de 30 segundos de hipóxia progressiva SpO2 nadir de 8 ± 1%, seguidos por 30 segundos de normóxia. Um milhão de células de melanoma B16F10 foi injetado por via subcutânea. No dia 14, após a eutanásia, os tumores foram removidos, fixados e corados. Médias e resultados: coloração imunohistoquímica de Ki-67, PCNA, S100-B, HMB-45, Melan-A, TGF, Caspase-1 e HIF-1α foi quantificada por dois observadores que utilizaram captura digital e processamento em três lâminas de cada animal para cada marcador. O tamanho e o peso dos tumores foram semelhantes nas experiências de hipóxia e simulada. A percentagem da mediana [25-75 quartis] de área positiva corada para Ki-67 foi de 23% [15-28] no grupo hipóxia e 0,3% [0,2-1,1] no grupo controle (P = 0,02); para PCNA, as percentagens foram 31% [25-38] e 7% [5-18], respectivamente (P = 0,009). As diferenças entre os grupos para os marcadores restantes não foram significativas. Conclusões: Os marcadores da transcrição do RNA ribossomal e da síntese de DNA são mais expressos em tumores de camundongos expostos a hipóxia intermitente do que em controles, indicando que a apneia do sono pode levar a uma maior agressividade do tumor. / Study Objectives: Increased melanoma growth has been reported in mice exposed to intermittent hypoxia. Proteins that characterize tumor aggressiveness have not been investigated. The study aims to verify whether intermittent hypoxia mimicking sleep apnea affects markers of melanoma tumor progression. Design: Prospective controlled animal study. Settings: University hospital. Participants: Twelve C57bl/6 mice. Interventions: Mice were exposed to intermittent or sham hypoxia. During 8 hours per day, the hypoxia group was submitted to a total of 480 cycles of 30 seconds of progressive hypoxia to a nadir FIO2 of 8±1%, followed by 30 seconds of normoxia. One million B16F10 melanoma cells were injected subcutaneously. On the 14th day, after euthanasia, tumors were removed, fixed and stained. Measurements and Results: Immunohistochemistry staining for Ki-67, PCNA, S100-B, HMB-45, Melan-A, TGFβ, Caspase-1 and HIF-1α was quantified by two observers using digital capture and processing in three slides from each animal for each marker. The size and weight of the tumors were similar in hypoxia and simulated experiments. Median [25-75 quartiles] percentage of positive area stained for Ki-67 was 23% [15-28] in the hypoxia group and 0.3% [0.2-1.1] the control group (P=0.02); for PCNA, the percentages were 31% [25-38] e 7% [5-18], respectively (P=0.009). The differences between the groups for the remaining markers were not significant. Conclusions: Markers of ribosomal RNA transcription and of DNA synthesis are more expressed in tumors of mice exposed to intermittent hypoxia than of controls, indicating that sleep apnea can lead to greater tumor aggressiveness.

Objetivos do Estudo: O aumento do crescimento de melanoma foi avaliado em camundongos expostos a hipóxia intermitente. As proteínas que caracterizam a agressividade do tumor ainda não foram investigadas. O estudo teve como objetivo verificar se a hipóxia intermitente simulada pela apneia do sono afeta marcadores de melanoma na progressão tumoral. Desenho: Estudo prospectivo controlado em animais. Senário: Hospital Universitário. Participantes: Doze camundongos C57BL/6. Intervenções: Camundongos foram expostos a hipóxia intermitente ou simulada. Durante 8 horas por dia, o grupo hipóxia foi submetido a um total de 480 ciclos de 30 segundos de hipóxia progressiva SpO2 nadir de 8 ± 1%, seguidos por 30 segundos de normóxia. Um milhão de células de melanoma B16F10 foi injetado por via subcutânea. No dia 14, após a eutanásia, os tumores foram removidos, fixados e corados. Médias e resultados: coloração imunohistoquímica de Ki-67, PCNA, S100-B, HMB-45, Melan-A, TGF, Caspase-1 e HIF-1α foi quantificada por dois observadores que utilizaram captura digital e processamento em três lâminas de cada animal para cada marcador. O tamanho e o peso dos tumores foram semelhantes nas experiências de hipóxia e simulada. A percentagem da mediana [25-75 quartis] de área positiva corada para Ki-67 foi de 23% [15-28] no grupo hipóxia e 0,3% [0,2-1,1] no grupo controle (P = 0,02); para PCNA, as percentagens foram 31% [25-38] e 7% [5-18], respectivamente (P = 0,009). As diferenças entre os grupos para os marcadores restantes não foram significativas. Conclusões: Os marcadores da transcrição do RNA