L’activateur tissulaire du plasminogène (tPA) est une sérine protéase qui est synthétisée principalementpar les cellules endothéliales des vaisseaux. Initialement découvert dans le compartiment vasculaire où sa fonctionprincipale est de participer à la fibrinolyse, le tPA est aussi exprimé dans le parenchyme cérébral par plusieurstypes cellulaires comme les neurones ou les oligodendrocytes. Le tPA est impliqué dans de nombreuses fonctionscérébrales comme la plasticité synaptique ou encore la potentialisation glutamatergique. Le tPA est aussi un acteurclé de la neuroinflammation. Il active la microglie et participe à l’ouverture de la barrière hémato-encéphalique pardes effets de type cytokine et via son domaine protéase en générant de la plasmine à partir du plasminogène. Uneactivité plus importante du tPA est retrouvée dans le liquide céphalorachidien des patients atteints de sclérose enplaques (SEP). De plus, le tPA possède des aspects délétères dans son modèle murin, l’encéphalomyélite autoimmune expérimentale (EAE). Dans le but de mieux comprendre le rôle du tPA dans la physiopathologie de l’EAE,nous nous sommes intéressés à son implication dans la réponse immunitaire pendant la maladie. Nos donnéesmontrent que les animaux tPA-/- ont des scores cliniques moins importants que les animaux WT pendant une EAE.Les nombres absolus de LT CD4+, de microglie activée et de macrophages infiltrés, ainsi que de cellulesdendritiques sont moins importants dans le parenchyme spinal des animaux tPA-/- en comparaison avec lesanimaux WT. En lien avec ces observations in vivo, le tPA augmente in vitro l’activation et la prolifération des LTainsi que la sécrétion d’IL-6 par un mécanisme dépendant du domaine protéase et de la génération de plasmine.Dans des expériences in vitro en collaboration avec l’équipe du Dr Diego Clemente, le tPA induit l’augmentation del’expression des molécules du CMH de classe II et des molécules de costimulation à la surface des cellulesdendritiques et des macrophages par un effet de type cytokine, suggérant une capacité plus importante pour cescellules à présenter des antigènes en présence de tPA. Notre étude apporte une meilleure compréhension du rôledu tPA dans la réponse immunitaire pendant l’EAE et ouvre de nouvelles perspectives dans l’étude de l’axe tPA/plasmine dans la physiopathologie de la maladie. / Tissue plasminogen activator (tPA) is a serine protease, mainly synthesized by endothelial cells of vessels.Initially discovered in the vascular compartment where its main function is to participate to fibrinolysis, tPA is alsopresent in the cerebral parenchyma, and expressed by several cell types like neurons or oligodendrocytes. tPA isinvolved in many physiological brain functions such as synaptic plasticity or glutamatergic potentiation. tPA is alsoa main actor of neuroinflammation. It activates microglia and participates in the opening of the blood-brain barrier(BBB) by cytokine-like effects and via its protease domain and plasmin generation from plasminogen. Interestingly,tPA activity is more important in cerebrospinal fluid of multiple sclerosis (MS) patients. In addition, tPA revealsdeleterious aspects in experimental autoimmune encephalomyelitis (EAE), the mouse model of MS. In order tobetter understand the role of tPA in EAE physiopathology, we focused on its involvement in the immune responseduring disease. tPA-/- EAE animals present less severe clinical scores than WT animals. Our results indicate alsothat absolute numbers of CD4 + T cells, activated microglia and infiltrated macrophages, as well as dendritic cellsare less important in the spinal parenchyma of tPA-/-. In connection with these in vivo observations, our in vitro datashow that tPA increases activation and proliferation of T cells, as well as IL-6 secretion by a protease-dependentmechanism and plasmin generation. In experiments in collaboration with Dr Diego Clemente's team, our data showthat tPA increases the expression of MHC class II and costimulatory molecules on the surface of dendritic cells andmacrophages in vitro by a cytokine-like effect, suggesting a more important ability for these cells to present antigenswith tPA. Our study provides a better understanding of the role of tPA in immune response during EAE, and opensup new perspectives in the study of the tPA / plasmin axis in the physiopathology of the disease.

