Mutations in the gene encoding the nuclear lamina protein lamin A/C (LMNA) and the associated integral inner nuclear membrane protein emerin (EMD) give rise to similar disease phenotypes and are both classified as Emery-Dreifuss muscular dystrophy (EDMD). However, the connection between the function of these nuclear envelope proteins and disease phenotype remains elusive. Given the consistent manifestation of dilated cardiomyopathy in EDMD, my investigation focused on deciphering the roles of these nuclear envelope proteins in the heart. To better understand their functions, I generated a set of isogenic human induced pluripotent stem cell (iPSC) lines with either LMNA mutation causing lamin A/C haploinsufficiency or EMD mutation causing emerin deficiency. I differentiated these iPSCs into cardiomyocytes (iPSC-CMs) and obtained their RNA transcript and protein expression profiles. I found that both mutant lines exhibited significant overlap in transcriptome and proteome changes. Analyzing alterations at both RNA and protein levels shed light on the potential functional roles of lamin A/C and emerin in cardiomyocytes and pathogenic mechanisms. To better understand the cardiac defects caused by loss of lamin A/C. I generated mice lines with tissue-specific and temporally regulated knockout of Lmna in the heart. The mutant mice experienced lethality due to heart failure, regardless of whether Lmna was knocked out at the embryonic or mature adult heart. This demonstrates that lamin A/C has a vital role in the normal function of cardiomyocytes.

Orientador: Heitor Moreno Junior / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-06T19:55:16Z (GMT). No. of bitstreams: 1 Melo_SilviaElainedeSousaFerreiraCarvalhode_D.pdf: 6801672 bytes, checksum: d5d157af717b53ac33305c8ec554a2d0 (MD5) Previous issue date: 2005 / Resumo: O óxido nítrico (NO) é um mediador biológico multifuncional que serve como molécula chave em muitos processos fisiopatológicos, sintetizado nas células endoteliais em resposta a estímulos fisiológicos ou patológicos. Sua síntese se dá a partir da clivagem do terminal nitrogênio-guanidina do aminoácido L-arginina, em uma reação catalizada pela enzima óxido nítrico sintase (NOS). Há três isoformas de NOS: a NOS endotelial (eNOS), a NOS neuronal (nNOS) e a NOS induzível (iNOS). A eNOS e a nNOS são isoformas expressas constitutivamente nas células endoteliais vasculares e nas células neuronais, respectivamente; e a iNOS que a forma induzível, expressa em células inflamatórias após a indução por citocinas e outros mediadores inflamatórios. Após sua síntese o NO se difunde para as células do músculo liso vascular ativando a enzima guanilato ciclase solúvel (GCs), que converte guanosina-tri-fostato (GTP) em guanosina-3¿,5¿-monofosfato cíclica (GMPc), um segundo mensageiro para seus diversos efeitos biológicos, dentre os quais o relaxamento da musculatura lisa vascular. A síntese de NO pode ser inibida por vários compostos análogos à L-arginina, como L-NMMA, L-NAA, L-NAME e L-NIO de forma dose-dependente. A inibição crônica da síntese de óxido nítrico pela administração crônica de L-NAME é um modelo complexo e bem estabelecido de hipertensão arterial e miocardiopatia hipertensiva. É caracterizado por elevação da pressão arterial (PA) de forma severa, redução na freqüência cardíaca, no fluxo coronário e débito cardíaco (DC), aumento da resistência vascular periférica total (RVPT), diminuição do relaxamento vascular e alterações na contratilidade cardíaca, hipertrofia cardíaca, aumento do tamanho cardiomiócito, remodelamento miocárdico e microvascular com fibrose perivascular, sendo que o índice peso cardíaco/peso corporal e peso ventricular esquerdo/peso corporal estão usualmente aumentados. As fosfodiesterases são enzimas que degradam os nucleotídeos cíclicos GMPc e AMPc nas suas formas inativas. São conhecidas 11 famílias de enzimas (PDE1 ¿ PDE11) que diferem com relação ao padrão distribuição, especificidade de substrato, regulação pelas PKs e proteínas ligantes. Estão envolvidas em diversos processos fisiológicos e patológicos, tais como ereção peniana, asma, hipertensão pulmonar, aterosclerose, insuficiência cardíaca e diabetes. Consequentemente, os inibidores seletivos de PDE são interessantes