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O domínio da técnica de microanastomose vascular é um pré-requisito essencial para a realização de procedimentos microcirúrgicos reconstrutivos, como reimplantes e transferência livre de tecidos. Até hoje, a técnica de sutura convencional é a mais aceita na prática clínica, por sua segurança e versatilidade. Apesar disso, ela apresenta alguns problemas por ser tecnicamente difícil, consumir tempo considerável e causar traumatismo adicional à parede do vaso. O objetivo deste estudo, foi testar um método alternativo de microanastomose arterial, reduzindo o número de pontos de sutura com aplicação do adesivo de fibrina. Sessenta ratos da raça Wistar foram submetidos a microanastomose vascular nas artérias femorais ou carótidas. Os animais foram divididos em quatro subgrupos de acordo com a artéria operada e a técnica de sutura empregada: FSC (femoral - sutura convencional), FAF (femoral - sutura mínima com adesivo de fibrina), CSC (carótida - sutura convencional) e CAF (carótida - sutura mínima com adesivo de fibrina). As duas técnicas de anastomose foram comparadas através de análise estatística dos parâmetros clínicos e histopatológicos. A média de pontos de sutura por anastomose nos subgrupos FSC e CSC foi de 7,7 e 9,5, respectivamente. No subgrupo FAF, as anastomoses foram realizadas com apenas quatro pontos de sutura e no subgrupo CAF, com apenas seis. O tempo de anastomose foi, em média: 15,81 minutos no subgrupo FSC, 13,62 minutos no subgrupo FAF, 18,87 minutos no subgrupo CSC e 17,33 minutos no subgrupo CAF. A aplicação do adesivo de fibrina reduziu, significativamente, o número de pontos e o tempo necessário para realização das anastomoses, nos subgrupos FAF e CAF. A intensidade do sangramento anastomótico também foi reduzida de maneira significativa nestes subgrupos. A freqüência da permeabilidade imediata e tardia foi de 100% em todos os subgrupos, exceto no subgrupo FAF, onde a permeabilidade tardia foi de 93,33%. Não foram observadas diferenças significativas entre as duas técnicas, em relação aos parâmetros histopatológicos avaliados (processo inflamatório, fibrose da camada média e hiperplasia subintimal). O autor concluiu que a técnica de sutura mínima com aplicação do adesivo de fibrina foi mais fácil e rápida que a técnica de sutura convencional, sem aumento da trombogenicidade das anastomoses, no modelo experimental utilizado. / Mastering of the microvascular anastomosis technique is an essencial requirement to perform reconstructive microsurgical procedures, such as replantation surgery and free tissue transfers. Until now, the conventional suture technique is the most widely accepted in the clinical setting, for its safety and versatility. However, this technique presents some problems for being technically difficult, time consuming and causes additional trauma to the vessel wall. The aim of this study was to test an alternative method of microvascular arterial anastomosis, by reducing the number of sutures with application of fibrin adhesive. Sixty Wistar rats underwent to microvascular anastomosis at the femoral or carotid arteries. The animals were divided into four subgroups, according to the operated artery and the employed suture technique: FCS (femoral - conventional suture), FFA (femoral - minimal suture with fibrin adhesive), CCS (carotid - conventional suture) and CFA (carotid - minimal suture with fibrin adhesive). Both anastomosis techniques were compared by means of statistical analisys of the clinical and histopathological parameters. The mean number of sutures required to complete the anastomosis was 7,7 in subgroup FCS and 9,5 in subgroup CCS. In subgroup FFA, the anastomosis was performed with only four sutures and in subgroup CFA, with only six. The mean anastomotic time was 15,81 minutes in subgroup FCS, 13,62 minutes in subgroup FFA, 18,87 minutes in subgroup CCS and 17,33 minutes in subgroup CCS. The application of fibrin adhesive, significantly reduced the number of sutures and the time taken to perform the anastomosis, in subgroups FFA and CFA. The amount of anastomotic bleeding was also significantly reduced in these subgroups. The immediate and late patency rates were 100% in all subgroups, except in subgroup FFA where it was 93,33%. No significant differences were observed among the two techniques, concerning the evaluated histopathological parameters (inflammatory process, medial fibrosis and subintimal hyperplasia). The author concluded that, the fibrin adhesive application with minimal suture technique was faster and easier than the conventional suture technique, without increasing the trombogenicity of the anastomosis, in this experimental model.

