L'implication des polynucléaires neutrophiles (PN) dans l'hémostase n'est pas un concept nouveau, mais requière encore beaucoup d'éclaircissements. Des données attribuent à ces cellules à la fois une capacité à favoriser (voire à déclencher) les mécanismes et une capacité à limiter voire éliminer le caillot de fibrine. Pour expliquer leur implication, une contribution des enzymes granulaires, et essentiellement la cathepsine G (Cath G) et l'élastase (HNE), est fréquemment citée. L'objet de ces travaux est d'étudier chez des sujets sains l'impact des PN humains et des 2 enzymes granulocytaires (Cath G et HNE) sur la coagulation, à l'aide de tests globaux : thromboélastométrie rotative et test de génération de thrombine. Le potentiel procoagulant des PN a aussi été étudié en thrombinographie chez des patients atteints de syndrome myéloprolifératif (SMP) JAK2V617F positif. Dans les systèmes choisis, les PN font preuve d'une activité procoagulante claire, permettant notamment une réduction systématique du temps de coagulation et une augmentation du travail thrombinique total. Cette activité procoagulante est proportionnelle à la concentration en PN et est exacerbée après stimulation préalable par le fMLP, mais elle n'est pas liée à une activité facteur tissulaire. La Cath G et l'HNE permettent également toutes deux une réduction du temps de coagulation, mais elles font preuve à la fois d'effets procoagulants (par inactivation des inhibiteurs comme le TFPI) et anticoagulants (par inactivation du facteur V ou par dégradation de la (du) fibrin(ogèn)e). Enfin, les données de ce travail ne mettent pas en évidence une hypercoagulabilité liée aux PN dans le contexte de SMP. / Polymorphonuclear neutrophils (PMN) are the most abundant nucleated cells in blood. Their involvement in haemostasis – in particular in coagulation and clot formation – is not a new concept, but is not yet fully understood. Many data from the literature indicate that these cells can enhance (even trigger) coagulation, whereas others indicate it can impair fibrin formation and facilitate clot elimination. Among the hypotheses explaining this involvement, attention has focused on PMN granules enzymes, in particular, Cathepsin G (Cath G) and elastase (HNE). We first aim at studying in healthy subjects the impact of PMN as well as Cath G and HNE on coagulation by use of global tests: rotative thromboelastometry (ROTEM®) and thrombin generation test (CAT®). Second, procoagulant potential of PMN is investigated using CAT® in patients affected by myeloproliferative disorders (MPD), with presence of JAK2V617F mutation. Under our conditions, PMN show an unambiguous procoagulant activity, inducing systematically a decrease in clotting time, along with an increase in total thrombin work. This activity is proportional with PMN concentration; fMLP-induced PMN stimulation enhances also it, but this is not related to tissue factor activity. Both Cath G and HNE induce a decrease in clotting time, but support procoagulant (by inactivation of inhibitors such as TFPI) as well as anticoagulant activity (by inactivation of factor V or fibrin(ogen) degradation). At last, data obtained don't show MPD-associated hypercoagulability which can be attributed to PMN.

Histidine-rich glycoprotein (HRG) is a plasma protein that regulates key cardiovascular processes such as coagulation, angiogenesis and immune response. The protein consists of six distinct functional domains: two N-terminal domains (N1 and N2), two proline-rich regions (PRR1 and PRR2), a central histidine-rich region (HRR) and a C-terminal domain. The HRR binds Zn²⁺, which alters the affinity of HRG towards various ligands including the anticoagulant, heparin. A key aim of this study was to structurally characterise HRG. The 1.93 Å crystal structure of the HRG N2 domain presented here represents the first crystallographic snapshot of the molecule. The N2 domain is cystatin-like and N-glycosylated at Asn184. An S-glutathionyl adduct was observed at Cys185, providing in vivo evidence that release of an anti-angiogenic HRR/PRR fragment is controlled in part by a redox mechanism, representing a novel further role for GSH in regulation of angiogenesis. Since Zn²⁺ regulates some of the functions of HRG, the dynamics of Zn²⁺ in plasma were investigated using a combination of ITC, ELISA and thrombin assay systems. Zn²⁺ is normally associated with albumin in circulation, but its ability to bind Zn²⁺ is allosterically inhibited upon fatty acids binding to albumin. Elevated plasma fatty acid levels are associated with some disease states. It is proposed that this may alter the proportion of Zn²⁺ bound to HRG, which could in turn activate thrombin to promote coagulation. These studies provide evidence to suggest that Zn²⁺-dependent activation of HRG (following fatty acid binding to albumin) may play a role in the development of haemostatic complications in susceptible individuals. Finally, the Zn²⁺ binding ability of albumin was probed in order to locate unidentified sites using recombinant albumin mutants. H9A, H67A, E252A, D256A and H288A mutants all exhibited diminished Zn²⁺ binding ability, indicating that these residues are involved directly or indirectly in Zn²⁺ binding.

