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Obesity and associated metabolic syndrome are growing concerns in modern society due to the negative consequences for human health and well-being. Cardiovascular diseases and type 2 diabetes are only some of the pathologies associated to overweight. Among the main causes are decreased physical activity and food availability and composition. Diets with high content of fat are energy-dense and their overconsumption leads to an energy imbalance, which ultimately promotes energy storage as fat and obesity. Aberrant activation of signalling cascades and hormonal imbalances are characteristic of this disease and members of the Protein Kinase D (PKD) family have been found to be involved in several mechanisms mediating metabolic homeostasis. Therefore, we aimed to investigate the role of Protein Kinase D2 (PKD2) in the regulation of metabolism. Our investigation initiated with a mice model for global PKD2 inactivation, which allowed us to prove a direct involvement of this kinase in lipids homeostasis and obesity. Inactivation of PKD2 protected the mice from high-fat diet-induced obesity and improved their response to glucose, insulin and lipids. Furthermore, the results indicated that, even though there were no changes in energy intake or expenditure, inactivation of PKD2 limited the absorption of fat from the intestine and promoted energy excretion in feces. These results were verified in a mice model for specific deletion of intestinal PKD2. These mice not only displayed an improved metabolic fitness but also a healthier gut microbiome profile. In addition, we made use of a small-molecule inhibitor of PKD in order to prove that local inhibition of PKD2 in the intestine was sufficient to inhibit lipid absorption. The usage of the inhibitor not only protected the mice from obesity but also was efficient in avoiding additional body-weight gain after obesity was pre-established in mice. Mechanistically, we determined that PKD2 regulates lipids uptake in enterocytes by phosphorylation of Apolipoprotein A4 (APOA4) and regulation of chylomicron-mediated triglyceride absorption. PKD2 deletion or inactivation increased abundance of APOA4 and decreased the size of chylomicrons and therefore lipids absorption from the diet. Moreover, intestinal activation of PKD2 in human obese patients correlated with higher levels of triglycerides in circulation and a detrimental blood profile. In conclusion, we demonstrated that PKD2 is a key regulator of dietary fat absorption in murine and human context, and its inhibition might contribute to the treatment of obesity. / Fettleibigkeit und das damit verbundene metabolische Syndrom stellt in der modernen Gesellschaft aufgrund der negativen Folgen für die menschliche Gesundheit und das Wohlbefinden ein zunehmendes Problem dar. Herz-Kreislauf-Erkrankungen und Typ- 2-Diabetes sind nur einige der mit Übergewicht verbundenen Pathologien. Zu den Hauptursachen zählen eine verminderte körperliche Aktivität sowie die Verfügbarkeit und Zusammensetzung von Nahrungsmitteln. Diäten mit hohem Fettgehalt haben eine hohe Energiedichte und ihr übermäßiger Konsum führt zu einem Energieungleichgewicht, das letztendlich die Energiespeicherung als Fett und Fettleibigkeit fördert. Aberrante Aktivierung von Signalkaskaden und hormonelle Ungleichgewichte sind charakteristisch für diese Krankheit, und es wurde festgestellt, dass Mitglieder der Protein Kinase D (PKD) -Familie an mehreren Mechanismen der metabolischen Homöostase beteiligt sind. Daher zielten wir darauf ab die Rolle der Proteinkinase D2 (PKD2) bei der Regulation des Stoffwechsels zu untersuchen. Unsere Untersuchung begann mit einem Mäusemodell für die globale PKD2- Inaktivierung, welches es uns ermöglichte, eine direkte Beteiligung dieser Kinase an der Lipidhomöostase und Fettleibigkeit nachzuweisen. Die Inaktivierung von PKD2 schützte die Mäuse vor fettreicher diätbedingter Fettleibigkeit und verbesserte ihre Reaktion auf Glukose, Insulin und Lipide. Darüber hinaus zeigten die Ergebnisse, dass die Inaktivierung von PKD2 die Absorption von Fett über den Darm begrenzte und die Energieausscheidung im Kot förderte, obwohl sich die Energieaufnahme oder der Energieverbrauch nicht änderten. Diese Ergebnisse wurden in einem Mäusemodell mit spezifischer Deletion von intestinaler PKD2 verifiziert. Diese Mäuse zeigten nicht nur eine verbesserte metabolische Fitness, sondern auch ein gesünderes Darmmikrobiomprofil. Zusätzlich verwendeten wir einen niedermolekularen PKD- Inhibitor, um zu beweisen, dass