Aggregations of fused in sarcoma (FUS), a multifunctional RNA processing protein, define a pathological subtype of both frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS), whilst mutations in the FUS gene are causative for ALS. To model the impact of FUS mutations, expression vectors containing the entire genomic sequence of FUS, up and downstream regions, and native promoter sequences have been generated. The constructs have been tagged with an mCherry fluorescent tag, and three separate pathological mutations (R244C, R521C, and P525L) have been separately inserted. Transgenic mice have been generated using the WT and P525L FUS vectors to provide a highly physiological model of FUS in disease. Within transfected HEK293 cells, insertion of the P525L and R521C FUS mutations leads to relocalisation of FUS from the nucleus to the cytoplasm. R521C and P525L mutant FUS incorporates into cytoplasmic aggregations of untranslated mRNA and RNA binding proteins known as stress granules. The strong relocalisation seen with P525L-FUS is associated with a gain of cytotoxicity. Reversal of this cytoplasmic relocalisation by demethylation of FUS rescues this cytotoxicity, suggesting a toxic gain of cytoplasmic function in the majority of FUS mutations. By contrast, insertion of the R244C mutation leads to neither relocalisation, stress granule association, nor cytotoxicity. Notably the R244C mutation, located away from the nuclear localization domain in which the majority of FUS mutations are found, leads to the presence of smaller FUS fragments in western blot analyses. These fragments appear not to be due to splicing defects in FUS but rather are due to post-translational modifications or aberrant protein cleavage. These data suggest an alternative pathway for FUS toxicity based upon a nuclear loss of function.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterised clinically by rapidly progressive paralysis leading ultimately to death from respiratory failure. There is no cure for ALS and no definitive explanation for the onset and rapid progression of motor neuron degeneration. Genetics is a known risk factor for a portion of familial cases. However, the role of genetics in the commoner sporadic form of the disease is poorly understood, although numerous genes have been implicated. The primary aim of this thesis project is to uncover the genetic causes that underlie ALS. To accomplish this goal, the main focus of this thesis is to perform genome-wide association analysis of sporadic ALS using high density SNP arrays. This thesis describes the first and the largest genome-wide association studies of ALS to date. Results demonstrate that there is no single large effect susceptibility variant underlying a large proportion of ALS, such as ApoE in Alzheimer’s disease. However, the genotyping data has been made publically available and the digital nature of this data means that it is a resource that can grow with future studies. Beyond genome-wide association, this thesis describes work using linkage, haplotype and sequence analysis to investigate the genetic overlap between ALS and frontotemporal dementia. Lastly, this thesis presents a novel method for linkage analysis using high throughput SNP arrays. Ultimately, it is hoped that by uncovering the genes that cause ALS, such knowledge will shed light on the pathogenic mechanisms underlying motor neuron degeneration and potentially lead to new rational therapies effective in slowing or even halting disease progression.

TDP-43 est une protéine multifonctionnelle possédant des rôles dans la transcription, l'épissage des pré-ARNm, la stabilité et le transport des ARNm. TDP-43 interagit avec d'autres hnRNP, incluant hnRNP A2, via son extrémité C-terminale. Plusieurs membres de la famille des hnRNP étant impliqués dans la réponse au stress cellulaire, alors nous avons émis l’hypothèse que TDP-43 pouvait y participer aussi. Nos résultats démontrent que TDP-43 et hnRNP A2 sont localisés au niveau des granules de stress, à la suite d’un stress oxydatif, d’un choc thermique, et lors de l’exposition à la thapsigargine. TDP-43 contribue à la fois à l'assemblage et au maintien des granules de stress en réponse au stress oxydatif. TDP-43 régule aussi de façon différentielle les composants clés des granules de stress, notamment TIA-1 et G3BP. L'agrégation contrôlée de TIA-1 est perturbée en l'absence de TDP-43. En outre, TDP-43 régule le niveau d`ARNm de G3BP, un facteur de granule de stress de nucléation. La mutation associée à la sclérose latérale amyotrophique, TDP-43R361S, compromet la formation de granules de stress. Ainsi, la fonction cellulaire de TDP-43 s'étend au-delà de l’épissage; TDP-43 est aussi un composant de la réponse cellulaire au stress central et un acteur actif dans le stockage des ARNs. / TDP-43 is a multifunctional protein with roles in transcription, pre-mRNA splicing, mRNA stability and transport. TDP-43 interacts with other hnRNPs, including hnRNP A2, via its C-terminus and several hnRNP family members are involved in the cellular stress response. This relationship led us to investigate the role of TDP-43 in cellular stress. Our results demonstrate that TDP-43 and hnRNP A2 are localized to stress granules, following oxidative stress, heat shock, and exposure to thapsigargin. TDP-43 contributes to both the assembly and maintenance of stress granules in response to oxidative stress and differentially regulates key stress granules components including TIA-1 and G3BP. The controlled aggregation of TIA-1 is disrupted in the absence of TDP-43. In addition, TDP-43 regulates G3BP mRNA levels, a stress granule nucleating factor. A mutation associated with amyotrophic lateral sclerosis, TDP-43R361S, compromises stress granule formation. Thus, the cellular function of TDP-43 extends beyond splicing and places TDP-43 as a participant of the central cellular response to stress and an active player in RNA storage.

