Die vorliegende Arbeit befasst sich mit der Entwicklung und Anwendung elektrochemischer Biosensoren zur Erweiterung oder zum Ersatz herkömmlicher Diagnostikverfahren. Als Basis für die Biosensoren wurden Elektrodenarraychips entworfen und im Reinraum gefertigt. Die als 9WPtE bezeichneten Elektrodenarrays waren aus 3 x 3 Elektrodenpaaren im 96-well-Maßstab (ANSI-Standard) aufgebaut. Jedes Elektrodenpaar bestand aus einer kreisrunden Arbeitselektrode mit einem Durchmesser von 1,9 mm und einer Gegenelektrode als offenem Kreisring um die Arbeitselektrode mit einem Durchmesser von 7 mm. Außerhalb des Reinraums wurden separate Messkammern und Ag/AgCl-Referenzelektroden integriert. Sowohl das Referenzsystem als auch die Signalqualität der 9WPtE-Elektrodenarraychips wurden mittels Zyklovoltammetrie, Impedanzspektroskopie und Rasterkraftmikroskopie analysiert und anhand dieser Untersuchungen optimiert. Das Augenmerk lag hierbei auf den Produktionsprozessen zur Herstellung der Elektrodenarraychips, auf den Elektrolytbedingungen für die elektrochemischen Messungen und auf der Recyclebarkeit der Chips. Die Funktionalisierung der Arbeitselektroden der 9WPtE-Chips erfolgte mit sich selbst-organisierenden Schichten aus Thiolen. An die Thiole wurden mittels Chemoligation die biologischen Erkennungskomponenten kovalent gekoppelt. Mit dem 9WPtE-Elektrodenarray wurde auf diese Weise ein funktionsfähiger kompetitiver Immunosensoren gegen den Tumormarker Tenascin C entwickelt. Außerdem wurden der 9WPtE-Chip und ein zusätzlich entwickelter Durchflusssensor, basierend auf dem Prinzip des 9WPtE, genutzt, um die Möglichkeit der Detektion ganzer eukaryotischer Zellen zu untersuchen.

Toll-like receptor (TLR)-4 is a pattern recognition receptor (PRR) that recognises the pathogen-associated molecular pattern (PAMP) lipopolysaccharide (LPS) produced by Gram-negative bacteria. LPS binds to Myeloid differentiation 2 (MD-2)/TLR-4 heterodimers, driving their dimerisation and inducing a conformational change of the intracellular TLR-4 toll/interleukin-1 receptor (TIR) domains. The adaptor protein Myeloid differentiation primary response gene 88 (MyD88)-adaptor-like (Mal)/TIR domain-containing adaptor protein (TIRAP) then binds to the TIR domains of TLR-4 and acts as a bridge for MyD88 which goes on to form the myddosome, a large protein complex of six to eight MyD88 molecules and four Interleukin-1 receptor- associated kinase (IRAK) 4 and four IRAK1/2 molecules. This triggers a signalling cascade which results in nuclear factor (NF)-κB transcription factor activation and production of pro-inflammatory effector molecules such as the cytokine Tumour Necrosis Factor (TNF)-α. Upon activation TLR-4 is also endocytosed where it interacts with a second set of adaptor proteins TIR-domain-containing adaptor- inducing interferon (IFN)-β (TRIF)-related adaptor molecule (TRAM) and TRIF to initiate the type I IFN response. How TLR-4 dimerisation results in the formation of the oligomeric myddosome is not fully understood, but it is possible that the stoichiometry of Mal/TIRAP may be important in the formation of this protein complex. The aim of my thesis was to determine the stoichiometry of Mal/TIRAP at the plasma membrane of immortalised bone marrow derived macrophages (iBMDMs) and whether this stoichiometry changes upon stimulation with different TLR-4 ligands. To investigate Mal/TIRAP stoichiometry I first developed a viral transduction experimental cell model to visualise fluorescently labelled Mal/TIRAP. Mal/TIRAP-/- iBMDMs were lentivirally transduced with a Mal/TIRAPHALO construct. The halotag was fluorescently labelled then the cells were stimulated with TLR-4 ligands, such as LPS, fixed at different time points, then imaged. Total internal reflection fluorescence (TIRF) microscopy was used to image the plasma membrane and photobleaching experiments performed to determine Mal/TIRAP stoichiometry. I developed a computer-based analysis pipeline to analyse the resulting photobleaching data. Under resting conditions, Mal/TIRAP is present at the plasma membrane in clusters of approximately ten Mal/TIRAP molecules per cluster. After five minutes of stimulation with 10 ng/ml LPS Mal/TIRAP redistributes into cluster sizes of approximately six, twelve and much larger. After ten and fifteen minutes stimulation with 10 ng/ml LPS the clusters return to the resting size of approximately ten Mal/TIRAP molecules per cluster with a few much larger clusters remaining present. This confirms the rapid time frame within which TLR-4 signalling occurs at the plasma membrane and is consistent with myddosome stoichiometry of six MyD88 molecules