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Sudden Infant Death Syndrome (SIDS) is the sudden death of an infant younger than one year of age that remains unexplained after a complete investigation. For these infants, many different reasons have been hypothesized as to the cause of these deaths including: inherent vulnerability and improper hypoxic arousal. Studies done in other laboratories have shown that there seems to be a reduction in the levels of the neurotransmitter serotonin (5-HT) in the neurons of the raphe, extra-raphe, and ventral populations along with projection sites of these neurons. The huge implications of 5-HT in the control of respiration, prompted animal model studies to further investigate a potential connection between 5-HT and SIDS. 5-HT deficient mice were engineered by knocking out the Pet-1 transcription factor so that knockout mice only retained 30-40% of their brainstem 5-HT neurons. By comparing these 5-HT deficient Pet-1 knockout mice to wild-type mice, it was demonstrated that 5-HT deficient mice failed to autoresuscitate themselves after repeated bouts of hypoxia. Intriguingly, these mice only experienced an autoresuscitation deficit during a specific time period during development. To further evaluate the pathological development behind this behavior issue, in the current study we utilized mice that have modified Pet-1-Flpe driver, Egr2-Cre driver, along with a knock-in RC::FPSit allele to observe 5-HT development in the brainstem in a mature adult and across the critical period (postnatal days 8 and 13- P8 and P13). The transgenic mouse model Pet1-Krox20 gives us a way of exploring a specific subset of 5-HT neurons that rise from the developmental rhombomeres r3 and r5. The use of the knock-in RC::FPSit allele allows us to view the axonal projections of these specific 5-HT neurons by utilizing the presynaptic marker synaptophysin-GFP. This model (PKSit) will allow us to target 5-HT neurons that are implicated in respiration. We chose to compare two projection targets of the PKSit 5-HT neuron subtype through the vulnerable period of development and mature adult mouse: the Locus Coeruleus (LC) and the Nucleus Tractus Solitarius (NTS). In this study we tested the amount of colabeling between 5-HT and GFP in the LC and NTS at P8, P13, as well as the mature adult. We hypothesize that the LC undergoes significant serotonergic axon development and increases colocalization with GFP labeled axon projections between the ages of P8 and P13. We sliced mouse brains and ran immunofluorescence before taking confocal images. By utilizing ImageJ software to run colocalization analysis on the images obtained, we were able to quantify the amount of 5-HT labeled axon projections that are colocalized with GFP labeled axon projections. The parameters we used to quantify the amount of colocalization include the Pearson's Coefficient (PC), Mander's Coefficient (M1/M2), Cytofluorograms, Costes' Method, and van Steensel's Cross-Correlation Coefficient (CCF). We found that the LC shows significant changes with age in the colocalization of 5-HT with GFP while the NTS does not exhibit significant changes with age. The significant changes found in the LC 5-HT/GFP expression between the ages of P8 and P13 suggest one possible cause of failure of arousal. At P8, this lack of 5-HT colabeling with GFP projections suggests that there is some development occurring, which prevents the proper function of 5-HT. At P13, there is a significant increase in the colabeling of 5-HT with GFP, which indicates that the Pet1-Krox20 lineage is actively using 5-HT. The colocalization studies demonstrate that as the mouse ages, the amount of 5-HT labeling with GFP-synaptophysin in the NTS stays the same. The lack of overlap even in mature adult mice suggests that the expression of 5-HT in GFP labeled projections is not necessary. This colocalization study shows that there is an effect of age on the development of the serotonergic system in the LC, but no effect of age in the NTS. While this demonstrates that there is a critical period of development in relation to the LC, it is only one aspect of why mice pups failed to respond to repeated bouts of hypoxia.

Aim of paper is to find out what effects do physical exercises have on the psychical part of the person. Theoretical part speaks about psychology and emotions from the psychical view, and also from the biological view. It speaks about the effect of sport, group mentality and the way people in a group perceive the sport. It also mentions biological processes in the body and the substances that are made during the physical exertion. Methodical parts speaks about how we will put out hypothesis to the test. That is how, where, how long and under what circumstances will we do our experiement, and how will we evaluate it. Conclution is made of results, which containt tables and graphs with collected data and their explanation in text, evaluation and personal comments. Annexes contain the prototype of the used questionnaire. Results showed, that theoretical hypothesis, that physical activities are beneficial for a human, and statistical hypothesis both proved correct, and statistical one in 83,3% of the cases.

