Mechanisms underlying the association between atherosclerosis and periodontitis are not defined. Matrix metalloproteinases (MMPs) are increased in untreated periodontitis. Fetuin, a serum protein, inhibits vascular mineralization in humans. I hypothesized that MMP-7 affects fetuin function. In vitro mineralization was conducted based on methods developed by Hunter and colleagues. Mineralization was quantified using absorbance measurements (at 540 nm) of alizarin red bound to nascent crystals. Mineralization assays included intact MMP-3 and MMP-7-treated human and bovine fetuin (0-2 μM).The inhibition of mineralization mediated by fetuin (2 μM) was maximal at 3.5-4 hours. Transmission electron microscopy and electron diffraction analysis of crystals formed revealed the presence of hydroxyapatite. SDS-PAGE demonstrated that MMP-7 is more effective in digesting fetuin than MMP-3. The inhibitory effect of fetuin on mineralization was more reduced by MMP-7 digestion compared to MMP-3. Fetuin inhibits mineralization in vitro and this effect is reduced by MMP-7 degradation.

Mechanisms underlying the association between atherosclerosis and periodontitis are not defined. Matrix metalloproteinases (MMPs) are increased in untreated periodontitis. Fetuin, a serum protein, inhibits vascular mineralization in humans. I hypothesized that MMP-7 affects fetuin function. In vitro mineralization was conducted based on methods developed by Hunter and colleagues. Mineralization was quantified using absorbance measurements (at 540 nm) of alizarin red bound to nascent crystals. Mineralization assays included intact MMP-3 and MMP-7-treated human and bovine fetuin (0-2 μM).The inhibition of mineralization mediated by fetuin (2 μM) was maximal at 3.5-4 hours. Transmission electron microscopy and electron diffraction analysis of crystals formed revealed the presence of hydroxyapatite. SDS-PAGE demonstrated that MMP-7 is more effective in digesting fetuin than MMP-3. The inhibitory effect of fetuin on mineralization was more reduced by MMP-7 digestion compared to MMP-3. Fetuin inhibits mineralization in vitro and this effect is reduced by MMP-7 degradation.

Premature death from cardiovascular disease is especially high in patients with chronic kidney disease (CKD). Vascular calcification is a potent risk factor for developing cardiac-related morbidity and mortality and is especially prominent within the CKD population. Deficiencies in serum levels of fetuin-A as well as inadequate production of matrix Gla protein (MGP) correlate inversely with the extent of vascular calcification and time spent on dialysis. Fetuin-A is a well-known systematic regulator of bone metabolism and MGP is a local antagonist of bone forming proteins. To meet the clinical need of at-risk patients prone to cardiac-related mortality. We propose a targeted protein therapy to treat arteriosclerotic arteries. The focus of this thesis was to characterize the binding interactions of fetuin-A with calcium mineral in a simulated body fluid and to study the in vitro effects of a fetuin vitamin K2 co-therapy on the prevention of calcification of vascular smooth muscle cells.

Cette thèse a pour objectif d’identifier et caractériser des biomarqueurs liés aux traitements d’immunothérapie allergénique (ITA). En particulier, le travail s’est porté sur les biomarqueurs prédictifs de l’efficacité du traitement : leur estimation avant la prise médicamenteuse permettrait d’évaluer les bénéfices cliniques à l’issue de l’ITA. À partir d’échantillons de sérum collectés avant ITA et provenant de patients inclus dans une étude clinique contrôlée, randomisée et dirigée contre les pollens de graminées, une méthode d’analyse protéomique différentielle (la 2D-DIGE) a permis d’identifier une protéine comme candidat biomarqueur prédictif de l’efficacité de l’ITA. Dans un premier temps, les variants moléculaires de la protéine identifiée ont été caractérisés. L’analyse en spectrométrie de masse de la protéine a permis d’identifier les modifications post-Traductionnelles associées aux isoformes plus abondants dans le sérum des patients pour lesquels une réponse positive à l’ITA est observée. Une approche protéomique de quantification relative a été mise en œuvre par LC-MS/MS sans marquage, et a permis d’identifier des peptides de la protéine d’intérêt, portant des modifications post-Traductionnelles spécifiques, associés à un bénéfice clinique accru en fin d’ITA. Dans un deuxième temps, l’implication de la fétuine-A dans la physiopathologie de l’allergie a été étudiée. Des modèles cellulaires humains ont mis en évidence le caractère essentiel des acides sialiques portés par la protéine pour l’activation de la voie TLR4, dans les mécanismes de l’immunité innée initiant la réaction allergique. In vivo, les modèles murins d’asthme allergique développés ont en revanche montré la fonction anti-Inflammatoire de la protéine. La fétuine-A a donc un rôle ambivalent, mais est indubitablement liée à la régulation de l’inflammation allergique. La validation des candidats biomarqueurs peptidiques de la protéine dans d’autres cohortes cliniques représente une future étape clé, qui permettrait d’envisager l’usage de ces marqueurs en clinique, pour améliorer la sélection des patients les plus susceptibles de répondre à l’ITA. / This thesis aimed at identifying and characterizing predictive biomarkers associated with allergen-Specific immunotherapy (AIT) efficacy. In particular, we were focused on biomarkers predictive of AIT efficacy: quantifying such markers before treatment would allow estimating the final clinical benefit. For this purpose, serum samples were collected before AIT from patients included in a double-Blind, placebo controlled clinical study against grass pollen allergy. Their analysis by means of differential proteomics (2D-DIGE) pointed out a protein, named fetuin-A, as a candidate biomarker predictive of AIT efficacy. First, the protein fetuin-A isoforms were extensively characterized by mass spectrometry, and specific post-Translational modifications (PTMs) were associated to the isoforms more abundant in sera from patients positively responding to AIT. A second proteomic approach allowed identifying fetuin-A peptides, differentially expressed among groups of patients. Some peptides from the candidate protein, bearing specific post-Translational modifications (PTMs), are associated with an increased clinical benefit at the end of the treatment. In a second part, we studied the involvement of the fetuin-A during the course of allergic inflammation. Human cellular assays highlighted that sialic acids on the protein PTMs are essential to activate the TLR4 pathway, and inducing innate immune mechanisms linked to allergy. In vivo, murine models of allergic asthma showed an opposite anti-Inflammatory function of the protein. Thus, the protein fetuin-A is still ambivalent, but is undoubtedly linked to the regulation of allergic inflammation. Validation of peptides candidate biomarkers in larger clinical cohorts is of utmost interest, since using such biomarkers in clinics would improve patients’ selection and therefore clinical benefit from the treatment.

