Submitted by Neusa Fagundes (neusa.fagundes@unioeste.br) on 2019-03-29T16:56:55Z No. of bitstreams: 2 Camila_Kuhn2018.pdf: 2657327 bytes, checksum: 9eb518e6dcb5d576b52f1606ea47d2fa (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2019-03-29T16:57:16Z (GMT). No. of bitstreams: 2 Camila_Kuhn2018.pdf: 2657327 bytes, checksum: 9eb518e6dcb5d576b52f1606ea47d2fa (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-04-03 / Studies show that maternal obesity can affect fetal development, resulting in diseases in adult life, such as diabetes mellitus type 2, cardiovascular disease, obesity itslef. To reduce the effects of obesity and its comorbidities, bariatric surgeries stand out among the most effective interventions, with Roux-en-Y gastric bypass (RYGB) being the most frequently performed type of bariatric procedure. However, there are still few studies in the literature that evaluate the effects of obesity and bariatric surgeries on the morphology of skeletal muscle tissue in adult offspring. Thus, the objective of this study was to evaluate microscopic parameters of muscle fibers and neuromuscular junctions (NMJs) of the extensor digitorum longus muscle (EDL) in obese rats’ offspring submitted or not to RYGB surgery. Three-week Wistar rats were randomly divided into three groups: Control Group (CTL) which received a standard diet; 2) Cafeteria False Operated (CAF FO) and 3) Cafeteria RYGB (CAF RYGB), the latter two received a cafeteria diet before and after the surgical procedure until the weaning of the offspring. In the 18th of life, the surgical procedure and false operation were performed in the CAF RYGB and CAF FO groups, respectively. The mating of the animals occurred five weeks after the surgical procedure. The birth of the offspring was postnatal day 0, and weaning occurred at three weeks of age, and only the male offspring were separated for the experiment. The offspring of the first generation (F1) were named CTL-F1, OB-F1, CAF FO-F1 and CAF RYGB and received standard diet. At 17 weeks the animals were euthanized and the EDL muscle collected for analysis of fiber muscles and NMJs. When the CTL-F1 and OB-F1 groups were analyzed, the latter had an increase in body weight, retroperitoneal and periepididymal fats, and capillary/fiber ratio. Reduction in the number of nuclei, conjunctive and morphological changes in the parameters evaluated in the ultrastructure. The area and larger diameter of NMJs also showed reduction. The analysis between CAF RYGB-F1 and CAF FO-F1 groups showed reduction of body weight, ELD muscle weight, retroperitoneal and periepididimal fat, nasoanal length, fiber area and nuclei/fiber ratio in the CAF RYGB-F1 group. This group also presented increase in the number of fibers of type I and IIa and number of capillaries, as well as reduction in the area of the NMJs and morphological alterations in the ultrastructure. These results demonstrate that both obesity and bariatric surgery expose the offspring, through metabolic programming, to effects on the morphology of skeletal muscle tissue, being found greater aggravations in the muscular fiber of the offspring of mothers submitted to RYGB. / Estudos apontam que a obesidade materna pode afetar o desenvolvimento fetal, resultando em doenças na vida adulta, tais como diabetes mellitus tipo 2, doenças cardiovasculares e a própria obesidade. Para reduzir os efeitos da obesidade e as suas comorbidades, as cirurgias bariátricas destacam-se entre as intervenções mais eficazes, sendo a derivação gástrica em Y de Roux (DGYR) o tipo de procedimento bariátrico mais frequentemente realizado. No entanto, ainda são escassos na literatura estudos que avaliem os efeitos da obesidade e das cirurgias bariátricas na morfologia do tecido muscular esquelético da prole adulta. Diante disso, o objetivo deste estudo foi avaliar a morfologia e a morfometria das fibras musculares e as junções neuromusculares (JNMs) do músculo extensor longo dos dedos (ELD) da prole de ratas obesas submetidas ou não à cirurgia de DGYR. Para tanto, ratas Wistar de três semanas de vida foram separadas aleatoriamente em três