La barrière hémato-encéphalique (BHE) représente la principale interface d'échange moléculaire entre la circulation sanguine et le système nerveux central (SNC), où elle joue un rôle essentiel sur le contrôle du passage bidirectionnel de composés endogènes et exogènes. À la BHE, la P-glycoprotéine (P-gp) et Breast Cancer Resistance Protein (BCRP) sont les transporteurs d’efflux ABC les plus importants, empêchant l'entrée de composés toxiques, des médicaments et des xénobiotiques circulant dans le sang dans le cerveau. Il y a un intérêt croissant pour la compréhension des mécanismes moléculaires sous-jacents à la modulation de l’expression et de la fonction de la P-gp et BCRP, afin de pouvoir contrôler l'accumulation de substances neurotoxiques dans le SNC et de surmonter les phénomènes de pharmaco-résistance. Des études récentes ont montré que la morphine, elle-même un substrat de la P-gp, est impliquée dans l’augmentation de l'expression de la P-gp, qui peuvent contribuer à sa faible pénétration dans le cerveau et pour le développement de la tolérance. Cependant, le mécanisme sous-jacent à l’induction de la P-gp par la morphine, bien comme son rôle sur l'expression de BCRP était inconnu. Des rats ont été utilisés comme modèle animal pour l'étude de l'amplitude et la cinétique de la modulation de la P-gp et Bcrp à la BHE, après un traitement morphinique subchronique, en utilisant un protocole d’escalade de doses. Des microvaisseaux cérébraux isolés ont été utilisés comme modèle pour étudier la BHE, et les contenus en P-gp et Bcrp après le traitement in vivo, tandis que la lignée cellulaire hCMEC/D3 a parfois été utilisé pour des études complémentaires. Nos résultats ont montré qu’un régime subchronique de traitement à la morphine pendant 5 jours a induit la P-gp et Bcrp 12 à 24 heures après la dernière dose de morphine, un effet qui n'a pas été enregistrée lors des précédentes temps de sacrifices des animaux, ni avec une traitement aigue à la morphine. Le traitement des animaux avec un antagoniste de du récepteur glutamatergique NMDA, ou avec un inhibiteur de la COX-2 a aboli l’induction protéique de la P-gp et Bcrp par la morphine-subchronique, ce qui suggère que les deux facteurs sont impliqués dans l’up-régulation morphine-dépendante de la P-gp et BCRP. Sachant que l’induction a été enregistrée seulement à partir de 12h après la dernière dose de morphine, nous avons examiné si elle était un effet direct de l'exposition continue à la morphine, ou plutôt une conséquence du sevrage à la morphine développé après l'arrêt du traitement. Les rats ont été traités soit avec une perfusion constante de morphine (5 jours), soit avec deux schémas chroniques de morphine lorsque le sevrage a été précipité par l'administration de naloxone: un régime de doses croissantes (5 jours) ou un régime de doses constantes de morphine. La perfusion en continue de morphine n'a pas changé les niveaux de P-gp et Bcrp dans les microvaisseaux cérébraux de rat, et du coup n'a pas une conséquence directe sur la cascade de régulation de ces transporteurs à la BHE. Le sevrage provoqué par la naloxone a augmenté les niveaux d’ARNm pour le Mdr1a et Bcrp, mais l'expression et de l'activité protéiques sont restées inchangées après l'administration de naloxone. Cette disparité peut être dû soit à un effet de la régulation post-traductionnelle, soit à l’action de la naloxone dans des récepteurs non-opioïdes, qui peut entraver l’induction de la P-gp et Bcrp. Par la suite, on a fait un large screening de l'expression de plusieurs récepteurs de neurotransmetteurs chez la BHE de rat, beaucoup d'entre eux impliqués dans la signalisation inflammatoire, et qui peut jouer un rôle dans la modulation de ces transporteurs ABC. (...) / The blood-brain barrier (BBB) is the main interface of molecular exchange between the bloodstream and the central nervous system (CNS), where it plays an essential role on the control over the bi-directional passage of endogenous and exogenous compounds. At the BBB, P-glycoprotein (P-gp) and Breast Cancer Resistance Protein (BCRP) are the most important ABC drug efflux transporters preventing the entry into the brain of toxic compounds, drugs and xenobiotics circulating in the blood. There is increasing interest in understanding the molecular mechanisms underlying the modulation of P-gp and BCRP expression and function in order to control CNS accumulation of neurotoxicants and to overcome pharmacoresistance phenomena. Recent studies showed that morphine, itself a substrate of P-gp, is implicated in the up-regulation of P-gp expression, which may contribute to its poor brain penetration and tolerance. However, it was unknown the mechanism underlying P-gp induction by morphine and its role on BCRP expression. Rats were used as an animal model for the study of the amplitude and the kinetics of the modulation of P-gp and Bcrp expressions at the BBB following a subchronic morphine treatment, in an escalating morphine dose regimen. Freshly isolated rat brain microvessels were used as BBB model to study P-gp and Bcrp contents following the in vivo treatment, while the hCMEC/D3 cell line was occasionally used for complementary studies. Our results demonstrated that a 5-day subchronic morphine regimen up-regulated both P-gp and Bcrp 12 to 24h after the last dose of morphine, which was not registered at earlier time-points of animal sacrifice, nor with a single dose of morphine. The animal treatment with a glutamatergic NMDA receptor antagonist, or a COX-2 inhibitor abolished the subchronic morphine-induced P-gp and Bcrp protein up-regulation, 24h after the last dose of morphine, suggesting