Introduction: The outcomes following radical treatment for bladder cancer (BC) remain poor, with 5 year overall survival (OS) rates of approximately 50% and over 5000 deaths per year in the U.K. There has been paucity of significant therapeutic developments since the introduction of cisplatinum based chemotherapy in the 1970’s. The aim of this study was to identify putative drug targets for the treatment of this aggressive form of cancer. Methods: A tissue microarray (TMA) was constructed from the cystectomy specimens of 497 BC patients and 70 controls, linked to a clinical database with extended follow up. The online database Oncomine® was interrogated to identify putative treatment targets which were subsequently evaluated using in-vitro models of high grade invasive bladder cancer (using the J82 and T24 cell lines). In-vitro modelling was conducted using siRNA target knockdown during proliferation, chemo-sensitivity, migration and Matrigel™ invasion assays. Expression of the putative targets was then correlated with tumour characteristics and patient outcomes, by IHC and automated image analysis of the TMA. Results: The proteins CYR61 and CTGF were selected from Oncomine® and studied in conjunction with the HGF/MET axis, on the basis of known interactions in other cancer types. siRNA knockdown of both proteins abrogated HGF induced Matrigel™ invasion in both cell lines. CYR61 knockdown significantly reduced HGF induced cell migration and foetal calf serum (FCS) induced Matrigel™ invasion in both cell lines. Knockdown of both proteins also significantly increased the sensitivity of both cell lines to cisplatinum. CYR61 expression was significantly increased in BC samples compared to normal controls and an independent predictor of OS at 6 years (HR 1.493, p=0.030). In contrast, loss of CTGF expression was significantly associated with increasing tumour stage and worse OS. MET expression was reduced in BC compared to controls and not predictive of survival following cystectomy. Conclusions: The in-vitro findings for CTGF as a treatment target were encouraging, although these findings were not supported by the TMA data. CYR61 promotes an aggressive bladder cancer phenotype and knockdown reverses features of EMT and increases chemo-sensitivity. Clinical cohort correlation confirms CYR61 to be a promising treatment target in bladder cancer.

Tuberous Sclerosis Complex (TSC) is an autosomal dominant syndrome characterized by epilepsy, intellectual disability, and autism. Recent studies have suggested that white matter abnormalities, including hypomyelination, contribute to the cognitive deficits in TSC patients, but the mechanism has remained elusive. I used the neuron-specific Tsc1 knockout mice that display a marked decrease in myelin and show that oligodendrocytes are arrested at immature stages of development in vivo resulting in a reduction in the number of myelinating cells. I established an oligodendrocyte culture system and examined the effect of neuron-conditioned media and found that the Tsc1 mutant phenotype was replicable in vitro using medium collected from Tsc1 knockdown (TSC-KD) neurons, confirming that a secreted signal is responsible for inhibiting differentiation of the oligodendrocytes. I took an unbiased genome-wide approach and identified Connective Tissue Growth Factor (CTGF) as a putative candidate for the secreted signal. I confirmed that CTGF was upregulated in Tsc1 mutant neurons and characterized its spatial and developmental expression pattern in our mouse model. In vitro, CTGF was sufficient to inhibit differentiation of oligodendrocytes. The addition of CTGF neutralizing antibody to the TSC-KD neuronal media was able to reverse the suppression of oligodendrocyte maturation, strongly suggesting that CTGF is a major component of the oligodendrocyte inhibitory signal derived from Tsc mutant neurons. Since TSC mutation affects all cells, I investigated the role of TSC in oligodendrocytes. In response to TSC knockdown, oligodendrocytes demonstrate an upregulation of cellular stress marker. I also found a decrease in myelin protein genes, a finding that offers interesting implications for the role of TSC in hypomyelination. Furthermore, I expanded my research into Zellweger disease, a syndrome that involves TSC in its neuropathological manifestations including white matter deficits, and found that localization of TSC to the peroxisome is a critical factor in neuron development. Together, this body of work developed new approaches in Tuberous Sclerosis research in the brain to investigate a previously under-appreciated aspect of TSC pathology - myelination. I have demonstrated that the TSC pathway has important roles in neuron-oligodendrocyte communication and emphasize the critical importance of neuron-derived signals in the establishment of myelination.