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

L'infarctus du myocarde (IDM) est consécutif à une occlusion coronaire provoquant une ischémie prolongée. La taille de l'infarctus est le déterminant majeur de la récupération du myocarde et de la survie du patient. La reperfusion coronaire la plus précoce (par thrombolyse ou angioplastie) est reconnue comme étant le seul traitement recommandé. Cependant, malgré les effets bénéfiques, la reperfusion s'accompagne d'effets délétères appelés « lésions de reperfusion ». Récemment, l'efficacité du postconditionnement ischémique (PostC) a été démontrée en clinique. Il permet, lorsqu'il est utilisé au cours de l'angioplastie primaire ou de sauvetage, de réduire significativement la taille de l'infarctus. L'application du protocole de PostC reste cependant limitée aux patients admis dans les centres d'angioplastie, ce qui exclut tous les patients thrombolysés. Afin d'améliorer la cardioprotection, il est nécessaire de déterminer la fenêtre thérapeutique temporelle optimale d'administration du PostC. De plus, il est nécessaire de développer des stratégies thérapeutiques nouvelles, adjuvants de la reperfusion, qui pourront être administrées dès que le diagnostic d'IDM est posé. L'objectif de notre travail a donc été d'étudier l'influence du délai d'application du PostC sur l'efficacité de cardioprotection dans un modèle murin d'ischémie-reperfusion et de rechercher des substances pharmacologiques cardioprotectrices. Nos travaux révèlent que l'efficacité du PostC est maintenue s'il est appliqué les 30 premières minutes après le début de la reperfusion. D'autre part, nous avons évalué le potentiel thérapeutique de peptides inhibiteurs ciblant l'apoptose responsable de la mort cellulaire au cours de l'ischémie-reperfusion. L'utilisation de peptides Tat-BH4 et Pip2b-BH4 pour le traitement des lésions d'ischémie-reperfusion myocardique a fait l'objet d'une étude preuve-de-concept in vivo. Les constructions peptidiques inhibant l'interaction FAS-DAXX, injectées en intraveineuse au moment de la reperfusion, induisent une diminution de 50% de la taille d'infarctus et de l'apoptose. Ils ont fait l'objet d'un dépôt de brevet car ils constituent des outils pharmacologiques à haut potentiel thérapeutique. / Myocardial infarction (MI) results from a coronary occlusion leading to severe ischemia. Infarct size is a major determinant of myocardial salvage and mortality. Prompt revascularization (either by thrombolysis or primary angioplasty) is recommended for AMI patients but leads to deleterious effects called "reperfusion injury". Recently, ischemic postconditioning (PostC) efficiency has been reported in patients. However, its application during primary angioplasty is limited to patients admitted in angioplasty centers thereby excluding thrombolysed patients. In order to improve cardioprotection, it is necessary to define the time window for optimal cardioprotection and to develop new pharmacological strategies for AMI patients. Our work, using an in vivo mouse model of ischemia-reperfusion, shows that PostC efficiency is maintained if applied the first 30 minutes after the onset of reperfusion. Furthermore, we evaluated the therapeutic potential of peptide inhibitors targeting apoptosis, which is responsible for cell death during ischemia-reperfusion. As a proof-of-concept study, the cardioprotective effects of Tat-BH4 and Pip2b-BH4 peptidic constructs have been revealed in vitro and in vivo. The peptidic constructs targeting FAS-DAXX interaction, injected intravenously as a single bolus at the time of reperfusion, reduced by 50% both infarct size and apoptosis. These pharmacological tools have been patented due to their high therapeutic potential.

