A síndrome de Knobloch (SK) é uma doença autossômica recessiva rara, caracterizada por problemas oculares e presença de encefalocele occipital, porém o quadro clínico é variável. Os pacientes apresentam principalmente miopia de grau elevado, degeneração vítreo-retiniana e descolamento de retina; o grau de comprometimento da alteração no occipital também é variável. Nossos estudos mostraram que a SK é causada por mutações no gene COL18A1, que codifica o colágeno tipo XVIII. Esse colágeno, uma proteoglicana da matriz extracelular, tem sido estudado principalmente por liberar a endostatina, um fragmento de 20 kDa clivado proteoliticamente de sua porção C-terminal e que possui atividade inibidora da angiogênese. O colágeno XVIII possui três isoformas conhecidas, as quais diferem entre si apenas na porção N-terminal e apresentam padrões de expressão distintos nos tecidos, mesmo estando ubiquamente presentes nas membranas basais epiteliais e endoteliais. Além da endostatina, o colágeno XVIII apresenta outros motivos com funções ainda desconhecidas: um domínio trombospondina, presente em todas as isoformas e um domínio frizzled, encontrado apenas na forma mais longa da proteína. O espectro de variação clinica na SK ainda é incerto, assim como os mecanismos moleculares que levam ao fenótipo. Nosso trabalho teve como objetivos principais a identificação de mutações no COL18A1 em um número maior de famílias com a SK, estabelecimento de novos protocolos que possam auxiliar no diagnóstico clínico e a avaliação do efeito funcional de variações encontradas na endostatina, domínio de maior conservação do colágeno XVIII. Propusemo-nos ainda a identificar proteínas que interagem com o domínio trombospondina. Apresentamos aqui a caracterização de sete novas mutações no colágeno XVIII em pacientes com SK, permitindo assim uma melhor determinação do espectro de variação fenotípica da SK. Com base na identificação dessas mutações pudemos incluir problemas neurológicos nos possíveis sinais clínicos presentes na SK ao apresentar pela primeira vez alterações de migração neuronal em pacientes com a síndrome. A ausência de mutações detectadas em três famílias sugere ainda a existência de heterogeneidade genética na SK. Também propomos neste trabalho a utilização da imunohistoquímica em biópsias de pele como teste diagnóstico para essa doença. Nossos resultados mostram também que a variação A48T da endostatina leva a alterações em sua interação com proteínas da matriz extracelular, enquanto a variação polimórfica D104N, previamente associada ao desenvolvimento de câncer de próstata, não leva a um efeito sobre a interação com as proteínas testadas. E, por último, o método de duplo híbrido não foi eficaz para a identificação de proteínas que possam interagir com o domínio trombospondina do colágeno XVIII. / Knobloch syndrome (KS) is an autosomal recessive disorder characterized by ophthalmological defects and presence of an occipital encephalocele. Clinical variability is present, however, all patients present high grade myopia, vitreoretinal degeneration and in most cases, retinal detachment; the occipital defect is also variable. Studies show that the KS is caused by mutations in COL18A1, the gene that codes for type XVIII collagen. This collagen is an extracellular matrix proteoglycan and has been the focus of a great number of studies due to its C-terminal domain, endostatin. Endostatin is a 20 kDa fragment that is proteolytically cleaved and possesses a high antiangiogenic activity. Type XVIII collagen is known to be expressed in three isoforms, different among themselves in the N-terminal region. These isoforms have distinct expression patterns, but are present in most basement membranes. Besides endostatin, type XVIII collagen also presents other domains with unknown functions: a thrombospondin domain, found in all isoforms; a frizzled domain, present in the longest isoform. The clinical variability spectrum in KS and the molecular mechanisms that lead to the phenotype are still uncertain. The aim of this study was to identify novel mutations in COL18A1 in additional KS families, to develop biochemical diagnostic tests that could allow the screening of a larger number of patients and to evaluate the effect of naturally found variants in the function of endostatin. We also performed a two-hybrid screening in order to identify proteins that can interact with the thrombospondin domain. The characterization of seven novel mutations in KS patients allowed us to better determine the clinical variability of KS. This work shows for the first time the presence of neuronal migration defects in some KS patients. The lack of detected pathogenic mutations in three families led us to propose the genetic heterogeneity of this syndrome. We demonstrate the possibility to use immunohistochemistry in skin biopsies as a diagnosis method. Our results also show the altered properties of T48 endostatin in its interaction with some extracellular matrix proteins. The N104 variant, that has been previously associated with prostate cancer, do not present any change in its interaction to the tested molecules. Finally, the two-hybrid system was not a good method to detect interacting proteins with the thrombospodin domain of collagen XVIII.