Depuis plus d’une cinquantaine d’années, de formidables avancées ont été initiées dans le domaine de l’ingénierie tissulaire cutanée menant à la reconstruction in vitro de substituts de peau. La plupart sont des substituts dermiques destinés à être utilisés comme aide à la cicatrisation des plaies aigües et chroniques en complément des traitements de greffes conventionnels ainsi que pour l’augmentation des tissus mous. Bien qu’un nombre croissant de patients aient pu bénéficier de ces matrices dermiques, leur application clinique reste encore restreinte, en raison de leur coût élevé mais également à cause de résultats cicatriciels parfois peu satisfaisants. Par conséquent, il reste un défi de taille, celui de développer des substituts dermiques stimulant activement la cicatrisation, présentant un faible coût de production, sans propriétés antigéniques et possédant des propriétés mécaniques adaptées. Dans ce cadre, les hydrogels à base de fibrine constituent des candidats prometteurs, en particulier en raison du rôle central de cette protéine dans la cicatrisation. Le principal inconvénient est qu’à concentration physiologique, ces hydrogels sont faibles mécaniquement, ce qui les rend difficilement manipulables. L’objectif de cette thèse a été la mise au point ainsi que la caractérisation de différents hydrogels destinés à être utilisés comme substituts dermiques. Ces derniers présentent l’avantage d’associer les propriétés biologiques de la fibrine avec les propriétés mécaniques d’un polymère synthétique, le polyéthylène glycol dans une architecture de réseaux interpénétrés de polymères (RIP). Les résultats obtenus ont permis : - de confirmer les propriétés physico-chimiques des RIP développés initialement par nos collaborateurs de l’université de Cergy-Pontoise, - de valider en trois étapes (in vitro, ex vivo puis in vivo) la biocompatibilité de ces nouvelles matrices, destinées à être utilisées comme supports de culture 2D et pour l’augmentation des tissus mous, - d’élaborer et de caractériser des matrices macroporeuses, optimisées pour la culture 3D de fibroblastes de dermes humains. / Over the past five decades, we assisted in extraordinary advances in the field of skin tissue engineering which led to the in vitro reconstruction of a wide range of skin substitutes. Most of them are dermal substitutes: Their clinical application ranges from treating acute and chronic wounds to soft tissue augmentation. Although increasing numbers of patients have been treated with dermal substitutes, their clinical application has been limited by their substantial cost and some poor healing outcomes. Hence, there is still a challenge to produce a dermal substitute which enhance sufficiently wound healing. To this end, the substitute should exhibit suitable properties for enabling the repair process. Other requirements such as excellent biocompatibility, minimal antigenicity, ease to handle and cost-effective production are also essential. In this context, fibrin hydrogels constitute promising candidates for skin tissue engineering since fibrin fibers form a physiological and provisional backbone during wound healing. However, the poor mechanical properties of fibrin-based hydrogels at physiological concentration are an obstacle to their use. In this study, our aim was to design and characterize mechanically reinforced fibrin-based hydrogels by combining the intrinsic properties of a fibrin network with the mechanical features of a polyethylene glycol network using an interpenetrating polymer network (IPN) architecture. They are intended to be used as dermal scaffolds. The results obtained in this thesis: - Confirmed the suitable physico-chemical properties of IPN, first developed by our partner of the University of Cergy-Pontoise. - Validated their biocompatibility using a three-step approach (in vitro, ex vivo and in vivo assays). - Led to the synthesis and characterization of a new type of fibrin-based macroporous matrices, optimized for 3D dermal fibroblast culture.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Corynebacterium diphtheriae pode ser isolado tanto de quadros de difteria clássica, quanto de infecções sistêmicas, como endocardite. O fibrinogênio (Fbn) e a fibronectina (Fn) são glicoproteínas presentes na matriz extracelular de tecidos conjuntivos. A influência destas proteínas na patogênese das infecções locais e invasivas causadas por C. diphtheriae é objeto de estudo devido ao fato do bacilo diftérico poder ser encontrado em lesões nas quais o Fbn e a Fn são predominantes, incluindo a pseudomembrana diftérica e vegetações cardíacas presentes na endocardite infecciosa. São crescentes as evidências de que o C. diphtheriae pode, além de aderir, ser internalizado por células em cultura. No presente estudo, investigou-se a participação de C. diphtheriae e das proteínas de superfície 67-72p na aderência à Fn e ao Fbn de plasma humano e a eritrócitos. A aderência às células HEp-2 e internalização também foram analisadas. A participação de 67-72p nos mecanismos de morte celular foi avaliada através das colorações por Azul de Tripan e 46-diamidino-2-fenil indol (DAPI), pelo ensaio de redução utilizando dimetil-tiazol-difenil tetrazólio (MTT) e por citometria de fluxo. As 67-72p foram extraídas da superfície da amostra toxigênica C. diphtheriae subsp. mitis CDC-E8392 através de processos mecânicos e precipitação com sulfato de amônio saturado. Análises por SDS-PAGE e immunoblotting detectaram a presença das bandas protéicas de 67 e 72kDa nas amostras toxinogênicas e atoxinogênicas analisadas, as quais pertenciam aos biotipos fermentador e não fermentador de sacarose. C. diphtheriae foi capazes não só de formar agregados na presença de plasma de coelho, mas também de converter Fbn em fibrina independentemente da presença do gene tox. No entanto, a amostra atoxinogênica ATCC 27010 (tox-) foi menos aderente ao Fbn do que a homóloga ATCC 27012 (tox+). A interação bacteriana com eritrócitos foi inibida somente pela Fn. Ligações entre Fn e/ou Fbn com 67-72p foram demonstradas por dot blotting, ELISA e/ou ensaios utilizando fluorescência. As 67-72p foram capazes de inibir as interações bacterianas com o Fbn, indicando que 67-72p