A angiogênese é um processo fundamental e fisiológico de organismos vertebrados, sendo responsável pela formação de novos vasos sanguíneos a partir dos já existentes. Entretanto, a angiogênese pode ocorrer também em condições patológicas, como causa ou consequência de doenças. Um exemplo disso está nos tumores, que para crescer além de alguns milímetros cúbicos, necessitam de um suprimento adequado de oxigênio e nutrientes, e, portanto, dependem da angiogênese. Por isso, compostos que inibem a angiogênese já estão em uso na clínica, não só para o tratamento de tumores, mas também de outras doenças dependentes da angiogênese, as retinopatias. Neste projeto, daremos continuidade à linha de pesquisa do nosso grupo, que procura identificar e validar peptídeos com potencial translacional (pré-fármacos), por apresentarem atividade anti-angiogênica. Utilizando a metodologia do Phage Display, nosso grupo identificou e caracterizou um hexapeptídeo, que foi selecionado por interagir com os receptores do principal fator iniciador da angiogênese, o VEGF (fator de crescimento endotelial vascular). Os receptores de VEGF (ou VEGFR) são proteínas do tipo receptor tirosina quinase, expressos em células endoteliais e essenciais para a iniciação e progressão da neovascularização. O hexapeptídeo identificado em nosso laboratório liga-se ao VEGFRs e inibe a formação de vasos sanguíneos in vivo em modelos animais de angiogênese. Neste trabalho, procuramos estender os estudos com este hexapeptídeo para identificar o sítio de ligação do mesmo no VEGFR e avançar em modelos que permitam a determinação dos requisitos estruturais de interação peptídeoreceptor. Com estes conhecimentos, poderemos num futuro próximo, caminhar para o desenvolvimento racional de moléculas peptideomiméticas com propriedades anti-angiogênicas. / Angiogenesis is a fundamental and physiological process for vertebrate organisms, being responsible for the formation of new blood vessels, sprouting from the existent ones. However, angiogenesis may occur in pathological conditions, being cause or consequence of diseases. One example is tumor development. To grow beyond a few cubic millimeters, tumors need a suitable supply of oxygen and nutrients, and, therefore, they are dependent of angiogenesis. In fact, anti-angiogenic compounds are already in therapeutic use, targeting not only tumors but other angiogenesis dependent diseases, like retinopathies. In this project, we expand research from our own group to identify and develop anti-angiogenic peptides with translational potential (pre-drugs). Using Phage Display methodology, our group identified and characterized a hexapeptide, that was selected based on its capacity to interact with the receptors for the main initiator factor of angiogenesis, the VEGF (Vascular Endothelial Growth Factor). VEGF receptors (VEGFR) are tyrosine kinase proteins, expressed by endothelial cells and essential for neovascularization initiation and progress. The hexapeptide identified in our lab binds to VEGFRs and inhibit blood vessel formation in vivo when tested in an angiogenesis animal model. In this study, we seek to further understand the interaction of this hexapeptide with its receptor by identifying its binding domain on VEGFR and develop models that will allow the determination of the structural requirements for interaction of this receptor ligand pair. With this knowledge, we can in a near future progress to a rational development of novel peptidemimetic molecules with angiogenic properties similar to this hexapeptide.

A angiogênese é um processo fundamental e fisiológico de organismos vertebrados, sendo responsável pela formação de novos vasos sanguíneos a partir dos já existentes. Entretanto, a angiogênese pode ocorrer também em condições patológicas, como causa ou consequência de doenças. Um exemplo disso está nos tumores, que para crescer além de alguns milímetros cúbicos, necessitam de um suprimento adequado de oxigênio e nutrientes, e, portanto, dependem da angiogênese. Por isso, compostos que inibem a angiogênese já estão em uso na clínica, não só para o tratamento de tumores, mas também de outras doenças dependentes da angiogênese, as retinopatias. Neste projeto, daremos continuidade à linha de pesquisa do nosso grupo, que procura identificar e validar peptídeos com potencial translacional (pré-fármacos), por apresentarem atividade anti-angiogênica. Utilizando a metodologia do Phage Display, nosso grupo identificou e caracterizou um hexapeptídeo, que foi selecionado por interagir com os receptores do principal fator iniciador da angiogênese, o VEGF (fator de crescimento endotelial vascular). Os receptores de VEGF (ou VEGFR) são proteínas do tipo receptor tirosina quinase, expressos em células endoteliais e essenciais para a iniciação e progressão da neovascularização. O hexapeptídeo identificado em nosso laboratório liga-se ao VEGFRs e inibe a formação de vasos sanguíneos in vivo em modelos animais