Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2007. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 6 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 5 uppsatser.

One important objective of prostate cancer (PCa) research is to understand the molecular basis underlying the progression of these cancers from an androgen dependent to an androgen independent state. Hypermethylation of the promoter CpG islands is associated with the transcriptional silencing of specific gene sets in each tumor type and subtype. Transcriptional silencing of antitumor genes via CpG island hypermethylation could be a mechanism mediating PCa progression from an androgen-dependent to an androgen-independent state. Hypermethylation associated gene silencing has been reported for a great number of genes in PCa with the exception of the genes that undergo methylation associated silencing specifically during cancer development to androgen independence. The first aim of this thesis is to identify novel glenes which undergo DNA hypermethylation associated gene silencing during the cancer progression. The androgen-dependent (AD, as defined as the inability of celill to proliferate in the absence of androgen) PCa cell line LNCaP gives rise to the androgen-independent (AI) subline LNCaPcs generated by maintaining LNCaP in medium with charcoal-stripped (CS) serum for over 30 passages. This LNCaP cell model was used to identify differentially methylated sequences between the two genomes using the Methylation-Sensitive Restriction Fingerprinting (MSRF) technique. One sequence identified is located in a 5' CpG island, which encompasses part of the promoter, exon 1, and part of intron 1, of the Peroxisomal Membrane Protein 24 KD (PMP24) gene. PMP24 is silenced in concert with the hypermethylation of its CpG island in AI LNCaPcsand PC-3 cell lines. The silencing is reactivated by the treatment with a DNA methyltransferase inhibitor, 5-aza-2'-deoxycytidine (5AZAdC). PMP24 is specifically silenced in PCa cancer cell lines and shows potential antitumor properties. These results demonstrate the utility of MSRF in the identification of novel, differentially methylated DNA sequences in the genome and suggest that hypermethylation-mediated silencing of PMP24 is an epigenetic event involved in PCa progression to androgen independence. The next study investigated the molecular mechanism for DNA methylation associated gene silencing of PMP24 in AI LNCaPcs and PC-3 cell lines. We demonstrated that PMP24 transcription is repressed by the disruption of transcription factor binding to a critical cis-element by hypermethylation of its promoter CpG island. We found a CpG containing activator protein 2 (AP-2) cis-element in the intron 1 of PMP24 whose first CpG dinucleotidle is essential for the sequence-specific protein binding and the promoter activity of the gene. We presented first in cellulo evidence that the methylation of AP-2 cis-element alone but not the whole CpG island, using a newly developed methylated oligonucleotides treatment, is sufficient for the downregulation of PMP24. Our study is the first to report that the silencing mechanism for PMP24 in AI LNCaPcs and PC-3 is mediated by the complete methylation of a single GpG site of AP-2 cis-element in the intron 1 part of the CpG island, which interferes with transcription factor binding. Most interestingly, the promoter CpG island of PMP24 is hypermethylated in AD LNCaP cells with the incomplete methylation specifically at the AP-2 cis-element. The silencing of PMP24 in AD LNCaP cells was reactivated not by the 5AZAdC treatment but by the treatment with Trichostatin A (TSA), a histone deacetylase inhibitor. An alternative silencing mechanism for PMP24 other than the interference with transcription factor binding by methylation is therefore likely involved at this androgen-dependent stage. During the androgen ablation process, this mechanism is either evolved by the spread of methylation in the promoter CpG island or selected against, leading to the methylation-dominant silencing mechanism in the AI cells as seen in LNCaPcsand PC-3 cells. Taken together, this thesis emphasized the important role of DNA methylation in the progression of PCa into androgen independence. Particular respect should be paid to the specific CpG dinucleotides in cis-elements critical for the promoter activity, whose complete methylation could dominate the silencing mechanism which is independent of androgen. This thesis also pointed to the importance of monitoring the effects of cell culture on the methylation status of genes. Most importantly, this thesis raised the possibility that the silencing mechanisms for PMP24 could be different in AD LNCaP cells as compared to AI LNCaPcs and PC-3 cells. Either the evolution of such mechanism or the selectivity against it during the androgen ablation process would result in a methylation-dominant silencing mechanism of the genes such as PMP24 in AI cells and may contribute to the overall androgen independence of the cells.

