Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 3 uppsatser.

München, Techn. University, Diss., 2005.

O carcinoma epidermoide de lábio (CEL), que é causado pela exposição crônica e excessiva à radiação ultravioleta do sol, é precedido por uma desordem potencialmente maligna, a queilite actínica (QA). No entanto, ainda não é possível determinar quais casos de QA evoluirão para CEL. O método mais utilizado por patologistas para prever o prognóstico de desordens potencialmente malignas é a graduação histológica das displasias epiteliais. Entretanto, o sistema é subjetivo e ineficiente quanto ao seu valor preditivo. Acredita-se que o epitélio adjacente ao CEL tenha alterações genéticas semelhantes ao corpo da neoplasia. O objetivo deste estudo foi graduar as displasias epiteliais na margem do CEL e verificar a presença de proteína p53 mutada nessas áreas. Foram utilizados 40 casos de CEL com epitélio adjacente, no qual a displasia epitelial foi classificada pelo sistema proposto pela Organização Mundial da Saúde (OMS) e pelo sistema binário. Os casos foram, ainda, submetidos a reações de imuno-histoquímica com anticorpo anti-proteína p53 mutada. Entre os 40 casos estudados, 15 apresentaram displasia epitelial discreta, 18 moderada e 7 intensa. Pelo sistema binário, 36 casos foram classificados como de baixo risco e 4 como de alto risco. A marcação imuno-histoquímica para a proteína p53 mutada foi encontrada no epitélio adjacente de 32 casos (80%) dessa amostra. Considerando-se as duas graduações estudadas, a marcação foi detectada em 11/15 casos de displasia discreta, 16/18 de moderada e 5/7 de intensa pelo sistema da OMS e em 29/36 casos de baixo risco e 3/4 casos de alto risco. Concluiu-se, assim, que o epitélio adjacente ao CEL, mesmo exibindo poucas alterações morfológicas pode ter um comprometimento genético importante em genes que comandam a estabilidade genômica. / The lip squamous cell carcinoma (LSCC), which is caused by chronic and excessive exposure to solar ultraviolet radiation, is preceded by a potentially malignant disorder, the actinic cheilitis (AC). However, it is not possible to determine which AC cases will progress to LSCC. The method used by pathologists to predict the prognosis of potentially malignant disorders is the histologic grading of epithelial dysplasia. Nevertheless, this system is subjective and inefficient as to its predictive value. It is considered that the epithelium adjacent to LSCC has genetic alterations similar to the main tumor. The aim of this study was to grade the epithelial dysplasia on the LSCC border and also to verify the presence of mutated p53 protein in these areas. Forty LSCC cases with adjacent epithelium were retrieved from our files. The epithelial dysplasia was classified by the system proposed by the World Health Organization (WHO) as well as the binary system. Three m sections were submitted to the antibody against mutated p53 protein by means of immunohistochemistry. Among the 40 cases studied, 15 were classified as mild dysplasia, 18 moderate and 7 severe. When the binary system was considered, 36 cases were classified as low risk and four as high risk. Immunostaining revealed the presence of mutated p53 protein in the adjacent epithelium of 32 cases (80%). Analyzing the two grading systems separately, the staining was detected in 11/15 cases of mild dysplasia, 16/18 of moderate and 5/7 of intense; 29/36 of low-risk cases and 3/4 cases high-risk. In conclusion, even if it shows few morphological changes, the epithelium adjacent to LSCC may have a genetic involvement in important genes that control genomic stability.