e promissores alvos farmacológicos. Os inibidores das PDEs inpedem a degradação do AMPc, GMPc, elevando seus níveis intracelulares. Esses inibidores mimetizam as estruturas do AMPc e GMPc, mas não são degradados. Sildenafil é um inibidor seletivo da PDE5 induzindo o e relaxamento do músculo vascular liso e têm sido utilizados com sucesso no tratamento da disfunção erétil. A base racional para este projeto é a hipótese de que o sildenafil, por inibir de forma seletiva a PDE5 e conseqüentemente aumentar a disponibilidade de GMPc, possa ter efeitos cardiovasculares benéficos na inibição crônica da síntese de NO que reduz os níveis de GMPc no músculo cardíaco e vascular. Para isso foram estudados 4 grupos experimentais divididos aleatoriamente em: CONTROLE, L-NAME, SILDENAFIL e SILDENAFIL + L-NAME, durante 8 semanas de tratamento. Analisamos as alterações hemodinâmicas através das medidas da pressão arterial média, débito cardíaco, freqüência cardíaca e resistência vascular. As análises histológicas foram feitas através de técnicas morfométricas para determinação do diâmetro de miócito, lesões miocárdicas e espessura da camada média vascular e análises imunohistológicas. Nossos resultados demonstraram que a administração crônica de sildenafil altera os padrões hemodinâmicos e histolólgicos do modelo de miocardiopatia hipertensiva induzida pela inibição da síntese de NO por L-NAME. A inibição da PDE5 restaurou parcialmente os padrões hemodinâmicos, avaliados através da PA, DC e RVPT, além de protege parcialmente o miocárdio e músculo vascular liso contra as lesões e remodelamento cardiovascular característicos deste modelo experimental. A biodisponibilidade de GMPc, nos animais do grupo L-NAME + sildenafil, foi totalmente restaurada após 8 semanas de tratamento e a expressão das enzimas PDE3 e PDE5 estavam modificadas no músculo vascular liso e nos discos intercalares dos miócitos. Dessa forma, concluimos que o sildenafil, através da inibição da PDE5, aumentando a biodisponibilidade do GMPc, resulta em um efeito cardioprotetor e antiproliferativo contra as alterações cardiovasculares descritas no modelo de miocardiopatia hipertensiva induzida pela inibição crônica da síntese de NO em ratos Wistar / Abstract: Many of the physiological responses to nitric oxide (NO) are mediated by cyclic 5'-guanosine monophosphate (cGMP), the intracellular levels of which are regulated by phosphodiesterase type 5 (PDE5). In situations of reduced NO formation, the inhibition of PDE5 by selective inhibitors such as sildenafil could be beneficial in restoring physiological functions by enhancing the intracellular levels of cGMP. In this study, we evaluated the effects of sildenafil on the hemodynamic and histological alterations induced by the chronic treatment of rats with Nw¿nitro-L¿arginine¿methyl ester (L-NAME). After 8 weeks of concomitant treatment with sildenafil and L-NAME, arterial blood pressure was significantly lower (P<0.05) than in L-NAME treated rats. The fall in blood pressure was associated with a slight reduction in the total peripheral vascular resistance (P<0.05). Sildenafil partially restored the decrease in cardiac output seen in L-NAME-treated rats. Morphologically, sildenafil reduced the total area of the myocardial lesions and attenuated the cardiomyocyte and vascular smooth muscle remodeling seen with L-NAME. These results show that sildenafil reversed the deleterious hemodynamic and morphological alterations associated with L-NAME-induced hypertension. This beneficial effect was probably mediated by an increase in cardiac and vascular cGMP levels as reflected in circulating plasma cGMP levels / Doutorado / Doutor em Farmacologia

