Les vésicules extracellulaires telles que les microvésicules et les exosomes sont libérées lors de l’apoptose ou de l’activation cellulaire. Ce sont des médiateurs importants dans la communication intercellulaire, suggérant que ces vésicules pourraient jouer un rôle physiopathologique, en particulier dans les maladies cardiovasculaires. L'athérosclérose est une maladie inflammatoire chronique de la paroi artérielle qui résulte de l’interaction entre les lipoprotéines, les cellules inflammatoires, et les cellules vasculaires. L'infarctus du myocarde est une complication aiguë et grave de l'athérosclérose. La réaction inflammatoire post-infarctus joue un rôle central dans la formation de néovaisseaux sanguins et la cicatrisation. Cependant, les mécanismes de l’inflammation sont encore mal connus dans ces pathologies. Mon travail de thèse a porté sur les effets des vésicules extracellulaires isolées de tissus pathologiques sur les cellules inflammatoires. Nous avons montré dans un premier travail que les microvésicules s’accumulant dans les lésions d’athérosclérose humaines contribuent à la surcharge en cholestérol et en triglycérides des macrophages et facilitent la formation de cellules spumeuses. L’accumulation des lipides intracellulaires induite par ces microvésicules est contrebalancée par une augmentation de l’efflux du cholestérol associée à une activation d’ABCA1. Dans un deuxième travail, nous avons examiné les effets des vésicules produites dans le cœur post-infarctus sur la réponse inflammatoire. Nos résultats montrent : 1- une augmentation de la libération in situ des microvésicules majoritairement d’origine cardiomyocytaire et des exosomes 15 heures après infarctus ; 2- la stimulation de la production de VEGF monocytaire par les vésicules extracellulaires ; 3- l’incapacité en ce qui concerne les vésicules isolées de cœur diabétique infarci à reproduire cet effet sur les monocytes des souris contrôles. Afin de clarifier les déterminants de l’angiogenèse post-ischémique, nous avons également étudié les profils de miARNs des vésicules contrôles et diabétiques. Après infarctus du myocarde, l’expression de miR-126-3p et de miR-92a-3p est significativement diminuée dans les vésicules diabétiques en comparaison avec les vésicules contrôles. Par ailleurs, nous avons observé une augmentation de miR-126-3p et de miR-92a-3p respectivement dans les microvésicules et les exosomes chez les souris contrôles post-infarctus. En conclusion, ce travail apporte des éléments nouveaux sur les fonctions des vésicules extracellulaires générées localement dans les tissus inflammatoires, en particulier leur capacité à promouvoir la transformation des macrophages en cellules spumeuses dans la plaque. Par ailleurs, les vésicules isolées du cœur ischémique pourraient favoriser l’angiogenèse post-infarctus en stimulant la production de VEGF monocytaire. La disparition de cet effet bénéfique dans le diabète pourrait être associée à des modifications d’adressage des miARNs dans les vésicules extracellulaires au cours de cette pathologie. / Extracellular vesicles, such as microvesicles and exosomes, are released during cell apoptosis or activation. They are important mediators of intercellular communication, suggesting that these vesicles could play a pathophysiological role, especially in cardiovascular diseases. Atherosclerosis is a chronic inflammatory disease of the arterial wall which results from the interaction between lipoproteins, inflammatory cells, and vascular cells. Myocardial infarction is an acute and severe complication of atherosclerosis. The postinfarction inflammatory response plays a central role in the formation of new blood vessels and scarring. However, the mechanisms of inflammation are still poorly known in these pathologies. My thesis concerned the effects of extracellular vesicles isolated from pathological tissues on inflammatory cells. We showed in the first work that microvesicles accumulating in human atherosclerotic lesions contribute to cholesterol and triglyceride overload in macrophages and facilitate foam cell formation. The accumulation of the intracellular lipids induced by those microvesicles is offset by an increase in cholesterol efflux associated with activation of ABCA1. In the second study, we examined the effect of vesicles produced in the infarcted heart on the inflammatory response. Our results showed : 1- an increased release in situ of microvesicles mostly of cardiomyocyte origin and exosomes 15 hours after infarction ; 2- the stimulation of monocyte VEGF production by extracellular vesicles ; 3- the incapacity of diabetic vesicles isolated from infarcted heart to reproduce that effect on control mice monocytes. In order to clarify the determinants of postischemic angiogenesis, we also studied miRNA profiles of control and diabetic vesicles. After myocardial infarction, the expression level of miR-126-3p and miR-92a-3p was significantly decreased in diabetic vesicles compared to control vesicles. Furthermore, we observed an increased expression of miR-126-3p and miR-92a-3p respectively in the microvesicles and the exosomes isolated from control mice heart after myocardial infarction. In conclusion, this work provides new information on the functions of extracellular vesicles locally generated in inflamed tissues, particularly in promoting macrophage transformation into foam cells in the atherosclerotic plaque. Furthermore, vesicles isolated from ischemic heart could enhance postinfarction angiogenesis by stimulating monocyte VEGF production. The loss of this beneficial effect in diabetes may be associated with changes of miRNA cargo in extracellular vesicles in this pathology.

