Cluster of differentiation 1 (CD1) d ist ein antigenpräsentierendes Glykoprotein, das verschiedene Lipidklassen (z.B. Glycerophospholipide und Sphingolipide) bindet. CD1d zeigt intrazellulär eine Verteilung sowohl im sekretorischen als auch im endolysosomalen Kompartiment und bindet dort endogene (körpereigene) und exogene (körperfremde, z.B. mikrobiellen) Lipide, die an natürliche Killer T-Zellen, eine Gruppe lipidreaktiver T-Zellen, präsentiert werden. Nach Antigenerkennung zeigen NKT-Zellen eine schnelle Zytokinsekretion, was wiederum zu einer breiten Aktivierung anderer angeborener und adaptiver Immunzellpopulationen wie dendritischer Zellen, natürlicher Killerzellen, B-Zellen und konventioneller T-Zellen führt. In meiner Dissertation untersuchte ich die Rolle von CD1d und NKT-Zellen im Kontext der intestinalen Tumorentstehung (Kapitel 1). Darüber hinaus untersuchte ich CD1d-abhängige Effekte auf den hepatischen Lipidmetabolismus, verbunden mit der Frage ob diese Effekte zumindest partiell in NKT-Zell-unabhängiger Weise vermittelt werden (Kapitel 2). CD1d und NKT-Zellen in der intestinalen Tumorentwicklung NKT-Zellen beeinflussen CD1d-abhängig entzündliche Prozesse im Darm sowie die intestinale Tumorentwicklung. Verschiedene Modelle und Strategien, die sich mit der Klärung der Rolle der NKT-Zelluntergruppen in diesen Erkrankungen beschäftigten, zeigten, dass hierbei eine komplexe Regulierung durch spezifische NKT-Zelluntergruppen, nämlich invariante (i)NKT-Zellen und diverse (d)NKT-Zellen, mit teils gegensätzlichen Effekten zu beobachten ist. CD1d zeigt eine ubiquitäre Expression und kann in zellspezifischer Weise in die NKT-Zell-Aktivierung eingreifen. So vermittelt CD1d im Kontext der intestinalen Entzündung regulatorische NKT-Zell-Signale wenn die Antigenpräsentation von intestinalen Epithelzellen (IECs) ausgeht, während CD1d-Signale von professionellen Immunzellen intestinale Entzündung in NKT-Zell-abhängiger Weise fördern. Das Ziel des ersten Teils meiner Arbeit (Kapitel 1) war die Analyse zelltypspezifischer Effekte von CD1d in der Aktivierung von NKT-Zellen im Rahmen der intestinalen Tumorentstehung. Unter Verwendung des Cre-lox-Systems zur Erzeugung von IEC- und myeloidspezifischen CD1d-defizienten Mäusen und der ApcMin/+ und Apcfl/wt-Mausemodelle intestinaler Tumorentwicklung untersuchte ich die Wirkung der zelltypspezifischen CD1d-Deletion auf die NKT-Zell-Immunantwort im Rahmen der intestinalen Tumorentwicklung. Ich konnte dabei zeigen, dass CD1d in NKT-Zell-abhängiger Weise das intestinale Tumorwachstum fördert. Während die intestinal-epitheliale Deletion von CD1d keine Effekte auf die Tumorentwicklung hatte, führte die myeloide Deletion von CD1d zumindest zu einem partiell reduzierten Tumorwachstum. Diese Daten zeigen, dass myeloide Zellen zum CD1d- und NKT-abhängigen Tumorwachstum beitragen. Darüber hinaus ist anzunehmen, dass weitere, bislang uncharakterisierte Zellen zur CD1d-abhängigen Regulation der Tumorentwicklung beitragen. NKT-Zell-unabhängige Effekte von CD1d im hepatischen Lipidmetabolismus. Der zweite Teil meiner Dissertation (Kapitel 2) befasste sich mit der Rolle von CD1d in der Regulierung des hepatischen Fettstoffwechsels unter konstitutiven Bedingungen sowie im Kontext der nichtalkoholischen Fettleberkrankheit (NAFLD). Mausmodelle mit konstitutiver Deletion von CD1d zeigten dabei, dass diese Prozesse in CD1d-abhängiger Weise vermittelt werden. Da die Deletion von CD1d mit einem Verlust von NKT-Zellen verbunden ist, wurde daraus geschlossen, dass NKT-Zellen zur Pathogenese metabolischer und inflammatorischer Veränderungen bei NAFLD beitragen. Ob CD1d auch in NKT-Zell-unabhängiger Weise zur Regulation des hepatischen Metabolismus beitragen kann, wurde bislang nicht untersucht. CD1d wird ubiquitär und abundant von verschiedenen Zelltypen einschließlich Enterozyten, Adipozyten und Hepatozyten exprimiert und interagiert mit verschiedenen Lipidtransferproteinen. Ich untersuchte daher, ob CD1d auch in direkter, NKT-Zell-unabhängiger Weise Einfluss auf den hepatischen Lipidmetabolismus nimmt. Hierzu wurden CD1d-exprimierende und CD1d-defiziente Mäuse auf einem genetischen Hintergrund mit Defizienz des recombination activating gene 1 (Rag1) untersucht, in dem aufgrund der fehlenden VDJ-Rekombination reife T- und B-Zellen einschließlich NKT-Zellen fehlen. Meine Ergebnisse zeigen, dass CD1d den hepatischen Lipidstoffwechsel unter konstitutiven Bedingungen wie auch im Kontext der nicht-alkoholischen Fettleber in einer NKT-Zell-unabhängigen Weise regulieren kann. Die Mechanismen über die diese Regulation vermittelt wird, werden derzeit experimentell untersucht. Zusammenfassend habe ich in dieser Arbeit die Rolle von epithelialem und myeloiden CD1d in der intestinalen Tumorentstehung charakterisiert. Darüber hinaus konnte ich zeigen, dass CD1d in NKT-Zell-unabhängiger Weise den hepatischen Lipidmetabolismus reguliert.:Zusammenfassung Summary General introduction 1 The CD1 family of antigen presenting proteins 1.1 Structure of CD1 proteins 1.2 Trafficking of CD1 proteins 1.3 Lipid transfer proteins 1.4 CD1 associated lipid repertoire 2 CD1d-restricted