Orientador: Joyce Annichino-Bizzacchi / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-13T01:42:43Z (GMT). No. of bitstreams: 1 Bittar_LuisFernando_M.pdf: 1309049 bytes, checksum: 8d7bbcbc4a659300d128bc58336cbb88 (MD5) Previous issue date: 2009 / Resumo: Níveis elevados de fator VIII (FVIII) são um fator de risco independente e prevalente para trombose venosa profunda (TVP), e tem influência do FvW. A ADAMTS13 é responsável pela modulação do tamanho molecular do FvW, clivando os multímeros de altíssimo peso molecular. Alterações moleculares no gene da ADAMTS13 têm correlação com sua atividade. Neste estudo avaliamos a prevalência do polimorfismo A4751G no gene do FvW (região de ligação com a ADAMTS13), os polimorfismos C1797T e C1852G e a mutação C4006T no gene da ADAMTS13 em 435 pacientes com TVP (156M/279F; idade mediana=37) e 580 controles (170M/410F, idade mediana=35). Investigamos a relação entre os genótipos e a dosagem de FVIII e FvW no plasma e o risco de TVP. A dosagem de FVIII:C foi realizada por método coagulométrico de um estágio, e as dosagens de FVIII:Ag e FvW:Ag por método imunoenzimático. As alterações moleculares foram determinadas por PCR e digestão com enzimas específicas, ou SSCP e sequenciamento para confirmação. Pacientes com TVP mostraram níveis significantemente aumentados de FVIII:C (203.7 UI/dl vs. 127 UI/dl; p<0.001), FVIII:Ag (109.6 UI/dl vs. 82.4 UI/dl; p<0.001) e FvW:Ag (154.2 UI/dl vs. 108 UI/dl; p<0.001) quando comparados com o grupo controle. Não houve diferença significativa entre os grupos na prevalência das alterações moleculares estudadas. Os indivíduos com genótipo AG (FvW A4751G) apresentavam níveis significativamente reduzidos de FVIII:C (p=0.04). Embora também tenha demonstrado uma discreta associação com níveis diminuídos de FvW:Ag, esta não foi estatisticamente significativa (p= 0.07). Os indivíduos com genótipo CG (ADAMTS13 C1852G) apresentavam níveis significativamente aumentados de FVIII:Ag (p=0.05) e FvW:Ag (p= 0.01). Apesar da relação com diminuição do FVIII o polimorfismo A4751G não mostrou um efeito protetor para TVP. O polimorfismo ADAMTS13 C1852G está associado à diminuição desta metaloprotease, e sua associação com níveis aumentados de FVIII:Ag e FvW:Ag neste estudo favorece essa hipótese. / Abstract: Elevated levels of factor VIII (FVIII) are a prevalent and independent risk factor for deep venous thrombosis (DVT), and are affected by von Willebrand factor (vWF) levels. ADAMTS13 is responsible for the modulation of the molecular size of vWF, cleaving the ultra large multimers. Mutations and polymorphisms in the ADAMTS13 gene are related with its activity. This study evaluated the prevalence of polymorphism A4751G in the vWF gene, polymorphisms C1797T, C1852G and the mutation C4006T in the ADAMTS13 gene in 435 patients with DVT and 580 healthy controls. Subsequently, we investigated the relationship between the genotypes and plasma levels of FVIII and vWF and DVT risk. FVIII:C was measured by a one-stage clotting method, and FVIII:Ag and vWF:Ag were measured by chromogenic method. The molecular changes were determined by restriction endonucleases or single strand conformation polymorphism followed by sequencing. Statistical test:U Mann-Whitney, = 0.05. Patients with DVT had higher plasma levels of FVIII:C (mean 203,7 UI/dl vs. 127 UI/dl; p<0.001), FVIII:Ag (mean 109,6 UI/dl vs. 82,4 UI/dl; p<0.001) and vWF:Ag (154,2 UI/dl vs. 108 UI/dl; p<0.001) when compared to controls. We observed no statistical difference in the prevalence of all molecular changes studied between patients and controls. A4751G heterozygotes had significantly reduced levels of FVIII:C (p=0,04). Althought there was a slight association with reduced levels of vWF: Ag, this association was not statistically significant (p= 0,07). C1852G heterozygotes had significantly elevated levels of FVIII:Ag (p=0.05) and vWF:Ag (p= 0,01). Despite the relative decline of FVIII:C with the A4751G polymorphism there was no protective effect for DVT. The C1852G polymorphism is associated with a reduction of ADAMTS13, and its association with increased levels of FVIII: Ag and vWF: Ag observed in this study supports this hypothesis. / Mestrado / Biologia Estrutural, Celular, Molecular e do Desenvolvimento / Mestre em Fisiopatologia Médica

