<p>Patients with peritonitis or malignant obstructive jaundice (HPB⁺) have an increased morbidity and mortality due to sepsis. An altered cell-mediated immunity in the intestinal mucosa might promote gut barrier failure, increased endotoxin and cytokine release and bacterial translocation (BT) in these conditions. A clinically relevant rat model of polymicrobial peritonitis induced sepsis by cecal ligation and puncture (CLP) was used. Septic animals demonstrated a superficial injury in the small intestinal mucosa, and a significant reduction in T lymphocytes in the villi, as well as increased number of macrophages in the villi and in the MLNs as compared to sham. CLP caused increased concentration of TNF-α and IL-6 in ascitic fluid. CLP + the immunomodulator Linomide decreased the TNF-α level, reduced mucosal damage and attenuated the changes in T lymphocytes and macrophages observed following CLP. CLP + selective cyclooxygenase (COX)-2 inhibitor (SC-236) or nonselective COX inhibitor (indometacin) decreased the amount of macrophages in the mucosa and the MLNs compared to untreated CLP. CLP + indometacin decreased T lymphocytes in the villi and MLNs. SC-236 + CLP reduced mucosal injury and cytokine release as compared to indometacin. An increased rate of apoptosis in both the mucosa and MLNs was seen following CLP; COX inhibitors enhanced this phenomenon in the MLNs.</p><p>BT occurred infrequently in patients with acute peritonitis and in HPB⁺ there was no evidence of BT. Peritonitis and HPB⁺causes significant inflammatory cellular reactions as increased endotoxin and cytokine plasma levels and an altered immune cell distribution in MLNs, in HPB⁺a high rate of apoptosis in MLNs was observed. </p><p>An altered pattern of immunocompetent cells within the mucosa and in MLNs was found in experimental and clinical peritonitis as in HPB⁺.Lymphocyte depletion may be a result of increased apoptosis, which could reduce the ability of septic or jaundice patients to eradicate infection.</p>

<p>Patients with rheumatoid arthritis (RA) are at increased risk of developing malignant lymphoma, although details about this association remain unclear. The aims of this thesis were to investigate risk factors for lymphoma in patients with RA and to characterize these lymphomas regarding subtype, presence of Epstein-Barr virus (EBV), clinical manifestations and prognosis. </p><p>The Swedish hospital discharge register and the cancer register were used to identify RA patients with lymphoma. Two case-control studies were performed, one smaller including RA patients with lymphoma hospitalised in Uppsala health care region 1964-1983 (n=41) and one larger study of hospitalised RA patients with lymphoma in Sweden 1964-1995 (n=378). RA patients from the same cohorts, but without lymphoma, were matched as controls. Medical records for cases and controls were scrutinized for exposure information. The lymphoma tissues were reclassified according to the WHO classification, and presence of EBV was analysed by EBER in situ hybridisation.</p><p>The most important risk factor for lymphoma development was high RA disease activity. No association was determined between treatment with traditional disease modifying drugs, non-steroidal anti-inflammatory drugs, aspirin, peroral and intra-articular corticosteroids and lymphoma risk. Diffuse large B-cell lymphoma (DLBCL) was more frequent in RA patients than in lymphoma patients in the general population and displayed stronger association with RA disease activity than other lymphoma subtypes. RA patients with DLBCL had increased extranodal involvement and more advanced lymphoma stage at presentation than DLBCL patients in general, and the prognosis was poor. </p><p>A further subdivision of DLBCL into germinal centre (GC) and non-GC subtypes by the expression patterns of CD10, bcl-6 and IRF-4 showed a predominance of the non-GC subtype. This suggested peripheral activated B-cells as the cells of origin in these lymphomas. </p><p>The presence of EBV was low in lymphomas in RA patients (12%). </p>

