Orientador: Dora Maria Grassi Kassisse / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-20T06:22:42Z (GMT). No. of bitstreams: 1 Ishizu_LarissaYuri_M.pdf: 1236160 bytes, checksum: d3b83c5f6882f0bbaa5b2be15aa753a0 (MD5) Previous issue date: 2012 / Resumo: Dados do Laboratório de Estudo do Estresse revelaram que a produção de lactato por adipócitos isolados de tecido adiposo visceral de humanos eutróficos e obesos mórbidos está sob estímulo de adrenoceptores ?1. Observou-se também hiperlactatemia no jejum de obesos mórbidos, aumento na liberação de lactato e na lipólise basal e estimulada em adipócitos viscerais isolados destes indivíduos, comparados com eutróficos. Porém dados de nosso laboratório e da literatura sugerem uma relação antagônica entre lipólise e lactatogênese, da qual participa o receptor GPR81, o qual está envolvido com lactato, inibindo a lipólise. Dados da literatura também sugerem a supressão da lipogênese e maior lipólise basal e estimulada dos adipócitos de obesos, com aumento da expressão da aquaporina 7, pelo qual o glicerol gerado na lipólise, é liberado. Por outro lado, estudos da literatura relatam a ocorrência da reesterificação dos produtos liberados após a lipólise de triacilgliceróis (TAGs) no tecido adiposo, na obesidade. Possivelmente, este seria o processo que promoveria a manutenção de grandes estoques de TAGs no tecido adiposo, apesar da maior lipólise e menor lipogênese. Frente aos nossos dados funcionais e os presentes na literatura sobre tecido adiposo visceral na obesidade, o objetivo deste estudo foi detectar alterações no metabolismo glicídico e lipídico neste tecido isolado de humanos obesos, em comparação com eutróficos, sob o enfoque da expressão gênica. Para tanto, quantificamos a expressão de genes envolvidos com a lactatogênese (lactato desidrogenase A, LDHA), lipogênese (acetil-CoA carboxilase, ACACA; glicerol quinase, GK; lipoproteína lipase, LPL) e lipólise (lipase hormônio sensível, LIPE; fosfodiesterase 3b, PDE3b; aquaporina 7, AQP7), e o gene relacionado com a inibição da lipólise via lactato (receptor-órfão acoplado à proteína G 81, GPR81) através do Real- Time PCR. Os resultados obtidos mostraram que o tecido adiposo de mulheres obesas expressa significativamente 49% a mais o gene LIPE e 66% a mais o gene LPL o de que mulheres eutróficas (p<0,05), enquanto que no tecido adiposo de homens não foi encontrada diferença significativa, apenas uma tendência a aumento do gene LPL nos obesos, comparados com eutróficos. Os adipócitos isolados do tecido adiposo visceral de homens obesos são morfometricamente maiores que os provenientes de eutróficos tendo como provável fator o aumento da expressão de LPL sem ser acompanhado de alterações na expressão de LIPE. Por outro lado, os adipócitos isolados do tecido adiposo visceral de mulheres obesas não apresentaram alterações morfométricas quando comparados aos adipócitos isolados de eutróficas, estes resultados são explicados pela análise da expressão dos genes LPL e LIPE do tecido adiposo desta região que se apresentou significativamente elevada em obesas. Desta forma, para este tecido estudado, existem alterações, dependente de gênero, que devem ser consideradas para estudos futuros sobre a obesidade. Neste trabalho, com as condições e a população estudada, referente a obesos e eutróficos de ambos os gêneros, podemos indicar as seguintes conclusões: a expressão de enzimas relacionadas à lipólise e a lipogênese em adipócitos isolados da região visceral de obesos é dependente do gênero enquanto que não há alterações significativas na expressão gênica relacionada à lactatogênese / Abstract: Previous data from the Laboratory of Stress Study showed that lactate production by adipocytes isolated from visceral adipose tissue of human normal and morbidly obese is under ?1-adrenoceptor stimulation. It was also observed hyperlactatemia in fasting from morbidly obese, an increase basal and stimulated lactate and glycerol production in visceral adipocytes isolated from these individuals, compared with normal weight. But data from our laboratory and the literature suggest an antagonistic relationship between lipolysis and lactatogênese, which participates in the GPR81 receptor, which is involved with lipolysis inhibition by lactate. Literature data also suggest the suppression of lipogenesis and increased basal and stimulated lipolysis in adipocytes of obese, with increased