Dissertations / Theses on the topic 'Neoplastic Stem Cells'

In the normal adult human, hemopoiesis appears to be maintained by the simultaneous activity of many stem cell-derived clones. Conversely, most examples of human myeloid malignancies have been shown to represent clonal populations arising as a result of the unregulated expansion of a single transformed hemopoietic stem cell. The limits of the proliferative capacity of normal hemopoietic stem cells in humans and their persistence in hemopoietic malignancies have, however, not been extensively Investigated. One of the most likely reasons for this is the lack, until very recently, of a widely applicable method to analyze the clonality status of human cell populations. Methylation analysis of two polymorphic genes. HPRT and PGK, now allows such studies to be performed in approximately 50 % of females. The possibility that normal human hemopoietic stem cells might have the capacity to mimic the behaviour of some transformed stem cells by generating clones of progeny that could dominate the entire hemopoietic system was then examined. Such a phenomenon has been well documented in animal models of marrow cell transplantation. I therefore undertook an analysis of all allogeneic marrow transplants performed over a 1 to 1-1/2 year period where the genotype of the donor made clonality analysis using the HPRT or PGK systems possible. Using this approach, I obtained evidence in two patients suggesting that a single or, at most, a very small number of normal primitive hemopoietic stem cells were able to reconstitute the hemopoietic system. In one case the data suggested that such reconstitution was likely to have derived from a stem cell with both lymphopoietic and myelopoietic potential. However, in all other cases hemopoiesis in the transplant recipient was found to be polyclonal. Such findings indicate that clonal dominance in the hemopoietic system is not sufficient to infer that a genetically determined neoplastic change has occurred. In addition, these findings have implications for the design of future gene therapy protocols. The same methodology was also applied to investigate the clonality of different hemopoietic cell populations in patients with chronic myelogenous leukemia (CML) and essential thrombocytosis (ET). In both of these myeloproliferative disorders, the neoplastic clone produces terminally differentiated progeny that appear minimally different from normal. Data from the CML studies confirmed the non-clonal nature of the cells emerging in long-term CML marrow cultures. Similarly, patients transplanted with cultured autologous marrow were shown to undergo polyclonal and bcr-negative reconstitution of their hemopoietic system. Analysis of a series of patients with a clinical diagnosis of ET showed that polyclonal hemopoiesis in the presence of an amplified neoplastic clone is not a rare event in this disorder, and that clonality results do not always correlate with other neoplastic markers associated with myeloproliferative diseases in general. Another example of polyclonal hemopoiesis in the presence of an amplified neoplastic clone was demonstrated in a patient with Ph¹-positive ALL whose disease appeared to have originated in a lymphoid-restricted stem cell. The studies described in this thesis reveal a level of complexity of normal and neoplastic stem cell dynamics not previously documented. They highlight the need for more precise information about the molecular basis of regulatory mechanisms that govern hemopoietic cell proliferation and survival at every level of differentiation. Finally they support the accumulating evidence that acquisition of full malignant potential requires several additive genetic changes first postulated many years ago as the somatic mutation theory of carcinogenesis.
Medicine, Faculty of
Pathology and Laboratory Medicine, Department of
Graduate

The stringent requirement for hemopoietic growth factors (HGF) in the induction of hemopoiesis in vitro has raised questions as to their possible role(s) in leukemogenesis. Several recent clinical studies have shown aberrant cell growth factor gene activation in patient derived leukemic cells. Assessment of growth factor activity is often based on in vitro bioactivity assays of conditioned media or body fluids. The specificity of this type of endpoint is, however, open to question due to the overlap in biological activities of many HGFs. In assessing the role of growth factor gene expression in a murine myeloid leukemia model I have used a sensitive RNA detection procedure coupled with a vector-probe system that enables the synthesis of uniformly labelled radioactive DNA probes to detect unambiguously the expression of particular growth factor genes. The Abelson murine leukemia virus (A-MuLV) derived myeloid transformants used in this study had previously been shown to produce a multi-lineage colony stimulating activity (CSA). While these A-MuLV transformants were shown to produce GM-CSF, it seemed likely that the multi-lineage CSA was due to another factor. In addition to confirming the expression of GM-CSF mRNA, I was able to show that the cells of all four A-MuLV transformed lines tested also expressed interleukin-3 mRNA. This finding was strongly corroborated by bio-activity data obtained using the CM from the A-MuLV myeloid transformants. Additional preliminary analysis by bioactivity assays have also shown the possible presence of interleukin-6 (IL-6) and a recently described pre-B cell factor suggesting perhaps a common mechanism underlying the activation of these various growth factor genes.
Medicine, Faculty of
Medical Genetics, Department of
Graduate

The integrin α6β4 (referred to as β4) is expressed in epithelial cells where it functions as a laminin receptor. Integrin β4 is important for the organization and maintenance of epithelial architecture in normal cells. Particularly, β4 is shown to be essential for mammary gland development during embryogenesis. Integrin β4 also plays important roles in tumor formation, invasion and metastasis in breast cancer. However, the mechanism of how integrin β4 mediates breast tumor formation has not been settled. A few studies suggest that integrin β4 is involved in cancer stem cells (CSCs), but the mechanism is not clear. To address this problem, I examined the expression of β4 in breast tumors and its potential role involved in regulating CSCs. My data shows that β4 is expressed heterogeneously in breast cancer, and it is not directly expressed in CSCs but associated with a basal epithelial population. This work suggests that β4 can regulate CSCs in a non-cell-autonomous manner through the interactions between β4+ non-CSC population and β4- CSC population. My data also shows that β4 expression is associated with CD24+CD44+ population in breast tumor. To further study the role of β4 in breast cancer progression, I generated a β4 reporter mouse by inserting a p2A-mCherry cassette before ITGB4 stop codon. This reporter mouse can be crossed with breast tumor models to track β4+ population during tumor progression.

The integrin α6β4 (referred to as β4) is expressed in epithelial cells where it functions as a laminin receptor. Integrin β4 is important for the organization and maintenance of epithelial architecture in normal cells. Particularly, β4 is shown to be essential for mammary gland development during embryogenesis. Integrin β4 also plays important roles in tumor formation, invasion and metastasis in breast cancer. However, the mechanism of how integrin β4 mediates breast tumor formation has not been settled. A few studies suggest that integrin β4 is involved in cancer stem cells (CSCs), but the mechanism is not clear. To address this problem, I examined the expression of β4 in breast tumors and its potential role involved in regulating CSCs. My data shows that β4 is expressed heterogeneously in breast cancer, and it is not directly expressed in CSCs but associated with a basal epithelial population. This work suggests that β4 can regulate CSCs in a non-cell-autonomous manner through the interactions between β4+ non-CSC population and β4- CSC population. My data also shows that β4 expression is associated with CD24+CD44+ population in breast tumor. To further study the role of β4 in breast cancer progression, I generated a β4 reporter mouse by inserting a p2A-mCherry cassette before ITGB4 stop codon. This reporter mouse can be crossed with breast tumor models to track β4+ population during tumor progression.

Chronic myeloid leukemia (CML) is a disease characterized by the expansion of granulocytic cells. The BCR-ABL tyrosine kinase inhibitor imatinib, the frontline treatment for Ph+ leukemias, can induce complete hematologic and cytogenetic response in most chronic phase CML patients. Despite the remarkable initial clinic effects, it is now recognized that imatinib will unlikely cure patients because a small cell population containing leukemic stem cells (LSCs) with self-renewal capacity is insensitive to tyrosine kinase inhibitors. In Chapter I, I briefly review the BCR-ABL kinase and its related signaling pathways. BCR-ABL kinase activates several signaling pathways including MAPK, STAT, and JNK/SAPK. BCR-ABL also mediates kinase-independent pathways through SRC family kinases. I will also discuss pathways involving β-catenin, hedgehog, FoxO and Alox5 are critical to the regulation of self-renewal and differentiation in LSC of CML. As detailed in Chapter II, I describe our work evaluating the effects of omacetaxine, a novel CML drug inducing cell apoptosis by inhibition of protein synthesis, on self-renewal and differentiation of LSCs and BCR-ABL-induced CML and acute lymphoblastic leukemia (B-ALL) in mice. We found that treatment with omacetaxine decreased the number of LSCs and prolonged the survival of mice with CML or B-ALL. In chapter III, I describe that Alox5 is an essential gene in the function of LSCs and CML development. We show evidence that Alox5 affects differentiation, cell division, and survival of long-term LSCs. Treatment of CML mice with a 5-LO inhibitor also impaired the function of LSCs similarly and prolonged survival. In chapter IV, I present evidence of our work showing a further dissection the Alox5 pathway by comparing the gene expression profiles of wild type and Alox5-/- LSCs. We show that Msr1 deletion causes acceleration of CML development. We also show that Msr1 affects CML development by regulating the PI3K-AKT pathway and β-catenin. Taken together, these results demonstrate that some pathways including Alox5 and Msr1 play an important role in regulating the self-renewal and differentiation of LSC. More efforts should be put into developing the novel strategies that may effectively target LSCs and thus cure CML.

