Chronic inflammatory conditions such as Crohn's disease (CD) and Ulcerative colitis (UC) are risk factors for colon cancer. TGFβ has been shown to be dysregulated in colon cancer. Bacteria-induced inflammation is necessary for the induction of colon cancer in TGFβ mouse models. However, the mechanism by which TGFβ regulates the inflammatory response in these models is not well elucidated. It was our thought that we needed to be able to distinguish what was TGFβ dependent and what was inflammation dependent. To do this we created 2 colonies of Smad3 mice. One colony was housed with normal colonic bacteria (Smad3-uninfected animals) and the other colony (Smad3-infected animals) had chronic H. hepaticus infection. As previously seen the Smad3⁻/⁻- infected animals developed colitis and carcinoma (~40%). In the absence of H. hepaticus infection SMAD3 was found to negatively regulate TLR4 expression. This was then exacerbated with the addition of H. hepaticus resulting extreme up-regulation of TLR4 and the downstream effectors IRAK4 and NF-κB in Smad3⁻/⁻-infected colonic tissues. Examination of adaptive immune regulation in this model demonstrated that SMAD3 was necessary for FOXP3 expression in H. hepaticus-infected splenocytes. Loss of SMAD3 resulted in up-regulation of IL17 and reduced iTreg populations. These data demonstrate the important role SMAD3 has in maintaining tolerance to microbial populations through both the innate and adaptive immune systems.

Hereditary non-polyposis colon cancer syndrome (HNPCC) is associated with an increased risk of developing several types of cancer and is the most common cause of hereditary ovarian cancer after BRCA1 and BRCA2 mutations. HNPCC results from a germline mutation in one of the DNA mismatch repair (MMR) genes: MLH1, MSH2, PMS1, PMS2, MSH6, MSH3 and MLH3. While there has been extensive investigation of MMR deficiency in colorectal cancer, MMR in ovarian cancer is relatively under-investigated. The goal of this project was to study MMR deficiency in ovarian cancer at both the clinical and molecular level. The first aim was to examine the frequency of MMR loss in a large patient cohort and investigate the clinical consequences of MMR deficiency. The second aim was to describe the molecular characteristics of MMR deficiency in ovarian cancer cell lines and establish an in vitro cell line model of MMR deficiency in ovarian cancer. The third aim was to identify synthetic lethal strategies for the treatment of ovarian cancer to maximise cytotoxicity in a MMR-deficient background. In order to characterise the clinical consequences of MMR deficiency, a large patient cohort was studied with regard to MMR status. Three tissue microarrays consisting of 581 ovarian tumours were constructed, and expression of the four most frequently lost MMR proteins: MLH1, MSH2, PMS2 and MSH6 were detected by immunohistochemistry. Afterwards, MMR status and histology subtypes were analysed in combination with the associated clinical data. The overall incidence of MMR deficiency (loss of any MMR protein) was 15.7%, with PMS2 being the most frequently lost protein (9.7%). In addition, MMR deficiency tended to appear in a grouped fashion: MLH1 with PMS2; MSH2 with MSH6. Patients with non-serous subtypes of ovarian cancer, clear cell or mucinous especially, had higher incidence of MMR deficiency compared to patients with serous ovarian cancer. Overall MMR deficient patients were more likely to be diagnosed at early stages compared with MMR proficient patients, and this is probably due to the association between MMR deficiency and non-serous histology. However, platinum-based treatment for patients with MMR deficiency gives no advantage over those without MMR deficiency. Therefore better treatments for this subgroup of patients may be needed. The features of MMR deficiency in ovarian cancer were also characterized at the molecular level. After quantifying mRNA and protein expression of MMR genes in 19 ovarian cell lines, three cell lines (SKOV3, TOV21G and IGROV1) were found to have a defect in MLH1 expression at both the mRNA and protein level. Interestingly, the three cell lines also carried a defect in PMS2 expression at the protein level but not at the mRNA level, which is consistent with our clinical data demonstrating that MLH1 protein and PMS2 protein are paired in loss. In addition, across the 19 cell lines, MLH1 and PMS2 showed positive correlation at both the mRNA level (R=0.53, p=0.02) and protein level (R=0.72, p=0.0006). In order to study co-expression of MLH1 and PMS2, a plasmid encoding the cDNA for MLH1 was transfected into the three MLH1 deficient cell