A endostatina (ES) é uma proteína inibidora da angiogênese, com ação específica sobre células endoteliais em proliferação, utilizada para tratamento de tumores sólidos. No entanto, o elevado efeito antitumoral da ES observado em animais não é reproduzido em humanos. Com o intuito de potencializar a eficácia terapêutica da ES, produzimos duas proteínas híbridas com dois domínios funcionais. O primeiro domínio é a ES, que apresenta especificidade por células endoteliais ativadas, dirigindo estas proteínas de fusão às células endoteliais em proliferação, promovendo sua internalização e seu efeito inibitório. Como segundo domínio funcional utilizamos os domínios BH3 próapoptóticos de duas proteínas BH3-only com o objetivo de promover a liberação de citocromo C e desencadear o processo de apoptose, aumentando a ação antiangiogênica da ES. Neste trabalho, foram desenhadas duas proteínas de fusão que contêm o domínio BH3 das potentes proteínas pró apoptóticas PUMA e BIM (ES-PUMA e ES-BIM), que deveriam apresentar efeito antiangiogênico potencializado em relação à ES selvagem. A inserção dos fragmentos de DNA codificantes para os domínios BH3 de PUMA e BIM no vetor contendo o gene da ES (pET-ES) foram realizadas por mutagênese sítiodirigida. Estas proteínas de fusão recombinantes foram expressas como corpos de inclusão em E.coli, renaturadas utilizando processo que utiliza alta pressão e purificadas em resina de afinidade por heparina. O tratamento de células endoteliais com as proteínas ES-PUMA e ES-BIM não levou à queda de viabilidade em ensaio de MTS ou de apoptose avaliado por citometria de fluxo, em comparação com os resultados obtidos pelo tratamento com ES. / Endostatin (ES) is an angiogenesis inhibitor protein, with specific effect on proliferating endothelial cells, used to treat solid tumors. However, the high antitumor effect observed in animals is not reproduced in humans. In order to enhance the therapeutic efficacy of ES, we produced two hybrid proteins with two functional domains. The first domain is the ES that is specific for activated endothelial cells, directing the fusion proteins to endothelial cells in proliferation, promoting the internalization and the inhibitory effect. As a second functional domain we used the pro-apoptotic BH3 domains of two BH3-only proteins in order to promote the release of cytochrome C and trigger the apoptosis process, increasing the ES antiangiogenic action. In this work, we produced two fusion proteins containing the BH3 domain of the potent pro-apoptotic proteins BIM and PUMA (PUMA-ES and ES-BIM), which should provide enhanced antiangiogenic effect in relation to ES. The insertion of DNA fragments coding for the BH3 domain and PUMA and BIM in a vector containing ES gene (pETES) was accomplished by site-directed mutagenesis. These recombinant fusion proteins were expressed as inclusion bodies in E. coli, refolded using process at high pressure and purified on heparin affinity resin. Treatment of endothelial cells with ES-PUMA and ES-BIM did not lead to loss in viability in MTS assay or increase of apoptosis evaluated by flow cytometry, in comparison with the results obtained by treatment with ES.

Background Pancreatic ductal adenocarcinoma (PDAC) patients have the poorest 5-year survival rates of all cancer forms. It is difficult to diagnose at early disease stages, tumour relapse after surgery is common, and current chemotherapies are ineffective. Carbohydrate antigen 19-9 (Ca 19-9), the only clinically implemented PDAC biomarker, is insufficient for diagnostic and screening purposes. PDAC tumours are characterised by a voluminous stroma that is rich in extracellular matrix (ECM) molecules such as collagens, hyaluronan (HA) and matricellular proteins. These stromal components have been suggested to promote PDAC cell migration, proliferation, evasion of apoptosis and chemotherapy resistance. Those events are mediated via interactions with adhesion receptors, such as integrins and CD44 receptors expressed on cancer cell surfaces. Micro-RNAs (miRNA) post-transcriptionally regulate gene expression in health and disease. At the time of PDAC diagnosis, miRNA levels are altered both in plasma and tumour tissue. Before PDAC diagnosis, tissue miRNA levels are altered in precursor lesions, raising the possibility that plasma miRNAs might aid in early detection. In this thesis, it is hypothesised that stromal components and miRNAs can serve as tissue or blood based biomarkers in PDAC. The aims are: (1) to characterise the expression of stromal components and their receptors in normal and cancerous tissue; (2) to find potential stroma-associated tissue and blood-based biomarkers for diagnosis and prognosis estimates; (3) to determine the cellular effects of type IV collagen (Col IV) in PDAC; (4) to determine if plasma miRNAs that are altered in manifest PDAC can be used to diagnose PDAC earlier. Methods The expression patterns of Col IV, Col IV-binding integrin subunits (α1, α2, β1), Endostatin, Osteopontin (OPN) and Tenascin C (TNC) were analysed in frozen PDAC and normal pancreatic tissue. A tissue microarray (TMA) was constructed using formalin-fixed, paraffin-embedded primary tumours and lymph node metastases. The TMA was used to study the expression levels and associations with survival of the standard CD44 receptor (CD44s), its variant isoform 6 (CD44v6), HA, OPN and Col IV. Circulating levels of HA, Col IV, Endostatin, OPN and TNC were measured in PDAC patients and healthy individuals, and compared with conventional tumour markers (Ca 19-9, CEA, Ca 125 and TPS). The functional roles of Col IV were studied in PDAC cell lines by: (1) growth on different matrices (2) blocking Col IV binding integrin subunits, (3) blocking the Col IV domains 7s, CB3 and NC1, and (4) by down regulation of PDAC cell synthesis of Col IV using siRNA