Estudo de polimorfismos nos genes TP53 e p21(WAF1) e do perfil imunohistoquímico das proteínas p53, p21(WAF1), p16(INK4a) e ciclina D1 pela técnica de Tissue Microarray (TMA) e sua importância para o desenvolvimento e/ou severidade das neoplasias cervicais

O câncer de colo do útero é o terceiro tipo de câncer mais frequente em mulheres no mundo, e a infecção persistente pelo papilomavirus humano (HPV) oncogênico é condição necessária, mas não suficiente para seu desenvolvimento. As oncoproteínas virais E6 e E7 interferem direta ou indiretamente na ação de várias proteínas celulares. Entretanto, as variantes proteicas, resultantes de polimorfismos genéticos, podem apresentar comportamento distinto mediante a infecção pelo HPV. O objetivo deste estudo foi avaliar possíveis associações entre polimorfismos nos genes TP53 (p53 PIN3, p53 72C>G) e p21 (p21 31C>A) e o desenvolvimento de neoplasias cervicais, considerando os níveis de expressão das proteínas p53, p21, p16 e ciclina D1, e fatores de risco clássicos para o câncer cervical. Foram selecionadas 466 mulheres residentes no Rio de Janeiro, 281 com diagnóstico histopatológico de neoplasia cervical de baixo (LSIL) e alto grau (HSIL) e câncer (grupo de casos) e 185 sem história atual ou pregressa de alteração citológica do colo uterino (grupo controle). A técnica de PCR-RFLP (reação em cadeia da polimerase - polimorfismo de comprimento de fragmento de restrição), foi empregada na análise dos polimorfismos p53 72C>G e p21 31C>A, usando as enzimas de restrição BstUI e BsmaI, respectivamente. A avaliação do polimorfismo p53 PIN3 (duplicação de 16 pb) foi feita por meio da análise eletroforética direta dos produtos de PCR. A expressão das proteínas p53, p21, p16, ciclina D1 e Ki-67 e a pesquisa de anticorpos anti-HPV 16 e HPV pool foram avaliadas por imunohistoquímica (Tissue Microarray - TMA) em 196 biópsias do grupo de casos. O grupo controle se mostrou em equilíbrio de Hardy-Weinberg em relação aos três polimorfismos avaliados. As distribuições genotípicas e alélicas relativas a p53 PIN3 e p53 72C>G nos grupos controles e de casos não apresentaram diferenças significativas, embora o genótipo p53 72CC tenha aumentado o risco atribuído ao uso de contraceptivos das pacientes apresentarem lesões mais severas (OR=4,33; IC 95%=1,19-15,83). O genótipo p21 31CA(Ser/Arg) conferiu proteção ao desenvolvimento de HSIL ou câncer (OR=0,61, IC 95%=0,39-0,97), e modificou o efeito de fatores de risco associados à severidade das lesões. A interação multiplicativa de alelos mostrou que a combinação p53 PIN3A1, p53 72C(Pro) e p21 31C(Ser), representou risco (OR=1,67, IC95%=1,03-2,72) e a combinação p53 PIN3A1, p53 72C(Pro) e p21 31A(Arg) conferiu efeito protetor (OR=0,26, IC95%=0,08-0,78) para o desenvolvimento de HSIL e câncer cervical. Observou-se correlação positiva da expressão de p16 e p21 e negativa da ciclina D1 com o grau da lesão. A distribuição epitelial de p16, Ki-67, p21 e p53 se mostrou associada à severidade da lesão. Os polimorfismos analisados não apresentaram associação com a expressão dos biomarcadores ou positividade para HPV. Nossos resultados sugerem a importância do polimorfismo p21 31C>A para o desenvolvimento das neoplasias cervicais e ausência de correlação dos polimorfismos p53 PIN3 e p53 72C>G com a carcinogênese cervical, embora alguns genótipos tenham se comportado como modificadores de risco. Nossos resultados de TMA corroboram o potencial de uso de biomarcadores do ciclo celular para diferenciar as lesões precursoras do câncer cervical.