lines; and conversely siRNA targeting MLH1 was transfected into the MMR proficient cell line A2780 and expression of MLH1 protein and PMS2 protein was quantified. The results showed that re-introduction of MLH1 into MLH1 deficient cells resulted in increased expression of PMS2 protein, while knocking down MLH1 in MMR proficient cells leads to decreased PMS2 protein expression. This indicates that MLH1 may play a crucial role in regulating PMS2 protein expression. As the three MLH1 and PMS2 protein deficient cell lines all express PMS2 mRNA, the regulation of PMS2 expression by MLH1 is likely to be at the translational or post-translational level. However, the expression of PMS2 protein was not increased in the absence of MLH1, even when the proteasomal and lysosomal protein degradation pathways were blocked (as seen with SKOV3 cells), suggesting decreased PMS2 protein expression is not due to rapid degradation in the absence of MLH1. Therefore MLH1 may play a role in regulating the synthesis of PMS2 protein at the translational level, rather than preventing the degradation of PMS2. Thus, to investigate the mechanism by which PMS2 protein levels are regulated by MLH1, future work should focus on translational regulation of PMS2. In order to identify synthetic lethal strategies to target MMR deficiency in ovarian cancer, an isogenic cell line model of MMR deficiency was established by stable transfection of a plasmid for MLH1 and its corresponding empty vector into SKOV3 cells. The MLH1+ cell line SAC-1 and MLH1- cell line SN-5 were selected for drug screening based on their phenotype and growth rate. The AlamarBlue assay, with z’ above 0.5, was chosen for drug screening and a kinase inhibitor library containing 362 drugs of known target was screened. Two drugs with similar structures that targeted PLK1 showed greater growth inhibition of SN-5 compared with SAC-1. When the two cell lines were treated with another PLK1 inhibitor, BI2536, with different structure, a 2-fold difference in growth inhibition between SAC-1 and SN-5 was also observed, suggesting PLK1 is a potential synthetic lethal target for MLH1 deficiency in ovarian cancer. Together these data demonstrate that clinically, MMR deficiency is associated with non-serous subtypes of ovarian cancer and specific MMR proteins are paired in loss. While current standard therapy offers no selective benefit to ovarian cancer patients with MMR deficiency, inhibiting PLK1 activity may confer selective benefit.

La voie de signalisation Notch joue un rôle essentiel dans le développement et l'homéostasie de l’épithélium intestinal et présente un potentiel oncogénique dans le cancer du côlon (CRC). L'un de ses gènes cibles, HES1, est un répresseur transcriptionnel de divers gènes, dont KLF4, facteur impliqué dans l'homéostasie intestinale et qui favorise la différenciation des cellules à mucus. De plus, afin d’éviter une activité aberrante de la voie Notch, HES1 exerce une boucle de rétrocontrôle négative sur son propre promoteur. Notre laboratoire s’intéresse à RIP140, un corégulateur transcriptionnel qui réprime l'activité de nombreux facteurs de transcription impliqués dans divers processus physiopathologiques. Dans l'épithélium intestinal, RIP140 inhibe la prolifération cellulaire et régule la différenciation en cellules de Paneth. L'objectif de ce travail a été d'étudier le dialogue entre RIP140 et la voie de signalisation Notch/HES1 ainsi que son impact sur différents paramètres cellulaires en utilisant différentes lignées cellulaires cancéreuses colorectales humaines ainsi que des modèles murins présentant une invalidation du gène Rip140. Pour cela, diverses expériences ont été mises en place en utilisant le gène HES1 comme principal marqueur d’activation de la voie Notch dans les lignées cellulaires de CRC SW620 et HT29. L’expression du gène HES1 a été analysée au niveau protéique, ARNm et transcriptionel en utilisant respectivement les techniques de Western-blot et d’immunofluorescence, de RT-QPCR et de gène rapporteur luciférase. L'activité de la voie Notch a été modulée par l'expression ectopique du domaine intracellulaire de récepteur Notch (NICD) ou en utilisant un inhibiteur de la γ-sécrétase. Le dialogue entre RIP140 et la voie de signalisation Notch est étroitement lié au niveau d'activation de la voie Notch et au niveau d’expression du facteur de transcription HES1. A de faibles niveaux d’activité de la voie Notch, RIP140 est une cible négative de NICD et exerce un effet positif sur la transcription du gène HES1 qui implique, au moins en partie, le complexe RBPJ/NICD. A de niveaux élevés d’activé de la voie Notch, RIP140 devient