that both are implicated in the morphine-dependent P-gp and Bcrp up-regulation. Since the registered up-regulation only occurred from 12h after the last dose of morphine-onwards, we investigated whether it was a direct effect of continued exposure to morphine, or rather a consequence of the morphine withdrawal developed after discontinuation of treatment. Rats were treated either with a constant morphine infusion (5 days), or two chronic morphine regimens where withdrawal was precipitated by naloxone administration: an escalating dose (5 days) or a constant dose morphine regimen followed by a withdrawal period (2 days) and resume of the treatment for 3 additional days. Continuous i.v. morphine did not change P-gp and Bcrp levels in rat brain microvessels, it does not have a direct consequence on the cascade of regulation of these transporters at the BBB. Naloxone-precipitated withdrawal after escalating or chronic morphine dose regimen increased Mdr1a and Bcrp mRNA levels, but protein expression and activity remained unchanged after naloxone administration. This latter result discrepancy may be due to posttranslational regulation or naloxone action at non-opioid receptors hampering P-gp and Bcrp up-regulation. Subsequently, we did a large screening of the expression of several neurotransmitter receptors at the rat BBB, many of them implicated in the inflammatory cell-cell signaling, and which may have a role in the modulation of these ABC transporters. Also, we compared two different approaches of isolation of rat brain microvessels, mechanical dissection and enzymatic digestion, to assess which yield the purest microvessel fraction for the BBB study. The enzymatic digestion provided the highest enrichment of endothelial cells and pericytes, and the least contamination with astrocyte and neuron markers. (...) / A barreira hemato-encefálica (BHE) representa a principal interface entre a corrente sanguínea e o sistema nervoso central (SNC), desempenhando um papel essencial no controlo da passagem sangue-cérebro de diversos compostos endógenos e exógenos. A glicoproteina P (P-gp) e a proteína de resistência ao cancro da mama (BCRP) são os principais transportadores de efluxo da família ABC presentes ao nível da BHE, limitando a passagem cerebral de compostos tóxicos, fármacos e xenobióticos circulantes na corrente sanguínea. Actualmente, regista-se um crescente interesse na comunidade científica para a melhor compreensão dos mecanismos moleculares subjacentes à modulação quer da expressão quer da função da P-gp e BCRP, no sentido de desenvolver medidas mais eficazes quer para prevenção da acumulação de compostos neurotóxicos no SNC, quer para superar fenómenos de farmacorresistência associados à terapêutica. Estudos recentes evidenciam que a morfina, por si só um substrato da P-gp, está envolvida na indução da expressão da P-gp, o que poderá contribuir para a sua menor penetração cerebral, bem como para o desenvolvimento de tolerância. No entanto, não se conhece o mecanismo subjacente a tal indução da P-gp pela morfina, nem o seu eventual papel na expressão da BCRP. Com efeito, na condução da presente dissertação, realizamos um estudo da amplitude e a cinética da regulação da expressão da P-gp e BCRP ao nível da BHE na sequência de um tratamento subcrónico com morfina, em regime de doses crescentes, usando o rato como modelo animal. Para o efeito, foram isolados os capilares cerebrais dos animais sujeitos a tratamento, in vivo, enquanto que a linha celular hCMEC/D3 foi ocasionalmente utilizada para estudos complementares. Os nossos resultados demonstraram que um tratamento subcrónico com morfina (5 dias) foi capaz de induzir tanto a P-gp como a Bcrp 12 a 24 horas após a última dose de morfina administrada, mas não para tempos de sacrifício anteriores, bem como tal indução não foi registada quando a morfina foi administrada de forma aguda. O tratamento animal com um antagonista do receptor glutamatérgico NMDA, ou com um inibidor da COX-2 anulou este efeito de indução da P-gp e Bcrp pela administraçãosubcrónica de morfina, o que sugere o envolvimento destes dois componentes na indução da P-gp e Bcrp dependente da morfina. Uma vez que este aumento da expressão só surgiu a partir de 12h após a última dose de morfina, decidimos investigar se tal seria um efeito direto da exposição continuada à morfina, ou por outro lado, uma consequência do síndrome de abstinência à morfina, desenvolvido após a descontinuação do tratamento. Desta forma, os animais foram tratados por um lado com uma infusão contínua de morfina (5 dias), ou sujeitos a dois diferentes regimes de exposição crónica à morfina, após os quais o síndrome de abstinência foi provocado pela administração de naloxona. A administração de morfina em contínuo, via i.v., não alterou os níveis de P-gp e BCRP nos capilares cerebrais de rato, o que indica a ausência de uma consequência directa da morfina na cascata de regulação destes transportadores ao nível da BHE. O síndrome de abstinência opióide provocado pela naloxona aumentou os níveis de mRNA Mdr1a e Bcrp, mas tanto a expressão e atividade proteicas mantiveram-se inalteradas após a administração de naloxona. Esta discrepância de resultados pode-se dever ou a um regulamento pós-translacional, ou a uma acção inespecífica da naloxona em receptores não opiáceos, impedindo a indução da P-gp e Bcrp. Num outro estudo, foi feito um screening da expressão de vários receptores de neurotransmissores na BHE de rato, muitos deles envolvidos na sinalização célula-célula em processos inflamatórios, e que podem ter um papel na modulação destes transportadores ABC. (...)