Efeitos do tratamento com erva-mate (Ilex paraguariensis) sobre desordens endócrinas e metabólicas em ratos obesos programados pelo desmame precoce

A erva-mate (Ilex paraguariensis) contribui para a perda de peso e reversão da resistência à insulina, mesmo em combinação com dieta hiperlipídica, despertando interesse do seu uso como uma possível estratégia no controle da obesidade. Previamente demonstramos que ratos desmamados precocemente desenvolvem sobrepeso, obesidade central, hiperleptinemia, resistência à insulina e à leptina na idade adulta. Propomos então avaliar os benefícios do extrato aquoso do Ilex paraguariensis sobre a composição corporal, perfis lipídico e hormonal, sinalização da leptina, neuropeptídeos envolvidos com o controle do consumo alimentar, marcadores inflamatórios e do estresse oxidativo. Para indução do desmame precoce, as tetas das ratas lactantes foram envolvidas com uma atadura para bloquear o acesso da prole ao leite materno nos últimos 3 dias da lactação (grupo DP). Os filhotes do grupo controle tiveram livre acesso ao leite durante todos os 21 dias do período de lactação normal (grupo C). Aos 150 dias de idade, as proles DP foram subdivididas em: DP e DP+Mate, de acordo com o tratamento (água ou extrato aquoso de erva-mate 1g/kg PC, respectivamente), por gavagem, diariamente, por 30 dias. As proles C receberam água por gavagem por 30 dias. Aos 180 dias de idade, os 3 grupos foram sacrificados por decapitação. Dados foram considerados significativos quando p <0,05. Aos 180 dias (1 mês após o tratamento), o grupo DP+Mate corrigiu várias alterações observadas no grupo DP, tais como maior massa corporal (+9%), massa de tecido adiposo retroperitoneal e epididimal (+34% e +39%, respectivamente), gordura corporal total (+76%), gordura subcutânea (+61%), área de adipócitos viscerais (+34%), triglicerídeos séricos (+35%), TNF-α no núcleo ARC (+57%), expressão de IL-1β no adipócito (+3,6 vezes), percentual de esteatose hepática (+4,8 vezes) e TBARS em fígado e plasma (+56%, +87%). A atividade SOD diminuída no grupo DP é normalizada pelo tratamento com mate, enquanto, paradoxalmente, a catalase que estava aumentada no grupo DP é normalizada com o tratamento com mate. As alterações de glicemia e HDL-c sérico no grupo DP não se modificaram ao final do tratamento com a erva-mate. A hiperfagia não foi observada na prole DP+Mate, provavelmente devido a normalização parcial da sensibilidade central à leptina (confirmada pelo teste do efeito anorexigênico da leptina) e pela redução de NPY e aumento de POMC. Assim, até o momento evidenciamos que o tratamento por 30 dias com extrato de erva-mate foi capaz de impedir a gênese de obesidade abdominal, a resistência à leptina, a hipertrigliceridemia e algumas alterações do perfil inflamatório e do estresse oxidativo nos ratos com obesidade programada pelo DP, tornando o uso da erva-mate como uma estratégia promissora no controle de peso e das desordens metabólicas presentes na obesidade.

Efeito da restrição alimentar materna durante a lactação sobre a função ovariana da prole fêmea na puberdade e vida adulta

