A study of hyperglycemia and its effects on endothelial activation, macrophage recruitment, and atherosclerotic plaque development in mice. Hyperglycemic mice demonstrated greater VCAM but not ICAM expression along the endothelium, increased macrophage presence within the subendothelial space of these regions, and a greater volume of plaque in adulthood. / Cardiovascular disease is the leading cause of death in the world today. Atherosclerosis is the formation of plaque in the arteries and a major underlying cause of these fatalities. Type I and II diabetes are each strong independent risk factors for atherosclerosis. This study examines the effects of hyperglycemia on early atherosclerosis. Hyperglycemia did not promote atherosclerosis in the absence of hypercholesterolemia. Hyperglycemic mice demonstrated greater VCAM, but not ICAM, expression in regions of the endothelium susceptible to atherogenesis, prior to initiation of plaque development. Regions correlating to upregulation of VCAM exhibited a greater quantity of macrophages infiltrating the intima. This study suggests a unique and important role for VCAM in early atherosclerotic development and may explain the accelerated atherosclerotic plaque progression seen in hyperglycemic mice. This study also identifies VCAM as a potential target for the development of therapies to block or slow atherosclerotic plaque development in people with diabetes. / Thesis / Master of Science (MSc) / Cardiovascular disease is the leading cause of death in the world today. A major underlying cause of cardiovascular disease is atherosclerosis – a condition involving the thickening of the artery wall. Type I and II diabetes are each strong independent risk factors for atherosclerosis. The purpose of this study is to examine the effects of high blood glucose (hyperglycemia) on early events leading to atherosclerosis. This study found that hyperglycemia was not sufficient to promote atherosclerosis unless plasma cholesterol levels were also elevated. Hyperglycemia appeared to induce atherosclerosis by increasing the expression of factors responsible for recruiting white blood cells to the artery wall. This is consistent with the observation that hyperglycemic mice also had significantly more macrophages in the sites of plaque development. This study implicates one macrophage-recruitment factor in particular, vascular cell adhesion molecule (VCAM), as playing an important and unique role in the initiation of atherosclerosis by hyperglycemia. Therefore, VCAM is a possible target for the development of therapies to block or slow the development of atherosclerosis in individuals with diabetes.

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Einführung - Periphere Blutmonozyten spielen eine Rolle in der Pathogenese der Arteriosklerose. Bei spontan hypertensiven Ratten wurden im Vergleich zu normotonen Wistar-Kyoto-Ratten signifikant erhöhte Zahlen aktivierter Monozyten beobachtet [Liu 1996]. Wir untersuchten Monozyten von Patienten mit essentieller Hypertonie und von gesunden Probanden hinsichtlich möglicher Unterschiede in der Aktivierung anhand ihrer Adhäsion an von uns kultivierte (HAEC) und isolierte (HSVEC, HUVEC, HUAEC) humane Endothelzellen. Wir bestimmten die Adhäsionsmoleküle ICAM-1, VCAM-1 sowie E-Selektin und analysierten die Superoxidfreisetzung von humanem Endothel und Monozyten. Methoden - Humane periphere Blutmonozyten wurden mittels Dichtegradienten-zentrifugation und Plastikadhärenz isoliert und mit LPS, Angiotensin II (Ang II), und Ang II nach Vorinkubation mit dem AT1-Antagonisten Eprosartan stimuliert. Die Monozyten wurden auf einschichtigem Endothel ausgesät und die Adhäsion als Prozentsatz der initial gesäten Zellen erfasst. Die durch PMA induzierte Superoxidfreisetzung des Endothels oder der Monozyten wurde mittels Chemilumineszenz bestimmt. Ergebnisse - Monozyten von Patienten mit essentieller Hypertonie hefteten sich im Vergleich zu gesunden Probanden spontan und nach Stimulation mit Ang II signifikant verstärkt an HAEC und HUVEC-Monolayer an. Die Spiegel von ICAM-1 und VCAM-1 waren bei Patienten mit arterieller Hypertonie im Vergleich zu den gesunden Kontrollpersonen signifikant erhöht. Die Chemilumineszenzaktivität postkonfluenter Endothelzellen erhöhte sich nach Stimulation mit Ang II im Vergleich zur Messung ohne vorherige Stimulierung. Nach Stimulation mit PMA oder mit Ang II wurden bei Hypertonikern signifikant höhere Werte für die Chemilumineszenzaktivität der Monozyten gemessen als bei gesunden Kontrollpersonen. Schluss - Mit diesen Versuchen an humanen Monozyten und Endothelzellen wurde ein weiterer Beweis für die Aktivierung der Monozyten von Patienten mit essentieller