Introdução: A Organização Mundial da Saúde estimou para o ano de 2008 aproximadamente 1.38 milhões de casos novos de câncer de mama no mundo e 458 mil mortes. A maioria dos casos (56%) e das mortes (64%), ocorrendo em países economicamente desenvolvidos. Apesar dos avanços e do diagnostico precoce, um número significativo de mulheres com tumores da mama operáveis apresentando evolução desfavorável vêm à sucumbir devido ao surgimento de doença metastática. Uma melhor compreensão da heterogeneidade do tumor e das características microambientais subjacentes, bem como dos mecanismos e as consequências das suas interações é essencial para melhorar o direcionamento das terapias existentes e desenvolver novos agentes terapêuticos para o câncer. Objetivos: Descrever as características clínicas, anatomopatológicas e imuno-histoquímicas de um grupo de pacientes com câncer de mama operável, e estudar o impacto destas características no estadiamento da doença, sobrevivência livre de recorrência e sobrevivência global. Além disto, analisar as potenciais correlações existentes entre estas características. Métodos: Estudo de coorte retrospectiva de base hospitalar envolvendo 86 mulheres com câncer primário de mama, submetidas a tratamento entre julho de 1999 e dezembro de 2004, no Serviço de Mastologia do Hospital de Clinicas de Porto Alegre. Dados clinicopatológicos e imuno-histoquimicos (RE, RP, HER2, Ki67 e p53) foram coletados dos registros hospitalares. Expressão do VEGF, MMP-2, MMP-9, TIMP-1 e TIMP-2 foram analisadas através de imuno-histoquimica. Variáveis contínuas foram analisadas pelo coeficiente de correlação de Spearman, ou pelo teste não paramétrico U de Mann-Whitney e H de Kruskal-Wallis, quando comparadas com variáveis categóricas. Variáveis categóricas foram analisadas pelo teste 2 de Pearson. Estimativas da probabilidade de sobrevivência foram obtidas pelo estimador não paramétrico de Kaplan-Meier e pelo semiparamétrico modelo de regressão de Cox. Comparação entre as curvas de sobrevivência foi realizada pelo teste estatístico de log-rank. O IC foi calculado em 95% e valores p< 0,05 foram considerados estatisticamente significativos. Resultados: A sobrevivência livre de recorrência em 5 e 10 anos foi de 82,2% e 68%, e a global foi de 90,2% e 82,9%, respectivamente. Número de linfonodos positivos (p= 0,00; p= 0,03), diâmetro tumoral (p= 0,01; p= 0,01) e estádio (p= 0,00; p= 0,02) são fatores de risco isolado para recorrência e óbito, respectivamente. Superexpressão de HER2 é um fator de risco isolado para recorrência (p= 0,04). Existe uma correlação positiva significativa entre: VEGF e MMP-9 (rs: 0,246; p= 0,023); TIMP-2 e MMP-2 (rs: 0,358; p= 0,001). Também foram encontradas associações significativas entre as variáveis: a) VEGF e receptor de progesterona positivo (p= 0,045); b) TIMP-2 e idade ≥ 50 anos (p= 0,002), e diâmetro ≤ 2,0 cm (p= 0,016); c) TIMP-1 e menarca ≤ 12 anos (p= 0,038); d) Maior diâmetro e alto grau histológico (2: 19,3; p= 0,004), invasão vascular (2: 12,6; p= 0,006), status do linfonodo axilar (2: 8,6; p= 0,035), número de linfonodos metastáticos (2: 7,2; p= 0,028), e recidiva a distancia (2: 4,0; p= 0,046); e) Invasão vascular e status do linfonodo axilar, e número de linfonodos metastáticos, ambos com 2: 24,7; p= 0,000. Conclusões: O número de linfonodos positivos, diâmetro tumoral, e estádio foram identificados como fatores de risco isolado para a ocorrência de recidiva e óbito. A superexpressão de HER2 é fator de risco isolado