die lokale Hemmung von PKD2 im Darm ausreicht, um die Lipidabsorption zu hemmen. Die Verwendung des Inhibitors schützte die Mäuse nicht nur vor Fettleibigkeit, sondern verhinderte auch wirksam eine zusätzliche Gewichtszunahme, nachdem bei Mäusen bereits Fettleibigkeit festgestellt worden war. Mechanistisch haben wir festgestellt, dass PKD2 die Lipidaufnahme in Enterozyten durch Phosphorylierung von Apolipoprotein A4 (APOA4) und Regulation der Chylomicron-vermittelten Triglyceridabsorption reguliert. Die Deletion oder Inaktivierung von PKD2 erhöhte die Häufigkeit von APOA4 und verringerte die Größe der Chylomikronen und damit die Lipidabsorption aus der Nahrung. Darüber hinaus korrelierte die intestinale Aktivierung von PKD2 bei adipösen Patienten mit höheren Triglyceridspiegeln im Kreislauf und einem schädlichen Blutprofil. Zusammenfassend haben wir gezeigt, dass PKD2 ein Schlüsselregulator für die Aufnahme von Nahrungsfett im murinen und menschlichen Kontext ist und seine Hemmung zur Behandlung von Fettleibigkeit beitragen könnte

L’hypertriglycéridémie postprandiale représente un facteur de risque émergent des maladies cardiovasculaires et est retrouvé en cas de syndrome métabolique, d’obésité et d’insulino-résistance. L’intestin grêle conditionne la triglycéridémie postprandiale puisque la taille et de la quantité des chylomicrons sécrétés modulent l’activité de la Lipoprotéine Lipase (LPL). La synthèse des chylomicrons est un mécanisme complexe dont l’étape de lipidation de l’Apolipoprotéine B48 (ApoB48) par la Microsomal Triglyceride Transfert Protein (MTP) et celle de leur transfert du réticulum vers le Golgi dans laquelle intervient la Liver Fatty Acid binding Protein (L-FABP) sont limitantes. Des expériences menées in vivo chez des animaux sauvages et transgéniques et ex vivo sur des segments intestinaux, nous ont permis de démontrer qu’il existe une adaptation postprandiale du métabolisme intestinal des lipides. Cette adaptation postprandiale est déclenchée par la glycoprotéine CD36 qui en présence d’acides gras à longue chaîne (AGLC) régule la voie ERK1/2 et conduit à l’induction de l’ApoB48, de la MTP et de la L-FABP. La dégradation rapide du CD36 par la voie ubiquitine-protéasome en présence d’AGLC, qui conduit à la désactivation de la voie ERK1/2, est typique d’un récepteur. Puisque d’une part les souris invalidées pour le Peroxisome Proliferator Activated receptor (PPAR) présentent une altération de l’adaptation et une hypertriglycéridémie postprandiale et que d’autre part les lipides alimentaires induisent le PPAR via CD36, CD36 et PPAR pourraient faire partie d’un mécanisme commun de régulation. En conclusion, CD36 et PPAR contribuent au sensing entérocytaire des AGLC d’origine alimentaire, responsable de l'adaptation postprandiale du métabolisme des lipides qui favorise la formation de gros chylomicrons efficacement épurés de la circulation sanguine. / Postprandial hypertriglyceridemia is an emerging risk factor for cardiovascular diseases and is associated with metabolic syndrome, obesity and insulin resistance. The small intestine participates in the postprandial triglyceridemia since both the size and number of secreted chylomicrons modulate lipoprotein lipase activity (LPL). Chylomicron synthesis is a complex mechanism in which the lipidation of Apolipoprotein B48 (ApoB48) by the Microsomal Triglyceride Transfer Protein (MTP) and the transfer between reticulum and Golgi in which the Liver Fatty Acid Binding Protein (L -FABP) is involved are limiting steps. An intestinal fat-mediated adaptation in postprandial period has been demonstrated by in vivo (transgenic and wild type mice) and ex vivo (intestinal segments) approches. This postprandial adaptation is triggered by the glycoprotein CD36 in the presence of Long chain Fatty Acids (LCFA) that regulates the ERK1/2 pathway and leads to the induction of ApoB48, MTP and L-FABP. The rapid degradation of CD36 by the ubiquitin-proteasome pathway in the presence of LCFA, which leads to ERK1/2 deactivation, has a feature of a receptor. Since firstly, Peroxisome Proliferator Activated Receptor (PPAR) knockout mice display an alteration of postprandial adaptation associated with a hypertriglyceridemia and secondly, dietary fat-mediated PPAR up-regulation is CD36 dependent, CD36 and PPAR might participate to a common regulation mechanism. In conclusion, CD36 and PPAR contribute to the enterocyte LCFA sensing responsible for postprandial adaptation that promotes the formation of large chylomicrons efficiently cleared into the blood.