Mdm2 and Mdm4 are critical negative regulators of the p53 tumor suppressor. Mdm4-null mutants are severely anemic and exhibit impaired proliferation of the fetal liver erythroid lineage cells. This phenotype may indicate a cell-intrinsic function of Mdm4 in erythropoiesis. In contrast, red blood cell count was nearly normal in mice engineered to express low levels of Mdm2, suggesting that Mdm2 might be dispensable for red cell production. In the first part of the thesis, we further explore the tissue-specific functions of Mdm2 and Mdm4 in the erythroid lineage by crossing the conditional Mdm4 and Mdm2 alleles to an erythroid-specific-cre (EpoRGFP-Cre ) knock-in allele. Our data show that Mdm2 is required for rescuing erythroid progenitors from p53-mediated apoptosis during primitive erythropoiesis. In contrast, Mdm4 is only required for the high erythropoietic rate during embryonic definitive erythropoiesis. Thus, in this particular cellular context, interestingly, Mdm4 only contributes to p53 regulation at a specific phase of the differientation program.<p><p>Moreover, a large body of evidence indicates that aberrant expression of either MDM2 or MDM4 impairs p53 tumor suppression function and consequently favors tumor formation. Overexpression of MDM2 was observed in 10% of 8000 human cancers from various sites, including lung or stomach, and MDM4 was found amplified and/or overexpressed in 10-20% of over 800 diverse tumors including lung, colon, stomach and breast cancers. Remarkably, selective MDM4 amplification occurs in about 65% of human retinoblastomas. In contrast, MDM2 amplifications are relatively rare (about 5%) in retinoblastomas, indicating that depending on the tumor context (cell type, initiating oncogene, …), MDM4, rather than MDM2, overexpression might be selected for as a more efficient mean of suppression of p53 function. As part of a large effort to better understand why different cell types require distinct combinations of mutations to form tumours, we will examine the molecular basis for selective up-regulation of Mdm4 in retinoblastomas. In this context, we have successfully generated 2 conditional transgenic mouse lines expressing either mycMdm2 or mycMdm4 driven by the PCAGGs promoters in the ROSA26 locus. Since a cassette containing a floxed transcriptional stop element is inserted upstream of the transgenes, we can achieve tissue-specific expression and spatio-temporal regulation of the transgenes by using different Cre and CreER. By the use of N-terminal myc-tag fused with the transgenes, we are able to compare the expression levels of the transgenes. Finally, due to C-terminal IRES-GFP element, we can easily identify transgene expressing cells. One of our aims is to use this Mdm4 conditional transgenic mouse line as the first, non-chimeric, mouse model of retinoblastoma that can be used as an appropriate preclinical model to improve treatment of this disease.<p> / Doctorat en Sciences / info:eu-repo/semantics/nonPublished

Plusieurs modèles pharmacocinétiques-pharmacodynamiques moléculaires ont été proposés au cours des dernières décennies afin de représenter et de prédire les effets d'un médicament dans les chimiothérapies anticancéreuses. La plupart de ces modèles ont été développés au niveau de la population de cellules, puisque des effets mesurables peuvent y être observés beaucoup plus facilement que dans les cellules individuelles.Cependant, les véritables cibles moléculaires des médicaments se trouvent au niveau de la cellule isolée. Les médicaments utilisés soit perturbent l'intégrité du génome en provoquant des ruptures de brins de l'ADN et par conséquent initialisent la mort cellulaire programmée (apoptose), soit bloquent la prolifération cellulaire, par inhibition des protéines (cdks) qui permettent aux cellules de procéder d'une phase du cycle cellulaire à la suivante en passant par des points de contrôle (principalement en $G_1/S$ et $G_2/M$). Les dommages à l'ADN causés par les médicaments cytotoxiques ou la $\gamma$-irradiation activent, entre autres, les voies de signalisation contrôlées par la protéine p53 qui forcent directement ou indirectement la cellule à choisir entre la survie et la mort.Cette thèse vise à explorer en détail les voies intracellulaires impliquant la protéine p53, ``le gardien du génome", qui sont initiées par des lésions de l'ADN, et donc de fournir un rationnel aux cancérologues pour prédire et optimiser les effets des médicaments anticancéreux en clinique. Elle décrit l'activation et la régulation de la protéine p53 dans les cellules individuelles après leur exposition à des agents causant des dommages à l'ADN. On montre que les comportements dynamiques qui ont été observés dans les cellules individuelles