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Articular cartilage functions to reduce the mechanical stresses associated with diarthrodial joint movement, protecting these joints over a lifetime of use. Tissue function is maintained through the balance between synthesis and resorption (i.e., metabolism) of extracellular matrix (ECM) by articular chondrocytes (ACs). Two important hormonal regulators of cartilage metabolism are interleukin-1 (IL-1) and insulin-like growth factor-I (IGF-I). These factors have antagonistic effects on chondrocyte activity, and during the progression of osteoarthritis, IL-1 is thought to promote chondrocyte hyporesponsiveness to IGF-I. To better understand how the anabolic (IGF-I) and catabolic (IL-1) stimuli are linked within articular cartilage, we examined the mechanisms by which IL-1 regulates the IGF-I signaling system of ACs. Equine chondrocytes from non-arthritic stifle joints were multiplied over serial passages, re-differentiated in alginate beads, and stimulated with recombinant equine IL-1β. Chondrocytes were assayed for type I IGF receptor (IGF-IR), IGF binding proteins (IGFBPs), and endogenously-secreted IGF-I. Our experimental findings solidify the significance of IL-1 as a key regulator of IGF-I signaling within articular cartilage, demonstrating that regulation of the IGF-I system occurs through both direct (transcription) and indirect (proteolysis) mechanisms. These results have implications for molecular therapies (e.g., gene transfer) directed at reversing osteoarthritic cartilage deterioration. The presented research concerns not only cartilage biology but also tissue engineering strategies for cartilage repair. Alginate hydrogel culture has been reported to re-establish chondrocytic phenotype following monolayer expansion, but studies have not addressed effects on the signaling systems responsible for chondrocyte metabolism. We investigated whether chondrocyte culture history influences the IGF-I system and its regulation by IL-1. ACs expanded by serial passaging were either encapsulated in alginate beads or maintained on tissue culture plastic (TCP). Bead and TCP cells were plated at high-density, stimulated with IL-1β, and assayed for expression of IGF-I signaling mediators. Intermediate alginate culture yielded disparate basal levels of IGF-IR and IGFBP-2, which were attributed to differential transcription. The distinct mediator profiles coincided with varied effects of exogenous IL-1β and IGF-I on collagen Ia1 expression and cell growth rate. This study demonstrates that culture strategy impacts the IGF-I system of ACs, likely impacting their capability to mediate cartilage repair. / Ph. D.

[ES] La comprensión de los aspectos de la funcionalidad de las células que cuentan para los mecanismos de las enfermedades es el mayor reto de la medicina personalizada. A pesar de la disponibilidad creciente de los datos de genómica y transcriptómica, sigue existiendo una notable brecha entre la detección de las perturbaciones en la expresión de genes y la comprensión de su contribución en los mecanismos moleculares que últimamente tienen relación importante con el fenotipo estudiado. A lo largo de la última década, distintos modelos computacionales y matemáticos se han propuesto para el análisis de las rutas. Sin embargo, estos modelos no toman en cuenta los mecanismos dinámicos de las rutas como la estructura y las interacciones entre genes y proteínas. En esta tesis doctoral, presento dos modelos matemáticos ligeramente distintos, para integrar los datos transcriptómicos masivos de humano con un conocimiento previo de de las rutas de señalización y metabólicas para estimar las actividades mecánicas que están detrás de esas rutas (MPAs). Las MPAs son variables continuas con valores de nivel individual que pueden ser usadas con los modelos de aprendizaje de máquinas y métodos estadísticos para determinar los biomarcadores que podemos usar para los diagnósticos tempranos y la clasificación de subtipos de enfermedades, además de poder sugerir las dianas terapéuticas potenciales para las intervenciones individualizadas. El objetivo global es desarrollar nuevos y avanzados enfoques de la biología de sistemas para proponer unas hipótesis funcionales que nos ayuden a entender e interpretar los mecanismos complejos de las enfermedades. Estos mecanismos son cruciales para mejorar los tratamientos personalizados y predecir los resultados clínicos. En primer lugar, contribuí al desarrollo de un método que está diseñado para extraer las subrutas elementales desde la ruta de señalización con sus actividades estimadas. Posteriormente, este algoritmo se ha adaptado a los módulos metabólicos