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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
121

Modalités de régulation d’ERα36 et leurs conséquences sur la physiopathologie de la glande mammaire / Modalities of ERα36 regulation and their consequences on the pathophysiology of the mammary gland

Thiebaut, Charlène 30 September 2019 (has links)
Les récepteurs nucléaires aux œstrogènes, ERα66 et ERβ1, sont les principaux médiateurs des effets des œstrogènes. Ces hormones régulent le développement physiologique de la glande mammaire mais participent aussi à la progression du cancer sein. L’expression d’ERα66 est d’ailleurs utilisée dans la classification moléculaire des tumeurs mammaires afin d’orienter la stratégie thérapeutique. Depuis son clonage, le variant des récepteurs alpha aux œstrogènes, ERα36, a été principalement décrit dans la littérature pour son rôle dans la progression des tumeurs mammaires et dans l’acquisition de résistances aux anti-œstrogènes comme le Tamoxifène. Si une forte expression d’ERα36 dans les cellules cancéreuses mammaires apparaît nettement comme un facteur de mauvais pronostic, peu de données sont disponibles concernant son rôle dans le développement de la glande mammaire saine. C’est pourquoi le premier objectif de ce travail était de déterminer le rôle d’ERα36 dans le développement physiologique de cette glande. Grâce à une approche pluridisciplinaire, incluant des études in vivo sur un modèle de souris transgéniques MMTV-ERα36 et des études in vitro et in silico sur des cellules épithéliales mammaires immortalisées, nous avons montré que l’expression d’ERα36 perturbe le phénotype des cellules épithéliales mammaires et conduit à l’apparition d’altérations structurales des canaux mammaires à l’âge adulte. De plus, nous avons mis en évidence que les alkylphénols, qui sont des perturbateurs endocriniens œstrogèno-mimétiques, stimulent l’expression endogène de ce variant dans les cellules MCF-10A et augmentent leurs capacités migratoires sans pour autant amplifier les effets d’ERα36 sur l’histologie des canaux mammaires. En parallèle, afin de mieux comprendre l’implication d’ERα36 au moment de l’initiation et de la progression tumorale, nous avons étudié les modalités de régulation de l’expression de ce variant dans les cellules cancéreuses mammaires. Les résultats obtenus indiquent que l’expression d’ERα36 est positivement corrélée au statut de méthylation de sa région promotrice et que l’ARNm codant ce variant est la cible d’hsa-miR136-5p. Enfin, le dernier objectif de ce travail était de développer une approche visant à identifier in silico de nouveaux partenaires d’ERα36. L’ensemble de ce travail s’inscrit dans une démarche de raffinement de la classification moléculaire actuelle des tumeurs mammaires en y ajoutant une composante associée à l’expression d’ERα36. / The estrogen nuclear receptors, represented by the canonical forms ERα66 and ERβ1, are the main mediators of the estrogenic effects in mammals. These hormones, which regulate the physiological development of the mammary gland, participate in the initiation and progression of breast cancer. In fact, ERα66 expression is a key molecular classifier of breast tumors used in order to guide the therapeutic strategies toward hormonotherapy. However, in 30% of cases, therapeutic failures are observed, which highlights the importance of identifying new biomarkers. The estrogen receptor variant, ERα36, has been cloned in 2005 and mainly described in the literature to be involved in the progression of mammary tumors and in the acquired resistance to anti-estrogen drugs, such as Tamoxifen. Even if a high expression of ERα36 in breast cancer cells appears to be associated with a poor prognosis, few data are available concerning its role in the normal development of the mammary gland. Therefore, the aim of this work was to determine the role of ERα36 in the physiological development of the mammary gland. Thanks to a multidisciplinary approach, that combines in vivo studies on MMTV-ERα36 transgenic mice, and in vitro and in silico studies on immortalized normal epithelial mammary cells (MCF-10A), we showed that ERα36 expression is sufficient to disturb the mammary epithelial cells phenotype, leading to the emergence of structural alterations of mammary ducts at adulthood. Moreover, we showed that exposure to the estrogen mimicking compounds alkylphenols stimulates the endogenous expression of this variant in MCF-10A cells, and increases their migratory ability. Then, in order to get a better understanding of ERα36 contribution to tumor initiation and/or progression, we studied classical and epigenetic regulation of this variant expression in breast cancer cells. Our results show that ERα36 expression is positively correlated with the methylation status of its promoter region, and that the ERα36 mRNA is the target of the microRNA, has-miR-136-5p. Finally, the last aim of this work was to develop a bioinformatic approach in order to study the ERα36 partners. To summarize, all of this work falls within a need of the current breast tumor molecular classification refinement by adding a component related with ERα36 expression.
122

