Systemic sclerosis (SSc) is immune-mediated fibrotic disease of unknown aetiology. Among the dominant pathogenic manifestations of SSc belong vascular changes, production of autoantibodies, activation of innate and adaptive immune responses and fibrotic processes. Transforming growth factor beta (TGF-β) has been identified as a central profibrotic factor stimulating fibroblasts to produce collagen. There are, however, a number of other mediators involved in the pathogenesis of SSc. Mutual activation and amplification of these molecules and their cascades may be a central mechanism of the SSc pathogenesis. Hedgehog (Hh) canonical signalling pathway plays an important role in the development and progression of fibrotic diseases. Expression of Hh target genes can be regulated through a canonical or non-canonical signalling cascade. The non-canonical activation of GLI transcription factors by TGF-β has not yet been investigated in SSc. The substantial part of this thesis is focused on the study of the mutual interaction of TGF-β and Hh signalling pathway. In vitro analysis confirmed TGF- β/SMAD3 dependent activation of GLI2 in dermal fibroblasts. Fibroblasts specific knockout of GLI2 prevented the development of experimental fibrosis in vivo. Combined targeting of canonical and non-canonical Hh...

Cavalcanti, BN. Resposta de fibroblastos de polpa humanos frente a substâncias liberadas por capeadores pulpares diretos [Tese de Doutorado]. São Paulo: Faculdade de Odontologia da USP; 2003. RESUMO O objetivo do presente estudo foi o de avaliar os efeitos citotóxicos de substâncias liberadas durante a aplicação de materiais utilizados em capeamento pulpar direto, sobre fibroblastos de polpa dentária humana. Utilizou-se para o experimento meios condicionados pelas substâncias a serem testadas, divididas nos grupos a seguir: grupo I: controle (meio de cultivo sem condicionamento); grupo II: cimento de hidróxido de cálcio; grupo III: adesivo dentinário; grupo IV: ácido ortofosfórico a 37%. O condicionamento foi realizado, colocando-se meio de cultivo fresco sobre os materiais de modo que a presa (grupo II), polimerização (grupo III) ou o contato direto (grupo IV) liberassem substâncias para esse meio de cultivo. Esse meio era colocado sobre as células durante todo o experimento, excetuando-se o grupo IV, onde o contato foi feito por um período de 15 segundos, conforme recomendações clínicas. Posteriormente foram realizadas contagens em hemocitômetro pelo método de exclusão por azul de Trypan, que cora somente as células mortas. As contagens foram realizadas em períodos de 0, 6, 12 e 24 horas para o experimento de viabilidade celular (curto prazo), onde se avaliou o percentual de células vivas sobre o total de células, e em períodos de 1, 3, 5 e 7 dias para o experimento de sobrevivência celular, no qual se avaliou o número absoluto de células vivas. Observou-se que as substâncias liberadas pelo adesivo dentinário são citotóxicas em qualquer período, diminuindo consideravelmente a viabilidade celular e afetando suas curvas de crescimento. Aquelas liberadas pelo ácido ortofosfórico a 37% provocam diminuição da viabilidade somente nos primeiros momentos do contato com as células, enquanto as substâncias liberadas durante a presa do hidróxido de cálcio não são citotóxicas em nenhum momento. / The purpose of the present study was to evaluate the cytotoxic effects of substances leached during the use of direct pulp capping materials, on human pulp fibroblasts. There were used cell culture mediums conditioned by the test materials, as follows: group I: control (fresh medium without conditioning); group II: calcium hydroxide cement; group III: bonding system; group IV: 37% orthophosphoric acid. The medium conditioning was made, pouring the fresh conditioning medium on the materials, in order that its setting (group II), polymerization (group III) or the direct contact (group IV) would be able to leach substances to this culture medium. These conditioned mediums were put on the cells for the entire experiment, excepting the group IV, in which the mediums were put in contact with the cells for 15 seconds, following clinical recommendations. Cell counting was performed in hemocytometer, using the Trypan blue exclusion method, which mark only the dead cells. These counting was made at experimental times of 0, 6, 12 and 24 hours for the cell viability assay (short term), where it is evaluated the percentage of live cells on the total number of cells, and at experimental times of 1, 3, 5 and 7 days for the survival assay, in which is evaluated the absolute number of live cells. It was observed that the substances leached by the bonding system are cytotoxic at all experimental times, decreasing significantly the cell viability and affecting its growing rate. Those leached by the 37% orthophosphoric acid decreased the cell viability only at the first contact with the cells, and the substances leached during the setting of the calcium hydroxide cement are not cytotoxic.

