L’étude des mécanismes aboutissant à la tumorigénèse a permis de révéler, dans beaucoup de cancers, une amplification ou une mutation de divers oncogènes, avec pour conséquence des capacités de prolifération et de survie accrues pour la cellule tumorale. L’identification des protéines kinases comme étant des éléments centraux de ces processus en ont fait des cibles thérapeutiques prometteuses. Plusieurs inhibiteurs ciblant de façon plus ou moins spécifique les tyrosines kinases oncogéniques ont ainsi été développés. Parmi eux, l’imatinib mesylate (Gleevec®, Novartis) a constitué la première chimiothérapie ciblée. Il correspond aujourd’hui au traitement de première intention contre la LMC. Cependant, malgré sa très grande efficacité, il est apparu que certains mécanismes de résistances pouvaient être mis en place pour diminuer son effet pro-apoptotique. Le travail de cette thèse a consisté à mieux comprendre les mécanismes d’apoptose induits par les inhibiteurs de tyrosine kinases (ITK), et à rechercher quelles voies alternatives de survie devront être bloquées pour leur assurer une meilleure efficacité. Trois modèles ont été utilisés : la leucémie myéloïde chronique (LMC), les leucémies aiguës myéloïdes (LAM) et les glioblastomes (GBM). La LMC a été utilisé comme modèle et la démarche utilisé pour essayer d’augmenter l’efficacité des ITK, a été transposée aux modèles des LAM et des GBM. L’ensemble des résultats obtenus a démontré qu’une meilleure compréhension de la réponse apoptotique et des mécanismes de résistance permettait l’identification de nouvelles cibles thérapeutiques. Nous avons pu observer que, tout en favorisant la diminution des doses de molécules administrées, l’inhibition simultanée de plusieurs cibles apportait plusieurs bénéfices. Elle permet d’augmenter l’action pro-apoptotique des ITK, de contrer certains mécanismes de résistances, d’atteindre la cellule souche cancéreuse résistance et par conséquent de cibler simultanément des populations a plusieurs de stades de différenciation. / Protein kinases have been identified as playing fundamental roles in cancer development, suggesting that they could represent a promising therapeutic target. Several kinase inhibitors have been developed and the most successful of them, by far, is Gleevec® (imatinib, STI57; Novartis), a BCR-ABL inhibitor. It is currently used as the treatment of reference for chronic myeloid leukemia. However, despite a huge efficiency, some resistance mechanisms could be used to decrease its pro-apopototic effect. The global aim of my PhD was to understand the apoptotic mechanisms induced by tyrosine kinase inhibitors (TKI) to identify new potential therapeutic targets. I work on three different tumors: Chronic Myeloid Leukemia (CML), Acute Myeloid Leukemia (AML) and Glioblastomas (GBM). CML has been used as a model and the approach followed to increase TKI efficiency has been transposed to AML and GBM models. Altogether, our results showed that a better understanding of apoptotic response and resistance mechanisms could lead to the identification of new therapeutic targets. We observed that combination therapy brings several benefits. It allows to increase the TKI-induced apoptotic response, to counter some resistance mechanism, to reach the resistant cancer stem cells, and thus, to target simultaneously several populations in the tumour.

Charles University Faculty of Pharmacy in Hradec Králové Department of Pharmacology & Toxicology Student: Adéla Janoušková Supervisor: RNDr. Jakub Hofman, Ph.D. Title of diploma thesis: Study on impact of selected protein kinase inhibitors on drug resistance mediated by cytochromes P450 Pharmacokinetic drug resistance often leads to failure of an anticancer therapy. One of the mechanisms is increased efflux of drugs from tumour cells, whereas some studies suggest that increased drug conversion to an inactive metabolite might be another contributing mechanism. The aim of this work was to define the possible role of CYP3A4 and CYP2C8 enzymes in the phenomenon of pharmacokinetic resistance and to investigate the possibility of its modulation by new targeted drugs. In the first part, we used the MTT proliferation method together with HepG2 cells stably transduced with particular human enzymes and demonstrated significant involvement of CYP3A4 in docetaxel resistance. In the following part, we examined the inhibitory effects of four selected tyrosine kinase inhibitors on the CYP3A4 activity in intact cells using a commercial kit. Cobimetinib and dabrafenib showed significant inhibitory activity, while osimertinib and brivanib did not. In the final part, we demonstrated the ability of the first two...

