An increase in degenerative bone disease in an ageing population, combined with a rise in the number of patients suffering from bone defects caused by physical trauma, makes the repair of bone an issue of growing clinical relevance. Current treatments such as autografts and allografts have major drawbacks, including donor site morbidity, limited availability, disease transmission and immune rejection. To overcome these issues synthetic bone grafts have been developed to mimic the mineral phase of bone. Given the significant roles of silicon in bone growth and development there has been great interest in introducing silicon into synthetic bone grafts to enhance their bioactivity. Calcium phosphate based silicate containing grafts have demonstrated enhanced bioactivity, improved physical properties, enhanced protein adsorption and greater bone formation, when compared to non-silicated calcium phosphates such as hydroxyapatite. However, is not clear whether the increased bone formation associated with these materials is the result of greater osteoblast activity or a rise in numbers of osteoblasts resulting from activation and differentiation of stem/ progenitor cells. To answer this question, multipotent stem cells were cultured on silicate substituted calcium phosphate (Si-CaP) and hydroxyapatite (HA). Si-CaP promoted greater cell adhesion and enhanced proliferation when compared to HA. Cells differentiated along the osteogenic lineage on both substrates as evidenced by up regulation of osteoblast specific genes and proteins. However, cells on Si-CaP showed earlier and greater gene expression of all osteoblast genes examined, and greater protein production as detected by immunohistochemistry. Integrin gene expression analysis revealed up regulation of α an d β subunits on both substrates during differentiation. Integrins α5 and β1 expression were greater on Si-CaP than on HA, suggesting preferential binding of fibronectin. The implication of these findings for tissue engineering is clear, suggesting these substrates may be utilized to control stem cell fate in vivo and in vitro without the need for osteogenic supplementation. Furthermore, the increased rate of differentiation seen on Si-CaP may enable the development of novel substrates for osteogenic differentiation of MSC, which may have significant impact in regenerative medicine.

Introduction: Heart failure remains a major public health problem, with recent estimates indicating that end-stage heart failure with two-year mortality rates of 70-80% affects over 60,000 patients in the US each year. Medical management can be used but success declines for patients with end stage heart failure. Although cardiac transplantation is optimal, less than 2500 cardiac transplants are performed annually due to the severely limited supply of donor organs. Mechanical circulatory support (MCS) devices are now routinely used to bridge patients with end-stage heart failure who become critically ill until a donor heart is available. The use of stem cell therapy to treat heart failure has been gaining significant ground in recent years, specifically due to its regenerative properties, and both animal and human models have shown significant improvements in ventricular mass, ejection fraction, vascularization, wall thickness, and infarct size reduction. Using the patients' HeartWare HVAD device diagnostics, we were able to acquire our response variable; pulsatility. Pulsatility is a variable measure of the differential between minimum and maximum flow and is dependent on device motor speed, power, current, and fluid viscosity. This measurement is important as it relates to the contractility of the heart and could potentially be used as an end point in determining when a patient is healthy enough to have their HVAD explanted. We set out to develop a low cost and effective predictive model to determine amniotic mesenchymal stem cell's ability to repair compromised cardiac tissue of patients using the Total Artificial Heart (TAH) and Donovan Mock Circulation Tank (DMC). Methods: Predictive modelling was performed using the TAH and DMC. The system was set to a range from critical heart failure to a normal operating conditions through the variation of preload, afterload, and ventricular drive pressures with the intent of comparing the results to our patient population. Patients (n=7, 3 dilated, 4 ischemic) received intravenous and intra-myocardial injections of a heterogeneous amniotic mesenchymal stem cells mixture and liquid matrix (MSCs+LM) at HVAD implant. Groups were analyzed based on treatment; control (HVAD only, n=7) versus stem cells (HVAD + MSCs+LM). HeartWare log files were acquired from patients' devices and analyzed in SAS and Matlab. Results from the patient study were compared to the predictive model to determine levels of stem cell response. Results: Pulsatility was found to increase with left drive pressure and afterload. Lower drive pressures resulted in a drop off in pulsatility at higher afterloads while higher drive pressures were able to compensate for any afterload. Pulsatility also increased with preload but lower drive pressures were unable to fully eject at the highest preloads, resulting in a reduced pulsatility. We observed the effects of the stem cell injections on pulsatility and found that patients receiving therapy demonstrated statistically significant increases in pulsatility at 15-20 (p=.0487), 25-30 (p=.0131), 35-40 (p=.0333), and 75-80 (p=0.0476) days post implant. At minimum, when comparing the patient results to the in vitro model, the therapy resulted in a progression from end stage HF conditions to medium cardiac function conditions. At maximum, the therapy resulted in a progression from end stage HF to normal healthy operating cardiac function. Conclusions: Stem cells demonstrated a significantly increased rate of change in pulsatility within the first 40 days and at 80 days post implant when compared to control. They also demonstrated progression from end stage HF to normal healthy cardiac function at two time periods (Days 40, 90). These results justify expansion of the study to encompass a larger patient population to verify the results of the in vitro model to predict cardiac regeneration with multiple functional status indicators.