transfection. Plasma miRNAs alterations were screened for in samples from patients with manifest disease, using real-time quantitative PCR (RT-qPCR). To find early miRNA alterations, levels of those miRNAs that were altered at diagnosis were measured in prediagnostic plasma samples. Results High tissue expression of both the standard CD44 receptor (CD44s) and its variant isoform CD44v6 as well as low expression of stromal OPN were associated with poor survival. In addition, high CD44s and low OPN predicted poor survival independent of established prognostic factors. Circulating Col IV, Endostatin, OPN, TNC and HA were increased in preoperative samples from PDAC patients. Preoperatively, higher levels of serum-HA and plasma-Endostatin were associated with shorter survival. Postoperatively, higher levels of Col IV, Endostatin and OPN were associated with shorter survival. On the contrary, only one of the conventional tumour markers was associated with survival (Ca 125). Col IV stimulated PDAC cell proliferation and migration and inhibited apoptosis in vitro, dependent on the collagenous domain (CB3) of Col IV and the Col IV binding integrin subunit β1. Reduced endogenous Col IV synthesis inhibited these effects, suggesting that PDAC cells synthesise Col IV to stimulate tumour-promoting events via a newly discovered autocrine loop. 15 miRNAs were altered in early stage PDAC patients and the combination of these markers outperformed Ca 19-9 in discriminating patients from healthy individuals. However, none of the miRNAs were altered in prediagnostic samples, suggesting that plasma miRNA alterations appear late in the disease course. Conclusions Up regulated stromal components in PDAC tumours are detectable in blood samples and are potential diagnostic and prognostic biomarkers in PDAC. High circulating levels of Col IV, Endostatin, OPN and HA predict poor survival, as well as high expression of CD44s and CD44v6 and low expression of OPN in tumour tissue. PDAC cells synthesise Col IV, which forms BM-like structures close to cancer cells and promote tumour progression in vitro via an autocrine loop. Several plasma-miRNAs are altered in PDAC, but are not useful for early discovery.

OBJECTIF: Évaluer le rôle de l’endostatine, un nouveau marqueur anti-angiogénique, pour prédire le risque de prééclampsie (PE). METHODES: Il s’agit d’une étude cas témoins nichée dans deux cohortes prospectives. Les échantillons sanguins étaient collectés entre 11 et 17 semaines puis entre 18 et 26 semaines d’aménorrhée. L’hypertension gestationnelle était définie par une tension artérielle supérieure ou égale à 140/90mmHg à 2 reprises. Les cas de prééclampsie étaient définis par une hypertension gestationnelle associée à une protéinurie supérieure ou égale à 0.3 g /24h après 20 semaines de grossesse. La concentration d’endostatine était mesurée par une technique d’ELISA. Les résultats étaient exprimés en multiples de la médiane (MoM) et ajustés pour l’âge maternel, l’âge gestationnel, l’ethnie, et la cohorte d’origine. Une régression logistique était utilisée pour calculer des odds ratios (OR) ajustés et prédire le risque de PE. RESULTATS: Au total nous avons étudié 77 PE et 150 témoins chez des grossesses uniques. Parmi les PE 21 étaient de survenue précoce, avec un diagnostic avant 34 semaines et 41 étaient des PE sévères. Les cas avaient un IMC plus élevé que les témoins et étaient plus souvent Africaines. Les taux médians d’endostatine étaient significativement plus élevés chez les PE que chez les témoins au 1er trimestre (94.2 versus 90.7 ng/ml, p=0.004) et 2ème trimestre (105.8 versus 99.3 ng/ml p=0.002). Le taux d’endostatine entre 18 et 26 semaines était même plus élevé chez les patientes qui développaient une PE précoce. Lorsque l’endostatine était supérieure au 75èmepercentile (exprimée en MoM), le OR ajusté était de 1.33 95IC [0.68-2.58] à 11-17 semaines et 1.77 [0.94-3.34] à 18-26 semaines. L’OR ajusté pour les PE précoces était 3.51 [1.18-10.43] entre 11-17 semaines et 2.17 [0.67-7.06] entre 18-26 semaines. CONCLUSIONS: Un taux élevé d’endostatine dès le 1er trimestre est associé à une augmentation du risque de PE et surtout d’un risque de prééclampsie précoce. Toutefois l’endostatine seule a une trop faible valeur prédictive pour avoir une utilité clinique. / OBJECTIVE: To evaluate a new anti-angiogenic factor, endostatin, in relation to the risk of preeclampsia (PE). STUDY DESIGN: We performed a case control study nested in two separate prospective cohorts. Serum samples were collected at 11-17 weeks and 18-26 weeks of gestation. Maternal endostatin levels were measured by ELISA. Results were expressed as multiples of the median (MoM) adjusted for maternal age, gestational age, ethnicity, and cohort of origin. Logistic regression was used to calculate adjusted odds ratios (aORs) of PE. RESULTS: A total of 77 PE and 150 controls of singleton pregnancies were studied, including 21 early-onset PE (diagnosis before 34 weeks) and 41 severe PE. Cases had a higher pre-pregnancy BMI and were more likely of African ethnicity than controls. Endostatin levels were significantly higher in women with PE compared to controls at both the first and second trimester (median 94.2 vs. 90.7 ng/ml p=0.004 and 105.8 vs. 99.3 ng/ml p= 0.002 respectively). Endostatin levels were even higher in women with early-onset PE. At a cut-off level of 75th percentile of endostatin MoMs, the adjusted ORs for PE were 1.33, 95CI [0.68-2.58] at 11-17 weeks and 1.77 [0.94-3.34] at 18-26 weeks. The aORs for early-onset PE were 3.51 [1.18-10.43] at 11-17 weeks and 2.17 [0.67-7.06] at 18-26 weeks, respectively. CONCLUSION: Higher endostatin levels as early as in the first trimester may indicate an increased risk of subsequent PE, especially early onset PE. However endostatin alone has a poor predictive value for clinical usefulness.

