The transcriptional repressor Delta EF1 controls resistance to the EGFR inhibitor erlotinib in human HNSCC lines

Epidermal Growth Factor Receptor (EGFR) overexpression occurs in about 90% of Head and Neck Squamous Cell Carcinoma (HNSCC) cases. Aberrant EGFR signaling has been implicated in the malignant features of HNSCC. Thus, EGFR appears to be a logical therapeutic target with increased tumor specificity for the treatment of HNSCC. Erlotinib, a small molecule tyrosine kinase inhibitor, specifically inhibits aberrant EGFR signaling in HNSCC. Only a minority of HNSCC patients were able to derive a substantial clinical benefit from erlotinib. ^ This dissertation identifies Epithelial to Mesenchymal Transition (EMT) as the biological marker that distinguishes EGFR-dependent (erlotinib-sensitive) tumors from the EGFR-independent (erlotinib-resistant) tumors. This will allow us to prospectively identify the patients who are most likely to benefit from EGFR-directed therapy. More importantly, our data identifies the transcriptional repressor DeltaEF1 as the mesenchymal marker that controls EMT phenotype and resistance to erlotinib in human HNSCC lines. si-RNA mediated knockdown of DeltaEF1 in the erlotinib-resistant lines resulted in reversal of the mesenchymal phenotype to an epithelial phenotype and significant increase in sensitivity to erlotinib. ^ DeltaEF1 represses the expression of the epithelial markers by recruiting HDACs to chromatin. This observation allows us to translate our findings into clinical application. To test whether the transcriptional repression by DeltaEF1 underlines the mechanism responsible for erlotinib resistance, erlotinib-resistant lines were treated with an HDAC inhibitor (SAHA) followed by erlotinib. This resulted in a synergistic effect and substantial increase in sensitivity to erlotinib in the resistant cell lines. Thus, combining an HDAC inhibitor with erlotinib represents a novel promising pharmacologic strategy for reversing resistance to erlotinib in HNSCC patients. ^

Genetic epidemiology of childhood brain tumors

A rare familial cancer syndrome involving childhood brain tumors (CBT), breast cancer, sarcomas and an array of other tumors has been described (Li and Fraumeni 1969, 1975, 1982, 1987). A survey of CBT identified through the Connnecticut Tumor Registry in 1984 revealed a high frequency of CBT, leukemia and other childhood cancer in siblings of CBT patients (Farwell and Flannery, 1984). Other syndromes such as neurofibromatosis and nevoid basal cell carcinoma syndrome have also been associated with CBT; however, no systematic family studies have been conducted to determine the extent to which cancer aggregates in family members of CBT patients. This family study was designed to determine the frequency of cancer aggregation overall or at specific sites, to determine the frequency of known or potentially hereditary syndromes in families of CBT patients, and to determine a genetic model to characterize familial cancer syndromes and to identify specific kindreds to which such a model(s) might apply. This study includes 244 confirmed CBT patients referred to the University of Texas M. D. Anderson Cancer Center between the years 1944 and 1983, diagnosed under the age of 15 years and resident in the U.S. or Canada. Family histories were obtained on the proband's first (parents, siblings and offspring) and second degree (proband's aunts, uncles and grandparents) relatives following sequential sampling scheme rules. To determine if cancer aggregates in families, we compared the cancer experience in the population to that expected in the general population using Connecticut Tumor Registry calendar year, age, race and sex-specific rates. The standardized incidence ratio (SIR) for cancer overall was 0.91 (41 observed (O) and 44.94 expected (E); 95% Confidence Interval (CI) = 0.65-1.24). We observed a significant excess of colon cancer among the proband's first degree relatives (O/E = 5/1.64; 95% CI = 1.01-7.65), in particular those under age 45 year. Segregation analysis showed evidence for multifactorial inheritance in the small percentage (N = 5) of the families. ^

{\it cis\/} -acting elements and {\it trans\/} -acting factors that control serum amyloid A gene expression during inflammation

