A epilepsia é normalmente a associação de pré-disposição genética e doença ou uma lesão cerebral. Aproximadamente 1 entre 50 a 100 pessoas apresentam essa pré-disposição à convulsões. Um dos fármacos mais prescritos e utilizados para o tratamento de convulsões é o ácido valpróico (AV), tornando-se a medicação de primeira escolha no tratamento da epilepsia infantil por apresentar um amplo espectro de ação, embora apresente efeitos colaterais bastante conhecidos como pancreatite e a hepatotoxicidade, que pode ser fatal. Sistemas nanoparticulados como nanocápsulas, obtidas a partir da utilização de polímeros biodegradáveis como o polietilenoglicol (PEG) e macromoléculas naturais como a quitosana (QS), que proporcionam hidrofilia e bioadesividade, têm sido estudadas com o objetivo de aumentar a penetração cerebral e reduzir a dosagem do fármaco. Nesse contexto, o presente trabalho teve como objetivo desenvolver e caracterizar físico-quimicamente nanocápsulas de poli(ε-caprolactona) contendo AV e revestidas com QS (NCQ) e/ou com PEG 6000 (NCP e NCQP), investigar a farmacocinética plasmática, a penetração do AV através da barreira hematoencefálica (BHE) por microdiálise e a hepatotoxicidade em ratos Wistar. Nanocápsulas revestidas com QS (NCQ) foram obtidas pelo método de nanoprecipitação do polímero pré-formado seguido do revestimento com adição de 5 mL de solução de QS a 1%. Para a preparação de NCP, foi utilizada metodologia similar adicionando 0,7% de PEG 6000 na fase aquosa. Para a preparação de NCQP, as nanocápsulas preparadas com a adição de 0,35% de PEG 6000 e revestidas posteriormente com solução de QS a 1% (2,5 mL). As formulações foram caracterizadas físico-quimicamente avaliando-se o tamanho das partículas, potencial zeta, pH e taxa de incorporação. As nanocápsulas foram visualizadas por MET e a estabilidade foi investigada por retroespalhamento de luz (Turbiscan Lab®). As formulações (AV 5 mg/mL) apresentaram um pequeno tamanho de partícula (144,2 ± 2,0 nm, 153,2 ± 1,8 nm, e 231,3 ± 15,6 nm, para NCQ, NCP e NCQP, respectivamente), com baixo índice de polidispersão, alta taxa de incorporação (95 a 98 %), pH ácido, potencial zeta positivo para NCQ (+8,7 ± 0,4 mV) e negativo para NCP (- 6,6 ± 0,8 mV) e NCQP (- 2,8 ± 1,3 mV). As fotomicrografias mostraram partículas de forma esférica e as formulações demonstraram boa estabilidade durante 24h de análise a 40°C. As concentrações plasmáticas foram investigadas em ratos Wistar (15 mg/kg via i.v. de AV) para todas as formulações e valproato sódico (grupo controle). A análise farmacocinética compartimental apresentou uma distribuição muito rápida para o AV em NCQ e a ASC0-∞ aproximadamente duas vezes menor em comparação à NCP, NCQP e o fármaco livre (3874 ± 1775; 8280 ± 2136; 7849 ± 1021 e 7978 ± 3622 μg/mL/min, respectivamente). O clearance do AV aumentou significativamente para NCQ (0,284 ± 0,156 L/h/kg) (α = 0,05%). A penetração do AV através da BHE foi realizada em ratos Wistar acordados por microdiálise (MD) cerebral, no córtex frontal utilizando sondas CMA/12 (3 mm). Os experimentos de MD mostraram um aumento de 5 vezes no fator de penetração cerebral após a administração de NCQ em comparação com o fármaco em solução (0,110 and 0,021, respectivamente), demonstrando a viabilidade da utilização de QS como polímero de revestimento objetivando a BHE. A NCP demonstrou um aumento de 1,7 vezes no fator de penetração cerebral e NCQP não demonstrou qualquer diferença na penetração. A investigação da hepatotoxicidade do AV foi realizada após cinco dias de tratamento (dose de 30 mg/kg q12h de AV) em solução ou em nanocápsulas (NCQ ou NCP) com grupo controle de solução salina. Os níveis séricos de asparto aminotransferase (AST), alanina aminotransferase (ALT), gama-glutamiltransferase (GGT), fosfatase alcalina (FAL), creatinina (CRE) e uréia foram determinados. Os resultados mostram a manutenção dos níveis normais de enzimas hepáticas como a ALT e FAL para NCQ (54,2 ± 11,2 UI/mL and 149 ± 26 UI/mL) demonstrando um efeito hepatoprotetor não observado para os outros grupos. Análises histológicas do fígado dos animais não apresentaram a formação de esteatose microvesicular para NCQ em comparação com a formação de esteatoses em todos os outros grupos, incluindo o grupo controle. Ao final, os resultados indicaram que NCQ possa ser uma formulação em potencial, necessitando ser investigada pelo aumento da penetração cerebral de AV e efeito hepatoprotetor observados. / Epilepsy is usually a combination of genetic pre-disposition and a disease or a brain damage. About 1 in 50 to 100 people has this genetic predisposition to seizures. One of the world’s most prescribed drugs to treat epileptic seizures is valproic acid (VA), which is the first choice drug to treat epilepsy in childhood due to its broad spectrum of action, although its well known side effects such as pancreatitis, hepatotoxicity can be fatal. Nanoparticulated systems such as nanocapsules, obtained from biodegradable polymers like polyethylene glycol and natural macromolecules like chitosan, who gives the system hidrophilicity and bioadhesivity, have been used to increase brain penetration and reduce drug doses. In this context, the present work aimed to develop and physicochemically characterize poly(ε-caprolactone) nanocapsules loaded with VA and coated with chitosan (NCQ) and/or polyethylene glycol (PEG) 6000 (NCP and NCQP), and to investigate their plasma pharmacokinetics, VA blood-brain barrier penetration (BBB) by microdialysis and hepatotoxicity in Wistar rats. Nanocapsules coated with chitosan were obtained by nanoprecipitation of preformed polymer followed by coating with 1% chitosan solution added prior to final adjustments at a volume of 5 mL. For NCP preparation, similar methodology was used adding 0.7% PEG 6000 in the aqueous phase. For NCQP preparation, the nanocapsules prepared with PEG 6000 (0.35% w/v) was further coated with chitosan 1% in solution adding 2.5 mL prior to the final adjustments. The formulations were physicochemical characterized by particle size, zeta potential, pH, incorporation efficiency. The particles were visualized by MET and the stability investigated by backscattering (Turbiscan Lab®). The formulations (VA 5 mg/mL) presented small particle sizes (144.2 ± 2.0 nm, 153.2 ± 1.8 nm, and 231.3 ± 15.6 nm, for NCQ, NCP and