Las propiedades quimioterapéuticas e hipolipemiantes de los compuestos de origen vegetal han recibido gran atención con el objetivo de encontrar sustancias que puedan ser usadas como alternativas a las drogas convencionales. Los monoterpenos -presentes en aceites esenciales de frutas cítricas y plantas aromáticas- están siendo activamente muy estudiados debido a su bajo costo, buena biodisponibilidad y escasa toxicidad. Se demostró que muchos de ellos ejercen múltiples efectos sobre la vía del mevalonato (VM) en células de mamíferos que podrían causar los efectos terapéuticos deseados. La VM produce isoprenoides que son incorporados en diversos productos finales como colesterol, dolicol y ubiquinona o grupos prenilo utilizados por preniltransferasas para las modificaciones postraduccionales de ciertas proteínas de la superfamilia Ras y Rho, GTPasas pequeñas que regulan importantes procesos celulares, como proliferación celular, diferenciación, apoptosis y organización del citoesqueleto. Mutaciones en los genes que codifican estas proteínas forman oncogenes encontrados en una amplia variedad de tumores; por ejemplo, en un 90% de las neoplasias de páncreas, 50% de las tumoraciones de colon y tiroides y, aproximadamente, en un 30% de las leucemias mieloides y en el cáncer de pulmón. La etapa limitante de la velocidad de la VM es catalizada por la 3-hidroxi-3-metil glutaril coenzima A reductasa (HMGCR), enzima que se encuentra regulada -a nivel transcripcional, traduccional y postraduccional- a través del propio colesterol y de algunos intermediarios de la vía. La VM está presente en células de todos los tejidos estudiados y es particularmente activa en el hígado, órgano que cumple un rol central en el mantenimiento de la homeostasis del colesterol corporal. La familia de las estatinas está constituida por drogas naturales (de origen fúngico), semisintéticas (obtenidas por modificaciones de las anteriores) y sintéticas. Estos compuestos son estructuralmente similares a la mevalonolactona, característica que les posibilita actuar como inhibidores competitivos de la HMGCR. Uno de los posibles efectos de las estatinas es la modulación del crecimiento celular. Las estatinas se utilizan con éxito en el tratamiento de la hipercolesterolemia, ya que ocasionan una disminución del contenido de colesterol celular que se traduce, vía SREBPs, en un incremento del número de receptores para LDL con el concomitante aumento de la captación de LDL-colesterol del plasma. La dosis recomendada en terapias hipocolesterolemiantes en humanos es menor a 1mg/Kg/día. Pero, aún a dosis terapéuticas, las estatinas causan en ocasiones disfunción hepática, progresión de las cataratas, disfunción eréctil, miopatías, sensibilidad al tacto o debilidad con niveles elevados de creatina quinasa. Hipótesis de Trabajo - Debido a sus múltiples efectos sobre la vía del mevalonato, los monoterpenos tendrían “in vivo” efectos hipocolesterolemiantes y antitumorales - El hecho de que la inhibición de la HMGCR por los monoterpenos se produzca a través de un mecanismo diferente del empleado por las estatinas y que además afecten a la vía del mevalonato a otros niveles, sugiere la posibilidad de que el uso combinado de estatinas con monoterpenos naturales permita disminuir la dosis efectiva de estatinas en el tratamiento de hipercolesterolemias e incrementar la eficacia de ambos compuestos. Objetivos - Evaluar in vivo la actividad hipocolesterolemiante e hipolipemiante del geraniol (G) y avanzar en el conocimiento de los mecanismos de acción de este monoterpeno en el metabolismo del colesterol y los triglicéridos mediante el estudio de la expresión de genes claves como el de HMGCR, el receptor de LDL y de SREBP. De este modo, se avanzará en el conocimiento de los beneficios que aporta G en la prevención / tratamiento de enfermedades cardiovasculares. - Estudiar el efecto antitumoral de G y de las estatinas in vivo, utilizando un modelo de adenocarcinoma de pulmón humano, en células A549 implantadas en ratones atímicos, con el fin de aportar conocimientos sobre los mecanismos por los cuales podrían ejercer actividad antitumoral, como así también determinar la relación existente entre la VM y el control del crecimiento celular. - Estudiar el efecto y mecanismo de acción de la combinación de estatinas (simvastatina) con monoterpenos (G) sobre el metabolismo lipídico, la síntesis de colesterol y el crecimiento tumoral. Metodología Ensayos con Geraniol: Para los estudios in vivo se utilizaron ratones NIH nu/nu. Los animales de aproximadamente 6 semanas de edad, provistos por el Centro Atómico Ezeiza, fueron criados en nuestro bioterio en ambiente climatizado, con ciclos de luz (6 a.m. a 6 p.m.) y oscuridad (6 p.m. a 6 a.m.) controlados en forma automática. Estos fueron alimentados “ad libitum” con una dieta standard de laboratorio para roedores esterilizada con radiación gamma, permitiéndoseles libre acceso al consumo de agua esterilizada en autoclave. Los ratones se dividieron en dos grupos: animales no portadores y animales portadores de tumor, los cuales fueron implantados subcutáneamente con la