Thesis (Ph. D.)--University of Oklahoma. / Bibliography: leaves 229-253.

Current approaches to treat neurodegenerative disease provide only mild symptomatic relief but do not modify the natural history of these conditions. A large body of evidence suggests that mitochondrial dysfunction is a key event in the pathophysiology of neurodegeneration. Supporting and improving mitochondrial function has a big potential as a strategy for neuroprotection. The goal of this dissertation was to test whether interventions that target mitochondrial function are effective at preventing neurodegeneration induced by mitochondrial failure in vivo. A rodent model of optic neuropathy induced by the mitochondrial toxin rotenone was used to test the neuroprotective effects of methylene blue (MB) and near-infrared light (NIL), two interventions with mechanisms of action localized to mitochondria. This work also tested the effects of memantine, an NMDA receptor blocker, to further characterize the relationship between excitotoxicity and mitochondrial dysfunction. Neuroprotective effects were evaluated via behavioral testing of visual function and histopathological analysis of the retina. The neurochemical effects of MB, NIL and memantine were analyzed in vitro and in vivo with indicators of oxidative stress, cell respiration and catalytic activity of respiratory enzymes, including NADH dehydrogenase and cytochrome oxidase. MB, a diaminophenothiazine with potent antioxidant and unique redox properties, prevented the changes in visual function and the retinal histopathology induced by rotenone. In vitro, MB increased oxygen consumption and prevented the increases in oxidative stress in brain tissue induced by rotenone. NIL prevented the behavioral impairment and the decrease in retinal and visual pathway metabolic activity, retinal nerve fiber layer thickness and ganglion cell layer cell density induced by rotenone in a dose-dependent manner. Whole-brain cytochrome oxidase and superoxide dismutase activities were also increased in NIL-treated subjects in a dose-dependent manner, suggesting an in vivo transcranial effect of NIL. Finally, uncompetitive NMDA receptor blockade with memantine displayed neuroprotection against rotenone-induced neurodegeneration in a dose-response manner, and this effect was associated with a decrease in retinal oxidative stress and a long-term increase in neuronal energy metabolism capacity. These data constitute a proof-of-principle that interventions that target the mitochondria and support the function of the respiratory chain are effective at preventing neurodegeneration in vivo. / text

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Introdução: Muitos estudos veem sendo realizados com a finalidade de identificar agentes que possam ter efeito benéfico no tratamento ou prevenção das lesões causadas nos neurônios devido à isquemia. A hipotermia já demonstrou resultados consistentes em estudos experimentais e a Estimulação Magnética Transcraniana (EMTr) já foi usada visando reduzir danos em neurônios hipocampais de animais submetidos a isquemia cerebral. Com a propriedade de aumentar ou diminuir a excitabilidade cortical a partir do estímulo magnético, estima-se que ocorra uma interferência na produção de alguns neurotransmissores e receptores de membrana, que promoveriam efeito protetor a estas células. Neste estudo avaliamos a capacidade da EMTr de proteger os neurônios de uma lesão por hipóxia, e sua possível interferência no efeito protetor da hipotermia, tentando identificar alguns mecanismos que possivelmente estariam envolvidos neste fenômeno. Métodos: Como modelo de isquemia, foram utilizados Gerbils previamente submetidos a uma avaliação de comportamento e memória por meio do teste de esquiva. O protocolo de EMTr foi a partir de sessões diárias com 25 séries de 5 segundo a 25Hz, com um intervalo de 45 segundos entre as séries, por sete dias consecutivos, com um total de 21 875 pulsos com uma intensidade de 100% do limiar motor, e sendo realizada a indução da isquemia logo após o término da última sessão, ou na isquemia após a EMTr, em sessões diárias com 25 séries de 5 segundos a 25Hz, com um intervalo de 45 segundos entre as séries, durante 3 dias consecutivos, começando imediatamente após a cirurgia. Foi mantida a temperatura de 36 °C durante o período de oclusão do vaso e os 30 minutos consecutivos, ou 31 a 32 °C quando em hipotermia. O preparo das lâminas teve cortes envolvendo a região do hipocampo, corados com hematoxilina e eosina, além de outros preparos, a marcação de TUNEL e Caspase, que visam evidenciar a ocorrência de apoptose. Resultados: Embora sem significância