abstract: Glioblastoma (GBM) is the most common primary brain tumor with an incidence of approximately 11,000 Americans. Despite decades of research, average survival for GBM patients is a modest 15 months. Increasing the extent of GBM resection increases patient survival. However, extending neurosurgical margins also threatens the removal of eloquent brain. For this reason, the infiltrative nature of GBM is an obstacle to its complete resection. We hypothesize that targeting genes and proteins that regulate GBM motility, and developing techniques that safely enhance extent of surgical resection, will improve GBM patient survival by decreasing infiltration into eloquent brain regions and enhancing tumor cytoreduction during surgery. Chapter 2 of this dissertation describes a gene and protein we identified; aquaporin-1 (aqp1) that enhances infiltration of GBM. In chapter 3, we describe a method for enhancing the diagnostic yield of GBM patient biopsies which will assist in identifying future molecular targets for GBM therapies. In chapter 4 we develop an intraoperative optical imaging technique that will assist identifying GBM and its infiltrative margins during surgical resection. The topic of this dissertation aims to target glioblastoma infiltration from molecular and cellular biology and neurosurgical disciplines. In the introduction we; 1. Provide a background of GBM and current therapies. 2. Discuss a protein we found that decreases GBM survival. 3. Describe an imaging modality we utilized for improving the quality of accrued patient GBM samples. 4. We provide an overview of intraoperative contrast agents available for neurosurgical resection of GBM, and discuss a new agent we studied for intraoperative visualization of GBM. / Dissertation/Thesis / Ph.D. Neuroscience 2014

Gliomas são os tumores cefálicos mais comuns na vida adulta, geralmente estão associados a um mau prognóstico. A forma mais agressiva, o Glioblastoma Multiforme (GBM) leva metade de seus pacientes a morte em 12 a 14 meses, e os tratamentos pouco ou nada melhoram esta expectativa. O desenvolvimento de terapias é bastante complexo, uma vez que se trata de um tumor com alta diversidade de células, devido a sua instabilidade genômica. Esta instabilidade interfere no equilíbrio “estequiométrico” da transcrição gênica, implicando alterações na proporção entre proteínas atuantes em um mesmo complexo. Analisando proteínas que participam de um mesmo processo sob uma perspectiva de redes (de interação proteica), pode-se analisar a probabilidade de fluxo de informação entre proteínas conectadas, ponderando pela correlação de expressão gênica, assumindo que altos valores de correlação (de expressão – entre duas proteínas) correspondem a uma maior a probabilidade de fluxo de informação entre elas. Utilizando-se de uma medida de entropia chamada entropia local de rede, é possível analisar a organização do fluxo de informação entre uma determinada proteína e as demais com quem esta se relaciona. O aumento nestes valores de entropia é proposto enquanto uma assinatura sistêmica de tumores, tendo sido primeiramente demonstrada em tumores gástricos, de pulmão, bexiga, pâncreas, fígado e do colo uterino. Compreender como a informação flui ao longo de redes de interação proteica em glioblastomas pode trazer novas perspectivas de tratamento deste tumor. Portanto, este trabalho visa avaliar: I se há aumento da entropia local de rede em glioblastomas quando comparados ao tecido sadio; II: quais os genes responderiam pelo maior aumento de entropia e qual o papel biológico destes genes (em que rotas ou processos biológicos estariam atuando), III: se estas rotas ou processos biológicos apresentam alterações de expressão gênica, e IV: se algum dos genes alterados em nível de transcrição possui associação com prognóstico. Foi verificado: I: que Glioblastomas apresentam um aumento significativo da entropia local de rede em comparação a condição fisiológica normal. II: que os genes de maior ganho de entropia atuam em (28) processos biológicos relacionados com a biologia tumoral; III que estes processos biológicos têm alterações transcricionais (quando comparados com a situação fisiológica normal) em alguns de seus genes; IV que dentre todos os genes diferencialmente expressos nos (28) processos biológicos indicados pelos genes de entropia alterada, os genes PAK6 e MYC tiveram correlação com sobrevida em