Neste trabalho foram estudadas as potencialidades eletroanalíticas de um material híbrido condutor baseado em acetato de celulose e grafite com eletrodeposição de filme condutor de Azul da Prússia (CA/G/PB) como sensor para espécies com importância biológica. O material híbrido foi preparado pelo processo de inversão de fase e caracterizado pelas técnicas de microscopia eletrônica de varredura acoplada com espectroscopia de energia dispersiva (SEM-EDS) e voltametria cíclica. O composto Azul da Prússia (PB) foi imobilizado na superfície do material por eletropolimerização, aplicando-se um potencial fixo de 20 mV em uma janela de -0,3 V a 1,2 V. Os estudos eletroquímicos do eletrodo modificado CA/G/PB foram realizados em solução de KCl 0,1 mol.L-1, sendo obtidos dois pares redox para a espécie eletroativa imobilizada com potenciais médios (E0) em 0,204 V e 0,842 V, indicando um comportamento quase-reversível. O eletrodo demonstrou alta estabilidade após 500 ciclos redox, não sendo observada lixiviação da espécie eletroativa da superfície da matriz modificada. Os dois pares redox do material híbrido CA/G/PB permaneceram praticamente constantes entre os pH 5,0 e 8,0, indicando que as intensidades de pico não são significativamente afetadas nessa faixa de pH. A correlação linear entre as intensidades de pico e a raiz quadrada da velocidade de varredura, indicou que o sistema possui um comportamento similar aqueles em que o processo é controlado por difusão das espécies eletroativas à superfície do eletrodo. O azul da Prússia imobilizado foi aplicado na determinação de dopamina (DP), ácido úrico (AU), ácido ascórbico (AA) e Paracetamol (PCT) através da técnica de voltametria cíclica, voltametria de pulso diferencial e cronoamperometria. / In this work, we studied the electroanalytical potential of a conductive hybrid material based on cellulose acetate and graphite with electrodeposition Blue conductor film of Prussia (CA / G / PB) as a sensor for species with biological importance. The hybrid material was prepared by phase inversion process and characterized by the techniques of scanning electron microscopy coupled with energy dispersive spectroscopy (SEM-EDS) and cyclic voltammetry. The dye of Prussian blue (PB) was immobilized on the surface of the material by electropolymerization applying a fixed potential of 20 mV in a interval from -0.3 V to 1.2 V. The electrochemical behavior of the modified electrode CA / G / PB were performed in solution of 0.1 mol L-1 KCl being obtained two redox couples for the electroactive species immobilized with midpoint potentials (E0) in 0.204 V and 0.842 V, indicating a quasi-reversible behavior. The electrode showed high stability after 500 redox cycles with no observed leaching of electroactive species to the surface of the modified electrode. The two redox pair of the CA / G / PB electrode was kept practically constant within pH 5.0 and 8.0, indicating that the peak intensities are not significantly affected in this pH range. The linear correlation between peak intensities and the square root of scan rate, indicated that the system has a similar behavior those in which the process is controlled by diffusion of electroactive species to the electrode surface. The immobilized Prussian blue was applied to determine dopamine (DP), uric acid (UA), ascorbic acid (AA) and paracetamol (PCT) by analytical techniques of cyclic voltammetry, differential pulse voltammetry and chronoamperometry.

A oxidação do ácido úrico (7,9-diidro-1H-purina-2,6,8(3H)-triona) pela mieloperoxidase (MPO) gera o radical de urato que, em presença do radical ânion superóxido combinam para formar o hidroperóxido de urato (HOOU). Considerando os altos níveis de MPO, ácido úrico e superóxido na placa de ateroma espera-se que o ácido úrico seja oxidado a HOOU neste microambiente inflamatório. O HOOU é um oxidante mais forte que o peróxido de hidrogênio e pode oxidar grupos tiólicos de proteínas como a proteína dissulfeto isomerase (PDI). Como consequência à oxidação da PDI, ocorre uma modulação positiva sobre a NADPH oxidase (Nox) com aumento da produção de superóxido por neutrófilos. Sendo assim, a formação do HOOU no leito vascular poderia elucidar os mecanismos moleculares pelos quais o urato colabora para a progressão da aterosclerose em pacientes com hiperuricemia. Para investigar a interação do HOOU com a PDI, padronizou-se a síntese química do HOOU através de um sistema de fotooxidação do tipo I, utilizando urato, riboflavina (fotossensibilizador) e luz UVA. Inicialmente padronizou-se o tipo de irradiação e tempo de reação com o melhor rendimento para a síntese do HOOU. O HOOU formado e seu produto de redução o álcool 5-hidroxiisourato foram separados, identificados e caracterizados através de cromatografia liquida acoplada à espectrometria de massa (LC/MS). Após a purificação, determinou-se o coeficiente de absortividade molar em 308 nm (ε308 = 6537 ± 377 M-1.cm-1) e o tempo de meia-vida, aproximadamente 41 minutos à 22°C do HOOU. O HOOU foi capaz de reagir seletivamente com o aminoácido metionina e com o tripeptídeo glutationa. Além disso, o HOOU não forma adutos estáveis com a glutationa, sendo que toda glutationa consumida foi transformada em glutationa dissulfeto. Quando incubado com a PDI (10 µM), cerca de 70 e 100% do total de HOOU (3 µM) foi consumido após 30 e 120 segundos, respectivamente, enquanto que a PDI (23 µM) teve seus grupos tiólicos oxidados após a incubação com 140 µM HOOU por 30 min a 22°C. O HOOU oxidou os resíduos de cisteína dos dois sítios catalíticos da PDI com uma constante de velocidade da reação de 1,5 ± 0,04 x 103 M-1.s-1, demonstrando uma interação favorável com essa proteína no meio biológico e um possível papel modulatório do HOOU sobre a via PDI-Nox. Interessantemente, o ácido úrico aumentou a produção de superóxido e o consumo de oxigênio de células HL-60 diferenciadas em neutrófilos (dHL-60) e ativadas com acetato de miristato de forbol (PMA). Essa regulação poderia ser mediada através da formação do HOOU durante o \"burst\" oxidativo dos