京都大学 / 新制・論文博士 / 博士(医学) / 乙第13418号 / 論医博第2226号 / 新制||医||1052(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 羽賀 博典, 教授 長船 健二, 教授 伊藤 貴浩 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

The mammalian/mechanistic target of rapamycin complex 1 (mTORC1) signaling pathway appears to be the primary regulator of protein synthesis and growth. While resistance exercise paradigms are often divided into hypertrophy (HYP) and strength (STR) protocols, it is unknown whether these protocols differentially stimulate mTORC1 signaling. The purpose of this study was to examine mTORC1 signaling in conjunction with circulating hormone concentrations following a typical lower-body HYP and STR resistance exercise protocol. Ten resistance-trained men (24.7±3.4y; 90.1±11.3kg; 176.0±4.9cm) performed each resistance exercise protocol in a random, counterbalanced order. Blood samples were obtained at baseline (BL), immediately (IP), 30 minutes (30P), 1 hour (1H), 2 hours (2H), and 5 hours (5H) post-exercise. Fine needle muscle biopsies were completed at BL, 1H, and 5H. Electromyography of the vastus lateralis was also recorded during each protocol. HYP and STR produced a similar magnitude of muscle activation across sets. Myoglobin and lactate dehydrogenase concentrations were significantly greater following STR compared to HYP (p=0.01-0.02), whereas the lactate response was significantly higher following HYP compared to STR (p=0.003). The GH, cortisol, and insulin responses were significantly greater following HYP compared to STR (p=0.0001-0.04). No significant differences between protocols were observed for the IGF-1 or testosterone response. Intramuscular anabolic signaling analysis revealed a significantly greater (p=0.03) phosphorylation of IGF-1 receptor at 1H following HYP compared to STR. Phosphorylation status of all other signaling proteins including mTOR (mammalian target of rapamycin), p70S6k (ribosomal S6 kinase 1), and RPS6 (ribosomal protein S6) were not significantly different between trials. Despite significant differences in markers of muscle damage and the endocrine response following STR and HYP, both protocols appeared to elicit similar mTORC1 activation in resistance-trained men.

Hepatocellular carcinoma (HCC) is the second most common cause of cancerrelated mortality worldwide. AKT pathway has been found activated in 50% of HCC cases, making it promising target. Therefore we assess efficacy of the allosteric AKT inhibitor or the combination of Sorafenib with AKT inhibitor compared to untreated control and to standard treatment, Sorafenib, in vitro and in vivo. AKT inhibitor blocked phosphorylation of AKT in vitro and strongly inhibited cell growth with significantly higher potency than Sorafenib. Similarly, apoptosis and cell migration were strongly reduced by AKT inhibitor in vitro. To mimic human advanced HCC, we used diethylnitrosamine-induced cirrhotic rat model with fully developed HCC. MRI analyses showed that AKT inhibitor significantly reduced overall tumor size. Furthermore, number of tumors was decreased by AKT inhibitor, which was associated with increased apoptosis and decreased proliferation. Tumor contrast enhancement was significantly decreased in the AKT inhibitor group. Moreover, on tumor tissue sections, we observed a vascular normalization and a significant decrease in fibrosis in surrounding liver of animals treated with AKT inhibitor. Finally, pAKT/AKT levels in AKT inhibitor treated tumors were reduced, followed by down regulation of actors of AKT downstream signalling pathway: pmTOR, pPRAS40, pPLCγ1 and pS6K1. In conclusion, we demonstrated that AKT inhibitor blocks AKT phosphorylation in vitro and in vivo. In HCC-rat model, AKT inhibitor was well tolerated, showed anti-fibrotic effect and had stronger antitumor effect than Sorafenib. Our results confirm the importance of targeting AKT in HCC. / Hepatocellular carcinoma (HCC) is the second most common cause of cancerrelated mortality worldwide. AKT pathway has been found activated in 50% of HCC cases, making it promising target. Therefore we assess efficacy of the allosteric AKT inhibitor or the combination of Sorafenib with AKT inhibitor compared to untreated control and to standard treatment, Sorafenib, in vitro and in vivo. AKT inhibitor blocked phosphorylation of AKT in vitro and strongly inhibited cell growth with significantly higher potency than Sorafenib. Similarly, apoptosis and cell migration were strongly reduced by AKT inhibitor in vitro. To mimic human advanced HCC, we used diethylnitrosamine-induced cirrhotic rat model with fully developed HCC. MRI analyses showed that AKT inhibitor significantly reduced overall tumor size. Furthermore, number of tumors was decreased by AKT inhibitor, which was associated with increased apoptosis and decreased proliferation. Tumor contrast enhancement was significantly decreased in the AKT inhibitor group. Moreover, on tumor tissue sections, we observed a vascular normalization and a significant decrease in fibrosis in surrounding liver of animals treated with AKT inhibitor. Finally, pAKT/AKT levels in AKT inhibitor treated tumors were reduced, followed by down regulation of actors of AKT downstream signalling pathway: pmTOR, pPRAS40, pPLCγ1 and pS6K1. In conclusion, we demonstrated that AKT inhibitor blocks AKT phosphorylation in vitro and in vivo. In HCC-rat model, AKT inhibitor was well tolerated, showed anti-fibrotic effect and had stronger antitumor effect than Sorafenib. Our results confirm the importance of targeting AKT in HCC.

