A growing body of research is targeted towards characterizing and explaining nicotine’s complex interactions with the ApoE E4 allele on brain responses underlying cognitive processes. However, when and how the ε4 allele modulates neuroelectric brain responses in the presence of nicotine versus nicotine abstinence in nicotine-dependent smokers is not well characterized. Being able to understand this modulation is potentially quite important given that recent research implies that, relative to non-ε4 carriers, young adult carriers of the ε4 allele exhibit greater cognitive benefits from the use of nicotine. In the present study, electroencephalography (EEG) and the oddball-related P3b event-related potential (ERP) were used to better characterize the potential moderating effects of ApoE on P3b ERP amplitude changes associated with overnight nicotine deprivation in dependent smokers. Results showed a significant interaction between ApoE genotype and nicotine use, as ε4 carriers, relative to noncarriers, demonstrated significantly greater decreases following overnight deprivation, relative to prequit baseline levels. Additionally, there was a main of effect of P3b ERP amplitude to target stimuli being greater in ε4 allele carriers than in noncarriers during nicotine use, but no main effect of APOE genotype during overnight nicotine deprivation. These results are consistent with findings that the ApoE genotype moderates the effects of nicotine and alters neuroelectric brain responses associated with selective attention to infrequent target stimuli.

Microglia, the resident immune cells of the brain, play a critical role in brain homeostasis and neurological disease progression. In neurodegenerative diseases, microglia acquire a neurodegenerative phenotype (MGnD), the function of which is poorly understood. MicroRNA-155 (miR-155), a multifunctional microRNA enriched in cells of the immune system, and Apolipoprotein E (APOE), a lipoprotein which is significantly associated with Alzheimer’s disease (AD) risk, critically regulate MGnD. However, the role of these molecules in AD pathogenesis remains unclear. Here, we report that microglial deletion of miR-155 induces an early MGnD response activation state via interferon-ɣ (IFNɣ) signaling in mice. This phenotypic transition increases plaque-associated Apoe, enhances amyloid plaque compaction, reduces neuritic dystrophy and attenuates plaque-associated synaptic degradation, resulting in improved cognition. These findings provide a novel mechanism detailing the phenotypic switch from homeostatic microglia to MGnD, and highlight the beneficial role of IFNɣ responsive MGnD in restricting neurodegenerative pathology and preserving cognitive function in a mouse model of AD. In addition, we demonstrate that Apoe deficient microglia induce an MGnD signature comparable to controls, but enhance MGnD physiological phenotypes including enhanced cognitive behavioral performance and reduced plaque associated neuritic dystrophy. Furthermore, we highlight a potential mechanism by which Apolipoprotein C-1 may attenuate synaptic ß-amyloid accumulation in a mouse model of AD. These findings may serve as the basis novel immunomodulatory therapies targeting microglial miR-155 and APOE to treat AD.

Die Atherosklerose ist eine progressiv fortschreitende entzündliche Erkrankung der Gefäße. Dem Chemokin CCL5 kommt in der Modulation sowie der Progression eine entscheidende Rolle zu. In der vorliegenden Studie wurde der Einfluss der genetischen CCL5-Defizienz auf dem Boden einer Hypercholesterinämie nach Induktion einer experimentellen Gefäßwandläsion hinsichtlich der arteriellen Thrombose und Bildung einer Neointima untersucht. Diesbezüglich wurden Tiere mit dem doppelten Gen-Knockout für ApoE-/- und CCL5-/- (Versuchsgruppe) sowie Tiere mit dem einzelnen Gen-Knockout für ApoE-/- und CCL5+/+ (Kontrollgruppe) generiert. Im Experiment wurde das FeCl3-Modell zur Induktion einer arteriellen Gefäßwandläsion der A.carotis communis sin. verwendet, in deren Folge innerhalb weniger Minuten eine arterielle Thrombose verursacht wurde und die Bildung einer Neointima innerhalb von drei Wochen zur Folge hatte. In beiden Gruppen führte die Gefäßwandverletzung zu einer Thrombusbildung, ein Unterschied bedingt durch die CCL5-Defizienz konnte nach sieben Tagen nicht gezeigt werden. Hingegen konnte eine signifikante Reduktion der Neointima-Fläche sowie eine signifikant verringerte Lumenstenose in der ApoE-/- x CCL5-/--Gruppe (jeweils p<0,05) bei ähnlicher Media-Fläche mit einer signifikant reduzierten I/M-Ratio (p<0,05) ermittelt werden. Immunhistochemische Analysen zeigten eine signifikante Reduktion der CCR5+-Gesamtfläche und eine Steigerung der CCR1+-Neointima-Fläche in der ApoE-/- x CCL5-/--Gruppe (jeweils p<0,05) sowie einen signifikanten Anstieg der CD45+-Neointima-Fläche, der Mac-+Neointima-Fläche (p<0,05) und der Mac-2+-Media-Fläche und der