GASP1 modulerait le trafic intracellulaire des RCPG après endocytose provoquée par les ligands. Au cours de ce travail nous nous sommes focalisés sur l’interaction de GASP-1 avec le récepteur beta2-adrénergique (B2AR) et ses conséquences fonctionnelles. Les agonistes du récepteur B2AR sont des bronchodilatateurs puissants utilisés dans le traitement de l’asthme. Avec le Dr N. Frossard, nous avons montré qu'un traitement chronique avec un agoniste B2AR induit le développement d'une hyper-réactivitée bronchique chez les souris sauvages mais pas chez les KO GASP1. Ce phénotype n’est pas relié à une différence dans la dégradation du récepteur B2AR entre les souris sauvages et KO GASP-1 mais est corrélé avec une augmentation du niveau de collagène dans les poumons des souris sauvages. Nos résultats indiquent que GASP1 joue un rôle important dans ce phénomène adaptatif qui serait relié à un remaniement des tissus bronchiques dépendant de cette protéine. / GASP1 have been shown to modulate the postendocytic sorting of different GPCRs.In order to better understand the role of GASP1 in regulating the activity and intracellular traffic king of GPCRs, we have focused our project on the functional consequences of the interaction between GASP1 and beta2-adrenergic receptor (B2AR). B2AR agonists are potent bronchodilators used in the treatment of asthma. With Dr. N. Frossard, we have shown that achronic treatment with a B2AR agonist induces the development of bronchial hyperresponsiveness in wild-type but not in KO GASP1 mice. Furthermore, we have shown that this phenotype is not related to a difference of B2AR receptor degradation between wild type and KO animals but correlates with an increase in collagen levels in the lungs of wild type mice that is not observed in GASP1KO animals. Altogether, our data suggest thatGASP1 is critically involved in these adaptations, which could be related to a GASP1-dependent modification of lung tissues.

Growth and deposition of amyloid fibrils, polymers of proteins with a cross beta-sheet structure, are associated with a significant number of human pathologies including Alzheimer’s disease, Parkinson’s disease, prion diseases, type II diabetes, and senile systematic or dialysis-related amyloidoses. The broader objective of my research is to identify the basic mechanisms regulating nucleation and growth of amyloid fibrils. There is increasing evidence that amyloid formation may proceed along at least two distinct assembly pathways for the formation of rigid fibrils. One pathway involves the nucleated polymerization of the characteristic rigid fibrils from partially denatured monomers and the other proceeds via the growth of globular oligomers and their associated curvilinear fibrils (also known as protofibrils) which, in ways yet to be determined, transform into late-stage rigid fibrils. These oligomeric intermediates of fibril assembly, in particular, have been implicated as the predominant aggregate species causing cellular toxicity in amyloid diseases. Yet, amyloid oligomers and curvilinear fibrils are considered transient, metastable aggregates. This raises the question whether and how such transient aggregate species can be responsible for most of the cell/tissue toxicity? In this dissertation, I report on my investigation of several basic questions related to the mechanisms of amyloid formation. Using the model amyloid hen egg-white lysozyme, I participated in research to characterize the distinct kinetics of amyloid formation along distinct assembly pathways, to determine the morphological features of the various aggregate species emerging along either pathway, and to investigate the structural evolution of the monomers from their native state to the amyloid cross- sheet structure (chapter 3). Chapters 4-6 represent the core of my dissertation work. There I investigated whether amyloid aggregates from three different amyloid proteins, formed under denaturing condition, could undergo prion-like proliferation upon return to physiological solution conditions. I was also intimately involved in a project on the conditions inducing amyloid spherulites formation by polyglutamic acid and the mechanisms resulting in the formation of this often-overlooked amyloid aggregate structure (chapter 7). In the appendix I provide a short summary of the various experimental techniques I have used in the above experiments.

