Beaucoup de progrès restent à réaliser dans la compréhension de la physiopathologie ainsi que dans la prise en charge thérapeutique de lépilepsie. De nombreux patients restent réfractaires au traitement médical et sont susceptibles dêtre de bons candidats à un traitement chirurgical. Lapport de nouvelles techniques dimagerie est une avancée importante dans la définition des crises et dans la localisation du foyer épileptogène et a permis daméliorer le résultat du traitement chirurgical par une meilleure sélection des candidats. La première partie de notre travail est une introduction générale où sont principalement exposées les techniques actuelles dexploration de lépilepsie ainsi que les résultats à long terme du traitement chirurgical chez 399 patients souffrant dépilepsie réfractaire, de manière à préciser le rôle de la chirurgie ainsi que les facteurs pouvant influencer le résultat postopératoire. La prise en charge des crises dépilepsie réfractaire dont le foyer épileptique se localise au niveau de zone fonctionnelle reste difficile et controversée. Il existe des arguments historiques et physiologiques justifiant une exérèse chirurgicale du foyer au niveau de zones fonctionnelles telles que le cortex sensitivomoteur mais il nexiste pourtant pas dans la littérature moderne de série qui permette dévaluer lefficacité de ce traitement et de le comparer avec dautres techniques chirurgicales comme par exemple les transsections sous- piales multiples. Dans la deuxième partie de ce travail, nous présentons une série de cinq patients provenant de la série des 399 patients exposée dans la première partie de notre travail, qui ont tous bénéficié dune résection corticale au niveau du cortex sensitivomoteur. Nous montrons que la difficulté du traitement de ces patients nest pas tant le geste chirurgical mais la définition et la localisation exacte du foyer épileptogène. Nous démontrons également que la mise au point exhaustive et précise de cette pathologie, en utilisant les méthodes dinvestigation décrites dans la première partie, permet de sélectionner les candidats de manière optimale avec des résultats postopératoires satisfaisants. La physiopathologie des crises dépilepsie est encore mal définie. Le mécanisme le plus souvent évoqué est un déséquilibre synaptique entre les afférences excitatrices et inhibitrices, une anomalie des canaux ioniques membranaires ou encore un trouble du métabolisme neuronal ou glial au niveau dun foyer où les neurones présentent une activité anormale. Une des questions primordiales à éclaircir est de savoir si cest le neurone qui est hyperexcitable, le réseau neuronal présent au sein du foyer ou les deux. Les structures gliales formées par les astrocytes et les oligodendrocytes jouent-elles un rôle accessoire ou primordial dans ce phénomène ? En dehors du rôle que pourraient jouer les connexions synaptiques dans le phénomène épileptique, les jcs semblent être importantes dans le mécanisme physiopatholgique des crises. Elles pourraient favoriser la synchronisation de lactivité épileptique ainsi que la propagation de celle-ci vers les régions cérébrales avoisinantes. La troisième partie de notre travail explore le rôle que pourrait jouer les jcs dans le phénomène épileptique. Les épilepsies mésiotemporales associées à une sclérose hippocampique sont les épilepsies dont le traitement chirurgical est le plus fréquemment proposé lorsque les crises deviennent réfractaires au traitement médical. Lobtention de tissu est dès lors aisée ce qui nous a permis détudier lexpression des jcs au niveau de tissus hippocampiques provenant de patients épileptiques et de la comparer avec celle déterminée au niveau dhippocampes provenant de patients non épileptiques et obtenus postmortem. Notre objectif est de savoir si cette éventuelle contribution au phénomène épileptique est liée à une augmentation de lexpression des jcs au niveau des tissus épileptiques et, si oui au niveau de quels types cellulaires (neurones, astrocytes) et de quelles régions de lhippocampe (gyrus dentelé, CA1 à CA4, subiculum)

published_or_final_version / Obstetrics and Gynaecology / Master / Master of Medical Sciences

