A presença de metástase em linfonodos cervicais é o fator prognóstico mais importante para o carcinoma epidermóide de boca (CEB), uma das neoplasias malignas mais comuns da região de cabeça e pescoço. Estudos têm associado os mecanismos de progressão tumoral, recorrência e metástase com a presença e manutenção de células-tronco de câncer (CSC, do inglês cancer stem cells), que correspondem à subpopulação celular mais migratória e altamente metastática quando comparada com outras subpopulações presentes no tumor. Ainda, evidências recentes mostram que há uma ligação entre as CSC e o processo de transição epitélio-mesenquimal (EMT, do inglês epithelial-mesenchymal transition), evento em que as células perdem a polaridade e a aderência célula-célula e exibem uma morfologia mesenquimal, o que as permite migrar além do tumor primário. Portanto, o objetivo deste estudo foi de avaliar, in vitro, a associação das propriedades biológicas relacionadas ao fenótipo tronco tumoral e de transição epitélio-mesenquimal, com o comportamento invasivo e metastático das linhagens SCC-9 de CEB primário e metastático correspondente. Para este fim, linhagens celulares parental (SCC-9 ZsGreen) e metastática (SCC-9 ZsGreen LN-1), obtidas após ensaios de tumorigênese in vivo, foram caracterizadas em relação à capacidade de proliferação e migração, bem como à presença e proporção da subpopulação de CSC, baseado na capacidade de formação de colônias tumorais, preferencialmente holoclones, e de esferas tumorais. Ensaios de expressão gênica (qRT-PCR) também foram conduzidos para se verificar os níveis de expressão diferencial dos marcadores de CSC (CD44, BMI1, ALDH1 e p75NTR), bem como de EMT (SNAIL1, TWIST1, AXL, vimentina, E-caderina e N-caderina) em ambas as linhagens tumorais, utilizando-se células epiteliais de palato humano (CEPH) como controle. Tanto a capacidade de proliferação e migração celular, quanto a quantidade de holoclones e esferas tumorais, foram significativamente maiores na linhagem metastática quando comparada com a parental. A linhagem metastática SCC-9 ZsGreen LN1 exibiu, ainda, superexpressão estatisticamente significante de CD44, BMI-1, AXL, vimentina e N-caderina e baixa expressão de E-caderina, quando comparadas com a linhagem parental. O potencial metastático de SCC-9 ZsGreen LN-1 parece ser uma consequência da sua maior quantidade de subpopulação com fenótipo de CSC que, ainda, passou pelo processo de EMT. Portanto, sugere-se que as propriedades biológicas relacionadas à capacidade metastática da linhagem SCC-9 ZsGreen LN-1 parecem estar relacionadas a ambos os fenótipos tronco tumoral e de transição epitélio-mesenquimal. / The presence of metastasis in cervical lymph nodes is the most significant prognostic factor for the oral squamous cell carcinoma (OSCC), one of the most common malignant neoplasms of the head and neck. Studies have associated the mechanisms of tumor progression, recurrence and metastasis with the presence and maintenance of cancer stem cells (CSC), which correspond to the most migratory and highly metastatic cellular subpopulation when compared to other cell subpopulations within the tumor. Moreover, recent evidence shows that there is a link between the CSC and the process of epithelial-mesenchymal transition (EMT), an event in which the cells lose their polarity and cell-cell adhesion and exhibit a mesenchymal morphology, which allows them to migrate beyond the primary tumor. Thus, the purpose of the present study was to evaluate, in vitro, the combination of the biological properties related to CSC and EMT phenotypes with the invasive and metastatic behavior of the corresponding primary and metastatic OSCC SCC-9 cell line. For this, parental (SCC-9 ZsGreen) and metastatic (SCC-9 ZsGreen LN-1) OSCC cell lines, obtained after in vivo tumorigenesis assays were characterized regarding the ability of proliferation and migration, as well as the presence and proportion of CSC subpopulation, based on the capacity of generating tumor colonies, preferably holoclones, and tumor spheres. Gene expression assays (qRTPCR) were also conducted to verify the differential expression levels of CSC markers (CD44, BMI-1, ALDH-1 and p75NTR) and EMT (SNAIL1, TWIST1, AXL, vimentin, Ecadherin and N-cadherin) markers in both tumor cell lines, using human palate epithelial cells (HPEC) as control. Both proliferation and cell migration capacity, as well as the numbers of holoclones and tumor spheres were significantly higher in metastatic cell line compared to the parental. Furthermore, the metastatic cell line SCC-9 ZsGreen LN-1 showed significantly higher expression of CD44, BMI-1, ALDH- 1, vimentin, and N-cadherin and lower expression of E-cadherin, when compared to parental cell line. The metastatic potential of SCC-9 ZsGreen LN-1 seems to be a consequence of the greater amount subpopulation with CSC phenotype that also underwent the EMT process. Therefore, it is suggested that the biological properties related to metastatic ability of SCC-9 ZsGreen LN-1 cell line are related to both CSC and EMT phenotypes.

