Résumé français manquant / Scientific background: GAGs mimetics properties on regenerative process.Glycosaminoglycans (GAGs) are sulfated polysaccharides actually considered as major structural components of the extracellular matrix as well as regulators of cells functions during homeostatic and pathological processes. These GAGs activities are based on their ability to interact with heparin binding growth-factors (HBGF), chemokines and enzymes, to protect them from proteolytic degradation and to potentialyze their interaction with cell surface specific receptors and/or other components of the ECM. GAGs are characterized by their extensive structural diversity, based on the number and location of sulfate or acetylate groups, that would determine specific biological interactions.As comparative tool to study the relationship between the complexity of GAGs chemical structures and their biological functions, we used synthetic GAGs mimetics, derivate from a polymer of dextran and functionalized with carboxylate, sulfate and/or acetate groups. They are structurally and functionally related to natural heparan sulfates. These compounds improved both the rate and quality of regenerative process in numerous animal models of injury after topical treatment.Our hypothesize is that specific HS cooperative interactions with HBGF and ECM compounds could influence both therapeutic progenitors and stem cells properties by compartmentalizing them to specific microenvironment niches, and protecting them against deleterious signals. Such abilities to modulate stem cell biology could be a new way to explain and to take advantage of regenerative properties of these compounds. The principal aim of this work was to demonstrate the effects of GAGs mimetics on Mesenchymal Stem Cells (MSC) properties for application in bone repair. GAGs mimetics as new potentializing agents of mesenchymal stem cells propertiesDuring osteogenesis, a controlled expression of functional HS is required to interact and regulate the activity of growth promoting and osteogenic differentiation factors. However effects of GAGs on MSC properties remain to be analyzed. We focus on two GAGs mimetics leader molecules [OTR4131] and [OTR4120], with distinct chemical characteristics, since sulfated mimetic [OTR4120] was previously shown to stimulate bone repair in vivo. We demonstrate that its acetylated and sulfated counterpart [OTR4131] enhances proliferation, whereas [OTR4120] clearly stimulates migration and osteogenic differentiation properties of rat MSC in vitro, that could explain its bone regenerative effect in vivo. This indicates that GAGs mimetics would be of great interest for potential application in therapy, since according to their structural signature they could modulate specific activities of progenitors and stem cells, and represent an alternative to exogenous growth factor treatments. New matricial strategy for bone repair associating GAGs mimetics to biomaterials and human MSCCell based therapy associated to biomaterials for repair of bone defects are promising but not enough efficient. We proposed to develop matricial strategy, associating efficient micro-environment molecules such as GAGs mimetics, to optimize cell therapeutic approaches. First we validated that GAGs mimetics are effective on human MSC proliferation, migration and differentiation properties in vitro. We demonstrated that colonization efficiency of hydroxyapatite/β-tricalcium phosphate biomaterial scaffolds by human MSC was improved when scaffolds are functionalized with GAGs mimetics in vitro. Finally osteoformation in vivo was evaluated after ectopic transplantation of functionalized and/or cellularized biomaterials in nude mice: few effects were observed on bone formation, whereas osteoclastogenesis and vascularization were clearly modulated by GAGs mimetics immobilized. GAGs mimetics as new mobilizing agents of stem cells...

A menopausa é provocada pela falência da produção de hormônios ovarianos e tem como consequências alterações desfavoráveis no metabolismo e perda de massa óssea. O declínio da produção de estrógeno é considerado um grande fator de risco para o desenvolvimento da osteoporose em mulheres e como tratamento faz-se o uso da Terapia de Reposição Hormonal. No entanto, esta terapia tem trazido riscos á saúde de alguns grupos de mulheres. Como alternativa ao tratamento tradicional, tem-se os fitoestrógenos, e com eles as isoflavonas, encontradas principalmente na soja, Trifolium pratense e Cimicifuga racemosa. Este estudo teve como objetivo comparar a capacidade de estimular a osteogênese in vitro, a partir de cultura de osteoblastos derivados de células tronco mesenquimais, em