L’artériopathie oblitérante des membres inférieurs conduit progressivement au rétrécissement des artères qui assurent la vascularisation des membres inférieurs. Il en résulte une ischémie des tissus irrigués par ces artères et à terme, en cas d’occlusion artérielle, une ischémie critique conduisant à une amputation du membre. De nouvelles stratégies de thérapie cellulaire basées sur l’injection de cellules progénitrices capables d’induire une angiogenèse thérapeutique se sont développées ces dernières années. Cependant le faible taux d’incorporation des cellules transplantées dans le tissu ischémique limite le développement de ces nouvelles approches. Dans ce contexte, mon travail de thèse a consisté à étudier deux approches thérapeutiques distinctes pouvant améliorer les thérapies pro-angiogènes. La première étude porte sur le fucoïdane, polysaccharide sulfaté d’origine naturelle, antithrombotique favorisant la formation de nouveaux vaisseaux sanguins dans le modèle murin d’ischémie du membre inférieur. Nous avons montré qu’il induisait le recrutement de monocytes en améliorant leur adhésion à l’endothélium activé en condition dynamique, ainsi que leur adhésion à la matrice et leur transmigration in vitro. Cette action est médiée par l’activation des voies de signalisation ERK et p38 et la sécrétion de métalloprotéinases 9. De plus, le fucoïdane entraine une polarisation des macrophages de type pro-angiogènes in vitro. Il augmente leur recrutement dans le muscle ischémié permettant de réduire ainsi la phase inflammatoire post-ischémique, la nécrose et de favoriser le processus de cicatrisation. La deuxième étude porte sur le rôle des neuropilines (NRP), co-récepteurs du VEGF (facteur de croissance pro-angiogène) exprimés à la surface des ECFC, afin de comprendre leur implication au niveau moléculaire dans le mécanisme d’action pro-angiogène des ECFCs et optimiser l’efficacité de la thérapie cellulaire. A l’aide du système d’extinction par ARN interférent, nous avons découvert un mécanisme de compensation jamais étudié auparavant puisque l’inhibition de NRP1 entraine une augmentation de celle de NRP2 et une diminution de la prolifération et de la migration des ECFCs. En revanche, l’extinction de NRP2 n’a pas d’effet sur l’expression de NRP1, mais induit une augmentation de l’adhésion des ECFCs à la matrice extracellulaire associée à une augmentation de la phosphorylation des ERK1/2. / Vascular diseases such as Peripheral Arterial Disease may evolve towards critical limb ischemia, requiring revascularization or amputation. New strategies of cell therapy based on the injection of progenitor cells able to induce therapeutic angiogenesis have been recently developed. However the low level of incorporation of transplanted cells in the ischemic tissue limits the development of these new approaches. In this context, my thesis was to study two different therapeutic approaches that can improve the pro-angiogenic therapies. The first focuses on fucoidan, a marine sulphated polysaccharide with antithrombotic properties. We have previously shown promising angiogenic properties of fucoidan in vivo. We found that fucoidan increases monocyte recruitment and improves their adhesion to activated endothelium under dynamic condition. It also increases in vitro transmigration. This action is mediated by the activation of ERK and p38 signaling pathways and metalloproteinase 9 secretion. Further, fucoidan can lead macrophage polarization to the pro-angiogenic type in vitro. It increases macrophage recruitment in ischemic muscle that could reduce post-ischemic inflammatory phase and necrosis leading to healing process. The second study focuses on the role of neuropilin (NRP), co-receptors of VEGF (pro-angiogenic growth factor). The aim of this part was to understand their involvement in the pro-angiogenic properties of ECFC at molecular level and optimize the efficiency of cell therapy. Using siRNA, we found a compensation mechanism never studied before. The NRP1 inhibition leads to an increase in the NRP2 expression and a decrease of ECFC proliferation and migration. The NRP2 silencing has no impact on NRP1, but induces ECFC adhesion to the extracellular matrix correlated with an increased level of ERK1 / 2 phosphorylation.