Traumatic injuries to the spinal cord (SCI) and peripheral nerve (PNI) affect several thousand people worldwide every year. At present, there is no effective treatment for SCI and despite continuous improvements in microsurgical reconstructive techniques for PNI, many patients are still left with permanent, devastating neurological dysfunction. This thesis investigates the effects of mesenchymal stem cells (MSC) derived from adipose (ASC) and dental (DSC) tissue and chitosan/microRNA-124 polyplex particles on regeneration after spinal cord and peripheral nerve injury in adult rats. Dental stem cells were obtained from apical papilla, dental pulp, and periodontal ligament. ASC and DSC expressed MSC surface markers (CD73, CD90, CD105 and CD146) and various neurotrophic molecules including BDNF, GDNF, NGF, VEGF-A and angiopoietin-1. Growth factor stimulation of the stem cells resulted in increased secretion of these proteins. Both ASC and DSC supported in vitro neurite outgrowth and in contrast to Schwann cells, ASC did not induce activation of astrocytes. Stimulated ASC also showed an enhanced ability to induce capillary-like tube formation in an in vitro angiogenesis assay. In a peripheral nerve injury model, ASC and DSC were seeded into a fibrin conduit, which was used to bridge a 10 mm rat sciatic nerve gap. After 2 weeks, both ASC and DSC promoted axonal regeneration in the conduit and reduced caspase-3 expression in the dorsal root ganglion (DRG). ASC also enhanced GAP-43 and ATF-3 expression in the spinal cord, reduced c-jun expression in the DRG and increased the vascularity of the implant. After transplantation into injured C3-C4 cervical spinal cord, ASC continued to express neurotrophic factors and laminin and stimulated extensive ingrowth of 5HT-positive raphaespinal axons into the trauma zone. In addition, ASC induced sprouting of raphaespinal terminals in C2 contralateral ventral horn and C6 ventral horn on both sides. Transplanted cells also changed the structure and the density of the astroglial scar. Although the transplanted cells had no effect on the density of capillaries around the lesion site, the reactivity of OX42-positive microglial cells was markedly reduced. However, ASC did not enhance recovery of forelimb function. In order to reduce activation of microglia/macrophages and the secondary tissue damage after SCI, the role of microRNA-124 was investigated. In vitro transfection of chitosan/microRNA-124 polyplex particles into rat microglia resulted in the reduction of reactive oxygen species and TNF-α levels and lowered expression of MHC-II. Upon microinjection into uninjured rat spinal cords, particles formed with Cy3-labeled control sequence RNA, were specifically internalized by OX42 positive macrophages and microglia. Alternatively, particles injected in the peritoneum were transported by macrophages to the site of spinal cord injury. Microinjections of chitosan/microRNA-124 particles significantly reduced the number of ED-1 positive macrophages after SCI. In summary, these results show that human MSC produce functional neurotrophic and angiogenic factors, creating a more desirable microenvironment for neural regeneration after spinal cord and peripheral nerve injury. The data also suggests that chitosan/microRNA-124 particles could be potential treatment technique to reduce neuroinflammation.

