La maladie de Parkinson (MP) est une maladie neurodégénérative caractérisée par trois symptômes moteurs principaux : la bradykinésie, la rigidité et le tremblement de repos. Son diagnostic définitif repose sur l’identification post-mortem d’une importante mort des neurones dopaminergiques de la substance noire (SN) et la présence de corps de Lewy dans les neurones survivants. Cette maladie progresse lentement et les premiers symptômes moteurs n’apparaissent qu’après la dégénérescence de plus de 50% de la SN. Le diagnostic clinique de MP est donc établi tardivement, réduisant ainsi la fenêtre d’action thérapeutique. De plus, les traitements actuels ne soulagent que temporairement les symptômes moteurs. Les défis de la recherche actuelle pour la MP sont donc : 1) d’anticiper le diagnostic de la MP à un stade où la SN est encore suffisamment intacte pour mettre en place des stratégies neuroprotectrices, et 2) d’améliorer les traitements actuels et/ou développer de nouvelles stratégies thérapeutiques pour stopper la progression de la maladie avant que le phénotype moteur ne soit installé. Le stade clinique de la MP est précédé d’une phase prémotrice durant laquelle les patients présentent souvent des symptômes non moteurs tels que l’anosmie, la dépression ou la constipation. Des travaux récents suggèrent que les lésions caractéristiques de la MP pourraient d’abord apparaître dans le système nerveux périphérique puis progresser lentement jusqu’au cerveau. Ces stades précoces de la MP sont cependant mal connus et leurs caractéristiques méritent d’être étudiées dans des modèles expérimentaux appropriés. Ainsi, des études récentes ont montré que la ghréline, un peptide gastro-intestinal, protège les neurones dopaminergiques de la SN contre la mort dans des modèles in vivo et in vitro de syndrome parkinsonien. De plus, dans un modèle animal de syndrome parkinsonien, la ghréline prévient l’aggravation des symptômes gastro intestinaux par la L-DOPA, traitement médicamenteux principal de la MP. Enfin, des altérations des concentrations plasmatiques de ghréline ont également été observées chez les patients aux stades précoces de la maladie. Dans ce contexte, nous avons émis l’hypothèse que la ghréline pourrait jouer un rôle important aux stades précoces de la maladie et donc être utilisée comme biomarqueur et/ou agent neuroprotecteur dans la MP. Ainsi, l’objectif de ma thèse était d’étudier les rôles de la ghréline aux stades précoces de la MP par des approches in vitro et in vivo.La première étape a consisté à déterminer les effets de la ghréline dans des cultures primaires de cellules mésencéphaliques exposées au pesticide roténone, un inhibiteur du complexe I mitochondrial connu pour son association avec la MP. Contrairement aux données de la littérature, nous montrons un effet délétère en fonction de la dose et du temps sur les cellules exposées à la roténone. Nous ne confirmons donc pas l’effet neuroprotecteur de la ghréline dans nos conditions expérimentales. En parallèle, nous avons étudié le potentiel de la ghréline en tant que biomarqueur dans un modèle murin de syndrome parkinsonien reproduisant les stades précoces de la maladie après exposition orale chronique à de faibles doses de roténone. Nous avons d’abord validé ce modèle et confirmé le développement des altérations non motrices et l’absence de mort neuronale au sein de la SN après 1.5 mois de ce régime. En revanche, nos résultats ne montrent pas de modification des taux plasmatiques de ghréline chez les souris exposées 1.5 mois à la roténone. Cependant, des facteurs tels que l’anxiété pourraient avoir affecté les taux de ghréline. Ces données devront donc être confirmées avec des animaux stratifiés selon leur niveau d’anxiété et/ou de plus longues expositions. En conclusion, nos résultats interrogent le rôle neuroprotecteur de la ghréline dans la MP et posent les bases pour de futures recherches sur l’implication de cette hormone orexigène dans la MP. / Parkinson’s disease (PD) is the second most frequent neurodegenerative disease in the world. It is characterized by motor symptoms such as bradykinesia, rigidity and resting tremor. Its definite diagnosis relies on the identification of specific neuropathological hallmarks at autopsy including severe neuronal death within the substantia nigra (SN) and the presence of Lewy bodies