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| Author(s): |
Vanessa Karen de Sá
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) |
| Defense date: | 2012-08-02 |
| Examining board members: |
Vera Luiza Capelozzi;
Paulo Campos Carneiro;
Fábio José Haddad;
Durvanei Augusto Maria;
Ilka Lopes Santoro
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| Advisor: | Vera Luiza Capelozzi |
| Abstract | |
Given the poor results obtained in the treatment of Lung Cancer, in early stages or locally advanced disease, there is a need to develop molecular markers and immunohistochemical studies that can predict tumor behavior. Hyaluronic Acid (HA) is a component of extracellular matrix is responsible for hydration and maintenance of tissue osmotic equilibrium. Concentrations of HA are elevated in several types of cancers, including lung. Hyaluronidases (HAases) are a family of enzymes involved in the spread of bacterial toxins, poisons and tumor progression. The breakdown of HA into small fragments (3-25 disaccharides) promoted by the action of type HAases Hyal1, Hyal 2 and Hyal 3 is related to the promotion of cancer by inducing angiogenesis and stimulate proliferation through activation of the tyrosine kinase. Some isoforms HAases, described as the product of alternative splicing, have diverse enzymatic activity. The heterogeneity of expression of HAases was identified in some cancers and can be correlated with the different behavior of tumors. In a first instance, the expression profile of Hyal spliced forms was evaluated in tumor and normal lung tissue of 69 tumors resected from patients with adenocarcinomas(ADC) and squamous cell carcinomas (SqCC) from the Hospital das Clínicas and Hospital AC. Camargo. Gene expression of HYAL1 wild-type (wt) and variants 1 to 5 HYAL2-wt, and HYAL3-wt and variants 1 to 3 was identified by PCR and direct sequencing. Different proportions of HYAL3-wt and variants were expressed in tumor and normal lung tissue. HYAL1-wt was associated with unfavorable prognosis and HYAL3-v1 with favorable prognosis. Given the genetic abnormalities found in tumors of patients from Hospital das Clinicas and Hospital AC. Camargo, we continued our research to study the expression of Hyal 1.3 and HAS 1, 2, 3 in squamous cell carcinomas and adenocarcinomas. We observed that the intensity of expression of Hyal 3 was higher in tumor cells compared to controls, but this difference was marginally significant. Since the result of frequency analysis of immunoreactivity of Hyal 1 and 3, and HAS1, 2 e 3 showed expression in the majority of tumor samples and controls. The association between variables was tested and showed concomitant immunoexpression of the HAS and HYAL in tumors. The mathematical model of survival, adjusted for sex, age and staging showed risk of death associated with adenocarcinoma and solid and HAS3 HAS2 immunoreactivity.To validate the results, especially with the immunostaining of Hyal and HAS in squamous cell carcinomas and adenocarcinomas of the lung, the patient population studied at the University Hospital of Coimbra. Documented for the first time a route by which the overexpression of HAS3 and Hyal 3 respectively by neoplastic epithelial and mesenchymal cells may favor the invasion in ADC and SqCC, respectively. Surprisingly, we demonstrated that hyper HAS1 and 3 immunoreactivity by neoplastic epithelial cells confers more aggressiveness to the ADC acinar and papillary, but a negative expression of HAS1 by mesenchymal cells confers a protective role ECM-helping to prevent the invasion by tumor cells in both types histological subtypes.The interaction between the expression of hialuronidades and hyaluronic acid synthases was evaluated for protein expression of epithelial-mesenchymal transition in tumor patients at the University Hospital of Coimbra. Hyaluronidase, hyaluronan synthase, Ecadherin, and TGF- modulated via an invasive tumor-induced in the ADC and SqCC lung, and were associated with a different spectrum of aggressiveness, since there was an inverse relationship between the expression of epithelial biomarkers and mesenchymal cells. While overexpression of HAS1 and HAS3 provides an aggressiveness to SqCC and ADC, an overexpression of TGF- and E-cadherin confers a protective effect by preventing the ECM invasion by tumor cells in both histological types. We compared the levels of immunostaining Hyal 1, 3 and HAS1, 2 and 3 in tumors resected at the Hospital AC. Camargo, and the levels obtained in tumors of the Hospital Universitário de Coimbra. We found that the immunostaining of HAS 1, 2, 3 and Hyal1 was significantly higher in tumors from patients of Coimbra, while Hyal 3 immunoreactivity was significantly. higher in tumors of patients in Brazil. For all these reasons, our results suggest that strategies directed at modulating the levels of HYAL1-wt and HYAL3-v1, the immunohistochemical expression of HAS3 and Hyal 3 respectively by neoplastic epithelial and mesenchymal cells, the synthesis of HAS3 and Hyal1 or the local response of low TGF- and E-cadherin, may have great impact on lung cancer (AU) | |