NCQP, respectively), with low polidispersion index, high incorporation efficiency (95 to 98 %) and acid pH. The zeta potential was positive for NCQ (+8.7 ± 0.4 mV) and negative for NCP (- 6.6 ± 0.8 mV) and NCQP (- 2.8 ± 1.3 mV). The photomicrography of all formulations showed spherically shaped particles. The formulations showed good stability during 24 hours investigation at 40 ºC. Plasma concentrations were investigated in Wisar rats after 15 mg/kg i.v. dosing of all formulations and sodium valproate solution (control group). The pharmacokinetic compartmental analysis showed a very rapid distribution of VA when incorporated in NCQ in comparison to the other formulations and the AUC0-∞ about two times lower in comparison to NCP, NCQP and the drug alone (3874 ± 1775; 8280 ±2136; 7849 ± 1021 and 7978 ± 3622 μg/mL/min, respectively). VA clearance was significantly increased after NCQ dosing (0.284 ± 0.156 L/h/kg) (α = 0.05 %). Drug penetration through BBB was performed in awaken Wistar rats by brain microdialysis at the frontal cortex using CMA/12 probes (3 mm). The microdialysis experiments showed a five times increase in VA brain penetration factor after NCQ administration in comparison to drug alone (0.110 and 0.021, respectively), demonstrating the viability of chitosan as coating polymer to aim the BBB. NCP showed only a 1.7 times increase in brain penetration factor and NCQP did not showed any difference in comparison to drug alone. The investigation of drug hepatotoxicity was conducted after 5 days i.v. dosing of VA 30 mg/kg q12h as solution or nanocapsules (NCQ or NCP). A saline control group was also investigated. Serum levels of asparte aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, alkaline phosfatase, creatinin and urea were determined. The results showed the maintenance of normal levels of hepatic enzymes such as alanine aminotransferase and alkaline phosfatase for NCQ (54.2 ± 11.2 IU/mL and 149 ± 26 IU/mL) showing a hepatoprotective effect not observed in the other groups investigated. Histological analysis of animals livers showed no microvesicular steatosis formation when NCQ was administered in comparison with the formation of steatosis in all other groups including control. Overall the results indicate that NCQ is a potential formulation to be investigated for the treatment of epilepsy due to its increase in VA brain penetration and hepatoprotective effect observed.

Made available in DSpace on 2018-06-27T18:56:03Z (GMT). No. of bitstreams: 3 Diego Becker Borin.pdf: 1553948 bytes, checksum: b94d052c85f74f3bcc5e4cadbcb71e67 (MD5) Diego Becker Borin.pdf.txt: 134530 bytes, checksum: f3ad94a2052d1806ff21e9c0ce7733fb (MD5) Diego Becker Borin.pdf.jpg: 3538 bytes, checksum: b4b8b2603cafaeb4736f56efe30f7f1d (MD5) Previous issue date: 2013-03-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Creatine is a biomolecule endogenously synthesized from amino acids which can also be obtained through the diet. But it does not permeate easily through the blood-brain barrier (BBB), so the brain must supply their needs through the synthesis of creatine in the central nervous system (CNS) by itself. Creatine has a major role in maintaining stable levels of adenosine triphosphate (ATP) thus keeping the whole body in a proper condition. Neurodegenerative diseases leads to decreases in ATP levels, which compromises cellular metabolism, generating the increase of reactive species that could lead to neuronal cell death. Therefore, it becomes important to increase creatine levels in neurodegenerative diseases, so it could provide new alternative treatments for these diseases. This study aimed to develop and characterize liposomes with creatine, as well as investigate its protective effect in ischemia and reperfusion (I/R) brain model. Two methodologies were used for the preparation of liposomes, the lipid film hydration and ethanol injection. Due the best results were obtained by the ethanol injection method, this was chosen for the preparation of liposomes in in vivo tests. The rats were tested using I/R by clamping bilateral carotid arteries and different groups were treated with creatine (30 mg/kg) in free form (Liv+I/R) and liposomed (Lip+I/R) and compared with the control group and I/R. The animals motor activity, exploratory and memory abilities were evaluated through field tests and passive avoidance, 24 and 48 hours after I/R, respectively. After 72 hours, the animals were euthanized and the brains removed for biochemical determination of levels of reactive species and ascorbic acid (AA), and the biochemical breakdown activity of superoxide dismutase (SOD) and catalase (CAT). The suspensions of liposomes used for the in vivo treatment had homogenous average particle diameter (154 ± 6.9 nm), low polydispersity index (0.211 ± 0.019), pH near neutral (around 6.7), negative potential Zeta (-21 ± 1.8 mV) and association rate around 31%. The results of field tests have shown that I/R caused a change in exploratory activity of animals and increased oxidative stress in the brain of rats subjected to I/R. Liposomes creatine protected the change in exploratory activity and increased oxidative stress in rat cortex. Already in free form, creatine was not able to protect against these changes. With these results, we can conclude that the production of liposomes containing creatine technological feasibility presented, demonstrating the potential to increase the bioavailability of creatine into the CNS via the BBB. / A creatina é uma biomolécula sintetizada endogenamente a partir de aminoácidos, que também pode ser obtida através da dieta. Porém, ela não permeia facilmente através da barreira hematoencefálica (BHE), assim o cérebro deve suprir suas necessidades através da síntese de creatina no próprio sistema nervoso central (SNC). A grande importância da creatina para o funcionamento correto do organismo está em manter estáveis os níveis de adenosina trifosfato (ATP). Doenças neurodegenerativas levam a déficits de ATP, o que compromete o metabolismo celular, gerando espécies reativas (ERs) capazes de levar as células neuronais à morte. Assim, torna-se importante aumentar os níveis de creatina em doenças neurodegenerativas, podendo gerar novas alternativas de tratamento para estas doenças. Desta forma, o presente trabalho teve como objetivo desenvolver