The functional compartmentalization underlying neuronal polarity makes tightly regulated intracellular transport between the cell body, axons, and dendrites essential for proper development and homeostatic maintenance. Disruptions to neuronal trafficking are a major cause of neurodegenerative disease. Pathogenic variants in the microtubule motor protein KIF1A cause KIF1A Associated Neurological Disorder (KAND), a spectrum of rare neurodegenerative conditions. KAND is clinically and genetically heterogeneous, with a broad phenotypic spectrum and over a hundred pathogenic variants identified. KAND is poorly understood at both the clinical and molecular level, and there is currently no treatment. This work characterizes the natural history of KAND and describes a novel heuristic severity score. This severity score is then used to show how the location of pathogenic missense variants within the KIF1A motor domain correlates with disease severity, providing evidence the clinical phenotypic heterogeneity in KAND reflects and parallels the molecular phenotypes. Insights from the neuropathology of deceased KAND patients is used to focus a histopathologic assessment of the C3-Kif1aLgdg mouse model. C3-Kif1aLgdg/Lgdg mice have a cerebellar axonal torpedo phenotype, paralleling some of the pathological changes seen in the patients. Phenotypically, the C3-Kif1aLgdg mice were found to recapitulate some of the symptoms seen in patients including progressive spasticity and gait abnormalities associated with hind limb paralysis. To model the disease at a cellular level, iPSCs were derived from affected individuals and successfully used to generate neural stem cells and neurons. These patient-derived neurons were found to have increased markers of protein aggregates, a cellular phenotype that can be used to test potential treatments. Taken together, these studies provide foundational knowledge for future therapeutic development.

INTRODUÇÃO: A infecção pelo vírus C é um grande problema de saúde pública e tem se tornado a principal indicação de transplante de fígado. Com uma distribuição universal, é a segunda doença crônica viral mais frequente no mundo. No entanto, a hepatite C crônica é mais que uma doença hepática. Pacientes com infecção crônica pelo HCV podem desenvolver um grande número de manifestações extra-hepáticas independentemente da gravidade da doença hepática. Há muitas doenças reumatológicas associadas à infecção pelo HCV, incluindo artralgia, mialgia e artrite. MÉTODOS: Um estudo transversal desenvolvido entre os pacientes atendidos no Ambulatório de Hepatites da Divisão de Clínica de Moléstias Infeciosas e Parasitárias do HCFMUSP, na cidade de São Paulo, no período de 2004 a 2008, selecionou 243 pacientes que preencheram os critérios de inclusão e assinaram o termo de consentimento após esclarecimentos sobre a pesquisa. Foi realizada uma entrevista com os pacientes, em que foram coletadas informações demográficas, epidemiológicas e clinico-laboratoriais. Foram realizados exames laboratoriais, bioquímicos, hematológicos, imunológicos, PCR, HCV, RNA quantitativo e genotipagem do HCV. A avaliação das características da infecção pelo HCV (epidemiológica, histológica, virológica), associada às manifestações extra-hepáticas clínicas reumatológicas (aquelas com prevalência > 10%) e laboratoriais (com prevalência > 5%), foi realizada utilizando-se as análises univariada e multivariada (regressão logística). Odds ratios (OR) ajustados e intervalos de confiança de 95% (IC 95%) foram derivados do coeficiente do modelo logístico multivariado final. Todas as análises foram realizadas com o pacote estatístico SPSS. RESULTADOS: Dos 243 pacientes estudados, pudemos determinar a provável forma de infecção em 147 (60,49%). Dos 147 pacientes, 93 (38,27%) sofreram transfusão sanguínea prévia, 10 (4,11%) tinham histórico de uso droga injetável há mais de 1 ano, 15 (6,17%) tinham antecedente de uso do droga inalatória há mais de 1 ano, 11 (4,52%) eram profissionais da saúde com histórico de acidente com material perfuro-cortante, 10 (4,11%) realizaram tatuagem e 8 (3,29%) tinham parceiro portador de hepatite C crônica. Nessa análise, 148 (60,9%) dos pacientes com hepatite C crônica apresentaram queixa de artralgia, 145 (59,7%) apresentaram queixa de mialgia, 144 (59,3%), de cansaço. A artrite esteve presente em 50 (20,57%) dos pacientes avaliados nesse estudo. Dentre estes pacientes, o envolvimento foi predominantemente poliarticular em 36 (72%) deles, acometendo grandes e pequenas articulações, simultaneamente, em 29 (58%). Idade maior que 50 anos, dor nas costas e crepitação em articulações mostraram-se fatores associados à artrite. Observou-se que sexo feminino, tabagismo importante e fibrose hepática avançada (F3 e F4) foram fatores associados à artralgia. Sexo feminino e tabagismo importante foram fatores associados à mialgia. CONCLUSÃO: Foi encontrada elevada prevalência de manifestações musculoesqueléticas entre os pacientes portadores de hepatite C crônica deste serviço. Os fatores de risco mais frequentes para a presença das manifestações extra-hepáticas foram sexo feminino e idade maior que 50 anos. Os autoanticorpos, embora freqüentes, não mostraram significância estatística com relação às principais manifestações musculoesqueléticas analisadas. Infiltrado inflamatório hepático