O megacólon chagásico pode acometer até 10% dos pacientes na fase crônica da doença e o principal sintoma é a constipação intestinal que pode variar de dias a meses. Vários aspectos da fisiopatologia do megacólon não são bem compreendidos. O objetivo deste trabalho foi avaliar o tempo de trânsito colônico com marcadores radiopacos em portadores de megacólon chagásico com constipação intestinal crônica acima de oito dias. Foram estudados 64 pacientes (36 mulheres e 28 homens), idade variando de 32 a 76 anos, com história clínica de constipação intestinal crônica, diagnóstico radiológico por enema opaco de megacólon e com provas sorológicas positivas para doença de Chagas. Foi considerado como megacólon quando o diâmetro do cólon era maior ou igual 6,5 cm. Para avaliar o tempo de trânsito colônico, cada paciente ingeriu uma cápsula contendo 24 marcadores em forma de anéis radiopacos (Sitzmarks, Consil Pharmaceutics, Fort Worth, EEUU), e realizadas radiografias simples de abdome (ortostase) após três e cinco dias. Um grupo de 20 pacientes, sem constipação e com sorologia negativa para doença de Chagas, foi avaliado pela mesma metodologia e considerado como controle. A interpretação da localização e contagem dos marcadores foi realizada dividindo-se o intestino grosso nos segmentos: cólon direito, cólon esquerdo e retossigmóide. Empregou-se o teste de Kolmogorov-Smirnov para comparação do número de marcadores colônicos entre si e no 3o e 5o dias. O número de marcadores em cada grupo, em períodos distintos, foi avaliado com o teste de Wilcoxon. O coeficiente de correlação de Pearson foi utilizado para se avaliar a influência dos fatores externos (sexo, idade, tempo do início dos sintomas em anos, dias de constipação e presença de megarreto). O tempo de início dos sintomas variou de um a 33 anos e a duração da constipação, em dias, variou de oito a 90 dias. O megarreto ocorreu em 68,8% dos pacientes. Não se observou diferença, com significado estatístico, na quantidade total de marcadores retidos no 3o e 5o dias do exame entre os pacientes de ambos os sexos com e sem megarreto. A quantidade de marcadores, em cada segmento, colônico mostrou diferença estatística. Estes marcadores apresentaram uma distribuição em forma de um gradiente, crescendo de proximal para distal tanto no 3o quanto no 5o dia. Ocorreu uma progressão dos marcadores em direção ao ânus com um acúmulo no retossigmóide com diferença estatística do 3o para o 5o dia. Conclusões: houve retenção quase total dos marcadores até o 5o dia com predomínio no cólon esquerdo e no retossigmóide, sendo maior no retossigmóide; não houve diferença estatisticamente significante na retenção total dos marcadores entre o 3o e o 5o dia de exame; os fatores: idade, sexo, início dos sintomas, dias de constipação e megarreto não interferiram na quantidade e localização dos marcadores; os segmentos colônicos direito e esquerdo apresentaram trânsito lento, tendo ocorrido estase dos marcadores no retossigmóide / Chagasic megacolon may be present in up to 10% of infected people during chronic phase of the disease. Long lasting constipation of a few days up to months is the main complaint. Phisiopathology of megacolon is not completely understood as well as the predominant dilatation of sigmoid colon. This study addressed the colonic transit time (CTT) in patients with acquired megacolon with chronic constipation grater then 8 days. Study group consisted of 64 patients (36 women and 28 men); age ranged from 32 to 76 years. All patients had clinical history of constipation, barium enema showing megacolon (colon diameter ³ 6,5 cm) and positive serological tests for Chagas disease. CTT was evaluated by oral administration of a capsule with 24 ring-shaped radiopaque markers (Sitzmarks, Consil Pharmaceutics, Fort Worth, USA) and plain abdominal X-Rays were taken in the 3rd and 5th days post capsule ingestion. Twenty patients with no colorectal complaint and negative serology for Chagas disease were submitted to the same CTT exam as a control group. Results of number and position of radiopaque markers were evaluated according to large bowel segments: right colon, left colon and rectosigmoid colon. Kolmogorov-Smirnov test was used to compare the number of markers by segments in the 3rd and 5th days and Wilcoxon test to compare groups by the number of markers. Pearson correlating test was applied to analyze variables as sex, age, symptoms onset (years), period of constipation (days) and megarectum association. Onset of symptoms ranged from 1 to 33 years while constipation varied from 8 to 90 days. There was not difference between the number of retained colonic markers in the 3rd and 5th days post administration. The number of markers in each colonic segment had significant difference statistically in the 3rd and 5th days with greater numbers from proximal to distal colon. Such distribution assumed an aspect of a gradient and some radiopaque markers moved towards rectosigmoid colon from 3rd to 5th days with difference statistically significant. Conclusions: majority of radiopaque markers was retained up to 5th day in the left and rectosigmoid colon with greater accumulation in the rectosigmoid; sex, age, symptoms onset (years), period of constipation (days) and megarectum association had not influenced the number and position of retained markers; right an left colons showed slow transit while rectosigmoid showed fecal stasis

All cells are equipped to sense changes in their environment and make adaptive responses according to the stimuli. Signal recognition usually occurs at the cell membrane (with the exception of steroid signalling) where the ligand, which can be a small molecule, a peptide or a protein, binds its cognate receptor. This results in a change in the conformation of the receptor which in turn can regulate the production of second messengers. Second messengers can now modulate specific pathways which control gene expression and modify various aspects of cell behaviour. The signalling cascade is terminated by the removal of second messenger and/or by desensitisation of the receptor to the extracellular signal. Cyclic guanosine monophosphate (cGMP) was first identified in the rat urine and since then has emerged as an important second messenger regulating diverse cell processes. Subsequent to its discovery in mammalian cells, enzymes responsible for its synthesis (guanylyl cyclases), hydrolysis (phosphodiesterases) and its most common effectors (cGMP-dependent protein kinases) were identified. Guanylyl cyclases exist in two forms, cytosolic