A leucemia mielóide crônica (LMC) é uma doença mieloproliferativa resultante da expansão clonal da célula hematopoética precursora. Sua fisiopatologia está associada ao cromossomo (cr) Philadelphia (Ph) originado da t(9;22) e ao oncogene bcr-abl1 que codifica a proteína Bcr-Abl1 com constitutiva atividade de tirosinoquinase (TK). A expressão de Bcr-Abl determina a leucemogênese por meio da alteração da adesão das células progenitoras leucêmicas ao estroma medular e resistência à apoptose. Os inibidores de TK, o mesilato de imatinibe, dasatinibe e nilotinibe são utilizados no tratamento da LMC, entretanto, casos de resistência têm sido relacionados à presença de mutações em Bcr-Abl1, duplicação do cr Ph e superexpressão do gene bcr-abl1. A resistência ou refratariedade de alguns pacientes ao tratamento com inibidores de TK impulsiona a realização de estudos para melhor conhecimento da fisiopatologia da LMC e descrição de novos alvos terapêuticos. Nesse contexto, o presente estudo investigou a participação de microRNAs na modulação da expressão de genes que regulam a apoptose. O objetivo geral deste trabalho foi investigar o efeito de bcr-abl1 e da atividade tirosinoquinase de Bcr-abl na expressão desses miRNAs em linhagens celulares e pacientes com LMC. O RNA das linhagens celulares, de pacientes e controles foram obtidos por meio da extração com Trizol® e o cDNA sintetizado com o kit High Capacity cDNA reverse transcription. A expressão dos microRNAs e dos genes alvoss foi quantificada por PCR em tempo real utilizando o kit SYBR Green PCR Master Mix® e TaqMan Universal PCR Master Mix®. A inibição de Bcr-Abl1 na linhagem HL-60.Bcr-Abl1 tratada com o mesilato de imatinibe aumentou a expressão de miR-let-7d, miR-15a, miR-130a e miR-145 e diminuiu os níveis de miR-21. O tratamento com dasatinibe aumentou a expressão de miR-let-7e, miR-15a, miR-16, miR-21, miR-30e, miR-130a e miR-142-3p. O nilotinibe aumentou a expressão de miR-let-7e, miR-15a, miR-16, miR-130a e miR-145 e, diminuiu os níveis de miRlet- 7d e miR-21. Os resultados obtidos da análise entre os de pacientes com LMC em diferentes fases da doença mostraram elevados níveis de miR-15a, miR-130b e miR-145 em pacientes na fase crônica versus controles e baixos níveis de miR-16, miR-26a e miR-146a. Pacientes em fases avançadas versus controles apresentaram baixa expressão de miR-let-7d, miR-16, miR-142-3p, miR-145 e miR-146a. Baixos níveis de miR-let-7d, miR-15a, miR-16, miR-29c, miR-142-3p, miR-145 e miR-146a foram observados nas fases avançadas da LMC em relação a fase crônica. Os genes anti-apoptóticos a1, bcl-2, c-flip, ciap-1 e ciap-2 estavam mais elevados na fase crônica do que nos controles. A expressão do gene c-flip estava diminuída e dos genes a1, ciap-1 e mcl-1 aumentada nas fases avançadas em relação aos controles e a fase crônica. Pacientes com LMC resistentes ao MI apresentaram menores níveis de miR-26a, miR-29c, miR-130b, miR-146a e dos genes anti-apoptóticos ciap-1 e mcl-1. Os dados obtidos sugerem que a TK Bcr-Abl modula a expressão de microRNAs que possuem como alvos genes que regulam a apoptose celular / Chronic myeloid leukemia (CML) is a myeloproliferative disease resulting from clonal expasion of hematopoietic precursor cells. Its physiopathology is associated to Philadelphia (Ph) chromosome (cr) originated from the t(9;22) and bcr-abl1 oncogene that encodes the Bcr-Abl protein with constitutive tyrosine kinase activity (TK). The Bcr-Abl1 expression determines leukemogenesis by altering the leukemic progenitor cells´ adhesion by bone marrow stroma and apoptosis resistance. TK inhibitors imatinib mesylate, dasatinib and nilotinib are used to treat CML, however, cases of resistance have been linked to mutation in Bcr-Abl1, duplication of the cr Ph and overexpression of the bcr-abl1. The resistance or refractoriness of some patients to treatment with TK inhibitors drives the studies to better understand the CML physiopathology and description of new therapeutic targets. In this context, this study investigated the participation of microRNAs in modulating expression of the genes that regulate apoptosis. The aim of this study was to investigate the effect of Bcr- Abl1 