Orientador: Humberto Santo Neto / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Médicas / Made available in DSpace on 2018-08-13T22:18:59Z (GMT). No. of bitstreams: 1 Oggiam_DaniellaSilva_M.pdf: 1790150 bytes, checksum: f55f529364fdf6fa2bae8c646e2b2d8b (MD5) Previous issue date: 2009 / Resumo: A distrofia Muscular de Duchenne (DMD) é uma miopatia progressiva causada por uma doença autossômica recessiva ligada ao sexo, que acomete crianças do sexo masculino, e evolui para incapacidade motora na puberdade até causar óbito ao redor da segunda década de vida. É causada por uma alteração no gene codificador da proteína distrofina, que mantém a integridade do sarcolema da fibra muscular. O camundongo mdx é utilizado como modelo experimental da DMD para investigações do tecido muscular esquelético e cardíaco, por apresentar muitas semelhanças com humano portador da doença. Na DMD os pacientes iam á óbito por falência respiratória, desde a evolução do tratamento com técnicas de ventilação mecânica artificial, as disfunções cardíacas tornaram-se importantes, visto que a partir disto, a maioria dos óbitos começaram a ser em função da falência cardíaca, que resulta de um processo seguido de: necrose, inflamação, fibrose evoluindo para cardiomiopatia grave. Várias estratégicas farmacológicas tem sido utilizadas para melhora da função cardíaca tanto no portador de DMD como no camundongo mdx. Um dos medicamentos utilizados é o deflazacorte, um glucocorticóide de ação anti-inflamatória, administrado por toda vida do portador de DMD. Embora os efeitos do deflazacorte sobre a função cardíaca no humano e no camundongo mdx têm sido extensivamente estudados, pouco se sabe sobre os efeitos histopatológicos no tecido cardíaco. Neste trabalho foi avaliado o efeito da administração a longo prazo de deflazacorte na progressão da fibrose miocárdica intersticial em camundongos mdx de 6 meses de idade. Os animais foram tratados diariamente com deflazacorte durante 15 meses, após foram sacrificados, o coração foi removido e congelado em nitrogênio líquido para posterior análise histológica e morfológica do tecido. O coração do grupo de camundongos mdx tratados com deflazacorte foi comparado com camundongos mdx não tratados. As áreas de fibrose miocárdica diminuíram significativamente 40% em relação ao grupo não tratado. Concluiu-se que o tratamento à longo prazo com deflazacorte é eficiente para diminuir a progressão da fibrose cardíaca. Sendo assim, como a cardiomiopatia está diretamente relacionada à disfunções celulares que acarreta a necrose dos cardiomiócitos, é de interesse investigar o acúmulo de lipofuscina, um biomarcador do envelhecimento, nos corações de camundongos mdx. Neste trabalho também foi observado o acúmulo de lipofuscina em animais controle C57BL10 e mdx de 14 dias a 23 meses de idade sem serem submetidos a qualquer tratamento. Os animais foram sacrificados, o coração removido e congelado em nitrogênio líquido para posterior análise da fluorescência dos grânulos de lipofuscina. Após contagem dos grânulos observou-se que aumentam com a idade, e dos 4 para os 6 meses ocorreu um acréscimo no acúmulo de lipofuscina. Considerando-se que o acúmulo de lipofuscina relaciona-se a disfunção celular é possível que isto contribua para lesão de cardiomiócitos em corações desprovidos de distrofina / Abstract: The Duchenne Muscle Dystrophy is a progressive myopathy caused by recessive autossomic disease connected to the gender, which attacks male kids, and involves to motor disability in the property, leading to death around the second decade of life. It is caused by an alteration in the codifier gene of the protein dystropin, which maintains the integrity of the muscle fiber sarcolemma. The mdx mouse is used as an experimental model of DMD to investigate the skeletal and cardiac muscle fiber, because it presents a lot of similarities with the human carrier of the disease. In the DMD, the patients used to die due to respiratory failure. Since there was a treatment evolution with artificial mechanical ventilation techniques, the cardiac dysfunctions became important considering that from this moment on, most of the deaths started occurring because of a cardiac failure, resulting of a process followed by necrosis, inflammation, fibrosis involving to a serious cardiomyopathy. Several pharmacological strategies have been used to improve the cardiac function both in the DMD carrier and in the mdx one of the medications utilized is the deflazacort, a glucocorticóide of anti-inflammatory action, administrated during the whole life of the DMD carrier. Although the deflazacort effects upon the cardiac function in the human being and in the mouse mdx have been extensively studied just a little is know about the histopathological effects on the cardiac tissue. In this paper, the