Orientadores: Miriam Dambros, Luis Alberto Magna / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-08T00:26:33Z (GMT). No. of bitstreams: 1 Perchon_LygiaFerreiraGomes_M.pdf: 1294691 bytes, checksum: a72c898a6ea9573ee2b6576eed28d447 (MD5) Previous issue date: 2006 / Resumo: O presente trabalho, com duração de 24 semanas, avaliou a eficácia da terapia comportamental em grupo em promover mudanças positivas no padrão de qualidade de vida (Qol) de pacientes com incontinência urinária (IU) e disfunção erétil (DE), após prostatectomia radical. Participaram da pesquisa 30 pacientes. A intervenção foi desenhada visando melhorar a QoL, através de técnicas específicas para ensinar os participantes a identificarem e a administrarem situações estressantes e teve como foco as queixas de IU e DE, pós prostatectomia radical. A diferença entre o início e o final do estudo, para cada variável, foi comparada pelo teste t de Student para dados pareados. Análise múltipla, realizada com regressão linear múltipla escalonada, foi precedida de análise de correlação simples de Pearson. Consideraram-se variáveis dependentes: percepção geral da saúde, disfunção erétil e impacto da incontinência urinária e as variáveis independentes: idade, status profissional, alcoolismo, atitude frente ao câncer e frente à cirurgia, satisfação sexual anterior à cirurgia e planos para o futuro. A média de tempo entre a data da cirurgia e o início da terapia comportamental de grupo foi de 14,8 meses (desvio padrão=6,2; mediana=16,5). Para 63,3% dos pacientes, esse intervalo foi maior que 12 meses. Não foi encontrada correlação significativa entre esse tempo e as variáveis dependentes. O escore do domínio percepção geral da saúde diminuiu ao final do estudo (p=0,000), assim como o escore referente ao impacto da incontinência urinária (p=0,023), o que significa melhora dos dois fatores. A diferença entre os escores do impacto da incontinência correlacionou-se negativamente com a idade (p=0,04) e status profissional (p=0,05). A regressão múltipla mostrou que a idade foi a variável mais importante (r2 = 26,0%); considerados simultaneamente, idade e status profissional, há um aumento de 10,3% (r2 = 36,3%). O escore de disfunção erétil aumentou no final do estudo (p=0,000), e as diferenças entre os escores dessa variável correlacionaram-se positivamente e significantemente somente com os de satisfação sexual anterior à cirurgia (p=0,029), o que demonstrou a influência da satisfação sexual anterior à cirurgia sobre a disfunção erétil (r2 = 15,8%). A terapia de grupo mostrou-se efetiva em melhorar a percepção da qualidade de vida de homens submetidos à prostatectomia radical, particularmente em relação à IU e DE / Abstract: The current study evaluated the efficacy of a 24-week, group based, behavioral therapy in improving quality of life (QoL) among men who were treated for localized prostate carcinoma (PC) with radical prostatectomy (RP), and had treatment related dysfunctions: Urinary Incontinence (UI) and Erectile Dysfunction (ED). Thirty men were assigned to a 24-week group therapy. The intervention was designed to improve QoL by helping participants to identify and effectively manage stressful experiences and was focused on treatment-related sequelae of PC. The difference of all variables was compared between the beginning and the end of the study by means of Student¿s t test for paired samples. Multiple analysis was carried out by stepwise multiple linear regression following bivariate Pearson¿s correlation analysis. This was achieved with all predictors (i.e. general health perception, ED and the impact of UI) and relevant covariates (i.e. age, work/retirement status, alcohol addiction, attitude before cancer and before surgery, sexual satisfaction, and plans for the future). The mean time from surgery to attending the behavioral group intervention was 14.8 months (sd = 6.2; median = 16.5), and for 63.3% of the patients, this time was over 12 months. There was no significant correlation between that time and the predictor variables. General health perception scores decreased at the end of the study (p = 0.000), as well as urinary incontinence impact (UI) score (p=0.023), thus denoting improvement of both factors. The difference between the scores of the latter correlated negatively and significantly with both age (p = 0.04) and work/retirement (p = 0.05). Multiple stepwise regression showed that age was the most important variable (r2 = 26.0%); considering