and its kinase activity in the expression of miRNAs in cell lines and CML patients. The RNA from cell lines, patients and controls were obtained by extraction with Trizol® and cDNA was synthesized with the kit High Capacity cDNA reverse transcription. The expression of miRNAs and target genes was quantified by real time PCR using SYBR Green PCR Master Mix® kit and TaqMan Universal PCR Master Mix®. The Bcr-Abl1 inhibition in the cell line HL-60.Bcr-Abl1 treated with imatinib mesylate increased the expression of miR-let- 7d, miR-15a, miR-130a and miR-145 and decreased miR-21 levels. Treatment with dasatinib increased the expression of miR-let-7e, miR-15a, miR-16, miR-21, miR-30e, miR-130a and miR- 142-3p. Nilotinib increased the expression of miR-let-7e, miR-15a, miR-16, miR-130a and miR- 145 and, decreased miR-let-7d and miR-21 levels. The results of the analysis among patients with CML in different stages of disease showed high levels of miR-15a, miR-130b and miR-145 in chronic phase versus controls and low levels of miR-16, miR-26a and miR-146a. Patients in advanced phases versus controls showed low expression of miR-let-7d, miR-16, miR-142-3p, miR-145 and miR-146a. Low levels of miR-let-7d, miR-15a, miR-16, miR-29c, miR-142-3p, miR-145 and miR-146a were observed in CML advanced phases when compared with chronic phase. The antiapoptotic genes a1, bcl-2, c-flip, ciap-1 and ciap-2 were higher in chronic phase than in controls. The c-flip expression was decreased and a1, ciap-1 and mcl-1 expression was increased in advanced phases when compared to controls and chronic phase. CML patients resistant to imatinib mesylate presented low levels of miR-26a, miR-29c, miR-130b, miR-146a and ciap-1 and mcl-1 antiapoptotic genes. The data obtained suggest that Bcr-Abl1 TK modulates the miRNA expression which has target genes involved in the apoptosis´ regulation.

A leucemia mielóide crônica (LMC) é uma doença mieloproliferativa, resultante da expansão clonal da célula-tronco hematopoética pluripotente. A fisiopatologia da LMC está associada a uma translocação entre os braços longos dos cromossomos 9 e 22, o que promove o aparecimento do neogene bcr-abl, cujo gene codifica uma proteína denominada Bcr-Abl. A oncoproteína Bcr-Abl possui atividade tirosina-quinase constitutiva que é a responsável pelo fenótipo maligno da célula, incluindo resistência à apoptose. O tratamento da LMC pode ser realizado com hidroxiuréia, IFN- associado à citarabina, inibidores de TK (mesilato de imatinibe e dasatinibe) e transplante de medula óssea. O tratamento de escolha para pacientes com LMC na fase crônica é o inibidor de tirosina-quinase mesilato de imatinibe e para os refratários utiliza-se o dasatinibe. Apesar do conhecimento acerca do mecanismo de ação dos inibidores de TK, pouco se sabe sobre seu efeito na maquinaria apoptótica. Sendo assim, no presente trabalho foi detectada a expressão dos genes e proteínas anti- (A1, Bcl-2, Bcl-Xl, Bcl-W, C-Flip, Ciap-1, Ciap-2 e Mcl-1) e pró-apoptóticos (Bad, Bak, Bax, Bcl-Xs, Bid, Bik, Bimel, Bmf, Bok, Fas, Fasl, Noxa e Puma) em células mononucleares de 32 indivíduos saudáveis e 26 pacientes com LMC antes e após 12 meses da terapia com mesilato de imatinibe e dasatinibe. Dentre os 26 pacientes avaliados, 13 eram do sexo feminino e 13 do sexo masculino, três eram negros, um amarelo e 22 brancos, com idade média de 48 anos (faixa etária de 25 a 77 anos). O grupo controle foi composto por 32 indivíduos, 16 do sexo feminino e 16 do sexo masculino, 26 eram brancos, quatro negros e dois amarelos, com idade média de 45 anos (idade de 23 a 77 anos). O isolamento das células mononucleares foi realizado pelo método de Ficoll-Hypaque, a determinação da expressão gênica por PCR em tempo real e a protéica por western-blot. Os resultados foram expressos em unidade relativa de expressão (U.R.E.), comparados entre os diferentes grupos (controle e pacientes pré- e pós-tratamento), associados à resposta aos medicamentos e correlacionados ao índice de prognóstico de SOKAL. Na comparação dos dados de expressão gênica entre pacientes e controles, verificou-se que os pacientes apresentaram maior expressão dos genes bcl-xL, c-flip, mcl-1 