Microenvironment and prognostic factors in bone tumors: IDH mutations in chondrosarcoma

Microenvironment in bone tumors is a dynamic entity composed of cells from different origins (immune cells, stromal cells, mesenchymal stem cells, endothelial cells, pericytes) and vascular structures surrounded by a matrix of different nature (bone, cartilage, myxoid). Interactions between cancer cells and tumor microenvironment (TME) are complex and can change as tumor progress, but are also crucial in determining response to cancer therapies. Chondrosarcoma is the second most frequent bone cancer in adult age, but its treatment still represents a challenge, for the intrinsic resistance to conventional chemotherapy and radiation therapy. This resistance is mainly due to pathological features, as dense matrix, scarce mitoses and poor vascularization, sustained by biological mechanisms only partially delucidated. Somatic mutation in the Krebs cycle enzyme isocytrate dehydrogenase (IDH) have been described in gliomas, acute myeloid leukemia, cholangiocarcinoma, melanoma, colorectal, prostate cancer, thyroid carcinoma and other cancers. In mesenchymal tumors IDH mutations are present in about 50% of central chondrosarcoma. IDH mutations are an early event in chondrosarcoma-genesis, and contribute to the acquisition of malignancy through the block of cellular differentiation, hypoxia induction through HIF stabilization, DNA methylation and alteration of cellular red-ox balance. While in gliomas IDH mutations confers a good prognosis, in chondrosarcoma IDH prognostic role is controversial in different reported series. First aim of this project is to define the prevalence and the prognostic role of IDH mutation in high grade central conventional chondrosarcoma patients treated at Istituto Ortopedico Rizzoli. Second aim is the critical revision of scientific literature to understand better how a genomic event in cancer cell can trigger alteration in the TME, through immune infiltrate reshaping, angiogenesis induction, metabolic and methylation rewiring. Third aim is to screen other sarcoma histotypes for the presence of IDH mutation.

A single-sided NMR approach to study structural differences of bovine articular tissue

This thesis work has been developed in collaboration between the Department of Physics and Astronomy of the University of Bologna and the IRCCS Rizzoli Orthopedic Institute during an internship period. The study aims to investigate the sensitivity of single-sided NMR in detecting structural differences of the articular cartilage tissue and their correlation with mechanical behavior. Suitable cartilage indicators for osteoarthritis (OA) severity (e.g., water and proteoglycans content, collagen structure) were explored through four NMR parameters: T2, T1, D, and Slp. Structural variations of the cartilage among its three layers (i.e., superficial, middle, and deep) were investigated performing several NMR pulses sequences on bovine knee joint samples using the NMR-MOUSE device. Previously, cartilage degradation studies were carried out, performing tests in three different experimental setups. The monitoring of the parameters and the best experimental setup were determined. An NMR automatized procedure based on the acquisition of these quantitative parameters was implemented, tested, and used for the investigation of the layers of twenty bovine cartilage samples. Statistical and pattern recognition analyses on these parameters have been performed. The results obtained from the analyses are very promising: the discrimination of the three cartilage layers shows very good results in terms of significance, paving the way for extensive use of NMR single-sided devices for biomedical applications. These results will be also integrated with analyses of tissue mechanical properties for a complete evaluation of cartilage changes throughout OA disease. The use of low-priced and mobile devices towards clinical applications could concern the screening of diseases related to cartilage tissue. This could have a positive impact both economically (including for underdeveloped countries) and socially, providing screening possibilities to a large part of the population.

Utilizzo di sistemi bioreattori per l’ingegnerizzazione di sostituti del tessuto cartilagineo

La mancanza di vascolarizzazione dei costrutti tissutali cartilaginei ingegnerizzati rende opportuno e necessario l’impiego di bioreattori che permettano di indurre un flusso nel terreno di coltura favorendo il trasporto di massa e quindi lo sviluppo del metabolismo e del differenziamento cellulare. I bioreattori intendono replicare gli stimoli fisici fisiologici, nello specifico condrogenici, e a regolare la formazione della matrice extracellulare tramite meccanotrasduzione, il fenomeno biologico che traduce le sollecitazioni meccaniche applicate alle cellule in segnali biochimici che suscitano risposte adattative. In questo elaborato sono riportati i risultati di un recente lavoro - pubblicato da J. Hallas, A. J. Janvier, K. F. Hoettges & J. R. Henstock e intitolato “Pneumatic piston hydrostatic bioreactor for cartilage tissue engineering – che propone la realizzazione di un bioreattore idrostatico a pistone pneumatico, realizzato con componenti facilmente acquisibili a basso costo in commercio. Il bioreattore è collegato a una camera di coltura tramite un connettore pneumatico e un tubo per l’aria in polipropilene. La camera di coltura è realizzata in acido polilattico (PLA) tramite stampante 3D. Il dispositivo è in grado di applicare a una coltura cellulare tridimensionale una pressione idrostatica intermittente con ampiezza compresa tra 0 e 400 kPa e frequenza massima di 3,5 Hz. Condrociti provenienti dalla cartilagine di un’articolazione di ginocchio sono stati coltivati all’interno della camera di coltura del bioreattore dove sono stati sottoposti a una pressione di picco di 300 kPa per 3 ore al giorno per un totale di 5 giorni. Al termine della coltura si è ottenuto un aumento dell’attività metabolica cellulare del 21% e un aumento significativo del contenuto di glicosamminoglicani nell’ECM.