para a ocorrência de recidiva da doença. Novas pesquisas devem ser realizadas, com padronização de procedimento e um maior número de casos para melhor caracterização da doença. / Background: The World Health Organization estimated approximately 1.38 million new breast cancer cases and 458,000 deaths worldwide for 2008. Most of these (56% of new cases and 64% of deaths) occur in economically developed countries. In Brazil, approximately 52,000 new cases are predicted for 2013. Better understand the heterogeneity of the tumor and microenvironmental characteristics around you, as well as the mechanisms and consequences of their interactions is essential to improve the targeting of existing therapies and develop new therapeutic agents for cancer. Objectives: The aim of this study was to describe the clinical, anatomopathological and immunohistochemical characteristics of a group of patients with operable breast cancer, and investigate the impact of these characteristics on disease staging, disease-free survival and overall survival. In addition, the potential correlations between these characteristics were analyzed. Methods: This is a hospital-based retrospective cohort study of 86 women with primary breast cancer, subjected to surgical and adjuvant treatment between July 1999 and December 2004. Clinicopathological and immunohistochemical (ER, PR, HER2, Ki67 e p53) data were collected from hospital records. The expression of VEGF, MMP-2, MMP-9, TIMP-1 and TIMP-2 was analyzed using the immunohistochemical technique. Continuous variables were assessed with Spearman’s rank correlation coefficient, or the non-parametric Mann-Whitney U or Kruskal-Wallis H tests. Pearson’s 2 test was employed to asses categorical variables. The possibility of survival was estimated using the non-parametric Kaplan-Meier estimator and the semiparametric Cox regression model. Survival curves were compared using the statistical log-rank test. CI was calculated at 95% and p values <0.05 were considered statistically significant. Results: Disease-free survival at 5 and 10 years was 82.2% and 68%, and overall survival 90.2% and 82.9%, respectively. Number of positive lymph nodes (p= 0.00; p= 0.03), tumor diameter (p= 0.01; p= 0.01) and stage (p= 0.00; p= 0.02) were isolated risk factors for relapse and death, respectively. HER2 overexpression was an isolated risk factor for relapse (p= 0.04). There was a significant positive correlation between: VEGF and MMP-9 (rs: 0.246; p= 0.023) and TIMP-2 and MMP-2 (rs: 0.358; p= 0.001). Significant associations were also recorded between the following variables: a) VEGF and progesterone receptor-positive status (p= 0.045); TIMP-2 and age ≥ 50 years (p= 0.002) and diameter ≤ 2.0 cm (p= 0.016); c) TIMP-1 and menarche ≤ 12 years (p= 0.038); d) greater diameter and high histologic grade (2: 19.3; p= 0.004), vascular invasion (2: 12.6; p= 0.006), axillary lymph node status (2: 8.6; p= 0.035), number of metastatic lymph nodes (2: 7.2; p= 0.028) and distant relapse (2: 4.0; p= 0.046); e) vascular invasion and axillary lymph node status and number of metastatic lymph nodes, both with 2: 24.7 and p= 0.000. Conclusion: Number of positive lymph nodes, tumor diameter, and stage were identified as isolated risk factors for relapse and death. HER2 overexpression is an isolated risk factor for the occurrence of relapse. Further studies are needed, with standardization of the procedure and a larger number of cases, for better characterization of the disease.