Em pacientes submetidos à diálise peritoneal (DP), alterações morfofuncionais da membrana peritoneal (MP) ocorrem de forma progressiva ao longo dos anos. Estas alterações caracterizam-se, morfologicamente, por perda da camada mesotelial, inflamação, neoangiogênese e fibrose peritoneal (FP) e, funcionalmente, pela queda na ultrafiltração. Tais alterações implicam diretamente em perda da eficiência dessa terapia renal substitutiva. Até o momento, não existe tratamento específico capaz de prevenir ou reverter esta situação. As células tronco mesenquimais (CTm) têm mostrado efeitos terapêuticos benéficos em doenças associadas à fibrose. A participação das CTm no reparo tecidual está principalmente relacionada à sua atividade parácrina, através da liberação de fatores solúveis e vesículas extracelulares (VE). As VE liberadas são importantes na intercomunicação célula-célula e possivelmente contribuem para o efeito terapêutico das CTm ao entregar seu conteúdo (mRNAs, miRNAs, proteínas) para as células alvo. Assim, o objetivo central do presente estudo foi comparar o possível efeito terapêutico das CTm de tecido adiposo (CTmTA) e de VE derivadas de CTmTA na prevenção da FP experimental em ratos. A FP foi induzida em ratos Wistar machos através de injeções intraperitoneais (IP) de gluconato de clorexidina (GC) a 0,1%, em dias alternados, por um período de 30 dias. As CTmTA utilizadas foram obtidas de tecido adiposo gonadal de rato Wistar, cultivadas e expandidas até a 4ª passagem e caracterizadas de acordo com a sua capacidade de aderência ao plástico, presença de marcadores de superfície e pela diferenciação celular in vitro. As VE derivadas de CTmTA foram isoladas por ultracentrifugação. Os protocolos de isolamento por ultracentrifugação e caracterização por microscopia eletrônica, rastreamento de nanopartículas e quantificação das proteínas totais das VE foram padronizados e estabelecidos no laboratório. Os tratamentos com 2x106 CTmTA ou com 30 ug VE foram administrados por injeções de IP. Os animais do estudo foram divididos em 4 grupos: Grupo Controle (n = 8), animais que receberam apenas injeções IP de solução fisiológica; Grupo FP (n = 9), animais que receberam injeções IP de GC para indução da FP e foram tratados com solução fisiológica; Grupo FP + CTmTA (n = 8), animais que receberam injeções IP de GC para indução da PF e foram tratados com 2x106 CTmTA, no 3º e 10º dias, via IP, e Grupo FP + VE (n = 8), animais que receberam injeções IP de GC para indução da FP e foram tratados com 30 ug de VE, IP no 3º e 10º dias, via IP. Após 30 dias da indução de FP, os animais foram submetidos ao teste de função peritoneal e, em seguida, à eutanásia para coleta de amostras de tecido do peritôneo. As amostras do peritôneo parietal foram direcionadas para análises histológicas, imunohistoquímicas, de imunofluorescência e biologia molecular. No Grupo FP, como esperado, houve um aumento significativo da espessura da MP. Os tratamentos com CTmTA e VE preveniram o espessamento da MP, mantendo a espessura similar à do Grupo Controle. Os tratamentos com CTmTA e VE bloquearam o aumento do número de miofibroblastos, da expressão de fibronectina e de fatores envolvidos na FP (TGF-beta e FSP-1), observados nos animais do Grupo FP. Além disso, a expressão gênica de Smad3, que está associada à ativação de genes pró-fibróticos, estava aumentada no Grupo FP e foi reduzida nos grupos tratados. Por outro lado, a expressão gênica de Smad7, um gene associado à contrarregulação do TGF-beta, estava reduzida no Grupo FP e foi aumentada nos grupos que receberam tratamento. Os tratamentos com CTmTA e VE também apresentaram efeitos anti-inflamatórios, reduzindo o número de macrófagos e de linfócitos na MP e diminuindo a expressão do TNF-alfa, uma citocina pró-inflamatória, quando comparados ao Grupo FP. Com relação a análise funcional, o grupo tratado com VE apresentou melhora na capacidade de ultrafiltração. No entanto, os tratamentos com CTmTA e VE não alteraram o transporte de glicose pela MP em relação ao Grupo FP. Outro aspecto dos efeitos dos tratamentos CTmTA e VE diz respeito à neoangiogênese na MP, importante fator relacionado a capacidade de ultrafiltração. Apesar dos grupos tratados com CTmTA e VE apresentarem diminuição significativa da expressão de VEGF na MP, não foi constatada diferença na densidade capilar na MP destes grupos, em relação ao Grupo FP. Em conclusão, no modelo experimental de FP, os tratamentos com CTmTA e VE apresentaram efeito anti-inflamatório e foram igualmente eficientes no bloqueio do processo de FP. O tratamento com VE mostrou melhor capacidade de preservação da função peritoneal, com aumento da capacidade de ultrafiltração. Portanto, os tratamentos com CTmTA ou com VE derivadas de CTmTA apresentam potencial terapêutico e constituem uma nova abordagem, ainda pouco explorada, na prevenção do desenvolvimento da FP associada à DP / In patients undergoing peritoneal dialysis (PD), morphofunctional changes of the peritoneal membrane (PM) occur progressively over the years. These modifications are morphologically characterized by loss of the mesothelial layer, inflammation, neoangiogenesis and peritoneal fibrosis (PF), and functionally, by the reduction in ultrafiltration (UF). Moreover, these changes directly imply in failure of treatment. Currently, there is no clinical alternative to prevent or reverse this situation. In this context, mesenchymal stem cells (MSC) have shown beneficial therapeutic effects in diseases associated with fibrosis. The participation of MSC in tissue repair is related to their paracrine activity, through the release of soluble factors and extracellular vesicles (EV). The EV released are important to cell-to-cell communication and the possibility to contribute to the therapeutic effect of MSC, by delivering their content (mRNAs, miRNAs, proteins) to the target cells. Therefore, the aim of this study was to compare the possible therapeutic effect of MSC versus EV derived from MSC for prevention of experimental PF fibrosis in rats. PF was induced in male Wistar rats by intraperitoneal (IP) injections of 0.1% chlorhexidine gluconate (CG) on alternate days, for a period of 30 days. The MSC used were obtained from Wistar rats gonadal adipose tissue (ASC), cultured and expanded to the 4th passage and characterized according to their ability to adhere to plastic, presence of membranes markers and by cell differentiation in vitro. EV derived from ASC were isolated by ultracentrifugation. The protocols of ultracentrifugation and characterization by electron microscopy, nanoparticle tracking and quantification of total proteins from EV were standardized and established in the laboratory. Both treatments using ASC (2x106 cells) or EV (30 ug) were administered via IP injections. The animals were divided into four groups: Control group (n = 8), animals that received only IP injections of physiological solution; PF group (n = 9), animals that received IP injections of CG to induce PF and were treated with physiological solution; PF+ASC group (n = 8), animals that received IP injections of CG for induction of PF and were treated with 2x106 ASC, at the 3rd and 10th day, by IP delivery; PF+EV group (n = 8), animals that received IP injections of CG for induction of PF and were treated with 30 ug of EV at the 3rd and 10th day, by IP delivery. After 30 days of PF induction, the animals were submitted to the peritoneal function test and then, to euthanasia to collect tissue samples from the peritoneum. The samples were analyzed by histology immunohistochemistry, immunofluorescence, and also by molecular biology. In the FP group, there was a significant increase in the thickness of the PM. Both treatments with ASC or EV prevented increase in PM thickness. Importantly, ASC and EV treatments blocked the increased number of myofibroblast, fibronectin expression and the factors involved in PF (TGF-beta and FSP-1) observed in the PF group. In addition, the Smad3 gene expression, which is associated with activation of pro-fibrotic genes, was increased in the PF group and decreased in the treatments groups. Conversely, the gene expression of Smad7, a gene associated with TGF-beta against regulation, was