podem participar do processo de aderência do patógeno aos tecidos do hospedeiro. Através da microscopia óptica, demonstrou-se a ligação de 67-72p adsorvidas em microesferas de látex com células HEp-2. Anticorpos de coelho do tipo IgG anti 67-72p interferiram somente com a expressão do padrão de aderência do tipo difuso, normalmente apresentado pela amostra CDC-E8392. A Microscopia Eletrônica de Transmissão (MET) e a inibição da internalização bacteriana pela IgG anti 67-72p ou por 67-72p indicaram o papel de 67-72p como invasina. Alterações do citoesqueleto de células HEp-2 com acumulação de actina polimerizada, induzida por microesferas sensibilizadas com 67-72p, foi observada pelo fluorescent actin staining (FAS) test. Foi visualizado um aumento no número de bactérias viáveis no compartimento intracelular após tratamento de células HEp-2 ou dos microrganismos com Fn. A presença de partículas de látex adsorvidas com 67-72p no interior de vacúolos frouxos em células HEp-2 sugeriu que estas proteínas podem causar efeito citotóxico. A avaliação através das colorações com Azul de Tripan, DAPI e os ensaios de redução utilizando MTT demonstraram um decréscimo na viabilidade de células tratadas com 67-72p. As mudanças morfológicas observadas 3 horas após o início do tratamento com 67-72p incluíram vacuolização, fragmentação nuclear e formação de corpúsculos apoptóticos. A citometria de fluxo revelou um decréscimo de 15,13% no volume/tamanho de células tratadas com 67-72p. Além disso, o ensaio utilizando Iodeto de Propídio (IP) e Anexina V (AV)-FITIC demonstrou que havia 66,1% de células vivas (IP-/AV-), 16,6% de células em apoptose inicial (IP-/AV+) e 13,8% de células em apoptose tardia ou necrose secundária. Em conclusão, as 67-72p estão diretamente envolvidas na interação com Fn e Fbn. As proteínas não fimbriais 67-72p são hemaglutininas implicadas na aderência a células respiratórias e na internalização. Além disso, estas proteínas podem atuar como fatores de virulência em potencial para induzir apoptose de células epiteliais nos estágios iniciais da difteria e nas infecções invasivas causadas pelo C. diphtheriae / Corynebacterium diphtheriae have been isolated from classical diphtheria and systemic infections such as endocarditis. Fibrinogen (Fbn) and fibronectin (Fn) are high molecular-weight glycoproteins that may be found in extracellular matrix of connective tissues. Their influence in the pathogenesis of local and in invasive C. diphtheriae infection is object of interest due to the fact that diphtheria bacilli is recovered from lesions where such proteins are predominant, including pharyngeal pseudomembrane and valve heart vegetations in infectious endocarditis. There is growing evidence that C. diphtheriae may adhere to and be internalized by cells in culture. The present study investigated the participation of C. diphtheriae strains and 67-72p, a surface protein, in adherence to human plasma Fn, Fbn, erythrocytes, adherence to and internalization by HEp-2 cells. The participation of 67-72p in promoting cell death was evaluated by the Trypan blue, DAPI staining methods, methylthiazole tetrazolium (MTT) reduction assay and flow cytometry. The 67-72p was extracted from C. diphtheriae subsp. mitis CDC-E8392 toxigenic strain, by mechanical process and ammonium sulfate fractionation. SDS-PAGE and immunoblotting analysis detected the polypeptide bands of 67 and 72 kDa in all toxigenic and nontoxigenic strains from both sucrose-fermenting and non-fermenting biotypes. Diphtheria bacilli were capable to both form bacterial aggregates in rabbit plasma and to convert Fbn to fibrin independently to the presence of tox gene, albeit the ATCC 27010 (tox-) strain was less adherent to Fbn than the parental strain ATCC 27012 (tox+). Bacteria-erythrocytes interaction was inhibited only by Fn. Interactions of Fn and/or Fbn with 67-72p were demonstrated by dot blotting, ELISA and/or fluorescence assays. Bacteria-Fbn interaction was inhibited by 67-72p, indicating that 67-72p may participate in the adhesion of the pathogen to host tissues. The interaction of HEp-2 cells with 67-72p-adsorbed latex microspheres was demonstrated by light microscopy. Rabbit IgG anti 67-72p was shown to interfere with diffuse adherence phenotype to HEp-2 cells displayed by CDC-E8392, but not by other phenotypes. Transmission electron microscopy (TEM) and the inhibition of bacterial internalization by anti 67-72p IgG and 67-72p indicated the role of 67-72p as invasin. Cytoskeletal accumulation of polymerized actin in HEp-2 cells induced by 67-72p-microspheres was observed by the fluorescent actin staining (FAS) test. Fn enhanced the intracellular viability of all strains tested. The presence of 67-72p-latex particles inside spacious vacuoles (SV) in HEp-2 cells, suggested a citotoxic effect of these proteins. Evaluation by the Trypan blue staining method, 4,6-Diamidine-2-phenylindole dihydrochloride DAPI and the 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction assay showed a significant decrease in viability of HEp-2 cells treated with 0.2 mg/ml 67-72p. Morphological changes in HEp-2 cells (vacuolization, nuclear fragmentation, and the formation of apoptotic bodies) was observed after 3 h post-treatment with 67-72p. Flow cytometry revealed a 15.13% reduction apoptotic volume of HEp-2 cells treated with 0.2 mg/ml 67-72p. Moreover, a double-staining assay using Propidium Iodide (PI)/Annexin V (AV) demonstrated the numbers of vital (PI-/AV-) (66.1%) vs. early apoptotic (PI-/AV+) (16.6%) cells and late apoptotic or secondary necrotic cells (PI+/AV+) (13.8%). In conclusion, the 67-72p are directly implicated in C. diphtheriae interaction with Fn and Fbn. The non-fimbrial Fn/Fbn binding 67-72p are hemagglutinins directly implicated in adherence to and internalization by respiratory epithelial cells. Moreover, 67-72p may act as a potential virulence factor to induce apoptosis of epithelial cells in the early stages of diphtheria and C. diphtheriae invasive infection