duas preparações de fitoestrógenos: O extrato de soja biotransformado pelo fungo Aspergillus awamori (ESBF), e o Menoflavon® 40mg (Melbrosin International) composto pela isoflavona Trifolium pratense. Para este objetivo foram realizadas: a) Avaliação do crescimento e proliferação celular b) Viabilidade e crescimento das culturas de osteoblastos. c) Dosagem de proteína total das culturas de osteoblastos. d) Determinação da atividade específica da enzima fosfatase alcalina. e) Formação da matriz mineralizada. O Menoflavon® foi testado nas concentrações de 28,75 nM de daidzeína (D) + 7,5 nM de genisteína (G) (0,5 ?g/mL de Menoflavon®); 57,5 nM de D + 15 nM de G (1 ?g/mL de Menoflavon®); e 230 nM de D + 60 nM de G (4 ?g/mL de Menoflavon®); controle padrão de 57,5 nM de D + 15 nM de G comercial e controle de dimetilsulfóxido (DMSO). O ESBF foi testado nas concentrações de 1,181 nM de D + 0,922 nM de G (0,5 ?g/mL de ESBF); 2,361 nM de D + 1,845 nM de G (1 ?g/mL de ESBF); 9,445 nM de D + 7,379 nM de G (4 ?g/mL de ESBF); controle padrão de 2,361 nM de D + 1,845 nM de G comercial e controle de DMSO. Com a metodologia do MTT (3[4,5-dimetiltiazol-2-il]-2,5-brometo difenil tetrazolium) e da Resazurina comprovamos que não houve morte celular nas concentrações testadas com as duas formulações. A dosagem de proteínas totais manteve-se constante com as duas formulações e a formação de matriz mineralizada também manteve-se constante em relação ao controle para ambos. A atividade específica da fosfatase alcalina teve um decréscimo significativo ao 14º dia com todas as concentrações testadas e ao 21º dia com algumas concentrações de Menoflavon e com o ESBF decresceu em alguns dias, no entanto manteve-se estável no restante do teste. O ESBF mostrou ser melhor que o Menoflavon®, já que obtivemos resultados semelhantes e sua concentração é 24 vezes menor. No entanto, o estudo realizado mostrou que tanto o ESBF quanto o Menoflavon® não são capazes de estimular a osteogênese in vitro, a partir de cultura de osteoblastos derivados de células tronco mesenquimais. / Menopause is caused by failure in the production of ovarian hormones and its consequences are unfavorable changes in metabolism and bone loss. The decline in estrogen production is considered a major risk factor for the development of osteoporosis in women, and the Hormone Replacement Therapy is used as treatment. However, this therapy has brought some risks to the health of some groups of women. As an alternative to the traditional treatment, phytoestrogens as isoflavones, found mainly in soy, Trifolium pratense, Cimicifuga racemosa and rye can be used. This study aimed to compare the ability of two preparations of phytoestrogens to stimulate osteogenesis in vitro (from cultures of osteoblasts derived from mesenchymal stem cells): soy extract biotransformed by the fungus Aspergillus awamori (ESBF), and Menoflavon® 40mg (Melbrosin International) composed by the isoflavone Trifolium pratense. With this objective, were used: a) Evaluation of cell growth and proliferation; b) Viability of the cultures of osteoblasts; c) Determination of total protein from the cultures of osteoblasts; d) Determination of the specific activity of the enzyme alkaline phosphatase; e) Formation of mineralized matrix. Menoflavon® was tested at the concentrations of 28.75 nM of daidzein (D) + 7.5 nM of genistein (G) (Menoflavon® 0.5 ?g/mL); 57.5 nM D + 15 nM G (Menoflavon® 1 ?g/mL); and 230 nM D + 60 nM G (Menoflavon® 4 ?g/mL); standard control of commercial 57.5 nM D + 15 nM G and DMSO control. ESBF was tested at the concentrations of 1.181 nM D + 0.922 nM G (ESBF 0.5 ?g/mL); 2.361 nM D + 1.845 nM G (ESBF 1 ?g/mL); 9.445 nM D + 7.379 nM G (ESBF 4 ?g/mL); standard control of commercial 2.361 nM D + 1.845 nM G and dimetilsulfoxide (DMSO) control. With the MTT and Resazurin methods we verified that there was no cell death for all concentrations tested with the two formulations. The amount of total protein remained constant with the two formulations, and the formation of mineralized matrix also were the same as the control. The specific activity of alkaline phosphatase decreased significantly on day 14 for all concentrations tested, and at day 21 for some concentrations of Menoflavon®, with the ESBF decreased some days, however remained constant in the other tests. Therefore, ESBF proved better than Menoflavon®, since we obtained similar results for both, but the concentration of ESBF is 24 times smaller than the concentration of Menoflavon®. However, both the ESBF and the Menoflavon® were not capable of stimulating osteogenesis in vitro from cultures of osteoblasts derived from mesenchymal stem cells.

