Glioblastoma multiform (GBM) is an aggressive primary brain tumour. Despite treatment advances in recent years, outcomes remain poor. Disease progression tends to occur adjacent to the original tumour or surgical resection bed, usually within the radiotherapy planning field. This local recurrence and progression is believed to be the result of invasive disease in the surrounding tissue at the time of diagnosis and treatment, which is not currently detectable by conventional non-invasive methods. A number of novel therapies are currently under development which target specific aspects of the tumour behaviour, to try and improve outcomes from this devastating disease. Imaging biomarkers are under development, therefore, in order to provide a non-invasive assessment of tumour extent and behaviour, to provide bespoke image-guided therapies, and detect recurrence or treatment failure at the earliest opportunity. These are also of value in the context of novel therapeutics, which may have a very specific affect on an aspect of tumour behaviour that is not readily apparent on standard clinical imaging. Key to the progression of GBM is the invasion into surrounding white matter. This is followed by a period of tumour growth and subsequent angiogenesis in which microvasculature is produce that is distinct from the highly regulated blood-brain barrier. This thesis covers the development of suite of advanced magnetic resonance imaging (MRI) techniques aimed at characterising those very traits of GBM responsible for the aggressiveness and treatment resistance. Repeatability studies are undertaken to determine the performance of the biomarkers in healthy tissues, and also in a range of gliomas. Dynamic Contrast Enhanced (DCE-) and dynamic susceptibility-enhanced (DSC-)MRI are used to provide estimates of perfusion and permeability in the tumour. In order to address the reasons behind preferential invasion of the corpus callosum, they are used in conjunction with ASL to non-invasively map perfusion territories and watershed regions in the brain through perfusion timing parameters. Diffusion Tensor Imaging (DTI) and quantitative magnetisation transfer (qMT) are used to provide complementary information about white matter integrity, in order to identify changes occurring with glioma invasion as early as possible and direct image-guided treatments at presentation. Their complementary nature is assessed by comparing the two parameters simultaneously in white matter. Additionally, one of the qMT parameters which may be related to tissue pH is shown to be sensitive and specific for the detection of high-grade tumour tissue. Finally, a novel multiparametric imaging biomarker is introduced. Tumour surface mapping assesses the boundary between the solid tumour and surrounding tissue in order to identify areas of potential aggressiveness and invasion. Multiple imaging parameters can be combined to improve specificity and sensitivity. Using the diffusion-weighted imaging parameter, mean diffusivity (MD - also referred to as the apparent diffusion coefficient (ADC)), it is shown to be predictive of clinical outcome in a retrospective and prospective study, while a multiparametric example is given indicating the utility as a predicative biomarker for regions of progression and recurrence, and as potential spatial discriminator for image-guided therapies.

No description available.

Glioblastoma multiforme (GBM) is a destructive brain cancer that results in death 12 to 15 months after diagnosis. The purpose of this retrospective study was to determine if variations in tumor size at diagnosis, treatment options, and survival rate occur in GBM patients living in urban and rural areas of the United States. Using the behavior model of health services as the theoretical framework, this study used secondary data sets of GBM cases reported from 1988 to 2011 from the Surveillance, Epidemiology, and End Results program. Tumor size was measured in millimeters; treatment was evaluated by ascertaining the number of GBM patients who had surgical resection of their tumors, radiation, and chemotherapy; and survival rate was evaluated using Cox Regression analysis. With a sample size of 33,202 cases, data were examined using descriptive and multivariable analyses with SPSS. Results showed statistically significant differences in tumor size at diagnosis in rural patients compared to urban patients (p = 0.0085; p = 0.018), more urban patients were treated with radiation compared to rural patients (p < 0.001), and rural patients had poorer survival rates than urban patients (p < 0.001). Finally, when controlling for region, race, age, gender, education, and income, longer survival time was associated with urban status, female cases, and higher family income (p < 0.0001), and greater age was associated with reduced survival time (p < 0.0001). Study results could promote positive social change by identifying predictive variables associated with health outcomes of GBM patients. It may also educate providers on the risk of rurality of patients diagnosed with GBM, and inform lawmakers responsible for the creation of healthcare policy and the equitable allocation of healthcare resources.

