Os tumores hipofisários mesmo sendo, em sua maioria, benignos, podem apresentar comportamento invasivo, com extensão para seio cavernoso, seio esfenoidal e clivo. As metaloproteinases de matriz tipo 2 (MMP-2) e 9 (MMP-9) e o inibidor tecidual de metaloproteinases-2 (TIMP-2) têm sido estudados em relação ao comportamento invasivo desses tumores, em especial quanto à invasão do seio cavernoso. Esse estudo teve como objetivo avaliar a expressão proteica das MMP-2, MMP-9 e do TIMP-2 nos tumores hipofisários e sua relação com invasão do seio cavernoso e, de maneira inédita, investigar a expressão dessas proteínas em nível plasmático. Adicionalmente, foram avaliadas a expressão dos RNAs mensageiros (RNAm) das MMP-2 e TIMP-2 com intuito de correlacioná-las com a expressão proteica no tecido tumoral, bem como a expressão do marcador de proliferação Ki67. Foram selecionados 77 casos, todos com amostras de tumor emblocado em parafina para análise imuno-histoquímica (IHQ). Destes, foram coletadas amostras de tumor fresco em 29 pacientes e de sangue periférico pré-operatório em outros 29 casos. A expressão proteica plasmática foi detectada de forma semi-quantitativa utilizando um arranjo de anticorpos em membrana comercial. A expressão dos RNAm das MMP-2 e TIMP-2 foi avaliada por reação em cadeia da polimerase quantitativo (qPCR) em tempo real. Do total de casos, 20 pacientes apresentavam tumores com invasão para o seio cavernoso. A expressão proteica tumoral das MMP-2, MMP-9 e TIMP-2 apresentou-se aumentada no grupo invasivo, contudo esta diferença não foi estatisticamente significante em relação ao grupo não- invasivo. A expressão plasmática das MMP-9 e TIMP-2 também não mostrou diferença entre os dois grupos e não se correlacionou com a expressão tumoral. A expressão plasmática da MMP-2 não foi detectada em nenhum caso. Quanto à expressão do RNAm das MMP-2 e TIMP-2, também não houve diferença significante entre os grupos e nem correlação com a expressão proteica tecidual ou plasmática. Foi observada uma diferença significante na dimensão tumoral [3.6 (2.5-5.2) x 2.0 (1.3-2.7); P < 0.001] e no índice do Ki67 [1.05 (0.27-25) x 0.5 (0.2-1.0); P < 0.001] entre os grupos invasivo e não-invasivo respectivamente. Em conclusão, em nossa coorte, não foi encontrada relação entre a expressão tecidual e plasmática das MMP-2, MMP-9 e TIMP-2 e a invasão para o seio cavernoso nos adenomas hipofisários / Pituitary tumors, although mostly benign, may present invasive behavior, with extension to the cavernous sinus, sphenoid sinus and clivus. Type 2 (MMP-2) and type 9 (MMP-9) matrix metalloproteinases and the metalloproteinase tissue inhibitor type 2 (TIMP-2) have been studied in relation to the invasive behavior of these tumors, especially regarding invasion of the cavernous sinus. The aim of this study was to evaluate the protein expression of MMP-2, MMP-9 and TIMP-2 in pituitary tumors and its relation with invasion of the cavernous sinus and, in an unprecedented way, to investigate the expression of these proteins at the plasma level. Additionally, expression of MMP-2 and TIMP-2 messenger RNAs (mRNAs) was evaluated in order to correlate with protein expression in tumor tissue, as well as Ki67 proliferation marker expression. A total of 77 cases were selected, all of them with paraffin embedded tumor samples for immunohistochemical analysis (IHC). Of these, fresh tumor samples were collected in 29 patients and preoperative peripheral blood in another 29 cases. Protein plasma expression was detected semi-quantitatively using a commercial membrane antibody array. Expression of MMP-2 and TIMP-2 mRNAs was evaluated by quantitative realtime polymerase chain reaction (qPCR). Of the total cases, 20 patients presented tumors invasive to the cavernous sinus. Tumor protein expression of MMP-2, MMP-9 and TIMP-2 was increased in the invasive group, not reaching, however, statistically