Adaptation to chronic hypoxia increases myocardial resistance to acute ischemia/reperfusion (I/R) injury, similarly to application of exogenous erythropoietin (EPO). Nevertheless, it is not known if EPO induced by chronic hypoxia plays a role in its cardioprotective mechanism. The aim of this study was to find out if protective effect of exogenous EPO adds up to protection offered by chronic hypoxia. Adult male mice (ICR) were adapted to intermittent hypobaric hypoxia 8 hours per day, 5 days per week for 5 weeks. The degree of hypoxia corresponded to 7000 metres. Control animals were housed for the same time in normoxic environment. Resistance to I/R injury was assessed according to size of myocardial infarction induced by 45-min global ischemia and 1-h reperfusion of the heart in vitro. Animals were treated 24 h before the experiment with 200 or 5000 U/kg EPO. Treatment with 200 U/kg EPO was sufficient to significantly limit infarct size in normoxic animals (33,56 ± 2,93 % vs. 25,71 ± 2,29 %). Hypoxic adaptation decreased infarct area to 23,49 ± 2,30%, but additive effect of EPO in hypoxic group was not detected. The results indicate that exogenous EPO employs the same cardioprotective mechanisms as adaptation to chronic intermittent hypoxia. Preliminary results indicate that repeated application of EPO...

Le système kallicréine-kinines (SKK) est un système peptidique vasodilatateur. Les métabolites actifs du système, les kinines, sont produites par la kallicréine tissulaire (TK), et agissent via leurs deux récepteurs, B2 et B1. Le SKK a été impliqué dans les processus physiopathologiques conduisant au diabète de type 2. Son rôle est bien établi dans la protection des complications cardiovasculaires et rénales du diabète. Nous avons étudié le rôle du SKK dans le développement des anomalies métaboliques liées à l'obésité en utilisant des souris déficientes en TK dans deux modèles d'obésité (mutation ob/ob et régime gras). Nous n'avons pas mis en évidence d'effet de la déficience en TK sur les anomalies glucidiques dans ces deux modèles. Chez l'homme, nous avons étudié l'effet d'un polymorphisme génétique de la TK dans une cohorte de 4843 sujets de la population générale suivi pendant 9 ans. Nous n'avons pas observé d'effet d'un déficit partiel en activité TK sur l'apparition des troubles glucidiques.Ensuite, nous avons étudié l'effet de la stimulation du SKK par des agonistes spécifiques de chaque récepteur lors d'une ischémie reperfusion cardiaque. Chez les souris non diabétiques, l'agoniste B2 réduit la taille de l'infarctus. L'agoniste B1 n'a pas d'effet. Chez les souris diabétiques, l'agoniste B2 n'a pas d'effet. En revanche, l'agoniste B1 diminue la taille de l'infarctus. On observe une induction de la synthèse du B1R dans le c¿ur diabétique.Nos travaux clarifient le rôle du SKK dans le développement du diabète et de ses complications cardiaques. L'effet des agonistes ouvre une nouvelle piste thérapeutique dans la prise en charge des du syndrome coronarien aigu. / Kallikrein-kinin system (KKS) is a vasodilator peptide system. Kinins, the active peptides, are produced by tissue kallikrein (TK), and act via their two receptors, B1 and B2. KKS was involved in the pathophysiological process leading to type 2 diabetes. Its role is well established in the protection of cardiovascular and renal complications of diabetes. We studied the role of SKK in the development of metabolic abnormalities associated with obesity using TK deficient mice in two models of obesity (Ob/Ob and high fat diet). We did not observed any effect of TK deficiency on metabolic parameters in these two models. In humans, we studied the effect of a polymorphism of TK in a population-based cohort of 4843 subjects followed for 9 years. We did not observe any effect of a partial deficiency in TK on the occurrence of metabolic disorders. Next, we studied the effect of specific agonists of B1 and B2 receptors in cardiac ischemia reperfusion injury. In non-diabetic mice, the B2 agonist reduces infarct size. Agonist B1 has no effect. In diabetic mice, B2 agonist had no effect. In contrast, B1 agonist reduces infarct size. Overexpression of B1R is observed in the diabetic heart. Our work clarifies the role of SKK in the development of diabetes and its cardiac complications. Agonists of kinins receptors could be a new therapeutic approach in the management of acute coronary syndrome.