in the surviving neurons. PD progresses slowly and the first motor symptoms appear when more than 50% of the SN has degenerated. Therefore, the clinical diagnosis is established late in the course of the disease, thus restricting the therapeutic window for clinicians. In addition, the currently available therapeutic options can only temporarily alleviate PD motor symptoms. The challenges of current PD research are: 1) to anticipate the diagnosis and be able to identify the disease as early as possible, when the SN is still intact enough to implement a disease-modifying/neuroprotection strategy to prevent the appearance of motor symptoms, and 2) to improve current medications and/or develop new therapeutic strategies able to stop the disease before the motor phenotype is installed. The decade preceding PD clinical diagnosis is of particular interest since patients often complain about non-motor symptoms such as anosmia, depression or constipation. Moreover, recent evidences suggest that PD-characteristic lesions could first appear in the peripheral nervous system and slowly progress towards the brain. Thus PD earlier stages and their characteristics deserve better investigations using appropriate experimental models. In this regard, recent studies realized in animal and cellular models of advanced parkinsonism have suggested that ghrelin, an orexigenic peptide mainly produced in the stomach, could play a neuroprotective role in PD. Indeed, exposure to ghrelin has shown a protective effect against the neuronal death in animal and cellular models of parkinsonism. In addition, in a rodent model of parkinsonism, ghrelin was shown to alleviate the L-DOPA-induced worsening of gastro-intestinal symptoms, L-DOPA being the current main therapeutic option in PD. Moreover, ghrelin plasma concentrations have shown alterations in early stages of the disease in small cohorts of PD patients. We therefore hypothesized that ghrelin might play an important role in PD early stages and could serve as a biomarker and a neuroprotective agent in PD. In this context, the aim of my PhD was to investigate the roles of ghrelin in PD early stages using both in vitro and in vivo approaches.We first studied the effects of ghrelin in primary mesencephalic cells exposed to the pesticide rotenone, a potent inhibitor of mitochondrial complex I known for its association with PD. Contrary to the data of the literature, we show a dose and time-dependant deleterious effect of ghrelin on mesencephalic cells exposed to rotenone. This does not confirm the neuroprotective potential of ghrelin in our experimental conditions. In parallel, we investigated the potential of ghrelin as a biomarker in a rodent model of parkinsonism mimicking early stages of the disease after chronic oral exposure to low doses of rotenone. We first validated this model in our animal facility and confirmed that mice exposed to such a regimen develop progressive non-motor alterations but no dopaminergic neuronal death in the SN after 1.5 months. Our initial results do not show a modification of plasma ghrelin levels in rotenone-exposed mice at early stages of the pathological condition. However, confounding factors such as anxiety might have altered ghrelin levels. This should therefore be further ascertained in animals stratified for their anxiety levels and/or in longer exposures. In conclusion, these results challenge the suggested role of ghrelin as a disease-modifying agent in PD and set the bases for future investigations of ghrelin in the context of PD.

Confidentiel / Confidentiel

Einleitung: Erosive und ulzerative Magenschleimhautläsionen beim Pferd, zusammengefasst unter dem Begriff des Equine Gastric Ulcer Syndromes (EGUS), spielen beim Pferd aufgrund ihres häufigen Vor¬kommens und der mit ihnen verbundenen klinischen Symptome wie Inappetenz, Gewichtsverlust, rezi¬divierender Kolik und Leistungsminderung eine wichtige Rolle. Es wird zwischen Läsionen der kutanen Schleimhaut (Equine Squamous Gastric Disease, ESGD) und der glandulären Schleimhaut (Equine Glandular Gastric Disease, EGGD) unterschieden, wobei viel über die Prävalenz, Risikofaktoren und The¬rapie der ESGD bekannt ist, während im Hinblick auf die EGGD, insbesondere für die entscheidend an der Magenentleerung beteiligte Pylorusregion, noch viele Fragen offen sind. Ziele der Untersuchung: Ziel der vorliegenden Arbeit war es, die Prävalenz von Läsionen im Sinne der EGGD im Bereich des Pylorus des Pferdes im gastroskopisch untersuchten Patientengut der Medizi-nischen Tierklinik zu ermitteln. Die Patientendaten wurden hinsichtlich auf prädisponierender Risiko-faktoren analysiert und außerdem Korrelationen zwischen den verschiedenen Magenschleimhautlokali¬sationen untersucht und bei mehrfach untersuchten Patienten die Entwicklung der Pylorusschleimhaut im zeitlichen Verlauf untersucht. Material und Methoden: Die Daten von 315 gastroskopierten Pferdepatienten der Medizinischen Tier-klinik aus den Jahren 2004 bis 2013 wurden für die vorliegende Studie retrospektiv ausgewertet. Es er-folgte eine Einteilung in Altersgruppen (<1 Jahr: n=20; 1-6 Jahre: n=80; 7-14 Jahre: n=152; ≥15 Jahre: n=60) mit einem Altersmedian von 9,6 Jahren. Die Studie umfasste 133 Stuten, 45 Hengste und 135 Wallache; bei zwei Pferden war das Geschlecht unbekannt. Im Patientengut waren diverse Rassen ver-treten, wobei Warmblutpferde (n=214) dominierten. 263 Pferde konnten mit Hilfe der vorberichtlichen Angaben des Besitzers und ergänzender Informa¬tionen aus der Turnierdatenbank Equira einem von drei Leistungsniveaus zugeordnet werden (geringe Leistung: n=182; mittlere Leistung: n=70; hohe Leistung: n=11). Die während der Gastroskopie gewon¬nenen Aufzeichnungen wurden für diese Studie retrospektiv mithilfe des EGUS-Scores von Grad 0-4 ge¬trennt für die kutane Schleimhaut, die glanduläre Schleimhaut des Magenkörpers und die Pylorus-schleimhaut bewertet. Von neun Pferden lagen vollständige Daten einer erneuten Gastroskopie inner¬halb von 42 Tagen nach der Erstuntersuchung vor. Die statistische Auswertung erfolgte mittels deskrip¬tiver Statistik, Chi-Quadrat-Test zur Analyse möglicher Risikofak¬toren, Rangkorrelationskoeffizient nach Spearman für die Korrelationen der Scores der verschiedenen Lokalisationen und Wilcoxon-Test für die Verlaufsuntersuchungen, wobei das Signifikanzniveau auf p<0,05 festgelegt wurde. Ergebnisse: Von 262 der 315 gastroskopierten Pferde (83,2%) lagen auswertbare Befunde der Pylorus-region vor. 98 Pferde wiesen Magenschleimhautläsionen ≥ Grad 2 im Bereich des Pylorus auf, was einer Prävalenz von 37,4% entspricht. Der mittlere Score für die Pylorusschleimhaut betrug 2,27. Die Risiko¬faktorenanalyse ergab einen signifikanten Zusammenhang zwischen dem Vorliegen von Pylorusschleim-hautläsionen und steigender Leistung und einen tendenziell, jedoch nicht signifikant höheren Schwere¬grad der Läsionen bei höherem Leistungsniveau. 34,0% der Pferde, die geringe Leis-tungen erbrachten, und 44,4% der Pferde, die dem mittleren Leistungsniveau zugeordnet wurden, waren von Pylorusschleimhautläsionen betroffen. Die Prävalenz für Hochleistungspferde betrug 72,7%. Alter, Geschlecht und Rasse der Patienten standen nicht im Zusammenhang mit Pylorusschleimhautläsionen. Zwischen Läsionen der kutanen Schleimhaut und Pylorusschleimhaut sowie der glandulären Schleimhaut des Magenkörpers und der Pylorusschleimhaut bestand eine schwache Korrelation. Die Kontrollunter¬suchungen ergaben keine signifikanten Veränderungen der Scores im Bereich des Pylorus im zeitlichen Verlauf. Schlussfolgerungen: Läsionen der Pylorusschleimhaut im Sinne einer EGGD stellen mit einer Prävalenz von 37,4% im untersuchten Patientengut ein relevantes Problem dar. Aufgrund der nur schwachen Kor¬relationen zwischen den Scores der verschiedenen Magenregionen ist eine vollständige gastroskopische Unter¬suchung zur sicheren Diagnosestellung unerlässlich. Steigende Leistung stellt einen Risikofaktor für das Vorkommen von Pylorusschleimhautläsionen dar, wobei bereits bei Pferden des mittleren, dem Brei¬ten¬sport entsprechenden Leistungsniveaus signifikant häufiger erkranken. Hochleistungspferde sind mehr als doppelt so häufig betroffen wie Pferde, die nur geringe Leistungen erbringen. Die Verlaufsunter¬suchungen ergaben keine signifikanten Verbesserungen im Bereich des Pylorus, weshalb überein¬stimmend mit Ergebnissen anderer Autoren empfohlen wird, die aktuell verfügbaren Therapie¬konzepte zu überarbeiten. Außerdem sollten pathophysiologische Mechanismen, die Zusammenhänge von Pylorusschleimhautläsionen mit Magen¬entleerungsstörungen und Veränderungen des dafür wich¬tigen Hormons Ghrelin erklären, zukünftig weiter untersucht werden.

