Introdução: A doença de Parkinson (DP) é uma doença neurodegenerativa cujo quadro clínico é essencialmente motor, no entanto as manifestações não motoras frequentemente estão presentes e muitas vezes são negligenciadas. Dentre as manifestações não motoras o declínio cognitivo tem ganhado destaque sendo causa de maior morbidade e mortalidade. A prevalência da demência na doença de Parkinson (DDP) varia de acordo com a população estudada e no momento do diagnóstico até 20% dos pacientes já apresentam algum grau de declínio cognitivo e com a evolução da doença até 80% dos pacientes apresentaram um quadro demencial associado a DP. Como A DP apresenta características clinico e patológicas sobrepostas à Doença de Alzheimer (DA) e a Apolipoproteína (ApoE) é o principal preditor de risco para desenvolvimento de demência na DA aventou-se a hipótese de que o alelo ?4 da ApoE pudesse ter relação com o risco de o paciente com DP desenvolver quadro demencial. Objetivo: analisar a relação entre o polimorfismo do gene ApoE com o desempenho cognitivo, avaliado pela MoCA, de pacientes com doença de Parkinson e descrever prevalência de cada alelo do gene em uma amostra de pacientes com DP da população brasileira. Método: estudo transversal onde foram analisados 186 pacientes em seguimento nos ambulatórios especializados em Distúrbios do Movimento do Hospital das Clínicas de Ribeirão Preto - HCFMRP e do Hospital São Paulo da Universidade Federal de São Paulo - UNIFESP, no período entre os anos de 2007 e 2014. Foi realizada a genotipagem dos alelos da ApoE e a avaliação cognitiva foi realiza através do MoCA. Para análise da amostra os pacientes foram classificados em portadores ou não do alelo ?4. Os grupos foram comparados utilizando o teste do Qui-quadrado para a variável sexo e o teste nãoparamétrico de Mann-Whitney para idade, tempo de doença e anos de estudo. Resultados: A análise dos escores da MoCA nos grupos com e sem o alelo ?4 não revelou diferença estatisticamente significativa entre os grupos (p=0,20). A frequência genotípica foi semelhante à descrita nos demais estudos sobre o assunto. Conclusão: a presença do alelo ?4 não está associada, em nossa amostra, a um pior desempenho cognitivo, quando este é avaliado pela escala cognitiva global MoCA. / Introduction: The Parkinson\'s disease (DP) is a neurodegenerative disorder where clinical findings are primarily motor however non-motor manifestations are often present and are frequently neglected. Among the non-motor events cognitive decline has gained prominence because it is cause of increased morbidity and mortality. The prevalence of Parkinson\'s disease dementia (PDD) varies depending on the population studied but at the time of diagnosis about 20% of patients already have some degree of cognitive decline and the progression of the disease up to 80% of patients demonstrated PDD. As DP has overlapping clinical and pathological features with Alzheimer\'s disease (DA) and apolipoprotein (ApoE) is the main predictor of risk for developing dementia in AD the hypothesis has suggested that the allele ?4 of ApoE could be related to the risk of the patient with PD develop dementia. Objective: analyze the relationship between ApoE gene polymorphism with the cognitive performance of patients with Parkinson\'s disease and describe prevalence of each allele of the gene in a sample of with PD in a Brazilian population. Method: cross-sectional study which analyzed 186 patients in follow-up in specialized of Hospital das Clínicas de Ribeirão Preto - HCFMRP and Hospital São Paulo of Universidade Federal de São Paulo - UNIFESP, between the years 2007 and 2014. Was made the genotyping for assessing the ApoE allele and cognitive assessment was carried out through the MoCA. For sample analysis, patients were classified as carriers or not allele ?4. The groups were compared using the chi-square test for gender and non-parametric Mann-Whitney test for age, disease duration and years of study. Results: The analysis of MoCA scores in the groups with and without the ?4 allele revealed no statistically significant difference between groups (p = 0.20). The genotypic frequency was similar to that described in other studies

