La sclérose systémique (ScS) est une maladie auto-immune dévastatrice d'étiologie inconnue. Le dysfonctionnement immunitaire, la fibrose et la vasculopathie sont les trois principales caractéristiques de cette maladie. Une récente étude a révélé un nouveau lien entre l'auto-immunité et la fibrose, par la présence d'auto-anticorps stimulant le récepteur du facteur de croissance dérivé des plaquettes (PDGFR) des fibroblastes. Ces auto-anticorps sont capables de stimuler les espèces réactives de l'oxygène et d’activer la kinase régulée par un signal extracellulaire (ERK1/2). L’hypothèse que nous formulons est que les cellules musculaires lisses vasculaires (VSMCs) exprimant conjointement les PDGFR, répondront elles aussi aux autoanticorps anti-PDGF-R. Le travail présenté ici vise à valider la présence d'auto-anticorps PDGFR dans les sérums de patients ScS, et à caractériser ensuite la réponse de VSMCs exposées à de l'immunoglobuline G (IgG) de ces sérums, en mesurant l’activation des cascades de signalisation spécifiques, ainsi que l'induction des gènes impliqués dans la réponse fibrotique. Nos résultats démontrent la présence d'une fraction IgG stimulant une réponse phénotypique dans les cultures de VSMCs. Notamment, d’importantes régulations positive et négative des gènes pro-fibrotiques tgfb1 et tgfb2 respectivement, ont été observées dans les VSMCs exposées à des fractions de ScS-IgG. Les fractions de IgG positives pour l'activation de ERK étaient présentes dans la plupart, mais pas dans tous les échantillons de SSc (68%, 19/28), et moins présentes dans les contrôles 27% (11/3). Bien que, les fractions de SSc-IgG ont pu considérablement immunoprécipiter le PDGFR, l'utilisation d'un inhibiteur spécifique des récepteurs au PDGF (AG1296), n'a pas inhibé l'activation de ERK médiée par les fractions de SSc-IgG. Globalement, nos résultats indiquent la présence d'autoanticorps stimulants avec activité pro-fibrotique dans les sérums des patients ScS. Des travaux sont en cours pour identifier l'entité moléculaire responsable de la réponse d’IgG observée dans les cultures de VSMCs. / Systemic Sclerosis (SSc) is a devastating autoimmune disease of unknown etiology. Immune dysfunction, fibrosis and vasculopathy are the three major features of the disease; however, the interactions between these components are poorly understood. A novel link between autoimmunity and fibrosis has been proposed by the presence of stimulatory autoantibodies to the platelet-derived growth factor receptor (PDGFR) on fibroblasts. These autoantibodies were capable of stimulating reactive oxygen species and subsequent activation of ERK1/2. If the anti-PDGFR autoantibodies are present in the systemic circulation of SSc patients, they will most certainly encounter vascular smooth muscle cells (VSMCs). The latter are known to express the PDGFR and response to PDGF, which is a known phenotypic modulator of VSMCs. The work presented here seeks to readdress the presence of stimulatory anti-PDGFR autoantibodies in serum derived from SSc-patients and to characterize the effects of SSc-IgG on VSMCs by measuring the activation of specific signaling cascades and the induction of genes involved in fibrotic responses. Our results demonstrate the presence of an IgG fraction stimulating a phenotypic response in cultured VSMCs. Notably, a significant up-regulation of the pro-fibrotic gene tgfb1 and a significant down-regulation of the anti-fibrotic gene tgfb2 were observed in VSMC exposed to SSc-IgG fractions. Positive IgG fractions for ERK activation were present in most, but not all, SSc samples (68%, 19/28), and they were less present in controls (27%) (3/11). Although, the SSc-IgG fractions were able to significantly immunoprecipitate the PDGFR, the use of a selective PDGFR inhibitor, AG1296, did not inhibit the activation of ERK mediated by SSc-IgG fractions. Altogether, our findings suggest the presence of stimulatory autoantibodies with profibrotic activity in serum derived form SSc patients. Work is in progress to identify the molecular entity responsible for the IgG response observed in cultured VSMCs.

