Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A disfunção endotelial tem sido sugerida como evento precoce na patogênese das complicações vasculares do DM1. O presente estudo objetivou avaliar a função endotelial na microcirculação e rigidez arterial no diabetes tipo 1 comparando com controles não diabéticos e correlacionando com variáveis clínicas, demográficas e laboratoriais. Foram avaliados 57 pacientes com diabetes tipo 1 com idade de 32,5 (13-61) anos e duração de doença de 15 (1-48) anos e 53 controles através de fluxometria cutânea por laser-Doppler após iontoforese de Acetilcolina(ACh) (resposta endotélio dependente), hiperemia reativa pós oclusiva(HRPO) e a capacidade máxima de vasodilatação após hiperemia térmica. Já a resposta endotélio independente foi avaliada após iontoforese de Nitroprussiato de sódio (NPS). A rigidez arterial foi mensurada através da análise da onda de pulso digital com os índices de rigidez arterial e de reflexão. Os pacientes diabéticos foram submetidos à avaliação clínica e laboratorial (histórico de tabagismo, dose diária de insulina, duração do diabetes, uso de drogas que alteram a função endotelial como anti-hipertensivos e estatinas, níveis pressóricos, índice de massa corporal, excreção urinária de albumina, perfil lipídico, controle glicêmico e níveis de proteína C-reativa). O fluxo microvascular médio em repouso não foi diferente entre pacientes e controles , assim como a complacência arterial mensurada através do índice de rigidez arterial e do índice de reflexão. A resposta vascular a vasodilatação mediada pela ACh encontrou-se significantemente reduzida nos pacientes (p=0,002). No entanto, apesar da diferença verificada na área abaixo da curva de NPS em relação ao controle, a análise por medidas repetidas não apontou diferença entre os grupos em relação às doses entre os grupos (p=0,15). A vasodilatação cutânea máxima induzida pela hiperemia térmica foi maior entre os controles em comparação com os diabéticos 93,6(24,5-379-,9) e 56,6(31,5-204,5), respectivamente p=0,04. Por outro lado, durante a HRPO, o aumento máximo no fluxo e a área abaixo da resposta hiperêmica não divergiram entre pacientes e controles, embora o tempo para alcançar o fluxo máximo tenha sido maior nos diabéticos do que nos controles(p=0,02). As principais variáveis correlacionadas com a microcirculação foram o ácido úrico, a hemoglobina glicada, a idade e a proteína C reativa, e com a rigidez arterial, foram a duração do Diabetes, a Pressão arterial diastólica e o HDL. Apesar da correlação entre o uso de drogas com propriedades hemorreológicas e a rigidez arterial, a exclusão dos pacientes usuários daqueles medicamentos não alterou os resultados obtidos. Concluímos que, na população de diabéticos tipo 1 estudada, a resposta vascular endotélio dependente, e a capacidade máxima de vasodilatação estão significativamente reduzidas. Não houve diferença entre diabéticos e controles quanto à rigidez arterial. Ademais, a vasodilatação microcirculatória mediada pela Acetilcolina pode ser correlacionada com a rigidez arterial em diabéticos. Estudos posteriores devem ser realizados no intuito de avaliar a influência exercida pelas drogas que alteram a função endotelial sobre a reatividade micro e macrovascular. / Endothelial dysfunction in patients with type 1 diabetes appears to be an early event in the genesis of vascular complications. The purpose of the present study is to assess endothelial function in the microcirculation and arterial stiffness, by comparing with non-diabetic controls, and correlating with clinical, demographic and laboratorial parameters. We evaluated 57 patients with type 1 diabetes aged 32.5 (13-61) years and with a disease duration of 15 (1-48)years, and 53 controls using laser Doppler flowmetry during low-current iontophoresis of acetylcholine (ACh) (endothelium dependent response), post occlusive reactive hyperemia(PORH) and maximum vasodilator function during thermal hyperemia. Endothelium-independent response was measured after iontophoresis of sodium nitroprusside (SNP).The peripheral pressure waveform was analyzed to assess the arterial stiffness. Diabetic patients underwent clinical and laboratory evaluation (smoking, disease duration, daily insulin dose, use of medications that could improve endothelial function such as antihypertensive drugs and statins, blood pressure, body mass index, urinary albumin excretion, lipid profile, glycemic control and C-reactive protein levels-CRP). Mean resting microvascular flux did not differ between control subjects and patients with type 1 diabetes, as well as arterial stiffness assessed through stiffness index and reflection index. Microvascular response to ACh was significantly reduced in patients (p=0,002). However, despite