or proposed super myddosomes of twelve MyD88 molecules. The computer-based analysis pipeline developed can be used to analyse any protein of interest at the plasma membrane. Protein ligands have also been found to activate TLR-4; for example allergens, such as Fel d 1 and Der p 2, as well as endogenous damage associated molecular patterns (DAMPs), such as extracellular matrix (ECM) proteins, for example fragments of fibronectin and tenascin-C. The mechanism by which these proteins interact with TLR-4 and induce signalling is unclear. Proteins from the ECM (fragments FNIII1c, FNIII13-14, FNIII9-E and FNIII9-E-14 from fibronectin and the fibrinogen-like globe (FBG) domain of tenascin-C) were tested using a transient transfection assay in HEK293 cells and shown to activate TLR-4. In conclusion, I have developed new tools and methodology to investigate how TLR-4 signals in response to LPS and DAMPs in living cells. Whether DAMP- activated TLR-4 forms similar signalling complexes to those induced by LPS will form part of a future study.

Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Recentemente, nosso grupo demonstrou que a matriz extracelular de astrocitomas promove a seleçãode células endoteliais altamente proliferativas, porém com reduzida capacidade tubulogênica, além de determinar a morte de uma segunda sub-população endotelial, por desaderência ou anoikis. Estratégias de simulação dos teores de tenascina-C (TN-C) e fibronectina (FN) nas matrizes de astrocitomas, realizados com ambas as proteínas purificadas na forma de substratos definidos, sugeriram que o balanço TN-C:FN estava relacionado com os fenótipos endoteliais observados. No entanto, este procedimento não permitia abordar a participação de outros componentes da matriz tumoral nativa neste processo. Com objetivo de estudar a modulação do fenótipo angiogênico das células endoteliais por matrizes de astrocitoma, realizamos o silenciamento da expressão de TN-C na linhagem de astrocitoma U-373 MG. O silenciamento foi confirmado por western blotting, PCR em tempo real e ELISA, que permitiram concluir que, no período pós-transfecção (120h) necessário para se obter matrizes tumorais nativas para ensaios funcionais com células endoteliais, as células U-373 MG mantiveram-se silenciadas em índices superiores a 90%. A diminuição de TN-C nas matrizes tumorais resultou em um pequeno (≅18%, em média), porém significativo aumento na taxa de adesão endotelial. HUVECs incubadas com a matriz secretadas por células silenciadas apresentaram uma redução de ≅35% do número de núcleos picnóticos, quando comparadas a HUVECs incubadas com a matriz de células U-373 MG (selvagens ou transfectadas com siRNA controle). O silenciamento da expressão da TN-C na matriz nas células U-373 MG restaurou ainda o defeito tubulogênico das células endoteliais, que passaram a apresentar formação de tubos comparável à obtida quando HUVECs foram incubadas com sua matriz autóloga, rica em FN. Tais resultados apoiam observações anteriores do grupo, que já sugeriam que a maior proporção de FN na matriz autóloga, comparada a matriz do astrocitoma, seria o fator principal para a seleção dos fenótipos angiogênicos observados, demonstrando mais uma vez a importância do balanço FN:TN-C na regulação de processos angiogênicos. Dados anteriores sugeriam ainda que a sub-população endotelial que morre por anoikisapós contato prolongado (24 horas) com matrizes de astrocitomas corresponde a células que já haviam entrado na fase S do ciclo celular, no início da incubação. A fim de nos aprofundarmos sobre a participação do ciclo celular neste processo, a expressão da proteína p27, um inibidor de quinases dependentes de ciclinas (CKI), também foi analisada. HUVECs incubadas com a matriz de astrocitoma apresentaram um aumento de 2 a 3 vezes na expressão de p27, quando comparada com HUVECs provenientes de sua matriz autóloga. No entanto, células endoteliais incubadas com matriz secretada por células U-373 MG silenciadas apresentaram um nível de expressão de p27 comparável ao das HUVECs incubadas com matriz secretada por células selvagens, indicando que a expressão de TN-C não modula, ou não está diretamente correlacionada à expressão da proteína p27. Este resultado sugere que outros componentes da matriz tumoral devam estar envolvidos na modulação do ciclo celular endotelial. / We have previously shown that extracellular matrices secreted by high-grade astrocitoma promotes the selection of highly proliferative and tubulogenesis-defective endothelial cells, while also leading to the death, by anoikis, of another endothelial subpopulation. The use of defined adhesion substrata