Introdução: A micose fungóide foliculotrópica (MFF) é subtipo de linfoma cutâneo de células T que atinge especialmente o folículo piloso e parece ter prognóstico mais reservado. Informações clínicas sobre a população acometida por linfomas cutâneos no Brasil são escassas. O fenômeno de imunoprivilégio (IP) diz respeito à habilidade de alguns órgãos em permanecer protegidos contra reações inflamatórias. Tem sido sugerido que o folículo piloso normal represente um local de IP. Nesse estudo aventou-se a possibilidade de haver uma quebra no equilíbrio desse fenômeno na MFF, com alteração na expressão de moléculas do complexo maior de histocompatibilidade (MHC) e na expressão de MHC não-clássicos (HLA-G), com algum papel no mecanismo do foliculotropismo. Os objetivos foram: descrever o perfil clínico-epidemiológico de paciente com MFF, descrever a histologia e imunofenótipo dos casos de MFF e investigar os mecanismos envolvidos na predileção dos linfócitos atípicos pelo folículo piloso. Metodologia: Os prontuários de pacientes com diagnóstico de MFF provenientes do ambulatório de Linfomas Cutâneos da Faculdade de Medicina da Universidade de São Paulo (FMUSP) foram revisados (n=33). O material histológico de biópsias de pele dos pacientes com MFF provenientes dos ambulatórios de Linfomas Cutâneos da FMUSP e da Northwestern University foi analisado por meio de escala semi-quantitativa (n=43). Na coloração de hematoxilina-eosina foram avaliados os seguintes parâmetros: infiltrado neoplásico epidérmico, infiltrado neoplásico dérmico, presença de acantose/espongiose, de mucinose folicular, de fibroplasia do tecido conjuntivo, de eosinófilos, de plasmócitos, o tamanho celular e o grau de dano folicular. Analisou-se a positividade do infiltrado neoplásico para os seguintes marcadores celulares: CD1a, CD56, TIA-1 e CD117. As expressões do complexo de histocompatibilidade HLA-G e do MHCII no infiltrado celular e no epitélio folicular foram investigadas no grupo de pacientes com MFF e comparadas com o grupo de pacientes com micose fungóide clássica (MFC) e pele normal. A expressão do complexo de histocompatibilidade MHCII também foi investigada na epiderme. Resultados: A mediana das idades ao diagnóstico foi de 46 anos com 61% dos pacientes classificados como portadores de estágio avançado. A proporção entre homens e mulheres foi de 1,54 e a mediana de duração de doença antes do diagnóstico foi de três anos. Ao final de três anos de acompanhamento, 67% dos casos estavam vivos com a doença. O prurido foi relatado em 82% dos casos. Histologicamente, encontrou-se associação entre a presença de eosinófilos e de plasmócitos com fibroplasia do tecido conjuntivo. Observou-se diminuição da expressão do HLA-G no epitélio folicular nos grupos MFF e MFC em relação à pele normal. Observou-se aumento da expressão do MHCII no epitélio folicular na MFF em comparação à pele normal e na epiderme na MFC quando comparada à MFF. Conclusões: Dados clínicos da população estudada assemelharam-se aos dados da literatura como estágio avançado ao diagnóstico e prognóstico reservado. Cerca de metade dos casos de MFF foi positiva para o marcador citotóxico TIA-1. Demonstrou-se haver um provável colapso do imunoprivilégio folicular nos linfomas cutâneos com expressão diminuída de moléculas HLA-G em comparação à pele normal. O aumento da expressão do MHCII poderia relaciona-se com o foliculotropismo na MFF e com o epidermotropismo na MFC / Introduction: Folliculotropic mycosis fungoides (FMF) is a subtype of cutaneous T cells lymphoma affecting mainly the hair follicle and seems to have a less favorable prognosis. Clinical information on the population affected by cutaneous lymphomas in Brazil is scarce. The immune privilege (IP) phenomenon involves the ability of some body sites remaining protected from inflammatory reactions. It has been suggested that normal hair follicle represents an IP location. We hypothesized that a collapse of this phenomenon would occur in FMF, with changes in the expression of classical major histocompatibility molecules (MHC) and in the expression of nonclassical MHC molecules (HLA-G) with a role in folliculotropism mechanism. The objectives of this study were to describe the clinical and epidemiological profile of patients with MFF, describe the histology and immunophenotype of cases of MFF and investigate the expression of MHC molecules. Methods: The medical records of patients from the outpatient Cutaneous Lymphoma Clinic of the University of Sao Paulo Medical School (FMUSP) diagnosed with MFF were reviewed (n = 33). The histological material from skin biopsies of patients