Tang Sze-Wan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (leaves 104-118). / Abstracts in English and Chinese. / Abstract --- p.i / Abstract (Chinese) --- p.iii / Acknownledgement --- p.iv / List of Abbreviations --- p.v / List of Tables --- p.vii / List of Figures --- p.viii / Table of Contents --- p.xi / Chapter Chapter 1 - --- Introduction / Chapter 1.1 --- Trichosanthes spp --- p.1 / Chapter 1.1.1 --- Use of Trichosanthes --- p.2 / Chapter 1.1.2 --- Trichosanthin --- p.2 / Chapter 1.1.3 --- Karasurin --- p.5 / Chapter 1.1.4 --- Ribosome Inactivating Proteins --- p.6 / Chapter 1.1.5 --- Immunosuppresion --- p.7 / Chapter 1.1.6 --- Anti-Cancer Activity --- p.8 / Chapter 1.1.7 --- Miscellaneous Uses --- p.8 / Chapter 1.2 --- Cancer --- p.9 / Chapter 1.2.1 --- Oncogenes --- p.10 / Chapter 1.2.2 --- Tumor-Suppressor Genes --- p.11 / Chapter 1.2.3 --- Stability Genes --- p.12 / Chapter 1.2.4 --- Types of Cancer --- p.13 / Chapter 1.2.5 --- Cancer Therapy --- p.13 / Chapter 1.2.6 --- Apoptosis --- p.14 / Chapter 1.3 --- Chronic Myelogenous Leukemia (CML) --- p.17 / Chapter 1.3.1 --- Philadelphia Chromosome and BCR-ABL gene --- p.18 / Chapter 1.3.2 --- Treatment of CML --- p.20 / Chapter 1.4 --- Dendritic Differentiation of LC976 on K-562 --- p.20 / Chapter 1.4.1 --- Dendritic Cells --- p.21 / Chapter 1.4.2 --- Cancer Vaccine Development of Leukemia --- p.22 / Chapter 1.4.3 --- Dendritic differentiation of K-562 cells --- p.23 / Chapter 1.5 --- Perspective of the Project --- p.23 / Chapter Chapter 2 - --- Materials and Methods / Chapter 2.1 --- Materials / Chapter 2.1.1 --- Chemicals and Reagents --- p.25 / Chapter 2.1.2 --- Bioassay Kits --- p.26 / Chapter 2.1.3 --- Human Cell Lines --- p.26 / Chapter 2.1.4 --- Lab Wares and Equipments --- p.28 / Chapter 2.2 --- Extraction of LC9 --- p.76 / Chapter 2.2.1 --- Chemical Properties of the Lead Compound --- p.28 / Chapter 2.2.2 --- Crude Extraction of Trichosanthes sp --- p.29 / Chapter 2.2.3 --- Purification by Reversed-Phase Column --- p.29 / Chapter 2.2.4 --- Lyophilization and Preparation of LC976 --- p.31 / Chapter 2.3 --- Anti-Proliferation Effect of LC976 on Human Cell Lines / Chapter 2.3.1 --- Maintenance of Cell Lines --- p.32 / Chapter 2.3.2 --- MTT Assay --- p.32 / Chapter 2.3.3 --- BrdU Cell Proliferation ELISA --- p.34 / Chapter 2.4 --- Apoptosis Induction on K-5 --- p.62 / Chapter 2.4.1 --- PI Staining --- p.35 / Chapter 2.4.2 --- Annexin V-FITC FACS Analysis --- p.36 / Chapter 2.4.3 --- Caspase Activation --- p.37 / Chapter 2.5 --- Effect on Normal Human Lymphocytes / Chapter 2.5.1 --- Preparation of Human Normal Lymphocytes --- p.38 / Chapter 2.5.2 --- MTT Cell Viability Assay --- p.38 / Chapter 2.5.3 --- PI Staining --- p.39 / Chapter 2.5.4 --- Annexin V-FITC FACS Analysis --- p.39 / Chapter Chapter 3 - --- Results / Chapter 3.1 --- Extraction of LC976 --- p.40 / Chapter 3.2 --- LC976 Inhibited Proliferation of Human Cell Lines / Chapter 3.2.1 --- MTT Assay --- p.41 / Chapter 3.2.2 --- BrdU Cell Proliferation ELISA --- p.52 / Chapter 3.3 --- LC976 Induced Apoptosis in K-562 Cells / Chapter 3.3.1 --- PI Staining --- p.63 / Chapter 3.3.2 --- Annexin V-FITC FACS Analysis --- p.70 / Chapter 3.3.3 --- Caspase Activation --- p.73 / Chapter 3.4 --- Effect on Normal Human Lymphocytes / Chapter 3.4.1 --- MTT Cell Viability Assay --- p.76 / Chapter 3.4.2 --- PI Staining --- p.78 / Chapter 3.4.3 --- Annexin V-FITC FACS Analysis --- p.82 / Chapter Chapter 4 - --- Discussion / Chapter 4.1 --- Extraction of LC976 --- p.85 / Chapter 4.2 --- LC976 Inhibited Proliferation of Human Cell Lines / Chapter 4.2.1 --- MTT Assay --- p.86 / Chapter 4.2.2 --- BrdU Cell Proliferation ELISA --- p.88 / Chapter 4.3 --- LC976 induced Apoptosis in K-562 Cells / Chapter 4.3.1 --- PI Staining --- p.90 / Chapter 4.3.2 --- Annexin V-FITC Analysis --- p.95 / Chapter 4.3.3 --- Caspase Activation --- p.96 / Chapter 4.4 --- Effect on Normal Human Lymphocytes / Chapter 4.4.1 --- MTT Cell Viability Assay --- p.98 / Chapter 4.4.2 --- PI Staining --- p.99 / Chapter 4.4.3 --- Annexin V-FITC FACS Analysis --- p.100 / Chapter 4.5 --- Conclusion --- p.103 / Reference --- p.104

