Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Diabetes mellitus (DM) is a disorder of the metabolism of carbohydrates, lipids and proteins characterized by hyperglycemia, which in type 2 diabetes (T2DM) involves the production deficiency and / or insulin action. Diabetic subjects exhibit high levels of oxidative stress due to chronic and persistent hyperglycemia, which impairs the activity of the antioxidant defense system and promotes the generation of free radicals. This level of oxidative stress can cause renal, neurological, ocular and cardiovascular complications, such as systemic arterial hypertension (HAS). The enzyme δ-aminolevulinate dehydratase (δ-ALA-D) is a sulfhydryl enzyme, which participates in the synthesis of pyrrole compounds and has been linked to several diseases, including DM. The aim of this study was to evaluate the oxidative status of patients with DM2 and its relationship with the activity of the enzyme δ-ALA-D, lipid profile, body fat distribution besides the role of hypertension in the parameters analyzed. The results showed a decreased activity of the enzyme δ-ALA-D as well as an increase in its reactivation index in patients (n = 63) compared to controls (n = 63). It was also observed, in the T2DM group, an increased level of thiobarbituric acid reactive species (TBARS) and a smaller amount of antioxidants as vitamin C plasma protein thiol groups (P-SH) in plasma and nonprotein (NP-SH) in erythrocytes, as well as a reduction in activity of the enzyme catalase in erythrocytes. Patients who had DM2 plus hypertension (n = 30) showed a more pronounced decrease in the activity of δ-ALA-D than patients with type 2 diabetes only (n = 23) compared to healthy subjects (n = 30), along with an increased rate of reactivation. Also, patients DM2/HAS showed a greater depletion of NP-SH. Correlations among activity of δ-ALA-D and its reactivation index with oxidative stress markers, such as NP-SH and carbonyl groups, as well as lipid profile of patients were also observed. Further, correlations were found between the level of TBARS and triglycerides, as well as between vitamin C, plasma glucose and HbA1c as well as P-SH and body mass index. Therefore, patients with DM2 have changes in lipid profile and body fat distribution, and a situation of oxidative stress that can lead to changes in key molecules as the enzyme δ-ALA-D. This enzyme was effective in reflecting the level of oxidative stress of patients can be considered an interesting biomarker for assessment of damage in chronic metabolic processes such as DM. Furthermore, hypertension appears to be a synergistic factor to the metabolic condition of patients with type 2 diabetes, contributing to the development of its complications. / O Diabetes mellitus (DM) é uma desordem do metabolismo de carboidratos, lipídeos e proteínas caracterizado pela hiperglicemia, que no tipo 2 da doença (DM2) envolve a deficiência da produção e/ou ação da insulina. Indivíduos diabéticos exibem alto nível de estresse oxidativo devido à hiperglicemia crônica e persistente, que prejudica a atividade do sistema de defesa antioxidante e promove a geração de radicais livres. Esse nível de estresse oxidativo pode acarretar complicações renais, neurológicas, oculares e cardiovasculares, como a hipertensão arterial sistêmica (HAS). A enzima δ-Aminolevulinato desidratase (δ-ALA-D) é uma enzima sulfidrílica, que participa da síntese de compostos pirrólicos e vem sendo relacionada a diversas patologias, inclusive o DM. O objetivo deste estudo foi avaliar o status oxidativo de pacientes portadores de DM2 e sua relação com a atividade da enzima δ-ALA-D, perfil lipídico, distribuição de gordura corporal assim como o papel da HAS nos parâmetros analisados. Os resultados demonstraram uma diminuição da atividade da enzima δ-ALA-D assim como um aumento de seu índice de reativação nos pacientes (n=63) em relação aos controles (n=63). Observou-se também, no grupo DM2, um aumentado índice de espécies reativas ao ácido tiobarbitúrico (TBARS) e uma menor quantidade de antioxidantes como vitamina C plasmática, grupamentos tióis protéicos (PSH) em plasma e não protéicos (NP-SH) em eritrócitos, assim como uma redução na atividade da enzima catalase em eritrócitos. Os pacientes que além de DM2 apresentavam HAS (n=30) demonstraram uma diminuição mais pronunciada na atividade da δ-ALA-D do que os pacientes somente com DM2 (n=23) em relação a indivíduos saudáveis (n=30), juntamente com um aumentado índice de reativação. Também, os pacientes DM2/HAS apresentaram uma maior depleção de NP-SH. Correlações entre atividade da δ-ALA-D e seu índice de reativação com marcadores de estresse oxidativo, como NP-SH e grupamentos carbonílicos, bem como com o perfil lipídico dos pacientes também foram observadas. Ainda foram encontradas correlações entre o nível de TBARS e triglicerídeos, bem como entre vitamina C, glicose plasmática e HbA1c além de P-SH e índice de massa corporal. Portanto, os pacientes com DM2 apresentam alterações no perfil lipídico e na distribuição de gordura corporal, além de uma situação de estresse oxidativo que pode levar a alterações de moléculas importantes como a enzima δ-ALA-D. Tal enzima se mostrou efetiva em refletir o nível de estresse oxidativo dos pacientes podendo ser considerada um interessante biomarcador para avaliação de danos em processos metabólicos crônicos como o DM. Ainda a HAS parece ser um fator sinérgico à condição metabólica do paciente com DM2 podendo contribuir para o desenvolvimento de suas complicações.

