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<p>Endotelin-1 je najpotentniji vazokontstriktorni peptid koji značajno doprinosi funkcionalnim i strukturnim bubrežnim promenama i poslednjih godina se izdvojio kao značajan faktor u razvoju i progresiji dijabetesne nefropatije. Cilj ovog istraživanja bio je odrediti nivo plazmatskog endotelina-1 kod bolesnika sa tipom 2 &scaron;ećerne bolesti u odnosu na zdravu populaciju kao i ispitati odnos plazmatskog endotelina-1 i funkcionog statusa bubrega kod bolesnika sa &scaron;ećernom bolesti tip 2 i dijabetesnom nefropatijom. U istraživanje je uključeno sto dvadeset ispitanika sa tipom 2 dijabetesa i sekundarno inzulin zavisni, koji&nbsp; su podeljeni u dve grupe u odnosu na izmerenu jačinu glomerulske filtracije: Grupa I (n=60) ispitanici sa jačinom glomerulske filtracije većom od 60 ml/min/1.73m2 i grupa II (n=60) ispitanici sa jačinom glomerulske filtracije manjom od 60 ml/min/1.73m2. Kod svih ispitanika izmerena je plazmatska vrednost endotelina-1 i izvr&scaron;ena procena funkcionog statusa bubrega merenjem jačine glomerulske filtracije, efektivnog bubrežnog protoka plazme i ostalih parametara bubrežne funkcije: serumske koncentracije cistatina C, uree, kreatinina, mokraćne kiseline kao i određivanje 24h albuminurije i proteinurije. Dobijeni rezultati upoređivani su sa rezultatima kontrolne grupe ispitanika (n= 30). Postoji statistički značajna razlika u medijanama vrednosti endotelina-1 između ispitivanih grupa (p&lt;0.001). Značajno niže vrednosti plazmatske koncentracije endotelina-1 su imali ispitanici kontrolne grupe (0.80 &plusmn;0.3) u odnosu na ispitanike sa &scaron;ećernom bolesti i JGF&gt;60 ml/min (1.4&plusmn;0.4) kao i u odnosu na dijabetesne bolesnike sa JGF&lt;60ml/min (2.5 &plusmn;0.8). Značajno vi&scaron;e vrednosti endotelina-1 su&nbsp; imali bolesnici sa &scaron;ećernom bolesti i većim stepenom redukcije jačine glomerulske filtracije u odnosu na bolesnike sa manjim stepenom redukcije jačine glomerulske filtracije (p&lt;0.001). U grupi bolesnika sa tipom 2 &scaron;ećerne bolesti postoji statistički značajna inverzna korelacija između plazmatskog nivoa endotelina-1 i izmerene vrednosti jačine glomerulske filtracije i efektivnog bubrežnog protoka plazme (r= -0,75; p=0,000; r= -0,74; p=0,000) odnosno bolesnici sa &scaron;ećernom bolesti kod kojih postoje povi&scaron;ene vrednosti plazmatskog endotelina-1 imaju veći stepen redukcije jačine glomerulske filtracije i efektivnog bubrežnog protoka plazme. Kod bolesnika sa tipom 2 dijabetes melitusa i različitim stepenom bubrežne hipofunkcije endotelin-1 u značajnoj meri utiče na vrednosti jačine glomerulske filtracije i efektivnog bubrežnog protoka plazme ali i druge funkcijske parametre bubrega i samim tim može imati važnu ulogu u nastanku i razvoju dijabetesne nefropatije.</p> / <p>Endothelin-1, potent vasoconstrictor peptide may contribute to the functional and structural renal changes and in recent years emerged as a significant factor in the development&nbsp; and progression of diabetic nephropathy. The aim of&nbsp; this study was to determine the level of plasma endothelin-1 levels in patients with type 2 diabetes and compared to healthy&nbsp; population as well as to examine the relationship of plasma endothelin-1 and the functional status of the kidneys in patients with type 2 diabetes. The study included one hundred&nbsp; and&nbsp; twenty patients&nbsp; with type 2 diabetes and insulin-dependent secondary, which are divided into two groups with respect to the measured GFR: Group I (n = 60) subjects with by glomerular filtration rate greater than 60 ml /min/1.73m2 and group II (n&nbsp; =&nbsp; 60) subjects with by glomerular filtration rate of less than 60ml/min/1.73m2 . Plasma levels of endothelin-1, glomerular filtration rate and effective renal plasma flow were determined using appropriate methods in all subjects. Other renal function parameters such as serum&nbsp; concentrations of cystatin C, urea, creatinine, uric acid, 24h albuminuria and proteinuria were measured additionaly. The results were compared with control groups of subjects (n= 30). There was a statistically significant difference in median values of endothelin-1 between the groups (p&lt;0.001). Significantly lower plasma concentrations of endothelin-1 had control subjects (0.80&nbsp; &plusmn;&nbsp; 0.3) compared to subjects with diabetes and GFR&gt;60 ml/min (1.4 &plusmn; 0.4) and in relation to diabetic patients with GFR &lt;60 ml/min (2.5 &plusmn; 0.8). Significantly higher values of endothelin-1 had patients with diabetes and a higher degree of reduction of glomerular filtration rate compared with patients with a lower degree of&nbsp; reduction of glomerular filtration rate (p &lt;0.001). In the group of patients with type 2 diabetes, there was a statistically significant inverse correlation between plasma levels endothelin-1 and the measured values of glomerular filtration rate and effective renal plasma flow (r= -0.75; p=0.000; r= -0.74; p=0.000) and patients with diabetes who have the higher values of&nbsp; plasma endothelin-1 have a higher degree of reduction of glomerular filtration rate and effective renal plasma flow. In patients with type 2 diabetes mellitus and various degrees of renal hypofunction endothelin-1 significantly affects the value of the glomerular filtration rate and effective renal plasma flow or other parameters of renal function and thus can play an important role in thedevelopment of diabetic nephropathy.</p>

LIMA, V.V. Papel da O-glicosilação com N-acetil-glucosamina (O-GlcNAc) nas alterações vasculares associadas a altos níveis de endotelina-1. 2012. 106 f. Tese (Doutorado) - Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo, Ribeirão Preto, 2012. A O-Glicosilação com N-acetilglucosamina (O-GlcNAc) é uma modificação pós-traducional altamente dinâmica que modula diversas vias de sinalização. O processo de O-GlcNAc é controlado por duas enzimas: UDP-NAc transferase (OGT) e O-GlcNAcase (OGA). A enzima OGT catalisa a adição de N-acetil-glucosamina no grupo hidroxila dos resíduos de serina ou treonina das proteínas alvo. Por outro lado, a OGA catalisa a remoção hidrolítica de O-GlcNAc das proteínas modificadas. Proteínas com importante papel na função vascular são alvos da O-GlcNAc, e recentemente demonstramos que a expressão de proteínas modificadas com O-GlcNAc está aumentada em artérias de ratos com hipertensão DOCA-sal. Considerando que a produção de endotelina-1 (ET-1) encontra-se aumentada na vasculatura de diferentes modelos de hipertensão sensível ao sal, nós investigamos a hipótese de que o aumento da resposta vascular contrátil induzida pela ET-1 é decorrente da hiperativação da via RhoA/Rho cinase, mediada pelo aumento dos níveis de proteínas O-GlcNAc. Durante a realização de nossos experimentos, demonstramos que a exposição de aortas ou células do músculo liso vascular (CMLV) à ET-1 (0,1 mol/L) aumenta a vasoconstrição para fenilefrina (PE) e serotonina, bem como os níveis de proteínas O-GlcNAc, além de modular a expressão das enzimas OGT e OGA. A infusão de ET-1 (2 pmol/Kg/min) por 14 dias também promoveu aumento dos níveis vasculares de proteínas O-GlcNAc e da resposta contrátil da aorta à PE. O tratamento de