Mutações no gene Hfe causam a forma mais comum da hemocromatose hereditária, doença caracterizada por acúmulo progressivo de ferro nos tecidos parenquimatosos. Um estudo prévio conduzido em nosso laboratório (Am J Cardiol 88(4):388-91, 2001) encontrou associação entre mutação do gene Hfe e cardiomiopatia isquêmica, sugerindo que o acúmulo de ferro no tecido cardíaco pode ser um fator que potencializa as agressões ao sistema cardiovascular. O objetivo do presente trabalho foi testar a hipótese de que o ferro aumenta a susceptibilidade ao risco cardiovascular. A análise de dados de 318 pacientes seguidos durante 10 anos indicou que variantes genéticas do Hfe estão associadas com maior mortalidade em pacientes com insuficiência cardíaca de diferentes etiologias. Em seguida, verificou-se o acúmulo de ferro no coração, aorta e fígado ao longo de 1, 3, 6 e 12 meses em camundongos FVB. Para mimetizar os efeitos deletérios do ferro no ser humano, validamos proteínas envolvidas no metabolismo do ferro em camundongos e tratamos os animais com 10 mg diárias de ferro dextrano durante 4 semanas. Os resultados sem a sobrecarga de ferro já apontaram acúmulo de ferro significativo no coração e no fígado ao longo de 12 meses de vida, consistente com a ideia de aumento progressivo de risco cardiovascular associado ao envelhecimento. A sobrecarga de ferro foi associada com maior mortalidade e deterioração da função cardíaca. Os camundongos tratados com ferro apresentaram diminuição da fração de ejeção, redução da espessura do septo, maior remodelamento cardíaco e aumento do volume nuclear dos cardiomiócitos. Para entender as modulações gênicas causadas pelo ferro no coração, foi medida a expressão dos transcritos primários de mRNA relativo para os genes Hfe e para a hepcidina, encontrando-se ambos os genes significativamente menos expressos nos animais tratados com ferro em comparação ao grupo que só recebeu salina. Por fim, com o intuito de estudar em condições mais controladas o comportamento cardíaco frente à sobrecarga de ferro, foram comparados dois protocolos de extração primária de cardiomiócitos ventriculares de ratos neonatos para testes farmacológicos com ferro in vitro. O enriquecimento de cardiomiócitos in vitro se estabeleceu por dois métodos: separação por gradiente de percoll (Per) e por uma pré-seleção nomeada pre plating (PP). As células cardíacas foram mantidas por 8 dias em cultura e avaliações do metabolismo, produção de espécies reativas de oxigênio e contratilidade foram medidas. Ambos os métodos foram eficientes para a obtenção de células cardíacas, entretanto, as células extraídas por protocolo PP apresentaram metabolismo aumentado, com maior consumo de glicose e produção de lactato. Por diferentes parâmetros testados o protocolo PP apresentou maior estresse oxidativo, porém sem modular a quantidade de glutationas reduzidas e oxidadas. Notadamente, o protocolo PP apresentou maior atividade contrátil com aumento dos batimentos e maior influxo intracelular de cálcio. Células cardíacas extraídas pelo método PP foram tratadas com citrato de amônia férrico com doses de 50 ?g/mL e 100 ?g/mL e, após 24 horas, foi possível observar aumento significativo de apoptose. Desta forma, os modelos celulares em questão apresentam-se como importantes ferramentas para a identificação de mecanismos moleculares e celulares associados aos efeitos deletérios causados pelo ferro. Em conjunto, os resultados do presente trabalho apoiam a hipótese de que o acúmulo de ferro no tecido cardíaco aumenta a susceptibilidade cardiovascular. Trabalhos futuros permitirão melhor compreensão dos mecanismos envolvidos no acúmulo de ferro no coração ao longo do envelhecimento em pacientes com insuficiência cardíaca / Mutations in Hfe gene lead to the most common form of hereditary hemochromatosis, an autosomal recessive disease associated with iron accumulation in parenchymal tissues. In a previous study conducted in our laboratory (Am J Cardiol 88(4):388-91, 2001), genetic variation in the Hfe gene was associated with ischemic cardiomyopathy, suggesting that higher cardiac concentrations of iron aggravates injuries on the cardiovascular system. The aim of the present study was to test the hypothesis that iron increases susceptibility to cardiovascular risk. Analysis of data from 318 patients with 10-year follow-up showed that genetic variation in the Hfe gene was associated with higher mortality among patients with heart failure due to cardiomyopathy of different etiologies. Next, we demonstrated iron accumulation in heart, aorta, and liver in mice (FVB background) aged 1, 3, 6, and 12 months. To mimic the deleterious effect of iron observed in humans, we validated proteins playing a major role in iron metabolism and treated mice with 10 mg of iron-dextran daily for 4 weeks. Results showed that even without iron overload there is significant iron accumulation in the heart and liver with time, at 12 months of age, consistent with the idea that there is a progressive age-related increase in cardiovascular risk. Iron overload was associated with higher mortality in mice and impairment of cardiac function; in response to iron treatment ejection fraction and septum thickness were reduced, while cardiac remodeling and myocyte nuclear volume were increased. To understand the underlying mechanisms associated with iron-mediated modulation of genes in the heart, we assessed Hfe and hepcidin mRNA expression and found that these genes were significantly less expressed in iron-treated animals compared with the saline solution group. Lastly, to study cardiac behavior in the face of iron overload under well-controlled conditions we compared two protocols for primary extraction of neonatal rat cardiomyocytes for in vitro pharmacological tests: Percoll (Per) and pre plating (PP) extraction methods. Cardiac cells were used after 8 days and we measured metabolism, ROS production, and contractility. Both methods were effective in obtaining a high yield of cardiomyocytes. Nevertheless, cells extracted using PP protocol presented higher metabolic rate, as suggested by increased lactate production and glycolysis rate. In the PP protocol there was an increased oxidative stress, notwithstanding without modulating the amount of oxidized and reduced glutathione peroxidase. Notably, we found an increased contractile activity for pre-platting-prepared cells, with increased beating rate and higher calcium influx. Cardiac cells extracted by PP exposed to ferric ammonium citrate with doses of 50?g/mL and 100?g/mL, after 24 hours, displayed significant increased apoptosis. The cell models examined can be considered important tools for the identification of cell and molecular mechanisms associated with the harmful effects caused by iron. Taken together, the results of the present study support the hypothesis that cardiac tissue iron accumulation increases cardiovascular susceptibility. Further studies will help to unravel the mechanisms involved in cardiac iron accumulation throughout the aging process in patients with heart failure

Dissertation (Ph.D.)--University of South Florida, 2008. / Includes vita. Also available online. Includes bibliographical references (leaves 121-140).

