CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A incidÃncia e mortalidade por cÃncer colorretal apresentam tendÃncia ao crescimento. O cÃncer colorretal à a quinta neoplasia mais incidente no Brasil. A etiologia està relacionada com hereditariedade e modificaÃÃes no estilo de vida. A lesÃo prÃ-neoplÃsica mais precoce com presenÃa de displasia à o foco de cripta aberrante, estando relacionada como lesÃo precursora de adenomas colorretais e cÃncer em humanos. Entender a natureza destas lesÃes contribui na pesquisa de agentes preventivos eficazes no cÃncer colorretal. O objetivo foi verificar o potencial quimiopreventivo da soluÃÃo aquosa do lÃtex de Euphorbia tirucalli L. quanto a formaÃÃo de focos de cripta aberrante (FCA) em ratos induzidos com azoximetano (AOM). Foram usados 32 ratos da linhagem Wistar, machos, com peso mÃdio estimado de 100g -200g (4 â 6 semanas). Foram distribuÃdos aleatoriamente em 04 grupos contendo 08 animais, denominados: GRUPO 01- grupo estudo com ratos induzidos com AOM e tratados com extrato aquoso do lÃtex da E. tirucalli L..GRUPO 02 - grupo estudo controle com ratos induzidos com AOM sem tratamento com extrato aquoso do lÃtex da E tirucalli L..GRUPO 03 - grupo estudo controle sem induÃÃo com AOM e tratados com extrato aquoso do lÃtex da E. tirucalli L.. GRUPO 04 - grupo estudo controle sem induÃÃo com AOM e sem tratamento com extrato aquoso do lÃtex da E. tirucalli L..Os animais dos Grupos 01 e 02 receberam injeÃÃo de AOM 12 mg/kg, intraperitoneal (IP), uma vez por semana, por 02 semanas. Uma semana antes do inÃcio da administraÃÃo do carcinÃgeno, foi administrada diariamente soluÃÃo por gavagem, respectivamente, de extrato aquoso do lÃtex da E. tirucalli L. 400mg/Kg e soluÃÃo fisiolÃgica a 0,9% em uma administraÃÃo diÃria. Os Grupos 03 e 04 nÃo foram induzidos com AOM e receberam soluÃÃo por gavagem, respectivamente, de extrato aquoso do lÃtex da E. tirucalli L. 400mg/Kg e soluÃÃo fisiolÃgica a 0,9%. Todos os grupos continuaram recebendo a soluÃÃo por gavagem diÃria atà o dia estabelecido para eutanÃsia. Foram mortos na 15 semana, apÃs a induÃÃo com carcinÃgeno ou administraÃÃo IP de soluÃÃo estÃril para injeÃÃo. Os animais foram avaliados quanto ao peso, alteraÃÃo clÃnica, presenÃa de adenomas ou tumores cÃlicos, e quanto à presenÃa de FCA e o nÃmero de criptas por cada foco (multiplicidade) de acordo com a localizaÃÃo cÃlica, definidas regiÃo distal, medial e proximal. Verificamos no presente estudo que o extrato aquoso da E tirucalli L. (400mg/kg) apresentou uma diminuiÃÃo significante do nÃmero total de FCA do grupo 01 em relaÃÃo ao grupo 02 (p<0,001), adicionalmente a multiplicidade nestes grupos apresentou diferenÃa significante (p<0,0001) quanto a presenÃa de &#8804; 5 criptas por foco em todo cÃlon examinado. Este estudo sugere que extrato aquoso de E. tirucalli L tem potencial quimiopreventivo em relaÃÃo a carcinogÃnese cÃlica, inibindo a formaÃÃo de FCA em ratos induzidos com AOM. / Colorectal cancer is the fifth most frequently diagnosed malignancy in Brazil. The etiology may be related with inherited and life-style that can be modified. Aberrant crypt foci have been recognized as early preneoplastic lesions and being related with colorectal adenoma and precursors of cancer in humans. Undertanding the nature of early appearing lesions efforts to find effective agents in colorrectal cancer. The aim of this study was verify the potential chemopreventive of aqueous solution of the latex of Euphorbia tirucalli L. in aberrant crypt foci (ACF) in rats induced with azoxymethane (AOM). Thirty-two Wistar male rats were used, average weight 100g -200g (4 - 6 weeks). They were randomly divided into 04 groups of 08 animals each. Group 01 with rats induced with AOM and treated with aqueous extract of the latex of E. tirucalli L., group 02 with rats induced with AOM without treatment with aqueous extract of the latex of E. tirucalli L., group 03 with rats without AOM induction and treated with aqueous extract of the latex of E. tirucalli L. and group 04 with rats without induction