A depressão pós-parto (DPP) é um importante problema de saúde pública podendo provocar uma ruptura do vínculo entre a mãe e o bebê e até estar associada com respostas trágicas, como suicídio materno e infanticídio. A DPP é multifatorial e o seu surgimento pode ser favorecido por componentes hormonais, genéticos e ambientais. O ciclo gravídico-puerperal é considerado um período de risco, pois algumas mulheres possuem uma sensibilidade particular as alterações hormonais. O risco de DPP é aumentado em mulheres que possuem histórico de depressão na família, logo, um componente genético determina maior suscetibilidade. Segundo o DMS-IV, existe uma relação entre a sintomatologia depressiva e as alterações na concentração cerebral de neurotransmissores, com destaque para serotonina. O transportador de serotonina (SERT) controla a intensidade e duração da re-captação da serotonina nas sinapses serotonérgicas. Diversos trabalhos associam os polimorfismos do SERT com transtornos mentais, como unipolar, bipolar, depressão e esquizofrenia. Nosso objetivo foi analisar as concentrações salivares de cortisol (CORT), as freqüências alélicas e genotípicas dos polimorfismos 5-HTTVNTR e 5- HTTLPR no gene SLC6A4 entre mulheres que desenvolveram ou não DPP. A amostra foi constituída por 128 mulheres brancas da cidade de Pelotas/RS, triadas em ambulatórios do SUS. A avaliação diagnóstica foi realizada através de entrevista psiquiátrica e diagnóstica usando como instrumento o Beck Depression Inventory entre 30 a 45 dias após o nascimento das crianças. A coleta de material biológico (leucócitos e saliva) foi realizada no turno da manhã, respeitando o período de duas horas de jejum. A região promotora do gene contendo o polimorfismo 5-HTTLPR (inserção/deleção) e a região do segundo íntron contendo o polimorfismo 5- HTTVNTR (repetições em tandem) foram amplificadas através da reação em cadeia da polimerase. A dosagem do CORT foi realizada a partir da saliva por técnica de ELISA utilizando kit específico. A mediana e o intervalo interquartil das concentrações salivares do CORT entre os portadores dos diferentes genótipos foram comparados entre os grupos estudados usando o teste de Kruskal-Wallis e Mann-Whitney. A comparação das freqüências alélicas e genotípicas dos polimorfismos estudados entre as mulheres que apresentarem ou não DPP foram feitas pelo teste do Qui-quadrado com correção de Yates (p£ 0,05). A análise da distribuição das freqüências genotípicas dos polimorfismos 5-HTTLPR e 5- HTTVNTR do SERT permitiu verificar que a população está sob Equilíbrio Hardy– Weinberg. Quando os polimorfismos foram analisados isoladamente, não foi observada associação entre os polimorfismos 5-HTTLPR (p=0,48) e 5-HTTVNTR (p=0,77) e o diagnóstico para DPP. Porém, a análise combinada dos haplótipos dos polimorfismos 5-HTTLPR e 5-HTTVNTR demonstraram que mulheres portadoras do diplótipo L-12/L-12 apresentaram escores menores de sintomas depressivos (mediana: 0,5; intervalo inter-quartil: 0,00-4,00, p=0,04) quando comparadas com mulheres portadoras de outros diplótipos (mediana: 4,0; intervalo inter-quartil: 1,00- 10,00). O polimorfismo 5-HTTVNTR foi associado com as concentrações salivares de CORT (p=0,03), já o polimorfismo 5-HTTLPR não foi associado (p=0,41). Nossos achados são inovadores, visto que até a presente data a associação dos genótipos 5-HTTLPR e 5-HTTVNTR com DPP e concentrações salivares de CORT ainda não haviam sido investigados. / The postpartum depression (PPD) is an important public health problem that may cause a rupture of the bond between the mother and the baby and may even be associated with tragic responses such as maternal suicide and infanticide. The DPP is multifactorial and its appearance can be favored by hormonal components, genetic and environmental factors. The pregnancy and childbirth is considered a risk period, because some women have a particular sensitivity to hormonal changes. The rate of DPP is increased in women who have a record of depression in the family, so a genetic component determines higher susceptibility. According to the DSM-IV, there is a relationship between depressive symptoms and brain concentration changes of neurotransmitters, particularly serotonin. The serotonin transporter (SERT) controls the intensity and duration of re-uptake of serotonin in serotonergic synapses. Several studies linking polymorphisms of SERT with mental disorders such as unipolar, bipolar, depression, and schizophrenia. Our objective was to analyze the concentrations of salivary cortisol (CORT), the allele and genotype frequencies of polymorphisms 5-HTTLPR and 5-HTTVNTR SLC6A4 gene in women who developed or not DPP. The sample consisted of 128 white women from Pelotas, RS, sorted out from public health clinics. The diagnostic evaluation was conducted through interviews and psychiatric diagnostic instrument as using the Beck Depression Inventory among 30 to 45 days after the birth of children. The collection of biological materials (leukocytes and saliva) was performed in the morning, observing the twohour period of fasting. The promoter region of the gene containing the 5-HTTLPR polymorphism (insertion/deletion) and the region containing the second intron polymorphism 5-HTTVNTR (tandem repeats) were amplified by polymerase chain reaction. The dose of CORT was performed from the saliva by ELISA using the specific kit. The median and interquartile interval of salivary concentrations of CORT among patients of different genotypes were compared between groups using the Kruskal-Wallis and Mann-Whitney. The comparison of allele and genotype frequencies of polymorphisms among women who developed or not DPP were made by chi-square test with Yates correction (p <0.05). The analysis of the distribution of genotype frequencies of polymorphisms 5-HTTLPR and 5-HTTVNTR SERT showed that the population is under Hardy-Weinberg Equilibrium. When the polymorphisms were analyzed alone, no association was observed between the 5-HTTLPR (p=0.48) and 5-HTTVNTR (p=0.77) polymorphisms and the PPD diagnosis. But, the information from these analyses combined with information regarding the haplotypes of the 5-HTTLPR and 5-HTTVNTR polymorphisms demonstrated that women carriers of diplotype L-12/L-12 have a lower depression symptoms score (median: 0.5; interquartile range: 0.00-4.00; p=0.04) than women with other diplotypes (median: 4.0; inter-quartile range: 1.00-10.00). The 5-HTTVNTR polymorphism was associated with the salivary concentrations of CORT (p=0.03), whereas the 5-HTTLPR polymorphism was not associated (p=0.41). Our findings are innovative since the association of 5- HTTLPR genotypes and 5-HTTVNTR with DPP and salivary concentrations of CORT had not been investigated before.

