Made available in DSpace on 2016-07-18T17:53:05Z (GMT). No. of bitstreams: 1 dissertacao Bianca.pdf: 325135 bytes, checksum: 8bbf94808bc25e72a05aba3d84bca76a (MD5) Previous issue date: 2008-11-14 / The aim of the study was to evaluate the effect of bovine somatotropin in follicular deviation of sixteen Tabapuã cows. The animals received an ear implant of progesterone and 1 mg of estradiol benzoate, IM (day 0). On day 5, the females were divided into 2 groups: GI (control, n=8) and GII (treated with 500 mg bST, n=8). On day 10, the implants were removed and injected 500 µg of PGF2α in all cows. Only cows with follicles bigger 9 mm received 300 µg of GnRH. Ultrasound examinations were performed each 12 hours. There was no statistical difference between the follicular deviation in GI (2.4 days) and GII (2,1 days). At the divergence moment, FD and FS of GI were 6.28±0.42 and 6.26±0.41 mm, respectively, and FD and FS of GII were 6.08±0.72 and 6.12±0.39 mm. The mean maximum diameter of FD after ovulation was at 110.0±8.43 hours in GI and 115.2±8.98 hours in GII. FS reached the maximum diameter at 55.0±20.0 hours in GI and 76.8±10.46 hours in GII. The mean maximum diameter reached by FD and FS in GI was 8.85±0.41 and 6.5±0.42 mm, respectively, and GII 9.83±0.63 and 6.87±0.35 mm. There was no significant difference (p> 0.05) in diameter of FD and FS, neither in growth rates (mm/12 hours) of the FD before and after the deviation, neither in the moment of follicle deviation / O objetivo do presente estudo foi avaliar o efeito da somatotrofina bovina na divergência folicular em vacas da raça Tabapuã. Foram utilizadas 16 vacas da raça Tabapuã, inicialmente receberam implante de progestágeno auricular concomitante à aplicação IM de 1mg de benzoato de estradiol (dia 0). No dia 5, dividiram-se as fêmeas em 2 grupos: G-I (controle, n=8) e as vacas do G-II foram tratadas com 500 mg bST (n=8). No dia 10 foi feita a retirada do crestar concomitante a aplicação de 500 g de PGF2 e apenas nas vacas com folículos> 9 mm aplicação de 300 g de GnRH. Foram realizados exames ultrassonográficos a cada 12 horas por 5 dias. Não houve diferença estatística entre os momentos de divergência folicular, no G-I foi de 2,4 dias e no G-II 2,1 dias. Nesse momento o FD e FS mediram 6,28  0,42 e 6,26  0,41 mm no G-I e 6,08  0,72 e 6,12  0,39 mm no G-II. O FD atingiu diâmetro máximo após a ovulação em média 110,00 ± 8,43 horas no GI e 115,20 ± 8,98 horas no GII. Já o FS atingiu o diâmetro máximo às 55,00 ± 20,00 e 76,80 ± 10,46 horas, respectivamente. A média do diâmetro máximo atingido pelo FD e FS no GI foi respectivamente 8,85 ± 0,41 e 6,50 ± 0,42 mm e no GII foi 9,83 ± 0,63 e 6,87 ± 0,35 mm. Não houve diferença significativa (p>0,05) no diâmetro do FD e FS e nem nas taxas de crescimento (mm/12h) do FD antes e após a divergência folicular. Concluímos que a aplicação de bST não afetou o diâmetro folicular, a taxa de crescimento do FD e FS antes e após a divergência, nem tampouco, o momento da divergência folicular

Adipositas und das polyzystische Ovarsyndrom (PCOS) sind häufig Gründe für Anovulation, Infertilität und unerfüllten Kinderwunsch. Sowohl Adipositas als auch das PCOS können zu einem Ungleichgewicht zwischen Anti- und Prooxidanzien im menschlichen Körper führen. Durch Übergewicht der Prooxidanzien ensteht oxidativer Stress. Reaktive Sauerstoffspezies (reactive oxygen species, ROS) fallen vermehrt an und oxidieren Lipoproteine zu „oxidized low density lipoproteins“ (oxLDL). Durch Bindung von oxLDL an den „lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1)“ wird Apoptose und Autophagie induziert. Wir vermuten, dass sich diese Prozesse auch in der Follikelflüssigkeit (FF), dem Milieu der Eizelle, abspielen und zum Absterben reifender Follikel und somit zur Anovulation und Infertilität führen. Das Ziel dieser Arbeit war es, zu untersuchen, welchen Einfluss Adipositas, hormonelle Stimulation und PCOS auf die enzymatischen Antioxidanzien Superoxiddismutase (SOD), Katalase, Glutathionperoxidase (GPx) und Glutathionreduktase (GR) sowie auf den oxLDL-Spiegel haben. Es wurden Serum und FF von Frauen unter IVF (in vitro Fertilisation) -Therapie untersucht, die anhand ihres Body Mass Index (BMI), des Taille-Hüft-Quotienten (T/H-Quotient) sowie des PCOS in vier Gruppen eingeteilt wurden. Die Konzentration an oxLDL als Repräsentant des oxidativen Systems und die Aktivität der Enzyme SOD, Katalase, GPx und GR, Repräsentaten des antioxidativen Systems, wurden im Serum vor Stimulationsbeginn und zum Zeitpunkt der Follikelpunktion sowie in der FF gemessen. Adipöse Frauen mit und ohne PCOS hatten höhere Konzentrationen an oxLDL in der FF als normalgewichtige. Die oxLDL-Konzentrationen der FF waren 1000-fach niedriger als die der Seren. Interessanterweise waren auch die Katalase-Aktivitäten in der FF adipöser Frauen mit und ohne PCOS höher als die der normalgewichtigen. Zusammenfassend lässt sich folgern, dass erhöhte oxLDL-Konzentrationen in der FF von adipösen Frauen, unabhängig vom Vorliegen eines PCOS, mit einer gesteigerten Katalase-Aktivität und einer niedrigeren IVF-Erfolgsrate assoziiert sind.:Inhaltsverzeichnis Bibliographie III Abkürzungsverzeichnis IV 1. Einleitung 