<p>Michelle N. Ingle. M.S., Purdue University, December 2019. Computational Modeling of Transforming Growth Factor-β2 Receptor Complex Assembly. Major Professor: David M. Umulis.</p> <p> </p> <p> Transforming growth factor (TGF)-β1, TGF-β2, and TGF-β3 are secreted signaling proteins that play an essential role in tissue development, immune response, and physiological homeostasis. TGF-β ligands signal through a tetrameric complex made up of two type I receptors (TβRI) and two type II receptors (TβRII). Dysregulation of TGF-β signaling has been linked to uncontrolled cell proliferation and cancer metastasis. An accurate understanding of TGF-β’s receptor complex assembly pathway may allow for pharmacological intervention and/or preservation of proper TGF-β signaling.</p> <p> Amongst the ligand types, TGF-β1 and TGF-β3 are efficient signalers, presumably by strong binding to both type I and II receptors. However, TGF-β2 has a very weak affinity for TβRII and requires an additional membrane-bound protein called betaglycan (BG) to achieve similar levels of downstream signaling. While computational modeling has been performed on the signaling pathway of the TGF-β system, to date no computational modeling has aimed to decipher BG’s role in the potentiation of TGF-β2 signal. To determine the role of BG in selectively facilitating signaling by TGF-β2, we developed computational models with different assumptions based on the levels of cooperativity between receptor subtypes and types of BG behavior (No Receptor Recruitment model, Single-stage Receptor Recruitment model, and Two-stage Receptor Recruitment model). </p> <p> With each of the receptor recruitment models we hypothesized that BG uses two domains to successfully enhance TGF-β2 signaling. This model was first proposed in Villarreal et al., 2016 and is further investigated in this work using a two-step computational approach. First, a root mean square error (RMSE) calculation was performed between our computational models with no BG present and published experimental signaling data in cell lines with no BG present. Lower RMSE values indicate the simulated data is more representative of experimental signaling behavior when no BG is present. The second round of model validation was performed by adding BG into the simulations and comparing its behavior to experimentally determined and hypothesized behaviors of BG. </p> <p> In summary, the simulations indicate there may be more cooperative receptor recruitment present in the system then stated in literature. Furthermore, it appears that BG binding to TGF-β2 ligand through two domains provides an effective transfer mechanism that can be tuned to control differential signaling between TGF-β ligand subtypes. Experiments were then suggested in order to support or refute one of the models offered in this thesis. For the purpose of uncovering how BG enhances TGF-β2 signaling, the computational work performed in this thesis highlights the areas where researchers should focus their experimental efforts and provides a baseline model for further computational work in the TGF-β system.</p>

The beta2-adrenergic receptor is a G-protein coupled receptor, involved in several physiological processes, which enables signaling through the cell membrane. To study the effect of dopamine and adrenaline binding on the receptor structure and function, we used machine learning methods applied to data from molecular dynamics simulations. We found that the three machine learning methods Random Forest, Kullback-Leibler divergence, and Principal Component Analysis generated results that correspond to previous studies. When comparing the active state of the receptor with or without a ligand bound, we found that residues around Ser203 and Asn301 of the orthosteric binding pocket and residues around Ala91 of the TM2 differed. When instead comparing the active state of the receptor with adrenaline or dopamine bound, we found that residues around Thr68 differed. Additionally, we also found that adrenaline and dopamine cause different structural changes in the intracellular parts of TM5 and TM6. These findings indicate ligand-specific effects on the receptor, providing potentially useful information for the understanding of the interaction of adrenaline and dopamine with the beta2-adrenergic receptor.