effect of the long term administration of deflazacort daily for 15 months, after they were sacrificed, had their hearts removed and frozen in liquid nitrogen for histological and morphological tissue further analysis. The heart of the mdx mice group treated with deflazacort was compared to the heart of the untreated mdx mice group. The myocardial fibrosis areas diminished significantly in comparison to the untreated group, in 40%. It was concluded that the long term treatment with deflazacort is effective to diminish the cardiac fibrosis progression the cardiomyopathy which cause the myocites cardiac necrosis, and therefore it is interesting to investigate the lipofuscin is a pigment related to the age, it is considered an aging biomarker. In this paper, the accumulation of lipofuscin in control animals C57BL10 and mdx with ages between 14 days and 21 months without any treatment was observed that they increase with the age, and from the 4 to the 6 months there was a raise in the lipofuscin accumulation. It was so, concluded, that the myocites cardiac functioning can be harmed even before the age of 8 months, and the accumulation of lipofuscin can mean a degeneration process which is more intensive in mdx / Mestrado / Biologia Celular / Mestre em Biologia Celular e Estrutural

The objective of the current study is to present the case of an intercollegiate basketball player diagnosed with an ifliopathic cardiomyopathy. The athlete illustrated in the case study experienced ongoing chest discomfort with exercise. Episodic chest pain and syncope in athletes is often alarming and may signal an underlying cardiac condition. Early recognition and maJagement of these athletes is vital to the prevention of sudden cardiac death (SCD). Fortunately, the athlete was referred to a cardiologist by her team physician during her pre-participation physical examination to rule out heart conditions that may lead to SCD. The athlete was presented a mildly reduced ejection fraction during her screening with the cardiologist. In cardiovascular physiology, ejection fraction is the fraction of end-diastolic volume that is ejected from the ventricle with each heart beat. Damage to the myocardium, as seen in cardiomyopathies, decreases the heart's ability to eject blood and therefore reduces the ejection fraction. The athlete underwent VO2max testing as well where it was discovered that her VO2max was exceptionally low for a physically active division-I athlete. This low VO2max suggested that the athlete had an insufficient oxygen uptake during intense exercise. The athlete experienced a treatment protocol consisting of a progressive conditioning regimen of additional cardiovascular exercise that proved to be effective in raising her VO2max by 10%. The athlete returned to full participation and remained asymptomatic throughout the remainder of the season. The pre-participation physical examination is crucial in early detection of events that may lead to sudden cardiac death. A thorough history and physical examination are the most efficient screening methods for detecting cardiovascular abnormalities. Any athlete with episodes of syncope, hypertension, or changes in heart rhythm should be referred to a physician.

Cardiovascular disease is the leading cause of death in the United States and the world. Progress in the development of new therapeutic strategies is hindered by shortcomings in our understanding of human myocardial pathophysiology and limitations in the ability of preclinical models to accurately predict successful clinical translation. The development of engineered models of the myocardium comprised of human cells derived from induced pluripotent stem cells has emerged as a promising strategy to overcome these problems. This dissertation builds on this work by developing a new engineered cardiac tissue platform and then utilizing it to investigate three distinct myocardial pathologies: (1) genetic restrictive cardiomyopathy, (2) autoimmune mediated myocardial injury, and (3) myocardial ischemia and reperfusion injury. Results from these studies provide new insights into therapeutic strategies for the first two conditions and describe substantial progress towards the creation of an innovative model of the third.

