Despite improvements in therapy, the prognosis for non-small cell lung cancer (NSCLC) patients remains poor, and cure is only possible in localized tumors after surgical resection. A new generation of targeted cancer drugs has led to the expectation that lung cancer therapy can be significantly improved, but these drugs are today only an option in a small subset of NSCLC patients, and their effect is temporary. Therefore, the aim of this thesis was to characterize NSCLC in order to find new treatment targets and to evaluate biomarkers that further optimize therapy selection. In Paper I, the expression of the potential treatment targets claudin 6 and claudin 18.2 were evaluated based on immunohistochemical- and gene expression analysis. High ectopic protein and gene expression were demonstrated for both claudins in small subgroups of NSCLC. Clinical trials using humanized monoclonal antibodies against both proteins are ongoing in other cancer forms and may be extended to NSCLC. In Paper II, the prognostic impact of the inflammatory mediator cyclooxygenase 2 (COX-2) was evaluated. No prognostic significance was found in a meta-analysis incorporating gene expression data of 1337 NSCLC patients. Likewise, COX-2 protein expression in tumor cells was not associated with survival in two independent NSCLC cohorts. However, in one of the analyzed cohorts, higher COX-2 expression in the tumor stroma was associated with longer survival and may therefore be a subject for further investigation. In Paper III, tumor and stromal COX-2 protein expression was examined in patients treated with the COX-2 inhibitor celecoxib in order to evaluate if COX-2 expression is a predictive biomarker for benefit of celecoxib therapy. Celecoxib did not prolong overall survival neither in the whole cohort nor in patients stratified according to COX-2 expression in tumor or stromal cells. Noteworthy, a tendency towards longer survival was again demonstrated in patients with high COX-2 stromal expression. In Paper IV, the diagnostic methods for identification of ALK rearrangements were assessed in a large representative Swedish NSCLC population. Fluorescence in situ hybridization (FISH), as the diagnostic standard, was compared to two immunohistochemical assays. ALK gene expression levels were incorporated to supplement the molecular data. The frequency of ALK rearrangements was lower than previously reported. The different methods to detect the ALK fusion demonstrated overlapping results. However, the overlap was poor, so the methods cannot be regarded as interchangeable and should thereby be interpreted with caution when used in clinical diagnostics. In summary, this thesis applied an integrative translational approach to characterize potential new treatment targets and to evaluate the detection of existing predictive biomarkers in NSCLC.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Mehrere Studien haben gezeigt, daß die Cyclooxygenase-2 (COX-2) eine bedeutende Rolle sowohl bei Entstehung als auch Progression maligner Tumoren spielt. COX-2-Inhibitoren werden bereits in klinischen Studien zur Krebstherapie getestet. COX-2 ist die induzierbare Isoform der Cyclooxygenase - dem Schlüsselenzym der Synthese von Prostaglandinen und anderen Eicosanoiden. Im Tier- und Zellkulturmodell konnten COX-Hemmer anti-Tumor-Effekte hervorrufen. Es ist jedoch unklar, ob diese Effekte durch Hemmung des COX-Enzyms oder durch COX-unabhängige Mechanismen vermittelt werden. Wir untersuchten daher die Auswirkung der COX-Inhibition zum einen durch den selektiven COX-2-Hemmer NS-398 sowie zum anderen durch COX-Isoform-spezifische RNA-Interferenz (RNAi) in zwei humanen Ovarialkarzinomzellinien (OVCAR-3 und SKOV-3). OVCAR-3 zeigte eine konstitutive COX-1-Expression und eine durch IL-1beta induzierbare COX-2-Expression. SKOV-3 war COX-1- und COX-2-negativ. IL-1beta führte bei OVCAR-3 zu einer vermehrten Produktion von Prostaglandin E2 (PGE2), die durch eine gegen die COX-2 gerichtete siRNA gehemmt werden konnte, wohingegen COX-1-siRNA keinen Effekt hatte. Das deutet darauf hin, daß die COX-2 die Hauptquelle von PGE2 in OVCAR-3 ist. 1mikroM NS-398 waren ausreichend, um die PGE2-Produktion und somit auch die COX-2 in OVCAR-3 zu inhibieren. Höhere Konzentrationen NS-398 (>10mikroM) hatten einen antiproliferativen Effekt. Auch in der COX-2-negativen Zellinie SKOV-3 trat diese Wachstumshemmung auf; sie war nicht durch exogene Zufuhr von PGE2 (10mikroM) reversibel. Durchflußzytometrische Zellzyklusanalyse ergab, daß der Wachstumshemmung in beiden Zellinien ein G0/G1-Zellzyklusarrest zugrunde liegt. Dagegen