Segundo a Organização Mundial da Saúde, a obesidade acomete mais de meio milhão de pessoas no mundo. A obesidade desencadeia uma inflamação sistêmica crônica de baixo grau caracterizada pela presença de mediadores pró-inflamatórios gerados no tecido adiposo. Esta inflamação crônica também está presente no tecido pulmonar podendo ser exacerbada por episódios isquêmicos. A Isquemia e Reperfusão (IR) intestinal é um modelo experimental no qual observamos inflamação pulmonar. Estudos do laboratório mostram que os hormônios sexuais femininos (HSF), principalmente o estradiol, modulam a inflamação pulmonar após a IR. Nossos estudos demostram que a redução prolongada dos HSF associada à obesidade induz aumento da inflamação local e sistêmica, com foco na inflamação pulmonar. Após a indução da IR intestinal a inflamação pulmonar mostrou-se mais acentuada. Conclui-se que os HSF apresentam papel importante no controle da inflamação decorrente da IR intestinal, podendo sugerir um estudo que avalie o tratamento prolongado de estradiol. / According to World Health Organization, obesity affects more than half a million people in the world. Obesity triggers a low-grade chronic, systemic inflammation characterized by the presence of proinflammatory mediators generated by the adipose tissue. It is noticeable that this chronic inflammation is also present in the lung tissue and may be exacerbated by ischemic episodes. Intestinal ischemia and reperfusion (IR) is an experimental model in which we observe pulmonary inflammation. Laboratory studies show that female sex hormones (FSH), especially estradiol, modulate pulmonary inflammation after IR. As a whole, our studies showed that the prolonged reduction of FSH in association with obesity induced exacerbated local, systemic and lung inflammation. After intestinal IR, pulmonary inflammation was more pronounced. In conclusion, FSH play an important role in the control of inflammation due to intestinal IR. It is suggested that the effects of a chronic treatment with estradiol in this scenario should be studied.

O tempo para 1,0mm de depressão do segmento ST (T-1,0mm) adotado para caracterizar o fenômeno do aquecimento, uma expressão do precondicionamento isquêmico (PCI), em testes ergométricos sequenciais é consistente e reprodutível, porém, possui várias limitações. O objetivo deste estudo foi aplicar um escore eletrocardiográfico de isquemia miocárdica em testes ergométricos sequenciais comparando com o clássico índice T-1,0mm. Avaliamos 61 pacientes, com idade média de 62,2+7,5 anos, 86,9% homens, portadores de diabetes mellitus tipo 2 e coronariopatia multiarterial. Foram analisados 151 exames, destes 116 de pacientes completaram as duas fases de avaliação. A primeira fase compreendia dois testes ergométricos sequenciais para documentação do PCI e a segunda fase, após 1 semana, mais dois testes sob efeito de repaglinida oral. Dois observadores aplicaram o escore de forma cega. Observou-se concordância perfeita inter e intraobservador (Kendall Tau-b = 0,96, p<0,0001, Kendall Tau-b=0,98, p<0,0001, respectivamente). Os valores de sensibilidade, especificidade, valor preditivo negativo, valor preditivo positivo e acurácia, foram respectivamente de 72,41%, 89,29%, 75,8%, 87,5% e 81%. Concluímos que o escore de isquemia é um método consistente e reprodutível para documentação do fenômeno do aquecimento, representando uma alternativa factível ao índice T-1,0mm. / The time to 1.0mm ST-segment depression (T-1.0mm), adopted to document the warm-up phenomenon, an expression of the ischemic preconditioning (IPC), during sequential exercise tests is considered reliable and reproductible, although with several limitations. The main goal of this study was to apply an electrocardiographic ischemic myocardium score to sequential exercise tests, comparing with the standard T-1.0mm. We evaluated 61 patients, mean age 62,2+7,5 years-old, 86.9% male, with type 2 diabetes mellitus and multivessel coronary disease. We analyzed 151 exercise tests, being 116 tests from patients who fulfilled the two phases of the study. The first phase enrolled the patients for two sequential exercise tests to document the IPC and the second phase, after 1 week, two additional sequential exercise tests were performed under repaglinide treatment. We observed a perfect concordance inter and intraobserver (Kendall Tau-b=0.96, p<0.0001; Kendall Tau-b=0,98, p<0,0001, respectively). The sensibility, specificity, positive predictive value and negative predictive value were also determined: 72.41%, 89.29%, 75.8%, 87.5% and 81%, respectively. In conclusion, the electrocardiographic ischemic score is a consistent and reproductible tool to document the warm-up phenomenon, representing a reliable alternative to the T-1.0mm.

Neutrophils are significant players in both acute and chronic inflammatory conditions, and function in infectious and autoimmune ailments. MicroRNAs regulate homeostasis in health and disease by fine tuning the expression of a network of genes through post transcriptional regulation. Many microRNAs are expressed in restricted tissues, regulated by physiological conditions such as stress and disease, and are emerging as mediators for intercellular communication that shape the tissue environments. MicroRNA profiles have been recently utilized as biomarkers for diagnosis and prognostic purposes for their stability in plasma and significant correlation with the disease progress. In addition, several microRNAs are in clinical trials for infectious diseases, cardiovascular disorders and cancer. As for neutrophil biology, microRNAs that regulate hematopoiesis and neutrophil development are well known. However, only a few microRNAs are characterized in the context of neutrophil migration and activation by loss of function studies either in mice or in cell culture. In this work we characterize the role of total microRNA regulation on neutrophil function through whole body and neutrophil specific Dicer1 knockout, and identify a microRNA regulator of neutrophil motility. MiR-722 downregulates the transcript level of rac2 through binding to a seed match in the rac2 3'UTR. Furthermore, miR-722 over-expressing larvae display improved outcomes in both sterile and bacterial systemic models. Finally, the miR-722 mimics protect zebrafish from lethal LPS challenge, providing evidence and mechanism of an anti-inflammatory microRNA that restrains detrimental systemic inflammation. We further investigated the role of the inflammatory response in an ischemia-reperfusion model. Extensive future work is required, especially in animal models, to illustrate the pivotal and complex microRNA mediated regulatory network in neutrophils, which is expected to provide the foundation for highly selective microRNA based therapy to control neutrophil behavior in infection and inflammatory disorders.

Introdução: O pré-condicionamento isquêmico tem a capacidade de minimizar as lesões decorrentes do processo de isquemia e reperfusão. O pós-condicionamento isquêmico, descrito posteriormente, apresenta resultados semelhantes na proteção contra as lesões por isquemia e reperfusão em miocárdio, cérebro, rins, músculo esquelético e medula espinhal. Objetivo: Avaliar o efeito do pré e do pós-condicionamentos isquêmicos bem como sua associação sobre a lesão tecidual em músculo esquelético de ratos submetidos ao processo de isquemia e reperfusão. Método: Foram utilizados 50 ratos Wistar, distribuídos em cinco grupos de 10 animais: grupo Controle, em que se realizou isquemia parcial por clampeamento aórtico infra-renal (240 min) e reperfusão (60 min); Grupo Sham, fez-se o mesmo procedimento cirúrgico, porem sem o clampeamento da aorta abdominal; grupo Pós-condicionamento, onde precedendo o início da reperfusão, foi realizado o pós-condicionamento isquêmico (três ciclos de um minuto de reperfusão intercalados por três ciclos de um minuto de isquemia); grupo Pré-condicionamento, precedendo ao período isquêmico procedeu-se ao pré-condicionamento isquêmico(três ciclos de 5 min de isquemia intercalados por três ciclos de 5 min de reperfusão); grupo Pré e Pos-condicionamento, neste grupo associaram-se os dois métodos. Avaliaram-se os resultados pela dosagem de enzimas tissulares (aspartato aminotransferase-AST, creatinofosfoquinase-CK e desidrogenase lática-DHL), malondialdeído (MDA) e glicogênio tissular com tratamento estatístico. Resultado: Houve elevação significativa dos níveis de CK em todos os grupos em relação ao grupo sham. A AST elevou-se no grupo pré+pós-condicionamento em relação ao grupo controle. O comportamento da LDH foi semelhante entre os grupos. O marcador de lesão de membrana celular representado pelo MDA mostrou-se elevado em todos os grupos, exceto no grupo pós-condicionamento em relação ao grupo sham. Não ocorreu diferença entre os grupos isquêmicos e reperfundidos. Quanto à reserva energética ocorreu queda significativa do glicogênio no grupo controle em relação aos grupos sham, pré-condicionamento e pré+pós-condicionamento, exceto no grupo pós. Conclusão: Concluiu-se que o pré-condicionamento bem como a associação do pré com o pós-condicionamento isquêmico foram capazes de minimizar a lesão tecidual em musculatura estriada de ratos submetidos à isquemia e reperfusão, porém a associação dos métodos não trouxe vantagens adicionais sobre os mesmos aplicados isoladamente / Background: Ischemic preconditioning has the ability to reduce injuries resulting from ischemia and reperfusion. Ischemic post-conditioning, described later, shows similar protective results against injury by ischemia and reperfusion in myocardium, brain, kidney, skeletal muscle, and spinal cord. Objective: To evaluate the effect of ischemic pre- and post-conditioning and their combination on protection against skeletal muscle tissue injury in rats subjected to ischemia and reperfusion. Methods: We used 50 Wistar rats divided into five groups of 10 animals each: Control group, subjected to partial ischemia by infrarenal aortic clamping (240 min) and reperfusion (60 min); Sham group, subjected to the same surgical procedure but without clamping of the abdominal aorta; Post-conditioning group, in which ischemic post-conditioning was performed before the onset of reperfusion (three cycles of one min of reperfusion interspersed with three cycles of one min ischemia); pre-conditioning group, subjected to ischemic pre-conditioning prior to the ischemic period (three cycles of 5 min ischemia interspersed with three cycles of 5 min reperfusion); pre-and post-conditioning group, in which the two methods were used in combination. Results were evaluated by measuring levels of tissue enzymes (aspartate aminotransferase (AST), creatine kinase (CK) and lactate dehydrogenase (LDH), malondialdehyde (MDA) and tissue glycogen, with statistical analysis. Results: There was a significant elevation of CK levels in all groups compared to the sham group. AST increased in the pre- + post-conditioning group compared to the control group. The behavior of LDH was similar for all groups. The marker of cell membrane damage represented by MDA was high in all groups except the post-conditioning one compared to the sham group. No significant difference was observed between the ischemic and reperfused groups. As to the energy reserve (glycogen), a significant decrease occurred in the control group compared to the sham, pre-conditioning and pre- + post-conditioning groups, but not in the post-conditioning group. Conclusion: We conclude that pre-conditioning and combined pre - and post-conditioning were able to minimize tissue injury in the skeletal muscle of rats subjected to the ischemia and reperfusion process, but the combined methods did not bring about additional advantages compared to each method applied aloneT

Early deterioration and long-term recurrence were common after stroke or transient ischemic attach (TIA), however, it is unclear whether they were correlated with active embolization and the consequent new cerebral infarct in acute phase. By employing TCD and diffusion weighted imaging (DWI), we studied the significance of the progression of MES and infarcts during acute phase on the clinical outcomes. We found that the disappearance of MES was correlated with better improvement on day 7 of recruitment; for the long-term outcome, occurrence of exacerbating infarct tended to predict recurrent stroke. Treatment aiming to reduce MES and prevent infarct exacerbation in acute phase may improve the prognosis after stroke. / Finally, one study was performed to assess the changes of hemodynamic parameters after stenting of severe stenosis in the MCA. We aimed to investigate whether TCD can reflect the lumen changes after revascularization and detect hyperperfusion. The findings showed that the velocity of stented MCA in most patients normalized within 24 hours after procedure, but the role of TCD in detecting restenosis in long run needed to be verified; no one suffered from hyperperfusion during the period of our study. The long-term outcomes of patients with normalized velocity versus those with persistently high velocity needed to be further studied. Apart from the velocity changes, changes of the collateral flow after intervention may also be an important part of hemodynamic changes. (Abstract shortened by UMI.) / It was suggested that anti-platelet therapy can reduce the MES, but little was known about the efficacy of low molecular weight heparin (LMWH) although in theory LMWH can reduce the red fibrin-dependent thromboemboli. As a sub-analysis of Fraxiparine in Ischemic Stroke (FISS)-tris study, our study did not show advantages of LMWH in eliminating MES compared with aspirin. / Previous studies showed the accuracy of TCD in diagnosis of middle cerebral artery (MCA) stenosis was variable and the positive predictive value (PPV) was less than 50% in a recent report. One of the important reasons was that most criteria were based on the velocity-only method, ignoring other non-velocity information. Thus, we tried to establish new diagnostic criteria by means of designing an assessment form which integrated more characteristics apart from the velocity acceleration. A composite score for each MCA was calculated according to following parameters in the form: Velocity Scale (score 0-6 for peak systolic velocities&lt;140 to &ge;300cm/s), Hemodynamic Scale (score 0-5 for focal or diffuse velocity increase; score 0-6 for differences between bilateral MCA; score 17 for damping velocity), Spectrum Scale (score 0-2 for normal spectrum, turbulence and musical murmurs). Our results showed that compared with the previously reported criteria, the score calculated from the assessment form yielded much more balanced accuracy against magnetic resonance angiography (MRA) and digital subtraction angiography (DSA). However, the composition of the assessment form was only based on personal experience and need to be further modified. Multicenter studies with large sample size are also needed to confirm the advantages of this new method. / Second, we performed three studies to investigate the relationship between the progression of MES and the short or long-term outcome and the relationship between MES and different treatments. / Hao, Qing. / Adviser: Ka Sing Wong. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3419. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 155-181). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2016-09-27T15:19:20Z No. of bitstreams: 1 marcosaureliobdeoliveira_tese.pdf: 6679652 bytes, checksum: cda6b164bdebbe6a1f4cfdb403d7ea04 (MD5) / Made available in DSpace on 2016-09-27T15:19:20Z (GMT). No. of bitstreams: 1 marcosaureliobdeoliveira_tese.pdf: 6679652 bytes, checksum: cda6b164bdebbe6a1f4cfdb403d7ea04 (MD5) Previous issue date: 2014-12-09 / Introduction: Solutions that cause elective cardiac arrest are often evolving, but the ideal compound has not yet been found. The authors compare a new cardioplegic solution with histidine-tryptophan-glutamate (HTG) with histidine-tryptophan-acetoglutarato (HTK) in a model of isolated rat heart. Objective: Benchmarking HTK and HTG solutions regarding the activity of caspase, KI -67, IL - 8, Shannon entropy and fractal dimension. Materials and Methods: Twenty male rats, Wistar race, were analyzed and heparinized. The chest was opened, held and cardiectomia infused 40 mL/kg of appropriate cardioplegia. The hearts were kept for 2 hours at 4°C in the same solution, and afterwards placed in the Langendorff apparatus for 30 min with Ringer-Locke solution. The immunohistochemical analyses were performed for caspase, IL-8, KI-67, Shannon entropy and fractal dimension. Results: The concentration of caspase was lower in group 2, and KI-67 was higher in group 2, both P<0.05. There was no statistical difference between the values of IL-8 between the groups. Both the Shannon entropy and the fractal dimension were not different in the two groups. Conclusions: The HTG solution was better than with HTK because they had reduced caspase (apoptosis) increased KI-67 (cell proliferation), they did not show different values of IL-8 (inflammation, necrosis). Additionally they did not show change in amount or distribution of the information (observed by the Shannon entropy and fractal dimension) in histological slices. / Introdução: As soluções que provocam parada cardíaca eletiva estão em constante evolução, porém o composto ideal ainda não foi encontrado. Os autores comparam uma nova solução cardioplégica com histidina-triptofano-glutamato (HTG) com histidinatriptofano- acetoglutarato (HTK) em modelo de coração isolado de rato. Objetivo: Avaliar comparativamente as soluções HTK e HTG no que se refere à atividade de caspase, KI-67, IL-8, entropia de Shannon e dimensão fractal. Materiais e Métodos: Vinte ratos machos de raça Wistar foram anestesiados e heparinizados. O tórax foi aberto, realizada cardiectomia e infundido 40 mL/Kg de solução cardioplégica apropriada. Os corações foram mantidos por 2 horas na mesma solução a 4oC e, após esse período, colocados em aparato de Langendorff por 30 minutos com solução de Ringer Locke. Foram feitas análises imuno-histoquímicas para caspase, IL-8, KI-67, entropia de Shannon e dimensão fractal. Resultados: A concentração de caspase estava menor no grupo 2, e da KI-67 estava mais elevada no grupo 2, ambos com P<0,05. Não houve diferença estatística entre os valores de IL-8 entre os grupos. Tanto a entropia de Shannon quanto a dimensão fractal não foram diferentes nos dois grupos. Conclusões: A solução com HTG foi mais eficaz que a com HTK, pois reduziu a caspase (apoptose), aumentou o KI-67 (proliferação celular); não apresentou valores diferentes de IL-8 (inflamação e necrose) que no grupo 1 e não apresentou alteração da quantidade ou distribuição das informações (observadas pela entropia de Shannon e dimensão fractal) nas lâminas histológicas.

No description available.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A aplicação tópica do hidrogel Pluronic F-127 (poli(óxido de etileno)99-poli(óxido de propileno)65-poli(óxido de etileno)99, PEO99-PPO65-PEO99) contendo um doador de óxido nítrico, a S-nitrosoglutationa (GSNO) é conhecida por exercer efeitos benéficos no reparo tecidual cutâneo. O objetivo deste trabalho foi avaliar o efeito da aplicação tópica do hidrogel Pulronic F-127 contendo um doador de óxido nítrico no reparo tecidual de lesões isquêmicas. Ratos Wistar machos foram submetidos a duas lesões incisionais paralelas no dorso, a pele foi separada do tecido subjacente, as incisões foram suturadas e uma lesão excisional foi feita entre elas para criar uma condição isquêmica ao redor da lesão. Os animais foram separados em grupo controle, que recebeu a aplicação apenas do hidrogel sem doador de óxido nítrico e grupo tratado, que recebeu a aplicação do hidrogel contendo o doador de óxido nítrico. Os animais foram tratados por 7 dias consecutivos com uma aplicação diária dos hidrogéis. O grupo tratado apresentou taxas mais altas de contração e re-epitelização, menor quantidade de células inflamatórias, um aumento na densidade e organização de fibras colágenas e uma diminuição na neovascularização 14 dias após a lesão, comparado ao grupo controle. Esses resultados indicam que a aplicação tópica do gel doador de óxido nítrico é eficaz no tratamento de lesões isquêmicas em ratos, levando a uma melhora significativa na cicatrização. Consequentemente, a aplicação tópica de um hidrogel contendo doador de óxido nítrico poderá ter, futuramente, potencial para o tratamento terapêutico de úlceras venosas e decorrentes de diabetes. / Topical application of Pluronic F-127 hydrogel (poly(ethylene oxide)99-poly(propylene oxide)65-poly(ethylene oxide)99, PEO99-PPO65-PEO99) containing the NO donor S-nitrosoglutathione (GSNO) is known to exert beneficial effects on cutaneous wound healing. The aim of this study was to evaluate the effect of topical application of GSNO on the healing of ischemic wounds. Wistar rats were submitted to two parallels incisions on their back, the skin was separated from the underlying tissue, the incisions were sutured and an excisional wound was done between the parallel incisions to create an ischemic condition surrounding the wound. The animals were separated into a control group, which received a hydrogel vehicle without GSNO and a GSNO-treated group, which received a GSNO-containing hydrogel. The animals were treated for 7 days consecutively with daily application. The GSNO-treated group displayed higher rates of wound contraction and re-epithelization, lower amount of inflammatory cells, an increase in collagen fiber density and organization and a decrease in the neovascularization 14 days after wounding, compared to control. These results show that topical application of GSNO is effective in the treatment of ischemic wounds, leading to a significant improvement in the wound healing. Therefore, in the future, topical GSNO-containing hydrogel will have potential for the therapeutic treatment of ischemic diabetic and venous ulcers.

Made available in DSpace on 2014-06-11T19:30:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-03-13Bitstream added on 2014-06-13T19:00:53Z : No. of bitstreams: 1 delbin_ma_dr_rcla.pdf: 750379 bytes, checksum: 217de471de3341cdcc9171a5f69905f5 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / O objetivo deste trabalho foi o de avaliar o efeito do treinamento físico na reatividade vascular de artérias mesentérica e pulmonar de ratos submetidos à isquemia/reperfusão (IR) pulmonar. Ratos wistar foram utilizados nesse estudo, e divididos em cinco grupos: controle sedentário (C/SD); controle treinado (C/TR); falso operado sedentário (SHAM/SD); isquemia/reperfusão sedentário (IR/SD) e isquemia/reperfusão treinado (IR/TR). O treinamento físico consistiu em corrida em esteira, sessões de 60 min/dia, 5 vezes por semana durante 8 semanas (velocidade 1,2 km/h e 0% de inclinação). O processo de IR pulmonar foi realizado através de oclusão total da artéria pulmonar, veia pulmonar e brônquio esquerdo por 90 minutos e reperfusão de 120 minutos. Em seguida, as artérias mesentérica e pulmonar foram isoladas e curvas concentração-resposta à acetilcolina (ACh), histamina (HIST), nitroprussiato de sódio (SNP) foram obtidas na presença e na ausência de endotélio. Curvas concentração-resposta à fenilefrina (PHE) e ao análogo do tromboxano A2 (U46619) também foram obtidas na presença de endotélio. Análise do extravasamento de proteínas plasmáticas, atividade da mieloperoxidase pulmonar (MPO), nitrato e nitrito (NOx-), atividade da enzima superóxido dismutase (SOD), interleucina-6 (IL-6) plasmáticas e expressão de proteína arterial da eNOS, nNOS, Cu/Zn SOD-1, p47phox e TNF- α foram avaliados. Verificou-se aumento nos valores de NOx-, SOD, IL-6 plasmático, atividade da MPO e extravasamento de proteínas nos grupos IR/SD e IR/TR quando comparados aos demais grupos. O treinamento físico não alterou nenhum destes parâmetros. Em artéria mesentérica, houve diminuição na potência à ACh e a PHE no grupo IR/SD quando comparado aos grupos C/TR e IR/TR, sem alterações nos valores de resposta máxima. Não foram verificadas alterações na resposta ao U46619... / The aim of this work was to evaluate the effect of physical training in the responsiveness of rat mesenteric and pulmonary rings submitted to lung ischemia/reperfusion (IR). Rats were divided into five groups named: control sedentary (C/SD); control trained (C/TR); sham operated sedentary (SHAM/SD); ischemia/reperfusion sedentary (IR/SD) and ischemia/reperfusion trained (IR/TR). Run training was performed for 5 days/week, each session of 60 minutes, during 8 weeks (speed of 1.2 km/h and 0% grade). Left pulmonary IR was performed by occluding the pulmonary artery, bronchus and pulmonary vein for 90 minutes and reperfusion for 120 minutes. Concentration-response curves to acetylcholine (ACh), histamine (HIST), sodium nitroprusside (SNP) with intact and denuded endothelium were obtained. Contractile response curves were performed for phenylephrine (PHE) and tromboxane A2 analogue (U46619). The pulmonary plasma protein extravasation, lung myeloperoxidase activity (MPO), plasma levels of nitrite/nitrate (NOx-), superoxide dismutase activity (SOD), interleukin-6 (IL-6) and the protein expression for eNOS, nNOS, Cu/Zn SOD-1, p47phox and TNF-α were evaluated. The levels of NOx-, SOD, IL-6, MPO activity and pulmonary plasma protein extravasation were markedly increased in IR/SD and IR/TR compared to others groups which were not modified by exercise training. In mesenteric rings a decreased of potency to ACh and PHE in IR/SD compared to C/TR and IR/TR without changes in the maximal response were observed. No changes to U46619 were seen in all groups. The nNOS, Cu/Zn SOD-1 and p47phox protein expression were not modified. In pulmonary rings the potency to PHE was decreased in IR/SD and IR/TR without changes in the maximal response. No changes to U46619 were seen in all groups. Neither pulmonary IR nor exercise training changed the protein expression for eNOS, nNOS, Cu/Zn SOD-1 and p47phox... (Complete abstract click electronic access below)

