Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

INTRODUÇÃO: As doenças retinianas associadas à neovascularização, tais como a degeneração macular relacionada à idade e as retinopatias diabética e da prematuridade são as principais e mais importantes causas da cegueira em todo o mundo. Nos últimos anos, injeções intravítreas de fármacos com ação antiangiogênica, como o bevacizumabe (BVZ), têm sido de grande valia tanto em pacientes na fase adulta quanto nos recém-natos. Todavia, estudos experimentais in vitro e in vivo sugerem que essas drogas promovam efeitos adversos sobre alguns processos celulares, interferindo diretamente em mecanismos fisiológicos que mantém a homeostase do tecido retiniano, incluindo os mecanismos de proliferação, diferenciação e morte celular. OBJETIVO: investigar o efeito do BVZ nos processos de transcrição e tradução de marcadores da gliose: GFAP e vimentina, de morte celular, caspase-3 e beclina-1, e dos proteoglicanos relacionados à manutenção e desenvolvimento de tecido retiniano: neurocam, fosfacam e sindecam-3. MÉTODOS: Dois modelos experimentais foram usados nesse estudo: 1) linhagem celular de Müller de Glia humana adulta (MIO-M1), cultivada em meio de cultura D-MEM na presença e ausência de BVZ por 12 e 24 horas nas concentrações de 0,25 mg/mL e 0,50 mg/mL e 2) explantes de retinas de ratos 2 dias pós-nascidos submetidos à 0,50 mg/mL da droga por 48 horas. Durante este período foram mantidos a 5% de dióxido de carbono à temperatura de 37°C. A análise de proteínas foi realizada por imunocitohistoquímica e Western Blotting e a expressão de RNAm, pela reação em cadeia da polimerase em tempo real (PCR Real Time). Foi utilizado o Teste de ANOVA - fator único para a comparação entre os grupos controle e tratados com BVZ de um mesmo período (12h ou 24h) e o teste t de Student para a comparação entre as mesmas concentrações de 12h e 24h, e para a comparação entre os grupos controle e tratado com BVZ dos explantes (p < 0,05). RESULTADOS: Nas células MIO-M1, o BVZ, aumentou a expressão gênica e diminui a tradução de VEGF na concentração de 0,50 mg/mL em 24h comparado a 12h. Para o GFAP, houve um aumento da transcrição em 0,50 mg/mL em 24h comparado a 12h e aos outros grupos em 24h. Entretanto, houve diminuição da tradução para estes mesmos períodos e condições. Para a vimentina, houve aumento na transcrição em 0,50 mg/mL após 24h. Os achados de beclina-1 revelaram uma diminuição da transcrição e tradução em 0,25 mg/mL em 24h comparado a 12h. A transcrição entre os grupos do mesmo período aumentou nos grupos tratados com BVZ tanto em 12h quanto em 24h. A tradução da beclina-1 diminuiu em 0,25 mg/mL, mas aumentou em 0,50 mg/mL em 24h em relação à 12h. A comparação entre os grupos de 24h revelou aumento da tradução em 0,50 mg/mL. Para a caspase-3, houve diminuição da transcrição em 0,25 mg/mL e 0,50 mg/mL em 24h em relação a 12h e entre nos grupos tratados com BVZ em 24h. A tradução revelou um aumento em 0,50 mg/mL em 24h em relação a 12h. No fosfacam, houve diminuição da transcrição em 0,50 mg/mL em 24h comparado a 12h e entre os grupos tratados com BVZ e controles para 12h e 24h. A transcrição de neurocam diminuiu em 0,25 mg/mL e 0,50 mg/mL em 24h comparado a 12h e entre os grupos tratados com BVZ e controles em 12h e 24h. A tradução aumentou em 0,50 mg/mL em 24h em relação a 12h, mas diminuiu entre os grupos em 24h. Nos explantes, a transcrição e tradução de VEGF diminuiram no grupo tratado com BVZ após 48h. CONCLUSÃO: Nossos resultados relacionados às células MIO-M1 e ao explante de ratos, in vitro, nos permitem aventar o possível comprometimento ocasionado pela depleção do VEGF pelo BVZ na homeostase do tecido retiniano, in vivo, interferindo nas moléculas envolvidas na morte e diferenciação celular e na neuroproteção em indivíduos em fase adulta e recém-nato / Backgraound: Vasoproliferative retinal disorders such as age-related