The c-Jun NH2-terminal kinase (JNK) group of kinases include ten members that are created by alternative splicing of transcripts derived from Jnk1, Jnk2 and Jnk3 genes. The JNK1 and JNK2 protein kinases are ubiquitously expressed while JNK3 is expressed in a limited number of tissues. The JNK signaling pathway is implicated in multiple physiological processes including cell transformation. There is growing evidence that JNK signaling is involved in oncogenesis. Nevertheless, the role that JNK plays in malignant transformation is still unclear. The aim of this thesis is to examine the role of JNK in malignant transformation. For this purpose, I used the Bcr/Abl oncogene as a transforming agent. Bcr/Abl is a leukemogenic oncogene that is created by reciprocal translocation between chromosome 9 and 22. The translocation breakpoint is variable and several different Bcr/Abl isoforms have been identified such as Bcr/AblP185 and Bcr/AblP210, whose expression is associated with different types of leukemia. Bcr/Abl activates the JNK signaling pathway in hematopoietic cells and increases AP-1 transcription activity. Furthermore, dominant negative approaches demonstrate that inhibition of c-Jun or JNK prevents Bcr/ Abl-induced cell transformation in vitro. These data implicate the JNK signaling pathway in Bcr/Abl transformation although the role that JNK might have in this process is unclear. Thus, I examined the importance of JNK signaling in Bcr/Abl-induced lymphoid or myeloid transformation. For this purpose I compared Bcr/AblP185- and Bcr/AblP210- induced transformation of wild-type and JNK1-deficient cells using three approaches: in vitro, in vivo and ex vivo. The results obtained with the in vitro approach suggest that both Bcr/AblP185 and Bcr/AblP210 require JNK activity to induce lymphoid transformation. While JNK1-deficiency inhibits Bcr/AblP210 oncogenic potential in lymphoid cells both in vitro and in vivo, pharmacological inhibition of JNK activity (JNK1 and/or JNK2) blocked Bcr/AblP185 induced malignant proliferation in vitro. The differential requirement for JNK observed in the two Bcr/Abl isoforms can be ascribed to the presence in Bcr/AblP210 of the Dbl domain which can activate the JNK pathway in vitro. In the case of Bcr/AblP210, JNK1 is critical for the survival of the ex vivo derived transformed lymphoblasts upon growth factor removal. This result correlates with the fact that mice reconstituted with Bcr/AblP210 transformed Jnk1-l- bone marrow showed normal malignant lymphoid expansion in the bone marrow yet they had reduced numbers of lymphoblast in the bloodstream and lacked peripheral organ infiltration. Thus JNK1 is essential for the survival of the transformed lymphoblast outside the bone marrow microenvironment in Bcr/AblP210induced lymphoid leukemia. Interestingly, while JNK1 is essential for lymphoid transformation, it is dispensable for the proliferation of transformed myeloblasts. Taken together these results indicate that the JNK signaling pathway plays an essential role in the survival of Bcr/AblP210 lymphoblasts and that JNK-deficiency decreases the leukomogenic potential of Bcr/AblP210 in vivo. Thus, cell survival mediated by JNK may contribute to the pathogenesis of proliferative diseases.

One important objective of prostate cancer (PCa) research is to understand the molecular basis underlying the progression of these cancers from an androgen dependent to an androgen independent state. Hypermethylation of the promoter CpG islands is associated with the transcriptional silencing of specific gene sets in each tumor type and subtype. Transcriptional silencing of antitumor genes via CpG island hypermethylation could be a mechanism mediating PCa progression from an androgen-dependent to an androgen-independent state. Hypermethylation associated gene silencing has been reported for a great number of genes in PCa with the exception of the genes that undergo methylation associated silencing specifically during cancer development to androgen independence. The first aim of this thesis is to identify novel glenes which undergo DNA hypermethylation associated gene silencing during the cancer progression. The androgen-dependent (AD, as defined as the inability of celill to proliferate in the absence of androgen) PCa cell line LNCaP gives rise to the androgen-independent (AI) subline LNCaPcs generated by maintaining LNCaP in medium with charcoal-stripped (CS) serum for over 30 passages. This LNCaP cell model was used to identify differentially methylated sequences between the two genomes using the Methylation-Sensitive Restriction Fingerprinting (MSRF) technique. One sequence identified is located in a 5' CpG island, which encompasses part of the promoter, exon 1, and part of intron 1, of the Peroxisomal Membrane Protein 24 KD (PMP24) gene. PMP24 is silenced in concert with the hypermethylation of its CpG island in AI LNCaPcsand PC-3 cell lines. The silencing is reactivated by the treatment with a DNA methyltransferase inhibitor, 5-aza-2'-deoxycytidine (5AZAdC). PMP24 is specifically silenced in PCa cancer cell lines and shows potential antitumor properties. These results demonstrate the utility of MSRF in the identification of novel, differentially methylated DNA sequences in the genome and suggest that hypermethylation-mediated silencing of PMP24 is an epigenetic event involved in PCa progression to androgen independence. The next study investigated the molecular mechanism for DNA methylation associated gene silencing of PMP24 in AI LNCaPcs and PC-3 cell lines. We demonstrated that PMP24 transcription is repressed by the disruption of transcription factor binding to a critical