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Impacts cliniques et physiopathologiques de l'équilibre redox et de la protéine S100A8 extracellulaire dans les leucémies aiguës myéloïdes de novo de l'adulte (hors LAM3)

Abstract : Acute myeloid leukemia (AML) is characterized by clonal expansion of leukemic(s) cell(s) blocked at an early stage of maturation. Despite therapeutic advances, their prognosis remains poor and therapeutic improvements are needed. In AML, reactive oxygen species (ROS) are considered to contribute to leukemogenesis and, on the opposite, standard chemotherapies exert cytotoxicity via ROS. In addition, the redox balance acts on metabolic dysregulation in AML and depends on many regulators, such as S100A8 protein, associated with worst prognostic in AML and known to stimulate NADPH oxidase.In this context, this work focuses on oxidative disorders, and S100A8 expression in bone marrow microenvironment according to clinical-biological characteristics and evaluate their prognostic impact in AML. In addition, we investigated the impact of exogenous S100A8 on ROS production, mitochondrial respiration, and metabolism in leukemia cell lines.In a cohort of 84 de novo AML at diagnosis, we demonstrate the existence of redox balance disorders on leukemic cells, on normal cells from bone marrow microenvironment, and on antioxidant systems (SOD, GPX, glutathione ...). In addition, ROS production observed in response to mitochondrial modulators indirectly reflects mitochondrial functionality plays a prognostic role independent of the current prognostic factors. The analysis of S100A8 in bone marrow plasmas shows a higher expression in AML than in healthy controls or other hematological neoplasms. This hyperexpression is predominantly of monocytic origin and is associated with molecular abnormalities of good prognosis such as (inv (16), NPM1) or with a subgroup of mutated FLT3-ITD patients with better survival. Finally, the study of S100A8 on leukemia cell lines highlights its heterogeneous effect on cell growth, apoptosis, ROS production and on NOX regulation. Furthermore, we observe a S100A8-phosphocholine change which remains to be explored.In conclusion, this work provides original information on bio-energetic balance in AML and their prognostic impacts, emphasizing that these metabolic alterations impact AML prognosis through complex interactions.
Keywords : S100a8 Leukemia Ros
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Julie Mondet. Impacts cliniques et physiopathologiques de l'équilibre redox et de la protéine S100A8 extracellulaire dans les leucémies aiguës myéloïdes de novo de l'adulte (hors LAM3). Médecine humaine et pathologie. Université Grenoble Alpes, 2018. Français. ⟨NNT : 2018GREAS007⟩. ⟨tel-02379986⟩

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