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21013号 / 医博第4359号 / 新制||医||1028(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 長船 健二, 教授 瀬原 淳子, 教授 小川 修 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Der Connective tissue growth factor, CTGF, ist ein mit der EZM assoziiertes Protein, das diverse zelluläre Aktivitäten, einschließlich Adhäsion, Proliferation, Differenzierung und Migration, besitzt. Die umfassenden biologischen Eigenschaften des CTGF in verschiedenen Zelltypen spiegelt seine Fähigkeit, eine Vielfalt an Zelloberflächenmolekülen (HSPGs, Integrine, …) als auch andere bioaktive Moleküle (BMP-4, TGF-β1, ...) zu binden, wieder. Eine veränderte CTGF-Expression ist mit mehreren fibrotischen Erkrankungen assoziiert und CTGF selbst stimuliert die Entstehung und Progression fibrotischer Defekte. Genauere Informationen über den Einfluss des CTGF auf die Genexpression von Zellen waren bisher unbekannt. In dieser Arbeit wurde zunächst humanes CTGF in HEK-Zellen exprimiert und anschließend in mehreren chromatographischen Schritten aufgereinigt. Die biologische Charakterisierung zeigte, dass das rekombinante Protein mit BMP-2 in Oberflächenplasmonresonanzstudien und auf Zellbasis interagiert. Desweiteren konnte auch eine Interaktion mit Balb3T3-Zellen festgestellt werden. Die biologische Aktivität des Proteins wurde durch Proliferationsassays mit einer Endothelzelllinie und primären Fibroblasten des menschlichen Tenon bestätigt. Das reine rekombinante Protein wurde für Genexpressionsanalysen an humanen primären Fibroblasten des Tenon eingesetzt. Ergebnisse dieser Studie der Genexpression von HTF von drei unabhängigen Spendern zeigten, dass CTGF verschiedene biologische und physiologische Prozesse beeinflusst. Bekannte proliferatorische Eigenschaften und der Einfluss auf die EZM konnten bestätigt werden. Neben den bisher bekannten Funktionen der durch CTGF verursachten Effekte bei der Wundheilung, die überwiegend in der zweiten und dritten Phase der Wundheilung im Bereich der Umstrukturierung der EZM zu finden sind, konnten mehrere regulierte Gene nachgewiesen werden, die eine Rolle in der ersten Phase der Wundheilung, der Inflammation, spielen. Die interessantesten bisher im Zusammenhang mit CTGF noch nicht beschriebenen proinflammatorischen Proteine sind die CXC-Chemokine 1, 2, 6 und 8 sowie IL-6, die in den CTGF behandelten Fibroblasten stärker exprimiert waren. CTGF scheint somit eine mannigfaltige koordinierte Rolle in der Wundheilung am Auge, einschließlich Inflammation und EZM-Remodeling sowie möglicherweise auch in der Angiogenese und Hämostase, zu spielen und damit seine Rolle als mulitmodularer Faktor zu bestätigen. / Connective tissue growth factor, CTGF, is an ECM associated protein that has diverse cellular activities including adhesion, proliferation, differentiaton and migration. The widespread biological properties of CTGF reflects its ability to bind many cell surface molecules (HSPGs, Integrins, LDL, …) and other bioactive molecules (BMP-4, TGF-β ...). Expression of CTGF is associated with many fibrotic diseases and CTGF itself stimulates development and progression of fibrotic defects. Detailed information about the effect of CTGF on cellular gene expression is relatively unknown so far. In this study human CTGF was expressed in HEK-cells and subsequently purified in several chromatographic steps. Biological characterization shows an interaction of the protein with BMP-2 in surface plasmon resonance studies and also in cell based assays. Furthermore there was detected an interaction with Balb3T3 cells. Biological activity of the protein was confirmed by proliferation assays with an endothelial cell line and primary fibroblasts of the human tenon. Pure recombinant protein was used for gene expression analysis of human primary fibroblast of the tenon. Results of this gene expression study from three independent donors showed influence of CTGF on different biological and physiological processes. Known proliferative properties and influence on the ECM could be confirmed. Beside up to now known function of CTGF induced effects in wound healing, predominantly found in second and third phase of wound healing in range of ECM remodeling and myofibroblast differentiation, several regulated genes, important in first phase of wound healing, the inflammation, could be detected. As yet unknown CTGF regulated interesting genes are the upregulated chemokines 1, 2, 6 and 8 as well as Interleukin 6, all with proinflammatoric properties. Significant influence of CTGF on the genexpression of tenon fibroblasts indicates the meaningful part of this protein in ocular woundhealing, including inflammation and ECM remodeling, potentially also angiogenesis and haemostasis, and confirms its multimodular function.