The incidence of sudden death is higher in epileptic people compared to the general population and sudden unexpected death in epilepsy (SUDEP) is second only to stroke in the years of potential life loss among the major neurological disorders. In the majority of observed human SUDEP cases, respiratory dysfunction post-seizure is shown to be the primary initiating event leading to cardiac asystole and death. During seizures, several neuroactive agents are shown to be released, including serotonin and adenosine. Previous research has shown the effects of these neuroactive agents on seizure and respiratory function independently. A role of adenosine in triggering death post-seizures in a chemically-induced seizure model has been shown, but the mechanism of death is not clear. Studies from our lab have shown the role of fluoxetine (selective serotonin-reuptake inhibitor) in preventing seizure-induced respiratory arrest (S-IRA) in DBA/1 mouse model of SUDEP, but the neuronal networks mediating S-IRA and the brain structures involved in the fluoxetine-mediated blockade of S-IRA are not known. Data from human SUDEP imaging has underlined the role of periaqueductal gray (PAG), which is also implicated in audiogenic seizure (AGSz) network and respiratory modulation in other models. The goal of my dissertation is to understand the mechanisms by which adenosine could cause SUDEP susceptibility, the neuronal networks in the DBA/1 mice that lead to S-IRA and how fluoxetine modulates the neuronal activity at these neuronal network structures to prevent S-IRA. A better understanding of these mechanisms may lead to development of potentially important targeted therapies to prevent SUDEP in future. In the first aim, I have examined the role of adenosine in mediating SUDEP. Genetically epilepsy prone rats (GEPR-9s) exhibit AGSz but the incidence of death post-seizure is very low. I tested whether decreasing adenosine breakdown could increase the incidence of death in GEPR-9s. My study shows that adenosine metabolic blockers, which prevent the metabolism of released adenosine during seizures significantly increased the duration of respiratory dysfunction, post-ictal depression, decreased the peripheral oxygen saturation and subsequently, increased the incidence of death post-seizure in GEPR-9s. These findings on the role of adenosine and role of specific adenosine receptors in SUDEP are required to be validated in another SUDEP model. This formed the core of my second specific aim and since DBA/2 mice are susceptible to AGSz, and after seizures a large percent of these DBA/2 mice show S-IRA, while the rest don’t show S-IRA. Therefore, I tested if adenosine antagonism could prevent S-IRA post AGSz in DBA/2 mice, and found that caffeine a non-selective adenosine antagonist significantly decreased the incidence of S-IRA post AGSz. Administration of adenosine metabolic blockers increased the incidence of S-IRA in DBA/2 mice similar to GEPR-9s. Parallel studies from our lab have shown that administration of selective A2a antagonist but not A1 antagonist also decreased S-IRA incidence in DBA/2 mice. These data from GEPR-9s and DBA/2 mice suggests for a potentially important role of selective adenosine receptors in mediating the susceptibility to SUDEP by acting on respiratory function. In the third specific aim, I have examined the role of subcortical neuronal network structures including the PAG in mediating S-IRA and the quantitative differences in respiratory function elicited by electrical stimulation at PAG between DBA/1 and C57 mice. While the role of neuroactive agents in SUDEP has received attention, the neuronal networks mediating SUDEP in pre-clinical models are not known, specifically in DBA/1 mice an established SUDEP model susceptible to AGSz. The role of subcortical neuronal network structures including PAG in AGSz has been well-studied in other AGSz models. To decipher the neuronal networks that lead to S-IRA in DBA/1 mice, I exposed both DBA/1 mice that show AGSz and S-IRA and C57 mice that are non-susceptible to AGSz to acoustic stimulus and performed an ex vivo manganese-enhanced magnetic resonance imaging (MEMRI). Data analyses revealed the role of several brain structures in auditory, sensorimotor-limbic, respiratory networks and serotonergic raphe nuclei in DBA/1 mice. Of interest the PAG, a region implicated in other models of AGSz, respiratory modulation and human SUDEP has shown a significant increase in MEMRI signal intensity compared to C57 mice. These findings formed the rationale for the fourth specific aim to examine the quantitative differences in PAG-mediated respiratory modulation in response to electrical stimulation between C57 and DBA/1 mice. The threshold of current needed at PAG for a significant increase in respiration in DBA/1 mice is four times greater than C57 mice. Electrical stimulation at amygdala (AMG) showed marginal differences between DBA/1 and C57 mice suggesting the least possible pathological role of AMG in DBA/1 mice to mediate S-IRA. These data support a reduced respiratory function of PAG in DBA/1 mice compared to C57 mice. Taken together, these findings suggest that a reduced respiratory function of PAG in DBA/1 mice could lead to S-IRA and support a potentially critical compensatory role of PAG in DBA/1 mice. In the fifth specific aim, I examined the effect of fluoxetine on the subcortical neuronal network structures in DBA/1 mice that may lead to blockade of S-IRA. Fluoxetine has been shown to prevent S-IRA in DBA/1 mice effectively, but where in the brain does this drug act to prevent the susceptibility to SUDEP in DBA/1 mice is not known. To address this question, I used ex vivo MEMRI in DBA/1 mice that received fluoxetine at a dose which selectively blocks S-IRA but not AGSz. Fluoxetine treated DBA/1 mice that didn’t show S-IRA have shown a potential compensatory increase in activity at several sub-cortical structures including PAG compared to DBA/1 mice that showed S-IRA. In summary, these data suggest the PAG as a critical compensatory structure among the other sub-cortical neuronal network structures identified for SUDEP in this mice model. Differential modulation of these subcortical neuronal network structures by adenosine or serotonin released during seizures could determine the susceptibility to SUDEP.