Feridas nos membros inferiores são a principal causa de hospitalização e morbidade nos pacientes portadores de diabetes mellitus (DM). Atualmente, atribuem-se as complicações tardias do DM ao acúmulo de produtos finais de glicação avançada (AGE) nos diversos órgãos-alvo, incluindo a pele. Já foi demonstrado que a função deficitária dos fibroblastos de diabéticos está relacionada diretamente ao acúmulo de AGEs. Neste cenário, o uso de células-tronco mesenquimais tem ganhado destaque, tendo sido demonstrado, na literatura, que células-tronco derivadas de medula óssea (BMSC) produzem lisozima, um anti-AGE fisiológico. As células-tronco derivadas do tecido adiposo (ADSC) são de fácil captação e apresentam melhor rendimento em cultura celular quando comparadas às BMSC. Neste estudo, investigamos se as ADSC sintetizam lisozima e avaliamos se o produto das ADSC tem a capacidade de diminuir os efeitos deletérios dos AGEs nos fibroblastos. Para esse fim, foram cultivadas ADSC provenientes de lipoaspiração de pacientes hígidos, fibroblastos provenientes de feridas de pacientes diabéticos e fibroblastos provenientes de pacientes hígidos. Os fibroblastos de pacientes diabéticos ou hígidos foram submetidos a três meios de cultura diferentes: normoglicêmico (controle), contendo AGE ou contendo AGE mais o meio de cultura proveniente de ADSC (eluato) e, nesses grupos, foi feito ensaio de migração de fibroblastos. Observamos que, nos meios contendo AGE, não ocorreu migração dos fibroblastos, e na cultura contendo AGE mais eluato, os fibroblastos apresentaram migração semelhante à do grupo controle. Concluímos que as ADSC produzem lisozima e que os produtos sintetizados por essas células têm a capacidade de inibir os efeitos deletérios dos AGEs em fibroblastos in vitro / Lower limb ulcers are one of the major causes of morbidity and hospital admission in diabetic patients. Current researches indicate that diabetes mellitus (DM) complications are related to the accumulation in target organs, including the skin of advanced glycation end products (AGEs). It has been shown that cutaneous fibroblasts dysfunction in DM patients is directly dependent on AGE accumulation. In this context, the use of mesenchymal stem cells has been proposed, since bone marrow stem cells (BMSC) produce lysozyme, a physiological anti-AGE enzyme. Adipose tissue derived stem cells (ADSC) are easier to harvest and proliferate faster in cell cultures compared to BMSC. In this study, we investigated whether ADSC are able to produce lysozyme and also the ability of those stem cells to reduce the deleterious effects of AGEs in fibroblasts. ADSC were isolated and cultured from liposuction samples from non diabetic patients; fibroblasts were also isolated and cultured from wounds of diabetic patients and from non diabetic patients\' skin. Fibroblasts were maintained in three different conditions: in normoglycemic culture medium (control), a culture medium containing AGE or a culture medium previously in contact with ADSC for 24 hours (eluate) with addition of AGE. A fibroblast migration assay was performed. There was a lack of fibroblast migration in fibroblast culture with AGE-supplemented medium, whereas fibroblast culture containing ADSC\'s eluate and AGE showed fibroblast migration similar to the control group. Our study demonstrates that ADSC can synthesize lysozyme and we infer that the products of ADSC are able to inhibit in vitro AGE deleterious effects in fibroblas

Um dos fatores que regula o córtex adrenal é o hormônio adrenocorticotrópico, ACTH, no entanto, o fator de crescimento de fibroblastos do tipo 2, FGF2, e os peptídeos N-terminais da pro-opiomelanocortina, N-POMC, também podem estar envolvidos. As vias de sinalização das proteínas quinases: ERK, JNK e p38, juntamente com outras vias como PKA, PKC e PI3K/Akt são importantes para a definição trófica das células. Nós analisamos a importância destas vias de sinalização e sua influência na viabilidade, proliferação e morte celular, induzidas pelo ACTH, FGF2 e N-POMC, utilizando inibidores farmacológicos e moleculares em culturas