aortas ou CMLV com ST045849 (inibidor da OGT, 100 µMol/L) ou atrasentan (antagonista do receptor ETA, 1 mol/L), preveniu o aumento dos níveis de proteínas O-GlcNAc induzido pela ET-1. Além disso, o tratamento com atrasentan por cinco semanas (atrasentan - 5 mg/kg/dia, por via oral) normalizou os níveis vasculares de proteínas O-GlcNAc em ratos DOCA-sal e também diminuiu a resposta contrátil da aorta à PE. A transfecção de CMLV com siRNA para OGT aboliu o efeito da ET-1 sobre os níveis de proteínas O-GlcNAc. Considerando que o aumento nas contrações da aorta à PE, após o tratamento com PUGNAc (inibidor seletivo da OGA) ou ET-1, foi abolido pelo inibidor de Rho cinase (Y-27632, 1 mol/L) e que a ET-1 ativa a via de sinalização da RhoA/Rho cinase, decidimos investigar se aumento dos níveis de proteínas O-GlcNAc ativa/modula a via RhoA/Rho cinase. A incubação de CMLV com ET-1 não mudou a expressão protéica das formas totais de ROCK-, ROCK-, CPI-17, MYPT-1 ou MLC, porém aumentou a expressão das formas fosforiladas da MYPT-1 (Tre853), CPI-17 (Tre38) e MLC (Tre18/Ser19). Estes efeitos não foram observados quando CMLV foram tratadas com ST045849, atrasentan ou previamente transfectadas com o siRNA para OGT. Também observamos que a ET-1 aumentou a atividade e a expressão protéica da RhoA, assim como a expressão da PDZ-Rho GEF e p115-Rho GEF. Este efeito foi abolido, quando CMLV foram previamente transfectadas com siRNA para OGT, incubadas com o inibidor da OGT ou tratadas com o antagonista de receptores ETA. Em conclusão, nossos dados fornecem evidências de que a ET-1 aumenta os níveis vasculares de proteínas O-GlcNAc, resultando na ativação da via RhoA/Rho cinase e no aumento da reatividade vascular. É possível que o aumento de proteínas O-GlcNAc, induzido pela ET-1, possa representar um novo mecanismo para a disfunção vascular induzida por este potente peptídeo. / LIMA, V.V. O-GlcNAcylation contributes to the vascular effects of ET-1 via activation of RhoA/Rho-kinase pathway. 2012. 106 f. Ph.D. Thesis - Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo, Ribeirão Preto, 2012. Glycosylation with O-linked -N-acetylglucosamine (O-GlcNAc) is a highly dynamic post-translational modification that plays a key role in signal transduction pathways. The cycling of O-GlcNAc is controlled by two enzymes: UDP-NAc transferase (OGT) and O-GlcNAcase (OGA). Whereas OGT catalyses the addition of O-GlcNAc to the hydroxyl group of serine and threonine residues of a target protein, OGA catalyses the hydrolytic cleavage of O-GlcNAc from post-translationally-modified target. Proteins with an important role in vascular function are targets for O-GlcNAcylation and we have recently shown that the vascular content of O-GlcNAc-proteins is augmented in arteries from DOCA-salt rats. Since endothelin-1 (ET-1) production is increased in the vasculature of salt-sensitive forms of hypertension, we tested the hypothesis that O-GlcNAc contributes to the vascular effects of ET-1, via activation of the RhoA/Rho-kinase pathway. Incubation of rat aortas or vascular smooth muscle cells (VSMCs) with ET-1 (0,1 mol/L) produced a time-dependent increase in O-GlcNAc levels, decreased expression of O-GlcNAc transferase (OGT) and -N-acetylglucosaminidase (OGA), key enzymes in the O-GlcNAcylation process. Overnight treatment of aortas with ET-1 increased phenylephrine (PE) vasoconstriction. ET-1 effects were not observed when vessels were previously instilled with anti-OGT antibody or after incubation with an OGT inhibitor (ST045849, 100 mol/L). Aortas from DOCA-salt rats, which exhibit increased pre-pro-ET-1 expression, displayed