Au cours de ces années de Doctorat, nous avons étudié les effets ototoxiques de certains médicaments et les moyens de prévenir les surdités neuro-sensorielles quils peuvent induire. Parmi ces molécules, nous nous sommes concentrés sur les plus couramment utilisées en pratique clinique : les antibiotiques de la famille des aminoglycosides et le cisplatine, un agent anti-cancéreux. Lintroduction de notre travail replace la surdité dans son contexte de santé publique. En particulier, nous décrivons pourquoi les médicaments ototoxiques sont utilisés et dans quelles circonstances. Nous présentons la structure de loreille interne et nous tentons dexpliquer sa vulnérabilité aux molécules ototoxiques. Nous abordons ensuite les moyens de prévention et/ou de traitement de ces atteintes neuro-sensorielles pharmaco-induites. Outre les moyens classiques de prévention, que sont les facteurs trophiques et les antioxydants, nous décrivons de nouvelles voies dapproche que sont les voies de signalisation impliquant la protéine kinase C ou la cascade dactivation RhoA/ROCK. La présentation de notre travail original sarticule autour de deux parties. Dans la première partie, nous rapportons les résultats obtenus au cours de notre étude de la toxicité des aminoglycosides et du cisplatine chez la souris et le cobaye in vivo. Nous avons mis en évidence une différence de vulnérabilité significative entre ces deux espèces face à lagression ototoxique. Cette différence existe au niveau fonctionnel, mis en évidence par létude des potentiels évoqués auditifs, et au niveau anatomique, étudié en histologie et en immunohistochimie. Nous en discutons les implications en recherche et en pratique clinique. Dans la seconde partie, nous étudions les moyens de prévenir cette surdité in vivo et in vitro. Nous avons utilisé un modèle de surdité par aminoglycoside chez le cobaye. Nous avons testé et validé une technique de perfusion intra-cochléaire in vivo. Nous avons observé les effets de deux molécules expérimentales : la Bryostatine 1, un activateur de la protéine kinase C, et un inhibiteur de la voir RhoA-ROCK. Leffet protecteur de ces molécules est actuellement limité au ganglion spiral, dont la survie est essentielle à tout traitement dimplantation prothétique et de réadaptation. Nous discutons des perspectives en médecine humaine dans notre conclusion. In this work, we focused our attention on the effects of main ototoxic drugs i.e. aminoglycosides and cisplatin in mammals. We identified new avenues for the prevention of this toxicity. In the introduction, we described how and why ototoxic drugs are used. We then described potential otoprotective strategies in neurosensory deafness. Among them, trophic factors and antioxidant molecules have been widely used. New otoprotective approaches do exist, implying the protein kinase C or RhoA/ROCK signalling. Our original work was presented in two parts. In the first part, we reported the in vivo effects of aminoglycosides and cisplatin in two mammalian species: mice and guinea pigs. Contrarily to guinea pigs, evidence of mice resistance to ototoxicity was found at a functional level, assessed by auditory brainstem responses, and at an anatomical level, studied by immunohistochemistry. We discussed the implication of such differences in research and in clinical practice. In the second part, we studied the effect of two potential otoprotective molecules: Bryostatine 1, an activator of the protein kinase C, and Y-27632, a Rho kinase inhibitor. We showed that these molecules are protecting spiral ganglion neurons both in vitro and in vivo. Survival of spiral ganglion neurons is crucial in the management and rehabilitation of deafness. The potential perspectives of these results in human medicine were discussed.

Degradation of the mRNA 3'-end located poly(A) tail is an important step for mRNA decay in mammalian cells. Thus, to understand mRNA decay in detail, it is important to identify the catalytic activities involved in degrading poly(A). We identified and purified a 54-kDa polypeptide responsible for poly(A)-specific 3' exonuclease activity in calf thymus extracts. The 54-kDa polypeptide is a proteolytic fragment of the poly(A)-specific ribonuclease (PARN) 74-kDa polypeptide. PARN is a divalent metal ion dependent, poly(A)-specific, oligomeric, processive and cap interacting 3' exonuclease. An active deadenylation complex, consisting of the poly(A)-tailed RNA substrate and PARN, has been identified. The interaction with the 5'-end cap structure stimulates PARN activity and also amplifies the processivity of the deadenylation reaction. Furthermore, the cap binding site and the active site of PARN are separate from each other. To characterise the active site of PARN, we per-formed side-directed mutagenesis, Fe2+-mediated hydroxyl radical cleavage and metal ion switch experiments. We have demonstrated that the conserved acidic amino acid residues D28, E30, D292 and D382 of human PARN are essential for PARN activity and that these amino acid residues are directly involved in the co-ordination of at least two metal ions in the active site of PARN. Phosphorothioate modification on RNA substrates revealed that the pro-R oxygen atom of the scissile phosphate group interacts directly with the metal ion(s). Based on our studies, we propose a model for the action of PARN. Similarly to what has been observed for ribozymes, aminoglycoside antibiotics inhibit PARN activity, most likely by the displacement of catalytically important divalent metal ions. Among the aminoglycoside antibiotics tested, neomycin B is the most potent inhibitor. We speculate that inhibition of enzymes using similar catalytic mechanisms as PARN could be a reason for the toxic side effects caused by aminoglycoside antibiotics in clinical practice.