Mutações no gene Hfe causam a forma mais comum da hemocromatose hereditária, doença caracterizada por acúmulo progressivo de ferro nos tecidos parenquimatosos. Um estudo prévio conduzido em nosso laboratório (Am J Cardiol 88(4):388-91, 2001) encontrou associação entre mutação do gene Hfe e cardiomiopatia isquêmica, sugerindo que o acúmulo de ferro no tecido cardíaco pode ser um fator que potencializa as agressões ao sistema cardiovascular. O objetivo do presente trabalho foi testar a hipótese de que o ferro aumenta a susceptibilidade ao risco cardiovascular. A análise de dados de 318 pacientes seguidos durante 10 anos indicou que variantes genéticas do Hfe estão associadas com maior mortalidade em pacientes com insuficiência cardíaca de diferentes etiologias. Em seguida, verificou-se o acúmulo de ferro no coração, aorta e fígado ao longo de 1, 3, 6 e 12 meses em camundongos FVB. Para mimetizar os efeitos deletérios do ferro no ser humano, validamos proteínas envolvidas no metabolismo do ferro em camundongos e tratamos os animais com 10 mg diárias de ferro dextrano durante 4 semanas. Os resultados sem a sobrecarga de ferro já apontaram acúmulo de ferro significativo no coração e no fígado ao longo de 12 meses de vida, consistente com a ideia de aumento progressivo de risco cardiovascular associado ao envelhecimento. A sobrecarga de ferro foi associada com maior mortalidade e deterioração da função cardíaca. Os camundongos tratados com ferro apresentaram diminuição da fração de ejeção, redução da espessura do septo, maior remodelamento cardíaco e aumento do volume nuclear dos cardiomiócitos. Para entender as modulações gênicas causadas pelo ferro no coração, foi medida a expressão dos transcritos primários de mRNA relativo para os genes Hfe e para a hepcidina, encontrando-se ambos os genes significativamente menos expressos nos animais tratados com ferro em comparação ao grupo que só recebeu salina. Por fim, com o intuito de estudar em condições mais controladas o comportamento cardíaco frente à sobrecarga de ferro, foram comparados dois protocolos de extração primária de cardiomiócitos ventriculares de ratos neonatos para testes farmacológicos com ferro in vitro. O enriquecimento de cardiomiócitos in vitro se estabeleceu por dois métodos: separação por gradiente de percoll (Per) e por uma pré-seleção nomeada pre plating (PP). As células cardíacas foram mantidas por 8 dias em cultura e avaliações do metabolismo, produção de espécies reativas de oxigênio e contratilidade foram medidas. Ambos os métodos foram eficientes para a obtenção de células cardíacas, entretanto, as células extraídas por protocolo PP apresentaram metabolismo aumentado, com maior consumo de glicose e produção de lactato. Por diferentes parâmetros testados o protocolo PP apresentou maior estresse oxidativo, porém sem modular a quantidade de glutationas reduzidas e oxidadas. Notadamente, o protocolo PP apresentou maior atividade contrátil com aumento dos batimentos e maior influxo intracelular de cálcio. Células cardíacas extraídas pelo método PP foram tratadas com citrato de amônia férrico com doses de 50 ?g/mL e 100 ?g/mL e, após 24 horas, foi possível observar aumento significativo de apoptose. Desta forma, os modelos celulares em questão apresentam-se como importantes ferramentas para a identificação de mecanismos moleculares e celulares associados aos efeitos deletérios causados pelo ferro. Em conjunto, os resultados do presente trabalho apoiam a hipótese de que o acúmulo de ferro no tecido cardíaco aumenta a susceptibilidade cardiovascular. Trabalhos futuros permitirão melhor compreensão dos mecanismos envolvidos no acúmulo de ferro no coração ao longo do envelhecimento em pacientes com insuficiência cardíaca / Mutations in Hfe gene lead to the most common form of hereditary hemochromatosis, an autosomal recessive disease associated with iron accumulation in parenchymal tissues. In a previous study conducted in our laboratory (Am J Cardiol 88(4):388-91, 2001), genetic variation in the Hfe gene was associated with ischemic cardiomyopathy, suggesting that higher cardiac concentrations of iron aggravates injuries on the cardiovascular system. The aim of the present study was to test the hypothesis that iron increases susceptibility to cardiovascular risk. Analysis of data from 318 patients with 10-year follow-up showed that genetic variation in the Hfe gene was associated with higher mortality among patients with heart failure due to cardiomyopathy of different etiologies. Next, we demonstrated iron accumulation in heart, aorta, and liver in mice (FVB background) aged 1, 3, 6, and 12 months. To mimic the deleterious effect of iron observed in humans, we validated proteins playing a major role in iron metabolism and treated mice with 10 mg of iron-dextran daily for 4 weeks. Results showed that even without iron overload there is significant iron accumulation in the heart and liver with time, at 12 months of age, consistent with the idea that there is a progressive age-related increase in cardiovascular risk. Iron overload was associated with higher mortality in mice and impairment of cardiac function; in response to iron treatment ejection fraction and septum thickness were reduced, while cardiac remodeling and myocyte nuclear volume were increased. To understand the underlying mechanisms associated with iron-mediated modulation of genes in the heart, we assessed Hfe and hepcidin mRNA expression and found that these genes were significantly less expressed in iron-treated animals compared with the saline solution group. Lastly, to study cardiac behavior in the face of iron overload under well-controlled conditions we compared two protocols for primary extraction of neonatal rat cardiomyocytes for in vitro pharmacological tests: Percoll (Per) and pre plating (PP) extraction methods. Cardiac cells were used after 8 days and we measured metabolism, ROS production, and contractility. Both methods were effective in obtaining a high