de angiogênese. Neste trabalho, procuramos estender os estudos com este hexapeptídeo para identificar o sítio de ligação do mesmo no VEGFR e avançar em modelos que permitam a determinação dos requisitos estruturais de interação peptídeoreceptor. Com estes conhecimentos, poderemos num futuro próximo, caminhar para o desenvolvimento racional de moléculas peptideomiméticas com propriedades anti-angiogênicas. / Angiogenesis is a fundamental and physiological process for vertebrate organisms, being responsible for the formation of new blood vessels, sprouting from the existent ones. However, angiogenesis may occur in pathological conditions, being cause or consequence of diseases. One example is tumor development. To grow beyond a few cubic millimeters, tumors need a suitable supply of oxygen and nutrients, and, therefore, they are dependent of angiogenesis. In fact, anti-angiogenic compounds are already in therapeutic use, targeting not only tumors but other angiogenesis dependent diseases, like retinopathies. In this project, we expand research from our own group to identify and develop anti-angiogenic peptides with translational potential (pre-drugs). Using Phage Display methodology, our group identified and characterized a hexapeptide, that was selected based on its capacity to interact with the receptors for the main initiator factor of angiogenesis, the VEGF (Vascular Endothelial Growth Factor). VEGF receptors (VEGFR) are tyrosine kinase proteins, expressed by endothelial cells and essential for neovascularization initiation and progress. The hexapeptide identified in our lab binds to VEGFRs and inhibit blood vessel formation in vivo when tested in an angiogenesis animal model. In this study, we seek to further understand the interaction of this hexapeptide with its receptor by identifying its binding domain on VEGFR and develop models that will allow the determination of the structural requirements for interaction of this receptor ligand pair. With this knowledge, we can in a near future progress to a rational development of novel peptidemimetic molecules with angiogenic properties similar to this hexapeptide.

Elevation of VEGFR-3, the primary mediator of lymphangiogenesis (i.e., new lymphatic vessel formation), is frequently associated with inflammation related to chronic disease and cancer. In the latter case, VEGFR-3 dependent lymphangiogenesis induced by inflamed tumors increases the incidence of distant metastasis, leading to decreased patient survival. However, the molecular mechanisms underlying inflammation-induced VEGFR-3 elevation and lymphangiogenesis are currently unknown. Two potential candidate genes that may regulate expression of VEGFR-3 are Prox1, the primary mediator of embryonic lymphangiogenesis, and NF-κB, the key intracellular regulator of inflammation-induced transcription. We hypothesized that the key inflammatory mediator, NF-κB, regulates transcription of key mediators of lymphangiogenesis, VEGFR-3 and Prox1. We further hypothesized that inflammation-induced elevation of VEGFR-3 and Prox1 are essential steps required for robust lymphangiogenesis in response to inflammation. The three primary goals of this study were to (1) delineate the time-course of events leading to inflammation-induced lymphangiogenesis in vivo; (2) clone and characterize the VEGFR-3 promoter and identify factors regulating VEGFR-3 expression in vitro; and (3) characterize the lymphatic phenotype of NF-κB p50 knockout mice. To begin testing these hypotheses, we used a mouse model of peritonitis to characterize induction of lymphangiogenesis and expression kinetics of NF-κB, Prox1 and VEGFR-3. In vivo time-course analysis of inflammation-induced lymphangiogenesis showed activation of NF-κB followed by sequential upregulation of Prox1 and VEGFR-3 that preceded lymphangiogenesis by 4 and 2 days, respectively. Characterization of the VEGFR-3 promoter by luciferase-reporter and ChIP assays showed direct activation by Prox1, NF-κB p50 and p65 transcription factors. This also revealed that Prox1 and NF-κB p50 bind in close proximity and synergistically activate the VEGFR-3 promoter. Characterization of p50 knockout mice revealed significantly decreased lymphatic vessel density in several organs that corresponded to reduced VEGFR-3 and Prox1 expression. Activation of NF-κB by inflammatory stimuli also elevated expression of NF-κB, Prox1 and VEGFR-3 in cultured lymphatic endothelial cells, which enhanced proliferation and migration in response to the VEGFR-3-specific ligand, VEGF-C152S. Collectively, our findings suggest that induction of the NF-κB pathway by inflammatory stimuli activates Prox1, and both NF-κB and Prox1 activate the VEGFR-3 promoter leading to increased receptor expression in lymphatic endothelial cells. This, in turn, enhances the responsiveness of pre-existing lymphatic endothelium to VEGFR-3 binding factors, VEGF-C and VEGF-D, ultimately resulting in robust lymphangiogenesis.