L’infarctus du myocarde (IDM) est une cause majeure de mortalité dans le monde. La stratégie thérapeutique actuelle repose sur la reperfusion précoce du myocarde qui contribue largement à l’amélioration du pronostic des malades. Les investigations menées chez des modèles d’ischémie/reperfusion (I/R) cardiaque ont montré que l’apoptose des cardiomyocytes était contrôlée en partie par les protéines de type Bcl-2. La production de radicaux libres (RL), en particulier par la nicotinamide adénine dinucléotide phosphate (NADPH) oxydase, contribue aussi à l’altération de la fonction cardiaque. Récemment, les effets observés de l’érythropoïétine (Epo) sur l’I/R, sont principalement liés à ses effets anti-apoptotiques, anti-inflammatoires et à son rôle dans l’angiogénèse et le remodelage vasculaire. Ces propriétés suggèrent le potentiel de l’Epo dans la cardioprotection suite à un IDM. Dès lors, les objectifs de cette thèse ont été : 1) de confirmer les effets cardioprotecteurs d’un analogue de l’Epo, la darbepoétine-a (DA), chez un modèle d’I/R chez le rat; 2) d’étudier les voies de signalisation impliquées dans ses effets anti-apoptotiques et ; 3) de caractériser les effets antioxydants de la DA médiée par l’hème-oxygénase-1 (HO-1), et ; d’étudier le rôle de la NADPH oxydase. Dans la 1ère étude, le traitement par DA a permis de diminuer significativement la taille de l’infarctus, la production de RL et l’apoptose. La DA a activé la voie des protéines Jak2/Akt, augmenté l’expression des protéines P-Bad et P-GSK3ß et anti-apoptotiques, Bcl-2 et Bcl-xL. Ces mêmes effets bénéfiques ont été confirmés à plus long terme avec la réduction des lésions fibrotiques et l’augmentation du nombre da capillaires sanguins, suggérant une meilleure perfusion du ventricule gauche. La seconde étude, a confirmé les effets cardioprotecteurs de la DA. Parallèlement, la DA a induit l’expression et l’activité de l’HO-1 et régulé l’expression des sous-unités p47phox et Rac1 nécessaires à l’activation de la NADPH oxydase. Ces résultats sont concordants avec la baisse de la production des RL observés dans le groupe DA. Les effets bénéfiques de la DA ont été annihilés en présence de ZnPP, inhibiteur de l’HO-1. Des essais cliniques sont actuellement en cours pour démontrer que les bénéfices observés chez l’animal, peuvent être retrouvés chez l’homme. / Cardiovascular disease remains a leading cause of mortality in industrialized countries. Loss of cardiomyocytes via apoptosis is believed to contribute to the continuous decline of the ventricular function in heart failure. Several investigations revealed that following ischemia-reperfusion (I/R), cardiomyocytes apoptosis is controlled, at least, by the Bcl-2 proteins family members. The excessive reactive oxygen species (ROS) production, through NADPH oxidase, contributes also to cellular damages and death. Recently, erythropoietin (EPO), a hematopoietic cytokine, has been shown to protect heart exposed to ischemia or ischemia-reperfusion, limiting infarct size and cardiac remodeling. However, to date the precise cellular mechanism of DA-induced cardioprotection remains incompletely understood. Thus, the aims of this work were 1) to assess the short and long term cardioprotective effects of darbepoetin-a (DA), an Epo analog, in an in vivo rat model of I/R ; 2) to investigate the signaling pathway through which DA potentially limits apoptosis and ; 3) to elucidate whether its cardioprotective effect, and more particularly its antioxidative effect, is linked to an HO-1-dependent inhibition of the NADPH activity. In the first study, left ventricle infarct size (LV) was smaller than that in the control rats, in agreement with echocardiographics parameters. DA-treatment activated the JAK2/Akt signaling pathway, lowered cleaved caspase-3 and increased both P-Bad and P-GSK-3ß proteins. This was consistent with the decrease of ROS production and the lowered binding of Bad to Bcl-xL and Bcl-. Similarly, in long term study, histology alterations implicated lower LV cardiac fibrosis and greater capillary density; furthermore both Bcl-xL and Bcl-2 were upregulated. In the second study, both LVSF and LVEF were higher versus control and DA+ZnPP, a heme-oxygenase-1 (HO-1) inhibitor, matching with the decreased LV infarct size in DA rats. DA induced HO-1 and down regulated the expression of p47phox and the activation of Rac1, both regulatory subunits of the NADPH-oxidase. This was consistent with the decrease of ROS production and these DA effects were inhibited by ZnPP. Further experiments in humans are now required to prove benefits effects of DA and to promote the use of EPO as therapeutics in heart infarction.

