Rôle de l'adrénomédulline dans la néoangiogenèse et l'invasion tumorale

Les glioblastomes sont des tumeurs fatales du fait de leur agressivité et du manque de traitements efficaces. La prolifération accrue, le caractère invasif et la résistance à la mort cellulaire leur confèrent une croissance rapide et une invasion du parenchyme cérébral environnant, à l origine de leur systématique récidive. Exprimée par la composante tumorale en hypoxie mais également par la composante vasculaire, l AM participe de façon autocrine et paracrine au développement des glioblastomes en favorisant la croissance des cellules tumorales et l angiogenèse tumorale.Il a été montré que des anticorps polyclonaux dirigés contre les récepteurs de l AM inhibent in vitro la croissance, la migration et la formation de pseudo-capillaires des cellules endothéliales, suggérant une neutralisation par ces anticorps de certaines étapes de l angiogenèse. De même, il a été montré in vivo que ces anticorps inhibent la croissance tumorale en supprimant l angiogenèse et la croissance des cellules tumorales suggérant ainsi que les récepteurs de l AM constitueraient une bonne cible thérapeutique. Des anticorps capables de reconnaître et neutraliser à la fois l AM, les CLR, RAMP2 et RAMP3 agissant de la même manière sur la croissance tumorale et l angiogenèse représenteraient un bénéfice thérapeutique majeur. Des anticorps dirigés contre un peptide chimérique constitué de l enchainement de séquences peptidiques des protéines CLR, RAMP2, RAMP3 et du peptide AM sont en cours. Le traitement par ces anticorps diminue la croissance des cellules tumorales ainsi que leurs migration et invasion. Ces résultats très encourageants nous permettent pour le moment de valider la faisabilité du concept d anticorps développés à partir d un peptide chimérique pour neutraliser le système AM/AMR dans le but d envisager dans le futur une application thérapeutique.Glioblastoma are fatal tumors because of their aggressiveness and lack of effective treatments. The increased proliferation, the invasiveness and resistance to cell death gives them a rapid growth and invasion of brain parenchyma surrounding the origin of their systematic recurrence. Expressed by the tumoral component in hypoxia but also by the vascular component, the AM participate by an autocrine and paracrine way, the development of glioblastoma by promoting tumor ell growth and tumor angiogenesis.It was shown that polyclonal antibodies directed against the AM receptor inhibit in vitro growth, migration and the formation of pseudo-capillary of endothelial cells, suggesting neutralization by theses antibodies in certain stages of angiogenesis. Similarly, it has been shown in vivo that these antibodies inhibit tumor growth by suppressing angiogenesis and tumor cell growth, suggesting that the AM receptor would be a good therapeutic target. Antibodies that recognized and neutralized both the AM, the CLR, RAMP2 and RAMP3 acting the same way on tumor growth and angiogenesis represent a major therapeutic benefit. Antibodies against a chimeric peptide consisting of peptide sequence of CLR, RAMP2, RAMP3 and AM peptide are in progress. Treatment with these antibodies decreases the growth of tumor cells, their migration and invasion. These encouraging results allow us the time to validate the feasibility of the concept of antibodies developed from a chimeric peptide to neutralize the AM/AMR system in order to consider in the future therapeutic application.AIX-MARSEILLE2-Bib.electronique (130559901) / SudocSudocFranceF

SENTADOS EN LA CALLE [Material gráfico]

Copia digital. Madrid : Ministerio de Educación, Cultura y Deporte, 201

Inequity in access to personalized medicine in France: Evidences from analysis of geo variations in the access to molecular profiling among advanced non-small-cell lung cancer patients: Results from the IFCT Biomarkers France Study

In this article, we studied geographic variation in the use of personalized genetic testing for advanced non-small cell lung cancer (NSCLC) and we evaluated the relationship between genetic testing rates and local socioeconomic and ecological variables. We used data on all advanced NSCLC patients who had a genetic test between April 2012 and April 2013 in France in the frame of the IFCT Biomarqueurs-France study (n = 15814). We computed four established measures of geographic variation of the sex-adjusted rates of genetic testing utilization at the “départment” (the French territory is divided into 94 administrative units called ‘départements’) level. We also performed a spatial regression model to determine the relationship between département-level sex-adjusted rates of genetic testing utilization and economic and ecological variables. Our results are the following: (i) Overall, 46.87% lung cancer admission patients obtained genetic testing for NSCLC; département-level utilization rates varied over 3.2-fold. Measures of geographic variation indicated a relatively high degree of geographic variation. (ii) there was a statistically significant relationship between genetic testing rates and per capita supply of general practitioners, radiotherapists and surgeons (negative correlation for the latter); lower genetic testing rates were also associated with higher local poverty rates. French policymakers should pursue effort toward deprived areas to obtain equal access to personalized medicine for advanced NSCLC patients

