L'ischémie se caractérise par l'obstruction d'une artère coronaire qui prive le tissu d'un apport en oxygène et nutriments. Bien que nécessaire, la reperfusion, c'est-à-dire la réouverture de l'artère, s'accompagne de lésions tissulaires, appelées lésions de reperfusion. Au cours de l'I/R, le TNF-α, cytokine pro-inflammatoire, augmente. Sa liaison sur son récepteur TNFR1 induit le recrutement des protéines FADD et procaspase-8 formant le complexe DISC qui permet l'activation de la caspase-8. La caspase-8 clive une protéine pro-apoptotique, Bid, qui induit une perméabilisation de la membrane mitochondriale entrainant une production excessive de radicaux libres et une libération de cytochrome c. Cette dernière associée à Apaf-1 et procaspase-9 sert de plateforme d'activation à la caspase-9, qui, une fois activée, clive et active la caspase-3. La caspase-2 est une caspase initiatrice, tout comme la caspase-8. Pourtant, son rôle dans l'I/R cardiaque est peu connu. La production de ROS via la voie TNF-α/caspase-8 provoque des dommages à l'ADN. Ceci entraine l'activation de PARP-1, une enzyme impliquée dans la réparation de l'ADN. En fonctionnant, PARP-1 produit de l'ADP-ribose qui peut se fixer sur le canal TRPM2 et ainsi l'activer. L'ouverture de ce canal cationique provoque une entrée de Ca2+ qui contribue à la mort cellulaire et aux lésions de reperfusion. L'objectif de ce travail est de déterminer les mécanismes de mort cellulaire faisant intervenir la caspase-8, la caspase-2 et TRPM2 et d'évaluer les effets d'une inhibition de ces protéines sur les lésions de reperfusion. Un modèle de rat I/R met en évidence une augmentation de TNF-α après seulement 1h de reperfusion suivie d'une activation de la caspase-8. Cette activation entraine une production de ROS qui altère la structure et la fonction du canal RyR2, favorisant la fuite de Ca2+ du reticulum sarcoplasmique vers le cytosol. La caspase-2, exprimée dans le ventricule gauche, est activée avant la caspase-8 et induit une voie apoptotique de type intrinsèque. L'inhibition de la caspase-8 ou de la caspase-2 diminue les lésions de reperfusion. Parallèlement, le TNF-α induit un courant de type TRPM2 via l'activation de la caspase-8 et la production de ROS. In vivo, l'inhibition de TRPM2 par le clotrimazole diminue les lésions de reperfusion chez un modèle de souris I/R. La caspase-8, la caspase-2 et TRPM2 contribuent aux lésions de reperfusion et apparaissent comme de bonnes cibles dans la cardioprotection. / Myocardial ischemia and reperfusion (I/R) lead to repefusion injury. TNF-α, a pro-inflammatory cytokine, increases during reperfusion and contributes to this injury. The binding TNF/TNFR1 leads to the recruitment of FADD, TRADD and procaspase-8 and form a complexe named DISC. This complexe activates caspase-8, which cleaves Bid, a pro-apoptotic member of Bcl-2 family. tBid disrupts the mitochondrial membrane and induces a ROS production and a release of cytochome c, localized in intermembrane space. In cytosol, a complexe named apoptosome is formed with cytochrome c, Apaf-1 and procaspase-9 to activate caspase-9, which cleaves and activates caspase-3. Like caspase-8, caspase-2 is an initiator caspase. But little data exists on the role of this caspase in myocardial I/R.The disruption of mitochondria induces a ROS production which causes DNA damage. The enzyme PARP-1, involved in DNA repair, is then activated. By operating, PARP-1 produces ADP-ribose which can bind on TRPM2, a non selective cationic channel of TRP family. The opening of TRPM2 causes an increase of cytosolic calcium promoting cell death and reperfusion injury. The goal of this study was to determine the mechanisms of cell death after I/R involving caspase-8, caspase-2 and TRPM2 and to test an inhibitor of each protein on reperfusion injury. With a model of rat I/R, we demonstrated that TNF-α increases after only 1h of reperfusion following by a caspase-8 activation and a ROS production. Oxidative stress causes a modification of RyR2 with a leak of calcium in cytosol. Caspase-2, also expressed in ventricles, is activated before caspase-8 and induces an intrinsic apoptotic pathway until caspase-3 activation. An inhibition of caspase-8 or caspase-2 decreases the reperfusion injury.In mouse cardiomyocytes, TNF-α induces a TRPM2-like current through caspase-8 activation and ROS production. TRPM2 inhibition by clotrimazole decreases cell death and reperfusion injury in vivo.In conclusion, caspase-2, caspase-8 and TRPM2 play an important role in cell death pathway ans should be good therapeutical tools.