Patients with peritonitis or malignant obstructive jaundice (HPB+) have an increased morbidity and mortality due to sepsis. An altered cell-mediated immunity in the intestinal mucosa might promote gut barrier failure, increased endotoxin and cytokine release and bacterial translocation (BT) in these conditions. A clinically relevant rat model of polymicrobial peritonitis induced sepsis by cecal ligation and puncture (CLP) was used. Septic animals demonstrated a superficial injury in the small intestinal mucosa, and a significant reduction in T lymphocytes in the villi, as well as increased number of macrophages in the villi and in the MLNs as compared to sham. CLP caused increased concentration of TNF-α and IL-6 in ascitic fluid. CLP + the immunomodulator Linomide decreased the TNF-α level, reduced mucosal damage and attenuated the changes in T lymphocytes and macrophages observed following CLP. CLP + selective cyclooxygenase (COX)-2 inhibitor (SC-236) or nonselective COX inhibitor (indometacin) decreased the amount of macrophages in the mucosa and the MLNs compared to untreated CLP. CLP + indometacin decreased T lymphocytes in the villi and MLNs. SC-236 + CLP reduced mucosal injury and cytokine release as compared to indometacin. An increased rate of apoptosis in both the mucosa and MLNs was seen following CLP; COX inhibitors enhanced this phenomenon in the MLNs. BT occurred infrequently in patients with acute peritonitis and in HPB+ there was no evidence of BT. Peritonitis and HPB+ causes significant inflammatory cellular reactions as increased endotoxin and cytokine plasma levels and an altered immune cell distribution in MLNs, in HPB+ a high rate of apoptosis in MLNs was observed. An altered pattern of immunocompetent cells within the mucosa and in MLNs was found in experimental and clinical peritonitis as in HPB+. Lymphocyte depletion may be a result of increased apoptosis, which could reduce the ability of septic or jaundice patients to eradicate infection.

Patients with rheumatoid arthritis (RA) are at increased risk of developing malignant lymphoma, although details about this association remain unclear. The aims of this thesis were to investigate risk factors for lymphoma in patients with RA and to characterize these lymphomas regarding subtype, presence of Epstein-Barr virus (EBV), clinical manifestations and prognosis. The Swedish hospital discharge register and the cancer register were used to identify RA patients with lymphoma. Two case-control studies were performed, one smaller including RA patients with lymphoma hospitalised in Uppsala health care region 1964-1983 (n=41) and one larger study of hospitalised RA patients with lymphoma in Sweden 1964-1995 (n=378). RA patients from the same cohorts, but without lymphoma, were matched as controls. Medical records for cases and controls were scrutinized for exposure information. The lymphoma tissues were reclassified according to the WHO classification, and presence of EBV was analysed by EBER in situ hybridisation. The most important risk factor for lymphoma development was high RA disease activity. No association was determined between treatment with traditional disease modifying drugs, non-steroidal anti-inflammatory drugs, aspirin, peroral and intra-articular corticosteroids and lymphoma risk. Diffuse large B-cell lymphoma (DLBCL) was more frequent in RA patients than in lymphoma patients in the general population and displayed stronger association with RA disease activity than other lymphoma subtypes. RA patients with DLBCL had increased extranodal involvement and more advanced lymphoma stage at presentation than DLBCL patients in general, and the prognosis was poor. A further subdivision of DLBCL into germinal centre (GC) and non-GC subtypes by the expression patterns of CD10, bcl-6 and IRF-4 showed a predominance of the non-GC subtype. This suggested peripheral activated B-cells as the cells of origin in these lymphomas. The presence of EBV was low in lymphomas in RA patients (12%).

Paclitaxel is one of the most successful drugs for the treatment of cancer because of its ability to target tubulin, block cell cycle progression at mitosis, and induce apoptosis. Despite the success of Paclitaxel, the development of drug resistance hampers its clinical applicability. Paclitaxel is used in malignant tumors in the present research, including non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), head-neck scale epitheliomatous, urinary bladder cancer, tumor of the reproduction organ and so on. Clinical treatment of paclitaxel be injected 250mg/m2 to previously non-treated patients of small lung cancer its effect about 34% and previously non-treated patients of non-small lung cancer its effect about 21% to 24% . On the other hand we had established a taxol-resistant human lung carcinoma subline A549R by paclitaxel to compare the different proteins with A549 wild type and treat the different concention of paclitaxel with MTT assay so as to observe the tolerance dosage of subline growth.We obtained the patient¡¦s specimens of lung cancer to treat with paclitaxel some of resistant and some of non-resistant to compare differentially expressed proteins between normal and tumor. When we cultured taxol-resistant human lung carcinoma subline in which paclitaxel and calcium regulate growth, owing to the proteins of changes result to resistance. The extraction cell subline and specimens were analyzed by 2-D electrophoresis patterns and we found that interact paclitaxel with calcium it is the important factor of drug resistant. Verified from clinical treatment might have hypercalcemia in malignant tumors and calcium ion may increase paclitaxel drug resistance and hypercalcemia patient will be more insensitive to paclitaxel treatment.