with MFF from the Cutaneous Lymphomas Clinic of FMUSP and Northwestern University was stained and evaluated by semi-quantitative scale. In hematoxylin-eosin staining the following parameters were evaluated: epidermal neoplastic infiltrate, dermal neoplastic infiltrate, acanthosis/spongiosis, follicular mucinosis, connective tissue fibroplasia, presence of eosinophils and plasma cells, cell size and degree of follicular damage. We analyzed the positivity of the neoplastic infiltrate for the following cellular markers: CD1a, CD56, TIA-1, and CD117. Finally, the expression of histocompatibility complex HLA-G and MHC II in the neoplastic infiltrate and the follicular epithelium was investigated in MFF group and compared to patients with classical mycosis fungoides (CMF) and to normal skin. MHCII expression in the epidermis was also investigated. Results: The median age at diagnosis was 46 years, with 61% classified as advanced stage disease. The ratio between men and women was 1.54, the median disease duration before diagnosis was three years. After a median time of follow-up of three years, 67% of the cases were alive with disease. Pruritus was reported in 82% of the cases. Histologically, an association between the presence of eosinophils and plasma cells with fibroplasia of collagen was found. There was a decrease of HLA-G expression in the follicular epithelium in MFF and CMF groups compared to normal skin. There was an increase of MHCII expression in the follicular epithelium in FMF group compared to normal skin. There was an increased MHCII expression in the epidermis in CMF compared to FMF. Conclusions: Clinical data from the studied population were similar to the previous literature in relation to advanced stage at diagnosis and prognosis. There was a relationship between the presence of eosinophils and plasma cells in neoplastic infiltrate and the connective tissue fibrosis. Near half of the cases of FMF was positive for the cytotoxic marker TIA-1. A possible hair follicle immune privilege collapse was suggested by a decreased expression of HLA-G molecules in FMF and CMF compared to normal skin. Increased MHCII expression appears to be involved in the folliculotropism of FMF and epidermotropism of CMF

Les lymphomes anaplasiques à grandes cellules (LAGC) sont des lymphomes non-hodgkiniens dits de type T ou nul, représentant la majorité des lymphomes T pédiatriques (20 à 30%). Dans plus de 80% des cas, une translocation chromosomique réciproque aboutissant à l'expression anormale de protéines chimères de type X-ALK qui arborent constitutivement et de manière anormale l'activité tyrosine-kinase ALK (Anaplastic Lymphoma Kinase) est le moteur de la tumorigenèse (LAGC dits "ALK+ "). L'une des particularités de ces lymphomes, mise en évidence par mon équipe, est le fait que B-Cell Lymphoma-2 (BCL-2) demeure indétectable dans les cas ALK+ contrairement aux cas ALK-. Ce point est d'autant plus surprenant que BCL-2, oncogène largement établi comme prototype de protéines anti-apoptotiques ainsi que régulateur clé de l'autophagie, est fortement surexprimé dans la majorité des lymphomes. A l'inverse, Human Antigen R (HuR) est surexprimée dans les LAGC (comme dans la plupart des cancers). Il a été démontré que cette protéine de liaison aux ARN participait au maintien du phénotype tumoral, et que sa localisation subcellulaire et ses fonctions dépendaient étroitement de son statut de phosphorylation, lequel est régulé par ALK dans les LAGC ALK+. Au niveau du cytoplasme, HuR permet de stabiliser et d'augmenter la traduction d'ARNm possédant, dans leur région 3'-UTR, des séquences riches en adénine et uridine (AU-rich elements, "ARE"). De manière plus générale, HuR a la capacité de dialoguer avec les microARNs (miARN), soit en empêchant leur action par compétition, soit à l'inverse en coopérant avec ces derniers et en promouvant ainsi leur fonction de régulateur négatif sur certains transcrits cibles communs. Le transcrit Bcl-2, dont l'expression est réprimée dans les LAGC ALK+, fait partie des cibles potentielles de HuR. Au cours de ma thèse, j'ai ainsi cherché à comprendre les mécanismes moléculaires mis en jeu dans la répression de l'expression de Bcl-2, en me focalisant sur le rôle de HuR et de miARN "partenaires" dans ce processus. Mes données semblent indiquer que ce mécanisme implique le recrutement par HuR du miR-34a sur l'ARNm Bcl-2, conduisant à la mise en silence de ce dernier. A l'inverse, quand l'activité tyrosine- kinase de ALK est inhibée, l'interaction entre HuR et le transcrit Bcl-2 diminue, ce qui limite le recrutement de miR-34a et conduit à une restauration