Le cancer de l’ovaire est la première cause de décès par cancer gynécologique chez la femme. La survie globale à 5 ans est inférieur à 40% due à un diagnostique tardif et une haute fréquence des récidives malgré une chimiosensibilité initiale. Les caractéristiques cliniques et anatomopathologiques ne prédisent pas de façon précise le pronostic des patients et il est urgent de trouver de nouvelles cibles moléculaires. Ces dernières années plusieurs nouvelles stratégies ont émergé. De nombreux consortium ont analysé de façon exhaustive le génome des cancers ovariens établissant ainsi une carte d ‘identité précise des cancers avancés. Par ailleurs plusieurs groupes ont montré le rôle primordial du stroma tumoral dans la progression des tumeurs ovariens.Dans ce travail de thèse nous avons d’abord mis en place un modèle de culture tridimensionnel des cancers de l’ovaire en utilisant la membrane amniotique comme substitut au péritoine. Nous avons pu ainsi quantifier les premières étapes de l’invasion tumorale et montrer le rôle primordial des MSCs via la sécrétion de l’Interleukin IL6. Notre deuxième travail a consisté en une analyse des données de génomiques du TCGA. Nous avons utilisé les concepts de Background mutation rate et mis en place un système de mutagenèse in silico avec des boucles de réitération (Bootstrap). Cette stratégie nous a permis d’obtenir une liste des gènes qui auraient du être retrouvé muté. En posant l ‘hypothèse que les gènes protégés des mutations étaient primordiales au développement tumoral nous avons mis en place une plateforme de screening basé sur l’inhibition par siRNA pour démontrer la validité de notre stratégie. Ainsi nous avons pu montrer le rôle primordial de gène dont la fonction n’était pas décrite dans le cancer de l’ovaire (ANKLE2, MAB1-Beta).Au total utilisant deux stratégies différentes de recherche nous avons pu mettre ne évidence le rôle d’IL6 dans l’invasion initiale du péritoine par les cellules tumorales ovariennes et déterminer le rôle de gènes non muté dans la progression tumorale / Ovarian cancer causes more deaths in the United States than any other type of female reproductive tract cancer, with an estimated 21,980 new cases and 14,270 deaths in 2014. Approximately 70% of ovarian cancers are diagnosed at advanced stage and only 30% of women with such cancers can expect to survive 5 years. This low survival rate is due to the frequent diagnosis of epithelial ovarian cancer at an advanced stage, and to intrinsic and acquired resistance to platinum-based chemotherapy. Clinical and pathological classification methods, including tumor grade and the extent of surgical debulking, still fail to fully predict disease progression and patient outcome. Clinical profile of initial response to chemotherapy in the majority of patients followed by recurrence in high proportion of patients suggests the presence of a subpopulation of cells that survives and leads to chemoresistance. Only by treating this subpopulation we can achieve durable response rates.Genomic instability is a hallmark of malignant tumors, causing disturbed integrity of the genome, numerical alterations, and structural changes. For various cancer types greater genomic instability has been associated with poor prognosis, suggesting that genomic instability may confer growth advantage of cancer cells. With the recent development of next-generation sequencing (NGS) technology, the Cancer Genome Atlas (TCGA) researchers have identified molecular abnormalities related to the pathophysiology, clinical outcome, and potential therapeutic targets in high-grade serous ovarian cancer (HGSC). The TCGA study provides a large-scale integrative view of the aberration in HGSC with extensive heterogeneity between individual tumorsOur research protocols enabled us to combine computational biology approach and gene knock down in the first part to identify genes that play an important role in ovarian cancer biology. we carried out in silico mutagenesis of the human genome corresponding to the regions sequenced by publically available ovarian cancer sequencing data from the TCGA. We compared the simulated mutations to the observed mutations in the TCGA cohort. We found genes that were observed to be mutated less than expected from the simulation data.Our approach allowed us to identify therefore a set of genes that we think are selected and remain unmutated for their potential role in tumor progression. Silencing of un-mutated genes impacted growth, morphology, migration, invasion and chemotherapeutic. This is the first study depicting that inhibition of a specific non-mutated gene by its single targeting siRNA can be utilized to obtain improved therapeutic efficiency.