estatística, os animais que receberam EMTr aparentemente tiveram uma melhor performance no teste da esquiva, principalmente se aplicado após a indução da isquemia. A hipotermia demonstrou uma eficiência significativa, tanto na análise histológica quanto no teste da esquiva, associado ou não à EMTr, e nestes animais submetidos a isquemia durante a hipotermia, os que receberam EMTr tiveram área de sobrevida no hipocampo significativamente maior na análise histológica com hematoxilina e eosina. Nos animais submetidos à isquemia durante a temperatura normal, a EMTr não demonstrou aumentar a área de sobrevida das células do hipocampo. Conclusões: A EMTr (ativa ou placebo, prévia ou posterior à isquemia) pareceu ter um efeito positivo no teste de esquiva. O procedimento de estimulação pareceu bastante traumático e estressante para os animais, tendo ocorrido alguns óbitos durante a imobilização, provavelmente por asfixia. A EMTr apresentou efeito protetor significativo apenas nos animais submetidos a isquemia durante hipotermia / Introduction: Over the time many researches have been conducted with the aim of identifying agents that may have beneficial effects in the treatment or prevention of cerebral ischemia, hypothermia has shown consistent results in experimental trials and Repetitive Trans Cranial Magnetic Stimulation (rTMS) has been used in a study attempting to reduce damage in hippocampal neurons. With the property to increase or decrease cortical excitability from the repetitive magnetic stimulus, it is estimated that an interference occurs in the production of some neurotransmitters and receptors of neuronal membrane, which therefore protects these cells from hypoxia. In this study we evaluated the ability of rTMS to protect neurons from injury due to hypoxia, and its possible interference in the protective effect of hypothermia and we tried to identify some mechanisms that possibly are involved in this phenomenon. Methods: Ischemia model was performed using Gerbil that was subsequently submitted to an evaluation of behavior and memory through passive avoidance task. The rTMS protocol was daily sessions with 25 series of 5 seconds at 25Hz with an interval of 45 seconds between series, for 7 consecutive days, with a total of 21 875 pulses with an intensity of 100% of motor threshold, and being carried through the induction of ischemia soon after the end of the last session, or rTMS after ischemia, in daily sessions with 25 series of 5 seconds at 25Hz with an interval of 45 seconds between series, for 3 consecutive days, starting immediately after surgery. The temperature of 36 °C was maintained during the period of vessel occlusion and subsequent 30 minutes, or 31 °C to 32 °C when in hypothermia. The preparation of the slices had sections of the region involving the hippocampus, stained with hematoxylin and eosin in addition to other preparations, TUNEL and caspase, which aim to evidence the occurrence of apoptosis. Results: Although not statistically significant, animals that received rTMS, apparently had better performance in passive avoidance task especially when applied after ischemia. The hypothermia demonstrated a significant efficiency, both in the histological analysis and in the passive avoidance task, associated or not to applications of rTMS and, in these animals undergoing ischemia during hypothermia, the ones who received rTMS had survival area in hippocampus significantly higher in histological analysis with hematoxylin and eosin. In animals undergone to ischemia during normal temperature, the rTMS has not shown to increase the area of hippocampal cell survival. Conclusions: rTMS (placebo or active, after or before the ischemia) seems to have a positive effect on passive avoidance task. The stimulation procedure appeared to be very traumatic and stressful for the animal, in which a few deaths occurred during the procedure, probably from asphyxiation due to restraint. The rTMS had a significant protective effect only in animals undergoing ischemia during hypothermia, as demonstrated in the histological analysis with hematoxylin and eosin

>Magister Scientiae - MSc / This study focused on the synthesis of a series of novel tricycloundecane derivatives and evaluation of these compounds for neuroprotection using the fluorescent ratiometric calcium assay that indicates the ability of the test compounds to inhibit NMDA receptors and VGCC. The cycloaddition reaction between p-benzoquinone and monomerised dicyclopentadiene yielded tricycloundeca- 4,9-diene-3,6-dione which was used as the base structure and further derivatised. These derivatives were conjugated with benzylamine to form a series of imines and amines. A total of 10 compounds were synthesised for evaluation of inhibition of calcium influx through NMDA receptor channels and voltage-gated calcium channels. The structures were confirmed using NMR, IR and MS. On the proton NMR, the characteristic AB-quartet system was observed in the region of 1-2 ppm for all the compounds and the aromatic moiety was observed between 6.5-7.5 ppm for the novel polycyclic amines. These, with other functional groups, were used to confirm the individual structures