Connective Tissue Growth Factor (CTGF) is a matricellular protein that has been shown to mediate cell adhesion, and as a consequence, it regulates cell proliferation, migration, differentiation and gene transcription. Although previous in vivo and in vitro studies supported the anabolic role of CTGF in skeletogenesis, to date mechanisms of this effect remain unknown. So far, no specific receptor has been identified for CTGF, although previous studies have shown that integrins can serve as functional signaling receptors for CTGF. The CTGF-integrin interaction initiates intracellular signaling cascades that ultimately regulate cell cytoskeleton reorganization, gene transcription and cell function. To study the effect of CTGF on osteoblasts, we first conducted adhesion assays using the MC3T3-E1 osteoblastic cell line. We confirmed that osteoblasts adhere to rCTGF in a concentration-dependent manner and we showed this adhesion has characteristics of integrin mediated adhesions. Next, we used an array of blocking antibodies directed against the individual alpha and beta; integrin subunits that are known to be expressed in osteoblasts. Significant decreases in cell adhesion were observed upon treatment with anti-alpha-v or anti-beta1 blocking antibodies. Subsequent coimmunoprecipitation analyses demonstrated that CTGF interacts with alpha-v and beta1 integrins in osteoblasts. Furthermore, we showed that the specificity of this CTGF-integrin interaction occurs in the C-terminal domain (fourth module) of CTGF. The immunefluorescence staining of cells cultured on substrates of rCTGF, fibronectin (positive control) or BSA (negative control) demonstrated that osteoblast adhesion to rCTGF results in actin cytoskeleton reorganization, focal adhesion formation, enhanced cell spreading and Rac activation. These series of events are necessary for proper cell-matrix interaction and integrins' downstream signaling initiation. Next, through alkaline phosphatase (ALP) staining and activity assays, as well as Alizarin red staining, we demonstrated that osteoblast attachment to CTGF matrix enhances cell maturation, bone nodule formation and matrix mineralization. To investigate whether the effect of CTGF on osteoblast differentiation involves activation of specific signaling molecules, we performed Western blot and chromatin immunoprecipitation (ChIP) assays. Osteoblasts cultured on rCTGF expressed higher levels of both total and phosphorylated forms of focal adhesion kinase (FAK) and extracellular signal-regulated kinase (ERK) compared to the cells cultured on BSA. In addition, these osteoblasts showed an increase in runt-related transcription factor 2 (Runx2) binding to the osteocalcin gene promoter compared to the negative control. These experiments confirmed CTGF's effect on enhancing osteoblast differentiation through regulation of important signaling molecules. In another series of experiments, we used primary osteoblasts isolated from CTGF KO mice, their WT littermates, or WT cells infected to overexpress (OE) CTGF to study the effect of different levels of endogenous CTGF on osteoblast cytoskeleton reorganization and motility. Our assays showed enhanced cell adhesion, spreading and Rac expression in CTGF OE osteoblasts, while in CTGF KO osteoblasts, cell adhesion, spreading and Rac expression were significantly decreased. In contrast, CTGF OE osteoblasts that showed high adhesion and spreading, exhibited diminished cell motility and low levels of RhoA expression, while KO cells migrated quickly and expressed high levels of RhoA. Together, these experiments establish CTGF as an adhesion protein for osteoblasts; they demonstrate that the alpha-v beta1 integrin is a functional signaling receptor for CTGF; they confirm that osteoblast differentiation is enhanced when cultured on CTGF matrix through activation of regulatory signaling molecules; and finally, these experiments establish a role for CTGF in the regulation of small RhoGTPases expression, which in turn implies a significant role for CTGF in cell cytoskeleton reorganization and motility. / Cell Biology