Le seul traitement actuellement disponible pour les accidents vasculaires cérébraux d’origine ischémique est la thrombolyse par l’activateur tissulaire du plasminogène recombinant (rt-PA). Cependant, l’efficacité du rt-PA est souvent partielle ou absente, et des phénomènes de réocclusion du vaisseau peuvent être observés. Par ailleurs, l’administration de rt-PA est associée à un risque hémorragique. Il apparaît donc indispensable de rechercher les mécanismes à l’origine de la toxicité vasculaire du rt-PA, afin de pouvoir développer des stratégies capables de protéger le lit vasculaire. Parmi ces stratégies, notre équipe a montré dans des modèles expérimentaux que l’inhibition d’une enzyme nucléaire, la poly(ADP-ribose) polymérase ou PARP, permet de protéger la barrière hémato-encéphalique, de réduire les hémorragies et d’améliorer la reperfusion cérébrale suite à l’administration post-ischémique de rt-PA. Dans ce contexte, mon travail a consisté à étudier les mécanismes impliqués dans les altérations vasculaires associées à l’administration de rt-PA à la suite de l’ischémie. Mes travaux de recherche ont comporté un volet in vivo et un volet in vitro. Les études réalisées in vivo ont été menées dans un modèle murin d’ischémie cérébrale thrombo-embolique. Nos résultats indiquent que ni l’ischémie, ni le rt-PA, ni l’association au rt-PA d’un puissant inhibiteur de PARP, le PJ34, ne modifient à 24 heures la présence de dépôts de fibrine, marqueur d’hypoperfusion et de réocclusion. Nous nous sommes ensuite intéressés à deux marqueurs endothéliaux d’inflammation : VCAM-1 et ICAM-1, et avons montré que leur expression, qui augmente 24 heures après l’ischémie, n’est pas modifiée par le rt-PA. Enfin, l’association du PJ34 au rt-PA réduit significativement l’expression post-ischémique de VCAM-1, ce qui suggère le rôle de la PARP dans l’expression de cette molécule d’adhésion. La seconde partie de mon travail a été réalisée in vitro sur une lignée de cellules endothéliales cérébrales murines (bEnd.3). Le rt-PA est à l’origine de changements caractéristiques au niveau de l’organisation et de la morphologie de ces cellules. Ces changements ne sont pourtant associés ni à une dégradation de l’expression des molécules de jonctions inter-endothéliales (occludine, VE-cadhérine), ni à une augmentation de l’expression des marqueurs endothéliaux pro-inflammatoires (VCAM-1, ICAM-1). Nous nous sommes également intéressés à d’autres marqueurs de dysfonction endothéliale, les microparticules endothéliales (MPE). Nos résultats montrent que le rt-PA est à l’origine d’une augmentation importante de la libération des MPE. L’utilisation d’un inhibiteur de la protéine p38, le SB203580, et d’un inhibiteur de PARP, le PJ34, permet de réduire cette augmentation, ce qui suggère que p38 et la PARP pourraient être impliquées dans la production de MPE induite par le rt-PA. En conclusion, l’ensemble de ce travail contribue à préciser les effets vasculaires du rt-PA. Parmi ces effets, la mise en évidence de la production de MPE, via la PARP, est particulièrement novatrice. / Thrombolysis with recombinant tissue plasminogen activator (rt-PA) is currently the only approved pharmacological strategy for acute ischemic stroke. However, the efficacy of rt-PA is rarely complete, and arterial reocclusion can be observed. Furthermore, administration of rt-PA increases the risk of hemorrhagic transformations. Therefore, it is essential to seek mechanisms underlying the vascular toxicity of rt-PA in order to develop strategies protecting the vascular bed. Among these strategies, our laboratory has previously shown that inhibition of poly (ADP-ribose) polymerase (PARP), a nuclear enzyme, protects the blood-brain barrier, reduces hemorrhagic transformations and improves cerebral reperfusion following the post-ischemic administration of rt-PA. In this context, the aim of the present work was to establish the post-ischemic mechanisms of rt-PA-induced vascular alterations. The research was divided into (1) in vivo experiments and (2) in vitro studies to examine the effect of rt-PA on the endothelium. The in vivo studies were performed in a mouse model of thrombo-embolic stroke induced by thrombin injection in the middle cerebral artery. Our results showed that neither ischemia, nor rt-PA, nor the association to rt-PA of the potent inhibitor of PARP PJ34 alter cerebral fibrin deposits, a marker of hypoperfusion and reocclusion, at 24 hours after ischemia. We then evaluated the expression of two endothelial markers of inflammation : VCAM-1 (vascular cell adhesion molecule-1) and ICAM-1 (intercellular adhesion molecule-1). Our results showed that their expressions increase 24 hours after ischemia and are not modified by rt-PA. Finally, the association of PJ34 to rt-PA significantly reduced the post-ischemic expression of VCAM-1, suggesting a role for PARP in the expression of this adhesion molecule. The second part of my work was carried out in vitro in cultures of mouse brain-derived endothelial cells bEnd.3. In the presence of rt-PA, the organization and the morphology of the endothelial cells radically changed. However, these changes were associated neither to a degradation of endothelial junction proteins (occludin, VE-cadherin (vascular endothelial-cadherin)), nor to an increase in the expression of pro-inflammatory endothelial markers (VCAM-1, ICAM-1). We were also interested in a recently identified marker of endothelial dysfunction : endothelial microparticles (EMP). Our results showed that rt-PA induces a significant increase in the EMP released by bEnd.3 cells. The use of a p38 inhibitor, SB203580, and the PARP inhibitor, PJ34, reduced this increase, suggesting that p38 and PARP could be involved in the EMP production induced by rt-PA. In conclusion, this work helps to clarify the vascular effects of rt-PA. Among these effects, the highlight of EMP production, through PARP pathway, is particularly original.