neutrófilos que oxidaria a enzima PDI induzindo um consequente aumento da atividade da Nox. / The oxidation of the uric acid (7,9-dihidro-1H-purine-2,6,8(3H)-trione) by myeloperoxidase (MPO) generates the urate radical. In inflammatory conditions the superoxide reacts with urate radical to form the urate hydroperoxide (HOOU). Taking into account the high amount of MPO, urate and superoxide in the atheroma plaque, it is likely that HOOU is being formed in this inflammatory environment. The HOOU is a strong oxidizing agent and can react with thiol groups from proteins, like the protein disulfide isomerase (PDI). As a consequence of its oxidation, PDI positively modulates NADPH oxidase (Nox) and increases superoxide production by neutrophils. Therefore, the formation of HOOU in the vascular sheet would contribute to tissue damage and would explain the positive correlation between hyperuricemia and the risk for cardiovascular disease. To investigate the interaction of HOOU with PDI, we performed the chemical synthesis of the compound by the Type I photooxidation, using UVA irradiation and riboflavin as a photosensitizer. Initially, we standardized the irradiation light and the time of the reaction that produced the highest income. The HOOU and its reduced product 5-hydroxiisourate were separate, identified and characterized by liquid chromatography coupled to mass spectrometry (LC/MS). We also determine the molar extinction coefficient of HOOU at 308 nm (ε308 = 6537 ± 377 M-1.cm-1). The half-life of the compound was 41 min at 22°C. The HOOU selectively oxidized methionine and glutathione. The reaction of HOOU with glutathione did not form any stable adducts. Thus, all consumed glutathione generated glutathione disulfide. When incubated with PDI (10 µM), 70 and 100% of the total amount of HOOU (3 µM) was consumed within 30 and 120 seconds, respectively. Besides, the PDI (23 µM) had its thiol groups oxidized after incubation with 140 µM HOOU for 30 min at 22°C. The HOOU oxidized the cysteine residues from the catalytical sites of PDI with a second order rate constant of 1.5 ± 0.04 x 103 M-1.s-1. This result suggests a favorable interaction of HOOU with this protein in the biological system, as well as a possible modulatory role of HOOU on the PDI-Nox pathway. Interestingly, urate increased superoxide production and oxygen consumption by neutrophil-like cells (differentiated HL-60 cells). This effect could be mediated by the formation of HOOU during the neutrophil oxidative burst, followed by the oxidation of PDI, a positive regulation of Nox and an increase in superoxide production.

Neste trabalho foram estudadas as potencialidades eletroanalíticas de um material híbrido condutor baseado em acetato de celulose e grafite com eletrodeposição de filme condutor de Azul da Prússia (CA/G/PB) como sensor para espécies com importância biológica. O material híbrido foi preparado pelo processo de inversão de fase e caracterizado pelas técnicas de microscopia eletrônica de varredura acoplada com espectroscopia de energia dispersiva (SEM-EDS) e voltametria cíclica. O composto Azul da Prússia (PB) foi imobilizado na superfície do material por eletropolimerização, aplicando-se um potencial fixo de 20 mV em uma janela de -0,3 V a 1,2 V. Os estudos eletroquímicos do eletrodo modificado CA/G/PB foram realizados em solução de KCl 0,1 mol.L-1, sendo obtidos dois pares redox para a espécie eletroativa imobilizada com potenciais médios (E0) em 0,204 V e 0,842 V, indicando um comportamento quase-reversível. O eletrodo demonstrou alta estabilidade após 500 ciclos redox, não sendo observada lixiviação da espécie eletroativa da superfície da matriz modificada. Os dois pares redox do material híbrido CA/G/PB permaneceram praticamente constantes entre os pH 5,0 e 8,0, indicando que as intensidades de pico não são significativamente afetadas nessa faixa de pH. A correlação linear entre as intensidades de pico e a raiz quadrada da velocidade de varredura, indicou que o sistema possui um comportamento similar aqueles em que o processo é controlado por difusão das espécies eletroativas à superfície do eletrodo. O azul da Prússia imobilizado foi aplicado na determinação de dopamina (DP), ácido úrico (AU), ácido ascórbico (AA) e Paracetamol (PCT) através da técnica de voltametria cíclica, voltametria de pulso diferencial e cronoamperometria. / In this work, we studied the electroanalytical potential of a conductive hybrid material based on cellulose acetate and graphite with electrodeposition Blue conductor film of Prussia (CA / G / PB) as a sensor for species with biological importance. The hybrid material was prepared by phase inversion process and characterized by the techniques of scanning electron microscopy coupled with energy dispersive spectroscopy (SEM-EDS) and cyclic voltammetry. The dye of Prussian blue (PB) was immobilized on the surface of the material by electropolymerization applying a fixed potential of 20 mV in a interval from -0.3 V to 1.2 V. The electrochemical behavior of the modified electrode CA / G / PB were performed in solution of 0.1 mol L-1 KCl being obtained two redox couples for the electroactive species immobilized with midpoint potentials (E0) in 0.204 V and 0.842 V, indicating a quasi-reversible behavior. The electrode showed high stability after 500 redox cycles with no observed leaching of electroactive species to the surface of the modified electrode. The two redox pair of the CA / G / PB electrode was kept practically constant within pH 5.0 and 8.0, indicating that the peak intensities are not significantly affected in this pH range. The linear correlation between peak intensities and the square root of scan rate, indicated that the system has a similar behavior those in which the process is controlled by diffusion of electroactive species to the electrode surface. The immobilized Prussian blue was applied to determine dopamine (DP), uric acid (UA), ascorbic acid (AA) and paracetamol (PCT) by analytical techniques of cyclic voltammetry, differential pulse voltammetry and chronoamperometry.