IN ENGLISH The ischemia-reperfusion (I/R) injury, which is a consequence of myocardial infarction, represents a major cause of death worldwide. One of the most effective cardioprotective interventions increasing the resistance of hearts to the I/R injury is the adaptation to a chronic hypoxia (CH). However, the molecular mechanisms of CH are still not well understood. The most important factors responsible for the I/R injury are reactive oxygen species (ROS) produced by complexes I and III within the mitochondrial electron transport chain. Potential candidates maintaining ROS at a low level are mitochondrial creatine kinase (mtCK) and two hexokinase isoforms (HK1 and HK2). These enzymes highly support the mitochondrial oxidative phosphorylation by increasing the availability of ADP for complex V of the respiratory chain. In addition, the HK binding to mitochondria inhibits binding of the pro- apoptotic protein BAX, thereby protecting cardiac cells against apoptosis. Besides the mitochondrial CK isoform, there are two cytosolic CK (CKM and CKB) present in cardiomyocytes that help to maintain energy homeostasis. Based on the known anatomical and physiological differences between the left (LV) and the right (RV) ventricles, the first study focused on the comparing ventricles in terms of the energy...

L’ischémie/reperfusion (I/R) induit des lésions impliquées dans la physiopathologie de la transplantation cardiaque où elles contribuent à augmenter le rejet de greffe. Le stress induit par l’ischémie entraîne la libération d’ATP conduisant à l’activation de récepteurs purinergiques (P2R) dont l’expression est établie au niveau cardiaque et immunitaire. L’objectif de ce travail a été d’explorer l’effet de la signalisation P2R sur le phénotype des cellules dendritiques (DCs) et la réponse des cardiomyocytes (CM) à l’I/R. Nous avons montré que la récepteur P2Y11 (P2Y11R) avait une action immunomodulatrice sur les DCs en diminuant la sécrétion d’IL-6 et IL-12 et en inhibant la polarisation de la réponse adaptative vers Th1. Le post-conditionnement pharmacologique ciblant P2Y11R a apporté une protection efficace sur les CM en limitant le stress oxydant et en activant la PKCe connue pour inhiber l’ouverture du mPTP. Les effets protecteurs et immunomodulateurs de P2Y11R se sont confirmés in vivo en diminuant le rejet allogénique dans un modèle murin de transplantation cardiaque hétérotopique. Nos résultats suggèrent que P2Y11R pourrait être une cible thérapeutique apportant des effets bénéfiques en transplantation cardiaque. / Ischemia/reperfusion (I/R) injuries are involved in the pathophysiology of heart transplantation where they will increase graft rejection. Ischemia generates cellular stress leading to ATP release in the extracellular medium that may activate purinergic receptors (P2R) expressed by cardiomyocytes and immune cells. Therefore, these receptors may play important regulatory roles. The aim of this study was to investigate the effect of P2R signaling on dendritic cells phenotype (DCs) and cardiomyocyte (CM) response to I/R. We showed that P2Y11 receptor (P2Y11R) exhibited an immunomodulatory role in DCs by decreasing release of IL-6 and IL-12 and inhibiting polarization of the adaptive response towards Th1. Pharmacological post-conditioning targeting P2Y11R provided effective protection to CM by limiting oxidative stress and activating PKCe known to inhibit the opening of the mPTP. The protective and immunomodulatory effects of P2Y11R stimulation were confirmed in vivo by the decrease of allogeneic acute rejection in a murine model of heterotopic heart transplantation. In conclusion, our results strongly suggest that P2Y11R may be a promising therapeutic target providing beneficial effects in cardiac transplantation.