y se ha implementado como una herramienta web. Finalmente , el método ha revelado un panorama metabólico para una lista completa de diferentes tipos de cánceres. En este estudio, analicé el perfil metabólico de 25 tipos de cáncer distintos y se validó el método usando varios enfoques computacionales y experimentales. Cada método desarrollado en esta tesis ha sido enfrentado a otros métodos similares existentes, evaluados por sus sensibilidades y especificidades, experimentalmente validados cuando fue posible y usados para predecir resultados clínicos de varios tipos de cánceres. La investigación descrita en esta tesis y los resultados obtenidos fueron publicados en distintas revistas arbitradas que están relacionadas con el cáncer y biología de sistemas, y también en los periódicos nacionales. / [CA] La comprensió dels aspectes de la funcionalitat de les cèl·lules que compten per als mecanismes de les malalties és el major repte de la medicina personalitzada. Malgrat la disponibilitat creixent de les dades de genòmica i transcriptómica, continua existint una notable bretxa entre la detecció de les pertorbacions en l'expressió de gens i la comprensió de la seua contribució en els mecanismes moleculars que últimament tenen relació important amb el fenotip estudiat. Al llarg de l'última dècada, diferents models computacionals i matemàtics s'han proposat per a l'anàlisi de les rutes. No obstant això, aquests models no tenen en compte els mecanismes dinàmics de les rutes com l'estructura i les interaccions entre gens i proteïnes. En aquesta tesi doctoral, presente dos models matemàtics lleugerament diferents, per a integrar les dades transcriptómicos massius d'humà amb un coneixement previ de de les rutes de senyalització i metabòliques per a estimar les activitats mecàniques que estan darrere d'aqueixes rutes (MPAs). Les MPAs són variables contínues amb valors de nivell individual que poden ser usades amb els models d'aprenentatge de màquines i mètodes estadístics per a determinar els biomarcadores que podem usar per als diagnòstics primerencs i la classificació de subtipus de malalties, a més de poder suggerir les dianes terapèutiques potencials per a les intervencions individualitzades. L'objectiu global és desenvolupar nous i avançats enfocaments de la biologia de sistemes per a proposar unes hipòtesis funcionals que ens ajuden a entendre i interpretar els mecanismes complexos de les malalties. Aquests mecanismes són crucials per a millorar els tractaments personalitzats i predir els resultats clínics. En primer lloc, vaig contribuir al desenvolupament d'un mètode que està dissenyat per a extraure les subrutas elementals des de la ruta de senyalització amb les seues activitats estimades. Posteriorment, aquest algorisme s'ha adaptat als mòduls metabòlics i s'ha implementat com una eina web. Finalment, el mètode ha revelat un panorama metabòlic per a una llista completa de diferents tipus de càncers. En aquest estudi, vaig analitzar el perfil metabòlic de 25 tipus de càncer diferents i es va validar el mètode usant diversos enfocaments computacionals i experimentals. Cada mètode desenvolupat en aquesta tesi ha sigut enfrontat a altres mètodes similars existents, avaluats per les seues sensibilitats i especificitats, experimentalment validats quan va ser possible i usats per a predir resultats clínics de diversos tipus de càncers. La investigació descrita en aquesta tesi i els resultats obtinguts van ser publicats en diferents revistes arbitrades que estan relacionades amb el càncer i biologia de sistemes, i també en els periòdics nacionals. / [EN] Understanding the aspects of the cell functionality that account for disease or drug action mechanisms is the main challenge for precision medicine. In spite of the increasing availability of genomic and transcriptomic data, there is still a gap between the detection of perturbations in gene expression and the understanding of their contribution to the molecular mechanisms that ultimately account for the phenotype studied. Over the last decade, different computational and mathematical models have been proposed for pathway analysis. However, they are not taking into account the dynamic mechanisms contained by pathways as represented in their layout and the interactions between genes and proteins. In this thesis, I present two slightly different mathematical models to integrate human transcriptomic data with prior knowledge of signalling and metabolic pathways to estimate the Mechanistic Pathway Activities (MPAs). MPAs are continuous and individual level values that can be used with machine learning and statistical methods to determine biomarkers for the early diagnosis and subtype