Un bio-marqueur est un paramètre biologique absent ou exprimé à un taux basal en situation physiologique, et présent ou surexprimé en cas d'altération de la fonction tissulaire correspondante. Le dosage de certain bio-marqueurs permet de suivre voire d'anticiper la survenue d'une complication en post-opératoire, et permet la prise en charge rapide et adaptée de cette complication. Les patients opérés cardiaques sont exposés à plusieurs types de complications. Les plus importantes sont l'ischémie myocardique résiduelle voire l'infarctus péri-opératoire, les complications respiratoires, l'insuffisance rénale et les infections de la cicatrice sternale. Chacune de ces complications augmente la morbi-mortalité post-opératoire. Le dosage de la TROPONINE I CARDIAQUE a montré son intérêt dans la détection des ischémies myocardiques résiduelles et le diagnostic d'infarctus péri-opératoire. Nous avons testé l'intérêt du ratio Troponine I cardiaque à 12h / Troponine I cardiaque à 6h dans la détection des ischémies myocardiques résiduelles post-opératoires. Nous avons démontré qu'un rapport de troponine H 12/H6> 1.3 permet de détecter les lésions des greffons au décours de pontages coronariens. Leur détection précoce permet de prévenir l'évolution péjorative des greffons. La NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (NGAL), est un marqueur de l'insuffisance rénale jamais encore testé chez les patients insuffisants rénaux chroniques en pré-opératoire de chirurgie cardiaque. Nous avorn démontré que la NGAL plasmatique est un marqueur robuste de l'apparition d'une insuffisance rénale aigüe en post­opératoire de chirurgie cardiaque, chez des patients déjà insuffisants rénaux en pré-opératoire. Un taux de NGAL à la 6ème heure supérieur à l 55ng/ml est un facteur de risque indépendant de survenue d'une insuffisance rénale aigüe post­opératoire. L'ENDOCAN est un marqueur de l'atteinte pulmonaire, qui n'a jamais été testé dans le cadre de la chirurgie cardiaque. Nous proposons de: 1) Déterminer la cinétique de L'Endocan dans le contexte inflammatoire de la CEC, 2) Evaluer le lien entre la diminution du taux d'Endocan circulant et le risque d'évolution vers une défaillance respiratoire d'origine septique ou inflammatoire, 3) Comparer la cinétique de l'Endocan à celle d'autres marqueurs de l'inflammation et de l'infection: Protéine C Réactive (CRP) et procalcitonine (PCT), et 4) Evaluer la valeur pronostique du taux d'Endocan dans la survenue des décès postopératoires d'origine respiratoire. Nous avons réalisé une étude pilote qui a mis en évidence que 6 heures après l'intervention, les patients ayant présenté une infection pulmonaire post-opératoire avaient des niveaux significativement plus élevés d'Endocan que les patients sans infection pulmonaire. Cette étude pilote a montré un intérêt potentiel pour concevoir une étude spécifique, qui a été soumise pour publication. Nous avons réalisé secondairement une étude prospective incluant 155 patients. Les résultats confirment ceux de l'étude pilote à savoir que le taux d'Endocan en préopératoire et à 6 heures est prédictif de l'atteinte pulmonaire post-opératoire. / A biomarker is a biological parameter absent or expressed at a basal Ievel in physiological situation, and present or overexpressed in the event ofalteration of the corresponding tissue function. The dosage ofsome biomarkers makes it possible to follow or even anticipate the occurrence of a postoperative complication, and allows a rapid and adapted management ofthis complication. Patients with heart surgery are exposed to several types of complications. The most important are residual myocardial ischemia and perioperative infarction, respiratory complications, renal insufficiency and sternal wound infections. Each c these complications increases post-operative morbidity and mortality. The determination of the cardiac TROPONINE I has shown its interest in the detection ofresidual myocardial ischemia and the diagnosis ofperioperative infarction. We tested the cardiac Troponin I ratio at 12 h / cardiac Troponin I at 6 h in the detection ofpost-operative residual myocardial ischemia. We have demonstrated that a ratio oftroponin Hl2 / H6> 1.3 makes it possible to detect the lesions of the grafts after coronary bypass surgery. Their early detection makes it possible to prevent the pejorative evolution of the grafts. NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (NGAL), is a marker ofrenal failure never tested in patients with chronic renal failure in preoperative cardiac surgery. We have demonstrated that plasma NGAL is a robust marker for the development of acute renal failure in postoperative cardiac surgery in patients with pre-operative renal failure. An NGAL level at the 6th hour above 155ng / ml is an independent risk factor for the occurrence of post­operative acute renal failure. ENDOCAN is a marker ofpulmonary involvement, which has never been tested in cardiac