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Corynebacterium diphtheriae pode ser isolado tanto de quadros de difteria clássica, quanto de infecções sistêmicas, como endocardite. O fibrinogênio (Fbn) e a fibronectina (Fn) são glicoproteínas presentes na matriz extracelular de tecidos conjuntivos. A influência destas proteínas na patogênese das infecções locais e invasivas causadas por C. diphtheriae é objeto de estudo devido ao fato do bacilo diftérico poder ser encontrado em lesões nas quais o Fbn e a Fn são predominantes, incluindo a pseudomembrana diftérica e vegetações cardíacas presentes na endocardite infecciosa. São crescentes as evidências de que o C. diphtheriae pode, além de aderir, ser internalizado por células em cultura. No presente estudo, investigou-se a participação de C. diphtheriae e das proteínas de superfície 67-72p na aderência à Fn e ao Fbn de plasma humano e a eritrócitos. A aderência às células HEp-2 e internalização também foram analisadas. A participação de 67-72p nos mecanismos de morte celular foi avaliada através das colorações por Azul de Tripan e 46-diamidino-2-fenil indol (DAPI), pelo ensaio de redução utilizando dimetil-tiazol-difenil tetrazólio (MTT) e por citometria de fluxo. As 67-72p foram extraídas da superfície da amostra toxigênica C. diphtheriae subsp. mitis CDC-E8392 através de processos mecânicos e precipitação com sulfato de amônio saturado. Análises por SDS-PAGE e immunoblotting detectaram a presença das bandas protéicas de 67 e 72kDa nas amostras toxinogênicas e atoxinogênicas analisadas, as quais pertenciam aos biotipos fermentador e não fermentador de sacarose. C. diphtheriae foi capazes não só de formar agregados na presença de plasma de coelho, mas também de converter Fbn em fibrina independentemente da presença do gene tox. No entanto, a amostra atoxinogênica ATCC 27010 (tox-) foi menos aderente ao Fbn do que a homóloga ATCC 27012 (tox+). A interação bacteriana com eritrócitos foi inibida somente pela Fn. Ligações entre Fn e/ou Fbn com 67-72p foram demonstradas por dot blotting, ELISA e/ou ensaios utilizando fluorescência. As 67-72p foram capazes de inibir as interações bacterianas com o Fbn, indicando que 67-72p podem participar do processo de aderência do patógeno aos tecidos do hospedeiro. Através da microscopia óptica, demonstrou-se a ligação de 67-72p adsorvidas em microesferas de látex com células HEp-2. Anticorpos de coelho do tipo IgG anti 67-72p interferiram somente com a expressão do padrão de aderência do tipo difuso, normalmente apresentado pela amostra CDC-E8392. A Microscopia Eletrônica de Transmissão (MET) e a inibição da internalização bacteriana pela IgG anti 67-72p ou por 67-72p indicaram o papel de 67-72p como invasina. Alterações do citoesqueleto de células HEp-2 com acumulação de actina polimerizada, induzida por microesferas sensibilizadas com 67-72p, foi observada pelo fluorescent actin staining (FAS) test. Foi visualizado um aumento no número de bactérias viáveis no compartimento intracelular após tratamento de células HEp-2 ou dos microrganismos com Fn. A presença de partículas de látex adsorvidas com 67-72p no interior de vacúolos frouxos em células HEp-2 sugeriu que estas proteínas podem causar efeito citotóxico. A avaliação através das colorações com Azul de Tripan, DAPI e os ensaios de redução utilizando MTT demonstraram um decréscimo na viabilidade de células tratadas com 67-72p. As mudanças morfológicas observadas 3 horas após o início do tratamento com 67-72p incluíram vacuolização, fragmentação nuclear e formação de corpúsculos apoptóticos. A citometria de fluxo revelou um decréscimo de 15,13% no volume/tamanho de células tratadas com 67-72p. Além disso, o ensaio utilizando Iodeto de Propídio (IP) e Anexina V (AV)-FITIC demonstrou que havia 66,1% de células vivas (IP-/AV-), 16,6% de células em apoptose inicial (IP-/AV+) e 13,8% de células em apoptose tardia ou necrose secundária. Em conclusão, as 67-72p estão diretamente envolvidas na interação com Fn e Fbn. As proteínas não fimbriais 67-72p são hemaglutininas implicadas na aderência a células respiratórias e na internalização. Além disso, estas proteínas podem atuar como fatores de virulência em potencial para induzir apoptose de células epiteliais nos estágios iniciais da difteria e nas infecções invasivas causadas pelo C. diphtheriae / Corynebacterium diphtheriae have been isolated from classical diphtheria and systemic infections such as endocarditis. Fibrinogen (Fbn) and fibronectin (Fn) are high molecular-weight glycoproteins that may be found in extracellular matrix of connective tissues. Their influence in the pathogenesis of local and in invasive C. diphtheriae infection is object of interest due to the fact that diphtheria bacilli is recovered from lesions where such proteins are predominant, including pharyngeal pseudomembrane and valve heart vegetations in infectious endocarditis. There is growing evidence that C. diphtheriae may adhere to and be internalized by cells in culture. The present study investigated the participation of C. diphtheriae strains and 67-72p, a surface protein, in adherence to human plasma Fn, Fbn, erythrocytes, adherence to and internalization by HEp-2 cells. The participation of 67-72p in promoting cell death was evaluated by the Trypan blue, DAPI staining methods, methylthiazole tetrazolium (MTT) reduction assay and flow cytometry. The 67-72p was extracted from C. diphtheriae subsp. mitis CDC-E8392 toxigenic strain, by mechanical process and ammonium sulfate fractionation. SDS-PAGE and immunoblotting analysis detected the polypeptide bands of 67 and 72 kDa in all toxigenic and nontoxigenic strains from both sucrose-fermenting and non-fermenting biotypes. Diphtheria bacilli were capable to both form bacterial aggregates in rabbit plasma and to convert Fbn to fibrin independently to the presence of tox gene, albeit the ATCC 27010 (tox-) strain was less adherent to Fbn than the parental strain ATCC 27012 (tox+). Bacteria-erythrocytes interaction was inhibited only by Fn. Interactions of Fn and/or Fbn with 67-72p were demonstrated by dot blotting, ELISA and/or fluorescence assays. Bacteria-Fbn interaction was inhibited by 67-72p, indicating that 67-72p may participate in the adhesion of the pathogen to host tissues. The interaction of HEp-2 cells with 67-72p-adsorbed latex microspheres was demonstrated by light microscopy. Rabbit IgG anti 67-72p was shown to interfere with diffuse adherence phenotype to HEp-2 cells displayed by CDC-E8392, but not by other phenotypes. Transmission electron microscopy (TEM) and the inhibition of bacterial internalization by anti 67-72p IgG and 67-72p indicated the