e nível de transaminases também não apresentaram significância estatística / INTRODUCTION: C virus infection is a major public health problem and has become the leading indication for liver transplantation. With a worldwide distribution, is the second most common chronic viral worldwide. However, chronic hepatitis C is more than a liver disease. Patients with chronic HCV infection may develop a large number of extra hepatic manifestations regardless of the severity of liver disease. There are many rheumatic diseases associated with HCV infection including arthralgia, myalgia and arthritis. METHODS: A cross-sectional study carried out among patients treated in outpatient Hepatitis Clinical Division of Infectious and Parasitic Diseases of the HC-USP, in São Paulo, in the period from 2004 to 2008, selected 243 patients who met the inclusion criteria and signed the consent form after clarification of the research. An interview was conducted with patients which were collected demographic, epidemiological and clinical-laboratory. Laboratory tests were carried, biochemical, hematological, immunological, quantitative PCR HCV RNA and HCV genotyping. The evaluation of the characteristics of HCV infection (epidemiological, histological, virological) associated with extrahepatic manifestations rheumatology clinics (those with prevalence > 10%) and laboratory (with prevalence > 5%) were performed using univariate and multivariate analysis (regression logistics). Odds ratios (OR) and adjusted confidence intervals of 95% (95% CI) were derived from the ratio of the final multivariate logistic model. All analyzes were performed with the SPSS statistical package. RESULTS: Of the 243 patients studied were able to determine the likely form of infection in 147 (60.49%). Of the 147 patients, 93 (38.27%) had previous blood transfusion, 10 (4.11%) had a history of injection drug use for more than 1 years, 15 (6.17%) had prior use of the drug is inhaled over 1 year, 11 (4.52%) were health professionals with a history of accidents with sharp objects, 10 (4.11%) underwent tattooing and 8 (3.29%) had a partner with hepatitis C chronic. In this analysis, 148 (60.9%) of patients with chronic hepatitis C complained of arthralgia, 145 (59.7%) complained of myalgia, 144 (59.3%) of fatigue. Arthritis was present in 50 (20.57%) of the patients evaluated in this study. Among patients with arthritis of this study, involvement was predominantly polyarticular in 36 (72%) of them, affecting large and small joints simultaneously in 29 (58%). Age greater than 50 years, back pain and crepitus in the joints proved to be factors associated with arthritis. We observed that female smoking important and advanced liver fibrosis (F3 and F4) were associated with arthralgia. Female gender and smoking were important factors associated with myalgia. CONCLUSION: We found a high prevalence of musculoskeletal manifestations among patients with chronic hepatitis C of this service. The most common risk factors for the presence of extra hepatic manifestations were female and older than 50 years. The autoantibodies, although frequently not statistically significant compared with the major musculoskeletal manifestations analyzed. Inflammatory infiltrate and liver transaminase levels did not show statistical significance

Wong Cheuk Ying. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 101-124). / Abstracts in English and Chinese. / Abstract --- p.i / 摘要 --- p.iv / Acknowledgement --- p.vi / List of Abbreviations --- p.vii / Chapter Chapter 1. --- General Introduction --- p.1 / Chapter Chapter 2. --- Methods --- p.4 / Chapter 2.1 --- Measurement of cAMP and cGMP in VSMCs --- p.4 / Chapter 2.1.1 --- Cell culture --- p.4 / Chapter 2.1.2 --- Enzyme-immunoassay colorimetric measurement for cAMP and cGMP --- p.5 / Chapter 2.1.3 --- Statistical analysis --- p.6 / Chapter 2.2 --- Measurement of apoptosis in VSMCs and bone marrow-derived stem cells --- p.6 / Chapter 2.2.1 --- Cell culture --- p.6 / Chapter 2.2.2 --- Hoechst33258 --- p.7 / Chapter 2.2.3 --- Cell Death ELISA plus --- p.7 / Chapter 2.2.4 --- Protein extraction and Western blot analysis of PKG expression --- p.8 / Chapter 2.2.5 --- Statistical analysis --- p.9 / Chapter 2.3 --- Measurement of cell proliferation in VSMCs and bone marrow-derived stem cells --- p.9 / Chapter 2.3.1 --- Cell culture --- p.9 / Chapter 2.3.2 --- Cell count --- p.10 / Chapter 2.3.3 --- MTT assay --- p.11 / Chapter 2.3.4 --- BrdU-(5`Bromo-2-deoxyuridine) ELISA colorimetric assay --- p.11 / Chapter 2.3.5 --- Statistical analysis --- p.12 / Chapter Chapter 3. --- Effects of hyperglycemia on CGRP-induced cAMP response in VSMCs / Chapter 3.1 --- Introduction --- p.13 / Chapter 3.2 --- Results --- p.18 / Chapter 3.3 --- Discussion --- p.22 / Chapter Chapter 4. --- Role of cGMP and protein kinase G in regulation of apoptosis in VSMCs / Chapter 4.1 --- Introduction --- p.26 / Chapter 4.2 --- Results --- p.30 / Chapter 4.3 --- Discussion --- p.44 / Chapter Chapter 5. --- Role of protein kinase G in regulation of proliferation in VSMCs / Chapter 5.1 --- Introduction --- p.55 / Chapter 5.2 --- Results --- p.58 / Chapter 5.3 --- Discussion --- p.67 / Chapter Chapter 6. --- Effects of aging and eNOS- and iNOS-gene deletion (using eNOS- and iNOS-knockout mice) on apoptosis of VSMCs / Chapter 6.1 --- Introduction --- p.73 / Chapter 6.2 --- Results --- p.76 / Chapter 6.3 --- Discussion --- p.79 / Chapter Chapter 7. --- Role of protein kinase G in regulation of apoptosis and proliferation of bone marrow stromal stem cells / Chapter 7.1 --- Introduction --- p.81 / Chapter 7.2 --- Results --- p.84 / Chapter 7.3 --- Discussion --- p.92 / Chapter Chapter 8. --- Overall discussion --- p.95 / Chapter Chapter 9. --- References --- p.101

