Cardiovascular diseases have always been the leading cause of global morbidity and mortality. Aortic stenosis, which is a kind of cardiovascular disease has a high prevalence in elderlies that are 75 years and older. Currently, the only available treatment would be valve replacement surgery. Recently, a few studies have risen regarding the potential of extracellular vesicles to reduce the effects of aortic stenosis, hence allowing patients to opt for a non-life-threatening treatment in comparison to a surgical one. The goal within this study is to determine the pro-coagulability of extracellular vesicles (EVs) that were endogenously derived from human blood (patients and healthy individuals) and their effect on the coagulation cascade. This study was performed on cardiac spheroids that were formed through seeding human aortic endothelial cells in an ultra-low attachment 96-well plate for 96 hours. Spheroids were challenged with tumour necrosis factor-alpha (TNFα) for 24 hours prior to EVs incubation for 48 and 72 hours. The effects of EVs on these spheroids were observed in terms of their ability to induce tissue factor activity. There was no significant difference in the tissue factor activity between spheroids incubated with patient derived EVs or healthy individual derive EVs irrespective of TNFα challenge. To conclude, the results of this study were not significant to stipulate that extracellular vesicles are procoagulant. Hence, further research regarding their ability to reduce or rescue the effects of cardiovascular diseases needs to be performed.

EPHB2, an ephrin receptor (EPH) from receptor tyrosine kinase (RTK) family, is one of the substrates for tissue factor (TF) - coagulation factor VIIa (FVIIa) complex and it is cleaved in its ectodomain. EPHB2 cleavage is important for ephrin receptor (EPH) - ephrin ligand (EFN) signaling and cell repulsion. TF has been reported to be overexpressed in different cancer types such as breast and colorectal cancer (CRC). Furthermore, EPHB2 R155C mutation, at the TF/FVIIa-mediated cleavage site, has been identified as one of the somatic mutation sites in human metastatic CRC. Therefore, the aim of the present work was to characterize the EPHB2 R155C mutation and its effect on the cleavage by TF/FVIIa on EPHB2 in context to CRC. We generated overexpression cell models for EPHB2 wild type (wt) and R155C mutant in human CRC DLD-1 cell line for in vitro compartmentalization assay analysis to demonstrate repulsion event in EPH-EFN signaling. Whereas low endogenous TF expression led to incomplete cleavage of EPHB2 wt protein, stable overexpression of TF resulted in complete cleavage. Moreover, overexpression of TF resulted in reduced compartmentalization in EPHB2 wt cells after FVIIa treatment. Transient expression of TF in EPHB2 wt and R155C cells showed no clear difference in EPHB2 cleavage. Interestingly, it was difficult to obtain similar stable overexpression level of TF in EPHB2 R155C cells compared to EPHB2 wt cells. This may lead to further research in context to the role of TF/FVIIa-mediated EPHB2 cleavage in CRC by the generation of TF overexpression cell lines using lentiviral transduction.