e caracterizar lipossomas de creatina, bem como, investigar o seu efeito protetor em um modelo de isquemia e reperfusão (I/R) cerebral. Foram utilizadas duas metodologias para o preparo dos lipossomas, a hidratação do filme lipídico e a injeção de etanol. Devido aos melhores resultados obtidos pelo método de injeção de etanol, este foi escolhido para o preparo dos lipossomas a serem aplicados nos testes in vivo. Os ratos foram submetidos ao processo de I/R pelo clampeamento bilateral das artérias carótidas, sendo os diferentes grupos tratados com a creatina (30 mg/kg) na forma livre (Liv+I/R) e lipossomada (Lip+I/R), sendo comparados com os grupos controle e I/R. A atividade locomotora, exploratória e a memória dos animais foram avaliadas através dos testes de campo aberto e da esquiva passiva, 24 e 48 h após a I/R, respectivamente. Após 72 h, os animais foram eutanasiados e os cérebros removidos para as determinações bioquímicas dos níveis de ERs e ácido ascórbico (AA), e a atividade das enzimas superóxido dismutase (SOD) e catalase (CAT). As suspensões de lipossomas utilizadas para o tratamento in vivo apresentaram diâmetro médio de partícula homogêneo (154 ± 6,9 nm), com baixo índice de polidispersão (0,211 ± 0,019), pH próximo a neutralidade (em torno de 6,7), potencial Zeta negativo (-21 ± 1,8 mV) e taxa de associação em torno de 31%. Os resultados do teste de campo aberto demonstraram que a I/R causou alteração na atividade exploratória dos animais. Além disso, o estudo demonstrou aumento no estresse oxidativo no cérebro de ratos submetidos a I/R. Os lipossomas de creatina protegeram a alteração na atividade exploratória e o aumento do estresse oxidativo em córtex de ratos. Já a creatina na forma livre não foi capaz de proteger contra estas alterações. Através destes resultados, pode-se concluir que a produção de lipossomas contendo creatina apresentou viabilidade tecnológica, demonstrando potencial para aumentar a biodisponibilidade de creatina para o SNC através da BHE.

INTRODUÇÃO: As imagens de lesões hiperdensas encontradas em exames de tomografia (TC) de crânio após o tratamento endovascular do acidente vascular cerebral isquêmico (AVCi) agudo têm sido correlacionadas ao risco de transformação hemorrágica após o AVC. Entretanto, a correlação entre as lesões hiperdensas e a área cerebral infartada é desconhecida. O objetivo deste estudo é determinar a correlação entre as lesões hiperdensas encontradas em TC de crânio realizadas logo após tratamento endovascular do AVCi agudo e a área de AVC isquêmico. MATERIAIS E MÉTODOS: Foram coletados retrospectivamente dados radiológicos de pacientes com AVCi agudo por oclusão de grandes vasos da circulação anterior submetidos ao tratamento endovascular. Foram analisadas imagens de TC de crânio nas primeiras 24 horas e até 21 dias após o tratamento. As áreas hiperdensas foram classificadas utilizando o escore ASPECTS e comparadas com as áreas de AVC isquêmico final pelo mesmo escore. As imagens foram analisadas independentemente por dois avaliadores, sendo que um terceiro avaliador analisou os casos discordantes. A concordância entre avaliadores (CCI) e os valores de sensibilidade, especificidade, preditivos positivo e negativos e acurácia foram calculados. RESULTADOS: Lesões hiperdensas foram encontradas em 71 dos 93 (76,34%) pacientes com AVC isquêmico de circulação anterior. As áreas captantes de contraste corresponderam às áreas de AVC final segundo o escore ASPECTS (CCI=0,58 [0,40 0,71]). Os valores para cada região individual foram avaliados e a sensibilidade variou de 58,3% a 96,9%, a especificidade de 42,9% a 95,6%, os valores preditivos positivos de 71,4% a 97,7%, os valores preditivos negativos de 53,8% a 79,5% e os valores de acurácia de 0,68 a 0,91. Os maiores valores de sensibilidade foram encontrados para os núcleos lentiforme (96,9%) e caudado (80,4%) e para a cápsula interna (87,5%) e os menores para os córtices M1 (58,3%) e M6 (66,7%). CONCLUSÕES: A aplicação do escore ASPECTS para avaliação das imagens de tomografia de crânio após o tratamento endovascular do AVCi agudo que apresentam captação de contraste, demonstrou ser uma ferramenta útil para a predição da área final de infarto cerebral. A predição foi maior na região profunda e menor nos córtices cerebrais, provavelmente devido maior circulação colateral cortical. Além disso, o método se mostrou reprodutível e de fácil utilização. / INTRODUCTION: The hyperdense lesions images found in head computed tomography (CT) scan after endovascular treatment have been correlated to risk of hemorrhagic transformation after stroke. However, the correlation between hyperdense lesions and the infarcted brain area is unknown. The aim of this study is to determine the correlation between the hyperdense lesions found on CT scan performed after endovacular treatment of acute stroke and final ischemic stroke area. MATERIALS AND METHODS: It was collected radiological data of patients with acute ischemic stroke by occlusion of large vessels in the anterior circulation were treated with endovascular treatment. Head CT scan were evaluated in the first 24 hours and by 21 days after treatment. The hyperdense areas were rated using the ASPECTS score and compared with final ischemic stroke by the same score. The images were analyzed independently by two reviewers, and a third evaluator examined the discordant cases. The interrater agreement (ICC) and the sensitivity, specificity, positive and negative predictive values and accuracy were calculated. RESULTS: hyperdense lesions were found in 71 of 93 (76.34%) patients with ischemic stroke of anterior circulation. The contrast iodineaccumulating areas corresponded to the final stroke areas (ICC = 0.58 [0.40 to 0.71]) as the ASPECTS score. The values for each individual region were evaluated and the sensitivity ranged from 58.3% to 96.9%, specificity of 42.9% to 95.6%, the positive predictive value of 71.4% to 97, 7%, the negative predictive value of 53.8% to 79.5% and the accuracy of values from 0.68 to 0.91. The higher sensitivity found for lenticular nuclei (96.9%) and caudate (80.4%) and the internal capsule (87.5%) and lower for M1 (58.3%) and M6 (66.7%) cortices. CONCLUSIONS: The use of the ASPECTS score for evaluation of CT head scan after endovascular treatment of acute ischemic stroke images that exhibit contrast enhancement proved to be a useful tool for predicting the final ischemic stroke area. The prediction was higher in the deep region and lower in the cerebral cortex, probably because the cortical collateral circulation. Futhermore, these method was reproducible and easy to use.