A common feature of many neuropathies is axon degeneration. While the reasons for degeneration differ greatly, the process of degeneration itself is similar in most cases. Axon degeneration after axotomy is termed ‘Wallerian degeneration,’ whereby injured axons rapidly fragment and disappear after a short period of latency (Waller, 1850). Wallerian degeneration was thought to be a passive process until the discovery of the Wallerian degeneration slow (Wlds) mouse mutant. In these mice, axons survive and function for weeks after nerve transection. Furthermore, when the full-length protein is inserted into mouse models of disease with an axon degeneration phenotype (such as progressive motor neuronopathy), Wlds is able to delay disease onset (for a review, see Coleman, 2005). Wlds has been cloned and was found to be a fusion event of two neighboring genes: Ube4b, which encodes an ubiquitinating enzyme, and NMNAT-1 (nicotinamide mononucleotide adenylyltransferase-1), which encodes a key factor in NAD (nicotinamide adenine dinucleotide) biosynthesis, joined by a 54 nucleotide linker span (Mack et al., 2001). To address the role of Wlds domains in axon protection and to characterize the subcellular localization of Wlds in neurons, our lab developed a novel method to study Wallerian degeneration in Drosophila in vivo (MacDonald et al., 2006). Using this method, we have discovered that mouse Wlds can also protect Drosophila axons for weeks after acute injury, indicating that the molecular mechanisms of Wallerian degeneration are well conserved between mouse and Drosophila. This observation allows us to use an easily manipulated genetic model to move the Wlds field forward; we can readily identify what Wlds domains give the greatest protection after injury and where in the neuron protection occurs. In chapter two of this thesis, I identify the minimal domains of Wlds that are needed for protection of severed Drosophila axons: the first 16 amino acids of Ube4b fused to Nmnat1. Although Nmnat1 and Wlds are nuclear proteins, we find evidence of a non-nuclear role in axonal protection in that a mitochondrial protein, Nmnat3, protects axons as well as Wlds. In chapter 3, I further explore a role for mitochondria in Wlds-mediated severed axon protection and find the first cell biological changes seen in a Wlds-expressing neuron. The mitochondria of Wlds- and Nmnat3-expressing neurons are more motile before injury. We find this motility is necessary for protection as suppressing the motility with miro heterozygous alleles suppresses Wldsmediated axon protection. We also find that Wlds- and Nmnat3- expressing neurons show a decrease in calcium fluorescent reporter, gCaMP3, signal after axotomy. We propose a model whereby Wlds, through production of NAD in the mitochondria, leads to an increase in calcium buffering capacity, which would decrease the amount of calcium in the cytosol, allowing for more motile mitochondria. In the case of injury, the high calcium signal is buffered more quickly and so cannot signal for the axon to die. Finally, in chapter 4 of my thesis, I identify a gene in an EMS-based forward genetic screen which can suppress Wallerian degeneration. This mutant is a loss of function, which, for the first time, definitively demonstrates that Wallerian degeneration is an active process. The mammalian homologue of the gene encodes a mitochondrial protein, which in light of the rest of the work in this thesis, highlights the importance of mitochondria in neuronal health and disease. In conclusion, the work presented in this thesis highlights a role for mitochondria in both Wlds-mediated axon protection and Wallerian degeneration itself. I identified the first cell biological changes seen in Wlds-expressing neurons and show that at least one of these is necessary for its protection of severed axons. I also helped find the first Wallerian degeneration loss-of-function mutant, showing Wallerian degeneration is an active process, mediated by a molecularly distinct axonal degeneration pathway. The future of the axon degeneration field should focus on the mitochondria as a potential therapeutic target.

