京都大学 / 0048 / 新制・課程博士 / 博士(医科学) / 甲第18186号 / 医科博第51号 / 新制||医科||4(附属図書館) / 31044 / 京都大学大学院医学研究科医科学専攻 / (主査)教授 小柳 義夫, 教授 松岡 雅雄, 教授 朝長 啓造 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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Mes travaux de thèse concernent le rôle du récepteur D1 de la dopamine dans les dyskinésies L-dopa induites, effets secondaires extrêmement handicapants du traitement de la maladie de Parkinson. En condition de dénervation striatale mimant l’environnement de la maladie de Parkinson, le traitement chronique par la L-dopa entraine des altérations majeures du trafic intraneuronal et de la signalisation du récepteur D1 de la dopamine dans les principaux neurones cibles de la dopamine, les neurones épineux de taille moyenne du striatum. Il existe en particulier une hypersensibilisation des récepteurs D1 dans les neurones striataux, avec une abondance accrue à la membrane plasmique et une diminution du niveau d’expression de la protéine GRK6 (Protéine kinase des Récepteurs Couplés aux Protéines G 6), un des acteurs clefs des phénomènes de désensibilisation, en relation directe avec l’apparition des dyskinésies.C’est dans ce contexte que se situe mon travail de thèse qui a eu pour objectif de mettre à profit et/ou de développer différents modèles expérimentaux et outils « in vivo » et « in vitro ». Nous avons associé des techniques d’imagerie cellulaire et tissulaire à des approches comportementales, afin d’explorer certains des événements cellulaires et moléculaires à l’échelle du neurone striatal et des réseaux neuronaux, reliant le niveau d’expression du récepteur D1, sa compartimentation cellulaire, son trafic intraneuronal et les dyskinésies ou des conditions pharmacologiques équivalentes.Nous avons confirmé dans le modèle du rat lésé unilatéralement à la 6-OHDA, traité par la L-dopa et développant des mouvements anormaux analogues aux dyskinésies chez l’homme, que le récepteur D1 est anormalement abondant à la membrane plasmique des neurones du striatum, alors qu’il devrait être internalisé après stimulation par son ligand naturel, la dopamine. Nous avons mis en évidence que les mécanismes d’internalisation après stimulation par un agoniste restent néanmoins fonctionnels. Après administration de l’agoniste D1, chez les animaux dyskinétiques, l’abondance des récepteurs D1 augmente dans les compartiments notamment impliqués dans les mécanismes d’internalisation et de transport (vésicules) et de dégradation (corps multivésiculaires). Nous avons apporté une explication possible à cette abondance anormale et à ce défaut d’internalisation, en montrant qu’ils pourraient être dus à une hétérodimérisation entre les récepteurs D1 et D3. La co-activation des récepteurs D1 et D3 par la L-dopa favoriserait l’ancrage du récepteur D1 à la membrane plasmique des neurones striataux.Dans ce cadre, l’abord de l’étude de l’implication du protéasome dans la régulation de l’expression du récepteur D1 de la dopamine nous a semblé particulièrement important, sur la base des premières études soulignant l’implication de ce système catalytique dans le contrôle de l’activité et du métabolisme des récepteurs aux neurotransmetteurs. Nous avons révélé pour la première fois des liens entre l’activité catalytique du protéasome et la dynamique intraneuronale du récepteur D1 et plus particulièrement nous avons montré que son activité chymotrypsine-like est réduite de façon spécifique dans le striatum d’animaux dyskinétiques, comme une conséquence directe d’une déplétion en dopamine associée à une hyperstimulation dopaminergique.Nous avons testé en situation expérimentale une stratégie « thérapeutique » nouvelle en restaurant le mécanisme de désensibilisation homologue du récepteur D1 de la dopamine, par correction du déficit de la kinase GRK6 par transfert du gène correspondant via l’injection intrastriatale d’un vecteur lentiviral. Nous avons montré que cette approche permet de réduire considérablement la sévérité des dyskinésies dans les modèles rat et primate non-humain, analogues des dyskinésies chez l’homme et qu’elle restaure les effets thérapeutiques de la L-dopa. Ces effets sont la conséquence de la restauration des mécanismes de désensibilisation homologue : la surexpression de GRK6 entraîne l’internalisation spécifique des récepteurs D1. L’ensemble de nos résultats s’inscrit dans une démarche de recherche