Introdução: Os micro RNA (miRNA) são formados a partir de RNA precursores de fita dupla que contém entre 60 a 110 nucleotídeos e formam estruturas do tipo hairpin. Imediatamente após sua transcrição pela RNA polimerase II a enzima Dicer promove a clivagem do RNA precursor em seqüências menores contendo 19 a 22 nucleotídeos. Após a clivagem, o miRNA integra-se ao complexo silenciador induzido pelo RNA (RISC) que o conduz ao seu RNA mensageiro (mRNA) homólogo recém transcrito. Esta associação promove a degradação do mRNA, ou interfere na tradução da proteína caracterizando um grande mecanismo de controle da expressão dos genes. Este mecanismo está relacionado ao desenvolvimento de órgãos e tecidos, e está envolvido no processo de carcinogênese. Nosso objetivo é identificar um perfil de expressão de miRNA que defina o adenocarcinoma de próstata de prognóstico favorável e desfavorável considerando os níveis de PSA e dados anatomopatológicos. Materiais e métodos: Foram selecionados 53 pacientes com tumores desfavoráveis (mediana do escore de Gleason igual a 8, 79,2% estadiados pT3, mediana de PSA 10,1 ng/mL e mediana do volume tumoral de 23%) e 45 considerados favoráveis (mediana do escore de Gleason igual a 5, 80% estadiados pT2, mediana de PSA de 7,8 ng/mL e mediana do volume tumoral de 11,5%). O controle foi representado por 7 pacientes com hiperplasia prostática benigna (HPB). Todos os pacientes foram submetidos a prostatectomia radical pelo mesmo cirurgião. Os espécimes cirúrgicos foram examinados na sua totalidade pelo mesmo patologista. A análise dos miRNA foi feita a partir de tecido congelado e tecido incluído em parafina usando a técnica da reação em cadeia da polimerase em tempo real quantitativa (qRT-PCR) utilizando primers e sondas Taqman® específicas. O RNU43 foi usado como controle interno. Resultados: Com exceção dos miRNA 199a, 21, 15a, 16 e 25 que se mostraram subexpressos tanto nos casos desfavoráveis como nos favoráveis, houve uma diminuição global na expressão dos miRNA com redução estatisticamente significativa na expressão dos miRNA 143, 145 e 146a, 191, 218 e Let7c em tumores desfavoráveis em relação aos tumores favoráveis. Conclusão: Demonstramos que no processo de transição entre os carcinomas favoráveis e desfavoráveis de próstata existe uma perda global na expressão de miRNA que podem ser importantes controladores de expressão de uma série de genes relacionados a progressão desta neoplasia. Dados experimentais avaliando o papel desses miRNA devem ser conduzidos para que possamos definir seu papel na evolução do câncer de próstata / Introduction: micro RNA (miRNA) are formed from double-stranded RNA precursors that contain between 60-110 nucleotides and form structures such as hairpin. Immediately after their transcription by RNA polymerase II, the enzyme Dicer promotes the cleavage of precursor RNA sequences containing minor 19-22 nucleotides. After cleavage, the miRNA is part of the RNA-induced silencing complex (RISC) that leads to its messenger RNA (mRNA) newly transcribed counterpart. This association promotes the degradation of mRNA, or interferes with the protein translation characterizing a great mechanism for controlling gene expression. This mechanism is related to the development of organs and tissues, and may be involved in the process of carcinogenesis. Our goal is to identify a miRNA expression profile that distinguishes prostate adenocarcinoma of favorable and unfavorable prognosis considering the PSA and pathological findings. Material and Methods: We studied 53 patients with tumors considered unfavorable (Median of Gleason score 8, 79.2% staged pT3, median of PSA 10.1 ng/mL and median of tumor volume of 23%) and 45 considered favorable (Median of Gleason score 5, 80% staged pT2, median of PSA 7.8 ng/mL and median of tumor volume of 11.5%). The control group was represented by seven patients with benign prostatic hyperplasia (BPH). All patients underwent radical prostatectomy by the same surgeon. The surgical specimen was examined entirely by the same pathologist. The analysis of miRNA was made from frozen and paraffin embedded tissue by quantitative real-time polymerase chain