BERTOLINI, WAGNER L. H. M. A influência do D-limoneno como promotor de absorção do ácido 5-aminolevulínico para Terapia Fotodinâmica do câncer de pele: avaliação in vitro e in vivo da permeação e retenção cutâneas. 2009 118f. Tese (Doutorado). Faculdade de Ciências Farmacêuticas de Ribeirão Preto Preto Universidade de São Paulo, Ribeirão Preto, 2009. O câncer é a segunda doença principal do planeta, muito próximo de se tornar a mais incidente. Os tratamentos tradicionais do câncer, tais como cirurgia, radioterapia e quimioterapia apresentam severos efeitos colaterais ao paciente devido à citotoxicidade que podem causar às células normais, além das cancerosas. Objetivando minimizar estes efeitos indesejáveis pesquisadores de diversas áreas afins vislumbram novas técnicas, novos tipos e formas de tratamentos que apresentem um melhor perfil terapêutico; que possam agir de forma mais seletiva contra as células cancerosas, minorando os efeitos indesejáveis em relação às células saudáveis. Dentre as técnicas pesquisadas destaca-se a Terapia Fotodinâmica (TFD). Esta é uma técnica de tratamento nova e promissora. A técnica do tratamento consiste em aplicar, no tecido alvo, substâncias fotossensibilizantes, posteriormente ativadas com luz de comprimentos de onda específicos, com a finalidade de produzir destruição celular, por meio da ação de produtos citotóxicos fotoativados. Destaca-se a seletividade apresentada pela técnica, que deve ser reconhecida como uma das vantagens entre as técnicas empregadas no tratamento do câncer. O presente trabalho objetiva verificar a influência do D-limoneno como promotor de permeação do ácido 5-aminolevulínico (5-ALA) em aplicação tópica. Isto visa aumentar a permeação do 5-ALA quando aplicado topicamente. O 5-ALA é convertido a protoporfirina-IX (PpIX) pela via do ciclo Heme. Esta é um potente agente fotossensibilizador endógeno. O interesse no uso deste promotor foi aumentar a taxa de penetração do 5-ALA, possibilitando a permeação de maiores quantidades do fármaco em questão. Para isto foram realizados estudos de permeação in vitro do 5-ALA, em concentração de 1% (p/p) utilizando-se formulações (emulsões O/A) com diferentes concentrações do promotor D-limoneno (0, 5, 10, 20 e 30%), (p/p). Observou-se que o fluxo in vitro do 5-ALA através da pele de orelha de porco aumentou para todas as formulações empregadas quando comparado ao controle, sem D-limoneno, para um período de estudo de 12h. A retenção no estrato córneo e na [epiderme + derme] apresentou aumento significativo, evidenciando, assim, um efeito eficiente do D-limoneno como promotor. Experimentos in vivo foram conduzidos em camundongos objetivando a análise do efeito da formulação na produção e acúmulo de PpIX na pele. Observou-se que o D-limoneno aumentou significantemente a quantidade de PpIX extraída da pele. Os resultados in vitro e in vivo mostraram o potencial do D-limoneno como promotor de absorção cutânea para o 5-ALA para a TFD tópica do cancer de pele. / BERTOLINI, WAGNER L. H. M. D-limonene influence in the cutaneous penetration enhancer for 5-aminolevulinic acid in photodynamic therapy of skin cancer: in vitro and in vivo skin permeation and retention studies. 2009 118f. Thesis (Doctoral). Faculdade de Ciências Farmacêuticas de Ribeirão Preto Preto Universidade de São Paulo, Ribeirão Preto, 2009. The topical administration of 5-ALA has been distinguished on skin cancer photodynamic therapy (PDT) because of its efficiency in the treatment of tumors and the reduced phototoxic collateral effects. However, this effectiveness is limited by its low penetration in the skin. A proposal to optimize the 5-ALA penetration in the skin is the use of cutaneous penetration enhancers, which seek to alter the cutaneous barrier for many bioactive molecules. The aim of this work was the pharmaceutical development of formulations containing D-limonene as a cutaneous penetration enhancer, seeking the increase of the cutaneous penetration of 5-ALA for skin cancer PDT. The in vitro flux of 5-ALA present in 1% (w/w) from different formulations containing D-limonene (20 e 30% w/w) was significantly increased after 12 hours of experiment, in comparison with formulations without D-limonene, mainly for the formulations containing 20% and 30% of D-limonene with 1% of 5-ALA (1,45 and 2,01 times, respectively). The stratum corneum (SC) and [epidermis + dermis] without SC retention were also significantly increased, showing an enhancer effect of the promoter. In addition, in vivo experiments were accomplished in mice, with the purpose of analyzing the formulation effect on the PpIX production and accumulation in the skin. It was observed that the penetration enhancer\'s presence significantly increased the amount of PpIX extracted from the skin. Both in vitro and in vivo results showed the potentiality of the formulations containing D-limonene as a cutaneous penetration enhancer for 5-ALA delivery on the skin cancer PDT.