La barrière hémato-encéphalique (BHE) contrôle le passage des médicaments, en partie par la présence d’ATP Binding Cassette (ABC) transporteurs. Dans de nombreuses pathologies cérébrales, la BHE est altérée. Parmi elles, les hémorragies intracérébrales (HIC), qui sont un effet iatrogène des anticoagulants. Des analyses cliniques montrent que les patients sous Anticoagulants Oraux Directs (AODs) présentent moins d’HIC que les patients traités avec les anticoagulants de référence, les anti-vitamine K (AVK), sans que les mécanismes cellulaires soient élucidés. Une des différences entre les AODs et les AVK résident dans leur profil pharmacocinétique, effectivement, les AODs sont des substrats des ABC transporteurs contrairement aux AVKs. Au cours des HIC, la thrombine est activée et entraine une altération de la BHE par clivage et des récepteurs protease activated receptor (PAR). Les objectifs de ce travail de thèse ont été de mettre en place un modèle in vitro de BHE afin d’étudier les interactions des médicaments avec les ABC transporteurs. Ensuite, le modèle est utilisé pour étudier les interactions des AODs en condition pathologique. Le modèle développé est basé sur la lignée HBEC-5i, peu décrite dans la littérature. Les cellules ont été cultivées en monocouche sur insert avec milieu conditionné issu d’astrocytes humains. Le modèle permet l’étude de l’interaction de thérapeutiques avec des ABC transporteurs par des mesures d’efflux ratios. Le modèle a été validé par des études de transport de molécules pharmacologiques. Ensuite, nous avons comparé, sur notre modèle, les effets de l’exposition à la thrombine avec ou sans prétraitement d’anticoagulants (rivaroxaban, dabigatran, apixaban, warfarine et héparine). Les AODs limitent l’ouverture de la BHE induite par la thrombine contrairement aux autres anticoagulants. Nos résultats ont montré que l’altération de la BHE est médiée par le clivage du récepteur PAR-1 par la thrombine. Ce clivage n’est pas le même en fonction de la classe d’anticoagulants utilisée, les AODs minimisant ce clivage. L’ensemble de ce travail de thèse a permis de donner des premières explications cellulaires quant aux mécanismes d’ouverture de la BHE consécutifs aux HIC sous AODs. / The blood-brain barrier (BBB) controls the passage of drugs, in part through the expression of the ATP Binding Cassette (ABC) transporters. In many brain diseases, the BBB is altered. Among them, intracerebral haemorrhages (ICH), which are an iatrogenic effect of anticoagulants. Clinical analyses show that patients with Direct Oral Anticoagulants (DOACs) treatment have less HIC than patients treated with the reference anticoagulants, Vitamin K Antagonist (VKA), without understanding the cellular mechanisms. One of the differences between DOACs and VKA lies in their pharmacokinetic profile, indeed, DOACs are substrates of ABC transporters unlike VKA. During HIC, thrombin, is activated and causes alterations in the BBB by the cleavage of the protease activated receptor (PAR). The objectives of this thesis work were first to set up an in vitro model of the BBB in order to study the passage of drugs and their interactions with ABC transporters. In a second step, the model is used to study the interactions of DOACs in pathological conditions. The model developed is based on the HBEC-5i cell line seldom described in the literature. The cells were cultured in monolayer on insert with conditioned medium from human astrocytes. It allows the study of the interaction of therapeutics with ABC transporters by measuring efflux ratios. The model has been validated by transport studies of pharmacological molecules. In order to meet our second objective, we compared the effect of thrombin exposure with or without pretreatment with anticoagulants (rivaroxaban, dabigatran, apixaban, warfarin and heparin sodium) on our model. DOACs limit the BBB damage induced by the thrombin unlike other anticoagulants. Our results showed that alteration of the BBB is mediated by the cleavage of the PAR-1 receptor by thrombin. This cleavage is not the same depending on the class of anticoagulants used, DOACs minimizing this cleavage. All this thesis work made it possible to provide the first cellular explanations of the opening mechanisms of the BBB following HIC under DOACs.

Submitted by Angela Maria de Oliveira (amolivei@uepg.br) on 2018-02-22T14:26:17Z No. of bitstreams: 1 Flávia Pedroso.pdf: 2062416 bytes, checksum: e05f376a163a4ea5fd727a8979c3cc06 (MD5) / Made available in DSpace on 2018-02-22T14:26:17Z (GMT). No. of bitstreams: 1 Flávia Pedroso.pdf: 2062416 bytes, checksum: e05f376a163a4ea5fd727a8979c3cc06 (MD5) Previous issue date: 2016-09-02 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Vários tratamentos para desordens neurológicas são malsucedidos por não poderem atingir efetivamente o Sistema Nervoso Central (SNC). A presença da barreira hematoencefálica (BHE) dificulta esse acesso e muitas substâncias são incapazes de atravessá-la quando empregadas sem qualquer modificação química ou físico-química. O ácido ferúlico, um polifenol encontrado abundantemente na natureza e bem reconhecido por sua atividade antioxidante, antiinflamatória e anticâncer, é amplamente estudado e sua atividade neuroprotetora vem sendo descrita. Um dos principais problemas, que limita sua utilização clínica, é sua baixa biodisponibilidade quando administrado por via oral, que pode ser contornado por alterações e/ou modificações em sua estrutura química e/ou pelo preparo de formulações à base de lipídeos. Desta forma, o objetivo do presente trabalho foi sintetizar um derivado lipossolúvel do AF, o ferulato de hexadecila (FH), e posteriormente obter nanocápsulas poliméricas como sistema de vetorização para sua potencial ação no SNC. O FH foi obtido por esterificação e sua caracterização estrutural foi realizada por espectroscopia na região do infravermelho com transformada de Fourier (IVTF) e de ressonância magnética nuclear. A modificação estrutural não anulou a atividade scavenger frente aos radicais DPPH•, ABTS•+ e ao HOCl. As nanocápsulas poliméricas, em concentração de 0 a 2,0 mg.mL-1, foram desenvolvidas pelo método de deposição interfacial do polímero, utilizando poli(-caprolactona) (PCL) e blendas com polietilenoglicol (PEG). Todas as formulações preparadas apresentaram partículas esféricas e de superfície lisa, como observado por microscopia eletrônica de varredura com emissão de campo (MEV), pH entre 5,75 e 6,04, tamanhos adequados, inferiores a 234 nm, índice de polidispersão inferior a 0,26, garantindo sua homogeneidade, e potencial zeta com valores negativos, entre -28 e -38 mV, sugerindo estabilidade das suspensões de nanocápsulas poliméricas. O processo de nanoencapsulação promoveu a amorfização do FH, comprovada por análise de difração de raios X, calorimetria exploratória diferencial (CED) e MEV, bem como o aumento de sua estabilidade térmica, verificado por termogravimetria e CED, e as análises efetuadas de IVTF demonstraram que não houve interação entre o FH e os polímeros utilizados. Os estudos de toxicidade em eritrócitos demonstraram que o FH, livre ou nas