Orientador: Margareth Castro Ozelo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-15T13:42:22Z (GMT). No. of bitstreams: 1 Damian_GuilhermeBenedini_M.pdf: 1979799 bytes, checksum: 8b7242b6fe37a1f5f52bc6f26ca9d829 (MD5) Previous issue date: 2010 / Resumo: A doença de von Willebrand (DVW) é a doença hemorrágica hereditária mais freqüente. Dentre os subtipos relacionados à DVW, o tipo 2N apresenta exclusivamente diminuição da afinidade do fator de von Willebrand (FVW) ao fator VIII (FVIII). Como conseqüência, esses pacientes apresentam redução do FVIII plasmático. Por essa razão, comumente esses casos são diagnosticados erroneamente como portadores de hemofilia A. Em um recente estudo brasileiro, foi observado que cerca de 10% dos casos de hemofílicos A leve sem antecedente familiar prévio para a doença, na verdade tratavam-se de DVW tipo 2N (SIMON & ROISENBERG, 2004). Para o diagnóstico de certeza da DVW tipo 2N, a avaliação molecular é o método mais utilizado, uma vez que os testes laboratoriais confirmatórios não apresentam boa reprodutividade. Esse estudo tem como objetivos fazer a investigação molecular de casos previamente diagnosticados ou com suspeita de DVW tipo 2N baseados na história clínica, familiar e dados laboratoriais. Além disso, pacientes diagnosticados com hemofilia A moderada e leve, foram investigados para a presença das quatro mutações mais freqüentes relacionadas à DVW tipo 2N. Esse estudo avaliou oito casos não relacionados de paciente com suspeita ou diagnóstico de DVW tipo 2N, acompanhados no Hemocentro da UNICAMP (Campinas, SP) e no Hemocentro do Espírito Santo (Vitória, ES). Os oito casos foram investigados para mutações presentes na região que corresponde ao local do sítio de ligação do FVIII ao FVW, localizada entre os éxons 18 a 27 do gene do FVW. Apenas um caso foi conclusivo, com a presença da mutação em homozigose R816W no gene do FVW Essa mutação corresponde à 11% dos casos de DVW tipo 2N. Os outros sete casos foram exaustivamente investigados para mutações nessa região, incluindo o seqüenciamento do DNA genômico e codificante da região entre éxon 18 a 27 do gene do FVW e não foram conclusivos. Esses mesmos casos foram investigados através do seqüenciamento do gene do FVIII, para avaliar a presença de mutação associada à hemofilia A. Em um dos casos do sexo feminino, foi possível a identificação de uma mutação em homozigose G265 +1 G>T no íntron 3 do gene do FVIII. Trata-se de uma mutação não descrita no local de um sítio doador de splice. Foram avaliados ainda 67 pacientes não relacionados com diagnóstico de hemofilia A leve ou moderada para as quatro mutações mais freqüentes relacionadas à DVW tipo 2N. Em nenhum desses casos essas mutações estavam presente, nem mesmo em heterozigose. Em conclusão, na avaliação de oito casos não relacionados com suspeita de DVW tipo 2N, em apenas um caso esse diagnóstico foi confirmado. Em outro caso do sexo feminino foi confirmado o diagnóstico de hemofilia A grave/moderada. Ao contrário do que foi observado em outra população brasileira estuda, entre os pacientes diagnosticados com hemofilia A leve e moderada aqui estudos, as quatro mutações mais freqüentes na região do sítio de ligação do FVIII ao FVW estavam ausentes em todos os casos. O diagnóstico de certeza entre a DVW tipo 2N e hemofilia A é de extrema importância para o tratamento correto desses casos e para o aconselhamento genético. A investigação molecular continua sendo a melhor maneira para a diferenciação desses casos / Abstract: The von Willebrand disease (VWD) is the most frequently