cis-element by hypermethylation of its promoter CpG island. We found a CpG containing activator protein 2 (AP-2) cis-element in the intron 1 of PMP24 whose first CpG dinucleotidle is essential for the sequence-specific protein binding and the promoter activity of the gene. We presented first in cellulo evidence that the methylation of AP-2 cis-element alone but not the whole CpG island, using a newly developed methylated oligonucleotides treatment, is sufficient for the downregulation of PMP24. Our study is the first to report that the silencing mechanism for PMP24 in AI LNCaPcs and PC-3 is mediated by the complete methylation of a single GpG site of AP-2 cis-element in the intron 1 part of the CpG island, which interferes with transcription factor binding. Most interestingly, the promoter CpG island of PMP24 is hypermethylated in AD LNCaP cells with the incomplete methylation specifically at the AP-2 cis-element. The silencing of PMP24 in AD LNCaP cells was reactivated not by the 5AZAdC treatment but by the treatment with Trichostatin A (TSA), a histone deacetylase inhibitor. An alternative silencing mechanism for PMP24 other than the interference with transcription factor binding by methylation is therefore likely involved at this androgen-dependent stage. During the androgen ablation process, this mechanism is either evolved by the spread of methylation in the promoter CpG island or selected against, leading to the methylation-dominant silencing mechanism in the AI cells as seen in LNCaPcsand PC-3 cells. Taken together, this thesis emphasized the important role of DNA methylation in the progression of PCa into androgen independence. Particular respect should be paid to the specific CpG dinucleotides in cis-elements critical for the promoter activity, whose complete methylation could dominate the silencing mechanism which is independent of androgen. This thesis also pointed to the importance of monitoring the effects of cell culture on the methylation status of genes. Most importantly, this thesis raised the possibility that the silencing mechanisms for PMP24 could be different in AD LNCaP cells as compared to AI LNCaPcs and PC-3 cells. Either the evolution of such mechanism or the selectivity against it during the androgen ablation process would result in a methylation-dominant silencing mechanism of the genes such as PMP24 in AI cells and may contribute to the overall androgen independence of the cells.

A common phenotype observed in most cancers is chromosomal instability. This includes both structural and numerical chromosomal aberrations, which can promote carcinogenesis. The fusion gene CBFB/MYH11 is created by the structural chromosomal inversion(16)(p13.1q22), resulting in the fusion protein CBFβ-SMMHC, which blocks differentiation in hematopoietic progenitor cells. This mutation alone, however, is not sufficient for transformation, and at least one additional cooperating mutation is necessary. The role of wildtype Cbfb in modulating the oncogenic function of the fusion protein Cbfβ-SMMHC in mice was examined. Transgenic mice expressing the fusion protein, but lacking a wild-type copy of Cbfb, were created to model the effects of these combined mutations. It was found that wild-type Cbfb is necessary for maintaining normal hematopoietic differentiation. Consequently, complete loss of wild-type Cbfb accelerates leukemogenesis in Cbfb/MYH11 mice compared to mice expressing both the fusion and wild-type proteins. While there is no evidence in human patient samples that loss of wild-type Cbfb expression cooperates with the fusion protein to cause transformation, it is apparent from these experiments that wild-type Cbfβ does play a role in maintaining genomic integrity in the presence of Cbfβ-SMMHC. Experiments have also shown that loss of Cbfb leads to accumulation of hematopoietic progenitor cells, which may acquire additional cooperating mutations. Not unlike CBFB/MYH11, the human papillomavirus (HPV) E6 and E7 proteins are not sufficient for cellular transformation. Instead, high risk HPV E7 causes numerical chromosomal aberrations, which can lead to accumulation of additional cooperating mutations. Expression of HPV-16 E7 and subsequent downregulation of the retinoblastoma protein (Rb) has been shown to induce polyploidy in human keratinocytes. Polyploidy predisposes cells to aneuploidy and can eventually lead to transformation in HPV positive cells. There are several possible mechanisms through which E7 may lead to polyploidization, including abrogation of the spindle assembly checkpoint, cleavage failure, abrogation of the postmitotic checkpoint, and re-replication. Rb-defective mouse and human cells were found to undergo normal mitosis and complete cytokinesis. Furthermore, DNA re-replication was not found to be a major mechanism to polyploidization in HPV-E7 cells upon microtubule disruption. Interestingly, upon prolonged mitotic arrest, cells were found to adapt to the spindle assembly checkpoint and halt in a G1-like state with 4C DNA content. This post-mitotic checkpoint is abrogated by E7-induced Rb-downregulation leading to S-phase induction and polyploidy. This dissertation explores two examples of the multi-step pathway in human cancers. While certain genes or genetic mutations are often characteristic of specific cancers, those mutations are often not sufficient for transformation. The genetic or chromosomal abnormalities that they produce often stimulate the additional mutations necessary for oncogenesis. The studies with Cbfb/MYH11 and HPV E7 further exemplify the significance of numerical and structural chromosomal aberrations in multi-step carcinogenesis.

