Smad7作為轉化生長因數-β信號通路中的負性調節因子為人所知，異常的Smad7表達通常會引發癌症及組織纖維化等疾病。而目前對於其在骨重建及其相關疾病中的作用尚未有研究。本研究利用Smad7部分敲除小鼠來探索Smad7在骨重建，骨質疏鬆以及間充質幹細胞分化等方面的作用。 / 本研究所用的Smad7部分敲除小鼠模型來源於已有報導過的Smad7ΔE1(KO)小鼠。該小鼠體內Smad7基因組外顯子I的翻譯區被替換，導致部分蛋白失及其功能破壞。研究結果表明，KO小鼠在6、12、24周齡時股骨遠端幹骺端均有不同程度下降的骨小梁數目、厚度，骨礦化率，骨密度，骨體積分數，及其上升的骨小梁間隙和破骨細胞表面。骨髓來源間充質幹細胞的多向分化實驗表明，KO組呈現出抑制性的成骨能力，表現為鈣結節形成減少，鹼性磷酸酶活性下降，早晚期成骨標記基因表達下降。該組亦表現出促進性的成脂能力，有較多及較早的脂滴形成，成脂標記基因表達上升。而對於骨髓來源巨噬細胞的體外破骨誘導實驗表明，KO組有更多且更大的破骨細胞形成，較大的骨吸收面積，以及上升的破骨標記基因表達。卵巢切除小鼠模型的研究表明，術後4、8、16周，KO组的股骨遠端幹骺端对比野生组有更大程度下降的骨形态学参数，以及明顯升高的破骨細胞融合標記蛋白的表達。體外實驗表明KO组有更多且更大的破骨細胞形成，以及更大面積的骨吸收。積雪草酸曾被證實在肝纖維化模型中誘導Smad7 基因的表達，也在本實驗中用以研究對骨質疏鬆疾病的作用。卵巢切除動物模型連續給藥8周後，骨質疏鬆的現象有明顯逆轉，表現為升高的骨形态学参数，及下降的股骨內破骨細胞融合標記蛋白的表達。 / 總結，本研究證實了Smad7在骨骼發育重建及骨疾病的病理機理等方面的研究提供了突破性的見解。部分敲除Smad7可以導致抑制性的成骨能力，促進性的破骨能力，以及損傷性的骨重建，亦會加速骨質疏鬆的進程，并可作為全新的藥物治療靶點，提示Smad7 本身對於骨重建及骨代謝的保護性作用，為代謝性骨疾病的研究及其臨床藥物開發提供了更廣泛的前景。 / Smad7 has been well documented as a negative regulator of TGF-β signaling, and its altered expression often leads to human diseases such as cancer and fibrosis. However, the role of Smad7 in regulating bone remodeling and related diseases remains unclear. We performed both in vivo and in vitro experiments as well as disease model and drug therapy studies using both wild-type (WT) and Smad7ΔE1 (KO) mice to investigate the functional role of Smad7 in bone remodeling, osteoporosis, and MSCs differentiation. / The Smad7ΔE1 mice were generated by replacing part of the exon1 of Smad7 gene as reported, which resulted in truncated protein and partial loss of Smad7 function. Mice were genotyped by PCR. The μ-CT, histological assays and bone histomorphometric assays in metaphysic region of the femurs showed lower trabecular number (TbN), trabecular thickness (TbTh), mineral apposition rate (MAR), higher trabecular separation (TbSp) and Osteoclast Surface (Oc.S/BS & Oc.N/BS) in the KO mice at 6, 12, to 24 weeks old; as well as lower bone mineral density (BMD) and bone volume fraction (BV/TV) at 24 weeks old in the KO mice. The in vitro BM-MSCs multi-lineage differentiation studies showed the suppressed osteogenic potential in the KO group with fewer mineralized nodules, lower ALP activity and expression of Col1A1, Runx2 and OCN; while the adipogenic potential was elevated with more lipid droplets formation and higher expression of Adipsin and C/EBPα. The osteoclastogenic potential of KO mice BMMs was also elevated, showing higher osteoclasts activity and larger resorptive areas, as well as elevated expression of TRAP and CTR. Both in vivo and in vitro studies of the osteoporotic models showed that the KO mice had lower BMD, TbTh, and higher TbSp compared to the WT mice at 4, 8, 16 weeks after OVX, similar results of lower BV/TV and TbN were observed at 4 weeks after OVX in the KO mice. The RANKL-induced osteoclastogenesis potential was elevated compared to WT mice, with more and bigger osteoclasts, larger resorptive areas, as well as elevated expression of TRAP and CTR. The osteoclastic cell fusion was also enhanced. Treatment of Asiatic acid (one traditional Chinese medicine