<p>Nitric oxide (NO) is an endogenous gaseous signaling molecule produced by three NO synthase isoforms (NOS1, 2, 3) and important in host defense. The induction of NOS2 during bacterial sepsis is critical for pathogen clearance but its sustained activation has long been associated with increased mortality secondary to multiple organ dysfunction syndrome (MODS). High levels of NO produced by NOS2 incite intrinsic cellular dysfunction, in part by damaging macromolecules through nitration and/or nitrosylation. These include mitochondrial DNA (mtDNA) and enzymes of key mitochondrial pathways required for maintenance of normal O2 utilization and energy homeostasis. However, animal studies and clinical trials inhibiting NOS2 have demonstrated pronounced organ dysfunction and increased mortality in response to live bacterial infections, confirming that NOS2 confers pro-survival benefits. Of particular interest here, the constitutive NOS1 and NOS3 have been linked to the up-regulation of nuclear genes involved in mitochondrial biogenesis but no comparable role has been described for NOS2. <italic> Therefore, I hypothesized that NOS2 is indispensible for host protection but must be tightly regulated to ensure NO levels are high enough to activate mitochondrial and other pro-survival genes, but below the threshold for cellular damage.</italic></p><p>This hypothesis was explored with two major Aims. The <italic>first Aim</italic> was to define the role of NOS2 in the activation of mitochondrial biogenesis in the heart of <italic>E. coli</italic>-treated mice. The <italic>second</italic> was to investigate the ability of NOS2 to be transcriptionally regulated by an enzyme previously shown to induce mitochondrial biogenesis, heme oxygenase-1 (HO-1). This hypothesis was tested using an <italic>in vivo</italic> model of sublethal heat-killed <italic>E. coli</italic> (<italic>HkEC</italic>) peritonitis in C57B/L6 (Wt), NOS2-/-, and TLR4-/- mice. Additionally, <italic>in vitro</italic> systems of mouse AML-12 or Hepa 1-6 cells pretreated with HO-1 activators or <italic>Hmox1</italic> shRNA prior to inflammatory challenge with lipopolysaccharide (LPS) +/- tumor necrosis factor-&alpha; (TNF-&alpha;). For the first Aim, Wt, NOS2-/-, and TLR4-/- mice were treated with (<italic>HkEC</italic> and cardiac tissue analyzed for mitochondrial function, expression of nuclear and mitochondrial proteins needed for mitochondrial biogenesis, and histological expression of NOS2 and TLR4 relative to changes in mitochondrial mass. For the second Aim, Wt mice were pretreated with hemin or carbon monoxide (CO) to activate HO-1 prior to <italic>HkEC</italic>-peritonitis. Liver tissue in these animals was evaluated at four hours for HO-1 induction, <italic>Nos2</italic> mRNA expression, cytokine profiles, and nuclear factor (NF)-&kappa;B activation. Liver cell lines were pretreated with hemin, CO-releasing molecule (CORM), or bilirubin one hour before LPS exposure and the <italic>Nos2</italic> transcriptional response evaluated at two and 24 hours. The MTT assay was used to confirm that <italic>in vitro</italic> treatments were not lethal. </p><p>These studies demonstrated that <italic>HkEC</italic> induced mtDNA damage in the heart that was repaired in Wt mice but not in NOS2-deficient mice. In KO mice, sustained mtDNA damage was associated with the reduced expression of nuclear (NRF-1, PGC-1&alpha;) and mitochondrial (Tfam, Pol-&gamma;) proteins needed for mitochondrial biogenesis. The findings thus supported that NOS2 is required for mitochondrial biogenesis in the heart during Gram-negative challenge. Evaluation of the relationship between HO-1 and NOS2 in murine liver was more complex; HO-1 activation in <italic>HkEC</italic>-treated Wt mice attenuated 4-hour <italic>Nos2</italic> gene transcription. In liver cell lines, hemin, CORM, and bilirubin were unable to suppress <italic>Nos2</italic> expression at the time of maximal induction (2 hours). <italic>Nos2</italic> was, however, suppressed by 24 hours, suggesting that the regulatory impact of HO-1 induction was not engaged early enough to reduce <italic>Nos2</italic> transcription at 2 hours. It is concluded that NOS2 induction in bacterial sepsis optimizes the expression of the mitochondrial biogenesis transcriptional program, which subsequently can also be regulated by HO-1/CO in murine liver. This provides a potential new mechanism by which immune suppression and mitochondrial repair can occur in tandem during the acute inflammatory response.</p> / Dissertation

No description available.

