Les pathologies de la paroi artérielle, et notamment l’athérosclérose, sont responsables de plus de 25% des décès dans le monde. Ces pathologies sont à l’origine de la thrombose,caractérisée par l’occlusion d’une artère par un caillot, ou thrombus. Ce travail de thèse explore l’utilisation de nanoparticules et microparticules polymères pour améliorer le diagnostic et le traitement de la thrombose. Ce type de particules permet en effet d’associer des agents de contraste et des actifs thérapeutiques à des agents de ciblage pour favoriser leur accumulation spécifique au niveau du thrombus. Les particules sont formulées à partir de polysaccharides et/ou de poly(cyanoacrylate d’isobutyle). Elles sont fonctionnalisées en surface avec du fucoïdane, un polysaccharide naturel extrait d’algues brunes. Le fucoïdane présente une affinité très forte pour la P-sélectine, molécule exprimée par les plaquettes activées qui constituent en partie le thrombus. Au cours de ce projet, un test in vitro d’adhésion en flux a été mis au point pour valider l’interaction des systèmes développés avec leur cible moléculaire, la P-sélectine, et leur cible cellulaire, les plaquettes activées. L'agent thérapeutique standard utilisé pour induire la dégradation du thrombus est l’activateur tissulaire du plasminogène. Celui-ci a été chargé sur des nanoparticules copolymères fonctionnalisées avec du fucoïdane. L’efficacité de ces systèmes a ensuite été validée dans un modèle murin de thrombose. Enfin, des nanoparticules composées exclusivement de polysaccharides et entièrement hydrophiles, dites “nanogels”, ont été synthétisées par un procédé innovant. Les résultats obtenus dans ce travail de thèse confirment le fort potentiel des approches ciblées pour le diagnostic et le traitement de la thrombose. Ils contribuent d’une manière plus générale au développement de la médecine personnalisée dans le domaine cardiovasculaire. / Arterial wall diseases, including atherosclerosis, are responsible for more than 25% of all deaths worldwide. These pathologies are at the origin of thrombotic events, characterized by the occlusion of an artery by a clot, called a thrombus. This thesis explores the use of polymer nanoparticles and microparticles for thrombosis imaging and therapy. This type of particles combines contrast agents and therapeutic agents with targeting moieties to promote their specific accumulation at the thrombus. The particles are composed of polysaccharides and/or poly(isobutyl cyanoacrylate). They are functionalized with fucoidan, a polysaccharide extracted from brown algae. Fucoidan shows a very strong affinity for P-selectin, a molecule expressed by activated platelets which form part of the thrombus. In this study, an in vitro flow adhesion assay is set up to validate the interaction of developed systems with their molecular target, the P-selectin, and with their cellular target, the activated platelets. Tissue plasminogen activator is the standard therapeutic agent used to induce thrombus degradation.This agent is loaded onto copolymer nanoparticles functionalized with fucoidan. Their efficiency is then validated in a murine model of thrombosis. Finally, nanoparticles exclusively composed of polysaccharides and entirely hydrophilic, called “nanogels”, are synthesized by an innovative process. The results of this work confirm the high potential of using targeted approach for thrombosis diagnosis and treatment and pave the way towards the development of personalized cardiovascular medicine.

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Although platelets are anucleate, they do inherit 1500-3000 mRNA transcripts from their megakaryocyte progenitors, in addition to all the machinery essential for protein synthesis; however, there is little understanding why platelets initiate de novo synthesis of these transcripts. Our group demonstrated that fibrinogen (Fg), a ligand of platelet Glycoprotein (GP)IIb-IIIa (αIIbβ3 integrin), is required for platelet P-selectin expression and that engagement of Fg with GPIIb-IIIa is essential for this process. The present study shows that murine platelets incubated with Fg synthesize P-selectin de novo, and this synthesis is blocked by puromycin. A similar effect is also observed when platelets are incubated with fibronectin, another ligand of GPIIb-IIIa. Furthermore, platelets from both ligand- (Fg−/−, von Willebrand factor−/−, apolipoprotein A-IV−/−) and GPIIb-IIIa-deficient mice have altered proteomes. These data suggest an intricate mechanism by which engagement of platelets with their environment triggers signal-dependent translation of the platelet transcriptome, consequently altering the platelet proteome.