ribossomal e da síntese de DNA são mais expressos em tumores de camundongos expostos a hipóxia intermitente do que em controles, indicando que a apneia do sono pode levar a uma maior agressividade do tumor. / Study Objectives: Increased melanoma growth has been reported in mice exposed to intermittent hypoxia. Proteins that characterize tumor aggressiveness have not been investigated. The study aims to verify whether intermittent hypoxia mimicking sleep apnea affects markers of melanoma tumor progression. Design: Prospective controlled animal study. Settings: University hospital. Participants: Twelve C57bl/6 mice. Interventions: Mice were exposed to intermittent or sham hypoxia. During 8 hours per day, the hypoxia group was submitted to a total of 480 cycles of 30 seconds of progressive hypoxia to a nadir FIO2 of 8±1%, followed by 30 seconds of normoxia. One million B16F10 melanoma cells were injected subcutaneously. On the 14th day, after euthanasia, tumors were removed, fixed and stained. Measurements and Results: Immunohistochemistry staining for Ki-67, PCNA, S100-B, HMB-45, Melan-A, TGFβ, Caspase-1 and HIF-1α was quantified by two observers using digital capture and processing in three slides from each animal for each marker. The size and weight of the tumors were similar in hypoxia and simulated experiments. Median [25-75 quartiles] percentage of positive area stained for Ki-67 was 23% [15-28] in the hypoxia group and 0.3% [0.2-1.1] the control group (P=0.02); for PCNA, the percentages were 31% [25-38] e 7% [5-18], respectively (P=0.009). The differences between the groups for the remaining markers were not significant. Conclusions: Markers of ribosomal RNA transcription and of DNA synthesis are more expressed in tumors of mice exposed to intermittent hypoxia than of controls, indicating that sleep apnea can lead to greater tumor aggressiveness.

Objetivos do Estudo: O aumento do crescimento de melanoma foi avaliado em camundongos expostos a hipóxia intermitente. As proteínas que caracterizam a agressividade do tumor ainda não foram investigadas. O estudo teve como objetivo verificar se a hipóxia intermitente simulada pela apneia do sono afeta marcadores de melanoma na progressão tumoral. Desenho: Estudo prospectivo controlado em animais. Senário: Hospital Universitário. Participantes: Doze camundongos C57BL/6. Intervenções: Camundongos foram expostos a hipóxia intermitente ou simulada. Durante 8 horas por dia, o grupo hipóxia foi submetido a um total de 480 ciclos de 30 segundos de hipóxia progressiva SpO2 nadir de 8 ± 1%, seguidos por 30 segundos de normóxia. Um milhão de células de melanoma B16F10 foi injetado por via subcutânea. No dia 14, após a eutanásia, os tumores foram removidos, fixados e corados. Médias e resultados: coloração imunohistoquímica de Ki-67, PCNA, S100-B, HMB-45, Melan-A, TGF, Caspase-1 e HIF-1α foi quantificada por dois observadores que utilizaram captura digital e processamento em três lâminas de cada animal para cada marcador. O tamanho e o peso dos tumores foram semelhantes nas experiências de hipóxia e simulada. A percentagem da mediana [25-75 quartis] de área positiva corada para Ki-67 foi de 23% [15-28] no grupo hipóxia e 0,3% [0,2-1,1] no grupo controle (P = 0,02); para PCNA, as percentagens foram 31% [25-38] e 7% [5-18], respectivamente (P = 0,009). As diferenças entre os grupos para os marcadores restantes não foram significativas. Conclusões: Os marcadores da transcrição do RNA ribossomal e da síntese de DNA são mais expressos em tumores de camundongos expostos a hipóxia intermitente do que em controles, indicando que a apneia do sono pode levar a uma maior agressividade do tumor. / Study Objectives: Increased melanoma growth has been reported in mice exposed to intermittent hypoxia. Proteins that characterize tumor aggressiveness have not been investigated. The study aims to verify whether intermittent hypoxia mimicking sleep apnea affects markers of melanoma tumor progression. Design: Prospective controlled animal study. Settings: University hospital. Participants: Twelve C57bl/6 mice. Interventions: Mice were exposed to intermittent or sham hypoxia. During 8 hours per day, the hypoxia group was submitted to a total of 480 cycles of 30 seconds of progressive hypoxia to a nadir FIO2 of 8±1%, followed by 30 seconds of normoxia. One million B16F10 melanoma cells were injected subcutaneously. On the 14th day, after euthanasia, tumors