une cible positive de HES1 et exerce un effet négatif sur la transcription de ce gène en contribuant à la boucle de rétrocontrôle négative de HES1. De manière intéressante, comme le gène HES1, RIP140 a un impact important sur différents paramètres cellulaires. En effet, RIP140, est non seulement capable d’inhiber la prolifération des cellules intestinales, mais est également capable d’augmenter l'expression du gène KLF4 et de favoriser la différenciation en cellules à mucus. Conformément à ce dialogue entre RIP140 et la voie Notch/HES1, nous avons ensuite montré que HES1 et RIP140 inhibent mutuellement leurs effets sur la différenciation et la prolifération cellulaires. Nos données démontrent ainsi l'existence d'une boucle de rétrocontrôle impliquant RIP140 et la voie Notch/HES1 dans les lignées cellulaires de CRC. En effet, le gène RIP140 est à la fois une cible et un régulateur de la voie de signalisation Notch/HES1. Une activité aberrante de la voie Notch bascule la régulation de l'expression du gène HES1 par RIP140 d'un effet positif à un effet négatif via la boucle de rétrocontrôle négative de HES1. De plus, ce lien puissant entre RIP140 et HES1 a un impact sur la différenciation et la prolifération cellulaires. Il sera nécessaire d’analyser le recrutement de RIP140 et HES1 sur différents promoteurs cibles et de valider l'impact de ce dialogue in vivo, en utilisant un modèle de souris que j’ai développé au sein du laboratoire et qui présentent une invalidation conditionnelle du gène Rip140 dans l'épithélium intestinal. / The Notch signaling pathway plays an essential role in intestinal development and homeostasis and has an oncogenic potential in colon cancer (CRC). One of its target genes HES1 is a transcription repressor of a number of genes, including KLF4, which is implicated in intestinal homeostasis and promotes Goblet cell differentiation. In addition, to avoid aberrant activity of the Notch pathway, HES1 exerts a negative feedback loop on its own promoter. Our laboratory is studying RIP140, a transcriptional coregulator which represses the activity of many transcription factors involved in various pathophysiological processes. In the intestinal epithelium, RIP140 inhibits cell proliferation and regulates differentiation towards the Paneth cell lineage. The goal of this work was to investigate the crosstalk between RIP140 and the Notch/HES1 pathway and to study its cellular impacts in human CRC cells. Various experiments have been set up using the HES1 gene as the main output of the Notch pathway in two CRC cell lines (SW620 and HT29). HES1 gene expression has been assessed at the protein, mRNA and transcriptional levels using western-blot/immunofluorescence, RT-QPCR and luciferase reporter assays, respectively. The activity of the Notch pathway has been modulated through ectopic expression of the Notch intracellular domain (NICD) or using a γ-secretase inhibitor. RIP140 crosstalk with the Notch signaling pathway is tightly related to the level of activation of the Notch pathway and to the level of HES1 expression. At low Notch activity, RIP140 is a negative target of NICD and exerts a positive effect on HES1 gene transcription which involves, at least partly, the RBPJ/NICD complex. When the Notch pathway is fully activated, RIP140 becomes a positive target of HES1 and exerts a negative effect on HES1 gene transcription by contributing to the HES1 negative feedback loop. Interestingly, as it is the case for HES1, RIP140 has a strong impact on different cellular parameters. Indeed, we found that RIP140, not only decreases intestinal cell proliferation, but also increases KLF4 gene expression and Goblet cell differentiation. In line with the strong crosstalk between RIP140 and the Notch/HES1 pathway, we then showed that HES1 and RIP140 mutually inhibit their effects on cell differentiation and proliferation. Altogether, our data demonstrated the existence of a feed-back loop involving RIP140 and the Notch/HES1 pathway in CRC cells. Indeed, the RIP140 gene is both a target and a regulator of the Notch/HES1 signaling pathway. A high level of Notch/HES1 activity switches the regulation of HES1 gene expression by RIP140 from a positive to a negative effect through the HES1 negative feedback loop. Moreover, this strong link between RIP140 and HES1 has an impact on cell differentiation and proliferation. It would be however interesting to demonstrate the recruitment of each factor on target promoters and to validate the impact of this strong crosstalk, in vivo, using the newly mouse model that I developed with a conditional knock-out of the Rip140 gene in the intestinal epithelium.