Os acidentes ofídicos são considerados um grande problema de saúde pública e no Estado de São Paulo a serpente Bothrops jararaca é o agente considerado mais relevante epidemiologicamente. O antiveneno é o único medicamento oficialmente aprovado para o tratamento de picadas de serpentes e, apesar de ser eficaz em diversos aspectos, mostra-se ineficaz em relação a complicações secundárias do envenenamento, como o estresse oxidativo/nitrosativo, caracterizado por um desequilíbrio no estado redox, que pode ser extremamente deletério aos pacientes. Portanto, vê-se necessária a busca por terapias complementares que possam combater o estresse oxidativo/nitrosativo. Ademais, distúrbios da hemostasia observados em envenenamentos pela B. jararaca, tais como a plaquetopenia, a hipofibrinogenemia e o aumento da atividade do fator tissular (TF) plasmático podem ter também como causa indireta o estresse oxidativo/nitrosativo, induzido por componentes do veneno de B. jararaca (BjV). Recentemente, demonstrou-se que a regulação da atividade biológica do TF, a proteína responsável pela iniciação da cascata de coagulação in vivo, pode ser controlada pela isomerase de dissulfeto proteico (PDI) e que a atividade da PDI é inibida in vivo pela quercetina-3-rutinosídeo (rutina), um antioxidante natural encontrado em plantas e alimentos. Considerando essas premissas, o presente trabalho objetivou investigar em camundongos injetados com o veneno de B. jararaca (BjV): (a) a ocorrência de distúrbios do estado redox; (b) as alterações hematológicas e hemostáticas (em plasma e tecidos) associadas ao desequilíbrio do estado redox; (c) a atividade da rutina como agente modulador sobre essas alterações. Para isso, camundongos Swiss (30-35 g) foram divididos em 4 grupos experimentais: controle salina (salina, controle negativo), controle rutina (rutina+salina), BjV+salina (BjV+salina, controle positivo) e BjV+rutina (BjV+rutina, tratamento). Após 3, 6 e 24 h da administração dos tratamentos (via s.c.), foram coletados sangue e fragmentos de tecidos para posteriores análises. O envenenamento induziu um aumento de espécies reativas, diminuição da capacidade antioxidante total, alterações hematológicas (plaquetopenia, neutrofilia e diminuição de eritrócitos), distúrbios hemostáticos (hipofibrinogenemia, prolongamento do tempo de protrombina e aumento da atividade de TF no plasma), além de diminuir a expressão proteica de PDI no coração. A rutina não inibiu in vitro a atividade biológica de proteínas presentes no BjV (metaloproteinases, serinaproteases, fosfolipases A2 e L-aminoácido oxidases) e nem mesmo a agregação plaquetária induzida pelo veneno. No entanto, a administração do veneno incubado com rutina foi capaz de reduzir os níveis de espécies reativas, impedir a queda de eritrócitos, normalizar os níveis de fibrinogênio e o tempo de protrombina e alterar a atividade de TF e expressão proteica de TF e PDI em tecidos. Desse modo, concluímos que a rutina foi capaz de favoravelmente modular importantes alterações hemostáticas e de estado redox no envenenamento por B. jararaca, o que indica seu grande potencial como agente terapêutico complementar em envenenamentos / Snakebites are a major public health issue and in São Paulo State, and Bothrops jararaca snakes are considered the most important agents epidemiologically. Antivenom is the only officially approved treatment for snakebites and although effective in many aspects, it is ineffective in combating secondary complications induced by envenomation, e.g. oxidative/nitrosative stress (ONS), which can be extremely deleterious to patients. Therefore, it is necessary to search for new complementary therapies that could attenuate ONS. Furthermore, the hemostatic disturbances in B. jararaca envenomation - characterized by the presence of thrombocytopenia, hypofibrinogenemia and increased tissue factor (TF) activity in plasma - could be indirectly evoked by ONS induced by B. jararaca venom (BjV) components. Recently, the biological activity of TF - the protein responsible for initiating the extrinsic pathway of the coagulation cascade - was demonstrated to be regulated by protein disulfide isomerase (PDI), which in turn, can be inhibited in vivo by quercetin-3-rutinose (rutin), a natural antioxidant found in plants and diet. Based on that, the present study aimed to investigate in mice injected with BjV: (a) the alterations in redox status in plasma and tissues; (b) the hematological/hemostatic disturbances (in plasma and tissues) associated with the imbalance in redox status; (c) the activity of rutin as a modulatory agent on those alterations. Swiss mice (30-35 g) were divided in four experimental groups: saline control (saline, negative control), rutin control (rutin+saline), BjV+saline (BjV+saline, positive control) and BjV+rutin (BjV+rutin, treatment) and after 3, 6 and 24 h of the injection of treatments (s.c. route), blood and tissues were collected to further analyses. Envenomation