No description available.

The enzymes CYP27A1 and CYP7B1 are widely expressed in various human tissues and perform catalytic reactions in cholesterol homeostasis and endocrine signaling. We have investigated the metabolism of a synthetic oxysterol. In this study, we show that CYP27A1 is the enzyme responsible for a 28-hydroxylation of this oxysterol and that the rate of CYP27A1-mediated metabolism is relatively slow. This may give an explanation for the prolonged inhibitory effects on cholesterol biosynthesis that have been shown for this oxysterol. The current study contributes to the knowledge of synthetically produced oxysterols and their potential use as cholesterol lowering drugs. In two studies we investigated CYP7B1-mediated metabolism of different sex hormones. Our data indicate that CYP7B1 may carry out a previously unknown catalytic reaction involving an androgen. Taken together the data suggest that varying steroid concentrations in cells and tissues may be important for CYP7B1-dependent metabolism of sex hormones and sex hormone precursors. CYP7B1-mediated hydroxylation of sex hormones may influence the cellular levels of these steroids and may be a potential pathway for elimination of the steroids from the cell. Some known CYP7B1 substrates are agonists for ERα and ERβ but the reported role(s) of CYP7B1 for ER action are not fully understood. In the last study we investigated the role(s) of CYP7B1-mediated metabolism for ER-mediated action. Our data indicate that CYP7B1-mediated conversion of steroids that affect ER-mediated response into their 7α-hydroxymetabolites will result in loss of action. This indicates that CYP7B1 may have an important role for regulation of ER-mediated processes in the body. In summary, results from this thesis contribute to the knowledge on the metabolism of synthetic oxysterols of potential use as cholesterol lowering drugs and the role(s) of CYP7B1-mediated metabolism for processes related to the functions of sex hormones. / Disputationsordförande;Professor Eva Brittebo, Inst. för Biovetenskap, Avd. för Toxikologi, Uppsala Universitet, UppsalaBetygsnämndens ledamöten; Docent Lena Ekström, Inst. för Laboratoriemedicin, Avd. för Klinisk Kemi, Karolinska Universitetssjukhuset, HuddingeDocent Ulf Diczfaluzy, Inst. för Laboratoriemedicin, Avd. för Klinisk Kemi, Karolinska Universitetssjukhuset, HuddingeProfessor Agneta Oskarsson, Inst. BVF, Avd. för farmakologi och toxikologi, SLU, Uppsala

The androgen receptor (AR) fulfils important roles for both sexes. By mediating the biological function of androgens, the AR has remained the target for endocrine therapies treating prostate cancer. The AR also determines the effectiveness of medroxyprogesterone acetate (MPA) in treating AR positive breast cancer. Every man will be affected by prostate cancer if he lives long enough. Prostate cancer continues to be a leading cause of death for males despite research into this cancer covering more than 60 years since Huggins' seminal 1941 study showing that androgens play a key role in this cancer. Unfortunately, significant advances have not been forthcoming and the effect of treatment has remained largely the same over past decades, whereby initial treatment provides temporary remission but eventually advanced cases become refractory to further intervention and the disease recurs in a more aggressive form. A plethora of factors are exquisitely sensitive to minute changes in the AR's structural profile, which can be altered by a single mutation, resulting in aberrant activity. A principal feature of these variant ARs associated with prostate cancer, is enhanced capacity to bind a number of molecules other than its cognate ligand, dihydrotestosterone (DHT). The promiscuous activity of this receptor leads to continued AR signalling and stimulus for the cancer despite low androgen levels induced by treatment regimes. A key question is whether mutations occurring within the AR occur as a result of cancer or contribute to the propagation of the cancer. Recent research has demonstrated that treatments incorporating anti-androgens such as flutamide, which are designed to impede prostate cancer progression by inhibiting AR activity, may actually provide selective pressure favouring somatic mutation of the receptor to take place. The specific changes to the AR which are responsible for gains of function have not been resolved as their crystal structures, which are used to provide conformational analysis of proteins, are tremendously problematic to produce with little success found in literature. Generating representative crystals of the AR protein involves producing soluble recombinant protein. Unfortunately the AR is prone to aggregation and is highly unstable, especially in the presence of antagonistic molecules or absence of a stabilising ligand, preventing the protein from being maintained in the soluble state required for crystallization. In order to produce sufficient quantities of soluble material for crystallization, the androgen receptor's ligand binding domain (LBD) was produced as a recombinant protein in Escherichia coli bacteria strain BL21 (DE3) in the presence of DHT, flutamide, as well as in the absence of ligand. Since soluble unbound AR-LBD has not been produced until now, the bacterial culture containing no ligand was further processed to the stage of cleaving the purification tag from the recombinant protein and represents considerable progress into producing soluble material for crystallizing the troublesome