341 resultados para bax
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Background: The bone morphogenetic proteins (BMPs) belong to a unique group of proteins that includes the growth factor TGF-beta. BMPs play important roles in cell differentiation, cell proliferation, and inhibition of cell growth. They also participate in the maturation of several cell types, depending on the microenvironment and interactions with other regulatory factors. Depending on their concentration gradient, the BMPs can attract various types of cells and act as chemotactic, mitogenic, or differentiation agents. BMPs can interfere with cell proliferation and the formation of cartilage and bone. In addition, BMPs can induce the differentiation of mesenchymal progenitor cells into various cell types, including chondroblasts and osteoblasts. The aim of this study was to analyze the effects of treatment with rhBMP-2 on the proliferation of canine mesenchymal stem cells (cMSCs) and the tumor suppression properties of rhBMP-2 in canine osteocarcoma (OST) cells. Osteosarcoma cell lines were isolated from biopsies and excisions of animals with osteosarcoma and were characterized by the Laboratory of Biochemistry and Biophysics, Butantan Institute. The mesenchymal stem cells were derived from the bone marrow of canine fetuses (cMSCs) and belong to the University of Sao Paulo, College of Veterinary Medicine (FMVZ-USP) stem cell bank. After expansion, the cells were cultured in a 12-well Transwell system; cells were treated with bone marrow mesenchymal stem cells associated with rhBMP2. Expression of the intracytoplasmic and nuclear markers such as Caspase-3, Bax, Bad, Bcl-2, Ki-67, p53, Oct3/4, Nanog, Stro-1 were performed by flow citometry. Results: We evaluated the regenerative potential of in vitro treatment with rhBMP-2 and found that both osteogenic induction and tumor regression occur in stem cells from canine bone marrow. rhBMP-2 inhibits the proliferation capacity of OST cells by mechanisms of apoptosis and tumor suppression mediated by p53. Conclusion: We propose that rhBMP-2 has great therapeutic potential in bone marrow cells by serving as a tumor suppressor to increase p53 and the pro-apoptotic proteins Bad and Bax, as well as by increasing the activity of phosphorylated caspase 3. Study design: Canine bone marrow mesenchymal stem cells associated with rhBMP2 in canine osteosarcoma treatment: "in vitro" study
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Cannabidiol (CBD) is the most abundant cannabinoid in Cannabis sativa that has no psychoactive properties. CBD has been approved to treat inflammation, pain and spasticity associated with multiple sclerosis (MS), of which demyelination and oligodendrocyte loss are hallmarks. Thus, we investigated the protective effects of CBD against the damage to oligodendrocyte progenitor cells (OPCs) mediated by the immune system. Doses of 1 mu M CBD protect OPCs from oxidative stress by decreasing the production of reactive oxygen species. CBD also protects OPCs from apoptosis induced by LPS/IFN gamma through the decrease of caspase 3 induction via mechanisms that do not involve CB1, CB2, TRPV1 or PPAR gamma receptors. Tunicamycin-induced OPC death was attenuated by CBD, suggesting a role of endoplasmic reticulum (ER) stress in the mode of action of CBD. This protection against ER stress-induced apoptosis was associated with reduced phosphorylation of eiF2 alpha, one of the initiators of the ER stress pathway. Indeed, CBD diminished the phosphorylation of PKR and eiF2 alpha induced by LPS/IFN gamma. The pro-survival effects of CBD in OPCs were accompanied by decreases in the expression of ER apoptotic effectors (CHOP, Bax and caspase 12), and increased expression of the anti-apoptotic Bcl-2. These findings suggest that attenuation of the ER stress pathway is involved in the 'oligoprotective' effects of CBD during inflammation. Cell Death and Disease (2012) 3, e331; doi:10.1038/cddis.2012.71; published online 28 June 2012
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Calegari VC, Abrantes JL, Silveira LR, Paula FM, Costa JM Jr, Rafacho A, Velloso LA, Carneiro EM, Bosqueiro JR, Boschero AC, Zoppi CC. Endurance training stimulates growth and survival pathways and the redox balance in rat pancreatic islets. J Appl Physiol 112: 711-718, 2012. First published December 15, 2011; doi:10.1152/japplphysiol.00318.2011.-Endurance training has been shown to increase pancreatic beta-cell function and mass. However, whether exercise modulates beta-cell growth and survival pathways signaling is not completely understood. This study investigated the effects of exercise on growth and apoptotic markers levels in rat pancreatic islets. Male Wistar rats were randomly assigned to 8-wk endurance training or to a sedentary control group. After that, pancreatic islets were isolated; gene expression and the total content and phosphorylation of several proteins related to growth and apoptotic pathways as well as the main antioxidant enzymes were determined by real-time polymerase chain reaction and Western blot analysis, respectively. Reactive oxygen species (ROS) production was measured by fluorescence. Endurance training increased the time to reach fatigue by 50%. Endurance training resulted in increased protein phosphorylation content of AKT (75%), AKT substrate (AS160; 100%), mTOR (60%), p70s6k (90%), and ERK1/2 (50%), compared with islets from control group. Catalase protein content was 50% higher, whereas ROS production was 49 and 77% lower in islets from trained rats under basal and stimulating glucose conditions, respectively. Bcl-2 mRNA and protein levels increased by 46 and 100%, respectively. Bax and cleaved caspase-3 protein contents were reduced by 25 and 50% in islets from trained rats, respectively. In conclusion, these results demonstrate that endurance training favors the beta-cell growth and survival by activating AKT and ERK1/2 pathways, enhancing antioxidant capacity, and reducing ROS production and apoptotic proteins content.