role of 67-72p as invasin. Cytoskeletal accumulation of polymerized actin in HEp-2 cells induced by 67-72p-microspheres was observed by the fluorescent actin staining (FAS) test. Fn enhanced the intracellular viability of all strains tested. The presence of 67-72p-latex particles inside spacious vacuoles (SV) in HEp-2 cells, suggested a citotoxic effect of these proteins. Evaluation by the Trypan blue staining method, 4,6-Diamidine-2-phenylindole dihydrochloride DAPI and the 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction assay showed a significant decrease in viability of HEp-2 cells treated with 0.2 mg/ml 67-72p. Morphological changes in HEp-2 cells (vacuolization, nuclear fragmentation, and the formation of apoptotic bodies) was observed after 3 h post-treatment with 67-72p. Flow cytometry revealed a 15.13% reduction apoptotic volume of HEp-2 cells treated with 0.2 mg/ml 67-72p. Moreover, a double-staining assay using Propidium Iodide (PI)/Annexin V (AV) demonstrated the numbers of vital (PI-/AV-) (66.1%) vs. early apoptotic (PI-/AV+) (16.6%) cells and late apoptotic or secondary necrotic cells (PI+/AV+) (13.8%). In conclusion, the 67-72p are directly implicated in C. diphtheriae interaction with Fn and Fbn. The non-fimbrial Fn/Fbn binding 67-72p are hemagglutinins directly implicated in adherence to and internalization by respiratory epithelial cells. Moreover, 67-72p may act as a potential virulence factor to induce apoptosis of epithelial cells in the early stages of diphtheria and C. diphtheriae invasive infection

O domínio da técnica de microanastomose vascular é um pré-requisito essencial para a realização de procedimentos microcirúrgicos reconstrutivos, como reimplantes e transferência livre de tecidos. Até hoje, a técnica de sutura convencional é a mais aceita na prática clínica, por sua segurança e versatilidade. Apesar disso, ela apresenta alguns problemas por ser tecnicamente difícil, consumir tempo considerável e causar traumatismo adicional à parede do vaso. O objetivo deste estudo, foi testar um método alternativo de microanastomose arterial, reduzindo o número de pontos de sutura com aplicação do adesivo de fibrina. Sessenta ratos da raça Wistar foram submetidos a microanastomose vascular nas artérias femorais ou carótidas. Os animais foram divididos em quatro subgrupos de acordo com a artéria operada e a técnica de sutura empregada: FSC (femoral - sutura convencional), FAF (femoral - sutura mínima com adesivo de fibrina), CSC (carótida - sutura convencional) e CAF (carótida - sutura mínima com adesivo de fibrina). As duas técnicas de anastomose foram comparadas através de análise estatística dos parâmetros clínicos e histopatológicos. A média de pontos de sutura por anastomose nos subgrupos FSC e CSC foi de 7,7 e 9,5, respectivamente. No subgrupo FAF, as anastomoses foram realizadas com apenas quatro pontos de sutura e no subgrupo CAF, com apenas seis. O tempo de anastomose foi, em média: 15,81 minutos no subgrupo FSC, 13,62 minutos no subgrupo FAF, 18,87 minutos no subgrupo CSC e 17,33 minutos no subgrupo CAF. A aplicação do adesivo de fibrina reduziu, significativamente, o número de pontos e o tempo necessário para realização das anastomoses, nos subgrupos FAF e CAF. A intensidade do sangramento anastomótico também foi reduzida de maneira significativa nestes subgrupos. A freqüência da permeabilidade imediata e tardia foi de 100% em todos os subgrupos, exceto no subgrupo FAF, onde a permeabilidade tardia foi de 93,33%. Não foram observadas diferenças significativas entre as duas técnicas, em relação aos parâmetros histopatológicos avaliados (processo inflamatório, fibrose da camada média e hiperplasia subintimal). O autor concluiu que a técnica de sutura mínima com aplicação do adesivo de fibrina foi mais fácil e rápida que a técnica de sutura convencional, sem aumento da trombogenicidade das anastomoses, no modelo experimental utilizado. / Mastering of the microvascular anastomosis technique is an essencial requirement to perform reconstructive microsurgical procedures, such as replantation surgery and free tissue transfers. Until now, the conventional suture technique is the most widely accepted in the clinical setting, for its safety and versatility. However, this technique presents some problems for being technically difficult, time consuming and causes additional trauma to the vessel wall. The aim of this study was to test an alternative method of microvascular arterial anastomosis, by reducing the number of sutures with application of fibrin adhesive. Sixty Wistar rats underwent to microvascular anastomosis at the femoral or carotid arteries. The animals were divided into four subgroups, according to the operated artery and the employed suture technique: FCS (femoral - conventional suture), FFA (femoral - minimal suture with fibrin adhesive), CCS (carotid - conventional suture) and CFA (carotid - minimal suture with fibrin adhesive). Both anastomosis techniques were compared by means of statistical analisys of the clinical and histopathological parameters. The mean number of sutures required to complete the anastomosis was 7,7 in subgroup FCS and 9,5 in subgroup CCS. In subgroup FFA, the anastomosis was performed with only four sutures and in subgroup CFA, with only six. The mean anastomotic time was 15,81 minutes in subgroup FCS, 13,62 minutes in subgroup FFA, 18,87 minutes in subgroup CCS and 17,33 minutes in subgroup CCS. The application of fibrin adhesive, significantly reduced the number of sutures and the time taken to perform the anastomosis, in subgroups FFA and CFA. The amount of anastomotic bleeding was also significantly reduced in these subgroups. The immediate and late patency rates were 100% in all subgroups, except in subgroup FFA where it was 93,33%. No significant differences were observed among the two techniques, concerning the evaluated histopathological parameters (inflammatory process, medial fibrosis and subintimal hyperplasia). The author concluded that, the fibrin adhesive application with minimal suture technique was faster and easier than the conventional suture technique, without increasing the trombogenicity of the anastomosis, in this experimental model.

Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2016-10-21T13:25:36Z No. of bitstreams: 2 Dissertação - Lidiana Candida Piveta - 2016.pdf: 1349571 bytes, checksum: a3430d01588aec9260e619f74991bcd1 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2016-11-08T17:41:10Z (GMT) No. of bitstreams: 2 Dissertação - Lidiana Candida Piveta - 2016.pdf: 1349571 bytes, checksum: a3430d01588aec9260e619f74991bcd1 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-11-08T17:41:10Z (GMT). No. of bitstreams: 2 Dissertação - Lidiana Candida Piveta - 2016.pdf: 1349571 bytes, checksum: a3430d01588aec9260e619f74991bcd1 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-07-22 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Cataracts is the treatable eye diseases that cause most blindness in the world. The effective treatment is surgical and phacoemulsification the most applied technique. Some complications are associated with the procedure as corneal opacities, uveitis and fibrin deposits. The presence of fibrin in the anterior chamber is associated with the formation of synechia and secondary glaucoma low visual recovery of patients. Some medications, as TPA (Tissue Plasminogen Activator) which acts in the degradation of fibrin, seeing being used to soften these deposits. Tenecteplase is a third generation of the synthetic TPA and have a longer half-life than the others with application in ophthalmology without damage to the cornea and retina of rabbits and humans. The study was conducted on 15 rabbits of New Zealand race, share in three groups GC, GT and GNT. The GNT and GT were surgery by phacoemulsification technics, GT was treated with 0.1 ml intracameral tenecteplase (50 μg) transoperative. The rabbits were evaluated in M0 moments - when selected, underwent phacoemulsification surgery and reassessed in M1d – 1th day M3d – 3th day M7d – 7th day M15d - 15th day and M21d – 21th days. In the clinical evaluation of the use of intracameral tenecteplase in transoperative and postoperative complications were observed, emphasizing the change in IOP, the corneal edema, fibrin deposits, hyphema, aqueous flare and synechia incidences. In the M21d animals were sacrificed, and samples of aqueous humor were collected for physical-chemical analysis (pH, density, concentration of chloride ions and total proteins). No statistical differences were observed in the clinical evaluation of the GC and GNT within the recommended parameters. In physical-chemical analysis of aqueous humor showed no statistical difference between the three groups in terms of pH and concentration of chloride ion. The density values and total protein concentration between the GC and the other groups. / A catarata está entre as oftalmopatias tratáveis que mais causam cegueira no mundo. O único tratamento efetivo é cirúrgico, sendo a facoemulsificação a técnica mais aplicada. Algumas complicações estão associadas ao procedimento como opacidades corneanas, uveítes e depósitos de fibrinas. A presença de fibrina na câmara anterior esta associada à formação de sinéquias, glaucoma secundário e baixa recuperação visual dos pacientes. Algumas medicações vêm sendo usadas para amenizar esses depósitos como os TPA, que atua na degradação da fibrina. A tenecteplase é um TPA sintético de terceira geração que apresenta um tempo de meia vida maior que as outras gerações, com aplicação na oftalmologia sem danos à córnea e retina de coelhos e humanos. O estudo foi realizado com 15 coelhos da raça Nova Zelândia, divididos em três grupos GC, GNT e GT. Os grupos GNT e GT foram operados pela técnica de facoemulsificação, GT recebeu tratamento com 0,1 ml de tenecteplase intracameral (50μg) no transoperatório. Os coelhos foram avaliados nos momentos M0 - quando selecionados, submetidos ao procedimento cirúrgico de facoemulsificação e reavaliados em M1d - 1° dia, M3d - 3°dia, M7d - 7 °dia, M15d - 15° dia e M21d - 21°dia. Na avaliação clínica do uso da tenecteplase intracameral no transoperatório foram observadas as complicações pós-operatórias, dando ênfase à variação da pressão intraocular (PIO), ao edema de córnea, depósito de fibrina, hifema, flare aquoso e incidências de sinéquias. No M5 os animais foram eutanasiados, e coletado amostras do humor aquoso para avaliação físico-química (pH, densidade, concentração de íons de cloreto e proteínas totais). Não foram observadas diferenças estatísticas na avaliação clínica entre o GNT e GT dentro dos parâmetros preconizados. Na avaliação físico-química do humor aquoso não apresentou diferença estatística entre os três grupos quanto aos valores de pH e concentração do íon cloreto. Os valores de densidade e concentração de proteínas totais entre o GC e os demais grupos.