e fas e níveis reduzidos de bik. O mesilato de imatinibe modulou significativamente a transcrição dos genes bcl-xL, bok, mcl-1 e noxa, enquanto que o dasatinibe agiu sobre a expressão dos genes a1, bmf, c-flip, ciap-1, ciap-2 e mcl-1. Os pacientes refratários ao mesilato de imatinibe apresentaram níveis elevados de expressão de a1 e c-flip e reduzida expressão de bcl-2, ciap-2, bak, bax, bid e fasl em relação aos pacientes em remissão. A expressão protéica refletiu os dados da quantificação do RNAm dos genes. Os dados da presente investigação indicam que as células mononucleares dos pacientes com LMC apresentam desregulação do processo de apoptose celular. Essa alteração pode ser parcialmente associada ao fenótipo de resistência das células leucêmicas Bcr-Abl+ à apoptose e ausência de resposta aos inibidores de TK. Os dados revelam ainda que os inibidores de tirosina-quinase interferem na transcrição e tradução das moléculas envolvidas na regulação do processo de apoptose. / Chronic myeloid leukemia (CML) is a myeloproliferative disease resultant of a clonal expansion of pluripotent hematopoietic stem cells. The CML physiopathology is associated with a translocation between chromosomes 9 and 22 long arms, promoting the formation of a bcr-abl neogene, which codifies the Bcr-Abl protein. The Bcr-Abl oncoprotein presents tyrosine-kinase activity that is responsible for the malign phenotype which includes apoptosis resistance. CML treatment may be performed with hydroxyurea, IFN- plus cytarabine, tyrosine-kinase inhibitors (imatinib mesylate and dasatinib) and bone marrow transplantation. The standard treatment for CML patients in chronic phase is the tyrosine-kinase inhibitor imatinib mesylate (IM) and for IM-refractory patients dasatinibe is employed. Despite of the knowledge related to the mechanism of action of tyrosine-kinase inhibitors, little is known about its effects on the apoptosis machinery. In this work we characterized both the mRNA and protein patterns of expression of the anti- (A1, Bcl-2, Bcl-Xl, Bcl-W, C-Flip, Ciap-1, Ciap-2 e Mcl-1) and pro-apoptotic (Bad, Bak, Bax, Bcl-Xs, Bid, Bik, Bimel, Bmf, Bok, Fas, Fasl, Noxa e Puma) regulators in peripheral blood mononuclear cells (PBMC) from 32 healthy individual and 26 CML patients before and after 12 months of imatinib mesylate and dasatinibe therapy. Thirteen patients were female and thirteen were male, three were black, one was japanese and 22 were white, the mean age was 48 years (varying from 25 to 77 years). The control group was composed of 32 individuals, 16 were female and 16 were male, 26 were white, four black and two japanese, the mean age was 45 years (varying from 23 to 77 years). PBMC isolation was performed by Ficoll-Hypaque, gene expression was assessed by real time PCR and protein expression was carried out by western-blot methodology. Results were given by the relative expression, after comparison between the different groups (control and patients before and after treatment), associated with drug response and related to Sokal index. The comparison of gene expression profiles between patients and controls showed that CML patients present increased levels of bcl-xL, c-flip, mcl-1 and fas expression and reduced levels of bik gene expression. The imatinib mesylate significantly modulated the transcription of bcl-xL, bok, mcl-1 and noxa, whereas dasatinib affected the expression of a1, bmf, c-flip, ciap-1, ciap-2 and mcl-1. MI-refractory patients present higher levels of a1 and c-flip and lower levels of bcl-2, ciap-2, bak, bax, bid and fasl when compared to patients who achieved complete cytogenetic response. Overall, the patterns of protein expression agree with the profiles of mRNA expression. Taken together, the results described in this investigation indicate that PBMC from CML patients present deregulation in cell death pathways. These alterations could partly account for the apoptosis resistance phenotype observed in Bcr-Abl+ leukemic cells and for lack of response to tyrosine kinase inhibitors. Furthermore, our data also reveal that tyrosine kinase inhibitors interfere in the transcription and translation of molecules that regulate the apoptosis process.

