Increasing age is the single biggest independent risk factor for cardiovascular disease, which is in turn the leading cause of morbidity and mortality worldwide. Ageing is associated with hypertension and metabolic changes which all increase the risk of the development of cardiovascular disease. In young, healthy individuals, perivascular adipose tissue (PVAT) secretes factors that can influence vascular contractility, exerting a net anti-contractile effect against numerous vasoconstrictors including the thromboxane A2 mimetic U46619 and α1-adrenoceptor phenylephrine. Whilst it is known that dysfunction in PVAT can contribute to obesity-related hypertension, little is known whether similar dysfunction occurs with ageing. In young Wistar rats, wire myography and pharmacological studies showed that the anti-contractile effect of PVAT in the presence of U46619 is dependent on both PVAT-derived nitric oxide and prostaglandins, whereas the anti-contractile effect in the presence of phenylephrine is nitric oxide independent. This finding was supported by Western blot experiments that showed increased phosphorylation of endothelial nitric oxide synthase (eNOS) in PVAT following U46619 incubation, but not phenylephrine. In the Wistar rat model of ageing used, wire myograph studies revealed that the PVAT anti-contractile effect in the presence of phenylephrine is preserved at 24 months of age, but in in the presence of U46619 is lost. Furthermore PVAT from aged animals had a deleterious effect on endothelial function, suggesting changes in its secreted factors. These changes are accompanied by alterations in the expression and activation of key enzymes in the nitric oxide synthesis pathway within the PVAT as measured by Western blot, as well as alterations in cardiometabolic phenotype including hypertension, hyperglycaemia and insulin resistance. Taken together these findings suggest that previously unidentified age-related PVAT dysfunction may contribute to age-related hypertension and thus may provide a potential therapeutic target for future study.

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No. of bitstreams: 1 silva_cpv_dr_rcla.pdf: 3391182 bytes, checksum: 8bfcf2d76191e2dfdab26a4cc2057921 (MD5) Previous issue date: 2018-04-12 / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O sistema nervoso simpático desempenha importante papel no sistema cardiovascular e no metabolismo, sendo que os receptores adrenérgicos do subtipo β3 (β3 –AR) estão amplamente distribuídos em diferentes células, encontrando-se especialmente no tecido cardíaco, musculatura lisa e tecido adiposo. Esses receptores estão relacionados a diversas ações fisiológicas, como relaxamento da musculatura lisa vascular e não vascular, lipólise do tecido adiposo branco e termogênese do tecido adiposo marrom. Por outro lado, a importância dos β3 –AR no tecido adiposo perivascular (PVAT) e regulação do tono vascular não é conhecida. O mirabegron (YM-178) é um agonista β₃-AR seletivo, atualmente desenvolvido por Astellas Pharma Inc., e aprovado desde 2012 pelos EUA, para tratamento de bexiga hiperativa, considerando a ação dos receptores β₃-AR no relaxamento do músculo liso. Contudo não existe nenhum estudo envolvendo o mirabegron nos parâmetros cardiometabólicos plasmáticos e no metabolismo do tecido adiposo e em modelos de obesidade. Objetivos: Analisar os efeitos do tratamento de Mirabegron (Mira), um agonista β₃-AR seletivo, por duas semanas em parâmetros cardiometabólicos e reatividade vascular na presença ou ausência de PVAT de camundongos obesos. Métodos: Camundongos C57BL/6J foram divididos em grupos controle veículo (CTR), controle tratado com Mira (CTR+MIRA), obeso alimentado com dieta hiperlipídica (HFD 12 semanas) tratado com veículo (OB) e obeso tratado com Mira (OB+MIRA). Mira foi administrado por duas semanas (10mg/kg) na forma de gavagem. Curvas concentração-resposta à acetilcolina (ACh 100pM a 30 μM) e serotonina (5HT 1nM a 30μM) foram realizadas em anéis de aorta