La sclérose latérale amyotrophique (SLA) est une maladie neurodégénérative due à une dégénérescence des motoneurones. Plus de 40 mutations du gène TARDBP ont été identifiées chez des patients SLA. Les défauts biochimiques de ces mutations étant encore inconnus, les modèles animaux sont présentement la seule mesure possible d’un phénotype. Pour étudier les conséquences physiopathologiques d’une de ces mutations, nous avons développé deux lignées transgéniques de poisson zébré, exprimant le gène humain TARDBP soit de type sauvage, soit avec la mutation G348C liée à la SLA, sous le contrôle d’un promoteur de choc thermique. Ces lignées ont été étudiées sur trois générations, après avoir établi un protocole de choc thermique induisant une expression ubiquitaire du transgène. Les embryons transgéniques de la génération F2 de la lignée exprimant la mutation développent un phénotype moteur suite à un choc thermique de 38.5°C pendant 30 minutes lorsque les embryons sont à 18 heures post-fertilisation. 60% des embryons ont une réponse anormale au toucher. De plus, une réduction de 28% de la longueur de pré-branchement des axones des motoneurones est observée. Ces résultats indiquent que notre lignée exprimant la protéine mutante TDP-43 est un modèle génétique de la SLA prometteur, qui ouvre des perspectives pour la compréhension de la physiopathologie de la maladie et la découverte de molécules thérapeutiques. / Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease due to motoneurons degeneration. More than 40 mutations of the gene TARDBP, coding for the protein TDP-43 have been found in ALS patients. As the biochemical defects of these mutations are not known, in vivo models are currently the only windows onto the pathology. To study the pathophysiological consequences of one of these mutations, we have generated two stable zebrafish transgenic lines, expressing the human gene TARDBP, either the wild-type version, or the G348C mutated version linked to ALS, under the control of a heat shock promotor. These lines were studied for three generation, after establishing a heat shock protocol sufficient to induce a ubiquitous expression of the transgene. The transgenic embryos of the F2 generation of the line expressing the mutant protein develop a motor phenotype after a 38.5°C heat shock for 30 minutes when the embryos are 18 hours post-fertilization. 60% of these embryos have an abnormal touch escaped evoked response, and a 28% reduction of the pre-branching axonal length of the motoneurons axons. These results indicate that our line expressing the mutant TDP-43 protein is a promising genetic model of ALS, opening perspectives for the pathophysiological understanding of the disease, and the discovery of new therapeutics.