translationnelle menée depuis plusieurs années au laboratoire allant de la cellule au patient, avec pour but de transposer la compréhension des données expérimentales concernant les anomalies de l’expression du récepteur D1 de la dopamine en stratégies thérapeutiques dans les dyskinésies L-dopa induites. Nos investigations montrent qu’il est possible d’agir sur l’expression du récepteur D1 à la membrane plasmique des neurones striataux de manière indirecte, en manipulant trois co-activateurs de son métabolisme, pour espérer réduire « in fine » la sévérité des dyskinésies. / In my thesis work, I studied the role of dopamine D1 receptor in L-dopa induced dyskinesia, a debilitating complication of Parkinson's disease’s treatment. In condition of striatal denervation, that mimics the Parkinson's disease environment, chronic treatment with L-dopa leads to major alterations of intraneuronal trafficking and dopamine D1 receptor signaling in the major target of dopamine neurons, the striatal medium spiny neurons. In particularly, there is a D1 receptor hypersensitivity in striatal neurons, with an increased abundance of D1 receptor at the plasma membrane and a decreased level of GRK6 protein expression, a key actor in desensitization mechanism, directly related with the apparition of dyskinesia.In this context, I used different in vitro and in vivo experimental models and tools. I have associated cell and tissue imaging techniques and behavioural approaches in order to explore cellular and molecular events in striatal neuron and neuronal networks, linking the D1 receptor expression level, its cellular compartmentalization, its intraneuronal trafficking and the dyskinesia behaviour or equivalent pharmacological conditions.We confirmed in the rat analog of L-dopa-induced dyskinesia, i.e., the L-dopa-induced abnormal involuntary movements in unilaterally 6-hydroxydopamine (6-OHDA)-lesioned animals, that D1 receptor is abnormally abundant in the plasma membrane of neurons in the striatum, whereas it should be internalized after stimulation by its natural ligand, the dopamine. We showed that nevertheless the internalization mechanisms after agonist stimulation remains functional. After D1 agonist administration in dyskinetic animals, D1 receptor abundance increases in the cytoplasmic compartments involved in the internalization and transport (vesicles) and degradation (multivesicular bodies) mechanisms. Based on D3 receptor antagonist experiment, we propose that this abnormal abundance and this lack of internalization could be due to heterodimerization between the D1 and D3 receptors. D1 and D3 receptors co-activation by L-dopa might anchor D1 receptor at the plasma membrane of striatal neurons.In this context, analysis of proteasome involvement in the regulation of dopamine D1 receptor expression seemed particularly important, on the basis of the first studies underlying proteasome involvement in the activity and metabolism of neurotransmitter receptors. We demonstrated for the first time links between the proteasomal catalytic activity and D1 receptor intraneuronal dynamics and more particularly we showed that the proteasome chymotrypsin-like activity is reduced specifically in the striatum of dyskinetic animals, as a direct consequence of dopamine depletion associated with dopaminergic hyperstimulation.We tested in experimental condition, a new "therapeutic"strategy in order to restore the dopamine D1 receptor homologous desensitization mechanism, correcting the GRK6 kinase deficit by gene transfer through the intrastriatal injection of a lentiviral vector. We showed that this approach reduces significantly the dyskinesia severity in rat and non-human primate models and restores the L-dopa therapeutic effects. These effects are a consequence of the homologous desensitization mechanisms restoration : indeed GRK6 overexpression provokes specific D1 receptor internalization.Our results are part of a translational research conducted over several years in the laboratory from cell to patient, in order to translate our increased understanding of D1 receptor function abnormalities into therapeutic strategies for L-dopa induced dyskinesia. Our investigations show that it is possible to act on D1 receptor expression at the plasma membrane of striatal neurons via various routes, all resulting into diminished dyskinesia severity.