MMed thesis - Faculty of Health Sciences / The field of organ and tissue transplantation has necessitated an improved understanding of their associated pathophysiological pathways. Specific areas of interest involve the changes that follow ischaemia and derangement’s that accompany organ and tissue storage, reperfusion injury and the “no-reflow” phenomenon. Strategies have been devised to manipulate and modify these processes, improving tissue and organ survival and function. These have involved the use of preservation solutions. Although most research involves organ transplantation, these principles have been translated and applied to various tissues, surgical flaps and microvascular replantations. These studies have generally used the skin flap as their model with little knowledge regarding muscle flaps, the most vulnerable to the ischaemic process. This study targets the use of one such preservation system and uses skeletal muscle as its tissue model. The vascular anatomy of the rectus femoris muscle in the New Zealand white rabbit was studied anatomically and radiologically and thus described. The isolated rectus femoris muscle flap was harvested and perfused in-vitro with cooled, oxygenated University of Wisconsin solution (UWS) using a pulsatile renal perfusion pump. UWS was selected as it contains vital additives important in cryopreservation of organs. Monitoring of various physiological parameters was performed. The muscle was examined at 0, 4, 8, 12, 18 and 24 hours of extra-corporeal perfusion using warm and cold, non-perfused controls. The contralateral muscle served as the control. End-points were the percentage of muscle survival, as determined by a new grading system of muscle ischaemia, based on 3 light and 7 electron microscopic criteria. The overall percentage of muscle survival (combined light and electron microscopy scores) resulted in approximately 58% survival at 24 hours for the perfused muscle versus 31% for the cold stored muscle. The stored muscle had the same survival rate at 12 hours as did the perfused muscle at 24 hours. For all time periods beyond 4 to 8 hours, perfused muscle showed statistically improved survival rates compared to the stored muscle. Eight hours appears to be a crucial point beyond which survival in muscle deteriorates to a much greater degree without perfusion. Questions remain as to which method of preservation yields the best survival benefit and, as yet, there is no “ideal” perfusate. The future involves manipulating perfusion solutions and trying to arrest or reverse established warm ischaemia. Success of free tissue transfers and replantations of musclecontaining body parts may be enhanced. These techniques may also allow us to effectively store previously harvested flaps and eventually, to enter the realm of “banked” allograft tissue flaps.

A gravidade da síndrome isquemia/reperfusão determina o prognóstico da lesão renal aguda (LRA). Agentes como o citrato de sildenafil (Sil) e a N-acetilcisteína (NAC) tem demonstrado efeito renoprotetor na LRA isquêmica com resultados ainda inconclusivos. Esse estudo investigou o efeito do Sil e da NAC na LRA com diferentes tempos de isquemia. Foram utilizados grupos de ratos Wistar, adultos e machos: SHAM; Isquemia 30 min (clampeamento dos pedículos renais por 30 min); Isquemia 30 + Sil (Sil 0,25 mg/kg 60 min antes da isquemia renal); Isquemia 30 + NAC (NAC 150 mg/kg antes e após a isquemia renal); Isquemia 45 (clampeamento dos pedículos renais por 45 min); Isquemia 45 + Sil e Isquemia 45 + NAC. Foram avaliadas a função renal (clearance de creatinina e fração de excreção de sódio-FENa); a lesão oxidativa (peróxidos urinários; substâncias reativas ao ácido tiobarbitúrico - TBARS; óxido nítrico - NO e tióis no tecido renal); a síntese protéica da óxido nítrico sintase induzível iNOS e da heme oxigenase-1 HO-1 (western blotting) e análise histológica renal (área intersticial relativa - AIR e lesão tubulointersticial). Os grupos 30 min tratados com Sil e NAC demonstraram melhora da função renal, redução dos índices oxidantes e NO, ausência de iNOS e presença de HO-1. Nos grupos 45 min, o Sil manteve a função renal, porém demonstrou proteção tubular e oxidante; a NAC não demonstrou efeito protetor em nenhum dos parâmetros avaliados. Quanto à histologia, apenas o Sil induziu redução da AIR e da lesão tubulointersticial nos tempos 30 e 45 min. O estudo confirmou que