No description available.

O desenvolvimento de nanocarreadores a base de albumina são considerados biocompatíveis e biodegradáveis, e tem sido extensivamente estudada com objetivo de novas alternativas de tratamento para inúmeras doenças. A característica mais relevante reside no fato de que estes sistemas proteicos serem capazes de atravessar a barreira Hematoencefálica (BHE) e atingir as células-alvo, a partir de sinalizações por canais específicos na barreira cerebral. Por serem proteínas com ligações covalentes, pode-se afirmar que o processo de clivagem proteolítica tende a ser realizado pelas enzimas pertencente à família das proteases. Dada à importância desses sistemas de entrega de fármacos (DDS) e sua eficaz permeação através da BHE, propôs-se um desenvolvimento científico multidisciplinar combinando-se protocolos, técnicas e ensaios experimentais das áreas de tecnologia farmacêutica, nanotecnologia e química para realização da incorporação do fotoativo ou outros compostos, como a ftalocianina de cloro alumínio (AlClPc ou Pc) livre e/ou pré encapsuladas e as nanopartículas magnéticas, nestes sistemas de DDS conhecidos como nanopartícula de albumina (NpA). Dentre as técnicas usadas nestes estudos destaca-se tanto o método de cross-linking térmico (via Térmica) quanto o químico (via Química), sendo que no segundo, foram utilizados 2 reagentes distintos, o glutaraldeído e o gliceraldeído, os quais foram analisados e comparados neste projeto de pesquisa. Análises de Microscopia Eletrônica de Varredura (MEV), Microscopia de Força Atômica (MFA), medidas de estabilidade por ZetaSizer demonstraram claramente que as nanopartículas preparadas pelos diferentes reagentes possuíam formato esféricos, diâmetro médio em torno de 200 nm e eram homogêneas, entretanto, apenas os nanocarreadores preparados com GU apresentaram elevada repulsão eletrostática (prevenindo a agregação das mesmas). Após caracterização, os estudos foram baseados na utilização da AlClPc como fotoativo aplicado a terapia fotodinâmica (TFD) para o tratamento in vitro das doenças que acometem o sistema nervoso central (SNC). / The development of albumin-based nanocarriers, which are nontoxic and biocompatible and biodegradable, have been extensively studied for seeking new alternatives of the treatment for numerous diseases. The most relevant characteristic is that these protein-based systems could across the blood-brain barrier (BBB) and selectively achieve the target cells within of the brain. These nanocarriers are proteins-based and have covalent bonds, and consequently it can be digested by a class of enzymes belonging to the protease family, which rapidly degrade the protein-based nanoparticles through of the proteolytic cleavage process. Given the importance of these drug delivery systems (DDS) and their effective permeation through BBB, it was proposed a multidisciplinary scientific development combining protocols, techniques and experimental tests of the areas of pharmaceutical technology, nanotechnology and chemistry to carry out the incorporation of the photoactive or another compound, as aluminum chlorine phthalocyanine (AlClPc or Pc), free and/or pre-encapsulated or magnetic nanoparticles in these albumin-based DDS systems known as albumin nanoparticles (NpA). Among the techniques used in these studies we highlight by thermal cross-linking method (via Thermal) and chemistry (via Chemistry), in this second, it was used 2 reagents, glutaraldehyde and glyceraldehyde, that were analyzed and compared in this research project. From Scanning Electron Microscopy, Atomic Force Microcopy, Zeta potential measurements, we have clearly shown that the elaborated nanoparticles (NPs) have a smaller size with a spherical shape and are more homogeneous, however only the nanoparticles prepared with glutaraldehyde showed greater electronic repulsion (preventing their aggregation). After the characterization, the studies were based on the use of AlClPc as a photoactive applied in the photodynamic therapy (PDT) for the treatment of central nervous system (CNS) diseases.