Additionally, we showed that SeC induced S-phase arrest in MCF-7 cells associated with a marked decrease in the protein expression of cyclin A, D1 and D3 and cyclin-dependent kinases (CDK) 4 and 6, with concomitant induction of p21waf1/Cip1, p27Kip1 and p53. Expose of MCF-7 cells to SeC resulted in delayed onset of apoptosis as evidenced by caspase activation, PARP cleavage and DNA fragmentation. SeC treatment also triggered the activation of JNK, p38 MAPK, ERK and Akt phosphorylation. Inhibitors of ERK (U0126) or Akt (LY294002), but not JNK (SP600125) and p38 MAPK (SB203580), significantly suppressed SeC-induced S-phase arrest and apoptosis in MCF-7 cells. In conclusion, our findings establish a mechanistic link between the PI3K/Akt pathway, MAPK pathway and SeC-induced cell cycle arrest and apoptosis in human breast cancer cells. (Abstract shortened by UMI.) / The role of selenium as potential cancer chemopreventive and chemotherapeutic agents has been supported by epidemiological, preclinical and clinical studies. Although cell apoptosis has been evidenced as a critical mechanism mediating the anticancer activity of selenium, the underlying molecular mechanisms remain elusive. In the present study, selenocystine (SeC), a novel organic selenocompound, is identified as a novel antiproliferative agent with a broad spectrum of inhibition against eight human cancer cell lines with the IC50 values ranged from 3.6 to 37.0 muM. Despite this potency, SeC was relatively nontoxic toward HS68 human fibroblasts with an IC 50 value exceeded 400 muM. Further investigation on the molecular mechanisms indicated that SeC induced caspase-independent apoptosis in MCF-7 breast carcinoma cells, which was accompanied by poly(ADP-ribose) polymerase (PARP) cleavage, caspase activation, DNA fragmentation, phosphatidylserine exposure and nuclear condensation. Moreover, SeC induced the loss of mitochondrial membrane potential (DeltaPsim) by regulating the expression and phosphorylation of pro-surivival and pro-apoptotic Bcl-2 family members. Loss of DeltaPsim led to the mitochondrial release of cytochrome c and apoptosis-inducing factor (AIF) which subsequently translocated into the nucleus and induced chromatin condensation and DNA fragmentation. MCF-7 cells exposed to SeC shown increase in total p53 and phosphorylated p53 on serine residues of Ser15, Ser20, and Ser392 prior to mitochondrial dysfunction. Silencing and attenuation of p53 expression with RNA interference and pifithrin-alpha treatment respectively, partially suppressed SeC-induced cell apoptosis. Furthermore, generation of reactive oxygen species (ROS) and subsequent induction of DNA strand breaks were found to be upstream cellular events induced by SeC. The thiol-reducing antioxidants, N-acetylcysteine and glutathione, completely blocked the initiation and execution of cell apoptosis. Taken together, these results suggest that SeC, as a promising anticancer selenocompound, induces caspase-independent apoptosis in MCF-7 cells mediated by ROS generation and p53 phosphorylation through regulating the mitochondrial membrane permeability. / Chen, Tianfeng. / Adviser: Yun-Shing Wong. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3260. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 124-136). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

At present, there is no cure for bone metastasis. The current goals in patient care are to palliate pain, prevent pathological bone fracture and increase the strength and function of bone, so as to extend the life expectancy and maintain a good quality of life. Bisphosphonate treatment is the currently standard therapy of bone metastasis and is commonly used by physicians; it alleviates the tumour-induced hypercalcemia in 90% of patients and reduces the metastatic bone pain in 50% of patients. Moreover, it also prevents the pathological fracture of the affected bones. However, while effective, bisphosphonate injections are very costly, though its oral formulation is less expensive it is also less efficacious, and causes gastrointestinal