Sex steroids are inevitable in women. However, long-term exposure to sex steroids increases the risk of breast cancer. A complete understanding of sex steroid control of the breast and how it relates to breast cancer risk is still lacking. Angiogenesis and proteolytic enzyme activity are crucial for the process by which tumors evolve into a vascularized, invasive phenotype. Matrix metalloproteinases are potent matrixdegrading enzymes that affect several steps in tumor progression including angiogenesis. In the female reproductive organs, sex steroids regulate angiogenesis and MMP activity, yet little is known how sex steroids affect these crucial events in normal and malignant breast tissue. This thesis elucidates a link between sex steroids, MMP activity, and angiogenesis. It is shown that estradiol down-regulates while tamoxifen up-regulates the protein expression and activity of MMP-2 and MMP-9 in human breast cancer cells in vitro and in human breast cancer xenografts in vivo. The results further suggest that a biological consequence of this regulation may be modulation of tumor angiogenesis. The net effect of adding tamoxifen to estradiol treatment was an increase in extracellular levels of the endogenous angiogenesis inhibitor endostatin and decreased levels of the tumor promoter TGF-β1 compared to estradiol treatment only. This was accompanied by reduced vasculature and decreased tumor growth. Similarly, a regulatory effect of estradiol and tamoxifen on endostatin generation was observed in normal human breast tissue by whole-tissue culture and microdialysis in human breast tissue in situ. In conclusion, the results presented in this thesis suggest previously unknown mechanisms of action of estradiol and tamoxifen in breast cancer and in normal human breast tissue, and novel means by which estradiol may tip the scale to favor angiogenesis. This knowledge may be important for the understanding of sex steroid dependent breast carcinogenesis and in the future development of tissue-specific preventive as well as therapeutic strategies against breast cancer.

OBJECTIF: Évaluer le rôle de l’endostatine, un nouveau marqueur anti-angiogénique, pour prédire le risque de prééclampsie (PE). METHODES: Il s’agit d’une étude cas témoins nichée dans deux cohortes prospectives. Les échantillons sanguins étaient collectés entre 11 et 17 semaines puis entre 18 et 26 semaines d’aménorrhée. L’hypertension gestationnelle était définie par une tension artérielle supérieure ou égale à 140/90mmHg à 2 reprises. Les cas de prééclampsie étaient définis par une hypertension gestationnelle associée à une protéinurie supérieure ou égale à 0.3 g /24h après 20 semaines de grossesse. La concentration d’endostatine était mesurée par une technique d’ELISA. Les résultats étaient exprimés en multiples de la médiane (MoM) et ajustés pour l’âge maternel, l’âge gestationnel, l’ethnie, et la cohorte d’origine. Une régression logistique était utilisée pour calculer des odds ratios (OR) ajustés et prédire le risque de PE. RESULTATS: Au total nous avons étudié 77 PE et 150 témoins chez des grossesses uniques. Parmi les PE 21 étaient de survenue précoce, avec un diagnostic avant 34 semaines et 41 étaient des PE sévères. Les cas avaient un IMC plus élevé que les témoins et étaient plus souvent Africaines. Les taux médians d’endostatine étaient significativement plus élevés chez les PE que chez les témoins au 1er trimestre (94.2 versus 90.7 ng/ml, p=0.004) et 2ème trimestre (105.8 versus 99.3 ng/ml p=0.002). Le taux d’endostatine entre 18 et 26 semaines était même plus élevé chez les patientes qui développaient une PE précoce. Lorsque l’endostatine était supérieure au 75èmepercentile (exprimée en MoM), le OR ajusté était de 1.33 95IC [0.68-2.58] à 11-17 semaines et 1.77 [0.94-3.34] à 18-26 semaines. L’OR ajusté pour les PE précoces était 3.51 [1.18-10.43] entre 11-17 semaines et 2.17 [0.67-7.06] entre 18-26 semaines. CONCLUSIONS: Un taux élevé d’endostatine dès le 1er trimestre est associé à une augmentation du risque de PE et surtout d’un risque de prééclampsie précoce. Toutefois l’endostatine seule a une trop faible valeur prédictive pour avoir une utilité clinique. / OBJECTIVE: To evaluate a new anti-angiogenic factor, endostatin, in relation to the risk of preeclampsia (PE). STUDY DESIGN: We performed a case control study nested in two separate prospective cohorts. Serum samples were collected at 11-17 weeks and 18-26 weeks of gestation. Maternal endostatin levels were measured by ELISA. Results were expressed as multiples of the median (MoM) adjusted for maternal age, gestational age, ethnicity, and cohort of origin. Logistic regression was used to calculate adjusted