Atherosclerosis is thought to be initiated by endothelial cell dysfunction. Research described in this dissertation is focused on interactions of nutrients, cytokines and pharmaceutical compounds in the intracellular signaling pathways leading to endothelial cell activation. The flavonoid quercetin could significantly downregulate the inflammatory pathways induced by linoleic acid as determined by DNA binding assays of the proinflammatory transcription factors nuclear factor-kappaB and activator protein-1 as well as by gene expression studies of interleukin-6 and vascular adhesion molecule-1. Interestingly, quercetin and vitamin E also prevented the linoleic acid-induced activation of PPAR DNA binding - suggesting a role of oxidation in the fatty acid-mediated induction of PPAR. In addition, we studied an interaction of zinc with the antiinflammatory transcription factors, peroxisome proliferator activated receptors (PPARs) alpha and gamma. Our data suggest that PPAR alpha and gamma and their synthetic agonists require zinc for their antiinflammatory properties in endothelial cells. We could confirm the importance of zinc in PPAR gamma signaling in vivo by a decreased PPAR DNA binding activity in livers of zinc deficient mice. Furthermore, zinc had dramatic lipid lowering effects in LDL-receptor deficient mice on a diet rich in corn oil. Triglycerides, phospholipids and cholesterol levels were significantly elevated in mice receiving a zinc deficient diet when compared to control and where decreased in zinc supplemented animals. Zinc deficiency also increased oxidative stress as determined by quantitation of plasma isoprostanes and mRNA expression of glutathione reductase. In conclusion, our data show novel interactions of proinflammatory nutrients, such as linoleic acid, with antioxidant and anti-inflammatory nutrients, such as quercetin and zinc.

Based on accumulating evidence, adequate intake of whole grains is associated with reduced cardiovascular disease CVD risk. Germinated brown rice (GBR) has been used in East Asian countries as an alternative grain. Preliminary studies suggest GBR has potential health benefits, including reducing CVD risk, but the mechanism remains unclear. The hypothesis of the project is that long-term consumption of GBR would reduce atherogenic risk factors in low-density lipoprotein receptor knockout (LDLr-KO) mice. To test the hypothesis, three groups of male LDLr-KO mice were fed with one of the following diets for 24 weeks: (a) commercial mouse chow, used as the control diet; (b) chow was replaced with 60% (w/w) Chinese white rice (CWR); and (c) chow was replaced with 60% (w/w) GBR. All diets were supplemented with 0.06% (w/w) dietary cholesterol to accelerate atherogenesis. Blood samples, hearts, livers and feces were collected and used for biochemical and histological analyses. The results demonstrated that no significant difference was detected in body weights, plasma or fecal lipid profiles and antioxidant enzyme activities among groups. However, GBR consumption significantly decreased atherosclerotic lesion (P = 0.003) in the aortic roots as compared with that in the CWR group, but there was no significant difference as compared with that in the control group (P = 0.4). In addition, GBR significantly decreased monocyte adhesion to the aorta in LDLr-KO mice as compared to that in the CWR group (P=0.0001), but not with the control group. These data suggested that GBR may be beneficial for the prevention of vascular inflammation and atherogenesis in LDLr-KO mice. Additional studies in animal models and humans may further investigate the mechanisms of the beneficial effects of GBR on vascular inflammation and atherogenesis. / May 2017

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Estudos mostram que indivíduos portadores de modificações ateroscleróticas precoces e mais graves possuem um ou mais fatores e marcadores equivalentes de risco cardiovascular na vida adulta como, dislipidemia, hipertensão, obesidade e hiperglicemia. Objetivos. Identificar marcadores plasmáticos, histológicos e imunohistoquímicos de gênese e progressão da aterosclerose humana precoce e crônica em amostras de plasma e fragmentos vasculares de pacientes submetidos à revascularização miocárdica. Casuística e Métodos. Foram avaliadas amostras de plasma e tecido vascular de 23 pacientes de ambos os gêneros, 44 a 73 anos, em dois grupos > 56 e < 56 anos, da Unidade de Cirurgia de Revascularização Miocárdica (RM) /Hospital Ana Nery/UFBA, com