Introdução: Os corticosteróides e a persistência do hiperparatiroidismo são os principais fatores envolvidos na perda de massa óssea de pacientes ao longo do primeiro ano de transplante renal (TR).Os estudos no TR tardio são muito contraditórios,uma vez que as populações avaliadas foram heterogêneas.Os resultados revelaram diminuição da formação e aumento da reabsorção óssea além de defeito na mineralização. Objetivos: 1) Avaliar o metabolismo mineral e o tecido ósseo após o segundo ano de transplante renal em pacientes com boa função do enxerto e sem fatores de risco para a perda de massa óssea. 2) Determinar os possíveis fatores determinantes da massa e remodelação óssea. 3) Estudar a atividade funcional dos osteoblastos in vitro. Métodos: Avaliamos 27 pacientes transplantados renais com idade entre 18 a 50 anos (36,4 + 8,9 anos) boa função do enxerto (clearance de creatinina > 50ml/min), recebendo o mesmo esquema imunossupressor desde o início do TR e doses mínimas de corticosteróides. Todos apresentavam função gonadal normal. Excluímos os pacientes submetidos a paratiroidectomia, que receberam tratamento prévio com cálcio, vitamina D ou bisfosfonato. Os pacientes foram submetidos a avaliação clínica, laboratorial, densitometria óssea (DO) e biópsia óssea da crista ilíaca. Foi realizado cultura de células de osteoblastos, obtidos da biópsia óssea, e analisada a taxa de proliferação celular e expressão de fosfatase alcalina. Resultados: A hipercalcemia esteve presente em 40% dos pacientes, hipofosfatemia em 26% e 15% apresentavam acidose metabólica. Nos pacientes em uso de tacrolimus (FK) os níveis de fósforo sérico foram significativamente inferiores aos do grupo ciclosporina (CSA) (p=0.019). Os níveis de PTH estavam adequados para a função renal na maioria dos pacientes, entretanto 30% tinham níveis superiores a 65 pg/ml. Os níveis de osteoprotegerina (OPG) (85%) e deoxipiridinolina (DPD) (95%) estavam elevados na maioria dos pacientes Quanto aos valores de 25(OH) D (25,4 ± 8,7 ng/ml) os mesmos encontravam-se reduzidos em 63% dos pacientes. Não houve perda óssea significativa pela análise do score Z lombar (-0,9 ± 1,5) e do femur (-0,8 ± 1,1), porém em 26% dos pacientes diagnosticamos osteoporose pela densitometria. A média do volume ósseo estava dentro da normalidade, porém, 30% dos pacientes apresentavam redução do BV/TV. Nossos pacientes tinham aumento da separação e diminuição do número das trabéculas ósseas, além de aumento das superfícies osteóide, osteoblástica, de reabsorção e osteoclástica. Em cerca de 60% dos pacientes observamos diminuição da taxa de formação óssea e em 85% deles da superfície mineralizante. Retardo na mineralização óssea foi observado em 46% dos pacientes. Insuficiência de 25(OH) D cursou com defeito de mineralização em todos os pacientes. Os osteoblastos em cultura apresentaram elevada taxa de proliferação apesar da diminuída expressão de fosfatase alcalina. A proliferação celular foi maior no grupo FK que CSA (p=0,0007). O PTH foi o determinante independente do fósforo sérico (p=0,042), DMO lombar (0,044) e volume osteóide (p=0,001). Conclusões: Após dois anos de transplante renal estável no qual, os principais fatores de risco para perda de massa óssea, foram afastados nenhum paciente apresentava tecido ósseo normal. Encontramos, predominantemente, diminuição da formação, aumento da reabsorção óssea e defeito de mineralização caracterizando a presença de doença mista. Esses achados se devem provavelmente à hipofosfatemia, persistência do hiperparatiroidismo, insuficiência de 25(OH) D e a ação de drogas imunossupressoras / We evaluated bone mineral metabolism and histology from twenty seven late kidney transplanted patients, as well as osteoblastic activity in vitro obtained from bone biopsies. Patients were young, with stable graft function, in use of minimal immunosuppressive drugs doses and without known risk factors for bone loss. Hypercalcemia was found in 40%, whereas 26% had hypophosphatemia, 30% hyperparathyroidism and 63% 25-OH vitamin D insuficiency. Bone volume was decreased in 30% of them with elevated bone resorption in the majority, low bone formation in 60% and mineralization defect in 46%. Osteoblastic cells on culture expressed less alkaline phosphatase despite high proliferation rate. After a high restrictive selection of the patients, they still presented mixed bone diseased. These findings are probably related to immunosuppressive drugs, persistence of hyperparathyroidism and 25-OH vitamin D insuficiency