Dyslipidemia often accompanies metabolic diseases such as obesity and type II diabetes mellitus and represents a risk factor for cardiovascular disease. Clearance of triglycerides from the plasma is mediated by lipoprotein lipase (LPL), which hydrolyzes the triglycerides in chylomicrons and VLDL, liberating fatty acids for tissue uptake. LPL functions in the capillaries of the heart, adipose tissue, and skeletal muscle where LPL is anchored to the capillary wall by its endothelial cell transporter GPIHBP1. LPL activity is regulated by several factors including three members of the angiopoietin-like (ANGPTL) family–ANGPTL3, ANGPTL4, and ANGPTL8. How these proteins interact with LPL, especially in the physiological context of LPL anchored to endothelial cells by GPIHBP1, has not been well characterized. In my studies of ANGPTL4, I found when LPL is bound to GPIHBP1, it is partially, but not completely, protected from inactivation by ANGPTL4. Inactivation of LPL by ANGPTL4 leads to the dissociation of active LPL dimers into inactive monomers and I found that these monomers have a greatly reduced affinity for GPIHBP1. ANGPTL4 can be cleaved in vivo, separating the N-terminal coiled-coil domain from the C-terminal fibrinogen like-domain. I found the N-terminal domain alone is a much more potent LPL inhibitor than the full-length protein, even though both appear to have similar binding affinities for LPL-GPIHBP1 complexes. When I investigated ANGPTL3, I found ANGPTL3 itself is not a potent inhibitor of LPL at physiological concentrations, and unlike ANGPTL4, cleavage of ANGPTL3 does not improve its ability to inhibit LPL. Instead I found that ANGPTL3 forms a complex with ANGPTL8, a complex that only forms efficiently when the two proteins are co-expressed, and that this complex allows ANGPTL3 to bind and inhibit LPL. My data provide new insights into how ANGPTL proteins regulate LPL activity and the delivery of fat to tissues.

La lipémie postprandiale se caractérise par une augmentation des lipoprotéines riches en triglycérides après un repas, et joue un rôle important dans la biodisponibilité des lipides alimentaires pour les tissus périphériques. En effet, une lipémie postprandiale élevée est souvent associée à l'obésité et à une dyslipidémie, deux composantes du syndrome métabolique qui peuvent engendrer des complications médicales, incluant diabète et maladies cardiovasculaires. La lactoferrine (Lf) inhibe l'épuration hépatique des chylomicrons, conduisant à une élévation de la lipémie postprandiale par des mécanismes moléculaires non élucidés. Il est aussi établi que le Lipolysis Stimulated Receptor (LSR) contribuait à l'épuration des lipoprotéines riches en triglycérides pendant la phase postprandiale. L'objectif était de déterminer s'il existait une interaction entre la Lf et le LSR. Les études de cultures cellulaires ont montré que si la Lf n'affectait pas le taux d'expression du LSR dans des cellules Hepa 1-6 de souris, elle co-localisait avec le LSR en présence d'oléate, un composé requis pour l'activation du récepteur. Des expériences de ligand-blotting ont également montré que la Lf se fixait sur le LSR purifié et inhibait la fixation de lipoprotéines riches en triglycérides. Les domaines N et C-terminaux isolés de cette protéine, ainsi qu'un mélange de peptides obtenu après double hydrolyse de la Lf par la trypsine et la chymotrypsine, conservent cette propriété. Nous proposons que l'élévation de la lipémie postprandiale observée in vivo suite à un traitement par la Lf soit médiée par son interaction avec le LSR, inhibant ainsi l'épuration des chylomicrons et de leurs remnants / Postprandial lipemia is characterized by an increase in plasma triglyceride-rich lipoproteins after the ingestion of meal, and is important towards determining the bioavailability of dietary lipids amongst the peripheral tissues. Indeed, elevated postprandial lipemia is often observed with obesity and dyslipidemia, two disorders that can lead to health complications including diabetes and cardiovascular diseases. Lactoferrin (Lf), has been shown to inhibit hepatic chylomicron remnant removal, resulting in increased postprandial lipemia, for which the molecular mechanisms remain unclear. The lipolysis stimulated lipoprotein receptor (LSR) has been shown to contribute to the removal of triglycerides-rich lipoproteins during the postprandial phase. The aim was to determine if there was interaction between Lf and LSR. Both Lf and LSR were purified with purities upper to 95% and characterized. Cell culture studies demonstrated that while Lf does not have any significant effect on LSR protein levels in mouse Hepa1-6 cells, it co-localizes with LSR in cells, but only in the presence of oleate, which is needed to obtain LSR in its active form. Ligand blotting using purified LSR revealed that Lf binds directly to the receptor in the presence of oleate and prevents the binding of triglycerides-rich lipoproteins. Both C- and N-lobes of Lf, and a mixture of peptides derived from its tryptic and chymotryptic double hydrolysis retained the ability to bind LSR. We propose that the elevated postprandial lipemia observed upon Lf treatment in vivo is mediated by its direct interaction with LSR, thus preventing clearance of chylomicrons and their remnants through the LSR pathway

