A tuberculose representa um sério problema de Saúde Pública para o Brasil e o mundo. Estima-se que cerca de um terço da população mundial seja infectado pelo bacilo, sendo que 95% destes indivíduos desenvolvem a forma latente da tuberculose. Dessa forma, encontrar um marco entre o que faz o bacilo Mycobacterium tuberculosis (Mtb) induzir no hospedeiro uma doença ativa ou sua forma latente tem sido o objeto de estudo de diferentes grupos de pesquisa. Neste contexto, o objetivo deste estudo foi correlacionar mudanças na resposta imune desenvolvida por monócitos de pacientes em diferentes estágios da tuberculose pulmonar com alterações epigenéticas, e então com aspectos clínicos de cada estágio. Nosso estudo incluiu 17 pacientes com a doença ativa, 14 indivíduos com tuberculose latente e 16 controles não infectados. A partir de sangue periférico, foi coletado plasma para quantificação de citocinas, sCD163 e sCD14. Complementarmente, monócitos foram purificados para avaliação da ativação imune através da quantificação de citocinas e espécies reativas de oxigênio mediante estimulação in vitro com Mtb inativado por calor, bem como PCR array para detectar expressão de enzimas de repressão ou ativação epigenética entre os grupos e avaliação do padrão de metilação global. Pacientes com tuberculose ativa apresentaram níveis plasmáticos elevados de citocinas como IL-6, IP-10, TNF-, IL-12, bem como IL-5. Dentre as citocinas, TNF-, IL-5, IL-6 e IP-10 permitiram diferenciar indivíduos latentes dos pacientes com tuberculose ativa. Também demostramos que maior número de correlações entre as citocinas foi observado nos pacientes com a doença ativa, indicando um estado geral mais ativado do sistema imune. Níveis plasmáticos de sCD163 e sCD14 estavam elevados nos pacientes quando comparados com indivíduos latentes e controles, e poderiam também diferenciar a tuberculose ativa. Tais níveis aumentados correlacionam-se com o estado ativado de monócitos dos pacientes, que produzem maior quantidade de espécies reativas de oxigênio e tendem a produzir mais citocinas inflamatórias, como IL-6 e TNF-. Este perfil parece ser modulado por modificações epigenéticas, uma vez que monócitos de pacientes com tuberculose pareceram mostrar menor expressão de enzimas responsáveis por mudanças relacionadas à repressão e maior expressão de enzimas relacionadas à ativação da expressão gênica, bem como redução no padrão global de metilação do DNA genômico, sugerindo maior atividade destas células. Finalmente, uma vez que pacientes com tuberculose apresentaram níveis elevados de alguns mediadores, correlacionamos estes com o grau de lesão pulmonar, e consequentemente, com a gravidade da doença. Nós mostramos que dentre os marcadores, TNF- e sCD163 correlacionaram-se positivamente com a progressão da tuberculose. Assim, concluímos que em relação aos indivíduos controle e com TB latente, os pacientes com tuberculose ativa apresentam o sistema imune em maior estado de ativação, e ainda, que alterações epigenéticas podem ser as responsáveis pela modulação observada. Dentre os fatores aumentados nos pacientes, TNF-, IL-6, IP-10, IL-5, sCD163 e sCD14 podem diferenciar os pacientes com doença ativa dos demais indivíduos analisados, e ainda sCD163 e TNF- podem atuar como indicativos da gravidade da tuberculose. / Tuberculosis is a major public health problem for Brazil and worldwide. It is estimated that about one third of the world population is infected with the bacillus, and 95% of those individuals have the condition in the latent form. Thus, finding a hallmark between what makes the Mycobacterium tuberculosis (Mtb) induces in the host an active disease or its latent form has been the subject of different research groups. In this context, the objective of this study was to correlate changes in the immune response developed by monocytes from patients at different stages of pulmonary tuberculosis with epigenetic alterations and then, with clinical aspects of each stage. Our study included 17 patients with active disease, 14 individuals with latent tuberculosis and 16 uninfected controls. From the peripheral blood, plasma was collected for cytokine and CD163s, sCD14 quantification. In addition, monocytes were purified to evaluation of the immune activation through cytokine and reactive oxygen species quantification upon in vitro stimulation with heat-killed Mtb, as well as PCR array for epigenetic repression or activation enzymes were performed to detect epigenetic changes between the groups and evaluation of the global methylation profile. We have shown that patients with active tuberculosis have increased plasma levels of cytokines such as IL-6, IP-10, TNF-, IL-12, as well as IL-5. Among these cytokines, TNF-, IL-5, IL-6 and IP-10 could differentiate latent-infected from TB patients. We also showed that patients with active disease