primárias de células adrenocorticais, células glomerulosa e fasciculadas/reticulares. Nossos resultados mostram que as vias mediadoras envolvidas na resposta proliferativa do FGF2 e da N-POMC são, respectivamente, as vias ERK/JNK e ERK/JNK/Akt. Por outro lado, a resposta pró-apoptótica promovida pelo ACTH é mediada pela via p38, provavelmente associada à ausência de ativação das vias relacionadas com a sobrevivência, como as vias ERK e JNK. / One of the factors that regulate adrenal cortex is the adrenocorticotrophic hormone, ACTH, however, the fibroblast growth factor type 2, FGF2) and pro-opiomelanocortin N-terminal peptides, N-POMC, might also be involved. The mitogen-activated protein kinase pathways: ERK, JNK and p38, together with other signaling pathways such as PKA, PKC and PI3K/Akt are important for cells trophic definition. We analyze the importance of these pathways and their influence in viability, proliferation and cell death stimulated by ACTH, FGF2 and N-POMC, using pharmacological and molecular inhibitors in primary culture of adrenocortical cells, glomerulosa and fasciculata/reticularis cells. Our results show that the mediating signaling pathways involved in FGF2 and N-POMC proliferative effects are, respectively, ERK/JNK and ERK/JNK/Akt. On the other hand, the pro-apoptotic response promoted by ACTH is through p38 signaling, probably associated with the absence of activation of other pathways involved with cell survival, like ERK and JNK.

INTRODUÇÃO: Os níveis séricos de fósforo (P) têm sido associados a doenças cardiovasculares e mortalidade em pacientes com doença renal crônica e na população geral. Estudos in vitro demonstram que altas concentrações de fósforo extracellular são capazes de induzir calcificação vascular e disfunção endotelial. O Fibroblast Growth Factor 23 (FGF-23) é um hormônio fosfatúrico e foi relacionado à presença de aterosclerose em pacientes idosos. OBJETIVO: O objetivo deste estudo foi investigar as relações entre P, FGF-23 e outros atores do metabolismo mineral e a ocorrência de doença arterial coronariana em pacientes com função renal preservada. MÉTODOS: Duzentos e noventa pacientes clinicamente estáveis com indicação de cineangiocoronariografia eletiva e clearance de creatinina superior a 60 ml/min/1.73 m2 foram submetidos à Tomografia Computadorizada Multislice para avaliação da calcificação coronariana e coleta de sangue para dosagens bioquímicas. A calcificação coronariana foi quantificada através do Escore de Agatston (EA) e os Escores de Friesinger e Gensini foram calculados para quantificar a obstrução coronariana. RESULTADOS: A média de idade dos pacientes foi 58,1± 9,3 anos, 81% eram hipertensos e 35,5% diabéticos. Os pacientes foram divididos em grupos de acordo com o EA utilizando-se como ponto de corte o valor de 10 Unidades Hounsfield (HU). O P sérico foi maior no grupo de pacientes com EA > 10 HU (3,63 0,55 vs 3,49 0,52mg/dL; p=0,019). Cada 1 mg/dL de elevação no P sérico associou-se a um aumento de 92% no risco de apresentar o EA > 10HU [Odds Ratio (OR) =1,92, CI 1,56-3,19; p=0,01]. Quando os pacientes foram divididos de acordo com a mediana do Escore de Friesinger (4 pontos), o grupo com valores superiores à mediana apresentou P sérico maior (3,6 0,5 vs. 3,5 0,6 mg/dl; p=0,04) e FGF-23 menor (mediana 40,3 pg/mL intervalo interquartil 24,1-62,2 vs. 45,7 pg/mL intervalo interquartil 31,7-76,1; p=0,01) quando comparado àquele com valores menores ou iguais a 4. Pacientes no tercil mais alto do escore de Gensini também apresentaram P sérico mais elevado que os demais (p<0,05). Nas análises de regressão logística uni e multivariadas, cada 1 mg/dL de elevação no P sérico implicou em um aumento de 74% no risco de apresentar o Escore de Friesinger superior à mediana (OR 1,74, CI 1,06- 2,88; p=0,03) e o FGF-23 sérico foi preditor negativo do Escore de Friesinger (OR 0,26, CI 0,11-0,63; p=0,002) Os níveis séricos de cálcio e paratormônio não mostraram associação com a presença de doença coronariana. CONCLUSÃO: Em pacientes com suspeita de doença arterial coronariana e função renal