The mammalian palate develops early in embryogenesis by way of a carefully orchestrated series of temporally and spatially regulated signaling events. Molecular signaling pathways that have been proven to be vital to the process of palatogenesis include TGF-βs, BMPs, FGFs, EGF, and Wnts. The absence of connective tissue growth factor (CTGF/CCN2) has been shown previously to cause failure of proper palatogenesis, i.e. cleft palate. However, the details about the phenotype of this model of cleft palate were scarce. Additionally, CCN2 is known to interact with TGF-βs, BMPs, FGFs, EGF, and Wnts, though information on how these pathways were impacted in the developing palate lacking CCN2 were also not available. In Chapters 2 and 3, through our use of gross specimen and histological examination combined with cell and organ culture, we produced the most detailed characterization of the CCN2 knockout (KO) model of cleft palate with identification of negatively affected signaling pathways that lead to the clefting phenotype. Collection and examination of gross and histological sections revealed at 100% penetrance of cleft palate in which development is impaired around the phase of palatal shelf elevation. Organ culture also revealed that when artificially apposed, the CCN2 KO model system also suffers from a fusion deficit. Finally, utilizing cells isolated from the developing palates, we found a reduction in proliferation, adhesion, and spreading with an enhanced migratory ability. Addition of recombinant CCN2 was able to rescue cell spreading but not proliferation. CCN2 as an immobilized substrate did not rescue adhesive ability. Decreased adhesion and spreading in the KO cells are attributed to the inability of the KO cells to activate Rac1 and RhoA. Examination of gene expression differences by mRNA-sequencing and qRT-PCR revealed numerous gene expression alterations between the wild type (WT) and the KO palates, most notably FGF4 and EGFR. Addition of FGF4 or EGF to cell culture was unable to promote increased proliferation in the KO cells while producing a response in the WT cells. Examination of downstream signaling revealed highly amplified and prolonged ERK1/2 signaling in the FGF4 treated palate cells indicating that FGF signaling is significantly altered in the absence of CCN2. Treatment of the cells with EGF produced a response proportional to EGFR expression differences indicating that EGFR signaling is not impacted beyond the receptor protein levels. The link between EGFR protein levels and FGF mediated ERK1/2 activation is a protein called Spry2. We found greatly reduced Spry2 mRNA levels in the KO palates and upon FGF4 stimulation at 24 hours of exposure indicating that in the absence of CCN2, proper inhibition of FGF signaling and EGFR degradation is negatively altered. Collectively, the data demonstrate that CCN2 is vital to palatogenesis by impacting proliferation, shelf elevation, and shelf fusion through increased FGF signaling and reduced EGFR signaling resulting partially from reduced Spry2 activity. / Biomedical Sciences

Die Mehrheit chronischer Nierenerkrankungen wird durch glomeruläre Defekte hervorgerufen. In dieser Arbeit wurde deshalb im Mausmodell die Bedeutung der Kollagenrezeptoren DDR1 (Discoidin Domain Rezeptor 1) und ITGA2 (Integrin Alpha 2) in der Pathogenese von glomerulären Nierenerkrankungen untersucht. Von zentralem Interesse waren neben der Betrachtung des renalen Phänotyps, die Analyse der glomerulären Basalmembran sowie die Prüfung auf Vorhandensein nierenschädigender Faktoren. Zur Orientierung angefertigte H.E.