induced an increase in reactive species, a decrease in total antioxidant capacity, hematological alterations (thrombocytopenia, neutrophilia and a decrease in red blood cell counts), hemostatic disturbances (hypofibrinogenemia, prolonged prothrombin time and an increase in the TF activity in plasma), and a decrease in protein expression of PDI in the heart. In vitro, rutin failed to inhibit the biological activity of the main BjV enzymes (metalloproteinases, serine proteases, phospholipases A2 and L-amino acid oxidases) and BjV-induced platelet aggregation. However, when the venom was incubated with rutin, there were reduced reactive species levels, less intense red blood cell drops, recovery of fibrinogen levels and prothrombin time, and alteration of TF activity and protein expression of TF and PDI in tissues. Therefore, we conclude that rutin favorably modulated important hemostatic and redox status alterations in B. jararaca envenomation, indicating its great potential as a complementary therapeutic agent for snakebites

<p>Pancreatic ductal adenocarcinoma (PDAC) is an incredibly lethal disease with a 5-year survival rate of less than 8 percent in the United States due to a lack of viable treatment options. The failures of chemo- and radiotherapies have been linked to the heterogeneous nature of the tumor microenvironment which forms a hypovascular, immunosuppressive and high coagulation activity tissue. Indeed, PDAC patients have one of the highest rates of thrombosis complications among all cancer types. The expression of two key coagulation factors, Tissue Factor (TF) and Protease Activated Receptor 1 (PAR-1), have been associated with poor patient prognosis and aggressive cancer progression. However, the molecular roles/mechanisms of TF and PAR-1 in PDAC progression are not known. To establish how clotting factors (PAR-1, TF) influence PDAC tumor progression, I utilized a genetically modified mouse model (KPC) where <i>KRas^G12D</i> and <i>TRP53^R172H</i> mutations were specifically introduced into mouse pancreas acinar cells to initiate PDAC progression. Multiple primary mouse PDAC cell lines were generated and characterized. TF and PAR-1 were highly expressed in primary KPC pancreatic lesions, in PDAC tumors, and in KPC-derived cell lines, an expression profile that is also observed in PDAC patient biopsies. In allograft studies, tumor growth and metastatic potential were significantly diminished by shRNA reduction of TF or PAR-1 in cancer cells or by genetic or pharmacological reduction of the coagulation zymogen prothrombin in mice. Notably, PAR-1 deleted KPC cells (KPC-Par-1^KO) failed to generate sizable tumors; a phenotype completely rescued by restoration of PAR-1 expression. To test the significance of targeting PAR-1 in a clinical setting, PAR-1 expression was withdrawn from established tumors to mimic a potential inhibitory effect of PAR-1 on solid PDAC tumors. Removal of PAR-1 from tumors (11 days post injection) yielded a diverse effect on tumor growth which can be categorized into (i) a decline in tumor growth; (ii) continued tumor growth; and (iii) stagnant tumor growth. Immunohistochemistry analysis of KPC2 shCon vs. shPar-1 subcutaneous allograft tumor samples revealed a massive immune cell infiltration in KPC2 shPAR-1 tumors when compared to KPC2 shCon control tumors. Accordingly, KPC-Par-1^KO cells failed to form tumors in immune-competent mice but displayed robust tumor growth in immune-compromised <i>NSG</i> mice, providing the first evidence of a PAR-1 mediated tumor immune evasion pathway operating in PDAC. </p> <p>Together, these results demonstrate that PDAC disease is driven by activation of the coagulation system through tumor cell-derived TF, circulating prothrombin, and tumor cell-derived PAR-1. These studies also highlight a novel mechanism by which thrombin/PAR-1-mediated tumor growth involves suppression of anti-tumor immunity in the tumor microenvironment. <b></b></p>

<p>Tissue factor (TF) is the initiator of the coagulation cascade. Monocytes do not normally express TF, but can be induced to do so by certain stimuli. Aberrant TF expression is important in the thrombotic complications of bacterial sepsis, certain malignancies and coronary artery disease (CAD). In this thesis, regulation of monocyte TF by cytokines and by interactions with other vascular cells were studied, as well as the activation of blood cells, inflammation and coagulation in CAD patients and the association of the pro-inflammatory cytokine interleukin (IL)-6 with prognosis in unstable CAD. </p><p>In a whole blood experimental system, the anti-inflammatory cytokine IL-10 was shown to suppress lipopolysaccharide-induced TF expression in monocytes, whereas IL-4 and IL-13 did not, contrary to previous in vitro findings. Activated platelets also induced monocyte TF in whole blood in a P-selectin-dependent manner, causing a rapid surface exposure of TF independent of mRNA formation. The differentiated monocytic cell line U-937 displayed different kinetics of platelet-stimulated TF induction.