línea tumoral A549. Cada grupo fue subdividido en lotes experimentales que recibieron una dieta suplementada con cantidades crecientes de geraniol (0; 25; 50; 75 mmol de geraniol/Kg dieta) durante 21 días. Durante el tratamiento el tumor fue medido dos veces por semana. Se cuantificó trigliceridemia y colesterolemia utilizando un kit enzimático, síntesis lipídica en hígado por incorporación de [14C]acetato y contenido hepático de colesterol (libre y esterificado) y de ácidos grasos por métodos bioquímicos. Se determinó HMGCR por western blot y se midió su actividad enzimática en microsomas de hígado aislados. Se establecieron los niveles de ARNm de HMGCR, del receptor de LDL y del factor de transcripción SREBP-2 por RT-PCR a partir de ARN hepático aislado. Se determinaron los niveles de apoptosis tumoral por el método de TUNEL y midiendo la actividad de caspasa-3 y se cuantificó Ras en homogenado y en membrana del tumor. Ensayos con Simvastatina: Se utilizaron ratones NIH hembras portadoras del genotipo nu/nu. Los animales de aproximadamente 6 semanas de edad, provistos por el Centro Atómico Ezeiza, fueron criados en nuestro bioterio como se detalla anteriormente. Luego de ser implantados subcutáneamente con la línea tumoral A549 se dividieron en dos grupos, control y experimental, al que se le suplementó la dieta con Simvastatina (0.5mM) en el agua de bebida. El tratamiento se prolongó por 3 semanas. Dos veces por semana se midió el crecimiento relativo del tumor, en los diferentes lotes de animales, utilizando un calibre. Luego de finalizado el tratamiento los ratones fueron sacrificados y se obtuvieron los tumores y los hígados de los mismos. Se determinó el porcentaje de células apoptóticas en los tumores obtenidos al momento del sacrificio de los animales y se cuantificó la proteína Ras en homogenado y en membrana plasmática del tumor. Aquí también se determinó síntesis lipídica hepática y contenido de colesterol (libre y esterificado) y de ácidos grasos en hígado. Ensayos con Geraniol y Simvastatina: animales portadores de tumor subcutáneo de células A549, se separaron en cuatro grupos: un grupo control y tres grupos experimentales; un grupo tratado con G (50 mmol / Kg de dieta) adicionado al alimento, otro con S (50 mg / Kg peso / día) suministrada en el agua de bebida y un grupo con la combinación de ambos compuestos a las concentraciones previamente mencionadas (G + S). El tratamiento se realizó durante tres semanas, en las cuales se monitoreó el crecimiento de los tumores y se controló asimismo el peso, el consumo de alimento y de agua de los animales. A las 3 semanas de tratamiento los animales fueron sacrificados por dislocación cervical y se obtuvieron muestras de suero, hígado y tumor. Se midió apoptosis tumoral y los niveles de Ras total y Ras anclada a membrana plasmática de las células tumorales. Se determinó colesterol plasmático, hepático y tumoral, incorporación en hígado y en tumor de [14C]acetato en lípidos totales, lípidos insaponificables y ácidos grasos. Resultados y Conclusiones - Hemos demostrado que el geraniol tiene efectos hipolipemiantes y antitumorales “in vivo” en ratones nude con dosis que no presentan toxicidad. - Se avanzó en el conocimiento de los mecanismos de acción de este monoterpeno sobre la vía del mevalonato debido a que hemos demostrado: - Inhibición de la HMGCR a nivel postranscripcional, con una disminución de la cantidad y actividad de la enzima. Como consecuencia de ello disminuye la colesterogénesis en hígado y en tumor y aumenta la expresión del receptor de LDL hepático como mecanismo compensatorio al descenso del colesterol intracelular. - Inhibición de la cantidad de proteína Ras unida a membranas sin modificación de los niveles totales de la misma. Estos resultados sugieren una disminución de la prenilación por limitación en la disponibilidad de precursores o bien por inhibición directa de las preniltranferasas. - Se demostró una disminución de la síntesis de ácidos grasos que sugiere un posible mecanismo responsable del efecto hipolipemiante ejercido por el geraniol. - Se demostró un efecto proapoptótico y antiproliferativo del geraniol. A partir de nuestros resultados se sugiere que estos efectos se deberían a la limitación en la disponibilidad de lípidos esenciales para el crecimiento tumoral. - La administración combinada de geraniol y simvastatina inhibió significativamente el crecimiento e indujo la apostosis tumoral, y demostró tener un efecto sinérgico sobre la inhibición de la síntesis de lípidos tanto hepáticos como tumorales. Esto reforzaría la hipótesis de la acción inhibitoria del geraniol en distintos puntos de vías del metabolismo lipídico. Consideramos que la labor desarrollada en el presente trabajo colabora con una mejor comprensión de la acción de un componente muy frecuente en los aceites esenciales sobre una compleja vía metabólica, con el objetivo de mejorar el diseño de estrategias terapéuticas que incluyan el uso de compuestos naturales de manera individual o en combinación con drogas sintéticas para la lucha contra el cáncer y enfermedades asociadas a dislipemias.