that has been proved to induce the expression of Smad7 as reported) in the OVX mice reversed the osteoporotic process with increase BMD, BV/TV, TbN, TbTh, and decreased TbSp compared to the untreated group. The osteoclastic cell fusion was suppressed after AA treatment. / Partial loss of Smad7 function leads to impaired bone remodeling in vivo, reduced osteogenesis and enhanced osteoclastogenesis in vitro, and also accelerates the osteoporotic development and osteoclastic cell fusion. Asiatic acid may be a novel potential drug for prevention of osteoporosis. Our findings provide new evidences for a better understanding of the biological functions of Smad7 in bone remodeling and its therapeutic potential for metabolic bone diseases. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Li, Nan. / Thesis (Ph.D.) Chinese University of Hong Kong, 2014. / Includes bibliographical references (leaves 131-153). / Abstracts also in Chinese.

A interação entre as vias de sinalização dos estrógenos e fatores de crescimento está relacionada a maior agressividade dos tumores de mama. Assim, o objetivo deste trabalho foi verificar a interação entre as vias do E2 e do EGF no controle da expressão dos genes HNRPK, PAWR e PHLDA1 nas células MCF-7 (ER+) e MDA-MB-231 (ER-). Nas células MCF-7, o EGF e o E2 diminuíram a expressão do PAWR e aumentaram a expressão de PHLDA1. A inibição do ER pelo ICI resultou no aumento da expressão de PAWR sendo que a adição do E2 ou do EGF diminuiu sua expressão sem retomar os níveis observados nos tratamentos com E2 ou EGF isoladamente. Para o gene PHLDA1, o efeito do E2 e do EGF não variou após o tratamento com ICI. Nas células MDA-MB-231, a ação do EGF foi mais efetiva sobre a expressão de PAWR. A via ERK1/2 é importante na ativação do ER pelo EGF. O efeito do EGF sobre o PHLDA1 ocorre através da ativação das vias ERK1/2 e p38 MAPK. Estes resultados mostram a interação entre as vias do E2 e do EGF no controle da expressão do PAWR, mas não do PHLDA1. / The crosstalk between estrogens and growth factors pathways has been associated with breast cancer aggressiveness. Based on this, the present study aimed to determine the possible crosstalk between E2 and EGF pathways on the HNRPK, PAWR and PHLDA1 expression regulation in MCF-7 (ER+) and MDA-MB-231 (ER-) cells. In MCF-7 cells, treatments with E2 and EGF decreased PAWR expression and increased PHLDA1 expression. The ER inhibition by the ICI treatment resulted in increased PAWR expression. The E2 or EGF addition down-regulated its expression without a return to the levels observed after the E2 or EGF treatments alone. To the PHLDA1 gene, the effect of E2 and EGF treatments did not change after the ICI treatment. In MDA-MB-231 cells, the EGF effect was more significant on the PAWR gene expression control. The ERK1/2 pathway is important to the ER activation by EGF. The EGF effect over the PHLDA1 is dependent on the ERK1/2 and p38 MAPK activation. These findings suggest a crosstalk between E2 and EGF pathways on the PAWR expression control but not to PHLDA1.

