No description available.

INTRODUÇÃO: Acredita-se que os fatores de crescimento insulina símile 1 (IGF1) e IGF2 tenham um papel chave na progressão de tumores, resistência à apoptose e terapias. A resistência à insulina tem sido associada ao aumento do volume tireoidiano e aumento do risco de desenvolver nódulos e câncer de tireoide; no entanto, há poucos estudos que avaliaram o papel dos IGFs e seus receptores no carcinoma papilífero de tireoide (CPT) e, até o momento, nenhum estudo foi conclusivo sobre a relação entre a via insulina/IGF e o comportamento do CPT. OBJETIVOS: 1) Estudar a expressão do IGF1, IGF2 e o IGF1R no CPT, incluindo o microcarcinoma papilífero; 2) Correlacionar essa expressão com as características clínicas, variante histopatológica, estadiamento e estratificação de risco. MÉTODOS: Foram selecionados, retrospectivamente, 110 pacientes operados por CPT e atendidos no Ambulatório do Serviço de Endocrinologia do Hospital das Clínicas da FMUSP e separados em dois grupos: 62 microcarcinomas papilíferos (MCP) e 48 CPT > 1,0 cm. A presença e expressão do IGF1, IGF2 e IGF1R foi avaliada, através de exame imunohistoquímico, em 110 tecidos tumorais e 98 tecidos não tumorais (controle). Os casos positivos foram classificados, de acordo com a quantidade de células coradas, em: + (menos de 10% das células); ++ (em 10-50% das células) e +++ (mais de 50% das células). O grau da expressão foi classificada em leve, moderada e forte. A presença e intensidade desses marcadores foram correlacionados com as características clínicas, variante histopatológico, TNM e estratificação de risco. RESULTADOS: O IGF1 e o IGF1R estiveram presentes em 100% e 99% dos CPTs e mostraram-se significativamente hiperexpressos, tanto nos MCPs quanto nos CPTs > 1,0 cm, quando comparados ao tecido adjacente não tumoral (p < 0,001). O IGF2 esteve expresso em 46,7% dos CPTs e mostrou fraca expressão em apenas um tecido não tumoral (p < 0,001). O IGF1 apresentou expressão significativamente maior nos microcarcinomas nos estágios III e IVA quando comparados aos estágios I e II (p=0,022). Não houve diferença significativa na quantidade e intensidade de expressão do IGF1 e IGF1R nos MCT quando comparados aos CPTs > 1,0 cm. O IGF2 apresentou expressão significativamente maior nos MCTs e, nesse grupo, apresentou maior expressão nos tumores multicêntricos (p=0,017) e nos estágios III e IVA, quando comparados aos estagios I e II (p=0,041). CONCLUSÕES: No presente estudo, observamos que o IGF1 e IGF2 foram significativamente mais expressos nos microcarcinomas em estágios mais avançados. O IGF2 apresentou maior expressão nos microcarcinomas papilíferos e esta expressão foi significativamente maior nos tumores multicêntricos / INTRODUCTION: Insulin-like growth factor-1 and 2 (IGF-1 and IGF-2) are believed to play a key role in the progression of tumors, resistance to apoptosis and therapies. The insulin resistence has been associated with increased thyroid volume and increased risk in developing thyroid nodules and thyroid cancer. However, few studies have evaluated the role of IGFs and their receptors on papillary thyroid carcinomas (PTC), and there is no conclusive studies about the relationship between IGF axis and PTC behavior. OBJECTIVES: The aim of this study was to investigate the expression of IGF-1, IGF-2, and IGF-1R in PTC, including papillary microcarcinoma (PTMC), and correlate the expression data with clinical, histologic variants, TNM staging, and risk of recurrence. METHODS: We retrospectively selected 110 paraffin-embedded tumoral tissues from patients with PTC who underwent thyroidectomy at Hospital das Clínicas of FMUSP. These patients were divided into two groups: 62 microcarcinomas (PTMC) and 48 PTC > 1.0 cm. The presence and intensity of expression of IGF-1, IGF-2, and IGF-1R were evaluated through immunohistochemical staining in 110 tumoral tissues, and in 98 non-tumoral tissues (control group). Positive cases were classified according to the numbers of staining cells in: + less than 10% of staining cells; ++ in 10-50% of the staining cells, and +++ in more than 50% of staining cells. The degree of expression was classified as mild, moderate and strong. The presence and degree of IGF1, IGF2, and IGF1R staining were correlated with clinical features, histologic type, TNM staging, and risk stratification. RESULTS: IGF-1 and IGF-1R were expressed in 100% and 99% of PTC, and were significantly overexpressed in both PTMC and PTC > 1.0 cm, in comparison with non-tumoral tissues (control group) (p < 0.001). IGF-2 was expressed in 46.7% of PTC and had mild positivity expression in only one non-tumoral tissue (p < 0.001). IGF1 was significantly overexpressed in PTMC on stage III and IVa and was less expressed in stage I and II. There was no significant difference on IGF1 and IGF1R expression between PTMC and PTC >1.0 cm. IGF-2 presented greater expression in multicentric PTMC (p=0.017), specially in stage III and IVa. CONCLUSIONS: In our study, both IGF-1 and IGF2 were significantly overexpressed in PTMC group in advanced stages. IGF-2 was also significantly overexpressed in PTMC multicentric tumors

A leucemia linfoide aguda (LLA) é uma neoplasia hematológica agressiva, caracterizada pela expansão clonal de progenitores linfoides e ativação exacerbada de vias de sinalização. A via de sinalização de IGF1R/IRS1 inicia-se pela ligação do ligante IGF1 ao seu receptor transmembrana IGF1R, e subsequente ativação de seu substrato IRS1, que transmite sinais mitogênicos e antiapoptóticos, principalmente através da modulação das vias de sinalização PI3K/AKT/mTOR e MAPK . Estas vias de sinalização desempenham uma importante função na proliferação, sobrevivência e migração de células de leucêmicas. Dessa forma, o objetivo do nosso trabalho foi investigar a participação da via de sinalização IGF1R/IRS1 na LLA. Linhagens celulares Jurkat, MOLT-4, Namalwa e Raji foram tratadas ou não com inibidor de IGF1R/IRS1-2, NT157, ou com inibidor de IGF1R/IR, OSI-906, e submetidas à avaliação da viabilidade celular, apoptose, proliferação, ciclo celular, migração e expressão/ativação gênica e proteica. Células mononucleares de pacientes com LLA e de doadores saudáveis foram submetidas aos ensaios de viabilidade e apoptose, após tratamento com NT157 e OSI-906. O efeito do NT157 in vivo foi avaliado utilizando modelo de xenotransplante de células CEM em camundongos NSG. O estudo foi aprovado pelo Comitê de Ética em Pesquisa e Comitê de Ética no Uso dos Animais da Instituição. A análise estatística foi realizada pelo teste ANOVA e teste t de Student. O tratamento com NT157 reduziu a viabilidade e a proliferação, induziu apoptose e modulou o ciclo celular em todas as linhagens testadas (p<0,05). Similarmente, OSI- 906 reduziu a viabilidade e a proliferação, modulou o ciclo celular, porém não foi capaz de induzir apoptose nas linhagens de LLA (p<0,05). Os tratamentos com NT157 e com OSI-906 diminuíram significativamente a migração de Jurkat em fibronectina, porém não modularam a migração de Namalwa. Em um contexto molecular, a exposição ao NT157 resultou em inibição da fosforilação de proteínas da via de sinalização PI3K/AKT/mTOR e modulou a expressão de 25 genes relacionados com a via de sinalização MAPK, dentre eles CDKN1A (p21), FOS e JUN (p<0,05). OSI-906modulou a ativação das proteínas da via de sinalização PI3K/AKT/mTOR e a expressão gênica de p21, FOS e JUN, porém de uma forma diferente da modulação encontrada pelo tratamento com NT157 (p<0,05). Em células mononucleares de pacientes com LLA, NT157 induziu uma resposta heterogênea na viabilidade e induziu apoptose, e OSI-906 reduziu a viabilidade, porém não foi capaz de induzir apoptose nestes pacientes (p<0,05). Os tratamentos com NT157 e OSI-906 não apresentaram citotoxicidade em células de doadores saudáveis. Adicionalmente, o tratamento in vivo com veículo ou NT157 na dose de 50mg/kg/dia, via intraperitoneal, em modelos de xenotransplante com células CEM em camundongos NSG (n=5 para cada grupo) não apresentou efeitos antineoplásicos. Em conclusão, a inibição farmacológica de IGF1R/IRS1-2, por NT157, e de IGF1R/IR, por OSI-906, apresentaram efeitos