and membrane bound. Both have a conserved guanylyl cyclase domain, but differ in their choice of ligands, overall structure and tissue localization. It is now known that cytosolic and the membrane-bound forms are involved in eliciting distinct cellular responses. Receptor guanylyl cyclase C (GC-C) was identified as the target for a family of heat-stable enterotoxin toxins (ST) produced by enterotoxigenic E.coli. Stable toxin-mediated diarrhoeas are observed frequently in infants and contribute significantly to the incidence of Travellers’ Diarrhea. Early studies demonstrated that the effects of ST were mediated by an increase in intracellular cGMP levels in intestinal cells, and the receptor for ST was almost exclusively expressed in the apical microvilli of the intestinal brush-border epithelia. Effectors of cGMP in intestinal cells include protein kinase G (PKG), cyclic nucleotide gated ion channel 3 (CNG), and the cystic fibrosis transmembrane conductance regulator (CFTR). ST is an exogenous ligand which serves as a hyperagonist for GC-C, in comparison with the endogenous ligands guanylin and uroguanylin, which maintain fluid-ion homeostasis in the intestinal epithelia. The GC-C/cGMP signal transduction pathway also modulates intestinal cell proliferation along the crypt-villus axis by exerting a cytostatic effect on the epithelial cells, thereby regulating their turnover and neoplastic transformation. The current study describes in molecular detail two signalling pathways, one impinging on and one emerging from GC-C, which regulate colonic cell proliferation. The first part identifies the cross-talk and cross-regulation of GC-C and c-src. The second part delves into the molecular basis of GC-C/cGMP-mediated cytostasis and its effect on colonic tumorigenesis. Cross-talk between signalling pathways is believed to play a key role in regulating cell physiology. Phosphorylation of signalling molecules by protein kinases is frequently used as a means of achieving this cross-regulation. Aberrant hyperactivation of the c-src tyrosine kinase is an early event in the progression of colorectal cancer, and activated c-src specifically phosphorylates a number of proteins in the cell. It was found that c-src can phosphorylate GC-C in T84 colorectal carcinoma cells, as well as in the rat intestinal epithelia. Tyrosine phosphorylation of GC-C resulted in attenuation of ligand-mediated cGMP production; an effect which was reversed by chemical or transcriptional knockdown of c-src. These effects were found to be cell line-independent and relied only on the extent of c-src expression and activation in the cell. Mutational analysis revealed GC-C to be phosphorylated on a conserved tyrosine residue (Y820) in the guanylyl cyclase domain. The sequence of GC-C around Y820 allowed for efficient phosphorylation by c-src, and indeed, kinase assays indicated that the affinity of c-src for the GC-C Y820 peptide was one of the highest reported till date. A phospho-mimetic mutation at this site, which mimics a constitutively phosphorylated receptor, resulted in a sharp reduction of guanylyl cyclase activity of the receptor, reiterating the inhibitory role of Y820 phosphorylation on GC-C activity. Phosphorylation of GC-C at Y820 generated a docking site for the SH2 domain of c-src which could interact and thereby co-localize with GC-C on the cell membrane. Intriguingly, this interaction resulted in activation of c-src, setting-up a feed-forward loop of inhibitory GC-C phosphorylation and c-src activation. Treatment of colorectal carcinoma cells with ligands for GC-C reduces cell proliferation and inhibits tumorigenesis. It was observed that this cytostatic effect can be modulated by the status of c-src activation, and consequently, the fraction of tyrosine phosphorylated GC-C in these cells. Since activation of c-src is a frequent event in intestinal neoplasia, phosphorylation of GC-C by active c-src may be one of the means by which the cytostatic effects of GC-C agonists (guanylin and uroguanylin) in the intestine are bypassed, thereby leading to cancer progression. Colonisation of the gut with enteropathogenic microorganisms induces secretion of IFNγ from the host mucosal immune system, which subsequently activates c-src in intestinal epithelial cells. Ligand-stimulated activity of GC-C was found to be reduced in IFNγ treated cells. This could be one of the host defence mechanisms initiated in response to enterotoxigenic E. coli infection. These results provide the first evidence of cross-talk between a receptor guanylyl cyclase and a tyrosine kinase that results in heterologous desensitisation of the receptor. Populations with a higher incidence of enterotoxigenic E.coli infections appear to be protected from intestinal neoplasia. It was found that mice lacking GC-C, and therefore unable to respond to ST, displayed an increased cell proliferation in colonic crypts and enhanced carcinogen-induced aberrant crypt foci formation, which is a surrogate marker for colorectal carcinogenesis. However, pharmacological elevation of cGMP was able to efficiently induce cytostasis even in GC-C knockout mice, indicating a key role for cGMP in regulating colonic cell proliferation. Through microarray analyses, genes regulated by ST-induced GC-C activation in T84 colorectal carcinoma cells were identified. Genes involved in a number of cellular pathways were differentially expressed, including those involved in signal transduction, protein and solute secretion, transcriptional regulation and extracellular matrix formation. One of the genes found to be significantly up-regulated was the cell-cycle inhibitor, p21. The increase in p21 expression was validated at both the transcript and protein level. This p53-independent up-regulation of p21 was coupled to the activation of the cGMP-responsive kinase, PKGII, since knockdown of PKGII using specific siRNAs abolished ST-induced p21 induction. Activation of PKGII led to phosphorylation and activation of the stress responsive p38 MAPK. Similar to what was seen following knockdown of PKGII, inhibition of p38 MAPK activity attenuated the up-regulation of p21 in response to cGMP, indicating that PKGII and p38 MAPK could be a part of a pathway regulating p21 expression. It was found that active p38 MAPK phosphorylated the ubiquitous transcription factor SP1, enhancing its occupancy at the proximal p21 promoter. Therefore, SP1 could be one of the factors linking cGMP to transcription of the p21 mRNA. Chronic activation of GC-C led to nuclear accumulation of p21 in colonic