La problématique concernant la présence et les risques potentiels liés aux micropolluants dans l'environnement est devenue une préoccupation d'actualité. Aujourd'hui, les stations d'épuration ne sont pas en mesure de traiter de manière adéquate ce nouveau type de pollution. Dans le cadre de cette thèse, l'application de la technologie des bioréacteurs à membrane a été envisagée afin d'évaluer leur potentiel pour la dégradation d'un médicament anticancéreux : le cyclophosphamide (CP). Les objectifs de cette étude sont d'une part évaluer le potentiel des bioréacteurs à membrane pour la dégradation du cyclophosphamide, ainsi que pour l'élimination de sa toxicité, d'autre part rechercher l'effet du CP et de ses métabolites sur les performances globales du procédé et sur l'activité de la biomasse épuratrice ainsi que sur les propriétés physico-chimiques de la liqueur mixte et les conséquences sur le colmatage. Deux âges de boues ont été évalués, 50 jours lors de la première campagne et 70 jours lors de la deuxième. L'élimination du CP et du métabolite 4-Keto-CP durant les deux campagnes expérimentales est d'environ 80% pour les deux composés. Les processus d'adsorption et de biodégradation contribuent à l'élimination du CP de l'eau résiduaire traitée. Le cocktail de CP et ces métabolites aux conditions opératoires étudiées n'a pas d'influence significative sur l'élimination globale de la DCO et de l'azote total. Cependant, la toxicité du cocktail des composés pharmaceutiques sur la boue activée modifie les caractéristiques de la matrice biologique : Une diminution de la production de boues du BÀM R1 CP par rapport au BÀM R2 contrôle est observée. La présence du CP et ses principaux métabolites stimule les mécanismes de survie et de production des EPS avec une production légèrement plus forte des polysaccharides que des protéines. Les résultats mettent en évidence que la réponse des boues activées des BÀM au cisaillement est dépendante de la présence de ces molécules. Cette étude démontre au final l'intérêt des BÀM pour traiter ce type d'effluents, et limiter la pollution relarguée dans le milieu naturel. / In hospital or pharmaceutical discharges, but also in wastewater treatment plants and more generally in the aquatic environment, toxics pollutants have been identified. Some pharmaceuticals are not completely eliminated in the municipal wastewater treatment plants and are discharged as contaminants into receiving waters. The application of membrane bioreactor process is investigated here with the aim of evaluating the potential for removal of cyclophosphamide (CP). In this study, two membrane bioreactors (MBR) were operated: one of the MBR served as a control, whereas to the other CP and its main metabolites were continuously added. Two sludge retention times were assessed, 50 days and 70 days. Removal of CP in a MBR and its effects on the membrane performance, COD and total nitrogen (TN) removal efficiency were studied. CP and 4-Ketocyclophosphamide removals up to 80% were achieved under studied operating conditions. The sludge adsorption and biodegradation (cometabolism) play an important role in the process of CP removal. CP and its metabolites toxicity do not alter COD and total nitrogen removal efficiency of MBRs. However, it induces a modification of the biological suspended solids and in doing so a modification on the membrane fouling: a decrease in the production of sludge MBR CP compared to MBR control is observed; the presence of CP and its main metabolites stimulates mechanisms of protection and production of EPS with a slightly higher production of polysaccharides than proteins. The results underline that the response of activated sludge to shear stress is dependent on the presence of these molecules. This study demonstrates the interest of MBR to treat this type of effluent and reduce the pollution released into the environment

Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (leaves 101-113).