Mac-2+-Gesamtfläche in der ApoE-/- x CCL5-/--Gruppe (jeweils p<0,05). Darüber hinaus konnte eine signifikante Steigerung des antiatherogen wirkenden Transskriptionsfaktors KLF4 in der KLF4+-Neointima-Fläche in der ApoE-/- x CCL5-/--Gruppe (p<0,05) gezeigt werden, sodass die Hypothese einer gegenseitigen Beeinflussung nahe liegt. Zusammenfassend führt die CCL5-Defizienz zu einer signifikant reduzierten Neointima-Fläche nach Induktion einer Gefäßwandläsion mit der Folge einer arteriellen Thrombose. Hämodynamische und Histologische Analysen ergaben jedoch keinen Hinweis dafür, dass dieser Unterschied auf Veränderungen in der Thrombusformation bedingt durch die CCL5- Defizienz beruht. Möglicherweise könnte der atheroprotektive Effekt der CCL5- Defizienz bedingt durch die Hochregulation des atheroprotektiven Transskriptionsfaktors KLF4 oder durch pleiotrope Effekte im Signalweg, aufgrund der verschiedenen Rezeptoren, vermittelt sein.

Introduction: Cardiovascular disease (CVD) is the leading cause of global mortality and its prevalence is increasing among black South Africans in spite of their favourable lipid profile. Apolipoprotein E (ApoE) is a well-described risk factor for CVD and certain polymorphisms within this gene alter the lipid profile. The author hypothesised that there are population-specific effects within the ApoE gene that are responsible for the favourable lipid profile observed in black South Africans whose effects are being altered by environmental factors. Objectives: The main aim of this study was to investigate the associations between specific ApoE single nucleotide polymorphisms (SNPs) and the lipid profile of a black South African population, taking into account certain environmental and phenotypic factors in order to explore the interaction effects between these variables. Methods: Genotyping within this cross-sectional study (n=1 588), nested within the Prospective Urban and Rural Epidemiology (PURE) study, was achieved using Illumina‘s® GoldenGate Genotyping Assay with VeraCode® technology on the BeadXpress® platform (proprietary multiplex fluorescent hybridisation assays on a bead array substrate) or the Bio-Rad CFX Manager© (version 2.0). The Konelab20i™ auto analyser was used for quantitative determination of serum total cholesterol; high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) concentrations. Low-density lipoprotein cholesterol concentrations were estimated by the Friedewald equation. Results: All SNPs adhered to the assumptions of the Hardy-Weinberg equilibrium, yet the frequency of the SNPs often differed from that reported in other ethnic groups. The well-reported rs429358 and rs7412 SNPs (as the constituent SNPs of the haplotype-genotypes) presented with the strongest associations with various components of the blood lipid profile in the black South African cohort under investigation. Two gene-environment (rs405509 and rs7412) interaction effects on TG remained significant after conducting post hoc tests. Two genotype-phenotype interaction effects between the rs7412 SNP and body mass index and gamma-glutamyl transferase on the HDL-C concentrations remained significant after conducting post hoc tests. Conclusions: The variety of associations between these particular SNPs and the blood lipid profile determined in the present cohort strongly indicates that it is integral to any public health investigation into CVD development that these SNPs be investigated. This study further produced greater insight into the biological mechanisms underlying serum lipid and cholesterol concentrations in a black South African population. Therefore, from these results it is evident that the lipid profile of black South Africans is most definitely influenced by not only genetic variations in the ApoE gene and certain environmental factors, but by the interaction between these factors as well. The present study is the largest study to date to investigate the effect of polymorphisms in the ApoE gene on the lipid profile of black South Africans. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2014

Os mecanismos pelos quais os agentes infecciosos, independentes ou não de meio ambiente permissivo, podem promover a aterogênese e as manifestações clínicas não estão completamente esclarecidos. Apesar das numerosas publicações demonstrando a presença de antígenos ou DNA de agentes infecciosos nas placas de ateroma, a questão se o agente infeccioso pode iniciar o processo aterosclerótico ou agravá-lo permanece sem resposta, possibilitando o aprofundamento das pesquisas neste assunto. Desta forma, este trabalho tem como objetivo estudar se a infecção experimental, por C.pneumoniae e/ou M.pneumoniae, em camundongos C57BL/6 apoE KO induziria ou afetaria a intensidade e a característica de vulnerabilidade da placa ateromatosa, de acordo com o sexo e/ou a dieta rica em colesterol. Métodos: um grupo de camundongos recebeu dieta