As células dendriticas (DC) da lamina própria constituem um grupo heterogêneo de células essenciais na homeostase do intestino. Nos últimos anos, estudos vem mostrando participação do complexo mTORC2 na regulação de células da imunidade inata. Desta forma, usando animais deficientes em mTORC2 nas DCs nos investigamos o papel deste complexo sob a funcoes das DCs num modelo de colite ulcerativa. Observamos que a ausência de mTORC2 nas DCs diminui a inflamação intestinal e prejudica a migração dessas células para os linfonodos. Consequentemente, estes animais também apresentam redução no numero de linfócitos Th17, Treg e T CD8&#43IFNg&#43. Estes resultados parecem ser independentes da composição da microbiota intestinal. In vitro, células dendriticas derivadas da medula ossea (BMDCs) deficientes em mTORC2 não mostraram deficiência na regulação positiva de CD80 e MHC-II quando estimuladas, mas mostraram menor produção de TNF-a e IL-6. Estas células também apresentaram menor capacidade na diferenciação de Th17. Nossos resultados indicam que mTORC2 participa na regulação das funções das DCs, especialmente na migração e produção de citocinas pos estímulos lnflamatorios. / Dendritic cells from lamina propria encompass a heterogeneous group of cells which play a key role in intestinal homeostasis. In the past few years, it has been shown the participation of mTORC2 in regulating innate immune cells. In our study, we used mTORC- deficient DCs to investigate the role of this complex in DCs functions in ulcerative colitis model. Absence of mTORC2 in DCs reduces the intestinal inflammation, impairs DCs migration which in turn decreases the number of Th17, Tregs and CD8&#43IFNg&#43 T cells. These results seem to be independent of gut microbiota composition. Our in vitro results showed that bone marrow-derived DCs (BMDCs) deficient in mTORC2 can upregulate CD80 and MHC-II after stimulus but present decreased production of TNF-a and IL-6. Those cells also showed deficiency in Th17 differentiation. Our results suggest that mTORC2 play pivotal role in DCs functions highlighting migration and cytokine production.