T cells 2.1 Lipid antigens presented to CD1 restricted T cells 2.2 NKT cell subsets 2.3 NKT cells in homeostasis and disease Chapter I: CD1d in intestinal tumor development Introduction 1 The role of CD1d and NKT cells in intestinal homeostasis 1.1 The intestine: structure and function 1.2 Immune cell populations in the intestine 1.3 Interplay between iNKT cells and intestinal microbiota 1.3.1 The intestinal microbiota shapes mucosal iNKT cells 1.3.2 Effect of the microbiota on systemic iNKT cells 1.3.3 Bacterial lipid antigens influence iNKT cell-dependent mucosal immunity 1.3.4 Effect of CD1d deficiency on commensals 2 CD1d & NKT cells in cancer 2.1 Enhancing anti-tumor immunity 2.2 Suppressing anti-tumor immunity 3 CD1d & NKT cells in colorectal cancer 3.1 Spontaneous tumorigenesis 3.2 Intestinal inflammation and inflammation-induced cancer Aim of the study Materials and Methods Results 1.1. Validation of the conditional CD1d knockout mouse lines 1.2. Analysis of tumorigenesis in the ApcMin/+ and Apcfl/wt models 1.3. The impact of myeloid cell-specific deletion of CD1d on spontaneous tumor development 1.4. The impact of intestinal epithelial cell specific deletion of CD1d on spontaneous tumorigenesis 1.5. Analysis of constitutive deletion of CD1d in spontaneous tumorigenesis model Discussion Chapter II: CD1d and hepatic lipid metabolism in non-alcoholic fatty liver disease (NAFLD) Introduction 1 Metabolic diseases as a multi-organ pathology 2 Lipid metabolism and inflammation in metabolic diseases 3 Non alcoholic fatty liver disease (NAFLD) 3.1 Mouse models of NAFLD 4 NKT cells in metabolic diseases 4.1 NKT cells in obesity 4.2 NKT cells in NAFLD 5 Potential NKT cell-independent roles of CD1d Materials and methods Results 2.1 Absence of CD1d on the Rag1-deficient background under constitutive conditions reduces neutral lipid accumulation in the liver 2.2 Deletion of CD1d on a Rag1-deficient background reduces hepatic neutral lipid accumulation in response to a HFD and protects from liver injury 2.3 Choline-deficient HFD as a model of NASH shows no difference between CD1d-deficient Rag1-deficient mice and CD1d-proficient littermates Discussion References Appendix 132 List of abbreviations 132 List of tables 137 List of figures 138 Acknowledgments Anlage 1 Anlage 2 / Cluster of differentiation 1 (CD1) d is an atypical antigen-presenting glycoprotein which binds diverse lipid classes including glycerophospholipids and sphingolipids. Trafficking through secretory and endolysosomal compartments, CD1d broadly surveys the cell for endogenous (self) and exogenous (e.g. microbial) lipids and presents those lipids to a subset of T cells, named natural killer T (NKT) cells. NKT cells exhibit rapid and abundant cytokine secretion upon antigen recognition, leading to a broad activation of other innate and adaptive immune cell populations such as dendritic cells, natural killer cells, B cells, and conventional T cells. My thesis studied CD1d and NKT cells in the context of intestinal tumorigenesis (chapter I) and investigated a novel NKT cell-independent role of CD1d in the regulation of hepatic lipid metabolism (chapter II). CD1d and NKT cells in intestinal tumor development NKT cells modulate intestinal inflammation and tumor development in a CD1d-dependent manner. Different models and strategies have been used to elucidate the role of NKT cell subsets in these processes, highlighting a complexity of regulation by specific NKT cells subsets, namely invariant (i)NKT cells and diverse (d)NKT cells, and other immune cells and mediators in the tumor microenvironment. In addition, CD1d, which is ubiquitously expressed, can elicit cell-type specific effects on NKT cell subsets as shown in intestinal inflammation, where intestinal epithelial cell (IEC) CD1d provide regulatory cues, while CD1d signal from bone marrow-derived cells promote intestinal inflammation. The first part of my thesis (chapter I) aimed at further dissecting potential cell type-specific effects of CD1d in the activation of NKT cells in the context of intestinal tumorigenesis. Using the Cre-lox system to generate IEC- and myeloid-specific CD1d-deficient mice and the ApcMin/+ and Apcfl/wt mouse models of intestinal tumorigenesis, I investigated the effects of cell type-specific CD1d deficiency on iNKT cell immune responses and tumor development. My findings show that CD1d, presumably through iNKT cells, promotes tumor growth as shown in a model of constitutive CD1d deletion. While epithelial CD1d did not contribute to NKT cell-dependent tumor growth, myeloid deletion of CD1d was associated with a trend towards reduced tumor growth. These results suggest that myeloid CD1d promotes NKT cell-dependent tumor growth and that other, yet uncharacterized cells, have additional contributions to this process. NKT cell-independent roles of CD1d in the regulation of liver metabolism The second part of my thesis (chapter II) tackled the role of CD1d in the regulation of hepatic lipid metabolism under constitutive conditions and in the context of non-alcoholic fatty liver disease (NAFLD), a prevalent metabolic liver