cells, which entered a quiescent state. These cells arrested in the G1 phase of the cell cycle, consequent to p21-dependent inhibition of the G1 cyclin-CDK complexes. A fraction of these quiescent cells stochastically initiated a cGMP-dependent senescence programme and displayed all the hallmarks of senescent cells, including flattened cell morphology, expression of SA- galactosidase and formation of senescence-associated heterochromatic foci. Activation of senescence and loss of tumorigenicity in these cells was crucially dependent on the up-regulation of p21. This irreversible exit from the cell cycle due to cGMP-mediated activation of the PKGII/p38/p21 axis was well correlated with reduced colonic polyp formation in mice exposed to ST. In summary, these observations may provide a possible explanation for the low incidence of colorectal carcinoma seen in countries with a high incidence of ST-mediated diarrhoea. Interestingly, c-src mediated tyrosine phosphorylation of GC-C prevented p21 accumulation following ligand application. The findings described in this thesis may have important implications in understanding the molecular mechanisms involved in the progression and treatment of colorectal cancer.

Les douleurs abdominales, reflet d’une hypersensibilité viscérale (HSV), sont l’un des premiers motifs de consultation en médecine générale et en gastro-entérologie. Ces douleurs abdominales, généralement passagères, peuvent également être causées par des pathologies sous-jacentes plus graves. Parmi ces maladies sont retrouvés notamment le Syndrome de l’Intestin Irritable (SII), et les Maladies Inflammatoires Chroniques de l’Intestin (MICI) qui regroupent la maladie de Crohn (MC) et la RectoColite Hémorragique (RCH).Bien que le SII et les MICI diffèrent sur de nombreux points, des facteurs communs à ces deux pathologies peuvent contribuer au symptôme majeur de ces maladies, à savoir la douleur abdominale. En effet, les facteurs environnementaux (alimentation, stress, etc.) prennent une part importante dans l’étiologie du SII, mais il s’avère aujourd’hui qu’ils participent également à l’aggravation des symptômes associés aux MICI. De même, si de nombreux polymorphismes génétiques et l’atteinte inflammatoire sont les bases de la physiopathologie des MICI, des études récentes montrent que de telles modifications peuvent également être retrouvées au cours du développement du SII (identification de gène de susceptibilité et présence de micro-inflammation). Enfin, les récentes études menées sur le microbiote intestinal mettent en évidence des perturbations de celui-ci aussi bien chez des patients atteints du SII que de MICI.Les MICI se caractérisent par des phases d’inflammation sévère au niveau du tube digestif, pour lesquelles la pharmacopée actuelle, qui consiste à réduire cette inflammation, est plutôt satisfaisante. Ces phases sont entrecoupées par des phases dites « de rémission », durant lesquels l’HSV reste un problème chez un grand nombre de patients (environ 38%). Ces douleurs abdominales, diffuses et irradiantes, peuvent être assimilées à celles retrouvées chez les patients atteints du SII (symptômes SII-like). La prise en charge thérapeutique de ces douleurs est limitée, puisque basée sur d’anciens médicaments qui présentent un ratio bénéfice/ risque faible.Les antiépileptiques, sont des molécules qui ciblent l’excitabilité neuronale en modulant l’activité des canaux ioniques, de récepteurs ou encore de voies de signalisation intracellulaires. Parmi ces molécules, la gabapentine (GBP) et la prégabaline (PGB) (regroupées sous le terme de gabapentinoïdes) sont des ligands des sous-unités α2δ des canaux calciques voltage-dépendants (CCVD). Ces ligands α2δ sont actuellement prescrits dans le cadre de douleurs neuropathiques, au même titre que les antidépresseurs, qui sont également utilisés pour le traitement de l’HSV. / Abdominal pain, which can reflect visceral hypersensitivity (VHS), is one of the primary reasons for consultations in general medicine and gastroenterology. These abdominal pain, usually transient, can also be caused by more serious underlying pathologic conditions, such as irritable bowel syndrome (IBS) and chronic inflammatory bowel disease (IBD), which include Crohn's disease (CD) and ulcerative colitis (UC).Although IBS and IBD differ on many points, common factors to these two conditions may contribute to the major symptoms of these intestinal disorders, the abdominal pain. Indeed, environmental factors (diet, stress) play an important part in the etiology of IBS, but it turns out today that they are also involved in the worsening of symptoms associated with IBD. Similarly, if many genetic polymorphisms and inflammatory disorders are the basis of the IBD pathogenesis, recent studies show that such changes can also be found in the development of IBS (identification of susceptibility gene and the presence of micro-inflammation). Finally, recent studies on intestinal microbiota reveal some disturbances, called dysbiosis, as well in IBS or IBD patients.Inflammatory bowel disease is characterized by short phases of severe intestinal inflammation, for which the current pharmacopoeia consisting of reducing this inflammation is rather satisfactory. These phases are interspersed with so-called "remission" phase, during which the VHS remains a problem for many patients (about 38%). These abdominal, diffuse and radiating pain can be similar to the one observed in IBS patients. The therapeutic management of this pain is limited, as it is based on old drugs that are of low benefit / risk ratio.Antiepileptics are molecules that target neuronal excitability by modulating the activity of ion channels, receptors or intracellular signaling pathways. Among these molecules, gabapentin (GBP) and pregabalin (PGB) (grouped under the term gabapentinoids) are ligands of the α2δ subunit for voltage gated calcium channel (VGCC). These α2δ ligands are currently prescribed for neuropathic pain, as well as antidepressants, which are also used for the treatment of VHS.About visceral pain, current data only relate to the treatment of VHS associated with IBS. Two clinical studies show a profit of GBP or PGB on symptoms associated with IBS. These data have also been found in preclinical animal models of various non-inflammatory VHS. In addition, the analgesic effects of these molecules is been highlighted on somatic inflammatory pain models, but no study is looking into the potential beneficial effect of these ligands on models of inflammatory visceral pain or in patients with IBD.

