Thesis (M.S.)--University of Michigan, 2004. / Includes bibliographical references.

Thesis (doctoral)--Karolinska Institutet, Stockholm, 1991. / T.p. with thesis statement inserted. Includes bibliographical references.

Thesis (doctoral)--Karolinska Institutet, Stockholm, 1991. / T.p. with thesis statement inserted. Includes bibliographical references.

Thesis (M.S.)--University of Florida, 2004. / Typescript. Title from title page of source document. Document formatted into pages; contains 31 pages. Includes Vita. Includes bibliographical references.

Thesis (M.S.)--University of Florida, 2004. / Typescript. Title from title page of source document. Document formatted into pages; contains 35 pages. Includes Vita. Includes bibliographical references.

Neste estudo retrospectivo, controlado, de 94 adolescentes consecutivos com maloclusão de Classe II, divisão 1ª de Angle e retrognatismo mandibular, no surto de crescimento puberal, foram avaliadas as mudanças dentoesqueléticas decorrentes do tratamento com aparelho de Herbst (Grupo A coroas de aço e B splints acrílicos) e de acompanhamento (Grupo C - controle), em um período de 12 meses. As telerradiografias laterais foram obtidas em T1 (inicial) e T2 (no final do período de observação). As variáveis cefalométricas foram analisadas com testes paramétricos. Os resultados mostraram que os dois grupos tratados caracterizaram-se diferencialmente do grupo controle, com restrição do crescimento maxilar e maior crescimento mandibular, o que permitiu melhorar a relação sagital. Da mesma forma, no aspecto dentoalveolar houve melhora da sobressaliência pela retroinclinação dos incisivos superiores e vestibularização dos incisivos inferiores, distalização com controle vertical dos molares superiores e mesialização dos molares inferiores. Os três grupos mostraram semelhança na extrusão dos molares inferiores, na preservação da morfologia mandibular e do padrão facial. O plano oclusal rotacionou no sentido horário nos grupos tratados e anti-horário no grupo controle. Pode-se concluir que no tratamento com dois tipos de aparelho de Herbst da maloclusão de classe II, em adolescentes no pico máximo de crescimento, observaram-se um conjunto de mudanças que melhoraram as relações dentoesqueléticas sagitais, independentemente do crescimento. No aspecto vertical, apesar das pequenas mudanças observadas houve preservação do padrão facial assim como no grupo controle. / This retrospective controlled study enrolled 94 consecutive adolescents during growth spurt with Angle class II division 1 malocclusion and mandibular retrognathism and evaluated skeletal and dental changes resulting from treatment with a Herbst appliance (Group A: steel crowns; Group B: acrylic splints) and compared them with results of a follow-up group (Group C: control) for 12 months. Lateral radiographs were obtained in the beginning of the treatment (T1) and at the end of the observation period (T2). Cephalometric variables were analyzed using parametric tests. The results of the two treatment groups were different from those found for the control group. Maxillary growth was restricted, whereas mandibular growth was greater, which resulted in a better sagittal relation. At the same time, the analysis of dentoalveolar aspects revealed that overjet was reduced due to distal tipping of maxillary incisors and buccal inclination of mandibular incisors, vertical control of maxillary molars and mesial movement of mandibular molars. The three groups had similar extrusion of mandibular molars, preservation of mandibular morphology and facial pattern. The occlusal plane rotated clockwise in the treated groups and counterclockwise in the control group. It can be concluded that the treatment of class II malocclusion in adolescents during growth spurt with two types of Herbst appliance resulted in a set of changes that improved sagittal skeletal and dental relations, regardless of growth. Vertically, facial pattern was preserved in treatment and control groups, despite some small differences.