Transcriptional regulation is the principal mechanism in establishing cell-type specific gene activity by exploring an almost infinite space of different combinations of regulatory elements, transcription factors with high precision. Recent efforts have mapped thousands of candidate regulatory elements, of which a great portion is cell-type specific yet it is still unclear as to what fraction of these elements is functional, what genes these elements regulate, or how they are established in a cell-type specific manner. In this dissertation, I will discuss methods and approaches I developed to better understand the role of regulatory elements and transcription factors in gene expression regulation. First, by comparing the transcriptome and chromatin landscape between mouse and human innate immune cells I showed specific gene expression programs are regulated by highly conserved regulatory elements that contain a set of constrained sequence motifs, which can successfully classify gene-induction in both species. Next, using chromatin interactions I accurately defined functional enhancers and their target genes. This fine mapping dramatically improved the prediction of transcriptional changes. Finally, we built a supervised learning approach to detect the short DNA sequences motifs that regulate the activation of regulatory elements following LPS stimulation. This approach detected several transcription factors to be critical in remodeling the epigenetic landscape both across time and individuals. Overall this thesis addresses several important aspects of cis-regulatory elements in transcriptional regulation and started to derive principles and models of gene-expression regulation that address the fundamental question: “How do cis-regulatory elements drive cell-type-specific transcription?”

Während der Entwicklung des Organismus führen naive Zellen aufgrund eines streng regulierten Transkriptionsprogramms zu differenzierten Zelltypen und Geweben. Obwohl viele Aspekte dieses Differenzierungsprozesses noch wenig verstanden sind, ist allgemein anerkannt, dass Transkriptionsfaktoren (TFs), die mit cis-regulatorischen Modulen (CRMs), nämlich Enhancern, interagieren, einen wesentlichen Beitrag zur Regulierung der räumlich-zeitlichen Genexpression leisten. Um die regulatorischen Wechselwirkungen von Enhancern zu verstehen, verwendete ich eine Technik namens inSTEP, von zwei wichtigen neurogenen Enhancern und einem mesodermalen Enhancer zu entschlüsseln. inSTEP ist eine Abkürzung für in vivo Spatio-Temporal Enhancer Proteomics und beinhaltet die Präzipitation eines ausgewählten Enhancers zusammen mit all seinen gebundenen Elementen aus einem bestimmten Gewebe zur Identifizierung durch Massenspektrometrie (MS), wodurch die Identifizierung von regulatorischen Kandidaten ermöglicht wird, die die Neurogenese vorantreiben. Das Herunterfallen von mindestens zwei der mutmaßlichen Regulierungskandidaten CG4707 und CG2962 führte zu einem veränderten Reportergen-Expressionsmuster, das vom vndenhancer gesteuert wurde, was darauf hindeutet inSTEP ist in der Lage, neue regulatorische Proteine zu identifizieren, die an der Regulation der Genexpression im sich entwickelnden Nervensystem beteiligt sind. Einer der Enhancer, an denen ich am meisten interessiert bin, ist ein Enhancer für das Gen vnd, das einen entscheidenden TF für die Neurogenese codiert. Ich habe mein Projekt daher über die Frage hinaus erweitert, wie vnd-Expression reguliert wird, um auch die Rolle einzubeziehen, die Vnd selbst bei der Neurogenese spielt. Ich habe ChIP-seq-Experimente durchgeführt, um die genomweiten Bindungsprofile von Vnd aufzuklären, und ich habe Werkzeuge entwickelt, die die isoformspezifische Rolle von Vnd aufklären. / During organismal development, naive cells give rise to differentiated cell types and tissues as a result of a tightly regulated transcriptional programs. Although many aspects of this differentiation process are still poorly understood, it is widely accepted that transcription factors (TFs) interacting with cis-regulatory modules (CRMs), namely enhancers, are major contributors to regulate spatio-temporal gene expression. In order to understand the regulatory interactions of enhancers, I used a technique called inSTEP to unravel the enhancer-protein interactions on two major neurogenic enhancers (for the vnd and rho genes) and one mesodermal enhancer (1070enhancer), for which no target genes are known. inSTEP is an acronym for in vivo Spatio-Temporal Enhancer Proteomics and entails precipitation of a chosen enhancer together with all its bound elements from a specific tissue, for identification by mass spectrometry (MS), thus enabling the identification of regulatory candidates driving neurogenesis. I have identified candidate regulators in the ventral column and selected ten to do follow-up experiments The knock down of at least two of the vndenhancer putative regulators, CG4707 and CG2962, led to an altered reporter gene expression pattern driven by the vndenhancer, suggesting that inSTEP is able to identify new regulatory proteins involved in the regulation of gene expression in the developing nervous system. One of the enhancers I am most interested in is an enhancer for the gene vnd, which encodes a crucial TF for neurogenesis. I have therefore expanded my project beyond the question of ‘how’ vnd expression is regulated, to also include the role Vnd itself plays in neurogenesis. I have conducted ChIP-seq experiments to elucidate the genome-wide binding profiles of Vnd and I have developed tools that will elucidate the isoform-specific role of Vnd.