Introduction HNF-1β is a transcription factor that plays a crucial role in the ontogenesis, regulates expression of multiple genes involved in cell cycle modulation and seems to be involved in cancerogenesis of various tumors. HNF-1β protein is coded by the HNF1B gene. Genetic and epigenetic changes of HNF1B play role in tumorigenesis and these changes can be accompanied by loss of expression or increased protein expression as detected by immunohistochemistry. In gynecopathology, expression of HNF-1β was considered as specific marker of clear cell carcinomas of the ovary and endometrium. However, more recent studies described HNF-1β expression also in tumors of other histogenesis. Aims: Our study focused on the immunohistochemical and molecular analysis of HNF1B in the normal tissue, various types of tumors and non-neoplastic lesions of the female genital tract. The goals of our study were: 1. Analysis of HNF-1β expression in cervical carcinomas. 2 Analysis of HNF-1β expression in endometrial carcinomas and non-neoplastic tissues of the female genital tract. 3. Analysis of epigenetic and genetic changes of HNF1B in endometrioid carcinomas and ovarian clear cell carcinomas. 4. Comprehensive analysis of atypical polypoid adenomyomas. Material and methods: A total of 574 samples including 399...

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.

As fraturas benignas osteoporóticas e malignas da coluna vertebral representam um desafio diagnóstico para os médicos especialistas. As fraturas benignas osteoporóticas ocorrem em virtude da fragilidade óssea da osteoporose e as fraturas malignas são secundárias a infiltração neoplásica. Estes dois grupos tem em comum o fato de acometerem predominantemente a população idosa. Alguns sinais radiológicos favorecem o diagnóstico de fraturas benignas osteoporóticas enquanto outros sinais de imagem favorecem o diagnóstico de fraturas malignas, no entanto nenhum sinal identificado nas imagens é específico. O propósito de realizar esse estudo foi identificar se o nível de formação médica dos radiologistas e ortopedistas (cirurgiões da coluna vertebral) exerce influência para o diagnóstico etiológico dessas fraturas nos exames de RM da coluna lombar, assim como avaliar o grau de concordância intra e interobservador para o diagnóstico de fraturas benignas por osteoporose e fraturas malignas. Foram incluídos no estudo de forma retrospectiva os exames de 63 pacientes consecutivos da rotina clínica do HCRP, realizados previamente por indicação clínica e com diagnóstico de fratura não traumática de corpo vertebral. Para avaliar a influência do nível de formação médica, quatro radiologistas e dois cirurgiões da coluna vertebral com diferentes níveis de formação realizaram avaliações de forma independente e as cegas em relação as demais leituras e em relação às informações do prontuário clínico. As imagens de RM anonimizadas e no formato DICOM foram avaliadas em workstation OsiriX. Os médicos observadores fizeram as leituras classificando cada vértebra da região lombar da seguinte forma: sem fratura, com fratura de características benignas ou com fratura de características malignas. Cada observador realizou duas leituras, com intervalo de 15 dias entre as leituras. O padrão de referência foi obtido a partir da avaliação pormenorizada do prontuário eletrônico de cada paciente realizada por médico radiologista sênior, a partir do Sistema de Informações do Hospital (HIS) e do Sistema Informatizado da radiologia (RIS), incluindo a biópsia com confirmação histopatológica nos casos de neoplasia e o seguimento clinico e laboratorial por pelo menos dois anos nos casos em que não houve indicação clínica de biópsia. Utilizando este padrão de referência foram calculadas para cada leitura, a sensibilidade, a especificidade, acurácia, valor preditivo positivo e negativo com intervalo de confiança (IC) 95%. Os resultados demonstram uma excelente concordância intraobservador e uma boa concordância interobservador, porém sem relevância estatística. Além disso, de uma forma geral a sensibilidade dos observadores para a detecção de fraturas malignas foi boa. A especificidade, acurácia e valor preditivo negativo foram elevados para todos os observadores. O valor preditivo positivo variou de moderado a substancial. Portanto, não houve influência do nível de formação médica para o desempenho diagnóstico na detecção de fraturas benignas osteoporóticas e fraturas malignas nas imagens de ressonância magnética. / Benign osteoporotic and malignant spinal fractures represent a diagnostic challenge for medical specialists. Osteoporotic benign fractures occur because of the bone fragility of osteoporosis and malignant fractures are secondary to neoplastic infiltration. These two groups have in common the fact that they affect predominantly