O leite materno constitui uma rica fonte de nutrientes e peptídeos. O desmame precoce (DP) induz o aumento da proliferação e da diferenciação celular, e pode ser uma condição estressante capaz de elevar a corticosterona (CORT). Neste estudo, investigamos a interação entre padrão alimentar, CORT, TGF<font face=\"Symbol\">a e TGF<font face=\"Symbol\">b na regulação da proliferação celular na mucosa gástrica de ratos em desenvolvimento pós-natal. Utilizamos ratos Wistar em DP a partir do 15ºd, e observamos o aumento de CORT aos 16, 17 e 18d (p<0,05). No 17ºd, encontramos nível alto de TGF<font face=\"Symbol\">a e baixo de TGF<font face=\"Symbol\">b1 na mucosa gástrica (p<0,05). Para avaliarmos a ação da CORT, usamos o RU486, que ao reduzir a ação hormonal, estimulou a proliferação celular nos animais amamentados e DP (p<0,05), sem alterar os níveis de TGF<font face=\"Symbol\">a e TGF<font face=\"Symbol\">b. A sinalização para esses fatores foi estudada, e RU486 reduziu a ativação de ERK1/2 (p<0,05) no DP. Concluímos que a corticosterona circulante possui efeito antiproliferativo sobre a mucosa gástrica de ratos, e sua ação parece direta sem depender da regulação dos níveis de TGF<font face=\"Symbol\">a e TGF<font face=\"Symbol\">b. / Milk is a source of nutrients and active peptides. Early weaning (EW) leads to the increase of cell proliferation and differentiation, and can characterize a stressful condition to induce corticosterone (CORT). In the current study we investigated the interaction among dietary pattern, CORT, TGF<font face=\"Symbol\">a and TGF<font face=\"Symbol\">b on the regulation of cell proliferation in gastric mucosa of developing rats. We used Wistar rats submitted to EW on the 15thd, and we observed higher CORT levels throughout EW (p<0.05). At 17d, we also found higher TGF<font face=\"Symbol\">a and lower TGF<font face=\"Symbol\">b1 in the gastric mucosa (p<0.05). To evaluate CORT action, we used RU486 which antagonized the hormone and increased cell proliferation in both suckling and EW pups (p<0.05), without changing TGF<font face=\"Symbol\">a and TGF<font face=\"Symbol\">b1 levels. The signaling pathways triggered by these factors were studied and RU486 reduced ERK1/2 phosphorylation (p<0.05) in EW. We conclude that CORT is repressive for cell proliferation in the rat gastric mucosa, and its action seems to be direct, i.e. independent of TGF<font face=\"Symbol\">a and TGF<font face=\"Symbol\">b regulation.

O corpo lúteo é uma glândula endócrina temporária que regula tanto o ciclo estral quanto a prenhez, apresentando extrema dependência de aporte sanguíneo adequado. O tratamento superovulatório aumenta a concentração sérica de progesterona (P4) e conseqüentemente as taxas de concepção e de prenhez. Esse trabalho objetivou quantificar a vascularização dos corpora lútea (CLL) de animais controle e superovulados, correlacionando-a com a P4 sérica e expressão de VEGF e seus receptores. Foram utilizadas 30 búfalas, cujos CLL foram divididos em cinco grupos: superovulados (receberam 400 mg de FSH divididos em doses diárias decrescentes: 80 mg, 60 mg, 40 mg e 20mg a cada 12 horas durante 4 dias), corpos hemorrágicos (CH), corpo lúteo maduro (CL), CL em regressão (CR) e corpo albicans (CA), que não receberam nenhum tratamento. Três CLL de cada grupo foram fixados em formol tamponado para quantificação da densidade vascular e imunolocalização de VEGF, VEGFR-1 e VEGFR-2. Os três restantes foram injetados com resina Mercox para análise da microvascularização. Amostras de sangue foram coletadas e a P4 mensurada através de RIA convencional. A densidade capilar média encontrada foi de 37,78 ± 8,89; 17,8 ± 3,33; 11,92 ± 3,57; 10,83 ± 2,42 e 3,46 ± 1,66 vasos/ mm2 