with AOM and without treatment with aqueous extract of the latex of E. tirucalli L.. The animals of the groups 01 and 02 were injected intraperitoneallly (IP), with AOM once a weekly for 02 weeks at a dose level of 12 mg/kg body weight. One week before the beginning of the administration of the carcinogen, it was administered solution daily by intragastric gavage, respectively, aqueous extract of latex of E. tirucalli L. 400mg/Kg and physiologic solution to 0,9%. The groups 03 and 04 were not induced with AOM and they received daily solution by gavage, respectively, aqueous extract of the latex of E. tirucalli L. 400mg/Kg and physiologic solution to 0,9%. All groups continued receiving daily solutions by intragastric gavage until the day established for euthanasia. All animals were sacrificed by diethyl ether inhalation 15th week, after AOM initiation or sterile solution injected IP. The animals were evaluated concerning to the weight, clinical alteration, presence of adenomas or colic tumors, and the presence of ACF and the number of crypts for each focus (multiplicity) in agreement with colic location, defined area distal, medial and proximal. We verified in the present study that the aqueous extract of E. tirucalli L. (400mg/kg) presented a significant decrease of the global number of ACF group 01 compared to the group 02 (p<0,001). Additionally, the multiplicity in these groups showed significant decrease (p<0,0001) in the number of ACF with 5 crypts/focus in the whole large intestine. This study suggests the aqueous extract of E. tirucalli L. has potential chemopreventive against colon carcinogenesis with inhibition of the formation of ACF in rats induced with AOM .

The typical Western dietary pattern is characterized by the consumption of energy-dense, nutrient-poor foods and has been linked to increased risk of colorectal cancer (CRC). Our research group previously developed the total Western diet (TWD) that emulates typical human dietary intakes of macro- (carbohydrates, proteins, and fats) and micronutrients (vitamins and minerals) on an energy density basis for rodents. In the present study, we sought to determine the impact of TWD on biomarkers of metabolic syndrome and obesity in comparison to a commercial 45% fat diet used for models of diet-induced obesity (DIO diet) and the standard basal AIN93G diet, which is optimized for rodent health. Also, we included 2 additional test diets to evaluate the contribution of the micronutrient (vitamin- and mineral-modified diet, [VMM]) or macronutrient (macro-modified diet [MM]) contents of the TWD in development of cancer, obesity, and glucose intolerance. A chemical carcinogenesis model of inflammation-associated colon cancer was employed to evaluate impact of diets on colon cancer in mice. As expected, mice consuming the DIO diet acquired an obesity/metabolic syndrome phenotype typified by increased food energy intake, greater rate of body weight gain, increased proportion of body composition as fat mass, higher fasting glucose, impaired glucose tolerance, and higher circulating levels of leptin. However, consumption of TWD did not alter any of these classic biomarkers of metabolic health, as these mice adjusted food intake so that energy consumption was similar to that for mice fed AIN93G. A different pattern was observed for colon carcinogenesis. Consumption of the TWD or VMM diet markedly increased colon tumor multiplicity and size compared to the AIN93G control, whereas consumption of the DIO or MM diets did not enhance colon tumorigenesis. Collectively, these observations point to a critical role of dietary micronutrients in colon carcinogenesis, and that this promoting effect is likely unrelated to the metabolic syndrome phenotype induced by a high fat diet. Moreover, our observations emphasize the need to take into account the micronutrient content of rodent basal diets when modeling typical U.S. nutrition in pre-clinical animal experiments in order to improve the translation of these studies to human nutrition and dietary intervention programs.

CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / O cÃncer colorretal (CCR) à a quinta neoplasia mais incidente no Brasil e sua freqÃÃncia vem aumentando em paÃses industrializados. A lesÃo prÃ-neoplÃsica mais precoce com presenÃa de displasia à o foco de cripta aberrante (FCA), estando relacionada como lesÃo precursora de adenomas colorretais e cÃncer em humanos. O entendimento destas lesÃes à fundamental para esclarecer os mecanismos da carcinogÃnese colorretal e sua prevenÃÃo. O objetivo foi verificar se a dieta hipercalÃrica (DH), hiperlÃpidica, interfere na formaÃÃo de criptas aberrantes na mucosa cÃlica induzida por azoximetano (AOM), em ratos. Foram usados 36 ratos Wistar, machos, com peso mÃdio inicial de 180g a 250g e 8 semanas de idade. Foram distribuÃdos em 04 grupos com 09 animais cada: GI- Grupo com ratos submetidos à DH e nÃo expostos ao AOM, GII- Grupo com ratos submetidos à dieta padrÃo (DP) e nÃo expostos ao AOM, GIII- Grupo com ratos submetidos à DH e expostos ao AOM, GIV- Grupo com ratos submetidos à DP e expostos ao AOM. Utilizou-se, a partir da 8 semana, nos grupos I e III uma dieta hipercalÃrica (4.250cal/kg), rica em gordura poliinsaturada, relaÃÃo &#969;-6: &#969;-3 = 3:1, acrescida de fibras, minerais e vitaminas. Os grupos II e IV receberam uma dieta padrÃo (3.000cal/kg). Na 16 semana, GIII e GIV receberam injeÃÃo de AOM 15mg/kg, intraperitoneal (IP), 01 vez por semana, por 02 semanas, enquanto GI e GII receberam soluÃÃo salina a 0,9%. Foram mortos na 15 semana apÃs a induÃÃo com carcinÃgeno ou administraÃÃo IP de soluÃÃo estÃril. Avaliaram-se os animais quanto ao peso, alteraÃÃo clÃnica, presenÃa de adenomas, FCA e o nÃmero de criptas por foco (multiplicidade) de acordo com a localizaÃÃo cÃlica (proximal, medial e distal). Os resultados foram submetidos aos testes de anÃlise de variÃncia e estabelecido o nÃvel de 5% (p < 0,05) para a rejeiÃÃo da hipÃtese de nulidade. Verificou-se que a dieta hipercalÃrica hiperlÃpidica promoveu um incremento no peso no grupo III, quando comparado ao grupo IV e nÃo apresentou aumento significante no nÃmero total de FCA nos segmentos mÃdio (p = 0,985) e distal (p = 0,854). Analisando ambos os grupos em relaÃÃo à multiplicidade de FCA, nÃo houve predominÃncia da presenÃa de 01 a 04 criptas nos segmentos mÃdio (p = 0,499) e distal (p = 0,244), como tambÃm, de 05 ou mais criptas nos segmentos mÃdio (p = 0,371) e distal (p = 0,820). Verificando a presenÃa do nÃmero total de criptas por foco em toda a mucosa cÃlica, o teste do qui-quadrado mostrou que o grupo IV apresenta, em proporÃÃo, um maior nÃmero de focos com 05 ou mais criptas do que o grupo III (P= 0,043). Conclui-se que a dieta usada aumenta o peso corporal, porÃm nÃo interfere na quantidade de FCA, contudo reduz o aparecimento de criptas aberrantes, quando &#8805; 5 criptas por foco, no colo de ratos Wistar, induzido por azoximetano. / Colorectal cancer is the fifth most common type of cancer in Brazil and the incidence is growing in developed countries. The earliest preneoplastic lesion presenting dysplasia is aberrant crypt foci (ACF), a precursor of colorectal adenoma and cancer in humans. Knowledge of ACF formation is crucial to understanding the mechanisms involved in colorectal cancer and their inhibition. The objective of this study was to determine whether a hypercaloric, hyperlipidic diet (HCD) affects azoxymethane (AOM)-induced ACF formation in rat colonic mucosa. Thirty-six 8-week old male Wistar rats weighing 180-250g were distributed into 4 groups of 9 animals each: Group I: HCD without AOM; Group II: normocaloric diet (NCD) without AOM; Group III: HCD and AOM; Group IV: NCD and AOM. From the eighth week onwards the animals in Groups I and III were fed HCD (4,250 cal/kg; rich in polyunsaturated fat; ratio &#969;6:&#969;3=3:1, with addition of fiber, minerals and vitamins). The animals in Groups II and IV were fed NCD (3,000 cal/kg). At 16 weeks, the animals in Groups III and IV were injected i.p. with 15 mg/kg AOM once a week for 2 weeks, while the animals in Groups I and II received 0.9% physiological saline. At 15 weeks after AOM or saline administration, the animals were euthanized and their weight, clinical changes, adenomas, ACF and number of crypts per focus (multiplicity) according to colon section (proximal, middle or distal) were registered. The findings were submitted to variance analysis and the level of statistical significance was set at 5% (p<0.05). HCD was found to promote weight increase in Group III compared to Group IV. No significant increase in the total number of ACF was observed for the middle and distal segments (p=0.985 and p=0.854, respectively). The multiplicity of foci with 1-4 aberrant crypts was similar for the middle and distal segments (p=0.499 and p=0.244, respectively). The corresponding figures for foci with &#8805;5 aberrant crypts were p=0.371 and p=0.820. The total number of ACF in the colonic mucosa differed significantly between Group IV and Group III (&#967;2 = 4.091; p=0.043). It may thus be concluded that HCD promotes weight increase and, while not affecting the total number of ACF, reduces the proportion of foci with &#8805;5 aberrant crypts, thereby indirectly preventing the emergence of preneoplastic lesions in rat colonic mucosa.