Made available in DSpace on 2015-07-22T20:49:56Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-11-26. Added 1 bitstream(s) on 2015-08-11T03:25:31Z : No. of bitstreams: 1 Publico-00387.pdf: 2025016 bytes, checksum: 1d807dcd8112ef82a43a87d394716763 (MD5) / Objetivos: 1- Investigar o efeito imediato (01 sessão) e mediato (10 sessões) da acupuntura no tratamento da síndrome de apnéia-hipopnéia obstrutiva do sono (SAHOS) de grau moderado. 2- Avaliar a especificidade da técnica, comparando acupuntura manual, eletroacupuntura 2 Hz e eletroacupuntura 10 Hz. 3- Avaliar o envolvimento da serotonina neste mecanismo de ação da acupuntura. Método: Um ensaio clínico, randomizado, controlado, simples cego, foi conduzido no Departamento de Fisiologia, no Setor de Distúrbios do Sono, no Setor de Medicina Chinesa-Acupuntura e no Laboratório de Rim e Hormônios da Universidade Federal de São Paulo - Escola Paulista de Medicina, no período de Janeiro de 2004 a outubro de 2006. Foram recrutados 43 pacientes previamente diagnosticados clínica e polissonograficamente como portadores de SAHOS moderada {índice de apnéia-hipopnéia (IAH) > 15/hora < 30/hora}. Os pacientes foram randomizados em quatro grupos: grupo controle (CTRL), grupo acupuntura manual, grupo eletroacupuntura 2 Hz e grupo eletroacupuntura 10 Hz. O grupo controle não recebeu qualquer tipo de intervenção. Os grupos acupuntura manual e eletroacupuntura receberam tratamento por 05 semanas (2 aplicações por semana). Todos os pacientes foram avaliados pré e pós-tratamento através de exame polissonográfico e da dosagem de serotonina. A dosagem de serotonina foi feita por HPLC-ED (Cromatografia Líquida acoplada a Detecção Eletroquímica). Resultados: Em relação ao efeito imediato (01 sessão) da acupuntura, houve diminuição significativa do IAH (P=0,006; P=0,009), dos eventos respiratórios (P=0,012; P=0,005), dos microdespertares (P=0,046; P=0,05) e da saturação de O2 (P=0,006; P=0,035) nos grupos acupuntura manual e eletroacupuntura 10 Hz, antes e depois de uma aplicação de acupuntura. O índice de apnéia (P=0,028) e o índice de hipopnéia (P=0,046) tiveram diminuição significativa apenas no grupo eletroacupuntura 10 Hz. Não houve alterações significativas nos grupos eletroacupuntura 2 Hz e grupo controle quando foram comparados polissonograficamente antes e após a sessão de acupuntura. Quando todos os grupos foram comparados ao grupo controle, apenas o grupo eletroacupuntura 10 Hz apresentou diminuição significativa do IAH. Em relação ao efeito mediato (10 sessões) da acupuntura houve diminuição significativa do tempo de início do sono (P=0,011; P=0,005), do IAH (P=0,011; P=0,006), do índice de apnéia (P=0,042; P=0,005) dos eventos respiratórios (P=0,011; P=0,009) e dos microdespertares (P=0,011; P=0,021) nos grupos acupuntura manual e eletroacupuntura 10 Hz, antes e depois do tratamento. O índice de hipopneia (P=0,021) teve diminuição significativa apenas no grupo eletroacupuntura 10 Hz. O tempo de inicio do sono (P=0,005; P=0,005) dimimuiu significativamente tanto no grupo controle quanto no grupo eletroacupuntura 2 Hz. A exceção deste dado, nenhum outro evento se modificou significativamente nestes grupos. Quando todos os grupos foram comparados ao grupo controle, apenas o grupo eletroacupuntura 10 Hz apresentou diminuição significativa do IAH e dos microdespertares (P=0,004; P=0,008). Em relação ao envolvimento da serotonina no mecanismo de ação imediato da acupuntura na SAHOS Moderada, não observamos significância estatística entre grupos quando comparados ao Controle: Acupuntura Manual (P=0,7674), Eletroacupuntura 2 Hz (P=0,9849) e Eletroacupuntura 10 Hz (P=0,1042). Em relação ao envolvimento da serotonina no mecanismo de ação mediato da acupuntura na SAHOS Moderada o grupo Acupuntura Manual apresentou significância estatística quando comparado ao grupo Controle (P=0,0067) e o grupo Eletroacupuntura 10 Hz, apresentou tendência à significância estatística quando comparado ao grupo Controle (P=0,0984). A não significância estatística destes resultados parece estar relacionada à variabilidade inicial da 5HT e ao pequeno tamanho da amostra. Conclusões: A acupuntura manual e a eletroacupuntura 10 Hz são mais eficazes que a eletroacupuntura 2 Hz em melhorar o IAH e outros eventos respiratórios do sono de pacientes portadores de SAHOS Moderada. Esta eficácia foi observada tanto no efeito imediato (01 sessão de acupuntura), como no efeito mediato (10 sessões de acupuntura). Os resultados preliminares relacionados à serotonina, já apontam para uma direção neurofisiológica que possa justificar a eficácia da acupuntura no tratamento de pacientes portadores da SAHOS. / STUDY OBJECTIVES: 1 - To investigate the immediate (single session) and mediate (ten sessions) effect of acupuncture over the sleep pattern of patients with moderate obstructive sleep hypopnea apnea (OSHA). 2 - To compare manual acupuncture (MA) and electroacupuncture (EA) with different stimulation frequencies (2 Hz and 10 Hz). 3 - To determine the role of endogenous serotonin in this mechanism. SETTING: Department of Physiology, Sleep Division of Department of Psychobiology, Chinese Medicine Division and Department of Nephrology, Federal University of São Paulo, Brazil. INTERVENTIONS: Acupuncture applied in true acupoints accompanied by needle manipulations or electroacupunture 2 hz and 10 Hz for 30 minutes in all patients, except control group pacients. DESIGN: In a randomized, placebo-controlled and single blind study, fourty-three patients with an apnea-hypopnea index (AHI) of 15 to 30 per hour were randomly assigned to 4 groups: control group, MA group, EA 2Hz group and EA 10Hz group. The control group received no intervention. The MA group, EA 2Hz group and EA 10Hz group received treatment for five weeks (02 acupuncture aplications per week). All the patients were evaluated pre-treatment and