No description available.

<p>UVOD: Karcinom kolona (KK) je velik javnozdravstveni problem usled visoke incidence i stope mortaliteta. Kod KK je stadijum bolesti najvažniji pojedinačni nezavisni faktor prognoze. U prisustvu nepovoljnih prognostičkih parametara, u koje spadaju visok histolo&scaron;ki gradus, ileus, limfo-vaskularna i perineuralna invazija, nakon potencijalno kurativne operacije se kod pacijenata u stadijumu II indikuje primena adjuvantne hemioterapije koja ima pozitivan uticaj na ukupno preživljavanje i na produženje perioda bez bolesti. Međutim, relapsi bolesti nastaju kod nekih bolesnika bez negativnih prognostičkih faktora, &scaron;to ukazuje na moguće postojanje drugih tkivnih faktora lo&scaron;e prognoze. U novije vreme se sve veća pažnja posvećuje fenomenu tumorskog pupljenja koje predstavlja pojavu tumorskih pupoljaka (TP), odnosno oligocelularnih grupa tumorskih ćelija koje se na invazivnom frontu tumora odvajaju od glavne tumorske mase. Ove tumorske ćelije poprimaju fenotip mezenhimnih ćelija i stiču sposobnost ameboidnog kretanja kroz ekstracelularni matriks, uz pomoć citoplazmatskih podija koje se na dvodimenzionalnim histolo&scaron;kim rezovima vizualizuju kao citoplazmatski pseudofragmenti (CPF). Značaj gustine TP i CPF je jo&scaron; uvek nedovoljno ispitan, ali postoje indicije da se radi o moćnom prediktoru biolo&scaron;kog pona&scaron;anja tumora. CILJ: Cilj je bio da se ispita zavisnost dužine perioda bez relapsa, veličine primarnog tumora, gustine peritumorske limfocitne infiltracije i konfiguracije tumorske margine od gustine TP i CPF kod bolesnika sa KK u stadijumu II. METODOLOGIJA: Istraživanjem je obuhvaćeno 114 bolesnika operisanih od KK u stadijumu II na Institutu za onkologiju Vojvodine, bez nepovoljnih prognostičkih faktora i bez indikacija za primenu adjuvantne hemioterapije. Mikroskopskom analizom rutinskih histolo&scaron;kih i imunohistohemijskih preparata utvrđivana je gustina TP i CPF, koja je zatim korelirana sa vremenom pojave relapsa, veličinom primarnog tumora, gustinom peritumorske limfocitne infiltracije i konfiguracijom tumorske margine. REZULTATI: Velika gustina TP i/ili CPF nađena je kod 45 tumora (39,5%). U ovoj grupi se relaps dogodio kod 26 bolesnika (57,8%). U grupi bolesnika sa malom gustinom TP/CPF relaps je registrovan u 4 slučaja (5,8%). Poređenje krivih preživljavanja pokazalo je da je verovatnoća relapsa značajno veća ako se u tumoru nalazi velika gustina TP/CPF (p&lt;0,0001). Tumori sa velikom gustinom TP/CPF su imali najveći prečnik koji je varirao u rasponu od 25 do 100 mm, dok su tumori sa malom gustinom TP/CPF bili najvećeg prečnika od 20 do 110 mm (p=0,6744). Intenzitet peritumorskog limfoidnog odgovora je bio velik kod 13 tumora sa velikom gustinom TP/CPF (28,9%) i kod 17 tumora sa malom gustinom TP/CPF (24,6%), p=0,7747. Konfiguracija tumorske margine je bila infiltrativna u svim tumorima sa velikom gustinom TP/CPF, kao i kod 42 tumora sa malom gustinom TP/CPF (60,9%). ZAKLJUČAK: Velika gustina TP/CPF je nezavisan tkivni indikator lo&scaron;e prognoze kod bolesnika sa KK u stadijumu II, koji je ne korelira ni sa veličinom primarnog tumora ni sa intenzitetom peritumorskog limfoidnog odgovora. Velika gustina TP/CPF nije kompatibilna sa ekspanzivnom konfiguracijom tumorske margine, ali infiltrativna konfiguracija tumorske margine nije prediktor velike gustine TP/CPF.</p> / <p>INTRODUCTION: Colonic carcinoma (CC) is a serious public health problem due to its high incidence and mortality rate. Stage is the single most important independent prognosticator in patients with CC. In the presence of indicators of poor prognosis, including high histologic grade, ileus, lympho-vascular invasion and perineural invasion, there is a need for adjuvant chemotherapy after a potentially curative operation in patients with stage II CC, because the therapy improves both overall survival and disease-free survival. However, some patients with no documented poor prognostic factors suffer recurrences, which indicates that there may be some other tissue features that confer poor prognosis. In the recent publications there is an increasing interest in the phenomenon of tumor budding, a term assigned to the presence of small groups of discohesive tumor cells at the invasive front of the tumor &ndash; tumor buds (TB&#39;s). These cells acquire mesenchymal phenotype and gain the ability to migrate through the extracellular matrix by means of cytoplasmic extrusions which are visible on the two-dimensional immunohistologic sections and are called cytoplasmic pseudofragments (CPF&#39;s). Significance of density of TB&#39;s and CPF&#39;s is still to be