containing various levels of tenascin-C (TN-C) and fibronectin (FN) allowed us to confirm that the balance between TN-C and FN was a major cause of the selection of both endothelial phenotypes. However, this strategy did not allow us to address the potential role of other molecular components present in tumor matrices. In the present work, we studied the effect of a matrix produced by U-373 MG cells previously silenced for TN-C expression in endothelial cell adhesion, survival and tubulogenic differentiation, as compared to the matrix secreted by wild-type astrocitoma cells. U-373 MG cells silencing was confirmed by Western blotting, real time RT-PCR and ELISA, and cells remained silenced (≥ 90 %) throughout the 120 hours period necessary for generating immobilized native matrices required for endothelial cell function assays. Human umbilical vein endothelial cells (HUVECs) adhesion to the extracellular matrix secreted by astrocitoma cells silenced for TN-C expression was significantly increased by ≅18 %, as compared to wild-type tumor matrix. The number of HUVECs exhibiting picnotic nuclei a hallmark of advanced apoptosis has also been significantly decreased by ≅35 %, when endothelial cells were allowed to incubate with TN-C-depleted tumor matrix, as compared to the wild-type tumor matrix. Concerning angiogenic differentiation, endothelial cells incubated with the matrix produced by silenced U-373 cells were strongly attenuated for their tubulogenesis defect, as compared to HUVECs incubated with the TN-C-rich wild-type matrix. Thus, these data corroborated our previous observations that TN-C in astrocitoma matrices crucially interferes with endothelial cell differentiation. Besides adhesion, survival and tubulogenic differentiation, the responses of endothelial cells to astrocitomas matrices are also affected by cell cycle transitions. We have previously shown that endothelial cells undergoing anoikis had already transitioned through the S-phase of cell cycle at the moment of seeding. Thus, we decided to investigate the expression of p27 protein, an inhibitor of ciclin-dependent kinases (CKI) that has been already implicated in glioma angiogenesis. We found that HUVECs incubated with the matrix secreted by U-373 MG wild-type cells for 24 hours exbibited a 2 to 3-fold increase in p27 expression. In contrast to the other results discussed herein, these differences were not correlated with the expression of TN-C by U-373 MG cells, since the matrix produced by tumor cells silenced for TN-C did not alter the expression of p27 in endothelial cells. Overall, the present data suggest that, although TN-C in native tumor matrix does play a major role in endothelial cell angiogenic differentiation, other matrix components may act in concert with TN-C to modulate endothelial cell proliferation in tumor contexts.

Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro / Recentemente, nosso grupo demonstrou que a matriz extracelular de astrocitomas promove a seleçãode células endoteliais altamente proliferativas, porém com reduzida capacidade tubulogênica, além de determinar a morte de uma segunda sub-população endotelial, por desaderência ou anoikis. Estratégias de simulação dos teores de tenascina-C (TN-C) e fibronectina (FN) nas matrizes de astrocitomas, realizados com ambas as proteínas purificadas na forma de substratos definidos, sugeriram que o balanço TN-C:FN estava relacionado com os fenótipos endoteliais observados. No entanto, este procedimento não permitia abordar a participação de outros componentes da matriz tumoral nativa neste processo. Com objetivo de estudar a modulação do fenótipo angiogênico das células endoteliais por matrizes de astrocitoma, realizamos o silenciamento da expressão de TN-C na linhagem de astrocitoma U-373 MG. O silenciamento foi confirmado por western blotting, PCR em tempo real e ELISA, que permitiram concluir que, no período pós-transfecção (120h) necessário para se obter matrizes tumorais nativas para ensaios funcionais com células endoteliais, as células U-373 MG mantiveram-se silenciadas em índices superiores a 90%. A diminuição de TN-C nas matrizes tumorais resultou em um pequeno (≅18%, em média), porém significativo aumento na taxa de adesão endotelial. HUVECs incubadas com a matriz secretadas por células silenciadas apresentaram uma redução de ≅35% do número de núcleos picnóticos, quando comparadas a HUVECs incubadas com a matriz de células U-373 MG (selvagens ou transfectadas com siRNA controle). O silenciamento da expressão da TN-C na matriz nas células U-373 MG restaurou ainda o defeito tubulogênico das células endoteliais, que passaram a