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Growing evidence has shown that leukotrienes are important contributors in the pathophysiology of several SNC inflammatory diseases where excitotoxicity is involved, including traumatic brain injury, encephalitis, Parkinson's disease, ischemia, epilepsy and neuropathic pain. However little is known about the molecular mechanism by which leukotrienes facilitate excitatory activity in the brain. Thus, in this study we investigated the effect of antagonists for cysteinyl leukotrienes receptors (CysLT) on PTZ-induced seizure in mice. Bay-u9973 (3 and 30 nmol), montelukast (0.03 and 0.3 μmol) and pranlukast (1 and 3 μmol), increased the latency to generalized seizures and decreased the mean amplitude of EEG recordings during seizures. LTD4 (0.2 and 2 pmol) reverted the anticonvulsant effect of montelukast (0.3 μmol). Montelukast (0.03 and 0.3 μmol) prevented PTZ-induced BBB disruption, an effect that was reversed by LTD4 (6 pmol). In addition, doses of LTD4 (0.2 and 2 pmol) which reversed the effect of montelukast in crisis did not alter the protective effect of montelukast on the barrier, dissociating the anticonvulsant of protective effect on BBB. The confocal microscopy analysis revealed that 1. PTZ increased the number of CD45+ and IgG cells in cerebral cortex, indicating BBB leakage with leukocyte infiltration; 2. while LTD4 (6 pmol) potentiated, montelukast decreased the effect of PTZ on leukocyte migration. Considering that increase levels of leukotrienes and decrease in Na+,K+-ATPase are common findings in several excitotoxic conditions, including epileptic seizures, we also investigated the effects of LTD4 on the activity of Na+,K+-ATPase activity in mice hippocampal slices. LTD4 10 and 100 nM decreases Na+,K+-ATPase activity alpha 2, 3 and alpha 1 subunits, respectively, in mice hippocampal slices. The inhibitory effect of LTD4 on Na+,K+-ATPase activity was not observed in hippocampal homogenates, indicating that it requires intact cells. Moreover, we showed that LTD4-induced decrease Na+,K+-ATPase activity was reversed by CysLT1R inverse agonis, montelukast (1 μM). In addition, we also showed that possibly the PKC activation pathway is involved in LTD4-induced decrease of Na+,K+-ATPase activity in mice hippocampal slices, since PKC inhibitor, GF 109203X (0,3 μM), prevent this effect. Finally, but not least important, we have demonstrated that animals injected with LTD4 (2 pmol/3 μL icv), there also occurs a decrease in Na+,K+-ATPase activity, corroborating our in vitro findings and confirming the biological importance of this work. In summary, we showed that CysLT1 receptor activation modulates hippocampal Na+,K+-ATPase activity in mice, suggesting a possible mechanism for the involvement of leukotrienes in several dosorders related with brain inflammation and hyperexcitability. / Evidências crescentes têm mostrado que os leucotrienos são importantes contribuintes na patofisiologia de diversas doenças inflamatórias do sistema nervoso central nas quais a excitotoxicidade esteja envolvida, incluindo trauma crânio-encefálico, encefalite, doença de Parkinson, isquemia, dor neuropática e epilepsia. Entretanto pouco se sabe sobre o mecanismo molecular pelo qual os leucotrienos facilitam a atividade excitatória no encéfalo. Assim, neste trabalho investigamos o efeito de antagonistas para receptores de leucotrienos cisteínicos (CysLT) sobre as convulsões induzidas por PTZ em camundongos. Bay-u9973 (3 and 30 nmol), montelucaste (0.03 and 0.3 μmol) e pranlucaste (1 and 3 μmol), aumentaram a latência para as crises e diminuíram a amplitude média do EEG durante as crises. Montelucaste (0.03 and 0.3 μmol) preveniu a ruptura da BHE induzida pelo PTZ, e o efeito foi revertido pelo LTD4 (6 pmol). Além disso, as doses de LTD4 (0.2 and 2 pmol) que reverteram o efeito do montelucaste nas crises não alteraram o efeito protetor do montelucaste sobre a barreira, dissociando o efeito anticonvulsivante do efeito protetor sobre a BHE. As análises de microscopia confocal revelaram: 1) PTZ aumentou o número de células CD45+ e IgG no córtex, evidenciando a ruptura da BHE; 2) enquanto o LTD4 (6 pmol) potencializou, o montelucaste diminuiu o efeito do PTZ sobre a migração leucocitária. Considerando que níveis aumentados de leucotrienos e diminuição na atividade da Na+,K+-ATPase são achados comuns em diversas condições excitotóxicas, incluindo crises epilépticas, também investigamos o efeito do LTD4 sobre a atividade da Na+,K+- ATPase em fatias de hipocampo de camundongos. LTD4 nas doses de 10 e 100 nM, diminuiu a atividade das subunidades alfa 2/3 e alfa 1, respectivamente. O efeito inibitório do LTD4 na atividade da Na+,K+-ATPase não foi reproduzido quando realizado com homogeneizado de hipocampo, indicando que esse efeito requer a célula intacta. A fim de nos certificarmos de que o LTD4 (10 nM) estava se ligando ao receptor CysLT1, incubamos as fatias com anticorpo anti- CysLT1, e verificamos que, na presença do anticorpo, o LTD4 perde o efeito. Além disso, observamos que a diminuição na atividade da Na+,K+-ATPase induzida pelo LTD4 foi revertida pelo montelucaste (1 μM), agonista inverso dos receptores CysLT1. Neste trabalho mostramos ainda que a ativação da PKC possivelmente esteja envolvida no efeito do LTD4 sobre a atividade da Na+,K+-ATPase em fatias de hipocampo de camundongos, uma vez que o GF 109203X (0,3 μM), inibidor da PKC, preveniu esse efeito. Por fim, mas não menos importante, também demonstramos que em animais injetados i.c.v. com LTD4 (2 pmol/3 μL, i.c.v.), também ocorre uma diminuição na atividade da Na+,K+-ATPase, corroborando com nossos achados in vitro e confirmando a importância biológica deste trabalho. Assim, este trabalho mostrou evidências do envolvimento dos receptores CysLT1 nas crises induzidas por PTZ bem como na permeabilidade da BHE, sendo a modulação da enzima Na+,K+-ATPase um possível mecanismo para a implicação dos leucotrienos em diversas doenças do SNC relacionadas com inflamação e hiperexcitabilidade.