Oxidative stress (OS) plays a critical role in the pathogenesis of atherosclerosis potentially through interaction with nitric oxide (NO) generated by the inducible nitric oxide synthase (iNOS) pathway. Although considerable literature supports a pro-atherogenic role for iNOS-induced NO, recent evidence suggest an anti-atherogenic property for this enzyme where iNOS-induced NO attenuates atherosclerotic lesions after immune injury, enhancing endothelial integrity, survival, protecting against OS-induced apoptosis and necrosis. We therefore hypothesize that iNOS may have a cardio-protective role in the atherosclerotic vessel and that under conditions of OS, expression and function of this enzyme may be impaired, thus contributing to the deleterious consequences of OS. Experiments have therefore been conducted to establish whether pro-oxidants regulate iNOS expression/function in rat cultured aortic smooth muscle cells (RASMCs). These cells were induced for 24 hours with LPS and IFN-γ to mimic inflammatory conditions. Oxidative stress inducers may modulate iNOS-induced NO production through alteration of the expression and/or function of the inducible L-arginine-NO pathway. We examined the effects of hydrogen peroxide (H2O2), antimycin A and diethyl maleate (DEM) on this pathway in vascular smooth muscle cells. H2O2 had little effect on NO production or L-arginine transport while antimycin A and DEM independently caused a concentration dependent inhibition of both processes. Only DEM induced hemeoxygenase-1 (HO-1) expression, monitored by western blotting as a marker of OS. The effects of statins on NO synthesis and L-arginine transport in the presence and absence of OS were also investigated. The benefits of statins therapy in cardiovascular medicine are ascribed in part to their lipid-lowering effect by inhibiting 3-hydroxy-3-methoxyglutaryl coenzyme A (HMG-CoA) reductase, the rate limiting enzyme for cholesterol synthesis. However, statins may possess anti-inflammatory properties and are able to improve endothelial function, stabilize atherosclerotic plaque, and inhibit platelet aggregation, vascular smooth muscle cells proliferation and vessel wall inflammation. These effects may be exerted through novel actions of statins that include interaction with specific signalling pathways in cells which may be associated with the induction of iNOS and/or cationic amino acid transporters (CATs). Thus, we have extended our investigations to include an examination of the effects of statins on both iNOS and CAT function and expression under control conditions and following exposure of cells to OS. Atorvastatin caused a bell shaped response on NO production and iNOS expression and also enhanced L-arginine transport but in a non-concentration dependent manner. Simvastatin only affected NO synthesis without altering transporter activity. Pravastatin was without effect on either system. Further studies demonstrated that that atorvastatin was able to reverse the effects of antimycin A and DEM but only on NO production. These findings confirm that the inducible L-arginine-NO pathway can be downregulated by pro-oxidants. This mechanism may therefore contribute to the deleterious effects observed in disease states associated with OS. Moreover, statins (in particular atorvastatin) appear to be effective in reversing the inhibition of NO production caused by inducers of OS. This, together with the fact that atorvastatin and simvastatin can potentiate iNOS-induced NO production and indeed L-arginine transport (with atorvastatin), highlights a potential novel mechanism through which the cardio-protective actions of these compounds could be mediated.

A fisiopatologia da pré-eclâmpsia não está completamente elucidada. No entanto, o aumento do estresse oxidativo e o comprometimento da atividade da sintase induzida do óxido nítrico (iNOS) têm sido envolvido nesse estado crítico. O aumento do estresse oxidativo com o aumento das espécies altamente reativas, incluindo o superóxido, pode formar o peroxinitrito. Verificamos o papel da sintase induzida do óxido nítrico e do estresse oxidativo no modelo experimental de pré-eclâmpsia caracterizado pela redução de pressão de perfusão uterina (RUPP). Este foi induzido em ratas wistar. Ratas grávidas do grupo RUPP tiveram a aorta clipada no 14° dia de gestação. Após uma incisão na linha média, um clipe de prata (0.203 mm) foi colocado em torno da aorta acima da bifurcação ilíaca; clipes de prata (0.100 mm) também foram colocados em ambos os ramos das artérias ovarianas direita e esquerda, que abastecem o útero. Ratas Sham operados (ratas grávidas controles) e RUPP foram tratadas com veículo ou