L’asthme est une des maladies chroniques les plus prévalentes, affectant environ 300 millions d’individus dans le monde et causant plus de 400 000 décès annuellement. La condition se caractérise par une hyperréactivité bronchique, de l’inflammation pulmonaire et des changements structuraux (remodelage) des voies respiratoires. Bien que l’inflammation soit le plus souvent de type éosinophilique dans l’asthme, une proportion importante des patients affectés par la forme sévère de la maladie présente plutôt une infiltration des voies respiratoires par les neutrophiles. Cette inflammation neutrophilique a été associée à plusieurs issues cliniques négatives, notamment à une mauvaise réponse aux traitements, à une obstruction respiratoire permanente et à la mortalité. Malgré l’importance de ces conséquences cliniques pour les patients affectés, le rôle de l’inflammation neutrophilique dans la pathophysiologie de l’asthme, dont ses effets sur le remodelage bronchique, demeure peu exploré. Dans toutes les formes d’asthme, les traitements usuels de la maladie (glucocorticoïdes et bronchodilatateurs) ne permettent pas de renverser entièrement les lésions de remodelage bronchique, dont l’augmentation de la masse du muscle lisse, et ne contrôlent pas adéquatement la neutrophilie pulmonaire. L’augmentation de la masse musculaire lisse bronchique représente pourtant une cible thérapeutique importante vu son implication dans le rétrécissement de la lumière bronchique et le bronchospasme. Les objectifs de cette thèse ont donc été d’étudier les mécanismes potentiellement impliqués dans l’association entre l’inflammation neutrophilique et la sévérité de la maladie, et d’investiguer les effets de thérapies anti-neutrophiliques sur le remodelage bronchique dans le modèle de l’asthme équin sévère. Similairement à la condition humaine, l’asthme équin sévère est caractérisé par une obstruction respiratoire fluctuante, de l’inflammation pulmonaire et un remodelage bronchique, notamment une augmentation de la masse du muscle lisse. Cette maladie se prête particulièrement bien à l’étude du phénotype neutrophilique puisque c’est cette cellule granulocytaire qui infiltre le milieu pulmonaire lors des exacerbations cliniques. Les études réalisées dans ce projet doctoral ont permis de déterminer que l’azithromycine, un macrolide possédant des propriétés immunomodulatrices, réduit l’inflammation neutrophilique dans le modèle de l’asthme équin. Toutefois, ce traitement n’a pas diminué l’obstruction bronchique ni les lésions de remodelage lorsqu’utilisé en monothérapie, et n’a pas potentialisé les effets des corticostéroïdes inhalés. Ces résultats suggèrent que l’atténuation de l’inflammation pulmonaire ne suffit pas à rétablir l’homéostasie tissulaire dans la phase chronique de la maladie. Toutefois, l’hétérogénéité phénotypique des neutrophiles pourrait rendre leur simple quantification dans les sécrétions respiratoires insuffisante pour élucider leurs répercussions dans l’asthme. Par exemple, les neutrophiles pourraient contribuer au remodelage bronchique par la relâche de vésicules extracellulaires, des nanoparticules qui peuvent modifier la biologie des cellules locales et distantes. Ainsi, les caractéristiques des vésicules neutrophiliques et leur effet prolifératif sur le muscle lisse bronchique ont été examinés. Les résultats obtenus indiquent que les vésicules produites par les neutrophiles augmentent la prolifération du muscle lisse bronchique lorsqu’elles proviennent de cellules exposées au lipopolysaccharide, un fragment bactérien omniprésent dans l’environnement et incriminé dans l’infiltration neutrophilique et le développement de l’obstruction bronchique dans l’asthme humain et équin. / Asthma is one of the most prevalent chronic diseases, affecting approximately 300 million people worldwide and causing over 400,000 deaths annually. The condition is characterized by the combination of bronchial hyperreactivity, lung inflammation, and structural changes in the airways (remodeling). Although an eosinophilic inflammation is common in asthma, a significant proportion of patients affected by the severe form of the disease have a neutrophilic airway infiltration. The neutrophilic phenotype has been associated with several negative outcomes in human asthma, including poor response to therapy, permanent airway obstruction and mortality. Despite these associations, the role of neutrophils in asthma, including its effects on airway remodeling, remains insufficiently explored. Unfortunately, standard asthma therapies (glucocorticoids and bronchodilators) do not adequately control neutrophilic inflammation and reverse only partially, if at