Routine molecular profiling of cancer: results of a one-year nationwide program of the French Cooperative Thoracic Intergroup (IFCT) for advanced non-small cell lung cancer (NSCLC) patients.

International audienceBackground: The molecular profiling of patients with advanced non-small-cell lung cancer (NSCLC) for known oncogenic drivers is recommended during routine care. Nationally, however, the feasibility and effects on outcomes of this policy are unknown. We aimed to assess the characteristics, molecular profiles, and clinical outcomes of patients who were screened during a 1-year period by a nationwide programme funded by the French National Cancer Institute. Methods This study included patients with advanced NSCLC, who were routinely screened for EGFR mutations, ALK rearrangements, as well as HER2 (ERBB2), KRAS, BRAF, and PIK3CA mutations by 28 certified regional genetics centres in France. Patients were assessed consecutively during a 1-year period from April, 2012, to April, 2013. We measured the frequency of molecular alterations in the six routinely screened genes, the turnaround time in obtaining molecular results, and patients' clinical outcomes. This study is registered with ClinicalTrials.gov, number NCT01700582. Findings 18 679 molecular analyses of 17 664 patients with NSCLC were done (of patients with known data, median age was 64·5 years [range 18–98], 65% were men, 81% were smokers or former smokers, and 76% had adenocarcinoma). The median interval between the initiation of analysis and provision of the written report was 11 days (IQR 7–16). A genetic alteration was recorded in about 50% of the analyses; EGFR mutations were reported in 1947 (11%) of 17 706 analyses for which data were available, HER2 mutations in 98 (1%) of 11 723, KRAS mutations in 4894 (29%) of 17 001, BRAF mutations in 262 (2%) of 13 906, and PIK3CA mutations in 252 (2%) of 10 678; ALK rearrangements were reported in 388 (5%) of 8134 analyses. The median duration of follow-up at the time of analysis was 24·9 months (95% CI 24·8–25·0). The presence of a genetic alteration affected first-line treatment for 4176 (51%) of 8147 patients and was associated with a significant improvement in the proportion of patients achieving an overall response in first-line treatment (37% [95% CI 34·7–38·2] for presence of a genetic alteration vs 33% [29·5–35·6] for absence of a genetic alteration; p=0·03) and in second-line treatment (17% [15·0–18·8] vs 9% [6·7–11·9]; p<0·0001). Presence of a genetic alteration was also associated with improved first-line progression-free survival (10·0 months [95% CI 9·2–10·7] vs 7·1 months [6·1–7·9]; p<0·0001) and overall survival (16·5 months [15·0–18·3] vs 11·8 months [10·1–13·5]; p<0·0001) compared with absence of a genetic alteration. Interpretation Routine nationwide molecular profiling of patients with advanced NSCLC is feasible. The frequency of genetic alterations, acceptable turnaround times in obtaining analysis results, and the clinical advantage provided by detection of a genetic alteration suggest that this policy provides a clinical benefit

Pharmacogenetic profiling and cetuximab outcome in patients with advanced colorectal cancer