Exploration transcriptomique et logique de la voie TLR4 dans le contexte physiopathologique du sepsis / Transcriptomic and logic exploration of the TLR4 signaling pathway in the pathophysiology context of sepsis

Monteiro Sousa, Claudio 29 June 2016 (has links)
Le sepsis est un syndrome observé chez des patients associant une infection documentée (microbiologiquement ou cliniquement suspectée) à une réponse inflammatoire systémique (Systemic Inflammatory Response Syndrome : SIRS).Celui-ci peut évoluer vers un sepsis sévère s'il est associé à la défaillance d'un ou de plusieurs organes. Le choc septique est l'association d'un état septique grave et d'une défaillance hémodynamique caractérisée par une chute aiguë de la pression artérielle ne pouvant pas être corrigée par une procédure standard de remplissage vasculaire. Les syndromes septiques sont aujourd'hui la première cause de mortalité en unités de réanimation. Cette mortalité élevée, en particulier pour les cas les plus graves tels que les chocs septiques, témoigne d'une absence de traitements curatifs pour cette pathologie. Partant de l'hypothèse que les syndromes septiques graves sont la conséquence d'une perte de contrôle précoce de la régulation de la réponse inflammatoire, nous avons étudié, via deux démarches complémentaires, l'initiation de la voie de signalisation TLR4 et les mécanismes intracellulaires contribuant à sa régulation. Dans un premier temps, l'utilisation d'approches transcriptomiques nous a permis d'identifier la voie de signalisation mTOR comme discriminante entre des patients sains (SIRS induit par l'injection d'endotoxines) et des patients souffrant de syndromes septiques graves. Nous avons ensuite développé et utilisé des techniques de modélisation logique pour simuler in silico le rôle joué par la voie mTOR dans la résolution d'une réponse inflammatoire. Ces résultats encourageants ouvrent des perspectives pour de nouvelles applications thérapeutiques dans le domaine du sepsis / Sepsis is a syndrome observed in patients combining a documented infection (microbiologically or clinically suspected) with a systemic inflammatory response (Systemic Inflammatory Response Syndrome : SIRS). It may progress to severe sepsis if it is associated with failures of one or more organs. Septic shock is the combination of a severe sepsis and a hemodynamic dysfunction characterized by an acute fall in blood pressure that cannot be corrected by a procedure of vascular filling.Sepsis syndromes represent today the first cause of mortality in intensive care units around the world. This poor survival rate, in particular for the most severe cases, such as septic shock, testifies a real curative therapeutic demand.Based on the assumption that severe sepsis syndromes are the consequence of a loss of control in early mechanisms of inflammatory response regulation, we studied via two complementary approaches the initiation of TLR4 signaling pathway and the intracellular mechanisms contributing to its regulation.First, the use of transcriptomic approaches allowed us to identify the mTOR signaling pathway as discriminating between healthy patients (SIRS induced by the infusion of endotoxins) and patients with severe septic syndromes. We then developed and used logic modeling approaches to in silico simulate the role played by the mTOR signaling pathway in the resolution of an inflammatory response. These encouraging results open perspectives for new therapeutic applications in the field of sepsis
123

Physiopathologie des formes infectieuses de maladies à prions humaines : étude des formes iatrogènes secondaires à un traitement par l'hormone de croissance / Physiopathology of the infectious forms of human prion diseases : a study of iatrogenic forms after human cadaver-sourced growth hormone treatment in France