AXL est un récepteur tyrosine kinase (RTK) impliqué dans de nombreux mécanismes cellulaires tels que la migration, l'invasion, l'angiogenèse et la prolifération des cellules. Sa surexpression a été observée dans de nombreux cancers et est souvent liée à un mauvais pronostic vital pour le patient. De plus, ce récepteur semble agir dans un mécanisme important dans la formation de métastases et la résistance aux thérapies anticancéreuses : la transition épithélio-mésenchymateuse (EMT). Nous avons dans un premier temps généré des anticorps monoclonaux murins spécifiques du récepteur AXL. Deux de ces anticorps ont ensuite été sélectionnés pour leurs propriétés inhibitrices de l'expression d'AXL à la surface et de l'activation de ce récepteur par son ligand GAS6. En effet ces deux anticorps, le 20G7D9 et le 3E3E8, entraine l'internalisation et la dégradation lysosomale d'AXL.Nous avons dans un deuxième temps étudié l'expression et le rôle de ce récepteur dans le cancer du pancréas qui possède un manque cruel de solutions thérapeutiques aujourd'hui et dont le taux de survie reste très faible (moins 5% des patients survivent 5 ans après son diagnostic). Nous avons ainsi observé une expression d'AXL dans une majorité des tumeurs de patients (76%), notamment au niveau du front invasif de ces tumeurs. Le ciblage d'AXL par nos deux anticorps inhibe sa signalisation et permet une réduction in vitro et in vivo de la croissance tumorale.Enfin, l'importante expression d'AXL dans le front invasif des tumeurs nous a incité à étudier le rôle d'AXL au cours de la transition épithélio-mésenchymateuse. Nous avons ainsi démontré que le couple AXL/GAS6 induit l'EMT dans des modèles invasifs de cancer du sein triple négatifs. De plus, l'expression du récepteur dans des tumeurs de cancer du sein de type basal-like est corrélée à celle de différents marqueurs importants dans l'EMT. L'application de nos anticorps anti-AXL dans ce type de cancer permet d'inhiber l'induction de l'EMT par le récepteur ainsi que l'invasion cellulaire in vitro et in vivo.Cette thèse a ainsi permis de démontrer l'importance du récepteur tyrosine kinase AXL dans des mécanismes oncogéniques clés et l'efficacité de son ciblage par des anticorps monoclonaux dans des modèles précliniques de cancer. / The Tyrosine Kinase Receptor (TKR) AXL is implicated in various cellular mechanisms (migration, invasion, angiogenesis and cell proliferation). Its overexpression has been observed in many cancers and is often correlated with poor prognosis. Moreover, this receptor seems to be important in Epithelial to Mesenchymal Transition (EMT), a mechanism related to metastasis formation and resistance to anticancer therapies.We have generated several AXL specific murine monoclonal antibodies. Two of them, 20G7D9 and 3E3E8, have been selected for their inhibition properties in AXL expression and activation by its ligand GAS6. In fact, both antibodies induce internalization and lysosomal degradation of AXL.Then we decided to study AXL expression and role in pancreatic cancer, which is characterized by a dramatic overall survival (<5%, 5 years after diagnosis) and a lack of efficient therapeutic solutions. We observed an ectopic expression of AXL in a majority of patient' pancreatic tumors (76%), notably in the invasive front of the tumor. Targeting AXL with both 20G7D9 and 3E3E8 inhibits its signaling and decreases tumor growth in vitro and in vivo.As AXL is mainly expressed in the invasive front of tumors, we analyzed its role during EMT. We observed that AXL/GAS6 signaling induces EMT in triple negative breast cancer cell lines. Furthermore, its expression is correlated with well-defined EMT markers in basal-like breast cancer tumors. In vitro and in vivo application of our antibodies inhibits AXL-dependant EMT signaling and cellular migration and invasion.In conclusion, this thesis demonstrates the importance of AXL Tyrosine Kinase Receptor in oncogenic processes and the efficacy of targeting this receptor with monoclonal antibodies in cancer preclinical models.