significant difference as compared with the non-invasive group. Plasma expression of MMP-9 and TIMP-2 also did not differ between the two groups and did not correlate with tumor expression. Plasma expression of MMP-2 was not detected in any case. Concerning MMP-2 and TIMP-2 mRNA expression, there was also no significant difference between groups and no correlation with tissue or plasma protein expression was observed. A significant difference was observed in tumor size [3.6 (2.5-5.2) x 2.0 (1.3-2.7); P < 0.001] and in the Ki67 index [1.05 (0.27-25) x 0.5 (0.2-1.0); P < 0.001] between the invasive and non-invasive groups respectively. In conclusion, in our cohort, no relationship was found between the tissue and plasma expression of MMP-2, MMP-9 and TIMP-2 and the invasion of the cavernous sinus in pituitary adenomas

Abstract Endometrial carcinoma is the most common gynegologic malignancy in developed countries. Due to early symptoms, including abnormal uterine bleeding, endometrial cancer is often diagnosed at an early stage and in that case usually has a good prognosis and high cure rates. However, the nature of the disease is heterogeneous. During the last decades, the improvement in survival rates among endometrial cancer patients has not been significant, suggesting that the traditional clinicopathological factors may be inadequate to identify patients with high-risk disease. Furthermore, aggressive adjuvant treatments can be costly and very toxic. Therefore, better prognostic markers associated with biological aggressiveness of endometrial carcinoma are needed to identify the patients with high-risk disease, and to be able to select the treatment more individually. Gelatinases (MMP-2 and MMP-9) and their tissue inhibitors (TIMP-1 and TIMP-2) have been found to play a role in tumor progression. In the present work, the expression and prognostic value of MMP-2, MMP-9, TIMP-1 and TIMP-2 were assessed in endometrial carcinoma. The patient material consisted of a total of 266 women diagnosed with primary endometrial carcinoma. The tissue expression of immunoreactive proteins was examined in paraffin-embedded tumor sections by immunohistochemical staining using specific antibodies, and the pretreatment serum levels of the proteins were quantitatively measured by ELISA. Tissue MMP-2 expression associated with a worsened prognosis, whereas tissue TIMP-2 overexpression was an indicator of a favorable outcome. Furthermore, we observed a combination of strong MMP-2 and weak TIMP-2 tissue expression to identify a group of women at high risk of adverse outcome in endometrial carcinoma. Patients with negative MMP-2 immunostaining had the best prognosis, regardless of TIMP-2 staining result. In serum measurements, high preoperative TIMP-1 concentration was a prognostic indicator of unfavorable outcome. These results indicate that tissue MMP-2 and TIMP-2 as well as circulating TIMP-1 may be prognostic markers in endometrial carcinoma. Of these, tissue MMP-2 seems to be the most potent prognostic marker. Studies with larger patient materials are needed to further explore the value of these enzymes in clinical practice in endometrial cancer. / Tiivistelmä Kohdunrungon syöpä on yleisin gynekologinen maligniteetti kehittyneissä maissa. Varhaisten oireiden, kuten poikkeavan verisen vuodon, vuoksi kohdunrungon syöpä havaitaan usein varhaisessa vaiheessa, jolloin sen ennuste on hyvä. Taudin käyttäytyminen voi kuitenkin olla moninaista. Viime vuosikymmenten aikana kohdunrungon syöpään sairastuneiden ennuste ei ole merkittävästi parantunut. Vaikuttaisi siltä, että perinteiset ennustetekijät eivät ole riittävän tarkkoja ennustamaan syövän taudinkulkua. Lisäksi liitännäishoidot voivat olla kalliita, ja niihin voi liittyä vakavia haittavaikutuksia. Uusien biologisten ennustetekijöiden löytäminen olisi tärkeää, jotta aggressiivista syöpätyyppiä sairastavat potilaat