Made available in DSpace on 2016-08-10T10:39:08Z (GMT). No. of bitstreams: 1 STANLEY SILVANO SOUSA.pdf: 1573160 bytes, checksum: 779804c156f10ab50a1b61b85240a0ab (MD5) Previous issue date: 2015-08-27 / The main regulatory enzyme of cholesterol biosynthesis is hydroxyl-methylglutaryl-CoA reductase (HMGCR) and several polymorphisms are described in the gene encoding this enzyme. Currently, associations between genetic polymorphisms and cardiovascular disease are investigated in order to better understand the genetic factors associated with such diseases. The objective of this study was to evaluate the frequency of -911 polymorphism (rs3761740) in the promoter region of HMGCR gene in patients with coronary artery disease (CAD), as well as the possible associations between the resultant genotypes and clinical features of patients with CAD. Genomic DNA isolated from patients blood samples were analyzed for the detection of genetic polymorphism, by using polymerase chain reaction (PCR) analysis and restriction fragment length polymorphism (RFLP). Allele frequencies obtained for the -911 polymorphism (rs3761740) in the promoter region of the HMGCR gene were: A (51.2%) and C (48.8%). The genotype frequencies obtained were: AA (11.9%), AC (78.6%) and CC (9.5%). Significant associations between the diferente genotypes and clinical features of the patients with CAD were not detected in this study. Our results show that -911 polymorphism (rs3761740) in the promoter region of the HMGCR gene was not associated with clinical and laboratory characteristics in patients with coronary artery disease. / A principal enzima regulatória da biossíntese do colesterol é a hidrox-imetilglutaril-CoA redutase (HMGCR) e vários polimorfismos são descritos no gene que codifica esta enzima. Atualmente, associações entre tais polimorfismos genéticos e as doenças cardiovasculares são investigadas no sentido de compreender melhor os fatores genéticos associados a essas doenças. O objetivo deste estudo foi avaliar a frequência do polimorfismo -911(rs3761740) na região promotora do gene da HMGCR em pacientes com doença arterial coronariana (DAC), bem como as possíveis associações entre os genótipos encontrados e os aspectos clínicos dos pacientes com DAC. O DNA genômico isolado das amostras de sangue dos pacientes foi analisado para detecção do polimorfismo genético, por meio da reação em cadeia da polimerase (PCR) e análise de polimorfismos de comprimento de fragmentos de restrição (RFLP). As frequências alélicas obtidas para o polimorfismo -911 (rs3761740) na região promotora do gene HMGCR foram: A (51,2%) e C (48,8%). As frequências genotípicas obtidas foram: AA (11,9%), AC (78,6%) e CC (9,5%). Associações significativas entre os genótipos encontrados e os aspectos clínicos dos pacientes com DAC não foram detectadas neste estudo. Nossos resultados permitem concluir que polimorfismo -911(rs3761740) na região promotora do gene da HMGCR não esteve associado aos aspectos clínicos e laboratoriais em pacientes com doença arterial coronariana.

Background: Genome-wide association studies (GWAs) have identified almost one hundred genetic loci associated with variances in human blood lipid phenotypes including very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol and triglycerides. Nevertheless the revealed loci only explain a small fraction of heritability and therefore a subtile phenotype of cholesterol homoestasis was examined in our study for the very first time. Methods and Results: Using a multi-stage approach of a GWA, firstly, a genome-wide analysis (Affymetrix 500K GeneChip) for serum lanosterol and serum total cholesterol using LC-MS/MS was conducted in 1495 participants of the KORA-S3/F3 cohort with subsequent replication in two additional independent samples of the the KORA-S3/F3 cohort (n = 1157) and CARLA cohort (n = 1760). Two genetic variants, SNP rs7703051 and rs17562686, in the HMGCR locus were significantly associated with serum lanosterol and showed similar effects of elevated serum lanosterol for each minor allele (combined n = 4412: p = 1,4 x 10-10, +7,1% and p = 4,3 x 10-6, +7,8%). Furthermore, rs7703051 showed a nominal statistical significance to serum cholesterol (p = 0,04). A combined analysis of both SNPs demonstrated that observed associations of rs17562686 can be partly explained by LD with rs7703051 being the primary polymorphism in that study. Nevertheless, rs17562686 shows consistent independent effects on serum lanosterol, thus being associated to a lipid phenotype for the very first time. The following SNP-fine mapping of the HMGCR locus was carried out in the CARLA cohort with subsequent validation in the LE-Heart cohort (n = 1895). The recently published SNP rs3846662 being in tight LD with rs7703051 could be associated with variances of serum lanosterol in both cohorts and functional in vivo studies of gen expression using qRT-PCR assays demonstrated a highly significant association of higher expression of alternatively spliced HMGCR mRNA lacking exon 13 with homozygosity for the rs3846662 major allele in 51 human liver samples (p < 0,01) and 958 human PBMCs (p = 2,1 x 10-7). The overall HMGCR gen expression was not affected. Further investigation of in vivo HMG-CoA reductase enzyme activity in both human samples (n = 48 and n = 55) using anionic exchange column chromatography and scintillation counting of [3-14C]-HMG-CoA and [5-3H]-mevalonolacton did not show any significant results. In addition there was not any association in the LE-Heart cohort between these SNPs and the development of CAD. Finally, rs7703051 could be replicated for already published total cholesterol (combined n = 4412) and rs3846662 for LDL-cholesterol (LE-Heart n = 1895). Since fine mapping in CARLA showed several SNPs throughout the HMGCR locus being in LD with rs17562686 we performed a DNA sequencing of the extended 5´-HMGCR promotor region in six human liver samples. A unknown SNP was discovered in the promotor but could not be associated with any of the examined phenotypes mentioned above. The minor allele of SNP rs5909 situated next to the stop codon and being in high LD with rs17562686 was associated with elevated serum lanosterol and slightly reduced HMGCR gen expression, but further studies including the above mentioned as well as measurement of 3’-UTR transcript lengths using qRT-PCR assays did not produce significant results. Conclusion: The phenotype serum lanosterol could be associated with genetic polymorphisms (e.g. rs7703051) in the HMGCR locus. Therefore already published associations of HMGCR with total cholesterol and LDL-cholesterol can be explained by variances of cholesterol homeostasis. The SNP rs17562686 could be associated with a phenotype of human blood lipids for the very first time. Subsequent gen expression analyses demonstrated a highly significant association of rs3846662 with variant patterns of HMGCR alternative splicing. A significant effect of alternatively spliced protein on enzyme activity and a association of these SNPs with CAD could not be shown.