subcutaneamente com 1 mg / kg de N-[3 - (aminometil)-benzil] acetamidina (1400W, inibidor da iNOS), durante 5 dias. Após o tratamento, a pressão arterial média foi verificada. Para determinarmos o estresse oxidativo foram avaliadas as concentrações plasmáticas de espécies reativas ao ácido tiobarbitúrico (TBARS), níveis do 8-isoprostano plasmático, atividade vascular da NADPH oxidase e produção de superóxido com dihidroetídeo. Além disso, utilizamos a técnica de imunohistoquímica para avaliar os níveis de nitrotirosina. A expressão vascular da iNOS foi verificada por western imunoblotting e concentrações de nitrito plasmático por quimiluminescência. Observamos um aumento da pressão arterial média em RUPP comparado com ratas grávidas controles e o tratamento com 1400W exerceu efeitos anti-hipertensivos. O tratamento com 1400W reduziu os níveis de 8-isoprostano, atividade vascular da NADPH oxidase e concentrações de EROs, expressão da iNOS e formação de peroxinitrito em RUPP 1400W em comparação com ratos não tratados RUPP. Nossos resultados sugerem que o 1400W atenua a hipertensão no modelo RUPP principalmente pela inibição da iNOS e formação de peroxinitrito. / The pathophysiology of preeclampsia (PE) is not entirely known. However, increased oxidative stress possibly leading to impaired nitric oxide (NO) activity has been implicated in this critical condition. The increased NO production associated with highly reactive oxygen species (ROS), including superoxide may generate peroxynitrite. We examined the role of inducible nitric oxide synthase (iNOS) and oxidative stress in the reduction uterine perfusion pressure (RUPP) in preeclampsia experimental model. RUPP was induced in wistar rats. Pregnant rats in the RUPP group had their aortic artery clipped at day 14 of gestation. After a midline incision, a silver clip (0.203 mm) was placed around the aorta above the iliac bifurcation; silver clips (0.100 mm) were also placed on branches of both the right and left ovarian arteries that supply the uterus. Sham-operated (pregnant control rats) and RUPP rats were treated with subcutaneous vehicle or 1 mg/kg of iNOS inhibitor (1400W) for 5 days. After the treatment the mean arterial pressure (MAP) was monitored. To evaluated oxidative stress we measured thiobarbituric acid-reactive species (TBARS) and 8-isoprostane levels in plasma, aortic NADPH oxidase activity, and production of superoxide with dihydroethidine. Futhermore, the immunohistochemical analysis assessed nitrotyrosine levels. The vascular iNOS expression was determinated by western imunoblotting and nitrite concentrations in plasma were measured by chemiluminescence. We found increased MAP in RUPP compared with pregnant control rats and 1400W treatment exerted antihypertensive effects. Treatment with 1400W decreased RUPP-induced higher systemic 8-isoprostane levels and vascular NADPH oxidase activity and attenuated ROS concentrations, iNOS expression and peroxynitrite formation in RUPP 1400W rats compared with untreated RUPP rats. Our results suggest that treatment with 1400W attenuates the development of hypertension in RUPP mainly due to inhibition of iNOS and decreased peroxynitrite formation.

A fisiopatologia da pré-eclâmpsia não está completamente elucidada. No entanto, o aumento do estresse oxidativo e o comprometimento da atividade da sintase induzida do óxido nítrico (iNOS) têm sido envolvido nesse estado crítico. O aumento do estresse oxidativo com o aumento das espécies altamente reativas, incluindo o superóxido, pode formar o peroxinitrito. Verificamos o papel da sintase induzida do óxido nítrico e do estresse oxidativo no modelo experimental de pré-eclâmpsia caracterizado pela redução de pressão de perfusão uterina (RUPP). Este foi induzido em ratas wistar. Ratas grávidas do grupo RUPP tiveram a aorta clipada no 14° dia de gestação. Após uma incisão na linha média, um clipe de prata (0.203 mm) foi colocado em torno da aorta acima da bifurcação ilíaca; clipes de prata (0.100 mm) também foram colocados em ambos os ramos das artérias ovarianas direita e esquerda, que abastecem o útero. Ratas Sham operados (ratas grávidas controles) e RUPP foram tratadas com veículo ou subcutaneamente com 1 mg / kg de N-[3 - (aminometil)-benzil] acetamidina (1400W, inibidor da iNOS), durante 5 dias. Após o tratamento, a pressão arterial média foi verificada. Para determinarmos o estresse oxidativo foram avaliadas as concentrações plasmáticas de espécies reativas ao ácido tiobarbitúrico (TBARS), níveis do 8-isoprostano plasmático, atividade vascular da NADPH oxidase e produção de superóxido com dihidroetídeo. Além disso, utilizamos a técnica de imunohistoquímica