1 1.1. Infertilität 1 1.2. PCOS 2 1.2.1. Definition des PCOS 2 1.2.2. PCOS und Adipositas 3 1.3. Oxidativer Stress 4 1.3.1. Reaktive Sauerstoffspezies 4 1.3.2. Superoxiddismutase (SOD) – Schutz vor Superoxidradikalen 5 1.3.3. Katalase – Schutz vor H2O2 5 1.3.4. Glutathionperoxidase (GPx) und Glutathionreduktase (GR) 5 1.4. Oxidativer Stress, „oxidized low density lipoprotein“(oxLDL) und 6 Adipositas 1.5. Oxidativer Stress, antioxidative Enzyme und Infertilität 7 1.6. Ziele der Arbeit 9 2. Material und Methoden 10 2.1. Patientinnen und Material 10 2.2. Methoden 12 2.2.1. Follikelspektrumanalyse – Kontamination mit Blutbestandteilen 12 2.2.2. Proteinbestimmung 12 2.2.3. Bestimmung der SOD-Aktivität 13 2.2.4. Bestimmung der Katalase-Aktivität 14 2.2.5. Bestimmung der GPx-Aktivität 15 2.2.6. Bestimmung der GR-Aktivität 16 2.2.7. Bestimmung der oxLDL-Konzentration mittels ELISA 17 2.3. Statistische Auswertung 18 3. Ergebnisse 19 3.1. Vergleich der Proteinkonzentrationen in Seren und FF 19 3.2. Erhöhte SOD-Aktivität in der FF im Vergleich zum Serum 20 3.3. Erhöhte Katalase-Aktivität bei Adipositas unabhängig vom PCOS-Status 21 3.4. Erhöhte GPx-Aktivität bei adipösen Patientinnen ohne PCOS 22 3.5. Erhöhte GR-Aktivität bei Adipositas unabhängig vom PCOS-Status 23 3.6. Erhöhte oxLDL-Konzentrationen in der FF adipöser Patientinnen 25 unabhängig vom PCOS-Status 3.7. Schwangerschaftsrate der vier Patientengruppen 26 4. Diskussion 28 4.1. Das oxidative System 28 4.1.1. LOX-1 und oxLDL – Stand der Forschung 28 4.1.2. OxLDL – Diskussion der Methode 29 4.1.3. OxLDL – Konzentration im Serum 30 4.1.4. Einfluss der hormonellen Stimulationstherapie auf oxLDL 31 4.1.5. OxLDL – Konzentration in der FF 32 4.1.6. Oxidativer Status - Zusammenfassung 34 4.2. Das antioxidative System 34 4.2.1. SOD-Aktivität im Serum 35 4.2.2. SOD-Aktivität in der FF 35 4.2.2. Katalase, ein klinischer Parameter zur Bestimmung des 36 oxidativen Stress? 4.2.3. Zelltod als Ursache für erhöhte Enzymaktivitäten bei Adipositas? 36 4.2.5. Grenzen der Studie 37 4.3. Schlussfolgerung und Ausblick 38 5. Zusammenfassung 40 6. Literaturverzeichnis 44 7. Anhang 59 7.1. Tabellenverzeichnis 59 7.2. Abbildungsverzeichnis 59 7.3. Eidesstattliche Versicherung 60 7.4. Werdegang 61 7.5. Danksagung 63

Background: Recently high-throughput sequencing (HTS) using next generation sequencing techniques became useful in digital gene expression profiling. Our study introduces analysis options for HTS data based on mapping to miRBase or counting and grouping of identical sequence reads. Those approaches allow a hypothesis free detection of miRNA differential expression. Methods: We compare our results to microarray and qPCR data from one set of RNA samples. We use Illumina platforms for microarray analysis and miRNA sequencing of 20 samples from benign follicular thyroid adenoma and malignant follicular thyroid carcinoma. Furthermore, we use three strategies for HTS data analysis to evaluate miRNA biomarkers for malignant versus benign follicular thyroid tumors. Results: High correlation of qPCR and HTS data was observed for the proposed analysis methods. However, qPCR is limited in the differential detection of miRNA isoforms. Moreover, we illustrate a much broader dynamic range of HTS compared to microarrays for small RNA studies. Finally, our data confirm hsa-miR-197-3p, hsa-miR-221-3p, hsa-miR-222-3p and both hsa-miR-144-3p and hsa-miR-144-5p as potential follicular thyroid cancer biomarkers. Conclusions: Compared to microarrays HTS provides a global profile of miRNA expression with higher specificity and in more detail. Summarizing of HTS reads as isoform groups (analysis pipeline B) or according to functional criteria (seed analysis pipeline C), which better correlates to results of qPCR are promising new options for HTS analysis. Finally, data opens future miRNA research perspectives for HTS and indicates that qPCR might be limited in validating HTS data in detail.:Background; Methods; Results; Discussion; Conclusions

Le système immunitaire humain est majoritairement commandé par les cellules dendritiques et les lymphocytes T auxiliaires. Lorsque les cellules dendritiques détectent un pathogène, elles vont instruire les lymphocytes T auxiliaires afin qu’ils adoptent le phénotype approprié à la menace rencontrée. Les lymphocytes T auxiliaires peuvent être divisés en plusieurs sous-populations, caractérisées par la production de cytokines spécifiques. Chaque sous-population de lymphocyte T auxiliaire possède des fonctions propres et est impliquée dans l’élimination de pathogènes distincts. Si les réponses des lymphocytes T auxiliaires ne sont pas finement régulées, ils peuvent devenir pathogéniques, et dans ce cas, considérés comme cibles potentielles pour des thérapies. Dans ce contexte, j’ai concentré mon travail de doctorat sur l’étude de la diversité des sous- populations de lymphocytes T auxiliaires et de leur régulation. Premièrement, j’ai démontré que les cellules dendritiques activées par la TSLP sont capables d’induire la polarisation de lymphocytes T folliculaires. Ensuite, j’ai participé à la construction d’un modèle mathématique capable de prédire la réponse lymphocytaire T