O câncer de ovário é uma neoplasia ginecológica e alternâncias hormonais poderiam ter um papel na manifestação da doença. As ADAMTS´s são proteases secretadas dependentes de Zn2+/Ca2+. Nosso objetivo foi avaliar se há Influência de hormônios sexuais nos níveis de expressão de mRNA, proteínas e distribuição de ADAMTS 1 e 4 e alteração na migração e invasão em células tumorais humanas de ovário. As linhagens foram tratadas com progesterona, estrógeno ou testosterona e o controle não recebeu tratamento. O estrógeno e a testosterona induziram uma menor e a progesterona uma maior expressão gênica de ADAMTS 1 e 4 em relação ao controle para a linhagem ES-2. A progesterona foi capaz de induzir aumento nos níveis proteicos de ADAMTS 1 e 4 no lisado de ambas as linhagens. A progesterona diminuiu a capacidade migratória e de invasão das linhagens. Observamos na imunofluorescência ADAMTS 1 no núcleo das células. Concluímos que a progesterona regula a expressão das ADAMTS 1 e 4, e reduz a invasão e migração de células derivadas de câncer de ovário. / Ovarian carcinoma is the leading cause of gynecological neoplastic death, being associated primarily with deregulation of sex hormones. ADAMTS are secreted proteases. Our aim is to assess whether sex hormones would affect ADAMTS1 and 4 expressions in ovarian cancer cells. Estrogen and testosterone induced a decrease on gene expression of ADAMTS 1 and 4 compared to the control for the ES-2 cell line, while progesterone led to an increase in the mRNA levels of these same proteases. Progesterone increases ADAMTS\'s protein levels in the lysate and in conditioned medium from NIH-OVCAR-3 and in the lysate from ES-2 cells. Immunofluorescence showed ADAMTS 1 located at the cell nucleus. NIH-OVCAR-3 cells treated with progesterone exhibited decrease migratory activity compared to control and ES-2 exhibited decrease invasion activity. We conclude that progesterone modulates ADAMTS1 and 4 levels in ovarian cancer cell lines and decrease migratory and invasion behavior in ovarian cancer cells.

Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Durante o tratamento ortodôntico, a resposta inicial dos tecidos periodontais ao estímulo mecânico envolve várias alterações estruturais e bioquímicas que permitem a movimentação do dente. As metaloproteinases da matriz (MMPs) parecem desempenhar um papel importante na manutenção da integridade funcional da matriz extracelular periodontal. O objetivo do presente estudo foi avaliar, em diferentes intervalos de tempo, os níveis de metaloproteinases da matriz -1, -2, -3, -7, -8, -12 e -13 no fluido gengival (FG) de caninos superiores submetidos ao movimento de distalização e testar a hipótese de possíveis alterações nos níveis destas MMPs com o emprego de forças ortodônticas. Amostras de FG foram obtidas de dezesseis pacientes ortodônticos saudáveis (nove do sexo masculino e sete do sexo feminino, com idades entre 13 e 27 anos, média de idade 17,7 anos) que possuíam indicação de exodontias dos primeiros pré-molares superiores e tiveram os caninos distalizados como parte da terapia ortodôntica. Um dos caninos superiores foi distalizado ortodonticamente, sendo considerado dente teste. O canino contralateral não foi submetido a nenhuma força, no entanto foi incluído na aparatologia ortodôntica e utilizado como controle. A coleta de FG foi realizada nos sítios mesial (tensão) e distal (pressão) dos dentes testes e controles 7 dias antes da montagem da aparatologia ortodôntica, imediatamennte após a aplicação da força ortodôntica, e após 1 h, 24 h, e 7, 14 e 21 dias, respectivamente denominados -7d, 0h, 1h, 24h, 7d, 14d e 21d. A arcada superior de cada paciente foi dividida em um lado teste e um lado controle. Os resultados mostraram que foram encontradas diferenças significativas no volume do FG apenas nos intervalos de tempo entre -7d e 0h nos lados controle-pressão (CP), teste-tensão (TT) e teste-pressão (TP). Em TP foi observado ainda aumento do volume entre os tempos 0h e 14d. Foi possível detectar no FG as MMPs estudadas nos lados controle/teste e lados pressão/tensão, em todos os intervalos de tempo. As flutuações dos níveis das MMPs apresentaram poucas alterações significativas nos diferentes intervalos de tempo, nos lados controle/teste e lados pressão/ tensão. As diferenças intergrupos (TT, TP, CT e CP) em cada tempo não mostraram resultados significativos assim como as comparações entre os lados pressão e tensão para cada tempo individualmente. Os níveis de expressão da MMP-8 foram muito