enriquecida com 1% de colesterol (hiperlipidêmica), e o outro ração com formulação adequada para espécie (normolipidêmica), desde os dois meses de idade. Aos 8 meses de idade foram subdivididos, inoculados com 106 UFI de C.pneumoniae e/ou 106 UFC de M.pneumoniae, por via intraperitoneal, reinoculados um mês após e sacrificados aos 10 meses de idade. Para análise histopatológica secções transversais das aortas torácicas foram processadas para emblocamento em parafina, cortadas com 5 &micro;m de espessura e coradas pelas técnicas de hematoxilina-eosina e tricrômico de Masson. As medianas das variáveis: altura da placa, área da placa, área de gordura da placa, área da artéria, área da luz e porcentagem de obstrução da luz da artéria dos diferentes grupos foram submetidas ao teste de Mann Whitney, com o nível de rejeição de 5%. Resultados: a infecção por C.pneumoniae e/ou M.pneumoniae causou agravamento da aterosclerose tanto em camundongos C57BL/6 apoE KO machos quanto em fêmeas. No entanto, as fêmeas infectadas somente com M.pneumoniae evoluíram com placas mais instáveis, representadas por maior remodelamento positivo. A co-infecção por C.pneumoniae e M.pneumoniae induziu placas mais estáveis, ou seja, com menor conteúdo de gordura e sem remodelamento, tanto nos machos quanto nas fêmeas. A introdução de dieta rica em colesterol levou ao não desenvolvimento de remodelamento positivo do vaso nas fêmeas infectadas por M.pneumoniae, mas sim nas co-infectadas por C.pneumoniae e M.pneumoniae que apresentaram placas mais instáveis, por serem mais volumosas e com maior conteúdo de gordura. Nos machos houve desenvolvimento de placas mais gordurosas nos infectados por C.pneumoniae. Conclusão: A infecção por C.pneumoniae e/ou M.pneumoniae em camundongos C57BL/6 apoE KO levou ao desenvolvimento ou agravamento de placas de aterosclerose, com diferenças em relação a intensidade e padrões de vulnerabilidade de acordo com o sexo versus o tipo de agente infecciosos. Os subgrupos infectados de fêmeas apresentaram maior agravamento da aterosclerose do que os machos. A dieta rica em colesterol agravou a intensidade da aterosclerose e mudou os padrões de vulnerabilidade dos subgrupos infectados. / Independent of the presence or not a favorable ambient, mechanisms by which infectious agents may boost atherogenesis and clinical aspects are not fully elucidated. In spite of many demonstrations of infeccious agent antigens or DNA, the question if the infection may iniciate or aggravate the atherosclerotic process remains unanswered, requiring further studies. Therefore, the present work studies if the experimental infection of C57BL/6 apoE KO mice by C. pneumoniae and/or M. pneumoniae induces or affects the intensity of atherosclerosis and its characteristics of plaque vulnerability, with regard to the gender and/or the cholesterolrich diet. Methods: a group of mice was fed with 1% cholesterol-enriched diet (hyperlipidemic), from two months of age; the other group received adequately formulated food for the species (normolipidemic). At eight months of age, the mice were subgrouped according to inoculation intra-peritoneally with 106 IFU of C. pneumoniae and/or 106 CFU of M. pneumoniae, and re-inoculation one month later. They were killed at ten months of age. Cross-sectional thoracic aorta fragments were studied in embedded in paraffin block sections stained Hematoxylin-eosin and Masson?s trichromic techniques. Differences in the median of the variables: plaque height, plaque area, area of fat plaque, luminal area and percent obstruction of the lumen searched using the Mann Whitney?s test, with a 5% level of rejection. Results: the infection by C. pneumoniae and/or M. pneumoniae worsened atherosclerosis in both males and females C57BL/6 apoE KO mice. However, the M. pneumoniae inoculated female group presented more unstable plaques represented by positive remodeling of the vessel. The co-infection by both bacteria induced more stable plaque represented by low fat content and absence of vessel remodeling, in both male and female mice. The introduction of cholesterol enriched diet led to lack of positive vessel remodeling in M.pneumoniae inoculated female group, but development of unstable plaques characterized by large plaque are with high content of fat, in co-infected ones. In male groups there was development of plaque with higher fat content in the subgroup inoculated with C.pneumoniae. Conclusion: Infection by M. pneumoniae and/or C. pneumoniae, in C57BL/6 apoE KO mice, led to development or aggravation of atherosclerotic plaques, with differences regarding intensity and pattern of vulnerability according to the gender versus type of infectious agents. The infected female groups presented more aggravation of atherosclerosis than male ones. Cholesterol enriched diet aggravated the intensity of atherosclerosis and changed the patterns of vulnerability of infected subgroups.

