Au sein des tumeurs, y compris pour le carcinome hépatocellulaire (CHC), des sous-populations de cellules néoplasiques ont révélé une grande capacité à initier de nouvelles tumeurs et à induire des métastases. Les premières études sur ces cellules ont rapidement montré que la présence de ces cellules était déterminante dans le développement tumoral et elles ont donc été renommées " cellules souches cancéreuses " (CSCs). Malheureusement les mécanismes impliqués dans la maintenance de ces CSCs ne sont que partiellement compris. Par ailleurs dans le CHC un lien a été établi entre les signaux du facteur de croissance de transformation (Transforming Growth Factor, TGF-ß) provenant du microenvironnement tumoral et certaines populations de cellules cancéreuses dont la présence est corrélée à un faible pronostic. La façon dont TGF-ß peut ainsi établir et modifier un phénotype cellulaire dans le CHC reste néanmoins obscure. La méthylation de l'ADN étant un acteur majeur dans la mise en place des programmes cellulaires, notre but a été de caractériser le méthylome de CSCs hépatiques et son lien avec la capacité de TGF-ß à induire des CSCs. Nous nous sommes appuyés sur l'expression du marqueur CD133 pour définir la population de CSCs hépatiques. Afin comprendre l'importance des marques de méthylation de l'ADN dans les CSCs hépatiques, nous avons dans un premier temps déterminé quelle était la signature des cellules CD133+ au niveau de la méthylation de l'ADN en utilisant des puces de méthylation à grande échelle. Les sites CpG différentiellement méthylés ont montré un enrichissement pour d'une part des voies de signalisation déjà identifiées dans les CSCs et, d'autre part, pour des voies de signalisation associées au processus inflammatoire dont la voie TGF-ß/SMAD. Par la suite, nous avons montré que TGF-ß pouvait induire de façon permanente les cellules CD133+ contrairement à une autre cytokine influente dans le cancer du foie, l'interleukine 6. Cette augmentation de cellules CD133+ induite par TGF-ß est associée à des changements de méthylation de l'ADN sur l'ensemble du génome et qui sont, de plus, maintenus au cours des divisions cellulaires. La comparaison entre les deux méthylomes (liés aux cellules CD133+ et à l'action de TGF-ß) a exposé une signature commune significative indiquant que TGF-ß pourrait promouvoir le phénotype de CSC via le processus de méthylation de l'ADN. Mais nous avons également déterminé qu'une grande partie des effets sur la méthylation induits par TGF-ß était totalement indépendante de l'induction de cellules CD133+. Enfin, nous avons observé que les sites de méthylation sensibles au signal de TGF-ß étaient regroupés de façon significative au niveau de régions " enhancer " qui régulent la transcription des gènes. Par ailleurs, ces sites incluaient également des gènes précédemment identifiés comme cibles de TGF-ß mais aussi des gènes codant pour des acteurs épigénétiques de premier ordre comme les méthyltransférases de l'ADN. Ces résultats constituent la première description d'une signature de méthylation de l'ADN induite par TGF-ß permettant une reprogrammation stable vers un profil épigénétique de CSC hépatiques.

With the dawn of metazoans, the ability of cells to communicate with each other became of paramount importance in maintaining tissue homeostasis. The transforming growth factor β (TGF-β) signaling pathway, which plays important roles during embryogenesis and in the adult organism, signals via a heterodimeric receptor complex consisting of two type II and two type I receptors. After receptor activation through ligand binding, Smads mediate the signal from the receptor complex to the nucleus, where they orchestrate transcription. Depending on the context of activation, TGF-β can mediate a plethora of cellular responses, including proliferation, growth arrest, apoptosis and differentiation. In cancer, TGF-β can act as both as a tumor suppressor and promoter. During early stages of tumorigenesis, TGF-β prevents proliferation. However, TGF-β is also known to promote tumor progression during later stages of the disease, where it can induce differentiation of cancer cells towards a migratory phenotype. The aim of this thesis was to investigate how cells can differentiate their response upon TGF-β pathway activation. The first paper describes the role of Notch signaling in TGF-β induced growth arrest, demonstrating that TGF-β promotes Notch activity and that Notch signaling is required for prolonged TGF-β induced cell cycle arrest. In the second and third paper, we investigate the role of SIK, a member of the AMPK family of kinases, mediating signaling strength of TGF-β through degradation of the TGF-β type I receptor ALK5. While the second paper focuses on the effect of SIK on ALK5 stability and subsequent alterations in TGF-β signaling, the third paper emphasizes cooperation between SIK, Smad7 and the E3 ligase Smurf in degradation of ALK5. Finally, the fourth paper explores a novel role of SIK during TGF-β induced epithelial to mesenchymal transition (EMT). SIK binds to and degrades the polarity protein Par3, leading to enhanced EMT.