α.O objetivo deste estudo foi avaliar se a restrição alimentar materna durante a lactação altera a função ovariana da prole na puberdade e na vida adulta. No dia do nascimento da ninhada, as ratas foram separadas aleatoriamente nos seguintes grupos: (C) controle = dieta com 23% de proteína; (PER) restrição protéica calórica = dieta com 8% de proteína. Após o desmame, as proles tiveram livre acesso a dieta com 23% proteína e apenas os animais na fase diestro foram sacrificados com uma dose letal de pentobarbital aos 40 e 90 dias de idade. O sangue foi retirado por punção cardíaca e o soro armazendo para posterior dosagem dos níveis hormonais por radioimunoensaio. O ovário direito foi excisado, pesado e armazenado a 80C para subseqüente avaliação do receptor de androgênio (AR), das isoformas dos receptores de estrogênio (ERα, ERβ1 e ERβ2), do receptor do hormônio folículo estimulante (FSHR), do receptor do hormonio luteinizante (LHR), das isoformas dos receptores de leptina (Ob-R, Ob-Ra and Ob-Rb), e da enzima aromatase pela técnica de RT-PCR. O ovário esquerdo foi incluido em parafina, seccionado em cortes de 5 μm de espessura e processado por análise histológica de rotina, para classificação dos foliculos ovarianos. Na puberdade, o grupo PER apresentou um aumento significativo (p<0,05) no número dos folículos pré-antrais e antrais, enquanto o número de folículos primordiais, folículos de Graaf e corpo lúteo foram reduzidos significativamente (p<0,05). As concentrações sericas de estradiol (pg/ml) foram significativamente aumentadas (p<0,05). Houve aumento significativo na expressão do RNAm dos FSHR (p<0.05) e LHR (p<0.05), e diminuição significativa na expressão do RNAm dos AR (p<0.05), ERα (p<0.05), ERβ1 (p<0.05) e ERβ2 (p<0.05). Na vida adulta, a restrição alimentar causou uma diminuição no número total de folículos ovarianos, entretanto esta redução só foi significativa no número dos folículos primordiais, primários e de Graaf (p<0.05). Houve redução significativa da expressão da enzima aromatase (p<0.01), do FSHR (p<0.05), LHR (p<0.05), Ob-R (p<0.05) e Ob-Rb (p<0.05). Podemos concluir que a restrição alimentar materna durante a lactação causa uma programação metabólica no ovário da prole, alterando a foliculogênese, expressão das diferentes isoformas dos receptores de estrogênio, leptina, androgênio e gonadotropinas e da enzima aromatase. Essa programação, possivelmente decorrente dos baixos níveis de leptina nos primeiros dias de vida, pode contribuir para uma senescência precoce e redução da fertilidade já descrita na literatura.

Efeito da suplementação dietética com cálcio sobre a plasticidade ontogenética no modelo de superalimentação pós-natal

A obesidade está relacionada com o desenvolvimento da diabetes, estresse oxidativo, esteatose hepática, alteração da sensibilidade hormonal e redução da capacidade termogênica pelo tecido adiposo marrom (TAM). Na obesidade, alterações do sistema dopaminérgico mesocorticolímbico podem levar ao vício por alimentos palatáveis. Todas estas características contribuem para o baixo gasto energético e o alto consumo alimentar. Para estudar os efeitos em longo prazo da obesidade infantil, utilizamos o modelo de redução do tamanho da ninhada. Para induzir a superalimentação neonatal, o tamanho da ninhada foi reduzido para 3 filhotes machos de PN3 21 (grupo SL). O grupo controle permaneceu com 10 filhotes (grupo NL). Em PN120, o grupo SL foi dividido em: SL que recebeu ração controle e SL-Ca que recebeu dieta controle suplementada com 10g/kg de CaCO3. Os sacrifícios ocorreram em PN120 e PN180. Durante todo o período experimental, avaliamos o consumo alimentar e peso corporal. Em PN175, avaliamos a preferência alimentar dos animais por uma dieta rica em açúcar ou em lipídio. Avaliamos os hormônios por ELISA, RIA e quimioluminescência; o conteúdo proteico por Western blotting no fígado, tecido adiposo branco (TAB) e marrom (TAM), adrenal e regiões cerebrais; as atividades enzimáticas no soro e no fígado por cinética enzimática. Em PN21, PN120 e PN180, avaliamos in vivo a atividade simpática do TAM. Ao desmame, os ratos SL apresentaram maior estado pró-oxidativo no fígado e plasma e menor sensibilidade às catecolaminas no TAB. Na idade adulta, a suplementação é capaz de melhorar o estado pró-oxidativo no fígado e plasma, a sensibilidade à insulina e a microesteatose no fígado. Tanto a alteração de metabolismo/ação da vitamina D e do glicocorticóide no tecido adiposo como a menor capacidade termogênica do TAM contribuem para a maior adiposidade dos animais do grupo SL. A suplementação com cálcio corrigiu parte dessas alterações. A superalimentação pós-natal levou a redução da via dopaminérgica e a maior preferencia por gordura, enquanto a suplementação com cálcio normalizou esta via apenas a nível hipotalâmico e corrigiu a preferência alimentar. Nossos dados destacam o impacto benéfico da suplementação dietética com cálcio, que pode ter um papel nutricional promissor para auxiliar a perda de peso e minimizar os distúrbios relacionados a obesidade e a síndrome metabólica dos animais obesos que foram superalimentados na lactação.