classification of the diseases, and also to suggest potential therapeutic targets for individualized therapeutic interventions. The overall objective is, developing new and advanced systems biology approaches to propose functional hypotheses that help us to understand and interpret the complex mechanism of the diseases. These mechanisms are crucial for robust personalized drug treatments and predict clinical outcomes. First, I contributed to the development of a method which is designed to extract elementary sub-pathways from a signalling pathway and to estimate their activity. Second, this algorithm adapted to metabolic modules and it is implemented as a webtool. Third, the method used to reveal a pan-cancer metabolic landscape. In this study, I analyzed the metabolic module profile of 25 different cancer types and the method is also validated using different computational and experimental approaches. Each method developed in this thesis was benchmarked against the existing similar methods, evaluated for their sensitivity and specificity, experimentally validated when it is possible and used to predict clinical outcomes of different cancer types. The research described in this thesis and the results obtained were published in different systems biology and cancer-related peer-reviewed journals and also in national newspapers. / Cubuk, C. (2020). Modeling Functional Modules Using Statistical and Machine Learning Methods [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/156175

Le récepteur tyrosine kinase FLT3 est impliqué dans le maintien et le renouvellement des cellules souches et des progéniteurs hématopoïétiques. Dans environ 30% des cas de leucémies aiguës myéloïdes, il est activé constitutivement par des mutations, dont les plus fréquentes impliquent une duplication de séquence dans le domaine juxtamembranaire (Internal Tandem Duplication, ou ITD). Des inhibiteurs chimiques de FLT3 ont été développés dans le cadre de thérapies anti-cancéreuses, mais leurs essais cliniques se sont révélés assez décevants avec des effets essentiellement transitoires. Par ailleurs, certaines études ont mis en évidence une signalisation intracellulaire spécifique au mutant FLT3-ITD, comme l’activation spécifique de STAT5a. Ces données soulignent la nécessité d’étudier exhaustivement et en détail la signalisation intracellulaire induite par le récepteur FLT3 et ses mutants oncogéniques dans des modèles pertinents, avec l’espoir d’identifier de nouvelles cibles thérapeutiques. Nous avons surexprimé FLT3 et sa forme mutante ITD dans la lignée murine de progéniteurs myéloïdes FDCP-1/Fms. Ce modèle s’est avéré représentatif des processus observés in vivo en termes de survie, de prolifération et de différenciation monocytaire. Nous l’avons alors utilisé dans une approche protéomique pour identifier des protéines différemment phosphorylées et/ou exprimées entre les deux cas. L’utilisation d’ARN interférant et la surexpression des protéines candidates ou de leurs mutants a permis de révéler l’implication fonctionnelle de plusieurs d’entre elles dans la signalisation FLT3, telles que Hcls1, Ezrin, et PAK1 qui sont toutes des régulateurs du cytosquelette / The FLT3 receptor is involved in stem cells and myeloid progenitors self renewal processes. In about 30% of the acute myeloid leukemia cases, this receptor is mutated and constitutively active, the most common mutation being duplication of sequences in the juxtamembrane domain (Internal Tandem Duplication, ITD). Many chemical inhibitors of FLT3 have been developed for anti-cancer therapies but the clinical trials were a bit disappointing, showing mainly transient effect on blast reduction. Several studies have shown that FLT3-ITD triggers a different signaling from the wild-type receptor, like the specific activation of STAT5a. These data show the necessity of the exhaustive and detailed study of the intracellular signaling induced by FLT3 and its oncogenic mutants, to identify new therapeutic targets. We have overexpressed wild-type and ITD mutant forms of FLT3 in the murine myeloid progenitors cell line FDCP-1/Fms. This model proved it-self representative of the in vivo processes described in the literature in terms of survival, proliferation and monocytic differentiation. Consequently, we have used it for a proteomic approach to identify differentially expressed and/or phosphorylated proteins depending on FLT3 status. Using RAN interference and overexpression of these identified candidate proteins, we have demonstrated the functional involvement of several of them in FLT3 signaling, including Hcls1, Ezrin, and PAK1, which all regulate the cytoskeleton