Estudos têm demonstrado que o microambiente tumoral é rico em ATP e adenosina, sugerindo o envolvimento da sinalização purinérgica no desenvolvimento e/ou manutenção do câncer. Ainda, o receptor purinérgico P2X7, conhecido pelo seu papel na indução de apoptose, encontra-se reduzido em alguns tecidos tumorais em comparação aos tecidos saudáveis, indicando que a sua redução possa ser um mecanismo de resistência celular à apoptose. Dessa forma, compreender o papel da sinalização purinérgica no contexto do câncer se torna indispensável e permite que novas abordagens terapêuticas sejam implementadas. Nesse trabalho, avaliamos a função dos nucleotídeos e nucleosídeos da adenina, bem como do receptor P2X7 na indução da morte celular em células de câncer cervical. Também verificamos o efeito do heat shock na potencialização da atividade do receptor P2X7 frente à curta exposição ao ATP em células de câncer de cólon. De acordo com os nossos resultados, o efeito citotóxico do ATP extracelular nas linhagens de câncer cervical é mediado principalmente pela ação do seu metabólito adenosina, que ao entrar no interior das células, promove o aumento dos níveis intracelulares de AMP, ativação de AMPK, aumento da p53 e indução de autofagia. O papel do receptor P2X7 nesse contexto parece ser apenas coadjuvante, visto que o seu bloqueio ou silenciamento impediu em apenas 20% a morte celular. Além disso, utilizando células de câncer de cólon, nós demonstramos que o heat shock aumenta a funcionalidade do receptor P2X7, independente da interação com heat shock proteins ou canais do tipo conexina/panexina, potencializando o efeito citotóxico do ATP. Esse efeito parece estar relacionado à mudanças na composição e arquitetura da membrana celular, visto que o uso do agente fluidizador de membrana benzil álcool foi capaz de mimetizar o efeito do heat shock na potencialização do receptor P2X7 a 37ºC. Este estudo fornece evidências adicionais sobre o papel da sinalização purinérgica no contexto da biologia celular tumoral e abre novas perspectivas para o uso dos nucleotídeos de adenina associados a hipertermia como agentes adjuvantes na terapia do câncer. / The tumor microenvironment is rich in ATP and adenosine, suggesting an involvement for purinergic signaling in cancer development and surveillance. The P2X7 receptor, among the P2 purinergic receptors, is broadly recognized as the “death receptor”, because it promotes cell apoptosis when exposed to high levels of extracellular ATP. Researches have been shown that P2X7 protein levels are decreased at the tumor site in comparison to adjacent healthy tissue, suggesting a mechanism of tumor escape to cell death. Thus, understanding purinergic signaling in a cancer context becomes urgent and opens a new field for therapeutic strategies. Here, we evaluated adenine nucleotides and nucleosides cytotoxicity, as well as P2X7 role in cell death induction using cervical cancer cell lines. Indeed, we investigated heat shock effect on P2X7 functionality through exposing colon cancer cell shortly to ATP at 40ºC. According to our data, adenosine uptake formed from ATP metabolism is the main responsible for the extracellular ATP cytotoxicity in cervical cancer cells. While inside of the cell, adenosine is converted to AMP, leading to AMPK activation, p53 increase and autophagy induction. ATP induced cell death per se through P2X7 in this context seems to be less important, since P2X7 blockage or knocking down reduced only 20% of cell death. In colon cancer cells, we found that heat shock stress was able to increase P2X7 pore formation independently of heat shock protein interaction or native pore-forming transporters association (e.g pannexin-or connexin-type channels), thus leading to an increase ATP cytotoxicity. The mechanism enrolled in this process seems to be related to changes in the lipid composition and architecture of membrane, as the membrane fluidizer benzyl alcohol could reproduce heat stress effect in potentiating P2X7 activation at 37ºC. In conclusion, our work provides further evidence for a purinergic signaling role in the cancer biology context and opens new perspectives for the utility of purine-based drugs associated to hypertermia as adjunctive agents in cancer therapy.

Gene expression analysis can be performed by a number of methods. One of the most common methods is using relative qPCR  to assess the relative expression of a determined set of genes compared to a reference gene. Analysis methods benefits from an as homogeneous sample set as possible, as great variety in original sample disease status, quality, type, or distribution may yield an uneven base expression between replicates. Additionally normalization of qPCR data will not work if there are missing values in the data. There are methods for handling non-detects (i.e. missing values) in the data, where most of them are only recommended to use when there is a single, or very few, value missing. By integrating microarray expression data with qPCR data, the data quality could be improved on, eradicating the need to redo an entire experiment when too much data is missing or sample data too is heterogeneous. In this project, publically available microarray data, with similar sample status of a given qPCR dataset, was downloaded and processed. The qPCR dataset included 51 genes, where a set of four DLG genes has been chosen for in-depth analysis. For handling missing values, mean imputation and inserting Cq value 40 were used, as well as a novel method initialized where microarray data was used to replace missing values. In summary replacing missing values with microarray data did not show any significant difference to the other two methods in three of the four DLG genes. From this project, it is also suggested an initialized approach towards testing the possibility of qPCR and microarray data integration.