macular, degeneration, diabetic retinopathy and retinopathy of prematurity are major causes of blindness in the world. In recent years, intravitreal injections of drugs with antiangiogenic action, as bevacizumab, have been very useful for both patients in adulthood and in newborns. However, experimental studies, in vivo and in vitro, suggest that antiangiogenic drugs may promote side effects in cellular proceedings, interfering directly in physiological mechanisms of cellular proliferation, differentiation and death. POURPOSE: Investigate the bevacizumab effects in transcription and translation processes of gliosis, GFAP and vimentin, cellular death markers, caspase-3 and beclin-1, and proteoglycans involved in retinal tissue maintenance and development, neurocan, phosphacan and syndecan-3. METHODS: Two experimental models were used on this research: cellular lineage of adult and human Müller glial cell(MIO-M1) were cultivated on D-MEM medium with 0,25 and 0,50 mg/mL bevacizumab for 12 and 24 hours, and two days old rat retinal explants submitted to 0,50 mg/mL for 48 hours. During this period were stored in laboratory ovens at 5% carbon dioxide pressure and 37 °C average temperature. Molecular techniques were used to evaluate gene expression and protein content. Protein assessments were performed by immunocytochemistry and western blotting analysis, while Real Time PCR was used to measure mRNA content. ANOVA tests one factor were applied to compare the control and BVZ groups of the same period (12h or 24h) and t test from Student to compare the same conditions of 12h and 24h, and to compare the control and BVZ retinal explants groups (p<0.05). RESULTS: At MIO-M1 cells, BVZ increased the gene expression and reduced the translation of VEGF at concentration of 0.50 mg / mL in 24 hours compared to 12 hours. For GFAP, there was an increase of transcription at 0.50 mg / mL in 24 hours compared to 12 hours and to the other groups at 24 hours. However, there was a decrease in translation for these same periods and conditions. For vimentin, there was an increase in transcription at 0.50 mg / mL after 24 hours. The beclin-1 findings revealed a decrease of transcription and translation at 0.25 mg / ml compared at 24 h compared to 12h. Transcription among groups increased in BVZ treated groups at 12h and 24h. The translation of beclin-1 decreased at 0.25 mg / ml, but increased at 0.50 mg / mL at 24 hours compared to 12 hours. The comparison between the groups at 24h revealed an increased in translation at 0.50 mg / mL. For caspase-3, there was a decrease in transcription at 0.25 mg / ml and 0.50 mg / ml at 24 compared to 12 hours and among BVZ treated groups at 24h. Translation revealed an increase at 0.50 mg / mL at 24 hours compared to 12 hours. For fosfacam, there was a decreased in transcription at 0.50 mg / mL in 24 hours compared to 12 hours and among BVZ treated groups and controls at 12h and 24h. The transcription of neurocam decreased at 0.25 mg / ml and 0.50 mg / ml at 24 hours compared to 12 hours and among BVZ treated groups and controls at 12h and 24h. Translation increased at 0.50 mg / mL at 24 compared to 12 hours, but decreased among the groups at 24 hours. For explants, transcription and translation of VEGF decreased in the BVZ group treated after 48h. CONCLUSION: Our results related to the MIO-M1 cells and explants of rats,in vitro, allow us to suggest the possible impairment caused by depletion of VEGF by BVZ in the homeostasis of retinal tissue, in vivo, interfering in the molecules involved in cell death and cell differentiation and neuroprotection in individuals in adulthood and newborns