odds ratios (aORs) of PE. RESULTS: A total of 77 PE and 150 controls of singleton pregnancies were studied, including 21 early-onset PE (diagnosis before 34 weeks) and 41 severe PE. Cases had a higher pre-pregnancy BMI and were more likely of African ethnicity than controls. Endostatin levels were significantly higher in women with PE compared to controls at both the first and second trimester (median 94.2 vs. 90.7 ng/ml p=0.004 and 105.8 vs. 99.3 ng/ml p= 0.002 respectively). Endostatin levels were even higher in women with early-onset PE. At a cut-off level of 75th percentile of endostatin MoMs, the adjusted ORs for PE were 1.33, 95CI [0.68-2.58] at 11-17 weeks and 1.77 [0.94-3.34] at 18-26 weeks. The aORs for early-onset PE were 3.51 [1.18-10.43] at 11-17 weeks and 2.17 [0.67-7.06] at 18-26 weeks, respectively. CONCLUSION: Higher endostatin levels as early as in the first trimester may indicate an increased risk of subsequent PE, especially early onset PE. However endostatin alone has a poor predictive value for clinical usefulness.

Abstract Colorectal cancer (CRC) is among the most common cancers in Finland. Prognostic factors are important for predicting disease outcome and adjusting optimal treatment. The currently used prognostic methods for CRC have their limitations and consequently several biomarkers have been studied to find potential prognostic markers, but none have been adapted for routine use so far. In the present study, the relationships between the components of the immune system and other factors modulating tumor growth were assessed and their suitability to be used for use as prognostic tools in CRC were studied. The study material consisted of blood samples and surgical specimens collected from 148 CRC patients operated on in Oulu University Hospital and blood samples of 86 healthy controls. Concentrations of endostatin and 27 cytokines were measured from preoperative serum samples and control samples. Immunohistochemical methods were used for collagen XVIII and inflammatory cell analyses. The levels of several cytokines were altered in CRC patients compared to the controls. The serum cytokine profile achieved an excellent accuracy in discriminating CRC patients from healthy controls. Advanced CRCs were associated with elevated cytokine levels and a metastasized disease was linked to an orientation towards Th2 cytokine milieu. The presence of systemic inflammation, depicted by a modified Glasgow Prognostic Score (mGPS), correlated to CRC progression. The serum endostatin levels were elevated in CRC and correlated with invasion through muscular layer and systemic inflammation, but not with densities of local inflammatory cells. Collagen XVIII was expressed in tumor stroma and in the muscle layer of bowel wall. The serum cytokines and tumor infiltrating immune cells showed relatively weak associations. In conclusion, CRC is associated with significant alterations in serum cytokine milieu, which underlines the relevance of studying several cytokines and their relative alterations. The serum cytokine profile is a promising tool for discriminating CRC patients from healthy controls, but its clinical value needs to be validated. The elevated endostatin levels may result from invasion-related cleavage of collagen XVIII in the bowel wall, but further studies are needed to determine the value of endostatin in CRC prognosis. / Tiivistelmä Paksu- ja peräsuolisyöpä (kolorektaalisyöpä) on yleisimpiä syöpämuotoja Suomessa. Sen ennustetta kuvaavat mittarit ovat tärkeitä taudin etenemisen ennustamisessa ja hoidon suunnittelussa. Käytössä olevat kolorektaalisyövän ennusteen arvioinnin menetelmät eivät ole riittäviä. Uusia merkkiaineita onkin kehitetty ja testattu, mutta rutiinikäyttöön soveltuvia menetelmiä ei ole vielä löydetty. Tässä tutkimuksessa selvitettiin immuunijärjestelmän ja muiden kasvaimen kasvua säätelevien tekijöiden keskinäisiä yhteyksiä ja niiden merkitystä kolorektaalisyövän ennusteen arvioinnissa. Tutkimusmateriaali koostui Oulun yliopistollisessa sairaalassa leikattujen kolorektaalisyöpäpotilaiden (n = 148) leikkaus- ja verinäytteistä ja terveiden verrokkihenkilöiden (n = 86) verinäytteistä. Endostatiinin ja 27 sytokiinin pitoisuudet mitattiin seeruminäytteistä. Kollageeni XVIII:n ja tulehdussolujen analysoimiseen käytettiin immunohistokemiallisia menetelmiä. Useiden sytokiinien pitoisuudet olivat korkeammat potilailla kuin verrokeilla, mutta osassa sytokiineista pitoisuudet olivat alentuneet. Seerumin sytokiiniprofiili erotteli luotettavasti potilaat verrokeista. Pidemmälle edenneeseen tautiin liittyi sytokiinien korkeampia pitoisuuksia ja etäpesäkkeitä muodostanut tauti oli yhteydessä Th1-tyypin sytokiinien