INTRODUÇÃO: acredita-se que o controle glicêmico inadequado, a duração do diabetes melito (DM) e a presença de hipertensão arterial e dislipidemia sejam os fatores de risco mais importantes para o desenvolvimento das complicações microvasculares no DM, contudo, existem inúmeras evidências sugerindo que uma predisposição genética participe da suscetibilidade para o desenvolvimento dessas complicações. Vários genes relacionados aos mecanismos dos danos induzidos pela hiperglicemia têm sido investigados. O papel do estresse oxidativo na patogênese das complicações crônicas do DM vem sendo demonstrado e os genes que codificam enzimas que participam dos mecanismos antioxidantes são candidatos a conferirem suscetibilidade ou proteção contra as complicações crônicas. A glutationa é um dos mais importantes antioxidantes endógenos; no entanto, a associação entre polimorfismos em genes que codificam enzimas que participam desse sistema e complicações crônicas do DM foi pouco explorada na literatura. OBJETIVOS: avaliar a associação de polimorfismos em três genes que codificam enzimas relacionadas ao metabolismo da glutationa com o desenvolvimento de nefropatia e retinopatia em pacientes diabéticos tipo 1. Foram estudados: o polimorfismo -129C/T do gene GCLC, o número de repetições do trinucleotídeo GCG no exon 1 do gene GPX1 e o polimorfismo -65T/C do gene GPX3. CASUÍSTICA E MÉTODOS: 299 pacientes (139 do gênero masculino e 160 do gênero feminino) com DM tipo 1 com mais de 15 anos de diagnóstico e mau controle glicêmico foram divididos conforme presença ou ausência das seguintes complicações: nefropatia diabética (ND) avançada, ND, doença renal crônica (DRC) estágios 3 a 5 e retinopatia diabética proliferativa (RDP). Em cada grupo foram avaliadas as freqüências das variantes alélicas dos três genes estudados. RESULTADOS: a distribuição dos genótipos na população estudada foi consistente com o equilíbrio de Hardy-Weinberg para os três genes analisados. A presença de pelo menos um alelo T do polimorfismo -129C/T do gene GCLC conferiu risco independente para a presença de ND avançada (OR = 2,82 ; IC 95% = 1,13 - 7,05; p = 0,026), para ND (OR = 3,64; IC 95% = 1,27 10,36; p = 0,016) e para DRC estágios 3 a 5 (OR = 5,74; IC 95% = 2,17 15,1; p < 0,001) e a presença de pelo menos um alelo C do polimorfismo -65 T/C conferiu risco independente para a presença de ND avançada (OR = 2,62; IC 95% = 1,19 -5,72, p = 0,022) na população estudada. Não houve associação do número de repetições do trinucleotídeo GCG do gene GPX1 com nenhuma das complicações estudadas. O haplótipo CC_TT, composto pelos alelos selvagens dos genes GCLC e GPX3, foi negativamente associado com ND avançada (OR = 0,32, IC 95% = 0,15 0,66; p = 0,002) e DRC (OR = 0,25; IC 95% = 0,11 - 0,55; p = 0,001). CONCLUSÕES: a presença de pelo menos um alelo T do polimorfismo -129 C/T do gene GCLC e de pelo menos um alelo C do polimorfismo -65 T/C do gene GPX3, ambos associados a uma menor atividade transcricional do respectivo gene, conferiram risco para a presença de complicações renais na população de pacientes estudada. / INTRODUCTION: glycemic control, diabetes duration, systemic hypertension and dyslipidemia have been implicated as main risk factors for the development of diabetic microangiopathy, however there is evidence suggesting that genetic predisposition plays a role in the susceptibility to microvascular complications. Based on underlying pathogenesis, polymorphisms of several genes belonging to multiple pathways have been investigated, like the genes related to mechanisms of hyperglycemia-induced damage. The role of oxidative stress in the pathogenesis of diabetic complication has been increasingly demonstrated and genes coding enzymes involved in antioxidant defense are candidates to confer susceptibility or protection against these complications. Glutathione is one the most important endogen antioxidants, however, the association between polymorphisms in genes related to glutathione metabolism and diabetic complications has not been deeply investigated. OBJECTIVES: to study the association between polymorphisms in three genes which code enzymes related to glutathione metabolism and the development of nephropathy and retinopathy in type 1 diabetic patients: the polymorphism -129 C/T of GCLC, the number of trinucleotide GCG repeats at exon 1 of GPX1 and the polymorphism -65 T/C of GPX3. CASUISTIC AND METHODS: 299 type 1 diabetic patients (139 male and 160 female) with at least 15 years from diagnosis and poor glycemic control were studied. The patients were divided in two groups according to the presence or absence of diabetic complications: with and without diabetic nephropathy (DN), advanced DN, chronic kidney disease (CKD) stages 3 to 5 and proliferative diabetic retinopathy (PDR). RESULTS: The allelic distribution of the three studied polymorphisms was consistent with Hardy-Weinberg equilibrium. The presence of at least one T allele of GCLC 129 C/T was an independent risk factor for advanced DN (OR = 2.82 ; CI 95% = 1.13 -7.05; p = 0.026), for DN (OR = 3.64; CI 95% = 1.27 10.36; p = 0.016) and for CKD stages 3 to 5 (OR = 5.74; CI 95% = 2.17 15.1; p < 0.001) and the presence of at least one C allele of GPX3 -65 T/C was an independent risk factor for advanced DN (OR = 2.62; IC 95% = 1.19 -5.72, p = 0.022) in the studied population. There were no associations between GCG trinucleotide repeats of GPX1 and diabetic complications. The haplotype CC_TT, composed by GCLC and GPX3 wild type alleles, was negatively related to advanced DN (OR = 0.32, CI 95% = 0.15 0.66; p = 0.002) and CKD (OR = 0.25; CI 95% = 0.11 0.55; p = 0.001). CONCLUSIONS: the presence of at least one T allele of -129C/T polymorphism of GCLC and one C allele of -65 T/C polymorphism of GPX3, both associated to a lower transcriptional activity of its genes, conferred risk for renal complications in the studied population.