Estudos têm demonstrado que o microambiente tumoral é rico em ATP e adenosina, sugerindo o envolvimento da sinalização purinérgica no desenvolvimento e/ou manutenção do câncer. Ainda, o receptor purinérgico P2X7, conhecido pelo seu papel na indução de apoptose, encontra-se reduzido em alguns tecidos tumorais em comparação aos tecidos saudáveis, indicando que a sua redução possa ser um mecanismo de resistência celular à apoptose. Dessa forma, compreender o papel da sinalização purinérgica no contexto do câncer se torna indispensável e permite que novas abordagens terapêuticas sejam implementadas. Nesse trabalho, avaliamos a função dos nucleotídeos e nucleosídeos da adenina, bem como do receptor P2X7 na indução da morte celular em células de câncer cervical. Também verificamos o efeito do heat shock na potencialização da atividade do receptor P2X7 frente à curta exposição ao ATP em células de câncer de cólon. De acordo com os nossos resultados, o efeito citotóxico do ATP extracelular nas linhagens de câncer cervical é mediado principalmente pela ação do seu metabólito adenosina, que ao entrar no interior das células, promove o aumento dos níveis intracelulares de AMP, ativação de AMPK, aumento da p53 e indução de autofagia. O papel do receptor P2X7 nesse contexto parece ser apenas coadjuvante, visto que o seu bloqueio ou silenciamento impediu em apenas 20% a morte celular. Além disso, utilizando células de câncer de cólon, nós demonstramos que o heat shock aumenta a funcionalidade do receptor P2X7, independente da interação com heat shock proteins ou canais do tipo conexina/panexina, potencializando o efeito citotóxico do ATP. Esse efeito parece estar relacionado à mudanças na composição e arquitetura da membrana celular, visto que o uso do agente fluidizador de membrana benzil álcool foi capaz de mimetizar o efeito do heat shock na potencialização do receptor P2X7 a 37ºC. Este estudo fornece evidências adicionais sobre o papel da sinalização purinérgica no contexto da biologia celular tumoral e abre novas perspectivas para o uso dos nucleotídeos de adenina associados a hipertermia como agentes adjuvantes na terapia do câncer. / The tumor microenvironment is rich in ATP and adenosine, suggesting an involvement for purinergic signaling in cancer development and surveillance. The P2X7 receptor, among the P2 purinergic receptors, is broadly recognized as the “death receptor”, because it promotes cell apoptosis when exposed to high levels of extracellular ATP. Researches have been shown that P2X7 protein levels are decreased at the tumor site in comparison to adjacent healthy tissue, suggesting a mechanism of tumor escape to cell death. Thus, understanding purinergic signaling in a cancer context becomes urgent and opens a new field for therapeutic strategies. Here, we evaluated adenine nucleotides and nucleosides cytotoxicity, as well as P2X7 role in cell death induction using cervical cancer cell lines. Indeed, we investigated heat shock effect on P2X7 functionality through exposing colon cancer cell shortly to ATP at 40ºC. According to our data, adenosine uptake formed from ATP metabolism is the main responsible for the extracellular ATP cytotoxicity in cervical cancer cells. While inside of the cell, adenosine is converted to AMP, leading to AMPK activation, p53 increase and autophagy induction. ATP induced cell death per se through P2X7 in this context seems to be less important, since P2X7 blockage or knocking down reduced only 20% of cell death. In colon cancer cells, we found that heat shock stress was able to increase P2X7 pore formation independently of heat shock protein interaction or native pore-forming transporters association (e.g pannexin-or connexin-type channels), thus leading to an increase ATP cytotoxicity. The mechanism enrolled in this process seems to be related to changes in the lipid composition and architecture of membrane, as the membrane fluidizer benzyl alcohol could reproduce heat stress effect in potentiating P2X7 activation at 37ºC. In conclusion, our work provides further evidence for a purinergic signaling role in the cancer biology context and opens new perspectives for the utility of purine-based drugs associated to hypertermia as adjunctive agents in cancer therapy.