L’infarctus du myocarde constitue la première cause de mortalité cardiovasculaire. Ainsi, toute stratégie permettant de moduler la vulnérabilité du coeur à l’ischémie-reperfusion (IR) peut représenter un intérêt majeur de santé publique. L’exercice en endurance est reconnu comme une stratégie de cardioprotection efficace dont les mécanismes cellulaires restent néanmoins peu connus. Les objectifs de ce travail de thèse sont donc i) d’évaluer le rôle préventif de l’exercice sur le développement d’un phénotype sensible à l’IR myocardique, et ii) de tenter de mieux comprendre le rôle de la eNOS dans la radioprotection par l’exercice. Dans la première partie de ce travail, nous avons mis en évidence que l’exercice permet de prévenir le développement d’un phénotype pathologique cardiomyocytaire,par une amélioration du statut antioxydant et un maintien de l’homéostasie calcique cellulaire, et ainsi permet de normaliser la sensibilité du coeur à l’IR chez une population à risque. Dans un second temps, les travaux réalisés ont permis de mettre en avant le rôle majeur de la eNOS dans la cardioprotection par l’exercice. Cette cardioprotection est associée à une diminution du niveau de phosphorylation (Ser1177) et surtout de l’état de découplage de cette enzyme au cours des premières minutes de reperfusion. Ces modifications, associées à l’amélioration du statut antioxydant cardiaque par l’exercice, sont à l’origine d’une diminution du stress nitro-oxydant au cours de la reperfusion,expliquée par une moindre synthèse de NO et une meilleure capacité à éliminer l’O2.-, permettant ainsi de limiter la synthèse de ONOO-. L’ensemble de ce travail de thèse a ainsi permis de mettre en évidence la complexité de la cardioprotection par l’exercice, nécessitant l’interaction entre différents mécanismes cellulaires tels que l’amélioration du statut enzymatique antioxydant, le découplage de la eNOS au cours de la reperfusion précoce et la régulation de l’homéostasie calcique intracellulaire. Ce travail à d’autre part permis de mieux appréhender le rôle complexe de la voie de synthèse du NO parla eNOS dans la modulation de la vulnérabilité du coeur à un stress tel que l’IR / Exercise training is recognized as an efficient way to protect the myocardium against ischemiareperfusion(IR). However, mechanisms responsible for such cardioprotection remain still unclear. Theaims of this work were then i) to evaluate the preventive effect of exercise on a model highly sensitiveto myocardial IR, and ii) to investigate the role of eNOS in exercise-induced cardioprotection. In a firstpart we showed that regular boots of exercise, by its beneficial effects on calcium handling andenzymatic antioxidant status, prevents the highly sensitive phenotypical remodeling of the heart andthen normalized heart vulnerability to IR. Then, in a second part of this work, we showed that exerciseinducedcardioprotection was associated with a decrease of eNOS phosphorylation at Ser1177 andespecially its uncoupling during early reperfusion. Such phenomenon, associated with increased heartantioxidant capacity was responsible for reduced nitro-oxidative stress. Indeed, reduced NOSdependentNO synthesis associated with the improved capacity to scavenge O2.- contribute to preventthe formation of ONOO-. Altogether, these results showed that exercise-induced cardioprotection is acomplex mechanism requiring interactions between antioxidant capacity improvement, eNOSuncoupling during reperfusion and intracellular calcium homeostasis. Finally, this work opens newperspectives regarding the role of NO synthesis modulation to impact heart sensitivity to IR