No description available.

Le diabète est une maladie métabolique qui se caractérise par une résistance à l’insuline des tissus périphériques et par une incapacité des cellules β pancréatiques à sécréter les niveaux d’insuline appropriés afin de compenser pour cette résistance. Pour mieux comprendre les mécanismes déficients dans les cellules β des patients diabétiques, il est nécessaire de comprendre et de définir les mécanismes impliqués dans le contrôle de la sécrétion d’insuline en réponse au glucose. Dans les cellules β pancréatiques, le métabolisme du glucose conduit à la production de facteurs de couplage métabolique, comme l’ATP, nécessaires à la régulation de l’exocytose des vésicules d’insuline. Le mécanisme par lequel la production de l’ATP par le métabolisme oxydatif du glucose déclenche l’exocytose des vésicules d’insuline est bien décrit dans la littérature. Cependant, il ne peut à lui seul réguler adéquatement la sécrétion d’insuline. Le malonyl-CoA et le NADPH sont deux autres facteurs de couplage métaboliques qui ont été suggérés afin de relier le métabolisme du glucose à la régulation de la sécrétion d’insuline. Les mécanismes impliqués demeurent cependant à être caractérisés. Le but de la présente thèse était de déterminer l’implication des navettes du pyruvate, découlant du métabolisme mitochondrial du glucose, dans la régulation de la sécrétion d’insuline. Dans les cellules β, les navettes du pyruvate découlent de la combinaison des processus d’anaplérose et de cataplérose et permettent la transduction des signaux métaboliques provenant du métabolisme du glucose. Dans une première étude, nous nous sommes intéressés au rôle de la navette pyruvate/citrate dans la régulation de la sécrétion d’insuline en réponse au glucose, puisque cette navette conduit à la production dans le cytoplasme de deux facteurs de couplage métabolique, soit le malonyl-CoA et le NADPH. De plus, la navette pyruvate/citrate favorise le flux métabolique à travers la glycolyse en réoxydation le NADH. Une étude effectuée précédemment dans notre laboratoire avait suggéré la présence de cette navette dans les cellules β pancréatique. Afin de tester notre hypothèse, nous avons ciblé trois étapes de cette navette dans la lignée cellulaire β pancréatique INS 832/13, soit la sortie du citrate de la mitochondrie et l’activité de l’ATP-citrate lyase (ACL) et l’enzyme malique (MEc), deux enzymes clés de la navette pyruvate/citrate. L’inhibition de chacune de ces étapes par l’utilisation d’un inhibiteur pharmacologique ou de la technologie des ARN interférant a corrélé avec une réduction significative de la sécrétion d’insuline en réponse au glucose. Les résultats obtenus suggèrent que la navette pyruvate/citrate joue un rôle critique dans la régulation de la sécrétion d’insuline en réponse au glucose. Parallèlement à notre étude, deux autres groupes de recherche ont suggéré que les navettes pyruvate/malate et pyruvate/isocitrate/α-cétoglutarate étaient aussi importantes pour la sécrétion d’insuline en réponse au glucose. Ainsi, trois navettes découlant du métabolisme mitochondrial du glucose pourraient être impliquées dans le contrôle de la sécrétion d’insuline. Le point commun de ces trois navettes est la production dans le cytoplasme du NADPH, un facteur de couplage métabolique possiblement très important pour la sécrétion d’insuline. Dans les navettes pyruvate/malate et pyruvate/citrate, le NADPH est formé par MEc, alors que l’isocitrate déshydrogénase (IDHc) est responsable de la production du NADPH dans la navette pyruvate/isocitrate/α-cétoglutarate. Dans notre première étude, nous avions démontré l’importance de l’expression de ME pour la sécrétion adéquate d’insuline en réponse au glucose. Dans notre deuxième étude, nous avons testé l’implication de IDHc dans les mécanismes de régulation de la sécrétion d’insuline en réponse au glucose. La diminution de l’expression de IDHc dans les INS 832/13 a stimulé la sécrétion d’insuline en réponse au glucose par un mécanisme indépendant de la production de l’ATP par le métabolisme oxydatif du glucose. Ce résultat a ensuite été confirmé dans les cellules dispersées des îlots pancréatiques de rat. Nous avons aussi observé dans notre modèle que l’incorporation du glucose en acides gras était augmentée, suggérant que la diminution de l’activité de IDHc favorise la redirection du métabolisme de l’isocitrate à travers la navette pyruvate/citrate. Un mécanisme de compensation à travers la navette pyruvate/citrate pourrait ainsi expliquer la stimulation de la sécrétion d’insuline observée en réponse à la diminution de l’expression de IDHc. Les travaux effectués dans cette deuxième étude remettent en question l’implication de l’activité de IDHc, et de la navette pyruvate/isocitrate/α-cétoglutarate, dans la transduction des signaux métaboliques reliant le métabolisme du glucose à la sécrétion d’insuline. La navette pyruvate/citrate est la seule des navettes du pyruvate à conduire à la production du malonyl-CoA dans le cytoplasme des cellules β. Le malonyl-CoA régule le métabolisme des acides gras en inhibant la carnitine palmitoyl transférase 1, l’enzyme limitante dans l’oxydation des acides gras. Ainsi, l’élévation des niveaux de malonyl-CoA en réponse au glucose entraîne une redirection du métabolisme des acides gras vers les processus d’estérification puis de lipolyse. Plus précisément, les acides gras sont métabolisés à travers le cycle des triglycérides/acides gras libres (qui combinent les voies métaboliques d’estérification et de lipolyse), afin de produire des molécules lipidiques signalétiques nécessaires à la modulation de la sécrétion d’insuline. Des études effectuées précédemment dans notre laboratoire ont démontré que l’activité lipolytique de HSL (de l’anglais hormone-sensitive lipase) était importante, mais non suffisante, pour la régulation de la sécrétion d’insuline. Dans une étude complémentaire, nous nous sommes intéressés au rôle d’une autre lipase, soit ATGL (de l’anglais adipose triglyceride lipase), dans la régulation de la sécrétion d’insuline en réponse au glucose et aux acides gras. Nous avons démontré que ATGL est exprimé dans les cellules β pancréatiques et que son activité contribue significativement à la lipolyse. Une réduction de son expression dans les cellules INS 832/13 par RNA interférant ou son absence dans les îlots pancréatiques de souris déficientes en ATGL a conduit à une réduction de la sécrétion d’insuline en réponse au glucose en présence ou en absence d’acides gras. Ces résultats appuient l’hypothèse que la lipolyse est une composante importante de la régulation de la sécrétion d’insuline dans les cellules β pancréatiques. En conclusion, les résultats obtenus dans cette thèse suggèrent que la navette pyruvate/citrate est importante pour la régulation de la sécrétion d’insuline en réponse au glucose. Ce mécanisme