Šio eksperimentinio darbo tikslas buvo įvertinti 1,4-dihidropiridino ir benzimidazolo junginių poveikį jūros kiaulyčių širdies papiliarinių raumenų izometrinei funkcijai bei žmogaus kraujagyslių segmentų susitraukimui ir atsipalaidavimui. Buvo atlikti eksperimentiniai tyrimai su izoliuotais jūros kiaulyčių širdies papiliarinių raumenų preparatais ir izoliuotais žmogaus v.saphena magna ir a.thoracica interna kraujagyslių segmentais. Kraujagyslių preparatai gauti iš pacientų, kuriems buvo atliekamos širdies vainikinių arterijų jungčių suformavimo operacijos LSMU ligoninės Kauno klinikos Kardiochirurgijos klinikoje. Žmogaus izoliuotų kraujagyslių preparatų tyrimams išduotas Kauno regioninio bioetikos komiteto leidimas Nr. BE–2–64, data 2010–11–05. Buvo tiriamas 1,4-dihidropiridinų bei benzimidazolo junginių poveikis izometrinei jūros kiaulyčių širdies papiliarinių raumenų funkcijai, registruojant preparatų elektromechaninį susitraukimo jėgos ir transmembraninio veikimo potencialus. Eksperimentiniai tyrimai, atlikti in vitro sąlygomis, įvertinant 1,4-dihidropiridinų bei benzimidazolo junginių poveikį žmogaus izoliuotų kraujagyslių (v.saphena magna ir a.thoracica interna) segmentų susitraukimui ir atsipalaidavimui, skirtingų ekstraląstelinio Ca2+ koncentracijų įtaką tiriamųjų junginių poveikiui kraujagyslių segmentų susitraukimui ir atsipalaidavimui. Tiriamieji 1,4–dihidropiridinų junginiai sintezuoti Latvijos Organinės Sintezės institute. / This study aim was to evaluate the effects of 1,4-dihydropiridines and benzimidazole deriva¬tives on the isometric function of guinea pig papillary cardiac muscles and the contraction and relaxation of vascular segments in humans. The experiments were carried out on isolated samples of human great saphenous vein (v. saphena magna) and internal thoracic artery (a. tho¬racica interna). The vein and arteries samples were taken from patients who underwent coronary artery bypass. The study was approved by the Regional Ethics Committee of the Biomedical Research on 05/11/2010, license No. BE-2-64, Kaunas, Lithuania. The inotropic activity and transmembrane AP duration of the dihydropyridine derivatives were evaluated on the guinea-pig papillary muscles and aorta vascular samples. Synthesis of 1,4-dihydropyridine derivatives were performed in Latvian Organic Synthesis institute. During this study were performed the evaluation of 1,4-dihydropyridines and benzimidazole derivatives on contraction force and action potential in guinea pig papillary muscles. Effects of 1,4-dihydropyridines and benzimidazole derivatives on contraction and relaxation of the segments of the great sa¬phenous vein (v. saphena magna) and internal thoracic artery (a. tho¬racica interna) in humans, the extra-cellular concentration of Ca2+ and the effect of the studied compounds and were evaluated. Also assessment of preventive effect of the calcium channel blockers and benzimidazole derivative on contraction... [to full text]

L’hypertension artérielle est le facteur de risque le plus important dans les maladies cardiovasculaires (MCV) et les accidents vasculaires cérébraux (AVC). L’hypertension artérielle essentielle est une maladie complexe, multifactorielle et polygénique. Même si on a identifié de nombreux facteurs de risque de l’hypertension artérielle, on ne comprend pas encore clairement les mécanismes qui la régissent. Les kinases hépatocytes produisant l’érythropoïétine (Eph) constituent la plus grande famille des récepteurs tyrosine kinase qui se lient à des ligands de surface cellulaire appelés éphrines sur les cellules avoisinantes. On sait que les interactions de Eph et des éphrines sont essentielles aussi bien dans les processus de développement que dans le fonctionnement des organes et des tissus adultes. Cependant on n’a pas encore étudié la relation entre Eph/éphrines et l’hypertension artérielle. Nous avons créé des modèles de souris knockout (K.O.) Ephb6-/-, Efnb1-/- et Efnb3-/- pour cette étude. Dans le modèle EphB6-/-, nous avons observé que les souris K.O. Ephb6 castrées, mais pas les femelles, ainsi que les souris mâles non castrées présentaient une tension artérielle élevée (TA) par rapport à leurs homologues de type sauvage (TS). Ceci