hemorrhagic disease. Among the different types of VWD, the type 2N VWD is characterized by a markedly decreased affinity of von Willebrand factor (VWF) to factor VIII (FVIII). As consequence, the clearance of FVIII is accelerated and these patients while maintaining the concentration of VWF and its ability to normal platelet aggregation have reduced plasma FVIII. Frequently these cases are misdiagnosed as carriers of hemophilia A (HA). In a recent Brazilian study, it was observed that about 10% of cases of mild hemophilia A with no family history, it was actually type 2N VWD (SIMON & ROISENBERG, 2004). The molecular investigation is the best method to confirm the diagnosis of type 2N VWD once the confirmatory test, VWF:FVIII binding assay (VWF:FVIIIB) it is not reproducible. This study aims investigate the molecular diagnosis of cases previously diagnosed or with suspect of type 2N VWD, based on clinical and family history, and laboratorial data. Furthermore, patients diagnosed with mild or moderate hemophilia A, were investigated for the presence of the four most frequent mutations related to type 2N VWD. The study evaluated eight unrelated cases with suspect or diagnosis of type 2N VWD followed at Hemocentro UNICAMP (Campinas, SP) and Hemocentro do Espírito Santo (Vitória, ES). The eight cases were investigated for mutations in the region that corresponds to the location of the binding site of FVIII to VWF, located between exons 18 to 27 of the VWF gene. Only one case was conclusive, with the presence of the R816W mutation in the VWF gene. This mutation corresponds to 11% of type 2N VWD. The other seven cases were repeatedly investigated for mutations in this region, including the sequencing of genomic DNA and the coding region of exon 18 to 27 of the VWF gene and were not conclusive. These same cases were investigated by sequencing of the FVIII gene to assess the presence of mutations associated with hemophilia A. In one female case, it was possible to determine the presence in homozigose of a mutation G265 +1 G>T, a donor splicing region in the intron 3 of the FVIII gene. This mutation was not previously described. In addition, we evaluated 67 unrelated patients with diagnosis of mild or moderate hemophilia A for the four most frequent mutations related to type 2N VWD. None of these cases showed the presence of these mutations, even in heterozygosis. In conclusion, the evaluation of eight unrelated cases for type 2N VWD showed that just one case this diagnosis was confirmed. Different to what was observed in another Brazilian population studied, among mild and moderate hemophilia A followed at the Hemocentro UNICAMP, the four mutations in the binding site of FVIII to VWF were absent in all the cases. The confirmatory diagnosis between type 2N VWD and hemophilia A is extremely important for the correct treatment and the appropriate genetic counselling. The molecular investigation remains the best way to differentiate these cases / Mestrado / Clinica Medica / Mestre em Clinica Medica

A Hemofilia A é uma doença sanguínea condicionada por gene localizado no cromossomo X. É causada pela deficiência parcial ou total da atividade do Fator VIII (FVIII), uma glicoproteína plasmática cuja função é necessária para a coagulação normal do sangue. Devido às dificuldades encontradas para o reconhecimento direto da mutação no gene F8, o diagnóstico das portadoras é feito de forma indireta, isto é, por análise de ligação com marcadores polimórficos localizados dentro ou próximos ao gene que permite determinar a co-segregação do haplótipo e da mutação na família sob estudo e, desta maneira, detectar o estado de portadora e, eventualmente, auxiliar no diagnóstico pré-natal. O presente trabalho teve por objetivo avaliar o poder de alguns desses marcadores na diferenciação das populações e determinar o grau de sua informatividade para o diagnóstico e aconselhamento genético de famílias