Introdução: A endometriose é uma doença ginecológica comum caracterizada pela presença de estroma e/ou glândula endometrial fora da cavidade uterina, e que não possui sua etiopatogenia bem estabelecida. A transição epitélio-mesênquima (TEM) é um processo que consiste em uma série de mudanças no fenótipo de células epiteliais que fazem com que estas células assumam características de células mesenquimais. Assim como observado na TEM, as células endometriais no contexto da endometriose apresentam capacidade migratória, invasibilidade e elevada resistência à apoptose. As moléculas de adesão têm adquirido crescente relevância na TEM, pois relacionam-se à perda de adesão célula-célula com o aumento da invasão e metástase. O objetivo deste estudo foi investigar a expressão de marcadores relacionados com a TEM na endometriose superficial, ovariana e profunda. Pacientes e Métodos: Foram selecionadas 103 mulheres que preenchiam os critérios de inclusão estabelecidos, constituindo 2 grupos de estudo independentes entre si: 18 mulheres com endometriose peritoneal, ovariana e profunda concomitantes; 85 mulheres com endometriose ovariana e/ou profunda, dividido em 44 mulheres com endometriose ovariana e 41 com endometriose intestinal. Através de reações de imunoistoquímica, a expressão proteica dos marcadores e-caderina, n-caderina, betacatenina, receptor de estrogênio e receptor de progesterona foram avaliados nos tecidos de interesse em cada grupo de estudo. Além dos locais de doença, as mulheres foram avaliadas quanto à relação com a fase do ciclo e à classificação histológica da doença. Resultados: As lesões de endometriose de ovário mostraram uma menor expressão de n-caderina em comparação às lesões de intestino e peritônio (p=0,032). O receptor de estrogênio e receptor de progesterona se mostraram significativamente menos expressos no componente epitelial da doença de ovário do que no epitélio da endometriose de peritônio e intestino (p=0,002; p=0,48). A expressão da n-caderina apresentou uma correlação direta com a expressão do receptor de estrogênio no estroma da endometriose de intestino (p=0,036). Conclusão: Estes resultados sugerem que a transição epitélio-mesênquima esteja envolvida na etiopatogenia da endometriose, demonstrando que a doença de ovário se comporta de maneira diferente da doença superficial e da doença infiltrativa profunda, sendo a n-caderina um importante fator envolvido neste processo possivelmente influenciada pela ação do estrogênio / Background: Endometriosis is a common gynecological disease defined as the presence of ectopic endometrial glands and stroma outside the uterine cavity, and its pathogenesis is not well established. The epithelial to mesenchymal transition (EMT) is a process consisting of a series of changes in the phenotype of epithelial cells that make these cells assume the characteristics of mesenchymal cells. As observed in the EMT, endometrial cells in the context of endometriosis have the capacity of migration, invasiveness and high resistance to apoptosis. . The adhesion molecules have become progressively relevant in EMT, in view of the cell-to-cell adhesion loss, with increased invasion and metastasis. The goal of this study was to investigate the expression of markers related to EMT in superficial, ovarian and deep endometriosis. Patients and Methods: 103 women were selected who met the inclusion criteria, constituting two independent study groups: 18 women with peritoneal, ovarian and deep concomitant endometriosis, 85 women with ovarian and / or deep endometriosis, divided in 44 women with ovarian endometriosis and 41 with intestinal endometriosis. Through immunohistochemical reactions, the protein expression of e-cadherin, ncadherin, beta-catenin, estrogen receptor and progesterone receptor markers were evaluated in tissues of interest in each study group. In addition to the sites of the disease, menstrual phase and histological classification (well-differentiated, undifferentiated, mixed pattern and stromal) of the disease were recorded. Results: The ovarian endometrisis showed less n-cadherin marker than lesions of the peritoneum and bowel (p=0,032). Ovarian endometriosis also showed markedly decreased expression of estrogen and progesterone receptors in epithelial cells, compared with peritoneal and deep endometriosis (p=0,002; p=0,48). The expression of N-cadherin showed a direct correlation with estrogen receptor expression in the stroma of bowel endometriosis (p = 0.036). Conclusion: These results suggest that epithelial to mesenchymal transition involved in the pathogenesis of endometriosis, demonstrating that the ovary disease behaves differently disease than peritoneal and deep disease, so that the n-cadherin is an important factor involved in this process, possibly influenced by the action of estrogen