Les cellules NK sont des lymphocytes de l’immunité innée qui ont un rôle majeur dans le contrôle précoce des infections virales et dans l’immunosurveillance des tumeurs. Cependant, en cas de stimulation chronique, un état d’anergie, où les cellules NK n’exercent plus leur fonction a été mis en évidence. Les mécanismes conduisant à cette perte de fonction demeurent mal caractérisés et s’il s’agit d’une cause ou d’une conséquence de la chronicité n’est pas non plus déterminé. Cibler les cellules NK constitue une perspective thérapeutique de choix mais nécessite une meilleure compréhension de ces aspects. L’objectif de ce travail de thèse s’articule autour de trois points. Premièrement, nous avons généré un modèle tumoral murin sensible aux cellules NK permettant l’étude de la réponse anti-tumorale et l’établissement d’une stimulation chronique. Deuxièmement, l’utilisation de ce modèle a permis d’investiguer les mécanismes conduisant à la perte de fonctionnalité des cellules NK et de tester des stratégies de restauration. Enfin, nous avons mené une étude parallèle, chez l’homme, par analyse d’une cohorte de patients chroniquement infectés par le virus de l’Hépatite B dans le but de déterminer le phénotype des cellules NK et d’identifier les causes conduisant à leur perte de fonction dans ce contexte / NK cells are innate lymphocytes which play a crucial role in the early control of viral infection and in tumor immunosurveillance. However, a state of tolerance, where NK cells are poorly functional, occurs in the context of chronic stimulation. The mechanisms leading to this process remain poorly understood and whether this is a cause, or a consequence of chronicity is unknown. Targeting NK cells appears to be a potent therapeutic strategy but requires further investigation. With the lack of clarity in the field this work had three main objectives. First, we engineered a tumoral mouse model that was strongly immunogenic for NK cells and thus allowed us to study the anti-tumoral response of NK cells and to trigger chronic stimulation. Then, we used this model to investigate the mechanisms driving NK cell loss of function and to test potential therapeutic strategies to reverse this state. Finally, in the context of human chronic infection we analyzed samples from HBV infected patients in order to determine the phenotype, function and signaling capacity of NK cells to identify the drivers of NK cell dysfunction

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21420号 / 医博第4410号 / 京都大学大学院医学研究科医学専攻 / (主査)教授 羽賀 博典, 教授 武田 俊一, 教授 坂井 義治 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Submitted by LUIS GABRIEL RIVERA CALDERON (lgriveramvz@gmail.com) on 2018-05-02T17:50:21Z No. of bitstreams: 1 Tese_Luis_Gabriel_Rivera_Calderon.pdf: 12272198 bytes, checksum: 78d4519bb4d6661c6d6284b28f290374 (MD5) / Rejected by Alexandra Maria Donadon Lusser Segali null (alexmar@fcav.unesp.br), reason: Solicitamos que sejam feitas as correções listadas abaixo: O arquivo PDF submetido no repositório deve conter ficha catalográfica e certificado de aprovação (documentos obrigatórios). Favor inserir os mesmos no arquivo PDF e fazer novamente a submissão. Agradecemos a compreensão. on 2018-05-02T18:50:24Z (GMT) / Submitted by LUIS GABRIEL RIVERA CALDERON (lgriveramvz@gmail.com) on 2018-05-03T11:50:35Z No. of bitstreams: 1 Tese Luis Gabriel Rivera.pdf: 12908129 bytes, checksum: a2bb73ad103cbc2de776d2b460919a3c (MD5) / Approved for entry into archive by Alexandra Maria Donadon Lusser Segali null (alexmar@fcav.unesp.br) on 2018-05-04T18:04:24Z (GMT) No. of bitstreams: 1 riveracalderon_lg_dr_jabo.pdf: 12908129 bytes, checksum: a2bb73ad103cbc2de776d2b460919a3c (MD5) / Made available in DSpace on 2018-05-04T18:04:24Z (GMT). No. of bitstreams: 1 riveracalderon_lg_dr_jabo.pdf: 12908129 bytes, checksum: a2bb73ad103cbc2de776d2b460919a3c (MD5) Previous issue date: 2018-03-26 / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / O câncer é uma doença complexa que precisa de um microambiente favorável para seu crescimento e progressão. Esse microambiente tumoral esta constituido por células neoplásicas, vasos sanguíneos, células imunes, fibroblastos e a matriz extracellular (MEC). Geralmente, as células neoplásicas apresentam modificações nas suas vias de sinalização. No homem, a via mTOR/4E-BP1/eIF4E foi descrita como alterada em diferentes tumores, incluindo o câncer de próstata (CP).Além do homem, o cão é espécie doméstica que desenvolve com mais frequência o CP, sendo considerada um potencial modelo para estudos na área de Oncologia Comparada. Devido à limitada informação sobre a via mTOR/4E-BP1/eIF4E e os componentes da MEC nos CP caninos, o objetivo deste estudo foi avaliar a expressão gênica e protéica de mTOR, 4E-BP-1 e eIF4E neste tipo de tumor. Outrossim, avaliar a expressão dos colágenos (C-I e C-III) pela técnica Picrosirius (PSR) e imuno-histoquímica no tecido prostático normal e