decreased in the PF group and increased in the animals that received the treatment. ASC and EV injections also showed anti-inflammatory effects, reducing the infiltration of macrophages and lymphocytes into the PM and decreasing the expression of TNF-alpha, a proinflammatory cytokine. The treatments with ASC and EV did not alter the glucose transport by the PM in relation to the PF group, but promoting an increase of the UF capacity. Only the EV treated group showed an increase in UF capacity. Another aspect of the effects of ASC and EV treatments concerns to neoangiogenesis in the PM, an important factor related to the UF capacity. Although the treated groups showed a significant decrease of the VEGF expression in the PM, no difference in the capillary density was observed in relation of PF group. In conclusion, in the experimental model of FP, treatement with ASC or EV showed anti- inflammatory effects and were equally efficient in blocking the PF process. However, the treatment with EV showed a better capacity of preservation of the peritoneal function, with increased capacity of UF. Therefore, the use of ASC and EV potentially represents a new therapeutic approach in preventing the development of PF associated with PD

Les vésicules extracellulaires nanométriques (nEVs) issues de cellules souches mésenchymateuses (CSMs) et les nanovésicules synthétiques sont au centre de nombreuses recherches pour le développement de nouvelles stratégies thérapeutiques en médecine régénérative. La mise en place d’une méthode standardisée pour isoler les nEVs à partir de milieu conditionné de CSMs et de pouvoir les caractériser a été nécessaire. Nous nous sommes concentrés sur leur taille qui se situe entre 30 et 150 nm ainsi que la présence de certains de leur marqueurs membranaires (CD9, CD63 et CD81). Durant ce travail, deux méthodes d’isolement ont été testées. Les résultats obtenus par les analyses physiques (Nanosight®, microscopie électronique à transmission) et biologiques (cytométrie en flux) des différents échantillons ont permis de standardiser la méthode d’isolement des nEVs par centrifugations et ultracentrifugations successives. Ensuite, nous nous sommes intéressés à l’utilisation de ces nEVs sécrétées par les CSMs en culture cellulaire. Il a été mis en évidence que des interactions existent entre ces nEVs et des cellules endothéliales (CEs) in vitro. Ces interactions vont entraîner des modifications dans le comportement cellulaire des CEs en augmentant leur potentiel de formation de réseaux vasculaires. En parallèle de ces travaux sur les nEVs, une étude a été réalisée sur l’utilisation de nanovésicules synthétiques, des nanoliposomes (NLPs), élaborées à partir de lécithine d’agro-ressource (saumon) comme transporteur de TGF-ß1 pour une application en médecine régénérative. Après leur caractérisation physico-chimique, cette étude préliminaire a montré que ces NLPs ne présentent pas de cytotoxicité pour les CSMs in vitro. Il existe un potentiel important d’utilisation des nEVs de CSMs ainsi des NLPs pour développer de nouvelles stratégies innovantes en thérapie « cell-free » dans le domaine de la médecine régénérative / Nanoscale extracellular vesicles (nEVs) derived from mesenchymal stem cells (MSCs) and synthetic nanovesicles are at the centre of many research studies for the development of new therapeutic strategies in regenerative medicine. A standardized method was used to isolate nEVs from conditioned media of CSMs and to characterize them. We focused on their size with a range of 30 to 150 nm and the presence of some of their membrane markers (CD9, CD63 and CD81). During this work, two isolation methods were tested. The results obtained by the physical (Nanosight®, transmission electron microscopy) and biological (flow cytometry) analyses of the different samples allowed to standardize the method of isolation of the nEVs by successive centrifugation and ultracentrifugation. Then, we studied the use of these nEVs derived from MSCs in cell culture. Interactions between these nEVs and endothelial cells (ECs) have been demonstrated in vitro. These interactions lead to changes in the cellular behaviour of ECs by increasing their potential to form vascular networks. In parallel of this work on nEVs, we studied the use of synthetic nanovesicles, called nanoliposomes (NLPs) prepared from agro-resource derived lecithin (salmon) as TGF-β1 transporters for applications in regenerative medicine. After their physicochemical characterization, this preliminary study showed that these NLPs do not exhibit cytotoxicity for MSCs in vitro. There is an important potential for the use of nEVs derived from MSCs as well as NLPs to develop new cell-free therapy innovative strategies in the field of regenerative medicine

Les vésicules extracellulaires telles que les microvésicules et les exosomes sont libérées lors de l’apoptose ou de l’activation cellulaire. Ce sont des médiateurs importants dans la communication intercellulaire, suggérant que ces vésicules pourraient jouer un rôle physiopathologique, en particulier dans les maladies cardiovasculaires. L'athérosclérose est une maladie inflammatoire chronique de la paroi artérielle qui résulte de l’interaction entre les lipoprotéines, les cellules inflammatoires, et les cellules vasculaires. L'infarctus du myocarde est une complication aiguë et grave de l'athérosclérose. La réaction inflammatoire post-infarctus joue un rôle central dans la formation de néovaisseaux sanguins et la cicatrisation. Cependant, les mécanismes de l’inflammation sont encore mal connus dans ces pathologies. Mon travail de thèse a porté sur les effets des vésicules extracellulaires isolées de tissus pathologiques sur les cellules inflammatoires. Nous avons montré dans un premier travail que les microvésicules s’accumulant dans les lésions d’athérosclérose humaines contribuent à la surcharge en cholestérol et en triglycérides des macrophages et facilitent la formation de cellules spumeuses. L’accumulation des lipides intracellulaires induite par ces microvésicules est contrebalancée par une augmentation de l’efflux du cholestérol associée à une activation d’ABCA1. Dans un deuxième travail, nous avons examiné les effets des vésicules produites dans le cœur post-infarctus sur la réponse inflammatoire. Nos résultats montrent : 1- une augmentation de la libération in situ des microvésicules majoritairement d’origine cardiomyocytaire et des exosomes 15 heures après infarctus ; 2- la stimulation de la production de VEGF monocytaire par les vésicules extracellulaires ; 3- l’incapacité en ce qui concerne les vésicules isolées de cœur diabétique infarci à reproduire cet effet sur les monocytes des souris contrôles. Afin de clarifier les déterminants de l’angiogenèse post-ischémique, nous avons également étudié les profils de miARNs des vésicules contrôles et diabétiques. Après infarctus du myocarde, l’expression de miR-126-3p et de miR-92a-3p est significativement diminuée dans les vésicules diabétiques en comparaison avec les vésicules contrôles. Par ailleurs, nous avons observé une augmentation de miR-126-3p et de miR-92a-3p respectivement dans les microvésicules et les exosomes chez les souris contrôles post-infarctus. En conclusion, ce travail apporte des éléments nouveaux sur les fonctions des vésicules extracellulaires générées localement dans les tissus inflammatoires, en particulier leur capacité à promouvoir la transformation des macrophages en cellules spumeuses dans la plaque. Par ailleurs, les vésicules isolées du cœur ischémique pourraient favoriser l’angiogenèse post-infarctus en stimulant la production de VEGF monocytaire. La disparition de cet effet bénéfique dans le diabète pourrait être associée à des modifications d’adressage des miARNs dans les vésicules extracellulaires au cours de cette pathologie. / Extracellular vesicles, such as microvesicles and exosomes, are released during cell apoptosis or activation. They are important mediators of intercellular communication, suggesting that these vesicles could play a pathophysiological role, especially in cardiovascular diseases. Atherosclerosis is a chronic inflammatory disease of the arterial wall which results from the