reaction (qRT-PCR) using the Taqman® specific primers and probes. The RNU43 was used as a internal control. Results: Except for miRNAs 199a, 21, 15a, 16 e 25 that were underexpressed by both favorable and unfavorable prostate cancer, there was a global decrease of all miRNAs studied, and some differences were statistically significant as miRNAs 143, 145 e 146a, 191, 218 e Let7c that were underexpressed in unfavorable carcinomas compared favorable tumor. Conclusion: We have demonstrated that in the process of transition between favorable and unfavorable prostate cancer there is a global loss of expression of miRNAs. These molecules can be important controllers of a series of genes related to cancer progression. Experimental studies are needed in order to comprehend the role of these genes in prostate carcinogenesis

O Papel da 1,25(OH)2D3 (VD3) ou calcitriol, o metabolito ativo da Vitamina D, em câncer de mama tem sido extremamente explorado. Os efeitos antiproliferativos, prodiferenciativos e antiinflamatórios da VD3 são bem documentados na literatura. Análises de microarray vêm auxiliando a identificação de vários genes responsivos e modulados pela VD3 e seus análogos. A maioria desses genes apresentados na literatura é proveniente de estudos utilizando linhagens celulares de câncer de mama ou modelos animais. Pouco é sabido sobre a ação da VD3 em outros tipos celulares constituintes do microambiente tumoral. Fibroblasto associado ao câncer (FAC), o principal componente do microambiente tumoral, apresenta um papel central no complexo processo de interação entre tumor e estroma e consequentemente em todos os passos envolvidos na tumorigênese. O objetivo do nosso estudo foi identificar genes chaves regulados pela VD3 em fibroblastos associados ao câncer de mama. Para isso, culturas primárias de fibroblastos provenientes de cinco amostras de carcinoma mamário ductal invasivo foram estabelecidas e posteriormente caracterizadas fenotipicamente por um conjunto de marcadores. Após a confirmação da presença de receptor de vitamina D, os fibroblastos de cada amostra foram divididos em três grupos: um grupo controle e grupos de tratamento com 0,5 nM e 100 nM de VD3 durante 24 horas. A determinação do perfil de expressão gênica foi realizado utilizando tecnologia de oligo microarray com o GeneChip Human Genome U133 Plus 2.0 (Affymetrix). Foram obtidos 274 genes diferentemente expressos entre os grupos controle e tratamento com 0,5 nM de VD3, muitos deles envolvidos em processos como apoptose e migração celular. Os 161 genes diferentemente expressos obtidos a partir da comparação entre grupos controle e tratamento com 100 nM de VD3 apresentaram-se funcionalmente envolvidos em diversos processos biológicos, sendo que os mais significativos processos regulados pela VD3 em fibroblastos associados ao câncer de mama foram respostas inflamatória e imune, sugerindo que a ação antiinflamatória da VD3, anteriormente relatada em estudos utilizando células epiteliais de câncer de mama, pode também ser aplicada a fibroblastos associados ao câncer de mama / The role of 1,25(OH)2D3 (calcitriol), the active metabolite of Vitamin D, in breast cancer has been extremely explored. Antiproliferative, prodifferentiating and anti-inflammatory effects of calcitriol have been reported in breast cancer. Expression profile by microarray analysis has identified many responsive genes modulated by calcitriol and analogs. The majority of them defined to date are based on studies using breast cancer cell lines or mouse models. Little is known about the action of calcitriol in the others cell types present into the tumor microenvironment. Cancerassociated fibroblasts (CAFs), the principal cell component of the tumor microenvironment, play a central role in the complex process of tumour stroma interaction and consequently in all breast cancer tumorigenesis steps. The aim of our study was to identify key genes that are regulated by calcitriol in breast cancer associated fibroblasts. Primary fibroblasts cell cultures from five breast cancer samples were established and then phenotyping characterized by a set of markers. The occurrence of vitamin D receptor