Analyse globale des altérations abberantes de la méthylation de l'ADN dans le cancer de l'ovaire

Le cancer de l’ovaire représente 4% de tous les cancers chez la femme et est la première cause de décès parmi les tumeurs gynécologiques en occident. Le cancer épithélial de l’ovaire (CEO) représente 90% de toutes les tumeurs de l’ovaire. Malgré les avancées médicales et chirurgicales, le taux de survie à long terme demeure décevant en raison de la nature asymptomatique de la maladie. Le traitement repose sur la chirurgie cytoréductive suivie de la chimiothérapie combinant les dérivés de platine et de taxanes avec un taux de réponse de plus de 80%. Cependant, la des patientes font une récidive par l’émergence de la résistance à ces drogues conventionnelles. Les bases moléculaires du déclenchement et de la progression du cancer de l’ovaire sont encore méconnues. Au cours d’un cancer, l’hyperméthylation des ilots CpG de certains promoteurs géniques conduit souvent à l’inactivation des gènes suppresseurs de tumeur. Parallèlement, l’hypométhylation des ilots CpG de certains promoteurs est également impliquée dans la réactivation des proto-oncogènes et des gènes pro-métastatiques. La technologie des micropuces à ADN est grandement utilisée au niveau de la recherche sur le cancer, y compris celles portant sur les mécanismes et les biomarqueurs associés à la progression et à la chimiorésistance dans les cancers ovariens. Dans ce travail de thèse, nous avons évalué le profil de méthylation abberante dans les différents grades des tumeurs de CEO de type séreux par rapport aux tissus normaux de l’ovaire, et dans les cellules primaires post-chimiothérapeutiques par rapport aux cellules primaires pré-chimiothérapeutiques de l’ovaire de deux patientes. Nos résultats ont montré que l’hyperméthylation est un événement très précoce de la carcinogenèse avec suppression des gènes ayant un rôle protecteur. Alors que l’hypométhylation massive est associée à la phase avancée de la maladie avec la surexpression des gènes impliqués dans l’invasion et la métastase. Découlant de ces études, RUNX1 et RUNX2 ont été identifiés comme des gènes hypométhylés dans les cellules post-chimiothérapeutiques. Les études fonctionnelles ont montré que ces deux gènes sont associés à la prolifération, la migration et l’invasion cellulaire dans le CEO. Cependant, ces effets similaires sont exercés par des mécanismes moléculaires différents.Ovarian cancer accounts for 4% of all cancers in women and is the leading cause of death among Gynecologic tumours in the western countries. The epithelial ovarian cancer (EOC), which represents 90% of all ovarian tumors. Despite advances in medical and surgical treatment, long term survival rate remains disappointing due to the asymptomatic nature of the disease. The treatment uses cytoreductive surgery followed by chemotherapy combining derivatives of platinum and taxanes with a response rate of over 80%. However, the most part of the patients have a recurrence by the emergence of resistance to these conventional drugs. The molecular basis of the initiation and progression of ovarian cancer are still unknown. During cancer, hypermethylation of gene promoter CpG islands often leads to inactivation of some tumor suppressor genes. At the same time, CpG islands hypomethylation is also associated to reactivation of proto-oncogenes and pro-metastatiques genes. The microarray technology has been successfully used in cancer research, including studies on mechanisms and biomarkers linked to ovarian cancer progression and chemoresistance. In this study, we have evaluated the aberrant DNA methylation profile in tumour grades of serous type EOC compared to normal ovarian tissue, and primary cells culture prior to and post chemotherapy (CT) treatment from 2 EOC patients. Our results showed that hypermethylation is an early event in carcinogenesis with down-regulation of genes having a protective role. While massive hypomethylation is associated with advanced serous EOC with upregulation of genes involved in cell invasion and metastasis. From these studies, we identified RUNX1 and RUNX2 as hypomethylated genes in post-chemotherapy primary cells culture. Sebsequent functional analyses pointed to RUNX1 and RUNX2 association with EOC cell proliferation (including cell cycle control for RUNX1), migration and invasion. However, RUNX1 and RUNX2 display overlapping functions in EOC dissemination, these nevertheless employ distinct molecular mechanisms, specific for each gene. Our data are indicative of strong oncogenic potential of both transcription factors in EOC progression