La méthylation de l'ADN est une marque épigénétique importante chez les mammifères. Malgré le fait que la méthylation de la cytosine en 5' (5mC) soit reconnue comme une modification épigénétique stable, il devient de plus en plus reconnu qu'elle soit un processus plus dynamique impliquant des voies de méthylation et de déméthylation actives. La dynamique de la méthylation de l'ADN est désormais bien caractérisée dans le développement et dans le fonctionnement cellulaire des mammifères. Très peu est cependant connu concernant les implications régulatrices dans les réponses immunitaires. Pour se faire, nous avons effectué des analyses du niveau de transcription des gènes ainsi que du profilage épigénétique de cellules dendritiques (DCs) humaines. Ceux-ci ont été faits avant et après infection par le pathogène Mycobacterium tuberculosis (MTB). Nos résultats fournissent le premier portrait génomique du remodelage épigénétique survenant dans les DCs en réponse à une infection bactérienne. Nous avons constaté que les changements dans la méthylation de l'ADN sont omniprésents, identifiant 3,926 régions différentiellement méthylées lors des infections par MTB (MTB-RDMs). Les MTB-RDMs montrent un chevauchement frappant avec les régions génomiques marquées par les histones associées avec des régions amplificatrices. De plus, nos analyses ont révélées que les MTB-RDMs sont activement liées par des facteurs de transcription associés à l'immunité avant même d'être infecté par MTB, suggérant ces domaines comme étant des éléments d'activation dans un état de dormance. Nos données suggèrent que les changements actifs dans la méthylation jouent un rôle essentiel pour contrôler la réponse cellulaire des DCs à l'infection bactérienne. / DNA methylation is an important epigenetic mark in mammals. Although methylation at the 5’ position of cytosine (5mC) is recognized as a stable epigenetic modification, it is becoming increasingly viewed as a more dynamic process that involves both active methylation and demethylation pathways. While the dynamics of DNA methylation has been well characterized in mammalian development and normal cellular function, little is known about its regulatory implications in immune responses. To that end, we performed comprehensive transcriptional and epigenetic profiling of primary dendritic cell (DC) samples from humans, before and after infection with Mycobacterium tuberculosis (MTB). Our results provide the first complete genomic portrait of the extensive epigenetic remodeling occurring in primary DCs in response to a bacterial infection. We found that active changes in DNA methylation are pervasive, identifying 3,926 MTB-induced differentially methylated regions (MTB-DMRs). MTB-DMRs show a striking overlap with genomic regions marked by histones associated with enhancer activity. ATAC-seq footprinting analysis revealed that regions that change methylation were actively bound by immune-related TFs prior to MTB-infection suggesting that these domains are likely to represent enhancer elements in a poised state. Our data suggests that active changes in DNA methylation play an essential and previously unappreciated role at controlling of the regulatory programs engaged by DCs in response to a bacterial infection.

O câncer configura uma das maiores causas de mortalidade no mundo, caracterizando-se como uma doença complexa orquestrada por alterações genômicas e epigenômicas capazes de alterar a expressão gênica e a identidade celular. Nova evidência obtida por meio de um estudo genômico em larga escala e cujos dados encontram-se disponíveis no banco público do TCGA sugere que um em cada dez pacientes portadores de câncer pode ser classificado com maior eficácia tendo como base a taxonomia molecular quando comparada à histologia. Dessa maneira, nós hipotetizamos que o estabelecimento de mapas genômicos exibindo a localização de sítios de ligação de fatores de transcrição combinada à identificação de regiões diferencialmente metiladas e perfis alterados de expressão gênica possa nos auxiliar a caracterizar e explorar, ao nível molecular, fenótipos associados ao câncer. Avanços tecnológicos e bancos de dados públicos a exemplo do The Cancer Genome Atlas (TCGA), The Encyclopedia of DNA Elements (ENCODE) e o NIH Roadmap Epigenomics Mapping Consortium (Roadmap) têm proporcionado um recurso inestimável para interrogar o (epi)genoma de linhagens de células tumorais em cultura, bem como de tecidos normais e tumorais em alta resolução. Todavia, a informação biológica encontra-se armazenada em diferentes formatos e não há ferramentas computacionais para integrar esses dados, evidenciando um cenário atual que requer, com urgência, o desenvolvimento de ferramentas de bioinformática e softwares capazes de direcionar a solução deste obstáculo. Nesse contexto, o objetivo principal deste estudo consiste em implementar o desenvolvimento de ferramentas de bioinformática, na linguagem de programação R que, ao final do estudo, será submetido à comunidade científica do projeto Bioconductor sob a licença de código aberto GNU GPL versão 3. Além disso, ajudaremos nossos colaboradores com o aperfeiçoamento do ELMER, um pacote R/Bioconductor que identifica elementos reguladores usando dados de expressão gênica, de metilação do DNA e análise de motivo. Nossa expectativa é que essas ferramentas possam automatizar com acurácia a pesquisa, o download e a análise dos dados (epi)genômicos que se encontram atualmente disponíveis nas bases de dados públicas dos consórcios internacionais TCGA, ENCODE e Roadmap, além de integrá-los facilmente aos dados genômicos e epigenômicos gerados por pesquisadores por meio de experimentos em larga escala. Além disso, realizaremos também o