all, bronchial remodeling lesions, including the increased airway smooth muscle mass. This structural modification is however an important therapeutic target because of its involvement in bronchial lumen narrowing and bronchospasm. The main objectives of this thesis were therefore to study mechanisms potentially involved in the association between neutrophilic inflammation and asthma severity, and to investigate the effects of anti-neutrophilic therapies on bronchial remodeling reversibility in the severe equine asthma model. Similar to the human disease, severe equine asthma is characterized by fluctuating airflow obstruction, pulmonary inflammation, and remodeling lesions, including a large increase in airway smooth muscle mass. Clinical exacerbations are characterized by a marked pulmonary neutrophilic influx, making this disease particularly suitable to study the neutrophilic phenotype. Studies conducted during this doctoral program revealed that azithromycin, a macrolide with immunomodulatory properties, reduces neutrophilic inflammation in the equine asthma model, but fails to alleviate bronchial obstruction and remodeling lesions, suggesting that the control of neutrophilic inflammation is not sufficient to restore tissue homeostasis when the disease reaches its chronic phase. However, the simple quantification of neutrophils within respiratory secretions might not elucidate comprehensively the possible functional consequences of this cell in the pathophysiology of asthma. For instance, neutrophils could lead and sustain bronchial structural lesions through the release of extracellular vesicles. Those nanoparticles can modify the biology of local and distant cells and are involved in the pathophysiology of several inflammatory diseases. Thus, the characteristics and the effect of neutrophil extracellular vesicles on airway smooth muscle proliferation were studied in horses with severe asthma. The results obtained indicate that extracellular vesicles increase bronchial smooth muscle cell proliferation when they are produced by neutrophils exposed to lipopolysaccharide, a ubiquitous environmental contaminant incriminated in the development of neutrophilic infiltration and bronchial obstruction in human and equine asthma.

Acquired tamoxifen resistance develops in the majority of hormone responsive breast cancers and frequently involves overexpression of the PI3K/AKT axis. Here, breast cancer cells, with elevated endogenous AKT or overexpression of activated AKT exhibited tamoxifen-stimulated cell proliferation and enhanced cell motility. To gain mechanistic insight on AKT-induced endocrine resistance, gene expression profiling was performed to determine the transcripts that are differentially expressed post-tamoxifen therapy under conditions of AKT overexpression. Consistent with the biological outcome, many of these transcripts function in cell proliferation and cell motility networks and were quantitatively validated in a larger panel of breast cancer cells. Moreover, ribonucleotide reductase M2 (RRM2) was revealed as a key contributor to AKT-induced tamoxifen resistance. Inhibition of RRM2 by RNAi-mediated approaches significantly reversed the tamoxifen-resistant cell growth, inhibited cell motility, and activated pro-apoptotic pathways. In addition, treatment of tamoxifen-resistant breast cancer cells with the small molecule RRM2 inhibitor Didox significantly reduced cell growth in vitro and in vivo. To further establish a functional association between RRM2 expression and tamoxifen resistance in breast cancer cells, gain of function studies were performed by overexpressing RRM2 in MCF-7 cells. Overexpression of RRM2 profoundly reduced tamoxifen sensitivity and down-regulated ER-&agr; in otherwise tamoxifen sensitive breast cancer cells. Furthermore, breast cancer cells with high RRM2 had elevated Her-2 and EGFR expression, modulated ER-&agr; signaling and NFκB expression. These findings also indicate that it may be possible to use RRM2 as a prognostic factor in breast cancer patients under tamoxifen therapy, and can be considered a potential therapeutic target in tumors that have acquired resistance to tamoxifen. Finally, inhibition of RRM2 by drug Didox effectively eradicates the tamoxifen resistant population, revealing a potential beneficial effect of combination therapy that includes RRM2 inhibition to delay or abrogate tamoxifen resistance. In conclusion, the findings of this work delineate the important role of RRM2 in Akt induced and acquired tamoxifen resistance in breast cancer. It also provides a preclinical rationale for evaluating tamoxifen in combination with Didox for breast cancer treatment.