Os tumores odontogênicos benignos compreendem um grupo de neoplasias originárias dos tecidos dentários. Pesquisas vêm buscando identificar moléculas envolvidas nos mecanismos moleculares que regulam a remodelação da matriz extracelular (MEC) e como isto influencia no comportamento localmente invasivo presente em alguns destes tumores. A Transição Epitélio-Mesenquimal (TEM conversão do fenótipo epitelial em mesenquimal) é bem caracterizada em diversos carcinomas, culminando em mestástase. MMPs são enzimas que degradam os componentes da MEC, geram moléculas bioativas, participam da TEM e o controle da remodelação da MEC dá-se pelo balanço entre elas, seus inibidores (TIMPs e RECK) e seu ativador (EMMPRIN). Assim, o objetivo deste trabalho foi delinear o perfil de expressão das MMPs (-2, -7, -9 e -14), seus inibidores (TIMPs -2, -3, -4 e RECK), seu ativador (EMMPRIN) e marcadores da TEM (Snail, Slug, N-caderina, Fibronectina, a-Actina de músculo liso e Vimentina) em Ameloblastomas (AB) e Tumores Odontogênicos Cístico Calcificantes (TOCC). Ainda, realizamos a comparação da expressão de cada molécula avaliada em cada compartimento celular (epitélio e estroma) e correlação entre as moléculas avaliadas no mesmo tumor. Utilizamos 19 casos de AB e 18 casos de TOCC (Serviço de Anatomia Patológica da FOUSP), localização das enzimas/proteínas por imunoistoquímica e analisadas nos compartimentos epitelial e estromal. Todas as proteínas/enzimas analisadas foram detectadas tanto nos AB quanto nos TOCC, sendo a maioria expressa em ambos os compartimentos. A N-caderina foi localizada apenas no epitélio dos AB e a Vimentina somente no estroma em ambos os tumores. Na comparação entre o epitélio x estroma dos ameloblastomas, verificamos que houve diferença estatisticamente significante (p<0,05) para a MMP-2, MMP-7, EMMPRIN/CD147, Fibronectina, a-Actina de músculo liso, N-caderina, Vimentina, Snail e Slug. Na comparação entre o epitélio x estroma dos TOCC, verificamos que houve diferença estatisticamente significante (p<0,05) para a MMP-9, RECK, EMMPRIN/CD147, Vimentina, N-caderina, Snail e Slug. Assim, entre o epitélio x estroma dos ameloblastomas e TOCC, verificamos que houve diferença estatisticamente significante (p<0,05) para a MMP-2, MMP-7, MMP-9, RECK, EMMPRIN/CD147, Fibronectina, Vimentina, a-Actina de músculo liso, N-caderina, Snail e Slug. Esta é a primeira vez que a EMMPRIN, RECK, TIMP-3, TIMP-4, Ncaderina, Snail e Slug são descritas em TOCC e TIMP-3, TIMP-4, Snail e Slug em ameloblastomas. Concluímos que estas proteínas/enzimas estão diferencialmente expressas tanto no epitélio quanto no estroma destes tumores e sugerimos que estes podem participar do comportamento localmente invasivo. / Odontogenic tumors comprise a group of benign neoplasms originating from dental tissues. Research looking for identify molecules involved in the molecular mechanisms that regulate extracellular matrix remodeling (ECM) and how this impacts on locally invasive behavior present in some of these tumors. Epithelial-Mesenchymal Transition (EMT - conversion of epithelial phenotype into mesenchymal phenotype) is well characterized in several carcinomas, leaving to metastasis. MMPs are enzymes that degrade ECM components, generate bioactive molecules, participating in the EMT and control ECM remodeling is given by the balance between them, their inhibitors (TIMPs and RECK) and its activator (EMMPRIN). The aim of this study was evaluate expression profile of MMPs (-2, -7, -9 and - 14), their inhibitors (TIMPs -2, -3, -4 and RECK), its activator (EMMPRIN) and EMT markers (Snail, Slug, N-cadherin, Fibronectin, -smooth muscle actin and Vimentin) in ameloblastomas (AB) and Calcifying Cystic Odontogenic Tumor (CCOT). We also compared the expression of each molecule assessed in each cellular compartment (epithelium and stroma) and correlation between molecules evaluated in the same tumor. We used 19 AB cases and 18 CCOT cases from files of Pathology Laboratory (FOUSP), localization of enzymes/proteins and analyzed by immunohistochemistry in epithelial and stromal compartments. All proteins/enzymes were detected in both AB and CCOT, mostly expressed in both compartments. N-cadherin was localized only in the epithelium of AB and Vimentin only in stromal in both tumors. Comparing \"epithelium vs stroma\" of AB, we observed a statistically significant difference (p <0.05) for MMP-2, MMP-7, EMMPRIN/CD147, Fibronectin, -smooth muscle actin, N-cadherin, Vimentin, Snail and Slug. Comparing \"epithelium vs stroma\" of CCOT, we observed a statistically significant difference (p <0.05) for MMP-9, RECK, EMMPRIN/CD147, Vimentin, N-cadherin, Snail and Slug. Analizing epithelium vs stroma\" between AB and CCOT, we observed a statistically significant difference (p <0.05) for MMP-2, MMP-7, MMP-9, RECK, EMMPRIN/CD147, Fibronectin, Vimentin , -smooth muscle actin, N-cadherin, Snail and Slug. This is the first time that EMMPRIN, RECK, TIMP-3, TIMP-4, N-cadherin, Snail and Slug are described in CCOT and TIMP-3, TIMP-4, Snail and Slug in AB. We conclude that these proteins/enzymes are differentially expressed in both epithelium and stroma of these tumors and suggest that they may participate locally invasive behavior.