surgery. We propose to: 1) Determine the kinetics ofEndocan in the inflammatory context of the CEC, 2) Assess the Iink between the decrease in circulating endocan and the risk ofprogress towards respiratory failure ofseptic origin or Inflammatory, 3) Compare endocan kinetics with other markers of inflammation and infection: Protein C Reactive (CRP) and procalcitonin (PCT), and 4) Assess the prognostic value of the rate of inflammation, Endocan in the occurrence ofpostoperative respiratory deaths. We conducted a pilot study that found that 6 hours after the procedure, patients with postoperative pulmonary infection had significantly higher levels ofEndocan than patients without pulmonary infection. This pilot study showed a potential interest in designing a specific study, which was submitted for publication. We performed a prospective study, which included 155 patients. The results confirm the results of the pilot study, namely that the preoperative and 6-hour Endocan is predictive ofpostoperative pulmonary involvement

Une tumeur nécessite un approvisionnement en oxygène et en nutriments pour sa croissance mais aussi pour la dissémination à distance vers d’autres organes. L’angiogenèse tumorale est le phénomène exploité par la tumeur pour accomplir ses besoins. Les «Tip cells » situées à l’extrémité des capillaires en bourgeonnement initient et guident la croissance des néovaisseaux. Ces cellules sont considérées actuellement comme une cible thérapeutique pertinente pour les médicaments anti-angiogéniques. De nombreuses études ont permis d’identifier un cluster de marqueurs moléculaires exprimés de manière privilégiée au niveau des « Tip cells ». Un de ces marqueurs appelé endocan, a été identifié au laboratoire, et a fait objet du travail réalisé pendant la thèse. Endocan est un protéoglycane circulant surexprimé dans de nombreux cancers humains dont l’expression est fréquemment associée à un mauvais pronostic. Par son glycane, endocan intervient dans la croissance tumorale en augmentant l’effet des facteurs de croissance, mais aussi la migration des cellules endothéliales. Mon travail de thèse s’est orienté sur la caractérisation biochimique et fonctionnelle d’endocan murin afin d’avoir un modèle animal utile pour une meilleure compréhension de l’activité pro-tumorale d’endocan humain. Les travaux présentés dans ce manuscrit montrent qu’endocan murin est un protéoglycane de type chondroitine sulfate, mais partiellement glycosylé. Ce déficit de glycosylation est gouverné par des domaines peptiques distants codés par l’exon 1 et l’exon 2 et qui distinguent l’endocan murin de son homologue humain. Dans un modèle de xénogreffe tumorale chez la souris SCID, nous avons démontré qu’endocan murin ne présente aucun pouvoir pro-tumoral. Contrairement à l’endocan humain, il ralentit la vitesse de croissance tumorale. Cette propriété anti-tumorale est liée à la présence d’une forme non glycosylée. Nous avons pu montrer à travers plusieurs modèles de xénogreffes tumorales que cette propriété de freinage de la croissance tumorale s’étend aussi au core protéique d’endocan humain. De plus, nous avons pu démonter qu’une administration systémique d’endocan non glycosylé est significativement associée à un ralentissement de la croissance tumorale. Ceci établit la relation de causalité entre le polypeptide d’endocan et la propriété anti-tumorale observée dans les différents modèles animaux. Le polypeptide d’endocan ne modifie pas in vitro la prolifération ni la viabilité des cellules HT-29 ce qui laisse penser à un mécanisme d’action indirect. Sur le plan pathologique, nous avons montré que les formes non glycosylée d’endocan humain et murin sont associées à une réaction inflammatoire stromale constituée d’une infiltration pan-leucocytaire. La déplétion des leucocytes CD122+ (essentiellement les cellules NK murines) abolit partiellement l’effet anti-tumoral induit par l’endocan non glycosylé. Nos résultats ajoutent endocan au concert des molécules endothéliales tumorales qui participent au contrôle de la réaction inflammatoire stromale. / Solid tumor requires a supply of oxygen and nutrients for growth but also for metastasizing to another organ. Tumor angiogenesis is the phenomenon exploited by tumor to fulfill these needs. The"Tip cells" located at the end of sprouting capillaries initiate and guide the growth of neovessels. These cells are currently considered as an important therapeutic target for anti-angiogenic drugs. Many studies have identified a cluster of molecular markers selectively expressed by the \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\"Tip cells.