yet considerably important AR in the absence of ligand. Although distinct from prostate cancer in males, AR activity in breast tissue is also a factor determining the action of drugs, such as MPA, included in therapies aimed at breast cancer. The use of MPA has declined primarily due to its adverse effects including unsuccessful generation of a biological response, as well as the advent of other drugs administered for hormonal therapies treating breast cancer. Alternative drugs are needed when breast cancer therapies fail as tumours develop resistance to primary drugs. Although there are a number of drugs on the market, success would be maximised if the determined therapy is matched with the patient, based for example, on their genetic makeup. There is a conundrum whereby some patients with an AR do not respond to MPA, a drug normally recognised by the receptor. In clinical trials it was discovered that an AR with threonine instead of methionine at residue 780 (M780T) fails to activate in response to MPA, but the exact mechanism has remained elusive and needs to be answered at the molecular level. The X-ray crystallographic studies that generate 3D images of macromolecules and wet chemistry, which have traditionally been used to provide insight into science in these dimensions, are incorporated with computer based molecular simulation. This is both complementary and distinct to traditional scientific methodologies, enabling further elucidation of protein-protein interactions, and the influence applied to such inter-relations by natural and drug ligands. This approach has been used, and is continually developed, to understand the binding mechanisms of current drugs as well as designing new drugs. In order to produce a receptor representing the M780T variant, the crystal structure representing the AR-LBD was mutated in silico, into which MPA was then docked. It was found that MPA binds into the M780T AR-LBD with considerably more spatial displacement compared to the position of DHT in the crystal structure, and is predicted to be the primary reason for the inability of MPA to activate this variant AR. The clarification of MPA binding and failure to elicit a response from the variant AR is significant for a cohort of breast cancer patients, as not only does the presence of an AR in the tumour determine the effectiveness of MPA, but correct composition of the AR, specifically, the absence of a M780T mutation. In the absence of this AR mutation, MPA could effectively be used either as an alternative to primary drugs, or in secondary therapies when primary therapies fail. Aberrant activity of variant ARs in response to MPA should also be taken into consideration when analysing drug studies about the effectiveness of MPA. The findings on the loss of response to MPA by the M780T variant AR have been included in the journal article &quotDecreased Androgen Receptor Levels and Receptor Function in Breast Cancer Contribute to the Failure of Response to Medroxyprogesterone Acetate" appearing in the September 2005 issue of Cancer Research journal.

Studies in Europe, Japan, and North America have reported that wild fish exposed to treated sewage effluents can exhibit significant physiological and reproductive abnormalities consistent with exposure to hormonally active chemicals. The main objective of this research project was to examine the estrogenic and androgenic activity in treated sewage to determine the risk associated with treated sewage discharges in Australia and New Zealand. Several bioassays, including a sheep estrogen receptor and a rainbow trout androgen receptor binding assay, were set up and validated with model compounds. The assays were then used to measure the estrogenic and androgenic activity in sewage samples from 15 municipal sewage treatment plants (STP) utilizing a variety of treatment technologies. Raw sewage samples contained high levels of both estrogenic and androgenic activity, up to 185 ng/L estradiol equivalents (EEq) and up to 9330 ng/L testosterone equivalents (TEq), respectively. Secondary treatment processes such as activated sludge had the greatest impact on removal of biological activity from the wastewater. The estrogenic and androgenic activity in final treated effluents were <1 to 4.2 ng/L EEq and <6.5 to 736 ng/L TEq, respectively. Based on lowest observable effective concentrations reported in the literature, these levels are unlikely to induce biological effects in exposed fish in the short term. To examine potential long-term effects, resident mosquitofish chronically exposed to undiluted treated sewage were sampled. Several morphological biomarkers indicative of endocrine disruption were measured and compared with mosquitofish captured at a reference site. Mosquitofish captured in a constructed wetland for tertiary treatment of secondary treated sewage exhibited morphological differences such as elongated anal fins consistent with exposure to androgenic chemicals, although this effect was not measurable in fish collected at sites further downstream or at any of the other sites. Based on these results, it is unlikely that mosquitofish populations would be significantly affected by exposure to final treated sewage. A reverse transcription real-time polymerase chain reaction (RT-PCR) method to measure the production of a female-specific protein (vitellogenin) mRNA in adult male mosquitofish was developed, and this could be used as a rapid test to detect early changes in individuals exposed to estrogenic activity.