antineoplásicos significativos em modelos de linhagens celulares e amostras primárias de pacientes com LLA. Os resultados dos estudos in vivo em modelos de xenotransplante indicam a necessidade de estudos de farmacocinética e farmacodinâmica para o NT157. Nossos resultados revelaram que NT157 exerce um efeito citotóxico nas células de LLA, enquanto que OSI-906 tem um efeito predominantemente citostático. Estes dados indicam que o inibidor de IGF1R/IRS1-2, NT157, obteve resultados antineoplásicos mais atrativos e a inibição direta de IRS1 pode ser um potencial alvo terapêutico em LLA. / Acute lymphoid leukemia (ALL) is an aggressive hematological neoplasm, characterized by clonal expansion of lymphoid progenitors and exacerbated activation of signaling pathways. The IGF1R/IRS1 signaling pathway initiated through binding of the ligand IGF1 to its transmembrane receptor IGF1R, and the subsequent activation of its substrate IRS1, which transmit mitogenic and antiapoptotic signals, mainly through the modulation of the PI3K/AKT/mTOR and MAPK signaling pathways. These signaling pathways play an important function in cell proliferation, survival and migration of leukemia cells. Therefore, the objective of our study was to investigate the participation of the IGF1R/IRS1 signaling pathway in ALL. Jurkat, MOLT-4, Namalwa and Raji cell lines were treated or not with IGF1R/IRS1-2 inhibitor, NT157, or with IGF1R/IR inhibitor, OSI-906, and evaluated for cell viability, apoptosis, proliferation, cell cycle, migration, gene and protein expression/activation. Mononuclear cells from patients with ALL and from healthy donors were submitted to the viability and apoptosis assays, after treatment with NT157 and OSI-906. The NT157 effect in vivo was evaluated using CEM cell line xenograft model in NSG mice. The study was approved by the Research Ethics Committee and the Ethics Committee on the Use of Animals of the Institution. Statistical analysis was performed by ANOVA and Student t test. Treatment with NT157 reduced viability and proliferation, induced apoptosis, and modulated the cell cycle in all cell lines tested (p<0.05). Similarly, OSI-906 reduced viability and proliferation, modulated the cell cycle, but was not able to induce apoptosis in ALL cell lines (p<0.05). Treatments with NT157 and OSI-906 significantly decreased the migration of Jurkat in fibronectin, but did not modulate the Namalwa migration. In a molecular context, the NT157 exposure resulted in inhibition of the PI3K/AKT/mTOR signaling pathway protein phosphorylation and modulated the expression of 25 genes related to the MAPK signaling pathway, including CDKN1A (p21), FOS and JUN (p<0,05). OSI-906 modulated the activation of the PI3K/AKT/mTOR signaling pathway proteins and the p21, FOS and JUN geneexpression, but in a different way from the modulation found by treatment with NT157 (p<0.05). In mononuclear cells of patients with ALL, NT157 induced a heterogeneous response in viability and induced apoptosis, and OSI-906 reduced viability, but was not able to induce apoptosis in these patients (p<0.05). Treatments with NT157 and OSI- 906 did not show cytotoxicity in healthy donor cells. Additionally, in vivo treatment with vehicle or NT157 at the dose of 50 mg/kg/day, intraperitoneally, in xenotransplantation models with CEM cells in NSG mice (n=5 for each group) showed no antineoplastic effects. In conclusion, the pharmacological inhibition of IGF1R/IRS1- 2, by NT157, and IGF1R/IR, by OSI-906, showed significant antineoplastic effects in cell line models and in primary samples of patients with ALL. The results of in vivo studies in xenotransplantation models indicate the need for pharmacokinetic and pharmacodynamic studies for NT157. In conclusions, our results revealed that NT157 exerts a cytotoxic effect on ALL cell lines and primary ALL cells, whereas OSI-906 has a predominantly cytostatic effect. These data indicate that the IGF1R/IRS1-2 inhibitor, NT157, obtained more attractive antineoplastic results and the direct inhibition of IRS1 may be a potential therapeutic to target in ALL.