Thesis (MScMedSc)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: INTRODUCTION: The mechanism behind obesity-related cardiomyopathies is at present not completely known, however, cardiac insulin resistance has been implicated as one of the main arbitrators of obesity-related cardiovascular disease. A few studies have associated perturbations in the insulin-mediated PI3K/PKB/Akt pathway in mediating this insulin resistance. Moreover, this pathway has been shown to regulate myocardial apoptosis, which in turn has been implicated in a number of cardiovascular diseases. Currently, few studies have compared the early onset and advanced effects of obesity on the heart. AIMS: To compare the early and advanced stages of obesity in terms of myocardial (i) PI3K/PKB/Akt signalling, (ii) apoptotic signalling and (iii) mitochondrial integrity. Furthermore, we aim to assess the cardiac mitochondrial (i) PI3K/PKB/Akt signalling, (ii) apoptotic signalling and (iii) integrity during the advanced stages of obesity. METHODS: Male Wistar rats were randomly assigned to either a control or diet-induced obesity (DIO) group. Controls were fed a standard rat chow diet and the DIO group fed a high caloric diet (standard rat chow supplemented with sucrose and condensed milk). The diets were implemented for either 8 or 20 weeks and thereafter, the body weight, intra-peritoneal fat mass, and fasting blood glucose and insulin levels (including intra-peritoneal glucose tolerance tests (IPGTTs)) were determined. Freeze-clamped hearts from both groups were subjected to cytosolic western blot analysis for PI3K p85 subunit, PKB/Akt, GSK-3α/β, Bad, Bax and Bcl-2. A fraction of each heart was also subjected to WB analysis of the mitochondrial electron transport chain (ETC) complexes (I-V). Thereafter, the above mentioned proteins were also probed for in mitochondria isolated from the 20 weeks group after administering insulin and exposing the hearts to ischemia. Oxidative phosphorylation (OXPHOS) capacity analysis was then conducted on mitochondria isolated from 20 weeks DIO and control groups and thereafter a citrate synthase (CS) activity assay was performed on these mitochondria. RESULTS: After the 8 and 20 weeks diet, the DIOs had significantly increased intra-peritoneal fat mass, fasting plasma glucose and insulin levels, compared to their controls. Cytosolic WB analysis: The tp85, pp85 and pPKB/Akt levels were significantly higher in the DIOs in comparison to the controls after 8 weeks of diet. Furthermore, pBad and Bax expression were significantly elevated in these animals. After 20 weeks of diet, the DIOs had significantly decreased pp85, tPKB/Akt and pPKB/Akt levels. The tBad was significantly elevated, while the Bad phosphorylated over total expression (P/T) ratio was significantly decreased, in these animals. CS activity assay: CS activity was significantly decreased in the DIOs, versus the controls, at 20 weeks. Mitochondrial ETC WB analysis: The subunit expression in complexes I-III and V did not differ significantly after 8 weeks however, the expression was significantly lower in complexes I and II after 20 weeks. Interestingly, the complexes III and V expression was significantly elevated. Mitochondrial OXPHOS analysis: The ADP/O ratio with (1) glutamate or (2) palmitoyl-L- carnitine as substrate, showed a significant decrease in the DIOs at 20 weeks. Mitochondrial WB analysis: The pp85 subunit was significantly elevated in the control and DIO groups, exposed to insulin and ischemia, in comparison to the untreated controls. The Bcl-2 levels were significantly decreased in the insulin and ischemia DIOs, when matched against the untreated DIOs. The tBad expression did not differ significantly between the insulin and untreated controls, while the tBad was significantly augmented in the ischemia controls versus untreated controls. All significant differences were taken as p<0.05. CONCLUSION: The results indicate that the initial stage of diet-induced obesity is associated with cardioprotection as there is augmented PI3K/PKB/Akt pathway signalling and a decrease in apoptotic markers. In contrast, during the advanced stages of obesity a decreased activity in PI3K/PKB/Akt pathway is associated with myocardial apoptosis and decreased mitochondrial function and integrity. / AFRIKAANSE OPSOMMING: INLEIDING: Die meganisme verantwoordelik