A corticoterapia tem sido utilizada frequentemente nas éguas suscetíveis. O uso de isuflupredona melhora a taxa de prenhez e altera o perfil proteico do líquido endometrial em relação a éguas não tratadas. A utilização de dexametasona diminui o acúmulo de líquido pós-cobertura, reduz o edema do útero, porém, desconhecem-se seus efeitos no perfil proteico do líquido endometrial. O objetivo do presente estudo foi analisar o efeito da dexametasona em éguas suscetíveis à endometrite persistente póscobertura sobre perfil proteico do líquido endometrial na presença ou ausência de infecção. Nove éguas suscetíveis foram utilizados, com idade entre 7 a 30 anos. Após a verificação dos sinais de estro as éguas foram submetidas a quatro tratamentos: (C) éguas não receberam nenhum tipo de tratamento e serviram como controle; (D) éguas receberam 40mg de dexametasona (IV), no momento da cobertura, com coleta da amostras após 6 horas, (I-6 e I-24) infusão intra-uterina de 1 x 109 de S. zooepidemicus/mL, com coleta da amostra após 6 e 24 horas; (I/D-6 e I/D-24) infusão intra-uterina de 1 x 109 S. zooepidemicus/mL e administração de 40mg de dexametasona (IV), com coleta da amostra após 6 e 24 horas. Todas as éguas foram submetidas a todos os tratamentos. As amostras foram coletadas e submetidas à eletroforese bidimensional para separação proteica e espectrometria de massa para a identificação das bandas proteicas relevantes. A corticoterapia provocou alteração na proteômica do líquido endometrial de éguas suscetíveis, caracterizada pelo aumento (TTR) e/ou diminuição (ApoA1) na densidade óptica de proteínas da fase aguda da inflamação. Conclui-se que a utilização da dexametasona em éguas com e sem presença de infecção altera a proteômica do fluido endometrial de éguas suscetíveis. Sugere-se que a dosagem ou a frequência de aplicação da dexametasona deva ser aumentada. / Corticotherapy has often been used in susceptible mares. The use of isuflupredona improves pregnancy rate and alters the protein profile of the endometrial fluid in relation to untreated mares. The use of dexamethasone decreases the post breeding fluid accumulation, reduces the uterine edema, however is unaware of its effects on the protein profile of endometrial fluid. The aim of the present study was analyze the effect of dexamethasone in mares susceptible to post-breeding persistent endometritis on the protein profile of endometrial fluid in the presence or absence of infection. Nine susceptible mares were used, aged 7-30 years old. After checking the signs of estrus, mares were subjected to four treatments: (C) mares received no treatment and served as controls; (D) mares received 40 mg of dexamethasone at breeding time, with collection of samples after 6 hours; (I-6 and I-24) intrauterine infusion of 1 x 109 S. zooepidemicus/ml and the sample was collected after 6 and 24 hours; (I/D-6 and I/D-24) intrauterine infusion of 1 x 109 S. zooepidemicus/ml and 40 mg of dexamethasone administration, collecting the sample after 6 and 24 hours. All of the mares were subjected to all treatments. Samples were collected and subjected to two-dimensional electrophoresis for protein separation and mass spectrometry for the identification of relevant protein bands. Corticotherapy resulted in alteration of the protein profile of the endometrial fluid of susceptible mares, characterized by an increase (TTR) and/or decrease (ApoA1) in optical density of the acute phase of proteins of inflammation. We conclude that the use of dexamethasone in mares with and without the presence of infection alters the protein profile of endometrial fluid of susceptible mares. It is suggested that the dosage or frequency of application of dexamethasone should be increased.

