Orientador: Gilberto de Nucci / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-04T10:02:10Z (GMT). No. of bitstreams: 1 AbibJunior_Eduardo_D.pdf: 639040 bytes, checksum: e96fa4a810e2980947816b23f3c078a1 (MD5) Previous issue date: 2005 / Resumo: Objetivo: Esta tese tem por objetivos: avaliar a agregação plaquetária e o comportamento da pressão arterial em três momentos (sem alho; alho dose única (3,5 g) e alho dose diária (3,5 g) duas vezes ao dia por 4 dias) em voluntários sadios; Analisar a resposta de agregação plaquetária in vitro adicionando extrato de alho diluído em PRP e por ultimo correlacionar os dados obtidos da analise da agregação com os parâmetros TxB2, GMPc entre in vivo e in vivo. Para Analise em in vivo foram selecionados dezoito (18) voluntários do sexo masculino, entre 18 a 45 anos, saudáveis, para estudo não randomizado, aberto e divididos em tres grupos (Grupo Sem alho; Grupo Com Alho Único e Grupo Alho Diário). Amostras de sangue dos voluntários foram coletadas de acordo com horários pré-estabelecidos. Após execução da agregação plaquetária, Pressão arterial através da MAPA e quantificação dos níveis de TXB2, foram realizadas análises estatisticas. Para analise in vitro foram selecionados 5 voluntários sadios, de ambos os sexos, isentos de qualquer medicação uma semana antes coleta. O sangue foi coletado e o PRP foi separado e adicionado extrato de alho em volume determinado. Após execução da agregação plaquetária e quantificação dos níveis de TXB2, foram tb realizadas análises estatisticas. Tendo estes dados tanto in vivo quanto in vivo procedeu-se a analise comparativa entre eles. Resultados : Na analise in vivo, tanto a agregação plaquetária quanto a inibição da formação de TxB2 não se observou diferença entre os outros grupos independente do agonista utilizado. Na analise in vitro, os resultados sugeriram que o extrato de alho, em quantidades pequenas, inibi a agregação plaquetária Os resultados se confirmaram com o TXB2, pois quantidades de extrato que foram capazes de inibir a agregação plaquetária induzida por todos agonistas, inclusive àquela induzida por AA, não causou diminuição significativa da síntese de TXA2 induzida por AA. Houve variação significativa da PA sistólica e FC com administração diária de alho fresco comparada ao sem alho e alho único. Conclusão: Concluímos que outros mecanismos podem estar envolvidos na inibição da agregação plaquetária que não da inibição da ciclooxigenase plaquetária quando utilizado o extrato de alho. Não há uma inibição da agregação plaquetária através da ação sobre a ciclooxigenase quando observado em voluntários que ingeriram alho fresco. A administração de alho in natura, pequenas quantidades (3,5g de dente de alho = 16 mg alicina/g de alho) pode contribuir para promover alterações no comportamento hemodinâmico como observado através da MAPA em voluntários sadios / Abstract: Objective: This thesis has as objectives: to evaluate the platelet aggregation and the behavior of blood pressure in three moments (control; garlic single dose (3,5 g) and garlic daily dose (3,5 g) twice a day for 4 days) in healthy volunteers; To analyze the in vitro platelet aggregation answer adding garlic extract diluted in PRP and the last to correlate the obtained data from the aggregation analysis with the TxB2, GMPc parameters between in vivo and in vivo. For the in vivo Analysis eighteen (18) healthy volunteers of the masculine gender between 18 and 45 years old were selected, for an open, non-randomized study and divided into three groups (Control; Group With Single Garlic and Group Daily Garlic). Samples of the volunteers' blood were collected according to the pre-established schedules. After execution of the platelet aggregation, blood Pressure through AMBP and quantification of TXB2 levels , statistical analyses were accomplished. For in vitro analysis 5 healthy volunteers of both genders were selected, free of any medication one week before collection. The blood was collected and the PRP was separated and added garlic extract in determined volume. After execution of the platelet aggregation and quantification of TXB2 levels, statistical analyses were also accomplished. Having these in vivo data as well in in vivo the comparative analysis between them was preceeded. Results: There was significant variation of the systolic BP and HR with daily administration of fresh garlic compared to control and single garlic. Regarding the platelet aggregation it was observed difference between the daily garlic group and the other two groups (P <0.005) when used agonist arachidonic acid. In the in vitro analysis, the results suggested that the garlic extract, in small amounts, can inhibit the platelet aggregation without affecting in a significant way the activity of ciclooxygenase. The results were confirmed with the TXB2, for amounts of extract that were capable to inhibit the platelet aggregation induced by all agonists, including that one induced by AA, didn't cause significant decrease of TXA2 synthesis induced by AA. Conclusion: We concluded that other mechanisms can be involved in the inhibition of the platelet aggregation other than the inhibition of the platelet ciclooxygenase when used the garlic extract. There is not an inhibition of the platelet aggregation through the action on the ciclooxygenase when observed in volunteers that ingested fresh garlic. The administration of garlic in natura, small quantities (3,5g garlic glove = 16 mg allicim/g garlic) can contribute to promote alterations in the hemodynamic behavior as observed through the AMBP in healthy volunteers / Doutorado / Clinica Medica / Doutor em Clínica Médica