simultaneously age and work/retirement, there is an increase of 10.3% (r2 = 36.3%). Erectile dysfunction (ED) showed an increase at the end of the study (p = 0.000), and the difference between the scores of this variable correlated positively and significantly with sexual satisfaction only (p = 0.029), which means the positive influence of previous sexual satisfaction over erectile dysfunction (r2 = 15.8%). In conclusion, a 24-week behavioral group therapy was effective in improving the perceived QoL among men treated for PC. There were changes associated with the therapy, particularly the improvement in UI and ED / Mestrado / Pesquisa Experimental / Mestre em Cirurgia

Orientador: Ana Valéria Colnaghi Simionato / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Química / Made available in DSpace on 2018-08-24T11:07:57Z (GMT). No. of bitstreams: 1 Buzatto_AdrianaZardini_M.pdf: 6706551 bytes, checksum: 371c3400224fcd4031972f241185d555 (MD5) Previous issue date: 2014 / Resumo: O câncer está entre as maiores causas de óbitos no mundo, porém, se a enfermidade for detectada no início, grande parte dos casos pode atingir a cura. Os nucleosídeos são moléculas originadas da degradação do RNA e suas concentrações em fluidos biológicos são alteradas na presença de tumores devido à maior taxa de replicação celular, portanto são potenciais biomarcadores tumorais. A investigação do perfil de tais metabólitos pode auxiliar no diagnóstico e no tratamento do câncer. Neste trabalho, um novo método para a análise de nucleosídeos em soro sanguíneo por eletroforese capilar (CE-UV) no modo cromatografia micelar eletrocinética capilar (MECK) foi desenvolvido e validado. O surfactante catiônico brometo de cetiltrimetilamônio (CTAB) foi empregado, com consequente inversão do fluxo eletrosmótico. Os analitos foram extraídos da matriz de soro sanguíneo através de extração em fase sólida (SPE) e um amplo estudo sobre estratégias de pré-concentração foi realizado para obtenção de limites de quantificação mais baixos e adequados. Sete padrões de nucleosídeos mais o padrão interno foram separados em c.a. 25 min sob as condições de análise otimizadas, i.e. eletrólito de corrida composto por ácido bórico 30 mmol/L, CTAB 50 mmol/L e metanol 10% (v/v) em pH 9,90; tensão de -10 kV; temperatura de 20°C; injeção hidrodinâmica a 50 mbar por 120 s seguida por aplicação 25 kV entre vials de eletrólito por 15 s; e capilar de sílica fundida com 50 µm de diâmetro interno e 56 cm de comprimento efetivo. Foram atingidas eficiências entre 4,3 ? 104 e 1,0 ? 105 e resolução mínima de 1,5. A metodologia foi validada em um pool de soro sanguíneo de indivíduos sadios e foram obtidos limites de quantificação entre 1,0 e 4,0 µmol/L, coeficientes de correlação linear entre 0,9801 e 0,9969 e precisões e exatidões menores que 20%. O método foi aplicado a amostras de 60 indivíduos sadios e 66 portadores de câncer de próstata e um estudo quimiométrico foi realizado para avaliação da potencialidade dos nucleosídeos como biomarcadores tumorais, com obtenção de especificidade acima de 90%. Tal metodologia, portanto, pode ser empregada em conjunto com as já bem estabelecidas para o diagnóstico do câncer de próstata / Abstract: Cancer is amongst the major causes of death worldwide, but, if the disease is detected early, most cases can be cured. Nucleosides are molecules originated from RNA degradation and their concentrations in biological fluids are altered during tumor development due to a higher rate of cell replication; therefore, they are putative tumor biomarkers. The investigation of the profile of such metabolites may aid in the diagnosis and treatment of cancer. In this work, a novel method for the analysis of nucleosides in blood serum by capillary electrophoresis (CE-UV) under micellar electrokinetic capillary chromatography (MECK) mode was developed and validated. The cationic surfactant cetyltrimethyl ammonium bromide (CTAB) was employed, with consequent reversal of the electrosmotic flow. The analytes were extracted from blood serum samples by solid phase extraction (SPE) and a wide study on pre-concentration strategies was accomplished in order to obtain lower and more adequate limits of quantification. Seven nucleoside standards plus the internal standard were separated within c.a. 25 min under the optimized conditions, i.e. electrolyte composed by 30 mmol/L boric acid, 50 mmol/L CTAB and 10% methanol (v/v) with pH 9,90; voltage of -10 kV; temperature of 20°C; hydrodynamic injection under 50 mbar for 120 s followed by 25 kV for 15 s between electrolyte vials; and fused silica capillary with 50 µm internal diameter and 56 cm of effective length. Efficiencies between 4.3 ? 