apresentar formação de tubos comparável à obtida quando HUVECs foram incubadas com sua matriz autóloga, rica em FN. Tais resultados apoiam observações anteriores do grupo, que já sugeriam que a maior proporção de FN na matriz autóloga, comparada a matriz do astrocitoma, seria o fator principal para a seleção dos fenótipos angiogênicos observados, demonstrando mais uma vez a importância do balanço FN:TN-C na regulação de processos angiogênicos. Dados anteriores sugeriam ainda que a sub-população endotelial que morre por anoikisapós contato prolongado (24 horas) com matrizes de astrocitomas corresponde a células que já haviam entrado na fase S do ciclo celular, no início da incubação. A fim de nos aprofundarmos sobre a participação do ciclo celular neste processo, a expressão da proteína p27, um inibidor de quinases dependentes de ciclinas (CKI), também foi analisada. HUVECs incubadas com a matriz de astrocitoma apresentaram um aumento de 2 a 3 vezes na expressão de p27, quando comparada com HUVECs provenientes de sua matriz autóloga. No entanto, células endoteliais incubadas com matriz secretada por células U-373 MG silenciadas apresentaram um nível de expressão de p27 comparável ao das HUVECs incubadas com matriz secretada por células selvagens, indicando que a expressão de TN-C não modula, ou não está diretamente correlacionada à expressão da proteína p27. Este resultado sugere que outros componentes da matriz tumoral devam estar envolvidos na modulação do ciclo celular endotelial. / We have previously shown that extracellular matrices secreted by high-grade astrocitoma promotes the selection of highly proliferative and tubulogenesis-defective endothelial cells, while also leading to the death, by anoikis, of another endothelial subpopulation. The use of defined adhesion substrata containing various levels of tenascin-C (TN-C) and fibronectin (FN) allowed us to confirm that the balance between TN-C and FN was a major cause of the selection of both endothelial phenotypes. However, this strategy did not allow us to address the potential role of other molecular components present in tumor matrices. In the present work, we studied the effect of a matrix produced by U-373 MG cells previously silenced for TN-C expression in endothelial cell adhesion, survival and tubulogenic differentiation, as compared to the matrix secreted by wild-type astrocitoma cells. U-373 MG cells silencing was confirmed by Western blotting, real time RT-PCR and ELISA, and cells remained silenced (≥ 90 %) throughout the 120 hours period necessary for generating immobilized native matrices required for endothelial cell function assays. Human umbilical vein endothelial cells (HUVECs) adhesion to the extracellular matrix secreted by astrocitoma cells silenced for TN-C expression was significantly increased by ≅18 %, as compared to wild-type tumor matrix. The number of HUVECs exhibiting picnotic nuclei a hallmark of advanced apoptosis has also been significantly decreased by ≅35 %, when endothelial cells were allowed to incubate with TN-C-depleted tumor matrix, as compared to the wild-type tumor matrix. Concerning angiogenic differentiation, endothelial cells incubated with the matrix produced by silenced U-373 cells were strongly attenuated for their tubulogenesis defect, as compared to HUVECs incubated with the TN-C-rich wild-type matrix. Thus, these data corroborated our previous observations that TN-C in astrocitoma matrices crucially interferes with endothelial cell differentiation. Besides adhesion, survival and tubulogenic differentiation, the responses of endothelial cells to astrocitomas matrices are also affected by cell cycle transitions. We have previously shown that endothelial cells undergoing anoikis had already transitioned through the S-phase of cell cycle at the moment of seeding. Thus, we decided to investigate the expression of p27 protein, an inhibitor of ciclin-dependent kinases (CKI) that has been already implicated in glioma angiogenesis. We found that HUVECs incubated with the matrix secreted by U-373 MG wild-type cells for 24 hours exbibited a 2 to 3-fold increase in p27 expression. In contrast to the other results discussed herein, these differences were not correlated with the expression of TN-C by U-373 MG cells, since the matrix produced by tumor cells silenced for TN-C did not alter the expression of p27 in endothelial cells. Overall, the present data suggest that, although TN-C in native tumor matrix does play a major role in endothelial cell angiogenic differentiation, other matrix components may act in concert with TN-C to modulate endothelial cell proliferation in tumor contexts.