INTRODUÇÃO: As doenças retinianas associadas à neovascularização, tais como a degeneração macular relacionada à idade e as retinopatias diabética e da prematuridade são as principais e mais importantes causas da cegueira em todo o mundo. Nos últimos anos, injeções intravítreas de fármacos com ação antiangiogênica, como o bevacizumabe (BVZ), têm sido de grande valia tanto em pacientes na fase adulta quanto nos recém-natos. Todavia, estudos experimentais in vitro e in vivo sugerem que essas drogas promovam efeitos adversos sobre alguns processos celulares, interferindo diretamente em mecanismos fisiológicos que mantém a homeostase do tecido retiniano, incluindo os mecanismos de proliferação, diferenciação e morte celular. OBJETIVO: investigar o efeito do BVZ nos processos de transcrição e tradução de marcadores da gliose: GFAP e vimentina, de morte celular, caspase-3 e beclina-1, e dos proteoglicanos relacionados à manutenção e desenvolvimento de tecido retiniano: neurocam, fosfacam e sindecam-3. MÉTODOS: Dois modelos experimentais foram usados nesse estudo: 1) linhagem celular de Müller de Glia humana adulta (MIO-M1), cultivada em meio de cultura D-MEM na presença e ausência de BVZ por 12 e 24 horas nas concentrações de 0,25 mg/mL e 0,50 mg/mL e 2) explantes de retinas de ratos 2 dias pós-nascidos submetidos à 0,50 mg/mL da droga por 48 horas. Durante este período foram mantidos a 5% de dióxido de carbono à temperatura de 37°C. A análise de proteínas foi realizada por imunocitohistoquímica e Western Blotting e a expressão de RNAm, pela reação em cadeia da polimerase em tempo real (PCR Real Time). Foi utilizado o Teste de ANOVA - fator único para a comparação entre os grupos controle e tratados com BVZ de um mesmo período (12h ou 24h) e o teste t de Student para a comparação entre as mesmas concentrações de 12h e 24h, e para a comparação entre os grupos controle e tratado com BVZ dos explantes (p < 0,05). RESULTADOS: Nas células MIO-M1, o BVZ, aumentou a expressão gênica e diminui a tradução de VEGF na concentração de 0,50 mg/mL em 24h comparado a 12h. Para o GFAP, houve um aumento da transcrição em 0,50 mg/mL em 24h comparado a 12h e aos outros grupos em 24h. Entretanto, houve diminuição da tradução para estes mesmos períodos e condições. Para a vimentina, houve aumento na transcrição em 0,50 mg/mL após 24h. Os achados de beclina-1 revelaram uma diminuição da transcrição e tradução em 0,25 mg/mL em 24h comparado a 12h. A transcrição entre os grupos do mesmo período aumentou nos grupos tratados com BVZ tanto em 12h quanto em 24h. A tradução da beclina-1 diminuiu em 0,25 mg/mL, mas aumentou em 0,50 mg/mL em 24h em relação à 12h. A comparação entre os grupos de 24h revelou aumento da tradução em 0,50 mg/mL. Para a caspase-3, houve diminuição da transcrição em 0,25 mg/mL e 0,50 mg/mL em 24h em relação a 12h e entre nos grupos tratados com BVZ em 24h. A tradução revelou um aumento em 0,50 mg/mL em 24h em relação a 12h. No fosfacam, houve diminuição da transcrição em 0,50 mg/mL em 24h comparado a 12h e entre os grupos tratados com BVZ e controles para 12h e 24h. A transcrição de neurocam diminuiu em 0,25 mg/mL e 0,50 mg/mL em 24h comparado a 12h e entre os grupos tratados com BVZ e controles em 12h e 24h. A tradução aumentou em 0,50 mg/mL em 24h em relação a 12h, mas diminuiu entre os grupos em 24h. Nos explantes, a transcrição e tradução de VEGF diminuiram no grupo tratado com BVZ após 48h. CONCLUSÃO: Nossos resultados relacionados às células MIO-M1 e ao explante de ratos, in vitro, nos permitem aventar o possível comprometimento ocasionado pela depleção do VEGF pelo BVZ na homeostase do tecido retiniano, in vivo, interferindo nas moléculas envolvidas na morte e diferenciação celular e na neuroproteção em indivíduos em fase adulta e recém-nato / Backgraound: Vasoproliferative retinal disorders such as age-related macular, degeneration, diabetic retinopathy and retinopathy of prematurity are major causes of blindness in the world. In recent years, intravitreal injections of drugs with antiangiogenic action, as bevacizumab, have been very useful for both patients in adulthood and in newborns. However, experimental studies, in vivo and in vitro, suggest