Οι όγκοι εγκεφάλου αποτελούν μια ομάδα όγκων με ιδιαίτερα χαρακτηριστικά. Η ογκογένεση έχει συσχετισθεί σε αρκετούς όγκους, ανάμεσά τους και ορισμένοι όγκοι εγκεφάλου, με την πρωτείνη θερμικού σοκ 90 (Hsp90). Σε πρόσφατες μελέτες, έχει αποδειχθεί η η συμμετοχή της Hsp90 στην αποδόμηση της ογκοκατασταλτικής πρωτείνης pVHL, η οποία είναι απαραίτητητη για την αποδόμηση του μεταγραφικού παράγοντα που ενεργοποιείται στην υποξία (HIF-1α). Επιπλέον, έχει βρεθεί πως οι ανταγωνιστές της Hsp90 μειώνουν τα επίπεδα έκφρασης του VEGFR-3. Στόχος της παρούσας μελέτης ήταν η εκτίμηση των επιπέδων έκφρασης των μορίων Hsp90, pVHL, HIF-1α και VEGFR-3 στους όγκους εγκεφάλου και οι πιθανές συσχετίσεις μεταξύ τους. Εξετάσθηκαν συνολικά 89 óγκοι εγκεφάλου με την ανοσοϊστοχημική μέθοδο. Στους αστροκυτταρικούς όγκους, η Ηsp90 φαίνεται πως οδηγεί στη σταθεροποίηση του HIF-1α μέσω της σύνδεσής της με τη pVHL. Στα μυελοβλαστώματα από την άλλη, ο HIF-1α ρυθμίζεται από τη Hsp90 με τρόπο ανεξάρτητο από τη pVHL. Βρέθηκε συσχέτιση της έκφρασης του VEGFR-3 με τη Hsp90 αλλά και τον HIF-1α σε ομάδα όγκων του εγκεφάλου, η βιολογική συμπεριφορά των οποίων θα πρέπει να διερευνηθεί. / Brain tumors constitute a special group of tumors. In many tumors, including brain tumors, tumorigenesis has been associated with heat shock protein 90 (Hsp90). ). Recent studies have demonstrated that Hsp90 is essential for the degradation of tumor suppressor protein, pVHL, which is essential for the degradation of Hypoxia Induced Factor 1α (HIF-1α). In addition,it has been proved that Hsp90 antagonists, reduce the expression VEGFR-3. the aim of the current study was to estimate the levels of expression of Hsp90, pVHL, HIF-1α and VEGFR-3 in brain tumors and the possible correlations among them.89 human brain tumors were studied immunohistochemically. In astrocytic tumors, Hsp90 seems to stabilize HIF-1α, through binding to pVHL. On the other hand, in medulloblastomas, HIF-1α seems to be regulated by Hsp90, in a way that seems to be independent from pVHL. We found a correlation between the expression of VEGFR-3 and Hsp90 and HIF-1α in a group of brain tumors, the biological behavior of which must be studied.

<p>Angiogenesis can be defined as the formation of new blood vessels from pre-existing ones. Angiogenesis is required for development and maintenance of our vascular system and thus of fundamental importance to our existence. The endothelial cells that line the inside of the vessels de-differentiate, migrate, proliferate and re-differentiate during angiogenesis. Angiogenesis is tightly regulated, controlled by several angiogenic factors of various classes that promote angiogenesis but also by anti-angiogenic factors that counteract the effect of the pro-angiogenic factors. We have examined three factors involved in angiogenesis regulation, Vascular endotelial growth factor (VEGFR) -3, the matrix protein laminin-1 and the collagen XVIII derived fragment endostatin. </p><p>Five tyrosine phosphorylation sites in the cytoplasmic tail of VEGFR-3 were identified by phosphopeptide mapping (PPM). The data was confirmed by PPM using point-mutated receptors generated by site-directed mutagenesis.</p><p>Laminin-1 was found to promote angiogenesis in the chicken chorioallantoic membrane assay and in a synergistic fashion together with suboptimal levels of fibroblast growth factor 2 (FGF-2) in embryoid bodies. Laminin-1 also promoted endothelial tubular morphogenesis in vitro, and upregulated the expression of the endothelial differentiation marker Jagged-1. </p><p>Endostatin was shown to affect endothelial FGF-2-induced cell survival and morphogenesis. This was a result of direct binding to endothelial cells and induction of tyrosine phosphorylation of many proteins including the adaptor protein Shb. The apoptotic and morphogenic responses induced by endostatin was shown to be dependent on Shb. Further, endostatin inhibited endothelial migration and affected molecules implicated in migration. In particular, FGF-2 induced actin reorganization, and β-catenin regulation was modulated by endostatin. </p>

<p>The mechanisms behind many important aspects of blood- and lymphatic vessel formation have yet not been elucidated in detail. The primary objectives of this thesis have therefore been to study the effects of hypoxia, platelet-derived growth factor (PDGF) and vascular endothelial growth factors (VEGFs) on vascular development and function. </p><p>In conditions of low oxygen pressure, hypoxia, the survival of the organism is critically dependent on the ability to compensate for the reduced oxygen levels by promoting blood vessel growth and oxygen-independent energy production. Many direct effects of hypoxia in cells are attributed to the induction of a family of hypoxia-inducible transcription factors (HIFs) which control the expression of specific target genes. We found that capillary endothelial cells (ECs) respond to hypoxia with upregulation of genes involved in growth and remodeling of blood vessels. On the other hand, vein ECs responded to hypoxia with increased expression of genes involved in