grupos: 1) Controle (CTL), que recebeu dieta padrão; 2) Cafeteria Falso operado (CAF FO) e 3) Cafeteria DGYR (CAF DGYR); esses dois últimos receberam dieta de cafeteria antes e após o procedimento cirúrgico, até o desmame da prole. Na 18ª semana de vida, foi realizado o procedimento cirúrgico e a falsa operação nos grupos CAF DGYR e CAF FO, respectivamente. O cruzamento dos animais ocorreu cinco semanas após o procedimento cirúrgico. O nascimento dos animais foi considerado o dia zero pós-natal e o desmame se deu na terceira semana vida, quando somente os machos foram separados para o experimento. A prole da primeira geração (F1) foi nomeada em CTL-F1, OB-F1, CAF FO-F1 e CAF DGYR-F1 e todos os animais receberam dieta padrão. Na 17ª semana, os animais foram eutanasiados e o músculo ELD coletado para análise das fibras musculares e JNMs. Quando analisado os grupos CTL-F1 e OB-F1, esse último apresentou aumento do peso corpóreo, das gorduras retroperitoneal e periepididimal, e relação capilar/fibra. Além disso, houve a redução do número de núcleos, conjuntivo e alterações morfológica nos parâmetros avaliados na ultraestrutura. A área e diâmetro maior das JNMs também apresentaram redução. A análise entre os grupos CAF DGYR-F1 e CAF FO-F1 evidenciou redução do peso corporal, do peso do músculo ELD, da gordura retroperitoneal e periepididimal, don comprimento nasoanal, da área das fibras e relação núcleo/fibra no grupo CAF DGYR-F1. Esse grupo também apresentou aumento no número de fibras do tipo I e IIa e no número de capilares, assim como redução na área das JNMs e alterações morfológicas na ultraestrutura. Esses resultados demonstram que tanto a obesidade como a cirurgia bariátrica expõem a prole, por meio da programação metabólica, com efeitos na morfologia do tecido muscular esquelético, sendo encontrado maiores agravos na fibra muscular da prole de mães submetidas à DGYR.

Introdução e objetivos: a monitorização neuromuscular objetiva é prática médica baseada em evidências e deve ser empregada rotineiramente quando do uso de fármacos bloqueadores neuromusculares. Entretanto, pesquisas relacionadas a esta monitorização em pacientes pediátricos não estão vastamente documentadas como nos adultos. Em pesquisa clínica, o monitor neuromuscular deve apresentar resposta estável (menor que 5% de variação na altura de T1) por um período de dois a cinco minutos antes da administração do bloqueador neuromuscular. O tempo necessário para se alcançar esta estabilidade na resposta pode variar, mas pode ser encurtado por meio da aplicação de um estímulo tetânico por cinco segundos. Aventouse a hipótese de que a aplicação de estímulo tetânico antes da calibração poderia levar a diferenças nos parâmetros de início de ação e nos tempos de recuperação. O objetivo primário deste estudo foi comparar o tempo de início de ação e os tempos de recuperação após dose única de rocurônio 0,6 mg/kg seguido de recuperação espontânea, entre dois grupos de pacientes com sequências diferentes para a calibração (com e sem o uso de estímulo tetânico). Os objetivos secundários foram a avaliação da altura inicial e final de T1, tempo para se obter estabilidade da altura de T1 e os seguintes ajustes do monitor neuromuscular: corrente elétrica e sensibilidade. Método: consentimento informado dos responsáveis, foram incluídos no estudo 50 pacientes, estado físico 1 ou 2, de dois a 11 anos, agendados para cirurgias abdominais e/ou perineais com tempo cirúrgico estimado superior a 60 minutos. Os pacientes (25 por grupo) foram submetidos a anestesia intravenosa e alocados randomicamente para receber estímulo tetânico (grupo T) ou não (grupo C), antes da calibração do monitor. Após a calibração do monitor, a modalidade sequência de quatro estímulos foi iniciada e mantida em intervalo de 15 segundos. Resultados: não houve diferença significativa no início de ação (C: 57,5±16,9 versus T: 58,3±31,2 s; p=0,917). O tempo normalizado para as relações da sequência de quatro estímulos 0,7, 0,8 e 0,9 diferiram significativamente entre os grupos (C: 40,1 ± 7,9 versus T: 34,8±10 min; p=0,047, C: 43,8±9,4 versus