that antiangiogenic drugs may promote side effects in cellular proceedings, interfering directly in physiological mechanisms of cellular proliferation, differentiation and death. POURPOSE: Investigate the bevacizumab effects in transcription and translation processes of gliosis, GFAP and vimentin, cellular death markers, caspase-3 and beclin-1, and proteoglycans involved in retinal tissue maintenance and development, neurocan, phosphacan and syndecan-3. METHODS: Two experimental models were used on this research: cellular lineage of adult and human Müller glial cell(MIO-M1) were cultivated on D-MEM medium with 0,25 and 0,50 mg/mL bevacizumab for 12 and 24 hours, and two days old rat retinal explants submitted to 0,50 mg/mL for 48 hours. During this period were stored in laboratory ovens at 5% carbon dioxide pressure and 37 °C average temperature. Molecular techniques were used to evaluate gene expression and protein content. Protein assessments were performed by immunocytochemistry and western blotting analysis, while Real Time PCR was used to measure mRNA content. ANOVA tests one factor were applied to compare the control and BVZ groups of the same period (12h or 24h) and t test from Student to compare the same conditions of 12h and 24h, and to compare the control and BVZ retinal explants groups (p<0.05). RESULTS: At MIO-M1 cells, BVZ increased the gene expression and reduced the translation of VEGF at concentration of 0.50 mg / mL in 24 hours compared to 12 hours. For GFAP, there was an increase of transcription at 0.50 mg / mL in 24 hours compared to 12 hours and to the other groups at 24 hours. However, there was a decrease in translation for these same periods and conditions. For vimentin, there was an increase in transcription at 0.50 mg / mL after 24 hours. The beclin-1 findings revealed a decrease of transcription and translation at 0.25 mg / ml compared at 24 h compared to 12h. Transcription among groups increased in BVZ treated groups at 12h and 24h. The translation of beclin-1 decreased at 0.25 mg / ml, but increased at 0.50 mg / mL at 24 hours compared to 12 hours. The comparison between the groups at 24h revealed an increased in translation at 0.50 mg / mL. For caspase-3, there was a decrease in transcription at 0.25 mg / ml and 0.50 mg / ml at 24 compared to 12 hours and among BVZ treated groups at 24h. Translation revealed an increase at 0.50 mg / mL at 24 hours compared to 12 hours. For fosfacam, there was a decreased in transcription at 0.50 mg / mL in 24 hours compared to 12 hours and among BVZ treated groups and controls at 12h and 24h. The transcription of neurocam decreased at 0.25 mg / ml and 0.50 mg / ml at 24 hours compared to 12 hours and among BVZ treated groups and controls at 12h and 24h. Translation increased at 0.50 mg / mL at 24 compared to 12 hours, but decreased among the groups at 24 hours. For explants, transcription and translation of VEGF decreased in the BVZ group treated after 48h. CONCLUSION: Our results related to the MIO-M1 cells and explants of rats,in vitro, allow us to suggest the possible impairment caused by depletion of VEGF by BVZ in the homeostasis of retinal tissue, in vivo, interfering in the molecules involved in cell death and cell differentiation and neuroprotection in individuals in adulthood and newborns

<p>Women with pregestational diabetes have a 2-5 fold increased risk of giving birth to malformed babies compared with non-diabetic women. Diabetes-induced oxidative stress in maternal and embryonic tissues has been implicated in the teratogenic process. The malformations are likely to be induced before the seventh week of pregnancy, when the yolk sac is partly responsible for the transfer of metabolites to the embryo, and the uterine blood flow to the implantation site determines the net amount of nutrients available to the conceptus. We aimed to evaluate the effect on embryogenesis caused by a diabetes-induced disturbance in yolk sac morphology, uterine blood flow or altered maternal antioxidative status in conjunction with a varied severity of the maternal diabetic state.