was confirmed in all samples and fibroblasts were divided in three groups: one control group and two treatment groups, 0.5 nM and 100 nM of calcitriol during 24 hours. The determination of gene expression profile was performed by oligo microarray technology using the GeneChip Human Genome U133 Plus 2.0 (Affymetrix). Control and 0.5 nM calcitriol analysis resulted in 274 differentially expressed genes, many of then involved in biological processes as apoptosis and cell migration. The 161 differentially expressed genes obtained from comparison between groups control and 100 nM calcitriol treatment were functionally involved in several biological processes. The most significantive processes regulated by VD3 in breast CAFs were the inflammatory and immune responses, suggesting that the anti-inflammatory action of calcitriol, yet reported in several studies using epithelial breast cancer cells, may also been applied to breast cancer associated fibroblasts

La greffe cardiaque est le traitement ultime de l’insuffisance cardiaque. Le rejet aigu pose plusieurs problématiques, en particulier sa survenue imprévisible même sous traitement immunosuppresseur, et un diagnostic histologique qui nécessite des biopsies endomyocardiques (BEM) invasives répétées, et qui souffre de nombreuses limites. Le besoin de critères diagnostiques et prédictifs, idéalement non invasifs, nous a conduits à étudier le rejet aigu de greffe cardiaque sur le plan moléculaire. Nous avons caractérisé les profils d’expression génique (PEG) myocardiques et sanguins lors de différentes phases du rejet cellulaire (RC) et du rejet médié par les anticorps (RMA), par analyse sans a priori des transcriptomes sur puce à ADN. Par une première étude des PEG myocardiques menée sur une collection historique de BEM, nous avons montré la modification des PEG tissulaires lors du RC. Pour le même grade histologique, deux profils de RC aux degrés d’activation immunitaire différents ont été identifiés. De plus, les PEG myocardiques étaient modifiés dès un mois avant la survenue d’un RC, quand l’analyse histologique ne montrait encore aucune anomalie. Par une seconde étude conduite sur une collection prospective de BEM et échantillons sanguins, nous avons confirmé les résultats de la première étude, et de plus montré l’existence de modulations des PEG également dans le sang périphérique, aussi bien pendant un épisode de RC qu’un mois avant. Enfin pour la première fois la modulation tissulaire et périphérique des PEG a été montrée dans le RMA en transplantation cardiaque. L’existence de voies modulées dans les deux types de rejet devrait conduire à la recherche de biomarqueurs. / Heart transplantation is the last treatment in case of terminal heart failure. Acute rejection after heart transplantation raises several issues due to its occurrence despite immunosuppressive therapies and the requirement of invasive and repeated endomyocardial biopsies (EMB) that have several histological grading limitations. The need of non-invasive diagnostic and predictive criteria led us to study the acute rejection of cardiac allograft using a molecular approach. We characterized myocardial and peripheral blood gene expression profiles (GEP) during acute cellular rejection (CR) and antibody-mediated rejection (AMR) by mean of microarray analyses. By a retrospective study conducted on a historical EMB collection, we first showed a strong immunologic modulation during CR. For the same CR histological grading, two transcriptional profiles were identified according to the inflammation level. Moreover, myocardial GEP modifications were observed one month before the occurrence of CR, while histological characteristics showed no abnormality. A second study conducted on a prospective collection of both EMB and peripheral blood samples confirmed the results obtained on EMB and showed peripheral blood GEP modulations during both CR and even one month earlier. Finally, we have also shown for the first time in heart transplantation, myocardial and peripheral GEP modulations in AMR. Identification of modulated pathways in both types of rejection should allow for the determination of rejection biomarkers.