lymphatic vessel growth. Using differentiating embryonic stem (ES) cells, we have shown that hypoxia upregulates expression of VEGF receptor-3 (VEGFR-3) on blood vascular ECs. Furthermore, we have provided evidence for a critical role of VEGFR-3 in hypoxia-induced blood vessel development. </p><p>Activation of PDGF receptor-β (PDGFR-β) on early vascular progenitors in differentiating ES cells or in mice induces blood vessel differentiation, while negatively influencing early hematopoiesis. PDGFR-β expression on vascular progenitors may therefore play a role in guiding differentiation of the vascular lineages. </p><p>We have investigated the usefulness of differentiating ES cells as a model to study early lymphatic development. Administration of VEGF-C and VEGF-A induced formation of lymphatic vessel-like structures that seemed connected to the blood vasculature, supporting the general view that lymphatic ECs are derived from blood vascular ECs.</p><p>In summary, this thesis has provided new insights in the contribution of different growth factors in hematopoietic, blood- and lymphendothelial development. </p>

Angiogenesis can be defined as the formation of new blood vessels from pre-existing ones. Angiogenesis is required for development and maintenance of our vascular system and thus of fundamental importance to our existence. The endothelial cells that line the inside of the vessels de-differentiate, migrate, proliferate and re-differentiate during angiogenesis. Angiogenesis is tightly regulated, controlled by several angiogenic factors of various classes that promote angiogenesis but also by anti-angiogenic factors that counteract the effect of the pro-angiogenic factors. We have examined three factors involved in angiogenesis regulation, Vascular endotelial growth factor (VEGFR) -3, the matrix protein laminin-1 and the collagen XVIII derived fragment endostatin. Five tyrosine phosphorylation sites in the cytoplasmic tail of VEGFR-3 were identified by phosphopeptide mapping (PPM). The data was confirmed by PPM using point-mutated receptors generated by site-directed mutagenesis. Laminin-1 was found to promote angiogenesis in the chicken chorioallantoic membrane assay and in a synergistic fashion together with suboptimal levels of fibroblast growth factor 2 (FGF-2) in embryoid bodies. Laminin-1 also promoted endothelial tubular morphogenesis in vitro, and upregulated the expression of the endothelial differentiation marker Jagged-1. Endostatin was shown to affect endothelial FGF-2-induced cell survival and morphogenesis. This was a result of direct binding to endothelial cells and induction of tyrosine phosphorylation of many proteins including the adaptor protein Shb. The apoptotic and morphogenic responses induced by endostatin was shown to be dependent on Shb. Further, endostatin inhibited endothelial migration and affected molecules implicated in migration. In particular, FGF-2 induced actin reorganization, and β-catenin regulation was modulated by endostatin.

The mechanisms behind many important aspects of blood- and lymphatic vessel formation have yet not been elucidated in detail. The primary objectives of this thesis have therefore been to study the effects of hypoxia, platelet-derived growth factor (PDGF) and vascular endothelial growth factors (VEGFs) on vascular development and function. In conditions of low oxygen pressure, hypoxia, the survival of the organism is critically dependent on the ability to compensate for the reduced oxygen levels by promoting blood vessel growth and oxygen-independent energy production. Many direct effects of hypoxia in cells are attributed to the induction of a family of hypoxia-inducible transcription factors (HIFs) which control the expression of specific target genes. We found that capillary endothelial cells (ECs) respond to hypoxia with upregulation of genes involved in growth and remodeling of blood vessels. On the other hand, vein ECs responded to hypoxia with increased expression of genes involved in lymphatic vessel growth. Using differentiating embryonic stem (ES) cells, we have shown that hypoxia upregulates expression of VEGF receptor-3 (VEGFR-3) on blood vascular ECs. Furthermore, we have provided evidence for a critical role of VEGFR-3 in hypoxia-induced blood vessel development. Activation of PDGF receptor-β (PDGFR-β) on early vascular progenitors in differentiating ES cells or in mice induces blood vessel differentiation, while negatively influencing early hematopoiesis. PDGFR-β expression on vascular progenitors may therefore play a role in guiding differentiation of the vascular lineages. We have investigated the usefulness of differentiating ES cells as a model to study early lymphatic development. Administration of VEGF-C and VEGF-A induced formation of lymphatic vessel-like structures that seemed connected to the blood vasculature, supporting the general view that lymphatic ECs are derived from blood vascular ECs. In summary, this thesis has provided new insights in the contribution of different growth factors in hematopoietic, blood- and lymphendothelial development.