BRCA1 est un suppresseur de tumeur majeur jouant un rôle dans la transcription, la réparation de l’ADN et le maintien de la stabilité génomique. En effet, des mutations dans le gène BRCA1 augmentent considerablement le risque de cancers du sein et de l’ovaire. BRCA1 a été en majorité caractérisé pour son rôle dans la réparation de l’ADN par la voie de recombinaison homologue (HR) en présence de bris double brins, par example, induits par l’irradiation gamma (IR). Cependant, la fonction de BRCA1 dans d’autres voies de réparation de l’ADN, comme la réparation par excision de nucléotides (NER) ou par excision de base (BER), demeurent toutefois obscures. Il est donc important de comprendre la régulation de BRCA1 en présence d’agents génotoxiques comme le méthyle méthanesulfonate (MMS) ou l’UV, qui promouvoient le BER et le NER respectivement. Nos observations suggèrent que BRCA1 est dégradée par le protéasome après traitement avec le MMS ou les UV, et non avec l’IR. Par ailleurs, cette dégradation semble compromettre le recrutement de Rad51, suggérant que la voie de HR est inhibée. Nos résultats suggèrent que la HR est inhibée afin d’éviter l’activation simultanée de multiples voies de réparation. Nous avons aussi observé que la dégradation BRCA1 est réversible et que la restauration des niveaux de BRCA1 coïncide avec le recrutement de Rad51 aux sites de dommages. Cela suggère que la HR est réactivée tardivement par les bris double brins générés suite à l’effondrement des fourches de réplication. Ayant observé que BRCA1 est hautement régulé par l’ubiquitination et est ciblé par le protéasome pour dégradation, nous avons émis une hypothèse que BRCA1 est régulé par des déubiquitinases. Cela amène à caractériser plus en profondeur par un criblage en déplétant les déubiquitinases individuellement par RNAi et en observant leur effet sur le recrutement de BRCA1 et des protéines reliées à cette voie. Un criblage préliminaire nous a permi d’identifié candidats potentiels tel que BAP1, CXORF53, DUB3, OTUB1 et USP36. / BRCA1 is a tumour suppressor involved in transcription, DNA repair and maintenance of genomic stability. Indeed, BRCA1 mutation carriers have an exceptionally higher risk of breast and ovarian cancers. BRCA1 is mainly known for its role in homologous recombination repair (HR) by recruiting HR proteins to chromatin upon double strand break (DSBs) formation, e.g., following treatment with ionizing irradiation (IR). However, the function of BRCA1 in other DNA repair pathways such as nucleotide excision repair (NER) or base excision repair (BER) is still obscure. It is thus of fundamental and clinical importance to investigate BRCA1 function following exposure to diverse genotoxic agents. Using human cultured cell, we observed that BRCA1 is downregulated by the proteasome upon treatment with MMS or UV, but not with IR. Moreover, this downregulation prevents Rad51 recruitment to chromatin following exposure to MMS. Given that DNA damage induced by UV and MMS trigger NER and BER pathways respectively, this implies that HR could be inhibited in order to prevent competition between independent DNA repair pathways. We also found that BRCA1 downregulation is reversible and the recovery of BRCA1 levels correlates with the reappearance of BRCA1 and Rad51 on chromatin. This implies that the HR has been reactivated at the late stage of DNA damage for the repair of double strand breaks generated by replication fork collapse. Since BRCA1 stability is highly regulated by ubiquitination and is downregulated following MMS treatment, one would expect that a deubiquitinase is responsible for relieving this downregulation to promote the reactivation of the HR pathway. To characterize this aspect further, we conducted DUB RNAi screens in which a particular DUB is depleted and the localization of BRCA1 and other related proteins were observed. According to a preliminary screen, a few DUBs (BAP1, CXORF53, DUB3, OTUB1, and USP36) were identified as potential regulators of the stability and localization of BRCA1 and proteins involved in homologous recombination.