La découverte des antigènes tumoraux dans les années 1980s a permis d’envisager l’élaboration de protocoles de vaccination de patients cancéreux. Les résultats obtenus chez les patients traités sont prometteurs mais encore insuffisants et la chimiothérapie reste, à ce jour, régulièrement utilisée dans le traitement de tumeurs.<p>\ / Doctorat en Sciences / info:eu-repo/semantics/nonPublished

Plus de 50 ans après son approbation par les agences réglementaires, le cyclophosphamide (CTX) reste une drogue aux propriétés variées et aux effets pléiotropiques couramment utilisée en clinique. Cet agent cytotoxique, administré en cancérologie, possède des propriétés immuno-modulatrices et stimule les réponses immunitaires anti-tumorales. A doses métronomiques, le CTX induit notamment une polarisation des splénocytes CD4+ vers un profil Th1 et Th17, caractérisés par la sécrétion d’IFNet d’IL-17, nécessaire à l’activité tumoricide du CTX. Comme tout agent cytotoxique, le CTX cible les cellules en prolifération, qu’elles soient normales ou cancéreuses. Le CTX compromet ainsi l’intégrité de la barrière intestinale et l’homéostasie du tractus digestif. Nous avons démontré que l’individu sous CTX a une fragilisation de la barrière intestinale qui permet la rupture de la tolérance de celui-ci à sa flore commensale et son immunisation contre certaines espèces bactériennes. L’immunisation anti-bactérienne est composée de lymphocytes effecteurs CD4+, appelés « Th17 pathogéniques » et producteurs d’IL-17 et d’IFN, qui aident les lymphocytes anti-tumoraux à endiguer la croissance de tumeurs chez la souris. Nous avons mis en évidence que la stérilisation des animaux avec des antibiotiques à large spectre ou ciblant certaines populations bactériennes comme la vancomycine (ciblant les Gram+) et la colistine (ciblant les Gram-), abrogent l’efficacité anti-tumorale du CTX. Par ailleurs, nous avons identifié deux bactéries, une bactérie Gram+ Enterococcus hirae, capable de restaurer l’efficacité de cette chimiothérapie en induisant la polarisation de réponses Th1 et pTh17 stimulant la mise en place de réponses lymphocytaires T CD4 et T CD8 dirigées contre des antigènes tumoraux et une bactérie Gram- Barnesiella intestinihominis, impliquée dans la mise en place de réponses mémoires induites par la combinaison CTX+vaccin. Ces travaux démontrent ainsi l’importance de la flore intestinale dans la réponse à la chimiothérapie par CTX. / More than 50 years after its approval by the Food and Drug Administration, cyclophosphamide (CTX) remains a drug with miscellaneous properties currently used in anti-cancer chemotherapy. This cytotoxic agent has immuno-modulatory properties and stimulate anti-tumoral immune responses. At metronomic doses, CTX induces the polarisation of splenocytes toward a Th1 and Th17 profile, characterized by the secretion of IFN et IL-17, both mandatory for the tumoricidal activity of this drug. CTX, as cytotoxic agent, targets proliferating cells, either normal or tumoral. Indeed, CTX is responsible for disrupting the gut barrier integrity as well as intestinal homeostasis. We have shown that people treated with CTX have a weaker intestinal barrier which breaks the tolerance toward the intestinal microbiota and leads to its immunization against some bacterial strains. This immunization is composed of CD4+ effector lymphocytes called « pathogenic Th17 » producing IFN and IL-17, which helps tumor-infiltrating lymphocytes to control the tumor growth in mice. Broad spectrum antibiotics as well as vancomycin (which mainly kills Gram positive bacteria) and colistin (which mainly eliminates Gram negative bacteria) all compromised the full-blown anticancer activity of CTX in vivo. Moreover, we have identified two bacteria, Enterococcus hirae and Barnesiella intestinihominis, able to rescue the efficacy of CTX abolished with antibiotics. E. hirae, a Gram+ bacterium, elicits Th1 immune responses and pathogenic Th17 cells capable of enhancing tumor-specific CD4+ and CD8+ T cell responses against candidate tumor antigens associated with tumor control. B. intestinihominis, a Gram- bacterium, was able to rescue the long term cognate responses lost with broad spectrum antibiotics or colistin treatment. Our data underscore the role of the gut microbiota in the efficacy of chemotherapy by CTX.