Les acides aminés sont des éléments chiraux essentiels de la vie, ils ont des effets biologiques et pharmacologiques très importants. La séparation chirale des énantiomères des acides aminés est indispensable dans de nombreux domaines tels que l'industrie pharmaceutique, l'agroalimentaire, l'archéologie et la médecine légale. La chromatographie liquide haute performance (CLHP) avec l'utilisation d'une phase stationnaire chirale constitue à l'heure actuelle la méthode de choix pour séparer des énantiomères. Ce travail a permis d'étudier les mécanismes d'interactions mis en jeu dans la fixation et la séparation des énantiomères du tryptophane sur des phases stationnaires chirales (PSCs) de type teicoplanine et teicoplanine aglycone (TAG). Une étude thermodynamique comparative entre ces deux PSCs a permis de déterminer le rôle négatif joué par les trois unités saccharidiques de la teicoplanine dans le processus de discrimination chirale du tryptophane. Ainsi, nous avons montré que cet acide aminé interagit considérablement avec la poche aglycone de la teicoplanine. L'utilisation d'une nouvelle PSC de type teicoplanine, immobilisée de manière non-covalente sur des supports chromatographiques de type C8 et C18, a permis de séparer quelques acides aminés aromatiques et d'inverser leur ordre d'élution énantiomérique (L>D) par rapport à celui classiquement obtenu avec une immobilisation covalente sur gel de silice (D>L). Par ailleurs, nous avons développé une nouvelle classe de sélecteurs chiraux à base d'aminoglycosides en chromatographie chirale d'échange de ligands. Plusieurs énantiomères d'acides aminés et de nucléosides ont été séparés avec succès sur ce nouveau type de PSCs.

In this study, a strategy called gene splicing by overlap extension, &ldquo / Gene SOEing&rdquo / , was used for the construction of the fusion proteins with the purpose of increasing the thermostability of mesophilic enzymes by incorporation of stability domain from a thermostable enzyme. Gene SOEing is a PCR-based approach for recombining DNA molecules at precise junctions irrespective of nucleotide sequences at the recombination site and without the use of restriction endonucleases or ligase. In fusion constructs, as the stability determinant Thermoplasma volcanium citrate synthase (CS) large domain has been used. This gene has recently been cloned in our laboratory. In two different fusions, as fusion partners, dehalogenase II (dehCII) gene of Pseudomonas sp. CBS3 and aminoglycoside-3&#039 / -phosphotransferase-II (APH(3&#039 / )-II) gene of E. coli were employed. Following the Gene SOEing, two fusion products, 1722 bp long CS Large Domain-dehCII and 1750 bp long CS Large Domain-APH(3&#039 / )-II were constructed. Also a 1586 bp long dehCII-APH(3&#039 / )-II fusion was prepared. Three fusion constructs were cloned in E. coli. Cloning was confirmed in each case, by restriction analysis of the isolated plasmids from recombinant colonies. APH(3&#039 / )-II gene associated with CS Large Domain-APH(3&#039 / )-II and dehCII-APH(3&#039 / )-II fusion constructs were successfully expressed in E. coli as revealed by enzyme assay and antibiotic agar plate assay. CS Large Domain-APH(3&#039 / )-II fusion protein retained 9.4% of the original APH(3&#039 / )-II activity after 10 minutes at 60&ordm / C. However, CS Large Domain-dehCII and dehCII-APH(3&#039 / )-II fusions did not display any dehalogenase activity.