yield of cardiomyocytes. Nevertheless, cells extracted using PP protocol presented higher metabolic rate, as suggested by increased lactate production and glycolysis rate. In the PP protocol there was an increased oxidative stress, notwithstanding without modulating the amount of oxidized and reduced glutathione peroxidase. Notably, we found an increased contractile activity for pre-platting-prepared cells, with increased beating rate and higher calcium influx. Cardiac cells extracted by PP exposed to ferric ammonium citrate with doses of 50?g/mL and 100?g/mL, after 24 hours, displayed significant increased apoptosis. The cell models examined can be considered important tools for the identification of cell and molecular mechanisms associated with the harmful effects caused by iron. Taken together, the results of the present study support the hypothesis that cardiac tissue iron accumulation increases cardiovascular susceptibility. Further studies will help to unravel the mechanisms involved in cardiac iron accumulation throughout the aging process in patients with heart failure

Orientador: Kleber Gomes Franchini / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T03:46:54Z (GMT). No. of bitstreams: 1 Pereira_AnaHelenaMacedo_D.pdf: 4791935 bytes, checksum: 1afe275f0fa4f53003b18816bc5c27cb (MD5) Previous issue date: 2013 / Resumo: Os fatores MEF2 (Myocyte Enhancer Factor 2) pertencem à família MADS Box (MCM1-Agamous-Deficiens-Serum response factor) e foram descritos pela primeira vez como fatores de transcrição que se ligam a sequencias de DNA ricas em A/T nos promotores de vários genes músculo específicos. Existem 4 genes da família MEF2 que foram identificados em vertebrados: MEF2A, B, C e D que são expressos de forma distinta durante a embriogênese e nos tecidos adultos. Estudos anteriores do nosso laboratório demonstraram que o fator de transcrição MEF2 é ativado por estiramento mecânico e influencia a expressão de genes relacionados à hipertrofia cardíaca. Utilizando a tecnologia de siRNA para MEF2C (siRNAMEF2C) demonstramos a atenuação da hipertrofia cardíaca induzida por coarctação da aorta nos animais que receberam o siRNAMEF2C. Por outro lado trabalhos demonstraram que animais transgênicos com a superexpressão de MEF2A ou de MEF2C e submetidos à sobrecarga de pressão por coarctação da aorta, não apresentam hipertrofia cardíaca compensatória. Nesses animais a superexpressão de MEF2A ou de MEF2C no coração está associada à deterioração cardíaca funcional e estrutural e o desenvolvimento de cardiomiopatia dilatada. Contudo, a caracterização fenotípica e os mecanismos moleculares envolvidos na superexpressão de MEF2C em miócitos cardíacos ainda são desconhecidos. Da mesma forma não é conhecido o papel do fator de transcrição MEF2C na resposta hipertrófica do miócito cardíaco após coarctação da aorta. No presente trabalho foi demonstrado que a superexpressão de MEF2C em miócitos cardíacos de ratos neonatos (NRMV), com o uso de partículas adenovirais, induziu a desdiferenciação celular e a ativação de mecanismos envolvidos na progressão do ciclo celular. Esses resultados foram obtidos por meio de experimentos de microarranjo de DNA, proteoma, PCR em tempo real e western blotting. A análise do fenótipo celular por microscopias de luz, confocal e eletrônica de transmissão demonstra que NRMV possuem aumento na binucleação e desorganização sarcomérica, alterações coerentes com o quadro de desdiferenciação celular e ativação da progressão do ciclo celular. Por meio da técnica de incorporação de iodeto de propídeo e citometria de fluxo confirmamos o aumento de células em ciclo celular. Para confirmar os achados nos cardiomiócitos neonatos passamos a investigar o efeito da superexpressão de MEF2C em cardiomiócitos de ratos adultos. Para isso padronizamos a técnica de isolamento destas células e tratamos com AdMEF2C. Sendo assim o tratamento com AdMEF2C em miócitos cardíacos de ratos adultos resultou em aumento da expressão de MEF2C após 48 horas de tratamento. O efeito observado foi semelhante ao encontrado em cardiomiócitos neonatos, sendo que os adultos apresentaram aumento da expressão de genes relacionados ao ciclo celular e diminuição dos genes estruturais. O nível ultraestrutural observado por microscopia eletrônica de transmissão no tempo de 48 horas de tratamento não observamos diferenças na estrutura sarcomérica das células tratadas com AdMEF2C. Por fim demonstramos que o silenciamento de MEF2C pela injeção de lentivírus no coração demonstrou ser capaz de impedir o desenvolvimento da hipertrofia cardíaca em camundongos coarctados por 15 dias. A hipertrofia do coração foi avaliada por meio da espessura da parede posterior do ventrículo esquerdo e gravimetria do ventrículo esquerdo e dos pulmões. O conjunto de dados demonstra que a superexpressão de MEF2C leva a alterações estruturais no miócito cardíaco compatíveis com quadro de deterioração e insuficiência cardíaca e que o silenciamento de MEF2C no coração impede o desenvolvimento da hipertrofia cardíaca decorrente da coarctação da aorta / Abstract: The factors MEF2 (myocyte enhancer factor 2) belong to the family MADS box (MCM1-Agamous-deficiens-Serum response factor) and were first described as transcription factors that bind DNA sequences rich in A / T in the promoters of multiple muscle-specific genes. There are four MEF2 family genes that were identified in vertebrates MEF2A, B, C and D are expressed differently during embryogenesis and in adult tissues. Previous studies from our laboratory demonstrated that the transcription factor MEF2 is activated by mechanical stretch and influences the expression of genes related to cardiac hypertrophy. Using siRNA technology to MEF2C (siRNAMEF2C) demonstrated attenuation of cardiac hypertrophy induced by aortic coarctation in animals that received siRNAMEF2C. On the other hand studies have demonstrated that transgenic mice with overexpression of MEF2A or MEF2C and subjected to pressure overload