the reduction ofAUC NPS, the analysis with repeated measures disclosed no difference between the groups in relation to the doses (p=0,15). Maximal skin microvascular vasodilation induced by thermal hyperemia was found to be higher in the control group than among patients (93,6(24,5-379-,9) e 56,6(31,5-204,5), respectively p=0,04). On the other hand, during PORH, maximal increase in flux and area under the curve of the hyperemic response did not differ between patients and controls, although the time frame to reach maximum flux and the time to half recovery after hyperemia was longer in patients than in controls (P=0.02) . Uric acid, hba1c, age and CRP were the most important contributing factors to the variation of microvascular reactivity, while disease duration, the diastolic arterial pressure and HDL cholesterol were independently associated to arterial stiffness. Despite the correlation between drugs with hemorheologycal properties and arterial stiffness, the exclusion of patients who were taking such substances did not affect the results. We conclude that in the studied population of type 1 diabetic patients, the endothelium-dependent vascular responses and maximal vasodilator capacity are significantly reduced. In what concerns arterial stiffness, our study disclosed no difference between diabetics and controls. Moreover, Acetylcholine response can be correlated to arterial stiffness in diabetics, and further studies aiming at the evaluation of the micro and macrovascular reactivity should be performed with consumers of drugs which may be likely to affect the endothelial function.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A disfunção endotelial tem sido sugerida como evento precoce na patogênese das complicações vasculares do DM1. O presente estudo objetivou avaliar a função endotelial na microcirculação e rigidez arterial no diabetes tipo 1 comparando com controles não diabéticos e correlacionando com variáveis clínicas, demográficas e laboratoriais. Foram avaliados 57 pacientes com diabetes tipo 1 com idade de 32,5 (13-61) anos e duração de doença de 15 (1-48) anos e 53 controles através de fluxometria cutânea por laser-Doppler após iontoforese de Acetilcolina(ACh) (resposta endotélio dependente), hiperemia reativa pós oclusiva(HRPO) e a capacidade máxima de vasodilatação após hiperemia térmica. Já a resposta endotélio independente foi avaliada após iontoforese de Nitroprussiato de sódio (NPS). A rigidez arterial foi mensurada através da análise da onda de pulso digital com os índices de rigidez arterial e de reflexão. Os pacientes diabéticos foram submetidos à avaliação clínica e laboratorial (histórico de tabagismo, dose diária de insulina, duração do diabetes, uso de drogas que alteram a função endotelial como anti-hipertensivos e estatinas, níveis pressóricos, índice de massa corporal, excreção urinária de albumina, perfil lipídico, controle glicêmico e níveis de proteína C-reativa). O fluxo microvascular médio em repouso não foi diferente entre pacientes e controles , assim como a complacência arterial mensurada através do índice de rigidez arterial e do índice de reflexão. A resposta vascular a vasodilatação mediada pela ACh encontrou-se significantemente reduzida nos pacientes (p=0,002). No entanto, apesar da diferença verificada na área abaixo da curva de NPS em relação ao controle, a análise por medidas repetidas não apontou diferença entre os grupos em relação às doses entre os grupos (p=0,15). A vasodilatação cutânea máxima induzida pela hiperemia térmica foi maior entre os controles em comparação com os diabéticos 93,6(24,5-379-,9) e 56,6(31,5-204,5), respectivamente p=0,04. Por outro lado, durante a HRPO, o aumento máximo no fluxo e a área abaixo da resposta hiperêmica não divergiram entre pacientes e controles, embora o tempo para alcançar o fluxo máximo tenha sido maior nos diabéticos do que nos controles(p=0,02). As principais variáveis correlacionadas com a microcirculação foram o ácido úrico, a hemoglobina glicada, a idade e a proteína C reativa, e com a rigidez arterial, foram a duração do Diabetes, a Pressão arterial diastólica e o HDL. Apesar da correlação entre o uso de drogas com propriedades hemorreológicas e a rigidez arterial, a exclusão dos pacientes usuários daqueles medicamentos não alterou os resultados obtidos. Concluímos que, na população de diabéticos tipo 1 estudada, a resposta vascular endotélio dependente, e a capacidade máxima de vasodilatação estão significativamente reduzidas. Não houve diferença entre diabéticos e controles quanto à rigidez arterial. Ademais, a vasodilatação microcirculatória mediada pela Acetilcolina pode ser correlacionada com a rigidez arterial em diabéticos. Estudos posteriores devem ser realizados no intuito de