Orientador: André Almeida Schenka
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: O câncer de mama é a neoplasia maligna mais frequente no mundo. A hipótese da célula-tronco neoplásica (CTN) é um novo paradigma de carcinogênese. A imunoistoquímica (IHC) é um método de escolha para detecção de CTN em tecidos parafinizados, com as seguintes vantagens: (1) maior adaptação à rotina diagnóstica; (2) menor custo; (3) menor complexidade. Entretanto, há poucos estudos de marcadores imunoistoquímicos CTN na literatura, a maioria com poucos pacientes e resultados controversos. Um painel de marcadores imunoistoquímicos CTN foi usado em 74 casos de câncer mamário, os quais foram diagnosticados, tratados e acompanhados no UNACON- Poços de Caldas, de 2004 a 2006. Objetivos: (1) descrever quali e quantitativamente um amplo painel imunoistoquímico de anticorpos; (2) estabelecer associações entre marcadores CTN e fatores clínicos, patológicos e prognósticos / preditivos de resposta terapêutica; (3) estabelecer o impacto da expressão de marcadores CTN na sobrevida e recidiva tumoral; (4) estabelecer possíveis correlações intermarcadores. Métodos: Foram testados em cortes de TMA, obtidos a partir dos blocos de parafina originais contendo os tumores mamários, os seguintes anticorpos: CD34, c-kit, CD10, SOX-2, Oct 3/4, p63, CD24, CD44, CD133 e ESA/EPCAM. Fotomicrografias foram obtidas das lâminas de imunoistoquímica dos TMAs e as células positivas foram contadas. As variáveis clínicas, patológicas e prognósticas / preditivas de resposta terapêutica foram obtidas dos prontuários médicos. Resultados e conclusões: A média de idade das pacientes foi de 57 anos (28-84), o IMC médio (índice de massa corpórea) foi 27 (13-39), 6,8% eram tabagistas, 58,9% eram menopausadas e 10,8% referiram história familiar de câncer. O acompanhamento clínico médio foi de 52 meses, com recidiva em 28,6% dos casos, tempo médio de recidiva de 37 meses e óbito de 26,7% das pacientes. Os principais anticorpos imunoistoquímicos CTN neste estudo foram CD24, CD44, CD133 e ESA. Os demais anticorpos foram positivos em menos de 15% dos casos. Pelo menos um marcador CTN foi expresso em 85% dos casos. O principal anticorpo CTN individualmente positivo foi o CD44, em 60,8% dos casos. Por motivos didáticos, 2 perfis CTN foram definidos: (1) CD24 - / CD44+ e (2) CD133+ / ESA+. O primeiro perfil CTN foi mais frequente: (1) nas pacientes acima dos 40 anos; (2) em tumores menores de 2,0 cm; (3) em estádios clínicos iniciais (I e II); (4) e sua positividade elevou o risco de óbito em cerca de 4 vezes. A expressão de qualquer marcador CTN foi mais frequente nos graus histológicos elevados (2 e 3). A expressão isolada de CD133 foi mais frequente nas pacientes menopausadas, a expressão isolada de CD24 foi mais frequente nos tumores maiores que 2,0 cm e a expressão isolada de CD44 foi mais frequentes nas pacientes acima de 40 anos de idade. Não foram observadas correlações intermarcadores significativas. Portanto, a imunoistoquímica é um método de baixa sensibilidade para detectar marcadores CTN no câncer mamário humano, limitando a sua análise quantitativa. Por este motivo, não há evidências suficientes que apoiem o valor clínico dos marcadores CTN
Abstract: Breast cancer is the most frequent malignant neoplasm in the world. The neoplastic stem-cell hypothesis (NSC) is a new paradigm of carcinogenesis. Immunohistochemistry (IHC) is a elegible method to detect NSC in paraffinized tissue, with the following advantages: (1) more adaptable to diagnostic routine, (2) lower cost, (3) lower complexity. Though, there are few researches in the literature analysing the NSC antibodies in human breast cancer, the majority with few patients and controversial results. A IHC pannel of NSC markers was used in 74 breast cancer cases, which were diagnosed, treated and followed in Poços de Caldas Cancer Hospital (UNACON), from 2004 to 2006. The present study aims to: (1) describe a large IHC pannel of NSC antibodies, quantitatively and qualitatively; (2) establish associations between NSC markers and clinical, pathological and prognostic / predictive therapeutic response factors; (3) establish the impact of NSC markers expression to the survival and to the tumor relapse; (4) establish possible intermarkers correlations. Methods: The IHC antibodies CD34, c-kit, CD10, SOX-2, Oct 3/4, p63, CD24, CD44, CD133 and ESA/EPCAM were tested in tissue microarrays (TMA) sections, obtained from the original paraffin blocks of breast tumors. Photomicrographies were obtained from the immunohistochemistry TMA slides. The positive cells were counted. Clinical, pathological and prognostic / predictive therapeutic response variables were obtained from the medical records. Results and conclusions: The median patient age was 57 years (range 28-84), the median BMI (body mass index) was 27 (range 13-39), 6,8% were smokers, 58,9% were in menopause and 10,8% related familial cancer history. The median follow-up was 52 months, with tumor relapse in 28,6% of the cases, median relapse time of 37 months and death of 26,7% of the patients. The mainly positive NSC immunohistochemistry antibodies in our study were CD24, CD44, CD133 and ESA. The others antibodies were positive in less of 15% of the cases. At least one NSC marker was expressed in 85% of the cases. The mainly individual positive NSC antibody was CD44, in 60,8% of the cases. For didatic reasons, two NSC profiles were defined: (1) CD24 - / CD44+ cells and (2) CD133+ / ESA+ cells. The first NSC profile was more frequent in: (1) patients older than 40 years; (2) tumors smaller than 2,0 cm; (3) beginning tumor clinical stages (I and II); (4) and this expression rise the death risk in about 4 times. The second NSC profile rise the relapse tumor risk in about 3,75 times. Anyone NSC antibody expression was more frequent in high histologic grades of tumor (2 and 3). Isolated CD133 expression was more frequent in menopaused patients, isolated CD24 expression was more frequent in tumors larger than 2,0 cm and isolated CD44 expression was more frequent in patients upper than 40 years. No significant intermarkers correlations were observed. Thus, immunohistochemistry is a low sensibility method to detect NSC markers in human breast cancer, limiting the quantitative analysis of them. For this reason, there is not sufficient evidences to support the clinical value of NSC markers
Mestrado
Fisiopatologia Médica
Mestre em Ciências

Chronic myeloid leukemia (CML) is a clonal hematopoietic stem cell disorder associated with the Philadelphia chromosome (Ph) that arises from a reciprocal translocation between chromosomes 9 and 22, thereby resulting in the formation of the chimeric BCR-ABL oncogene encoding a constitutively activated tyrosine kinase. BCR-ABL tyrosine kinase inhibitors (TKIs) induce a complete hematologic and cytogenetic response in the majority of chronic phrase CML patients. However, TKIs cannot efficiently eradicate leukemia stem cells (LSCs) because of the insensitivity of LSCs to TKIs. Therefore, developing new strategies to target LSCs is necessary and critical for curing CML, and success of this approach depends on further understanding the molecular mechanisms by which LSCs survive and are maintained. In Chapter I, I briefly introduce CML disease, BCR-ABL oncoprotein, and TKIs. I also describe the identification and features of LSCs. Several key pathways in LSCs including Wnt/ß-catenin, hedgehog, FoxO, Bcl6 and HIF1, are discussed. I also propose our strategy to identify unique molecular pathways that are important for LSCs but not their normal stem cell counterparts. In Chapter II, I describe our finding about the function of the positive regulator, HIF1α, in CML development and LSC survival. I show that loss of HIF1α impairs the maintenance of CML through impairing cell cycle progression and inducing apoptosis of LSCs, and I also report that p16Ink4a and p19Arf mediate the effect of HIF1α on LSCs, as knockdown of p16Ink4a and p19Arf rescues the defective colony-forming ability of HIF1α-/- LSCs. As detailed in Chapter III and IV, through comparing the global gene expression profiles of LSCs and HSCs, I find two novel regulators, Blk and Scd1, which act as tumor suppressors in CML development. In Chapter III, I show that Blk is markedly down-regulated by BCR-ABL in LSCs, and that c-Myc and Pax5 mediate this down-regulation. Deletion of Blk accelerates CML development; conversely, Blk overexpression significantly delays the development of CML and impairs the function of LSCs. I also demonstrate that p27, as a downstream effector, is involved in the function of Blk in LSCs. Blk also functions as a tumor suppressor in human CML stem cells, and inhibits the colony-forming ability of human CML cells. In Chapter IV, I investigate the function of another negative regulator, Scd1, in CML LSCs, and find that expression of Scd1 is down-regulated in mouse LSCs and human CML cells. We report that Scd1 acts as a tumor suppressor in CML, as loss of Scd1 causes acceleration of CML development and overexpression of Scd1 delays CML development. Using a colony-forming assay, I demonstrate that Scd1 impairs the maintenance of LSCs due to the change of expression of Pten, p53 and Bcl2. Importantly, I find that both Blk and Scd1 do not affect normal hematopoietic stem cells (HSCs) or hematopoiesis. Taken together, our findings demonstrate that HIF1α is required for the maintenance of CML LSCs, and conversely that Blk and Scd1 suppress the function of LSCs, suggesting that combining TKI treatment with specific targeting of LSCs will be necessary for curing CML.

Tumor recurrence after chemotherapy is a major cause of patient morbidity and mortality. Recurrences are thought to be due to small subsets of stem-like cancer cells that are able to survive chemotherapy and drive tumor re-growth. A more complete understanding of stem-like cancer cell regulation is required to develop therapies to better target and eliminate these cells. Slow-cycling stem cells are integral components of adult epithelial tissues and may give rise to cancer stem cell populations that share similar characteristics. These slow-cycling adult stem cells are inherently resistant to traditional forms of chemotherapy and transference of this characteristic may help to explain therapy resistance in cancer stem cell populations. Using a novel application for the proliferation marker CFSE, we have identified populations of slow-cycling cancer cells with tumor initiating capabilities. As predicted, slow-cycling cancer cells exhibit a multi-fold increase in chemotherapy resistance and retain the ability to re-enter the cell cycle. Furthermore, we observed consistent over-expression of the CDK5 activator, p35, in slow-cycling cancer cells. Manipulation of p35 expression in cancer cells affects cell cycle distribution and survival when these cells are treated with traditional forms of chemotherapy. Additionally, we demonstrate that alterations in p35 expression affect BCL2 levels, suggesting a mechanism for the survival phenotype. Combined, our data suggest a model whereby slow-cycling stem-like cancer cells utilize the p35/CDK5 complex to slow cell cycling speed and promote resistance to chemotherapy. Future p35 targeting, in combination with traditional forms of chemotherapy, may help eliminate these cells and reduce tumor recurrence rates, increasing long-term patient survival.

Células-tronco (CT) são células com um alto poder de indiferenciação, plasticidade celular e autorrenovação. Baseado na autorrenovação das CT, pesquisas recentes sugerem que uma falha durante este processo pode levar ao surgimento de um novo tipo de célula, sendo esta responsável pelo aparecimento, propagação e manutenção de diversos tipos de neoplasias. Além disso, apresenta resistência às formas de tratamento convencionais do câncer. Tais células foram denominadas de células-tronco tumorais (CTT). As CTT já foram caracterizadas em leucemias e em diversos tipos de tumores sólidos, porém, até o presente momento, não foram descritas em linfoma não- Hodgkin (LNH). Por esta razão, o presente estudo teve como objetivo investigar a presença de CTT em pacientes com LNH. Biópsias de linfonodos e medulas ósseas (MO) de pacientes com LNH foram as fontes utilizadas para isolar e cultivar as CT mesenquimais. Uma vez caracterizadas as CTT, estas foram inoculadas em camundongos imunodeprimidos para observar uma possível formação de tumor. As células isoladas de biópsias de linfonodo não apresentaram CD133 positivo, marcador de membrana presente nas CTT, bem como não expressaram os genes de indiferenciação (Nanog e Oct-4) e não formaram tumores quando inoculadas nos animais. Por outro lado, as células isoladas de MO apresentaram subpopulações de células positivas para o CD133, expressaram os genes de indiferenciação e, após inoculadas, desenvolveram tumores em camundongos imunodeprimidos. Com isto, concluise que as células isoladas dos linfonodos possam ser fibroblastos, indicando, assim, uma dificuldade de se isolar as CTT deste material. Enquanto que, como já bem descrito e estabelecido na literatura, CT foram facilmente isoladas de MO, entretanto, quando isoladas de pacientes LNH foi ainda possível caracterizar a presença de uma subpopulação de CTT
Stem cells (SC) are undifferentiated cells, with high capacity of cellular plasticity and self-renewal. Based on the self-renewal, recent research suggests that a failure during this process, it can lead to the emergence of a new type of cell, which is responsible for the development, propagation and maintenance of several types of malignancies. Moreover, it is resistant to the conventional treatment of cancer. These cells are denominated as cancer stem cells (CSC). CSC were already characterized in leukemia and in several types of solid tumors. However, until the present moment nothing was described in non- Hodgkin lymphoma (NHL). For this reason, the present study aimed to investigate the presence of CSC in patients with NHL. Biopsies of lymph nodes and bone marrow (BM) from patients with NHL were used for isolate and cultivate MSC. The techniques used to characterize these cells were flow cytometry and PCR. Once CSC were characterized, these cells were inoculated into immunodeficient animals to observe a possible tumor formation. Cells isolated from lymph node biopsies did not show the presence of CD133, a membrane marker present in the CSC, as well as did not express differentiation genes (Nanog and Oct-4) and no ability to form tumors in immunodeficient mice. In another hands, cells isolated from BM showed a subpopulation of CD133 positive, expressed undifferentiated genes and also after the inoculation was possible to observe the tumor formation in immunodeficient mice. In conclusion, isolated cells from lymph nodes could be fibroblasts, indicating a difficulty to isolate CSC from this material. Whereas, as already describe and establish in the literature, SC were easily isolate from MO. However, when isolated from NHL patients was possible to characterize the presence of CSC subpopulation