interaction between lipoproteins, inflammatory cells, and vascular cells. Myocardial infarction is an acute and severe complication of atherosclerosis. The postinfarction inflammatory response plays a central role in the formation of new blood vessels and scarring. However, the mechanisms of inflammation are still poorly known in these pathologies. My thesis concerned the effects of extracellular vesicles isolated from pathological tissues on inflammatory cells. We showed in the first work that microvesicles accumulating in human atherosclerotic lesions contribute to cholesterol and triglyceride overload in macrophages and facilitate foam cell formation. The accumulation of the intracellular lipids induced by those microvesicles is offset by an increase in cholesterol efflux associated with activation of ABCA1. In the second study, we examined the effect of vesicles produced in the infarcted heart on the inflammatory response. Our results showed : 1- an increased release in situ of microvesicles mostly of cardiomyocyte origin and exosomes 15 hours after infarction ; 2- the stimulation of monocyte VEGF production by extracellular vesicles ; 3- the incapacity of diabetic vesicles isolated from infarcted heart to reproduce that effect on control mice monocytes. In order to clarify the determinants of postischemic angiogenesis, we also studied miRNA profiles of control and diabetic vesicles. After myocardial infarction, the expression level of miR-126-3p and miR-92a-3p was significantly decreased in diabetic vesicles compared to control vesicles. Furthermore, we observed an increased expression of miR-126-3p and miR-92a-3p respectively in the microvesicles and the exosomes isolated from control mice heart after myocardial infarction. In conclusion, this work provides new information on the functions of extracellular vesicles locally generated in inflamed tissues, particularly in promoting macrophage transformation into foam cells in the atherosclerotic plaque. Furthermore, vesicles isolated from ischemic heart could enhance postinfarction angiogenesis by stimulating monocyte VEGF production. The loss of this beneficial effect in diabetes may be associated with changes of miRNA cargo in extracellular vesicles in this pathology.

A produção in vitro de embriões é uma biotecnologia bastante difundida mundialmente. O Brasil, em 2015, foi responsável por aproximadamente 67% dos embriões bovinos produzidos in vitro no mundo (PERRY, 2014). Embora essa tecnologia seja bastante utilizada, é de grande interesse para o mercado desenvolver estratégias que levem ao maior aproveitamento dos oócitos obtidos e compreender os mecanismos, dentro do ambiente folicular, que determinam a competência oocitária. O microambiente folicular é fundamental para o crescimento e a aquisição da competência oocitária, tornando o oócito apto a desenvolver-se e manter o embrião até a transição materno embrionária. Para tanto, os componentes foliculares - células da granulosa, células do cumulus, oócito e líquido folicular - precisam trabalhar em unidade, visto que possuem uma relação de interdependência. Dentro dos mecanismos de comunicação existentes no ambiente folicular estão as vesículas secretadas por células, chamadas vesículas extracelulares, que foram descritas no líquido folicular, contendo material bioativo como proteínas, lipídios e RNAs, incluindo os microRNAs. Contudo, os componentes do ambiente folicular podem refletir na qualidade do oócito que será produzido e a hipótese geral deste trabalho é de que os miRNAs presentes no ambiente folicular regulam vias de sinalização importantes para o desenvolvimento oocitário e que os miRNAs e ou RNAs mensageiros presentes nas células foliculares podem ser explorados como importantes ferramentas para o diagnóstico da qualidade oocitária. O primeiro estudo determinou perfis transcricionais de miRNAs em células da granulosa, em complexos cumulus-oócito e em vesículas extracelulares derivadas destas células e também do fluido folicular. Além de conhecer a origem e o papel dos miRNAs no ambiente folicular, estes perfis de expressão indicaram a regulação no ambiente folicular da via de sinalização da PI3K-Akt. No segundo estudo, componentes desta via de sinalização foram então determinados em células foliculares associadas a oócitos de alta ou baixa competência ao desenvolvimento. Os resultados demonstram que a ativação da via PI3K-Akt em células foliculares correlaciona-se à maior competência oocitária; de modo oposto, a menor atividade desta via nas células foliculares está relacionada à reduzida competência oocitária. Nos estudos três e quatro, um conjunto de experimentos foram realizados para determinar o perfil de microRNAs e RNAs mensageiros em células do cumulus associadas a oócitos de alta ou baixa competência ao desenvolvimento. Buscou-se esclarecer alguns dos mecanismos responsáveis pela melhor qualidade oocitária e levar a identificação de biomarcadores de qualidade oocitária permitindo o avanço e o desenvolvimento de novas ferramentas para intensificar a produção in vitro de embriões bovinos. Por fim, estes resultados demonstram respostas integradas entre oócitos e células foliculares durante o desenvolvimento folicular e o processo de aquisição de competência oocitária e identificaram marcadores de qualidade oocitária. / In vitro embryo production of is a widespread biotechnology worldwide. In 2015 Brazil was responsible for approximately 67% of bovine embryos produced in vitro in the world (PERRY, 2014). Although widely used, to develop strategies that lead to better use of oocytes and understand the mechanisms (in follicular microenvironment) that determine oocyte competence is of great interest to national market. The follicular microenvironment is fundamental for oocyte growth and acquisition of competence, making the oocyte able to develop and maintain the embryo until the embryonic maternal transition. For this end, the follicular components - granulosa cells, cumulus cells, oocytes and follicular fluid - need to work in unity, since they have arelation of interdependence. Within the mechanisms of communication existing within the follicular environment are vesicles secreted by cells, called extracellular vesicles, which were described in follicular fluid, containing bioactive material such as proteins, lipids and RNAs, including microRNAs. The components of follicular environment may reflect the quality of the oocyte that will be produced and the general hypothesis of this work is that the miRNAs present in the follicular environment regulate signaling pathways important for oocyte development and that the miRNAs and/or messenger RNAs present in the follicular cells can be explored as important tools for the diagnosis of oocyte quality. The first study determined profiles of miRNAs in granulosa cells, cumulus-oocyte complexes and extracellular vesicles derived from these cells and also in follicular fluid. In addition, by knowing the origin and role of miRNAs in the follicular environment, the expression profiles indicated the PI3K-Akt signaling pathway regulation in the follicular environment. In the second study, components of this signaling pathway were then determined in follicular cells associated with oocytes of high or low developmental competence. The results demonstrated that the activation of the PI3K-Akt pathway in follicular cells correlates with increased oocyte competence; conversely, the lower activity of this pathway in follicular cells is related to reduced oocyte competence. In studies three and four, experiments were performed to determine the profile of microRNAs and messenger RNAs in cumulus cells associated with oocytes of high or low developmental competence. Aiming to clarify some of the mechanisms responsible for the best oocyte quality that lead to the identification of oocyte quality biomarkers, allows the advancement and development of new tools to intensify the in vitro production of bovine embryos. Finally, results obtained demonstrate integrated responses between oocytes and follicular cells during follicular development and give new insights to the study of oocyte competence acquisition process and identified oocyte quality markers.