La déubiquitinase BAP1 (« BRCA1-Associated Protein1 ») a initialement été isolée pour sa capacité de promouvoir la fonction suppressive de tumeurs de BRCA1. BAP1 est muté de manière homozygote dans plusieurs cancers (tel que le cancer du rein, de la peau, de l’oeil et du sein) suggérant fortement que cette déubiquitinase est un suppresseur de tumeurs. Effectivement, la surexpression de BAP1 réduit la prolifération cellulaire et la croissance tumorale dans des modèles de xénogreffe de souris. Toutefois, la fonction biologique et le mécanisme d’action de cette déubiquitinase restent encore marginalement connus. Ainsi, les objectifs de cette thèse sont de caractériser la fonction biologique de BAP1 et de révéler les bases moléculaires de sa fonction suppressive de tumeurs. Pour déterminer la fonction biologique de BAP1, nous avons immuno-purifié et identifié les protéines associées à BAP1, qui s’avèrent être principalement des facteurs et co-facteurs de transcription. Ensuite, nous avons démontré que BAP1 est un régulateur de la transcription. Parallèlement, un autre groupe a montré que BAP1 chez la drosophile, Calypso, régule l’ubiquitination de H2A et la transcription génique. D’autre part, nos résultats d’analyse d’expression génique globale suggèrent que BAP1 jouerait un rôle important dans la réponse aux dommages à l’ADN. Effectivement, des expériences de gain et de perte de fonction (méthode de l’ARNi, modèle de cellules KO en BAP1 et de cellules déficientes en BAP1 re-exprimant BAP1) ont révélé que cette déubiquitinase régule la réponse aux bris double brin d’ADN par la recombinaison homologue. Nos résultats suggèrent que BAP1 exerce sa fonction suppressive de tumeurs en contrôlant la réparation sans erreur de l’ADN via la recombinaison homologue. En cas d’inactivation de BAP1, les cellules deviendront plus dépendantes du mécanisme de réparation par jonction d'extrémités non-homologues, qui est potentiellement mutagénique causant ainsi l’instabilité génomique. D’autres études seront nécessaires afin de déterminer le rôle exact de BAP1 dans la transcription et de comprendre comment la dérégulation de l’ubiquitination de H2A contribue au développement du cancer. Définir les mécanismes de suppression tumorale est de grand intérêt, non seulement pour comprendre la carcinogénèse mais également pour le développement de nouvelles thérapies contre cette maladie. / The deubiquitinase BAP1 (BRCA1-Associated Protein1) is a nuclear member of the ubiquitin C-terminal hydrolase (UCH) family, previously isolated for promoting the function of the tumor suppressor BRCA1. Importantly, homozygous inactivating mutations of BAP1 have been found in mesothelioma, renal, melanoma and breast cancers strongly suggesting that this deubiquitinase is a tumor suppressor. Indeed BAP1 overexpression reduces cell proliferation and tumor growth in xenograft models. Nonetheless, the biological function and the mechanism of action of this deubiquitinase remain poorly defined. The goals of this thesis are to characterize the biological function of BAP1 and to reveal the molecular basis of its tumor suppressive function. To provide insights into BAP1 biological function, we conducted a tandem affinity immunopurification of BAP1-associated proteins and found that most interacting partners are transcription factors and cofactors. Next, we demonstrated that BAP1 is indeed a transcription regulator. Concomitantly, another group showed that the drosophila BAP1, Calypso, is a Polycomb Group protein that regulates the ubiquitination levels of H2A and gene expression. Indeed, our global gene expression analysis suggests that BAP1 plays important role in DNA damage response. Consistently, loss- and gain- of function experiments (RNAi approach, DT40 chicken B cells KO model and re-introduction of BAP1 in BAP1 null-cells) revealed that BAP1 promotes homologous recombination-mediated DNA double strand break repair. Our data suggest that BAP1 exerts its tumor suppressor function by controlling error-free DNA repair by homologous recombination. Thus, in a situation of BAP1 inactivation, cells might become more reliant on non-homologous end joining, an error-prone DNA repair mechanism, which would result in the accumulation of mutations and chromosomal aberrations, causing genomic instability. Further studies are required to delineate the exact role of BAP1 in transcription and to define how deregulation of H2A ubiquitination pathway contributes to cancer. Defining the mechanisms of tumor suppression is of great interest, not only for understanding cancer development, but also for designing rational cancer therapies.