vir vetsug-verwante kardiomiopatieë is huidiglik nie bekend nie maar kardiale insulienweerstandigheid word geïmpliseer as een van die hoof bemiddelaars van vetsug-verwante hartsiektes. Verskeie studies het versteurings in die insulien-gemediëerde PI3K/PKB/Akt pad geassosieer met die bevordering van hierdie insulienweerstandigheid. Daarbenewens is dit getoon dat hierdie pad betrokke is in die regulering van miokardiale apoptose, wat op sy beurt geïmpliseer is in 'n aantal kardiovaskulêre siektes. Daar is tans min studies beskikbaar wat die vroeë en laat gevolge van obesiteit op die hart vergelyk. DOELWITTE: Om die vroeë en gevorderde stadiums van vetsug te vergelyk in terme van miokardiale (i) PI3K/PKB/Akt seintransduksie, (ii) apoptotiese seintransduksie en (iii) mitokondriale integriteit. Verder, het die studie ten doel om die kardiale mitokondriale (i) PI3K/PKB/Akt en (ii) apoptotiese seintransduksie en (iii) integriteit in die gevorderde stadiums van vetsug te bepaal. METODES: Manlike Wistar rotte is ewekansig toegewys aan óf 'n kontrole of dieet-geïnduseerde vetsug (DIO) groep. Kontroles is met 'n normale rotkos dieet en die DIO groep met 'n hoë kalorie dieet (normale rotkos aangevul met sukrose en kondensmelk) gevoed. Die dieet is vir 8 of 20 weke volgehou en daarna was die liggaamsgewig, intra-peritoneale vet massa, en vastende bloed glukose en insulien vlakke (insluitende intra-peritoneale glukose toleransie toets (IPGTT`s)) bepaal. Gevriesklampte harte van beide groepe is onderwerp aan sitosoliese WB-analise vir die PI3K p85 subeenheid, PKB / Akt, GSK-3α/β, Bad, Bax en Bcl-2. `n Fraksie van hierdie harte is ook onderwerp aan westerse klad analise (WK-analise) van die mitokondriale elektron vervoer ketting (EVK) komplekse (I-V). Daarna is bogenoemde proteïene ondersoek in mitokondrieë geïsoleer uit die 20 weke groep ná die toediening van insulien en die blootstelling van die harte aan iskemie. Die oksigraaf mitokondriale oksidatiewe fosforilering (OXPHOS) kapasiteit analise is dan op mitokondrieë van 20 weke DIO en kontrole groepe uitgevoer en daarna is 'n sitraatsintase (SS) aktiwiteitstoets gedoen. RESULTATE: Na die 8 en 20 weke dieet, het die intra-peritoneale vet massa, vastende plasma glukose en insulien vlakke in die DIOs aansienlik toegeneem, in vergelyking met hul kontroles. Sitosoliese WK-analise: Die tp85, pp85 en pPKB/Akt vlakke was beduidend hoër in die DIOs in vergelyking met die kontroles, na 8 weke van die dieet. Verder is die pBad en Bax vlakke beduidend verhoog in hierdie diere. Na 20 weke van die dieet, het die pp85, tPKB/Akt en pPKB/Akt vlakke beduidend afgeneem in die DIOs, in vergelyking met die kontroles. Die tBad was beduidend verhoog, terwyl die Bad verhouding van gefosforileerde oor die totale proteïen uitdrukking (P/T)-verhouding) beduidend verminder het in hierdie diere. SS aktiwiteitstoets: SS aktiwiteit is beduidend verminder in die DIOs, teenoor die kontroles, op 20 weke. Mitokondriale EVK WK-analise: Die subeenheid uitdrukking in komplekse I-III en V was nie beduidend verskillend na 8 weke nie. Na 20 weke egter, was die uitdrukking aansienlik laer in komplekse I en II. Interessant genoeg, is die uitdrukking aansienlik verhoog in komplekse III en V. Mitokondriale OXPHOS analise: Die ADP/O verhouding met (1) glutamaat of (2) palmitiel-L-karnitien as substraat, het beduidend afgeneem in die DIOs teen 20 weke. Mitokondriale WK-analise: Die pp85 subeenheid was beduidend verhoog in die kontrole en DIO groepe, blootgestel aan insulien en iskemie, in vergelyking met die onbehandelde kontroles. Die Bcl-2 vlakke was beduidend verminder in die insulien en isgemie DIOs, in vergelyking met onbehandelde DIOs. Die tBad uitdrukking het nie beduidend verskil tussen die insulien en onbehandelde kontroles nie, terwyl die tBad beduidend verhoog was in die isgemie kontroles versus onbehandelde kontroles. Alle beduidende verskille is geneem as p<0.05. GEVOLGTREKKING: Die resultate dui daarop dat die eerste fase van dieet-geïnduseerde obesiteit geassosieer is met kardiale beskerming want `n toename in PI3K/PKB/Akt seintransduksie en 'n afname in apoptotiese merkers is waargeneem. In teenstelling, in die gevorderde stadium van vetsug is daar 'n afname in aktiwiteit in die PI3K/PKB/Akt pad wat verband hou met verhoogde miokardiale apoptose en verminderde mitokondriale funksie en integriteit.