L’infection par le virus de l’hépatite C (HCV) est une cause majeure de maladies hépatites sévères et constitue un problème majeur de santé public. Le HCV est associé aux lipopoprotéines formant une lipoviroparticule (LVP) qui est la forme infectieuse du virus. L’apolipoprotéine E (apoE), associée aux lipoprotéines, est impliquée dans les étapes précoces et tardives de l’infection. Elle interagit avec de récepteurs impliqués dans le métabolisme lipidique tels les héparanes sulfates protéoglycanes (HSPG). Durant ma thèse, j’ai démontré que les acides aminés chargés positivement du domaine de liaison aux HSPG d’apoE sont impliqués dans l’entrée du HCV dans l’hépatocyte. J’ai également démontré que la production et/ou l’infectiosité des particules virales est corrélée au taux d’expression d’apoE dans les cellules sans avoir d’impact sur la traduction ou la réplication virales. Enfin, j’ai identifié syndecan-4, un membre de la famille des HSPG, comme l’HSPG principal impliqué dans l’entrée du HCV dans les lignées Huh7.5.1. L’ensemble de ces résultats démontre qu’HCV utilise l’interaction apoE-SDC4 pour établir une infection virale efficace. / Hepatitis C virus (HCV) infection is a major cause of liver disease worldwide and represents a major health problem. HCV associates with host lipoproteins forming host/viral hybrid complexes termed lipoviral particles. Apolipoprotein E (apoE) is a lipoprotein component that interacts with heparan sulfate proteoglycans (HSPG) to mediate hepatic lipoprotein uptake, and may likewise mediate HCV entry. I sought to define the functional regions of apoE with an aim to identify critical apoE binding partners involved in HCV infection. I demonstrated a direct correlation of apoE expression and HCV infectivity, whereas no correlation exists with viral protein translation or replication. Mutating the HSPG binding domain (HSPG-BD) of apoE revealed key residues that are critical for mediating HCV infection. Finally, I identified Syndecan-4 (SDC4), an HSPG family member, as the principal HSPG mediating HCV entry. Our data demonstrate that HCV uses apoE-SDC4 interactions to enter hepatocytes and establish efficient viral infection.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Polymorphisms in the apolipoprotein E (APOE) have constituted the major rationale to identify potential risk groups for developing late-onset Alzheimer's disease and help to predict recovery of cognitive function after brain injury. However, the APOE impact on cognitive development in children living in poor areas of the developing world, where we have discovered profound significant associations of early childhood diarrhea (at 0-2 yo) with lasting impairments of growth, cognition and school performance, is not known. Therefore, we conducted APOE genotyping in 72 Brazilian shantytown children under active surveillance since birth, using purified DNA extracted from buccal cell samples. We found a high frequency of APOE4 alleles (18% vs 9-11% expected) in children with lower diarrhea burdens. When we examined the children who experienced the heavier diarrhea burdens (+/- median of 7 illnesses in the first 2 years of life), those with APOE4 did significantly better in the coding subtest (39 +/- 9.9; n=7, p=0.01), when compared with APOE4 negative children with similar diarrhea burdens (25 +/- 12.7; n=27). Positive correlations between the APOE4 occurrence and coding scores remained even after adjusting for family income, maternal education and breast-feeding (p<0.05). Moreover, the APOE4 positive group, under heavy burdens of diarrhea, preserved semantic fluency and the mean difference in fluency scores (DIFF), n=73, p=0.025, a standardized coefficient for disproportional verbal fluency impairment. Our findings show that APOE4 is relatively common in children from the GonÃalves Dias Community in the Northeast Brazil and suggest a protective role of APOE4 allele in children with a history of heavy burdens of diarrhea in their first 2 years of life. / Os polimorfismos da apolipoproteÃna E (APOE) tÃm se constituÃdo no principal mÃtodo para identificar grupos de risco para desenvolver a doenÃa de Alzheimer de inÃcio tardio e para servir de prognÃstico da recuperaÃÃo da funÃÃo cognitiva apÃs traumatismo craniano. Entretanto, o impacto da APOE no desenvolvimento cognitivo de crianÃas de Ãreas pobres do Brasil, onde nÃs jà temos encontrado associaÃÃes profundas e significativas entre os eventos de diarrÃia infantil precoce (aos 0-2 anos de idade) com o comprometimento duradouro do crescimento, cogniÃÃo e performance escolar, nÃo à ainda conhecido. Portanto, nÃs conduzimos um estudo da genotipagem da APOE em 72 crianÃas da Comunidade GonÃalves Dias, em Fortaleza, Nordeste do Brasil, acompanhadas por um projeto coorte desde o nascimento, utilizando DNA extraÃdo de amostras de cÃlulas bucais. Nesse trabalho, encontramos uma elevada freqÃÃncia dos alelos da APOE4 (18% vs 9-11% esperada) em crianÃas com baixa morbidade de diarrÃia. Quando avaliamos as crianÃas que apresentaram elevada morbidade de diarrÃia (+/- mediana de 7 episÃdios nos primeiros 2 anos de vida), Ãquelas portadores do alelo APOE4 mostraram uma melhor performance cognitiva no subteste de coding (39 +/- 9,9; n=7, p=0,01), quando comparadas com crianÃas negativas para o alelo APOE4 com similar morbidade de diarrÃia (25 +/- 12,7; n=27). CorrelaÃÃes positivas entre a ocorrÃncia do alelo APOE4 e os escores de coding permaneceram, mesmo apÃs controlar para renda familiar, educaÃÃo materna e aleitamento materno (p<0,05). AlÃm disso, o grupo positivo para APOE4, com elevada morbidade de diarrÃia, preservou a fluÃncia semÃntica e a diferenÃa mÃdia dos escores de fluÃncia semÃntica (DIFF), n=73, p=0,025, um coeficiente padrÃo para avaliar o impedimento desproporcional da fluÃncia verbal. Nossos achados, portanto, mostram que o alelo APOE4 à relativamente comum em crianÃas da Comunidade GonÃalves Dias, no Nordeste do Brasil, e sugerem um papel protetor do alelo APOE4 em crianÃas com histÃria de alta morbidade de diarrÃia nos primeiros dois anos de idade.