führten weder COX-1- noch COX-2-Ausschaltung durch RNAi zu ähnlichen Auswirkungen auf Proliferation bzw. Zellzyklus. Diese Ergebnisse zeigen, dass ein COX-2-unabhängiger Mechanismus für den durch NS-398 induzierten G0/G1-Arrest verantwortlich ist. / Several studies have provided evidence that the enzyme Cyclooxygenase-2 (COX-2) plays an important role in tumor development and progression. COX-2-inhibitors are already evaluated in clinical trials as cancer therapeutics. COX-2 is the inducible isoform of cyclooxygenase - the rate-limiting enzyme in the synthesis of prostaglandins and other eicosanoids. COX-inhibitors cause antitumor effects in animal models and in cell culture experiments. However, it is not clear, whether these effects are due to inhibition of the COX-enzyme or mediated via a COX-independent mechanism. We therefore investigated the effects of COX inhibition by the selective COX-2-inhibitor NS-398, as well as by COX-isoform specific RNA interference (RNAi) in the human ovarian carcinoma cell lines OVCAR-3 and SKOV-3. OVCAR-3 cells showed a constitutive expression of COX-1, and an inducible COX-2 expression. COX-2 was induced through stimulation with Interleukin-1beta, leading to production of high levels of Prostaglandin E2 (PGE2). SKOV-3 cells were negative for both COX isoforms. Selective COX-2-suppression by RNAi reduced PGE2 production in OVCAR-3, whereas COX-1-siRNA had no effect on PGE2 synthesis. Thus, COX-2 is the main source of PGE2 in OVCAR-3 cells. In these cells, 1microM NS-398 was sufficient to completely inhibit PGE2-synthesis - and thus the activity of the COX-2 enzyme. Increasing amounts of NS-398 (>10microM) had an antiproliferative effect. This growth inhibition was also observed in the COX-negative cell line SKOV-3, it could not be reverted by exogenous addition of PGE2 (10microM). Flowcytometric analysis of the cell cycle revealed that this growth inhibition was based on a G0/G1-cell-cycle-arrest. In contrast, suppression of COX-1 or COX-2 by RNAi had no effect on proliferation or cell cycle progression. These results suggest that a COX-independent mechanism is responsible for the G0/G1-arrest induced by NS-398.

Resumo:As neoplasias testiculares caninas são achados ocasionais. São descritas como benignas, mas podem metastatizar ou mostrar características de malignidade com o avanço da idade do animal, o que torna necessário o melhor entendimento do comportamento destas neoplasias no cão. O objetivo deste estudo foi caracterizar a expressão imuno-histoquímica de Ki-67, COX-2, MMP-9 e p53 em neoplasias testiculares de 50 cães, verificar a relação entre o padrão histológico e raça, idade e posicionamento testicular e verificar a expressão imuno-histoquímica dos anticorpos avaliados nos diferentes tipos de neoplasia. A avaliação imuno-histoquímica das proteínas Ki-67, MMP-9 e p53 foi mais intensa nos seminomas, enquanto que os leydigocitomas exibiram maior marcação para COX-2. A avaliação histológica e imuno-histoquímica dos subtipos de seminomas em cães, particularmente o seminoma difuso, podem resultar em diferença significativa que permita a utilização destas proteínas como marcadores de prognóstico. As características histopatológicas em associação ao histórico dos animais e à expressão das proteínas estudadas podem contribuir para a caracterização do comportamento biológico nas neoplasias testiculares caninas / Abstract:testicular neoplasms are sporadic findings. They are described as benign, but they can metastasize or express malignant features with the animal ageing, which makes necessary the better understanding of theses neoplasms behavior in dogs. The aim of this study was to characterize the immunoexpression of Ki-67, COX-2, MMP-9 and p53 in testicular neoplasms of fifty dogs, to verify the relation among histological pattern of the neoplasms and breed, age and testicular localization; and also to verify the immunoexpression of these markers in different types of testicular tumours. Ki-67, MMP-9 and p53 immunostaining were more intense in seminomas, whereas COX-2 presented a more intense staining in Leydig cell tumors. The histological and immunohistochemical analyses of the subtypes of canine seminomas, especially the diffuse seminoma, may result in significant differences which would allow the use of these markers as prognostic factors. The histopathological features associated with the day-history of the animals and with these markers may contribute to the characterization of the biological behavior of canine testicular neoplasms / Orientador:Gisele Fabrino Machado / Banca:Felipe Augusto Ruiz Sueiro / Banca:Rosemary de Oliveira Vasconcelos / Mestre