auxiliaire en fonction de signaux dérivés des cellules dendritiques. Ce modèle nous a permis d’identifier un rôle spécifique pour l’IL-12p70, dépendant du contexte IL-1, dans l’induction d’IL-17F sans IL-17A. Enfin, j’ai monitoré huit populations de lymphocytes T auxiliaires et folliculaires dans le sang périphérique de patients atteints de dermatite atopique traités par Dupilumab, une immunothérapie ciblant la sous-unité alpha du récepteur de l’IL-4 et j’ai pu montré que la diminution du pourcentage de lymphocytes Th17 correlait avec l’amélioration du score clinique EASI. Globalement, mon travail sur la diversité de phénotypes Th apporte une ressource mécanistique importante, avec une potentielle application en immunothérapie. / Human immunity is essentially driven by dendritic cells and T helper cells. When dendritic cells detect a pathogen, they will instruct T helper cells to adopt the adapted phenotype for the specific threat encountered. T helper cells are subdivided in multiple subsets, characterized by particular sets of cytokines. Each T helper subset has specific functions and is involved in the clearance of distinct pathogens. If T helper responses are not precisely regulated, they can become pathogenic, in this case T helper pathways can be considered as potential targets for therapy. In this context, I focused my PhD work on studying T helper cell subset diversity and regulation. First, I demonstrated the ability of TSLP-activated dendritic cell to induce T follicular helper cell polarization. Then I participated in building a mathematical model capable of predicting T helper cell response to dendritic-cell derived signals. This model allowed us to identify the specific role of IL-12p70, in an IL-1 context, to induce IL-17F without IL-17A. Finally, I monitered eight T helper and T follicular helper cell populations in peripheral blood from atopic dermatitis patients treated with Dupilumab, an immunotherapy targeting the IL-4 receptor alpha subunit, and was able to show a correlation between decrease of Th17 cell percentage and improvement of EASI clinical score. Overall, my work on Th phenotype diversity provides key mechanistic insight with potential application in immunotherapy.

Bakgrund: Under menstruationscykeln, som består av follikelfasen och lutealfasen, så varierar hormonerna kraftigt. Det anabola hormonet östrogen är dominerande under follikelfasen och det katabola hormonet progesteron är dominerande under lutealfasen. Detta talar för att prestationen i styrketräning kan vara högre under follikelfasen än under lutealfasen. Syfte: Syftet med denna studie var att undersöka om kvinnor i fertil ålder upplevde variationer i sin prestation inom styrketräning under menstruationscykelns olika faser. Metod: I denna studie användes en kvalitativ studiedesign där datainsamling genomfördes med semistrukturerade intervjuer. Fem kvinnor i fertil ålder (24-32 år) med erfarenhet av styrketräning förde träningsdagbok under en menstruationscykel och intervjuades därefter. Intervjuerna analyserades med konventionell kvalitativ innehållsanalys. Resultat: Resultatet visade att kvinnornas upplevelse av prestation varierade under menstruationscykels faser. Vid analysen utkristalliserade sig fyra övergripande teman ”Varierande mentala och fysiska upplevelser i den tidiga follikelfasen”, ” Framför allt toppad prestation under sena follikelfasen”, ”Brytpunkt vid ägglossning” och ”Varierande mentala och fysiska upplevelser under lutealfasen”. Konklusion: Kvinnor i fertil ålder verkar uppleva variationer i sin prestation i styrketräning under menstruationscykelns olika faser. Det kan därför vara fördelaktigt att periodisera styrketräningen utifrån menstruationscykeln. / Background: During the menstrual cycle, which consists of the follicular phase and the luteal phase, the hormones vary greatly. The anabolic hormone estrogen dominates the follicular phase and the catabolic hormone progesterone dominates during the luteal phase. This suggests that performance in strength training may be higher during the follicular phase than during the luteal phase. Purpose: The aim was to investigate whether women of childbearing age experienced variations in their performance in strength training during the different phases of the menstrual cycle. Method: In this study, a qualitative study design was used where data collection was carried out with semi-structured interviews. Five women of childbearing age (24-32 years) with experience in strength training kept an exercise diary during a menstrual cycle and were subsequently interviewed. Results: The results showed that women's experience of performance varied during the phases of the menstrual cycle. Four categories were identified "Varying mental and physical experiences in the early follicle phase", "Mostly peak performance during the late follicle phase", "Breakpoint in ovulation" and "Varying mental and physical experiences during the luteal phase". Conclusion: Women of childbearing age seem to experience variations in strength training performance during the different phases of the menstrual cycle. Thus, periodizing strength training program, based on the menstrual cycle, might be beneficial.