processamento e a análise manual dos dados que serão automatizados pelas ferramentas, visando validar sua capacidade em descobrir assinaturas epigenômicas que possam redefinir subtipos de câncer. Por xi fim, as usaremos para investigar as diferenças moleculares entre dois subgrupos de gliomas recentemente descobertos por nosso laboratório. / Cancer, which is one of the major causes of mortality worldwide, is a complex disease orchestrated by aberrant genomic and epigenomic changes that can modify gene regulatory circuits and cellular identity. Emerging evidence obtained through high-throughput genomic data deposited within the public TCGA international consortium suggests that one in ten cancer patients would be more accurately classified by molecular taxonomy versus histology. Therefore, we have hypothesized that the establishment of genome-wide maps of the de novo DNA binding motifs localization coupled with differentially methylated regions and gene expression changes might help to characterize and exploit cancer phenotypes at the molecular level. Technological advances and public databases like The Cancer Genome Atlas (TCGA), The Encyclopedia of DNA Elements (ENCODE), and The NIH Roadmap Epigenomics Mapping Consortium (roadmap) have provided unprecedented opportunities to interrogate the epigenome of cultured cancer cell lines as well as normal and tumor tissues with high resolution. Markedly however, biological information is stored in different formats and there is no current tool to integrate the data, highlighting an urgent need to develop bioinformatic tools and/or computational softwares to overcome this challenge. In this context, the main purpose of this study is the development of bioinformatics tools in R programming language that will be submitted to the larger open-source Bioconductor community project under the GNU GPL3 (General Public License version 3). Also, we will help our collaborators improve of the R/Bioconductor ELMER package that identifies regulatory enhancers using gene expression, DNA methylation data and motif analysis. Our expectation is that these tools can effectively automate search, retrieve, and analyze the vast (epi)genomic data currently available from TCGA, ENCODE, and Roadmap, and integrate genomics and epigenomics features with researchers own high-throughput data. Furthermore, we will also navigate through these data manually in order to validate the capacity of these tools in discovering epigenomic signatures able to redefine subtypes of cancer. Finally, we will use them to investigate the molecular differences between two subgroups of gliomas, one of the most aggressive primary brain cancer, recently discovered by our laboratory.

MHC Klasse II Moleküle präsentieren Peptidantigene für die Überwachung durch CD4+ T Zellen an der Zelloberfläche. Um Sicherzustellen, dass diese Peptidliganden möglichst genau die intrazelluläre Proteinzusammensetzung widerspiegeln, hat sich im Verlauf der Evolution ein komplexer Prozessierungsweg entwickelt, welcher möglichst stabile Peptid/MHC Komplexe an die Zelloberfläche liefert. MHC Moleküle, welche ihren Liganden verloren haben, konvertieren zudem spontan in einen ‚nichtrezeptiven’ Zustand, was als zusätzlicher Sicherheitsmechanismus dient. Diese Studie zeigt jedoch, dass Aminosäureseitenketten kurzer Peptide diesen Sicherheitsmechanismus umgehen können indem sie katalytisch einen reversiblen Ligandenaustausch auslösen. Die katalytische Aktivität von Dipeptiden, wie z.B. Tyr-Arg (YR), war dabei stereospezifisch und konnte durch zusätzliche Modifikationen verstärkt werden, welche das konservierte H-Brückennetzwerk der so genannten P1-Tasche des MHC Moleküls adressierten. Die Dipeptide verstärkten dabei sowohl die Antigenbeladung als auch den Ligandenaustausch, wobei deren relative Aktivität genau mit den bekanten Ankerpräferenzen der P1 Tasche korrelierte. Letzteres weist somit auf eine direkte Interaktion der katalytischen Seitenkette des Dipeptides mit dieser Tasche hin. Der Verstärkungseffekt war auch in CD4+ T Zellassays zu beobachten, bei denen der alleleselektive Einfluss der Dipeptide direkt in eine deutliche Erhöhung der Sensitivität der antigenspezifischen T Zellantwort führte. Durch weitere molekulardynamische Berechnungen konnte die Hypothese unterstützt werden, dass die Besetzung der P1 Tasche durch Aminosäureseitenketten einen Kollaps der leeren Bindungstasche zum ‚nichtrezeptiven’ Zustand verhindert. Während der Antigenpräsentation könnte P1 somit unmittelbar als ‚Sensor’ für die Beladung mit Peptiden dienen. Diese Annahme konnte experimentell durch spektroskopische Untersuchungen unter Verwendung des ANS-Farbstoffes (8-Anilino-1-Naphtalensulfonsäure) sowie durch Messung der intrinsischen Tryptophanfluoreszenz bestätigt werden. Darüber hinaus konnten konformationsspezifische Antikörper, welche bislang lediglich mit unbeladenen MHC Molekülen in Verbindung gebracht wurden, hier als spezifische Sonden für den nichtrezeptiven Zustand definiert werden. Als mögliche Risikofaktoren könnten katalytische kurze Peptide eine Rolle bei der Auslösung von Autoimmunerkrankungen spielen. In dieser Studie konnte gezeigt werden, dass sie die Beladung von Glutenantigenen auf das Zöliakie-assozierte HLA-DQ2 Molekül verstärken können. Zumindest in vitro konnte ihre Anwesenheit deshalb auch die antigenspezifische Antwort von CD4+ T Zellen verstärken, welche zuvor von Zöliakiepatienten isoliert worden waren. Auf der einen Seite könnten diese Peptide als ‚MHC-loading enhancer’ (MLE) deshalb als mögliche Risikofaktoren die Ausbildung entzündlicher (Auto-) Immunerkrankungen beschleunigen. Auf der anderen Seite könnten sie jedoch auch als ‚drug-like’ Vakzinadditiv zur Verbesserung von Immuntherapien