PVAT+, PVAT-. Foram medidos a temperatura corporal e gasto energético; bem como pressão arterial, frequência cardíaca e tolerçancia ao esforço, além de análises bioquímicas de perfil lipídico, glicemia de jejum, insulina sérica, Glicerol, AGL, TBARS, leptina e TNF-α. Foram calculados o índice HOMA e o índice aterogênico. A histologia hepática e dos depósitos de tecido adiposo foi realizada pela coloração de hematoxilina e eosina. Resultados: O tratamento com Mira (OB+ mira) por duas semanas aumentou o gasto energético (17%) sem alterar a temperatura corporal, redução do peso corporal (7%), gordura epididmal (25%), colesterol total (17%), LDL-C (55%), índice aterogênico (45%), TBARS (20%), TNF-α (48%), Glicerol e AGL (40%), insulina (67%), e índice HOMA (65%) quando comparados ao grupo OB. Os níveis elevados de leptina (1000%) no grupo OB não foram alterados pelo Mira. Como esperado os depósitos de lipídios hepáticos, do TAM e PVAT foram aumentado com a dieta HFD e Mira reverteu parcialmente essa alteração, observados na histologia. Observamos modificação nas gotículas lipídicas tecido adiposo inguinal dos grupos CTR+MIRA e OB+MIRA. Anéis com PVAT+ apresentaram aumento na resposta máxima (Emax) à 5HT (%KCl) em anéis de aorta de OB+MIRA (109±10) comparado aos outros grupos (CTR: 69±9; CTR+MIRA: 77±11; OB: 65±9). Conclusão: Em camundongos obesos, o tratamento com Mira por duas semanas resultou em modificação dos tecidos adiposos marrom e inguinal, aumento do gasto energético, melhora de importantes parâmetros bioquímicos como o perfil lipídico e glicêmico, além de reduzir o marcador de estresse oxidativo TBARS, sem contudo alterar a tolerância ao esforço, pressão arterial e frequência cardíaca. Entretanto, em anéis de aorta PVAT+, o tratamento com Mira resultou em aumento da Emax para 5-HT. / Sympathetic nervous system plays an important role in the cardiovascular system and metabolism. In particular, the β3 subtype adrenergic receptors (β3-AR) are widely distributed in different cells, especially in cardiac tissue, smooth muscle and adipose tissue. These receptors are related to several physiological actions, such as vascular and non-vascular smooth muscle relaxation, lipolysis and thermogenesis. In addition, β3-AR participates in the increasing of the number of mitochondria at specific sites of white adipose tissue, called browning of white adipose tissue. Finally, it is not known whether these receptor subtypes may play a role in regulation of the perivascular adipose tissue (PVAT) vasomotricity. Despite these important actions involving these receptor population, studies involving selective β3-AR agonists on obesity state are scarce. Mirabegron (YM-178) is a selective β₃-AR agonist, currently developed by Astellas Pharma Inc. and approved since 2012 by the USA for overactive bladder treatment, considering the action of β₃-AR receptors on smooth muscle relaxation. Intrestingly, there is no study involving the effects of mirabegron on cardiometabolic parameters, adipose tissue metabolism in obesity models. Objectives: To examine the effects of Mirabegron (Mira) treatment, for two weeks on cardiometabolic parameters and vascular reactivity in the presence or in the absence of PVAT in obese mice. Methods: C57BL / 6J mice were divided into vehicle control (CTR), Mira treated (CTR + MIRA), obese mice fed with hyperlipid diet (HFD 12 weeks) treated with vehicle (OB) and obese treated with Mira (OB + MIRA). Mira was given for two weeks (10mg / kg) as a gavage. Concentration-response curves to Acetylcholine (ACh 100pM at 30μM) and serotonin (5HT 1nM at 30μM) were obtained in PVAT + aorta rings, PVAT-. Body temperature and energy expenditure were measured as well as biochemical parameters: lipid profile, fasting glycemia, serum insulin, glycerol, FFA, TBARS, leptin and TNF-α. HOMA index and atherogenic index were calculated. Hepatic and adipose tissue histology was performed by staining hematoxylin and eosin. Results: Treatment with Mira for two weeks