Submitted by Cleide Dantas (cleidedantas@ufpa.br) on 2014-07-01T12:18:37Z No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Tese_AtividadeAnitiproliferativaAntineoplasica.pdf: 5441260 bytes, checksum: 14e10e679631c83ea061a6d32c8472ca (MD5) / Approved for entry into archive by Ana Rosa Silva (arosa@ufpa.br) on 2014-07-30T11:57:44Z (GMT) No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Tese_AtividadeAnitiproliferativaAntineoplasica.pdf: 5441260 bytes, checksum: 14e10e679631c83ea061a6d32c8472ca (MD5) / Made available in DSpace on 2014-07-30T11:57:44Z (GMT). No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Tese_AtividadeAnitiproliferativaAntineoplasica.pdf: 5441260 bytes, checksum: 14e10e679631c83ea061a6d32c8472ca (MD5) Previous issue date: 2013 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / FAPESPA - Fundação Amazônia de Amparo a Estudos e Pesquisas / Dentre os tumores que acometem o sistema nervoso, o glioblastoma multiforme (GBM), destaca-se por seu alto grau de agressividade e baixo prognóstico, apresentando em média uma sobrevida de 15 meses a partir do diagnóstico. O presente estudo objetivou investigar a atividade antiproliferativa e antineoplásica de quatro flavonoides isolados da espécie Brosimum acutifolium (Huber), duas flavanas: 4’-hidroxi-7,8-(2”,2”-dimetilpirano) flavana (BAS-1) e 7,4’-dihidroxi-8,(3,3-dimetilalil)-flavana, (BAS-4); e duas chalconas: 4,2’-dihidroxi-3’,4’-(2”,2”-dimetilpirano)-chalcona (BAS-6) e 4,2’,4’-trihidroxi-3’-(3,3-dimetilalil)-chalcona (BAS-7), em glioblastoma C6 de rato in vitro. Nossos resultados mostraram boa atividade citotóxica para as flavanas (BAS-1, -4) e para a chalcona BAS-7, com IC50 menor que 100 μM em teste de viabilidade pelo MTT, já a chalcona BAS-6, não demonstrou atividade citotóxica nas concentrações testadas. Estes flavonoides mostram ser menos citotóxico para célula não neoplásica (glia), com grau de segurança maior para a BAS-4 e BAS-7, uma vez que apresentaram menor efeito citotóxico à célula não neoplásica e menores índices hemolíticos. A análise de migração celular mostrou que o tratamento com BAS-1, BAS-4 e BAS-7 em baixas concentrações foi efetivo em promover inibição da migração celular. Estes três flavonoides também foram muito promissores em inibir a formação e o crescimento de colônia, além de promover parada no ciclo celular, com substancial aumento na população SubG0 para o tratamento com BAS-1 e BAS-4 com 100 μM. As flavanas BAS-1 e BAS-4 também mostraram maior capacidade de promover a perda na integridade do potencial de membrana mitocondrial (ΔΨm) e aumento para marcação com anexina V, indicativo de que estas drogas promovem morte por apoptose. No entanto a análise por microscopia eletrônica demonstrou marcantemente no tratamento com a BAS-4 a presença de vacúolos autofágicos, sugestivo que o processo de morte neste tratamento ocorre tanto por apoptose quanto autofagia. Com base nestes resultados pode-se concluir que dos flavonoides testados a BAS-1, BAS-4 e BAS-7 possuem potencial como agente antineoplásico na terapia do GBM, sendo a BAS-4 a mais promissora de todas. / Among the tumors that affect the nervous system, glioblastoma multiforme (GBM) is notable by its high degree of aggressiveness and poor prognosis, with an average survival of 15 months from diagnosis. The present study aimed to investigate the antiproliferative and antineoplastic activity of four flavonoids isolated from species Brosimum acutifolium (Huber). two flavans: 4'-hydroxy-7,8-(2",2"-dimethylpyran)-flavan (BAS-1) and 7,4'-dihydroxy-8-(3,3-dimethylallyl)-flavan (BAS-4), and two chalcones: 4,2'-dihydroxy-3',4'-(2",2"-dimetilpirano)-chalcone (BAS-6) and 4,2',4'-trihydroxy-3'-(3,3-dimethylallyl)-chalcone (BAS-7), tested on rat C6 glioblastoma in vitro. Our results showed good cytotoxic activity for flavans (BAS-1, -4) and the chalcone BAS-7, with IC50 less than 100 μM in the MTT viability test, since the chalcone BAS-6, showed no cytotoxicity at the concentrations tested. These flavonoids showed less cytotoxity for non-neoplastic cell (glia), with higher degree of security for the BAS and BAS-4-7, once showed lower cytotoxic effect on non-neoplastic cell, and less hemolytic. Analysis of cell migration showed that treatment