<p>Abstract</p> <p>Background</p> <p>We analyzed the influence of 8 germinal polymorphisms of candidate genes potentially related to EGFR signalling (<it>EGFR</it>, <it>EGF</it>, <it>CCND1</it>) or antibody-directed cell cytotoxicity (<it>FCGR2A </it>and <it>FCGR3A</it>) on outcome of colorectal cancer (CRC) patients receiving cetuximab-based therapy.</p> <p>Methods</p> <p>Fifty-eight advanced CRC patients treated with cetuximab-irinotecan salvage therapy between 2001 and 2007 were analyzed (mean age 60; 50 PS 0-1). The following polymorphisms were analyzed on blood DNA: <it>EGFR </it>(CA repeats in intron 1, -216 G > T, -191C > A, R497K), <it>EGF </it>(A61G), <it>CCND1 </it>(A870G), <it>FCGR2A </it>(R131H), <it>FCGR3A </it>(F158V). Statistical analyses were conducted on the total population and on patients with wt KRas tumors. All SNPs were considered as ternary variables (wt/wt <it>vs </it>wt/mut <it>vs </it>mut/mut), with the exception of -191C > A <it>EGFR </it>polymorphism (AA patient merged with CA patients).</p> <p>Results</p> <p>Analysis of skin toxicity as a function of EGFR intron 1 polymorphism showed a tendency for higher toxicity in patients with a low number of CA-repeats (p = 0.058). <it>CCND1 </it>A870G polymorphism was significantly related to clinical response, both in the entire population and in KRas wt patients, with the G allele being associated with a lack of response. In wt KRas patients, time to progression (TTP) was significantly related to <it>EGFR </it>-191C > A polymorphism with a longer TTP in CC patients as compared to others, and to <it>CCND1 </it>A870G polymorphism with the G allele being associated with a shorter TTP; a multivariate analysis including these two polymorphisms only retained <it>CCND1 </it>polymorphism. Overall survival was significantly related to <it>CCND1 </it>polymorphism with a shorter survival in patients bearing the G allele, and to <it>FCGR3A </it>F158V polymorphism with a shorter survival in VV patients (in the entire population and in KRas wt patients). <it>FCGR3A </it>F158V and <it>CCND1 </it>A870G polymorphisms were significant independent predictors of overall survival.</p> <p>Conclusions</p> <p>Present original data obtained in wt KRas patients corresponding to the current cetuximab-treated population clearly suggest that <it>CCND1 </it>A870G polymorphism may be used as an additional marker for predicting cetuximab efficacy, TTP and overall survival. In addition, <it>FCGR3A </it>F158V polymorphism was a significant independent predictor of overall survival.</p

Etude sur la biosynthese de la thyrotropin-releasing hormone (TRH) pancreatique

SIGLECNRS T Bordereau / INIST-CNRS - Institut de l'Information Scientifique et TechniqueFRFranc

Caractérisation du système AM/AMR dans les glioblastomes humains et étude d'un nouveau concept d'anticorps à visée thérapeutique