La sclérose latérale amyotrophique est une maladie neurodégénérative fatale caractérisée par la dégénérescence progressive des neurones moteurs centraux et périphériques. L’un des premiers signes de la maladie est la dénervation de la jonction neuromusculaire (JNM). Les diverses unités motrices (UM) ne présentent toutefois pas la même vulnérabilité à la dénervation dans la SLA: les UM rapide fatigables sont en fait les plus vulnérables et les UM lentes sont les plus résistantes. Alors que des études précédentes ont démontré dans plusieurs modèles animaux de la SLA de nombreuses variations synaptiques, les découvertes ont été contradictoires. Par ailleurs, le type d’UM n’a pas été tenu en compte dans ces divers travaux. Nous avons donc émis l’hypothèse que la présence de la mutation SOD1 pourrait affecter différemment la transmission synaptique des UM, en accord avec leur vulnérabilité sélective. En effectuant des enregistrements électrophysiologiques et de l’immunohistochimie, nous avons étudié la transmission synaptique des différents types d’UM du muscle à contraction rapide Extensor Digitorum Longus (EDL; rapide fatigable (FF) MU) et du muscle à contraction lente Soleus (SOL; lente (S) and rapide fatigue-résistante (FR) MU) de la souris SOD1G37R et leur congénères WT. Pour identifier le type d’UM, un marquage par immunohistochimie des chaînes de myosine a été effectué. Un triple marquage de la JNM a également été effectué pour vérifier son intégrité aux différents stades de la maladie. À P160, dans la période asymptomatique de la maladie, alors qu’aucune altération morphologique n’était présente, l’activité évoquée était déjà altérée différemment en fonction des UM. Les JNMs FF mutantes ont démontré une diminution de l’amplitude des potentiels de plaque motrice (PPM) et du contenu quantique, alors que les JNMs lentes démontraient pratiquement le contraire. Les JNMs FR montraient quant à elles une force synaptique semblable au WT. À P380, dans la période présymtomatique, de nombreuses altérations morphologiques ont été observées dans le muscle EDL, incluant la dénervation complète, l’innervation partielle et les extensions du nerf. La transmission synaptique évoquée des UM FF étaient toujours réduites, de même que la fréquence des potentiels de plaque motrice miniatures. À P425, à l’apparition des premiers symptômes, l’activité synaptique des JNMs S était redevenue normale alors que les JNMs FR ont montré à ce moment une diminution du contenu quantique par rapport au contrôle. De manière surprenante, aucun changement du ratio de facilitation n’a été observé malgré les changements flagrants de la force synaptique. Ces résultats révèlent que la fonction de la JNM est modifiée différemment en fonction de la susceptibilité des UM dans l’ALS. Cette étude fournit des pistes pour une meilleure compréhension de la physiologie de la JNM durant la pathologie qui est cruciale au développement d’une thérapie adéquate ciblant la JNM dans la SLA. / Amyotrophic lateral sclerosis (ALS) is a fatal late-onset neurodegenerative disease characterized by the progressive loss of upper and lower motor neurons. Denervation of the neuromuscular junction (NMJ) is an early pathological event in various ALS models. Motor units (MU) appear unequally susceptible to denervation, the fast fatigable (FF) MU being the most vulnerable and the slow (S) MU the most resistant. While previous studies in several ALS models have consistently reported alterations in synaptic transmission, their findings have been contradictory. Interestingly, the MU types were not taken into account in these studies, which could explain these discrepancies. We hypothesized that the MU selective vulnerabilities observed in ALS will be associated with MU-specific NMJ alterations throughout the disease course. Using electrophysiology, we studied synaptic transmission of different types of MU in the fast-twitch Extensor Digitorum Longus (EDL; fast fatigable (FF) MU) and the slow-twitch Soleus (SOL; slow (S) and fast fatigue resistant (FR) MU) of the SOD1 mice and their WT littermates. MU types were identified using immunohistochemical labelling of the respective myosine heavy chains. Immunohistochemistry was also performed to assess NMJ integrity by using antibodies against main NMJ components. At a presymptomatic stage (P160), while no morphological alterations of NMJs were seen in both muscles, evoked activity was altered in a MU-specific manner in SOD1 mice. FF MU from SOD1 mice showed a decrease in EPP amplitude and quantal content whereas S MU showed the opposite. Mutant FR MU showed no difference in evoked activity compared to WT. At presymptomatic stage (P380), various morphological alterations were seen in the SOD1 EDL, including denervation, partial innervation and nerve sprouting. Evoked activity was still reduced in FF MU, as well as mEPP frequency. In contrast, at disease onset (P425), synaptic strength of the S MU was now similar to WT MU, whereas FR NMJs showed a decrease in EPP amplitude and quantal content. Surprisingly, paired-pulse facilitation was not altered in any MU type and at any age despite changes in synaptic strength. Taken together, these results reveal that NMJ function is differentially modified according to MU susceptibility in ALS. This study provides insights for a better understanding of NMJ physiology during the illness that is crucial to the development of a proper NMJ-targeted treatment in ALS.