Orientador: André Almeida Schenka
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: O câncer de mama é a neoplasia maligna mais frequente e a primeira causa de óbito por neoplasia em mulheres. A despeito de toda a pesquisa e todos os progressos realizados até o momento, a morbimortalidade ainda é alta em pacientes em estádio avançado. Recentemente, foi descrito um novo modelo de carcinogênese no qual as células-tronco (CT) seriam responsáveis pela origem, heterogeneidade morfológica e autorrenovação das neoplasias malignas. Apoiando essa teoria, observam-se, na maioria das neoplasias sólidas, células com características biológicas e fenotípicas de CT, as quais são designadas células-tronco neoplásicas (CTN). Estando associadas à resistência terapêutica e recidivas tumorais a longo prazo, as CTNs constituem um importante alvo de estudos fisiopatológicos e farmacológicos. Além das CTNs, outro importante alvo terapêutico em câncer de mama é representado pela angiogênese tumoral. Contudo, raros são os estudos focados nas interrelações dessas duas estratégias. As estatinas constituem um grupo de fármacos utilizados no tratamento de primeira linha das dislipidemias e na prevenção de suas consequências cardiovasculares. Além dos efeitos antidislipidêmicos, são descritas propriedades antineoplásicas, cujas bases parecem estar associadas a ações antiapoptóticas e antiangiogênicas, ainda não totalmente esclarecidas. Resultados preliminares in vitro de Gauthaman et al. e in vivo do grupo de pesquisa em que o presente trabalho se insere apontam um efeito inibitório de estatinas (principalmente as lipofílicas) sobre CTN mamárias humanas e murinas. Assim sendo, buscou-se neste trabalho elucidar o efeito da sinvastatina sobre angiogênese tumoral, CTNs CD34+, além de investigar possíveis interrelações fisiopatológicas desses importantes elementos tumorais. Para tanto, utilizou-se um modelo consagrado de carcinogênese mamária (baseado na indução com 7,12-dimetilbenz(a)antraceno [DMBA]) em ratas Sprague-Dawley, sendo a primeira vez em que o fenômeno de angiogênese é descrito neste modelo. Após a aplicação do protocolo experimental e a eutanásia dos animais controles e experimentais, suas linhas mamárias (contendo ou não tumores) foram avaliadas morfologicamente e do ponto de vista de imunoexpressão de CD34. Nos animais tratados com sinvastatina (na dose de 40mg/kg), houve uma maior representação tecidual relativa do subtipo histológico "carcinoma ductal" quando comparado ao tecido tumoral virgem de tratamento, fato que sugere um efeito da sinvastatina sobre a plasticidade morfológica das neoplasias induzidas pelo DMBA. Também se observou redução significativa da densidade microvascular do tecido tumoral tratado em relação ao não tratado. Contudo, não foi observado efeito significante da sinvastatina sobre as CTNs CD34+, neste modelo, o que contraria resultados in vitro relatados na literatura, bem como resultados in vivo deste grupo de pesquisa. Em conclusão, neste modelo, o tratamento crônico (14 dias) com sinvastatina (na dose de 40mg/kg, ao dia - dose comparada à utilizada na terapêutica antidislipidêmica em seres humanos), apresenta efeito antiangiogênico e modulador da heterogeneidade morfológica em tumores mamários induzidos pelo DMBA
Abstract: Breast cancer is the most common malignancy and the leading cause of death from cancer among females worldwide. Despite all the research and all the progress achieved so far, the morbidity and mortality due to this cancer remains high in patients at advanced stages. Recently, it was described a new model of carcinogenesis in which stem cells (SC) could be responsible for the origin, morphological heterogeneity and self-renewal of cancer. In support of this theory, it has been observed, in most solid tumors, the presence of cells showing phenotypic and biological characteristics of stem cells, which have thus been designated cancer stem cells (CSC). Being associated with therapeutic resistance and tumor recurrence in the long run, CSCs constitute an important target in pharmacological and pathophysiological studies. In addition to CSCs, promising therapeutical targets also include tumor angiogenesis. Nevertheless, very few studies have focused on the interrelations of these two strategies. Statins are first-line anti-dyslipidemic drugs which have been shown to possess anti-neoplastic properties - possibly related to anti-apoptotic and/or anti-angiogenic effects (although these putative mechanisms have not yet been entirely investigated). Based on preliminary results of Gauthaman et al. (in vitro data) and of our group (in vivo data), indicating that statins (specially the lipophilic ones) may have a specific inhibitory effect over mammary CSCs, we sought to elucidate the in vivo effect of simvastatin on tumor angiogenesis and CD34+ CSC, simultaneously; this was achieved using a well-recognized carcinogenesis model, where a single dose of 7,12-Dimethylbenz(a)anthracene (DMBA) is used to induce of mammary tumors in Sprage-Dawley female rats. Of notice, this is the first time angiogenesis is quantitatively and morphologically assessed in this model. Our results show that simvastatin significantly increases the relative participation of invasive ductal carcinoma as a subcomponent of the induced mixed tumors, suggesting that this drug may modulate the morphologic plasticity of DMBA-induced mammary neoplasms. It was also observed a significant reduction in the microvessel density (MVD) of treated tumor tissue, when compared to that of untreated specimens. No significant difference was seen in terms of CD34+CSC number, when comparing treated and untreated tissues, which is in clear contrast to in vitro results reported in the literature and to our own in vivo results (using other CSC markers). In conclusion, in the present protocol, simvastatin, at the dose of 40mg/kg daily for 14 days (which is comparable to the anti-dyslipidemic doses used in humans), has anti-angiogenic and morphologic effects on DMBA-induced mammary tumors, but no significant action on CD34+ CSCs
Mestrado
Farmacologia
Mestre em Farmacologia

A presença de metástase em linfonodos cervicais é o fator prognóstico mais importante para o carcinoma epidermóide de boca (CEB), uma das neoplasias malignas mais comuns da região de cabeça e pescoço. Estudos têm associado os mecanismos de progressão tumoral, recorrência e metástase com a presença e manutenção de células-tronco de câncer (CSC, do inglês cancer stem cells), que correspondem à subpopulação celular mais migratória e altamente metastática quando comparada com outras subpopulações presentes no tumor. Ainda, evidências recentes mostram que há uma ligação entre as CSC e o processo de transição epitélio-mesenquimal (EMT, do inglês epithelial-mesenchymal transition), evento em que as células perdem a polaridade e a aderência célula-célula e exibem uma morfologia mesenquimal, o que as permite migrar além do tumor primário. Portanto, o objetivo deste estudo foi de avaliar, in vitro, a associação das propriedades biológicas relacionadas ao fenótipo tronco tumoral e de transição epitélio-mesenquimal, com o comportamento invasivo e metastático das linhagens SCC-9 de CEB primário e metastático correspondente. Para este fim, linhagens celulares parental (SCC-9 ZsGreen) e metastática (SCC-9 ZsGreen LN-1), obtidas após ensaios de tumorigênese in vivo, foram caracterizadas em relação à capacidade de proliferação e migração, bem como à presença e proporção da subpopulação de CSC, baseado na capacidade de formação de colônias tumorais, preferencialmente holoclones, e de esferas tumorais. Ensaios de expressão gênica (qRT-PCR) também foram conduzidos para se verificar os níveis de expressão diferencial dos marcadores de CSC (CD44, BMI1, ALDH1 e p75NTR), bem como de EMT (SNAIL1, TWIST1, AXL, vimentina, E-caderina e N-caderina) em ambas as linhagens tumorais, utilizando-se células epiteliais de palato humano (CEPH) como controle. Tanto a capacidade de proliferação e migração celular, quanto a quantidade de holoclones e esferas tumorais, foram significativamente maiores na linhagem metastática quando comparada com a parental. A linhagem metastática SCC-9 ZsGreen LN1 exibiu, ainda, superexpressão estatisticamente significante de CD44, BMI-1, AXL, vimentina e N-caderina e baixa expressão de E-caderina, quando comparadas com a linhagem parental. O potencial metastático de SCC-9 ZsGreen LN-1 parece ser uma consequência da sua maior quantidade de subpopulação com fenótipo de CSC que, ainda, passou pelo processo de EMT. Portanto, sugere-se que as propriedades biológicas relacionadas à capacidade metastática da linhagem SCC-9 ZsGreen LN-1 parecem estar relacionadas a ambos os fenótipos tronco tumoral e de transição epitélio-mesenquimal.
The presence of metastasis in cervical lymph nodes is the most significant prognostic factor for the oral squamous cell carcinoma (OSCC), one of the most common malignant neoplasms of the head and neck. Studies have associated the mechanisms of tumor progression, recurrence and metastasis with the presence and maintenance of cancer stem cells (CSC), which correspond to the most migratory and highly metastatic cellular subpopulation when compared to other cell subpopulations within the tumor. Moreover, recent evidence shows that there is a link between the CSC and the process of epithelial-mesenchymal transition (EMT), an event in which the cells lose their polarity and cell-cell adhesion and exhibit a mesenchymal morphology, which allows them to migrate beyond the primary tumor. Thus, the purpose of the present study was to evaluate, in vitro, the combination of the biological properties related to CSC and EMT phenotypes with the invasive and metastatic behavior of the corresponding primary and metastatic OSCC SCC-9 cell line. For this, parental (SCC-9 ZsGreen) and metastatic (SCC-9 ZsGreen LN-1) OSCC cell lines, obtained after in vivo tumorigenesis assays were characterized regarding the ability of proliferation and migration, as well as the presence and proportion of CSC subpopulation, based on the capacity of generating tumor colonies, preferably holoclones, and tumor spheres. Gene expression assays (qRTPCR) were also conducted to verify the differential expression levels of CSC markers (CD44, BMI-1, ALDH-1 and p75NTR) and EMT (SNAIL1, TWIST1, AXL, vimentin, Ecadherin and N-cadherin) markers in both tumor cell lines, using human palate epithelial cells (HPEC) as control. Both proliferation and cell migration capacity, as well as the numbers of holoclones and tumor spheres were significantly higher in metastatic cell line compared to the parental. Furthermore, the metastatic cell line SCC-9 ZsGreen LN-1 showed significantly higher expression of CD44, BMI-1, ALDH- 1, vimentin, and N-cadherin and lower expression of E-cadherin, when compared to parental cell line. The metastatic potential of SCC-9 ZsGreen LN-1 seems to be a consequence of the greater amount subpopulation with CSC phenotype that also underwent the EMT process. Therefore, it is suggested that the biological properties related to metastatic ability of SCC-9 ZsGreen LN-1 cell line are related to both CSC and EMT phenotypes.