L’adénosine (ADO) est un nucléoside ubiquitaire issu de l’ATP et du cycle de la méthionine. Via les récepteurs A1 (A1R), elle favorise la fibrillation atriale (FA). Via les récepteurs A2A (A2AR), elle induit une dilatation coronaire. L’ADO est donc un intermédiaire métabolique et un neurotransmetteur du système cardiovasculaire.La 1ère étude montre que, chez les patients coronariens, l’ADO est corrélée à l’homocystéine (Hcy) et l’uricémie. De plus, l’ADO et l’Hcy sont corrélées au score évaluant l’étendue de l’athérosclérose (score SYNTAX). Enfin, sur un modèle d’hépatocyte, l’ADO induit la production d’Hcy selon un effet dose et un effet temps. L’hyperadénosinémie semble ainsi participer à l’augmentation de l’homocystéinémie et de l’uricémie. Ces données apportent un nouvel éclairage sur la physiopathologie de la maladie coronarienne.Dans le 2nd travail, l’ADO augmente significativement uniquement chez les patients coronariens à test d’effort positif. De plus, leur expression des A2AR est plus faible que les patients à test négatif. Ainsi, la faible expression A2AR chez les coronariens à test d’effort positif participe au défaut d’adaptation coronaire durant le test. Un faible niveau d’A2AR pourrait être alors un biomarqueur de coronaropathie.Dans la 3ème étude, les patients avec FA sans cardiopathie sous-jacente ont une adénosinémie normale et une surexpression des A2AR. Sachant que l’ADO peut favoriser la FA, la surexpression des A2AR pourrait donc participer au déclenchement de FA en augmentant la sensibilité à l’adénosine.En conclusion, les médicaments modulant le système adénosinergique pourraient être utiles au traitement de la coronaropathie ou de la FA. / Adenosine (ADO) is an ubiquitous nucleoside that comes from ATP and from the methionine cycle. Via A1 receptors (A1R), it promotes atrial fibrillation (AF). Via A2A receptors (A2AR), it leads to coronary vasodilatation. Thus, adenosine is a metabolic intermediate and a neurotransmitter of the cardiovascular system.The first study showed that adenosine plasma level (APL) is correlated with homocystein (Hcy) and uric acid in coronary artery disease (CAD) patients. Furthermore, APL and Hcy are correlated with the SYNTAX score which evaluate CAD severity. Finally, in cellulo, ADO induced a dose and time dependant increase of HCY production by human hepatocytes. We concluded that high APL may participate into the high HCY and uric acid levels. These data bring new highlight on the physiopathology of CAD.In the second work, APL increased significantly only in patients with positive exercise stress testing (EST). Furthermore, A2AR expression was lower in positive EST patients compared with those with negative EST. Then, we concluded that the low expression of A2AR in CAD patients with positive EST, participates in the lack of adaptive response (coronary vasodilatation) to the EST. This result suggests that low A2AR expression may be a biological marker of CAD.In the third study, patients with AF and no structural heart disease have a normal APL but an increase in A2AR expression. Because adenosine promotes AF, we concluded that high A2AR expression may participate into the triggering of AF by increasing the sensitivity to adenosine.In conclusion, drugs that modulate the purinergic system should be useful tools for the treatment of CAD or AF.

Les traumatismes graves sont une cause principale d’hospitalisations et peuvent induire des handicaps physiques et psychologiques. Dans ce travail, nous nous intéressons au choc hémorragique (CH), défini par une perte sanguine de plus de 30% menant à une ischémie systémique causant de la mort cellulaire et la libération de médiateurs circulants. Parmi ces médiateurs, notre groupe a déjà démontré l’augmentation en circulation de l’acide urique (AU) après le CH et son rôle dans l’atteinte d’organes ; un effet qui est prévenu par l’utilisation d’une uricase, qui métabolise l’AU circulant. Notre objectif actuel est de démontrer le rôle de l’AU dans l’altération du système nerveux central. Pour ce faire nous utilisons un modèle murin de CH reperfusé avec 3 groupes expérimentaux : SHAM (contrôle), CH et CH+U (uricase IP au moment de la reperfusion). Nos résultats démontrent que l’altération de la perméabilité de la barrière hématoencéphalique (augmentation significative de la perméabilité à la fluorescéine de sodium (NaF)) et de l’expression de ICAM-1 après le CH peut être prévenu par l’administration d’uricase. Les résultats sont les mêmes pour la mesure de la neuroinflammation (activité de la myéloperoxidase (neutrophiles) ainsi que astrocytes et microglie activés) et de l’apoptose/dégérescence neuronale (caspase-3, coloration TUNEL et fluorojade). En conséquence à l’atteinte neuroinflammatoire et apoptotiques, nous observons une augmentation significative des comportements anxieux après le CH, détectés par le test de nage forcée, le labyrinthe en croix surélevé et l’intéraction sociale, et qui sont prévenus par le traitement avec uricase. En conclusion, ce projet permet de confirmer que l’AU joue un rôle important dans l’atteinte cérébrale et l’altération des comportements, après le CH reperfusé. / Polytrauma is one of the main causes of hospitalisations and can lead to physical and psychological handicaps. This work focuses on hemorrhagic shock (HS), defined by a blood-loss of at least 30%, leading to systemic ischemia, cell death and the release of various mediators in circulation. The importance of one of these mediators, uric acid (UA), in multiple organ failure after HS and the improvement by the use of an uricase, which can destroy UA, was already demonstrated by our lab. Our objective is to illustrate the implication of UA in central nervous system alterations after HS. To reach this goal, we use a murine model which is assigned to one of our 3 experimental groups: SHAM (control), HS and HS+U (IP injection of uricase at reperfusion). Our results show an altered blood-brain barrier permeability (significant infiltration of NaF in the brain after HS), an increased expression of ICAM-1 after HS and a prevention of both these results by uricase treatment. The same results are observed for neuroinflammation (myeloperoxidase activity (neutrophils), astrocytes and microglia) and for neuronal apoptosis/degeneration (caspase-3, TUNEL staining and FluoroJade staining). Furthermore, anxiety is increased after HS compared to SHAM but prevented with uricase treatment. The tests used to reach this conclusion are the elevated plus maze, the forced swim test and social interaction. In conclusion, this project confirms the central role of UA in brain lesions and subsequent behavioral alterations after resuscitated HS.