Les métalloenzymes d’origine naturelle constituent une riche source d’inspiration pour la conception de catalyseurs synthétiques en raison de leur capacité à réaliser des réactions d’oxydation sélective dans des conditions douces. Parmi ces métalloenzymes, les amine-oxydases à cuivre (CuAOs) permettent l’oxydation sélective des amines primaires grâce à la coopération d’un catalyseur organique quinonique (topaquinone) et d’un ion cuivrique. Récemment, un regain d’intérêt s’est manifesté pour le développement de catalyseurs biomimétiques permettant l’oxydation des amines en imines à l’air ambiant, en raison de l’importance des imines comme intermédiaires de synthèse en chimie fine et en pharmacologie. Au laboratoire, un système co-catalytique mimant l’activité des CuAOs a été décrit pour l’oxydation, à l’air ambiant, des amines primaires en imines, permettant une forte économie d’atomes. Le procédé catalytique comprend deux couples redox comparables à ceux des CuAOs : le catalyseur organique o-iminoquinonique 1ox, généré in situ à partir de l’o-aminophénol correspondant 1red, est le véritable catalyseur de l’oxydation de l’amine substrat, tandis que le sel de cuivre (II) sert de médiateur redox. Il est intéressant de noter que de faibles quantités de sel de cuivre (II) biocompatible et de catalyseur organique 1ox suffisent à activer la liaison C-H située en α de la fonction NH2 des amines primaires aliphatiques, qui sont converties, à l’air ambiant, en imines issues du couplage hétérolytique, à l’issue d’un processus de transamination qui conduit à l’imine résultant du couplage homolytique, suivi d’une réaction de transimination. Les conditions douces utilisées sont particulièrement intéressantes d’un point de vue synthétique, notamment pour engager les alkylimines instables in situ dans des réactions subséquentes. Aussi, avons-nous envisagé d’utiliser ce système co-catalytique bioinspiré dans la synthèse one-pot d’hétérocycles d’intérêt pharmacologique. Dans la première partie de la thèse, nous avions l’intention d’utiliser le système co-catalytique Cu(II)/1ox dans la synthèse de nouveaux dérivés de la 1,4-benzoxazine. Dans le cas particulier des amines primaires de type R1R2CHCH2NH2, le processus catalytique se trouvait bloqué après un certain nombre de cycles catalytiques en raison de l’engagement du catalyseur 1ox dans une réaction de Diels-Alder à demande électronique inverse avec la forme énamine tautomère de l’imine éliminée au cours du processus catalytique, conduisant ainsi aux dérivés de la 1,4-benzoxazine. Toutefois, l’utilisation de ce procédé s’avéra un échec, les énamines générées étant trop instables à l’air ambiant pour permettre l’isolement des dérivés de la 1,4-benzoxazine avec des rendements acceptables. Nous avons ainsi été amenés à développer une réaction alternative en tandem : les dérivés o-aminophénols sont oxydés dans le méthanol sous atmosphère d’azote, à l’aide d’une quantité stoechiométrique de dioxyde de manganèse activé, en o-iminoquinones. Ces hétérodiènes sont ensuite piégés in situ par différentes énamines diénophiles pour conduire aux dérivés de la 1,4-benzoxazine attendus, dans des conditions douces. La possibilité d’introduire des éléments de diversité dans chacun des partenaires de la cycloaddition permet de préparer des dérivés de la 1,4-benzoxazine hautement substitués. Parmi ces composés, un dérivé présentant deux groupements phényle en position 3 s’est avéré présenter une activité neuroprotectrice notable chez la souris nouveau-né, faisant de lui un candidat potentiel pour le traitement et la prévention de la paralysie cérébrale du nouveau-né. Dans la seconde partie de la thèse, le système co-catalytique Cu(II)/1ox est utilisé dans une réaction de couplage oxydatif d’amines primaires, activées ou non, avec des o-aminoanilines conduisant ainsi à des dérivés du benzimidazole d’intérêt biologique au travers d’un procédé