peuvent être reconstruits et prédits par fragmentation des événements cellulaires survenant après lésion de l'ADN, soit dans le noyau, soit dans le cytoplasme. Ceci est mis en œuvre par la description du réseau des protéines à l'aide d'équations différentielles ordinaires (EDO) et partielles (EDP) impliquant plusieurs agents dont les protéines ATM, p53, Mdm2 et Wip1, dans le noyau aussi bien que dans le cytoplasme, et entre les deux compartiments. Un rôle positif de Mdm2 dans la synthèse de p53, qui a été récemment observé, est exploré et un nouveau mécanisme provoquant les oscillations de p53 est proposé. On pourra noter en particulier que le nouveau modèle rend compte d'observations expérimentales qui n'ont pas pu être entièrement expliquées par les modèles précédents, par exemple, l'excitabilité de p53.En utilisant des méthodes mathématiques, on observe de près la façon dont un stimulus (par exemple, une $\gamma$-irradiation ou des médicaments utilisés en chimiothérapie) est converti en un comportement dynamique spécifiques (spatio-temporel) de p53, en particulier que ces dynamiques spécifiques de p53, comme messager de l'information cellulaire, peuvent moduler le cycle de division cellulaire, par exemple provoquant l'arrêt du cycle ou l'apoptose. Des modèles mathématiques EDO et EDP de réaction-diffusion sont utilisés pour examiner comment le comportement (spatio-temporel) de p53 émerge, et nous discutons des conséquences de ce comportement sur les réseaux moléculaires, avec des applications possibles dans le traitement du cancer.Les interactions protéine-protéine sont considérées comme des réactions enzymatiques. On présente quelques résultats mathématiques pour les réactions enzymatiques, en particulier on étudie le comportement en temps grand du système de réaction-diffusion pour la réaction enzymatique réversible à l'aide d'une approche entropique. À notre connaissance, c'est la première fois qu'une telle étude est publiée sur ce sujet. / Various molecular pharmacokinetic–pharmacodynamic models have been proposed in the last decades to represent and predict drug effects in anticancer therapies. Most of these models are cell population based models since clearly measurable effects of drugs can be seen on populations of (healthy and tumour) cells much more easily than in individual cells.The actual targets of drugs are, however, cells themselves. The drugs in use either disrupt genome integrity by causing DNA strand breaks and consequently initiate programmed cell death or block cell proliferation mainly by inhibiting proteins (cdks) that enable cells to proceed from one cell cycle phase to another. DNA damage caused by cytotoxic drugs or $\gamma$-irradiation activates, among others, the p53 protein-modulated signalling pathways that directly or indirectly force the cell to make a decision between survival and death.The thesis aims to explore closely intracellular pathways involving p53, ``the guardian of the genome", initiated by DNA damage and thus to provide oncologists with a rationale to predict and optimise the effects of anticancer drugs in the clinic. It describes p53 activation and regulation in single cells following their exposure to DNA damaging agents. We show that dynamical patterns that have been observed in individual cells can be reconstructed and predicted by compartmentalisation of cellular events occurring either in the nucleus or in the cytoplasm, and by describing protein interactions, using both ordinary and partial differential equations, among several key antagonists including ATM, p53, Mdm2 and Wip1, in each compartment and in between them. Recently observed positive role of Mdm2 in the synthesis of p53 is explored and a novel mechanism triggering oscillations is proposed. For example, new model can explain experimental observations that previous (not only our) models could not, e.g., excitability of p53.Using mathematical methods we look closely on how a stimulus (e.g., $\gamma$-radiation or drugs used in chemotherapy) is converted to a specific (spatio-temporal) pattern of p53 whereas such specific p53 dynamics as a transmitter of cellular information can modulate cellular outcomes, e.g., cell cycle arrest or apoptosis. Mathematical ODE and reaction-diffusion PDE models are thus used to see how the (spatio-temporal) behaviour of p53 is shaped and what possible applications in cancer treatment this behaviour might have. Protein-protein interactions are considered as enzyme reactions. We present some mathematical results for enzyme reactions, among them the large-time behaviour of the reaction-diffusion system for the reversible enzyme reaction treated by an entropy approach. To our best knowledge this is published for the first time.

