京都大学 / 新制・課程博士 / 博士(医学) / 甲第23372号 / 医博第4741号 / 新制||医||1051(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 滝田 順子, 教授 髙折 晃史, 教授 江藤 浩之 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 新制・課程博士 / 博士(医学) / 甲第25486号 / 医博第5086号 / 新制||医||1073(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 伊藤 貴浩, 教授 万代 昌紀, 教授 松田 文彦 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

A doença arterial periférica (DAP) é uma síndrome degenerativa multifatorial que acomete principalmente idosos e tem como principais características a redução da qualidade de vida e o aumento da mortalidade cardiovascular. Dentre as limitações funcionais impostas pela doença, a mais evidente é a piora da capacidade locomotora decorrente da claudicação intermitente (períodos alternados de isquemia e reperfusão). Atualmente não existem tratamentos farmacológicos capazes de bloquear a progressão da DAP, caracterizada pela redução da capacidade oxidativa muscular, excessivo estresse oxidativo e consequente acúmulo de aldeídos reativos no leito afetado. Com base nisso, o presente trabalho visou caracterizar o papel da enzima aldeído desidrogenase 2 na progressão da DAP. Para isso caracterizamos o modelo animal de DAP, e verificamos que camundongos C57Bl/6 após a cirurgia de oclusão de fluxo apresentam redução da atividade catalítica da enzima ALDH2. Fato acompanhado por uma intolerância ao esforço físico, atrofia e prejuízo na contratilidade muscular, além de desarranjo sarcomérico e mitocondrial. Em modelo de cultura celular, a inativação da enzima ALDH2, após hipóxia e reoxigenação levou à prejuízo na angiogênese e disfunção mitocondrial. Mesmo fenômeno observado nos animais DAP tratados com inibidor, que desenvolveram disfunção mitocondrial e pobre resposta à atividade física. Em modelo de genético de redução da atividade da enzima ALDH2, foi possível ver exacerbada disfunção muscular. Baseado nesses resultados, acreditamos que a enzima ALDH2 desempenha um importante papel na progressão da doença arterial periférica, sendo um possível alvo terapêutico. / Peripheral arterial disease (PAD) is a multifactorial disease which mainly affects elderly reducing quality of life and increasing cardiovascular mortality. Among the functional limitations imposed by the disease, the progressive worsening of locomotor capacity arising from intermittent periods of ischemia and reperfusion, are related to reduced muscle oxidative capacity, excessive oxidative stress and consequent accumulation of reactive aldehydes in the affected leg. We recently demonstrated that lipid peroxidation induced-toxic aldehydes accumulation contributes to ischemic heart disease progression. Interestingly, oxidation of these aldehydes through aldehyde dehydrogenase 2 (ALDH2) activation is cardioprotective. Based on that, this work characterizes the role of ALDH2 during PAD progression. The PAD animal model presents decreased skeletal muscle ALDH2 enzyme activity associated with exercise intolerance, muscle atrophy, poor muscle contraction, skeletal muscle sarcomeric disruption and giant mitochondrial accumulation. After ALDH2 inhibitor treatment, cell culture submitted to hypoxia/reoxygenation stress showed no angiogenesis and mitochondrial dysfunction. Similar data was seen at animal model, where PAD mice treated with ALDH2 inhibitor shows mitochondrial dysfunction, greater atrophy and affected physical exercise response. Also, transgenic mice for ALDH2 (which has a reduced ALDH2 activity) submitted to PAD showed a smaller muscle contraction, compared to wild type PAD mice. Our data points to ALDH2 as an important therapeutic target to develop new therapy strategies to counteract PAD progression.

