京都大学 / 0048 / 新制・課程博士 / 博士(医科学) / 甲第19370号 / 医科博第64号 / 新制||医科||5(附属図書館) / 32384 / 新制||医科||5 / 京都大学大学院医学研究科医科学専攻 / (主査)教授 長澤 丘司, 教授 河本 宏, 教授 髙折 晃史 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21259号 / 医博第4377号 / 新制||医||1029(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 河本 宏, 教授 濵﨑 洋子, 教授 髙折 晃史 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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La leucémie myéloïde chronique (LMC) est une hémopathie maligne caractérisée par un syndrome myéloprolifératif. Elle est secondaire à la formation d’un gène chimérique BCR-ABL dont le produit de ce gène de fusion est une protéine possédant une activité tyrosine kinase dérégulée, nécessaire et suffisante à la leucémogénèse. Plusieurs arguments suggèrent l’implication des cellules du système immunitaire dans le contrôle de la LMC.Nous avons montré que les lymphocytes Natural Killer T invariant (iNKT), une population minoritaire de lymphocytes T non conventionnels impliqués dans l’immunosurveillance, sont anergiques chez les patients en phase chronique (LMC-PC). Ce défaut est corrigé chez les patients en rémission cytogénétique complète après traitement par Imatinib Mesylate (LMC-IM) ou IFN-α.Les lymphocytes iNKT sont impliqués chez la Souris dans la génération de cellules T CD8+ « innate-memory », une autre population de lymphocytes T innés découverte récemment chez la Souris. Nous avons mis en évidence chez l’Homme, l’existence d’une population de cellules T ayant un phénotype inné et mémoire, exprimant fortement le facteur de transcription Eomesodermine et capable de produire rapidement de l’IFN-γ en réponse à une stimulation innée par les interleukines (IL)-12 et IL-18.Cette population de cellules est déficiente sur le plan numérique et fonctionnel chez les patients LMC-PC. Ces défauts sont partiellement corrigés chez les patients LMC-IM.L’ensemble de ces résultats souligne le rôle des lymphocytes T innés dans l’immunité anti-leucémique et pourrait permettre le développement de stratégies d’immunothérapies ciblées contre la LMC. / Chronic myeloid leukemia (CML) is a myeloproliferative disorder that results from dysregulated tyrosine kinase activity of the fusion oncoprotein BCR-ABL, which is sufficient to induce malignant transformation. A critical role of the immune system in the control of CML is supported by several reports. Invariant Natural Killer T (iNKT) lymphocytes are a population of non-conventional T cells that are believed to play a key role in cancer immunosurveillance. Here, we showed that CML in chronic phase is associated with anergy of iNKT cells that is restored upon complete cytogenetic remission (CCyR) following Imatinib Mesylate (IM) or IFN-α therapy. In mouse, iNKT cells are involved in the generation of a recently characterized subset of innate CD8 T cells. Importantly, we provided definitive evidence of the existence of an equivalent of these innate CD8 T cells in humans, harboring innate and memory phenotype with high Eomesodermin expression. These cells also exhibited innate functions such as prompt IFN-γ expression in response to innate stimulation by interleukin (IL)-12 and IL-18 and cytolytic activity in a TCR independent manner.Size and functions of this innate-like CD8 T cell subset were severely impaired in CML patients at chronic phase. These defects were partially reversed in patients who achieved CCyR following IM treatment.Altogether, these results reveal a possible contribution of innate CD8 T lymphocytes in anti-leukemic immunity and should contribute to development of immunotherapeutic strategies against CML.

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

Recentemente, a expressão gênica dos receptores TLR foi encontrada em diversos tipos de células tumorais. A sua participação na biologia do câncer é controversa já que foram descritas ações pró e anti-tumorais após a ativação de sua sinalização. Na Leucemia Mielóide Crônica (LMC) nada se tem demonstrado. BCR-ABL é uma oncoproteína quimérica cujo sítio tirosina quinasa constitutivamente ativado promove inúmeras vias de sinalizações que desencadeia a transformação celular. Este trabalho se inicia com a hipótese de existir uma relação entre o oncogene BCR-ABL e a expressão dos receptores TLRs. Nós verificamos em células murinas TonB210.1 com expressão de BCR-ABL induzível por doxiciclina que Tlr1 e Tlr2 tem sua expressão gênica relativa aumentada na presença da oncoproteína. A regulação positiva de Tlr1 é dependente da ação tirosina quinasa de BCR-ABL. Também mostramos que as vias p38 e JNK estão reprimindo a expressão de Tlr1 induzida por BCR-ABL enquanto que a via ERK é utilizada pelo BCR-ABL para promovê-la. Por outro lado, observamos que a ligação de TLR1/TLR2 com seu agonista sintético Pam3CSK4 em células TonB210.1 BCR-ABL positivas induz um aumento da produção de IL-6 e leva ao aumento da resistência a morte quando induzida pelas drogas Ara-C e VP16. Em conclusão, estes resultados indicam que BCR-ABL esta regulando a expressão gênica de alguns TLRs. Por tanto esses dados contribuem para a compreensão sobre o comportamento de células tumorais BCR-ABL positivas em um contexto de infecção e por conseqüência, dão margem ao estudo de novos alvos de fator de risco para a LMC. / Recently, the gene expression of TLR receptors have been described in several kinds of tumour cells. Its participation in cancer biology is controversial because roles were already been described in pro and anti-tumoral activities after their signaling activation. In Chronic Myeloid Leukemia (CML) there are no published data. BCR-ABL is a quimeric protein and its tyrosine-kinase site is activated constitutively. Thus, many signaling pathways are activated and several cell processes are altered thereby resulting in cellular transformation. This work has started with the hypothesis that a putative relationship between the oncogene BCR-ABL and the expression of TLR receptors could exists. We verified in murine cells TonB210.1 BCR-ABL expression inducible by doxycicline that Tlr1 and Tlr2 have their relative gene expression up-regulated in the presence of the oncoprotein. Therefore the Tlr1 regulation is dependent of BCR-ABL tyrosine kinase action. Using MAPK inhibitors we showed that p38 and JNK pathways are suppressing the TLR1 induction by BCR-ABL while ERK pathway is used by the oncoprotein for promote it. On the other hand, we observed in TonB210.1 BCR-ABL positive cells that the binding of TLR1/TLR2 heterodimer to their synthetic agonist Pam3CSK4 induced an increased production of IL-6 and when these cells were induced by Ara-C and VP-16 drugs the apoptosis resistance increased. In conclusion, these results indicate that the oncoprotein regulates the gene expression of some TLRs. Therefore, this fact gives us data about the behavior of BCR-ABL positive tumor cells in the context of infection and in consequence the study of new risk factor targets for CML.

Dissertation (Ph.D.)--University of South Florida, 2009. / Includes vita. Includes bibliographical references. Also available online.

Dissertation (Ph.D.)--University of South Florida, 2009. / Title from PDF of title page. Document formatted into pages; contains 149 pages. Includes vita. Includes bibliographical references.

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