evaluated, but the pool of evidence suggests that this is a powerful predictor of biologic behaviour of CC. AIM: The aim of this study was to determine the influence of density of TB&#39;s and CPF&#39;s on the risk of recurrence in patients with stage II CC. This research also attempted to establish whether there is a correlation between the density of TB&#39;s and CPF&#39;s and several other morphologic features such as tumor diameter, peritumoral lymphocytic response and the configuration of the tumor margin. METHODS: 114 patients with stage II CC were enrolled in the study. All the patients received surgery at the Institute of Oncology in Sremska Kamenica and no patient had indication for adjuvant chemotherapy. Microscopic analysis of routine histologic and immunohistochemical slides was performed to establish the density of TB&#39;s and CPF&#39;s, to estimate the intensity of the peritumoral lymphocytic response and to determine the configuration of the tumor margin. RESULTS: High density of TB&#39;s and/or CPF&#39;s was found in 45 tumors (39.5%). In this group recurrence occured in 26 patients (57.8%). In the group of patients with low density of TB/CPF in the tumor tissue 4 patients relapsed (5.8%). Comparison of survival curves showed that the probability of recurrence was significantly greater if the density of TB/CPF&#39;s was high (p&lt;0.0001). Tumors with high density of TB/CPF&#39;s ranged from 25 to 100 mm in greatest diameter, while those with low density measured from 20 to 110 mm (p=0.6744). Intensity of peritumoral lymphocytic response was high in 13 tumors with high density of TB/CPF&#39;s (28.9%) and in 17 tumors with low density of TB/CPF&#39;s (24.6%), p=0.7747. All tumors with high density of TB/CPF&#39;s and 42 tumors with low density of TB/CPF&#39;s (60.9%) had infiltrative configuration of tumor margin. CONCLUSION: High density of TB/CPF&#39;s is an independent indicator of poor prognosis in patients with stage II CC and it correlates neither with tumor diameter nor with intensity of peritumoral lymphocytic response. High density of TB/CPF&#39;s is not compatible with the expansive configuration of tumor margin, but the infiltrative configuration of tumor margin is not a predictor of high density of TB/CPF&#39;s.</p>

<p>Karcinom debelog creva predstavlja treći uzrok smrnosti od maligniteta kod mu&scaron;karaca i drugi kod žena. Postoji osnovana sumnja da kancerske matične ćelije (KMĆ) imaju veliki značaj u karcinogenezi, invazivnosti, &scaron;irenju i rezistenciji na hemioterapiju primarnog tumora. Njihova identifikacija u primatnom kolorektalnom karcinomu (KRK) putem markera kancerskih matičnih ćelija bi selektovala visokorizičnu grupu bolesnika, omogućila ciljano delovanje na ove ćelije i veću &scaron;ansu za izlečenje. Cilj ovog istraživanja je bio utvrđivanje uticaja prisustva kancerskih matičnih ćelija u primarnom tumoru obolelih od karcinoma kolona na pojavu relapsa bolesti, dužino preživljavanja bez bolesti i sveukupno preživljavanje.&nbsp; Istraživanje je sprovedeno kao prospektivno&minus;retrospektivna randomizovana analitička studija na Klinici za operativnu onkologiju i Službi za patolo&scaron;ko &ndash; anatomsku i laboratorijsku dijagnostiku Instituta za onkologiju Vojvodine u Sremskoj Kamenici u periodu od 2016-2019. godine. U studiju su uključeno 112 bolesnica operisanih na Institutu za onkologiju Vojvodine u periodu od 2007-2012. godine sa patohistolo&scaron;ki potvrđenom dijagnozom primarnog, nemetastatskog (stadijumi I, II i III) KRK. Bolesnici su randomizovani u odnosu na pojavu recidiva bolesti i prisustvo metastaza u regionalnim limfnim čvorovima u odnosu 1:1. Uzorci tumorskog tkiva dobijeni hirur&scaron;kom resekcijom su nakon standardne patohistolo&scaron;ke obrade tretirani primenom monoklonskih antitela na CD44, CD166 i &alpha;-Lgr5. Određivani su prisustvo, intezitet i lokalizacija kancerskih matičnih ćelija (KMĆ) u primarnom tumoru i njihov uticaj na pojavu relapsa bolesti, dužinu preživljavanja bez bolesti i sveukupno preživljavanje u grupi svih bolesnika a potom bolesnika podeljenih prema stadijumu bolesti. Bolesnici u prvom i drugom stadijumu bolesti koji su imali relaps su imali statistički značajno veće prisustvo CD44+ KMĆ u primarnom tumoru. Kod ovih bolesnika je prisutan kraći period preživljavanja bez bolesti kao i kraće sveukupno preživljavanje. Takođe, uočen je statistički značajan uticaj koekspresije CD44/CD166 u KMĆ na pojavu relapsa bolesti, dužinu preživljavanja bez bolesti i sveukupno preživljavanje kod bolesnika u prvom i drugom stadijumu bolesti. Nije uočena statistička značajnost prisustva KMĆ u primarnom tumoru na pojavu relapsa bolesti, dužinu preživljavanja bez bolesti i sveukupno preživljavanje kod bolesnika u trećem stadijumu bolesti. Prisustvo CD166 i &alpha;-Lgr5 obojenih KMĆ nije pokazalo statističku značajnost u pogledu pojave relapsa bolesti, dužine preživljavanja bez bolesti i sveukupnog preživljavanja, kako u grupi svih bolesnika tako i prilikom podele bolesnika na stadijume bolesti.