Introdução: O fígado é um órgão chave na manutenção da homeostasia corpórea e o transplante hepático ainda continua sendo o padrão-ouro no tratamento da insuficiência hepática aguda. A falta de doadores tem favorecido o desenvolvimento da terapia celular. Células derivadas de medula óssea podem se diferenciar em células tipo-hepatócitos em menos de 24 horas e a comunicação através de vesículas extracelulares (VEs) é um dos mecanismos propostos para explicar essa capacidade. Muitos estudos têm demonstrado que as células-tronco mesenquimais (CTMs) da medula tem alta plasticidade para se diferenciar em hepatócitos, mas os protocolos normalmente utilizados levam entre 7 e 28 dias. Objetivo: Analisar a capacidade de diferenciação das CTMs da medula em se tornar uma célula tipo-hepatócito através do mecanismo de comunicação celular por VEs em cultura (6 e 24 horas). Materiais e métodos: Para avaliar o efeito de hepatócitos primários isolados de ratos saudáveis e lesados com CCl4 na diferenciação das CTMs foi utilizado um sistema de co-cultivo com insertos que não permitem o contato entre as células colocando as CTMs na câmera superior e os hepatócitos na câmera inferior do sistema. Meio condicionado de hepatócitos com lesão foi utilizado para avaliar a capacidade das CTMs de capturar VEs e se diferenciar em célula-tipo hepatócito. Os marcadores de célula tipo-hepatócito avaliados foram expressão gênica (alfa fetoproteina, albumina e citoqueratina-18), armazenamento de glicogênio e liberação de ureia. Para rastrear VEs, hepatócitos de ratos lesados foram marcados com PKH-26. As VEs foram obtidas por ultracentrifugação do sobrenadante e analisadas por citometria de fluxo. Hepatócitos e CTMs também foram analisados por citometria de fluxo na busca de marcação positiva. Resultados: CTMs co-cultivadas durante 6 e 24 horas com hepatócitos não apresentaram expressão de genes hepáticos, mesmo quando expostas a um ambiente de lesão. Os ensaios funcionais confirmaram a falta de sinais de diferenciação, sendo que não foi observado armazenamento de glicogênio nem liberação de ureia nas CTMs. Um achado interessante foi que ao analisar o sobrenadante da câmera superior do sistema de co-cultivo, não foram achadas VEs marcadas com PKH-26 nem CTMs com rastros do marcador. Por outro lado, os experimentos utilizando meio condicionado mostraram que as CTMs têm capacidade de capturar VEs. A citometria de fluxo mostrou que às 6 horas e 24 horas respetivamente 2,28% e 3,97% das CTMs eram positivas para o marcador PKH-26. Quando analisadas no microscópio de fluorescência, foram vistos pontos vermelhos nas CTMs alguns dos quais parecem carregar a proteína albumina. Porém a expressão gênica e analise de ureia não se adequaram a um perfil de célula tipo-hepatócito. Conclusões: O sistema de co-cultivo não foi adequado para permitir a transferência e comunicação através de VEs entre hepatócitos e CTMs sendo que as VEs não conseguem atingir a câmara superior. Os experimentos com meio condicionado sugerem que as CTMs têm capacidade de capturar VEs derivadas de hepatócitos, porém a captação não conduz ao desenvolvimento de um perfil de célula tipo-hepatócito em 6 e 24 horas. São necessários mais estudos para esclarecer a dinâmica de transferência das VEs e suas consequências em longo prazo. / Introduction: Liver is a key organ for corporeal homeostasis maintenance and whole organ replacement still remains the gold standard procedure to treat acute liver failure. Shortage of liver donor has promoted the increase on cell-therapy research. Bone marrow (BM) derived cell have shown potential for differentiation into hepatocyte-like cells in a short time and extracellular vesicles communication (EVs) is one of the proposed mechanisms. Plasticity of bone marrow mesenchymal stem cells (BM-MSCs) is extensively supported by scientific literature but protocols applied to differentiation usually take from 7 to 28 days. Objective: To analyze in vitro differentiation potential of BM-MSCs into hepatocyte-like cells through EVs transfer mechanism in 6 and 24 hours. Materials and Methods: Co-culture system with cell-impermeable inserts and conditioned medium experiments were used to explore the effects of healthy and CCl4-injured hepatocytes, over BM-MSCs differentiation. Assessment of hepatocyte-like cell profile on BM-MSCs was revealed by gene expression (alpha fetoprotein, albumin and cytokeratin-18), glycogen storage and urea release. Hepatocytes from CCl4-injured rats were labeled by PKH-26 to track EVs. Ultracentrifugation was used to isolate EVs from supernatant medium of the two chamber of the co-culture system. PKH-26 positive EVs and PKH-26 positive cells were revealed by flow cytometry analysis and fluorescent microscopy. BM-MSCs cultured with conditioned medium were stained with ALB-FITC antibody. Results: Co-cultured BM-MSCs for 6 and 24 hours, showed no expression of hepatocyte-like genes, even after exposure to damaged microenvironment. Functional assays confirm the lack of differentiation signs there were no glycogen storage or urea release. Interestingly, EVs traffic analysis revealed no PKH-26 positive EVs at the upper chamber of co-culture system and no positive BM-MSCs were found either. On the other hand, conditioned medium experiment showed that BM-MSCs could uptake EVs. Flow cytometry analysis showed positive PKH-26 BM-MSCs at 6 (2.28%) and 24 (3.97%) hours. Flourescence microscopy revealed red points into BM-MSCs and immunofluorescence suggest that some EVs contain albumin. Gene expression and urea assay of BM-MSCs were not in accordance with a hepatocyte-like profile. Conclusions: Co-culture system, by using cell-impermeable membrane, was not adequate to promote EVs transfer between hepatocyte and BM-MSCs since EVs do not pass from the lower to the upper chamber. Conditioned medium experiments can suggest that BM-MSCs could uptake hepatocyte-derived EVs but this not drive to a hepatocyte-like profile in a short period of time. More studies will be necessary to clarify the dynamic of EVs transfer and their long time effects.