de l'expression de cette oncogène majeur dans les cellules lymphomateuses. Dans le contexte des essais cliniques d'inhibiteurs ciblant l'activité tyrosine kinase de ALK tels que le Crizotinib, la question de cette ré-expression de BCL-2 éclaire d'une lumière nouvelle certains échecs thérapeutiques subis par cette molécule pourtant prometteuse. Je me suis donc également consacré, pendant ma thèse, à l'étude des conséquences de cette ré-expression de BCL-2 sur les LAGC ALK+ traités par le Crizotinib. Les résultats que j'ai obtenus in vitro et in vivo montrent que contrecarrer, par interférence à l'ARN, l'élévation du taux de BCL-2 consécutive au traitement par le Crizotinib, permet de potentialiser les effets de la drogue : cela se traduit en particulier par une potentialisation de la mort par apoptose induite par le traitement mais aussi, de manière fascinante, par une conversion de la réponse autophagique initialement cytoprotectrice et pro-tumorale en une autophagie incontrôlée et délétère, qui participe alors à l'effet thérapeutique accru de la drogue. De manière globale, ce travail permet d'envisager de nouvelles combinaisons et alternatives thérapeutiques pour les patients souffrants de LAGC ALK+, et illustre la complexité des régulations croisées entre processus apoptotiques et autophagiques. / Anaplastic large cell lymphoma (ALCL) are T/-null non-hodgkin lymphoma representing most of childhood T-cell lymphoma (up to 30%). More than 80% of cases bear reciprocal chromosomic translocation responsible for abnormal expression and constitutive activation of X-ALK type (Anaplastic Lymphoma Kinase) chimeric proteins (ALK+ ALCL). A striking characteristic of this lymphoma is that B-Cell Lymphoma-2 (BCL-2) remains undetectable in ALK+ cases compared to ALK- cases. This is all the more surprising as the BCL-2 oncogene, which is firmly established as a prototypic anti-apoptotic factor as well as a key autophagy regulator, has been shown to be overexpressed in a majority of lymphomas. On the other hand, the RNA-binding protein HuR (Human Antigen R) is overexpressed in ALCL (as in most cancers). It has been demonstrated that this protein was involved in the sustainability of the tumoral phenotype, and that its subcellular localization and functions were closely related to its phosphorylation status, which in turn heavily depends on ALK activity in ALK+ ALCL. In the cytoplasm, HuR has the ability to bind adenine and uridine-rich elements (ARE) located on the 3'-UTR of target mRNAs, and both protect them from degradation and increase their translation. From a general point of view, HuR is able to establish an interplay with microRNAs (miRNAs), either blocking them through competition, or actually cooperating with them and thus promote their function of negative regulators of gene expression on common target transcripts. The BCL-2 transcript, which expression seems to be silenced in ALK-expressing ALCL, has been described as a potential target of HuR. During my PhD work, I dedicated myself to understand the molecular mechanism at work in the silencing of BCL-2 expression with a focus on HuR and collaborating miRNA. The data I obtained point at a cooperation between HuR and miR-34a leading to the silencing of the BCL-2 transcript. However, when the ALK tyrosine kinase activity is inhibited, it appears the interaction between the BCL-2 mRNA diminishes, which limitates the miR-34a 's access to this transcript and ultimately results in a re-expression of the BCL-2 oncogene in these lymphoma cells. In the current context of clinical trials for ALK-targeting inhibitors, such as the Crizotinib, this BCL-2 re-expression observed upon ALK inhibition shed light on potential reasons behind some therapeutic failures that have recently been reported. Indeed, during my PhD work, I also studied the consequences of the BCL-2 re-expression observed in Crizotinib-treated cells. The data I obtained in vitro and in vivo show that, by blocking this re-expression using RNA interference, the Crizotinib anti-tumoral efficiency can be greatly potentiated. This potentiation took the form of an increase of apoptotic cell death induction and, interestingly, also affected the autophagic response triggered by the drug, making it switch from a cytoprotective- type, protumoral autophagic flux to an enhanced, deletary-type and tumor suppressive flux, adding to the therapeutic effect of the drug. This work in general provides insights for new therapeutic combinations that could potentially benefit to ALK+ ALCL patients, and illustrates the complex cross-regulations between apoptotic and autophagic pathway.