Autoimmune diseases are a group of different diseases which are characterized by an immune disorder leading to decreased tolerance to components of the body itself. These diseases have many factors that trigger such as a decrease of the share or percentage of regulatory T cells (Tregs). The Transforming Growth Factor-beta 1 (TGF-β1) is involved in the suppression of the inflammatory response during the pathogenesis of autoimmune diseases (juvenile idiopathic arthritis, multiple sclerosis, diabetes), through the activation of this cell type. This cytokine is also associated with modulation of an inflammatory response either by increasing Treg cells and by modulating proinflammatory cytokines such as tumor necrosis factor alpha (TNF-α). The components found in both innate immune responses as adaptive must be considered potential targets for developing new drugs immune modulators. Thus, manipulation of Tregs is an attractive strategy for immunotherapy and hence, the use of mimetic peptide to TGF-β1 can be adopted to reduce the effects of severe autologous response, then creating an additional therapy for autoimmunity as well as for the treatment of inflammatory diseases. Our results show that we can select TGF-β1 mimetic peptides since we can prove by bioinformatics both bind to this receptor molecule. Thus, the peptides can be used as immunomodulators to combat inflammation and in the treatment of autoimmune diseases since they can modulate the production of TNF-α and IL-10. / Doenças autoimunes são um grupo de doenças distintas que se caracterizam por uma desordem imunológica levando a diminuição da tolerância aos componentes do próprio organismo. Essas doenças possuem vários fatores que as desencadeiam como a diminuição da ação ou porcentagem de células T regulatórias (Tregs). O Fator Transformante de Crescimento-beta 1 (TGF-β1) está envolvido na supressão da resposta inflamatória durante a patogênese de doenças autoimunes (artrite idiopática juvenil, esclerose múltipla, diabetes), por meio da ativação desse tipo celular. Esta citocina também está associada a modulação de uma resposta inflamatória, seja pelo aumento de células Tregs como pela modulação de citocinas pro-inflamatórias como o Fator de necrose tumoral alfa (TNF-α). Os componentes encontrados em respostas tanto imune inatas quanto adaptativas devem ser considerados potenciais alvos para o desenvolvimento de novos fármacos imuno moduladores. Assim, a manipulação de Tregs é uma estratégia atraente para a imunoterapia e, desta forma, o uso de peptídeos miméticos ao TGF-β1 poderá ser adotado para diminuir as consequências de uma resposta autóloga severa, criando, então, uma terapia complementar para a autoimunidade bem como para o tratamento de doenças inflamatórias. Nossos resultados mostram que conseguimos selecionar peptídeos miméticos a molécula do TGF- β1, uma vez que conseguimos provar por bioinformática que ambos se ligam ao receptor desta molécula. Assim, os peptídeos podem ser utilizados como imunomoduladores para o combate de inflamação e no tratamento de doenças autoimune já que conseguem modular a produção de TNF- α e IL-10. Experimentos in vivo realizados também demonstraram a sua capacidade de diminuir inflamação modulação a migração de neutrófilos e leucócitos. / Mestre em Genética e Bioquímica

Patients with classical vitiligo lose partially their protecting inherited pigment. The cause of the disease is still unknown. Despite massive epidermal oxidative / nitrative stress and signs for DNA-damage in the skin and in the plasma, these patients have no higher prevalence for sun induced non-melanoma skin cancer and increased photo-damage. Protection and DNA-repair have been attributed to a functioning up-regulated wild type p53 / p21 cascade in association with up-regulated p76 MDM2. As some patients with cutaneous melanoma develop depigmentations away from their primary tumour site post surgical excision, it became of our interest, whether this melanoma associated leucoderma (MAL) is the same as classical vitiligo. The purpose of this thesis was two-fold. In part I, we wanted to further substantiate the reasons behind the constantly up-regulated wild-type functioning p53 / p21 cascade in classical vitiligo utilising a panel of proteins with direct and / or indirect action on p53 regulation, including p21, p76MDM2, MDM4/MDM4phospho, SPARC, VEGF-A and TGF-β1. In part II, we wanted to characterize MAL and compare this peculiar leucoderma with classical vitiligo using the same protein panel and methodologies. To achieve our goals, we used in vivo FT-Raman spectroscopy, in vitro cell cultures, in vitro and in situ immuno-fluorescence labelling, Western blot, dot blot and computer modelling techniques. Our data showed distinct differences between classical vitiligo and MAL. Our results in MAL exhibited a concentration dependent protein expression gradient between the basal / suprabasl layers and the upper layers of the epidermal compartment using catalase, ONOO-, p53, p21, MDM4, p76MDM2, TGF-β1 and VEGF-A expression gradient. Moreover, we document for the first time the presence of a nitrated non-fuctional SPARC protein in classical vitiligo which is absent in MAL. Although we show in vivo considerable ROS / RNS- mediated stress in MAL and classical vitiligo documented by FT-Raman spectroscopy, Western blot and in situ immuno-fluorescence, our results prove that MAL and classical vitiligo are two distinct entities.