Abstract The Achilles tendon is the largest tendon in the human body and is affected by many diseases and is vulnerable to many forms of damage due to the heavy loads it must bear. Rupture of the Achilles tendon has become more common in recent times, with an almost four-fold increase in prevalence from 1979–1990 to 1991–2000 and a peak incidence of 19 ruptures per 100 000 of population in 1999 in our epidemiological assessment. The incidences of major complications, re-rupture and deep infection, increased along with primary ruptures, peaking in 1999. The results after successful primary repair are good in over 90% of cases, as we have shown in a randomized study and in a review of the literature, and the result after re-rupture is still good in about 70% of cases, but achieving good performance after deep infection is a highly random matter. Our retrospective survey did not identify any good results, but the deep infection cases in our randomized study showed good performance due to prompt action taken for their treatment. The best method for treating a ruptured Achilles tendon has been under debate for almost 100 years, with surgery and conservative methods advocated to equal extents. We have advocated surgical treatment as the primary choice and conservative treatment is given for selected high risk patients, for example patients with diabetes, skin problems, systemic use of corticosteroids or severe other illness. The type of surgery technique is not a straightforward choice, either, and various forms of open surgery and percutaneous techniques exist. We compared an end-to-end simple suture with the same suture augmented with one central gastrocnemius turn-over flap in a randomized series of 60 patients and found no differences with respect to subjective complaints, calf muscle strength or tendon elongation with time. The end-to-end technique is simpler and is therefore justified as the primary method of choice for the surgical repair of fresh complete Achilles tendon ruptures. The tissue composition has been shown to alter not only with time but also after repeated tearing of the tendon collagen fibres. A normal tendon is mainly composed of type I collagen, but the rupture areas express more type III collagen, which is thinner and withstands loads less effectively. Type III collagen accumulates slowly in the tendon, since its production does not increase very much, a situation that is indicative of microtrauma. Crosslinking of the fibres is important for collagen matrix properties, and we found that there is a change in the quality of crosslinking with age and that this may have role in the observed changes in tendon stiffness, as also noted in other studies. We also studied the appearance of tenascin-C at the rupture site in the Achilles tendon and at two other sites in the same tendon, but found no difference in its expression. It has been proposed that tenascin-C may take part in the tendon’s reaction to loading, but its exact function remains unknown.

Fragile X syndrome (FXS) is identified by abnormal dendrite morphology and altered synaptic protein expression. Astrocyte secreted factors such as Tenascin C (TNC), may contribute to the synaptic changes, including maturation of the synapse. TNC is a known endogenous ligand of toll-like receptor 4 (TLR4) that has been shown to induce the expression of pro-inflammatory cytokines such as interleukin-6 (IL-6). At the molecular level, elevated IL-6 promotes excitatory synapse formation and increases dendrite spine length. With these molecular changes linked to the phenotype of FXS, we examined the expression and the mechanism of the endogenous TLR4 activator TNC, and its downstream target IL-6 in astrocytes from the FMR1 KO mouse model. Secreted TNC and IL-6 were significantly increased in FMR1 KO astrocytes. Exogenous TNC and lipopolysaccharide (LPS) stimulation of TLR4 induced secreted IL-6, whereas the antagonist of TLR4 (LPS-RS) had an opposing effect. Cortical protein expression of TNC and IL-6 were also significantly elevated in the postnatal FMR1 KO mouse. These results identify TNC as an endogenous ligand of TLR4, capable of effecting IL-6 secretion by astrocytes. In addition, there was an increase in the number of VGLUT1/PSD95 positive synaptic puncta of both WT and FMR1 KO neurons when plated with astrocyte conditioned media from FMR1 KO astrocytes, compared to those plated with media from wild type astrocytes. By assessing the cellular mechanisms involved, a novel therapeutic option could be made available to target abnormalities of synaptic function seen in FXS. / Thesis / Master of Science (MSc) / Autism spectrum disorders (ASDs) are neurodevelopmental disorders which arise from genetic and environmental factors. In the brain, a type of cell called the astrocyte is responsible for proper brain growth and development. Astrocytes release factors that promote inflammation, causing disruption of brain functions that control learning, memory and behaviour. Such factors released by astrocytes are capable of binding to their receptors, in turn impacting downstream targets, which have physiological effects. This research used various biological and genetic techniques to determine if the mechanism of an astrocyte-specific factor called Tenascin C (TNC) is impaired in the Fragile X mouse model. In a normal astrocyte, TNC with its binding partner is able to release molecules responsible for inflammation. Such molecules have been shown to increase the number synapses, where neurons and astrocytes exchange information, to control brain function. This proposed research would be the first to determine a role for TNC in ASDs. By assessing the cellular mechanisms involved between TNC and its binding partner, a novel therapeutic option could be made available in ASDs.