La dysfonction chronique du greffon est la cause majeure d’échec en transplantation rénale, que son mécanisme soit immunologique ou non. Lorsque l’épithélium tubulaire rénal subit des changements phénotypiques épithéliaux (CPE), évocateurs de transition épithélio-mésenchymateuse (TEM) et associés au développement de lésions irréversibles de fibrose interstitielle et d’atrophie tubulaire, l’évolution se fait vers la diminution de la fonction rénale et de la perte du greffon. Nous avons étudié le phénotype de l’épithélium tubulaire rénal par immunohistochimie et par la mesure dans les urines des ARN messagers de la vimentine, CD45, GAPDH et Uroplakine 1a par RT-PCR. Nous avons comparé les greffes avec donneurs cadavériques et celles avec donneurs vivants et nous avons évalué les performances diagnostiques de la RT-PCR dans les urines pour le diagnostic de CPE chez les patients greffés, ayant une biopsie rénale de surveillance à 3 mois et une biopsie sur indication particulière. Nous avons montré que le score de TEM sur la biopsie de surveillance et l’évolution de la fonction rénale sont meilleurs chez les greffés à partir de donneur vivant, comparé à ceux ayant un greffon de donneur cadavérique. La valeur de l’ARNm de la vimentine et CD45 rapportée à l’uroplakine 1a est corrélée avec le score de vimentine en immunomarquage dans les biopsies de surveillance. Ces biomarqueurs pourraient être utilisés comme un outil non invasif pour surveiller la fibrogénèse dans le greffon rénal. Ce test pourrait être utilisé pour le dépistage précoce des pathologies fibrosantes du greffon rénal. Une étude transcriptomique indépendante a été réalisée, confirmant l’intérêt de la normalisation des ARN messagers par l’ARNm de l’uroplakine, et montrant / Chronic graft dysfunction is the major cause for end-stage renal failure after renal transplantation, both through immune and non-immune mechanisms. When the renal tubular epithelium undergoes epithelial phenotypic changes (EPC), reminiscent of epithelial mesenchymal transition (EMT), and associated with interstitial fibrosis and tubular atrophy, the prognosis is poor with a diminution of renal function and graft loss. In this prospective study. We studied the renal epithelial phenotype by immunohistochemistry and measured mRNA in urine of vimentin, CD45, GAPDH and uroplakin 1a by RT-PCR. We compared grafts from living donors and those from deceased donors. We evaluated the diagnostic performance of RT-PCR on urine for the diagnosis of epithelial phenotypic changes in transplant patients, with renal biopsy surveillance at 3 months and a biopsy on particular indication. We have shown that the EMT score on renal biopsy surveillance and the evolution of graft renal function were better in the patients from living donors than in those from cadaveric donors. The value of the mRNA of vimentin and CD45 relative to the uroplakin is correlated with the score in vimentin immunostaining in routine biopsies. These biomarkers could be used as a noninvasive tool to monitor the renal graft fibrogenesis. This test could be used for early detection of fibrotic diseases of the kidney transplant. In an independant study, the transcriptome in urine was analyzed, and it was found that normalization of mRNA with uroplakin mRNA was useful, and that EPC were associated with immune and inflammatory profiles.

