Metabolic signature of lung cancer: a metabolomic study of human tissues and biofluids

This thesis reports the application of metabolomics to human tissues and biofluids (blood plasma and urine) to unveil the metabolic signature of primary lung cancer. In Chapter 1, a brief introduction on lung cancer epidemiology and pathogenesis, together with a review of the main metabolic dysregulations known to be associated with cancer, is presented. The metabolomics approach is also described, addressing the analytical and statistical methods employed, as well as the current state of the art on its application to clinical lung cancer studies. Chapter 2 provides the experimental details of this work, in regard to the subjects enrolled, sample collection and analysis, and data processing. In Chapter 3, the metabolic characterization of intact lung tissues (from 56 patients) by proton High Resolution Magic Angle Spinning (HRMAS) Nuclear Magnetic Resonance (NMR) spectroscopy is described. After careful assessment of acquisition conditions and thorough spectral assignment (over 50 metabolites identified), the metabolic profiles of tumour and adjacent control tissues were compared through multivariate analysis. The two tissue classes could be discriminated with 97% accuracy, with 13 metabolites significantly accounting for this discrimination: glucose and acetate (depleted in tumours), together with lactate, alanine, glutamate, GSH, taurine, creatine, phosphocholine, glycerophosphocholine, phosphoethanolamine, uracil nucleotides and peptides (increased in tumours). Some of these variations corroborated typical features of cancer metabolism (e.g., upregulated glycolysis and glutaminolysis), while others suggested less known pathways (e.g., antioxidant protection, protein degradation) to play important roles. Another major and novel finding described in this chapter was the dependence of this metabolic signature on tumour histological subtype. While main alterations in adenocarcinomas (AdC) related to phospholipid and protein metabolisms, squamous cell carcinomas (SqCC) were found to have stronger glycolytic and glutaminolytic profiles, making it possible to build a valid classification model to discriminate these two subtypes. Chapter 4 reports the NMR metabolomic study of blood plasma from over 100 patients and near 100 healthy controls, the multivariate model built having afforded a classification rate of 87%. The two groups were found to differ significantly in the levels of lactate, pyruvate, acetoacetate, LDL+VLDL lipoproteins and glycoproteins (increased in patients), together with glutamine, histidine, valine, methanol, HDL lipoproteins and two unassigned compounds (decreased in patients). Interestingly, these variations were detected from initial disease stages and the magnitude of some of them depended on the histological type, although not allowing AdC vs. SqCC discrimination. Moreover, it is shown in this chapter that age mismatch between control and cancer groups could not be ruled out as a possible confounding factor, and exploratory external validation afforded a classification rate of 85%. The NMR profiling of urine from lung cancer patients and healthy controls is presented in Chapter 5. Compared to plasma, the classification model built with urinary profiles resulted in a superior classification rate (97%). After careful assessment of possible bias from gender, age and smoking habits, a set of 19 metabolites was proposed to be cancer-related (out of which 3 were unknowns and 6 were partially identified as N-acetylated metabolites). As for plasma, these variations were detected regardless of disease stage and showed some dependency on histological subtype, the AdC vs. SqCC model built showing modest predictive power. In addition, preliminary external validation of the urine-based classification model afforded 100% sensitivity and 90% specificity, which are exciting results in terms of potential for future clinical application. Chapter 6 describes the analysis of urine from a subset of patients by a different profiling technique, namely, Ultra-Performance Liquid Chromatography coupled to Mass Spectrometry (UPLC-MS). Although the identification of discriminant metabolites was very limited, multivariate models showed high classification rate and predictive power, thus reinforcing the value of urine in the context of lung cancer diagnosis. Finally, the main conclusions of this thesis are presented in Chapter 7, highlighting the potential of integrated metabolomics of tissues and biofluids to improve current understanding of lung cancer altered metabolism and to reveal new marker profiles with diagnostic value.

Characterization of RSOA modulators in radio over fiber links

In this work physical and behavioral models for a bulk Reflective Semiconductor Optical Amplifier (RSOA) modulator in Radio over Fiber (RoF) links are proposed. The transmission performance of the RSOA modulator is predicted under broadband signal drive. At first, the simplified physical model for the RSOA modulator in RoF links is proposed, which is based on the rate equation and traveling-wave equations with several assumptions. The model is implemented with the Symbolically Defined Devices (SDD) in Advanced Design System (ADS) and validated with experimental results. Detailed analysis regarding optical gain, harmonic and intermodulation distortions, and transmission performance is performed. The distribution of the carrier and Amplified Spontaneous Emission (ASE) is also demonstrated. Behavioral modeling of the RSOA modulator is to enable us to investigate the nonlinear distortion of the RSOA modulator from another perspective in system level. The Amplitude-to-Amplitude Conversion (AM-AM) and Amplitude-to-Phase Conversion (AM-PM) distortions of the RSOA modulator are demonstrated based on an Artificial Neural Network (ANN) and a generalized polynomial model. Another behavioral model based on Xparameters was obtained from the physical model. Compensation of the nonlinearity of the RSOA modulator is carried out based on a memory polynomial model. The nonlinear distortion of the RSOA modulator is reduced successfully. The improvement of the 3rd order intermodulation distortion is up to 17 dB. The Error Vector Magnitude (EVM) is improved from 6.1% to 2.0%. In the last part of this work, the performance of Fibre Optic Networks for Distributed and Extendible Heterogeneous Radio Architectures and Service Provisioning (FUTON) systems, which is the four-channel virtual Multiple Input Multiple Output (MIMO), is predicted by using the developed physical model. Based on Subcarrier Multiplexing (SCM) techniques, four-channel signals with 100 MHz bandwidth per channel are generated and used to drive the RSOA modulator. The transmission performance of the RSOA modulator under the broadband multi channels is depicted with the figure of merit, EVM under di erent adrature Amplitude Modulation (QAM) level of 64 and 254 for various number of Orthogonal Frequency Division Multiplexing (OFDM) subcarriers of 64, 512, 1024 and 2048.