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O câncer de mama é a principal causa de mortalidade por câncer entre as mulheres. Alguns biomarcadores e características clínicas são utilizados para avaliar o prognóstico e prever a resposta a uma série de abordagens terapêuticas. A Homocisteína é conhecida como um fator de risco para doença vascular aterosclerótica, mas sua participação na biologia do câncer ainda é incerta. Cisteína é o aminoácido sulfurado derivado da Homocisteína no ciclo da Metionina. Este ciclo metabólico origina as bases nitrogenadas e também determina o nível de metilação da molécula de DNA. É atualmente reconhecido que a hipometilação global do genoma é um evento chave na transformação maligna das células. O objetivo deste estudo foi avaliar os níveis séricos de homocisteína e cisteína como biomarcadores de sobrevida e de progressão da doença em câncer de mama. Também foi avaliado o efeito de um curso de curta duração (um mês) de tratamento hormonal sobre os níveis de Homocisteína, Cisteína e metilação do DNA. Amostras de sangue foram obtidos por ocasião da biópsia inicial (pré-tratamento) em todas as pacientes e, de tumor e de tecido normal adjacente, ao diagnóstico eem um mês após, para as pacientes que receberam o regime hormonal neo-adjuvante (pré-operatório). Todas as pacientes eram mulheres na pós-menopausa, com tumores de mama ressecáveis, acompanhadas em dois hospitais públicos, que consentiram em participar de outros dois protocolos de pesquisa prévios. Homocisteína e Cisteína foram analisadas por HPLC e a metilação global do DNA do tecido foi determinada por meio da técnica de MSRE (Methylation-Sensitive Restriction Enzyme). Foi observada uma diferença significativa entre os níveis pré e póstratamento de Homocisteína e Cisteína em tumores avançados, sugerindo um papel prognóstico em pacientes com características clínicas reservadas. As variações nos níveis de Homocisteína se mostraram significativamente correlacionadas com a sobrevida livre de doença. O modelo de risco proporcional de Cox demonstrou que os níveis de homocisteína e o status dos linfonodos representaram fatores prognósticos independentes em termos de sobrevida livre de doença. Embora mais estudos sejam necessários para confirmar estes resultados, nossa pesquisa sugere que a Homocisteína pode ser usada como um biomarcador de prognóstico para câncer de mama / Breast cancer is the leading cause of cancer mortality among women. Some biomarkers and clinical features are used to evaluate prognosis and to predict response to a range of therapeutic approaches. Homocysteine is well known as a risk factor in atherosclerotic vascular diseases, but its participation in cancer biology is still unclear. Cysteine is a sulfur amino acid derived from Homocysteine in the Methionine cycle. This metabolic cycle originates the nitrogenous bases and determines the methylation level of the DNA molecule as well. It is currently recognized that the global hipomethylation of the genome is a key event in the malign transformation of cells. The aim of this study was to evaluate serum Homocysteine and Cysteine as biomarkers of survival and disease progression in breast tumor, as well as the methylation status of tumor and normal tissues. The effect of a short course (one month) of hormonal treatment on Homocysteine, Cysteine and DNA methylation levels was also evaluated. Blood samples were collected during the initial biopsy (pretreatment) in all patients and, tumor samples and normal adjacent tissue, at diagnosis and one month after, for the patients that received neo-adjuvant hormonal regimen (pre-treatment). All patients were post-menopausal women, with resectable breast tumors, followed at two public hospitals, and that had consented to participate in two previous research protocols related to their disease. Serum Homocysteine and Cysteine were analyzed by HPLC and tissue global DNA methylation was determined by the MSRE (Methylation- Sensitive Restriction Enzyme) technique. A significant difference was observed between pre- and post-treatment levels of Homocysteine and Cysteine in advanced tumors, suggesting a prognostic role in patients with poor clinical characteristics. Variations in Homocysteine levels were significantly correlated with disease free survival. Cox proportional risk model demonstrated that nodal status and Homocysteine levels were independent prognostic factors for Disease Free Survival. Although more studies are needed to confirm these results, our research suggests that Homocysteine might be used as a prognostic biomarker for breast cancer

O câncer de mama é a principal causa de mortalidade por câncer entre as mulheres. Alguns biomarcadores e características clínicas são utilizados para avaliar o prognóstico e prever a resposta a uma série de abordagens terapêuticas. A Homocisteína é conhecida como um fator de risco para doença vascular aterosclerótica, mas sua participação na biologia do câncer ainda é incerta. Cisteína é o aminoácido sulfurado derivado da Homocisteína no ciclo da Metionina. Este ciclo metabólico origina as bases nitrogenadas e também determina o nível de metilação da molécula de DNA. É atualmente reconhecido que a hipometilação global do genoma é um evento chave na transformação maligna das células. O objetivo deste estudo foi avaliar os níveis séricos de homocisteína e cisteína como biomarcadores de sobrevida e de progressão da doença em câncer de mama. Também foi avaliado o efeito de um curso de curta duração (um mês) de tratamento hormonal sobre os níveis de Homocisteína, Cisteína e metilação do DNA. Amostras de sangue foram obtidos por ocasião da biópsia inicial (pré-tratamento) em todas as pacientes e, de tumor e de tecido normal