ambas as coortes analisadas. No entanto ao estratificar por idade, verificamos que esta relação se mantinha apenas em pacientes com idade inferior a 50 anos, onde verificou-se que PLCB1, MAPK8, CDK6 e MYD88 também tinha correlação com sobrevida, enquanto a expressão de duas formas da cinase dependente de cálcio/calmodulina (CAMK2A e CAMK2B) associou-se a um prognóstico ruim. Um estudo ainda mais aprofundado destes genes, bem como de outras enzimas chave nos processos identificados são promissores no sentido do desenvolvimento de estratégias de combate a glioblastomas. / Gliomas are the most common form of brain tumor in adults, being generally associated with dismal prognosis. Glioblastoma Multiform (GBM) is the most aggressive glioma subtype and – despite the recent advances in therapy regimens and patient care – median survival remains between 12 and 14 months after diagnosis, and the treatment is basically palliative. The development of GBM therapy is a difficult task, given that GBM possesses high levels of genomic instability, which consequently promotes the formation of a variety of highly proliferative, invasive and chemoresistant cell phenotypes. Such a genomic instability in tumors potentially impact the “stoichiometric” balance between functionally related proteins, mostly due to changes in transcriptional activity with these entities. Analyzing protein relations under a protein interaction network perspective allow studying the informational flux probability between linked proteins. It means that linked proteins with positive correlation are more prone to information flux than negatively correlated links. The local network entropy is an index which measures the “disorder” of the informational flux between a protein and its neighbors. Increased local network entropy was recently shown as a systemic hallmark of diverse tumors. However, to best of our knowledge, there are no studies investigating the significance of local network entropy changes in brain tumors thus far. We believe that understanding the network informational flux, and the biological processes affect in this context, can bring new insights on the pathobiology and drugable pathways in GBM. In this study, we aimed to investigate; i) whether the local network entropy of GBM differs from normal brain tissues; ii) which genes displayed increases in entropy and what biological pathways or processes they are involved in; iii) if the identified biological processes/pathways carry differentially expressed genes and; iv) whether some of the differentially expressed belonging to highly entropic pathways are correlated with GBM patients survival. In view of such a aims, our results showed that: i) GBMs showed a significant increase in local network entropy values when compared to non-tumor brain tissues; ii) genes with high entropy played a role in 28 biological processes potentially related to GBM physiopathology; iii) Several genes with the identified pathways were found overexpressed or down-regulated in tumor versus normal brain tissues and; iv) amidst them, the expressions of PAK6, PLCB1, MAPK8, CDK6 e MYD88 predicted better prognosis, while overexpression of two Calcium/Calmodulin Kinase isoforms (CAMK2A e CAMK2B) were correlated to poor prognosis; an effect only observed in patients younger (<50 years-old) at the age of diagnosis. In summary, this study shows that local network entropy in combination with pathway enrichment analysis are a useful strategy to improve our knowledge on the biological alterations as well as genes relevant to prognosis in GBM under a systems biology perspective.

A identificação de novos alvos terapêuticos no tratamento de glioblastomas multiformes (GBMs) se faz necessária devido ao mau prognóstico e ineficiência das terapias associadas a esses tumores. Nesta dissertação, avaliamos o envolvimento do Fator Nuclear kappaB (NFkappaB) e da via da PI3K/Akt no crescimento in vitro de glioblastomas, e o potencial uso dos inibidores de NFkappaB e de PI3K/Akt como possíveis agentes antitumorais. Com esta finalidade foram utilizados os inibidores farmacológicos de NFkappaB (partenolide), e de PI3K/Akt (quercetina e Ly294002), e o inibidor misto de NFkappaB/Akt (curcumina). Os inibidores de NFkappaB causaram uma significativa diminuição na viabilidade dos GBMs quando comparado com os inibidores de outras vias de sinalização (MAPK, MEK/ERK1/2, EGFr e JNK1/2), a qual