OBJETIVOS: Evidências consistentes sugerem que a quimioterapia (QT) sistêmica para o tratamento do câncer pode apresentar efeitos deletérios na cognição levando a prejuízos de memória, atenção, velocidade de processamento e função executiva. A maioria dos estudos anteriores, entretanto, foi realizada em mulheres com câncer de mama, o que levanta a possibilidade de que o déficit possa ter sido causado por alterações hormonais e/ou menopausa precoce induzidas pela QT. Pouco se sabe sobre a toxicidade da QT na cognição de pacientes portadores de câncer coloretal (CCR). O objetivo do estudo foi avaliar os efeitos cognitivos da QT adjuvante baseada em fluorouracil (5FU) associado ou não a oxaliplatina (FLOX) em pacientes portadores de CCR estádios II e III , em comparação a indivíduos com câncer de cólon estádio II de baixo risco não submetidos à QT. METODOLOGIA: Estudo de coorte prospectivo, não intervencionista, unicêntrico, onde os pacientes com CCR foram submetidos a uma avaliação neuropsicológica detalhada, além da avaliação de queixas subjetivas de memória e de sintomas depressivos antes do início da quimioterapia (t1) e após 12 meses de seguimento (t2). Avaliamos ainda o papel da apoliproteína E como preditor de risco para disfunção cognitiva e a presença de lesão de substância branca por ressonância magnética (RM) de crânio. RESULTADOS: Num período de 2 anos, de dezembro de 2012 a dezembro de 2014, 85 pacientes foram recrutados e completaram a avaliação inicial (t1): 26 no grupo controle (sem quimioterapia= QT-) e 59 no grupo casos (quimioterapia= QT+). Dentre os 85 pacientes que participaram da avaliação inicial, 16 foram excluídos da análise do desfecho principal. A maioria dos pacientes era do sexo masculino (60,3%), idosos com idade média de 62,5 anos (DP 9,4) e escolaridade média de 7,6 anos (DP 3,7). Considerando o desfecho primário do escore composto global e também os domínios cognitivos de memória e atenção, não econtramos diferença significativa de desempenho no t1 e t2 entre os grupos. Com relação a função executiva, os pacientes que realizaram QT apresentaram melhor desempenho no t1, entretanto, evoluíram com maior declínio e pior desempenho que os controles no t2 após ajuste para idade, sexo, escolaridade e sintomas depressivos no baseline (beta -1,80; 95%CI -3,50; -0,11, p=0,04). Um subgrupo de 32 pacientes foram submetidos a RM de crânio que não mostrou alterações significativas de substância branca pela técnica de imagem de tensor de difusão (DTI) no seguimento. A presença do alelo ?4 da apolipoproteína E não foi diferente entre os grupos. CONCLUSÃO: Pacientes portadores de câncer colorretal que receberam quimioterapia adjuvante com esquema FLOX apresentaram declínio no desempenho cognitivo no domínio função executiva em comparação a pacientes com doença localizada que não receberam QT após 12 meses de seguimento / PURPOSE: Cognitive dysfunction may occur after chemotherapy in cancer survivors, especially in those that received chemotherapy for breast cancer. The frequency and to which extent such toxicity develops in colorectal cancer (CRC) survivors is unknown. This prospective study evaluated the effects of adjuvant chemotherapy on the cognitive performance of patients with localized CRC in comparison with a control group who did not receive chemotherapy. METHODS: Consecutive patients with localized stages II and III CRC completed neuropsychological assessments, self-reported cognitive complaints questionnaires, and depressive symptoms evaluation before starting fluoropyrimidine-based adjuvant chemotherapy (t1) and after 12 months (t2). Control group was assessed at matching intervals. Blood was collected for apolipoprotein E (APOE) genotyping. Clinical and demographic data were also collected. Diffusion tensor imaging (DTI) data was acquired from a subset of participants at both time-points. RESULTS: From December 2012 to December 2014, 137 patients were approached and 85 patients were recruited: 59 received chemotherapy (CTh+) and 26 did not (CTh-), based on standard recommendation for adjuvant therapy for CRC. The mean age was 62.5 years (SD 9.4), 60% were male, and the mean years of education was 7.6 (SD 3.7). No difference was found on global composite score (p=0.38), attention (p= 0.84) or memory (p= 0.97) between the two groups during the followup (mean 375 days, SD 29). However there was a significant difference on executive function domain, after adjustment for age, sex, education, and depressive symptoms at baseline (beta - 1.80; 95%CI -3.50; -0.11, p=0.04), suggesting worse performance for the CTh+ group. In 32 patients who underwent MRI, there was no significant differences for all DTI indices in any white matter regions between CTh+ and CTh- groups during follow-up. APOE polymorphisms were not predictive of cognitive dysfunction. CONCLUSION: After adjusting for confounding factors, patients with CRC who received adjuvant fluorouracil with or without oxaliplatin presented cognitive decline on executive function after 12 months in comparison with patients with localized disease that did not receive chemotherapy