L’insuffisance rénale aiguë (IRA) est une pathologie fréquente en réanimation. Elle est associée à une mortalité et une morbidité importante. Le sepsis en est la cause la plus fréquente. La compréhension de la physiopathologie du sepsis et de ses complications a beaucoup progressé ces dernières années mais ne s’est pas encore traduite par des avancées thérapeutiques significatives en pratique clinique. Le paradigme d’une altération de la perfusion sanguine comme paramètre clé de la constitution des lésions rénales a ainsi été remis en question, plusieurs travaux révélant que le débit sanguin rénal n’est pas toujours altéré en cas de sepsis, et qu’une IRA peut se développer en cas de débit sanguin rénal préservé, voire augmenté. Le sepsis est caractérisé par de profondes perturbations de la réponse immunitaire et une réaction inflammatoire disproportionnée. A l’origine de l’atteinte rénale, l’inflammation et les altérations de la microcirculation sont maintenant considérés comme des mécanismes physiopathologiques fondamentaux. Au-delà de leur rôle dans l’hémostase, la contribution des plaquettes sanguines à la réponse inflammatoire, au maintien de l’intégrité tissulaire et à la défense contre les infections a considérablement élargi le spectre de leurs compétences et en a fait des acteurs physiopathologiques potentiels dans le sepsis. Les plaquettes sanguines exercent la plupart de ces fonctions grâce à l’expression de nombreux médiateurs membranaires ou solubles. Parmi eux, le CD154 tient une place particulière : les plaquettes sont une source essentielle de CD154 dans l’organisme et il joue un rôle central dans la réponse inflammatoire. Nous proposons dans ce travail un aperçu de ces avancées physiopathologiques récentes et nous discutons de la contribution des plaquettes et du CD154 dans les atteintes microcirculatoires et les défaillances multi-viscérales dans le sepsis. Nous nous sommes intéressés au rôle pro-inflammatoire du CD154 en conditions d’hypoxie au niveau de l’épithélium tubulaire rénal. Des données récentes soulignent en effet l’importance de l’hypoxie dans la réaction inflammatoire. Le contrôle de la production d’interleukine (IL)-6, une cytokine centrale de la réponse inflammatoire, par le CD154 a été étudié dans un modèle de culture de cellules épithéliales tubulaires (CET) rénales. Un modèle murin d’IRA par ischémie/reperfusion rénale a également été mis au point et appliqué à des souris déficientes en CD154 et CD40. Nos travaux révèlent que le CD154 induit fortement la sécrétion d’IL-6 par les CET en conditions d’hypoxie et que les souris déficientes en CD154 régénèrent plus rapidement leur épithélium tubulaire après ischémie/reperfusion rénale. Ces résultats pourraient ouvrir la voie à de potentielles pistes thérapeutiques pour la prise en charge des IRA d’origine septique. / Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with increased morbidity and mortality. Sepsis is the most common cause of AKI. The understanding of sepsis pathophysiology and its complications has progressed significantly in recent years but has not yet been translated into significant therapeutic advances in clinical practice. The traditional paradigm that sepsis-induced AKI is linked to renal hypoperfusion has been challenged by recent evidences showing that renal blood flow is not universally impaired during sepsis,and that AKI can develop in the presence of normal or even increased renal bloodflow. Sepsis is characterized by profound alterations of the immune response and adisproportionate inflammatory response. Inflammation and microcirculatorydysfunction are now considered as fundamental pathophysiological mechanisms atthe origin of renal injuries. Beyond haemostasis, the contribution of platelets ininflammation, tissue integrity and defence against infections has considerablywidened the spectrum of their role and made them potential physiopathologicalactors in sepsis. Platelets fulfil most of these functions through the expression ofmembrane-bound or soluble mediators. Among them, CD154 holds a peculiarposition, as platelets represent a major source of CD154 and as CD154 is a centralregulator of inflammation. Here, we provide an overview of these recentpathophysiological advances and discuss the platelets and CD154 contribution tomicrocirculatory alterations in multi-organ dysfunction in sepsis. We investigated thepro-inflammatory role of CD154 under hypoxic conditions in the renal tubularepithelium as recent data highlight the importance of hypoxia in the inflammatoryreaction. We studied the control of interleukin (IL)-6 production, a key cytokineinvolved in inflammation, by CD154 in oxygen deprivation conditions using a kidneytubular epithelial (TEC) cell line model. We also studied a murine model of kidneyinjury after ischemia/reperfusion, a model that was applied in CD154 and CD40deficient mice. We found that CD154 is a potent inducer of IL-6 secretion by TEC inhypoxia and that CD154-deficient mice regenerate earlier the tubular epithelium afterischemia/reperfusion injury. These findings may provide potential avenues for septicAKI management and therapy.