T: 37,4±11 min; p=0,045 e C: 49,9±12,2 versus T: 41,7±13,1 min; p=0,026, respectivamente). O tempo necessário para a estabilização da altura de T1 não mostrou diferença estatística entre os grupos (C: 195±203 versus T: 116±81,6 s; p=0,093). Os valores de altura inicial de T1 mostraram diferença significativa entre os grupos (C: 98 versus T: 82,7%; p < 0,001). Os valores de altura final de T1 também mostraram diferença significante entre os grupos (C: 95,3 versus T: 69,3%; p < 0,001). Conclusões: o estímulo tetânico encurtou o tempo normalizado das relações da sequência de quatro estímulos 0,7, 0,8 e 0,9. As alturas inicial e final de T1 foram menores no grupo tétano. Não houve diferença estatística entre os grupos relativo ao tempo necessário para estabilização da altura de T1. Os ajustes do monitor (corrente elétrica e sensibilidade) não apresentaram diferenças entre os gruposEffect of tetanic stimulation, prior to calibration, on the onset of action and recovery times of neuromuscular blockade in pediatric patients / Background and objective: objective neuromuscular monitoring is evidence-based medical practice and should be routinely used when using neuromuscular blocking drugs. However, research related to this monitoring in pediatric patients is not widely documented as in adults. In clinical research, the neuromuscular monitor should have a stable response (less than 5% change in T1 height) for a period of two to five minutes before administration of the neuromuscular block agent. The time required to achieve this stability in response may vary, but may be shortened by the application of a tetanic stimulus for 5 seconds. It was hypothesized that the application of tetanic stimulus prior to calibration could lead to differences in the parameters of onset of action and recovery times. The primary outcome of this study was to compare time to onset and recovery times after single dose rocuronium 0.6 mg.kg-1 followed by spontaneous recovery between two groups of patients with different sequences for calibration (with and without use of tetanic stimulus). The secondary outcomes were the evaluation of the initial and final T1 height, time to obtain stability of T1 height and the following neuromuscular monitor settings: electric current and sensitivity. Methods: after approval by the Institutional Ethics Committee and obtaining the informed consent of those responsible for the patient, were included in the study 50 patients, physical status 1 or 2, from 2 to 11 years, scheduled for abdominal and/or perineal surgeries with estimated surgical time greater than 60 minutes. Patients (25 per group) underwent intravenous anesthesia and were allocated randomly to receive tetanus stimulation (group T) or not (group C) prior to calibration of the monitor. After calibration of the monitor, train-of-four mode was initiated and maintained at interval of 15 seconds. Results: there was no significant difference in onset of action (C: 57,5±16,9 versus T: 58,3±31,2 s; p=0,917). The train-of-four normalized times 0.7, 0.8 and 0.9 differed significantly between the groups (C: 40,1±7,9 versus T: 34,8±10 min; p=0,047, C: 43,8±9,4 versus T: 37,4±11 min; p=0,045 and C: 49,9±12,2 versus T: 41,7±13,1 min; p=0,026, respectively). The time required to stabilize the T1 height did not show statistical difference between the groups (C: 195±203 versus T: 116±81,6 s; p=0,093), The initial values of T1 height showed a significant difference between the groups (C: 98 versus T: 82,7%; p < 0,001). The final T1 height values also showed a significant difference between the groups (C: 95,3 versus T: 69,3%; p < 0,001). Conclusions: the tetanic stimulus shortened the normalized time of the fourstimulus sequence ratios 0.7, 0.8, and 0.9. The initial and final T1 heights were lower in the tetanus group. There was no statistical difference between the groups regarding the time required to stabilize the T1 height. The monitor settings (electric current and sensitivity) did not show differences between groups. Trial registration: Clinicaltrials.gov identifier: NCT0249867

No description available.