Les télomères sont les extrémités des chromosomes et sont protégés par le complexe shelterin pour ne pas être reconnus comme des cassures accidentelles d'ADN double brin. Un enjeu majeur dans la recherche sur les télomères est de comprendre comment l'intégrité des extrémités des chromosomes au cours de l'oncogenèse est modifiée. La perte de répétitions télomériques à chaque division cellulaire peut être compensée par l’activité de l’enzyme télomérase qui ajoute "de novo" des motifs télomériques. Bien que la télomérase soit surexprimée dans la majorité des cellules cancéreuses, l’impact de modifications des protéines shelterin qui coiffent les télomères dans le processus oncogénique n'est pas clair. Dans la première étude, nous avons analysé l'état des télomères de patients atteints de la Leucémie Lymphoïde Chronique (LLC) uniquement au stade précoce de la LLC, stade A de Binet. La LLC est une leucémie commune aux pays occidentaux et se développe chez les personnes âgées. Nous avons montré que la majorité des patients atteints de la maladie présente des télomères dysfonctionnels. Les dommages télomériques ne corrèlent pas avec la longueur des télomères ou le statut mutationnel des patients, mais corrèlent avec la faible expression des protéines télomériques TIN2 et TPP1. Dans la seconde étude, nous avons montré que l'expression de l'oncogène H-RasV12 confère une résistance accrue vis-à-vis des télomères dysfonctionnels et aucun défaut de croissance n’est observable lorsque TRF2, une protéine télomérique est inhibée. Cet effet dépend de l'expression de l'interleukine 6 (IL-6), révélant un rôle inattendu de cette cytokine dans la fonction des télomères. De plus, la co-inhibition de TRF2 et IL-6 dans les cellules RasV12 conduit à blocage G2 / M associé à une séparation des chromatides sœurs. Ces résultats suggèrent que l'induction de la tumorigénicité par l’oncogène Ras protège les télomères contre les dommages et que la ségrégation des chromosomes est dépendante de TRF2 et IL-6. / Telomeres protect the chromosome extremities from being repaired and recognized as accidental DNA breaks double-strand. A major issue in telomere research is to understand how systems monitoring the integrity of chromosomes ends change during oncogenesis. Although telomerase overexpression occurs in the majority of cancer cells, whether other types of telomere changes play roles in the oncogenic process is unclear. In the first study, we analyzed the status of telomeres in patients with early stage Chronic Lymphocytic Leukemia (B-CLL), which is a common leukemia in Western countries that develops in the elderly. We showed that the majority of CLL patients exhibit telomeric dysfunction. It does not correlate with telomere length or mutation status of patients, but correlates with low expression of telomeric proteins TIN2 and TPP1. In the second study, we showed that expression of the H-RasV12 oncogene confers increased resistance to telomere uncapping and protects against to growth defects when TRF2, a telomeric protein, is depleted. This effect depends upon the expression of interleukin 6 (IL-6), revealing an unexpected role for this cytokine in telomere function. Notably, the co-inhibition of TRF2 and IL-6 in RasV12 cells led to G2/M block associated with an increased incidence of premature sister chromatid separation. These findings suggest that the induction of a tumorigenic state by oncogenic Ras protects against telomere damage and chromosome segregation defects in TRF2-compromised cells through an increase of IL-6 expression

Estima-se que mais de 800.000 cirurgias cardíacas de revascularização do miocárdio por ano são realizadas no mundo. Nesta intervenção terapêutica uma das complicações mais comuns é a fibrilação atrial, que esta intimamente relacionada com aumento de risco de morbidade e mortalidade pós-operatória. Os fatores determinantes desta manifestação podem ser pré, intra e pós-operatórios que possivelmente se relaciona com as proteínas pró-inflamatórias, canais iônicos e sistema renina-angiotensina. Portanto, os polimorfismos nos genes que codificam essas proteínas podem ter importante papel no desenvolvimento da FAPo. O objetivo deste trabalho foi de avaliar a associação entre os polimorfismos dos genes IL6 (G-174C), KCNE5 (C97T) e AGT (A-217G) e a incidência da FAPo e seus efeitos na expressão de RNAm, em apêndice atrial direito e em sangue periférico. Para o estudo foram selecionados 76 indivíduos portadores de insuficiência coronariana obstrutiva com indicação de intervenção cirúrgica de revascularização do miocárdio. Desses, 16 com FAPo, 52 sem FAPo e 8 pacientes foram excluídos por motivo de óbito. Amostras de sangue periférico foram obtidas para análise de parâmetros bioquímicos e para extração de DNA genômico e RNA total, antes e 48 horas após a cirurgia cardíaca. Os polimorfismos de nucleotídeo único (SNP) dos genes da IL-6, KCNE5 e do AGT foram detectados pela PCR-RFLP e confirmados por sequenciamento de DNA. A expressão de RNAm em leucócitos totais de sangue periférico e de tecido foi analisada pela PCR em tempo real, utilizando o gene GAPDH como referência endógena. A freqüência do alelo -174G foi de 75 % no GFA e 69,2% no GC e não foi associada ao desenvolvimento de FAPo. A freqüência do alelo 97T foi de 0% no GFA e 10,8% no GC e não foi associada a menor incidência de FAPo. A freqüência do alelo -217A foi de 12,5% no GFA e 15,9% no GC e também não foi associado ao desenvolvimento de FAPo. A expressão de RNAm da IL-6 em LTSP foi reduzida do pré para o pós-operatório de cirurgia de RM em ambos os grupos e não houve correlação entre a expressão de RNAm da IL-6 em LTSP e apêndice auricular direito. A expressão de RNAm do KCNE5 em LTSP foi reduzida do pré para o pós-operatório de cirurgia de RM, exceto em indivíduos do gênero masculino do GC, sugerindo a influência do gênero na expressão desse gene. Não houve correlação entre a expressão de RNAm do KCNE5 em LTSP e apêndice auricular direito. Não se detectou expressão de RNAm do AGT em LTSP e sua expressão em apêndice auricular direito foi extremamente baixa, portanto não está associada ao desenvolvimento de FAPo. / It is estimated that more than 800,000 heart surgery coronary artery bypass grafting are performed annually in the world. This therapeutic intervention of the most common complication was atrial fibrillation, which is closely related to increased risk of morbidity and postoperative mortality. The determining factors of this event can be pre, intra and