La mégacaryocytopoïèse est le processus de différenciation des cellules souches hématopoïétiques en mégacaryocytes produisant les plaquettes sanguines. Des données de transcriptome indiquent la présence des récepteurs aux interleukines (IL) -10, -17A et -21 sur les mégacaryocytes. Mon travail montre que les IL-10 et -17 n’ont pas d’effet apparent sur la prolifération et la différenciation in vitro des mégacaryocytes à partir des progéniteurs hématopoïétiques humains CD34+. Cependant, l’IL-21 augmente la prolifération des progéniteurs mégacaryocytaires dérivés de ces cellules et sans modifier leur différenciation. Les mégacaryocytes de la moelle osseuse humaine expriment aussi le récepteur à l’IL-21, ce qui suggère un rôle direct de l’IL-21 sur la mégacaryocytopoïèse in vivo. De façon concordante, l’expression de l’IL-21 chez la souris stimule la mégacaryocytopoïèse ainsi que la production des plaquettes, mais augmente la clairance des plaquettes par les macrophages. Ces travaux suggèrent que durant les réponses immunitaires, l’expression de l’IL-21 par les lymphocytes T CD4+ activés module l’homéostasie des plaquettes sanguines. / Megakaryocytopoiesis is the process by which hematopoietic stem cells give rise to megakaryocytes which in turn produce blood platelets. Transcriptional studies indicate the presence of interleukin (IL) -10, -17 and -21 receptors on megakaryocytes. This work shows that IL-10 and -17 have no apparent effect on in vitro proliferation and differentiation of megakaryocytes derived from human CD34+ hematopoietic progenitors. However, IL-21 increases the proliferation of megakaryocyte progenitors derived from these CD34+ cells without modifying their differentiation. Moreover, human bone marrow megakaryocytes express IL-21 receptor, suggesting a direct role of IL-21 on megakaryocytopoiesis in vivo. Concordantly, IL-21 expression in mice stimulates megakaryocytopoiesis and platelet production, but increases platelet clearance by macrophages. This work suggest that during immune responses, the expression of IL-21 by activated CD4+ T lymphocytes modulate blood platelet homeostasis.

Sporotrichosis is a cosmopolitan mycosis whose etiological agent is the fungus Sporothrix schenckii, affecting humans and several animals, especially felines. The most frequent form of the mycosis is the lymphocutaneous. The disseminated forms are less frequent and have been described mainly among immunocompromised patients. The Sporothrix schenckii is accidentally introduced in the human or animal body through wounds caused by thorns, wood splinters or any sharp object contaminated by the fungus. Cat as domestic animals may transmit sporotrichosis to humans through scratches and/or bite due to the large amount of yeast found in the lesions and the possibility of these animals carry the agent under nails and oral cavity. The infection activates an immune and inflammatory response, modulated by purinergic signaling, which involves extracellular purines, purinergic receptors and ectoenzymes. The purines are an important class of extracellular molecules which by interacting with specific receptors on the cell surface signaling pathways that mediate many important biological effects. The signaling induced by these molecules is directly correlated to the activity of enzymes on the surface of the cell membrane, the ectoenzymes. The objective of this study was to evaluate the influence of sporotrichosis in the activity of ectoenzymes in platelets and its thrombus regulatory process. For this study, male Wistar rats were divided into 3 groups, where each group consisted of 10 animals (control, infected with clinical isolate of systemic action of Sporothrix schenckii and infected with clinical isolate of lymphocutaneous action of Sporothrix schenckii). After 28 days, blood was collected and the activity of certain ectoenzymes in platelets as well as the profile of platelet aggregation. The only change was observed in NTPDase activity, with an increase in ATP and ADP hydrolysis in platelets from rats experimentally infected with clinical isolate of lymphocutaneous action of Sporothrix schenckii. This change may be contributing to the reduction of extracellular ADP, which is responsible for the uncontrolled activation of platelets and trigger thrombogenic processes. Thus, it could also be protecting the body against the formation of thrombi and nodular lesions present in sporotrichosis. Then it is suggested that the purinergic system is involved in hemostasis and tromborregulação during infection by Sporothrix schenckii, avoiding excessive platelet aggregation and therefore the formation of thrombus. / A esporotricose é uma micose cosmopolita que tem como agente etiológico o fungo Sporothrix schenckii, que afeta o homem e várias espécies de animais, especialmente, os felinos. A forma linfocutânea da micose é a mais freqüente, já as formas disseminadas, são menos freqüentes e têm sido descritas principalmente entre pacientes imunocomprometidos. O Sporothrix schenckii é introduzido acidentalmente no organismo humano ou animal através de ferimentos causados por espinhos, farpas de madeira ou por qualquer objeto pontiagudo contaminado pelo fungo. Como o felino é um animal doméstico, pode transmitir a esporotricose ao homem, através da arranhadura e/ou mordedura, devido à grande quantidade de leveduras encontradas nas lesões e a possibilidade destes animais carrearem o agente nas unhas e cavidade oral. A infecção ativa uma resposta imune e inflamatória, modulada pela sinalização purinérgica, a qual envolve purinas extracelulares, receptores purinérgicos e ectoenzimas. As purinas representam uma importante classe de moléculas extracelulares, que ao interagirem com receptores específicos na superfície celular, sinalizam vias de grande importância que medeiam diversos efeitos biológicos. A sinalização induzida por estas moléculas correlaciona-se diretamente à atividade de enzimas localizadas na superfície da membrana celular, as ectoenzimas. O objetivo deste trabalho foi avaliar a influência da esporotricose na atividade de ectoenzimas em plaquetas e seus processos tromborregulatórios. Para este estudo, foram utilizados ratos Wistar machos divididos em 3 grupos (controle, infectado com isolado clínico de ação sistêmica de Sporothrix schenckii e infectado com isolado clínico de ação linfocutânea de Sporothrix schenckii), onde cada grupo foi constituído por 10 animais. Após 28 dias, foi coletado o sangue e determinadas as atividades das ectoenzimas em plaquetas, assim como o perfil de agregação plaquetária. A única alteração observada foi na atividade da NTPDase, com aumento na hidrólise de ATP e ADP nas plaquetas dos ratos experimentalmente infectados com o isolado clínico de ação linfocutânea de S. schenckii. Esta alteração pode estar contribuindo para a redução de ADP extracelular, o qual é responsável pela ativação descontrolada de plaquetas e desencadeamento de processos trombogênicos. Desta forma, poderia também estar protegendo o organismo contra a formação de trombos e lesões nodulares, presentes na esporotricose. Sugere-se então, que o sistema purinérgico está envolvido no processo de hemostasia e tromborregulação durante a infecção por Sporothrix schenckii, evitando a excessiva agregação plaquetária e consequentemente, a formação de trombos.