Ovarian cancer is the fifth leading cause of cancer death in women between the ages of 35 and 74. With 22 thousand new cases and 15 thousand deaths annually ovarian cancer is among the most deadly cancers with a death to incidence ratio of 68%. With 70% of cases High Grade Serous Ovarian Carcinoma (HGSOC) is the most common type of ovarian cancer and causes 90% of ovarian cancer deaths. 80% of patients have reoccurrence within five years and only 15-30% of patients with recurrent metastatic ovarian cancer respond to current therapies, chemotherapy and surgery. One reason for the high reoccurrence rate is thought to be linked to the heterogeneity of tumors: there is evidence that, among tumor cells, a subpopulation is cancer stem cells (CSCs). Since CSCs are frequently drug resistant, when the patient undergoes chemotherapy many of the cells may die but the CSCs are left behind and the tumors can therefore regrow. CSCs are also more likely to undergo epithelial-mesenchymal transition which gives these cells the ability to more readily migrate and invade through the extracellular matrix, leaving the primary tumor to form metastases. One key inducer of EMT and therefore possibly of metastasis of particular interest in this project is SNAI1 (Snail). It is therefore the goal of this project to understand the growth, makeup and metastatic ability of HGSOC cell lines to test possible strategies to decrease growth of cancer and prevent metastasis. In this thesis project the phenotype, CSC population make up, and functionality of various HGSOC cell lines was examined. The cell lines assessed were A2780, Kuramochi, OVSAHO, COV318, SKOV3 and OVCAR8. A Snail knockdown OVCAR8 cell line was also assessed as described above and in a xenograft model. It was determined that the cell lines show varying phenotype from epithelial like to mesenchymal like morphology and the cell lines have varying concentrations of cancer stem cells. It was also determined that the CSC population of the HGSOC cell lines were positive for both epithelial and mesenchymal markers in the same cells. OVCAR8 stood out as a hybrid line with both epithelial and mesenchymal characteristics and was therefore chosen for the Snail knockdown model. In the Snail knockdown we observed that CSC markers were reduced, however no change between control and knockdown was seen in the in vitro functional experiments. There was a difference seen between Snail knockdown and control in the in vivo mouse xenograft model. Snail knockdown showed a trend for decreasing tumor burden in both primary and metastatic tumors and showed a significant decrease in growth of metastatic tumor at day 43. Based on these results Snail may be an important target for cancer therapy.

This study focused on the role of RANKL in prostate cancer EMT progression and metastasis. Activation of RANK, a receptor activator of NF-kB, by its ligand RANKL, in a paracrine manner is responsible for osteoclast differentiation and bone remodeling. RANK activation in cancer cells, however, is thought to be promoted by both autocrine and paracrine mechanisms because RANKL has been shown to be derived from either tumor or its microenvironment, such as osteoblasts, infiltrating inflammatory cells and stromal fibroblasts. In the present study, we demonstrated that autocrine and paracrine RANKL-RANK signaling could be responsible for driving prostate cancer bone metastasis by promoting epithelial to mesenchymal transition (EMT). We further characterized a novel converging RANKL-c-Met signaling network in which the activation of RANKL was found to promote the expression of both RANKL and c-Met in an autocrine manner in prostate cancer cells. The induced RANKL and c-Met in prostate cancer cells is biologically functional and contributes to increased osteoclastogenesis, epithelial to mesenchymal transition (EMT), cell motility, migration and invasion and conferred bone and soft tissue metastases. Remarkably, RANKL expression by 1,000 prostate cancer cells can provoke bone and soft tissue metastases of a “dormant” population of prostate cancer cells which by themselves failed to form tumors and colonize mouse skeleton, suggesting RANKL can serve as a factor in “reawakening” cancer dormancy to initiate the re-growth and metastasis of cancer cells. We also showed that RANKL-induced RANKL feed-forward autocrine regulation is mediated through cMyc transactivation, allowing the establishment of a “vicious cycle” further promoting prostate cancer growth and metastasis. The converging RANKL-c-Met signaling network is therefore a novel target that could be further manipulated for delaying the lethal progression of castration-resistant human prostate cancer bone metastasis.

