Connexins are a family of gene products sharing a similar topology that mediate transmembrane and intercellular diffusion of ions and small molecules through hemichannels (HCs) and gap junction channels (GJCs), respectively, and participate in intracellular signaling through protein-protein interaction. Connexin 37 (Cx37) and Cx40 are co-expressed by endothelial cells, suggesting a unique role for each connexin in regulating cellular function. Through gene knockout studies in mice, Cx37 was found to regulate vascular cell proliferation while Cx40 regulates conduction of upstream vasomotor signals and leukocyte infiltration. The unique functions of Cx37 and Cx40 result in contrasting effects of ischemic injury in mice lacking expression of either Cx37 or Cx40 genes. Cx37 knockout mice (Cx37-/-) have significantly improved recovery due to an increase in both vasculogenesis and angiogenic processes. In the current studies, the mechanism by which Cx37 mediates cellular proliferation is explored by examining the role of functional GJCs and HCs. Channel function is necessary, but HC function is not sufficient for Cx37-mediated suppression of proliferation. These results suggest that Cx37 requires a competent GJC that supports a specific conformation of the carboxyl terminus that is able to interact with necessary growth regulatory protein(s). Conversely, Cx40-/- mice have reduced angiogenic and arteriogenic processes and impaired post-ischemic recovery. In the current study, we explored the inflammatory response following the femoral artery ligation (FAL) surgery, in wildtype (WT) and Cx40-/- mice. Cx40-/- mice had an excessive infiltration of activated neutrophils to the ischemic gastrocnemius muscle and a prolonged presence of activated macrophages. We depleted mice of circulating neutrophils during the induction of ischemia to evaluate if the excessive infiltration of neutrophils impaired recovery and found no improvement in post-ischemic recovery in either WT or Cx40-/- mice. These data indicate that, although Cx40-/- mice have a pro-inflammatory state that results in an excessive and prolonged presence of leukocytes post-ischemia, reduction of acute leukocyte infiltration does not improve post-ischemic recovery. Additional information is necessary to determine the mechanisms by which Cx37 and Cx40, individually or in concert with each other, regulate endothelial cell function and arterial vascular response to ischemic injury.

Le système de conduction ventriculaire (SCV) est responsable de la propagation rapide de l’activité électrique dans le cœur. Il est composé du faisceau de His, des branches droite et gauche, et des fibres de Purkinje. 1) Le développement du SCV a été étudié par l’utilisation de souris transgéniques exprimant la recombinase Cre inductible, insérée par recombinaison homologue au locus du gène de la connexine-40 (Cx40). Ce gène code pour une protéine exprimée dans les trabécules ventriculaires et le SCV. La recombinaison est observée uniquement dans les cellules exprimant la Cx40 et leur descendance. Mes résultats révèlent une restriction progressive du destin des trabécules Cx40-positives en cardiomyocytes conducteurs. Les progéniteurs Cx40-positifs participent à la formation du myocarde contractile et du SCV de E10.5 à E14.5 ; alors qu’ils ne donnent que des cardiomyocytes conducteurs après E16.5. 2) L’analyse du SCV a été étudiée dans un modèle de malformation cardiaque congénitale. Le mutant Tbx1-/-, modèle du syndrome de DiGeorge humain, présente une communication inter-ventriculaire. Des défauts morphologiques du SCV sont détectés chez ces mutants : absence de branche droite et un faisceau de His moins compacté. Ceux-ci sont corrélés avec des défauts de conduction. Le phénotype observé ne résulte pas d’un défaut d’activation du programme génique à l’origine de l’établissement du SCV ; mais semble dû à la présence de la communication inter-ventriculaire qui empêcherait les cellules progénitrices du SCV de rejoindre le sommet du septum inter-ventriculaire. / The ventricular conduction system (VCS) is responsible for the rapid propagation of electrical activity in the heart. The VCS is composed of the His bundle, the left and right bundle branches, and the peripheral Purkinje fibers. 1) The development of the VCS has been studied by using transgenic mice expressing the inducible Cre recombinase, introduced by homologous recombination at the locus of gene of connexin-40 (Cx40). Cx40 encodes for a protein expressing in the ventricular trabeculae and the VCS. The recombination is observed in the cells expressing Cx40 and in their descendants. My results suggest a progressive restriction of the fate of Cx40-positive trabeculae in conductive cardiomyocytes. Cx40-positive progenitors give rise to the formation of the compact myocardium and of the VCS when they are induced between E10.5-E14.5; while they participate only in the cardiomyocytes of VCS after E16.5. 2) The analysis of the VCS has been studied in a model of congenital heart malformation. The mutant Tbx1-/-, model of the DiGeorge syndrome, present a ventricular septal defect. Morphological defects of the VCS are found in Tbx1-/- hearts: an absence of right bundle branch and a non-compacted His bundle; which are correlated with functional defect. The phenotype observed in these mutants does not result from a defect of the activation in the genetic program being at the origin of the establishment in the VCS, but seems to be explain by the presence of a large ventricular septal defect, because it could block the progression of the progenitors of the VCS along the crest of the inter-ventricular septum.