Mise en contexte : Le syndrome du X fragile (SXF) résulte de la perte d’expression de la protéine FMRP. L’absence de FMRP est responsable d’une série de perturbations signalétiques, notamment une hyperactivation de la voie MAPK/ERK. La lovastatine, un médicament hypocholestérolémiant, possède comme effet pléiotrope la capacité d’inhiber la voie MAPK/ERK et a permis de corriger certains phénotypes pathologiques clés du modèle murin du SXF, mettant en lumière son potentiel thérapeutique chez l’humain. Ainsi, nous avons réalisé en 2013 une étude ouverte visant à étudier l’effet d’un traitement de 12 semaines à la lovastatine sur les troubles cognitifs et comportementaux des enfants et des adultes avec SXF. La plupart des individus ont présenté des améliorations cognitives et comportementales, telles qu’évaluées par les échelles cliniques Vineland-II Adaptive Behavior Scale (VABS-II) et Aberrant Behavior Checklist-Community (ABC-C), respectivement. Ces échelles remplies par les tuteurs et les soignants sont toutefois évaluateur-dépendantes et sujettes à l’effet expérimentateur. Ces variables parasites, qui s’ajoutent à l’effet placebo inhérent à la conception ouverte de l’essai thérapeutique, peuvent ainsi avoir faussé l’évaluation de la réponse au traitement. Nous avons donc étudié si les cascades signalétiques des plaquettes sanguines peuvent être utilisées comme biomarqueurs objectifs pour surveiller la réponse au traitement. Méthode : Des échantillons sanguins des 15 individus SXF ayant participé à l’essai clinique ont été recueillis au début et à la fin de l’étude afin d’évaluer par Western Blot l’effet in vivo de la lovastatine sur l’activité de ERK dans les plaquettes sanguines, et ainsi de pouvoir corréler les réponses biologiques et cliniques. L’état de phosphorylation de ERK a également été étudié dans les plaquettes d’une cohorte contrôle. Résultats : Nos résultats démontrent une augmentation significative de près du double de la phosphorylation basale de ERK dans les plaquettes sanguines des individus avec SXF en comparaison avec les sujets contrôles (p=0,002). De plus, nous avons observé une normalisation de la phosphorylation de ERK chez 13 des 15 individus SXF après le traitement de 12 semaines à la lovastatine (p=0,007). Notre étude fournit ainsi les premières évidences d’un effet bénéfique de la lovastatine dans le SXF chez l’humain. Nous avons également démontré que les changements de la phosphorylation de ERK étaient partiellement corrélés à la réponse clinique, et ce, pour le score total et les scores des sous-domaines ‘socialisation’ et ‘compétences de la vie quotidienne’ de l’échelle VABS-II (p=0,003). Conclusion : De façon générale, ces résultats suggèrent que les cascades signalétiques plaquettaires peuvent être utilisées comme biomarqueurs pour évaluer de façon objective la réponse au traitement lors de futurs essais thérapeutiques. / Abstract: Background: Fragile X syndrome (FXS) results from loss of FMRP expression, which causes several signaling dysregulations, including the hyperactivation of the Mitogen-activated protein kinase (MAPK)/Extracellular signal-regulated kinase (ERK) pathway. Lovastatin, a drug used for the treatment of hypercholesterolemia, pleiotropically inhibits the MAPK/ERK cascade and has successfully corrected key pathological phenotypes in the FXS mouse model, underscoring its ‘disease-modifying’ potential. Thereby, we conducted in 2013 the first open-label clinical trial investigating the effect of a 12-week lovastatin regimen on cognitive and behavioral disabilities in FXS. Most individuals presented subtle positive cognitive changes as assessed by the Vineland-II Adaptive Behavior Scale (VABS-II) as well as behavior improvements using the widely used scale Aberrant Behavior Checklist-Community (ABC-C). The latter two scales are filled up by caregivers making them rater-dependent and prone to observer-expectancy effect. This might result in a placebo effect which is inherent to the open-label design of the trial. We therefore investigated whether blood platelets’ signaling cascades may be used as objective biomarkers to monitor treatment response. Methods: Blood samples were gathered from 15 FXS individuals during the trial in order to evaluate by quantitative Western Blotting the in vivo effect of lovastatin on ERK activity in blood platelets, and to correlate clinical and biological responses. The basal phosphorylation status of ERK was also assessed in platelets from a control cohort. Results: Our results showed a more than two-fold significant increase in FXS blood platelet basal ERK phosphorylation as compared to controls (p=0.002). Of note, we found that this hyperphosphorylation was normalized following the 12-week lovastatin trial (p=0.007) in 13 of the 15 FXS individuals enrolled in the trial. This represents the first evidence for a beneficial effect of lovastatin in human FXS. The extent of changes in ERK phosphorylation was also found to partly correlate with the clinical response scales’ scores, especially for the VABS-II. Indeed, the composite total score and the ‘daily living skills’ as well as the ‘socialization’ subscales scores of the VABS-II were correlated with the biological response (p=0.03). In comparison, no correlation was observed with the ABC-C scale. Conclusion: Broadly, these results suggest that platelets’ signaling cascades could be used as biomarkers to objectively assess treatment response during future clinical trials.