discomfort. Furthermore, prolonged use of bisphosphonate treatment may lead to certain adverse effects, including hypocalcemia. These factors will prohibit the longterm use of such medication as it can negatively affect the treatment outcome. / Based on enormous medical potentials illustrated by the aforementioned findings, BBYNG deserves wider clinical application, large-scale clinical study on its preventive effect against bone metastasis and detailed investigation of its mode(s) of action in the body. / Based on the above-described understanding of Chinese medicine and bone metastasis, supplementing the kidney and strengthening bone could be the basic principle for the treatment of bone metastasis using Chinese medicine. In view of this theory, and in addition to the clinical observation and a thorough search of the available literature, we selected relevant kidney-tonifying Chinese herbs, namely (Fructus Ligustri Lucidi), (Rhizoma Drynariae), (Herba Epimedii), (Psoralea Corylifolia) and wide-spectrum anticancer herbs (Herba Hedyotidis Diffusae) for the preparation of a combined formula--BBYNG. / Chinese medicine has long been used to treat cancers. Its advantages reside in its holistic properties, which bring palliative, corrective and convalescing functions against damage caused by radiotherapy, chemotherapy and surgery. These features position Chinese medicines as the adjuvant to orthodox cancer treatment. During the late stage of tumour development, when standard therapy is no longer effective, Chinese medicine plays a critical role as an integrated therapy. Searching for a safe, inexpensive and effective Chinese medicine preparation suitable for prolonged use as adjunct therapy in late cancer cases is of paramount importance. / Clinical results. Both Chinese medicine and Western medicine treated patients showed no significant change in their blood parameters or liver and kidney examinations before and after drug administration; Male subjects on BBYNG, their bone mass density remained stable after 6 months treatment and the subjects on OSTAC showed slightly decreased In females, subjects on BBYNG remained stable, but subjects on OSTAC slightly increased. / Clinical study. The study was designed as a randomized, parallel-group comparison between BBYNG formula and Bisphosphonate. The patients who meet the inclusion/exclusion criteria were randomly assigned to receive either BBYNG granules, which was prepared by a GMP manufacturer, or Clodronic acid. The treatment period was 6 months (24 weeks). For both groups, various clinical parameters such as body functions, blood examinations, bone density (BMD) assessment, X-ray examinations, pain intensity and quality of life were evaluated and compared. / Conclusions. (1) As an adjuvant to patients with bone metastases, BBYNG is effective in relieving the metastatic bone pain, improving the quality of life. (2) In the animal model, BBYNG reduced the metastatic bone damage, prolonged the survival and enhanced the T lymphocyte immunity in the tumour-bearing mice. (3) In vitro study on the breast and lung cancer cell lines showed that BYYNG could induce apoptosis and prevent tumour cell invasion. It suggests that BYYNG may restrict tumour growth and development, thus reducing the occurrence of bone metastasis. / In accordance with Chinese medicine, bone metastasis can be categorized into "bone tumour" "bone erosion" "bone wilting" "bone necrosis" and "bone impediment". The main cause of bone metastasis is twofold: cancer toxicity, and in Chinese medicine theory, the kidney governs the bone marrow, if the kidney is not functioning in balance, then the bone will become weak. Cancer toxicity is the "pathogenic cause" to skeletal metastases, while kidney weakness decreases the body defence against the cancer. A vicious cycle ensues when cancer and kidney deficiency and bone weakness occurs simultaneously coincidently and worsens the conditions. / In vitro study on tumour cell lines. The anticancer effects of different concentrations of BBYNG formula and various single components against human breast cancer and lung cancer cell lines were