This study was done to investigate the effect of ischemia-reperfusion injury on cytosolic and mitochondrial glutathione levels in the rat kidney. Glutathione is the main cellular defense against free radicals that are thought to cause ischemia-reperfusion injury. Right kidneys from anesthetized female Lewis rats (9-12 months old) were exposed to 60 minutes of ischemia followed by 0, 30, or 120 minutes of reperfusion. The kidneys were perfused with isotonic saline, harvested, homogenized, and separated into cytosolic and mitochondrial fractions by differential centrifugation. Reduced (GSH) and oxidized (GSSG) glutathione levels were measured spectrophotometrically. There were significant decreases in both the GSH levels and the % GSH/Total Glutathione in the cytosol and mitochondria of kidneys exposed to ischemia-reperfusion injury when compared to control kidneys. The glutathione levels in either the cytosol or mitochondria did not recover even after 120 minutes of reperfusion. This study demonstrates that 60 minutes of ischemia followed by 0, 30, or 120 minutes of reperfusion decreases both cytosolic and mitochondrial levels of glutathione in the rat kidney. / Department of Physiology and Health Science

Hypertension is a risk factor for myocardial ischemia via the promotion of endothelial dysfunction and atherosclerosis (Ogita et al., 2004). Hypertension not only a predisposes the heart to ischemic events, but as shown by clinical and experimental studies, exacerbates the heart’s susceptibility to ischemia-reperfusion injury (Golden et al., 1994; Besík et al., 2007; Snoeckx et al., 1986) due to impairments in regulation of calcium handling, ion homeostasis, and energy metabolism (Galiñanes et al., 2004). Nutraceuticals have demonstrated beneficial and protective effects on both hypertension and ischemia reperfusion injury. Resveratrol, a naturally occurring polyphenol which is present in grapes and wine, acts as a cardioprotective agent and can be used to protect the heart against ischemia reperfusion injury. Here we investigate the effectiveness of chronic dietary resveratrol intake in normotensive and hypertensive rats on protection against ischemia-reperfusion injury, assessed in an isolated perfused Langendorff heart model. Rats ingested either a High dose of 2.7mg/day-which mimicked the resveratrol content in daily supplemental intake levels, a Low dose of 0.027mg/day- which mimicked the resveratrol content in moderate red wine intake, or no resveratrol in the drinking water for 28 days, at which point hearts were excised and mounted on a Langendorff apparatus. Once stable conditions were established all hearts were subjected to 30 minutes of no flow ischemia followed by 2 hours of reperfusion. Interestingly, SHR animals did not exhibit reduced recovery, or increased infarct size as compared to WKY. Infarct size as measured by triphenyltetrazolium chloride staining after 2 hours of reperfusion was significantly reduced in High and Low groups (combined WKY and SHR) as compared to Controls (19.9±0.9 and 19.4±0.8 vs 27.7±0.7 % of baseline, p<0.0001). Left ventricular developed pressure was significantly improved 2 hours post ischemia in both High and Low groups (combined SHR and WKY) compared to Controls (83.1±4.1 and 78.6±3.4 vs.67.9±3.2% of baseline, p<0.01). A higher rate of maximal pressure development was maintained in High and Low groups (combined SHR and WKY) compared to Controls (90.5±4.7 and 95.6±5.0 vs.73.5±4.8% of baseline, p<.05). Resveratrol treatment at a High and Low dose reduced contracture of the myocardium as compared to Control (7.2±3.0 and 6.9±2.9 vs. 20.1±2.9 mmHg- LVEDP, p<0.01). In conclusion resveratrol treatment at both a High and Low dose protects against a decline in cardiac function, and reduces infarct size post ischemia reperfusion. Additionally, tolerance to ischemia reperfusion injury in SHR is not reduced as compared to WKY.