A regeneração de defeitos ósseos continua sendo um grande desafio na área de Odontologia e Medicina. É bem estabelecido que células-tronco mesenquimais (CTMs) e osteoblastos (OBs) desempenham um papel crítico na osteogênese, tornando-se candidatos a utilização em procedimentos de terapia celular que visam otimizar o processo de reparação óssea. Porém, pouco se sabe sobre a interação entre CTMs e OBs, e a maioria dos estudos enfatiza o efeito dos OBs sobre CTMs, fazendo com que a influência das CTMs na atividade osteogênica dos OBs continue sendo uma questão desafiadora. Baseados em nossos estudos anteriores, formulamos a hipótese de que a terapia celular que fizesse uso de uma associação de CTMs e OBs poderia ser mais eficaz para o reparo do tecido ósseo do que essas células isoladamente, principalmente como resultado da estimulação de OBs por CTMs. Para tal, foi realizado estudo in vitro para avaliar os efeitos das CTMs sobre os OBs e in vivo para avaliar os efeitos dessas células, isoladamente e combinadas, sobre a reparação óssea. CTMs da medula óssea de rato foram cultivadas em meio de crescimento para manterem-se como CTMs ou em meio osteogênico para diferenciarem-se em OBs. Após alcançar a subconfluência, as células foram cultivadas in vitro em três diferentes condições: (1) co-cultura direta de CTMs e OBs usando três proporções celulares (1:1, 1:2 e 2:1), (2) co-cultura indireta de CTMs e OBs usando insertos e (3) OBs cultivados em meio condicionado por CTMs. Para avaliação das respostas celulares foram realizados ensaios de proliferação celular, atividade de fosfatase alcalina (ALP), formação de matriz mineralizada, expressão gênica de marcadores osteoblásticos, imunolocalização de sialoproteína óssea (BSP) e osteopontina (OPN) e migração celular. Para os experimentos in vivo, as células foram carreadas em esponja de colágeno através de vários ciclos de centrifugação. Após, defeitos ósseos em calvária de rato foram preenchidos com (1) esponja de colágeno sem células, (2) esponja de colágeno com CTMs, (3) esponja de colágeno com OBs e (4) esponja de colágeno com associação de CTMs e OBs. Para avaliação da reparação óssea in vivo após 4 semanas, foram realizadas análises histomorfométricas através de cortes histológicos e microtomografia computadorizada. Os dados foram comparados pelo teste de Kruskal-Wallis e, se necessário pelo teste de Mann-Whitney (p≤0,05). Foi observado que CTMs têm efeito repressivo sobre a proliferação e as expressões fenotípicas e genotípicas de OBs (P≤0,05). Em relação ao reparo dos defeitos ósseos, somente naqueles tratados com células observou-se formação óssea predominantemente como ilhotas isoladas e diferenças, principalmente qualitativas, entre os tipos celulares utilizados, com tendência de maior formação óssea em defeitos tratados com OBs em comparação ao uso de CTMs. Com base nos resultados obtidos, pôde-se concluir que as CTMs apresentam efeito inibitório sobre OBs e que a terapia celular com OBs parece ser mais eficaz no reparo do tecido ósseo. / The regeneration of bone defects remains a major challenge in the field of Dentistry and Medicine. It is well known that mesenchymal stem cells (MSCs) and osteoblasts (OBs) play critical roles in osteogenesis, making them promising alternatives to be employed in cell therapy procedures to enhance the process of bone regeneration. Studies about the crosstalk between MSCs and OBs are mainly focused on the effect of OBs on MSCs, thus how MSCs may affect OBs phenotype expression remains a challenging question. Based on our previous studies, we have hypothesized that cell therapy using a combination of MSCs and OBs could be more effective for the bone repair than these cells separately, mainly due to the stimulation of OBs by MSCs. For this, we carried out in vitro experiments to evaluate the effects of MSCs on the OBs and in vivo experiments to assess the effects of these cells either isolated or combined on bone repair. Rat bone marrow MSCs were cultured either in growth medium to keep MSCs features or in osteogenic medium to differentiate into OBs. After reaching subconfluence, cells were grown in vitro in three different conditions: (1) direct coculture of MSCs and OBs using three cell proportions (1:1, 1:2 and 2:1), (2) indirect coculture of MSCs and OBs using transwell porous filters and (3) OBs cultured in MSCs conditioned medium. Cell responses were evaluated by assaying cell proliferation, alkaline phosphatase activity (ALP), mineralized matrix formation, gene expression of osteoblast markers, immunolocalization of bone sialoprotein (BSP) and osteopontin (OPN), and cell migration. For in vivo experiments, cells were seeded into collagen sponge by a centrifugation method. After, calvarial defects were implanted with (1) collagen sponge without cells, (2) collagen sponge with MSCs, (3) collagen sponge with OBs, and (4) collagen sponge and association of MSCs with OBs. To evaluate bone repair at the end of 4 weeks, histomorphometric analyzes were carried out using histological slides and micro-computed tomography. Data were compared by Kruskal-Wallis test and, if appropriated, by Mann-Whtiney test (p≤0.05). It was observed that MSCs repressed proliferation, phenotypic and genotypic expressions of OBs (P≤0.05). Bone formation was observed only in cell treated defects as isolated islets and qualitative differences were noticed among cell types, with a tendency of more bone formation in OBs treated defects compared with MSCs ones. Based on these results, we can conclude that MSCs exhibited inhibitory effect on OBs and that cell therapy with OBs seemed to be more effective for bone repair.