postoperative possibly relates to the pro-inflammatory proteins, ion channels and renin-angiotensin system. Therefore, polymorphisms in the genes encoding these proteins may play an important role in the development of PoAF. The objective of this study was to evaluate the association between polymorphisms of IL6 gene (G-174C), KCNE5 (C97T) and AGT (A-217G) and the incidence of PoAF and its effects on mRNA expression in right atrial appendage and peripheral blood. For the study we selected 76 individuals with obstructive coronary artery disease with indication for surgical myocardial revascularization. Of these, 16 with PoAF, 52 without PoAF and 8 patients were excluded because of death. Blood samples were obtained for biochemical analysis and extraction of genomic DNA and total RNA before and 48 hours after cardiac surgery. The single nucleotide polymorphisms (SNPs) of IL-6, KCNE5 and AGT were detected by PCR-RFLP and confirmed by DNA sequencing. mRNA expression in total leukocytes in peripheral blood and tissue were analyzed by real-time PCR, using GAPDH gene as endogenous reference. The frequency of-174G allele was 75% in the GFA and 69.2% in GC and was not associated with the development of FAPO. The 97T allele frequency was 0% in GFA and 10.8% in GC and was not associated with a lower incidence of PoAF. The frequency of allele-217A was 12.5% in the GFA and 15.9% in GC and was not associated with the development of PoAF. The mRNA expression of IL-6 on LTSP was reduced from preoperative to the postoperative period of CABG in both groups and no correlation between mRNA expression of IL-6 on LTSP and right atrial appendage. The mRNA expression of KCNE5 LTSP was reduced in the pre and postoperative CABG, except among males in the CG, suggesting the influence of gender on expression of this gene. There was no correlation between the expression of mRNA KCNE5 in LTSP and right auricular appendage. There was no mRNA expression of AGT in LTSP and its expression in right atrial appendage was extremely low, so it is associated with the development of PoFA.

Une des difficultés majeures dans le traitement des cancers est l’acquisition de résistance par les cellules tumorales vis-à-vis de la mort induite par les différentes chimiothérapies. Au sein du laboratoire, nous nous intéressons aux propriétés anti-tumorales d’un donneur de monoxyde d’azote (NO), le Glycéryl TriNitrate (GTN), fréquemment utilisé dans le traitement de l’angine de poitrine. Au cours de ce travail, nous avons étudié les mécanismes moléculaires par lesquels le GTN sensibilise les cellules tumorales de plusieurs types de cancer (colique, mammaire, prostatique) à la mort impliquant des voies de signalisation régulées par des cytokines telles que le TNFα, l’IL-6 ou encore le GDF-15.Une meilleure compréhension des mécanismes sous-jacents à l’action anti-tumorale du GTN permettrait de potentialiser son utilisation comme nouvelle thérapie anti-cancéreuse.Modèle colique : le GTN, en présence de la cytokine pro-inflammatoire TNFα, sensibilise les cellules cancéreuses coliques et mammaires à l’apoptose. Du point de vue mécanistique, le GTN induit la S-nitrosylation de cIAP1, inhibant ainsi son activité ubiquitine E3 ligase. Ce qui abroge la voie de signalisation classique NF-кB de survie cellulaire activée par la voie TNFα/TNFR1 en faveur d’une voie de signalisation pro-apoptotique.Modèle mammaire : le GTN intervient au niveau de la migration cellulaire en altérant la voie de signalisation Jak2/STAT3 activée par la cytokine pro-inflammatoire IL-6, dans un modèle de cancer du sein triple négatif. En présence de dérivés du platine (carboplatine) générant de l’IL-6, le GTN freine la migration des cellules en induisant la S-nitrosylation, et probablement l’inactivation, de la kinase Jak-2, indispensable pour l’activation de la voie.Modèle prostatique : le GTN sensibilise à la mort les cellules cancéreuses prostatiques résistantes au docétaxel en modulant le taux de deux marqueurs de résistance à cette chimiothérapie : la clusterine (CLU) et le growth differentiation factor 15 (GDF-15). Au niveau moléculaire, le GTN diminue le taux de l'isoforme cytoprotectrice soluble de la CLU (sCLU) et augmente le taux de l'isoforme cytotoxique nucléaire (nCLU) dans les cellules prostatiques résistantes au docétaxel. Plus particulièrement, en présence de GTN, nous avons établi un lien entre le GDF-15 et la modulation du taux des isoformes de la CLU. / One of the main difficulties in the treatment of cancers is the acquisition of resistance by the tumor cells vis-à-vis the death induced by the different chemotherapies. In the laboratory, we are interested in the anti-tumor properties of a nitric oxide (NO) donor, Glyceryl TriNitrate (GTN), frequently used in the treatment of angina pectoris. In this work, we investigated the molecular mechanisms by which GTN sensitizes tumor cells of several types of cancer (colonic, mammary, prostate) to death involving signaling pathways regulated by cytokines such as TNFα, IL-6 or GDF-15.A better understanding of the mechanisms underlying the GTN's anti-tumor action would make it possible to use it as a new anti-cancer therapy.Colon model: GTN, in the presence of the pro-inflammatory cytokine TNFα, sensitizes colon and mammary cancer cells to apoptosis. From a mechanistic point of view, GTN induces S-nitrosylation of cIAP1, thus inhibiting its ubiquitin E3 ligase activity. This abrogates the classical NF-κB signaling pathway of TNFα / TNFR1 activated cell survival in favor of a pro-apoptotic signaling pathway.Mammary model: GTN intervenes at the level of cell migration by altering the Jak2 / STAT3 signaling pathway activated by the pro-inflammatory cytokine IL-6, in a model of triple negative breast cancer. In the presence of platinum (carboplatin) derivatives generating IL-6, GTN inhibits cell migration by inducing S-nitrosylation, and probably inactivation, of Jak-2 kinase, essential for the activation of the way.Prostate model: GTN sensitizes prostatic prostate cancer cells to death by modulating the level of two markers of resistance to this chemotherapy: clusterin (CLU) and growth differentiation factor 15 (GDF-15). At the molecular level, GTN decreases the level of the soluble cytoprotective isoform of CLU (sCLU) and increases the level of nuclear cytotoxic isoform (nCLU) in prostatic cells resistant to docetaxel. More particularly, in the presence of GTN, we have established a link between GDF-15 and the modulation of the isoform rate of the CLU.