neoplásico. Foram utilizadas 35 amostras de tecido prostático caninos. Identificou-se alta expressão protéica de p-mTOR e eIF4E nos CP caninos com alto GS (≥ 8), assim como, correlação positiva entre essas proteínas. Nos colágenos não foi observada diferença de expressão quando comparadas amostras de próstata normal e CP canino. De forma similar com o CP humano, estes resultados sugerem que p-mTOR e eIF4E podem ser bons marcadores para o processo carcinogênico prostático canino e estão correlacionados com alto GS. Além disso, a distribuição de colágenos foi similar no tecido prostático normal e neoplásico. / Cancer is a complex disease that needs a favorable microenvironment for its growth and progression. This tumor microenvironment consists of neoplastic cells, blood vessels, immune cells, fibroblasts and extracellular matrix (ECM). Generally, neoplastic cells show modification in their signaling pathways. In men, the mTOR/4EBP1/eIF4E pathway has been described as altered in different tumors, including prostate cancer (PC). Apart from men, the dog is the only species that develops with high frequency the PC, being considered a potential model for comparative oncology initiatives. Due to limited information on this pathway and ECM components in canine tumors, this study aimed to investigate mTOR, 4E-BP1 and eIF4E gene and protein expression in canine PC. Additionally, to evaluate the expression of collagens (C-I and C-III) by Picrosirius Red and Immunohistochemistry in normal samples and canine PC. Were used a total of 35 formalin-fixed paraffin-embedded (FFPE) samples from canine prostatic tissue. We identified higher p-mTOR and eIF4E protein levels in the canine PC with higher GS (≥ 8), as well as, significant positive correlation between these proteins. No difference statistical was observed in the collagen expression between normal samples and canine PC. Similar to human PC; our data suggested that p-mTOR and eIF4E good markers for canine prostatic carcinogenic process and are correlated with higher GS. Also, the distribution and collagen levels are similar in normal and neoplastic canine prostate. / 443884/2014-5

Les léiomyosarcomes (LMS) sont des tumeurs d’origine mésenchymateuse caractérisées par une différenciation musculaire lisse. La voie de signalisation PI3K/mTOR (qui contrôle la prolifération et la survie cellulaire) joue un rôle majeur dans le développement de ces tumeurs. De nos jours, cette voie est devenue une cible thérapeutique majeure en oncologie. Cette étude est la première qui évalue le bénéfice thérapeutique de l’inhibition de la voie PI3K/mTOR pour des patients atteint de LMS. Nous avons mis en évidence qu’une double inhibition de PI3K et mTOR est associée à une activité antitumorale supérieure à celle observée avec une inhibition de PI3K ou mTOR seule. Nous avons également montré que l’inhibition de la voie PI3K/mTOR est associée à une activation paradoxale de la voie MAPK et qu’un ciblage concomitant de cette voie est associé à une synergie antitumorale in vitro et in vivo. Afin de caractériser les mécanismes de résistance secondaire à l’inhibition de la voie PI3K/mTOR, nous avons développé in vitro et in vivo un modèle de résistance secondaire à l’inhibiteur double cible PI3K/mTOR. Nous avons notamment détecté une sous-population de cellules résistantes à l’inhibiteur et ayant des caractéristiques proches de celles des cellules souches. Nous avons mis en évidence que l’inhibition pharmacologique d’EZH2, une protéine cruciale du complexe Polycomb, permet de restaurer la sensibilité des modèles résistants. Ces résultats apportent de nouvelles perspectives thérapeutiques pour les patients atteints de LMS. / Leiomyosarcomas (LMS) are tumors of mesenchymal origin characterized by a smooth cell differentiation. The PI3K/mTOR pathway has been shown to play a crucial role in the tumorigenesis of LMS. Several agents targeting this pathway are under clinical development for the treatment of solid tumors and hematological malignancies. We report here the first study evaluating its potential therapeutic benefit for patients with LMS. We have demonstrated that dual inhibition of PI3K and mTOR is associated with more effective antitumor activity than agents targeting PI3K or mTOR only. We have also shown that PI3K and mTOR inhibition is associated with a paradoxal activation of the MAPK pathway and that combined treatment with MEK inhibitor resulted in synergistic antitumor activity in vitro and in vivo. Moreover, we developed in vitro and in vivo resistant model to dual PI3K/mTOR inhibitor. Interestingly, we have found that a cancer stem cell-like subpopulation may be involved in treatment resistance. We have shown that pharmacological inhibition of EZH2, a crucial protein of the Polycomb complex, is able to reverse dual PI3K/mTOR inhibitor resistance in vitro and in vivo. These results provide new therapeutic strategies for patients with LMS.