pystyttäisiin tunnistamaan entistä paremmin, ja hoito kyettäisiin räätälöimään yksilöllisemmin taudinkuvaa vastaavasti. Gelatinaasien (MMP-2 ja MMP-9) sekä niiden kudosinhibiittoreiden (TIMP-1 ja TIMP-2) on havaittu osallistuvan syövän etenemiseen. Tässä tutkimuksessa tarkasteltiin MMP-2:n ja MMP-9:n sekä niiden kudosinhibiittoreiden TIMP-1:n ja TIMP-2:n ilmentymistä ja ennusteellista merkitystä kohdunrungon syövässä. Aineisto käsitti yhteensä 266 primaariseen kohdunrungon syöpään sairastunutta naista. Määritysmenetelminä käytettiin sekä immunohistokemiallista värjäystä parafiiniin valettujen kudosnäytteiden osalta että ELISA-määrityksiä ennen hoitoa otettujen seeruminäytteiden osalta. Syöpäkudoksen runsas MMP-2 -proteiinin ilmentyminen liittyi epäsuotuisaan ennusteeseen, kun taas kasvainkudoksen voimakas TIMP-2 -proteiinin ilmentyminen oli hyvän ennusteen merkki. Lisäksi kasvainkudoksen voimakkaan MMP-2- ja heikon TIMP-2 -proteiinien ilmentymisen yhdistelmän havaittiin liittyvän suurempaan syövästä johtuvaan kuolleisuuteen. MMP-2 -negatiivisten potilaiden eloonjäämisennuste oli paras, TIMP-2 -värjäystuloksesta riippumatta. Seerumin korkea TIMP-1 -pitoisuus oli merkittävä huonontuneen ennusteen merkki. Tutkimuksen tulokset viittaavat siihen, että kasvainkudoksessa esiintyvät MMP-2- ja TIMP-2 -proteiinit samoin kuin seerumin TIMP-1 -pitoisuus voivat ennustaa kohdunrungon syövän kliinistä käyttäytymistä. Kasvainkudoksessa esiintyvä MMP-2 -proteiini vaikuttaisi olevan merkittävin ennusteellinen tekijä, mutta tulosten varmistamiseksi tarvitaan lisää tutkimuksia suuremmilla potilasaineistoilla.

Indiana University-Purdue University Indianapolis (IUPUI) / The negative heath consequences of smoking are widely recognized, but there are still about 20% of the people in United States using tobacco products. Cigarette smoke condensate (CSC), the particulate matter of cigarette smoke, is comprised of thousands of chemicals (e.g., nicotine). Secondary only to bacterial plaque, cigarette smoking is a major risk factor for periodontal disease. Human gingival fibroblasts (HGFs) are the main cellular component of periodontal connective tissues. During the development of periodontal disease, collagen degradation occurs. Collagen is the major extracellular matrix component of the gingiva. The major extracellular matrix degrading enzymes produced by the HGFs are the matrix metalloproteinases (MMPs). The MMPs are mainly modulated by the tissue inhibitors of metalloproteinases (TIMPs). In this dissertation, three studies aimed at understanding the effects of tobacco on human gingival fibroblasts and their mechanisms have been conducted: the effects of CSC on HGF-mediated collagen degradation; comparison of the effects of CSC on HGFs with that of nicotine; and the combined effects of CSC and bacteria on HGFs. The cell proliferation of HGFs decreased and cytotoxicity increased in HGFs treated with increasing concentrations of CSC. CSC increased the collagen degrading ability of the HGFs by altering the production and localization of MMPs and TIMPs. Nicotine is one of the major components and the most pharmacologically active agent in tobacco. The percentage of nicotine in the CSC was 2.4%. CSC (100 µg/ml) increased the collagen degrading ability of the HGFs by affecting membrane associated MMP-2, MMP-14, and TIMP-2, but the level of nicotine in the CSC may only play a limited role in this process. Porphyromonas gingivalis (P. gingivalis) is an opportunistic pathogen involved in periodontal disease. The combined effects of CSC and P. gingivalis supernatant increased HGF-mediated collagen degradation by destroying the balance between the MMPs and TIMPs at the protein and mRNA levels. This project demonstrated that tobacco (with or without P. gingivalis) increased HGF mediated collagen degradation, as seen in the periodontal disease, through altering the MMPs and TIMPs.