expression of aquaporin 7, whereby the glycerol generated in lipolysis, is released. Furthermore, published studies have reported the occurrence of re-esterification of the products released after lipolysis triacylglycerols (TAGs) in adipose tissue, in obesity. Possibly, this would be the process that would promote the maintenance of large stocks of TAGs in adipose tissue, despite the increased lipolysis and reduced lipogenesis. Front of our functional data and the literature on visceral adipose tissue in obesity, the aim of this study was to detect changes in glucose and lipid metabolism in this tissue isolated from obese humans, compared with normal weight, with a focus on gene expression. To this end, we quantified the expression of genes involved in lactatogênese (lactate dehydrogenase A LDHA), lipogenesis (acetyl- CoA carboxylase, ACACA, glycerol kinase, GK, lipoprotein lipase, LPL) and lipolysis (hormone sensitive lipase, LIPE; phosphodiesterase 3b , PDE3b; aquaporin 7 AQP7), and the gene related to the inhibition of lipolysis via lactate (orphan receptor-G protein coupled 81, GPR81) using Real-Time PCR. The results showed that adipose tissue isolated from obese women expressed significantly 49% more gene LIPE and 66% more LPL gene that women with normal weight (p <0.05), whereas in men no significant difference was found, only a tendency towards increased LPL gene in obese compared with normal weight. The isolated adipocytes visceral adipose tissue of obese men morphometrically are larger than those from normal weight bearing as the most probable cause increased expression of LPL without being accompanied by alterations in the expression of LIPE. Moreover, the isolated adipocytes visceral adipose tissue of obese women showed no morphological changes compared to normal weight of isolated adipocytes. These results are explained by analysis of gene expression of LPL and LIPE adipose tissue in this region which was significantly higher in obese women. Thus, there are changes, in this tissue studied, dependent on gender, which should be considered for future studies on obesity. In this work, the conditions and the population studied, referring to obese and normal for both genders, we can state the following conclusions: the expression of enzymes related to lipolysis and lipogenesis in adipocytes isolated from visceral fat of obese people is dependent on the gender while not there are significant changes in enzyme expression related to lactatogenesis / Mestrado / Fisiologia / Mestre em Biologia Funcional e Molecular

As células-tronco mesenquimais (MSCs) são células estromais não-hematopoiéticas que possuem capacidade de diferenciação, sendo capazes, de diferenciar em diversos tecidos. As MSCs residem em vários tecidos vêm sido isoladas de diferentes tecidos, tais como cartilagem, tendão, tecido adiposo, do vaso e sangue umbilical, além de tecidos fetais . O isolamento e caracterização das populações mesenquimais no modelo ovino se faz importante, visto que ele é usado em ensaios pré-clínicos ortopédicos . Nesse estudo foram utilizados 5 amostras de sangue de cordão umbilical e 5 amostras de tecido adiposo peri-renal, provenientes de 10 ovinos fêmeas adultas. As coletas foram realizadas através de cirurgia para que o material coletado fosse o mais asséptico possível. Essas amostras foram submetidas a diferentes protocolos de isolamento, com a finalidade de se testar o mais eficiente. Somente um protocolo de cada tecido mostrou-se eficiente no isolamento da MSCs, porém nenhuma dessas amostras manteve-se viável após a primeira passagem. / Mesenchymal stem cells (MSCs) are non hematopoietic stromal cells that are able to differentiate through several tissues . MCSs home in several tissues and are being isolated from different tissues, such cartilage, tendon, adipose tissue, vessels and umbilical blood, and also from fetal tissues . The isolation and characterization of mesenchymal cells in sheep are important, because it is used in orthopedic pre-clinical trials . In this study were used 5 samples of umbilical blood and 5 samples of perirenal adipose tissue from 10 female sheep. All the samples were obtained through surgery, to harvest aseptic samples. These samples were tested in different protocols to evaluate the more efficient. Just one protocol from each source showed significant results in isolation, although none of the samples survived trough the first passage.