by aortic coarctation show no compensatory cardiac hypertrophy. In these animals the overexpression of MEF2A or MEF2C in the heart is associated with structural and functional cardiac deterioration and development of dilated cardiomyopathy. However, the phenotypic and molecular mechanisms involved in the overexpression of MEF2C in cardiac myocytes are still unknown. Likewise, there is known the role of the transcription factor MEF2C in cardiac myocyte hypertrophic response after aortic coarctation. In the present study it was shown that overexpression of MEF2C in neonatal rat cardiac myocytes (NRMV) with the use of adenoviral particles, and cellular dedifferentiation induced activation mechanisms involved in cell cycle progression. These results were obtained by DNA microarray experiments, proteomics, real time PCR and western blotting. The analysis of cell phenotype by light microscopy, confocal and transmission electron shows that NRMV have increased binucleation and sarcomeric disorganization, changes consistent with the framework of cellular dedifferentiation and activation of cell cycle progression. By means of the propidium iodide incorporation technique and flow cytometry, confirmed increasing cells in the cell cycle. To confirm the findings in neonatal cardiomyocytes we investigate the effect of overexpression of MEF2C in cardiomyocytes of adult rats. For this standardized technique and isolation of these cells treated with AdMEF2C. Thus treatment with AdMEF2C in adult rat cardiac myocytes resulted in increased expression of MEF2C after 48 hours of treatment. The observed effect was similar to that found in cardiomyocytes neonates, adults who showed increased expression of genes related to cell cycle and decreased structural genes. The ultrastructural level observed by transmission electron microscopy in the time of 48 hours of treatment showed no difference in sarcomeric structure of cells treated with AdMEF2C. Finally we show that MEF2C silencing by lentivirus injection in the heart has been shown to prevent the development of cardiac hypertrophy in mice after 15 days of pressure overload. The heart hypertrophy was evaluated by the thickness of the posterior wall of the left ventricle and the left ventricle gravity and lungs. The data set shows that overexpression of MEF2C leads to structural changes in the cardiac myocyte compatible framework of deterioration and failure, and MEF2C silencing of the heart prevents the development of cardiac hypertrophy due to aortic coarctation / Doutorado / Biologia Estrutural, Celular, Molecular e do Desenvolvimento / Doutora em Ciências

O estudo de mutações genéticas como causa das cardiomiopatias teve início com a descoberta de mutações em proteínas sarcoméricas que levavam à Cardiomiopatia Hipertrófica, desde então, alterações em diversos genes, de proteínas contráteis ou não, foram descobertas e listadas como a responsável pelo desenvolvimento de diferentes cardiomiopatias. Estudar o efeito destas mutações nos cardiomiócitos destes pacientes permanecia um desafio devido ao difícil acesso às células cardíacas. Em 2007, a técnica de reprogramação de células somáticas em células-tronco pluripotentes foi descoberta. Pelo fato das células-tronco pluripotentes serem capazes de ser diferenciadas em cardiomiócitos, surgiu-se a possibilidade de se estudar essas células de indivíduos portadores das mutações genéticas. Esta tese teve como objetivo a criação de um modelo celular para estudar a Cardiomiopatia Hipertrófica causada por mutações genéticas. Inicialmente foi estabelecido um protocolo de reprogramação celular para se estabelecer linhagens celulares das células-tronco induzidas de um paciente com mutação no gene MYH7. Tendo as células caracterizadas, elas foram diferenciadas em cardiomiócitos através de um protocolo adaptado de protocolos de diferenciação direta em cardiomiócitos. Os cardiomiócitos gerados apresentaram características moleculares e funcionais semelhantes à cardiomiócitos primários humanos e foi visualizado, através de microscopia eletrônica de transmissão, que os cardiomiócitos do paciente com alteração genética possuíam grande proporção de sarcômeros desorganizados em comparação a cardiomiócitos de indivíduos saudáveis. Em conclusão, o modelo celular desenvolvido sugere ser possível o estudo do efeito de mutações genéticas em Cardiomiopatia Hipertrófica. / The study of genetic mutations as the cause of cardiomyopathies initiates with the discovery of mutations in sarcomeric proteins genes that lead to Hypertrophic Cardiomyopathy. Since then, mutations in several genes, coding to sarcomeric proteins or not, were discovered and listed as the reason to the cardiomyopathies. To study the effect of these mutations was a challenge due the difficulty to accesses cardiac cells. In 2007, the technique of reprogramming somatic cells into pluripotent stem cells was discovered. The fact that the pluripotent stem cells are capable of differentiating into cardiomyocytes opened the opportunity to study these cells from individuals with genetic mutations. This thesis aimed to create a cellular model to study Hypertrophic Cardiomyopathy caused by genetic mutations. Initially we established a cell reprogramming protocol to establish induced stem cells lines from a patient with mutation in MYH7 gene. Having characterized the cells, they were differentiated into cardiomyocytes using an adapted protocol from direct differentiation protocols. Cardiomyocytes generated showed molecular and functional characteristics similar to human primary cardiomyocytes and were visualized by means of transmission electron microscopy. The patient\'s cardiomyocytes had a large proportion of disorganized sarcomeres compared to cardiomyocytes from healthy individuals. In conclusion, the cell model developed suggests that it is possible to study the effect of genetic mutation in Hypertrophic Cardiomyopathy using induced pluripotent stem cells derived cardiomyocytes.