A transferência de retalhos livres e o reimplante de tecidos têm em comum a exposição dos tecidos à isquemia e tempos de reperfusão variáveis, que são importantes na determinação dos danos celulares estruturais e ultraestruturais, às vezes irreversíveis. O tempo de isquemia dificilmente pode ser controlado no período pré ou transoperatório, mas pode-se tentar prevenir ou diminuir as alterações celulares com soluções preservadoras, como, por exemplo, a da Universidade de Wisconsin, amplamente utilizada na prática clínica dos transplantes de tecidos. Porém a disponibilidade e o custo alto destas soluções dificultam seu uso rotineiro nos centros cirúrgicos. O presente trabalho propõe a utilização de solução de preservação (Solução Plástica-USP) que pode ser facilmente preparada com medicamentos accessíveis e baixo custo; a eficiência desta solução foi comparada com a da solução de Wisconsin. Os resultados demonstraram que não existe diferencia significativa entre a solução Plástica-USP, comparável à solução de Wisconsin; conferindo, ambas, um maior nível de proteção celular sobre os controles; beneficiando significativamente os resultados, e diminuindo assim os riscos de perdas do transplante a baixo custo / The free flaps transfer and reimplantation of tissue has in common the exposure of the tissue to ischemia and different time of reperfusion which are important for the determination of the extent of the cellular injury, being sometimes irreversible. In the pre and trans-surgical procedure the control of the ischemic period is difficult. Although efforts are made to prevent and decrease cellular changes using preservative solution, such as University of Wisconsin (UW) used in routine transplant of organs. The availability and high cost of this solution some time is one problem. The present study was made in a rat model that we have been reported in others works, we proposed the utilization of a preservation solution that we called Plastic Surgery-USP solution (PS-USP); witch can be easily prepared with accessible and low cost drugs. The efficiency of this PS-USP solution was compared to UW; our result showed that there is not significative difference in the protective effects of the PS-USP and UW solutions; both solutions were efficient considering cellular protection to ischemia/reperfusion injury, decreasing the risks of flap lost, with low cost and easy disposition

Citocinas geradas durante a I/R-i promovem lesão pulmonar aguda e podem causar imunossupressão. Investigamos se a inflamação pulmonar após dias de reperfusão intestinal está relacionada com alterações no sistema imune. Ratos machos Wistar foram submetidos a oclusão da artéria mesentérica superior por 45 min e a 2 h, 3, 5 ou 20 dias de reperfusão. Observamos que após 5 dias de reperfusão intestinal enterobactérias estão presentes nos linfonodos mesentéricos e que os neutrófilos circulantes estão mais ativos no combate a patógenos, enquanto leucócitos da cavidade peritoneal não. Notamos aumento de IL-1b, TNF-a, IL-17, IL-4 e diminuição de IL-10 no explante pulmonar e aumento de IL-1b, IFN-g e LDH no soro. Já os níveis de nitritos, corticosterona, HMGB-1, ácido úrico, AMPc e a mecânica respiratória não se alteraram. Os resultados apontam para a I/R-i como promotora de modificação temporais no organismo. Alterações nos mecanismos regulatórios da inflamação e do sistema imune contribuem para a inflamação pulmonar e sistêmica, sem alterar a função mecânica pulmonar / Cytokines generated during intestinal I/ R promote acute lung injury and may cause immunosuppression. We investigate if the pulmonary inflammation observed after several days of reperfusion is related to changes in the immune system. Male Wistar rats were subjected to occlusion of the superior mesenteric artery for 45 min and reperfused for 2 h , 3, 5 or 20 days. We observed that after 5 days of reperfusion enterobacteraceae are present in mesenteric lymph nodes and that circulating neutrophils are more effective against pathogens, whereas leukocytes from the peritoneal cavity are not. We noted increase of IL-1b, TNF-a, IL-17, IL -4 and decrease of IL-10 in lung explant and increase of IL-1b, IFN-g and LDH in serum. Furthermore, the levels of nitrites, corticosterone, HMGB -1, uric acid, cAMP, as well as respiratory function, did not change. Based on the foregoing, we observed that alterations in regulatory mechanisms of inflammation and immune system after contribute to pulmonary and systemic inflammation, but do not alter pulmonary mechanical function.