Les mammifères femelles naissent avec un très grand nombre de follicules ovariens primordiaux (104-106); par contre, la grande majorité (99%) de ces follicules n’atteignent jamais la maturité et subissent l’atrésie, principalement par l’apoptose des cellules de la granulosa. Notre laboratoire a démontré que les hyaluronidases des mammifères induisent l’apoptose des cellules de la granulosa et sont impliquées dans l’atrésie des follicules mais que cet effet apoptotique ne serait pas dû à leur activité enzymatique. Notre modèle propose que les hyaluronidases aient un rôle dans les follicules non destinés à ovuler. Le but de la présente étude est d’évaluer la folliculogénèse et la fertilité des souris déficientes de ces enzymes. Les résultats montrent que la délétion de Hyal-3 ne semble pas affecter la fonction ovarienne des souris mais qu’il pourrait y avoir un effet compensatoire par Hyal-1 chez les souris déficientes de Hyal-3 étant donné que son expression est augmentée chez ces souris. La délétion de Hyal-1 a pour effet d’augmenter le nombre des follicules primordiaux, primaires et secondaires, particulièrement chez les souris de bas âge, et de diminuer le niveau d’apoptose des cellules de la granulosa. Afin d’évaluer la fonction de Hyal-1, -2 et -3 sans effet compensatoire entre elles, nous avons voulu créer une souris déficiente des ces 3 hyaluronidases spécifiquement dans les gonades en utilisant le système Cre/loxP. Un vecteur contenant la séquence Cre sous le contrôle du promoteur de Inhibin-α, qui conduit l’expression des gènes en aval chez les cellules somatiques des gonades, a été construit avec succès. En conclusion, cette étude nous révèle que Hyal-3 ne semble pas affecter la fonction ovarienne mais que la délétion de Hyal-1 augmente la folliculogénèse et diminue l’apoptose des cellules de la granulosa. / Female mammals are born with a large number of ovarian primordial follicles, though the vast majority of these never reach the preovulatory stage and undergo atresia, mainly through granulosa cell apoptosis. Our laboratory has established that mammalian hyaluronidases induce apoptosis of ovarian granulosa cells and that they are involved in follicular atresia but that their apoptotic effect is not due to their enzymatic activity. Our model suggests that mammalian hyaluronidases might have a role in follicles not destined to ovulate. The aim of this study was to evaluate the folliculogenesis and fertility of mice devoid of these enzymes. Our results showed that Hyal-3 KO mice have normal folliculogenesis, which could be explained by a compensatory effect of Hyal-1 since its expression is upregulated in these mice. In contrast, Hyal-1 KO mice had increased numbers of primordial, primary and secondary follicles, particularly in young mice, and lower levels of granulosa cell apoptosis. In order to investigate the effect of the three hyaluronidases, Hyal-1, -2 and -3, without a compensatory effect by one another, we decided to create a transgenic mouse deficient in all these three hyaluronidases but only in the gonads by using the Cre/loxP system. We successfully created a plasmid containing the Cre sequence under the control of Inhibin-α promoter, which conducts gene expression in somatic cells of the gonads. In conclusion, the present work demonstrates that Hyal-3 does not have any effect on ovarian function, but that deletion of Hyal-1 in mice promotes increased folliculogenesis and lowers granulosa cell apoptosis.

Malignant lymphomas are tumors arising by clonal proliferation of lymphocytes stopped at a specific stage of differentiation. All tumor cells arising from the original clone thus share the same characteristics and that can be used in their detection. Finding a suitable molecular marker of tumor cells is an essential step not only to disease diagnosis, but also for monitoring of minimal residual disease. Minimal residual disease is defined as the subclinical disease level, which malignant cells are not detectable for conventional cytological methods during the therapy. These residual cells can cause relapse. The main goals of the diploma thesis are a detection and analysis of immunoglobulin genes rearrangement and chromosomal translocation t(11; 14) in the MTC region, and a development and optimization of RQ-PCR system for detection of minimal residual disease. Quantification of clonal rearrangement or chromosomal translocation allows the detection of minimal residual disease level in patients with malignant lymphomas. Clonal immunoglobulin genes rearrangement or characteristic chromosomal translocation were analyzed in 19 patients with malignant lymphomas. There were analyzed individual gene segments, N-region and combination variability in immunoglobulin genes rearrangement. There was developed...

No presente estudo avaliamos o impacto da adição de fluido folicular (FF) de mulheres inférteis sem e com endometriose em estágios iniciais (I/II) e avançados [(III/IV) sem e com endometrioma] ao meio de maturação in vitro (MIV) sobre as taxas de normalidade meiótica de oócitos bovinos. Avaliamos se a L-carnitina (LC) e os ácidos graxos ômega-3 [n3, ácidos docosahexaenóico (DHA) e eicosapentaenoico (EPA)] são capazes de prevenir os danos meióticos em oócitos bovinos induzidos por FF de mulheres inférteis com endometriose I/II e III/IV durante a MIV. Para isso, realizamos um estudo experimental utilizando modelo bovino. Trinta e duas amostras de FF foram colhidas de 24 mulheres inférteis com endometriose (8 com I/II, 8 com III/IV sem endometrioma e 8 III/IV com endometrioma no ciclo) e 8 sem endometriose (controle) que foram submetidas à estimulação ovariana controlada para realização de injeção intracitoplasmática de espermatozoide. Complexos cumulus-oócitos (CCOs) imaturos de bovinos foram submetidos à MIV divididos em 9 grupos: sem FF (sem-FF), com 1% de FF de mulheres inférteis sem endometriose (FFControle) e com endometriose (FFEI/II, FFEIII/IV e FFEendometrioma) suplementados ou não com LC (0,6mg/mL) e ácidos graxos ômega-3 (0,4 nM de DHA e 0,6 nM de EPA) (FFControle+LC+n3, FFEI/II+LC+n3, FFEIII/IV+LC+n3 e FFEendometrioma+LC+n3). Após 22-24h de MIV, os oócitos foram denudados, fixados e armazenados para realização de imunofluorescência para visualização do fuso meiótico e cromossomos por microscopia confocal. As taxas de metáfase II (MII) e de MII normais foram comparadas entre os 9 grupos utilizando o teste do qui-quadrado (p<0,05). Um total de 1686 CCOs imaturos foram submetidos à MIV, e 1401 oócitos foram visualizados por microscopia confocal. A adição de FF de mulheres com endometriose ao meio de MIV reduziu a taxa de MII normais (FFEI/II: 62,2%, FFEIII/IV: 70,2% e FFEendometrioma: 72,7%) comparado aos grupos sem-FF (87,2%) e FFControle (87,2%). O grupo FFEendometrioma (69,3%) apresentou a menor taxa de MII comparado a todos os demais grupos (sem-FF: 91,9%, FFControle: 89,2%, FFControle+LC+n3: 89,2%, FFEI/II: 85,4%, FFEI/II+LC+n3: 85,3%, FFEIII/IV: 80,7%, FFEIII/IV+LC+n3: 90,8%, FFEndometrioma+LC+n3: 86,4%). O grupo FFEIII/IV apresentou menor taxa de MII comparado ao grupo sem-FF. No grupo com FFControle, a adição de LC+n3 não alterou as taxas de MII (89,2% vs 89,2) e de MII normais (87,2% vs 82,5%). No grupo FFEI/II, a adição de LC+n3 aumentou a taxa de MII normais (84,5% vs. 62,2%). No grupo FFEIII/IV a adição de LC+n3 aumentou a taxa de MII normais (70,2% vs 84,1%) e de MII (90,8%), que passou a ser semelhante a dos grupos sem-FF e FFControle. No grupo FFEendometrioma a adição de LC+n3 aumentou a taxa de MII normais (86,4%), comparado ao grupo FFEendometrioma (69,3%), a qual foi similar a dos grupos sem-FF e FFControle. Portanto, o FF de mulheres com endometriose prejudica o fuso meiótico e o alinhamento cromossômico de oócitos bovinos, independentemente, do estágio da doença. Entretanto, o avanço da endometriose e a presença de endometrioma parecem ter um impacto ainda mais negativo na qualidade oocitária, prejudicando também a maturação nuclear. A adição de LC+n3 previne os danos meióticos oocitários provocados pelo FF de mulheres com endometriose em estágios iniciais e avançados. Dessa forma, sugerimos que inflamação, o estresse oxidativo e a desregulação da ?-oxidação são fatores envolvidos na alteração da qualidade oocitária e, consequente, piora da fertilidade natural de mulheres com endometriose. / In the present study, we evaluated the impact of the addition of follicular fluid (FF) from infertile women without and with endometriosis in the early (I/II) and advanced stages [(III/IV) with and without endometrioma] to the in vitro maturation (IVM) medium on the meiotic normality rates of bovine oocytes. We evaluated whether L-carnitine (LC) and omega-3 fatty acids [n3, docosahexaenoic (DHA) and eicosapentaenoic acid (EPA)] were able to prevent bovine meiotic oocyte damage induced by FF from infertile women with endometriosis in stages I/II and III/IV during IVM. For this, we performed an experimental study using bovine model. Thirty-two FF samples were collected from 24 infertile women with endometriosis (8 with I/II, 8 with III/IV without endometrioma and 8 III/IV with endometrioma in the cycle) and 8 without endometriosis (control) who underwent to controlled ovarian stimulation for intracytoplasmic sperm injection. Immature cumulus oocytes complexes(COCs) of bovines were submitted to IVM divided into 9 groups: without FF (No-FF), with 1% FF of infertile women without endometriosis (FFControl) and with endometriosis (FFEI/II, FFEIII/IV and FFEendometrioma) supplemented or not with LC (0.6 mg/mL) and omega-3 fatty acids (0.4 nM DHA and 0.6 nM EPA) (FFControl+LC+n3, FFEI/II+LC+n3, FFEIII/IV+LC+n3 and FFEendometrioma+LC+n3). After 22-24h of IVM, the oocytes were denuded, fixed and stored for subsequent immunofluorescence to visualize the meiotic spindle and chromosomes by confocal microscopy. The metaphase II (MII) and normal MII rates were compared between the 9 groups using the chi-square test (p <0.05). A total of 1686 immature COCs were submitted to IVM, and 1401 oocytes were visualized by confocal microscopy. Addition of FF from women with endometriosis to the IVM medium decreased the rate of normal MII (FFEI/II: 62.2%, FFEIII/IV: 70.2% and FFEendometrioma: 72.7%) compared to the No-FF (87.2%) and FFControl (87.2%) groups. The FFEendometrioma group (69.3%) presented the lowest rate of MII compared to all other groups (No-FF: 91.9%, FFControl: 89.2%, FFControl+LC+n3: 89.2%, FFEI/II: 85.4%, FFEI/II+LC+n3: 85.3%, FFEIII/IV: 80.7%, FFEIII/IV+LC+n3: 90.8%, FFEndometrioma+LC+n3: 86.4%). The FFEIII/IV group had a lower MII rate compared to the No-FF group. In the group with FFControl, the addition of LC+n3 did not change the rates of MII (89.2% vs 89.2%) and normal MII (87.2% vs 82.5%). In the FFEI/II group, the addition of LC+n3 increased the normal MII rate (84.5% vs 62.2%). In the FFEIII/IV group, the addition of LC+n3 increased the normal MII rate (70.2% vs 84.1%) and MII (90.8%), which was similar to that of the No-FF and FFControl. In the FFEendometrioma group, the addition of LC+n3 increased the normal MII rate (69.3% vs 86.4%) which was similar to No-FF and FFControl groups. Therefore, the FF of women with endometriosis impairs the meiotic spindle and the chromosomal alignment of bovine oocytes, regardless of the stage of the disease. However, the progression of endometriosis and the presence of endometrioma appear to have an even more negative impact on oocyte quality, and also impairs nuclear maturation. The addition of LC+n3 prevents meiotic oocyte damages induced by FF from women with endometriosis in the early and advanced stages. Thus, we suggest that inflammation, oxidative stress and deregulation of ?-oxidation are factors involved in the alteration of oocyte quality and, consequently, worsening of the natural fertility of women with endometriosis.