Peckeu, Laurène 04 December 2017 (has links)
Les maladies à prions sont des maladies neurodégénératives et transmissibles. Elles sont à l'origine de formes infectieuses comme la maladie de Creutzfeldt-Jakob iatrogène secondaire à un traitement par hormone de croissance d'origine humaine (MCJ post-hGH). La compréhension des facteurs gouvernant la physiopathologie de ces formes demeure parcellaire. Notre objectif a été de les étudier en analysant la cohorte des patients français exposés à l'hGH. Les analyses épidémiologiques, ont montré, à partir de données quantifiées, pour la première fois chez l'homme, une relation entre la dose d'exposition et le risque de développer la maladie d'une part et la durée de la période d'incubation d'autre part. La modélisation de la période d'incubation, a permis d'estimer que 95% des cas sont déjà apparus et d'évaluer l'influence du polymorphisme au codon 129 du gène codant la protéine prion sur la période d'incubation. L'étude descriptive a montré des similarités clinico-pathologiques entre tous les cas de maladies à prion humaines par contamination périphérique laissant supposer un rôle important de la voie d'exposition. Les expériences de transmission à la souris transgénique devraient permettre de valider les hypothèses que nous avons émises sur l'identité des souches présentes dans les lots contaminés. Ce travail a donc permis de mieux caractériser les facteurs impliqués dans la transmission des maladies à prions chez l'homme et de fournir un cadre méthodologique et des informations qui pourraient être utiles pour évaluer le risque de transmission potentielle des autres protéinopathies du système nerveux central pour lesquelles un mécanisme " prion like " a été proposé. / Prion diseases are fatal and transmissible neurodegenerative disorders. Infectious forms include iatrogenic Creutzfeldt-Jakob disease after human cadaver-sourced growth hormone treatment (hGH-iCJD). Our understanding of the factors governing the pathophysiology of infection, upon exposure to an exogenous prion, remains very limited in humans. The aim of this study was to better understand these phenomena using data from the French cohort of patients who were exposed to this at risk treatment. Using Cox hazards model, we provided the first epidemiological evidence of a relationship between dose of exposure and disease occurrence on one hand and incubation time on the other hand. Incubation period modelling by Weibull distribution estimated that 95% of the cases have already occurred. In a descriptive study, we showed that clinical and neuropathological features resembled other forms of infectious prion diseases after a peripheral contamination supporting a major role of the route of exposure. We also performed experimental transmission to transgenic mice expressing human PrP to test our hypotheses about the infecting prion strain that were transmitted to French hGH-iCJD patients. To conclude, we identified factors implicated in human prion transmission and provided a methodological frame and useful information that could help to evaluate the transmission risk associated with other brain proteinopathies such as Alzheimer and Parkinson’s diseases for which a prion-like mechanism has been proposed.
124

Le Syndrome de choc de dengue, approches clinique et in vitro / Dengue shock syndrome, clinical and in vitro investigations

Devignot, Stéphanie 28 June 2010 (has links)
Le syndrome de choc de dengue (DSS) est une complication potentiellement mortelle dela dengue, première arbovirose humaine et problème majeur de santé publiquemondial. Il survient chez une fraction des patients, et résulte d’une fuite plasmatiquemassive, non prédictible, dont la physiopathologie est mal connue. Le décryptage de laréponse de l’hôte est donc essentiel pour améliorer le pronostic et le traitement despatients. Ce travail de thèse a abordé les mécanismes de la fuite plasmatique du DSS dedeux façons : versant immunitaire et versant endothélial. D’une part, nous avons comparéen ex vivo les profils transcriptionnels sanguins de patients présentant différentes formescliniques de dengue, afin d’identifier des mécanismes contribuant à la survenue du DSS.Cette étude a révélé l’activation chez les patients en DSS, de signatures proinflammatoiresà l’interface entre immunité innée et métabolisme lipidique, représentantde nouveaux bio-marqueurs potentiels du DSS. D’autre part, les études in vitro desinteractions entre un virus de dengue et deux lignées de cellules endothélialesmicrovasculaires humaines (CEM), a révélé des différences d’intensité de réponseantivirale, ainsi que des différences dans l’expression de protéines impliquées dans laperméabilité, selon l’origine des territoires endothéliaux. Ces résultats suggèrent que levirus contribue directement au dysfonctionnement endothélial, au côté de mécanismesindirects médiés par des facteurs de l’hôte. Les deux types d’approches mises en oeuvreont ainsi établi de nouvelles données sur la physiopathologie du DSS, qui pourraient àterme trouver des applications dans la prise en charge des malades. / Dengue Shock Syndrome (DSS) is a life-threatening form of dengue infection, which is thefirst arboviral disease worldwide and a major public health problem. This severecomplication happens in a fraction of patients, and is the consequence of anunpredictable massive plasma leakage. The pathophysiology underlying DSS is stillunknown. Deciphering the host response to dengue infection is essential to improve boththe prognosis and the therapeutic management of dengue patients. This thesis workintended to study the mechanisms involved in DSS’ plasma leakage at both immunity (exvivo study) and endothelium (in vitro study) levels. First, in a ex vivo study, we comparedwhole blood cells’ transcriptional profiles of patients suffering from different clinicalpresentations of dengue disease, in order to identify mechanisms contributing to DSSoutcome. This study revealed the activation of pro-inflammatory signatures at theinterface of innate immunity and lipid metabolism, in DSS patients. Those signatures maybe new bio-markers of DSS. Second, in vitro studies of the consequences of a directinteraction between a dengue virus and human microvascular endothelial cells (MEC),revealed differences in antiviral response intensities and in the expression of proteinsinvolved in the endothelial permeability, depending on the endothelial origin of theMEC. Those results suggest that the virus directly contributes to the endotheliumdysfunction, together with indirect mechanisms triggered by soluble and cellular factors.Our investigations have produced new data on the pathophysiology of DSS that couldhave applications to the monitoring and treatment of the patients.
125