disease which is associated, in a subset of individuals, with immune-mediated progression to liver fibrosis and cirrhosis. Inflammation has an important role in the progression of NAFLD and metabolic diseases, and iNKT cells have been linked to these processes. Specifically, constitutive deletion of CD1d, which is associated with loss of NKT cells, has been demonstrated to influence hepatic lipid metabolism and the progression of NAFLD. In this thesis, I investigated whether the effects of CD1d are indeed dependent on NKT cells or whether CD1d has direct, NKT cell-independent effects on liver metabolism. CD1d is expressed ubiquitously and abundantly by various cell types including enterocytes, adipocytes and hepatocytes, and it binds to a plethora of endogenous cellular lipids through the interaction with lipid transfer proteins, which are important regulators of lipid metabolism. To investigate CD1d-mediated effects that are independent from NKT cells, CD1d-proficient and CD1d-deficient mice were analyzed on a recombination activating 1 (Rag1)-deficient background, which lacks mature T and B cells including NKT cells due to the lack of VDJ recombination. My results demonstrate that CD1d can regulate hepatic lipid metabolism in an NKT cell-independent manner under constitutive conditions and in the context of models of NAFDL. The mechanisms by which CD1d can directly regulate hepatic lipid metabolism are currently being addressed. In conclusion, in this thesis I have characterized the cellular contributions to CD1d- and NKT cell-dependent regulation of intestinal tumor development. In addition, I have identified a novel, NKT cell-independent effect of CD1d on hepatic lipid metabolism.:Zusammenfassung Summary General introduction 1 The CD1 family of antigen presenting proteins 1.1 Structure of CD1 proteins 1.2 Trafficking of CD1 proteins 1.3 Lipid transfer proteins 1.4 CD1 associated lipid repertoire 2 CD1d-restricted T cells 2.1 Lipid antigens presented to CD1 restricted T cells 2.2 NKT cell subsets 2.3 NKT cells in homeostasis and disease Chapter I: CD1d in intestinal tumor development Introduction 1 The role of CD1d and NKT cells in intestinal homeostasis 1.1 The intestine: structure and function 1.2 Immune cell populations in the intestine 1.3 Interplay between iNKT cells and intestinal microbiota 1.3.1 The intestinal microbiota shapes mucosal iNKT cells 1.3.2 Effect of the microbiota on systemic iNKT cells 1.3.3 Bacterial lipid antigens influence iNKT cell-dependent mucosal immunity 1.3.4 Effect of CD1d deficiency on commensals 2 CD1d & NKT cells in cancer 2.1 Enhancing anti-tumor immunity 2.2 Suppressing anti-tumor immunity 3 CD1d & NKT cells in colorectal cancer 3.1 Spontaneous tumorigenesis 3.2 Intestinal inflammation and inflammation-induced cancer Aim of the study Materials and Methods Results 1.1. Validation of the conditional CD1d knockout mouse lines 1.2. Analysis of tumorigenesis in the ApcMin/+ and Apcfl/wt models 1.3. The impact of myeloid cell-specific deletion of CD1d on spontaneous tumor development 1.4. The impact of intestinal epithelial cell specific deletion of CD1d on spontaneous tumorigenesis 1.5. Analysis of constitutive deletion of CD1d in spontaneous tumorigenesis model Discussion Chapter II: CD1d and hepatic lipid metabolism in non-alcoholic fatty liver disease (NAFLD) Introduction 1 Metabolic diseases as a multi-organ pathology 2 Lipid metabolism and inflammation in metabolic diseases 3 Non alcoholic fatty liver disease (NAFLD) 3.1 Mouse models of NAFLD 4 NKT cells in metabolic diseases 4.1 NKT cells in obesity 4.2 NKT cells in NAFLD 5 Potential NKT cell-independent roles of CD1d Materials and methods Results 2.1 Absence of CD1d on the Rag1-deficient background under constitutive conditions reduces neutral lipid accumulation in the liver 2.2 Deletion of CD1d on a Rag1-deficient background reduces hepatic neutral lipid accumulation in response to a HFD and protects from liver injury 2.3 Choline-deficient HFD as a model of NASH shows no difference between CD1d-deficient Rag1-deficient mice and CD1d-proficient littermates Discussion References Appendix 132 List of abbreviations 132 List of tables 137 List of figures 138 Acknowledgments Anlage 1 Anlage 2

A NAFLD é uma das principais patologias de fígado. Estudos reportam o exercício físico como um dos principais alvos terapêuticos para esta doença. Verificamos se o treinamento melhora a resistência à insulina, inflamação e esteatose hepática causados pela dieta hiperlipídica (HF) e se o PPAR-alpha está envolvido neste processo. Animais selvagens C57BL6 (WT) e knockout para PPARα (KO) foram alimentados com dieta padrão ou HF durante 12 semanas e treinados por 8 semana. Metade dos animais KO treinados receberam rosiglitazona. A dieta HF aumentou TAG hepático, e resistência periférica à insulina levando a NALFD. O treinamento foi eficiente em reduzir esses parâmetros em ambos genótipos. O desenvolvimento da NAFLD não foi associado à inflamação hepática, entretanto animais KO treinados apresentaram uma resposta inflamatória exacerbada, causada pela redução de PPARγ. Quando eles receberam rosi