</p><p>In co-culture with cytokine-activated human coronary artery endothelial cells, U-937 cells expressed TF, and also IL-6. The endothelial cells up-regulated their production of IL-10. Simvastatin, enalapril and dalteparin, all commonly used drugs in CAD treatment, suppressed TF induction but did not alter cytokine expression in co-cultures.</p><p>In unstable CAD, there was an activation of both coagulation and inflammation compared to stable CAD that coincided with an increased activation of platelets and leukocytes. Women had different patterns of cellular activation than men, indicating differences in pathogenetic mechanisms.</p><p>Plasma levels of IL-6 above 5 ng/L proved to be a strong, independent marker for increased risk of death in a 6-12 month perspective in patients with unstable CAD. This risk was significantly reduced by an early invasive strategy.</p>

<p>Cardiopulmonary bypass (CPB) is associated with inflammatory response and activation of coagulation. Heparin coating of the CPB circuit is shown to improve the biocompatibility of the surface. The biological effects of a new heparin surface, the Corline Heparin Surface (CHS), prepared according to a new principle, have been studied. </p><p>The CHS used during coronary artery bypass grafting with CPB in sixty patients prevented adhesion of cells to the extracorporeal device. The activation of inflammation, coagulation, and fibrinolysis was significantly reduced by the use of CHS. Both a reduced and an increased dose of systemic heparin in combination with the heparin-coated surface resulted in more activation of inflammation and coagulation. </p><p>Photoelectron spectroscopy studies of the molecular structure of the CHS demonstrated that a single layer of the heparin surface, equivalent to what was used in the <i>in vivo</i> studies, did not completely cover the substrate surface. Additional layer of immobilized heparin has resulted in a complete coverage. We examined the biological effects, i.e. activation of inflammation and coagulation, by CHS in one and two layers in an <i>in vitro</i>-study. The data from this study clearly demonstrated that a uniform surface coating of the CHS results in only minor activation of coagulation, inflammation and cell activation. </p><p>Monocytes do not normally express tissue factor (TF), initiator of the coagulation <i>in vivo</i>, but can be induced upon adhesion to artificial surfaces. TF is receptor for coagulation factor VIIa (FVIIa) and binding subsequently leads to formation of thrombin. Other biological effects beyond coagulation, as inflammation and angiogenesis, has recently been associated with the formation of TF·FVIIa. The TF∙FVIIa signal transduction induced an increased sensitivity to PDGF-BB-stimulated migration and an increased production of IL-8 and TNF-α in monocytes. These could be important mechanisms for continued recruitment of cells to sites of inflammation. </p>

Tissue factor (TF) is the initiator of the coagulation cascade. Monocytes do not normally express TF, but can be induced to do so by certain stimuli. Aberrant TF expression is important in the thrombotic complications of bacterial sepsis, certain malignancies and coronary artery disease (CAD). In this thesis, regulation of monocyte TF by cytokines and by interactions with other vascular cells were studied, as well as the activation of blood cells, inflammation and coagulation in CAD patients and the association of the pro-inflammatory cytokine interleukin (IL)-6 with prognosis in unstable CAD. In a whole blood experimental system, the anti-inflammatory cytokine IL-10 was shown to suppress lipopolysaccharide-induced TF expression in monocytes, whereas IL-4 and IL-13 did not, contrary to previous in vitro findings. Activated platelets also induced monocyte TF in whole blood in a P-selectin-dependent manner, causing a rapid surface exposure of TF independent of mRNA formation. The differentiated monocytic cell line U-937 displayed different kinetics of platelet-stimulated TF induction. In co-culture with cytokine-activated human coronary artery endothelial cells, U-937 cells expressed TF, and also IL-6. The endothelial cells up-regulated their production of IL-10. Simvastatin, enalapril and dalteparin, all commonly used drugs in CAD treatment, suppressed TF induction but did not alter cytokine expression in co-cultures. In unstable CAD, there was an activation of both coagulation and inflammation compared to stable CAD that coincided with an increased activation of platelets and leukocytes. Women had different patterns of cellular activation than men, indicating differences in pathogenetic mechanisms. Plasma levels of IL-6 above 5 ng/L proved to be a strong, independent marker for increased risk of death in a 6-12 month perspective in patients with unstable CAD. This risk was significantly reduced by an early invasive strategy.