formulações de nanocápsulas com PCL-PEG, não apresentou ação hemolítica, mesmo com variações na dose testada e em função do tempo. Adicionalmente, apresentou ação protetora sobre a hemólise promovida pelo AAPH. A possível ação das formulações desenvolvidas sobre o SNC, considerando que possuem características adequadas para sua vetorização, deve ser investigada futuramente. / Many neurological disorder treatments are unsuccessful because they can not effectively reach the central nervous system (CNS). The presence of the blood-brain barrier (BBB) hinders this access and a lot of substances are unable to pass through it when used without any chemical or physical-chemical modification. The ferulic acid, a polyphenol found abundantly in nature and well known for its antioxidant, anti-inflammatory and anti-cancer activity, is widely studied and their neuroprotective activity has been described. One of the main problem, which limits its clinical use, is its low bioavailability when administered orally, it can be circumvented by changes in their structure and/or for preparing lipid-based formulations. In this way, the aim of this study was to synthesize a lipophilic derivative of AF, the hexadecyl ferulate (HF), and then get polymeric nanocapsules as vectoring system for its potential action in the CNS. The HF was obtained by esterification reaction and their structural characterization was performed by spectroscopy in the Fourier transform infrared spectroscopy (FTIR) and nuclear magnetic resonance. The structural modification did not annul the scavenger activity against the DPPH•, ABTS•+ and HOCl. The polymeric nanocapsules in concentration from 0 to 2.0 mg.mL-1 were developed by interfacial deposition method of the polymer using poly (-caprolactone) (PCL), and blends with polyethylene glycol (PEG). All prepared formulations presented spherical and smooth surface, as observed by scanning electron microscopy (SEM) with field emission, pH between 5.75 and 6.04, proper sizes below 234 nm, polydispersity index below 0.26, ensuring homogeneity, and zeta potential with negative values between -28 and -38 mV, suggesting stability of the suspensions of polymeric nanocapsules. The nanoencapsulation process promoted the FH amorphization. This was verified by X-ray diffraction analysis, differential scanning calorimetry (DSC) and SEM. It also promoted the increasing thermal stability of the FH which was verified by thermogravimetry and DSC, and FTIR analysis demonstrated there was no interaction between HF and the used polymers.Toxicity studies in erythrocytes showed that HF , in free or nanocapsule formulations of PCL- PEG, showed no hemolytic action, even with variations in dose tested and function of time. Additionally, introduced protective effect on hemolysis promoted by AAPH. The possible action of the developed formulations of CNS, considering that they have appropriate characteristics for your vectorization, should be investigated in the future.

Le déficit en transporteur de la créatine est une maladie rare neurologique dans laquelle la perte de fonctionnalité du transporteur de la créatine (SLC6A8) conduit à une absence de créatine au niveau cérébral et à des retards de développement majeurs chez les enfants. A l’heure actuelle, aucune thérapie efficace n’est disponible.Une approche thérapeutique potentielle est le développement de molécules prodrogues de la créatine plus lipophiles qui franchiront les membranes cellulaires de façon passive et la recherche d’une formulation galénique susceptible d’emmener la prodrogue vers les cellules cibles d’intérêt, les neurones. Ainsi, dans cette thèse, nous proposons une nouvelle voie de synthèse originale d’esters de la créatine à longue chaîne aliphatique. Ces composés présentent des propriétés pharmacologiques intéressantes : nous montrons qu’il existe une relation de structure-activité entre la taille de la chaîne aliphatique (et donc la lipophilie) et la capacité de la molécule à être internalisée dans les cellules endothéliales cérébrales, astrocytaires et neuronales, constituant l’unité neurovasculaire. Il ressort de nos observations expérimentales que l’ester dodécylique de créatine est le meilleur candidat médicament. De plus, après avoir été internalisé dans les fibroblastes des patients présentant un déficit fonctionnel du transporteur de la créatine, l’ester dodécylique subit une conversion par les estérases cellulaires, libérant ainsi la créatine dans le compartiment intracellulaire.La formulation galénique permettant de protéger ces esters de créatine jusqu’au cerveau repose, elle, sur la nanovectorisation, par encapsulation de l’ester dodécylique de créatine dans des NanoCapsules Lipidiques. L’avantage de cette formulation est de permettre également un ciblage actif vers la Barrière Hémato-Encéphalique, obstacle majeur dans le développement de thérapies ciblant le Système Nerveux Central. Nos observations expérimentales mettent en exergue cette double stratégie thérapeutique pour le traitement du déficit en transporteur de la créatine.Ce travail a été soutenu financièrement par la Fondation Lejeune. / Creatine transporter deficiency is a rare brain disease associated with the loss of function of the SLC6A8 (creatine transporter) leading to an absence of creatine at the cerebral level and to a dramatic neurodevelopmental retardation in the children. To date, no effective therapy is available.A potential therapeutic option would be the design of a pharmaceutical formulation of lipophilic prodrugs of creatine that will cross the cell membranes passively and target the neurons in order to restore the creatine content inside these cells.One of the main purposes of this dissertation is to propose an original chemistry synthesis process of creatine esters with long aliphatic chain. These compounds show interesting pharmacological properties of structure-activity relationship between the length of the aliphatic chain (i.e. lipophilicity) and the ability for the drug to enter cerebral endothelial, astroglial and neuronal cells. According to our experimental observations, the dodecyl ester creatine seems to be the best drug candidate. Moreover, the dodecyl ester is acted on by cellular esterases inside patients’ fibroblasts with a functional deficit of the SLC6A8 and increases the intracellular creatine content.The pharmaceutical formulation developed in this study consists by incorporation of dodecyl ester inside a nanovector (Lipid NanoCapsules). Two main advantages can be gained by nanovectorization: firstly, the dodecyl ester is protected from the degradation by plasmatic esterases before reaching the brain. Secondly, the nanovectorization strategy is highly valuable to brain targeting bypassing the blood-brain barrier, which remains until now a major impediment in the drug design for the Central Nervous System. Our experimental observations highlight this two-step therapeutic strategy for the treatment of deficiency of the creatine transporter.This work was financially supported by the International PhD Program of the Life Sciences division of the CEA and the Fondation Jérôme Lejeune.