104 and 1.0 ? 105 and a minimum resolution of 1.5 were achieved. The methodology was validated in a pool of blood serum samples from healthy individuals and limits of quantification between 1,0 and 4,0 µmol/L were obtained, as well as linear correlation coefficients between 0,9801 and 0,9969 and precision and accuracy lower than 20%. The method was applied to samples from 60 healthy individuals and 66 prostate cancer patients and a chemometric study was employed in order to evaluate the potentiality of the nucleosides as tumor biomarkers, with specificity higher than 90%. Therefore, this methodology may be applied in conjunction with those already established for prostate cancer diagnosis / Mestrado / Quimica Analitica / Mestra em Química

Orientador: Nelson Eduardo Durán Caballero / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Química / Made available in DSpace on 2018-08-27T13:02:52Z (GMT). No. of bitstreams: 1 Bueno_CamilaPedrosoSilveira_M.pdf: 80017692 bytes, checksum: afdb5714b60ba879bf69cbd031077a1d (MD5) Previous issue date: 2015 / Resumo: Um dos principais problemas da quimioterapia, atualmente, é o uso de fármacos extremamente citotóxicos, cuja falta de especificidade acarreta na ação sob todos os tipos de células, incluindo as saudáveis, gerando efeitos colaterais intensos, que prejudicam a terapia em si. Nesse sentido, os nanomateriais oferecem uma opção terapêutica valiosa, pois podem conjugar especificidade e liberação sustentada do fármaco, prevenindo-o de ser degradado prematuramente e permitindo o uso de menores doses. A fim de desenvolver um sistema do tipo drug depot que servisse como plataforma para a liberação sustentada de fármacos, foram produzidas, neste trabalho, formulações baseadas em nanopartículas mesoporosas de sílica e hidrogel de Pluronic F-127, associadas a dois fármacos individualmente: doxorrubicina e sildenafila. As nanopartículas mesoporosas de sílica são boas alternativas para uso médico, pois são biocompatíveis e possuem grande volume de poros, atuando como carreadoras, promovendo a liberação sustentada do fármaco. O Pluronic F-127 atua como agente gelificante e promove uma liberação prolongada das nanopartículas e do fármaco incorporado, uma vez que é um polímero termo-reversível que permite a formação de um hidrogel à temperatura ambiente. A doxorrubicina é um antibiótico antitumoral de largo espectro, amplamente usada no tratamento de diversos cânceres, que atua ligando-se ao DNA e induzindo apoptose celular. Por sua vez, a sildenafila faz parte de uma classe de inibidores da enzima fosfodiesterase-5, cuja expressão aparece aumentada em diversos carcinomas e, por isso, seu papel na progressão tumoral vem sendo amplamente estudado. Após estudar os aspectos físico-químicos envolvendo os componentes dos sistemas, como estabilidade coloidal e interações entre as nanopartículas e biomoléculas presentes no meio biológico, as formulações foram testadas contra câncer de próstata quimicamente induzido em ratos. Os resultados mostram que as nanopartículas possuem um papel determinante no quadro de melhora de tumor, minimizando, também, a toxicidade do antitumoral / Abstract: One of the largest problems of chemotherapy currently is the use of highly cytotoxic drugs with lack of specificity, thus damaging all kinds of tissues, including healthy cells. This leads to aggressive side effects that jeopardize the therapy itself. In this context, nanomaterials emerge as a valuable therapeutic option, as they can provide the specificity to target tumor tissues and a sustained release of the drug, preventing the drugs premature degradation and allowing lower doses. Aiming to develop a drug depot system that would act as platform for the sustained release of drugs, this project proposed to develop formulations based on mesoporous silica nanoparticles and Pluronic F-127 hydrogels, associated with two drugs individually: doxorubicin and sildenafil. The mesoporous silica nanoparticles are good alternatives for biomedical use because of their biocompatible features and their great pore volume, acting as carriers and providing sustained release. Pluronic F-127 acts as the gelling agent and provides a prolonged release of the nanoparticles and the loaded drug, since it is a thermo-reversible