Contraceptivos orais combinados (COCs) são largamente utilizados e bem aceitos para se obter a contracepção. Estima-se que mais de 100 milhões de mulheres ao redor do mundo fazem uso deste método contraceptivo. Embora seja alcançada a contracepção, estas usuárias estão predispostas ao desenvolvimento de tromboembolismo venoso (TEV) ou arterial (TEA), e ao desenvolvimento de aterosclerose, em virtude da alteração hemostática causada pela dose de estrógeno e tipo de progesterona utilizada nas formulações. Como forma de obter uma formulação dita \"ideal\" e na esperança de que os efeitos adversos que podem ocorrer em detrimento da composição da formulação contraceptiva sejam minimizados, a literatura aponta um contraceptivo recentemente lançado, cuja composição contém o Valerato de Estradiol (chamado de estrógeno natural pela indústria farmacêutica) como componente estrogênico e o Dienogest como progesterona sintética, integrando o grupo dos assim classificados novos progestágenos. OBJETIVO: Dentro do contexto que acima apresentamos, o projeto de pesquisa teve como objetivo avaliar duas formulações contraceptivas, através de um estudo experimental comparativo, onde como grupo controle utilizamos o clássico Levonorgestrel (LVG) e Etinilestradiol (EE), para compará-lo com o novo progestágeno lançado no mercado brasileiro em 2011, composto por Dienogest (DNG) e Valerato de estradiol (17? Estradiol - metabólito ativo) - ambos medicamentos isolados e em mistura, representados por MIX I (LVG+EE) e MIX II (DNG+17?), respectivamente. Pelo fato de pouco se saber sobre os efeitos deste novo progestágeno sobre os fatores vasoativos, hemostáticos e inflamatórios, propusemos aqui trabalhar com cultura de células endoteliais extraídas de cordão umbilical humano, estimulá-las com agente inflamatório LPS e/ou TNF? para posteriormente dosar os seguintes fatores: em Célula Endotelial de Veia Umbilical Humana (HUVEC) - moléculas de adesão VCAM-I, ICAM-I e E-Selectina (sobrenadante e superfície celular de HUVEC); fatores vasoativos derivados do endotélio (NO, Prostaglandina PGE2 e Endotelina ET-1 - sobrenadante) e citocinas pró-inflamatórias IL-1? e IL-6 no sobrenadante. Em Célula Endotelial de Artéria Humana (HAEC): Fator Tecidual. Os medicamentos reduziram a expressão de moléculas de adesão no sobrenadante e na superfície celular, regularam a produção de fatores vasoativos derivados do endotélio, reduziram a produção de citocinas pró-inflamatórias e reduziram também a expressão de fator tecidual, de maneira preventiva e terapêutica. A mistura dos contraceptivos representada por MIX I e MIX II apresentou diferenças significativas quando comparadas aos demais grupos de estudo e MIX II apresentou maior efetividade na redução de alguns fatores aqui estudados, conferindo uma proteção endotelial. Desta maneira, podemos concluir que o novo progestágeno lançado no mercado brasileiro apresentou efeitos antitrombóticos e anti-inflamatórios, por reduzir de maneira significativa os níveis de moléculas de adesão, fatores vasoativos, fatores pró-inflamatórios e fator hemostático / Combined oral contraceptives (COCs) are widely used and well accepted to provide contraception. It\'s estimated that over 100 million women around the world make use of this contraceptive method. Although contraception is achieved, these users are predisposed to developing venous thromboembolism or arterial and development of atherosclerosis due to the change caused by the hemostatic dose of estrogen and progestin type used in the formulations. In order to get a said formulation \"correct\" and hoping that the adverse effects that may occur at the expense of the contraceptive formulation composition are minimized, the literature indicates a contraceptive recently launched, whose composition contains Estradiol valerate (called natural estrogen by the pharmaceutical industry) as estrogen component and the Dienogest as synthetic progesterone, integrating the group of so classified new progestins. OBJECTIVE: Within the context that we present