骨形成蛋白 (bone morphogenetic proteins, BMPs) 屬於TGF家族的成員，過去的研究指出BMPs對神經系統的發育及維持非常的重要，並且會參與調控突觸的形成。然而，在哺乳類動物的研究中，BMPs在神經肌肉系統中所調控的生理功能仍未完全了解。本實驗室初步的研究資料顯示BMPs的type II受體 (bone morphogenetic protein type II receptor, BMPRII) 會表現在神經與肌肉接合處 (neuromuscular junction, NMJ) ，而從本論文中的免疫染色實驗結果觀察到骨形成蛋白-4 (BMP4) 會表現在肌肉及許旺細胞上，且BMP4與乙醯膽鹼受體 (acetylcholine receptors, AChRs) 有colocalization的現象。由double nerve ligations的實驗觀察到BMP4會堆積在打結處的兩端，顯示BMP4可能是由肌肉或許旺細胞分泌後送進運動神經元之軸突內運輸，其方向為雙向性運輸，而利用Q-PCR mRNA定量實驗發現BMP4 mRNA在double-ligated之坐骨神經中表現量下降，但在肌肉中表現量則顯著增加。 由上述實驗顯示肌肉細胞為BMP4主要來源之ㄧ，利用NG108-15神經細胞及C2C12肌肉細胞培養，我們發現BMP4 mRNA在C2C12肌小管上有高度表現，相反地在分化後的NG108-15神經細胞上表現量極少，而BMP4的mRNA及protein在C2C12肌肉上的表現量則受到神經衍生蛋白Agrin的調控。此外我們亦發現來自於肌肉的BMP4則會保護分化後的NG108-15神經細胞對抗Glutamate所誘導的細胞死亡反應。綜合這些結果，我們認為BMP4主要來自於運動神經元之周邊的肌肉及許旺細胞，其可能會參與調控運動神經元的存活機制。 / Bone morphogenetic proteins (BMPs), members of the TGF superfamily, have been shown to play important roles in the development of nervous system including neuronal survival and synaptogenesis. However, the physiological functions of BMP signaling at the mammalian neuromuscular system are not well understood. Our preliminary data showed that proteins of the type II bone morphogenetic receptors (BMPRII) were specifically expressed in nerve terminals at neuromuscular junctions. In this study, we found that proteins of bone morphogenetic protein-4 (BMP4) were detected at Schwann cells and colocalized with postsynaptic acetylcholine receptors (AChRs) in skeletal muscle fibers. In double-ligated nerves, BMP4 proteins were accumulated at the proximal and distal portions of the axons, suggesting that Schwann cell- and muscle fiber-derived BMP4 proteins were anterogradely and retrogradely transported by motor neurons. Additionally, BMP4 mRNA was significantly up-regulated in the muscle but down-regulated in ligated sciatic nerves. The physiological functions of BMP4 in the neuromuscular system were further examined in vitro. We found that mRNA of BMP4 was highly expressed in differentiated C2C12 muscle cells, but it was barely detectable in NG108-5 neurons. The expression of BMP4 mRNA and protein in C2C12 muscle cells were upregulated when the motor neuron-derived factor, agrin, was presented in the culture. Moreover, muscle-derived BMP4 could protect NG108-5 neurons from glutamate-induced excitotoxicity. These results together suggest that BMP4 is a peripheral-derived factor that may regulate the survival of motor neurons.

Synaptic transmission alters the strength of the postsynaptic potential, through a process called short-term synaptic plasticity (STP). In this study, endplate potentials (EPPs) from the frog neuromuscular junction were used to resolve and quantify the presynaptic components involved in enhancement and depression of transmitter release during repetitive stimulation under normal quantal release conditions (2 mM Ca2+, 1mM Mg2+). During trains of stimulation given between 10 - 200 Hz, the amplitude of the EPPs first increased then decreased; a maximum increase of 77% was produced after 2-4 stimuli. EPP amplitudes began to increase at ~ 20 Hz, were maximal at ~ 55 Hz, and thereafter, decreased as the rate of stimulation increased. The integrated total release after 25 stimuli was little changed across frequencies between 10 - 100 Hz. EPPs ran down in two phases: a fast phase, attributed to the depletion of a readily releasable pool (RRP) of synaptic vesicles, followed by a slow phase, attributed to the depletion of vesicles from a depot pool (DP). Depletion of the readily releasable pool of synaptic vesicles (RRP) was determined by quantifying release under the fast and slow time rundowns and subtracting the number of vesicles associated with mobilization to the RRP from the total number of vesicles released during stimulation trains of 50 impulses. Impulses were delivered at 12 different rates ranging from 50 to 200 /s. Estimates of the number of vesicles released from the RRP increased with frequency of stimulation until maximal depletion levels of 5500 - 6000 vesicles were reached at stimulation rates between 90-130/s, assuming a control quantal content of 200 vesicles released per impulse. Depletion was less at lower frequencies when the number of stimuli delivered was identical. When the RRP maximally depleted, release was inversely related to stimulation rate, as would be expected if mobilization from the depot pool was the sole determinate of release during the slow phase. An equation constructed from four known components of enhancement and two components of depression - the depletion of vesicles from a readily releasable pool (RRP) and from the depot pool (DP) that refills the RRP, was used to fit and then simulate EPPs obtained during trains using different patterns of stimulation and varying amounts of extracellular Ca2+; the decay time constant parameters of enhancement, numerically derived from the observed data, were fixed at tau ~ 46, 220, 1600, and 20000 ms. The number of components of enhancement necessary to approximate the data decreased, from four in low (0.14 - 0.2mM) extracellular Ca2+, to one (tau ~ 46 ms) in 2.0 mM extracellular Ca2+, but four components of enhancement were necessary to fit the data when the amplitude of the EPP was not depressed below the control amplitude. This model was able to predict within ~ 3 % EPP amplitudes over a 10-fold range of frequency and Ca2+ concentration.