Patients and methods: Malignant supratentorial glioma (anaplastic astrocytoma, oligoastrocytoma, oligodendroglioma and glioblastoma incl. gliosarcoma), age 16-70y, KPS 50-100. Postoperative randomization to chemotherapy with either BCNU (B) (80 mg/m2 x 3 every 6 weeks) alone or additional VM 26 (V) (50 mg/m2 x 3 every 6 weeks) starting concomitant with radiotherapy. Central histopathological review was required. Primary endpoints were survival time (ST) and progression free survival (PFS) . In addition confirmative analysis of prognostic factors and their interaction with therapy was performed. Results: Eligible: 501 of 522 randomized pts: 82% WHO grade IV gliomas, 18% grade III gliomas. 57% male, mean KPS 74, mean age 50.9 years. The high incidence of lung toxicity – with a cumulative risk of 19% during the first year - was alarming. Survival was not significantly different ( median 50.3 (B) versus 52.4 (V) (weeks), but an increase in long term survivors was observed (18 months: 29% B, 34% V, 5 years 5% B, 12% V) and PFS showed a significant difference with a median of 31.4 (B) versus 34.3 (V) weeks. Qualitative interaction between KPS and therapy (p < 0.01) was demonstrated: pts with a KPS ≥ 70 benefited from additional VM26, those with reduced KPS < 70 did better with BCNU-monotherapy. Conclusion: Adding VM26 to BCNU is effective in the chemotherapy of malignant gliomas. Because of the demonstrated interaction with therapy performance status, not tumor grade is the crucial factor to determine application and aggressiveness of chemotherapy. With risk adapted therapy a significant proportion of patients even with glioblastoma survive for years in good general condition. BCNU should be replaced by an equipotent alkylans to avoid the unacceptable high rate of lung toxicity.

Le cancer épithélial de l’ovaire est le cancer gynécologique le plus létal. La survie à 5 ans est de 30-40% chez les patientes atteintes d’une tumeur invasive (TOV), comparativement à 95% chez les patientes diagnostiquées pour une tumeur à faible potentiel de malignité ou borderline (LMP). Au laboratoire, l’analyse de l’expression des gènes de la micropuce à ADN U133 d’Affymetrix a révélé que la SERPINA1 est un gène dont l’expression varie entre les tumeurs LMP et TOV. La validation par Q-PCR nous a confirmé que cette antiprotéase est majoritairement surexprimée dans les tumeurs LMP, par rapport aux tumeurs bénignes (BOV) et aux tumeurs TOV. Nous avons donc surexprimé la SERPINA1 dans les lignées cellulaires invasives TOV 112D et TOV 1946 du cancer de l’ovaire et dérivé des clones stables. Les résultats obtenus nous indiquent que la surexpression de la SERPINA1 a un effet sur la capacité d’invasion et de migration cellulaire et non au niveau de la croissance cellulaire et la formation de structures tridimensionnelles. Les résultats issus de l’étude in vivo dans les souris SCID nous permettront de déterminer si la surexpression de la SERPINA1 a un effet sur la tumorigénèse ovarienne. Ainsi, la SERPINA1 demeure à notre avis un candidat d’intérêt pour tenter de mieux comprendre les différences biologiques entre les tumeurs LMP et TOV, ainsi que le rôle des protéases et de leurs inhibiteurs dans la progression tumorale du cancer de l’ovaire. / Epithelial ovarian cancer is the most lethal gynecologic cancer with a five-year survival rate of 30-40% in patients diagnosed with high-grade invasive disease (TOV). This is in stark contrast to the 95% five-year survival in patients diagnosed with low malignant potential (LMP) disease. It is therefore important to understand the biological differences between LMP and TOV. We have previously identified differential expression of SERPINA1 between serous LMP and TOV tumors through gene expression analysis using Affymetrix U133 DNA microarrays. Expression of this protease inhibitor in the majority of LMP tumors was confirmed and validated by Q-PCR. To study the effects of its overexpression on the invasive potential of ovarian cancer cell lines, SERPINA1 was cloned in the pcDNA3.1+ plasmid and stable clones were derived from two invasive ovarian cancer cell lines, TOV 112D and TOV 1946. Comparisons between clones and controls have shown no SERPINA1-dependent difference in cellular growth or spheroid formation. However, effects on cellular migration and invasion are observed in cells overexpressing SERPINA1. Results from an in vivo xenograft study in SCID mice will allow us to determine if SERPINA1 overexpression affects ovarian tumorigenesis. SERPINA1 remains an interesting candidate gene whose further characterization may lead to insights into its role, and the role of proteases and their inhibitors, in ovarian cancer disease progression.