Das fibrillen-bildende beta2-Mikroglobulin (b2M) und das CRF1-Mimetikum mit verzweigter Rückgratstruktur können als „schwierige“ Proteine betrachtet werden, deren Darstellung sich eignet, gegenwärtige Möglichkeiten und Grenzen der Proteinsynthese zu ermitteln. Die Proteine sollen zu spektroskopischen Untersuchungen von Proteinfaltung bzw. Ligand-Rezeptor- Wechselwirkungen eingesetzt werden. Versuche zur Chemosynthese von b2M über drei Segmente führten per NCL zwar zu linearen Produkten mit korrekter Primärstruktur, aber wiederholt wurden zwei, mittels HPLC trennbare Proteine erhalten, deren enzymatische Spaltung zu identischen Fragmenten führte. Eine Isomerisierung (wie z.B. Epimerisierung) als Ursache für die Bildung der zwei Produkte konnte ausgeschlossen werden. Mittels CD- und FTIR-Spektroskopie wurden für beide Produkte beta- Faltblatt-Strukturen ermittelt, die sich sowohl untereinander als auch vom rekombinanten Protein unterschieden. Die „fehlgefalteten“ Syntheseprodukte konnten nicht entfaltet und anschließend in die „korrekte“ Struktur des rekombinanten b2M überführt werden. Es ist denkbar, dass die beobachtete „Fehlfaltung“, deren Ursache nicht geklärt werden konnte, für vom b2M ausgelöste Amyloidosen verantwortlich ist. Das CRF1-Modell, das aus drei zyklischen Peptiden und einem Protein mit Disulfidbrücken besteht, welche auf einem linearen Peptid-Templat verankert sind, wurde durch ein zyklisches Templat zur strukturellen Einschränkung modifiziert. Durch das zyklische Templat ergaben sich keine Syntheseprobleme, aber interessanterweise führte die Zyklisierung des Templats zu einer signifikant höheren Affinität für den Agonisten Urocortin-I im funktionellen Assay. Darüber hinaus wurde gezeigt, dass ein zyklisches Rezeptor-Loop-Peptid mittels EPL im mg-Maßstab erhalten werden kann, was künftig die Synthese isotopenmarkierter Analoga für Struktur-Untersuchungen ermöglicht. / The fibril forming beta2-microglobulin (b2m) and the CRF1 mimic with branched peptide backbone could be considered as “difficult” proteins, whose synthesis is suited for determining present possibilities and limits of protein synthesis. The proteins shall be used for spectroscopic analysis of protein misfolding or ligand-receptor-interaction, respectively. Efforts of the chemosynthesis of b2m over three segments may lead via NCL to linear products with correct primary structure, but two, via HPLC isolatable proteins were repetitively susbstained, whose enzymatic digest lead to identical fragments. An isomerization (such as e. g. epimerization) as reason for the formation of the two products could be excluded. By means of CD and FTIR spectroscopy for both products beta-sheet structure were determined, which differ among themselves as well as from the recombinant protein. The “misfolded” synthetic product could not be unfolded und subsequently converted into the “correct” structure of the recombinant b2m. It is possible that the observed “misfolding”, whose cause could not be clarified, is reasonable for the amyloidosis induced by b2m. The CRF1 model that consists of three cyclic peptides and one protein with disulfid bridges coupled to a linear peptide template, was modified for structural constraints by a cyclic template. In consequence of the cyclic template no synthetic problems aroused, although the cyclisation of the template leads interestingly to a significant higher affinity for the antagonist urocortin-I in the functional assay. Furthermore, it was shown that a cyclic receptor loop peptide could be received via EPL in mg scale, what in future enables the synthesis of isotopically labeled analogs for structure investigations.

No description available.