No description available.

Nasal administration of analgesics for achieving rapid pain relief is currently a topic of great interest. The blood-brain barrier (BBB) restricts access to the central nervous system (CNS) for several central-acting drugs, such as morphine and dihydroergotamine, which results in a substantial effect delay. Evidence for the olfactory transfer of drugs from the nasal cavity to the CNS after nasal administration, bypassing the BBB, is available for both animals and humans. The aims of this thesis were to study the olfactory transfer of morphine to the CNS after nasal administration, and to compare the nasal transport of analgesic drugs across nasal respiratory and olfactory mucosa. In vivo studies in rodents demonstrated that morphine is transferred via olfactory pathways to the olfactory bulbs and the longitudinal fissure of the brain after nasal administration. Further, olfactory transfer of morphine significantly contributed to the early high morphine brain hemisphere concentrations seen after nasal administration to rats. Olfactory transfer was tracked by collecting and analysing brain tissue and blood samples after right-sided nasal administration and comparing the results to the situation after i.v. administration. The olfactory transfer was also visualised by brain autoradiography. In vitro studies indicated that the olfactory mucosa should not be a major barrier to the olfactory transfer of dihydroergotamine or morphine, since transport of these drugs was no more restricted across the olfactory mucosa than across the nasal respiratory mucosa. The in vitro studies were performed using the horizontal Ussing chamber method. This method was further developed to enable comparison of drug transport across nasal respiratory and olfactory mucosa which cannot be achieved in vivo. In conclusion, these analgesic drugs showed potential for olfactory transfer, and access to the CNS by this route should be further investigated in humans, especially for the drugs with central effects that are currently under development for nasal administration.

La Sclérose en plaques (SEP) est une maladie auto-immune inflammatoire démyélinisante du système nerveux central (SNC), lors de laquelle des cellules inflammatoires du sang périphérique infiltrent le SNC pour y causer des dommages cellulaires. Dans ces réactions neuroinflammatoires, les cellules immunitaires traversent le système vasculaire du SNC, la barrière hémo-encéphalique (BHE), pour avoir accès au SNC et s’y accumuler. La BHE est donc la première entité que rencontrent les cellules inflammatoires du sang lors de leur migration au cerveau. Ceci lui confère un potentiel thérapeutique important pour influencer l’infiltration de cellules du sang vers le cerveau, et ainsi limiter les réactions neuroinflammatoires. En effet, les interactions entre les cellules immunitaires et les parois vasculaires sont encore mal comprises, car elles sont nombreuses et complexes. Différents mécanismes pouvant influencer la perméabilité de la BHE aux cellules immunitaires ont été décrits, et représentent aujourd’hui des cibles potentielles pour le contrôle des réactions neuro-immunes. Cette thèse a pour objectif de décrire de nouveaux mécanismes moléculaires opérant au niveau de la BHE qui interviennent dans les réactions neuroinflammatoires et qui ont un potentiel thérapeutique pour influencer les interactions neuro-immunologiques. Ce travail de doctorat est séparé en trois sections. La première section décrit la caractérisation du rôle de l’angiotensine II dans la régulation de la perméabilité de la BHE. La seconde section identifie et caractérise la fonction d’une nouvelle molécule d’adhérence de la BHE, ALCAM, dans la transmigration de cellules inflammatoires du sang vers le SNC. La troisième section traite des propriétés sécrétoires de la BHE et du rôle de la chimiokine MCP-1 dans les interactions entre la BHE et les cellules souches. Dans un premier temps, nous démontrons l’importance de l’angiotensinogène (AGT) dans la régulation de la perméabilité de la BHE. L’AGT est sécrété par les astrocytes et métabolisé en angiotensine II pour pouvoir agir au niveau des CE de la BHE à travers le récepteur à l’angiotensine II, AT1 et AT2. Au niveau de la BHE, l’angiotensine II entraîne la phosphorylation et l’enrichissement de l’occludine au sein de radeaux lipidiques, un phénomène associé à l’augmentation de l’étanchéité de la BHE. De plus, dans les lésions de SEP, on retrouve une diminution de l’expression de l’AGT et de l’occludine. Ceci est relié à nos observations in vitro, qui démontrent que des cytokines pro-inflammatoires limitent la sécrétion de l’AGT. Cette étude élucide un nouveau mécanisme par lequel les astrocytes influencent et augmentent l’étanchéité de la BHE, et implique une dysfonction de ce mécanisme dans les lésions de la SEP où s’accumulent les cellules inflammatoires. Dans un deuxième temps, les techniques établies dans la première section ont été utilisées afin d’identifier les protéines de la BHE qui s’accumulent dans les radeaux lipidiques. En utilisant une technique de protéomique nous avons identifié ALCAM (Activated Leukocyte Cell Adhesion Molecule) comme une protéine membranaire exprimée par les CE de la BHE. ALCAM se comporte comme une molécule d’adhérence typique. En effet, ALCAM permet la liaison entre les cellules du sang et la paroi vasculaire, via des interactions homotypiques (ALCAM-ALCAM pour les monocytes) ou hétérotypiques (ALCAM-CD6 pour les lymphocytes). Les cytokines inflammatoires augmentent le niveau d’expression d’ALCAM par la BHE, ce qui permet un recrutement local de cellules