Le traitement par BRAF-inhibiteur (BRAFi) et MEK-inhibiteur (MEKi) en association a permis d’améliorer significativement la survie des patients atteints de mélanome métastatique muté BRAFV600. Cette mutation est présente chez 50 % des patients. Les BRAFi et MEKi sont des inhibiteurs de protéines kinase, dont le métabolisme fait intervenir le CYP 3A4, à l’origine de grandes variabilités des concentrations plasmatiques inter-patients pour une même dose administrée. La moitié des patients répondent au traitement, et 90% des patients présentent des effets indésirables, nécessitant une diminution de la posologie dans 33% des cas. Dans ce contexte, nous avons décrit les effets indésirables de chacun des BRAFi et MEKi et, pour ceux qui sont dose-dépendants, nous avons cherché à établir un lien entre concentration plasmatique et survenue d’effet indésirable. Grace à la mise au point d’une méthode analytique en chromatographie liquide couplée à la spectrométrie de masse, nous avons mesuré prospectivement les concentrations plasmatiques des BRAFi et MEKi chez les patients bordelais. Ces données permis de définir un seuil de toxicité de 48 ng/ml pour le dabrafenib. La définition de ce seuil constitue une étape essentielle à la conduite d’une étude randomisée visant à évaluer l’intérêt du suivi thérapeutique pharmacologique. / The combination of BRAF-inhibitors (BRAFi) and MEK-inhibitors (MEKi) has significantly improved the survival of patients with metastatic melanoma with BRAFV600 mutation. About 50% of patients harbour BRAFV600 mutation. BRAFi and MEKi are kinase inhibitors, metabolized by CYP 3A4, responsible for large between-patients variability in plasma concentrations for the same administered dose. About half of patients respond to treatment, and 90% of patients present adverse drug reactions (ADR), requiring dose reduction in 33% of cases. In this context, we described ADR profiles of each of the BRAFi and MEKi in the global pharmacovigilance database, and for ADR that are dose-dependent; we looked for the link between plasma exposure to the drug and the occurrence of ADR. Using the assay method developed, we prospectively measured the plasma concentrations of BRAFi and MEKi in Bordeaux patients, which allowed us to define a toxicity threshold of 48 ng / ml for dabrafenib. This work allowed to deepen the knowledge on the profiles and the occurrence of the ADR for each BRAFi and MEKi. The definition of a toxicity threshold for dabrafenib is a prerequisite for a randomized study to evaluate the value of therapeutic drug monitoring.

Na leucemia mielóide crônica (LMC) a proteína Bcr-Abl possui atividade tirosina-quinase constitutivamente ativada, induzindo a mieloproliferação e a resistência das células à apoptose. A maioria dos pacientes na fase crônica da LMC tratados com inibidores de tirosina-quinase (TKIs), como o mesilato de imatinibe, apresenta remissão citogenética completa da doença, mas uma parcela desses pacientes tem se mostrado resistente à terapia. A fisiopatologia da LMC e os mecanismos celulares e moleculares envolvidos na resistência à terapia com TKIs são diversos e precisam ser melhor estudados. Nesse contexto, o objetivo do presente estudo foi quantificar os níveis de expressão do gene DIDO, incluindo suas diferentes isoformas (DIDO 1, 2 e 3) e promotores (DIDO PP e PD) em controles e em pacientes com LMC nas diferentes fases da doença, tratados ou não com TKIs, bem como em linhagens celulares BCR-ABL1+ sensíveis (S) e resistentes (R) ao mesilato de imatinibe (MI). A literatura relata que DIDO 1 participa do processo de apoptose e que alterações na expressão de DIDO 2 e DIDO 3 podem estar associadas com o desenvolvimento de neoplasias mielóides. Dessa forma, foram estudados 60 pacientes com LMC e 57 controles, assim como as linhagens celulares HL-60, HL-60.Bcr-Abl+, LAMA 84 S, LAMA 84 R, KCL 22 S e KCL 22 R. Foram separadas as células mononucleares de sangue periférico dos pacientes e controles, com posterior extração de RNA e síntese de cDNA, que foi então empregado nas reações de PCR em tempo real (qPCR) para quantificação das expressões gênicas de DIDO 1, 