führen. / MHC class II molecules present antigenic peptides on the cell surface for the surveillance by CD4+ T cells. To ensure that these ligands accurately reflect the content of the intracellular MHC loading compartment, a complex processing pathway has evolved that delivers only stable peptide/MHC complexes to the surface. As additional safeguard mechanism, MHC molecules quickly acquire a ‘non-receptive’ state once they have lost their ligand. This study shows that amino acid side chains of short peptides can bypass these safety mechanisms by triggering the reversible ligand-exchange. The catalytic activity of dipeptides such as Tyr-Arg (YR) is stereo-specific and could be enhanced by modifications addressing the conserved H-bond network near the P1 pocket of the MHC molecule. It enhanced both antigen-loading and ligand-release and strictly correlated with reported anchor preferences of P1, the specific target site for the catalytic side chain of the dipeptide. The effect was evident also in CD4+ T cell assays, where the allele-selective influence of the dipeptides translated into increased sensitivities of the antigen-specific immune response. The hypothesis that occupation of P1 prevents the ‘closure’ of the ‘empty’ peptide binding site into the ‘non-receptive’ state was further supported by molecular dynamic calculations. During antigen processing and presentation P1 may therefore function as important ‘sensor’ for peptide-load. Spectroscopic studies using ANS dye (8-aninilino-1-napthalenesulfonic acid) and intrinsic tryptophan fluorescence data, confirm the postulate by providing direct evidence for the conformational transitions. Moreover conformation specific antibodies previously described to be specific for ‘empty’ MHC could be shown to be a ‘probe’ for ‘receptive conformation’. As potent risk factors short peptides may be involved in the induction of autoimmune diseases. It could be shown here that they could enhance the loading of gluten derived antigen on celiac disease linked-HLA-DQ2 allele. At least in vitro the effect could enhance gluten specific CD4+ T cell response on T cell clones obtained from celiac disease patients. Thus, on one hand short peptides might work as ‘MHC loading enhancer’ (MLE) in the precipitation of inflammatory-‘autoimmune’ disorder, on the other hand they might be used as drug like vaccine ‘additive’ in various therapeutic settings.

Les genodermatoses sont des maladies génétiques rares à expression cutanée. Parmi elles, les dysplasies ectodermiques (DE) caractérisées par des anomalies du développement d’au moins deux structures ectodermiques (dents, ongles, glandes sudorales et poils), constituent un groupe hétérogène de genodermatoses de plus de 200 syndromes rares. Si la plupart de ces syndromes associent des anomalies des seuls dérivés ectodermiques, d'autres plus complexes, tels que le syndrome de Bazex-Dupré-Christol et l’Incontinentia Pigmenti, rassemblent en plus des manifestations disparates. Le syndrome de Bazex-Dupré-Christol (SBDC) associe une DE à la prédisposition aux carcinomes basocellulaires (CBCs) de survenue précoce. L’étude de 6 familles nous a permis d’identifier, chez 2 d’entre elles, une mutation tronquante dans le gène ACTRT1, codant la protéine Arp-T1. Dans l’épiderme, la protéine Arp-T1 est diminuée chez tous les patients atteints de SBDC, porteurs ou non de mutations dans le gène ACTRT1. Le séquençage à haut débit de la région candidate a permis d’identifier des mutations dans des régions transcrites, régulatrices du gène ACTRT1 chez les patients des 4 autres familles. Notant que la voie Hedgehog est dérégulée dans 70 % des CBCs, nous avons démontré qu’ACTRT1 est un nouvel inhibiteur de cette voie, en particulier par sa liaison au promoteur de GLI1 dont il inhibe l’expression. Enfin, ACTRT1 est un nouveau gène suppresseur de tumeur capable de réduire in vivo la progression tumorale de certaines lignées cancéreuses par la régulation de gènes impliqués dans la prolifération, la mort et la survie cellulaire, ou encore la migration. L’Incontinentia Pigmenti (IP) est une affection multisystémique caractérisée par une atteinte de la peau, des dents, des yeux et parfois du système nerveux central. Elle résulte de mutation dans le gène NEMO et l’abolition de l’activation de la voie NF-KB. L’étude d’une famille concernée par l’IP à permis d’identifier une nouvelle mutation d’épissage du gène NEMO aboutissant à l’expression d’une protéine tronquée. Cette protéine conserve l’intégralité des domaines fonctionnels de NEMO connus à ce jour. Sa caractérisation a révélé une perte d’interaction avec SHARPIN, composants du complexe LUBAC permettant l’ubiquitination linéaire. Il s’agit de la première mutation humaine de NEMO montrant l’importance de son ubiquitination linéaire dans l’activation de la voie NF-KB. Mes travaux de thèse ont ainsi mis en évidence de nouveaux mécanismes physiopathlogiques responsables de deux formes de dysplasie ectodermique. Ces mécanismes reflètent la complexité des voies moléculaires impliquées dans le développement de la peau et le maintien de son homéostasie durant la vie adulte. / Genodermatoses are rare genetic diseases with cutaneous expression. Among them, ectodermal dysplasia (ED) characterized by abnormal development of at least two ectodermal structures (teeth, nails, sweat glands and hair) constitute a heterogeneous group of genodermatoses of more than 200 rare syndromes. While most of these syndromes associate only abnormalities of the ectodermal derivatives, others more complex, such as Bazex-Dupré-Christol syndrome and Incontinentia Pigmenti, bring together disparate manifestations. Bazex-Dupré-Christol syndrome (BDCS) associates ED with predisposition