Yuen Yee Man. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (leaves 108-125). / Abstracts in English and Chinese. / TITLE PAGE --- p.1 / ACKNOWLEGDEMENTS --- p.2 / ABSTRACT --- p.3 / 摘要 --- p.5 / table of contents --- p.7 / list of figures and tables --- p.13 / CHAPTER 1 GENERAL INTRODUCTION --- p.16 / Chapter 1.1 --- role of PHYTOESTROGENS in soy and red WINE the PREVENTION OF CARDIOVASCULAR DISEASES (CVD) --- p.17 / Chapter 1.1.1 --- INTRoduction and Classification of Phytoestrogens --- p.17 / Chapter 1.1.2 --- estrogenic1ty of phytoestrogens and theIr abundancesin Plasma --- p.18 / Chapter 1.1.3 --- phytoestrogens as one of the active components In cvd Protection --- p.21 / Chapter 1.1.4 --- effects of Phytoestrogens on LDL Receptor and Apolipoprotein A-1 --- p.22 / Chapter 1.2 --- role of estrogen receptors (ers) in gene regulation --- p.24 / Chapter 1.2.1 --- "structure, Classification and tissue distribution of ERS" --- p.24 / Chapter 1.2.2 --- ligands for ERS --- p.25 / Chapter 1.2.3 --- mechaniSMS OF LIgands-ERS complex in GENE regulation --- p.27 / Chapter 1.2.4 --- ligand-independent ER activation --- p.28 / Chapter 1.3 --- aims and scopes of investigation --- p.29 / Chapter CHAPTER 2 --- MATERIALS AND METHODS --- p.30 / Chapter 2.1 --- chemicals and materials --- p.30 / Chapter 2.1.1 --- Chemicals --- p.30 / Chapter 2.1.2 --- Plasmids --- p.30 / Chapter 2.2 --- mammalian cell culture maintainence --- p.30 / Chapter 2.2.1 --- Maintenance of Cells --- p.31 / Chapter 2.2.2 --- Preparation of Cell Stock --- p.31 / Chapter 2.2.3 --- Cell Recovery from Liquid Nitrogen Stock --- p.31 / Chapter 2.3 --- manipulation of dna --- p.31 / Chapter 2.3.1 --- isolation of HEPG2 cells genonmic DNA --- p.31 / Chapter 2.3.2 --- separation and purification of dna from agarose gel --- p.31 / Chapter 2.3.3 --- Restriction digestionof DNA --- p.32 / Chapter 2.3.4 --- Ligation of DNA Fragments --- p.32 / Chapter 2.3.5 --- Transformation of --- p.32 / Chapter 2.3.6 --- Small Scale Plasmids Purification from DH5a --- p.32 / Chapter 2.4 --- construction of expression and reporter plasmids --- p.33 / Chapter 2.4.1 --- Construction of Estrogen Receptorα (Erα) Expression Vectors --- p.33 / Chapter 2.4.2 --- construction of reporter vectors of LDLR promoter and the Respective Mutants --- p.33 / Chapter 2.4.3 --- Construction of Reporter Vectors of APOAI Promoter and the Respective Mutants --- p.33 / Chapter 2.5 --- determination of promoter transcrtiption activities --- p.34 / Chapter 2.5.1 --- Transient Transfection of Cell with ERa Expression Vector and Promoter Reporter using Lipofectamine PLUS Reagent --- p.34 / Chapter 2.5.2 --- Dual Luciferase Assay --- p.34 / Chapter 2.6 --- semi-quantitative and quantitative rt-pcr assay --- p.34 / Chapter 2.6.1 --- Transient transfection of Cell with ERa Expression Vector Using Lipofectamine PLUS Reagent --- p.34 / Chapter 2.6.2 --- "Isolation of RNA using TRIzol® Reagent (Life Technology, USA)" --- p.35 / Chapter 2.6.3 --- Quantitation of RNA --- p.35 / Chapter 2.6.4 --- First Strand cDNA Synthesis --- p.35 / Chapter 2.6.5 --- Sem卜Quantitative PCR Reactions --- p.35 / Chapter 2.6.6 --- Quantitative PCR Reactions --- p.36 / Chapter 2.7 --- western blotting analysis --- p.36 / Chapter 2.8 --- statistical methods --- p.36 / Chapter CHAPTER 3 --- REGULATION BY PHYSIOLOGICAL LEVEL OF 17B-ESTRADIOL ON APOLIPOPROTEIN A-I AND LOW-DENSITY- LIPOPROTEIN RECEPTOR IN HEPG2 CELLS --- p.37 / Chapter 3.1 --- introduction --- p.37 / Chapter 3.2 --- results --- p.39 / Chapter 3.2.1 --- Determination of transient transfection functionality of estrogen receptors in hepg2 cells --- p.39 / Chapter 3.2.2 --- Effect of 17β-Estradiolon LDLR promoter transcription activity --- p.39 / Chapter 3.2.3 --- Effect of 17β-Estradiol on apoai promoter transcription activity --- p.40 / Chapter 3.2 --- discussion --- p.47 / Chapter CHAPTER 4 --- SOY ISOFLAVONES AND RESVERATROL DISPLAY DIFFERENT MECHANISM IN THE UP-REGULATION OF LOVV-DENSITY-LIPOPROTEIN RECEPTOR IN HEPG2 CELLS --- p.49 / Chapter 4.1 --- introduction --- p.49 / Chapter 4.2 --- results --- p.54 / Chapter 4.2.1 --- Association of ERα and isoflavones or resveratrol on LDLR promoter transcription activity --- p.54 / Chapter 4.2.2 --- Association of ERβ and isoflavones or resveratrol on LDLR promoter transcription activity --- p.54 / Chapter 4.2.3 --- "Role of MAP Kinase, PKA and PKC in isoflavones