INTRODUÇÃO: A infecção pelo vírus C é um grande problema de saúde pública e tem se tornado a principal indicação de transplante de fígado. Com uma distribuição universal, é a segunda doença crônica viral mais frequente no mundo. No entanto, a hepatite C crônica é mais que uma doença hepática. Pacientes com infecção crônica pelo HCV podem desenvolver um grande número de manifestações extra-hepáticas independentemente da gravidade da doença hepática. Há muitas doenças reumatológicas associadas à infecção pelo HCV, incluindo artralgia, mialgia e artrite. MÉTODOS: Um estudo transversal desenvolvido entre os pacientes atendidos no Ambulatório de Hepatites da Divisão de Clínica de Moléstias Infeciosas e Parasitárias do HCFMUSP, na cidade de São Paulo, no período de 2004 a 2008, selecionou 243 pacientes que preencheram os critérios de inclusão e assinaram o termo de consentimento após esclarecimentos sobre a pesquisa. Foi realizada uma entrevista com os pacientes, em que foram coletadas informações demográficas, epidemiológicas e clinico-laboratoriais. Foram realizados exames laboratoriais, bioquímicos, hematológicos, imunológicos, PCR, HCV, RNA quantitativo e genotipagem do HCV. A avaliação das características da infecção pelo HCV (epidemiológica, histológica, virológica), associada às manifestações extra-hepáticas clínicas reumatológicas (aquelas com prevalência > 10%) e laboratoriais (com prevalência > 5%), foi realizada utilizando-se as análises univariada e multivariada (regressão logística). Odds ratios (OR) ajustados e intervalos de confiança de 95% (IC 95%) foram derivados do coeficiente do modelo logístico multivariado final. Todas as análises foram realizadas com o pacote estatístico SPSS. RESULTADOS: Dos 243 pacientes estudados, pudemos determinar a provável forma de infecção em 147 (60,49%). Dos 147 pacientes, 93 (38,27%) sofreram transfusão sanguínea prévia, 10 (4,11%) tinham histórico de uso droga injetável há mais de 1 ano, 15 (6,17%) tinham antecedente de uso do droga inalatória há mais de 1 ano, 11 (4,52%) eram profissionais da saúde com histórico de acidente com material perfuro-cortante, 10 (4,11%) realizaram tatuagem e 8 (3,29%) tinham parceiro portador de hepatite C crônica. Nessa análise, 148 (60,9%) dos pacientes com hepatite C crônica apresentaram queixa de artralgia, 145 (59,7%) apresentaram queixa de mialgia, 144 (59,3%), de cansaço. A artrite esteve presente em 50 (20,57%) dos pacientes avaliados nesse estudo. Dentre estes pacientes, o envolvimento foi predominantemente poliarticular em 36 (72%) deles, acometendo grandes e pequenas articulações, simultaneamente, em 29 (58%). Idade maior que 50 anos, dor nas costas e crepitação em articulações mostraram-se fatores associados à artrite. Observou-se que sexo feminino, tabagismo importante e fibrose hepática avançada (F3 e F4) foram fatores associados à artralgia. Sexo feminino e tabagismo importante foram fatores associados à mialgia. CONCLUSÃO: Foi encontrada elevada prevalência de manifestações musculoesqueléticas entre os pacientes portadores de hepatite C crônica deste serviço. Os fatores de risco mais frequentes para a presença das manifestações extra-hepáticas foram sexo feminino e idade maior que 50 anos. Os autoanticorpos, embora freqüentes, não mostraram significância estatística com relação às principais manifestações musculoesqueléticas analisadas. Infiltrado inflamatório hepático e nível de transaminases também não apresentaram significância estatística / INTRODUCTION: C virus infection is a major public health problem and has become the leading indication for liver transplantation. With a worldwide distribution, is the second most common chronic viral worldwide. However, chronic hepatitis C is more than a liver disease. Patients with chronic HCV infection may develop a large number of extra hepatic manifestations regardless of the severity of liver disease. There are many rheumatic diseases associated with HCV infection including arthralgia, myalgia and arthritis. METHODS: A cross-sectional study carried out among patients treated in outpatient Hepatitis Clinical Division of Infectious and Parasitic Diseases of the HC-USP, in São Paulo, in the period from 2004 to 2008, selected 243 patients who met the inclusion criteria and signed the consent form after clarification of the research. An interview was conducted with patients which were collected demographic, epidemiological and clinical-laboratory. Laboratory tests were carried, biochemical, hematological, immunological, quantitative PCR HCV RNA and HCV genotyping. The evaluation of the characteristics of HCV infection (epidemiological, histological, virological) associated with extrahepatic manifestations rheumatology clinics (those with prevalence > 10%) and laboratory (with prevalence > 5%) were performed using univariate and multivariate analysis (regression logistics). Odds ratios (OR) and adjusted