Um Projeto Temático de Pesquisa foi desenvolvido no Laboratório de Poluição Ambiental do Departamento de Patologia da Faculdade de Medicina da Universidade de São Paulo com o objetivo de avaliar os efeitos da exposição aguda/crônica ao ar ambiente de um grande centro urbano sobre a saúde. Dentro deste projeto, uma linha de pesquisa foi dedicada ao estudo dos efeitos dessa exposição sobre a saúde reprodutiva feminina. Evidências de estudos epidemiológicos e experimentais implicam os fatores ambientais na infertilidade humana e resultado obstétrico adverso. Contudo, poucos estudos foram conduzidos até o presente para avaliar um possível efeito da exposição à poluição ambiental particulada sobre a saúde reprodutiva feminina. Portanto, o objetivo dos projetos da minha linha de pesquisa é fornecer dados que possam demonstrar os possíveis efeitos da exposição pré-concepcional de curta duração às partículas de exaustão do diesel (PED) e à poluição ambiental particulada sobre a função ovariana, o desenvolvimento embrionário inicial e resultado gestacional utilizando um modelo experimental e um epidemiológico. O objetivo do primeiro projeto desta tese foi avaliar os efeitos de dois meios de cultura comerciais no desenvolvimento de oócitos de camundongo fertilizados in vitro até o estágio de blastocisto. Zigotos obtidos de fêmeas de camundongo de 8 semanas de idade submetidas à indução da ovulação foram cultivados in vitro até o estágio de blastocisto em meio simples otimizado enriquecido com potássio (KSOM) ou meio G1/G2. A porcentagem de zigotos que se desenvolveu até o estágio de blastocisto 96 e 120 horas após a inseminação e que sofreu eclosão parcial ou completa no quinto dia de cultivo foi significativamente maior no grupo KSOM. O número médio de células da massa celular interna (MCI) foi 11,7 ± 4,0 e 9,2 ± 5,2 para os zigotos cultivados nos grupos KSOM e G1/G2, respectivamente, mostrando um número significativamente maior de células MCI em blastocistos derivados da cultura no meio KSOM. Concluímos que o meio KSOM comercialmente disponível é superior ao meio seqüencial G1/G2 para o cultivo de zigotos até o estágio de blastocisto no modelo de fertilização in vitro (FIV) em camundongos. No segundo projeto que compõe esta tese, o objetivo foi avaliar os efeitos da exposição de curta duração às PED sobre a fertilização, desenvolvimento embrionário e segregação das linhagens celulares em blastocistos pré-implantacionais utilizando o modelo de FIV em camundongo. A instilação intranasal de água destilada (grupo controle), de PED nativas (grupo PED-N) ou de PED ácidoextraídas (grupo PED-AE), realizada uma vez ao dia por três dias, iniciada no primeiro dia de administração de gonadotrofinas, foi realizada em fêmeas de camundongo com oito semanas de idade. Os pontos de avaliação reprodutivos analisados incluíram a resposta ovariana a estimulação, taxa de fertilização, desenvolvimento embrionário, taxas de formação e de eclosão dos blastocistos, contagem celular total e proporção da alocação celular à MCI e trofoectoderma (TE), e a morfologia da MCI. A resposta ovariana não foi afetada pelo protocolo de exposição. Um efeito multivariado para a exposição às PED-N e PED-AE na coloração diferencial de blastocistos e na morfologia da MCI, mas não para a FIV ou desenvolvimento embrionário, foi observado. A contagem celular da MCI e a razão MCI/TE em blastocistos produzidos no grupo controle foram significativamente maiores do que em blastocistos produzidos nos grupos PED-N e PED-AE. O número total de células dos blastocistos foi similar entre os grupos. O escore que representa a morfologia da massa celular interna foi significativamente maior no grupo controle quando comparado àquele encontrado nos grupos PED-N e PEDAE. Baseando-se nesses resultados, nosso estudo sugere que a exposição de curta duração às PED pode afetar negativamente o processo reprodutivo através do distúrbio da especificação das linhagens celulares do embrião em estágio de blastocisto. Finalmente, a exposição a toxinas ambientais pode ser inevitável durante o período pré-concepcional em grandes centros urbanos e seus efeitos são desconhecidos. Portanto, o propósito do terceiro projeto que compõe esta tese foi avaliar os potenciais efeitos da exposição de curta duração à poluição ambiental particulada durante a fase folicular sobre os resultados clínicos, laboratoriais e gestacionais de casais submetidos à fertilização in vitro e transferência de embriões (FIVETE). Trezentos e quarenta e oito mulheres submetidas ao seu primeiro ciclo de FIVETE foram avaliadas retrospectivamente neste estudo coorte, casocontrole casado. A exposição ao material particulado ambiental (MP) durante a fase folicular de cada paciente foi estimada baseando-se em dados da poluição ambiental (1997-2006) categorizados em período Q1-3 ( 56,72 g/m3) e Q4 (>56,72 g/m3). Desse grupo, 177 pacientes que engravidaram (casos) foram comparadas com 354 mulheres que conceberam espontaneamente (controles). Os principais pontos de avaliação incluíram a resposta ovariana às gonadotrofinas, o número de oócitos recuperados e as taxas de fertilização, de clivagem, de qualidade embrionária, de implantação, de gestação, de abortamento e de nascidos vivos. Nenhum efeito da exposição a níveis elevados de MP durante a fase folicular foi observado nos resultados clínico e laboratorial, na transferência embrionária ou no sucesso dos ciclos de tratamento das pacientes submetidas à FIVETE. Mulheres expostas ao período Q4 durante a fase folicular do ciclo de concepção apresentaram um risco significativamente maior de abortamento, independentemente do método de concepção (razão de chance: 2,58; intervalo de confiança de 95%: 1,63 4,07), quando comparado àquele de mulheres expostas ao período Q1-3. O risco de perda da gestação aumentou 3% por unidade de aumento do valor médio do MP na fase folicular (p= 0,000). Os resultados apresentados aqui fornecem evidências para uma relação causal entre a breve exposição a níveis elevados de MP ambiente durante o período pré-concepcional e a perda gestacional inicial, independentemente do método de concepção e está associada a um aumento de 2,6 vezes no risco de abortamento. Apesar da ausência de efeitos