Effects of hydrocarbons on reproductive physiology of the pearl oyster, Pinctada fucata

There are a lot of evidence that show hvdrocarbones cause some defect in reproduction and growth of bivalves. Bivalves are filter-feeder, thus accumulate more hydrocarbones in their tissue. In this study adult pearl producing oysters (Pinctada fucata) are used for all experimens. Samples of oysters, water and sediment from four natural beds; Nakhiloo (clean), Hendurabi (semipolluted), Lavan 1 (semipolluted) and Lavan 2 (polluted) were gatherd for 13 succesive months. Temperature, salinity, pH, oxygen and turbidity were recorded in each sampling. Oysters were kept in laboratory for adapation and then their length (DVM) were measured. Hemolymph samples were collected by insuline syring. Sediments and soft tissues of oysters were dissolved in carbon tetrachloride and when heated to extract oil hydrocarbones. UV, GC and IR were used to assay oil hydrocarbones. Accumulation of hydrocabones in soft tissue were as follows : Kakhiloohormonal cycles. Turbidity was the most effective factor for releasing of progesterone. Progesterone was a stimulating factor for releasing estradiol also release of testosterone was corrolated with oxygen and depth of beds. One way analysis of variance showed that there is not significant relasionship (P<0.05) between different factory in stations.

Examining the possibilty of multiplication and breeding of (Schizothorav [sic] zarudnyi) in order to restoration of regional aquatics reservations of Hamoon Lake and taking its advantag [sic] for aquaculture

Schizothorax zarudnvi, is an endemic fish of east country waters. (Triple lagoons of Hamoon and relevant water resources) that in the world it is reported in this resource specially. This fish named Hamoon mahi is one of the most economically valuable species in this region. Because of the recent years droughts, Hamoon logoon has been drive since 2000. Also, semi-wells (a semi natural resource) were affected drastically by recent drought years and their volume reduced to nearly one third of their real volume and resulted in changing at growth and reproduction physiology process in Schizothorax zanidnyi, brood stocks. Beginning of this project was done from October 2003. It's field studies begun (brood catching) since November 2001 by two methods including entangling gairs and at semi wells of Sistan that (Beach seine) had maximum rate of preparing qualified brood stocks. Broods transferred to Cyprinidea reproduction work shop of Zahak and after taking primary measures they stored in to the edaphic pools. Increasing the success safety factor (coefficient) for artificial reproduction of Sthizothorax zarudnyi , identifying the appropriate tune for Hormonal acceptance (physiological preparation of broods) is needed , so this important work was done regularly by histological studies and GSI measurements since November. Highest GSI rates of females (%80.51) and highest IV stage abundance of sexual maturity (%l 00) were observed an march. On the base of this date, Hormone therapy was done on broods on march. The used hormones are as follows Hypophysis. extraction, GnRHa and Anti Dopamin at the dozes of 3-6 ml, 20-30kg and 10-15 ml per kg body weight respectively and 2-3 times from 11-12-80 they were injected. Injected broods kept in to two circumstances, flow-through (rounded pool) and stagnant systems. In stagnant system 14 and 19 individuals of female and male (Schizothorax zauiulnri) broods, respectively injected in 11th, 15111, 19th, and 24th of march 1380. Non of the injected broods in 11 and 15 and 19th march (in stagnant Condition) answered to Hormone therapy. After final injection broods had general less activity and a few of them died. Mean temperature of brood pond waters (daily) which were injected. Fluctuated between 10-25-13. 63°c but injected broods on 24th march had different characteristics. They had pale color and had few fecundity. In this stage of injection they hadn't any successful vulation. After injection, Mean daily water temperature was 15, 88-17, 54°c. In Flowing system, 13-16 individual of males and females respectively were injected on 15th, 19th, 22th and 23th march. None of injected producers on 15th and 19th march with mean daily water temperature of 10, 25-12°c were prepared for spawning but injected producers on 22nd an 23th march with mean daily water temperature of 13.5-1 rc responded about 75-100 percent. (Schizothorax zarudnyi) brood stocks were prepared for spawning after 353-428 hours/day from final injection. Diameter of obtained eggs (before fertilization) was between 1.9-2.3 min and of fertilized eggs was 3.8mm. Fertilized eggs of (Schizothorax zarudnyi) were hatched after 6-7 days with mean water temperature of 17.08°c. Mean length of on one day larvae was 9.47 mm. Larvae was 9.47 mm. Larvae adsorbed the whole yolk sac after , 5-6 days at 17- 1°c and were prepared for releasing in to edaphic pools. Because of the lack of necessary and complementary facilities in the region , they had to release them in to veniros and growing them for 8 days. At the end of 18th day , 35000 larvae (at first) released into an edaphic pond with a volume of 150m2. After growing them for one moth , mean length and weight of new hatched larvae was 29.41 mm and 1.12►r , respectively. With respect to results of this investigation , artificial reproduction of (Schizothorax zarudnyi) Can be possible at 14-17°C and flowing water with Hormonal treatment. It -s breeding has increased development than other cultural specious in the region. Due to high economical value of this specious in Sistan and ti-s specialization east waters of Iran and having high resistance and proper growth There is a need of it's development and reproduction and culture in fish culture fanns (edaphic ponds• two-purpose pools) at the region and country.