INTRODUÇÃO: O ozônio (O3) é encontrado na natureza e também pode ser produzido no corpo humano através da ativação de anticorpos. Seus efeitos anti-bactericidas são descritos na literatura, mas esses dados são controversos quanto a um potencial efeito benéfico da ozonioterapia no tratamento de certos tipos de infecção. OBJETIVO: Avaliar os efeitos da aplicação intraperitoneal (i.p.) de uma mistura gasosa de ozônio em um modelo de ligadura e punção de ceco (LPC) em ratos, através da dosagem de interleucinas (IL)-6, IL-10 e da quimiocina CINC-1 (cytokine-induced neutrophil chemoattractant), da lesão pulmonar aguda (LPA) e da análise das taxas de sobrevida. MÉTODO: Quatro grupos de ratos Wistar foram utilizados para análise de cada objetivo (CTR, LPC, LPC+O2 e LPC+O3). Os animais do grupo CTR foram submetidos somente a laparotomia. O grupo LPC foi submetido aos procedimentos de LPC. Os outros grupos foram submetidos à LPC e receberam injeção (i.p.) da mistura gasosa correspondente, administrada a cada 12 horas durante o período de observação. Os níveis séricos de IL-6, CINC-1 e IL-10 foram determinados por imuno- ensaio (enzyme linked immunosorbent assay- ELISA). A LPA foi avaliada através da histologia pulmonar e quantificada através do método do extravasamento pulmonar do Azul de Evans. Os animais da análise de sobrevivência foram observados por cinco dias. Os valores obtidos foramexpressos como médias ± erro-padrão da média (EP) ou medianas mais percentis 25 e 75(P25; P75), de acordo com a distribuição dos dados. Considerou-se significante p<0,05. RESULTADOS: Os ratos do grupo CTR exibiram os menores níveis de CINC-1 (p<0,01). O grupo LPC+O3 teve níveis menores de CINC-1 comparado a LPC+O2 e LPC (p<0,05). Os níveis de IL-10 do grupo CTR foram menores do que nos outros 3 grupos(p=0,02) . Não houve diferenças entre os outros 3 grupos (p=0,85). IL-6 foi significativamente menor para o grupo CTR (30,8± 4,8) quando comparado a todos os outros grupos (p<0,001). LPC+O3 e LPC+O2 exibiram níveis menores quando comparados ao grupo LPC (p<0,01). Não houve diferença entre os grupos LPC+O3 e LPC+O2 (p=0,54). O escore de histologia pulmonar foi menor para CTR (p=0,02). Os outros grupos não apresentaram diferenças significantes intergrupos (p=0,3). Os valores dos coeficientes de extravasamento pulmonar do Azul de Evans foram menores para LPC+O3 quando comparado aos grupos LPC+O2 e LPC (p=0,02), porém não houve diferença na comparação com CTR O grupo CTR teve o maior tempo de sobrevida (110±10h) comparado com os outros grupos, ou seja, LPC (57,3± 10,4h), LPC+O2 (71 ± 12,9h) e LPC+O3 (52,1 ± 8), os quais não apresentaram diferenças entre si quanto à sobrevida (p=0,4). CONCLUSÃO: No presente estudo experimental em ratos, a ozonioterapia teve um benefício potencial na modulação da resposta inflamatória e na LPA, mas não influenciou as taxas de sobrevida dos animais. / INTRODUCTION: Ozone (O3) is found in nature and also can be produced in the human body through activation of antibodies. Its antibacterial effect has been described in the literature, but these data are controversial regardi ng a benefic role of O3 therapy in the treatment of certain types of infection. OBJECTIVE: To evaluate the effects of intraperitoneal (i.p.) application of an O3 gas mixture in a rat model of cecal ligation and puncture (CLP), by analyzing interleukin (IL)-6, IL-10 and cytokine-induced neutrophil chemoattractant (CINC)-1 levels, acute lung injury (ALI) and survival rates. METHOD: Four animal groups were used (SHAM, CLP, CLP+O2 and CLP+O3). SHAM animals were submitted solely to laparotomy. CLP group was submitted to cecal ligation and puncture. The other groups were submitted to CLP and received injections (i.p.) of the corresponding gas mixture every 12 hours during the observation period. The serum concentrations of IL-6, CINC-1 and IL-10 were determined by the enzyme-linked immunosorbent assay (ELISA). ALI was evaluated with pulmonary histology and quantitated by means of the Evans blue dye (EBD) lung leakage method. For survival analysis, animals were observed for 5 days. Values were expressed as means ± SEM or medians (P25; P75), according to the data distribution. A p<0,05 was considered significant.RESULTS: SHAM rats had the lowest levels of CINC-1 compared to all other groups (p<0,01). CLP+O3 group had lower levels of CINC-1 compared to CLP+O2 and CLP (p<0,05). SHAM IL-10 levels were the lowest compared to the 3 other groups (p=0,02). There were no differences between the other 3 groups (p=0,85). IL-6 was significantly lower for SHAM compared to all groups (p<0,001). CLP+O3 and CLP+O2 had lower levels when compared to CLP (p<0,01). Comparison between groups CLP+O3 and CLP+O2 showed no significant difference (p=0,54). Pulmonary histology score was lower for SHAM (p=0,02). The other groups presented no statistical difference when compared to each other (p=0,3). EBD lung leakage values were lower to CLP+O3 compared to CLP+O2 and CLP (p=0,02). SHAM group had the longest survival time (110±10h) compared to all other groups (p=0,002). CLP (57,3± 10,4h), CLP+O2 (71 ± 12,9h) and CLP+O3 (52,1 ± 8h), which did not show difference on survival compared to each other (p=0,4). CONCLUSION: In this rat model of sepsis, ozone therapy had a potential benefit in the modulation of inflammatory response and ALI, but no improvement on survival rates was observed.