Orientador: André Almeida Schenka
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: O câncer mamário é a neoplasia maligna mais incidente e a principal causa de óbito por malignidade no sexo feminino no Brasil e no mundo. Estipula-se que há mais de 1.2 milhões de novos casos anuais de câncer de mama, e que a heterogeneidade e a complexidade molecular do câncer de mama dificultam estratégias terapêuticas de prevenção e tratamento desta doença. Atualmente, acredita-se que, em diversas neoplasias, incluindo o câncer de mama, a célula alvo de mutações cumulativas responsáveis pelo desenvolvimento do fenótipo canceroso é uma célula-tronco adulta. Independentemente da origem da neoplasia (se em célula madura/diferenciada ou em CT), é possível constatar in vitro e in vivo, na grande maioria dos tumores malignos, uma subpopulação de células indiferenciadas, com características fenotípicas de célula-tronco. Tais células são designadas como "células tronco cancerosas ou neoplásicas (CTNs)". Com frequência, especula-se se as CTNs seriam responsáveis pela heterogeneidade morfológica e molecular de algumas neoplasias mamárias. Em conjunto, essas peculiaridades das CTNs as tornam importantes alvos no desenvolvimento de novas abordagens farmacoterapêuticas antineoplásicas. Recentemente, Gauthaman et al (2009) demonstraram de forma inédita em estudos in vitro que estatinas apresentam efeito inibitório específico sobre células tronco embrionárias com alterações cariotípicas e células de linhagens neoplásicas mamárias com fenótipo CTN, não afetando o crescimento de células tronco normais. As estatinas são inibidores competitivos da 3-hidroxi-3-metilglutaril coenzima A (HMG-CoA) e são amplamente utilizada para o tratamento de doenças cardiovascular primário e secundário. Além de amplamente utilizadas na prevenção e tratamento de doenças cardiovasculares secundárias a dislipidemias, evidências cumulativas apontam para um possível papel destas drogas na prevenção ou regressão de processos neoplásicos. Entre os efeitos antineoplásicos comprovados das estatinas, destacam-se: a inibição da proliferação celular, a promoção de apoptose, a inibição da angiogênese e a prevenção de metástases. Assim, buscou-se neste trabalho elucidar o efeito da sinvastatina e pravastatina sobre células progenitoras e CTNs e em algumas vias de sinalização intracelular em modelo de carcinogênese mamária (baseado na indução com 7,12 dimetilbenz(a)antraceno[DMBA]) em ratas Sprague-Dawley. Após um tratamento de 14 dias com as estatinas, as mamas das ratas foram analisadas para verificar a imunoexpressão de células progenitoras e CTNs (CD133, CD24, CD44 e EpCAM), variáveis biológicas (volume tumoral, mitose, índice proliferativo) além da análise proteica de Akt e Src. A maior dose da sinvastatina testada (40 mg/Kg) diminui o número de tumores desenvolvidos, volume e incremento tumoral e os índices de proliferação celular. Não houve alteração da percentagem de necrose com o tratamento com as estatinas. Ainda, sinvastatina diminuiu os níveis da fosforilação da Akt e aumento da PTEN, não havendo diferenças significantes nos níveis da Src. Sinvastatina também foi capaz de reduzir o número de células positivas CD133, CD24 e CD44. Pelas doses testadas, não houve diferença dos parâmetros biológicos analisados com o tratamento com a pravastatina. Em conclusão, neste modelo, o tratamento crônico com a sinvastatina apresentou efeitos citostáticos, ações reguladoras na via da Akt além do controle de células progenitoras e CTNs em modelo in vivo de carcinoma mamário
Abstract: Breast cancer is the malignant neoplasm with the highest incidence and the main cause of death by cancer within females in Brazil and in the world. It is estimated that there are over 1.2 million new annual cases of breast cancer. The heterogeneity and the molecular complexity of this type of cancer complicate the therapeutic strategies for its prevention and treatment. Nowadays, it is believed that in many different neoplasms, including breast cancer, the cell which is the target of cumulative mutations responsible for the development of the cancerous phenotype is an adult stem cell. Regardless the origin of the neoplasm (whether in mature/differentiated cell or in SC), a subpopulation of undifferentiated cells with phenotypic characteristics of stem cells can be seen in vitro and in vivo in most malignant tumours. These cells are designated as "neoplastics or cancer stem cells (CSCs)". It is often especulated whether CSCs would be responsible for the molecular and morphological heterogeneity in some breast neoplasms. The peculiarities of the CSCs make them a relevant/an important/a serious object for the development of new antineoplastic pharmacotherapeutic approaches. Recently, Gauthaman et al (2009) demonstrated in unprecedented in vitro studies that statins exhibit specific inhibitory effect on embryonic stem cells with karyotypic alterations and neoplastic mammary cell lines with phenotype CSC, not affecting the growth of normal stem cells. Statins are competitive inhibitors of coenzyme 3-hydroxy-3-methylglutaryl A (HMG-CoA) reductase and are widely used for the primary and secondary treatment of cardiovascular diseases. Moreover, cumulative evidence points to a possible role of these drugs in the prevention or regression of neoplastic processes. Amongst the proven anticancer effects of statins, some of them stand out such as: inhibition of cell proliferation, promotion of apoptosis, inhibition of angiogenesis and metastasis prevention. Thus, this study sough to elucidate simvastatin and pravastatin effects on progenitor cells and NSCs, and on some signaling pathways in breast carcinogenesis model (based on induction 7,12 dimethylbenz (a) anthracene [DMBA]) in female Sprague-Dawley rats. After a 14 days treatment with the statins, the rats' breasts were examined to verify immunostaining of progenitor cells and CSCs (CD133, CD24, CD44 and EpCAM), biological variables (tumor volume, mitosis, proliferation index) in addition to protein analysis of Akt and Src. The highest dose of the tested simvastatin (40mg/kg) decreased the number of tumors developed, volume and tumor growth as well as the cell proliferation index. There was no change in the percentage of necrosis to treatment with statins. Furthermore, simvastatin decreased the levels of Akt phosphorylation and increased PTEN levels, without significant differences in Src levels. Simvastatin was also able to reduce the number of CD133, CD24 and CD44 positive cells. For the doses tested, there was no difference on the analyzed parameters in the treatment with pravastatin. As a conclusion, in this model, chronic treatment with simvastatin showed cytostatic effects, regulatory actions towards Akt, as well as the control of CSCs and progenitor cells in the in vivo model of mammary carcinoma
Doutorado
Farmacologia
Doutor em Farmacologia

Orientador: André Almeida Schenka
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: O câncer de mama é a neoplasia maligna mais prevalente e a principal causa de óbito entre mulheres, no mundo. A despeito de avanços substanciais no entendimento da biologia da doença, nos métodos de detecção precoce, e em sua farmacoterapia, a sobrevida geral não se modificou significantemente nas últimas décadas. Portanto, pode se dizer que um dos deveres primordiais das Universidades Públicas engajadas com pesquisa básica e aplicadas consiste em contribuir para o desenvolvimento de novas estratégias de tratamento sistêmico desta neoplasia. Nesse contexto, um dos alvos estratégicos mais promissores no desenvolvimento de novos fármacos antineoplásicos é representado pela célula-tronco neoplásica (CTN). As CTNs têm sido associadas em inúmeros estudos à capacidade de algumas neoplasias malignas de resistir às principais modalidades terapêuticas antineoplásicas, especialmente à: radio-, quimio-, hormônio- e imunoterapias. Em resumo, na atualidade, a detecção de CTNs constitui uma ferramenta clínica bastante promissora enquanto alvo terapêutico, fator prognóstico e preditivo de resposta terapêutica. O objetivo deste trabalho foi descrever e discutir as potencialidades e limitações do modelo de carcinogênese mamária pelo DMBA, após reclassificação das neoplasias mamárias segundo os critérios diagnósticos da OMS (2003, 2012), subtipagem molecular e quantificação de imunomarcadores prognósticos, preditivos e de CTN. Após a aplicação do protocolo experimental de indução química pelo DMBA e a eutanásia dos animais controle e experimental, suas linhas mamárias (contendo ou não tumores) foram ressecadas e avaliadas quanto à morfologia e a imunoexpressão para marcadores de CTNs. Após 13 semanas, 100% dos animais desenvolveram neoplasias macroscópicas e histologicamente compatíveis com os critérios de avaliação indicados pela OMS. Os tumores foram classificados em carcinoma ductal, carcinoma papilífero, carcinoma lobular, carcinoma mioepitelial e tumor filóide, sendo o tipo mais frequente, o ductal. Poucos marcadores imunoistoquímicos mostraram correlação com variáveis de comportamento biológico. Mesmo assim, o grau de correlação não foi elevado. A grande heterogeneidade morfológica intratumoral e interanimal, associada à presença de subtipos histológicos bifásicos (tumor filóide), tumores com diferenciação mioepitelial/basal e à grande positividade para marcadores CTN clássicos (tanto em termos de frequência na amostra como em termos de distribuição média nas neoplasias) demonstram a participação clara de CTNs no modelo, o que o torna um importante referencial como modelo in vivo para o teste de drogas anti-CTN específicas. O modelo reproduz os principais subtipos histológicos e moleculares de câncer mamário, o que significa que poderá ser utilizado no estudo pormenorizado de drogas indicadas especificamente para cada subcategoria molecular (e.g., agentes hormonais que são indicados especificamente para os tipos luminais e trastuzumab, indicado nos tumores do subtipo HER2), bem como no desenvolvimento de novas drogas com maior especificidade para a classe molecular de interesse
Abstract: Breast cancer is the most common malignancy and the leading cause of death from cancer among females worldwide. Despite all the research and all the progress, methods of early detection, and its pharmacotherapy, overall survival has not changed significantly in recent decades. Therefore, the Public University has been engaged in basic and applied research is too contributed to the development of new strategies for systemic treatment of this malignancy. In this context, one of the most promising strategic targets in the development of the anticancer drugs is represented by neoplastic stem cell (NSC). Neoplastic stem cell has been linked in various studies to the capacity of some malignancies to resist major antineoplastic therapeutic modalities, especially: radio-, chemo-, hormone- and immunotherapies. In summary, the detection of NSCs is a clinical tool very promising while therapeutic target and prognostic factor predictive of therapeutic response. The aim of this study was to describe and discuss the strengths and limitations of the model of mammary carcinogenesis by DMBA, after reclassification of breast cancer according to the diagnostic criteria of the WHO (2003, 2012), and quantification of molecular subtyping prognostic immunomarkers, predictive and NSC. After application of the experimental protocol of chemical induction by DMBA and euthanasia of experimental and control animals, the mammary lines (with or without tumors) were resected and evaluated the morphology and immunostaining for markers of NSCs. After 13 weeks, 100% of the animals developed macroscopic neoplasms and histologically consistent with the evaluation criteria of evaluation indicated by WHO. Tumors were classified as ductal carcinoma, papillary carcinoma, lobular carcinoma, myoepithelial carcinoma and phyllodes tumor, being the most common type, the ductal. Few immunohistochemical markers correlated with variable behavior biological. Nevertheless, the degree of correlation was not high. The morphological intratumoral heterogeneity and interanimal associated with the presence of histological biphasic subtypes (phyllodes tumor), tumors with myoepithelial/basal differentiation and the positivity for NSCs classic markers (both in terms of frequency in the sample and in terms of the average distribution neoplasias) demonstrate a clear involvement of NSCs in the model, making it an important reference as a model for in vivo testing of anti-specific NSC. The model reproduces the main molecular and histological subtypes of breast cancer, which means that could be used in detailed study drug indicated specifically for each subcategory molecular (eg, hormonal agents that are suitable specifically for the luminal type and trastuzumab indicated in tumors HER2 subtype), as well as to develop new drugs with higher specificity for the class of molecular interest
Mestrado
Farmacologia
Mestre em Farmacologia

Includes abstract.
Includes bibliographical references.
Melanocytic neoplasia is a multifaceted process involving a complex interplay of genetic and environmental factors. Despite recent advances, the aetiology and pathogenesis of melanocytic neoplasms remains unclear and the anatomical location and state of differentiation of the initiating cell remains to be elucidated. Traditional models propose melanoma arises from an epidermal melanocyte which passes through defined stages of increasing atypia due to the accumulation of mutational events. The newly proposed tumour stem cell hypothesis, however, advocates melanoma may arise from a mutated tissue-resident precursor cell, and not froma terminally differentiated melanocyte. The overall aim of this study was to investigate whether benign naevi contain cells with a stem cell-like phenotype, and to examine the question of whether these might be stem cell precursors of malignant melanoma. Ten formalin-fixed and paraffin embedded human naevus biopsy samples, of five different naevus subtypes, were systematically re-evaluated by direct immunofluorescence first, to understand the lineage of a “naevus” cell, and second, to evaluate whether melanocytic naevi may originate from a precursor cell and not via de-differentiation from an epidermal melanocyte. For phenotypic characterisation, results were highly suggestive of a melanocytic lineage with 85.36% of naevus cells staining positively for the melanocyte specific differentiation antigen, Melan-A, as determined by a semi-quantitative analysis. Yet, these cells showed important morphological variations and were distinct from differentiated epidermal melanocytes. Furthermore, although studies have suggested regional variations in naevi and a possible Schwann cell lineage, there was no evidence in support of a Schwann cell phenotype of naevus cells in this study. Secondly, precursor markers were identified in all naevus subtypes analysed, thereby convincingly demonstrating the presence of precursor cells within naevus tissue. The majority of positively labelled cells localised to the epidermal compartment (72.72%) and this was similar for all three markers analysed: OCT4 (77.22%), NANOG (63.72%) and p75 (57.15%). Interestingly, dysplastic naevi showed a large proportion of OCT4+ cells (5.81%), which was by far the greatest proportion of any precursor marker identified in this study. As dysplastic subtypes are associated with an increased risk of melanoma development, this may imply an increased stem cell component confers this risk. Thirdly, analysis with the proliferation marker Ki-67 revealed the epidermal compartment contained the majority of dividing naevus cells (76.17%), thereby supporting an epidermal origin of naevi. Since the majority of precursor cells identified were within the epidermal compartment, this may suggest precursor cells drive naevus development, in support of the tumour stem cell hypothesis. In addition, the predominance of these precursor cells within the interfollicular epidermis may aid in identifying a potential stem cell niche. However, no precursor cells were noted in the normal intervening interfollicular epidermis or dermis of naevi, or in the epidermis or dermis of normal human skin, as may have been expected. In conclusion, the presence of stem cell markers in naevus tissue supports the hypothesis that at least some naevus cells may arise from stem cells, and not from differentiated melanocytes.