Cardiopulmonary bypass (CPB) is associated with inflammatory response and activation of coagulation. Heparin coating of the CPB circuit is shown to improve the biocompatibility of the surface. The biological effects of a new heparin surface, the Corline Heparin Surface (CHS), prepared according to a new principle, have been studied. The CHS used during coronary artery bypass grafting with CPB in sixty patients prevented adhesion of cells to the extracorporeal device. The activation of inflammation, coagulation, and fibrinolysis was significantly reduced by the use of CHS. Both a reduced and an increased dose of systemic heparin in combination with the heparin-coated surface resulted in more activation of inflammation and coagulation. Photoelectron spectroscopy studies of the molecular structure of the CHS demonstrated that a single layer of the heparin surface, equivalent to what was used in the in vivo studies, did not completely cover the substrate surface. Additional layer of immobilized heparin has resulted in a complete coverage. We examined the biological effects, i.e. activation of inflammation and coagulation, by CHS in one and two layers in an in vitro-study. The data from this study clearly demonstrated that a uniform surface coating of the CHS results in only minor activation of coagulation, inflammation and cell activation. Monocytes do not normally express tissue factor (TF), initiator of the coagulation in vivo, but can be induced upon adhesion to artificial surfaces. TF is receptor for coagulation factor VIIa (FVIIa) and binding subsequently leads to formation of thrombin. Other biological effects beyond coagulation, as inflammation and angiogenesis, has recently been associated with the formation of TF·FVIIa. The TF∙FVIIa signal transduction induced an increased sensitivity to PDGF-BB-stimulated migration and an increased production of IL-8 and TNF-α in monocytes. These could be important mechanisms for continued recruitment of cells to sites of inflammation.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / Apesar do desenvolvimento de novas drogas antifúngicas e da sua utilização como terapia profilática visando à prevenção de infecções fúngicas invasivas, estas ainda constituem-se num problema emergente, com elevadas taxas de mortalidade. Neste contexto, destaca-se a aspergilose invasiva, uma infecção fúngica oportunista que acomete pacientes com neutropenia profunda e prolongada, principalmente os pacientes com leucemia aguda ou submetidos a transplante de medula óssea. Aspergillus fumigatus, um fungo filamentoso, é o principal agente etiológico da aspergilose invasiva, sendo um patógeno angioinvasivo. As hifas deste fungo são capazes de causar injúria e ativação endotelial, induzindo o endotélio a um fenótipo pró-trombótico, que por sua vez, é mediado pela secreção de citocinas pró-inflamatórias, em especial, o TNF-&#945;. O presente trabalho teve como objetivo estudar a capacidade de cepas mutantes de A. fumigatus em ativar células endoteliais, avaliando o perfil de secreção de citocinas em meio condicionado e a expressão de fator tecidual. Resumidamente, monocamadas confluentes de células endoteliais isoladas da veia umbilical humana foram incubadas com conídios e tubos germinativos de cepas selvagens (Af293 e Ku80) e mutantes (&#916;ugm1, &#916;calA, &#916;crzA, &#916;prtT) de A. fumigatus. A taxa de adesão e endocitose destas cepas às monocamadas de HUVEC foi avaliada a partir de um ensaio quantitativo de imunofluorescência diferencial. O perfil cinético de secreção de citocinas foi determinado em meio condicionado das HUVECs, por ensaio de multiplex para IL-6, IL-8 e TNF-&#945;. A ativação endotelial, por sua vez, foi determinada pela expressão de fator tecidual por RT-PCR em tempo real. Os resultados obtidos demonstraram que a mutante para o gene ugm1, responsável por codificar a enzima UDP-galactopiranose mutase, que converte resíduos de galactopiranose a galactofuranose, apresentou um fenótipo hiperaderente