multi-étapes. (...) / Naturally occurring metalloenzymes constitute a rich source of inspiration for the design of synthetic catalysts because of their ability to perform controlled aerobic oxidations under very mild conditions. Among metalloenzymes, copper amine oxidases (CuAOs) promote selective aerobic oxidation of primary amines through the cooperation of a quinone-based cofactor (topaquinone) and a copper ion. Recently, there has been a boost in the development of biomimetic catalysts for the aerobic oxidation of amines to imines owing to the importance of imines as pivotal intermediates in the synthesis of fine chemicals and pharmaceuticals. In our laboratory, a CuAOs-like homogeneous co-catalytic system has been described for the atom-economical oxidation of primary amines to imines, under ambient air. The catalytic process combines two redox couples in a way reminiscent of CuAOs: the o-iminoquinone organocatalyst 1ox, generated in situ from the corresponding o-aminophenol 1red, is the substrate-selective catalyst, whereas the copper (II) salt serves as an electron transfer mediator. Interestingly, low loadings of biocompatible CuII and organocatalyst 1ox are sufficient to activate the α-C-H bond of primary aliphatic amines, which are converted, under ambient air, into cross-coupled imines through a transamination process that leads to the homocoupled imine intermediate, followed by dynamic transimination. The mild reaction conditions are highly favorable from a synthetic viewpoint, in particular for trapping the unstable alkylimines in situ for further reactions. So, we have envisioned the use of this bioinspired co-catalytic system in the one-pot synthesis of heterocycles of pharmacological interest. In the first part of the thesis, we envisioned that the Cu(II)/1ox cooperative system might be utilized to synthesize novel 1,4-benzoxazine derivatives. In the specific case of R1R2CHCH2NH2 amines, the catalytic process should stop after a few turnovers, because the catalyst 1ox should be trapped through inverse-electron-demand Diels-Alder (IEDDA) reaction with the simultaneously in situ generated tautomeric enamine form of the alkylimine extruded during the catalytic process, leading to 1,4-benzoxazine derivatives. Unfortunately, this protocol failed to produce the expected cycloadducts in acceptable yields as enamines rapidly decomposed under ambient air. For this reason, we have developed a tandem oxidation-inverse electron demand Diels-Alder reaction as an alternative: a stoichiometric amount of activated MnO2, in deaerated methanol, was then sufficient to convert various o-aminophenol derivatives into o-iminoquinone heterodienes which were trapped in situ by different enamine dienophiles leading to the expected 1,4-benzoxazine derivatives under mild conditions. The possibility of introducing variations in both cycloaddition partners led to highly substituted 1,4-benzoxazine cycloadducts with up to five elements of diversity. Among these compounds, a 3,3-diphenyl-substituted-1,4-benzoxazine derivative was identified as an effective neuroprotective agent in newborn mice, suggesting that it could be a potential candidate for the treatment and prevention of cerebral palsy. In the second part of the thesis, the Cu(II)/1ox cooperative system has been successfully used for the catalytic oxidative coupling of a diverse range of activated and non-activated primary amines with o-amino-anilines under ambient air leading to benzimidazoles of biological interest through multistep oxidation and nucleophilic addition reactions. Through the variation of both solvent and coupling partners, MeOH proved to be the best solvent for this transformation because it provided the ideal balance of 1ox solvation and reaction rate, except when reactive N-alkyl o-aminoanilines were used as in situ imine traps, due to the concomitant formation of a benzimidazole byproduct originated from MeOH itself. (...)