L’atròfia muscular espinal (AME) és una malaltia d’origen genètic que afecta, majoritàriament a la població infantil. La malaltia cursa amb una mort de les motoneurones  i atròfia muscular. El gen implicat és el survival motor neuron (SMN) que està delecionat en un 95% dels casos. El nostre estudi està dividit en dues parts: 1- l’aprofundiment de les alteracions musculars en dos models animals murins transgènics que pateixen les formes més greus d’AME (Tipus 1-2) i 2- estudi dels possibles efectes terapèutics del liti en un d’aquests models d’AME. S’ha trobat alteracions greus en les unions neuromusculars d’animals nounats i prenatals en marcadors relacionats amb l’ancoratge de les vesícules a la membrana presinàptica, organització dels canals de calci presinàptics i altres proteïnes presinàptiques, desorganització i apoptosi de les cèl•lules musculars, apoptosi massiva del timus i alteracions generalitzades en els òrgans limfoides. L’estudi ultraestructural del múscul ens indica que hi ha una mort, per apoptosi, de les cèl•lules satèl•lit, confirmat amb la tècnica de TUNEL. L’augment de les apoptosi, però no es reflexa en un increment, per altra banda esperat, de la densitat dels macròfags. El tractament amb concentracions terapèutiques del liti no millora l’evolució de la malaltia en els ratolins que manifesten l’AME, s’observa una acumulació progressiva dels nivells de liti, provocant toxicitat en l’animal. L’efecte del liti inhibint la GSK3 no es tradueix en el increment d’expressió de SMN, tal com s’ha deduït d’alguns experiments publicats. / La atrofia muscular espinal (AME) es una enfermedad de origen genético que afecta, mayoritariamente a la población infantil. La enfermedad cursa con muerte de las motoneuronas y atrofia muscular. El gen implicado es el “survival motor neuron” (SMN) que está delecionado en un 95% de los casos. Nuestro estudio está dividido en dos partes: 1 - la caracterización de las alteraciones musculares en dos modelos animales murinos transgénicos que sufren las formas más graves de AME (Tipo 1-2) y 2 - estudio de los posibles efectos terapéuticos del litio en uno de estos modelos. Se han encontrado alteraciones pre y postnatales graves en las sinapsis neuromusculares a nivel de marcadores relacionados con el anclaje de las vesículas en la membrana presináptica, en la organización de los canales de calcio presinápticos y en otras proteínas presinápticas, Asimismo se ha hallado desorganización y apoptosis de las células musculares, apoptosis masiva del timo y alteraciones generalizadas en los órganos linfoides. El estudio ultraestructural del músculo nos revela muerte, por apoptosis, de las células satélite, confirmado con la técnica de TUNEL. El aumento de las apoptosis muscular no conlleva un incremento, por otra parte esperado, de la densidad de los macrófagos. El tratamiento con litio no mejora la evolución de la enfermedad en los ratones con AME. Se observa un incremento progresivo de los niveles de litio, provocando toxicidad en el animal. Por otra parte, el efecto del litio inhibiendo la GSK3 no se traduce en un aumento de la expresión de SMN, tal como se ha deducido de algunos experimentos publicados. / The spinal muscular atrophy (SMA) is a pediatric genetic disease. The SMA is a motor neuron disease that affects the motor neurons causing its death and muscle atrophy. The gene involved is the survival motor neuron (SMN) that is mutated in the 95% of the cases. Our study is divided into two parts: 1 – studies of the neuromuscular junction in two transgenic SMA murine models that develop the most severe forms of SMA (type 1-2) and 2 - study of the possible therapeutic effects of lithium on one of these models of SMA. We found severe alterations in the neuromuscular junctions of newborn animals and also in prenatal markers related to the vesicle docking at the presynaptic membrane, lack of organization of presynaptic calcium channels and defects in the expression of other presynaptic proteins. We found also, disruption and apoptosis of muscular cells, massive apoptosis of the thymus and widespread alterations in lymphoid organs. The ultrastructural study of muscle identifies apoptotic satellite cells that was confirmed by the TUNEL technique. The increase in apoptosis is not followed by the expected increase, in the macrophage density. Treatment with therapeutic concentrations of lithium does not improve the course of the disease in SMA mice. There was a progressive accumulation of lithium, causing toxicity in the animal. The effect of lithium inhibiting GSK3 does not determine an increased expression of SMN, as could be deduced from some published experiments.