preservada, o fósforo sérico foi preditor da presença de calcificação e obstrução coronariana e houve uma associação negativa entre o FGF-23 sérico e a presença de obstrução coronariana. / INTRODUCTION: Serum phosphorus (P) has been associated with cardiovascular diseases and mortality in chronic kidney disease patients and in the general population. In vitro studies suggest that excessive phosphorus induces vascular calcification and endothelial dysfunction. Fibroblast growth factor 23 (FGF-23) is a phosphaturic hormone and has been correlated to atherosclerosis in the community. AIM: This study intended to investigate the associations between P, FGF-23 and other mineral metabolism players and coronary artery disease in patients with preserved renal function. METHODS: Two-hundred ninety patients with a creatinine clearance higher than 60ml/min/1,73m2 undergoing elective coronary angiography were submitted to Multislice Computed Tomography in order to evaluate coronary calcification and blood was collected for biochemical analyses. Coronary artery calcification was quantified using the Agatston Score (AS). Friesinger (FS) and Gensini Scores (GS) were calcutalet to quantify coronary obstruction. RESULTS: Considering the whole population, mean age was 58.1±9.3 anos, 81% were hypertensive and 35.5% were diabetics. Patients were divided according to AS using the value of 10 Hounsfield Units (HU) as the cutoff.point. Serum phosphorus was higher in patients with an AS > 10HU when compared to the group with an AS 10 HU (3.63 0.55 vs 3.49 0.52mg/dL, p=0.019). Each 1 mg/dL of elevation in the serum phosphorus implied a 92% additional risk of presenting an AS > 10 HU [Odds Ratio (OR) =1.92, CI 1.56-3.19; p=0.01]. Patients were also divided using the median Friesinger score (4 points) as the cutoff value. Serum phosphorus was higher (3.6 0.5 vs. 3.5 0.6 mg/dl, p=0.04) and intact FGF-23 was lower (median 40.3 interquartile range 24.1-62.2 pg/mL vs. 45.7 interquartile range 31.7- 76.1 pg/mL, p=0.01) in the FS > 4 group. Patientis in the higher Gensini Score tertile presented elevated serum phosphorus when compared to the other groups (p<0,05). In the uni and multivariate logistic regression analyses, a rise of 1 mg/dL of serum phosphorus carried a 74% increase in the risk of having a FS higher than 4 (OR 1.74, CI 1.06-2.88; p=0.03) and FGF-23 was a negative predictor of FS (OR 0.26, CI 0.11-0.63; p=0.002). Serum calcium and parathormone were not associated with the presence of coronary artery disease. CONCLUSIONS: In patients with suspected coronary artery disease and preserved renal function, phosphorus was predictive of both coronary artery calcification and obstruction. There was a negative association between FGF-23 and coronary obstruction

Introdução: Doador de rim em vida é uma importante fonte de órgão para os pacientes portadores de doença renal crônica (DRC). Os doadores experimentam uma redução abrupta da taxa de filtração glomerular (TFG) e adaptações ao metabolismo mineral demandam estudos nesta população. Nós avaliamos prospectivamente esta adaptação em doadores de rim em vida. Métodos: Entre janeiro de 2010 a agosto de 2011, no hospital das Clínicas de São Paulo e na Universidade de Miami, realizamos a avaliação prospectiva do metabolismo mineral e da função renal por 1 ano em 74 doadores de rim em vida. Medimos a taxa de filtração glomerular (TFG), fósforo (Pi), cálcio (Ca), paratohormônio (PTH), fibroblast Growth Factor 23 (FGF23) e a fração de excreção do fósforo (FePO4) no pré-operatório e nos dias 1, 2, 14, 180 e 360 do pós-operatório. Resultados: Observamos uma redução, aproximadamente, de 40% da TFG nos dois primeiros dias após a cirurgia. No décimo quarto dia após a nefrectomia, observamos o início da recuperação da TFG, chegando ao máximo da recuperação com 1 ano, quando se atingiu 68,6% da função renal se comparado com o dia anterior a doação (75,3 ml/min/1,73m2, p < 0,001). O cálcio sérico apresentou seu nadir no dia 1 (7,99 mg/dL; p < 0,01) e o Pi sérico atingiu seu nadir no dia 2 (2,61 mg/dL; p < 0,01). Já no dia 14, os valores de Ca