evaluated by cell viability test (MTT assay), cell apoptosis test and invasion suppression test. / In vitro study results. BBYNG and the aqueous extracts of its component herbs at very low drug concentrations stimulated the growth of three tumour cell lines tested. When the concentrations were slightly increased, they showed an inhibitory effect on cancer cell proliferation. As the drug concentrations further increased, the extracts showed cytotoxic effects on these tumor cells. At the noncytotoxic dose, the extracts could trigger apoptosis and enhance the caspase-3 activity in all three tumour cell lines. In addition, at this "non toxic" concentration, the extracts markedly inhibited the in vitro invasive property of the 4T1 breast cancer cell lines in our Matrigel invasion model. Thus these in vitro results suggested that BBYNG possess anticancer, invasion-inhibitory and anti-metastatic activities. / In vivo animal study results. (Tumour growth was slower in the BBYNG treatment group when compared to the OSTAC and control groups, but this was not significantly difference) BBYNG significantly delayed tumour growth in tumour bearing mice, but it did not minimize the tumour size markedly. Moreover, BBNYG did minimize the mobility restriction caused by tumours, reduce the damage to bones, prolong the survival time and enhanced the T lymphocyte immunity. / In vivo animal study. A well-established animal model for breast cancer was used to evaluate and compare the pharmacological effects of BBYNG formula and Clodronic acid, as shown by different indicators such as tumour progression, animal's mobility, survival time, bone metastasis-induced fracture intensity and the immunological status of the tumour-bearing mice. / Malignant tumour is characterized by early metastasis. Among them 37 to 80 (depending on which type of cancer) patients show tendency of bone metastasis. Bone metastasis is usually accompanied by various complications, such as severe pain, pathological bone fracture, hypercalcemia, and bone marrow suppression, which can substantially affect the quality of life of the patients. Thus, the prevention and treatment of bone metastasis in cancer is an issue worth pursuing. / Malignant tumours leading to high mortality and morbidity are a serious threat to human health. It is the leading cause of death in China. In Hong Kong, there are over 20 thousand new cancer cases and more than 1100 people die due to cancers every year. / Study objectives. To elucidate the efficacy and some pharmacological aspects of BBYNG in regard to the treatment of bone metastasis through clinical observation and different laboratory experiments. This study would be of significant reference value to the disease-oriented drug formulation and application, mechanistic study and research methodology of the treatment of bone metastasis using Chinese medicines. / The clinical and laboratory experimental results are summarized as below: / The research study is composed of three parts, the clinical study, in vivo animal study and in vitro study on tumour cell lines. The research methods used are as follows: / Those on BBYNG treatment showed more a stable and satisfactory quality of life than those in the Western medicine-treated group. For the Clodronic acid treatment group, patients generally showed worsened symptoms and quality of life deteriorated. The ECOG index of the BBYNG group was statistically better than that of the Clodronic acid group. Within the 72-week clinical observational period, the mortality of Clodronic acid group is significantly higher that of the BBYNG group. The effects of BBYNG group as presented in relieving the pain-induced influence on patients' emotion, interpersonal relationship and entertainment was more pronounced than that in the Clodronic acid group. / Wu Ka. / 論文(哲學博士)--香港中文大學, 2006. / 參考文獻(p. 299-324). / Adviser: Leung Ping Chung. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1570. / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / School code: 1307. / Lun wen (zhe xue bo shi)--Xianggang Zhong wen da xue, 2006. / Can kao wen xian (p. 299-324). / Wu Ka.