To understand how the serum amyloid A (SAA) genes are regulated, the cis-acting elements and trans-acting factors involved in the regulation of mouse SAA3 and rat SAA1 genes expression during inflammation were analyzed.^ To identify DNA sequences involved in the liver-specific expression of the mouse SAA3 gene, the 5$\sp\prime$ flanking region of this gene was analyzed by transient transfection studies. Results suggest that C/EBP, a liver-enriched transcription factor, plays an important role for the enhanced expression of the mouse SAA3 gene in hepatocytes.^ Transfection studies of the regulation of the expression of rat SAA1 gene indicated that a 322 bp fragment ($-$304 to +18) of the gene contains sufficient information for cytokine-induced expression of the reporter gene in a liver cell-specific manner. Further functional analysis of the 5$\sp\prime$ flanking region of the rat SAA1 gene demonstrated that a 65 bp DNA fragment ($-$138/$-$73) can confer cytokine-inducibility onto a heterologous promoter both in liver and nonliver cells. DNase I footprint and gel retardation assays identified five putative cis-regulatory elements within the 5$\sp\prime$ flanking region of the gene: one inducible element, a NF$\kappa$B binding site and four constitutive elements. Two constitutive elements, footprint regions I and III, were identified as C/EBP binding sites with region III having over a 10-fold higher affinity for C/EBP binding than region I. Functional analysis of the cis-elements indicated that C/EBP(I) and C/EBP(III) confer liver cell-specific activation onto a heterologous promoter, while sequences corresponding to the NF$\kappa$B element and C/EBP(I) impart cytokine responsiveness onto the heterologous promoter. These results suggest that C/EBP(I) possesses two functions: liver-specific activation and cytokine responsiveness. The identification of two cytokine responsive elements (NF$\kappa$B and C/EBP(I)), and two liver-specific elements (C/EBP(I) and C/EBP(III)) implies that multiple cis-acting elements are involved in the regulation of the expression of the rat SAA1 gene. The tissue-specific and cytokine-induced expression of rat SAA1 gene is likely the result of the interactions of these cis-acting elements with their cognate trans-acting factors as well as the interplay between the different cis-acting elements and their binding factors. (Abstract shortened with permission of author.) ^

Identification and characterization of cellular genes differentially expressed in a subset of tumors with non -functional WT1

Wilms tumor (WT) or nephroblastoma is a genetically heterogeneous pediatric renal tumor that accounts for 6–7% of all childhood cancers in the U.S. WT1, located at 11p13, is the sole WT gene cloned to date. Additional genomic regions containing genes that play a role in the development of Wilms tumor include 11p15, 7p, 16q, 1p, 17q and 19q. This heterogeneity has made it extremely difficult to develop an understanding of the pathways involved in the development of WT, even in the 5–20% of tumors that show mutations at the WT1 locus. My research addresses this gap in our current comprehension of the development of WT. ^ I have used two complementary approaches to extend the current understanding of molecular changes involved in the development of WT. In order to minimize complexities due to genetic heterogeneity, I confined my analysis to the WT1 pathway by assessing those genetically defined tumors that carry WT1 mutations. WT1 encodes a zinc finger transcription factor, and in vitro studies have identified many genes that are potentially regulated in vivo by WT1. However, there is very little in vivo data that suggests that they are transcriptionally regulated endogenously by WT1. In one approach I assessed the role of WT1 in the in vivo regulation of PDGFA and IGF2, two genes that are strong contenders for endogenous regulation by WT1. Using primary tissue samples, I found no correlation between the level of RNA expression of WT1 with either PDGFA or IGF2, suggesting that WT1 does not play a critical role in their expression in either normal kidney or WT. ^ In a parallel strategy, using differential display analysis I compared global gene expression in a subset of tumors with known homozygous inactivating WT1 mutations (WT1-tumors) to the gene expression in a panel of appropriate control tissues (fetal kidney, normal kidney, rhabdoid tumor and pediatric renal cell carcinoma). Transcripts that are aberrantly expressed in this subset of Wilms tumors are candidates for endogenous transcriptional regulation by WT1 as well as for potentially functioning in the development of WT. By this approach I identified several differentially expressed transcripts. I further characterized two of these transcripts, identifying a candidate WT gene in the process. I then performed a detailed analysis of this WT candidate gene, which maps to 7p. Future studies will shed more light on the role of these differentially expressed genes in WT. ^