Οι όγκοι εγκεφάλου του ανθρώπου είναι φαινοτυπικά και γονοτυπικά ετερογενείς. Υπάρχουν σημαντικά κενά στην κατανόηση των μοριακών οδών που εμπλέκονται στην γένεση και ανάπτυξη των νεοπλασμάτων αυτών, καθώς και στη βιολογική και κλινική συμπεριφορά τους. Δεδομένου ότι: α) υπάρχει ένας αυξανόμενος όγκος πληροφοριών σχετικά με την εμπλοκή των υποδοχέων νευροτροφινών Trks (υποδοχείς κινάσης τυροσίνης) στην παθογένεια των νεοπλασμάτων του ΚΝΣ, β) οι νευροτροφίνες μπορούν να ρυθμίζουν τη γονιδιακή έκφραση στο νευρικό σύστημα μέσω του μεταγραφικού παράγοντα STAT-5 με μηχανισμό ανεξάρτητο της ενεργοποίησης της κινάσης JAK-2, γ) η οδός μεταγωγής σήματος JAK-2/STAT-5 ενεργοποιείται από την ερυθροποιητίνη (Epo) (μέσω δέσμευσής της με τον υποδοχέα της EpoR) η οποία πρόσφατα έχει θεωρηθεί ως παράγοντας-κλειδί της αύξησης των όγκων λόγω των αντιαποπτωτικών και αγγειογενετικών ιδιοτήτων και δυνητικός στόχος ογκολογικών θεραπευτικών στρατηγικών, δ) η Epo διαντιδρά με τον παράγοντα αγγειογένεσης VEGF ενδυναμώνοντας την αγγειοδραστικότητά του και συχνά οι δύο αυτοί αναπτυξιακοί παράγοντες συνεκφράζονται, ε) ερευνητικά δεδομένα υποδεικνύουν ένα δυνητικό ρόλο του άξονα VEGF/JAK-2/ STAT-5 στην αγγειογένεση στον καρκίνο και στ) σε πολλά νεοπλάσματα, τα κύτταρα του όγκου καθώς και τα μακροφάγα του στρώματος εκφράζουν τους παράγοντες λεμφαγγειογένεσης VEGF-C και VEGF-D οι οποίοι μέσω του υποδοχέα τους VEGFR-3 (υποδοχέας κινάσης τυροσίνης) έχει βρεθεί ότι προάγουν την αγγειογένεση στα νεοπλάσματα αυτά, ο στόχος της παρούσας εργασίας είναι η μορφολογική μελέτη της έκφρασης των υποδοχέων κινάσης τυροσίνης Trks (υποδοχείς νευροτροφινών) και VEGFR-3 και η συσχέτισή τους με την οδό μεταγωγής σήματος EpoR/ JAK-2/ STAT-5 στα νεοπλάσματα του εγκεφάλου στον άνθρωπο. Για την ανίχνευση των Trks, EpoR, JAK-2, STAT-5 και VEGFR-3, χρησιμοποιήθηκε η ανοσοϊστοχημική μέθοδος σε διαδοχικές τομές ιστού πάχους 4μm, μονιμοποιημένου σε φορμόλη και εγκλεισμένου σε παραφίνη. Χρησιμοποιήθηκαν ειδικά αντισώματα έναντι των προς μελέτη πρωτεϊνών. Εξετάσθηκαν συνολικά 92 όγκοι εγκεφάλου (50 αστροκυτώματα: 5 πιλοκυτταρικά αστροκυττώματα WHO grade I, 6 διάχυτα αστροκυττώματα WHO grade II, 10 αναπλαστικά αστροκυττώματα. WHO grade III και 29 πολύμορφα γλοιοβλαστώματα. WHO grade IV, 8 ολιγοδενδρογλοιώματα, 6 επενδυμώματα, 5 μυελοβλαστώματα και 23 μηνιγγιώματα). Επιπλέον, στη μελέτη συμπεριλήφθηκαν τομές ιστού φυσιολογικού εγκεφάλου. Στην παρούσα εργασία, η πλειονότητα των αστροκυττωμάτων ανεξαρτήτως βαθμού κακοήθειας, έδειξε μέτρια έως έντονη κυτταροπλασματική ανοσοδραστικότητα για τους υποδοχείς TrkA (57%), TrkB (56%) και TrkC (46%). Όλα τα ολιγοδενδρογλοιώματα και τα επενδυμώματα που εξετάσθηκαν ήταν αρνητικά για τους υποδοχείς Trk ενώ έκφραση των υποδοχέων ανιχνεύθηκε σε μικρό ποσοστό των μυελοβλαστωμάτων. Στις ανοσοθετικές περιοχές των όγκων, το τοίχωμα των αγγείων ήταν έντονα θετικό για τον υποδοχέα TrkB. Σε ένα σημαντικό ποσοστό αστροκυττωμάτων (41%), επενδυμωμάτων (33%) και μηνιγγιωμάτων (48%) ανιχνεύθηκε έκφραση του EpoR, ενώ τα ολιγοδενδρογλοιώματα και τα μυελοβλαστώματα που εξετάσθηκαν ήταν αρνητικά. Συνέκφραση των JAK-2/STAT-5 ανιχνεύθηκε στο 39% των αστροκυττωμάτων, στο 43% των ολιγοδενδρογλοιωμάτων, στο 50% των επενδυμωμάτων και σε όλα (100%) τα μυελοβλαστώματα που συμπεριλήφθηκαν στη μελέτη. Η πλειονότητα των μηνιγγιωμάτων έδειξε ασθενή έως μηδενική έκφραση των πρωτεινών JAK-2 και STAT-5. Σε κάποιους όγκους, ανιχνεύθηκε έκφραση της πρωτείνης STAT-5 ενώ ήταν αρνητικοί για την