Squamous cell carcinoma of the head and neck (SCCHN), the 6th most common cancer worldwide, has a low 5-year survival. Disease as well as treatment often causes patients severe functional and aesthetic problems. In order to improve treatment and diagnosis at earlier stages of tumour development it is important to learn more about the molecular mechanisms behind the disease. p63, an important regulator of epithelial formation, has been suggested to play a role in the development of SCCHN. Six different isoforms of p63 have been found and shown to have various functions. The aim of the studies in this thesis was to learn more about the role of p63 and proteins connected to p63 in SCCHN. Expression of p63, Cox-2, EGFR, beta-catenin, PP2A and p53 isoforms was mapped in tumours and normal tumour adjacent tissue from patients with SCCHN using western blot or RT-PCR. Results showed no significant difference between tumours and normal tumour adjacent tissue concerning expression of EGFR and beta-catenin. Cox-2 and PP2A showed significantly higher expression in tumours while p63 was more expressed in normal tumour adjacent tissue. However, expression of all these proteins in normal tumour adjacent tissue differed from tissue from disease-free non-smoking individuals. Smoking in itself did not affect expression of these proteins. The p53 isoforms p53, p53beta, p53gamma, ∆133p53, ∆133p53beta and ∆133p53gamma were expressed at RNA level in samples both from tumours and normal tumour adjacent tissue, though most of them at fairly low levels. The functional properties of the different p63 isoforms have not been fully mapped. By establishing stable cell lines over-expressing the different p63 isoforms we investigated their specific effect on tumour cells from SCCHN. Only the ∆Np63 isoforms could be stably over-expressed, whereas no clones over-expressing TAp63 could be established. Using microarray technique, cell lines stably expressing the ∆Np63 isoforms were studied and CD44, Keratins 4, 6, 14, 19 and Cox-2 were found to be regulated by p63. In conclusion, the present project adds new data to the field of p63 and SCCHN. For example, we have shown that clinically normal tumour adjacent tissue is altered compared to normal oral mucosa in non tumour patients, and that smoking does not change expression of p63, Cox-2, EGFR, beta-catenin or PP2A in oral mucosa. Novel p53 isoforms are expressed in SCCHN, and even though levels are very low they should not be overlooked. Furthermore, CD44, keratins 4, 6, 14, 19 and Cox-2 were identified as p63 targets in SCCHN.

Salivary duct carcinoma (SDC) is an uncommon neoplasm showing extensive local invasion and metastasis. Histologically it exhibits ductal differentiation without myoepithelial participation and resembles intraductal and invasive ductal carcinoma of the breast. This study investigates the incidence of intraductal disease within invasive SDC and characterizes the expression of CK19, COX-2, MMP-2, 9 and 11 in intraductal and invasive SDC. 21 conventional SDC, 8 SDC arising as carcinoma ex-pleomorphic adenoma (CaExPA), 2 pure low-grade intraductal SDC, 1 pure high-grade intraductal SDC and 1 intraductal SDC with de-differentiation were studied. The presence of intraductal tumor in SDC is relatively common (52.4%) but is not a prominent component. SDC tumor cells were strongly positive for CK19 and COX-2. MMP-2 and 9 expression showed no significant pattern. MMP-11 was expressed by fibroblasts surrounding invasive tumor and was significantly associated with lymph node positivity (p=0.02).

Salivary duct carcinoma (SDC) is an uncommon neoplasm showing extensive local invasion and metastasis. Histologically it exhibits ductal differentiation without myoepithelial participation and resembles intraductal and invasive ductal carcinoma of the breast. This study investigates the incidence of intraductal disease within invasive SDC and characterizes the expression of CK19, COX-2, MMP-2, 9 and 11 in intraductal and invasive SDC. 21 conventional SDC, 8 SDC arising as carcinoma ex-pleomorphic adenoma (CaExPA), 2 pure low-grade intraductal SDC, 1 pure high-grade intraductal SDC and 1 intraductal SDC with de-differentiation were studied. The presence of intraductal tumor in SDC is relatively common (52.4%) but is not a prominent component. SDC tumor cells were strongly positive for CK19 and COX-2. MMP-2 and 9 expression showed no significant pattern. MMP-11 was expressed by fibroblasts surrounding invasive tumor and was significantly associated with lymph node positivity (p=0.02).