<p>Aminoglycoside antibiotics are commonly used to treat bacterial infections but are highly susceptible to chemical modification, leading to resistance. Chemical modification can be hindered through the use of small molecule inhibitors that target bacterial enzymes involved in resistance, most notably kinases. Current methods for the discovery of small molecule inhibitors of kinases and related “kinase-like” enzymes are limited in throughput and utilize slow, tedious, and expensive assays. This thesis is focused on the development of highly versatile and scaleable kinase and “kinase-like” screening platforms for the discovery of small molecule inhibitors of these drug targets. The work begins with the validation of a matrix-assisted laser desorption/ionization tandem mass spectrometry (MALDI-MS/MS) platform utilizing phosphorylation of kanamycin, an aminoglycoside antibiotic, by aminoglycoside phosphotransferase 3ʹIIIa (APH 3ʹIIIa) as a model system. Using a product-to-substrate signal ratio as an internal standard, the assay was used to functionally screen over 200 compounds, combined into mixtures to enhance assay throughput. Moreover, the assay was used to determine inhibitory dissocation constants for newly discovered modulators. Throughput was further increased to a novel dual-kinase assay targeting a bacterial enzyme, APH 3ʹIIIa and a human kinase, protein kinase A (PKA), which was validated using the previous small molecule library. Alternative assay development platforms were also studied using imaging mass spectrometry of reaction microarrays and the fabrication of sol-gel derived bioaffinity chromatography columns. The MS-based kinase assays developed herein are highly amenable to high throughput screening, and have the potential to be extended to other important therapeutic targets.</p> / Doctor of Philosophy (PhD)

Thesis (MScMedSc (Biomedical Sciences. Molecular Biology and Human Genetics))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: South Africa is currently facing a major multidrug-resistant tuberculosis (MDR-TB) epidemic and has one of the highest incidences in the world. Aminoglycoside antibiotics are commonly used in this country as a treatment against MDR-TB. A well known side-effect of aminoglycosides is permanent hearing loss and this is thought to have a significant genetic component. To date, at least six mutations in the mitochondrial genome are known to confer susceptibility to aminoglycosideinduced hearing loss. It is imperative that we investigate the frequency of these mutations in our populations and determine whether certain sub-groups are at increased risk. The aim of the present study was therefore to investigate the genetic aetiology of aminoglycoside-induced hearing loss in the South African population. A multiplex method using the ABI Prism® SNaPshotTM Multiplex system was optimised to screen for six mutations in the MT-RNR1: A1555G, C1494T, T1095C, 961delT+C(n), A827G and T1291C. A total of 115 MDR-TB patients from the Brooklyn Chest Hospital in Cape Town who were receiving high doses of either streptomycin, kanamycin or capreomycin were recruited for this study. Furthermore, 439 control samples, comprising of 93 Afrikaner, 104 Caucasian, 112 Black and 130 Mixed Ancestry individuals were recruited and screened for the presence of the six mutations. Identification of novel variants in the MT-RNR1 and the entire mitochondrial genome was performed using High Resolution Melt analysis (HRM) and whole mitochondrial DNA sequencing, respectively. A total of 97 family members from a South African family known to harbour the A1555G mutation were recruited and genotyped using SNaPshot analysis. In addition, mitochondrial functioning in the presence of different streptomycin drug concentrations, in transformed lymphoblasts of an individual harbouring the A1555G, was assessed by means of the MTT colorimetric assay. Detection of heteroplasmic mutations was performed using PCRRestriction Fragment Length Polymorphism (RFLP) analysis and UN-SCAN-IT software. We successfully developed a robust and cost-effective method that detects the presence of all six mutations simultaneously. The method worked equally well on both blood (from adults) and buccal swabs (from children). The C1494T, T1095C and T1291C mutations were not detected in any of the MDR-TB or control groups. Alarmingly, the A1555G mutation was detected in 0.9% of the Black control samples and in 1.1% of the Afrikaner controls (in one sample in the heteroplasmic state 25%). The A827G mutation was present at a frequency of 0.9% in the MDR-TB patients and in 1.1% of the Afrikaner controls. The 961delT + insC(n) mutation was found in relatively high frequencies in both the MDR-TB patients (3.5%) and control groups (1.1% of the Afrikaner, 1.5% of the Mixed Ancestry and 7.1% of the Black samples). Similarly, the T961G mutation was III detected at high frequencies in the Caucasian (2.9%) and Afrikaner (3.2%) controls. Screening for novel variants in MT-RNR1 in MDR-TB patients experiencing ototoxicity revealed two novel variants (G719A and T1040C). However, G719A and T1040C are not likely to be pathogenic since they were detected in ethnic-matched controls: Mixed Ancestry (20.7%) and Black (1.8%) controls. Furthermore, a total of 50 novel variants were identified within the mitochondrial genome of eight MDR-TB patients with ototoxicity. Only five of the 50 variants (one in the MT-TH, ND3, COX3 and two in the CYTB gene) were shown to reside at positions that are evolutionarily conserved across five species from human to frog, and the four variants in the protein coding genes resulted in missense changes. A total of 76 of the 97 family members recruited were found to be A1555Gpositive (on mitochondrial haplogroup L0d) and are therefore at risk of developing irreversible hearing loss. Genes and variants known to act as genetic modifiers: tRNASer(UCN), homozygous A10S in TRMU and 35delG in GJB2 were not present in this family. For the MTT assay, decreased mitochondrial functioning of cells harbouring the A1555G mutation in the presence of streptomycin were (compared to wild type) observed but this was not statistically significant (p-value: 0.615- 0.999). The high frequency of the A1555G mutation (0.9%) in the Black population in South Africa is of concern given the high incidence of MDR-TB in this particular ethnic group. However, future studies with larger numbers of samples are warranted to determine the true frequencies of the aminoglycoside deafness mutations in the general South African population. Our data suggests that the 961delT + insC(n) and T961G variants are common non-pathogenic polymorphisms due to the high frequencies observed in controls (>1%). The identification of the first novel variants within protein coding genes that could possibly be associated with aminoglycoside-induced hearing loss holds great possibilities with regards to the identification of a second gene involved in drug induced hearing loss. Future studies where the possible effect of these variants on the normal functioning of these genes could be assessed would contribute greatly to this field of research. All 76 A1555Gpositive members of the family were given genetic reports and counseled about their risk and that of their children for developing hearing loss due to aminoglycoside use. The development of a rapid and cost-effective genetic method facilitates the identification of individuals at high risk of developing hearing loss prior to the start of aminoglycoside therapy. This is of critical important in a low-resource country like South Africa where, despite their adverse sideeffects, aminoglycosides will be continue to be used routinely and are accompanied with very limited or no audiological monitoring. Future studies and greater public awareness is therefore needed to address this serious problem. / AFRIKAANSE OPSOMMING: Suid Afrika beleef tans „n grootskaalse tuberculose epidemie (veral weerstandige vorme van tuberculose) (MDR-TB), met een van die hoogste voorkomssyfers in die wêreld. Aminoglikosied antibiotikums word baie algemeen gebruik in Suid Afrika vir die behandeling van MDR-TB. ‟n Bekende newe effek van die middels is permanente gehoor verlies en dit is van mening dat dit gekoppel is aan „n genetiese component. Daar is tans ses mutasies in die mitochondriale genoom wat vatbaarheid tot aminoglikosied-geinduseerde gehoor verlies veroorsaak. Daarom is dit van uiterse belang dat die frekwensie van die mutasies in ons populasies bepaal word sodat daar vasgestel kan word watter groepe „n hoë risiko het om gehoor verlies te kan ontwikkel. Die ABI Prism® SNaPshotTM Multipleks sisteem is gebruik en geoptimiseer om te toets vir die ses mutasies in die MT-RNR1: C1494T, T1095C, 961delT+C(n), A827G and T1291C. „n Totaal van 115 MDR-TB pasiente van die Brooklyn Chest Hospital in Kaap Stad is gewerf vir die studie. Hierdie pasiente ontvang daaglikse hoë dosese van een van die volgende aminoglikosiede: streptomycin, kanamycin of capreomycin. Verder is „n totaal van 439 kontrole DNA monsters gewerf vanuit die volgende etniese groepe: 93 Afrikaner, 104 Blank, 112 Swart and 130 Kleurling. Hierdie monsters is ook getoets vir die ses mutatsies. Hoë Resolusie Smelt analise (HRS) is gebruik om nuwe DNS volgorde veranderinge in die MT-RNR geen te identifiseer. Die hele mitochondriale genoom is blootgestel aan DNA volgorde bepaling in „n poging om nuwe DNS volgorde verandering in die genoom te identifiseer wat moontlik betrokke kan wees by