Pathophysiologie et pathobiologie de la défaillance ventriculaire droite

Dewachter, Céline January 2013 (has links)
Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished
126

From rapid correction of hyponatremia to demyelinative brain lesions: new insights into the pathophysiology and treatment of osmotic demyelination syndrome

Gankam Kengne, Fabrice 19 January 2012 (has links)
Adaptation to osmotic imbalance is crucial for cell survival and many organisms have developed complex mechanisms to counteract the changes induced by aniosmolarity. In mammals, the central nervous system is one of the most vulnerable organs after sudden changes in osmolarity. This is best exemplified by two common clinical disorders, brain edema resulting from acute hyponatremia and brain dehydration after hypernatremia. In clinical practice, hyponatremia is the most common electrolyte disorder and carries a significant mortality and morbidity. However, correction of hyponatremia should be undertaken with great caution as failure to adapt to rapid changes in chronic hyponatremia will cause rapid and fatal demyelination of the central nervous system. This syndrome is called osmotic demyelination syndrome (ODS) or central pontine myelinolysis. In this work, we investigated the pathophysiology and new diagnostic and treatments tools for osmotic demyelination syndrome. Using a rat model, we demonstrated the efficacy of the neuroprotective agent minocycline in osmotic demyelination syndrome. We also compared treatment with dexamethasone and re-lowering of serum sodium after rapid correction of hyponatremia and we showed that re-lowering of serum sodium is better than administration of dexamethasone. We explored the mechanisms underlying brain demyelination in ODS and demonstrated that the rupture of the blood brain barrier is not necessary for demyelination and that activated microglia does not play a key role in brain demyelination but can potentiate the lesions induced by rapid correction of hyponatremia. We also investigated the role of astrocytes during the development of osmotic demyelination and demonstrated that astrocytes are a major component of the physiopathology of osmotic demyelination. We showed that early and massive astrocyte apoptosis delineates the regions of future myelin damage and found that astrocyte death induces severe upregulation of myelinolytic cytokines and destruction of astrocyte oligodendrocyte junctions with subsequent disruption of panglial syncitium. <p>Finally, as there are currently no markers of demyelination, we investigated the astroglial protein S100B in ODS and found a significant release of S100B during development of ODS, which correlated with astrocyte damage. We also showed that the increase in S100B is prevented by protective treatment of hyponatremia with urea and demonstrated that serum levels of S100B could be used as a prognosis factor in ODS .<p>All together, our work has revealed a central role of astrocytes in the pathophysiology of ODS and clarified the importance of blood barrier dysfunction and microglial activation. This work also proposes new diagnostic and treatment tools for ODS. <p> / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished
127

Non-invasive quantitative evaluation of the exocrine pancreas in physiologic and pathologic conditions using functional magnetic resonance imaging