No description available.

Bcl-xL et Mcl-1 sont deux protéines anti-apoptotiques de la famille Bcl-2 dont dépendent les cancers de l’ovaire pour leur survie, leur inhibition semble donc être une stratégie pertinente. La molécule BH3-mimétique ABT 737 (ou son analogue oral, l’ABT-263), est un puissant inhibiteur de Bcl-xL mais l’inhibition de Mcl-1 reste problématique. Les voies de signalisation PI3K/Akt/mTOR et MAPK/ERK régulent l’expression et l’activité de cette dernière protéine et de ses partenaires BH3-only (Bim, Puma, Noxa). Nous nous sommes donc intéressés à l’intérêt de leur inhibition pour sensibiliser les cellules cancéreuses ovariennes à l’ABT-737. La première étude menée avec le BEZ235, double inhibiteur PI3K/mTOR développé par le laboratoire Novartis, montre qu’il inhibe l’expression de Mcl-1 et induit celle de Puma, et qu’il sensibilise les cellules cancéreuses ovariennes à l’ABT-737 à condition que l’expression de Bim soit également induite. La deuxième étude a évalué les effets de l’AZD8055, inhibiteur du site actif de mTOR développé par le laboratoire AstraZeneca, et du trametinib, inhibiteur allostérique de MEK développé par le laboratoire GlaxoSmithKline et actuellement en clinique, sur trois lignées cancéreuses ovariennes. L’inhibition de l’expression de Mcl-1 et l’induction de celle de Puma par l’AZD8055 ne permettent pas de diminuer suffisamment le ratio [Mcl-1/protéines BH3-only] pour sensibiliser les cellules à l’ABT-737. En revanche, la forte induction de Bim sous forme active déphosphorylée par le trametinib permet de diminuer suffisamment ce ratio pour sensibiliser deux des trois lignées testées à l’ABT-737. C’est cependant la triple combinaison AZD8055/trametinib/ABT-737 qui est la plus efficace pour induire une apoptose massive dans les trois lignées. Par ailleurs, de façon intéressante, l’association de l’AZD8055 et du trametinib est cytotoxique sans ABT 737 dans une des lignées testées. Ces résultats mettent en évidence l’efficacité de différentes stratégies thérapeutiques multi-cibles et la nécessité de définir des marqueurs prédictifs de la réponse afin d’évoluer vers un traitement personnalisé pour améliorer la prise en charge des cancers de l’ovaire. / Ovarian cancers depend on Bcl-xL and Mcl-1, two anti-apoptotic protein of the Bcl-2 family, for their survival and their inhibition seems to by a relevant strategy. The BH3-mimetic molecule ABT-737 (or its oral form, ABT-263), is a strong Bcl-xL inhibitor, but Mcl-1 inhibition remains problematic. Signaling pathways PI3K/Akt/mTOR and MAPK/ERK regulate expression and activity of Mcl-1 and its BH3-only partners (Bim, Puma, Noxa). We focused on the interest of their inhibition to sensitize ovarian cancer cells to ABT-737. The first study with BEZ235, a PI3K/mTOR dual inhibitor developed by Novartis, inhibits Mcl-1 expression and induces the one of Puma, and sensitizes ovarian cancer cells to ABT-737 provided that Bim expression is induced. The second study evaluated the effects of AZD8055, mTOR active site inhibitor developed by AstraZeneca, and of trametinib, MEK allosteric inhibitor developed by GlaxoSmithKline and currently in clinic, on three ovarian cancer cell lines. Mcl-1 expression inhibition and Puma expression induction by AZD8055 does not sufficiently reduce [Mcl-1/BH3-only proteins] ratio to sensitize cells to ABT-737. On the other hand, strong Bim induction in its active dephosphorylated form by trametinib sufficiently reduce this ratio to sensitize two of the three cell lines tested to ABT-737. Nevertheless, the triple combination AZD8055/trametinib/ABT-737 is the most efficient to induce massive apoptosis in the three cell lines. Besides, interestingly, AZD8055 and trametinib association is cytotoxic without ABT-737 in one of the tested cell lines. These results highlight the efficacy of different multi-targets therapeutic strategies and the need of predictive marker definition of the response to develop personalized treatment and to improve ovarian cancer management.