avaliar a influência exercida pelas drogas que alteram a função endotelial sobre a reatividade micro e macrovascular. / Endothelial dysfunction in patients with type 1 diabetes appears to be an early event in the genesis of vascular complications. The purpose of the present study is to assess endothelial function in the microcirculation and arterial stiffness, by comparing with non-diabetic controls, and correlating with clinical, demographic and laboratorial parameters. We evaluated 57 patients with type 1 diabetes aged 32.5 (13-61) years and with a disease duration of 15 (1-48)years, and 53 controls using laser Doppler flowmetry during low-current iontophoresis of acetylcholine (ACh) (endothelium dependent response), post occlusive reactive hyperemia(PORH) and maximum vasodilator function during thermal hyperemia. Endothelium-independent response was measured after iontophoresis of sodium nitroprusside (SNP).The peripheral pressure waveform was analyzed to assess the arterial stiffness. Diabetic patients underwent clinical and laboratory evaluation (smoking, disease duration, daily insulin dose, use of medications that could improve endothelial function such as antihypertensive drugs and statins, blood pressure, body mass index, urinary albumin excretion, lipid profile, glycemic control and C-reactive protein levels-CRP). Mean resting microvascular flux did not differ between control subjects and patients with type 1 diabetes, as well as arterial stiffness assessed through stiffness index and reflection index. Microvascular response to ACh was significantly reduced in patients (p=0,002). However, despite the reduction ofAUC NPS, the analysis with repeated measures disclosed no difference between the groups in relation to the doses (p=0,15). Maximal skin microvascular vasodilation induced by thermal hyperemia was found to be higher in the control group than among patients (93,6(24,5-379-,9) e 56,6(31,5-204,5), respectively p=0,04). On the other hand, during PORH, maximal increase in flux and area under the curve of the hyperemic response did not differ between patients and controls, although the time frame to reach maximum flux and the time to half recovery after hyperemia was longer in patients than in controls (P=0.02) . Uric acid, hba1c, age and CRP were the most important contributing factors to the variation of microvascular reactivity, while disease duration, the diastolic arterial pressure and HDL cholesterol were independently associated to arterial stiffness. Despite the correlation between drugs with hemorheologycal properties and arterial stiffness, the exclusion of patients who were taking such substances did not affect the results. We conclude that in the studied population of type 1 diabetic patients, the endothelium-dependent vascular responses and maximal vasodilator capacity are significantly reduced. In what concerns arterial stiffness, our study disclosed no difference between diabetics and controls. Moreover, Acetylcholine response can be correlated to arterial stiffness in diabetics, and further studies aiming at the evaluation of the micro and macrovascular reactivity should be performed with consumers of drugs which may be likely to affect the endothelial function.

Abstract The introduction of physiologically and therapeutically effective drugs in anaesthetic treatment has meant a significant change. Their discovery has thus contributed to a minimisation of their negative effects on a living organism. As a result, anaesthesiology has become more controllable and safer. These new drugs translate into more comfort for the patient in the course of anaesthesiology as well as his or her rapid recovery resulting in a shorter period of hospitalisation. The research of new physiologically and therapeutically effective substances is a pre-requisition of a potential higher standard of medical care. Older substances, e.g. Alkuronium and Gallamin, which, due to their undesirable effects, have come out of use, have lost their significance. Nowadays, these substances have been generally replaced by substances with an intermedial effect, e.g. Rokuronium and Cisatrakurium, which, compared with Alkuronium and Gallamin, show a minimum of undesirable effects. One of the foremost objectives of the current pharmaceutical research is to find a replacement of Sukcinylcholin, which, in spite of its known side effects, has had a non-substitutable position in urgent intubation. As a result, its use is limited to out-patient application and a certain selection of patient categories. Let us hope that we shall see a replacement of Sukcinylcholin being introduced in treatment in the near future. This would mean a final solution of problems arising from its side effects limiting its scope of application.

