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Traumatic injuries to the spinal cord (SCI) and peripheral nerve (PNI) affect several thousand people worldwide every year. At present, there is no effective treatment for SCI and despite continuous improvements in microsurgical reconstructive techniques for PNI, many patients are still left with permanent, devastating neurological dysfunction. This thesis investigates the effects of mesenchymal stem cells (MSC) derived from adipose (ASC) and dental (DSC) tissue and chitosan/microRNA-124 polyplex particles on regeneration after spinal cord and peripheral nerve injury in adult rats. Dental stem cells were obtained from apical papilla, dental pulp, and periodontal ligament. ASC and DSC expressed MSC surface markers (CD73, CD90, CD105 and CD146) and various neurotrophic molecules including BDNF, GDNF, NGF, VEGF-A and angiopoietin-1. Growth factor stimulation of the stem cells resulted in increased secretion of these proteins. Both ASC and DSC supported in vitro neurite outgrowth and in contrast to Schwann cells, ASC did not induce activation of astrocytes. Stimulated ASC also showed an enhanced ability to induce capillary-like tube formation in an in vitro angiogenesis assay. In a peripheral nerve injury model, ASC and DSC were seeded into a fibrin conduit, which was used to bridge a 10 mm rat sciatic nerve gap. After 2 weeks, both ASC and DSC promoted axonal regeneration in the conduit and reduced caspase-3 expression in the dorsal root ganglion (DRG). ASC also enhanced GAP-43 and ATF-3 expression in the spinal cord, reduced c-jun expression in the DRG and increased the vascularity of the implant. After transplantation into injured C3-C4 cervical spinal cord, ASC continued to express neurotrophic factors and laminin and stimulated extensive ingrowth of 5HT-positive raphaespinal axons into the trauma zone. In addition, ASC induced sprouting of raphaespinal terminals in C2 contralateral ventral horn and C6 ventral horn on both sides. Transplanted cells also changed the structure and the density of the astroglial scar. Although the transplanted cells had no effect on the density of capillaries around the lesion site, the reactivity of OX42-positive microglial cells was markedly reduced. However, ASC did not enhance recovery of forelimb function. In order to reduce activation of microglia/macrophages and the secondary tissue damage after SCI, the role of microRNA-124 was investigated. In vitro transfection of chitosan/microRNA-124 polyplex particles into rat microglia resulted in the reduction of reactive oxygen species and TNF-α levels and lowered expression of MHC-II. Upon microinjection into uninjured rat spinal cords, particles formed with Cy3-labeled control sequence RNA, were specifically internalized by OX42 positive macrophages and microglia. Alternatively, particles injected in the peritoneum were transported by macrophages to the site of spinal cord injury. Microinjections of chitosan/microRNA-124 particles significantly reduced the number of ED-1 positive macrophages after SCI. In summary, these results show that human MSC produce functional neurotrophic and angiogenic factors, creating a more desirable microenvironment for neural regeneration after spinal cord and peripheral nerve injury. The data also suggests that chitosan/microRNA-124 particles could be potential treatment technique to reduce neuroinflammation.

Objetivos: Avaliar a influencia do estresse sobre os pesos maternos, placentários e fetais, as alterações histológicas placentárias e a expressão gênica dos fatores angiogênicos em ratas prenhes. Métodos: De setembro de 2007 a julho de 2008, foi realizado um estudo experimental do tipo casocontrole, em que 6 ratas prenhes foram submetidas a estímulos estressantes crônicos e agudos enquanto que 6 animais constituíram o grupo controle. No 20o dia de prenhez, todas as ratas foram sacrificadas. Os seguintes dados foram analisados e comparados entre os grupos: a. pesos maternos, placentários e fetais; b. alterações histológicas placentárias; e, c. expressão gênica dos fatores angiogênicos (VEGF-A e PlGF), dos seus receptores (VEGFR-1 e VEGFR-2) e do fator induzido por hipoxia (HIF-1). Resultados: Os pesos maternos, placentários e fetais foram significativamente menores no grupo de ratas prenhes-estressadas em relação ao controle. Histologicamente foram encontradas a presença de núcleos picnóticos no grupo prenhe-estressado. Observou-se expressão gênica significativamente maior de VEGF-A no grupo rata prenhe-estressada assim como redução significante da expressão gênica de PlGF, VEGFR-1, VEGFR-2, quando comparadas ao controle. Não houve alterações entre os grupos para o gene HIF-1. Conclusões: No modelo animal de estresse estudado, observou-se alterações significativas no peso placentário e da expressão gênica dos fatores angiogênicos placentários em ratas submetidas ao estresse. / Objectives: to evaluate the influence of the stress on the maternal, placental and fetal weights, on the histological findings and on the genetic expression of the angiogenic factors in pregnant rats. Methods: From September 2007 to Julie 2008, an experimental case-control study was conduced in which 6 pregnant rats were submitted to chronic and acute stress while six other were considered as controls. In the 20th day of gestation, all animals were sacrified. The following data were evaluated and compared between both groups: a. maternal, placental and fetal weights; b. histological findings; and c. genetic expression of angiogenic factors (VEGF-A and PIGF), receptors (VEGFR-1 and VEGFR-2) and hypoxic-induced factor (HIF- 1). Results: Maternal, placental and fetal weights were statistically smaller in the stressed animals comparing to controls. Histological analysis revealed picnotic nuclei in the placentas of stressed rats. A statistically significant increase in the genetic expression of VEGF-A as well as a reduction of the expression of the PlGF, VEGFR-1, VEGFR-2 were observed in the placentas of the stressed group in comparison to controls. There was no difference of expression of the gene HIF-1 between both groups. Conclusions: In the present animal model of stress, significant alterations in the placental weights, histology and genetic expression of the angiogenic factors among pregnant rats under stress.