Homeostasis is an indispensable phenomenon in the maintenance of living organisms. Genetic defects which disrupt negative feedback processes can impact homeostatic regulation, potentially resulting in disease. To uncover the molecular mechanisms governing these and other diseases potentially related to defective homeostasis, I used the Drosophila neuromuscular junction as a model system. I characterized two potential mechanisms that regulate homeostasis within the nervous system. First, in Drosophila larval motor neurons, ligand activation of Drosophila metabotropic glutamate receptor A (DmGluRA) mediates a Phosphoinositide 3-kinase (PI3K)-dependent downregulation of neuronal activity, but the mechanism by which mGluR activates PI3K remains incompletely understood. Here, I identified Ca 2+ /Calmodulin-dependant protein kinase II (CaMKII) and the Focal adhesion kinase (DFak) as critical intermediates in the DmGluRA-dependent activation of PI3K at Drosophila motor nerve terminals. I found that transgene-induced CaMKII inhibition or the DFak CG1 null mutation each block the ability of glutamate application to activate PI3K in larval motor nerve terminals, whereas transgene-induced CaMKII activation increases PI3K activity in motor nerve terminals in a DFak-dependent manner, even in the absence of glutamate application. I conclude that the activation of PI3K by DmGluRA is mediated by CaMKII and DFak. Second, I observed that Push, a putative E3-ubiquitin ligase and Ca 2+ /Calmodulin binding protein, regulates both neurotransmitter release and retrograde signaling in the Drosophila neuromuscular junction. I found that RNAi-mediated Push inhibition in the neuron increases but, in the muscle decreases, neurotransmitter release. Similar results were obtained from RNAi knock down of PLCβ and IP3R, which mediates Ca 2+ release from the endoplasmic reticulum. I conclude that Push mediation of the ubiquitin proteasome system may be important in the regulation of PLCβ/IP3R-mediated intracellular Ca 2+ release, and that this Ca 2+ release in the neuron inhibits neurotransmitter release, but in the muscle activates neurotransmitter release via a retrograde signal.

During cell communication, cells produce secreted signals termed morphogens, which traffic through the tissue until they are received by target, responding cells. Using the fruit fly Drosophila melanogaster as a model organism, I have studied transforming growth factor-beta (TGF-beta) signal from the secreting to the receiving cells in the developing wing epithelial cells and at the neuromuscular junctions. Cell culture studies have suggested that cells modulate morphogenetic signaling by expressing the receptors and secreting the ligand in spatially defined areas of the cell. Indeed, I have found that TGF-beta ligands, receptors and R-Smads show a polarized distribution both in the epithelial cells and at the synapses. My results indicate that the cellular junctions define a signaling domain within the plasma membrane, to which TGF-beta signaling machinery is targeted. In the context of epithelial cells, the junctions play a role in TGF-beta signaling regulation through their component beta-cat. A complex forms between beta-cat and the R-Smad Mad, but the mechanism by which beta-cat modulates signaling is not yet understood. At the synapse, the sub-cellular localization of TGF-beta pathway components indicates the occurrence of an anterograde signal. Moreover, my results suggest a scenario in which TGF-beta signaling is coupled with synaptic activity: quanta of growth factor, released upon neurostimulation together with neurotransmitter quanta, could modulate therefore the development and the function of the synapse.