confidence intervals of 95% (95% CI) were derived from the ratio of the final multivariate logistic model. All analyzes were performed with the SPSS statistical package. RESULTS: Of the 243 patients studied were able to determine the likely form of infection in 147 (60.49%). Of the 147 patients, 93 (38.27%) had previous blood transfusion, 10 (4.11%) had a history of injection drug use for more than 1 years, 15 (6.17%) had prior use of the drug is inhaled over 1 year, 11 (4.52%) were health professionals with a history of accidents with sharp objects, 10 (4.11%) underwent tattooing and 8 (3.29%) had a partner with hepatitis C chronic. In this analysis, 148 (60.9%) of patients with chronic hepatitis C complained of arthralgia, 145 (59.7%) complained of myalgia, 144 (59.3%) of fatigue. Arthritis was present in 50 (20.57%) of the patients evaluated in this study. Among patients with arthritis of this study, involvement was predominantly polyarticular in 36 (72%) of them, affecting large and small joints simultaneously in 29 (58%). Age greater than 50 years, back pain and crepitus in the joints proved to be factors associated with arthritis. We observed that female smoking important and advanced liver fibrosis (F3 and F4) were associated with arthralgia. Female gender and smoking were important factors associated with myalgia. CONCLUSION: We found a high prevalence of musculoskeletal manifestations among patients with chronic hepatitis C of this service. The most common risk factors for the presence of extra hepatic manifestations were female and older than 50 years. The autoantibodies, although frequently not statistically significant compared with the major musculoskeletal manifestations analyzed. Inflammatory infiltrate and liver transaminase levels did not show statistical significance

Ng Chi Ho. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (leaves 147-160). / Abstracts in English and Chinese. / ACKNOWLEDGMENTS --- p.I / ABSTRACT --- p.II / LIST OF ABBREVIATIONS --- p.VII / TABLE OF CONTENTS --- p.IX / Chapter CHAPTER 1 --- GENERAL INTRODUCTION / Chapter 1.1 --- Introduction of Low-density lipoprotein --- p.1 / Chapter 1.1.1 --- What are lipids? --- p.1 / Chapter 1.1.2 --- Function and structure of cholesterol --- p.1 / Chapter 1.1.3 --- Function and classification of lipoprotein --- p.1 / Chapter 1.2 --- Functions of low-density lipoprotein --- p.2 / Chapter 1.3 --- Basic structure of low-density lipoprotein --- p.4 / Chapter 1.4 --- Principle on isolation and purification of low-density lipoprotein --- p.4 / Chapter 1.5 --- Cholesterol transport system --- p.7 / Chapter 1.5.1 --- Exogenous pathway of cholesterol metabolism --- p.7 / Chapter 1.5.2 --- Endogenous pathway of cholesterol metabolism --- p.7 / Chapter 1.5.3 --- Reverse transport of Cholesterol --- p.8 / Chapter 1.6 --- Oxidation of LDL --- p.10 / Chapter 1.6.1 --- Agents that causes oxidation --- p.10 / Chapter 1.6.1.1 --- Lipoxygenases --- p.10 / Chapter 1.6.1.2 --- Myeloperoxidase --- p.10 / Chapter 1.6.1.3 --- Reactive nitrogen species --- p.11 / Chapter 1.6.1.4 --- Reactive oxygen species --- p.11 / Chapter 1.6.2 --- Factors that affect the susceptibility of LDL oxidation --- p.13 / Chapter 1.7 --- Hyperlipidaemia 一 chance to increase LDL oxidation --- p.13 / Chapter 1.7.1 --- Definition of hyperlipidemia and hypercholesterolemia --- p.13 / Chapter 1.7.2 --- Risk factors of hyperlipidaemia --- p.13 / Chapter 1.7.2.1 --- High fat low fibre diets: --- p.13 / Chapter 1.7.2.2 --- Obesity --- p.14 / Chapter 1.7.2.3 --- Type II diabetes --- p.14 / Chapter 1.7.2.4 --- Genetic factors (Familial hyperlipidemias) --- p.14 / Chapter 1.8 --- Diseases related to oxidized LDL --- p.15 / Chapter 1.8.1 --- Cardiovascular diseases --- p.15 / Chapter 1.8.1.1 --- Atherosclerosis and ischemic heart attack --- p.15 / Chapter 1.8.1.2 --- Factors that affect incidence of atherosclerosis --- p.16 / Chapter 1.8.1.2.1 --- Triglyceride-rich lipoprotein --- p.16 / Chapter 1.8.1.2.2 --- Small and dense LDL --- p.16 / Chapter 1.8.1.3 --- Stroke --- p.17 / Chapter 1.8.2 --- Common ways to reduce plasma cholesterol level --- p.17 / Chapter 1.8.2.1 --- Diet control --- p.17 / Chapter 1.8.2.2 --- Physical activity --- p.17 / Chapter 1.8.2.3 --- Drug therapy --- p.18 / Chapter CHAPTER 2 --- IMPAIRMENT OF OXIDIZED LDL ON ENDOTHELIUM-DEPENDENT RELAXATION / Chapter 2.1 --- Introduction --- p.19 / Chapter 2.1.1 --- Properties and function of phenylephrine hydrochloride --- p.22 / Chapter 2.1.2 --- Properties and function of acetylcholine --- p.22 / Chapter 2.2 --- Objectives --- p.23 / Chapter 2.3 --- Materials and methods --- p.24 / Chapter 2.3.1 --- Preparation of drugs --- p.24 / Chapter 2.3.2 --- Preparation of human native LDL --- p.25 / Chapter 2.3.3 --- Preparation of oxidized LDL --- p.27 / Chapter 2.3.4 --- Preparation of aorta --- p.27 / Chapter 2.3.5 --- Measurement of Isometric Force in vitro --- p.30 / Chapter 2.3.5.1 --- Protocol 1- Dose effect of oxidized LDL on acetylcholine-induced vasorelaxation --- p.30 / Chapter 2.3.5.2 --- Protocol 2 - Time effect of oxidized LDL on acetylcholine-induced vasorelaxation --- p.30 / Chapter 2.3.5.3 --- Protocol 3 - Effect of co-incubation of LDL and copper(ll) sulphate on acetylcholine-induced vasorelaxation --- p.31 / Chapter 2.3.5.4 --- Protocol 4 - Effect of oxidized LDL on selected