<p>Diss. (sammanfattning) Umeå : Umeå universitet, 1994, härtill 5 uppsatser.</p> / digitalisering@umu

Submitted by Irene Nascimento (irene.kessia@ufpe.br) on 2016-10-06T17:20:04Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação Denise Maria do Nascimento Costa.pdf: 2568349 bytes, checksum: 97687424c47175731885cd254c815ad4 (MD5) / Made available in DSpace on 2016-10-06T17:20:04Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação Denise Maria do Nascimento Costa.pdf: 2568349 bytes, checksum: 97687424c47175731885cd254c815ad4 (MD5) Previous issue date: 2016-07-21 / Introdução: Glomerulopatia membranosa (GM) é uma causa de síndrome nefrótica cuja etiologia pode ser primária (GMP) ou secundária, dentre estas é frequente o Lúpus eritematoso sistêmico (LES). Trata-se de uma doença imunologicamente mediada, caracterizada pela deposição de imunocomplexos no espaço subepitelial glomerular. A maioria dos antígenos envolvidos identificados são alvos da imunoglobulina G4 (IgG4), subclasse predominante em imunofluorescências renais na GMP, em contraste com a GM secundária a LES (GMS) na qual IgG1, IgG2 e IgG3 prevalecem. Apesar da IgG4 ser um subtipo de imunoglobulina com baixa capacidade de ativação do complemento, há várias evidências deste envolvimento na GMP. Esses dados, em conjunto com achados de depósitos glomerulares de lectina ligadora de manose (MBL), um dos principais componentes da via das lectinas do complemento, podem sugerir que tanto a via da lectina como a IgG4 estão envolvidas nesta patologia. Sabe-se ainda que o desenvolvimento de GMP também está associado a alterações genéticas. Entretanto, a etiopatogenia da GMP ainda não é totalmente conhecida e estudos para avaliação gênica do MBL2 e dosagem sérica de IgG em GM são escassos. Assim, foi realizado este estudo com o objetivo de avaliar a frequência de polimorfismos do gene MBL2 em portadores de GM, comparados a indivíduos saudáveis. Um segundo objetivo foi comparar pacientes com GMP e GMS quanto a diferenças do percentual de IgG4 sérico em relação a IgG (%IgG4) e da frequência de polimorfismos do MBL2. Métodos: Estudo realizado entre 2014 e 2015, em Pernambuco - Brasil. A amostra incluiu 60 pacientes adultos com diagnóstico histopatológico de GMP ou GMS. Outras causas de GM secundárias foram excluídas. Foram avaliados 35 pacientes com GMP e 24 com GMS, e um grupo controle (GC), formado por 101 indivíduos saudáveis. Resultados: O alelo mutante O do gene MBL2 foi mais frequente no grupo com GM comparados aos GC (42% x 22%; p < 0,001). A heterozigose A/O, em relação ao genótipo A/A, predominou entre os pacientes comparados ao GC, associando-se a GM com OR = 11,16 (95% IC = 4,77 - 28,41). À análise comparativa entre os pacientes com GMP e GMS, não houve diferença das frequências dos polimorfismos genéticos entre os grupos. O grupo GMP apresentou menor mediana de IgG sérica total (p = 0,008) e maior %IgG4 (p = 0,016), comparado ao grupo GMS. Nível sérico de IgG4 não diferiu significativamente entre os grupos GMP e GMS (p = 0,289). Conclusão: O polimorfismo do éxon 1 do gene MBL2 associou-se à GM, comparado a indivíduos saudáveis, porém sem diferença entre as etiologias avaliadas. Já o %IgG4 sérico foi maior na GMP em relação a GMS. Estes resultados sugerem que esta mutação genética possa conferir maior vulnerabilidade a GMP e que o %IgG4 sérico possa ser utilizado como marcador adicional para diagnóstico diferencial entre as duas etiologias da GM. / Introduction: Membranous glomerulopathy (MG) is a cause of nephrotic syndrome whose etiology may be primary (PMG) or secondary, wich is frequent systemic lupus erythematosus (SLE). It is an immune-mediated disease characterized by the deposition of immune complexes in the glomerular subepithelial space. Most of the identified antigens are targets to immunoglobulin IgG4, most common subclass in renal immunofluorescence in GMP, in contrast to the SLE secondary MG (SMG) in which IgG1, IgG2 and IgG3 prevail. Although IgG4 is a immunoglobulin subtype with low complement activation capacity, there is abundant evidence of this involvement in PMG. These data, together with glomerular deposits of mannose-binding lectin (MBL), a major component of the lectin pathway of complement, may suggest that both the lectin pathway and IgG4 are involved in this pathology. It is also known that the development of PMG is associated with genetic alterations. As the pathogenesis of PMG is not yet fully known, and studies for genetic evaluation of MBL2 and serum IgG in MG are scarce, this study was conducted to evaluate the frequency of MBL2 gene polymorphisms in patients with MG, compared to healthy subjects. A second objective was to compare patients with PMG and SMG with respect to the percentage of serum IgG4 (IgG4%) and frequency MBL2 polymorphisms. Methods: This study was conducted