às células endoteliais e um estímulo 10 vezes maior à secreção de TNF-&#945; e 2,5 vezes maior a secreção de IL-6, quando comparada a ativação observada para as cepas selvagens. A galactofuranose é um componente importante de glicoconjugados da parede celular de A. fumigatus. Dessa forma, a ausência desse monossacarídeo na célula fúngica leva a um mecanismo compensatório caracterizado por um aumento na expressão de moléculas de galactosaminogalactana na parede celular. De maneira contrária, mutantes para os genes calA e crzA, apresentaram um fenótipo hipoaderente às HUVECs e uma perda na capacidade de induzir a secreção de citocinas e ativar o endotélio. Essas mutantes apresentam deleções que interferem na via de cálcio/calcineurina, responsável por regular a morfogênese e virulência de A. fumigatus, além de apresentarem alterações no conteúdo de beta-1-3 glucana. Já a cepa &#916;prtT, mutante para o fator de transcrição prtT que regula a secreção de múltiplas proteases, apresentou um fenótipo de adesão, estímulo e ativação endotelial semelhante ao observado para as cepas selvagens. A comparação entre a capacidade de conídios e tubos germinativos em ativar células endoteliais, corroborou achados anteriores da literatura que reportam que só hifas são capazes de ativar células endoteliais, independentemente da sua viabilidade. Os dados deste estudo permitiram concluir que dentre os componentes de superfície celular de A. fumigatus, os polímeros de galactose, em especial a galactosaminogalactana, parecem ser responsáveis, pelo menos em parte, pelos mecanismos de interação e ativação endotelial. / Besides the emergency of more active and less toxic antifungal agents and the conventional use of antifungal prophylaxis, invasive mold infections have still high mortality rates, especially, invasive aspergillosis (IA). This life-threatening disease is a predominant fungal opportunistic infection for patients with long-term neutropenia, mostly HSCT recipients. Aspergillus fumigatus is the most important species causing IA and is already known as an angioinvasive fungal pathogen. Upon filamentation this fungus can damage and activate human vein endothelial cells (HUVEC) which in turn switch to a pro-thrombotic phenotype. HUVEC activation is known to be mediated by TNF-&#945; once cell-cell contact occurs. The aim of this study was to investigate the endothelial activation ability of several mutants of A. fumigatus. Briefly, HUVECs were infected with germ tubes and conidia of A. fumigatus wild type (WT) Af293 and Ku80 and mutant (&#916;ugm1, &#916;calA, &#916;crzA, &#916;prtT) strains and a differential quantitative fluorescence assay performed to determine adhesion and internalization rates. Thus, a kinetic study of secreted pro-inflammatory cytokines and chemokines in HUVEC conditioned medium was achieved by a multiplex immuneassay. The cytokine production was assayed at three time points (4, 8 and 16 hours) using dead germ tubes, and at one time point (16 hours) using dead conidia, for an E:T ratio of 2:1. Additionally, to investigate endothelial activated phenotype, the expression of tissue factor was performed by a real time RT-PCR assay. The ugm1 mutant, which lacks the ugm1 gene encoding UDP-galactopyranose mutase, an enzyme responsible for the conversion of galactopyranose in galactofuranose, showed a hiperadherent phenotype and an increased capability to cause endothelial cell stimulation and activation. This mutant stimulated at least a 10-fold and 2.5-fold increase of TNF-alfa and IL-6 secretion, respectively and 2-fold increase of tissue factor expression by host cells, as compared to WT strains. Galactofuranose is an uncommon 5-membered ring form of galactose and a very important component of glycostructures of the A. fumigatus cell wall. The lack of this monosaccharide in the fungal cell wall leads to a compensatory mechanism characterized by an increment in the galactosaminogalactan expression. In contrast, the calA and crzA mutants, with