Although platelets are anucleate, they do inherit 1500-3000 mRNA transcripts from their megakaryocyte progenitors, in addition to all the machinery essential for protein synthesis; however, there is little understanding why platelets initiate de novo synthesis of these transcripts. Our group demonstrated that fibrinogen (Fg), a ligand of platelet Glycoprotein (GP)IIb-IIIa (αIIbβ3 integrin), is required for platelet P-selectin expression and that engagement of Fg with GPIIb-IIIa is essential for this process. The present study shows that murine platelets incubated with Fg synthesize P-selectin de novo, and this synthesis is blocked by puromycin. A similar effect is also observed when platelets are incubated with fibronectin, another ligand of GPIIb-IIIa. Furthermore, platelets from both ligand- (Fg−/−, von Willebrand factor−/−, apolipoprotein A-IV−/−) and GPIIb-IIIa-deficient mice have altered proteomes. These data suggest an intricate mechanism by which engagement of platelets with their environment triggers signal-dependent translation of the platelet transcriptome, consequently altering the platelet proteome.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / IntroduÃÃo e objetivos: Os neutrÃfilos desempenham importante papel na pancreatite aguda grave. InfiltraÃÃo de neutrÃfilos no pÃncreas à um processo complexo, coordenado por molÃculas de adesÃo especÃficas, tais como a P-selectina. Fucoidina à um polissacarÃdeo sulfatado que bloqueia a funÃÃo da L-e P-selectinas. No presente estudo avaliamos se o tratamento com fucoidina poderia impedir a infiltraÃÃo de neutrÃfilos e, assim, reverter a inflamaÃÃo sistÃmica e dismotilidades gastrintestinais associadas à pancreatite aguda grave. MÃtodos: A pancreatite aguda foi induzida em camundongos Swiss pela infusÃo retrÃgrada de Ãcido taurolitocÃlico (3,0%) (TLC-S) no ducto pancreÃtico ou por injeÃÃes intraperitoneais de ceruleÃna (50 Âg/kg/h). Os grupos experimentais receberam fucoidina (25 mg/kg, iv) antes da induÃÃo da pancreatite, e os grupos de controle receberam apenas soluÃÃo salina. ApÃs 24 horas, os nÃveis sÃricos de amilase, lipase, IL-1β, TNF-α, nitrito e de malondialdeÃdo (MDA) pancreÃtico foram medidos. AlÃm disso, a atividade de mieloperoxidase (MPO) (pulmÃo, pÃncreas, estÃmago e jejuno) e avaliaÃÃo histolÃgica (pÃncreas) foram determinadas. O esvaziamento gÃstrico e trÃnsito gastrintestinal foram medidos pelo mÃtodo de centro geomÃtrico. A contratilidade gastrintestinal in vitro foi registrada atravÃs de transdutores de forÃa conectados a sistema computadorizado de aquisiÃÃo de dados. Carbacol (0,01 ÂM - 30 ÂM), KCl 60 mM e estimulaÃÃo elÃctrica (0,5-8,0 Hz; 1ms, 40 V), foram aplicados sobre o fundo gÃstrico e jejuno dos animais 24 horas apÃs a pancreatite induzida por TLC-S. Resultados: Os nÃveis de MDA pancreÃtico, amilase, lipase, nitrito, TNF-α e IL-1β sÃricos, bem como MPO pancreÃtica e pulmonar estavam aumentados tanto no modelo de pancreatite aguda induzida por TLCS quanto no modelo ceruleÃna quando comparado aos grupos controle correspondentes. Fucoidina reduziu significativamente os nÃveis aumentados de amilase, lipase, MPO pancreÃtica e pulmonar, MDA, TNF-α, IL-1β e nitrito em ambos os modelos de pancreatite aguda. As mudanÃas histolÃgicas observadas no pÃncreas em ambos os modelos foram significativamente atenuadas pela fucoidina. O modelo de pancreatite aguda induzida por TLC-S induziu retardo no esvaziamento gÃstrico e trÃnsito gastrointestinal, aumento de MPO no estÃmago e no jejuno, alÃm de hipercontratilidade de jejuno in vitro. Fucoidina reverteu significativamente os distÃrbios gastrintestinais in vivo e in vitro e os nÃveis aumentados de MPO gÃstrica e jejunal induzidos pela injeÃÃo de TLC-S. ConclusÃo: Fucoidina reduziu a gravidade da pancreatite aguda experimental atravÃs da diminuiÃÃo da infiltraÃÃo de neutrÃfilos, inflamaÃÃo sistÃmica e dismotilidades gastrintestinais, sugerindo que a modulaÃÃo das selectinas, pode constituir uma abordagem terapÃutica promissora para pancreatite aguda. / Background & Aims: Neutrophils play a critical role in severe acute pancreatitis. Tissue infiltration of neutrophils in the pancreas is a multistep process, coordinated by specific adhesion molecules, such as P-selectin. Fucoidin is a sulphated fucosylated polysaccharide that binds to and blocks the function of L- and P-selectins, and the present study has evaluated whether fucoidin treatment could prevent neutrophil infiltration, and thereby reverse the systemic inflammation and gastrointestinal dysmotility associated with severe acute pancreatitis. Methods: Acute pancreatitis was induced in Swiss mice either by the retrograde infusion of taurolithocholic acid (3.0%) (TLC-S) into the pancreatic duct or by intraperitoneal injections of cerulein (50 Âg/kg/h). The experimental groups received fucoidan (25 mg/kg, i.v.) before pancreatitis induction whist control groups received only saline. After 24 