vasodilators --- p.32 / Chapter 2.3.5.5 --- Protocol 5 - Effect of pretreatment of L-arginine on oxidized LDL impaired -endothelium-induced relaxation --- p.32 / Chapter 2.3.5.6 --- Protocol 6 - Effect of a -tocopherol on oxidized LDL-damaged acetylcholine- induced vasorelaxation --- p.33 / Chapter 2.3.5.7 --- Protocol 7 - Effect of a -tocopherol on LDL and copper(ll) sulphate- induced endothelial dysfunction --- p.33 / Chapter 2.3.6 --- Western blot analysis of endothelial nitric oxide synthase (eNOS) protein --- p.34 / Chapter 2.3.7 --- Statistics --- p.35 / Chapter 2.4 --- Results --- p.36 / Chapter 2.4.1 --- Dose effect of oxidized LDL on acetylcholine-induced vasorelaxation --- p.36 / Chapter 2.4.2 --- Time effect of oxidized LDL on acetylcholine-induced vasorelaxation --- p.36 / Chapter 2.4.3 --- Effect of co-incubation of LDL and copper(II) sulphate on acetylcholine- induced vasorelaxation --- p.39 / Chapter 2.4.4 --- Effect of oxidized LDL on selected vasodilators --- p.41 / Chapter 2.4.5 --- Effect of pretreatment of L-arginine on oxidized LDL impaired- acetylcholine-induced relaxation --- p.41 / Chapter 2.4.6 --- Effect of a-tocopherol on oxidized LDL-damaged acetylcholine- induced vasorelaxation --- p.48 / Chapter 2.4.7 --- Effect of a-tocopherol on LDL and copper(II) sulphate-induced endothelial dysfunction --- p.50 / Chapter 2.4.8 --- eNOS Protein expression --- p.50 / Chapter 2.5 --- Discussion --- p.53 / Chapter CHAPTER 3 --- EFFECTS OF LDL INJECTION ON THE ENDOTHELIAL FUNCTION OF RATS / Chapter 3.1 --- Introduction --- p.58 / Chapter 3.2 --- Objective --- p.60 / Chapter 3.3 --- Methods and Materials --- p.61 / Chapter 3.3.1 --- Preparation of Drugs --- p.61 / Chapter 3.3.2 --- Preparation of LDL --- p.61 / Chapter 3.3.3 --- Animal Treatment --- p.61 / Chapter 3.3.4 --- Serum lipid and lipoprotein determinations --- p.62 / Chapter 3.3.5 --- Measurement of serum MDA level by TBARS assay --- p.62 / Chapter 3.3.6 --- Preparation of aorta --- p.62 / Chapter 3.3.7 --- Organ bath experiment --- p.63 / Chapter 3.3.8 --- Statistics --- p.64 / Chapter 3.4 --- Result --- p.65 / Chapter 3.4.1 --- Growth and food intake --- p.65 / Chapter 3.4.2 --- "Effect of LDL injection on serum TC, TG and HDL-C" --- p.65 / Chapter 3.4.3 --- Effect of LDL injection on non-HDL-C and ratio of non-HDL-C to HDL-C --- p.65 / Chapter 3.4.4 --- Serum MDA level --- p.68 / Chapter 3.4.5 --- Phenylephrine-induced contraction --- p.70 / Chapter 3.4.6 --- Endothelium-dependent and -independent relaxation --- p.75 / Chapter 3.5 --- Discussion --- p.79 / Chapter CHAPTER 4 --- EFFECTS OF INDIVIDUAL COMPONENT OF OXIDIZED LDL ON ENDOTHELIUM-DEPENDENT RELAXATION / Chapter 4.1 --- Introduction --- p.83 / Chapter 4.2 --- Objectives --- p.85 / Chapter 4.3 --- Materials and methods --- p.86 / Chapter 4.3.1 --- Preparation of drugs --- p.86 / Chapter 4.3.2 --- Preparation of human native LDL and oxidized LDL --- p.86 / Chapter 4.3.3 --- GC analysis of fatty acid composition in LDL --- p.86 / Chapter 4.3.4 --- TBARS assay analysis of MDA content in LDL --- p.87 / Chapter 4.3.5 --- GC analysis of cholesterol oxidation products in LDL --- p.89 / Chapter 4.3.6 --- Thin-layer chromatography analysis of LPC in LDL --- p.91 / Chapter 4.3.7 --- Preparation of aorta --- p.92 / Chapter 4.3.8 --- Measurement of Isometric Force in vitro --- p.92 / Chapter 4.3.8.1 --- Protocol 1- effect of LPC on acetylcholine-induced vasorelaxation --- p.92 / Chapter 4.3.8.2 --- Protocol 2- effect of cholesterol oxidation products on acetylcholine-induced vasorelaxation --- p.92 / Chapter 4.3.8.3 --- Protocol 3- effect of oxidized fatty acids on acetylcholine-induced vasorelaxation --- p.93 / Chapter 4.3.9 --- Statistics --- p.93 / Chapter 4.4 --- Results --- p.94 / Chapter 4.4.1 --- Compositional differences between native LDL and oxidized LDL.… --- p.94 / Chapter 4.4.2 --- Effect of LPC on endothelium-dependent relaxation --- p.98 / Chapter 4.4.3 --- Effect of COPs on endothelium-dependent relaxation --- p.98 / Chapter 4.4.4 --- Effect of oxidized fatty acids on endothelium-dependent relaxation --- p.101 / Chapter 4.5 --- Discussion --- p.103 / Chapter CHAPTER 5 --- EFFECTS OF DIETARY OXIDIZED CHOLESTEROL ON BLOOD CHOLESTEROL LEVEL IN HAMSTERS / Chapter 5.1 --- Introduction --- p.107 / Chapter 5.2 --- Objectives --- p.111 / Chapter 5.3 --- Materials and Methods --- p.112 / Chapter 5.3.1 --- Preparation of Oxidized Cholesterol --- p.112 / Chapter 5.3.2 --- Diet preparation --- p.112 / Chapter 5.3.3 --- Animals --- p.113 / Chapter 5.3.4 --- Serum lipid and lipoprotein determinations --- p.116 / Chapter 5.3.5 --- GC analysis of cholesterol and cholesterol oxidation products on organs --- p.116 / Chapter 5.3.6 --- Extraction of neutral and acidic sterols from fecal samples --- p.117 / Chapter 5.3.6.1 --- Determination of neutral sterols --- p.117 / Chapter 5.3.6.2 --- Determination of acidic sterols --- p.117 / Chapter 5.3.6.3 --- GLC analysis of neutral and acidic sterols --- p.118 / Chapter 5.3.7 --- Organ bath experiment --- p.121 / Chapter 5.3.7.1 --- Preparation of aorta --- p.121 / Chapter 5.3.7.2 --- Aortic relaxation --- p.121 / Chapter 5.3.8 --- Analysis of the total area of atherosclerotic plaque on aorta --- p.122 / Chapter 5.3.9 --- Statistics --- p.122 / Chapter 5.4 --- Results --- p.123 / Chapter 5.4.1 --- GC of