A substituição de cardiomiócitos na vida pós-natal tem sido um dos maiores desafios da medicina regenerativa. O conceito de que os cardiomiócitos proliferam ativamente durante o desenvolvimento, mas perdem completamente esse potencial logo após o nascimento, foi recentemente questionado quando as primeiras evidências mostraram a existência de mecanismos endógenos de regeneração cardíaca em camundongos com um dia de vida. Nós avaliamos esse fenômeno em ratos de um dia de vida (P1) e investigamos o impacto da regeneração inicial na perfusão tecidual em longo prazo e a função cardíaca global em resposta ao stress. A homogeneidade da cirurgia de ressecção apical foi comprovada através do exame de ressonância magnética (MRI) e demonstramos que os ratos P1 apresentaram evidências de neoformação de cardiomiócitos a partir da marcação de Troponina I e Conexina 43 na àrea da lesão 21 dias após a cirurgia de ressecção, enquanto os ratos de sete dias de idade (P7) apresentaram a substituição do tecido principalmente por deposição de colágeno. De maneira interessate, as células recém-formadas apresentaram uma aparente falta de alinhamento uniforme nos ratos P1, e a hipoperfusão do tecido cardíaco foi detectada para ambos os grupos de pós-ressecção 21 e aos 60 dias do exame de SPECT. A função cardíaca basal direta aos 60 dias apresentou-se preservada em todos os grupos, enquanto sob estresse hemodinâmico, o grau de mudança na LVDEP, Volume Sitólico e Trabalho Sistólico indicaram função cardíaca diminuída nos ratos P7. Além disso, a relação pressão-volume diastólica final e o aumento da deposição de colágeno intersticial no P7 são consistentes com o aumento da rigidez da câmara. Coletivamente, nós mostramos que o potencial regenerativo com ausência de remodelamento cardíaco adverso é restrito aos ratos P1. Em seguida, procurou-se avaliar os mecanismos moleculares que regulam esse fenômeno através da combinação de ferramentas exploratórias. Embora tenha sido descrito anteriormente que o sistema imunológico não é totalmente maduro ao nascimento, o sequenciamento do RNA total de corações de ratos sham-operados, P1 e P7 mostrou que o procedimento cirúrgico foi suficiente para ativar algumas vias ligadas à resposta inflamatória e considerando as subpopulações de macrófagos pró (M1) e anti-inflamatórios (M2), sugerimos que o perfil de macrófagos anti-inflamatórios (M2) infiltrados no coração de ratos P1 são diferentes das células adultas pró-fibróticas regulares. Os meios condicionados M1 e M2 elevaram a taxa de proliferação de cardiomiócitos em condições de normóxia, mas somente o M2 apresentou resposta proliferativa em hipóxia e preveniu a diferenciação-induzida de fibroblastos cardíacos por menor expressão ?SMA. Por membranas array de citocinas, 15 citocinas apresentaram-se comuns aos dois meios condicionados, mas apenas 4 citocinas, sendo elas IL-4, IL-1?, IL-6 e Fractalkine, foram exclusivas ao meio condicionado M2, e que poderiam ser possíveis candidatos aos efeitos regenerativos encontrados. Nesse sentido, experimentos futuros fazem-se necessários a fim de explorar os efeitos dessas citocinas e desenvolver novas estratégias terapêuticas / The replacement of cardiomyocytes in postnatal life has proven to be one of the biggest challenges in regenerative medicine. The concept that cardiomyocytes proliferate actively during development but cease completely right after birth has been recently questioned when first evidences showed the existence of endogenous mechanisms of cardiac regeneration in one-day-old mice. We sought to evaluate this phenomenon in one-day-old rats (P1) and to assess the impact of the early regenerative process on long-term tissue perfusion and overall cardiac function in response to stress. We confirmed the successful apical resection surgery through magnetic resonance imaging (MRI) and that P1 heart was associated with evidence of cardiomyocytes neoformation as indicated by Troponin I and Connexin 43 expression at 21 days postresection, while in seven-day-old rats (P7) mainly scar tissue replacement ensued. Interestingly, there was an apparent lack of uniform alignment of newly formed cells in P1, and cardiac tissue hypoperfusion has been detected for both groups at 21 postresection and at 60 days through SPECT scanning. Direct basal cardiac function at 60 days, was preserved in all groups, whereas under hemodynamic stress the degree of change on LVDEP, Stroke Volume and Stroke Work indicated diminished overall cardiac function in P7. Furthermore, the End-Diastolic Pressure-Volume relationship and increased interstitial collagen deposition in P7 is consistent with increased chamber stiffness. Collectively, we showed that regenerative potential with slight collagen deposition is restricted to P1 rats. Then we sought to evaluate the molecular mechanisms that regulate this phenomenon through explorative tools. Although it has been previously described that the immune system is not fully mature at birth, total RNA sequenced from sham-operated, P1 and P7 heart rats showed that surgery is sufficient to activate inflammatory pathways, and considering pro (M1) and anti-inflammatory (M2) macrophages subpopulations, we suggested that invaded macrophages in resected P1 hearts are different from the traditional pro-fibrotic M2-like adult cells. Conditioned M1 and M2 medium elevated cardiomyocytes proliferative rate under basal conditions, but only M2 produced the same effect in cardiomyocytes under hypoxia and prevented myofibroblasts-induced differentiation through ?SMA intensity expression. Membrane array for cytokines showed 15 common cytokines for both M1 and M2 conditioned medium, but only 4, as IL-4, IL-1?, IL-6 and Fractalkine, were M2 exclusive and possible candidates to the regenerative potential. Additional experiments are needed to further explore these cytokines and to maybe develop new therapeutic strategies