Heart transplantation is often the only therapeutic option for patients with end stage heart disease. Allograft organs are in short supply. Thus, preserving the life of a grafted organ is extremely important. Cardiac allograft vasculopathy (CAV) is an expression of chronic rejection that accounts for the greatest loss of graft function in transplanted hearts. Peri-transplant ischemia/reperfusion (I/R)-injury occurs during transplantation when blood flow is stopped to remove the heart from the donor and then is reinstated upon implantation of the donor heart into the recipient. This oxidative injury contributes to vascular dysfunction and CAV. In this dissertation, I hypothesize that prevention and/or reduction of I/R during transplantation reduces post-transplant vascular dysfunction and CAV. In this regard, myself and my colleagues examined the roles of apoptosis repressor with caspase recruitment domain (ARC) and cytochrome p450 (CYP) 2C enzymes in UR-induced vascular dysfunction and CAV. ARC expression was detected in endothelial cells (ECs) and smooth muscle cells (SMCs); however, increased levels of ARC do not protect against oxidant injury. ARC overexpression did protect against oxidant-induced cell death in H9c2 rat embryonic myoblasts. We observed that ARC-overexpression prevented H9c2 differentiation into muscle cells. With our focus on vascular injury, we turned our attention to the CYP 2C enzymes. Both endothelium-dependent and independent vascular function was impaired following I/R. Pre-treatment with the CYP 2C inhibitor sulfaphenazole (SP) restored endothelial sensitivity to acetylcholine, but did not restore sensitivity to endothelium-independent vasodilators. Rat heterotopic heart transplants were performed with rats being treated with SP or vector control prior to surgery. Rats treated with SP showed significantly reduced luminal narrowing and had decreased SMC proliferation, oxidant and interferon-y levels. No differences were detected in immune infiltration or apoptosis. Complementary studies in cultured vascular cells revealed that CYP 2C9 expression decreased viability and increased ROS production following hypoxia and re-oxygenation in ECs but not in SMCs. In summary, we did not detect protection of vascular cells by ARC, but did discover a novel role for ARC in differentiation. CYP 2C contributes to post-ischemic vascular dysfunction and CAV through increased oxidative stress and endothelial dysfunction.

L’ischémie reperfusion pulmonaire et sa traduction clinique la dysfonction primaire du greffon sont responsables d’une morbi-mortalité importante en transplantation pulmonaire aussi bien à court terme qu’à long terme. Nous avons voulu faire la démonstration de la pertinence des microparticules comme marqueur de l’ischémie reperfusion pulmonaire. Nous avons reproduit et validé la stabilité d’un modèle de perfusion ventilation ex vivo de poumon de rat aussi bien en conditions normales (pas d’ischémie pulmonaire avant reperfusion) qu’en conditions extrêmes (1 h d’ischémie chaude avant reperfusion pulmonaire). Nous avons étudié la génération de microparticules par des poumons soumis à des conditions variables d’ischémie froide et d’ischémie chaude. Les poumons soumis à de fortes conditions d’ischémie froide (20h) produisent un pic précoce de microparticules d’origine épithéliale alvéolaire, leucocytaire et endothéliale. Nous en concluons que le modèle de perfusion ventilation ex vivo de poumons de rats est un modèle pertinent pour l’étude des réactions d’ischémie reperfusion. Les microparticules apparaissent comme un marqueur précoce des lésions d’ischémie reperfusion pulmonaires dans ce modèle. / Lung ischemia reperfusion and its clinical expression as primary graft dysfunction are provider of immediate and long term morbidity and mortality for patients. We aimed at demonstrating the usefulness and relevance of microparticles as biomarkers for lung ischemia reperfusion injury. We first reproduced an ex vivo rat lung perfusion and ventilation experimental model. Stability of the model was validated for normal conditions (no ischemia before reperfusion) as well as for extreme conditions (1 hour warm ischemia before reperfusion). The generation of microparticles was studied in that model for variable conditions of cold ischemia and for warm ischemia. Lung submitted to strong ischemic injury (20hours cold ischemia) generate an early pike of microparticles originated from leukocyes, endothelial cells, and epithelial alveolar cells. We may conclude the ex vivo model of rat lung perfusion and ventilation is relevant for the study of lung ischemia reperfusion injury. Microparticles are relevant markers of rat lung ischemia reperfusion injury in our model.

Heart transplantation is often the only therapeutic option for patients with end stage heart disease. Allograft organs are in short supply. Thus, preserving the life of a grafted organ is extremely important. Cardiac allograft vasculopathy (CAV) is an expression of chronic rejection that accounts for the greatest loss of graft function in transplanted hearts. Peri-transplant ischemia/reperfusion (I/R)-injury occurs during transplantation when blood flow is stopped to remove the heart from the donor and then is reinstated upon implantation of the donor heart into the recipient. This oxidative injury contributes to vascular dysfunction and CAV. In this dissertation, I hypothesize that prevention and/or reduction of I/R during transplantation reduces post-transplant vascular dysfunction and CAV. In this regard, myself and my colleagues examined the roles of apoptosis repressor with caspase recruitment domain (ARC) and cytochrome p450 (CYP) 2C enzymes in UR-induced vascular dysfunction and CAV. ARC expression was detected in endothelial cells (ECs) and smooth muscle cells (SMCs); however, increased levels of ARC do not protect against oxidant injury. ARC overexpression did protect against oxidant-induced cell death in H9c2 rat embryonic myoblasts. We observed that ARC-overexpression prevented H9c2 differentiation into muscle cells. With our focus on vascular injury, we turned our attention to the CYP 2C enzymes. Both endothelium-dependent and independent vascular function was impaired following I/R. Pre-treatment with the CYP 2C inhibitor sulfaphenazole (SP) restored endothelial sensitivity to acetylcholine, but did not restore sensitivity to endothelium-independent vasodilators. Rat heterotopic heart transplants were performed with rats being treated with SP or vector control prior to surgery. Rats treated with SP showed significantly reduced luminal narrowing and had decreased SMC proliferation, oxidant and interferon-y levels. No differences were detected in immune infiltration or apoptosis. Complementary studies in cultured vascular cells revealed that CYP 2C9 expression decreased viability and increased ROS production following hypoxia and re-oxygenation in ECs but not in SMCs. In summary, we did not detect protection of vascular cells by ARC, but did discover a novel role for ARC in differentiation. CYP 2C contributes to post-ischemic vascular dysfunction and CAV through increased oxidative stress and endothelial dysfunction. / Medicine, Faculty of / Pathology and Laboratory Medicine, Department of / Graduate