A leucemia linfoide aguda (LLA) é uma neoplasia hematológica agressiva, caracterizada pela expansão clonal de progenitores linfoides e ativação exacerbada de vias de sinalização. A via de sinalização de IGF1R/IRS1 inicia-se pela ligação do ligante IGF1 ao seu receptor transmembrana IGF1R, e subsequente ativação de seu substrato IRS1, que transmite sinais mitogênicos e antiapoptóticos, principalmente através da modulação das vias de sinalização PI3K/AKT/mTOR e MAPK . Estas vias de sinalização desempenham uma importante função na proliferação, sobrevivência e migração de células de leucêmicas. Dessa forma, o objetivo do nosso trabalho foi investigar a participação da via de sinalização IGF1R/IRS1 na LLA. Linhagens celulares Jurkat, MOLT-4, Namalwa e Raji foram tratadas ou não com inibidor de IGF1R/IRS1-2, NT157, ou com inibidor de IGF1R/IR, OSI-906, e submetidas à avaliação da viabilidade celular, apoptose, proliferação, ciclo celular, migração e expressão/ativação gênica e proteica. Células mononucleares de pacientes com LLA e de doadores saudáveis foram submetidas aos ensaios de viabilidade e apoptose, após tratamento com NT157 e OSI-906. O efeito do NT157 in vivo foi avaliado utilizando modelo de xenotransplante de células CEM em camundongos NSG. O estudo foi aprovado pelo Comitê de Ética em Pesquisa e Comitê de Ética no Uso dos Animais da Instituição. A análise estatística foi realizada pelo teste ANOVA e teste t de Student. O tratamento com NT157 reduziu a viabilidade e a proliferação, induziu apoptose e modulou o ciclo celular em todas as linhagens testadas (p<0,05). Similarmente, OSI- 906 reduziu a viabilidade e a proliferação, modulou o ciclo celular, porém não foi capaz de induzir apoptose nas linhagens de LLA (p<0,05). Os tratamentos com NT157 e com OSI-906 diminuíram significativamente a migração de Jurkat em fibronectina, porém não modularam a migração de Namalwa. Em um contexto molecular, a exposição ao NT157 resultou em inibição da fosforilação de proteínas da via de sinalização PI3K/AKT/mTOR e modulou a expressão de 25 genes relacionados com a via de sinalização MAPK, dentre eles CDKN1A (p21), FOS e JUN (p<0,05). OSI-906modulou a ativação das proteínas da via de sinalização PI3K/AKT/mTOR e a expressão gênica de p21, FOS e JUN, porém de uma forma diferente da modulação encontrada pelo tratamento com NT157 (p<0,05). Em células mononucleares de pacientes com LLA, NT157 induziu uma resposta heterogênea na viabilidade e induziu apoptose, e OSI-906 reduziu a viabilidade, porém não foi capaz de induzir apoptose nestes pacientes (p<0,05). Os tratamentos com NT157 e OSI-906 não apresentaram citotoxicidade em células de doadores saudáveis. Adicionalmente, o tratamento in vivo com veículo ou NT157 na dose de 50mg/kg/dia, via intraperitoneal, em modelos de xenotransplante com células CEM em camundongos NSG (n=5 para cada grupo) não apresentou efeitos antineoplásicos. Em conclusão, a inibição farmacológica de IGF1R/IRS1-2, por NT157, e de IGF1R/IR, por OSI-906, apresentaram efeitos antineoplásicos significativos em modelos de linhagens celulares e amostras primárias de pacientes com LLA. Os resultados dos estudos in vivo em modelos de xenotransplante indicam a necessidade de estudos de farmacocinética e farmacodinâmica para o NT157. Nossos resultados revelaram que NT157 exerce um efeito citotóxico nas células de LLA, enquanto que OSI-906 tem um efeito predominantemente citostático. Estes dados indicam que o inibidor de IGF1R/IRS1-2, NT157, obteve resultados antineoplásicos mais atrativos e a inibição direta de IRS1 pode ser um potencial alvo terapêutico em LLA. / Acute lymphoid leukemia (ALL) is an aggressive hematological neoplasm, characterized by clonal expansion of lymphoid progenitors and exacerbated activation of signaling pathways. The IGF1R/IRS1 signaling pathway initiated through binding of the ligand IGF1 to its transmembrane receptor IGF1R, and the subsequent activation of its substrate IRS1, which transmit mitogenic and antiapoptotic signals, mainly through the modulation of the PI3K/AKT/mTOR and MAPK signaling pathways. These signaling pathways play an important function in cell proliferation, survival and migration of leukemia cells. Therefore, the objective of our study was to investigate the participation of the IGF1R/IRS1 signaling pathway in ALL. Jurkat, MOLT-4, Namalwa and Raji cell lines were treated or not with IGF1R/IRS1-2 inhibitor, NT157, or with IGF1R/IR inhibitor, OSI-906, and evaluated for cell viability, apoptosis, proliferation, cell cycle, migration, gene and protein expression/activation. Mononuclear cells from patients with ALL and from healthy donors were submitted to the viability and apoptosis assays, after treatment with NT157 and OSI-906. The NT157 effect in vivo was evaluated using CEM cell line xenograft model in NSG mice. The study