Les cancers moléculaires apocrines sont un sous-groupe de cancer du sein caractérisé par l'expression du récepteur aux androgènes (RA), l'absence du récepteur aux oestrogènes (RE) et l'expression paradoxale de nombreux gènes typiquement exprimés dans les tumeurs RE positives. Une proportion significative de ces patientes va récidiver sous forme de métastases dont la prise en charge repose sur des traitements non spécifiques (chimiothérapies). En préclinique, la lignée cellulaire MDA-MB-453 a été identifiée comme ayant un profil transcriptomique similaire à ce sous-groupe tumoral. En clinique, les essais réalisés dans ce sousgroupe tumoral avec différents anti-androgènes, dont l’abiratérone (inhibiteur de la synthèse des androgènes), retrouvent un bénéfice clinique chez environ 25% des patientes. L’objectif de cette thèse est d’améliorer les connaissances et les prises en charge thérapeutiques spécifiques de ces tumeurs. Nos données précliniques comparatives montrent que l'ODM-201, nouvel antiandrogène, ne présente pas une efficacité supérieure par rapport aux antiandrogènes déjà étudiés. Afin de contourner les limites des lignées cellulaires identifiées dans ce premier projet, nous avons démontré la nécessité de développer de nouveaux modèles : les Patient-Derived-Xenograft orthotopiques. Notre deuxième projet est en faveur d’une meilleure sélection des patientes à traiter par abiratérone notamment basé sur des caractéristiques immunohistochimiques apocrines. Chez les patientes ne présentant pas ces caractéristiques, nous avons isolé CHEK1 comme une cible d’intérêt en combinaison thérapeutique pour majorer les taux de réponse de l’abiratérone en monothérapie. / Molecular apocrine cancers are a subgroup of breast cancer characterized by the expression of the androgen receptor (AR), the absence of the estrogen receptor (ER) and the paradoxical expression of many genes typically expressed in ER positive tumors. A significant proportion of these patients will recur in the form of metastases whose management is based on non-specific treatments (chemotherapy). In preclinical study, the MDA-MB-453 cell line was identified as having a transcriptomic profile similar to this tumor subgroup. Clinical trials in this tumor subgroup testing different antiandrogens, including abiraterone (inhibitor of androgen synthesis), found a clinical benefit in about 25% of patients. The aim of this thesis is to improve the knowledge and the specific therapeutic management of these tumors. Our comparative preclinical data show that ODM-201, a new anti-androgen, does not show superior efficacy compared to previously studied anti-androgens. In order to circumvent the limits of cell lines provided by this first project, we have shown the need to develop new models: orthotopic Patient-Derived-Xenograft. Our second project favors a better selection of patients to be treated with abiraterone, especially based on apocrine immunohistochemical characteristics. In patients without these characteristics, we isolated CHEK1 as a target of interest in combination therapy to increase response rates of abiraterone monotherapy.

La voie de signalisation du récepteur des androgènes (RA) reste une cible thérapeutique privilégiée dans les cancers de la prostate (CaP). Ce travail de thèse a abordé trois thématiques : 1) l’identification et l’étude fonctionnelle des mutations du RA, 2) l’étude du lien existant entre les RA tronqués, résultant de mutations non-sens, et l’angiogenèse tumorale et 3) l’étude exploratoire de l’hétérogénéité tumorale dans les CaP. Au cours de la 1e partie, nous avons identifié 90 mutations du RA à l’aide d’un test fonctionnel chez la levure et émis des hypothèses concernant leur implication dans de potentiels mécanismes de résistance à l’hormonothérapie (HT). La 2e partie nous a permis de montrer un lien entre les variants tronqués et l’expression du VEGF-A, médiateur principal de l’angiogenèse. Enfin dans la dernière partie nous avons étudié, par approche de séquençage à haut-débit, l’hétérogénéité tumorale en fonction du temps et du stade de la maladie. L’ensemble du travail a permis une meilleure connaissance des altérations de la voie de signalisation du RA, leur rôle dans les étapes clés de la progression tumorale et l’évolution des anomalies génomiques. / The androgen receptor signaling pathway (AR) remains a prime therapeutic target in prostate cancer (PCa). This work focused on three topics: 1) the identification of AR mutations and their functional impact, 2) the assessment of a link between the truncated AR, resulting from nonsense mutations and tumor angiogenesis and 3) an exploratory study of tumor heterogeneity in PCa. In the first part, we identified 90 AR mutations using a yeast-based functional assay and speculated about their involvement in potential mechanisms to hormone therapy (HT) resistance. In the second part we assessed a link between the truncated AR and the overexpression of VEGF-A, the main proangiogenic factor. In the last part we investigated the tumor heterogeneity within the primary tumor and metastasis using a whole exome sequencing approach. This work leads to a better knowledge of the AR signaling pathway alterations, their role in the key steps of tumor progression and the evolution of genomic abnormalities.