Class of 2012 Abstract / Specific Aims: Autologous stem cell transplant (ASCT) is the current gold standard following induction therapy to improve survival of multiple myeloma (MM). Lenalidomide (LEN) is used for treatment of MM before ASCT, but exposure may impair autologous peripheral blood stem cell (PBSC) mobilization. Chemomobilization with cyclophosphamide (CTX) has not been evaluated in this setting. CTX + filgrastim was investigated to determine if LEN-associated mobilization impairment can be abrogated. Methods: 36 pts (group A=12 pts who received ≥2 cycles of LEN and group B=24 pts without LEN) were analyzed retrospectively. Baseline characteristics were matched (p>0.05 for all variables). All pts received CTX (median group B, 1.5g/m2; median group A, 3gm/m2(p=0.18)) and filgrastim 10μg/kg/day. Primary outcomes include number of CD34+ cells collected and number of leukapheresis sessions. Secondary outcomes include failure to collect CD34+ cells and total CD34+ cells collected after second leukapheresis. Main Results: Total median number of CD34+ cells collected in group B=9.15x106/kg CD34+ cells and group A=7.43x106/kg CD34+ cells (p=0.159). Median number of apheresis sessions in group B=2 and group A=3 (p=0.42). Two of 12 pts with antecedent LEN usage failed to collect while no patient without previous LEN exposure failed to collect (p=0.105). Total number of CD34+ cells collected after 2 apheresis sessions for group B=8.13x106/kg CD34+ cells and group A=3.34x106/kg CD34+ cells (p=0.06). Conclusions: Chemomobilization with CTX + filgrastim yields robust PBSC collections irrespective of antecedent lenalidomide. There was a trend towards lesser PBSC collection in LEN-treated pts.

A farmacocinética dos enantiômeros da ciclofosfamida (CPA) foi avaliada em pacientes portadores de nefrite lúpica distribuídos em dois grupos de acordo com o clearance da creatinina: Grupo 1 90,6-144,6mL/min/1,73m2 e Grupo 2 42,8-76,4mL/min/1,73m2. Os pacientes foram tratados com doses de 0,75 a 1,3g de ciclofosfamida racêmica sob forma de infusão com duração de 2h e com 1mg de midazolam (MDZ) administrado via endovenosa para a avaliação da atividade in vivo do CYP3A. As concentrações plasmáticas dos enantiômeros da CPA e do MDZ foram avaliadas por LC-MS/MS. Os enantiômeros da CPA foram resolvidos na coluna Chiralcel OD-R, com fase móvel constituída por mistura de acetonitrila e água (75:25, v/v) adicionada de 0,2% de ácido fórmico. Os enantiômeros da CPA foram extraídos do plasma com recuperações maiores que 95% e o limite de quantificação obtido foi de 2,5ng de cada enantiômero da CPA/mL plasma. As seguintes diferenças (teste de Wilcoxon, p<0,05) foram observadas nos parâmetros farmacocinéticos entre os enantiômeros (S)-(-)-CPA e (R)-(+)-CPA para os pacientes do Grupo 1: AUC do tempo 0 ao infinito 152,41 vs 129,25g.h/mL; Cl 3,28 vs 3,89L/h; Vd 31,38 vs 29,74L e t1/2 6,79 vs 5,56h e para os pacientes do Grupo 2: AUC do tempo 0 ao infinito 167,20 vs 139,08g.h/mL; Cl 2,99 vs 3,59L/h e t1/2 6,15 vs 4,99h. Não foi observada diferença (teste de Mann-Whitney, p<0,05) nos parâmetros farmacocinéticos de ambos os enantiômeros entre os grupos 1 e 2. Não foi observada corrrelação entre o clearance do MDZ (2,92-16,40ml/min.kg) e o clearance de cada enantiômero da CPA. Concluindo, a farmacocinética da CPA é enantiosseletiva em pacientes portadores de nefrite lúpica com acúmulo plasmático do enantiômero (S)-(-)-CPA e a farmacocinética de ambos os enantiômeros da CPA não é alterada pela agravamento