Background: Multipotent mesenchymal stromal cells (MSC) can be recovered from a variety of tissues in the body. Yet, their functional properties were shown to vary depending on tissue origin. While MSC have emerged as a favoured cell type for tendon regenerative therapies, very little is known about the influence of the MSC source on their properties relevant to tendon regeneration. The aim of this study was to assess and compare the expression of tendon extracellular matrix proteins and tendon differentiation markers in MSC derived from different sources as well as in native tendon tissue. MSC isolated from equine bone marrow, adipose tissue, umbilical cord tissue, umbilical cord blood and tendon tissue were characterized and then subjected to mRNA analysis by real-time polymerase chain reaction. Results: MSC derived from adipose tissue displayed the highest expression of collagen 1A2, collagen 3A1 and decorin compared to MSC from all other sources and native tendon tissue (p < 0.01). Tenascin-C and scleraxis expressions were highest in MSC derived from cord blood compared to MSC derived from other sources, though both tenascin-C and scleraxis were expressed at significantly lower levels in all MSC compared to native tendon tissue (p < 0.01). Conclusions: These findings demonstrate that the MSC source impacts the cell properties relevant to tendon regeneration. Adipose derived MSC might be superior regarding their potential to positively influence tendon matrix reorganization.

Background Pancreatic ductal adenocarcinoma (PDAC) patients have the poorest 5-year survival rates of all cancer forms. It is difficult to diagnose at early disease stages, tumour relapse after surgery is common, and current chemotherapies are ineffective. Carbohydrate antigen 19-9 (Ca 19-9), the only clinically implemented PDAC biomarker, is insufficient for diagnostic and screening purposes. PDAC tumours are characterised by a voluminous stroma that is rich in extracellular matrix (ECM) molecules such as collagens, hyaluronan (HA) and matricellular proteins. These stromal components have been suggested to promote PDAC cell migration, proliferation, evasion of apoptosis and chemotherapy resistance. Those events are mediated via interactions with adhesion receptors, such as integrins and CD44 receptors expressed on cancer cell surfaces. Micro-RNAs (miRNA) post-transcriptionally regulate gene expression in health and disease. At the time of PDAC diagnosis, miRNA levels are altered both in plasma and tumour tissue. Before PDAC diagnosis, tissue miRNA levels are altered in precursor lesions, raising the possibility that plasma miRNAs might aid in early detection. In this thesis, it is hypothesised that stromal components and miRNAs can serve as tissue or blood based biomarkers in PDAC. The aims are: (1) to characterise the expression of stromal components and their receptors in normal and cancerous tissue; (2) to find potential stroma-associated tissue and blood-based biomarkers for diagnosis and prognosis estimates; (3) to determine the cellular effects of type IV collagen (Col IV) in PDAC; (4) to determine if plasma miRNAs that are altered in manifest PDAC can be used to diagnose PDAC earlier. Methods The expression patterns of Col IV, Col IV-binding integrin subunits (α1, α2, β1), Endostatin, Osteopontin (OPN) and Tenascin C (TNC) were analysed in frozen PDAC and normal pancreatic tissue. A tissue microarray (TMA) was constructed using formalin-fixed, paraffin-embedded primary tumours and lymph node metastases. The TMA was used to study the expression levels and associations with survival of the standard CD44 receptor (CD44s), its variant isoform 6 (CD44v6), HA, OPN and Col IV. Circulating levels of HA, Col IV, Endostatin, OPN and TNC were measured in PDAC patients and healthy individuals, and compared with conventional tumour markers (Ca 19-9, CEA, Ca 125 and TPS). The functional roles of Col IV were studied in PDAC cell lines by: (1) growth on different matrices (2) blocking Col IV binding integrin subunits, (3) blocking the Col IV domains 7s, CB3 and NC1, and (4) by down regulation of PDAC cell synthesis of Col IV using siRNA transfection. Plasma miRNAs alterations were screened for in samples from patients with manifest disease, using real-time quantitative PCR (RT-qPCR). To find early miRNA alterations, levels of those miRNAs that were altered at diagnosis were measured in prediagnostic plasma samples. Results High tissue expression of both the standard CD44 receptor (CD44s) and its variant isoform CD44v6 as well as low expression of stromal OPN were associated with poor survival. In addition, high CD44s and low OPN predicted poor survival independent of established prognostic factors. Circulating