para avaliar os níveis de nitrotirosina. A expressão vascular da iNOS foi verificada por western imunoblotting e concentrações de nitrito plasmático por quimiluminescência. Observamos um aumento da pressão arterial média em RUPP comparado com ratas grávidas controles e o tratamento com 1400W exerceu efeitos anti-hipertensivos. O tratamento com 1400W reduziu os níveis de 8-isoprostano, atividade vascular da NADPH oxidase e concentrações de EROs, expressão da iNOS e formação de peroxinitrito em RUPP 1400W em comparação com ratos não tratados RUPP. Nossos resultados sugerem que o 1400W atenua a hipertensão no modelo RUPP principalmente pela inibição da iNOS e formação de peroxinitrito. / The pathophysiology of preeclampsia (PE) is not entirely known. However, increased oxidative stress possibly leading to impaired nitric oxide (NO) activity has been implicated in this critical condition. The increased NO production associated with highly reactive oxygen species (ROS), including superoxide may generate peroxynitrite. We examined the role of inducible nitric oxide synthase (iNOS) and oxidative stress in the reduction uterine perfusion pressure (RUPP) in preeclampsia experimental model. RUPP was induced in wistar rats. Pregnant rats in the RUPP group had their aortic artery clipped at day 14 of gestation. After a midline incision, a silver clip (0.203 mm) was placed around the aorta above the iliac bifurcation; silver clips (0.100 mm) were also placed on branches of both the right and left ovarian arteries that supply the uterus. Sham-operated (pregnant control rats) and RUPP rats were treated with subcutaneous vehicle or 1 mg/kg of iNOS inhibitor (1400W) for 5 days. After the treatment the mean arterial pressure (MAP) was monitored. To evaluated oxidative stress we measured thiobarbituric acid-reactive species (TBARS) and 8-isoprostane levels in plasma, aortic NADPH oxidase activity, and production of superoxide with dihydroethidine. Futhermore, the immunohistochemical analysis assessed nitrotyrosine levels. The vascular iNOS expression was determinated by western imunoblotting and nitrite concentrations in plasma were measured by chemiluminescence. We found increased MAP in RUPP compared with pregnant control rats and 1400W treatment exerted antihypertensive effects. Treatment with 1400W decreased RUPP-induced higher systemic 8-isoprostane levels and vascular NADPH oxidase activity and attenuated ROS concentrations, iNOS expression and peroxynitrite formation in RUPP 1400W rats compared with untreated RUPP rats. Our results suggest that treatment with 1400W attenuates the development of hypertension in RUPP mainly due to inhibition of iNOS and decreased peroxynitrite formation.

Type 1 diabetes (T1D) is a chronic autoimmune disease targeted against the pancreatic β-cells. Proinflammatory cytokines are considered to play a major role in the destruction of the insulin-producing β-cells. This thesis studied strategies to counteract proinflammatory cytokines in experimental T1D. Both animal models for T1D as well as β-cell preparations exposed in vitro to putative noxious conditions were examined. In the first study we observed that cytokine treatment of mouse pancreatic islets lacking inducible nitric oxide synthase (iNOS) induced a prolongation of the early stimulatory phase of glucose stimulated insulin secretion. Various experiments led to the conclusion that this prolonged stimulatory effect may involve the DAG/PLD/PKC pathway. Next, we transplanted mouse islets deficient in iNOS to spontaneously diabetic NOD mice. We observed a normalization of hyperglycemia but not a delayed allograft rejection compared to transplanted wild type islets. Thus, absence of iNOS in the graft was not sufficient to prolong allograft survival. In paper III we found that sustained glucose stimulation of rat pancreatic islets was coupled to a decreased conversion of proinsulin to insulin. Islet treatment with IL-1β was also coupled to a decreased proinsulin conversion. Islet proconvertase activity may be a target in islet damage. In paper IV prolactin (PRL) was administered to mice in the multiple low dose streptozotocin model and we observed that PRL enhanced a Th2 response. This may contribute to the protective action by PRL in this model of autoimmune T1D. Finally, by examining β-cells overexpressing Suppressor of cytokine signalling 3 (SOCS-3) it was found that this could inhibit IL-1β induced signalling through the NF-κB and MAPK pathways. SOCS-3 overexpression also inhibited apoptosis induced by cytokines in primary β-cells. Lastly, we demonstrated that SOCS-3 transgenic islets were protected in an allogeneic transplantation model.