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / IntroduÃÃo e objetivos: Os neutrÃfilos desempenham importante papel na pancreatite aguda grave. InfiltraÃÃo de neutrÃfilos no pÃncreas à um processo complexo, coordenado por molÃculas de adesÃo especÃficas, tais como a P-selectina. Fucoidina à um polissacarÃdeo sulfatado que bloqueia a funÃÃo da L-e P-selectinas. No presente estudo avaliamos se o tratamento com fucoidina poderia impedir a infiltraÃÃo de neutrÃfilos e, assim, reverter a inflamaÃÃo sistÃmica e dismotilidades gastrintestinais associadas à pancreatite aguda grave. MÃtodos: A pancreatite aguda foi induzida em camundongos Swiss pela infusÃo retrÃgrada de Ãcido taurolitocÃlico (3,0%) (TLC-S) no ducto pancreÃtico ou por injeÃÃes intraperitoneais de ceruleÃna (50 Âg/kg/h). Os grupos experimentais receberam fucoidina (25 mg/kg, iv) antes da induÃÃo da pancreatite, e os grupos de controle receberam apenas soluÃÃo salina. ApÃs 24 horas, os nÃveis sÃricos de amilase, lipase, IL-1β, TNF-α, nitrito e de malondialdeÃdo (MDA) pancreÃtico foram medidos. AlÃm disso, a atividade de mieloperoxidase (MPO) (pulmÃo, pÃncreas, estÃmago e jejuno) e avaliaÃÃo histolÃgica (pÃncreas) foram determinadas. O esvaziamento gÃstrico e trÃnsito gastrintestinal foram medidos pelo mÃtodo de centro geomÃtrico. A contratilidade gastrintestinal in vitro foi registrada atravÃs de transdutores de forÃa conectados a sistema computadorizado de aquisiÃÃo de dados. Carbacol (0,01 ÂM - 30 ÂM), KCl 60 mM e estimulaÃÃo elÃctrica (0,5-8,0 Hz; 1ms, 40 V), foram aplicados sobre o fundo gÃstrico e jejuno dos animais 24 horas apÃs a pancreatite induzida por TLC-S. Resultados: Os nÃveis de MDA pancreÃtico, amilase, lipase, nitrito, TNF-α e IL-1β sÃricos, bem como MPO pancreÃtica e pulmonar estavam aumentados tanto no modelo de pancreatite aguda induzida por TLCS quanto no modelo ceruleÃna quando comparado aos grupos controle correspondentes. Fucoidina reduziu significativamente os nÃveis aumentados de amilase, lipase, MPO pancreÃtica e pulmonar, MDA, TNF-α, IL-1β e nitrito em ambos os modelos de pancreatite aguda. As mudanÃas histolÃgicas observadas no pÃncreas em ambos os modelos foram significativamente atenuadas pela fucoidina. O modelo de pancreatite aguda induzida por TLC-S induziu retardo no esvaziamento gÃstrico e trÃnsito gastrointestinal, aumento de MPO no estÃmago e no jejuno, alÃm de hipercontratilidade de jejuno in vitro. Fucoidina reverteu significativamente os distÃrbios gastrintestinais in vivo e in vitro e os nÃveis aumentados de MPO gÃstrica e jejunal induzidos pela injeÃÃo de TLC-S. ConclusÃo: Fucoidina reduziu a gravidade da pancreatite aguda experimental atravÃs da diminuiÃÃo da infiltraÃÃo de neutrÃfilos, inflamaÃÃo sistÃmica e dismotilidades gastrintestinais, sugerindo que a modulaÃÃo das selectinas, pode constituir uma abordagem terapÃutica promissora para pancreatite aguda. / Background & Aims: Neutrophils play a critical role in severe acute pancreatitis. Tissue infiltration of neutrophils in the pancreas is a multistep process, coordinated by specific adhesion molecules, such as P-selectin. Fucoidin is a sulphated fucosylated polysaccharide that binds to and blocks the function of L- and P-selectins, and the present study has evaluated whether fucoidin treatment could prevent neutrophil infiltration, and thereby reverse the systemic inflammation and gastrointestinal dysmotility associated with severe acute pancreatitis. Methods: Acute pancreatitis was induced in Swiss mice either by the retrograde infusion of taurolithocholic acid (3.0%) (TLC-S) into the pancreatic duct or by intraperitoneal injections of cerulein (50 Âg/kg/h). The experimental groups received fucoidan (25 mg/kg, i.v.) before pancreatitis induction whist control groups received only saline. After 24 hours, pancreatic malondialdehyde (MDA), serum amylase, lipase, IL-1β, TNF- and nitrite were measured. In addition, myeloperoxidase (MPO) activity (lung, pancreas, stomach and jejunum) and histological assessment (pancreas) were determined. Gastric emptying and gastrointestinal transit (using the geometric center method) were also measured. Gastrointestinal contractility in vitro was recorded through force transducers coupled to a computerized data acquisition system, carbachol (0,01 ÂM â 30 ÂM), KCl 60mM and electrical field stimulation (0.5-8.0 Hz; 1ms; 40 V), was applied on gastric fundus and jejunum of mice 24 hours after TLC-S induced pancreatitis. Results: Pancreatic MDA, serum amylase, lipase, nitrite, TNF- and IL-1β, pancreatic and lung MPO, were increased in both TLCS- and cerulein acute pancreatitis compared with respective control groups. Fucoidan significantly decreased the augmented levels of amylase, lipase, pancreatic and lung MPO, MDA, TNF-, IL-1β and nitrite in both acute pancreatitis models. Pancreas histological changes observed in both models were significantly attenuated by fucoidan. The acute pancreatitis model induced by TLC-S caused delayed gastric emptying and gastrointestinal transit, incresead gastric and jejunum MPO, and jejunum hypercontractility in vitro. Fucoidan significantly reversed the gastrointestinal disorders in vivo and in vitro and augmented levels of gastric and jejunum MPO induced by TLC-S. Conclusion: Fucoidan reduced the severity of acute pancreatitis in mice by decreasing neutrophil infiltration, systemic inflammation and gastrointestinal dysmotility, suggesting that modulation of selectins may constitute a promising therapeutic approach for acute pancreatitis.