The selective degeneration of motoneurons in the spinal cord, the brainstem and the brain cortex is the core pathology of amyotrophic lateral sclerosis (ALS), but evidences suggest that the neighbouring non-neuronal cells are also involved in the disease progression. Beside Riluzole, only drug approved to treat this fatal neurodegenerative disease, new pharmaceutical agents or novel strategies including stem cell therapy are currently under development and evaluated preclinically in front line on mutant SOD1 rodents mimicking all hallmarks of the human disease. <p>Current intravenously delivered drugs tested in ALS therapy assume an intact blood-brain barrier and suppose the passage across the endothelium to hit their targets in the CNS parenchyma. If BBB impairment occurs in ALS, it may lead to revision of planned pharmaceutical treatment. In the first part of the work, we have validated the mutant SOD1 rat model of ALS and we characterized properties and integrity of its BBB. We observed a significant BBB disruption at symptomatic phase of ALS, evidenced by blood protein leakage, IgG accumulation and microhemorrhage. To look for the mechanism of BBB opening, we demonstrated that the expression of key genes involved in the BBB integrity was decreased. At the ultrastructure, the morphology of endothelial cells and vascular astrocyte end-feet was altered. Our results suggest that BBB disruption is a late event in ALS disease course and appears like a consequence of the local degenerative process or neuroinflammation rather than a cause. Since a lot of extracellular oedema and swollen astrocyte end-feet were found in mutant SOD1 rats, we also looked at the expression and localization of aquaporin-4, a key protein involved in CNS water movement. We found that its expression was highly increased in the symptomatic phase of ALS course and we hypothesize that this overexpression might be related to the resolution of oedema after BBB opening. <p>In the second part of the work, we considered an original, easy, non-invasive and safe therapeutical approach of stem cell delivery in ALS rats. Since ALS affects the motoneurons throughout the CNS, we decided to use the bloodstream to deliver neural stem cells. We studied cell homing, survival, proliferation, integration and differentiation. Interestingly, the highest efficiency of cell delivery to the CNS was found in symptomatic ALS and the lowest in healthy animals. Neural stem cells injected into ALS animals preferentially colonized the motor cortex, hippocampus and spinal cord. We detected their successful differentiation into neural lineages by the appearance of MAP2-, GFAP-positive cells and the decrease of nestin expression.<p>One of the realistic near-term clinical goals for ALS is the transplantation of stem cells that counteract the loss of motoneurons by secreting neuroprotective factors. Accordingly, we evaluated in vitro the expression of neurotrophic factors released by stem cells after stimulation with tissue extracts from ALS rats. The aim of this paradigm was to determine whether the ALS environment triggers neuroprotective factors release from stem cells. Mesenchymal stem cells and neural stem cells were able to express a wider range of growth factors than fibroblasts. According to the stem cell population stimulated, we obtained differential expression pattern, raising the choice of cell population for appropriate clinical applications in ALS.<p> / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished

L’intégrité fonctionnelle de la barrière hémato-encéphalique (BHE) est altérée dans de nombreuses pathologies neurologiques et métaboliques. Les vaisseaux cérébraux sont des tissus cibles des hormones stéroïdes sexuelles mais la contribution respective de ces effecteurs endocriniens et de leurs récepteurs dans l’intégrité de la BHE reste encore à être précisée. Les effets des hormones gonadiques sur l’unité neurovasculaire chez la souris ont été étudiés, en se concentrant sur l’aire préoptique médiane de l’hypothalamus, une région cérébrale hormono-sensible. L’augmentation de la perméabilité de la BHE chez des souris mâles et femelles gonadectomisés. Elle est associée chez le mâle à une désorganisation des jonctions serrées et une diminution de l’expression des protéines les constituant, à une activation des cellules gliales, et à une augmentation de l’expression de molécules inflammatoires, la supplémentation en testostérone permettant la restoration. Les récepteurs des androgènes et des estrogènes peuvent ainsi être impliqués dans la régulation hormono-dépendante du transport paracellulaire. La lignée de souris transgéniques sélectivement invalidées pour le récepteur neural des androgènes, a permis de mettre en évidence l’effet délétère de l’absence de ce récepteur sur l’intégrité de la BHE et des jonctions serrées. Pour compléter, un modèle ex vivo de tranches d’hypothalamus a permis d’appréhender les effets à court terme de la testostérone sur la BHE. Ces données soulèvent des questions sur les effets délétères potentiels des perturbateurs endo-criniens sur l'intégrité BBB et l'apparition de maladies neurologiques et métaboliques associées. / Functional integrity of the blood-brain barrier (BBB) is compromised in many neurological and metabolic pathologies. Cerebral blood vessels are target tissue for sex steroid hormones but the relative contribution of these endocrine effectors and their receptors in the BBB integrity are still unclear. Effects of gonadal hormones on the mouse neurovascular unit were studied, focusing on the hypothalamic medial preoptic area, a highly sensitive brain area to gonadal steroid hormones. BBB permeability increased in both gonactectomized male and female, is associated with tight junction disorganization and lower expression of tight junction proteins, glial activation, and up-regulation of inflammatory molecules in male. Testosterone supplementation restores the BBB impermeability, tight junction integrity, and almost completely abrogated the inflammatory features. Androgen and estrogen receptor may be involved in testosterone-induced regulation of the formation and maintenance of tight junction in males. Studying the involvement of these receptors using a trans-genic mice line selectively lacking neural AR in the CNS, highlighted the negative effect of this dele-tion on the BBB and TJ integrity. To complete, ex vivo slices of male mouse hypothalamus allowed to assess short-term molecular mechanisms of testosterone on the BBB structure and function.These data raise questions about the potential deleterious effects of endocrine disruptors on the BBB integrity and the occurrence of neurological and metabolic diseases.