apresentaram melhora no quadro inflamatório hepático e na resistência à insulina. O exercício diminuiu os danos causados pela dieta HF independente do PPARα; a ausência do PPARα junto com exercício leva a queda na expressão de PPARγ, e a uma resposta inflamatória exacerbada, que é revertida pela administração da rosiglitazona. / NAFLD is one of the main liver diseases. Studies have shown the beneficial effects of exercise on reverse NAFLD. We verify whether exercise improve insulin resistance, liver inflammation and steatohepatitis caused by a high fat diet (HF) and whether PPARα is involved in these actions. C57BL6 wild type (WT) and PPAR-α knockout (KO) mice were fed with a standard (SD) or HF during 12 weeks and trained on a treadmill during 8 weeks, half of KO trained animals received 15mg/kg/day of rosiglitazone. HF diet increased TAG in the liver and peripheral insulin resistance leading to NAFLD. Exercise reduced all this parameters in both animals genotype. NAFLD was not associated with inflammation, however KO mice when trained presented an inflammatory response that was caused by a decrease on PPARγ. When these mice were treated with rosiglitazone, they presented decrease on inflammatory cytokines as well as improvement on insulin sensitivity. Exercise improved the damage caused by a HF independently of PPARα and the absence of PPARα together with exercise leads to decrease on PPARγ expression and an inflammatory response, which was attenuated by rosiglitazone administration.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / O estudo teve como objetivo avaliar os efeitos da rosuvastatina (ST) e darosiglitazona sobre a resistência à insulina (RI), morfologia do fígado e do tecido adiposo em camundongos alimentados com dieta hiperlipídica (HF). O tratamento com rosuvastatina resultou em uma acentuada melhoria na sensibilidade à insulina caracterizada pela melhor depuração da glicose durante o teste de tolerância à insulina e uma redução do índice HOMA-IR em 70% (P = 0,0008). O grupo tratado com rosuvastatina apresentou redução no ganho massa corporal (-8%, P <0,01) e menor depósito de gordura visceral (-60%, P <0,01) em comparação com o grupo HF não tratado. Em comparação com camundongos HF, animais do grupo HF+ST reduziram significativamente a massa hepática e a esteatose hepática (-6%; P <0,05% e -21; P <0,01, respectivamente). O grupo HF+ST, reduziu os níveis de triglicerídeos hepáticos em 58% comparado com o grupo HF (P <0,01). Além disso, a expressão de SREBP-1c (proteína 1c ligadora do elemento regulado por esteróis) foi reduzido em 50% no fígado dos animais HF + ST (P <0,01) em comparação com o grupo HF. Os níveis de resistina foram menores no grupo HF + ST comparado com o grupo HF (44% a menos, P <0,01). Em conclusão, demonstramos que camundongos alimentados com dieta HF tratados com rosuvastatina melhoram a sensibilidade à insulina, com redução da esteatose hepática. Além disso, ST reduziu o ganho de massa corporal, melhorou os níveis circulantes de colesterol e triglicerídeo plasmático, com menor conteúdo de hepático de triglicerídeo, que foi concomitante com menor resistina e aumento da adiponectina. / The study aimed to evaluate the effects of rosuvastatin (ST) and rosiglitazone on insulin resistance (IR) and liver and adipose tissue morphologies in mice fed a high-fat (HF) diet. Our data show that treatment with rosuvastatin resulted in a marked improvement in insulin sensitivity characterised by enhanced glucose clearance during insulin tolerance and a decrease in the HOMA-IR index level by 70% (P=0.0008). The group of mice treated with rosuvastatin exhibited reduced body mass gain (-8%; P<0.01) and visceral fat pad thickness (-60%; P<0.01)compared with the untreated HF group. In comparison with HF mice, HF+ST mice showed a significant reduction in hepatomegaly and liver steatosis (-6%; P<0.05 and -21%; P<0.01, respectively). In HF+ST mice, the hepatictriglyceride levels were reduced by 58% compared with the HF group (P <0.01). In addition, the expression of SREBP-1c (sterol regulatory element-binding protein) was decreased by 50% in the livers of HF+ST mice (P<0.01) compared with the HF mice. The levels of resistin were lower in the HF+ST group compared with the HF group (44% less, P< 0.01). In conclusion, we demonstrated that rosuvastatin-treated mice fed HF has been improving in insulin sensitivity, with decreased steatosis found in HF mice. Furthermore, ST reduced body mass gain, improved the circulating levels of plasma cholesterol and triglycerides and reduced hepatic triglycerides, which was concomitant with lower resistin and increased total adiponectin.