were removed, fixed and stained. Measurements and Results: Immunohistochemistry staining for Ki-67, PCNA, S100-B, HMB-45, Melan-A, TGFβ, Caspase-1 and HIF-1α was quantified by two observers using digital capture and processing in three slides from each animal for each marker. The size and weight of the tumors were similar in hypoxia and simulated experiments. Median [25-75 quartiles] percentage of positive area stained for Ki-67 was 23% [15-28] in the hypoxia group and 0.3% [0.2-1.1] the control group (P=0.02); for PCNA, the percentages were 31% [25-38] e 7% [5-18], respectively (P=0.009). The differences between the groups for the remaining markers were not significant. Conclusions: Markers of ribosomal RNA transcription and of DNA synthesis are more expressed in tumors of mice exposed to intermittent hypoxia than of controls, indicating that sleep apnea can lead to greater tumor aggressiveness.

Le cholangiocarcinome (CC) est un cancer des voies biliaires qui représente environ 15% des cancers primitifs du foie,mais de pronostic redoutable en raison d'un diagnostic tardif faute de marqueurs spécifiques.La présence d'auto anticorps (Ac) est rapportée comme marqueurs diagnostiques précoce de certains cancers.La présence d'auto-Ac dans le CC n'a pas été signalée, et aucun biomarqueur immunologique de cette maladie n'a été identifié. L'objectif de notre étude était d'identifier des auto-Ac potentiellement utilisables comme biomarqueur de CC, par analyse sérologique du protéome. Des immunoblots ont été réalisés à partir de la séparation par électrophorèse 2D de protéines de lignées tumorales de CC, CCSW1 et CCLP1, de 5 pièces d'hépatectomie ac leur partie tumorale et non tumorale,ainsi que de foie normal de neuropathie amyloïde. Les sérums de 13 patients atteints de CC et un pool de 10 sujets sains ont été testés sur ces immunoblot.La comparaison informatique des profils des protéines immunomarquées par les sérums des patients comparés aux profils des contrôles a permis de définir des spots immunoréactifs d'intérêt.Ces spots d'intérêt marqués par plus d'1/3 de sérums ont été ensuite identifiés par spectrométrie de masse de type Orbitrap®.Ainsi, nous avons identifié 10 protéines d'intérêt de CCSW1,11 protéines de CCLP1, 9 de la partie tumorale des foies, 14 des parties non-tumoral et 16 protéines appartenant au foie normal.Une extrême variabilité était observée selon les sérums pour un même Ag.Différents profils de réactivité étaient observés sur le même extrait antigénique en fonction des sérums testés, et pour un même sérum selon l'extrait antigénique utilisé.Il en résulte qu'un AC d'intérêt donné ne peut être considéré comme biomarqueur de CC que pour une faible proportion de patients.Pr cette raison, il faut envisager la combinaison de plusieurs anticorps pour avoir un test avec une sensibilité et une spécificité utilisable en clinique. Les protéines identifiées ont été classées par bio-informatique (logiciel Panther®) selon la description des gènes et de leurs produits selon une ontologie commune à toutes les espèces : fonctions moléculaires effectuées, processus biologiques assurés et localisation subcellulaire.Dans cette classification, 2 profils d'immunoréactivité se distinguent. La grande majorité des protéines cibles d'intérêt avec une fonction catalytique étaient présentes dans le foie normal ou dans les parties non tumorales des exérèses. L'autre profil était celui des protéines-cibles avec une fonction de protéines structurale et étaient présentes dans les lignées cellulaires tumorales ainsi que des parties tumorales des hépatectomies. Les protéines identifiées avec une activité catalytique étaient:l'alpha-énolase, le fructose biphosphate aldolase B et la glyceraldedyde 3-phosphate déshydrogénase, toutes troisréactives avec+de 50% des sérums de CC. Les protéines de structure identifiées par+de 60% des sérums de CC provenaient des lignées cellulaires et des tissus tumoraux.Il s'agissait de la vimentine, des prélamines A / C, de l'annexine A2 et de l'actine.Enfin, la sérotranferrine, protéines de transport, est reconnues par 100% des sérums CC en utilisant comme antigène des tissus tumoraux.Une sensibilité importante et une spécificité élevée sont des caractéristiques princeps d'un Ac pour pouvoir l'utiliser comme biomarqueur.La plupart des auto-Ac détectés dans cette étude avaient déjà été rapportées dans d'autres cancers et maladies auto-immunes. Pour trouver