Orientador: Mario Jose Abdalla Saad / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-13T00:52:58Z (GMT). No. of bitstreams: 1 Zambon_RenataAlvaresBagarolli_M.pdf: 4989777 bytes, checksum: f40828d6f5cfd74ebf3f3ddc47d0158d (MD5) Previous issue date: 2009 / Resumo: Atualmente, o DM2 constitui-se como um grande problema de saúde pública mundial devido à sua elevada prevalência, morbimortalidade, além do impacto que apresenta nos custos públicos com a saúde. Os mecanismos fisiopatológicos desta doença têm se tornado cada vez mais evidentes, estando relacionados com o envolvimento exclusivo de células, receptores e mediadores do sistema imune inato. Dentre estes compostos destacam-se o TLR4, um receptor de antígenos deste sistema, responsável por ativar a transcrição de citocinas pró-inflamatórias, e a iNOS, uma enzima cálcio independente, que produz elevadas concentrações de NO. Ambas as proteínas estão envolvidas no desenvolvimento de resistência à insulina. Por esta razão, este presente trabalho investigou se 2 polimorfismos no promotor do gene da iNOS (NOS2) (deleção / inserção AAAT e (CCTTT)n) e 2 polimorfismos na seqüência codificadora do gene do TLR4 (TLR4) (Asp299Gly e Thr399Ile), tanto isolados como em conjunto, possuíam alguma associação com a susceptibilidade de desenvolvimento DM2. Além disso, também foi avaliado se os polimorfismos estavam associados com fatores de risco para a resistência à insulina e características clínicas do DM2. Foram coletadas amostras de sangue de 411 indivíduos, sendo 211 portadores de DM2 e 200 controles (doadores de sangue) saudáveis acima de 50 anos, de ambos os sexos. A glicemia de jejum foi determinada e o DNA de cada sujeito foi extraído para posterior amplificações dos 4 fragmentos desejados por PCR. Para a determinação dos genótipos, os 2 polimorfismos da iNOS - AAAT e (CCTTT)n - foram submetidos à eletroforese em seqüenciador automático e os 2 polimorfismos do TLR4 - Asp299Gly e Thr299Ile - foram submetidos a reação de digestão utilizando-se enzima de restrição. Além das análises estatísticas convencionais, os resultados foram avaliados pelo método MDR (multifactor-dimensionality reduction), que visa verificar interações entre polimorfismos. As freqüências genotípicas para os polimorfismos, considerando ambos os grupos, estão em equilíbrio de Hardy-Weinberg. Para o polimorfismo de deleção / inserção AAAT nós encontramos que a presença da inserção resultou em um aumento de risco para a doença. A inserção também se associou com a história familiar de diabetes em homens diabéticos e fatores de risco para a resistência à insulina. Para o polimorfismo (CCTTT)n notamos que os genótipos que continham apenas as repetições longas (12-16 repetições) do microssatélite estavam associados com uma chance aumentada de desenvolver DM2, além destas mesmas repetições estarem relacionadas com colesterol total e nefropatia diabética. As freqüências dos polimorfismos Asp299Gly e Thr399Ile do TLR4 também foram avaliadas. Para ambas as mutações, os alelos menos prevalentes foram significativamente maior nos controles, mostrando um papel protetor para os alelos que codificam os aminoácidos 299Gly e 399Ile, respectivamente. Pelo método MDR também foi observado que existe uma forte interação entre os quatro polimorfismos estudados e que a combinação dos genótipos D/I do polimorfismo de deleção / inserção AAAT no gene NOS2, C/L (formas curtas / formas longas) do polimorfismo (CCTTT)n no gene NOS2 e Asp/Asp ou Thr/Thr dos polimorfismos Asp299Gly ou Thr299Ile, respectivamente, no gene TLR4 apresenta alto risco para o desenvolvimento do DM2. Sendo assim, as variações genéticas no promotor do gene NOS2 e na seqüência codificadora do TLR4, consideradas tanto isoladas como em conjunto, podem levar a efeitos deletérios ou protetores, respectivamente, que são oriundos de funções alteradas do sistema imune inato em pacientes com DM2. / Abstract: Background: The toll-like receptor 4 (TLR4) and inducible nitric oxide synthase (iNOS) are proteins from the innate immune system that, when activated, can induce insulin resistance. Polymorphisms in these genes could affect the immune response, as well as the prevalence of type 2 diabetes (T2DM). Objective: The aims of the present study were: to investigate the contribution, isolated or together, of four polymorphisms (Asp299Gly and Thr399Ile from TLR4; deletion / insertion AAAT and (CCTTT)n from NOS2) to susceptibility to T2DM in a southeast Brazilian population; and to verify if these polymorphisms are associated with risk factors for insulin resistance syndrome and clinical characteristics for T2DM. Design: A total of 211 patients with T2DM and 200 unrelated controls were genotyped for the Asp299Gly and Thr399Ile polymorphisms of the TLR4 gene and for the deletion / insertion AAAT and (CCTTT)n polymorphisms of the NOS2 promoter gene. Besides the conventional statistics analysis, the data was also analyzed for gene-to-gene interactions among the four polymorphic loci using the multifactor-dimensionality reduction (MDR) method. Results: With regard to the NOS2 promoter region, the data showed that the I allele of the deletion / insertion AAAT polymorphism was more prevalent in the T2DM group and also was related with some risk factors for insulin resistance syndrome (body mass index, waist circumference). Similarly, the L/L genotype of (CCTTT)n polymorphism were more frequent in the T2DM group and the L allele was associated with total cholesterol and diabetic nephropathy. In contrast, the 299Gly allele and the 399Ile allele from the Asp299Gly and Thr399Ile TLR4 gene polymorphisms, respectively, were associated with protection of T2DM. The MDR analysis showed a significant gene-to-gene interaction between the four polymorphisms studied. Moreover, the combination of the NOS2 deletion / insertion AAAT heterozygote, the NOS2 (CCTTT)n (stratified in short and long forms) heterozygote and the TLR4 Asp299Gly Asp/Asp or Thr399Ile Thr/Thr, homozygotes was associated with a increased risk of T2DM. Conclusions: Genetic variations in the NOS2 gene promoter and TLR4 coding sequence, when analyzed together or isolated, may lead to deleterious and protective effects, respectively, arising from altered function of the innate immune system in patients with T2DM. / Mestrado / Medicina Experimental / Mestre em Fisiopatologia Médica