La barrière hémato-encéphalique (BHE), localisée au niveau des capillaires cérébraux, contrôle les échanges entre le sang et le compartiment cérébral et assure ainsi le maintien de l'homéostasie du système nerveux central (SNC). La présence de la BHE est un atout lors du développement de médicament à visée périphérique. En effet, en limitant le passage de nombreuses molécules, la BHE protège le SNC des effets potentiellement neurotoxiques de ces molécules. Toutefois, l‟exposition des cellules endothéliales des capillaires cérébraux à des agents chimiques est susceptible d‟engendrer une augmentation transitoire de la perméabilité de la BHE. Cette augmentation peut perturber l‟homéostasie cérébrale et permettre l‟entrée massive de molécules potentiellement neurotoxiques dans le SNC. La prise en compte de la BHE en amont de l‟étude de la neurotoxicité d‟un médicament est donc un élément important. De plus, la majorité des médicaments sont utilisés de façon chronique et les effets secondaires indésirables résultant d‟une administration chronique sont fréquemment liés à une atteinte cérébrale. Afin de répondre à cette problématique, notre modèle in vitro de BHE, qui consiste en une co-culture de cellules endothéliales de capillaires cérébraux et de cellules gliales, a été adapté à l‟étude de la toxicité de molécules lors d‟un traitement prolongé. Les propriétés protectrices de la BHE deviennent une contrainte importante lors du développement de médicament à visée cérébrale. En effet, la présence de la BHE explique en partie les taux de succès très faibles des molécules lors du développement de médicaments à visée cérébrale. Afin de limiter les taux d‟échec, il est nécessaire de prédire efficacement la distribution cérébrale des composés en prenant en compte la BHE. Or, il est admis que l‟effet pharmacologique est lié à la concentration libre du médicament au niveau de sa cible. Ainsi, les nouvelles approches visent à prédire la concentration libre que la molécule atteindra dans le cerveau. Toutefois, les méthodes existantes pour prédire ce paramètre reposent sur une méthodologie in vivo et ne présentent pas un débit suffisant pour être utilisées lors des phases précoces du développement de médicaments. Une méthodologie in vitro pour obtenir le ratio de concentrations libres d‟une molécule entre le cerveau et le sang a été développée pour répondre à ce besoin. Le travail réalisé a permis de développer deux méthodologies in vitro. La première permet de prédire la toxicité chronique des molécules. En prédisant le ratio des concentrations libres entre le compartiment cérébral et sanguin des composés, la seconde facilite la sélection des médicaments candidats lors du développement de médicaments à visée cérébrale. Ces méthodologies pourront donc contribuer à diminuer les taux d‟échecs lors des phases précliniques et cliniques du développement de médicaments. / The blood-brain barrier (BBB), located at the level of brain capillaries, is responsible for brain homeostasis maintenance by tightly controlling blood-borne substances access to the brain. The presence of the BBB is an asset during peripheral drug development. Indeed, the BBB protects the central nervous system (CNS) against potential neurotoxic effects of compounds by strongly limiting their passage. However, exposure of brain capillaries endothelial cells to chemical agents is likely to cause a transient increase in BBB permeability. This increase can disrupt brain homeostasis and allow the massive entry of potentially neurotoxic molecules in the CNS. Hence, taking into account BBB toxicity in alternative neurotoxicity studies is important. In addition, the CNS side effects of several drugs used chronically could be at least partly attributed to their toxicity at the level of the BBB causing unwanted, indirect effect on brain cells. To address this issue, our in vitro BBB model, which consist of a co-culture of brain capillary endothelial cells and glial cells, has been adapted to the evaluation of repeated-dose toxicity at the BBB. The protective properties of the BBB become a major hurdle during CNS drug development. One way to reduce theimportant attrition rate, consists in predicting the CNS distribution of drug candidates early in CNS drug discovery programs. The use of unbound brain concentrations has been shown to provide the best correlations with pharmacological data. Hence, new approaches aim to predict the free brain concentration of compounds. However, the determination of free brain / free plasma ratios requires both in vitro and in vivo experiments that are both animal and time consuming. Consequently, we have explored the possibility to directly generate free brain / free plasma ratios under steady-state and non-steady state conditions in our in vitro BBB model, thereby greatly simplifying existing experimental procedures.. The work presented herein aimed to develop two in vitro methodologies. The first one allows the study of repeated-dose BBB toxicity. The second one allows free brain / free plasma ratios assessment using an in vitro model of the blood brain barrier, which can drive the selection of CNS drug candidates with the most favourable target engagement. The use of these two methodologies may help to reduce attrition rates in drug discovery and development by appreciating the eventual central toxicity of systemic drug associated with BBB dysfunction and by identifying centrally acting-compounds with a desirable in vivo response in the CNS early on in the drug discovery process.