des protéines antigéniques spécifiques du CC, une combinaison de plusieurs semble nécessaire afin de permettre le développement de nouveaux biomarqueurs pour le diagnostic et le pronostic des CC.En conclusion, les biomarqueurs potentiels proposés dans cette étude doivent être testés en différentes combinaisons avec un panel en nb significatif de patients et en utilisant le substrat antigénique le plus approprié comme défini au cours de cette étude. / Cholangiocarcinoma (CC) is a rare but fatal primary liver cancer and accounts for an estimated 15% of primary liver cancer worldwide. It is associated with high mortality due to the lack of established diagnostic approaches. Autoantibodies can be used clinically as diagnostic markers for early cancer detection of cholangiocarcinoma. Studies, indicating the presence of auto-antibodies (AAbs) in CC have not been reported yet. No immunological biomarker, correlated to the disease, has been identified. The objective of our study was to identify cellular proteins from liver tissues (tumoral and non tumoral) and cholangiocarcinoma cell lines which could be recognized by antibody of CC patients. We used serological proteome analysis (SERPA) technique which leads us to suggest some molecules as potential biomarkers for the early diagnosis of CC. Proteins from different origins were 2DE separated: CCSW1 and CCLP1 tumor cell lines, five different samples of hepatectomies for CC with respect to their tumoral and non-tumoral counterparts and a normal liver from amyloid neuropathy. Sera from 13 CC patients and a pool of 10 healthy subjects were probed on immunoblot performed with these different separations. Comparison of immunoblotting patterns given by patient’s sera compared to patterns given by controls allowed to define immunoreactive spots of interest and those reacting with more than one-third of sera were identified by orbitrap type mass spectrometry. In this way we identified 10, 11, 9, 14 and 16 proteins from CCSW1, CCLP1, tumor part, non-tumor counterpart and normal liver antigenic extracts respectively. Different patterns of reactivity were observed according to sera on the same antigenic extract, and for a same serum, according to the antigenic extract, even though few common patterns were also observed. This widespread of reactivity is not unusual and reported earlier in several studies of this sort. It is indicated that a single AAb have an ability to identify only a small proportion of patient. For this reason, several antibodies in combination must be used to ensure sensitivity and specificity of assays used in the daily clinic.Identified proteins were then categorized by gene ontology analysis by which they fall into three main groups; biological process and molecular functions, protein class and molecular pathway and cellular component, according to the Panther classification. By Gene Ontology classification, two different patterns of targeted antigens were observed. The vast majority of targeted-proteins with catalytic activity were found in normal liver or non-tumor specimens. The second pattern was mainly represented by targeted proteins categorized as structural proteins extracted from CC cell lines and tumor tissues. Proteins identified with catalytic activity were: alpha-enolase, fructose biphosphate aldolase B and glyceraldedyde 3-phosphate dehydrogenase; which were reactive with more than 50% of CC sera. Proteins identified with structural activity, and detected with high rates by using cell lines and tumor tissues, were: vimentin, prelamine A/C, annexin A2 and actin; reactivity of each protein was higher than 62% with CC sera. Serotranferrin, identified under the category of transfer/carrier proteins, recognized by 100% of CC sera by using tumor tissues.High sensitivity and specificity is a prime requisite of AAbs that might be used as CC biomarkers for CC diagnosis. Most of the AAbs detected in this study had previously been reported in other cancers and auto-immune disorders. Hence it is essential to prove the specificity of antigenic proteins, a combination of various antigens therefore needs to be tested to enable the development of new biomarkers for the diagnosis and prognosis of CC.In conclusion, the proposed potential biomarkers need to be tested in a variety of different combinations with a panel of significant number of patients and using the most appropriate substrate defined during this study.