was approved by the Research Ethics Committee and the Ethics Committee on the Use of Animals of the Institution. Statistical analysis was performed by ANOVA and Student t test. Treatment with NT157 reduced viability and proliferation, induced apoptosis, and modulated the cell cycle in all cell lines tested (p<0.05). Similarly, OSI-906 reduced viability and proliferation, modulated the cell cycle, but was not able to induce apoptosis in ALL cell lines (p<0.05). Treatments with NT157 and OSI-906 significantly decreased the migration of Jurkat in fibronectin, but did not modulate the Namalwa migration. In a molecular context, the NT157 exposure resulted in inhibition of the PI3K/AKT/mTOR signaling pathway protein phosphorylation and modulated the expression of 25 genes related to the MAPK signaling pathway, including CDKN1A (p21), FOS and JUN (p<0,05). OSI-906 modulated the activation of the PI3K/AKT/mTOR signaling pathway proteins and the p21, FOS and JUN geneexpression, but in a different way from the modulation found by treatment with NT157 (p<0.05). In mononuclear cells of patients with ALL, NT157 induced a heterogeneous response in viability and induced apoptosis, and OSI-906 reduced viability, but was not able to induce apoptosis in these patients (p<0.05). Treatments with NT157 and OSI- 906 did not show cytotoxicity in healthy donor cells. Additionally, in vivo treatment with vehicle or NT157 at the dose of 50 mg/kg/day, intraperitoneally, in xenotransplantation models with CEM cells in NSG mice (n=5 for each group) showed no antineoplastic effects. In conclusion, the pharmacological inhibition of IGF1R/IRS1- 2, by NT157, and IGF1R/IR, by OSI-906, showed significant antineoplastic effects in cell line models and in primary samples of patients with ALL. The results of in vivo studies in xenotransplantation models indicate the need for pharmacokinetic and pharmacodynamic studies for NT157. In conclusions, our results revealed that NT157 exerts a cytotoxic effect on ALL cell lines and primary ALL cells, whereas OSI-906 has a predominantly cytostatic effect. These data indicate that the IGF1R/IRS1-2 inhibitor, NT157, obtained more attractive antineoplastic results and the direct inhibition of IRS1 may be a potential therapeutic to target in ALL.

INTRODUÇÃO: Acredita-se que os fatores de crescimento insulina símile 1 (IGF1) e IGF2 tenham um papel chave na progressão de tumores, resistência à apoptose e terapias. A resistência à insulina tem sido associada ao aumento do volume tireoidiano e aumento do risco de desenvolver nódulos e câncer de tireoide; no entanto, há poucos estudos que avaliaram o papel dos IGFs e seus receptores no carcinoma papilífero de tireoide (CPT) e, até o momento, nenhum estudo foi conclusivo sobre a relação entre a via insulina/IGF e o comportamento do CPT. OBJETIVOS: 1) Estudar a expressão do IGF1, IGF2 e o IGF1R no CPT, incluindo o microcarcinoma papilífero; 2) Correlacionar essa expressão com as características clínicas, variante histopatológica, estadiamento e estratificação de risco. MÉTODOS: Foram selecionados, retrospectivamente, 110 pacientes operados por CPT e atendidos no Ambulatório do Serviço de Endocrinologia do Hospital das Clínicas da FMUSP e separados em dois grupos: 62 microcarcinomas papilíferos (MCP) e 48 CPT > 1,0 cm. A presença e expressão do IGF1, IGF2 e IGF1R foi avaliada, através de exame imunohistoquímico, em 110 tecidos tumorais e 98 tecidos não tumorais (controle). Os casos positivos foram classificados, de acordo com a quantidade de células coradas, em: + (menos de 10% das células); ++ (em 10-50% das células) e +++ (mais de 50% das células). O grau da expressão foi classificada em leve, moderada e forte. A presença e intensidade desses marcadores foram correlacionados com as características clínicas, variante histopatológico, TNM e estratificação de risco. RESULTADOS: O IGF1 e o IGF1R estiveram presentes em 100% e 99% dos CPTs e mostraram-se significativamente hiperexpressos, tanto nos MCPs quanto nos CPTs > 1,0 cm, quando comparados ao tecido adjacente não tumoral (p < 0,001). O IGF2 esteve expresso em 46,7% dos CPTs e mostrou fraca expressão em apenas um tecido não tumoral (p < 0,001). O IGF1 apresentou expressão significativamente maior nos microcarcinomas nos estágios III e IVA quando comparados aos estágios I e II (p=0,022). Não houve diferença significativa na quantidade e intensidade de expressão do IGF1 e IGF1R nos MCT quando comparados aos CPTs > 1,0 cm. O IGF2 apresentou expressão significativamente maior nos MCTs e, nesse grupo, apresentou maior expressão nos tumores multicêntricos (p=0,017) e nos estágios III e IVA, quando comparados aos estagios I e II (p=0,041). CONCLUSÕES: No presente estudo, observamos que o IGF1 e IGF2 foram significativamente mais expressos nos microcarcinomas em estágios mais avançados. O