The adaptor protein Shb has been implicated in the signaling of several tyrosine kinase receptors and previous studies have suggested a role for Shb in the signal transduction of T cells. Shb associates with the T cell receptor (TCR) and partakes in the signal propagation of activated T lymphocytes. In order to explore Shb’s influence on TCR signaling in vivo, T cell development and function was studied in a Shb knockout mouse. The loss of Shb led to aberrant TCR signaling in both thymocytes and peripheral CD4+ TH cells, with elevated basal phosphorylation of key components in the signal cascade. Shb was found to be dispensable for thymocyte development, but its absence resulted in a TH2 bias in in vitro stimulated peripheral CD4+ TH cells. As imbalances in TH2 responses are linked to allergic diseases, we further explored Shb’s role in immune regulation in a mouse model of atopic dermatitis. Shb knockout mice exhibit more aggravated signs of atopic dermatitis, including increased immune cell recruitment to the affected areas and elevated mRNA levels of typical TH2 cytokines. The effect of Shb on hematopoiesis in general was determined by examining populations of long-term hematopoietic stem cells (LT-HSCs) and hematopoietic progenitor cells in bone marrow of Shb knockout and wild type mice. Shb deficient bone marrow was found to contain significantly fewer relative numbers of LT-HSCs due to a proliferative defect. The reduced cell cycle activity of Shb LT-HSCs could further be linked to an abnormal regulation of the focal adhesion kinase/Rac1/p21-activated kinase pathway. Since alterations in LT-HSC proliferative abilities may have implications for leukemia development, BCR-Abl induced myeloid neoplasia was investigated in the absence of Shb. Shb deficiency confers a more aggressive progression of BCR-Abl induced myeloid neoplasia characterized by an increased peripheral blood neutrophilia and a deregulated cytokine profile. In addition, focal adhesion kinase and STAT3 signaling is hyperactivated in Shb knockout leukemic cells. In conclusion, Shb appears to be a multifunctional signaling mediator that controls several responses in hematopoietic cells, under homeostatic as well as disease conditions.

Carcinomas de mama são heterogêneos e consistem de diversos tipos celulares. Perfis de expressão gênica usando DNA microarrays identificaram quatro subtipos moleculares fundamentais baseados na expressão de receptores hormonais (estrógeno e progesterona) e de fator de crescimento epidérmico (HER2) (luminal tipo A, luminal tipo B, tumores expressando somente HER2 e triplos negativos) refletindo a heterogeneidade molecular dos carcinomas. Sugeriu-se que esta heterogeneidade advém da presença de células tronco tumorais com a capacidade de se diferenciar ao longo de vias divergentes e outros estudos sugeriram que a presença destas células tronco tumorais pode ser evidenciada pela análise fenotípica de CD44 e CD24. Nosso objetivo foi detectar a freqüência de CD24 e CD44 isolados ou combinados, analisados por imunoistoquímica e sua associação com os subtipos moleculares e com diversos marcadores biológicos em 95 casos de carcinoma ductal infiltrativo organizados em um microarranjo tissular (TMA). Realizamos determinações imunoistoquímicas de CD44, CD24, citoqueratinas (CK5, CK6, CK18), claudina 7 e Ki67. Subgrupos moleculares foram definidos pela expressão imunoistoquímica de RE, RP e HER2. Resultados: Os tumores apresentaram uma maior freqüência dos grupos luminais (49,5%) atribuído à alta expressão de RP ou RE (47,4%), e freqüência menor de tumores triplo negativos (21,5%) e HER2 (9,5%). Os fenótipos CD44+CD24- e CD44-/CD24+ estavam respectivamente presentes em 8,4% e 16,8% dos tumores e o fenótipo duplamente positivo foi predominante (45,3%). Ausência de ambas as proteínas foi evidente em 6,3% dos tumores. Tumores com fenótipo CD44+CD24- (definido como um marcador de células tronco tumorais por estudos in vitro) foram mais comuns em tumores triplos negativos mas não demonstraram nenhum tipo de associação com características clinico-patológicas e demais marcadores. Este fenótipo não foi expresso nos tumores HER2 positivos. O fenótipo duplamente positivo CD44+CD24+ mostrou-se mais freqüente nos subtipos luminais ou com alta expressão de HER2. Os fenótipos (CD44-CD24+ e CD44-CD24-) não mostraram associação com os subgrupos. Tumores expressando CD24+ isolado, com grande freqüência deste marcador (74,7%), mostraram significativa associação com positividade do RE, RP e Ki67 e uma significância marginal com marcadores de diferenciação luminal (CK18 e claudina 7, p = 0,14). Nenhuma associação foi observada com tumores CD44+ quando analisado isoladamente. A expressão de claudina 7 e Ki67 não mostrou associação com os subgrupos e a expressão de CK5 apresentou uma tendência a uma maior negatividade nos subtipos luminais e uma freqüência maior de positividade nos tumores HER2 e triplo negativos. De outro lado, associação da freqüência da expressão positiva de CK18 nos subgrupos luminais foi estatisticamente significativa (p = 0,003). Para se determinar se CD24+ e CD44+ e seus subtipos combinados poderiam afetar a sobrevida global e o intervalo livre da doença preparamos curvas de sobrevida de acordo com Kaplan-Meier que foram analisadas estatisticamente (log rank test). A mediana do período de seguimento das pacientes do nosso estudo foi de 4,8 anos (0,36 10,9 anos). Estas análises não demostraram influência dos fenótipos CD44+CD24- ou CD44+ sobre a sobrevida global ou intervalo livre de doença, mas observamos uma tendência a um prognóstico mais favorável. Interessantemente tumores HER2 positivos não expressaram este fenótipo, sugerindo que outros marcadores de células tronco caracterizam estes tumores. O fenótipo CD44-CD24+ mostrou-se mais freqüente nos tumores luminais, mas não apresentou correlação com marcadores clínico-patológicos ou biológicos analisados. Não houve diferenças significativas com respeito a sobrevida global ou intervalo livre de doença . A expressão de CD24+ isolado associou-se a expressão dos marcadores de diferenciação celular e a uma diminuição do intervalo livre de doença. A sobrevida livre de doença (10 anos) indicou uma percentagem de 94,1% para CD24- e 72,1% para os pacientes CD24+ enquanto a sobrevida global foi de 84,2% para os pacientes CD24- e 72,1% para os pacientes CD24+. Citoqueratinas (CK5, CK18) e Ki67 não influenciaram a sobrevida e o intervalo livre de doença. No entanto a expressão positiva de claudina 7, embora não associada à sobrevida global, foi estatisticamente associada ao decréscimo do intervalo livre da doença (p = 0,05). Conclusão: As características dos tumores CD44+CD24- e sua tendência a associação um prognóstico mais favorável parecem não estar de acordo com as propriedades descritas na literatura para células tronco e enfatizam a necessidade de outros marcadores. A determinação da freqüência de CD44+ e claudina 7 positiva pode contribuir para a análise do prognóstico em carcinoma de mama
Background: Breast carcinomas consist phenotypically of diverse cells and exhibit intra tumoral heterogeneity being stratified in several subgroups based in gene expression profiles or histochemical biomarkers. It was suggested that this heterogeneity is derived in part from the transformation of different subsets of cancer stem cells (CSC) in each intrinsic subgroup. The presence of CSC can be evidenced by phenotypic analysis of CD44 e CD24. This study aimed to identify the CD24 and CD44 immunophenotype within invasive ductal breast carcinoma (IDC) subtypes and determine its influence on prognosis as well as its association with the expression of Ki67, citokeratins (CK5, CK6 and CK18) and claudin-7. Methods: Immuno expression of CD44 and CD24 alone or in combination was investigated in 95 IDC cases arranged in a tissue microarray (TMA). The association with intrinsic subgroups defined as luminal A (ER+, PR+, HER2-), luminal B (ER and or PR+, HER2+), HER2 subtype (ER-, PR-, HER2+) and triple negative (ER-, PR-, HER2-), and the other markers and prognosis was analyzed. Results: CD44+CD24- and CD44-CD24+ were respectively presents in 8.4% and 16.8% of the tumors, a lack of both proteins was detected in 6.3%, while CD44+CD24+ was determined in 45.3% of the tumors. Although there was no significant correlation between subgroups and different phenotypes, the CD44+CD24- phenotype was more common in the basal subgroups but the frequency of this subtype has not been associated with clinical characteristic or biological markers. The phenotype was absent in HER2 tumors whereas luminal tumors are enriched in CD44-CD24+ and CD44+CD24+ cells which did not show associations with clinical/biological markers features. There was also no significant association of the subtypes with the event free (DFS) and overall survival (OS) but the CD44+CD24- phenotype showed a more favorable prognostic as compared to CD44-CD44+ phenotype that showed a worse prognosis (p = 0.26) (median follow up, 4.8 years) CD44+ alone was evident in 57.9%, while CD24+ was positive in 74.7% of the tumors, the latter showing a significant association with ER, PR and Ki67 and a marginal association with CK18 and claudin-7. Expression of claudin-7 and Ki67 did not associate with the cancer subgroups, while a positive association between CK18 and the luminal subgroups was found. CD44+ was not significantly associated with OS (p = 0.684) and DFS (p = 0.386) whereas CD24+ expression was also no significantly associated with OS (p = 0.32) but was associated with a decrease in DFS (p = 0.07). CK5, CK18 and Ki67 expression had no influence in OS or DFS, however claudin-7 positive although not statistically associated with OS, was associated with reduced DFS (p = 0.05). Conclusions: The heterogeneity of cells with several CD44CD24 expression may indicate the presence of different stem cell populations. Ocurrence of CD44+CD24- phenotype is more common in triple negative tumors and lower in tumors of luminal type and absent in HER2 tumors. Although not associated significantly with patho-biological markers or OS and DFS, the CD44+CD24- phenotype has a tendency to be a favorable prognostic marker in breast cancer raising the possibilty that the putative tumorigenic ability may no be restricted to cells of this phenotype. The presence of CD44-CD24+ may indicat a worse prognosis. CD24+ was associated with ER, PR, Ki67and showed a marginal association with CK18 and claudin-7. CD24 and Claudin-7 positivity were the only biological markers associated with reduced DFS. These two investigated markers can be used to improve the assessement of prognosis in breast cancer