L'obésité et le diabète sont associés à des complications cutanées, en particulier des fonctions dermiques impliquées dans le maintien de la résistance mécanique de la peau. Cependant, les mécanismes par lesquels l'obésité provoque la fragilité du tissu cutané sont peu étudiés. Notre travail consistait à évaluer les effets d'un régime hypercalorique sur la microcirculation cutanée et les conséquences sur le développement de lésions cutanées. Les études ont été réalisées chez des souris C57Bl6/J développant une obésité induite par une alimentation enrichie en graisse et en sucre pendant 2, 4, 12 et 20 semaines. Les propriétés de la microcirculation cutanée sont évaluées par les variations du flux sanguin en réponse : 1) à l'acétylcholine afin de déterminer la vasodilatation endothélium-dépendante, 2) au nitroprussiate de sodium afin de déterminer la vasodilatation endothélium-indépendante, 3) à l'application de la pression locale afin de déterminer la vasodilatation induite par la pression (PIV). Ces études sont complétées par des explorations métaboliques (IPGTT, IPITT), morphologiques, immuno-histologiques et biochimiques pour caractériser les quatre modèles. Enfin, chaque modèle a été testé pour l'incidence d'ulcère de pression par l'application d'une pression unique de 85 mmHg. Dans ce travail de thèse, nous avons mis en évidence de nombreux mécanismes de compensation accompagnant l'évolution de l'obésité et qui permettent de maintenir les fonctions vasculaires intactes et permettent de s'adapter à l'environnement inflammatoire induit par l'alimentation hypercalorique. La PIV est un outil de diagnostic nous permettant d'évaluer l'intégrité de la fonction neurovasculaire et prédire l'incidence de lésions cutanées / Obesity and diabetes are associated to skin pathophysiology, particularly the dermal functions involved in maintaining the skin’s mechanical strength. The underlying mechanisms in pressure ulcer during obesity remain unclear. In this study we evaluated the effects of a hypercaloric diet on the cutaneous microcirculation and its consequences on pressure sores. C59Bl6/J mice were fed a high fat and high sugar diet during 2, 4, 12 and 20 weeks. Microvascular properties were assessed by measuring the skin blood flow variations in response to 1) acetylcholine in order to determine the endothelium-dependent vasodilation, 2) sodium nitroprusside in order to determine the endothelium-independent vasodilation, 3) local pressure application in order to determine the pressure-induced vasodilation (PIV). Each model was characterized for metabolic assessment (IPGTT, IPITT), hisological, immune-histological and biochemical measurements. Finally, each model was tested for pressure ulcer incidence with a 85 mmHg pressure application on skin layers. In this study, we found that obesity is a pathology in constant evolution that is associated with many compensatory mechanisms for maintaining vascular functions and for the adaptation of the skin tissue to an inflammatory environment induced by a hypercaloric diet. PIV has become a useful tool for pressure ulcer prediction

Brown adipose tissue (BAT) is the main tissue involved in non-shivering heat production. A greater understanding of BAT could possibly lead to new ways of prevention and treatment of obesity and type 2 diabetes. The increasing prevalence of these conditions and the problems they cause society and individuals make the study of the subject important. An ongoing study performed at the Turku University Hospital uses images acquired using PET/MRI with 18F-FDG as the tracer. Scans are performed on sedentary and athlete subjects during normal room temperature and during cold stimulation. Sedentary subjects then undergo scanning during cold stimulation again after a six weeks long exercise training intervention. This degree project used images from this study. The objective of this degree project was to examine methods to automatically and objectively quantify parameters relevant for activation of BAT in combined PET/MRI data. A secondary goal was to create images showing glucose uptake changes in subjects from images taken at different times. Parameters were quantified in adipose tissue directly without registration (image matching), and for neck scans also after registration. Results for the first three subjects who have completed the study are presented. Larger registration errors were encountered near moving organs and in regions with less information. The creation of images showing changes in glucose uptake seem to be working well for the neck scans, and somewhat well for other sub-volumes. These images can be useful for identification of BAT. Examples of these images are shown in the report.