INTRODUÇÃO: A retinopatia diabética (RD) é uma das complicações mais frequentes dos diabetes mellitus tipo 1 (DM1). Durante a hiperglicemia, as células endoteliais da retina são expostas a altas concentrações de glicose e são incapazes de conter seu influxo. Isso resulta na ativação de vias deletérias intracelulares que culminam com o aumento de espécies reativas de oxigênio (ROS) e lesão neuronal e vascular. O estado pró inflamatório e pró trombótico ativa vias pró-oxidantes como a da NADPH oxidase. O excesso de ROS não é devidamente tamponado pelas vias antioxidantes (tais como as vias da glutationa e da tiorredoxina) em situações de hiperglicemia crônica, o que contribui para perpetuar o dano. OBJETIVO: Caracterizar uma população de pacientes DM1 quanto ao grau de RD e analisar a associação desta complicação microvascular com cinco polimorfismo de um único nucleotídeo (SNP) em genes pertencentes a vias pró- e antioxidantes. MÉTODOS: Pacientes acompanhados no ambulatório de diabetes de dois hospitais terciários do estado de São Paulo foram submetidos a fotos digitais do fundo de olho que incluíam os sete campos padronizados no estudo Early Treatment Diabetic Retinopathy Study (ETDRS) ou a uma oftalmoscopia binocular indireta; ambos foram avaliados por um único oftalmologista em cada um dos hospitais. A genotipagem dos SNPs foi feita por reação em cadeia de polimerase após transcrição reversa com duas sondas marcadas para cada reação. Os seguintes SNPs foram estudados: rs713041 (gene GPX4), rs17883901 (gene GCLC), rs6610650 (gene CYBB), -675 T/A (gene CYBA) e rs7211 (gene TXNIP). Os dados clínicos foram coletados por consulta ao prontuário médico ou questionário. Foi utilizado o modelo de regressão logística nominal politômica, tendo como categoria de referência a ausência de RD (ARD) ou dicotômica, tendo como categorias de referência a ausência de RD proliferativa (RDP) ou ARD. Após correção de Bonferroni, um valor de p <= 0,02 foi considerado significante. RESULTADOS: Um total de 341 pacientes (62% mulheres; idade média de 35 [±11] anos; com 22 [±9] anos de duração do DM1 e HbA1c de 8,6% [±1,6]) foi incluído. A prevalência de RDP foi de 30%, enquanto 42% dos pacientes apresentavam RD não proliferativa (RDNP). Somente os SNPs cuja distribuição dos genótipos respeitou o equilíbrio de Hardy-Weinberg foram analisados. Após ajuste para potenciais fatores de confusão, a presença do alelo T no SNP rs713041 (+718 C/T) no GPX4 foi inversamente associada à prevalência de RDP em pacientes do sexo feminino, com um odds ratio (OR) de 0,36 (intervalo de confiança [IC] de 95% de 0,17 a 0,75; p = 0,007) na análise dicotômica de RDP versus ausência de RDP. A presença do alelo T no SNP rs17883901 (-129 C/T) no GCLC conferiu risco para RDP na análise politômica (OR de 4,23; IC 95% de 1,38 a 12,93; p=0,01) e conferiu risco para a presença de qualquer grau de RD na análise dicotômica (ARD versus RDNP + RDP; OR de 3,07; IC 95% de 1,22 a 8,95; p=0,02). Não houve associação entre o SNP rs6610650 (gene CYBB) e RD nessa população. CONCLUSÃO: Os SNPs funcionais rs713041 no GPX4 e rs17883901 no GCLC modularam a susceptibilidade a RD na população de pacientes com DM1 estudada / INTRODUCTION: Diabetic retinopathy (DR) is one of the most frequent complications of type 1 diabetes mellitus (T1D). During hyperglycemia, retinal endothelial cells are exposed to high glucose concentrations and are unable to contain their influx. This results in the activation of deleterious intracellular pathways that culminate with the increase of reactive oxygen species (ROS) and neuronal and vascular injury. The pro-inflammatory and prothrombotic state activates pro-oxidant pathways such as NADPH oxidase. The excess of ROS is not adequately buffered by the antioxidant pathways (such as glutathione and thioredoxin pathways) in situations of chronic hyperglycemia, which contributes to perpetuate the damage. OBJECTIVE: To characterize a population of T1D patients regarding DR degree and to analyze the association of this microvascular complication with five single nucleotide polymorphisms (SNP) in genes belonging to pro- and antioxidant pathways. METHODS: Patients followed at the diabetes outpatient clinic of two tertiary hospitals in the state of São Paulo were submitted to digital photos of the eye fundus that included the seven fields standardized in the Early Treatment Diabetic Retinopathy Study (ETDRS) or to binocular indirect ophthalmoscopy; both were evaluated by a single ophthalmologist in each one of the hospitals. SNP genotyping was performed by polymerase chain reaction after reverse transcription with two labeled probes for each reaction. The following SNPs were studied: rs713041 (GPX4 gene), rs17883901 (GCLC gene), rs6610650 (CYBB gene), -675 T/A (CYBA gene) and rs7211 (TXNIP gene). The clinical data were collected by consulting the medical chart or by questionnaire. The polytomous nominal logistic regression model was used, having as reference category the absence of DR (ADR) or the dichotomous nominal logistic regression model was used, having as reference categories the absence of proliferative DR (PDR) or ADR. After Bonferroni correction, a p value <= 0.02 was considered significant. RESULTS: A total of 341 patients (62% female; mean age of 35 [± 11] years-old; diabetes duration of 22 [± 9] years and HbA1c of 8.6% [± 1.6]) was included. The prevalence of PDR was 30%, while 42% of the patients had non-proliferative DR (NPDR). Only SNPs whose distribution of genotypes respected the Hardy-Weinberg equilibrium were analyzed. After adjusting for potential confounding factors, the presence of the T allele at rs713041 (+718 C/T) in GPX4 was inversely associated with the prevalence of PDR in female patients, with an odds ratio (OR) of 0.36 (95% confidence interval [CI] 0.17-0.75; p = 0.007) in the dichotomous analysis of PDR versus absence of PDR. The presence of the T allele at rs17883901 (-129 C/T) in GCLC conferred risk for PDR in the polytomous analysis (OR of 4.23; 95% CI 1.38 to 12.93; p = 0.01) and for any degree of DR in the dichotomous analysis (ADR versus NPDR + PDR; OR of 3.07; 95% CI 1.22-8.95; p = 0.02). There was no association between the SNP rs6610650 (CYBB gene) and DR in this population. CONCLUSION: The functional SNPs rs713041 in GPX4 and rs17883901 in GCLC modulated the susceptibility to DR in the studied population of patients with T1D