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / O estudo teve como objetivo avaliar os efeitos da rosuvastatina (ST) e darosiglitazona sobre a resistência à insulina (RI), morfologia do fígado e do tecido adiposo em camundongos alimentados com dieta hiperlipídica (HF). O tratamento com rosuvastatina resultou em uma acentuada melhoria na sensibilidade à insulina caracterizada pela melhor depuração da glicose durante o teste de tolerância à insulina e uma redução do índice HOMA-IR em 70% (P = 0,0008). O grupo tratado com rosuvastatina apresentou redução no ganho massa corporal (-8%, P <0,01) e menor depósito de gordura visceral (-60%, P <0,01) em comparação com o grupo HF não tratado. Em comparação com camundongos HF, animais do grupo HF+ST reduziram significativamente a massa hepática e a esteatose hepática (-6%; P <0,05% e -21; P <0,01, respectivamente). O grupo HF+ST, reduziu os níveis de triglicerídeos hepáticos em 58% comparado com o grupo HF (P <0,01). Além disso, a expressão de SREBP-1c (proteína 1c ligadora do elemento regulado por esteróis) foi reduzido em 50% no fígado dos animais HF + ST (P <0,01) em comparação com o grupo HF. Os níveis de resistina foram menores no grupo HF + ST comparado com o grupo HF (44% a menos, P <0,01). Em conclusão, demonstramos que camundongos alimentados com dieta HF tratados com rosuvastatina melhoram a sensibilidade à insulina, com redução da esteatose hepática. Além disso, ST reduziu o ganho de massa corporal, melhorou os níveis circulantes de colesterol e triglicerídeo plasmático, com menor conteúdo de hepático de triglicerídeo, que foi concomitante com menor resistina e aumento da adiponectina. / The study aimed to evaluate the effects of rosuvastatin (ST) and rosiglitazone on insulin resistance (IR) and liver and adipose tissue morphologies in mice fed a high-fat (HF) diet. Our data show that treatment with rosuvastatin resulted in a marked improvement in insulin sensitivity characterised by enhanced glucose clearance during insulin tolerance and a decrease in the HOMA-IR index level by 70% (P=0.0008). The group of mice treated with rosuvastatin exhibited reduced body mass gain (-8%; P<0.01) and visceral fat pad thickness (-60%; P<0.01)compared with the untreated HF group. In comparison with HF mice, HF+ST mice showed a significant reduction in hepatomegaly and liver steatosis (-6%; P<0.05 and -21%; P<0.01, respectively). In HF+ST mice, the hepatictriglyceride levels were reduced by 58% compared with the HF group (P <0.01). In addition, the expression of SREBP-1c (sterol regulatory element-binding protein) was decreased by 50% in the livers of HF+ST mice (P<0.01) compared with the HF mice. The levels of resistin were lower in the HF+ST group compared with the HF group (44% less, P< 0.01). In conclusion, we demonstrated that rosuvastatin-treated mice fed HF has been improving in insulin sensitivity, with decreased steatosis found in HF mice. Furthermore, ST reduced body mass gain, improved the circulating levels of plasma cholesterol and triglycerides and reduced hepatic triglycerides, which was concomitant with lower resistin and increased total adiponectin.

A NAFLD é uma das principais patologias de fígado. Estudos reportam o exercício físico como um dos principais alvos terapêuticos para esta doença. Verificamos se o treinamento melhora a resistência à insulina, inflamação e esteatose hepática causados pela dieta hiperlipídica (HF) e se o PPAR-alpha está envolvido neste processo. Animais selvagens C57BL6 (WT) e knockout para PPAR&alpha; (KO) foram alimentados com dieta padrão ou HF durante 12 semanas e treinados por 8 semana. Metade dos animais KO treinados receberam rosiglitazona. A dieta HF aumentou TAG hepático, e resistência periférica à insulina levando a NALFD. O treinamento foi eficiente em reduzir esses parâmetros em ambos genótipos. O desenvolvimento da NAFLD não foi associado à inflamação hepática, entretanto animais KO treinados apresentaram uma resposta inflamatória exacerbada, causada pela redução de PPAR&gamma;. Quando eles receberam rosi apresentaram melhora no quadro inflamatório hepático e na resistência à insulina. O exercício diminuiu os danos causados pela dieta HF independente do PPAR&alpha;; a ausência do PPAR&alpha; junto com exercício leva a queda na expressão de PPAR&gamma;, e a uma resposta inflamatória exacerbada, que é revertida pela administração da rosiglitazona. / NAFLD is one of the main liver diseases. Studies have shown the beneficial effects of exercise on reverse NAFLD. We verify whether exercise improve insulin resistance, liver inflammation and steatohepatitis caused by a high fat diet (HF) and whether PPAR&alpha; is involved in these actions. C57BL6 wild type (WT) and PPAR-&alpha; knockout (KO) mice were fed with a standard (SD) or HF during 12 weeks and trained on a treadmill during 8 weeks, half of KO trained animals received 15mg/kg/day of rosiglitazone. HF diet increased TAG in the liver and peripheral insulin resistance leading to NAFLD. Exercise reduced all this parameters in both animals genotype. NAFLD was not associated with inflammation, however KO mice when trained presented an inflammatory response that was caused by a decrease on PPAR&gamma;. When these mice were treated with rosiglitazone, they presented decrease on inflammatory cytokines as well as improvement on insulin sensitivity. Exercise improved the damage caused by a HF independently of PPAR&alpha; and the absence of PPAR&alpha; together with exercise leads to decrease on PPAR&gamma; expression and an inflammatory response, which was attenuated by rosiglitazone administration.