Submitted by TATIANA EMY KOIKE null (tatikoike@yahoo.com) on 2016-03-10T11:09:02Z No. of bitstreams: 1 Encadernaçao Mestrado UNESP- Tatiana Emy Koike.pdf: 1535953 bytes, checksum: 25ca75a268f1c6bf7d7ca80e833b9cbd (MD5) / Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2016-03-10T20:19:49Z (GMT) No. of bitstreams: 1 koike_te_me_prud.pdf: 1535953 bytes, checksum: 25ca75a268f1c6bf7d7ca80e833b9cbd (MD5) / Made available in DSpace on 2016-03-10T20:19:49Z (GMT). No. of bitstreams: 1 koike_te_me_prud.pdf: 1535953 bytes, checksum: 25ca75a268f1c6bf7d7ca80e833b9cbd (MD5) Previous issue date: 2016-02-17 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Muscle injuries are often cause due to the practice of sports and recreational activities. Because of its high incidence, it is important to research the treatments that promote quality in the muscle and shorter repair process. To evaluate the effect of the combination of the therapeutic resources of Cryotherapy and Therapeutic Ultrasound in the treatment of muscle damage by impact. 55 Wistar rats was separate into groups, Acute Injury (AI), Injury (I), Cryotherapy (CR), Therapeutic Ultrasound (TU), Cryotherapy and Therapeutic Ultrasound (CRTU). All animals were anesthetize and muscle damage due to impact by the release of a load of 200 g at 30 cm. Then received treatments as allocated group and CR protocol using ice bag for 20 minutes and TU for five minutes with an intensity of 0.5W / cm2 and the frequency of 1MHz. Euthanasia was performed by intraperitoneal administration of overdose of Xylazine and Ketamine. The collection of the gastrocnemius muscle for the Body and Muscle mass analysis, histological analysis and fractal dimension of inflammation and collagen gene quantification of mRNA (TNF-α and TGF-β1). Data analysis was performed using SPSS for Windows 22. The Shapiro-Wilk test to verify the normality of the data was performed. When data showed normal, we used t test for paired samples test and one-way ANOVA followed by Tukey’s post-test. When it violated the normality of the data, followed by the Kruskal- Wallis test with Dunn’s post-test. For all analyzes was adopted the significance level of 5%. Among all groups, the CRTU lose less body and muscle mass, improved morphometry, besides presenting collagen reduction by DF compared to AI and CR (p <0.05). With regard to the inflammatory process CRTU group showed a significant reduction of DF in relation to the AI groups (p = 0.001), I (p = 0.001) and CR (p = 0.007), and TU reduced the DF significantly relative to AI groups (p = 0.001), I (p = 0.001) and CR (p = 0.036). The reduction of TNF-α was significant in TU group compared with AI groups (p = 0.008); I (p = 0.032) and CR (p = 0.046) and TGF- β1 in the CR group compared to AI (p = 0.001) and I (p = 0.006), in the TU group compared to AI (p = 0.049) and CRTU compared to AI (p = 0.023). The combination treatment was superior to the results presented by the isolated treatments in the muscle repair process. Observed by reducing the loss of body and muscle mass, improved histological appearance and reduction of collagen. / As lesões musculares são frequentemente ocasionadas em decorrência da prática de atividades esportivas e recreativas. Devido sua alta incidência, é importante pesquisar os tratamentos que promovam qualidade no processo de reparação muscular e menor duração. Avaliar o efeito da combinação dos recursos terapêuticos de Crioterapia e Ultrassom Terapêutico no tratamento de lesão muscular por impacto. 55 ratos wistar foram separados em Grupos Lesão Aguda (LA), Lesão (L), Crioterapia (CR), Ultrassom Terapêutico (US), Crioterapia e Ultrassom Terapêutico (CRUS). Todos os animais foram anestesiados e submetidos à lesão muscular por impacto pela liberação de uma carga de 200g a 30 cm de altura. Em seguida receberam os tratamentos conforme grupo alocado, sendo o protocolo de CR por meio de bolsa de gelo durante 20 minutos e o US durante cinco minutos com intensidade de 0,5W/cm2 e frequência de 1MHz. A eutanásia foi realizada por administração intraperitoneal de superdosagem de Xilazina e Ketamina, para subsequente coleta do músculo gastrocnêmio destinado às análises de massa Corporal e Muscular, análises Histológica e Dimensão Fractal do processo inflamatório e de