Les glioblastomes sont des tumeurs fatales du fait de leur agressivité et du manque de traitements efficaces. La prolifération accrue, le caractère invasif et la résistance à la mort cellulaire du compartiment tumoral des glioblastomes leur confèrent une croissance rapide et une invasion du parenchyme cérébral environnant, à l origine de leur systématique récidive. De plus, le processus d angiogenèse au sein de ces tumeurs participe activement au mauvais pronostic en développant une forte vascularisation qui favorise leur croissance.Un peptide vasoactif l Adrénomédulline (AM), est exprimé de façon ubiquitaire chez l homme et a de ce fait un large champ d action à travers l organisme dont la progression tumorale en agissant de façon autocrine et paracrine via ses récepteurs CLR/RAMP2 et CLR/RAMP3 ( AMR ). Or l expression de l AM est corrélée avec le grade des gliomes. De plus, il a été démontré au sein de notre équipe que des anticorps polyclonaux anti-AM développés au laboratoire inhibent la prolifération des cellules gliales tumorales de glioblastomes in vitro ainsi que la croissance tumorale in vivo. Il a également été montré que des anticorps polyclonaux (anti-AMR) dirigés contre les récepteurs de l AM (CLR, RAMP2 et RAMP3) inhibent in vitro la croissance, la migration et la formation en pseudo-capillaires des cellules endothéliales (HUVECs), suggérant une neutralisation par ces anticorps, de certaines étapes de l angiogenèse. De même, il a été démontré dans des modèles in vivo que les anticorps anti-AMR inhibent la croissance tumorale en supprimant l angiogenèse et la croissance des cellules tumorales, suggérant ainsi que les récepteurs de l AM constitueraient une bonne cible thérapeutique. Ces études ayant été effectuées à partir de lignées cellulaires, nous avons caractérisé le système AM/AMR au sein des composantes gliales et microvasculaires provenant des cultures primaires de glioblastomes de patients puis nous avons testé l effet de l AM dans certains phénomènes caractéristiques des glioblastomes comme l invasion et certaines étapes de l angiogenèse tumorale. Il résulte de cette étude que l AM est trois fois plus secrétée par la composante microvasculaire tumorale au sein de laquelle l AM favorise la migration, l invasion et l organisation en pseudo-capillaires. De plus, l AM favorise l invasion des cellules de la composante gliale tumorale.Des anticorps capables de reconnaître et neutraliser à la fois l AM, le CLR, RAMP2 et RAMP3 agissant de la même manière sur la croissance tumorale et l angiogenèse représenteraient un bénéfice thérapeutique majeure. Le laboratoire a alors développé des anticorps dirigés contre un peptide chimérique constitué de l enchainement de séquences peptidiques des protéines CLR, RAMP2, RAMP3 et du peptide AM ( AMRc ). Les tests effectués avec les anticorps anti-AMRc nous permettent d affirmer leur efficacité sur le système AM/AMR. Le traitement par ces anticorps diminue la croissance in vitro et in vivo des cellules tumorales de glioblastomes U87, ainsi que leur migration et leur invasion et la densité vasculaire au sein de xénogreffes, ce qui suggère leur effet sur l angiogenèse tumorale. De plus, le traitement par ces anticorps augmente la perméabilité du modèle de cellules endothéliale microvasculaires HMECs. Ces résultats très encourageants, nous permettent donc pour le moment de valider la faisabilité du concept d anticorps développés à partir d un peptide chimère pour neutraliser le sytème AM/AMR, dans le but d envisager dans le futur une application thérapeutique.Glioblastomas are fatal tumors because of their aggressiveness and the lack of effective treatments. The increased proliferation, invasiveness and resistance in cell death of glioblastomas tumoral compartment confer them a fast growth and an invasion of the surrounding cerebral parenchyma, at the origin of glioblastomas systematic recurrence. Furthermore, angiogenesis within these tumors participates actively in the poor prognosis developing a strong vascularization, which favors their growth.Adrenomedullin (AM), is a vasoactive peptide ubiquitously expressed in humans and thus induces multiple biological actions through the body as tumor growth, via autocrine and paracrine activation of its receptors CLR/RAMP2 and CLR/RAMP3 ( AMR ). But AM expression is correlated with gliomas grading and our team demonstrated that polyclonal antibodies anti-AM developped in the laboratory inhibited in vitro glioblastoma tumoral cells proliferation and in vivo tumor growth. Polyclonal antibodies (anti-AMR) directed against AM receptors (CLR, RAMP2 and RAMP3) also inhibited in vitro growth, migration and endothelial cells (HUVECs) pseudo-capillar formation, suggesting neutralization of some steps of angiogenesis. Moreover, anti-AMR antibodies inhibited in vivo tumor growth by suppression of angiogenesis, suggesting AM receptors as a therapeutical target.These studies have been done from lineage cells. We thus characterized AM/AMR system within glial and microvascular components from patients glioblastoma primary cultures and we investigated AM impact in some stages of angiogenesis. We showed that AM was three fold higher expressed by microvascular cells in whom AM induces migration, invasion and organization into a meshwork of capillary-like tubular structures. AM increased too, glial tumoral cells migration and invasion.Antibodies able to recognize and neutralize AM, CLR, RAMP2, RAMP3 and acting in tumor growth and angiogenesis would represent a major therapeutic benefit. Then, the laboratory developped polyclonal antibodies directed against one chimeric peptide synthesized with AM, CLR, RAMP2 and RAMP3 peptide sequences (named AMRc ). The tests made with anti-AMRc antibodies allow us to assert their efficiency on the AM / AMR system. Glioblastoma cell line U87 s growth decreases in vitro and in vivo after treatment with anti-AMRc antibodies, as well as its migration, invasion and vascular density inside tumor xenografts, suggesting an impact in tumor angiogenesis. Furthermore, the treatment with these antibodies increases the microvascular endothelial HMECs permeability. These promising results allow us to validate the feasibility of a concept of antibodies developed against one peptide to neutralize AM/AMR system, in order to envisage a future therapeutic application.AIX-MARSEILLE2-Bib.electronique (130559901) / SudocSudocFranceF

Expression et rôle de l'adrénomédulline dans les adénocarcinomes colorectaux

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF

Characterization and regulation of peptidylglycine alpha-amidating monooxygenase (PAM) expression in H9c2 cardiac myoblasts.