inflammatoires. Enfin, l’inhibition des interactions ALCAM-ALCAM et ALCAM-CD6 limite la transmigration des cellules inflammatoires (monocytes et cellules T CD4+) à travers la BHE in vitro et in vivo dans un modèle murin de la SEP. Cette deuxième partie identifie ALCAM comme une cible potentielle pour influencer la transmigration de cellules inflammatoires vers le cerveau. Dans un troisième temps, nous avons pu démontrer l’importance des propriétés sécrétoires spécifiques à la BHE dans les interactions avec les cellules souches neurales (CSN). Les CSN représentent un potentiel thérapeutique unique pour les maladies du SNC dans lesquelles la régénération cellulaire est limitée, comme dans la SEP. Des facteurs qui limitent l’utilisation thérapeutique des CSN sont le mode d’administration et leur maturation en cellules neurales ou gliales. Bien que la route d’administration préférée pour les CSN soit la voie intrathécale, l’injection intraveineuse représente la voie d’administration la plus facile et la moins invasive. Dans ce contexte, il est important de comprendre les interactions possibles entre les cellules souches et la paroi vasculaire du SNC qui sera responsable de leur recrutement dans le parenchyme cérébral. En collaborant avec des chercheurs de la Belgique spécialisés en CSN, nos travaux nous ont permis de confirmer, in vitro, que les cellules souches neurales humaines migrent à travers les CE humaines de la BHE avant d’entamer leur différenciation en cellules du SNC. Suite à la migration à travers les cellules de la BHE les CSN se différencient spontanément en neurones, en astrocytes et en oligodendrocytes. Ces effets sont notés préférentiellement avec les cellules de la BHE par rapport aux CE non cérébrales. Ces propriétés spécifiques aux cellules de la BHE dépendent de la chimiokine MCP-1/CCL2 sécrétée par ces dernières. Ainsi, cette dernière partie suggère que la BHE n’est pas un obstacle à la migration de CSN vers le SNC. De plus, la chimiokine MCP-1 est identifiée comme un facteur sécrété par la BHE qui permet l’accumulation et la différentiation préférentielle de cellules souches neurales dans l’espace sous-endothélial. Ces trois études démontrent l’importance de la BHE dans la migration des cellules inflammatoires et des CSN vers le SNC et indiquent que de multiples mécanismes moléculaires contribuent au dérèglement de l’homéostasie du SNC dans les réactions neuro-immunes. En utilisant des modèles in vitro, in situ et in vivo, nous avons identifié trois nouveaux mécanismes qui permettent d’influencer les interactions entre les cellules du sang et la BHE. L’identification de ces mécanismes permet non seulement une meilleure compréhension de la pathophysiologie des réactions neuroinflammatoires du SNC et des maladies qui y sont associées, mais suggère également des cibles thérapeutiques potentielles pour influencer l’infiltration des cellules du sang vers le cerveau / Multiple Sclerosis is an inflammatory demyelinating disease in which immune cells from the peripheral blood infiltrate the central nervous system (CNS) to cause a pathologic neuroinflammatory reaction. Blood borne leucocytes cross the restrictive cerebral endothelium, the blood brain barrier (BBB), to gain access to the CNS parenchyma and cause cellular damage leading to the characteristic demyelinating lesions. The BBB is the interface between the blood and the CNS and as such is a critical mediator of neuro-immune reactions and an important therapeutic target to modulate neuroinflammation. It is essential to have a better understanding of the molecular mechanisms that regulate the BBB properties to elaborate new therapeutic strategies to modulate the BBB and thus the local neuroinflammation reaction. This Ph.D. thesis describes three distinct molecular mechanisms which regulate key BBB properties. The first section describes a novel role for the renin-angiotensin system (RAS) in the neuro-vascular unit (NVU) as a regulator of paracellular permeability. The second part of this thesis characterises the role of a novel adhesion molecule of the BBB, ALCAM. The third part of this work studies the interactions between neural stem cells (NSC) and the BBB and identifies MCP-1 as a critical factor involved in NSC recruitment to the CNS. In the first experimental section we provide evidence that angiotensinogen (AGT) produced and secreted by astrocytes, is cleaved into angiotensin II (AngII) and acts on type 1 angiotensin receptors (AT1) expressed by BBB endothelial cells (ECs). Activation of AT1 restricts the passage of molecular tracers across human BBB-derived ECs through threonine-phosphorylation of the tight junction protein occludin and its mobilization to lipid raft membrane microdomains. We also show that AGT knockout animals have disorganized occludin strands at the level of the BBB and a diffuse accumulation of the endogenous serum protein plasminogen in the CNS, as compared to wild type animals. Finally, we demonstrate a reduction in the number of AGT-immunopositive perivascular astrocytes in multiple sclerosis (MS) lesions, which correlates with a reduced expression of occludin similarly seen in the CNS of AGT knockout animals. Such a reduction in astrocyte-expressed AGT and AngII is dependent, in vitro, on the pro-inflammatory cytokines tumor necrosis factor-α and interferon-γ. Our study defines a novel physiological role for AngII in the CNS and suggests that inflammation-induced downregulation of AngII production by astrocytes is involved in BBB dysfunction in MS lesions. In the second experimental part we focus on adhesion molecules of the BBB. Using a lipid raft-based proteomic