between 2014 and 2015 in Pernambuco - Brazil. The sample included 60 adult patients with histopathologic diagnosis of PMG or SMG. Other causes of secondary MG were excluded. Thity five patients with PMG and 24 with SMG were evaluated, compared to a control group (CG) of 101 healthy subjects. Results: The mutant allele O was more frequent in the MG population compared to CG (42% vs. 22%; p <0.001). The heterozygous A/O, compared to genotype A/A, predominated among patients compared to the control group, and was associated with MG (OR = 11.16; 95% CI = 4.77 to 28.41). In the comparative analysis between patients with PMG and SMG, there was no difference in the frequency of genetic polymorphisms between groups. The PMG group had lower median total serum IgG (p = 0.008) and higher IgG4% (p = 0.016) compared to the SMG group. Serum IgG4 did not differ significantly between the groups PMG and SMG (p = 0,289). Conclusion: The polymorphism of exon 1 MBL2 gene was associated with MG, compared to healthy subjects, but no difference between the assessed etiologies. Serum IgG4% was higher in PMG relative to SMG. These results suggest that this gene mutation can confer increased vulnerability to PMG and the serum IgG4% may be used as an additional marker for the differential diagnosis between the two etiologies MG.

Research on nanoparticles for pharmaceutical applications has become increasingly popular in recent years. N-trimethyl chitosan chloride (TMC) is a cationic polymer that can enhance absorption across mucosal surfaces. It has been explored as a nanoparticulate drug delivery system for the delivery of vaccines, vitamins, insulin and cancer medication. It has special interest for intravenous use, as it is soluble over a wide range of pH values. However, polycationic nanoparticles run a great risk for intravenous toxicity, as the positive surface charge allows easy electrostatic interactions with negatively charged blood components, such as red blood cells and plasma proteins. Additionally, the small size of the nanoparticles permits the binding of more proteins per mass, than larger particles do. These interactions can lead to extensive hemolysis, cell aggregation, complement activation, inflammation and fast clearance of the particles from the circulation. A decrease in the surface charge density can ameliorate these toxic interactions. Such a decrease is achieved by adding poly(ethylene) glycol (PEG) to the particle’s formulation. PEG creates a steric shield around the particles, preventing a certain extent of interaction between the particles and the blood components. To be able to use TMC nanoparticles as a successful drug delivery system, the hemocompatibility must first be determined, which was the aim of this study. The influence of particle size, concentration and the addition of PEG were also examined. The extent of hemolysis and cell aggregation caused by the experimental groups (20% and 60% concentration small TMC nanoparticles, 20% larger TMC nanoparticles and 20% cross-linked PEGTMC nanoparticles) were determined by incubating the groups with whole blood and/or blood components. Complement activation was determined with a Complement C3 Human enzyme-linked immunosorbent assay (ELISA) and plasma protein interactions were quantified through rapid equilibrium dialysis and a colorimetric assay. It was determined that 60% concentration small TMC nanoparticles caused 49.08 ± 2.538% hemolysis at the end of a 12-hour incubation period, significantly more than any other experimental group. This group had also caused mild aggregation of the white blood cells and platelets. This was the greatest extent of cell aggregation seen in any of the groups. No significant complement activation was seen by any of the experimental groups. Because of the cationic nature of the particles, all groups had more than 50% of the initial particles in the sample bound to plasma proteins after a 4-hour incubation period. However, at 90.68 ± 0.828%, the 60% small TMC nanoparticles had had significantly more interaction with the plasma proteins than the other groups. Through the experimental measurements it was revealed that TMC nanoparticles had hemotoxic effects at high concentrations. The addition of PEG to the particle formulation stabilized the particles and decreased their zeta potential , but had no significant effect on improving hemocompatibility. It was concluded that although further tests are needed, TMC nanoparticles seem to have potential as a successful intravenous carrier for high molecular weight active pharmaceutical ingredients. / MSc (Pharmaceutics), North-West University, Potchefstroom Campus, 2014

