Les troubles du spectre autistique (TSA) affectent un individu sur 100 et sont caractérisés par des déficits de la communication et des interactions sociales, et par des comportements restreints et répétitifs. Les TSA présentent une forte composante génétique ; les premiers gènes impliqués ont été identifiés au laboratoire et codent des protéines d’adhérence ou d’échafaudage localisées à la synapse : les neuroligines (NLGN) et SHANK. Nous nous sommes intéressés à l’implication dans les TSA des contactines (CNTN), un groupe de six molécules d’adhérence neurales de la superfamille des immunoglobulines. Ces protéines sont ancrées à la membrane plasmique par un groupement glycosyl phosphatidylinositol (GPI) et peuvent être sécrétées par clivage du GPI. Elles interviennent dans des processus variés du développement neuronal comme la croissance neuritique, le guidage et la fasciculation des axones ou la myélinisation. Des études génétiques ont suggéré l’implication des contactines 4 à 6 dans les TSA, mais aucune étude fonctionnelle n’a confirmé cette hypothèse. Ce travail de thèse associe une analyse génétique, une analyse fonctionnelle sur des cultures de neurones primaires de rat et une analyse structurale par modélisation moléculaire. Nous avons identifié plusieurs "Copy-Number Variants" (CNV) dans les gènes CNTN (essentiellement des délétions affectant CNTN5 et CNTN6) et observé une tendance à l’enrichissement chez les patients par rapport aux individus témoins. Le séquençage des exons codants de CNTN5 et CNTN6 chez plus de 200 patients et 200 témoins nous a ensuite permis d’identifier des variants ponctuels non synonymes. Les variants privés (présents chez un seul individu ou dans une seule famille) sont plus fréquents chez les patients que chez les témoins. Les CNV et les variants ponctuels sont hérités, de parents pour la plupart non atteints, ce qui suggère que les altérations des contactines constituent des facteurs de vulnérabilité aux TSA plutôt que des facteurs causaux. Afin de déterminer l’effet fonctionnel des variants ponctuels rares, nous avons comparé l’effet sur la neuritogenèse des CNTN mutées à celui des CNTN sauvages. Nous avons ainsi analysé, sur plusieurs centaines de neurones par condition, la longueur et la ramification des neurites dans un système de co-culture avec des cellules HEK surexprimant la CNTN. La plupart des protéines CNTN5 et CNTN6 mutées présentent des effets différents de ceux des protéines sauvages (inhibition ou augmentation des effets positifs de celles-ci). Le dernier objectif de cette étude consistait à évaluer l’influence de certains de ces variants sur l’interaction des CNTN, via les domaines immunoglobuline (Ig) 2 et 3, avec l’un de leurs ligands, le récepteur à activité tyrosine phosphatase PTPRG. Par homologie avec la structure cristallographique déjà résolue pour les quatre premiers domaines Ig de CNTN4 de souris, nous avons modélisé cette région pour les CNTN5 et 6 humaines, sauvages et mutées. Nous avons ainsi pu prédire que certains variants étaient susceptibles de modifier les liaisons ioniques ou l’encombrement stérique dans cette région d’interaction. L’ensemble de nos résultats démontre l’existence d’effets fonctionnels délétères de plusieurs variants rares des contactines retrouvés chez les patients atteints de TSA. La présence de ces variants rares chez des apparentés non atteints indique que les altérations des CNTN s’inscrivent dans un modèle de "multiple hit", qui propose que l’autisme puisse résulter de la combinaison de plusieurs atteintes génétiques, chacune représentant un facteur de risque à effet modéré et n’entraînant pas, à elle seule, le développement du trouble. Le séquençage d’exomes et de génomes entiers, en cours au laboratoire, permettra une meilleure compréhension de ces atteintes génétiques multiples. / Autism Spectrum Disorders (ASDs) affect one individual out of 100 and are characterised by deficits in communication and social interactions, and by restricted and repetitive behaviours. ASDs display a strong genetic component ; the first genes involved were identified in our laboratory and encode for cell-adhesion or scaffolding proteins localised at the synapse : neuroligins (NLGNs) and SHANKs. We were interested in the implication, in the ASDs, of contactins (CNTNs), a group of six neural cell-adhesion molecules of the immunoglobulin superfamily. These proteins are anchored to the plasma membrane by a glycosyl phosphatidylinositol (GPI) and can be secreted by cleavage of this anchor. They participate in various processes of neuronal development such as neurite outgrowth, axon guidance and fasciculation, and myelination. Genetic studies have suggested the involvement of contactins 4, 5 and 6 in the ASDs, but no functional study has confirmed this hypothesis. The present work combines a genetic analysis, a functional analysis on cultured primary rat cortical neurons and a structural analysis by molecular modelling. We identified several "Copy-Number Variants" (CNVs) in CNTN genes (mainly deletions affecting CNTN5 and CNTN6) and observed a trend of enrichment in patients compared to control individuals. Subsequent sequencing of CNTN5 and CNTN6 coding exons in more than 200 patients and 200 controls allowed us to identify non synonymous single-nucleotide variants (SNVs). Private variants (present only in one individual or one family) are enriched in patients compared to controls. CNVs and SNVs are inherited, mainly from unaffected parents, which suggests that impairments in contactins represent susceptibility factors for ASDs, rather than causal factors. In order to determine the functional effects of rare SNVs, we compared the effect on neuritogenesis of mutant CNTNs to that of WT CNTNs. We therefore analysed, on several hundreds of neurons per condition, the length and branching of neurites in a co-culture system with HEK cells overexpressing a CNTN protein. Most of CNTN5 and CNTN6 mutant proteins either inhibited or increased the positive effects of WT proteins. The last aim of the present study consisted in evaluating the influence of some of these variants on the interaction of CNTNs, via their immunoglobulin (Ig) domains 2 and 3, with one of their ligands, the protein tyrosine phosphatase receptor PTPRG. Using homology with the crystal structure that had already been solved for the first four Ig domains Ig of mouse CNTN4, we modelled this region for human CNTN5 and CNTN6, WT and mutated. We have thus been able to predict that some variants were likely to alter ionic bonds or steric constraints in this interaction module. Taken as a whole, our results demonstrate that several rare CNTN variants found in patients with ASD have deleterious functional effects. The presence of these rare variants in unaffected relatives indicates that CNTN impairments fit into a "multiple hit" model, according to which autism may result from the combination of several genetic defects, each being a risk factor with moderate effect but not triggering, in itself, the development of the disorder. Sequencing of exomes and whole genomes, ongoing in the laboratory, will allow better understanding of those multiple genetic impairments.

Our laboratory is working with the human NTera2/D1 (NT2) cell line which have properties similar to progenitor cells in the CNS. These neural-like precursors cells can differentiate into all three major lineages - neurons, astrocytes, andoligodendrocytes. The pure neuronal population, called the hNT cells, possess characteristics of dopamine (DA) cells. In this dissertation, we performed various experiments to examine the neuronal and dopaminergic development of this cellline. We first cultured our hNT neurons with cells from the developingnigrostriatal (NS) pathway, the ventral mesencephalon and striatum, to determine their influence on survival, neuritic outgrowth, and DA phenotype. The survival ofhNT neurons was substantially greater when they were cultured with embryonicday (E) 18 cells, compared to monocultures or cocultures with either E14 orpostnatal day (P) 1 cells. The neuritic outgrowth of hNT neurons as assessed by the number of primary neurites per cell was increased when cultured with theareas of the brain from E14 and P1. The DA phenotype, as determined by the expression of the rate-limiting enzyme of DA synthesis was not increased in hNTneurons when they were cultured with primary rat cells from the NS pathway.Next we analyzed if the retinoic acid (RA)-treated hNT neurons and the NT2 precursor cells expressed three transcription factors required for development ofthe DA phenotype. We report that NT2 cells endogenously expressed Engrailed-1, Ptx3, and Nurr1 while RA treatment increased Nurr1 but down-regulated Engrailed-1 and Ptx3. Finally, lithium has been shown to stimulate neurogenesisin adult hippocampal precursors as well as influence the Wnt pathway known to be important for the induction of the DA phenotype.