as características funcionais e histológicas induzidas pelo tempo de isquemia na LRA determinam as respostas às manobras farmacológicas de prevenção. A expressão HO-1 pode ser considerada um mediador de proteção renal. / Severity of ischemic/reperfusion injury syndrome determines the prognosis of acute kidney injury (AKI). Agents such as sildenafil citrate (Sil) and N-acetylcysteine (NAC) have demonstrated renoprotective effect on ischemic AKI which data is still inconclusive. This study investigated the protective action of Sil and NAC in the AKI with different time of ischemia. Adult, male, Wistar rats were divided: SHAM, Ischemia 30 min (renal pedicles clamping for 30 min), Ischemia 30 + Sil (Sil 0,25 mg/kg 60 min before renal ischemia), Ischemia 30 + NAC (NAC 150 mg/kg before and after renal ischemia), Ischemia 45 min (renal pedicles clamping for 45 min), Ischemia 45 + Sil, Ischemia 45 + NAC. Renal function (creatinine clearance and urine sodium fractional excretion - FENa); oxidative injury (urinary peroxides, thiobarbituric acid reactive substances - TBARS, nitric oxide - NO and thiols in renal tissue); expression of inducible nitric oxide synthase - iNOS and heme oxygenase-1 HO-1 (western blotting) and kidney histological analysis (fractional interstitial area - FIA and tubuleinterstitial injury) were evaluated. Sil and NAC treatment in 30 min renal ischemia induced increase in renal function, decrease in the rate of oxidation and NO levels, iNOS absence and HO-1 expression. In the Ischemia 45 groups, Sil it maintained renal function, however demonstrated tubular and oxidative protection; NAC produced no renoprotective effect on any of the parameters evaluated. Histology studies showed that, only Sil induced reduction in FIA and tubuleinterstitial injury at 30 and 45 min ischemic time. The study confirmed that the functional and histological characteristics induced by time of ischemia determine the renoprotective pharmacological agent action in the AKI. HO-1 expression can be a renal protection mediator.

Introdução: Injúria renal aguda (IRA) é uma síndrome cuja etiologia mais frequente é isquemia reperfusão. Diversos estudos clínicos e pré-clínicos sobre IRA têm sido desenvolvidos no sentido de esclarecer os seus mecanismos fisiopatológicos e as possíveis intervenções farmacológicas com efeito renoprotetor. Merecem destaque os resultados renoprotetores de alguns fitomedicamentos. Esse estudo avaliou o efeito da Justicia acuminatissima, planta da região amazônica com propriedades anti-inflamatória e antioxidante, sobre o modelo experimental mencionado. Objetivo: Avaliar a função renal, o perfil oxidativo e a histologia renal dos ratos submetidos à isquemia/reperfusão renal, tratados com Justicia acuminatissima (sara tudo). Métodos: ensaio pré-clínico com Ratos Wistar, adultos, machos (250-350g), distribuídos nos grupos SHAM, Isquemia 30 minutos e Isquemia + sara tudo (1,0g/kg, via oral, 1 vez). Foram avaliados os parâmetros hemodinâmicos (pressão arterial média - PAM, frequência cardíaca - FC, resistência vascular renal RVR e fluxo sanguíneo renal FSR), função renal - FR (clearance de creatinina - Clcr), estresse oxidativo (peróxidos urinários PU, substâncias reativas ao ácido tiobarbitúrico TBARs, óxido nítrico NO e tióis no tecido renal) e histologia renais. Resultados: O grupo Isquemia demonstrou declínio na FR, associado ao aumento de PU, TBARs e NO, além da redução dos tióis. O pré-tratamento com sara tudo atenuou a lesão funcional, com elevação do Clcr, redução dos marcadores oxidativos (PU, TBARs e NO) e elevação de tióis. Quanto à hemodinâmica renal, o grupo Isquemia demonstrou elevação da RVR e redução do FSR (p<0,05), enquanto que o tratamento com sara tudo induziu melhora significativa desses parâmetros. A análise histológica confirmou edema, infiltrado, achatamento e necrose tubular no grupo Isquemia, enquanto que o grupo tratado com sara tudo apresentou melhora desses parâmetros. Conclusão: A proteção renal da Justicia acuminatissima, na IRA isquêmica, caracterizou-se por melhora significativa da função renal, reduzindo a lesão oxidativa, com impacto positivo na histologia renal. / Introduction: Acute Kidney Injury (AKI) is a syndrome with growing prevalence, which ischemic-reperfusion is most frequent cause. Several clinical and pre-clinical studies about AKI have been developed to verify the pathophysiological mechanisms and the