indicação de RM, entre Dez/2009 e Jun/2012. Foi determinado perfil lipídico, calculados indicadores de risco cardiovasculares e marcações para os receptores LDL-r, CD36 e CD68 em fragmentos de aorta e torácica interna. Resultados. Os dados do perfil lipídico entre os grupos dito crônico (> 56 anos) e dito precoce (< 56 anos) foram diferentes (p < 0,05). Os índices calculados no grupo < 56 anos estavam acima dos valores de referência. Em ambos os grupos, o índice de Gazziano (TG/HDL-C) indicou presença de LDL pequenas e densas. O grupo < 56 anos, mostra valores de tamanho de LDL inferiores (7,1 ± 1,4 vs 4,15 ± 2,9) quando comparados ao grupo > 56 anos, respectivamente. O não-HDL-C mostrou-se mais graves no grupo < 56 anos em função da hipertrigliceridemia (234±58mg/dL; p=0,0006). Nos estudos histológicos e imunohistoquímicos, observou-se aterosclerose discreta e marcações com diferentes intensidades entre os dois grupos para LDL-r, CD36 e CD68. Nos < 56 anos, observou-se estrias lipídicas, macrófagos degenerados, cristais de colesterol, basofilia de fibras elásticas e pontos hemorrágicos. A marcação para LDL-r nos >56 anos, mostrou-se difusa. Na torácica interna, as marcações foram focais e de baixa intensidade, porém, menos intensas do que nos < 56 anos. A marcação CD36 na torácica interna foi intensa nos pacientes < 56 anos, quando comparada com os cortes dos > 56 anos. A marcação para CD68 nos cortes de aorta foi intensa em ambos os grupos, porém, nos cortes de torácica interna a marcação foi tênue independente do grupo avaliado. Para o CD36, os dados apontam para risco em < 56 anos, em função da marcação intensa observada, esse receptor está implicado na gênese do processo aterosclerótico. Conclusões. Pode-se conceber que existe interação importante entre os marcadores plasmáticos e teciduais atuando no evento aterogênico, sendo mais graves em pacientes com menos de 56 anos. / Introduction. Although cardiovascular disease (CVD) often manifest in adulthood, the atherosclerotic process begins in childhood. Studies show that individuals with early atherosclerotic changes possess one or more equivalent factors and markers of cardiovascular risk in adult life as dyslipidemia, hypertension, obesity and hyperglycemia. Objective. Identify plasma markers, histological and immunohistochemical features of the genesis and progression of atherosclerosis in early human plasma samples and fragments of vascular patients undergoing myocardial revascularization. Casuistic and Methods. Samples of plasma and vascular tissue from 23 patients of both genders, 44 to 73 years, in two groups >56 and <56 years, from Myocardial Revascularization (MR) Surgery Unit / Ana Nery’s Hospital / UFBA, indicated to MR, between Dec/2009 Jun/2012. Lipid profile, calculated indices of cardiovascular risk markers and receptors for LDL-r, CD36 and CD68 in fragments and internal thoracic aorta was determined. Results. Lipid profile data between groups said as chronic (> 56 years) and said as precocious (<56 years) were different (p <0.05). The indices in the group <56 years were above the reference values. In both groups, the rate of Gazziano (TG / HDL-C) indicates the presence of small, dense LDL. The group <56 years, shows lower LDL size values (7.1 ± 1.4 vs 4.15 ± 2.9) when compared to > 56 years group, respectively. The non-HDL-C was more severe in the group <56 years due to hypertriglyceridemia (234 ± 58mg/dL, p = 0.0006). In histological and immunohistochemical studies, were observed discrete atherosclerosis and marks with different intensities between the two groups for LDL-r, CD36 and CD68. In <56 years, were observed lipid streaks, degenerate macrophages, cholesterol crystals, basophilia of elastic fibers and bleeding points. The markup for LDL-r in > 56 years was diffused. In internal thoracic, the tissue marks were of low intensity and focally localized, but less intense when compared to <56 years group. The internal mammary CD36 mark was high in patients <56 years, when compared with > 56 years. The marks for CD68 in aorta was intense in both groups, however, in internal thoracic was tenuous independent of evaluated group. For CD36, the data point to risk from <56 years, due to the intense labeling observed, this receptor is really implicated in the pathogenesis of atherosclerosis. Conclusion. It is conceivable that there is significant interaction between the plasma and tissue markers acting in atherogenic event, being most severe in patients younger than 56 years.