e Pi retornaram aos valores basais tendo o fósforo evoluído novamente com valores inferiores ao basal no último dia de seguimento (3,36mg/dL; p < 0,001). FGF23 e PTH apresentaram elevação no D1 (111,0144,6 percentil 25-75: 16-63 RU/ml 64,9 30,3pg/mL; p < 0,01). Os valores de FGF23 se mantiveram elevados até o final do estudo enquanto que o PTH retornou aos valores de base no segundo dia e, a partir de então, manteve sem diferença do valores basais até o último dia de estudo. FePO4 elevou de 11,45,2% para 15,28,1% entre o pré-operatório e D365 (p < 0,01). Conclusão: A nefrectomia para doação de rim em 74 pacientes saudáveis elevou os valores de FGF23 durante todo o estudo juntamente com a FePO4. O fósforo, cálcio e PTH séricos apresentaram queda nos seus valores na primeira semana após a nefrectomia, e, com duas semanas após a cirurgia, retornaram aos valores basais mantendo-se estáveis até o final do estudo / Introduction: Living kidney donors (LKDs) experience an abrupt decline in glomerular filtration rate (GFR). Mineral metabolism adaptations in early CKD are still debated and not well studied in LKDs. We prospectively studied acute and long term mineral metabolism adaptation of LKDs. Materials and Methods: We measured renal function and mineral metabolites longitudinally for 1 year (days (D) 1, 2, 14, 180, & 365 post-operatively) in 74 healthy individuals who underwent kidney live donation. Results: eGFR (MDRD) decreased to 59% of its baseline on day 2 and started to increase at day 3, to its maximum at day 360 (75.3±15.6 ml/min/1.73m2, p < 0.01) wile FGF23 increased from 60.6 (25th-75th percentile 19-81 RU/mL) at baseline to 111.0±144.6 (p < 0.01) on day 1 and keep higher than baseline throwout the study. PTH rose maximally on day 1 (64.9 ± 30.3pg/ml) and returned to its base line on D2 and did not change after that. Total serum Calcium levels decreased from 9,40±0,48 mg/dL to a nadir of 7.99±0,51 mg/dL on day 1 (p < 0.001). Serum Phosphate levels reached their nadir on day 2 (2.61±0,52 mg/dL; p < 0.01). At D14 total calcium and phosphate levels had returned to baseline, but phosphate levels returned down on D360 (3.36±0,52 mg/dL; p < 0.001). Phosphate excretion fraction (FePO4) increased from base line (11.4±5.2%) up to 15.2±8.1% until D360 (p < 0.001). Conclusions: Abrupt reduction in eGFR induces physiological increases in FGF23 and PTH, and decreases in serum Ca and Pi in the first week. The changes in FGF23 and Pi urinary fractional excretion of Pi remain modestly yet significantly different from baseline throughout the first year after nephrectomy. Wile Ca, PTH and Pi serum levels are not significantly different from the baseline

Dissialogangliosídios, como GD3 e derivados são marcadores da progressão de melanomas. Para avaliar as possíveis funções desta molécula, transfectamos células de melanócitos com o gene da enzima ST8Sia I, que converte GM3 em GD3. Mostramos que GD3 não interfere na capacidade proliferativa dessas células, porém a expressão de GD3 mostrou-se associada à sobrevivência celular. Melanomas adquirem autonomia quanto às vias dependentes do fator de crescimento de fibroblastos (FGF-1 e -2). A expressão de GD3 não interfere na resposta proliferativa a estes fatores, porém GD3 e outros glicoesfingolipídios de membrana modulam a resposta migratória induzida por FGF-2. A expressão de GD3 sensibiliza as células à morte celular induzida por diferentes quimioterápicos, como cisplatina e vimblastina; porém, torna as células resistentes ao tratamento com temozolamida. A sensibilização ao tratamento com vimblastina, mas não às outras drogas, depende da presença de GD3, como observado por ensaios de depleção metabólica / Disialoganglioside GD3 and its derivatives are melanoma progression markers. To evaluate the possible roles of these molecules along melanoma progression, we have transfected the GD3 synthase gene (ST8Sia I) in a melanocyte cell line. Accumulation of GD3 did not confer any proliferative advantage to melanocytes. However, GD3 expression was associated with cell survival. The autonomic growth of melanomas is