Increases in the expression of prostaglandin E2 (PGE2) are widely known to be involved in aberrant growth in the early stage of colon cancer development. We herein demonstrated that the novel indole compound MW-03 reduced PGE2-induced cAMP formation by catalization to an inactive metabolite by inducing 15-hydroxyprostaglandin dehydrogenase through the activation of peroxisome proliferator-activated receptor-γ. MW-03 also inhibited colon cancer cell growth by arresting the cell cycle at the S phase. Although the target of MW-03 for cell cycle inhibition has not yet been identified, these dual anti-cancer effects of MW-03 itself and/or its leading compound(s) on colon cancer cells may reduce colon cancer development and, thus, have potential as a novel treatment for the early stage of this disease.

Le système immunitaire joue un double rôle dans le cancer : il peut non seulement supprimer la croissance tumorale en détruisant les cellules cancéreuses, mais aussi promouvoir la progression de la tumeur en sélectionnant les cellules tumorales ou en créant un microenvironnement tumoral immunosuppresseur. Notre idée principale est de développer des stratégies pour mieux comprendre l’immunologie du cancer colique.Au cours de ma thèse, je me suis tout d’abord intéressée à une population du système immunitaire : les MDSC (Myeloïd Derived Suppressor Cells). Nous avons exploré des stratégies pour réduire le nombre de ces cellules au cours de la croissance tumorale. Nous avons pu découvrir que de petites doses de 5 fluorouracil sont capables d’induire spécifiquement une mort par apoptose des cellules myéloïdes suppressives. Nous avons ainsi caractérisé un effet immunologique positif nouveau du 5-fluorouracil. Cet effet immunologique contribue à l’effet antitumoral du 5-fluorouracil chez la souris. Dans une deuxième partie nous avons étudié le rôle pronostic des infiltrats immunitaires dans une série de patients présentant un cancer du côlon avec des métastases hépatiques. Nous avons étudié le rôle pronostic des infiltrats en cellules CD8, CD45R0 et Foxp3. Nous avons mis en évidence que la présence d’un fort infiltrat en cellules CD45RO et Foxp3 est un facteur de bon pronostic. L’association des 2 marqueurs permet de définir 3 groupes pronostics et ainsi d’individualiser un groupe de mauvais pronostic ne bénéficiant probablement pas de la chirurgie hépatique. / Immune system plays a dual role in cancer: it can not only suppress tumor growth by destroying cancer cells, but also promote tumor progression by selecting immunoresistant tumor cells or by establishing an immunosuppressive microenvironment. Our main objective is to foster on the context of immune response in colon cancer settingDuring my thesis, I focused on one population of the immunosuppressive cells immune system: MDSC (myeloid derived suppressor cells). In this work, we explored strategies to reduce the number of these cells during tumor growth. We have discovered that small doses of 5 Fluorouracil are able to specifically induce apoptotic death of MDSC. We have characterized a novel positive immunological effect of 5-fluororuracil. This immunological effect contributes to the antitumor effect of 5-fluorouracil in mice. In the second part we investigated the prognostic role of immune infiltrates in a series of colon cancers with liver metastases. We investigated the prognostic role of tumor infiltrates, by CD8, CD45R0 and Foxp3 cells. We found that the presence of a strong infiltrate of tumors by CD45RO and Foxp3 cells is a factor of good prognosis. The combination of the two markers could be used to define three prognostic groups and underline a poor prognosis group which may not benefit of liver surgery.