respectivamente para os cinco grupos, indicando maior vascularização (p<0,001) para o grupo superovulado. A microvasculatura apresentou comportamento semelhante para ambos os grupos, revelando apenas maior densidade da rede capilar dos CLL de animais superovulados, o que se refletiu nos valores séricos de progesterona que foram significativamente maiores (p<0,05) para estes animais, com concentração média de 5,58 ( 0,97ng/ml vs 2,02 ( 0,16 ng/ml para os animais controle na mesma fase. O VEGF, bem como seus receptores (VEGFR-1 e VEGFR-2) foram encontrados imunohistoquimicamente no CLL de búfalas. A imunoreatividade para o VEGF e receptores, pode ser observada nas células endoteliais e luteínicas a partir do 2° dia após a ovulação (p.o.) até a fase de corpo lúteo em regressão (17° dia p.o.), com forte reação nas fase luteínicas inicial e média. A imunoreatividade foi mais intensa nos animais submetidos a superovulação. / Corpus luteum is a temporary organ, which regulates the estrous cycle and pregnancy; it is extremely dependent on vascularization. During corpus luteum life span P4 production is associated with an increase of capillary number known as angiogenesis. The angiogenic process is modulated by many factors, including VEGF (vascular endothelial growth factor), which is considered the most important of them. Hyperstimulation of ovarian function, a largely spread technique employed in cattle raising, is associated with high levels of estradiol and P4, as well as an increase of capillary invasion of the new formed CL. This study intended to quantify the vascularization of normal and superovulated corpora lutea (CLL), trying to correlate this parameter with blood P4 concentrations and expression of VEGF and its receptors. For that purpose thirty buffalo cows were divided into five groups: superovulated (received 400 mg FSH divided in decreasing doses of 80 mg, 60 mg, 40 mg e 20mg 12/12h during 4 days), corpus hemorragicans (CH), mature corpus luteum (CL), regression CL (CR) e corpo albicans (CA), that received no treatment and were slaughtered at days 2, 9, 17 and 26 after ovulation. After slaughter ovaries were collected and corpora lutea prepared as follows: three animals from each group had their CLL fixed in buffered formol solution, cut into 0,5 cm pieces, dehydrated in increasing ethanol concentrations, cleared in xylene and embedded in paraffin using conventional procedures. Five µm slices were prepared for quantification of vascular density and immunolocalization of VEGF, VEGFR-1 and VEGFR-2. The ovaries of the remaining animals were injected with Mercox resin through ovarian artery in order to have the microvascularization evaluated by electron scanning microscopy. Blood samples were collected and P4 measured through conventional RIE. Capillary density during CL life span was 37,78 ± 8,89; 17,8 ± 3,33; 11,9 ± 3,57; 10,83 ± 2,42 and 3,46 ± 1,66 vessels/ mm2 respectively for superovulated (CS), CH, CL, CR and CA, indicated higher vascularization (p<0,001) for superovulated group. The microvasculature showed similar behavior: the density of capillary network was higher in CLL of superovulated animals. Values of serum progesterone were significantly higher (p<0,05) for CS animals: 5,58 ± 0,97 ng/ml vs 2,02 ± 0,16 ng/ml for control animals in the same stage of estrous cycle. The VEGF system and its receptors (VEGFR-1 e VEGFR-2) were immunolocalized in CLL of buffalo cows. The immunoreactivity could be detected in endothelial and luteal cells since day two post ovulation (p.o.) until the stage of regression corpus luteum (Day 17 p.o.), with strong immunostaining at the early and midluteal phase. The immunostaining was more intense in CLL of animals submitted to superovulation.