colágeno, Quantificação gênica de RNAm (TNF-α e TGF-β1). A análise dos dados foi realizada utilizando o programa estatístico SPSS 22 for Windows. Foi realizado o teste de Shapiro-Wilk para verificação da normalidade dos dados. Quando os dados apresentaram normalidade, foi utilizado teste T para amostras pareadas e teste de Anova one-way, seguido pelo pós-teste de Tukey. Quando violada a normalidade dos dados, seguiu-se com o teste de Kruskall-Wallis, com pós-teste de Dunn. Para todas as análises foi adotado o nível de significância de 5%. Dentre todos os grupos, o CRUS perdeu menos massa corporal e muscular, melhora da morfometria, além de apresentar redução de colágeno pela DF em comparação aos LA e CR (p < 0,05). Com relação ao processo inflamatório, grupo CRUS apresentou redução significante da DF em relação aos grupos LA (p = 0,001), L (p = 0,001) e CR (p = 0,007), e o US reduziu a DF significativamente em relação aos grupos LA (p = 0,001), L (p = 0,001) e CR (p = 0,036). A redução de TNF-α foi significante no grupo US comparado com grupos LA (p = 0,008); L (p = 0,032) e CR (p = 0,046), e TGF-β1 no grupo CR em comparação aos LA (p = 0,001) e L (p = 0,006), no grupo US em comparação ao LA (p = 0,049), e CRUS em comparação aos LA (p = 0,023). A associação de tratamentos foi superior aos resultados apresentados pelos tratamentos isolados no processo de reparação muscular. Observado pela redução da perda de massa corporal e muscular, melhora do aspecto histológico e redução de colágeno.

Schistosomiasis is probably the main cause of pulmonary arterial hypertension (PAH) in the world. Splenectomy is used as treatment of upper gastrointestinal bleeding due to rupture of gastroesophageal varices secondary to schistosomal portal hypertension. However, it is a risk factor to PAH in others clinical scenarios, being possible that it increases the risk of PAH in mansonic schistosomiasis. The risk factors that determine the expression of PAH in some individuals with schistosomiasis are unknown. A role of the interleukyn (IL)-13 and transforming growth factor (TGF)-beta is suggested in the pulmonary vascular changes found in animal models of schistosomiasis. This thesis had the main objectives: verify the association of splenectomy and others risk factors with PAH in patients with hepatosplenic schistosomiasis and assess the seric levels of TGF-β and interleukin IL-13 in patients with schistosomal periportal fibrosis with and without PAH. The first article (Splenectomy and others risk factors to pulmonary hypertension associated to mansonic schistosomiasis) describes one case-control study that recruted patients evaluated in outpatient clinic of schistosomiasis in Hospital das Clínicas – Universidade Federal de Pernambuco and outpatient clinic of PAH reference center of Pronto Socorro Cardiológico de Pernambuco. Sixty four patients with hepatosplenic schistosomiaisis splenectomized or not with PAH defined by cardiac catheterization (mean pulmonary arterial pressure ≥25mmHg and pulmonary capillary wedge pressure ≤ 15mmHg) and 173 patients with hepatosplenic schistosomiaisis splenectomized or not, without PAH by transthoracic Doppler echocardiogram (pulmonary arterial systolic pressure ≤ 36mmHg) were enrolled. In the multivariate logistic regression model, splenectomy, thyroid disease increased levels of D dimer were independently associated with an increased risk of PAH. Adrenergic blockers use, previous schistosomal treatment and previous upper gastrointestinal bleeding were associated with a decreased risk of PAH. The second article (TGF-β and interleukin-13 in pulmonary arterial hypertension associated with mansonic schistosomiasis) describes a study conducted with 34 patients without PAH by transthoracic Doppler echocardiogram and 34 patients with PAH by right cardiac catheterization and both groups with schistosomal periportal fibrosis on abdominal ultrasound. They were submitted to assessment of seric dosage of TGF-β and IL-13 by ELISA. A significantly increased median of TGF-β in patients with PAH was found compared to patients without PAH (p=0.006). There was no significant difference regarding the difference between the median of IL-13 in patients with and without PAH (p>0.05). Conclusion: splenectomy and increased levels of