pos-treatment by polissomnography recordings and assessment of serotonin levels. The 5HT measurement was made with a HPLC-ED (Liquid Chromatografy coupled with Electrochemical Detection). MEASUREMENTS AND RESULTS: 1 – Immediate effect: when compared before and after treatment, the AHI (P=0,006; P=0,009), respiratory events (P=0,012; P=0,005), microarousals (P=0,046; P=0,05) and mean O2 saturation (P=0,006; P=0,035) showed significant improvement in both the manual and electroacupuncture 10 Hz respectively. The apnea index (P=0,028) and the hipopneia index (P=0,046) showed significant improvement only in EA 10 Hz group. There were no significant changes in the electroacupuncture 2 Hz as well as in the control group when compared before and after (first and second for controls) PSG recordings. When compared each group and control group, AHI significantly decreased only in the EA 10 Hz. 2 – Mediate effect: When compared before and after treatment, sleep onset (P=0,011;P=0,005), AHI (P=0,011;P=0,006), apnea index (P=0,042;P=0,005), respiratory events (P=0,011;P=0,009) and microarousals (P=0,011;P=0,021 ) significantly improved in MA and EA 10 Hz respectively. Hipopnea-index (P=0,021) decreased only in the EA 10Hz. Latency for sleep onset (P=0,005;P=0,005) decreased in both EA 2Hz and control group. Except for this change, there were no other significant changes in EA 2 Hz, or in control group after treatment. When compared to the control group the only significant differences were AHI and microarousals that were decreased in EA 10 Hz group (P=0,004;P=0,008). As concerned to the levels of seric serotonin we could not evidence an involvement of this neurotransmitter (as measured in blood) with the immediate effects of acupuncture for OSHA (MA vs. controls [P=0,7674], EA 2 Hz vs controls [P=0,9849]) despite a tendency for a difference for EA 10 Hz as compared to controls (P=0,1042). With regard to an effect of mediate acupuncture in moderate OSHA we found that seric serotonin levels were signficantly different form controls for MA (P=0,0067) with a tendency for group EA 10 Hz (P=0,0984). The lack of more robust differences for seric serotonin levels might have been influcenced by a smaller numeber of subjects as that required for this sort of evaluations. Conclusions: MA and EA 10 Hz have greater efficacy as compared to EA 2 Hz in improving AHI and other respiratory events in patients with moderate OHSA. This effect was shown to hold for both in the immediate (1 acupuncture session) as in the mediate (10 sessions) acupuncture application. The preliminary serotonin results indicate a possible mechanistic link between acupuncture treatment and its beneficial effects for the treatment of patients with moderate OHSA. / TEDE / BV UNIFESP: Teses e dissertações

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2013-04-18T17:27:33Z No. of bitstreams: 1 Elenilda Farias de Oliveira. Efeito do bloqueio- 2010.pdf: 39365946 bytes, checksum: 63a6f116b63af4ec0fd8bfd91cf54a8a (MD5) / Made available in DSpace on 2013-04-18T17:27:33Z (GMT). No. of bitstreams: 1 Elenilda Farias de Oliveira. Efeito do bloqueio- 2010.pdf: 39365946 bytes, checksum: 63a6f116b63af4ec0fd8bfd91cf54a8a (MD5) Previous issue date: 2010 / Universidade Federal da Bahia. Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz / Estudos mostram a participação das vias serotoninérgicas e opiatérgicas centrais no controle da pressão sanguínea. A existência de interação entre vias serotoninérgicas e opiatérgicas centrais tem sido demonstrada por diferentes autores. Objetivo: O presente trabalho foi desenvolvido para investigar a participação dos receptores do tipo k e ô opiatérgicos centrais na resposta hipotensora induzida por ativação serotoninérgica e o papel do sistema nervoso simpático. Material e Métodos: Foram utilizados ratos Wistar (280 a 320g) submetidos a cirurgia de estereotaxia com canulação do ventrículo lateral. Um dia antes da sessão experimental, os animais foram submetidos à cateterização da artéria carótida para registro da pressão sanguínea e da veia jugular para infusão de drogas. A pressão sanguínea e frequência cardíaca foram registradas continuamente por 120 min após a injeção das drogas (Sistema de Aquisição de Dados - AqDados) e expressas como delta da pressão arterial média (PAM) e da frequência cardíaca (FC) em relação aos valores pré-injeção. Resultados: A administração de m-CPBG, agonista serotoninérgico S-HTs (160 nmol) em animais pré-tratados com salina causou redução significante da pressão sanguínea. A administração de ondansetrona, antagonista serotoninérgico 5-HT3 (80 nmol) promoveu aumento significante da pressão sanguínea. O pré-tratamento com ondansetrona bloqueou a resposta hipotensora decorrente da ativação dos receptores serotoninérgicos 5-HT3. O pré-tratamento com os antagonistas opiatérgicos naloxona, (30 nmol) e nor-binaltorfimina (10 nmol) bloqueou resposta hipotensora decorrente da ativação dos receptores 5-HT3, enquanto o pré-tratamento com o antagonista naltrindole (1 imiol) promoveu resposta hipertensora. A administração dos antagonistas isoladamente não promoveu alterações significativas da pressão sanguínea e fi’equéncia cardíaca. O bloqueio simpático periférico com prazosin (3mg/mL), antagonista ai- adrenérgico, impediu bloqueio à hipotensão promovido pelo antagonista nor- binaltorfimina, e reduziu parciahnente o bloqueio promovido pelos antagonistas naloxona e naltrindole. Conclusões principais: Os dados sugerem que a resposta hipotensora decorrente da ativação farmacológica dos receptores 5-HT3 centrais é dependente da integridade funcional dos receptores opioides tipo [x, k e 5 localizados no sistema nervoso central e é justificada por um mecanismo de inibição da atividade simpática. / Central serotonergic and opiatergic pathways participate in the mechanisms regulating blood pressure. Furthermore, interaction