O tratamento radioterápico continua aperfeiçoando-se, porém ainda pode estar associado com toxicidade pulmonar. Objetivo: Estudar os efeitos locais e sistêmicos provocados pela radioterapia conformacional torácica adjuvante em mulheres portadoras de câncer de mama, sem fatores de riscos prévios para desenvolvimento de alterações pulmonares. Por meio da tomografia computadorizada de alta resolução; identificar as possíveis alterações radiológicas no parênquima pulmonar. Se presentes, correlacioná-las com parâmetros obtidos da exploração funcional dos pulmões, com os efeitos sistêmicos, pela dosagem de mediadores inflamatórios, IL-1, IL-6 e TNF- , e suas repercussões sobre a qualidade de vida. Material e Métodos: Em 25 pacientes saudáveis foram coletadas amostras de sangue para serem utilizadas apenas como referência de normalidade da IL-1, IL-6 e TNF- . Em decorrência dos rígidos critérios de inclusão e exclusão estabelecidos, das 157 pacientes entrevistadas apenas 24 foram selecionadas para o estudo. A avaliação funcional pulmonar foi abrangente e constou de: medida dos volumes e capacidade dos pulmões, sendo o volume residual obtido pelo método de diluição do hélio em circuito fechado; estudo dos fluxos expiratórios máximos (curva fluxo x volume e curva volume x tempo) e medida da capacidade de difusão pulmonar pela técnica de respiração única do CO. A tomografia computadorizada de alta resolução (16 detectores) foi realizada no pré-planejamento da radioterapia conformacional do tórax, esta com dose total de 45-50 Gy em 25 frações. Para as dosagens de citocinas plasmáticas foram empregadas as técnicas de imunoabsorção enzimáticas (ELISA). Na avaliação da qualidade de vida foi aplicado o questionário Saint George´s Respiratory Questionnary traduzido e adaptado culturalmente ao Brasil. Todos estes procedimentos foram obtidos na fase pré e repedidos 3 meses após a radioterapia. Os resultados das duas fases foram comparados utilizando-se a versão exata do teste Wilcoxon e o teste de Correlação de Spearman, nível de significância p 0,05. Resultados: Entre parâmetros funcionais houve queda significativa apenas na difusão e no fluxo expiratório a 50% da capacidade vital forçada. Mesmo comportamento observou-se para citocina IL-6, já que os mesmos encontravam-se aumentados pré-RT. Não ocorreram mudanças significativas em nenhum dos domínios do questionário de qualidade de vida. As alterações tomográficas ocorreram 60,87% das pacientes na fase pós-radioterapia, em sua maioria de graus leves a moderados e não correlacionaram-se com as alterações observadas em outros parâmetros estudados. Conclusão: O aumento observado na IL-6 durante a fase pré-RT, parece ser um bom índice preditivo de alteração pulmonar. A capacidade de difusão foi a alteração mais evidente e parece ser o índice que melhor reflete as alterações pulmonares que afetam essas pacientes. Diante das discretas alterações tomográficas e funcionais observadas após a RT, é provável que para a redução observada na DLCO concorra uma combinação de fatores ao nível da membrana alvéolo-capilar. No conjunto, as alterações induzidas pela radioterapia conformacional nas pacientes estudadas foram de pequena monta, insuficientes para influenciar aspectos funcionais do pulmão e a qualidade de vida. / Radiotherapy continues to improve itself, but it may still be associated with pulmonary toxicity. Objective: To study the effects caused by local and systemic adjuvant thoracic conformal radiotherapy in women with breast cancer, without risk factors prior to the development of pulmonary alterations. Through high-resolution computed tomography, to identify the possible radiological alterations in the lung parenchyma. If positive identification occurs, correlates it with pulmonary functional parameters, its systemic effects, the dosage of inflammatory mediators IL-1, IL-6 and TNF-, and their impact on quality of life. Material and Methods: Blood samples were collected from 25 healthy patients to be used as a normal reference for IL-1, IL-6 and TNF- mediators. Due to the established strict inclusion and exclusion criteria, only 24 from the initial 157 interviewed patients were selected for this study. The evaluation of pulmonary function was comprehensive and included: Lung volume and capacity measurement through closed loop helium residual volume dilution method;Peak expiratory flow study (flow curve x volume and volume vs. time curve) and CO diffusing capacity measurement through single breath technique. High-resolution computerized tomography (16 detectors) was performed in the pre-planning phase of thoracic conformal radiotherapy where 45-50 Gy total dose was applied in 25 fractions. For cytokines plasma measurement, the enzymatic immunosorbent techniques (ELISA) were used. For quality of life assessment, the Brazil´s validated Saint George\'s Respiratory Questionnary was used. All these