Os esteróides anabólicos androgênicos (EAA) aumentam a massa muscular e o desempenho físico. O uso abusivo de EAA leva a uma grande diminuição da concentração de HDL-C, podendo ocorrer um aumento nas concentrações de LDL-C e triglicérides. Os efeitos dos EAA na cinética plasmática das lipoproteínas que transportam os lípides da dieta, na circulação sanguínea, os quilomícrons e seus produtos de lipólise, os quilomícrons remanescentes, não foram avaliados e podem estar relacionados com o processo aterosclerótico. No presente estudo, foram estudados 12 indivíduos que realizam exercício de força localizada e admitem fazer uso de EAA (grupo Musculação+EAA), 16 indivíduos que também realizam exercício de força localizada, porém não fazem uso de EAA (grupo Musculação) e 18 indivíduos sedentários e normolipidêmicos (grupo Sedentário). A emulsão de quilomícrons artificiais, marcada com triglicérides radioativos (TG-3H) e éster de colesterol radioativo (EC-14C), foi injetada endovenosamente e amostras de sangue foram colhidas durante intervalos de tempo préestabelecidos. As curvas de decaimento plasmático dos lípides radioativos da emulsão foram traçadas e as taxas fracionais de remoção (TFR) foram calculadas por meio de análise compartimental. A TFR-EC do grupo Musculação+EAA apresentou-se diminuída comparando-se aos grupos Sedentário e Musculação (0,0073± 0,0079 min -1, 0,0155± 0,0100 min -1, 0,0149± 0,0160 min -1, respectivamente; p< 0,05), enquanto que as TFR-TG foram similares. As concentrações plasmáticas de LDL-C foram maiores no grupo Musculação+EAA comparando-se com os grupos Sedentário e Musculação (143±54,101±31, 111±52 mg/dL, respectivamente; p=0,047). As concentrações plasmáticas de HDL-C e de apolipoproteína A1 foram menores no grupo Musculação+EAA quando comparados aos grupos Sedentário e Musculação (HDL-C= 22±13; 41±7; 38±13 mg/dL, respectivamente; p<0,001 e apo A1= 88±50; 156±35; 140±24 mg/dL, respectivamente; p<0,001). As curvas de geração de ácidos graxos livres originados pela hidrólise de triglicérides radioativos dos quilomícrons artificiais na circulação sanguínea foram similares entre os grupos estudados. A atividade da lipase hepática foi maior no grupo Musculação+EAA, comparando-se aos grupos Sedentário e Musculação (7243±1822; 3898±1232; 2058±749, respectivamente; p<0,001), enquanto que a atividade da lipase lipoprotéica não diferiu. O diâmetro da HDL e concentração de triglicérides presentes na HDL também foram similares nos três grupos estudados. / Anabolic androgenic steroids (AAS) increase muscle mass and physical performance. Abusive use of AAS has led to a significant reduction of HDL-C concentration in the plasma, which in turn can cause lead to an increase in LDL-C and trigliceride concentrations. The effects of steroids on lipoprotein plasmatic kinetics which transport diet lipids in the blood, the chilomicrons and its lypolisis products, chilomicron reminiscents have not yet been studied and can be contributing factors to the ateroclesrosis process. In this study 12 local weight lifters and admitted steroid users (AAS group), 16 local weight lifters but nonsteroids use (non-user group) and 18 sedentary and normolipidemic individuals (control group) were studied. The artificial chilomicron emulsion, marked with radioactive triglyceride (3H-TG) and radioactive oleate cholesterol (14C-OC) were injected interveneously and blood samples collected during pre-established time intervals. The plasmatic decay curve of the radioactive lipids of the emulsion was traced and fractional clearance rate was calculated (FCR) through compartamental analysis. The FCR-OC of the AAS group when compared to the control and nonuser groups was reduced (0,0073±0,0079 min -1,0,0155±0,0100 min -1, 0,0149± 0,0160 min -1, respectivelly; p< 0,05), while FCR-TG were similar. The LDL-C plasmatic concentration were higher in the AAS group when compared to control and non-user groups (143±54,101±31, 111±52 mg/dL, respectivelly; p=0,047). The HDL-C plasmatic concentration and the apolipoprotein A1 were lower in the AAS group when compared control and non-user groups (HDL-C: 22±13; 41±7; 38±13 mg/dL, respectivelly; p<0,001 e apo A1: 88±50; 156±35; 140±24 mg/dL,respectivelly; p<0,001). No difference was observed of the area under the fatty acid generated curve. Hepatic lipase activity was greater in the AAS group when compared to control and the non-user groups (7243±1822; 3898±1232; 2058±749, respectivelly; p<0,001). However, no difference was observed for lipoproteic lipase activity. The analisys of HDL size and triglyceride concentration in HDL were similar for all three groups.