between serotonergic and opiatergic circuits at the central nervous system has been demonstrated. In the present study, we investigated the role of central k and 8 opioid receptors in the hypotensive response obtained after pharmacological activation of central 5-HT3 receptors, as well as the role of the sympathetic nervous system in this response. Wistar male rats (280-320 g) had the right lateral ventricle cannulated 5 days before the experimental sessions; polyethylene catheters were inserted into the left carotid artery (for blood pressure monitoring) and into the right jugular vein (for drug administration) 24h before the experiments. Blood pressure and heart rate were monitored for the next 2 hours after the administration of the drugs (Data Aquisition System by AqDados). Data were expressed as delta mean arterial pressure (MAP) and heart rate (HR). The MAP value at the end of the stabihzation period was considered the reference blood pressure at time zero and delta values are presented throughout the experiments. The central administration of m-CPBG, a selective 5-HT3 receptor agonist (160 nmol) induced a significant decrease in MAP in control (saline-pretreated) animals. Conversely, the central administration of ondansetron, a selective 5-HT3 receptor antagonist (80 nmol), evoked a significant increase in MAP. Pretreatment with ondansetron abolished the hypotensive response obtained after the stimulation of central 5-HT3 receptors by m- CPBG. Pretreatment with naloxone (30 imiol), a non-selective opiod antagonist, and with nor-binaltorfimine (NOR-BNI), a selective K-opioid receptor antagonist, blocked the hypotensive response observed after central 5-HT3 receptor stimulation. On the other hand, pretreatment with naltrindole (1 nmol), a selective 5-opioid antagonist, blocked the hypotensive response generated by central 5-HT3 receptor stimulation and promoted, after 15 minutes, a significant hypertensive response. The administration of each one of the opioid antagonists alone was unable to promote any significant change in MAP and HR, The blockade of sympathetic function by the peripheral administration of prazosin (al receptor blocker) abolished the blockade of the hypotensive response observed after 5-HT3 receptor stimulation induced by the K-opioid receptor antagonist NOR-BNI and blunted the blockade of the hypotensive response previously seen in animals treated with m-CPBG and pretreated with the opioid antagonists naloxone and naltrindole. The data presented here suggest that the hypotensive response obtained after the central stimulation of 5-HT3 receptors depends on the fiinctional integrity of central K and Ô opioid receptors and relies on a sympathoinhibitory mechanism.

Sérotonine (5-HT) neurones du mésencéphale sont nés de jour embryonnaire 10 à 12, et commencent à étendre axones, peu après la neurogenèse, tant rostrale du télencéphale et caudale du tronc cérébral. Ces projections sont très garantis, mais avec un certain degré d'organisation topographique. Dans le télencéphale, le schéma de la 5-HT innervation provenant de la dorsale (B7, B6) ou de la médiane (B5-B8) se distingue des noyaux. Cependant, il n'y a pas d'études de développement détaillées systématiques chez la souris, qui sont le modèle le plus largement utilisé, en particulier pour les études génétiques. Ces données sont importantes pour rassembler afin d'analyser les effets des mutations de la souris sur la voie moléculaire défini des neurones de la sérotonine. De plus, les molécules de guidage qui dirigent ces neurones du raphé 5-HT à différentes cibles ne sont pas connus. Nous avons effectué de nombreuses études sur l'innervation 5-HT visant à détecter la façon dont la partie dorsale et les noyaux du raphé médian sont ciblées sur des régions différentes du cerveau antérieur au cours du développement.Nous avons étudié le rôle de la signalisation ephrinA-EphA dans le ciblage sélectif. Nos résultats démontrent que l'ARNm EphA5 est exprimé sélectivement dans des sous-populations distinctes de neurones du raphé sérotonine. En particulier, EphA5 présentait le plus haut niveau dans les neurones raphé de la sérotonine dorsale (B7). Les résultats des cultures d'explants in vitro et in vivo électroporation analyses indiquent que les ligands de EphA5 (ephrinA5 et ephrinA3) agissent comme des facteurs répulsifs pour les cônes de croissance de l'axone sérotoninergique. Antérograde traçage dans le ephrinA5 - / - souris ont montré des neurones mauvais ciblage du raphé dorsal projections, y compris la projection sérotoninergique. En particulier, notre analyse de tracer les études montrent que le ciblage des dorsales et raphé médian axones à différentes couches du bulbe olfactif est modifié dans le ephrinA5 KO. Cependant, nous ne savons pas à quel stade de développement de ces altérations se produisent, en particulier si cela reflète un changement dans l'orientation des tracts croissant de fibres, ou si cela reflète la maturation de développement en retard quand axones raphé et garantissent des branches dans les régions cibles spécifiques. Nous avons profité d'une nouvelle méthode morphologique, ce qui permet d'analyser l'étiquetage immunocytochimique dans 3_D. 5-HT immunomarquage, dans la projection du cerveau sérotoninergique dans 3_D. Nos résultats montrent que les fibres sérotoninergiques projetant vers le bulbe olfactif besoin d'un calendrier spécial pour entrer la cible. Le profil d'expression de ephrinA5 suggère que ephrinA5 peut être l'un des facteurs qui modulent ce moment... / In mice, serotonin (5-HT) midbrain neurons are born from embryonic day 10 to 12, and start extending axons, shortly after neurogenesis, both rostrally to the telencephalon and caudally to the brainstem. These projections are highly collateralized but with some degree of topographic organization. In the telencephalon, the pattern of 5-HT innervation