with BAS-1; -4 and -7 at low concentrations was effective in promoting the inhibition of cell migration. These three flavonoids were also very promising in inhibiting colony formation and growth, and promote cell cycle arrest with a substantial increase in population SubG0 for treatment with BAS-1 and -4 with 100 μM. The flavans BAS-1 and -4 also showed increased ability to promote losing in the integrity of the mitochondrial membrane potential (ΔΨm) and increased for staining with Annexin V, indicating that these drugs cause death by apoptosis. However the analysis by electron microscopy showed markedly the presence of autophagic vacuoles in the treatment with BAS-4 suggesting that the process of cell death occurs by apoptosis as well as autophagy. Based on these results it can be concluded that the flavonoids BAS-1, -4, and -7 have potential as an anticancer agent in the therapy of GBM and BAS-4 is the most promising of all.

L'œuvre de Shakespeare - et plus particulièrement les histoires et les tragédies - dont les proportions sont si vastes mais qui est si humaine, semble confirmer la conception pythagoricienne que « tout est nombre ». l'histoire du nombre, en effet, qui comprend l'innombrable, s'absorbe dans l'oeuvre théâtrale de Shakespeare. Elle tend à faire du nombre, du multiple, du multiforme et de leur présence tantôt discrète, tantôt ostentatoire, une histoire. L'histoire synchrone du nombre et de l'innombrable et inversement, celle du nombre et de l'innombrable en tant qu'histoire dans l'oeuvre de Shakespeare sont deux faits coïncidents. Dans le théâtre de Shakespeare, le nombre pullule : nombre de vers, nombre de corrections, d'augmentations, nombre d'auteurs, succession des règnes, des rois et des reines, foule innombrable…... La profusion de mots, de procédés qui se rapportent au nombre est imposante. Vertige de la liste. Le nombre est innombrable. Le nombre crée un modèle mais il existe une tension entre ce modèle et les irrégularités qui en sont l'avatar. Le vers de Shakespeare révèle l'existence de forces qui travaillent à la reproduction d'un schéma tout en valorisant et en intégrant l'irrégularité. Les mouvements désordonnés d'une foule, de la multitude qui s'émeut, qui s'enthousiasme ou qui se soulève sont canalisés par le pouvoir. le versant sombre de cette étude concerne l'appareil répressif et les relations qu'il entretient avec le spectacle. Il montre que le nombre et l'innombrable sont aussi le paradigme de l'inhumain. Hors du nombre, sans nombre, prémisses de l'innombrable, se situe l'oeuvre de Shakespeare, celle de « l'homme innombrable ». Les sciences ont pénétré l'univers de Shakespeare, qui subit, semble-t-il, l'influence des « mondes innombrables » de la cosmologie brunienne. L'innombrable est l'essence même du nombre, au confluent du démotique et de l'ésotérique. la conception d'une mystique du nombre, toutefois, ne peut être aisément raccordée à celle du génie populaire au caractère universel de Shakespeare. En raison de la coïncidence des contraires, de l'extraordinaire saisie du passé, du présent et de l'avenir, l'oeuvre se prête admirablement au jeu du dessaisissement, du désoeuvrement. / With its vast but so human proportions, Shakespeare’s theatre seems to confirm the Pythagorean conception that “all is number”. Indeed, the history of number, which combines with the multiple, the multiform and the innumerable, has been absorbed into Shakespeare’s theatre. It is apt to transform the presence of numbers, which are sometimes unobtrusive sometimes ostentatious, into a story. The synchronous history of number and the innumerable, and conversely number and the innumerable as story meet in Shakespeare’s works. Numbers abound, namely the number of lines, the number of authors, the succession of reigns, of kings and queens and infinite numbers of people… The profusion of words and devices that are related to number is imposing. Lists are dizzying. Numbers are innumerable. Number shapes patterns but there may be tension between this pattern and the irregularities that are their final manifestation. The unruly movements of the crowd, of the multitude, that is easily moved, that is enthusiastic or may rebel, are channeled by the established power. The dark