</p><p>We investigated to which extent maternal diabetes with or without folic acid (FA) supplementation affects mRNA levels and protein distribution of ROS scavenging enzymes (SOD, CAT, GPX), vascular endothelial growth factor-A (Vegf-A), folate binding protein-1 (Folbp-1), and apoptosis associated proteins (Bax, Bcl-2, Caspase-3) in the yolk sacs of rat embryos on gestational days 10 and 11. We found that maternal diabetes impairs, and that FA supplementation restores, yolk sac vessel morphology, and that maternal diabetes is associated with increased apoptotic rate in embryos and yolk sacs, as well as impaired SOD gene expression. We assessed uterine blood flow with a laser-Doppler-flow-meter and found increased blood flow to implantation sites of diabetic rats compared with controls. Furthermore, resorbed and malformed offspring showed increased and decreased blood flow to their implantation sites, respectively. In mice with genetically altered CuZnSOD levels, maternal diabetes increased embryonic dysmorphogenesis irrespective of CuZnSOD expression. We thus found the maternal diabetic state to be a major determinant of diabetic embryopathy and that the CuZnSOD status exerts a partial protection for the embryo in diabetic pregnancy. </p>

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal.

Traumatic brain injury (TBI) has a dramatic impact on our society in terms of mortality, morbidity, and inherently high financial costs. Formidable research efforts are being addressed to the identification of neuroprotective agents capable of ameliorating the neurological outcome after TBI. Preclinical studies have recently demonstrated lithium to be a promising neuroprotective agent for both acute ischemic brain injury and chronic neurodegenerative disease. In light of these encouraging data, we designed a lateral fluid-percussion injury (FPI) study aimed at investigating the role of early post-traumatic administration of lithium as a strategy for reducing TBI-induced motor and cognitive deficits. The optimal dose of this agent and the time window for its administration have been determined on the basis of data derived from the assessment of motor and cognitive functioning in experimental animals, as well as from the stereological quantification of neuronal survival (PID 7) within the CA3 and hilar regions of the hippocampus ipsilateral to the FPI. In addition, we attempted to elucidate the mechanisms underlying the neuroprotective properties of this drug via western blot analysis of levels of the pro-apoptotic marker caspase-3 (PID 1, 7) and two neuroplasticity markers, growth associated protein-43 (GAP-43) and brain-derived neurotrophic factor (BDNF) (PID 1, 7, 21). Our findings indicate that low-dose lithium chloride (0.125 or 0.25 mmol/kg), given either 30 min or 8 hr after lateral FPI significantly ameliorates injury-induced cognitive and motor impairment. Specifically, cell survival in the CA3 region of the hippocampus of the injured lithium-treated animals (but not in the hilus) was significantly increased compared to injured vehicle-treated animals. Western blot analyses revealed a significant increase in GAP-43 levels on PID 7 in injured animals when treated with lithium, indicating a possible mechanism for lithium-induced neuroprotection. In contrast, BDNF levels were relatively unchanged until PID 21, and caspase-3 activation was not observed at all, suggesting that these proteins play less significant roles in the observed neuroprotective effects of lithium treatment after lateral FPI. Early administration of lithium, within 8 hours after TBI, holds promise as an effective therapy to ameliorate postinjury neurobehavioral deficits and warrants further investigation in clinical TBI studies.