L’élastine est la protéine de la matrice extracellulaire (MEC) responsable des propriétés de résilience et d'élasticité des tissus élastiques. Durant le vieillissement, les protéines de la MEC vasculaire sont exposées à des réactions délétères qui altèrent leurs propriétés structurales et fonctionnelles. Une des caractéristiques principales des protéines de la MEC est leur longue demi-vie, associée à un renouvellement très lent, comme pour l'élastine. Ainsi, tout dommage survenant sur l'élastine est essentiellement irréparable. La fragmentation des fibres élastiques génère des peptides d’élastine (EDP) bioactifs capables de modifier le comportement des cellules environnantes en se liant au complexe récepteur de l’élastine (CRE), composé de trois sous-unités dont la neuraminidase-1 (Neu-1), sous-unité catalytique du CRE. Cette thèse a consisté en l'étude, chez la souris, du rôle des EDP dans le développement du diabète de type 2 et dans la thrombose, deux pathologies vasculaires liées à l'âge, et s'est également focalisée sur la sous-unité Neu-1 du CRE. Dans un premier temps, nous avons montré que les EDP favorisent le développement d’une insulinorésistance et d’un diabète de type 2. Cet effet implique l'interaction de Neu-1 avec la sous-unité β du récepteur à l'insuline qui diminue son niveau de sialylation altérant ses voies de signalisation. Dans un second temps, nous avons identifié un mécanisme d'action des EDP à deux niveaux (matriciel et plaquettaire) et mis en évidence la présence d'un CRE fonctionnel dans les plaquettes régulant la thrombose. Enfin, nous avons étudié la topologie membranaire de Neu-1 par différentes approches technologiques et identifié un domaine transmembranaire potentiel jouant un rôle important pour sa dimérisation et son activité sialidase. En conclusion, les EDP sont des acteurs clefs du remodelage vasculaire physiopathologique et des pathologies vasculaires associées et de contribuer à faire avancer nos connaissances sur l'organisation de Neu-1 à la membrane plasmique. / Elastin is the extracellular matrix (ECM) protein responsible for resilience and elasticity of tissues such as arteries. During ageing, vascular ECM proteins are subjected to deleterious reactions that alter their structural and functional properties (addition reactions, proteolysis). One of the main features of ECM proteins is their long half-life, associated with a low, or even, inexistent turnover. This is the case for elastin with an estimated half-life at 70 years. Therefore, any damage occurring on elastin will be mostly irreparable. Fragmentation of elastic fibers produces bioactive elastin-derived peptides (EDP) able to modify the behavior of surrounding cells by binding to the elastin receptor complex (ERC). This receptor is composed of three subunits, among which neuraminidase-1 (Neu-1) is the catalytic subunit. The aim of this thesis was to study, in mice, the role of EDP in the development of type 2 diabetes and in thrombosis, two age-related vascular diseases, and to focus on the Neu-1 subunit of the ERC. In a first time, we have shown that EDP promote the development of insulin resistance and type 2 diabetes. This effect involves Neu-1 interaction with the β subunit of the insulin receptor and leads to its reduced sialylation level and signaling. In a second time, we have demonstrated that EDP are regulators of thrombosis. We identified a two-level mechanism (matrix and platelet) and the presence of a functional ERC in platelets. Finally, we have studied the membrane topology of Neu-1 by different biophysical, biochemical and molecular biology approaches, and identified a potential transmembrane domain involved in the dimerization and sialidase activity of Neu-1. In conclusion, this thesis consolidates the concept that EDP are crucial actors of pathophysiological vascular remodeling and related vascular diseases, and expands our knowledge on the plasma membrane organization of Neu-1.