Spinal cord injury induces anatomical plasticity throughout the nervous system, including distant locations in the brain. Several types of injury-induced plasticity have been identified, such as neurite sprouting, axon regeneration and synaptic remodeling. However, the molecular mechanisms involved in anatomical plasticity after injury are unclear, as is the extent to which injury-induced plasticity in the brain is conserved across vertebrate lineages. Here, I used lampreys to identify the molecular mechanisms in mediating anatomical plasticity, because lampreys undergo anatomical plasticity and functional recovery after a complete spinal cord transection. Due to their robust roles in neurite outgrowth during neuronal development, I examined synapsin and synaptotagmin for their potential involvement in anatomical plasticity after injury. I found increased synapsin I mRNA throughout the lamprey brain as well as increased protein levels of synapsin I, phospho-synapsin (Ser 9) and synaptotagmin in the lamprey hindbrain after injury, suggestive of anatomical plasticity. Anatomical plasticity was confirmed at the ultrastructural level, where I found increased neurite density in the lamprey hindbrain after injury. Other molecular mechanisms that promote anatomical plasticity have been previously identified, such as cyclic AMP (cAMP). However, the cellular mechanisms and the molecular targets of cAMP in mediating anatomical plasticity are unclear. My investigation of cAMP revealed that cAMP enhanced the number of regenerated axons beyond the lesion site in lampreys after injury. For the first time in a spinal cord injury model, I found cAMP prevented the death of axotomized neurons that normally have a high tendency to die after injury. In addition, cAMP promoted more regenerating axons to re-grow in straighter paths rather than turning rostrally towards the brain stem. At the molecular level, I found cAMP increased synaptotagmin protein level at the regenerating axon tips, suggestive of enhanced axon elongation. Taken together, my results show that neurite sprouting in the brain and the cAMP-enhanced axon regeneration are conserved responses in vertebrates after spinal cord injury. In addition, my results suggest that at least some developmental pathways are activated during injury-induced and cAMP-enhanced anatomical plasticity. Further understanding of these pathways will provide insights for improving recovery after spinal cord injury. / text

A neurite auto-imune experimental (NAE) é uma polineuropatia desmielinizante monofásica do sistema nervoso periférico (SNP). A NAE é considerada modelo experimental da síndrome de Guillain-Barré (SGB). Por se tratar de uma doença autoimune, pode ser induzida experimentalmente em camundongos geneticamente susceptíveis, através da imunização com componentes da mielina de nervos periféricos. Para a indução da NAE podem ser utilizados P0 e P2, proteínas da mielina do nervo periférico, ou sequências conhecidas de peptídeos dessas proteínas 180-199 e 58-81 respectivamente, consideradas neuritogênicas, ou ainda transferência adotiva de lifócitos T CD4+, oriundas de camundongos previamente imunizados. Para o presente estudo foram utilizados camundongos fêmeas SJL/J nãográvidas, com idade entre 8 e 12 semanas, pesando de 17 a 20 g. Os animais foram divididos em dois grupos: um controle e outro com NAE. 200 µg da sequência de peptídeos 58-81 de P2 emulsificada em 100 µl de adjuvante de Freund completo (AFC) foram injetados por via subcutânea, em quatro locais na região lombar. Para os controles, foi utilizado solução tamponada de fosfato (PBS), emulsionada em AFC desprovida da sequência 58-81 de peptídeos P2, injetada no mesmo local, na mesma quantidade e forma. Cada camundongo tratado com P2 recebeu 200 ng de toxina pertussis em 100 ?L de PBS intraperitonealmente (i.p.) nos dias 0 e 2 pós-imunização (p.i.). No grupo controle, volumes iguais de PBS e toxina pertussis foram administrados pela mesma via sem o peptídeo. Avaliações da motricidade foram realizadas diariamente até o 60º dia, além de análises funcionais e eletroneuromiográficas. Foram encontradas alterações exclusivamente eletrofisiológicas, desmielinizantes e axonais, em cerca de dois terços dos camundongos. Sendo o camundongo SJL/J considerado o camundongo mais susceptível para a provocação de NAE, os achados do presente estudo indicam a limitação do modelo: ausência de alterações motoras detectáveis clinicamente, ocorrendo distúrbios eletrofisiológicos em apenas parte dos animais. O melhor modelo de NAE continua