The toll skeletal muscle injury, resulting in significant muscle mass loss, has on the patient reaches far more than physical and emotional, as the tolls are financial as well. Approximately more than 3 billion dollars is spent on the initial medical costs and on subsequent disability benefits, following a volumetric muscle loss. Skeletal muscle has a robust capacity for self-repair; this propensity for repair is hindered when skeletal muscle loss is larger than 20% of the total mass of the muscle. Previous work in our lab, has shown functional and morphological improvements following the cellular therapy, with mesenchymal stem cells (MSC), as well as with nerve relocation to the extracellular matrix (ECM). To further observe the regenerative properties of the above treatments, a defect weighing approximately 307 ± 3.7 mg wet weight and measuring approximately 1x 1cm² was removed from the lateral gastrocnemius (LGAS) of male Sprague Dawley rats. Additionally, the medial branch of the plantar nerve was then relocated and implanted to the middle of the ECM. Seven days post injury bone-marrow derived mesenchymal stem cells were injected directly into the implant using a PEGylated Fibrin hydrogel (PEG). Following 56 days of recovery, partial functional restoration was observed in the LGAS ECM seeded with MSC and implanted with the plantar nerve. The LGAS produced 86.3 ± 5.8% of the contralateral LGAS, a value that was significantly higher than ECM implantation alone (p <.05). The implanted ECM seeded with MSC and implanted with the plantar nerve showed significant increases in blood vessel density and myofiber content (p <.05). The data suggest that a volumetric injury can be repaired by neurotization of an implanted muscle-derived ECM seeded with MSCs. / text

Hyaluronan is a ubiquitous glycosaminoglycan which is an important constituent of the extracellular matrix (ECM). In addition to organizing the extracellular matrix and regulating tissue homeostasis, hyaluronan, by binding to its main cell surface receptor CD44, is involved in intracellular signaling pathways regulating major cellular processes during development, wound healing, inflammation and cancer. Accumulation of hyaluronan in cancer promotes progression of the disease and correlates with poor prognosis. This thesis focuses on the regulation of hyaluronan synthesis and its signaling in normal and cancer cells. Cancer cells in solid tumors are surrounded by stroma, which has an essential role in the growth and metastasis of tumors. Prominent members of the tumor stroma are fibroblasts, which synthesize ECM components, such as hyaluronan, and secrete growth factors, and activate intracellular signaling pathways. We demonstrate a cross-talk between the receptors for platelet-derived growth factor BB (PDGF-BB), transforming growth factor β (TGFβ) and CD44 in dermal fibroblasts. We found that PDGF-BB can activate the Smad signaling pathway downstream of the TGFβ receptor I (TβRI), and that PDGF-BB-induced migration depends on TβRI. CD44 forms a ternary complex with the receptors for PDGF-BB and TGFβ, and negatively regulates their signaling. Furthermore, we demonstrate that TGFβ stimulation of mammary epithelial cells transcriptionally upregulates hyaluronan synthase 2 (HAS2), which is essential for TGFβ-induced epithelial-mesenchymal transition (EMT); in this process, polarized epithelial cells adapt a mesenchymal phenotype which facilitates migration and invasion. HAS2 protein activity and stability is regulated by posttranslational modifications, including ubiquitination. We investigated the ubiquitination of HAS2 in aggressive breast cancer cells, whose metastasizing capability depends on HAS2-synthesized hyaluronan. We identified two deubiquitinating enzymes, USP4 and USP17, which target HAS2 and affect its activity and stability. In summary, these studies increase the knowledge about the regulation of hyaluronan production and its role in cancer progression.