Le cancer épithélial de l’ovaire est le cancer gynécologique le plus létal. La survie à 5 ans est de 30-40% chez les patientes atteintes d’une tumeur invasive(TOV), comparativement à 95% chez les patientes diagnostiquées pour une tumeur à faible potentiel de malignité (LMP). Au laboratoire, l’analyse de l’expression des gènes de la micropuce à ADN HuFL d’Affymetrix a révélé que Cks1 est un gène dont l’expression varie entre les tumeurs LMP et TOV. En effet, ce régulateur du cycle cellulaire est surexprimé dans les tumeurs TOV par rapport aux tumeurs LMP. Nous avons donc déplété Cks1 dans des lignées cellulaires tumorales invasives du cancer de l’ovaire dérivées au laboratoire, soit la TOV112D et la TOV1946, en utilisant des shRNAs sous le contrôle d’un répresseur inductible à la tétracycline. Puis, nous avons dérivé des clones stables inductibles à la tétracycline. Les résultats obtenus nous indiquent que la déplétion de Cks1 n’a pas d’effet sur la prolifération et la migration cellulaires, ni sur la formation de structures tridimensionnelles in vitro. Ainsi, nous pouvons conclure que Cks1 ne joue pas un rôle clé dans la progression tumorale par rapport aux paramètres testés. Or, des études supplémentaires seraient nécessaires pour expliquer les différences biologiques observées entre les deux types de tumeurs étudiées, et justifier cette variation observée de l’expression de Cks1. / Epithelial ovarian cancer is the most lethal gynecologic cancer with a five-year survival rate of only 30-40% in patients diagnosed with high-grade invasive disease (TOV). This contrasts with the 95% five-year survival in patients diagnosed with the low malignant potential (LMP)disease. Previously, we have identified differential expression of Cks1 between serous LMP and TOV tumors through gene expression analysis using Affymetrix HuFL DNA microarrays. Overexpression of this cell cycle regulator was observed in the TOV tumors, but not in the LMP samples. To study its role on the invasive potential of ovarian cancer cell lines, Cks1 was depleted in two tumoral invasive ovarian cancer cell lines established in our laboratory, TOV112D and TOV1946, using an inducible shRNA strategy. Then, tetracycline-inducible stable clones were derived and studied further. Comparisons between clones and controls have shown no Cks1-dependent effect on cellular growth, neither in migration capacity nor spheroid formation. Thus, we can conclude that Cks1 does not play a crucial role in the tested parameters for cancer progression, but further experiments could elucidate the biological differences observed between the two kinds of tumors studied.