impliquerait la production du NADPH et du malonyl-CoA dans le cytoplasme en fonction du métabolisme du glucose. Cependant, nos travaux remettent en question l’implication de la navette pyruvate/isocitrate/α-cétoglutarate dans la régulation de la sécrétion d’insuline. Le rôle exact de IDHc dans ce processus demeure cependant à être déterminé. Finalement, nos travaux ont aussi démontré un rôle pour ATGL et la lipolyse dans les mécanismes de couplage métabolique régulant la sécrétion d’insuline. / Diabetes is a metabolic disorder characterized by a combination of insulin resistance in peripheral tissues with an inappropriate amount of insulin secreted by the pancreatic β-cells to overcome this insulin resistance. In order to help find a cure for diabetic patients, we need to elucidate the mechanisms underlying the proper control of insulin secretion in response to glucose. In pancreatic β-cells, glucose metabolism leads to the production of metabolic coupling factors, like ATP, implicated in the regulation of insulin vesicle exocytosis. The mechanism linking ATP production by the oxidative metabolism of glucose to the triggering of insulin release that involves Ca2+ and metabolically sensitive K+ channels is relatively well known. Other mechanisms are also involved in the regulation of insulin secretion in response to glucose and other nutrients, such as fatty acids and some amino acids. Malonyl-CoA and NADPH are two metabolic coupling factors that have been suggested to be implicated in the transduction of metabolic signaling coming from glucose metabolism to control the release of insulin granules. However, the mechanisms implicated remained to be defined. The goal of the present thesis was to further our understanding of the role of the pyruvate shuttles, derived from mitochondrial glucose metabolism, in the regulation of insulin secretion. In pancreatic β-cells, pyruvate shuttles are produced by the combination of anaplerosis and cataplerosis processes and are thought to link glucose metabolism to the regulation of insulin secretion by the production metabolic coupling factors. In our first study, we wished to determine the role of the pyruvate/citrate shuttle in the regulation of glucose-induced insulin secretion. The pyruvate/citrate shuttle leads to the production in the cytoplasm of both malonyl-CoA and NADPH and also stimulates the metabolic flux through the glycolysis by re-oxidating NADH. A previous study done in the group of Dr Prentki has suggested the feasibility of the pyruvate/citrate shuttle in pancreatic β-cells. To investigate our hypothesis, we inhibited three different steps of this shuttle in INS 832/13 cells, a pancreatic β-cell line. Specifically, we repressed, using pharmacological inhibitors or RNA interference technology, the mitochondrial citrate export to the cytoplasm and the expression of malic enzyme (MEc) and ATP-citrate lyase (ACL), two key enzymes implicated in the pyruvate/citrate shuttle. The inhibition of each of those steps resulted in a reduction of glucose-induced insulin secretion. Our results underscore the importance of the pyruvate/citrate shuttle in the pancreatic β-cell signaling and the regulation of insulin secretion in response to glucose. Other research groups are also interested in studying the implication of pyruvate cycling processes in the regulation of insulin exocytosis. They suggested a role for the pyruvate/malate and the pyruvate/isocitrate/α-ketoglutarate shuttles. Therefore, three different shuttles derived from the mitochondrial glucose metabolism could be implicated in the regulation of glucose-induced insulin release. All those three shuttles can produce NADPH in the cytoplasm. In the pyruvate/malate and the pyruvate/citrate shuttles, the NADPH is formed by cytosolic malic enzyme (MEc), whereas in the pyruvate/isocitrate/α-ketoglutarate, NADPH is produced by cytosolic isocitrate dehydrogenease (IDHc). In our first study, we established the importance of MEc expression in the regulation of insulin secretion. In our second study, we wanted to investigate the importance of IDHc expression in glucose-induced insulin secretion. The reduction of IDHc expression in INS 832/13 cells stimulated insulin release in response to glucose by a mechanism independent of ATP production coming from glucose oxidative metabolism. This stimulation was also observed in isolated rat pancreatic cells. IDHc knockdown cells showed elevated glucose incorporation into fatty acids, suggesting that isocitrate metabolism could be redirected into the pyruvate/citrate shuttle in these cells. Taken together, these results suggest that IDHc is not essential for glucose-induced insulin secretion and that a compensatory mechanism, probably involving the pyruvate/citrate shuttle, explains the enhanced insulin secretion in IDHc knockdown cells . The pyruvate/citrate shuttle is the only pyruvate shuttle that is linked to the production of malonyl-CoA. Malonyl-CoA is a known inhibitor of carnitine palmitoyl transferase 1, the rate-limiting step in fatty acid oxidation. Therefore, the raising level of malonyl-CoA in response to glucose redirects the metabolism of fatty acids into the triglycerides/free fatty acids cycle which combine esterification and lipolysis processes. Previous studies done in the laboratory of Dr Prentki supported the concept that lipolysis of endogenous lipid stores is an important process for the appropriate regulation of insulin secretion. A first lipase, hormone-sensitive lipase (HSL), has been identified in pancreatic β-cells. HSL expression is important, but not sufficient, for the β-cell lipolysis activity. In a complementary study, we have investigated the role of another lipase, adipose triglyceride lipase (ATGL), in the regulation of insulin secretion in response to glucose and to fatty acids. We first demonstrated the expression and the activity of ATGL in pancreatic β-cells. Reducing ATGL expression using shRNA in INS 832/13 cells caused a reduction in insulin secretion in response to glucose and to fatty acids. Pancreatic islets from ATGL null mice also showed defect in insulin release in response to glucose and to fatty acids. The results demonstrate the importance of ATGL and intracellular lipid signaling in the regulation of insulin secretion. In conclusion, the work presented in this thesis suggests a role for the pyruvate/citrate shuttle in the regulation of insulin secretion in response to glucose. This mechanism possibly implicates the production of NADPH and malonyl-CoA in the cytoplasm. The results also points to a re-evaluation of the role of IDHc in glucose-induced insulin secretion. The precise role of IDHc in pancreatic β-cells needs to be determined. Finally, the data have also documented a role of lipolysis and ATGL in the coupling mechanisms of insulin secretion in response to both fuel and non-fuel stimuli.