afetadas, bem como verificar o eventual uso forense de tais marcadores. Foram então determinadas as frequências alélicas e haplotípicas, diversidade genética, diferenciação populacional, desequilíbrio de ligação e composição ancestral de quatro microssatélites intragênicos (IVS 1, IVS 13, IVS 22, IVS 25.3), localizados em introns do F8, e um extragênico (IKBKG) em amostras de populações brasileiras urbanas (indivíduos normais de São Paulo, Rio Grande do Sul e Pernambuco), de quilombos (Mimbó, Sítio Velho e Gaucinha localizados no Estado do Piauí) e Ameríndios (Tikúna, Baníwa e Kashináwa). As análises, quando cabível, incluíram um grupo de pacientes hemofílicos. O DNA dos sítios polimórficos foi amplificado por PCR, os produtos separados em PAGE e corado por nitrato de prata. Para as análises estatísticas foram empregados programas já considerados de uso rotineiro. Os parâmetros de diversidade mostraram diferenças entre as amostras populacionais analisadas. Tais diferenças regionais nas frequências alélicas devem ser levadas em conta quando o diagnóstico indireto da Hemofilia A estiver sendo realizado. Com exceção do IKBKG, todos os demais microssatélites apresentaram altas taxas de heterozigose. Usando tais marcadores, o diagnóstico foi possível em 10 das 11 famílias analisadas. Os microssatélites IVS 22, IVS 1, IVS 13, IVS 25.3 e IKBKG foram informativos em 63,6% (7/11), 54.5% (6/11), 54.5% (6/11), 45.5% (5/11) e 18.2% (2/11) dos casos, respectivamente, demonstrando a eficácia do uso desses microssatélites no diagnóstico pré-natal e na identificação de portadoras na população brasileira. / Hemophilia A is a bleeding disorder conditioned by a gene located on the X chromosome and caused by partial or total deficiency of the Factor VIII (FVIII) activity, a plasma glycoprotein whose function is necessary for normal blood clotting. Due to difficulties faced on direct recognition of the F8 gene mutation, carrier diagnosis is done indirectly by linkage analysis with polymorphic markers located within or near the gene. These markers may determine the haplotype and the mutation co-segregation within the studied family, and thus detect the carrier status and possibly assist in prenatal diagnosis. This study aimed to evaluate the power of some of these markers in population differentiation and to determine their degree of informativeness for diagnosis and genetic counseling of affected families, as well as to verify the possible forensic use of such markers. We then determined the allele and haplotype frequencies, genetic diversity, population differentiation, linkage disequilibrium and ancestral composition in Brazilian urban (healthy individuals from São Paulo, Rio Grande do Sul and Pernambuco), quilombo remnant (Mimbó, Sítio Velho and Gaucinha in the State of Piauí) and Amerindian (Tikúna, Baníwa and Kashináwa) population samples by the analysis of four intragenic microsatellites (IVS 1, IVS 13, IVS 22, IVS 25.3), located on F8 introns, and one extragenic (IKBKG ). When appropriated, the analysis included a group of hemophilic patients. DNA polymorphisms were detected by PCR, PAGE and silver nitrate staining. Statistical analysis was implemented by programs already considered in routine use. Diversity parameters showed differences among the populational samples analyzed. Such regional differences in allele frequencies must be taken into account when conduct the indirect diagnosis of Hemophilia A. Except for IKBKG, all other microsatellites showed high rates of heterozygosity. Using these markers, the diagnosis was possible in 10 of the 11 families analyzed. The microsatellites IVS 22, IVS 1, IVS 13, IVS 25.3 and IKBKG were informative in 63.6% (7 / 11), 54.5% (6 / 11), 54.5% (6 / 11), 45.5% (5 / 11 ) and 18.2% (2 / 11) of the cases, respectively, demonstrating the effectiveness of the use of these microsatellites in prenatal diagnosis and on carrier identification in the Brazilian population.