foi tipo dose resposta. Além disso, os inibidores de NFkappaB apresentaram extravasamento de LDH no meio de cultura e perda de integridade da membrana plasmática que foi vista através da técnica do Iodeto de Propideo (PI). Já os inibidores de PI3K/Akt apresentaram um menor efeito do que o apresentado pelos inibidores de NFkappaB, não demonstrando uma curva do tipo dose resposta, ainda assim, diminuíram a viabilidade dos GBMs. Entretanto, não apresentaram extravasamento de LDH no meio de cultura, e não houve incorporação de PI, mostrando que, diferentemente do que ocorre com os inibidores de NFkappaB, a perda de viabilidade vista nas células tratadas com os inibidores de PI3K/Akt está preponderavelmente relacionada com uma diminuição na proliferação, e não com morte celular. Vimos também que os inibidores foram capazes de alterar o imunoconteúdo de fatores relacionados com morte e sobrevivência celular, tais como caspase 3, LC3 A/B, PARP e Hsp70, assim como o ciclo celular. Portanto, nossos resultados demonstram que a via da PI3K/Akt parece estar preferencialmente relacionada com a proliferação celular, enquanto a via do NFkappaB preferencialmente com sobrevivência. / The identification of new therapeutic targets for treatment of glioblastoma multiforme (GBMs) is necessary due to poor prognosis and ineffective therapies associated with these tumors. In this study we have assessed the role of Nuclear Factor-kappaB (NFkappaB) and the PI3K/Akt pathway in glioblastomas in vitro growth, and their inhibitors as potential antitumor agents. For this we used the pharmacological inhibitors of NFkappaB (Parthenolide), and PI3K/Akt (LY294002 and quercetin), and mixed inhibitor of NFkB / Akt (curcumin). NFkappaB inhibitors yielded a significant decrease in viability of GBMs compared to inhibitors of other signaling pathways (MAPK, MEK/ERK1/2, EGFr and JNK1 / 2), which was dose-dependent. Furthermore, inhibitors of NFkappaB showed LDH releasing in culture medium and membrane integrity losing, evaluated through the Propidium Iodide (PI)-based method. The PI3K/Akt inhibitors showed a smaller effect than NFkappaB inhibitors, also decreasing GBMs viability but playing no dose-dependence response. Despite there was not LDH releasing in culture medium and PI incorporation, showing that the loss of viability observed in cells treated with inhibitors of PI3K/Akt is associated with a decrease in the proliferation, unlike what happens with inhibitors of NFkappaB, no cell death was observed. We have also seen that the inhibitors were able to alter the contents of immune-related factors death and cell survival, such as caspase-3, LC3 A / B, PARP and Hsp70, as well as the cell cycle. Therefore, our results demonstrate that the PI3K/Akt pathway seems to be related to cell proliferation, while the NFkappaB pathway to survival.

Orientadora: Profa. Dra. Maria Cristina Carlan da Silva / Tese (doutorado) - Universidade Federal do ABC, Programa de Pós-Graduação em Biossistemas, 2018. / A relação entre a presença do Citomegalovírus Humano (HCMV) e diversos tipos de tumores tem sido alvo de investigação por décadas, e em especial, em Glioblastoma Multiforme (GBM). O GBM é o mais maligno tumor do Sistema Nervoso Central (SNC), com baixa sobrevida mesmo após o tratamento. Nosso grupo e outros demonstraram a presença do HCMV neste tipo de tumor restrita a uma pequena quantidade de células, além disso, vários mecanismos de aumento de malignidade tumoral mediados pelo HCMV já foram demonstrados in vitro e in vivo. As principais drogas utilizadas durante o tratamento quimioterápico, Temozolamida (TMZ) e Carmustina (BCNU), levam a adição de adutos no DNA, criando erros durante a replicação celular. Estudos demonstram que o HCMV pode modular vias de reparo de DNA em fibroblastos, entretanto, o possível efeito durante a quimioterapia não é conhecido. Com isto, neste trabalho avaliou-se a infecção viral de linhagens celulares de GBM bem como a resposta das mesmas ao tratamento com TMZ e BCNU. Demonstrou-se que linhagens de GBM U87MG, A172, U251MG e TP365MG são suscetíveis a infecção por HCMV, mas não igualmente permissíveis as linhagens virais laboratoriais (AD169) e clínica (TB40), provavelmente refletindo a infectividade do vírus nos tumores. Observou-se também uma diminuição na viabilidade celular nas linhagens TP365MG e U251MG infectadas com HCMV, de maneira dependente da multiplicidade de