in part related to a constitutive activation of fibroblast growth factor dependent pathways. GD3 expression did not alter the proliferative response to either FGF-1 or FGF-2. However, GD3 and other membrane glycospingolipids modulate the motogenic activity of FGF-2. GD3 expression sensitizes melanocytes to chemotherapeutic agent-induced cell death, as cisplatin and vimblastin. On the other hand, GD3 turned melanocytes more resistant to temozolomide. Chemosensitization to vimblastin, but not to the other drugs, was dependent on the presence of GD3 within the cells, as shown by metabolic depletion of glycosphingolipids

No description available.

La gencive correspond à un modèle de régénération naturelle grâce notamment à sa capacité de cicatrisation « ad integrum ». Ce phénomène est permis par sa composition en fibroblastes gingivaux. Ces cellules, composante cellulaire principale du tissu conjonctif gingival, sont au cœur de la régulation des réponses inflammatoires et de la cicatrisation. Ce tissu contient, comme d’autres tissus mésenchymateux, des cellules souches ; qui expliquent en partie ces capacités de régénération. De plus, comme le tissu gingival est abondant et facilement accessible, l’utilisation de ces cellules souches pourraient être d’un intérêt prometteur en thérapie cellulaire ou pour de la modélisation in vitro. Au cours de cette thèse, nous avons pu montrer que les Cellules Souches dérivées de la Gencive Humaine (CSGH) possèdent des propriétés communes avec les cellules souches adultes dérivées des crêtes neurales. Ces cellules peuvent être qualifiées de « souche » par leur capacité d’auto-renouvèlement, d’adhésion au plastique et de multipotence. Premièrement, nous avons montré que la méthode ainsi que les produits de culture utilisés pour l’isolation des fibroblastes gingivaux in vitro à partir de biopsies de gencive avait une influence sur les cellules obtenues. Dans un second temps, une analyse clonale in vitro de populations de fibroblastes gingivaux a permis de montrer que les fibroblastes gingivaux sont composés de sous-populations qui expriment des marqueurs spécifiques des cellules souches et des crêtes neurales. Outre leur origine embryologique, l’étude de leur multipotence a aussi été caractérisée après expansion et en fonction des additifs utilisés. Pour finir, deux exemples d’utilisation de ces cellules comme modèle d’étude de la biocompatibilité de biomatériaux in vitro ont été développés; imitant la muqueuse buccale ainsi que les réactions dentaires (réparatrices et réactionnaire). / Gingiva is a natural regeneration model thanks to its "ad integrum" healing capability. Gingival fibroblasts are the main actors of this property. These cells, the main cellular component of the gingival connective tissue, regulate the inflammatory responses and healing process. This tissue contains, like many others, mesenchymal stem cells; which also partly explain these regenerative abilities. Moreover, as the gingiva is abundant and easily accessible, the use of these stem cells may interest cell therapy or in vitro model tissues responses. In this work, we demonstrated that Stem Cells Derived from Human Gingiva (SCHG) have common properties with neural crest adult stem cells. These cells can be called "stem cells" for their ability to self-renew, adhere to plastic and to differentiate. First, we have shown that the method and the culture products used for isolation of gingival fibroblasts from gingival biopsy had an influence on the obtained cells. Secondly, an analysis of in vitro clonal populations of gingival fibroblasts has shown that gingival fibroblasts are composed of subpopulations that express specific markers of stem cells and neural crests. In addition to their embryological origin, the study of their multipotency was also characterized after expansion and depending on the used additives. Finally, two examples of using these cells and dental pulp stem cells as a model to study the in vitro biocompatibility of biomaterials have been developed, mimicking oral mucosa or dentin reactions (reparative or reactional).