oxidized cholesterol --- p.123 / Chapter 5.4.2 --- Growth and food intake --- p.123 / Chapter 5.4.3 --- "Effect of non-oxidized and oxidized cholesterol on serum TC, TG and HDL-C" --- p.123 / Chapter 5.4.4 --- Effect of non-oxidized and oxidized cholesterol on non-HDL-C and ratio of non-HDL-C to HDL-C --- p.124 / Chapter 5.4.5 --- Effect ofnon-oxidized and oxidized cholesterol on concentration of hepatic cholesterol --- p.128 / Chapter 5.4.6 --- Effect of non-oxidized and oxidized cholesterol on concentration of cholesterol oxidation products accumulated in liver --- p.128 / Chapter 5.4.7 --- Effect of non-oxidized and oxidized cholesterol on concentration of brain and aortic cholesterol --- p.128 / Chapter 5.4.8 --- Effect of non-oxidized and oxidized cholesterol on fecal neutral and acidic sterols --- p.129 / Chapter 5.4.9 --- Effect of non-oxidized and oxidized cholesterol on aortic relaxation --- p.135 / Chapter 5.4.10 --- Effect of non-oxidzied and oxidized cholesterol on area of atherosclerotic plaque --- p.137 / Chapter 5.5 --- Discussion --- p.139 / Chapter CHAPTER 6 --- CONCLUSION --- p.143 / REFERENCES --- p.146

Indiana University-Purdue University Indianapolis (IUPUI) / LIM homeodomain 3 (LHX3) is an important regulator of pituitary and nervous system development. To date, twelve LHX3 gene mutations have been identified in patients with combined pituitary hormone deficiency disease (CPHD). Understanding the molecular mechanisms governing LHX3/Lhx3 gene regulation will provide critical insights into organ development pathways and associated diseases. DNA methylation has been implicated in gene regulation in multiple physiological systems. This dissertation examines the role of DNA methylation in regulating the murine Lhx3 gene. To determine if demethylation of the Lhx3 gene promoter would induce its expression, murine pre-somatotrope pituitary cells that do not normally express Lhx3 (Pit-1/0 cells) were treated with the demethylating reagent, 5-Aza-2’-deoxycytidine. This treatment lead to activation of the Lhx3 gene and thus suggested that methylation contributes to Lhx3 gene regulation. Proteins that modify chromatin, such as histone deacetylases (HDACs) have also been shown to affect DNA methylation patterns and subsequent gene activation. Pit-1/0 pituitary cells treated with a combination of the demethylating reagent and the HDAC inhibitor, Trichostatin A led to activation of the Lhx3 gene, suggesting crosstalk between DNA methylation and histone modification processes. To assess DNA methylation levels, treated and untreated Pit-1/0 genomic DNA were subjected to bisulfite conversion and sequencing. Treated Pit-1/0 cells had decreased methylation compared to untreated cells. Chromatin immunoprecipitation assays demonstrated interactions between the methyl-binding protein, MeCP2 and the Lhx3 promoter regions in the Pit-1/0 cell line. Overall, the study demonstrates that DNA methylation patterns of the Lhx3 gene are associated with its expression status.

Indiana University-Purdue University Indianapolis (IUPUI) / The impact of tobacco smoking on human health is well documented. The influence of smoking on tooth loss and cardiovascular diseases was investigated in the current study via both epidemiology and in vitro studies. From analyzing the 2006 Behavioral Risk Factor Surveillance System (2006 BRFSS) database, we confirmed that smoking was significantly associated with the number of teeth lost in a dose-dependent manner and smoking cessation reduced the risk when compared to those subjects continuing to smoke. In addition, the virulence factors related to caries were compared between Streptococcus mutans and Streptococcus gordonii in response to cigarette smoking condensate (CSC) treatment. We observed that S. gordonii was more susceptible to CSC treatment than S. mutans. CSC significantly enhanced S. mutans sucrose-dependent and independent adherence. Western blot assays revealed that several bacterial surface proteins including glucosyltransferase (GTF), glucan-binding proteins and antigen I/II, were significantly upregulated for the treated S. mutans. These findings suggested that the oral environment with CSC may favor a cariogenic dominant composition, which may increase the risk for smokers to develop caries. We also found that smoking and oral health status modified each other and synergistically increased the risk of CVD and this joint effect was more pronounced among the youngest age group using the 2006 BRFSS database. To further understand the joint effect, we conducted an in vitro study to investigate bacterial attachment to fibronectin and endothelial cells in response to smoking condensate treatment. Our study clearly demonstrated CSC significantly enhanced S. mutans attachment to both soluble and immobilized fibronectin as well as endothelial cells. Furthermore, our data suggested that bacteria possessed several adhesins that bound to host tissues and endothelial cells also had multiple receptors for bacterial attachment. Among these adhesins, antigen I/II seemed essential for bacterial attachment to endothelial cells without CSC. The knowledge of bacterial attachment to host tissues in the presence of CSC may help in developing different preventive or therapeutic strategies against attachment and colonization of the host by S. mutans.