La Sclérose Latérale Amyotrophique (SLA) est une maladie neurodégénérative qui affecte les neurones moteurs. 10% des cas sont des cas familiaux et l’étude de ces familles a mené à la découverte de plusieurs gènes pouvant causer la SLA, incluant SOD1, TARDBP et FUS. L’expansion de la répétition GGGGCC dans le gène C9orf72 est, à ce jour, la cause la plus connue de SLA. L’impact de cette expansion est encore méconnu et il reste à déterminer si la toxicité est causée par un gain de fonction, une perte de fonction ou les deux. Plusieurs gènes impliqués dans la SLA sont conservés entre le nématode Caenorhabditis elegans et l’humain. C. elegans est un vers transparent fréquemment utilisé pour des études anatomiques, comportementales et génétiques. Il possède une lignée cellulaire invariable qui inclue 302 neurones. Aussi, les mécanismes de réponse au stress ainsi que les mécanismes de vieillissement sont très bien conservés entre ce nématode et l’humain. Donc, notre groupe, et plusieurs autres, ont utilisé C. elegans pour étudier plusieurs aspects de la SLA. Pour mieux comprendre la toxicité causée par l’expansion GGGGCC de C9orf72, nous avons développé deux modèles de vers pour étudier l’impact d’une perte de fonction ainsi que d’un gain de toxicité de l’ARN. Pour voir les conséquences d’une perte de fonction, nous avons étudié l’orthologue de C9orf72 dans C. elegans, alfa-1 (ALS/FTD associated gene homolog). Les vers mutants alfa-1(ok3062) développent des problèmes moteurs causant une paralysie et une dégénérescence spécifique des neurones moteurs GABAergiques. De plus, les mutants sont sensibles au stress osmotique qui provoque une dégénérescence. D’autre part, l’expression de la séquence d’ARN contenant une répétition pathogénique GGGGCC cause aussi des problèmes moteurs et de la dégénérescence affectant les neurones moteurs. Nos résultats suggèrent donc qu’un gain de toxicité de l’ARN ainsi qu’une perte de fonction de C9orf72 sont donc toxiques pour les neurones. Puisque le mouvement du vers peut être rapidement évalué en cultivant les vers dans un milieu liquide, nous avons développé un criblage de molécules pouvant affecter le mouvement des vers mutants alfa-1 en culture liquide. Plus de 4 000 composés ont été évalués et 80 ameliore la mobilité des vers alfa-1. Onze molécules ont aussi été testées dans les vers exprimant l’expansion GGGGCC et huit diminuent aussi le phénotype moteur de ces vers. Finalement, des huit molécules qui diminent la toxicité causée par la perte de fonction de C9orf72 et la toxicité de l’ARN, deux restaurent aussi l’expression anormale de plusieurs transcrits d’ARN observée dans des cellules dérivées de patient C9orf72. Avec ce projet, nous voulons identifier des molécules pouvant affecter tous les modes de toxicité de C9orf72 et possiblement ouvrir de nouvelles avenues thérapeutiques / Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder affecting the motor neurons. 10% of the cases are familial and using those families, many genes were shown to be involved in ALS pathogenesis, including SOD1, TARDBP and FUS. The GGGGCC repeat found in the first intron of C9orf72 is, to this day, the most common genetic cause of ALS. Many hypotheses have been speculated to explain the toxicity of the pathogenic GGGGCC repeat, including loss and gain of function mechanisms. Many proteins involved in amyotrophic lateral sclerosis (ALS) are evolutionarily conserved in the worm Caenorhabditis elegans. C. elegans is a transparent nematode widely used for anatomical, behavioural and genetic studies. It possesses an invariant cell lineage that includes 302 neurons in the adult nematode. Also, cellular stress responses and survival mechanisms are genetically regulated and conserved from the nematode and human. Therefore, our group, and others, have used C. elegans to model different aspects of neurodegenerative diseases including ALS. To better understand the toxicity caused by the GGGGCC repeat expansion in C9orf72, we have developed two C. elegans models to understand either the impact of the loss of function of C9orf72 or the gain of toxicity of the RNA containing the GGGGCC repeat. To understand the loss of function, we have characterized the orthologue of C9orf72 in C. elegans, alfa-1 (ALS/FTD associated gene homolog). Mutant alfa-1 worms exhibit motor impairments leading to paralysis and neurodegenereation of the GABAergic neurons. Mutant worms are also sensitive to osmotic stress which can lead to increased neurodegeneration. On the other part, exposure of C. elegans neurons to the RNA containing the GGGGCC repeat causes also motor problem and degeneration affecting the motor neurons. Therefore, our data suggest that both loss of function of C9orf72 and toxic gain of function are detrimental to neurons. Since motor dysfunctions in worms can be easily accessed in liquid culture, we have screened more than 4,000 FDA approved compounds in the alfa-1(ok3062) worms. 