Purpose of the Review Mitochondrial dysfunction has long been proposed to play a crucial role in the pathogenesis of a considerable number of disorders, such as neurodegeneration, cancer, cardiovascular, and metabolic disorders, including obesity-related insulin resistance and non-alcoholic fatty liver disease (NAFLD). Mitochondria are highly dynamic organelles that undergo functional and structural adaptations to meet the metabolic requirements of the cell. Alterations in nutrient availability or cellular energy needs can modify their formation through biogenesis and the opposite processes of fission and fusion, the fragmentation, and connection of mitochondrial network areas respectively. Herein, we review and discuss the current literature on the significance of mitochondrial adaptations in obesity and metabolic dysregulation, emphasizing on the role of hepatocyte mitochondrial flexibility in obesity and NAFLD. Recent Findings Accumulating evidence suggests the involvement of mitochondrial morphology and bioenergetics dysregulations to the emergence of NAFLD and its progress to non-alcoholic steatohepatitis (NASH). Summary Most relevant data suggests that changes in liver mitochondrial dynamics and bioenergetics hold a key role in the pathogenesis of NAFLD. During obesity and NAFLD, oxidative stress occurs due to the excessive production of ROS, leading to mitochondrial dysfunction. As a result, mitochondria become incompetent and uncoupled from respiratory chain activities, further promoting hepatic fat accumulation, while leading to liver inflammation, insulin resistance, and disease’s deterioration. Elucidation of the mechanisms leading to dysfunctional mitochondrial activity of the hepatocytes during NAFLD is of predominant importance for the development of novel therapeutic approaches towards the treatment of this metabolic disorder.

Obesity and insulin resistance are associated with a constellation of features including hypertension, dyslipidaemia, type 2 diabetes, and premature cardiovascular disease, collectively termed the metabolic syndrome. Non-alcoholic fatty liver disease (NAFLD) represents the hepatic component of this syndrome, incorporating a spectrum of liver disease with increasing morbidity and mortality, from simple steatosis, to non-alcoholic steatohepatitis (or NASH), fibrosis, cirrhosis and ultimately hepatocellular carcinoma. However, factors influencing this progression are incompletely understood. In this thesis I sought to investigate pathways which promote hepatic inflammation and fibrosis by studying two contrasting dietary models of NAFLD in mice in which the risk of hepatic inflammation, insulin resistance and fibrosis differ; namely the methionine and choline deficient diet (MCDD) which induces steatohepatitis, hepatic insulin resistance, and weight loss, and the choline deficient diet (CDD) which may be protected from insulin resistance, and leads to steatosis without inflammation or weight loss. I investigated the possible molecular mechanisms underlying these differences, and whether they influenced progression to hepatic fibrosis induced by carbon tetrachloride (CCl4).

Oxidative stress, lipid peroxidation, and endotoxaemia with cytokine-mediated injury have been implicated as factors in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). The degree of insulin resistance together with co-existing inadequacies of vital antioxidant defence mechanisms may be important determinants of progression to fibrosis in patients with non-alcoholic steatohepatitis (NASH). Current therapies are targeted at improving insulin sensitivity as well as addressing hepatic repair including anti-inflammatory strategies. Anti-oxidants remedies have also been tested but the role of selenoenzymes with antioxidant action, namely thioredoxin reductase 1 (TR1) and glutathione peroxidase 1 (GPX1) have been ignored. The aim of this thesis is to investigate the role of selenium in the pathophysiology of NAFLD both in vitro and in vivo. The in vitro studies used cell lines representing the cell types involved in the disorder; hepatocytes (C3A line) and hepatic stellate cells (LX-2 line). In order to assess the influence of selenium status and selenoenzymes expression on the pathogenesis of NAFLD it was necessary to develop a culture system which allowed good cell viability in selenium free culture medium. This was achieved by the use of an insulin and transferrin (IT)-supplemented medium which importantly was free of any animal serum additions. Using this IT culture medium, selenium addition (as selenite) produced a significant increase in the expression of GPX1 and TR1 in both C3A and LX2 cells. TR1 and GPX1 were expressed at similar levels in both C3A and LX-2 cells. It was also necessary to develop an in-vitro model for fat loading C3A cells to mimic fatty liver pathophysiology. Two models of fat loading were investigated. One model used lactate, pyruvate, octanoate and ammonium (LPON). LPON has been previously used to increase the functionality of C3A cells but it was observed that fat droplets accumulated in these LPON treated cells. Dissection of the agents in the LPON revealed that octanoate was the factor that increased the triglyceride accumulation. Interestingly, octanoate also increased the expression of TR1 and GPX1, suggesting that it could induce oxidative stress leading to the induction of selenoenzymes to afford a protective defence mechanism. In the second model, oleate and/or palmitate were used to fat-load C3A cells. These cells had significantly higher triglyceride content than the LPON-fat-loaded cells. However, oleate and/or palmitate treatments did not increase the expression of either TR1 or GPX1 in C3A cells suggesting perhaps these cells were not under oxidative stress. LPON and oleate/palmitate were also capable of fat loading LX2 cells. Selenium-supplementation of C3A and LX-2 cells efficiently protected (measured by their lactate dehydrogenase retention) them from oxidative damage induced by t-butylhydroperoxide. This suggests that selenium supplementation through its incorporation into selenoenzymes could protect the cells from the oxidative damage. The role of selenium was also investigated in the regulation of α-1 pro-collagen mRNA expression. In LX-2 cells, the expression of α-1 pro-collagen mRNA was unaffected by the selenium status of the cell. Similarly the selenium status of C3A cells had no effect on modifying α-1 pro-collagen mRNA of LX2 cells when co-culture or conditioned medium experiments were performed. These results suggest that LX-2 cells were already largely activated and at a stage unable to be ameliorated by selenium treatment. In contrast, studies on C3A cells revealed that TGF-β1 (common inducer of α-1 pro-collagen mRNA in hepatic stellate cells) dramatically increased the expression of α-1 pro-collagen mRNA in C3A cells to the levels observed in LX-2 cells. More interestingly, selenium supplementation of C3A cells notably decreased α-1 pro-collagen mRNA expression in response to TGF-1. In the in vivo study, plasma selenium in type 2 diabetics (high risk of developing NAFLD) were inversely related to the body mass index and in most patients selenium levels were below that required to maximally express GPX1 in red cells. Furthermore, type 2 diabetics had lower plasma selenium levels compared to the healthy control group. Collectively, this suggests that in the UK population, obesity is a risk factor for both insulin resistance and decreased selenium status leading to sub-optimal antioxidant protection. In conclusion, this study provides evidence that selenium through increasing the expression of selenoenzymes is beneficial in protecting liver cells from oxidative stress. Furthermore, selenium is capable of suppressing α-1 pro-collagen mRNA expression in hepatocytes although not in activated hepatic stellate cells. Taken together these data support the view that suboptimal selenium intake in the UK may be a risk factor in the pathogenesis of NAFLD.

Le diabète de type 2 (T2D) est un trouble métabolique de l’homéostasie du glucose. Il est caractérisé par une hyperglycémie chronique qui résulte en partie d’une production excessive de glucose par le foie conséquence au développement d’une résistance à l’insuline. Le T2D est une pathologie multifactorielle à la fois génétique et environnementale. Récemment des études d’associations de gènes (GWAS) dans différentes cohortes ont mis en évidence une forte corrélation entre le locus CDKN2A et le risque de développement du T2D en se basant sur certains paramètres métaboliques tel que la glycémie à jeun. Le locus CDKN2A code pour des protéines régulatrices du cycle cellulaire dont la protéine p16INK4a. p16INK4a est largement décrite dans la littérature pour son rôle suppresseur de tumeurs et comme marqueur de sénescence, cependant son rôle dans le contrôle de l’homéostasie hépatique du glucose n’a jamais été rapporté. Afin de déterminer le rôle de p16INK4a dans le métabolisme hépatique du glucose, nous avons utilisé in vivo des souris sauvages (p16+/+) et déficientes pour p16INK4a (p16-/-) et in vitro des hépatocytes primaires ainsi que la lignée AML12. Nous avons montrés qu’après un jeune, les souris p16-/- présentent une hypoglycémie moins prononcée qui se traduit par une expression hépatique plus élevée de gènes de la néoglucogenèse tels que PEPCK, G6Pase et PGC1a. De plus, les hépatocytes primaires de souris p16-/- présentent une meilleur réponse au glucagon que ceux des p16+/+. Enfin, nous avons montrés que la diminution d’expression de p16INK4a par siRNA dans les AML12 suffit à induire l’expression des gènes de la néoglucogenèse et potentialise la réponse de ces cellules à différents stimuli gluconéogenique. L’effet observé dépend de l’activation de la voie PKA-CREB-PGC1A. L’ensemble de ces données montrent pour la première fois que p16INK4a pourrait jouer un rôle un cours du développement du T2D. / P16INK4a is a tumor suppressor protein well described as a cell cycle regulator. p16INK4a blocks cyclin D/ cyclin dependent kinase (CDK) 4 activity by binding to the catalytic subunit of CDK4, preventing retinoblastoma protein phosphorylation and subsequently the release of the E2F1 transcription factor. As a consequence; the transcription of genes required for progression to the S phase is restrained. Recently, genome-wide association studies (GWAS) associated the CDKN2A locus, encoding, amongst other genes, p16INK4A, with an increased risk of type 2 diabetes (T2D) development. However, the pathophysiological link between p16INK4a and hepatic glucose homeostasis remains unknown. In this context, we investigated the role of p16INK4a in hepatic glucose metabolism in vivo using p16+/+ and p16-/- mice and in vitro using primary hepatocytes and the AML12 hepatocyte cell line.p16-/- mice exhibited a higher response to fasting as shown by an increased hepatic gluconeogenic gene expression including phosphoenolpyruvate carboxykinase (PEPCK), fructose-1,6-biphosphatase (F1,6P) and glucose-6-phosphatase (G6Pase). p16-/- mice displayed an enhanced hepatic gluconeogenic activity in vivo upon administration of pyruvate, a gluconeogenic substrate. Consistent with this, in vitro data show that p16-/- primary hepatocytes display an enhanced gluconeogenic response to glucagon. In addition, knock down of p16INK4a by siRNA in AML12 cells increased gluconeogenic gene expression. These effects were associated with an increased activity of the PKA-CREB signaling pathway which leads to increased PPARg coactivator 1 (PGC1)α expression, a key transcriptional co-activator that regulates genes involved in energy metabolism. These findings describe a new function for p16INK4a as an actor in the hepatic adaptation to metabolic stress and suggest that p16INK4a could play a role during T2D development .