Le terme d’« hypertension artérielle pulmonaire » (HTAP) décrit une maladie vasculaire pulmonaire caractérisée par une augmentation progressive des pressions artérielles pulmonaires (PAP), définie par une PAP moyenne supérieure ou égale à 25 mmHg au repos et dont le principal symptôme est un essoufflement à l’effort. Un remodelage artériel pulmonaire intense conduisant à une obstruction des petits vaisseaux pulmonaires est responsable de la maladie. C’est une maladie rare mais néanmoins grave car pouvant aboutir à une insuffisance ventriculaire droite et entraîner le décès du patient.Le cadre général de notre étude est l’amélioration de la compréhension des mécanismes physiopathologiques de l’HTAP afin d’identifier de nouvelles cibles thérapeutiques potentielles. Nous nous sommes intéressés plus particulièrement au phénotype « pseudo-tumoral » des cellules musculaires lisses des artères pulmonaires (CML-AP) des patients atteints d’HTAP qui jouent un rôle primordial dans le remodelage vasculaire pulmonaire de l’HTAP et qui présentent des caractéristiques communes avec les cellules cancéreuses, notamment une hyper-prolifération, une résistance à l’apoptose, des désordres métaboliques et une instabilité génomique. Etant donné que la protéine p53, un des plus importants suppresseurs de tumeur, est largement décrite comme inactivée dans la plupart des cancers, nous avons émis l’hypothèse qu’elle pourrait également jouer un rôle important dans le développement de l’HTAP. Les résultats des études in vitro menées sur des CML-AP de patients atteints d'HTAP idiopathiques (HTAPi) versus des sujets contrôles semblent indiquer que la protéine p53 n’est pas altérée dans les CML-AP HTAPi. En effet, la séquence codante du gène TP53 ne présente pas de mutation dans les CML-AP HTAPi, les expressions génique et protéique de p53 (et de certaines de ses protéines cibles) ne semblent pas être différentes entre contrôles et HTAPi, ni à l’état basal ni en réponse à différents stress cellulaires inducteurs de p53 (étoposide et H2O2). Cependant, la régulation de p53 semble altérée puisque nous avons observé une augmentation du taux protéique de MDM2, principal régulateur de p53, dans les CML-AP HTAPi. Ce résultat peut être considéré comme une des caractéristiques « pseudo-tumorales » des CML-AP HTAPi mais également être un élément déterminant du mécanisme d’action de la Nutlin-3a, qui a montré des effets anti-prolifératifs accrus dans les CML-AP HTAPi.Dans des études in vivo menées chez le rat, la protéine p53 semble jouer un rôle dans l’initiation de la pathogénèse d’une HTAP. En effet, les taux protéiques pulmonaires de p53, de sa cible p21 et de son régulateur (mais également cible transcriptionnelle) MDM2 sont diminués lors de la première semaine dans un modèle d’induction d’HTAP par mono-injection de monocrotaline (MCT) chez le rat, au cours duquel la pathologie se développe à partir de la 2ème semaine. De plus, l’administration quotidienne à des rats d’un inhibiteur de l’activité transcriptionnelle de p53, le pifithrin-α (PFT), conduit au développement d’une HTAP en 14 jours, au même titre qu’une mono-injection de MCT, et aggrave l’HTAP induite par la MCT. Des effets pro-prolifératifs et anti-apoptotiques du PFT révélés sur des CML-AP indiquent que l’inhibition de l’activité transcriptionnelle de p53 est à l'origine d'une prolifération exagéree et une résistance à l'apoptose, deux composantes clés dans le remaniement vasculaire pulmonaire et le développement de l'HTAP.En conclusion, ces résultats mettent en évidence l’implication de l’inactivation de la voie de p53 lors de la phase initiatrice du développement de l’HTAP, alors qu’aux stades tardifs et sévères de la maladie, il semble il y avoir une normalisation de p53. En revanche, l’augmentation de l’expression de son principal régulateur MDM2 observée dans les CML-AP de patients HTAP semble être une cible thérapeutique potentiellement intéressante. / Pulmonary artery hypertension (PAH) is a severe pulmonary vascular disease characterized by a progressive increase of the pulmonary arterial pressure (PAP), defined by a mean PAP greater than or equal to 25 mmHg at rest. The main symptom is a shortness of breath. An intense pulmonary arterial remodeling that leads to an obstruction of the small pulmonary vessels is responsible of the disease. PAH is a rare but severe disease that develops into right ventricular cardiac failure leading to the patient's death.The general framework of our study was to improve the understanding of the pathophysiology of PAH in order to identify new potential therapeutic targets and improve the clinical management of patients. In particular, we were interested in the “cancer-like phenotype” of PAH patient pulmonary arterial smooth muscle cells (PA-SMCs). PA-SMCs play a key role in the pulmonary vascular remodeling of PAH. These cells share characteristics with cancerous cells, such as: exaggerated proliferation, apoptosis resistance, metabolic disorders and genomic instability. Owing