Introdução: Diversas evidências apontam para um papel da disfunção mitocondrial no Transtorno de Humor Bipolar (THB), mas pouco se sabe sobre isso no THB de início recente. Na mitocôndria a atividade da cadeia transportadora de elétrons (CTE) atua juntamente com o ciclo do ácido cítrico na produção de energia, mas não está claro se estão alteradas no THB. O DNA mitocondrial (DNAmt) codifica diversas proteínas da CTE e está associado ao estresse oxidativo, mas nunca foi avaliado em pacientes no THB in vivo. O estresse oxidativo está associado ao THB e à disfunção mitocondrial, mas não se sabe muito das atividades das enzimas antioxidantes no THB de início recente. O óxido nítrico (NO) é uma molécula com efeitos neuromoduladores, mas com um papel no THB ainda não elucidado. O lítio é um tratamento padrão-ouro no THB, tendo mostrado efeitos neuroprotetores. Apesar disso, pouco se conhece do efeito do lítio na CTE, nas enzimas do ciclo do ácido cítrico, no conteúdo de DNAmt e na regulação de NO em humanos. Também não está claro o papel antioxidante do lítio no THB. Metódos: Pacientes com THB em depressão (n=31), não medicados em sua maioria (84%), foram tratados por 6 semanas com lítio. Antes e depois do tratamento, verificaram-se em leucócitos as atividades dos complexos I-IV da CTE, atividades das enzimas citrato sintase, succinato desidrogenase e malato desidrogenase e também o conteúdo de DNAmt; em plasma foram analisados os níveis de NO, substâncias reativas ao ácido tiobarbitúrico (TBARS) e as atividades de catalase (CAT), glutationa peroxidase (GPx), superóxido dismutase (SOD) e razão de SOD/CAT. Os pacientes com depressão bipolar foram comparados com 28 controles saudáveis. Resultados: Em comparação com controles, os pacientes com THB tiveram um aumento de GPx (p < 0,001) e CAT (p=0,005) e uma diminuição de SOD/CAT (p=0,001), sem outras diferenças nos demais biomarcadores. Pacientes com THB I mostraram uma diminuição de citrato sintase (p=0,02) e uma discreta diminuição do conteúdo de DNAmt (p=0,05) em comparação com o THB II; o conteúdo de DNAmt esteve ligeiramente diminuído no THB I comparado com controles (p=0,05). Do início ao fim do tratamento com lítio houve aumento da atividade do complexo I da CTE (p=0,02), diminuição de TBARS (p=0,02) e SOD (p=0,03) e aumento de NO (p=0,02), sem haver alteração de outros parâmetros. Depois do tratamento, o TBARS se mostrou diminuído em respondedores comparados a não respondedores (p=0,02) e diminuído no THB II em comparação com o THB I (p=0,04). Discussão: No THB de início recente, houve poucas alterações em biomarcadores. Os achados sugerem aumento de CAT e GPx na depressão bipolar de início recente e uma diminuição de conteúdo mitocondrial no THB I comparado com o THB II, que devem ser confirmadas por outros estudos. Os resultados reforçam um papel neuroprotetor do lítio, sugerindo que a droga aumente a atividade do complexo I da CTE mitocondrial e aumente os níveis de NO na depressão bipolar. Além disso, o lítio reforçou o seu papel antioxidante e modulador das enzimas antioxidantes no THB / Background: Several evidences point to a role for mitochondrial dysfunction in Bipolar Disorder (BD), but few is known about it on short-term BD. In mitochondria the electron transport chain (ETC) acts jointly with citric acid cycle to produce energy, but it is not clear if they are altered in BD. Mitochondrial DNA (mtDNA) encodes several ETC proteins and is associated with oxidative stress, but it was never evaluated in BD in vivo. Oxidative stress is associated with BD and with mitochondrial dysfunction, but few is known about the activities of antioxidant enzymes in short-term BD. Nitric oxide (NO) is a molecule with neuromodulatory effects, but with an unclear role in BD. Lithium is a gold-standard treatment for BD, which has shown neuroprotective effects. However, few is known about lithium effect on ETC, citric acid cycle, mtDNA