above, the research project aimed to evaluate two contraceptive formulations, through a comparative experimental study, where as the control group used the classic Levonorgestrel (LVG) and ethinylestradiol (EE), to compare it with the new progestin released in Brazil in 2011, composed of Dienogest (DNG) and estradiol valerate (17? Estradiol - active metabolite) - both alone and in combination medications, represented by MIX I (LVG plus EE) and MIX II (DNG plus 17?), respectively. \'Cause little is known about the effects of the progestogen on the new vasoactive factors, hemostatic and inflammatory proposed here work with cultured endothelial cells derived from human umbilical cord stimulus them with LPS inflammatory agent and / or TNF? to further quantitate the following factors: HUVEC (Human Umbilical Vein Endothelial Cell) - adhesion molecules VCAM-I, ICAM-I and E-selectin (supernatant and cell surface); endothelium-derived vasoactive factors (NO, PGE2 and Endothelin ET-1 - culture supernatant) and pro-inflammatory cytokines as IL-1? and IL-6 in the supernatant. HAEC (Human Arterial Endothelial Cell): Tissue factor on primary cell culture of umbilical cord artery. The drugs reduced the expression of adhesion molecules in the supernatant and the cell surface reduced the production of endothelium-derived vasoactive factors, regulated the production of cytokines proinflammatory and also reduced the expression of tissue factor, preventive and therapeutic way. The mixture of contraceptives represented by MIX MIX I and II showed significant differences when compared to the other study groups and MIX II showed greater effectiveness in reducing some factors studied here, giving an endothelial protection. Thus, we can conclude that the new progestogen released in Brazil showed antithrombotic effects and anti-inflammatory, to reduce significantly the levels of adhesion molecules, vasoactive factors, proinflammatory factors and hemostatic factor.

Os mecanismos responsáveis pelas manifestações hemorrágicas durante a leptospirose severa ainda são pouco compreendidos. Este trabalho avaliou os efeitos diretos e indiretos das leptospiras sobre moléculas do sistema de coagulação. Foi verificado que leptospiras virulentas são eficientes em bloquear a atividade da enzima trombina por meio do sequestro de seu sítio de ligação ao substrato, gerando uma menor formação do coágulo de fibrina, acarretando em sangramento e consequente disseminação do patógeno para outros sítios de infecção. Foi mostrado também que a inflamação causada pela resposta imune contra as bactérias causa uma ativação da coagulação, muito provavelmente via expressão de Fator Tissular, o que ocasiona um consumo e consequente esgotamento dos fatores e inibidores de coagulação, culminando em hemorragia e formação de trombos, os quais podem levar à falência de órgãos. Estes resultados melhoram o entendimento da patogênese da leptospirose e podem favorecer o desenvolvimento de terapias para as manifestações hemorrágicas. / The mechanisms responsible for the hemorrhagic manifestations during severe leptospirosis are still poorly understood. This work evaluated the direct and indirect effects of leptospires upon molecules of the coagulation system. It has been shown that virulent leptospires are effective in blocking the activity of the enzyme thrombin by sequestration of its substrate binding site, generating less fibrin clot formation, leading to bleeding and consequent dissemination of the pathogen to other sites of infection. It has also been shown that the inflammation caused by the immune response against the bacteria causes an activation of the coagulation, most probably via expression of Tissue Factor, which causes a consumption and consequent depletion of coagulation factors and inhibitors, culminating in hemorrhage and thrombus formation, which can lead to organ failure. These results improve the understanding of the pathogenesis of leptospirosis and may favor the development of therapies for hemorrhagic manifestations.