presented higher number of correlations between plasma cytokines, indicating an activated state of the immune system. The plasma levels of sCD163 and sCD14 were more elevated in patients than latent and control individuals, and might differentiate TB active from these other groups. These increased levels of biomarkers correlate with the activated state of monocytes from patients, which produced raised quantities of reactive oxygen species and tended to produced more pro-inflammatory cytokines, such as IL-6 and TNF-. This profile seems to be modulated by epigenetic modifications, since monocytes from patients with tuberculosis seemed to show reduced expression of enzymes responsible for changes related to repression and enhanced expression of enzymes responsible for activation of gene expression, and in addition, these patients presented reduction in the percentage of global methylation of genomic DNA, suggesting increased activity of these cells when compared to the other groups. Finally, once tuberculosis patients presented increased levels of some mediators, we correlated these with the degree of lung injury, and consequently tuberculosis severity. We have showed that TNF- and sCD163 were correlated with disease progression in tuberculosis. In conclusion, we demonstrated that patients with active tuberculosis are more activated than the other groups, and epigenetic alterations might be responsible for these modulations, indicated by the alteration of the enzymes and methylation pattern analyzed. Among the cytokines/chemokines differentially expressed TNF-, IL-6, IP-10, IL-5 and monocyte activation markers, sCD163 and sCD14 could discriminate between active disease from others, and also sCD163 and TNF- could indicate tuberculosis severity.

A tuberculose representa um sério problema de Saúde Pública para o Brasil e o mundo. Estima-se que cerca de um terço da população mundial seja infectado pelo bacilo, sendo que 95% destes indivíduos desenvolvem a forma latente da tuberculose. Dessa forma, encontrar um marco entre o que faz o bacilo Mycobacterium tuberculosis (Mtb) induzir no hospedeiro uma doença ativa ou sua forma latente tem sido o objeto de estudo de diferentes grupos de pesquisa. Neste contexto, o objetivo deste estudo foi correlacionar mudanças na resposta imune desenvolvida por monócitos de pacientes em diferentes estágios da tuberculose pulmonar com alterações epigenéticas, e então com aspectos clínicos de cada estágio. Nosso estudo incluiu 17 pacientes com a doença ativa, 14 indivíduos com tuberculose latente e 16 controles não infectados. A partir de sangue periférico, foi coletado plasma para quantificação de citocinas, sCD163 e sCD14. Complementarmente, monócitos foram purificados para avaliação da ativação imune através da quantificação de citocinas e espécies reativas de oxigênio mediante estimulação in vitro com Mtb inativado por calor, bem como PCR array para detectar expressão de enzimas de repressão ou ativação epigenética entre os grupos e avaliação do padrão de metilação global. Pacientes com tuberculose ativa apresentaram níveis plasmáticos elevados de citocinas como IL-6, IP-10, TNF-, IL-12, bem como IL-5. Dentre as citocinas, TNF-, IL-5, IL-6 e IP-10 permitiram diferenciar indivíduos latentes dos pacientes com tuberculose ativa. Também demostramos que maior número de correlações entre as citocinas foi observado nos pacientes com a doença ativa, indicando um estado geral mais ativado do sistema imune. Níveis plasmáticos de sCD163 e sCD14 estavam elevados nos pacientes quando comparados com indivíduos latentes e controles, e poderiam também diferenciar a tuberculose ativa. Tais níveis aumentados correlacionam-se com o estado ativado de monócitos dos pacientes, que produzem maior quantidade de espécies reativas de oxigênio e tendem a produzir mais citocinas inflamatórias, como IL-6 e TNF-. Este perfil parece ser modulado por modificações epigenéticas, uma vez que monócitos de pacientes com tuberculose pareceram mostrar menor expressão de enzimas responsáveis por mudanças relacionadas à repressão e maior expressão de enzimas relacionadas à ativação da expressão gênica, bem como redução no padrão global de metilação do DNA genômico, sugerindo maior atividade destas células. Finalmente, uma vez que pacientes com tuberculose apresentaram níveis elevados de alguns mediadores, correlacionamos estes com o grau de lesão pulmonar, e consequentemente, com a gravidade da doença. Nós mostramos que dentre os marcadores, TNF- e sCD163 correlacionaram-se positivamente com a progressão da tuberculose. Assim, concluímos que em relação aos indivíduos controle e com TB latente, os pacientes com tuberculose ativa apresentam o sistema imune em maior estado de ativação, e ainda, que alterações epigenéticas podem ser as responsáveis pela modulação observada. Dentre os fatores