to early basal cell carcinoma (BCCs). The study of 6 families allowed us to identify, in 2 of them, a truncated mutation in the ACTRT1 gene, encoding the Arp-T1 protein. In the epidermis, Arp-T1 protein is decreased in all patients with BDCS, carrying or not of mutations in ACTRT1 gene. High-throughput sequencing of the candidate region allowed to identify mutations in transcribed enhancer regions, regulating the ACTRT1 gene in patients of the remaining 4 families. Noting that the Hedgehog pathway is deregulated in more than 70% of BCCs, we have demonstrated that ACTRT1 is a novel inhibitor of this pathway, via its binding to GLI1 promoter and inhibiting its expression. Finally, ACTRT1 is a new tumor suppressor gene capable of reducing in vivo the tumor progression of certain cancer lines by the regulation of genes involved in proliferation, death and cell survival, or migration. Incontinentia Pigmenti (IP) is a multisystemic disorder characterized by involvement of skin, teeth, eyes and sometimes the central nervous system. It results from mutation in the NEMO gene and the abolition of activation of NF-KB pathway. The study of a family concerned with IP allowed to identify a new splicing mutation of NEMO gene leading to a truncated protein expression. This protein retains all the functional domains of NEMO known. Its characterization revealed a loss of interaction with SHARPIN, components of LUBAC complex allowing linear ubiquitination. This is the first human mutation of NEMO showing the importance of its linear ubiquitination in the activation of the NF-KB pathway. Thus, my thesis work revealed novel physiopathological mechanisms responsible for two forms of ectodermal dysplasia. These mechanisms reflect the complexity of the molecular pathways involved in the development of the skin and the maintenance of its homeostasis during adult life.

Purpose: Prescription stimulant use as "cognitive enhancers" has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. Method: Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary and anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. Results: Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). Conclusions: Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., "cognitive enhancement"), educational quality, and patient safety or health care quality.

L’administration par voie orale des médicaments reste encore de nos jours la voie royale de la prise des médicaments car moins onéreuse et plus adaptée au confort du patient. Mais cette voie reste toujours inaccessible pour certains médicaments comme les médicaments biologiques et les bio similaires voir certains anticancéreux et antirétroviraux.Le but de ce travail est d’améliorer la biodisponibilité par voie orale des médicaments à faible biodisponibilité par la mise au point d’un promoteur d’absorption. Pour y arriver nous avons adopté comme stratégie de développer un promoteur qui agit à la fois sur le passage passif et sur le passage actif des médicaments. Les études in vitro ont été réalisées en chambre de perméation d’Ussing adaptées par la société Biomécatronics SAS (BéthuneFrance). Dans la première partie de ce travail (Brevet), nous avons montré que l’utilisation d’une composition pharmaceutique et/ou diététique comprenant un extrait de plante(Hibiscus sabdariffa) pouvait augmenter la biodisponibilité in vitro des médicaments et des xénobiotiques qui passent par la voie paracellulaire comme le cisplatine (21 fois),l’oxaliplatine (11fois), la fluorescéine isothiocyanate-Dextran 4000 (3 fois), mais également les médicaments connus pour leur transport actif par la voie transcellulaire comme l’Efavirenz (7 fois) et l’Atazanavir (4 fois). Dans la seconde partie de ce travail, nous avons cherché à vérifier si notre promoteur d’absorption des médicaments a un effet sur la couche de mucus intestinale.Cette couche peut être un facteur limitant de passage des médicaments au travers de la barrière intestinale.Dans un premier temps (article 1), nous avons induit l’augmentation de la couche mucus au niveau du colon de rat après un prétraitement pendant une semaine avec le métronidazole. Puis nous avions confirmé (article 2) que l’administration par voie orale de deux antibiotiques le Cotrimoxazole (CTX) et le métronidazole (MTZ) pendant une semaine augmente la couche de mucus au niveau du côlon ; aussi nous avons montré qu’il existe une relation entre l’augmentation de la couche de mucus et la diminution de la conductance qui est l’index de transport passif des ions, des électrolytes et de certaines molécules à faibles poids moléculaires.De plus l’augmentation de la couche de mucus au niveau de l’intestin est responsable de la diminution du passage transépithélial des deux antirétroviraux dont l’utilisation est recommandée en première ligne par l’OMS (le.Ritonavir et l’Atazanavir) surles sujets porteurs du VIH (virus de l’immunodéficience humain). Après les traitements auMTZ et au CTX la sécrétion de l’Atazanavir augmente respectivement dans le côlon proximal de 2 et 4 fois et dans le côlon distal de 3 et 5 fois. On obtient également une sécrétion du Ritonavir de 5 et 10 fois dans le proximal et de 2 et 5 fois plus dans le distal.Le travail se poursuit par l’étude de l’effet de notre promoteur d’absorption des médicaments sur la couche de mucus intestinal.En conclusion, ce travail montre que l’on peut augmenter la biodisponibilité in vitroen utilisant les promoteurs de l’absorption des xénobiotiques qui agissent à la fois au niveau du transport passif et actif. / Oral dosing is still seen as the silver bullet of drug administration, as it is cheaper andbetter adapted to patient comfort. However, oral route is still inaccessible to many drugssuch as biologics