content, and NO regulation in humans. Also, lithium\'s antioxidant role in BD is unclear. Methods: Patients with BD depression (n=31) unmedicated in majority (84%) received lithium treatment for 6 weeks. Before and after treatment, in leukocytes the activities of ETC complex I-IV, citrate synthase, succinate dehydrogenase, and malate dehydrogenase, and mtDNA content were evaluated; in plasma, NO levels, thiobarbituric acid reactive substances (TBARS), the activities of catalase (CAT), glutathione peroxidase (GPx), and superoxide dismutase (SOD), and SOD/CAT ratio were evaluated. Bipolar depression patients were compared with 28 healthy controls. Results: When compared with controls, BD patients showed an increase in GPx (p < 0.001) and CAT (p=0.005) and a decrease in SOD/CAT (p=0.001), but showed no difference for other biomarkers. Patients with BD I showed a decrease in citrate synthase (p=0.02) and a slight decrease in mtDNA content (p=0.05) when compared to BD II; mtDNA content was slightly decreased in BD I compared to controls (p=0.05). From baseline to endpoint, there was an increase in ETC complex I activity (p=0.02), a decrease in TBARS (p=0.02) and SOD (p=0.03) and an increase in NO (p=0.02), without change in other parameters. After treatment, TBARS was decreased in responders compared to non-responders (p=0.02) and decreased in BD II compared to BD I (p=0.04). Discussion: In short-term BD few alterations were observed on biomarkers. The findings suggest increase on CAT and GPX in short-term bipolar depression and mitochondrial content decrease in BD I when compared to BD II, which deserve other studies for confirmation. The results reinforce a lithium\'s neuroprotective role and suggest that lithium increases ETC complex I activity and NO levels in bipolar depression. Moreover, lithium reinforced its role as antioxidant and as a modulator of antioxidant enzymes in BD

Dissertation (Ph.D.)--University of South Florida, 2007. / Includes vita. Includes bibliographical references. Also available online.

Introdução: Diversas evidências apontam para um papel da disfunção mitocondrial no Transtorno de Humor Bipolar (THB), mas pouco se sabe sobre isso no THB de início recente. Na mitocôndria a atividade da cadeia transportadora de elétrons (CTE) atua juntamente com o ciclo do ácido cítrico na produção de energia, mas não está claro se estão alteradas no THB. O DNA mitocondrial (DNAmt) codifica diversas proteínas da CTE e está associado ao estresse oxidativo, mas nunca foi avaliado em pacientes no THB in vivo. O estresse oxidativo está associado ao THB e à disfunção mitocondrial, mas não se sabe muito das atividades das enzimas antioxidantes no THB de início recente. O óxido nítrico (NO) é uma molécula com efeitos neuromoduladores, mas com um papel no THB ainda não elucidado. O lítio é um tratamento padrão-ouro no THB, tendo mostrado efeitos neuroprotetores. Apesar disso, pouco se conhece do efeito do lítio na CTE, nas enzimas do ciclo do ácido cítrico, no conteúdo de DNAmt e na regulação de NO em humanos. Também não está claro o papel antioxidante do lítio no THB. Metódos: Pacientes com THB em depressão (n=31), não medicados em sua maioria (84%), foram tratados por 6 semanas com lítio. Antes e depois do tratamento, verificaram-se em leucócitos as atividades dos complexos I-IV da CTE, atividades das enzimas citrato sintase, succinato desidrogenase e malato desidrogenase e também o conteúdo de DNAmt; em plasma foram analisados os níveis de NO, substâncias reativas ao ácido tiobarbitúrico (TBARS) e as atividades de catalase (CAT), glutationa peroxidase (GPx), superóxido dismutase (SOD) e razão de SOD/CAT. Os pacientes com depressão bipolar foram comparados com 28 controles saudáveis. Resultados: Em comparação com controles, os pacientes com THB tiveram um aumento de GPx (p < 0,001) e CAT (p=0,005) e uma diminuição de SOD/CAT (p=0,001), sem outras diferenças nos demais