superiores aos das outras MMPs avaliadas, porém sem diferenças signficativas entre os lados teste e controle. / During orthodontic treatment, the initial response of periodontal tissues to mechanical stress involves several structural and biochemical changes that allow the tooth movement. The matrix metalloproteinases (MMPs) seem to play an important role in maintaining the functional integrity of periodontal extracellular matrix. The aim of this study was to evaluate, in different periods, the levels of matrix metalloproteinases -1, -2, -3, -7, -8, -12 and -13 in gingival crevicular fluid (GCF) of the superior caninessubmitted to distalization movement and test the hypothesis of possible changes in these MMPs levels with the use of orthodontic forces. GCF samples were obtained from sixteen healthy orthodontic patients (nine males and seven females with ages ranging between 13 and 27 years, mean age 17.7 years) who had indication of first superior bicuspids extraction with cuspids distalization as part of orthodontic treatment. One maxillary canine was subjected to a distalizing force, and considered as the test tooth. The contralateral canine, which was not subjected to any force but was included in an orthodontic appliance, was used as a control. GCF sampling was performed at both mesial (tension) and distal (pressure) sites of the controls and tests teeth 7 days before applying the orthodontic appliance, immediately before applying the orthodontic force, and after 1 h, 24 h, and 7, 14 and 21 days, respectively called -7d, 0h, 1h, 24h, 7d, 14d and 21 d. The results showed significant differences in the GCF volume only in time intervals of 0h-7d on control-pressure (CP), test-tension (TT) and test-pressure (TP) sides. In TP side was observed an increase in volume between the time 0h and 14d. It was possible to detect in GCF all MMPs studied on control/test sides and pressure/tension sides at all periods. Fluctuations in levels of MMPs showed few significant changes in different periods on the sides control/test and pressure/tension. The differences between the groups (TT, TP, CT and CP) in each time showed no significant results as well as the comparisons between pressure and tension sides for each period individually. The expression levels of MMP-8 were much higher than those of other MMPs evaluated, but with no significant differences between sides test and control.

O câncer de mama é no Brasil o segundo maior causador de morte entre mulheres. Os hormônios sexuais estão dentre os vários fatores indutores ou promotores da carcinogênese. ADAMTS (uma desintegrina e metaloproteinase com domínios trombospondina) é uma enzima Zn2+/Ca2+dependente. Avaliamos a influência dos hormônios na expressão e localização da ADAMTS-1 em 3 linhagens de mama. qPCR demonstrou que a progesterona estimulou o aumento de mRNA de ADAMTS-1 na MCF-10A e na MDA-MB-231, o tratamento com estrógeno e progesterona estimulou a diminuição. No Western blot observamos nas linhagens MCF-10A e MCF-7 que os hormônios tendem a aumentar os níveis de ADAMTS-1, e o estrógeno estimulou uma acentuada secreção em MCF-7. Na linhagem MDA-MB-231, os tratamentos demonstraram uma tendência a diminuir os níveis de ADAMTS-1 intracelular. Na imunofluorescência e Western blot observamos a predominância de ADAMTS-1 nuclear. Os resultados sugerem que os hormônios regulam a expressão de ADAMTS-1 nas células normais e tumorais, e que está predominantemente presente no núcleo celular. / Breast cancer is the second largest cause of death among women in Brazil. Sex hormones are one of the several inducers factors or cancer promoters. ADAMTS (a disintegrin and metaloproteinase with thrombospondin motifs) are dependent on Zn2+/Ca2+ enzymes. We evaluated influence of hormones on ADAMTS-1 levels and localization in three different breast cell lines. qPCR showed that progesterone stimulated an increase of ADAMTS-1 mRNA in MCF-10A, however, in MDA-MB-231, the treatment by estrogen and progesterone decreased levels. Western blot analysis showed a tendency to increased ADAMTS-1 levels in MCF-10A and MCF-7 due to the hormone treatment. Treatment by estrogen led to a marked secretion in MCF-7. In MDA-MB-231 the treatment showed a tendency to decreased intracellular ADAMTS-1 protein levels. Immunofluorescence and Western Blot we observed ADAMTS-1 predominant in the nucleus. Results suggest that sex hormones regulate the ADAMTS-1 expression in normal and tumoral breast cells, ADAMTS-1 is predominant in the cellular nucleus.