IGF2 apresentou maior expressão nos microcarcinomas papilíferos e esta expressão foi significativamente maior nos tumores multicêntricos / INTRODUCTION: Insulin-like growth factor-1 and 2 (IGF-1 and IGF-2) are believed to play a key role in the progression of tumors, resistance to apoptosis and therapies. The insulin resistence has been associated with increased thyroid volume and increased risk in developing thyroid nodules and thyroid cancer. However, few studies have evaluated the role of IGFs and their receptors on papillary thyroid carcinomas (PTC), and there is no conclusive studies about the relationship between IGF axis and PTC behavior. OBJECTIVES: The aim of this study was to investigate the expression of IGF-1, IGF-2, and IGF-1R in PTC, including papillary microcarcinoma (PTMC), and correlate the expression data with clinical, histologic variants, TNM staging, and risk of recurrence. METHODS: We retrospectively selected 110 paraffin-embedded tumoral tissues from patients with PTC who underwent thyroidectomy at Hospital das Clínicas of FMUSP. These patients were divided into two groups: 62 microcarcinomas (PTMC) and 48 PTC > 1.0 cm. The presence and intensity of expression of IGF-1, IGF-2, and IGF-1R were evaluated through immunohistochemical staining in 110 tumoral tissues, and in 98 non-tumoral tissues (control group). Positive cases were classified according to the numbers of staining cells in: + less than 10% of staining cells; ++ in 10-50% of the staining cells, and +++ in more than 50% of staining cells. The degree of expression was classified as mild, moderate and strong. The presence and degree of IGF1, IGF2, and IGF1R staining were correlated with clinical features, histologic type, TNM staging, and risk stratification. RESULTS: IGF-1 and IGF-1R were expressed in 100% and 99% of PTC, and were significantly overexpressed in both PTMC and PTC > 1.0 cm, in comparison with non-tumoral tissues (control group) (p < 0.001). IGF-2 was expressed in 46.7% of PTC and had mild positivity expression in only one non-tumoral tissue (p < 0.001). IGF1 was significantly overexpressed in PTMC on stage III and IVa and was less expressed in stage I and II. There was no significant difference on IGF1 and IGF1R expression between PTMC and PTC >1.0 cm. IGF-2 presented greater expression in multicentric PTMC (p=0.017), specially in stage III and IVa. CONCLUSIONS: In our study, both IGF-1 and IGF2 were significantly overexpressed in PTMC group in advanced stages. IGF-2 was also significantly overexpressed in PTMC multicentric tumors

Au cours de la préimplantation, l'embryon de souris produit deux lignages cellulaires, le trophectoderme (TE), et la masse cellulaire interne (MCI) qui elle-même se différencie en épiblaste (Epi) et en endoderme primitif (EPr), caractérisés respectivement par l'expression exclusive de Nanog et de Gata6. La voie FGF/MAPK joue un rôle critique dans l’acquisition de l’identité EPr. J’ai examiné l’expression de pERK, DUSP4 et ETV5 qui permettent de visualiser l'activité des MAPK. Ces analyses ont été effectuées en activant ou inhibant la voie FGF/MAPK, ainsi que dans des embryons mutants pour Nanog et/ou Gata6. Ceci a permis d’observer l’activation de la voie FGF/MAPK dès E3,25. Un autre volet de mon travail a été d'analyser la voie de l’IGF dans les embryons préimplantatoires afin de comprendre l’influence de cette voie dans les différents lignages. J’ai montré que le récepteur activé pIGF1R est exprimé de manière différentielle dans le TE, l’EPr et l’Epi au cours du développement. Une supplémentation d’IGF1 induit une augmentation du nombre de cellules en deux phases, d'abord de l’Epi puis de l’EPr. A l’inverse, une perte de fonction d’IGF1R induit une diminution du nombre de cellules entre E3,75 et E4,25. / During preimplantation, mouse embryo produces two cellular lineages, the trophectoderm (TE), and the inner cell mass (ICM), which differentiates in epiblast (Epi) and primitive endoderm (PrE), characterized respectively by the complementary expression of Nanog and Gata6. FGF/MAPK pathway plays a critical role in the acquisition of a PrE identity. I examined the expression of the markers of MAPK activity pERK, DUSP4 and ETV5. The analyze was performed with activation or inhibition of FGF/MAPK pathway and in mutant embryos for Nanog or Gata6. This showed that FGF/MAPK pathway is activated as soon as E3,25. I have also analyzed the IGF pathway in preimplantation embryos in order to understand the role of this pathway in embryonic lineages. I showed that active receptor pIGF1R is differentially expressed in TE, PrE and Epi during embryonic development. Supplementation with IGF1 induces an increase in cell number in two phases, first in Epi then in PrE. Conversely, loss of function of IGF1R induces a decrease in cell number between E3,75 and E4,25.