Die 12/15-Lipoxygenasen (12/15-LOXs) gehören zu einer heterogenen Klasse Lipid-peroxidierender Enzyme, deren biologische Rolle noch nicht vollständig geklärt ist. Eine Reihe experimenteller Daten deuten darauf hin, dass diese Enzym an Reifungs- und Differenzierungsprozessen beteiligt sind und auch für die Pathogenese verschiedener Erkrankungen (Asthma bronchiale, Entzündung, Atherosklerose) bedeutsam zu sein scheinen. Die Expression von 12/15-LOXs wird in vielen Säugetierzellen durch TH2-Zytokine reguliert und die Zytokin-induzierte Signaltransduktionskaskade verläuft über die Aktivierung van JAK-Kinasen und STAT6. Nach einer Stimulation von A549 Lungenkarzinomzellen mit Interleukin-4 (IL-4) kommt es erst nach 12 Stunden zu einer Hochregulation der 12/15-LOX mRNA Expression. Untersuchungen zum Induktionsmechanismus haben gezeigt, dass Genistein, ein Hemmstoff von Tyrosinkinasen, die Phosphorylierung von STAT6 und dessen Bindung an den Promoter des 12/15-LOX Gens verhinderte. Damit konnte die Induktion der katalytisch aktiven LOX geblockt werden. In Gegensatz dazu verhinderte Zykloheximid, ein spezifischer Hemmstoff der Proteinbiosynthese, die Expression der 12/15-LOX mRNA nicht, Dieses Ergebnis deutet darauf hin, dass die Neusynthese eines Transkriptionsfaktors im Rahmen der IL-4 induzierten Transduktionskaskade unwahrscheinlich ist. Weiterhin wurde beobachtet, dass IL-4 die zelluläre Histonacetyltransferase-Aktivität stark erhöhte und dass dieser Effekt überwiegend auf die enzymatische Aktivität des (CREB-bindenden Protein)-bindenden Proteins (CBP) zurückzuführen ist. Transfektion der Zellen mit E1A, einem viralen Protein, welches als Hemmstoff der Histonacetyltransferase-Aktivität von CBP/p300 bekannt ist, führte zu einer Unterdrückung der 12/15-LOX Expression. Andererseits stimuliert Natriumbutyrat, ein Hemmstoff der Histondeacetylase, die 12/15-LOX Synthese. Damit konnte gezeigt werden, dass die Acetylierung von Histonproteinen und von STAT6 ein essentieller Prozesse bei der IL-4 induzierten 12/15-LOX Expression in A549 Zellen ist. Weiterhin belegen diese Daten, dass sowohl die Phosphorylierung als auch die Acetylierung von STAT6 an der transkriptionellen Aktivierung des 12/15-LOX Gens beteiligt sind, obwohl beide Prozesse eine unterschiedliche Kinetik aufweisen. STAT6 Phosphorylierung erfolgt innerhalb der ersten Stunde nach IL-4 Stimulation, während die Acetylierungsreaktion zeitlich verzögert abläuft. Zusammenfassend kann die Signaltransduktionskaskade, die in A549 Zellen zur Expression der 12/15-LOX führt, wie folgt beschrieben werden: IL-4 induziert über die Aktivierung von JAK-Kinasen eine Phosphorylierung von STAT6, dessen Bindung an den 12/15-LOX Promotor jedoch zunächst durch nicht-acetylierte Histonproteine verhindert wird. Nach 9-11 Stunden werden Histone und der phosphorylierte STAT6 durch die Acetyltransferase-Aktivität von CBP/p300 acetyliert. Diese Reaktion führt zu einer Veränderung der Histonstruktur, wodurch die Bindung von modifizierten STAT6 und damit die Expression des 12/15-LOX Gens ermöglicht wird. Als wesentliche zellphysiologische Konsequenz der IL-4 induzierten 12/15-LOX Expression in A549 Zellen, wurde eine Apoptoseinduktion beobachtet. Das endogene 12/15-LOX Produkt 15-HETE bindet an den Kernrezeptor PPARg und induziert damit den programmierten Zelltod. Vorinkubation von A549 Zellen mit dem LOX-Hemmstoff NDGA oder der Einsatz von PPARg Dominant Negativ Vektor verhinderten die Apoptose. Mechanistische Untersuchungen zum Ablauf des durch IL-4 induzierten Zelltodes zeigten, dass der Prozess überwiegend dem extrinsischen Mechanismus folgt, bei dem Kaspasen-8 direkt zu einer Aktivierung der Effektorkaspase-3 führt. Der mitochondriale Mechanismus (Spaltung von Bid bzw. initiale Cytochrom C Freisetzung) scheint dabei nicht involviert zu sein. Die IL-4 induzierte Apoptose könnte von patho-physiologischer Bedeutung für den Verlauf von Lungenerkrankungen sein, bei denen Zellen mit hoher konstitutiver 12/15-LOX Expression, z.B. eosinophile Granulozyten, beteiligt sind. Hepoxiline sind bioaktive Mediatoren des 12/15-LOX Weges der Arachidonsäurekaskade, die durch Isomerisierung des primären Oxygenierungsproduktes 12S-HpETE gebildet werden. Zu Beginn unserer Untersuchungen war überwiegend unklar, welche Enzyme an der Isomerisierungsreaktion beteiligt sind. Bei der Suche nach geeigneten zellulären Modellen für die Untersuchung dieser Fragestellung fanden wir heraus, dass in den Ratteninsulinom-Zellen Rinm5F, die wegen ihres Mangels an Glutathionperoxidasen eine geringe Kapazität zur Reduktion von 12S-HpETE aufweisen, die Synthese von Hepoxilin A3 (HXA3) besonders hoch ist. Da wir vermuteten, dass 12/15-LOXs für die Isomerisierung von 12S-HpETE zu HXA3 verantwortlich sein könnten, verfolgten wir eine duale Forschungsstrategie um experimentelle Hinweise für unsere Arbeitshypothese zu finden. In den 12/15-LOX exprimierenden Rinm5F Zellen führte eine Immunopräzipitation mit 12/15-LOX spezifischen Antikörper zu einen vollständigen Verlust der 12/15-LOX- und der Hepoxilinsynthase-Aktivität eines Zelllysates. Beide Aktivitäten wurden fast vollständig im Immunopräzipitat wiedergefunden. 2. Transfektion von HeLa Zellen, die selbst keine 12/15-LOX exprimieren, mit 12/15-LOX und gleichzeitige Hemmung der zellulären Glutathionperoxidasen (Depletion von GSH mit Diethlmaleat) führte zu einer deutlichen zellulären Hepoxilinsynthese. Bei entsprechenden Kontrolltransfektanten wurde diese Aktivität nicht beobachtet. Weiterhin konnte festgestellt werden, dass rekombinante 12/15-LOXs (Expression in E. coli) in vitro eine intrinsische Hepoxinsynthase-Aktivität aufweisen, wenn 12S-HpETE als Substrat angeboten wird. Diese Daten belegen, dass 12/15-LOXs neben den bisher beschriebenen katalytischen Aktivitäten (Oxygenase, Hydroperoxidase, Leukotrienesynthase) auch Hepoxilinsynthase-Aktivität aufweisen. / 12/15-Lipoxygenases (human 15-LOX-1, rat 12/15-lipoxygenase) belong to family of lipid peroxidising enzymes. The enzyme has been implicated with roles in a variety of pathological conditions such as asthma, atherosclerosis, inflammation and in cellular differentiation. The enzyme expression in most human cell types is tightly regulated by Th2 cytokines, interleukin-4 (IL-4) and interleukin-13 (IL-13). Interleukin-4 (IL-4) induces expression of reticulocyte-type 15-lipoxygenase-1 (15-LOX-1) in various mammalian cells via the Janus kinase/signal transducer and activator of transcription 6 (STAT6) signaling system. 15-LOX-1 mRNA expression was first observed only 12h post IL-4 stimuation and required a minimum of 11h exposure to the cytokine. The mechanism of 15-LOX-1 induction in A549 lung epithelial cells and the observed delay was studied and it was found that genistein, a potent tyrosine kinase inhibitor, prevented phopsphorylation of STAT6, its binding to the 15-LOX-1 promoter, and the expression of catalytically active enzyme. In contrast, cycloheximide did not prevent 15-LOX-1 induction. Surprisingly, it was observed that IL-4 up-regulated the histone acetyltransferase activity of CREB-binding protein (CBP)/p300, which is responsible for acetylation of nuclear histones and STAT6. The acetylation of both proteins appears to be essential for the IL-4-induced signal transduction cascade, because inhibition of CBP/p300 by the viral wild-type E1A oncoprotein abrogated acetylation of both histones and STAT6 and strongly suppressed transcriptional activation of the 15-LOX-1 gene. Moreover, the inhibition by sodium butyrate of histone deacetylases, which apparently suppress 15-LOX-1 gene transcription, synergistically