suggère que Ephb6 doit agir de concert avec l’hormone sexuelle mâle pour réguler la TA. Les petites artères des mâles castrés Ephb6-/- présentaient une augmentation de la contractilité, une activation de RhoA et une phosphorylation constitutive de la chaîne légère de la myosine (CLM) lorsque comparées à celles de leurs homologues TS. Ces deux derniers résultats indiquent que la phosphorylation de CLM et de RhoA passe par la voie de signalisation de Ephb6 dans les cellules du muscle lisse de la paroi vasculaire (CMLV). Nous avons démontré que la réticulation de Efnbs mais non celle de Ephb6 aboutit à une réduction de la contractilité des CMLV. Ceci montre que l’effet de Ephb6 passe par la signalisation inversée à travers Efnb. Dans le modèle Efnb1-/- conditionnel spécifique au muscle lisse, nous n’avons observé aucune différence entre Efnb1-/- et les souris de TS concernant la mesure de la TA dans des conditions normales. Cependant, la TA des souris K.O. Efnb1 lors d’un stress d’immobilisation est supérieure à celle des souris de TS. Dans les petites artères des souris K.O. Efnb1, le rétrécissement et la phosphorylation de CLM étaient élevés. In vitro, la contractilité et l’activation RhoA de la CMLV des souris TS étaient augmentées quand leur Efnb1 était réticulé. Ces résultats corroborent ceux des souris KO Ephb6 et prouvent que l’effet de Ephb6 dans le contrôle de la TA se produit au moins par l’intermédiaire d’un de ses ligands Efnb1 dans les CMLV. Dans le modèle Efnb3-/-, on a observé une augmentation de la TA et du rétrécissement des vaisseaux chez les femelles Efnb3-/-, mais non chez les mâles; l’échographie a aussi révélé une résistance accrue au débit sanguin des souris K.O. femelles. Cependant la mutation de Efnb3 ne modifie pas la phosphorylation de la CLM ou l’activation de RhoA in vivo. Dans l’expérience in vitro, les CMLV des souris femelles Efnb3-/- ont présenté une augmentation de la contractilité mais pas celle des souris mâles Efnb3-/-. La réticulation des CMLV chez les mâles ou les femelles de TS avec solide anti-Efnb3 Ab peut réduire leur contractilité. Notre étude est la première à évaluer le rôle de Eph/éphrines dans la régulation de la TA. Elle montre que les signalisations Eph/éphrines sont impliquées dans le contrôle de la TA. La signalisation inverse est principalement responsable du phénotype élevé de la TA. Bien que les Efnb1, Efnb3 appartiennent à la même famille, leur fonction et leur efficacité dans la régulation de la TA pourraient être différentes. La découverte de Eph/Efnb nous permet d’explorer plus avant les mécanismes qui gouvernent la TA. / Hypertension is the most important risk factor for the cardiovascular diseases (CVD) and strokes. The essential hypertension is a complex, multifactorial and polygenic disease. Although many hypertension risk factors have been identified, the comprehensive understanding of mechanisms remains elusive. Erythropoietin-producing hepatocyte kinases (Ephs) are the largest family of receptor tyrosine kinases, which bind to cell surface ligands called ephrins on neighboring cells. Eph and ephrin interactions are known to be essential in developmental processes, as well as in functions of adult organs and tissues. However the relationship between Ephs/ephrins and hypertension has not been studied. Ephb6-/-, Efnb1-/- and Efnb3-/-knockout mice models were established for this study. In the EphB6-/- model, we observed that the castrated Ephb6 KO mice but not female or uncastrated male mice presented heightened blood pressure (BP) compared to the wild type (WT) counterparts. This suggests that Ephb6 needs to act in concert with sex hormone to regulate blood pressure. Small arteries from castrated Ephb6-/- males showed increased contractility, RhoA activation and constitutive myosin light chain (MLC) phosphorylation compared to their WT counterparts. The latter two findings indicate that RhoA and MLC phosphorylation are in the signaling pathway of Ephb6 in vascular smooth muscle cell (VSMC). We demonstrated that, crosslinking of Efnbs but not Ephb6 resulted in reduced VSMC contractility. This indicates that the effect of Ephb6 is via reverse signaling through Efnbs. In smooth muscle-specific conditional