80 molecules were shown to improve alfa-1 impaired function and eleven of those were also tested for their effect to reduce the neurotoxicity caused by the GGGGCC repeat RNA. Eight molecules were shown to affect both types of neurotoxicity. Finally, from these eight molecules that can improveboth types of toxicity, two were shown to restore the abnormal RNA expression observed in C9orf72 patient-derive cells. With this project, we aimed to identify molecules that can affect the loss of C9orf72 toxicity and the toxic gain of RNA function containing the GGGGCC repeat to hopefully open new therapeutic avenues for ALS patients.

Mesenchymal stem cells (MSC) possess a multilineage differentiation potential and have the ability to regulate reactivity of the immune system. They are usually isolated and expanded from the bone marrow, adipose tissue or umbilical cord. MSC represent promising cell population for the treatment of some severe diseases, such as amyotrofic lateral sclerosis (ALS), due to the combination of regenerative and immunomodulatory properties. The aim of this study is to compare MSC from ALS patients and healthy donors in their phenotype, proliferative activity and mainly their immunomodulatory properties. The assessment of impact of the disease on the properties of MSC is important for their autologous use in clinical trials. In this study we used MSC isolated from bone marrow of 14 ALS patients and 15 patients undergoing mostly orthopedic surgery as control group. We also used MSC stimulated for 24 hours by poinflammatory cytokines. Cells were compared in terms of immunophenotype, differentiation in adipocytes and osteoblasts, metabolic activity, expression of selected genes for immunomodulatory molecules and for inhibition of lymphocyte proliferation. Further experiments were focused on evaluation of immunomodulatory properties of MSC. The effect of MSC on peripheral blood mononuclear cells stimulated...

LIGHT, un membre de la famille du TNF, déclenche la mort des motoneurones et contribue à la progression de la dégénérescence des motoneurones chez les souris modèles de la sclérose latérale amyotrophique. Étonnement, nous montrons que LIGHT peut également stimuler la croissance axonale in vitro et est nécessaire à la régénération axonale des motoneurones in vivo lors d'une lésion nerveuse périphérique. La compréhension des mécanismes dictant la bivalence de son récepteur mène à l'étude des effets de la régionalisation du signal LIGHT. Les chambres microfluidiques en isolant les axones des corps cellulaires, nous ont permis d'étudier la résultante fonctionnelle d'une stimulation axonale et somatique par LIGHT. Nous montrons que LIGHT active différentiellement la mort, quand il agit au niveau somatique, ou la régénération axonale, quand il stimule l'axone. L'ensemble de ces résultats mène à de nouvelles approches où l'administration de LIGHT au niveau du nerf lésé et du muscle correspondant nous renseignera sur le potentiel thérapeutique de LIGHT lors d'une lésion du système nerveux. / LIGHT, a member of the TNF superfamily, triggers death of motoneurons and contribute to the progression of motoneuron degeneration in an ALS mouse model. Interestingly, we demonstrate that LIGHT can elicit neurite outgrowth in vitro and contribute to axon regeneration in vivo following nerve injury. To better understand mechanisms governing the opposite effects of LIGHT on motoneurons we asked whether a regional activation of LIGHT pathway could trigger these opposite responses. Toward this goal we used microfluidic chambers to isolate the soma from the axon of motoneurons. We shows that LIGHT activates differentially motoneurons death when it acts at the soma and axon outgrowth when it acts at the level of the axon. Together, these results lead us to evaluate new therapeutic approaches to nerve injury.