increased contractions to PE and augmented levels of O-GlcNAc proteins. Treatment of DOCA-salt rats with atrasentan (ETA antagonist) abrogated augmented vascular levels of O-GlcNAc and prevented increased PE vasoconstriction. Aortas from rats chronically infused with low rate of ET-1 (2 pmol/Kg/min, 14days) exhibited increased O-GlcNAc-proteins and enhanced PE responses. These changes are similar to those induced by PUGNAc (OGA inhibitor which increases O-GlcNAc levels). ET-1 as well as PUGNAc augmented contractions to PE in endothelium-denuded rat aortas, an effect that was abolished by the Rho kinase inhibitor Y-27632 (1 mol/L). Incubation of VSMCs with ET-1 did not change expression of ROCK-, ROCK-, CPI-17, MYPT-1 or MLC, but increased phosphorylation levels of MYPT-1 (Thr853), CPI-17 (Thr38) and MLC (Thr18/Ser19). The effects of ET-1 on MYPT-1, CPI-17 and MLC phosphorylation were prevented by the OGT inhibitor and OGT siRNA transfection, as well as by atrasentan. ET-1 increased RhoA expression and activity in VSMCs, and this effect was abolished by OGT siRNA transfection and OGT inhibition. ET-1 also augmented expression of PDZ-Rho GEF and p115-Rho GEF in VSMCs and this was prevented by OGT siRNA, OGT inhibition (ST045849) and ETA receptor blockade (atrasentan, 1 mol/L). In conclusion, our data strongly suggest that ET-1 augments O-GlcNAc levels and this modification contributes to increase vascular contractile responses, via activation of the RhoA/Rho-kinase pathway. We speculate that the modulatory effect of ET-1 on O-GlcNAcylation may represent a novel mechanism underlying the vascular effects of the peptide.

Nous montrons pour la première fois qu’en plus de la MAPK ERK1/2, l’endothéline-1 (ET-1) via les récepteurs ETA et ETB active une autre MAP kinase : la p38 uniquement dans les cellules de léiomyomes utérins de rate (ELT3) mais pas dans les cellules myométriales saines. Dans les cellules ELT3, l’analyse des voies de signalisation montre que malgré les similitudes observées entre les modes d’activation des voies p38 et ERK1/2 par ET-1, celles-ci sont activées de façon indépendante l’une de l’autre. En plus, la forskoline active p38 (mais pas ERK1/2), par contre l’activation de p38 par ET-1 n’implique pas une production d’AMPc. Par ailleurs ERK1/2 et p38 coactivées par ET-1 coopèrent pour augmenter l’expression de COX2 et la production des prostaglandines E2 (PGE2) pour favoriser l’effet antiapoptotique de ET-1. De plus p38 activée par ET-1 contribue à la prolifération des léiomyomes. Nos résultats élucident les mécanismes par lesquels ET-1 contribue à la croissance des léiomyomes. / We demonstrated for the first time, that in addition to the MAPK ERK1/2, Endothelin-1 (ET-1) through ETA and ETB receptors activated another MAP kinase: p38 only in uterine leiomyoma cells (ELT3) but not in normal myometrial cells. In ELT3 cells, analysis of signaling pathways showed that, despite the similarities between the mechanisms involved in the activation of p38 and ERK1/2 pathways by ET-1, these kinases are activated independently one of another. In addition, forskolin (a cAMP inducer), activated p38 (but not ERK1/2), whereas the activation of p38 by ET-1 did not involve production cAMP. Moreover the coactivated ERK1/2 and p38 pathways by ET-1 cooperated to increase expression of COX2 and prostaglandin E2 (PGE2) production. This PGE2 like ET-1 exerted an antiapoptotic effect in ELT3 cells. Furthermore, p38 activated by ET-1 contributes to the proliferation of ELT3 leiomyoma cells. Our data highlight the mechanisms by which ET-1 could promote uterine leiomyoma growth.