Col IV, Endostatin, OPN, TNC and HA were increased in preoperative samples from PDAC patients. Preoperatively, higher levels of serum-HA and plasma-Endostatin were associated with shorter survival. Postoperatively, higher levels of Col IV, Endostatin and OPN were associated with shorter survival. On the contrary, only one of the conventional tumour markers was associated with survival (Ca 125). Col IV stimulated PDAC cell proliferation and migration and inhibited apoptosis in vitro, dependent on the collagenous domain (CB3) of Col IV and the Col IV binding integrin subunit β1. Reduced endogenous Col IV synthesis inhibited these effects, suggesting that PDAC cells synthesise Col IV to stimulate tumour-promoting events via a newly discovered autocrine loop. 15 miRNAs were altered in early stage PDAC patients and the combination of these markers outperformed Ca 19-9 in discriminating patients from healthy individuals. However, none of the miRNAs were altered in prediagnostic samples, suggesting that plasma miRNA alterations appear late in the disease course. Conclusions Up regulated stromal components in PDAC tumours are detectable in blood samples and are potential diagnostic and prognostic biomarkers in PDAC. High circulating levels of Col IV, Endostatin, OPN and HA predict poor survival, as well as high expression of CD44s and CD44v6 and low expression of OPN in tumour tissue. PDAC cells synthesise Col IV, which forms BM-like structures close to cancer cells and promote tumour progression in vitro via an autocrine loop. Several plasma-miRNAs are altered in PDAC, but are not useful for early discovery.

Ce travail de thèse fait partie d’un effort pour le développement des biomarqueurs, actuellement largement inexistants, pour une meilleure classification, pour une détermination plus précise du pronostic, et pour la prédiction de la réponse au traitement des tumeurs gliales malignes de l’enfant (épendymomes et gliomes de haut grade). Dans certains cas, ces biomarqueurs peuvent aussi devenir des cibles thérapeutiques.Dans ces études, nous avons pu montrer que la surexpression fréquente des marqueurs neuronaux distingue les épendymomes supratentoriels des formes infratentorielles. Parmi les épendymomes supratentoriels, une forte expression de neurofilament 70 (NF) est corrélée avec une meilleure survie sans récidive. La tenascine C (TNC) est surexprimée dans les épendymomes infratentoriels. Une étude de collaboration européenne multi-institutionnelle a été mise en place, permettant d’analyser une cohorte pédiatrique de 250 patients atteints d’un épendymome, et de démontrer la forte immunoexpression de TNC comme un marqueur robuste, associé a des survies globale et sans récidive plus péjoratives, particulièrement parmi les enfants âgés de moins de trois ans. Ceci a été validé dans une cohorte indépendante. Des immunomarquages pour NF et TNC pourraient être utilisés en clinique pour aider à déterminer le pronostic des épendymomes chez l’enfant.Une analyse des marqueurs pour la prédiction de la réponse à une thérapie ciblée anti-EGFR (erlotinib) a été réalisée par imunnohistochimie et FISH. La perte fréquente de PTEN dans les gliomes infiltrants du tronc cérébrale et la confirmation des caractéristiques des certains sous groupes (avec une forte expression de EGFR ou avec une différentiation oligodendrogliale) nous a permis de dessiner le protocole pour la prochaine étude de phase III pour cette maladie dans le cadre d’un futur essai thérapeutique de phase I/II. Nous rapportons par ailleurs des mutations du gène PI3KCA dans certains gliomes infiltrants du tronc cérébral, qui comme la perte d’expression de PTEN pourrait entrainer une activation de la voie mTOR qui devient donc une cible thérapeutique majeure théorique dans cette maladie. Des études ultérieures seront nécessaires pour définir le rôle de l’interaction entre la perte de PTEN, la surexpression de EGFR, la différentiation oligodendrogliale, les mutations de PI3KCA et d’autres altérations récemment décrites, (gains et amplifications de PDGFRA/MET mutations de TP53) et leur relation avec le devenir des patients sous traitement ciblé et les thérapies ciblées les plus intéressantes dans cette maladie uniformément fatale.Ce travail de thèse nous a permis d’explorer le rôle de la pathologie moléculaire dans la prise en charge des épendymomes et gliomas de haut grade chez l’enfant. / Biomarkers for the classification, clinical management and prognosis of pediatric brain tumors (ependymoma and high grade glioma, (HGG)) are lacking. To address this, biomarkers were developed and explored in view of classification, prognostication, target identification and prediction of the efficacy of treatment for patients with such tumors.We