Bali, Maria Antonietta 30 May 2011 (has links)
The proposal of this work was to determine the contribution of functional MR imaging techniques, i.e. secretin-enhanced MRCP (S-MRCP) and dynamic contrast-enhanced magnetic resonance (DCE-MR) imaging in the quantitative assessment of exocrine pancreatic function and perfusion.<p><p>The pancreas is both an exocrine and endocrine organ, though the exocrine tissue accounts for more than 90%. The exocrine pancreas is specialized in the synthesis and storage of digestive enzymes and in bicarbonate and water secretion in response respectively to various secretagogues (CCK, ach, GRP, VIP,…) and to secretin. <p>The arterial supply of the pancreas derives from branches of the celiac trunk and of the superior mesenteric artery. The microvascularity of the exocrine and the endocrine parts of the gland are anatomically and functionally separated, with differentially regulated blood perfusion. <p>Based on the knowledge of a close relationship between the activity of the gland and its blood supply, in normal conditions pancreatic perfusion responds to the functional state of the exocrine parenchyma: increased demands for exocrine secretions are associated with increased pancreatic blood flow. <p>The pancreatic gland can be involved at different degrees of severity in acute and chronic inflammatory processes due to various causes. In both processes microcirculatory changes occur and the pancreatic exocrine function can be impaired. Moreover, an exiguous microvascular component characterizes pancreatic ductal adenocarcinoma (PDA) related to a prominent stroma.<p><p><p>In the first section of this thesis, quantitative assessment of the pancreatic exocrine secretions was performed with S-MRCP in physiologic and non-physiologic conditions. The stimulating effect of secretin as well as the inhibitory effect of somatostatin on normal pancreas, both administered at different dose-regimens, were tested. The results of these investigations showed that quantitative S-MRCP is able to detect changes in pancreatic exocrine secretions correlated to the degree of stimulation or inhibition. <p>In pathologic settings, pancreatic exocrine secretions were assessed in chronic pancreatitis patients showing different degrees of severity, before and after endoscopic pancreatic duct drainage procedures (PDDP). In the group of patients presenting a reduced pancreatic exocrine reserve before treatment, quantitative S-MRCP showed a short-term improvement after PDDP. <p><p>In the second section, the feasibility and the reproducibility of DCE-MR imaging to quantify regional pancreatic perfusion was firstly investigated. DCE-MR imaging was performed in normal volunteers. Reference values for regional pancreatic perfusion were achieved with an intra-individual variability of 21%.<p>DCE-MR investigations were repeated during secretin stimulation and disclosed a significant increase of regional pancreatic perfusion in all individuals. <p>Secondly, DCE-MR imaging investigated benign and malignant focal pancreatic solid lesions and non tumoral tissue in patients undergoing pancreatic surgical resection. The purpose was to correlate DCE-MR quantitative parameters, (reflecting perfusion and/or permeability and the distribution volume fraction) with histologic features such as the degree of fibrosis and the microvascular density (MVD) in the corresponding tissues. A significant correlation was found between DCE-MR and histologic parameters: Ktrans was negatively correlated with the degree of fibrosis (high fibrosis was correlated with low perfusion), while the distribution volume fraction was positively correlated with the degree of fibrosis and with MVD (larger EES was correlated with high fibrosis and higher MVD). <p> / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished
128

Alterations of mitochondrial biogenesis and alterations of mitochondrial antioxidant defense in Friedreich's ataxia