Ghrelin analogs in food intake regulation Ghrelin, to date the only known peripherally produced and centrally acting peptide that stimulates food intake, is mainly synthesized in the stomach and acts through growth- hormone-secretagogue receptor (GHS-R). In addition to its orexigenic effect, ghrelin stimulates growth hormone (GH) release, gastric motility and acid secretion. The diverse functions of ghrelin raise the possibility of its clinical application for GH deficiency, eating disorders, and gastrointestinal diseases. Ghrelin agonists could be a promising therapeutics in cachexia occurring at cancer or chronic inflammatory diseases. Octanoylation of Ser3 is crucial for preservation of ghrelin activity. In this study, biological properties (binding to GHS-R, food intake stimulation in mice) of full length and shorter ghrelin analogues with octanoic acid coupled to diaminopropionic acid (Dpr) replacing Ser3 or without octanoic acid were followed. This substitution resulted in a prolonged stability and orexigenic effect of above mentioned ghrelin analogues. Importance of N-terminal part of ghrelin and octanoylation peptide was also confirmed.

We are still unable to effectively suppress neuropathic pain, therefore it remains a serious problem. Ghrelin, the orexigenic hormone released by enteroendocrine stomach cells, could contribute to alleviation of the neuropathic pain by its antinociceptive effect. Previous studies have shown that ghrelin prevents development of nociceptive symptoms of neuropathic pain. The aim of our study was to determine whether chronic administration of ghrelin will affect the already fully developed neuropathic pain and differentiate its antinociceptive and analgesic effect. We used a model of chronic constriction injury of the sciatic nerve. We have proven that ghrelin suppressed the already developed thermal and mechanical hyperalgesia, so ghrelin not only prevents the development, but also suppresses the already developed nociceptive symptoms. However analgesia test showed that ghrelin did not affect the temperature preference, neither did induce the place preference. We suppose that ghrelin does not cause analgesia in neuropathic pain and its antinociceptive effect could be caused by anti- inflammatory or neuroprotective action. Key words: Ghrelin, neuropathic pain, chronic constriction injury, preference methods

In den nächsten Jahren wird weltweit ein starker Anstieg des Anteils Übergewichtiger an der Bevölkerung zu verzeichnen sein. Daraus resultiert auch ein Anstieg der Adipositas assoziierten Krankheiten und der damit verbundenen medizinischen und volkswirtschaftlichen Konsequenzen. Im Hinblick darauf sind Untersuchungen zur Klärung der Regulation des Körpergewichtes und der Entstehung von Übergewicht von grundlegender Bedeutung. Die vorliegende Promotionsarbeit liefert einen Beitrag zur Erforschung dieser Regulationsmechanismen des Körpergewichts, die aus einem komplexen Netzwerk hormoneller Signalwege bestehen. Dem Peptidhormon Obestatin, das wahrscheinlich an den Rezeptor GPR39 bindet, wurde eine gewichtsreduzierende Wirkung zugeschrieben. Ziel dieser Arbeit war es deshalb, die Wirkungsweise dieses Hormons in Bezug auf die Proliferation und die Differenzierung im (Prä-)Adipozytenmodell 3T3-L1 näher zu untersuchen. Der Einfluss von Obestatin in Abhängigkeit von seiner Konzentration auf diese murinen, embryonalen Zellen wurde zum einen mittels colorimetrischem Proliferationstest untersucht. Zum anderen wurde die Aktivität der MAP-Kinase ERK1/2, Schlüsselenym der Zellproliferation und Zelldifferenzierung, während der Proliferation mittels in situ ELISA und SDS-Page/Western Blot bestimmt. Der Einfluss von Obestatin auf die Differenzierung der 3T3-L1 Zellen wurde anhand ihres Differenzierungsgrad mit Hilfe des lipophilen Farbstoffes AdipoRed evaluiert. Darüberhinaus erfolgte mittels quantitativer PCR die Bestimmung der Expression des Obestatinrezeptor-Gens GPR39 in humanem Fettgewebe. Ausgehend von der Annahme, dass durch eine autogene Regulation die Rezeptorenanzahl in Abhängigkeit vom Körpergewicht variiert wird, wurde der statistische Zusammenhang zwischen der Expression des hGPR39-Rezeptor-Gens und dem Alter bzw. Body-Mass-Index von Patienten untersucht, denen Proben von viszeralem oder subkutanem Fett entnommen wurden. In Zusammenschau aller Versuchsergebnisse, die in dieser Dissertationsarbeit erzielt wurden, kann davon ausgegangen werden, dass das hier verwendete Obestatin insgesamt keinen Effekt auf das Adipozytenmodell 3T3-L1 besitzt, weil ein Substrat verwendet wurde, das wohl eine zu geringe Konzentration des Hormons Obestatin enthielt. Durch neue Forschungsergebnisse anderer Arbeitsgruppen