and resveratrol induced LDLR promoter transcription" --- p.55 / Chapter 4.2.4 --- Identification of promoter regions responsible for induction of LDLR transcription by isoflavones in the presence OF ERα --- p.55 / Chapter 4.2.5 --- Identification of promoter regions responsible for induction of LDLR TRANSCRIPTION BY resveratrol IN THE ABSENCE OF ERα --- p.56 / Chapter 4.3 --- DISCUSSION --- p.75 / Chapter CHAPTER 5 --- SOY ISOFLAVONES AND RESVERATROL UP-REGULATE APOLIPOPROTEIN A-I SIMILAR TO 17B-ESTRADIOL IN HEPG2 CELLS --- p.80 / Chapter 5.1 --- INTRODUCTION --- p.80 / Chapter 5.2 --- RESULTS --- p.84 / Chapter 5.2.1 --- Association of ERα phytoestrogens on APCAI gene expression --- p.84 / Chapter 5.2.2 --- Association of ERβ and isoflavones or resveratrol on APOAI promoter transcription activity --- p.85 / Chapter 5.2.3 --- "Role of MAP Kinase, PKA and PKC in isoflavones and resveratrol in APOAI promoter transcription in the presence of ERα" --- p.85 / Chapter 5.2.4 --- Identification of promoter regions responsible for induction of APOAI transcription by isoflavones and resveratrol in the presence of ERα --- p.85 / Chapter 5.3 --- DISCUSSION --- p.100 / Chapter CHAPTER 6 --- GENERAL DISCUSSION --- p.103 / Chapter CHAPTER 7 --- SUMMARY --- p.106 / BIBLIOGRAPHY --- p.108 / APPENDIX 1 ABBREVIATIONS --- p.126 / APPENDIX 2 MATERIALS AND METHODS --- p.129 / APPENDIX 3 PRIMER LISTS --- p.145 / APPENDIX 4 REAGENTS AND BUFFERS --- p.147

Les lipoprotéines de haute densité (High Density Lipoprotein, HDL) permet deréduction de risque de maladies cardio-vasculaires principalement en raison de leurcapacité à éliminer le cholestérol accumulé des artères (via transport inverse ducholestérol). Les effets protecteurs des HDL sont médiés par l'apolipoprotéine AI(ApoA1), qui est le La protéine la plus importante quantitativement du HDL. L’ApoA1favorise l'efflux de cholestérol vers le foie pour l'excrétion. Une augmentation desniveaux plasmatiques de l’ApoA1 est généralement acceptée d'êtrecardioprotecteur, ce qui en fait un potentiel thérapeutique. Deux variantes naturelle(mutants) de l’ApoA1, Milano et Paris, sont caractérisées par une mutationponctuelle unique a permis l'introduction d'un résidu cystéine. Populations avecApoA1-Milano ont été rapportés d'avoir un système cardiovasculaire, même avec defaibles niveaux de plasma de ApoA1 et HDL. Il est donc d'intérêt pour générerrecombinante de type sauvage et des variantes de ApoA1 humaine pour desapplications thérapeutiques potentielles. Dans cette étude, de type sauvagerhApoA1 a été produit chez P. pastoris et purifié par chromatographie en modemixte en une seule étape. Par la suite, un processus intégré a été le développementde la production et la récupération rapide de type sauvage rhApoA1 chez P. pastorispar chromatographie par lit expansée. En outre, les variantes de l'ApoA1, Milano &Paris, ont été générées par mutagenèse dirigée et ont été exprimés chez P. pastoris.Les motifs d’adsorption de rhApoA1-Milano et rhApoA1-Paris ont été comparés àcelle de type sauvage ApoA1 et les différences ont été discutées. / The high-density lipoprotein (HDL) complex helps reduce the risk of cardiovasculardisorders mainly due to its ability to remove accumulated cholesterol from arteriesvia reverse cholesterol transport. These protective effects of HDL are known to bemediated by Apolipoprotein A-I (ApoA1), which is the major protein component ofHDL. ApoA1 is a lipid binding protein and promotes cholesterol efflux fromperipheral tissues to the liver for excretion. An increase in the plasma levels ofApoA1 is generally accepted to be cardioprotective, making it a potentialtherapeutic. Two naturally occuring variants of ApoA1, namely the Milano & Parismutants, are characterised by a single point mutation resulting in the introduction ofa Cysteine residue. Populations with ApoA1-Milano have been reported to have ahealthier cardiovascular system even with low plasma levels of ApoA1/HDL. It ishence of interest to generate recombinant wild type and variants of human ApoA1for potential therapeutic applications. In this study, wild type rhApoA1 was producedin P. pastoris and purified by mixed-mode chromatgraphy in a single step.Subsequently, an integrated process has been development for the production andrapid recovery of wild type rhApoA1 in Pichia pastoris. This has paved way to theestablishment of a scalable integrated process that could be further developed toindustrial levels. In addition, the cysteine variants of ApoA1, Milano & Paris, havebeen generated by site directed mutagenesis and have been successfully expressedin P. pastoris. The binding patterns of rhApoA1-Milano and rhApoA1-Paris have beencompared with that of wild-type ApoA1 and the differences have been discussed.