The survey of sexual maturity in Mugil cephalus so measuring sex hormones and histologic studies

In this study the process of female gray mullet brooders was carried out by using histological study and masurment of sex steroids. Results of histological studies showed that oocyte of gray mullet brooders in Gomishan Rearing Center conditions of develop to the end of yolk globule stage. The results were observed with oocyte in chromatin nucleolar stage (first stage) with means of diameter of 20 p m, in August, perinucleolar stage (second stage) in September with mean diameter of 87 p m, yolk vesicle stage (third stage) in October with mean diameter 200 p m and yolk granules stage (forth stage) from October to November with average diameter of 180 — 650 p m. For the reason of stopping oocyte develop at the end of fourth stage, hormonal induction to final oocyte maturation and ovulation was used. For this purpose, carp pituitary , HCG and LRH-A2 with different combinations were used in two stages, second injection was used 24 hours after first injection. 15 females brooders were divided in 5 groups, different hormonal combinations were injected to four groups and to fifth group as control, only saline, was injected. The process of female brooder rippening in hormonal induction was studied via masurment of sex steroids including 17 a - hydroxy progestrone, estradio1-17)6 and testosterone. Blood samples were collected from caudal vein during first injection, 24, 30 and 48 hours after the first injection. At the same time, for distinguishing histological changes the sample has been attained from the gonads Sex stroid fluctuation patterns in different brooder groups that injected hormon were similar, however hormonal composition had similar effects. All brooder that their oocyte in the beginning of hormonal injection were At the end of fourth stage with oocyte diameter average of 600 p m received to final maturation and ovulation. The brooder that its oocytes were At the begining or mid-fourth stage did not show ovulation but hormonal induction caused oocyte develop at the beginning of fifth stage. Study of 17-hydroxy progestrone fluctuation showed that the maximum level of this steroid (0.347 ng/ml) measured 30 hours after the first injection and was significantly higher (p< 0.05) than those of control group. So, 17-hydroxy progestrone is probably precursor of maturation inducing steroid (MIS). However the maximum level of that observed was coincident with germinal vesicle breakdown, oil droplets coalescence and dissolution of yolk granuls The maximum levels of esteradiol— 17/0 and testosterone (3.778 and 16.801ng/ml,respectively) in spawned brooders,were observed 24 hours after the first injection. levels of those steroids were significantly higher (p<0.05) than control group. Maximum level of sex steroids in the brooders that did not spawn to the end of treatment was observed with more delay than those in spawned brooders. Therefor maximum level of 17a-hydroxy progestrone (0.264 ng/ml) in those brooders observed in fourth sampling time and the maximum levels of estradio1-17a and testosterone (2.944 and 18.993 ng/ml, respectivly)observed in third sampling time that was significantly higher (p<0.05) than those of control group. For the study of stress effect on brooders during the hormonal induction, level of cortisol was measured in every sampling time. level of cortisol had high fluctuation that showed handling level and stress effect on brooders. However maximum level of cortisol in majority of brooders was dominant in third sampling time that was coincident with final maturation.