A sepse causa uma alta taxa de mortalidade no mundo. A fisiopatologia da doença envolve uma rede complexa de mediadores inflamatórios que promovem a lesão de diversos tecidos, além de diversas alterações hemodinâmicas e disfunção do sistema nervoso autonômico (SNA). Assim sabe-se que o sistema nervoso cumpre um papel importante no controle da inflamação sistêmica mediante a via colinérgica anti-inflamatória (VCA) através do receptor nicotínico de acetilcolina alfa7 (alfa7nAChR). O uso das células-tronco mesenquimais (CTM) tem mostrado efeitos benéficos em diversos ensaios clínicos de doenças inflamatórias. Neste contexto, as células-tronco mesenquimais derivadas da geleia de Wharton do cordão umbilical (CTM-GW) tornam-se promissórias, uma vez que essas células são reconhecidas pela regulação da resposta imunológica, reparação neural, efeito anti-apoptose, assim como a melhora da sobrevida na sepse, em modelos experimentais. Nossa hipótese foi de que as CTM-GW poderiam cumprir um papel neuroimunomodulador através da VCA e atenuar a disfunção de múltiplos órgãos em um modelo animal de sepse de ligadura e punção do ceco (LPC). Inicialmente células da matriz do cordão umbilical foram isoladas e caracterizadas de acordo com o consenso internacional vigente. Ratos Wistar machos adultos foram subdivididos em grupos: 1) sham (operação simulada); 2) LPC; 3) LPC+CTM-GW (injetado 106 CTM-GW via intraperitoneal, i.p. 6 h após LPC) e 4) LPC+MLA+CTM-GW (MLA: Metillicaconitine, antagonista do alfa7nAChR, i.p., 5:30 h após LPC e 106 CTM-GW 6h após). Às 24 horas após LPC, foram avaliadas a função cardiovascular, hemodinâmica assim como os outros parâmetros. Interessantemente, o tratamento com CTM-GW na sepse atenuou a disfunção diastólica e protegeu a sensibilidade baroreflexa. Além disso, as CTM-GW estimularam a atividade autonômica, simpática e parassimpática no coração. Observamos que o tratamento celular induziu uma regulação da expressão do receptor alfa7nAChR e TLR4 no baço e no coração, assim como a redução da relação p-STAT3TYR705 e STAT3 total no baço. Outros efeitos importantes e adicionais foram a diminuição da infiltração de leucócitos e a regulação das citocinas pró-inflamatórias pelas células. O bloqueio da VCA usando MLA confirmou que o receptor alfa7nAChR pode ser um provável alvo, chave da ação das CTM entre vários outros mecanismos envolvidos na resposta imune. Finalmente, as CTM-GW conseguiram reduzir a apoptose no pulmão e no baço independentemente da VAC reforçando o conceito de que as células-tronco tem efeitos diversos além da imuno-regulação. Em conclusão, as CTM-GW na sepse foram capazes de atenuar a lesão cardiopulmonar assim como modular a atividade autonômica, reduzindo a inflamação sistêmica, pelo menos em parte, através da via colinérgica anti-inflamatória. Indubitavelmente todos estes efeitos anteriormente descritos e em associação se demonstraram fundamentais no mecanismo de reparo e proteção tecidual em resposta a sepse. Mais estudos pré-clínicos e futuros testes clínicos precisam ser realizados para maior compreensão destes mecanismos bem como uma possível validação terapêutica / Sepsis induces organ dysfunction due to overexpression of the inflammatory host response, involving cardiorespiratory and autonomic dysregulation, thus increasing the associated morbidity and mortality. The cholinergic anti-inflammatory pathway (CAP) is mediated by nervous system through alpha7 nicotinic acetylcholine receptor (alpha7nAChR). This receptor has an important role in systemic inflammation control. Wharton\'s jelly-derived mesenchymal stem cells (WJ-MSCs) are known to express genes and secreted factors related to neurological and immunological protection, as well as to improve survival in experimental sepsis. We hypothesized that WJ-MSCs play a modulatory role through the CAP and attenuate sepsis-induced organ injury in a cecal ligation and puncture (CLP) model. Rats were randomly divided into 4 groups: 1) Control (sham-operated); 2) submitted to CLP without treatment; 3) submitted to CLP and treated with 106 WJ-MSCs 6 h later and 4) CLP+MLA+WJ-MSC group (MLA: Methyllycaconitine, alpha7nAChR antagonist). All experiments were performed 24 h post-surgery. Echocardiographic parameters and heart rate variability were assessed. Importantly, treatment with WJ-MSCs attenuated diastolic heart failure and recovered barorreflex sensitivity. Moreover, WJ-MSCs injection increased cardiac sympathetic and cardiovagal activity. In cardiac and splenic tissue, WJ-MSC treatment downregulated TLR4 and alpha7nAChR expression, as well as it reduced p-STAT3/Total STAT3 ratio in the spleen. In addition, WJ-MSC reduced leukocyte infiltration and pro-inflammatory cytokines, which only were abolished by MLA treatment. Finally, WJ-MSC treatment diminished apoptosis in lung and spleen tissue. Together these findings suggest that treatment with WJ-MSCs appears to protect against sepsis-induced organ injury reducing systemic inflammation, at least in part, through cholinergic anti-inflammatory pathway