O linfoma difuso de grandes células B (LDGCB) é o linfoma não-Hodgkin mais comum em nossa instituição (49,5%) e a classificação da Organização Mundial da Saúde reconhece vários subtipos de LDGCB com base na morfologia, imuno-histoquímica (IHQ) e perfil molecular. Metade dos pacientes permanecem incuráveis com terapia padrão baseada no anticorpo monoclonal anti-CD20 (rituximabe) e quimioterapia baseada em antraciclina. Portanto, é necessário identificar pacientes de alto risco e melhorar o seu prognóstico. Na era pré-rituximabe, a melhor maneira de identificar esse grupo de alto risco baseava-se no Índice de Prognóstico Internacional (IPI). Mais recentemente, grande interesse em subtipos moleculares e a caracterização da assinatura gênica das células malignas têm sido publicados. Pacientes com perfil de expressão gênica do centro germinativo (CG) parecem ter melhor prognóstico do que aqueles com assinatura de células B ativadas. Algoritmos IHC correspondentes foram propostos e o de Hans é o mais usado. No entanto, estes indicadores prognósticos têm sido questionados na era rituximabe. Além da classificação molecular, imagem funcional das células tumorais com 18F-fluodesoxiglucose (18F-FDG), a tomografia por emissão de pósitrons (PET/CT) tem sido recomendada ao diagnóstico e final do tratamento para aumentar a acurácia do estadiamento e avaliação de resposta. Embora alguns estudos tenham demonstrado que PET ínterim pode prognosticar a eficácia do tratamento, não há consenso e a utilização da PETi permanece controversa. O objetivo deste estudo foi investigar o impacto de fatores prognósticos clínicos, da PETi após dois ciclos de quimioterapia, e a célula de origem (CO) usando o algoritmo de Hans, como ferramentas prognósticas em pacientes tratados com R-CHOP 21. Foram analisados prospectivamente 147 pacientes. Dados clínicos estavam disponíveis em 146 casos. PETi foi realizada em 111 pacientes e 114 pacientes foram classificados em CG e NCG pelo algoritmo IHC de Hans. Com mediana de seguimento de 42,8 meses, a sobrevida global (SG), sobrevida livre de progressão (SLP) e resposta global (RG) para todos os pacientes foram 73,8%, 84,3% e 87,7%, respectivamente. IPI, R-IPI e NCCN IPI foram todos preditivos de SG. O IPI NCCN foi capaz de melhor discriminar um grupo de alto risco quando comparado ao de outros índices prognósticos clínicos. Embora PETi- tenha identificado um grupo com melhor SG (89,3% SG para PETi- versus 77,5% para a PETi+)(p = 0,04), a SLP entre os dois grupos não foi prognóstica (p=0,45), com SLP em 30 meses de 87,7%/81,2% para PETi- e PET+, respectivamente. O algoritmo de Hans não foi preditivo de SG, SLP ou RG. Associado à PETi-, ser do CG identificou um grupo de muito bom prognóstico, com SG e SLP de 100% em 48 meses. A análise univariada e multivariada revelou que, além da PETi-, o IPI, R-IPI e IPI do NCCN, juntamente com algumas variáveis que compõem este índice, foram preditivos para o SG, SLP e resposta completa. Este estudo mostrou que os fatores prognósticos clínicos são relevantes na era R-CHOP e a PETI, junto com a CO, foram capazes de identificar um subgrupo de muito bom prognóstico. Nossos resultados necessitam de confirmação / Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma in our institution (49.5%) and the World Health Organization classification recognizes several subtypes of DLBCL based on morphology, immunohistochemistry (IHC) and molecular analysis. A half of patients remain incurable with standard strategy with anti-CD20 monoclonal antibody (rituximab) and anthracycline-based chemotherapy. Therefore, it is necessary to identify high risk patients and improve their prognosis. In the pre-rituximab era, the best way to identify this high risk group was based on International Prognostic Index (IPI). More recently, lot of interest on molecular subtypes and aspects that characterize the gene signature of the malignant cells have been published. Patients with gene expression profile from germinal center (GC) seem to show better prognosis than those with Bcells activated signature. Correspondents algorithms based on IHC were proposed and Hans algorithm is the most commonly used. However these prognostic indicators have also been questioned in the rituximab era. In addition to the molecular classification, functional imaging of the tumor cells with 18F-fludeoxyglucose (18F-FDG) positron emission tomography PET/CT has been recommended at diagnosis and at the end of treatment to improve accuracy of staging and response evaluation. Although some studies have shown that interim PET may be a prognostic indicator of effectiveness of treatment, there is no agreement and the use of interim PET as a prognostic factor remains controversial. The objective of this study was to investigate the impact of clinical prognostic factors, interim imaging with 18F-FDG PET/CT after 2 cycles of treatment and cell of origin (CO) using Hans\' algorithm as prognostic tools in patients treated with R-CHOP 21. 