</p> / <p>Colon cancer is the third most common case of death of malignancy in the world. There is justified theory that cancer stemm cells have significant impact on colon cancer tumorogenesis, invasiviness, spread and resistancy on chemotherapy. Identification of colon cancer stem cells in primary tumor by various biological markers would lead to identification of high risk group of patients, target therapy of colon cancer an higher chance to cure. Aim of this study was to determine wether presence of colon cancer stem cells in primary tumour have impact on recurrence, disease free survival (DFS) and overall survival (OS) in patients with colorectal cancer. An randomized, analytical prospective-retrospective study was performed on Clinic for Operative Oncology and Department for Anatomical Pathology of Oncology Institute of Vojvodina in Sremska Kamenica in period of 2016&minus;2019. Study included 112 patient with patohistological proven, non metastatic colon adenocarcinoma who were operated on Oncology Institute of Vojvodina in period of 2007-2012. Patients were randomized by recurrence and presence of metastatic lymph nodes by 1:1 ratio. After standard patohistological preparation, tumour specimens were stained for monoclonal CD44, CD166 and &alpha;-Lgr5 antibody. Presence, intensity of expression and localization of colon cancer stem cells were observed and their impact on relapse, disease free survival and overall survival in group of all patients as well as in groups divided by stages of the disease. We demonstrate that patients in Stage I and II of the disease who experience disease recurrence have statistically significant higher expression of CD44+ in primary tumor specimen. They also have shorter DFS and OS. Coexpression of CD44/CD166 antibody also have strong negative impact on recurrence, disease free survival and overall survival in Stage I and II patients. There is no correlation between presence of colon cancer stem cells and recurrence nor presence of colon cancer stem cells had impact on disease free survival and overall survival. Presence of CD166 and &alpha;-Lgr5 expression did not show significant impact on recurrence nor disease free survival and overall survival as in group of all patients as well in group of patients divided by stages of the disease. High expression of CD44+ and coexpression of CD44/CD166+ colon cancer stem cell markers in primary tumor specimen correlates with higher chance for disease recurrence and also leads to shorter DFS and OS.</p>

No / The orally active microtubule-disrupting agent (S)-1-ethyl-3-(2-methoxy-4-(5-methyl-4-((1-(pyridin-3-yl)butyl)amino)pyrimidin-2- yl)phenyl)urea (CYT997), reported previously by us (Bioorg Med Chem Lett 19:4639-4642, 2009; Mol Cancer Ther 8:3036-3045, 2009), is potently cytotoxic to a variety of cancer cell lines in vitro and shows antitumor activity in vivo. In addition to its cytotoxic activity, CYT997 possesses antivascular effects on tumor vasculature. To further characterize the vascular disrupting activity of CYT997 in terms of dose and temporal effects, we studied the activity of the compound on endothelial cells in vitro and on tumor blood flow in vivo by using a variety of techniques. In vitro, CYT997 is shown to potently inhibit the proliferation of vascular endothelial growth factor-stimulated human umbilical vein endothelial cells (IC(50) 3.7 +/- 1.8 nM) and cause significant morphological changes at 100 nM, including membrane blebbing. Using the method of corrosion casting visualized with scanning electron microscopy, a single dose of CYT997 (7.5 mg/kg i.p.) in a metastatic cancer model was shown to cause destruction of tumor microvasculature in metastatic lesions. Furthermore, repeat dosing of CYT997 at 10 mg/kg and above (intraperitoneally, b.i.d.) was shown to effectively inhibit development of liver metastases. The time and dose dependence of the antivascular effects were studied in a DLD-1 colon adenocarcinoma xenograft model using the fluorescent dye Hoechst 33342. CYT997 demonstrated rapid and dose-dependent vascular shutdown, which persists for more than 24 h after a single oral dose. Together, the data demonstrate that CYT997 possesses potent antivascular activity and support continuing development of this promising compound.