arising from the dorsal (B7, B6) or the medial (B5-B8) nuclei differs. However, there are no systematic detailed developmental studies in mice, which are the most extensively used model, in particular for genetic studies. Such data are important to gather in order to analyze the effects of mouse mutations on defined molecular pathway of serotonin neurons. Moreover the guidance molecules that direct these 5-HT raphe neurons to different targets are not known. We performed several studies of 5-HT innervation aimed at detecting how the dorsal and median raphe nuclei are targeted to different forebrain regions during development. We investigated the role of ephrinA-EphA signaling in selective targeting. Our results demonstrate that EphA5 mRNA is selectively expressed in distinct subpopulation of serotonin raphe neurons. Particularly, EphA5 exhibited the highest level in dorsal raphe serotonin neurons (B7). The results of in vitro explant cultures and in vivo electroporation analyses indicated that the ligands of EphA5 (ephrinA5 and ephrinA3) act as repellent factors for the serotonergic axon growth cones. Anterograde tracing in the ephrinA5 -/- mice showed mistargeting of dorsal raphe neurons projections, including the serotonergic projection. Particularly, our analysis of tracing studies show that targeting of the dorsal and median raphe axons to different layers of the olfactory bulb is altered in the ephrinA5 KO. However we do not know at what developmental stage these alterations occur, in particular whether this reflects an alteration in the orientation of ascending fiber tracts, or whether this reflects late developmental maturation when raphe axons collateralize and branch in specific target regions. We have taken advantage a new morphological method, which allows analyzing immunocytochemical labeling in 3_D. 5-HT immunolabeling, in whole brain serotonergic projection in 3_D. Our findings show that serotonergic fibers projecting to olfactory bulb require a special timing to enter the target. The expression pattern of ephrinA5 suggests that ephrinA5 can be one of the factors that modulate this timing. Overall, our results show for the first time the implication a guidance molecule for the region-specific and time-specific targeting of serotonin raphe neurons and has implications for the anatomo-functional parsing of raphe cell groups.

A depressão pós-parto (DPP) é um importante problema de saúde pública podendo provocar uma ruptura do vínculo entre a mãe e o bebê e até estar associada com respostas trágicas, como suicídio materno e infanticídio. A DPP é multifatorial e o seu surgimento pode ser favorecido por componentes hormonais, genéticos e ambientais. O ciclo gravídico-puerperal é considerado um período de risco, pois algumas mulheres possuem uma sensibilidade particular as alterações hormonais. O risco de DPP é aumentado em mulheres que possuem histórico de depressão na família, logo, um componente genético determina maior suscetibilidade. Segundo o DMS-IV, existe uma relação entre a sintomatologia depressiva e as alterações na concentração cerebral de neurotransmissores, com destaque para serotonina. O transportador de serotonina (SERT) controla a intensidade e duração da re-captação da serotonina nas sinapses serotonérgicas. Diversos trabalhos associam os polimorfismos do SERT com transtornos mentais, como unipolar, bipolar, depressão e esquizofrenia. Nosso objetivo foi analisar as concentrações salivares de cortisol (CORT), as freqüências alélicas e genotípicas dos polimorfismos 5-HTTVNTR e 5- HTTLPR no gene SLC6A4 entre mulheres que desenvolveram ou não DPP. A amostra foi constituída por 128 mulheres brancas da cidade de Pelotas/RS, triadas em ambulatórios do SUS. A avaliação diagnóstica foi realizada através de entrevista psiquiátrica e diagnóstica usando como instrumento o Beck Depression Inventory entre 30 a 45 dias após o nascimento das crianças. A coleta de material biológico (leucócitos e saliva) foi realizada no turno da manhã, respeitando o período de duas horas de jejum. A região promotora do gene contendo o polimorfismo 5-HTTLPR (inserção/deleção) e a região do segundo íntron contendo o polimorfismo 5- HTTVNTR (repetições em tandem) foram amplificadas através da reação em cadeia da polimerase. A dosagem do CORT foi realizada a partir da saliva por técnica de ELISA utilizando kit específico. A mediana e o intervalo interquartil das concentrações salivares do CORT entre os portadores dos diferentes genótipos foram comparados entre os grupos estudados usando o teste de Kruskal-Wallis e Mann-Whitney. A comparação das freqüências alélicas e genotípicas dos polimorfismos estudados entre as mulheres que apresentarem ou não DPP foram feitas pelo teste do Qui-quadrado com correção de Yates (p£ 0,05). A análise da distribuição das freqüências genotípicas dos polimorfismos 5-HTTLPR e 5- HTTVNTR do SERT permitiu verificar que a população está sob Equilíbrio Hardy– Weinberg. Quando os polimorfismos foram analisados isoladamente, não foi observada associação entre os polimorfismos 5-HTTLPR (p=0,48) e 5-HTTVNTR (p=0,77) e o diagnóstico para DPP. Porém, a análise combinada dos haplótipos dos polimorfismos 5-HTTLPR e 5-HTTVNTR demonstraram que mulheres portadoras do diplótipo L-12/L-12 apresentaram escores menores de sintomas depressivos (mediana: 0,5; intervalo inter-quartil: 0,00-4,00, p=0,04) quando comparadas com mulheres portadoras de outros diplótipos (mediana: 4,0; intervalo inter-quartil: 1,00- 10,00). O polimorfismo 5-HTTVNTR foi associado com as concentrações salivares de CORT (p=0,03), já o polimorfismo 5-HTTLPR não foi associado (p=0,41). Nossos achados são inovadores, visto que até a presente data a associação dos genótipos 5-HTTLPR e 5-HTTVNTR com DPP e concentrações salivares de CORT ainda não haviam sido investigados. / The postpartum depression (PPD) is an important public