κινάση JAK-2. Επίσης, βρέθηκαν όγκοι JAK-2- ανοσοθετικοί/ EpoR-ανοσοαρνητικοί. Στα ενδοθηλιακά κύτταρα των αγγείων των όγκων ανιχνεύθηκε έκφραση των EpoR, JAK-2 και/ή STAT-5. Η μελέτη της έκφρασης του VEGFR-3 έδειξε την καθολική σχεδόν έκφραση του υποδοχέα στο ενδοθήλιο των αγγείων, στους όγκους εγκεφάλου που εξετάσθηκαν, καθώς και στο τοίχωμα μεγαλύτερων αγγείων εκτός της περιοχής των όγκων. Επίσης, σε κάποιες περιπτώσεις, παρατηρήθηκε έκφραση του υποδοχέα σε νεοπλασματικά κύτταρα. Στα αστροκυτταρικά γλοιώματα, η έκφραση των pan-Trk, TrkB και TrkC σχετίζεται στατιστικά σημαντικά με την έκφραση STAT-5 ενώ δεν υπάρχει στατιστικά σημαντική συσχέτιση της έκφρασης του υποδοχέα TrkA με την έκφραση των JAK-2 και STAT-5, καθώς και της έκφρασης των Trks με την έκφραση της κινάσης JAK-2. Στα αστροκυτταρικά γλοιώματα, η έκφραση JAK-2 σχετίζεται στατιστικά σημαντικά με την έκφραση STAT-5, ενώ η έκφραση των JAK-2 και STAT-5 δεν σχετίζεται σημαντικά με την έκφραση EpoR. Στα επενδυμώματα υπάρχει στατιστικά σημαντική συσχέτιση μεταξύ της έκφρασης JAK-2, STAT-5 και EpoR. Επίσης, στα μυελοβλαστώματα υπάρχει στατιστικά σημαντική συσχέτιση μεταξύ της έκφρασης JAK-2 και STAT-5. Σε σημαντικό ποσοστό των εξετασθέντων όγκων –ιδιαίτερα των γλοιωμάτων- συνεκφράζονται οι υποδοχείς EpoR και VEGFR-3 στο ενδοθήλιο και στα λεία μυικά κύτταρα των αγγείων. Συγκεκριμένα, έκφραση και των δύο υποδοχέων στο τοίχωμα των αγγείων του όγκου, ανιχνεύθηκε, στο 58% των αστροκυτταρικών γλοιωμάτων, στο 67% των ολιγοδενδρογλοιωμάτων, στο 50% των επενδυμωμάτων, στο 20% των μυελοβλαστωμάτων και στο 33% των μηνιγγιωμάτων. Επίσης συνέκφραση των υποδοχέων TrkB και VEGFR-3 στο ενδοθήλιο των αγγείων των όγκων ανιχνεύθηκε στο 57% των αστροκυτταρικών γλοιωμάτων. Η έκφραση στο ενδοθήλιο των αγγείων των όγκων (α) του υποδοχέα TrkB στην πλειονότητα των TrkB-ανοσοθετικών όγκων, (β) των EpoR, JAK-2 και/ή STAT-5 σε αρκετούς όγκους ανεξάρτητα της ανοσοθετικότητας των νεοπλασματικών κυττάρων για τις πρωτεΐνες αυτές και (γ) του VEGFR-3 σχεδόν σε όλους του εξετασθέντες όγκους, οδηγεί στο συμπέρασμα ότι οι παραπάνω παράγοντες πιθανόν συνεργάζονται στην αγγειογενετική διαδικασία στους όγκους εγκεφάλου. Η παρούσα μελέτη απέδειξε την παρουσία των: Trks, EpoR, JAK-2, STAT-5 και VEGFR-3 σε σημαντικό ποσοστό των όγκων εγκεφάλου στον άνθρωπο. Είναι απαραίτητο να διενεργηθούν λειτουργικές μελέτες των σηματοδοτικών οδών που προκύπτουν από την ενεργοποίηση των Trks, EpoR και VEGFR-3, προκειμένου να αποσαφηνισθούν οι πιθανές διαντιδράσεις αυτών των οδών στη διαδικασία της ογκογένεσης, γεγονός που θα μπορούσε να οδηγήσει στο σχεδιασμό νέων θεραπευτικών στρατηγικών για την αποτελεσματική αντιμετώπιση των όγκων εγκεφάλου στον άνθρωπο. / Brain tumors are phenotypically and genotypically heterogeneous. Significant gaps exist in current understanding of the molecular pathways involved in the genesis, progression, and biological and clinical behavior of brain tumors. Considering that : a) there is a growing amount of evidence implicating the neurotophin receptors Trks (receptor tyrosine kinases) in the pathogenesis of CNS tumors, b) neurotrophins may regulate neuronal gene expression via transcription factor STAT-5 in a JAK-2 independent manner, c) the JAK-2/STAT-5 signaling pathway is activated by Epo (recently characterized as a key factor for tumor growth) through its receptor EpoR, d) Epo is known to interact synergistically with vascular endothelial growth factor (VEGF), a potent angiogenic factor, and enhance