Research on nanoparticles for pharmaceutical applications has become increasingly popular in recent years. N-trimethyl chitosan chloride (TMC) is a cationic polymer that can enhance absorption across mucosal surfaces. It has been explored as a nanoparticulate drug delivery system for the delivery of vaccines, vitamins, insulin and cancer medication. It has special interest for intravenous use, as it is soluble over a wide range of pH values. However, polycationic nanoparticles run a great risk for intravenous toxicity, as the positive surface charge allows easy electrostatic interactions with negatively charged blood components, such as red blood cells and plasma proteins. Additionally, the small size of the nanoparticles permits the binding of more proteins per mass, than larger particles do. These interactions can lead to extensive hemolysis, cell aggregation, complement activation, inflammation and fast clearance of the particles from the circulation. A decrease in the surface charge density can ameliorate these toxic interactions. Such a decrease is achieved by adding poly(ethylene) glycol (PEG) to the particle’s formulation. PEG creates a steric shield around the particles, preventing a certain extent of interaction between the particles and the blood components. To be able to use TMC nanoparticles as a successful drug delivery system, the hemocompatibility must first be determined, which was the aim of this study. The influence of particle size, concentration and the addition of PEG were also examined. The extent of hemolysis and cell aggregation caused by the experimental groups (20% and 60% concentration small TMC nanoparticles, 20% larger TMC nanoparticles and 20% cross-linked PEGTMC nanoparticles) were determined by incubating the groups with whole blood and/or blood components. Complement activation was determined with a Complement C3 Human enzyme-linked immunosorbent assay (ELISA) and plasma protein interactions were quantified through rapid equilibrium dialysis and a colorimetric assay. It was determined that 60% concentration small TMC nanoparticles caused 49.08 ± 2.538% hemolysis at the end of a 12-hour incubation period, significantly more than any other experimental group. This group had also caused mild aggregation of the white blood cells and platelets. This was the greatest extent of cell aggregation seen in any of the groups. No significant complement activation was seen by any of the experimental groups. Because of the cationic nature of the particles, all groups had more than 50% of the initial particles in the sample bound to plasma proteins after a 4-hour incubation period. However, at 90.68 ± 0.828%, the 60% small TMC nanoparticles had had significantly more interaction with the plasma proteins than the other groups. Through the experimental measurements it was revealed that TMC nanoparticles had hemotoxic effects at high concentrations. The addition of PEG to the particle formulation stabilized the particles and decreased their zeta potential , but had no significant effect on improving hemocompatibility. It was concluded that although further tests are needed, TMC nanoparticles seem to have potential as a successful intravenous carrier for high molecular weight active pharmaceutical ingredients. / MSc (Pharmaceutics), North-West University, Potchefstroom Campus, 2014

Neisseria gonorrhoeae (Ng) which causes gonorrhea has become multidrug-resistant, necessitating the development of novel therapeutics and vaccines. mAb 2C7 which targets an epitope within an important virulence factor, the lipooligosaccharide (LOS), is a candidate therapeutic mAb. Ninety-four percent of clinical isolates express the 2C7-epitope which is also a vaccine target. Ng expresses multiple LOS(s) due to phase-variation (pv) of LOS glycosyltransferase (lgt) genes. mAb 2C7 reactivity requires a lactose extension from the LOS core Heptose (Hep) II (i.e. lgtG ‘ON’ [G+]). Pv results in HepI with: two (2-), three (3-), four (4-), or five (5-) hexoses (Hex). How HepI glycans impact Ng infectivity and mAb 2C7 function are unknown and form the bases of this dissertation. Using isogenic mutants, I demonstrate that HepI LOS glycans modulate mAb 2C7 binding. mAb 2C7 causes complement (C’)-dependent bacteriolysis of three (2-Hex/G+, 4-Hex/G+, and 5-Hex/G+) of the HepI mutants in vitro. The 3-Hex/G+ mutant (resistant to C’-dependent bacteriolysis) is killed by neutrophils in the presence of mAb and C’. In mice, 2- and 3-Hex/G+ infections are significantly shorter than 4- and 5-Hex/G+ infections. A chimeric mAb 2C7 that hyperactivates C’, attenuates only 4- and 5-Hex/G+ infections. This study enhances understanding of the role of HepI LOS pv in gonococcal infections and shows that longer HepI glycans are necessary for prolonged infections in vivo. This is the first study that predicts in vitro efficacy of mAb 2C7 against all four targetable HepI glycans thereby strengthening the rationale for development of 2C7-epitope based vaccines and therapeutics.