da função renal. / The pharmacokinetics of cyclophosphamide (CYC) enantiomers was evaluated in patients with lupus nephritis distributed in two groups according to creatinine clearance; Group 1 - 90.6-144.6mL/min/1.73m2 and Group 2 - 42.8- 76.4mL/min/1.73m2. All patients were treated with 0.75 to 1.3g of racemic CYC as a 2-hour infusion and with 1mg intravenous midazolam as a drug marker. CYC enantiomers and midazolam concentrations in plasma were measured by LC-MS/MS. CYC enantiomers were separated on a Chiralcel OD-R column, with the mobile phase consisting of a mixture of acetonitrile and water (75:25, v/v) plus 0.2% formic acid. Recovery rates were higher than 95% and the quantification limit was 2.5ng/ml plasma for both enantiomers. The coefficients of variation and the relative errors obtained for the validation of intra- and interassay precision and accuracy were less than 10%. The following differences in the pharmacokinetic parameters (Wilcoxon test, p<0.05) were observed between the (S)-(-) and (R)-(+) enantiomers for Group 1 AUC from time 0 to infinity 152.41 vs 129.25g.h/mL, Cl 3.28 vs 3.89L/h, Vd 31.38 vs 29.74L and t1/2 6.79 vs 5.56h and for Group 2 AUC from time 0 to infinity 167.20 vs 139.08g.h/mL, Cl 2.99 vs 3.59 L/h and t1/2 6.15 vs 4.99 h. No differences (Mann-Whitney test, p<0.05) were observed between Groups 1 and 2 in the pharmacokinetics parameters of both enantiomers. No significant relationship was observed between midazolam clearance (2.92-16.40 ml/min.kg) and clearance of each CYC enantiomer. In conclusion, CYC kinetic disposition is enantioselective resulting in higher exposure of (S)-(-)-CYC in lupus nephritis patients and the pharmacokinetic parameters of both enantiomers are not altered by the worsening of renal condition.

Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (leaves 129-144).

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2013-11-06T19:03:45Z No. of bitstreams: 1 Daniel Huber Pessina Análise imuno fenotípica de animais nod estudo da proteção ao diabetes..pdf: 2399319 bytes, checksum: 3fc4e57719b71c97883626a074b31ce3 (MD5) / Made available in DSpace on 2013-11-06T19:03:45Z (GMT). No. of bitstreams: 1 Daniel Huber Pessina Análise imuno fenotípica de animais nod estudo da proteção ao diabetes..pdf: 2399319 bytes, checksum: 3fc4e57719b71c97883626a074b31ce3 (MD5) Previous issue date: 2013 / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Os animais NOD representam o principal modelo experimental de estudo do diabetes autoimune. Apesar do progressivo número de estudos realizados, muitos aspectos imunes da promoção e regulação desta doença continuam obscuros. Utilizando o modelo (pela primeira vez aqui descrito) de proteção induzida pelo T. cruzi, bem como o modelo de aceleração pela ciclofosfamida, fizemos um estudo imuno-fenotípico em animais NOD com o objetivo de elucidar mecanismos imunes responsáveis pela regulação do diabetes tipo I. Demonstramos que a infecção de camundongos NOD com o T. cruzi os protege do desenvolvimento do diabetes. Estes animais desenvolvem uma resposta ao parasita caracterizada por uma pobre expansão de células T CD8 efetoras, bem como uma menor migração destas para os sítios parasitários. Estudo do perfil de citocinas mostraram ainda uma reduzida produção inicial de IFN no baço, mas elevada produção tardia nos tecidos inflamados, comparado a animais BALB/c. Estes dados, associados a uma maior produção inicial de IL-10 por esplenócitos, justificam a maior susceptibilidade à infecção