L’hypertriglycéridémie post prandiale constitue un facteur de risque des maladies cardiovasculaires et est présente en cas de syndrome métabolique, d’obésité et d’insulino-résistance. L’intestin conditionne la biodisponibilité des lipides et l’hypertriglycéridémie post prandiale. En effet, il contrôle la quantité et la qualité des chylomicrons sécrétés, en adaptant son métabolisme en fonction de la teneur en lipides du régime. Or à l’heure actuelle, le mécanisme de détection des lipides alimentaires par les entérocytes nécessaire à cette adaptation, n’est pas élucidé. Ce travail de thèse a permis de démontrer que la glycoprotéine transmembranaire CD36, est un récepteur aux AGLC qui déclenche l’activation des ERK1/2. Cette activation est responsable de l’induction du taux d’ARNm de 3 protéines clés de l’absorption des lipides (l’Apobec1, la Microsomal Triglyceride Transfer Protein (MTP), la Liver-Fatty Acid Binding Protein (L-FABP)) et de la dégradation post prandiale de CD36. La pertinence physiologique de ce récepteur a été évaluée chez des souris CD36 (-/-) soumises à un régime hyperlipidique riche en AGLC saturés ou insaturés. Nos données démontrent que CD36 intestinal est indispensable à l’absorption de forte quantité de lipides, au contrôle de l’hypertriglycéridémie post prandiale, de l’inflammation intestinale et de l’endotoxémie. Ces effets sont fortement aggravés en cas de régime hyperlipidique riche en AGLC insaturés qui peuvent même être léthal. Le CD36 intestinal pourrait donc être une cible thérapeutique dans le traitement de l’hypertriglycéridémie et de l’endotoxémie post prandiales. / Post prandial hypertriglyceridemia represents a risk factor for cardio-vascular diseases and it is associated with metabolic syndrom, obesity, and insulino-resistance. The intestine influences lipid bioavailibility and post prandial hypertriglyceridemia. It controls the quantity and the quality of secreted chylomicrons by adapting its metabolism according to the lipid content of the diet. Nevertheless, the mechanism of dietary lipid detection by the enterocyte is not understood. Our work demonstrates that the transmembrane glycoprotein CD36 is a Long Chain Fatty Acid (LCFA) receptor which triggers ERK1/2 activation. This activation is responsible for the induction of mRNA rate of 3 key proteins of lipid absorption (Apobec1, Microsomal Triglyceride Transfer Protein (MTP), Liver-Fatty Acid Binding Protein (L-FABP)) and for CD36 degradation. The physiological relevance of this receptor has been assessed in CD36 (-/-) mice fed with a High Fat Diet (HFD) rich in saturated or unsaturated LCFA. Our data demontstrates that CD36 is crucial for the absorption of an important quantity of lipids, to the control of hypertriglyceridemia, of intestinal inflammation and of endotoxemia. These effects are getting worse in the case of HFD rich in unsaturated LCFA, which can be lethal. Intestinal CD36 could represent a therapeutic target in the treatment of post prandial hypertriglyceridemia and endotoxemia.