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

This study was aimed at characterizing the apoptotic response equine small intestine subjected to experimental ischemia-reperfusion injury and determining if use of an angiotensin converting enzyme inhibitor (enalaprilat) would ameliorate the apoptotic response. It was designed to determine if mucosal epithelial cells undergo apoptosis during the ischemia phase and also examined if apoptosis is significantly exacerbated by reperfusion. It also investigated whether administration of enalaprilat decreased reperfusion injury secondary to reduced enterocyte apoptosis. Injury was induced using a low flow model of I-R. During celiotomy a single loop of jejunum was isolated and arterial flow decreased to 20% of baseline for one hour and complete occlusion for a second hour. Reperfusion was monitored for 3 hours. A control group (n=6) were not treated while the treatment group (n=6) received 0.5 mg/kg enalaprilat in 0.9% NaCl immediately following ischemia. Jejunal samples were taken prior to the induction of ischemia, immediately post-ischemia and at 1, 2 and 3 hours of reperfusion. Samples were evaluated for gross tissue pathology with standard hematoxylin and eosin staining, the presence of apoptotic cells via TUNEL staining, and gene expression of three apoptosis related genes (bax, bcl-2, p53) using qPCR. Serum enalaprilat and ACE concentrations were determined from blood samples drawn concurrent with jejunal sampling using HPLC/MS and standard HPLC. Plasma enalaprilat concentrations were comparable to previous reports in awake horses. Enalaprilat appeared to have no effect on serum ACE concentrations, however a significant spike in ACE concentration occurred in the treatment group at 1 hour of reperfusion (P=0.0001). Grade of mucosal damage was not significantly different between control and treatment groups at any time point. Subjectively apoptotic index appeared to be higher in the treatment group at end ischemia and during reperfusion. There were no changes in expression of p53 or bcl-2 in either group. Bax expression was significantly decreased (P= 0.02) in the control group at 2 hours of reperfusion. Based on our data administration of an ACE inhibitor during anesthesia in horses with an ischemic segment of intestine confers no protective benefit and may be associated with increased intestinal injury and apoptosis. Lack of expression of p53, bax and bcl-2 suggests another apoptotic mechanism in equine ischemic intestine. / Master of Science