Une caractéristique nutritionnelle peu connue des fromages est leur potentiel acidifiant, qui se révèle au cours du métabolisme et, à long terme, est susceptible d’induire des effets délétères sur la santé du consommateur. Malgré des conséquences physiopathologiques bien connues, très peu d’études se sont intéressées au potentiel acidifiant/alcalinisant des aliments et aucune à celui des fromages. L’objectif principal était d’évaluer d’une part le potentiel acidifiant des fromages et identifier ses déterminants au cours de la fabrication et d’autre part d’explorer des stratégies d’optimisation technologique permettant de réduire le potentiel acidifiant des fromages, tout en assurant leurs qualités gustatives. Le potentiel acidifiant a été évalué sur la base de l’indice PRAL (Potential Renal Acid Load, en tenant compte des teneurs en protéine, P, Cl, Na, K, Mg et Ca) et de la teneur en anions organiques (lactate et citrate). Dans un premier temps, l’étude du potentiel acidifiant de cinq types de fromages du commerce a permis d’établir un lien fort entre le type du fromage et son potentiel acidifiant. L’indice PRAL le plus faible est celui du fromage frais avec - 0,8 mEq/100 g, les indices les plus élevés atteignant 25,3 mEq/100 g pour le fromage à pâte pressée non-cuite (Cantal) et 28,0 mEq/100 g pour le fromage à pâte persillée (Fourme d’Ambert). Ce positionnement a ainsi permis de sélectionner un modèle fromage pour la suite des travaux : la Fourme d’Ambert. Dans une seconde phase, l’égouttage et le salage ont été identifiés comme les deux étapes technologiques déterminantes dans la génération du potentiel acidifiant du modèle fromage choisi, au cours de la transformation fromagère, suivie en milieu industriel. Ces études démontrent un déséquilibre important entre les éléments acidifiants (Cl, P, protéines) et les éléments alcalinisants majeurs (Na et Ca) du PRAL. En particulier, les Cl suivis par le P, ont exercé un très fort impact expliquant les indices élevés obtenus. Enfin, une substitution du NaCl par des sels organiques de calcium (lactate et citrate de Ca) a été testée en conditions industrielles pendant le salage à sec de la Fourme d’Ambert. Les deux sels ont montré un réel intérêt pour substituer partiellement le sel des fromages, sans affecter les propriétés sensorielles des produits finis et notamment les saveurs salée et amère. La substitution au lactate de Ca permettrait d’optimiser le potentiel acidifiant des fromages, en diminuant le PRAL et la teneur en Na et en augmentant la teneur en lactate. La substitution au citrate de Ca serait plutôt indiquée dans le cadre d’un enrichissement en Ca. En conclusion, ces études ont permis d’identifier les leviers à maîtriser pour réduire le potentiel acidifiant des fromages. L’approche adoptée a proposé la mise en application d’un concept connu principalement des nutritionnistes jusqu’ici dans les domaines de la biochimie et de la technologie alimentaires. Les perspectives d’innovation envisagées sont pertinentes avec les enjeux de santé publique actuels, en visant la réduction en Na dans les fromages et en participant à la limitation de l’acidose métabolique latente induite par les régimes occidentaux. Enfin, les retombées économiques de ces recherches sont prometteuses pour les filières fromagères. / A disregarded nutritional feature of cheeses is their acid-forming potential when ingested, associated with deleterious effects for consumers’ health. Despite the well-known pathophysiological consequences, very few studies investigated the acidifying/alkalizing potential of foods and especially, none targeted cheeses. The research project aimed on the one hand to evaluate the acid-forming potential of cheeses and identify the main key steps of the manufacture involved in this phenomenon and on the other hand to explore technological optimization strategies to reduce the acid-forming potential of cheeses, without altering their sensory properties. The acid-forming potential was evaluated on the basis of their Potential Renal Acid Load (PRAL) index (considering protein, P, Cl, Na, K, Mg and Ca contents) and organic anions contents (lactate and citrate). Firstly, the study of the acid-forming potential of five commercial cheeses from different cheese-making technologies established a strong link between the type of cheese and their acid-forming potential. PRAL index ranged from - 0.8 mEq/100 g for fresh cheese to 25.3 mEq/100 g for hard cheese (Cantal) and 28.0 mEq/100 g for the blue-veined cheese Fourme d’Ambert. This positioning allowed to select Fourme d'Ambert as model cheese for next steps. Secondly, draining and salting were identified as the main key steps responsible for the generation of the acid-forming potential of the model cheese, by following an industrial cheese-making process. These studies emphasized a great imbalance between acidifying elements of PRAL calculation (Cl, P and proteins elements) and alkalinizing ones (Na and Ca). Particularly, Cl followed by P elements had a strong impact on the PRAL value. Finally, the salt substitution with organic calcium salts (calcium lactate and calcium citrate) was tested under industrial conditions during the dry salting of Fourme d'Ambert cheese. Both salts showed a real nutritional interest to partially replace salt in cheese, without affecting their sensory properties and especially the salty and the bitter flavors. The salt substitution by calcium lactate could reduce the acid-forming potential of cheeses, by decreasing the PRAL and the sodium content and by increasing the lactate content. The calcium citrate substitution would rather be recommended for Ca enrichment of cheeses. As a conclusion, these studies allowed to identify technological solutions to reduce the acid-forming potential of cheeses. The adopted approach proposed the implementation of a concept, known mainly by nutritionists so far, to the biochemistry and the food technology fields. The considered prospects for innovation are relevant with the current public health issues, targeting the reduction of Na in cheeses and participating in the limitation of the Western diets induced metabolic acidosis. Finally, the economic benefits of this research are promising for cheese-making producers.

Le diabète est une maladie métabolique qui se caractérise par une résistance à l’insuline des tissus périphériques et par une incapacité des cellules β pancréatiques à sécréter les niveaux d’insuline appropriés afin de compenser pour cette résistance. Pour mieux comprendre les mécanismes déficients dans les cellules β des patients diabétiques, il est nécessaire de comprendre et de définir les mécanismes impliqués dans le contrôle de la sécrétion d’insuline en réponse au glucose. Dans les cellules β pancréatiques, le métabolisme du glucose conduit à la production de facteurs de couplage métabolique, comme l’ATP, nécessaires à la régulation de l’exocytose des vésicules d’insuline. Le mécanisme par lequel la production de l’ATP par le métabolisme oxydatif du glucose déclenche l’exocytose des vésicules d’insuline est bien décrit dans la littérature. Cependant, il ne peut à lui seul réguler adéquatement la sécrétion d’insuline. Le malonyl-CoA et le NADPH sont deux autres facteurs de couplage métaboliques qui ont été suggérés afin de relier le métabolisme du glucose à la régulation de la sécrétion d’insuline. Les mécanismes impliqués demeurent cependant à être caractérisés. Le but de la présente thèse était de déterminer l’implication des navettes du pyruvate, découlant du métabolisme mitochondrial du glucose, dans la régulation de la sécrétion d’insuline. Dans les cellules β, les navettes du pyruvate découlent de la combinaison des processus d’anaplérose et de cataplérose et permettent la transduction