Introdução: O transplante renal é amplamente reconhecido como a melhor forma de tratamento para os pacientes que necessitam de terapia de substituição renal. Frequentemente a equipe transplantadora se depara com a difícil questão de determinar se órgãos, provenientes de doadores falecidos e limítrofes ou em parada cardíaca, estão aptos para serem transplantados. É difícil quantificar a intensidade do dano provocado pela isquemia no enxerto a ser utilizado, especialmente se o doador apresentou quadro de instabilidade hemodinâmica com queda significativa da perfusão tecidual e aumento do risco de diminuir a função do enxerto e afetar adversamente sua sobrevida. Desta forma torna-se justificável a utilização da técnica de espectroscopia de fluorescência induzida pelo laser, na tentativa de se avaliar a correlação entre os seus achados e o grau de lesão histológica renal experimental, uma vez que se trata de um método objetivo, não invasivo, rápido e em tempo real que, futuramente, pode ser aplicada nos transplantes renais em humanos. Objetivos: Avaliar a correlação entre os dados da espectroscopia de fluorescência induzida pelo laser e alterações histológicas na isquemia e reperfusão renal em ratos, e se existe diferença significativa na leitura da espectroscopia entre os polos superior, inferior e o terço médio. Materiais e Métodos: Foram utilizados 33 ratos (Rattus norvegicus) machos adultos da linhagem Wistar que, depois de anestesiados, tiveram seus rins esquerdos abordados. Inicialmente os rins foram submetidos à detecção da espectroscopia de fluorescência dos pólos superiores, inferiores e terços médios. As excitações foram geradas por lasers com comprimentos de onda de 408, 442 e 532 nm. Em seguida os pedículos renais esquerdos foram dissecados, isolados e clampeados com auxílio de mini-pinça vascular. Então, os animais foram divididos aleatoriamente em três grupos isquêmicos de 30, 60 e 120 minutos de isquemia quente. Em cada um dos grupos, os rins foram novamente analisados pela espectroscopia de fluorescência, bem como após 5 minutos de reperfusão, utilizando novamente feixes excitatórios com os mesmos comprimentos de onda, nas mesmas regiões renais. Posteriormente os rins esquerdos foram coletados e enviados para estudo histológico. Resultados: O tempo de isquemia mostrou forte influência com a graduação histológica. Com 30 minutos de isquemia, nenhum comprimento de onda (408, 442 e 532 nm) apresentou correlação com a graduação histológica (p = 0,81; p = 0,11; p = 0,21, respectivamente). Com 60 minutos de isquemia, o laser de excitação de 532 nm (na fase de reperfusão) apresentou coeficiente de correlação negativa significativa (r = - 0,61) com a graduação histológica. Na isquemia de 120 minutos, o laser com 442 nm de comprimento de onda (na fase de reperfusão) mostrou o coeficiente de correlação negativa significativa (r = - 0,73) com a graduação histológica. O terço médio renal apresentou média estatística superior à dos polos (p < 0,001) na leitura da espectroscopia de fluorescência. Conclusões: Há correlação entre os dados da espectroscopia de fluorescência induzida pelo laser e as alterações histológicas na isquemia renal em ratos, sendo necessário, durante a investigação, analisar apenas o terço médio renal. / Introduction: Renal transplantation is widely recognized as the best form of treatment for patients who require renal replacement therapy. Often, the transplant team is faced with a difficult question, if organs from deceased marginal donors or non-heart beating donors are able to be transplanted. It is difficult to quantify the intensity of damage caused by ischemia in the graft to be used, especially if the donor had hemodynamic instability with a significant decrease of the tissue perfusion and an increased of the risk of diminishing the graft function which could affect adversely its survival. Thus it is justified to use the technique of laser-induced fluorescence spectroscopy, to assess the correlations between its results and the histological grade in experimental renal injury, since it is an objective, non-invasive, fast and in real-time analysis, which can be applied, in the future, in human kidney transplants. Objectives: To evaluate the correlation between the data of laser-induced fluorescence spectroscopy and histological changes in kidney ischemia and reperfusion in rats, and if there are significant differences of reading between the upper and lower poles and the middle area of such kidneys. Materials and Methods: We used 33 adults male rats (Rattus norvegicus) of Wistar strain, which after anesthetized, had their left kidney addressed. Initially such kidneys were submitted to detection of the fluorescence spectroscopy of the upper pole, lower pole and the middle area. Excitations were generated by lasers having wavelengths of 408, 442 and 532 nm. Then the left renal pedicles were dissected, isolated and clamped. Then the animals were randomized into three ischemic groups of 30, 60 and 120 minutes. In each group, the kidneys were analyzed by fluorescence spectroscopy for the second time, and again after 5 minutes of reperfusion, using excitatory beam with same wavelength, at the poles (upper and lower) and the middle area of the kidneys. Later, the left kidney were collected and sent for histological examination. Results: The ischemia time showed a strong influence on the histological grade. With 30 minutes of ischemia, no wavelength (408, 442 and 532 nm) was correlated with the histological lesions (p = 0.81, p = 0.11, p = 0.21, respectively). With 60 minutes of ischemia, the laser excitation of 532 nm (in the reperfusion phase) showed a significant negative correlation coefficient (r = - 0.61) with the histological grading. In 120 minutes of ischemia, laser with 442 nm wavelength (in the reperfusion phase) showed a significant negative correlation coefficient (r = - 0.73) with the histological grade. The middle area of the kidneys showed a higher average statistically (p< 0,001) than the poles in the reading of fluorescence spectroscopy. Conclusions: There is a strong correlation between the data of laser-induced fluorescence spectroscopy and the histological changes in rats renal ischemia, being necessary, during the investigation, to analyze only the middle area of the kidneys.