approach, we identified ALCAM (Activated leukocyte cell adhesion molecule) as an adhesion molecule involved in leukocyte migration across the BBB. ALCAM expressed on BBB endothelium co-localized with CD6 expressed on leukocytes and with BBB endothelium transmigratory cups. ALCAM expression on BBB cells was up-regulated in active multiple sclerosis and experimental auto-immune encephalomyelitis (EAE) lesions. Moreover, ALCAM blockade restricted transmigration of CD4+ lymphocytes and monocytes across BBB endothelium in vitro and in vivo, and reduced the severity and time of onset of EAE. Our findings point to an important role for ALCAM in leukocyte recruitment into the brain and identify ALCAM as a potential therapeutic target to dampen neuroinflammation. The third experimental part of this thesis studies the interactions between NCS and BBB. NCS represent an attractive source for cell transplantation and neural tissue repair. After systemic injection, NCS are confronted with the specialized BBB endothelial cells before they can enter the brain parenchyma. We investigated the interactions of human fetal neural precursor cells with human brain endothelial cells in an in vitro model using primary cultures. We demonstrated that human fetal neural precursor cells efficiently and specifically migrate to sub-endothelial space of human BBB-endothelium, but not pulmonary artery endothelial cells. When migrated across BBB-endothelial cells, fetal neural precursor cells spontaneously differentiate to neurons, astrocytes and oligodendrocytes. Effective migration and subsequent differentiation was found to be dependant on the chemokine CCL2/MCP-1, but not CXCL8/IL-8. Our findings suggest that an intact blood-brain barrier is not an intrinsic obstacle to neural stem cell migration into the brain and that differentiation of neural precursor cells occur in a sub-endothelial niche, under the influence of the chemokine CCL2/MCP-1. These three experimental sections demonstrate the crucial roles that the BBB plays in regulating the CNS homeostasis. Under pathological conditions, such as during neuro-immune reactions, the BBB is altered and becomes an important local player. The three different molecular mechanisms described in this thesis, contribute to our understanding of the BBB and may allow for the development of novel therapeutic strategies to limit neuroinflammation.

La sclérose en plaques (SEP) est une maladie inflammatoire démyélinisante et neurodégénérative du système nerveux central (SNC). Les cellules T activées qui expriment le PD-1 sont inhibées via l’interaction avec l’un des ligands: PD-L1 ou PD-L2. Des études effectuées chez le modèle murin de la SEP, l’encéphalomyélite auto-immune expérimentale (EAE), ont démontré que l’interaction du PD-1 avec ses ligands contribue à atténuer la maladie. Toutefois, le rôle du PD-1 et de ses ligands dans la pathogenèse de la SEP chez l’humain et dans le modèle murin n’a pas été complètement élucidé. Nous avons déterminé que plusieurs cellules du SNC humain peuvent exprimer les ligands du PD-1. Les astrocytes, les microglies, les oligodendrocytes et les neurones expriment faiblement le PD-L1 dans des conditions basales mais augmentent de façon significative cette expression en réponse à des cytokines inflammatoires. Le blocage de l’expression du PD-L1 par les astrocytes à l’aide de siRNA spécifiques mène à l’augmentation significative des réponses des cellules T CD8+ (prolifération, cytokines, enzymes lytiques). Nos résultats établissent ainsi que les cellules gliales humaines peuvent exprimer des niveaux suffisants de PD-L1 en milieu inflammatoire pour inhiber les réponses des cellules T CD8+. Notre analyse de tissus cérébraux post-mortem par immunohistochimie démontre que dans les lésions de la SEP les niveaux de PD-L1 sont significativement plus élevés que dans les tissus de témoins; les astrocytes et les microglies/macrophages expriment le PD-L1. Cependant, plus de la moitié des lymphocytes T CD8+ ayant infiltré des lésions de SEP n’expriment pas le récepteur PD-1. Au cours du développement de l’EAE, les cellules du SNC augmentent leur niveau de PD-L1. Le PD-1 est fortement exprimé par les cellules T dès le début des symptômes, mais son intensité diminue au cours de la maladie, rendant les cellules T insensibles au signal inhibiteur envoyé par le PD-L1. Nous avons observé que les cellules endothéliales humaines formant la barrière hémato-encéphalique (BHE) expriment de façon constitutive le PD-L2 mais pas le PD-L1 et que l’expression des deux ligands augmente dans des conditions inflammatoires. Les ligands PD-L1 et PD-L2 exprimés par les cellules endothéliales ont la capacité de freiner l’activation des cellules T CD8+ et CD4+, ainsi que leur migration à travers la BHE. L’endothélium du cerveau des tissus normaux et des lésions SEP n’exprime pas des taux détectables de PD-L1. En revanche, tous les vaisseaux sanguins des tissus de cerveaux normaux sont positifs pour le PD-L2, alors que seulement la moitié de ceux-ci expriment le PD-L2 dans des lésions SEP. Nos travaux démontrent que l’entrée des cellules T activées est contrôlée dans des conditions physiologiques grâce à la présence du PD-L2 sur la BHE. Cependant, l’expression plus faible du PD-L2 sur une partie des vaisseaux sanguins dans les lésions SEP nuit au contrôle de la migration des cellules immunes. De plus, une fois dans le SNC, les cellules T CD8+ étant dépourvues du PD-1 ne peuvent recevoir le signal inhibiteur fourni par le PD-L1 fortement exprimé par les cellules du SNC, leur permettant ainsi de rester activées. / Multiple sclerosis (MS) is an inflammatory, demyelinating