des signaux métaboliques provenant du métabolisme du glucose. Dans une première étude, nous nous sommes intéressés au rôle de la navette pyruvate/citrate dans la régulation de la sécrétion d’insuline en réponse au glucose, puisque cette navette conduit à la production dans le cytoplasme de deux facteurs de couplage métabolique, soit le malonyl-CoA et le NADPH. De plus, la navette pyruvate/citrate favorise le flux métabolique à travers la glycolyse en réoxydation le NADH. Une étude effectuée précédemment dans notre laboratoire avait suggéré la présence de cette navette dans les cellules β pancréatique. Afin de tester notre hypothèse, nous avons ciblé trois étapes de cette navette dans la lignée cellulaire β pancréatique INS 832/13, soit la sortie du citrate de la mitochondrie et l’activité de l’ATP-citrate lyase (ACL) et l’enzyme malique (MEc), deux enzymes clés de la navette pyruvate/citrate. L’inhibition de chacune de ces étapes par l’utilisation d’un inhibiteur pharmacologique ou de la technologie des ARN interférant a corrélé avec une réduction significative de la sécrétion d’insuline en réponse au glucose. Les résultats obtenus suggèrent que la navette pyruvate/citrate joue un rôle critique dans la régulation de la sécrétion d’insuline en réponse au glucose. Parallèlement à notre étude, deux autres groupes de recherche ont suggéré que les navettes pyruvate/malate et pyruvate/isocitrate/α-cétoglutarate étaient aussi importantes pour la sécrétion d’insuline en réponse au glucose. Ainsi, trois navettes découlant du métabolisme mitochondrial du glucose pourraient être impliquées dans le contrôle de la sécrétion d’insuline. Le point commun de ces trois navettes est la production dans le cytoplasme du NADPH, un facteur de couplage métabolique possiblement très important pour la sécrétion d’insuline. Dans les navettes pyruvate/malate et pyruvate/citrate, le NADPH est formé par MEc, alors que l’isocitrate déshydrogénase (IDHc) est responsable de la production du NADPH dans la navette pyruvate/isocitrate/α-cétoglutarate. Dans notre première étude, nous avions démontré l’importance de l’expression de ME pour la sécrétion adéquate d’insuline en réponse au glucose. Dans notre deuxième étude, nous avons testé l’implication de IDHc dans les mécanismes de régulation de la sécrétion d’insuline en réponse au glucose. La diminution de l’expression de IDHc dans les INS 832/13 a stimulé la sécrétion d’insuline en réponse au glucose par un mécanisme indépendant de la production de l’ATP par le métabolisme oxydatif du glucose. Ce résultat a ensuite été confirmé dans les cellules dispersées des îlots pancréatiques de rat. Nous avons aussi observé dans notre modèle que l’incorporation du glucose en acides gras était augmentée, suggérant que la diminution de l’activité de IDHc favorise la redirection du métabolisme de l’isocitrate à travers la navette pyruvate/citrate. Un mécanisme de compensation à travers la navette pyruvate/citrate pourrait ainsi expliquer la stimulation de la sécrétion d’insuline observée en réponse à la diminution de l’expression de IDHc. Les travaux effectués dans cette deuxième étude remettent en question l’implication de l’activité de IDHc, et de la navette pyruvate/isocitrate/α-cétoglutarate, dans la transduction des signaux métaboliques reliant le métabolisme du glucose à la sécrétion d’insuline. La navette pyruvate/citrate est la seule des navettes du pyruvate à conduire à la production du malonyl-CoA dans le cytoplasme des cellules β. Le malonyl-CoA régule le métabolisme des acides gras en inhibant la carnitine palmitoyl transférase 1, l’enzyme limitante dans l’oxydation des acides gras. Ainsi, l’élévation des niveaux de malonyl-CoA en réponse au glucose entraîne une redirection du métabolisme des acides gras vers les processus d’estérification puis de lipolyse. Plus précisément, les acides gras sont métabolisés à travers le cycle des triglycérides/acides gras libres (qui combinent les voies métaboliques d’estérification et de lipolyse), afin de produire des molécules lipidiques signalétiques nécessaires à la modulation de la sécrétion d’insuline. Des études effectuées précédemment dans notre laboratoire ont démontré que l’activité lipolytique de HSL (de l’anglais hormone-sensitive lipase) était importante, mais non suffisante, pour la régulation de la sécrétion d’insuline. Dans une étude complémentaire, nous nous sommes intéressés au rôle d’une autre lipase, soit ATGL (de l’anglais adipose triglyceride lipase), dans la régulation de la sécrétion d’insuline en réponse au glucose et aux acides gras. Nous avons démontré que ATGL est exprimé dans les cellules β pancréatiques et que son activité contribue significativement à la lipolyse. Une réduction de son expression dans les cellules INS 832/13 par RNA interférant ou son absence dans les îlots pancréatiques de souris déficientes en ATGL a conduit à une réduction de la sécrétion d’insuline en réponse au glucose en présence ou en absence d’acides gras. Ces résultats appuient l’hypothèse que la lipolyse est une composante importante de la régulation de la sécrétion d’insuline dans les cellules β pancréatiques. En conclusion, les résultats obtenus dans cette thèse suggèrent que la navette pyruvate/citrate est importante pour la régulation de la sécrétion d’insuline en réponse au glucose. Ce mécanisme impliquerait la production du NADPH et du malonyl-CoA dans le cytoplasme en fonction du métabolisme du glucose. Cependant, nos travaux remettent en question l’implication de la navette pyruvate/isocitrate/α-cétoglutarate dans la régulation de la sécrétion d’insuline. Le rôle exact de IDHc dans ce processus demeure cependant à être déterminé. Finalement, nos travaux ont aussi démontré un rôle pour ATGL et la lipolyse dans les mécanismes de couplage métabolique régulant la sécrétion d’insuline. / Diabetes is a metabolic disorder characterized by a combination of insulin resistance in peripheral tissues with an inappropriate amount of insulin secreted by the pancreatic β-cells to overcome this insulin resistance. In order to help find a cure for diabetic patients, we need to elucidate the mechanisms underlying the proper control of insulin secretion in response to glucose. In pancreatic β-cells, glucose metabolism leads to the production of metabolic coupling factors, like ATP, implicated in the regulation of insulin vesicle exocytosis. The mechanism linking ATP production by the oxidative metabolism of glucose to the triggering of insulin release that involves Ca2+ and metabolically sensitive K+ channels is relatively well known. Other mechanisms are also involved in the regulation of insulin secretion in response to glucose and other nutrients, such as fatty acids and some amino acids. Malonyl-CoA and NADPH are two metabolic coupling factors that have been suggested to be implicated in the transduction of metabolic signaling coming from glucose metabolism to control the release of insulin granules. However, the mechanisms implicated remained to be defined. The goal of the present thesis was to further our understanding of the role of the pyruvate shuttles, derived from mitochondrial glucose metabolism, in the regulation of insulin secretion. In pancreatic β-cells, pyruvate shuttles are produced by the combination of anaplerosis and cataplerosis processes and are thought to link glucose metabolism to the regulation of insulin secretion by the production metabolic coupling factors. In our first study, we wished to determine the role of the pyruvate/citrate shuttle in the regulation of glucose-induced insulin secretion. The pyruvate/citrate shuttle leads to the production in the cytoplasm of both malonyl-CoA and NADPH and also stimulates the metabolic flux through the glycolysis by re-oxidating NADH. A previous