Orientador: Li Li Min
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: As injeções de células tronco de medula óssea, autólogas ou heterólogas, estão na vanguarda das terapias celulares bem sucedidas, apresentando resultados interessantes na cura de diversas patologias, incluindo aquelas usualmente associadas com o envelhecimento. Entretanto, nunca foram testadas injeções de células-tronco em modelos de envelhecimento natural, o que constitui uma séria lacuna de conhecimento que precisa ser preenchida. Neste trabalho caracterizamos e injetamos células mononucleares de medula óssea de camundongos transgênicos c57Bl/6 EGFP jovens em camundongos c57Bl/6 em meia-idade e velhice extrema. As células injetadas foram caracterizadas como diplóides e normais em citometria de fluxo de ciclo celular apresentando, no entanto, instabilidade genética quando submetidas ao cultivo para análise citogenética, com formação de células poliplóides anormais, indicando um possível fenótipo "mutator". Foi feito o acompanhamento do estado geral e desempenho reprodutivo dos animais após as injeções, visualizando-se o comportamento das célulasmononucleares injetadas através de análise histológica e citogenética após a morte natural ou sacrifício dos animais. Todos os animais injetados apresentaram a formação de neoplasia EGFP+ hemolinfóide indiferenciada de alto grau histológico ao atingirem a idade média de mortalidade para a linhagem c57Bl/6. Em um experimento paralelo de injeções heterólogas de células mononucleares de medula óssea em cães SRD (sem raça definida) com seqüelas neurológicas causadas por cinomose, houve remissão dos sintomas na maior parte dos indivíduos injetados e não houve formação de neoplasia após 8 meses de acompanhamento. Estes resultados enfatizam a correlação entre células-tronco, tumorigênese e envelhecimento, demonstrando que células jovens portadoras de instabilidade genética intrínseca podem permanecer normais e quiescentes em organismos jovens, desencadeando a formação de neoplasia quando submetidas ao ambiente celular de organismos velhos
Abstract: Bone marrow mononuclear cell transplantation has been successfully used in the treatment of several pathologies. However, stem cell injections have not been examined in models of natural aging. In this study we derived bone marrow mononuclear cells from young c57Bl/6 EGFP mice and investigated the effects of transplantion into aged mice. EGFP transgenic mice have been an important tool in the study of stem cell behavior both in vivo and in vitro models. The bone marrow mononuclear fraction has been intensively used in animal experiments and human clinical trials and EGFP transgenic mice cells are the basis for many experiments involving bone marrow mononuclear cell transplantation. However, the EGFP mice mononuclear fraction has never been characterized concerning cellular content, stages in cell division and cytogenetic stability. We performed the cytometric characterization of EGFP transgenic mice bone marrow mononuclear cells, profiling cell proportions in stages of differentiation and cell division, as well as ploidy. We also make the cytogenetic control of these cells to determine chromosomic stability under cultivation. Aged c57Bl/6 mice were transplanted with young c57Bl/6 EGFP mice mononuclear cells. The general health and reproductive performance before and after transplantation was recorded, and histopathological analysis was performed after the death of the animals. All injected mice developed an hemolymphoid neoplasia of high histological degree originating from the transplanted cells upon reaching average death age for c57Bl/6. Neoplastic cells were found in the liver, spleen and lymph nodes, leading to death in a few weeks. Cytogenetic analysis showed abnormal karyotypes in cultured tumor cell lines obtained from these mice. The injected EGFP mononuclear cells have a normal cytometric profile, including normal ploidy, but upon cultivation for cytogenetic analysis loose stability, presenting polyploidy in many of the analyzed cells. These results suggest a mechanism of genetic instability innate to these cells. In a parallel experiment of heterologous bone marrow mononuclear cell injections in mixed breed dogs with neurologic canine distemper sequels, there was remission of symptoms in most patients and no neoplasia outcomes after an 8 months follow up. Our results highlight the relationship between stem cells, aging and tumorigenesis and suggest the need for careful investigation of the adverse effects of stem cell therapies due to their neoplastic potential
Mestrado
Neurociencias
Mestre em Fisiopatologia Médica

Karcinom debelog creva predstavlja treći uzrok smrnosti od maligniteta kod muškaraca i drugi kod žena. Postoji osnovana sumnja da kancerske matične ćelije (KMĆ) imaju veliki značaj u karcinogenezi, invazivnosti, širenju i rezistenciji na hemioterapiju primarnog tumora. Njihova identifikacija u primatnom kolorektalnom karcinomu (KRK) putem markera kancerskih matičnih ćelija bi selektovala visokorizičnu grupu bolesnika, omogućila ciljano delovanje na ove ćelije i veću šansu za izlečenje. Cilj ovog istraživanja je bio utvrđivanje uticaja prisustva kancerskih matičnih ćelija u primarnom tumoru obolelih od karcinoma kolona na pojavu relapsa bolesti, dužino preživljavanja bez bolesti i sveukupno preživljavanje.  Istraživanje je sprovedeno kao prospektivno−retrospektivna randomizovana analitička studija na Klinici za operativnu onkologiju i Službi za patološko – anatomsku i laboratorijsku dijagnostiku Instituta za onkologiju Vojvodine u Sremskoj Kamenici u periodu od 2016-2019. godine. U studiju su uključeno 112 bolesnica operisanih na Institutu za onkologiju Vojvodine u periodu od 2007-2012. godine sa patohistološki potvrđenom dijagnozom primarnog, nemetastatskog (stadijumi I, II i III) KRK. Bolesnici su randomizovani u odnosu na pojavu recidiva bolesti i prisustvo metastaza u regionalnim limfnim čvorovima u odnosu 1:1. Uzorci tumorskog tkiva dobijeni hirurškom resekcijom su nakon standardne patohistološke obrade tretirani primenom monoklonskih antitela na CD44, CD166 i α-Lgr5. Određivani su prisustvo, intezitet i lokalizacija kancerskih matičnih ćelija (KMĆ) u primarnom tumoru i njihov uticaj na pojavu relapsa bolesti, dužinu preživljavanja bez bolesti i sveukupno preživljavanje u grupi svih bolesnika a potom bolesnika podeljenih prema stadijumu bolesti. Bolesnici u prvom i drugom stadijumu bolesti koji su imali relaps su imali statistički značajno veće prisustvo CD44+ KMĆ u primarnom tumoru. Kod ovih bolesnika je prisutan kraći period preživljavanja bez bolesti kao i kraće sveukupno preživljavanje. Takođe, uočen je statistički značajan uticaj koekspresije CD44/CD166 u KMĆ na pojavu relapsa bolesti, dužinu preživljavanja bez bolesti i sveukupno preživljavanje kod bolesnika u prvom i drugom stadijumu bolesti. Nije uočena statistička značajnost prisustva KMĆ u primarnom tumoru na pojavu relapsa bolesti, dužinu preživljavanja bez bolesti i sveukupno preživljavanje kod bolesnika u trećem stadijumu bolesti. Prisustvo CD166 i α-Lgr5 obojenih KMĆ nije pokazalo statističku značajnost u pogledu pojave relapsa bolesti, dužine preživljavanja bez bolesti i sveukupnog preživljavanja, kako u grupi svih bolesnika tako i prilikom podele bolesnika na stadijume bolesti.
Colon cancer is the third most common case of death of malignancy in the world. There is justified theory that cancer stemm cells have significant impact on colon cancer tumorogenesis, invasiviness, spread and resistancy on chemotherapy. Identification of colon cancer stem cells in primary tumor by various biological markers would lead to identification of high risk group of patients, target therapy of colon cancer an higher chance to cure. Aim of this study was to determine wether presence of colon cancer stem cells in primary tumour have impact on recurrence, disease free survival (DFS) and overall survival (OS) in patients with colorectal cancer. An randomized, analytical prospective-retrospective study was performed on Clinic for Operative Oncology and Department for Anatomical Pathology of Oncology Institute of Vojvodina in Sremska Kamenica in period of 2016−2019. Study included 112 patient with patohistological proven, non metastatic colon adenocarcinoma who were operated on Oncology Institute of Vojvodina in period of 2007-2012. Patients were randomized by recurrence and presence of metastatic lymph nodes by 1:1 ratio. After standard patohistological preparation, tumour specimens were stained for monoclonal CD44, CD166 and α-Lgr5 antibody. Presence, intensity of expression and localization of colon cancer stem cells were observed and their impact on relapse, disease free survival and overall survival in group of all patients as well as in groups divided by stages of the disease. We demonstrate that patients in Stage I and II of the disease who experience disease recurrence have statistically significant higher expression of CD44+ in primary tumor specimen. They also have shorter DFS and OS. Coexpression of CD44/CD166 antibody also have strong negative impact on recurrence, disease free survival and overall survival in Stage I and II patients. There is no correlation between presence of colon cancer stem cells and recurrence nor presence of colon cancer stem cells had impact on disease free survival and overall survival. Presence of CD166 and α-Lgr5 expression did not show significant impact on recurrence nor disease free survival and overall survival as in group of all patients as well in group of patients divided by stages of the disease. High expression of CD44+ and coexpression of CD44/CD166+ colon cancer stem cell markers in primary tumor specimen correlates with higher chance for disease recurrence and also leads to shorter DFS and OS.

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
O tumor venéreo transmissível (TVT) canino é uma neoplasia transplantável, considerada um alo-enxerto. Entretanto, pouco se sabe a respeito da origem e processo de cacinogênese. Atualmente, postula-se que alguns tumores originem-se de células iniciadoras tumorais, classicamente descritas nas leucemias mielóide humanas. As características intrínsecas do TVT fornecem indícios de uma possível participação de células iniciadores tumorais no processo de carcinogênese nesse tumor. Foi realizado estudo de fenotipagem do TVT canino para avaliar a marcação das proteínas CD44, CD133, CD90 e CD34, comumente associadas ao potencial iniciador tumoral. Para tanto utilizou-se a citometria de fluxo, imuno-histoquímica e RTq-PCR. Foram analisados também as frações de crescimento pelo Ki-67) e o número de células em apoptose pela caspase-3 clivada. Trinta e oito amostras de TVT foram obtidas de pacientes sem tratamento quimioterápico prévio. As amostras foram classificadas em plasmocitóide ou mistas, de acordo com o subtipo citológico; as células positivas na citometria de fluxo foram representadas em termos percentuais para os marcadores CD44, CD34, CD90 e CD133; a fração de crescimento foi representada pela técnica do H-Score; a quantidade de células apoptóticas foi representada pelo somatório de células positivas para a caspase-3 clivada; as imuno-marcações das proteínas CD44 e CD34 foram representadas por escores semi-quantitativos baseados na intensidade e percentual de células positivas; as expressões de RNAm foram calculadas em termos relativos; ainda, os pacientes foram divididos em grupos resistente e não resistente e comparados quanto a expressão dos marcadores de células iniciadoras supracitados. Não foram observadas diferenças significativas entre os marcadores e os grupos citológicos plasmocitóide e misto; o percentual de células CD44+ comumente foi superior a 90%, enquanto que o percentual de células CD34+, menor que 0,5%; o percentual de células CD90+ e CD133+ variou amplamente; houve uma tendência em termos de diferença estatística entre os grupos quimiorresistente e não resistente; houve correlação forte entre o percentual de células CD133+ e CD90+ na citometria de fluxo. O estudo permitiu verificar diferentes níveis de expressão protéica e gênica nas amostras de TVT canino; ainda, os grupos citológicos aparentam não possuir diferenças com relação a expressão dos marcadores CD44, CD90, CD133 e CD34; os grupos quimiorresistentes e não-resistentes parecem diferir com relação a expressão dos marcadores de células iniciadoras tumorais.
The canine transmissible venereal tumor (CTVT) is a transplantable neoplasia considered an allograft. Information about the origin and carcinogenesis process is scarcely known. Currently, some neoplasms are believed to arise from a tumor-initiating cell (TIC´s) classically described in human myeloid leukemia. TVT intrinsic characteristics provide evidence of a possible TIC´s participation in carcinogenesis process of this malignancy. Thus, a phenotyping study of CTVT was conducted to assess the immunophenotyping properties of the proteins CD44, CD133, CD90 and CD34, already known to be associated to tumor initiator potential. The use of flow cytometry and immunohistochemistry contributed to this purpose. In addition, growth fractions and cells undergoing apoptosis were examined by Ki-67 and caspase-3 cleaved, respectively. Thirty-eight samples were chosen from patients having no previous chemotherapy and cytological diagnosis of CTVT. Samples were classified into plasmacytoid or mixed according to cytological subtype. Positive cells in the flow cytometry were expressed in percentage for the markers CD44, CD34, CD90 and CD133. H-score technique helped to represent growth fractions. Apoptotic cell quantity was calculated by summing positive cells. Immunohistochemical marking of CD44 and CD34 proteins were determined by semiquantitative scores based on the intensity and percentage of positive cells. Moreover, specimens were divided into resistant and non-resistant groups and compared according cell marker expressions cited before. No significant differences appeared between the markers, and cytological plasmacytoid and mixed groups. The CD44 + cells and CD34 + percentages showed up high and low values, respectively. CD90 + and CD133 + cell percentages presented variable values. Amplitudes of the gene expression values among markers were similar to those observed in flow cytometry with a low expression of CD34, and a high expression of CD44. There was a positive statistical tendence between chemo-resistant and non-resistant groups, as well as a strong correlation between the percentage of CD133 + and CD90 + in flow cytometry. Besides, cytological groups apparently have no differences with the marker expression of CD44, CD90, CD133 and CD34. Resistant and non-resistant groups to chemotherapy seems to differ with respect to the marker expression of TIC´s.

