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

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

O perfil de ativação do NF-B foi avaliado em biópsias de 47 pacientes com diagnóstico clínico e laboratorial de hanseníase, seguidos no Ambulatório de Hanseníase do Centro de Referência Nacional em Dermatologia Tropical com Ênfase em Hanseníase do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo. O índice de ativação NF-B foi calculado de acordo com a porcentagem de positividade na histoquímica Southwestern. Índice de ativação NF-B >1 foi considerado representativo de ativação. Trinta e seis por cento dos pacientes apresentaram NF-B ativado na biópsia, o que foi mais frequente em multibacilares (54,6%) que em paucibacilares (20%), p=0,018. Hanseníase tuberculóide esteve associada com ausência de NF-B ativado (p=0,039). Forma dimorfa e neural pura estiveram associadas com ativação de NF-B, com odds ratio de 44 (p=0,014) e 30 (p=0,029), respectivamente. A ativação correlacionou-se com detecção in situ de fator de necrose tumoral por imuno-histoquímica (p=0,0064). Observou-se grande variação da ativação do NF-B nas formas clínicas de hanseníase. Ativação foi nula em granulomas de hanseníase tuberculóide, que representa a reação inflamatória mais efetiva contra o M. leprae. A ativação do NF-B ocorreu predominantemente em formas clínicas com maior suscetibilidade (multibacilares) e instabilidade imunológica (dimorfa), indicando condição favorável à infecção pela ativação do NF-B, por seus efeitos antiapoptóticos, visto que o bacilo depende das funções celulares para sobreviver. / NF-B activation profile was evaluated in cutaneous biopsies from 47 patients with clinical and laboratorial diagnosis of leprosy followed at a referral center for treatment of leprosy, the leprosy outpatient clinic of the Hospital of Clinics of Faculty of Medicine of Ribeirão Preto University of São Paulo. NF-B activation index (ranging from 0 to 4) was calculated according to the percentage of positivity in Southwestern histochemistry. Activation index >1 was considered representative of activation. Thirty-six percent of patients presented activated NF-B, which was more frequent in multibacillary (54,6%) than in paucibacillary (20%), p=.018. Tuberculoid leprosy was associated with absence of activated NF-B (p=.039). Borderline and pure neural leprosy clinical forms were associated with NF-B activation, with odds ratio of 44 (p=.014) and 30 (p=.029), respectively. NF-B activation was correlated with in situ detection of tumor necrosis factor- by immunohistochemistry (p=.0064). Great variation of NF-B activation was found in clinical forms of leprosy. Activation was absent in tuberculoid leprosys granulomas, which represent effective inflammatory reaction pattern against M. leprae. NF-B activation was present in clinical forms with increased susceptibility (multibacillary) and immunological instability (borderline), which suggests favorable conditions towards infection, probably due to the anti-apoptotic effects of NF-B, since bacillary survival is dependent of cellular functions.

Protein engineering and in vitro selection systems are powerful methods to generate binding proteins. In nature, antibodies are the primary affinity proteins and their usefulness has led to a widespread use both in basic and applied research. By means of combinatorial protein engineering and protein library technology, smaller antibody fragments or alternative non-immunoglobulin protein scaffolds can be engineered for various functions based on molecular recognition. In this thesis, a 46 amino acid small albumin-binding domain derived from streptococcal protein G was evaluated as a scaffold for the generation of affinity proteins. Using protein engineering, the albumin binding has been complemented with a new binding interface localized to the opposite surface of this three-helical bundle domain. By using in vitro selection from a combinatorial library, bispecific protein domains with ability to recognize several different target proteins were generated. In paper I, a bispecific albumin-binding domain was selected by phage display and utilized as a purification tag for highly efficient affinity purification of fusion proteins. The results in paper II show how protein engineering, in vitro display and multi-parameter fluorescence-activated cell sorting can be used to accomplish the challenging task of incorporating two high affinity binding-sites, for albumin and tumor necrosis factor-alpha, into this new bispecific protein scaffold. Moreover, the native ability of this domain to bind serum albumin provides a useful characteristic that can be used to extend the plasma half-lives of proteins fused to it or potentially of the domain itself. When combined with a second targeting ability, a new molecular format with potential use in therapeutic applications is provided. The engineered binding proteins generated against the epidermal growth factor receptors 2 and 3 in papers III and IV are aimed in this direction. Over-expression of these receptors is associated with the development and progression of various cancers, and both are well-validated targets for therapy. Small bispecific binding proteins based on the albumin-binding domain could potentially contribute to this field. The new alternative protein scaffold described in this thesis is one of the smallest structured affinity proteins reported. The bispecific nature, with an inherent ability of the same domain to bind to serum albumin, is unique for this scaffold. These non-immunoglobulin binding proteins may provide several advantages as compared to antibodies in several applications, particularly when a small size and an extended half-life are of key importance. / <p>QC 20121122</p>