Les troubles métaboliques caractéristiques d’une alimentation de type « Western diet », sont à l’origine de pathologies cardiovasculaires, première cause de mortalité dans le monde. Il apparait nécessaire d’améliorer la compréhension des mécanismes impliqués dans l’installation des dysfonctions cardiovasculaires afin de pouvoir proposer des stratégies thérapeutiques ou préventives adaptées. Ainsi, le premier objectif de la thèse a été d’évaluer les effets d’une boisson sucrée sur la fonction vasculaire macro- et micro-circulatoire chez des sujets sains, par une approche translationnelle allant de la clinique humaine à un modèle expérimental de rongeur. Nos résultats montrent une altération de la fonction endothéliale en réponse à une prise de boisson sucrée, dans l’ensemble des lits vasculaires. L’exploration des mécanismes sous-jacents ces altérations nous a permis d’identifier l’implication du couple stress-oxydant/voie du NO. Un second objectif de thèse, a été d’étudier l’impact d’un stress métabolique chronique sur la fonction vasculaire et son incidence sur la régulation de la pression artérielle. Comme observé chez certains sujets souffrant de syndrome métabolique, notre modèle de rat ne présentait pas d’hypertension artérielle, malgré une hyperactivité du système sympathique. Ceci semble être expliqué par une compensation endothéliale eNOS-dépendant, qui permet de garantir le maintien d’une pression artérielle normale en dépit de l’effet vasopresseur adrénergique élevé. Le troisième objectif de thèse a porté sur un nouvel élément participant au maintien de l’homéostasie vasculaire et impacté par les situations pathologiques : le tissu adipeux périvasculaire (PVAT). Nos travaux démontrent dans le contexte du SMet, une altération de la voie adiponectine/eNOS dans le PVAT, en parallèle d’une augmentation de la production d’espèces oxygénées réactives.La pratique régulière d’un exercice physique est aujourd’hui reconnue comme une stratégie non-pharmacologique permettant d’impacter à la fois les désordres métaboliques et cardiovasculaires, notamment via une amélioration de la voie du NO. Nos résultats démontrent une limitation de l’apparition des dysfonctions endothéliales causée par une hyperglycémie aigue lorsqu’un protocole d’exercice physique chronique est réalisé. Enfin, l’exercice physique permet également de prévenir les modifications des propriétés vaso-actives du PVAT dans un modèle de rat SMet. Ce phénomène pourrait être expliqué par une amélioration du statut oxydant de la paroi artérielle, et à une potentialisation de la voie adiponectine/eNOS par l’exercice physique / The globalization of the western diet has mediated prevalence in cardiovascular disease related mortality, the single leading cause of death worldwide. Considering this, it is imperative that the underlying mechanisms of cardiovascular dysfunctions are continually investigated to establish a greater understanding of its pathogenesis from a healthy state to the presence of cardiometabolic diseases; and to improve upon current treatment and preventative strategies. Therefore, the first aim of this research was to identify vascular impact of acute hyperglycaemic stress induced by sweet sugar beverage consumption, with a translational approach. The results of this study demonstrated that consumption of a single commercially available sugar-sweetened beverage (SSB) induced transient micro- and macrovascular endothelial dysfunction, even in a healthy population. Further exploration into the underlying mechanisms of SSB-mediated endothelial dysfunction indicated that an increase in oxidative stress disrupts normal function of the nitric oxide pathway. Although disturbances in cardiovascular function may initially be transient, repetitive acute metabolic stress may translate to chronic cardiometabolic disease. Therefore, the second aim of this research was to assess the impact of a chronic metabolic disorder, metabolic syndrome (MetS), on vascular function in a rat model. Despite increasing sympathetic activity, the MetS rats didn’t present elevated arterial pressure. Such findings may be explained by a compensatory adaptation of endothelial function that increases production of nitric oxide in response to α-adrenergic agonist and, thus, regulates arterial pressure despite sympathetic hyperactivity. Considering this, the third aim of this research evaluated the impact of perivascular adipose tissue (PVAT) on vascular fucntion in MetS rats; demonstrating that MetS altered the adiponectin-endothelial nitric oxide synthase pathway in PVAT, in an oxidative stress-dependant manner.Exercise training is well recognized as a non-pharmacological strategy that has a beneficial impact on both metabolic and cardiovascular disorders via an improvement in function of the nitric oxide pathway. Considering this, research also assessed the efficacy of this approach to prevent vascular injury induced by acute hyperglycaemia in a healthy population and by PVAT in those with MetS. It was demonstrated that exercise attenuated acute hyperglycemia-mediated endothelial dysfunction; and restored endothelium-dependent vascular reactivity in rats with MetS, due to an improvement in the biocommunication between PVAT and arterial tissue and a notable enhancement of the adiponectine-endothelial nitric oxide synthase pathway.