D-dimer were independently associated with an increased risk of PAH, suggesting that a pro-thrombotic state occurs in these patients. Thyroid disease was other risk factor. However, previous schistosomal treatment, history of upper gastrointestinal bleeding and use of adrenergic blockers were associated with a decreased risk of PAH. TGF-β may contribute to PAH pathogenesis in schistosomiasis and could be a target of treatment in PAH associated with schistosmisiasis / Submitted by Ramon Santana (ramon.souza@ufpe.br) on 2015-03-10T17:56:58Z No. of bitstreams: 2 Tese Rita de Cassia Ferreira.pdf: 1872861 bytes, checksum: 4e248d94fe004ff410acc217cf930086 (MD5) license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) / Made available in DSpace on 2015-03-10T17:56:58Z (GMT). No. of bitstreams: 2 Tese Rita de Cassia Ferreira.pdf: 1872861 bytes, checksum: 4e248d94fe004ff410acc217cf930086 (MD5) license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Previous issue date: 2013-05-24 / CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico) / A esquistossomose é provavelmente a maior causa de hipertensão arterial pulmonar (HAP) no mundo. A esplenectomia é utilizada no tratamento da hemorragia digestiva secundária à ruptura de varizes gastroesofágicas decorrente da hipertensão portal esquistossomótica, mas, é um fator de risco para HAP em outras situações, sendo possível que aumente o risco de HAP na esquistossomose. Não se sabe quais são os fatores de risco que determinam o aparecimento de HAP em alguns indivíduos com esquistossomose. Estudos em camundongos sugerem um papel para a interleucina (IL)-13 e o transforming growth factor (TGF)-β nas alterações vasculares pulmonares encontradas na HAP esquistossomótica. Esta tese teve como objetivos principais: verificar a associação da esplenectomia e outros fatores de risco com HAP em pacientes com esquistossomose hepatoesplênica e dosagem de TGF-β e IL-13 em pacientes com fibrose periportal esquistossomótica com e sem HAP. O primeiro artigo (Esplenectomia e outros fatores de risco para hipertensão arterial pulmonar associada à esquistossomose mansônica) descreve um estudo caso controle onde foram recrutados pacientes do ambulatório de esquistossomose do Hospital das Clínicas – Universidade Federal de Pernambuco e do ambulatório de HAP do Pronto Socorro Cardiológico de Pernambuco. Foram selecionados 64 pacientes com esquistossomose hepatoesplênica esplenectomizados ou não com HAP diagnosticada pelo cateterismo cardíaco (pressão média de artéria pulmonar ≥25mmHg e pressão diastólica final de ventrículo esquerdo ≤ 15mmHg) e 173 pacientes com esquistossomose hepatoesplênica esplenectomizados ou não, sem HAP no ecodopplercardiograma transtorácico (pressão sistólica de artéria pulmonar ≤ 36mmHg). As variáveis independentemente associadas com risco aumentado de HAP no modelo multivariado de regressão logística foram: esplenectomia, tireoidopatia e níveis aumentados de D-dímeros. O uso de bloqueadores adrenérgicos, história de tratamento prévio para esquistossomose e história de hemorragia digestiva alta foram associados com um risco reduzido de HAP. O segundo artigo (TGF-β e interleucina-13 na hipertensão arterial pulmonar associada à esquistossomose mansônica) descreve um estudo onde foram recrutados 34 pacientes sem HAP no ecodopplercardiograma transtorácico e 34 pacientes com HAP confirmada pelo cateterismo cardíaco direito e todos com fibrose periportal na ultrassonografia de abdome que tiveram as dosagens séricas de TGF-β e IL-13 realizadas através de ELISA. Uma mediana significativamente maior de TGF-β foi encontrada em pacientes com HAP em relação aos pacientes sem HAP (p=0,006). Não houve diferença significativa entre a mediana de IL-13 nos pacientes com ou sem HAP (p>0,05). Conclusões: Esplenectomia e elevação de Ddímeros foram associados a um risco aumentado de HAP, sugerindo um estado prótrombótico nestes pacientes. História de tireoidopatia também foi fator de risco. Pacientes com história de tratamento para esquistossomose, história de hemorragia digestiva alta e uso de bloqueadores adrenérgicos tiveram menor chance de desenvolver HAP. TGF-β tem um possível papel na patogênese da HAP na esquistossomose e pode vir a ser alvo de terapia na HAP associada à esquistossomose.