L’insuffisance hépatique aiguë (IHA) se caractérise par la perte soudaine de la fonction hépatique résultant de la nécrose massive des hépatocytes en l’absence de pathologie hépatique préexistante. L’IHA s’accompagne de perturbations métaboliques et immunologiques qui peuvent entraîner l’apparition de complications périphériques et cérébrales telles qu’un syndrome de réponse inflammatoire systémique (SIRS), une encéphalopathie hépatique (EH), un œdème cérébral, une augmentation de la pression intracrânienne, et la mort par herniation du tronc cérébral. Les infections sont une complication fréquente de l’IHA et elles sont associées à un risque accru de développer un SIRS et une aggravation subséquente de l’EH avec un taux de mortalité augmenté. L’ammoniaque joue un rôle majeur dans les mécanismes physiopathologiques qui mènent au développement de l’EH et de l’œdème cérébral, et des études récentes suggèrent que les cytokines pro-inflammatoires sont également impliquées. Le but de cette thèse est d’étudier le rôle des cytokines pro-inflammatoires circulantes et cérébrales dans le développement de l’EH et de l’œdème cérébral lors d’IHA. Dans l’article 1, nous démontrons que l’inhibition périphérique du facteur de nécrose tumorale-α (TNF-α) par l’etanercept retarde la progression de l’EH en diminuant le dommage hépatocellulaire, réduisant l’inflammation périphérique et centrale ainsi que le stress oxydatif/nitrosatif hépatique et cérébral associé chez la souris avec une IHA induite par l’azoxyméthane (AOM). Ces résultats démontrent un rôle important du TNF-α dans la physiopathologie de l’EH lors d’IHA d’origine toxique et suggèrent que l’etanercept pourrait constituer une approche thérapeutique dans la prise en charge des patients en attente de transplantation hépatique. Dans l’article 2, nous simulons la présence d’une infection chez la souris avec une IHA induite par l’AOM pour mettre en évidence une éventuelle augmentation de la réponse inflammatoire. Nous démontrons que l’endotoxémie induite par le lipopolysaccharide (LPS) précipite la survenue du coma et aggrave la pathologie hépatique. Les cytokines pro-inflammatoires systémiques et cérébrales sont augmentées de façon synergique par le LPS lors d’IHA et résultent en une activation accrue de la métalloprotéinase matricielle-9 cérébrale qui s’accompagne d’une extravasation d’immunoglobulines G (IgG) dans le parenchyme cérébral. Ces résultats démontrent une augmentation majeure de la perméabilité de la barrière hémato-encéphalique (BHE) qui contribue à la pathogenèse de l’EH lors d’IHA en condition infectieuse. Les résultats de l’article 3 démontrent que l’augmentation de la perméabilité de la BHE lors d’IHA induite par l’AOM en condition non infectieuse ne résulte pas de l’altération de l’expression des protéines constitutives de la BHE. Dans l’article 4, nous démontrons que l’exposition d’astrocytes en culture à des concentrations physiopathologiques d’ammoniaque ou d’interleukine-1β résulte en l’altération de gènes astrocytaires impliqués dans la régulation du volume cellulaire et dans le stress oxydatif/nitrosatif. Un effet additif est observé dans le cas d’un traitement combiné au niveau des gènes astrocytaires impliqués dans le stress oxydatif/nitrosatif. L’ensemble des résultats de cette thèse démontre un rôle important de l’inflammation périphérique et cérébrale dans la survenue des complications neurologiques lors d’IHA et une meilleure compréhension des mécanismes physiopathologiques impliqués pourrait contribuer à la mise en place de stratégies thérapeutiques chez les patients atteints d’IHA en attente de transplantation. / Acute liver failure (ALF) is the clinical manifestation of an abrupt loss of hepatic function resuting from a massive hepatocyte necrosis in a patient with no preexisting liver disease. ALF is associated with metabolic and immunological disturbances that may lead to peripheral and cerebral complications such as systemic inflammatory response syndrome (SIRS), hepatic encephalopathy (HE), brain edema, increased intracranial pressure (ICP) and ultimately death by cerebral herniation. ALF is frequently complicated by infections, which are known to increase the risk of developing a SIRS with a subsequent worsening of HE and higher mortality rates. Ammonia plays a pivotal role in the pathophysiological mechanisms leading to HE and brain edema, and recent studies suggest that pro-inflammatory cytokines may also be involved. The aim of this thesis is therefore to investigate the role of