sendo o provocado no rato Lewis por proteína da mielina periférica bovina. É desejável que se continue buscando modelo experimental de NAE em camundongos, tendo em vista que essa espécie animal é a mais bem estudada na Biologia animal e, por essa razão, dela haver extensa variedade de imunobiológicos disponíveis para estudo da patogenia e fisiopatologia de doenças auto-imunes. / Experimental autoimmune neurits (EAN) is a monophasic demyelinating disease of the peripheral nervous system (PNS). EAN is considered to be the experimental model for Guillain-Barré syndrome (GBS). EAN can be induced in genetically susceptible mice using peripheral myelin components as immunogens: peripheral nerve myelin proteins P0 or P2; peptides sequences of those proteins considered neuritogenic, or the adoptive transfer of TCD4+ lymphocytes from previously immunized mice. In the present study non-pregnant female SJL/J mice aged 8-12 weeks weighint 17-20 g where used. The experimental group was treated as follows. Peptides sequence of P2 (200 µg) emulsified in complete Freund adjuvant (CFA) (100 µl) injected in four sites at the lumbar paravertebral region s.c. Controls were injected in the same sites with equal quantities of phosphate buffer solution emulsified in CFA without the peptides sequence. Each mouse treated with P2 was also treated with 200 ng pertussis toxin in 100 ?L PBS i.p. at the days 0 and 2 post-immunisation. Controls were injected i.p. with equal volumes of PBS and pertussis toxin free of the peptides sequence. Motor strength, posture and coordination were evaluated daily until the 60th day postinoculation besides eletroneuromyographic (EMG) evaluation on the 10th and 30thy days of some mice. No clinical disturbances were observed and in two thirds of the animals demyelinating and axonal features were detected at the EMG. SJL/J mice are considered the most susceptible mouse strain for NAE induction but the findings of the present study indicates the limitations of the model and its reproducibility. The best NAE model is yet the obtained in Lewis rat. It is important to look for a mouse model of EAN because this animal species is the most studied in the animal Biology. The extensive variety of immunobiologic products from mice allows performing studies on the pathogeny or physiopathology of autoimmune diseases more easily.

Orientadores: Leonilda Maria Barbosa dos Santos, Benito Pereira Damasceno / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-22T19:26:19Z (GMT). No. of bitstreams: 1 Silva_FelipevonGlehn_D.pdf: 6687964 bytes, checksum: 5e92607a118fbc6e4c8085aa93b540a0 (MD5) Previous issue date: 2013 / Resumo: A Neuromielite óptica (NMO) é uma doença inflamatória e desmielinizante do SNC, de natureza autoimune, caracterizada por surtos graves de neurite óptica e mielite transversa, de evolução mais freqüente na forma recidivante-remitente, com pouca remissão dos déficits entre as crises, altamente incapacitante. A presença do anticorpo anti-aquaporina 4 (anti-AQP4) foi descrito em 73% a 91% dos pacientes com diagnóstico de NMO. Doenças autoimunes podem frequentemente ser desencadeadas após infecções por micro-organismos, como agentes virais. A NMO e a infecção pelo HTLV-1 possuem prevalência coincidentemente elevada em certas áreas do globo, como o Brasil. Com o objetivo de avaliar a associação do HTLV-1 com a NMO, foi pesquisada a presença de anti-AQP4 e anti-HTLV-1 em 34 pacientes com DENMO, 43 pacientes infectados com HTLV-1, assintomáticos ou com a doença mielopatia associada ao HTLV-1 (HAM/TSP) e 23 controles sadios. Nenhum paciente com DENMO apresentou sorologia positiva para HTLV-1. Nenhum paciente infectado pelo HTLV-1 apresentou soropositividade para anti-AQP4. 60% dos casos de DENMO foram positivos para anti-AQP4. Esses resultados sugerem que a mielopatia associada à variante aguda da HAM/TSP e aquela associada ao anticorpo anti-AQP4 são entidades clínicas distintas, e provalvemente, não relacionadas de forma patogênica ao HTLV-1 em nosso meio. O cérebro humano expressa amplamente AQP4, mas estudos anatomopatológicos e de neuroimagem não detectaram lesões corticais desmielinizantes ou infiltrados inflamatórios no DENMO. A fim de avaliar melhor a presença de alterações estruturais nas substâncias cinzenta e branca encefálicas no DENMO, foram estudados 34 pacientes por RNM de 3T e tomografia de coerência óptica retiniana pareados com controles sadios, divididos nas apresentações NMO, mielite transversa longitudinal extensa (MTLE) e neurite óptica (NO), além de soropositivos versus soronegativo para