Jusqu'à présent, les modifications de la réplication de l'ADN entre cellules normales et cancéreuses ont été peu étudiées. Dans ce travail, nous avons utilisé le séquençage des fragments d'Okazaki, une technique récemment développée au laboratoire, pour déterminer la directionalité des fourches de réplication dans plusieurs lymphomes de Burkitt (LB), qui surexpriment l'oncoprotéine Myc à la suite de translocations chromosomiques spécifiques, ainsi que dans des lignées lymphoblastoides contrôles (LLC) et dans des léiomyosarcomes (LMS). Les profils de directionalité des fourches de réplication permettent de déduire la localisation et l'efficacité des sites d'initiation et de terminaison de la réplication le long du génome. Nous avons observé de nombreuses (~2000) différences de zones d'initiation entre les lignées Raji (LB) et GM06990 (LLC) ainsi qu'entre les lignées BL 79 et IARC385, une paire LB/LLC provenant d'un même patient. Nous avons détecté un nombre comparable de différences en comparant deux à deux les lignées étudiées. Cependant, les profils de BL79 et de Raji (deux LB) sont un peu plus proches l'un de l'autre que de la lignée contrôle GM06990. Ceci suggère l'existence de changements de la réplication récurrents dans les lignées LB. L'importance des différences observées entre les lignées IARC385 et GM06990 indique de façon surprenante une grande variabilité entre les LLC normales, provenant de différents individus. De façon intéressante, de nombreuses différences observées entre les lignées LB et LLC sont associées à des changements de l'expression des gènes ou de la liaison de l'oncoprotéine Myc. La comparaison des profils des deux LMS avec tous les profils disponibles au laboratoire montre que c'est à celui de fibroblastes normaux (IMR90) qu'ils ressemblent le plus. Ceci suggère que les cellules de tumeurs musculaires lisses auraient subi une transformation fibroblastique au cours de la tumorigénèse. Des données récentes suggèrent que les champs magnétiques peuvent perturber certains processus cellulaires comme l'assemblage du cytosquelette. Nous avons utilisé le séquençage de fragment d'Okazaki pour rechercher d'éventuels effets d'un champ magnétique sur la réplication de l'ADN chez la levure. Aucun effet du champ magnétique sur la directionalité des fourches de réplication n'a été détecté. / Changes in DNA replication profiles between cancer and normal cells have been poorly explored. In this work, sequencing of Okazaki fragments, a novel methodology developed in the laboratory, was used to determine replication fork directionality (RFD) in several Burkitt's lymphomas (BL), which overexpress the Myc oncoprotein due to specific chromosomal translocations, and control normal lymphoblastoid cell lines (LCL), and in leiomyosarcomas (LMC). RFD profiles allow to infer the location and efficiency of replication initiation and termination sites genome-wide. A larger number (~2000) of differences in replication initiation zones were observed genome-wide between Raji (BL) and GM06990 (LCL), and between BL79 and IAR385, a BL / LCL pair of cell lines established from a single patient. Comparably large numbers of changes were slightly more similar to each other than to GM06990. This suggests the occurrence of some recurrent replication changes in BL cell lines. The large number of changes observed between IARC385 and GM06990 also indicates an unexpectedly large variation between normal LCLs of different individuals. Interestingly, many changes in RFD profiles between BLs and and LCLs are associated with cell-type specific gene expression and differential binding of the Myc oncoprotein. Comparison of the two LMS profiles with all RFD profiles available in the laboratory reveals that they most resemble normal fibroblasts (IMR90). This suggests that the smooth muscle cancer cells might have undergone a fibroblastic transformation during tumorigenesis. Magnetic fields have been reported to perturb cellular processes such as cytoskeleton assembly. Sequencing of Okazaki fragments was used in a preliminary investigation of the possible effects of magnetic fields on DNA replication in yeast cells. No effect of magnetic fields on replication fork directionality were observed.