Der Endozytoserezeptor Megalin gehört zu einer Gruppe von strukturell und funktionell verwandter Rezeptoren, der LDL R Gen Familie. Es sind zwei Arten von Lipidtransportpartikel beschrieben worden, die durch Megalin in Zellen aufgenommen werden. Zum einen werden Lipoproteine über ihre Apoproteine von Megalin erkannt und endozytiert. Zum anderen nimmt Megalin die hydrophoben Vitamine A und D über ihre Carrierproteine in ihre Zielzellen auf. Es handelt sich um Vitamin D bindendes Protein (DBP) und Retinol bindendes Protein (RBP). Zweck dieser Arbeit war es zu untersuchen, ob die Endozytose von Steroidcarriern durch Megalin ein genereller Mechanismus ist oder ob DBP und RBP Ausnahmen darstellen. Hierzu wurden exemplarisch drei Carrierproteine (24p3, Apo D und CCSP) für Steroide ausgesucht, die in Megalin-exprimierende Gewebe aufgenommen werden. Der (rekombinante) Retinolcarrier 23p3 zeigte bei surface plasmon resonance Analysen keine direkte Bindung an Megalin. Der Progesteron-Carrier Apo D hingegen bindet Megalin, ferner konnte in Zellkulturversuchen Endozytose und lysosomale Degradation von Apo D in Megalin-exprimierende Zellen nachgewiesen werden. Auch der Progesteron-Carrier CCSP wird durch Megalin in Zellen aufgenommen, allerdings ist zur Endozytose von CCSP ein Co-Rezeptor notwendig. Mit dieser Arbeit ist die erste in vivo-Beschreibung eines dualen Rezeptorsystems aus Megalin und einem peripheren Membranprotein namens Cubilin gelungen, welches u.a. im proximalen Tubulus der Niere existiert. Abschließend wurde exemplarisch für ein Steroidhormon-abhängiges Gewebe der murine Uterus hinsichtlich seiner Megalin-Expression untersucht. Es konnte ein bereits bekannter Ligand Megalins, das Glykoprotein Laktoferrin, aus der uterinen, luminalen Flüssigkeit aufgereinigt werden. Ferner konnte gezeigt werden, dass die Expression von Laktoferrin im Uterus strenger hormoneller Kontrolle unterliegt. / The endozytic receptor Megalin belongs to a group of structurally and functionally related receptors called LDL R gene family. Two different types of lipid particles are taken up by Megalin into target cells. The first type, lipoproteins are recognized and internalized by Megalin via their apoproteins. In addition, Megalin mediates the endocytosis of the lipophilic vitamins A and D into target cells by means of their carrier proteins. These proteins are the vitamin D binding protein (DBP) and retinal binding protein (RBP). The aim of the investigations was to determine, if the endocytosis of steroid hormone carriers by Megalin is a common occurrence or restricted only to DBP and RBP. Therefore, three carrier proteins for steroids (24p3, Apo D and CCSP) were chosen as an example. All of them are known to be taken up in Megalin expressing tissues. In surface plasmon resonance analysis recombinant 24p3, a carrier of retinol, showed no affinity to Megalin. Whereas the progesterone carrier Apo D bound to Megalin. Furthermore, it was endozytosed and degraded in lysosomes by Megalin expressing cells. The cellular uptake of the progesterone carrier CCSP is mediated by Megalin as well, however a co-receptor is needed. This work demonstrates for the first time the existence of a dual receptor pathway consisting of Megalin and a peripheral membrane protein named Cubilin in vivo. This systems is functional in addition to other tissues in the proximal tubule of the kidney. Finally, the Megalin expression in the murine uterus as an example of a steroid dependent tissue was investigated. Lactoferrin a known Megalin ligand was purified from the luminal uterine fluid. Furthermore, Lactoferrin expression in the uterus was shown to be under tight hormonal control.