Objetivos: Avaliar a influencia do estresse sobre os pesos maternos, placentários e fetais, as alterações histológicas placentárias e a expressão gênica dos fatores angiogênicos em ratas prenhes. Métodos: De setembro de 2007 a julho de 2008, foi realizado um estudo experimental do tipo casocontrole, em que 6 ratas prenhes foram submetidas a estímulos estressantes crônicos e agudos enquanto que 6 animais constituíram o grupo controle. No 20o dia de prenhez, todas as ratas foram sacrificadas. Os seguintes dados foram analisados e comparados entre os grupos: a. pesos maternos, placentários e fetais; b. alterações histológicas placentárias; e, c. expressão gênica dos fatores angiogênicos (VEGF-A e PlGF), dos seus receptores (VEGFR-1 e VEGFR-2) e do fator induzido por hipoxia (HIF-1). Resultados: Os pesos maternos, placentários e fetais foram significativamente menores no grupo de ratas prenhes-estressadas em relação ao controle. Histologicamente foram encontradas a presença de núcleos picnóticos no grupo prenhe-estressado. Observou-se expressão gênica significativamente maior de VEGF-A no grupo rata prenhe-estressada assim como redução significante da expressão gênica de PlGF, VEGFR-1, VEGFR-2, quando comparadas ao controle. Não houve alterações entre os grupos para o gene HIF-1. Conclusões: No modelo animal de estresse estudado, observou-se alterações significativas no peso placentário e da expressão gênica dos fatores angiogênicos placentários em ratas submetidas ao estresse. / Objectives: to evaluate the influence of the stress on the maternal, placental and fetal weights, on the histological findings and on the genetic expression of the angiogenic factors in pregnant rats. Methods: From September 2007 to Julie 2008, an experimental case-control study was conduced in which 6 pregnant rats were submitted to chronic and acute stress while six other were considered as controls. In the 20th day of gestation, all animals were sacrified. The following data were evaluated and compared between both groups: a. maternal, placental and fetal weights; b. histological findings; and c. genetic expression of angiogenic factors (VEGF-A and PIGF), receptors (VEGFR-1 and VEGFR-2) and hypoxic-induced factor (HIF- 1). Results: Maternal, placental and fetal weights were statistically smaller in the stressed animals comparing to controls. Histological analysis revealed picnotic nuclei in the placentas of stressed rats. A statistically significant increase in the genetic expression of VEGF-A as well as a reduction of the expression of the PlGF, VEGFR-1, VEGFR-2 were observed in the placentas of the stressed group in comparison to controls. There was no difference of expression of the gene HIF-1 between both groups. Conclusions: In the present animal model of stress, significant alterations in the placental weights, histology and genetic expression of the angiogenic factors among pregnant rats under stress.