the elderly population. Some radiological signs favor the diagnosis of benign osteoporotic fractures while other imaging signs favor the diagnosis of malignant fractures, however no signs identified in the images are specific. The purpose of this study was to identify whether the level of medical training of radiologists and orthopedists (spine surgeons) influences the etiological diagnosis of these fractures in lumbar spinal MRI (magnetic resonance imaging), as well as to evaluate the degree of intra and interobserver agreement for the diagnosis of benign fractures due to osteoporosis and malignant fractures. We retrospectively included the exams of 63 consecutive patients from the clinical routine of the HCRP, performed previously by clinical indication and with diagnosis of non-traumatic vertebral body fracture. To evaluate the influence of the level of medical training, four radiologists and two spine surgeons with different levels of training performed evaluations independently, without knowing the other readings and without the information in the medical record. The anonymized MRI in the DICOM format were evaluated in OsiriX workstation. Observer doctors did the readings by classifying each vertebra in the lumbar region as follows: no fracture, with fracture of benign features or with fracture of malignant characteristics. Each observer performed two readings, with a 15-day interval between readings. The reference standard was obtained from the detailed evaluation of each patient\'s electronic medical record by a senior radiologist, with the Hospital Information System (HIS) and the Computerized Radiology System, including biopsy with histopathological confirmation in cases of neoplasia and clinical and laboratory follow-up for at least two years in cases in which there was no clinical indication of biopsy. Using this reference standard, sensitivity, specificity, accuracy, positive and negative predictive value with 95% confidence interval (CI) were calculated for each reading. The results demonstrate excellent intraobserver agreement and good interobserver agreement, but without statistical relevance. In addition, the sensitivity of the observers for the detection of malignant fractures was generally good. The specificity, accuracy and negative predictive value were high for all observers. The positive predictive value ranged from moderate to substantial. Therefore, there was no influence of the level of medical training for diagnostic performance in the detection of benign osteoporotic fractures and malignant fractures in magnetic resonance imaging.

Orientador: André Almeida Schenka / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T22:24:18Z (GMT). No. of bitstreams: 1 Renno_AndreLisboa_D.pdf: 23208237 bytes, checksum: c782ca447d3fee7cb5573e4b122b7f94 (MD5) Previous issue date: 2014 / Resumo: O câncer mamário é a neoplasia maligna mais incidente e a principal causa de óbito por malignidade no sexo feminino no Brasil e no mundo. Estipula-se que há mais de 1.2 milhões de novos casos anuais de câncer de mama, e que a heterogeneidade e a complexidade molecular do câncer de mama dificultam estratégias terapêuticas de prevenção e tratamento desta doença. Atualmente, acredita-se que, em diversas neoplasias, incluindo o câncer de mama, a célula alvo de mutações cumulativas responsáveis pelo desenvolvimento do fenótipo canceroso é uma célula-tronco adulta. Independentemente da origem da neoplasia (se em célula madura/diferenciada ou em CT), é possível constatar in vitro e in vivo, na grande maioria dos tumores malignos, uma subpopulação de células indiferenciadas, com características fenotípicas de célula-tronco. Tais células são designadas como "células tronco cancerosas ou neoplásicas (CTNs)". Com frequência, especula-se se as CTNs seriam responsáveis pela heterogeneidade morfológica e molecular de algumas neoplasias mamárias. Em conjunto, essas peculiaridades das CTNs as tornam importantes alvos no desenvolvimento de novas abordagens farmacoterapêuticas antineoplásicas. Recentemente, Gauthaman et al (2009) demonstraram de forma inédita em estudos in vitro que estatinas apresentam efeito inibitório específico sobre células tronco embrionárias com alterações cariotípicas e células de linhagens neoplásicas mamárias com fenótipo CTN, não afetando o crescimento de células tronco normais. As estatinas são inibidores competitivos da 3-hidroxi-3-metilglutaril coenzima A (HMG-CoA) e são amplamente utilizada para o tratamento de doenças cardiovascular primário e secundário. Além de amplamente utilizadas na prevenção e tratamento de doenças cardiovasculares secundárias a dislipidemias, evidências cumulativas apontam para um possível papel destas drogas na prevenção ou regressão de processos neoplásicos. Entre os efeitos antineoplásicos