LYL1 (Lymphoblastic leukemia-derived sequence 1) est un facteur de transcription basic hélice-boucle-hélice (bHLH) exprimé dans les lymphocytes B, les cellules myéloïdes et les cellules endothéliales (CE). Les souris déficientes pour Lyl1 (Lyl1-/-) sont viables et chez la souris adulte, LYL1 a un rôle majeur dans la maturation des vaisseaux sanguins nouvellement formés et dans le contrôle de la perméabilité vasculaire basale, suggérant l'importance de LYL1 dans le maintien de la quiescence et/ou stabilisation des CE. Les vaisseaux sanguins représentent une barrière entre le sang et le tissu conjonctif. Ils peuvent également jouer le rôle de niche vasculaire contenant des progéniteurs des différentes cellules murines (par exemple, des cellules hématopoïétiques, des cellules β-pancréatiques, des cellules neuronales, des cellules hépatiques et des cellules adipeuses). Les deux tissus adipeux, blancs et bruns (WAT et BAT), sont très vascularisés. Jusqu'à présent, rien n'était connu sur le rôle de LYL1 dans le tissu adipeux. Les résultats présentés dans cette thèse montrent que l'augmentation significative du poids corporel des mâles Lyl1-/- par rapport aux souris sauvages (WT), sous régime normal, n'est pas associée à des troubles métaboliques. Ils présentent également un poids plus élevé de tissus adipeux (WAT et BAT) et de plus grandes gouttelettes lipidiques. In vivo, la perte de Lyl1 accélère le processus de différenciation des cellules souches adipeuses (CSA), puisque les adipocytes blancs et bruns sont matures et actifs plus tôt. De plus, les CSA sont moins nombreuses dans les tissus adipeux, ce qui confirme que la perte de Lyl1 favorise la différenciation des CSA vers adipocytes matures. Nous avons également démontré que Lyl1 est exprimée dans les CSA et les pré-adipocytes, suggérant un rôle direct dans LYL1 dans la différenciation adipocytaire. D'autre part, les vaisseaux des WAT des souris Lyl1-/- sont mal recouverts de cellules murales et plus perméables, suggérant que la niche vasculaire des tissus adipeux pourrait être perturbée. Sous alimentation riche en graisses (HFD), le poids corporel et le poids du tissu adipeux sont plus faibles chez les souris Lyl1-/- par rapport à WT. De plus les souris Lyl1-/- présentent de plus petites gouttelettes lipidiques que les WT, sous HFD. Ces résultats préliminaires, suggèrent que les souris Lyl1-/- pourraient être protégées contre l'obésité induite par l'alimentation. Cependant d'autres expériences sont nécessaires pour valider ces résultats. Il existe probablement un mécanisme de compensation qui se met en place chez les souris Lyl1-/- sous HFD. Ce travail a démontré que, sans Lyl1, la différenciation adipocytaire est accélérée et que la niche vasculaire adipocytaire est perturbée. / LYL1 (Lymphoblastic leukemia-derived sequence 1) is a basic helix-loop-helix (bHLH) transcriptional factor, which is expressed in B lymphocytes, myeloid cells and endothelial cells (EC). Lyl1 deficient (Lyl1-/-) mice are viable and in adult mice, LYL1 has an active role in the maturation of newly formed blood vessels and is also involved in the control of basal vascular permeability, suggesting that LYL1 is required for the maintenance of EC quiescence and stabilization. Blood vessels provide a barrier between connective tissue and blood. They also have been described as “vascular niche” containing progenitors of different murine cells (e.g. hematopoietic cells, pancreatic β-cells, neuronal cells, liver cells and adipose cells). Both white and brown adipose tissues (WAT and BAT) are highly vascularized. Up to now, nothing was known concerning the role of LYL1 in adipose tissue. The results presented in this thesis revealed that the significant increase in body weight of Lyl1-/- males compared to their wild type (WT) littermates under chow diet is not due to any metabolic disorders. They also showed higher adipose tissue weights (BAT and WAT) and bigger lipid droplets. In vivo Lyl1 deficiency cause early differentiation process of adipose stem cells (ASCs) since both white and brown adipocytes are mature and active faster. In addition, ASCs are less numerous in Lyl1-/- adipose tissues, which confirm that Lyl1 deficiency favors the differentiation of ASCs towards mature adipocytes. We also demonstrated that Lyl1 is expressed both in ASCs and pre-adipocytes, suggesting a direct role of LYL1 in adipocyte differentiation. On the other hand, the vessels in Lyl1-/- WAT are poorly covered with mural cells and more permeable, proposing that adipose stem cell vascular niche could be disturbed. Under high fat diet (HFD), total body weight and adipose tissue weight are lower in Lyl1-/- mice compared to WT. Moreover smaller lipid droplets were observed in Lyl1-/- mice under HFD. These preliminary results suggest that Lyl1-/- mice could be protected from diet-induced obesity. However more experiments are needed to validate these results. Probably there is a compensatory type of mechanism going on under HFD in Lyl1-/- mice. This work demonstrated that under Lyl1 deficiency adipocyte differentiation process becomes faster and adipose tissue vascular niche could be disturbed.