Les entérovirus humains (EV) constituent un groupe de virus à ARN d'une grande diversité génétique. Ils sont responsables d'infections cérébrales graves mais rares et de méningites bénignes mais fréquentes. Les évènements conduisant à l'entrée des EVs dans le système nerveux central (SNC), l'importance de la charge virale dans le liquide céphalo rachidien (LCR) et sa corrélation éventuelle avec l'intensité du processus inflammatoire réactionnel restent peu explorés. Comme de nombreux génotypes d'EV sont associés à des manifestations neurologiques semblables, des processus pathologiques communs sont envisageables. Le premier volet de cette thèse avait pour objectif d'étudier prospectivement la charge virale EV dans le LCR de patients présentant une méningite à l'aide d'une technique de RT-QPCR. Nos résultats montrent que les différences significatives de charge virale retrouvées dans le LCR en fonction de l'âge, des leucocytes et de la protéinorachie sont reliées au génotype de l'EV responsable de l'infection. Le second volet de cette thèse avait pour but d'explorer l'hypothèse qu'une infection de la barrière hémato-Encéphalique (BHE), peut représenter une voie d'accès commune à une majorité d'EVs vers le SNC. La réplication et la translocation des EVs ont été évaluées avec un modèle in vitro de BHE basé sur la lignée cellulaire hCMEC/D3. Nous avons validé ce modèle cellulaire en montrant une permissivité différentielle à un large éventail d'EVs et montré les spécificités du franchissement de cette barrière par l'EV-A71. Ces données soulèvent la question de l'origine de l'ARN EV dans le LCR au cours des premiers stades d'une méningite. / Human enteroviruses (EV) are RNA viruses characterized by a large genetic variability. They are associated with severe but rare neurological infections and frequent but self-Limiting meningitis. The processes of entry into the central nervous system (CNS), the level of EV viral load in the cerebrospinal fluid (CSF) and its possible relation to the intensity of the associated inflammatory process remain poorly understood. As several EV genotypes are related to common neurological disorders, common pathological processes may be involved. In the first part of this PhD thesis, we have prospectively investigated the EV viral load in the CSF of patients with meningitis using a RT-QPCR assay. Our results showed that significant differences between viral load levels and the age groups, the leukocytes count, the protein levels in the CSF, and with the EV genotype involved in the infection. We also explored the hypothesis that an infection of the blood brain barrier (BBB) could be a common pathway used by EVs released in the bloodstream to gain access into the CNS. The EV replication and translocation were analyzed with an in vitro model of BBB based on the hCMEC/D3 cell line. We validated this cell model by showing different permissivity patterns among a large array of EV genotypes. In addition, we showed the specificities in how the EV-A71 crosses the endothelial barrier. The overall data raise the unresolved issue of the origin of viral RNA in the CSF and the sources of infection during the early acute stage of EV meningitis.

L'épilepsie du lobe temporal est fréquente et souvent pharmacorésistante. L'épileptogenèse est imputée à la mort neuronale, l'inflammation ou au déséquilibre de la neurotransmission. Récemment, la perméabilité vasculaire a été reconnue comme une cause de crises d'épilepsie. Dans un modèle d'épilepsie chronique, nous avons montré une angiogenèse associant vascularisation, surexpression de VEGF, perte de protéines des jonctions serrées et perméabilité de la BHE. L'observation des immunoglobulines G (IgGs) comme marqueurs de perméabilité vasculaire nous a permis de découvrir que les IgGs s'accumulent dans les neurones. Nous avons alors étudié le rôle de ces protéines dans l'épileptogenèse. Ensuite, afin de corréler la perméabilité de la BHE à l'épileptogenèse, nous avons étudié le kindling, un modèle dans lequel les crises sont induites mais pas spontanées. Nous n'avons observé aucun remaniement vasculaire, si ce n'est une dérégulation transitoire de deux protéines de jonctions serrées. La comparaison de ces deux modèles confirme la contribution de la dérégulation de la BHE dans la genèse des crises et la désigne comme une nouvelle cible thérapeutique. / Temporal lobe epilepsy is the most frequent form of pharmacoresistant epilepsies. Epileptogenesis is commonly imputed to neuronal loss, inflammation and an imbalance in neurotransmission. Now, vascular permeability was shown to participate in epileptic seizures generation. In a model of chronic epilepsy, we showed a neo-vascularisation associated with VEGF over expression, loss of tight junction proteins and BBB permeability. The use of immunoglobulins G (IgGs) as markers of permeability vascular allowed us to discover that the IgGs accumulates in neurones. We then studied the role of these proteins in epileptogenesis. Then, to correlate BBB permeability to epileptogenesis, we studied the kindling, a model in which seizures are induced but never spontaneous. We observed no vascular remodeling, except for a transient deregulation of tight junctions proteins. The comparison of these models confirms the contribution of BBB deregulation and points it as new therapeutic target.