Movement is a prerequisite for normal fetal development and growth. Intrauterine movement restrictions cause a broad spectrum of disorders in which the unifying feature is a reduction or lack of fetal movement, giving rise to the term fetal akinesia deformations sequence (FADS [OMIM 208150]). FADS corresponds to a clinically and genetically heterogeneous constellation of properties and is characterized by multiple joint contractures, facial abnormalities, and lung hypoplasia as a result of the decreased in utero movement of the fetuses. Affected babies are often prematurely and stillborn, and those born alive typically die within minutes or hours after birth. The genetic causes for this fatal disorder are ill-defined as a genetic diagnosis is rarely executed, but mutations in three genes, namely RAPSN, DOK7, and MUSK, as well as in the subunits of the muscular nicotinic acetylcholine receptor (AChR) have been described. These mutations are thought to affect neuromuscular junctions, although this has not been proven experimentally.The nucleoporin NUP88 is a constituent of the nuclear pore complex (NPC), the gate for all trafficking between the nucleus and the cytoplasm. NUP88 resides on both the cytoplasmic and the nuclear side of NPCs, and it is found in two distinct subcomplexes. It associates with NUP214 and NUP62 on the cytoplasmic face, while on the nuclear side NUP88 binds NUP98 and the intermediate filament protein lamin A. The NUP88-NUP214-NUP62 complex plays an essential role in the nuclear export of a subset of proteins and pre-ribosomes, which is mediated by the nuclear export receptor CRM1. NUP88 in particular somewhat participates in the nuclear export of NF-κB proteins in a CRM1-dependent manner. Moreover, NUP88 is frequently overexpressed in a variety of human cancers, and its role in cancer appears linked to the deregulation of the anaphase-promoting complex. Here, we report the first Mendelian disorders caused by mutations in NUP88 and with that the first lethal developmental human disease due to mutations in a nuclear pore component. We demonstrate that biallelic mutations in NUP88 are likely to cause fetal akinesia of the Pena-Shokeir subtype. We confirm in zebrafish that loss of NUP88 impairs movement and the mutations identified in the affected individuals resemble a loss-of-function phenotype. We show that loss of NUP88 affects expression and localization of rapsyn, the protein encoded by RAPSN, in human and mouse cell lines, and patient samples. Consistent with altered rapsyn, AChR clustering and neuromuscular junction formation in zebrafish are abnormal. We therefore propose that defective NUP88 function cause FADS by affecting neuromuscular junction formation.Keywords: Nuclear pore complex, NUP88, Fetal Akinesia Deformation Sequence, rapsyn, acetylcholine receptor clustering, synaptic transmission, fetal development, inherited developmental disorder. / Doctorat en Sciences / info:eu-repo/semantics/nonPublished

ColQ est un collagène spécifique qui ancre l’acétylcholinestérase (AChE) dans la fente synaptique de la jonction neuromusculaire (JNM). L'importance du complexe AChE-ColQ dans la physiologie humaine de cette synapse est soulignée par l’identification de mutations dans le gène codant pour ColQ qui conduisent à un syndrome myasthénique congénital (SMC) associé à une déficience en AChE. Le déficit en AChE a, jusqu’à présent, été considéré comme l’unique facteur responsable des symptômes observés chez les patients ainsi que des défauts de la JMN chez le modèle de souris SMC (souris déficiente pour ColQ). Toutefois, ces symptômes sont complexes et l’absence d’AChE ne peut probablement pas expliquer tous les symptômes. Nous avons montré auparavant que ColQ participait à la formation de la synapse ce qui expliquerait les symptômes observés chez les patients et la souris modèle. En effet, nous avons pu montrer que ColQ contrôle l’agrégation du récepteur à l’acétylcholine (RACh) et de l’expression de gènes spécifiques de la synapse. En particulier, nous avons montré in vitro et in vivo, que l’absence de ColQ induit une augmentation du niveau des ARNm codant pour toutes les sous-unités de RACh et une expression réduite du niveau de leurs protéines. Des résultats préliminaires indiquent que cette augmentation de ces ARNm n’est pas transcriptionnelle. L’objectif de cette thèse est d’expliquer les mécanismes qui induisent l’augmentation