Depuis la découverte de la première protéine possédant une activité tyrosine kinase (protein tyrosine kinase [PTK]) dans les années 1980, l’importance des PTKs et de la phosphorylation sur résidu tyrosine dans la régulation des événements de signalisation intracellulaire est bien établie. Quant aux protéines qui possèdent une activité tyrosine phosphatase (protein tyrosine phosphatase [PTP]), dont l’existence n’a été dévoilée qu’une dixaine d’années plus tard, elles ont longtemps été perçues comme des enzymes dont le rôle ne se résumait qu'à contrecarrer passivement les activités des PTKs. Il est maintenant clair que les activités des PTPs sont spécifiques, hautement régulées, et qu’elles doivent être coordonnées avec celles des PTKs pour une régulation adéquate des événements de signalisation intracellulaire. En dépit de cette évidence, la contribution des PTPs à la régulation des différents processus physiologiques fondamentaux demeure encore peu caractérisée. C’est le cas, notamment, de l’angiogenèse, le processus par lequel de nouveaux vaisseaux sanguins sont formés à partir de ceux préexistants. Le VEGF (Vascular endothelial growth factor), un des facteurs angiogéniques les plus importants, est connu pour induire majoritairement ses effets biologiques via l’activation du récepteur à activité tyrosine kinase VEGFR2 (Vascular endothelial growth factor receptor 2). Puisque l’angiogenèse est impliquée dans le développement d’une multitude de pathologies, dont la progression tumorale, une meilleure caractérisation des PTPs qui assurent la qualité de la réponse angiogénique en agissant de pair avec le VEGFR2 s’avère cruciale et ce, afin de raffiner les outils thérapeutiques actuels. L’expression de la PTP DEP-1 corrèle avec la déphosphorylation du récepteur VEGFR2 localisé au niveau des jonctions cellules-cellules et contribue à l’inhibition de la prolifération des cellules endothéliales en réponse au VEGF lorsque les cellules sont à confluence. Par contre, la contribution spécifique de DEP-1 à la régulation des voies de signalisation et des réponses biologiques induites par le VEGF demeurait toujours inconnue. Les travaux de recherche présentés dans cette thèse démontrent tout d’abord que DEP-1 régule négativement l’activité tyrosine kinase de VEGFR2 en déphosphorylant spécifiquement les résidus tyrosine Y1054/Y1059 de sa boucle d’activation. Cette déphosphorylation mène par conséquent à une diminution générale de la phosphorylation du récepteur et à une atténuation de la plupart des voies de signalisation induites par le VEGF, incluant la voie mitogénique PLCγ-ERK1/2. Par ailleurs, malgré ce rôle négatif global, nos travaux révèlent étonnement, et pour la première fois, que DEP-1 contribue d’une manière positive à la promotion de la survie des cellules endothéliales via l’activation de la voie Src-Gab1-Akt en aval du récepteur VEGFR2. Ce pouvoir pro-survie de DEP-1 dans les cellules endothéliales réside avant tout dans sa capactié à déphosphoryler la tyrosine inhibitrice de Src (Y529). Au cours de notre étude, nous avons pu identifier deux résidus tyrosine au niveau de l’extrémité carboxy-terminale de DEP-1, Y1311 et Y1320, dont la phosphorylation est dépendante de Src. Nos travaux révèlent par ailleurs que ces deux résidus tyrosine phosphorylés lient le domaine SH2 de Src et que la Y1320 est principalement requise pour l’activation de Src et d’Akt en réponse au VEGF dans les cellules endothéliales. Ces résultats constituent donc une avancée majeure dans la compréhension des mécanismes moléculaires par lesquels DEP-1 peut réguler le programme angiogénique dépendant du VEGF. De plus, cette découverte d’un rôle positif pour DEP-1 dans la survie des cellules endothéliales pourrait mener à l’élaboration de nouvelles approches thérapeutiques visant à inhiber cette fonction spécifique de DEP-1 pour bloquer l'angiogenèse pathologique. / Since the discovery of the first protein tyrosine kinase [PTK] in 1980, the importance of these proteins and of tyrosine phosphorylation cascades in the regulation of intracellular signaling events has been well-established. The protein tyrosine phosphatases [PTPs], whose existence was only revealed ten years later, have been regarded for a long time as passive PTKs conteracting enzymes. It is now evident that PTPs activities are specific, exquisitely regulated, and that they have to be coordinated with PTKs activities for an appropriate regulation of intracellular signaling events. Despite these findings, the contribution of PTPs to the regulation of many fundamental physiological processes is not well-characterized. This is the case of angiogenesis, the process whereby new vessels are generated from pre-existing ones. Vascular