Resumo: Dezoito cães com diagnóstico citopatológico e/ou histopatológico de linfoma foram avaliados quanto às alterações clínicas e clinico-patológicas. Os animais foram submetidos ao protocolo quimioterápico de Madison-Wisconsin e avaliados clinicamente a cada sessão de quimioterapia quanto à sua resposta ao tratamento. Cinqüenta por cento dos cães apresentaram a forma multicêntrica da doença e 33% a forma cutânea. A manifestação clínica mais comum foi a linfadenomegalia superficial, acompanhada dos sinais sistêmicos de hiporexia, apatia e perda de peso. As principais alterações hematólogicas foram anemia normocítica normocrômica, trombocitopenia e leucocitose, associadas às síndromes paraneoplásicas. Elevações nas atividades séricas de lactato desidrogenase foram observadas em 58% dos cães e a hiperproteinemia ocorreu em 38% dos animais, sendo atribuída principalmente ao aumento de globulinas séricas. Vinte e sete por cento dos animais atingiram remissão completa da doença e 33% atingiram sobrevida de seis meses. Houve correlação positiva entre o valor do hematócrito e o tempo de sobrevida para os cães que morreram, entretanto, o mesmo não foi observado para o valor de lactato desidrogenase. Sugere-se a ocorrência da síndrome da lise tumoral aguda para sete animais dado o intervalo de tempo observado entre a quimioterapia e o óbito e o avançado estágio da doença. A ausência de resposta às tentativas de reindução da remissão, observada em quatro cães, pode estar relacionada com o fenômeno de resistência tumoral aos agentes quimioterápicos. / Abstract: Clinical and laboratorial evaluation were performed in eighteen dogs with cytopathological and/or histopathological lymphoma diagnosis. Animals underwent the Madison-Wisconsin chemotherapy protocol and were evaluated clinically at each session performed weekly. The multicentric and cutaneous forms of the disease were observed in 50% and 33% of the dogs, respectively. The most common clinical sign was superficial lymphadenomegaly, combined to systemic signs of hyporexia, apathy and weight loss. The main hematological changes were anemia, thrombocytopenia and leukocytosis, associated with paraneoplastic syndromes. Elevated serum activity of lactate dehydrogenase was observed in 58% of the dogs and hyperproteinemia in 38%, attributed to serum globulin increase. Complete remission was achieved in 27% of the animals and the six-month survival rate was 33%. There was a positive correlation between the hematocrit and survival time in dogs that died, however, there was no correlation between lactate dehydrogenase and survival time. The time interval between chemotherapy and death and the advanced stage of the disease in seven animals suggest the occurrence of acute tumor lysis syndrome. The absence of response to attempts of remission reinduction in four animals may be related to the drug tumoral resistance effect. / Orientador: Aureo Evangelista Santana / Coorientadora: Ana Paula Massae Nakage Canesin / Banca: Renée Laufer Amorim / Banca: Sílvia Ricci Lucas / Banca: Márcia Ferreira da Rosa Sobreira / Banca: Carlos Roberto Daleck / Doutor

O linfoma é uma neoplasia maligna do tecido linfóide, sendo reconhecidamente uma doença similar nos cães e no homem. Este trabalho teve como objetivo investigar se os fatores ambientais da cidade de São Paulo poderiam ser associados ao desenvolvimento de linfomas em cães. Para tanto, três estudos foram realizados. Primeiramente procedemos à realização de um estudo retrospectivo abordando o diagnóstico e a imunofenotipagem dos linfomas em cães em São Paulo. Foi feito um levantamento dos casos de linfoma coletados nos arquivos do Serviço de Patologia Animal do Departamento de Patologia da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, de 1995 a 2009. Os linfomas caninos foram diagnosticados morfologicamente de acordo com a classificação de Kiel atualizada. Foram coletados dados como raça, gênero e idade. Os casos de linfomas foram submetidos à imunofenotipagem, por meio de imuno-histoquímica, usando-se anticorpos primários anti-CD3 (linfócitos T) e anti-CD79a (linfócitos B). Cães sem raça definida e sem predileção de gênero foram os mais acometidos por linfomas. Em relação ao resultado da imunofenotipagem, 55 (85%) linfomas tiveram origem de células T e 10 (15%) tiveram origem de células B. Um segundo estudo vislumbrou aplicar um questionário epidemiológico a 83 proprietários de cães portadores de linfomas e a 84 controles. A análise multivariada dos resultados demonstrou que cães que viviam em ambientes externos e próximos às ruas ou avenidas movimentadas (mais de 50 veículos por minuto em um raio de 100 metros) apresentaram maior risco de desenvolver linfomas. O terceiro estudo procurou comparar a distribuição de casos de linfomas caninos e humanos na cidade de São Paulo. De 8804 casos de LNH em humanos do Registro de Câncer da cidade de São Paulo, foram selecionados aleatoriamente 629 casos, entre 1996 e 2006. Paralelamente, 