by Au Ka Wing. / "June 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 153-162). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Ng, Sze Ying. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 110-124). / Abstract also in Chinese. / Thesis Committee --- p.i / Acknowledgements --- p.ii / Contents --- p.iii / Abstract --- p.vii / 論文摘要 --- p.x / Abbreviations --- p.xi / List of Figures --- p.xiii / List of Tables --- p.xvii / Chapter CHAPTER ONE --- INTRODUCTION --- p.1 / Chapter 1.1 --- Embryonic Stem Cells (ESCs) --- p.1 / Chapter 1.1.1 --- What are ESCs and the characteristics of ESCs --- p.1 / Chapter 1.1.1.1 --- Pluripotent markers --- p.2 / Chapter 1.1.1.2 --- Germ layers' markers --- p.3 / Chapter 1.1.2 --- Mouse ESCs (mESCs) --- p.4 / Chapter 1.1.2.1 --- mESCs co-culture with mitotically inactivated mouse embryonic fibroblast (MEF) feeder layers --- p.4 / Chapter 1.1.2.2 --- Feeder free mESCs --- p.4 / Chapter 1.1.3 --- Promising uses of ESCs and their shortcomings --- p.5 / Chapter 1.1.4 --- Characteristics of ESC-derived cardiomyocytes (ESC-CMs) --- p.6 / Chapter 1.2 --- Cardiovascular diseases (CVD) --- p.7 / Chapter 1.2.1 --- Background --- p.7 / Chapter 1.2.2 --- Current treatments --- p.8 / Chapter 1.2.3 --- Potential uses of ESC-CMs for basic science research and therapeutic purposes --- p.9 / Chapter 1.2.4 --- Current hurdles in application of ESC-CMs for clinical uses --- p.10 / Chapter 1.3 --- Cardiac gene markers --- p.13 / Chapter 1.3.1 --- Atrial-specific --- p.13 / Chapter 1.3.2 --- Ventricular-specific --- p.19 / Chapter 1.4 --- Lentiviral vector-mediated gene transfer --- p.27 / Chapter 1.5 --- Cell cycle in ESCs --- p.29 / Chapter 1.5.1 --- Cell cycle --- p.29 / Chapter 1.5.2 --- Characteristics of cell cycle in ESCs --- p.30 / Chapter 1.6 --- Potassium (K+) channels --- p.31 / Chapter 1.6.1 --- Voltage gated potassium (Kv) channels --- p.32 / Chapter 1.6.2 --- Role of Kv channels in maintenance of membrane potential --- p.32 / Chapter 1.7 --- Objectives and significances --- p.33 / Chapter CHAPTER TWO --- MATERIALS AND METHODS --- p.35 / Chapter 2.1 --- Mouse embryonic fibroblast (MEF) culture --- p.35 / Chapter 2.1.1 --- Derivation of MEF --- p.3 5 / Chapter 2.1.2 --- MEF culture --- p.37 / Chapter 2.1.3 --- Irradiation of MEF --- p.37 / Chapter 2.2 --- mESC culture and their differentiation --- p.38 / Chapter 2.2.1 --- mESC culture --- p.38 / Chapter 2.2.2 --- Differentiation of mESCs --- p.39 / Chapter 2.3 --- Subcloning --- p.40 / Chapter 2.3.1 --- Amplification of Irx4 --- p.40 / Chapter 2.3.2 --- Purification of DNA products --- p.41 / Chapter 2.3.3 --- Restriction enzyme digestion --- p.42 / Chapter 2.3.4 --- Ligation of Irx4 with iDuet101A vector --- p.43 / Chapter 2.3.5 --- Transformation of ligation product into competent cells --- p.43 / Chapter 2.3.6 --- Small scale preparation of bacterial plasmid DNA --- p.44 / Chapter 2.3.7 --- Confirmation of positive clones by restriction enzyme digestion --- p.45 / Chapter 2.3.8 --- DNA sequencing of the cloned plasmid DNA --- p.45 / Chapter 2.3.9 --- Large scale preparation of target recombinant expression vector --- p.45 / Chapter 2.4 --- Lentiviral vector-mediated gene transfer to mESCs --- p.47 / Chapter 2.4.1 --- Lentivirus packaging --- p.47 / Chapter 2.4.2 --- Lentivirus titering --- p.48 / Chapter 2.4.3 --- Multiple transduction to mESCs --- p.48 / Chapter 2.4.4 --- Hygromycin selection on mESCs --- p.49 / Chapter 2.5 --- Selection of stable clone --- p.49 / Chapter 2.5.1 --- Monoclonal establishment and clone selection --- p.49 / Chapter 2.6 --- Differentiation of cell lines after selection --- p.50 / Chapter 2.7 --- Gene expression study on control and Irx4-overexpressed mESC lines --- p.50 / Chapter 2.8 --- Analysis of mESCs at different phases of the cell cycle --- p.55 / Chapter 2.8.1 --- Go/Gi and S phase synchronization --- p.55 / Chapter 2.8.2 --- Cell cycle analysis by propidium iodide (PI) staining followed by flow cytometric analysis --- p.55 / Chapter 2.8.3 --- Gene expression study by qPCR of Kv channel isoforms --- p.56 / Chapter 2.8.4 --- Membrane potential measurement by membrane potential-sensitive dye followed by flow cytometry --- p.57 / Chapter 2.9 --- Apoptotic study --- p.58 / Chapter 2.10 --- Determination of pluripotent characteristic of mESCs --- p.59 / Chapter 2.10.1 --- Expression of germ layers' markers by qPCR --- p.59 / Chapter 2.10.2 --- Differentiation by hanging drop method and suspension method --- p.61 / Chapter CHAPTER THREE --- RESULTS --- p.62 / Chapter 3.1 --- mESC culture --- p.62 / Chapter 3.1.1 --- Cell colony morphology of feeder free mESCs --- p.62 / Chapter 3.2 --- Subcloning --- p.63 / Chapter 3.2.1 --- PCR cloning of Irx4 --- p.63 / Chapter 3.2.2 --- Restriction digestion on iDuet101A --- p.64 / Chapter 3.2.3 --- Ligation of Irx4 to iDuet101A backbone --- p.66 / Chapter 3.2.4 --- Confirmation of successful ligation --- p.67 / Chapter 3.3 --- Lentivirus packaging --- p.68 / Chapter 3.3.1 --- Transfection --- p.68 / Chapter 3.4 --- Multiple transduction of mESCs and hygromycin selection of positively-transduced cells --- p.69 / Chapter 3.5 --- FACS --- p.70 / Chapter 3.6 --- Irx4 and iduet clone selection --- p.71 / Chapter 3.7 --- Characte rization of mESCs after clone selection --- p.74 / Chapter 3.7.1 --- Immunostaining of pluripotent and differentiation markers --- p.74 / Chapter 3.8 --- Differentiation of cell lines after selection --- p.77 / Chapter 3.8.1 --- Size of EBs of the cell lines during differentiation --- p.77 / Chapter 3.9 --- Gene expression study by qPCR --- p.79 / Chapter 3.10 --- Kv channel expression and membrane potential of mESCs at Go/Gi phase and S phases --- p.84 / Chapter 3.10.1 --- Expression of Kv channels subunits at G0/Gi phase and S phase --- p.86 / Chapter 3.10.2 --- Membrane potential at Go/Gi phase and S phase --- p.87 / Chapter 