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Die autosomal-dominant vererbte Familiäre Hypercholesterinämie ist durch eine exzessive Erhöhung der LDL-Serumcholesterinspiegel gekennzeichnet und bedingt aufgrund einer prämaturen Atherosklerose den frühzeitigen Tod der Patienten. Da ursächlich ein defekter LDL-Rezeptor (LDL-R) zugrundeliegt, der durch Mutationen im Bereich des LDL-R-Gens hervorgerufen wird, kommt der Gentherapie als potentieller Behandlungsmöglichkeit ein besonderer Stellenwert zu. Diese Arbeit untersuchte den Einfluß einer Virusdosiseskalation auf Cholesterinsenkung und Langzeitexpression im adenoviral vermittelten LDL-R-Gentransferversuch im Kaninchenmodell. Hierfür wurden 7 Watanabe Heritable Hyperlipidemic Kaninchen, welche an einer vergleichbaren kongenitalen Hypercholesterinämie durch einen LDL-R-Defekt leiden, mit unterschiedlichen Dosierungen eines Adenovirus des Serotyps 5 therapiert, der die Gensequenz für den humanen LDL-R enthielt. Vor und nach Therapie wurden Bestimmungen der Serumcholesterinkonzentrationen und LDL-Stoffwechselkinetiken mit 125I-LDL sowie semiquantitative szintigraphische Auswertungen durch 111In-LDL-Scans durchgeführt. Hierbei mußte festgestellt werden, dass die adenoviral vermittelte transgene Expression des LDL-R durch die Bestimmung des Serumcholesterins nicht korrekt wiedergegeben wird. Denn zum einen konnte bei der Bestimmung des Serumcholesterins ein dosisabhängiger Effekt beobachtet werden, dieser zeigte sich bei den Stoffwechselkinetiken mit 125I-LDL und bei den Scanuntersuchungen mit 111-In-LDL jedoch nicht. Zum anderen kam es innerhalb von 12-18 Tagen nach Gentransfer zu einem Wiedererreichen der Serumcholesterinausgangswerte, wohingegen die in vivo-Stoffwechselkinetiken eine erhöhte Abbaurate radiomarkierter LDL und die Szintigraphie eine LDL-R-Expression über die gesamte Dauer des Experimentes von 120 Tagen belegten. / Familial hypercholesterolemia is an autosomal dominantly inherited disease characterized by an exzessive elevation of serum LDL cholesterol which leads to premature atherosclerosis and an early death of the patients. As the reason is a defective LDL receptor (LDLR) caused by mutations in the gene encoding LDLR, gene therapy plays an increasingly important role as a treatment possibility. This paper examined the influence of an escalation of the virus dose on the cholestorol reduction and long-term expression in the adenovirally mediated LDLR gene therapy experiment using a rabbit animal model. To facilitate this 7 Watanabe Heritable Hyperlipidemic rabbits, suffering from an equivalent congenital hypercholesterolemia due to a LDLR defect, were treated with different doses of a serotype 5 adenovirus which contained the gene sequence of the human LDLR. Pre and post gene therapy measurements of the serum cholesterol levels and kinetics of LDL metabolism with 125I-LDL were performed, as well as semiquantitative scintigraphic analysis of 111In-LDL scans. The finding was that the adenovirally mediated transgene expression of the LDLR was not correctly reflected by the measurement of the serum cholesterol levels. This was because of a dose dependant effect concerning the measurements of the serum LDL cholesterol levels, which did not appear regarding the kinetics of LDL metabolism with 125I-LDL and the scans with 111In-LDL. Moreover, the serum cholesterol levels reached their initial value within 12-18 days post gene transfer whilst the in vivo-kinetics of LDL metabolism showed an increased catabolic rate of radiolabeled LDL and the scintigraphy indicated a LDLR expression for the whole period of the experiment lasting 120 days.

Cette maitrise a été fait en co-direction : Jean-Marc Lavoie (UdeM) et David St-Pierre (UQAM). / Mise en contexte : La présente étude a pour but de tester l’hypothèse selon laquelle l’accumulation excessive de lipides au foie perturbe le métabolisme du cholestérol. La stéatose hépatique perturberait ainsi principalement les voies métaboliques qui impliquent les récepteurs de LDL au foie. Méthodologie: Des rats Wistar (n/groupe = 10) ont été soumis soit à une diète standard (SD), une diète enrichie en lipides (HFD : High Fat Diet) ou à une diète occidentale (WD : Western Diet) pour une durée de 2 ou 6 semaines. Au niveau de la composition des diètes, 60% de l’apport calorique de la diète enrichie en lipides provient des lipides tandis que la diète occidentale est composée à 40% de lipides