La neuroinflammation est un dénominateur commun de plusieurs troubles du système nerveux central. Les réactions inflammatoires sont souvent médiées par plusieurs voies de signalisation qui conduisent à l'ouverture de la barrière hémato-encéphalique. L'activateur tissulaire du plasminogène (tPA) est une serine protéase qui induit l'ouverture de la barrière hémato-encéphalique. Au cours des dernières années, il a également été montré que les récepteurs NMDA situés dans les cellules endothéliales peuvent jouer un rôle crucial dans la propagation de la réaction inflammatoire.Mon travail au cours de ma thèse a mis l'accent sur la découverte des mécanismes par lesquels le récepteur NMDA effectue une médiation de l'ouverture de la barrière hémato-encéphalique induite par le TPA. Dans notre première étude, nous montrons que les récepteurs NMDA endothéliaux sont des cibles thérapeutiques potentielles pour prévenir l'infiltration et l'inflammation des cellules immunitaires médiées par l'EAE. Nous montrons que l'anticorps monoclonal du récepteur NMDA spécifique à la souris, le Glunomab, pourrait protéger la barrière de la moelle épinière de dommages inflammatoires. Nous montrons également que les récepteurs NMDA sont exprimés en étroite association avec les protéines de jonction serrées dans les cellules endothéliales cérébrales. Dans notre deuxième étude, nous montrons pour la première fois que les récepteurs NMDA neuroendothéliaux peuvent présenter une action métabotropique lors de l'inflammation. Nous soulignons également que ces récepteurs sont en effet des récepteurs NMDA non conventionnels exprimant la sous unité GluN3A. En outre, nous rapportons que le tPA accélère l'ouverture de la barrière hémato-encéphalique en présence d'une agoniste rare de la glycine par un mécanisme dépendant de l'activation de RhoA. Les résultats de mon projet apportent une nouvelle vision du rôle des récepteurs NMDA métabotropiques dans les cellules endothéliales cérébrales. En outre, il fournit également des détails plus précis sur l'ouverture de la barrière hémato-encéphalique via l’activateur tissulaire du plasminogène. / Neuroinflammation is a common denominator of several central nervous system disorders. Inflammatory reactions are often mediated by several signaling pathways which lead to the opening of the blood brain barrier. Tissue plasminogen activator (tPA) is a serine protease induces opening of the blood brain barrier. In recent years, it has also been shown that NMDA receptors located in endothelial cells can play a crucial role in propagation of inflammatory reaction. My doctoral study focused on the finding the underlying mechanisms of action(s) by which NMDA receptor mediates tPA induced opening of the blood brain barrier. In our first study we show that endothelial NMDA receptors are potential therapeutic targets to prevent EAE mediated immune cell infiltration and inflammation. We show that NMDA receptor specific mouse monoclonal antibody Glunomab could prevent the brain spinal cord barrier from inflammatory damage. We also show that NMDA receptors are expressed in close association of tight junction proteins in cerebral endothelial cells. In our second study, we show for the first time that, neuroendothelial NMDA receptors can exhibit metabotropic mode of action during inflammation. We also highlight that these receptors are indeed GluN3A expressing non-conventional NMDA receptors. In addition, we report that tPA accelerates the opening of blood brain barrier in presence of an uncommon agonist glycine by RhoA activation dependent mechanism.My project results provide a nouvelle insight for the role of metabotropic NMDA receptors in cerebral endothelial cells. In addition it also provides more precise details of blood brain barrier opening mediated by tissue plasminogen activator.