As doenças isquêmicas representam a principal causa de mortalidade e morbidade no mundo. Dessa forma, o melhor entendimento dos sinais intracelulares envolvidos no estabelecimento e propagação do dano induzido pela isquemia-reperfusão (I/R) é essencial para o desenvolvimento de novas estratégias, futuramente utilizadas na prevenção e no tratamento do infarto agudo do miocárdio, acidente vascular cerebral e isquemia renal. O processo de isquemia-reperfusão gera danos irreparáveis aos tecidos acometidos. A reperfusão do tecido afetado, que ficara temporariamente mantido em hipóxia (com baixa tensão de oxigênio), resulta em um brusco aporte de oxigênio (alta tensão de oxigênio) e consequente colapso metabólico, caracterizado pela disfunção mitocondrial associada à elevada produção de radicais livres. Recentemente demonstramos que estímulos cardioprotetores (ex. pré-condicionamento isquêmico e etanol) são acompanhados pela ativação da proteína quinase C isoforma épsilon (PKCε), aumento de sua translocação para a mitocôndria e consequente fosforilação/ativação da enzima mitocondrial aldeído desidrogenase 2 (ALDH2). A ALDH2 é uma enzima chave na proteção contra danos isquêmicos devido a sua capacidade de oxidar aldeídos, como 4-hidroxi-2-nonenal e acetaldeído, produzidos durante estresse oxidativo. Semelhante ao pré-condicionamento isquêmico, o exercício físico (EF) também promove um aumento da tolerância do miocárdio à lesão de isquemia-reperfusão, entretanto os mecanismos celulares envolvidos nessa cardioproteção ainda são pouco compreendidos. No presente projeto de pesquisa buscamos validar o eixo intracelular PKCε-ALDH2 como possível mecanismo cardioprotetor induzido pelo EF frente estresse de isquemia-reperfusão. Inicialmente, utilizando camundongos selvagens, avaliamos se o exercício físico (7 dias consecutivos) modula a PKCε e a ALDH2, e se essa resposta é transiente ou sustentada. Em seguida, por meio da técnica de isquemia-reperfusão ex vivo (Langendorff), avaliamos a participação individual da PKCε e ALDH2 na cardioproteção mediada pelo exercício físico. Nossos resultados mostram que o exercício físico aumenta a expressão da PKCε no cardiomiócito de forma transiente, visto que 24h após a última sessão de exercício físico esse valor foi restabelecido, e a ALDH2 mostrou aumento sustentado em sua atividade, mantida até mesmo 24h após a última sessão de exercício físico. Além disso, sete dias de exercício físico é capaz de proteger o coração da lesão de isquemia e reperfusão. Entretanto, quando foram utilizados inibidores específicos ou animais geneticamente modificados, essa cardioproteção foi perdida. Assim, nossos resultados sugerem um papel importante do eixo PKCε-ALDH2 na cardioproteção induzida pelo exercício físico frente a uma lesão por isquemia/reperfusão. / Ischemic diseases are the leading cause of mortality and morbidity worldwide. Thus, a better understanding of the intracellular signals involved in the establishment and propagation of damage induced by ischemia-reperfusion is essential to the development of new strategies that can be used in the prevention and treatment of myocardial infarction, stroke and renal ischemia. The process known as ischemia-reperfusion (I/R) causes irreparable damage to the affected tissues due to the wide variation in tissue oxygen tension. Reperfusion of the affected tissue, which had been temporarily maintained at hypoxia (low oxygen tension), results in abrupt oxygen supply (high oxygen tension) and consequent metabolic collapse, characterized by mitochondrial dysfunction associated with high production of free radicals. We recently demonstrated that cardioprotective stimuli (i.e. ischemic preconditioning and ethanol) are accompanied by increased translocation of protein kinase C isoform epsilon (PKCε) to the mitochondria and subsequent phosphorylation-activation of mitochondrial aldehyde dehydrogenase enzyme 2 (ALDH2), which has an inverse correlation with myocardial injury. ALDH2 is a key enzyme in the protection against ischemic damage due to its capacity to oxidize aldehydes (i.e. acetaldehyde and 4-hydroxynonenal) produced during oxidative stress. Similar to ischemic preconditioning, exercise promotes increased myocardial tolerance to ischemia-reperfusion injury; however, the cellular mechanisms involved in this process are still poorly understood. We proposed to validate the intracellular PKCε-ALDH2 axis as a possible exercise-mediated cardioprotective