et 35% de sucrose dont 17,5% de fructose. Résultats: Comparativement aux animaux traités pendant 2 semaines, le poids des tissus adipeux était environ trois fois plus élevé (~ 20 vs 7 g) chez les animaux soumis à 6 semaines de diètes obésogènes. Une augmentation significative du gain de poids (~ 40g) a été observée uniquement après 6 semaines chez les groupes soumis à la HFD ou la WD (P < 0.01). Comparativement aux animaux soumis à la diète conventionnelle, les niveaux de triglycérides (TG) hépatiques étaient significativement supérieurs chez les rats nourris avec la HFD et WD (P < 0.01) et ce, indépendamment de la durée du traitement. Après deux semaines, des concentrations de TG hépatiques significativement plus élevées (P < 0.05) ont été observés chez les animaux avec la WD comparativement à celles des rats avec la HFD. Des niveaux de cholestérol plasmatiques significativement plus élevés (P < 0.05) ont été mesurés chez les animaux avec la WD par rapport à la SD et la HFD et ce indépendamment de la durée. Après 2 et 6 semaines de diètes, l’expression génique au foie de LDL-R, PCSK9 et SREBP2, qui sont impliqués dans la captation des LDL-cholestérol, a significativement diminué chez les animaux soumis à la WD comparativement à ceux nourris avec la diète SD ou HFD (P < 0.01). De la même manière, des niveaux d’ARNm de LRP1 et ACAT2 significativement diminués (P < 0.01) ont été mesurés chez les animaux nourris avec WD comparativement ceux du groupe SD. L’expression de l’HMGCoAR, l’enzyme limitante impliquée dans la régulation de la synthèse endogène de cholestérol, a été significativement 6 diminuée chez les animaux soumis à la WD comparativement à ceux traités avec la SD ou la HFD après 2 (P < 0.001) et 6 semaines (P < 0.05). Dû au fait que la diète soit enrichie en sucrose et conséquemment en fructose, la WD a fortement favorisé l’expression de ChREBP et ACC, deux régulateurs majeurs dans la voie de la lipogenèse de novo. Conclusion: Ces résultats suggèrent que la diète de type occidentale augmenterait les niveaux de TG en favorisant simultanément la captation exogène de lipides ainsi que leur production endogène par l’activation de la lipogenèse de novo. L’altération de la voie de la captation du cholestérol par les LDL-R favoriserait une augmentation rapide des taux plasmatiques de cholestérol. / Background: The present study was designed to test the hypothesis that excessive fat accumulations impair cholesterol metabolism mainly through alterations in the LDL-receptor (LDL-R) pathway in liver. Method: Rats were either submitted to standard (SD), high fat (HFD; 60% kcal) or western (WD; 40% fat + 35% sucrose (17.5% fructose)) diets for 2 or 6 weeks. Results: Weight gain (~ 40g) was observed only following 6 weeks of the obesogenic diets (P < 0.01). Compared to the 2-week treatment, obesogenic diets tripled fat pad weight (~ 20 vs 7 g) after 6 weeks. Hepatic triglyceride (TG) levels were greater in response to both the WD and HFD compared to the SD (P < 0.01) at 2 and 6 weeks and their concentrations were greater (P < 0.05) in WD than HFD at 2 weeks. Plasma cholesterol levels were higher (P < 0.05) in animals submitted to WD compare to SD and HFD. After 2 and 6 weeks, liver expression of LDL-R, PCSK9 and SREBP2, involved in LDL-cholesterol uptake, was lower in animals submitted to WD than in others treated with HFD or SD (P < 0.01). Similarly, LRP1 and ACAT2 mRNA levels were lower (P < 0.01) among WD compared to SD-fed rats. Expression of the gene coding the main regulator of endogenous cholesterol synthesis, HMGCoAR was reduced in response to WD compared to SD and HFD at 2 (P < 0.001) and 6 (P < 0.05) weeks. Being enriched in fructose, the WD strongly promoted the expression of ChREBP and ACC, two key regulators of de novo lipogenesis. Conclusion: These results show that the WD promptly increased TG levels in the liver by potentiating dietary fat storage and de novo lipogenesis. This effect impaired hepatic cholesterol uptake via the LDL-R axis and promoted a rapid increase in plasma cholesterol levels.