dessa exposição sobre os resultados clínicos e laboratoriais e sobre o sucesso do tratamento, a FIVETE foi incapaz de reduzir esse risco / A thematic research project to evaluate the health effects of acute/chronic exposure to ambient air in a large urban center was developed at the Air Pollution Laboratory in the Department of Pathology at the University of São Paulo School of Medicine. Within this project a specific research line was committed to the study of the effects of this exposure on female reproductive health. Evidence from epidemiological and experimental studies implied environmental factors as possible contributors to human infertility and poor obstetric outcome. However, very few studies evaluating a possible effect of exposure to particulate air pollution on female reproductive health have been conducted so far. Thus, the aim of the projects in my research line was to provide data that could show the possible effects of short-term preconceptional exposure to diesel exhaust particles and particulate air pollution on ovarian function, early embryo development and pregnancy outcome using experimental and epidemiological models. The objective of the first project was to examine the effects of two commercial media on the development of mouse ova fertilized in vitro to the blastocyst stage. One-cell embryos obtained from eight-week old superovulated mice were cultured in vitro up to the blastocyst stage in potassium-enriched simplex optimized medium (KSOM) or G1/G2 media. The percentage of zygotes that developed to the blastocyst stage 96 and 120 hours after insemination and that partially or completely hatched by day five of culture was significantly higher in the KSOM group. The mean number of inner cell mass (ICM) cells was 11.7 ± 4.0 and 9.2 ± 5.2 for zygotes cultured in KSOM and G1/G2 groups respectively, revealing a significantly higher cell number in the ICM of blastocysts derived from culture in KSOM medium. I concluded that commercially available KSOM medium is superior to sequential G1/G2 media for culturing one-cell embryos up to the blastocyst stage in the mouse IVF model. In the second project the objective was to evaluate the effects of short-term exposure to diesel exhaust particles on fertilization, embryo development, and cell lineage segregation in preimplantation blastocysts using the mouse IVF model. Intranasal instillation of distilled water (control group), native diesel exhaust particles (N-DEP group) or acid-extracted diesel exhaust particles (AE-DEP) once a day, for three days starting on the first day of gonadotrophin administration was performed on eight-week old female mice. Reproductive endpoints evaluated included ovarian response to superovulation, fertilization rate, embryo development, blastocyst and hatching rates, total cell count, and proportion of cell allocation to ICM and trophectoderm (TE), and ICM morphology. Ovarian response was not affected by the exposure protocol. A multivariate effect for exposure to NDEP and AE-DEP on blastocyst differential staining and ICM morphology but not on IVF or embryo development was found. Cell counts in ICM and ICM/TE ratios in blastocysts produced in the control group were significantly higher than in blastocysts produced in N-DEP and AE-DEP groups. The total cell count was similar among groups. The score that represents ICM morphology was significantly higher in the control group when compared to that found in N-DEP and AE-DEP groups. Based on these results this study suggests that short-term exposure to DEP may negatively affect the reproductive process by disrupting the lineage specification at the blastocyst stage. Finally, exposure to environmental toxins may be unavoidable during the preconceptional period in large urban centers and its effects are unknown. Thus, the purpose of the third project was to assess the potential effects of short-term exposure to particulate air pollution during the follicular phase on clinical, laboratory, and pregnancy outcomes for couples undergoing IVF/ET. Three hundred forty-eight patients undergoing their first IVF/ET cycle were evaluated in this retrospective cohort-matched casecontrolled single-center study. Exposure to ambient particulate matter (PM) during the follicular phase for each patient was estimated based on air pollution data (1997-2006) categorized in Q1-3 ( 56.72 g/m3) and Q4 (>56.72 g/m3) periods. From this group 177 women who became pregnant (cases) were compared with 354 who had conceived spontaneously (controls). Main outcome measures included response to gonadotrophins, number of oocytes retrieved, fertilization, cleavage, embryo quality, implantation, pregnancy, miscarriage, and live birth rates. No effects of follicular phase exposure to high levels of PM on clinical, laboratory, embryo transfer or treatment outcome were found in women undergoing IVF/ET. Women exposed to Q4 level PM during the follicular phase of the conception cycle had significantly higher risk of miscarriage, regardless of the method of conception (odds ratio, 2.58; 95% confidence interval: 1.63-4.07) when compared to women exposed to Q1-3 level PM. The risk of miscarriage increased 3% per unit increase in follicular phase PM average level (p=0.000). The results presented here provide evidence of a causal role for brief exposure to high levels of ambient PM during the preconceptional period in early pregnancy loss, regardless of the method of conception, with a 2.6-fold increase in risk of miscarriage. Despite the absence of effects of this exposure on clinical, laboratory, and treatment outcome, IVF/ET was unable to reduce this risk