Marmolino, Daniele 25 January 2011 (has links)
Friedreich’s ataxia (FRDA) is an autosomal recessive inherited disorder affecting approximately 1 every 40,000 individuals in Western Europe, is characterized by progressive gait and limb ataxia, dysarthria, areflexia, loss of vibratory and position sense, and a progressive weakness of central origin. Additional features particularly include an hypertrophic cardiomyopathy that can cause premature death. A large GAA repeat expansion in the first intron of the FXN gene is the most common mutation underlying FRDA. Patients show severely reduced levels of the FXN-encoded mitochondrial protein frataxin.<p>Frataxin function is not yet completely elucidated. In frataxin deficiency conditions abnormalities of iron metabolism occur: decreased activities of iron-sulfur cluster (ISC) containing proteins, accumulation of iron in mitochondria and depletion in the cytosol, enhanced cellular iron uptake, and, in some models, reduced heme synthesis. <p>Evidence of oxidative stress has also been found in most though not all models of frataxin deficiency. Accordingly, yfh1-deficient yeast and cells from FRDA patients are highly sensitive to oxidants. Respiratory chain dysfunction further aggravate oxidative stress by increasing leakage of electrons and the formation of superoxide. Frataxin deficient cells not only generate more free radicals, but, they also show a reduced ability to mobilize antioxidant defenses, in particular to induce superoxide dismutase 2 (SOD2).<p>Peroxisome proliferator-activated receptor (PPAR) isoform-gamma play a key role in numerous cellular functions and is a key regulator of mitochondrial biogenesis and of the ROS metabolism. Recruitment of the PPAR coactivator-1a (PGC-1a) mediates many effects of the PPAR-γ activation.<p>In a first work we assessed the potential beneficial effects of a potent PPAR-gamma agonist on frataxin expression in primary fibroblasts from healthy controls and FRDA patients, and Neuroblastoma cells. We used the APAF molecule (1-0-hexadecyl-2-azelaoyl-sn-glycero-3-phosphocoline; C33H66NO9P). Our results show that this compound is able to increase frataxin amount both at transcriptional and post-transcriptional level. At a dose of 20µM frataxin mRNA significantly increases in both controls (p=0.03) and FRDA patients (p=0.002) fibroblasts (1). The finding was confirmed in Neuroblastoma cells (p=0.042). According to previous publications APAF, as others PPAR-gamma agonists is able to up-regulate PGC-1a transcription.<p>In a second part of the study we investigate the role of the PPAR-gamma/PGC-1a pathway in the pathogenesis of FRDA. We performed a microarray analysis of heart and skeletal muscle in a mouse model of frataxin deficiency and we found molecular evidence of increased lipogenesis in skeletal muscle and alteration of fiber-type composition in heart, consistent with insulin resistance and cardiomyopathy, respectively. Since the PPAR-gamma pathway is known to regulate both processes, we hypothesized that dysregulation of this pathway could play a key role in frataxin deficiency. We confirmed this by showing a coordinate dysregulation of Pgc1a and the transcription factor Srebp1 in cellular and animal models of frataxin deficiency, and in cells from FRDA patients, who have marked insulin resistance. Particularly, PGC-1a was found significantly reduced (2) in primary fibroblasts and lymphocytes from FRDA patients (p<0.05). Furthermore, PGC-1a mRNA levels strongly correlate with frataxin relative mRNA levels (r2=0.9, p<0.001). According to this observation, in C2C12 myoblasts, PGC-1a and a reporter gene under the control of the PGC-1a promoter are rapidly down-regulated (p<0.05) when frataxin expression is inhibited by an shRNA in vitro. To further investigate this relation, we then generate PGC-1a deficient fibroblasts cells using a specific siRNA; at 72 hours of transfection frataxin was found down-regulate (p<0.05) in control cells. <p>Taken together those data indicate that some mechanism directly links an early effect of frataxin deficiency with reduced PGC-1a transcription in this cell type, and presumably in other cells that also down-regulate PGC-1α when frataxin levels are low.<p>Finally, since PGC-1a has also emerged as a key factor in the induction of many antioxidant programs in response to oxidative stress, both in vivo and in vitro, in particular in neurons, we tested whether the PGC-1a down-regulation occurring in FRDA cells could be in part responsible for the blunted antioxidant response observed in frataxin deficiency.<p>Using primary fibroblasts from FRDA patients we found reduced SOD2 levels (p<0.05), according to PGC1& / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished
129

Rejet en transplantation cardiaque : au-delà du C4d, les nouveaux marqueurs biologiques, immunologiques et cellulaires / Rejection in heart transplantation : new cellular, biological and immunological markers and biomarkers beyond C4d