The cystic fibrosis transmembrane conductance regulator (CFTR) was identified to be involved in acidosis-induced ATP release from skeletal myocytes in vitro and from contracting muscle in vivo. My PhD studies aimed to investigate the underlying mechanism and identify the pathway for ATP release in acidosis-induced CFTR-regulated ATP release. Lactic acid (10 mM) decreased the intracellular pH of L6 skeletal myocytes to 6.87 ± 0.12 after 3 hours, and the lowered pH resulted in the elevation of ATP release from skeletal myocytes. The acidosis-induced ATP release was totally abolished by GlyH-101 (40 μM), an open-channel CFTR blocker, suggesting that CFTR was involved. The cAMP/PKA signaling pathway was involved in the CFTR-regulated ATP release from skeletal myocytes: 1). Forskolin increased the extracellular ATP and the phosphorylation of CFTR; IBMX, a phosphodiesterase inhibitor, further enhanced the forskolin-induced extracellular ATP and phosphorylation of CFTR; 2). Inhibition of PKA by its selective inhibitor KT-5720 abolished the acidosis-induced ATP release and the forskolin-induced phosphorylation of CFTR. In addition, the inhibition of Na+/H+ exchanger (NHE) by amiloride, or inhibition of Na+/Ca2+ exchanger (NCX) by its specific inhibitors SN-6 and KB-R7943 abolished the lactic-acid-induced ATP release from skeletal myocytes, indicating that NHE and NCX might be involved. Previous studies demonstrated that Connexin hemichannels and Pannexin channels were able to conduct ATP in response to stimuli. This study found that connexin 43 (Cx43) was strongly expressed on skeletal myocytes, while Pannexin 1 (Panx1) showed a strong expression in gastrocnemius muscle. Investigation of the role that Cx43 may play in acidosis-induced cAMP/PKA-activated CFTR-regulated ATP release from myocytes showed that: 1). Cx43 was immunoprecipitated with CFTR suggesting a physical interaction; 2). The opening of Cx hemichannels was increased by lactic acid and this lactic-acid-induced opening was inhibited by CFTRinh-172, suggesting the mediation of CFTR; 3). Inhibition of Cxs and Panxs with carbenoxolone abolished the acidosis-induced ATP release; moreover, specific silencing of the Cx43 gene using siRNA decreased both basal and acidosis-induced ATP release, suggesting that Cx43 was involved; 4). Overexpression of CFTR alone did not elevate the acidosis-induced ATP release, while overexpression of Cx43 alone doubled the acidosis-induced ATP, and co-overexpression of CFTR and Cx43 further elevated the acidosis-induced ATP release, supporting the concept that Cx43 functionally interacted with CFTR to induce the acidosis-induced ATP release. Panx1 was studied in native skeletal muscle, and found to be coimmunoprecipitated with CFTR. Inhibition of Panxs with gadolinium or probenecid abolished the muscle-contraction-induced ATP release, while inhibition with carbenoxolone or quinine reduced it to less than 10% of control, suggesting that Panx1 may be involved in the acidosis-induced ATP release during muscle contraction. All the in vitro and in vivo studies suggested that Cxs and Panx were involved in the acidosis-induced CFTR-regulated ATP release from skeletal myocytes and skeletal muscle. / published_or_final_version / Physiology / Doctoral / Doctor of Philosophy

Valvular interstitial cells (VICs) are responsible for the maintenance of heart valve leaflet structure, however their responses to mechanical loading are not fully understood. Further characterization of VIC responses with regards to phenotype (quiescent or activated via ?-smooth muscle actin [?-SMA]) and communication (through gap junction proteins connexins 43 and 26) were studied. Tissue strips from porcine aortic, pulmonary, and mitral valves were cyclically stretched in the circumferential direction at normal and above normal membrane tensions for 48 hours at 1 Hz, 37°C, and 5% CO2. Unloaded tissues were statically incubated concurrently with loaded tissues, and fresh tissue controls were collected immediately. VIC phenotype was identified by ?- SMA via immunohistochemical staining and cell enumeration, as well as by gene expression via RT-PCR. Gap junction protein Cx43 was also evaluated via immunohistochemical staining and cell enumeration and by gene expression via RT-PCR, whereas Cx26 was evaluated using immunohistochemical staining and cell enumeration only. Within the range tested, it was found that mechanical loading did not affect ?-SMA or gap junction protein levels, nor were any differences in responses noted between valve types. However, the ?-SMA gene expression level was significantly lower in the mitral valve compared to the aortic and pulmonary valves. This may indicate a difference in the genetic response pathways among the valves, but not in the functional outcomes. This difference may be explained by embryological origins, since the mitral valve, unlike the aortic and pulmonary valves, contains only VICs and no neural crest cells.