Le système lymphatique a pour rôle principal de drainer les fluides tissulaires et de participer à la surveillance immune. La lymphangiogenèse est principalement activée par deux facteurs : les vascular endothelial growth factors-C et -D (VEGF-C et VEGF-D). Ces facteurs participent à la progression métastatique à la fois en stimulant la prolifération des vaisseaux lymphatiques dans la tumeur et en périphérie et en provoquant la dilatation des vaisseaux collecteurs facilitant ainsi le passage des cellules tumorales de la tumeur primaire aux ganglions lymphatiques. Lors de son développement, une tumeur est soumise à de nombreux stress cellulaires tels que l'hypoxie, l'inflammation ou la déprivation en nutriments. Ma thèse a donc été consacrée à l'analyse des régulations moléculaires permettant une surexpression des facteurs lymphangiogéniques en condition de stress cellulaire. Lors d'un premier projet de recherche j'ai démontré que l'hypoxie réduit la transcription de VEGF-C ainsi que sa traduction coiffe-dépendante mais activait une traduction médiée par un site interne d'entrée du ribosome (IRES). De plus, cette activation de la synthèse de VEGF-C en hypoxie est indépendante de HIF-1a et stimule la lymphangiogenèse dans les tumeurs ainsi que dans les ganglions lymphatiques participant ainsi à la dissémination tumorale. Dans un second temps, j'ai démontré que le VEGF-D possédait lui aussi un IRES activé par un choc thermique. L'activité de l'IRES du VEGF-D est régulée par la localisation subcellulaire d'un facteur trans-activateur de l'IRES (ITAF) : la nucléoline. Cette protéine est exportée du noyau vers le cytoplasme lors d'un choc thermique. Ce processus est inhibé par un traitement avec un anti-inflammatoire non stéroïdien ce qui supprime l'activation de la traduction IRES dépendante du VEGF-D. Enfin lors d'un troisième projet, j'ai travaillé sur le lymphœdème secondaire, une pathologie caractérisée par une destruction du système lymphatique où la lymphangiogenèse doit être stimulée. J'ai évalué l'impact de l'hormonothérapie, principal traitement du cancer du sein, sur l'expression du VEGF-C et -D. J'ai démontré que l'estradiol stimulait l'expression de ces facteurs alors que l'hormonothérapie diminue leur synthèse et provoque une destruction de l'endothélium lymphatique. En conclusion, mes trois projets de thèse m'ont permis d'étudier les régulations moléculaires des deux facteurs lymphangiogéniques principaux dans des pathologies provoquées par une lymphangiogenèse excessive ou insuffisante. / Tumor lymphangiogenesis promotes lymph node metastasis using two mechanisms consisting of lymphatic vessels proliferation and dilatation to facilitate tumor spread. Lymphangiogenesis is mainly promoted by two growth factors: the vascular endothelial growth factor C and D. My PhD was focused on the molecular regulations inducing a tumoral over-expression of these two factors during stress. I demonstrated that hypoxia reduced VEGF-C transcription and cap-dependent translation while activating an Internal Ribosome Entry Site (IRES)-dependent mechanism of translation. This upregulation of VEGF-C in hypoxia is independent of HIF-1a; and stimulates lymphangiogenesis in tumors and lymph nodes and contribute to lymphatic metastasis. Then, I have discovered that VEGF-D had an IRES selectively activated by heat shock. VEGF-D IRES is regulated by a subcellular relocalization of an ITAF, the nucleolin. This molecular process is reversed by non-steroidal anti-inflammatory drugs (NSAID) that decrease VEGF-D IRES translation initiation by targeting the nucleolin. Finally, I worked on secondary lymphedema, a pathology that is characterized by a disruption of the lymphatic network where lymphangiogenesis thus need to be restored. In this condition, I have evaluated the impact of hormone therapy, the main treatment for breast cancer, on the regulation of lymphangiogenic factors. I found that estradiol stimulates the expression of VEGF-C and-D contrary to the hormone therapy that inhibits VEGF-C and -D and thus mediates a disruption of the lymphatic endothelium. Taken together, my PhD projects have allowed me to study the regulations of VEGF-C and -D in pathologies mediated either by an excessive or an insufficient lymphangiogenesis.