possible pharmacological interventions. The renoprotector effect of some phytomedicine in AKI induced by ischemia in rats model must be highlighted. This study evaluated the effect of Justicia Acuminatissima (sara tudo), plant from the Amazon region with antiinflammatory and antioxidant properties, in experimental model of AKI. Objective: To evaluate renal function, oxidative profile and renal histology in rats submitted to renal ischemia-reperfusion treated with Justicia Acuminatissima. Method: pre-clinical trial with Wistar rats, adult, male (250-350g), divided into groups: SHAM, Ischemia 30 minutes and Ischemia + (sara tudo) (1,0g/Kg, gavage, once). Hemodynamics parameters (medium arterial pressure-MAP; heart rate-HR; renal vascular resistance-RVR and renal blood flow- RBF), renal function - RF (creatinine clearance), oxidative stress (urinary peroxides-UP, thiobarbituric acid reactive substances- TBARS, nitric oxide- NO and thiols in renal tissue) and kidney histological analysis were evaluated. Results: The ischemia group demonstrated a decline on renal function (RF) associated with increase in UP, NO and TBARS and reduction in thiols levels. The pre-treatment with sara tudo resulted in understatement of functional injury, increase of crCl and reduction of oxidative biomarkers (UP, TBARS and NO) and enhancement of thiols levels. Considering renal hemodynamics, the ischemia group demonstrated increase in RVR with the decrease in RBF. The treatment with sara tudo induced significant improvement in these parameters. Histological analysis confirmed edema, infiltrated, flatness and tubular necrosis in ischemia group, while the sara tudo group presented amelioration in these parameters. Conclusion: The renoprotective effect of Justicia Acuminatissima, in ischemic AKI, features significant improvement in renal function, reducing the oxidative damage with positive impact in renal histology.

As células necessitam do contato com outras células e com a matriz extracelular, para a formação de tecidos. As junções gap são estreitos canais que conectam o citoplasma de células adjacentes, promovendo a passagem de íons orgânicos, aminoácidos, nucleotídeos e outros metabólitos. Estas junções são compostas por dois conexons ou hemicanais, que atravessam a membrana plasmática da célula a que pertencem, e são compostos por seis proteínas integrais de membrana denominadas conexinas (Cxs). A Cx43 é a mais expressa, e é fosforilada ao longo do ciclo de vida, sofrendo mudanças conformacionais, resultando em diferentes isoformas (P0, P1 e P2), apresentando propriedades distintas. A Cx43 apresenta-se distribuída em todo o rim adulto. A injúria renal aguda (IRA) é uma síndrome metabólica em que ocorre redução aguda da função renal e rápida diminuição da taxa de filtração glomerular, sendo hipóxia decorrente da isquemia sua causa principal. A restrição de oxigênio e nutrientes, e o acúmulo de metabólitos, resultam na injúria das células epiteliais tubulares. A depleção dos níveis de ATP, aumento nos níveis de cálcio intracelular, alterações na membrana e deformações no citoesqueleto caracterizam esta injúria. A reoxigenação tecidual atua como agressão adicional devido à liberação de radicais livres. Estudos sugerem que a ativação de hemicanais de Cx43, resultante da desfosforilação da proteína, durante depleção de ATP, esteja envolvida na IRA. Este trabalho verificou o envolvimento da Cx43 em modelo murino desta injúria, ocasionada por isquemia/reperfusão. Foram utilizados camundongos machos da linhagem C57BL/6J. A isquemia foi induzida por clampeamento das artérias renais por 45 minutos. A reperfusão ocorreu durante 24 horas após cirurgia. Foram utilizados 6 animais por grupo (isquêmicos, reperfundidos e controle). Após sacrifício, fragmentos dos rins foram submetidos a ensaios de western blot, PCR em tempo real, imuno-histoquímica e imunofluorescência. O modelo experimental foi validado através da dosagem de uréia e creatinina plasmática. As análises estatísticas foram realizadas pela análise de variância (ANOVA), seguido do teste de Bonferroni. Observou-se aumento significativo dos níveis de uréia e creatinina nos animais isquêmicos e reperfundidos, em relação ao controle. A expressão gênica apresentou aumento significativo apenas nos rins de camundongos reperfundidos (1,9 vezes; P<0,01 vs controle). No western blot verificou-se aumento na quantidade da isoforma hiperfosforilada