procedures were applied in the pre-phase and repeated three months later after radiotherapy sessions. The results of the two phases were compared using the exact version of the Wilcoxon test and Spearman correlation test with p 0.05 significance level. Results: Among the functional parameters, there were a significant decrease in dissemination and expiratory flow at 50% of forced vital capacity. The same behavior was observed for cytokine IL-6, since they were already high at pre-RT. There were no significant changes in any of the aspects of quality of life questionnaire. The tomographic alterations occurred in 60,87% of patients in the post radiotherapy phase, mostly having low to moderate degree and not correlated with the observed changes in other parameters. Conclusion: The IL-6 increase in the pre-RT phase appears to be a reasonable predictive index of pulmonary alterations. The diffusing capacity alterations were the most evident and seem to be the index that best reflects the pulmonary alterations that affect these patients. Given the discrete tomographic and functional abnormalities observed after RT, it is likely that for the observed reduction in DLCO compete a combination of factors occurring at alveolar-capillary membrane level. Overall, the conformal radiotherapy induced changes in the studied patients were not expressive, insufficient to influence the pulmonary functional aspects and the quality of life of the patients.

Darbo tikslas – nustatyti kompiuterizuoto inhibicinio kontrolės testo (IKT), IL-6, amoniako bei įprastinių kraujo rodiklių vertę diagnozuojant kognityvinius sutrikimus sergantiems lėtinėmis kepenų ligomis. Darbo uždaviniai: nustatyti kognityvinių sutrikimų dažnį, galimus rizikos veiksnius, palyginti IKT ir kraujo testų rezultatus lėtinio hepatito ir kepenų cirozės grupėse; nustatyti IKT bei IL-6, įprastinių kraujo testų vertę minimaliai hepatinei encefalopatijai (MHE). Iki šiol netirta ar pacientai, sergantys lėtiniu hepatitu ir kognityviniais sutrikimais, neturi analogiškų IKT rodiklių pakitimų, IL-6 koncentracijos padidėjimo kaip sergantieji kepenų ciroze ir MHE. Netirta kokie kraujo ar IKT rodikliai kognityvinius sutrikimus prognozuoja geriausia. Į tyrimą įtraukti 62 sergantieji kepenų ciroze be hepatinės encefalopatijos, 73 lėtiniu hepatitu bei 53 sveiki asmenys. Tą pačią dieną buvo atliekami kraujo tyrimai, psichometriniai testai ir IKT. Lėtinio hepatito grupėje kognityviniai sutrikimai nustatyti 54,8 %, о kepenų cirozės grupėje MHE ¬ 71,0 % tiriamųjų asmenų. Kognityvinius sutrikimus predisponuoja trumpesnė mokymosi trukmė, fibrozės laipsnis, dvigubas etiologinis veiksnys, amžius ir lytis įtakos neturi. Lėtinio hepatito grupėje kognityviniai sutrikimai koreliuoja su IKT rodikliais ir kepenų fermentų koncentracijos padidėjimu, o kepenų cirozių grupėje su IKT rodikliais ir IL-6 koncentracija kraujyje. Išvados: Kognityvinius sutrikimus sergant lėtiniu hepatitu ar... [toliau žr. visą tekstą] / The aim of the study was to ascertain a value of computerized inhibitory control test (ICT), routine blood tests, peripheral blood ammonia and IL-6 concentration for diagnosis of cognitive disorders in patients with chronic liver diseases. Tasks: to assess a frequency of cognitive impairments and associated risk factors and to compare ICT and blood tests results in chronic hepatitis and cirrhotic patients; to ascertain ICT, IL-6 and routine blood tests values for diagnosis of minimal hepatic encephalopathy (MHE). Until now there were no studies performed whether chronic hepatitis patients with cognitive disorders have analogous ICT, IL-6 and other tests abnormalities as cirrhotic patients with MHE. It has not been studied which ICT and other tests results predict best the cognitive disorders in such patients. 62 cirrhotic patients without overt hepatic encephalopathy, 73 chronic hepatitis and 53 healthy individuals were enrolled. On the same day blood tests, psychometric and ICT tests were performed by every participant. Cognitive disorders were detected in 54,8% of chronic hepatitis patients. In cirrhotic patients MHE was found in 71,0%. Cognitive disorders predispose shorter study time, the fibrosis score, double etiologic factor, while age and gender has no influence. In chronic hepatitis patients the cognitive impairments correlate with ICT and elevated liver enzymes. In cirrhotic patients cognitive disorders correlate with ICT and IL-6 concentration. Conclusion: the... [to full text]