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B. Tech. (Department of Biotechnology, Faculty of Applied and Computer Sciences), Vaal University of Technology. / Cardiovascular diseases (CVDs) are the leading cause of death worldwide, and the prevalence thereof is on the rise in developing countries due to the demographic transition and urbanization. The inflammatory process, atherosclerosis, is at the root of the majority of CVDs and is caused by unresolved inflammation. Various cardiovascular risk factors such as hyperglycaemia, dyslipidaemia, hypertension, smoking and aging stimulate the development of atherosclerosis through triggering inflammation. Being in a state of chronic low-grade inflammation therefor places an individual at higher risk of developing CVD, with inflammation playing a cause and effect role. The aim of this study was to investigate the inflammatory status of an elderly black South African population by analysis of inflammatory markers HS-CRP, TNF-α and IL-6, as well as the genetic polymorphism C174G associated with increased serum levels of IL-6 in some populations. The research was conducted in the field of Biomedical Sciences as a quantitative, cross-sectional, analytical observational design. The study was ethically approved and involved collection of 84 blood samples from volunteers in a purposively selected population as part of a larger collaborative study. Serum was used to analyse HS-CRP, TNF-α and IL-6 and DNA was extracted from whole blood for analysis of the C174G polymorphism. The median serum HS-CRP of 6.44mg/L (IQR = 2.82 - 9.86mg/L) fell within the highest risk (>5mg/L) of CVD and 75% of participants were at high (3.01-5mg/L) or very high (>5mg/L) risk. The median TNF-α of 0.00pg/mL was within the normal range and only 2.6% of participants had high serum TNF-α levels. The median serum IL-6 level was 1.92pg/mL and was also within the normal range with only 2.6% of participants who had high serum IL-6 levels. For the C174G polymorphism analysis, 98.6% had the GG, 1.4% the GC genotype and no participants had the CC genotype. The median serum IL-6 level of the homozygous GG group was 6.51mg/L, higher than the 4.13mg/L serum IL-6 of the heterozygous GC group. The difference in IL-6 should be considered with caution as only one participant had the C allele. A highly significant (p=0.001) correlation was found between HS-CRP and IL-6, as well as between IL-6 and TNF-α (p = 0.048). The elderly black Sharpeville community is in an increased inflammatory state which puts them at risk of CVD. The prevalence of the C allele in the C174G polymorphism is low in this population. Further research could be conducted as intervention studies to decrease the inflammatory state of the population and influence health policy changes to improve prevention of CVD.

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Objective: Anterior cruciate ligament (ACL) injuries are increasing in adolescents and increase the risk for early-onset knee osteoarthritis (OA). Biomarkers can be a non-invasive measure to assess physiological properties following knee injury or trauma. The objective of this thesis was to i) perform a systematic review to determine the most studied biomarkers of knee healing following ACL reconstruction (ACLR), and age of these patients, and ii) explore the feasibility of measuring these biomarkers in adolescents with ACL injuries. Design: Studies were included if i) participants underwent ACLR, and ii) at least one biomarker of healing was measured. Participant age, sample(s) collected, and biomarker(s) studied were recorded. Interleukin-6 (IL-6), c-terminal crosslinking telopeptide of type II collagen (CTX-II) and procollagen type II collagen propeptide (PIICP) were then measured using ELISA in adolescents prior to ACLR in urine (u) and synovial fluid (sf). Spearman’s Rho (rs) coefficients were calculated to determine the association between uCTX-II/sfCTX-II, and uIL-6/sfIL-6. A ratio of PIICP: CTX-II was calculated to represent the ratio of cartilage synthesis to degradation. Results: The review produced six studies evaluating healing following ACLR. IL-6 and CTX-II were the most studied (3/6 studies), and only one study included adolescents (age 19.6±4.5). Due to multiple undetectable biomarker levels, we could only report rs for uCTX-II/sfCTX-II (rs = -.200, p-value = .800, n=4). We also reported a ratio for sfPIICP: sfCTX-II (23.06 ±19.23). Conclusion: Exploring biomarkers in adolescents was motivated by their unique physiology due to puberty, and this was the first study to do so. The findings from this pilot study indicate that further analysis is required to determine optimal sample preparation. This will allow for reliable results while studying the feasibility of these biomarkers during ACLR recovery. This insight can ensure more informed decision making by clinicians clearing patients for return-to-activity.

Cortisol is a glucocorticoid produced by the zona fasciculata (ZF) of the adrenal cortex. Traditionally, cortisol production and release was seen as being regulated strictly by adrenocorticotropic hormone (ACTH). While this is true of baseline cortisol levels and in response to acute mental stress, the picture is somewhat more complicated in other situations.Interleukin-6 (IL-6) contributes to the maintenance of cortisol levels in situations of prolonged immune or inflammatory stress. AMP activated protein kinase (AMPK) was investigated as a possible mediator of the action of IL-6 or as an independent actor in raising cortisol levels in response to hypoxemic or hypoglycemic stress.5-aminoimidazole-4-carboxamide 1-b-D-ribofuranoside (AICAR) was used to activate AMPK. Bovine ZF tissue fragments were exposed to AICAR alone and together with a known AMPK inhibitor, compound C. Protein or mRNA was then extracted from these tissue fragments. As an indicator of overall steroidogenic activity, these extracts were tested using RT-PCR and western blot assays for relative protein and mRNA levels of steroidogenic acute regulatory (StAR) protein, steroidogenic factor-1 (SF-1), and dosage sensitive sex reversal adrenal hypoplasia congenita gene on the X chromosome, gene 1 (DAX-1). Also a reporter gene assay was performed on H295R cells with a transfected StAR promoter.In bovine ZF tissue fragments, AICAR caused a significant increase of StAR protein and mRNA and SF-1 protein with a decrease of DAX-1 protein in a dose and time dependant manner. DAX-1 mRNA was shown to decrease in response to AICAR administration in a dose dependant manner. AICAR induced increases in StAR protein and SF-1 protein, and the attendant decrease in DAX-1 protein were all shown to be reduced by administration of compound C. This demonstrated that in this situation AICAR is acting through AMPK. When IL-6 was given with compound C the levels of StAR, SF-1, and DAX-1 were significantly reduced from samples treated with IL-6 alone. AICAR exposure also increased StAR promoter activity in a dose and time dependant manner. This AMPK induced increase in steroidogenic activity provides a possible mechanism for increased cortisol during hypoxia and hypoglycemia, and a possible mediator for IL-6 in the ZF.