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Background: Essential Thrombocythemia (ET) and Primary Myelofibrosis (PMF) are Chronic Myeloproliferative Neoplasms (MPN) characterized by clonal myeloproliferation/myeloaccumulation without cell maturation impairment. The JAK2 V617F mutation and PRV1 gene overexpression may contribute to MPN physiopathology. We hypothesized that deregulation of the apoptotic machinery may also play a role in the pathogenesis of ET and PMF. In this study we evaluated the apoptosis-related gene and protein expression of BCL2 family members in bone marrow CD34(+) hematopoietic stem cells (HSC) and peripheral blood leukocytes from ET and PMF patients. We also tested whether the gene expression results were correlated with JAK2 V617F allele burden percentage, PRV1 overexpression, and clinical and laboratory parameters. Results: By real time PCR assay, we observed that A1, MCL1, BIK and BID, as well as A1, BCLW and BAK gene expression were increased in ET and PMF CD34(+) cells respectively, while pro-apoptotic BAX and anti-apoptotic BCL2 mRNA levels were found to be lower in ET and PMF CD34(+) cells respectively, in relation to controls. In patients' leukocytes, we detected an upregulation of anti-apoptotic genes A1, BCL2, BCL-XL and BCLW. In contrast, pro-apoptotic BID and BIMEL expression were downregulated in ET leukocytes. Increased BCL-XL protein expression in PMF leukocytes and decreased BID protein expression in ET leukocytes were observed by Western Blot. In ET leukocytes, we found a correlation between JAK2 V617F allele burden and BAX, BIK and BAD gene expression and between A1, BAX and BIK and PRV1 gene expression. A negative correlation between PRV1 gene expression and platelet count was observed, as well as a positive correlation between PRV1 gene expression and splenomegaly. Conclusions: Our results suggest the participation of intrinsic apoptosis pathway in the MPN physiopathology. In addition, PRV1 and JAK2 V617F allele burden were linked to deregulation of the apoptotic machinery.
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Background and Aim: The identification of gastric carcinomas (GC) has traditionally been based on histomorphology. Recently, DNA microarrays have successfully been used to identify tumors through clustering of the expression profiles. Random forest clustering is widely used for tissue microarrays and other immunohistochemical data, because it handles highly-skewed tumor marker expressions well, and weighs the contribution of each marker according to its relatedness with other tumor markers. In the present study, we e identified biologically- and clinically-meaningful groups of GC by hierarchical clustering analysis of immunohistochemical protein expression. Methods: We selected 28 proteins (p16, p27, p21, cyclin D1, cyclin A, cyclin B1, pRb, p53, c-met, c-erbB-2, vascular endothelial growth factor, transforming growth factor [TGF]-beta I, TGF-beta II, MutS homolog-2, bcl-2, bax, bak, bcl-x, adenomatous polyposis coli, clathrin, E-cadherin, beta-catenin, mucin (MUC) 1, MUC2, MUC5AC, MUC6, matrix metalloproteinase [ MMP]-2, and MMP-9) to be investigated by immunohistochemistry in 482 GC. The analyses of the data were done using a random forest-clustering method. Results: Proteins related to cell cycle, growth factor, cell motility, cell adhesion, apoptosis, and matrix remodeling were highly expressed in GC. We identified protein expressions associated with poor survival in diffuse-type GC. Conclusions: Based on the expression analysis of 28 proteins, we identified two groups of GC that could not be explained by any clinicopathological variables, and a subgroup of long-surviving diffuse-type GC patients with a distinct molecular profile. These results provide not only a new molecular basis for understanding the biological properties of GC, but also better prediction of survival than the classic pathological grouping.
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Background Human homeobox genes encode nuclear proteins that act as transcription factors involved in the control of differentiation and proliferation. Currently, the role of these genes in development and tumor progression has been extensively studied. Recently, increased expression of HOXB7 homeobox gene (HOXB7) in pancreatic ductal adenocarcinomas (PDAC) was shown to correlate with an invasive phenotype, lymph node metastasis and worse survival outcomes, but no influence on cell proliferation or viability was detected. In the present study, the effects arising from the knockdown of HOXB7 in PDAC cell lines was investigated. Methods Real time quantitative PCR (qRT-PCR) (Taqman) was employed to assess HOXB7 mRNA expression in 29 PDAC, 6 metastatic tissues, 24 peritumoral tissues and two PDAC cell lines. siRNA was used to knockdown HOXB7 mRNA in the cell lines and its consequences on apoptosis rate and cell proliferation were measured by flow cytometry and MTT assay respectively. Results Overexpression of HOXB7 mRNA was observed in the tumoral tissues and in the cell lines MIA PaCa-2 and Capan-1. HOXB7 knockdown elicited (1) an increase in the expression of the pro-apoptotic proteins BAX and BAD in both cell lines; (2) a decrease in the expression of the anti-apoptotic protein BCL-2 and in cyclin D1 and an increase in the number of apoptotic cells in the MIA PaCa-2 cell line; (3) accumulation of cell in sub-G1 phase in both cell lines; (4) the modulation of several biological processes, especially in MIA PaCa-2, such as proteasomal ubiquitin-dependent catabolic process and cell cycle. Conclusion The present study confirms the overexpression of HOXB7 mRNA expression in PDAC and demonstrates that decreasing its protein level by siRNA could significantly increase apoptosis and modulate several biological processes. HOXB7 might be a promising target for future therapies.
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Chemical agents used in cancer therapy are associated with cell cycle arrest, activation or deactivation of mechanisms associated to DNA repair and apoptosis. However, due to the complexity of biological systems, the molecular mechanisms responsible for these activities are not fully understood. Thus, studies about gene and protein expression have shown promising results for understanding the mechanisms related to cellular responses and regression of cancer after chemotherapy. This study aimed to evaluate the gene and protein expression profiling in bladder transitional cell carcinoma (TCC) with different TP53 status after gemcitabine (1.56 μM) treatment. The RT4 (grade 1, TP53 wild type), 5637 (grade 2, TP53 mutated) and T24 (grade 3, TP53 mutated) cell lines were used. PCR arrays and mass spectrometry were used to analyze gene and protein expression, respectively. Morphological alterations were observed using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The results of PCR array showed that gemcitabine activity was mainly related to CDKN1A, GADD45A and SERTDA1 overexpression, and BAX overexpression only in the wild type TP53 cells. Mass spectrometry demonstrated that gemcitabine modulated the protein expression, especially those from genes related to apoptosis, transport of vesicles and stress response. Analyses using SEM and TEM showed changes in cell morphology independently on the cell line studied. The observed decreased number of microvillus suggests low contact among the cells and between cell and extracellular matrix; irregular forms might indicate actin cytoskeleton deregulation; and the reduction in the amount of organelles and core size might indicate reduced cellular metabolism. In conclusion, independently on TP53 status or grade of bladder tumor, gemcitabine modulated genes related to the cell cycle and apoptosis, that reflected in morphological changes indicative of future cell death.