Le cellule staminali mesenchimali (MSCs) sono un tipo specifico di cellule staminali adulte con un elevato potenziale proliferativo e differenziativo verso cellule specializzate di derivazione mesodermica. Le MSCs svolgono anche una funzione paracrina attraverso il rilascio di molteplici fattori di crescita, chemochine e citochine. Le MSCs si comportanto da sentinelle che percepiscono il microambiente e agiscono di conseguenza, passando da un fenotipo pro-infiammatorio ad uno immunosoppressivo in base ai segnali che ricevono. Nel seguente lavoro sono valutati l’esistenza e il ruolo delle MSCs nella patogenesi e nella potenziale terapia di selezionate patologie ginecologiche con una componente infiammatoria come il leiomioma uterino, la neoplasia intraepiteliale cervicale (CIN) e in miopatie primarie, quali la Distrofia Muscolare di Duchenne (DMD). Nel primo studio, sono state identificate le cellule progenitrici nel leiomioma e nel miometrio sano ed è stata investigata la correlazione tra tali cellule e l’infiammazione nell’insorgenza del leiomioma. I dati suggeriscono che una overespressione di citochine relative all’infiammazione cronica nei progenitori del leiomioma potrebbe favorire un microambiente adeguato per l’insorgenza di questa patologia. Nel secondo studio, le MSCs sono state isolate da cervici di pazienti giovani (yC-MSCs) e pazienti vecchie (oC-MSCs) e i risultati mostrano come la loro immunobiologia sia condizionata dall’età dei donatori, influenzando anche il tasso di regressione della CIN. Inoltre, nel crosstalk con le cellule HeLa, yC-MSCs svolgono maggiormente un ruolo anti-tumorale sostenendo un’infiammazione acuta. L’obiettivo del terzo studio è stato quello di trovare una corretta strategia per aumentare la produzione di distrofina nella DMD mediante terapia genica. Pertanto, i mioblasti isolati da donatori di DMD sono stati trasdotti con la proteina fluorescente verde (GFP) e un vettore lentivirale esprimente l’snRNA per indurre il salto dell’esone; i dati indicano che i mioblasti trasdotti erano abili a differenziare in senso miogenico esprimendo la distrofina funzionale.
Mesenchymal stem or stromal cells (MSCs) are a specific type of adult stem cells with an extensive proliferation and differentiation potential towards specialized cells developing from the mesoderm. MSCs are also characterized by paracrine function through the release of multiple growth factors, chemokines and cytokines. MSCs play as sentinel that feel the microenvironment and act consequently, switching from a pro-inflammatory phenotype to an immunosuppressive phenotype according to the signals they receive. In the present work the existence and the role of MSCs in the pathogenesis and potential therapy of selected gynecological diseases with an inflammatory component as uterine leiomyoma, cervical intraepithelial neoplasia (CIN), and in primary myopathies, as Duchenne Muscular Dystrophy (DMD) were evaluated. In the first study, progenitor cells were identified both in leiomyomas and normal myometrium, and the correlation between these cells and inflammation in leiomyoma onset has been investigated. The data suggest that the upregulation of cytokines related to chronic inflammation in leiomyoma progenitors could favour a microenvironment suitable for the onset of this pathology. In the second study, MSCs from cervix of young (yC-MSCs) and old patients (oC-MSCs) were isolated and results show as their immunobiology is affected by the age of donors, influencing in turn the regression rate of CIN. In addition, in the crosstalk with HeLa cells, yC-MSCs play an anti-tumoral role sustaining an acute inflammatory environment. The goal of the third study was to find a correct strategy to enhance the production of dystrophin protein in DMD through gene therapy. Therefore, myoblasts isolated from DMD donor were transduced with green fluorescent protein (GFP) and a lentiviral vector expressing the snRNA to induce exon skipping; data indicate that transduced myoblasts were able to perform myogenic differentiation expressing a functional dystrophin protein.

Le Neoplasie Mieloproliferative (MPN) sono disordini ematologici caratterizzati dalla presenza di mutazioni somatiche che colpiscono le cellule staminali ematopoietiche e comprendono la Policitemia Vera, la Trombocitemia Essenziale e la Mielofibrosi Primaria (PMF). La PMF è una neoplasia eterogenea, contraddistinta dalla presenza di fibrosi midollare, iperplasia megacariocitaria e ematopoiesi extramidollare, e mostra la peggiore prognosi tra tutte le MPN. I pazienti spesso non rispondono ai trattamenti e nel 15-20% dei casi sviluppano una Leucemia Mieloide Acuta (LMA). Le mutazioni ricorrenti, conosciute come “mutazioni drivers”, interessano i geni JAK2, CALR e MPL, ma a complicare il profilo mutazionale intervengono altre alterazioni che sono spesso responsabili del peggioramento del quadro clinico e della trasformazione leucemica. La progressione della malattia e l’evoluzione leucemica nella PMF è accompagnata da un aumento della complessità genomica e dell’eterogeneità clonale. Molti studi hanno confermato come l’ordine di acquisizione delle mutazioni influenzi il decorso clinico. Tuttavia sono ancora poco conosciute le caratteristiche dei cloni che determinano la malattia e che guidano la trasformazione leucemica. Studi recenti hanno dimostrato come la genomica su singola cellula sia una tecnica sensibile per studiare l’eterogeneità clonale e l’evoluzione delle leucemie. Per questa ragione, abbiamo adottato un approccio di genomica su singola cellula per risolvere la complessità clonare della PMF. Dapprima abbiamo sviluppato un metodo di isolamento delle cellule staminali e progenitori ematopoietici CD34+ dal sangue cordonale, di fissazione e marcatura del CD34, al fine di ottenere una popolazione cellulare adatta alla separazione in singole cellule, sfruttando il sistema del DEP-array (Menarini Silicon Biosystem). In seguito, abbiamo confrontato diversi protocolli di amplificazione dell’intero genoma su singola cellula al fine di ottenere un’amplificazione omogenea, minimizzando l’effetto di allele drop out, per proseguire con il sequenziamento Sanger. Usando questa procedura, abbiamo analizzato le cellule CD34+ di un paziente affetto da PMF, positivo per la mutazione JAK2V617F e per altre alterazioni genetiche, caratteristiche delle MPN. Il paziente, nonostante il trattamento con il JAK2-inibitore Ruxolitinib, ha sviluppato una LMA. Al fine di ricostruire la gerarchia e l’architettura clonale, abbiamo analizzato le cellule CD34+ alla diagnosi (T1), durante la fase accelerata (T2) e nella fase di LMA (T3). Grazie alla analisi su singola cellula, abbiamo stabilito che il primo evento mutazionale investa TET2, precedendo la mutazione di JAK2, e probabilmente influenzando negativamente la risposta alla terapia. Abbiamo osservato, inoltre, un aumento dei cloni mutati per TP53 durante la progressione della malattia, suggerendo che siano stati questi cloni a supportare la fase T2. Inaspettatamente, già nella fase T1, abbiamo riscontrato una piccola popolazione cellulare recante una mutazione pro-leucemica su FLT3, alterazione che non era stata evidenziata dall'analisi in NGS ma che verosimilmente ha guidato lo sviluppo della fase T3. Infine, abbiamo evidenziato una mutazione omozigote su SRSF2 non ancora descritta. Tutti i nostri dati, confermano quindi come la genomica su singola cellula sia una tecnologia promettente di analisi della eterogeneità clonale delle MPN e che permetta sia di evidenziare precocemente caratteristiche leucemiche sia di ottenere un quadro chiaro degli eventi mutazioni che interessano i disordini ematologici.
Somatic mutations in Hematopoietic Stem Cells (HSCs) cause Myeloproliferative Neoplasms (MPNs), including Polycythemia Vera, Essential Thrombocythemia and Primary Myelofibrosis (PMF). PMF is a heterogeneous disorder consisting of bone marrow fibrosis, megakaryocyte hyperplasia and extramedullary hematopoiesis and is characterized by the worst prognosis among MPNs. About 15-20% of patients are unresponsive to conventional therapies and develop Acute Myeloid Leukemia (AML). In HSCs the main mutations, identified as “driver mutations” during MPNs pathogenesis, involve JAK2, CALR and MPL genes; in addition, many other genetic alterations contribute to the prognosis worsening and the development of AML. Disease progression and leukemic evolution in PMF results from an increase of the genomic complexity and clonal heterogeneity. Many studies confirmed that the mutational acquisition order affects the clinical outcome. However, the clonal architecture determining disease evolution and the clones guiding leukemic transformation are poorly understood. Recent studies demonstrate that single-cell (sc) genomics is a sensitive technique suitable to study clonal heterogeneity and to detect the evolution of the malignant cells in hematological neoplasms. For this reason, we used the sc-genomics approach to clarify the clonal complexity in PMF. Firstly, we developed a workflow for CD34+ Hematopoietic Stem Progenitor Cells (HSPCs) isolation from cord blood, fixation and immunostaining for CD34, in order to singularly separate the cells by DEP-array system (Menarini Silicon Biosystem) and to obtain a cell population suitable for sc-analysis. Then, we compared different whole genome amplification (WGA) protocols for single cells in order to obtain a uniform DNA amplification for Sanger sequencing and minimize allele drop out effect. Based on this method, we analyzed the CD34+ HSPCs of a PMF patient carrying JAK2V617F and other MPN frequent mutations. This patient was treated with JAK2-inhibitor Ruxolitinib but he was unresponsive to therapy and evolved to AML. In order to reconstruct the clonal hierarchy and architecture, we analyzed CD34+ cells during chronic phase (T1), the accelerated phase (T2) and the AML phase (T3). By means to sc-analysis, we established that TET2 was the first mutated gene, preceding JAK2 mutation, and this probably conferred a lower sensitivity to treatment. Moreover, we identified an increase of the allele burden of the TP53 mutation during disease progression, suggesting that TP53-mutated clones supported the accelerated (T2) phase. Interestingly, we already detected in T1 phase a small cell fraction, undetectable by bulk NGS and carrying the leukemogenic FLT3 mutation, probably driving the T3 phase. Finally, we characterized SRSF2 homozygous mutation that has not been described yet. Altogether our data demonstrate that sc-genomics is a promising method to uncover clonal heterogeneity in MPNs, highlighting the early occurrence of pro-leukemic mutations and to describe the real scenario of mutational events in hematological diseases.