show that overexpression of neuronal markers distinguishes supratentorial from infratentorial ependymoma, and among the former higher immunoexpression of neurofilament 70 (NEFL) is correlated with better progression free survival (PFS). Tenascin-C (TNC) is significantly overexpressed in infratentorial ependymoma. A multi-institutional European ependymoma collaboration group was established and analyses were performed in a pediatric cohort of 250 patients, where immunohistochemistry (IHC) for TNC showed to be a robust marker of poor overall survival (OS) and PFS, particularly among children under 3 years, this being further validated in an independent cohort. Techniques and scoring performed in different laboratories were highly reproducible. IHC for NEFL and TNC could be used for prognostication of pediatric ependymoma.The analysis of putative predictive markers for the response to targeted therapies in pediatric HGG in the setting of a clinical trial with the anti-EGFR agent erlotinib was performed by IHC and fluorescent in situ hybridization. The frequent loss of PTEN in diffuse intrinsic pontine glioma (DIPG) and the confirmation of the biological singularity of the certain subgroups (expressing EGFR, displaying oligodendroglial differentiation) which seem to be associated with better response to erlotinib have helped our group to establish the design of the next Phase III protocol for this disease at our institution. We report mutations in PI3KCA constituting the first identification of oncogene mutations in some DIPG, which further highlight their biological heterogeneity. Further studies are needed to define the interaction between PTEN loss, EGFR overexpression, oligodendroglial differentiation, PI3KCA mutations and other recent findings such as PDGFRA/MET gains/amplification and TP53 mutations in these heterogeneous lesions and their relationship to the outcome of patients under new targeted therapies for this largely fatal disease.This thesis has allowed us to explore the molecular pathology in the context of biology and clinical setting of pediatric brain tumors.

Une expression élevée de la protéine de la matrice extracellulaire ténascine-C (TNC) favorise la progression du cancer et est corrélée à une réduction de la survie des patients. Dans cette thèse, j’ai étudié comment la TNC affecte l'angiogenèse tumorale. J’ai montré que la TNC altère les protrusions angiogéniques, la tubulogenèse, la migration et la prolifération des cellules endothéliales. J’ai lié ces effets à la perturbation du cytosquelette d'actine et la réduction de la signalisation YAP par la TNC. Chez les cellules tumorales et les fibroblastes associés au cancer, la TNC favorise la sécrétion de facteurs angio-modulateurs qui stimulent la survie et la tubulogenèse des cellules endothéliales de façon paracrine. Cet effet implique la régulation de l’expression de SDF1 (CXCL12) et de deux membres de la famille des lipocalines. Ainsi, la TNC favorise l’angiogenèse en activant chez les cellules tumorales un sécrétome pro-angiogénique, et inhibe la tubulogenèse en altérant la survie des cellules endothéliales. Ces effets opposés pourraient expliquer pourquoi nous avons observé dans un modèle de tumeur spontanée chez la souris que la TNC favorise le switch angiogénique résultant en la formation d’une forte vascularisation tumorale, mais qui reste peu fonctionnelle associée à la formation de plus de métastases. Ce travail fournit pour la première fois la possibilité de contrer l’action de la TNC dans l'angiogenèse tumorale. / A high expression of the extracellular matrix molecule tenascin-C (TNC) enhances multiple steps in cancer progression and correlates with worsened survival prognosis. In this thesis I studied how TNC affects tumor angiogenesis. I showed that TNC impairs endothelial sprouting, tubulogenesis, migration and proliferation. I linked this effect to disruption of the actin cytoskeleton and reduced YAP signaling activity by TNC. In tumor cells and cancer associated fibroblasts, TNC regulated secretion of angio-modulatory factors that promoted endothelial cell survival and tubulogenesis in a paracrine manner involving regulation of SDF1 (CXCL12) and two lipocalin family members. Altogether, TNC promotes endothelial tubulogenesis through a pro-angiogenic secretome from tumor cells, and inhibits by direct contact tubulogenesis by impairing endothelial cell survival. These opposing effects could explain why we observed that TNC promotes the tumor angiogenic switch resulting in more but poorly functional blood vessels associated with more metastasis in a spontaneous tumor mouse model. This knowledge provides for the first time opportunities to counteract TNC activities in tumor angiogenesis.