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Il presente studio ha come obbiettivo lo sviluppo di composti di origine naturale come potenziali farmaci antitumorali, attraverso la definizione dei loro specifici target cellulari e molecolari su diversi modelli cellulari ad alta predittività. Gli isotiocianati, contenuti nei vegetali appartenenti alla famiglia delle Crucifereae, sono dotati di una comprovata capacità di inibire la formazione di tumori in modelli animali preventivamente trattati con cancerogeni. Questa attività è riconducibile principalmente alla modulazione degli enzimi coinvolti nell’attivazione/detossificazione di xenobiotici e ad effetti citostatici e citossici, osservati su numerose linee cellulari. Un isotiocianato particolarmente promettente è il sulforafane (SFN). La ricerca condotta durante il periodo di dottorato si è, quindi, focalizzata sull’isotiocianato SFN e in particolare sulla sua capacità di modulare specifici eventi cellulari e molecolari coinvolti nel processo di leucemogenesi. Inizialmente è stato indagato il potenziale citostatico e citotossico del SFN su una linea cellulare T linfoblastoide (cellule Jurkat), con particolare attenzione agli effetti sulla proliferazione cellulare, all’induzione di apoptosi/necrosi e all’analisi di alcuni dei meccanismi molecolari coinvolti negli effetti citostatici e citotossici dell’isotiocianato ( livelli proteici di p53, bax e bcl-2). Successivamente, poiché requisiti fondamentali di un antitumorale sono selettività d’azione e scarsa tossicità, è stato indagato il potenziale citostatico e citotossico dell’isotiocianato SFN sulla controparte non trasformata delle cellule leucemiche T linfoblastoidi, analizzando gli stessi eventi studiati su cellule tumorali e alcuni dei meccanismi molecolari coinvolti (livelli proteici di ciclina D2, ciclina D3, chinasi ciclina dipendente (CDK) 4 e CDK6 ). Il SFN si è dimostrato in grado di indurre apoptosi sulle cellule Jurkat e di inibirne la proliferazione, mediante un blocco in fase G2/M del ciclo cellulare e un incremento dei livelli di p53 e bax. Il SFN è in grado di indurre effetti citostatici e citotossici anche su linfociti T non trasformati. Tuttavia, le dosi necessarie per esibire tali effetti sono ben più elevate di quelle attive su cellule leucemiche. Una tappa importante nello sviluppo di un farmaco antitumorale è, la definizione, dove possibile, dei suoi effetti in un modello ex vivo, altamente predittivo di quella che sarà la risposta farmacologica in vivo. Sono stati quindi valutati gli effetti del SFN su colture primarie di blasti provenienti da pazienti affetti da diversi tipi di leucemia , sia mieloide che linfoblastica. Il SFN non sembra possedere alcuna attività su campioni da pazienti affetti da LLC, mentre un importante attività proapoptotica si registra nei campioni da pazienti affetti da LMA, dove l’effetto del SFN è sorprendentemente marcato anche su campioni da pazienti multiresistenti. L’attività dell’isotiocianato sui campioni da pazienti affetti da LLA è decisamente più marcata sul campione da paziente affetto da LLA a cellule B, mentre sul campione di Leucemia Acuta Bifenotipica l’effetto proapoptotico del SFN si registra dopo tempi di trattamento brevi piuttosto che dopo tempi di trattamento più lunghi. In conclusione, i risultati ottenuti evidenziano che il SFN possiede un’interessante attività antileucemica in vitro e, dato di particolare rilevanza, anche ex vivo.
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The β-Amyloid (βA) peptide is the major component of senile plaques that are one of the hallmarks of Alzheimer’s Disease (AD). It is well recognized that Aβ exists in multiple assembly states, such as soluble oligomers or insoluble fibrils, which affect neuronal viability and may contribute to disease progression. In particular, common βA-neurotoxic mechanisms are Ca2+ dyshomeostasis, reactive oxygen species (ROS) formation, altered signaling, mitochondrial dysfunction and neuronal death such as necrosis and apoptosis. Recent study shows that the ubiquitin-proteasome pathway play a crucial role in the degradation of short-lived and regulatory proteins that are important in a variety of basic and pathological cellular processes including apoptosis. Guanosine (Guo) is a purine nucleoside present extracellularly in brain that shows a spectrum of biological activities, both under physiological and pathological conditions. Recently it has become recognized that both neurons and glia also release guanine-based purines. However, the role of Guo in AD is still not well established. In this study, we investigated the machanism basis of neuroprotective effects of GUO against Aβ peptide-induced toxicity in neuronal (SH-SY5Y), in terms of mitochondrial dysfunction and translocation of phosphatidylserine (PS), a marker of apoptosis, using MTT and Annexin-V assay, respectively. In particular, treatment of SH-SY5Y cells with GUO (12,5-75 μM) in presence of monomeric βA25-35 (neurotoxic core of Aβ), oligomeric and fibrillar βA1-42 peptides showed a strong dose-dependent inhibitory effects on βA-induced toxic events. The maximum inhibition of mitochondrial function loss and PS translocation was observed with 75 μM of Guo. Subsequently, to investigate whether neuroprotection of Guo can be ascribed to its ability to modulate proteasome activity levels, we used lactacystin, a specific inhibitor of proteasome. We found that the antiapoptotic effects of Guo were completely abolished by lactacystin. To rule out the possibility that this effects resulted from an increase in proteasome activity by Guo, the chymotrypsin-like activity was assessed employing the fluorogenic substrate Z-LLL-AMC. The treatment of SH-SY5Y with Guo (75 μM for 0-6 h) induced a strong increase, in a time-dependent manner, of proteasome activity. In parallel, no increase of ubiquitinated protein levels was observed at similar experimental conditions adopted. We then evaluated an involvement of anti and pro-apoptotic proteins such as Bcl-2, Bad and Bax by western blot analysis. Interestingly, Bax levels decreased after 2 h treatment of SH-SY5Y with Guo. Taken together, these results demonstrate that Guo neuroprotective effects against βA-induced apoptosis are mediated, at least partly, via proteasome activation. In particular, these findings suggest a novel neuroprotective pathway mediated by Guo, which involves a rapid degradation of pro-apoptotic proteins by the proteasome. In conclusion, the present data, raise the possibility that Guo could be used as an agent for the treatment of AD.