147 DLBCL patients were analyzed prospectively and clinical data was available in 146 cases. 18 F-FDG interim PET/CT was performed in 111 patients and DLBCL was classified as GC and NGC subtype by IHC using Hans\'s algorithm in 114 patients. With a median follow-up of 42.8 months, overall survival (OS), progression free survival (PFS) and overall response (OR) for all patients were 73.8%, 84.3% and 87.7% respectively. IPI, R-IPI and NCCN IPI were all predictive of OS. NCCN IPI was able to better discriminate a high risk group comparable with other clinical prognostic indexes. Although negative iPET identified a group with better OS (89.3% OS for PETi- versus 77.5% for PETi+)(p=0.04), PFS between the two groups was not prognostic (p=0.45) with a 30 months PFS of 87.7% and 81.2%, for PETi- and PET+, respectively. Hans algorithm was not predictive for OS, PFS or OR. Instead it was, together with PETi- and CG origin, able to predict a very good prognostic group, with both 100% OS/PFS in 48 months. The univariate and multivariate analysis revealed that besides negative interim PET, IPI, R-IPI and NCCN IPI along with some variables that compose this indexes, were predictive for OS, PFS and complete response. This study showed that clinical prognostic factors are relevant in R-CHOP era and PETi, along with CO, were able to identify a very good prognostic subgroup. Our results should be confirmed in others studies

Pacientes com diagnósticos oncológicos diversos sob terapia com agentes nefrotóxicos, foram avaliados através de procedimentos radioisotópicos, em três momentos diferentes. Os achados radioisotópicos foram comparados com as avaliações laboratoriais rotineiras. Não mostraram alterações estatisticamente significativas os seguintes parâmetros: uréia, creatinina, sedimentos anormais e índice de Crockoft-Gault. Concluiu-se que a avaliação da função renal com os métodos rotineiramente utilizados na prática oncológica não foram estatisticamente significativas. Dentre os estudos utilizando radionuclídeos, o DTPA-99mTc e DMSA-99mTc, evidenciaram alterações, enquanto o EC-99mTc, não as detectou / Patients with different oncologic diagnoses under treatment with nephrotoxic drugs were evaluated by radioisotopic agents at three different moments. Radioisotopic data were compared with biochemical routine tests. Concerning laboratorial parameters like serum creatinine, urea and Cockroft Gault index, no statistically significant changes were observed. Possible to conclude that renal function evaluation with methods routinely used in oncological practice did not reveal any statistically significant change. Radioisotopic studies using 99mTc-DTPA and 99mTc-DMSA showed considerable alterations, however with 99mTc-EC no significant changes were evidenced

Pacientes com diagnósticos oncológicos diversos sob terapia com agentes nefrotóxicos, foram avaliados através de procedimentos radioisotópicos, em três momentos diferentes. Os achados radioisotópicos foram comparados com as avaliações laboratoriais rotineiras. Não mostraram alterações estatisticamente significativas os seguintes parâmetros: uréia, creatinina, sedimentos anormais e índice de Crockoft-Gault. Concluiu-se que a avaliação da função renal com os métodos rotineiramente utilizados na prática oncológica não foram estatisticamente significativas. Dentre os estudos utilizando radionuclídeos, o DTPA-99mTc e DMSA-99mTc, evidenciaram alterações, enquanto o EC-99mTc, não as detectou / Patients with different oncologic diagnoses under treatment with nephrotoxic drugs were evaluated by radioisotopic agents at three different moments. Radioisotopic data were compared with biochemical routine tests. Concerning laboratorial parameters like serum creatinine, urea and Cockroft Gault index, no statistically significant changes were observed. Possible to conclude that renal function evaluation with methods routinely used in oncological practice did not reveal any statistically significant change. Radioisotopic studies using 99mTc-DTPA and 99mTc-DMSA showed considerable alterations, however with 99mTc-EC no significant changes were evidenced