Indivíduos portadores do glutamato na posição 27 do gene que codifica para o receptor beta2-adrenérgico têm resposta vasodilatadora muscular aumentada durante manobras fisiológicas. No entanto, o impacto do consumo agudo de gordura nessa resposta não é conhecido. Neste estudo, testou-se a hipótese de que o consumo gordura afetaria a resposta vasodilatadora aumentada destes indivíduos durante manobras fisiológicas. Vinte e cinco indivíduos saudáveis foram subdivididos em dois grupos: 11 homozigotos para o glutamato (Glu27Glu, 40+-3 anos; 65+-3kg) e 14 homozigotos para a glutamina (Gln27Gln, 40+-2 anos; 64+-2kg). O fluxo sangüíneo muscular foi medido por pletismografia de oclusão venosa. A resposta vasodilatadora muscular foi avaliada durante 3 minutos de exercício e estresse mental em jejum e 3 horas após consumo de 62 g de gordura. A condutância basal foi semelhante entre grupos (Glu27Glu=2,3+-0,1; Gln27Gln=2,2+-0,1; P=0,21). O aumento da condutância vascular durante exercício e durante o estresse mental foi maior no grupo Glu27Glu (0,73+-0,2 vs 0,22+-0,1; P=0,008 e 1,8?0,3 vs 1,2+-0,2; P=0,04, respectivamente). O consumo agudo de uma preparação rica em gordura eliminou esta diferença. A resposta de pressão arterial e freqüência cardíaca foi semelhante antes e após a ingestão de gordura. Os níveis de triglicérides, glicose e insulina foram semelhantes ao longo de todo período de estudo. O consumo agudo de gordura elimina a resposta aumentada do fluxo sangüíneo muscular durante manobras fisiológicas dos indivíduos portadores do genótipo Glu27Glu no receptorbeta2- adrenérgico. / Subjects who have glutamic acid at position 27 in gene encoding to beta2-adrenoceptor have increased muscle vasodilatory response during physiological maneuvers. However, the impact of a high-fat meal in this response is unknown. We tested the hypothesis that a high-fat meal would modify the increased muscle vascular reactivity during handgrip and mental stress in these subjects. Twenty-five healthy subjects were subdivided in two groups: 11 were homozygous to glutamic acid (Glu27Glu, 40?3 years; 65+-3kg) and 14 were homozygous to glutamine (Gln27Gln, 40+-2 years; 64+-2kg). Forearm blood flow was measured by venous occlusion pletysmography. Forearm blood flow was recorded for 3 minutes of handgrip and mental stress during fasting and three hours after 62g of fat consumption. Baseline forearm vascular conductance was similar between groups (Glu27Glu=2.3+-0.1; Gln27Gln=2.2+-0.1; P=0.21). Forearm vascular conductance during handgrip and mental stress was greater in the genotype Glu27Glu (0.73+-0.2 vs 0.22+-0.1; P=0.008 and 1.8+-0.3 vs 1.2+-0.2; P=0.04, respectively). Acute fat consumption eliminated the difference of vasodilatory response previously achieved. Blood pressure and heart rate response were similar before and after fat intake. Triglycerides, glucose and insulin levels were also similar between groups. We concluded that high-fat ingestion abolishes the augmented muscle blood flow responses during physiological maneuvers in individuals who are homozygous for the Glu27 allele of the beta2-adrenoceptor gene.

Indivíduos portadores do glutamato na posição 27 do gene que codifica para o receptor beta2-adrenérgico têm resposta vasodilatadora muscular aumentada durante manobras fisiológicas. No entanto, o impacto do consumo agudo de gordura nessa resposta não é conhecido. Neste estudo, testou-se a hipótese de que o consumo gordura afetaria a resposta vasodilatadora aumentada destes indivíduos durante manobras fisiológicas. Vinte e cinco indivíduos saudáveis foram subdivididos em dois grupos: 11 homozigotos para o glutamato (Glu27Glu, 40+-3 anos; 65+-3kg) e 14 homozigotos para a glutamina (Gln27Gln, 40+-2 anos; 64+-2kg). O fluxo sangüíneo muscular foi medido por pletismografia de oclusão venosa. A resposta vasodilatadora muscular foi avaliada durante 3 minutos de exercício e estresse mental em jejum e 3 horas após consumo de 62 g de gordura. A condutância basal foi semelhante entre grupos (Glu27Glu=2,3+-0,1; Gln27Gln=2,2+-0,1; P=0,21). O