L’athérosclérose est caractérisée par l’accumulation de lipoprotéines de basse densité (LDL) liées aux protéoglycanes de la paroi artérielle. Des anticorps chimériques (ch) qui se lient aux glycosaminoglycanes (GAG) ont été générés. L'hypothèse est que la vaccination avec le chP3R99, un anticorps chimérique mutant de l'hybridome P3, pouvait interférer avec la rétention des LDL par l’induction d’une cascade d’anticorps anti-idiotypiques dirigés contre les GAG. Des souris mâles déficientes en apolipoprotéine E ont été soumises à une diète hypercholestérolémique et ont reçu 5 injections sous-cutanées de 50 μg de vaccin chP3R99 ou de vaccin chP3S98 (un mutant de faible réactivité). Les injections ont été effectuées à chaque semaine ou aux 2 semaines. Au moment du sacrifice, l'aorte perfusée avec du PBS a été excisée et analysée après coloration au Oil Red-O. Les résultats ont été exprimés en pourcentage de lésions sur la superficie totale de l'aorte. La réactivité contre le chP3R99, chP3S98, l’héparine, le sulfate de dermatane et de chondroïtine des sérums de souris immunisées a été mesurée par ELISA. De plus, la liaison de l'anticorps chP3R99 aux GAG dans la lésion d'athérosclérose a été observée par un appareil de visualisation in vivo.Nos résultats montrent que l’immunogénicité des anticorps chP3R99 est supérieure à celle des anticorps chP3S98 et que le sérum des souris immunisées avec le chP3R99 présente des anticorps anti-idiotypiques dirigés contre les GAG. Cet effet est associé à une réduction de 42 % (p < 0.01) du pourcentage de lésions athérosclérotiques chez les souris vaccinées. L'utilisation d’une immunisation active avec l’anticorps chP3R99 pourrait constituer une approche thérapeutique pour le traitement de l'athérosclérose. / Atherosclerosis is characterized by the accumulation of low density lipoprotein (LDL) associated with the proteoglycans of the arterial wall. Chimeric (ch) antibodies that react against glycosaminoglycans (GAG) were generated. We tested the hypothesis that vaccination with chP3R99, a mutant chimeric antibody of the P3 hybridoma, could interfere with the retention of LDL by inducing a cascade of anti-idiotypic antibodies directed against the GAG.Male mice deficient in apolipoprotein E fed with a hypercholesterolemic diet were given five subcutaneous injections of 50 μg of chP3R99 or chP3S98 (a mutant with low reactivity) vaccine. The injections were performed every week or every two weeks. After sacrifice, the aorta was perfused with PBS, excised and analyzed after staining with Oil Red-O. The results were expressed as a percentage of lesions areas on the total area of the aorta. The reactivity of the sera obtained was tested against the chP3R99, chP3S98, heparin, dermatan and chondroïtin sulfate from obtained immunized mice by ELISA. The anti-idiotypic response was measured by blocking the anti-isotypic reactivity by a nonspecific IgG, hR3. In addition, the antibody chP3R99 binding to GAG in the atherosclerotic lesion was shown by an in vivo molecular imaging device. Our results show that the immunogenicity of the antibodies chP3R99 is higher than chP3S98 and that sera from mice immunized with chP3R99 present anti-idiotypic antibodies directed against the GAG. This effect is associated with a 42 % reduction (p <0.01) of atherosclerotic lesions in vaccinated mice. The use of active immunization with antibodies chP3R99 may constitute a new therapeutic approach for the treatment of atherosclerosis.