Em pacientes submetidos à diálise peritoneal (DP), alterações morfofuncionais da membrana peritoneal (MP) ocorrem de forma progressiva ao longo dos anos. Estas alterações caracterizam-se, morfologicamente, por perda da camada mesotelial, inflamação, neoangiogênese e fibrose peritoneal (FP) e, funcionalmente, pela queda na ultrafiltração. Tais alterações implicam diretamente em perda da eficiência dessa terapia renal substitutiva. Até o momento, não existe tratamento específico capaz de prevenir ou reverter esta situação. As células tronco mesenquimais (CTm) têm mostrado efeitos terapêuticos benéficos em doenças associadas à fibrose. A participação das CTm no reparo tecidual está principalmente relacionada à sua atividade parácrina, através da liberação de fatores solúveis e vesículas extracelulares (VE). As VE liberadas são importantes na intercomunicação célula-célula e possivelmente contribuem para o efeito terapêutico das CTm ao entregar seu conteúdo (mRNAs, miRNAs, proteínas) para as células alvo. Assim, o objetivo central do presente estudo foi comparar o possível efeito terapêutico das CTm de tecido adiposo (CTmTA) e de VE derivadas de CTmTA na prevenção da FP experimental em ratos. A FP foi induzida em ratos Wistar machos através de injeções intraperitoneais (IP) de gluconato de clorexidina (GC) a 0,1%, em dias alternados, por um período de 30 dias. As CTmTA utilizadas foram obtidas de tecido adiposo gonadal de rato Wistar, cultivadas e expandidas até a 4ª passagem e caracterizadas de acordo com a sua capacidade de aderência ao plástico, presença de marcadores de superfície e pela diferenciação celular in vitro. As VE derivadas de CTmTA foram isoladas por ultracentrifugação. Os protocolos de isolamento por ultracentrifugação e caracterização por microscopia eletrônica, rastreamento de nanopartículas e quantificação das proteínas totais das VE foram padronizados e estabelecidos no laboratório. Os tratamentos com 2x106 CTmTA ou com 30 ug VE foram administrados por injeções de IP. Os animais do estudo foram divididos em 4 grupos: Grupo Controle (n = 8), animais que receberam apenas injeções IP de solução fisiológica; Grupo FP (n = 9), animais que receberam injeções IP de GC para indução da FP e foram tratados com solução fisiológica; Grupo FP + CTmTA (n = 8), animais que receberam injeções IP de GC para indução da PF e foram tratados com 2x106 CTmTA, no 3º e 10º dias, via IP, e Grupo FP + VE (n = 8), animais que receberam injeções IP de GC para indução da FP e foram tratados com 30 ug de VE, IP no 3º e 10º dias, via IP. Após 30 dias da indução de FP, os animais foram submetidos ao teste de função peritoneal e, em seguida, à eutanásia para coleta de amostras de tecido do peritôneo. As amostras do peritôneo parietal foram direcionadas para análises histológicas, imunohistoquímicas, de imunofluorescência e biologia molecular. No Grupo FP, como esperado, houve um aumento significativo da espessura da MP. Os tratamentos com CTmTA e VE preveniram o espessamento da MP, mantendo a espessura similar à do Grupo Controle. Os tratamentos com CTmTA e VE bloquearam o aumento do número de miofibroblastos, da expressão de fibronectina e de fatores envolvidos na FP (TGF-beta e FSP-1), observados nos animais do Grupo FP. Além disso, a expressão gênica de Smad3, que está associada à ativação de genes pró-fibróticos, estava aumentada no Grupo FP e foi reduzida nos grupos tratados. Por outro lado, a expressão gênica de Smad7, um gene associado à contrarregulação do TGF-beta, estava reduzida no Grupo FP e foi aumentada nos grupos que receberam tratamento. Os tratamentos com CTmTA e VE também apresentaram efeitos anti-inflamatórios, reduzindo o número de macrófagos e de linfócitos na MP e diminuindo a expressão do TNF-alfa, uma citocina pró-inflamatória, quando comparados ao Grupo FP. Com relação a análise funcional, o grupo tratado com VE apresentou melhora na capacidade de ultrafiltração. No entanto, os tratamentos com CTmTA e VE não alteraram o transporte de glicose pela MP em relação ao Grupo FP. Outro aspecto dos efeitos dos tratamentos CTmTA e VE diz respeito à neoangiogênese na MP, importante fator relacionado a capacidade de ultrafiltração. Apesar dos grupos tratados com CTmTA e VE apresentarem diminuição significativa da expressão de VEGF na MP, não foi constatada diferença na densidade capilar na MP destes grupos, em relação ao Grupo FP. Em conclusão, no modelo experimental de FP, os tratamentos com CTmTA e VE apresentaram efeito anti-inflamatório e foram igualmente eficientes no bloqueio do processo de FP. O tratamento com VE mostrou melhor capacidade de preservação da função peritoneal, com aumento da capacidade de ultrafiltração. Portanto, os tratamentos com CTmTA ou com VE derivadas de CTmTA apresentam potencial terapêutico e constituem uma nova abordagem, ainda pouco explorada, na prevenção do desenvolvimento da FP associada à DP / In patients undergoing peritoneal dialysis (PD), morphofunctional changes of the peritoneal membrane (PM) occur progressively over the years. These modifications are morphologically characterized by loss of the mesothelial layer, inflammation, neoangiogenesis and peritoneal fibrosis (PF), and functionally, by the reduction in ultrafiltration (UF). Moreover, these changes directly imply in failure of treatment. Currently, there is no clinical alternative to prevent or reverse this situation. In this context, mesenchymal stem cells (MSC) have shown beneficial therapeutic effects in diseases associated with fibrosis. The participation of MSC in tissue repair is related to their paracrine activity, through the release of soluble factors and extracellular vesicles (EV). The EV released are important to cell-to-cell communication and the possibility to contribute to the therapeutic effect of MSC, by delivering their content (mRNAs, miRNAs, proteins) to the target cells. Therefore, the aim of this study was to compare the possible therapeutic effect of MSC versus EV derived from MSC for prevention of experimental PF fibrosis in rats. PF was induced in male Wistar rats by intraperitoneal (IP) injections of 0.1% chlorhexidine gluconate (CG) on alternate days, for a period of 30 days. The MSC used were obtained from Wistar rats gonadal adipose tissue (ASC), cultured and expanded to the 4th passage and characterized according to their ability to adhere to plastic, presence of membranes markers and by cell differentiation in vitro. EV derived from ASC were isolated by ultracentrifugation. The protocols of ultracentrifugation and characterization