and biosimilars respectively certain anticancer drugs and antiretrovirals(ARV).The aim of this present study was to find new drugs enhancers that improve the oralbioavailability of drugs and xenobiotics. All the studies were realized in vitro using Ussingchambers technic. To achieve the set objective we used the strategy to develop drugenhancer which can modulate at the same time transcellular and paracellular pathways.In the first part of this study (patent) we have shown that the use of a pharmaceutical and /or a dietetic formulation containing a plant extract (Hibiscus sabdariffa) could increase thebioavailability in vitro in rats not only of cisplatin (21 fold), oxaliplatin (11 fold) andFluorescein Isothiocyanate-Dextran 4000 (FD4, 3 fold). All that drugs were transportedthrough intestinal barrier using paracellular pathway. In addition the study showed thatthis formulated enhancer can increased the bioavailability of Efavirenz (7 fold) andAtazanavir (4 fold) which are active transported.In order to assess the effect of new drugs enhancer on mucus thickness that limits thetransport of xenobiotic through intestinal barrier, we decide to evaluate his effect on passiveand active transport of drugs.In the second part of this study we have shown that after a week of pre-treatment of ratswith Metronidazole (MTZ, publication 1) and Cotrimoxazole (CTX, publication 2), the twomost commonly used antibiotics in the prophylaxis against opportunistic infections in HIV /AIDS, both increase colonic mucus thickness that affect directly passive intestinalpermeability by reducing conductance an index of passive transport through intestinalepithelium. In addition those antibiotics also entail a change in the transepithelialconductance and ARV fluxes. After MTZ and CTX treatment the secretion of Atazanavir(ATZ) increases respectively in the proximal colon by 2 to 4 fold and in the distal colon by 3to 5 fold respectively. Ritonavir (RTV) is poorly absorbed in control, after a week of pretreatmentwith MTZ and CTX one rather notices a secretion of RTV 5 to 10 fold higher in theproximal and 2 to 5 fold higher in the distal colon. The next study will be conducted toevaluate the effect of new drugs enhancer on mucus thickness layer.In conclusion, oral bioavailability of drugs and xenobiotics can be enhanced bypharmaceutical composition that contains herbal extract which increase passive and activetransport of drugs through intestinal barrier.

Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2016-10-18T13:45:31Z No. of bitstreams: 2 Tese - Lorena Maione Silva - 2016.pdf: 2670473 bytes, checksum: 1799734a5c9cb4a8d11804bbf32a24a5 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2016-10-18T16:43:26Z (GMT) No. of bitstreams: 2 Tese - Lorena Maione Silva - 2016.pdf: 2670473 bytes, checksum: 1799734a5c9cb4a8d11804bbf32a24a5 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-10-18T16:43:26Z (GMT). No. of bitstreams: 2 Tese - Lorena Maione Silva - 2016.pdf: 2670473 bytes, checksum: 1799734a5c9cb4a8d11804bbf32a24a5 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-02-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Skin aging involves events that lead to the reduction of its structural integrity and loss of biological functions. The reactive oxygen species (ROS) are potentially able to generate damage of tissues and are related with the cutaneous photoaging. Antioxidant molecules like vitamin C (VC) are capable of fighting these ROS. Besides, VC acts in the synthesis of collagen in the skin, the primary protein responsible for supporting its connective tissues. However, beneficial skin effects are only obtained when the VC is applied topically. In this work, liposomes containing VC for topical administration were developed and characterized. For quantification of VC in different matrixes, including pharmaceutical products, cosmetics, and porcine ear skin, a quantitative analytical method was developed and validated by high performance liquid chromatography with diode array detection (HPLC-DAD) using ion-pair reversed phase. The developed analytical method was capable of quantifying VC without the interference of the various components of the pharmaceutical formulations and the endogenous compounds of the biological matrix. The diluent chosen to extract and dilute VC was a mixture of water and methanol (4:1, v/v) acidified to pH 3.0 with phosphoric acid, with additional 0.02% sodium thiosulfate. This diluent was the most efficient to stabilize VC compared with other pH conditions and compositions, maintaining the amount of VC close to 100% after 10 days at 4°C. In this way, a method for quantification of VC that could be widely used by pharmaceutical companies and research laboratories was developed. It was precise and accurate in the evaluation of the content of VC in biological matrixes and different pharmaceutical formulations, making it advantageous towards other methods. Liposomes with VC were prepared by dehydration-rehydration vesicles method (DRV). Liposomes containing phosphatidylcholine (PC) or a mixture of PC and cholesterol and other electrically charged lipids were prepared, and liposomes with positive, negative and neutral charges were obtained. All formulations presented mean size inferior to 200 nm and low polydispersity index (<0.2). Encapsulation efficiency of VC was directly influenced by the amount of liposomes that were formed. In skin permeation studies, the association of VC in the liposomes only allowed greater retention in the dermis when negatively charged liposomes were used. After 6 hours, the application of this formulation promoted high skin retention of VC, with an accumulation of 37.9 ± 12.02 μg/cm2 and 73.95± 23.23 μg/cm2 in the