Orientador: Norma Sueli Pinheiro Modolo / Resumo: Justificativa: Durante lesão de isquemia e reperfusão renal ocorre a inativação de óxido nítrico (NO), essa inativação diminui o relaxamento arterial endotélio-dependente e independente. O aumento nos níveis de NO poderia melhorar a disfunção endotelial e o relaxamento arterial diminuindo a lesão renal. O NO, sintetizado a partir da L-arginina pela enzima óxido nítrico sintase (NOS), parece exercer um efeito protetor sobre os rins durante a lesão de isquemia/reperfusão (I/R). O objetivo do estudo foi avaliar o efeito da L-arginina nos níveis dos biomarcadores de lesão (NGALp, NGALu, KIM-1 e IL-18) na função e na histopatologia renal em ratos submetidos a lesão de I/R.Métodos: 32 ratos Wistar foram randomizados em 4 grupos: Sham (S): Laparotomia e nefrectomia direita. Controle (C): Laparotomia e nefrectomia direita, I/R em rim esquerdo. Controle L-arginina (CLA): Laparotomia e nefrectomia direita, L-arginina na dose de 800mg.kg-1.dose-1, 24 e 1 hora antes. L-arginina (LA): Laparotomia e nefrectomia direita, I/R em rim esquerdo, L-arginina na dose de 800mg.kg-1.dose-1, 24 e 1 hora antes. Foram analisados os níveis de NGALp, NGALu, KIM-1 e IL-18, creatinina e histopatologia renal. Nível de significância: p<0,05.Resultados: Creatinina aumenta em todos os grupos com LA≈C>S≈CLA. A NGALp, aumenta em todos os grupos com evolução semelhante. A NGALu foi maior no grupo C e CLA em relação ao grupo LA e apresentou valores intermediários no grupo S. Os níveis de KIM-1 aumentam nos gru... (Resumo completo, clicar acesso eletrônico abaixo) / Doutor

Les cardiofibroblastes (CF) possèdent des rôles clés dans la régulation de la structure et du fonctionnement myocardique. Leurs implications physiopathologiques, notamment dans le remodelage et la fibrose, ont été largement décrites dans les maladies cardiovasculaires chroniques. Cependant, leurs rôles au cours de la phase aigüe d'ischémie-reperfusion (l/R) restent encore à élucider. Nous avons donc émis l'hypothèse que les CF pouvaient participer à la protection des cardiomyocytes (CM) face aux lésions d'l/R. Le but de ce travail a donc consisté en l'exploration et l'identification des mécanismes de cette protection. Un modèle cellulaire de CM et CF de rats nouveau-nés in vitro et un modèle d'l/R in vivo chez la souris ont été utilisés. Nos résultats montrent que la présence des CF, en co-culture avec les CM, augmente de façon paracrine leur viabilité, face aux lésions d'l/R. Cette action paracrine a été confirmée par l'utilisation du sécrétome de CF hypoxiques capable, à lui seul, d'augmenter la viabilité des CM. Ces résultats ont été corroborés par des expériences d'l/R in vivo, dans lesquelles les souris traitées avec le sécrétome de CF présentent une diminution de la taille d'infarctus. De plus, nous avons montré que TlMP-1, un facteur fortement détecté dans le sécrétome de CF, est capable de diminuer à la fois la mortalité cellulaire in vitro des CM et la taille de l'infarctus in vivo. L'utilisation d'inhibiteurs pharmacologiques nous a permis de mettre en évidence que cette protection paracrine était médiée en partie par l'activation des voies de signalisation Pl3K/Akt et ERK1/2. En conclusion cette étude démontre pour la première fois que les CF participent, de façon paracrine, à la protection des CM au cours la phase aigüe d'ischémie reperfusion. TlMP-1 semble être un des facteurs clé de cette cardioprotection par les CF. En parallèle de ce travail, plusieurs études collaboratives ont été réalisées, sur une cible majeure d'investigation dans la cardioprotection : le pore de transition de perméabilité mitochondriale et notamment sa régulation par le complexe l de la chaîne respiratoire et les échanges calciques, ainsi que son implication dans la défaillance multi-organe face à l'arrêt cardiaque / Roles of cardiac fibroblasts (CF) in the regulation of myocardial structure and function have been emphasized in the last decade. Their implications in pathophysiological aspects of chronic heart diseases such as myocardial remodelling and fibrosis is now well established. However their contribution to the acute phase of ischemia reperfusion injury still remains elusive. We hypothesized that CF may contribute to cardiomyocytes (CM) protection