Synaptic plasticity, the ability of synapses to change in strength, underlies complex brain functions such as learning and memory, yet little is known about the precise molecular mechanisms and downstream signaling pathways involved. The major goal of my doctoral thesis was to understand these molecular mechanisms and cellular processes underlying synaptic plasticity using the Drosophilalarval neuromuscular junction (NMJ) as a model system. My work centered on a signaling pathway, the Wg/Wnt signaling pathway, which was found to be crucial for activity-driven synapse formation. The Wg/Wnt family of secreted proteins, besides its well-characterized roles in embryonic patterning, cell growth and cancer, is beginning to be recognized as a pivotal player during synaptic differentiation and plasticity in the brain. At the DrosophilaNMJ, the Wnt-1 homolog Wingless (Wg) is secreted from presynaptic terminals and binds to Frizzled-2 (DFz2) receptors in the postsynaptic muscle. Perturbations in Wg signaling lead to poorly differentiated NMJs, containing synaptic sites that lack both neurotransmitter release sites and postsynaptic structures. In collaboration with other members of the Budnik lab, I set out to unravel the mechanisms by which Wg regulates synapse differentiation. We identified a novel transduction pathway that provides communication between the postsynaptic membrane and the nucleus, and which is responsible for proper synapse development. In this novel Frizzled Nuclear Import (FNI) pathway, the DFz2 receptor is internalized and transported towards the nucleus. The C-terminus of DFz2 is subsequently cleaved and imported into the postsynaptic nucleus for potential transcriptional regulation of synapse development (Mathews, Ataman, et al. Science (2005) 310:1344). My studies also centered on the genetic analysis of Glutamate Receptor (GluR) Interacting Protein (dGRIP), which in mammals has been suggested to regulate the localization of GluRs and more recently, synapse development. I generated mutations in the gene, transgenic strains carrying a dGRIP-RNAi and fluorescently tagged dGRIP, and antibodies against the protein. Remarkably, I found dgrip mutants had synaptic phenotypes that closely resembled those in mutations altering the FNI pathway. Through the genetic analysis of dgrip and components of the FNI pathway, immunoprecipitation studies, electron microscopy, in vivotrafficking assays, time-lapse imaging, and yeast two-hybrid assays, I demonstrated that dGRIP had a hitherto unknown role as an essential component of the FNI pathway. dGRIP was found in trafficking vesicles that contain internalized DFz2. Further, DFz2 and dGRIP likely interact directly. Through the use of pulse chase experiments I found that dGRIP is required for the transport of DFz2 from the synapse to the nucleus. These studies thus provided a molecular mechanism by which the Wnt receptor, DFz2, is trafficked from the postsynaptic membrane to the nucleus during synapse development and implicated dGRIP as an essential component of the FNI pathway (Ataman et al. PNAS (2006) 103:7841). In the final part of my dissertation, I concentrated on understanding the mechanisms by which neuronal activity regulates synapse formation, and the role of the Wnt pathway in this process. I found that acute changes in patterned activity lead to rapid modifications in synaptic structure and function, resulting in the formation of undifferentiated synaptic sites and to the potentiation of spontaneous neurotransmitter release. I also found that these rapid modifications required a bidirectional Wg transduction pathway. Evoked activity induced Wg release from synaptic sites, which stimulated both the postsynaptic FNI pathway, as well as an alternative presynaptic Wg pathway involving GSK-3ß/Shaggy. I suggest that the concurrent activation of these alternative pathways by the same ligand is employed as a mechanism for the simultaneous and coordinated assembly of the pre- and postsynaptic apparatus during activity-dependent synapse remodeling (Ataman et al. Neuron (2008) in press). In summary, my thesis work identified and characterized a previously unrecognized synaptic Wg/Wnt transduction pathway. Further, it established a mechanistic link between activity-dependent synaptic plasticity and bidirectional Wg/Wnt signaling. These findings provide novel mechanistic insight into synaptic plasticity.

Introdução e objetivos: a monitorização neuromuscular objetiva é prática médica baseada em evidências e deve ser empregada rotineiramente quando do uso de fármacos bloqueadores neuromusculares. Entretanto, pesquisas relacionadas a esta monitorização em pacientes pediátricos não estão vastamente documentadas como nos adultos. Em pesquisa clínica, o monitor neuromuscular deve apresentar resposta estável (menor que 5% de variação na altura de T1) por um período de dois a cinco minutos antes da administração do bloqueador neuromuscular. O tempo necessário para se alcançar esta estabilidade na resposta pode variar, mas pode ser encurtado por meio da aplicação de um estímulo tetânico por cinco segundos. Aventouse a hipótese de que a aplicação de estímulo tetânico antes da calibração poderia levar a diferenças nos parâmetros de início de ação e nos tempos de recuperação. O objetivo primário deste estudo foi comparar o tempo de início de ação