L’adhésine impliquée dans l’adhérence diffuse (AIDA-I) est une adhésine bactérienne présente chez certaines souches d’Escherichia coli qui, associée aux toxines Stx2e ou STb, contribue à l’apparition de la maladie de l’œdème ou de la diarrhée post-sevrage chez les porcelets. AIDA-I est un autotransporteur qui confère des capacités d’autoaggrégation, de formation de biofilms et d’adhésion. L’objectif principal du projet de recherche consistait en la recherche de récepteur(s) potentiel(s) d’AIDA-I. Les bactéries pathogènes adhèrent aux cellules-cibles soit en liant directement des molécules à la surface cellulaire ou en utilisant des molécules intermédiaires qui permettent de diminuer la distance séparant la bactérie de la cellule-cible. Puisque le sérum est un fluide qui contient de nombreuses molécules, celui-ci a été utilisé comme matériel de départ pour l’isolement de récepteur(s) potentiels. Nous avons isolé un récepteur potentiel à partir du sérum porcin : l’apolipoprotéine A-I. L’interaction entre l’apolipoprotéine A-I et AIDA-I a été confirmée par ELISA et microscopie à fluorescence. La capacité à envahir les cellules épithéliales offre aux pathogènes la possibilité d’établir une niche intracellulaire qui les protègent contre les attaques du milieu extérieur. La présente étude a démontré que la présence d’AIDA-I en tant que seul facteur de virulence chez une souche de laboratoire permet de conférer la capacité d’envahir les cellules sans promouvoir la survie intracellulaire. L’étude de la souche sauvage 2787, exprimant AIDA-I en association avec d’autres facteurs de virulence, a démontré une différence significative pour les phénotypes d’invasion et de survie intracellulaire face à la souche de laboratoire exprimant AIDA-I. / The adhesin involved in diffuse adherence (AIDA-I) is a bacterial adhesin associated with some Escherichia coli strains that might, when associated with toxin Stx2e or STb, contribute to the development of edema disease or post-weaning diarrhea in piglets. AIDA-I is an autotransporter that mediates various phenotypes such as adhesion, autoaggregation and biofilm formation. The main aim of our project was to find potential receptor(s) for AIDA-I. Pathogens can either bind cell directly by targeting exposed cell surface molecules or use an intermediate molecule as a bridge to lessen the space separating them from their target cell. Serum is known to contain a wide range of molecules so it has been used as raw material for the isolation of a putative receptor for AIDA-I. We isolated a putative receptor for AIDA-I: the apolipoprotein A-I. The interaction between the apolipoprotein A-I and AIDA-I was confirmed by ELISA and fluorescent microscopy. The capacity to invade epithelial cell enables pathogens to create an intracellular niche that protects them against attacks from the extracellular environment. The present report has shown that the presence of AIDA-I as the sole virulence factor in a laboratory strain, enable bacteria to invade cultured cells but does not promote intracellular survival. Studies conducted on wild-type strain 2787, which express AIDA-I in association with other virulence factors, has shown a significant difference in invasion and intracellular survival phenotypes compared to the laboratory strain expressing AIDA-I.

This thesis describes two approaches for studying of lipoprotein metabolism in sheep. The first approach involves the assay of lipoprotein lipase (LPL) activity to determine the role of lipoprotein-triacylglycerol fatty acids in fat deposition in sheep. This enzyme is the rate limiting enzyme in the hydrolysis of fatty acids from lipoprotein-triacylglycerol. The second approach was to characterize and quantify in vivo lipoprotein metabolism using iodinated very low density lipoprotein (¹²⁵I-VLDL) and low density lipoprotein (¹³¹I-LDL). Cross-bred lambs were divided into two treatment groups and either weaned early at 5 weeks of age or remained suckling. Lambs were slaughtered at 12 or 23 weeks at which time the body composition and adipose tissue LPL activity were determined. The differences in rearing led to differences in body composition. The suckled lambs were larger and fatter than weaned lambs. The increased fatness in the suckled lambs was associated with increased LPL activity (U/mg protein) in subcutaneous adipose tissue and was reflected in higher LPL activity in post-heparin plasma (PHP) taken 2 days prior to slaughter. The role of insulin in the regulation of LPL activity was investigated by either infusing a subset of the weaned and suckled lambs with insulin for 7 or 18 weeks or using the euglycemic clamp technique to study the effect of short insulin infusions. The long term infusion of insulin had no significant effect on PHP LPL or on adipose tissue LPL (U/g tissue). However, after infusing insulin for 6h at 6.3 mU.kg⁻·⁷⁵.h⁻¹ during the euglycemic clamps, a two fold increase in LPL activity in biopsied subcutaneous adipose tissue was observed. In the second approach, in vivo lipoprotein metabolism was investigated in 4 lambs using apolipoprotein B as a marker. Following the simultaneous injection of ¹²⁵I VLDL and ¹³¹I VLDL, the specific activities of apoB in VLDL, IDL and LDL fractions were determined. ApoB specific activity curves demonstrated that VLDL is metabolised to IDL and subsequently to LDL. The turnover of VLDL-B (3.45mg.d⁻¹.kg⁻¹) and LDL-B (4.8mg.d⁻¹.kg⁻¹) was calculated by fitting the VLDL-¹²⁵I-B and LDL-¹³¹I-B specific activity data to a mono-exponential equation. The metabolism of lipoproteins, inferred from the study of apoB, was shown to be similar in sheep to that reported in other animals although the amount of lipoprotein synthesised was low. A model to describe the kinetics of apoB metabolism in sheep was developed using SAAM. The proposed model features a three pool delipidation chain for VLDL, and subsystems containing two pools for IDL and LDL. IDL may be catabolised to LDL or cleared directly from the plasma. The developed model can now be used to compare the metabolism of lipoproteins in different physiological states and to design new experiments to study lipoprotein metabolism further.