A tuberculose (TB) é um grave problema de saúde pública. Somente no ano de 2004, cerca de 9 milhões de pessoas desenvolveram TB ativa e mais de 2 milhões de pessoas morreram da doença. O desenvolvimento de novos modelos experimentais de TB seriam de grande utilidade para para elucidar mecanismos fisiopatológicos da doença e testar esquemas terapêuticos para a prevenção e contenção da doença. Além disso, o desenvolvimento de novas vacinas torna-se indispensável como ferramenta de prevenção e controle da TB. A TB no sistema nervoso central (SNC), assim como em outros tecidos do organismo, promove a ativação de células inflamatórias. No SNC a micróglia desempenha este papel, sendo capaz de produzir ou ser influenciada por mediadores solúveis. Vários mediadores estão envolvidos nos mecanismos moleculares decorrentes da infecção e inflamação causados pela TB, entre eles: NFB, iNOS e VEGF. A ativação do NFB, um fator de transcrição citoplasmático que sob estímulo migra para o núcleo celular, tem íntima relação com a indução da iNOS e de VEGF. A resistência intracelular a patógenos, inclusive ao Mycobacterium tuberculosis, parece estar associada a expressão de iNOS em macrófagos. O óxido nítrico (NO) tem papel importante na comunicação intercelular, estimulando a síntese de mediadores inflamatórios, como as citocinas, e regulando sua própria produção endógena. Estas citocinas por sua vez também podem induzir a atividade do NFB e a expressão da iNOS e VEGF. O VEGF é um potente ativador de permeabilidade vascular e de angiogênese, envolvido na ruptura da barreira hemato-encefálica. Neste estudo, mostramos a caracterização morfológica e imuno-histoquímica de um modelo murino de TB no SNC, com a indução da doença pela inoculação de BCG. Com este modelo experimental obtivemos importantes resultados que podem esclarecer mecanismos envolvidos na fisiopatologia da neuro-TB humana. A indução de meningite e tuberculomas foi possível através da inoculação de 104 cfu de BCG no cerebelo de camundongos, por estereotaxia, e esta indução foi dependente do tempo. A confirmação do diagnóstico foi feita pela detecção de bacilos álcool-ácido resistentes (BAAR), nas lesões tuberculosas. Observamos, ao longo do tempo (1 a 6 dias; 1, 2, 4 e 8 semanas) o recrutamento de diferentes populações gliais (micróglia e astrócitos) no sítio de injeção. Houve aumento de produção e ativação NFB nas lesões tuberculosas, caracterizada pela translocação da molécula do citoplasma para o núcleo celular. Houve expressão de iNOS restrita às lesões tuberculosas, além do aumento de expressão de VEGF nestas lesões. Além disso, camundongos imunizados com a vacina gênica hsp65, contra a TB, não expressam VEGF em suas lesões. Esta vacina parece conferir um efeito protetor em nosso modelo experimental, reduzindo a expressão de VEGF, e consequentemente reduzindo seu efeito angiogênico decorrente do processo inflamatório. O recrutamento glial, e a produção de mediadores solúveis (NFB, iNOS e VEGF) pelo hospedeiro, em resposta à invasão do patógeno no SNC, parecem estar envolvidos na fisiopatologia da neurotuberculose, como demonstrado neste modelo experimental. Nosso modelo permitirá investigar fatores possivelmente responsáveis pelo desenvolvimento e manutenção de lesões tuberculosas no SNC. O objetivo final seria elucidar a fisiopatologia desta grave doença e compreender eventos moleculares envolvidos na produção de lesões. O conhecimento gerado poderá permitir o delineamento de terapias específicas e efetivas. / Tuberculosis (TB) is a serious public health problem; in 2004, 9 million people developed active TB and the disease killed 2 million patients. Development of experimental models and new vaccines are essential both to elucidate physiopathological mechanisms and to control the disease. This infection in the central nervous system (CNS), as in other tissues of the organism, activates inflammatory cells. In CNS, this role is performed by the microglia, which is capable of producing or be influenced by soluble mediators. Several mediators are involved in the molecular mechanisms of the infection and inflammation by mycobacteria , such as NFB, iNOS and VEGF. NFB activation, a cytoplasmic transcriptional factor that migrates to the cellular nucleus under stimuli, is involved with the iNOS and VEGF induction of expression. The intracellular resistance to Mycobacterium tuberculosis has been associated with iNOS expression in macrophage cells. Nitric oxide (NO) is crucial in intercellular communication, modulating the synthesis of mediators of inflammation, such as cytokines, and modulation itself. These cytokines induces NFB activity, and induces iNOS and VEGF expression. VEGF is a potent activator of vascular permeability and of angiogenesis and it is a factor involved in the breakdown of the blood brain-barrier in tuberculous meningitis. In this study, we showed the morphologic and immunohistochemistry characterization of an experimental model of TB in the CNS, with inoculation of BCG in mice. In this model we elicited important outcome that can elucidate mechanisms involved in the physiopathology of human neuron-TB. Induction of meningitis and tuberculomas were possible with stereotaxic inoculation of 104 cfu of BCG in mice cerebellum, in a time-dependent way. Diagnostic was confirmed by detection of alcohol-acid resistant bacilli (BAAR), in tuberculous lesions. We observed, the time-course (1 to 6 days; 1, 2, 4 e 8 weeks) of the recruitment of different glial populations (microglia and astrocytes) in the injection site. There was increased production and activation of NFB in the tuberculous lesions, it was characterized by its nuclear translocation from cytoplasm. There was iNOS expression only in the tuberculous lesions, and expression increased of VEGF in these lesions. Furthermore, mice immunizated with vaccine DNA-hsp65 there was no expression of VEGF in its lesions. This vaccine seems confer a protector effect in our experimental model, reducing the expression of VEGF, and then reducing its angiogenic effect derived from inflammatory process. Glial recruitment, and the soluble mediators production (NFB, iNOS e VEGF) by the host, producing in response to invasion of the pathogen in the CNS, has been involved in the pathophysiology of the neuro-TB, such as demonstrated in this experimental model. Our model will allow investigate possible factors responsible for the development and maintenance of tuberculous lesions in the CNS. The final aim is to elucidate the physiopathology of this serious illness and understand the molecular events involved in the production of the lesions. The knowledge created may permit to pave the way to delineate specific and effective therapies.

In der vorliegenden Arbeit sind Untersuchungen vorgestellt, die sich mit Wirkungen und Interaktionen von zwei ubiquitär im menschlichen Körper vorkommenden Gasen befassen, i.e. Sauerstoff und Stickstoffmonoxid. Im Falle beider Substanzen ermöglicht die geringe Größe der Moleküle eine freie Diffusion über Membranen hinweg, eine Eigenschaft, die für die Funktion der Signaltransduktion geradezu prädestiniert. Aus den vorgelegten Untersuchungen lassen sich die folgenden Folgerungen ableiten: * Stickstoffmonoxid wirkt in-vitro selektiv bakteriostatisch auf Bakterien, die üblicherweise Früh- und Neugeborene besiedeln. Dabei hängt die Selektivität von den jeweiligen bakteriellen Verteidigungsmechanismen ab, die bakteriostatische Wirkung liegt in einem Konzentrationsbereich, der außerhalb desjenigen liegt, der derzeit klinisch angewendet wird. * Hyperoxie führt im Ganztiermodell der unreifen Ratte zu einer zerebralen Hochregulation von iNOS und damit zur Synthese von NO. Soweit dies anhand der Synthese von Peroxynitrit als definitivem Schädigungsmechanismus beurteilbar ist, wird trotz entsprechender iNOS-Expression wenig bis gar kein Peroxynitrit gebildet. Da das Zusammentreffen von NO und Sauerstoff sonst regelhaft zur Entstehung von Peroxynitrit führt, müssen im Gehirn der unreifen Ratte ausreichende antioxidative Schutzmechanismen präsent sein, die diese Reaktion verhindern. * Im in-vitro-Modell der Gasäquilibrierung von Nabelschnur-PMN zeigte sich unter Hyperoxie das ausgeprägteste Aktivierungsmuster aller verglichenen Sauerstoffkonzentrationen. Dies stand im Gegensatz zur Exposition adulter Zellen, hier fand sich eine größere Hyperoxietoleranz bei gleichzeitig stärkster Aktivierung unter Hypoxiebedingungen. Welche Bedeutung diesen Ergebnissen im klinischen Umgang mit Neugeborenen zukommt muß derzeit noch offen bleiben. Allerdings häufen sich Hinweise aus experimentellen Studien, die darauf hindeuten, daß ein restriktiver Umgang mit hohen Sauerstoffkonzentrationen auch im klinischen Umfeld gerechtfertigt sein könnte. / The present investigations deal with the effects and interactions of gases, which are ubiquitous in the human body i.e. oxygen and nitric oxide. Both substances are small enough to freely diffuse across biological membranes. This ability predestines both molecules for the function of signal transduction. The results of our investigations lead to conclusions as follows: * Nitric oxide has selective bacteriostatic effects in-vitro on some bacterial strains typically isolated from preterm and term newborn infants. Selectivity depends on the presence of bacterial defense mechanisms. The bacteriostatic effect takes place at concentrations above those currently used in clinical practice. * Hyperoxia leads to upregulation of iNOS and subsequent NO production in an animal model of the immature rat. Despite this upregulation of iNOS synthesis there is no increased production of peroxynitrite which is known to cause cellular and DNA damage. Since the combination of NO and high concentrations of oxygen lead to peroxynitrite formation on a regular basis, effective antioxidant mechanisms appear to prevent peroxynitrite formation in the brain of the immature rat. * The most pronounced activation of cord blood polymorphonuclear cells (PMN) during conditions of hyperoxia, normoxia, and hypoxia was found for exposure towards high oxygen concentrations in an in-vitro model of gas equilibration. As opposed to that, hypoxia was the most potent trigger for adult PMN. It remains to be determined which clinical implications must be derived from these results. However, increasing experimental evidence indicates that exposure towards high oxygen concentrations should be restricted also in clinical practice and not only in preterm infants, but also in term newborns.