anti-AQP4 e 5 anos ou menos de doença versus mais de 5 anos de doença. Houve maior grau de atrofia retiniana nos grupos NMO e NO, além dos grupos anti-AQP4+ e mais de 5 anos de doença. Foi constatado maior grau de atrofia cortical cerebral e estruturas da substância branca nos grupos NMO e MTLE, anti-AQP4+ e mais de 5 anos de doença. A atrofia retiniana se correlacionou positivamente com a atrofia do lobo occipital. Esses dados sugerem que o DENMO está associado à atrofia de estruturas das substâncias cinzenta e branca cerebrais; que a atrofia não se limita apenas às áreas das vias sensorial, motora e visual, mas é mais difusa; que quanto maior o tempo de doença e a presença do anticorpo anti-AQP4, maior é o grau de atrofia cortical, configurando estes fatores, tempo e anti-AQP4+, como de pior prognóstico; e a correlação positiva entre atrofia da camada de fibras nervosas retinianas e atrofia pericalcarina, além da escala de incapacidade funcional expandida (EDSS), sugere que a degeneração neuronal retrógrada e/ou anterógrada do tipo Walleriana é um importante causador da atrofia cortical no DENMO / Abstract: Neuromyelitis optica (NMO) is an inflammatory disease of the central nervous system (CNS) of putative autoimmune aetiology, which is characterized by severe attacks of myelitis and optic neuritis (ON). A relapsing course with rapid accumulation of neurological deficits with little or no remission is common. The NMO is autoimmune in nature and antibodies to Aquaporin 4 (AQP4) are associated with the development of the disease. AQP4 is the most common water channel protein of CNS; present in astrocytes processes, endothelium and piamater meninges. It predominates at some sites of the CNS, as optic nerve, brain stem and gray matter of medulla, the same sites of the usual inflammatory lesions. Autoimmune diseases may be triggered by microorganism infections and NMO and HTLV-1 infection have coincidentally high prevalence in certain areas of the world including Brazil. To study a possible relationship between these two diseases, we determined the seroprevalence of antibodies to AQP4 in 43 patients with HTLV-1 infection, asymptomatic or with HTLV-1 associated myelopathy (HAM/TSP) and that of HTLV-1 antibodies in patients with neuromyelitis optica spectrum disorders (NMOSD). AQP4ab positivity was found in 60% of NMOSD patients, but in none of the HAM/TSP patients and none of the asymptomatic HTLV-1 infected individuals. Conversely, all AQP4-Ab-positive NMOSD patients were negative for HTLV-1 antibodies. The results argue both against a role of antibodies to AQP4 in the pathogenesis of HAM/TSP and against an association between HTLV-1 infection and the development of AQP4-Ab. Moreover, the absence of HTLV-1 in all patients with NMOSD suggests that HTLV-1 is not a common trigger of acute attacks in patients with AQP4-Ab positive NMOSD in populations with high HTLV-1 seroprevalence. Although AQP4 is also expressed widely in the human brain cortex, beyond the common sites of lesions in NMO, recent studies have found no MRI or histopathological evidence for cortical demyelination. To investigate magnetic resonance imaging (MRI) patterns of gray matter (GM) and white matter (WM) abnormalities in patients with NMO and its incomplete forms, isolated longitudinally extensive transverse myelitis and optic neuritis, and to assess the prognostic impact of GM and WM abnormalities in these conditions, we performed both 3T high-resolution T1-weighted and diffusion tensor MRI in thirty-four patients with NMO spectrum disorders (NMOSD) and 34 matched healthy controls. Voxel-based morphometry (SPM8/MATLAB2012b), cortical analyses (Freesurfer), and diffusion tensor imaging analyses (TBSS-FSL) were used to investigate brain abnormalities. In addition, retinal nerve fiber layer was measured by means of optic coherence tomography (OCT). These analyses resulted in following findings: (1) NMOSD is associated with GM and WM atrophy, which encompasses more brain structures than the motor, sensory, and visual pathways; (2) this atrophy is more widespread in patients with NMO and LETM than in patients with ON; (3) the extent of GM atrophy correlates with disease duration, and (4) GM/WM atrophy in NMOSD is more pronounced in AQP4 antibody-seropositive than in -seronegative patients. Furthermore, it was demonstrated for the first time in NMOSD a correlation between RNFL atrophy and GM atrophy in the occipital lobes as assessed by OCT, indicating a role for retrograde degeneration in GM atrophy and suggesting that the extent of brain GM/WM atrophy may be of prognostic relevance in NMOSD / Doutorado / Neurologia / Doutor em Ciências Médicas