Background: Different types of cardiomyopathies are associated with variable hypertrophic response. <p>A number of growth factors are thought to play a role in pathologic cardiac remodeling. <p>Aims: We compared the modulation of the TGF-ƒÒ superfamily and IGF-1 signaling pathways and their target genes, the cell cycle regulatory proteins in tachycardia-induced dilated cardiomyopathy, a model with no detectable hypertrophy and in ischemic cardiomyopathy, a model with a marked hypertrophic reaction. <p>Methods: In the first study, endomyocardial biopsies were obtained weekly in 15 dogs, during the development of tachycardiomyopaty. Genes involved in the myostatin-TGF-ƒÒ-Activin-A/Smad signaling pathway, p21 and cyclin D were quantified and correlated to echocardiographic measures of hypertrophy. In the second study, myocardial tissue samples were obtained in 8 dogs with a healed myocardial infarction, in 8 dogs with heart failure induced by overpacing and in 7 healthy dogs. We measured gene expression of IGF-1, its receptor (IGF-1R) and cyclins A, B, D1, D2, D3 and E and correlated them to the level of hypertrophy. <p>Results: Tachycardiomyopathy was characterized by chambers dilation with no identifiable hypertrophy. Ischemic cardiomyopathy was characterized by eccentric hypertrophy. In tachycardiomyopathy, Activin-A mRNA was 4-fold higher than at baseline. Smad7 was overexpressed in severe heart failure; p21, a direct target gene of the Smad pathway was upregulated 8-fold and cyclin D1 was down-regulated. In that model, IGF-1 was overexpressed but neither IGF-1R nor any of the cyclins studied.<p> In ischemic cardiomyopathy, IGF-1, IGF-R, and cyclins B, D1, D3 and E gene expression were upregulated.<p> In tachycardiomyopathy, Activin-A and p21 were inversely correlated to the thickness of the interventricular septum. In normal dogs and in the both models of cardiomyopathy, IGF-1R was correlated to the thickness of the interventricular septum and to cyclins. <p>Conclusions: Taken together, these results agree with the notion that Activin-A, IGF and cyclins are involved in the modulation of hypertrophic response observed in cardiomyopathies. <p> / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished

Indiana University-Purdue University Indianapolis (IUPUI) / Friedreich’s Ataxia (FRDA) is a rare and poorly understood autosomal recessive disease caused by a pathological deficiency of the mitochondrial protein frataxin. Patients suffer neurodegeneration, ataxia, diabetes, and heart failure. In an effort to understand the mechanisms of heart failure in FRDA, we investigated the role of the protein modification acetylation, which is highly abundant on mitochondrial proteins and has been implicated in regulating intermediary metabolism. Using mouse models of FRDA, we found that cardiac frataxin deficiency causes progressive hyperacetylation of mitochondrial proteins which is correlated with loss of respiratory chain subunits and an altered mitochondrial redox state. Mitochondrial protein hyperacetylation could be reversed by the mitochondria-localized deacetylase SIRT3 in vitro, suggesting a defect in endogenous SIRT3 activity. Consistently, frataxin-deficient cardiac mitochondria showed significantly decreased rates of fatty acid oxidation and complete oxidation to carbon dioxide. However, the degree of protein hyperacetylation in FRDA could not be fully explained by SIRT3 loss. Our data suggested that intermediary metabolites and perhaps acetyl-CoA, which is required for protein acetylation, are accumulating in frataxin-deficient mitochondria. Upon testing the hypothesis that mitochondrial protein acetylation is non-enzymatic, we found that the minimal chemical conditions of the mitochondrial matrix are sufficient to cause widespread non-enzymatic protein acetylation in vitro. These data suggest that mitochondrial protein hyperacetylation in FRDA cardiomyopathy mediates progressive post-translational suppression of mitochondrial oxidative pathways which is caused by a combination of SIRT3 deficiency and, likely, an accumulation of unoxidized acetyl-CoA capable of initiating non-enzymatic protein acetylation. These findings provide novel insight into the mechanisms underlying a poorly understood and fatal cardiomyopathy and highlight a fundamental biochemical mechanism that had been previously overlooked in biological systems.