Le cancer épithélial de l’ovaire est le plus létal des cancers gynécologiques. Les tumeurs de l’ovaire se divisent en différentes classes reflétant l’étendue de la maladie. Les tumeurs à faible potentiel de malignité présentent une survie relative à 5 ans de 90%, alors que pour les tumeurs invasives, la survie à 5 ans chute drastiquement à 35-40%. Au laboratoire, nous avons précédemment identifié la protéine Ran, un membre de la superfamille des GTPases Ras, comme marqueur fortement exprimé dans les cancers épithéliaux de l’ovaire de haut grade et de haut stade dont la surexpression est associée à un mauvais pronostic. Ran est déjà connue pour contribuer au transport nucléocytoplasmique et à la progression du cycle cellulaire, mais son rôle dans le cancer ovarien n’est pas bien défini. En utilisant une approche de shRNA inductibles à la tétracycline basée sur les lentivirus, nous avons montré que la diminution de l’expression de Ran dans des lignées cellulaires agressives du cancer de l’ovaire affecte drastiquement la prolifération cellulaire par l’induction d’une apoptose caspase-3 dépendante. Par un essai de tumeurs en xénogreffes, nous avons démontré que la déplétion de Ran résulte en une diminution de la tumorigenèse et que la formation éventuelle de tumeurs est associée à une sélection des cellules tumorales ayant la capacité de ré-exprimer la protéine Ran. Ces résultats suggèrent un rôle critique pour Ran dans la survie et la tumorigénicité des cellules du cancer ovarien, indiquant que Ran pourrait être une cible thérapeutique intéressante. / Epithelial ovarian cancer (EOC) is the most lethal gynecological cancer. Malignant epithelial tumors can be divided into different classes reflecting the extent of the disease. Low malignant potential (LMP) tumors have a 5 years survival rate of 90-95%. For invasive cancers (TOVs), the survival rate drops dramatically to 35-40%. In the laboratory, we previously identified that Ran protein, a member of the Ras GTPase family, is highly expressed in high grade and high stage serous epithelial ovarian cancers, and that its over-expression is associated with a poor prognosis. Ran is known to contribute to both nucleocytoplasmic transport and cell cycle progression, but its role in ovarian cancer is not well defined. Using a lentivirus-based tetracycline inducible shRNA approach, we show that down-regulation of Ran expression in aggressive ovarian cancer cell lines drastically affects cellular proliferation by inducing a caspase-3 dependent apoptosis. Using a xenograft tumor assay, we demonstrate that depletion of Ran results in decreased tumorigenesis, and eventual tumor formation is associated with the selection of tumor cells able to re-express the Ran protein. These results suggest a critical role for Ran in ovarian cancer cell survival and tumorigenicity and suggest that this critical GTPase may be suitable as a therapeutic target.

Descreve-se os achados epidemiológicos e clínico-patológicos das clostridioses diagnosticadas no Setor de Patologia Veterinaria da Universidade Federal do Rio Grande do Sul no período 1996-março/2010. Este estudo incluiu uma pesquisa retrospectiva nos arquivos do SPV e uma etapa prospectiva, a qual também teve o objetivo de desenvolver exames complementares específicos para cada clostridiose. As clostridioses mais prevalentes foram tétano (em equinos, bovinos, ovinos e caprinos), botulismo (em bovinos, suínos e aves) e enterotoxemia (em caprinos). Também houve casos de edema maligno em equinos, bem como de carbúnculo sintomático e hemoglobinúria em bovinos. Adicionalmente, foram coletadas amostras de soro sanguíneo de animais afetados por tétano, em diferentes estágios de evolução da doença, para subsequente inoculação em camundongos (testes de bioensaio) e comprovação da técnica no diagnóstico da enfermidade. / This study describes the epidemiological and clinicopathological findings of clostridial diseases diagnosed in the 1996-March, 2010 period in the Setor de Patologia Veterinária da Universidade Federal do Rio Grande do Sul (SPV_UFRGS). A retrospective survey in the files of SPV was complemented with a prospective phase, which also aimed developing complementary diagnostic tests of clostridiosis. The most prevalent clostridiosis were tetanus (in horses, cattle, sheep and goats), botulism (in cattle, pigs and birds), and enterotoxemia in goats. There also were cases of malignant edema in horses, blackleg and bacillary hemoglobinuria in cattle. In addition, blood serum samples from animals affected by tetanus on different stages of the disease evolution were applied in mice bioassay, as a complementary diagnosing test for the disease.