Reproductive physiology of ribbon fish (Trichiurus lepturus)

The ribbon fishes ‘of the family Trichiuridac are represented as one of the most important food resources in Indian ocean. High density of the dominant species of ribbon fish (Trichiurus lepturus) in Oman sea and the 'Tillable catch in last yeas (more than 7000 tones per year) makes a trust area for studing their population biolog and stock assessment. As our knowledge on reproductive biology of this species has an important role on their fisheries management, as well as conservation of this stock from decline or over fishing, this research was held to determine some aspects of reproductive physiology of ribbon fish and the effects of environmental factors in gonadal cycle. The goals of the present thesis is to determine some aspects of reproductive physiology such as gonadosomatic index (GSI) , hepatosomatic index (HSI), condition factor (Ko, fecundity, sex ratio, size at first maturity, size at maturity (LM5O) and their relative hormonal & biochemical fluctuations. In this regards annual variation of sex hormones ic. estradiol 17-B, progestron, cortisol, testostrone and gonadotropins FSH (GTH-I) , LH (GTH-ll)I were measured ; gonadal histological studies were done by light & electron micrography. The research was carried out from April 1995 to January 19% in Ras Nleidani in the north part of Oman sea, and the environmental factors such as temperature, salinity, oxygen, rainfall and pH were measured. The effects of these parameters on reproductive cycle and hormonal fluctuationswere discussed by using correlation and principle component analysis (PCA). Female Ribbon fish reproductive strategy shows the same paterns of nonguarder marine teleosts. T. lepturus has more than one spawning season (existance of egges in different size in each month) and therfore it must have asynchronous ovaries and belong to continious spawners. GSI and HSI are good evidences for this type of reproductive patern. The testis of the lobular type , which is typical of most teleosts , is composed of numerous lobules which are separated from each other by a thin layer of fibrous connective tissue. GSI fluctuations revealed prolong- spawning time in males. There is significant increase in 17-13 estradiol. progestrone , cortisol and gonadotropins with maturity and prespawning period of female T lepturus. Plasma concentration of E2 and GTH II incresaed along with water temperature increasing (3300).. Spawning was observed from Nov. 1995 to Apr. 1996 in this species. Progestrone increased significantly with increasing rainfall in this season (P<0.01). Plasma cortisol levels increased with maturation and vitelpgenesis and also with the peak of spawning. From lenght-weight frequency and size distribution in each age groups and also minimum size at first maturity (52a cm) it would he concluded that T. lepturus must be matured at 2 years of age. Serum cholestrol and triglicerides significantly increased when maturation occured in this species. The relationship between alkaline phosphatase activity and hormonal fluctuations with maturity and vitelogenesis were discussed. Proximate compostion (muscle) shows significant variation with spawning period and maturity. Absolute individual fecundity (17420-159150) increased with body length and weight. Ultrastructural observations show dramatic variation in cell membrane (0ocyte membrane), yolk vesicles and, nucleolus dispersal in relation to maturity stages. fluctuations of gonadal hormones were discused in relation with vitelogenesis. Testosterone increased in males from Nov: to Mar. due to environmental impacts and spawning time. Sex ratio in different depth (10-40 m ,80-110 m) shows significnt differences in this ratio for two depths. In 10-40 m depth female shows dominant abundance to male in each months that may be due to their reproductive migration behaviour. The effects of temperature photoperiod and rainfall to maturity and spawning were discussed. According to -pawning period of T. leptunts in our sampling area it could be suggested that ribbon fish fi,theries must be restricted in the peak of spawning seasons (Feb. to Mar.) and in the spawning grounds (under 40 m depths). Other suggestions for population conservation have been mentioned.

Seasonal thermogenesis and body mass regulation in plateau pikas (Ochotona curzoniae)

Changes in photoperiod, ambient temperature and food availability trigger seasonal acclimatization in physiology and behavior of many animals. In the present study, seasonal adjustments in body mass and in several physiological, hormonal, and biochemical markers were examined in wild-captured plateau pikas (Ochotona curzoniae) from the Qinghai-Tibetan plateau. Our results showed that plateau pikas maintained a relatively constant body mass throughout the year and showed no seasonal changes in body fat mass and circulating levels of serum leptin. However, nonshivering thermogenesis, cytochrome c oxidase activity, and mitochondrial uncoupling protein 1 (UCP1) contents in brown adipose tissues were significantly enhanced in winter. Further, serum leptin levels were positively correlated with body mass and body fat mass while negatively correlated with UCP1 contents. Together, these data suggest that plateau pikas mainly depend on increasing thermogenic capacities, rather than decreasing body mass, to cope with cold, and leptin may play a potential role in their thermogenesis and body mass regulation.

Does multiparametric MRI increase Oncologic outcomes in prostate cancer?