Il existe un nombre grandissant de preuves au cours des dernières années que la diminution de la sécrétion des œstrogènes chez les animaux ovariectomisés (Ovx) et chez les femmes ménopausées conduit à une accumulation importante de triglycérides (TG) dans le foie. Cependant, les évidences de perturbations dans le métabolisme du cholestérol, en lien avec la diminution des œstrogènes, sont limitées à des observations de niveaux élevés de cholestérol total dans le plasma trouvés chez la femme ainsi que chez les animaux. En fait, l'impact de la suppression des œstrogènes sur le métabolisme du cholestérol dans le foie a reçu peu d'attention et montre quelques controverses. Par conséquent, les trois études présentées dans cette thèse ont été réalisées chez des rats Ovx, comme modèle animal de femmes post-ménopausées, afin de documenter les effets du retrait des œstrogènes sur les marqueurs moléculaires clés du métabolisme du cholestérol et des acides biliaires dans le foie et dans l'intestin et des effets potentiels de l’entraînement physique. Il a été en effet démontré que l'entraînement physique peut réduire le niveau plasmatique de cholestérol. Une amélioration du transport du cholestérol en périphérie vers le foie pour sa sécrétion subséquente dans la bile et pour son l'excrétion de l'organisme a été suggérée, bien que les mécanismes sous-jacents ne soient pas entièrement compris. Dans la première étude, nous avons démontré que les rattes Ovx nourris avec une diète standard et une diète standard + cholestérol avait un taux de cholestérol total dans le foie plus élevé (P <0,05) que les rattes avec une ovariectomie simulée (Sham) nourris avec ces deux derniers types de diète, tandis que la teneur en triglycérides du foie était plus élevée chez les rattes Ovx que chez les rattes Sham nourris avec une diète standard, une diète standard + cholestérol et aussi une diète riche en grasses + cholestérol. Étonnement, la diète standard + cholestérol a été associée à un niveau plasmatique plus faible (P <0,001) de cholestérol total et de triglycérides chez les rats Ovx que les rats Sham, ce qui suggère une diminution de la sécrétion de lipoprotéines à très basses densités (VLDL). Par conséquent, la transcription de plusieurs marqueurs clés de la synthèse des VLDL, y compris la microsomal triglyceride transfer Protein (MTP) et apoB-100, ont été réduites (P <0,05) chez les rattes Ovx par rapport aux rattes Sham nourris avec tous les trois types diètes et cette diminution de MTP et apoB-100 était plus prononcée chez les rats nourris avec la diète standard + cholestérol. Pour aller un peu plus loin, dans la deuxième étude, nous avons déterminé les effets de l'entraînement physique sur les marqueurs clés hépatiques de la voie farnesoid X receptor (FXR) - small heterodimer partner (SHP) - de cholestérol 7 alpha-hydroxylase (CYP7A1) (FXR-SHP-CYP7A1) impliquée dans la conversion de cholestérol en acides biliaires et de leur excrétion chez les rat Ovx nourris avec une diète standard + cholestérol. Notre groupe expérimental principal comprenait des rats Ovx nourris avec une diète riche en cholestérol (Ovx-Chol). Ce groupe a été comparé à un groupe de rats Ovx nourris avec une diète standard (Ovx-SD) et un groupe de rats Sham nourris avec une diète riche en cholestérol (Sham-Chol) pour observer, respectivement, l'effet de l'alimentation et l’effet du retrait de l'œstrogène. Les résultats de cette étude ont démontré que les niveaux de cholestérol total dans le plasma et dans le foie ne sont pas affectés par l'entraînement physique dans aucune des conditions expérimentales. L'alimentation en cholestérol a induit une accumulation plus importante chez les rats Sham et Ovx a mené à une accumulation du cholestérol dans le foie significativement plus élevée (P <0,001) que chez les rats Ovx-SD. Un effet principal d'entraînement physique (P <0,05) a été trouvée dans l’expression génique du SHP et de CYP7A1. Ce dernier gène est reconnu pour son implication majeure sur le contrôle de la biosynthèse des acides biliaires à partir du cholestérol. De plus, cette étude a montré que le récepteurs des LDL (LDL-R) et proprotein convertase subtilisin/kexin type 9 (PSCK9) au foie, qui sont impliqués dans l'absorption du cholestérol de la circulation, ne sont pas influencés par l’entraînement physique. Ces résultats suggèrent que l'entraînement physique module le métabolisme du cholestérol chez les animaux Ovx par un réglage positif de la formation des acides biliaires. Un nombre croissant de preuves récentes suggèrent que le transport inverse du cholestérol (RCT) peut également passer par une voie non-biliaire connue sous le nom « transintestinal cholesterol excretion » (TICE). En effet, le foie et l'intestin sont impliqués dans l'excrétion du cholestérol excédentaire du corps. Dans cette optique, dans la troisième étude, nous avons élargi