No / PURPOSE: Cytochrome P450 2W1 (CYP2W1) is a monooxygenase detected in 30% of colon cancers, whereas its expression in nontransformed adult tissues is absent, rendering it a tumor-specific drug target for development of novel colon cancer chemotherapy. Previously, we have identified duocarmycin synthetic derivatives as CYP2W1 substrates. In this study, we investigated whether two of these compounds, ICT2705 and ICT2706, could be activated by CYP2W1 into potent antitumor agents. EXPERIMENTAL DESIGN: The cytotoxic activity of ICT2705 and ICT2706 in vitro was tested in colon cancer cell lines expressing CYP2W1, and in vivo studies with ICT2706 were conducted on severe combined immunodeficient mice bearing CYP2W1-positive colon cancer xenografts. RESULTS: Cells expressing CYP2W1 suffer rapid loss of viability following treatment with ICT2705 and ICT2706, whereas the CYP2W1-positive human colon cancer xenografts display arrested growth in the mice treated with ICT2706. The specific cytotoxic metabolite generated by CYP2W1 metabolism of ICT2706 was identified in vitro. The cytotoxic events were accompanied by an accumulation of phosphorylated H2A.X histone, indicating DNA damage as a mechanism for cancer cell toxicity. This cytotoxic effect is most likely propagated by a bystander killing mechanism shown in colon cancer cells. Pharmacokinetic analysis of ICT2706 in mice identified higher concentration of the compound in tumor than in plasma, indicating preferential accumulation of drug in the target tissue. CONCLUSION: Our findings suggest a novel approach for treatment of colon cancer that uses a locoregional activation of systemically inactive prodrug by the tumor-specific activator enzyme CYP2W1.

Tesis por compendio / [ES] El mercado de bebidas vegetales está experimentando un crecimiento constante debido a la creciente demanda de productos de origen vegetal. Dentro de este mercado, la bebida de almendra, perteneciente al grupo de las oleaginosas, destaca por su alto contenido en nutrientes, compuestos fenólicos y sus propiedades antioxidantes. Por otra parte, la generación masiva de residuos y subproductos por parte de la industria alimentaria representa uno de los mayores desafíos a nivel global. De acuerdo con la Comisión Europea, aproximadamente se desperdicia un 13% de la producción alimentaria mundial, equivalente a 366 millones de toneladas dentro de la Unión Europea. La industria alimentaria ha estado trabajando en la implementación de los Objetivos de Desarrollo Sostenible (ODS) adoptados por las Naciones Unidas en 2015, con especial atención en el ODS 12, que promueve la producción responsable y sostenible. Este objetivo busca prevenir el desperdicio de alimentos, revalorizar residuos y promover la economía circular como parte de la Agenda 2030. En este contexto, el objetivo general de la presente tesis fue estudiar las posibilidades de revalorización del subproducto resultante del proceso de obtención de la bebida vegetal de almendra. Determinar las propiedades fisicoquímicas, tecnológicas y funcionales de la materia prima. Evaluar el efecto de la deshidratación (secado con aire caliente y liofilización) sobre las propiedades fisicoquímicas, el contenido de componentes bioactivos, su bioaccesibilidad y su influencia sobre la microbiota. Finalmente, se consideró la posibilidad de obtener un producto deshidratado con probióticos. La consecución de este objetivo se abordó desde tres enfoques que se presentan en tres capítulos en los que se ha estructurado el apartado de resultados. En el primer capítulo se evaluó el impacto del secado por aire caliente a 60 °C y 70 °C y de la liofilización, sobre las propiedades tecno-funcionales del bagazo de almendra. Se analizaron las curvas de secado y las isotermas de sorción. Luego, se evaluó el efecto del almacenamiento a temperatura ambiente y en condiciones aceleradas de los polvos obtenidos por ambos métodos de secado; durante 6 meses, se monitoreó el crecimiento microbiológico, la acidez, el índice de peróxidos, la capacidad antioxidante y el contenido de polifenoles. Finalmente, se evaluó la idoneidad del polvo de bagazo de almendra como sustituto en la elaboración de productos de panadería, concretamente galletas. Tanto el secado por aire caliente como la liofilización resultaron ser operaciones adecuadas para estabilizar el bagazo de almendra. Ambos métodos de secado, combinados con un triturado adecuado, proporcionaron polvos con propiedades favorables para su uso en la industria alimentaria. En relación con la actividad antirradical, no se presentaron diferencias significativas entre las muestras deshidratadas, si bien el contenido en fenoles totales fue mayor en las muestras liofilizadas. En cuanto al almacenamiento durante 6 meses, al finalizar dicho periodo se observó un aumento en la capacidad antirradical, así como en el contenido de fenoles totales, especialmente notable en las muestras secadas por aire caliente y sometidas a almacenamiento acelerado. Los valores de acidez e índice de peróxido aumentaron considerablemente durante el almacenamiento acelerado, posiblemente debido a la descomposición de los ácidos grasos. Finalmente, se evaluó la idoneidad del polvo de bagazo de almendra como ingrediente sustitutivo en la elaboración de productos de panadería. Los resultados mostraron la idoneidad del subproducto para ser utilizado como sustituto de la harina de trigo en la elaboración de galletas ya que proporcionó un producto de textura adecuada con mayor contenido en fibra y componentes con capacidad antirradical. / [CA] El mercat de begudes vegetals està experimentant un creixement constant a causa de la demanda creixent de productes d'origen vegetal. Dins aquest mercat, la beguda d'ametlla, pertanyent al grup de les oleaginoses, destaca pel seu alt contingut en nutrients, compostos fenòlics i propietats antioxidants. D'altra banda, la generació massiva de residus i subproductes per part de la indústria alimentària representa un dels desafiaments més grans a nivell global. D'acord amb la Comissió Europea, aproximadament es desaprofita un 13% de la producció alimentària mundial, equivalent a 366 milions de tones dins de la Unió Europea. La indústria alimentària ha estat treballant en la implementació dels Objectius de Desenvolupament Sostenible (ODS) adoptats per les Nacions Unides el 2015, amb especial atenció a l'ODS 12, que promou la producció responsable i sostenible. Aquest objectiu cerca prevenir el malbaratament