infecção (MOI). Na presença concomitante de drogas e vírus também ocorre a diminuição de viabilidade MOI dependente, especificamente em TP365MG tratada com BCNU. Em suma, os resultados indicam que a permissibilidade do HCMV em células de GBM é determinada por fatores celulares/hospedeiro e não por fatores virais. Por fim, o vírus também não aumenta a resistência ao tratamento por TMZ e BCNU em linhagens U251MG e TP365MG, entretanto, devido a heterogeneidade tumoral mais estudos são necessários em outros tipos celulares, especialmente em células tronco tumorais, levando a um melhor entendimento do possível efeito do vírus durante o tratamento quimioterápico / The relationship between the Human Cytomegalovirus (HCMV) and different types of tumors has been investigated for many decades, especially in Glioblastoma Multiforme (GBM). GBM is the most malignant tumor of the Nervous Central System (SNC), with a low overall survival even after treatment. We and others demonstrated the presence of HCMV in this type of tumor, restricted to a small number of cells, and various studies showed that the virus can increase cell malignancy both in vitro and in vivo. The chemotherapeutic agents Temozolomide (TMZ) and Carmustine (BCNU) used in GBM treatment lead to insertion of adducts in the DNA, creating errors during replication. It is well known that HCMV can modulate DNA repair pathways in fibroblasts, however, the possible effect of the virus during chemotherapy is not known. In this work we analyzed viral infection in GBM cell lines and their response to the TMZ and BCNU. We demonstrated that A172, U251MG and TP365MG GBM cell lines are susceptible to HCMV infection, but not equally permissive to both laboratory (AD169) and clinical strains (TB40), likely reflecting infection in the tumor. Additionally, we show a decrease in cell viability in TP365MG and U251MG infected with HCMV, in a MOI dependent manner. In infected and treated with chemotherapeutic drugs cells, there is also a reduction in cell viability MOI dependent in TP365MG treated with BCNU. Overall our results indicate that HCMV permissiveness in GBM cells is determined by host/cellular rather than viral factors and that the virus does not increase cell resistance to chemotherapeutic drugs in U251MG and TP365MG. Due to the tumor heterogeneity, more studies need to be performed in other tumor cells, especially in cancer stem cells, to lead to a better understanding of the possible effect of the virus during chemotherapy.

Astrocytoma, the tumor of astrocytic origin, accounts for about 60 % of the primary brain tumors. As per World Health Organization grading system, astrocytoma is classified as circumscribed astrocytoma (Grade I; pilocytic astrocytoma) and diffusely infiltrating astrocytoma. Grade I tumor is biologically benign and can be cured by surgical resection of the tumor. The diffusely infiltrating astrocytoma is further subclassified into grade II/diffuse astrocytoma (DA), grade III/anaplastic astrocytoma (AA) and grade IV/glioblastoma (GBM). Aggressiveness of the disease increases as the tumor progresses from lower grade to higher grade. In particular, GBMs are the most malignant and aggressive human cancers. For a newly diagnosed GBM patient, the current treatment option is surgical resection of the tumor followed by radiation and temozolomide therapy. Despite the treatment is multimodal (surgery+radiation+temozolomide) the median survival of GBM patients remain very low at 14.6 months. Although numerous markers with potential utility in prognosis and treatment of GBMs have been reported, they are yet to be translated into clinical utility. Our knowledge of understanding the complete biology of GBMs needs further comprehensive studies towards the identification of markers with potential utility to prognose/treat the GBM patients efficiently. Therefore, with an immense need to develop new biomarkers/therapeutic strategies in order to improve the diagnosis, prognosis and existing treatment of the GBM, the current work is designed to study the following aspects on glioma