aumento da condutância vascular durante exercício e durante o estresse mental foi maior no grupo Glu27Glu (0,73+-0,2 vs 0,22+-0,1; P=0,008 e 1,8?0,3 vs 1,2+-0,2; P=0,04, respectivamente). O consumo agudo de uma preparação rica em gordura eliminou esta diferença. A resposta de pressão arterial e freqüência cardíaca foi semelhante antes e após a ingestão de gordura. Os níveis de triglicérides, glicose e insulina foram semelhantes ao longo de todo período de estudo. O consumo agudo de gordura elimina a resposta aumentada do fluxo sangüíneo muscular durante manobras fisiológicas dos indivíduos portadores do genótipo Glu27Glu no receptorbeta2- adrenérgico. / Subjects who have glutamic acid at position 27 in gene encoding to beta2-adrenoceptor have increased muscle vasodilatory response during physiological maneuvers. However, the impact of a high-fat meal in this response is unknown. We tested the hypothesis that a high-fat meal would modify the increased muscle vascular reactivity during handgrip and mental stress in these subjects. Twenty-five healthy subjects were subdivided in two groups: 11 were homozygous to glutamic acid (Glu27Glu, 40?3 years; 65+-3kg) and 14 were homozygous to glutamine (Gln27Gln, 40+-2 years; 64+-2kg). Forearm blood flow was measured by venous occlusion pletysmography. Forearm blood flow was recorded for 3 minutes of handgrip and mental stress during fasting and three hours after 62g of fat consumption. Baseline forearm vascular conductance was similar between groups (Glu27Glu=2.3+-0.1; Gln27Gln=2.2+-0.1; P=0.21). Forearm vascular conductance during handgrip and mental stress was greater in the genotype Glu27Glu (0.73+-0.2 vs 0.22+-0.1; P=0.008 and 1.8+-0.3 vs 1.2+-0.2; P=0.04, respectively). Acute fat consumption eliminated the difference of vasodilatory response previously achieved. Blood pressure and heart rate response were similar before and after fat intake. Triglycerides, glucose and insulin levels were also similar between groups. We concluded that high-fat ingestion abolishes the augmented muscle blood flow responses during physiological maneuvers in individuals who are homozygous for the Glu27 allele of the beta2-adrenoceptor gene.

Flies are a widely distributed pest insect that poses a significant threat to food security. Flight is essential for the dispersal of the adult flies to find new food sources and ideal breeding spots. The supply of metabolic fuel to power the flight muscles of insects is regulated by adipokinetic hormones (AKHs). The fruit fly, Drosophila melanogaster, the flesh fly, Sarcophaga crassipalpis, and the oriental fruit fly, Bactrocera dorsalis all have the same AKH that is present in the blowfly, Phormia terraenovae; this AKH has the code-name Phote-HrTH. Binding of the AKH to the extracellular binding site of a G protein-coupled receptor causes its activation. In this thesis, the structure of Phote-HrTH in SDS micelle solution was determined using NMR restrained molecular dynamics. The peptide was found to bind to the micelle and be reasonably rigid, with an S 2 order parameter of 0.96. The translated protein sequence of the AKH receptor from the fruit fly, Drosophila melanogaster, the flesh fly, Sarcophaga crassipalpis, and the oriental fruit fly, Bactrocera dorsalis were used to construct two models for each receptor: Drome-AKHR, Sarcr-AKHR, and Bacdo-AKHR. It is proposed that these two models represent the active and inactive state of the receptor. The models based on the crystal structure of the β-2 adrenergic receptor were found to bind Phote-HrTH with a predicted binding free energy of –107 kJ mol–1 for Drome-AKHR, –102 kJ mol–1 for Sarcr-AKHR and –102 kJ mol–1 for Bacdo-AKHR. Under molecular dynamics simulation, in a POPC membrane, the β-2AR receptor-like complexes transformed to rhodopsin-like. The identification and characterisation of the ligand-binding site of each receptor provide novel information on ligand-receptor interactions, which could lead to the development of species-specific control substances to use discriminately against these pest flies.