Resultados de pesquisas prévias tem encontrado potencial aumentado para a consolidação de enxertos ósseos mediante desmineralização do material enxertado e/ou das superfícies de consolidação. Entretanto há carência de embasamento apoiado em evidências biológicas do benefício de tal procedimento. Para testar esta hipótese, o tecido ósseo da calvária de cobaias (Cavia porcellus) foi exposto ao condicionamento por ácido cítrico durante 15, 30, 90 e 180 segundos (grupos teste). Quarenta e cinco discos ósseos de três milímetros de diâmetro foram removidos dos animais, dos quais 36 foram condicionados com ácido cítrico pH 1 a 50% e nove não receberam condicionamento (grupo controle). Sobre nove discos de cada grupo foram cultivados pré-osteoblastos MC3T3-E1 durante 24, 48 e 72 horas (três discos de cada grupo em cada tempo). Análises da morfologia celular, do número de células aderidas sobre as superfícies e da área de cobertura destas superfícies por préosteoblastos foram realizadas à microscopia eletrônica de varredura. Observou-se aumento do número de células aderidas às superfícies com o tempo, independentemente de haver condicionamento ou de seu tempo de aplicação. Entretanto, essa diferença só foi estatisticamente significante intragrupos (p<0,05) e quando comparados os períodos de 24 e 72 horas de incubação. A área de cobertura das superfícies por células aumentou significantemente com o tempo somente nos grupos teste, também entre os períodos de incubação de 24 e 72 horas (p<0,01). O grupo controle apresentou-se com 50% ou menos de área de cobertura superficial em relação aos demais. A duração de aplicação do ácido não interferiu significantemente nesse parâmetro de avaliação, mas nos grupos 15 e 30, a área de recobrimento ósseo mais do que triplicou às 72 horas em relação às 24 horas (p<0,01), com cerca de 70% das superfícies cobertas por células, contra 30% no grupo controle. Conclui-se que a desmineralização óssea nos tempos de condicionamento estudados propicia um substrato sobre o qual as células pré-osteoblásticas adquirem morfologia compatível com estágio de diferenciação mais avançado, promovendo maior cobertura de área, o que aumenta o potencial para deposição de novo osso sobre essas superfícies em comparação ao tecido não condicionado. / Results of previous research has found increased potential for the consolidation of bone grafts by demineralization of the graft material and / or areas of consolidation. However there is a lack of foundation supported by biological evidence of benefits from such procedures. To test this hypothesis, the bone tissue of the calvaria of guinea pigs (Cavia porcellus) were exposed to conditioning by citric acid for 15, 30, 90 and 180 seconds (test group). Forty-five bone disks measuring three millimeters in diameter were removed from the animals, of which 36 were conditioned with citric acid pH 1 to 50% and nine did not receive conditioning (control group). About nine disks in each group were pre-cultured with MC3T3- E1 osteoblasts for 24, 48 and 72 hours (three discs of each group at each time point). Analysis of cell morphology, number of cells attached on the surface and the coverage area of these surfaces by pre-osteoblasts were performed on scanning electron microscopy. There was na increase in the number of cells attached to surfaces over time, regardless of conditioning or application time. However, this difference was not statistically significant intra-group (p <0.05) when comparing the periods of 24 and 72 hours of incubation. The coverage area of the surfaces of cells increased significantly with time only in the test groups, also among the incubation periods of 24 and 72 hours (p <0.01). The control group presented with 50% or less of surface area coverage compared to the other. The duration of application of the acid did not affect significantly this parameter of evaluation, but in groups 15 and 30, the bonearea covered more than tripled from 24 to 72 hours (p <0.01), with about 70 % of the area covered by cells, versus 30% in the control group. It was concluded that bone demineralization in the studied conditioning times provides a substrate on which cells acquire pre-osteoblastic morphology compatible with more advanced stage of differentiation, promoting greater coverage area, which increases the potential for deposition of new bone on these surfaces compared to the tissue-air basis.