Cholangiocarcinoma (CC) is a rare but fatal primary liver cancer and accounts for an estimated 15% of primary liver cancer worldwide. It is associated with high mortality due to the lack of established diagnostic approaches. Autoantibodies can be used clinically as diagnostic markers for early cancer detection of cholangiocarcinoma. Studies, indicating the presence of auto-antibodies (AAbs) in CC have not been reported yet. No immunological biomarker, correlated to the disease, has been identified. The objective of our study was to identify cellular proteins from liver tissues (tumoral and non tumoral) and cholangiocarcinoma cell lines which could be recognized by antibody of CC patients. We used serological proteome analysis (SERPA) technique which leads us to suggest some molecules as potential biomarkers for the early diagnosis of CC. Proteins from different origins were 2DE separated: CCSW1 and CCLP1 tumor cell lines, five different samples of hepatectomies for CC with respect to their tumoral and non-tumoral counterparts and a normal liver from amyloid neuropathy. Sera from 13 CC patients and a pool of 10 healthy subjects were probed on immunoblot performed with these different separations. Comparison of immunoblotting patterns given by patient's sera compared to patterns given by controls allowed to define immunoreactive spots of interest and those reacting with more than one-third of sera were identified by orbitrap type mass spectrometry. In this way we identified 10, 11, 9, 14 and 16 proteins from CCSW1, CCLP1, tumor part, non-tumor counterpart and normal liver antigenic extracts respectively. Different patterns of reactivity were observed according to sera on the same antigenic extract, and for a same serum, according to the antigenic extract, even though few common patterns were also observed. This widespread of reactivity is not unusual and reported earlier in several studies of this sort. It is indicated that a single AAb have an ability to identify only a small proportion of patient. For this reason, several antibodies in combination must be used to ensure sensitivity and specificity of assays used in the daily clinic.Identified proteins were then categorized by gene ontology analysis by which they fall into three main groups; biological process and molecular functions, protein class and molecular pathway and cellular component, according to the Panther classification. By Gene Ontology classification, two different patterns of targeted antigens were observed. The vast majority of targeted-proteins with catalytic activity were found in normal liver or non-tumor specimens. The second pattern was mainly represented by targeted proteins categorized as structural proteins extracted from CC cell lines and tumor tissues. Proteins identified with catalytic activity were: alpha-enolase, fructose biphosphate aldolase B and glyceraldedyde 3-phosphate dehydrogenase; which were reactive with more than 50% of CC sera. Proteins identified with structural activity, and detected with high rates by using cell lines and tumor tissues, were: vimentin, prelamine A/C, annexin A2 and actin; reactivity of each protein was higher than 62% with CC sera. Serotranferrin, identified under the category of transfer/carrier proteins, recognized by 100% of CC sera by using tumor tissues.High sensitivity and specificity is a prime requisite of AAbs that might be used as CC biomarkers for CC diagnosis. Most of the AAbs detected in this study had previously been reported in other cancers and auto-immune disorders. Hence it is essential to prove the specificity of antigenic proteins, a combination of various antigens therefore needs to be tested to enable the development of new biomarkers for the diagnosis and prognosis of CC.In conclusion, the proposed potential biomarkers need to be tested in a variety of different combinations with a panel of significant number of patients and using the most appropriate substrate defined during this study.