Dysregulated wound healing is commonly associated with excessive fibrosis. Connective tissue growth factor (CTGF/CCN2) is characteristically overexpressed in fibrotic diseases and stimulated by transforming growth factor-β (TGF-β) in dermal fibroblasts. Reepithelialisation and epidermal wound coverage counteract excessive scar formation. We have previously shown that interleukin-1α (IL-1α) derived from keratinocytes conteracts TGF-β-stimulated CTGF-expression. The aim of this thesis was to further explore the effects of keratinocytes and IL-1α on gene and protein expression, as well as pathways, in TGF-β stimulated fibroblasts. Fibroblasts were studied in vitro by conventional two dimensional cell culture models and in a three dimensional keratinocyte-fibroblast organotypic skin culture model. The results showed that IL-1 suppresses basal and TGF-β-induced CTGF mRNA and protein, involving a possible TAK1 mechanism. Keratinocytes regulate the expression of fibroblast genes important for the turnover of the extracellular matrix. Most of the genes analysed (11/13) were regulated by TGF-β and counter regulated by keratinocytes. The overall results support a view that keratinocytes regulate fibroblasts to act catabolically (anti-fibrotic) on the extracellular matrix. Transcriptional microarray and gene set enrichment analysis showed that antagonizing effects of IL-1α on TGF-β were much more prominent than the synergistic effects. The most confident of these pathways was the interferon signaling, which were inhibited by TGF-β and activated by IL-1α. A proteomics study confirmed that IL-1α preferentially conteracts TGF-β effects. Six new fibroblast proteins involved in synthesis/ regulation were identified, being regulated by TGF-β and antagonized by IL-1α. Pathway analysis confirmed counter-regulation of interferon signaling by the two cytokines. These findings have implications for understanding the role of fibroblasts for inflammatory responses and development of fibrosis in the skin.

Au cours de l'obésité, le Tissu Adipeux blanc (TAB) est le siège d'un important remaniement de sa Matrice Extracellulaire avec des amas fibrotiques autour des adipocytes et des vaisseaux. Cette organisation caractéristique semble avoir une incidence dans la physiopathologie de l'obésité. Les composés spécifiques à la Membrane Basale ont été mis en évidence autour des adipocytes et des cellules endothéliales et leur expression est fortement induite dans l'adipocyte obèse. L'expression de COL4A1 est positivement corrélée à l'insulino-résistance de sujets présentant une obésité modérée. De plus, dans un autre groupe de sujets massivement obèses candidats à la chirugie bariatrique, la diminution de l'expression génique de COL4A1 est à relier avec l'amélioration de l'insulino-résistance après l'intervention. Enfin, nous observons que, dans le TAB, l'expression de COL4A1 est positivement associée à l'expression génique de deux facteurs de croissance pro-fibrotiques, le TGF 1 et le TGF 3, dans le TAB. La culture tridimensionnelle d'adipocytes ou de cellules endothéliales exposés à ces deux facteurs induit un phénotype fibro-inflammatoire dans ces types cellulaires. Néanmoins, le traitement par le TGF 1 ou TGF 3 induit uniquement dans les cellules endothéliales une sur-expression de COL4A1 et non dans les adipocytes.En conclusion, nos données proposent un nouvel acteur de la fibrose du TAB au cours de l'obésité, la Membrane Basale adipocytaire et vasculaire, participant ainsi à la dysfonction tissulaire et métabolique. / During obesity, White Adipose Tissue (WAT) undergoes an important remodeling of its Extracellular Matrixwith fibrotic depots around adipocytes and vessels. This typical organization seems to have an impact in the pathophysiology of obesity. Basement Membrane components were detected around adipocytes and endothelial cells and their expression were significantly increased in obese adipocytes. COL4A1 expression in WAT is positively correlated to insulin-resistance parameters in moderate obese subjects, and its reduction is associated to insulin-resistance improvement after gastric bypass in a group of morbidly obese subjects. Finally, we demonstrated a postive correlation between COL4A1 expression and two pro-fibrotic growth factor (TGF1 and TGF3) in obese WAT. In vitro treatment of isolated adipocytes and endothelial cells with these TGF isoforms induced inflammatory and fibrotic phenotype. However, TGF1 and TGF3 exposure only provoked COL4A1 over-expression in endothelial cells, and not in adipocytes. In conclusion, our work have highlighted a new actor in WAT fibrosis during obesity, adipocytes and endothelial cells Basement Membrane, participating in the pathological alterations of obese adipose tissue and metabolism.