Orientador: Maria Alice da Cruz-Höfling / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-27T16:36:47Z (GMT). No. of bitstreams: 1 Soares_EdileneSiqueira_M.pdf: 11448561 bytes, checksum: 00aace7be2d8fec579aea2fd4166f813 (MD5) Previous issue date: 2015 / Resumo: Neste trabalho investigamos a permeabilização da barreira hematoencefálica (BHE) pela peçonha da aranha Phoneutria nigriventer (PNV) através da via transcelular no cerebelo de ratos. As cavéolas foram analisadas nas células endoteliais pela expressão de proteínas associadas à sua formação (caveolina-1, Cav-1 e dinamina-2, Din2) e internalização (caveolina-1 fosforilada, pCav-1 e quinase da família Src, SKF), e nos astrócitos com avaliação da caveolina-3 (Cav-3) e da conexina-43 (Cx43) (formadora de junções comunicantes). A ação do PNV sobre o endotélio também foi avaliada pela ativação (acoplamento) ou inativação (desacoplamento) da enzima eNOS, produtora de óxido nítrico (NO). As estruturas que compõe a BHE foram avaliadas através de microscopia eletrônica de transmissão. Inicialmente, o estudo de Cav-1 contemplou sua localização, expressão gênica e proteica após o envenenamento em diferentes idades, ratos neonatos eram mais suceptíveis ao envenenamento do que ratos adultos. Após PNV, a imunomarcação para Cav-1 foi mais evidente na camada granular e molecular e em neurônios de Purkinje. A expressão Cav-1 e Din2 (foramdoras das vesículas e seu gargalo, respectivamente) aumentou em períodos de envenenamento agudo (1 h), de recuperação (5 h) e na ausência de sinais clínicos (24 h); em contrapartida SKF e pCav-1 envolvidas na internalização caveolar foram superexpressas em períodos opostos (às 2 h e 72 h). O PNV induziu aumento da metaloproteinase-9 da matriz (MMP9), importante mediadora de quebra da BHE e aumentou a formação e o tráfego de vesículas no endótelio após envenenamento. A análise de eNOS revelou desacoplamento (aumento de monômeros) nos períodos de envenenamento agudo (1-2 h) com progressivo retorno e super-expressão de dímeros (re-acoplamento) às 72 h; essas alterações foram relacionadas à ação do PNV sobre os níveis intracelulares de cálcio investigado pelo aumento na expressão de calmodulina e confimado pela localização de calbindina-D28. Os dados revelam a interferência do PNV sobre a homeostase endotelial e função vascular ao afetar o sistema eNOS/NO, importante controlador do tônus vascular. Nos astrócitos, as cavéolas são formadas por Cav-3 e sua superexpressão é associada a doenças neurológicas. O PNV aumentou significativamente os níveis basais de Cav-3 em astrócitos GFAP positivos (astrogliose reativa) em períodos de aumento de Cx43 (às 1, 5 e 24 h), e na vigência de edema citotóxico nos pés astrocitários e alterações nos contatos sinápticos axo-dendríticos e axo-somáticos. Em conjunto os resultados revelam que: (a) a quebra da via transcelular da BHE pelo PNV tem aumento da endocitose via cavéolas; (b) componentes da unidade neurovascular, como endotélio, astrócitos e neurônios estão intimamente envolvidos; (c) no endotélio, os efeitos são mediados pelo sistema eNOS/NO; (d) a SKF ativa o sistema endocítico e de transporte vesicular; (e) nos astrócitos, a dinamica expressão de Cx43 e Cav-3 e o retorno aos níveis basais em paralelo com a ausência de sinais de intoxicação nos animais (72 h) dá evidências de que ambas as proteínas interagem na resposta astrocitária. Os dados permitem sugerir que a presença de peptídeos neurotóxicos no veneno de Phoneutria nigriventer estão no centro dos efeitos aqui relatados / Abstract: In this work, we investigated the blood-brain barrier (BBB) permeabilization induced by Phoneutria nigriventer venom (PNV) in the transcellular route of rats¿ cerebellum. Caveolae was analyzed in endothelial cells accessing the expression of proteins involved in caveolae formation (caveolin-1, Cav-1 and dynamin-2, Dyn2) and internalization (phosphorylated Caveolin-1, pCav-1 and Src kinase family, SKF), in astrocytes caveolae role were evaluated with caveolin-3 (Cav-3) and connexin-43 (Cx43) (gap-junction main protein). PNV action on the endothelium was also investigated through activation (coupling) or inactivation (uncoupling) of eNOS enzyme, responsible for nitric oxide (NO) production. BBB components were evaluated using transmission electron microcopy. Initially, Cav-1 study addressed its localization along with Cav-1 protein and gene expression after envenoming in different age animals, neonate rats were more susceptible to envenoming than adult rats. After PNV, Cav-1 labeling was intense in granular and molecular layers and in Purkinje neurons. Cav-1 and Dyn2 (responsible for caveolae vesicles formation and scission, respectively) expression increased in periods of acute envenomation (1 h), recovery (5 h) and in the absence of clinical signals (24 h); in opposition SKF and pCav-1 involved in caveolae internalization were overexpress in opposite periods (at 2 h and 72 h). PNV induced increases in matrix metaloproteinases-9 (MMP9) an important BBB breakdown mediator, and increases in vesicles formation and traffic in the endothelium after envenoming. The study of eNOS activity revealed uncoupling (increasing in eNOS monomers) in acute periods after envenomation (1 h and 2 h) and progressive return followed by overexpression of dimers (re-coupling) at 72 h; those alterations were related to PNV action on calcium intracellular levels confirmed by Calmodulin increased expression and confirmed using Calbindin-D28 localization. Data revealed PNV interference on endothelial homeostasis and vascular function once affects the eNOS/NO system, an important vascular tonus controller. In astrocytes, caveolae are formed by Cav-3 and its overexpression is related to neurological disorders. PNV increased the basal levels of Cav-3 in GFAP-positive astrocytes (reactive astrogliosis) in the same periods as increased Cx43 (at 1, 5 e 24 h), during cytotoxic edema in astrocytes end-feet and alterations in axo-dendrites and axo-somatic synaptic contacts. Together, the results revealed that: (a) the BBB breakdown in transcellular route by PNV involves upregulation of caveolae endocytosis (b) the neurovascular unit components such as the endothelium, astrocytes and neurons are intimal involved (c) in the endothelium the effects are mediated by the eNOS/NO system and (d) SKF activates endocytic system and vesicular transport; (e) in the astrocytes, Cx43 and Cav-3 dynamic expression and their return to basal level in parallel with the absence of toxic signals in the animals (72 h) provides evidence that both protein interacts in astrocytes response. The data allows us to suggest that the neurotoxic peptides presented in Phoneutria nigriventer venom are in the center of the effects reported here / Mestrado / Biologia Tecidual / Mestra em Biologia Celular e Estrutural