mechanism upon ischemia-reperfusion. Firstly, using wild-type mice, we evaluated whether exercise (7 consecutive days) modulates the activity of PKCε and ALDH2 (transient vs. sustained). Then, through the ex vivo ischemia-reperfusion technique (Langendorff), we evaluated the individual participation of PKCε and ALDH2 in exercise-mediated cardioprotection. Our results show that physical exercise increases the cardiomyocyte PKCε levels in a transient way, since this response was reestablished 24h after the last physical exercise session. Moreover, ALDH2 showed a sustained increase in its activity, which was maintained even 24h after the last session. In addition, seven days of physical exercise was able to protect the heart from ischemia and reperfusion injury, whereas this cardioprotection was lost when specific inhibitors or genetically modified animals (PKCε knockout mice and ALDH2 knock-in mice) were used. Thus, our results suggest an important role of the PKCε-ALDH2 axis in the cardioprotection induced by exercise against ischemia/reperfusion injury.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22002号 / 医博第4516号 / 新制||医||1038(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 滝田 順子, 教授 松田 文彦, 教授 山田 亮 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

The cancer stem cell (CSC) concept is still very controversial; therefore identification and isolation of this specific population remain challenging. A variety of putative markers have been described and measurement of high aldehyde dehydrogenase (ALDH) activity has been defined as a characteristic of stem cells (SCs). In this study, a library of novel small molecules (1,4-disubstituted acetalanthraquinones, AAQs), containing an acetal group as protected aldehyde functionality, was designed with the aim of probing affinity for ALDH metabolism and demonstrating their potential as molecular fluorescent probes to identify CSCs. The AAQs were shown to be subjective to acidic hydrolysis using 2M HCl at 37ºC; however compounds containing secondary or tertiary amine functionalities in their sidechain were only partly hydrolysed at 70 ºC. Metabolism studies were conducted using cytosolic fractions from rat liver enriched in ALDHs, yeast ALDH and human recombinant ALDH1A1. Some evidence was demonstrated which linked ALDH metabolism with aldehyde functionalities of hydrolysed AAQs (HAAQs). The AAQs were shown to emit far-red fluorescence (600-750 nm). A close relationship between structure modifications and alteration of cellular localisation, with gained specificity for selected sub-cellular compartments were achieved when assessed in A549 and U-2 OS cell lines. Thermal DNA denaturation and chemosensitivity assays were used to obtain information about DNA binding properties and cytotoxicity of AAQs and HAAQ congeners. All compounds were shown to be weak-to-moderately binding to DNA, and symmetrical 1,4-disubstituted compounds were shown to be non-toxic (IC50 = 100 :M) with nonsymmetrical analogues generating IC50 values in the 1-100 :M range. No fundamental variation in the biological activity was observed when comparing AAQs with HAAQs in the A549 (+ALDH) and MCF7 (-ALDH) cell lines. A pilot investigation revealed that aberrant gene methylation was cell-type dependent for three ALDH isoforms (1A1, 2, 3A1). Decitabine treatment led to enhanced protein expression for ALDH1A1 (A549), ALDH2 (MCF7) and ALDH3A1 (A549). In contrast, the protein level was reduced for ALDH1A1 in HT29 cells after decitabine treatment. ALDH1A1, ALDH2 and ALDH3A1 were highly expressed in prostate cell lines, with expression linked to promoter methylation. In contrast, low levels of DNA methylation were found in primary prostate cancer cells and benign prostatic hyperplasia. Interestingly, ALDH1A1, considered a SC marker, was found to be expressed at low levels in CD133⁺/ α₂β₁ hi stem cell fraction and upregulated in CD133⁻/ α₂β₁ lo differentiated prostate cancer cells. In summary, the results in this thesis demonstrate the complexity and tumour type specificity of ALDH expression. This creates challenges for the development of selective probes for CSC isolation, such as the AAQs discussed in this thesis. Although inconclusive results were obtained in regard to AAQs and their potential in targeting ALDHs, selected AAQs were shown to reveal interesting biological features highlighting them as potential non-invasive cytometric probes for tracking molecular interactions in live cells.