Efnb1-/- model, no difference was observed between Efnb1-/- and WT mice in BP measurement under a normal condition. However, the BP of Efnb1 KO mice during immobilization stress were higher than that of WT mice. In the small arteries from Efnb1 KO mice, the constriction and MLC phosphorylation were elevated. In vitro, the contractility and RhoA activation of WT VSMC were augmented when their Efnb1 was crosslinked. These results corroborate the findings from Ephb6 KO mice, and prove that the effect of Ephb6 in BP control is at least via one of its ligand Efnb1 in VSMC. In the Efnb3-/- model the heightened BP and increased vessel constriction were observed in Efnb3-/-females but not males; the echography also revealed the increased blood flow resistance of female KO mice. However the mutation of Efnb3 doesn’t alter the MLC phosphorylation or RhoA activation in vivo. In in vitro experiment, VSMCs from Efnb3-/- female mice showed increased contractility but did not Efnb3-/- male mice. Crosslinking of VSMCs from WT males or females with solid anti-Efnb3 Ab can reduce their contractility. Our study is the first to assess the role of Eph/ephrins in BP regulation. Eph/ephrins signalings are involved in the regulation of BP. The reverse signaling is mainly responsible for the elevated BP phenotype. Although the Efnb1, Efnb3 belongs to the same family, their function and effectiveness in the regulation of BP might be different. The discovery of Eph/Efnbs allows us to further explore the mechanism in BP.

Thesis (Ph. D.)--West Virginia University, 2007. / Title from document title page. Document formatted into pages; contains xxiii, 251 p. : ill. Vita. Includes abstract. Includes bibliographical references.

Thesis (Ph. D.)--University of Missouri--Columbia, 2004. / Typescript. Vita. Includes bibliographical references (leaves 166-179). Also issued on the Internet.

Vascular smooth muscle cell (VSMC) accumulation is a hallmark of atherosclerosis and vascular injury. However, fundamental aspects of proliferation and the phenotypic changes within individual VSMCs, which underlie vascular disease remain unresolved. In particular, it is not known if all VSMCs proliferate and display plasticity, or whether individual cells can switch to multiple phenotypes. To assess whether proliferation and plasticity in disease is a general characteristic of VSMCs or a feature of a subset of cells, multi-colour lineage labelling is used to demonstrate that VSMCs in injury-induced neointimal lesions and in atherosclerotic plaques are oligo-clonal, derived from few expanding cells, within mice. Lineage tracing also revealed that the progeny of individual VSMCs contribute to both alpha Smooth muscle actin (aSma)-positive fibrous cap and Mac-3-expressing macrophage-like plaque core cells. Co-staining for phenotypic markers further identified a double-positive aSma+ Mac3+ cell population, which is specific to VSMC-derived plaque cells. In contrast, VSMC-derived cells generating the neointima after vascular injury generally retained expression of VSMC markers and upregulation of Mac3 was less pronounced. Monochromatic regions in atherosclerotic plaques and injury-induced neointima did not contain VSMC-derived cells expressing a different fluorescent reporter protein, suggesting that proliferation-independent VSMC migration does not make a major contribution to VSMC accumulation in vascular disease. Similarly, VSMC proliferation was examined in an Angiotensin II perfusion model of aortic aneurysm in mice, oligo-clonal proliferation was observed in remodelling regions of the vasculature, however phenotypic changes were observed in a large proportion of VSMCs, suggesting that the majority of VSMCs have some potential to modulate their phenotype. To understand the mechanisms behind the inherent VSMC heterogeneity and observed functionality, the single cell transcriptomic techniques Smart-seq2 and the Chromium 10X system were optimized for use on VSMCs. The work within this thesis suggests that extensive proliferation of a low proportion of highly plastic VSMCs results in the observed VSMC accumulation after injury, and the atherosclerotic and aortic aneurysm models of cardiovascular disease.