Η HDL είναι ένα μείγμα λιποπρωτεϊνικών σωματιδίων υψηλής πυκνότητας, που ανάλογα με τη σύσταση τους σε λιπίδια μπορούν να είναι δισκοειδή ή σφαιρικά. Η κύρια αθηροπροστατευτική δράση της HDL, οφείλεται στο γεγονός ότι η συγκεκριμένη λιποπρωτεΐνη συλλέγει την περίσσεια χοληστερόλης από τους περιφερικούς ιστούς και τη μεταφέρει στο ήπαρ όπου καταβολίζεται. Επιπλέον, έχει αντιφλεγμονώδη και αντιοξειδωτική δράση. Η κύρια πρωτεΐνη της HDL είναι η απολιποπρωτεΐνη Α-Ι (apoA-I). Ωστόσο, πρόσφατα αποδείχθηκε ότι σε πειραματόζωα με έλλειψη στην apoA-I και κατά συνέπεια στην κλασσική HDL, η απολιποπρωτεΐνη Ε (apoE) αλληλεπιδρά με τον μεταφορέα λιπιδίων ABCA1 προάγοντας την de novo σύνθεση HDL σωματιδίων. Στην παρούσα μελέτη, στόχος ήταν η εύρεση της περιοχής της apoE που είναι υπεύθυνη για την λειτουργική αλληλεπίδραση με τον ABCA1 για το σχηματισμό HDL. Για το σκοπό αυτό, ανασυνδυασμένοι αδενοϊοί που εξέφραζαν καρβοξυ-τελικές συντετμημένες μορφές της apoE4 (AdGFP-E4[1-259], AdGFP-E4[1-229], AdGFP-E4[1-202], AdGFP-E4[1-185]), χορηγήθηκαν σε ποντίκια με έλλειψη στην ApoA-I σε δόση 8x108 pfu και πέντε μέρες μετά τη μόλυνση δείγματα πλάσματος αναλύθηκαν για το σχηματισμό HDL. Κλασματοποίηση των λιποπρωτεϊνών του πλάσματος με υπερφυγοκέντρηση σε διαβάθμιση πυκνότητας καθώς και FPLC χρωματογραφία αποκάλυψε ότι όλες οι συντετμημένες μορφές της apoE4 προάγουν το σχηματισμό HDL. Ανάλυση ηλεκτρονικής μικροσκοπίας με αρνητική χρώση των HDL κλασμάτων, επιβεβαίωσε ότι όλες οι συντετμημένες μορφές της apoE4 είναι ικανές να προάγουν το σχηματισμό σωματιδίων με διάμετρο στην περιοχή της HDL. Τα δεδομένα αυτά οδηγούν στο συμπέρασμα ότι η αμινοτελική περιοχή της apoE που εκτείνεται από τα αμινοξέα 1 έως 185 αρκεί για το σχηματισμό HDL σωματιδίων in vivo. Αυτά τα ευρήματα, ανοίγουν το δρόμο στην έρευνα για το σχεδιασμό βιολογικών φαρμάκων με βάση την apoE για τη θεραπεία της δυσλιπιδαιμίας, της αθηροσκλήρωσης και της στεφανιαίας νόσου. / HDL is a mixture of high density lipoprotein particles that depending on the lipid composition may be discoidal or spherical. The main atheroprotective property of HDL is reverse cholesterol transport, a process that unloads excess cholesterol from peripheral tissues and transports it to the liver for catabolism. HDL has also anti-inflammatory and antioxidant properties. The main protein of HDL is apolipoprotein A-I (apoA-I). However, recently it was shown that in the absence of apoA-I and consequently classical HDL, apolipoprotein E (apoE) interacts functionally with the lipid transporter ABCA1, promoting the de novo synthesis of HDL-like particles. The present study focused on the identification of the domain of apoE that is responsible for the functional interaction with ABCA1 and the formation of apoE-containing HDL. Recombinant attenuated adenoviruses expressing carboxy-terminal truncated forms of apoE4 (apoE4[1-259], apoE4[1-229], apoE4[1-202], and apoE4[1-185]) were administered to apoA-I-deficient mice at a low dose of 8x108 pfu and five days post-infection plasma samples were isolated and analyzed for HDL formation. Fractionation of plasma lipoproteins of the infected mice by density gradient ultracentrifugation and FPLC revealed that all forms were capable of promoting HDL formation. Negative staining electron microscopy analysis of the HDL density fractions confirmed that all C-terminal truncated forms of apoE4 promoted the formation of particles with diameters in the HDL region. Taken together, these data establish that the aminoterminal 1 to 185 region of apoE suffices for the formation of HDL particles in vivo. These findings may have important ramifications in the design of apoE-based biological drugs for the treatment of dyslipidemia, atherosclerosis and coronary heart disease.