3.11 --- Effects of TEA+ on feeder free mESCs --- p.89 / Chapter 3.11.1 --- Apoptotic study --- p.89 / Chapter 3.11.2 --- Expression of germ layers´ة markers --- p.91 / Chapter 3.11.3 --- Embryo id bodies (EBs) measurement after differentiation --- p.92 / Chapter CHAPTER FOUR --- DISCUSSION --- p.95 / Chapter 4.1 --- Effect of overexpression of Irx4 on the cardiogenic potential of mESCs --- p.95 / Chapter 4.2 --- Role of Kv channels in maintaining the chacteristics of mESCs --- p.99 / Chapter 4.2.1 --- Inhibition of Kv channels led to a redistribution of the proportion of cells in different phases of the cell cycle: importance of Kv channels in cell cycle progression in native ESCs --- p.99 / Chapter 4.2.2 --- Inhibition of Kv channels led to a loss of pluripotency at molecular and functional levels: importance of Kv channels in the fate determination of mESCs --- p.102 / Chapter 4.3 --- Insights from the present investigation on the future uses of ESCs --- p.105 / Conclusions --- p.108 / References --- p.110

Law, Sau Kwan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 111-117). / Abstract also in Chinese. / Thesis Committee --- p.i / Acknowledgements --- p.ii / Contents --- p.iii / Abstract --- p.vii / 論文摘要 --- p.x / Abbreviations --- p.xi / List of Figures --- p.xiii / List of Tables --- p.xxiii / Chapter CHAPTER ONE --- INTRODUCTION / Chapter 1.1 --- Embryonic Stem (ES) Cells / Chapter 1.1.1 --- Characteristics of ES Cells l / Chapter 1.1.2 --- Therapeutic Potential of ES Cells --- p.3 / Chapter 1.1.3 --- Myocardial Infarction and ES cells-derived Cardiomyocytes --- p.4 / Chapter 1.1.4 --- Current Hurdles of Using ES cells-derived Cardiomyocytes for Research and Therapeutic Purposes --- p.6 / Chapter 1.2 --- Transcription Factors for Cardiac Development / Chapter 1.2.1 --- GATA-binding Protein 4 (GATA-4) --- p.8 / Chapter 1.2.2 --- Myocyte Enhancer Factor 2C (MEF2C) --- p.10 / Chapter 1.2.3 --- "NK2 Transcription Factor Related, Locus 5 (Nkx2.5)" --- p.11 / Chapter 1.2.4 --- Heart and Neural Crest Derivatives Expressed 1 /2 (HANDI/2) --- p.11 / Chapter 1.2.5 --- T-box Protein 5 (Tbx5) --- p.13 / Chapter 1.2.6 --- Serum Response Factor (SRF) --- p.14 / Chapter 1.2.7 --- Specificity Protein 1 (Spl) --- p.15 / Chapter 1.2.8 --- Activator Protein 1 (AP-1) --- p.16 / Chapter 1.3 --- Reactive Oxygen Species (ROS) / Chapter 1.3.1 --- Cellular Production of ROS --- p.18 / Chapter 1.3.2 --- Maintenance of Redox balance --- p.18 / Chapter 1.3.3 --- Redox Signaling --- p.19 / Chapter 1.4 --- Nitric Oxide (NO) and NO Signaling --- p.20 / Chapter 1.5 --- Aims of the Study --- p.22 / Chapter CHAPTER TWO --- MATERIALS AND METHODS / Chapter 2.1 --- Mouse Embryonic Fibroblast (MEF) Culture / Chapter 2.1.1 --- Derivation of MEF --- p.23 / Chapter 2.1.2 --- Maintenance of MEF Culture --- p.24 / Chapter 2.1.3 --- Irradiation of MEF --- p.25 / Chapter 2.2 --- Mouse ES Cell Culture / Chapter 2.2.1 --- Maintenance of Undifferentiated Mouse ES Cell Culture --- p.26 / Chapter 2.2.2 --- Differentiation of Mouse ES Cells --- p.26 / Chapter 2.2.3 --- Exogenous addition of hydrogen peroxide (H2O2) and NO --- p.27 / Chapter 2.3 --- ROS Localization Study / Chapter 2.3.1 --- Frozen Sectioning --- p.28 / Chapter 2.3.2 --- Confocal microscopy for ROS detection --- p.28 / Chapter 2.4 --- Intracellular ROS Measurement / Chapter 2.4.1 --- "Chemistry of 2',7'-dichlorodihydrofluorescein diacetate (H2DCFDA)" --- p.29 / Chapter 2.4.2 --- Flow Cytometry for ROS Measurement --- p.29 / Chapter 2.5 --- Gene Expression Study / Chapter 2.5.1 --- Primer Design --- p.30 / Chapter 2.5.2 --- RNA Extraction --- p.31 / Chapter 2.5.3 --- DNase Treatment --- p.32 / Chapter 2.5.4 --- Reverse Transcription --- p.32 / Chapter 2.5.5 --- Quantitative Real Time PCR --- p.33 / Chapter 2.5.6 --- Quantification of mRNA Expression --- p.34 / Chapter 2.6 --- Protein Expression Study / Chapter 2.6.1 --- Total Protein Extraction --- p.34 / Chapter 2.6.2 --- Nuclear and Cytosolic Protein Extraction --- p.35 / Chapter 2.6.3 --- Measurement of Protein Concentration --- p.36 / Chapter 2.6.4 --- De-sumoylation Assay --- p.36 / Chapter 2.6.5 --- De-phosphorylation Assay --- p.37 / Chapter 2.6.6 --- De-glycosylation Assay --- p.38 / Chapter 2.6.7 --- Western Blot --- p.39 / Chapter 2.7 --- Statistical Analysis --- p.41 / Chapter CHAPTER THREE --- RESULTS / Chapter 3.1 --- Study of Endogenous ROS / Chapter 3.1.1 --- Level and Distribution of Endogenous ROS --- p.47 / Chapter 3.1.2 --- Quantification of intracellular ROS --- p.48 / Chapter 3.2 --- Effect of Exogenous Addition of Nitric Oxide (NO) on Cardiac Differentiation / Chapter 3.2.1 --- Beating Profile of NO-treated Embryoid Bodies (EBs) --- p.50 / Chapter 3.3 --- Effect of Exogenous Addition of H2O2 on Cardiac Differentiation / Chapter 3.3.1 --- Beating Profile of H2O2-treated EBs --- p.51 / Chapter 3.3.2 --- mRNA Expression of Cardiac Structural Genes --- p.52 / Chapter 3.3.3 --- Protein Expression of Cardiac Structural Genes --- p.54 / Chapter 3.3.4 --- mRNA Expression of Cardiac Transcription Factors --- p.58 / Chapter 3.3.5 --- Protein Expression of Cardiac Transcription Factors --- p.67 / Chapter 3.3.6 --- Post-translational Modifications of Cardiac Transcription Factors --- p.74 / Chapter 3.3.7 --- Translocation of Cardiac Transcription Factors --- p.89 / Chapter CHAPTER FOUR --- DISCUSSION / Chapter 4.1 --- Changes in the Level of Endogenous ROS During Cardiac Differentiation of Mouse ES Cells --- p.96 / Chapter 4.2 --- H2O2 and NO Have Opposite Effects Towards Cardiac Differentiation --- p.97 / Chapter 4.3 --- Exogenous Addition of H2O2 Advances Differentiation of Mouse ES Cells into Cardiac Lineage --- p.99 / Chapter 4.4 --- Possible Role of H2O2 in Mediating Cardiac Differentiation of Mouse ES Cells --- p.103 / Chapter 4.5 --- Future Directions --- p.108 / Conclusions --- p.110 / References --- p.111