polymer that allows the formation of a hydrogel at room temperature. Doxorubicin is an antibiotic and antitumor of large spectra, largely used to treat several types of cancer and acts binding the DNA and inducing cell apoptosis. Sildenafil, in turn, is part of a class of inhibidors of the enzyme phosphodiesterase-5, which expression is increased in many carcinomas and which role in tumor progression has been largely studied. After studying physico-chemical aspects involving the systems produced, such as the colloidal stability, release profile, and the interactions of the nanoparticles with the biomolecules present in biological medium. The formulations were also tested in rats with chemically induced prostate cancer. The results show that the nanoparticles play a determinant role on the improvement of tumor conditions, also reducing doxorubicin's toxicity / Mestrado / Físico-Química / Mestra em Química

Terminado o sequenciamento do genoma humano, as atenções se voltaram para a determinação do conjunto completo de transcritos humanos. Diversos trabalhos sugerem que enquanto apenas uma pequena fração de mRNAs codificantes para proteína não é conhecida, existe um grande número de RNAs não-codificantes (ncRNAs) ainda não caracterizados. Nesse contexto, o presente trabalho visou explorar as informações de expressão gênica contidas em ESTs para identificar e caracterizar novos transcritos humanos. A busca genômica por membros de famílias gênicas relacionadas com câncer levou a identificação de novas pequenas GTPases, destacando uma subfamília que deve apresentar função supressora tumoral em próstata. Uma classe de ncRNAs longos, sem splicing, expressos antisenso a partir de regiões intrônicas foi descrita utilizando plataformas de microarrays, construídas pelo grupo, enriquecidas com seqüências sem anotação. O perfil de expressão de 23 ncRNAs intrônicos estava significativamente correlacionado com o grau de diferenciação de tumores de próstata (Gleason Score), e pode ser utilizado como candidato a marcador molecular de prognóstico. Um total de 39 ncRNAs intrônicos responderam à estimulação por andrógeno, apontando para um mecanismo regulatório da expressão intrônica por sinais fisiológicos hormonais. A biogênese da expressão intrônica parece ser complexa, pois uma fração não é transcrita pela RNA Polimerase II. A transcrição intrônica estava correlacionada com uso de exons em células tratadas com andrógeno. Assinaturas de expressão intrônica conservadas em tecidos humanos e de camundongos, e interações de transcritos intrônicos com proteínas regulatórias foram observadas. Este trabalho contribui com novas e originais evidências que dão apoio ao papel postulado para esses ncRNAs no controle fino do programa transcricional humano. / With the completion of the human genome sequence, attention has shifted towards determining the complete set of human transcripts. Multiple lines of evidence suggest that while only a small fraction of protein-coding mRNAs remains to be described, there is a huge amount of uncharacterized non-coding RNAs (ncRNAs). In this context, the present work sought to explore the gene expression information provided by ESTs to identify and characterize new human transcripts. A genomic-wide search for cancer related gene family members identified novel small GTPase genes, and highlighted an uncharacterized subfamily that may have a tumor suppressor role in prostate cancer. A class of long unspliced ncRNAs, expressed antisense from introns of protein-coding genes was described using custom-designed microarray platforms enriched with unannotated sequences. The expression profile of 23 intronic ncRNAs was significantly correlated to the degree of prostate tumor differentiation (Gleason Score), and could be used as a candidate prognostic molecular maker. A total of 39 intronic ncRNAs were responsive to androgen stimulation, poiting to a mechanism of intronic expression regulation by physiological hormone signals. Intronic ncRNA biogenesis seems to be complex, since a fraction of them is not transcribed by RNA Polymerase II. Intronic transcription was correlated to exon usage in androgen treated cells. Tissue expression signatures of intronic transcription were conserved in human and mouse, and intronic transcripts were found to interact with regulatory proteins. This work provides new and original contributions that support the postulated role of ncRNAs in the fine tunning of the human transcriptional program.