L’étude de l’identification des défauts moléculaires mis jeu dans les pathologies héréditaires plaquettaires est d’un apport considérable pour améliorer la compréhension des mécanismes physiologiques. Durant ma thèse, j’ai étudié les plaquettes d’individus appartenant à deux familles distinctes souffrant de dysfonctions plaquettaires à l’origine d’hémorragies sévères. Par séquençage entier des exons, nous avons identifié pour la première famille une mutation du gène RASGRP2 à l’origine de la substitution Gβ48W empêchant l’activation de CalDAG-GEFI. Les plaquettes des individus porteurs de la mutation à l’état homozygote ont une capacité réduite à activer Rap1 et l’intégrine αIIbß3 en réponse à de faibles doses d'agonistes. La présence d'un allèle non muté (hétérozygotie) est suffisante pour prévenir lessaignements mais ne permet pas de rétablir totalement une fonction plaquettaire normale. La deuxième famille est porteuse d’une mutation du gène FERMT3 (pN54RfsX142) conduisant à une absence complète de kindline-3. Les plaquettes homozygotes pour cette mutation sont incapables d’activer l’intégrine αIIbß3. Elles forment des filopodes et desnodules d’actine mais ne peuvent étendre des lamellipodes même en présence de Mn2+. La kindline-3 s’est révélée essentielle à la régulation de l’activité de Cdc4β et au réarrangement au cytosquelette d'actine lors de la signalisation «outside-in» de l’intégrineαIIbß3. Seule la kindline-3 a jusqu’ici été impliquée dans l'activation des intégrinesplaquettaires. Nous mettons en évidence la présence de kindline-2 dans les plaquettes et les mégacaryocytes humains. Des localisations différentes ont été mises en évidence pour ces deux kindlines. Dans le mégacaryocyte la kindline-2 se situe dans les zones d’adhérence focales et s’associe préférentiellement avec les intégrines ß3. Dans les plaquettes, seule la kindline-3 est présente dans nodules d’actine. Ces résultats sont en faveur de rôles non redondants des kindlines-2 et -γ et d’une implication potentielle de la kindline-2 dans la mégacaryopoïèse. / Inherited platelet disorders are rare diseases that give rise to severe bleeding when platelets fail to fulfill their hemostatic function upon vessel injury. Identifying the molecular mechanisms involved brings important insight into platelet pathophysiology. During my PhD, I studied platelets isolated from members of two families suffering severe bleedings among those one had no established diagnosis. In the first family, using whole exome sequencing, we identified a RASGRP2 mutation causing a G248W substitution leaving CalDAG-GEFI inactive. Platelets from individualscarrying the mutation exhibit a reduced ability to activate Rap1 and to perform proper Inherited platelet disorders are rare diseases that give rise to severe bleeding when platelets fail to fulfill their hemostatic function upon vessel injury. Identifying the molecular mechanisms involved brings important insight into platelet pathophysiology. During my PhD, I studied platelets isolated from members of two families suffering severe bleedings among those one had no established diagnosis. In the first family, using whole exome sequencing, we identified a RASGRP2 mutation causing a G248W substitution leaving CalDAG-GEFI inactive. Platelets from individuals carrying the mutation exhibit a reduced ability to activate Rap1 and to perform proper αIIbß3 integrin inside-out signaling in response to low doses agonists. The presence of a single normal allele is sufficient to prevent bleeding but does not allow normal platelet function. integrin inside-out signaling in response to low doses agonists. The presence of a single normal allele is sufficient to prevent bleeding but does not allow normal platelet function. Members of the second family carry a FERMT3 mutation leading to a completekindlin-3 deficiency (pN54RfsX142). Platelets from the homozygous patient are unable to perform proper integrin αIIbß3 activation. We now observe that kindlin-3 deficient platelets form filipodia and actin nodules but are unable to extend lamellipodia even in presence of Mn2+. We demonstrate that kindlin-3 is essential for Cdc42 activity regulation and actincytoskeleton remodeling during αIIbß3 integrin outside-in signaling To date, only the kindlin-3 has been involved in integrin activation. We show that kindlin-2 is present in human platelets and megakaryocytes. Both kindlins exhibit distinctlocalizations. In megakaryocytes, kindlin-2 specifically localizes within focal adhesion and associates preferentially with ß3 integrins. In platelets, unlike kindline-2, kindline-3 is located in actin nodule. All together these data argue in favor of specific roles played by each kindlins and a possible implication of kindlin-2 in megakaryocytopoiesis.

In an effort to help understand the mechanical properties of human platelets, their deformations were measured using micropipette experiments over an aspiration pressure range of 1-5 cmH2O, in steps of 1 cmH2O. The experiments confirmed the previously reported linear relationship between deformation and pressure. The experimental results were used to determine the material constants of a thin-axisymmetric shell model based on a strain-energy constitutive relation to describe the platelet deformations under aspiration. The model was successful in capturing the experimental deformations. It also suggested that the mechanical properties of human platelets are not significantly influenced by their volumes, but do vary depending on the platelets’ undeformed shape ratios. In addition, the model suggested that platelet membrane ruptures due to micropipette aspiration may be strain-related. The limitations of the experimental methods arising from direct contact with reactive cells such as platelets are highlighted, prompting the need for developing new methods which will not require the use of inhibition agents that alter the platelets’ mechanical properties. Afin d’approfondir les connaissances des propriétés mécaniques des plaquettes humaines, leurs déformations ont été mesurées lors d’expériences avec des micropipettes pour des pressions d’aspiration de 1-5 cmH2O, par intervalles de 1 cmH2O. Les expériences ont confirmé la relation linéaire entre les déformations et la pression d’aspiration telle que précédemment publié. Les données expérimentales ont été utilisées pour déterminer les constantes matérielles d’un modèle de membrane mince axisymétrique basé sur une loi de comportement caractérisant l’énergie de déformation. Le modèle simule bien les déformations des plaquettes sous aspiration; il suggère également que les propriétés mécaniques des plaquettes humaines ne sont pas influencées significativement leur volume, mais varient en fonction de leurs formes avant déformation. De plus, le modèle suggère que les ruptures de la membrane des plaquettes sous aspiration seraient reliées aux déformations. Les limites des méthodes expérimentales utilisées, du fait du contact direct avec des cellules aussi réactives que les plaquettes sont soulignées, et mettent l’emphase sur le besoin de mettre au point de nouvelles méthodes ne requérant pas d’agents d’inhibitions qui altèrent les propriétés mécaniques des plaquettes.