O dimorfismo sexual relacionado à hipertensão arterial surge na adolescência e persiste por toda vida adulta. Homens apresentam maior incidência de doenças cardiovasculares quando comparados a mulheres de mesma faixa etária. O mesmo perfil é observado em modelos animais de hipertensão, nos quais machos apresentam maiores níveis pressóricos quando comparados a fêmeas. Dessa forma, a testosterona é frequentemente relacionada à hipertensão arterial. Entretanto, os mecanismos pelos quais a testosterona exerce efeitos vasculares ainda não estão esclarecidos. O objetivo deste trabalho foi investigar os efeitos da testosterona sobre a geração de espécies reativas de oxigênio (EROs), importantes mediadores do processo hipertensivo, em células da musculatura lisa vascular (CMLV) de ratos normotensos e espontaneamente hipertensos (SHR). Os receptores para andrógenos, as fontes de EROs (papel da NADPH oxidase), bem como os efeitos funcionais celulares (migração celular) relacionados aos efeitos da testosterona também foram analisados. Para tanto, CMLV do leito mesentérico de ratos Wistar (W), Wistar-Kyoto (WKY) e SHR foram isoladas, cultivadas e estimuladas com testosterona 10-7mol/L em diferentes tempos, de acordo com cada protocolo. Sempre que necessário, as células foram pré-incubadas por 30 minutos com inibidores específicos para o estudo dos mecanismos envolvidos, tais como: flutamida (inibidor do receptor clássico para andrógenos), apocinina (inibidor da NADPH oxidase), PP2 (inibidor da c-Src), actinomicina D (inibidor da transcrição gênica) e cicloheximida (inibidor da síntese protéica). Nossos resultados indicam que a testosterona induz a geração de EROs por mecanismos dependentes do tempo e da linhagem de ratos, de modo que células isoladas de animais SHR são mais sensíveis a testosterona. Esta geração ocorre por dois mecanismos principais: um mediado pelo receptor clássico para andrógenos (AR) e outro mediado pelo receptor de membrana para andrógenos (ARm), resultando em efeitos genômicos e não-genômicos, respectivamente. Enquanto os efeitos genômicos são comuns, isto é, são observados em células de animais normotensos e hipertensos, os efeitos não-genômicos são específicos, e ocorrem exclusivamente em células de animais hipertensos. A geração genômica de EROs, mediada pelo AR, depende da modulação da expressão de subunidades da NADPH oxidase. Por outro lado, a geração não-genômica, é mediada pelo ARm, independe de síntese protéica, e ocorre devido à ativação de vias de sinalização específicas, reguladoras do complexo enzimático NADPH oxidase. As EROs formadas a partir do estímulo com a testosterona tanto por mecanismos genômicos ou não-genômicos levam a migração celular por mecanismos mediados pelo RA. Nossos resultados sugerem que a testosterona tem papel importante na função de células da musculatura lisa vascular, o que pode contribuir para algumas alterações vasculares características do processo hipertensivo. Portanto, nosso trabalho é o primeiro a demonstrar que a testosterona regula vias de sinalização redox em CMLV levando a efeitos funcionais importantes, relacionados ao remodelamento vascular, os quais podem contribuir para o desenvolvimento e manutenção da hipertensão arterial. / Sexual dimorphism related to hypertension begins at childhood and persists through adulthood. The incidence of cardiovascular diseases is higher in men when compared to age-matched women. Although testosterone has been associated to the sexual dimorphism in hypertension, the mechanisms whereby testosterone acts in the vasculature remain unclear. The main objective of this study was to determine whether testosterone induces reactive oxygen species (ROS) generation, key players on hypertension, in vascular smooth muscle cells (VSMC) isolated from normotensive and hypertensive rats. The signaling pathways and the androgen receptors activated by testosterone, the role of NADPH oxidase in ROS generation and the cellular outcomes (cell migration) were also determined. Accordingly, VSMC isolated from the mesenteric bed of Wistar (W), Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats were stimulated with testosterone 10-7mol/L for different periods of time, according to each protocol. Whenever appropriate, cells were pre-incubated with specific inhibitors, such as flutamide 10-5mol/L (nuclear androgen receptor antagonist), apocynin 3x10-5mol/L (NADPH oxidase inhibitor), PP2 10-5mol/L (c-Src inhibitor), actinomycin D 10-5mol/L (inhibitor of gene transcription), and cycloheximide 10-5mol/L (protein synthesis inhibitor). Our findings