Recentemente, tem sido demonstrado que a maioria dos RNAs transcritos em células humanas são RNAs não-codificadores de proteínas (ncRNAs) originados de íntrons ou regiões intergênicas. Em trabalhos anteriores realizados por nosso grupo, foram descritos longos ncRNAs transcritos de regiões intrônicas de genes codificadores e cuja expressão foi correlacionada ao grau de diferenciação de tumores de próstata, apontando para a relevância fisiológica desta classe de transcritos. Apesar de sua abundância, as propriedades, funções e regulação da grande maioria dos ncRNAs ainda não foram elucidadas. O objetivo do presente trabalho foi investigar a biossíntese de ncRNAs intrônicos em células humanas, primordialmente a contribuição da RNA Polimerase II (RNAP II), bem como aspectos de sua regulação. Primeiramente, o modelo de regulação da expressão gênica por hormônio andrógeno foi utilizado para avaliação da participação direta de um fator de transcrição de RNAP II, o Receptor de Andrógeno (AR), na modulação da transcrição de ncRNAs intrônicos. Utilizando-se a técnica de imunoprecipitação da cromatina, foi detectada a ligação do AR ao elemento de resposta a andrógeno (ARE) presente em um possível promotor de um transcrito intrônico antisenso (derivado do locus Myo5A), cuja expressão é aumentada em células da linhagem LNCaP tratadas com o hormônio. A ligação ao ARE foi induzida pelo tratamento, sugerindo que o efeito do andrógeno na expressão do ncRNA é mediado pelo AR. Em uma segunda abordagem, o efeito da inibição da transcrição por RNAP II com &#945;-amanitina por 24 h em células LNCaP foi avaliado com o uso de microarranjos de oligonucleotídeos representando transcritos total ou parcialmente intrônicos, além de éxons de genes codificadores. A expressão de menos de 20 % dos transcritos intrônicos foi afetada, fração significativamente menor que a observada para os transcritos exônicos (40 %). Ainda que a maioria dos ncRNAs intrônicos diferencialmente expressos tenha sua abundância diminuída, interessantemente, 13 a 16 % foram aumentados, contrastando com aproximadamente 2 a 3 % de exônicos que aumentaram. Os resultados obtidos neste trabalho indicam que a RNAP II atua na transcrição de ncRNAs intrônicos, mas que uma fração considerável pode ser transcrita por outra RNA Polimerase. / It has been recently shown that the bulk of the transcription in human cells is comprised of non-protein-coding RNAs (or noncoding RNAs - ncRNAs) transcribed from introns and intergenic regions of the genome. Previous work from our group has demonstrated that expression of long intronic ncRNAs can be correlated to the degree of prostate tumor differentiation, underscoring the physiological relevance of these transcripts. However, the properties, functions, and regulation of this huge population of ncRNAs remain largely unknown. The present work aimed to investigate the biosynthesis of intronic ncRNAs and aspects of its regulation in human cells, focusing on the contribution of RNA Polymerase II (RNAP II). Initially, the model of regulation of gene expression by androgen hormone was used in order to evaluate the participation of the RNAP II transcription factor Androgen Receptor (AR) in the transcriptional regulation of intronic ncRNAs. Chromatin immunoprecipitation experiments revealed the binding of the AR in an androgen response element (ARE) present in a putative promoter driving the expression of an antisense intronic transcript in Myo5A locus in LNCaP cells. The interaction occurred in an androgen-inducible fashion, along with the up-regulation of the transcript, suggesting that hormone activation occurred in a direct manner mediated by the AR. In a different approach, the effect of RNAP II inhibition with &#945;-amanitin for 24 h in LNCaP cells was analyzed using an oligoarray representing totally and partially intronic transcripts, as well as exons of proteincoding genes. The expression of less than 20 % of the intronic transcripts was affected by the treatment, contrasting to a significantly higher fraction observed for exonic messages (40 %). Moreover, most differentially expressed intronic transcripts were down-regulated, but strikingly 13 to 16 % were up-regulated in cells with blocked RNAP II, while this fraction for exonic transcripts was about 2 %. The results described here demonstrate that RNAP II in fact plays a role in intronic transcription in human cells, but also highlight that another transcriptional system may account for the biogenesis of a fraction of intronic ncRNAs.