side of this study concerns the repressive state apparatus and the relationship with the theatre. This study shows that the inhuman is also no doubt inherent in the very notion of number and the innumerable. It is in the space of the numberless, without number, in the premise of the innumerable, that the works of “myriad-minded” Shakespeare reside. The sciences have penetrated Shakespeare’s works, which have been thought to undergo the influence of the innumerable worlds of Brunian cosmology. The innumerable lies somewhere between the demotic and the esoteric. The conception of a mystique of numbers, however, cannot be linked to the conception of Shakespeare’s universal popular genius. On account of the coincidentia oppositorum, of the extraordinary capture of the essence of the past, of the present and of the future, Shakespeare’s works admirably lend themselves to a process that entails a sense of loss.

Glioblastoma multiforme (GBM) is a grade IV astrocytoma and is the most aggressive malignant primary brain tumor in adults. Without treatment, patients are expected to survive an average of three months. Conversely, current treatment regimens only extend survival to 12-14 months. Characteristically, GBM tumors are highly proliferative, invasive and stop responding to treatments relatively fast due to therapy resistance. Interestingly, GBM also exhibits high metabolic activity but manages to maintain a low level of reactive oxygen species (ROS). These ROS neutralization capabilities are sustained by system Xc–, a sodium-independent, electro neutral transporter that is found in the plasma membrane of GBM cells. System Xc– is composed of a regulatory heavy subunit (4F2hc) linked to a 12 transmembrane domain catalytic light chain subunit (xCT) that mediates the uptake of L-cystine into the cell, and L-glutamate out of the cell, at a 1:1 ratio. Imported cystine is quickly reduced to L- cysteine, the rate limiting substrate in glutathione (GSH) synthesis. Glutathione is a major antioxidant in the central nervous system that is responsible for maintaining intracellular redox homeostasis by neutralizing ROS by direct and indirect methods. The function of chemo and radiation therapy is to generate significant levels of ROS that tigger the cell to undergo apoptosis. High intracellular GSH levels in cancer cells are associated with drug resistance and detoxification of alkylating agents such as temozolomide (TMZ). Therefore, system Xc– represents a potential target to reduce glioma cell survival and reduce tumor progression. Sulfasalazine is an FDA approved drug in the treatment of arthritis and Crohne’s disease and has been shown to inhibit system Xc–. In vitro SASP studies demonstrated a strong antitumor potential in preclinical mouse models of malignant glioma. However, two clinical trials using sulfasalazine with standard chemo and radiation therapy to treat GBM patients were terminated due to off-target effects. Both results showed high toxicity and no change in the overall survival of patients. These studies demonstrate the need for a more effective inhibitor of system Xc–. To further elucidate the role of system Xc– in GBM survival, stable xCT knock-down and over-expressing U251 glioma cells were generated. These lines were characterized for survival, proliferation, apoptosis and resistance to oxidative and genotoxic insult. As expected xCT-knockdown cells exhibited lower GSH levels, increased intracellular ROS and markers for apoptosis after oxidative and genotoxic insult. The xCT-over-expressing cells displayed higher levels of GSH, increased resistance to hydrogen peroxide and various chemotherapy drugs including TMZ. An interesting unforeseen result of xCT over-expression in glioma cells was an increase in the metabolic activity as a result of increased mitochondria. Using xCT-modified glioma lines stably, we demonstrate for the first time that system XC– over-expression not only promotes survival under oxidative stress but may also decreases sensitivity to chemotherapy treatment and increase metabolic properties. Therefore, therapeutic manipulation of this transporter either alone or in combination with other treatments may improve clinical outcome in patients diagnosed with GBM.