Übergewichtige Personen, die keine fettleibigkeitsbedingten metabolischen Komplikationen zeigen, wurden als 'metabolisch gesund fettleibig' (MHO, Metabolically healthy obesity) definiert. Im Gegensatz zu metabolisch ungesunden fettleibigen (MUO, Metabolically unhealthy obesity) Individuen zeigen MHOs keine metabolischen Störungen wie Bluthochdruck, Dyslipidämie, Insulinresistenz und Entzündung [50]. Aufgrund des Mangels an allgemein akzeptierten Kriterien ist die genaue Definition des MHO-Status jedoch immer noch umstritten. Es wird allgemein angenommen, dass die MHO-Definition von der Einführung zusätzlicher Biomarker profitieren könnte, welche wiederum zur Klärung der zugrunde liegenden Mechanismen metabolischer Komplikationen herangezogen werden können [24]. Darüber hinaus hat sich die klinische Forschung hauptsächlich auf Erwachsene konzentriert, und es liegen nur wenige Studien zu MHO bei jungen Menschen vor. Daher wird die Untersuchung des MHO-Status in der jungen Bevölkerung unter Verwendung gut etablierter und potentiell neuer Indikatoren als wesentlich angesehen, um einen positiven Beitrag zur Prävention und/oder Behandlung von zukünftigen fettleibigkeitsbezogenen Krankheiten zu leisten. Unter den möglichen neuen Biomarkern wurde festgestellt, dass Serumharnsäure (Serum-UA) eine wichtige Rolle als kardiometabolischer Risikofaktor [22] für Adipositas-assoziierte Komorbiditäten bei Kindern und Jugendlichen spielt. Dennoch haben nur wenige Studien den Zusammenhang zwischen dieser biochemischen Variablen und MHO in der jungen Bevölkerung untersucht. Der Schwerpunkt der vorliegenden Studie lag auf der Identifizierung potenzieller klinischer und metabolischer Indikatoren, die zur Unterscheidung zwischen MHO- und MUO-Phänotypen beitragen können. Die anthropometrischen, klinischen und biochemischen Merkmale von 458 Kindern und Jugendlichen wurden analysiert und diskutiert. MHO- und MUO-Individuen repräsentieren 38% bzw. 16% der dieser Grupe. Der häufigste kardiovaskuläre Risikofaktor bei MUO-Patienten war Hypertriglyceridämie (54,2%), gefolgt von niedrigem Serum-HDL-C (45,8%), Hypertonie (19,5%) und gestörter Glukosetoleranz (14,7%). Zusammenfassend deuten diese Ergebnisse darauf hin, dass eine frühzeitige Identifizierung von MUO in der Jugend möglich ist, wodurch eine frühzeitige Erkennung möglicher metabolischer Komplikationen gewährleistet ist. Verglichen mit der MUO-Gruppe zeigten MHO-Individuen niedrigere Nüchterninsulinwerte, Triglyceride, Blutdruck, Nüchternglucose und höhere Insulinsensitivität sowie niedrigere Serumharnsäure-, hs-CRP-, Albumin- und C-Peptidspiegel. Interessanterweise wurden im Gegensatz zu früheren Studien in den MHO- und MUO-Gruppen ähnlich hohe Werte für die Marker der Leberfunktion, einschließlich der zirkulierenden Konzentrationen von ALT, AST und alkalischer Phosphatase, festgestellt. Dieses Ergebnis legt nahe, dass niedrigere Leberenzyme zu dem günstigen metabolischen Profil von MHO-Individuen beitragen könnten. Darüber hinaus fördert diese Forschung ein besseres Verständnis der Wirkung potenzieller Indikatoren, die verwendet werden können, um MHO von MUO zu unterscheiden, insbesondere mit dem Fokus auf Serum-UA. Die Ergebnisse dieser Arbeit zeigen, dass Serum-UA mit mehreren kardiometabolischen Risikofaktoren assoziiert ist, die normalerweise mit Fettleibigkeit in Verbindung gebracht werden, wie Serumtriglycerid SDS, systolischer Blutdruck, C-Peptid und Cystatin C. Keine signifikante Beziehung zwischen Glukose-SDS und Serum-UA-Spiegeln wurde gefunden. Höhere Serumspiegel von UA erwiesen sich als signifikanter Indikator für den MUO-Phänotyp. Höhere C-Peptid-Spiegel, Taillenumfangs-SDS und Pubertätstadium sind mit einer höheren Wahrscheinlichkeit des MUO-Status assoziiert. Umgekehrt zeigte das Geschlecht der Person keine signifikante Wirkung. Hs-CRP und Albumin waren keine signifikanten MUO-Indikatoren, wenn sie nach Alter, Geschlecht, Pubertät und BMI-SDS kontrolliert wurden. Die in dieser Arbeit präsentierten Ergebnisse könnten für eine bessere Unterscheidung zwischen MUO- und MHO-Phänotypen nützlich sein und adipositasbedingte Komorbiditäten frühzeitig im Leben behandeln. Längsschnittstudien in größeren Kohorten mit jüngeren Individuen werden als ein vernünftiger nächster Schritt angesehen, um das Ergebnis dieser Arbeit zu bestätigen und zu erweitern. Mögliche zukünftige Untersuchungen könnten zusätzliche Eigenschaften und Wirkungen von MHO/MUO-Indikatoren betreffen. Zum Beispiel, wie der Serum-UA-Spiegel durch Konsum zuckergesüßter Erfrischungsgetränke und Alkohol beeinfluss wird.:LIST OF ABBREVIATIONS III I. BIBLIOGRAPHISCHE BESCHREIBUNG IV 1 INTRODUCTION 1.1 Obesity and associated diseases, a world health threat 1.1.1 Definitions and classifications of overweight and obesity 1.2 A ‘metabolic healthy’ type of obesity 1.2.1 Distinguishing characteristics of healthy obesity 1.3 Physiology of uric acid (UA) 1.3.1 Serum UA and cardiometabolic risk factors 1.3.2 Serum UA and type 2 diabetes 1.3.3 Serum UA and hypertension 1.3.4 Serum UA and kidney-related complications 1.3.5 Connection between Serum UA levels and metabolic health status THE PROJECT RESEARCH 1.4 Research question and hypotheses 1.5 The LIFE-Child study 2 PUBLICATION MANUSCRIPT