epidermis and dermis, respectively. Liposomes were capable of increasing the flow of VC through the skin. The presence of cholesterol and negative charge in the liposomes promoted an increase in VC flow of 4 and 7 times, respectively, when compared to free drug (FD). The interaction of liposomes with live biological membranes was simulated in keratinocytes (HaCat) and fibroblasts (3T3) through the analysis of cell internalization of liposomes. For this assay, during the preparation of liposomes, fluorescent lipids were used to label the lipid membrane (coumarin and rhodamine). After treatment, the groups treated with negatively charged liposomal formulation presented superior fluorescence than the groups treated with other formulations and control, suggesting a higher interaction between the negatively charged liposomes and keratinocytes and fibroblasts. Thus, this negatively charged formulation was compared with free VC in the cell regeneration of keratinocytes after exposure to UVA radiation and in the production of collagen type I in fibroblasts. In both cases, the beneficial effect was only observed when VC was encapsulated in the liposomes. Therefore, the technological development of a liposomal formulation containing VC generated a formulation with a stability of at least 30 days and with characteristics that favored its retention and skin flow. Besides, the encapsulation of VC in negatively charged liposomes promoted an enhancement in the efficacy of regeneration of keratinocytes and the synthesis of collagen in fibroblasts. / O envelhecimento da pele envolve eventos que levam à redução da integridade estrutural e perda das suas funções biológicas. As espécies reativas de oxigênio (EROs) são potencialmente capazes de gerar danos teciduais e estão relacionadas com o fotoenvelhecimento cutâneo. Moléculas antioxidantes como a vitamina C (VC) são capazes de combater estes compostos. Além disso, a VC atua na síntese de colágeno na pele, proteína fundamental à sua sustentação. No entanto, efeitos benéficos cutâneos só são obtidos quando a VC é aplicada topicamente. Neste trabalho, foram desenvolvidos e caracterizados lipossomas contendo VC para a aplicação tópica. Para a quantificação da VC em diferentes matrizes, incluindo produtos farmacêuticos, cosméticos e pele de orelha de porco, foi desenvolvido e validado um método quantitativo por cromatografia líquida de alta eficiência acoplada à detector de arranjo de diodos (HPLC-DAD) por pareamento iônico em fase reversa. O método analítico desenvolvido foi capaz de quantificar a VC sem sofrer interferência dos diversos componentes das formulações farmacêuticas e dos compostos endógenos da matriz biológica. O diluente escolhido para extrair e diluir a VC foi a mistura contendo água e metanol (4:1, v/v) acidificada com ácido fosfórico para pH 3,0 com a adição de 0,02% de tiossulfato de sódio. Este diluente foi o mais eficaz na estabilização da VC, comparando-se com outras condições de pH e composição, com a manutenção da quantidade de VC próximo a 100% depois de 10 dias a 4ºC. Desta forma, foi desenvolvido um método de quantificação da VC que pode ser amplamente utilizado por indústrias farmacêuticas e laboratórios de pesquisa, uma vez que foi preciso e exato na avaliação do teor da VC em matriz biológica e em diferentes preparações farmacêuticas. Os lipossomas contendo VC foram produzidos pela técnica de dehydrationrehydration vesicles (DRV). Foram produzidos lipossomas contendo fosfatidilcolina (PC) ou mistura de PC com colesterol e outros lipídeos eletricamente carregados, obtendo-se assim lipossomas com carga elétrica neutra, positiva ou negativa. Todas as formulações apresentaram tamanho médio inferior a 200 nm e baixo índice de polidispersão (< 0,2). A eficiência de encapsulação da VC foi diretamente influenciada pela quantidade de lipossomas formados. Nos estudos de permeação cutânea, a associação da VC aos lipossomas só permitiu maior retenção na derme quando foram utilizados os lipossomas carregados negativamente. Após 6 horas, a aplicação desta formulação proporcionou alta retenção cutânea da VC, com acúmulo de 37,19 ± 12,02 μg/cm2 e 73,95 ± 23,23 μg/cm2 na epiderme e derme, respectivamente. Os lipossomas foram capazes de aumentar o fluxo de VC através da pele. A presença de colesterol e carga superficial negativa nos lipossomas provocaram aumento do fluxo de VC de 4 e 7 vezes, respectivamente, em relação ao fármaco livre (FL). A interação dos lipossomas com membranas biológicas vivas foi simulada em linhagens de queratinócitos (HaCat) e fibroblastos (3T3) através da análise da internalização celular dos lipossomas. Neste caso, durante o preparo dos lipossomas foram adicionados marcadores de membrana lipídica fluorescentes (rodamina e cumarina). Após tratamento, os grupos que receberam formulação lipossomal com carga superficial negativa apresentaram fluorescência superior aos grupos tratados com as outras formulações e o controle, sugerindo maior interação entre os lipossomas negativos e os queratinócitos e fibroblastos. Assim, a formulação com carga negativa foi comparada com a VC livre na regeneração celular de queratinócitos após exposição à radiação UVA e na produção de colágeno tipo I em fibroblastos. Nos dois casos, os efeitos benéficos só foram observados com a encapsulação da VC nos lipossomas. Desta forma, o desenvolvimento tecnológico de uma formulação lipossomal contendo VC, permitiu a obtenção de uma formulação com estabilidade de pelo menos 30 dias e com características que favoreceram sua retenção e fluxo cutâneo. Além disso, a encapsulação da VC em lipossomas negativos proporcionou aumento da sua eficácia na regeneração de queratinócitos e na síntese de colágeno em fibroblastos.