Background: Genome-wide association studies (GWAs) have identified almost one hundred genetic loci associated with variances in human blood lipid phenotypes including very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol and triglycerides. Nevertheless the revealed loci only explain a small fraction of heritability and therefore a subtile phenotype of cholesterol homoestasis was examined in our study for the very first time. Methods and Results: Using a multi-stage approach of a GWA, firstly, a genome-wide analysis (Affymetrix 500K GeneChip) for serum lanosterol and serum total cholesterol using LC-MS/MS was conducted in 1495 participants of the KORA-S3/F3 cohort with subsequent replication in two additional independent samples of the the KORA-S3/F3 cohort (n = 1157) and CARLA cohort (n = 1760). Two genetic variants, SNP rs7703051 and rs17562686, in the HMGCR locus were significantly associated with serum lanosterol and showed similar effects of elevated serum lanosterol for each minor allele (combined n = 4412: p = 1,4 x 10-10, +7,1% and p = 4,3 x 10-6, +7,8%). Furthermore, rs7703051 showed a nominal statistical significance to serum cholesterol (p = 0,04). A combined analysis of both SNPs demonstrated that observed associations of rs17562686 can be partly explained by LD with rs7703051 being the primary polymorphism in that study. Nevertheless, rs17562686 shows consistent independent effects on serum lanosterol, thus being associated to a lipid phenotype for the very first time. The following SNP-fine mapping of the HMGCR locus was carried out in the CARLA cohort with subsequent validation in the LE-Heart cohort (n = 1895). The recently published SNP rs3846662 being in tight LD with rs7703051 could be associated with variances of serum lanosterol in both cohorts and functional in vivo studies of gen expression using qRT-PCR assays demonstrated a highly significant association of higher expression of alternatively spliced HMGCR mRNA lacking exon 13 with homozygosity for the rs3846662 major allele in 51 human liver samples (p < 0,01) and 958 human PBMCs (p = 2,1 x 10-7). The overall HMGCR gen expression was not affected. Further investigation of in vivo HMG-CoA reductase enzyme activity in both human samples (n = 48 and n = 55) using anionic exchange column chromatography and scintillation counting of [3-14C]-HMG-CoA and [5-3H]-mevalonolacton did not show any significant results. In addition there was not any association in the LE-Heart cohort between these SNPs and the development of CAD. Finally, rs7703051 could be replicated for already published total cholesterol (combined n = 4412) and rs3846662 for LDL-cholesterol (LE-Heart n = 1895). Since fine mapping in CARLA showed several SNPs throughout the HMGCR locus being in LD with rs17562686 we performed a DNA sequencing of the extended 5´-HMGCR promotor region in six human liver samples. A unknown SNP was discovered in the promotor but could not be associated with any of the examined phenotypes mentioned above. The minor allele of SNP rs5909 situated next to the stop codon and being in high LD with rs17562686 was associated with elevated serum lanosterol and slightly reduced HMGCR gen expression, but further studies including the above mentioned as well as measurement of 3’-UTR transcript lengths using qRT-PCR assays did not produce significant results. Conclusion: The phenotype serum lanosterol could be associated with genetic polymorphisms (e.g. rs7703051) in the HMGCR locus. Therefore already published associations of HMGCR with total cholesterol and LDL-cholesterol can be explained by variances of cholesterol homeostasis. The SNP rs17562686 could be associated with a phenotype of human blood lipids for the very first time. Subsequent gen expression analyses demonstrated a highly significant association of rs3846662 with variant patterns of HMGCR alternative splicing. A significant effect of alternatively spliced protein on enzyme activity and a association of these SNPs with CAD could not be shown.