Male Reproductive Anatomy

The male reproductive system, which is made up of the testes, scrotum, epididymis, vas deferens, seminal vesicles, prostate gland, bulbourethral gland, ejaculatory duct, urethra, and penis, functions mainly in the production, nourishment, and temporary storage of spermatozoa. Epigenetic modifications are essential to regulate normal gonadal development and spermatogenesis. The sperm epigenome is highly susceptible influence by a wide spectrum of environmental stimuli. This book focuses on the male reproductive system, discussing topics ranging from aspects of anatomy and risk factors for male infertility to clinical techniques and management of male reproductive health

iPS Cells for Modelling and Treatment of Human Diseases

The field of reprogramming somatic cells into induced pluripotent stem cells (iPSC) has moved very quickly, from bench to bedside in just eight years since its first discovery. The best example of this is the RIKEN clinical trial this year in Japan, which will use iPSC derived retinal pigmented epithelial (RPE) cells to treat macular degeneration (MD). This is the first human disease to be tested for regeneration and repair by iPSC-derived cells and others will follow in the near future. Currently, there is an intense worldwide research effort to bring stem cell technology to the clinic for application to treat human diseases and pathologies. Human tissue diseases (including those of the lung, heart, brain, spinal cord, and muscles) drive organ bioengineering to the forefront of technology concerning cell replacement therapy. Given the critical mass of research and translational work being performed, iPSCs may very well be the cell type of choice for regenerative medicine in the future. Also, basic science questions, such as efficient differentiation protocols to the correct cell type for regenerating human tissues, the immune response of iPSC replacement therapy and genetic stability of iPSC-derived cells, are currently being investigated for future clinical applications

Radiation Response Biomarkers for Individualised Cancer Treatments

Personalised medicine is the next step in healthcare, especially when applied to genetically diverse diseases such as cancers. Naturally, a host of methods need to evolve alongside this, in order to allow the practice and implementation of individual treatment regimens. One of the major tasks for the development of personalised treatment of cancer is the identification and validation of a comprehensive, robust, and reliable panel of biomarkers that guide the clinicians to provide the best treatment to patients. This is indeed important with regards to radiotherapy; not only do biomarkers allow for the assessment of treatability, tumour response, and the radiosensitivity of healthy tissue of the treated patient. Furthermore, biomarkers should allow for the evaluation of the risks of developing adverse late effects as a result of radiotherapy such as second cancers and non-cancer effects, for example cardiovascular injury and cataract formation. Knowledge of all of these factors would allow for the development of a tailored radiation therapy regime. This Special Issue of the Journal of Personalised Medicine covers the topic of Radiation Response Biomarkers in the context of individualised cancer treatments, and offers an insight into some of the further evolution of radiation response biomarkers, their usefulness in guiding clinicians, and their application in radiation therapy

Prevention and Reversal of Peripheral Neuropathy/Peripheral Arterial Disease

This monograph presents a five-step treatment protocol to prevent and reverse Peripheral Neuropathy (PN)/Peripheral Arterial Disease (PAD), based on the following systemic medical principle: at the present time, removal of cause is a necessary, but not necessarily sufficient, condition for restorative treatment to be effective. Implementation of the five-step PN/PAD treatment protocol is as follows: Step 1: Obtain a detailed medical and habit/exposure history from the patient. Step 2: Administer written and clinical performance and behavioral tests to assess the severity of the higher-level symptoms and degradation of executive functions Step 3: Administer laboratory tests (blood, urine, imaging, etc) Step 4: Eliminate ongoing PN/PAD contributing factors Step 5: Implement PN/PAD treatments This individually-tailored PN/PAD treatment protocol can be implemented with the data currently available in the biomedical literature. Additionally, while the methodology developed for this study was applied to comprehensive identification of diagnostics, contributing factors, and treatments for PN/PAD, it is general and applicable to any chronic disease/condition that, like PN/PAD, has an associated substantial research literature. Thus, the protocol and methodology developed to prevent or reverse PN/PAD can be used to prevent or reverse any chronic disease (with the possible exceptions of individuals with strong genetic predispositions to the disease in question or who have suffered irreversible damage from the disease)