Diversas evidências comprovam que a obesidade está associada a alterações estruturais e funcionais do coração em modelos humanos e animais. Outros estudos recentes também demonstram que a obesidade humana está associada com alterações na função e na estrutura vascular, especialmente em grandes e médias artérias. Estudos epidemiológicos têm confirmado que a obesidade é um fator de risco significativo para o aparecimento de proteinúria e de doença renal terminal em uma população normal. Com o objetivo de determinar as alterações morfológicas relacionadas ao remodelamento cardíaco, vascular e renal em um modelo experimental de obesidade induzida pelo glutamato monossódico (MSG) e os efeitos da metformina sobre estes achados, foram estudados 25 ratos divididos em cinco grupos: controle com 16 e 22 semanas (CON-16 e CON-22); obeso com 16 e 22 semanas (MSG-16 e MSG-22) e obeso + metformina (MET-22) 300mg/Kg/dia por via oral. A caracterização da resistência à insulina foi feita através da medida da insulina plasmática e cálculo do índice de HOMA-IR. As análises morfológicas e quantificação do colágeno miocárdico foram feitos pelo sistema de imagem Image Pro Plus analysis. A pressão arterial sistólica foi levemente maior no grupo MSG-22, adquirindo significância estatística quando comparada com o grupo MSG-16 (1222 vs 1082 mmHg, p<0,05). Por outro lado, o grupo MET-22 mostrou níveis mais baixos de pressão arterial (1181 mmHg), sem alcançar diferença significativa. No grupo de animais obesos, foi observado aumento na relação média-lumen com 16 semanas (39,93,7 vs 30,22,0 %, p<0,05) e com 22 semanas (39,81,3 vs 29,51,2%, p<0,05), que foi reduzida com o uso da metformina (31,50,9%). O depósito de colágeno na área perivascular no ventrículo esquerdo foi significativamente maior no grupo MSG-22 (1,390,06 vs 0,830,06 % no CON-22, p<0,01), sendo atenuado pela metformina (1,020,04%). No rim, a área seccional transversa das arteríolas intrarrenais foi semelhante entre os grupos (18,52,2 no CON-16; 19,93,7 no MSG-16; 18,93,1 no CON-22; 21,81,5 no MSG-22; 20,21,4 no MET-22). Foi observado aumento da área glomerular no grupo MSG-22 (141,34,5 vs 129,50,5 m2), mas sem significância estatística. Em conclusão, nos ratos com obesidade induzida pelo MSG, com resistência à insulina, as alterações cardíacas foram mais proeminentes do que as alterações renais. No coração foram observados sinais de remodelamento vascular hipertrófico nas pequenas artérias intramiocárdicas e evidências de fibrose miocárdica mais proeminente na área perivascular, alterações que foram, pelo menos parcialmente, atenuadas com o uso de metformina durante seis semanas, mostrando que esta droga pode ser benéfica na prevenção de complicações cardíacas, vasculares e renais associadas com a obesidade. / Many evidences show that obesity is associated to structural and functional changes in the heart of human and animal models. Recent studies also show that human obesity is associated with vascular structural and functional modifications, specially at large and medium-sized arteries. Epidemiological studies have confirmed that obesity is a significant risk factor for the development of proteinuria and end-stage renal disease in a normal population. With the objective to determinate morphological changes related to cardiac, vascular and renal remodeling in an experimental model of monosodium glutamate (MSG)-induced obesity and the effect of metformin at this finding. Twenty five rats were studied and divided into five groups: control with 16 e 22 weeks (CON-16 and CON-22); obese with 16 and 22 weeks (MSG-16 e MSG-22), and obese + metformin (MET-22) 300mg/Kg/day per oral. The characterization of insulin resistance was done through measurement of plasma insulin and calculation of HOMA-IR index. The morphological analysis and the quantification of myocardial collagen were carried out by Image Pro Plus analysis system. The systolic blood pressure was slightly higher in MSG-22 group, reaching statistical significance when compared to MSG-16 group (1222 vs 1082 mmHg, p<0.05). On the other hand, the MET-22 group demonstrated lower blood pressure levels (1181 mmHg), without reaching statistical difference. The obese animals presented increase in media-to-lumen ratio with 16 weeks (39.93.7 vs 30.22.0 %, p<0.05) and with 22 weeks (39.81.3 vs 29.51.2%, p<0.05), which was reduced with use of metformin (31.50.9%). The collagen deposition in perivascular area of left ventricle was significantly greater in MSG-22 group (1.390.06 vs 0.830.06 % in CON-22, p<0.01), and attenuated by metformin (1.020.04%). In the kidney, the media cross-sectional area of intrarenal arterioles was similar among the groups (18.52.2 in CON-16; 19.93.7 in MSG-16; 18.93.1 in CON-22; 21.81.5 in MSG-22; 20.21.4 in MET-22). An increase of glomerular area was observed in MSG-22 group (141.34.5 vs 129.50.5 m2), but without statistical significance. In conclusion, rats with MSG-induced obesity and insulin resistance presented more pronounced cardiac changes than renal alterations. In the heart, there were evidences of hypertrophic vascular remodeling were observed in intramyocardial small arteries and perivascular fibrosis. These findings were, at least partially, attenuated by metformin for six weeks, suggesting that this drug may be beneficial for prevention of cardiac, vascular and renal complications associated with obesity.