Queilitis actínica tratada con imiquimod 5%

Los inmunomoduladores tópicos han demostrado utilidad en las enfermedades orales inflamatorias resistentes a corticoesteroides tópicos, en enfermedades sistémicas con mucosa oral primeramente comprometida y en lesiones severas que involucren la mucosa oral. La queilitis actínica es una lesión potencialmente maligna, con riesgo de progresar a Carcinoma espinocelular, por ello es necesario su tratamiento temprano.

Contribución al estudio de propiedades ópticas en medios heterogéneos

Como contribución del estudio de medios heterogéneos, esta tesis recoge el trabajo llevado a cabo sobre modelado teórico y simulación del estudio de las propiedades ópticas de la piel y del agua del mar, como ejemplos paradigmáticos de medios heterogéneos. Se ha tomado como punto de partida el estudio de la propagación de la radiación óptica, más concretamente de la radiación láser, en un tejido biológico. La importancia de la caracterización óptica de un tejido es fundamental para manejar la interacción radiación-tejido que permite tanto el diagnóstico como la terapéutica de enfermedades y/o de disfunciones en las Ciencias de la Salud. Sin olvidar el objetivo de ofrecer una metodología de estudio, con un «enfoque ingenieril», de las propiedades ópticas en un medio heterogéneo, que no tiene por qué ser exclusivamente el tejido biológico. Como consecuencia de lo anterior y de la importancia que tiene el agua dentro de los tejidos biológicos se decide estudiar en otro capítulo las propiedades ópticas del agua dentro de un entorno heterogéneo como es el agua del mar. La selección del agua del mar, como objeto de estudio adicional, es motivada, principalmente, porque se trata de un sistema heterogéneo fácilmente descriptible en cada uno de sus elementos y permite evaluar una amplia bibliografía. Además se considera que los avances que han tenido lugar en los últimos años en las tecnologías fotónicas van a permitir su uso en los métodos experimentales de análisis de las aguas. El conocimiento de sus propiedades ópticas permite caracterizar los diferentes tipos de aguas de acuerdo con sus compuestos, así como poder identificar su presencia. Todo ello abre un amplio abanico de aplicaciones. En esta tesis doctoral, se ha conseguido de manera general: • Realizar un estudio del estado del arte del conocimiento de las propiedades ópticas de la piel y la identificación de sus elementos dispersores de la luz. • Establecer una metodología de estudio que nos permita obtener datos sobre posibles efectos de la radiación en los tejidos biológicos. •Usar distintas herramientas informáticas para simular el transporte de la radiación laser en tejidos biológicos. • Realizar experimentos mediante simulación de láser, tejidos biológicos y detectores. • Comparar los resultados conocidos experimentalmente con los simulados. • Estudiar los instrumentos de medida de la respuesta a la propagación de radiación laser en tejidos anisotrópicos. • Obtener resultados originales para el diagnóstico y tratamiento de pieles, considerando diferente razas y como alteración posible en la piel, se ha estudiado la presencia del basalioma. • Aplicación de la metodología de estudio realizada en la piel a la simulación de agua de mar. • Obtener resultados originales de simulación y análisis de cantidad de fitoplancton en agua; con el objetivo de facilitar la caracterización de diferentes tipos de aguas. La tesis doctoral se articula en 6 capítulos y 3 anexos perfectamente diferenciados con su propia bibliografía en cada uno de ellos. El primer capítulo está centrado en la problemática del difícil estudio y caracterización de los medios heterogéneos debidos a su comportamiento no homogéneo y anisotrópico ante las radiaciones ópticas. Así pues, presentaremos una breve introducción al comportamiento tanto de los tejidos como del océano ante radiaciones ópticas y definiremos sus principales propiedades: la absorción, el scattering, la anisotropía y los coeficientes de reflexión. Como continuación, un segundo capítulo trata de acercarnos a la resolución del problema de cómo caracterizar las propiedades ópticas descritas en el primer capítulo. Para ello, primero se introducen los modelos teóricos, en segundo lugar los métodos de simulación más empleados y, por último, enumerar las principales técnicas de medida de la propagación de la luz en los tejidos vivos. El tercer capítulo, centrado en la piel y sus propiedades, intenta realizar una síntesis de lo que se conoce sobre el comportamiento de la piel frente a la propagación de las radiaciones ópticas. Se estudian sus elementos