Prostate cancer is the most common cancer in men and the third leading cause of cancer-related deaths in Canadian men. Despite hormone and radiation therapies, most patients progress to late-stage metastatic castrate-resistant prostate cancer (mCRPC). 177Lu-PSMA617 radioligand therapy (rLT) is a radioactive biochemical substance that targets the human prostate-specific membrane antigen (hPSMA). This rLT has been used in compassionate trials in mCRPC patients and has been demonstrated significant clinical efficacy. However, recent findings suggest that this efficacy is short-lived, and most patients exhibit tumor recurrence [96]. Here we establish a murine model to study the anti-tumor effects and the corresponding immune response of 177Lu-PSMA617 rLT on prostate cancer. We generated a doxycycline-inducible hPSMA-expressing murine prostate cancer (hPSMA TRAMP-C2) cell line with high binding responses to PSMA617. Using this system, we evaluated the in vitro and in vivo binding of 177Lu-PSMA617 to the hPSMA TRAMP-C2 cell line. Here, we show that the hPSMA TRAMP-C2 cell line expresses hPSMA upon doxycycline induction and that 177Lu-PSMA617 can bind to its target in vitro and in vivo. Together, these results show that the developed hPSMA TRAMP-C2 cell line can be used to investigate therapeutic and immunological responses targeted against PSMA in prostate cancer. / Graduate

Les maladies chroniques de l’adulte (maladies cardiovasculaires, cancers, maladies respiratoires et diabète) tuent chaque année dans le monde 38 millions de personnes dont 16 millions avant l’âge de 70 ans. Jusqu’aux années 1990, l’origine de ces pathologies étaient associée au style de vie de l’individu : consommation de tabac, d’alcool, l’inactivité physique et un régime alimentaire déséquilibré. Depuis l’élaboration du concept de DOHaD, identifiant les origines développementales de la santé et des maladies, de nombreuses données montrent que les maladies chroniques de l’adulte ont, en partie, une origine très précoce pendant la période péri conceptionnelle (in utero, premières années de la vie). L’exposition, à cette période, à des déséquilibres alimentaires, des toxiques, des produits chimiques synthétiques perturbant les hormones endogènes (perturbateurs endocriniens, PEs) pourra impacter l’organisme en développement via des modifications épigénétiques qui retiennent la mémoire des facteurs environnementaux auxquels sont soumis les individus. Toutefois, les phénotypes et les mécanismes impliqués sont encore loin d’être décryptés. Au cours de ce travail de thèse, nous nous sommes intéressée aux effets développementaux sur la prostate. En effet, le cancer de la prostate (CaP) est la deuxième cause de cancer et la 5° cause de mort par cancer dans le monde. Les données de la littérature montrent que les déséquilibres alimentaires (régime riche en graisse, HFD) et les PEs œstrogèno-mimétiques sont des facteurs de risque pour ce cancer. Nous avons développé un modèle expérimental de rats (jeunes adultes, 90 jours post-natal) exposés pendant la gestation jusqu’au sevrage à un HFD (60% de graisses), ou à un estrogène (estradiol benzoate, EB) pendant la période néonatale, ou bien à la combinaison des deux, pour explorer les effets sur la prostate (lobe ventral). L’exposition péri natale à l’EB ou à la combinaison EB+HFD diminue le poids de la prostate adulte. Cette anomalie est associée à une inflammation de la prostate modérée (HFD), importante (EB) ou massive (EB+HFD). L’infiltrat est composé essentiellement de macrophages et de lymphocytes T. Cette inflammation est associée à une augmentation dans la prostate du taux de cytokines pro-inflammatoires TNFa, CCL2/MCP1 (EB) mais aussi IL-6 (EB+HFD) ainsi qu’à une dérégulation de l’inflammasome NLRP3. NLRP3 est activé de façon chronique puisque l’on observe une sur expression de ses substrats IL-1b et IL-18. En conclusion, nous montrons que l’exposition péri conception à un estrogène ou à la combinaison RRG+EB programme des lésions prostatiques chez l’animal adulte. Chez l’homme, il est suggéré que des lésions inflammatoires chroniques (atrophie proliférative inflammatoire) seraient, comme pour d’autres organes, une première étape vers le début de la carcinogenèse. Ainsi, notre modèle expérimental permettrait l’étude des étapes précoces de la tumorigenèse prostatique. / Non-communicable diseases (NCDs) including