study done in the group of Dr Prentki has suggested the feasibility of the pyruvate/citrate shuttle in pancreatic β-cells. To investigate our hypothesis, we inhibited three different steps of this shuttle in INS 832/13 cells, a pancreatic β-cell line. Specifically, we repressed, using pharmacological inhibitors or RNA interference technology, the mitochondrial citrate export to the cytoplasm and the expression of malic enzyme (MEc) and ATP-citrate lyase (ACL), two key enzymes implicated in the pyruvate/citrate shuttle. The inhibition of each of those steps resulted in a reduction of glucose-induced insulin secretion. Our results underscore the importance of the pyruvate/citrate shuttle in the pancreatic β-cell signaling and the regulation of insulin secretion in response to glucose. Other research groups are also interested in studying the implication of pyruvate cycling processes in the regulation of insulin exocytosis. They suggested a role for the pyruvate/malate and the pyruvate/isocitrate/α-ketoglutarate shuttles. Therefore, three different shuttles derived from the mitochondrial glucose metabolism could be implicated in the regulation of glucose-induced insulin release. All those three shuttles can produce NADPH in the cytoplasm. In the pyruvate/malate and the pyruvate/citrate shuttles, the NADPH is formed by cytosolic malic enzyme (MEc), whereas in the pyruvate/isocitrate/α-ketoglutarate, NADPH is produced by cytosolic isocitrate dehydrogenease (IDHc). In our first study, we established the importance of MEc expression in the regulation of insulin secretion. In our second study, we wanted to investigate the importance of IDHc expression in glucose-induced insulin secretion. The reduction of IDHc expression in INS 832/13 cells stimulated insulin release in response to glucose by a mechanism independent of ATP production coming from glucose oxidative metabolism. This stimulation was also observed in isolated rat pancreatic cells. IDHc knockdown cells showed elevated glucose incorporation into fatty acids, suggesting that isocitrate metabolism could be redirected into the pyruvate/citrate shuttle in these cells. Taken together, these results suggest that IDHc is not essential for glucose-induced insulin secretion and that a compensatory mechanism, probably involving the pyruvate/citrate shuttle, explains the enhanced insulin secretion in IDHc knockdown cells . The pyruvate/citrate shuttle is the only pyruvate shuttle that is linked to the production of malonyl-CoA. Malonyl-CoA is a known inhibitor of carnitine palmitoyl transferase 1, the rate-limiting step in fatty acid oxidation. Therefore, the raising level of malonyl-CoA in response to glucose redirects the metabolism of fatty acids into the triglycerides/free fatty acids cycle which combine esterification and lipolysis processes. Previous studies done in the laboratory of Dr Prentki supported the concept that lipolysis of endogenous lipid stores is an important process for the appropriate regulation of insulin secretion. A first lipase, hormone-sensitive lipase (HSL), has been identified in pancreatic β-cells. HSL expression is important, but not sufficient, for the β-cell lipolysis activity. In a complementary study, we have investigated the role of another lipase, adipose triglyceride lipase (ATGL), in the regulation of insulin secretion in response to glucose and to fatty acids. We first demonstrated the expression and the activity of ATGL in pancreatic β-cells. Reducing ATGL expression using shRNA in INS 832/13 cells caused a reduction in insulin secretion in response to glucose and to fatty acids. Pancreatic islets from ATGL null mice also showed defect in insulin release in response to glucose and to fatty acids. The results demonstrate the importance of ATGL and intracellular lipid signaling in the regulation of insulin secretion. In conclusion, the work presented in this thesis suggests a role for the pyruvate/citrate shuttle in the regulation of insulin secretion in response to glucose. This mechanism possibly implicates the production of NADPH and malonyl-CoA in the cytoplasm. The results also points to a re-evaluation of the role of IDHc in glucose-induced insulin secretion. The precise role of IDHc in pancreatic β-cells needs to be determined. Finally, the data have also documented a role of lipolysis and ATGL in the coupling mechanisms of insulin secretion in response to both fuel and non-fuel stimuli.

The supply of precursors from primary metabolism is often overlooked when engineering secondary metabolism for increased product yields. This is because precursor supply may be assumed to be non-limiting, and it is considered difficult to engineer primary metabolism, because control of carbon flow (flux) is generally distributed among most enzymes of the pathway. The aim of this thesis was to increase the production of sterols, part of the isoprenoid class of secondary metabolites, in tobacco (Nicotiana tabacum) Bright Yellow 2 (BY-2) cell cultures. This was achieved by genetically engineering increased activity of mitochondrial citrate synthase, an enzyme of the tricarboxylic acid (TCA) cycle that is involved in the provision of cytosolic acetyl coenzyme A, the primary metabolite precursor to sterols. Metabolic flux analysis revealed that citrate synthase exerts significant control over cyclic TCA cycle flux in BY-2 cells and suggested that increasing the activity of downstream enzymes within secondary metabolism could lead to a further redirection of TCA-cycle-derived precursors into sterol biosynthesis. Attempts were made to achieve this by genetically engineering increased activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGR), a key enzyme of secondary metabolism involved in sterol biosynthesis. Consistent with previous research, transgenic lines had increased sterol levels. However, the high sterol phenotype was unstable, and attempts to co-express HMGR and citrate synthase genes were unsuccessful. The thesis demonstrates that increasing the provision of precursors to secondary metabolites can result in increased yields of those secondary metabolites but suggests that in most cases the activity of enzymes within secondary metabolism has a greater effect on those yields. It also reveals that single enzymes can exert significant control of flux within primary metabolism, although the control exerted by specific enzymes probably changes with the demands placed on metabolism.

Adaptation to chronic hypoxia induces endogenous cardioprotection and increases the heart resistance to ischemia/reperfusion injury. The heart mitochondria, which produce reactive oxygen species (ROS) in addition to ATP, play an important role in these processes. During ischemia/reperfusion, ROS are produced in excessive amounts and damage the cells. However, in lower concentrations, ROS are involved in the signalling pathway of cardioprotection induced by adaptation to chronic hypoxia. In the heart, two mitochondrial subpopulations have been observed, subsarcolemmal mitochondria (SSM) and intermyofibrillar mitochondria (IMFM), which differ in cell localization as well as in morphological and biochemical properties. The aim of this work was to introduce the method of SSM and IMFM isolation in our laboratory and to analyse their antioxidative capacity after adaptation to chronic hypoxia. Adult male Wistar rats were kept either under normoxic conditions or exposed to intermittent high-altitude hypoxia (IHA; 7000 m, 5 days a week/8 hours a day, totally 25 exposures). Mitochondrial subpopulations were isolated from heart left ventricle and their functionality was verified by measuring oxygen consumption and enzyme activities. The IMFM had higher oxygen consumption in comparison with SSM and activities...