circulating and cerebral pro-inflammatory cytokines in the setting of HE and brain edema during ALF. In article No. 1, we demonstrated that peripheral inhibition of tumor necrosis factor-alpha (TNF-α) by etanercept delays the progression of HE by reducing hepatocellular damage, decreasing peripheral and cerebral inflammation as well as associated oxidative/nitrosatif stress in mice with ALF induced by azoxymethane (AOM). These findings demonstrate an important role of TNF-α in the pathophysiology of HE during toxic liver injury and suggest that etanercept may provide a therapeutic approach in the management of patient awaiting liver transplantation. In article No. 2, we mimicked infection in mice with AOM-induced ALF in order to better understand the effects of an increased inflammatory response. We demonstrated that endotoxemia induced by lipopolysaccharide (LPS) precipitates the onset of coma and worsens the liver pathology. Peripheral and brain pro-inflammatory cytokines are synergistically raised by LPS during ALF and result in a large increase in cerebral matrix metalloprotease-9 (MMP-9) activity that was associated with immunoglobulin G (IgG) extravasation in the brain parenchyma. These results demonstrate a major increase of blood-brain barrier (BBB) permeability that contributes to the pathogenesis of HE during ALF with superimposed infection. Results from article No. 3 demonstrate that increase of BBB permeability during AOM-induced ALF without superimposed infection is not due to alteration of BBB constitutive proteins. In article No. 4, we demonstrated that exposure of cultured astrocytes to pathophysiological concentrations of ammonia or interleukin-1β results in an alteration of the expression of astrocytic genes implicated in cell volume regulation and oxidative/nitrosative stress. An additive effect on astrocytic genes implicated in oxidative/nitrosative was made evident in case of co-treatment. Taken together, results of the present thesis demonstrate a major role of peripheral and cerebral inflammation in the onset of neurological complications during ALF and a better understanding of the pathophysiological mechanisms implicated may contribute to new therapeutic strategies for ALF patients awaiting transplantation.

L’insuffisance hépatique aiguë (IHA) se caractérise par la perte soudaine de la fonction hépatique résultant de la nécrose massive des hépatocytes en l’absence de pathologie hépatique préexistante. L’IHA s’accompagne de perturbations métaboliques et immunologiques qui peuvent entraîner l’apparition de complications périphériques et cérébrales telles qu’un syndrome de réponse inflammatoire systémique (SIRS), une encéphalopathie hépatique (EH), un œdème cérébral, une augmentation de la pression intracrânienne, et la mort par herniation du tronc cérébral. Les infections sont une complication fréquente de l’IHA et elles sont associées à un risque accru de développer un SIRS et une aggravation subséquente de l’EH avec un taux de mortalité augmenté. L’ammoniaque joue un rôle majeur dans les mécanismes physiopathologiques qui mènent au développement de l’EH et de l’œdème cérébral, et des études récentes suggèrent que les cytokines pro-inflammatoires sont également impliquées. Le but de cette thèse est d’étudier le rôle des cytokines pro-inflammatoires circulantes et cérébrales dans le développement de l’EH et de l’œdème cérébral lors d’IHA. Dans l’article 1, nous démontrons que l’inhibition périphérique du facteur de nécrose tumorale-α (TNF-α) par l’etanercept retarde la progression de l’EH en diminuant le dommage hépatocellulaire, réduisant l’inflammation périphérique et centrale ainsi que le stress oxydatif/nitrosatif hépatique et cérébral associé chez la souris avec une IHA induite par l’azoxyméthane (AOM). Ces résultats démontrent un rôle important du TNF-α dans la physiopathologie de l’EH lors d’IHA d’origine toxique et suggèrent que l’etanercept pourrait constituer une approche thérapeutique dans la prise en charge des patients en attente de transplantation hépatique. Dans l’article 2, nous simulons la présence d’une infection chez la souris avec une IHA induite par l’AOM pour mettre en évidence une éventuelle augmentation de la réponse inflammatoire. Nous démontrons que l’endotoxémie induite par le lipopolysaccharide (LPS) précipite la survenue du coma et aggrave la pathologie hépatique. Les cytokines pro-inflammatoires systémiques et cérébrales sont augmentées de façon synergique par le LPS lors d’IHA et résultent en une activation