Abstract The increase of cardiac hemodynamic load that requires increased mechanical performance drives adaptation of the heart to maintain cardiac function. Modification of protein synthesis in cardiomyocytes allows the cells to adapt to the increased load. Cardiomyocyte hypertrophy and activation of cardiac fibroblasts over the long term is maladaptive and leads to heart failure (HF). Members of the transforming growth factor-&#946; (TGF-&#946;) superfamily contribute to the remodeling process. TGF-β1 acts as a paracrine messenger between cardiomyocytes and cardiac fibroblasts. Connective tissue growth factor (CTGF) modulates TGF-&#946; signaling and plays a role in the development of fibrosis. In the current study, we aimed to investigate whether blocking the actions of CTGF could alleviate ischemic injury and reduce cardiac remodeling. We determined whether blocking the action of these ligands would modulate cardiac hypertrophy and fibrosis. In the first study, we found that antagonizing the function of CTGF protected from transverse aortic constriction (TAC) -induced left ventricular remodeling. In the second study in myocardial infarction (MI) model, blocking the function of CTGF resulted in improved post-MI survival and this prevented to the decrease in left ventricular contractile function as compared to the situation in control mice. Treatment with CTGF mAb attenuated the development of dilated cardiomyopathy and limited the increase in cardiomyocyte size and deposition of interstitial fibrosis in a remote area. In the third study, targeting the TGF-&#946; superfamily members myostatin and activins, by administration of a soluble decoy receptor of activin receptor 2B (ACVR2B-Fc) did not affect the extent of MI injury or cardiac remodeling in MI -induced ischemic HF. Understanding the complex and converging pathways regulating cardiac remodeling is a major challenge, but it may allow for opportunities to develop new therapies, new medicines and provide new hope for people with these life-threatening diseases. / Tiivistelmä Sydämen lisääntynyt kuormitus vaatii lisääntynyttä supistusvoimaa, joka johtaa sydänlihaksen adaptaatioon pumppaustehon ylläpitämiseksi. Alkuvaiheessa sydämen liikakasvu on hyödyllistä, mutta pidempään jatkuessaan se johtaa lopulta pumppaustoiminnan heikkenemiseen ja sydämen vajaatoimintaan. Useiden signalointimekanismien on osoitettu säätelevän sydänlihaksen adaptoitumista patologisille tiloille. Transformoiva kasvutekijä –&#946; (TGF-&#946;) proteiiniperhe säätelee sydämen adaptoitumista sekä vasemman kammion seinämän myötäävyyttä venytykselle. TGF-&#946;1 indusoi supistuskykyisten myofibroblastien muodostumista sekä kollageenin tuotantoa. Runsas kollageenin tuotanto vahvistaa sydämen seinämää ja on tarpeen sydäninfarktivaurion korjaamisessa, mutta pitkään jatkuessaan se heikentää sydämen toimintaa ja altistaa rytmihäiriöille, sydämen vajaatoiminnalle sekä sydänperäiselle äkkikuolemalle. Sidekudoskasvutekijä (CTGF) säätelee TGF-&#946;1:n signalointia ja se osallistuu haavan paranemiseen sekä fibroosiin. Tutkimuksessa selvitettiin, voidaanko sidekudoskasvutekijän tai TGF-&#946; -perheen proteiinien toimintaa estämällä lievittää sydämen vajaatoiminnan kehittymistä. Koetuloksemme osoittavat, että CTGF:n toiminnan estäminen vasta-aineen (mAb) avulla vähentää hemodynaamisen liikakuormituksen indusoimaa vasemman kammion toiminnan heikkenemistä, kammion laajenemista sekä fibroosia. CTGF mAb myös vähentää kuolleisuutta ja estää sydämen toiminnan heikkenemistä sydäninfarktin jälkeen sekä lievittää sydäninfarktin jälkeistä dilatoivan kardiomyopatian kehittymistä. Aktiviinien ja myostatiinin toiminnan esto liukoisen aktiviinireseptori 2B:n (ACVR2B-Fc) avulla sen sijaan ei vaikuta sydäninfarktivaurioon tai iskeemisen vajaatoiminnan kehittymiseen. ACVR2B-Fc kuitenkin lisää luurankolihaksen kasvua, estäen sydämen vajaatoimintaan liittyvää luurankolihaskatoa. Sydämen hypertrofian ja vajaatoiminnan syntymisen kannalta keskeisten signaalinvälitysreittien tunnistaminen ja niiden toiminnan ymmärtäminen auttaisi kehittämään tehokkaampia lääkehoitoja sydänsairauksiin.