L'étude systématique de l'hémostase post-thrombolytique a été peu étudiée. Chez 80 malades thrombolysés consécutifs, une étude prospective a comporté l'étude – aux heures 0, 2 et 24 – des facteurs de l'hémostase suivants: fibrinogène, plasminogène, PDF (produits de dégradation de la fibrine et du fibrinogène), D-dimères, alpha2-antiplasmine et facteur XIII, ainsi que l'hématocrite et la numération plaquettaire. Des calculs statistiques approfondis ont exploré les corrélations des variations des facteurs hémostatiques entre eux et avec 37 paramètres cliniques et étiologiques. Processus moléculaires post-thrombolytiques. Le rt-PA induit deux processus, indépendants statistiquement à la 2ème heure: d'une part une élévation des PDF et des D-dimères; d'autre part, une baisse du fibrinogène, corrélée à une baisse du plasminogène (r=0,48, p=0.01), de l'alpha2-antiplasmine (r=0.48, p =0.004) et du facteur XIII (r=0.44, p=0.01). La baisse du plasminogène est corrélée significativement avec celle de l'alpha2-antiplasmine (r=0.77, p<0.001), et du facteur XIII (r=0.47, p=0.02). La mise en jeu de facteurs anti-fibrinolytiques, qui n'avait jamais été décrite précédemment, peut jouer un rôle dans une limitation de la fibrinolyse et dans la rethrombose. Des corrélations sont notées entre la baisse précoce du plasminogène et l'étiologie cardioembolique (p=0.04), et un mauvais pronostic final (p=0.03), possiblement en rapport la thrombolyse intense de gros caillots. Les hématomes intra-cérébraux parenchymateux (HP) sont liés significativement à la baisse du fibrinogène (p=0.01) et à l'augmentation des PDF (p=0.01). Une baisse du fibrinogène au-dessous de 2g/L multiplie la probabilité de HP précoce par un facteur 12,82. Ainsi est confirmé le modèle d'une “coagulopathie précoce avec dégradation du fibrinogène”», prédictive de l'hématome, proposé par l'équipe lyonnaise de thrombolyse en 2004 / A systematic study of post-thrombolytic haemostasis has rarely been performed. In 80 consecutive patients, we have prospectively studied at hours 0, 2 and 24 the following parameters: fibrinogen, plasminogen, alpha2-antiplasmin, factor XIII, fibrin(ogen) Degradation Products (FDP), D-dimers, haematocrit and platelet count. Comprehensive statistical studies calculated correlations of the haemostatic values betwen themselves and with 38 etiological and clinical parameters. Molecular dynamics. Two changes between h0 and h2 were statistically independent: an increase in FDP and D-Dimers; a decrease in fibrinogen, plasminogen, alpha2-antiplasmin and factor XIII. At h2, the decrease in fibrinogen was significantly correlated with that of plasminogen (0.48, p = 0.01), alpha2-antiplasmin (0.48, p = 0.004), and factor XIII (0.44, p = 0.01). The decrease in plasminogen was significantly correlated with those of antifibrinolytic components, alpha2-antiplasmin (r=0.77, p<0.001) and factor XIII (0.47, p=0.02). To our knowledge, such an activation of antifibrinolytic components had not hitherto been mentioned. The h2 decrease of plasminogen was correlated with cardioembolic etiology (p=0.04) and final poor oucome (p=0.03), a fact possibly due to intense thrombolysis of large clots. Patients having early parenchymal hematomas (PH) showed h2 haemostasis disturbances: high FDP (p=0.01), and low fibrinogen (p=0.01). The decrease in fibrinogen less than 2g/L multiplies the odds of early PH by a factor 12.82. Thus, we confirm the model of an “early fibrinogen degradation coagulopathy” predictive of hematomas, which had been coined by the Lyon thrombolysis team in 2004

<p dir="ltr">Though mammalian spinal cord injury (SCI) has long been a topic of study, effective therapies that promote functional recovery are not yet available. The axolotl, <i>Ambystoma mexicanum</i>, is a valuable animal model in the investigation of spinal cord regeneration, as this urodele is able to achieve functional recovery even after complete spinal cord transection. Understanding the similarities and differences between the mammalian SCI response and that of the axolotl provides insight into the process of successful regeneration, and bolsters the fundamental knowledge used in the development of future mammalian SCI treatments. This thesis provides a detailed analysis of the ultrastructure of the axolotl meninges, as this has not yet been presented in existing literature, and reveals that the axolotl meninges consist of 3 distinct layers as does mammalian meninges; the dura mater, arachnoid mater, and pia mater. The role of reactive meningeal and ependymal cells is also investigated in regard to the deposition and remodeling of the fibrotic ECM, which is found to be similar in composition to hydrogel scaffolds being studied in mammalian SCI. It is shown that meningeal fibroblasts are the primary source of the extensive fibrillar collagen deposition that fills the entire spinal canal, peaking at approximately 3 weeks post transection and remaining until approximately 5 weeks post transection, and that there is no deposition of type IV collagen within the lesion site. Mesenchymal ependymal cells are shown to contribute to the ECM deposition through the production of glycosaminoglycans that are used in sidechains of both unsulfated and sulfated proteoglycans, while simultaneously remodeling the ECM through the production of MMPs and phagocytosis of cellular debris. Further, this study shows that mesenchymal ependymal cells and a population of foamy macrophages contribute to the degradation of the fibrin clot that forms in the acute phase of injury, and that this fibrin clot provides a necessary and permissive substrate for early mesenchymal outgrowth.</p>