by electron microscopy, nanoparticle tracking and quantification of total proteins from EV were standardized and established in the laboratory. Both treatments using ASC (2x106 cells) or EV (30 ug) were administered via IP injections. The animals were divided into four groups: Control group (n = 8), animals that received only IP injections of physiological solution; PF group (n = 9), animals that received IP injections of CG to induce PF and were treated with physiological solution; PF+ASC group (n = 8), animals that received IP injections of CG for induction of PF and were treated with 2x106 ASC, at the 3rd and 10th day, by IP delivery; PF+EV group (n = 8), animals that received IP injections of CG for induction of PF and were treated with 30 ug of EV at the 3rd and 10th day, by IP delivery. After 30 days of PF induction, the animals were submitted to the peritoneal function test and then, to euthanasia to collect tissue samples from the peritoneum. The samples were analyzed by histology immunohistochemistry, immunofluorescence, and also by molecular biology. In the FP group, there was a significant increase in the thickness of the PM. Both treatments with ASC or EV prevented increase in PM thickness. Importantly, ASC and EV treatments blocked the increased number of myofibroblast, fibronectin expression and the factors involved in PF (TGF-beta and FSP-1) observed in the PF group. In addition, the Smad3 gene expression, which is associated with activation of pro-fibrotic genes, was increased in the PF group and decreased in the treatments groups. Conversely, the gene expression of Smad7, a gene associated with TGF-beta against regulation, was decreased in the PF group and increased in the animals that received the treatment. ASC and EV injections also showed anti-inflammatory effects, reducing the infiltration of macrophages and lymphocytes into the PM and decreasing the expression of TNF-alpha, a proinflammatory cytokine. The treatments with ASC and EV did not alter the glucose transport by the PM in relation to the PF group, but promoting an increase of the UF capacity. Only the EV treated group showed an increase in UF capacity. Another aspect of the effects of ASC and EV treatments concerns to neoangiogenesis in the PM, an important factor related to the UF capacity. Although the treated groups showed a significant decrease of the VEGF expression in the PM, no difference in the capillary density was observed in relation of PF group. In conclusion, in the experimental model of FP, treatement with ASC or EV showed anti- inflammatory effects and were equally efficient in blocking the PF process. However, the treatment with EV showed a better capacity of preservation of the peritoneal function, with increased capacity of UF. Therefore, the use of ASC and EV potentially represents a new therapeutic approach in preventing the development of PF associated with PD

Le séquençage à haut débit est une technique très utile pour l’étude des ARN. Pendant mon doctorat, nous l’avons utilisé pour la caractérisation des ARN extracellulaire (ARNex) du plasma humain. Les ARNex du plasma sont retrouvés soit à l’état soluble sous forme de complexes ribonucléoprotéiques (RNP) ou encapsulés au sein de vésicules extracellulaires (VE) de diverses origines (exosomes, microvesicles, …). Dans ce projet, j’ai démontré que le plasma contenait principalement des micro ARN, le fragment hY4 et des ARN ribosomiques dégradés. Par ailleurs, après chromatographie à exclusion de tailles ou par traitement consécutif protéinase K/RNase A, des VE hautement purifiées peuvent être obtenus. Nous ne retrouvons plus en majorité les micro ARN et l’ARN hY4 dans ces échantillons mais plutôt des ARN du microbiote humain, montrant une composition différente entre les ARNex solubles et ceux des vésicules purifiées. Par ailleurs, j’ai également effectué une étude comparative de kits commerciaux qui sont supposés purifier les exosomes par précipitation. La composition en ARN de ces fractions est très similaire au plasma humain total, montrant une forte contamination par les RNP solubles. Ainsi, nous sommes en mesure de proposer un protocole pour l’étude des ARNex dans le cadre de biopsies liquides avec des échantillons cliniques afin de découvrir de potentiels biomarqueurs de diagnostic. Au-delà de la caractérisation d’ARN, le séquençage à haut-débit peut être utilisé pour la détection et quantification des modifications post-transcriptionnelles. Pendant ma thèse, j’ai utilisé le séquençage pour l’analyse des 2’O-méthylation des ARN de transfert chez E. coli par RiboMethSeq. Sous plusieurs conditions de stress (manque de nutriments ou des concentrations non létales d’antibiotiques), certaines 2’O-méthylations montrent une réponse adaptative. Alors que plus de la moitié des 2’O-méthylations en position 18 (Gm18) sont augmentées dans toutes les conditions de stress étudiées, les positions Nm34 montrent un effet opposé avec une diminution dans certains stress (chloramphénicol et streptomycine). Chacun de ces deux comportements peut être relié à un phénomène de régulation cellulaire en réponse au stress : un changement au niveau de la wobble base pourrait être un moyen de réguler la traduction en modifiant l’usage des codons. En ce qui concerne Gm18, son rôle dans l’évasion du système immunitaire inné lors de l’invasion d’un hôte est en cours d’élucidation. / For less than a decade, high-throughput sequencing became a very powerful, sensitive and precise technique for the study of ribonucleic acids. During my PhD thesis, I used this technology for in-depth characterization of the extracellular RNA (exRNA) content of human plasma. exRNA in plasma exists either in a “soluble state” as a component of ribonucleoprotein (RNP) complexes or encapsulated into extracellular vesicles (EV) of diverse origins (exosomes, microvesicles, …). In this project, I demonstrated that whole human plasma contains mostly micro RNA and the fragment of RNA hY4, as well as degraded ribosomal RNA. Moreover, using a rigorous strategy via size exclusion chromatography or consecutive proteinase K/RNase A treatments, highly purified EVs can be obtained. miRNAs and RNA hY4 fragments were not present in majority of samples, demonstrating a huge difference between soluble exRNA and exRNA from purified EVs. The RNA content of these EVs mainly reflects RNA composition of human microbiota. In addition, I also performed a comparative analysis of commercially available “exosome-enrichment” kits which are supposed to purify human exosomes by