Ho, Sui Fan Tong. / Thesis (M.Sc.)--Chinese University of Hong Kong, 1992. / Includes bibliographical references (leaves 68-71). / LIST OF TABLES / LIST OF FIGURES / ACKNOWLEDGEMENTS / ABSTRACT / Chapter 1. --- INTRODUCTION --- p.1 / Chapter 2. --- OBJECTIVES --- p.12 / Chapter 3. --- MATERIALS AND METHODS --- p.13 / Chapter 3.1 --- Materials --- p.13 / Chapter 3.1.1 --- Enzymes --- p.13 / Chapter 3.1.2 --- DNA Markers --- p.13 / Chapter 3.1.3 --- General Reagents --- p.13 / Chapter 3.2 --- General Methods --- p.15 / Chapter 3.2.1 --- Phenol and Phenol/Chloroform (1:1) Preparation --- p.15 / Chapter 3.2.2 --- Buffer Preparation --- p.15 / Chapter 3.2.3 --- Agarose Gel Electrophoresis --- p.18 / Chapter 3.2.4 --- Polyacrylamide Gel Electrophoresis --- p.18 / Chapter 3.3 --- DNA Study --- p.19 / Chapter 3.3.1 --- Haemophilia B Patient --- p.19 / Chapter 3.3.2 --- Blood Collection --- p.20 / Chapter 3.3.3 --- DNA Extraction --- p.20 / Chapter 3.3.4 --- DNA Quantitation --- p.21 / Chapter 3.3.5 --- Polymerase Chain Reaction --- p.22 / Chapter 3.3.6 --- Purification of PCR Products --- p.28 / Chapter 3.3.7 --- Sequencing --- p.32 / Chapter 3.3.8 --- Cloning --- p.37 / Chapter 4. --- RESULTS --- p.40 / Chapter 4.1 --- DNA Extraction --- p.40 / Chapter 4.2 --- Calibration of the Coy TempCycler --- p.42 / Chapter 4.3 --- Optimization of PCR --- p.44 / Chapter 4.3.1 --- PCR-1 --- p.44 / Chapter 4.3.2 --- PCR-2 --- p.46 / Chapter 4.3.3 --- PCR-3 --- p.46 / Chapter 4.3.4 --- PCR-4 --- p.48 / Chapter 4.3.5 --- PCR-5 --- p.49 / Chapter 4.3.6 --- PCR-6 --- p.50 / Chapter 4.3.7 --- PCR-7 --- p.51 / Chapter 4.4 --- Purification of PCR Product --- p.52 / Chapter 4.4.1 --- GC-1 --- p.52 / Chapter 4.4.2 --- GC-2 --- p.52 / Chapter 4.4.3 --- GC-3 --- p.53 / Chapter 4.4.4 --- PAGE-1 --- p.54 / Chapter 4.4.5 --- PAGE-2 --- p.54 / Chapter 4.4.6 --- Agarose Gel Extraction with Glasswool Exclusion --- p.55 / Chapter 4.5 --- Direct Sequencing of PCR Products --- p.55 / Chapter 4.6 --- Cloning --- p.55 / Chapter 5. --- DISCUSSION --- p.57 / Chapter 5.1 --- DNA Extraction --- p.57 / Chapter 5.2 --- Polymerase Chain Reaction --- p.57 / Chapter 5.3 --- Purification of PCR Products --- p.58 / Chapter 5.4 --- Sequencing --- p.61 / Chapter 5.5 --- Cloning --- p.61 / Chapter 6. --- CONCLUSION --- p.67 / Chapter 7. --- PHOTOGRAPHS --- p.64 / Chapter 8. --- REFERENCES --- p.68

Traumatic brain injury (TBI) is a major cause of death among trauma patients and is associated with a high rate of mortality due to complications such as bacterial pneumonia, sepsis, and subsequent coagulopathies. While severe TBI is positively associated with the development of pneumonia, mild traumatic brain injury (mTBI) results in a paradoxical decrease in mortality following bacterial pneumonia via an unidentified mechanism. New evidence suggests that mTBI stimulates vagus nerve signaling resulting in an anti-inflammatory state that is mediated by neurotransmitters (NT) such as acetylcholine (ACh) and substance P (Sub P). This anti-inflammatory state induced by mTBI has been correlated with an increased resistance to pneumonia (PNA) in mice and has been shown to be mediated in part by increased bacterial clearance in the lungs via enhanced neutrophil recruitment. However, it has not been investigated whether this reduced mortality is due to alterations in the coagulation system and if they have any effect on either the severity or occurrence of disseminated intravascular coagulation (DIC), a common sequelae of pneumonia-induced sepsis. Our study investigates whether administration of mTBI prior to pneumonia challenge in mice decreases mortality by ameliorating DIC. We assess and define DIC in our mouse models by changes in plasma coagulation parameters including fibrinogen, D-dimer, and plasminogen activator inhibitor-1 (PAI-1) Our study found that mTBI administration prior to pneumonia significantly decreased mortality in mice gavaged with