Os esteróides anabólicos androgênicos (EAA) aumentam a massa muscular e o desempenho físico. O uso abusivo de EAA leva a uma grande diminuição da concentração de HDL-C, podendo ocorrer um aumento nas concentrações de LDL-C e triglicérides. Os efeitos dos EAA na cinética plasmática das lipoproteínas que transportam os lípides da dieta, na circulação sanguínea, os quilomícrons e seus produtos de lipólise, os quilomícrons remanescentes, não foram avaliados e podem estar relacionados com o processo aterosclerótico. No presente estudo, foram estudados 12 indivíduos que realizam exercício de força localizada e admitem fazer uso de EAA (grupo Musculação+EAA), 16 indivíduos que também realizam exercício de força localizada, porém não fazem uso de EAA (grupo Musculação) e 18 indivíduos sedentários e normolipidêmicos (grupo Sedentário). A emulsão de quilomícrons artificiais, marcada com triglicérides radioativos (TG-3H) e éster de colesterol radioativo (EC-14C), foi injetada endovenosamente e amostras de sangue foram colhidas durante intervalos de tempo préestabelecidos. As curvas de decaimento plasmático dos lípides radioativos da emulsão foram traçadas e as taxas fracionais de remoção (TFR) foram calculadas por meio de análise compartimental. A TFR-EC do grupo Musculação+EAA apresentou-se diminuída comparando-se aos grupos Sedentário e Musculação (0,0073± 0,0079 min -1, 0,0155± 0,0100 min -1, 0,0149± 0,0160 min -1, respectivamente; p< 0,05), enquanto que as TFR-TG foram similares. As concentrações plasmáticas de LDL-C foram maiores no grupo Musculação+EAA comparando-se com os grupos Sedentário e Musculação (143±54,101±31, 111±52 mg/dL, respectivamente; p=0,047). As concentrações plasmáticas de HDL-C e de apolipoproteína A1 foram menores no grupo Musculação+EAA quando comparados aos grupos Sedentário e Musculação (HDL-C= 22±13; 41±7; 38±13 mg/dL, respectivamente; p<0,001 e apo A1= 88±50; 156±35; 140±24 mg/dL, respectivamente; p<0,001). As curvas de geração de ácidos graxos livres originados pela hidrólise de triglicérides radioativos dos quilomícrons artificiais na circulação sanguínea foram similares entre os grupos estudados. A atividade da lipase hepática foi maior no grupo Musculação+EAA, comparando-se aos grupos Sedentário e Musculação (7243±1822; 3898±1232; 2058±749, respectivamente; p<0,001), enquanto que a atividade da lipase lipoprotéica não diferiu. O diâmetro da HDL e concentração de triglicérides presentes na HDL também foram similares nos três grupos estudados. / Anabolic androgenic steroids (AAS) increase muscle mass and physical performance. Abusive use of AAS has led to a significant reduction of HDL-C concentration in the plasma, which in turn can cause lead to an increase in LDL-C and trigliceride concentrations. The effects of steroids on lipoprotein plasmatic kinetics which transport diet lipids in the blood, the chilomicrons and its lypolisis products, chilomicron reminiscents have not yet been studied and can be contributing factors to the ateroclesrosis process. In this study 12 local weight lifters and admitted steroid users (AAS group), 16 local weight lifters but nonsteroids use (non-user group) and 18 sedentary and normolipidemic individuals (control group) were studied. The artificial chilomicron emulsion, marked with radioactive triglyceride (3H-TG) and radioactive oleate cholesterol (14C-OC) were injected interveneously and blood samples collected during pre-established time intervals. The plasmatic decay curve of the radioactive lipids of the emulsion was traced and fractional clearance rate was calculated (FCR) through compartamental analysis. The FCR-OC of the AAS group when compared to the control and nonuser groups was reduced (0,0073±0,0079 min -1,0,0155±0,0100 min -1, 0,0149± 0,0160 min -1, respectivelly; p< 0,05), while FCR-TG were similar. The LDL-C plasmatic concentration were higher in the AAS group when compared to control and non-user groups (143±54,101±31, 111±52 mg/dL, respectivelly; p=0,047). The HDL-C plasmatic concentration and the apolipoprotein A1 were lower in the AAS group when compared control and non-user groups (HDL-C: 22±13; 41±7; 38±13 mg/dL, respectivelly; p<0,001 e apo A1: 88±50; 156±35; 140±24 mg/dL,respectivelly; p<0,001). No difference was observed of the area under the fatty acid generated curve. Hepatic lipase activity was greater in the AAS group when compared to control and the non-user groups (7243±1822; 3898±1232; 2058±749, respectivelly; p<0,001). However, no difference was observed for lipoproteic lipase activity. The analisys of HDL size and triglyceride concentration in HDL were similar for all three groups.