LIMA, V.V. Papel da O-glicosilação com N-acetil-glucosamina (O-GlcNAc) nas alterações vasculares associadas a altos níveis de endotelina-1. 2012. 106 f. Tese (Doutorado) - Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo, Ribeirão Preto, 2012. A O-Glicosilação com N-acetilglucosamina (O-GlcNAc) é uma modificação pós-traducional altamente dinâmica que modula diversas vias de sinalização. O processo de O-GlcNAc é controlado por duas enzimas: UDP-NAc transferase (OGT) e O-GlcNAcase (OGA). A enzima OGT catalisa a adição de N-acetil-glucosamina no grupo hidroxila dos resíduos de serina ou treonina das proteínas alvo. Por outro lado, a OGA catalisa a remoção hidrolítica de O-GlcNAc das proteínas modificadas. Proteínas com importante papel na função vascular são alvos da O-GlcNAc, e recentemente demonstramos que a expressão de proteínas modificadas com O-GlcNAc está aumentada em artérias de ratos com hipertensão DOCA-sal. Considerando que a produção de endotelina-1 (ET-1) encontra-se aumentada na vasculatura de diferentes modelos de hipertensão sensível ao sal, nós investigamos a hipótese de que o aumento da resposta vascular contrátil induzida pela ET-1 é decorrente da hiperativação da via RhoA/Rho cinase, mediada pelo aumento dos níveis de proteínas O-GlcNAc. Durante a realização de nossos experimentos, demonstramos que a exposição de aortas ou células do músculo liso vascular (CMLV) à ET-1 (0,1 mol/L) aumenta a vasoconstrição para fenilefrina (PE) e serotonina, bem como os níveis de proteínas O-GlcNAc, além de modular a expressão das enzimas OGT e OGA. A infusão de ET-1 (2 pmol/Kg/min) por 14 dias também promoveu aumento dos níveis vasculares de proteínas O-GlcNAc e da resposta contrátil da aorta à PE. O tratamento de aortas ou CMLV com ST045849 (inibidor da OGT, 100 µMol/L) ou atrasentan (antagonista do receptor ETA, 1 mol/L), preveniu o aumento dos níveis de proteínas O-GlcNAc induzido pela ET-1. Além disso, o tratamento com atrasentan por cinco semanas (atrasentan - 5 mg/kg/dia, por via oral) normalizou os níveis vasculares de proteínas O-GlcNAc em ratos DOCA-sal e também diminuiu a resposta contrátil da aorta à PE. A transfecção de CMLV com siRNA para OGT aboliu o efeito da ET-1 sobre os níveis de proteínas O-GlcNAc. Considerando que o aumento nas contrações da aorta à PE, após o tratamento com PUGNAc (inibidor seletivo da OGA) ou ET-1, foi abolido pelo inibidor de Rho cinase (Y-27632, 1 mol/L) e que a ET-1 ativa a via de sinalização da RhoA/Rho cinase, decidimos investigar se aumento dos níveis de proteínas O-GlcNAc ativa/modula a via RhoA/Rho cinase. A incubação de CMLV com ET-1 não mudou a expressão protéica das formas totais de ROCK-, ROCK-, CPI-17, MYPT-1 ou MLC, porém aumentou a expressão das formas fosforiladas da MYPT-1 (Tre853), CPI-17 (Tre38) e MLC (Tre18/Ser19). Estes efeitos não foram observados quando CMLV foram tratadas com ST045849, atrasentan ou previamente transfectadas com o siRNA para OGT. Também observamos que a ET-1 aumentou a atividade e a expressão protéica da RhoA, assim como a expressão da PDZ-Rho GEF e p115-Rho GEF. Este efeito foi abolido, quando CMLV foram previamente transfectadas com siRNA para OGT, incubadas com o inibidor da OGT ou tratadas com o antagonista de receptores ETA. Em conclusão, nossos dados fornecem evidências de que a ET-1 aumenta os níveis vasculares de proteínas O-GlcNAc, resultando na ativação da via RhoA/Rho cinase e no aumento da reatividade vascular. É possível que o aumento de proteínas O-GlcNAc, induzido pela ET-1, possa representar um novo mecanismo para a disfunção vascular induzida por este potente peptídeo. / LIMA, V.V. O-GlcNAcylation contributes to the vascular effects of ET-1 via activation of RhoA/Rho-kinase pathway. 