Tumor necrosis factor (TNF) is upregulated in a number of cardiomyopathies. This thesis investigates TNF in triggering the expression and activation of matrix metalloproteinases (MMPs) in pressure overload cardiac disease, and explores the role of superoxide. Cardiac pressure overload was generated in adult wild-type and TNF-/- mice by transverse aortic constriction. Isolated cardiomyocytes and cardiofibroblasts from neonatal mice ventricles were treated with recombinant TNF (rTNF), and MMP induction and activation were assessed, with and without apocynin (a NADPH-oxidase inhibitor). TNF-/- mice showed less superoxide production and MMP activation, compared to wild-type mice, following pressure overload. rTNF upregulated the production of NADPH-dependent superoxide in cardiomyocytes as early as 1 hour (24 hours in cardiofibroblasts). rTNF also increased the expression of MMP-9 and MMP-12 in cardiomyocytes more than in cardiofibroblasts, and MMP-8 and MMP-13 more in cardiofibroblasts. This induction in both cardiac cell types was concomitant with superoxide production.

Sex steroids are inevitable in women. However, long-term exposure to sex steroids increases the risk of breast cancer. A complete understanding of sex steroid control of the breast and how it relates to breast cancer risk is still lacking. Angiogenesis and proteolytic enzyme activity are crucial for the process by which tumors evolve into a vascularized, invasive phenotype. Matrix metalloproteinases are potent matrixdegrading enzymes that affect several steps in tumor progression including angiogenesis. In the female reproductive organs, sex steroids regulate angiogenesis and MMP activity, yet little is known how sex steroids affect these crucial events in normal and malignant breast tissue. This thesis elucidates a link between sex steroids, MMP activity, and angiogenesis. It is shown that estradiol down-regulates while tamoxifen up-regulates the protein expression and activity of MMP-2 and MMP-9 in human breast cancer cells in vitro and in human breast cancer xenografts in vivo. The results further suggest that a biological consequence of this regulation may be modulation of tumor angiogenesis. The net effect of adding tamoxifen to estradiol treatment was an increase in extracellular levels of the endogenous angiogenesis inhibitor endostatin and decreased levels of the tumor promoter TGF-β1 compared to estradiol treatment only. This was accompanied by reduced vasculature and decreased tumor growth. Similarly, a regulatory effect of estradiol and tamoxifen on endostatin generation was observed in normal human breast tissue by whole-tissue culture and microdialysis in human breast tissue in situ. In conclusion, the results presented in this thesis suggest previously unknown mechanisms of action of estradiol and tamoxifen in breast cancer and in normal human breast tissue, and novel means by which estradiol may tip the scale to favor angiogenesis. This knowledge may be important for the understanding of sex steroid dependent breast carcinogenesis and in the future development of tissue-specific preventive as well as therapeutic strategies against breast cancer.

The role of matrix metalloproteinase (MMP)-9 and processing conditions of biodegradable polymer scaffolds has been investigated to optimize engineering vascular constructs. For a small diameter vascular construct, uniform 10 mm thickness of highly porous scaffolds were developed using a computer-controlled knife coater and exploiting phase transition properties of salts. The comparative study of fast vs. slow degrading three-dimensional scaffolds using a fast degrading poly D, L-lactic-glycolic acid co-polymer (PLGA) and a slow degrading poly e-caprolactone (PCL) indicated that fast degradation negatively affects cell viability and migration into the scaffold in vitro and in vivo, which is likely due to the fast polymer degradation mediated acidification of the local environment. MMP-9 was crucial for collagen remodeling process by smooth muscle cells (SMC). MMP-9 deficiency dramatically decreased inflammatory cell invasion as well as capillary formation within the scaffolds implanted in vivo. This study reports that the angiogenic response developed within the scaffolds in vivo was related to the presence of inflammatory response. Combinatorial polymer libraries fabricated from blended PLGA and PCL and processed at gradient annealing temperatures were utilized to investigate polymeric interactions with SMC. Surface roughness was also found to correlate with SMC adhesion. SMC aggregation, proliferation, and protein production, were highest in regions that exhibited increased surface roughness, reduced hardness, and decreased crystallinity of the PCL-rich phases. This study revealed a previously unknown processing temperature and blending compositions for two well-known polymers, which optimized SMC interactions.