Résumé: Comparées aux classiques insulines humaines régulières (IHR), les insulines analogues ultrarapides (IAUR) ont été conçues pour mieux synchroniser le pic insulinémique avec l’absorption du repas. Le progrès a été démontré chez les patients diabétiques de type 1, mais le contrôle glycémique s’est peu ou pas amélioré chez les patients diabétiques de type 2 (DT2), qu’ils soient sous IAUR ou IHR. Or ces patients constituent 75 % des utilisateurs d’insuline. L’utilité des IAUR est donc toujours débattue. La dose (donc le volume) injectée et le flot sanguin dans le tissu adipeux sous-cutané (FSTA) sont les facteurs majeurs de l’absorption de l’insuline. Les patients DT2, résistants à l’insuline, s’injectent des doses importantes et leur FSTA est de 50 à 70 % plus faible que celui des sujets sains de poids normal (PN). Nous avons montré que l’absorption sous-cutanée des IAUR est diminuée chez les sujets obèses et DT2 (ODT2) par rapport aux sujets PN, que le volume injecté avait un effet délétère additionnel et que le FSTA peut être augmenté de façon pharmacologique avec un agent vasoactif (AV) chez des sujets résistants à l’insuline. Nous suggérons que l’ajout d’un AV à une IAUR va augmenter le FSTA au site d’injection et donc améliorer sa pharmacocinétique (PK) et sa pharmacodynamie (PD). Pour vérifier cette hypothèse, nous avons 1) évalué la réponse du FSTA à 4 AV chez des sujets PN, obèses non-diabétiques et ODT2; 2) évalué la PK/PD et la biodisponibilité de l’IAUR lispro ± AV chez des sujets ODT2; et 3) caractérisé l’expression des cibles des AV dans le tissu adipeux sous-cutané chez les sujets énumérés en 1). Les 4 AV ont augmenté le FSTA des sujets ODT2, mais moins que celui des autres sujets. L’occurrence de la raréfaction et/ou dysfonction microvasculaire chez les sujets ODT2 pourrait expliquer l’hyporéactivité vasculaire aux AV testés. Le plus actif des AV chez les sujets ODT2 a été ajouté à l’IAUR lispro pour améliorer sont absorption sc. Les PK/PD ont été améliorées seulement chez les sujets ODT2 avec une hémoglobine glycosylée A1c ≥ 8 %; c’est-à-dire 4 sujets sur 8. Chez ces derniers, l’absorption de 30 U + AV a été plus rapide de 14 et 71 min à 20 et 80 % de l’aire sous la courbe totale de la lispro plasmatique, respectivement. Chez les 4 autres sujets ODT2, l’absorption de la lispro semble s’être détériorée avec l’AV. Une interaction chimique a peut-être eu lieu entre l’AV et la lispro, ce qui aurait perturbé son absorption. Selon nos résultats, le niveau de contrôle du diabète, le volume d’injection et les caractéristiques chimiques de l’AV seraient des modulateurs de l’efficacité du concept IAUR + AV. Il nous faut maintenant déterminer l’impact de ces facteurs sur la capacité d’un AV à améliorer l’absorption sc de l’IAUR chez les sujets ODT2. / Abstract: Compared to classic regular human insulin (RHI), short-acting insulin analogues were designed to better synchronize plasma insulin increase to food absorption. Although improvements were noted in subjects with type 1 diabetes, slight to no improvement in glycemic control were observed in subjects with type 2 diabetes (T2D) using SAIA instead of RHI. Nevertheless, they represent 75 % of all insulin users. Consequently, the relative useful-ness of SAIA in T2D patients is currently hotly debated. Injected volume and subcutaneous (sc) adipose tissue blood flow (ATBF) are two main factors involved in insulin absorption. In fact, T2D patients use large doses of insulin because of their resistance to insulin and have an ATBF 50 to 70 % lower than lean healthy subjects. We already showed that SAIA absorption is decreased in obese T2D (OT2D) subjects compared to normal weight healthy subjects and that volume has additional detrimental effects. We also showed that ATBF can be increased pharmacologically with vasoactive agents (VA) in healthy and insulin-resistant subjects. Then we suggest that in OT2D subjects, addition of VA to SAIA preparations will locally increase ATBF, improve insulin sc absorption (Pharmacokinetic - PK) and bioavailability, thus insulin hypoglycemic effect (Pharmacodynamic - PD). To test this hypothesis, we 1) assessed ATBF response of 4 selected VA within three experimental groups (normal weight, obese non-diabetic and OT2D subjects); 2) evaluated insulin PK/PD and bioavailability improvement in OT2D subjects after the addition of the best VA to SAIA lispro and 3) characterized expression of selected VA targets in sc adipose tissue biopsies, within equivalent experimental groups, and compared results with ATBF responses. All 4 VA were able to increase ATBF of OT2D subjects but in a less extend than other subjects. The occurrence of microvascular rarefaction and/or dysfunction in OT2D subjects can explain the hyporeactivity to tested VA. Nevertheless, one VA among others was shown more effective to increase ATBF in OT2D subjects and was then tested (mixed) with SAIA lispro. With the AV, PK/PD were improved only in OT2D subjects with A1c glycated hemoglobin ≥ 8 %; 4 subjects on 8. The sc absorption of 30 U + VA was faster by 14 and 71 min for respectively 20 and 80 % of the total area under the lispro plasmatic curve. But the sc absorption with VA appeared blunted with the other subjects. Maybe detrimental chemical interactions occurred between the VA and lispro, which could impede absorption. Our results suggest that diabetes control state, injection volume, and VA chemical characteristics influence the efficacy of our SAIA + VA concept. Further tests are needed to seize the impact of these factors on VA effectiveness in sc absorption improvement of SAIA in OT2D subjects.