OBJETIVOS: Evidências consistentes sugerem que a quimioterapia (QT) sistêmica para o tratamento do câncer pode apresentar efeitos deletérios na cognição levando a prejuízos de memória, atenção, velocidade de processamento e função executiva. A maioria dos estudos anteriores, entretanto, foi realizada em mulheres com câncer de mama, o que levanta a possibilidade de que o déficit possa ter sido causado por alterações hormonais e/ou menopausa precoce induzidas pela QT. Pouco se sabe sobre a toxicidade da QT na cognição de pacientes portadores de câncer coloretal (CCR). O objetivo do estudo foi avaliar os efeitos cognitivos da QT adjuvante baseada em fluorouracil (5FU) associado ou não a oxaliplatina (FLOX) em pacientes portadores de CCR estádios II e III , em comparação a indivíduos com câncer de cólon estádio II de baixo risco não submetidos à QT. METODOLOGIA: Estudo de coorte prospectivo, não intervencionista, unicêntrico, onde os pacientes com CCR foram submetidos a uma avaliação neuropsicológica detalhada, além da avaliação de queixas subjetivas de memória e de sintomas depressivos antes do início da quimioterapia (t1) e após 12 meses de seguimento (t2). Avaliamos ainda o papel da apoliproteína E como preditor de risco para disfunção cognitiva e a presença de lesão de substância branca por ressonância magnética (RM) de crânio. RESULTADOS: Num período de 2 anos, de dezembro de 2012 a dezembro de 2014, 85 pacientes foram recrutados e completaram a avaliação inicial (t1): 26 no grupo controle (sem quimioterapia= QT-) e 59 no grupo casos (quimioterapia= QT+). Dentre os 85 pacientes que participaram da avaliação inicial, 16 foram excluídos da análise do desfecho principal. A maioria dos pacientes era do sexo masculino (60,3%), idosos com idade média de 62,5 anos (DP 9,4) e escolaridade média de 7,6 anos (DP 3,7). Considerando o desfecho primário do escore composto global e também os domínios cognitivos de memória e atenção, não econtramos diferença significativa de desempenho no t1 e t2 entre os grupos. Com relação a função executiva, os pacientes que realizaram QT apresentaram melhor desempenho no t1, entretanto, evoluíram com maior declínio e pior desempenho que os controles no t2 após ajuste para idade, sexo, escolaridade e sintomas depressivos no baseline (beta -1,80; 95%CI -3,50; -0,11, p=0,04). Um subgrupo de 32 pacientes foram submetidos a RM de crânio que não mostrou alterações significativas de substância branca pela técnica de imagem de tensor de difusão (DTI) no seguimento. A presença do alelo ?4 da apolipoproteína E não foi diferente entre os grupos. CONCLUSÃO: Pacientes portadores de câncer colorretal que receberam quimioterapia adjuvante com esquema FLOX apresentaram declínio no desempenho cognitivo no domínio função executiva em comparação a pacientes com doença localizada que não receberam QT após 12 meses de seguimento / PURPOSE: Cognitive dysfunction may occur after chemotherapy in cancer survivors, especially in those that received chemotherapy for breast cancer. The frequency and to which extent such toxicity develops in colorectal cancer (CRC) survivors is unknown. This prospective study evaluated the effects of adjuvant chemotherapy on the cognitive performance of patients with localized CRC in comparison with a control group who did not receive chemotherapy. METHODS: Consecutive patients with localized stages II and III CRC completed neuropsychological assessments, self-reported cognitive complaints questionnaires, and depressive symptoms evaluation before starting fluoropyrimidine-based adjuvant chemotherapy (t1) and after 12 months (t2). Control group was assessed at matching intervals. Blood was collected for apolipoprotein E (APOE) genotyping. Clinical and demographic data were also collected. Diffusion tensor imaging (DTI) data was acquired from a subset of participants at both time-points. RESULTS: From December 2012 to December 2014, 137 patients were approached and 85 patients were recruited: 59 received chemotherapy (CTh+) and 26 did not (CTh-), based on standard recommendation for adjuvant therapy for CRC. The mean age was 62.5 years (SD 9.4), 60% were male, and the mean years of education was 7.6 (SD 3.7). No difference was found on global composite score (p=0.38), attention (p= 0.84) or memory (p= 0.97) between the two groups during the followup (mean 375 days, SD 29). However there was a significant difference on executive function domain, after adjustment for age, sex, education, and depressive symptoms at baseline (beta - 1.80; 95%CI -3.50; -0.11, p=0.04), suggesting worse performance for the CTh+ group. In 32 patients who underwent MRI, there was no significant differences for all DTI indices in any white matter regions between CTh+ and CTh- groups during follow-up. APOE polymorphisms were not predictive of cognitive dysfunction. CONCLUSION: After adjusting for confounding factors, patients with CRC who received adjuvant fluorouracil with or without oxaliplatin presented cognitive decline on executive function after 12 months in comparison with patients with localized disease that did not receive chemotherapy