The purpose of this study is to compare the 4-year biochemical disease-free survival (BDFS) of patients with prostate cancer (PCa) staged according to multiparametric MRI (mpMRI) and treated with radical prostatectomy (RP) versus intensity-modulated radiation therapy (IMRT) ≥76 Gy ± hormonal therapy (HT).

Alterações do Funcionamento da Glândula da Tiróide

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas

Mature results of a randomized phase II multicenter study of exemestane versus tamoxifen as first-line hormone therapy for postmenopausal women with metastatic breast cancer.

BACKGROUND: Women with hormone-responsive metastatic breast cancer (MBC) may respond to or have stable disease with a number of hormone therapies. We explored the efficacy and safety of the steroidal aromatase inactivator exemestane as first-line hormonal therapy in MBC in postmenopausal women. PATIENTS AND METHODS: Patients with measurable disease were eligible if they had received no prior hormone therapy for metastatic disease and had hormone receptor positive disease or hormone receptor unknown disease with a long disease-free interval from adjuvant therapy. They were randomized to tamoxifen 20 mg/day or exemestane 25 mg/day in this open-label study. RESULTS: Blinded independently reviewed response rates for exemestane and tamoxifen were 41% and 17%, respectively. Fifty-seven per cent of exemestane- and 42% of tamoxifen-treated patients experienced clinical benefit, defined as complete or partial response, or disease stabilization lasting at least 6 months. There was a low incidence of severe flushing, sweating, nausea and edema in women who received exemestane. One exemestane-treated patient had a pulmonary embolism with grade 4 dyspnea. CONCLUSIONS: Exemestane is well tolerated and active in the first-line treatment of hormone-responsive MBC. An ongoing EORTC phase III trial is comparing the efficacy, measuring time-to-disease progression, of exemestane and tamoxifen.

Promising results with exemestane in the first-line treatment of metastatic breast cancer: a randomized phase II EORTC trial with a tamoxifen control.

Because tamoxifen (TAM), a nonsteroidal antiestrogen, is routinely used in the adjuvant setting, other hormone therapies are needed as alternatives for first-line treatment of metastatic breast cancer (MBC). Currently, exemestane (EXE) and other antiaromatase agents are indicated for use in patients who experience failure of TAM. In this multicenter, randomized, open-label, TAM-controlled (20 mg/day), phase II trial, we examined the activity and tolerability of EXE 25 mg/day for the first-line treatment of MBC in postmenopausal women. Exemestane was well tolerated and demonstrated substantial first-line antitumor activity based on intent-to-treat analysis of peer-reviewed responses. In the EXE arm, values for complete, partial, and objective response, clinical benefit, and time to tumor progression (TTP) exceeded those reported for TAM although no statistical comparison was made. Based on these encouraging results, a phase III trial will compare EXE and TAM.

Sensitivity of HER-2/neu antibodies in archival tissue samples of invasive breast carcinomas. Correlation with oncogene amplification in 160 cases.

Overexpression and amplification of the HER-2 oncogene in patients with breast cancer has correlated with early onset of metastasis, resistance to hormonal therapy and some forms of chemotherapy, and shortened survival. Therefore, evaluation of this putative prognostic or predictive factor seems critical. Because different antibodies are used for the detection of the 185-kd HER-2 oncoprotein, we studied the sensitivity of 3 frequently used antibodies. Immunohistochemistry results were correlated with gene amplification level as assessed by fluorescence in situ hybridization. Protein overexpression was found in 17.2% and 12.5% of cases using antibodies against the external (TAB250) and internal (CB11) domains of the protein, respectively, and in 38.0% of cases using a rabbit polyclonal antibody. Fluorescence in situ hybridization was successful in all 160 tumors, and amplification was found in 37 tumors (23.1%). The monoclonal antibody TAB250 had the lowest misclassification rate, 9.6% (sensitivity, 67%; specificity, 97.5%).

HER2: a 'predictive factor' ready to use in the daily management of breast cancer patients?

The past few years have witnessed an exponential increase in studies trying to identify molecular markers in patients with breast tumours that might predict for the success or failure of hormonal therapy or chemotherapy. HER2, a tyrosine kinase membrane receptor of the epidermal growth factor receptor family, has been the most widely studied marker in this respect. This paper attempts to critically review to what extent HER2 may improve 'treatment individualisation' for the breast cancer patient. Copyright (C) 2000.