aumentados nos pacientes, TNF-, IL-6, IP-10, IL-5, sCD163 e sCD14 podem diferenciar os pacientes com doença ativa dos demais indivíduos analisados, e ainda sCD163 e TNF- podem atuar como indicativos da gravidade da tuberculose. / Tuberculosis is a major public health problem for Brazil and worldwide. It is estimated that about one third of the world population is infected with the bacillus, and 95% of those individuals have the condition in the latent form. Thus, finding a hallmark between what makes the Mycobacterium tuberculosis (Mtb) induces in the host an active disease or its latent form has been the subject of different research groups. In this context, the objective of this study was to correlate changes in the immune response developed by monocytes from patients at different stages of pulmonary tuberculosis with epigenetic alterations and then, with clinical aspects of each stage. Our study included 17 patients with active disease, 14 individuals with latent tuberculosis and 16 uninfected controls. From the peripheral blood, plasma was collected for cytokine and CD163s, sCD14 quantification. In addition, monocytes were purified to evaluation of the immune activation through cytokine and reactive oxygen species quantification upon in vitro stimulation with heat-killed Mtb, as well as PCR array for epigenetic repression or activation enzymes were performed to detect epigenetic changes between the groups and evaluation of the global methylation profile. We have shown that patients with active tuberculosis have increased plasma levels of cytokines such as IL-6, IP-10, TNF-, IL-12, as well as IL-5. Among these cytokines, TNF-, IL-5, IL-6 and IP-10 could differentiate latent-infected from TB patients. We also showed that patients with active disease presented higher number of correlations between plasma cytokines, indicating an activated state of the immune system. The plasma levels of sCD163 and sCD14 were more elevated in patients than latent and control individuals, and might differentiate TB active from these other groups. These increased levels of biomarkers correlate with the activated state of monocytes from patients, which produced raised quantities of reactive oxygen species and tended to produced more pro-inflammatory cytokines, such as IL-6 and TNF-. This profile seems to be modulated by epigenetic modifications, since monocytes from patients with tuberculosis seemed to show reduced expression of enzymes responsible for changes related to repression and enhanced expression of enzymes responsible for activation of gene expression, and in addition, these patients presented reduction in the percentage of global methylation of genomic DNA, suggesting increased activity of these cells when compared to the other groups. Finally, once tuberculosis patients presented increased levels of some mediators, we correlated these with the degree of lung injury, and consequently tuberculosis severity. We have showed that TNF- and sCD163 were correlated with disease progression in tuberculosis. In conclusion, we demonstrated that patients with active tuberculosis are more activated than the other groups, and epigenetic alterations might be responsible for these modulations, indicated by the alteration of the enzymes and methylation pattern analyzed. Among the cytokines/chemokines differentially expressed TNF-, IL-6, IP-10, IL-5 and monocyte activation markers, sCD163 and sCD14 could discriminate between active disease from others, and also sCD163 and TNF- could indicate tuberculosis severity.

In our environment there are many compounds which can negatively influence humans and wildlife. Every day, a vast number of environmental pollutants are released into our environment and there is no way to avoid their exposure. Some of these compounds can even mimic endogenous hormones and interfere with our endocrine system (so called endocrine disruptors), which is the key regulatory system controlling almost all physiological processes in human and animal bodies. Also the reproductive system is largely regulated by various hormones, and their proper function is crucial for gamete formation, fertilization and embryo development. Environmental pollutants are therefore considered as one of the possible causes of increased infertility in human population. This prompted us to study the effect of two endocrine disruptors (tetrabromobisphenol A - TBBPA, and zearalenone - ZEA) on the male mouse reproductive system in vivo. According to our results, TBBPA is able to induce apoptosis as well as changes in the expression of selected testicular genes and sperm protamination. Our results also suggest that permanent exposure to TBBPA slightly enhances its effect in the next generation, depending on whether the parents have been affected or not. We hypothesized that differential protamination of the sperm DNA...