-Färbungen waren lichtmikroskopisch unauffällig, jedoch ließ sich mittels Gelelektrophorese eine Mikro-, Makro- und Albuminurie mit einem Maximum zum Zeitpunkt von 100 Lebenstagen nachweisen, die mit 200 Tagen wieder stark sank. Auf dem Boden der nierenschädigenden Proteinurie, zeigten die Western-Blot-Analysen das Vorhandensein der Zytokine TGF-ß und CTGF auf. Die zur Detektion von Narbengewebe durchgeführte Fibronektinfärbung, erbrachte keinerlei weiterführende Anhaltspunkte. In der Elektronenmikroskopie ließ sich vereinzelt eine Mehrschichtung der GBM nachweisen, was als Ausreifungsstörung interpretiert wurde. Der Wegfall der beiden Kollagenrezeptoren ITGA2 und DDR1 scheint somit die Interaktion der Podozyten mit der GBM zu stören. Dies hat eine Proteinurie zur Folge. In Folge dessen werden profibrotische Zytokine sezerniert. Das Fehlen der beiden Kollagenrezeptoren DDR1 und ITGA2 führte jedoch nicht zur Ausbildung einer renalen Fibrose, wie in der Fibronektin-Färbung gezeigt werden konnte. Gross und Girgert zeigten, dass nierenkranke Mäuse nach dem Verlust von DDR1 oder ITGA2 einen verzögerten Verlauf der Nierenfibrose entwickelten. Vielversprechend scheinen Untersuchungen z.B. am Mausmodell Col4A3/DDR1/ITGA2 -/- oder an einer diabetischen ITGA2/DDR1 -/- Maus. Gesetzt dem Fall, dass eine renale Fibrose im Vergleich zum Einzelknockout noch später eintritt, eignen sich diese beiden Kollagenrezeptoren als therapeutisches Ziel. Aktuell stehen nur wenige nephroprotektive Medikamente, wie ACE-Hemmer, zur Verfügung. Anti-Integrine und Inhibitoren gegen Tyrosinkinase-Rezeptoren, wie DDR1, haben bereits Einzug in den klinischen Alltag gehalten und stellen eventuell einen wirksamen Ansatzpunkt zur Verhinderung einer renalen Fibrose dar.

Il a été suggéré que l’autophagie pouvait participer au processus fibrotique en favorisant la différenciation du fibroblaste en myofibroblaste. La sénescence cellulaire a aussi été montrée comme impliquée dans la réparation tissulaire et la fibrose. Des liens ont été établis entre autophagie et sénescence. Cette étude a pour but d’investiguer les liens possibles entre autophagie, sénescence et différenciation myofibroblastique afin de mieux comprendre les mécanismes moléculaires régulant la réparation tissulaire et la fibrose. Les fibroblastes carencés en sérum pendant quatre jours montrent des ratios LC3B-II/-I élevés et des niveaux de SQSTM1/p62 diminués. L’augmentation de l’autophagie est accompagnée d’une augmentation de l’expression des marqueurs de différenciation myofibroblastique ACTA2/αSMA et collagènes de type 1 et 3 et de la formation de fibres de stress. Les fibroblastes autophagiques expriment les marqueurs de sénescence CDKN1A (p21) et p16INK4a (p16) et montrent une augmentation de l’activité beta-galactosidase associée à la sénescence. L’inhibition de l’autophagie à l’aide de différents inhibiteurs de phosphoinositide 3-kinase de classe I et de phosphatidylinositol 3-kinase de classe III (PtdIns3K) ou par inhibition génique à l’aide d’ARN interférant ATG7 bloquent l’expression des marqueurs de différenciation et de sénescence. L’expression et la sécrétion de CTGF (connective tissue growth factor) sont augmentées chez les fibroblastes autophagiques. L’inhibition de l’expression du CTGF par interférence génique prévient la différenciation myofibroblastique, démontrant l’importance de ce facteur pro-fibrotique pour la différenciation induite par l’autophagie. La phosphorylation de la kinase RPS6KB1/p70S6K, cible du complexe MTORC1, est abolie dans les fibroblastes autophagiques. La phosphorylation d’AKT à la Ser473, une cible du complexe MTORC2, diminue lors de la carence en sérum des fibroblastes mais est suivie d’une rephosphorylation après 2 jours. Ce résultat suggère la réactivation de MTORC2 lors d’une autophagie prolongée. Ceci a été vérifié par inhibition de l’autophagie dans les fibroblastes carencés en sérum. Les inhibiteurs de PtdIns3K et le siRNA ATG7 bloquent la rephosphorylation d’AKT. L’inhibition de la réactivation de MTORC2, et donc de la rephosphorylation d’AKT, est aussi obtenue par exposition des fibroblastes à la rapamycine, le Torin 1 ou par inhibition génique de RICTOR. Ces traitements