579 casos de linfoma não Hodgkin (LNH) em cães, ocorridos no mesmo período, foram obtidos de cinco hospitais veterinários de referência na mesma cidade. Todos os casos foram georreferenciados de acordo com o código de endereçamento postal. A correlação de Spearman mostrou-se altamente significante para a correlação entre a distribuição espacial de linfomas caninos e humanos. Essa sobreposição espacial dos casos de LNH sugere que os cães e os humanos podem compartilhar fatores etiológicos comuns, e que possivelmente os fatores ambientais podem desempenhar um papel na etiologia da LNH em ambas as espécies. Estes resultados sugerem um papel dos poluentes ambientais para o risco de desenvolvimento de linfoma nos cães. Pesquisas futuras devem avaliar os componentes da poluição do ar que podem se relacionar ao desenvolvimento de linfoma. / Lymphoma is a malignant neoplasm of lymphoid tissue, recognized as a similar disease in dogs and humans. This study aimed to investigate whether environmental factors of the city of São Paulo could be associated with the development of lymphoma in dogs. For this, three studies were conducted. First we proceed to carry out a retrospective study covering the diagnosis and the immunophenotyping of lymphomas in dogs in Sao Paulo. We conducted a survey of lymphoma cases collected in the archives of the Pathology Service of the Department of Animal Pathology, Faculty of Veterinary Medicine at the University of Sao Paulo, from 1995 to 2009. The canine lymphomas were diagnosed morphologically according to the updated Kiel classification. Data as race, gender and age were collected. Lymphomas underwent immunophenotyping through immunohistochemistry, using primary antibodies anti-CD3 (T lymphocytes) and anti-CD79a (B lymphocytes). Mongrel dogs and with no predilection of gender were the most affected by lymphoma. In relation to the result of immunophenotyping, 55 (85%) lymphomas had T-cell origin and 10 (15%) come from B cells. A second study was an epidemiological questionnaire applied to 83 owners of dogs with lymphoma and to 84 controls. Multivariate analysis results suggested that dogs that live outdoors and close to busy highways or streets (more than 50 vehicles per minute within a radius of 100 meters) had a higher risk of developing lymphomas. The third study sought to compare the distribution of cases of canine lymphoma and human lymphomas in São Paulo. From 8804 cases of human non Hodgkin Lymphoma (NHL) recorded at the Cancer Registry of São Paulo, 629 cases were randomly selected between 1996 and 2006. In addition, 579 cases of NHL in dogs were obtained from five veterinary hospitals veterinary in the same period in Sao Paulo. All cases were geocoded according to the postal code. The Spearman correlation was highly significant between spatial distribution of human and canine lymphoma. The spatial overlap in cases of NHL suggests that dogs and humans may share common etiological factors, and possibly environmental factors may play a role in the etiology of NHL in both species. These results suggest a role of environmental pollutants in the risk of development of lymphoma in dogs. Future research should evaluate the components of air pollution that may be involved in the development of lymphoma.

A Baccharis coridifolia é uma planta tóxica da família Compositae, gênero Baccharis L., conhecida popularmente como \"mio-mio\", a qual é encontrada no sul do Brasil e também em algumas regiões do Estado de São Paulo. Em bovinos, a intoxicação provoca lesões necróticas no trato gastrintestinal e nos tecidos linfóides sólidos em geral, com exceção do timo. Já em camundongos, a B. coridifolia promove, além das lesões em órgãos linfóides, lesões necróticas também no timo. Os princípios ativos da B. coridifolia foram isolados e identificados como sendo os tricotecenos macrocíclicos: roridinas A, D e E; verrucarinas A e J e miotoxina A. Em relação ao mecanismo de ação, trabalhos recentes in vitro demonstraram que as roridinas e as verrucarinas, promovem apoptose em tecido linfóide. Deste modo, considerando a toxicidade desta planta aos tecidos linfóides, o objetivo do presente estudo foi investigar se linfócitos tumorais (linfoma) seriam mais sensíveis aos efeitos tóxicos da B. coridifolia que linfócitos normais. Para tal, fez-se um experimento in vitro com culturas de linfócitos provenientes do baço e timo de camundongos hígidos, bem como células do linfoma murino A20 e carcinoma mamário de Ehrlich tratadas com o Resíduo Hexânico (RH) obtido do extrato etanólico de B. coridifolia por 24 horas. A viabilidade celular foi verificada pela técnica MTT, na qual se evidenciou diminuição da viabilidade das duas linhagens tumorais tratadas, linfoma A20 e carcinoma de Ehrlich, sem alteração na viabilidade dos linfócitos normais. Para melhor caracterizar este efeito tóxico do RH em linfócitos tumorais, camundongos nude (NMRI-nu/nu) foram inoculados com células A20, sendo posteriormente tratados