against ischemia reperfusion (l/R) injuries. This study was designed to investigate this protection and identify some of its mechanisms. Experiments were performed both on isolated neonatal rat CF and CM in vitro and in vivo mice model of myocardial infarction. We demonstrated that the presence of CF increases CM viability in co-cultures and that CF protect CM against l/R injuries in a paracrine manner. lt was confirmed by a similar effect of hypoxic CF secretome alone on CM viability. These findings were corroborated by in vivo experiments in which an infarct size reduction was observed in CF secretome treated mice. Furthermore, experiments with Tissue lnhibitor of Metalloproteinases-1 (TlMP-1), abundantly detected in CF secretome, was able to both decrease CM cell death and infarct size. Experiments with pharmacological inhibitors provided more evidence that this paracrine protection is partly mediated by Pl3K/Akt and ERK signalling pathways. Our data demonstrated for the first time that CF participate in cardioprotection during the acute phase of ischemia reperfusion, via a paracrine pathway, involving TlMP-1. Besides this first work, other collaborative studies have been performed, to investigate a major target in cardioprotection research : the mitochondrial permeability transition pore and its regulation by chain respiratory complex l and Ca2+ transfers and finally its implication in multiple organ failure in cardiac arrest

L'ischémie-reperfusion (IR) rénale entraîne des lésions de nécrose tubulaire aigue, nécessitant parfois une épuration extra rénale transitoire voir définitive. La mitochondrie joue un rôle important dans la physiopathologie de ces lésions d'IR en entrainant la mort cellulaire. L'étude de l'IR dans la cellule cardiaque a permis de mettre en évidence le rôle central du pore de transition de perméabilité mitochondriale (mPTP) dans le déclenchement de cette mort cellulaire. La ciclosporine (CsA) a été proposée comme thérapeutique pour protéger la cellule des lésions d'IR en retardant l'ouverture de ce mPTP. Cependant la CsA a des effets rénaux vasoconstricteurs aigus, nécessitant une validation expérimentale de sa protection dans l'IR rénale. Au cours de ce travail de thèse, nous avons mis au point un modèle murin d'IR rénale. Ensuite nous avons montré que le post-conditionnement à la CsA, ainsi que le post-conditionnement ischémique, permettent d'améliorer la fonction rénale avec un retard à l'ouverture du mPTP. Dans un deuxième travail, nous montrons que le pré conditionnement à la CsA est dose et temps dépendant, et médié en partie par l'augmentation d'expression d'une protéine chaperonne, l'Heat Shock Protéine 70 (HSP70). L'injection en bolus de CsA permet également d'améliorer la fonction rénale dans ce modèle d'IR avec un retard à l'ouverture du mPTP. Nos résultats ouvrent de nouvelles perspectives dans la protection rénale, notamment dans la réduction des épisodes d'insuffisance rénale aigue après chirurgie aortique ou en transplantation rénale / Ischemia-reperfusion (IR) is a situation encountered in transplantation or during aortic surgery, which can result in renal damages, requiring sometimes transient or definitive dialysis. Mitochondria play a crucial role in the pathophysiology of IR causing cell death. Previous studies of cardiac IR highlighted the role of mitochondrial permeability transition pore (mPTP). Cyclosporin A (CsA) has been proposed as a treatment to protect the kidney from IR by the delay of the opening of the mPTP. However, CsA has acute renal hemodynamic effects and a long-term toxicity, requiring an experimental validation of its protection in the renal IR. In this work, we developed a mouse model of renal IR. In a first study, we showed that the post-conditioning with CsA and ischemic postconditioning improve renal function with a delay of the opening of the mPTP. In a second study, we showed that a high dose of CsA injected just before the ischemia improves renal function and leads to the delay of the opening of mPTP mediated by an increase of HSP70. Our results open new perspectives in renal protection, especially for reducing episodes of acute renal failure in aortic surgery or in renal transplantation

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.