L’hypertriglycéridémie (HTG) correspond à une accumulation des lipoprotéines riches en triglycérides (LRTG) dans la circulation plasmatique, conséquence d’une augmentation de leur synthèse ou plus classiquement décrit, d’une diminution de leur catabolisme. Dans près de 50% des cas, aucune cause génétique n’est identifiée chez les patients présentant une présentant une HTG sévère, aussi bien dans le cadre du syndrome de chylomicronémie familiale (FCS) que dans celui du syndrome de chylomicronémie multifactorielle (MCS). Pour améliorer nos connaissances et la caractérisation de ces patients, la conduction de corrélations phénotypes-génotypes précises grâce à une collaboration clinico-biologique étroite, ainsi que le développement d’outils de diagnostic moléculaire performants, demeurent un enjeu majeur. Premièrement, l’évaluation de la concentration pré-héparinique en LPL et l’activité post-héparinique 60 minutes après l’injection d’héparine chez 62 patients MCS caractérises génétiquement a permis la mise en évidence deux sous-groupes chez ces patients. Deuxièmement, le développement d’une stratégie séquençage de nouvelle génération permettant d’explorer simultanément les 9 gènes les plus prévalents dans les hypercholestérolémies, les hypocholestérolémies et les hypertriglycéridémies, a permis de détecter les variants nucléotidiques avec une sensibilité équivalente au séquençage Sanger mais aussi de détecter des grands réarrangements. L’ensemble des résultats souligne la complexité des mécanismes de régulation du métabolisme des LRTG et l’intérêt de l’étude des interactions gène-gène. Ainsi, ces travaux ont permis de mettre en évidence de nouvelles hypothèses à explorer pour la compréhension des mécanismes physiopathologiques des HTG sévères et d’améliorer les outils disponibles pour les études de corrélation génotype-phénotype / Hypertriglyceridemia (HTG) correspond to an increase of triglyceride-rich lipoproteins (TGRL) circulating concentration, as a consequence of an increase in the synthesis of or a decrease in their catabolism, most classically described. In nearly 50% of patients with severe hypertriglyceridemia (HTG), no genetic cause is identified, either in familial chylomicronemia syndrome (FCS) or in multifactorial chylomicronemia syndrome (MCS). To gain new insights and to improve patient’s characterization, it remains important to conduct accurate phenotype-genotype association studies through close collaboration with referent lipidologists, and to develop high-performance tools for molecular diagnosis. Firstly, the assessment of pre-heparin LPL concentration as well as LPL activity 60 minutes after heparin injection, enabled the identification of two subgroups within 62 genotyped MCS patients Secondly, the development of a new sequencing generation workflow exploring simultaneously the 9 most prevalent genes in dyslipidemia, allowed the detection of single nucleotide variations with sensitivity equivalent to Sanger sequencing, but also allowed the detection of copy number variations. Collective consideration of the results underlines the complexity of the regulation mechanisms of TGRL metabolism and the interest of gene-gene interactions study. Thus, the studies presented herein bring new hypothesis to explore for understanding the pathophysiological mechanisms of severe HTG and to improve molecular diagnosis tools available for phenotype-genotype association studies

Dietas vegetarianas oferecem baixo conteúdo calórico, baixos níveis de gordura saturada, colesterol, proteína animal e mais altos de gordura polinsaturada, carboidratos, fibras, magnésio, boro, folato e antioxidantes. Todos esses nutrientes influenciam nos fatores de risco de doenças cardiovasculares como hipertensão arterial, diabetes mellitus, obesidade e dislipidemias. Níveis plasmáticos de colesterol total, colesterol de lipoproteína de baixa densidade (LDL), de lipoproteína de densidade muito baixa (VLDL) e triglicérides em indivíduos vegetarianos são menores, em vários estudos, quando comparados a indivíduos onívoros. O metabolismo de quilomícrons (Qm) e dos seus produtos de degradação pela lipase lipoprotéica, os remanescentes, lipoproteínas que transportam os lípides da dieta na circulação sanguínea, não foi avaliado até o momento e está relacionado à aterosclerose. O objetivo deste estudo foi avaliar a cinética plasmática de quilomícrons artificiais marcados com triglicérides (TG-3H) e éster de colesterol (EC-14C) e aspectos qualitativos da HDL, em 18 indivíduos ovolacto-vegetarianos (excluem da alimentação carne, frango e peixe), 21 indivíduos veganos (não consomem nenhum alimento de origem animal), há pelo menos 5 anos e 29 indivíduos onívoros (consomem alimentos de origem animal), todos normolipidêmicos, não diabéticos e sem uso de medicamentos hipolipemiantes. Após a injeção endovenosa dos Qm