enhanced the IL-4-stimulated 15-LOX-1 expression. These data suggest that both phosphorylation and acetylation of STAT6 as well as acetylation of nuclear histones are involved in transcriptional activation of the 15-LOX-1 gene, although these reactions follow differential kinetics. STAT6 phosphorylation proceeds within the first hour of IL-4 stimulation. In contrast, CBP/p300-mediated acetylation requires 9-11 h, and similar kinetics were observed for the expression of the active enzyme. Thus, the results suggest that in the absence of IL-4, nuclear histones may be bound to regulatory elements of the 15-LOX-1 gene, preventing its transcription. IL-4 stimulation causes rapid phosphorylation of STAT6, but its binding to the promoter appears to be prevented by nonacetylated histones. After 9-11 h, when histones become acetylated, STAT6 binding sites may be demasked so that the phosphorylated and acetylated transcription factor can bind to activate gene transcription. The proinflammatory cytokine IL-4 is secreted in large amounts during allergic inflammatory response in asthma and plays a pivotal role in the airway inflammation. IL-4 has been shown to up-regulate 15-lipoxygenase and produce 15(S)-hydroxyeicosatetraenoic acid (15(S)-HETE) in A549 cells via the Janus kinase/STAT6 pathway under coactivation of CREB binding protein/p300. IL-4 has also been shown to up-regulate peroxisome proliferator-activated receptor (PPARg ) nuclear receptors in macrophages and A549 cells. In this study it is observed that 15(S)-HETE binds to PPARg nuclear receptors and induces apoptosis in A549 cells. Moreover, pre-treatment of cells with nordihydroguaiaretic acid, a 15-lipoxygenase inhibitor, prevented PPARg activation and apoptosis. The latter was accomplished by the interaction of the 15(S)-HETE/PPARg complex with the adapter protein Fas-associating protein with death domain and caspase-8, as shown by transfection of Fas-associating protein with death domain dominant negative vector and cleavage of caspase 8 to active subunits p41/42 and p18. Whereas IL-4 and PPARg ligands failed to induce cleavage of Bid and release of cytochrome c from mitochondria, they caused translocation of the proapoptotic protein Bax from cytoplasm to mitochondria with a concomitant decrease in the Bcl-XL level. The cells were, thereofre, observed to follow the extrinsic pathway of apoptosis where caspase-8 directly activates the effector caspase-3, bypassing the mitochondria. The data also suggests that in IL-4-stimulated cells the 15(S)-HETE/PPARg complex down-regulates Bcl-XL, and the translocation of Bax to the mitochondria commits the cell to apoptosis. The IL-4-induced apoptosis may contribute to severe loss of alveolar structures and infiltration of eosinophils, mononuclear phagocytes, etc., into the lung tissue as observed in chronic asthma patients. The 12(S)-lipoxygenase (12-LOX) pathway of arachidonic acid (AA) metabolism after dioxygenation to 12(S)-hydroperoxy-eicosatetraenoic acid is bifurcated in a reduction route to formation of 12(S)-hydroxy-eicosatetraenoic acid (12-HpETE) and an isomerization route to formation of hepoxilins. Interestingly, rat insulinoma RINm5F cells, which are devoid of cytoplasmic glutathione peroxidase (cGPx)/phospholipid hydroperoxide glutathione peroxidase (PHGPx), were observed to produce solely hepoxilin A3 (HXA3). Since HXA3 synthesis was abolished in heat-denatured or cGPx- or PHGPx-transfected cells, suggesting that a HXA3 synthase activity regulated by cGPx/PHGPx is present. To confirm this assumption AA was incubated with HeLa cells overexpressing the rat 12/15-LOX. Neither HXA3 nor 12(S)-HETE were detected due to abundance of cGPx/PHGPx. But, pretreatment of transfected cells with diethyl maleate, an inhibitor of glutathione and PHGPx, restored HXA3 synthase and 12-LOX activities. Moreover, recombinant rat 12/15-LOX produced HXA3 when incubated with 12-HpETE. Further confirmation was obtained by immunoprecipitation with 12/15-LOX specific antibodies. Immunoprecipitation of Rinm5F lysates results in the depletion of hepoxilin synthase activity. The hepoxilin synthase activity was localised in the immunoprecipitated protein. Thus, cells containing rat 12/15-LOX also possess an intrinsic HXA3 synthase activity, which is activated by inhibition of cGPx/PHGPx. In normal cells HXA3 is down-regulated by cGPx/PHGPx, but, it is persistently activated in oxidatively stressed cells deficient in cGPx/PHGPx, such as Rinm5F. Furthermore, formation of corresponding epoxyhydroxy products was observed when 15-HpETE was used as substrate, indicating a broad range of specificity for the enzyme.

Improvement in the in vitro oxidative folding of disulfide-containing proteins, such as extracellular and pharmaceutically important proteins, is required. Traditional folding methods using small molecule aliphatic thiol and disulfide, such as glutathione (GSH) and glutathione disulfide (GSSG) are slow and low yielding. Small molecule aromatic thiols and disulfides show great potentiality because aromatic thiols have low pKa values, close to the thiol pKa of protein disulfide isomerase (PDI), higher nucleophilicity and good leaving group ability. Our studies showed that thiols with a positively charged group, quaternary ammonium salts (QAS), are better than thiols with negatively charged groups such as phosphonic acid and sulfonic acid for the folding of bovine pancreatic trypsin inhibitor (BPTI). An enhanced folding rate of BPTI was observed when the protein was folded with a redox buffer composed of a QAS thiol and its corresponding disulfide. Quaternary ammonium salt (QAS) thiols and their corresponding disulfides with longer alkyl side chains were synthesized. These QAS thiols and their corresponding disulfides are promising small molecule thiols and disulfides to fold reduced BPTI efficiently because these thiols are more hydrophobic and can enter the core of the protein. Conformational changes of disulfide-containing proteins during oxidative folding influence the folding pathway greatly. We performed the folding of BPTI using targeted molecular dynamics (TMD) simulation and investigated conformational changes along with the folding pathway. Applying a bias force to all atoms versus to only alpha carbons and the sulfur of cysteines showed different folding pathways. The formation of kinetic traps N' and N* was not observed during our simulation applying a bias force to all atoms of the starting structure. The final native conformation was obtained once the correct antiparallel β-sheets and subsequent Cys14-Cys38 distance were decreased to a bond distance level. When bias force was applied to only alpha carbons and the sulfur of cysteines, the distance between Cys14-Cys38 increased and decreased multiple times, a structure similar to the confirmation of N*, NSH were formed and native protein was ultimately obtained. We concluded that there could be multiple pathways of conformational folding which influence oxidative folding.