Les maladies chroniques, comme les maladies cardiovasculaires (MCV), la maladie d'Alzheimer (AD), la dépression et l'ostéoporose, sont les principales causes de mortalité dans le monde. L'identification de facteurs de risque communs à ces maladies pourrait contribuer à un vieillissement «sain» mieux surveillé en utilisant des stratégies personnalisées de prédiction des risques, de prévention précoce et de traitement adéquat, en tenant compte des comorbidités très souvent existantes. Dans cette thèse, 8 publications ont été développées. Dans un premier temps, j'ai résumé, dans un article de revue, les défis actuels et les opportunités de la pharmacogénomique des médicaments contre les maladies cardiovasculaires. J'ai participé à la formation d'un consortium international, le Consortium VEGF et j'ai participé à une étude qui a identifié des interactions épistasiques entre les polymorphismes qui régulent les niveaux de VEGF et la pression artérielle et les indices d'adiposité. J'ai également démontré qu’un marqueur génétique de VEGF, le rs4416670, était significativement associé à un risque accru de dépression. En outre, j'ai signalé deux interactions significatives entre les variantes liées au VEGF affectant la densité minérale osseuse du col fémoral chez les femmes ménopausées. J'ai également étudié deux marqueurs liés au métabolisme des lipides : l'apolipoprotéine E (APOE) et le «lipolysis-stimulated receptor» (LSR). J'ai trouvé que le variant LSR rs916147 peut interagir avec APOE d'une manière qui inverse l'effet protecteur de l'allèle ε2 de l'APOE sur les lipides sanguins, fournissant ainsi de nouvelles connaissances sur les mécanismes de l'hyperlipoprotéinémie de type III. Les interactions épistasiques entre ces deux gènes augmentent également le risque d’AD même en l'absence de l'allèle à risque, APOE ε4. Finalement, j'ai réalisé des études épigénetiques (EWAS) sur l'obésité centrale et les traits lipidiques chez des individus sains. Les résultats suggèrent qu'un CpG pourrait affecter le tour de taille à travers une voie de signalisation de l'insuline. En outre, deux CpGs ont été associées aux niveaux des triglycérides par des gènes liés aux maladies cardiaques génétiques (PRKAG2) et à l'inhibition de la signalisation Wnt / bêta-caténine impliquée dans le développement des MCV et d’AD (KREMEN2). En conclusion, dans cette thèse j’ai utilisé l'étude de l'épistasie et de l'épigénétique pour identifier des interrelations complexes entre VEGF, LSR, APOE et différentes maladies chroniques (MCV, AD, ostéoporose, dépression) proposant ainsi de nouveaux mécanismes et des dénominateurs communs de ces maladies qui devraient être utilisés comme biomarqueurs de médecine personnalisée / Chronic diseases, like cardiovascular diseases (CVD), Alzheimer’s disease (AD), depression and osteoporosis, are major causes of mortality in the world. Identification of common to those diseases risk factors could help for a better-monitored ‘healthy’ aging, by promotion of personalised strategies for risk prediction, early prevention and adequate treatment, all taking into account the very often existing comorbidities. In this thesis, 8 publications have been developed. Initially, in a review paper, I have summarised the current challenges and opportunities of pharmacogenomics of CVD medications. I have participated in the formation of an international consortium, the VEGF Consortium, and I have participated in a study that identified significant epistatic interactions between polymorphisms that regulate the levels of VEGF and their effects on blood pressure and adiposity indexes. I have also demonstrated that one genetic marker of VEGF, rs4416670, was significantly associated with an increased risk for depression. Furthermore, I have reported two significant interactions between VEGF-related variants affecting the femoral neck bone mineral density in post-menopausal women. I have focused also on two markers linked with lipids metabolism: the apolipoprotein E (APOE) and the lipolysis-stimulated receptor (LSR). I have found that the LSR variant rs916147 can interact with APOE in a way that reverses the protective effect of the ε2 allele of APOE on blood lipids, thus providing new insights in the mechanisms underlying type III hyperlipoproteinemia. Epistatic interactions between these two genes have also been shown to increase the risk of AD, even in the absence of the known risk allele APOE ε4. Finally, I have performed epigenome-wide association studies (EWAS) on central obesity and blood lipid traits in healthy individuals. The results suggest that one methylation probe could affect waist circumference through an insulin-signaling pathway. Furthermore, two methylations probes were associated with triglycerides levels through genes linked with genetic heart diseases (PRKAG2) and with inhibition of the Wnt/beta-catenin signaling that is involved in CVD and AD development (KREMEN2). In conclusion, this thesis used the study of epistasis and epigenetics and identified complex inter-relationships between VEGF, LSR, APOE and different chronic diseases (CVD, AD, osteoporosis, depression) and novel mechanisms that link disease development with DNA methylation, thus demonstrating their role as common denominators of diseases that can be used as valuable markers in personalised medicine