Nowadays, the emerging role of amyloid-β peptide (Aβ) oligomers in Alzheimer’s disease (AD) is widely accepted, putting aside the old idea that fibrils are the primary entities responsible for the onset of the disease. Recent studies indeed show that the level of soluble Aβ oligomeric forms better correlates with the progression of the disease than the level of fibrillar forms. <p>Using conditions which yield characteristic Aβ42 oligomers or fibrils, we studied the secondary structure of these species by ATR (attenuated total reflection)-FTIR (Fourier transform infrared) spectroscopy. Whereas fibrillar Aβ was organized in a parallel β-sheet conformation, oligomeric Aβ displayed distinct spectral features attributed to an antiparallel β-sheet structure. Antiparallel β-sheet structure may thus be a structural signature of oligomeric Aβ. Moreover, we noted striking spectral similarities between Aβ oligomers and a bacterial pore-forming protein, OmpF. <p>Apolipoprotein E (apoE) isoforms are strongly linked to Alzheimer’s disease, with the E4 isoform being the most recognized genetic risk factor so far. Nevertheless, the involvement of apoE4 in AD remains confusing. We evaluated the influence of apoE isoforms on Aβ aggregation in vitro. Comparing Aβ controls with Aβ incubated either with the apoE3 or apoE4 isoform, we observed a sharp reduction of the Aβ fibrillar content, whereas the oligomeric content was increased upon incubation with the pathological isoform apoE4. These data suggest that apoE4 binds and blocks Aβ in its oligomeric conformation, inhibiting further formation of less toxic fibrillar forms of Aβ. The enhanced interaction of apoE4 with Aβ oligomers could arise from its reported unique propensity to form a molten globule state, unlike the other isoforms of apoE. While previous studies mostly correlated E4 with fibrils, our data underline a correlation between apoE4 and Aβ oligomers. Our work reconciles apoE4 with the new amyloid cascade hypothesis and brings support to studies whose therapeutic strategy aims at designing inhibitors of the apoE/Aβ interaction./<p>Le rôle central des espèces oligomèriques du peptide amyloïde bêta (Aβ) dans la maladie d’Alzheimer est de plus en plus reconnu actuellement, mettant de côté l’ancien concept selon lequel les espèces fibrillaires sont les entités responsables du développement de la maladie. Des études récentes montrent en effet que le taux d’oligomères semble bien mieux corrélé à la progression de la maladie que le taux de fibrilles.<p>A l’aide de protocoles bien établis permettant de former des oligomères ou des fibrilles d’Aβ42 in vitro, nous avons étudié la structure secondaire de ces espèces par spectroscopie infrarouge en réflexion totale atténuée. Alors que les fibrilles présentaient une conformation en feuillets β parallèles, les oligomères quant à eux, ont révélé des caractéristiques spectrales distinctes, attribuées à du feuillet β antiparallèle. Cette structure en feuillets β antiparallèles pourrait donc représenter une signature structurale typique des espèces oligomèriques d’Aβ. De plus, nous avons observé de frappantes similarités spectrales entre les oligomères d’Aβ et une protéine bactérienne formant des pores, l’OmpF.<p>Les isoformes de l’apolipoprotéine E (apoE) sont fortement impliquées dans la maladie d’Alzheimer et plus particulièrement, l’isoforme E4 qui est actuellement reconnue comme étant le plus important facteur de risque d’origine génétique. Néanmoins, le rôle précis joué par l’apoE4 dans la maladie est encore mal connu. Nous avons étudié l’influence des isoformes de l’apoE sur l’agrégation du peptide amyloïde in vitro. En comparant des échantillons contrôle d’Aβ avec des échantillons incubés en présence d’apoE3 ou d’apoE4, nous avons observé une nette réduction de la quantité de fibrilles ainsi qu’une augmentation concomitante de la proportion d’oligomères lors de l’incubation avec l’isoforme pathologique E4. Ces résultats suggèrent que l’apoE4 interagit avec Aβ et le bloque dans sa conformation oligomèrique, inhibant ainsi le processus d’agrégation et la formation de fibrilles, espèces moins toxiques. Cette plus forte interaction entre l’apoE4 et les oligomères d’Aβ pourrait s’expliquer par la propriété unique de l’apoE4 à former un état intermédiaire ‘molten globule’, ce qui n’est pas le cas des autres isoformes. Tandis que d’anciennes études ont corrélé l’apoE4 principalement avec les fibrilles, nos résultats mettent en évidence un lien entre l’apoE4 et les oligomères d’Aβ, respectivement l’isoforme pathologique et les espèces les plus toxiques du peptide. Ce travail réconcilie donc l’apoE4 avec la nouvelle hypothèse de la « cascade amyloïde » et soutient les études thérapeutiques visant à mettre au point des inhibiteurs spécifiques de l’interaction apoE/Aβ.