Nous avons abordé dans l’ensemble de nos travaux deux paramètres importants pour l’immunomonitoring des patients atteints d’un cancer : les cellules tumorales circulantes (CTC) comme un indicateur de la « charge antigénique tumorale » et la réponse immune lymphocytaire T spécifique d’antigènes associés aux tumeurs (AAT). Nous avons évalué d’abord la valeur diagnostique et pronostique des CTC dans les cancers des voies aérodigestives supérieures (« HNSCC » en anglais) par une revue systématique et meta-analyse de la littérature. Les preuves actuelles identifient le test de détection de CTC comme un test extrêmement spécifique, mais de faible sensibilité dans les HNSCC. En outre, la présence de CTC indique une DFS (« disease free survival ») inférieure. Nous rapportons également pour la première fois un cas rare d’énumération extrêmement élevée de CTC détectées par le système CellSearch® chez un patient présentant un carcinome épidermoïde de la cavité buccale en utilisant. Le nombre absolu de CTC pourrait donc prédire une phase particulière de développement du cancer ainsi qu'une mauvaise survie, contribuant potentiellement à une prise en charge médicale personnalisée. De plus, nous décrivons une adaptation de la méthode CellSearch® qui nous avons développée pour détecter les cellules tumorales dans le liquide céphalo-rachidien de patients atteints de méningites carcinomateuses. Cette nouvelle approche permet une sensibilité nettement améliorée en comparaison avec la cytologie conventionnelle. La technologie CellSearch®, appliquée à des volumes limités des échantillons et permettant une augmentation du temps pré-analytique, pourrait ainsi avoir un grand intérêt dans le diagnostic de métastases leptoméningées chez les patients atteints d’un cancer d’origine épithéliale. Par une évaluation concomitante des CTC et des réponses lymphocytaires spécifiques aux AAT chez 24 patients avec HNSCC, nous avons trouvé que les CTC pourraient être un indicateur indépendant de la charge tumorale immunogène. L'absence de CTC, la présence de lymphocytes T spécifiques aux AAT, ou la combinaison de ceux-ci, étaient tous des paramètres montrant une tendance pour une meilleure survie globale ou une survie sans maladie. L’amplitude et les signatures fonctionnelles des lymphocytes T spécifiques aux AAT chez les patients atteints de HNSCC étaient associées à la présence de CTC. Ces résultats suggèrent qu’une évaluation concomitante de ces deux paramètres pourrait être plus informative sur le pronostic et potentiellement sur l’impact des traitements (notamment dans la perspective d’un traitement par des « immune checkpoints ») / We have evaluated herein two important parameters in the immunomonitoring of cancer patients: circulating tumor cells (CTC) as an indicator of “tumoral antigenic load” and tumor-associated antigens (TAA) specific T-cells. We firstly evaluated the diagnostic and prognostic value of CTC in Head and Neck Squamous Cell Carcinoma (HNSCC) by a systematic review and meta-analysis. We came to the conclusion that current evidence identifies the CTC detection test as an extremely specific but low sensitive test in HNSCC. In addition, the presence of CTC indicates a worse disease-free disease (DFS). Also, we report for the first time a rare case of extremely high enumeration of circulating tumor cells detected in a patient with squamous cell carcinoma of the oral cavity using the CellSearch® system. The absolute number of CTC could therefore predict a particular phase of cancer development as well as a poor survival, potentially contributing to personalized health. In addition, we describe an adaptation of the CellSearch® method that we have developed for detecting tumor cells in the cerebrospinal fluid of patients with carcinomatous meningitis. This new approach reaches a significantly improved sensitivity compared to conventional cytology. CellSearch® technology, applied to limited sample volumes and allowing an increased pre-analytical time, may be of great interest in the diagnosis of leptomeningeal metastases in patients with epithelial cancer. By a concomitant evaluation of CTC and TAA-specific lymphocyte responses in 24 HNSCC patients, we describe that CTC could be an independent indicator of immunogenic tumor burden. The absence of CTC, the presence of TAA-specific T-cells, or the combination of these, were all parameters showing a trend for a better overall survival or DFS. The amplitude and functional signatures of TAA-specific T-lymphocytes in patients with HNSCC were associated with the presence of CTC. These results suggest that a concomitant evaluation of these two parameters may be more pertinent for prognosis assessment as well as for treatment impact, especially in “checkpoint-inhibitors” new immunotherapies

No description available.