As BMPs (Bone Morphogenetic Proteins) são membros da superfamília de proteínas TGF-&#946; (Transforming Growth Factor &#946; ), regulam o crescimento e diferenciação de vários tipos celulares em diversos tecidos, e algumas delas desempenham um papel crítico na diferenciação de células de origem mesenquimal em osteoblastos. Particularmente, rhBMP2 e rhBMP7, promovem osteoindução tanto \"in vitro\" como \"in vivo,\" sendo, ambas as proteínas utilizadas terapeuticamente em Ortopedia/Odontologia para reparo ósseo. A expressão diferencial de genes durante a osteodiferenciação de células C2C12 induzida por rhBMP2 e rhBMP7, foi analisada através de microarranjos de DNA, selecionando 31 genes, dos quais 24 foram validados por qPCR, 13 dos quais são relacionados à transcrição, quatro associados a algumas vias de sinalização celular e sete associados à matriz extracelular. Análise funcional destes genes permitirá conhecer, com maiores detalhes, os eventos moleculares que ocorrem durante a diferenciação osteoblástica de células C2C12 induzida por rhBMPs. Em paralelo, foi perseguida a super-expressão de rhBMP2 e rhBMP7 em células HEK293T, demonstrando-se a atividade de rhBMP7, induzindo osteodiferenciação \"in vitro\" e formação de osso \"in vivo\", demonstrando a viabilidade do objetivo de se produzir estas proteínas para futura aplicação como biofármacos no Brasil. / The BMPs (Bone Morphogenetic Proteins) are members of the TGF-&#946; (Transforming Growth Factor &#946;) superfamily of proteins, regulate growth and differentiation of various cell types in various tissues, and some play a critical role in differentiation of mesenchymal cells into osteoblasts. Particularly, rhBMP2 and rhBMP7, promote osteoinduction \"in vitro\" and \"in vivo\" and both proteins are used therapeutically in Orthopedics and Dentistry. The differential expression of genes during osteodifferentiation induced by rhBMP2 and rhBMP7 in C2C12 cells was analyzed through DNA microarrays, allowing the selection of 31 genes, of which 24 were validated by qPCR, 13 of which are related to transcription, four associated with cell signaling pathways and seven are associated with the extracellular matrix. Subsequent functional analysis of these genes should reveal more details on the molecular events which take place during C2C12 cells osteoblastic differentiation induced by rhBMPs In paralel, rhBMPs 2 and 7 were overexpressed in HEK293T cells and BMP7 activity to induce osteodifferentiation \"in vitro\" and bone formation \"in vivo\" was demonstrated, reinforcing the viability of our objective to produce these proteins for future application as biopharmaceuticals in Brazil.

Cette thèse traite de la modélisation du remodelage osseux. Nous présentons tout d'abord un modèle général continu tenant compte de la réponse cellulaire à un stimulus mécanique. Ce modèle est appliqué à des géométries 2D et 3D macroscopiques afin de se rapprocher des problématiques réelles, ainsi que sur des géométries mésoscopiques d'os trabécullaires en 2D. Cependant la complexité du remodelage osseux ne permet pas d'avoir une approche unique de modélisation. Ainsi, dans un second temps, le cas particulier du remodelage osseux orthodontique est étudié. Un nouveau modèle spécifique est développé tenant compte de l'influence du ligament parodontal sur le remodelage osseux, et intégrant l'influence du taux d'oxygène qui contrôle les évolutions de densités cellulaires. Des données expérimentales in vitro sont extraites de la littérature et servent de données d'entrées du modèle développé afin d'obtenir l'évolution de la densité osseuse alentours d'une racine dentaire cylindrique en 3D. / This work deals with modelization of bane remodeling. We present first a madel thal accounts for the cellular res panse to a mechanical stimulus in a general case at a continuous scale. This madel is applied to 2D and 3D geometries at macroscopic scale to mimic real cases, as weil as 2D trabecular-type geometries at mesoscopic scale. However, the complexity of bane remodeling does not allow a unique approach. Th us, the thesis work is focused on the particular case of orthodontie bane re mode ling. A new specifie madel is developed accounting for the influence of the periodontal ligament on orthodontie bane remodeling by integrating the oxygen concentration effect controling the evolutions of cellular densities. The cellular experimental data in vitro are extracted from the literature, and serve as input data of the developed madel in arder to ablain the evolution of bane density around the root of a 3D cylindrical tooth.