2012. 106 f. Ph.D. Thesis - Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo, Ribeirão Preto, 2012. Glycosylation with O-linked -N-acetylglucosamine (O-GlcNAc) is a highly dynamic post-translational modification that plays a key role in signal transduction pathways. The cycling of O-GlcNAc is controlled by two enzymes: UDP-NAc transferase (OGT) and O-GlcNAcase (OGA). Whereas OGT catalyses the addition of O-GlcNAc to the hydroxyl group of serine and threonine residues of a target protein, OGA catalyses the hydrolytic cleavage of O-GlcNAc from post-translationally-modified target. Proteins with an important role in vascular function are targets for O-GlcNAcylation and we have recently shown that the vascular content of O-GlcNAc-proteins is augmented in arteries from DOCA-salt rats. Since endothelin-1 (ET-1) production is increased in the vasculature of salt-sensitive forms of hypertension, we tested the hypothesis that O-GlcNAc contributes to the vascular effects of ET-1, via activation of the RhoA/Rho-kinase pathway. Incubation of rat aortas or vascular smooth muscle cells (VSMCs) with ET-1 (0,1 mol/L) produced a time-dependent increase in O-GlcNAc levels, decreased expression of O-GlcNAc transferase (OGT) and -N-acetylglucosaminidase (OGA), key enzymes in the O-GlcNAcylation process. Overnight treatment of aortas with ET-1 increased phenylephrine (PE) vasoconstriction. ET-1 effects were not observed when vessels were previously instilled with anti-OGT antibody or after incubation with an OGT inhibitor (ST045849, 100 mol/L). Aortas from DOCA-salt rats, which exhibit increased pre-pro-ET-1 expression, displayed increased contractions to PE and augmented levels of O-GlcNAc proteins. Treatment of DOCA-salt rats with atrasentan (ETA antagonist) abrogated augmented vascular levels of O-GlcNAc and prevented increased PE vasoconstriction. Aortas from rats chronically infused with low rate of ET-1 (2 pmol/Kg/min, 14days) exhibited increased O-GlcNAc-proteins and enhanced PE responses. These changes are similar to those induced by PUGNAc (OGA inhibitor which increases O-GlcNAc levels). ET-1 as well as PUGNAc augmented contractions to PE in endothelium-denuded rat aortas, an effect that was abolished by the Rho kinase inhibitor Y-27632 (1 mol/L). Incubation of VSMCs with ET-1 did not change expression of ROCK-, ROCK-, CPI-17, MYPT-1 or MLC, but increased phosphorylation levels of MYPT-1 (Thr853), CPI-17 (Thr38) and MLC (Thr18/Ser19). The effects of ET-1 on MYPT-1, CPI-17 and MLC phosphorylation were prevented by the OGT inhibitor and OGT siRNA transfection, as well as by atrasentan. ET-1 increased RhoA expression and activity in VSMCs, and this effect was abolished by OGT siRNA transfection and OGT inhibition. ET-1 also augmented expression of PDZ-Rho GEF and p115-Rho GEF in VSMCs and this was prevented by OGT siRNA, OGT inhibition (ST045849) and ETA receptor blockade (atrasentan, 1 mol/L). In conclusion, our data strongly suggest that ET-1 augments O-GlcNAc levels and this modification contributes to increase vascular contractile responses, via activation of the RhoA/Rho-kinase pathway. We speculate that the modulatory effect of ET-1 on O-GlcNAcylation may represent a novel mechanism underlying the vascular effects of the peptide.