International audiencePeptidylglycine alpha-amidating monooxygenase (PAM), which catalazyes the two-step formation of bioactive alpha-amidated peptides from their glycine-extended precursors, has been found in H9c2 myoblasts. The expression of PAM has been evaluated in H9c2 cells. Northern blot analysis and amplification of fragments derived from rat PAM by the reverse transcription/polymerase chain reaction method has demonstrated the presence of rPAM-1, -2, -3, -3a and -3b mRNA transcripts. These forms of PAM mRNA may be generated by alternative splicing. PAM mRNA levels are increased to 160 +/- 12% of control values by treatment with dexamethasone but are unchanged during triiodothyronine incubation of the cells. PAM activity is very low, which is not comparable to the high levels found in adult atrium tissue. Western blot analysis has demonstrated 86-, 76-, and 46-kDa PAM proteins in the particulate fraction. The soluble fraction contains major PAM proteins of 110, 86, and 46 kDa. In situ hybridization studies with 35S-labeled full length RNA antisense transcripts of rat PAM-1 cDNA have localized autoradiographic grains around the nucleus. Our data clearly demonstrate PAM expression in H9c2 rat heart cells, suggesting the ability of these cardiac cells to make bioactive alpha-amidated hormones and/or neuropeptides

Rôle de l'adrénomédulline dans la néoangiogenèse tumorale des glioblastomes

La croissance tumorale et le processus de métastatisation dépendent de la néoformation de vaisseaux sanguins ou néoangiogenèse. Parmi les molécules intervenant dans ce processus, l'adrenomédul1ine (AM) est un peptide, dont l'expression est corrélée à l'agressivité de certaines tumeurs, et qui représente un maillon clé dans les interactions entre les cellules tumorales et les cellules du microenvironnement. Les résultats spectaculaires qu'offre le traitement des xénogreffes de cellules issues de glioblastomes (GBM) humains par les anticorps dirigés contre l'AM ou son récepteur sont très encourageants, puisque la tumeur traitée régresse en quelques semaines, la vascularisation tumorale s'en trouve touchée de manière spécifique. C'est dans ce contexte, que nous avons choisi de poursuivre notre travail sur les mécanismes d'action de l'AM dans la néoangiogenèse. Grâce à des études in vitro et in vivo, nous avons pu montrer que l'AM est impliquée dans plusieurs étapes de la néoangiogenèse tumorale : migration des cellules endothéliales, stabilisation des contacts endothéliaux et endothélio-péricytaires, recrutement des cellules mésenchymateuses. Nos résultats démontrent que nous sommes en présence d'une molécule d'AM qui agit sur diverses cibles moléculaires et cellulaires, régulant la stabilité du complexe d adhésion intercellulaire VE-cadhérine/-caténine, nécessaire à la protection des interactions homotypiques et hétérotypiques de lendothélium nouvellement formé. Ainsi, l'étude des mécanismes d'action de l'AM réalisée pennettra d'établir ue stratégie thérapeutique autour de l'AM.Tumoral growth and process of metastatization depend on the formation of new blood vessels or angiogenesis. Among the molecules implicated in this process, adrenomedullin (AM) is a peptide, which expression is correlated with the aggressiveness of tumors, and which represents a "key" link in the interactions between tumoral cells and the microenvironment cells. The spectacular results offered by the treatment of human glioblastoma (GBM) xenograft by antibodies directed against the AM or its receptor are very encouraging, as the treated tumor declines in some weeks, and the tumoral vascularization is also touched in a specific way. In this context, we chose to pursue our work on the mechanisms of action of AM in angiogenesis. In vitro and in vivo studies showed that AM is involved in several stages of tumoral angiogenesis : migration of endothelial cells, stabilization of endothelial contacts, stabilization of the pericyte coverage, recruitment of multipotent cells. Our results demonstrate that we are in presence of a molecule of AM which acts on diverse molecular and cellular targets, regulating the stability of the VE-cadherin/b-catenin complex, required for the protection of the homotypics and heterotypics interactions of the newly formed endothelium. The study of the mechanisms of action of AM realized will allow us to establish a therapeutic strategy around AM.AIX-MARSEILLE2-Bib.electronique (130559901) / SudocSudocFranceF