The human GI tract has evolved to simultaneously absorb nutrients and be the frontline in host defence. These seemingly mutually exclusive goals are achieved by a single cell thick epithelial barrier, and a complex resident immune system which lives in symbiosis with the intestinal microflora and is also able to rapidly respond to invading pathogens. An immunological balance is therefore required to permit tolerance to the normal intestinal microflora, but also prevent the dissemination of pathogenic micro-organisms to the rest of the host. Inappropriate immune responses in genetically susceptible individuals are the hallmark of human inflammatory bowel disease (IBD) and are thus targeting effector immune cells and their cytokines remains the mainstay of treatment. However despite vigorous efforts to delineate the genetic contribution to IBD disease susceptibility using large multinational cohorts, the majority of disease heritability remains unknown. Epigenetics describes heritable changes in chromatin that are not conferred by DNA sequence. These incorporate changes to histones, chromatin structure and DNA methylation, which confer changes to gene transcription and thus gene expression and cellular function. Methylbinding proteins (MBD) have the ability to bind to methylated DNA and recruit large chromatin remodeling complexes that underpin a variety of epigenetic modifications. Methyl- CpG-binding domain protein 2 (MBD2) is one such MBD that is required for appropriate innate (dendritic cell) and adaptive (T cell) immune function, though its role has not been investigated in the GI tract. We hypothesized that alterations in chromatin are central to the reprogramming of normal gene expression that occurs in disease states. By defining the phenotype of immune cells in the absence of MBDs we hope to understand the mechanisms of chromatin-dysregulation that lead to immune-mediated diseases such as IBD. We therefore aimed to assess the role of MBD2 in colon immune cells in the steady state and in murine models of GI tract inflammation, thereafter identifying the culprit cell types and genes responsible for any observed changes. We envisaged that investigating heritable, epigenetic changes in gene expression that are inherently more amenable to environmental manipulation than our DNA code, may provide novel insight to a poorly understood mechanism of disease predisposition. In addition identifying the cellular and gene targets of Mbd2 mediated changes to immune homeostasis that may provide exciting and novel approaches to therapeutic modulation of pathological inflammatory responses. In chapter 3 we assessed the expression of Mbd2/MBD2 in the murine/human GI tract. Consistent with existing mouse data, levels of Mbd2 mRNA increased between anatomical divisions of small (duodenum, ileum, terminal ileum) and large intestine (caecum, colon, rectum). In addition MBD2 mRNA was greater in the rectum versus ileum, with active IBD associated with lower rectal MBD2 mRNA compared to quiescent IBD controls. Thus we sought to understand the role of Mbd2 in the colon, where mRNA levels were the highest in the GI tract and where appropriate immune function is central to prevent damaging inflammation. To address these aims required the development of existing methods of cell surface marker expression analysis using flow cytometry techniques to simultaneously identify multiple innate and adaptive immune populations. Using naïve Mbd2 deficient mice (Mbd2-/-) we observed CD11b+ CD103+ DCs were significantly reduced in number in Mbd2 deficiency. To understand the role of Mbd2 in colonic inflammation we employed a mouse model of chemical (DSS) and infectious (T. gondii) colitis comparing Mbd2-/- and littermate controls (WT). Mbd2-/- were extremely sensitive to DSS and T. gondii mediated colonic inflammation, characterized by increased symptom score, weight loss and histological score of tissue inflammation (DSS) and increased antibody specific cytokine responses (T. gondii) in Mbd2 deficient animals. Flow cytometry analysis of colon LP cells in both infectious and chemical colitis revealed significant accumulation of monocytes and neutrophils in Mbd2-/-. Indeed monocytes and neutrophils were the principal myeloid sources of IL-1b and TNF in DSS colitis and the number of IL-1b/TNF+ monocytes/neutrophils was significantly greater in Mbd2-/-. Lastly we employed our colon LP isolation techniques