Des cellules souches neurales (CSN) persistent dans le cerveau de mammifères adultes, y compris l'Homme. Les CSN participent à l'homéostasie tissulaire en générant de nouveaux neurones, permettant le remplacement de certains neurones morts. Cependant, la production de nouvelles cellules se fait en excès et plus de la moitié des cellules nouvellement générées meurent. Les cellules mortes ainsi que leurs débris doivent être éliminés par phagocytose. Dans une première partie de ma thèse, nous avons montré pour la première fois, que les CSN sont capables de phagocytose et que cette activité des CSN est régulée par la protéine S (ProS), une protéine vitamine-K dépendante, et son récepteur MerTK. Une rupture de l'homéostasie tissulaire conduit à des pathologies dont les cancers. Les interactions entre les CSN et des tumeurs cérébrales, les gliomes, sont duelles et étroites : des CSN dont la prolifération est dérégulée seraient à l'origine des tumeurs, mais, à l'inverse, les CSN saines peuvent migrer vers les gliomes et inhiber leur croissance. Dans une deuxième partie de ma thèse, nous avons confirmé l'effet anti-tumoral des CSN et nous avons établi que la ProS sécrétée par les gliomes attire les CSN vers la tumeur d'une part, et d'autre part, que les CSN diminuent la croissance tumorale par la sécrétion de leur ProS. Nous démontrons de plus, que ce processus s'accompagne d'une mort cellulaire des gliomes dont les débris sont phagocytés par les CSN. Mon travail de thèse a permis d'identifier de nouveaux mécanismes impliqués dans le maintien de l'homéostasie tissulaire par les CSN en conditions physiopathologiques. / Neural stem cells (NSC) persist in the brain of adult mammals, including humans. NSC contribute to tissue homeostasis maintenance through the genesis of new neurons that replace part of the cells that are maybe lost. However, the production of new cells is in excess and half of the newly generated cells die. Dead cells and their debris must be removed by phagocytosis. NSC express protein S (ProS) and its receptors, which are involved in phagocytosis. During the first part of my PhD thesis, we established for the first time, using in vitro and in vivo experiments, that NSC possess a phagocytic activity which is regulated by protein S (ProS), a vitamin K-dependent protein, and its receptor MerTK. Tissue homeostasis disruption leads to diseases such as cancers. Interactions between the NSC and brain tumors such as gliomas are dual and complex: glioma may arise from transformed NSC, but, conversely, normal NSC migrate towards glioma and inhibit their growth. Our study confirms the anti-tumoral effect of NSC and demonstrates, for the first time that ProS secreted by gliomas acts on Tyro-3 to attract NSC and that NSC secrete ProS which reduces tumor growth of ProS. In addition, we show that this process results in the death of glioma cells that are then phagocytosed by NSC. Our highlights identified novel mechanisms by which NSC contribute to tissue homeostasis in pathophysiological conditions.

Arterial system is a system of vessels distributing blood. Ageing of arterial system leads to two distinct pathologies: atherosclerosis and arteriosclerosis - stiffening of arterial wall. These pathologies can coexist and interfere; however, they differ in their pathogenesis, location, scope and consequences. Progressive loss of elastic properties of large arteries is natural part of vascular ageing. It is directly responsible for several age dependent consequences, such as increase of central systolic pressure or prevalence of isolated systolic hypertension in the elderly. Clinically, central arteries stiffness manifests as aortic pulse wave velocity, which can be quantified, among other methods, using applanation tonometry. There is abundant evidence that aortic pulse wave velocity represents an independent predictor of cardiovascular mortality and morbidity. The most important mechanism in arterial stiffening is repeated mechanical damage which leads to fractures, fragmentation and thinning of elastin. Stiffening of large arteries can be accelerated by several other mechanisms, e.g. deposition of several substances (calcium, advanced glycation end-products, etc.), metabolic turnover of key elements of vascular extracellular matrix (collagen and elastin) or individual genetic susceptibility. In...

BACKGROUND: Current guidelines give class I recommendations for uninterrupted use of dabigatran rivaroxaban as an alternative to vitamin K antagonist (VKA) in patients of atrial fibrillation (AF) who are undergoing catheter ablation. The recent randomized controlled trials have shown similar efficacy of novel oral anticoagulants when compared to VKA in these patients. We sought to perform a meta-analysis with a focus on subgroup analysis of novel oral anticoagulants. METHODS: We searched PubMed, Clinical trials registry and the Cochrane Center Register of Controlled Trials were searched through August 2020. Six RCTs studies (n = 2260) comparing the use of NOACs versus VKA in patients with AF undergoing catheter ablation were included. The odds ratio (OR) with 95% confidence interval was computed and P < 0.05 was considered as a level of significance. Major adverse cardiac events (MACE) were considered as a primary endpoint. RESULTS: Our results showed a significant difference in MACE between NOACs and VKA [OR 0.57 (0.37-0.88); P = 0.01] and in major bleeding events [OR 0.55 (0.35-0.86); P = 0.009], which is mainly derived from the use of dabigatran. No significant difference in MACE or major bleeding events was found on the subgroup analysis of rivaroxaban and apixaban over VKA therapy. CONCLUSION: Uninterrupted use of NOACs is safe and effective alternative for the prevention of cerebral thromboembolism and reducing the risk of major bleeding in patients undergoing catheter ablation of AF. However, the individual subgroup analysis showed that only dabigatran is superior to VKA in terms of reducing MACE through a reduction in major bleeding. The rivaroxaban, apixaban and edoxaban are non-inferior to VKA therapy based on these results. Further studies are needed to generalize these recommendations in morbidly obese patients.