adjacente, ao diagnóstico eem um mês após, para as pacientes que receberam o regime hormonal neo-adjuvante (pré-operatório). Todas as pacientes eram mulheres na pós-menopausa, com tumores de mama ressecáveis, acompanhadas em dois hospitais públicos, que consentiram em participar de outros dois protocolos de pesquisa prévios. Homocisteína e Cisteína foram analisadas por HPLC e a metilação global do DNA do tecido foi determinada por meio da técnica de MSRE (Methylation-Sensitive Restriction Enzyme). Foi observada uma diferença significativa entre os níveis pré e póstratamento de Homocisteína e Cisteína em tumores avançados, sugerindo um papel prognóstico em pacientes com características clínicas reservadas. As variações nos níveis de Homocisteína se mostraram significativamente correlacionadas com a sobrevida livre de doença. O modelo de risco proporcional de Cox demonstrou que os níveis de homocisteína e o status dos linfonodos representaram fatores prognósticos independentes em termos de sobrevida livre de doença. Embora mais estudos sejam necessários para confirmar estes resultados, nossa pesquisa sugere que a Homocisteína pode ser usada como um biomarcador de prognóstico para câncer de mama / Breast cancer is the leading cause of cancer mortality among women. Some biomarkers and clinical features are used to evaluate prognosis and to predict response to a range of therapeutic approaches. Homocysteine is well known as a risk factor in atherosclerotic vascular diseases, but its participation in cancer biology is still unclear. Cysteine is a sulfur amino acid derived from Homocysteine in the Methionine cycle. This metabolic cycle originates the nitrogenous bases and determines the methylation level of the DNA molecule as well. It is currently recognized that the global hipomethylation of the genome is a key event in the malign transformation of cells. The aim of this study was to evaluate serum Homocysteine and Cysteine as biomarkers of survival and disease progression in breast tumor, as well as the methylation status of tumor and normal tissues. The effect of a short course (one month) of hormonal treatment on Homocysteine, Cysteine and DNA methylation levels was also evaluated. Blood samples were collected during the initial biopsy (pretreatment) in all patients and, tumor samples and normal adjacent tissue, at diagnosis and one month after, for the patients that received neo-adjuvant hormonal regimen (pre-treatment). All patients were post-menopausal women, with resectable breast tumors, followed at two public hospitals, and that had consented to participate in two previous research protocols related to their disease. Serum Homocysteine and Cysteine were analyzed by HPLC and tissue global DNA methylation was determined by the MSRE (Methylation- Sensitive Restriction Enzyme) technique. A significant difference was observed between pre- and post-treatment levels of Homocysteine and Cysteine in advanced tumors, suggesting a prognostic role in patients with poor clinical characteristics. Variations in Homocysteine levels were significantly correlated with disease free survival. Cox proportional risk model demonstrated that nodal status and Homocysteine levels were independent prognostic factors for Disease Free Survival. Although more studies are needed to confirm these results, our research suggests that Homocysteine might be used as a prognostic biomarker for breast cancer

Indiana University-Purdue University Indianapolis (IUPUI) / During pregnancy, maternal liver exhibits robust growth to meet the metabolic demands of the developing placenta and fetus. Although hepatocyte hypertrophy and hyperplasia are seen in the maternal liver, the molecular and cellular mechanisms mediating the maternal hepatic adaptations to pregnancy is poorly understood. Previous microarray analysis revealed a most upregulated gene named Ascl1, a transcription factor essential for neural development, in the maternal liver at mid-gestation. The aims of the study were to (1) validate the activation of Ascl1 gene; (2) identify Ascl1-expressing cells; and (3) determine the fate of Ascl1-expressing cells, in the maternal liver during the course of gestation. Timed pregnancy was setup in mice and the maternal livers were collected at various stages of gestation. Maternal hepatic Ascl1 mRNA expression was evaluated by qRT-PCR and northern blotting. The results demonstrated that the transcript level of maternal hepatic Ascl1 is exponentially increased during the second half of pregnancy in comparison with a non-pregnant state. Using a Ascl1-GFP mouse model generated by others to monitor the behavior of neural progenitor cells, we found that maternal hepatic Ascl1-expressing cells are non-parenchymal cells, very small in size, and expanding during pregnancy. To map the fate of this cell population, we generated an in vivo tracing mouse model named Ascl1-CreERT2/ROSA26-LacZ. Using this model, we permanently labeled maternal hepatic Ascl1-expressing cells at midgestation by giving tamoxifen and analyzed the labeled cells in the maternal liver prior to parturition. We observed that the initial small Ascl1-expressing cells undergoing expansion at mid-gestation eventually became hepatocyte-like cells at the end stage of pregnancy. Taken together, our findings strongly suggest that Ascl1-expressing cells represent a novel population of hepatic progenitor cells and they can differentiate along hepatocyte lineage and contribute to pregnancy-induced maternal liver growth. Further studies are needed to firmly establish the nature and property of maternal hepatic Ascl1-expressing cells. At this stage, we have gained significant insights into the cellular mechanism by which the maternal liver adapts to pregnancy.