REFERENCES 3 ZUSAMMENFASSUNG DER ARBEIT REFERENCES ANLAGEN II. Supplement Material III. Erklärung über die eigenständige Abfassung der Arbeit IV. Curriculum Vitae V. List of publications and conference participations VI. Acknowledgments / Obese individuals that do not show obesity-related metabolic complications have been defined as “metabolically healthy obese” (MHO). Unlike metabolic unhealthy obese (MUO) individuals, MHO do not show several metabolic disorders, such as hypertension, dyslipidemia, insulin resistance and inflammation. However, due to the lack of universally accepted criteria, the precise definition of the MHO status is still controversial. It is widely believed that the MHO definition might benefit from the introduction of additional biomarkers, which in turn can be used to clarify the underlying mechanisms of metabolic complications. Futhermore, clinical research has mostly focused on adults and few studies addressing MHO in young individuals are available. Therefore, the investigation of the MHO status in the young population, by using well-established and potential new indicators, is considered essential to positively contribute to prevention and/or treatment of future obese-related diseases. Among the possible potential new biomarker, serum uric acid (serum UA) has been found to play an important role as a cardiometabolic risk factor44 for obesity-related comorbidities in children and adolescents. Nonetheless, very few studies have investigated the association between this biochemical variable and MHO in the young population. The focus of the present study was to identify potential clinical and metabolic indicators that may help to distinguish between MHO and MUO phenotypes. The anthropometric, clinical and biochemical characteristics of 458 children and adolescents were analyzed and discussed. MHO and MUO individuals represent 38% and 16% of the overweight/obese population, respectively. The most frequent cardiovascular risk factor found in MUO individuals was hypertriglyceridemia (54.2%), followed by low serum HDL-C (45.8%), hypertension (19.5%) and impaired glucose tolerance (14.7%). Altogether, these findings suggest that early identification of MUO is possible during youth, thereby ensuring the early addressing of potential metabolic complications. Compared to the MUO group, MHO individuals showed lower fasting insulin values, triglycerides, blood pressure, fasting glucose and higher insulin sensitivity, as well as lower serum uric acid, hs-CRP, albumin and C-peptide levels. Interestingly, in contrast to previous studies, markers of liver function, including circulating concentrations of ALT, AST and alkaline phosphatase, were found to be similarly high in MHO and MUO groups. This finding suggests that lower levels of hepatic enzymes could contribute to the favorable metabolic profile of MHO individuals. In addition, the research promotes a better understanding of the action of potential indicators that can be used to distinguish MHO from MUO, especially focusing on serum UA. The results of this thesis revealed that serum UA is associated with several cardiometabolic risk factors usually linked with obesity, such as serum triglyceride SDS, systolic blood pressure, C-peptide and Cystatin C. No significant relationship between glucose-SDS and serum UA levels has been found. Higher levels of serum UA were found to be a significant indicator of the MUO phenotype. Higher levels of C-peptide, waist circumference SDS and pubertal stage are associated to higher likelihood of MUO status. Conversely, the individual’s gender showed no significant effect. Hs-CRP and albumin were non-significant MUO indicators when controlled for age, gender, pubertal stage and BMI-SDS. The results presented in this thesis might be valuable for a better distinction between MUO and MHO phenotypes and to properly address obesity-related comorbidities early in life. Longitudinal studies in larger cohorts with younger individuals are seen as a sensible next step to confirm and expand the outcome of this work. Possible future investigations might address additional properties and effects of MHO/MUO indicators, for instance by studying how serum UA levels are affected by alcohol consumption and sugar-sweetened soft drinks.:LIST OF ABBREVIATIONS III I. BIBLIOGRAPHISCHE BESCHREIBUNG IV 1 INTRODUCTION 1.1 Obesity and associated diseases, a world health threat 1.1.1 Definitions and classifications of overweight and obesity 1.2 A ‘metabolic healthy’ type of obesity 1.2.1 Distinguishing characteristics of healthy obesity 1.3 Physiology of uric acid (UA) 1.3.1 Serum UA and cardiometabolic risk factors 1.3.2 Serum UA and type 2 diabetes 1.3.3 Serum UA and hypertension 1.3.4 Serum UA and kidney-related complications 1.3.5 Connection between Serum UA levels and metabolic health status THE PROJECT RESEARCH 1.4 Research question and hypotheses 1.5 The LIFE-Child study 2 PUBLICATION MANUSCRIPT REFERENCES 3 ZUSAMMENFASSUNG DER ARBEIT REFERENCES ANLAGEN II. Supplement Material III. Erklärung über die eigenständige Abfassung der Arbeit IV. Curriculum Vitae V. List of publications and conference participations VI. Acknowledgments

