Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-12-06T20:11:07Z No. of bitstreams: 1 IonePereira.pdf: 4313615 bytes, checksum: b4b18d96e95ccf2676273520e2380e31 (MD5) / Made available in DSpace on 2017-12-06T20:11:07Z (GMT). No. of bitstreams: 1 IonePereira.pdf: 4313615 bytes, checksum: b4b18d96e95ccf2676273520e2380e31 (MD5) Previous issue date: 2017-03-09 / CAPES / FAPEMA / INCT / The transient receptor potential ankyrin 1 (TRPA1) is a non-selective Ca+2 channel expressed on neuronal and non-neuronal cells, and mediates pain and inflammation; being implicated in rheumatoid arthritis (RA). Here, we evaluated the expression of TRPA1 on peripheral blood leukocytes obtained from RA patients, as well as its correlation with pain and disability, in addtition to the immune alterations in RA patients treated or not with antirheumatic drugs: the disease-modifying angent leflunomide (LFN) and the anti-TNFα adalimumab (ADA); in comparison with healthy subjects. Peripheral blood samples were taken from 15 healthy subjects (controls), 10 RA patients not undertaking anti-rheumatic therapy (NST), 15 patients treated with LFN and 15 patients treated with ADA. C reactive protein (CRP), rheumatoid factor (FR), hydrogen peroxide (H2O2), 4-hydroxynonenal (4- HNE) and tumour necrose factor α (TNFα) levels were quantified. Also, leukocyte subpopulations, the number of red blood cells, the levels of haemoglobin and the expression of TRPA1 on peripheral blood leukocytes, were evaluated. TRPA1 expression was increased on NST leukocytes and this was correlated with pain and disability and was associated with the number of polymorphonuclear cells and the activation of CD14+ cells. It was also demonstrated that treatment with either LFN or ADA attenuates anaemia in AR, with those treatments being effective in treating both the intra- and extra-articular disease. Overall, our data showns that TRPA1 influences pain and disability in RA and that its expression is reduced in patients treated with LFN or ADA. These evidences, together with the promissing data on the anti-rheumatic therapy in reducing anaemia in RA patients suggest that these drugs are effective in treating both the intra- and extra-articular alterations of RA. / O receptor de potencial transitório anquirina 1 (TRPA1) é um canal não seletivo para Ca+2 , expresso em neurônios sensoriais e células não neuronais, o qual medeia a transdução da dor e a inflamação; tendo sido implicado na artrite reumatoide (AR). Este trabalho avaliou a expressão de TRPA1 em leucócitos de sangue periférico de pacientes com AR, bem como sua correlação com a dor e a prda de função articular, além de alterações imunes encontradas em indivíduos com AR recebendo ou não terapia anti-reumática com o modificador da doença leflunomida (LFN) e ou o anti-TNFα adalimumab (ADA); em comparação à indivíduos sadios. Amostras de sangue foram coletadas de 15 indivíduos sadíos (controle), 10 pacientes artríticos não submetidos à terapia anti-reumática específica (NST), 15 pacientes tratados com LFN e 15 pacientes tratados com ADA. Os níveis circulantes de proteína C reativa (PCR), fator reumatóide (FR), peróxido de hidrogênio (H2O2), 4-hidroxinonenal (4-HNE) e fator de necrose tumoral (TNFα) foram quantificados. Ainda, avaliou-se as populações de leucócitos, o número de hemácias, os níveis de hemoglobina e a expressão de TRPA1 em leucócitos do sangue periférico. Observou-se que a expressão de TRPA1 em leucócitos de sangue periférico está aumentada em pacientes NST, e que isto está associado ao aumento do número de células polimorfonucleares e à ativação de células CD14+ . Ainda, a expressão de TRPA1 correlaciona-se com a dor e disfunção articular, alterações estas, que encontram-se reduzidas em pacientes tratados com LFN e ADA. Demonstrou-se ainda que o tratamento com LFN ou ADA previne a anemia relacionada à AR, sendo efetivos tanto no tratamento das alterações intra quanto extra articulares decorrentes da doença.. Em conjunto, os dados demonstram que o TRPA1 influencia a resposta dolorosa e a disfunção articular da AR, e que sua expressão é reduzida pelo tratamento com LFN ou ADA. Estas evidências, aliadas com dados promissores na redução da anemia dos pacientes artríticos sugerem que o tratamento com estas drogas anti-reumáticas é efetivo no tratamento de manifestações intra- e extra-articulares da AR

Les états septiques demeurent un réel problème de santé publique. Depuis 20 ans, leur mortalité est restée globalement constante en dépit d'une meilleure prise en charge initiale des patients et de nombreux essais cliniques. Parmi les défaillances d'organes provoquées par les états septiques, une profonde immunodépression se met en place après la phase initiale de la maladie. Son amplitude et sa persistance dans le temps, variables d'un patient à l'autre, semblent associées à un risque accru d'infections nosocomiales et de décès secondaire. Aussi, un des challenges actuels est d'explorer de nouvelles pistes thérapeutiques immunostimulantes pour les patients septiques les plus immunodéprimés. En l'absence de signe clinique de cet état, l'identification et la validation de nouveaux biomarqueurs contribuera sans doute à la mise en place de thérapies ciblées et individualisées. Notre travail s'inscrit dans ce contexte. L'objectif était d'utiliser le niveau d'expression génique comme outil de monitorage clinique et de recherche en physiopathologie. Nous avons donc conduit un travail de recherche translationnelle alliant études cliniques (lymphopénie, apoptose) et expérimentales basées sur un modèle de tolérance à l'endotoxine dans lequel nous avons testé différentes options thérapeutiques. Nous avons validé l'hypothèse de travail en montrant qu'un panel d'ARNm, mesurable dans le sang total des patients, devrait permettre à la fois d'identifier les patients qui pourraient bénéficier de thérapeutiques immunostimulantes et d'en contrôler l'efficacité dans la restauration des fonctions immunitaires / Septic syndromes remain a real public health issue. For 20 years, despite improvements in early management of patients and despite a number of clinical trials, the rate of mortality due to septic syndrome has remained broadly constant. After the initial phase of sepsis, patients rapidly exhibit profound immunodepression. Amplitude and duration of this state vary between patients and appear to be associated with increased risk of nosocomial infections and secondary deaths. One of the current challenges is to develop novel immunostimulant therapeutics for the most immunocompromised septic patients. Development of biomarkers will allow patient stratification and will undoubtedly contribute to the development of appropriately targeted and individualized therapies. The goal of our study was to evaluate the potential of gene expression level for clinical monitoring and for research in pathophysiology. We conducted translational research by combining experimental data with clinical studies (lymphopenia, apoptosis). We used endotoxin tolerance as a model to test different therapeutic options. Our data confirmed that expression levels of a panel of mRNAs, measured in the whole blood of patients, is a powerful tool for patient stratification and the monitoring of the effect of immunostimulant therapy on the immune system