The oxysterol, 25-hydroxycholesterol (25-HC), is important for sterol metabolism and emerging evidence suggests that 25-HC plays a more critical role in immunity and infection. However, the precise antiviral mechanism and the target of 25- HC remains unclear. Here efforts were made to investigate the link between viral infection and the triggering of the 25-HC associated interferon (IFN) response, and how this dynamically alters the endogenous level of 3-hydroxy- 3-methylglutaryl-CoA reductase (HMGCR), a key enzyme that catalyses the production of the precursor of cholesterol and oxysterols. In this thesis I have sought to specifically explore the temporal changes and role of HMGCR in DNA virus (cytomegalovirus) and RNA (Influenza) virus infections. I hypothesise that HMGCR is a target for 25-HC associated IFN-mediated host defence against viral infection. To characterise HMGCR and test this hypothesis, the following objectives were defined: (1). To establish an experimental system to quantitatively study the endogenous HMGCR protein level; (2). To investigate the mechanism of the down-regulation of HMGCR involved in the IFN-mediated innate immune response; (3). To study the behaviour of HMGCR in the influenza virus induced 25-HC associated IFN-mediated innate immune response; (4). To study the behaviour of HMGCR in the cytomegalovirus induced 25-HC associated IFN-mediated innate immune response. Chapter 3, describes establishing an experimental system for the quantification of endogenous HMGCR levels. Different protein detection methods, including a modified western blot protocol and immunostaining, were tested. The results of RNA interference of HMGCR demonstrate that under lipid-deficient condition with the supplementation of mevastatin (an HMGCR inhibitor) the modified western blot protocol specifically detects endogenous HMGCR. This chapter lays the foundational work for the temporal analysis and testing the role of HMGCR in infection. In Chapter 4, the mechanism of the degradation of HMGCR following 25-HC and IFN treatments, in wild-type and Ch25h−/− mouse bone marrow derived macrophages (BMDMs), was investigated. Similar to 25-HC, IFN-γ treatment results in the drop of both the transcript and protein abundance of HMGCR in wild-type BMDMs. Differential temporal analysis of RNA and protein alterations and the use of proteasome inhibitors reveals that both 25-HC and IFN-γ lead to a marked reduction of HMGCR protein via a proteasomal degradation mechanism within early times of treatments. Further, the immediate reduction of HMGCR levels induced by IFN-γ was completely abrogated in Ch25h−/− BMDMs. Hence, the reduction of HMGCR following IFN-γ treatment is due to the de novo synthesis in macrophages of 25-HC. However, the decrease of Hmgcr gene expression was observed in not only wild-type but also Ch25h−/− BMDMs, suggesting additional mechanisms for regulating Hmgcr RNA levels. These results demonstrate the mechanism of the down-regulation of HMGCR resulted from the induction of IFN response during viral infection, is only partially due the de novo synthesis of 25-HC. In chapter 5, influenza A virus was used to investigate the role of HMGCR in the IFN-mediated innate immune response. The inhibition of HMGCR by RNA interference inhibited viral growth, suggesting the requirement of HMGCR for optimal intracellular viral growth. Viral infection in wild-type murine BMDMs reduced the endogenous HMGCR levels. However, the reduction of HMGCR at early times was prevented in Ch25h−/− BMDMs. Intriguingly, the decrease of HMGCR at late time points was still observed in Ch25h−/− BMDMs. These results indicate that the down-regulation of HMGCR with influenza virus infection in BMDMs at early times is completely due to the de novo synthesis of 25-HC; whereas at late times alternative pathways or mechanisms exist. Additionally, human epithelial A549 cells and A549/PIV5-V cells that are deficient in STAT1 were used to study the role of IFN pathway in the down-regulation of HMGCR at late times during viral infection. Results from these studies show that at late times the reduction of HMGCR is due to IFN-independent mechanisms. Chapter 6, extends these investigations to the herpes virus murine cytomegalovirus and infection of BMDMs. HMGCR is known to be essential for cytomegaloviral infections and 25-HC, statin and RNAi inhibition of HMGCR restrict viral growth. 25-HC is shown to reduce HMGCR at immediate early times of infection. However, most notably, the down-regulation of HMGCR was also observed in Ch25h−/− BMDMs at late times with murine cytomegalovirus infected BMDMs. These results confirm that alternative pathways or mechanisms exist, playing roles in the crosstalk between cholesterol metabolism and innate immune response. Collectively, this study characterises the role of HMGCR in the 25-HC associated IFN-mediated host defence against viral infection. Results indicate that, in addition to the IFN-mediated host response, alternative pathways or other mechanisms also result in the down-regulation of HMGCR during viral infection. HMGCR is at the crossroad of different pathways or mechanisms, and is therefore not only targeted by 25-HC. Hence, further questions can be addressed from these results: (1). What are the alternative pathways or mechanisms for the down-regulation of HMGCR? (2). How do these pathways or mechanisms work in hosts’ immune system? Answering these questions can contribute to refining the pathway map of innate immunity and understanding the precise role of HMGCR, or even the sterol biosynthesis pathway, in hosts’ immune response against pathogens.