Oral submucous fibrosis (OSF) is a debilitating irreversible fibrotic condition of the oral cavity. It is characterized by inflammation and ultimately results in trismus. Patients face difficulty in speaking, swallowing and chewing due to restricted mouth opening (trismus). This disease is also categorized as an oral premalignant disorder (OPMD). Recent reports cite a conversion rate of 10% from OSF to oral squamous cell carcinoma (OSCC). Epidemiological studies and case reports over the years have correlated the habit of chewing areca nut (Areca catechu) to the manifestation of OSF. It is a major cause of concern in the South and South East Asian parts of the world where areca nut is cultivated and routinely consumed. There are an estimated 700 million areca nut chewers around the globe with 0.5% of the population in the Indian subcontinent being affected by OSF due to this habit. Previous studies have reported differential gene expression profile and up regulation of the pro-fibrotic transforming growth factor-β (TGF-β) pathway in OSF. However, detailed molecular mechanisms for the pathogenesis of this disease are still unclear despite our knowledge about the etiological agent (areca nut) responsible for its progression. Therefore, to gain insights into the etiopathogeneses of OSF, following objectives were undertaken:  To study the gene expression changes induced by areca nut and pro-fibrotic cytokine TGF-β in primary fibroblast cells, and their implications in OSF.  To elucidate the mechanism of TGF-β signal activation in epithelial cells by areca nut. Fibroblast cells are the effectors in all fibrotic disorders. Therefore, it is essential to study the response of this cell type in fibrosis. With prior knowledge of the activation of TGF-β pathway in OSF and the etiological agent of this disease being areca nut; we wanted to study the differential gene response of fibroblasts to these two agents. For this purpose, human primary gingival fibroblasts (hGF) were used as a model system to study the global gene expression profile regulated by areca nut and/or TGF-β. hGF cells were treated with sub-cytotoxic dose of areca nut (5 µg/ml) with and without TGF-β (5 ng/ml) for 72 hours and microarray was performed. The results revealed 4666 genes being differentially regulated by areca nut in hGF cells while TGF-β regulated 1214 genes. Both of them together differentially regulated 5752 genes. 413 genes which were commonly regulated by areca nut and TGF-β were observed to have enhanced regulation with a combined treatment of areca nut, together with TGF-β. This result pointed towards the potential role of both areca nut and TGF-β in modulating fibroblast response. To further assess the role of areca nut in OSF manifestation, we first compared the transcriptome profile induced by it in epithelial cells with fibroblast cells. Areca nut was found to induce differential response in these two cell types which corroborates with the disease pathology wherein; epithelial atrophy is observed and conversely fibroblasts are proliferative. To extend these observations we compared the areca nut induced profile in epithelial cells with OSF differential profile and found that a majority of the genes regulated by areca nut which were common with OSF are regulated by TGF-β. Similarly, areca nut and TGF-β regulated profile in fibroblast cells overlapped significantly with OSF profile. Additionally, areca nut and TGF-β treatment positively enriched matrix associated and metabolic pathways among others which are reported to be differentially regulated in OSF. These observations also highlighted the importance of combined actions of areca nut and TGF-β in OSF manifestation. To test the physiological importance of combined actions of areca nut and TGF-β in the context of OSF; activation of fibroblasts by these treatments was assessed. Treatment of fibroblasts with areca nut and TGF-β enhanced the expression of myofibroblast markers αSMA and γSMA with a concomitant increase in the contractile property when compared to areca nut or TGF-β treatment alone. Further, we observed that areca nut did not regulate any of the TGF-β ligands or receptors in fibroblasts, whereas it induced TGF-β2 in epithelial cells. Therefore, this invoked a possible epithelial-mesenchymal interaction that may exist in OSF pathogenesis. To test this possibility in-vitro, epithelial cells were treated with areca nut and the secretome of these cells was put on hGF cells to study the regulation of fibrosis associated genes. This treatment enhanced the regulation of fibroblast activation markers (αSMA and γSMA) as compared to direct areca nut treatment. This increase in regulation was abrogated when induction of TGF-β2 was compromised in epithelial cells. Similar results were obtained for the regulation of other genes (TGM-2, THBS-1, EDN1, LOXL3, PLOD2, TMEPAI, TGFBI, CTGF, BMP1, LMIK1). Therefore, we concluded that TGF-β which is secreted in response to areca nut by epithelial cells influences fibroblasts in combination with areca nut to enhance fibrosis response. Furthermore, the secretome of untreated epithelial cells was found to down regulate the basal expression of fibrosis related genes in fibroblasts, invoking a role for epithelial secretome in regulating the fibrosis progression. Our data highlighted the importance of TGF-β’s influence on fibroblast response in OSF, but the mechanism for the regulation of this cytokine was not known. Areca nut did not induce TGF-β ligands in fibroblast as discussed above, but previous data from our group had reported areca nut mediated up regulation of TGF-β2 in epithelial cells. Therefore, we further elucidated the mechanistic details for this induction using immortalized keratinocytes (HaCaT and HPL1D) and correlated these in OSF