to the growth-suppressive and pro-apoptotic functions of p53 protein and its inactivation largely described in cancer, we hypothesized that the p53 pathway could also be altered during PAH development in PA-SMCs.The results of in vitro studies on PA-SMCs of late stage patients with idiopathic PAH (iPAH) versus control patients suggest that the p53 protein nor pathway is not altered in iPAH PA-SMCs. Indeed, the coding sequence of the TP53 gene presented no mutations in iPAH PA-SMCs. Analysis of mRNA and protein levels of p53 and its target proteins showed no difference between controls and iPAH PA-SMCs, neither in a basal state or in response to various cellular stresses such as etoposide and H2O2. However, regulation of p53 may be altered in iPAH PA-SMCs as we observed an increase of the MDM2 (the main p53 regulator) protein level compared to control. This last result may be considered as a “cancer-like” characteristic of iPAH PA-SMCs and also be a determining factor in the mechanism of action of Nutlin-3a, which had more important anti-proliferative effects in iPAH PA-SMCs than in control cells.In vivo studies in rats revealed, however, that the p53 pathway may play a role in the initiation stage of PAH pathogenesis. Indeed, kinetics evaluation of p53 lung expression in the PAH model, induced by a single injection of monocrotaline (MCT), revealed a decrease in the p53 protein level during the first week, followed by a normalization by the second week. PAH symptoms are developed in MCT rats after two weeks. Similarly, the protein levels of p21, a p53 target, and MDM2, the major p53 regulator, and also a transcriptional target of p53, decreased during the first week in the MCT-PAH model. In addition, daily treatment in rats with an inhibitor of p53 transcriptional activity, pifithrin-α (PFT), led to the development of PAH in 14 days, similarly to MCT, and worsened the PAH induced by MCT. Pro-apoptotic and anti-proliferative effects of PFT on PA-SMCs indicate that inhibition of p53 transcriptional activity causes an excessive proliferation and an apoptosis resistance, which are two key components of the pulmonary vascular remodeling and development of human and experimental PAH.In conclusion, these results demonstrate the involvement of the p53 pathway inactivation in the initiation stage of PAH development, whereas in late and severe stages of disease, its role seems to be less implicated. In contrast, the increased expression of MDM2 observed in PA-SMCs of PAH patients may be a potential therapeutic target.

Indiana University-Purdue University Indianapolis (IUPUI) / Although rare, classification of over 200 hereditary cancer susceptibility syndromes accounting for ~5-10% of cancer incidence has enabled the discovery and understanding of cancer predisposition genes that are also frequently mutated in sporadic cancers. The need to prevent or delay invasive cancer can partly be addressed by characterization of cells derived from healthy individuals predisposed to cancer due to inherited "single-hits" in genes in order to develop patient-derived samples as preclinical models for mechanistic in vitro studies. Here, we present microarray-based transcriptome profiling of Li-Fraumeni syndrome (LFS) patient-derived unaffected breast epithelial cells and their phenotypic characterization as in vitro three-dimensional (3D) models to test pharmacological agents. In this study, the epithelial cells derived from the unaffected breast tissue of a LFS patient were cultured and progressed from non-neoplastic to a malignant stage by successive immortalization and transformation steps followed by growth in athymic mice. These cell lines exhibited distinct transcriptomic profiles and were readily distinguishable based upon their gene expression patterns, growth characteristics in monolayer and in vitro 3D cultures. Transcriptional changes in the epithelial-to-mesenchymal transition gene signature contributed to the unique phenotypes observed in 3D culture for each cell line of the progression series; the fully transformed LFS cells exhibited invasive processes in 3D culture with disorganized morphologies due to cell-cell miscommunication, as seen in breast cancer. Bioinformatics analysis of the deregulated genes and pathways showed inherent differences between these cell lines and targets for pharmacological agents. After treatment with small molecule APR-246 that restores normal function to mutant p53, we observed that the neoplastic LFS cells had reduced malignant invasive structure formation from 73% to 9%, as well as an observance of an increase in formation of well-organized structures in 3D culture (from 27% to 91%) by stereomicroscopy and confocal microscopy. Therefore, the use of well-characterized and physiologically relevant preclinical models in conjunction with transcriptomic profiling of high-risk patient derived samples as a renewable laboratory resource can potentially guide the development of safer and more effective chemopreventive approaches.