Orientadores: Joyce Maria Annichino-Bizzacchi, Nicola Amanda Conran Zorzetto / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-22T04:29:01Z (GMT). No. of bitstreams: 1 Zapponi_KiaraCristinaSenger_M.pdf: 3766938 bytes, checksum: e4531f39f9f53ff883ad33f684d56647 (MD5) Previous issue date: 2012 / Resumo: Tromboembolismo venoso (TEV) é uma doença multifatorial que afeta 1-3:1000 indivíduos mundialmente. A formação do trombo venoso na superfície endotelial é um processo multicelular, de estrutura laminar composta por camadas de plaquetas, leucócitos, eritrócitos e fibrina, originando uma resposta inflamatória loco-regional. A relação entre inflamação e coagulação é bidirecional. e tem sido principalmente avaliada através de interações de proteínas entre citocinas próinflamatórias e elementos da cascata de coagulação. As células inflamatórias tais como neutrófilos, não foram previamente correlacionadas com os processos trombóticos ou pró-coagulantes. Objetivo: Avaliar as propriedades adesivas de neutrófilos, eritrócitos e plaquetas, assim como a expressão das moléculas de adesão de superfície dos neutrófilos em pacientes com TEV, correlacionando-os com marcadores sistêmicos da resposta inflamatória, presença de trombo residual e D-dímero aumentado. Pacientes e Métodos: Foram incluídos neste estudo 10 pacientes com TEV agudo atendidos no Hospital de Clínicas da Unicamp (HCUNICAMP), 30 pacientes com TEV crônico (1 a 6 anos após o evento agudo), atendidos no Hemocentro de Campinas-UNICAMP, e controles normais pareados aos pacientes por idade, gênero e etnia. A adesão de neutrófilos, eritrócitos e plaquetas foram determinados através de ensaio estático usando fibronectina (FN) e fibrinogênio (FB) como ligantes. A expressão das moléculas de adesão dos neutrófilos (CD11a, CD11b, CD18) foi avaliada por citometria de fluxo. Os níveis dos marcadores inflamatórios (IL-6, IL-8, TNF-_ e PCR) foram avaliados por ELISA e nefelometria. O trombo residual (TR) por ultrassom com Doppler e o Dímero-D (DD) por método coagulométrico. Resultados: A adesão de plaquetas ao fibrinogênio com e sem estímulo de trombina em pacientes dos grupos agudo e crônico foi semelhante ao observado nos controles normais. Da mesma forma, não houve diferença da adesão de eritrócitos à fibronectina nesses mesmos grupos analisados. No subgrupo de pacientes com alto risco de recorrência de TEV definido pela presença de altos níveis de D-dímero (>0,55mg/L) e trombo residual observou-se um aumento significativo da adesão de neutrófilos em relação aos controles (24.68% vs 19.07%, P<0.05). A atividade inflamatória também estava aumentada neste subgrupo em comparação aos outros pacientes, demonstrada pelo aumento significativo dos níveis séricos de IL-6, IL-8, TNF-_ e PCR (2.08pg/mL VS 0.90pg/mL, P=0.01; 28.72pg/mL vs 16.46pg/mL, P=0.02; 4.50pg/mL vs 2.11pg/mL, P=0.04; 0.35 pg/mL vs 0.14 pg/mL, P=0.09, respectivamente). Houve uma correlação das propriedades adesivas de neutrófilos com IL-6 (r=0.3815 e P=0.0375), e D-dímero (r=0.3831 e P=0.0367). A quantificação das proteínas de superfície (CD11a, CD11b e CD18) de neutrófilos não foi diferente entre os grupos analisados. Conclusão: Nossos resultados sugerem que pacientes com TEV não apresentam aumento das propriedades adesivas de plaquetas e eritrócitos. Entretanto, as propriedades adesivas dos neutrófilos foram aumentadas em pacientes com D-dímero aumentado e presença de trombo residual, independente da expressão quantitativa das proteínas de superfície em sua membrana. A hipótese para este aumento pode ser devido as alterações na afinidade das moléculas de adesão de superfície aos seus ligantes, como consequência do processo inflamatório associado com a hipercoagulabilidade que é característica desta doença / Abstract: Venous Thromboembolism (VTE) is a multifactorial disease that affects 1-3:1000 individuals worldwide. The venous thrombus develops via a multicellular process on the surface of the endothelium and presents a laminar structure comprised of layers of platelets, leukocytes, erythrocytes and fibrin. The relationship between inflammation and coagulation is bidirectional, and has been mainly evaluated through protein interactions between pro-inflammatory cytokines and elements of the coagulation cascade. Inflammatory cells such as neutrophils, have not been previously correlated with thrombotic or procoagulant processes. Objective: To evaluate the adhesive properties of neutrophils, erythrocytes and platelets, as well as the expression of neutrophil adhesion molecules in patients with VTE, correlating them with markers of the systemic inflammatory response, and with the presence of residual vein obstruction (RVO) and higher D-dimer (DD). Patients and Methods: Study group consisted of 30 chronic VTE patients (1-6 years after the acute episode) followed in our outpatient clinic, and 10 patients with VTE during the acute episode treated at the Hospital of Clinics (HC-UNICAMP) Campinas, as well as age, gender and ethnic background-matched healthy. Adhesive properties of neutrophils, erythrocytes and platelets were determined by a static adhesion assay using ligands such as fibrinogen (FB) and fibronectin (FN). The expression of neutrophils adhesion molecules (CD11a, CD11b, CD18) was evaluated by flow cytometry. Levels of inflammatory markers (IL-6, IL-8, TNF-_, PCR) were evaluated by ELISA and nephelometry. RVO was evaluated by Doppler ultrasound and DD by coagulometric method. Results: No significant difference could be