L’apparition d’une réponse immunitaire contre le Facteur VIII (FVIII) de la coagulation est une complication majeur qui survient chez 30% des hémophile A sévères. Bien que des avancées importantes aient abouti au développement de nouvelles molécules de FVIII thérapeutiques, les mécanismes conduisant à l’apparition d’une réponse immunitaire anti-FVIII restent non élucidés. Des facteurs de risques génétiques et environnementaux ont été identifiés ou suggérés, mais une compréhension complète des processus immunologiques permettant l’initiation de cette réponse au dépend de l’induction de tolérance immune chez 30% des patients restent incomprise. Ma thèse porte sur les aspects fonctionnels et structurels du FVIII et leur rôle dans l’initiation de la réponse immunitaire anti-FVIII chez le modèle murin hémophile A. Le premier rôle du FVIII est sa participation à la cascade de la coagulation, et donc la première partie de ma thèse adresse le rôle du processus de coagulation dans l’initiation de la réponse immunitaire anti-FVIII. La seconde partie de ma thèse se concentre sur l’importance des résidus du domaine C2 impliqué dans la liaison aux phospholipides dans l’endocytose et la présentation du FVIII par les cellules présentatrices de l’antigène in vitro et discute de leur relevance in vivo. / Immunogenicity of Factor VIII (FVIII) is a major hurdle that affects about 30% of severe hemophilia A patients. Though a significant advancement has been accomplished in the development of newer FVIII molecules, the factors that drive FVIII immune responses remain elusive. Many genetic and environmental risk factors have been identified or suggested but a complete understanding of the immunological basis for the antibody formation and the mechanism(s) behind tolerance induction, in the 30% of the patients that never develop anti-FVIII antibodies, are not understood. My thesis involves overlapping aspects important for initiation of an anti-FVIII immune response in a mouse model of hemophilia A. The primary role of FVIII is its participation in coagulation-associated events and thus, the first part of my thesis addresses whether coagulation events per se are implicated in the initiation of anti-FVIII immune responses. The second part of my thesis focuses on the importance of the membrane binding residues within the C2 domain of FVIII in antigen uptake and presentation by antigen presenting cells in vitro and discusses its relevance in vivo.

This degree project is a study investigating how the historiography of king Henry VIII of England has changed between 1887-1995. The aim of the study was to gain insight into how the historiography of Henry VIII and the most important aspects of his reign were viewed at different periods of the 19th and 20th centuries and how it has changed over that period. To achieve this aim, Karlsson’s and Zander’s theory about the uses of history was used along with a qualitative method of analysis. The results show that a change did occur in the historiography around Henry VIII at the beginning of the 20th century when the traditional Whig-school of writing history was surpassed by the modernist school of writing. Henry VIII went from being represented as a great ruler with his peoples’ best at heart to a flawed individual whose decisions were often motivated by selfish reasons. Overall, the historiography of Henry VIII has changed from glorifying the king’s personality to showing a more factual picture of the king and the advisors at his court.