high concentrations of Pseudomonas aeruginosa (Psd.). We also found that mTBI administration prior to pneumonia rescued fibrinogen levels and increased D-dimer levels in plasma, suggesting a compensated fibrinolytic state and amelioration of DIC. Circulating neutrophil and absolute leukocyte counts were also increased in mTBI/pneumonia models compared to those with pneumonia alone, supporting previous evidence implicating mTBI as the origin of enhanced bacterial clearance in lungs. Taken together, these data suggest that the increase in survival seen in patients with mTBI is in part due to alterations in coagulation.

Thesis. 1975. Ph.D.--Massachusetts Institute of Technology. Dept. of Mechanical Engineering. / Vita. / Bibliography: leaves 73-77. / Ph.D.

L'objectif de ce travail était d'étudier l'influence qu'exerce la microstructure des caséines sur la diffusion moléculaire de petites sondes ayant des tailles et des déformabilités différentes. La mobilité de sondes moléculaires flexibles (''PEGs'') et rigides (dendrimères) de taille variée a été étudiée dans des suspensions et des gels de PPCN et de CaNa à différentes concentrations en protéines. Les mesures ont été réalisées par RMN qui permet de sonder des mobilités translationnelles sur une distance de 1,5 µm, mais également des mobilités locales à l'échelle moléculaire (quelques nanomètres) à travers les temps de relaxation T2. Un modèle cohérent a été utilisé et un mécanisme unique a été proposé pour décrire la diffusion de petites sondes dans les deux systèmes de caséine. C'est la combinaison de différents facteurs qui doivent être pris en considération : le rapport de la taille de la sonde à la distance entre les particules obstruantes ou les points d'enchevêtrement ainsi que la flexibilité de la sonde. La mobilité locale des sondes était beaucoup moins réduite que la mobilité translationnelle dans les deux systèmes de caséine. Différents comportements de relaxation ont été obtenus entre les deux systèmes de caséine et une diminution des T2 a été mesurée dans les gels. Ces résultats ont été liés à la mobilité intrinsèque de la matrice. L'ensemble des résultats obtenus ont permis d'avoir une meilleure compréhension de la mobilité des sondes dans les systèmes caséiques et de proposer un nouveau modèle qui contredit celui déjà proposé par Le Feunteun et al. pour expliquer la diffusion des sondes dans ces systèmes. / The aim of this study was to investigate the impact of the casein microstructure on the molecular diffusion of probes with different sizes and deformabilities. The mobility of molecular flexible (‘PEG’) and rigid (dendrimer) probes of various sizes was studied in suspensions and gels of NPC and SC at various protein concentrations. Measurements were carried out by NMR, which makes it possible to probe translational mobilities over a distance of 1.5 microns, as well as local mobilities at the molecular scale (several nanometers) through the relaxation times, T2. A coherent model was used and the same mechanism was proposed to describe the diffusion of small probes in both casein dispersions. It is the combination of different factors that should be considered: the ratio of the probe size to the distance between the obstructing particles or the entanglement points, as well as the flexibility of the probe. The rotational diffusion of PEG and dendrimer probes was less hindered than translational diffusion in both casein systems. Different relaxation behaviors were observed between the two casein systems and retardation in T2 relaxation times was highlighted in rennet and acid casein gels. These results are probably related to the local mobility of the matrix. The overall results of this project led to a better understanding of probe mobility in casein systems and made it possible to propose a new model that challenges the previous one proposed by Le Feunteun et al. to describe the diffusion of probes in casein systems.