endothelial growth factor (VEGF), one of the most important angiogenic factors, is known to induce its biological effects mainly by activating VEGFR2 (Vascular endothelial growth factor receptor 2). As angiogenesis is involved in the development of a multitude of pathologies, including tumoral progression, a better characterization of PTPs, which ensure the quality of the angiogenic response by acting together with VEGFR2, is crucial to refine current therapeutic tools. Expression of a PTP called DEP-1 correlates with dephosphorylation of VEGFR2, and contributes to the inhibition of VEGF-induced endothelial cell proliferation at high cell confluence. However, the specific contribution of DEP-1 to the regulation of signaling pathways and biological responses induced by VEGF remained unknown. The research presented in this thesis demonstrates that DEP-1 negatively regulates the tyrosine kinase activity of VEGFR2 by dephosphorylating the specific tyrosine residues Y1054/Y1059 in its activation loop. Consequently, this leads to a global decrease in the phosphorylation of the receptor and to a reduced activation of most of the signaling cascades induced by VEGF, including the mitogenic PLCγ- ERK1/2 pathway. Moreover, despite this negative role, our work reveals for the first time that DEP-1 contributes in a positive way to promote the survival of endothelial cells via the activation of the Src-Gab1-Akt pathway downstream of VEGFR2. This survival function of DEP-1 in endothelial cells is accomplished by the dephosphorylation of the Src inhibitory tyrosine (Y529). During our study, we identified two residues in the carboxy-terminal tail of DEP-1, Y1311 and Y1320, whose phosphorylation is dependent on Src. These two phosphorylated tyrosine residues bind to the SH2 domain of Src, and our work also revealed that mostly Y1320 is required for Src and Akt activation upon VEGF stimulation of endothelial cells. These findings represent a major step forward in our understanding of the molecular mechanisms by which DEP-1 may regulate the VEGF-dependent angiogenic program. Moreover, the discovery of a positive role for DEP-1 in the survival of endothelial cells could lead to the development of new therapeutic approaches to inhibit this specific function of DEP-1 in order to block pathological angiogenesis.

Antigen presentation during which antigen fragments in complex with MHC glycoproteins are recognized by T cell antigen-specific receptors is necessary for the initiation of adaptive immune response. During this process, immunological synapse is assembled at the site of contact between the T cell and the antigen-presenting cell (APC). This leads to the activation of receptors on the surface of both cells followed by triggering of multiple signaling pathways. However, our knowledge about the signaling occurring at the APC-side of the IS is limited in comparison to the T cell side. Here, we analyze role of Src family kinases in the APC signaling pathways. For this purpose, constructs targeting Csk kinase to the plasma membrane of APCs were prepared to inhibit SFKs there. We show that expression of these constructs inhibits activation of SFKs, calcium mobilization and cell activation of K46 B cell line. Further, expression of these constructs in hematopoietic progenitors attenuates their differentiation into dendritic cells which then results in their decreased ability to stimulate T cells.

A engenharia de tecido pulpar tem como objetivo substituir a polpa dentária inflamada ou necrosada por um tecido saudável e funcional, capaz de formar nova dentina para reparar a estrutura dentária perdida. Assim, os objetivos deste trabalho foram: avaliar a habilidade de diferenciação de célulastronco de dentes decíduos exfoliados humanos (SHED) em odontoblastos funcionais, demonstrando a formação de tecido mineralizado in vivo; e estudar o efeito de VEGF em SHED com relação à estimulação de vias de sinalização celular (STAT3, AKT e ERK), proliferação, migração, formação de estruturas tubulares e diferenciação em células endoteliais. O início do processo de mineralização de SHED tratadas com dexametasona, ácido ascórbico \'beta\' - glicerofosfato pôde ser detectado por meio da produção da enzima fosfatase alcalina a partir da segunda semana de cultura, mas a expressão de RNAm para DSPP só foi observada após 28 dias de indução. Utilizando-se o modelo de fatias de dentes e matrizes condutivas implantadas no dorso de camundongos imunodeprimidos, demonstrou-se a diferenciação de SHED em células semelhantes a odontoblastos, as quais tiveram imunomarcação positiva com o anticorpo DMP-1. A deposição de dentina, seguindo um ritmo centrípeto de crescimento, numa taxa