to analyse immune populations in active and quiescent IBD and healthy controls, using endoscopically acquired biopsy samples. Analysis revealed that as in murine colitis, active human IBD is characterized by the accumulation of CD14High monocyte-like cells, with an associated increased ratio of macrophage:monocyte-like cells. In Chapter 4 we sought to understand the cellular sources of Mbd2 that may explain the predisposition of Mbd2-/- to colitis. Firstly we restricted Mbd2 deficiency to haematopoietic cells using grafting Mbd2-/- bone marrow (BM) into lethally irradiated WT mice. These animals treated with DSS displayed increased weight loss, symptom score, neutrophil accumulation and histopathology score compared to mice irradiated and grafted with WT BM. Given the accumulation of monocytes in Mbd2-/- DSS treated mice, and existing literature supporting a pathogenic role in this model, we then investigated the role of Mbd2 in monocyte function. Colon monocytes sorted from Mbd2-/- and WT DSS treated mice displayed similar expression for many pro-inflammatory genes (Il6, Il1a, Il1b, Tnf), but demonstrated significantly dysregulated expression for some others (Regb, Lyz1, Ido1, C4a). To investigate this in a more refined model, we lethally irradiated WT mice and repopulated them with a WT:Mbd2-/- BM mix. This enabled the analysis of WT and Mbd2-/- haematopoietic cells in the same animal. Colon WT and Mbd2-/- monocyte recruitment and cytokine production in DSS treated mixed BM chimeras was equivalent between genotypes suggesting that Mbd2 deficiency in monocytes alone did not explain the increased susceptibility of Mbd2-/- to DSS colitis. We then restricted Mbd2 deficiency to CD11c expressing cells, given the known role for Mbd2 in their function, and for CD11c+ cells in DSS, using a CD11cCreMbd2Fl/Fl system. DSS treated mice with Mbd2 deficient CD11c+ cells demonstrated increased weight loss, symptoms score, histolopathology score, monocyte and neutrophil colon accumulation compared to controls. To further explore the role of Mbd2 in colon CD11c+ cells, macrophage and DCs from DSS treated WT and Mbd2-/- mice were purified and their gene expression analysed. Mbd2-/- versus WT macrophages demonstrated significantly altered expression of both pro- (Il1a, C6, Ido1, Trem2) and antiinflammatory (Tgfbi, Retnla) pathways that we hypothesized was a method for attempted host control of excessive colon damage in Mbd2-/- mice. DC gene expression analysis was hampered by small sample size, but demonstrated a large number of small expression changes, including IL-12/IL-23 (Jak2) and autophagy (Lrrk2) pathways. Lastly levels of costimualtory molecules (CD40/CD80) were increased in Mbd2-/- but not CD11cΔMbd2 colon LP DCs/macrophages suggesting that non-CD11c+ cellular sources of Mbd2 were required to produce increased activation phenotype in these cells. Finally in Chapter 5 we explored the role for Mbd2 in non-haematopoietic cells, namely the colonic epithelium. Here we first developed a novel method for identifying and purifying these cells using flow cytometry. Mbd2 deficient colonic epithelium demonstrated increased expression of activation markers MHC II and LY6A/E in the steady state and in DSS / T. muris mediated colonic inflammation. Indeed FACS purified colon epithelial cells from naive and DSS treated, Mbd2-/- and WT mice revealed conserved dysregulated gene expression independent of inflammation: Both naïve and inflamed Mbd2 deficient epithelium displayed significantly increased expression of genes responsible for antigen processing/presentation (MHC I, MHC II, immunoproteasome) and decreased expression of genes involved in cell-cell adhesion (Cldn1, Cldn4). Lastly we investigated whether the observed differences in Mbd2-/- cell types conferred alterations in the makeup of the intestinal microflora. Interestingly independent of co-housing of Mbd2-/- and WT animals, Mbd2 deficiency consistently predicted the microbial composition, with increased levels of Clostridales and decreased levels of Parabacteroides bacteria. Collectively we have identified CD11c+ cells, monocytes and colon epithelial cells as key cell types for Mbd2 mediated changes in gene expression that affect mucosal immune responses. These data thus identify Mbd2 gene targets within these cell types as exciting new areas for investigation and therapeutic modulation to limit damaging GI tract inflammation.