biomarcadores. Pacientes com THB I mostraram uma diminuição de citrato sintase (p=0,02) e uma discreta diminuição do conteúdo de DNAmt (p=0,05) em comparação com o THB II; o conteúdo de DNAmt esteve ligeiramente diminuído no THB I comparado com controles (p=0,05). Do início ao fim do tratamento com lítio houve aumento da atividade do complexo I da CTE (p=0,02), diminuição de TBARS (p=0,02) e SOD (p=0,03) e aumento de NO (p=0,02), sem haver alteração de outros parâmetros. Depois do tratamento, o TBARS se mostrou diminuído em respondedores comparados a não respondedores (p=0,02) e diminuído no THB II em comparação com o THB I (p=0,04). Discussão: No THB de início recente, houve poucas alterações em biomarcadores. Os achados sugerem aumento de CAT e GPx na depressão bipolar de início recente e uma diminuição de conteúdo mitocondrial no THB I comparado com o THB II, que devem ser confirmadas por outros estudos. Os resultados reforçam um papel neuroprotetor do lítio, sugerindo que a droga aumente a atividade do complexo I da CTE mitocondrial e aumente os níveis de NO na depressão bipolar. Além disso, o lítio reforçou o seu papel antioxidante e modulador das enzimas antioxidantes no THB / Background: Several evidences point to a role for mitochondrial dysfunction in Bipolar Disorder (BD), but few is known about it on short-term BD. In mitochondria the electron transport chain (ETC) acts jointly with citric acid cycle to produce energy, but it is not clear if they are altered in BD. Mitochondrial DNA (mtDNA) encodes several ETC proteins and is associated with oxidative stress, but it was never evaluated in BD in vivo. Oxidative stress is associated with BD and with mitochondrial dysfunction, but few is known about the activities of antioxidant enzymes in short-term BD. Nitric oxide (NO) is a molecule with neuromodulatory effects, but with an unclear role in BD. Lithium is a gold-standard treatment for BD, which has shown neuroprotective effects. However, few is known about lithium effect on ETC, citric acid cycle, mtDNA content, and NO regulation in humans. Also, lithium\'s antioxidant role in BD is unclear. Methods: Patients with BD depression (n=31) unmedicated in majority (84%) received lithium treatment for 6 weeks. Before and after treatment, in leukocytes the activities of ETC complex I-IV, citrate synthase, succinate dehydrogenase, and malate dehydrogenase, and mtDNA content were evaluated; in plasma, NO levels, thiobarbituric acid reactive substances (TBARS), the activities of catalase (CAT), glutathione peroxidase (GPx), and superoxide dismutase (SOD), and SOD/CAT ratio were evaluated. Bipolar depression patients were compared with 28 healthy controls. Results: When compared with controls, BD patients showed an increase in GPx (p < 0.001) and CAT (p=0.005) and a decrease in SOD/CAT (p=0.001), but showed no difference for other biomarkers. Patients with BD I showed a decrease in citrate synthase (p=0.02) and a slight decrease in mtDNA content (p=0.05) when compared to BD II; mtDNA content was slightly decreased in BD I compared to controls (p=0.05). From baseline to endpoint, there was an increase in ETC complex I activity (p=0.02), a decrease in TBARS (p=0.02) and SOD (p=0.03) and an increase in NO (p=0.02), without change in other parameters. After treatment, TBARS was decreased in responders compared to non-responders (p=0.02) and decreased in BD II compared to BD I (p=0.04). Discussion: In short-term BD few alterations were observed on biomarkers. The findings suggest increase on CAT and GPX in short-term bipolar depression and mitochondrial content decrease in BD I when compared to BD II, which deserve other studies for confirmation. The results reinforce a lithium\'s neuroprotective role and suggest that lithium increases ETC complex I activity and NO levels in bipolar depression. Moreover, lithium reinforced its role as antioxidant and as a modulator of antioxidant enzymes in BD