Orientador: Keila Miriam Monteiro de Carvalho / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T01:38:29Z (GMT). No. of bitstreams: 1 Castro_StellaMarisdaCostae_M.pdf: 2612722 bytes, checksum: d1efcfd03f4ef0eb1389ac569a95728f (MD5) Previous issue date: 2011 / Resumo: A esclerose múltipla é uma doença crônica imunomediada do sistema nervoso central, caracterizada por inflamação, desmielinização e lesão axonal na fase inicial, e desmielinização crônica, degeneração progressiva e perda axonal, atrofia cerebral e gliose na fase crônica. O acometimento do sistema visual e motor ocular são manifestações comuns da doença. O objetivo desse estudo foi observar as alterações relacionadas das funções visuais no período remissivo da doença e sua correlação com as imagens da ressonância magnética. Foram realizadas a avaliação da acuidade visual, do campo visual central computadorizado, da visão cromática e da sensibilidade ao contraste em 48 pacientes com esclerose múltipla recidivante-remitente e em 25 controles. O evento anterior de neurite óptica aguda foi utilizado para classificar os pacientes: 26 com história positiva e 22 com história negativa. A avaliação clínica dos movimentos oculares foi realizada em 60 pacientes e 35 controles. O subgrupo com história de neurite óptica apresentou pior resultado (p<0,05) em todos os testes quando comparado ao grupo controle; o subgrupo sem história de neurite óptica apresentou pior resultado na perimetria estática e na visão de cores. Os dois subgrupos não diferiram entre si nos resultados dos testes visuais. Na avaliação comparativa entre as lesões observadas nas radiações ópticas de 29 pacientes e os índices da perimetria estática, houve associação entre lesões mais extensas e piores índices do campo visual. Na análise dos movimentos oculares, a falha do cancelamento do reflexo vestíbulo ocular, a dismetria sacádica e a presença de movimentos corretivos durante o acompanhamento ocular uniforme, foram as alterações mais freqüentes. O questionário de função visual e o suplemento de itens neuroftalmológicos detectaram pior qualidade de vida visual numa amostra de 41 pacientes com esclerose múltipla em relação a 22 controles. O comprometimento da função visual e motora ocular foi frequente na esclerose múltipla no estágio recidivante-remitente mesmo fora do período agudo da doença. Foi possível observar associação entre os índices da perimetria automatizada e resultados quantitativos das imagens por ressonância magnética. Alterações dos movimentos oculares, próprias do quadro de oftalmoplegia internuclear, puderam ser associadas às lesões do fascículo longitudinal medial / Abstract: Multiple sclerosis is a chronic immune-mediated disorder of the central nervous system characterized by inflammatory demyelination and axonal injury in the early phase, as well as chronic demyelination, progressive axonal degeneration and loss, cerebral atrophy and gliosis in the chronic phase. The involvement of the visual and ocular motor systems is a common manifestation of the disease. The objective of this research was to observe the disorders related to visual functions, in the remission phase of the disease, and their correlation to magnetic resonance images. Visual acuity, central automated visual field, color vision, and contrast sensitivity were assessed in 48 relapsing remitting multiple sclerosis patients and 25 controls. The episode of acute optic neuritis was used to classify the patients: 26 with positive history and 22 without. Careful clinical observation of ocular movements was done in 60 patients and 35 controls. The subgroup with positive history of acute optic neuritis had worse results (p<0.05) compared with the control group; the subgroup with no history of optic neuritis had worse results (p<0.05) in automated perimetry and color vision. Neither of the subgroups differed between one another (p>0.05). In the comparative assessment between optic radiations lesion of 29 patients and perimetric visual fields, there was a relationship between larger lesions and worse visual fields indices. In the examination of eye movements, the failure of the cancellation of vestibular ocular reflex and the presence of corrective movements during pursuit were the most frequent abnormalities. The National Eye Institute 25-Item Visual Functioning Questionnaire and their 10-Item Neuro-Ophthalmic Supplement scores were lower in 42 multiple sclerosis patients compared with 22 controls. The involvement of the visual and ocular motor function was frequent in multiple sclerosis patients in the relapsing remitting phase, even outside of the acute phase of the disease. It was possible to observe a relationship between visual field indices and quantitative measurements of magnetic resonance images. Abnormalities of the ocular movements, suggestive of internuclear ophtalmoplegia were associated with lesions of the medial longitudinal fasciculus / Mestrado / Ciencias Biomedicas / Doutor em Ciências Médicas