2, 3, PP, PD e ORF. As linhagens celulares foram tratadas por 4h com TKIs e então a expressão das diferentes isoformas de DIDO foi também quantificada por qPCR. A avaliação da expressão proteica de Bcr-Abl, c-Abl e proteínas fosforiladas nas linhagens foi realizada por Western-blotting. A expressão de DIDO 1 e 2 foi maior nos pacientes nas fases avançadas da LMC e nos pacientes na fase crônica da doença tratados com TKIs (mesilato de imatinibe ou dasatinibe) do que nos controles. Os pacientes na fase crônica da LMC tratados com MI expressaram mais DIDO 1 e 3 do que os pacientes na fase crônica sem tratamento. Houve uma correlação positiva entre expressão de BCR-ABL1 e de DIDO 2 e entre índice de Sokal dos pacientes e expressão de DIDO 2. Na linhagem HL60.Bcr-Abl+, a expressão de proteínas fosforiladas reduziu após tratamento de 4h com TKIs, mas não houve alteração na expressão gênica de DIDO. Nas linhagens celulares S e R, houve aumento da expressão de DIDO 1 após o tratamento de 4h com MI. Conclui-se, portanto, que as diferentes isoformas de DIDO parecem exercer funções distintas na leucemia mielóide crônica; que o tratamento de pacientes e linhagens BCR-ABL1 positivas com inibidores de tirosina-quinase aumenta expressão de DIDO 1; e que a expressão de DIDO 2 correlaciona-se positivamente à expressão de BCR-ABL1 e ao índice de Sokal dos pacientes. / In chronic myeloid leukemia (CML) the Bcr-Abl protein has constitutively activated tyrosine kinase activity, that induces to myeloproliferation and apoptosis resistance of the cells. Most patients in chronic phase of CML treated with the tyrosine kinase inhibitor (TKI) imatinib mesylate have a complete cytogenetic remission, but a portion of these patients have been shown to be resistant to therapy. The pathophysiology of CML and the cellular and molecular mechanisms involved in resistance to TKIs therapy are diverse and require further study. In this sense, the aim of this study was to quantify the expression levels of the DIDO gene, including its isoforms (DIDO 1, 2 and 3) and promoters (DIDO PP and PD) in controls and in patients with CML in different phases of the disease treated or not treated with TKIs, as well as in cell lines BCR-ABL1+ sensitive (S) and resistant (R) to imatinib mesylate (IM). The literature reports that DIDO 1 is involved in apoptosis process and that alterations of DIDO 2 and DIDO 3 expression may be associated with the development of myeloid neoplasms. Thus, 60 CML patients, 57 control individuals and the cell lines HL-60, HL-60.Bcr-Abl+, LAMA 84 S, LAMA 84 R, KCL 22 S and KCL 22 R were studied. Peripheral blood mononuclear cells of patients and controls were isolated and RNA extraction and cDNA synthesis were performed. The cDNA samples were used in Real-Time PCR reactions (qPCR) to quantify the DIDO 1, 2, 3, PP, PD and ORF gene expression. The cell lines were treated during 4h with TKIs and then the expression of DIDO different isoforms was also quantified by qPCR. The assessment of protein expression of Bcr-Abl, c-Abl and phosphorylated proteins in this cell lines was performed by Western blotting. The DIDO 1 and 2 expression was higher in advanced phases patients and in chronic phase patients CML treated with TKIs (imatinib mesylate and dasatinib) than in controls. Chronic phase CML Patients treated with IM expressed more DIDO 1 and 3 than chronic phase untreated patients. There was a positive correlation between BCR-ABL1 expression and DIDO 2 expression and between Sokal score prognostic and DIDO 2 expression. In HL60.Bcr-Abl+ cells the expression of phosphorylated proteins was lower after treatment during 4h with TKIs, but there was no change in DIDO gene expression. There were an increase of DIDO 1 expression in all S and R cell lines after treatment during 4h with IM. Therefore we conclude that the DIDO different isoforms may have different functions in chronic myeloid leukemia; the treatment of patients and BCR-ABL1+ cell lines with TKIs increases DIDO 1 expression; and that the DIDO 2 expression is positively correlated to the BCR-ABL1 expression and Sokal score prognostic of CML patients.