esiintymiseen. Systeeminen tulehdusreaktio oli yhteydessä syövän etenemiseen. Endostatiinipitoisuudet olivat kohonneet potilailla ja olivat yhteydessä kasvaimen invaasioon suolen seinämän lihaskerroksen läpi. Endostatiinipitoisuudet korreloivat myös systeemisen tulehdusreaktion kanssa, mutta eivät liittyneet paikallisten tulehdussolujen määrään. Kollageeni XVIII ilmentyi kasvaimen stroomassa ja suolen seinämän lihaskerroksessa. Sytokiineilla ja kasvaimen paikallisilla tulehdussoluilla todettiin olevan vain vähän keskinäisiä yhteyksiä. Kolorektaalisyöpään liittyy useita erisuuntaisia muutoksia seerumin sytokiinipitoisuuksissa, joten on olennaista tutkia eri sytokiinien suhteellisia muutoksia. Seerumin sytokiiniprofiili on lupaava potilaita ja verrokeita erotteleva mittari, jolla voi olla diagnostista arvoa. Kohonneet endostatiinipitoisuudet potilailla voivat johtua kasvaimen invaasioon liittyvästä kollageeni XVIII:n hajoamisesta suolen seinämässä, mutta lisätutkimuksia tarvitaan endostatiinin ennustetta kuvaavan arvon määrittämiseksi.

L’endostatine est le fragment C-terminal du collagène XVIII libéré dans la matrice extracellulaire par clivage enzymatique. C'est un inhibiteur endogène de l’angiogenèse et de la croissance tumorale. L'endostatine inhibe la prolifération et la migration des cellules endothéliales induite par le Fibroblast Growth Factor-2 ou le Vascular Endothelial Growth Factor et elle inhibe la croissance de 65 types de cellules tumorales. L’endostatine fait actuellement l’objet d’essais cliniques pour le traitement de différents cancers son mécanisme d’action est encore mal connu. Nous avons caractérisé par résonance plasmonique de surface (SPR) les interactions établies par l'endostatine avec les intégrines αvβ3 et α5β1 qui sont surexprimées à la surface des cellules endothéliales activée. Nous avons identifié le site de fixation l'endostatine sur les intégrines, proposé un modèle de structure du complexe formé par l'endostatine et l'intégrine αvβ3 et montré que l'endostatine ne peut pas se lier simultanément aux intégrines et aux chaînes d'héparane sulfate présentes à la surface cellulaire. Pour identifier des partenaires supplémentaires de l'endostatine, nous avons développé des puces à protéines et à glycosaminoglycanes basées sur la SPR et capables de suivre jusqu'à 400 interactions simultanément. Nous avons identifié neuf partenaires de l'endostatine (le dermatane sulfate, la transglutaminase-2, les collagènes I, IV et VI, le peptide amyloïde β1-42, et des protéines matricellulaires dont SPARC et thrombospondine-1). Nous avons montré que l’endostatine se fixe avec une forte affinité (KD ~ 6 nM) sur la transglutaminase-2 et que cette interaction nécessite la présence de calcium mais que l'endostatine n'est pas un substrat donneur d'acyle de l'enzyme. Nous avons montré que le réseau d'interactions de l'endostatine est enrichi en protéines contenant des modules EGF (Epidermal Growth Factor). Cela offre de nouvelles perspectives pour l'identification d'autres partenaires et donc de nouvelles fonctions de l'endostatine. Des protéines contenant des modules EGF comme la fibrilline-1, composant des fibres élastiques, et des protéines de l'immunité innée par exemple sont des partenaires potentiels de l'endostatine / Endostatin is the carboxyl-terminal fragment of collagen XVIII released in the extracellular matrix by proteolytic cleavage. It inhibits angiogenesis and tumor growth. Endostatin inhibits the proliferation and migration of endothelial cells induced by Fibroblast Growth Factor-2 and Vascular Endothelial Growth Factor and it inhibits 65 different tumor types. Endostatin is currently under clinical trials for several tumors. We have used surface plasmon resonance (SPR) binding assays to characterize interactions between endostatin and α5β1 or αvβ3 integrins which are over-expressed at cell surface of actived endothelial cell. We have identified the binding site of endostatin on those integrins, and we have built a molecular modeling of the endostatin/integrin αvβ3 complex. We have shown that endostatin can not bind simultaneously to integrins and to heparan sulfate. In order to identify new partners of endostatin we have developed glycosaminoglycan and protein arrays based on SPR detection. We have found nine new partners of endostatin include glycosaminoglycans (chondroitin and dermatan sulfate), matricellular proteins (thrombospondin-1 and SPARC), collagens (I, IV and VI), the amyloid peptide Aβ(1-42), and transglutaminase-2 (TG-2). We have shown that endostatin binds to transglutaminase-2 with an high affinity (KD ~ 6 nM) in a calcium-dependent manner. Enzymatic assays indicated that, in contrast to other extracellular matrix proteins, endostatin is not a glutaminyl substrate of TG-2, but would rather be an acyl acceptor. The endostatin network comprises a number of extracellular proteins containing EGF domains (Epidermal Growth Factor), and able to bind calcium. Depending on the trigger event, and on the availability of its members in a given tissue at a given time, the endostatin network might be involved either in the control of angiogenesis, and tumor growth, or in neurogenesis and neurodegenerative diseases