The statin family of hydroxymethylglutaryl coenzyme A reductase (HMGCR) inhibitors, used to control hypercholesterolemia, triggers apoptosis of various human tumour cells. HMGCR is the rate-limiting enzyme of the mevalonate (MVA) pathway, a fundamental metabolic pathway required for the generation of a number of biochemical end-products including cholesterol and isoprenoids, but the contribution of the MVA pathway to human cancer remains largely unexplored. Furthermore, as only a subset of tumour cells has been shown to be highly responsive to statins, the identification of appropriate subsets of patients will be required to successfully advance these agents as anticancer therapeutics. To this end, there were two major aims to this work: 1) Elucidate a molecular rationale for the observed therapeutic index of statin-induced apoptosis in normal and tumour cells; 2) Identify molecular determinants of sensitivity for statin-induced apoptosis in human tumour cells. To address the first aim we demonstrated that dysregulation of the MVA pathway, achieved by ectopic expression of either full length HMGCR (HMGCR-FL) or its novel splice variant lacking exon 13 (HMGCR-D13), increases transformation. Ectopic HMGCR promotes growth of transformed and non-transformed cells under anchorage-independent conditions or as xenografts in immunocompromised mice. We also show that high mRNA levels of HMGCR and four out of five other MVA pathway genes correlate with poor prognosis in primary breast cancer, suggesting the MVA pathway may play a role in the etiology of human cancers. To address the second aim, we show that dysregulation of the MVA pathway is a key determinant of sensitivity to statin-induced apoptosis in multiple myeloma. In a panel of 17 distinct myeloma cell lines, half were sensitive to statin-induced apoptosis and the remainder were insensitive. Interestingly, in sensitive cells, the classic feedback response to statin exposure is lost, a feature we demonstrated could distinguish a subset of statin-sensitive primary myeloma cells. We further illustrated that statins are highly effective and well tolerated in an orthotopic model of myeloma using cells harboring a dysregulated MVA pathway. Taken together, this work provides a molecular rationale and determinants of sensitivity for statin-induced apoptosis of human tumour cells.

The statin family of hydroxymethylglutaryl coenzyme A reductase (HMGCR) inhibitors, used to control hypercholesterolemia, triggers apoptosis of various human tumour cells. HMGCR is the rate-limiting enzyme of the mevalonate (MVA) pathway, a fundamental metabolic pathway required for the generation of a number of biochemical end-products including cholesterol and isoprenoids, but the contribution of the MVA pathway to human cancer remains largely unexplored. Furthermore, as only a subset of tumour cells has been shown to be highly responsive to statins, the identification of appropriate subsets of patients will be required to successfully advance these agents as anticancer therapeutics. To this end, there were two major aims to this work: 1) Elucidate a molecular rationale for the observed therapeutic index of statin-induced apoptosis in normal and tumour cells; 2) Identify molecular determinants of sensitivity for statin-induced apoptosis in human tumour cells. To address the first aim we demonstrated that dysregulation of the MVA pathway, achieved by ectopic expression of either full length HMGCR (HMGCR-FL) or its novel splice variant lacking exon 13 (HMGCR-D13), increases transformation. Ectopic HMGCR promotes growth of transformed and non-transformed cells under anchorage-independent conditions or as xenografts in immunocompromised mice. We also show that high mRNA levels of HMGCR and four out of five other MVA pathway genes correlate with poor prognosis in primary breast cancer, suggesting the MVA pathway may play a role in the etiology of human cancers. To address the second aim, we show that dysregulation of the MVA pathway is a key determinant of sensitivity to statin-induced apoptosis in multiple myeloma. In a panel of 17 distinct myeloma cell lines, half were sensitive to statin-induced apoptosis and the remainder were insensitive. Interestingly, in sensitive cells, the classic feedback response to statin exposure is lost, a feature we demonstrated could distinguish a subset of statin-sensitive primary myeloma cells. We further illustrated that statins are highly effective and well tolerated in an orthotopic model of myeloma using cells harboring a dysregulated MVA pathway. Taken together, this work provides a molecular rationale and determinants of sensitivity for statin-induced apoptosis of human tumour cells.

Les myopathies nécrosantes auto-immunes (MNAI) appartiennent au groupe des myopathies inflammatoires idiopathiques. Les MNAI sont des maladies musculaires sévères pouvant conduire à un déficit musculaire définitif et handicapant. Pour rétablir une force normale et prévenir le handicap, des traitements prolongés associant corticothérapie et immunosuppresseurs sont nécessaires. Les MNAI sont définies histologiquement par la prédominance de fibres musculaires en nécrose qui contraste avec l’absence ou la faible abondance d'inflammation musculaire. Les mécanismes impliqués dans la nécrose comme ceux impliqués dans les séquelles atrophiques sont en revanche inconnus. Les MNAI peuvent être associées à des auto-anticorps (aAc) soit anti-SRP, soit anti-HMGCR. Ces aAc ciblent des protéines cytoplasmiques ubiquitaires. Leurs titres sont corrélés avec l'activité de la maladie, suggérant ainsi le rôle pathogène de ces aAc. Dans ce travail de thèse, nous avons émis l’hypothèse que les aAc pouvaient être impliqués dans les lésions musculaires observées aux cours des MNAI anti-SRP+ et anti-HMGCR+. Durant cette étude, nous avons eu pour objectifs : (i) de caractériser et de quantifier la nécrose musculaire et l’inflammation associée, ainsi que les mécanismes physiopathologiques impliqués (rôle des aAc) ; (ii) d’analyser la régénération et l’atrophie musculaire et l’effet des aAc sur ces phénomènes. L'analyse histologique des biopsies musculaires des patients MNAI a montré que la proportion des fibres musculaires en nécrose était plus importante chez les patients anti-SRP+. Les taux sériques de créatine phosphokinase étaient corrélés avec la proportion de fibres nécrotiques, montrant ainsi que ce taux est un bon marqueur de l’activité de la maladie. De façon inattendue, une inflammation musculaire était régulièrement observée. En particulier, la densité lymphocytaire T était dans un quart des cas comparable à celle des autres myopathies inflammatoires. Cette densité cellulaire était de plus corrélée au pourcentage de fibres en nécrose. L’infiltrat inflammatoire était néanmoins composé principalement de macrophages. Des macrophages CD68+ iNOS+, impliqués dans des phénomènes de myophagocytoses dans un environnement Th-1 étaient régulièrement observés. Des macrophages avec un phénotype suggérant une activation alternative par l’immunité humorale ont aussi été observés. Dans ce sens, la présence de dépôts de complexe d’attaque membranaire à la surface des fibres musculaires, mais aussi des dépôts de C1q et d’IgG montraient l’activation de la voie classique du complément au cours des MNAI. De plus, la détection des protéines SRP et HMGCR sur certaines fibres musculaires immatures (in vitro et in vivo) suggérait le rôle pathogène des aAc. Concernant les mécanismes de régénération et les phénomènes d’atrophie musculaire, l’analyse des biopsies musculaires a révélé l’importance de l’irrégularité du diamètre des fibres avec une prédominance de petites fibres. Ces petites fibres correspondaient à la fois à des fibres en régénération et à des fibres en nécrose. In vitro, les Ac anti-SRP et anti-HMGCR induisent une atrophie musculaire en augmentant la transcription de MAFbx et Trim63. En outre, l'atrophie des fibres musculaires a été associée à un niveau élevé de cytokines inflammatoires comme TNF, IL-6 et ROS. Concernant l’étude de la régénération musculaire, in vitro, la présence des aAc réduisait la fusion des myoblastes. Ce défaut était associé à une diminution de la production de cytokines anti-inflammatoires IL-4 et IL-13. L’ajout d'IL-4 et/ou d’IL-13 permettait de corriger la fusion des myoblastes. Dans ce travail, les données recueillies convergent pour suggérer le rôle pathogène des aAc anti-SRP et anti-HMGCR dans les lésions musculaires nécrotiques mais aussi dans la régénération musculaire et l’atrophie. Ces données nouvelles soulignent l’importance de traitements ciblés au cours des MNAI. / Immune mediated necrotizing myopathy (IMNM) is recognized as a separate entity among inflammatory myopathies. IMNM is a severe disabling muscle disease requiring prolonged combination of corticosteroid and immunosuppressive drugs. IMNM is morphologically defined by predominant muscle fiber necrosis and no or little inflammation, and is associated with important variation of the size of the fiber. However pathogenic mechanisms involved in muscle necrosis and muscle atrophy are largely unknown. IMNM may be associated with either anti-SRP or anti-HMGCR auto-antibodies (aAbs). The titer of these aAbs, targeting ubiquitous cytoplasmic proteins, is correlated with the disease activity suggesting their pathogenic role. In this thesis, we described the morphology of skeletal muscle alterations occurring in both conditions of anti-SRP+ or anti-HMGCR+ patients, studied the role of the Abs in (i) the necrosis mechanisms and the associated inflammation; (ii) by analyzing the atrophy and the regeneration mechanisms. Muscle histological analysis of anti-SRP+ and anti-HMGCR+ patients showed a random distribution of necrotic fibers that was more pronounced in anti-SRP+ patients. Creatine Phosphokinase levels; myolysis indicator, and muscle regeneration were correlated with the proportion of necrotic fibers. Inflammation was regularly observed in IMNM muscle patients. Macrophages were the most abundant but T cells densities were in a quarter of cases in the same range as myositis controls. CD68+iNOS+ macrophages and a Th-1 immune environment were also observed and involved in ongoing myophagocytosis. Of note, macrophages with alternative activation were also detected. Humoral immunity with activation of the classical pathway of the complement cascade was observed in IMNM. Positive membrane staining for SRP and HMGCR proteins, on some muscle fibers, was detected both in vitro and in muscle biopsies of IMNM patients. An important proportion of small fibers corresponding to both atrophic and regenerating fibers was observed in anti-SRP+ and anti-HMGCR+ patients. In vitro, anti-SRP and anti-HMGCR aAbs induced muscle fibers atrophy and increased the transcription of MAFbx and Trim63. In addition, the muscle fiber atrophy was associated with high level of inflammatory cytokines such TNF, IL-6 and ROS. Muscle regeneration in vitro was also affected by impairing the myoblasts fusion in presence of anti-SRP and anti-HMGCR Abs. This default was associated with a decrease production of anti-inflammatory cytokines: IL-4 and IL-13. Of note, the addition of IL-4 and/or IL-13 totally rescued the fusion. Together those data suggest that these aAbs have a pathogenic effect on muscle. Anti-SRP and anti-HMGCR are involved in muscle atrophy and affect the regeneration. The role of these aAbs in muscle damages occurring in IMNM was highlighted and emphasizes the potential interest of targeted therapies.

No description available.