Le glioblastome multiforme (GBM) est la tumeur cérébrale la plus fréquente et la plus agressive. Il s’agit d’une tumeur capable de survivre même dans des conditions d’oxygénation faible ou hypoxie. En effet, les cellules cancéreuses du GBM activent des voies de survie en réponse à cette privation de dioxygène, dont l’autophagie. Il s’agit d’un mécanisme catabolique conduisant à la dégradation des constituants cellulaires, générant ainsi des précurseurs pour l’anabolisme cellulaire ainsi que de l’ATP. Nous avons étudié l’activation de l’autophagie en réponse à l’hypoxie, dans trois lignées cellulaires de GBM humain, les U87MG, les M059K et les M059J. Une autophagie de survie est activée dans les trois lignées cellulaires, en réponse à l’hypoxie. L’inhibition du flux autophagique par la chloroquine (CQ), induit une accumulation des autophagosomes, soulignant ainsi l’efficacité du processus. L’inhibition de l’autophagie par la CQ ou par des siRNA spécifiques dirigés contre les transcrits de Beclin1 ou d’Atg5, entraîne une diminution significative de l’activité métabolique cellulaire, ainsi qu’un retard de prolifération. Toutefois, nous n’avons pas détecté de mort apoptotique dépendante des caspases. Nous avons donc étudié une deuxième voie de signalisation de survie cellulaire, la signalisation neurotrophique. Une augmentation significative des transcrits de TrkC FL et T1 (TrkC tronqué) ainsi que de leur ligand, la NT-3 a été observée dans les cellules U87MG cultivées en hypoxie. De même, le taux de production des protéines TrkC FL et T1 a significativement augmenté en hypoxie. L’augmentation de l’expression du TrkC FL était accompagnée par une augmentation de sa phosphorylation et de celle de la p38 MAPK. L’inhibition de cette dernière par siRNA induit un clivage de la PARP, qui est d’autant plus important suite à l’ajout de la CQ. Ces effets étaient plus marqués au niveau des cellules cultivées en hypoxie. L’inhibition de l’autophagie par la CQ, augmente l’expression de TrkC FL et la phosphorylation de la p38, ce qui suggère qu’en absence de l’autophagie, les cellules s’adapteraient en augmentant la signalisation du TrkC.La recherche des zones hypoxiques et autophagiques sur des coupes de tumeurs issues de patients atteints de GBM, confirme le caractère hypoxique de cette tumeur, et montre une induction du processus autophagique. En comparaison avec le cavernome (tumeur cérébrale bénigne), les patients atteints de GBM montrent une augmentation significative de l’expression de TrkC et de NT-3, ce qui renforce l’importance de la signalisation neurotrophique dans la survie des cellules de GBM. / Glioblastoma multiform (GBM), a primary brain tumor that is the most common and the most aggressive. It’s characterized by a high degree of hypoxia and a resistance to therapy because of its adaptation capacities including autophagy. This degradation process allows recycling of cellular components to produce precursors for anabolism and ATP. We have studied the hypoxia-induced autophagy in three human GBM cell lines, the U87MG, M059K and M059J. We have found a survival hypoxia-induced autophagy that was efficient in all cell lines. Indeed, we observed an accumulation of autophagosomes when we inhibited the autophagic flux with chloroquine (CQ). Treatment with CQ or interference of Beclin1 or Atg5 expression by specific siRNA in GBM cells significantly decreased their metabolic activity and growth. However, we did not detect PARP cleavage by western blotting. Thus, we verified the neurotrophic signaling as another survival pathway by which GBM cells resist to hypoxia. After hypoxia, the transcription level of TrkC FL (full length), TrkC-T1 (truncated TrkC) and the NT-3 (the TrkC ligand) significantly increases in the U87MG cell lines, as far as the translation level of TrkC FL and TrkC-T1. When we explored the TrkC FL signaling pathway, there was an increase in the phosphorylation level of p38. After inhibition of this MAPK, we observed PARP cleavage, which was particularly important in hypoxia conditions. This cleavage was further enhanced upon CQ treatment. The autophagy inhibition using either CQ, siBeclin1 or siAtg5, increases TrkC FL and T1 expression, suggesting that in the absence of autophagy, cells would adapt by increasing TrkC signaling.Finally, we have verified for hypoxic (BNIP3) and autophagic (LC3) markers on tumor sections from patients with GBM. We confirmed the hypoxic character of GBM, and showed important autophagy activation, after autophagosomes quantification. In comparison with cavernoma (benign brain tumor), patients with GBM showed a significant increase in TrkC and NT-3 expression, highlighting the importance of neurotrophic signaling in GBM tumor cell survival.