precipitation. Their RNA composition was found to be almost identical to human plasma, showing strong uncontrolled contamination by soluble RNPs. Based on this study, we were able to propose a protocol for studies in exRNA in the field of liquid biopsies with clinical sample in order to discover new diagnostic biomarkers. Apart from the characterization of RNA, high-throughput sequencing can be used for detection and quantification of RNA post-transcriptional modifications. During my PhD thesis I applied deep sequencing for analysis of transfer RNA (tRNA) 2’-O-methylations in model bacteria (E. coli) using RiboMethSeq. Under several stress conditions, such as starvation and non-lethal antibiotics concentrations, some 2’-O-methylated nucleotides show an adaptive response. While over than half of Gm18 show a global increase under all investigated stress conditions, ribomethylated residues at position 34 show an opposite effect for some antibiotic treatments (chloramphenicol and streptomycin). Each of these dynamic profiles can be linked to cell regulation in response to stress. Change at the tRNA wobble base (position 34) could be a way to regulate translation by modifying the codon usage. Concerning Gm18, its role in the escape from the human innate immune system during host invasion is currently elucidated.

Significant advances in the efficacy of cancer therapy have been accompanied by an escalation of side effects that result from therapy-induced injury to normal tissues. Patients with high grade cancer or metastasis are often treated with chemotherapy, 50% of which are associated with reactive oxygen species generation and cellular oxidative stress. Heart is the normal tissue most susceptible to chemotherapy-induced oxidative stress and heart disease is the most common leading cause of death in cancer survivors. However, early and sensitive biomarkers to identify heart disease are still lacking. Extracellular vesicles (EVs) are released from cells during oxidative stress and send oxidized proteins into the circulation as a compensatory mechanism that prevents cellular proteotoxicity. Thus, the protein contents of EVs released during the pre-degeneration stage reveal that oxidative stress is occurring early in the damaged tissue. Using a mouse model of doxorubicin (DOX)-induced cardiac injury, we demonstrated that EVs can be used as an early diagnostic tool for tissue injury as they are oxidatively modified with 4-hydroxynonenal and contain tissue specific proteins—glycogen phosphorylase brain/heart, muscle, and liver isoforms—that indicate their origins. These biomarkers increased early, before the changes of conventional biomarkers occurred. EVs also mediate intercellular communication by transferring bioactive molecules between cells. In the cell culture system, EVs play an important role in oxidative stress response by inducing macrophage polarization. EVs from cardiomyocytes promoted both proinflammatory (M1) and anti-inflammatory (M2) macrophage polarization evidenced by higher pro- and anti-inflammatory cytokines and nitric oxide generation, as well as mitochondrial oxidative phosphorylation suppression and glycolysis enhancement. In contrast, EVs from the hepatocytes supported anti-inflammatory macrophage (M2) by enhancing oxidative phosphorylation and anti-oxidant proteins. DOX promoted the immunostimulatory effects of cardiomyocyte EVs but not hepatocyte EVs. The differential functions of EVs on macrophage phenotype switching are due to their different effects on Thioredoxin 1 redox state, which regulates activities of redox sensitive transcription factors NFκB and Nrf-2. Our findings shed light on the role of EVs as a redox active mediator of immune response during chemotherapy.

Histones are chromatin-associated proteins localized to the nucleus. However, extracellular histones are present in biofluids from healthy individuals and become elevated under disease conditions, such as neurodegeneration and cancer. Hence, extracellular histones may have important biological functions in healthy and diseased states, which are not understood. Histones have been reported in the proteomes of extracellular vesicles (EVs), including microvesicles and exosomes. The main aim of this thesis was to determine whether or not extracellular histones are secreted via EVs/exosomes. In an initial study (Paper I), I optimized methods for human embryonic kidney (HEK293) cell culture, transfection and protein detection using western blotting. In the main study (Paper II), I used oligodendrocyte cell lines (rat OLN-93 and mouse Oli-neu) to investigate the localization of histones to EVs. Western blotting of EVs purified from OLN-93 cell-conditioned media confirmed the presence of linker and core histones in them. Immunolocalization and transmission electron microscopy confirmed that histones are localized to EVs, as well as intraluminal vesicles (ILVs) within multivesicular bodies (MVBs). This suggests that histones are secreted via the MVB/exosome pathway. Localization of histones in EVs was investigated by biochemical/proteolytic degradation and purification followed by western blotting. Surprisingly, histones were associated with the membrane but not the luminal fraction. Overexpression of tagged histones in HEK293 cells confirmed their conserved, membrane localization. OLN-93 cell EVs contained both double stranded and single stranded DNA but nuclease and protease digestion showed that the association of histones and DNA with EVs was not interdependent. The abundance of histones in EVs was not affected by differentiation in Oli-neu cells. However, histone release was upregulated as an early response to cellular stress in OLN-93 cells and occurred before the release of markers of stress including heat shock proteins. Interestingly, a notable upregulation in secretion of small diameter (50-100 nm) EVs was observed following heat stress, suggesting that a sub-population of vesicles may be involved specifically in histone secretion in response to stress. Proteomic analyses identified the downregulation of endosomal sorting complex required for transport (ESCRT) as a possible mechanism underlying increased histone secretion. In Paper III, I developed methods to quantify extracellular histone proteins in human ascites samples from ovarian cancer patients.   In summary, we show for the first time that membrane-associated histones are secreted via the MVB/exosome pathway. We demonstrate a novel pathway for extracellular histone release that may have a role in both health and disease.