Les membres de la famille SMC (Structural Maintenance of Chromosomes), présents dans tous les domaines de la vie, sont impliqués dans des processus allant de la cohésion des chromatides-sœurs jusqu’à la réparation de l’ADN. Chacun des membres de cette famille, composée de 6 membres (Smc1 à Smc6), s’associe avec un autre membre ainsi qu’à des sous-unités non-SMC pour former 3 complexes : cohésine, condensine et Smc5-6. L’implication du complexe Smc5-6 dans plusieurs aspects du maintien de l’intégrité génomique est bien démontrée. Néanmoins, une question fondamentale concernant ce complexe demeure encore sans réponse: comment peut-il être impliqué dans autant d’aspects de la vie d’une cellule? Encore à ce jour, il est difficile de répondre à cette question en raison du manque d’information disponible au sujet des activités biochimiques de ce complexe. C’est pourquoi l’objectif de ce travail consiste en la caractérisation biochimique du complexe Smc5-6. La biochimie de cohésine et condensine suggère diverses possibilités en ce qui a trait aux activités biochimiques du complexe Smc5-6. La première étape de mon projet fut donc d’élaborer une procédure pour la purification de Smc5 et Smc6 après surexpression en levure. Après plusieurs expériences, il apparut clair que les deux protéines possèdent une activité de liaison à l’ADN simple brin (ADNsb) ainsi qu’à l’ADN double brins (ADNdb) et que, même si les protéines peuvent se lier aux deux types d’ADN, elles possèdent une plus grande affinité pour l’ADNsb. De plus, ces expériences permirent de démontrer que l’interaction entre Smc5 ou Smc6 et l’ADNsb est très stable, alors que l’interaction avec l’ADNdb ne l’est pas. Suite à l’obtention de ces résultats, la seconde étape fut la détermination de la ou des partie(s) de Smc5 et Smc6 permettant la liaison à l’ADN. Pour répondre à cette question, une dissection moléculaire fut réalisée, suivi d’une caractérisation des différents domaines constituants Smc5 et Smc6. De cette façon, il fut possible de démontrer qu’il existe deux sites de liaison à l’ADN sur Smc5 et Smc6 ; le premier site se trouvant dans le domaine «hinge» ainsi que dans la région adjacente du domaine «coiled-coil» et le second au niveau de la tête ATPase des deux protéines. Bien que les deux domaines puissent lier l’ADNsb, il fut démontré qu’une différence majeure existe au niveau de leur affinité pour ce type d’ADN. En effet, le domaine «hinge» possède une affinité plus forte pour l’ADNsb que la tête ATPase. De plus, cette dernière est incapable de lier l’ADNdb alors que le domaine «hinge» le peut. L’identification des sites de liaison à l’ADN sur Smc5 et Smc6 permettra de créer de nouveaux mutants possédant un défaut dans la liaison à l’ADN. Ainsi, l’étude du complexe Smc5-6 durant la réparation de l’ADN in vivo sera facilité. / The Smc5-6 complex is part of the SMC (Structural Maintenance of Chromosomes) family and is involved in the maintenance of genome integrity. This complex is required for the replication and repair of DNA. Unfortunately, the DNA substrates recognized by the Smc5-6 complex are still unknown. To address this gap, I used a biochemical approach to purify and functionally characterize the core of the Smc5-6 complex represented by the two SMC proteins. Subsequently, I wanted to understand which part(s) of Smc5 or Smc6 mediate their binding to DNA. I show here that Smc5 and Smc6 bind to all types of DNA tested. Despite this ability to associate with several types of nucleic acids, they have a clear preference for single-stranded DNA (ssDNA). The ability of Smc5 and Smc6 to link DNA independently of each other suggests that both SMC proteins have the potential to target the Smc5-6 complex to its DNA substrates in vivo. Furthermore, the minimal length of ssDNA required for the binding of Smc5 or Smc6 is between 45 to 75 nucleotides. This length of ssDNA is shorter than the size of ssDNA intermediates created during DNA repair or replication reactions. In addition to having a preference for ssDNA, the binding of both SMC proteins to this type of DNA is stronger than their binding to double-stranded DNA (dsDNA). Finally, the molecular dissection of SMC proteins into functional domains revealed that there are two independent DNA-binding sites on each molecule of Smc5 or Smc6. The first region is located in the hinge domain, while the second region is located in the ATPase head of the protein. The affinity and selectivity of independent domains towards DNA substrates suggest a functional differentiation between the two DNA-binding sites of SMC molecules. Indeed, the hinge domain has a greater affinity for ssDNA than the ATPase head. In terms of selectivity, the hinge domain is capable of binding to dsDNA whereas the ATPase head cannot. Taken together, our identification of the DNA-binding domains on Smc5 and Smc6 will enable the creation of new mutants with a defect in their DNA-binding activity. Thus, the study of the Smc5-6 complex during DNA repair, in vivo, will be facilitated.