Στόχος της παρούσας μελέτης ήταν να μελετήσει αν το εκχύλισμα των στιγμάτων του Crocus sativus L. αναστέλλει την επαγόμενη από σεληνιώδες νάτριο ανάπτυξη καταρράκτη σε ένα in vivo πείραμα με νεογνά επίμυων του γένους Wistar. Μέθοδοι: Τα νεογνά των επίμυων κατατάχθηκαν τυχαία σε 3 ομάδες. Ομάδα Ι (ομάδα μαρτύρων) όπου χορηγήθηκε υποδόρια φυσιολογικός ορός τη 10η ημέρα της ζωής. Ομάδα ΙΙ (ομάδα σεληνιώδους νατρίου) στην οποία χορηγήθηκε υποδόρια σεληνιώδες νάτριο (20 µmol/kg σωματικού βάρους) τη 10η ημέρα της ζωής. Ομάδα ΙΙΙ (ομάδα σεληνιώδους νατρίου και εκχυλίσματος στιγμάτων Crocus sativus L.) στην οποία εκτός από το σεληνιώδες νάτριο τη 10η ημέρα της ζωής χορηγήθηκε και εκχύλισμα στιγμάτων του Crocus sativus L. (60 mg/kg σωματικού βάρους) την 9η και 12η ημέρα της ζωής. Την 21η ημέρα της ζωής οι επίμυες θυσιάστηκαν και οι κρυσταλλοειδείς φακοί απομονώθηκαν και εξετάστηκαν για την εμφάνιση καταρράκτη. Ακολούθησε προσδιορισμός στους κρυσταλλοειδείς φακούς της δραστικότητας των αντιοξειδωτικών ενζύμων δισμουτάση του σουπεροξειδίου (SOD), της υπεροξειδάσης της γλουταθειόνης (GPx) καθώς και της καταλάσης (CAT). Προσδιορίστηκαν επίσης τα επίπεδα της γλουταθειόνης στους φακούς. Επιπλέον, μετρήθηκαν τα επίπεδα της μηλονικής διαλδεΰδης (MDA), ως δείκτη υπεροξείδωσης των λιπιδίων, καθώς και η συγκέντρωση των ελεύθερων σουλφυδρυλομάδων, ως δείκτη οξειδωτικής βλάβης των πρωτεϊνών, στους κρυσταλλοειδείς φακούς των επίμυων. Η επίδραση των χορηγούμενων παραγόντων στο πρωτεϊνικό προφίλ των φακών εκτιμήθηκε μέσω προσδιορισμού του λόγου των υδατοδιαλυτών προς τις μη υδατοδιαλυτές πρωτεΐνες του φακού. Τέλος έγινε ανάλυση των υδατοδιαλυτών πρωτεϊνών με ηλεκτροφόρηση σε πήκτωμα πολυακρυλαμιδίου. Αποτελέσματα: Το εκχύλισμα αποξηραμένων στιγμάτων του Crocus sativus L. επέδειξε σημαντική προστασία έναντι στην επαγόμενη από σεληνιώδες νάτριο καταρρακτογένεση στο in vivo πειραματικό μοντέλο που χρησιμοποιήσαμε. Οι μέσες τιμές των δραστικοτήτων των αντιοξειδωτικών ενζύμων SOD, GPx, CAT καθώς και της συγκέντρωσης της γλουταθειόνης αυξήθηκαν σημαντικά στην ομάδα που έλαβε εκχύλισμα στιγμάτων του Crocus sativus L. σε σύγκριση με την ομάδα των επίμυων που δέχθηκε μόνο την τοξική δράση του σεληνιώδους νατρίου. Το εκχύλισμα των στιγμάτων του Crocus sativus L. απέτρεψε σε σημαντικό βαθμό την υπεροξείδωση των λιπιδίων καθώς και την οξειδωτική βλάβη στις πρωτεΐνες του φακού. Επίσης απέτρεψε την πρωτεόλυση των υδατοδιαλυτών πρωτεϊνών του φακού. Συμπεράσματα: Χορήγηση εκχυλίσματος αποξηραμένων στιγμάτων του Crocus sativus L. απέτρεψε την επαγόμενη από το σεληνιώδες νάτριο καταρρακτογένεση σε νεογνά επίμυων του γένους Wistar πιθανώς μέσω ενίσχυσης της αντιοξειδωτικής άμυνας του κρυσταλλοειδούς φακού, μέσω αναστολής του βαθμού της υπεροξείδωσης των λιπιδίων, μέσω προστασίας των σουλφυδρυλομάδων των πρωτεϊνών καθώς και μέσω αναστολής της πρωτεόλυσης των υδατοδιαλυτών πρωτεϊνών του φακού. Αυτά τα ευρήματα τονίζουν τις πιθανές αντικαταρρακτογενετικές δράσεις των αποξηραμένων στιγμάτων του Crocus sativus L. οι οποίες αποδίδονται στις αντιοξειδωτικές τους ιδιότητες. / The present study sought to investigate whether Crocus sativus L. stigmas extract prevents selenite-induced cataractogenesis in vivo and to study the possible protective mechanism. Methods: Wistar rat pups were randomized into 3 groups. Group I (control) received subcutaneous injection of normal saline on postnatal day 10. Groups II (selenite treated) and III (selenite and Crocus sativus L. treated) received subcutaneous injection of sodium selenite (20 µmol/kg body weight) on postnatal day 10. Group III received intraperitoneal injections of Crocus sativus L. stigmas extract (60 mg/kg body weight) on postnatal days 9 and 12. On postpartum day 21, rats were sacrificed and the lenses were isolated and examined for cataract formation. Activities of superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) and glutathione levels, as markers of antioxidant defense, were measured in the isolated lenses. Levels of the indicator of lipid peroxidation, malondialdehyde (MDA), and protein oxidation (sulfhydryl content) in lens were also determined. Effect of the different treatments on lens’ protein profile was evaluated with the estimation of soluble to insoluble protein ratio and SDS-PAGE analysis of water-soluble fraction (WSF) of lens proteins. Results: Crocus sativus L. stigmas extract demonstrated significant protection against selenite-induced cataractogenesis in vivo. The mean activities of SOD, GPx, CAT and glutathione levels were significantly increased in group III compared to the selenite-treated group. Crocus sativus L. stigmas extract significantly prevented selenite-induced lipid peroxidation, protein oxidation, as well as proteolysis and insolubilization of the lens WSF. Conclusions: Crocus sativus L. stigmas extract prevented selenite-induced cataract formation in Wistar rats possibly by reinforcement of antioxidant status, reduction of the intensity of lipid peroxidation, protection of the sulfhydryl groups, and inhibition of proteolysis of the lens WSF. These findings highlight the anti-cataractogenic potential of Crocus sativus L. stigmas by virtue of their antioxidant properties.