Magister Scientiae (Medical Bioscience) - MSc(MBS) / Amygdalin, a controversial anti-cancer agent, is a cyanogenic glycoside plant compound found in apricot and peach kernels. Both amygdalin and its patented form, Laetrile®, have been promoted and sold as "vitamin B-17", although neither compound is a vitamin. No consensus on the efficacy of amygdalin regarding the treatment of different cancers has been reached. Cancer is now the third leading cause of death worldwide. More than 7.6 million deaths were estimated to have occurred in 2007 and by 2030 it is projected to increase to 17 million cancer deaths per year. Cancers of the lung, breast, colon/rectum, liver and prostate are no longer largely confined to Western industrialized countries but are among the most common cancers worldwide (Thun et al. 2010). In South Africa it is estimated that one in every four males and one in every five females will be affected by a cancer diagnosis in their lifetime. The most common cancers in males are prostrate, lung, oesophagus, bladder and colorectal and in females they are cervix, breast, colorectal, oesophagus and lung (Haggar & Boushey 2009). Colon cancer is one of the most prevalent cancers worldwide, especially in western societies and is nutrition dependent (Klenow et al. 2009). It is one of the leading causes of death in both men and women in industrialised western countries. Colon cancer development involves both hereditary factors and lifestyle factors which include absence of physical exercise, unbalanced nutrition and long term smoking (Forman et al. 2004; Heavey et al. 2004). Colon cancer is traditionally treated by the resection of the colon, chemotherapy, radium therapy, and pharmaceutical hormonal drugs (Willson et al. 1987; Padussis et al. 2004)). Epidemiological studies supports evidence that colon cancer is preventable by adjusting the diet (Forman et al. 2004) and a protective effect is attributable to polyphenols and foods such as fruits and vegetables (Araújo et al. 2011). It was reported by Ruan et al. (2006) that the addition of Chinese Herbal Medicine in conjunction with chemotherapy notonly raised the efficacy of the chemotherapeutic drug, but also reduced the toxic side-effects. The aim of this research was to carry out a comparative in vitro study of the anti-tumour effect of the Chinese , South African and Turkish apricot (Xing ren / Armeniacea Semen) and Chinese and South African peach (Tao ren / Persica Semen) kernel extracts on the HT-29 colon cancer cell line.All the extracts significantly reduced cell viability and inhibited proliferation in the HT-29 cancer cells after 24 hours with the lipophilic and total fractions of CAK being the most effective. After 72 hours, it is clear that the inhibitory effects have been abolished and replaced by a stimulatory effect as the cell viability is higher in the treated cultures than the untreated controls. Results show that the total and the hydrophilic fractions of all the kernels increased cell viability more than the lipophilic fractions. It cannot be said with certainty that it was the amygdalin metabolite cyanide that affected the cell viability or induced apoptosis on its own. If hydrolysis of amygdalin indeed happened and cyanide was produced, it would affect the cells by shutting down aerobic respiration. Since cancer cells have more β- glucosidases and less rhodanese than normal cells, it is a possibility that the HT-29 cancer cells had some rhodanese to convert cyanide into a relatively harmless compound thiocyanate. It could be that in vitro this conversion, in light of the low enzyme levels in the HT-29 cancer cells, happened slowly and that the effect was only seen after 48 hour. However, this does not explain the overall inhibition even by the lipophilic fractions that should not contain any amygdalin or the eventual stimulatory effect, observed from 48 hour onwards.The S phase block observed, was mostly seen after 24 hour exposure to organic extractions, with the SAK showing 86% of cells in the S phase in contrast to the aqueous extractions which only slightly increased the S phase fraction. This could indicate that synergistic and/or additive effects between polyphenolic compounds may also be responsible for the reduction of cell viability, proliferation and apoptosis. All the kernels and the various fractions affected cell viability and to an extent cell cycle progression, but more studies is needed to establish the most effective kernel and specific fraction or signature active component. Inhibition of cell viability and proliferation and the induction of apoptosis could be an important preventive approach in chemoprevention. Understanding how dietary components regulate proliferation and cell survival could play a critical role in development of new enriched agents that can prevent and treat cancer with reduced risk of toxicity.