Le glioblastome est la forme la plus commune et la plus mortelle de tumeur cérébrale chez l’adulte. La prise en charge thérapeutique conventionnelle de ce cancer consiste en une exérèse chirurgicale de la tumeur suivie d’une radiothérapie et d’une chimiothérapie par témozolomide (Temodal®). En dépit de ces traitements pourtant agressifs, la plupart des patients rechutent et leur survie n’excède généralement pas 15 mois. Plusieurs études ont été menées afin de comprendre les mécanismes qui conduisent à une résistance de la tumeur vis-à-vis de ces traitements et récemment, un contingent cellulaire appelé cellule souche de gliome(CSG) a été mis en évidence. L’objectif de cette thèse a été de développer un nanovecteur capable de cibler ces CSGs afin de concentrer l’efficacité de la radiothérapie au niveau des cellules radiorésistantes et notamment des cellules CXCR4-positives impliquées dans la prolifération, la migration cellulaire et la résistance à l’apoptose. Pour cela, nous avons développé des nanocapsules lipidiques (LNC) contenant du rhénium-188 (188Re), un émetteur bêta -, et fonctionnalisées au moyen d’un anticorps bloquant(12G5) dirigé contre le récepteur à chimiokine CXCR4. L’efficacité de cet objet a été testée dans un modèle orthotopique de glioblastome humain chez la souris et nous avons montré que les souris traitées avec cesLNC-188Re couplées au 12G5 présentent les meilleures médianes de survie. En parallèle de ce travail, nous avons conçu un autre nanovecteur contenant de la rapamycine, un inhibiteur de la voie PI3K/Akt/mTOR impliquée dans la radiorésistance et seulement soluble dans des solvants organiques. L’efficacité de ce vecteur à rendre la rapamycine biodisponible au niveau cellulaire et à bloquer la voie mTOR a été validée in vitro. Son activité antitumorale propre et son rôle en tant que radiosensibilisant ont de plus été caractérisés en amont d’investigations précliniques. En conclusion, cette thèse a permis de développer un outil de radiothérapie interne dans le cadre d’une thérapie ciblée dans le glioblastome. Nous avons pour la première fois montré que des LNC188Re couplées à un anticorps présentent un intérêt dans le traitement du glioblastome. / Glioblastoma is the most common and deadly primarily brain tumor in adult. Conventional therapy consists on a surgical resection of the tumor followed by radiotherapy and radiotherapy. Despite this treatments, most patients rescue. These recurrences have recently been assign to radio-chemotherapeutic resistant cell contingents called glioblastoma stem-cells (GSCs). The aim of this thesis was to develop nanovector targeting these GSCsCXCR4 positives cells implicated in proliferation, cell migration and apoptose resistance. Then, we have developed lipid nanocapsules(LNC) loaded with rhenium-188 (188Re), a beta-emitter, and functionalized with a blocking antibody (12G5) directed to CXCR4. Nanovector efficiency was evaluated in an orthotopic human glioblastoma mice model and we showed that 12G5-LNC188Re treated mice had the best median survival. Concurrently of this study, we have developed another nanovector loaded with rapamycin, an inhibitor of PI3K/Akt/mTOR signaling pathway implicated in radioresistance and only soluble in organics solvants. Efficiency of this new nanovector to improve rapamycine bioavaibility and to block mTOR phosphorylation was assessed in vitro. Its own antitumor activity and its role as radiosensitizer have been evaluated in up-stream of preclinical studies.To conclude, this thesis allowed the development of a new tool forvectorized internal radiotherapy in glioblastoma. We have shown for the first time that LNC-188Re functionalized with a blockin antibody present an interest in glioblastoma therapy.

SETMAR est un gène chimérique constitué d’un domaine SET (codant des fonctions d’histone méthylase) et du domaine MAR (ayant conservé certaines fonctions de la transposase HsMAR1). Des études ont montré que les deux domaines sont biologiquement actifs et sont impliqués dans la stabilité et/ou dans la régulation de l’expression du génome humain. La littérature suggère que l’expression de SETMAR est plus forte dans les cellules cancéreuses que dans les cellules saines. Notre hypothèse de travail est que la protéine SETMAR est surexprimée en conditions pathologiques, permettant aux cellules de franchir les points de contrôle du cycle cellulaire, contribuant ainsi à augmenter l’instabilité génétique. Notre objectif est d’étudier la régulation de l’expression de SETMAR et son implication dans l’oncogenèse, gliale en particulier. / SETMAR is a chimeric gene consisting of a SET domain (encoding methylase histone functions) and a MAR domain (having retained some of the of the HsMAR1 transposase functions). Studies have shown that the two domains are biologically active and are involved in the stability and / or in the regulation of the human genome expression. The literature suggests that SETMAR expression is higher in cancer cells than in normal cells. Our working hypothesis is that SETMAR protein is overexpressed in pathological conditions, allowing cells to overcome the cellular cycle checkpoints, helping to increase the genetic instability. Our goal is to study the regulation of the SETMAR expression and its involvement in oncogenesis, glial in particular.