A Esclerose Lateral Amiotrófica (ELA) é uma doença neurodegenerativa progressiva de evolução rápida, caracterizada pela perda seletiva dos neurônios motores (NM) superiores e inferiores. Recentemente, as células gliais centrais (astrócito, microglia e oligodendrócito) mostraram-se tóxicas aos NM, porém os detalhes moleculares não estão completamente elucidados. Em relação às células gliais periféricas, alterações eletrofisiológicas no nervo ciático do modelo animal da ELA na idade pré-sintomática foram reportadas pelo nosso grupo e os achados de denervação precoce tanto no modelo animal quanto em pacientes sugerem a participação das células de Schwann (CS) na morte neuronal retrógrada na ELA, teoria conhecida como dying back. Nesse contexto, as CS mostraram-se capazes de induzir a retração axonal e a denervação das junções neuromusculares, eventos precoces na doença, ocorrendo possivelmente na fase présintomática. O objetivo deste trabalho foi verificar a influência das CS do modelo experimental na fase pré-sintomática e do paciente com evolução recente da forma esporádica da ELA, na sobrevida e no tamanho dos prolongamentos dos NM in vitro e entender a natureza molecular do fenômeno. Culturas de CS altamente purificadas foram obtidas a partir do nervo ciático do camundongo modelo animal e do nervo periférico de pacientes com ELA. Os NM da medula espinal de camundongos neonatos foram co-cultivados com as CS. A neurodegeneração foi avaliada pela presença do marcador Fluoro-Jade C (FJC). Os NM também foram tratados com o meio condicionado das culturas de CS do modelo animal ou dos pacientes com ELA. Os motoneurônios tiveram os seus prolongamentos contados e a morte neuronal foi identificada pela presença do FJC. Diversos fatores neurotróficos foram quantificados no meio condicionado das culturas de CS pela técnica de ELISA. A reação em cadeia da polimerase quantitativa (do inglês, quantitative polymerase chain reaction - qPCR) foi realizada para detectar alterações nas CS e no nervo periférico que pudessem estar relacionadas com disfunção na unidade CS/NM. Os resultados mostraram que os NM cultivados na ausência das CS mostraram-se mais susceptíveis à morte. Os NM cocultivados com as CS ELA mostraram maior número de perfis neurodegenerativos em comparação com os NM co-cultivados com as CS controle. Após o tratamento com o meio condicionado das CS ELA, os NM mostraram redução no tamanho dos prolongamentos e aumento do número de células em neurodegeneração em comparação com o grupo controle. Quantidades reduzidas dos fatores neurotróficos foram encontradas no meio condicionado das culturas de CS ELA. Alterações na expressão gênica das CS e no nervo periférico evidenciaram disfunções na unidade CS/NM que podem estar contribuindo para o processo neurodegenerativo visto na ELA. Conclui-se que a falência nos mecanismos de neuroproteção pelas CS ELA é um importante mecanismo implicado na morte neuronal, com grande potencial terapêutico / Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease characterized by the selective loss of upper and lower motor neurons (MN). Recently, central glia (astrocytes, microglias and olygodendrocytes) were toxic to the MN, but the molecular aspects have not fully described. In relation to the peripheral glia, electrophysiological changes in the sciatic nerve of ALS animal model in the presymptomatic stage have been reported by our group and early denervation findings in both animal models and patients suggests the participation of Schwann cells (SC) in the retrograde neuronal death of ALS , theory known as dying back. In this context, the SC proved to be able to induce axonal retraction and denervation of the neuromuscular junctions, early events in the disease, possibly occurring in the pre-symptomatic phase. The aim of this thesis was to investigate the influence of SC of pre-symptomatic experimental model and from patient with recent evolution of ALS sporadic form, in the survival and axonal length of MN in vitro and understand the molecular nature of the phenomenon. Highly purified SC cultures were obtained from the sciatic nerve of the animal model and from ALS patient\'s peripheral nerve. MN from the newborn mouse spinal cord were co-cultured with SC and the neurodegeneration was assessed by the presence of the marker Fluoro-Jade C (FJC). MN were also treated with conditioned medium from cultures of SC of the animal model or ALS patients. MN had their neuronal length measured and neuronal degeneration was identified by the presence of the FJC. Several neurotrophic factors were measured in