Le cancer du sein est le cancer le plus fréquent chez la femme et représente un problème de santé publique majeur. L'agressivité des tumeurs mammaires varie notamment en fonction de leurstatut pour le récepteur α des oestrogènes (ERα). Les cancers du sein n'exprimant pas ERα ont unmauvais pronostic, de part leur capacité métastatique plus importante. Cependant, les facteurs sous jacents à cette plus grande agressivité des cancers ERα-négatifs restent mal compris. Il est aujourd'hui admis que la progression tumorale et la dissémination métastatique dépendent, non seulement des propriétés intrinsèques des cellules cancéreuses, mais également des régulations exercées sur ces cellules par le micro environnement tumoral. Les interactions entre les cellules cancéreuses et les cellules présentes au niveau du site tumoral, telles que les cellules leucocytaires,les cellules endothéliales, ainsi que les cellules stromales, sont nécessaires au développement et à l'évolution de la tumeur. Ces interactions sont médiées via la production d'hormones, de cytokines ainsi que de chimiokines. Les cellules stromales mésenchymateuses (MSC) sont de composants essentiels du stroma tumoral. Leur rôle dans la progression des tumeurs reste, pour le moment, très controversé. L'objectif de notre projet a été de comprendre les raisons pour lesquelles les MSC peuvent favoriser ou inhiber le développement tumoral. Nous nous sommes, dans un premier temps,intéressés aux interactions entre les cellules cancéreuses mammaires et les MSC. Nous avons déterminé si le fait que les cellules cancéreuses soit métastatiques ou non modifiait le phénotype des MSC et leur réponse dans les régulations de la croissance tumorale. Nous avons ainsi constaté quel es facteurs sécrétés spécifiquement par les cellules cancéreuses métastatiques ERα-négativesinduisaient la production de certaines chimiokines, dont CXCL5. Ces chimiokines peuvent êtressécrétées par les cellules du microenvironnement mais également par les cellules cancéreuses ellesmêmes.Nous avons donc étudié le rôle de CXCL5 dans l'agressivité des tumeurs mammaires. Nousavons ainsi montré que ces chimiokines induisent, in vitro, une augmentation des propriétésprolifératives, invasives et migratoires des cellules cancéreuses. Cette étude nous à permis demontrer que les chimiokines et les interactions entre les cellules cancéreuses et les MSC pouvaientêtre impliquées dans la progression tumorale ainsi que dans l'agressivité des tumeurs mammaires. / Breast cancer remains in Europe and USA the first cause of death by cancer for women.Breast cancer aggressiveness relies in particular on estrogen receptor α (ERa) status. Breast cancers which do not express ERα are more metastatic and have a poorer prognosis, than ERα-positivetumors. However underlying factors involved in these invasive properties are poorly understood.Today, it is established that tumor progression is regulated by intrinsic cancer cells properties, and byinteractions between cancer cells and surrounding microenvironment. Several evidences suggest thatleukocytes, endothelial cells, fibroblasts and infiltrating cells present in stromal compartment caninteract with tumor cells through the production of hormones, cytokines and chemokines.Mesenchymal stromal cells (MSC) belong also to the stromal compartment. Recent studies havehighlighted their potential role in cancer growth and metastasis. However, the ability of MSC to favor orprevent cancer progression remains controversial. The aim of this work was to understand the roles ofMSC in tumor progression and to explain the differential effects of MSC on cancer cells, depending onthe type of cancer cells involved. First, we were analyzed MSC and cancer cells interactions, anddetermined if metastatic cancer cells could affect MSC phenotypes and its response in terms of tumorgrowth. We observed that metastatic breast cancer cells secreted factors, which could highly enhancethe release by MSC of several chemokines, including CXCL5. CXCL5 can be secreted by stromal cellsbut also by cancer cells themselves. We next showed in vitro that CXCL5 increased proliferative,invasive and migratory properties of breast cancer cells. This study allowed us to demonstrate thatchemokines play a role in the cross-talk between MSC and breast cancer cells, and that they play akey role in tumor proliferation and aggressiveness.

La polarité apico-basolatérale, qui est essentielle pour le maintien de l'architecture tissulaire et pour des fonctions de l'épithelium sain, est fréquemment fragilisée, voire perdue, dans des lésions prénéoplasiques et au cours de la tumorigénèse. Les patients atteints de l'hépatite C chronique ont un risque accru de développer des carcinomes hépatocellulaires. Le contexte inflammatoire et cirrhotique, caractéristique de l'infection chronique par le virus de l'hépatite C (VHC), constitue un facteur de risque important de la tumorigenèse. De plus, le virus exerce des effets directs sur la physiopathologie de la cellule hôte, qui semblent favoriser la transformation oncogénique. Mon travail de thèse a permit de développer et de caractériser un modèle de culture tridimensionnelle qui reproduit la morphologie complexe des hépatocytes pour ensuite étudier l'effet d'une proteine