upstream and downstream dysfunction in the calcium/calcineurin pathway, with alteration in the cell wall &#946;-1,3-glucan content, showed a decrease capacity to adhere to HUVECs and did not induce both the secretion of pró-inflammatory cytokine and activation on endothelial cells. Furthermore, the mutant &#916;prtT, witch lacks the transcriptional factor (prtT) that regulates the secretion of multiple proteases, showed the same adhesion and endothelial cell activation phenotype as observed for WT strains. As indicated in previous investigations, our data showed that conidia of A. fumigatus werent able to cause the same endothelial cell cytokine stimulation observed for germ tubes, and that endothelial cell activation is independent on fungal cell viability. Finally, its possible to conclude that the polymers of galactose in the cell wall of A. fumigatus, especially the galactosaminogalactan molecule, seem to be responsible for the endothelial cell interaction mechanisms and activation.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / Apesar do desenvolvimento de novas drogas antifúngicas e da sua utilização como terapia profilática visando à prevenção de infecções fúngicas invasivas, estas ainda constituem-se num problema emergente, com elevadas taxas de mortalidade. Neste contexto, destaca-se a aspergilose invasiva, uma infecção fúngica oportunista que acomete pacientes com neutropenia profunda e prolongada, principalmente os pacientes com leucemia aguda ou submetidos a transplante de medula óssea. Aspergillus fumigatus, um fungo filamentoso, é o principal agente etiológico da aspergilose invasiva, sendo um patógeno angioinvasivo. As hifas deste fungo são capazes de causar injúria e ativação endotelial, induzindo o endotélio a um fenótipo pró-trombótico, que por sua vez, é mediado pela secreção de citocinas pró-inflamatórias, em especial, o TNF-&#945;. O presente trabalho teve como objetivo estudar a capacidade de cepas mutantes de A. fumigatus em ativar células endoteliais, avaliando o perfil de secreção de citocinas em meio condicionado e a expressão de fator tecidual. Resumidamente, monocamadas confluentes de células endoteliais isoladas da veia umbilical humana foram incubadas com conídios e tubos germinativos de cepas selvagens (Af293 e Ku80) e mutantes (&#916;ugm1, &#916;calA, &#916;crzA, &#916;prtT) de A. fumigatus. A taxa de adesão e endocitose destas cepas às monocamadas de HUVEC foi avaliada a partir de um ensaio quantitativo de imunofluorescência diferencial. O perfil cinético de secreção de citocinas foi determinado em meio condicionado das HUVECs, por ensaio de multiplex para IL-6, IL-8 e TNF-&#945;. A ativação endotelial, por sua vez, foi determinada pela expressão de fator tecidual por RT-PCR em tempo real. Os resultados obtidos demonstraram que a mutante para o gene ugm1, responsável por codificar a enzima UDP-galactopiranose mutase, que converte resíduos de galactopiranose a galactofuranose, apresentou um fenótipo hiperaderente às células endoteliais e um estímulo 10 vezes maior à secreção de TNF-&#945; e 2,5 vezes maior a secreção de IL-6, quando comparada a ativação observada para as cepas selvagens. A galactofuranose é um componente importante de glicoconjugados da parede celular de A. fumigatus. Dessa forma, a ausência desse monossacarídeo na célula fúngica leva a um mecanismo compensatório caracterizado por um aumento na expressão de moléculas de galactosaminogalactana na parede celular. De maneira contrária, mutantes para os genes calA e crzA, apresentaram um fenótipo hipoaderente às HUVECs e uma perda na capacidade de induzir a secreção de citocinas e ativar o endotélio. Essas mutantes apresentam deleções que interferem na via de cálcio/calcineurina, responsável por regular a morfogênese e virulência de A. fumigatus, além de apresentarem alterações no conteúdo de beta-1-3 glucana. Já a cepa &#916;prtT, mutante para o fator de transcrição prtT que regula a secreção de múltiplas proteases, apresentou um