Factor VIII, a component of the intrinsic pathway of blood coagulation, has yet to be purified to homogeneity. It appears that, in vivo, the factor VIII coagulant protein is closely associated with one or more other proteins (factor VHI-related antigen and platelet aggregating factor). The material normally isolated from bovine plasma as 'factor VIII' possesses all three activities and is therefore either a mixture or a complex of the various proteins. In the present study, bovine factor VIII:C was purified approximately fivethousand- fold by a combination of ion-exchange chromatography and fractional precipitation. The factor VIII coagulant activity can be separated from the other activities of the 'factor VIII complex' but the procedures involved are not suitable for preparative use as the factor VIII:C which is obtained is unstable. During coagulation, factor VIII:C is required during the activation of factor X. Studies with purified bovine clotting factors indicate that factor IX_a is the enzyme responsible for the cleavage of factor X, in a calcium-dependent reaction which is stimulated by phospholipid. Factor VIII:C further accelerates the rate at which factor X_a is generated. Preliminary investigations of the kinetic parameters of the reaction indicate that the stimulation by factor VIII:C occurs through a marked increase in the V_max of the reaction; factor VIII:C does not affect the K_m for factor X. The coagulant activity of factor VIII is enhanced by exposure to thrombin, but the 'activated' factor VIII:C which is produced is not itself capable of activating factor X in the absence of factor IX_a. Thus, the 'activation' of factor VIII:C, in contrast to the activation of, for example, factors IX and X, does not appear to result in the formation of an enzyme. That is, factor VIII:C is a non-enzymic, high molecular weight cofactor for factor IX_a.

Neutrophil degranulation involves a number of well-orchestrated structural and biochemical events. We have investigated the mechanism of intracellular signalling involved in neutrophil degranulation that was mediated by the high affinity leukotriene (LT)B[subscript 4] receptor, BLT1. The model systems used were consisted of Peripheral blood neutrophils as well as promyeloid PLB-985 cells, stably transfected with human BLT1 cDNA (PLB-BLT) or a substitution mutant (2L(304-305)/A) of the distal dileucine motif in helix VIII of BLT1, and differentiated into a neutrophil-like phenotype. The degranulation of these cells was measured in the presence and absence of factors that would affect the signaling pathway. The results show that Degranulation responses to LTB[subscript 4] were similar for differentiated PLB-BLT1 and neutrophils. However, the degranulation response of cells bearing the dileucine mutation in helix VIII of BLT1 was significantly reduced in response to LTB[subscript 4]. Pretreatment of differentiated PLB-BLT1 cells and neutrophils with Y-27632, a pharmacological inhibitor of p160-ROCK, the down-stream effector of the small GTPase RhoA, abrogated their degranulation in response to LTB[subscript 4]. The degranulation defect observed with the dileucine mutation was corrected by transient transfection of the cells bearing the mutation with a constitutively active form of RhoA. Taken together, our results suggest an essential role for the distal dileucine motif in helix VIII of BLT1 involving RhoA which allows normal neutrophil degranulation in response to LTB[subscript 4].

No description available.

O fator VIII de coagulação (FVIII), recombinante ou purificado de plasma, é o biofármaco necessário para o tratamento da hemofília A, a doença hemorrágica mais freqüente em humanos. O método tradicional para a purificação de FVIII parte de crioprecipitado de plasma e precipitação alcoólica. No Instituto Butantan, foi proposto um método alternativo, utilizando somente cromatografia para esta purificação. Este projeto teve por objetivo comparar dois métodos cromatográficos de purificação do FVIII: 1 - gel filtração direta do plasma e 2 - pré-purificação de FVIII do plasma por cromatografia de troca aniônica, seguida de gel filtração. A purificação foi analisada por dosagens de atividade específica de FVIII e presença de outras proteínas da cascata de coagulação nas frações de cromatografia. Foram realizadas clonagem de fragmentos gênicos de FVIII e expressão de fragmentos protéicos para imunização de animais. Os soros com anticorpos policlonais anti-FVIII foram usados em ensaios de \"western blot\" para detectar as cadeias de FVIII ou degradação. / Coagulation factor VIII (FVIII), recombinant or purified from plasma, is the biopharmaceutical used for treatment of haemophilia A, the most frequent human hemorrhagic disorder. The traditional method used for purification of FVIII starts from plasma cryoprecipitate and alcoholic precipitation. The Instituto Butantan proposed an alternative methodology using only chromatography for FVIII purification. The main objective of this project was to compare two chromatographic methods for FVIII purification: 1 - direct plasma gel filtration and 2 - pre-purification of FVIII by anion exchange chromatography, followed by gel filtration. The purification process was analyzed by determination of FVIII specific activity and detection of other coagulation factors co eluting in chromatographic fractions. Fragments of FVIII gene were cloned and protein fragments were expressed for animal immunization. Sera with polyclonal antibodies anti-FVIII were used in western blots assays to detect FVIII chains or its degradation.