virale, NS5A sur la physiopathologie de cellules hépatiques dans un contexte tridimensionnelle. Des cellules hépatiques, immortalisées ou primaires, s'organisent en organoides polarisés et acquièrent l'expression de marqueurs hépatocytaires matures. L'organisation tridimensionnelle et la polarité des organoides influent sur des voies de signalisation intracellulaires, dont la voie PI3K/Akt, un acteur crucial de la physiologie de la cellule et de sa transformation. Dans notre modèle, l'activation constitutive de la kinase Akt perturbe l'organisation tridimensionnelle des hépatocytes. NS5A, une des protéines du VHC, active la voie PI3K/Akt et interfère avec l'intégrité des organoides. Dans des précurseurs hépatiques primaires, les BMELs l'expression de NS5A conduit à la perte de marqueurs épithéliaux et à l'acquisition de marqueurs mésenchymateux et au phénotype migratoire et invasif. Ces effets de NS5A, qui suggèrent une transition épithelio-mésenchymateuse (TEM), sont additifs à l'action du TGF-β, un inducteur connu de la TEM. / Apico-basolateral polarity is essential to maintain tissue architecture and function of healthy epithelium. It is weakened or lost in preneoplastic lesions and in the course of carcinogenesis. Patients suffering from chronic hepatitis C are at risk for hepatocellular carcinoma. In addition to the necroinflammatory liver microenvironment, which favours tumorigenesis, direct effects of the virus on its host cell physiopathology also participate in the initiation of oncogenic transformation.To study the effects of viral proteins on cellular polarity and function, we developped an in vitro threedimensional (3D) culture model that reproduces complex hepatocyte morphology. Both immortalized cells and primary hepatocyte precursors organise themselves into intricate 3D organoids and acquire markers of mature hepatocytes. Their organisation and polarity impacts on several intracellular signal transduction pathways, including the PI3K/Akt axis, a major actor of physiology and of oncogenic transformation. Interestingly, constitutive Akt signalling perturbs hepatocyte 3D organization.NS5A, an HCV viral protein with pleiotropic activities, is an upstream activator of Akt. NS5A expression interferes with organoid formation and integrity. In primary hepatocyte precursors it leads to downregulation of epithelial and to acquisition of mesenchymal markers, suggesting an induction of epithelial-to-mesenchymal transition (EMT). Moreover, the effects of NS5A are additive to that of TGF-beta, a bona fide EMT inducer relevant to HCV-related pathologies. NS5A is also inducing pro-migratory and invasive phenotypes in BMEL cells as well as the hepatic cell line AML12. The signaling pahways underlying this results might involve Twist factors, well known actors of EMT, as NS5A is capable of their transcriptional regulation.The molecular mechanisms linking viral proteins to alterations of hepatocyte morphology are under investigation. Alterations of cell shape and function are of major interest in the context of virus-induced phenotype, relevant to tumour initiation and progression.

Les affections ostéo-articulaires concernent des millions de personnes. L’ingénierietissulaire osseuse, associant cellules souches mésenchymateuses humaines (CSM) etmatériaux synthétiques, pourrait répondre aux besoins cliniques. Pour cela, les différentescomposantes de cette approche et leur association doivent être mieux étudiées pour la rendreutile cliniquement. Durant cette thèse, une première étude animale proche du cas cliniquenous a permis de définir les points à améliorer pour le traitement des pertes osseuses. Nousavons ainsi pu développer un milieu spécifique induisant une différenciation rapide etterminale des CSM en ostéoblastes. Par la suite, l’utilisation de particules de céramiquescomme support cellulaire nous a permis d’obtenir des hybrides riches en matriceextracellulaire. Cet environnement 3D biomimétique permet l’engagement spontané des CSMvers un phénotype ostéoblastique et l’obtention d’une quantité osseuse importante in vivo.L’ensemble de ces résultats met en évidence l’importance de l’environnement et du stade dedifférenciation cellulaire pour la formation osseuse par ingénierie tissulaire osseuse. / Osteo-articular disorders affect millions of people over the world. Bone tissueengineering, an approach combining human mesenchymal stem cells (MSC) and syntheticmaterials, could potentially fulfill clinical needs. However, the different components of thisapproach and their association should be investigated further to make it clinically useful. Inthis thesis, an initial animal study close to clinical situation allowed us to identify areas thatneed improvement for regenerating bone defect. We were then able to develop a specificmedium which induces a rapid and terminal osteoblastic differentiation of MSC.Subsequently, the use of ceramic particles as cell support has allowed us to obtain hybridmainly composed of extracellular matrix. This biomimetic 3D environment allowsspontaneous osteoblastic commitment of MSC and induces a large bone quantity in vivo.Overall, these results highlight the importance of the environment and the cell differentiationstate for bone formation using bone tissue engineering.