aminoglikosied-geinduseerde gehoor verlies. „n Total van 97 lede van „n Suid Afrikaanse familie waar die A1555G mutasie teenwoordig is, is deur middle van die SNaPshot metode gegenotipeer. Verder is die normale funcitoneering van die mitochondrion in getransformeerde witbloed selle, getoets in die teenwoordigheid van verskillende konsentrasies streptomycin met behulp van die MTT kleurmetrie toets. Deteksie van heteroplasmiese mutasies is gedoen deur middle van die PCR-RFLP tegniek en alle analises is gedoen op die UN-SCAN-IT program. Ons was suksesvol in die ontwikkeling van „n vinnige, koste effektiewe en kragtige tegniek wat al ses die mutasies in MT-RNR1 in een reaksie kan optel. Hierdie tegniek het goed gewerk met DNA monsters van bloed en van selle verkry vanuit die wangholte (geneem van kinders jonger as 12 jaar). Die C1494T, T1095C en T1291C mutasies is glad nie waargeneem in enige van ons MDR-TB patiente of kontroles nie. Skrikwekkend is die hoë frekwensie (0.9%) waarby die A1555G mutasie in die Swart kontrole groep waargeneem is. Hierdie mutasie is ook in 1.1% van die Afrikaner kontrole groep opgemerk in heteroplasmie van 25%. Die A827G mutasie was teenwoordig in 0.9% en 1.1% van die MDR-TB patiente en Afrikaner kontrole monsters, onerskeidelik. Die 961delT + insC(n) mutasie is opgemerk in baie hoë frekwensies in beide die MDR-TB (3.5%) en kontrole groepe (1.1% van die Afrikaner, 1.5% van die Kleurling en 7.1% van die Swart monsters). Die T961G mutasie is ook in hoë frekwensies in slegs die Blanke (2.9%) en die Afrikaner (3.2%) kontrole groepe waargeneem. Nuwe DNS volgorde veranderinge in MT-RNR1 is gesoek in „n groep MDR-TB patiente wat gehoor verlies ondervind. Slegs twee nuwe verandering is ontdek (G719A en T1040C). Dit is onwaarskynlik dat hierdie veranderinge patogenies is siende dat hulle teen frekwensies van 20.7% en 1.8% waargeneem is in die Kleurling en Swart kontrole groepe onderskeidelik. Tydens die soeke na nuwe DNS volgorde veranderinge wat moontlik geassosieer is met aminoglikosied-geinduseerde gehoor verlies in die mitochondriale genoom is 50 onbekende veranderinge ontdek (een in die MT-TH, ND3, COX3 en twee in die CYTB gene). Die veranderinge is verder ondersoek vir evolusionêre konservasie op beide die nukliotied en amino suur vlak van mens to padda. Dit is bevind dat 76 uit die 97 familie lede positief is vir die A1555G mutasie en het dus „n hoë risiko om aminoglikosied-geinduseerde gehoor verlies te ontwikkel as hul bloot gestel word aan hierdie antibiotikums. Verder is gevind dat hierdie familie op die L0d mitochondriale haplogroep lê. Geen van die sogenaamde genetiese modifiseerde gene of DNS volgorde veranderinge in hierdie gene (tRNASer(UCN), A10S in TRMU in homosigotiese vorm en die 35delG in GJB2) is gevind in die familie nie. Die MTT toets het „n afname in die mitochondriale funksioneering van selle waar die A1555G mutasie teenwoordig was getoon, alhoewel die verskil tussen selle wat nie die A1555G mutasie het nie, nie statisties betekenisvol was nie (p-waarde: 0.615-0.999). Die hoë frekwensie van die A1555G mutasie (0.9%) in die Swart populasie van Suid Afrika is skrikwekkend siende dat die voorkomssyfer van MDR-TB in hierdie groep baie hoog is. Toekomstige studies met grooter getalle is nodig om die ware frekwensie van die mutasies geassosieer met aminoglikosied-geinduseerde gehoor verlies in die algemende Suid Afrikaanse populasie te bepaal. Ons data dui aan dat die 961delT + insC(n) en die T961G mutasies slegs algemene nie-patogeniese polimorphismis is siende dat dit in sulke hoë frekwensies (>1%) in kontroles opgemerk is. Die identifiseering van die eerste DNS volgorde veranderinge in proteïen kodeerende gene wat moontlik geassosieer is met aminoglikosied-geinduseerde gehoor verlies hou groot en belowende moontlikehede in, interme van die identifiseering van „n tweede geen. Toekomstige studies waarin die effek van hierdie veranderinge op die normale funktioneering van hierdie gene ondersoek word sal „n besondere groot bydrae lewer tot hierdie veld van navorsing. Al 76 van die A1555G positiewe familie lede is voorsien van genetiese verslae en het berading ontvang in verband met hul risiko en die risiko van hul kinders om aminoglikosied-geinduseerde gehoor verlies te ontwikkel. Die ontwikkeling van „n kragtige, vinnige en koste-effektiewe genetiese metode vergemaklik die vinnige identifiseering van hoë risiko individue vir die ontwikkeling van gehoor verlies voordat hulle met hul aminoglikosiede behandeling begin. Dit is veral noodsaaklik in „n derde wêreld land soos Suid Afrika waar, ten spyte van hul gevaarlike newe effekte, aminoglikosied antibiotikums steeds gebruik sal word. Daarom is grooter publieke bewusmaking nodig om hierdie problem te probeer oplos en te verhoed.