A incidência da obesidade tomou proporções epidêmicas nos últimos anos, atingindo bilhões de indivíduos mundialmente. A DHGNA é uma manifestação hepática das alterações metabólicas causadas pela obesidade e os casos desta doença vêm crescendo cada vez mais. Alternativas capazes de reduzir estas alterações são fundamentais para minimizar o impacto na qualidade de vida da população e na economia do país. Diversos estudos têm mostrado que os compostos bioativos de alimentos possuem efeitos benéficos à saúde. O camu-camu (Myrciaria dubia (H. B. K). Mc Vaugh) é um fruto nativo da região amazônica com potencial agroeconômico ainda inexplorado, que contém um grande número de compostos fitoquímicos que podem atuar sobre o metabolismo corporal. Desta forma, o objetivo deste estudo foi avaliar o efeito dos compostos fenólicos do camu-camu no desenvolvimento da DHGNA em camundongos C57BL/6 que receberam dieta rica em lipídios e sacarose (HFS). O extrato rico em compostos fenólicos da polpa comercial deste fruto foi obtido através de extração em fase sólida e caracterizado por cromatografia líquida de alta eficiência (CLAE/DAD). Os extratos obtidos foram testados em doses de 7 mg e de 14 mg equivalentes de ácido gálico/Kg de peso corporal. Foram investigados os efeitos destes compostos sobre as homeostases glicídica e lipídica através de análises séricas, testes de tolerância à insulina e à glicose e conteúdo de glicogênio e triacilglicerol intra-hepático. O extrato do camu-camu apresentou flavonóis, ácido elágico e elagitaninos em sua composição. A suplementação com extrato fenólico de camu-camu diminuiu a intolerância à glicose, independente da dose administrada, e melhorou a sensibilidade à insulina e regulou o conteúdo de glicogênio intra-hepático na maior dose. Não foi observado efeito sobre os lipídios plasmáticos. Entretanto, nota-se que houve uma melhora na função hepática em decorrência da redução da atividade da alanina aminotransferase (ALT), indicadora de dano celular, independente da dose. Além disso, a suplementação com extratos fenólicos do camu-camu na maior dose reduziu o conteúdo de triacilglicerol intra-hepático (p = 0,0001) e de biomarcadores inflamatórios, como Proteína - C Reativa (PCR) (p = 0,0359) e prostaglandina E2 (PGE2) (p = 0,004). Estes efeitos foram associados, principalmente, à menor ingestão alimentar. Portanto, neste estudo, os compostos fenólicos do camu-camu foram eficientes em prevenir a progressão da DHGNA em camundongos alimentados com dieta HFS. / Obesity has reached epidemic proportions in recent years, affecting billions of people worldwide. Nonalcoholic fatty liver disease (NAFLD) is a hepatic disorder induced by the metabolic changes caused by obesity and its incidence has been growing increasingly. Alternatives designed to reduce such changes are crucial to minimize their impact on the population´s quality of life and countries economy. Several studies have shown that food bioactive compounds have beneficial effects on health. Camu-camu (Myrciaria dubia (H. B. K.) Mc Vaugh) is a native fruit from Amazonan, with unexplored agroeconomic potential, which contains a large number of phytochemical compounds that can act on body metabolism. Therefore, this study was designed to assess the effect of the phenolic compounds of camu-camu in the development of NAFLD in C57BL/6 mice fed with a lipid and saccharose-rich diet (HFS). The phenolic compound-rich extract was obtained from the commercial pulp of this fruit using solid-phase extraction and high-performance liquid chromatography with diode array detector (HPLC/DAD). The resulting extracts were tested at 7 mg and 14 mg gallic acid equivalents/kg body weight. The effects of these compounds on glucose and lipid homeostasis were investigated by serum analyses, insulin and glucose tolerance tests and intrahepatic content of glycogen and triacylglycerol. Camu-camu extract presented flavonols, ellagic acid and ellagitannins in its composition. Supplementation with camu-camu phenolic extract decreased glucose intolerance, regardless the dose, improved insulin sensitivity and normalized the intra-hepatic glycogen content at the highest dose. No effects on plasma lipid were found. However, an improvement in liver function due to the decrease in alanine aminotransferase (ALT) was observed, suggestive of cell damage, regardless the dose. Moreover, the supplementation with phenolic extracts of camu-camu at the highest dose decreased the intrahepatic content of triacylglycerol (p = 0.0001) and inflammatory biomarkers, such as C-reactive protein (CRP) (p = 0.0359) and prostaglandin E2 (PGE2) (p = 0.004). Such effects were primarily associated with lower food intake. Therefore, in this study, the phenolic compounds of camu-camu have shown to be effective in preventing the progression of NAFLD in mice fed with HFS (high-fat/sucrose) diet.