Dans le domaine de l'électronique de puissance, la gestion thermique de l'intégration des puces en silicium au sein du système global constitue un problème clé. La chaleur dissipée par les composants électriques est évacuée vers l’extérieur à travers un drain thermique, généralement en cuivre, qui est brasé sur le substrat céramique. Cette étude est consacrée à l'élaboration de drains thermiques adaptatifs en matériaux composites cuivre allié/fibres de carbone (FC) qui combinent une bonne conductivité thermique et un CTE proche de celui du substrat. Dans ce type de matériau, la liaison interfaciale renfort/matrice doit être forte afin d'optimiser le transfert des propriétés entre les deux composants. Le couple cuivre/carbone étant non réactif, un élément d’addition carburigène (Cr ou B) est ajouté à la matrice de cuivre afin de créer cette liaison chimique forte. Un matériau modèle a été réalisé par pulvérisation cathodique afin d’étudier la diffusion de l’élément d’addition au sein de la couche de cuivre vers la zone interfaciale et la formation d’un carbure métallique. Une méthode de chimie des solutions a ensuite été utilisée pour élaborer des poudres de cuivre allié de stœchiométrie donnée. Enfin, les matériaux composites (Cu-B/FC et Cu-Cr/FC) ont été élaborés par métallurgie des poudres et leurs propriétés thermiques et mécaniques corrélées à la microstructure et à la chimie des zones interfaciales / In the field of power electronics, thermal management of silicon chips plays a key role in our ability to increase their performance. Heat generated by the electronic components is dissipated through the heat sink, generally made of Copper that is brazed on to a ceramic substrate. This study focuses on the elaboration of adaptive heat sink material using Copper alloys/Carbon fibers (CF) composite materials which have a good thermal conductivity and a CTE close to the ceramic substrate. In this kind of material, it is necessary to have a strong matrix/reinforcement link in order to optimize transfer properties. Since there is no reaction between Copper and Carbon, a carbide element (Cr or B) is added to the Copper matrix to create this strong chemical bond. A model material has been elaborated by cathode sputtering in order to study the diffusion of the alloying element in the Copper layer and the metallic carbide formation in the interfacial zone. Copper alloy powders, with a given stoichiometry, have also been synthesized by a chemical method. Lastly, composite materials (Cu-B/CF and Cu-Cr/CF) have been elaborated by a powder metallurgy process and their thermal and mechanical properties correlated to the microstructure and the chemistry of the interfacial zones.

INTRODUÇÃO: Pacientes com defeitos septais cardíacos ditos não restritivos podem apresentar remodelamento vascular pulmonar progressivo associado a alteração hemodinâmica (hipertensão arterial pulmonar - HAP) que se torna moderada a acentuada em cerca de 5% a 10% dos casos. A HAP persistente após a cirurgia cardíaca corretiva é uma condição com curso altamente desfavorável. Remover ou reduzir a carga hemodinâmica sobre a circulação pulmonar parece, portanto, crítico para uma possível indução de remodelamento arterial reverso. O presente estudo, prospectivo, longitudinal e de coorte, teve como objetivo avaliar o impacto de uma estratégia de tratamento combinado, cirúrgico (cardíaco) e medicamentoso, em especial sobre a hemodinâmica pulmonar analisada seis meses após, em pacientes pediátricos com alterações circulatórias pulmonares moderadas e acentuadas. MÉTODOS: Caracterizada a presença de hipertensão pulmonar por exame à beira leito, pacientes foram submetidos a estudo hemodinâmico (cateterismo cardíaco) com prova de vasorreatividade com óxido nítrico inalado. A seguir, passaram a receber a sildenafila (inibidor de fosfodiesterase 5) por via oral (1,0 a 5,0 mg/kg/dia), sendo a vasorreatividade novamente testada mediante estimação ecocardiográfica da variável Qp/Qs (razão entre os fluxos sanguíneos pulmonar e sistêmico). A indicação cirúrgica foi baseada em extensa análise de dados diagnósticos. Durante a cirurgia, houve coleta de material de biópsia para análise da microvasculatura pulmonar. Computados os eventos pós-operatórios, houve alta hospitalar sob uso da sildenafila por seis meses. Nesta ocasião, a nova situação hemodinâmica foi registrada (cateterismo), sendo investigados possíveis preditores de alterações residuais. RESULTADOS: Incluíram-se 31 pacientes (idade 11,0 (7,8-20,4) meses, mediana e intervalo interquartílico) com hipertensão pulmonar suficientemente importante para levar a saturação de oxigênio a 93% (90%-95%). A resistência vascular pulmonar (RVP) foi 4,7 (3,9-7,2) U x m2, com queda para 3,3 (1,8-5,6) U x m2 sob óxido nítrico inalado (p < 0,001). A razão entre as resistências pulmonar e sistêmica (RVP/RVS) foi 0,31 (0,23-0,49) e 0,23 (0,12-0,37), respectivamente (p < 0,001). Nos 21 casos com redução >- 20% em ambas as variáveis, houve incremento de Qp/Qs, subsequentemente em resposta à sildenafila (2,0 (1,3-2,2) para 2,3 (1,8-2,5), p = 0,019). Quatro indivíduos sem resposta inicial ao óxido nítrico tiveram incremento > 30%. Houve 28 indicações para a cirurgia, com três óbitos imediatos. Confirmando a gravidade, cinco dos 22 casos biopsiados tiveram lesões vasculares pulmonares de graus III / IV (classificação proposta por Heath e Edwards). O grau de hipertrofia muscular arteriolar teve relação direta com a resposta ao óxido nítrico (coeficientes de correlação sempre >- 0,50, p < 0,020). Seis meses após, houve redução de 47%, 40% e 38% respectivamente na pressão média arterial pulmonar, RVP e RVP/RVS (p < 0,001), com normalização em 14 dos 25 pacientes. A razão RVP/RVS >- 0,24 sob óxido nítrico (cateterismo inicial) foi preditiva de hemodinâmica anormal após seis meses (sensibilidade, 73%; especificidade, 79%; razão de chances, 9,78; intervalo de confiança de 95%, 1,51-61,65, p = 0,017). CONCLUSÕES: combinando-se os tratamentos cirúrgico e medicamentoso, foi possível reduzir (ou normalizar) a carga hemodinâmica pulmonar, fato com possível impacto sobre o remodelamento arterial reverso. A vasorreatividade se mantém apesar da gravidade, é demonstrável por metodologia diversa e possui substrato histopatológico bem caracterizado. A possibilidade de normalização hemodinâmica está relacionada ao grau de vasodilatação atingido no teste inicial, guardada a condição de manutenção da terapia vasodilatadora / INTRODUCTION: Patients with nonrestrictive congenital cardiac septal defects can present progressive pulmonary vascular remodeling associated with hemodynamic alteration (pulmonary arterial hypertension - PAH) which might range from moderate to severe in about 5% to 10% of the patients. The persistence of PAH following corrective cardiac surgery is a very unfavorable condition. Removing or reducing the hemodynamic stress overload over the pulmonary circulation is indeed critical, and might call for a possible induction of reversal of pulmonary vascular remodeling. This current study - prospective, longitudinal and cohort - means to assess the impact of a strategic treatment which associates cardiac surgery as well as medication, mostly over pulmonary hemodynamics within a six months follow-up in pediatric patients with moderate to severe pulmonary circulation alterations. METHODS: Once the presence of pulmonary hypertension was diagnosed through a bedside exam, the patients underwent a hemodynamic study (cardiac