health problem that may cause a rupture of the bond between the mother and the baby and may even be associated with tragic responses such as maternal suicide and infanticide. The DPP is multifactorial and its appearance can be favored by hormonal components, genetic and environmental factors. The pregnancy and childbirth is considered a risk period, because some women have a particular sensitivity to hormonal changes. The rate of DPP is increased in women who have a record of depression in the family, so a genetic component determines higher susceptibility. According to the DSM-IV, there is a relationship between depressive symptoms and brain concentration changes of neurotransmitters, particularly serotonin. The serotonin transporter (SERT) controls the intensity and duration of re-uptake of serotonin in serotonergic synapses. Several studies linking polymorphisms of SERT with mental disorders such as unipolar, bipolar, depression, and schizophrenia. Our objective was to analyze the concentrations of salivary cortisol (CORT), the allele and genotype frequencies of polymorphisms 5-HTTLPR and 5-HTTVNTR SLC6A4 gene in women who developed or not DPP. The sample consisted of 128 white women from Pelotas, RS, sorted out from public health clinics. The diagnostic evaluation was conducted through interviews and psychiatric diagnostic instrument as using the Beck Depression Inventory among 30 to 45 days after the birth of children. The collection of biological materials (leukocytes and saliva) was performed in the morning, observing the twohour period of fasting. The promoter region of the gene containing the 5-HTTLPR polymorphism (insertion/deletion) and the region containing the second intron polymorphism 5-HTTVNTR (tandem repeats) were amplified by polymerase chain reaction. The dose of CORT was performed from the saliva by ELISA using the specific kit. The median and interquartile interval of salivary concentrations of CORT among patients of different genotypes were compared between groups using the Kruskal-Wallis and Mann-Whitney. The comparison of allele and genotype frequencies of polymorphisms among women who developed or not DPP were made by chi-square test with Yates correction (p <0.05). The analysis of the distribution of genotype frequencies of polymorphisms 5-HTTLPR and 5-HTTVNTR SERT showed that the population is under Hardy-Weinberg Equilibrium. When the polymorphisms were analyzed alone, no association was observed between the 5-HTTLPR (p=0.48) and 5-HTTVNTR (p=0.77) polymorphisms and the PPD diagnosis. But, the information from these analyses combined with information regarding the haplotypes of the 5-HTTLPR and 5-HTTVNTR polymorphisms demonstrated that women carriers of diplotype L-12/L-12 have a lower depression symptoms score (median: 0.5; interquartile range: 0.00-4.00; p=0.04) than women with other diplotypes (median: 4.0; inter-quartile range: 1.00-10.00). The 5-HTTVNTR polymorphism was associated with the salivary concentrations of CORT (p=0.03), whereas the 5-HTTLPR polymorphism was not associated (p=0.41). Our findings are innovative since the association of 5- HTTLPR genotypes and 5-HTTVNTR with DPP and salivary concentrations of CORT had not been investigated before.

abstract: The current study utilized data from two longitudinal samples to test mechanisms in the relation between a polygenic risk score indexing serotonin functioning and alcohol use in adolescence. Specifically, this study tested whether individuals with lower levels of serotonin functioning as indexed by a polygenic risk score were vulnerable to poorer self-regulation, and whether poorer self-regulation subsequently predicted the divergent outcomes of depressive symptoms and aggressive/antisocial behaviors. This study then examined whether depressive symptoms and aggressive/antisocial behaviors conferred risk for later alcohol use in adolescence, and whether polygenic risk and effortful control had direct effects on alcohol use that were not mediated through problem behaviors. Finally, the study examined the potential moderating role of gender in these pathways to alcohol use. Structural equation modeling was used to test hypotheses. Results from an independent genome-wide association study of 5-hydroxyindoleacetic acid in the cerebrospinal fluid were used to create serotonin (5-HT) polygenic risk scores, wherein higher scores reflected lower levels of 5-HT functioning. Data from three time points were drawn from each sample, and all paths were prospective. Findings suggested that 5-HT polygenic risk did not predict self-regulatory constructs. However, 5-HT polygenic risk did predict the divergent outcomes of depression and aggression/antisociality, such that higher levels of 5-HT polygenic risk predicted greater levels of depression and aggression/antisociality. Results most clearly supported adolescents’ aggression/antisociality as a mechanism in the relation between 5-HT polygenic risk and later alcohol use. Deficits in self-regulation also predicted depression and aggression/antisociality, and indirectly predicted alcohol use through aggression/antisociality. These pathways to alcohol use might be the most salient for boys with low levels of socioeconomic status. Results are novel contributions to the literature. The previously observed association between serotonin functioning and alcohol use might be due, in part, to the fact that individuals with lower levels of serotonin functioning are predisposed towards developing earlier aggression/antisociality. Results did not support the hypothesis that serotonin functioning predisposes individuals to deficits in self-regulatory abilities. Findings extend previous research by suggesting that serotonin functioning and self-regulation might be transdiagnostic risk factors for many types of psychopathology. / Dissertation/Thesis / Doctoral Dissertation Psychology 2017