Hypertonie erbracht. Meine Ergebnisse unterstützen die Sicht einer Monozytenbeteiligung an der Pathogenese atherosklerotischer Läsionen, die mit arterieller Hypertonie in Zusammenhang stehen. / Introduction - Peripheral blood monocytes are involved in the pathogenesis of atherosclerosis. Significantly elevated numbers of activated monocytes were observed in spontaneously hypertensive rats compared to those in normotensive Wistar-Kyoto rats [Liu 1996]. We isolated and cultivated human endothelial cells and examined monocytes from patients with arterial hypertension and healthy volunteers to identify possible differences in their adhesion behavior to human endothelial cells (HAEC, HSVEC, HUVEC, HUAEC). We determined the levels of ICAM-1, VCAM-1 and E-selectin, and we analyzed superoxide release by human endothelium and human monocytes. Methods - Peripheral blood monocytes were isolated by density gradient centrifugation and plastic adherence. Subsets of the samples were stimulated with LPS, Angiotensin II, Angiotensin II following preincubation with the AT1-antagonist eprosartan or left without a stimulant. After incubation, monocytes were seeded onto confluent monolayers of human aortic endothelial cells and the adhesion was determined as the percentage of the initially seeded cells. Oxygen species release induced by PMA was analyzed for endothelium and monocytes in suspension by chemiluminescence. Results - Peripheral blood monocytes of patients with essential hypertension performed a significantly increased spontaneous adhesion and adhesion following stimulation with Angiotensin II to HAEC- and HUVEC-monolayers. Levels of human soluble adhesion molecules ICAM-1 and VCAM-1 were significantly raised in hypertensive patients. Chemiluminescence activity of post confluent endothelial cells was increased after stimulation with Angiotensin II compared to the measurement before stimulation. Following stimulation with PMA or Angiotensin II, significantly higher chem-iluminescence levels were measured in hypertensive patients compared to healthy volunteers. Conclusion - These data indicate that monocytes of patients with essential hypertension may be preactivated. My results support the view of a monocyte involvement in the pathogenesis of atherosclerotic lesions that are related to arterial hypertension.

Follicular dendritic cells (FDCs) reside in primary B-cell follicles and in the light zones of germinal centers (GCs) in secondary follicles, where their dendrites interdigitate forming extensive networks intimately interacting with B-cells. In GCs, FDCs can be found at the edges attached to the supporting reticular fibers. They trap and arrange immune complexes (ICs) in vivo and in vitro in a periodic manner with 200–500Å spacing and provide both antigen-specific and non-specific accessory signals to B-cells. FDCs exist in resting and activated states, with two characteristically different phenotypes. In their activated state, FDCs upregulate the expression of accessory molecules and cytokines important in the FDC-B cell interaction in GCs. We sought to determine the mechanisms influencing the transition of FDCs from a resting to an activated state in GCs and their impact on T-cell dependent (TD) and independent (TI)-GC reactions (GCRs). We found that IC-FDC interactions via FDC-FcgammaRIIB induce the upregulation of FDC-FcgammaRIIB, -ICAM-1, and -VCAM-1, at both the protein and mRNA levels. We also reported for the first time the expression of TLR-4 on FDCs. Moreover, engagement of FDC-TLR4 with LPS activated NF-kappaB, up-regulated expression of important FDC-accessory molecules, including FcgammaRIIB, ICAM-1, and VCAM-1, and enhanced FDC accessory activity in promoting recall IgG responses. Moreover, IC-activated FDCs produced IL-6 and FDC-IL-6 promoted GCRs, somatic hypermutation (SHM) and IgG production. Further, we reported that binding of FDCs to collagen coated surfaces induced restoration of their dendritic processes and networks in vitro. In addition, we designed an FDC-supported in vitro model capable of induction and assessment of primary human antibody responses to protein antigens characterized by class-switching and affinity maturation. Uniquely, we generated TI immune responses to TD protein Ags in the complete absence of T cell help in vivo and in vitro. In the presence of FDC-associated second signals such as BAFF and C4BP, FDC- FcgammaRIIB-periodically trapped-ICs induced the production of Ag-specific IgM, GC-development and plasmablast-differentiation in anti-Thy-1-pretreated nude mice. Purified murine and human B cells cultured in vitro with IC-bearing FDCs also showed the production of antigen–specific IgM within just 48 h.