Squamous cell carcinoma of the head and neck (HNSCC) is an extremely common and devastating disease with a bleak prognosis. Despite intensive research, survival rates have not improved over the past 30 years principally due to untreatable recurrent/metastasising disease. Feline oral squamous cell carcinoma (FOSCC) is an equally common disease in cats with an even less favourable prognosis than humans. Human and feline squamous cell carcinomas share similar etiopathogenesis, molecular markers, tumour biology and treatment thus making FOSCC an excellent model for HNSCC. Epithelial to mesenchymal transition (EMT), under the direction microRNAs (miRNAs/mirs) could be a key driver in oncogenic transformation and chemoresistance. The aim of this study was to induce resistance to characterise the EMT/resistance phenotype and to investigate whether common miRNA-mediated pathways are present in HNSCC and FOSCC that drive this phenomenon. We used epidermal growth factor (EGFR)-inhibitor gefitinib to induce resistance in HNSCC and FOSCC and investigated the associated EMT-related molecular changes. In vitro and in vivo invasive and migratory properties of both species were explored to determine whether resistance and/or EMT status conferred a functional advantage. We determined the miRNA expression pattern during acquisition of resistance to gefitinib in both species by next generation sequencing and screened candidate miRNAs as potential therapeutics. We found that gefitinib-resistance produced a previously unrecognised biphasic response that consisted of two distinct phenotypes, a highly invasive mesenchymal phenotype during early resistance, and a more epithelial phenotype associated with established resistance. The biphasic nature of this transition may prove critical in establishing effective therapeutic targets and the timing of treatment to overcome resistance or in preventing local invasion or metastatic spread of squamous cell carcinoma. We found that the major anti-apoptotic PI3K/AKT pathway was activated in transitioning and resistant cells of both species as demonstrated upregulation of AKT, pAKT and c-FLIP together with inactivation of PTEN by phosphorylation. This indicates that avoidance of apoptosis may be a major pathway in resistance that could be targeted therapeutically. We showed that three miRNAs were differentially expressed in both gefitinib-resistant human and feline cell lines: miR-107 was downregulated, and miR-551b and miR-574 were upregulated. These microRNAs provide potential therapeutic targets in the fight against drug resistance in head and neck cancer although much further research needs to be conducted to elucidate the complex network of interactions that may be affected by targeting these powerful regulatory molecules.

Τα φυσικά προϊόντα αποτελούν σημαντική πηγή βιοδραστικών ενώσεων με ποικίλο φαρμακολογικό ενδιαφέρον. Παρά την τεράστια πρόοδο που έχει συντελεστεί στη χημική σύνθεση φαρμάκων, ακόμα και σήμερα το ¼ των φαρμάκων που διατίθεται στην αγορά προέρχεται από φυσικές πηγές. Η σύγχρονη ανακάλυψη φαρμάκων βασίζεται πλέον στην εστιασμένη δράση ενώσεων έναντι συγκεκριμένων μοριακών στόχων που εμπλέκονται στην εμφάνιση και εξέλιξη της κάθε νόσου. Μοριακοί στόχοι με ιδιαίτερο ενδιαφέρον είναι και οι κυκλινο-εξαρτώμενες κινάσες (CDKs). Οι CDKs είναι μια κατηγορία πρωτεϊνικών κινασών οι οποίες μεταξύ άλλων διαδραματίζουν καθοριστικό ρόλο στη ρύθμιση και ομαλή εξέλιξη του κυτταρικού κύκλου, διασφαλίζοντας τον φυσιολογικό πολλαπλασιασμό των κυττάρων. Η απορρύθμιση της λειτουργίας τους έχει ως επακόλουθο την εμφάνιση διαφόρων παθολογικών καταστάσεων μεταξύ των οποίων και διαφόρων καρκινικών όγκων. Μέχρι σήμερα πληθώρα φυσικών και συνθετικών ενώσεων έχουν εμφανίσει ανασταλτική δράση έναντι των CDKs και αρκετές από αυτές βρίσκονται σε προχωρημένα στάδια κλινικών δοκιμών. Πρόσφατα πειραματικά δεδομένα έδειξαν ότι η CDK1, ελλείψει των υπολοίπων CDKs της μεσόφασης (2, 4, 6), επαρκεί για την ομαλή ολοκλήρωση του κυτταρικού κύκλου. Τα αποτελέσματα αυτά έγιναν αφορμή ώστε πολλές ερευνητικές προσπάθειες να στραφούν και προς την ανάπτυξη ενώσεων με εκλεκτική δράση έναντι της CDK1. Σκοπός της παρούσας μελέτης είναι ο σχεδιασμός και η σύνθεση νέων μικρών ετεροκυκλικών μορίων με πιθανή ανασταλτική δράση έναντι του ενζύμου CDK1. Συγκεκριμένα, σχεδιάσθηκαν νέα παράγωγα που θα έφεραν δύο νέους ισομερείς τετρακυκλικούς ινδολοαζεπινικούς σκελετούς. Ο σχεδιασμός των ενώσεων αυτών βασίστηκε σε δομικά χαρακτηριστικά φυσικών ή συνθετικών ενώσεων που έχουν μελετηθεί και έχουν εμφανίσει ανασταλτική δράση έναντι τόσο της CDK1 όσο και άλλων CDKs. Βασικό δομικό χαρακτηριστικό των