artificias, foram colhidas amostras de sangue em tempos pré-estabelecidos durante 60 minutos. A radioatividade em cada uma das amostras foi medida para o cálculo da taxa fracional de remoção (TFR) dos lípides radioativos, através de análise compartimental. Foram realizadas as determinações bioquímicas nesses indivíduos e calculada a atividade da lipase lipoprotéica pós-heparina, em ensaio in vitro. Verificou-se também a transferência de lípides de uma nanoemulsão lipídica para a lipoproteína de alta densidade (HDL) e o diâmetro dessa lipoproteína. A remoção plasmática dos remanescentes de quilomícrons avaliada pela taxa fracional de remoção do éster de colesterol da emulsão, foi maior nos veganos (p<0,05) e ovolacto-vegetarianos (p<0,05) comparando-se aos onívoros, enquanto que o processo de lipólise dos quilomícrons, avaliado pela taxa fracional de remoção dos triglicérides da emulsão e pela medida da atividade da lipase lipoprotéica in vitro foi similar nos três grupos avaliados. Não foram encontradas diferenças significativas nas concentrações plasmáticas de HDLC, VLDL e triglicérides entre os grupos estudados .No grupo vegano, as concentrações plasmáticas de LDL-C e glicose foram menores quando comparadas apenas ao grupo dos onívoros (p<0,05, p<0,01; respectivamente). Já em relação ao colesterol total, os indivíduos veganos apresentaram menores níveis quando comparados tanto aos ovolacto-vegetarianos (p<0,05) como aos onívoros (p<0,01). Não observou-se diferença na transferência de lípides da nanoemulsão para a HDL e no tamanho da HDL entre os três grupos. Os resultados do presente estudo sugerem que a dieta vegana e ovolacto-vegetariana aceleram a remoção dos remanescentes de quilomícrons, lipoproteínas aterogênicas, o que pode estar relacionado, aos efeitos benéficos dessa dieta em relação a doenças em relação ao processo aterosclerótico / Vegetarian diets provide less caloric content, low levels of saturated fats, cholesterol and animal protein while providing at the same time providing high levels of polyunsaturated fats, carbohydrates, fibers, magnesium, borium, folate and antioxidants. All these nutrients have an influence upon the cardiovascular diseases such as hypertension, diabetes mellitus, obesity and dyslipidemias. Studies have shown that total cholesterol plasmatic levels, low density lipoprotein (LDL), very low density lipoprotein (VLDL) and triglycerides in vegetarian individuals are lower when compared to omnivores individuals. Chylomicron metabolism (Qm) and its lipoprotein lipase degradation products, the remnants, lipoproteins that transport dietary lipids in the blood has not yet been evaluated, although it is related to atherosclerosis. This study evaluated the plasmatic kinetics of artificial chylomicrons marked with triglycerides (3HTG) and cholesterol esters (14C-CE), as well as the qualitative aspects of HDL in 13 ovolacto-vegetarians (no ingestion of meat, chicken or fish), 10 vegan individuals (no ingestion of any food of animal origin) for more than 5 years and 14 omnivores individuals (ingestion of animal origin foods). All participants were normolipidemic, non diabetic and using no hypolipemiants medication. After an intravenous injection containing artificial Qms, blood samples were collected during 60 minutes at predetermined times. The radioactivity of each sample was measured and the fractional clearance rate (FCR) calculated for the radioactive lipids using compartmental analysis. Biochemical determinations were undertaken in order to calculate the post-heparin lipoprotein lipase activity in vitro. Also evaluated were the lipid transfer of the lipid nanoemulsion to the HDL and the diameter of the HDL particles. The plasma removal of the chylomicron remnants evaluated by the fractional clearance rate of the cholesteryl ester of the emulsion was greater in the vegan (p<0,05) and ovolacto-vegetarian (p<0,05) groups when compared to the omnivore group. The lipolysis of the chylomicron evaluated by the fractional clearance rate of the emulsion triglycerides and by the in vitro lipoprotein lipase activity assay was similar in the three studied groups. There were no differences in the plasma concentrations of HDL-C, VLDL-C and triglycerides between the three groups. The plasma concentrations of LDL-C and glucose of the vegan group were lower than omnivore group (p<0.05 and p<0.01, respectively). In regards to total cholesterol, vegans present lower levels when compared to both ovolactovegetarians (p<0.05) and omnivores (p<0.01). No difference was found in the transfer of nanoemulsion lipids to HDL or in the size of the HDL of all three groups. These results suggest that the vegetarian diet can improve the metabolism of chylomicron remnants, atherogenic lipoproteins, which can be related to the beneficial effects of this diet upon the atherosclerosis process.