and neurodegenerative disease of the central nervous system (CNS). Responses of activated T cells are suppressed upon engagement of the receptor programmed cell death-1 (PD-1) with its ligands (PD-L1 and PD-L2). Experiments using the mouse model of MS, experimental autoimmune encephalomyelitis (EAE), have demonstrated that the PD-1/PD-Ls interaction contributes to attenuate disease severity. However, the expression and the role of PD-1 and PD-Ls have been partially documented in inflammatory murine models and human CNS data are still incomplete. We determined that primary cultures of human astrocytes, microglia, oligodendrocytes, or neurons expressed low or undetectable PD-L1 levels under basal conditions, but inflammatory cytokines significantly induced such expression, especially on astrocytes and microglia. Blocking PD-L1 expression in astrocytes using specific siRNA in co-culture led to significantly increased CD8 T cell responses (proliferation, cytokines, lytic enzyme). Thus, our results establish that inflamed human glial cells can express sufficient and functional PD-L1 to inhibit CD8 T cell responses. Extensive immunohistochemical analysis of post-mortem brain tissues demonstrated a significantly greater PD-L1 expression in MS lesions compared to control tissues, which co-localized with astrocyte and microglia/macrophage cell markers. However, more than half of infiltrating CD8 T lymphocytes in MS lesions did not express PD-1, the cognate receptor. Similar results were obtained in EAE mice. Even though CNS cells expressed PD-L1 at the peak of the disease, PD-1 intensity on infiltrating T cells decreased throughout EAE disease development. This reduction of PD-1 level on activated T cells prevented these cells to receive PD-L1 inhibitory signal. We also investigated whether human brain endothelial cells (HBECs), which form the blood brain barrier (BBB), can express PD-L1 or PD-L2 and thereby modulate T cells. HBECs expressed PD-L2 under basal conditions, whilst PD-L1 was not detected. Both ligands were up-regulated under inflammatory conditions. Blocking PD-L1 and PD-L2 led to increased transmigration and enhanced responses by human CD8 T cells in co-culture assays. Similarly, PD-L1 and PD-L2 blockade significantly increased CD4 T cell transmigration. Brain endothelium in normal tissues and MS lesions did not express detectable PD-L1; in contrast, all blood vessels in normal brain tissues were PD-L2-positive, while only about 50% expressed PD-L2 in MS lesions. Therefore, our results demonstrate that under basal conditions, PD-L2 expression by HBECs impedes the migration of activated immune T cells through the BBB, and inhibits their activation. However, such impact is impaired in MS lesions due to down-regulation of PD-L2 levels on the endothelium. The majority of infiltrating CD8 T cells is devoid of PD-1, thus insensitive to PD-L1 inhibitory signal providing by CNS cells once they have entered the CNS.

One major reason of CNS pharmacotherapy's impediment is the existence of "barriers" between blood and CNS, especially the Blood-Brain Barrier (BBB), a neurovascular structure localized at the level of brain microvasculature. Main factors responsible for this barrier function are drug efflux transporters type ABC (ATP-Binding Cassette) and SLC (SoLute Carrier) expressed at BBB level and known to be at the origin of multi-drug resistance phenomenon. Recent researches aim at unraveling the signaling mechanisms regulating these transporters in order to modulate their activity and improve pharmacotherapy in brain diseases. For years, these transporters have been studied in adult organism. But, there is a wide spread belief that the BBB in embryo, fetus, new born and infant is "immature", implying caution in giving drugs to infants. However, current knowledge on the functional status of the BBB in immature organism remains very limited.This study was performed in the aim of understanding: 1) The ontogenesis of ABC and SLC transporters during brain maturation, 2) the functional role of four BBB drug efflux transporters (P-glycoprotein (P-gp), Breast Cancer Resistance Protein (bcrp), Organic Anion Transporter 3 (oat3), and Transporting Peptide 1a4 (oatp1a4) transporters) in children's brain, and 3) the mechanisms that regulate their functional expression under normal and pathological conditions, mostly under inflammatory conditions, because indeed alterations in structural and functional components of the BBB have been reported in a long list of CNS pathologies in adults. Our results showed changing properties of the BBB during ontogenesis, as well as an age-related differential regulation of BBB drug efflux transporters under normal and inflammatory conditions.These findings highlight the importance of considering an age-related response of CNS to drugs and of taking into account the specific properties of juvenile BBB during definition of therapeutic strategies designed to treat childhood brain diseases, and this in the clinical perspective of developing new drugs with enhanced efficacy in children's CNS.

The proof of concept of an original nanotechnology-based theranostic approach for Alzheimer‟s disease has been explored. Novel fluorescently tagged nanoparticles have been designed and employed for internalization and transcytosis studies across a recently developed human in vitro blood-brain barrier model. A small library of polymeric nanoparticles have been designed and their ability to capture the Amyloid β1-42 peptide, considered one of the causes of the Alzheimer‟s disease, has been investigated and quantified using an on purpose designed method.