Periodontal diseases may increase risk of vascular calcification in cardiovascular diseases but the potential mechanisms are not defined. Fetuin, a naturally-occurring serum glycoprotein in humans, protects against ectopic arterial calcification. We considered that patients with periodontitis could be at increased risk of developing calcifying atheromas because periodontal-disease associated enzymes may enter the circulation and subsequently degrade fetuin, thereby disrupting its ability to inhibit calcification. By in silico investigation, MMP -3 and -7 were predicted to cleave fetuin but only MMP-7 actually degraded human fetuin in vitro. MMP-7 degradation of fetuin was time- and concentration- dependent and was inhibited by an MMP Inhibitor. By mass spectrometry the presence of novel, MMP-7-mediated cleavage sites in fetuin were found. Fetuin bound tightly to MMP-7 (kd =2.96 x 10-9 M). The degradation of fetuin by MMP-7 could explain, at least in part, the apparent association between periodontal diseases and calcifying atheromas.

Periodontal diseases may increase risk of vascular calcification in cardiovascular diseases but the potential mechanisms are not defined. Fetuin, a naturally-occurring serum glycoprotein in humans, protects against ectopic arterial calcification. We considered that patients with periodontitis could be at increased risk of developing calcifying atheromas because periodontal-disease associated enzymes may enter the circulation and subsequently degrade fetuin, thereby disrupting its ability to inhibit calcification. By in silico investigation, MMP -3 and -7 were predicted to cleave fetuin but only MMP-7 actually degraded human fetuin in vitro. MMP-7 degradation of fetuin was time- and concentration- dependent and was inhibited by an MMP Inhibitor. By mass spectrometry the presence of novel, MMP-7-mediated cleavage sites in fetuin were found. Fetuin bound tightly to MMP-7 (kd =2.96 x 10-9 M). The degradation of fetuin by MMP-7 could explain, at least in part, the apparent association between periodontal diseases and calcifying atheromas.

Infertility is a problem that could be treated by using In Vitro Fertilization (IVF). This procedure starts by increasing estrogen levels and then retrieving oocytes. However, studies have showed an increased risk for venous thromboembolism (VTE) and lung embolism that is correlated with the rising levels of estrogen. Microvesicles, vesicles formed from the cell membrane, increases in number in connection with IVF and diseases such as thrombosis. These vesicles can transport proteins, one of them is fetuin-B. Fetuin-B plays a role in fertilizing the egg by inhibiting ovastacin, a protein that leads to hardening of zona pellucida. Phosphatidylserine, a component of the cell membrane with strong binding capacity to annexin V, has also been studied while investigating VTE. The aim of this project was to analyze the amount of fetuin-B, ovastacin and phosphatidylserine in women undergoing IVF. The study included 55 women where three blood samples were collected from them at different time points. The tests were analyzed using flow cytometry and fluorescent antibodies targeting the proteins in question. The results showed a significant increase in fetuin-B and ovastacin after the treatment where double positive microvesicles (fetuin-B+ ovastacin+) had the highest significant difference, a rise of 78% after the hormone increase. (Fetuin-B+ annexin V+) increased over time, 205% after increasing estrogen levels, while no difference was seen for (ovastacin+ annexin V+). This thesis suggests that fetuin-B is strongly related to fertility and coagulation in women undergoing IVF. The protein has also a noticeable relationship to ovastacin. Most importantly, (fetuin-B+ ovastacin+) was suggested to be a better marker for women’s fertility than the other analyzed parameters.