Angiogenesis, the process of new vessel formation, appears to be a central mechanism that underlies the development of haemangiomas. Recently, intralesional bleomycin injection was used to treat paediatric haemangiomas with very good results. The purpose of this study was to determine whether there was significant systemic circulatory spill-over of bleomycin in haemangioma patients treated with intralesional bleomycin to determine safety of use. Furthermore, in order to elucidate bleomycin’s mechanism of action in inducing haemangioma regression, this study aimed at determining the effects of bleomycin on aspects of angiogenesis, namely, endothelial cell migration, growth and apoptosis, and comparing these effects with those of drugs previously reported to inhibit various aspects of the angiogenic process (mitomycin C, 2-methoxyestradiol, taxol, vincristine, vinblastine, colchicine, nocodazole and cytochalasin D). Lastly, the effects of bleomycin, mitomycin C, 2-methoxyestradiol, taxol, vincristine, vinblastine, colchicine, nocodazole and cytochalasin D were studied in an animal haemangioma model. A rapid and highly sensitive high performance liquid chromatographic (HPLC) method was developed. Blood samples were collected from four haemangioma patients before and after (over a 24 hour period) intralesional bleomycin (IB) therapy. As a control, blood samples were also collected at identical time intervals from four patients undergoing intravenous (IV) bleomycin chemotherapy for various malignant tumours. The HPLC method was used to quantitate bleomycin fractions in patient samples. The mean bleomycin concentration detected in plasma samples obtained from IB treated patients was 0.00 ìg/ml for both bleomycin A<Sub>2 and B2 over the 24-hour period following therapy. Plasma bleomycin A2 and B2 levels of 360.79 and 158.85 ìg/ml respectively were detected in samples obtained from cancer patients treated with bleomycin IV. These findings indicate that the low levels detected may translate to a significantly lesser risk of pulmonary fibrosis following IBI. The effect of drugs on endothelial cell migration was analyzed by wounding a confluent monolayer of cells and determining the number of cells that had migrated from the wound edge. Endothelial cell growth was determined in cells treated with various drug concentrations while apoptosis was examined using hematoxylin and eosin staining, DNA fragmentation assay and acridine orange staining. The effect of test drugs on in vitro angiogenesis was determined on endothelial cells induced to form capillary-like tubes in collagen gel. Test drugs were then evaluated for antitumour activity in an animal haemangioma model. Data demonstrated that test drugs inhibited endothelial cell migration, with the exception of mitomycin C. All test drugs induced a reduction in the percentage of viable endothelial cell in a dose-dependant manner, and also induced endothelial cell apoptosis. The drugs inhibited angiogenesis in vitro and inhibited tumour development in vivo with varying potency. In general, results from this study indicated that there was negligible systemic spill-over of bleomycin following IB administration in patients with haemangiomas, suggesting a much lesser risk of developing bleomycin-induced pulmonary fibrosis. This study also showed that test drugs inhibited angiogenesis in vitro and haemangioma development in vivo in a mouse model. Taken together, these observations demonstrate that bleomycin may inhibit haemangioma growth by inhibiting angiogenesis. In addition, mitomycin C, 2-methoxyestradiol, taxol, vincristine, vinblastine, colchicine, nocodazole and cytochalasin D may have potential in the treatment of haemangiomas of infancy, and should be investigated further in a murine haemangioma model to determine effective dose schedules. / Thesis (PhD)--University of Pretoria, 2009. / Physiology / unrestricted