L’activateur tissulaire du plasminogène (tPA) est une protéase initialement découverte dans le sang pour son rôle fibrinolytique. C’est pour cette fonction que le tPA recombinant est utilisé pour traiter la phase aigüe de l’accident vasculaire cérébral (AVC) ischémique, même s’il présente quelques limites. Le tPA exogène peut passer du compartiment vasculaire au parenchyme cérébral où il peut influencer des processus physiologiques, et participer au devenir neuronal, notamment aggraver la mort neuronale lors d’un AVC ischémique. Le laboratoire a montré que le tPA peut traverser la barrière-hémato-encéphalique (BHE), par transcytose au travers des cellules endothéliales de la BHE et cela sous le contrôle des récepteurs LRP1 (Low density lipoprotein receptor-related protein 1). D’autres barrières existent au sein du système nerveux central notamment la barrière sang-liquide cérébrospinal (BSLCS), formée par les plexus choroïdes (PCs). Les PCs sont une route de migration pour les cellules inflammatoires et le LCS peut véhiculer des solutés, via les espaces péri-artériels, vers le parenchyme cérébral. Ainsi, dans notre première étude, nous avons testé l’hypothèse d’un passage du tPA vasculaire par les PCs. Pour cela, nous avons produit un tPA traçable in vivo et in vitro. Nous avons commencé par étudier la distribution du tPA suite à une injection intraveineuse (IV) avec comme focus les PCs et le LCS. Nos résultats montrent que le tPA exogène, suite à une injection IV, est retrouvé de manière séquentielle dans les PCs puis dans le LCS. Le tPA est donc capable de traverser les PCs. Nous avons alors développé un modèle de culture primaire de cellules épithéliales de PCs (CPECs) de souris pour disséquer le(s) mécanisme(s) sous-jacents à l’internalisation du tPA par les CPECs. Ce modèle nous a permis de montrer que l’internalisation du tPA par les CPECs est un phénomène actif, médié par un membre de la famille des récepteurs LRP, mais qui n’est ni LRP1, ni LRP2. Nous avons également mis en évidence la nécessité du domaine Finger du tPA pour son internalisation par les CPECs. Une étude préliminaire dans un modèle d’AVC suggère que l’ischémie modifie la cinétique de passage du tPA, puisqu’il y a plus de tPA dans les PCs des souris ischémiées que les souris non ischémiées.Dans une deuxième étude nous nous sommes intéressés à l’effet du tPA endogène sur les PCs. Nous montrons que l’absence de tPA endogène n’influence ni la morphologie des PCs, ni la diffusion du LCS. De plus, nous montrons que cette absence de tPA n’influence pas le nombre de macrophages et de lymphocytes T dans les PCs en conditions basales. / Tissue-type plasminogen activator (tPA) is a protease initially discovered in the blood for its fibrinolytic role. Accordingly, recombinant tPA has become the gold standard to treat the acute phase of ischemic stroke, despite some limitations. Exogenous tPA can switch from the vascular compartment to the brain parenchyma, where it can influence physiological processes, and participate in neuronal fate, including a worsening of neuronal death during ischemic stroke. In the team, it has been shown that tPA can cross the blood-brain barrier (BBB), by a transcytosis through BBB endothelial cells, under the control of LRP1 receptors (Low density lipoprotein receptor-related protein 1). The central nervous system has other barriers, including the blood-cerebrospinal fluid barrier (BCSFB), that relies on choroid plexuses (CPs). CPs are a migration route for inflammatory cells and a major source of CSF, which carries solutes to the cerebral parenchyma, via peri-arterial spaces. Thus, in a first study, we tested the hypothesis of a passage of vascular tPA through CPs. We thus produced a fluorescent tPA that can be tracked in vivo and in vitro. We first studied the distribution of tPA following intravenous (IV) injection, focusing on CPs and CSF. We show that after an IV injection, exogenous tPA is sequentially found in the CPs and then in the CSF. tPA is therefore able to cross the CPs. We then developed a model of primary culture of mouse choroid plexus epithelial cells (CPECs) to dissect the mechanism (s) underlying the internalization of tPA. This model allowed us to demonstrate that the internalization of tPA by CPECs is an active phenomenon, mediated by a member of the family of LRP receptors, but which is neither LRP1 nor LRP2. We also highlight the requirement for the Finger domain of tPA for its internalization by CPECs. A preliminary study in a murine stroke model suggests that ischemia alters the tPA passage kinetics, since there is more tPA in ischemic CPs than non-ischemic CPs.In a second study, we investigated the effect of endogenous tPA on CPs. We show that the absence of endogenous tPA influences neither CPs morphology nor CSF diffusion . Moreover we show that the absence of tPA does not influence the number of macrophages and T cells in the stroma of PCs under basal conditions.

Urokinase-type plasminogen activator (uPA) protein is a serine protease of the trypsin family that is overexpressed by tumors cells seeking to metastasize. Molecular imaging methods using molecular imaging probe designed to target uPA could provide a method for the detection of aggressive cancers and monitoring response to treatment. Four classes of high affinity uPA inhibitors, three which were reversible and one irreversible, were used as platforms to develop radiolabeled probes for uPA. Based on structure-activity relationships, lead compounds were modified to allow for the introduction of a radiohalogen (radioiodine) at different sites in the corresponding molecules. Suitable synthetic strategies were developed to create libraries of iodinated phenyl guanidine, peptide, naphtamidine and phosphonate derivatives. For the phenylguanidines colorimetric assays showed the product had micromolar affinity while for the peptide derivatives low nanomolar affinity for the iodinated analogue was observed (1.4 nM to 2.53 nM). Unfortunately quantitative biodistribution studies showed low tumour uptake (<0.5% ID/g). More promising results were obtained for the irreversible iodinated phosphonated derivative which had an affinity of 2.1 nM. This reagent showed 1.95% ID/g tumour uptake and lower blood uptake in vivo which demonstrates advantageous properties over existing uPA probes in terms of tumour-to-blood ratios. A complementary development was also achieved in that the first example of a 125I-labelled tetrazine was prepared. This new reagent can be used in pre-targeted strategies that utilize bioorthogonal coupling between stained trans-cyclooctene (TCO) and tetrazines. The product was prepared using a concomitant oxidation iodo-destannylation reaction and the product isolated in 80% radiochemical yield. The reaction with transcycloctene proceeded rapidly to produce various isomers which were fully characterized through NMR analysis of the non-radioactive analogues. / Thesis / Doctor of Philosophy (PhD)

Excerpt: The recent study by Sahlas et al1 in the Journal of Stroke and Cerebrovascular Diseases concluded that “the estimation of a patient's weight in the acute setting can lead to overcalculation of the tissue plasminogen activator dose, which is associated with poorer functional outcomes.” However, this conclusion is not well supported by their study1 because the most severe ischemic stroke cases were the ones that were most likely not weighed, and this severity could have led to the increased mortality that was found2 and the majority of unweighed patients were actually given an underdose that was associated with better discharge outcomes, as explained below.