catheterization) with vasoreactivity testing with inhaled nitric oxide. Right after that, sildenafil (phosphodiesterase type 5 inhibitor) was administered orally (1.0 to 5.0 mg/kg/day). The vasoreactivity was again tested by the estimate of the echocardiographic variable Qp/Qs (pulmonary to systemic blood flow ratio). The indication for surgical treatment was based on the comprehensive analysis of diagnostic data. During the surgery, biopsy samples were collected in order to analyze the pulmonary microvasculature. Once the postoperative events were recorded, the patient was discharged, and the administration of sildenafil was maintained for six months. On that occasion, the new hemodynamic indices were recorded (catheterization), and residual alteration predictors were investigated. RESULTS: The study comprised 31 patients (mean age 11.0 (7.8-20.4) months, median and interquartile range) with significant pulmonary hypertension so as to lead to 93% (90%-95%) oxygen saturation. The pulmonary vascular resistance (PVR) was 4.7 (3.9-7.2) U x m2, dropping to 3.3 (1.8-5.6) U x m2 by the inhalation of nitric oxide (p < 0.001). The ratio between the pulmonary and systemic resistances (PVR/SVR) was 0.31 (0.23-0.49) and 0.23 (0.12-0.37) respectively (p < 0.001). In the 21 cases of >- 20% reduction in both variables, there was a Qp/Qs increment, subsequently, in response to sildenafil administration (2.0 (1.3-2.2) to 2.3 (1.8-2.5), p = 0.019). Four subjects with no response in the early inhalation of nitric oxide had a > 30% increment. Twenty-eight patients underwent surgery, three of whom died right after it. Five out of 22 biopsied cases had pulmonary vascular lesions level III / IV (Heath-Edwards grading system), confirming its severity. In all analyzed vascular segments, the level of arterial muscle hypertrophy was directly associated with the nitric oxide response (coefficients of correlation always >- 0.50, p < 0.020). Six months postoperatively, there was a 47%, 40% and 38% reduction, respectively, of the mean pulmonary arterial pressure, PVR and PVR/SVR (p < 0.001), with normalization in 14 out of 25 patients. The PVR/SVR ratio under nitric oxide (initial catheterization) >- 0.24, which was predictive to abnormal hemodynamics at six months (sensibility, 73%; specificity, 79%; hazard ratio, 9.78; confidence interval, 95%, 1.51-61.65, p = 0.017). CONCLUSIONS: By associating the surgical treatment along with medication, it was possible to reduce (or normalize) the pulmonary hemodynamic overload, which might have had some impact on the reverse cardiac remodeling. The vasoreactivity remains despite its severity, and it is demonstrated by diverse methodology that it has a distinct histopathologic component. The possibility of normalizing the hemodynamics is directly associated with the level of vasodilation, once the vasodilator therapy is maintained

INTRODUÇÃO: Pacientes pediátricos portadores de defeitos septais cardíacos não restritivos podem apresentar, em cerca de 5% a 10% dos casos, remodelamento vascular pulmonar progressivo, com evolução para hipertensão arterial pulmonar (HAP) de grau moderado ou acentuado. A inflamação e a imunidade exercem papel central na patogênese da HAP, porém são ainda pouco exploradas neste grupo específico de pacientes. O presente estudo, prospectivo, longitudinal e de coorte, teve como objetivo avaliar níveis circulantes de mediadores inflamatórios segundo grupos de pacientes hemodinamicamente distintos. Concomitantemente foram analisadas possíveis correlações com dados histopatológicos e com resposta à intervenção medicamentosa. MÉTODOS: Estabelecida a forte suspeita de hipertensão pulmonar por exame à beira leito, foram incluídos no estudo 47 pacientes, com idade de dois a 37 meses (mediana 10 meses), sendo 32 portadores de síndrome de Down. Pacientes classificados como Grupo 1 (n=16) apresentavam sinais clínicos de hiper-resistência pulmonar e foram aqueles submetidos ao cateterismo cardíaco, com níveis comprovadamente elevados de resistência vascular pulmonar (5,2 (4,2-8,9) U x m2, mediana e intervalo interquartílico). Pacientes classificados como Grupo 2 (n=31) apresentavam sinais clínicos de hiperfluxo com congestão pulmonar, não necessitando de cateterismo pré-operatório. A relação entre fluxo pulmonar e sistêmico (Qp/Qs), estimada por ecocardiografia, foi de 1,9 (1,3-2,6) no Grupo 1 e 2,8 (2,3-3,3) no Grupo 2 (p=0,008). Foram analisadas 36 citocinas séricas através de quimioluminescência. RESULTADOS: Observando-se os pacientes como um todo (n=47), os níveis séricos da quimiocina MIF (macrophage migration inhibitory factor) estavam aumentados (7510±2755 pixels x 5697±2051 pixels em controles pediátricos, média±desvio padrão). Entretanto, os níveis de MIF estiveram especificamente aumentados no Grupo 1 quando comparados ao Grupo 2 e controles (respectivamente, 8494±619 pixels, 6618±477 pixels e 6548±726 pixels, média ajustada para idade±erro padrão, p=0,037). Por outro lado, níveis da quimiocina RANTES (regulated on activation, normal T cell expressed and secreted) estavam aumentados especificamente no Grupo 2 quando comparados ao Grupo 1 e controles (respectivamente, 74183±3865 pixels, 60130±6455 pixels e 59332±3970 pixels, média±erro padrão, p=0,039). Este comportamento foi semelhante quando analisados apenas os pacientes com síndrome de Down. Em todos os pacientes, a quimiocina GRO-Alfa (growth-regulated oncogene alpha) esteve aumentada nos primeiros meses de vida, com subsequente declínio exponencial (R2= -0,47, p < 0,001), enquanto a interleucina 17E (também conhecida como IL-25) apresentou relação direta com a idade (R2=0,44, p=0,002). A interleucina 16 apresentou relação inversa com o fluxo sanguíneo pulmonar (rs= -0,34, p=0,018) e níveis mais elevados em pacientes com evidência de doença vascular avançada em biópsia realizada no intra-operatório (p=0,021). Pacientes do Grupo 1 receberam sildenafila no pré-operatório, o que resultou em aumento do fluxo sanguíneo pulmonar (p=0,012) e da saturação periférica de oxigênio (p=0,010), além de redução dos níveis de interleucina 6 (p=0,027) e ICAM-1 (intercellular adhesion molecule 1) (p=0,011). Não foi observado comportamento particular em pacientes com síndrome de Down. CONCLUSÕES: Os dados apresentados indicam uma relação entre níveis séricos de algumas citocinas e gravidade da doença vascular pulmonar, com potenciais implicações fisiopatológicas e clínicas. Além disso, o envolvimento da interleucina 17E e do MIF enfatizam o papel da resposta imune Th2, já descritas na HAP. Os resultados também permitem um questionamento a respeito das generalizações correntes relacionadas à vasculopatia pulmonar na síndrome de Down, anteriormente considerada como fator de risco em todos os casos / INTRODUCTION: Pediatric patients with nonrestrictive cardiac septal defects may present progressive pulmonary vascular remodeling with progression to pulmonary arterial hypertension (PAH), which might range from moderate to severe in about 5% to 10% of the patients. Inflammation and immunity play a central role in the pathogenesis of PAH, but are still poorly explored in this specific group of patients. This current study - prospective, longitudinal and cohort - was aimed at evaluating circulating levels of inflammatory mediators according to hemodynamically distinct groups of patients. At the same time, possible correlations with histopathological data and response to vasodilator intervention were analyzed. METHODS: After the establishment of