Dans cette thèse, l’impact du polymorphisme rs3846662 sur l’épissage alternatif de la 3-hydroxy-3-méthylglutaryl coenzyme A réductase (HMGCR) a été investigué in vivo, chez des patients atteints d’hypercholestérolémie familiale (HF) ou de maladie d’Alzheimer (MA). Le premier manuscrit adresse la problématique de la normalisation de la quantification relative des ARNm par PCR quantitative. Les découvertes présentées dans ce manuscrit nous ont permis de déterminer avec un haut niveau de confiance les gènes de référence à utiliser pour la quantification relative des niveaux d’ARNm de l’HMGCR dans des échantillons de sang (troisième manuscrit) et de tissus cérébraux post-mortem (quatrième manuscrit). Dans le deuxième manuscrit, nous démontrons grâce à l’emploi de trois cohortes de patients distinctes, soit la population canadienne française du Québec et les deux populations nord américaines « Alzheimer’s Disease Cooperative Study (ADCS) » et « Alzheimer’s Disease Neuroimaging Initiative (ADNI) », que le génotype AA au locus rs3846662 confère à ces porteurs une protection considérable contre la MA. Les femmes porteuses de ce génotype voient leur risque de MA diminuer de près de 50% et l’âge d’apparition de leurs premiers symptômes retarder de 3.6 ans. Les porteurs de l’allèle à risque APOE4 voient pour leur part leurs niveaux de plaques séniles et dégénérescences neurofibrillaires diminuer significativement en présence du génotype AA. Enfin, les individus atteints de déficit cognitif léger et porteurs à la fois de l’allèle APOE4 et du génotype protecteur AA voient leur risque de convertir vers la MA chuter de 76 à 27%. Dans le troisième manuscrit, nous constatons que les individus atteints d’HF et porteurs du génotype AA ont, contrairement au modèle établi chez les gens normaux, des niveaux plus élevés de cholestérol total et de LDL-C avant traitement comparativement aux porteurs de l’allèle G. Le fait que cette association n’est observée que chez les non porteurs de l’APOE4 et que les femmes porteuses du génotype AA présentent à la fois une augmentation des niveaux d’ARNm totaux et une résistance aux traitements par statines, nous indique que ce génotype influencerait non seulement l’épissage alternatif, mais également la transcription de l’HMGCR. Comme une revue exhaustive de la littérature ne révèle aucune étude abondant dans ce sens, nos résultats suggèrent l’existence de joueurs encore inconnus qui viennent influencer la relation entre le génotype AA, l’épissage alternatif et les niveaux d’ARNm de l’HMGCR. Dans le quatrième manuscrit, l’absence d’associations entre le génotype AA et les niveaux d’ARNm Δ13 ou de protéines HMGCR nous suggère fortement que ce polymorphisme est non fonctionnel dans le SNC affecté par la MA. Une étude approfondie de la littérature nous a permis d’étayer cette hypothèse puisque les niveaux de HNRNPA1, la ribonucléoprotéine influencée par l’allèle au locus rs3846662, sont considérablement réduits dans la MA et le vieillissement. Il est donc proposé que les effets protecteurs contre la MA associés au génotype AA soient le résultat d’une action indirecte sur le processus physiopathologique. / In this thesis, the impact of rs3846662 polymorphism on the alternative splicing of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) was investigated in vivo, in patients with familial hypercholesterolemia (FH) or Alzheimer disease (AD). The first manuscript addresses the issue of normalization in relative quantification of mRNA by quantitative PCR. The findings presented in this manuscript have allowed us to determine with a high level of certainty the appropriate reference genes to use for the relative quantification of HMGCR mRNA levels in blood samples (third manuscript) and postmortem brain tissues (fourth manuscript). In the second manuscript, we demonstrate through the use of three independent cohorts, namely the French Canadian population of Quebec and the two North American populations named "Alzheimer's Disease Cooperative Study (ADCS)" and "Alzheimer's Disease Neuroimaging Initiative (ADNI) ", that the AA genotype at locus rs3846662 confers significant protection against AD. Women carrying this genotype decrease their risk of AD by about 50%, and delay their age of onset of 3.6 years. For their part, individuals carrying both the APOE4 risk allele and the AA genotype have decreased levels of senile plaques and neurofibrillary tangles compared to individuals carrying both the APOE4 and HMGCR G alleles. Finally, individuals suffering from mild cognitive impairment and carrying both the APOE4 risk allele and the protective AA genotype see their risk of converting to AD drop from 76% to 27%. In the third manuscript, contrary to the model described in normal subjects, we discovered that individuals with FH carrying the AA genotype have higher levels of total cholesterol and LDL-C before treatment compared to the carriers of the G allele. This latter association is observed only in non-carriers of the APOE4 risk allele. Furthermore, women carrying the AA genotype have both an increase in total HMGCR mRNA levels and a decrease response to statin treatment. These results suggest the AA genotype has an impact not only on the alternative splicing, but also on the transcription of HMGCR. Since an exhaustive review of the literature has reveal no studies corroborating this hypothesis, our results suggest the existence of yet unknown players influencing the relationships between the AA genotype, alternative splicing and the mRNA levels of HMGCR. In the fourth manuscript, we uncovered no association between the AA genotype and Δ13 mRNA or HMGCR protein levels. This strongly suggests that the rs3846662 polymorphism is not functional in the CNS affected by AD. A thorough study of the literature enabled us to support this hypothesis since the levels of HNRNPA1, the ribonucleoprotein influenced by the allele status at rs3846662 locus, are significantly reduced in AD and aging. Accordingly, we propose that the protective effects of the AA genotype against AD may be mediated through indirect effects on the physiopathology of the disease.