Prostatacancer är den sjätte mest förekommande cancertypen i världen, och den tredje vanligaste cancertypen bland män. De olika typer av behandlingar som finns idag botar oftast inte sjukdomen. Det är därför viktigt att utveckla bättre behandlingsmetoder. Det är sedan tidigare känt att mangan kan orsaka apoptos i olika celltyper. Det ger en möjlighet att använda mangan för att hämma cancer och det är därför viktigt att veta vilka apoptotiska markörer som är involverade. Syftet med projektet var att undersöka om de sker en ökning av de apoptotiska markörerna kluven Kaspas-3 och kluven PARP efter manganbehandling av prostatacancerceller. Därefter kunna avgöra om manganbehandlingen har orsakat celldöd genom att inducera apoptos. Under projektet odlades prostatacancerceller (PC3) som sedan behandlades med 200 µM mangan under 6, 24 och 48 timmar. Därefter mättes mängden av proteinerna kluven Kaspas-3 och kluven PARP med hjälp av ett sandwich-ELISA kit. En tydlig stegvis ökning av apoptosmarkörerna med inkuberingstid hade förväntats. Det förväntade resultatet erhölls inte, för kluven Kaspase-3 ledde manganbehandlingen t.o.m. till en sänkning av koncentrationen. Det kan ha uppstått problem vid analysen som t.ex dålig lysering av cellerna eller ojämn tillväxt av dem. Det behövs fler studier för att utreda detta och för att undersöka andar potentiella apoptosmarkörer. / Prostate cancer is the sixth most common cancer type in the world, and the third most common cancer type among men. The different types of treatments that are available today do not usually cure the disease. It is therefore important to develop better treatment methods. It has previously been stated that manganese can cause apoptosis in different cell types. It provides an opportunity to use manganese to inhibit cancer and it is therefore important to know which apoptotic markers that are involved. The purpose of the project was to investigate whether an increase in the apoptotic markers cleaved Kaspas-3 and cleaved PARP after manganese treatment of prostate cancer cells. Thereafter, it can determine whether manganese treatment has caused cell death by inducing apoptosis. During the project prostate cancer cells (PC3-cells) were cultivated, then treated with 200 µM manganese for 6, 24 and 48 hours. The amount of the proteins cleaved Kaspas-3 and cleaved PARP was measured by using a sandwich ELISA kit. A clear gradual increase of apoptotic markers with incubation time was expected. The expected result was not obtained, for cleaved Kaspase-3 manganese treatment even decreased the concentrations. There may have been problems with the performance of the analysis such as poor lysis of the cells or uneven growth of the cells. More studies are required to investigate this and other potential apoptotic markers.

<p>Patients with peritonitis or malignant obstructive jaundice (HPB⁺) have an increased morbidity and mortality due to sepsis. An altered cell-mediated immunity in the intestinal mucosa might promote gut barrier failure, increased endotoxin and cytokine release and bacterial translocation (BT) in these conditions. A clinically relevant rat model of polymicrobial peritonitis induced sepsis by cecal ligation and puncture (CLP) was used. Septic animals demonstrated a superficial injury in the small intestinal mucosa, and a significant reduction in T lymphocytes in the villi, as well as increased number of macrophages in the villi and in the MLNs as compared to sham. CLP caused increased concentration of TNF-α and IL-6 in ascitic fluid. CLP + the immunomodulator Linomide decreased the TNF-α level, reduced mucosal damage and attenuated the changes in T lymphocytes and macrophages observed following CLP. CLP + selective cyclooxygenase (COX)-2 inhibitor (SC-236) or nonselective COX inhibitor (indometacin) decreased the amount of macrophages in the mucosa and the MLNs compared to untreated CLP. CLP + indometacin decreased T lymphocytes in the villi and MLNs. SC-236 + CLP reduced mucosal injury and cytokine release as compared to indometacin. An increased rate of apoptosis in both the mucosa and MLNs was seen following CLP; COX inhibitors enhanced this phenomenon in the MLNs.</p><p>BT occurred infrequently in patients with acute peritonitis and in HPB⁺ there was no evidence of BT. Peritonitis and HPB⁺causes significant inflammatory cellular reactions as increased endotoxin and cytokine plasma levels and an altered immune cell distribution in MLNs, in HPB⁺a high rate of apoptosis in MLNs was observed. </p><p>An altered pattern of immunocompetent cells within the mucosa and in MLNs was found in experimental and clinical peritonitis as in HPB⁺.Lymphocyte depletion may be a result of increased apoptosis, which could reduce the ability of septic or jaundice patients to eradicate infection.</p>