Résumé : La néphropathie diabétique (ND) est une complication microvasculaire du diabète évoluant ultimement en insuffisance rénale et l’hyperglycémie est connue comme étant l’un des facteurs de risques. De larges études cliniques, tel que le DCCT et l’UKPDS, ont montré que si le contrôle intensif de la glycémie se faisait de façon précoce, il serait possible de retarder le développement de la ND. Cependant, les résultats de l'EDIC montrent que si ce contrôle intensif se faisait plus tardivement, suite à une période d’hyperglycémie, il n’empêcherait plus sa progression. Les podocytes ont un rôle critique dans le maintien des fonctions rénales et leur apoptose corrèle de façon très spécifique avec la progression de la ND. Récemment, nous avons rapporté que SHP-1, une protéine tyrosine phosphatase, était augmentée en concentrations élevées de glucose (HG), menant à une inhibition des voies de signalisation de l'insuline. Notre hypothèse est que l’augmentation de l’expression de SHP-1 causée par l’hyperglycémie persiste même après réduction des niveaux de glucose, phénomène de mémoire hyperglycémique, causant une résistance à l'insuline, la mort des podocytes et une absence de réversibilité liée à la progression de ND. Les résultats in vivo montrent que la fonction et la pathologie rénale continuent de progresser et ce en dépit de la normalisation des niveaux de glucose avec implants d’insuline de 5 à 7 mois d’âge La progression de la pathologie corrèle avec le maintien de l’augmentation de l’expression de SHP-1, contribuant au maintien de l’inhibition des voies de l’insuline. En culture, des podocytes murins exposés en HG pendant 96 h et ensuite exposés en condition normale de glucose(NG) pour les dernières 24 h montrent une persistance de l’inhibition des voies de signalisation de l’insuline qui corrèle avec l’augmentation persistante de l’expression et l’activité phosphatase de SHP-1. L’activité des caspases 3/7 dans les podocytes est plus élevée lorsque ceux-ci sont exposés en HG qu’en NG. Le retour en NG pour les dernières 24 h n’a aucun effet bénéfique à réduire l’activité des caspases 3/7. Finalement, l’analyse épigénétique a été suggérée comme étant une explication du phénomène de mémoire hyperglycémique. La monométhylation de la lysine 4 de l’histone 3 (H3K4me1), un marqueur d’activation génique, est augmentée sur le promoteur de SHP-1 en HG et demeure élevée malgré le retour en NG pendant les dernières 24 h. En conclusion, l’hyperglycémie engendre une augmentation persistante de SHP-1 due possiblement à des modifications épigénétiques, causant le maintien de l’inhibition les voies de signalisation de l’insuline même après un retour à des niveaux normaux de glucose, contribuant à la progression de la ND. / Abstract : Diabetic nephropathy (DN) is the leading cause of end-stage renal disease. Renal podocytes apoptosis induced by hyperglycemia is an early event of DN. Clinical studies have shown that intensive blood glucose control reduced the development of DN but is not sufficient, if started late, to prevent its progression, introducing the concept of “hyperglycemic memory”. We have recently published that the tyrosine phosphatase SHP-1 is elevated in renal cortex of type 1 diabetic mice (Akita), contributing to insulin unresponsiveness and DN. We hypothesized that SHP-1 expression remains elevated regardless of systemic blood glucose normalization, and is responsible for hyperglycemic memory in podocytes leading to DN progression. In vivo contribution of SHP-1 in hyperglycemic memory was evaluated using Akita mice treated with insulin implants after 4 months of diabetes. Both urinary albuminuria and glomerular filtration rate were significantly increased in diabetic mice compared to non-diabetic mice and remained elevated despite normalization of blood glucose levels. Renal dysfunction was associated with a persistent increase of SHP-1 expression in renal cortex and inhibition of insulin action that were not normalized following insulin implants. Mouse podocytes were cultured in normal (5.6mM; NG), high glucose concentrations (25mM; HG) for 120 h or HG (96 h) followed by NG for an additional 24 h (HG+NG). We observed that Akt and ERK phosphorylation induced by insulin was inhibited in HG and were not restored despite returning glucose level to 5.6 mM after the HG period. This inhibition was associated with persistent increase of SHP-1 expression and phosphatase activity, leading to insulin signaling pathway inhibition. Moreover, caspase 3/7 activity in podocytes exposed to HG was higher than in podocytes cultured in NG and returning glucose concentrations to normal range for the last 24 h after the 96 h HG exposure had no effect on reducing caspase 3/7 activity. Epigenetic changes were studied to explain the hyperglycemic memory effect. On SHP-1 promoter, H3K4me1 levels, an activation mark, tended to be more elevated in podocytes exposed to HG and were maintained despite returning to NG levels after the HG conditions. In conclusion, hyperglycemia induces persistent and epigenetic changes of SHP-1 causing insulin unresponsiveness in the podocytes contributing to DN progression.