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The treatment of the Cerebral Palsy (CP) is considered as the “core problem” for the whole field of the pediatric rehabilitation. The reason why this pathology has such a primary role, can be ascribed to two main aspects. First of all CP is the form of disability most frequent in childhood (one new case per 500 birth alive, (1)), secondarily the functional recovery of the “spastic” child is, historically, the clinical field in which the majority of the therapeutic methods and techniques (physiotherapy, orthotic, pharmacologic, orthopedic-surgical, neurosurgical) were first applied and tested. The currently accepted definition of CP – Group of disorders of the development of movement and posture causing activity limitation (2) – is the result of a recent update by the World Health Organization to the language of the International Classification of Functioning Disability and Health, from the original proposal of Ingram – A persistent but not unchangeable disorder of posture and movement – dated 1955 (3). This definition considers CP as a permanent ailment, i.e. a “fixed” condition, that however can be modified both functionally and structurally by means of child spontaneous evolution and treatments carried out during childhood. The lesion that causes the palsy, happens in a structurally immature brain in the pre-, peri- or post-birth period (but only during the firsts months of life). The most frequent causes of CP are: prematurity, insufficient cerebral perfusion, arterial haemorrhage, venous infarction, hypoxia caused by various origin (for example from the ingestion of amniotic liquid), malnutrition, infection and maternal or fetal poisoning. In addition to these causes, traumas and malformations have to be included. The lesion, whether focused or spread over the nervous system, impairs the whole functioning of the Central Nervous System (CNS). As a consequence, they affect the construction of the adaptive functions (4), first of all posture control, locomotion and manipulation. The palsy itself does not vary over time, however it assumes an unavoidable “evolutionary” feature when during growth the child is requested to meet new and different needs through the construction of new and different functions. It is essential to consider that clinically CP is not only a direct expression of structural impairment, that is of etiology, pathogenesis and lesion timing, but it is mainly the manifestation of the path followed by the CNS to “re”-construct the adaptive functions “despite” the presence of the damage. “Palsy” is “the form of the function that is implemented by an individual whose CNS has been damaged in order to satisfy the demands coming from the environment” (4). Therefore it is only possible to establish general relations between lesion site, nature and size, and palsy and recovery processes. It is quite common to observe that children with very similar neuroimaging can have very different clinical manifestations of CP and, on the other hand, children with very similar motor behaviors can have completely different lesion histories. A very clear example of this is represented by hemiplegic forms, which show bilateral hemispheric lesions in a high percentage of cases. The first section of this thesis is aimed at guiding the interpretation of CP. First of all the issue of the detection of the palsy is treated from historical viewpoint. Consequently, an extended analysis of the current definition of CP, as internationally accepted, is provided. The definition is then outlined in terms of a space dimension and then of a time dimension, hence it is highlighted where this definition is unacceptably lacking. The last part of the first section further stresses the importance of shifting from the traditional concept of CP as a palsy of development (defect analysis) towards the notion of development of palsy, i.e., as the product of the relationship that the individual however tries to dynamically build with the surrounding environment (resource semeiotics) starting and growing from a different availability of resources, needs, dreams, rights and duties (4). In the scientific and clinic community no common classification system of CP has so far been universally accepted. Besides, no standard operative method or technique have been acknowledged to effectively assess the different disabilities and impairments exhibited by children with CP. CP is still “an artificial concept, comprising several causes and clinical syndromes that have been grouped together for a convenience of management” (5). The lack of standard and common protocols able to effectively diagnose the palsy, and as a consequence to establish specific treatments and prognosis, is mainly because of the difficulty to elevate this field to a level based on scientific evidence. A solution aimed at overcoming the current incomplete treatment of CP children is represented by the clinical systematic adoption of objective tools able to measure motor defects and movement impairments. A widespread application of reliable instruments and techniques able to objectively evaluate both the form of the palsy (diagnosis) and the efficacy of the treatments provided (prognosis), constitutes a valuable method able to validate care protocols, establish the efficacy of classification systems and assess the validity of definitions. Since the ‘80s, instruments specifically oriented to the analysis of the human movement have been advantageously designed and applied in the context of CP with the aim of measuring motor deficits and, especially, gait deviations. The gait analysis (GA) technique has been increasingly used over the years to assess, analyze, classify, and support the process of clinical decisions making, allowing for a complete investigation of gait with an increased temporal and spatial resolution. GA has provided a basis for improving the outcome of surgical and nonsurgical treatments and for introducing a new modus operandi in the identification of defects and functional adaptations to the musculoskeletal disorders. Historically, the first laboratories set up for gait analysis developed their own protocol (set of procedures for data collection and for data reduction) independently, according to performances of the technologies available at that time. In particular, the stereophotogrammetric systems mainly based on optoelectronic technology, soon became a gold-standard for motion analysis. They have been successfully applied especially for scientific purposes. Nowadays the optoelectronic systems have significantly improved their performances in term of spatial and temporal resolution, however many laboratories continue to use the protocols designed on the technology available in the ‘70s and now out-of-date. Furthermore, these protocols are not coherent both for the biomechanical models and for the adopted collection procedures. In spite of these differences, GA data are shared, exchanged and interpreted irrespectively to the adopted protocol without a full awareness to what extent these protocols are compatible and comparable with each other. Following the extraordinary advances in computer science and electronics, new systems for GA no longer based on optoelectronic technology, are now becoming available. They are the Inertial and Magnetic Measurement Systems (IMMSs), based on miniature MEMS (Microelectromechanical systems) inertial sensor technology. These systems are cost effective, wearable and fully portable motion analysis systems, these features gives IMMSs the potential to be used both outside specialized laboratories and to consecutive collect series of tens of gait cycles. The recognition and selection of the most representative gait cycle is then easier and more reliable especially in CP children, considering their relevant gait cycle variability. The second section of this thesis is focused on GA. In particular, it is firstly aimed at examining the differences among five most representative GA protocols in order to assess the state of the art with respect to the inter-protocol variability. The design of a new protocol is then proposed and presented with the aim of achieving gait analysis on CP children by means of IMMS. The protocol, named ‘Outwalk’, contains original and innovative solutions oriented