comprovados das estatinas, destacam-se: a inibição da proliferação celular, a promoção de apoptose, a inibição da angiogênese e a prevenção de metástases. Assim, buscou-se neste trabalho elucidar o efeito da sinvastatina e pravastatina sobre células progenitoras e CTNs e em algumas vias de sinalização intracelular em modelo de carcinogênese mamária (baseado na indução com 7,12 dimetilbenz(a)antraceno[DMBA]) em ratas Sprague-Dawley. Após um tratamento de 14 dias com as estatinas, as mamas das ratas foram analisadas para verificar a imunoexpressão de células progenitoras e CTNs (CD133, CD24, CD44 e EpCAM), variáveis biológicas (volume tumoral, mitose, índice proliferativo) além da análise proteica de Akt e Src. A maior dose da sinvastatina testada (40 mg/Kg) diminui o número de tumores desenvolvidos, volume e incremento tumoral e os índices de proliferação celular. Não houve alteração da percentagem de necrose com o tratamento com as estatinas. Ainda, sinvastatina diminuiu os níveis da fosforilação da Akt e aumento da PTEN, não havendo diferenças significantes nos níveis da Src. Sinvastatina também foi capaz de reduzir o número de células positivas CD133, CD24 e CD44. Pelas doses testadas, não houve diferença dos parâmetros biológicos analisados com o tratamento com a pravastatina. Em conclusão, neste modelo, o tratamento crônico com a sinvastatina apresentou efeitos citostáticos, ações reguladoras na via da Akt além do controle de células progenitoras e CTNs em modelo in vivo de carcinoma mamário / Abstract: Breast cancer is the malignant neoplasm with the highest incidence and the main cause of death by cancer within females in Brazil and in the world. It is estimated that there are over 1.2 million new annual cases of breast cancer. The heterogeneity and the molecular complexity of this type of cancer complicate the therapeutic strategies for its prevention and treatment. Nowadays, it is believed that in many different neoplasms, including breast cancer, the cell which is the target of cumulative mutations responsible for the development of the cancerous phenotype is an adult stem cell. Regardless the origin of the neoplasm (whether in mature/differentiated cell or in SC), a subpopulation of undifferentiated cells with phenotypic characteristics of stem cells can be seen in vitro and in vivo in most malignant tumours. These cells are designated as "neoplastics or cancer stem cells (CSCs)". It is often especulated whether CSCs would be responsible for the molecular and morphological heterogeneity in some breast neoplasms. The peculiarities of the CSCs make them a relevant/an important/a serious object for the development of new antineoplastic pharmacotherapeutic approaches. Recently, Gauthaman et al (2009) demonstrated in unprecedented in vitro studies that statins exhibit specific inhibitory effect on embryonic stem cells with karyotypic alterations and neoplastic mammary cell lines with phenotype CSC, not affecting the growth of normal stem cells. Statins are competitive inhibitors of coenzyme 3-hydroxy-3-methylglutaryl A (HMG-CoA) reductase and are widely used for the primary and secondary treatment of cardiovascular diseases. Moreover, cumulative evidence points to a possible role of these drugs in the prevention or regression of neoplastic processes. Amongst the proven anticancer effects of statins, some of them stand out such as: inhibition of cell proliferation, promotion of apoptosis, inhibition of angiogenesis and metastasis prevention. Thus, this study sough to elucidate simvastatin and pravastatin effects on progenitor cells and NSCs, and on some signaling pathways in breast carcinogenesis model (based on induction 7,12 dimethylbenz (a) anthracene [DMBA]) in female Sprague-Dawley rats. After a 14 days treatment with the statins, the rats' breasts were examined to verify immunostaining of progenitor cells and CSCs (CD133, CD24, CD44 and EpCAM), biological variables (tumor volume, mitosis, proliferation index) in addition to protein analysis of Akt and Src. The highest dose of the tested simvastatin (40mg/kg) decreased the number of tumors developed, volume and tumor growth as well as the cell proliferation index. There was no change in the percentage of necrosis to treatment with statins. Furthermore, simvastatin decreased the levels of Akt phosphorylation and increased PTEN levels, without significant differences in Src levels. Simvastatin was also able to reduce the number of CD133, CD24 and CD44 positive cells. For the doses tested, there was no difference on the analyzed parameters in the treatment with pravastatin. As a conclusion, in this model, chronic treatment with simvastatin showed cytostatic effects, regulatory actions towards Akt, as well as the control of CSCs and progenitor cells in the in vivo model of mammary carcinoma / Doutorado / Farmacologia / Doutor em Farmacologia