This review provides a short historical background to the field of axonal regeneration and discusses the advances made in over 100 studies between 2007 and 2012 in understanding the molecular mechanisms underlying the conditioning lesion and regeneration of primary sensory axons in the dorsal columns of the spinal cord. Treatment strategies to stimulate axon growth and reinnervation of the spinal cord through the dorsal root entry zone and of the dorsal column nuclei in the medulla are highlighted. Major breakthroughs have been made, e.g., reinnervating the nucleus gracilis in the medulla using neurotrophic factor gradients and grafts as relays and identifying chondroitin sulfate proteoglycan receptors. The experimental accessibility of the dorsal column axons has also resulted in new technological advances, including live imaging. Last, future directions are discussed, including some challenges of translation to humans.

L'atrophie musculaire bulbo-spinale (SBMA) est une dégénérescence lente et progressive des motoneurones causée par l'élongation du triplet nucléotidique (CAG) dans le gène codant pour le récepteur aux androgènes (RA) localisé sur le chromosome X. Dans la SBMA, ce récepteur à extension polyglutaminique (polyQ) pathogène s'accumule de manière ligand dépendante dans le cytoplasme sous forme d'agrégats mais également dans le noyau y créant des corps d'inclusions nucléaires considérés comme la marque identitaire histologique, dont le caractère cytotoxique est aujourd'hui remis en question. Nous avons développé un modèle SBMA in vitro basé sur l'expression inductible d'un RA51Q dans la lignée hybride NSC34, qui est comparé au modèle normal NSC34 exprimant un RA contenant 20Q. Nous avons démontré que l'expression du RA51Q entraîne une diminution de la viabilité ainsi qu'une altération de la croissance neuritique sans formation d'agrégats insolubles dans le noyau ou le cytoplasme des cellules. Le RA en tant que membre de la superfamille des récepteurs nucléaires est un facteur de transcription mais peut également induire des voies de signalisation non génomiques via sa localisation membranaire. Après avoir montré une localisation du RA20Q et du RA51Q dans les « lipid rafts », nous avons corrélé la diminution de la viabilité et de la pousse neuritique induite par le RA51Q à une altération de la signalisation cellulaire non génomique. Les résultats obtenus mettent en évidence une dérégulation des voies de signalisation PI3K/Akt et JNK/c-jun induite par l'expression du RA muté dans notre modèle SBMA. / Spinal Bulbar Muscular Atrophy (SBMA) is a progressive inherited motoneuron disease caused by the expansion of a trinucleotide (CAG) repeat in the gene coding for the androgen receptor (AR) located on the X chromosome. This rare disease causes muscle weaknesses, hypotonia, hyporeflexia, fasciculations of facial muscles in male patients. The androgen-dependent formation of cytoplasmic aggregates and nuclear inclusions are pathological hallmarks of this polyglutamine disease but their potential neurotoxicity is still under debate. We developed a SBMA model based on a doxycycline-inducible AR51Q expression system in the NSC34 hybrid cell line. We have shown that the expression of the mutated AR leads to a reduced viability and to an alteration of neurite outgrowth compared to cells expressing the normal AR20Q. The AR belongs to the nuclear receptor superfamily of transcription factors. However, recent data have put in evidence a membrane localization of AR initiating non-genomic signaling pathways. Because we have not observed insoluble aggregates, reduced viability and neurite outgrowth could not be correlated to AR aggregation. We hypothesized that motoneuron death is not only due to aggregate formation but also to the alteration of AR signaling pathways. We focused on a correlation between the AR localization in lipid rafts and the observed phenotypes. Our results highlight the deregulation of PI3K/Akt and JNK/c-jun signaling pathways induced by the expression of AR51Q in our SBMA model.