du niveau des ARNm de AChR en l’absence de ColQ et les voies de signalisation qui relient ColQ au métabolisme des ARN du RACh. Notre hypothèse de travail a été que l'absence de ColQ stimule la stabilisation post-transcriptionnelle des ARNm codant pour les sous-unités du RACh via la protéine HuR. HuR est une protéine qui stabilise les ARNm quand elle se fixe sur les AU-richelement (ARE) dans la séquence 3’UTR. HuR est une protéine clé dans la myogenèse et la formation de la JNM parce qu’elle stabilise de manière post-transcriptionnelle de nombreux transcrits tels que myogénine, MyoD et AChE. Dans cette étude, nous montrons pour la première fois qu’un mécanisme post-transcriptionnel de stabilisation des ARNm est responsable de l’augmentation du niveau des ARNm du RACh via ColQ. De plus, nous constatons qu’en absence de ColQ, il y a une augmentation aux niveaux d’ARNm et de protéine de HuR. HuR est également capable de se lier au domaine ARE dans le 3’UTR des ARNm des sous-unités de AChR. De plus, l’interaction entre HuR et les ARNm du RACh augmente la stabilité et par conséquence les niveaux des transcrits du RACh. Trois conclusions importantes ressortent de ma thèse : nous démontrons que (1) en plus de la régulation transcriptionnelle, il existe des mécanismes de régulation post-transcriptionnlle du RACh (2) ColQ régule la stabilité des ARNm RACh via HuR médiée par MuSK (3) la voie de signalisation p38 contrôle les niveaux de HuR de manière dépendante de ColQ. Ensemble, ces résultats donnent un aperçu des voies de signalisation du muscle qui sont affectées par les mutations de ColQ conduisant à des SMC avec une déficience en AChE. Nos résultats mettront en évidence des nouvelles cibles moléculaires spécifiques qui peuvent conduire au développement des interventions thérapeutiques dans le cadre de myasthénies congénitales. / ColQ is a specific collagen that anchors acetylcholinesterase (AChE) in the synaptic cleft of the neuromuscular junction (NMJ). The importance of AChE-ColQ complex in the physiology of this synapse has been highlighted by the identification of COLQ mutations in the human gene, leading to a congenital myasthenic syndrome (CMS) with AChE deficiency. The lack of AChE has been incriminated for the symptoms observed in patients along with NMJ defects in the CMS mouse model (ColQ-deficient). However, symptoms observed in the patients and mouse model of CMS with AChE deficiency are complex and AChE deficiency cannot account for all of them. We have demonstrated that ColQ could play a role per se in synapse formation which would explain some of the defects observed in patients and model mice. Indeed, we have shown that ColQ controls the clustering of Acetylcholine Receptors (AChR) and the expression of a number of specific synaptic genes. The most striking effect of the absence of ColQ is an upregulation of all AChR subunit mRNAs correlated by an increase in their protein levels. Preliminary results indicate that AChR mRNA upregulation is not transcriptional. This thesis deciphers the mechanisms that drive AChR mRNA upregulation in the absence of ColQ and the pathways that connect ColQ to the AChR RNA metabolism. Accordingly, we hypothesize that the absence of ColQ induces an upregulation of the stabilization of AChR subunit mRNAs, a post-transcriptional mechanism mediated by HuR. HuR is an RNA binding protein which stabilizes its target transcript by binding AU-rich elements (AREs) in their 3’UTR. HuR is critical during skeletal myogenesis and post-synaptic NMJ formation due to its stabilization of such transcripts as myogenin, MyoD and AChE. In this study, we show for the first time that a post-transcriptional mechanism of AChR mRNA stabilization is responsible for the ColQ mediated increase of AChR mRNAs. In support of these findings, the absence of ColQ also increased HuR mRNA and protein levels. We demonstrate that HuR is capable of binding to conserved ARE elements in the 3’UTR of AChR subunit mRNA. HuR’s interaction with AChR mRNA increased the stability of the transcripts, resulting in an increase in mRNA levels. Three major conclusions emerge from my thesis: we provide evidence that (1) in addition to transcriptional and assembly regulation of AChR, post-transcriptional mechanisms of AChR mRNA exist (2) ColQ regulates HuR mediated AChR stability through MuSK and (3) the p38 signalling pathway controls the levels of HuR in a ColQ dependent manner. Collectively, our data provides insight into the muscle signaling pathways which are affected by ColQ mutations leading to CMS with AChE deficiency. Thus, we have identified specific new molecular targets that may become important for the development of therapeutic interventions for patients with CMS.