Adipose tissue (AT) expansion and remodeling that maintains healthy function relies on stromal preadipocytes capable of differentiating into new adipocytes (adipogenesis). During chronic positive energy balance, a relative deficit in adipogenesis, from either a decrease in preadipocyte number or their capacity to differentiate, leads to excessive adipocyte hypertrophy and AT dysfunction. AT contains macrophages whose number and activation state is dynamically regulated with changes in AT mass. This study aims to investigate the effect of macrophage-secreted factors on preadipocyte survival. To assess the effect of macrophage-secreted factors on preadipocytes, murine 3T3-L1 preadipocytes or human primary preadipocytes were incubated with macrophage-conditioned medium (MacCM), prepared from either murine (J774A.1, RAW264.7, bone marrow-derived) or human (THP-1, monocyte-derived) macrophage models, respectively. MacCM inhibited preadipocyte apoptosis and activated pro-survival signaling in both preadipocyte models. Inhibition of PDGFR, Akt, or ERK1/2 reduced the pro-survival effect of MacCM in 3T3-L1 preadipocytes. Inhibition of reactive oxygen species (ROS) generation, or enhancement of ROS clearance, reduced MacCM-dependent 3T3-L1 preadipocyte survival. Whereas anti-inflammatory activated macrophages retained the ability to prevent preadipocyte apoptosis, pro-inflammatory activated macrophages did not. TNF-α immunoneutralization restored the survival activity of pro-inflammatory MacCM on 3T3-L1 preadipocytes. These studies reveal a novel pro-survival effect of MacCM on preadipocytes, and identify signaling molecules (PDGF, Akt, ERK1/2, and ROS) that underlie this action. Macrophage activation was found to regulate the pro-survival activity of MacCM. These in vitro cell culture studies are consistent with a model in which the extent of preadipocyte apoptosis in vivo may determine preadipocyte number and the ability of AT to expand while maintaining healthy function during chronic positive energy balance.

Le projet de cette thèse porte sur la graisse ectopique cardiaque et son lien avec les pathologies cardiovasculaires. Dans un premier travail, nous avons mis au point la technique de mesure du volume de graisse épicardique, et du contenu en triglycérides intramyocardique chez le patient obèse morbide en imagerie de résonance magnétique à 3T, et spectroscopie proton. Nous avons montré que les deux dépôts de graisse ectopique augmentent avec l’obésité, mais sans continuum avec la prise de poids. Alors que la graisse épicardique est liée aux paramètres de la tolérance glucidique, la graisse intramyocardique est liée à la fonction cardiaque. Dans un second travail, nous avons montré qu’une perte de poids induite par une chirurgie bariatrique induit une diminution significative de la graisse épicardique, sans modifier la graisse intramyocardique, suggérant une différence de flexibilité de ces graisses avec la perte de poids. Nous avons également exploré le lien entre graisse épicardique et athérosclérose. Sur une cohorte de volontaires sains, nous avons montré que l’accumulation de graisse épicardique était inversement corrélée à la vasoréactivité de la microcirculation coronaire, suggérant que la graisse épicardique pourrait influer de manière précoce la fonction endothéliale. Enfin, en utilisant une approche transcriptomique, nous avons montré une signature spécifique du TAE humain en fonction de sa localisation anatomique. Ces travaux ouvrent de nouvelles pistes dans la compréhension du développement de la graisse ectopique cardiaque. / Cardiac ectopic fat deposition and its link with cardiovascular pathophysiology was the aim of this PhD project. We first developed 3T cardiovascular magnetic resonance imaging assessment of epicardial fat volume, and proton spectroscopy measurement of myocardial triglyceride content in a cohort of morbid obese subjects. We demonstrated that the two cardiac depots increased with obesity, but not continuously with gain weight. While epicardial fat was related to glucose tolerance parameters, myocardial fat was related to cardiac function. We then studied the effect of bariatric surgery induced weight loss on epicardial and myocardial fat, and found a significant decrease in epicardial fat, but no change in myocardial fat, highlighting differences in the dynamics and flexibility of these two fat pads with weight loss. Focusing on epicardial fat and its potential role in atherosclerosis, we evaluated the effect of epicardial fat volume on endothelium dependent vasoreactivity of the coronary microcirculation, in highly selected healthy volunteers. We found that a high epicardial fat amount was associated with a lower coronary microvascular response, suggesting that epicardial fat could early influence endothelial function. Finally, we identified a specific signature of three anatomically distinct human epicardial adipose tissues, using a transcriptomic approach. All together, our data bring new insights in the comprehension of specific partitioning of cardiac ectopic lipid deposition.