La matrice extracellulaire est constituée d'un réseau tridimensionnel de protéines et de polysaccharides complexes, les glycosaminoglycanes. Elle apporte un support structural aux tissus et aux cellules dont elle est capable de moduler la prolifération, la migration et la différenciation. Nous avons créé une base de données d'interactions extracellulaires protéine-protéine et protéine-glycosaminoglycane, MatrixDB, qui est disponible sur le Web (http://matrixdb.ibcp.fr). Nous avons intégré des données expérimentales, des données issues de l’analyse de la littérature et des données issues de bases de données d'interactions publiquement disponibles. Nous avons respecté les standards de curation et d’échange de données du consortium IMEx dont fait partie MatrixDB. MatrixDB permet la construction et la visualisation de l'interactome extracellulaire entier et de plusieurs types de réseaux d'interactions, spécifiques d'une molécule, d'un tissu, d'une pathologie ou d'un processus biologique. Nous avons ainsi caractérisé le réseau d’interactions extracellulaire associé au vieillissement et mis en évidence le rôle important des glycosaminoglycanes et du calcium dans ce réseau. Nous avons construit le réseau d'interactions d'une matricryptine anti-angiogénique et anti-tumorale, l'endostatine, qui est issue du collagène XVIII. Les analyses structurales et fonctionnelles de ce réseau ont montré que les partenaires de l’endostatine sont majoritairement impliqués dans l’adhésion cellulaire et que les domaines EGF (Epidermal Growth Factor) sont surreprésentés. Cette propriété nous a permis d'identifier expérimentalement d'autres partenaires de l'endostatine possédant un ou plusieurs domaines EGF et de nouvelles fonctions de l’endostatine. Nous avons modélisé les complexes formés par l'endostatine avec deux de ses partenaires pour identifier les sites d'interactions. Ces prédictions, associées aux données expérimentales, ont permis de déterminer des interactions susceptibles d'être établies simultanément par l'endostatine. L'intégration de ces données et des paramètres cinétiques et d'affinité dans le réseau d'interactions de l'endostatine sera utilisée pour proposer un modèle de son mécanisme d'action qui reste mal connu / The extracellular matrix is composed of a tridimensional network of proteins and complex polysaccharides called glycosaminoglycans. It provides a structural support to tissues and modulates cell proliferation, migration and differenciation. We have created a database of protein-protein and proteinglycosaminoglycan extracellular interactions, MatrixDB (http://matrixdb.ibcp.fr). We have integrated experimental data, data issued of the literature curation and data from interaction databases publicly available. We have respected the curation and exchange standards of the IMEx consortium that includes MatrixDB. MatrixDB allows the construction and the visualization of the entire extracellular network and other types of interaction networks specific of a molecule, a tissue, a disease or a biological process. We have characterized the aging-related extracellular interaction network and underlined the important role of glycosaminoglycans and calcium in this network. We have constructed the interaction network of an antitumoral and anti-angiogenic matricryptin, endostatin, issued from collagen XVIII. Functional and structural analysis of their network showed that partners of endostatin are mostly involved in cell adhesion and that EGF domains are overrepresented. This has allowed us to to identify experimentally other partners of endostatin possessing one or more EGF domains and to propose new functions of endostatin. We have modelled complexes formed by endostatin with two of its partners to identify the binding sites.These predictions, associated with experimental data, allowed us to determine interactions able to be established simultaneously by endostatin. Integration of these data and of kinetics and affinity parameters in the interaction network of endostatin will be used to build a model of its mechanism of action that is not fully elucidated