La palourde japonaise, Ruditapes philippinarum, a été introduite en France en 1972 suite à une volonté de diversification de la production aquacole des bivalves. A la fin des années 1980, des épisodes de mortalité massive ont été observés dans les parcs vénéricoles du pays des Abers (Finistère, France). La mortalité massive des palourdes a été associée à la maladie de l’anneau brun (MAB), une vibriose dont l’agent étiologique est Vibrio tapetis. Le développement de la MAB en milieu naturel a été associé à la modulation de certains facteurs environnementaux tels que la température ou la présence de ressource trophique. Dans le cadre de ce travail et dans un premier temps, des infections expérimentales de palourdes avec différentes souches de V. tapetis ont été effectuées conjointement à une acclimatation des animaux à deux températures contrastées. L’augmentation de la température de 15 à 22 °C a été associée à de plus fortes activités enzymatiques de la superoxyde dismutase (SOD), impliquée dans le système antioxydant, et de la phénoloxydase (PO), impliquée dans le système immunitaire inné. L’augmentation de la température a également conduit à une diminution de la virulence de Vibrio tapetis. Ensemble, ces résultats permettent d’expliquer la baisse de la prévalence et de l’intensité de la MAB à 22 °C. Dans un second temps, des palourdes sexuellement matures nourries avec deux algues contrastées en termes de composition lipidique ont été infectées par V. tapetis. Si la qualité des microalgues n’a pas conduit à des différences de prévalence et d’intensité de la MAB, le statut de reproduction des animaux a eu une influence sur l’intensité de la maladie. Les réponses métaboliques de R. philippinarum exposée à V. tapetis n’ont pas été influencées par la qualité de la nourriture mais par le développement de la MAB. Ces réponses consistaient en une modulation de l’activité d’enzymes antioxydantes (SOD, catalase, glutathion peroxydase, glutathion réductase,glutathion-S-transférase) et d’enzymes reliées au système immunitaire inné (PO et oxyde nitrique synthase inductible) en fonction de la présence de signes cliniques de la MAB. Finalement, l’utilisation de ces indicateurs biochimiques pourrait permettre d’établir des critères de sélection d’individus résistants à la MAB. / The Manila clam, Ruditapes philippinarum, was introduced in France in 1972 following the willingness of bivalve aquaculture diversification. In the late 1980s, episodic mass mortality events were observed in ponds of the “Pays des Abers” region (Finistère, France). The massive mortality of clams was associated brown ring disease (BRD), a vibriosis which causative agent is Vibrio tapetis. BRD development in field has been associated with the modulation of environmental factors such as temperature or the presence of trophic resource. Firstly in the frame of the present work, experimental infections of clams with different strains of V. tapetis were performed together with animal acclimation at two contrasted temperatures. The increase of temperature from 15 to 22 ° C was associated with higher enzymatic activities of superoxide dismutase (SOD), involved in the antioxidant system, and the phenoloxidase (PO), involved in the innate immune system. Temperature increase also led to a decrease in virulence of V. tapetis. Together, these results might explain the decline in BRD prevalence and intensity observed at 22 ° C. Secondly, sexually mature clams fed with two microalgal diets contrasted in terms of lipid composition were infected with V. tapetis. Although microalgae quality did not lead to any difference in BRD prevalence and intensity, the reproductive status of clams influenced BRD intensity. Metabolic responses of R. philippinarum exposed to V. tapetis were not influenced by the food quality but mainly by BRD development. These responses consisted in a modulation of the activity of antioxidant enzymes (SOD, catalase, glutathione peroxidase, glutathione reductase, glutathione S-transferase) and enzymes related to innate immune system (PO and inducible nitric oxide synthase) according to the presence of BRD clinical signs. Finally, the use of these biochemical indicators could allow for new criteria for selection of BRD resistant clams.