Orientador: André Almeida Schenka / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-22T13:11:13Z (GMT). No. of bitstreams: 1 Souza_PhilipiCoutinhode_M.pdf: 7492039 bytes, checksum: 04ef7a018050c98ae0be37a7e79c79e7 (MD5) Previous issue date: 2013 / Resumo: O câncer de mama é a neoplasia maligna mais prevalente e a principal causa de óbito entre mulheres, no mundo. A despeito de avanços substanciais no entendimento da biologia da doença, nos métodos de detecção precoce, e em sua farmacoterapia, a sobrevida geral não se modificou significantemente nas últimas décadas. Portanto, pode se dizer que um dos deveres primordiais das Universidades Públicas engajadas com pesquisa básica e aplicadas consiste em contribuir para o desenvolvimento de novas estratégias de tratamento sistêmico desta neoplasia. Nesse contexto, um dos alvos estratégicos mais promissores no desenvolvimento de novos fármacos antineoplásicos é representado pela célula-tronco neoplásica (CTN). As CTNs têm sido associadas em inúmeros estudos à capacidade de algumas neoplasias malignas de resistir às principais modalidades terapêuticas antineoplásicas, especialmente à: radio-, quimio-, hormônio- e imunoterapias. Em resumo, na atualidade, a detecção de CTNs constitui uma ferramenta clínica bastante promissora enquanto alvo terapêutico, fator prognóstico e preditivo de resposta terapêutica. O objetivo deste trabalho foi descrever e discutir as potencialidades e limitações do modelo de carcinogênese mamária pelo DMBA, após reclassificação das neoplasias mamárias segundo os critérios diagnósticos da OMS (2003, 2012), subtipagem molecular e quantificação de imunomarcadores prognósticos, preditivos e de CTN. Após a aplicação do protocolo experimental de indução química pelo DMBA e a eutanásia dos animais controle e experimental, suas linhas mamárias (contendo ou não tumores) foram ressecadas e avaliadas quanto à morfologia e a imunoexpressão para marcadores de CTNs. Após 13 semanas, 100% dos animais desenvolveram neoplasias macroscópicas e histologicamente compatíveis com os critérios de avaliação indicados pela OMS. Os tumores foram classificados em carcinoma ductal, carcinoma papilífero, carcinoma lobular, carcinoma mioepitelial e tumor filóide, sendo o tipo mais frequente, o ductal. Poucos marcadores imunoistoquímicos mostraram correlação com variáveis de comportamento biológico. Mesmo assim, o grau de correlação não foi elevado. A grande heterogeneidade morfológica intratumoral e interanimal, associada à presença de subtipos histológicos bifásicos (tumor filóide), tumores com diferenciação mioepitelial/basal e à grande positividade para marcadores CTN clássicos (tanto em termos de frequência na amostra como em termos de distribuição média nas neoplasias) demonstram a participação clara de CTNs no modelo, o que o torna um importante referencial como modelo in vivo para o teste de drogas anti-CTN específicas. O modelo reproduz os principais subtipos histológicos e moleculares de câncer mamário, o que significa que poderá ser utilizado no estudo pormenorizado de drogas indicadas especificamente para cada subcategoria molecular (e.g., agentes hormonais que são indicados especificamente para os tipos luminais e trastuzumab, indicado nos tumores do subtipo HER2), bem como no desenvolvimento de novas drogas com maior especificidade para a classe molecular de interesse / Abstract: Breast cancer is the most common malignancy and the leading cause of death from cancer among females worldwide. Despite all the research and all the progress, methods of early detection, and its pharmacotherapy, overall survival has not changed significantly in recent decades. Therefore, the Public University has been engaged in basic and applied research is too contributed to the development of new strategies for systemic treatment of this malignancy. In this context, one of the most promising strategic targets in the development of the anticancer drugs is represented by neoplastic stem cell (NSC). Neoplastic stem cell has been linked in various studies to the capacity of some malignancies to resist major antineoplastic therapeutic modalities, especially: radio-, chemo-, hormone- and immunotherapies. In summary, the detection of NSCs is a clinical tool very promising while therapeutic target and prognostic factor predictive of therapeutic response. The aim of this study was to describe and discuss the strengths and limitations of the model of mammary carcinogenesis by DMBA, after reclassification of breast cancer according to the diagnostic criteria of the WHO (2003, 2012), and quantification of molecular subtyping prognostic immunomarkers, predictive and NSC. After application of the experimental protocol of chemical induction by DMBA and