por via oral, durante sete dias, com RH, associado ou não a uma aplicação intraperitoneal do quimioterápico ciclofosfamida no primeiro dia de tratamento. Resultados mostraram que os animais tratados com RH foram menos afetados com a ocorrência de metástase do linfoma primário para outros órgãos e que as involuções tumorais foram mais expressivas no grupo submetido à associação deste tratamento com uma aplicação de ciclofosfamida. Estes resultados permitem sugerir que linfócitos tumorais são mais suscetíveis aos efeitos tóxicos da B. coridifolia. / Baccharis coridifolia is a toxic plant from Compositae family, genus Baccharis L., known as \"mio-mio\". It is found in the south of Brazil, as well as in some regions of São Paulo state. In bovines, its intoxication leads to necrotic injuries to gastrointestinal tract and linfoid tissues. In mice, B. coridifolia leads, apart from linfoid solids in general to necrotic injuries in thymus. B. coridifolia\'s active principles were isolated and identified as being macrocyclic tricotecenes: roridines A, D and E; verrucarines A and J and miotoxine A. Related to action pathway, recent research (in vitro) has shown that roridines and verrucarines, B. coridifolia\'s active principles, lead to apoptosis in linfoid tissues. Therefore, considering this plant\'s toxicity to linfoid tissues, this work aimed the study of whether tumoral lymphocytes (lymphoma) would be more sensitive to B. coridifolia\'s effects than regular lymphocytes. In this sense, an experiment was carried out (in vitro) using healthy mice\'s lymphocytes from spleens and thymus, as well as cells from murine A20 lymphoma and Ehrlich breast carcinoma treated with a residue (RH, hexane obtained) from a B. coridifolia\'s ethanol effusion (24 hours). The cell viability was tested using MTT technique, where a decrease in viability was found for treated tumoral cells lineages, A 20 lymphoma and Ehrlich carcinoma, with no changes in normal lymphocytes viability. To find a better characterization to RH\'s toxic effect in tumoral lymphocytes, nude mice (NMRI-nu/nu) were inoculated with A 20 cells and then were orally treated, during 7 days, with RH, and, in some cases, with intraperitonial injection of cyclophosphamide, during the first day of treatment. Results showed that RH treated animals were less affected to primary lymphoma metastasis in other organs and tumoral involutions were more prominent in the group treated with cyclophosphamide concomitantly. These results suggest that tumoral lymphocytes are more susceptible to B. coridifolia\'s toxic effects.

This study consists of two pieces of work investigating haematological malignancies; Acute Lymphoblastic Leukaemia (ALL) and Diffuse Large B Cell Lymphoma (DLBCL). Firstly, Pre-B ALL represents the most common paediatric malignancy and despite increasingly improved outcomes for patients, ~ 20% of all patients diagnosed with ALL relapse. Activating mutations in the RAS pathway are common (~50%) and result in hyperactivation of the MAPK pathway. I identified Erk negative feedback control via DUSP6 to be crucial for NRASG12D-mediated pre-B cell transformation and investigated its potential as a therapeutic target. I showed that a small molecule inhibitor of DUSP6 (BCI) selectively induced cell death in patient-derived pre-B ALL cells; with a higher sensitivity observed in relapse pre-B ALL. I also discovered that a high level of Erk activity is required for proliferation of normal pre-B cells, but dispensable in leukemic pre-B ALL cells. In addition, I found that human B cell malignancies can be grouped into three categories that fundamentally differ in their ability to control Erk signalling strength. Secondly, DLBCL is the most common haematological malignancy and although potentially curable with chemotherapy, 40% of patients still succumb from their disease. Recent exome sequencing studies have identified hundreds of genetic alterations but, for most, their contribution to disease, or their importance as therapeutic targets, remains uncertain. I optimised a novel approach to screen the functional importance of these mutations. This was achieved by reconstituting non-malignant, primary, human germinal centre B cells (GC B cells) with combinations of wildtype and mutant genes to recapitulate the genetic events of DLBCL. When injected into immunodeficient mice, these oncogene-transduced GC B cells gave rise to tumours that closely resemble human DLBCL, reinforcing the biological relevance of this system. To screen potential tumour suppressor mutations in this system in a high throughput fashion, I developed a lymphoma-focused CRISPR library of 692 genes recurrently altered in B cell lymphomas. These experiments identified GNA13 as an unexpectedly potent tumour suppressor in human GC B cells and provided new understanding to its mechanism of action. These findings provide novel understanding of the complexity of oncogenic mechanisms in human B cell malignancies.