L'infarctus du myocarde est la première cause de mortalité cardiovasculaire dans les pays occidentaux. La reperfusion la plus précoce possible est actuellement le seul traitement validé pour réduire la taille d'infarctus, facteur pronostique fondamental de morbi-mortalité. Cependant, la reperfusion engendre des lésions d'ischémie-reperfusion (IR) irréversibles qui précipitent la mort par apoptose des cardiomyocytes. Une approche transcriptomique nous a permis d'identifier les gènes spécifiques du postconditionnement ischémique (PostC) dans le cœur de souris. Parmi ceux-ci, l'expression du gène codant pour le récepteur métabotrope de type 1 du glutamate (mGluR1) est augmentée par le PostC. L'objectif de mon travail de thèse a été d'étudier le rôle de mGluR1 au cours de l'IR myocardique. Notre stratégie, basée sur l'utilisation de souris knock-out, a permis de confirmer l'implication de mGluR1 dans la cardioprotection. L'injection de glutamate au moment de la reperfusion myocardique permet de diminuer significativement la taille de l'infarctus par inhibition de l'apoptose. Cet effet cardioprotecteur est diminué en présence de l'antagoniste spécifique YM 298198 ou en présence de wortmannin, inhibiteur de la PI3-kinase, activée dans la cascade de signalisation du récepteur. La réduction de la taille d'infarctus par le glutamate semble associée à une amélioration de la fonction contractile du ventricule gauche en échocardiographie (par speckle tracking, méthode de quantification de la déformation myocardique) dans un modèle murin d'IR myocardique. Ces résultats, bien que préliminaires, semblent prometteurs et nous permettent d'envisager une application clinique chez le patient coronarien. / Myocardial infarction is the major cause of cardiovascular mortality in western countries. Reperfusion as early as possible is the only treatment recognized to reduce infarct size, crucial prognostic factor of morbidity and mortality. However, reperfusion leads to ischemia-reperfusion (IR) injury leading to irreversible apoptotic death of cardiomyocytes. A transcriptomic approach has allowed us to identify genes specifically regulated upon ischemic postconditioning (PostC) in the mouse heart. Among them, the expression of the metabotropic glutamate receptor type 1 (mGluR1) gene is up-regulated by PostC. The aim of my thesis work was to study the role of mGluR1 during myocardial IR. Our strategy, based on the use of knockout mice, confirmed the involvement of mGluR1 in cardioprotection. Injection of glutamate at the time of reperfusion significantly reduced infarct size via apoptosis inhibition. This cardioprotective effect was reduced in presence of the specific antagonist YM 298198 or in presence of wortmannin, an inhibitor of PI3-kinase, which is activated downstream mGluR1. In our mouse model of myocardial IR injury, decrease in infarct size after glutamate treatment seems to be associated to an improved left ventricular contractile function assessed by echocardiography (speckle tracking method quantifying myocardial strain). These preliminary results are promising and allow us to consider a clinical trial for coronary patients.

Dans ce travail, nous avons montré qu'un nouveau ligand du TSPO, le TRO40303, possède des propriétés cardioprotectrices, confirmant que le TSPO joue un rôle important dans les effets délétères engendrés par l'ischémie-reperfusion myocardique. Des effets similaires ont déjà été observés avec d'autres ligands du TSPO, notamment le 4'-chlorodiazépam, mais le mécanisme d'action par lequel ces molécules exercent leur effet cardioprotecteur reste pour une large part encore mal connu. Nous avons montré chez le rat que la reperfusion d'un myocarde ischémié s'accompagne d'une augmentation du cholestérol mitochondrial, de la formation d'oxystérols et d'un stress oxydant majeur. Le 4'-chlorodiazépam inhibe ces effets et améliore les fonctions mitochondriales post-ischémiques, révélant que le TSPO est responsable du transport du cholestérol dans la mitochondrie cardiaque et que ce dernier, sous des formes oxydées ou non, pourrait participer aux effets délétères de la reperfusion. La limitation de l'entrée du cholestérol dans la mitochondrie lors de la reperfusion d'un myocarde ischémié est un mécanisme original qui pourrait donc contribuer à l'effet cardioprotecteur des ligands du TSPO. Enfin, nous avons montré que chez des rats génétiquement modifiés et associant hypercholestérolémie, obésité et diabète de type II, le cholestérol mitochondrial est d'une part très élevé, avec ou sans ischémie-reperfusion myocardique et d'autre part que le 4'-chlorodiazépam n'a pas d'effet sur le cholestérol mitochondrial après ischémie-reperfusion. Ces résultats suggèrent que les mécanismes d'action des ligands du TSPO sont probablement différents et que les traitements doivent être adaptés en présence de facteurs de co-morbidité. / In the present work we showed that a new TSPO ligand, TRO40303, has cardioprotective properties confirming that TSPO plays a key role in the deleterious effects of myocardial ischemia-reperfusion. Similar effects have been observed with other TSPO ligands, such as 4'-chlorodiazepam, but the mechanism of action of these molecules is not known. We showed that ischemia-reperfusion in rats increased mitochondrial concentration of cholesterol, oxysterol formation and oxidative stress. 4'-Chlorodiazepam inhibited these effects and improved post-ischemic mitochondrial functions, revealing that TSPO is responsible for cholesterol transport in cardiac mitochondria and that cholesterol, in oxidized or non-oxidized forms, could participate in the deleterious effects of reperfusion. The limitation of the increase in cholesterol in mitochondria during ischemia-reperfusion is an original mechanism which could contribute to the cardioprotective effect of TSPO ligands. We then showed, in genetically modified rats with hypercholesterolemia, obesity and type II diabetes, that the concentration of mitochondrial cholesterol is very high with or without ischemia-reperfusion. We further demonstrated that 4'-chlorodiazepam has no effect on mitochondrial cholesterol after ischemia-reperfusion. These results suggest that the mechanisms of action of TSPO ligands probably differ in these conditions and that treatment must be adapted in accordance with the presence of factors of co-morbidity.