Dans le glioblastome (GBM), la radiothérapie est un outil thérapeutique essentiel. Néanmoins, la récidive post-irradiation est quasiment inévitable, en raison de l’émergence d'une sous-population de cellules cancéreuses particulièrement radiorésistantes présentant une meilleure capacité proliférative, invasive et pro-angiogénique. Notre étude in vitro a cherché à déterminer comment les cellules cancéreuses survivantes à l’irradiation pouvaient affecter la fonction des cellules tumorales voisines et les cellules endothéliales non irradiées, en focalisant notre attention sur l’échange des signaux intercellulaires, à savoir, les facteurs solubles et les microvésicules tumorales (TMVs). La radiothérapie induit principalement un ralentissement de la prolifération des cellules de glioblastome (T98G et U87) et une mort cellulaire retardée (clonogénique) de 50-60%, sans engendrer d’apoptose. Grâce au suivi de la croissance cellulaire à long terme (via le système xCELLigence) et un test de blessure, nous avons confirmé que les cellules de glioblastome survivantes après irradiation libèrent des signaux qui peuvent modifier les fonctions de cellules endothéliales HUVEC et de cellules tumorales non-irradiées. Outre la sécrétion de certains facteurs solubles connus (VEGF, uPA), nous avons pu objectiver, en utilisant la microscopie électronique à balayage, le Nanoparticle Tracking Analysis (NTA), la libération de microvésicules tumorales (TMVs), dont la taille était globalement inférieure à 500 nm. Par NTA et cytométrie en flux, nous avons montré que cette libération de TMVs (exosome + "shedding vesicles"), peut être significativement stimulée par l’irradiation dans les 2 lignées, de façon temps-dépendant. D’après nos analyses protéomiques, les facteurs solubles tels que le VEGF ou l’IL-8, connus pour être des facteurs pro-angiogéniques, contribueraient plutôt à favoriser la survie, voire la prolifération, des cellules HUVEC, tandis que les TMVs libérées après irradiation, ont significativement modifié la capacité de migration des HUVEC et des cellules tumorales non-irradiées. Les propriétés pro-migratoires des TMVs pourraient en ce sens, contribuer aux processus de récidive dans les glioblastomes après irradiation / Radiation therapy is a major therapeutic tool for glioblastoma (GBM). However, the post-radiation recurrence is almost inevitable, due to the emergence of a subpopulation of radioresistant cancer cells with greater proliferative, invasive, and proangiogenic capacities. The objective of this study was to investigate in vitro how irradiated cancer cells affect the function of untreated neighboring tumor cells and endothelial cells, focusing on signals exchange initiated by irradiation, such as soluble factors and tumor microvesicles (TMVs). Radiotherapy has slowed down the proliferation of GBM cells (T98G, U87) and induced mitotic death of 50-60%, without significant apoptosis. Through long-term monitoring of cell growth (xCELLigence) and wound-healing assay, we have confirmed that surviving GBM cells after irradiation release signals that can change the functions of endothelial cells HUVEC and non-irradiated tumor cells. In addition to the secretion of known soluble factors (VEGF, uPA), we were able to show using scanning electron microscopy and the Nanoparticle Tracking Analysis (NTA), the release of tumor microvesicles (TMVS), whose size was generally less than 500 nm. By NTA and flow cytometry, we have shown that the release of TMVs (exosome + "shedding vesicles") can be significantly stimulated by irradiation in two lines, in a time-dependent manner. According to the proteomics analysis, soluble factors such as VEGF or IL-8, well known as pro-angiogenic factors, rather contribute to promote the survival or proliferation of HUVEC, while the released TMVs after irradiation, significantly altered the migration abilities of non-irradiated HUVEC and tumor cells. The pro-migratory properties of TMVs could thus contribute to glioblastoma recurrence after irradiation

Clinically, injuries affecting the spinal cord or peripheral nerves can leave those affected with severe disability and, at present, there are limited options for treatment. Peripheral nerve injury with a significant gap between the proximal and distal stumps is currently treated with autologous nerve grafting but this is limited by availability of donor nerve and has associated morbidities. In contrast, injuries to the spinal cord lead to an inhibitory environment caused by the glial cells and thereby, limit potential axonal regeneration. This thesis investigates the effects of human adipose derived stem cells (ASC) on regeneration after peripheral nerve and spinal cord injury in adult rats. Human ASC expressed various neurotrophic molecules and growth factor stimulation of the cells in vitro resulted in increased secretion of BDNF, GDNF, VEGF-A and angiopoietin-1 proteins. Stimulated ASC also showed an enhanced ability to induce capillary-like tube formation in an in vitro angiogenesis assay. In contrast to Schwann cells, ASC did not induce activation of astrocytes and supported neurite outgrowth from the adult rat sensory DRG neurons in culture. In a peripheral nerve injury model, ASC were seeded into a fibrin conduit, which was used to bridge a 10 mm rat sciatic nerve gap. After 2 weeks, ASC enhanced GAP-43 and ATF-3 expression in the spinal cord, reduced c-jun expression in the DRG and increased the vascularity of the fibrin nerve conduits. The animals treated with stimulated ASC showed an enhanced axon regeneration and reduced caspase-3 expression in the DRG. After transplantation into the injured C3-C4 cervical spinal cord. ASC continued to express neurotrophic factors and laminin and stimulated extensive ingrowths of 5HT-positive raphaespinal axons into the trauma zone. In addition, ASC induced sprouting of raphaespinal terminals in C2 contralateral ventral horn and C6 ventral horn on both sides. Transplanted cells also changed the structure and the density of the astroglial scar. Although the transplanted cells had no effect on the density of capillaries around the lesion site, the reactivity of OX42-positive microglial cells was markedly reduced.