a strong suspicion of pulmonary hypertension at bedside, 47 patients aged 2 to 37 months (median 10 months) were included in the study, of which 32 had Down syndrome. Patients classified as Group 1 (n = 16) had clinical signs of elevated pulmonary vascular resistance and were subjected to cardiac catheterization, with proven levels of increased pulmonary vascular resistance (5.2 (4.2-8.9) U x m2, median and interquartile range). Patients classified as Group 2 (n = 31) presented clinical signs of increased blood flow with pulmonary congestion, requiring no preoperative catheterization. The pulmonary to systemic blood flow ratio (Qp/Qs), estimated by echocardiography, was 1.9 (1.3-2.6) in Group 1 and 2.8 (2.3-3.3) in Group 2 (p = 0.008). Thirty-six cytokines and related proteins were analyzed in serum by chemiluminescence. RESULTS: Observing patients as a whole (n = 47), serum levels of the chemokine MIF (macrophage migration inhibitory factor) were increased (7510 ± 2755 pixels x 5697 ± 2051 pixels in pediatric controls, mean ± standard deviation). However, MIF levels were specifically increased in Group 1 when compared to Group 2 and controls (respectively, 8494 ± 619 pixels, 6618 ± 477 pixels and 6548 ± 726 pixels, mean age adjusted ± standard error, p = 0.037). On the other hand, RANTES (regulated on activation, normal T cell expressed and secreted) levels were specifically increased in Group 2 when compared to Group 1 and controls (respectively 74183 ± 3865 pixels, 60130 ± 6455 pixels and 59332 ± 3970 pixels, mean ± standard error, p = 0.039). This behavior was similar when only patients with Down syndrome were analyzed. In all patients, GRO-Alpha (growth-regulated oncogene alpha) was increased in the first months of life, with subsequent exponential decline (R2 = -0.47, p < 0.001), while interleukin 17E (also known as IL-25) presented a direct relationship with age (R2 = 0.44, p=0.002). Interleukin 16 was negatively related to pulmonary blood flow (rs = -0.34, p = 0.018) and was higher in patients with evidence of advanced vascular disease by intraoperative lung biopsy (p = 0.021). Patients in Group 1 received sildenafil in the preoperative period, which resulted in increased pulmonary blood flow (p = 0.012) and peripheral oxygen saturation (p = 0.010), as well as decreased levels of interleukin 6 (p = 0.027) and ICAM-1 (intercellular adhesion molecule 1) (p = 0.011). There was no particular behavior of subjects with Down syndrome at all. CONCLUSION: The presented data indicate a relationship between serum levels of some cytokines and the severity of pulmonary vascular disease, with potential pathophysiological and clinical implications. In addition, the involvement of interleukin 17E and MIF emphasizes the role of Th2 immune response, already described in PAH. The results also raise doubts if Down syndrome should be considered as a risk factor in a generalized way

A precipitação e cristalização de proteínas são operações unitárias amplamente utilizadas na indústria biotecnológica. A formação de precipitado nestas operações é muitas vezes atingida por meio da adição de um sal que diminui a solubilidade da proteína, ou seja, o chamado fenômeno de saltingout. A principal informação para o estudo da precipitação e da cristalização é o diagrama de fases, em que a solubilidade da proteína é apresentada em função das variáveis do sistema (temperatura, pH, concentração de sal). Outra medida importante é o segundo coeficiente virial, que é uma medida indireta da interação intermolecular. A combinação de ambas as informações é fundamental para a identificação das condições em que fases cristalina ou amorfa são obtidas. O equilíbrio sólido-líquido da lisozima de clara de ovo de galinha em soluções aquosas contendo sais biodegradáveis (succinato de sódio, citrato de sódio e tartarato de sódio) foi estudado por meio da determinação da solubilidade da proteína e do segundo coeficiente virial em função da força iônica. Os dados experimentais do segundo coeficiente virial em função da força iônica foram medidos por meio de cromatografia de autointeração. Estes dados foram correlacionados por modelos apropriados. As informações de solubilidade e do segundo coeficiente virial da proteína foram combinadas para gerar condições experimentais adequadas na identificação da janela de cristalização, i.e., as condições em que uma fase cristalina é obtida. Uma matriz do tipo placa de cultivo foi usada para os experimentos de cristalização. Os resultados experimentais mostraram que as regiões das fases cristalina e amorfa no diagrama de fases são funções simultâneas do segundo coeficiente virial, como parâmetro termodinâmico, e da supersaturação, como parâmetro cinético. Os três sais foram capazes de induzir o efeito salting-out, sendo o succinato de sódio o sal mais eficaz na diminuição da solubilidade da lisozima, seguido pelo tartarato de sódio e pelo citrato de sódio. No caso da lisozima, cristais foram obtidos em soluções de succinato de sódio e tartarato de sódio, e as condições nas quais a fase cristalina é formada foram identificadas; no entanto, para o citrato de sódio somente fase amorfa foi observada. Em conjunto, estes resultados mostram que estes sais biodegradáveis são agentes precipitantes promissores. / The precipitation and crystallization of proteins are unit operations widely used in the biotechnology industry. The formation of a solid phase in these operations is often achieved by adding a salt that lowers the protein solubility, the so-called salting-out phenomenon. The key information to study precipitation or crystallization is the phase diagram, in which the solubility of a protein is presented as a function of system variables (temperature, pH, salt concentration). Another important parameter is the second virial coefficient, which is an indirect measure of intermolecular interactions. The combination of both kinds of information is fundamental to identify the conditions in which crystal and amorphous phases can be formed. The solid-liquid equilibrium of hen egg-white lysozyme in aqueous solutions containing biodegradable salts, viz., sodium citrate, sodium tartrate and sodium succinate, was studied by determining both the protein solubility and the second virial coefficient as a function of ionic strength. Experimental data for second viral coefficient as a function of ionic strength were obtained through self-iteration chromatography. These data were correlated by appropriate models. The protein solubility and the second virial coefficient information were combined to generate adequate experimental conditions to identify the so-called crystallization slot, i.e., the conditions in which a crystalline solid phase is obtained. A plate matrix disposition was used for the crystallization experiments. The experimental results show that the crystal and amorphous regions in the phase diagram depend simultaneously on the second virial coefficient, as a thermodynamic parameter, and on the supersaturation ratio, as a kinetic parameter. All these salts were able to induce salting-out, being sodium succinate the most effective one in decreasing lysozyme solubility, followed by sodium tartrate and sodium citrate. For lysozyme in sodium succinate and sodium tartrate solutions, the conditions for which a crystal phase is formed were identified; however, for sodium citrate only amorphous solid phases were observed.! Overall, these results show that these biodegradable salts are promising precipitating agents.