Os mecanismos pelos quais os agentes infecciosos, independentes ou não de meio ambiente permissivo, podem promover a aterogênese e as manifestações clínicas não estão completamente esclarecidos. Apesar das numerosas publicações demonstrando a presença de antígenos ou DNA de agentes infecciosos nas placas de ateroma, a questão se o agente infeccioso pode iniciar o processo aterosclerótico ou agravá-lo permanece sem resposta, possibilitando o aprofundamento das pesquisas neste assunto. Desta forma, este trabalho tem como objetivo estudar se a infecção experimental, por C.pneumoniae e/ou M.pneumoniae, em camundongos C57BL/6 apoE KO induziria ou afetaria a intensidade e a característica de vulnerabilidade da placa ateromatosa, de acordo com o sexo e/ou a dieta rica em colesterol. Métodos: um grupo de camundongos recebeu dieta enriquecida com 1% de colesterol (hiperlipidêmica), e o outro ração com formulação adequada para espécie (normolipidêmica), desde os dois meses de idade. Aos 8 meses de idade foram subdivididos, inoculados com 106 UFI de C.pneumoniae e/ou 106 UFC de M.pneumoniae, por via intraperitoneal, reinoculados um mês após e sacrificados aos 10 meses de idade. Para análise histopatológica secções transversais das aortas torácicas foram processadas para emblocamento em parafina, cortadas com 5 &micro;m de espessura e coradas pelas técnicas de hematoxilina-eosina e tricrômico de Masson. As medianas das variáveis: altura da placa, área da placa, área de gordura da placa, área da artéria, área da luz e porcentagem de obstrução da luz da artéria dos diferentes grupos foram submetidas ao teste de Mann Whitney, com o nível de rejeição de 5%. Resultados: a infecção por C.pneumoniae e/ou M.pneumoniae causou agravamento da aterosclerose tanto em camundongos C57BL/6 apoE KO machos quanto em fêmeas. No entanto, as fêmeas infectadas somente com M.pneumoniae evoluíram com placas mais instáveis, representadas por maior remodelamento positivo. A co-infecção por C.pneumoniae e M.pneumoniae induziu placas mais estáveis, ou seja, com menor conteúdo de gordura e sem remodelamento, tanto nos machos quanto nas fêmeas. A introdução de dieta rica em colesterol levou ao não desenvolvimento de remodelamento positivo do vaso nas fêmeas infectadas por M.pneumoniae, mas sim nas co-infectadas por C.pneumoniae e M.pneumoniae que apresentaram placas mais instáveis, por serem mais volumosas e com maior conteúdo de gordura. Nos machos houve desenvolvimento de placas mais gordurosas nos infectados por C.pneumoniae. Conclusão: A infecção por C.pneumoniae e/ou M.pneumoniae em camundongos C57BL/6 apoE KO levou ao desenvolvimento ou agravamento de placas de aterosclerose, com diferenças em relação a intensidade e padrões de vulnerabilidade de acordo com o sexo versus o tipo de agente infecciosos. Os subgrupos infectados de fêmeas apresentaram maior agravamento da aterosclerose do que os machos. A dieta rica em colesterol agravou a intensidade da aterosclerose e mudou os padrões de vulnerabilidade dos subgrupos infectados. / Independent of the presence or not a favorable ambient, mechanisms by which infectious agents may boost atherogenesis and clinical aspects are not fully elucidated. In spite of many demonstrations of infeccious agent antigens or DNA, the question if the infection may iniciate or aggravate the atherosclerotic process remains unanswered, requiring further studies. Therefore, the present work studies if the experimental infection of C57BL/6 apoE KO mice by C. pneumoniae and/or M. pneumoniae induces or affects the intensity of atherosclerosis and its characteristics of plaque vulnerability, with regard to the gender and/or the cholesterolrich diet. Methods: a group of mice was fed with 1% cholesterol-enriched diet (hyperlipidemic), from two months of age; the other group received adequately formulated food for the species (normolipidemic). At eight months of age, the mice were subgrouped according to inoculation intra-peritoneally with 106 IFU of C. pneumoniae and/or 106 CFU of M. pneumoniae, and re-inoculation one month later. They were killed at ten months of age. Cross-sectional thoracic aorta fragments were studied in embedded in paraffin block sections stained Hematoxylin-eosin and Masson?s trichromic techniques. Differences in the median of the variables: plaque height, plaque area, area of fat plaque, luminal area and percent obstruction of the lumen searched using the Mann Whitney?s test, with a 5% level of rejection. Results: the infection by C. pneumoniae and/or M. pneumoniae worsened atherosclerosis in both males and females C57BL/6 apoE KO mice. However, the M. pneumoniae inoculated female group presented more unstable plaques represented by positive remodeling of the vessel. The co-infection by both bacteria induced more stable plaque represented by low fat content and absence of vessel remodeling, in both male and female mice. The introduction of cholesterol enriched diet led to lack of positive vessel remodeling in M.pneumoniae inoculated female group, but development of unstable plaques characterized by large plaque are with high content of fat, in co-infected ones. In male groups there was development of plaque with higher fat content in the subgroup inoculated with C.pneumoniae. Conclusion: Infection by M. pneumoniae and/or C. pneumoniae, in C57BL/6 apoE KO mice, led to development or aggravation of atherosclerotic plaques, with differences regarding intensity and pattern of vulnerability according to the gender versus type of infectious agents. The infected female groups presented more aggravation of atherosclerosis than male ones. Cholesterol enriched diet aggravated the intensity of atherosclerosis and changed the patterns of vulnerability of infected subgroups.

Introduction: Cardiovascular disease (CVD) is the leading cause of global mortality and its prevalence is increasing among black South Africans in spite of their favourable lipid profile. Apolipoprotein E (ApoE) is a well-described risk factor for CVD and certain polymorphisms within this gene alter the lipid profile. The author hypothesised that there are population-specific effects within the ApoE gene that are responsible for the favourable lipid profile observed in black South Africans whose effects are being altered by environmental factors. Objectives: The main aim of this study was to investigate the associations between specific ApoE single nucleotide polymorphisms (SNPs) and the lipid profile of a black South African population, taking into account certain environmental and phenotypic factors in order to explore the interaction effects between these variables. Methods: Genotyping within this cross-sectional study (n=1 588), nested within the Prospective Urban and Rural Epidemiology (PURE) study, was achieved using Illumina‘s® GoldenGate Genotyping Assay with VeraCode® technology on the BeadXpress® platform (proprietary multiplex fluorescent hybridisation assays on a bead array substrate) or the Bio-Rad CFX Manager© (version 2.0). The Konelab20i™ auto analyser was used for quantitative determination of serum total cholesterol; high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) concentrations. Low-density lipoprotein cholesterol concentrations were estimated by the Friedewald equation. Results: All SNPs adhered to the assumptions of the Hardy-Weinberg equilibrium, yet the frequency of the SNPs often differed from that reported in other ethnic groups. The well-reported rs429358 and rs7412 SNPs (as the constituent SNPs of the haplotype-genotypes) presented with the strongest associations with various components of the blood lipid profile in the black South African cohort under investigation. Two gene-environment (rs405509 and rs7412) interaction effects on TG remained significant after conducting post hoc tests. Two genotype-phenotype interaction effects between the rs7412 SNP and body mass index and gamma-glutamyl transferase on the HDL-C concentrations remained significant after conducting post hoc tests. Conclusions: The variety of associations between these particular SNPs and the blood lipid profile determined in the present cohort strongly indicates that it is integral to any public health investigation into CVD development that these SNPs be investigated. This study further produced greater insight into the biological mechanisms underlying serum lipid and cholesterol concentrations in a black South African population. Therefore, from these results it is evident that the lipid profile of black South Africans is most definitely influenced by not only genetic variations in the ApoE gene and certain environmental factors, but by the interaction between these factors as well. The present study is the largest study to date to investigate the effect of polymorphisms in the ApoE gene on the lipid profile of black South Africans. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2014

L‟athérosclérose est un processus inflammatoire chronique à l‟origine des accidents cardiovasculaires quiconstitue l‟une des premières causes de mortalité en France. L‟inflammation est le facteur essentiel dansl‟initiation, la progression et l'instabilité des lésions athéromateuses à l‟origine des accidents aigus. Lesdonnées récentes suggèrent que l‟activation des récepteurs nucléaires PPAR (Peroxysome-ProliferatorActivated Receptor) par des ligands pharmacologiques prévient le développement et la progression del‟athérosclérose et diminue de manière importante la mortalité cardiovasculaire. À côté de ces traitementspharmacologiques, l‟exercice physique prévient aussi la mortalité cardiovasculaire de manière significative.L‟objectif de notre premier travail a été d‟explorer les effets de l‟exercice physique de natation, sur le développementdes lésions athéromateuses d‟une part et d‟autre part, sur l‟expression des récepteurs nucléairesPPAR. Nos résultats montrent que l’exercice physique de natation diminue la progression del’athérosclérose et stimule l’expression des PPAR-γ vasculaires. De manière intéressante, lorsque lePPAR-γ est inhibé avec l'antagoniste BADGE, les effets antiathérogènes de l’exercice physique sontabolis.L‟hypertension est à l‟origine des complications graves telles que la rupture de plaque d‟athérosclérose.L‟objectif de notre deuxième travail a été d‟explorer l‟implication des PPAR dans la progression et la stabilitédes lésions athéromateuses chez des souris ApoE-/- hypercholestérolemiques et hypertendues (2K1C),soumises à des exercices physiques (volontaire ou imposé) ou traités avec le telmisartan, un antihypertenseur.Nos résultats montrent que l’exercice physique possède différents mécanismes protecteurs. Demanière similaire, l‟exercice physique favorise la stabilité de lésions athéromateuses de manière comparableau traitement pharmacologique. De plus, nos résultats montrent que les souris traitées avec l‟exerciceimposé ou le telmisartan présentent un mécanisme comparable qui permet de réduire significativementl‟expression des cytokines pro-inflammatoire et d‟activer les PPAR-γ vasculaires. L‟exercice volontairefavorise l‟expression des marqueurs des macrophages alternatifs Mβ et des cytokines anti-inflammatoires(CD 206, IL-1Ra). L‟exercice volontaire diminue significativement l‟extension des lésions athéromateuses demanière comparable au telmisartan. Ces résultats montrent que l’exercice physique volontaire etl’exercice physique imposé ont deux mécanismes d’actions distincts. De plus, la surexpression des M2en réponse à l‟exercice volontaire modifie la balance inflammatoire en faveur des Mβ. Ce renversement dela balance au profit des macrophages alternatifs M2 est significativement corrélé à la diminution dela progression des lésions athéromateuses.Les exercices imposé et volontaire possèdent des mécanismes d‟action distincts. L‟exercice soumis diminuel‟expression des cytokines pro-inflammatoires tandis que l‟exercice volontaire augmente l‟expression descytokines anti-inflammatoires et favorise un phénotype anti-inflammatoire des macrophages M2 quis‟accompagne d‟une réduction des lésions athéromateuses / Atherosclerosis is a complex inflammatory process, leading cause of morbidity and mortality in France.Inflammation is essential in initiation, progression and atherosclerosis plaque destabilization leading to acutecardiovascular events. Recent studies suggest that pharmacological PPAR activation prevents ATH developpementand progression and decreased cardiovascular mortality. Compared to pharmacological treatment,physical exercise also significantly prevents cardiovascular mortality.The aim of the first study was to investigate the influence of physical exercise on ATS development andPPAR expression in arterial wall. Our results had shown that physical exercise decrease ATH progressionand increase PPAR-γ expression in arterial wall. Interestingly, PPAR-γ inhibition with BADGE, a PPAR-γantagonist abolishes these antiatherogenic effects. Hypertension increase ATH complication such as plaque rupture. The aim of the second study were to investigatePPAR-γ implication in progression and stabilization of ATH lesions in hypercholesterolemic and hypertensiveApoE-/- mice (2K1C) submitted to different exercises (voluntary wheel running and submitted treadmillrunning) or treated with telmisartan an anti-hypertensive drug. Our results shown that, physical exerciseprevents ATS cardiovascular events by several mechanisms. Similarly to telmisartan, physical exercisesstabilize ATH lesion. Moreover results shown that, submitted exercise and telmisartan have an comparablemechanism. In fact, they significantly decrease pro-inflammatory cytokines expression and in the same timeactivated PPAR-γ expression in arterial wall. Contrary to submitted exercise, voluntary exercises increasesexpression of anti-inflammatory cytokines IL-1ra and increase M2 marker CD206. These results suggestthat voluntary and submitted exercise have two different mechanism of action. Moreover, M2 surexpressionin response to voluntary exercise shift the inflammatory balance in favor to M2. Further, this change of balancein favor to M2, is significantly correlated to decrease of ATH progression. Voluntary exercises significantlydecreases ATH progression in the same levels like telmisartan treatment.Voluntary and submitted exercise has two different mechanisms, submitted exercise decrease proinflammatory

Atherosclerosis is a slow-developing disease of large and medium sized arteries, and is the premier cardiovascular disease that underlies myocardial and cerebral infarction, aneurysm, stroke and gangrene of the extremities. At least 17 million people die of atherosclerotic complications each year worldwide, with another 15 million surviving unstable events. Despite therapeutic advances such as drug-eluting stents and statins, which reduce cardiovascular events by around 25%, there is an urgent need for additional strategies to complement these treatments and further reduce morbidity and mortality. Inflammation plays a fundamental role in mediating all stages of atherogenesis. The innate immune response has long been implicated in atherogenesis, and activation of the complement system has been associated with all stages of disease. In particular, C5b-9 (membrane attack complex) has been detected in human plaques and may be pathogenic. Since C5b-9 is produced in plaques then the complement activation product 5a (C5a) must also be generated. However, very little is known about the role of C5a in atherogenesis. Indeed, elevated levels of serum C5a have been detected in patients with advanced atherosclerosis and recently the classical C5a receptor, CD88, has been detected on most of the cells found in human atherosclerotic plaques. To date, no studies examining specific C5a receptor antagonism in an animal model of atherosclerosis have been performed. This thesis explored the potential therapeutic benefits of inhibiting C5a, using the C5a receptor antagonist, PMX53, in the ApoE knockout (ApoE-/-) mouse model of atherosclerosis. In Chapter 2, expression of both receptors to C5a, CD88 and C5L2, in aortae of ApoE -/- mice was explored. CD88 and C5L2 mRNA expression was detected in the aorta of ApoE -/- mice at 3, 5, 9,12, 17 and 25 weeks of age. CD88 expression in ApoE -/- mice increased with time, and with macrophage accumulation within the plaque, as indicated by an increase in expression of the macrophage marker, F4/80. Expresssion of CD88 was significantly increased at 17 and 26 weeks of age, compared with age-matched wild-type controls. C5L2 was also expressed albeit at much lower levels compared with wild-type controls. Having established the presence of C5a receptors in ApoE -/- mice, in Chapter 3, the effects PMX53-treatment on ApoE -/- mice on a normal chow diet was examined. PMX53 treatment (3 mg/kg; tri-weekly s.c., plus ~1mg/kg/day p.o. for 20 weeks) resulted in a significant reduction in neointimal area and therefore the intima:media ratio in the brachiocephalic artery compared to untreated controls (P < 0.05; n = 6-8). PMX53 treatment also reduced collagen content and outward remodelling of the brachiocephalic artery. In Chapter 4, studies exploring the effects of PMX53-treatment in the more inflammatory environment created by a high fat (or Western-type diet) were explored. Male ApoE -/- mice were treated with PMX53 from 5 – 25 weeks of age (3 mg/kg; tri-weekly s.c., plus v ~1mg/kg/day p.o.). Mice were placed on a high fat diet from 10 weeks of age. While PMX53- treated did not affect neo-intimal area, it did result in a significant increase in cell density (P<0.01; n=12) and a significant reduction in buried caps (P < 0.05; n = 12) in the brachiocephalic artery compared with untreated animals. Interestingly, PMX53-treated mice also had significantly reduced total cholesterol compared with untreated controls (P < 0.05; n = 12). These results provide the first evidence for a role for C5a in plaque destabilisation and cholesterol metabolism. Finally, Chapter 5 described the expression of CD88 and C5L2 in cultured primary rat vascular SMC was explored. Expression of CD88 and C5L2 was detected by Western blot; immunocytochemical analysis demonstrated intracellular expression of both C5L2 and CD88. Conversely, radioligand binding experiments suggested the presence of ~25000 cell surface receptors with a high affinity to C5a (KD = 0.3 nM). After establishing the presence of receptors to C5a, experiments were conducted to determine whether C5a has any functional effects on these cells. C5a induced a moderate increase in TNF-α release after 4 hours of treatment (P < 0.05, n = 3), but did not affect SMC proliferation (n = 3). In summary, this study is the first to demonstrate the benefits of specifically inhibiting C5a in a mouse model of atherosclerosis. These findings suggest that C5a plays a role in atherogenesis in ApoE -/- mice and that the C5a receptor antagonist PMX53 may have therapeutic potential in human atherosclerotic disease.