Patients with peritonitis or malignant obstructive jaundice (HPB+) have an increased morbidity and mortality due to sepsis. An altered cell-mediated immunity in the intestinal mucosa might promote gut barrier failure, increased endotoxin and cytokine release and bacterial translocation (BT) in these conditions. A clinically relevant rat model of polymicrobial peritonitis induced sepsis by cecal ligation and puncture (CLP) was used. Septic animals demonstrated a superficial injury in the small intestinal mucosa, and a significant reduction in T lymphocytes in the villi, as well as increased number of macrophages in the villi and in the MLNs as compared to sham. CLP caused increased concentration of TNF-α and IL-6 in ascitic fluid. CLP + the immunomodulator Linomide decreased the TNF-α level, reduced mucosal damage and attenuated the changes in T lymphocytes and macrophages observed following CLP. CLP + selective cyclooxygenase (COX)-2 inhibitor (SC-236) or nonselective COX inhibitor (indometacin) decreased the amount of macrophages in the mucosa and the MLNs compared to untreated CLP. CLP + indometacin decreased T lymphocytes in the villi and MLNs. SC-236 + CLP reduced mucosal injury and cytokine release as compared to indometacin. An increased rate of apoptosis in both the mucosa and MLNs was seen following CLP; COX inhibitors enhanced this phenomenon in the MLNs. BT occurred infrequently in patients with acute peritonitis and in HPB+ there was no evidence of BT. Peritonitis and HPB+ causes significant inflammatory cellular reactions as increased endotoxin and cytokine plasma levels and an altered immune cell distribution in MLNs, in HPB+ a high rate of apoptosis in MLNs was observed. An altered pattern of immunocompetent cells within the mucosa and in MLNs was found in experimental and clinical peritonitis as in HPB+. Lymphocyte depletion may be a result of increased apoptosis, which could reduce the ability of septic or jaundice patients to eradicate infection.

Women with pregestational diabetes have a 2-5 fold increased risk of giving birth to malformed babies compared with non-diabetic women. Diabetes-induced oxidative stress in maternal and embryonic tissues has been implicated in the teratogenic process. The malformations are likely to be induced before the seventh week of pregnancy, when the yolk sac is partly responsible for the transfer of metabolites to the embryo, and the uterine blood flow to the implantation site determines the net amount of nutrients available to the conceptus. We aimed to evaluate the effect on embryogenesis caused by a diabetes-induced disturbance in yolk sac morphology, uterine blood flow or altered maternal antioxidative status in conjunction with a varied severity of the maternal diabetic state. We investigated to which extent maternal diabetes with or without folic acid (FA) supplementation affects mRNA levels and protein distribution of ROS scavenging enzymes (SOD, CAT, GPX), vascular endothelial growth factor-A (Vegf-A), folate binding protein-1 (Folbp-1), and apoptosis associated proteins (Bax, Bcl-2, Caspase-3) in the yolk sacs of rat embryos on gestational days 10 and 11. We found that maternal diabetes impairs, and that FA supplementation restores, yolk sac vessel morphology, and that maternal diabetes is associated with increased apoptotic rate in embryos and yolk sacs, as well as impaired SOD gene expression. We assessed uterine blood flow with a laser-Doppler-flow-meter and found increased blood flow to implantation sites of diabetic rats compared with controls. Furthermore, resorbed and malformed offspring showed increased and decreased blood flow to their implantation sites, respectively. In mice with genetically altered CuZnSOD levels, maternal diabetes increased embryonic dysmorphogenesis irrespective of CuZnSOD expression. We thus found the maternal diabetic state to be a major determinant of diabetic embryopathy and that the CuZnSOD status exerts a partial protection for the embryo in diabetic pregnancy.