Diversas evidências comprovam que a obesidade está associada a alterações estruturais e funcionais do coração em modelos humanos e animais. Outros estudos recentes também demonstram que a obesidade humana está associada com alterações na função e na estrutura vascular, especialmente em grandes e médias artérias. Estudos epidemiológicos têm confirmado que a obesidade é um fator de risco significativo para o aparecimento de proteinúria e de doença renal terminal em uma população normal. Com o objetivo de determinar as alterações morfológicas relacionadas ao remodelamento cardíaco, vascular e renal em um modelo experimental de obesidade induzida pelo glutamato monossódico (MSG) e os efeitos da metformina sobre estes achados, foram estudados 25 ratos divididos em cinco grupos: controle com 16 e 22 semanas (CON-16 e CON-22); obeso com 16 e 22 semanas (MSG-16 e MSG-22) e obeso + metformina (MET-22) 300mg/Kg/dia por via oral. A caracterização da resistência à insulina foi feita através da medida da insulina plasmática e cálculo do índice de HOMA-IR. As análises morfológicas e quantificação do colágeno miocárdico foram feitos pelo sistema de imagem Image Pro Plus analysis. A pressão arterial sistólica foi levemente maior no grupo MSG-22, adquirindo significância estatística quando comparada com o grupo MSG-16 (1222 vs 1082 mmHg, p<0,05). Por outro lado, o grupo MET-22 mostrou níveis mais baixos de pressão arterial (1181 mmHg), sem alcançar diferença significativa. No grupo de animais obesos, foi observado aumento na relação média-lumen com 16 semanas (39,93,7 vs 30,22,0 %, p<0,05) e com 22 semanas (39,81,3 vs 29,51,2%, p<0,05), que foi reduzida com o uso da metformina (31,50,9%). O depósito de colágeno na área perivascular no ventrículo esquerdo foi significativamente maior no grupo MSG-22 (1,390,06 vs 0,830,06 % no CON-22, p<0,01), sendo atenuado pela metformina (1,020,04%). No rim, a área seccional transversa das arteríolas intrarrenais foi semelhante entre os grupos (18,52,2 no CON-16; 19,93,7 no MSG-16; 18,93,1 no CON-22; 21,81,5 no MSG-22; 20,21,4 no MET-22). Foi observado aumento da área glomerular no grupo MSG-22 (141,34,5 vs 129,50,5 m2), mas sem significância estatística. Em conclusão, nos ratos com obesidade induzida pelo MSG, com resistência à insulina, as alterações cardíacas foram mais proeminentes do que as alterações renais. No coração foram observados sinais de remodelamento vascular hipertrófico nas pequenas artérias intramiocárdicas e evidências de fibrose miocárdica mais proeminente na área perivascular, alterações que foram, pelo menos parcialmente, atenuadas com o uso de metformina durante seis semanas, mostrando que esta droga pode ser benéfica na prevenção de complicações cardíacas, vasculares e renais associadas com a obesidade. / Many evidences show that obesity is associated to structural and functional changes in the heart of human and animal models. Recent studies also show that human obesity is associated with vascular structural and functional modifications, specially at large and medium-sized arteries. Epidemiological studies have confirmed that obesity is a significant risk factor for the development of proteinuria and end-stage renal disease in a normal population. With the objective to determinate morphological changes related to cardiac, vascular and renal remodeling in an experimental model of monosodium glutamate (MSG)-induced obesity and the effect of metformin at this finding. Twenty five rats were studied and divided into five groups: control with 16 e 22 weeks (CON-16 and CON-22); obese with 16 and 22 weeks (MSG-16 e MSG-22), and obese + metformin (MET-22) 300mg/Kg/day per oral. The characterization of insulin resistance was done through measurement of plasma insulin and calculation of HOMA-IR index. The morphological analysis and the quantification of myocardial collagen were carried out by Image Pro Plus analysis system. The systolic blood pressure was slightly higher in MSG-22 group, reaching statistical significance when compared to MSG-16 group (1222 vs 1082 mmHg, p<0.05). On the other hand, the MET-22 group demonstrated lower blood pressure levels (1181 mmHg), without reaching statistical difference. The obese animals presented increase in media-to-lumen ratio with 16 weeks (39.93.7 vs 30.22.0 %, p<0.05) and with 22 weeks (39.81.3 vs 29.51.2%, p<0.05), which was reduced with use of metformin (31.50.9%). The collagen deposition in perivascular area of left ventricle was significantly greater in MSG-22 group (1.390.06 vs 0.830.06 % in CON-22, p<0.01), and attenuated by metformin (1.020.04%). In the kidney, the media cross-sectional area of intrarenal arterioles was similar among the groups (18.52.2 in CON-16; 19.93.7 in MSG-16; 18.93.1 in CON-22; 21.81.5 in MSG-22; 20.21.4 in MET-22). An increase of glomerular area was observed in MSG-22 group (141.34.5 vs 129.50.5 m2), but without statistical significance. In conclusion, rats with MSG-induced obesity and insulin resistance presented more pronounced cardiac changes than renal alterations. In the heart, there were evidences of hypertrophic vascular remodeling were observed in intramyocardial small arteries and perivascular fibrosis. These findings were, at least partially, attenuated by metformin for six weeks, suggesting that this drug may be beneficial for prevention of cardiac, vascular and renal complications associated with obesity.

Indiana University-Purdue University Indianapolis (IUPUI) / Epidemiological studies suggest that depression may be an independent risk factor for cardiovascular disease (CVD). Although several possible mediators of this association have been proposed, the precise mechanisms are yet unknown. Accordingly, we examined periodontal disease as a novel mediator of the depression-CVD association, given its separate links with both depression and CVD. Data from the National Health and Nutrition Examination Survey (NHANES) I and its Epidemiologic Follow-up Study (NHEFS) were analyzed. Participants were 3,346 individuals aged 25-74 years free of CVD at baseline (53% female, 16% non-white). Depression was assessed by the, depressed mood subscale of the General Well-Being Schedule Based on the Russell Periodontal Index, periodontal disease (43%) was defined as the presence of four or more periodontal pockets identified by a licensed dentist during an examination. The primary outcome was incident CVD (n=727, 22%), defined as nonfatal or fatal coronary artery disease or cerebrovascular disease, identified during the follow-up period by interviews and death certificate records. All analyses were adjusted for demographic and cardiovascular risk factors. Logistic regression analyses revealed no association between the GWBS depressed mood score and periodontal disease (OR=1.05, 95% CI: 0.96-1.14, p=.24). Cox proportional hazard models revealed that both periodontal disease (HR=1.24, 95% CI: 1.06-1.46, p=.009) and depressed mood (HR=1.08, 95% CI: 1.01-1.17, p=.03) were significant predictors of incident CVD. However, Sobel analyses found that periodontal disease was not a partial mediator of the depressed mood-incident CVD association (t=1.01, p=.31). Overall, these mediation results suggest that (a) both periodontal disease and depressed mood are independent predictors of incident CVD and that (b) the effect of depressive symptoms on incident CVD is not mediated by periodontal disease.