Plusieurs aminoglycosides font partie d’une famille d’antibiotiques à large spectre d’action. Les aminoglycosides ayant une activité antibiotique viennent interférer dans la synthèse protéique effectuée par les bactéries. Les protéines mal codées entraineront la mort cellulaire. Au fil des années, de nombreux cas de résistance ont émergé après une utilisation soutenue des aminoglycosides. De nombreux aminoglycosides semi-synthétiques ont été synthétisés avec comme objectif de restaurer leur activité antimicrobienne. Parmi les modifications ayant connu du succès, notons la didésoxygénation d’un diol et l’introduction de la chaine latérale HABA. Des études précédentes ont montré l’efficacité de ces modifications sur les aminoglycosides. Les présents travaux portent sur l’installation de la chaine latérale HABA et la didésoxygénation d’un diol sur la paromomycine et la néomycine. La didésoxygénation sélective des diols a été effectuée en utilisant la méthodologie développée par Garegg et Samuelsson, une variation de la réaction de Tipson-Cohen. Cette méthode a permis l’obtention du motif didésoxygéné sur les cycles A et D dans des rendements jamais égalés pour ce motif synthétique. La chaîne latérale a été introduite en tirant profit de la réactivité et de la sélectivité d’un carbamate cyclique. Ces méthodes combinées ont permis la synthèse efficace de nombreux analogues semi-synthétiques nouveaux. La 3',4'-didéhydro-N-1-HABA-néomycine et la 3',4',3''',4'''-tétradésoxy-N-1-HABA-néomycine montrent une activité impressionnante contre des souches de bactéries résistantes aux aminoglycosides. Des tests de toxicité effectués en collaboration avec Achaogen Inc. ont démontré que ces composés sont relativement toxiques sur les cellules rénales de type H2K, ce qui réduit de façon importante leur index thérapeutique. Afin d’abaisser la toxicité des composés, la relation entre toxicité et basicité a été explorée. Des substitutions de l’amine en 6''' ont été effectuées afin d’abaisser la basicité de l’amine. Les résultats de toxicité et d’activité antimicrobienne démontrent une corrélation importante entre la basicité des amines et la toxicité/activité des aminoglycosides antibiotiques. L’effet d’une modulation du pKa a aussi été exploré en installant des chaines fluorées sur l’amine en 6''' de la paromomycine et de la néomycine. Une séquence synthtétique pour isoler l’amine en 6''' de la néomycine a aussi été développée. / Some aminoglycosides are part of a broad-spectrum family of antibiotics used in the clinic. They interfere in protein synthesis in bacterium cell by interfering with the transcription of proteins leading to cellular death. After an intense usage of aminoglycosides in the clinic, numerous cases of resistance have been encountered which render aminoglycosides less effective. Semi-synthetic aminoglycosides have been synthesized with the objective of restoring their original antimicrobial activity. Deoxygenation of the diol on ring A and introduction of the lateral chain HABA at N-1 had a significant impact on their antimicrobial activity against resistant strains. The present work will focus on deoxygenation of the diol at 3', 4' and on the introduction of the lateral HABA chain on aminoglycoside, more specificaly on paromomycin and neomycin. The selective dideoxygenation of the A ring diol was done using a methodology developed by Garegg and Samuelsson, which is a modification of the original Tipson-Cohen reaction. This method allows the dideoxygenation on ring A and D with unprecedented yields. The lateral HABA chain was introduced via the ring opening of a cyclic carbamate. These methods were combined to produce very potent analogs such as 3',4'-didehydro-N-1-HABA-neomycin and 3',4',3''',4'''-tetradeoxy-N-1-HABA-neomycin. Toxicity tests done in collaboration with Achaogen Inc. showed that these analogs were toxic to H2K renal cells, which reduced significantly their therapeutic index. In order to lower the toxicity of those compounds, the relation between toxicity and basicity was explored. Substitution of the amine at 6''' was done in order to lower the basicity of this amine. The results showed a strong correlation beetween the basicity of this amine and toxicity/activity. The pKa of this amine was modulated by installing fluorinated alkyl chain on the amine at 6''' in order to see the effect of the pKa on the activity/toxicity on paromomycin and neomycin. A synthetic sequence was also developed to allow the 6''' amine on neomycin to be modified selectively.