Introdução: O homem transexual (HT) é um indivíduo de sexo genético feminino, com fenótipo feminino normal, que deseja viver e ser aceito como um membro do sexo masculino. O tratamento hormonal que é realizado no processo de redesignação sexual nesses pacientes consiste na administração de testosterona nas suas diversas apresentações, mais comumente ésteres de testosterona de curta ou longa ação. O tratamento hormonal visa induzir virilização, através da produção de um padrão masculino de crescimento dos pelos faciais e corporais, aumento da massa muscular e interrupção dos ciclos menstruais. O efeito da terapia androgênica na saúde cardiovascular de HT é pouco conhecido, principalmente em relação às repercussões em longo prazo. O HT representa um modelo ideal e único para a avaliação das ações da testosterona exógena administrada em doses suprafisiológicas em um organismo geneticamente feminino. Alguns estudos de farmacogenética demonstraram a influência da repetição CAG do gene do receptor androgênico (RA) nos efeitos observados durante terapia com testosterona em homens hipogonádicos e a maioria dos estudos confirmou a modulação desses polimorfismos sobre fatores de risco cardiovascular. Objetivos: avaliar em HT em tratamento androgênico a prevalência de fatores clássicos de risco cardiovascular e as propriedades estruturais e funcionais dos vasos arteriais; correlacionar a distribuição alélica do microssatélite CAG RA com a ocorrência de comorbidades e com as propriedades estruturais e funcionais dos vasos arteriais; comparar os valores das propriedades estruturais e funcionais dos vasos arteriais de HT com uma população controle (feminina e masculina). Pacientes: 46 pacientes com diagnóstico de HT (faixa etária 42 ± 10 anos) acompanhados no Ambulatório da Unidade de Disforia de Gênero do HCFMUSP e em tratamento com ésteres de testosterona há pelo menos um ano (variação de 1 a 38 anos) foram selecionados para o estudo. Métodos: Parâmetros clínicos (IMC, circunferência abdominal, relação cintura quadril, pressão arterial e pressão de pulso, composição corporal por bioimpedância), a presença de comorbidades (hipertensão arterial, dislipidemia, diabetes mellitus, obesidade) e vícios (tabagismo, etilismo e uso de drogas ilícitas), dados laboratoriais (hematócrito, glicemia de jejum, insulina, índice HOMA IR, hemoglobina glicada, colesterol total, HDL colesterol, LDL colesterol, triglicerídeos e creatinina) e parâmetros vasculares (espessura íntima média da carótida, diâmetro da carótida, percentual da variação sisto-diastólica da carótida e velocidade de onda de pulso dos vasos arteriais) foram avaliados no grupo de HT. Os mesmos parâmetros vasculares também foram avaliados em controles saudáveis masculinos e femininos pareados para idade e IMC com os HT. A distribuição alélica do microssatélite CAG RA foi avaliada em 44 HT através da análise do produto amplificado da região de repetições CAG do exon 1 do gene do RA, utilizando o software GeneMapper. Resultados e Conclusões: Neste grupo de HT em terapia com ésteres de testosterona observamos uma prevalência de dislipidemia de 42%, hipertensão arterial sistêmica de 35%, obesidade de 30%, diabetes de 4% e tabagismo de 20%. HT em tratamento androgênico apresentaram maior velocidade de onda de pulso carotídeo-femoral do que controles masculinos, mas não do que controles femininos, embora no subgrupo >= 42 anos os HT tenham apresentado maior VOP do que controles masculinos e femininos. Não houve diferença de diâmetro, distensão relativa e espessura íntima média carotídea entre HT e controles. Maior diâmetro, maior espessura íntima média e menor distensão relativa da carótida foram observados em HT obesos e hipertensos; e maior velocidade de onda de pulso aórtica em HT hipertensos. Os parâmetros correlacionados à medida funcional da artéria aorta foram a idade, o tempo de tratamento androgênico e a relação cintura-quadril, enquanto que as propriedades estruturais e funcionais da carótida se correlacionaram com idade, parâmetros antropométricos e glicêmicos. Não houve influência do trato CAG RA na comparação entre os HT com e sem comorbidades metabólicas. Repetições CAG RA curtas se associaram com níveis significativamente mais elevados de glicemia de jejum, insulina basal e HOMA IR. Em relação aos parâmetros antropométricos, pressóricos, lipídicos e arteriais, não foi identificada