tissues. The kinetics of the induction of TGF-β signaling by areca nut (5 µg/ml) in epithelial cells was established. Areca nut induced TGF-β2 transcript, protein and activated the canonical signaling (pSMAD2/3) at 2 hours post treatment, which persisted till 24 hours. The regulation of TGF-β2 mRNA at 2 hours was dependent on active transcription but was independent of protein translation whereas the activation of signaling (pSMAD2) required both transcription and translation at this time point. This warranted probing for the role of TβR-I in the activation of TGF-β signal by areca nut. A small molecule inhibitor was used to abrogate the kinase activity of TβR-I. Areca nut induced TGF-β2 mRNA at 2 hours even in the presence of TβR-I inhibitor whereas the induction was compromised at 24 hours although the activation of SMAD2 at both 2 and 24 hours was compromised in the presence of TβR-I. This result signified that induction of TGF-β signaling was dependent on the TβR-I activity at early and late time points, but the transcription of the ligand was independent of the receptor activity at early time point. These results indicated the activation of some other pathway by areca nut which could regulate the transcription of TGF-β2 and thereby activate TGF-β signaling in epithelial cells. To explore this possibility, a panel of pathway inhibitors was used and only JNK inhibitor compromised areca nut induced TGF-β2 mRNA and pSMAD2. The results were corroborated by transient knockdown of JNK1 and JNK2. Further, JNK was phosphorylated at 30 minutes to 2 hours by areca nut treatment on epithelial cells. This activation was found to be independent of TβR-I activity. In good correlation, activated JNK1/2 was also detected in OSF tissues and was not detectable in normal tissues. Since JNK activation was found to be a pre-requisite for areca nut induced TGF-β signal activation; we further explored the mechanism of JNK activation by areca nut itself. Areca nut mediated activation of JNK was found to be dependent on muscarinic acid receptor, Ca2+/CAMKII and ROS. Inhibition of these significantly compromised areca nut induced pJNK. In line with this, inhibition of muscarinic acid receptor activity, CAMKII and ROS also abrogated areca nut mediated induction of TGF-β2 mRNA and pSMAD2. The regulation of TGF-β signaling by areca nut in epithelial cells was dependent on transcription, and JNK activity was essential for this. We further sought to explore transcription factors which were regulated by JNK and therefore could possibly induce TGF-β2 promoter activity. ATF2 and c-Jun transcription factors were found to be induced at 30 minutes by areca nut and this up regulation also persisted till 24 hours. Further, activation of both ATF2 and c-Jun was dependent on JNK but independent of TβR-I activity. Moreover, areca nut treatment induced translocation of these phoshorylated transcription factors in the nucleus of epithelial cells. Additionally, pATF2 and p-c-Jun were enriched on TGF-β2 promoter after 2 hours of treatment by areca nut. To investigate the importance of this enrichment and regulation of TGF-β signal activation by areca nut, we transiently knocked down these proteins and studied the regulation of TGF-β2. Areca nut induced TGF-β2 mRNA and pSMAD2 was abrogated upon ATF2 and c-Jun knockdown, implicating JNK mediated activation of ATF2 and c-Jun in areca nut induced TGF- β signaling. To explore the significance of this mechanism in OSF, immunohistochemical staining for pATF2 and p-c-Jun was performed on OSF and normal tissues. Both the transcription factors were found in the nuclei of OSF tissues whereas their expression was not detected in normal tissues. This expression also correlated with the previously reported activation of SMAD2 in OSF tissues by our group. Hence, ATF2 and c-Jun were observed to be important in areca nut mediated TGF-β signaling in OSF. In conclusion, the work described in this thesis provides mechanistic details into OSF etiopathogenesis. Combined actions of areca nut and TGF-β induced a response in fibroblasts akin to OSF. Our results advocate a role for epithelial secreted factors in influencing fibroblast response in both normal and disease (OSF) conditions. Further, importance of TGF-β in OSF has been elucidated in terms of enhancing the fibroblast response to areca nut. We have also elucidated the mechanism for areca nut mediated activation of TGF-β signaling and have identified the contribution of JNK/ATF2/Jun axis in this process. This work can impact the management of oral submucous fibrosis by providing newer targets for treatment.

Approximately 7000 rare disorders exist, affecting 2 percent of Canadians and millions of people worldwide. Given that for many rare diseases only one allele is mutated, we hypothesize inducing expression of the remaining wild-type allele may have a therapeutic effect. SMAD3 heterozygosity results in Aneurysms-Osteoarthritis Syndrome (AOS) – an aortic aneurysm disorder also known as Loeys-Dietz Syndrome Type 3. We conducted a screen of FDA-approved compounds and found that 13-cis-retinoic acid (13-CRA) induces SMAD3 in normal human fibroblast cultures. Treatment with therapeutic concentrations of 13-CRA increased SMAD3 mRNA in normal human fibroblasts, patient fibroblasts, wild-type murine vascular smooth muscle cells and Smad3+/- murine vascular smooth muscle cells. Increases in SMAD3 protein were also observed in normal human fibroblasts, patient fibroblasts, and wild-type murine vascular smooth muscle cells. Immunofluorescent imaging revealed the primary site of protein induction to be nuclear. We report here the in vitro induction of SMAD3 mRNA and protein by therapeutic levels of 13-CRA and suggest further investigation of this modality for the treatment of AOS.