nos recherches afin de déterminer si l'entraînement physique module l’expression des récepteurs de cholestérol de la membrane intestinale qui sont impliqués dans TICE chez les rats intacts et Ovx nourris avec une diète standard et une diète riche en cholestérol. Les résultats de cette étude ont montré que l'entraînement physique a augmenté (P <0,01) l’expression génique intestinale de LDL-R et de PCSK9 impliquées dans la captation du cholestérol intestinal de la circulation et de leur récepteur nucléaire, « sterol regulatory element-binding protein 2 » (SREBP2) (P <0,05) chez les rats Sham et Ovx par rapport aux rats sédentaires (Sed). D'autre part, l’expression des gènes hépatiques de LDL-R et de PCSK9 ont été supprimées (P <0,01) par l’alimentation riche en cholestérol, mais pas affectée par l'entraînement physique. L'expression du gène « flavin monooxygénase 3 » (FMO3), en tant que régulateur de l'équilibre du cholestérol dans le foie, a été diminuée de façon significative (P <0,01) par le cholestérol alimentaire chez les rats Sham et Ovx par rapport aux rats nourris avec la diète standard, mais demeure inchangée suite à l'entraînement physique et le retrait des œstrogènes. Un réglage positif de l'expression de gènes du LDL-R et PCSK9 intestinale par l'entraînement physique chez les rats intacts et Ovx suggère que l'entraînement physique peut contribuer à l’accroissement de l'élimination de cholestérol par la voie TICE. Dans l'ensemble, nos résultats indiquent qu'une combinaison d’une diète riche en cholestérol et un retrait des œstrogènes a mené à une diminution de l'expression des gènes des marqueurs essentiels de la synthèse de VLDL, ce qui implique une réduction de l'excrétion du cholestérol du foie. Il semble que la réduction de LDL-R hépatique pourrait être due à l'accumulation du cholestérol dans le foie. De plus, nos résultats ont présenté l’entraînement physique comme une intervention non pharmacologique appropriée pour stimuler l'excrétion du cholestérol excédentaire de l'organisme par le réglage positif des gènes impliqués dans la biosynthèse des acides biliaires dans le foie et les récepteurs intestinaux de cholestérol dans la voie TICE. / There has been accumulating evidence in recent years that the estrogen deficient state in ovariectomized (Ovx) animals and in postmenopausal women results in substantial liver triglyceride (TG) accumulation. However, evidence of disturbances in cholesterol metabolism in link with estrogen deficiency is limited to observations of higher plasma total cholesterol levels found in human as well as in animals. In fact, the impact of estrogen withdrawal on liver cholesterol metabolism has received little attention and shows some controversies. Therefore, the three studies presented in this thesis have been conducted in Ovx rats, as an animal model of post-menopausal women, to investigate the effects of estrogen withdrawal on key molecular markers of cholesterol and bile acid metabolism in liver and in transintestinal cholesterol excretion (TICE), and also to determine the potential role of exercise training as a positive alternative intervention. It has been shown that exercise training can improve plasma cholesterol levels. An enhanced transport of peripheral cholesterol toward the liver for subsequent secretion into bile and excretion from the body has been suggested; however, the underlying mechanism for this action is not fully understood. In the first study, we showed that estrogen withdrawal was associated with higher (P < 0.05) liver total cholesterol under the standard diet and the standard diet + cholesterol diet, while liver triglyceride (TG) content was higher in Ovx than in Sham rats in all three dietary conditions which are the standard diet, the standard diet + cholesterol and the high fat diet + cholesterol. Surprisingly, the standard diet + cholesterol was associated with lower (P < 0.001) plasma total cholesterol and TG levels in Ovx than in Sham rats, suggesting a decrease in very low-density lipoprotein (VLDL) secretion. Accordingly, several transcripts of key markers of VLDL synthesis including microsomal triglyceride transfer protein (MTP) and apoB-100 were decreased (P < 0.05) in Ovx compared to Sham rats under the three dietary conditions and even more so for MTP and apoB-100 when rats were fed the standard diet + cholesterol. To go one step further, in the second study we determined the effects of exercise training on hepatic key markers of farnesoid X receptor (FXR)-small heterodimer partner (SHP)-cholesterol 7 alpha-hydroxylase (CYP7A1) (FXR-SHP-CYP7A1) pathway, involved in cholesterol conversion into bile acid and excretion from the body, in Ovx cholesterol fed rats. Our main experimental group was Ovx rats fed a high cholesterol diet (Ovx-Chol) that was compared, on one hand, to a group of Ovx rats fed a standard diet (Ovx-SD) to