Hintergrund: Der Insulin-like growth factor receptor (IGF1R) spielt eine zentrale Rolle bei Wachstumsprozessen. Heterozygote IGF1R-Mutationen führen durch eine partielle IGF1-Resistenz zu Kleinwuchs. Methoden: Auxologische und endokrinologische Daten des Patienten wurden erhoben. Anhand von Fibroblasten wurde die IGF1R-Deletion charakterisiert und die Auswirkungen auf die mRNA- und Protein-Expression sowie die Signaltransduktion untersucht. Ergebnisse: Der Junge, der eine heterozygote Exon 6 Deletion im IGF1R – durch Alu-Rekombination verursacht – und eine heterozygote SHOX-Variante (p.Met240Ile) in seinem Genom vereint, kam ‚appropriate for gestational age‘ zur Welt, entwickelte aber postnatal eine Wachstumsretardierung. Die Endokrinologischen Daten waren unauffällig. Der Patient zeigt keine Stigmata, die bei anderen IGF1- oder SHOX-Mutationsträgern beschrieben wurden. Durch Nonsense-Mediated mRNA Decay kommt es zu einer Dosisreduktion der IGF1-Rezeptoren und einer entsprechenden verminderten Aktivierung der Rezeptoren, nicht aber des Signalwegs. Zusammenfassung: Der Patient trägt eine bisher unbeschrieben heterozygote IGF1R-Deletion, die zu Kleinwuchs führt. Ursächlich dafür ist eine durch die Mutation verursachte Dosisreduktion der IGF1-Rezeptoren.

Hintergrund: Der Insulin-like growth factor receptor (IGF1R) spielt eine zentrale Rolle bei Wachstumsprozessen. Heterozygote IGF1R-Mutationen führen durch eine partielle IGF1-Resistenz zu Kleinwuchs. Methoden: Auxologische und endokrinologische Daten des Patienten wurden erhoben. Anhand von Fibroblasten wurde die IGF1R-Deletion charakterisiert und die Auswirkungen auf die mRNA- und Protein-Expression sowie die Signaltransduktion untersucht. Ergebnisse: Der Junge, der eine heterozygote Exon 6 Deletion im IGF1R – durch Alu-Rekombination verursacht – und eine heterozygote SHOX-Variante (p.Met240Ile) in seinem Genom vereint, kam ‚appropriate for gestational age‘ zur Welt, entwickelte aber postnatal eine Wachstumsretardierung. Die Endokrinologischen Daten waren unauffällig. Der Patient zeigt keine Stigmata, die bei anderen IGF1- oder SHOX-Mutationsträgern beschrieben wurden. Durch Nonsense-Mediated mRNA Decay kommt es zu einer Dosisreduktion der IGF1-Rezeptoren und einer entsprechenden verminderten Aktivierung der Rezeptoren, nicht aber des Signalwegs. Zusammenfassung: Der Patient trägt eine bisher unbeschrieben heterozygote IGF1R-Deletion, die zu Kleinwuchs führt. Ursächlich dafür ist eine durch die Mutation verursachte Dosisreduktion der IGF1-Rezeptoren.:Inhaltsverzeichnis I Abkürzungsverzeichnis - 4 - 1 Bibliographische Beschreibung - 7 - 1.1 Referat - 7 - 2 Einleitung und Hintergrund - 9 - 2.1 Das menschliche Wachstum - 9 - 2.2 Das IGF-System als Regulator von Wachstum u. Entwicklung - 10 - 2.3 Der IGF1-Rezeptor - 11 - 2.4 Formen des Kleinwuchses - 12 - 2.5 IGF1R-Mutationen - 13 - 2.6 SHOX-Defizienz - 14 - 2.7 Der Nonsense-Mediated mRNA Decay - 15 - 2.8 Alu-Elemente - 16 - 2.9 Überleitung - 17 - 4 Originalpublikation - 18 - 5 Zusammenfassung der Arbeit - 31 - 5.1 Patientenbeschreibung - 32 - 5.2 Experimentelle Untersuchungen - 33 - 5.3 Interpretation - 35 - 5.4 Ausblick - 37 - 6 Literaturverzeichnis - 39 - III Curriculum vitae - 50 - IV Danksagung - 52 -

The goal of this study was to identify novel drug repurposing opportunities in cancer by utilizing the off-target profiles of clinically relevant kinase inhibitors. This was based on the observation that the global target profiles of compounds are largely ignored and that many compounds have activity that cannot be explained by their cognate target alone. Additionally, by utilizing clinically relevant compounds, any results would hold a high potential for eventual clinical implementation. We utilized a systems pharmacology approach utilizing cell viability-based drug screening to identify compounds with beneficial off-target activity and then using chemical and phosphoproteomics in order to elucidate the mechanisms of action of these compounds. We found that tivantinib has off-target activity in NSCLC cells through inhibition of GSK3. Based on tivantinib’s ability to inhibit GSK3, we hypothesized that tivantinib would therefore have activity in acute myeloid leukemia (AML). We found that tivantinib