Le CD81 est une molécule de surface appartenant à la superfamille des tetraspanines. Son rôle pronostique a été précédemment étudié dans les pathologies lymphoïdes, dont le myélome multiple où son expression est associée à un pronostic péjoratif. A ce jour, ce marqueur n'a pas été étudié dans les leucémies aiguës myéloïdes (LAM). Nous avons étudié l'expression membranaire du CD81 sur les blastes de LAM au diagnostic, son association aux autres caractéristiques des LAM et sa potentielle influence sur la survie des patients sur une cohorte de 134 patients traités par chimiothérapie intensive.Le CD81 a été retrouvé chez 92 patients sur 134 (69%). Les patients exprimant ce marqueur avaient une leucocytose initiale plus élevée (p=0.02) et présentaient une cytogénétique intermédiaire ou défavorable (p<0.001). L'expression du CD81 avait un impact négatif sur la survie des patients (survie sans évènements (EFS), survie globale (OS), survie sans rechute (RFS)) en analyse uni- (p<0.001) et multivariées (p=0.003, 0.002 and <0.001 respectivement).De plus, le CD81 avait un impact négatif sur l'OS des patients avec une mutation de NPM1 (p=0.01) et chez les patients du groupe cytogénétique favorable (p=0.002) selon la classification ELN.Les anomalies du cycle cellulaire étant associées à la chimiorésistance, la croissance tumorale et l'agressivité de la pathologie, nous avons étudié l'expression du Ki67 sur les blastes de LAM au diagnostic. Ainsi, 10 prélèvements médullaires de patients avec une faible expression du CD81 par les blastes (moins de 20% de positivité) et 10 prélèvements avec une forte expression du marqueur ont été étudiés. Nous avons pu démontrer une expression significativement inférieure du Ki67 sur les blastes CD81 positifs par rapport aux blastes CD81 négatifs (p<0.001), suggérant ainsi un rôle potentiel du CD81 dans le contrôle du cycle cellulaire. De plus, nous nous sommes intéressés au rôle du CD81 dans la chimiorésistance et sur les différentes voies de signalisation cellulaire en étudiant le profil d'expression génique.En conclusion, le CD81 semble être un nouveau marqueur pronostique des LAM ainsi qu'une cible potentielle de traitement de ces pathologies. / CD81 is a cell surface protein which belongs to the tetraspanin family. While in multiple myeloma its expression on plasma cells is associated with worse prognosis, this has not yet been explored in acute myeloid leukemia (AML). We measured membrane expression of CD81 on AML cells at diagnosis, evaluated its association with AML characteristics and its influence on patient outcome after intensive chemotherapy in a cohort of 134 patients. CD81 was detected in 92/134 (69%) patients. Patients with AML expressing CD81 had elevated leukocyte count (p=0.02) and were more likely classified as intermediate or adverse-risk by cytogenetics (p<0.001). CD81 expression had a negative impact on survival (event-free [EFS], overall [OS] and relapse-free survival [RFS]) in univariate (p<0.001) and in multivariate analyses (p=0.003, 0.002 and <0.001, respectively). CD81 has a negative impact on OS in patients with NPM1 mutation (p=0.01) and in favorable risk patients by European Leukemia Net (ELN) classification (p=0.002).Since aberrations in cell cycle signaling can cause drug resistance, tumor growth and aggressiveness we measured Ki67 on primary blast cells from AML patients. We considered 10 bone marrow samples from AML patients with either weak CD81 expression (less than 20% of blast cells) or 10 bone marrow samples with strong CD81 expression on blasts. We found a significant lower ki67 expression on blast cells from CD81 positive patients compared with those from CD81 negative patients (p<0.001), indicating a potential role of CD81 in cell cycle control. Furthermore, we investigated the role of CD81 in chemotherapy resistance and investigated potentially implicated signaling pathways by gene expression profiling.In conclusion, the cell surface marker CD81 may be a new prognostic marker for diagnostic risk classification and a new potential therapeutic target for drug development in AML.