at obtaining joint kinematic with calibration procedures extremely comfortable for the patients. The results of a first in-vivo validation of Outwalk on healthy subjects are then provided. In particular, this study was carried out by comparing Outwalk used in combination with an IMMS with respect to a reference protocol and an optoelectronic system. In order to set a more accurate and precise comparison of the systems and the protocols, ad hoc methods were designed and an original formulation of the statistical parameter coefficient of multiple correlation was developed and effectively applied. On the basis of the experimental design proposed for the validation on healthy subjects, a first assessment of Outwalk, together with an IMMS, was also carried out on CP children. The third section of this thesis is dedicated to the treatment of walking in CP children. Commonly prescribed treatments in addressing gait abnormalities in CP children include physical therapy, surgery (orthopedic and rhizotomy), and orthoses. The orthotic approach is conservative, being reversible, and widespread in many therapeutic regimes. Orthoses are used to improve the gait of children with CP, by preventing deformities, controlling joint position, and offering an effective lever for the ankle joint. Orthoses are prescribed for the additional aims of increasing walking speed, improving stability, preventing stumbling, and decreasing muscular fatigue. The ankle-foot orthosis (AFO), with a rigid ankle, are primarily designed to prevent equinus and other foot deformities with a positive effect also on more proximal joints. However, AFOs prevent the natural excursion of the tibio-tarsic joint during the second rocker, hence hampering the natural leaning progression of the whole body under the effect of the inertia (6). A new modular (submalleolar) astragalus-calcanear orthosis, named OMAC, has recently been proposed with the intention of substituting the prescription of AFOs in those CP children exhibiting a flat and valgus-pronated foot. The aim of this section is thus to present the mechanical and technical features of the OMAC by means of an accurate description of the device. In particular, the integral document of the deposited Italian patent, is provided. A preliminary validation of OMAC with respect to AFO is also reported as resulted from an experimental campaign on diplegic CP children, during a three month period, aimed at quantitatively assessing the benefit provided by the two orthoses on walking and at qualitatively evaluating the changes in the quality of life and motor abilities. As already stated, CP is universally considered as a persistent but not unchangeable disorder of posture and movement. Conversely to this definition, some clinicians (4) have recently pointed out that movement disorders may be primarily caused by the presence of perceptive disorders, where perception is not merely the acquisition of sensory information, but an active process aimed at guiding the execution of movements through the integration of sensory information properly representing the state of one’s body and of the environment. Children with perceptive impairments show an overall fear of moving and the onset of strongly unnatural walking schemes directly caused by the presence of perceptive system disorders. The fourth section of the thesis thus deals with accurately defining the perceptive impairment exhibited by diplegic CP children. A detailed description of the clinical signs revealing the presence of the perceptive impairment, and a classification scheme of the clinical aspects of perceptual disorders is provided. In the end, a functional reaching test is proposed as an instrumental test able to disclosure the perceptive impairment. References 1. Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol. 2002 Set;44(9):633-640. 2. Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, et al. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol. 2005 Ago;47(8):571-576. 3. Ingram TT. A study of cerebral palsy in the childhood population of Edinburgh. Arch. Dis. Child. 1955 Apr;30(150):85-98. 4. Ferrari A, Cioni G. The spastic forms of cerebral palsy : a guide to the assessment of adaptive functions. Milan: Springer; 2009. 5. Olney SJ, Wright MJ. Cerebral Palsy. Campbell S et al. Physical Therapy for Children. 2nd Ed. Philadelphia: Saunders. 2000;:533-570. 6. Desloovere K, Molenaers G, Van Gestel L, Huenaerts C, Van Campenhout A, Callewaert B, et al. How can push-off be preserved during use of an ankle foot orthosis in children with hemiplegia? A prospective controlled study. Gait Posture. 2006 Ott;24(2):142-151.
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Als BH3-only Protein gehört Bid zu den proapoptotischen Mitgliedern der Bcl-2 Familie, die während der Apoptose die Freisetzung Caspase-aktivierender Proteine aus den Mitochondrien kontrollieren. Bid zählt zu den potentesten BH3-only Proteinen und wird von vielen transformierten und nichttransformierten Zellen konstitutiv exprimiert. Ziel dieser Arbeit war es, Bid durch RNA-Interferenz stabil zu depletieren, um Bid-abhängige Apoptosewege in HeLa Zervixkarzinomzellen zu identifizieren, die von intrinsischen Stressstimuli sowie von konventionellen und neuartigen Chemotherapeutika induziert werden. Da Bid im Todesrezeptor-vermittelten Signalweg der Apoptose durch Caspase-8 gespalten und aktiviert wird, waren die Bid-depletierten Zellen signifikant vor der Fas/CD95-, TRAIL- oder TNF-α-induzierten Apoptose geschützt und zeigten nach Exposition mit allen drei Todesrezeptorliganden eine drastisch reduzierte Effektorcaspase-Aktivität und eine höhere Proliferationsrate als die Kontrollzellen. Eine ektopische Bidexpression in Bid knock down (kd) Zellen hob die Protektion vor der Fas- und TRAIL-induzierten Apoptose auf. Der Proteasominhibitor Epoxomicin, der Proteinkinase-Inhibitor Staurosporin oder die ER Stress-induzierenden Agenzien Tunicamycin, Thapsigargin und Brefeldin A lösten hingegen einen Bid-unabhängigen Zelltod aus. Allerdings konnten subletale Tunicamycin- oder Thapsigarginkonzentrationen HeLa Zellen für die TRAIL-induzierte Apoptose sensitivieren. Da der Synergieeffekt auf einer ER Stress-vermittelten Amplifizierung des Todesrezeptorwegs beruhte, zu der eine Tunicamycin-induzierte Steigerung der Expression des Todesrezeptors DR5 signifikant beitrug, erfolgte diese Sensitivierung nur in Bid-profizienten Zellen. Bid war in HeLa Zellen außerdem an der apoptotischen Signalkaskade beteiligt, die von den DNA-schädigenden Agenzien Etoposid, Doxorubicin und Oxaliplatin (Oxa) ausgelöst wird. Nach Behandlung mit Oxa zeigten die Bid kd Zellen eine verzögerte Caspase-2, -3, -8 und -9 Aktivierung, einen geringeren Verlust des mitochondrialen Membranpotentials sowie eine reduzierte Apoptose- und eine höhere Proliferationsrate als Bid-profiziente Zellen. Neben Bid war ein weiteres BH3-only Protein, Puma, an der Oxa-induzierten Effektorcaspase-Aktivierung beteiligt, da eine Puma-spezifische siRNA unabhängig vom Bidstatus der Zellen antiapoptotisch wirkte. Im letzten Teil der Arbeit wurde untersucht, welche Proteasen für die durch gentoxische Agenzien induzierte Spaltung und Aktivierung von Bid verantwortlich sind. Obwohl Caspasen für die Exekutionphase der Oxa-induzierten Apoptose notwendig waren, trugen sie weder zur initialen Bidaktivierung noch zur mitochondrialen Depolarisierung bei, da sie erst postmitochondrial aktiviert wurden. Konventionelle Calpaine hingegen wurden nach DNA-Schädigung bereits stromaufwärts der Mitochondrien aktiviert und der Calpaininhibitor Calpeptin reduzierte nicht nur die Bid- und Caspasespaltung, sondern auch die mitochondriale Depolarisierung signifikant. Diese Protektion durch Calpeptin fiel in Bid-depletierten Zellen signifikant geringer als in Bid-profizienten Kontrollzellen aus. Auch war in Oxa-behandelten Bid kd Zellen, die eine durch Caspase-2, -3 und -8 nicht spaltbare Bidmutante exprimierten, trunkiertes Bid nachweisbar, dessen Generierung durch Calpain-, aber nicht durch Caspaseinhibierung verhindert werden konnte. Zusammenfassend deuten diese Ergebnisse auf eine Calpain-abhängige Bidaktivierung stromaufwärts der Mitochondrien hin und zeigen, dass die BH3-only Proteine Bid und Puma wichtige Vermittler der Oxa-induzierten Apoptose in HeLa Zellen darstellen.