Šiame darbe pateikiama ląstelių plyšinės jungties Markovo modelių sudarymo metodika, naudojant Markovo procesus, apimanti būsenų grafų generavimą, stacionariųjų tikimybių skaičiavimą ir plyšinės jungties laidumo priklausomybės nuo įtampos skaičiavimus. Darbe aprašomi skirtingi plyšinės jungties modeliai. Kiekvienas modelis turi savo koneksinų būsenų grafus, kuriais remiantis yra simuliuojama plyšinės jungties laidžio priklausomybė nuo įtampos. Kiekvienas koneksinas gali būti aprašomas dviejomis būsenomis: „O“ – atvira, „C“ - uždara ir trijomis būsenomis: „O“ – atvira, „C“ – uždara, „D“ – visiškai uždara. Remiantis sumodeliuotais modeliais, buvo sukurta programinė įranga leidžianti grafiškai pavaizduoti modelių būsenų grafus, simuliuoti modelius ir gauti simuliacijos rezultatus. Taipogi buvo realizuota programinės įrangos realizacija į kitas sistemas. / In this paper methology of composing Markov preocess models of gap junction cells is introduced. This methology contains state graphs generation, computing of stationary probabilities and computing of the conductance of the gap junction dependence on a voltage. In this paper different gap junction models are presented. Every model has it‘s own connexin state graphs, on which the conductance of the gap junction dependence on a voltage simulation is based. Every connexin can have two different state scenarios: first scenario where two connexin model is based on two states „O“ – open or „C“ – closed and second scenario where three connexin model is based on three states „O“ – open, „C“ – closed and „D“ – deep closed. The computer programs based on these models where created, which allows user graphically see the models state graphs, simulate models and get the needed results. Also these programs are integrated into more difficult systems and into other libraries.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 3 uppsatser.

Thesis (Ph. D.)--Biomedical Engineering, Georgia Institute of Technology, 2006. / Pollman, Matthew, Committee Member ; Galis, Zorina, Committee Member ; McIntire, Larry, Committee Member ; Taylor, W Robert, Committee Member ; Jo, Hanjoong, Committee Member ; Nerem, Robert, Committee Chair.

As junções comunicantes formadas por conexinas (Cx) ligam o citoplasma de células adjacentes e permitem a passagem de moléculas e íons entre elas. No sistema nervoso, esses canais constituem as sinapses elétricas e são fundamentais para a fisiologia glial. No desenvolvimento, as conexinas estão envolvidas nos processos de migração, proliferação e diferenciação celular. Caracterizamos a expressão gênica (RNAm) e protéica de duas importantes conexinas no cerebelo de aves: Cx36 (neuronal) e Cx43 (glial). Houve um aumento protéico e na expressão de RNAm tanto para a Cx36 quanto para a Cx43. Para a Cx43 esse aumento foi associado a sinaptogênese. A Cx36 foi observada em estágios mais precoces, na camada proliferativa cerebelar. No cerebelo pós-natal, A Cx36 foi observada nos dendritos das células de Golgi. A Cx43 encontra-se principalmente em astrócitos da camada granular e substância branca. Em conclusão, nós observamos uma padrão de expressão espaço-temporal distinto entre as duas conexinas, relacionado a papéis específicos na função de desenvolvimento cerebelares. / Gap junction channels composed of connexins (Cxs) connect the cytoplasm of adjacent cells and allow the flow of ions and molecules between them. In the nervous system, these channels constitute the electrical synapses and are fundamental for the glial physiology. In the development, Cx channels are involved in the processes of cell proliferation, migration and differentiation. We characterized the gene (mRNA) and protein expression of Cx36 (neuronal) and Cx43 (glial) in the embryonic and postnatal avian cerebellum. Cx36 and Cx43 mRNA and protein levels were upregulated during development. For Cx43 this increase was clearly associated with the synaptogenesis process. Cx36 was observed in earlier stages, localized in the cerebellar proliferative layer. In the postnatal period, Cx36 was observed in the dendrites of Golgi cells. Cx43 was localized in the astrocytes of the grey and white matter. In conclusion, we observed a distinct spatio-temporal expression pattern for Cx36 and Cx43, wich is likely related to particular roles in cerebellar development and function.