This thesis presents deeper insights into bone applicable biomaterials’ design. Poor affinity of BMP-2 towards scaffolds required supra-physiological dose administration. Though molecules containing sulfate could sustain BMP-2 release, side effects occurred due to BMP-2 supra-dose, or these sulfate-containing biomolecules. Improved affinity between BMP-2 and scaffolds was first witnessed by using an acidic carrier (paper I). Hyaluronic acid (HA) hydrazone derived hydrogels having a pH of 4.5-loaded BMP-2 showed sustained release of bioactive BMP-2 in vitro and enhanced bone formation in vivo, while pH 7 HA hydrogels showed Fickian behavior and less bone formation in vivo. Computational evaluation revealed stronger electrostatic interactions between BMP-2, and HA were predominant at pH 4.5, whereas, weaker Van der Waals interactions played a key role at pH 7. During the pre-bone formation phase, endogenous cell responses to pH 4.5 and 7 with or without BMP-2 were investigated. HA hydrogels exhibited extraordinary biocompatibility and recruitment of neutrophils, monocytes, macrophages and stromal cells regardless of hydrogels’ pH and BMP-2 presence.  The different inflammatory responses to HA hydrogels were observed (Appendix). Thiol derivatives can cleave the disulfide bond of BMP-2 to generate inactive monomeric BMP-2. In paper II, thiol-acrylate chemistry-based HA hydrogels (HA-SH) were compared to hydrazone-based HA hydrogels as BMP-2 carriers. Thiol modified HA disrupted BMP-2 integrity and bioactivity. HA-SH hydrogels with BMP-2 exhibited less bioactive BMP-2 release in vitro and induced less bone formation in vivo. Accumulated evidence has shown great osteogenic potential of lithium ions (Li). In paper III, we coordinated Li onto HA-PVA hydrazone hydrogels (Li-gel); Li-gel enhanced 3D cultured hMSCs osteogenic differentiation and induced higher bone formation in CAM defect model. Instead of BMP-2 protein, delivery of BMP-2-coding-plasmid can produce BMP-2 over a long term at a closer physiological level. Yet, efficient gene delivery reagents are needed. In paper IV, two novel gene delivery nanoplexes were developed by post coating DNA-nanoplexes with chondroitin sulfate (CS). To ensure the stability, aldehyde-modified CS (CS-CHO) reacted with free amines of pDNA/PEI complexes. We provided first evidence that CS-CHO coated nanoplexes controlled the release from endosomes, which is essential for higher transfection efficiency.

Prostate cancer (PCa) cells predominantly metastasize to bone and the complex crosstalk between PCa cells and osteoblasts (bone-forming cells) and osteoclasts (bone-destroying cells) leads to increased tumour growth and worsening of bone disease. Understanding the mechanisms of PCa bone metastasis can identify the aggressive fraction of PCa resulting in earlier intervention. The ability of PCa cells to express bone cell-specific features, termed osteomimicry, could potentially explain the osteotropic nature of PCa cells. The aim of this study was to determine the role of osteomimicry in the regulation of epithelial-mesenchymal transition (EMT) in bone metastatic prostate cancer cells. It was demonstrated that the osteoblast-specific marker alkaline phosphatase (bone/liver/kidney) (ALPL) was overexpressed in bone metastatic (ARCaPM), compared to non-metastatic (ARCaPE), human PCa cells. Knockdown of ALPL resulted in decreased cell viability, increased cell death and a change from mesenchymal to epithelial morphology in ARCaPM and PC3 cells, and increased CDH1 expression along with decreased migration in ARCaPM cells. Treatment with extracellular ATP also resulted in decreased viability, increased expression of epithelial markers (CDH1, KRT14) and decreased expression of mesenchymal markers (VIM, ZEB1), and reduced expression of ALPL in ARCaPM cells. Small RNA-sequencing identified microRNAs differentially expressed between ARCaPE and ARCaPM PCa cell lines: miR-373 expression was lower in ARCaPM compared to ARCaPE cells and its overexpression in ARCaPM cells resulted in a change to epithelial morphology, increased expression of the epithelial marker CDH1 and decreased expression of the mesenchymal markers VIM and ZEB1. Finally, the development of a high-throughput screening method to identify novel microRNA regulators of osteomimicry was described, which identified two microRNAs miR-199a-5p and miR-212 as positive regulators of ALP activity. Taken together, this thesis describes the identification of ALPL and ATP as novel regulators of epithelial-mesenchymal transition in PCa cells and high-throughput ALP-activity screening as a powerful tool to identify novel microRNA regulators of ALP expression.