No description available.

Les Phostines représentent une nouvelle classe de glycomimétiques contenant un atome de phosphore à la place du carbone anomérique. Leur synthèse a été réalisée par la condensation de furanoses protégés et de différents H-phosphinates en milieu basique. Ces phostines se sont révélées être très efficaces in vitro et in vivo contre des cellules cancéreuses de glioblastome de rat et humaines. Dans ce projet, nous avons eu pour premier but d’obtenir, majoritairement, le diastéréoisomère le plus actif. Différentes réactions ont été réalisées, en changeant la nature de la base ou le contre-ion de cette dernière. Une très légère amélioration a été notée avec le méthylate de césium au profit du dérivé de type glucose. Dans un deuxième temps, et dans le but d’améliorer l’activité anticancéreuse et de pouvoir étudier la biodistribution des phostines, différentes modifications chimiques ont été réalisées. Des dihydroxy-2,3- et 2,6-oxaphosphinanes, des thiophostines et des phostines de la série L ont été synthétisées. Par la suite, des variations, en alpha de l’atome de phosphore, nous ont permis d’obtenir des phostines halogénées, ainsi que deux nouveaux produits: un acide furanosylphosphinique et l’oxaphosphine-3-ène. La réactivité chimique de la fonction éther d’énol de ce dernier a été examinée, en synthétisant un beta-cétophosphinate et des beta-énaminophosphinates. Finalement des pseudo-disaccharides ont été synthétisés afin d’améliorer la biodisponibilité des phostines. Les phostines testées ont manifesté des propriétés anticancéreuses à une concentration de l’ordre du nanomolaire envers différentes lignées cellulaires, montrant la capacité de cette famille de composés de lutter contre certains types de cancers. / The Phostines represent a new class of glycomimetics, containing a phosphinolactone function instead of the anomeric carbon. Their synthesis was achieved by the reaction of protected furanose with various H-phosphinates, in the presence of a base. These compounds have been found to be very effective in vitro and in vivo against rat and human glioblastoma cells.In this project, our first goal was to obtain the most active phostine with higher diastereoselectivity. Different reactions were tested, changing the base or its counter ion. A very slight improvement was noted with cesium methoxide, favoring the glucose-like derivative.In the context of improving the anticancer activity and to study the biodistribution of the phostines, different chemical modifications were carried out. Dihydroxy-2,3- and 2,6-oxaphosphinanes, thiophostines and phostines of the L series were synthesized. Therefore, variations in alpha position of the phosphorus atom have produced halogenated phostines and two new products: furanosylphosphinic acid and the oxaphosphine-3-ene.The chemical reactivity of the enol ether of this latter has been examined by synthesizing beta-ketophosphinate and beta-enaminophosphinates. Finally, pseudo-disaccharides were synthesized to improve the bioavailability of phostines.The tested phostines have exhibited anticancer properties at nanomolar concentration against different cell lines, showing the ability of this family of compounds to fight some types of cancers.