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Maligne Melanome sind gegenüber Chemotherapeutika relativ resistent. Das methylierende Alkylanz Temozolomid sowie das chlorethylierende und DNA-Interstrand Crosslink (ICL) bildende Alkylanz Fotemustin kommen bei der Behandlung des malignen Melanoms als Mittel erster Wahl zum Einsatz. In der vorliegenden Arbeit konnte das erste Mal nachgewiesen werden, dass die zytotoxische Wirkung von Temozolomid und Fotemustin in Melanomzellen durch Apoptose vermittelt wird. Unter Verwendung klinisch relevanter Dosen der beiden Alkylantien konnte die Induktion von Apoptose durch vier unabhängige Methoden (Bestimmung der SubG1-Fraktion und der Apoptose- / Nekrose-Frequenz, Aktivierung der Effektorcaspasen-3 und -7 sowie Spaltung von PARP-1) nachgewiesen werden. Die Alkylierungen an der O6-Position des Guanins, welche durch beide Agenzien induziert werden, sind auch in Melanomzellen die wichtigsten Zytotoxizität-bewirkenden Läsionen in der DNA, und die O6-Methylguanin-DNA-Methyltransferase (MGMT) ist folglich ein herausragender Resistenzmarker. Eine der verwendeten Zelllinien (D05) exprimierte p53-Wildtypprotein. Diese Zelllinie war resistenter als alle anderen Zelllinien gegenüber Temozolomid und Fotemustin. Dies weist darauf hin, dass p53 nicht die Apoptoseinduktion in Melanomzellen verstärkt. Die Prozessierung des O6MeG erfolgt über die Mismatch-Reparatur (MMR) unter Generierung von DNA-Doppelstrangbrüchen (DSBs). Die Untersuchung der durch Temozolomid induzierten DSBs, nachgewiesen durch gammaH2AX-Induktion, korrelierte direkt mit der apoptotischen Antwort von Melanomzelllinien und DSBs können somit als eine entscheidende apoptoseauslösende Größe angesehen werden. Eine Resistenz gegenüber dem methylierenden Temozolomid in der Zelllinie MZ7 konnte auf einen Defekt in der MMR-Schadenserkennung auf der Ebene des MutSalpha-Komplexes zurückgeführt werden. Dieser Defekt hatte keinen Einfluss auf die Fotemustin-vermittelte Apoptoseinduktion. Neben MGMT konnte somit die MMR als Resistenzfaktor gegenüber methylierenden Agenzien in Melanomen identifiziert werden. Die Fotemustin-induzierte Apoptose wurde in Melanomzelllinien im Detail untersucht. Es konnte erstmals gezeigt werden, dass Fotemustin-bedingte ICLs in Zellen einen G2/M-Arrest im Behandlungszyklus induzieren. Wie anhand G1-arretierter Zellen nachgewiesen werden konnte, war das Durchlaufen der DNA-Replikation vor Erreichen des Arrests für die Induktion der Apoptose notwendig. Die Prozessierung von ICLs ist im Vergleich zu Methylierungen der DNA deutlich komplexer. Dies könnte erklären, warum in Melanomzellen die durch gammaH2AX-Induktion repräsentierten DSBs nicht mit der Sensitivität der einzelnen Zelllinien korreliert. Die Untersuchung unterschiedlich sensitiver Zelllinien zeigte ein vergleichbares Schadensniveau an ICLs und eine ebenso vergleichbare initiale Prozessierung derselben unter Generierung von DSBs. Die Prozessierung dieser sekundären Läsionen, welche anhand der Abnahme von gammaH2AX-Foci untersucht wurde, war hingegen in der sensitiveren Melanomzelllinie deutlich weniger effektiv. Es konnte weiterhin nachgewiesen werden, dass eine uneffektive Prozessierung der sekundären Läsionen einhergeht mit einer verstärkten und länger anhaltenden Aktivierung der in der DSB-Detektion beteiligten Kinase ATM und der Checkpoint Kinase 1. Es wäre daher denkbar, dass eine verstärkte Aktivität dieser Kinasen proapoptotische Signale vermittelt. Unterschiede in der Prozessierung der sekundären Läsionen könnten somit ein wichtiger Marker der ICL-induzierten Apoptose darstellen. Des weitern konnte nachgewiesen werden, dass nach Fotemustingabe die mitochondrial-vermittelte Apoptose einen effektiven Exekutionsweg in Melanomen darstellt. Während Cytochrom C-Freigabe, Bcl-2-Abnahme an den Mitochondrien, Bax-Rekrutierung und Caspase-9 Aktivität nachgewiesen werden konnten, wurden keine Hinweise auf eine Fas-Rezeptor-vermittelte Apoptose gefunden. Die Unfähigkeit, Rezeptor-vermittelte Apoptose zu unterlaufen, könnte die Bedeutungslosigkeit des p53-Gens in Melanomen begründen, da gerade dieser Weg in der Alkylantien-induzierten Apoptose in anderen Zellsystemen eine große Relevanz besitzt. Bei der Suche nach einem alternativen proapoptotischen Signalweg konnten Hinweise für die Beteiligung des Rb/E2F-1-Wegs, welcher über p73 agiert, in einer p53-mutierten Melanomzelllinie gefunden werden. Einen Einfluss der Proteine Survivin und XIAP als Resistenzfaktoren auf die Fotemustin-induzierte Apoptose wurde hingegen nicht nachgewiesen.