τελικών μορίων, που έχει αποδειχθεί κρίσιμο για την εκδήλωση CDK ανασταλτικής δράσης σε συγγενείς ενώσεις, είναι ένας επταμελής λακταμικός δακτύλιος ο οποίος συμπυκνώνεται σε κατάλληλες θέσεις με έναν ινδολικό και έναν πυρρολικό δακτύλιο. Η υποκατάσταση του πυρρολικού δακτυλίου με μία καρβοξυαιθυλ-ομάδα στη θέση-2, σε συνδυασμό με την εισαγωγή κατάλληλων υποκαταστατών στον ινδολικό δακτύλιο, δύναται να οδηγήσει σε βιβλιοθήκες αναλόγων. Η προσέγγιση που ακολουθήθηκε για την σύνθεση των τελικών μορίων περιελάμβανε αμιδική σύζευξη κατάλληλων ινδολικών και πυρρολικών πρόδρομων ενώσεων και Pd-καταλυόμενη ενδομοριακή κυκλοποίηση (σύζευξη Heck) για τον σχηματισμό του βασικού τετρακυκλικού ινδολοαζεπινικού σκελετού. Στα πλαίσια της μελέτης, αρχικά μελετήθηκε η συνθετική πορεία παραλαβής αναλόγων ενός εκ των δύο αρχικά σχεδιασθέντων σκελετών. Η διερεύνηση και βελτιστοποίηση των ενδιάμεσων συνθετικών σταδίων οδήγησε στην σύνθεση 59 νέων ενδιάμεσων μορίων και 4 νέων τετρακυκλικών ινδολοαζεπινονικών τελικών προϊόντων. Τα τελικά προϊόντα έφεραν προστατευμένα τόσο το άζωτο του ινδολίου όσο και του πυρρολίου με την ίδια προστατευτική ομάδα, ενώ η προσπάθεια παραλαβής αναλόγων του μη προστατευμένου σκελετού δεν ήταν επιτυχής. Τέλος, η διερεύνηση της συνθετικής πορείας που θα απέδιδε ανάλογα του δεύτερου σκελετού δεν απέδωσε τα αναμενόμενα αποτελέσματα. / Natural products constitute an important source of bioactive compounds with a pharmacological interest. 25% of the drugs that are nowadays available in the market come from natural sources, despite the great progress in the field of chemical composition. Drugs’ development is currently based upon the focused action of certain compounds towards a specific molecular target which is involved in the appearance and evolution of each disease. Some such molecular targets of particular interest are the Cyclin-dependent kinases (CDKs). CDKs are a subfamily of protein kinases that regulate a number of cellular processes, including the cell cycle, ensuring the normality of cell division. The deregulation of their function leads to several diseases, including human tumour. To this day a large number of natural and chemical compounds have been characterized as CDK inhibitors and some of them are already in the late phases of clinical trials. Recent genetic studies have indicated that CDK1 is sufficient to drive the cell cycle in absence of other CDKs (2, 4, 6). These results have led researchers to develop compounds with selective inhibitory activity against CDK1. The current research aims at the development of new compounds with possible inhibitory activity against CDK1. The scientific process was more specifically based on the design and synthesis of new small heterocyclic, tetracyclic indoloazepino compounds. The design of the above compounds was based on structural features that exist in other already known natural or chemical CDK inhibitors. The biological results of similar compounds have indicated that the seven-member lactamic ring of structure has an important role in the inhibitory CDK activity. The basic structural component of the designed compounds, proven to be crucial for the manifestation of the CDK inhibitory function, is a seven member lactamic ring among a pyrrole and indole nuclei. The substitution of the pyrrole with a 2-ethyl-carboxylic substitute along with the introduction of substitutes on specific positions of the indole nuclei are expected to lead to the development of library compounds. The selected procedure includes amide coupling between specific indole and pyrrole compounds and finally C-C intermolecular coupling with Heck reaction. The final aim is to form the basic tetracyclic indoloazepino structure. The current research was primarily directed to the synthesis of one of the two already designed structures. The intermediate reactions of the above structure’s synthetic process were examined and optimized, leading to the isolation of 60 intermediate compounds and 4 new tetracyclic indoloazepino derivatives. In the final derivatives, the pyrrole and indole nitrogen appeared to be protected under the same protective group while an effort to remove these protective groups, through certain reactions, was unsuccessful. Finally, a research into a synthetic process that would provide corresponding derivatives with the second main structure, did not yield the expected results.

Dissertation (Ph.D.)--University of South Florida, 2007. / Includes vita. Includes bibliographical references. Also available online.

Thesis (M.S.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed June 30, 2007). Includes bibliographical references (p. 30-36).