L’asthme est l’une des maladies chroniques les plus fréquentes durant la grossesse, affectant environ 4% à 12% des femmes enceintes et ayant une prévalence qui a augmenté au cours des dernières décennies. Plusieurs études ont identifié l'asthme comme un facteur de risque pour plusieurs enjeux de santé défavorables chez le fœtus et la mère. Les lignes directrices de traitement recommandent l’utilisation de médicaments antiasthmatiques pendant la grossesse afin de contrôler l’asthme et d’éviter les problèmes de santé maternels et fœtaux. L’évaluation de la littérature sur l'utilisation maternelle de médicaments antiasthmatiques et le risque de malformations congénitales majeures a relevé plusieurs études sur l’innocuité des bêta2-agonistes inhalés à courte durée d’action (BACA) et des corticostéroïdes inhalés (CSI) pendant la grossesse, mais peu de données sur les bêta2-agonistes à longue durée d’action (BALA) ainsi que sur les thérapies combinées (BALA-CSI). Un programme de recherche en trois volets a été développé pour combler ces lacunes. Dans le premier volet, nous avons entrepris une revue systématique de la littérature sur l'impact de l'utilisation de BACA et de BALA pendant la grossesse sur le risque de différents problèmes périnataux. Vingt et une études originales ont été identifiées. Quatre études ont rapporté une augmentation significative du risque de malformations congénitales avec BACA, une étude a rapporté une augmentation significative du risque de malformations congénitales avec BALA et quatre études ont rapporté un risque significatif accru de malformations congénitales avec bêta2-agonistes (BACA et/ou BALA). Toutefois, aucun risque majeur n’a été trouvé pour les autres complications périnatales. Fait important, la plupart des études récupérées ont subi plusieurs limitations méthodologiques, y compris l'utilisation des femmes non-asthmatiques comme groupe de référence et la faible puissance statistique. De plus, les résultats qui en découlent doivent être interprétés avec prudence. Dans le deuxième volet, nous avons utilisé la base de données Québec Asthma and Pregnancy Database qui comprend toutes les grossesses de femmes asthmatiques et un échantillon aléatoire de femmes non-asthmatiques ayant accouchées entre 1990 et 2010 pour effectuer deux études. La première était une étude comparant la prévalence des malformations congénitales majeures entre les femmes enceintes asthmatiques traitées avec une combinaison de BALA-CSI et celles traitées avec une dose plus élevée de CSI en monothérapie. Dans une sous-cohorte, il y’avait 643 femmes qui utilisaient un BALA plus CSI à dose faible et 305 qui ont utilisé une dose moyenne de CSI ; l'autre sous-cohorte comprenait 198 utilisatrices de BALA plus CSI à dose moyenne et 156 utilisatrices de CSI à dose élevée. La prévalence de malformations majeures a été 6,9% et 7,2%, respectivement. Le risque de malformations congénitales majeures était similaire entre ces deux groupes de femmes avec un odds ratio ajusté (OR) de 1,1 (IC 95%: 0,6-1,9) pour les femmes souffrant d’asthme modéré et un OR ajusté de 1,2 (IC 95%: 0,5-2,7) pour les femmes souffrant d’asthme sévère. La seconde était une étude méthodologique visant à étudier l’impact de six différentes définitions opérationnelles de malformations congénitales qui varient selon la source des données et la méthode de classification sur l’estimation de la prévalence des malformations et de l'association entre l'asthme maternel et les malformations majeures. Sur 467,946 grossesses, 12,3% étaient de femmes enceintes souffrant d’asthme actif. Nous avons démontré que la source des données et la méthode de classification ont eu un impact considérable sur la prévalence des malformations congénitales majeures (augmentation entre 10,0% et 50,4%), alors qu’elles ont eu peu d’influence sur l’association entre l’asthme maternel et les malformations congénitales. Dans le troisième volet du programme de recherche, nous avons développé une procédure systématique pour la classification des médicaments utilisés au cours du premier trimestre de grossesse en agents tératogènes et potentiellement tératogènes dans un contexte de recherche. Nous avons développé une procédure systématique qui s’actualise facilement, avec des composantes objectives dans la plupart de ses processus. Nous avons établi une liste comprenant 91 médicaments tératogènes, et une autre liste comprenant 81 médicaments potentiellement tératogènes. Les résultats présentés dans cette thèse ont fourni des données importantes sur l’innocuité des traitements de l'asthme pendant la grossesse, aidant les cliniciens et les femmes enceintes à choisir un traitement pharmacologique sécuritaire pour maintenir