hours, pancreatic malondialdehyde (MDA), serum amylase, lipase, IL-1β, TNF- and nitrite were measured. In addition, myeloperoxidase (MPO) activity (lung, pancreas, stomach and jejunum) and histological assessment (pancreas) were determined. Gastric emptying and gastrointestinal transit (using the geometric center method) were also measured. Gastrointestinal contractility in vitro was recorded through force transducers coupled to a computerized data acquisition system, carbachol (0,01 ÂM â 30 ÂM), KCl 60mM and electrical field stimulation (0.5-8.0 Hz; 1ms; 40 V), was applied on gastric fundus and jejunum of mice 24 hours after TLC-S induced pancreatitis. Results: Pancreatic MDA, serum amylase, lipase, nitrite, TNF- and IL-1β, pancreatic and lung MPO, were increased in both TLCS- and cerulein acute pancreatitis compared with respective control groups. Fucoidan significantly decreased the augmented levels of amylase, lipase, pancreatic and lung MPO, MDA, TNF-, IL-1β and nitrite in both acute pancreatitis models. Pancreas histological changes observed in both models were significantly attenuated by fucoidan. The acute pancreatitis model induced by TLC-S caused delayed gastric emptying and gastrointestinal transit, incresead gastric and jejunum MPO, and jejunum hypercontractility in vitro. Fucoidan significantly reversed the gastrointestinal disorders in vivo and in vitro and augmented levels of gastric and jejunum MPO induced by TLC-S. Conclusion: Fucoidan reduced the severity of acute pancreatitis in mice by decreasing neutrophil infiltration, systemic inflammation and gastrointestinal dysmotility, suggesting that modulation of selectins may constitute a promising therapeutic approach for acute pancreatitis.

L'élaboration de nouvelles stratégies pour la détection de l'activité de la sclérose en plaques (SEP) est importante pour améliorer le diagnostic et le suivi de cette pathologie. Pour cela, nous avons utilisé des microparticules d'oxyde de fer (MPIO) couplées à un anticorps spécifique de la protéine P-sélectine ou de MAdCAM-1. Durant cette thèse, nous avons démontré que l’IRM moléculaire spécifique de la P-sélectine est capable de détecter les événements pathologiques qui se déroulent dans la moelle épinière de modèles murins de SEP chronique et récurrente-rémittente. De façon intéressante, nous montrons ici que cette technique d'IRM peut prédire l'apparition des poussées et des récupérations dans l’EAE. De plus, nous avons démontré que l’IRM moléculaire de MAdCAM-1 est capable de détecter l’inflammation intestinale dans des modèles de pathologies intestinales et de SEP. Les techniques novatrices d'IRM développées dans cette étude pourraient apporter de nouvelles avancées dans le diagnostic et le pronostic des rechutes de la SEP en ciblant l'activation vasculaire. Enfin, nous rapportons dans la dernière partie de cette thèse que le système glymphatique existe également dans le parenchyme de la moelle épinière de la souris. Dans l’EAE, l’activité de ce système est réduite dans la moelle épinière mais pas dans le cerveau ou le cervelet. Cette altération est associée à l'accumulation de cellules inflammatoires dans l'espace péri-vasculaire, à la désorganisation de l'AQP4 et entraine une forte augmentation du volume ventriculaire. Ces perturbations pourraient contribuer à la physiopathologie de la SEP. Nos résultats sont très prometteurs pour l'élaboration de nouvelles stratégies thérapeutiques. / Developing new strategies to detect disease activity in multiple sclerosis (MS) is essential to improve the diagnosis and follow-up of this pathology. To this aim, we used microparticles of iron oxide (MPIO) coupled to an antibody specific to the P-selectin or MAdCAM-1 protein. In this thesis, we establish that molecular MRI specific to P-selectin protein is able to detect the pathological events that take place in the spinal cord of chronic and relapsing-remitting models of MS in mice. Interestingly, we show here that this MRI technique can predict the apparition of relapses and recoveries in EAE. Moreover, we demonstrate that MRI specific to MAdCAM-1 protein is able to detect the gut inflammation that takes place in models of bowel diseases or MS. The innovative MRI techniques developed in this study could bring new advances in the diagnosis and prognosis of MS relapses by targeting gut inflammation. In the last part of this work, we report that the glymphatic system also exists in the spinal cord parenchyma of the mouse. In EAE, the activity of this system is reduced in the spinal cord but not in the brain or cerebellum. This alteration is associated to inflammatory cell accumulation within the perivascular space, AQP4 disorganization and leads to a large increase of ventricular volume. These disruptions could contribute to the MS pathophysiology. Our results hold significant promise for the development of new therapeutic strategies.

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