observed in the platelets adhesion (basal: 16.37% vs. 14.59%, p=0.309; and stimulated with thrombin: 33.45% vs. 26.62%, p=0.200) and erythrocytes adhesion (7.28% vs 7.49%, p=0.859) between chronic VTE patients and healthy individuals. Similarly, no statistical differences were observed in the platelets adhesion (basal: 28.36% vs. 21.63%, p=0.109; and stimulated with thrombin: 38.45% vs. 30.15%, p=0.715) and erythrocytes adhesion (6.00% vs 4.62%, p=0.326) in the VTE acute xxii patients when compared to their respective controls. Interestingly, in patients with a higher risk of recurrent VTE (defined by the presence of high levels of DD and RVO), a significant increase in neutrophils adhesion was observed when compared to healthy individuals (24.68% vs. 19.07%, p <0.05). Inflammatory markers (IL-6, IL-8, TNF-_ and CRP) were significantly elevated (2.08pg/mL vs 0.90pg/mL, p=0.01; 28.72pg/mL vs 16.46pg/mL, p=0.02; 4.50pg/mL vs 2.11pg/mL, p=0.04; 0.35 pg/mL vs 0.14 pg/mL, p=0.09, respectively) in this subgroup of patients when compared to the other patients. Adhesive properties of neutrophils were correlated with IL-6 (r= 0.3815 and p= 0.0375) and D-dimer levels (r= 0.3831 and p= 0.0367). Neutrophils adhesion molecules (CD11a, CD11b and CD18) were not altered in any of the groups. Conclusion: Our results suggest that VTE patients do not exhibit increased adhesive properties of platelets and erythrocytes. Neutrophils adhesive properties were increased in patients with higher D-dimer levels and RVO, independently of the expression of neutrophil adhesion molecules. A hypothesis for this increase is alterations in affinity of surface adhesion molecules to their ligands, as a response to inflammatory processes associated with the hypercoagulability demonstrated in this subgroup of patients / Mestrado / Biologia Estrutural, Celular, Molecular e do Desenvolvimento / Mestra em Fisiopatologia Médica

Orientador: Claudio Chrysostomo Werneck / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-27T06:06:14Z (GMT). No. of bitstreams: 1 Pereira_CatherineNatalia_M.pdf: 4403950 bytes, checksum: 7142bd3654bd7f9d99e12cda4d33aeeb (MD5) Previous issue date: 2015 / Resumo: Fibrilina-1 (FBN-1) é um importante componente da rede de microfibrilas da matriz extracelular (MEC). As microfibrilas estão presentes nas fibras elásticas que são responsáveis pela resiliência de tecidos como pulmões, pele e grandes vasos. Mutações no gene da fibrilina-1 estão associadas à Síndrome de Marfan, doença autossômica dominante, caracterizada por uma desordem do tecido conjuntivo. Pacientes com esta Síndrome apresentam anomalias no sistema esquelético e trato cardiovascular. Dados da literatura relacionam a menor quantidade de FBN-1 na MEC com a atividade exacerbada do TGF-? promovendo a quase totalidade das alterações fenotípicas encontradas. Estudos preliminares em nosso laboratório com camundongos que possuem menor quantidade de FBN-1 de um camundongo normal tem demonstrado que necessitam do dobro do tempo para a formação de trombo em um modelo de trombose arterial. As plaquetas tem fundamental importância neste processo, quando são ativadas secretam várias moléculas que determinam a formação dos trombos. Realizamos um estudo comparativo do proteoma de plaquetas e da artéria aorta de camundongos selvagens e deficientes em FBN-1, através da técnica de eletroforese bidimensional (2DE) juntamente com a espectrometria de massas a fim de encontrar diferenças no perfil proteico que justificassem tais sintomas. Diversas proteínas plaquetárias foram encontradas apenas no grupo controle, como endoplasmina, fator de von Willebrand, calpaína, dentre outras; assim como a proteína vinculina foi encontrada apenas no grupo deficiente em FBN-1. Todas as proteínas encontradas podem ser de grande interesse para o esclarecimento a respeito do maior tempo de formação de trombo e os sintomas relacionados à Síndrome de Marfan / Abstract: Fibrillin-1 (FBN-1) is an important microfibril network component of extracellular matrix (ECM). Microfibrils are present in elastic fibers responsible for tissues resiliency, such as lungs, skin and great vessels. Mutations in fibrillin-1 gene are associated with Marfan Syndrome, a dominant autosomal disease characterized by connective tissue disorder. Patients with this syndrome show abnormalities in skeletal system and cardiovascular tract, aorta dilatation and aneurysms. Literature data relate less FBN-1 in the ECM with TGF-? heightened activity, promoting almost all the phenotypic alterations. Preliminary studies in our laboratory demonstrated that mice containing half amount of FBN-1 presented prolonged thrombosis time when compared to wild-type mice submitted to an arterial thrombosis model. Platelets are important in this process, when activated they release several molecules and factors which determine thrombi formation. We conducted a comparative proteome study of platelet and aorta from wild-type against FBN-1 deficient mice by two-dimensional electrophoresis (2DE) coupled with mass spectrometry in order to find some differences in protein profile that could justify such symptoms. Several platelet proteins were found only into control group, as endoplasmin, von Willebrand factor, calpain; as well as vinculin was found only in the FBN-1 deficient group. All proteins found may have great interest for understanding the prolonged thrombus formation time, and symptoms related to Marfan Syndrome / Mestrado / Bioquimica / Mestra em Biologia Funcional e Molecular