Glioblastoma multiforme (GBM) is the most common malignant primary brain tumour in adults. The employment of current standard of care management strategy, that is combining maximum but safe surgical resection, and concomitant chemoradiotherapy, only achieves very modest survival benefits. Antiangiogenesis is a widely studied therapeutic strategy, which restricts the tumour growth by cutting off blood supplement. Although several antiangiogenic agents are now under clinicaland preclinical trials, bevacizumab is still the only one that has been proven to be effective in the treatment of recurrent GBM. However, the clinical use of bevacizumab has encountered the emergence of drug resistance. Its therapeutic benefit is considered limited because of its single pathway targeting. Many researchers believe that the use of broad spectrum angiogenesis inhibitors may leadto better clinical outcomes by overcoming the shortcomings of bevacizumab. / Vastatin, the globular non-collagenous 1 (NC1) domain of collagen VIIIα1, was initially proved to inhibit the proliferation and migration of bovine aortic endothelial cells. Although vastatin is similar in origin to other collagen-derived antiangiogenic factors (CDAFs), its antiangiogenic capability in treatment of cancers has not been studied systematically. Our team members previously found that vastatin wasa safe and effective antiangiogenic therapeutic and a potential biomarker for liver cancer. In this thesis, I tried to explore the therapeutic potential of vastatin in treatment of GBM. / Using a recombinant adeno-associated virus mediated gene therapy, the antiangiogenic potential of vastatin was first confirmed in vitro that it inhibited proliferation, migration and tube formation of murine microvascular endothelial cells (MECs). These effects were further confirmed using another gene vector (H1) which was subsequently employed for the in vivo studies. H1 is a nanopolymer gene vector has high affinity with the folate receptors on tumour cells. Transfection ofH1/vastatin reduced MEC proliferation in a U87/MEC co-culture system, suggesting a paracrine inhibition. Mechanism studies showed that vastatin caused a wide range of changes in the global gene transcription level in MECs, indicating a broad spectrum of action. / Following the establishment of an orthotopic murine GBM model, the H1/DNA polyplexes were injected directly to the tumour area. Treatment induced a significant increase in intracranial mRNA level of the therapeutic gene. Both vastatin and endostatin, a positive control, prolonged the survivals of GBM bearing mice. Immunostaning showed that vastatin decreased microvessel density in the outer layer of