associação com o número de repetições CAG RA. Estes achados sugerem um potencial efeito deletério da terapia androgênica prolongada sobre os vasos arteriais e a necessidade de medidas preventivas em HT / Introduction: Transgender men (TM) are 46, XX individuals, with normal female phenotype, who desire to live and be accepted as a male member. Testosterone esters are used in sex reassignment therapy to induce virilization and to adapt the body to the male identity. The effects of androgen therapy on TM cardiovascular function are poorly known, particularly with regard to long-term androgen treatment. TM represents a good model for evaluation of high-dose exogenous testosterone action in biological women. Pharmacogenetic studies have demonstrated the influence of CAG polymorphic tract of the androgen receptor gene (AR) on the androgenic effects observed during testosterone therapy in hypogonadal men, and most studies confirmed the modulation of these polymorphisms on cardiovascular risk factors. Objective: to evaluate the prevalence of cardiovascular risk factors and the structural and functional properties of large arteries in TM on long-term cross sex hormone therapy compared to a male and female healthy control group; to correlate the allelic distribution of CAG AR polymorphic tract with the cardiovascular comorbidities and the structural and functional properties of large arteries in TM. Patients: Forty-six patients with a diagnosis of TM (42 ± 10 years old), followed at the Gender Dysphoria Unit-HCFMUSP, receiving cross-sex hormone treatment with testosterone esters for at least one year (ranging from 1 to 38 years) were selected for the study. Methods: Clinical parameters (BMI, waist circumference, waist-to-hip ratio, blood pressure, pulse pressure, body fat percentage), the presence of cardiovascular comorbidities (hypertension, dyslipidemia, diabetes mellitus, obesity) and addictions (smoking, alcohol and drug abuse), laboratory parameters (hematocrit, fasting plasma glucose, basal insulin, HOMA IR index, glycated hemoglobin, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides and creatinine) and vascular parameters (carotid intima-media thickness, carotid diameter, carotid relative distensibility and aortic pulse wave velocity - PWV) were evaluated in the TM group. The same vascular parameters were also evaluated in healthy male and female control group, matched for age and BMI. The allelic distribution of the CAG AR polymorphic tract was evaluated in 44 TM using the GeneMapper software. Results and Conclusions: In the TM group, we observed dyslipidemia in 42%, hypertension in 35%, obesity in 30%, diabetes in 4% and smoking habit in 20%. The mean aortic PWV values in TM was higher than in male healthy controls (p=0.005), but not than in female controls (p=0.640). When categorized by age, considering the median age, TM >= 42 years had higher aortic PWV measures than male (p < 0.001) and female (p = 0.024) controls, regardless of their arterial blood pressure values. There was no difference in carotid diameter, carotid relative distensibility and carotid intima-media thickness between TM and controls. Obese and hypertensive TM presented significantly higher values of carotid diameter and carotid intima-media thickness, and lower values of carotid relative distensibility than healthy transgenders. Hypertensive TM showed higher aortic PWV values than non-hypertensive TM. The aortic stiffness correlated significantly and positively with age, androgen treatment duration and waist-to-hip ratio in TM. Properties of the carotid artery correlated with age, anthropometric parameters and glycemic parameters in TM. Shorter CAG polymorphic tracts of TM were associated with higher levels of fasting plasma glucose, basal insulin and HOMA IR index. There was no influence of the CAG polymorphic tract of TM on the presence of cardiovascular comorbidities, anthropometric, pressure, lipid and arterial parameters. These findings suggest a potential deleterious effect of the long-term testosterone therapy on vessels and the need for preventive measures in TM