Η επιθηλιακή προς μεσεγχυματική μετατροπή είναι ένα φαινόμενο που πιθανότατα εμπλέκεται στην παθογένεια του καρκίνου του λάρυγγα. Η ΕΜΤ εξελισσόμενη μέσα από δαιδαλώδη μονοπάτια μεταγωγής σήματος καταλήγει να προσδώσει στο καρκινικό κύτταρο δομικά και λειτουργικά χαρακτηριστικά που το καθιστούν ικανό να μπορεί να διεισδύει στους ιστούς και να μεθίσταται. Κεντρικό μόριο στα μοριακά μονοπάτια που διαμεσολαβούν την ΕΜΤ στον καρκίνο του λάρυγγα είναι μια κινάση, η ILK, που δέχεται σήματα από τις ιντεγκρίνες και τους υποδοχείς αυξητικών παραγόντων. Στους επιθηλιακούς καρκίνους αναφέρεται η εμπλοκή της σε λειτουργίες όπως ρύθμιση του κυτταρικού κύκλου, αποφυγή της απόπτωσης, νεοαγγειογένεση, απώλεια των δομών συνοχής του κυττάρου, έκφραση μεταλλοπρωτεασών και αναδιαμόρφωση του κυτταροσκελετού. Στο λαρυγγικό καρκίνο όμως κρίσιμα φαινόμενα για τον μεταστατικό-επιθετικό χαρακτήρα των κυττάρων, όπως, η εξαφάνιση των E-cadherin, η μετακίνηση των β-catenin στον πυρήνα και η συσχέτιση μεταξύ τους, που διαπιστώθηκαν, δεν βρέθηκε να συνδέονται με την υπερέκφραση της ILK καθιστώντας προφανώς άλλους μηχανισμούς υπεύθυνους για την επιτέλεση αυτών των λειτουργιών. Ιδιαίτερα ενδιαφέρουσα όμως ήταν και η εντόπιση της ILK στον πυρήνα των κυττάρων του καρκίνου του λάρυγγα δίνοντας μια νέα προοπτική στην έρευνα για τον ρόλο της ILK στον καρκίνο. Στο μονοπάτι μεταγωγής σήματος της ILK στο λαρυγγικό καρκίνο βρέθηκε πως συμμετέχει και η ενεργοποιημένη Akt με την οποία επίσης σχετίζονται πολλές κρίσιμες λειτουργίες για το καρκινικό κύτταρο. Ωστόσο η p-Akt στο λαρυγγικό καρκίνο φαίνεται πως έχει κάποιο ρόλο αντίθετο με την λειτουργία του καρκινικού κυττάρου καθώς χαρακτηρίζει όγκους καλύτερης διαφοροποίησης. Ο λαρυγγικός καρκίνος τέλος διαπιστώθηκε πως χαρακτηρίζεται από την έκφραση υποδοχέων ανδρογόνων και οιστρογόνων καθιστώντας πολύ πιθανό το ρόλο αυτών των μορίων στην παθογένεια της νόσου. Ενδιαφέρουσα για την πιθανότητα εμπλοκής των υποδοχέων στερεοειδών ορμονών του φύλου στην ΕΜΤ ίσως να είναι η συσχέτιση των υποδοχέων ανδρογόνων και οιστρογόνων με την ILK και p-Akt αντίστοιχα. Οι υποδοχείς οιστρογόνων μάλιστα χαρακτηρίζοντας όγκους λάρυγγα αρχικών σταδίων ίσως θα μπορούσε να αποδειχτεί μόριο με προγνωστική αξία αλλά και θεραπευτικός στόχος. Τέλος η μελέτη της έκφρασης της ILK, της p-Akt και των υποδοχέων στεροειδών ορμονών του φύλου δεν ανέδειξε μια διαφορετική έκφραση μεταξύ υπεργλωττιδικών και γλωττιδικών καρκίνων του λάρυγγος ώστε να υποστηρίξει την ύπαρξη ενός μοριακού υποβάθρου στην παρατήρηση της ανόμοιας κλινικής συμπεριφοράς μεταξύ όγκων από τις δύο αυτές ανατομικά διακριτές περιοχές. / Epithelial to mesenchymal transition (EMT) is a process possibly implicated in the pathogenesis of laryngeal cancer. EMT is a type of epithelial cell plasticity which is characterized by long lasting phenotypic and molecular modifications of the epithelial cell as a result of a transforming procedure leading to a cell of mesenchymal type. This molecular procedure seems to be pivotal for the metastasis of epithelial cancers and its attribution to the epithelial cells is the gain of structural and functional traits which enable them to invade the tissues and metastaze. In the current study ILK expression, which is a central molecule in the signal transduction pathways of EMT, seems to be implicated in human laryngeal carcinoma. Furthermore, localization of ILK in the nucleus possibly suggests novel nuclear functions of ILK. In addition, enhanced ILK expression in laryngeal carcinoma correlates with activation of Akt. Moreover, while activated Act seems to characterize well differentiated tumors, loss of E-cadherin and activation of β-catenin were correlated with high grade carcinomas. Finally, in laryngeal cancer, mechanisms other than ILK overexpression seem to account for downregulation of E-cadherin and activation of β-catenin. Additionaly this study concluded that estrogen and androgen receptors are expressed in laryngeal carcinomas, indicating their possible role in the pathogenesis of this disease. It is interesting that the receptors of gender-related steroid hormones could have a possible relation to epithelial to mesenchymal