euthanasia of experimental and control animals, the mammary lines (with or without tumors) were resected and evaluated the morphology and immunostaining for markers of NSCs. After 13 weeks, 100% of the animals developed macroscopic neoplasms and histologically consistent with the evaluation criteria of evaluation indicated by WHO. Tumors were classified as ductal carcinoma, papillary carcinoma, lobular carcinoma, myoepithelial carcinoma and phyllodes tumor, being the most common type, the ductal. Few immunohistochemical markers correlated with variable behavior biological. Nevertheless, the degree of correlation was not high. The morphological intratumoral heterogeneity and interanimal associated with the presence of histological biphasic subtypes (phyllodes tumor), tumors with myoepithelial/basal differentiation and the positivity for NSCs classic markers (both in terms of frequency in the sample and in terms of the average distribution neoplasias) demonstrate a clear involvement of NSCs in the model, making it an important reference as a model for in vivo testing of anti-specific NSC. The model reproduces the main molecular and histological subtypes of breast cancer, which means that could be used in detailed study drug indicated specifically for each subcategory molecular (eg, hormonal agents that are suitable specifically for the luminal type and trastuzumab indicated in tumors HER2 subtype), as well as to develop new drugs with higher specificity for the class of molecular interest / Mestrado / Farmacologia / Mestre em Farmacologia

Orientador: Carmen Silvia Bertuzzo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T16:42:29Z (GMT). No. of bitstreams: 1 Viana_DaniloVilela_D.pdf: 5689445 bytes, checksum: ecee0316f70f957068dbfd39107b9161 (MD5) Previous issue date: 2013 / Resumo: Há muito tempo reconhece-se a importância de fatores hereditários na oncogênese. Dentre os genes associados ao câncer, um importante grupo é formado por aqueles direta ou indiretamente relacionados ao reparo do DNA, entre os quais está um grupo de genes pertencentes ao sistema de reparo de erros de pareamento de bases do DNA (mismatch repair - MMR), do qual fazem parte hMLH1, hMSH2, hMSH6 e hPMS2. Quando mutações monoalélicas nesses genes são herdadas, elas são responsáveis pela síndrome de Lynch, que cursa com predisposição ao câncer de cólon e endométrio, entre outros, geralmente na terceira ou quarta década de vida. A ocorrência de câncer na infância ou de tumores hematológicos não é comum na síndrome de Lynch. Nos últimos anos, entretanto, foram relatados diversos casos de pacientes que, na primeira ou segunda década de vida, apresentam tumores de sistema nervoso central, gastrintestinais, hematológicos, alguns deles com manifestações cutâneas semelhantes à neurofibromatose tipo 1. Nesses pacientes, foram identificadas mutações bialélicas nos genes do sistema MMR. O presente estudo propôs-se a analisar os tecidos tumorais de uma série retrospectiva de pacientes de zero a 35 anos de idade (inclusive), com diagnóstico de câncer de sistema nervoso central, visando a identificação de pacientes com mutações bialélicas nos genes do sistema MMR e a caracterização de seu quadro clínico. Teve por objetivos específicos: identificar os casos com instabilidade de microssatélites (MSI); determinar a proporção de tumores instáveis e o genótipo para os genes do sistema MMR nos casos que foram instáveis; correlacionar as mutações encontradas com o fenótipo e história familial. Um total de 79 pacientes foram incluídos no estudo. O diagnóstico era de glioma em 42 e meduloblastoma em 37. Inicialmente foi realizada a pesquisa de MSI nos tumores de todos os pacientes, seguido de avaliação clínica e coleta de sangue para pesquisa de mutações deletérias nos genes do sistema MMR, naqueles que apresentavam instabilidade. Foi encontrada baixa MSI (MSI-L) em sete casos de glioma e oito casos de meduloblastoma. Esses pacientes foram convocados para avaliação quanto à história clínica, exame físico e história familial. Seis pacientes atenderam ao convite, foram avaliados e tiveram sequenciamento e pesquisa de deleções por meio da técnica de MLPA realizados para os genes hMLH1, hMSH2, hMSH6. Não foram encontradas mutações deletérias em nenhum desses indivíduos. Procedeu-se, ainda, a determinação do intervalo de variação quase monomórfico para a população estudada, após o qual, cinco dos pacientes com diagnóstico de meduloblastoma, originalmente classificados como MSI-L, foram reclassificados como sendo estáveis (MSS). No presente estudo demonstrou-se que 8,3% dos pacientes com diagnóstico de meduloblastoma e 17,5% daqueles com gliomas possuíam MSI-L. A correlação do genótipo com o fenótipo e história familial não pôde ser realizada, visto não terem sido encontradas mutações