DNA is wrapped around proteins called histones, whose modification regulates numerous cellular processes. Therefore it is not surprising that mutations in the genes that modify the histones are frequently associated with human cancer. For example, mutations in SETD2, encoding the sole enzyme that catalyses histone H3 lysine 36 trimethylation (H3K36me3), occur frequently in multiple cancer types. This identifies H3K36me3 loss as an important event in cancer development, and also as a potential therapeutic target. This thesis investigates the following questions: (1) how does the loss of H3K36me3 contribute to cancer development; and (2) what therapy can be used to kill cancers that have already lost H3K36me3. To answer the first question, this thesis shows that H3K36me3 facilitates the accurate repair of DNA double-stranded breaks (DSBs) by homologous recombination (HR). H3K36me3 promotes HR by recruiting CtIP to the site of DSBs to carry out resection, allowing the binding of HR proteins (such as RPA and RAD51) to the damage sites. Thus it is proposed that error-free HR repair within H3K36me3-decorated transcriptionally active genomic regions suppresses genetic mutations which could promote tumourigenesis. To answer the second question, this thesis reveals a clinically relevant synthetic lethal interaction between H3K36me3 loss and WEE1 inhibition. WEE1 inhibition selectively kills H3K36me3-deficient cells by inhibiting DNA replication, and subsequent fork stalling results in MUS81 endonuclease-dependent DNA damage and cell death. The mechanism is found to be synergistic depletion of RRM2 (ribonucleotide reductase small subunit), the enzyme that generates deoxyribonucleotides (dNTPs). This work reveals two pathways that regulate RRM2: one involves transcriptional activation of RRM2 by H3K36me3, and the other involves RRM2 degradation regulated by Cyclin-Dependent Kinase, CDK1 (which is controlled by WEE1, CHK1 and ATR). Based on this mechanism, the synthetic lethal interaction is expanded, from between two genes, to between two pathways. Supported by in vivo experiments, the study suggests that patients with cancers that have lost H3K36me3 could benefit from treatment with the inhibitors of WEE1, CHK1 or ATR.

Grandes perdas de tecido neural não permitem a reparação por meio de anastomose primária. Nesses casos, a auto-enxertia de nervo é considerado o melhor tratamento. A despeito de um tratamento cirúrgico adequado, déficits funcionais são observados e melhoras quanto à recuperação funcional e diminuição das seqüelas são desejáveis. Várias são as técnicas que almejaram esse propósito. A interposição de condutores tubulares, como ponte entre os cotos proximal e distal do nervo seccionado, apresenta-se como uma técnica alternativa que oferece vantagens teóricas. A veia é um material estudado como possível condutor tubular avaliado experimentalmente e em casos clínicos. Estudos recentes têm dado importância na utilização de transplantes de tecidos armazenados em banco de tecidos. O glicerol é utilizado para preservação de tecidos, tendo sido relatado seu uso em nervos e vasos. Entretanto, não há relatos da utilização de veias preservadas em glicerol como substituto de enxerto de nervo. O objetivo deste trabalho foi comparar, em ratos, o grau de regeneração neural, utilizando análise histológica e análise funcional, obtida com a interposição de enxerto autógeno de nervo, veia autógena, veia autógena preservada em glicerol e veia alógena preservada em glicerol. Com técnica microcirúrgica, foram criados defeitos de 5 mm do nervo fibular de ratos da raça Lewis. Os animais foram divididos em quatro grupos de seis, de acordo com o tratamento empregado para correção do defeito: nos animais do Grupo A (grupo controle), foi realizado o reposicionamento do fragmento de nervo retirado (auto-enxerto); nos animais do Grupo B, foi interposto um segmento de 1 cm de veia jugular externa autógena; nos animais do Grupo C, foi interposto a veia jugular externa autógena preservada em glicerol a 98% a 4ºC por sete dias; no Grupo D os animais