transition phenomenon since a correlation between androgen and estrogen receptors with ILK and p-Akt respectively, was revealed. Moreover estrogen receptors characterize primary TMN-stage laryngeal carcinomas. This can be very important as it makes a prospect of using ER as a prognostic factor but even more as a novel hormonal therapy for laryngeal carcinomas. Finally the study of molecules like ILK, p-Akt, estrogen and androgen receptors did not reveal any differentiantal expression between glotic and supraglotic laryngeal carcinomas in order to support the existence of a molecular background, at least as far as those molecules are concerned, to the distinct clinical outcome of those different anatomically-derived laryngeal carcinomas. Metastasis is a rapid development in the ominous course of cancer. The effort to interpret the molecular basis of this phenomenon is not a subject of simple academic interest since the exploit of the molecular mechanisms so as to gain the control of metastasis could be the ‘‘bet’’ for a futuristic ‘‘molecular surgery’’.

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Le rejet chronique se manifeste dans le poumon par la bronchiolite oblitérante (BO), une pathologie inflammatoire et fibrotique menant à l’oblitération des bronchioles. L’étiologie exacte de cette maladie demeure inconnue. Certaines études suggèrent qu'un déséquilibre des leucotriènes (LT) sur les prostaglandines (PG) favorise la fibrose pulmonaire. Les taux des LT et des PG dans le poumon humain post-transplantation sont inconnus. Nous proposons qu'un déséquilibre de cystéinyl leucotriènes (CysLT) sur la PGE2 existe dans le poumon transplanté et pourrait être impliqué dans la pathogenèse de la BO. Aussi, les leucotriènes contribueraient à la fibrose par la transition épithélio-mésenchymateuse (TEM). Afin de vérifier ces hypothèses, nous avons déterminé les taux de CysLT et de PGE2 dans le liquide de lavage broncho-alvéolaire (LBA) provenant de poumons transplantés chez l'homme ainsi que leurs corrélations cliniques. Nous avons également déterminé la capacité des CysLT à induire l’expression des marqueurs de la TEM in vitro. Nous avons découvert des taux de CysLT et PGE2 supérieurs à la normale dans les LBA des greffés. Un pic prédominant de CysLT sur PGE2 est observée à 52 semaines postgreffe et deux facteurs de risque de la BO, les infections au CMV et à l’Aspergillus, sont associés au ratio CysLT/PGE2> 1. In vitro, les CysLT induisent une répression des marqueurs épithéliaux mais n’induisent pas l’expression de marqueurs mésenchymateux chez les cellules épithéliales bronchiolaires. / Chronic rejection occurs, in the lung, in the form of bronchiolitis obliterans (BO), an inflammatory and fibroproliferative disease that leads to the obliteration of the bronchioles. A concept of the pathogenesis of BO has been suggested and several risk factors are associated to it, however, the exact etiology of this disease remains unknown. Studies have suggested that an imbalance of leukotrienes (LT) over prostaglandins (PG) promotes pulmonary fibrosis. The levels of LT and PG in the human lung post-transplantation are unknown. We propose that an imbalance of cysteinyl leukotrienes (CysLT) on PGE2 exists in the transplanted lung and may be implicated in the pathogenesis of BO. We also suggest that leukotrienes contribute to fibrosis through epithelial-mesenchymal transition (EMT). In order to test these hypotheses, we have determined the levels of CysLTs and PGE2 in human transplanted lung bronchoalveolar lavage fluid (BALf) samples and their clinical correlations. We have also determined the capacity of CysLT to induce the expression of EMT markers in vitro. We found high average levels of CysLT and PGE2 in the BAL of transplant patients. A predominant peak of CysLT over PGE2 was observed at 52 weeks post-transplantation and two risk factors for BO, CMV infections and Aspergillus were associated with CysLT/PGE2 ratio> 1. According to our experimental parameters, CysLT can induce the repression of epithelial markers but do not induce the expression of mesenchymal markers in vitro in small airway epithelial cells.