d'aliments, revalorar residus i promoure l'economia circular com a part de l'Agenda 2030. En aquest context, l'objectiu general de la present tesi va ser estudiar les possibilitats de revaloració del subproducte resultant del procés d'obtenció de la beguda vegetal d'ametlla. Determinar les propietats fisicoquímiques, tecnològiques i funcionals de la matèria primera. Avaluar l'efecte de la deshidratació (assecat amb aire calent i liofilització) sobre les propietats fisicoquímiques, el contingut de components bioactius, la bioaccessibilitat i la influència sobre la microbiota. Finalment, es va considerar la possibilitat d'obtenir un producte deshidratat amb probiòtics. La consecució d'aquest objectiu es va abordar des de tres enfocaments que es presenten en tres capítols en el que s'ha estructurat l'apartat de resultats. En el primer capítol es va avaluar l'impacte de l'assecat per aire calent a 60 °C i 70 °C, i de la liofilització, sobre les propietats tecno-funcionals del bagàs d'ametlla. Es van analitzar les corbes d'assecat i les isotermes de sorció. Després, es va avaluar l'efecte de l'emmagatzematge a temperatura ambient i en condicions accelerades de les pols obtingudes pels dos mètodes d'assecat; durant 6 mesos, es va monitoritzar el creixement microbiològic, l'acidesa, l'índex de peròxids, la capacitat antioxidant i el contingut de polifenols. Finalment, es va avaluar la idoneïtat de la pols de bagàs d'ametlla com a substitut en l'elaboració de productes enfornats, concretament galetes. Tant l'assecat per aire calent com la liofilització van resultar ser operacions adequades per estabilitzar el bagàs d'ametlla. Ambdós mètodes d'assecat, combinats amb un triturat adequat, van proporcionar pols amb propietats favorables per al seu ús a la indústria alimentària. En relació amb l'activitat antirradical, no es van presentar diferències significatives entre les mostres deshidratades, si bé el contingut en fenols totals va ser més gran en les mostres liofilitzades. En relació amb l'emmagatzematge durant 6 mesos, en finalitzar aquest període es va observar un augment en la capacitat antirradical, així com en el contingut de fenols totals, especialment notable a les mostres assecades per aire calent i sotmeses a emmagatzematge accelerat. Els valors d'acidesa i índex de peròxid van augmentar considerablement durant l'emmagatzematge accelerat, possiblement degut a la descomposició dels àcids grassos. Finalment, es va avaluar la idoneïtat de la pols de bagàs d'ametlla com a ingredient substitutiu en l'elaboració de productes enfornats. Els resultats van mostrar la idoneïtat del subproducte per ser utilitzat com a substitut de la farina de blat en l'elaboració de galetes ja que va proporcionar un producte de textura adequada amb més contingut en fibra i components amb capacitat antirradical. / [EN] The vegetable beverage market is experiencing steady growth due to the increasing demand for products of vegetable origin. Within this market, the almond beverage, which belongs to the oilseed group, stands out for its high content of nutrients, phenolic compounds and antioxidant properties. On the other hand, the massive generation of waste and by-products by the food industry represents one of the major global challenges. According to the European Commission, approximately 13% of the world's food production is wasted, equivalent to 366 million tonnes within the European Union. The food industry has been working on the implementation of the Sustainable Development Goals (SDGs) adopted by the United Nations in 2015, with a particular focus on SDG 12, which promotes responsible and sustainable production. This goal aims to prevent food waste, revalue waste and promote the circular economy as part of the 2030 Agenda. In this context, the general objective of this thesis was to study the possibilities of revaluing the by-product resulting from the process of obtaining almond plant-based beverage. To determine the physicochemical, technological and functional properties of the raw material. Evaluate the effect of dehydration (hot air drying and freeze-drying) on the physicochemical properties, the content of bioactive components, their bioaccessibility and their influence on the microbiota. Finally, the possibility of obtaining a dehydrated product with probiotics was considered. The achievement of this objective was approached through three perspectives presented in three chapters, structuring the results section accordingly. In the first chapter, the impact of hot air drying at 60 °C and 70 °C and freeze-drying on the techno-functional properties of almond bagasse was evaluated. Drying curves and sorption isotherms were analysed. Then, the effect of storage at room temperature and under accelerated conditions of the obtained powders by both drying methods was evaluated; over a period of 6 months, microbiological growth, acidity, peroxide index, antioxidant capacity, and polyphenol content were monitored. Finally, the suitability of almond bagasse powder as a substitute in the production of bakery products, specifically biscuits, was assessed. Both hot air drying and freeze drying proved to be suitable operations to stabilise almond bagasse. Both drying methods, combined with appropriate grinding, provided powders with favourable properties for use in the food industry. Regarding the antiradical activity, there were no significant differences between the dehydrated samples, although the total phenol content was higher in the freeze-dried samples. After a 6-month storage period, an increase in antiradical capacity and total phenolic content was observed, particularly noticeable in the samples dried by hot air and subjected to accelerated storage. Acidity and peroxide index values increased considerably during accelerated storage, possibly due to the decomposition of fatty acids. Finally, the suitability of almond bagasse powder as a substitute ingredient in the production of bakery products was evaluated. The results indicated its suitability as a substitute for wheat flour in the production of biscuits, providing a product with appropriate texture, increased fibre content, and components with antiradical capacity. / Duarte Serna, S. (2024). Caracterización fisicoquímica, tecnológica y funcional del residuo procedente de la obtención de la bebida vegetal de almendra. Estrategias de valorización [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/204146 / Compendio

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