Made available in DSpace on 2016-01-26T12:51:25Z (GMT). No. of bitstreams: 1 joaofernandopicollodeoliveira_dissert.pdf: 2216002 bytes, checksum: 172981ec9e4daa13d8e1e6872337867d (MD5) Previous issue date: 2008-12-10 / Nephrotoxicity is the main adverse effect of aminoglycoside use. There are few information about its prevalence and risk factor in intensive care unit patients. Objectives: To assess the prevalence, mortality and risk factors for aminoglycoside nephrotoxicity in ICU patients. Casuistic and Method: In order to assess the prevalence of, and risk factors for aminoglycoside nephrotoxicity in the ICU, 360 consecutive patients starting aminoglycoside therapy in the ICU with a baseline calculated GFR (cGFR) &#8805;30 ml/min/1.73 m2 were evaluated. Results: Of them, 209 (58%) developed aminoglycoside-induced nephrotoxicity (AKI, decrease in cGFR >20% from baseline), while 151 did not (non-AKI). Both groups had similar baseline cGFR. The AKI group developed a lower cGFR nadir (45 ± 27 vs. 79 ± 39 ml/min/1.73 m2, p<0.001), was older (56 ± 18 y vs. 52 ± 19 y, p=0.033), had a higher prevalence of diabetes (19.6% vs. 9.3%, p=0.007), used other nephrotoxic drugs (51% vs. 38%, p=0.024) and iodinated contrast more frequently (18% vs. 8%, p=0.0054), showed higher prevalence of hypotension (63% vs. 44%, p=0.0003), shock (56% vs. 31%, p<0.0001), and jaundice (19% vs. 8%, p=0.0036). Mortality was 44.5% in the AKI and 29.1% in the non-AKI groups (p=0.0031). A logistic regression model identified as significant (p<0.05) independent factors affecting aminoglycoside-induced nephrotoxicity baseline cGFR<60 ml/min/1.73 m2 (OR 0.42), diabetes (OR 2.13), simultaneous use of other nephrotoxins (OR 1.61) or iodinated contrast (OR 2.13), and hypotension (OR 1.83). Conclusion: The AKI was frequent among ICU patients using aminoglycoside, and it was associated with high mortality. The presence of diabetes, hypotension, simultaneous use of other nephrotoxic drugs, and iodinated contrast were independent risk factors for the development of aminoglycoside-induced nephrotoxicity. / Nefrotoxicidade é a principal complicação do uso de aminoglicosídeos. Existem poucas informações sobre a prevalência e os fatores de risco para nefrotoxicidade por aminoglicosídeos em paciente internados em unidades de terapia intensiva. Objetivos: Avaliar a prevalência, a mortalidade e os fatores de risco para nefrotoxicidade por aminoglicosídeos em pacientes internados em Unidade de Terapia Intensiva geral. Casuística e Métodos: Foram avaliados a prevalência, os fatores de risco e a mortalidade da nefrotoxicidade por aminoglicosídeo de 360 pacientes internados em terapia intensiva com filtração glomerular calculada por fórmula (MDRD, RFG) basal &#8805;30ml/min/ 1,73m2, que iniciaram o uso do antibiótico na terapia intensiva; nefrotoxicidade foi definida como queda >20% na RFG em relação ao RFG basal. Resultados: Entre os pacientes estudados 209 (58%) desenvolveram nefrotoxicidade (IRA) e 151 não alteraram a função renal (não IRA). Ambos os grupos (média±desvio padrão) tinham RFG basal similar (89&#61617;42 ml/min/ 1,73m2 no grupo IRA versus 84±42 ml/min/ 1,73m2 no grupo não IRA). O grupo IRA teve menor nadir de RFG (45±27 ml/min/ 1,73m2 versus 79±39 ml/min/ 1,73m2, p<0,001), idade maior (56&#61617;18 anos versus 52&#61617;19 anos, p=0,033), maior prevalência de diabetes (19,6% versus 9,3%, p=0,007), uso simultâneo mais freqüente de outras drogas nefrotóxicas (51% versus 38%, p=0,024) e contraste (18% versus 8%, p=0,0054), maior prevalência de hipovolemia (44% versus 27%, p=0,001), hipotensão (63% versus 44%, p=0,0003), choque (56% versus 31%, p<0,0001) e icterícia (19% versus 8%, p=0,0036). A mortalidade foi 44,5% no grupo IRA e 29,1% no grupo não IRA (p=0,0031). A análise por regressão logística identificou como fatores de risco independente para a nefrotoxicidade por aminoglicosídeo, RFG basal <60ml/min/1,73m2 [OR 0,42 (IC 95% 0,24-0,72, p=0,02)], diabetes [OR 2,13 (IC 95% 1,01-4,49, p=0,046)], uso simultâneo de outras drogas nefrotóxicas [OR 1,61 (IC 95% 1,00-2,59, p=0,048)], uso de contraste iodado [OR 2,13 (IC 95% 1,02-4,43, p=0,043)] e hipotensão [OR 1,83 (IC 95% 1,14-2,94, p=0,012)]. Conclusões: Nefrotoxicidade por aminoglicosídeo foi freqüente e associada a alta mortalidade em pacientes de UTI. A presença de diabetes, hipotensão, uso simultâneo de outras drogas nefrotóxicas e contraste iodado foram fatores de risco independentes para o desenvolvimento de nefrotoxicidade.