Orientadores: Aarão Mendes Pinto Neto, Francesca de Lorenzi
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Introdução: O enxerto autólogo de gordura é uma importante técnica para corrigir as sequelas da cirúrgia conservadora (CCM) no câncer de mama. Apesar de este método estar ganhando popularidade, muito pouco se sabe sobre a interação entre o enxerto de gordura e o ambiente oncológico no qual é enxertado. Existem evidências sobre a segurança do método em pacientes com mamas saudáveis e em mamas reconstruídas pós-mastectomia radical. Entretanto, existe muito pouca informação sobre este procedimento em pacientes com antecedente de CCM, as quais estão sob um risco maior de recidiva local (RL) se comparado aos outros grupos estudados. Além disso, uma vez que a gordura é enxertada na mama, alterações radiológicas podem ocorrer no rastreamento destas pacientes, podendo provocar um aumento no número de biópsia desnecessárias ou até mesmo mascarar possíveis lesões, retardando o diagnóstico de uma possível RL Material e Métodos: Cinquenta e nove pacientes com antecedente de CCM foram submetidas a 75 procedimentos de enxerto autólogo de gordura, segundo a técnica de Coleman entre Outubro de 2005 e Julho de 2008. Todas pacientes assinaram um consentimento informado e foram tratadas na mesma instituição. Exame clínico e radiológico das mamas foi efetuado em todos os casos antes do procedimento e pelo menos uma vez após seis meses do procedimento. A análise de dados foi realizada através de médias e medianas e a curva de progressão livre de doença foi estimada pelo método Kaplan-Meyer com nível de significância de 5%. Resultados: A média de idade das pacientes foi de 50 anos (DP: 8.5) e o seguimento médio foi de 34.4 meses (DP: 15.3). O tempo médio entre a cirurgia oncológica e o enxerto autólogo de gordura foi de 76.6 meses (DP: 30.9). A maior parte das mulheres tinha estádios iniciais de câncer de mama: 0 (11,8%); I (33,8%) e IIA (23,7%). Complicação imediata foi observada em 3 casos e igualmente, em apenas 3 casos foram observadas RL. Achados radiológicos anormais na mama forma observados em 20% das mamografias pós enxertia (15 casos) e em 6 casos tais achados foram considerados suspeitos e biopsiados, resultando em 2 casos positivos. Conclusão: O enxerto autólogo de gordura parece ser uma ferramenta segura para corrigir sequelas da CCM em casos bem selecionados, e não está relacionado com aumento de RL além do esperado para o grupo de pacientes estudado. Apesar de estar relacionado com um aumento de achados mamográficos anormais, estes são de fácil caracterização entre benignos e suspeitos, não atrapalhando o seguimento destas pacientes
Abstract: Background: Autologous fat graft to the breast is a useful tool to correct defects after breast conservative treatment (BCT). Although this procedure gains popularity, little is known about the interaction between the fat graft and the prior oncological environment. Evidences of safety of this procedure in healthy breast and after postmastectomy reconstruction exist. However, there is paucity of data among patients who underwent BCT which are hypothetically under a higher risk of local recurrence (LR). Moreover, since fat is injected in the breast, this technique can potentially produce radiological features that could increase numbers of unnecessary biopsies or even mask suspicious hidden lesions. Material and Methods: Fifty nine patients, with prior BCT, underwent 75 autologous fat graft procedures using the Coleman's technique, between October 2005 and July 2008. All patients signed an informed consent and were treated at the same institution. Radiological and clinical examination was performed in all cases prior of the procedure. Follow up was made by clinical and radiological examination at least once, after 6 months of the procedure. Statistical analysis was performed by means and medians and progression free survival was estimated by the Kaplan-Meyer method with significance level of 5%. Results: Mean age was 50±8.5 years and mean follow up was 34.4 ±15.3 months. Mean time from oncological surgery to the first fat grafting procedure was 76.6± 30.9 months. Most of patients were at initial stage 0 (11,8%), I (33,8%) or IIA (23,7%). Immediate complication was observed in 3 cases and LR was observed in only 3 cases of true LR. Abnormal breast images were present in 20% of the post-operative mammograms (15 cases) and in six cases biopsy was warranted resulting positive for LR in two cases. Conclusion: Autologous fat graft seems to be a safe tool to correct defects after BCT without increasing the expected rates of LR, in low risk and selected cases. Although it increases the rate of abnormal mammographic findings, those are easily distinguished between benign and suspicious lesion by a trained radiologist and do not interfere with the patient's follow up
Doutorado
Oncologia Ginecológica e Mamária
Doutor em Tocoginecologia

Les cellules souches pluripotentes induites (CSPi) permettent la modélisation de processus avec, en oncologie, un intérêt potentiel pour la modélisation de syndromes de prédisposition au cancer liés à des mutations germinales d’oncogènes. Nous avons généré des lignées de CSPi à partir de patients atteints de néoplasies endocriniennes multiples de type 2 (NEM2), porteurs de mutations germinales du gène RET : RETC620R, RETC634Y et RETM918T. Nous avons généré une CSPi RETY634C, contrôle isogénique, par correction de la mutation RETC634Y via CRSPR/Cas9. Ces CSPi présentent tous les critères de pluripotence avec un caryotype normal et expriment Ret. L’étude histologique approfondie des tératomes a mis en évidence le développement de cellules C en leur sein et également de cellules neuroendocrines exprimant la Chromogranine A mais sans aspect d’hyperplasie des cellules C ou de carcinome médullaire de la thyroïde ni de tumeur neuroendocrine réminiscente du phénotype des NEM2. L’analyse comparative de l’expression des gènes de ces CSPi a mis en évidence, dès le stade de pluripotence, une activation du réseau transcriptionnel du gène EGR1 qui pourrait constituer un des mécanismes moléculaires responsables de la mise en place du phénotype des NEM2. La différenciation en cellules souches de la crête neurale (CSCN), cellules d’origine cibles des tumeurs développées dans le cadre des NEM2, en particulier le phéochromocytome, était efficace et reproductible pour toutes nos lignées. Nous avons mis en évidence l’activation d’un programme commun invasif au niveau des CSCN avec mutation RETC634Y et RETM918T ainsi qu’une forte dérégulation du réseau des intégrines entraînant une forte dérégulation de l’adhésion cellulaire. Ceci était confirmé par une augmentation des capacités de migration CSCN avec mutation de RET par rapport aux CSCN témoins. Ainsi, la génération de CSPi avec mutation de RET a permis d’identifier des voies de signalisation potentiellement impliquées dans la physiopathologie des NEM2 et constitue une première étape vers la modélisation des NEM2 in vitro
Induced pluripotent stem cell (iPSC) offer major perspectives in disease modelling and, in the oncology field, can be used for modelling cancer predisposition syndromes. We generated IPSC lines from somatic cells of patients with multiple endocrine neoplasia type 2 (MEN2) who harboured germline mutations in the RET gene: RETC620R, RETC634Y et RETM918T. We have also generated an isogenic RETY634C iPSC control line by genome engineering using CRSPR/Cas9-mediated method to "correct” C634Y mutation. All iPSC lines exhibited all markers of pluripotency with a normal karyotype and expressed Ret. A thorough histological study of teratomas from these iPSC highlighted the development of C cells and Chromogranin A-expressing neuroendocrine cells within them but without C-cell hyperplasia, medullary thyroid carcinoma or neuroendocrine tumours reminiscent of MEN2 phenotype. Comparative gene expression analysis revealed an activation of the EGR1 transcriptional network, at the pluripotent stem cell stage which could be one of the molecular effector of the phenotype. Neural crest stem cell (NCSC), the cell of origin of some of the tumoral features of MEN2, could be differentiated in vitro from all our RET-mutated iPSC lines effectively. Gene expression analysis revealed an activation of cell invasion program in RETC634Y and RETM918T–mutated NCSC and a deregulation of integrin network causing a strong deregulation of cell adhesion which was confirmed with increased migration capabilities in vitro. Thus, the generation of the first RET-mutated iPSCs allowed the identification of signalling pathways potentially implicated in the pathophysiology of MEN2 and constitute a first step in modelling these tumours in vitro

INTRODUÇÃO: Os enxertos de gordura tem se mostrado como uma poderosa técnica cirúrgica em reconstrução mamaria secundária e os enxertos enriquecidos com células-tronco, além de suas ações parácrinas, vem apresentando resultados encorajadores no que tange a persistência volumétrica. OBJETIVO: Este estudo clínico teve como objetivo analisar comparativamente quantitativa e qualitativamente enxertos de gordura enriquecidos com células da fração vásculoestromal em reconstrução mamária secundária e a incidência de complicações. MÉTODO: Nós desenvolvemos um método que produz enxertos de gordura, na sala de cirurgia, em uma taxa de enriquecimento maior que os já publicados (2:1). Este estudo clínico prospectivo e controlado analisou qualitativa e quantitativamente enxertos de gordura com (GT - grupo tronco) e sem (GC - grupo controle) adição das células da fração vásculo-estromal fresca em reconstrução mamária secundária; através de volumetria mamária por RNM de mamas, imunofenotipagem e contagem celular. Também foram estudados os resultados estéticos, a satisfação das pacientes e as complicações. RESULTADOS: A persistência volumétrica no GT foi 78,9% e 51,4% no GC, entretanto não houve diferença estatisticamente significativa entre os grupos. CD90 foi o marcador mais expresso e que alcançou diferença significante e ao mesmo tempo apresentou correlação positiva entre a sua expressão e a persistência volumétrica (r=0.651, p=0.03). Necrose gordurosa ocorreu, isoladamente em 4 pacientes do GT submetidas à radioterapia e nenhuma paciente do GC apresentou este evento. Desta forma, pacientes do GC mostraram tendência de estar mais satisfeitas com o enxerto de gordura. Nos dois grupos, os resultados estéticos foram iguais e não foram observadas recidivas loco-regionais. CONCLUSÃO: Os resultados do enriquecimento em uma taxa maior que as já publicadas são encorajadores, apesar de a persistência volumétrica não ter alcançado diferença estatisticamente significante entre os grupos. Enxertos de gordura enriquecidos na proporção 2:1 podem não ser indicados para pacientes submetidas à radioterapia apesar de terem se mostrados seguros num tempo de seguimento de 3 anos
BACKGROUND: Fat grafting is a tremendous tool in secondary breast reconstruction. Stromal vascular fraction (SVF) enriched fat grafts have been presenting promising results regarding volume maintenance. OBJECTIVE: The main purpose of this study was to analyze comparatively SVF-enriched fat grafts in secondary breast reconstruction: volumetric persistence, expression of surface markers and complications. METHODS: We developed a method that produces a superior SVF enrichment rate (2:1) in the operating theatre. This prospective and controlled trial analyzed quantitatively and qualitatively fat grafts with (stem cells group - SG) and without (control group - CG) SVF enrichment in secondary breast reconstruction, through MRI-based volumetry, immunophenotyping and cell counting. Also, patient satisfaction, aesthetic outcomes and complications were analyzed. RESULTS: Volumetric persistence in the SG was 78,9% and 51,4% in the CG, however it did not reach statistical significant difference. CD90 was the only marker highly expressed in the SG and showed a positive correlation with volumetric persistence (r=0.651, p=0.03). Fat necrosis occurred in 4 patients in the SG and in none in the CG. Patients in the CG showed a trend to be more satisfied. Considering aesthetics, both groups presented improvements. No locoregional recurrences were observed. CONCLUSIONS: Results are encouraging despite the fact that SVF enrichment in a higher supplementation rate did not improve, with statistical significance, fat graft volumetric persistence. Enriched fat grafts have proven to be safe in a 3-years follow up, however they do not seem suitable for patients that received radiotherapy

Choi, Pui Ying.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2013.
Includes bibliographical references (leaves 101-122).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts also in Chinese.

No
Aldehyde dehydrogenases (ALDHs) belong to a superfamily of 19 isozymes that are known to participate in many physiologically important biosynthetic processes including detoxification of specific endogenous and exogenous aldehyde substrates. The high expression levels of an emerging number of ALDHs in various cancer tissues suggest that these enzymes have pivotal roles in cancer cell survival and progression. Mapping out the heterogeneity of tumours and their cancer stem cell (CSC) component will be key to successful design of strategies involving therapeutics that are targeted against specific ALDH isozymes. This review summarises recent progress in ALDH-focused cancer research and discovery of small-molecule-based inhibitors.