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Membrane protein dynamics is of great importance for living organisms. The precise localization of proteins composing a synapse on the membrane facing a nerve terminus is essential for proper functioning of the nervous system. In muscle fibers, the nicotinic acetylcholine is densely packed under the motor nerve termini. A receptor associated protein, rapsyn, acts as a linker between the receptor and the other components of the synaptic suramolecular assembly. Advances in fluorescence microscopy have allowed to measure the behavior of a single receptor in the cell membrane. In this work single-molecule microscopy was used to track the motion of ionotropic acetylcholine (nAChR) and serotonin (5HT3R) receptors in the plasma membrane of cells. We present methods for measuring single-molecule diffusion and their analysis. Single molecule tracking has shown a high dependence of acetylcholine receptors diffusion on its associated protein rapsyn. Comparing muscle cells that either express rapsyn or are devoid of it, we found that rapsyn plays an important role on receptor immobilization. A three-fold increase of receptor mobility was observed in muscle cells devoid of rapsyn. However, in these cells, a certain fraction of immobilized receptors was also found immobile. Furthermore, nAChR were strongly confined in membrane domains of few tens of nanometers. This showed that membrane composition and membrane associated proteins influence on receptor localization. During muscle cell differentiation, the fraction of immobile nAChR diminished along with the decreasing nAChR and stable rapsyn expression levels. The importance of rapsyn in nAChR immobilization has been further confirmed by measurements in HEK 293 cells, where co-expression of rapsyn increased immobilization of the receptor. nAChR is a ligand-gated ion-channel of the Cys-loop family. In mammals, members of this receptor family share general structural and functional features. They are homo- or hetero-pentamers and form a membrane-spanning ion channel. Subunits have three major regions, an extracellular ligand binding domain, a transmembrane channel and a large intracellular loop. 5HT3R was used as a model to study the effect of this loop on receptor mobility. Single-molecule tracking experiments on receptors with progressively larger deletions in the intracellular loop did not show a dependence of the size of the loop on the diffusion coefficient of mobile receptors. However, two regions were identified to play a role in receptor mobility by changing the fractions of immobile and directed receptors. Interestingly, a prokaryotic homologue of cys-loop receptors, ELIC, devoid of a large cytoplasmic loop was found to be immobile or to show directed diffusion similar as the wild-type 5HT3R. The scaffolding protein rapsyn stabilizes nAChR clusters in a concentration dependent manner. We have measured the density and self-interactions of rapsyn using FRET microscopy. Point-mutations of rapsyn, known to provoke myopathies, destabilized rapsyn self-interactions. Rapsyn-N88K, and R91L were found at high concentration in the cytoplasm suggesting that this modification disturbs membrane association of rapsyn. A25V was found to accumulate in the endoplasmic reticulum. Fluorescent tools to measure intracellular concentration of calcium ions are of great value to study the function of neurons. Rapsyn is highly abundant at the neuromuscular junction and thus is a genuine synaptic marker. A fusion protein of rapsyn with a genetically encoded ratiometric calcium sensor has been made to probe synapse activity. This thesis has shown that the combined use of biologically relevant system and modern fluorescence microscopy techniques deliver important information on pLGIC behaviour in the cell membrane. / <p>QC 20151217</p>