A sinalização no sistema nervoso pode ocorrer pelo acoplamento direto entre células, via canais de junção comunicantes (JCs). Estes canais permitem a passagem de moléculas de até 1 kDa, e são formados por subunidades proteicas denominadas conexinas (Cxs). A comunicação celular via JCs desempenha um importante papel durante o desenvolvimento e a sinalização visual. Além disso, o acoplamento celular provido pelas JCs tem sido relacionado a processos de sobrevivência/morte celular. Do mesmo modo, ciclinas e cinases dependentes de ciclinas (CDKs), além de seu papel clássico na regulação do ciclo e diferenciação celular, estão envolvidas em processos neurodegenerativos. Estudos recentes têm observado a reentrada no ciclo celular de células neuronais pós-mitóticas em apoptose. Neste contexto, analisamos a expressão gênica e proteica das Cxs e ciclinas em resposta às lesões no sistema visual, especificamente na retina. Estas análises foram realizadas após a indução de trauma mecânico, modelo experimental que permite a visualização do foco, penumbra e áreas adjacentes à lesão. Utilizando técnicas combinadas, como a reação em cadeia da polimerase em tempo real (PCR Real-Time), Western Blot e imuno-histoquímica, avaliamos a expressão espaço-temporal destes genes e as proteínas por eles codificadas, em diferentes tempos pós-lesão. Os resultados da PCR Real-Time revelaram uma ausência de modulação da expressão gênica de Cx36 para os diferentes tempos pós-lesão analisados. A Cx43 mostrou aumento dos transcritos, após três e sete dias pós-lesão. A ciclina D1 e B1 apresentaram modulação significativa após um, três e sete dias pós-lesão. As análises de imuno-histoquímica revelaram uma redistribuição da Cx36 em resposta à lesão em diferentes tempos pós-lesão. A Cx43, por sua vez, apresentou um aumento aparente de sua expressão no foco e zona de penumbra da lesão, nos período de um, três e sete dias pós-lesão. Em retinas, após um e três dias de lesão, a ciclina D1 encontrou-se presente em células próximas ao foco da lesão. Observamos a presença de ciclina B1 no foco da lesão após um dia de lesão. Por meio de análises de Western Blot não foi possível detectar alterações das diferentes proteínas estudadas nas retinas, em períodos variados de exposição à lesão. Os dados deste estudo sugerem que i) possivelmente, as células afetadas pela lesão se encontram acopladas; ii) expressam proteínas reguladoras do ciclo celular. Levando em consideração o conjunto de resultados, sugerimos que é possível induzir ou prevenir a reentrada do ciclo celular em células pós-mitóticas da retina, controlando o acoplamento mediado pelas proteínas formadoras das JC. / Communication in the nervous system can occur directly between the cells through structures known as gap junction (GJ) channels. These channels allow the passage of small molecules up to 1 kDa and are composed of protein subunits named connexins (Cxs). Cell communication through GJ plays an important role during the development and visual signaling. Furthermore, cell coupling provided by the GJs has been related to processes of survival/cell death. Similarly, in addition to the classic role of cyclins and cyclins dependent kinases (CDKs) in the cell cycle regulation and differentiation, they are also involved in neurodegenerative processes. Recent studies have demonstrated the reentry of apoptotic post mitotic neurons in the cell cycle. In this context, we analyzed the gene and protein expression of Cxs and cyclins after lesions in the visual system, specifically in the retina. For this purpose, a mechanic trauma was induced in the retina, which represents a model that allows us to visualize the lesion focus, penumbra and adjacent areas. Using combined techniques, such as the real time polymerase chain reaction (real-time PCR), Western blot and immunohistochemistry, we evaluated the spatio-temporal expression of these genes and their encoded proteins at different times post-lesion. The real-time PCR revealed no modulation of the Cx36 gene expression for all the times post-lesion analyzed. Our results showed increase in the Cx43 transcripts one, three and seven days post-lesion. The immunohistochemistry analysis indicated redistribution of Cx36 in response to the lesion in different times. On the other hand, Cx43 presented evident increased expression in the focus and penumbra areas of the lesion one, three and seven days post-lesion. In our experiments we could observe that cyclin D1 is expressed in cells located close to the lesion focus one and three days post-lesion, while cyclin B1 is expressed in these cells only one day post-lesion. The Western blot analysis did not show changes on the protein levels evaluated in this study in any of the post-lesion times analyzed. Data obtained from this study suggest i) the cells affected by the lesion are possibly coupled by GJ; ii) these cells express protein regulators of cell cycle. Altogether, the results indicate that it is possible to induce or prevent the reentry of post mitotic cells of the retina in the cell cycle, by controlling cell coupling provided by GJ.