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Introduction: Among all cancer types leukemia represents the leading cause of cancer death in man younger than 40 years. Single-target drug therapy has generally been highly ineffective in treating complex diseases such as cancer. A growing interest has been directed toward multi-target drugs able to hit multiple targets. In this context, plant products, based on their intrinsic complexity, could represent an interesting and promising approach. Aim of the research followed during my PhD was to indentify and study novel natural compounds for the treatment of acute leukemias. Two potential multi-target drugs were identified in Hemidesmus indicus and piperlongumine. Methodology/Principal Findings: A variety of cellular assays and flow cytometry were performed on different cell lines. We demonstrated that Hemidesmus modulates many components of intracellular signaling pathways involved in cell viability and proliferation and alters gene and protein expression, eventually leading to tumor cell death, mediated by a loss of mitochondrial transmembrane potential, raise of [Ca2+]i, inhibition of Mcl-1, increasing Bax/Bcl-2 ratio, and ROS formation. Moreover, we proved that the decoction causes differentiation of HL-60 and regulates angiogenesis of HUVECs in hypoxia and normoxia, by the inhibition of new vessel formation and the processes of migration/invasion. Clinically relevant observations are that its cytotoxic activity was also recorded in primary cells from acute myeloid leukemia (AML) patients. Moreover, both Hemidesmus and piperlongumine showed a selective action toward leukemic stem cell (LSC). Conclusions: Our results indicate the molecular basis of the anti-leukemic effects of Hemidesmus indicus and indentify the mitochondrial pathways, [Ca2+]i, cytodifferentiation and angiogenesis inhibition as crucial actors in its anticancer activity. The ability to selectively hit LSC showed by Hemidesmus and piperlongumine enriched the knowledge of their anti-leukemic activity. On these bases, we conclude that Hemidesmus and piperlongumine can represent a valuable strategy in the anticancer pharmacology.
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Das metastasierende maligne Melanom ist durch eine geringe p53-Mutations-Rate und eine hohe Resistenz gegenüber Chemotherapie mit alkylierenden Agenzien wie Fotemustin (FM) und Temozolomid (TMZ) gekennzeichnet. In der vorliegenden Arbeit wurde die Rolle von p53 in der Resistenz von malignen Melanomzellen gegenüber FM untersucht und Möglichkeiten zur Sensitivierung von Melanomzellen gegenüber TMZ und FM aufgezeigt.rnAusgangspunkt war die Beobachtung, dass p53 Wildtyp (p53wt) Melanomzellen resistenter gegenüber FM sind als p53 mutierte (p53mt) Zellen. In der vorliegenden Arbeit wurde gezeigt, dass eine FM-Behandlung in p53wt Zellen eine Stabilisierung von p53 und eine Induktion des p53-Zielproteins p21 bewirkte. Mithilfe einer p53wt Zelllinie, welche einen p53 Knockdown trägt, konnte gezeigt werden, dass p53 für die geringe Apoptose-Rate nach FM-Behandlung verantwortlich ist. Eine Untersuchung der Interstrang-Crosslink (ICL)-Reparaturkapazität zeigte, dass p53mt Zellen im Gegensatz zu p53wt Zellen nicht in der Lage sind, FM-induzierte ICL zu reparieren. Dies ging mit einer im Vergleich zu p53wt Zellen starken DNA-Schadensantwort einher. Die Gene für die Proteine DDB2 und XPC wurden als durch FM regulierte DNA-Reparatur-Gene identifiziert, deren Induktion p53-abhängig und lang anhaltend (bis zu 144 h) erfolgt. Da XPC Knockdown-Zellen sensitiver als ihre Kontrollzellen gegenüber FM reagierten, konnte die biologische Relevanz von XPC bei der ICL-Reparatur bestätigt werden. Anhand von Xenograft-Tumoren wurde gezeigt, dass FM auch in situ eine Induktion von DDB2 und XPC auslöst. Die Beobachtung, dass DNA-Reparatur-Gene nach FM-Behandlung hochreguliert werden, liefert eine Erklärung für das schlechte Ansprechen von Melanomen auf eine Therapie mit ICL-induzierenden Chemotherapeutika.rnDes Weiteren befasste sich die vorliegende Arbeit mit Möglichkeiten zur Sensitivierung von Melanomzellen gegenüber den Chemotherapeutika TMZ und FM. In diesem Zusammenhang wurde Valproinsäure (VPA), ein in der Epilepsie-Therapie verwendetes Medikament und Histondesacetylase (HDAC)-Hemmer, bezüglich der chemosensitivierenden Wirkung untersucht. Zunächst konnte der in der Literatur häufig beschriebene stabilisierende Effekt von VPA auf „wildtypisches“ p53-Protein und destabilisierende Effekt auf mutiertes p53-Protein bestätigt werden. Zwei der vier untersuchten Zelllinien konnten mithilfe von VPA gegenüber TMZ sensitiviert werden, während nur eine der vier untersuchten Zelllinien gegenüber FM sensitiviert werden konnte. VPA begünstigt die Induktion von Apoptose, während der Effekt auf die Induktion von Nekrose nur gering ausfiel. Eine Wirkung von VPA auf die Aktivität des Resistenz-vermittelnden Enzyms O6-Methylguanin-DNA-Methyltransferase (MGMT) wurde nicht beobachtet. Zudem wurde ausgeschlossen, dass die Sensitivierung gegenüber TMZ und FM, welche S-Phase abhängige Gentoxine sind, auf einer