The aim of the study was to ascertain a value of computerized inhibitory control test (ICT), routine blood tests, peripheral blood ammonia and IL-6 concentration for diagnosis of cognitive disorders in patients with chronic liver diseases. Tasks: to assess a frequency of cognitive impairments and associated risk factors and to compare ICT and blood tests results in chronic hepatitis and cirrhotic patients; to ascertain ICT, IL-6 and routine blood tests values for diagnosis of minimal hepatic encephalopathy (MHE). Until now there were no studies performed whether chronic hepatitis patients with cognitive disorders have analogous ICT, IL-6 and other tests abnormalities as cirrhotic patients with MHE. It has not been studied which ICT and other tests results predict best the cognitive disorders in such patients. 62 cirrhotic patients without overt hepatic encephalopathy, 73 chronic hepatitis and 53 healthy individuals were enrolled. On the same day blood tests, psychometric and ICT tests were performed by every participant. Cognitive disorders were detected in 54,8% of chronic hepatitis patients. In cirrhotic patients MHE was found in 71,0%. Cognitive disorders predispose shorter study time, the fibrosis score, double etiologic factor, while age and gender has no influence. In chronic hepatitis patients the cognitive impairments correlate with ICT and elevated liver enzymes. In cirrhotic patients cognitive disorders correlate with ICT and IL-6 concentration. Conclusion: the... [to full text] / Darbo tikslas – nustatyti kompiuterizuoto inhibicinio kontrolės testo (IKT), IL-6, amoniako bei įprastinių kraujo rodiklių vertę diagnozuojant kognityvinius sutrikimus sergantiems lėtinėmis kepenų ligomis. Darbo uždaviniai: nustatyti kognityvinių sutrikimų dažnį, galimus rizikos veiksnius, palyginti IKT ir kraujo testų rezultatus lėtinio hepatito ir kepenų cirozės grupėse; nustatyti IKT bei IL-6, įprastinių kraujo testų vertę minimaliai hepatinei encefalopatijai (MHE). Iki šiol netirta ar pacientai, sergantys lėtiniu hepatitu ir kognityviniais sutrikimais, neturi analogiškų IKT rodiklių pakitimų, IL-6 koncentracijos padidėjimo kaip sergantieji kepenų ciroze ir MHE. Netirta kokie kraujo ar IKT rodikliai kognityvinius sutrikimus prognozuoja geriausia. Į tyrimą įtraukti 62 sergantieji kepenų ciroze be hepatinės encefalopatijos, 73 lėtiniu hepatitu bei 53 sveiki asmenys. Tą pačią dieną buvo atliekami kraujo tyrimai, psichometriniai testai ir IKT. Lėtinio hepatito grupėje kognityviniai sutrikimai nustatyti 54,8 %, о kepenų cirozės grupėje MHE ¬ 71,0 % tiriamųjų asmenų. Kognityvinius sutrikimus predisponuoja trumpesnė mokymosi trukmė, fibrozės laipsnis, dvigubas etiologinis veiksnys, amžius ir lytis įtakos neturi. Lėtinio hepatito grupėje kognityviniai sutrikimai koreliuoja su IKT rodikliais ir kepenų fermentų koncentracijos padidėjimu, o kepenų cirozių grupėje su IKT rodikliais ir IL-6 koncentracija kraujyje. Išvados: Kognityvinius sutrikimus sergant lėtiniu hepatitu ar... [toliau žr. visą tekstą]

Malgré le rôle des variants constitutivement actifs du récepteur des androgènes (RA) et du stroma tumoral dans le cancer de la prostate résistant à la castration (CRPC), leurs relations restent inconnues. Nous rapportons l’impact de l’interleukine-6 (IL-6) sécrétée par les cellules stromales prostatiques (PrSC) sur les cellules épithéliales tumorales prostatiques exprimant les variants autonomes du RA. Le milieu de culture conditionné par les PrSC (CMPrSC) contenait des taux élevés d’IL-6 et induisait une augmentation de l’activité transcriptionnelle de STAT3 dans les LNCaP et C4-2b exprimant le variant RAQ640X, via une activation de pY705-STAT3. Cette activité de STAT3 était inhibée par la neutralisation de l’IL-6. L’analyse par mRNA array et RT-qPCR a mis en évidence un profil transcriptomique spécifique lié à l’expression du RAQ640X et à l’exposition au CMPrSC, impliquant les fonctions de motilité, d’invasion et de migration cellulaires, et l’expression de gènes favorisant la dissémination métastatique. Ainsi, nos résultats illustrent une coopération épithélio-stromale «privilégiée» en présence de variants autonomes du RA, impliquée dans la progression tumorale. / Constitutively active androgen receptor (AR) variants and stromal microenvironment are involved in castration resistant prostate cancer (CRPC), but their relationship remains unknown. We describe the effects of interleukin-6 (IL6) secreted from prostate stromal fibroblast cells (PrSC) towards prostate epithelial cancer cells expressing constitutively active AR variants. Conditioned culture medium from PrSC (CMPrSC) contained high levels of IL-6 and led to an increased STAT3 transcriptional activity in LNCaP and C4-2b cells expressing the ARQ640X variant, through pY705-STAT3 activation. This STAT3 activity was significantly diminished with neutralizing antibody anti-IL6. Gene expression analysis using mRNA array and RT-qPCR highlighted a specific transcriptional profile related to ARQ640X expression and PrSC exposure, resulting in cellular motility, invasion and cellular migration, and IL-6 genes expression promoting metastatic dissemination. Overall, our data emphasize a “preferred” epithelio-stromal cooperation when expressing constitutive active RA variants, which contributes to tumor progression.