doadores foram ratos da raça Sprague-Dawley que tiveram a veia jugular externa preservada em glicerol de forma igual ao Grupo C e utilizadas para reconstrução do defeito neural em ratos da raça Lewis, sendo considerado um enxerto alógeno preservado em glicerol. Os animais foram sacrificados após seis semanas para realização dos estudos histológicos. Para a avaliação da recuperação funcional foram estudados os padrões de deambulação dos ratos (\"walking track analysis\") no pós-operatório imediato, 3 e 6 semanas de pós-operatório. O grupo controle (auto-enxerto) apresentou resultados histológicos semelhantes aos grupos de veias preservadas em glicerol (autógena e alógena), entretanto apresentou uma maior reação tecidual perineural e maior presença de escape axonal se comparada a todos os grupos. A utilização de veia autógena sem preservação demonstrou padrão histológico com maior neoangiogênese e áreas de rarefação axonal com presença de tecido conectivo no estroma neoformado. O padrão histológico foi semelhante nos demais grupos. O grupo que utilizou veia autógena (sem glicerol) apresentou menor recuperação funcional quando comparado com os demais grupos para 3 e 6 semanas. O resultado funcional foi estatisticamente semelhante entre os grupos de veias preservadas (autógena e alógena) e o auto-enxerto. / Great losses of neural tissue cannot be repaired by primary conventional suturing. In such cases, nerve autografting is considered to be the treatment of choice. In spite of adequate surgical treatment, functional deficits occur. Also, improvement in functional recuperation and decrease in sequelae are expected. There are many techniques aiming at this purpose. The interposition of tubular conduits, as a bridge between the ends of a sectioned nerve, among these the vein graft, is an alternative technique which offers theoretical advantages. The vein is a studied material as possible evaluated tubular conductor experimentally and in clinical cases. Recent studies have given importance in the use of tissues transplants stored in banks. Glycerol is used for tissue preservation, having been told to its use in nerves and vessels. However, it does not have studies of the use of glycerol reserved veins in as substitute of nerve graft. The purpose of this study was to compare, in rats, the neural regeneration degree, using histological analysis and functional analysis, obtained after interposition of a nerve graft, autogenous vein, autogenous vein preserved in glycerol and allograft vein preserved in glycerol. A 5 mm neural gap in the fibular nerve of rats (Lewis breed) has been created under microsurgical techinique. Four groups of six animals each have been divided according to the treatment employed: Group A - control group: replacement of the fibular nerve itself (autograft); Group B - a 1omm segment of external jugular vein was interposed; Group C - a preserved external jugular vein in glycerol 98% per 7 days was interposed in the fibular nerve gap; Group D - external jugular vein preserved in glycerol of Sprague-Dawley rats had been used equal form to group C in Lewis rats. The animals had been sacrificed after 6 weeks for accomplishment of the histological studies. The functional walking track analysis was performed after in the pre-op, and in the pos-op (immediately, 3 and 6 weeks). The control group (autograft) presented similar histological results to the groups of glycerol preserved veins (autogenous vein and allograft vein), however it presented a bigger perineural tecidual reaction and bigger presence of escape axonal if compared with all the groups. The use of autogenous vein without preservation demonstrated histological results with greater neoangiogenesis and presence of connective tissue inside the neo-formed stroma. Histological pattern was similar to other studied groups. The group that used autogenous vein (without glycerol) presented little functional recovery for 3 and 6 weeks. No statistical difference was seen between groups A (autograft) and groups C and C(preserved veins) in the degree of functional recovery.