Group of specialized cells that form cardiac conduction system is responsible for generation and coordinated propagation of the electrical impulse in the heart. Changes in its development can be connected with arrhythmias; therefore, a good level of knowledge is necessary and relevant for basic science and clinical practice. For correct development of the conduction system are important genes coding gap junctions proteins, ion channels, transcription factors and other molecules involved in signaling cascades (endothelin, neuregulin). Development of conduction system is determined in addition to genetic factors also by epigenetics and environmental factors. This thesis with its individual papers on which it is based is addressing different aspects of conduction system development, which appears to be a complex process. Another feature which is linking all papers together, is the methodological approach enabling us to study function of the conduction system - optical mapping. In the first publication we studied by the means of in vitro organ culture the impact of work load without interfering hemodynamics on the conduction system maturation in the chick embryonic heart. The phenotype observed during experiments was developmental regression of conduction system maturation together with changes in...

La fibrillation atriale (FA) est l'arythmie cardiaque soutenue la plus fréquente chez les adultes. Elle est associée à une augmentation du risque d'accident vasculaire cérébral, d'insuffisance cardiaque et de la mortalité. Un mécanisme de torsades auriculaires a été décrit chez des patients atteints du syndrome du QT long congénital (SQTL). Malgré une littérature très riche sur le sujet, les mécanismes impliqués dans la genèse et le maintien de ces arythmies restent mal connus et constituent un obstacle dans le diagnostic et la prise en charge de ces maladies. Dans la première partie de ce travail, nous avons abordé l'histologie et la distribution des connexines (Cxs) chez deux groupes de patients avec et sans FA par une approche de microscopie confocale. Nous avons ainsi décrit d'une part un réseau entre fibroblastes et myocytes communiquant via les Cx 40 et 43 et d'autre part la présence de myofibroblastes, d'une forte fibrose et d'un remodelage des Cx 40 et 43 dans le tissu de patients FA. Par ailleurs, pour identifier de nouvelles mutations impliquées dans ces arythmies, nous avons étudié une cohorte de 60 patients atteints de FA. Les recherches génétiques et l'étude fonctionnelle nous ont permis d'associer 5 nouvelles mutations: P41S et M207V (PITX2), G277E (Cx 40) A253V (Cx 43) et P1034H (KCNH2) à la FA. Celles-ci semblent jouer un rôle clé dans la constitution du substrat arythmogène. Enfin, dans la dernière partie, nous avons exploré l'impact électrophysiologique d'un variant de KCNH2, R148W, trouvé tout d'abord chez un enfant décédé de mort subite pendant le sommeil, puis chez plusieurs membres de la famille, dont certains présentent un intervalle QT allongé. Ce variant, exprimé dans les ovocytes de Xénope et étudié en voltage-clamp, réduit le courant de 29% et pourrait alors prédisposer à la survenue de torsades de pointes et expliquer en partie l'allongement du QTc. Outre les nouveaux variants géniques découverts, ce travail est le premier à associer un gain de fonction du facteur de croissance PITX2c en relation avec la FA. Le remodelage histologique des Cx et les variants nucléotidiques touchant les gènes GJA1, GJA5, PITX2 et KCNH2 pourraient ainsi participer à l'étiologie de la FA et du QT long / Atrial fibrillation (AF) is the most common sustained arrhythmia in adults. It is associated with an increased risk of stroke, heart failure and mortality. A mechanism of atrial torsades has been described in patients with congenital long QT syndrome (LQTS). Despite the already existing body of literature, the mechanisms involved in the genesis and maintenance of these arrhythmias remain poorly understood and constitute an obstacle in diagnosis and management of these diseases. In the first part of this work, we discussed the histology of connexins (Cxs) and their distribution in two groups of patients (with and without FA), by confocal microscopy approach. We have described a network of fibroblasts and myocytes communicating across Cx 40 and 43 and the presence of myofibroblasts, of a strong fibrosis and of a remodeling of Cx 40 and 43 distribution in the tissue of AF patients. In addition, to identify new mutations involved in these arrhythmias, we studied a cohort of 60 patients with AF. Genetic investigations and functional study enabled us to associate five novel mutations with AF: M207V and P41S (PITX2), G277E (Cx 40) A253V (Cx 43) and P1034H (KCNH2). These mutations likely play a key role in the formation of the arrhythmogenic substrate. Finally, we explored the electrophysiological impact of a KCNH2 variant, R148W, initially found in a child who died suddenly during sleep and subsequently disclosed in several family members, some with a long QT interval. When expressed in Xenopus oocytes and studied in voltage-clamp, this variant reduces the current by 29%, which might predispose to torsades de pointes and partly explain the QTc prolongation. In addition to these newly discovered gene variants, this work is the first to report a gain-of-function mutation of the transcription factor PITX2c in AF. Histological remodeling of Cxs and the nucleotide variants affecting GJA1, GJA5, PITX2 and KCNH2 might thus participate in the etiology of AF and LQTS

Group of specialized cells that form cardiac conduction system is responsible for generation and coordinated propagation of the electrical impulse in the heart. Changes in its development can be connected with arrhythmias; therefore, a good level of knowledge is necessary and relevant for basic science and clinical practice. For correct development of the conduction system are important genes coding gap junctions proteins, ion channels, transcription factors and other molecules involved in signaling cascades (endothelin, neuregulin). Development of conduction system is determined in addition to genetic factors also by epigenetics and environmental factors. This thesis with its individual papers on which it is based is addressing different aspects of conduction system development, which appears to be a complex process. Another feature which is linking all papers together, is the methodological approach enabling us to study function of the conduction system - optical mapping. In the first publication we studied by the means of in vitro organ culture the impact of work load without interfering hemodynamics on the conduction system maturation in the chick embryonic heart. The phenotype observed during experiments was developmental regression of conduction system maturation together with changes in...