demonstrate that testosterone induces ROS formation in a time and strain-dependent manner. Augmentation of ROS formation is higher in SHR-VSCMC, indicating an increased sensitivity of SHR-VSMC to testosterone stimuli. Testosterone-induced ROS production occurs by two main mechanisms: the first mediated through the classical androgen receptor (AR) and the second mediated through membrane-associated androgen receptor (ARm), leading to genomic and non-genomic effects, respectively. Whereas the genomic effects occur in VSMC from both strains, non-genomic effects are only observed in SHR-VSMC. The genomic ROS production is mediated through AR and depends on modulation of NADPH oxidase subunits. On the other hand, non-genomic ROS formation is mediated through RAm, does not rely on protein synthesis and occurs via specific signaling pathways that regulate NADPH oxidase. Genomic and non-genomic ROS production by testosterone leads to a common final effect: VSMC migration, indicating that testosterone plays a key role in VSMC function. These results indicate that testosterone signals through redox-sensitive pathways, important in c-Src-mediated migration of VSMCs in SHR. Such processes may contribute to vascular remodeling in hypertension.

L'angiodermite nécrotique ou "Hypertensive Leg Ulcer" (HLU) est un ulcère de jambe inflammatoire de traitement difficile, associé à une hypertension artérielle chronique. La douleur est très importante et nécessite l'utilisation de la morphine pour soulager les patients. Notre objectif était d'analyser les caractéristiques de l'inflammation et d'étudier son implication dans la physiopathologie de la nécrose cutanée. La peau inflammatoire est le siège d'un infiltrat composé de macrophages et de lymphocytes. L'épiderme et les cellules vasculaires lisses des microvaisseaux présentent des troubles de la différenciation et une importante prolifération. Nous observé une forte augmentation des transcrits de l'interleukine 1β (IL-1β), de l'IL-6 et de l'Oncostatin M (OSM), qui sont exprimées par les macrophages.Les kératinocytes humains in vitro et in vivo chez la souris montrent un phénotype semblable lorsqu'ils sont exposés à ces cytokines.Comparée à la peau inflammatoire et à la peau saine, la peau en périphérie de l'inflammation est douloureuse et présente des altérations histologiques intermédiaires. On observe une légère augmentation de l'expression des cytokines inflammatoires IL-1β et OSM. D'autre part, la consommation de morphine est associée au niveau d'expression de l'OSM et l'inflammation systémique reflète la douleur ressentie par le patient. Ces éléments sont en faveur d'une implication des cytokines inflammatoires IL-1β et OSM dans la physiopathologie de la douleur et de la nécrose dans l'HLU. Le cercle vicieux pourrait être bloqué par l'utilisation des biothérapies anticytokines, ce qui met en avant de nouvelles cibles thérapeutiques. / Hypertensive Leg Ulcer (HLU) is an inflammatory skin lesion associated to chronic high blood pressure. The ulcer is painful requiring morphine to relieve patients. Our objective was to analyze the characteristics of the inflammation and to study it’s implication in pathogenesis of skin necrosis. Inflammatory skin is infiltrated by macrophages and lymphocytes. Keratinocytes and vascular smooth muscle cells of microvessels display an alteration of differentiation and an important proliferation. We studied the expression of cytokines associated to skin inflammation and we observed a strong augmentation of the transcripts for the interleukin 1β (IL-1β), the IL-6 and the Oncostatin M (OSM); which are expressed by the macrophages. The reconstructed human epidermis in vitro exposed to these cytokines showed a similar phenotype of the histological studies in human. At least, injection of these cytokines to the mouse produces an inflammation and an alteration of the epidermis comparable to HLU.Compared to the inflammatory skin and to the healthy skin, the skin in periphery of the inflammation is painful and presents intermediate histological alterations. We observed a slight augmentation of the inflammatory cytokines IL-1β and OSM. On the other hand, the consumption of morphine is associated with the level of expression of the OSM and systemic inflammation reflects the pain felt by the patient.The present evidence indicates an involvement of inflammatory cytokines IL-1β and OSM in the pathogenesis of pain and skin necrosis in the HLU. The vicious circle may be blocked by the use of biotherapies against inflammatory cytokines, which highlights new therapeutic targets.