observada nos animais NOD. O estudo de populações celulares com atividade regulatória mostrou que há aumento de Treg no início da infecção. Contudo a proteção ao diabetes desencadeada pelo T. cruzi não se correlaciona ao número de células Treg, pois há uma redução destas ao longo da infecção. Este fato, associado à observação de que a ciclofosfamida é incapaz de induzir diabetes nos animais infectados, apontaram para um papel limitado destas células na proteção ao diabetes pelo T. cruzi. Entretanto, houve aumento de células Gr1+, e a depleção destas reverte a proteção ao diabetes causada pela infecção, além de induzir a expansão de células T CD8+ efetoras e sua produção de IFN. Verificamos ainda, que níveis aumentados da expressão de PD-L1 relacionaram-se com a proteção ao diabetes proporcionado pelo T. cruzi, enquanto níveis reduzidos se relacionaram ao seu desenvolvimento espontâneo. Contudo, o tratamento com ciclofosfamida não reduz a expressão de PD-L1 em linfócitos, mas induz rapidamente o diabetes em animais NOD não infectados e leva a uma drástica diminuição de células Tregs CD25+ esplênicas. Os resultados, aqui tomados em conjunto, apontam para um complexo mecanismo de controle do diabetes, que envolve diferentes populações celulares que atuam de maneira variada com o modelo estudado. / The NOD mice are the most used experimental model for the study of autoimmune diabetes. Despite progressive number of studies, many aspects about the immune regulation and disease onset remains unclear. Using our model (described here for the first time) of diabetes protection induced by T. cruzi, as well as cyclophosphamide acceleration, we performed a immunophenotypic analysis of NOD animals, aiming to elucidate the immune mechanisms responsible for regulation of type I diabetes. We demonstrated that infection of NOD mice with T. cruzi protects them from diabetes onset. These mice develop a poor expansion of effector CD8 T cells in response to parasite, and have lower percentage of those lymphocytes in inflammatory sites, when compared to BALB/c mice. Cytokine profile's analysis also revealed a reduced initial production of IFN in spleen, but high late production in inflamed tissues. Those data associated to an elevated production of IL-10 by spleen cells could explain the increased susceptibility observed in infected NOD mice. Further analysis showed an increased Treg cells rates early after infection, followed by a progressive reduction thereof along infection. This fact, coupled with the observation that cyclophosphamide is unable to induce diabetes in infected mice, indicates a limited role for these cells in diabetes protection by T. cruzi. However, increased Gr1 + cells numbers was also found in infected mice, and its depletion reverses the protection of diabetes related to infection. That reversion was associated to an expansion of effector CD8 + T cells and their production of IFN. We also found that increased expression of PD-L1 were also related to diabetes protection provided by T. cruzi infection, while low levels were related to spontaneous diabetes development. Treatment with cyclophosphamide however did not reduce PD-L1 expression on lymphocytes, despites rapidly set diabetes in NOD uninfected animals. On the other hand, cyclophosphamide leads to a drastic decrease of CD25 + Treg cells in the spleen of NOD mice. These results, taken together, point to a complex mechanism of diabetes control, which involves different cell populations acting variously with the model.