Retinal ganglion cells play a crucial role in the relay of visual signals from the eye to the brain. This cell type is affected and eventually lost in the eye disease glaucoma, resulting in progressive and irreversible loss of vision. Studies of the molecular mechanisms leading to retinal ganglion cell death are important for the understanding of the disease and for designing future treatments. This thesis addresses and studies these molecular mechanisms, including alterations in gene expression after experimental retinal injuries. The effects of a neuroprotective drug, brimonidine, after transient retinal ischemia were also studied in order to help explain the mechanisms behind the protective properties of this drug. Several methods, including quantitative reverse transcriptase PCR, micro-arrays, western blot and immunohistochemistry, were used. The results showed that transient retinal ischemia triggers cell division in Müller cells and alters the gene expression of growth factors, their receptors, and intermediate filaments in the retina. Several genes related to the apoptosis process were less affected. Pre-treatment with brimonidine increased the levels of certain growth factors (BDNF, NT3, CNTF, FGF9) compared with vehicle. Brimonidine also had marked effects on genes related to progenitor cells, among them the recognized neural stem cell marker nestin. The increase in levels of nestin after ischemia was countered by brimonidine treatment. Moreover, retinal ganglion cell death following either optic nerve transection or optic nerve crush appears to involve the extrinsic apoptotic pathway although the gene expression response appears to differ between these injuries. The results obtained in this work contribute to an increased understanding of retinal injuries and highlight the importance of Müller cells in the endogenous defense against retinal injuries.

Background. Myocardial hypertrophy is a risk factor for cardiovascular morbidity and mortality. Independent of underlying disease, the cardiac muscle strives in different ways to compensate for an increased workload. This remodelling of the heart includes changes in the extracellular matrix which will affect systolic and diastolic cardiac function. Furthermore, signal transduction, molecular diffusion and microcirculation will be affected in the hypertrophic process. One important extracellular component is the glycosaminoglycan hyaluronan. It has been shown to play a major role in other conditions that feature cellular growth and proliferation, such as wound healing and malignancies. The aim of this thesis was to investigate hyaluronan and its role in both an experimental rat model of cardiac hypertrophy as well as in cultured mouse cardiomyocytes and fibroblasts. Methods. Cardiac hypertrophy was induced in rats by aortic ligation. Hyaluronan concentration was measured and expression of genes coding for hyaluronan synthases were quantified after 1, 6 and 42 days after operation, in cardiac tissue from the left ventricular wall. Localization of hyaluronan and its receptor CD44 was studied histochemically. Hyaluronan synthesis was correlated to gene transcription using microarray gene expression analysis. Cultures of cardiomyocytes and fibroblasts were stimulated with growth factors. Hyaluronan concentration was measured and expression of genes coding for hyaluronan synthases were detected. Hyaluronan size was measured and crosstalk between cardiomyocytes and fibroblasts was investigated. Results. Increased concentration of hyaluronan in hypertrophied cardiac tissue was observed together with an up-regulation of two hyaluronan synthase genes. Hyaluronan was detected in the myocardium and in the adventitia of cardiac arteries whereas CD44 staining was mainly found in and around the adventitia. Hyaluronan synthesis correlated to the expression of genes, regulated by transcription factors known to initiate cardiac hypertrophy. Stimulation of cardiomyocytes by PDGF-BB induced synthesis of hyaluronan. Cardiomyocytes also secreted a factor into culture media that after transfer to fibroblasts initiated an increased synthesis of hyaluronan. When stimulated with hyaluronan of different sizes, a change in cardiomyocyte gene expression was observed. Different growth factors induced production of different sizes of hyaluronan in fibroblasts. The main synthase detected was hyaluronan synthase-2. Cardiomyocytes were also shown to secrete microvesicles containing both DNA and RNA. Isolated microvesicles incubated with fibroblasts were observed by confocal microscopy to be internalized into fibroblasts. Altered gene expression was observed in microvesicle stimulated fibroblasts. Conclusion. This study shows that increased hyaluronan synthesis in cardiac tissue during hypertrophic development is a part of the extracellular matrix remodelling. Cell cultures revealed the ability of cardiomyocytes to both synthesize hyaluronan and to convey signals to fibroblasts, causing them to increase hyaluronan synthesis. Cardiomyocytes are likely to express receptors for hyaluronan, which mediate intracellular signalling causing the observed altered gene expression in cardiomyocytes stimulated with hyaluronan. This demonstrates the extensive involvement of hyaluronan in cardiac hypertrophy.