conditioned medium of mice and ALS patient\'s SC cultures by ELISA. The chain reaction quantitative polymerase (qPCR) was performed to detect changes in the SC and peripheral nerve that could be related with dysfunction in the functional unit SC/MN. The MN co-cultured with ALS SC showed a greater number of neurodegenerative profiles compared with MN cocultured with control SC. After treatment with ALS SC conditioned medium, MN showed a reduction in the neuronal length and increased number of cells in neurodegeneration compared with the control group. Lower levels of neurotrophic factors were found in the conditioned medium of ALS SC cultures. Changes in the gene expression of SC and peripheral nerve showed dysfunctions in SC/MN unit, which may be contributing to the neurodegenerative process seen in ALS. In conclusion, the failure of neuroprotection by ALS SC is an important mechanism implicated in the MN cell death, with great therapeutic potential

Esta pesquisa se desenvolveu a partir da parceria entre o Projeto APOIAR do Laboratório de Saúde Mental e Psicologia Clinica Social do Instituto de Psicologia da USP e a ABRELA (Associação Brasileira de Esclerose Lateral Amiotrófica). O estudo refere-se à investigação e compreensão de aspectos afetivos, emocionais e de qualidade de vida dos profissionais da área de saúde, enfocando sua relação com cuidadores e pacientes portadores de Esclerose Lateral Amiotrófica (ELA), doença degenerativa dos neurônios motores, sem prognóstico de cura, embora com a consciência mantida até a morte. Foi empregado o método clínico de pesquisa em onze profissionais, médicos, assistentes sociais, fisioterapeutas respiratórios e motor, nutricionista e terapeuta ocupacional, no setor da Neuromuscular da UNIFESP/Escola Paulista de Medicina em parceria com a ABRELA. Foram empregados como instrumentos: Entrevista Psicológica Semi Estruturada, Método de Rorschach pelo Sistema de Avaliação Aníbal Silveira (sendo alguns índices selecionados) e o Questionário de Vida de McGill. Os dados foram tratados considerando o grupo de forma geral e não de modo individualizado. Principais resultados obtidos apontam para a maturidade do grupo de profissionais, a sensibilidade da maioria à dor e ao sofrimento dos pacientes, com respostas que denotam afetividade, frustração diante da falta de cura e sucesso no tratamento. Demonstram qualidade de vida preservada, e os dados sugerem que trabalham na área que escolheram apesar das dificuldades que sentem. Sugere-se que sejam implementados programas que possam dar aos profissionais de saúde o suporte necessário para que se mantenham como o grupo estudado nessa pesquisa, em condições de dar conta do contato com pacientes com enfermidades graves e crônicas como a ELA. / The actual research was possible due to the partnership between the Project APOIAR (SUPPORT) of the Laboratory of Mental Health and Clinical Psychology of the Institute of Psychology of USP University of Sao Paulo, and ABRELA ( Brazilian Association of Amyotrophic Lateral Sclerosis ( ALS ). This study intends to investigate and better understand the Quality of Life and emotional aspects of health professionals in their relationship with ALS patients and their carers. ALS is a degenerative illness which affects motor neurons causing severe physical impediments, even tough its patients continue lucid up to their death. This illness does not have a prognosis of cure. We have applied the Clinical Method of survey and research on eleven professionals physicians, social workers, motor and respiratory physiotherapists, nutritionist and occupational therapist from de Department of neuromuscular of UNIFESP/ Federal Paulista Medical School and partnership with ABRELA. The study Instruments used were the Semi- Structured psychological Interview, the Rorschach Method ( the Evaluation System by Anibal Silveira) and the Questionnaire of Quality of Life. The collected data considered the group as a whole and not individuals. The main results point towards the maturity of the group of health professionals and their sensitivity related to the pain and suffering of patients, with answers showing affection and frustration due to impossibility of cure and success of treatment. The results show preserved Quality of Life and suggest that those health professionals work within their chosen specialty despite their difficulties.The study suggests the need of implementing programs which give health professionals the necessary support, as shown in this study, so that they can deal with their patients with serious and chronic illnesses such ALS.