de 14,1 µm por dia também foi demonstrada por meio da marcação com tetraciclina. O tratamento das SHED com VEGF estimulou a fosforilação de ERK e AKT e a diminuiu a fosforilação de STAT3 em um período de uma hora, provavelmente por meio de sua ligação com os receptores VEGFR-1 e NP-1 presentes nestas células. Além disso, VEGF intensificou a organização das SHED em estruturas tubulares, havendo diferença estatisticamente significativa entre os grupos tratado e não tratado a partir do 5o dia de tratamento. Entretanto, VEGF não estimulou a proliferação nem a migração destas células. Os resultados de RT-PCR mostraram que SHED cultivadas em fatias de dentes e matrizes condutivas expressaram VEGFR-2 já após o primeiro dia de estímulo com VEGF. Ademais, os quatro marcadores de células endoteliais (VEGFR-1, VEGFR-2, CD31 e Caderina-VE) foram observados após 21 dias sob estímulo de VEGF, resultado ainda mais evidente aos 28 dias. In vivo, observou-se que SHED transfectadas com o gene LacZ foram capazes de formar estruturas semelhantes a vasos sangüíneos quando implantadas em camundongos, mas a presença de sangue no seu interior não pôde ser observada após 21 dias de implante. Portanto, SHED podem ser estimuladas a se diferenciar em odontoblastos funcionais, capazes de produzir estrutura mineralizada semelhante à dentina. Ademais, VEGF interfere nas vias de sinalização STAT3, ERK e AKT e estimula a formação de estruturas tubulares e a diferenciação de SHED em células endoteliais, mas não a proliferação e migração de SHED. Acreditamos que tecnologia igual ou semelhante à empregada neste estudo poderá eventualmente fornecer ferramentas clínicas para tratamentos endodônticos que visem à regeneração de um tecido pulpar completo e formação de tecido dentinário num futuro não muito distante. / Dental pulp tissue engineering aims to replace the inflamed or necrotic pulp by a healthy and functionally competent tissue able to form new dentin in order to repair lost structure. The purposes of this work were: to evaluate the differentiation ability of stem cells from human exfoliated deciduous teeth (SHED) into functional odontoblasts, showing the formation of mineralized tissue in vivo; and to study the effect of VEGF on SHED with regards to the stimulation of cell signaling pathways (STAT3, AKT and ERK), the proliferation, migration, capillary sprouting, and the differentiation into endothelial cells. The beginning of the mineralization process of SHED treated with dexamethasone, ascorbic acid and beta-glycerophosphate could be detected through the production of alkaline phosphatase after the second week of culture, but the expression of DSPP mRNA was only observed after 28 days of induction. Using the tooth slice and scaffold model implanted in the dorsum of immunocompromised mice, the differentiation of SHED into odontoblast-like cells, which were immunostained with DMP-1 antibody, was demonstrated. Dentin deposition following a centripetal rhythm, in a rate of 14.1 µm per day, was also shown through the tetracycline labeling. VEGF treatment of SHED stimulated the ERK and AKT phosphorilation, and decreased the phosphorilation of STAT3 over 1 hour period, presumably due to its binding to VEGFR-1 and NP-1 receptors in these cells. In addition, VEGF enhanced SHED organization into tubular structures, with statistically significant difference between the treated group and the non-treated one after the 5th day of treatment. However, VEGF did not stimulate proliferation and migration of these cells. RT-PCR results demonstrated that SHED seeded in the tooth slices and scaffolds expressed VEGFR-2 after the first day of VEGF stimulation. Moreover, the four endothelial cell markers (VEGFR-1, VEGFR-2, CD31 and VE-Cadherin) were observed after 21 days of VEGF stimulation, and this result was even clearer after 28 days. In vivo, SHED transduced with LacZ gene were able to give rise to blood vessel-like structures when implanted in immunocompromised mice, but the presence of blood flow was not observed after 21 days of implantation. Therefore, SHED can be stimulated to differentiate into functional odontoblasts, which in turn are able to produce mineralized structure resembling dentin. Furthermore, VEGF interferes with the STAT3, ERK and AKT signaling pathways, and stimulates the formation of tubular structures and the differentiation of SHED into endothelial cells, but does not stimulate SHEDs proliferation and migration. We believe that the same technology employed in this study or a similar one can eventually provide clinical tools for the endodontic treatments aiming at regenerating a complete pulp tissue and forming a dentin tissue in a near future.