e os tempos de recuperação após dose única de rocurônio 0,6 mg/kg seguido de recuperação espontânea, entre dois grupos de pacientes com sequências diferentes para a calibração (com e sem o uso de estímulo tetânico). Os objetivos secundários foram a avaliação da altura inicial e final de T1, tempo para se obter estabilidade da altura de T1 e os seguintes ajustes do monitor neuromuscular: corrente elétrica e sensibilidade. Método: consentimento informado dos responsáveis, foram incluídos no estudo 50 pacientes, estado físico 1 ou 2, de dois a 11 anos, agendados para cirurgias abdominais e/ou perineais com tempo cirúrgico estimado superior a 60 minutos. Os pacientes (25 por grupo) foram submetidos a anestesia intravenosa e alocados randomicamente para receber estímulo tetânico (grupo T) ou não (grupo C), antes da calibração do monitor. Após a calibração do monitor, a modalidade sequência de quatro estímulos foi iniciada e mantida em intervalo de 15 segundos. Resultados: não houve diferença significativa no início de ação (C: 57,5±16,9 versus T: 58,3±31,2 s; p=0,917). O tempo normalizado para as relações da sequência de quatro estímulos 0,7, 0,8 e 0,9 diferiram significativamente entre os grupos (C: 40,1 ± 7,9 versus T: 34,8±10 min; p=0,047, C: 43,8±9,4 versus T: 37,4±11 min; p=0,045 e C: 49,9±12,2 versus T: 41,7±13,1 min; p=0,026, respectivamente). O tempo necessário para a estabilização da altura de T1 não mostrou diferença estatística entre os grupos (C: 195±203 versus T: 116±81,6 s; p=0,093). Os valores de altura inicial de T1 mostraram diferença significativa entre os grupos (C: 98 versus T: 82,7%; p < 0,001). Os valores de altura final de T1 também mostraram diferença significante entre os grupos (C: 95,3 versus T: 69,3%; p < 0,001). Conclusões: o estímulo tetânico encurtou o tempo normalizado das relações da sequência de quatro estímulos 0,7, 0,8 e 0,9. As alturas inicial e final de T1 foram menores no grupo tétano. Não houve diferença estatística entre os grupos relativo ao tempo necessário para estabilização da altura de T1. Os ajustes do monitor (corrente elétrica e sensibilidade) não apresentaram diferenças entre os gruposEffect of tetanic stimulation, prior to calibration, on the onset of action and recovery times of neuromuscular blockade in pediatric patients / Background and objective: objective neuromuscular monitoring is evidence-based medical practice and should be routinely used when using neuromuscular blocking drugs. However, research related to this monitoring in pediatric patients is not widely documented as in adults. In clinical research, the neuromuscular monitor should have a stable response (less than 5% change in T1 height) for a period of two to five minutes before administration of the neuromuscular block agent. The time required to achieve this stability in response may vary, but may be shortened by the application of a tetanic stimulus for 5 seconds. It was hypothesized that the application of tetanic stimulus prior to calibration could lead to differences in the parameters of onset of action and recovery times. The primary outcome of this study was to compare time to onset and recovery times after single dose rocuronium 0.6 mg.kg-1 followed by spontaneous recovery between two groups of patients with different sequences for calibration (with and without use of tetanic stimulus). The secondary outcomes were the evaluation of the initial and final T1 height, time to obtain stability of T1 height and the following neuromuscular monitor settings: electric current and sensitivity. Methods: after approval by the Institutional Ethics Committee and obtaining the informed consent of those responsible for the patient, were included in the study 50 patients, physical status 1 or 2, from 2 to 11 years, scheduled for abdominal and/or perineal surgeries with estimated surgical time greater than 60 minutes. Patients (25 per group) underwent intravenous anesthesia and were allocated randomly to receive tetanus stimulation (group T) or not (group C) prior to calibration of the monitor. After calibration of the monitor, train-of-four mode was initiated and maintained at interval of 15 seconds. Results: there was no significant difference in onset of action (C: 57,5±16,9 versus T: 58,3±31,2 s; p=0,917). The train-of-four normalized times 0.7, 0.8 and 0.9 differed significantly between the groups (C: 40,1±7,9 versus T: 34,8±10 min; p=0,047, C: 43,8±9,4 versus T: 37,4±11 min; p=0,045 and C: 49,9±12,2 versus T: 41,7±13,1 min; p=0,026, respectively). The time required to stabilize the T1 height did not show statistical difference between the groups (C: 195±203 versus T: 116±81,6 s; p=0,093), The initial values of T1 height showed a significant difference between the groups (C: 98 versus T: 82,7%; p < 0,001). The final T1 height values also showed a significant difference between the groups (C: 95,3 versus T: 69,3%; p < 0,001). Conclusions: the tetanic stimulus shortened the normalized time of the fourstimulus sequence ratios 0.7, 0.8, and 0.9. The initial and final T1 heights were lower in the tetanus group. There was no statistical difference between the groups regarding the time required to stabilize the T1 height. The monitor settings (electric current and sensitivity) did not show differences between groups. Trial registration: Clinicaltrials.gov identifier: NCT0249867