deletérias. Sugere-se que sejam realizados estudos adicionais, preferencialmente prospectivos, para estabelecer a frequência de mutações nos genes do sistema MMR em pacientes pediátricos e adultos jovens com tumores de sistema nervoso central e instabilidade de microssatélites, uma questão importante para o aconselhamento genético, e, possivelmente, para implantação de uma rotina de rastreamento com pesquisa de MSI nessa população de pacientes / Abstract: Lynch syndrome (LS) is an autosomal dominant hereditary cancer predisposition disorder characterized by early onset of cancer (mean age, approximately 40-45 years), especially edometrium and/or colorectal cancer in the absence of gastrointestinal polyposis, and which, in addition, shows increased frequency of carcinomas of the ovary, small intestine, ureter, renal pelvis, stomach, among others. Its molecular hallmark is a type of genetic instability known as miscrosattelite instability (MSI) that affects short sequences of DNA repeats (miscrosattelites) found throughout the genome, leading to accumulation of genetic alterations. In LS, Cancer predisposition is due almost exclusively to heterozygous germline mutations in one of the DNA MMR genes (hMSH2, hMLH1, hPMS1, hPMS2, and hMSH6). Childhood cancers and hematological neoplasia generally do not belong to the Lynch tumour spectrum. However, over the past few years there have been reports of children that have presented with the constellation of early onset gastrointestinal cancers, along with features of neurofibromatosis type-1 and/or hematologic malignancies, and/or neurological tumors due to homozygous mutations in the mismatch repair genes. The present study analyzed a retrospective series of central nervous system tissue from patients with 0 to 35 years of age, with the aim to identify biallelic mutations in MMR genes and characterization of its clinical tumor spectrum. The aims of this study were to analyze: the frequency of microsattelite instability in tumors; the genotype and the frequency of germline mutations in MMR genes in patients who had MSI; its correlation to the phenotype and family history. A total of 42 gliomas and 37 medulloblastomas were analyzed. Initially, they were screened for microsatellite instability (MSI), followed by clinical evaluation, family history taking and sequence analysis of DNA obtained from blood lymphocytes. Low MSI (MSI-L) was found in seven gliomas and eight meduloblastomas. These patients were invited for clinical examination, family history taking and blood drawing. Six attended the clinical evaluation and had their sequence analysis done for hMLH1, hMSH2, hMSH6. No deleterious mutations were found among these patients. In adition, the quasi-monomorphic variation range was determined for this population, a important step previously not investigated in Brazilian population, that showed that with the proper values for the target population, 5 from the original MSI-L medulloblastomas were reclassified as stable (MSS). In clonclusion, the present study showed that 8,3% of the medulloblastomas and 17,5% of gliomas had MSI-L. The correlation of the genotype with clinical characteristics and family history could not be done, as no deleterious mutations were found. It was suggestd that new prospective studies are necessary to properly address the issue of the frequency of biallelic mutations in pediatric and young adults patients with MSI-L tumors of the CNS / Doutorado / Genetica Medica / Doutor em Ciências Médicas

Introduction HNF-1β is a transcription factor that plays a crucial role in the ontogenesis, regulates expression of multiple genes involved in cell cycle modulation and seems to be involved in cancerogenesis of various tumors. HNF-1β protein is coded by the HNF1B gene. Genetic and epigenetic changes of HNF1B play role in tumorigenesis and these changes can be accompanied by loss of expression or increased protein expression as detected by immunohistochemistry. In gynecopathology, expression of HNF-1β was considered as specific marker of clear cell carcinomas of the ovary and endometrium. However, more recent studies described HNF-1β expression also in tumors of other histogenesis. Aims: Our study focused on the immunohistochemical and molecular analysis of HNF1B in the normal tissue, various types of tumors and non-neoplastic lesions of the female genital tract. The goals of our study were: 1. Analysis of HNF-1β expression in cervical carcinomas. 2 Analysis of HNF-1β expression in endometrial carcinomas and non-neoplastic tissues of the female genital tract. 3. Analysis of epigenetic and genetic changes of HNF1B in endometrioid carcinomas and ovarian clear cell carcinomas. 4. Comprehensive analysis of atypical polypoid adenomyomas. Material and methods: A total of 574 samples including 399...