\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\" One of these markers called “endocan”, has represented the subject of the thesis work.Endocan is a circulating proteoglycan overexpressed in many human carcinomas, and expression is often associated with poor prognosis. It is suspected to play an important role in tumor development. Through its glycan chain, endocan modulates the effect of growth factors, and also the migration of endothelial cells. My thesis work has focused on the biochemical and functional characterization of mouse endocan in order to obtain a useful animal model for better understanding of the pro tumoral activity of human endocan. The work presented in this manuscript shows that mouse endocan is a chondroitin sulfate proteoglycan but much less glycanated than human endocan. Our data indicate that combinatorial distant domains from the O-glycanation site, located within exons 1 and 2 determine the glycanation pattern of endocan. In SCID mouse model of tumor xenograft we demonstrated that mouse endocan does not exhibit a pro tumoral activity. In opposite to the human homologue, overexpression of mouse endocan in HT-29 cells delayed the tumor appearance and reduced the tumor growth rate. This tumor growth inhibition was mostly supported by non glycanated mouse endocan. Unexpectedly, human non glycanated endocan overexpressed in HT-29, A549, or K1000 cells also delayed the tumor appearance and reduced the tumor growth. Moreover, systemic delivery of human non glycanated endocan also reproduced HT-29 tumor delay. In vitro, endocan polypeptide did not affect HT-29 cell proliferation, nor cell viability.Interestingly, a stromal inflammatory reaction was observed only in tumors overexpressing endocan polypeptide. In addition, depletion of CD122+ cells was able to delete partially the tumor delaying effect of endocan polypeptide. These results reveal a novel pathway for endocan in the control of tumor growth, which involves innate immune cells.

Les protéoglycannes exercent de nombreuses fonctions par le biais de leur partie protéique ou de leurs glycosaminoglycannes. La caractérisation des interactions entre les glycosaminoglycannes et des protéines a ouvert de larges champs d'applications. Dans ce cadre, deux thèmes de recherche ont été développés. Premièrement, nous nous sommes intéressés à un nouveau protéoglycanne appelé endocan. La développement des capacités de production et de purification de cette macromolécule, nous a permis par différentes approches de déterminer le profil structural de sa chaîne glycannique et de sa partie protéique, mais aussi d'étudier les interactions avec plusieurs de ses partenaires protéiques dont l'interféron γ et l'hépatocyte growth factor, impliqués respectivement dans l'inflammation et le développement tumoral. Parallèlement, une étude structurale et fonctionnelle de l'interaction entre l'interféron γ et des glycosaminoglycannes de type héparanes sulfates a conduit au développement de mimes oligosaccharidiques obtenus par synthèse chimique. Parmi ces molécules, certaines permettent de moduler in vitro l'activité de la cytokine, et constituent une base possible pour le développement de nouveaux médicaments.

Angiogenesis, the formation of new blood vessels from preexisting ones through creation of new vessel branch points by sprouting or vessel splitting, is an important part of tissue growth in both physiological processes like wound healing and pathological conditions such as cancer. Growth factors like VEGF-A, FGF-2 and PDGF-BB are involved in both types of angiogenesis. Screening for genes regulated by VEGF-A stimulation in endothelial cells revealed up regulation of the endothelial cell specific glycoprotein endocan. Endocan itself did not stimulate angiogenesis. VEGF was a specific inducer since FGF-2, PDGF-BB, HGF and EGF did not alter expression. The signaling molecule PI3K was a negative regulator of endocan expression. Endocan was expressed in tumor cells and vessels, suggesting that although endocan did not directly regulate angiogenesis it can serve as a marker for angiogenic tumors. In two models of wound healing angiogenesis, the chick extra-embryonal CAM assay and the mouse cornea assay, we observed that blood vessels grew into avascular areas as functional mural cell covered loops by elongation of preexisting vessels. Loop formation was simultaneous with contraction of the avascular matrix mediated by proto/myofibroblasts. Reducing the contractibility of the stroma reduced vessel ingrowth, showing that contraction was necessary for mediating and directing growth of the vascular loops. These findings suggest a model for biomechanical regulation of vascularization that is complementary to sprouting angiogenesis which is guided by gradients of growth factors. In defining the role of growth factors, in the CAM assay, we found that FGF-2 and PDGF-BB induced vessel ingrowth, while VEGF-A, EGF and HGF did not. TGF-beta reduced the effect of FGF-2. By use of specific receptor kinase inhibitors we found an absolute requirement VEGF- and PDGF-receptor activity for vascularization while FGF- and TGF-beta-receptor function was dispensable. This suggests that functional VEGF- and PDGF-receptors are needed for vessel elongation.