Les aminoglycosides, des dérivés aminés de saccharides, interfèrent avec le mécanisme de synthèse des protéines chez les bactéries en se fixant au site de décodage de l'ARN de transfert aminoacylé (site A) situé en 3' de l'ARN ribosomique 16S. Au cours de ce travail de thèse, les structures de trois complexes entre des fragments d'ARN incorporant le site A et les aminoglycosides paromomycine, tobramycine et généticine, ont été résolues par cristallographie aux rayons X à 2,40-2,54 Å. L'analyse des structures montre que la reconnaissance et la fixation spécifiques des aminoglycosides au site A font intervenir de nombreuses liaisons hydrogène directes et pontées par des molécules d'eau. Dans ces structures, la partie néamine commune aux aminoglycosides (cycles I et II) s'intercale dans l'hélice de manière similaire : le cycle I (non plan) forme une pseudo paire de bases avec l'adénine 1408 ; la néamine oblige les adénines 1492 et 1493 à pointer hors de l'hélice. La comparaison des structures 3D de ces trois complexes offre des explications moléculaires aux différents résultats de biochimie et de microbiologie, ainsi qu'à certains phénomènes de résistances et de toxicités. Les conformations du site A et des aminoglycosides au sein de ces complexes sont similaires à celles du site A et de la paromomycine au sein de la sous-unité ribosomique 30S. Ainsi, la stratégie développée permet une description des interactions et des modes de fonctionnement des aminoglycosides proche du contexte naturel mais plus précise, essentielle à notre connaissance du système ARN/aminoglycoside. De ces résultats découlent des lignes directrices laissant envisager sous un jour nouveau la conception d'antibiotiques moins sujets aux résistances et moins toxiques.

ResumenEn esta tesis se ha optimizado un protocolo de regeneración a partir de material varietal de 'Helena' y 'Canino'. Mediante el estudio de los diversos factores que afectan la transformación de material adulto, se ha establecido por primera vez un protocolo eficiente de transformación mediada por Agrobacterium tumefaciens de una variedad comercial de albaricoquero.El diseño de una estrategia de selección gradual con paromomicina ha permitido la regeneración de plántulas transformadas con los genes marcadores nptII y sgfp o gus, con las eficiencias más elevadas que se han publicado hasta el momento para transformar material varietal en especies del género Prunus, aunque la baja viabilidad de las yemas transformadas redujo el número final de plantas obtenidas.El protocolo establecido en esta tesis sienta las bases que permitirán la introducción de genes de interés agronómico y comercial, modificando de manera discreta variedades élite aceptadas y establecidas en el mercado. / In this thesis a protocol of regeneration has been optimized from leaf explants of the cultivars 'Helena' and 'Canino'. By means of the study of the diverse factors that affect the transformation of adult material, an efficient protocol of Agrobacterium tumefaciens-mediated transformation has been established for the first time for a commercial cultivar of apricot.The design of a gradual selection strategy with paromomycin has permitted the regeneration of transformed shoots with the marker genes nptII and sgfp or gus, with the highest efficiencies that have been published up to now from adult material in Prunus, although the low viability of the transformed buds reduced the final number of plants obtained. This protocol establishes the bases that will permit the introduction of agronomic and commercial interesting genes, modifying discreetly commercial cultivars accepted and established in the market.