INTRODUÇÃO: Os carcinomas papilífero e folicular são neoplasias malignas primárias da glândula tireóide. Em conjunto, recebem o nome de carcinoma bem diferenciado. Determinar o risco individual da ocorrência de metástase nesses casos auxilia na seleção da terapêutica que é atualmente baseada na classificação de acordo com fatores prognósticos, aos quais pode ser associada a pesquisa de marcadores biológicos. Dentre eles, destaca-se a galectina-3, cujas funções exercidas nos compartimentos celulares foram descritas em uma variedade de neoplasias. Entretanto, seu papel no carcinoma tireóideo permanece controverso. Com o intuito de investigar se a galectina-3 pode auxiliar na predição do risco individual da ocorrência de metástase e se está associada aos critérios de malignidade do carcinoma bem diferenciado, a presente pesquisa objetivou verificar as seguintes hipóteses: 1) se há diferença da imunoexpressão da galectina-3 nos compartimentos do tireócito maligno entre os doentes com e sem metástase e se é possível predizer o risco de metástase em função da quantificação digital desse marcador; 2) se há diferença da imunoexpressão da galectina-3 entre o tecido tireóideo maligno e o não neoplásico; conforme a presença de invasão tecidual; e conforme a sobrevivência; 3) se há indício do envolvimento da galectina-3 com apoptose, indução da proliferação celular e angiogênese. MÉTODO: Trata-se de estudo retrospectivo de caso-controle que envolveu 109 doentes operados por carcinoma bem diferenciado da tireóide e seguidos por mais de cinco anos, distribuídos em dois grupos equivalentes: com e sem metástase. Foram feitos coleta de dados clínicos, avaliação anátomo-patológica e análise imunohistoquímica digital dos biomarcadores galectina-3, Ki-67, caspase-3 e CD-34. RESULTADOS: 1) A média do índice de positividade nucleolar da galectina-3 foi maior no grupo de doentes com metástase linfática cervical (1,78 ± 0,41 nucléolos/CGA contra 0,35 ± 0,13, p=0,004). A expressão nucleolar da galectina-3 apresentou especificidade de 75% para identificação da ocorrência de metástase e foi fator independente associado à ocorrência metástase linfática (p=0,01). A equação logística obtida permitiu calcular o risco individual de desenvolvimento de metástase linfática cervical que é próximo a 100% quando a galectina-3 está imunoexpressa em quatro ou mais nucléolos por campo microscópico de grande aumento. 2) não houve expressão da galectina-3 no tireócito não neoplásico; o índice de expressão citoplasmático foi fator independente associado à presença de invasão linfática (p=0,013) e a média desse índice foi maior nos casos com extensão extratireóidea (52,7 ± 3,9 uo/µm2 contra 41,0 ± 4,0, p=0,037); não houve associação dos índices de imunoexpressão da galectina-3 e sobrevivência; 3) no grupo de doentes com metástase, a expressão nucleoplasmática da galectina-3 correlacionou-se de forma positiva com o índice de positividade do Ki-67 e, nos dois grupos, a expressão citoplasmática com o índice de expressão da caspase-3. CONCLUSÕES: Foi possível predizer o risco individual da ocorrência de metástase linfática cervical em função da quantificação digital da imunoexpressão nucleolar da galectina-3. O presente estudo sugere que alta expressão citoplasmática está associada com algumas características de invasão local. Houve indícios do envolvimento da galectina-3 com indução da proliferação celular e apoptose no grupo de doentes com metástase. / INTRODUCTON: Papillary and follicular carcinomas are primary malignant neoplasias of the thyroid gland and are classified as well-differentiated carcinoma. In these cases, determination of individual risk of metastasis allows offering an adequate treatment. Nowadays therapy is chosen based on classification according to prognostic factors and biomarkers can be associated with them. Galectin-3 is one of these markers and has been thoroughly studied. A wide range of functions that it carries out in the subcellular compartments have been described in several neoplasms. However, its role in thyroid carcinomas remains controversial. In order to investigate if galectin-3 can be used to predict the individual risk of metastasis and if this marker is associated with malignant criteria of well-differentiated carcinoma, this study was proposed to verify the following hypotheses: 1) if galectin-3 immunostaining in subcellular compartments of the malignant thyrocyte is different when comparing patients with and without metastasis and if it is possible to predict the individual risk of metastasis based on digital quantification of the galectin-3 immunostaining; 2) if galectin-3 immunoexpression is different from malignant and benign thyroid tissue; according to tissue invasion and survival; 3) if there are indications that galectin-3 plays a role in apoptosis and cell proliferation or angiogenesis induction. METHODS: It was performed a retrospective case-control study involving 109 patients treated for well-differentiated thyroid carcinoma and followed up for more than five years. They were divided into two equivalent groups: with and without metastasis. The search of clinical data, morphological evaluation and digital immunohistochemical analysis with galectin-3, Ki-67, caspase-3 and CD-34 antibodies were done. RESULTS: 1) the average of the nucleolar galectin-3 positive index was higher in lymph node metastasis group (1.78 ± 0.41 nucleoli/HPF versus 0.35 ± 0.13, P=.004). Nucleolar staining was an independent factor associated with lymph node metastasis (P=.01) and its specificity to identify metastasis was 75%. The logistic model allowed predicting the individual risk of cervical lymph node metastasis. It was almost 100% for carcinomas displaying more than four galectin-3 immunostained nucleoli by microscopic high power field. 2) There was no galectin-3 immunostaining in non-neoplasic thyrocyte; the cytoplasmic galectin-3 expression index was an independent factor associated with lymphatic invasion (P=.013) and these index average was higher in cases with extrathyroidal extension (52.7 ± 3.9 uo/µm2 versus 41.0 ± 4.0, P=.037); there was no association of galectin-3 immunostaining indexes with survival; 3) in the metastasis group, there was positive correlation between nucleoplasmic staining of galectin-3 and Ki-67 positive index; there was positive correlation between cytoplasmic staining of galectin-3 and caspase-3 positive index in both groups. CONCLUSION: It was possible to predict the individual risk of cervical lymph node metastasis based on digital quantification of the nucleolar galectin-3 immunostaining. This study suggests that there is association of high cytoplasmic expression with local tissue invasion. In the metastasis group there were indications that galectin-3 plays a role in cell proliferation and apoptosis induction.