Introduction: Idiopathic Pulmonary arteriole hypertension (IPAH) is a rare but severely debilitating disease that strikes women to men at a ratio of 3:1. Endothelial cell (EC) dysfunction is a hallmark of the disease. This includes rapid growth of the ECs until the occlusion of the vasculature as well as decreased blood levels of vasodilators. Markedly increased levels of endothelin-1, a potent vasoconstrictor and smooth muscle mitogen, have been noted in IPAH patients. / Recently mutations in the bone morphogenic protein receptor type II (BMPRII) have been linked to the disease. Interestingly mutations in activin-like kinase-1 (ALK-1) and endoglin have been linked to hereditary haemorrhagic telangiectasia (HHT), a disease that results in PAH clinically indistinguishable from IPAH. All of these proteins are either receptors or co-receptors to members of the TGFbeta superfamily. The connection of these mutations to the disease still remains largely a mystery to researchers and the effects of either bone morphogenic proteins 2, 4, 7 or TGFbeta levels on endothelin-1(ET-1) production in human microvascular endothelial cells cultured from normal lungs (HMVEC-LBI) are unknown. / Methods: HMVEC-LBI cells were cultured in the presence of various concentrations of BMP 2,4,7 and TGFbeta, in complete media or serum starved conditions. After allotted time points the media was collected and assayed by ELISA, meanwhile the cells were lysed and protein content assayed for normalization purposes. Small Mothers against Decapentaplegic (SMAD) 1/5 phosphorylation was also measured. / Results and Conclusions: Despite evidence that all BMPs used were biologically active, namely through SMAD phosphorylation studies, only BMP7 at very high dosages increased ET-1 production levels. TGFbeta had a more pronounced effect at earlier time points with lower concentrations. The results provide insights on the effects of an important group of proteins, the BMPs and TGFbeta, on lung microvascular ECs and which are likely the key cellular player In IPAH development. These findings may have clinical relevance in terms of control of the disease and understanding the normal response of these cells BMPs and TGFbeta.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 6 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

Η ενδοθηλίνη-1 (ΕΤ-1) είναι ένα ισχυρό αγγειοσυσπαστικό και βρογχοσυσπαστικό μόριο το οποίο παρουσιάζει και προφλεγμονώδεις ιδιότητες. Η ικανότητά του να ελκύει φλεγμονώδη κύτταρα στην εστία παραγωγής της, να προκαλεί την παραγωγή μορίων προσκόλλησης στην επιφάνειά τους αλλά και κυτταροκινών αποτελεί απόδειξη της δράσης αυτής. Από την άλλη οι κυτταροκίνες είναι σε θέση να επάγουν την σύνθεση και την έκκριση αυτού του μορίου, δημιουργώντας έτσι ένα μοριακό φαύλο κύκλο ενίσχυσης της φλεγμονής των αεραγωγών που λαμβάνει χώρα στη Χρόνια Αποφρακτική Πνευμονοπάθεια (ΧΑΠ). Με το τρόπο αυτό η φλεγμονή συνεχίζει να υφίσταται ακόμα και μετά την διακοπή του ερεθιστικού παράγοντα που προκάλεσε την έκλυσή της όπως είναι π.χ. το κάπνισμα. Έτσι, οι λειτουργικοί πολυμορφισμοί που αυξάνουν την παραγωγή της ΕΤ-1 δυνατό να αυξάνουν και το κίνδυνο ανάπτυξης ΧΑΠ. Υλικά-μέθοδοι: Σε αυτή την προοπτική μελέτη ερευνήθηκε η επίδραση στην αναπνευστική λειτουργία δυο λειτουργικών πολυμορφισμών του γονιδίου της ΕΤ-1 σε ένα πληθυσμό 190 καπνιστών (95 υγιείς καπνιστές και 95 καπνιστές που νοσούσαν από ΧΑΠ). Οι δυο πολυμορφισμοί αφορούσαν μια ένθεση αδενίνης στο 5’-άκρο στη θέση +138 (εξώνιο 1, 138/ex1ins/delA) και την αντικατάσταση μιας γουανίνης με θυμίνη στη θέση +5665 (εξώνιο 5) που αλλάζει το αμινοξύ λυσίνη της θέσης 198 σε ασπαραγίνη (Lys198Asn). Στα άτομα αυτά διενεργήθηκε λειτουργικός έλεγχος της αναπνοής σε ετήσια βάση για συνολικό χρονικό