da Cx43 (P2) em rins isquêmicos (2,73 vezes; P<0,05 vs controle), com diminuição significativa nos reperfundidos (2,37 vezes; P<0,05 vs isquêmico). Nas isoformas menos fosforiladas (P1/P0), observou-se aumento nos rins isquêmicos (2,33 vezes; P<0,05 vs controle), com diminuição nos reperfundidos (10 vezes; P<0,01 vs isquêmico). Nos ensaios imuno-histológicos verificou-se diferentes localizações da Cx43 nas células epiteliais de túbulos corticais nos grupos comparados. Nos controles verificou-se distribuição difusa, e nos isquêmicos observou-se intensa marcação em superfície celular apical. Nos rins reperfundidos, a distribuição da Cx43 foi basolateral. As alterações observadas na expressão gênica, fosforilação protéica e distribuição da Cx43 nos rins foram semelhantes às mudanças observadas na isquemia cardíaca. Este estudo mostrou pela primeira vez a regulação da Cx43 em níveis transcricionais e pós-traducionais, e sua localização celular na IRA ocasionada por isquemia/reperfusão, indicando sua participação neste processo. / The cells require contact with other cells and the extracellular matrix for tissue formation. Gap junctions are narrow channels connecting the cytoplasm of two adjacent cells, promoting the passage of inorganic ions, amino acids, nucleotides and other metabolites. These junctions are composed of two conexons or hemichannels, crossing the cell plasma membrane where they belong, and consist of six integral membrane proteins called connexins (Cxs). The Cx43 is the most expressed, and is phosphorylated throughout the life cycle, undergoing conformational changes, resulting in different isoforms (P0, P1 and P2) that have different properties. The Cx43 is distributed throughout the adult kidney. The acute kidney injury (AKI) is a metabolic syndrome that occurs in acute reduction of renal function and rapid decline in glomerular filtration rate. Hypoxia resulting from ischemia is its principal cause. The restriction of oxygen and nutrients, and accumulation of metabolites, result in the injury of tubular epithelial cells. The depletion of ATP levels, increased levels of intracellular calcium, changes in the membrane and cytoskeleton deformation characterize this injury. Reoxygenation tissue acts as additional injury due to release of free radicals. Studies suggest that activation of Cx43 hemichannels, resulting from dephosphorylation of the protein during ATP depletion, is involved in the AKI. This study investigated the involvement of Cx43 in a murine model of this injury, caused by ischemia/ reperfusion. We used male mice of strain C57BL/6J. Ischemia was induced by clamping the renal arteries for 45 minutes. Reperfusion occurred 24 hours after surgery. We used six animals per group (ischemic, reperfused, and sham). After sacrifice, kidney fragments were tested for western blot, real-time PCR, immunohistochemistry and immunofluorescence. The levels of plasma urea and creatinine were measured to validate the experimental model. Statistical analysis was performed by analysis of variance (ANOVA) followed by Bonferroni test. We observed significant increase in serum urea and creatinine in ischemic and reperfused animals compared to sham. Gene expression increased significantly only in the reperfused kidneys (1.9 fold, P <0.01 vs sham). The western blot showed an increase in the amount of hyperphosphorylated isoform of Cx43 (P2) in ischemic kidneys (2.73 times, P <0.05 vs sham), with significant reduction in reperfused (2.37 times, P <0 05 vs ischemic). In the less phosphorylated isoforms (P1/P0), we observed an increase in ischemic kidneys (2.33 times, P <0.05 vs sham), with a decrease in reperfused (10 times, P <0.01 vs ischemic). In immuno-histological tests we verified different locations of Cx43 in the epithelial cells of cortical tubules. In normal kidneys there was patchy distribution, while in ischemic there was intense staining in the apical cell surface. In the reperfused kidney, the distribution of Cx43 was basolateral. The changes in gene expression, protein phosphorylation and distribution of Cx43 in the kidney observed in this study were similar to changes observed in cardiac ischemia. This study showed for the first time the regulation of Cx43 in transcriptional and post-translational levels, and its cellular localization in acute renal failure caused by ischemia/reperfusion, indicating its involvement in this injury.