Camundongos Swiss, quando submetidos à dieta hiperlipídica (HL), apresentam considerável ganho ponderal e de depósitos adiposos, tornando-se obesos e resistentes à insulina. O objetivo deste trabalho foi avaliar o efeito da dieta HL por 8 semanas no perfil inflamatório, síntese de triacilglicerol (TAG) com ênfase na vias de geração de glicerol-3-fosfato (G3P) e lipólise nos tecidos adiposos brancos (TAB) retroperitoneal (RETRO) e epididimal (EPI) de camundongos. Camundongos Swiss foram alimentados com as dietas: controle (CT) - dieta purificada (AIN-93G); ou HL - dieta AIN-93G modificada contendo 35% de lipídeos (4% de óleo de soja e 31% de gordura suína). Os camundongos alimentados com a dieta HL apresentaram uma maior massa corporal, acompanhada pelo aumento nos tecidos RETRO e EPI, além de desenvolverem resistência à insulina constatada no teste de tolerância à glicose (TTG), hiperglicemia e hiperinsulinemia. O conteúdo protéico da pAKT, avaliado por western blot (WB), e a adiponectina, dosada em homogenados dos tecidos adiposos, estão reduzidos apenas no EPI. Houve aumento na expressão gênica de MCP-1 e PAI-1, e foi observada menor área dos adipócitos no EPI, sem alteração no RETRO dos animais HL. A síntese de novo de ácidos graxos (AG), avaliada pela incorporação de 3H de 3H2O em AG foi maior em ambos os TAB, porém a captação de AG das lipoproteínas circulantes avaliada pela atividade e expressão da lipase lipoproteica (LPL) aumentou no EPI e reduziu no RETRO. A dieta HL induziu aumento na fosforilação do glicerol, avaliada pela atividade e conteúdo da GK que aumentaram nos dois TAB, e maior incorporação de 1-14C-glicerol em TAG no EPI. A captação de glicose in vitro e conteúdo do GLUT- 4, que indicam atividade da via glicolítica foram reduzidos no EPI e RETRO, assim como a gliceroneogênese avaliada pela incorporação de 1-14C-piruvato em TAG, sem alterações na atividade e conteúdo da fosfoenolpiruvato carboxiquinase (PEPCK). A atividade lipolítica basal foi avaliada in vitro pela liberação de glicerol por adipócitos isolados, e não foi alterada pela ingestão de dieta HL, porém quando estimulada por noradrenalina a liberação de glicerol foi menor nos animais HL, assim como as fosforilações da ATGL e HSL e conteúdo do receptor adrenérgico ?3. A dieta HL levou a uma redução no conteúdo de PPAR? e aumento de ATF3 em ambos os tecidos. No EPI houve aumento de pCREB, pSTAT3 e RGS2 em relação aos controles enquanto no RETRO a única diferença encontrada foi a menor pSTAT3. Nossos resultados demonstram que o aumento nos TAB é resultado de maior síntese e captação de AG, e que o G3P necessário para a esterificação a TAG é proveniente principalmente da fosforilação direta do glicerol pela GK; além disso, a reduzida lipólise também parece contribuir para esse quadro. Nos animais HL, o EPI parece ser mais propenso aos efeitos da dieta do que o RETRO / Swiss mice when subjected to high fat diet (HFD), shown considerable weight gain and adipose depots, becoming obese and insulin resistant. The aim of this study was to evaluate the effect of HFD diet for 8 weeks in the inflammatory profile, triacylglycerol (TAG) synthesis with emphasis in glycerol-3-phosphate (G3P) generation pathways and lipolysis in retroperitoneal (RETRO) and epididymal (EPI) white adipose tissue (WAT) of mice. Swiss mice were fed with diets: control (CT) - purified diet (AIN-93G); or HFD - purified diet (AIN-93G) plus 35% of fat (4% soybean oil and 31% of lard). Mice fed a HFD diet had a higher body mass, accompanied by an increase in RETRO and EPI tissues, in addition to developing insulin resistance, evidenced by glucose tolerance test (GTT), hyperglycemia and hyperinsulinemia. The protein content of pAKT, accessed by western blot, and adiponectin, measured in WAT homogenates, are reduced only in EPI. There was an increase in gene expression of MCP-1 and PAI-1, and was observed smaller area of adipocytes in EPI, with no change in RETRO of HFD fed animals. De novo synthesis of fatty acids (FA), evaluated by incorporation of 3H from 3H2O in FA was higher in both TAB, but the uptake of FA, from blood lipoproteins, evaluated by the activity and expression of lipoprotein lipase (LPL) was increased in EPI and reduced in RETRO. HFD induced increase in phosphorylation of glycerol, evaluated by the activity and content of glycerolkinase (GyK) which increased in both TAB and greater incorporation of 1-14C-glycerol in the TAG only in EPI. The in vitro glucose uptake and GLUT-4 content, which indicates the activity of the glycolytic pathway were reduced in EPI and RETRO, as well as glyceroneogenesis assessed by the incorporation of 1-14C- pyruvate into TAG without changes in the activity and contents of phosphoenolpyruvate carboxykinase (PEPCK). The basal lipolytic activity was evaluated in vitro by glycerol releasing from isolated adipocytes, and was not altered by HFD intake, but when stimulated by noradrenaline glycerol release was lower in HFD animals as well as the phosphorylation of ATGL and HSL and ?3 adrenergic receptor content. HFD led to a reduction in the content of PPAR gamma and an increase in ATF3 in both tissues. In EPI there was an increase in pCREB, pSTAT3 and RGS2 while in RETRO the only difference was reduced pSTAT3. Our results shown that TAB increase is result of increased FA synthesis and uptake, and G3P required for esterification TAG comes mainly from direct phosphorylation of glycerol by GyK; Furthermore, reduced lipolysis also seems to contribute to this scenario. HFD effects seem to be more prominent in EPI than in RETRO