A substituição de cardiomiócitos na vida pós-natal tem sido um dos maiores desafios da medicina regenerativa. O conceito de que os cardiomiócitos proliferam ativamente durante o desenvolvimento, mas perdem completamente esse potencial logo após o nascimento, foi recentemente questionado quando as primeiras evidências mostraram a existência de mecanismos endógenos de regeneração cardíaca em camundongos com um dia de vida. Nós avaliamos esse fenômeno em ratos de um dia de vida (P1) e investigamos o impacto da regeneração inicial na perfusão tecidual em longo prazo e a função cardíaca global em resposta ao stress. A homogeneidade da cirurgia de ressecção apical foi comprovada através do exame de ressonância magnética (MRI) e demonstramos que os ratos P1 apresentaram evidências de neoformação de cardiomiócitos a partir da marcação de Troponina I e Conexina 43 na àrea da lesão 21 dias após a cirurgia de ressecção, enquanto os ratos de sete dias de idade (P7) apresentaram a substituição do tecido principalmente por deposição de colágeno. De maneira interessate, as células recém-formadas apresentaram uma aparente falta de alinhamento uniforme nos ratos P1, e a hipoperfusão do tecido cardíaco foi detectada para ambos os grupos de pós-ressecção 21 e aos 60 dias do exame de SPECT. A função cardíaca basal direta aos 60 dias apresentou-se preservada em todos os grupos, enquanto sob estresse hemodinâmico, o grau de mudança na LVDEP, Volume Sitólico e Trabalho Sistólico indicaram função cardíaca diminuída nos ratos P7. Além disso, a relação pressão-volume diastólica final e o aumento da deposição de colágeno intersticial no P7 são consistentes com o aumento da rigidez da câmara. Coletivamente, nós mostramos que o potencial regenerativo com ausência de remodelamento cardíaco adverso é restrito aos ratos P1. Em seguida, procurou-se avaliar os mecanismos moleculares que regulam esse fenômeno através da combinação de ferramentas exploratórias. Embora tenha sido descrito anteriormente que o sistema imunológico não é totalmente maduro ao nascimento, o sequenciamento do RNA total de corações de ratos sham-operados, P1 e P7 mostrou que o procedimento cirúrgico foi suficiente para ativar algumas vias ligadas à resposta inflamatória e considerando as subpopulações de macrófagos pró (M1) e anti-inflamatórios (M2), sugerimos que o perfil de macrófagos anti-inflamatórios (M2) infiltrados no coração de ratos P1 são diferentes das células adultas pró-fibróticas regulares. Os meios condicionados M1 e M2 elevaram a taxa de proliferação de cardiomiócitos em condições de normóxia, mas somente o M2 apresentou resposta proliferativa em hipóxia e preveniu a diferenciação-induzida de fibroblastos cardíacos por menor expressão ?SMA. Por membranas array de citocinas, 15 citocinas apresentaram-se comuns aos dois meios condicionados, mas apenas 4 citocinas, sendo elas IL-4, IL-1?, IL-6 e Fractalkine, foram exclusivas ao meio condicionado M2, e que poderiam ser possíveis candidatos aos efeitos regenerativos encontrados. Nesse sentido, experimentos futuros fazem-se necessários a fim de explorar os efeitos dessas citocinas e desenvolver novas estratégias terapêuticas / The replacement of cardiomyocytes in postnatal life has proven to be one of the biggest challenges in regenerative medicine. The concept that cardiomyocytes proliferate actively during development but cease completely right after birth has been recently questioned when first evidences showed the existence of endogenous mechanisms of cardiac regeneration in one-day-old mice. We sought to evaluate this phenomenon in one-day-old rats (P1) and to assess the impact of the early regenerative process on long-term tissue perfusion and overall cardiac function in response to stress. We confirmed the successful apical resection surgery through magnetic resonance imaging (MRI) and that P1 heart was associated with evidence of cardiomyocytes neoformation as indicated by Troponin I and Connexin 43 expression at 21 days postresection, while in seven-day-old rats (P7) mainly scar tissue replacement ensued. Interestingly, there was an apparent lack of uniform alignment of newly formed cells in P1, and cardiac tissue hypoperfusion has been detected for both groups at 21 postresection and at 60 days through SPECT scanning. Direct basal cardiac function at 60 days, was preserved in all groups, whereas under hemodynamic stress the degree of change on LVDEP, Stroke Volume and Stroke Work indicated diminished overall cardiac function in P7. Furthermore, the End-Diastolic Pressure-Volume relationship and increased interstitial collagen deposition in P7 is consistent with increased chamber stiffness. Collectively, we showed that regenerative potential with slight collagen deposition is restricted to P1 rats. Then we sought to evaluate the molecular mechanisms that regulate this phenomenon through explorative tools. Although it has been previously described that the immune system is not fully mature at birth, total RNA sequenced from sham-operated, P1 and P7 heart rats showed that surgery is sufficient to activate inflammatory pathways, and considering pro (M1) and anti-inflammatory (M2) macrophages subpopulations, we suggested that invaded macrophages in resected P1 hearts are different from the traditional pro-fibrotic M2-like adult cells. Conditioned M1 and M2 medium elevated cardiomyocytes proliferative rate under basal conditions, but only M2 produced the same effect in cardiomyocytes under hypoxia and prevented myofibroblasts-induced differentiation through ?SMA intensity expression. Membrane array for cytokines showed 15 common cytokines for both M1 and M2 conditioned medium, but only 4, as IL-4, IL-1?, IL-6 and Fractalkine, were M2 exclusive and possible candidates to the regenerative potential. Additional experiments are needed to further explore these cytokines and to maybe develop new therapeutic strategies