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / Oxidative stress is an important molecular mechanism of lead (Pb) toxicity. The thioredoxin system (selenoenzyme thioredoxin reductase-TrxR, thioredoxin protein- Trx and NADPH) is essential for the antioxidant defense and cellular redox control. In our previous study, it was showed that cytosolic renal TrxR1 activity of rats increased after acute and long-term exposure to Pb and this was the only parameter that changed after both exposures to low Pb doses. Then, it was suggested that TrxR1 could operate in the early defense against Pb toxicity and it could also be used as a bioindicator of early effects of Pb. Thus, the main objective of this thesis was to investigate the role of thioredoxin system in Pb-induced changes, evaluating: I) in vitro the activity of purified TrxR1, as well as the activity and the protein expression of TrxR1 and Trx1 in renal HEK 293 culture cells exposed to Pb; II) in vivo, the effects of Pb exposure in rats and in occupationally-exposed humans on renal (only in rats) and blood TrxR1 activity (both rats and humans), comparing these effects to oxidative stress parameters, as well as to classical bioindicators of Pb effect and exposure. The results of the in vitro study showed that lead is a less potent inhibitor of the purified TrxR1 activity (IC50 = 0.27 TM) than its structural homologous glutathione reductase (IC50 = 0.048 TM). TrxR1 inhibition was independent on the selenocysteine residue of the active site and was reversible by bovine serum albumin and by the EDTA chelating. TrxR1 inhibition also occurred in HEK 293 cells exposed to the highest Pb acetate concentration (60 TM), without alterations in protein expression. However, under glutathione (GSH) depletion after pre-incubation of cells with L-buthionine-[S,R]-sulfoximine (BSO) and further exposure to Pb, the activity and expression of both TrxR1 and Trx1 increased in the absence of cytotoxicity and of changes in GR and glutathione S-transferase activities, which indicates Trx system as an important protective mechanism against Pb toxic effects in GSH-depleted cells. On the other hand, blood TrxR1 activity did not change either after acute exposure of rats or long-term exposure of humans to Pb. However, the increase of renal TrxR1 activity in rats exposed to the highest dose of Pb acetate (25 mg/kg) occurred concomitantly with the increase of blood and renal Pb levels over time (6, 24 e 48 h), whereas the erythrocyte δ-ALA-D inhibition, which is a classical indicator of Pb effects, occurred after 6 h of exposure and the activity was further recovered (at 24 and 48 h). Moreover, the increase of renal TrxR1 activity occurred without renal histopathologycal damage, which corroborates the increase of this enzyme as an early event of Pb toxicity. Overall, the results of the current study point out the thioredoxin system as a target for Pb, but mainly as a protective mechanism against Pb toxicity. However, the absence of changes in blood TrxR1 activity in Pb-exposed animals and humans indicates that this enzyme is not an appropriate bioindicator of the toxic effects of Pb in exposed populations. / O estresse oxidativo é um importante mecanismo molecular da toxicidade do chumbo (Pb). O sistema da tiorredoxina (selenoenzima tiorredoxina redutase -TrxR, proteína tiorredoxina -Trx e NADPH) é essencial na defesa antioxidante e no controle redox celular. Em nosso estudo prévio, foi demonstrado que a atividade da enzima TrxR1 (citosólica) renal de ratos aumentou na exposição aguda e prolongada ao Pb, sendo o único parâmetro alterado em ambas exposições a doses baixas de Pb. Assim, foi sugerido que a TrxR1 atuaria precocemente na defesa contra a toxicidade do metal, podendo também ser utilizada como um bioindicador dos efeitos precoces do Pb. Assim, o objetivo geral desta tese foi investigar o papel do sistema da tiorredoxina nas alterações induzidas pelo Pb, avaliando: I) in vitro a atividade da TrxR1 purificada, bem como a atividade e expressão protéica da TrxR1 e Trx1 em culturas de células renais HEK 293 expostas ao Pb e II) in vivo, os efeitos do Pb em ratos e em humanos ocupacionalmente expostos ao Pb sobre a atividade da TrxR1 renal (somente em ratos) e sanguínea (ratos e humanos), comparando esses efeitos com parâmetros de estresse oxidativo, bem como com indicadores clássicos de efeito e de exposição ao Pb. Os resultados do estudo in vitro mostraram que a atividade da enzima TrxR1 purificada foi inibida pelo Pb (IC50 = 0.27 TM) de forma menos potente que a sua homóloga estrutural glutationa redutase (IC50 = 0.048 TM). Essa inibição foi independente do resíduo de selenocisteína do sítio ativo da TrxR1 e foi revertida pela albumina sérica bovina e pelo quelante EDTA. A inibição da TrxR1 também ocorreu em células HEK 293 expostas à maior concentração de acetato de Pb (60 TM), sem alterações na expressão protéica. Entretanto, quando os níveis celulares de glutationa (GSH) foram depletados por pré incubação das células com L-butionina-[S,R]-sulfoximina (BSO) e posterior exposição ao Pb, a atividade e a expressão da TrxR1 e da Trx1 aumentaram na ausência de citotoxicidade e de alterações nas atividades da GR e glutationa S-transferase, apontando esse sistema como um importante mecanismo contra a toxicidade do Pb em células sob depleção de GSH. Por outro lado, a atividade da TrxR1 sanguínea não alterou na exposição aguda de ratos e prolongada de humanos ao Pb. No entanto, o aumento da atividade da TrxR1 renal em ratos expostos à maior dose de acetato de Pb (25 mg/kg) foi concomitante com o aumento dos níveis sanguíneos e renais de Pb ao longo do tempo (6, 24 e 48 h), enquanto que a inibição da enzima δ-ALA-D eritrocitária, um indicador clássico de efeito do Pb, ocorreu após 6 h de exposição, sendo sua atividade restabelecida posteriormente (24 e 48 h). Além disso, o aumento da atividade da TrxR1 renal ocorreu sem danos histopatológicos renais, confirmando essa alteração como um evento precoce da toxicidade do Pb. Em geral, os resultados do presente estudo apontam o sistema da tiorredoxina como alvo do Pb, mas principalmente como um mecanismo de proteção contra o metal. Entretanto, a ausência de alterações na atividade da TrxR1 sanguínea em animais e humanos expostos ao Pb, indica que essa enzima não é um bioindicador adequado dos efeitos tóxicos do Pb em populações expostas.

INTRODUÇÃO: acredita-se que o controle glicêmico inadequado, a duração do diabetes melito (DM) e a presença de hipertensão arterial e dislipidemia sejam os fatores de risco mais importantes para o desenvolvimento das complicações microvasculares no DM, contudo, existem inúmeras evidências sugerindo que uma predisposição genética participe da suscetibilidade para o desenvolvimento dessas complicações. Vários genes relacionados aos mecanismos dos danos induzidos pela hiperglicemia têm sido investigados. O papel do estresse oxidativo na patogênese das complicações crônicas do DM vem sendo demonstrado e os genes que codificam enzimas que participam dos mecanismos antioxidantes são candidatos a conferirem suscetibilidade ou proteção contra as complicações crônicas. A glutationa é um dos mais importantes antioxidantes endógenos; no entanto, a associação entre polimorfismos em genes que codificam enzimas que participam desse sistema e complicações crônicas do DM foi pouco explorada na literatura. OBJETIVOS: avaliar a associação de polimorfismos em três genes que codificam enzimas relacionadas ao metabolismo da glutationa com o desenvolvimento de nefropatia e retinopatia em pacientes diabéticos tipo 1. Foram estudados: o polimorfismo -129C/T do gene GCLC, o número de repetições do trinucleotídeo GCG no exon 1 do gene GPX1 e o polimorfismo -65T/C do gene GPX3. CASUÍSTICA E MÉTODOS: 299 pacientes (139 do gênero masculino e 160 do gênero feminino) com DM tipo 1 com mais de 15 anos de diagnóstico e mau controle glicêmico foram divididos conforme presença ou ausência das seguintes complicações: nefropatia diabética (ND) avançada, ND, doença renal crônica (DRC) estágios 3 a 5 e retinopatia diabética proliferativa (RDP). Em cada grupo foram avaliadas as freqüências das variantes alélicas dos três genes estudados. RESULTADOS: a distribuição dos genótipos na população estudada foi consistente com o equilíbrio de Hardy-Weinberg para os três genes analisados. A presença de pelo menos um alelo T do polimorfismo -129C/T do gene GCLC conferiu risco independente para a presença de ND avançada (OR = 2,82 ; IC 95% = 1,13 - 7,05; p = 0,026), para ND (OR = 3,64; IC 95% = 1,27 10,36; p = 0,016) e para DRC estágios 3 a 5 (OR = 5,74; IC 95% = 2,17 15,1; p < 0,001) e a presença de pelo menos um alelo C do polimorfismo -65 T/C conferiu risco independente para a presença de ND avançada (OR = 2,62; IC 95% = 1,19 -5,72, p = 0,022) na população estudada. Não houve associação do número de repetições do trinucleotídeo GCG do gene GPX1 com nenhuma das complicações estudadas. O haplótipo CC_TT, composto pelos alelos selvagens dos genes GCLC e GPX3, foi negativamente associado com ND avançada (OR = 0,32, IC 95% = 0,15 0,66; p = 0,002) e DRC (OR = 0,25; IC 95% = 0,11 - 0,55; p = 0,001). CONCLUSÕES: a presença de pelo menos um alelo T do polimorfismo -129 C/T do gene GCLC e de pelo menos um alelo C do polimorfismo -65 T/C do gene GPX3, ambos associados a uma menor atividade transcricional do respectivo gene, conferiram risco para a presença de complicações renais na população de pacientes estudada. / INTRODUCTION: glycemic control, diabetes duration, systemic hypertension and dyslipidemia have been implicated as main risk factors for the development of diabetic microangiopathy, however there is evidence suggesting that genetic predisposition plays a role in the susceptibility to microvascular complications. Based on underlying pathogenesis, polymorphisms of several genes belonging to multiple pathways have been investigated, like the genes related to mechanisms of hyperglycemia-induced damage. The role of oxidative stress in the pathogenesis of diabetic complication has been increasingly demonstrated and genes coding enzymes involved in antioxidant defense are candidates to confer susceptibility or protection against these complications. Glutathione is one the most important endogen antioxidants, however, the association between polymorphisms in genes related to glutathione metabolism and diabetic complications has not been deeply investigated. OBJECTIVES: to study the association between polymorphisms in three genes which code enzymes related to glutathione metabolism and the development of nephropathy and retinopathy in type 1 diabetic patients: the polymorphism -129 C/T of GCLC, the number of trinucleotide GCG repeats at exon 1 of GPX1 and the polymorphism -65 T/C of GPX3. CASUISTIC AND METHODS: 299 type 1 diabetic patients (139 male and 160 female) with at least 15 years from diagnosis and poor glycemic control were studied. The patients were divided in two groups according to the presence or absence of diabetic complications: with and without diabetic nephropathy (DN), advanced DN, chronic kidney disease (CKD) stages 3 to 5 and proliferative diabetic retinopathy (PDR). RESULTS: The allelic distribution of the three studied polymorphisms was consistent with Hardy-Weinberg equilibrium. The presence of at least one T allele of GCLC 129 C/T was an independent risk factor for advanced DN (OR = 2.82 ; CI 95% = 1.13 -7.05; p = 0.026), for DN (OR = 3.64; CI 95% = 1.27 10.36; p = 0.016) and for CKD stages 3 to 5 (OR = 5.74; CI 95% = 2.17 15.1; p < 0.001) and the presence of at least one C allele of GPX3 -65 T/C was an independent risk factor for advanced DN (OR = 2.62; IC 95% = 1.19 -5.72, p = 0.022) in the studied population. There were no associations between GCG trinucleotide repeats of GPX1 and diabetic complications. The haplotype CC_TT, composed by GCLC and GPX3 wild type alleles, was negatively related to advanced DN (OR = 0.32, CI 95% = 0.15 0.66; p = 0.002) and CKD (OR = 0.25; CI 95% = 0.11 0.55; p = 0.001). CONCLUSIONS: the presence of at least one T allele of -129C/T polymorphism of GCLC and one C allele of -65 T/C polymorphism of GPX3, both associated to a lower transcriptional activity of its genes, conferred risk for renal complications in the studied population.

INTRODUÇÃO: A retinopatia diabética (RD) é uma das complicações mais frequentes dos diabetes mellitus tipo 1 (DM1). Durante a hiperglicemia, as células endoteliais da retina são expostas a altas concentrações de glicose e são incapazes de conter seu influxo. Isso resulta na ativação de vias deletérias intracelulares que culminam com o aumento de espécies reativas de oxigênio (ROS) e lesão neuronal e vascular. O estado pró inflamatório e pró trombótico ativa vias pró-oxidantes como a da NADPH oxidase. O excesso de ROS não é devidamente tamponado pelas vias antioxidantes (tais como as vias da glutationa e da tiorredoxina) em situações de hiperglicemia crônica, o que contribui para perpetuar o dano. OBJETIVO: Caracterizar uma população de pacientes DM1 quanto ao grau de RD e analisar a associação desta complicação microvascular com cinco polimorfismo de um único nucleotídeo (SNP) em genes pertencentes a vias pró- e antioxidantes. MÉTODOS: Pacientes acompanhados no ambulatório de diabetes de dois hospitais terciários do estado de São Paulo foram submetidos a fotos digitais do fundo de olho que incluíam os sete campos padronizados no estudo Early Treatment Diabetic Retinopathy Study (ETDRS) ou a uma oftalmoscopia binocular indireta; ambos foram avaliados por um único oftalmologista em cada um dos hospitais. A genotipagem dos SNPs foi feita por reação em cadeia de polimerase após transcrição reversa com duas sondas marcadas para cada reação. Os seguintes SNPs foram estudados: rs713041 (gene GPX4), rs17883901 (gene GCLC), rs6610650 (gene CYBB), -675 T/A (gene CYBA) e rs7211 (gene TXNIP). Os dados clínicos foram coletados por consulta ao prontuário médico ou questionário. Foi utilizado o modelo de regressão logística nominal politômica, tendo como categoria de referência a ausência de RD (ARD) ou dicotômica, tendo como categorias de referência a ausência de RD proliferativa (RDP) ou ARD. Após correção de Bonferroni, um valor de p <= 0,02 foi considerado significante. RESULTADOS: Um total de 341 pacientes (62% mulheres; idade média de 35 [±11] anos; com 22 [±9] anos de duração do DM1 e HbA1c de 8,6% [±1,6]) foi incluído. A prevalência de RDP foi de 30%, enquanto 42% dos pacientes apresentavam RD não proliferativa (RDNP). Somente os SNPs cuja distribuição dos genótipos respeitou o equilíbrio de Hardy-Weinberg foram analisados. Após ajuste para potenciais fatores de confusão, a presença do alelo T no SNP rs713041 (+718 C/T) no GPX4 foi inversamente associada à prevalência de RDP em pacientes do sexo feminino, com um odds ratio (OR) de 0,36 (intervalo de confiança [IC] de 95% de 0,17 a 0,75; p = 0,007) na análise dicotômica de RDP versus ausência de RDP. A presença do alelo T no SNP rs17883901 (-129 C/T) no GCLC conferiu risco para RDP na análise politômica (OR de 4,23; IC 95% de 1,38 a 12,93; p=0,01) e conferiu risco para a presença de qualquer grau de RD na análise dicotômica (ARD versus RDNP + RDP; OR de 3,07; IC 95% de 1,22 a 8,95; p=0,02). Não houve associação entre o SNP rs6610650 (gene CYBB) e RD nessa população. CONCLUSÃO: Os SNPs funcionais rs713041 no GPX4 e rs17883901 no GCLC modularam a susceptibilidade a RD na população de pacientes com DM1 estudada / INTRODUCTION: Diabetic retinopathy (DR) is one of the most frequent complications of type 1 diabetes mellitus (T1D). During hyperglycemia, retinal endothelial cells are exposed to high glucose concentrations and are unable to contain their influx. This results in the activation of deleterious intracellular pathways that culminate with the increase of reactive oxygen species (ROS) and neuronal and vascular injury. The pro-inflammatory and prothrombotic state activates pro-oxidant pathways such as NADPH oxidase. The excess of ROS is not adequately buffered by the antioxidant pathways (such as glutathione and thioredoxin pathways) in situations of chronic hyperglycemia, which contributes to perpetuate the damage. OBJECTIVE: To characterize a population of T1D patients regarding DR degree and to analyze the association of this microvascular complication with five single nucleotide polymorphisms (SNP) in genes belonging to pro- and antioxidant pathways. METHODS: Patients followed at the diabetes outpatient clinic of two tertiary hospitals in the state of São Paulo were submitted to digital photos of the eye fundus that included the seven fields standardized in the Early Treatment Diabetic Retinopathy Study (ETDRS) or to binocular indirect ophthalmoscopy; both were evaluated by a single ophthalmologist in each one of the hospitals. SNP genotyping was performed by polymerase chain reaction after reverse transcription with two labeled probes for each reaction. The following SNPs were studied: rs713041 (GPX4 gene), rs17883901 (GCLC gene), rs6610650 (CYBB gene), -675 T/A (CYBA gene) and rs7211 (TXNIP gene). The clinical data were collected by consulting the medical chart or by questionnaire. The polytomous nominal logistic regression model was used, having as reference category the absence of DR (ADR) or the dichotomous nominal logistic regression model was used, having as reference categories the absence of proliferative DR (PDR) or ADR. After Bonferroni correction, a p value <= 0.02 was considered significant. RESULTS: A total of 341 patients (62% female; mean age of 35 [± 11] years-old; diabetes duration of 22 [± 9] years and HbA1c of 8.6% [± 1.6]) was included. The prevalence of PDR was 30%, while 42% of the patients had non-proliferative DR (NPDR). Only SNPs whose distribution of genotypes respected the Hardy-Weinberg equilibrium were analyzed. After adjusting for potential confounding factors, the presence of the T allele at rs713041 (+718 C/T) in GPX4 was inversely associated with the prevalence of PDR in female patients, with an odds ratio (OR) of 0.36 (95% confidence interval [CI] 0.17-0.75; p = 0.007) in the dichotomous analysis of PDR versus absence of PDR. The presence of the T allele at rs17883901 (-129 C/T) in GCLC conferred risk for PDR in the polytomous analysis (OR of 4.23; 95% CI 1.38 to 12.93; p = 0.01) and for any degree of DR in the dichotomous analysis (ADR versus NPDR + PDR; OR of 3.07; 95% CI 1.22-8.95; p = 0.02). There was no association between the SNP rs6610650 (CYBB gene) and DR in this population. CONCLUSION: The functional SNPs rs713041 in GPX4 and rs17883901 in GCLC modulated the susceptibility to DR in the studied population of patients with T1D

Compartmentalization of redox reactions is essential to all life forms. Protein activity can respond to changes in the local redox environment through the reversible oxidation of cysteine thiols. For the majority of cysteines in the proteome, this interaction takes place through equilibration with the glutathione pool; this raises the question whether this redox pool acts as a buffer, or instead as a sensitive media, transducing information from a local physiological state into protein function.

Numerous enzymatic reactions are controlled by the chemistry of metallic ions. This dissertation investigates the electronic properties of three transition metal (copper, chromium, and nickel) complexes and describes modeling studies performed on glutathione synthetase. (1) Copper nitrene complexes were computationally characterized, as these complexes have yet to be experimentally isolated. (2) Multireference calculations were carried out on a symmetric C2v chromium dimer derived from the crystal structure of the [(tBu3SiO)Cr(µ-OSitBu3)]2 complex. (3) The T-shaped geometry of a three-coordinate β-diketiminate nickel(I) complex with a CO ligand was compared and contrasted with isoelectronic and isosteric copper(II) complexes. (4) Glutathione synthetase (GS), an enzyme that belongs to the ATP-grasp superfamily, catalyzes the (Mg, ATP)-dependent biosynthesis of glutathione (GSH) from γ-glutamylcysteine and glycine. The free and reactant forms of human GS (wild-type and glycine mutants) were modeled computationally by employing molecular dynamics simulations, as these currently have not been structurally characterized.