Thesis (Ph.D. (Biochemistry)) --University of Limpopo, 2009 / Refer to document / National Research Foundation (NRF) and University of Limpopo

Bcl-2 family members are important regulators of apoptosis, and their tampered expression is often involved in oncogenesis. Of particular importance are the levels of Bcl-2 family members in forming lymphomas. We studied two groups of murine thymic T cell lymphomas derived from either Bcl-2 or Bax overexpression in order to predict their sensitivity and resistance to treatments. While the growth rate and histological characteristics were similar for both lymphoma groups, Bax-derived lymphomas failed to undergo cell cycle arrest following radiation treatment and had frequent p53 mutations. In contrast, Bcl-2-derived lymphomas often halted proliferation following radiation delivery and rarely had p53 mutations. Bax-derived lymphomas were uniformly sensitive to treatment with 2-deoxy-D-glucose (2DG) while all Bcl-2-derived lymphomas were resistant. This led us to hypothesize that the Bcl-2 family is involved in 2DG-induced cell death. Focusing on the mechanism of 2DG toxicity in Bax-derived lymphomas, our studies demonstrate the following: cell death involved the activation of proapoptotic Bax, was effectively blocked by anti-apoptotic Bcl-2, and was mediated, at least in part, by the BH3-only family member Bim. Based on these results, we explored whether a BH3 mimetic (ABT-737) could sensitize lymphomas to 2DG killing. Indeed, a combination of ABT-737 with 2DG enhanced killing in Bax-derived lymphomas and resensitized Bcl-2-overexpressing lymphomas to 2DG. Since both 2DG and BH3 mimetics are currently in clinical trials, understanding their killing mechanisms and optimal combinations are of potential clinical significance. The work in this dissertation demonstrates a novel role of Bcl-2 family member proteins in regulating 2DG toxicity and may predict response to 2DG treatment. The information found presents a new strategy of combining 2DG with BH3 mimetics to improve existing lymphoma therapies.

Les leucémies aiguës lymphoblastiques et les lymphomes de type T sont des cancers très agressifs, génétiquement hétérogènes. Les pronostics sont globalement défavorables et la survie après rechute n’est que de 10%. Les plus fréquentes mutations ont pour conséquence l’activation constitutive de l’axe PI3K/AKT/mTOR favorisant la progression tumorale. La compréhension des mécanismes de la transformation cancéreuse, à l’aide d’un modèle murin (invalidation spécifique de PTEN dans les lymphocytes T), va permettre de proposer de nouvelles cibles potentielles et de futurs traitements ciblés qui peuvent agir seuls ou en combinaison avec les médicaments chimiothérapeutiques et améliorer le pronostic et la survie des patients. Dans un premier temps, je me suis intéressée au fait de cibler à la fois le métabolisme leucémique élevé et l’activation oncogénique de la voie mTOR en utilisant des activateurs du senseur de stress AMPK : metformin, phenformin et AICAR. Puis, comme il est connu que la concentration en acides aminés intracellulaire influe sur la voie mTOR je me suis intéressée à interférer avec l’action du transporteur d’acides aminés LAT-1, dont le gène slc7a5 est fortement surexprimé dans un grand nombre de cancers dont notre modèle de lymphome T tPTEN-/-. Enfin, je me suis intéressée aussi au rôle de la surrexpression du récepteur de la transferrine (CD71) par les cellules tPTEN-/-, qui suggère que ces cellules cancéreuses pourraient avoir développé une addiction au fer, co-facteur essentiel de nombreux processus métaboliques. Globalement, les résultats présentés dans ce mémoire de thèse démontrent l’intérêt de cibler le métabolisme reprogrammé des cellules cancéreuses. / Lymphoids proliferative malignancies of T-cell origin, lymphomas (T-NHL) and acute lymphoblastic leukemias (T-ALL), are genetically heterogeneous and very aggressive diseases. Their prognosis is still unfavourable and relapse-free survival is only 10%. A common feature of T-LL/T-ALL is the frequent (85% of cases) and abnormal activation of the PI3K/AKT/mTOR pathway that promotes tumor progression. A better molecular understanding of tumoral transformation, using a murine model (T-cell-specific depletion of PTEN), will help identify new potential therapeutic targets for future innovative treatments, that could be efficient alone or in combination with current chemotherapeutic drugs to improve prognosis and patients survival. First of all, I was interested in studying the effects of interfering with the high metabolism and the oncogenic activation of the mTOR pathway, by using metformin, phenformin and AICAR that activates the stress and energy sensor AMPK. Next, as it was well known that intracellular amino acids concentration influences the mTOR pathway, I explored the possibility to target the amino acids transporter LAT-1 that is encoded by the slc7a5 gene, upregulated in a large numbers of cancers including our T-lymphoma murine model. Lastly, I also observed an upregulation of the transferrin receptor (CD71) in tPTEN-/- cells, suggesting that cancer cells require high levels of iron uptake, an essential element for numerous metabolic processes, to sustain high proliferation and survival. More generally, the results presented in this manuscript thesis show an interest to target the reprogrammed metabolism of tumor cells.