cardiovascular diseases, cancers, respiratory diseases and diabetes kill 38 million people worldwide every year, 16 million of them before the age of 70. Until the 1990s, the origin of these pathologies was associated with the lifestyle of the individual: consumption of tobacco, alcohol, physical inactivity and an unbalanced diet. Since the development of the concept of DOHaD, identifying the developmental origins of health and disease, number of evidence showed that NCDs have, in part, an early origin during the peri-conception period (in utero, first years of life). Exposure during this period to food imbalances, toxic chemicals, synthetic chemicals disrupting endogenous hormones (endocrine disruptors, EDCs) may impact the developing body through epigenetic changes imprinted by the environmental factors to which individuals are exposed. However, the phenotypes and mechanisms involved are still far from being decrypted. During this thesis, we focused on developmental effects on the prostate. In fact, prostate cancer (PCa) is the second leading cause of cancer and the fifth leading cause of death by cancer in the world. Data from the literature shows that dietary imbalances (High Fat Diet, HFD) and estrogen-like EDCs are risk factors for this cancer. We developed an experimental model of rats (young adults, 90 days postnatal) exposed during pregnancy until weaning to HFD (60% fat), or estrogen (estradiol benzoate, EB) during the neonatal period, or a combination of both, to explore the effects on the prostate (ventral lobe). Peri-natal exposure to EB or EB + HFD reduces the weight of the adult prostate. This abnormality is associated with low (HFD), moderate (EB) or massive (EB + HFD) prostate inflammation. The infiltrate is composed mainly of macrophages and T lymphocytes. This inflammation is associated with an increase in the prostate of pro-inflammatory cytokine TNFa, CCL2 / MCP1 (EB) but also IL-6 (EB + HFD) as well as a deregulation of the NLRP3 inflammasome. NLRP3 is chronically activated since its substrates IL1b and IL-18 were over expressed. In conclusion, we show that peri-conception exposure to an estrogen or HFD + EB combination programs prostatic lesions in adult animals. In men, it is suggested that chronic inflammatory lesions (proliferative inflammatory atrophy) would, as for other organs, be a first step towards the onset of carcinogenesis. Thus, our experimental model is relevant for the study of the early stages of prostatic tumorigenesis.

<p>In eukaryotic systems, the genetic material of the cell –DNA– is packed into a protein-dense structure called chromatin. Chromatin structure is critical for preservation of the genetic material as well as coordination of vital processes such as DNA replication, transcription and DNA damage repair. The fundamental repeating unit of chromatin is nucleosome which is composed of an octamer of small alkaline proteins called histones and the DNA wrapped around this octamer. The nucleosomes are then packed into higher-order structures leading to formation of 3D chromatin architecture. The chromatin is a dynamic structure; the spacing between nucleosomes, or the folding of the larger chromatin segments is subjected to alterations during embryonic development, tissue specifications or <i>simply during any event that require gene expression changes</i>. Failure in proper regulation of chromatin structure has been associated with embryonic defects and disease such as cancer. </p> <p>This work has focused on a class of ATP-dependent chromatin remodeling complexes known as switch/sucrose-non-fermentable (SWI/SNF) or BRG-associated factors (BAF) complex. This family of complexes act on chromatin and alter its physical structure by mobilizing histones or nucleosome particles through the activity of its ATPase –BRG1 or BRM, enabling more accessible DNA for the other factors such as transcription factors to localize and recruit transcription machinery. In particular, we discovered and biochemically defined a novel version of this family of chromatin complexes that we named as GLTSCR1/1L-BAF (GBAF). GLTSCR1 and GLTSCR1L are two uncharacterized paralogous proteins that have been identified as BRG1-interacting proteins. Biochemically surveying the essence of this interaction, we realized that these proteins incorporates into a previously unknown SWI/SNF family complex that lacks well-characterized