<p> / Doctorat en Sciences agronomiques et ingénierie biologique / info:eu-repo/semantics/nonPublished

La Dégénérescence Maculaire Liée à l'Age (DMLA) constitue dans les pays industrialisés la 1ère cause de cécité chez les personnes de plus de 50 ans, et représente un enjeu majeur de santé publique d'autant plus important que le vieillissement de la population ne fait que s'accroître. La forme atrophique de cette maladie, pour laquelle il n'existe actuellement aucun traitement, est notamment caractérisée par une inflammation sous-rétinienne associée une dégénérescence des photorécepteurs, et conduit à une perte progressive de la vision centrale pouvant aller jusqu'à la cécité. Nos résultats montrent qu'au stade précoce de la maladie (MLA) on peut déjà observer de nombreux phagocytes mononucléaires (PM) dans l'espace sous-rétinien, en contact avec les drusen. Ces PM expriment de l'apolipoprotéine E (APOE), protéine impliquée dans l'homéostasie lipidique et la régulation de réponses inflammatoires, qui est retrouvée dans les drusen des patients atteints de DMLA, et dont le variant génétique APOε2 est associé à un risque élevé de développer une DMLA. Grâce à l'utilisation de souris Cx3cr1GFP/GFP déficientes en CX3CR1, un récepteur de chimiokine, et de souris humanisées APOε2, les travaux présentés ici démontrent que l'APOE exerce un rôle pro-inflammatoire conduisant de manière dose-dépendante à une altération du privilège immun sous-rétinien. Cet environnement immunosuppresseur est dépendant du FasL exprimé par l'épithélium pigmentaire rétinien (EPR), et empêche en condition physiologique la présence de cellules inflammatoires dans la rétine externe. Nos résultats montrent que l’APOE stimule de manière autocrine la sécrétion d’IL-6 par les PM, possiblement par un mécanisme impliquant une activation des Toll-like receptors (TLR) et de leur corécepteur CD36. Nous montrons que l’IL-6 inhibe l’expression de FasL sur l’EPR et altère sa capacité de clairance sous-rétinienne, ce qui facilite la survie des PM infiltrants au contact des photorécepteurs. La persistance de cette inflammation pathologique dans la rétine externe conduit au cours du vieillissement à une dégénérescence des photorécepteurs, phénomène qui peut est inhibé chez des souris déficientes en APOE. Ensemble, ces résultats permettent d’apporter une explication inédite au risque élevé de développer une DMLA pour les porteurs de l’allèle APOε2, et pourrait ouvrir la voie vers de nouvelles perspectives thérapeutiques. / Age-related Macular Degeneration (AMD) is the first cause of blindness in people over 50 year old in industrialized countries, and represents a major public health concern as the population of elderly is more and more increasing. The atrophic form of the disease, for which there is currently no treatment available, is characterized by subretinal inflammation associated with photoreceptor degeneration and leads to a progressive loss of central vision that can lead to blindness. Our results show many mononuclear phagocytes (MP) are already present at the early stage of the disease (MLA), in the subretinal space and in apposition with drusen. These PM express apolipoprotein E (APOE), a protein involved in lipid homeostasis and the regulation of inflammatory responses, which is found in drusen in patients with AMD, and whose genetic APOε2 variant is associated with a high risk of developing AMD. Using Cx3cr1GFP/GFP mice (deficient in CX3CR1, a chemokine receptor) and humanized APOε2 mice, the work presented herein demonstrates that APOE exerts a pro-inflammatory role leading to a dose-dependent alteration of the subretinal immune privilege. This immunosuppressive environment is dependent