Les virus des hépatites B et C (VHB et VHC) entretiennent des liens étroits avec le métabolisme lipidique des hépatocytes. Ainsi, la réplication du VHB est dépendante de certains récepteurs nucléaires hépatiques, tels que HNF4α et PPARα, impliqués dans ce métabolisme. L’assemblage des particules virales du VHC dépend lui de la voie de synthèse des lipoprotéines de très faible densité (VLDL) et le virus circule dans le sang sous forme de lipo-viro-particules associé notamment à l’apolipoprotéine B, un composant essentiel des VLDL. Dans ce travail, nous avons d’abord étudié le rôle de FXRα, le récepteur nucléaire des sels biliaires, sur la réplication du VHB. Nous avons montré, in vitro, que les sels biliaires, via FXRα, activaient le promoteur de Core du VHB qui contrôle le niveau de réplication virale. Puis dans l’étude des liens entre les lipoprotéines et le VHC, nous avons montré que l’apoB présente sur certaines particules virales jouaient un rôle important dans l’infectiosité du virus in vitro, et que la protéine Cideb, présente en surface des gouttelettes lipidiques et impliquée dans l’assemblage des VLDL, était impliquée dans l’association du VHC avec l’apoB et influençait l’infectiosité des virions sécrétés. De plus nous avons mis en évidence l’existence de particules sub-virales chez les patients infectés, de nature lipoprotéique mais ne portant que les protéines d’enveloppes du VHC. Tous ces résultats renforcent l’idée d’une adaptation du VHB et du VHC au métabolisme lipidique hépatique. Les bénéfices éventuels qu’en retirent ces deux virus, ainsi que l’existence de possibles thérapeutiques anti-virales ciblant le métabolisme lipidique, restent à explorer / Hepatitis B and C viruses (HBV and HCV) infections are tightly linked with hepatic lipid metabolism. HBV replication depends on specific nuclear receptors, such as HNF4α and PPARα, both implicated in this metabolism. HCV assembly depends on the synthesis of Very-Low-Density Lipoproteins (VLDL), and the virus circulates in the blood as lipo-viral-particles associated in particular with apoB, an essential component of VLDL. In this study, we first studied the influence of FXRα, the nuclear receptor for bile acids, on HBV replication. We showed that, in vitro, bile acids, via FXRα, were able to activate the HBV Core promoter which controls the level of viral replication. Then, in the study of the interactions between HCV and lipoproteins, we demonstrated that apoB, which is associated with a proportion of viral particles, played an important role in HCV infectivity in vitro, and that Cideb, a protein involved in VLDL assembly, was implicated in the association between HCV and apoB and influenced the infectivity of secreted viral particles. Finally, we showed that, besides HCV infectious particles, sub-particles bearing only viral envelope glycoproteins circulated in the blood of infected patients. Interactions of HBV with the metabolism of bile acids, and of HCV with the metabolism of lipoproteins, are two examples of adaptation of a parasite to its host. The potential benefits from these interactions are still to be determined, as well as the possibility to develop anti-viral strategies targeting lipid metabolism

Many neurodegenerative diseases are characterized by the accumulation of misfolded proteins that often share common morphological and biochemical features, and can similarly co-localize with several other proteins, including various chaperone proteins. Chaperone proteins, like heat shock protein 27 (HSP27), heme oxygenase 1 (HO-1) and clusterin, have been implicated as potent modulators of misfolded proteins, thus may play important roles in the pathogenesis of neurodegenerative diseases. The present study aims to investigate their roles in the pathogenesis of Frontotemporal lobar degeneration (FTLD), Alzheimer's disease (AD), Parkinson's disease (PD), and Motor neuron disease (MND) by determining their distribution and amount via immunohistochemical staining and western blotting in diseased and control subjects.There were distinct patterns of HSP27 and clusterin immunostaining in different brain regions. For HSP27, patients with AD and FTLD were in general more severely affected than were patients with MND and control subjects. For clusterin, patients with AD and FTLD were more severely affected than control subjects where neurons and glial cells were concerned, while patients with AD and control subjects were more severely affected than those with FTLD where diffuse and cored plaques were concerned. However, there were no obvious differences in the pattern of HO-1 immunostaining in various brain regions in patients with AD or FTLD relative to control subjects. Moreover, there was no association between HSP27, HO-1 and clusterin with disease or histological type, and the ‘classic’ neuropathological changes in FTLD, AD and MND were not immunoreactive to any of these proteins. There were significant correlations between the degrees of HO-1 and clusterin immunostaining in many brain areas for both AD and FTLD cases, and for all cases overall, but none between HSP27 and clusterin or HSP27 and HO-1. Present results suggest an involvement with ongoing cellular stress, misfolded or unfolded protein accumulation or the deficits/failure of other relevant protein quality control systems, in the pathogenesis of these neurodegenerative diseases. Present work may therefore have implications for the further development of ideas concerning the cause or treatment of neurodegenerative diseases where there is aberrant accumulation of misfolded, aggregated protein, and perhaps for conformational diseases in general. However, there are still many issues remain to be elucidated. Further research aimed at understanding the function and mechanisms of the chaperone system, and other protein quality control mechanisms, in the pathogenesis of neurodegenerative diseases is still needed.