Tible, Marion 29 September 2014 (has links)
La transplantation cardiaque est aujourd'hui la seule option de traitement à long terme pour les patients souffrant d'insuffisance cardiaque terminale. Malgré des progrès considérables dans les traitements immunosuppresseurs, le rejet d'allogreffe reste une cause majeure de la perte du greffon. Dans ce domaine, des études récentes ont souligné l'importance du rejet humoral (AMR) comme un facteur contributif important à l’évolution, précoce ou tardive, de la maladie vasculaire du greffon et, in fine, à la perte de ce greffon. La pierre angulaire du diagnostic de rejet repose sur la biopsie endomyocardique (BEM) et l'évaluation histopathologique classique. Cependant, les épisodes de rejet observés sont aujourd'hui plus rares et plus complexes qu'auparavant, du fait de la présence de formes tronquées, indolentes et mixtes empêchant un diagnostic précis avec une évaluation conventionnelle. En outre, la BEM est une procédure invasive, entrainant des coûts importants, un inconfort pour le patient et un risque non négligeable de complications graves. Par conséquent, l'évaluation histologique conventionnelle ne reflète pas la complexité du rejet de greffe cardiaque et a besoin d'améliorations en termes de diagnostic. Le travail présenté dans cette thèse explore deux types de biomarqueurs, la voie mTOR, marqueur in situ, et les micro-ARNs, marqueurs circulants, qui permettraient une meilleure classification du rejet et constitueraient une aide diagnostique et/ou prédictive à la pratique clinique quotidienne lors du suivi des patients transplantés. / Cardiac transplantation is currently the only option for long-term treatment for patients with terminal heart failure. Despite considerable advances in immunosuppressive therapy, allograft rejection remains a major cause of graft loss. In this regard, recent studies have highlighted the importance of antibody-mediated rejection (AMR) as an important contributory factor in the evolution of vascular graft disease and, ultimately, graft loss. The cornerstone of the rejection diagnosis is based on endomyocardial biopsy (EMB) and the classical histopathological evaluation. However, rejection episodes observed today are becoming scarce and more complex than before, due to the presence of truncated, indolent and mixed forms preventing an accurate diagnosis with a conventional assessment. In addition, the biopsy is an invasive procedure, resulting in significant costs, discomfort for the patient and a significant risk of serious complications. Therefore, conventional histological assessment does not reflect the complexity of cardiac transplant rejection and needs improvement in terms of diagnosis. The work presented in this thesis explores two types of biomarkers, the mTOR pathway, an in situ marker, and the micro-RNAs, circulating markers that would allow a better classification of rejection and provide diagnosis and/or predictive help to daily clinical practice during the monitoring of transplant patients.
130

Bases moléculaires et physiopathologiques de l'ostéochondrose équine / Molecular and physiopathological bases of horse susceptibility to osteochondrosis.

Desjardin, Clémence 08 October 2013 (has links)
L'ostéochondrose (OC) est une affection ostéo-articulaire juvénile caractérisée par une perturbation locale de la maturation du cartilage créant des zones de fragilité. L'OC a été décrite chez de nombreuses espèces dont l'Homme, le Chien, le Porc, le Poulet et le Cheval. Chez le cheval les lésions s'installent progressivement, sans symptômes, avant l'âge d'un an et les manifestations cliniques ne se manifestent que tardivement, souvent à l'entraînement. L'OC affecte 10 à 30 % de la population équine représentant ainsi un souci majeur pour la filière tant sur le plan du bien être animal que sur le plan économique. Son étiologie, multifactorielle, est encore mal comprise et implique des composantes génétiques et environnementales ainsi que traumatiques. Les objectifs des travaux présentés étaient d'améliorer la compréhension de la physiopathologie de l'OC équine et de mettre en évidence les processus biologiques perturbés. L'ensemble des résultats a permis de préciser la définition des différentes entités de l'OC et pourraient également être pertinentes dans l'amélioration du diagnostic et le dévelopement de nouveaux traitements. Un défaut constitutif de l'os et du cartilage a été mis en évidence chez les individus atteints d'OC, notamment associé à une perturbation du métabolisme énergénique et un stress du reticulum endoplasmique. De plus, selon le type de lésions, des mécanismes moléculaires sous-jacents différents sont impliqués dans leur développement. D'autre part, les microARNs (miRNAs) semblent également jouer un rôle dans la physiopathologie de l'OC et certains d'entre eux pourraient constituer de bonnes cibles thérapeutiques ou être utilisés comme biomarqueurs diagnostics. / Osteochondrosis (OC) is a juvenile osteo-articular disease characterized by a focal failure of cartilage maturation leading to weak areas. OC has been described in several species including Human, Dog, Swine, Poultry and Horse. In horse, lesions develop gradually without symptoms before one year old and clinical manifestations occur tardily during training. OC affects 10 to 30% of equine population and constitutes a major concern in terms of animal welfare and economy. Its multifactorial etiology remains poorly understood and involved several factors including genetics, environment and traumas. The aim of this current work was to improve the comprehension of equine OC physiopathology and highlight biological pathways disrupted. Taken together, our results made it possible to refine the definition of OC entities and our data could be relevant to improve diagnosis and develop new therapies. A constitutive defect was found in cartilage and bone of OC-affected horses and particularly a defective energy metabolism and a endoplasmic reticulum stress. Moreover, in function of lesion type, different underlying molecular mechanisms are involved in their development. Secondly, mircoRNAs (miRNAs) seem to take part in the OC physiopathology and some miRNAs could constitute a relevant therapeutic target or be used as diagnosis biomarkers.

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