La Diabetis Mellitus tipus 2 (DM2) és una malaltia metabòlica complexa que afecta entre un 4 i un 5% de la població en les societats industrialitzades. Aquesta patologia es caracteritza per la presència, en la seva fase inicial, de resistència a la insulina (RI). Freqüentment, una de les primeres alteracions que s´observen en els individus amb predisposició a patir RI/DM2 és l´acumulació de grassa intraabdominal. De fet, la relació epidemiològica entre l´obesitat i la RI és molt sòlida. A més, en l´última dècada nombroses evidències han posat de manifest l´existència d´una estreta relació entre un estat d´inflamació crònic de baixa intensitat i la presència d´obesitat-RI-DM2. De tota manera, tot i que el vincle entre l´increment d´àcids grassos lliures en plasma i la diabetis està ben acceptat, els mecanismes implicats en l´aparició de RI i DM2 induïdes per aquests àcids grassos no són ben coneguts. Per aquest motiu, l´objectiu d´aquesta tesi doctoral ha estat aprofundir en els mecanismes implicats en l´aparició de RI induïda per l´àcid gras saturat palmitat i estudiar la funció de l´enzim COX-2 en aquestes condicions, així com també determinar la capacitat de l´àcid gras monoinsaturat oleat i de l´agonista PPARdelta GW501516 per a prevenir la inflamació i la RI induïdes pel palmitat en miotubs de ratolí C2C12.Els estudis realitzats indiquen que la presència elevada de l´àcid gras saturat palmitat provoca una disminució de PGC-1alfa(coactivador que controla l´expressió de gens mitocondrials) a través de l´activació de la via ERK-MAPK-NF-kB, així com també l´acumulació de diacilglicerol intramiocel·lular, fent que apareguin estats d´inflamació i RI. A més, s´ha observat que un augment agut de determinats marcadors inflamatoris, com la COX-2, contribueixen a resoldre aquest procés inflamatori generat per l´acumulació de lípids, tot i que la seva presència de manera crònica accentua l´estat inflamatori. Segons hem pogut constatar amb el nostre model in vitro de RI, l´àcid gras monoinsaturat oleat i el GW501516 podrien ser dues noves possibilitats terapèutiques per evitar la inflamació induïda per àcids grassos i millorar la sensibilitat a la insulina, ja que tenen la capacitat d´incrementar la beta-oxidació mitocondrial impedint així que s´acumulin metabolits lipotòxics com el diacilglicerol. / Insulin resistance (IR) is a major characteristic of type 2 diabetes mellitus and is also associated with obesity. Impairment of glucose utilization and insulin sensitivity has been related to the presence of high free fatty acids in plasma and a low-grade chronic systemic inflammation. However, the mechanisms by which free fatty results in inflammation and IR are not well understood. After exposing C2C12 cells (mouse myotubes) to the saturated fatty acid palmitate, we observed, on the one hand, a reduction in PGC-1-alpha gene expression through the activation of ERK-MAPK-NF-kB pathway, and on the other hand, an increase in diacylglycerol accumulation. Moreover, we observed that the presence of palmitate increased COX-2 expression, which seems to contribute to resolve the acute, but not chronic, inflammation. Our in vitro model of IR also showed that the monounsaturated fatty acid oleate and the PPAR-delta agonist GW501516, could avoid the development of inflammation and IR induced by fatty acids through an increase in mitochondrial beta-oxidation, thus preventing the accumulation of lipotoxic metabolites, such as dicylglycerol.

Skeletal muscle has an integral role in many activities. Although mechanical stretch and active force generation are known to be required for the maintenance of healthy muscle function, the mechanism by which those signals mediate muscle growth is unknown. This project was based on the hypothesis that stretch and force generation activate the Calcineurin/NFAT pathway and induce Cox-2 expression and initiate muscle hypertrophy. The specific aims of this study were to 1) develop a minimally invasive system capable of initiating hypertrophic signaling in mice, 2) characterize the effects of isometric activation, passive lengthening, and active lengthening on signaling cascades, and 3) determine the involvement of the Calcineurin/NFAT pathway and activation of COX-2 gene expression. We propose a pathway in which stimuli increase intracellular calcium, which activates the phosphatase calcineurin. Calcineurin dephosphorylates NFAT, which is translocated into the nucleus and initiates transcription of the COX-2 gene. COX-2 mediated synthesis of PGG2 is the rate-limiting step in bioactive prostaglandin synthesis. Prostaglandins then stimulate known hypertrophic signals including the PI-3 Kinase and MAP Kinase signaling cascades.