upon FasL expression by the retinal pigment epithelium (RPE), and prevents in physiological condition the presence of inflammatory cells in the outer retina. Our results show that APOE stimulates in an autocrine fashion the secretion of IL -6 by PM, possibly through a mechanism involving activation of Toll- like receptors (TLR) and their coreceptor CD36. We show that IL-6 inhibits the expression of FasL on the RPE and impairs its subretinal clearance capacity, which facilitates the survival of infiltrating PM in contact with photoreceptors. The persistence of a pathological inflammation in the outer retina leads to age-dependent photoreceptor degeneration, which can be inhibited in APOE-deficient mice. Taken together, these results provide novel rationale for the higher risk of developing AMD for APOε2allele carriers, and could allow the emergence of new therapeutic perspectives.

The field of proteomics studies the structure and function of proteins in a large scale and high throughput manner. My work in the field of proteomics focuses on identifying interactions between proteins and discovering novel interactions. The identification of these interactions provides new information on metabolic and disease pathways and the working proteome of a cell. Cells are lysed and purified using antibody based affinity purification followed by digestion and identification using an HPLC coupled to a mass spectrometer. In my studies, I looked at the interaction networks of several AD related genes (Apolipoprotein E, Clusterin variant 1 and 2, Low-density lipoprotein receptor, Phosphatidylinositol binding clathrin assembly protein, Alpha-synuclein and Platelet-activating factor receptor) and an endosomal recycling pathway involved in cholesterol metabolism (Eps15 homology domain 1,2 and 4, Proprotein convertase subtilisin/kexin type 9 and Low-density lipoprotein receptor). Several novel and existing interactors were identified and these interactions were validated using co-immunopurification, which could be the basis for future research.

Une augmentation de l’activité de la protéine de transfert des esters de cholestérol (CETP) est retrouvée associée à une élévation du développement de l’athérosclérose. L’apolipoprotéine C1 est l’inhibiteur physiologique de la CETP. Ses propriétés électrostatiques jouent un rôle important dans sa capacité d’inhibition de l’activité CETP. Aucune étude de ce potentiel inhibiteur de l’apoC1 n’a été réalisée chez des patients à haut risque cardio-vasculaire ou dyslipidémiques. Nous avons souhaité étudier la fonctionnalité de l’apoC1 par rapport à la CETP chez des patients coronariens normolipidémiques et hyperlipidémiques d’une part et chez des patients diabétiques de type 1 et de type 2 en comparaison à des sujets sains normolipidémiques d’autre part. Nous avons confirmé que l’apoC1 était un inhibiteur physiologique de la CETP chez l’homme normolipidémique. Nous avons montré pour la première fois la perte de cette capacité d’inhibition en cas d’hyperlipidémie chez des sujets coronariens et en cas de diabète de type 1 ou de type 2.En cas d’hyperlipidémie, l’hypertriglycéridémie joue un rôle important en stimulant la réaction de transfert des esters de cholestérol. La possible modification de répartition de l’apoC1 entre HDL et VLDL secondaire à l’hyperlipidémie est probablement également impliquée dans cette perte de fonctionnalité. Au cours du diabète, notamment de type 1, nous avons démontré que l’hyperglycémie, à l’origine du phénomène de glycation, participe, au moins en partie, à cette perte de potentiel inhibiteur. Nous avons également mis en évidence que la glycation in vitro de l’apoC1 modifiait sa charge électrostatique, facteur déterminant de son potentiel inhibiteur. / High cholesteryl ester transfer protein (CETP) activity was found to accelerate the progression of atherosclerosis. Apolipoprotein C1 (apoC1) is a potent physiological inhibitor of CETP. ApoC1 operates as CETP inhibitor through its ability to modify the electrostatic charge at the lipoprotein surface. The inhibitory potential of apoC1 has never been studied in high risk patients or in patients with hyperlipidemia. Our aim was to address the functionality of apoC1 as CETP inhibitor in normo- and