observe the effects of the diet and, on the other hand, compared to a group of Sham operated rats fed the cholesterol diet (Sham-Chol) to observe the effect of estrogen withdrawal. Results of this study showed that plasma and liver total cholesterol levels were not affected by exercise training in any of the experimental conditions. Cholesterol feeding in both Sham and Ovx rats resulted in significantly (P<0.001) higher hepatic cholesterol accumulation than in Ovx-SD rats. A main effect of training (P< 0.05) was, however, found for transcripts of SHP and CYP7A1. The SHP and CYP7A1 transcripts were increased by training. These results suggest that exercise training through up-regulation of genes involved in bile acid formation may modulate cholesterol metabolism in Ovx animals. Finally, a recent growing body of evidence suggests that reverse cholesterol transport (RCT) can also proceed through a non-biliary pathway known as transintestinal cholesterol excretion (TICE). Indeed, both liver and intestine are involved in excretion of the excess cholesterol from the body. Based on this concept, we expanded our research to determine whether exercise training has an effect on intestinal membrane cholesterol receptors involved in TICE pathway in intact and Ovx rats fed a normal and a high cholesterol diet. Results of the third study showed that exercise training increased (P< 0.01) transcripts of intestinal LDL-R and PCSK9, which are involved in intestinal cholesterol uptake from circulation, and their nuclear transcription factor, intestinal sterol regulatory element-binding protein 2 (SREBP2) (P< 0.05) in both Sham and Ovx rats compared to rats remaining sedentary (Sed). On the other hand, hepatic LDL-R and PCSK9 gene expression was suppressed (P< 0.01) by cholesterol feeding but not affected by exercise training. Flavin monooxygenase 3 (FMO3) gene expression, as a cholesterol balance regulator in liver, was significantly decreased (P<0.01) by cholesterol feeding in both Sham and Ovx rats compared to rats were fed the SD diet but unchanged following exercise training and estrogen withdrawal. An up-regulation of intestinal gene expression of LDL-R and PCSK9 following voluntary wheel running in intact and Ovx rats suggests that exercise training may contribute to increased cholesterol elimination through the TICE pathway. Overall, our results indicate that a high cholesterol diet and ovariectomy combine to decrease the gene expression of key markers of VLDL synthesis suggesting a reduction in cholesterol excretion from the liver. Alternatively, it seems that reduced hepatic LDL-R transcript found in Ovx animals might be due to hepatic cholesterol accumulation. Moreover, our findings introduced exercise training as an appropriate non-pharmacological intervention to stimulate the excretion of the excess cholesterol from the body through upregulation of genes involved in bile acid biosynthesis in liver and intestinal basolateral cholesterol transporters in TICE.

Proprotein Convertase Subtilisin/Kexin 9 (PCSK9) is the ninth member of the Ca+2-dependent mammalian proprotein convertase super family of serine endoproteases that is structurally related to the bacterial subtilisin and yeast kexin enzymes. It plays a critical role in the regulation of lipid metabolism and cholesterol homeostasis by binding to and degrading low-density lipoprotein-receptor (LDL-R) which is responsible for the clearance of circulatory LDL-cholesterol from the blood. Owing to this functional property, there is plenty of research interest in the development of functional inhibitors of PCSK9 which may find important biochemical applications as therapeutic agents for lowering plasma LDL-cholesterol. The catalytic domain of PCSK9 binds to the EGF-A domain of LDL-R on the cell surface to form a stable complex and re-routes the receptor from its normal endosomal recycling pathway to the lysosomal compartments leading to its degradation. Owing to these findings, we propose that selected peptides from PCSK9 catalytic domain, particularly its disulphide (S-S) bridged loop1 323-358 and loop2 365-385, are likely to exhibit strong affinity towards the EGF-A domain of LDL-R. Several regular peptides along with corresponding all- dextro and retro-inverse peptides as well as the gain-of-function mutant variants were designed and tested for their regulatory effects towards LDL-R expression and PCSK9-binding in human hepatic HepG2 and mouse hepatic Hepa1c1c7 cells. Our data indicated that disulfide bridged loop1-hPCSK9323-358 and its H357 mutant as well as two short loop2-hPCSK9372-380 and its Y374 mutant peptides modestly promote the LDL-R protein levels. Our study concludes that specific peptides from the PCSK9 catalytic domain can regulate LDL-R and may be useful for development of novel class of therapeutic agents for cholesterol regulation.