Coronary artery stent placement has been a significant advance in the percutaneous treatment of atherosclerotic disease, and tissue engineered vascular grafts may provide a viable alternative to autologous segments for small diameter vessels. However, in-stent restenosis remains an important limitation, and tissue engineered grafts have poor patency and high risk of thrombus formation due to their inability to maintain a confluent, adherent, and quiescent endothelium. While animal models provide insight into the pathophysiology of these situations, elucidation of the relative importance of stent or graft components, hemodynamic factors, and molecular factors is difficult. Very little research has focused on bridging gaps in knowledge concerning blood/biomaterial interactions, blood/endothelial cell interactions, and endothelial cell/smooth muscle cell cross-talk. The work presented within this thesis will do just that. The objective of this thesis research was to elucidate the influence of biomaterial-induced activation of leukocytes on endothelial cell or smooth muscle cell phenotype, as well as endothelial cell/smooth muscle cell cross-talk in co-culture systems. Towards this goal, two complimentary in vitro endothelial cell/smooth muscle cell co-culture models with divergent smooth muscle cell phenotype were developed and characterized. Using these systems, it was found that the presence of more secretory smooth muscle cells (as would be seen in wound healing or disease) in general enhanced endothelial cell activation in response to biomaterial-pretreated monocytes, while the presence of less secretory smooth muscle cells (to model more quiescent smooth muscle cells found in uninjured healthy vessels) suppressed endothelial cell activation in response to biomaterial-pretreated monocytes (and neutrophils to a small degree). Additionally, biomaterial-pretreated monocytes and neutrophils amplified a smooth muscle cell phenotypic shift away from a more quiescent state. It is likely that the compounding effect of secretory smooth muscle cells and biomaterial-activated leukocytes are responsible for altered vascular wound healing upon implantation of stents or vascular grafts. Understanding the specific signals causing these effects, or signals delivered by contractile smooth muscle cells that limit these effects help to provide design criteria for development of devices or grafts capable of long term patency.

Current therapeutic strategies to stimulate endogenous angiogenic processes within injured tissue areas are typically based on introducing exogenous pro-angiogenic molecules or cell populations. Stem cell transplantation for angiogenic therapy aims to deliver populations of cells that secrete angiogenic factors and/or engraft in the new branching vasculature within the damaged tissue. Utilizing stem or progenitor cells has been shown to induce a rather robust angiogenic response despite minimal repopulation of the host vasculature, suggesting that stem cells may provide paracrine factors that transiently induce endogenous angiogenesis of tissues undergoing regeneration. Early differentiating embryonic stem cell (ESC) aggregates, referred to as embryoid bodies (EBs), can undergo vasculogenic differentiation, and also produce extracellular matrix and growth factors that induce proliferation, differentiation, and tissue morphogenesis. Taken together, the ESC extracellular environment may be an effective means by which to manipulate cell behavior. Thus, the objective of this project was to harness morphogens derived from ESCs undergoing differentiation and analyze their bioactive potential. To examine the expression of extracellular factors within EBs, gene expression arrays in conjunction with a variety of analytical tools were utilized to gain an understanding of the importance of extracellular factors in ESC differentiation. Furthermore, the soluble fraction of secreted factors contained within EB-conditioned media was compared to the matrix-associated factors produced by EBs, which led to the development of novel ESC-derived matrices via mechanical acellularization methods. Acellular embryonic stem cell-derived matrices demonstrated the retention of bioactive factors that impacted aspects of angiogenesis. In conclusion, extracellular factors were modulated in response to the progression of EB differentiation and can further be harnessed via acellularization techniques, in order to deliver bioactive ESC-secreted factors in a cell-free manner.