Estima-se que mais de 800.000 cirurgias cardíacas de revascularização do miocárdio por ano são realizadas no mundo. Nesta intervenção terapêutica uma das complicações mais comuns é a fibrilação atrial, que esta intimamente relacionada com aumento de risco de morbidade e mortalidade pós-operatória. Os fatores determinantes desta manifestação podem ser pré, intra e pós-operatórios que possivelmente se relaciona com as proteínas pró-inflamatórias, canais iônicos e sistema renina-angiotensina. Portanto, os polimorfismos nos genes que codificam essas proteínas podem ter importante papel no desenvolvimento da FAPo. O objetivo deste trabalho foi de avaliar a associação entre os polimorfismos dos genes IL6 (G-174C), KCNE5 (C97T) e AGT (A-217G) e a incidência da FAPo e seus efeitos na expressão de RNAm, em apêndice atrial direito e em sangue periférico. Para o estudo foram selecionados 76 indivíduos portadores de insuficiência coronariana obstrutiva com indicação de intervenção cirúrgica de revascularização do miocárdio. Desses, 16 com FAPo, 52 sem FAPo e 8 pacientes foram excluídos por motivo de óbito. Amostras de sangue periférico foram obtidas para análise de parâmetros bioquímicos e para extração de DNA genômico e RNA total, antes e 48 horas após a cirurgia cardíaca. Os polimorfismos de nucleotídeo único (SNP) dos genes da IL-6, KCNE5 e do AGT foram detectados pela PCR-RFLP e confirmados por sequenciamento de DNA. A expressão de RNAm em leucócitos totais de sangue periférico e de tecido foi analisada pela PCR em tempo real, utilizando o gene GAPDH como referência endógena. A freqüência do alelo -174G foi de 75 % no GFA e 69,2% no GC e não foi associada ao desenvolvimento de FAPo. A freqüência do alelo 97T foi de 0% no GFA e 10,8% no GC e não foi associada a menor incidência de FAPo. A freqüência do alelo -217A foi de 12,5% no GFA e 15,9% no GC e também não foi associado ao desenvolvimento de FAPo. A expressão de RNAm da IL-6 em LTSP foi reduzida do pré para o pós-operatório de cirurgia de RM em ambos os grupos e não houve correlação entre a expressão de RNAm da IL-6 em LTSP e apêndice auricular direito. A expressão de RNAm do KCNE5 em LTSP foi reduzida do pré para o pós-operatório de cirurgia de RM, exceto em indivíduos do gênero masculino do GC, sugerindo a influência do gênero na expressão desse gene. Não houve correlação entre a expressão de RNAm do KCNE5 em LTSP e apêndice auricular direito. Não se detectou expressão de RNAm do AGT em LTSP e sua expressão em apêndice auricular direito foi extremamente baixa, portanto não está associada ao desenvolvimento de FAPo. / It is estimated that more than 800,000 heart surgery coronary artery bypass grafting are performed annually in the world. This therapeutic intervention of the most common complication was atrial fibrillation, which is closely related to increased risk of morbidity and postoperative mortality. The determining factors of this event can be pre, intra and postoperative possibly relates to the pro-inflammatory proteins, ion channels and renin-angiotensin system. Therefore, polymorphisms in the genes encoding these proteins may play an important role in the development of PoAF. The objective of this study was to evaluate the association between polymorphisms of IL6 gene (G-174C), KCNE5 (C97T) and AGT (A-217G) and the incidence of PoAF and its effects on mRNA expression in right atrial appendage and peripheral blood. For the study we selected 76 individuals with obstructive coronary artery disease with indication for surgical myocardial revascularization. Of these, 16 with PoAF, 52 without PoAF and 8 patients were excluded because of death. Blood samples were obtained for biochemical analysis and extraction of genomic DNA and total RNA before and 48 hours after cardiac surgery. The single nucleotide polymorphisms (SNPs) of IL-6, KCNE5 and AGT were detected by PCR-RFLP and confirmed by DNA sequencing. mRNA expression in total leukocytes in peripheral blood and tissue were analyzed by real-time PCR, using GAPDH gene as endogenous reference. The frequency of-174G allele was 75% in the GFA and 69.2% in GC and was not associated with the development of FAPO. The 97T allele frequency was 0% in GFA and 10.8% in GC and was not associated with a lower incidence of PoAF. The frequency of allele-217A was 12.5% in the GFA and 15.9% in GC and was not associated with the development of PoAF. The mRNA expression of IL-6 on LTSP was reduced from preoperative to the postoperative period of CABG in both groups and no correlation between mRNA expression of IL-6 on LTSP and right atrial appendage. The mRNA expression of KCNE5 LTSP was reduced in the pre and postoperative CABG, except among males in the CG, suggesting the influence of gender on expression of this gene. There was no correlation between the expression of mRNA KCNE5 in LTSP and right auricular appendage. There was no mRNA expression of AGT in LTSP and its expression in right atrial appendage was extremely low, so it is associated with the development of PoFA.