had potent activity in AML through inhibition of GSK3. We also identified a highly synergistic combination with ABT-199 by drug synergy screening which was effective in HL60 cells and patient derived AML cells. We also found that the anaplastic lymphoma kinase (ALK) inhibitor, ceritinib, had activity across several ALK-negative lung cancer cell lines. We utilized integrated functional proteomics to identify the new targets and network-wide signaling effects. Combining pharmacological inhibitors and RNA interference revealed a polypharmacology mechanism involving the noncanonical targets IGF1R, FAK1, RSK1 and RSK2. Mutating the downstream signaling hub YB1 protected cells from ceritinib. Consistent with YB1 signaling being known to cause taxol resistance, combination of ceritinib with paclitaxel displayed strong synergy, particularly in cells expressing high FAK autophosphorylation, which we show to be prevalent in lung cancer. Together, we present a systems chemical biology platform for elucidating multikinase inhibitor mechanisms, synergistic drug combinations, mechanistic biomarker candidates and identifying novel drug repurposing opportunities.

The calcium-sensing receptor (CaR) is a G-protein coupled receptor that controls mammalian extracellular calcium (Ca2+o) homeostasis. CaR downstream signalling involves intracellular calcium (Ca2+i) mobilisation which can be negatively modulated by protein kinase C (PKC)-mediated phosphorylation of CaR residue Thr-888 (CaRT888). The nature of this regulation was investigated here using siRNA-based knockdown of individual PKC isotypes. Knocking down PKCα expression increased CaR-induced Ca2+i mobilisation in CaR-HEK cells, significantly lowering the EC50 for Ca2+o relative to control siRNA-transfected cells. In accordance, PKCα knockdown also decreased CaRT888 phosphorylation which also permitted the triggering of Ca2+i mobilisation in CaR-HEK cells at sub-threshold Ca2+o concentrations. Interestingly, PKCε knockdown attenuated CaR-induced Ca2+i mobilisation in CaR-HEK cells, significantly increasing the EC50 for Ca2+o. However, this knockdown was also also found to inhibit CaRT888 phosphorylation and this is the first time that CaRT888 phosphorylation has been shown to be dissociate from Ca2+i mobilisation. The results show the complexity of the interactions that potentially underlie the CaR’s pleiotropic signalling and provides novel targets for examining signal bias. Classically an increase in cAMP is known to trigger PTH seceretion. The observation in this study shows that raising intracellular cAMP levels with forskolin also decreased CaRT888 phosphorylation permitting increased Ca2+i mobilisation. This suggests that cAMP may stimulate the phosphatase (most likely protein phosphatase 2A (PP2A)). Nevertheless, knocking down Gα12, which has been shown to activate PP2A, resulted in increased CaRT888 phosphorylation and lower Ca2+i mobilisation (increased EC50 for Ca2+o). This suggests the possibility of CaR as a cAMP sensor that can detect an increase in intracellular cAMP in order to stop PTH serection. Three novel CaR effectors, P70 ribosamal protein S6 kinase, insulin-like growth factor receptor-1 and nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor, were identified in CaR-HEK cells. It was shown that a) high Ca2+o stimulated the activation of these effectors and b) each effector was inhibited by knockdown of PKCα and Gα12, which further confirmed the association of these signals with CaR. These data show that CaR also plays an important role outside Ca2+o homeostasis, such as growth and inflammation. Finally, five CaR mutations associated with autosomal dominant hypocalcaemia (ADH) were found to increase Ca2+o-induced Ca2+i mobilisation, as well as ERK and p38MAPK activation, when transfected stably in HEK-293 cells. Cotreatment with the calcilytic NPSP795 inhibited ERK and p38MAPK phosphorylation in all 5 gain-of-function mutants and in the wild type CaR cells, with IC50s for the compound in the nanomolar range. These data highlight the potential utility of CaR negative allosteric modulators in the treatment of gain-of-function CaR mutations. Together these data enhance our understanding of CaRT888 phosphorylation and CaR signalling.