hyperlipidemic patients with documented coronary artery disease and in patients with type 1 and type 2 diabetes in comparison with normolipidemic-normoglycemic healthy subjects. We confirmed that apoC1 is a physiological inhibitor of CETP in normolipidemic subjects. We showed for the first time that this inhibitory potential is lost in hyperlipidemic patients with coronary artery disease and in patients with type 1 or type 2 diabetes. During hyperlipidemia, abundant triglyceride-rich lipoproteins, as preferential acceptors of HDL cholesteryl ester, probably drive the CETP-mediated cholesteryl ester transfer reaction. The modified distribution of apoC1 between HDL and VLDL might play a role in this loss of inhibitory property. During diabetes, especially in type 1, we showed that hyperglycemia, responsible for glycation, is involved, at least in part, in this loss of CETP inhibitory ability of apoC1. We also showed that in vitro glycation of apoC1 changed its electrostatic properties, which is recognized as a major determinant of its inhibitory ability.

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L’augmentation de la longévité et une meilleure prise en charge des maladies cardiovasculaires entraînent un accroissement de la fréquence des maladies liées au vieillissement cérébral, les accidents vasculaires cérébraux (AVC) et la démence étant les plus fréquents. Les marqueurs IRM de vieillissement cérébrovasculaire (hypersignaux de la substance blanche [HSB], infarctus silencieux, microhémorragies) sont de forts prédicteurs d’AVC et de démence, très fréquents en population générale âgée et facilement mesurables. Nous avons étudié l’association entre des composantes du métabolisme lipidique (taux de lipides plasmatiques, génotype ε de l’Apolipoprotéine E [APOE]) et les marqueurs IRM de vieillissement cérébrovasculaire. Nous rapportons dans une revue systématique et méta-analyse que l’allèle APOEε4 est associé à un volume accru de HSB et à un risque accru de microhémorragies et que l’allèle APOEε2 est associé avec un volume accru de HSB et une fréquence plus élevée d’infarctus silencieux. Nous rapportons dans les études 3C-Dijon et EVA, que les taux croissants de triglycérides (TG) sont associés à un volume accru de HSB et à une fréquence plus élevée de lacunes (petits infarctus silencieux). Enfin nous avons exploré la signification clinique de ces associations dans l’étude 3C. Nous rapportons que des taux plus élevés de TG, LDL-cholestérol, et cholestérol total sont associés à un risque accru de démence et de ses sous-types, en population générale âgée de 74 ans à l’inclusion et suivie pendant 12 ans. Nous concluons que le métabolisme lipidique est associé aux marqueurs IRM de vieillissement cérébrovasculaire et à la démence. / Increasing longevity and improved management of cardiovascular diseases has led to an increase in the frequency of age-related neurological diseases, especially stroke and dementia. MRI markers of vascular brain injury (white matter hyperintensities [WMH], silent infarcts and microbleeds) are powerful predictors of stroke and dementia, very frequent in the elderly, and can be measured easily. We studied the association between some components of lipid metabolism (plasma lipid levels, Apolipoprotein E [APOE] ε genotype) and MRI markers of vascular brain injury. We found in a systematic review with meta-analysis that the ε4 allele of the APOE gene is associated with larger WMH volume and a higher frequency of cerebral microbleeds, and that the APOEε2 allele is associated with larger WMH volume and a higher frequency of silent brain infarcts. We also report in the 3C-Dijon Study and in the EVA study that higher triglyceride levels are associated with an increased WMH volume and with a higher frequency of silent lacunar (small subcortical) brain infarcts. Finally, we investigated the clinical significance of these associations the 3C Study. We observed that higher triglycerides, LDL-cholesterol and total cholesterol levels, were associated with an increased risk of all dementia and its subtypes, in community persons aged 74 years at baseline and followed for up to 12 years. We conclude that lipid metabolism is associated with MRI-markers of cerebrovascular aging and dementia.