Orientador: Roberto Carlos Burini / Resumo: Fetuina-A é uma glicoproteína multifuncional, sintetizada pelo fígado como proteína de fase aguda. Atua na inibição da cascata da insulina, e estimula a síntese de citocinas pró-inflamatórias. Assim, sugere-se que a fetuina-A esteja envolvida na patogênese da doença gordurosa hepática não-alcoólica (DGHNA), constituindo-se em um dos seus indicadores. O presente estudo tem como objetivo investigar as concentrações de fetuina-A na DGHNA e sua associação com distúrbios metabólicos, bem como, com o risco de fibrose hepática, e doença cardiovascular (DCV), mediante marcadores bioquímicos. Para tanto, foi realizado estudo transversal com mulheres ingressantes em programa para mudança do estilo de vida. Foram avaliadas 148 mulheres com idade entre 35 a 78 anos, as quais foram submetidas às avaliações clínicas, sócio-demográfica, antropométrica, de consumo alimentar e análises bioquímicas. O nível de significância considerado foi p<0,05. Verificou-se DGHNA, pelo Índice de Gordura Hepática (IGH≥60), em 55,4% das mulheres. Fetuina-A sérica correlacionou-se positivamente com Índice de Massa Corporal, circunferência abdominal, IGH e proteína C-reativa ultra-sensível (PCR-us). A proporção de mulheres com resistência insulínica (RI) pelo modelo homeostático de resistência à insulina (HOMA-IR) foi maior dentre os valores maiores (Tercil 3) de fetuina-A, comparativamente, aos menores valores (Tercil 1). Resultado análogo foi encontrado para a PCR-us, mas não para proteína ligadora de lipopol... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Fetuin-A is a multifunctional glycoprotein, synthesized by the liver as a acute phase protein. It acts in insulin cascade inhibition, and stimulates pro-inflammatory cytokines. It is postulated that fetuin-A is involved in non-alcoholic fatty liver disease (NAFLD) pathogenesis, as one of its indicators. The present study aims to investigate fetuin-A concentration in NAFLD and its association with metabolic disturbers, as well as with hepatic fibrosis risk, and cardiovascular disease (CVD), through biochemical markers. For that, a cross-sectional study was carried out with women entering a lifestyle modification program. We evaluate 148 women, with age that range from 35 to 78 years old that were submitted to clinical, sociodemographic, anthropometric, food consumption and biochemical evaluation. The statistical significance considered was p<0,05. We verified that NAFLD, measured by Fatty Liver Index (FLI ≥60), was found in 55.4% of women. Serum fetuin-A was positively correlated with Body Mass Index, waist circumference, FLI and high-sensitivity C-reactive protein (hs-CRP). The proportion of women with insulin resistance (IR) by insulin resistance homeostatic model assessment (HOMA-IR), was higher among the higher values (Tercil 3) of fetuin-A, compared to the lowest values (Tercil 1). Analog results were found to hs-CRP, but not to lipopolysaccharide-binding protein (LBP), albuminemia and hepatic fibrosis. After adjustments, HOMA-IR and hs-CRP altered, constitute independent... (Complete abstract click electronic access below) / Mestre

Purpose: To determine whether reduced serum levels of AHSG and elevated levels of BMP-2, 4, 7 are associated with post-arthroplasty HO. Patients: Thirty arthroplasty patients were included, 15 with evidence of peri-articular HO and 15 without (NHO). Methods: Blood samples were collected from all patients ≥ 8 weeks after arthroplasty. Analytes were measured using ELISAs. Mann-Whitney U tests were performed to compare serum analyte concentrations between HO and NHO groups, and between arthroplasty patients and healthy humans. Results: There is no difference in serum concentrations of AHSG, BMP-2, 4, 7 between HO and NHO patients. Arthroplasty patients showed significantly higher BMP-2 and BMP-4 and lower AHSG serum levels compared to healthy humans (p < 0.01). Conclusion: Baseline BMP-2, 4, 7 and AHSG serum levels are not markers of acquired HO. However, elevated baseline levels of BMP- 2, 4 and reduced levels of AHSG appear to be markers of severe inflammatory arthritis.

Purpose: To determine whether reduced serum levels of AHSG and elevated levels of BMP-2, 4, 7 are associated with post-arthroplasty HO. Patients: Thirty arthroplasty patients were included, 15 with evidence of peri-articular HO and 15 without (NHO). Methods: Blood samples were collected from all patients ≥ 8 weeks after arthroplasty. Analytes were measured using ELISAs. Mann-Whitney U tests were performed to compare serum analyte concentrations between HO and NHO groups, and between arthroplasty patients and healthy humans. Results: There is no difference in serum concentrations of AHSG, BMP-2, 4, 7 between HO and NHO patients. Arthroplasty patients showed significantly higher BMP-2 and BMP-4 and lower AHSG serum levels compared to healthy humans (p < 0.01). Conclusion: Baseline BMP-2, 4, 7 and AHSG serum levels are not markers of acquired HO. However, elevated baseline levels of BMP- 2, 4 and reduced levels of AHSG appear to be markers of severe inflammatory arthritis.