Glioblastoma Multiforme (GBM) is a primary malignant brain cancer, affecting children and adults and has a very poor prognosis. Up to 30% of the tumour mass consists of host derived immune cells, and a better understanding of how these cells affect tumour behaviour is required. These cells, called ‘Tumour Associated Macrophages’ (TAM) have been shown to occur in peripheral solid organ cancers, where they can cause local immune suppression, increase invasiveness and aid tumour growth. In the brain however, TAMs can consist of centrally derived microglia and peripherally derived macrophages, and although these cells could be exerting different effects on the tumour, there is currently no reliable way of distinguishing between the two. Cancer Stem Cells (CSC) are a subpopulation of cells within the tumour mass with stem-like features, are capable of self-renewal, and can recapitulate a tumour in an immunocompromised mouse host. It is thought that these cells play a role in disease recurrence and hence represent a potential target for anti-GBM therapies. In the first project we investigate the interaction between Cancer Stem Cells and TAMs. We first describe a method of culturing CSCs and TAMs from a single human patient sample, followed by an investigation into the functional properties of these cell types. We found functional differences between established cell line pairings of U87-MG and CHME3 versus primary patient derived CSCs and TAM cell line pairings. Polarisation of microglia/TAMs with lipopolysaccharide caused significant decrease in proliferative capacity of the GBM cell lines. Next we used a Non-Myeloablative Conditioning System (NMCS) to selectively replace the peripheral bone marrow compartment of wild type animals with labelled bone marrow cells, without disturbing brain homeostasis. We demonstrate that peripheral cells home exclusively to the orthotopically implanted tumour, and that some of these cells are CD11b+ and Gr1+, suggestive of myeloid derived suppressor cells (MDSC). We evaluate current CD45 based gating strategies for distinguishing peripheral and central cells and show them to be inadequate. Finally we compared the chemosensitivity profiles of different patient derived CSC lines using high throughput content screening (HTCS), against currently approved chemotherapeutic drugs and rank these drugs in a response space, based on HTCS parameters including 2D and 3D culture with and without irradiation. Differential chemosensitivities were noted between different patient derived cell lines. Drugs not currently used in the treatment of GBM such as Actinomycin D and Mitoxantrone were also identified using HTCS, suggesting the potential utility of such an approach to personalised treatments in GBM.

Glioblastoma Multiforme (GBM) is the most common lethal brain tumour associated with dismal survival rate. GBM is considered to be an incurable malignancy as these tumours evade all intricate attempts of therapy and no contemporary chemotherapeutic regimen is effective. Although the existence of cancer stem cells (CSCs) is still debatable, it is widely accepted that GBM has a small population of cells expressing CSC markers (~1%) that are highly resistant to chemo-radiation therapy. Recent evidence indicates that hypoxia induces cancer stem cell (CSC) phenotypes via epithelial-to-mesenchymal transition (EMT) that promote therapeutic resistance in solid tumours. Given that GBMs are extensively hypooxygenated heterogenous tumours, understanding the molecular relationship between hypoxia, biology of CSCs, EMT and chemoresistance would be invaluable for development of drugs that can target CSCs. Evidence suggests that hypoxia inducible factors (HIFs), NF-B and aldehyde dehydrogenase (ALDH) together orchestrate the stemness and chemoresistance in hypoxia induced CSCs. But the insights on the mechanisms still remain obscure. In this study we used an in vitro GBM CSC and hypoxia model along with NF-B-p65 and HIF transfected GBM cell lines to investigate the relationship between HIFs, NF-B activation and ALDH activity and their role in chemoresistance. The findings of this study demonstrated that GBM cells grown as spheres consist of a vast proportion of hypoxic cells with elevated CSC and EMT markers suggesting hypoxia induced EMT. GBM-CSCs are chemoresistant and displayed increased levels of HIFs, NF-B and ALDH activity. It was also observed that stable transfection of GBM cells with NF-B-p65 or HIFs induced CSC and EMT markers indicating their essential role in maintaining CSC phenotypes. The study also highlighted the importance of NF-B and ALDH in driving chemoresistance and the potential role of NF-B as the master regulator of hypoxia induced stemness in GBM cells. In this study, we used Disulfiram (DS), an anti-alcoholism drug, in combination with copper (Cu) to target the hypoxia-NF-B axis and inhibit ALDH activity to reverse chemoresistance in GBM CSCs. We showed that DS/Cu is cytotoxic to GBM cells and completely eradicated the resistant CSC population at low nanomolar levels in vitro. We also demonstrated that DS/Cu effectively inhibited GBM in vivo using newly formulated PLGA-DS nanoparticles. DS is an FDA approved drug with low/no toxicity to normal tissues and can freely pass through the blood brain barrier (BBB). Further study may lead to quick translation of DS into clinical trials.