Rationnel : L’artérite à cellules géantes (ACG) est une vascularite primitive des gros vaisseaux dont le diagnostic repose sur la mise en évidence d’un infiltrat inflammatoire et de cellules géantes à la biopsie d’artère temporale (BAT). On note également un remodelage de la paroi vasculaire lié à une prolifération des cellules musculaires lisses vasculaires (CMLV) pouvant aboutir à une occlusion artérielle. Objectif : Caractériser les auto-anticorps dirigés contre les cellules endothéliales (CE) et les CMLV au cours de l’ACG et préciser le rôle des CMLV dans le remodelage pariétal. Méthodes : La recherche d’auto-anticorps a reposé sur un immunoblot 2D couplé à la spectrométrie de masse. Les protéomes des CMLV d’artère ombilicale, d’artère pulmonaire et d’aorte humaines normales a été comparés par protéomique différentielle (2D-DIGE). Nous avons utilisé la 2D-DIGE et des puces d’expression pan-génomiques pour comparer les CMLV issues de BAT de patients suspects d’ACG (avec un diagnostic final d’ACG ou non), afin d’identifier les mécanismes contribuant à la prolifération des CMLV. Résultats : Chez 15 patients atteints d’ACG, nous avons notamment identifié la lamine, la vinculine et l’annexine A5 comme cible des auto-anticorps anti-CMLV. Les antigènes cibles identifiés sont liés à Grb2, une protéine adaptatrice impliquée dans la prolifération des CMLV. Nous avons mis en évidence des protéomes différents au sein des CMLV humaines normales selon leur origine vasculaire et avons principalement identifié des protéines du cytosquelette et du métabolisme énergétique.A partir des CMLV isolées des BAT et à l’aide d’Ingenuity®, nous avons identifié l’endothéline 1 (ET-1) et la paxilline comme des molécules impliquées dans le remodelage vasculaire. En immunohistochimie et par qPCR, nous avons confirmé l’expression de l’ET-1 et de ses récepteurs ETAR et ETBR au sein des artères temporales de patients atteints d’ACG. Enfin, nous avons inhibé la prolifération des CMLV avec du macitentan, un inhibiteur d’ETAR et en particulier avec son métabolite actif, mais pas avec d’autres inhibiteurs des récepteurs de l’ET-1. Conclusion : Nous avons identifié chez les patients atteints d’ACG des anticorps anti-CMLV dont le rôle pathogéne potentiel reste à définir. Les différences protéiques observées à partir des CMLV humaines normales pourraient correspondre à des phénotypes différents. A partir d’un matériel biologique unique, nous avons pu montrer que la prolifération excessive des CMLV au cours de l’ACG pouvait être inhibée par le macitentan ce qui permet d’envisager un usage thérapeutique de cette molécule. / Background : Giant cell arteritis (GCA) is a large vessel vasculitis and its diagnosis usually relies on the identification of an inflammatory infiltrate made of mononuclear cells and giant cells upon temporal artery biopsy. There is also a remodeling process in the arterial wall due to an excessive proliferation of vascular smooth muscle cells (VSMC) which can sometimes lead to arterial occlusion. Purpose: Identify auto-antibodies targeting either endothelial cells (EC) and/or VSMC during GCA and better understand the role of VSMC in the remodeling process. Methods : Auto-antibodies were detected by a 2-dimensionnal immunoblot and their target antigens were identified by mass spectrometry. Proteoms of umbilical artery, pulmonary artery and aorta VSMC were compared by 2 dimension differential in gel electrophoresis (2D-DIGE). In order to identify mechanisms involved in VSMC proliferation in GCA, we used both 2D-DIGE and pan genomic chips in order to compare VSMC isolated at the time of temporal artery biopsy (TAB) from patients with a final diagnosis of GCA or another diagnosis. Results : In 15 patients with GCA, we identified lamin, vinculin and Annexin A5 as target antigens of anti-VSMC antibodies. Target antigens were linked with Grb2, an adaptator protein involved in VSMC proliferation. Normal VSMC originating from different vascular beds have