The changes in quaternary structure of casein supramolecules with various physical and chemical treatments were studied using transmission electron microscopy, and a model to account for the changes is put forth. The effects of casein structure on coagulation properties were also studied. The sample preparation for transmission electron microscopy involved physical methods of fixation and flash freeing to preserve the structure of caseins in the sample. The structure of caseins in sodium and calcium caseinate varied with sodium caseinate not exhibiting any spherical structure as opposed to the spherical structure seen in calcium caseinate, non-fat dried milk and native milk. This difference in structure was carried over to rennet coagulum made from those sources of casein. Addition of calcium and phosphate to sodium and calcium caseinate, respectively, improved their coagulation properties. Hydration parameters such as time and shear of hydration affected the extent of hydration. High shear (733 s-1) or approximately 10 hr of hydration was required to disperse and hydrate the dried milk protein powders. Acidification and treatment with excess EDT A resulted in dissociation of casein supramolecules into various sizes and shapes. Heat treatment of milk in the presence of ethanol also resulted in its dissociation. High heat treatment of milk at various pH levels induced different types of whey protein casein interactions. All these changes can be explained using an irregular supramolecular structure of caseins based on a node and strand network of proteins and calcium phosphate nanoclusters. Such a filigreed sponge-like appearance is seen in native bovine milk and in milk of other species.

Highly concentrated micellar casein concentrate (HC-MCC), a potential ingredient for cheese making, containing ~20% casein with ~70% of serum proteins removed by microfiltration, and diafiltration of skim milk, and then further concentrated by vacuum evaporation. The objectives of this research were to investigate solubilization, cold gelation, rennet coagulation properties of recombined HC-MCC and cream for its use in cheese making. In Chapter 3, either mixing thawed HC-MCC in water at high temperature (~50C) or addition of trisodium citrate can achieve complete dispersion and more than 80% solubility of HC-MCC in water (3% protein). Overnight storage helps to fully disperse HC-MCC, but only reaches ~30% of solubility at 20C. Cold-gelation of HCMCC is thermally reversible and reducing protein levels in HC-MCC can decrease its CGT. The HC-MCC with less than 16% of protein does not gel at 5C. We propose that cold-gelation of HC-MCC occurs when the kinetic energy of the casein micelles is sufficiently reduced to inhibit their mobility in relation to adjacent casein micelles. In Chapter 4, the recombined concentrated milk (RCM) by mixing thawed frozen HC-MCC and cream with 12% casein at pH 6.6 does not gel until cooled below 12°C. Addition of either sodium citrate or high levels of calcium increased CGT, although low levels of calcium did not impact CGT. Cold gelation of RCM was thermally reversible, even when citrate was added to partially chelate calcium. We propose that cold gelation of RCM occurs when protein strands that have been partially released from the casein micelles entangle, restrict their mobility and form a fine stranded gel network. The RCM at a casein level of 12% (wt/wt) has potential for use in cheese making. In Chapter 5, reducing rennet level can increase coagulation time of RCM (11% casein) without impact on curd firmness or firming rate. Decreased coagulation temperature helps to increase coagulation time and decrease curd firmness rate, but also increases the initial viscosity of RCM. Pre-acidified RCM has no advantage in increasing coagulation time, decreasing curd firmness or firming rate. Microstructure of RCM and its coagulum indicates that the increased curd firmness probably results from the highly inter-linked and longer protein strands in RCM curd. Reducing rennet level can be applied to slow down rennet coagulation of RCM (11% casein) in cheese making.