constituyentes y los distintos tipos de pieles. Por último se describe un ejemplo de aplicación más inmediata que se beneficia de este conocimiento. Sabemos que el porcentaje de agua en el cuerpo humano es muy elevado, en concreto en la piel se considera de aproximadamente un 70%. Es obvio, por tanto, que conocer cómo afecta el agua en la propagación de una radiación óptica facilitaría el disponer de patrones de referencia; para ello, se realiza el estudio del agua del mar. En el cuarto capítulo se estudian las propiedades del agua del mar como medio heterogéneo de partículas. En este capítulo presentamos una síntesis de los elementos más significativos de dispersores en el océano, un estudio de su comportamiento individual frente a radiaciones ópticas y su contribución al océano en su conjunto. Finalmente, en el quinto capítulo se describen los resultados obtenidos en los distintos tipos de simulaciones realizadas. Las herramientas de simulación empleadas han sido las mismas tanto para el caso del estudio de la piel como para el agua del mar, por ello ambos resultados son expuestos en el mismo capítulo. En el primer caso se analizan diferentes tipos de agua oceánica, mediante la variación de las concentraciones de fitoplancton. El método empleado permite comprobar las diferencias que pueden encontrarse en la caracterización y diagnóstico de aguas. El segundo caso analizado es el de la piel; donde se estudia el comportamiento de distintos tipos de piel, se analizan para validar el método y se comprueba cómo el resultado es compatible con aplicaciones, actualmente comerciales, como la de la depilación con láser. Como resultado significativo se muestra la posible metodología a aplicar para el diagnóstico del cáncer de piel conocido como basalioma. Finalmente presentamos un capítulo dedicado a los trabajos futuros basados en experimentación real y el coste asociado que implicaría el llevarlo a cabo. Los anexos que concluyen la tesis doctoral versan por un lado sobre el funcionamiento del vector común de toda la tesis: el láser, sus aplicaciones y su control en la seguridad y por otro presentamos los coeficientes de absorción y scattering que hemos utilizado en nuestras simulaciones. El primero condensa las principales características de una radiación láser desde el punto de vista de su generación, el segundo presenta la seguridad en su uso y el tercero son tablas propias, cuyos parámetros son los utilizados en el apartado de experimentación. Aunque por el tipo de tesis que defiendo no se ajusta a los modelos canónicos de tesis doctoral, el lector podrá encontrar en esta tesis de forma imbricada, el modelo común a todas las tesis o proyectos de investigación con una sección dedicada al estado del arte con ejemplos pedagógicos para facilitar la compresión y se plantean unos objetivos (capítulos 1-4), y un capítulo que se subdivide en materiales y métodos y resultados y discusiones (capítulo 5 con sus subsecciones), para finalizar con una vista al futuro y los trabajos futuros que se desprenden de la tesis (capítulo 6). ABSTRACT As contribution to the study of heterogeneous media, this thesis covers the work carried out on theoretical modelling and simulation study of the optical properties of the skin and seawater, as paradigmatic examples of heterogeneous media. It is taken as a starting point the study of the propagation of optical radiation, in particular laser radiation in a biological tissue. The importance of optical characterization of a tissue is critical for managing the interaction between radiation and tissues that allows both diagnosis and therapy of diseases and / or dysfunctions in Health Sciences. Without forgetting the aim of providing a methodology of study, with "engineering approach" of the optical properties in a heterogeneous environment, which does not have to be exclusively biological tissue. As a result of this and the importance of water in biological tissues, we have decided to study the optical properties of water in a heterogeneous environment such as seawater in another chapter. The selection of sea water as an object of further study is motivated mainly because it is considered that the advances that have taken place in recent years in photonic technologies will allow its use in experimental methods of water analysis. Knowledge of the optical properties to characterize the different types of waters according to their compounds, as well as to identify its presence. All of this opens a wide range of applications. In this thesis, it has been generally achieved: • Conduct a study of the state of the art knowledge of the optical