its vascular activity, and these two growth factors, are often co-expressed, e) recent data suggest a potential role for a VEGF/JAK-2/STAT-5 axis in tumor angiogenesis and f) in many tumors, VEGF-C and -D are produced by tumor cells as well as by tumor-associated macrophages and through their receptor VEGFR-3 are involved in tumor angiogenesis and growth, the aim of this thesis is the morphological study of the expression patterns of the receptor tyrosine kinases Trks (neurotrophin receptors) and VEGFR-3 and their correlation with the EpoR/ JAK-2/ STAT-5 signaling pathway in human brain tumors. Immunohistochemistry was performed on formalin-fixed, paraffin-embedded, 4μm thick serial sections using the anti-Mouse/ Rabbit Poly HRP IHC Detection kit (CHEMICON International, Inc.). Antibodies against the Trk receptors, EpoR, JAK-2, STAT-5 and VEGFR-3, were used. A total of 92 brain tumors (50 astrocytic gliomas: 5 pilocytic astrocytomas; WHO grade I, 6 diffuse fibrillary astrocytomas; WHO grade II, 10 anaplastic astrocytomas; WHO grade III and 29 glioblastomas multiforme; WHO grade IV, 8 oligodendrogliomas, 6 ependymomas, 5 medulloblastomas, and 23 meningiomas) were included in this study. Normal human brain tissue was obtained postmortem (2 males). The present study demonstrated moderate to strong, granular cytoplasmic immunoreactivity in the majority of astrocytomas, for TrkA (57%), TrkB (56%) and TrkC receptors (46%), independently of grade. All the oligodendrogliomas and the ependymomas examined, were Trk immunonegative while a small percentage of medulloblastomas exhibited Trk immunopositivity. The endothelium of tumor vessels, in the immunopositive areas of the tumors, showed conspicuous immunoreactivity for TrkB receptor. A significant percentage of astrocytomas (41%), ependymomas (33%) and meningiomas (48%) displayed EpoR immunoreactivity. Oligodendrogliomas and medulloblastomas were EpoR- immunonegative. JAK-2/STAT-5 co-expression was detected in 39% of astrocytomas, 43% of oligodendrogliomas, 50% of ependymomas and in all (100%) the medulloblastomas examined. In contrast, most of the meningiomas showed weak or no immunoreactivity for JAK-2 and STAT-5 proteins. Some tumors exhibited STAT-5 immunoreactivity being JAK-2-immunonegative and others were JAK-2-immunopositive being EpoR- immunonegative. In some tumors - independently of EpoR immunoreactivity in tumors cells- the endothelium of tumor capillaries as well as florid angioproliferative changes and/or proliferations of smooth muscle cells showed conspicuous immunoreactivity for EpoR. Furthermore, endothelial cells of some tumor vessels showed JAK-2 and/or STAT-5 immunoreactivity. The present study demonstrated the almost catholic VEGFR-3 expression in the endothelium of tumor vessels in the brain tumor specimens examined, as well as in the smooth muscle cells in peritumoral vessels. In some tumors, the tumor cells expressed VEGFR-3receptor. In astrocytic gliomas, pan-Trk, TrkB and TrkC expression was significantly correlated with STAT-5 expression but not with JAK-2 whereas TrkA expression was not significantly correlated with either JAK-2 or STAT-5 expression. In astrocytic gliomas, JAK-2 expression was significantly correlated with STAT-5 expression whereas JAK-2 and STAT-5 expression were not significantly correlated with EpoR expression. In ependymomas, strong relationship between JAK-2, STAT-5 and EpoR expression was confined. Furthermore, in medulloblastomas, strong