A farmacocinética dos enantiômeros da ciclofosfamida (CPA) foi avaliada em pacientes portadores de nefrite lúpica distribuídos em dois grupos de acordo com o clearance da creatinina: Grupo 1 90,6-144,6mL/min/1,73m2 e Grupo 2 42,8-76,4mL/min/1,73m2. Os pacientes foram tratados com doses de 0,75 a 1,3g de ciclofosfamida racêmica sob forma de infusão com duração de 2h e com 1mg de midazolam (MDZ) administrado via endovenosa para a avaliação da atividade in vivo do CYP3A. As concentrações plasmáticas dos enantiômeros da CPA e do MDZ foram avaliadas por LC-MS/MS. Os enantiômeros da CPA foram resolvidos na coluna Chiralcel OD-R, com fase móvel constituída por mistura de acetonitrila e água (75:25, v/v) adicionada de 0,2% de ácido fórmico. Os enantiômeros da CPA foram extraídos do plasma com recuperações maiores que 95% e o limite de quantificação obtido foi de 2,5ng de cada enantiômero da CPA/mL plasma. As seguintes diferenças (teste de Wilcoxon, p<0,05) foram observadas nos parâmetros farmacocinéticos entre os enantiômeros (S)-(-)-CPA e (R)-(+)-CPA para os pacientes do Grupo 1: AUC do tempo 0 ao infinito 152,41 vs 129,25g.h/mL; Cl 3,28 vs 3,89L/h; Vd 31,38 vs 29,74L e t1/2 6,79 vs 5,56h e para os pacientes do Grupo 2: AUC do tempo 0 ao infinito 167,20 vs 139,08g.h/mL; Cl 2,99 vs 3,59L/h e t1/2 6,15 vs 4,99h. Não foi observada diferença (teste de Mann-Whitney, p<0,05) nos parâmetros farmacocinéticos de ambos os enantiômeros entre os grupos 1 e 2. Não foi observada corrrelação entre o clearance do MDZ (2,92-16,40ml/min.kg) e o clearance de cada enantiômero da CPA. Concluindo, a farmacocinética da CPA é enantiosseletiva em pacientes portadores de nefrite lúpica com acúmulo plasmático do enantiômero (S)-(-)-CPA e a farmacocinética de ambos os enantiômeros da CPA não é alterada pela agravamento da função renal. / The pharmacokinetics of cyclophosphamide (CYC) enantiomers was evaluated in patients with lupus nephritis distributed in two groups according to creatinine clearance; Group 1 - 90.6-144.6mL/min/1.73m2 and Group 2 - 42.8- 76.4mL/min/1.73m2. All patients were treated with 0.75 to 1.3g of racemic CYC as a 2-hour infusion and with 1mg intravenous midazolam as a drug marker. CYC enantiomers and midazolam concentrations in plasma were measured by LC-MS/MS. CYC enantiomers were separated on a Chiralcel OD-R column, with the mobile phase consisting of a mixture of acetonitrile and water (75:25, v/v) plus 0.2% formic acid. Recovery rates were higher than 95% and the quantification limit was 2.5ng/ml plasma for both enantiomers. The coefficients of variation and the relative errors obtained for the validation of intra- and interassay precision and accuracy were less than 10%. The following differences in the pharmacokinetic parameters (Wilcoxon test, p<0.05) were observed between the (S)-(-) and (R)-(+) enantiomers for Group 1 AUC from time 0 to infinity 152.41 vs 129.25g.h/mL, Cl 3.28 vs 3.89L/h, Vd 31.38 vs 29.74L and t1/2 6.79 vs 5.56h and for Group 2 AUC from time 0 to infinity 167.20 vs 139.08g.h/mL, Cl 2.99 vs 3.59 L/h and t1/2 6.15 vs 4.99 h. No differences (Mann-Whitney test, p<0.05) were observed between Groups 1 and 2 in the pharmacokinetics parameters of both enantiomers. No significant relationship was observed between midazolam clearance (2.92-16.40 ml/min.kg) and clearance of each CYC enantiomer. In conclusion, CYC kinetic disposition is enantioselective resulting in higher exposure of (S)-(-)-CYC in lupus nephritis patients and the pharmacokinetic parameters of both enantiomers are not altered by the worsening of renal condition.