Les protéoglycannes exercent de nombreuses fonctions par le biais de leur partie protéique ou de leurs glycosaminoglycannes. La caractérisation des interactions entre les glycosaminoglycannes et des protéines a ouvert de larges champs d'applications. Dans ce cadre, deux thèmes de recherche ont été développés. <br />Premièrement, nous nous sommes intéressés à un nouveau protéoglycanne appelé endocan. La développement des capacités de production et de purification de cette macromolécule, nous a permis par différentes approches de déterminer le profil structural de sa chaîne glycannique et de sa partie protéique, mais aussi d'étudier les interactions avec plusieurs de ses partenaires protéiques dont l'interféron Γ et l'hépatocyte growth factor, impliqués respectivement dans l'inflammation et le développement tumoral. Parallèlement, une étude structurale et fonctionnelle de l'interaction entre l'interféron gamma et des glycosaminoglycannes de type héparanes sulfates a conduit au développement de mimes oligosaccharidiques obtenus par synthèse chimique. Parmi ces molécules, certaines permettent de moduler in vitro l'activité de la cytokine, et constituent une base possible pour le développement de nouveaux médicaments.

Angiogenesis, de novo formation of blood vessels from the pre-existing vasculature, is crucial in embryo development, and in processes in the adult such as wound healing and ovulation. Angiogenesis is also involved in pathological conditions such as cancer and chronic inflammatory diseases, which are propagated by dysregulated, excess angiogenesis. On the other hand, lack of functional vessels and poor blood flow is a major problem in myocardial and peripheral ischemia. A detailed understanding of the molecular mechanisms underlying angiogenesis is of vital importance for the development of drugs to regulate angiogenesis. The aim of this thesis has been to identify genes involved in regulation of angiogenesis. We have investigated gene expression over time in endothelial cells (ECs), using different in vitro models. We show that the proteoglycan endocan is upregulated in ECs invading a fibrin matrix in response to vascular endothelial growth factor (VEGF)-A. There was increased expression of endocan in renal tumour cells and tumour vessels compared to normal renal tissues, indicating that endocan might have a role in tumour growth and tumour angiogenesis. We also show that vascular endothelial protein tyrosine phosphatase (VE-PTP) is induced in ECs during differentiation into vessel structures in a three dimensional collagen matrix. Silencing of VE-PTP disrupts vessel formation and increases the activity of VEGF receptor-2 (VEGFR-2) and downstream signalling, leading to increased EC proliferation. This presents a possible mechanism for the failure of vessel formation, as EC morphogenesis requires growth arrest of the cells. We also show that VE-PTP and VEGFR-2 are closely associated in resting ECs. VEGF-A stimulation leads to rapid loss of association, coinciding with increased phosphorylation of VEGFR-2. The function of VE-PTP in vivo was investigated using the zebrafish model. We demonstrate specific expression of a zebrafish VE-PTP orthologue (zVE-PTP) in the developing vasculature. Silencing of zVE-PTP leads to defective vessel sprouting and branching, indicating a critical role for zVE-PTP in development of the zebrafish vasculature. In conclusion, this thesis presents gene regulation during endothelial cell morphogenesis and details the expression pattern of endocan and the function of VE-PTP in regulation of VEGFR-2-driven angiogenesis.

Este trabalho descreve o desenvolvimento de seletivas fases extratoras para técnicas de microextração empregadas para a determinação de fármacos e endocanabinóide em amostras de plasma por cromatografia líquida acoplada a espectrometria de massas em Tandem (LC-MS/MS). O capítulo I descreve o desenvolvimento e aplicação da fase extratora de material de acesso restrito (RAM) para a extração em ponteiras descartáveis (DPX) de dezesseis fármacos psicotrópicos em amostras de plasma de pacientes esquizofrênicos. Em virtude da complexidade de sintomas associados à esquizofrenia, a politerapia tem sido uma prática clínica cada vez mais comum. A maioria destes fármacos possui estreito índice terapêutico, o que requer acompanhamento adequado por meio de estudos de monitorização terapêutica. Tais estudos visam otimizar as doses terapêuticas, minimizar os efeitos adversos e avaliar a anuência do paciente ao regime de dosagens. O emprego da fase seletiva, RAM, permitiu a exclusão das macromoléculas, simultaneamente, a pré-concentração dos analitos de forma rápida e eficiente. A otimização das variáveis DPX favoreceu a sensibilidade e seletividade do método, empregando pequenos volumes de amostra biológica e de solvente orgânico. O método DPX/LC-MS/MS, desenvolvido e validado, apresentou linearidade adequada com limite inferior de quantificação na faixa de concentração de 0,5-20,0 ng mL-1, precisão