Obsessive-compulsive disorder (OCD) and the spectrum of associated conditions, affect 2-4% of the population worldwide. Although heritability studies in OCD have shown a 3 - 12 times increased risk for first degree relatives, the identification of the underlying risk-conferring genetic variation using classic genetic association studies has proven to be difficult. The possibility of a larger contribution of rare genetic variants to the risk of psychiatric disorder has been suggested by several successful studies. We expect that a spectrum of risk allele frequencies exists, which includes not only common variation but also a substantial amount of rare genetic variants that contribute to OCD. This thesis is aimed at identifying and functionally characterizing rare genetic variation in the OCD spectrum. Identified statistically significant variants were scrutinized for changes related to synaptic function using high content screening and subsequent functional analyses. Identifying the genetic profile of rare variants found in the OCD spectrum cohort combined with the functional impact that these variants have has provided insight into the etiology of the OCD spectrum. With these approaches a foundation can be laid for the development of a predictive model of the OCD spectrum.

The oncogene Anaplastic Lymphoma Kinase (ALK) is a Receptor Tyrosine Kinase (RTK) and was initially discovered as the fusion protein NPM (nucleophosmin)-ALK in a subset of Anaplastic Large Cell Lymphomas (ALCL). Since then more fusion proteins have been identified in a variety of cancers. Further, overexpression of ALK due to gene amplification has been observed in many malignancies, amongst others neuroblastoma, a pediatric cancer. Lately, activating point mutations in the kinase domain of ALK have been described in neuroblastoma patients and neuroblastoma cell lines. In contrast, the physiological function of ALK is still unclear, but ALK is suggested to play a role in the normal development and function of the nervous system. By employing cell culture based approaches, including a tetracycline-inducible PC12 cell system and the in vivo D. melanogaster model system, we aimed to analyze the downstream signalling of ALK and its role in neuroblastoma. First, we wished to analyze whether ALK is able to activate the small GTPase Rap1 contributing to differentiation/proliferation processes. Activated ALK recruits a complex of the GEF C3G and CrkL and activates C3G by tyrosine phosphorylation. This activated complex is able to activate Rap1 resulting either in neurite outgrowth in PC12 cells or proliferation of neuroblastoma cells suggesting a potential role in the oncogenesis of neuroblastoma driven by gain-of-function mutant ALK. Next, we could show that seven investigated ALK mutations with a high probability of being oncogenic (G1128A, I1171N, F1174L, F1174S, R1192P, F1245C and R1275Q), are true gain-of-function mutations, respond differently to ALK inhibitors and have different transforming ability. Especially the F1174S mutation correlates with aggressive disease development. However, the assumed active germ line mutation I1250T is in fact a kinase dead mutation and suggested to act as a dominant-negative receptor. Finally, ALK mutations are most frequently observed in MYCN amplified tumours correlating with a poor clinical outcome. Active ALK regulates mainly the initiation of MYCN transcription in human neuroblastoma cell lines. Further, ALK gain-of-function mutants and MYCN synergize in transforming NIH3T3 cells. Overall, somatic mutations appear to be more aggressive than germ line mutations, implying a different impact on neuroblastoma. Further, successful application of ALK inhibitors suggests a promising future for the development of patient-specific treatments for neuroblastoma patients.