relationship between JAK-2 and STAT-5 expression was detected. A significant percentage of astrocytomas (58%), oligodendrogliomas (67%), ependymomas (50%), medulloblastomas (20%) and meningiomas (33%), displayed EpoR and VEGFR-3 co-expression in tumor vessels. Additionally, TrkB and VEGFR-3 co-expression was detected in the endothelium of tumor capillaries in 57% of the astrocytomas examined. The above results indicate the existence of a ligand (other than Epo)-dependent or independent JAK-2 activation that leads to the constitutive activation of STAT-5 as well as the existence of at least one mechanism, other than the Trk - dependent gene induction by STAT-5 that results to the latter’s constitutive activation in these tumors. Furthermore, the finding of EpoR, JAK-2 and/or STAT-5 immunoreactivity in endothelial cells of tumor vessels, supports the ongoing notion of an angiogenic role of Epo in tumor neovascularization. The presence of TrkB, EpoR, JAK-2, STAT-5 and VEGFR-3 in the endothelium of tumor vessels in the brain tumors specimens included in this study, implicate these factors as possible critical players in the process of angiogenesis. The present study demonstrates the expression of Trks, EpoR, JAK-2, STAT-5 and VEGFR-3 in a significant percentage of human brain tumors. Functional studies of the Trks, EpoR and VEGFR-3-activated signaling pathways, are necessary in order to clarify the meaning of a possible cross-talking between these pathways in the process of oncogenesis, the deep understanding of which, could lead to innovative new strategies for drug targeting to human brain tumors.

Το λεμφαγγειακό σύστημα διαδραματίζει σημαντικό ρόλο στη διατήρηση της ομοιόστασης των ιστών, στην ανοσολογική απόκριση του οργανισμού, στην απορρόφηση των λιπών από τον πεπτικό σωλήνα, και στη διασπορά των καρκινικών κυττάρων. Η πρόσφατη ανακάλυψη ειδικών για τα λεμφαγγειακά ενδοθηλιακά κύτταρα δεικτών και αναπτυξιακών παραγόντων, όπως επίσης και η δημιουργία γενετικών μοντέλων ποντικιών με διαταραγμένη τη λειτουργία του λεμφαγγειακού συστήματος, παρείχαν σημαντικότατες πληροφορίες για τη μοριακή ρύθμιση της εμβρυικής ανάπτυξης του λεμφαγγειακού συστήματος και της φυσιολογίας του. Τα σχετικά πρόσφατα αναγνωρισμένα μοριακά σηματοδοτικά μονοπάτια από τα οποία ρυθμίζεται η λεμφαγγειογένεση επέτρεψαν τη μελέτη της σχετιζόμενης με όγκους λεμφαγγειογένεσης. Οι μελέτες αυτές κατέδειξαν ότι η σχετιζόμενη με τους όγκους λεμφαγγειογένεση αποτελεί σημαντικό στοιχείο της μεταστατικής διαδικασίας, ενώ παράλληλα αναδεικνύουν συνεχώς καινούρια μόρια/σηματοδοτικά μονοπάτια-ρυθμιστές της εν λόγω διαδικασίας. / The lymphatic vascular system plays an important role in the maintenance of fluid homeostasis, in the afferent immune response, in the intestinal lipid uptake and in the metastatic spread of malignant cells. The recent discovery of specific markers and growth factors for lymphatic endothelium and the establishment of genetic mouse models with impairment of lymphatic function have provided novel insights into the molecular control of the lymphatic system in physiology and in embryonic development. Recently, molecular pathways that signal for lymphangiogenesis have been described allowing analyses of tumor lymphangiogenesis to be performed. These studies demonstrate that tumor lymphangiogenesis is a major component of the metastatic process, while at the same time new molecules and transduction pathways are discovered to regulate tumor lymphatics growth.