Made available in DSpace on 2017-07-20T12:40:17Z (GMT). No. of bitstreams: 1 Cleverson Santos.pdf: 2904178 bytes, checksum: 85140c2fc4cb486fe6c03e6a011296a3 (MD5) Previous issue date: 2016-05-06 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This thesis describes the preparation, characterization and application of electrochemical sensors and biosensors, using different modification techniques, based on Au as transducer. The enzymatic biosensor applied on the detection of pesticide carbaryl was built on a gold electrode functionalized with a monolayer of polyamidoamine dendrimer of fourth generation with a cystamine core (PAMAM-G4) on which it was immobilized the acetylcholinesterase enzyme (AChE), with the aid of glutaraldehyde. After evaluate and determine the best conditions for immobilization of the AChE enzyme (glutaraldehyde concentration of 1% (v/v) and the concentration of enzyme units 496 U. mL-1) on the monolayer of PAMAM, the catalytic activity of the enzyme was evaluated by chronoamperometry in presence of enzymatic substrate AChI obtaining = 2.9 . −1 . The biosensor response for carbaryl detection was based on the inhibition of the enzymatic activity caused by the pesticide. It was verified that 5 min in the pesticide solution is sufficient to block the enzyme active sites. After determining the best conditions for the construction of the biosensor, it was applied for carbaryl detection in the concentration range from 1.0 to 9.0 mol. L-1. The detection and quantification limits were found to be 0.0108 mol. L-1 and 0.032 mol. L-1, respectively. In the second chapter, it is reported the development of an immunosensor applied to qualitative detection of antibodies (AB) T. cruzi. The sensor was built on gold electrode modified with the thiol 3-mercaptopropionic acid (MPA) and the antigens (AG) T. cruzi were covalently immobilized on this surface by the reaction with EDC and NHS. The influence of concentration and of immersion time in the AG solution were evaluated using the techniques of cyclic voltammetry and electrochemical impedance spectroscopy in presence of [Fe(CN)6]3-/4- and the results showed that the best conditions were immersion time of 15 minutes and AG concentration of 0.5 g. L-1.The possible sites of non-specific binding were blocked with bovine serum albumin (BSA). The immersion time in the solution (AB) was also evaluated and the results showed that 30 minutes are sufficient for all specific bonds sites were occupied by AB T. cruzi. Selectivity tests in the absence of AB, only in the serum sample, and in the presence of AB Toxoplasma were performed. The results demonstrated that the immunosensor is selective, since it presented charge transfer resistance (Rct) values in the presence of AB T. cruzi 70% higher than the Rct values in presence of possible interferences.Therefore, the immunosensor presents itself as an alternative to qualitative diagnosis of american trypanosomiasis. In the third chapter, it is reported the modification of carbon graphite electrodes (CG) obtained from dry batteries zinc/carbon with Au microparticles obtained by potentiostatic electrodeposition. The variables involved in the electrodeposition process, such as the gold salt concentration, time and deposition potential were evaluated and optimized using cyclic voltammetry technique in the presence of redox couple [Fe(CN)6]3-/4-. The best conditions for the Au deposition were electrodeposition time of 700 s, potential of +0.3 V and concentration of 10.0 mmol. L-1. In these conditions, Au spherical particles were obtained with an average size of 420 nm, which were homogeneously deposited on the surface of GC electrode and promoted the increase of the electroactive area (GC electrode showed an area of 0.12 cm2 and GC/Au electrode presented an area of 0.25 cm2). The GC/Au electrode was applied for the separation and quantification of dopamine and uric acid present in a mixture. The voltammetric results showed that the GC/Au sensor is selective, once the potential peak separation between the DA and UA species was 370 mV. The detection and quantification limits were found to be 1.86 mol. L-1 and 6.09 mol. L-1 for dopamine and uric acid 17.5 mol. L-1 and 58.5 mol. L-1, respectively. In the development of the three electrochemical devices gold electrodes were used. From the results obtained for the three developed electrochemical devices it can be concluded that high electric conductivity, chemical stability, biocompatibility, ability to miniaturization in the form of microstructures and ease of functionalization of Au electrodes make them suitable conductive matrixes for construction of electrochemical sensors and particularly biosensors. / Esta tese descreve a preparação, caracterização e aplicação de sensores e biossensores eletroquímicos, utilizando diferentes técnicas de modificação baseadas no Au como transdutor. O biossensor enzimático aplicado na detecção do pesticida carbaril foi construído sobre um eletrodo de ouro funcionalizado com uma monocamada do dendrímero poliamidoamina de quarta geração com núcleo de cistamina (PAMAMG4),sobre o qual foi imobilizada com o auxílio de glutaraldeído a enzima acetilcolinesterase (AChE).Após avaliar e determinar as melhores condições de imobilização da enzima AChE (concentração de GLUT 1% (v/v) e