BACKGROUND: Human papilloma virus (HPV) in patients with esophageal carcinoma has previously been studied with an average detection rate of 15%, but the role of HPV in relation to survival is less clear. In cervical cancer, lung cancer and tonsil cancer HPV viral load is a predictive factor for survival and outcome of treatment. The primary aim was to study the spectrum of high-risk HPV types in esophageal tumors. Secondary, as a pilot study we investigated the association between HPV status and the survival rates. METHODS: We compared both the presence and the viral load of high-risk HPV types 16, 18, 31, 33, 39, 45, 52, 58, and 67 in relation to clinical data from patients with esophageal carcinoma. Survival data and tumor samples were retrieved from 100 patients receiving treatment at the Department of Oncology, Uppsala Hospital, Uppsala, Sweden. The tumor samples were investigated for HPV viral load using real-time PCR. RESULTS: HPV 16 was detected in 16% of the patients; no other HPV type was detected. HPV 16 infection had no significant effect on survival (p = 0.72). Also, HPV 16 did not improve survival after treatment (radiotherapy or chemotherapy). CONCLUSION: Only HPV 16 was detected among the patients. HPV 16 in esophageal carcinoma patients did not influence survival or improve therapy response. However, given the size of the study there is a need to examine a larger cohort in order to understand in more detail the effect of high risk HPV types in esophageal carcinoma. / <p>De två första författarna delar förstaförfattarskapet.</p>

The societal burden of autoimmune diseases and donor organ transplant rejection in developed countries reflects the lack of effective immune suppressive drugs. The main objective of my thesis was to develop novel fusion proteins targeting receptors linked to autoimmunity; strategies that will allow the suppression of autoreactive cells while sparing resting lymphocytes. Interleukin (IL) 15 has been demonstrated to exert its effects mainly on activated T-cells triggered via their T-cell receptor (TCR). Since we found that the fusion of granulocyte-macrophage colony stimulating factor (GMCSF) to IL15 - aka GIFT15 - paradoxically leads to aberrant signalling downstream of the IL15R and blocks interferon (IFN)-gamma secretion in a mixed lymphocyte reaction (MLR), we hypothesized to use this fusokine in proof-of-principle cell transplantation models and shown that GIFT15 can indeed block the rejection of allogeneic and xenogeneic cells in immunocompetent mice. Additionally, we found that ex vivo GIFT15 treatment of mouse splenocytes lead to the generation of regulatory B-cells (Bregs). These Bregs express high levels of MHCII, IL10 and are capable to block antigen (Ag)-presentation in vitro as third party bystander cells. Moreover, a single injection of these GIFT15-generated Bregs in mice with pre-developed experimental autoimmune encephalomyelitis (EAE) leads to long lasting remission of disease. / Along those lines, we also found that mesenchymal stromal cells (MSCs) lead to the paracrine conversion of CCL2 to an antagonist form capable of specifically inhibiting plasma cells and activated Th17 cells. This mechanistic insight informed the design of a second class of suppression fusokine. Namely, the fusing of antagonist CCL2 to GMCSF - aka GMME1. We tested its potential use in autoimmune diseases such as EAE and rheumatoid arthritis (RA). We demonstrated that GMME1 leads to asymmetrical signalling and inhibition of plasma cells as well as Th17 EAE/RA-reactive CD4 T-cells. The net outcome of these pharmacological effects is the selective depletion of CCR2-reactive T-cells as demonstrated both in vitro and in vivo. / Overall, our data support the use of our fusion proteins as part of a powerful and specific immunosuppressive strategy either as directly injectable protein biopharmaceuticals or through the ex vivo generation of autologous Bregs in the case of GIFT15.

No description available.

No description available.