SWI/SNF subunits such as ARID1/2, BAF170, BAF47; instead, uniquely comprise GLTSCR1/1L and bromodomain-containing protein BRD9. Focusing on the GLTSCR1 subunit, we observed that its absence is well-tolerated by many different cell types except slight growth retardation by prostate cancer cells. Expanding the cohort of prostate cancer cells, we realized that not the paralogous subunits GLTSCR1 or GLTSCR1L but unique and non-redundant subunit BRD9 is the major GBAF-dependence in prostate cancer cells. We observed that especially the androgen-receptor positive cell lines have severe growth defects upon <i>BRD9 </i>knockdown or inhibition. <i>In vivo, </i>we showed that xenografts with <i>BRD9 </i>knockdown prostate cancer cells (LNCaP) have smaller tumor size. We demonstrated that BRD9 inhibition can block the expression of androgen-receptor targets. Similarly, <i>BRD9 </i>knockdown and treatment with antiandrogen drug (enzalutamide) has overlapping transcriptional effects. Mechanistically, we showed that BRD9 interacts with AR and it colocalizes with AR in subset of AR -binding sites. Surprisingly, we realized that BRD9 depletion has similar transcriptional and phenotypic effects as BET protein inhibitors. BET protein family contains 4 bromodomain containing proteins (BRD2, BRD3, BRD4, BRDT). These proteins were previously shown to be critical for AR-dependent gene expression. We detected interaction between BRD9 and BRD2/4. We demonstrated that BRD4 and BRD9 had shared binding sites on genome, a fraction of which are co-bound by AR. At particular target sites we showed that BRD9 localization is dependent on BET proteins, but not the other way around. Taking together, we provided some evidences that GBAF targeting through BRD9 can be a novel therapeutic approach for prostate cancer. Growing body of reports suggested that current therapy options targeting the androgen receptor is failing due to acquired resistance. Therefore, targeting the AR pathways via its coregulators such as BET proteins or SWI/SNF complexes can serve as potent alternative approaches. Further research is needed to elucidate the roles of GBAF and BET proteins in androgen receptor independent prostate cancer cells, which are still responsive to GBAF or BET manipulations although to a lesser extent.</p>

Since the late 90’s the diagnostic activity for prostate cancer has increased in Sweden, primarily due to increased use of PSA testing, and this has led to a large increase in diagnoses. Simultaneously, there have been changes in treatment strategies, and more effective treatments have been introduced. This thesis aims to increase the understanding of short and long term consequences of these changes by use of high quality data on virtually all men diagnosed with prostate cancer in Sweden. In paper I, the survival of men with metastatic prostate cancer at diagnosis was investigatedby use of survival models, including Kaplan-Meier analyses and Cox proportional hazards regression.The median survival from diagnosis increased with 6 months when comparing mendiagnosed 1998-2001 with men diagnosed 2010-2015, and the risk of death decreased with 13%, while median levels of prostate specific antigen at diagnosis dropped with up to 50%. In paper II, the interplay between diagnostic activity, incidence and risk of death by prostate cancer was modelled using a discrete time model. Data on diagnostic activity, e.g. in termsof testing frequencies, was not available and therefore a proxy for the diagnostic activity wasused. The hazards were estimated within the framework of generalized additive models. Two simulations were performed, assuming low and high diagnostic activity respectively, to compare incidence and mortality from 2017-2060. Higher diagnostic activity, compared to lower, led to more men being diagnosed, primarily with lower risk prostate cancer, but in the long run it led to fewer men diagnosed with metastatic disease and fewer prostate cancer deaths.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21995号 / 医博第4509号 / 新制||医||1037(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 戸井 雅和, 教授 万代 昌紀, 教授 武藤 学 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・論文博士 / 博士(社会健康医学) / 乙第13358号 / 論社医博第15号 / 新制||社医||11(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 川上 浩司, 教授 小川 修, 教授 松村 由美 / 学位規則第4条第2項該当 / Doctor of Public Health / Kyoto University / DFAM