A auto-enxertia de nervo é considerado o melhor tratamento para a restauração de grandes perdas de nervo periférico. Mesmo com o tratamento cirúrgico adequado, déficits funcionais são observados e melhoras quanto à recuperação funcional e diminuição das seqüelas são desejáveis. Várias são as técnicas que almejaram esse propósito. A interposição de condutores tubulares, como ponte entre os cotos proximal e distal do nervo seccionado, apresenta-se como uma técnica alternativa que oferece vantagens teóricas. A veia é um material estudado como possível condutor tubular avaliado experimentalmente e em casos clínicos. Estudos recentes têm dado importância na utilização de transplantes de tecidos armazenados em banco de tecidos. O glicerol é utilizado para preservação de tecidos, tendo sido relatado seu uso em nervos e vasos. Entretanto, não há relatos da utilização de veias preservadas em glicerol como substituto de enxerto de nervo. O objetivo deste trabalho foi comparar, em ratos, o grau de regeneração neural, utilizando análise histológica qualitativa e quantitativa e a recuperação funcional, obtida com a interposição de enxerto autógeno de nervo, veia autógena, veia autógena preservada em glicerol e veia alógena preservada em glicerol. Com técnica microcirúrgica, foram criados defeitos de 5 mm do nervo fibular de ratos da raça Lewis. Os animais foram divididos em quatro grupos de seis, de acordo com o tratamento empregado para correção do defeito: nos animais do Grupo A (grupo controle), foi realizado o reposicionamento do fragmento de nervo retirado (auto- enxerto); nos animais do Grupo B, foi interposto um segmento de 1 cm de veia jugular externa autógena; nos animais do Grupo C, foi interposto a veia jugular externa autógena preservada em glicerol a 98% a 4ºC por sete dias; no Grupo D os animais doadores foram ratos da raça Sprague-Dawley que tiveram a veia jugular externa preservada em glicerol de forma igual ao Grupo C e utilizadas para reconstrução do defeito neural em ratos da raça Lewis, sendo considerado um enxerto alógeno preservado em glicerol. Os animais foram sacrificados após seis semanas para realização dos estudos histológicos. Para a avaliação da recuperação funcional foram estudados os padrões de deambulação dos ratos (walking track analysis)no pós-operatório imediato, 3 e 6 semanas de pós-operatório. O grupo controle (auto-enxerto) apresentou resultados histológicos semelhantes aos grupos de veias preservadas em glicerol (autógena e alógena), entretanto apresentou uma maior reação tecidual perineural e maior presença de escape axonal se comparada a todos os grupos. A utilização de veia autógena sem preservação demonstrou padrão histológico com maior neoangiogênese e áreas de rarefação axonal com presença de tecido conectivo no estroma neoformado. O padrão histológico foi semelhante nos demais grupos. A análise histológica quantitativa demonstrou estatisticamente menor concentração de axônios regenerados no grupo B (veia autógena) do que a dos demais grupos. O grupo que utilizou veia autógena (sem glicerol) apresentou menor recuperação funcional quando comparado com os demais grupos para 3 e 6 semanas. O resultado funcional foi estatisticamente semelhante entre os grupos de veias preservadas (autógena e alógena) e o auto-enxerto / Nerve autografting is considered the best treatment for the restoration of great losses of peripheral nerve. In spite of adequate surgical treatment, functional deficits occur. Also, improvement in functional recuperation and decrease in sequelae are expected. There are many techniques aiming at this purpose. The interposition of tubular conduits, as a bridge between the ends of a sectioned nerve, among these the vein graft, is an alternative technique which offers theoretical advantages. The vein is a studied material as possible evaluated tubular conductor experimentally and in clinical cases. Recent studies have given importance in the use of tissues transplants stored in banks. Glycerol is used for tissue preservation, having been told to its use in nerves and vessels. However, it does not have studies of the use of glycerol reserved veins in as substitute of nerve graft. The purpose of this study was to compare, in rats, the neural regeneration degree, using qualitative and quantitative histological analysis and functional recovery, obtained after interposition of a nerve graft, autogenous vein, autogenous vein preserved in glycerol and allograft vein preserved in glycerol. A 5 mm neural gap in the fibular nerve of rats (Lewis breed) has been created under microsurgical techinique. Four groups of six animals each have been divided according to the treatment employed: Group A Î control group: replacement of the fibular nerve itself (autograft); Group B Î a 1omm segment of external jugular vein was interposed; Group C Î a preserved external jugular vein in glycerol 98% per 7 days was interposed in the fibular nerve gap; Group D - external jugular vein preserved in glycerol of Sprague-Dawley rats had been used equal form to group C in Lewis rats. The animals had been sacrificed after 6 weeks for accomplishment of the histological studies. The functional walking track analysis was performed after in the pre-op, and in the pos-op (immediately, 3 and 6 weeks). The control group (autograft) presented similar histological results to the groups of glycerol preserved veins (autogenous vein and allograft vein), however it presented a bigger perineural tecidual reaction and bigger presence of escape axonal if compared with all the groups. The use of autogenous vein without preservation demonstrated histological results with greater neoangiogenesis and presence of connective tissue inside the neo- formed stroma. Histological pattern was similar to other studied groups. Quantitative histological analysis showed statistically lower concentration of regenerated axons in group B (autogenous vein) than the other groups.The group that used autogenous vein (without glycerol) presented little functional recovery for 3 and 6 weeks. No statistical difference was seen between groups A (autograft) and groups C and C (preserved veins) in the degree of functional recovery