the tumour, while decreased cell density and caused abnormal vessel structures inthe centre. No synergistic effect was observed when GBM was treated with the combination of H1/vastatin and temozolomide (TMZ) in this model. / Finally, the therapeutic effect of vastatin on a TMZ resistant model was studied. GBM cells with acquired TMZ resistance (ATR) were established by chronic exposure of U87 cells to TMZ. Animals grafted with the U87-ATR cells were proved to be tolerant of TMZ treatment. H1/vastatin injection significantly prolonged the survival in this model. More interestingly, H1/vastatin also resensitized these animals to TMZ treatment. Stem cell related drug resistance was supposed to be disturbed in this process. / In conclusion, the present study has demonstrated for the first time that vastatin, a broad spectrum endogenous angiogenesis inhibitor, is of therapeutic benefit in a murine orthotopic GBM model. Vastatin’s capability to reverse TMZ resistance highlights an important area for further research. / 胶质母细胞瘤(GBM)是成人最常见的恶性原发性脑肿瘤。目前的治疗手段包括了手术切除和放化疗，但是效果仍不能让人满意。与传统的化疗药不同，抗血管生成药物能通过抑制肿瘤内新血管的形成，切断血流供给，达到限制肿瘤生长的目标。贝伐单抗（Bevacizumab)是目前唯一获得批准用于临床GBM治疗的抗血管生成药物。然而Bevacizumab在临床应用中必须面对耐药性产生的问题， 而且因为Bevacizumab只单一性地阻断血管内皮生长因子相关的通路，所以它的治疗效果也受到了一定程度的限制，让肿瘤可以选择替代性的通路来获得新生血管。因此一些研究人员认为，改用多靶点或者广谱的抗血管生成药物，治疗效果应该会更好。 / Vastatin是VIII型胶原蛋白α1链上的球状非胶原裂解片断。人体内这一类的片段多被证明了具有抗血管生成的功能，它们统称为“源自胶原蛋白的抗血管生成因子”。Vastatin具有抑制牛主动脉内皮细胞增殖和迁移的作用，然而它在抗肿瘤血管生成方面的作用却没有被系统地研究过。我们之前的实验曾经发现Vastatin对肝癌模型中的血管生成具有明显的抑制效果，而本论文将对Vastatin是否同样具有治疗GBM的作用展开研究。 / 在体外，我们首先证明了重组腺相关病毒（rAAV）介导的Vastatin基因治疗能有效抑制MEC的增殖和迁移，并阻止其形成管状结构。我们同时也测试了另一种基因载体H1，以方便后续动物实验的开展。H1是一种纳米聚合物，对肿瘤细胞表面高表达的叶酸受体有高亲和力。H1 介导的Vastatin 基因治疗对肿瘤细胞和MEC都没有直接的作用，但在两种细胞的共培养体系中，Vastatin可以通过旁分泌的方式来抑制MEC的增殖。对机制的研究发现，Vastatin使MEC内基因转录的水平发生了大范围多通路的改变，说明了它的作用具有一定的广谱性。 / 实验进一步研究了Vastatin在小鼠原位GBM 模型中的作用。将H1/DNA 复合物直接注入瘤区可以明显提高颅内相应基因的转录水平。Vastatin和作为阳性对照的Endostatin都能有效地延长GBM小鼠的生存期。免疫组织化学的结果显示Vastatin 能降低肿瘤内部的微血管密度，并诱导组织坏死。这与之前报道过的Endostatin的作用相似。在同一模型上，我们还测试了Vastatin和Temozolomide(TMZ)结合给药的效果，但并没有了现明显的协同作用。 / 实验最后研究了Vastatin在TMZ耐药模型中的治疗效果。通过将U87细胞长期浸泡中含有TMZ的培养基中，我们成功地筛选出了具有TMZ耐药性的GBM细胞。用这些细胞建立的小鼠GBM模型对TMZ的作用不敏感。实验表明，H1/Vastatin基因疗法不仅能够明显延长模型小鼠的生存期，还可以逆转耐药性，使TMZ重新发挥作用。我们推测干细胞相关的耐药性的产生和维持可能在这个过程中受到了影响。 / 上述研究第一次阐明了Vastatin对GBM的治疗效果。Vastatin具有广谱的抗血管特性，能够通过作用于MEC抑制肿瘤内部新血管的生成。Vastatin不仅本身具有治疗作用，还能逆转动物模型对化疗药物的耐受性，因些具有很高的研究价值。相信对Vastatin更一步的探索不但可以拓宽我们对抗血管生成药物的理解，也可能意味着一个新的研究领域的出现。 / Li, Yi. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2014. / Includes bibliographical references (leaves 102-110). / Abstracts also in Chinese. / Title from PDF title page (viewed on 05, January, 2017). / Li, Yi. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.