La spondyloarthrite (SpA) est une pathologie rhumatologique caractérisée notamment par une inflammation et par des ossifications excessives se formant au niveau des enthèses. Il s’agit de zones de fortes contraintes mécaniques où les tendons et ligaments sont ancrés dans l’os via une zone fibrocartilagineuse. La sphingosine 1-phosphate (S1P) est un lipide bioactif qui joue un rôle important à la fois dans le remodelage osseux et la réponse inflammatoire. Notre objectif était donc d’explorer le rôle de la S1P dans l’ossification excessive de la SpA. Nous avons observé que les taux sériques de S1P des patients atteints de SpA sont significativement supérieurs à ceux de donneurs contrôles. Nous avons utilisé comme modèle des cultures primaires murines d’ostéoblastes, de chondrocytes et de ténocytes et des cultures organotypiques d’enthèse de souris. Nous avons observé que les enzymes de synthèse de la S1P, les sphingosine kinases 1 et 2, contribuent à la minéralisation des ostéoblastes et des chondrocytes. L’effet pro-minéralisant de la S1P est partiellement médié par deux de ses récepteurs (S1P1 et S1P3). De plus, la production de S1P est stimulée suite à un étirement cyclique dans les ostéoblastes et les chondrocytes, et après un traitement avec les cytokines TNF-α et IL-17 dans les chondrocytes. Finalement, l’inhibition générale du métabolisme de la S1P par le Fingolimod conduit à une diminution de la minéralisation dans les ostéoblastes et encore davantage dans les chondrocytes. Ces résultats suggèrent que le métabolisme de la S1P participe à l’ossification excessive de la SpA. Des études in vivo sont maintenant nécessaires pour valider cette possibilité / Spondyloarthritis (SpA) is a rheumatic disease characterized in particular by enthesis ectopic ossification and inflammation. Enthesis is a zone of concentration of mechanical stresses where ligaments and tendons attach to bone through fibrocartilaginous connections. Sphingosine 1-phosphate (S1P) is a bioactive lipid that plays an important role in both bone remodelling and in inflammatory response. Our aim was to explore the role of S1P in SpA excessive ossification. We observed that serum S1P concentrations in SpA patients are significantly higher compared to control donors. We used primary mouse osteoblasts, chondrocytes and tenocytes as cellular models and organotypic cultures of mice enthesis. We observed that S1P synthetizing enzymes, sphingosine kinases 1 and 2, stimulate osteoblasts’ and chondrocytes’ mineralizing process. S1P pro-mineralizing effect was partially mediated by two of the S1P receptors (S1P1 and S1P3). Moreover, S1P production was enhanced by cyclic strain in osteoblasts and chondrocytes and by pro-inflammatory cytokines (TNF-α and IL-17) in chondrocytes. Finally, the inhibition of S1P metabolic pathway by Fingolimod reduced the mineralization in cultured osteoblasts and even more in chondrocytes. These results suggest that S1P metabolism participates in SpA excessive ossification. In vivo studies are now needed to validate this possibility

Inflammatory processes in, or in close vicinity of, the skeleton often lead to loss of bone tissue. Different cytokines have been shown to be involved as stimulators of inflammatory induced osteoclastic bone resorption. During inflammatory processes also the kallikrein-kinin system is activated, leading to production of kinins that can cause pain, vasodilation and increased permeability of vessels. Kinins can also induce bone resorption in vitro. All cytokines and kinins that stimulate bone resorption stimulate in parallell prostaglandin synthesis, and prostaglandins, per se, have also been shown to induce bone resorption. The aim of this project was to increase the knowledge about the mechanisms involved in the interactions between different inflammatory mediators (i.e. kinins, cytokines and prostaglandins) suggested to be involved in the pathogenesis of inflammatory bone resorbing diseases. Human osteoblasts (MG-63) are equipped with both kinin B1 and B2 receptors linked to prostaglandin release and the stimulation of prostaglandin release are likely mediated via separate molecular mechanisms (Paper I). Activation of B1 or B2 receptors causes synergistic stimulation of PGE2 synthesis induced by either interleukin-1b (IL-1b) or tumour necrosis factor-a (TNF-a) (Paper II). The molecular mechanism involves increased expression of cyclooxygenase-2 (COX-2) and results in synergistic potentiation of receptor activator of NF-kB ligand (RANKL) protein expression. The synergistic interaction is dependent on the activation of NF-kB and the mitogen-activated protein kinases (MAPK) p38 and JNK (Paper II). The synergistic increase in RANKL expression might be an explanation why kinins potentiate IL-1b induced bone resorption, a mechanism likely to be important in inflammation induced bone resorption in diseases such as periodontal disease and rheumatoid arthritis. The synergism between kinins and IL-1b or TNF-a might also be dependent on regulation of kinin receptors, since both IL-1b and TNF-a markedly upregulated B1 and B2 receptors, both at the mRNA level and protein level (Paper III). This upregulation is not further potentiated by the kinins, and different kinin receptor agonists do not regulate the receptors for IL-1b or TNF-a, in MG-63 cells. No other cytokines known to stimulate bone resorption regulates the expressions of B1 and B2 receptors. The IL-1b- or TNF-a-induced enhancements of B1 and B2 receptor expressions involve activation of NF-kB and MAPK. The enhancement of kinin receptors may also be an important mechanism in the synergistic interactions between the two pro-inflammatory cytokines and kinins (paper III). IL-4 and IL-13 are two cytokines that have been shown to inhibit bone resorption. We have shown that COX-2 and both B1 and B2 receptors are down-regulated by IL-4 and IL-13, via a ‘signal transducer and activator of transcription6’ (STAT6) dependent pathway, which might be an important regulatory mechanism in inflammation induced bone resorption (paper IV). In conclusion, the mechanisms behind the synergistic potentiation of prostaglandin formation and increased bone resorption caused by co-stimulation with kinins and IL-1b or TNF-a seem to involve both potentiation of COX-2 and subsequently increased levels of RANKL, as well as upregulation of B1 and B2 kinin receptors. Interestingly, IL-4 and IL-13 decreased the expressions of COX-2 and both B1 and B2 receptors. These events might be important in the regulation of inflammation induced bone resorption in diseases such as periodontitis and rheumatoid arthritis.