La grossesse est une période de majoration du risque vasculaire, participant à une morbi-mortalité maternelle et fœtale pouvant justifier des mesures de prévention primaire et secondaire. Notre travail évalue l'impact de certains déterminants et l'apport de nouveaux acteurs moléculaires impliqués dans la dysfonction vasculo-placentaire. Le but ultime étant d'optimiser les prises en charge et de développer de nouvelles stratégies thérapeutiques. Nous avons étudié les complications vasculaires placentaires associées à des marqueurs biologiques connus : mutation du facteur V Leiden, mutation du gène de la prothrombine et marqueurs conventionnels du syndrome des anticorps anti-phospholipides (SAPL). Nos résultats montrent que les femmes à antécédents de fausses couches précoces répétitives et porteuses, soit du polymorphisme du facteur V, soit du polymorphisme du facteur II, soit d'un SAPL (traité par héparine et aspirine faible dose), ont un risque élevé de fausse couche tardive lors d'une nouvelle grossesse. Les femmes à antécédent de fausse couche tardive et porteuses des mêmes particularités biologiques, traitées pendant leur grossesse selon les recommandations (héparine pour l'anomalie du facteur V ou II, héparine plus aspirine faible dose pour le SAPL), ont un risque diminué de récidive de perte fœtale tardive mais demeurent, dans le groupe SAPL, fréquemment exposées aux complications tardives de la grossesse malgré la prophylaxie antithrombotique. Nous avons évalué l'apport de nouveaux marqueurs de la dysfonction vasculaire placentaire. Nous montrons que le polymorphisme Ile89Leu du gène de la phosphatase alcaline placentaire (PLAP), enzyme exprimée par les cellules du syncytiotrophoblaste -polymorphisme associé à une augmentation de l'activité PLAP-, exerce un effet protecteur sur l'échec d'implantation et la survenue d'une fausse couche primaire. Un facteur angiogénique (brevet en cours) a également été étudié (génétique, dosage plasmatique, fécondation in vitro) et nous montrons une association de ce marqueur avec les échecs d'implantation et les fausses couches idiopathiques. L'ensemble de ces travaux suggère que ces nouveaux marqueurs moléculaires pourraient contribuer au diagnostic des complications vasculaires de la grossesse et fournir des biomarqueurs d'implantation embryonnaire et/ou de développement placentaire. Ils pourraient suggérer de nouvelles cibles et stratégies thérapeutiques, répondant aux limites des traitements disponibles. / Vascular risk increases during pregnancy, contributing to maternal and foetal morbidity and mortality, and potentially justifying primary and secondary preventive measures. Our work evaluates the impact of some determinants and the contribution of new molecular actors implicated in placental vascular dysfunction. The ultimate aim is to optimize management and to develop new therapeutic strategies. We studied the placental vascular complications associated with known biological markers: the factor V Leiden or prothrombin polymorphisms, and conventional markers of the antiphospholipid antibody syndrome (APS). Women with previous recurrent abortions carrying polymorphisms of either factor V or factor II, or with APS (treated with heparin and low-dose aspirin), had an increased risk of foetal loss during subsequent pregnancies. Women with a previous foetal loss carrying these biological markers, treated according to recommendations during a new pregnancy (heparin for the polymorphisms, heparin plus low-dose aspirin for APS) had a lower risk of foetal loss, but an excess of late complications was observed in the APS group despite prophylaxis. We evaluated the contribution of new markers of placental vascular dysfunction. The placental alkaline phosphatase enzyme (PLAP) is synthesized and expressed by syncytiotrophoblastic cells. We found that the Ile89Leu polymorphism of the PLAP gene provides protection against implantation failure and primary miscarriage and induces increased PLAP activity. We also studied (genetics, plasma determinations, in vitro fertilisation) an angiogenic factor (patent application underway), which we showed to be associated with idiopathic implantation failure and miscarriage. These findings suggest that these molecular actors are potentially useful for the diagnosis of placenta-mediated pregnancy complications and may be relevant biomarkers of embryo implantation and/or placental development. They may indicate new targets for relevant therapeutic strategies, potentially overcoming the limitations of the currently available treatments.