De nombreux agents chimiothérapeutiques sont gonadotoxiques et peuvent donc induire une insuffisance ovarienne précoce chez les jeunes patientes traitées. La protection pharmacologique de l'ovaire pendant la chimiothérapie à l'aide d'analogues de la Gonadotropin-Releasing Hormone (GnRHa) est une option intéressante de préservation de la fertilité de par son caractère non-invasif et la possibilité d’une récupération spontanée de la fonction ovarienne. Ces molécules sont des inhibiteurs bien connus de l'axe hypothalamo-hypophyso-gonadique, mais leur efficacité dans cette indication est, cependant, controversée et leurs mécanismes d'action sont mal compris. Par conséquent, nous avons investigué les mécanismes potentiels de protection ovarienne des GnRHa pendant la chimiothérapie sur modèle murin. Nous avons montré que le cyclophosphamide (Cy) induit une déplétion folliculaire aiguë et proportionnelle à la dose affectant à la fois les follicules quiescents et en croissance. Lorsqu'ils sont administrés seuls à différentes doses et sites, l'agoniste et l'antagoniste de la GnRH altèrent les cycles oestraux, mais ne bloquent ni la folliculogenèse ni la sécrétion de la Follicle-Stimulating Hormone (FSH) chez la souris. De plus, le Cy atteint les follicules primordiaux, que les souris aient été traitées avec les GnRHa ou non. Ces résultats suggèrent que les GnRHa n'inhibent pas l'axe hypophyso-gonadique aussi efficacement chez la souris que chez la femme. Par conséquent, nous avons développé de nouveaux modèles pour étudier les mécanismes potentiels de protection ovarienne des GnRHa. Afin de différencier les effets directs des GnRHa via leurs récepteurs ovariens ou indirects par inhibition de la sécrétion de gonadotrophines, l'effet de l'agent alkylant sur le développement folliculaire et la réserve ovarienne a été testé sur des follicules cultivés in vitro avec ou sans GnRHa et in vivo chez des souris déficientes en FSHb (Fshb-/-). Pour imiter la profonde inhibition de FSH observée chez la femme après traitement aux GnRHa, nous avons étudié la toxicité de la chimiothérapie chez les souris Fshb-/-. L’administration de gonadotrophines exogènes (pregnant mare serum gonadotropin, PMSG) induit une croissance folliculaire jusqu’au stade antral mais n’influence pas le nombre total de follicules au sein de l’ovaire. Le Cy induit une perte folliculaire significative dans le groupe contrôle et dans le groupe traité au PMSG. Aucune différence concernant la prolifération ni l'apoptose n'a été observée entre les groupes traités à la chimiothérapie. A ce jour, ce modèle murin représente le meilleur modèle pour étudier l'inhibition gonadotrope induite par les GnRHa observée chez la femme. Ces résultats suggèrent que la FSH n'est pas impliquée dans la protection ovarienne potentielle des GnRHa pendant la chimiothérapie. Afin d’évaluer les effets directs des GnRHa sur les follicules en croissance et quiescents, des follicules préantraux ou des ovaires de nouveau-nés (PND4) ont été cultivés avec ou sans GnRHa avant l'exposition au métabolite actif du Cy, le 4-hydroperoxycyclophosphamide (4HC). Nous avons d'abord montré que l'exposition in vitro aux GnRHa n'affectait ni la survie et le développement folliculaire, ni la maturation ovocytaire. Dans les follicules en croissance, le 4HC diminue significativement les taux de survie et de maturation; et retarde le développement folliculaire, indépendamment du traitement aux GnRHa. La chimiothérapie diminue le nombre de cellules de la granulosa par follicule tandis que la production d’adénosine monophosphate cyclique (AMPc) par million de cellules de la granulosa n'est pas modifiée, ni par le 4HC, ni par les GnRHa. La sécrétion d'oestradiol tend à être retardée dans le groupe traité à l’agoniste mais pas dans le groupe antagoniste. De même, dans les ovaires PND4, le 4HC induit une perte folliculaire importante et atteint directement les cellules de la granulosa des follicules ovariens. Aucune différence dans la distribution folliculaire, la prolifération ou l'apoptose n'a été observée entre les groupes traités avec le 4HC, peu importe la présence des GnRHa ou non. Pour conclure, en se basant sur des modèles murins robustes et originaux, notre travail remet en question l'efficacité des GnRHa pour préserver l'ovaire contre les dommages causés par la chimiothérapie que ce soit par une action directe sur l'ovaire, ou indirectement par l'absence de FSH. D'autres investigations seront nécessaires pour comprendre les mécanismes d'action potentiels des GnRHa sur l'ovaire et les voies impliquées. Des preuves expérimentales sont encore indispensables pour clore le débat sur cette option attrayante de préservation de la fertilité. / Doctorat en Sciences biomédicales et pharmaceutiques (Médecine) / info:eu-repo/semantics/nonPublished