Le syndrome de détresse respiratoire aiguë (SDRA) est une forme sévère de défaillance respiratoire qui se caractérise par la présence de dommages alvéolaires, d’un oedème pulmonaire et d’une réponse inflammatoire exacerbée. C’est une condition pour laquelle il n’existe à ce jour aucun traitement pharmacologique efficace. Lors des dernières années, des antagonistes des récepteurs de l’IL-1 (Kineret) et de l’IL-6 (tocilizumab) ont fait preuve d’une efficacité modérée pour le traitement du SDRA causé par la COVID-19. Cependant, leur potentiel thérapeutique en SDRA clinique non causé par la COVID reste à démontrer et les résultats obtenus dans les modèles animaux sont mitigés. Nous avons émis l’hypothèse que le tocilizumab et le Kineret pourraient améliorer la résolution des différents paramètres du SDRA non causé par la COVID-19. Nous avons aussi posé l’hypothèse que des peptides, antagonistes des récepteurs de l’IL-1 (rytvela) ou de l’IL- 6 (HSJ633) et permettant de préserver certaines voies aux propriétés cytoprotectrices en aval de ces récepteurs, pourraient potentiellement être plus efficaces que le Kineret et le tocilizumab pour le traitement des paramètres du SDRA. L’objectif de ma maîtrise était donc de tester ces deux hypothèses dans un modèle murin d’atteinte pulmonaire aiguë (ALI) induite par la bléomycine, qui mime pendant sa phase aiguë les principaux paramètres du SDRA. Mes travaux montrent qu’aucun des quatre antagonistes n’a permis d’améliorer significativement les paramètres observés à jour 7 post-bléomycine (état général, dommages alvéolaires, oedème et inflammation pulmonaire). Ainsi, mes données suggèrent que dans notre modèle d’ALI induit par la bléomycine, la réponse inflammatoire induite via le IL-1R ou le IL-6R ne semble pas constituer un des mécanismes principaux engendrant les différentes atteintes, puisqu’elles ne sont pas prévenues par les antagonistes de ces récepteurs. En plus de contribuer à mieux comprendre ce modèle animal, mes résultats permettent de mettre en lumière que la réparation des dommages ainsi que la résorption secondaire de l’oedème sont cruciales pour la résolution du SDRA et que de viser seulement la voie inflammatoire est insuffisant. / Acute respiratory distress syndrome (ARDS) is a form of severe lung failure characterized by the presence of a pulmonary edema, an inflammatory response, and alveolar damage. There is currently no effective pharmacological treatment for ARDS. In recent years, IL-1 and IL-6 receptor antagonists Kinerert and tocilizumab, respectively, have shown some efficacy as a treatment of ARDS caused by COVID-19. However, their therapeutic potential in non-COVID ARDS remains to be proven and the results obtained in animal models are conflicting. We thus tested the hypothesis that tocilizumab and Kineret could improve the resolution of key parameters of non-COVID ARDS. We also hypothesized that two peptides, rytvela and HSJ633, IL-1 and IL-6 receptor antagonists, respectively, which preserve some of the cytoprotective downstream pathways, could potentially be more effective than Kineret and tocilizumab in treating the various parameters of ARDS. The goal of my master thesis was therefore to test these two hypotheses in a mouse model of acute lung injury (ALI) induced by bleomycin instillation, which, during its acute phase, mimics the main parameters of ARDS. My work has shown that none of the antagonists were able to significantly improve the parameters observed on day 7 post-bleomycin (general condition of the mice, alveolar damages, pulmonary edema and inflammation). Thus, my data suggest that in our bleomycin-induced ALI model, the inflammatory response triggered via IL-1R or IL-6R does not appear to be the principal mechanism generating the main damaging outcome, since they are not prevented by the antagonists of these receptors. In addition to contributing to a better understanding of this animal model of ALI, my research has highlighted the fact that targeting inflammation alone is insufficient and that repairing alveolar damages, and secondary resorbing lung edema, are cornerstones for the resolution of ARDS.