Les patients décrits initialement par J. Noonan se ressemblent et ont une cardiopathie congénitale :soit une sténose valvulaire pulmonaire (SVP), soit une persistance du canal artériel. Avant la découverte du premier gène responsable de ce qui est devenu le syndrome de Noonan, cinq études de cohortes décrivant ces patients ont répertorié la prévalence de SVP mais le spectre des cardiopathies semble large, n’a pas été décrit de manière exhautive et aucune hypothèse n’est émise ou ne fait de lien entre ces différentes manifestations cardiaques et une compréhension intégrée du développement embryonnaire. Le gène PTPN11 est le premier gène identifié chez 40% de ces patients. Une corrélation existe entre la présence d’une mutation et la survenue de SVP de même qu’entre l’absence de mutation et la présence d’une cardiomyopathie hypertrophique. Six études de cohortes ont repris la description des mutations identifiées au sein du gène PTPN11 et les phénotypes associés, mais les cardiopathies n’ont pas été systématiquement ou spécifiquement analysées (tant au sein des groupes de patients porteurs de mutation que de ceux sans mutation). Le syndrome LEOPARD est allélique du syndrome de Noonan depuis que des mutations spécifiques au sein des exons 7,12 et 13 du gène PTPN11 ont été identifiées chez 95% des patients. <p><p>Afin d’appréhender les implications possibles du gène PTPN11 dans la survenue des cardiopathies chez les patients porteurs de ces deux syndromes, nous avons conduit une étude chez 272 patients au syndrome de Noonan et une étude chez 19 patients porteurs du syndrome LEOPARD. Parmi la cohorte de patients atteints du syndrome de Noonan, 104 ont été diagnostiqués porteurs d’une mutation du gène (38%). Une prévalence de survenue de cardiopathies affectant les structures droites du cœur se dégage chez les patients identifiés porteurs d’une mutation avec une différence significative pour la SVP, une tendance est relevée pour le canal atrio-ventriculaire et la communication inter-auriculaire de type Ostium Secundum. L’absence de mutation est corrélée avec la survenue de cardiomyopathie hypertrophique et de cardiopathies du cœur gauche. Parmi les patients atteints du syndrome LEOPARD, il n’existe pas de différence statistiquement significative pour les patients porteurs d’une mutation ou non et/ou pour une cardiopathie particulière. <p><p>Toutes les mutations identifiées du gène PTPN11 sont des mutations ‘faux-sens’. Ce gène appartient à la famille des gènes codant pour une protéine tyrosyl phosphatase, SHP-2, ne possédant pas de récepteur trans-membranaire. Cette phosphatase est impliquée dans la voie de signalisation cellulaire des MAP (‘Mitogen-activated protein’) kinases dont l’expression est ubiquitaire et inclut le coeur. Depuis nos travaux, le concept de syndrome « neuro-cardio-facio-cutané » est établi puisque, à ce jour, 9 gènes (SOS1, RAF1, BRAF, KRAS, NRAS, HRAS, NF1, SPRED1 et SHOC2), tous impliqués dans la voie de signalisation RAS (voie des MAP kinases) sont identifiés. Un spectre phénotypique existe avec des signes communs mais aussi distinctifs chez les patients présentant le syndrome de Noonan, le syndrome LEOPARD, le syndrome de Costello, le syndrome Cardio-Facio-Cutané (CFC), le syndrome « Noonan-NF1 », le syndrome de Legius et le syndrome « Noonan/Multiple Giant Cell Lesion ». Nous rapportons enfin l’observation d’une patiente atteinte du syndrome CFC et porteuse d’une mutation (p.R257Q) au sein du gène BRAF ayant développé une cardiomyopathie hypertrophique. <p><p>Ces travaux de cohortes de patients au phénotype du syndrome de Noonan, du syndrome LEOPARD et cette dernière description d’une patiente au syndrome CFC ont permis de participer à la découverte de l’implication d’une voie de signalisation cellulaire dont l’origine génétique est maintenant démontrée. Les résultats de nos travaux réalisés depuis 2002 auront permis, avec les équipes travaillant sur le même sujet, d’orienter les investigations et les nouveaux projets de recherche qui étudient spécifiquement le rôle du gène PTPN11 dans l’embryologie du cœur. Les études des orthologues (zebrafish, murin et Drosophila) porteurs à l’état hétérozygote d’une mutation du gène PTPN11 permettent d’intégrer les anomalies phénotypiques et cardiaques observées. Ces études permettent de postuler les effets cellulaires produits par les mutations chez les patients atteints du syndrome de Noonan et chez les patients atteints du syndrome LEOPARD engendrant in vitro une activation de la phosphatase (effet « gain de fonction ») pour les premiers ou une réduction de l’activité phosphatase (« dominant négatif ») mais engendrant un effet gain de fonction in vivo. Nous discutons les connaissances acquises, les compréhensions obtenues et intégrées et traçons enfin les perspectives offertes par ces travaux.<p> / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished