Neointimal hyperplasia (NIH) is a cardiovascular disease characterised by increased smooth muscle cell (SMC) inflammation and proliferation. Suppressor of cytokine signalling 3 (SOCS3) limits Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathways involved in vascular remodelling but is limited by its short biological half-life. Therefore, mutation of all 9 Lys residues that are potential sites of ubiquitylation to Arg should produce a mutated SOCS3 resistant to ubiquitin-mediated proteasomal degradation (“Lys-less” SOCS3). This study hypothesise that enhancing SOCS3 stability and limiting JAK/STAT signalling may provide sustained inhibition of the vascular remodelling in NIH. Lentiviral transduction of WT and Lys-less SOCS3 in human saphenous vein (HSVSMCs) was highly efficient after 48 hours (>97%) and was sustained over 2 weeks. Lys-less SOCS3 was resistant to ubiquitylation contrary to WT-transduced HSVECs, and Lys-less SOCS3 was more stable (t1/2=4h) than WT (t1/2<4h) (n=6, P<0.001) in HSVSMCs. In HSVSMCs, both Lys-less SOCS3 and WT inhibited sIL-6Rα/IL-6 mediated STAT3 activation but not extracellular signal regulated protein kinase 1/2 (ERK1/2) by 80±7% (Lys-lessSOCS3/pSTAT3) and 74±6% (WT/pSTAT3) (n=3, P<0.05) and similarly inhibited PDGF-mediated STAT3 activation but not ERK1/2 by 67±17% (Lys-less SOCS3/pSTAT3) and 72±18% (WT/pSTAT3) (n=3, P<0.05). Functionally, Lys-less SOCS3 and WT were equivalent in inhibiting sIL-6Rα/IL-6 and PDGF-induced proliferation, whilst having no effects on PDGF-induced migration in HSVSMCs. Lys-less SOCS3 can be successfully transduced into primary HSVSMCs. It is more stable than WT yet retains its functional ability to ameliorate pro-inflammatory signalling and SMC proliferation, making it an attractive option for developing treatment of NIH. / University of Botswana

Stroke is an enormous global burden, six and a half-million people die fromstroke annually [1]. Effectively monitoring blood hemodynamic parameters suchas blood velocity and volume flow permits to help and cure people. This projectaimed to calibrate a custom-made wearable system for measuring cerebral bloodflow (CBF) using a photoplethysmography (PPG) sensor. The measurementswere validated using Doppler ultrasound as a reference method. Five (N=5)subjects (age = 24±1.41 years) were selected for the project. The PPG and Dopplerultrasound probe were placed above the left and right common carotid arteries(CCA), respectively. Measurements were taken simultaneously for 12 secondseach, with six consecutive measurements per subject and 2 time-synchronizedECG recordings. Subsequently, using an extraction algorithm the velocityenvelope (TAMEAN) was extracted from the Doppler image to obtain the bloodvolume flow (ml/min). After synchronization, the PPG signal output expressedin volts was calibrated to the corresponding volume, and a calibration curve wascreated.The extraction algorithm achieved remarkable results, with almost perfectcorrelation with the Doppler image reference, rT AM EAN =0.951 and rvolume=0.975demonstrating its reliability. Challenges encountered during postprocessingand synchronization highlighted the need for careful refinement in the projectframework. Despite successful signal processing and alignment techniques,calibration results were suboptimal due to synchronization difficulties andmotion artifacts. Limitations included impractical measurement locations andsusceptibility to movement artifacts. The calibration process did not yield theexpected outcomes and the project aim was not achieved. All the linear regressionmodels for each subject failed to accurately predict the volume flow based on themeasured voltages. Future work could focus on refining calibration procedures,improving synchronization methods, and expanding studies to include largercohorts. Although the wearable device was tested, the project’s goal was onlypartially achieved, underscoring the complexity of accurately measuring cerebralblood flow using PPG sensors. / Stroke är en enorm global börda, sex och en halv miljon människor dör av strokeårligen [1]. Effektiv övervakning av hemodynamiska blodparametrar såsomblodflödeshastighet och volymflöde gör det möjligt att hjälpa och bota människor.Detta projekt syftade till att kalibrera ett specialtillverkat bärbart system föratt mäta cerebralt blodflöde (CBF) med hjälp av en fotopletysmografisensor(PPG). Mätningarna validerades med Doppler-ultraljud som referensmetod. Fem(N=5) försökspersoner (ålder = 24±1.41 år) valdes ut för projektet. PPG- ochDoppler-ultraljudssonden placerades över vänster respektive höger gemensamhalsartär (CCA). Mätningar togs samtidigt i 12 sekunder vardera, med sexpå varandra följande mätningar per försöksperson och 2 tids-synkroniseradeEKG-inspelningar. Därefter användes en extraktionsalgoritm för att extraherahastighetskuvertet (TAMEAN) från Doppler-bilden för att få blodvolymflödet(ml/min). Efter synkronisering kalibrerades PPG-signalens utgång uttryckt i volttill motsvarande volym, och en kalibreringskurva skapades.Extraktionsalgoritmen uppnådde anmärkningsvärda resultat, med nästan perfektkorrelation med Doppler-bildreferensen, rT AM EAN =0.951 och rvolume=0.975,vilket visar dess tillförlitlighet. Utmaningar som uppstod under efterbearbetningoch synkronisering betonade behovet av noggrann förfining av projektetsramverk. Trots framgångsrik signalbehandling och justeringstekniker varkalibreringsresultaten suboptimala på grund av synkroniseringssvårigheteroch rörelseartefakter. Begränsningar inkluderade opraktiska mätplatser ochkänslighet för rörelseartefakter. Kalibreringsprocessen gav inte de förväntaderesultaten och projektmålet uppnåddes inte. Alla linjära regressionsmodellerför varje försöksperson misslyckades med att noggrant förutsäga volymflödetbaserat på de uppmätta spänningarna. Framtida arbete kan fokusera på att förfinakalibreringsprocedurer, förbättra synkroniseringsmetoder och utöka studier tillatt omfatta större kohorter. Även om den bärbara enheten testades, uppnåddesprojektets mål endast delvis, vilket understryker komplexiteten i att noggrantmäta cerebralt blodflöde med hjälp av PPG-sensorer.

Introduktion: Fetal microchimerism är en fysiologisk process som sker under en graviditet, och innebär att ett lågt antal av intakta fosterceller överförs från fostrets blodcirkulation till moderns blodcirkulation via placentan. Fetala celler kan sedan detekteras i moderns cirkulation samt i moderns vävnader i upp till 27 år efter förlossningen. De överförda fetala cellerna ger upphov till livslånga fysiologiska konsekvenser hos modern vad gäller utveckling, hälsa och sjukdom. Syfte: Examenarbetets syfte var att med hjälp av kliniska studier undersöka fördelaktiga och skadliga effekter av fetal microchimerism på moderns fysiologi. Metod: Arbetet är en litteraturstudie baserad på fem kliniska studier sökta från databasen PubMed. Studierna granskades kritiskt tillsammans med andra relevanta artiklar inom ämnetför att besvara litteraturstudiens syfte. Resultat: Studien visade att fetal microchimerism är en process som påverkar moderns fysiologi på både ett fördelaktigt och skadligt vis. Fetal microchimerism ökar risken för uppkomst av autoimmuna sjukdomar, och minskar risken för uppkomst av äggstockscancer, ischemisk hjärtsjukdom samt virussjukdomen Covid-19. Vidare är fetal microchimerism positivt bidragande i fysiologiska processer som sårläkning. Sammantaget visar litteraturstudien att de fördelaktiga processerna av fetal microchimerism är fler än de skadliga, och att immunologiska faktorer spelar en viktig roll. Slutsats: Genom litteraturstudien kan konstateras att fetal microchimerism påverkar moderns fysiologi i flertalet fysiologiska processer, vilket bidrar till att fetal microchimerism kan ses som djupgående och avgörande för moderns hälso- och sjukdomsstatus. / Introduction: Fetal microchimerism is a physiological process during pregnancy and means that a low levels of fetal cells are transmitted from fetal blood circulation to mothers’ blood circulation via the placenta. Fetal cells can then be detected in the mother´s circulation and tissues for up to 27 years after delivery. The transferred fetal cells give rise to lifelong physiological consequences in the mother’s development, health and disease. Aim: The aim of the study was to investigate beneficial and harmful effects of fetal microchimerism on mother´s physiology. Method: This work is a literature review based on five clinical studies from the PubMeddatabase. The studies and other relevant articles on the subject were critically reviewed to answer the purpose of the literature study.  Results: The study showed that fetal microchimerism is a process that affects mother´s physiology both beneficially and harmfully. Fetal microchimerism contributes to the emergence of autoimmune diseases in a negative way and reduces the risk to the emergence of ovarian cancer, ischemic heart disease and Covid-19 in a positive way. Fetal microchimerism is also positively contributing to physiological processes such as wound healing. Overall, the literature study shows that the beneficial effects of fetal microchimerism are more than the harmful andthat immunological factors play an essential role. Conclusion: The study found that fetal microchimerism affects the mother´s physiology in many physical processes, which means that fetal microchimerism is profound and decisive in mother´s health.

Die Magnetresonanztomographie (MRT), die Mehrschicht-Spiral-Computertomographie (MSCT) und die Elektronenstrahl-Computertomographie (EBCT) sind nichtinvasive diagnostische Verfahren, welche die bisherige kardiale Bildgebung zumindest in Teilbereichen ersetzen oder ergänzen können. MR-Perfusions- und MR-Funktionsuntersuchungen konnten in der vorgelegten Arbeit direkte Parameter der myokardialen Vitalität regional erfassen. Die Signalintensitäten im Blut und im Herzmuskel dienten zur quantitativen Bestimmung der Myokardperfusion. Die Ortsauflösung ermöglichte eine Differenzierung der subendo- und der subepikardialen Durchblutung. Zusätzliche Streßuntersuchungen steigerten die Sensitivität des Verfahrens. Relativ geringgradige Koronarstenosen ließen sich durch vornehmlich subendokardial lokalisierte Perfusionsdefekte nachweisen. MR-Tagging- Funktionsanalysen konnten durch ein artifizielles Markierungsgitter zwischen endokardial lokalisiertem Narbengewebe und epikardial liegendem vitalem Gewebe differenzieren. Die Dehnungen, Stauchungen und Rotationen des Myokardverbandes wurden registriert und ausgewertet. Die MSCT und die EBCT wurden als Röntgenverfahren für die nichtinvasive Koronarangiographie verglichen. Bei der Definition der Gefäßkonturschärfe über die Anstiegssteilheit der CT-Dichtewerte zeigte sich eine bessere Abbildungsqualität der MSCT gegenüber der EBCT. Die Bestimmung der Segmenterkennbarkeit zeigte, dass mit der MSCT signifikant mehr erkannt werden konnten. Die vorgestellten kardialen MR- und CT-Untersuchungen konnten aus Gründen der Reproduzierbarkeit sowie aufgrund des Strahlenschutzes nur tierexperimentell durchgeführt werden. Die Validität der unterschiedlichen Tiermodelle ist in vorausgegangenen Studien belegt worden. Die in der Literatur verfügbaren Ergebnisse am Menschen bestätigen in vieler Weise die vorgelegten Daten. / Magnetic resonance imaging (MRI), multislice spiral computed tomography (MSCT), and electron-beam computed tomography (EBCT) are noninvasive imaging modalities that may supplement or in part even replace established diagnostic procedures for assessment of the heart. MRI perfusion and functional studies were shown to enable determination of direct parameters of regional myocardial vitality. The signal intensities of blood and myocardium served to quantify myocardial perfusion. The spatial resolution allowed for differentiating subendocardial and subepicardial perfusion. Additional stress tests improved the sensitivity of the procedure. Relatively low-grade coronary artery stenoses were identified by the presence of perfusion gaps primarily in subendocardial location. Functional analysis by means of MRI tagging using an artificial grid allowed for differentiating endocardial scar tissue from epicardial vital tissue. Extension, compression, and rotation of the myocardial complex were recorded and analyzed. MSCT and EBCT were compared as radiographic procedures for noninvasive coronary angiography. MSCT was found to be superior to EBCT in terms of image quality defined as vascular contour sharpness determined as the steepness of the increase in CT densities. Assessment of segment identification showed that significantly more segments were visualized by MSCT. The cardiac MRI and CT studies presented here could only be performed in animals because of the radiation exposure involved and to ensure reproducibility of the results. The validity of the different animal models used has been demonstrated in preceding studies. The results of the present animal experiments are in agreement with many of the human data published in the literature.

<strong>Chapter 1</strong> Provides an overview of drug discovery with particular emphasis on library selection and hit identification methods using virtual based approaches. <strong>Chapter 2</strong> Gives an outline of the bone morphogenetic protein (BMP) signalling pathway and literature BMP pathway modulators. The association between the regulation of BMP pathway and cardiomyogenesis is also described. <strong>Chapter 3</strong> Describes the use of ligand based virtual screening to discover small molecule activators of the BMP signalling pathway. A robust cell based BMP responsive gene activity reporter assay was developed to test the libraries of small molecules selected. Hit molecules from the screen were synthesised to validate activity. It was found that a group of known histone deacetylase (HDAC) inhibitors displayed most promising activity. These were evaluated in a secondary assay measuring the expression of two BMP pathway regulated genes, hepcidin and Id1, using reverse transcription polymerase chain reaction (RT-PCR). 188 was discovered to increase expression of both BMP-responsive genes. <strong>Chapter 4</strong> Provides an overview of existing cannabinoid receptor (CBR) modulating molecules and their connection to progression of atherosclerosis. <strong>Chapter 5</strong> Outlines the identification and optimisation of selective small molecule agonists acting at the cannabinoid 2 receptor (CB₂R). Ligand based virtual screen was undertaken and promising hits were synthesised to allow structure activity relationship (SAR) to be developed around the hit molecule providing further information of the functional groups tolerated at the active site. Subsequent studies led to the investigation and optimisation of physicochemical properties around 236 leading to the development of a suitable compound for in vivo testing. Finally, a CB₂R selective compound with favourable physicochemical properties was evaluated in vivo in a murine inflammation model and displayed reduced recruitment of monocytes to the site of inflammation.

Background: Research in heart disease can be aided by modelling myocardial hemodynamics with knowledge of coronary pressure and vascular resistance measured from the geometry and morphometry of coronary vasculature. This study presents methods to automatically reconstruct accurate detailed coronary vascular anatomical models from high-resolution three-dimensional optical fluorescence cryomicrotomography image volumes for simulating blood flow in coronary arterial trees. Methods: Images of fluorescent cast and bead particles perfused into the same heart comprise the vasculature and microsphere datasets, employed in a novel combined approach to measure vasculature and simulate a flow model on the extracted coronary vascular tree for estimating regional myocardial perfusion. The microspheres are used in two capacities - as fiducial biomarker point sources for measuring the image formation in order to accurately measure the vasculature dataset and as flowing particles for measuring regional myocardial perfusion through the reconstructed vasculature. A new model-based template-matching method of vascular radius estimation is proposed that incorporates a model of the optical fluorescent image formation measured from the microspheres and a template of the vessels’ tubular geometry. Results: The new method reduced the error in vessel radius estimation from 42.9% to 0.6% in a 170 micrometer vessel as compared to the Full-Width Half Maximum method. Whole-organ porcine coronary vascular trees, automatically reconstructed with the proposed method, contained on the order of 92,000+ vessel segments in the range 0.03 – 1.9 mm radius. Discrepancy between the microsphere perfusion measurements and regional flow estimated with a 1-D steady state linear static blood flow simulation on the reconstructed vasculature was modelled with daughter-to-parent area ratio and branching angle as the parameters. Correcting the flow simulation by incorporating this model of disproportionate distribution of microspheres reduced the error from 24% to 7.4% in the estimation of fractional microsphere distribution in oblique branches with angles of 100°-120°.

Nitric oxide (NO) is an important biological molecule within the body, which over production of this molecule in response to different stimulations can cause various inflammatory diseases. Over production of this molecule is caused by the induction of the inducible nitric oxide synthase (iNOS) enzyme. This enzyme uses L-arginine as a substrate and therefore the presence and transport of this amino acid into the cells can be a key factor in regulating NO over production. Different signalling mechanisms have been implicated in the regulation of this pathway and one of which involves the Mitogen Activated Protein Kinases (MAPK). This family of proteins respond to inflammatory conditions and may mediate effects induced by inflammatory mediators. Of the MAPKs, the role of the c-Jun-N-terminal kinase (JNK) pathway in the induction of iNOS is still controversial. JNK and its downstream target, the transcription factor Activator Protein-1 (AP-1), have shown contradictory effects on iNOS induction leading to controversies over their role in regulating iNOS expression in different cell systems or with various stimuli. The studies described in this thesis have determined the role of JNK/AP-1 on iNOS expression, NO production, L-arginine uptake and also on the transporters responsible for L-arginine transport into the cells. The studies were carried out in two different cell types: rat aortic smooth muscle cells (RASMCs) and J774 macrophages which are both critically associated with the over production of NO in vascular inflammatory disease states. The first approach was to block the expression of the inducible L-arginine-NO pathway using SP600125 and JNK Inhibitor VIII which are both pharmacological inhibitors of JNK. The results from these studies showed that the pharmacological intervention was without effect in RASMCs, but inhibited iNOS, NO and L-arginine transport in J774 macrophages. In contrast, the molecular approach employed using two dominant negative constructs of AP-1 (TAM-67 and a-Fos) revealed a different profile of effects in RASMCs, where a-Fos caused an induction in iNOS and NO while TAM-67 had an inhibitory effect on iNOS, NO, L-arginine transport and CAT-2B mRNA expression. The latter was unaffected in RASMCs but suppressed in J774 macrophages by SP600125. Examination of JNK isoforms expression showed the presence of JNK1 and 2 in both cell systems. Moreover, stimulation with LPS/IFN- or LPS alone resulted in JNK phosphorylation which did not reveal any difference between smooth muscle cells and macrophages. In contrast, expression and activation of AP-1 subunits revealed differences between the two cell systems. Activation of cells with LPS and IFN- (RASMCs) or LPS alone (J774 macrophages) resulted in changes in the activated status of the different AP-1 subunit which was different for the two cell systems. In both cell types c-Jun, JunD and Fra-1 were increased and in macrophages, FosB activity was also enhanced. Inhibition of JNK with SP600125 caused down-regulation in c-Jun in both cell types. Interestingly this down-regulation was in parallel with increases in the subunits JunB, JunD, c-Fos and Fra-1 in RASMCs or JunB and Fra-1 in J774 macrophages. Since, SP600125 was able to exert inhibitory effects in the latter cell type but not in RASMCs, it is possible that the compensatory up-regulation of certain AP-1 subunits in the smooth muscle cells may compensate for c-Jun inhibition thereby preventing suppression of iNOS expression. This notion clearly needs to be confirmed but it is potentially likely that hetero-dimers formed between JunB, JunD, c-Fos and Fra-1 could sustain gene transcription in the absence of c-Jun. The precise dimer required has not been addressed but unlikely to exclusively involve JunB and Fra-1 as these are up-regulated in macrophages but did not sustain iNOS, NO or induced L-arginine transport in the presence of SP600125. To further support the argument above, the dominant negatives caused varied effects on the activation of the different subunits. a-Fos down-regulated c-Jun, c-Fos, FosB, Fra-1 whereas TAM-67 reduced c-Jun and c-Fos but marginally induced Fra-1 activity. Associated with these changes was an up-regulation of iNOS-NO by a-Fos and inhibition by TAM-67. Taken together, the data proposes a complex mechanism(s) that regulate the expression of the inducible L-arginine-NO pathway in different cell systems and the complexity may reflect diverse intracellular changes that may be different in each cell type and not always be apparent using one experimental approach especially where this is pharmacological. Moreover, these findings strongly suggest exercising caution when interpreting pure pharmacological findings in cell-based systems particularly where these are inconsistent or contradictory.

Diabetic vasculopathy (DV) is the most important consequence of chronic hyperglycemia in patients with diabetes mellitus (DM). This thesis explores the interaction of blood, bone and kidney in the pathogenesis of DV by i) reviewing the current understanding of pathogenesis of macrovascular and microvascular diseases in DM to identify gaps in literature and generate hypotheses relating to various facets of DV ii) undertaking a series of prospective studies to examine these hypotheses iii) analysing the findings and integrating any new information obtained from the clinical studies into the current knowledge base and iv) generating hypotheses upon which future work might be based. The literature search was carried out with the aim of understanding current concepts of pathogenesis of DV and its potential modulators. The original reviews resulting from this process are presented in chapters 2 to 4. A series of pilot studies reported in chapters 7 to 11, were then carried out to interrogate hypotheses originating from this process. The first study was carried out in healthy individuals to define the biological variation of potential modulators of DV, namely erythropoietin (EPO), parathyroid hormone, 25 hydroxyvitamin D and 1, 25-dihydroxyvitamin D to facilitate the design and interpretation of subsequent studies. It revealed a wide biological variation of these modulators in the healthy population thus,emphasizing the need to have a control group in the subsequent study population. To examine whether tubulointerstitial dysfunction occurs before the onset of microalbuminuria, a measurement of the above mentioned parameters was carried out along with markers of tubulointerstitial injury in patients with type 1 and type 2 DM without microalbuminuria and in non-diabetic controls. It was found that tubulointerstitial dysfunction with low levels of EPO and 1, 25-dihydroxyvitamin D and higher excretion of tubular injury markers, occurs before the onset of microalbuminuria. Subsequently, diabetic and nondiabetic chronic kidney disease (CKD) patients with EPO deficiency anaemia were examined to study the effects of EPO therapy on the excretion of tubular injury markers. However, in these patient groups, we were unable to demonstrate an effect of EPO therapy on the markers of tubular injury in spite of a beneficial haematological response. To examine whether vascular calcification (VC) and bone mineral density (BMD) were linked in patients with diabetes mellitus and to explore their relationship to modulators of DV, an assessment of VC and BMD was undertaken in patients with type 2 DM with different degrees of proteinuria and normoalbuminuria. VC was assessed by CT scan and BMD by a DEXA scan. Modulators of DV were measured including serum Osteoprotegerin (OPG) and receptor activator of nuclear factor kappa-b-ligand (RANKL). The findings were i) a high prevalence of VC and osteopenia in normoalbuminuric type 2 DM patients with normal serum creatinine ii) a weak inverse relationship between VC and osteopenia iii) proteinuric patients had worse VC but not osteopenia iv) weak relationships between OPG levels and both VC and osteopenia, masked by age in multivariate analysis. The final study examined the relationship between modulators of DV, including OPG and RANKL, and the degree of CKD. It was found that abnormalities of OPG and RANKL occur before the onset of microalbuminuria and progress with deterioration of renal function. Compared to nondiabetics, DM patients have higher OPG levels in the predialysis phase and lower levels in haemodialysis phase, a phenomenon that might indicate endothelial exhaustion in dialysis patients with DM. The derangements associated with DV seem to occur earlier than previously thought. Further work is required to untangle these complexities and to define the contribution of factors such as the adverse blood milieu, the vasculature, abnormal bone and mineral metabolism, and early tubulointerstitial damage. The findings from the studies reported here may help in the formulation of new hypotheses, which might contribute to future work in this area.

Advancements in clinical care have led to a growing cohort of preterm-born individuals now entering adulthood. Before birth, such adults were often exposed to a suboptimal intrauterine environment, and after delivery, key developmental stages that would normally occur in utero during the third trimester had to take place under ex utero physiological conditions. Through detailed cardiovascular phenotyping, this thesis investigates the cardiovascular changes in preterm-born young adults, utilising a cohort of individuals with data collection since recruitment at birth. The detailed perinatal information was first used to design nested case-control studies to investigate the effects of early lipid and glucocorticoid exposure on long-term cardiovascular physiology in individuals born preterm. It was demonstrated that intravenous lipid administration leads to an artificial elevation of total cholesterol levels in immediate postnatal life, which is associated with long-term changes in aortic and left ventricular function proportional to the degree of cholesterol elevation. Additionally, exposure to antenatal glucocorticoids relates to a regional increase in aortic arch stiffness in young adulthood, as well as changes in glucose metabolism. It was then shown that young adults born preterm have increased left ventricular mass, out of proportion to blood pressure, and a unique three-dimensional left ventricular geometry, with reduced systolic and diastolic function compared to term-born controls. Similarly, they also show distinct differences in the right ventricle, with increased right ventricular mass and a proportion having clinically impaired right ventricular systolic function. Finally, it was demonstrated that preterm-born individuals have increased circulating levels of antiangiogenic factors in young adulthood, which relate to capillary rarefaction and blood pressure elevation. These findings are of considerable public health relevance given that nearly 10% of births are now preterm. Understanding whether modification of these variations in cardiovascular structure and function prevent the development of cardiovascular disease in this growing subgroup of the population will be of future interest.

La dysfonction de l’endothélium vasculaire, associée à une diminution de ses propriétés vasorelaxantes et anti-thrombogéniques, survient avec le vieillissement mais également chez de plus jeunes patients athérosclérotiques présentant plusieurs facteurs de risque cardiovasculaire. Au niveau cellulaire, le vieillissement des cellules endothéliales (CE) mène à un état irréversible de non division cellulaire appelé sénescence. Ces cellules sénescentes présentent des changements spécifiques au niveau de leur morphologie et de l’expression génique, menant à leur dysfonction. La sénescence dite réplicative est déclenchée par le raccourcissement des télomères survenant à chaque division cellulaire, mais peut également être induite prématurément par le stress oxydant (SIPS). L’objectif principal de cette étude est de caractériser la sénescence de CE vasculaires isolées à partir de patients athérosclérotiques, et d’observer l’impact des facteurs de risque sur cette sénescence. Afin de confirmer la contribution des deux principales voies de la sénescence, nous avons par la suite étudié conjointement ou séparément, l’impact d’un traitement chronique avec un antioxydant sur la sénescence de CE, et d’une surexpression de la sous-unité catalytique de la télomérase (hTERT), une enzyme responsable de l’allongement des télomères. Nous avons isolé et cultivé des CE provenant d’artères mammaires internes prélevées lors de pontages coronariens. Selon les études, les cellules ont été infectées ou non avec un lentivirus surexprimant la hTERT, et cultivées in vitro jusqu’à sénescence, en présence ou en absence de l’antioxydant N-acétyl-L-cystéine (NAC). Différents marqueurs des deux principales voies de la sénescence (réplicative ou SIPS) ont été quantifiés. La sénescence cellulaire se développe exponentiellement avec le temps et est associée à une réduction de la viabilité et de la prolifération cellulaires. Chez les patients athérosclérotiques, le vieillissement des CE passe par les deux principales voies de la sénescence : des télomères courts initialement en culture et la durée d’exposition in vivo aux facteurs de risque cardiovasculaire prédisent une apparition prématurée de la sénescence. Toutefois, chez les fumeurs, la sénescence est exclusivement du type SIPS. Ces facteurs de risque cardiovasculaire et principalement l’hypertension, semblent accélèrer le vieillissement biologique et favoriser la dysfonction des CE. Lorsque traitées chroniquement avec le NAC, les CE présentant initialement de moindres dommages cellulaires et moléculaires ainsi qu’une meilleure défense antioxydante développent une sénescence retardée. Lorsque le NAC est combiné à une surexpression de la hTERT, les deux voies de la sénescence sont bloquées et une immortalisation cellulaire est observée. À l’inverse, dans les CE les plus endommagées par les ROS in vivo, le NAC n’a aucun effet sur le développement de la sénescence, la hTERT, seule ou en combinaison avec le NAC, retarde légèrement la sénescence mais aucune immortalisation n’est observée lorsque ces traitements sont combinés. En conclusion, nos études démontrent que l’exposition chronique au stress oxydant associé aux facteurs de risque cardiovasculaire accélère le développement de la sénescence de CE vasculaires, contribuant potentiellement à l’athérogénèse. Dans les cellules de patients athérosclérotiques, il semble exister un seuil de dommages cellulaires et moléculaires subis in vivo au-delà duquel, aucun traitement (antioxydant ou hTERT) ne peut être bénéfique. / Vascular aging is associated with a decrease in endothelial dilatory and antithrombotic functions. This typical endothelial dysfunction, however, is also present in younger patients with cardiovascular diseases (CVD). At the cellular level, aging of healthy vascular endothelial cells (EC) leads to senescence, a state of permanent growth arrest. Senescence is characterized by specific changes in cell morphology and gene expression, which reduce EC function and thus are proposed to be pro-atherogenic. Age-associated telomere shortening leads to replicative senescence of human endothelial cells, but senescence can also be induced prematurely by oxidative stress (SIPS). Our aim was to characterize senescence of EC isolated from atherosclerotic patients and look at the influence of risk factors for CVD on the onset of senescence. To confirm the contribution of each of the two mains pathways triggering senescence, we then looked at the impact on senescence of a chronic treatment with an antioxidant combined or not with an overexpression of the catalytic subunit of telomerase (hTERT), a reverse transcriptase involved in telomere elongation. We used EC isolated from internal mammary arteries discarded during coronary bypass graft surgery. Depending on the study, EC were infected or not with a lentivirus overexpressing hTERT, and cells were cultured in vitro until senescence, in the presence or the absence of the antioxidant N-acetyl-L-cysteine (NAC). Different markers of the two main pathways of senescence (replicative ou SIS) were quantified. Senescence develops exponentially with time in culture and is associated with a decrease in cell viability and proliferation. In atherosclerotic patients, cellular aging displays an overlap between replicative and stress-induced senescence: short initial telomere length in vitro and a long exposure to risk factors for CVD in vivo predict the onset of a premature senescence. However, in smoking patients, premature senescence is exclusively induced by oxidative stress. Risk factors for CVD seem to accelerate the biological aging leading to EC dysfunction. When treated chronically with NAC, EC presenting initially lower levels of damage and a better endogenous antioxidant capacity develop a delayed senescence, probably due to a slight hTERT activation. When NAC is combined with an overexpression of hTERT, both pathways triggerring senescence are blocked and cellular immortalization is observed. In contrast, in EC presenting higher levels of damage undergone in vivo, NAC has no effect by itself on the onset of senescence, hTERT delays the onset of senescence in combination or not with NAC, but no cellular immortalization was observed in NAC-hTERT cells. In conclusion, our studies show that a chronic in vivo exposition to oxidative stress associated with risk factors for CVD accelerates the onset of vascular endothelial cells senescence that could potentially contribute to atherogenesis. EC having strong antioxidant defense capacity and DNA repair mechanisms may be rescued from replicative and stress-induced senescence unless EC have undergone an insurmountable cellular and molecular damage possibly due to uncontrolled free radical production associated with risk factors for CVD.