Matrix metalloproteinases (MMPs) network with other biological molecules to maintain the extracellular matrix (ECM) in normal physiology and perform different roles. Understanding and assigning specific role to each of 24 members of these endoproteinases is impeded because of lack of specific and efficient detection methods in biological samples. Moreover, MMP-based anti-cancer drug development has also been challenged because, currently, there is no robust methodology to distinguish the inactive pro-enzymes, active enzymes or those complexed with endogenous inhibitors in biological specimens. The objective of this project is to develop a chemical proteomics strategy based on Matrix assisted laser desorption ionization tandem mass spectrometry (MALDI-MS/MS) to help identify and discriminate the various MMP forms. Firstly, a triazine dye-based ligand immobilized on chromatography beads was utilized to assess whether it binds to recombinant human MMPs (rhMMPs). The results highlighted that the ligand interacts with latent forms of MMPs in agreement with the literature. Secondly, the potential of the ligand was assessed using MALDI-MS/MS based methodology in in vitro cancer models. Cell line culture supernatants were used in amounts to emulate the availability of tumour biopsies in clinical settings. The MS/MS spectral peaks specific to MMPs (MMP-2 and MMP- 14), and two endogenous inhibitors TIMP-1 and TIMP-2 were found in affinity chromatography eluates of cell culture supernatants with higher Mascot scores for the latter. While western blot detected MMP-2 in cell extracts, MALDI-MS/MS did not detect MMPs because of amounts below the limit of detection (LOD) of the instrument. Although the ligand was found to be interacting with MMPs and detergent-free salt elution buffers improved MALDI analysis, recovery of MMPs from biological samples was sub-optimal. The dye ligand was observed to bind other enzymes and despite various strategies to reduce non-specific binding of proteins or enable selective elution did not improve MMP enrichment. Further work using methodology described in this study is required after scaling up the MMP amounts in biological specimen and to resolve the issue of non-specific binding of proteins to the ligand by understanding its structure.

In this work, a new polyurethane (PU) chain extender was developed to incorporate a Glycine-Leucine (Gly-Leu) dipeptide, the cleavage site of several matrix metalloproteinases. PUs were synthesized with either the Gly-Leu-based chain extender (Gly-Leu PU) or a phenylalanine-based chain extender (Phe PU). Both PUs had high molecular weight averages (Mw > 125,000 g/mol) and were phase segregated, semi-crystalline polymers (Tm ~ 42°C) with a low soft segment glass transition temperature (Tg < -50°C). Uniaxial tensile testing of PU films revealed that the polymers could withstand high ultimate tensile strengths (~ 8-13 MPa) and were flexible with breaking strains of ~ 870-910% but the two PUs exhibited a significant difference in mechanical properties. The Phe and Gly-Leu PUs were electrospun into porous scaffolds for degradation and cell-based studies. Fibrous Phe and Gly-Leu PU scaffolds were formed with randomly organized fibers and an average fiber diameter of approximately 3.6 µm. In addition, the Phe PU was electrospun into scaffolds of varying architecture to investigate how fiber alignment affects the orientation response of cardiac cells. To achieve this, the Phe PU was electrospun into aligned and unaligned scaffolds and the physical, thermal, and mechanical properties of the scaffolds were investigated. The degradation of the Phe and Gly-Leu PU scaffolds was investigated in the presence of active MMP-1, active MMP-9, and a buffer solution over 28 days to test MMP-mediated and passive hydrolysis of the PUs. Mass loss and structural assessment suggested that neither PU experienced significant hydrolysis to observe degradation over the course of the experiment. In cell-based studies, Phe and Gly-Leu PU scaffolds successfully supported a high density of viable and adherent mouse embryonic fibroblasts (MEFs) out to at least 28 days. Culturing murine embryonic stem cell-derived cardiomyocytes (mESCDCs) alone and with MEFs on aligned and unaligned Phe PU scaffolds revealed both architectures supported adherent and functionally contractile cells. Importantly, fiber alignment and coculture with MEFs improved the organization and differentiation of mESCDCs suggesting these two parameters are important for developing engineered myocardial constructs using mESCDCs and PU scaffolds.

No description available.