inhibent l’augmentation de l’expression du CTGF ainsi que des marqueurs de différenciation et de sénescence, démontrant le rôle central joué par MTORC2 dans ces processus. Le stress oxydant peut induire la sénescence et la carence en sérum est connue pour augmenter la quantité de ROS (reactive oxygen species) dans les cellules. Afin d’investiguer le rôle des ROS dans la différenciation et la sénescence induites par l’autophagie, nous avons incubés les fibroblastes carencés en sérum en présence de N-acetyl-L-cysteine (NAC). Le NAC diminue la production de ROS, diminue les marqueurs d’autophagie, de sénescence et de différenciation myofibroblastique. Le NAC inhibe aussi la phosphorylation d’AKT Ser473. L’ensemble de ces résultats identifient les ROS en association avec une autophagie prolongée comme des nouveaux activateurs du complexe MTORC2. MTORC2 est central pour l’activation subséquente de la sénescence et de la différenciation myofibroblastique. / Recent evidence suggests that autophagy may favor fibrosis through enhanced differentiation of fibroblasts in myofibroblasts. Cellular senescence is also involved in tissue repair and fibrosis. Autophagy has been linked with senescence. This study focuses on understanding the molecular mechanisms linking autophagy, senescence and myofibroblast differentiation and the roles they could play in wound healing and fibrosis. Fibroblasts, serum starved for up to 4 days, showed increased LC3B-II/-I ratios and decreased SQSTM1/p62 levels. Autophagy was associated with acquisition of markers of myofibroblast differentiation including increased protein levels of ACTA2/αSMA (actin, α 2, smooth muscle, aorta), enhanced gene and protein levels of COL1A1 (collagen, type I, α 1) and COL3A1, and the formation of stress fibers. Autophagic fibroblasts showed expression of the senescence markers CDKN1A (p21) and p16INK4a (p16) and also exhibit increase in Senescence Associated-beta-galactosidase activity. Inhibiting autophagy with different class I phosphoinositide 3-kinase and class III phosphatidylinositol 3-kinase (PtdIns3K) inhibitors or through ATG7 silencing prevented myofibroblast differentiation and senescence markers expression. Autophagic fibroblasts showed increased expression and secretion of CTGF (connective tissue growth factor), and CTGF silencing prevented myofibroblast differentiation. Phosphorylation of the MTORC1 target RPS6KB1/p70S6K kinase was abolished in starved fibroblasts. Phosphorylation of AKT at Ser473, a MTORC2 target, was reduced after initiation of starvation but was followed by spontaneous rephosphorylation after 2 d of starvation, suggesting the reactivation of MTORC2 with sustained autophagy. Importantly, inhibition of autophagy with PtdIns3K inhibitors or ATG7 silencing blocked AKT rephosphorylation. Inhibiting MTORC2 activation with long-term exposure to rapamycin, Torin 1 or by silencing RICTOR, a central component of the MTORC2 complex, abolished AKT rephosphorylation. RICTOR silencing, Torin 1 and rapamycin treatments prevented CTGF and ACTA2 upregulation and induction of senescence markers demonstrating the central role of MTORC2 activation in CTGF and senescence induction for myofibroblast differentiation. Since oxidative stress is a known inducer of senescence, we investigated the role of reactive oxygen species (ROS) in autophagy-induced myofibroblast differentiation and senescence markers induction. Exposing fibroblasts to N-acetyl-L-cysteine (NAC) decreased production of ROS during serum starvation, inhibited autophagy and significantly decreased the expression of senescence and myofibroblast differentiation markers. NAC also inhibited the phosphorylation of AKT Ser473, establishing the importance of ROS in fuelling MTORC2 activation. Collectively, these results identify ROS production in association with sustained autophagy as novel inducers of MTORC2 signaling which in turn concomitantly activate senescence and myofibroblast differentiation.