fenótipo de adesão, estímulo e ativação endotelial semelhante ao observado para as cepas selvagens. A comparação entre a capacidade de conídios e tubos germinativos em ativar células endoteliais, corroborou achados anteriores da literatura que reportam que só hifas são capazes de ativar células endoteliais, independentemente da sua viabilidade. Os dados deste estudo permitiram concluir que dentre os componentes de superfície celular de A. fumigatus, os polímeros de galactose, em especial a galactosaminogalactana, parecem ser responsáveis, pelo menos em parte, pelos mecanismos de interação e ativação endotelial. / Besides the emergency of more active and less toxic antifungal agents and the conventional use of antifungal prophylaxis, invasive mold infections have still high mortality rates, especially, invasive aspergillosis (IA). This life-threatening disease is a predominant fungal opportunistic infection for patients with long-term neutropenia, mostly HSCT recipients. Aspergillus fumigatus is the most important species causing IA and is already known as an angioinvasive fungal pathogen. Upon filamentation this fungus can damage and activate human vein endothelial cells (HUVEC) which in turn switch to a pro-thrombotic phenotype. HUVEC activation is known to be mediated by TNF-&#945; once cell-cell contact occurs. The aim of this study was to investigate the endothelial activation ability of several mutants of A. fumigatus. Briefly, HUVECs were infected with germ tubes and conidia of A. fumigatus wild type (WT) Af293 and Ku80 and mutant (&#916;ugm1, &#916;calA, &#916;crzA, &#916;prtT) strains and a differential quantitative fluorescence assay performed to determine adhesion and internalization rates. Thus, a kinetic study of secreted pro-inflammatory cytokines and chemokines in HUVEC conditioned medium was achieved by a multiplex immuneassay. The cytokine production was assayed at three time points (4, 8 and 16 hours) using dead germ tubes, and at one time point (16 hours) using dead conidia, for an E:T ratio of 2:1. Additionally, to investigate endothelial activated phenotype, the expression of tissue factor was performed by a real time RT-PCR assay. The ugm1 mutant, which lacks the ugm1 gene encoding UDP-galactopyranose mutase, an enzyme responsible for the conversion of galactopyranose in galactofuranose, showed a hiperadherent phenotype and an increased capability to cause endothelial cell stimulation and activation. This mutant stimulated at least a 10-fold and 2.5-fold increase of TNF-alfa and IL-6 secretion, respectively and 2-fold increase of tissue factor expression by host cells, as compared to WT strains. Galactofuranose is an uncommon 5-membered ring form of galactose and a very important component of glycostructures of the A. fumigatus cell wall. The lack of this monosaccharide in the fungal cell wall leads to a compensatory mechanism characterized by an increment in the galactosaminogalactan expression. In contrast, the calA and crzA mutants, with upstream and downstream dysfunction in the calcium/calcineurin pathway, with alteration in the cell wall &#946;-1,3-glucan content, showed a decrease capacity to adhere to HUVECs and did not induce both the secretion of pró-inflammatory cytokine and activation on endothelial cells. Furthermore, the mutant &#916;prtT, witch lacks the transcriptional factor (prtT) that regulates the secretion of multiple proteases, showed the same adhesion and endothelial cell activation phenotype as observed for WT strains. As indicated in previous investigations, our data showed that conidia of A. fumigatus werent able to cause the same endothelial cell cytokine stimulation observed for germ tubes, and that endothelial cell activation is independent on fungal cell viability. Finally, its possible to conclude that the polymers of galactose in the cell wall of A. fumigatus, especially the galactosaminogalactan molecule, seem to be responsible for the endothelial cell interaction mechanisms and activation.