Dans le cas de larges pertes de substance osseuse, l’ingénierie tissulaire représente une alternative intéressante aux greffes. Cette technique consiste à associer des cellules à des biomatériaux dans le but de réparer le tissu. L'objectif de ce travail est l'étude de l'amélioration du potentiel ostéogénique des cellules souches mésenchymateuses issues du tissue adipeux humain (ASC), afin d’augmenter la formation de matrice osseuse en territoire ischémique. Nous avons montré que le fucoïdane, un polysaccharide d’origine marine, était capable d’améliorer la différenciation ostéogénique des ASC in vitro. Cependant, la combinaison de ces cellules avec des biomatériaux (granules de biphosphate de calcium) ne suffit pas à permettre une formation osseuse dans un modèle de pousse osseuse en site ectopique chez la souris. Afin d’augmenter l’angiogenèse, essentielle dans la réparation osseuse, nous avons associé les ASC à des cellules progénitrices endothéliales (appelées ECFC), dans ce modèle. Cette association ne permet d’améliorer que faiblement la formation osseuse. Nos études in vitro d'association de CPE et d'ASC ont montré que ces cellules en coculture étaient capables de synthétiser un grand nombre de cytokines impliquées dans les différenciations ostéogénique et angiogénique, telles que le transforming growth factor (TGFß1), l’insulin like growth factor (IGF-1) ou encore le vascular endothelial growth factor (VEGF). Dans nos conditions de culture, le surnageant de l’association des ECFC avec des ASC induit, par rapport au surnageant des ASCs seules, une inhibition de la différenciation ostéogénique dont le mécanisme reste à identifier.L’ensemble de nos données démontre le potentiel du fucoïdane dans l’ingénierie tissulaire osseuse et que les ASC seules ne sont pas capables de former de matrice osseuse. / In the case of large bone defects, tissue engineering represents an attractive alternative to transplantation. Tissue engineering is a combination of cells with biomaterials in order to repair tissue. The aim of this work was the study of the improvement of the osteogenic potential of mesenchymal stromal/stem cells derived from human adipose tissue (ASC) in the order to increase the formation of bone matrix in the ischemic territory. We have shown that fucoidan, a marine polysaccharide, was able to improve the osteogenic differentiation of ASC in vitro. However, the combination of these cells with biomaterials (biphasic calcium phosphate particles) is not enough to have bone formation in an ectopic bone growth model in mice. To promote angiogenesis, a crucial step in bone repair, we associated ASC with endothelial progenitor cells (called ECFC), in our model. This association promotes only lightly the bone formation. Our in vitro coculture studies of ECFC with ASC showed that the cells in coculture were able to synthesize several cytokines involved in angiogenic and osteogenic differentiation, such as transforming growth factor (TGF-ß1), insulin like growth factor (IGF-1) or vascular endothelial growth factor (VEGF). However, ASC in coculture did not express the receptors of these cytokines. In our culture conditions, the supernatant of the association of ECFC + ASC induces, compare to ASC alone, an inhibition of osteogenic differentiation which mechanism has to be identified.Our data show the potential of fucoidan in bone tissue engineering and that ASC alone did not promote bone matrix formation.