ABSTRACT The porphyrias are a diverse group of metabolic disorders arising from diminished activity of enzymes in the heme biosynthetic pathway. They can present with acute neurovisceral symptoms, cutaneous symptoms, or both. The complexity of these disorders is demonstrated by the fact that some acute porphyria patients with the underlying genetic defect(s) are latent and asymptomatic while others present with severe symptoms. This indicates that there is at least one other risk factor required in addition to the genetic defect for symptom manifestation. A systematic review of the heme biosynthetic pathway highlighted the involvement of a number of micronutrient cofactors. An exhaustive review of the medical literature uncovered numerous reports of micronutrient deficiencies in the porphyrias as well as successful case reports of treatments with micronutrients. Many micronutrient deficiencies present with symptoms similar to those in porphyria, in particular vitamin B6. It is hypothesized that a vitamin B6 deficiency and related micronutrient deficiencies may play a major role in the pathogenesis of the acute porphyrias. In order to further investigate the porphyrias, a computational model of the heme biosynthetic pathway was developed based on kinetic parameters derived from a careful analysis of the literature. This model demonstrated aspects of normal heme biosynthesis and illustrated some of the disordered biochemistry of acute intermittent porphyria (AIP). The testing of this model highlighted the modifications necessary to develop a more comprehensive model with the potential to investigated hypotheses of the disordered biochemistry of the porphyrias as well as the discovery of new methods of treatment and symptom control. It is concluded that vitamin B6 deficiency might be the risk factor necessary in conjunction with the genetic defect to trigger porphyria symptoms.

Les poly(ADP-ribose) polymérases (PARP) sont des enzymes qui modifient les protéines ou l’ADN par ADP-ribosylation à l’aide du nicotinamide adénine dinucléotide (NAD+). Tankyrase est une PARP qui régule divers processus cellulaires, tels que la maintenance des télomères, la signalisation Wnt et le traitement de l’ARN. Elle est constituée de groupes de répétitions d’ankyrine (ARC) N-terminaux qui se lient aux protéines substrats, d’un domaine de motif α stérile intermédiaire qui médie la polymérisation avec d’autres molécules de tankyrase et d’un domaine catalytique C-terminal. Étant donné que l’activité de la tankyrase favorise la signalisation pro-oncogène Wnt/β-caténine, des inhibiteurs sous forme de petites molécules ont été développés pour cibler son domaine catalytique et se sont révélés prometteurs pour le traitement du cancer colorectal. Certaines protéines se lient à la tankyrase, mais plutôt que d’être ciblées pour l’ADP-ribosylation, elles inhibent son activité catalytique. Ces partenaires de liaison comprennent la GDP-mannose 4,6-déshydratase (GMD) et le gène 4 associé à la prostate (PAGE4). Il est important de noter que la structure de l’enzyme tankyrase complète n’a pas encore été déterminée, et on ignore actuellement pourquoi certaines protéines qui se lient à la tankyrase sont modifiées par l’ADP-ribose, tandis que d’autres restent inchangées et inhibent plutôt son activité catalytique. Comprendre ce mécanisme d’inhibition par analyse structurale pourrait fournir de nouvelles voies thérapeutiques bloquant la signalisation Wnt/β-caténine en ciblant le domaine N-terminal de la tankyrase. Notre objectif était d’utiliser la microscopie à coloration négative et la cryomicroscopie électronique pour déterminer les structures de la tankyrase seule et en complexe avec GMD et PAGE4. Nous avons observé que la tankyrase 1 s’assemble en double hélice lors de la polymérisation, créant des contacts interdomaines susceptibles de faciliter ses rôles catalytiques et d’échafaudage dans la signalisation cellulaire. De plus, GMD compactée et ARC1–5 de la tankyrase 1 se lient dans un rapport molaire 1:1 pour former un complexe bilobé, ce qui aide à expliquer pourquoi la GMD reste inchangée. Ces connaissances permettront le développement d’interventions cliniques plus efficaces ciblant les ARC N-terminaux ainsi que les contacts interdomaines de la tankyrase humaine. / Poly(ADP-ribose) polymerases (PARPs) are enzymes that modify proteins or DNA by ADP-ribosylation using nicotinamide adenine dinucleotide (NAD+). Tankyrase is a PARP that regulates diverse cellular processes, such as telomere maintenance, Wnt signaling, and RNA processing. It is made up of N-terminal ankyrin repeat clusters (ARCs) that bind substrate proteins, a middle sterile α motif domain that mediates polymerization with other tankyrase molecules, and a C-terminal catalytic domain. Due to the fact that tankyrase activity promotes pro-oncogenic Wnt/β-catenin signaling, small molecule inhibitors have been developed that target its catalytic domain and have shown promise for the treatment of colorectal cancer. Certain proteins bind tankyrase, but rather than being targeted for ADP-ribosylation, they inhibit its catalytic activity. These binding partners include GDP-mannose 4,6-dehydratase (GMD) and prostate-associated gene 4 (PAGE4). Importantly, the structure of the full-length tankyrase enzyme has yet to be determined, and it is currently unknown why some proteins that bind to tankyrase are modified with ADP-ribose, while others remain unmodified and instead inhibit its catalytic activity. Understanding this mechanism of inhibition by structural analysis could provide new therapeutic avenues that oppose Wnt/β-catenin signaling by targeting the N-terminal domain of tankyrase. We aimed to use negative stain and cryo-electron microscopy to determine the structures of tankyrase alone and in complex with GMD and PAGE4. We observed that tankyrase 1 assembles as a double helix upon polymerization, creating interdomain contacts that may facilitate its catalytic and scaffolding roles in cellular signaling. Moreover, compacted GMD and ARC1–5 of tankyrase 1 bind in a 1:1 molar ratio to form a bilobal complex, which aids in explaining why GMD remains unmodified. These insights will allow for the development of more effective clinical interventions targeting the N-terminal ARCs as well as interdomain contacts of human tankyrase.