La bilharziose reste un problème de santé majeur. L'équipe du Pr Dessein a montré que les infections élevées étaient déterminées par un locus majeur en 5q31 et que des polymorphismes dans un gène à ce locus,IL13, aggravent l'infection. Notre premier objectif était d'évaluer si des variants d'autres gènes de la voie de l'IL13 intervenaient dans le contrôle de l'infection. Nous avons observé une association entre le SNP rs324013, dans le promoteur de STAT6,et les niveaux d'infection à S. haematobium. Ce polymorphisme a un effet additif avec le polymorphisme IL13rs1800925. Ce SN modifie la fixation de facteurs nucléaires au niveau du promoteur de STAT6. L'équipe du Pr Dessein avait également montré que les fibres hépatiques avancées et sévères étaient déterminées par un autre locus majeur localisé en 6q23. Notre deuxième objectif fut d'évaluer dans le laboratoire du Pr Dessein et en étroite collaboration avec le laboratoire du Pr Li(Yueyang Institute of Parasitic disease)deux gènes candidats(IFNGR1 et CTGF) situés dans cette région chromosomique. Nous avons observé une association entre les deux polyporphismes(rs17066192 er rs673156)localisés dans le promoteur du gène. Nous avons observé une association entre les deux polymorphismes(rs17066192 et rs673156)localisés dans le promoteur du gène IFNGR1 et la fibrose hépatique: le génotype rs673156A/A et rs17066192C/C sont associés à un risque 7.3 fois et 1.5 fois plus élevé, respectivement, de fibrose avancée. Nous avons également montré que les variants rs9402373 et rs12526196 du gène CTGF sont indépendamment associés à la fibrose chez les fermiers et pêcheurs chinois infectés par S.japonicum. Sur la population chinoise d'étude, les risques relatifs associés aux polymorphismes rs9402373 et rs12526196 sont de 2.8 et 3 / Schistosomiasis remains one of the world’s most prevalent diseases. It comprises a group of chronic diseases caused by helminths of the Schistosoma genus. Schistosoma haematobium causes obstructive nephropathy that can be aggravated by urinary bacterial infections. S.japonicum and S.mansoni cause hepatic fibrosis associated with portal blood hypertension, which can be lethal. In previous studies, our laboratory had shown that worm burden in S.haematobium infections were aggravated by IL13 variants and that severe hepatic fibrosis (HF) was controlled by gene(s) located on 6q23. The present study is to further evaluate other IL-13 pathway genes (STAT6) in the control of infection in Malian farmers and to test candidate genes in the 6q23 region in hepatic fibrosis (HF) in S.japonicum infected Chinese fishermen and farmers. First we have developped an improved FTA® technology technique to perform SNP genotyping. This technique allows us to use saliva samples for genotyping SNPs. Subsequently, this improved FTA® technology was used in our study on HF.Our work on a Malian sample infected with S. haematobium indicated that a polymorphism (rs324013) in the promoter of STAT6 gene was associated with the control of S. haematobium infection levels and has an additive effect with IL13rs1800925, a polymorphism previously associated with infection in this same population. Both SNPs modify the binding of nuclear factors to the promoter regions of their respective genes. Thus, both SNPs may play a crucial role in controlling S. haematobium infection levels. In order to study HF in S.japonicum infections, we have participated actively in the study that recruited of a large sample of Chinese fishermen and farmers who had been exposed to the infection for most of their life. HF was evaluated by ultrasound and covariates that could affect HF were evaluated by interviews. Then, we tested two genes (IFNGR1, CTGF) of the 6q23 region that were good candidates for the control of HF on these samples. Both genes encode molecules that were shown in animal and human studies to have strong effect on extracellular matrix proteins deposition and turnover. We found that two polymorphisms (rs17066192 and rs673156) in IFNGR1 promoter were associated with HF: the rs673156A/A genotype was associated with a 7.3-fold increased risk of advanced HF; and rs17066192C/C genotype with a 1.5-fold increased risk of HF. These results must now be confirmed in another population sample. We also found that variants of CTGF rs9402373 and rs12526196 were independently associated with HF in Chinese fishermen and farmers, in Sudanese, and in Brazilians infected with either S. japonicum or S. mansoni. Our results provide additional evidence for a protective role of IL-13 in schistosome infections, and they also demonstrate that TGFβ / CTGF pathway plays a key role in HF and should be targeted by chemotherapy. Ongoing studies evaluate whether CTGF variants could be used in the prognosis of the HF caused by schistosomes and also by other infectious agents.

No description available.