Abstract The tumor microenvironment (TME) is critically important for tumor development. The microenvironment consists of fibroblasts, endothelial and immune cells as well as extracellular matrix (ECM), proteases and various other soluble factors produced by the cells. It is challenging to develop methods that appropriately mimic the human microenvironment, but this effort is essential in order to reliably elucidate the properties of potential anti-tumor drugs. The aim of this study was to create new 3D organotypic invasion models based on human tissue that would be used to study the effects of the anti-angiogenic molecules arresten and endostatin on tongue squamous carcinoma cells. The classic way to study cancer invasion has been to use a collagen invasion model that is created by mixing rat type I collagen, matrix produced by mouse EHS tumor cells and human fibroblasts. Our research group has developed a novel human myoma tissue based invasion model, which is composed of several different cell types and molecules that are normally present in the human TME. We show how this model is suitable for invasion studies, not only for oral cancer, but for other invasive cell lines as well. There are several matrix-derived fragments that have been shown to possess anti-angiogenic activity. Arresten is a 26 kDa fragment that is cleaved from type IV collagen and is known to inhibit angiogenesis, the formation of new capillaries and tumor growth in vivo. However, its effect on the tumor microenvironment in addition to endothelial cells has not been studied. We show that arresten also directly affects oral cancer cells by decreasing their migration and invasion as well as tumor size, invasion and angiogenesis in in vivo mouse xenografts. Another inhibitor of angiogenesis, endostatin, is cleaved from type XVIII collagen. It has been shown to suppress angiogenesis and tumor growth without toxicity or side effects in mouse models. Our studies show that endostatin directly affects tongue squamous carcinoma cells by reducing their invasion and spreading in organotypic 3D assays and mouse tumor models. In summary, arresten and endostatin are anti-angiogenic as well as anti-invasive molecules and therefore potential cancer drugs. They seem to have a direct effect on carcinoma cells making the cells less invasive. The myoma model allows us to study the effects of anti-cancer molecules with a new prospective. / Tiivistelmä Syövän mikroympäristö on erittäin tärkeä syövän kehittymisen kannalta. Se koostuu fibroblasteista, endoteeli- ja immuunisoluista, soluväliaineesta, proteaaseista ja monista muista solujen tuottamista liukoisista molekyyleistä. On haastavaa kehittää uusia menetelmiä, jotka jäljittelisivät oikeaa ihmisen syövän mikroympäristöä, mutta se on välttämätöntä uusien syöpälääkkeiden tutkimiseksi. Väitöstutkimuksen tavoitteena oli kehittää kolmiulotteinen ihmisen myoomakudokseen perustuvan invaasiomalli, jonka avulla voisimme tutkia verisuonten kasvua estävien arresten ja endostatin molekyylien vaikutusta kielisyöpäsoluihin. Aiemin syövän invaasiota on tutkittu käyttämällä klassista kollageeni-invaasiomallia, joka tehdään sekoittamalla rotan tyypin I kollageeniä, hiiren sarkoomasolujen tuottamaa matriksia ja ihmisen fibroblasteja. Tutkimuksissamme kehitimme uuden invaasiomallin, joka perustuu ihmisen myoomakudokseen. Tutkimuksessa sen todettiin sisältävän monia erilaisia soluja ja molekyylejä, joita on normaalistikkin syövän mikroympäristössä. Lisäksi osoitimme, että se sopii invaasiotutkimuksiin monille syöpätyypeille. Soluvälitilamatriksista pilkotaan useita erilaisia molekyylejä joilla on osoitettu olevan angiogeneesia hillitseviä ominaisuuksia. Arresten on 26 kDa kokoinen polypeptidi, jota pilkotaan tyypin IV kollageenista. Sen tiedetään vähentävän angiogeneesia – uusien verisuonten muodostumista ja syövän kasvua in vivo. Sen vaikutuksia muihin kuin endoteelisoluihin ei ole kuitenkaan tutkittu. Tutkimuksissamme se vaikutti suoraan kielisyöpäsoluihin vähentäen niiden liikkumista ja invaasiota kolmiulotteisissa organotyyppisisssä malleissa ja hiirimallissa. Toinen tutkimamme angiogeneesin inhibiittori on endostatin, jota pilkotaan tyypin XVIII kollageenista. Sen tiedetään vähentävän angiogeneesia hiirimalleissa ilman toksisia sivuvaikutuksia. Me osoitimme tutkimuksissamme, että se vaikuttaa suoraan kielisyöpäsoluihin vähentäen niiden invaasiota ja leviämistä 3D organotyyppisissä malleissa sekä hiirikokeissa. Koska arresten ja endostatin ovat anti-angiogeenisiä ja anti-invasiivisia molekyylejä, ne ovat täten potentiaalisia syöpälääkkeitä. Ne näyttäisivät vaikuttavan suoraan syöpäsoluihin vähentämällä niiden invaasiota. Myoomainvaasiomalli mahdollistaa syöpää ehkäisevien molekyylien tutkimisen uudella ja todenmukaisemmalla tavalla.