A lesão hepática por isquemia e reperfusão (I/R) ocorre em situações clínicas diversas, como nas grandes hepatectomias e no transplante hepático. A fisiopatologia desta lesão é composta, principalmente, por intensa resposta inflamatória aguda e estresse oxidativo hepático. Em consequência a essa lesão a proliferação pós hepatectomia pode ser prejudicada. Por outro lado, Pirroloquinolina Quinona (PQQ) é um cofator que vem sendo estudado em virtude de suas ações antioxidantes e de estimulação de crescimento. Materiais e métodos: Camundongos balb-c foram submetidos à lesão hepática por I/R normotérmica seguida de hepatectomia e tratados com PQQ (10mg/kg de peso corporal) ou solução salina. Foram avaliados o grau de lesão hepatocelular (nível sérico de aminotransferases e escore histológico de agressão tecidual), a intensidade do estresse oxidativo (dosagem de MDA, GSH, NRF2 e eNOS hepáticos), a intensidade da resposta inflamatória aguda (quantificação de NFkB, Il-1? e TNF-? no fígado) e a proliferação hepatocelular (quantificação hepática de PCNA e ciclina D1). Resultados: PQQ reduziu significativamente os parâmetros de lesão hepática. Adicionalmente, os animais tratados com PQQ exibiram reduzido estresse oxidativo hepático devido à preservação da reserva antioxidante de GSH, à estimulação de expressão de NRF2 e à diminuição dos níveis hepáticos de MDA. Todavia, os níveis de eNOS não sofreram alteração com o tratamento. A atividade inflamatória aguda também foi reduzida com regulação da expressão hepática de NFkB e IL-1?. Entretanto, TNF-?, PCNA e Ciclina D1 não apresentaram diferença estatisticamente significativa entre os grupos. Conclusão: Os resultados obtidos indicam que PQQ é capaz de proteger o fígado contra a lesão por IR normotérmica seguida de hepatectomia e que essa proteção foi relacionada à sua ação antioxidante e anti- inflamatória. Todavia, a capacidade proliferativa hepática não foi alterada pelo tratamento no tempo avaliado. / Liver injury following ischemia and reperfusion (IR) occurs in several clinical situations such as major hepatectomies and liver transplantation. The physiopathology of this damage is composed for hepatic acute inflammatory response and oxidative stress. As a result of this injury the proliferation can be impaired. In other hand, Pyrroloquinoline Quinone (PQQ) is a cofactor that has been studied because has antioxidant activity and stimulates growth. Materials and Methods: Balb-c mice were underwent to hepatic injury by normothermic I/R followed by partial hepatectomy, and treated with PQQ (10mg/kg body weight) or saline solution. We evaluate the degree of hepatocellular damage (Serum level of aminotransferases and histological score of tissue damage), the intensity of liver oxidative stress (measurement of MDA,GSH, NRF2 and eNOS hepatic levels), the intensity of inflammatory response (measurement of NFkB, IL-1? e TNF-? hepatic levels). Results: PQQ significantly reduced the parameters of hepatocellular damage. PQQ-treated animals showed decreased hepatic oxidative stress by preserving antioxidant reserve of GSH, expression stimulation of NRF2 and reduced hepatic level of MDA. However, eNOS levels dind\'t change with the treatment. Inflammatory activity was also reduced by the down- regulation of NF?B and IL1- ?. Nevertheless, TNF-? and PCNA and D1 Cyclin did not show significant differences between the animal groups . Conclusion: These data indicate that PQQ was able to protect the liver against normothermic IR injury followed by hepatectomy and that protection was related with its antioxidant and antiinflammatory capability. Although, the hepatic proliferative capacity was not altered by the treatment in the evaluate time.