Philosophiae Doctor - PhD / The aim of this study was to determine whether dietary fats constituting specific ω-6/ω-3 fatty acids (FA) ratio has chemopreventive modulating effects on the development of colon cancer. Western diets intake of saturated FA (SATS) and ω-6 polyunsaturated FA (PUFA) are very high relative to low ω-3 PUFA consumption. This high ω-6 and low ω-3 FA intake, resulting in a high ω-6/ω-3 FA ratio, appears to have a promoting effect on disease outcome, whilst increased ω-3 FA intake exhibiting anti-cancer effects. An animal cancer model was employed to evaluate the effects of dietary fat ratios on chemically induced carcinogenesis during cancer promotion. This was to determine whether the FA diets have a promoting or inhibitory effect on early neoplastic lesions by quantifying aberrant crypt foci (ACF) development and monitoring the crypt cells proliferative and apoptotic indices. The expressions of genes associated with changes in cells redox balance were also assessed. Common dietary fats were combined to produce the dietary fat ratios: sunflower oil (S), borage oil (B) and fish oil (F). Combinations of these oils generated the different ω-6/ω-3 FA ratios: SB (ω-6/ω-3: 38:1), SF (ω-6/ω-3: 13:1) and SBF (10:1). To represent the Western diet's high ω-6/ω-3 FA ratio profile, S (ω-6/ω-3: 501: 1) was used as a control, and canola oil and olive oil as additional reference. The dietary fats had no toxic effects on the liver and kidney based on serum clinical biochemical measurements. Diets containing borage oil (SB and SBF diets), canola and olive oil decreased (p<0.05) the crypt multiplicity of large (≥7 crypts/focus) ACF, exhibiting anti-cancer effects by decreasing (p<0.05) the proliferative activity of the rat colon crypts. Borage oil's protective effect resulted from the enhanced supply of C18:3ω-6 that has anti-inflammatory and anti-proliferative properties. The observed decrease (p<0.05) in apoptosis in the ACF was also facilitated by the up- and down-regulation of DNA repair and DNA replication associated genes, Xpa and Ercc2 by borage oil, respectively. Canola oil and olive had the largest inhibitory effect on suppressing crypt multiplicity by reducing (p<0.05) proliferation in the colon. Both oils effected the up-regulation (p<0.05) of the expression of several oxidative stress and anti-oxidant defence genes mediating the regulation of cell proliferation. The increased supply of C18:1ω-9 (canola and olive) and total polyphenolic content (olive) protected cells against oxidative stress induced apoptosis, which provided interesting interactive effects between FA and polyphenolic oil constituents that should be further elucidated. In contrast, the fish oil containing (SF diet) and the control sunflower (S diet) increased (p<0.05) the total ACF and colon crypt multiplicity (≥7 crypts/focus) when compared to the SB, SBF, olive oil and canola oil diets. An increased resistance to oxidative stress induced apoptosis appears to facilitate fish oil’s enhancing effect on crypt multiplicity despite the increased supply of LC ω-3 FA, which are prone to oxidation and leads to increased oxidative stress. This protective effect on crypt multiplicity and ACF development was mainly due to enhanced cellular antioxidant and DNA repair responses through the up-regulation (p<0.05) of Gpx4 and Nudt1, which favoured the increase (p<0.05) of crypt cells proliferation.The in vitro study demonstrated that oil ratio emulsions (S: ω-6/ω-3 = 249:1; SB: ω-6/ω-3 = 28:1; SF: ω-6/ω-3 = 12:1 and SBF: ω-6/ω-3 = 12:1) had differential effects on the survival indices of HT-29 and Caco-2 colon cancer cells. Contrary to the in vivo model, fish oil (SF and SBF emulsions) significantly (p<0.05) reduced the viability and proliferation of both cell lines, with the HT-29 cells showing greater sensitivity to the oil’s anti-proliferative effect. The HT-29 cells exposure to increased levels of C20:5ω-3 and C22:6ω-3 predisposes it to lipid peroxidation that increases the potential for cell removal via apoptosis. However, apoptotic effects were absent due to the HT-29 cells removal via necrosis as the cells energy status (ATP production) was significantly (p<0.05) depleted. Similar to the animal cancer model, borage oil (SB and SBF emulsions) had a reducing (p<0.05) effect on cell proliferation in both cell lines. However, as ATP was decreased (p<0.05), the S, SF and SBF emulsions resulted in an increased (p<0.05) apoptotic response in the Caco-2 cells in a dose dependent manner. This response resulted from the altered FA and lipid composition effected by the oil emulsions. Increased (p<0.05) incorporation of C20:5ω-3 and C22:6ω-3 in membrane phospholipid, phosphatidylethanolamine (PE), resulted in a significant decrease (p<0.05) in total SATS and MUFA content. A decrease (p<0.05) in membranes ω-6/ω-3 FA ratio was noted as well. This effect seems to selectively favour the induction of apoptosis by borage oil (SB and SBF). Similarly, an increase (p<0.05) in the PC/PE ratio by all oil emulsions, and a decrease (S and SB) and increase (SF and SBF) (p<0.05) in the chol/PL ratio appears to facilitate apoptosis too. A different threshold of the FA and lipid composition parameters elicits the inhibition of cell proliferation utilising lower oil emulsion concentrations. Therefore, the dietary supply of fats characterised by a defined low ω-6/ω-3 FA ratio can selectively modulate the growth indices of colon cancer. Specific oil ratio combinations by incorporating borage oil and fish oil hereby provide a selective strategy for chemoprevention in the colon, although underlying interactions and threshold effects of specific FA seems to prevail that should be further unravelled. / Medical Research Council (MRC) and Cancer Association of South Africa (CANSA)