O Papel da 1,25(OH)2D3 (VD3) ou calcitriol, o metabolito ativo da Vitamina D, em câncer de mama tem sido extremamente explorado. Os efeitos antiproliferativos, prodiferenciativos e antiinflamatórios da VD3 são bem documentados na literatura. Análises de microarray vêm auxiliando a identificação de vários genes responsivos e modulados pela VD3 e seus análogos. A maioria desses genes apresentados na literatura é proveniente de estudos utilizando linhagens celulares de câncer de mama ou modelos animais. Pouco é sabido sobre a ação da VD3 em outros tipos celulares constituintes do microambiente tumoral. Fibroblasto associado ao câncer (FAC), o principal componente do microambiente tumoral, apresenta um papel central no complexo processo de interação entre tumor e estroma e consequentemente em todos os passos envolvidos na tumorigênese. O objetivo do nosso estudo foi identificar genes chaves regulados pela VD3 em fibroblastos associados ao câncer de mama. Para isso, culturas primárias de fibroblastos provenientes de cinco amostras de carcinoma mamário ductal invasivo foram estabelecidas e posteriormente caracterizadas fenotipicamente por um conjunto de marcadores. Após a confirmação da presença de receptor de vitamina D, os fibroblastos de cada amostra foram divididos em três grupos: um grupo controle e grupos de tratamento com 0,5 nM e 100 nM de VD3 durante 24 horas. A determinação do perfil de expressão gênica foi realizado utilizando tecnologia de oligo microarray com o GeneChip Human Genome U133 Plus 2.0 (Affymetrix). Foram obtidos 274 genes diferentemente expressos entre os grupos controle e tratamento com 0,5 nM de VD3, muitos deles envolvidos em processos como apoptose e migração celular. Os 161 genes diferentemente expressos obtidos a partir da comparação entre grupos controle e tratamento com 100 nM de VD3 apresentaram-se funcionalmente envolvidos em diversos processos biológicos, sendo que os mais significativos processos regulados pela VD3 em fibroblastos associados ao câncer de mama foram respostas inflamatória e imune, sugerindo que a ação antiinflamatória da VD3, anteriormente relatada em estudos utilizando células epiteliais de câncer de mama, pode também ser aplicada a fibroblastos associados ao câncer de mama / The role of 1,25(OH)2D3 (calcitriol), the active metabolite of Vitamin D, in breast cancer has been extremely explored. Antiproliferative, prodifferentiating and anti-inflammatory effects of calcitriol have been reported in breast cancer. Expression profile by microarray analysis has identified many responsive genes modulated by calcitriol and analogs. The majority of them defined to date are based on studies using breast cancer cell lines or mouse models. Little is known about the action of calcitriol in the others cell types present into the tumor microenvironment. Cancerassociated fibroblasts (CAFs), the principal cell component of the tumor microenvironment, play a central role in the complex process of tumour stroma interaction and consequently in all breast cancer tumorigenesis steps. The aim of our study was to identify key genes that are regulated by calcitriol in breast cancer associated fibroblasts. Primary fibroblasts cell cultures from five breast cancer samples were established and then phenotyping characterized by a set of markers. The occurrence of vitamin D receptor was confirmed in all samples and fibroblasts were divided in three groups: one control group and two treatment groups, 0.5 nM and 100 nM of calcitriol during 24 hours. The determination of gene expression profile was performed by oligo microarray technology using the GeneChip Human Genome U133 Plus 2.0 (Affymetrix). Control and 0.5 nM calcitriol analysis resulted in 274 differentially expressed genes, many of then involved in biological processes as apoptosis and cell migration. The 161 differentially expressed genes obtained from comparison between groups control and 100 nM calcitriol treatment were functionally involved in several biological processes. The most significantive processes regulated by VD3 in breast CAFs were the inflammatory and immune responses, suggesting that the anti-inflammatory action of calcitriol, yet reported in several studies using epithelial breast cancer cells, may also been applied to breast cancer associated fibroblasts