The cancer stem cell (CSC) concept is still very controversial; therefore identification and isolation of this specific population remain challenging. A variety of putative markers have been described and measurement of high aldehyde dehydrogenase (ALDH) activity has been defined as a characteristic of stem cells (SCs). In this study, a library of novel small molecules (1,4-di-substituted acetalanthraquinones, AAQs), containing an acetal group as protected aldehyde functionality, was designed with the aim of probing affinity for ALDH metabolism and demonstrating their potential as molecular fluorescent probes to identify CSCs. The AAQs were shown to be subjective to acidic hydrolysis using 2M HCl at 37ºC; however compounds containing secondary or tertiary amine functionalities in their sidechain were only partly hydrolysed at 70 ºC. Metabolism studies were conducted using cytosolic fractions from rat liver enriched in ALDHs, yeast ALDH and human recombinant ALDH1A1. Some evidence was demonstrated which linked ALDH metabolism with aldehyde functionalities of hydrolysed AAQs (HAAQs). The AAQs were shown to emit far-red fluorescence (600-750 nm). A close relationship between structure modifications and alteration of cellular localisation, with gained specificity for selected sub-cellular compartments were achieved when assessed in A549 and U-2 OS cell lines. Thermal DNA denaturation and chemosensitivity assays were used to obtain information about DNA binding properties and cytotoxicity of AAQs and HAAQ congeners. All compounds were shown to be weak*to*moderately binding to DNA, and symmetrical 1,4-di-substituted compounds were shown to be non*toxic (IC50 = 100 :/! with non-symmetrical analogues generating IC50 values in the 1-100 :/ range. No fundamental variation in the biological activity was observed when comparing AAQs with HAAQs in the A549 (+ALDH) and MCF7 (-ALDH) cell lines. A pilot investigation revealed that aberrant gene methylation was cell-type dependent for three ALDH isoforms (1A1, 2, 3A1). Decitabine treatment led to enhanced protein expression for ALDH1A1 (A549), ALDH2 (MCF7) and ALDH3A1 (A549). In contrast, the protein level was reduced for ALDH1A1 in HT29 cells after decitabine treatment. ALDH1A1, ALDH2 and ALDH3A1 were highly expressed in prostate cell lines, with expression linked to promoter methylation. In contrast, low levels of DNA methylation were found in primary prostate cancer cells and benign prostatic hyperplasia. Interestingly, ALDH1A1, considered a SC marker, was found to be expressed at low levels in CD133+/ α2β1hi stem cell fraction and upregulated in CD133-= α2β1lo differentiated prostate cancer cells. In summary, the results in this thesis demonstrate the complexity and tumour type specificity of ALDH expression. This creates challenges for the development of selective probes for CSC isolation, such as the AAQs discussed in this thesis. Although inconclusive results were obtained in regard to AAQs and their potential in targeting ALDHs, selected AAQs were shown to reveal interesting biological features highlighting them as potential non-invasive cytometric probes for tracking molecular interactions in live cells. / EPSRC, Biostatus / The full text was made available at the end of the re-embargo period, 1st September 2017.

Indiana University-Purdue University Indianapolis (IUPUI) / Recent work has shown that specific ALDH isoenzymes can contribute to the underlying pathology of different diseases. Many ALDH isozymes are important in oxidizing reactive aldehydes resulting from lipid peroxidation, and, thus, help maintain cellular homeostasis. Increased expression and activity of ALDH isozymes are found in many human cancers and are often associated with poor prognosis. Therefore, the development of inhibitors of the different ALDH enzymes is of interest as means to treat some of these disease states. Here I describe the results of assays designed to characterize the site of interaction and the mode of inhibition for the unique compounds that function as inhibitors of aldehyde dehydrogenase 2 and determine their respective IC50 values with intent to develop structure-activity relationships for future development.