differ in protein contents with differential expression of cytoskeleton and energy metabolism proteins. We compared VSMC from TAB with Ingenuity software and identified endothelin-1 (ET-1) and paxillin as proteins involved in vessel remodeling. We confirmed by immunohistichemistry and qPCR that ET-1 and its receptor ETAR and ETBR were expressed in temporal arteries from patients with GCA. Last, we reduced VSMC proliferation with Macitentan, an ETAR and ETBR antagonist and significantly inhibited VSMC proliferation with its active metabolite whereas other ET-1 inhibitors had no effect. Conclusion : We identified anti-VSMC auto-antibodies in patients with GCA. Their pathogenic role remains to be determined. Normal VSMC from different vascular locations differ in protein conten which might reflect different phenotypes and different properties. The escessive proliferation of VSMC from patients with GCA was inhibited by Macitentan. This drug might constitute a future therapeutic option.

The increasing demand on healthcare from pregnancies complicated by gestational diabetes (GDM) and obesity is caused in large part by fetal macrosomia (FM). Alterations to the vasculature of the placenta leading to changes to nutrient flux may be more frequent when GDM and obesity occur concomitantly. However, the impact of obesity as an independent comorbidity is poorly understood. The current study sought to characterise structural and functional changes in placenta from pregnancies complicated by GDM and/or obesity and examine the involvement of miRs in this phenomenon, as the phenotype of vascular smooth muscle (VSM) has been documented to be influenced by microRNA (miR) expression. Patients were stratified according to the presence or absence of GDM and/or obesity, which resulted in four groups. Morphometric analysis of CD31 immuno-stained placentas showed that pregnancies complicated by GDM or obesity both had a higher mean sum ratio of the area of the lumen compared to the endothelium. No relationship was found with FM. The ratio increased with maternal body mass index (BMI) in all pregnancies. Immunohistochemistry with a panel of VSM markers suggested an altered phenotype of VSM in pregnancies complicated by GDM and/or obesity. RT-QPCR and immunoblotting showed a higher expression of smooth muscle myosin (SM-MHC), h-caldesmon (HC) and alpha smooth muscle actin (ASMA) in pregnancies complicated by obesity, consistent with a greater contractile capacity. This was most marked when obesity occurred without GDM.Studies were conducted on two miRs, miR-145, which is associated with VSM in many vascular tissues, and the snoRNA-derived species miR-664a-3p, which microarray studies had shown to be higher in placentas from pregnancies complicated by GDM. Dicer and dyskerin, components of the snoRNA-derived miR biogenesis pathway, were increased and reduced respectively in GDM placenta. However, studies in cultured placental villous explants suggested that neither miR species was regulated by glucose, insulin or IGF-I. Placental mesenchymal cells are the developmental precursors of VSM. In primary culture, these cells expressed both miRs. To determine the function of miR-664a-3p, a nucleofection protocol was developed in a fetal mesenchymal cell line, WI38, and applied to first-trimester placental mesenchymal cells. Preliminary proteomic analysis after nucleofection-mediated knockdown of miR-664a-3p suggested a series of novel candidate target proteins for this uncharacterised miR species. Blood vessel structure and VSM phenotype are both altered in pregnancies complicated by GDM and/or obesity. The significance of apparently higher level of contractile proteins with wider vessel lumens in obesity requires further investigation. Translational regulation by miRs including miR-145 and miR-664a-3p is implicated in these alterations. In future, targeted therapies that alter miR levels in the placenta may be useful in control of fetal overgrowth such as FM.