διάστημα τριών ετών. Αποτελέσματα: Η μέση ετήσια μείωση στον δυναμικά εκπνεόμενο όγκο στο πρώτο δευτερόλεπτο (ΔFEV1) ήταν η παράμετρος που μελετήθηκε. Αυτή ήταν μεγαλύτερη για όσους έφεραν το μεταλλαγμένο γόνο 138/ex1ins/delA σε σχέση με τα άτομα που έφεραν το φυσιολογικό αλληλόμορφο. Οι ετεροζυγώτες για το μεταλλαγμένο αλληλόμορφο που ανήκαν στην ομάδα των καπνιστών δίχως ΧΑΠ παρουσίαζαν μια ΔFEV1 μεγαλύτερη κατά 19,4 ml σε σχέση με τα άτομα που ήταν ομόζυγα για το φυσιολογικό αλληλόμορφο (p=0.004). Η αντίστοιχη διαφορά για τους ετεροζυγώτες του μεταλλαγμένου αλληλόμορφου που ανήκαν στην ομάδα των καπνιστών που νοσούσαν από ΧΑΠ ήταν 11,15 ml (p=0.003). Αντιθέτως, όσοι έφεραν τον πολυμορφισμό Lys198Asn παρουσίαζαν μια μικρότερη ΔFEV1 σε σχέση με τα άτομα που έφεραν το φυσιολογικό αλληλόμορφο. Έτσι, οι ετεροζυγώτες για το μεταλλαγμένο αλληλόμορφο που ανήκαν στην ομάδα των καπνιστών δίχως ΧΑΠ παρουσίαζαν μια ΔFEV1 μεγαλύτερη κατά 11,24 ml (p<0.001) ενώ η αντίστοιχη διαφορά για τους ετεροζυγώτες του μεταλλαγμένου αλληλόμορφου της ομάδα των καπνιστών που νοσούσαν από ΧΑΠ ήταν 11,42 ml (p=0.002). Τα παραπάνω συνηγορούν υπέρ μιας προστατευτικής δράσης του πολυμορφισμού Lys198Asn στην αναπνευστική λειτουργία. Συμπεράσματα: Τα δεδομένα αυτής της μελέτης δείχνουν πως τόσο η ΕΤ-1 όσο και οι λειτουργικοί πολυμορφισμοί του γονιδίου της δύνανται να ενέχονται στο τελικό φαινότυπο της ΧΑΠ και στη σοβαρότητα αυτής. / Background: Endothelin-1 (ET-1) is a potent vasoconstrictor and bronchoconstrictor but it has been shown to have also proinflammatory properties. Its ability to attract inflammatory cells in its site of production, upregulates the synthesis of adhesion molecules and stimulates the release of cytokines. The fact that cytokines have the ability to induce its synthesis and release, creates a dynamic loop for self-preservation and augmentation of the airway inflammation in COPD, even after the ceasing of the noxious stimulus i.e. cigarette smoke. Therefore, functional polymorphisms that may lead to increased levels of ET-1 may also cause an increased susceptibility to COPD development. Materials and Methods: We analyzed the longitudinal effect on lung function of two ET-1 gene polymorphisms in a population of 190 smokers (95 non-COPD and 95 COPD smokers). The two polymorphisms involved an insertion polymorphism (+138 adenine insertion 3A/4A, 138bp downstream from the transcription start site, exon 1) and a single nucleotide transversion polymorphism on exon 5 (G/T, Lys198Asn). A total of 190 subjects were enrolled in the study for each polymorphism and were followed for 3 years by annual spirometry sessions. Results: The adjusted annual decline of forced expiratory volume in 1 second (dFEV1) was greater for those having at least one copy of the mutated gene ins/delA compared to those with the wild type allele both in the non-COPD smokers group (mean difference in dFEV1 of 19.4 ml/year, p=0.004) and COPD smokers (mean difference in dFEV1 of 11.15 ml/year, p=0.003). On the contrary, those heterozygous for the Lys198Asn polymorphism were found to have a slower decline in FEV1 compared to those homozygous for the wild type allele. The non-COPD smokers group had a gain-in-loss of 11,24 ml/year (p<0.001) while the COPD-smokers group had a slower decline of 11,42 ml/year (p=0.002). Those homozygous for the polymorphisms examined show an even greater deviation from those with the wild type allele but due to the small number comprising their group, the results don’t have enough statistical power. Though, they still show the trend of the effect the polymorphisms have on annual FEV1 decline. Conclusions: The present data shows that ET-1 and its functional polymorphisms may be implicated in COPD phenotype and severity.