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La sclérose en plaques (SP) est une maladie neuro-inflammatoire caractérisée par l’invasion de cellules immunitaires périphériques dans le système nerveux central (SNC), entraînant une perte de myéline à des endroits bien délimités appelés « plaques » ou lésions. Les processus neuroinflammatoires sont associés au dommage des neurones et oligodendrocytes (OLs) en SP. Les mécanismes sous-tendant cette dégradation des OLs par les cellules immunitaires en SP sont toutefois encore mal compris. Les lymphocytes T CD4 activés, notamment les sous-types proinflammatoires Th1 et Th17, jouent un rôle clé dans la pathobiologie de la SP et de son modèle murin l’encéphalite auto-immune expérimentale (EAE). Nous avons donc choisi d’investiguer leur contribution à l’endommagement des OLs en neuroinflammation. Pour ce faire, nous avons premièrement caractérisé les interactions entre les lymphocytes Th17 et les OLs matures in vivo à l’aide de l’imagerie intravitale chez la souris EAE (microscopie deux photons) et in vitro en utilisant des cultures primaires humaines. Ceci nous a permis de mettre en évidence que les lymphocytes pro-inflammatoires Th17 adhèrent de façon prolongée aux OLs et leur causent plus de dommage que les lymphocytes anti-inflammatoires Th2. Après avoir établi que le contact avec les lymphocytes Th17 entraîne tout d’abord la perte des prolongements cellulaires puis la mort des OLs, nous avons identifié deux mécanismes à l’origine de ces dommages. En effet, tandis que la sécrétion de glutamate par les lymphocytes Th17 à proximité des OLs entraîne une perte des prolongements cellulaires de ces derniers et une diminution de leur capacité à myéliniser, la sécrétion de granzyme B mène à la mort des OLs. Dans le but de comprendre comment prévenir les dommages causés par les lymphocytes Th17 aux OLs en SP, nous avons par la suite étudié les mécanismes sous-tendant le contact entre les deux types cellulaires. Comme nous avons confirmé que les OLs matures n’expriment pas le MHC II au niveau protéique, nous avons caractérisé l’expression par les OLs de molécules d’adhérence cellulaire (CAMs) qui seraient susceptibles de sous-tendre l’adhérence des lymphocytes Th17. Nous avons découvert que cette interaction est notamment médiée par ALCAM, et que bloquer cette molécule permet de diminuer le dommage aux OLs médié par les Th17 in vitro. A l’inverse, l’expression et/ou la sécrétion d’ICAM-1 par les OLs semble avoir un effet protecteur face aux lymphocytes Th17. En résumé, nous avons distingué de nouveaux mécanismes impliqués dans le dommage aux OLs en neuroinflammation et identifié de nouvelles cibles thérapeutiques prometteuses pour la protection des OLs en SP. / Multiple Sclerosis (MS) is a neuroinflammatory disease characterized by infiltration of immune cells into the central nervous system (CNS), demyelination in multifocal areas called “plaques” or lesions, and damage to neurons and oligodendrocytes (OLs). The mechanisms underlying immune-mediated injury to OLs in MS remains only partially understood. Activated CD4 T cells, in particular pro-inflammatory subsets Th1 and Th17, play an important role in the pathobiology of MS and its animal model experimental autoimmune encephalitis (EAE). We set out to investigate their contribution to immune-mediated oligodendrocytic damage in neuroinflammation. We first characterized the interactions between Th17 cells and mature OLs in vivo using live imaging of EAE mice (two photon microscopy) and in vitro using human primary cell cultures. We found that pro-inflammatory Th17 cells form prolonged contacts with OLs and cause greater harm compared to anti-inflammatory Th2 cells. After demonstrating that contact with Th17 cells leads first to destruction of cell processes and then death of OLs, we identified two mechanisms underlying these deleterious impacts. Indeed, while secretion of glutamate by Th17 cells in contact with OLs is associated with damage to OLs cell processes and impairment of their myelinating capacity, secretion of granzyme B leads to OLs death. To better understand how to prevent Th17-mediated OLs injury in MS, we next studied mechanisms involved in the interaction between these two cell types. As we confirmed that mature OLs do not express MHC II at the protein level, we characterized expression of cell adhesion molecules (CAMs) by OLs that could mediate Th17 cell adhesion. We discovered that ALCAM contributes to OLs and Th17 cells interactions, and that blocking this olecule reduces Th17-mediated OL damage in vitro. Inversely, ICAM-1 expression and/or secretion by OLs seems to have a protective effect in neuroinflammatory conditions. In summary, we have uncovered new mechanisms implicated in OLs njury in neuroinflammation and have identified potential novel therapeutic targets for neuroprotection in MS.

Part I. The aldosterone synthase gene (CYP11B2) polymorphism T-344C in blood pressure and left ventricular hypertrophy. BACKGROUND: Aldosterone is a key cardovascular hormone, it significantly influences volume, pressure and electrolyte balance. Aldosterone plays an important role in development of left ventricular (LV) hypertrophy and myocardial fibrosis. The aldosterone synthase gene (CYP11B2) is an important candidate gene region in essential hypertension. DESIGN AND METHODS: We assessed the influence of the T-344C polymorphism of aldosterone synthase - the rate-limiting enzyme in aldosterone biosynthesis - on the structure of the left ventricle in young normotensive men. The population included 113 normotensive mid-European Caucasian men aged 18-40 years (mean 27 +/- 5 years). We also studied the association of -344T/C polymorphism of the CYP11B2 gene with the presence and severity of hypertension in 369 individuals, of whom 213 were hypertensive patients (139 controlled hypertensive, 74 resistant hypertensive) and 156 were healthy normotensive subjects. The genotype was assessed using polymerase chain reaction with subsequent cleavage with restriction enzyme HAEIII (restriction fragment length polymorphism method) and visualization with ethidium bromide. Plasma renin activity (PRA) and plasma...