Le cancer de la prostate (CaP) représente le premier cancer chez l'homme et la seconde cause de mortalité. Alors que la plupart des malades atteints de cancer de la prostate évoluent favorablement (forme indolente), une fraction non négligeable développera une maladie agressive avec l’apparition de métastases. La recherche des biomarqueurs tumoraux peut aider à différencier les CaP dits indolent et les CaP agressifs qui sont responsables du décès des patients. Ils permettront de mieux sélectionner des patients afin d’éviter le surtraitement. La protéine CRIPTO est le premier membre de la superfamille des protéines EGF-CFC. Ce facteur de croissance est largement impliqué dans le développement embryonnaire et s'exprime dans de nombreux types de cancers. Son rôle dans le CaP reste encore non élucidé. L’objectif de mon travail de thèse consiste à examiner le profil d'expression de CRIPTO et d'évaluer son impact potentiel sur l’agressivité du cancer de la prostate.Les résultats ont montré que CRIPTO est exprimé de manière significative dans 37,9% de CaP. Il est absent voire faiblement détecté dans les prostates hyperplasiques bénignes et dans les tissus sains. Nous avons montré ensuite que la surexpression de CRIPTO favorise une transition épithéliale-mésenchymateuse (TEM) associée à l’augmentation de la capacité de migration et de la survie des cellules tumorales. Les voies de signalisation régulées par CRIPTO impliquent l’activation des voies PI3K / AKT et FGFR1 / ERK.De manière très intéressante, les cellules tumorales mésenchymateuses surexprimant CRIPTO secrètent excessivement des vésicules. Nous avons tenté alors de découvrir le rôle de ces vésicules dans la progression du cancer de la prostate. Les vésicules extracellulaires (VEs) purifiés étaient capables de moduler la signalisation du récepteur des androgènes et d’activer la voie du TGFß. Les cellules tumorales prostatiques traitées par ces VEs deviennent plus agressive et acquierent des caractéristiques mésenchymateuses.En conclusion, nos résultats mettent en évidence une nouvelle fonction importante de CRIPTO dans le cancer de la prostate. Nous démontrons également que les cellules tumorales surexprimant ce facteur de croissance secrètent excessivement des vésicules qui participent activement dans la communication intercellulaire et promeuvent la progression du CaP. L’ensemble de nos travaux suggère que le ciblage thérapeutique de CRIPTO et le blocage de la sécrétion des VEs pourraient être des nouvelles approches thérapeutiques innovantes pour le traitement du cancer de la prostate. / Prostate cancer (PCa) remains at the top of the list of the most common malignant tumors and the dominant cause of mortality and morbidity in men worldwide. Detection of tumor biomarkers to aid differentiate indolent from severe PCa cases and well-choose patients at high risk for intensive treatment. The founding member of EGF-CFC protein superfamily, CRIPTO, is widely implicated in embryonic development and is found to be expressed in a wide spectrum of human tumors. As its role in PCa was still unclear, we aimed to investigate expression profile of CRIPTO in PCa and relate its potential impact on prostate malignancy.Prostatic tissues and cell lines, both normal and cancerous, were engaged in experimental studies and design was based on techniques used in biochemistry, cellular and molecular biology.CRIPTO showed to be upregulated in 37.9% of PCas, while being absent or marginally detected in benign conditions. Our results displayed that CRIPTO overexpression promoted epithelial-mesenchymal transition (EMT) associated with enhanced migration capacity and survival under stress conditions due to propensity to stimulate PI3K/AKT and FGFR1/ERK signaling pathways.More interestingly, tumor mesenchymal like cells overexpressing CRIPTO secreted vesicles excessively. Thus we attempted to uncover the role of these vesicles in the progression of PCa. Extracellular vesicles derived from these cells were highly capable to modulate androgen receptor signaling through TGF-ß pathway and rendering the recipient prostatic cells more aggressive by acquisition of mesenchymal features.Our results highlight a new substantial function of CRIPTO in PCa and put in evidence its importance as a new promising target for PCa treatment. Moreover, we emphasize on an original role of mesenchymal extracellular vesicles in the interclonal communication to carry and transfer tumorigenic contents and enhance progression of PCa. This opens new scopes towards better understanding of vesicles secreted by prostate cancer cells and their impact to better cure the disease.

No description available.