concentração de unidades enzimáticas 496 U. mL-1) sobre a monocamada de PAMAM,a atividade catalítica da enzima AChE imobilizada foi avaliada por cronoamperometria na presença do substrato enzimático (AChI) obtendo-se o = 2,9 . −1. A resposta do biossensor na detecção de carbaril foi baseada na inibição da atividade enzimática causada pelo pesticida. Foi constatado que 5 min de imersão na solução do pesticida foram suficientes para que os sítios ativos da enzima fossem bloqueados. Após determinar as melhores condições de construção do biossensor, este foi aplicado na detecção de carbaril na faixa de 1,0 a 9,0 mol. L-1. Os limites de detecção e quantificação encontrados foram de 0,0108 mol. L-1 e 0,032 mol. L-1, respectivamente. No segundo capítulo é relatado o desenvolvimento de um imunossensor aplicado na detecção qualitativa de anticorpos (AB) T. cruzi. O sensor foi construído sobre eletrodo de ouro modificado com o tiol ácido 3-mercaptopropiônico (MPA) e sobre esta superfície foram imobilizados covalentemente pela reação com EDC e NHS, os antígenos (AG) T. cruzi. A influência da concentração da solução de AG e do tempo de imersão nesta solução para a construção do imunossensor foram avaliadas utilizando as técnicas de voltametria cíclica e espectroscopia de impedância eletroquímica na presença de [Fe(CN)6]3-/4- e os resultados demonstraram que as melhores condições foram: tempo de 15 min e concentração de 0,5 g. L-1. Os possíveis sítios de ligações não específicas foram bloqueados com albumina de soro bovino (BSA). O tempo de imersão na solução de AB também foi avaliado. Os resultados mostraram que 30 min são suficientes para que todos os sítios de ligações específicos fossem ocupados pelos AB T. cruzi. Testes de seletividade na ausência de AB,apenas em amostra de soro e também na presença de AB de Toxoplasma foram realizados. Os resultados demonstraram que o imunossensor é seletivo, pois este apresentou valores de resistência de transferência de carga (Rct) na detecção de AB T. cruzi 70% maiores do que na detecção dos possíveis interferentes. Portanto, o imunossensor apresenta-se como uma alternativa no diagnóstico qualitativo de tripanossomíase americana. No terceiro capítulo é descrito a modificação de eletrodos de carbono grafite (CG) obtidos de pilhas secas de zinco/carbono com micropartículas de Au obtidas pela eletrodeposição potenciostática. As variáveis envolvidas no processo de eletrodeposição, tais como concentração do sal de ouro, potencial e tempo de deposição foram avaliadas e otimizadas utilizando a técnica de voltametria cíclica na presença do par redox [Fe(CN)6]3-/4-. As melhores condições foram: tempo de 700 s, potencial de +0,3 V e concentração de 10,0 mmol. L-1. Nestas condições, foram obtidas partículas de Au esféricas com tamanho médio de 420 nm, as quais se apresentaram homogeneamente dispersas sobre toda a superfície do eletrodo de CG e promoveram o aumento da área eletroativa, (o eletrodo CG apresentou uma área de 0,12 cm2 e o eletrodo CG/Au uma área 0,25 cm2). O desempenho do eletrodo CG/Au foi avaliado na separação e quantificação de dopamina e ácido úrico presentes em uma mistura. Os resultados voltamétricos demonstraram que o sensor CG/Au é seletivo, pois apresentou separação de potencial pico de 370 mV entre as duas espécies. Os limites de detecção e quantificação encontrados foram de 1,86 mol. L-1 e 6,09 mol. L-1 para dopamina, e 17,5 mol. L-1 e 58,5 mol. L-1 para ácido úrico, respectivamente. A partir dos resultados obtidos para os três dispositivos eletroquímicos desenvolvidos pode-se concluir que a elevada condutividade elétrica, estabilidade química, biocompatibilidade, possibilidade de miniaturização na forma de microestruturas e a facilidade de funcionalização dos eletrodos de Au fazem destes matrizes condutoras apropriadas para construção de sensores e particularmente biossensores eletroquímicos.

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In this work I present conclusions of clinical-laboratory research focused on the patients with diabetic macular edema (DME). We performed biochemical and immunochemical analyses of vitreous samples that were collected during the pars plana vitrectomy. Moreover, at patients with non-proliferative diabetic retinopathy (NPDR) we assessed morphological characteristics of DME using optical coherence tomography (OCT). According to our findings, the vitreous and serum concentrations of uric acid and glucose were significantly higher in patients with diabetic retinopathy and DME compared to controls. Also total ratio (serum/ vitreous concentration) of uric acid and glucose was in diabetics significantly higher than in controls. The most important determinant of increasing concentration of both uric acid and glucose in the vitreous was the grade of diabetic retinopathy. Moreover, we demonstrated significant correlation between vitreous concentration of uric acid and concentration of the vascular endothelial growth factor (VEGF) in patients with DME and NPDR. We found further, that the volume of the macula (cube volume - CV) computed with the software of Cirrus HD-OCT correlates in diabetics significantly with the vitreous VEGF concentration, but not with uric acid. This OCT parameter could be used to...