accrue de la métalloprotéinase matricielle-9 cérébrale qui s’accompagne d’une extravasation d’immunoglobulines G (IgG) dans le parenchyme cérébral. Ces résultats démontrent une augmentation majeure de la perméabilité de la barrière hémato-encéphalique (BHE) qui contribue à la pathogenèse de l’EH lors d’IHA en condition infectieuse. Les résultats de l’article 3 démontrent que l’augmentation de la perméabilité de la BHE lors d’IHA induite par l’AOM en condition non infectieuse ne résulte pas de l’altération de l’expression des protéines constitutives de la BHE. Dans l’article 4, nous démontrons que l’exposition d’astrocytes en culture à des concentrations physiopathologiques d’ammoniaque ou d’interleukine-1β résulte en l’altération de gènes astrocytaires impliqués dans la régulation du volume cellulaire et dans le stress oxydatif/nitrosatif. Un effet additif est observé dans le cas d’un traitement combiné au niveau des gènes astrocytaires impliqués dans le stress oxydatif/nitrosatif. L’ensemble des résultats de cette thèse démontre un rôle important de l’inflammation périphérique et cérébrale dans la survenue des complications neurologiques lors d’IHA et une meilleure compréhension des mécanismes physiopathologiques impliqués pourrait contribuer à la mise en place de stratégies thérapeutiques chez les patients atteints d’IHA en attente de transplantation. / Acute liver failure (ALF) is the clinical manifestation of an abrupt loss of hepatic function resuting from a massive hepatocyte necrosis in a patient with no preexisting liver disease. ALF is associated with metabolic and immunological disturbances that may lead to peripheral and cerebral complications such as systemic inflammatory response syndrome (SIRS), hepatic encephalopathy (HE), brain edema, increased intracranial pressure (ICP) and ultimately death by cerebral herniation. ALF is frequently complicated by infections, which are known to increase the risk of developing a SIRS with a subsequent worsening of HE and higher mortality rates. Ammonia plays a pivotal role in the pathophysiological mechanisms leading to HE and brain edema, and recent studies suggest that pro-inflammatory cytokines may also be involved. The aim of this thesis is therefore to investigate the role of circulating and cerebral pro-inflammatory cytokines in the setting of HE and brain edema during ALF. In article No. 1, we demonstrated that peripheral inhibition of tumor necrosis factor-alpha (TNF-α) by etanercept delays the progression of HE by reducing hepatocellular damage, decreasing peripheral and cerebral inflammation as well as associated oxidative/nitrosatif stress in mice with ALF induced by azoxymethane (AOM). These findings demonstrate an important role of TNF-α in the pathophysiology of HE during toxic liver injury and suggest that etanercept may provide a therapeutic approach in the management of patient awaiting liver transplantation. In article No. 2, we mimicked infection in mice with AOM-induced ALF in order to better understand the effects of an increased inflammatory response. We demonstrated that endotoxemia induced by lipopolysaccharide (LPS) precipitates the onset of coma and worsens the liver pathology. Peripheral and brain pro-inflammatory cytokines are synergistically raised by LPS during ALF and result in a large increase in cerebral matrix metalloprotease-9 (MMP-9) activity that was associated with immunoglobulin G (IgG) extravasation in the brain parenchyma. These results demonstrate a major increase of blood-brain barrier (BBB) permeability that contributes to the pathogenesis of HE during ALF with superimposed infection. Results from article No. 3 demonstrate that increase of BBB permeability during AOM-induced ALF without superimposed infection is not due to alteration of BBB constitutive proteins. In article No. 4, we demonstrated that exposure of cultured astrocytes to pathophysiological concentrations of ammonia or interleukin-1β results in an alteration of the expression of astrocytic genes implicated in cell volume regulation and oxidative/nitrosative stress. An additive effect on astrocytic genes implicated in oxidative/nitrosative was made evident in case of co-treatment. Taken together, results of the present thesis demonstrate a major role of peripheral and cerebral inflammation in the onset of neurological complications during ALF and a better understanding of the pathophysiological mechanisms implicated may contribute to new therapeutic strategies for ALF patients awaiting transplantation.