properties of the skin and identifying its light scattering elements. • Establish a study methodology that allows us to obtain data on possible effects of radiation on biological tissues. • Use different computer tools to simulate the transport of laser radiation in biological tissues. • Conduct experiments by simulating: laser, detectors, and biological tissues. • Compare the known results with our experimentally simulation. • Study the measuring instruments and its response to the propagation of laser radiation in anisotropic tissues. • Get innovative results for diagnosis and treatment of skin, considering different races and a possible alteration in the skin that we studied: the presence of basal cell carcinoma. • Application of the methodology of the study conducted in the skin to simulate seawater. • Get innovative results of simulation and analysis of amount of phytoplankton in water; in order to facilitate the characterization of different types of water. The dissertation is divided into six chapters and three annexes clearly distinguished by their own literature in each of them. The first chapter is focused on the problem of difficult study and characterization of heterogeneous media due to their inhomogeneous and anisotropic behaviour of optical radiation. So we present a brief introduction to the behaviour of both tissues at the cellular level as the ocean, to optical radiation and define the main optical properties: absorption, scattering, anisotropy and reflection coefficients. Following from this, a second chapter is an approach to solving the problem of how to characterize the optical properties described in the first chapter. For this, first the theoretical models are introduced, secondly simulation methods more used and, finally, the main techniques for measuring the propagation of light in living tissue. The third chapter is focused on the skin and its properties, tries to make a synthesis of what is known about the behaviour of the skin and its constituents tackle the spread of optical radiation. Different skin types are studied and an example of immediate application of this knowledge benefits described. We know that the percentage of water in the human body is very high, particularly in the skin is considered about 70%. It is obvious, therefore, that knowing how the water is affected by the propagation of an optical radiation facilitate to get reference patterns; For this, the study of seawater is performed. In the fourth chapter the properties of seawater as a heterogeneous component particles are studied. This chapter presents a summary of the scattering elements in the ocean, its individual response to optical radiation and its contribution to the ocean as a whole. In the fifth chapter the results of the different types of simulations are described. Simulation tools used were the same for the study of skin and seawater, so both results are presented in the chapter. In the first case different types of ocean water is analysed by varying the concentrations of phytoplankton. The method allows to check the differences that can be found in the characterization and diagnosis of water. The second case analysed is the skin; where the behaviour of different skin types are studied and checked how the result is compatible with applications currently trade, such as laser hair removal. As a significant result of the possible methodology to be applied for the diagnosis of skin cancer known as basal cell carcinoma is shown. Finally we present a chapter on future work based on actual experimentation and the associated cost which it would involve carrying out. The annexes conclude the thesis deal with one hand on the functioning of the common vector of the whole thesis: laser, control applications and safety and secondly we present the absorption and scattering coefficients we used in our simulations. The first condenses the main characteristics of laser radiation from the point of view of their generation, the second presents the safety in use and the third are own tables, whose parameters are used in the experimental section. Although the kind of view which I advocate does not meet the standard models doctoral thesis, the reader will find in this thesis so interwoven, the common model to all theses or research projects with a section on the state of the art pedagogical examples to facilitate the understanding and objectives (Chapters 1-4), and a chapter is divided into materials and methods and results and discussions (Chapter 5 subsections) arise, finishing with a view to the future and work future arising from the thesis (Chapter 6).