increased energy expenditure (17%), without alteration in body temperature. Reduction is body weight (7%), epididymal fat (25%), total cholesterol (17%), LDL-C (55%), atherogenic index (45%), TBARS %), TNF-α (48%), Glycerol and AGL (40%), insulin (67%) and HOMA index (65%) was seen in OB + MIRA when compared with OB group. The increase in leptin levels (1000%) in OB group was not modified by Mira. In contrast, the increased lipid deposits in hepatic, TAM and PVAT, observed in histology, was partially reversed by Mira. We observed changes in lipid droplets in the inguinal adipose tissue of CTR+MIRA and OB+MIRA groups. Rings with PVAT + showed an increase in the Emax to 5HT (% KCl) in aortic rings of OB + MIRA (109 ± 10) compared with the other groups (CTR: 69 ± 9; 65 ± 9; CTR+MIRA: 77±11; OB: 65±9). Conclusion: In obese mice, treatment with Mira for two weeks resulted in modification of brown and inguinal adipose tissues, an increase in energy expenditure, improvement of biochemical parameters such as lipid profile and glycemia, without any modification in the tolerance to exercise effort, blood pressure and heart rate. On the other hand, in PVAT + aortic rings, Mira treatment resulted in increased in Emax to 5HT.

Perivascular adipose tissue (PVAT) and vascular endothelial cells both have important structural and functional roles in blood vessels and are the focus of this doctoral thesis. Firstly, PVAT has been rediscovered as an endocrine organ, releasing vasorelaxing substances. Secondly, the endothelial monolayer functions as an important barrier, the role of which is to restrict the transfer of molecules or even blood-borne cells between the lumen of the blood vessel and the surrounding tissue. In my main study, the presence of PVAT caused 'anti-contractile' effects, which were reversed by nitric oxide synthase (NOS) inhibition in rat mesenteric arteries and were lost in adiponectin-knockout mice. The β3 adrenoceptor agonist CL-316,243 increased PVAT-dependent anti-contractile effects and caused myocyte hyperpolarisation. Hyperpolarisation to CL-316,243 could be mimicked by the adipokine, adiponectin, and by the 5'AMP kinase (AMPK) activator, A-769662. In addition, the AMPK inhibitor, dorsomorphin, and the selective BKCa channel blocker, iberiotoxin, each blocked hyperpolarisations to CL-316,243, adiponectin and A-769662. The anti-contractile effects of CL-316,243 could also be mimicked by A-769662 but were not blocked by dorsomorphin. Moreover CL-316,243 still had anti-contractile effects in adiponectin-knockout mice. However, inhibiting the production of both NO and hydrogen peroxide reduced anti-contractile effects of CL-316,243. In obese Sprague Dawley rats both the hyperpolarising and the anti-contractile effects to CL-316,243 were impaired, while hyperpolarisation to A-769662 were unchanged. Western blots revealed that NOS, a possible downstream target of AMPK, was phosphorylated in PVAT control samples, a form which was decreased in PVAT from obese rats. These results collectively indicate that the anti-contractile and hyperpolarising effects observed following stimulation with CL-316,243 are due to activation of different PVAT-dependent pathways, both of which probably contribute to vasodilatation in blood vessels. Understanding these pathways is crucial for the development of improved treatments for obesity and hypertension. During my work at Novartis, I found that activation of sphingosine-1-receptors type 1 (S1P1) with the activator FTY720 (Fingolimod, Novartis; used in multiple sclerosis treatment) caused closure of the endothelial barrier in human umbilical vein cells. This effect could be mimicked with a recombinant peptide of nectin, an adherens junction protein. The novel S1P1 antagonists 'A1' and 'A2' (Novartis) inhibited the effect of FTY720, but not those of nectin. The discovery of nectin as a potential barrier closure modulator might contribute to the development of additional treatments for use in multiple sclerosis.