inter e intra-ensaio com coeficientes de variação inferiores a 15% e exatidão com valores de EPRs variando de -12% a 11%. O método proposto foi aplicado com êxito na determinação destes fármacos em amostras de plasma de pacientes esquizofrênicos. As variações encontradas nas concentrações plasmáticas de alguns pacientes podem ser atribuídas a interações farmacocinéticas ou a variações inerentes ao paciente. No capítulo II, um polímero molecularmente impresso foi sintetizado in situ, no interior de um capilar de sílica fundida, para microextração em fase sólida no capilar (in-tube SPME) do endocanabinóide, anandamida (AEA), em amostras de plasma de pacientes com Doença de Parkinson (DP). A DP é caracterizada pela neurodegeneração dos neurônios dopaminérgicos. Estudos demonstram correlação entre os sistemas endocanabinóide e dopaminérgico, ligados ao controle motor. O processo de impressão molecular (não-covalente) do MIP, bem como os reagentes de síntese empregados, originaram sítios seletivos, complementares, em forma e tamanho à AEA. Micrografias eletrônicas de varredura (MEV) e espectros de infravermelho (FTIR) ilustraram as modificações físicas e químicas da superfície do capilar impresso e não impresso (NIP), após a polimerização. A otimização das variáveis in-tube SPME, favoreceu a eficiência das extrações. O método in-tube SPME/LC-MS/MS apresentou intervalo linear de 5 ng mL-1 (LOQ) a 20 ng mL-1; os ensaios de precisão apresentaram CV variando de 1,2 a 13% e exatidão com valores de EPRs variando de -3,6 a 7,5 %. Amostras de plasma de pacientes com DP foram analisadas pelo método de adição de padrão, e a concentração plasmática média de AEA de 0,2 ng mL-1, está em concordância com os valores da literatura, demonstrando a aplicabilidade do método in-tube SPME/LC-MS/MS na área clínica. / This work describes the development of highly selective sorbents for use in microextraction techniques for determination of drugs and endocannabinoid in plasma samples by liquid chromatography coupled to Tandem mass spectrometry (LC-MS/MS). Chapter I describes the development and application of a restricted access material (RAM-BSA) for use as extractive phase in DPX technique (\"Disposable pipette extraction\") for determination of 16 psychotropic drugs in plasma samples obtained from schizophrenic patients. Polytherapy has been increasingly common in clinical practice associated with schizophrenia due the complexity of its symptoms. Most of these drugs have narrow therapeutic index, wherefore requires adequate follow-up through therapeutic monitoring studies. This monitoring aims to optimizing therapy, to minimize adverse effects and verify patient adherence to treatment. By using a selective phase, RAM, we were able to exclude the macromolecules and to pre-concentrate the analytes quickly and efficiently. Optimization of the DPX variables improved the sensitivity and selectivity of the method, which demanded only small volumes of sample and organic solvent. The DPX/LC-MS/MS method developed and validated presented adequate linearity; the lower limit of quantification ranged from 0.5 to 20.0 ng mL-1. The inter- and intra-assay precision tests provided coefficients of variation (CV) lower than 15%; and the relative standard error (RSD) values, of the accuracy tests, varied from -12% to 11%. We successfully applied the proposed method to determine drugs in plasma samples from schizophrenic patients. Variations in the plasma concentrations of drugs in some patients may result from pharmacokinetic interactions or variations inherent in the patient. Chapter II details the \"in situ\" synthesis of a molecularly imprinted polymer within a fused silica capillary for capillary solid phase (in-tube SPME) of the endocannabinoid, anandamide (AEA), in plasma samples obtained from patients with Parkinson\'s Disease (PD), which is characterized by neurodegeneration of dopaminergic neurons. Studies have demonstrated a relationship between this endocannabinoid and dopaminergic systems, which are linked to motor control. The molecular imprinting process (non-covalent) and the synthesis reagents used to obtain the MIP gave rise to complementary, selective sites with the same shape and size as AEA. Scanning electron micrographs (SEM) and infrared spectra (FTIR) helped to illustrate the physical and chemical modification of the printed and non-printed capillary surface (NIP) after polymerization. Optimization of in-tube SPME variables favored the extraction process efficiency. The \"in tube\" SPME/LC-MS/MS method showed a linear range from 5 ng mL-1 (LOQ) to 20 ng mL-1. The precision tests presented CV that varied from 1.2 to 13%; and the RSD accuracy ranged from -3.6 to 7.5%. We analyzed plasma samples from patients with PD by the standard addition method. The mean plasmatic concentration was 0.2 ng mL-1, in agreement with the literature. This resut suggested that the \"in tube\" SPME/LC-MS/MS employing the MIP extractive phase is suitable to determine AEA in plasma samples