VPA-induzierten Erhöhung der Proliferation beruht. Mithilfe einer Zelllinie, welche stabil dominant-negatives FADD (Fas-associated death domain) exprimiert, konnten keine Hinweise auf eine Beteiligung des extrinsischen Apoptose-Signalwegs an der VPA-vermittelten Sensitivierung gewonnen werden. Gleichzeitig wurde gezeigt, dass VPA keine Induktion der niedrig exprimierten Procaspase-8 verursachte. Mithilfe eines PCR-Arrays wurden transaktivierende und –reprimierende Effekte von VPA auf die Genexpression gezeigt, wobei das proapoptotische Protein BAX (Breakpoint cluster-2-associated x protein) als ein in der Sensitivierung involviertes Kandidatengen identifiziert wurde. Obwohl eine vollständige Aufklärung der dem Sensitivierungseffekt von VPA zu Grunde liegenden Mechanismen nicht erbracht werden konnte, zeigen die in dieser Arbeit erlangten Beobachtungen einen vielversprechenden Weg zur Überwindung der Resistenz von Melanomzellen gegenüber DNA-alkylierenden Zytostatika auf.rn
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Metastasierender Krebs ist bei Erwachsenen in der Regel nicht heilbar. Eine Ausnahme stellen testikuläre Keimzelltumoren (TKZT) dar, da über 75 % der Patienten mit fortgeschrittenen metastasierenden TKZT mit einer auf Cisplatin basierenden Kombinations-Chemotherapie geheilt werden können. Zelllinien, die aus TKZT isoliert wurden, behalten diese Cisplatin-Sensitivität in vitro bei. Somit spiegeln Testistumorzelllinien die klinische Situation wider und sind deswegen ein gutes Modellsystem um zu untersuchen, welche Faktoren der Cisplatin-Sensitivität zugrunde liegen. Die Ursachen der Cisplatin-Sensitivität in Testistumoren sind nicht bekannt. Es wurde bereits gezeigt, dass Testistumorzellen eine geringe Kapazität für die Entfernung von Cisplatin-induzierten DNA-Platinierungen aufweisen. Dieser Defekt in der DNA-Reparatur könnte ein Faktor für die beobachtete Cisplatin-Sensitivität sein. Cisplatin induziert sowohl Intrastrang-Vernetzungen als auch Interstrang-Vernetzungen (ICLs). Die Bildung und Reparatur der Cisplatin-induzierten Intrastrang-Vernetzungen wurde mittels DNA-Slot-Blot, die Bildung und Entfernung von Interstrang-Vernetzungen wurde mithilfe des Comet-Assays untersucht. In der vorliegenden Arbeit wurde gezeigt, dass die Reparatur von Intrastrang-Vernetzungen in Testis- und Blasentumorzelllinien vergleichbar ist. Somit sind Testistumorzellen in diesem Reparaturweg nicht beeinträchtigt. Im Unterschied dazu zeigte sich, dass Testistumorzellen die ICLs nicht oder nur mit einer reduzierten Kapazität entfernen können.Da die ICL-Reparatur über die Bildung von DNA-Doppelstrangbrüchen (DSB) mit anschließender DSB-Reparatur verläuft, wurde die Kinetik der DSB-Reparatur anhand der Immundetektion der Histon-Variante γH2AX, die zur Visualisierung von DSB verwendet wird, verfolgt. γH2AX Foci wurden nach Behandlung mit Cisplatin in Testistumorzellen und Blasentumorzellen gebildet. Anders als in Blasentumorzellen blieb der Prozentsatz an γH2AX-positiven Zellen in Testistumorzellen bestehen. Offensichtlich konnten die Testistumorzellen die Cisplatin-induzierten ICLs nicht korrekt prozessieren, was dazu führte, dass γH2AX Foci persistierten. Da unreparierte DNA-Läsionen eine DNA-schadensabhängige Antwort einleiten können, wurde die Aktivierung der Hauptfaktoren dieser Signalwege untersucht. In den Testistumorzellen zeigte sich eine Erhöhung der p53 Proteinmenge nach Cisplatin-Behandlung. Des Weiteren wurde die durch Cisplatin induzierte Aktivierung von ATM/ATR, Chk1/Chk2, Bax und Noxa in Testis- und Blasentumorzellen vergleichend untersucht. Es wurde bereits gezeigt, dass der Reparaturfaktor ERCC1-XPF in Testistumorzelllinien reduziert vorliegt. Um eine mögliche Rolle von ERCC1-XPF für die Reparatur-Defizienz der ICLs und Cisplatin-Sensitivität in Testistumorzellen zu analysieren, wurde ERCC1-XPF in der Testistumorenzelllinie 833K mithilfe eines Expressionsvektors überexprimiert, und der Einfluss von ERCC1-XPF auf ICL-Reparatur sowie Cisplatin-Sensitivität wurde ermittelt. Überexpression von ERCC1-XPF führte zur Reparatur der ICLs in 833K-Zellen und verminderte die Cisplatinsensitivität. Somit scheint die Cisplatinsensitivität der Testistumorzellen, zumindest zum Teil, auf einer verminderten ICL-Reparatur zu beruhen. Des Weiteren wurde in „proof of principle“ Experimenten ERCC1-XPF in der Cisplatin-resistenten Blasentumorzelllinie MGH-U1 mittels siRNA herunterreguliert, und die Auswirkung der Herunterregulation auf die ICL-Reparatur und die Cisplatinsensitivität wurde geprüft. RNA-Interferenz-vermittelte Herunterregulierung von ERCC1-XPF reduzierte die Prozessierung der Cisplatin-induzierten ICLs und verstärkte die Cisplatinsensitivität in MGH-U1 Zellen. Somit wurde in dieser Arbeit zum ersten Mal gezeigt, dass die Testistumorzellen in Vergleich zu Blasentumorzellen in der Reparatur von ICLs defizient sind, wobei die verminderte ICL-Reparatur auf die geringe Expression von ERCC1-XPF zurückgeführt werden konnte. Diese ICL-Reparatur-Defizienz könnte, zumindest zu einem Teil, für die Sensitivität der Testistumoren gegenüber Cisplatin verantwortlich sein.