The works presented in this dissertation provide insights into the mechanisms of chemotherapy-induced cognitive impairment (CICI or “ChemoBrain”) and take steps toward outlining a preventive strategy. CICI is now widely recognized as a complication of cancer chemotherapy experienced by a large percentage of cancer survivors. Approximately fifty percent of existing FDA-approved anti-cancer drugs generate reactive oxygen species (ROS). Doxorubicin (Dox), a prototypical ROS-generating chemotherapeutic agent, produces the reactive superoxide radical anion (O2-•) in vivo. Dox treatment results in oxidation of plasma proteins, including ApoA-I, leading to TNF-α-mediated oxidative stress in plasma and brain. TNF-α elevation in brain leads to further central nervous system toxicity including mitochondrial dysfunction, neuronal death, and cognitive impairment. Co-administration of the antioxidant drug, 2-mercaptoethane sulfonate sodium (MESNA), prevents Dox-induced protein oxidation and subsequent TNF-α elevation in plasma without interfering with the cancer-killing ability of Dox. In studies presented in this dissertation, we measured oxidative stress in both brain and plasma of Dox-treated mice both with and without MESNA. MESNA ameliorated Dox-induced oxidative protein damage in plasma, confirming our prior studies, and in a new finding led to decreased oxidative stress in brain. Using novel object recognition (NOR), we demonstrated the Dox administration resulted in memory deficits. Using hydrogen magnetic resonance imaging spectroscopy (H1-MRS) techniques, we demonstrated that Dox administration led to a dramatic decrease in choline(phosphocholine)/creatine (Cho/Cr) ratios in mouse hippocampus. The activities of both phosphatidylcholine-specific phospholipase C (PC-PLC) and phospholipase D(PLD) were severely diminished following Dox administration. The activity of PC-PLC was preserved when MESNA was co-administered with Dox. In the absence of TNF-α, MRS-indexed Cho/Cr ratio, PLD activity, and mitochondrial oxygen consumption are preserved in brain, and markers of oxidative stress are reduced. Together with results from our previous studies, these results provide strong evidence that TNF-α is strongly associated, if not responsible for CICI. We also tested the notion that O2-• is responsible for Dox-induced plasma protein oxidation and TNF-α release. O2-• resulted in increased oxidative damage to proteins when added to plasma and increased levels of TNF-α in macrophage culture, providing strong evidence that O2-• is responsible for these Dox-induced toxicities.

Atrial fibrillation (AF), the most common arrhythmia encountered in clinical practice, is a major source of morbidity and mortality, and is highly associated with inflammation and oxidative stress. In the present study, we show that acute exposure of mice atrial tissue to tumor necrosis factor-α (TNF-α) increases susceptibility to AF. We further show that acute exposure to TNF-α led to increased spontaneous sarcoplasmic reticulum (SR) calcium release and generated triggered activities in isolated mice atrial myocytes. This increase in spontaneous SR calcium activity was found to be due to elevated reactive oxygen species production from mitochondria and NADPH oxidase sources triggered by TNF-α. Hence we concluded that acute exposure to TNF-α leads to elevated oxidative stress that increases spontaneous SR Ca2+ release and triggered activity through which it can lead to AF induction and maintenance

Atrial fibrillation (AF), the most common arrhythmia encountered in clinical practice, is a major source of morbidity and mortality, and is highly associated with inflammation and oxidative stress. In the present study, we show that acute exposure of mice atrial tissue to tumor necrosis factor-α (TNF-α) increases susceptibility to AF. We further show that acute exposure to TNF-α led to increased spontaneous sarcoplasmic reticulum (SR) calcium release and generated triggered activities in isolated mice atrial myocytes. This increase in spontaneous SR calcium activity was found to be due to elevated reactive oxygen species production from mitochondria and NADPH oxidase sources triggered by TNF-α. Hence we concluded that acute exposure to TNF-α leads to elevated oxidative stress that increases spontaneous SR Ca2+ release and triggered activity through which it can lead to AF induction and maintenance

O perfil de ativação do NF-B foi avaliado em biópsias de 47 pacientes com diagnóstico clínico e laboratorial de hanseníase, seguidos no Ambulatório de Hanseníase do Centro de Referência Nacional em Dermatologia Tropical com Ênfase em Hanseníase do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo. O índice de ativação NF-B foi calculado de acordo com a porcentagem de positividade na histoquímica Southwestern. Índice de ativação NF-B >1 foi considerado representativo de ativação. Trinta e seis por cento dos pacientes apresentaram NF-B ativado na biópsia, o que foi mais frequente em multibacilares (54,6%) que em paucibacilares (20%), p=0,018. Hanseníase tuberculóide esteve associada com ausência de NF-B ativado (p=0,039). Forma dimorfa e neural pura estiveram associadas com ativação de NF-B, com odds ratio de 44 (p=0,014) e 30 (p=0,029), respectivamente. A ativação correlacionou-se com detecção in situ de fator de necrose tumoral por imuno-histoquímica (p=0,0064). Observou-se grande variação da ativação do NF-B nas formas clínicas de hanseníase. Ativação foi nula em granulomas de hanseníase tuberculóide, que representa a reação inflamatória mais efetiva contra o M. leprae. A ativação do NF-B ocorreu predominantemente em formas clínicas com maior suscetibilidade (multibacilares) e instabilidade imunológica (dimorfa), indicando condição favorável à infecção pela ativação do NF-B, por seus efeitos antiapoptóticos, visto que o bacilo depende das funções celulares para sobreviver. / NF-B activation profile was evaluated in cutaneous biopsies from 47 patients with clinical and laboratorial diagnosis of leprosy followed at a referral center for treatment of leprosy, the leprosy outpatient clinic of the Hospital of Clinics of Faculty of Medicine of Ribeirão Preto University of São Paulo. NF-B activation index (ranging from 0 to 4) was calculated according to the percentage of positivity in Southwestern histochemistry. Activation index >1 was considered representative of activation. Thirty-six percent of patients presented activated NF-B, which was more frequent in multibacillary (54,6%) than in paucibacillary (20%), p=.018. Tuberculoid leprosy was associated with absence of activated NF-B (p=.039). Borderline and pure neural leprosy clinical forms were associated with NF-B activation, with odds ratio of 44 (p=.014) and 30 (p=.029), respectively. NF-B activation was correlated with in situ detection of tumor necrosis factor- by immunohistochemistry (p=.0064). Great variation of NF-B activation was found in clinical forms of leprosy. Activation was absent in tuberculoid leprosys granulomas, which represent effective inflammatory reaction pattern against M. leprae. NF-B activation was present in clinical forms with increased susceptibility (multibacillary) and immunological instability (borderline), which suggests favorable conditions towards infection, probably due to the anti-apoptotic effects of NF-B, since bacillary survival is dependent of cellular functions.

The objectives of this thesis were to synthesize existing RCT evidence and post-market observational evidence of TNF-α inhibitors in IBD. Two separate systematic reviews were performed: an overview of systematic reviews of RCTs, and a systematic review of post-market observational studies of TNF-α inhibitors in Crohn’s disease and ulcerative colitis. The overview of systematic reviews included 37 studies. RCT evidence demonstrated superiority of all agents to placebo in Crohn’s disease and ulcerative colitis, with no increased risk of malignancy or serious adverse events. Network meta-analyses have not shown superiority of any agent compared to another. The second systematic review included 255 studies. Included studies were deemed to be unamenable to pooling with substantial methodological and clinical diversity. Available evidence is insufficient to determine whether real-world effectiveness and safety is consistent with RCTs, but suggests no increased risk of malignancy and no difference in efficacy between adalimumab and infliximab.

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