Das RANKL/RANK/OPG-System spielt eine entscheidende Rolle in der Steuerung der Osteoklastendifferenzierung und -aktivierung durch Osteoblasten/ Knochenmarkbindegewebszellen im Rahmen des Knochenremodelings. Osteoblasten/Knochenmarkbindegewebszellen exprimieren RANKL. Dieses hat im Körper zwei Rezeptoren: RANK und OPG. RANKL kann durch Bindung an RANK auf Osteoklasten/Osteoklastenvorläuferzellen in Gegenwart von M-CSF seine osteoklastenstimulierende Wirkung entfalten. Der ebenfalls von Osteoblasten gebildete „decoy“-Rezeptor OPG blockiert als freies Protein durch Bindung an RANKL dessen Interaktion mit RANK und verhindert somit die Osteoklastogenese und Osteoklastenaktivierung. Das RANKL/RANK/OPG-System erfüllt im Körper noch weitere Funktionen im Immunsystem, in der Organentwicklung lymphatischer Gewebe und in der Entwicklung der laktierenden Brustdrüse. Viele Zytokine greifen hemmend oder aktivierend in die Osteoklastogenese ein. Sie können dies zum einen durch die Beeinflussung des RANKL/OPG-Verhältnisses, zum anderen durch direkte Interaktion mit Osteoklasten/Osteoklastenvorläuferzellen tun. Zytokine, die die Osteoklastogenese begünstigen, werden vor allem bei inflammatorischen Prozessen ausgeschüttet. Zusammen mit dem, bei diesen Zuständen von aktivierten T-Zellen produzierten RANKL kann dies längerfristig zu einem Knochenverlust führen, welcher sich im klinischen Bild der Osteoporose äußert. Aus den in der vorliegenden Dissertation durchgeführten Untersuchungen ergeben sich folgende Schlussfolgerungen: 1. Monozyten der Zelllinie RAW 264.7 lassen sich, wie bereits in der Literatur beschrieben, durch Zugabe von M-CSF und RANKL zu osteoklastenähnlichen Zellen differenzieren. 2. Die Osteoklastogenese lässt sich anhand der Veränderung verschiedener osteoklastenspezifischer Parameter charakterisieren. Es zeigt sich bei den mit M-CSF und RANKL stimulierten Monozyten eine erhöhte Transkription von CTR (Calcitoninrezeptor)- und TRAP (tartratresistente saure Phosphatase)-mRNA, eine erhöhte Expression des CTR-Proteins, eine erhöhte TRAP-Aktivität und eine Formierung TRAP-positiver mehrkerniger Riesenzellen, die in diesen Eigenschaften Osteoklasten entsprechen. Die zusätzliche Zugabe von TGF-b1 in Kombination mit M-CSF und RANKL resultiert in einer verstärkten Expression von CTR-mRNA und CTR-Protein. TRAP-mRNA-Expression und TRAP-Aktivität bleiben davon unbeeinflusst. 3. Als funktionelles Merkmal der in vitro differenzierten Osteoklasten können ihre Fähigkeit zur Ausbildung von Aktinringen und die Resorption von mineralisiertem Kollagen nachgewiesen werden. 4. Im Verlauf ihrer Differenzierung sekretieren Osteoblasten unterschiedliche Mengen an OPG. Das Maximum der Synthese liegt bei Tag 11. Freies RANKL lässt sich in Überständen von MC3T3-E1-Osteoblasten nicht nachweisen. 5. Das von Osteoblasten in das Medium abgegebene OPG ist in der Lage, die durch RANKL induzierte Osteoklastogenese von RAW-Monozyten zu hemmen. 6. In Kokulturen von MC3T3-E1-Osteoblasten und RAW-Monozyten kann keine Osteoklastogenese beobachtet werden, wahrscheinlich durch Fehlen der RANKLExprimierung oder zu starke OPG-Sekretion durch Osteoblasten. Besonders in der westlichen Welt mit ihrer hohen Lebenserwartung haben Krankheiten mit Knochenverlust sowie bösartige Neubildungen mit Knochenbefall eine große medizinische Bedeutung. Die Beeinflussung des RANKL/RANK/OPG-Systems bietet eine vielversprechende Möglichkeit zur Entwicklung hochwirksamer und nebenwirkungsarmer Medikamente zur Behandlung dieser Zustände.