As conexinas são proteínas essenciais e estão diretamente relacionadas à propagação do impulso elétrico no coração, à velocidade de condução bem como à gênese de muitas afecções cardíacas. Em face da circulação extracorpórea (CEC) ainda ser utilizada de forma inconsistente na medicina veterinária e devido aos poucos estudos observados na literatura sobre os efeitos provocados pelo emprego da CEC na expressão da conexina 43 (Cx43) no miocárdio, objetivou-se avaliá-la em 15 animais da espécie canina, distribuidos em três grupos (C, CEC-1 e CEC -2) sendo, respectivamente, antes de realizada a CEC, com 60 minutos após esta e 60 minutos de CEC seguida de 30 minutos de restauração da perfusão espontânea. Avaliou-se a Cx43 pelas técnicas de imunofluorescência, western blot e RT-PCR em tempo real no tecido muscular cardíaco de regiões correspondentes aos átrios direito (AD) e esquerdo (AE), ventrículos direito (VD) e esquerdo (VE) e septo transverso. Os resultados indicaram a presença da Cx43 em todas as regiões do miocárdio nos grupos C, CEC-1 e CEC-2. A expressão da Cx43 variou significativamente em CEC-2 no AE e VD em relação ao grupo C (p<0,05). A expressão gênica de Gja1 (gene da Cx43) não apresentou diferença significativa entre os grupos estudados. Em CEC-2 identificou-se a presença de vacuolização na túnica média de artérias de pequeno calibre do miocárdio. Concluiu-se também que a canulação da aorta bem como a instalação do circuito de CEC no modo aorto-bicaval constitui técnica exequível / Connexins are essential proteins that are directly associated with electrical impulse propagation and speed of propagation in the heart. They also play a major role in numerous heart conditions. The use of cardiopulmonary bypass (CPB) in veterinary medicine is inconsistent and few studies describe the effect of cardiopulmonary bypass on the expression of connexin 43 (Cx43) in the myocardium. The objective of this study was to evaluate myocardial expression of Cx43. Connexin 43 of 15 dogs was assessed at 3 moments: prior to CPB (Group C); 60 minutes after CPB (Group CPB1); and 60 minutes after CPB followed by 30 minutes of spontaneous perfusion (Group CPB2). Assessment of Cx43 included immunofluorescence, western blot and RT-PCR real time of heart tissue samples from the right atrium (RA), left atrium (LA), right ventricle (LV), right ventricle (RV) and transverse septum. Our results showed the presence of Cx43 in all 5 areas of the myocardium in groups C, CPB1 and CPB2. A significant variation on the expression of Cx43 was observed when CPB2 LA and CPB2 RV were compared to group C (p<0,05). Expression of Gja1 (gene for Cx43) did not vary significantly among the study groups. Group CBP2 presented vacuolation of the tunica media of small myocardial arteries. We conclude that cannulation of the aorta and aorto-bicaval setup of the CPB circuit is feasible technique