l’asthme sous contrôle. De plus, les données présentées dans cette thèse sur la minimisation du biais d'indication, les définitions opérationnelles de malformations congénitales et l’identification des médicaments tératogènes pourront aisément être utilisées par les chercheurs en pharmacoépidémiologie, en tératologie et en épidémiologie périnatale. / Asthma is one of the most prevalent chronic diseases during pregnancy, affecting about 4% to 12% of pregnant women and shows an increasing prevalence over time. In the past decades, several studies have identified asthma as a risk factor for several poor fetal and maternal outcomes. A consensus exists on favoring the use of asthma medications during pregnancy to maintain asthma under control to prevent adverse maternal and fetal outcomes. An assessment of the published literature on maternal asthma medications and the risk of major congenital malformations revealed more data on the safety of short-acting beta2-agonists (SABA) and inhaled corticosteroids (ICS) during pregnancy compared to long-acting beta2-agonists (LABA), as well as a paucity of data on the fetal safety of combination therapies (e.g. LABA-ICS). A three-part research program was developed to fill this knowledge gap and answer other intriguing questions we faced, adding necessary evidence in this field. In the first part, we summarized the published evidence on the impact of maternal use of SABA and LABA during pregnancy and different perinatal outcomes in a comprehensive systematic review. Twenty-one original studies were identified. Four studies reported a significant increased risk of congenital malformations with SABA, one study reported a significant increased risk of congenital malformations with LABA and four studies reported a significant increased risk of congenital malformations with beta2-agonists (SABA and/or LABA). However, no major increased risk was found for the other perinatal outcomes. Importantly, most of the retrieved studies suffered several methodologic limitations, including using non-asthmatic women as the reference group and low statistical power. Moreover, the non-significant results reported should be interpreted with caution. In the second part, we used the Quebec Asthma and Pregnancy Database – which includes all pregnancies in asthmatic women and a random sample in nonasthmatic women between 1990 and 2010 – to conduct two studies. The first was a comparative safety study examining the prevalence of major congenital malformations in pregnant asthmatic women treated with a combination of LABA-ICS compared to those treated with a higher dose of ICS monotherapy. In one subcohort there were 643 women who used a LABA plus low-dose ICS and 305 women who used a medium-dose ICS; the other subcohort included 198 users of a LABA plus a medium dose ICS and 156 users of a high-dose ICS. The prevalence of major malformations was 6.9% and 7.2%, respectively. The risk of major malformations did not differ when a combination therapy was used among both moderate and severe asthmatic women (aOR: 1.1; 95% CI: 0.6–1.9 and aOR: 1.2; 95% CI: 0.5–2.7 respectively). The second was a methodological study aiming to compare the prevalence of major malformations using six different case ascertainment definitions that vary by the source of data and the classification method, as well as to evaluate the impact of these definitions on the association between maternal asthma and major malformations. From the 467,946 pregnancies, 12.3% were with active asthma. We demonstrated that the source of data and the classification method had a considerable impact on the prevalence of major malformations (increases between 10.0% and 50.4%), but only a small influence on the measure of association. In the third part of the research program, we aimed at constructing a systematic procedure for the classification of proven and potential teratogenic medications during the first trimester of pregnancy to be used for research. We structured a procedure that is both systematic and updatable, with objective components in most of its processes. We identified a substantial list of teratogenic medications, including 91 medications, and an extensive list of potentially teratogenic medications, including 81 medications. The results presented in the current thesis provided essential evidence on the safety of asthma treatments during pregnancy, helping clinicians and mothers to choose the optimal therapeutic regimen to keep asthma under control. The added knowledge on indication bias minimization, congenital malformations ascertainment and teratogenic medications are directly transferable to researchers in pharmacoepidemiology, teratology and other related research fields.