Introduction: Alors que le choc hémorragique représente la première cause de mortalité précoce chez les patients subissant un traumatisme sévère, la défaillance d’organes est responsable d’une mortalité tardive chez cette population. Les alarmines, molécules libérées en situation d’ischémie-reperfusion et capables d’induire une réponse inflammatoire systémique et locale, représentent potentiellement une cible thérapeutique afin de minimiser la défaillance d’organes post-traumatique. L’acide urique est une molécule pro-inflammatoire et pro-apoptotique libérée en situation de choc hémorragique dont les effets au niveau des organes sont peu investigués. Le premier volet de ce mémoire présente une preuve de concept que l’acide urique joue un rôle clé dans l’atteinte hépatique et intestinale dans un modèle animal de choc hémorragique, et sera présenté sous forme de manuscrit soumis. Le deuxième volet de ce mémoire présente des données préliminaires d’une étude clinique prospective visant à évaluer la cinétique de l’acide urique chez une cohorte de patients traumatisés. Volet animal: Un choc hémorragique a été induit chez des rats Wistar en retirant du volume circulant titré à une tension artérielle moyenne (TAM) de 30-35 mmHg pendant 60 minutes. Les rats ont été réanimés avec une solution composée de sang retiré et de lactate ringer (1 :1), avec ou sans Uricase, une enzyme recombinante qui métabolise l’acide urique. Les résultats démontrent une diminution significative de plusieurs marqueurs d’hépatolyse (AST, ALT), inflammatoire (ICAM-1, MPO, TNF-alpha, IL-1, Caspase-1) et apoptotique (Caspase-3, -8, Bax/BCL-2, pAKT/AKT) au sein du groupe uricase. L’intervention sur l’acide urique a également pu prévenir l’augmentation de la perméabilité intestinale suite au choc hémorragique, de même que la translocation de produits bactériens en circulation (LPS). Volet clinique: Vingt patients subissant un choc hémorragique traumatique ont été recrutés de façon prospective à l’Hôpital Sacré-Cœur de Montréal, dans le cadre d’un projet pilote soutenu par le consortium de trauma du FRSQ. Des prélèvements d’acide urique sérique ont été effectués de façon sériée pendant 7 jours. Les critères de faisabilité, notamment les taux de consentement (95%) et d’observance des prélèvements sériés (90% pour le premier prélèvement, 65% pour les prélèvements aux 4 heures, et 73% pour les prélèvements aux 8 heures) ont été jugés acceptables. Les cinétiques d’acide urique étaient reproductibles dans l’ensemble de la cohorte (R2 = 0.87). L’aire sous la courbe était significativement plus élevée chez les patients avec un score de défaillance d’organes plus élevé à 72h (SOFA6). Conclusions: Bien que les mécanismes demeurent à élucider, ces travaux démontrent que l’acide urique est important médiateur dans l’atteinte des organes suivant un choc hémorragique. Cette molécule représente potentiellement une cible thérapeutique dont l’objectif ultime est de minimiser la défaillance d’organes suite au choc hémorragique. / While hemorrhagic shock is the first cause of early mortality among severe trauma patients, organ failure leads to late mortality and morbidity in this population. Alarmins, molecules released after ischemia-reperfusion, are able to activate local and systemic inflammatory pathways and potentially represent a therapeutic target to minimize organ failure. Uric acid is a pro-inflammatory and pro-apoptotic molecule released after hemorrhagic shock and its role pertaining to organ failure is incompletely studied. The first part of this thesis presents a proof of concept that uric acid plays a key role in liver and intestinal damage in an animal model of hemorrhagic shock; it will be presented in the format of a submitted article. The second part of this thesis presents preliminary data from a prospective observational clinical study evaluating uric acid kinetics in a cohort of trauma patients. Animal study Hemorrhagic shock was induced with blood withdrawal among Wistar rats for a target mean arterial blood pressure of 30-35 mmHg for 60 minutes. Animals were resuscitated with a 1 :1 mix of Ringer Lactate and drawn blood with or without Uricase, a recombinant enzyme that metabolizes uric acid. Results show a statistically significant decrease in hepatocellular damage (plasma AST and ALT), inflammatory markers (ICAM-1, MPO, TNF-alpha, IL-1, Caspase-1) and apoptotic markers (Caspase-3, -8, Bax/BCL-2, pAKT/AKT) among the Uricase group. The intervention on uric acid also prevented increased intestinal permeability and bacterial product (LPS) translocation. Clinical study Twenty patients sustaining major trauma with hemorrhagic shock were prospectively recruited at Montreal Sacré-Cœur Hospital, in the context of a pilot study funded by the FRSQ trauma consortium. Uric acid concentration was determined serially for 7 days after trauma. Feasibility criteria, notably consent rate (95%), sampling observance rate (90% for first sample, 65% for samples every 4 hours, and 73% for samples every 8 hours) were considered acceptable. Uric acid kinetics were reproducible among the entire cohort (R2 = 0.87). The area under the curve was significantly increased among patients with higher sequential organ failure assessment score at 72h (SOFA³6). Conclusions Although mechanisms remain to be elucidated, these studies show that uric acid is an important mediator for the development of organ damage after hemorrhagic shock. This molecule potentially represents a therapeutic target with the ultimate goal of minimizing organ failure after hemorrhagic shock.