muss vermutet werden, dass der tatsächliche Anteil von Obestatin in nicht speziell aufbereiteten Substraten zu gering ist, um mit den angewendeten Nachweisverfahren signifikante Effekte zu erzielen. Bei den Untersuchungen eines Zusammenhangs zwischen der Expression des hGPR39-Gens und dem BMI wurden die Ergebnisse der 12 Proben mithilfe der univarianten Varianzanalyse (SPSS) statistisch geprüft. Ohne Beachtung eines Ausreißer-Messwertes konnte dabei ein nahezu signifikanter, positiv linearer Zusammenhang zwischen der normierten Kopienzahl des Rezeptor-Gens und dem BMI gezeigt werden. Sollte durch zusätzliche Experimente dieser Zusammenhang Signifikanz erlangen, schiene es denkbar, dass Obestatin nicht – wie bisher angenommen – eine Verminderung der Gewichtszunahme bewirkt, sondern möglicherweise den adipösen Phänotyp und die damit verbundenen Begleit- und Folgekrankheiten befördert.

For many years, the nasal route of administration as part of a therapeutic treatment has been used. This route of administration is easy to implement, especially due to its non-invasiveness the ease of administration that it affords for the patient. In addition, it is suitable for chronic treatment as well as for an emergency situation when the patient is unconscious. For instance, the administration of benzodiazepines, such as midazolam, may be done to stop convulsions in a patient.Traditionally, intranasal administration was mainly borrowed to target a local effect (e.g. treatment of a cold with a decongestant agent). Subsequently, its application for systemic delivery (e.g. treatment of migraine with triptans) was more and more frequently considered. However, the administration of a drug in the nasal cavities for systemic delivery still remains limited. Indeed, even if the intravenous route has several major limitations such as its invasiveness or the pain generated during administration, it remains more widely used than the intranasal route. This can be explained, on the one hand, by the knowledge that was relatively limited regarding the nasal delivery but also because of the unavailability of nasal devices allowing precise control of the nasal administration (i.e. accurate dose delivery, strong deposition in the nasal cavity, etc).Subsequently, the intranasal route has led to a third therapeutic targeting, namely, the “nose-to-brain pathway”. In that case, the nasal cavity was considered as an opportunity to access the central nervous system (CNS). Indeed, the nose-to-brain delivery allows reaching the brain while bypassing the blood-brain barrier which is known to be a major obstacle to the diffusion of drugs in the CNS. Moreover, the passage through the nasal cavity would allow the administration of sensitive molecules (e.g. biopharmaceuticals) while avoiding excessive enzymatic degradation.Therefore, the nose-to-brain pathway appears to be an attractive route for the delivery of unstable molecules, requiring an access to the brain to reach their site of action. In this context, the therapeutic target that has been selected was "cachexia". It is a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass. It usually results in particular from undernutrition and a generalized inflammatory state in the patient. In order to treat this syndrome and to restore the appetite in these patients, the goal was to use ghrelin (GHRL) as a model drug. GHRL is a peptide hormone that exhibits, among other effects, an orexigenic action. This biopharmaceutical needs to reach its receptors, located in the hypothalamus, to exert its therapeutic effect.In this study, the goal was to develop a formulation that was able to protect GHRL during its nasal administration, while increasing its residence time to promote its diffusion through the nasal olfactory epithelium.In the first part of the project, GHRL was mainly characterized in terms of stability (e.g. temperature and pH), but also in terms of surface charge. These results allowed selecting the most suitable strategy of formulation as well as the optimal storage conditions. After these preformulation evaluations, it was decided to work on the development of a liquid formulation. The first formulation was based on micelles composed of lipids with polyethylene glycol "DSPE-PEG (1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N- [amino (polyethylene glycol) -2000] (ammonium salt)" as hydrophilic group. This type of pegylated lipids have already shown, in many scientific studies, interesting properties in the context of intranasal administration, especially in terms of mucopenetration. With a slight adaptation of the protocol found in the literature, it was possible to obtain micelles of an adequate size (~15 nm). The micelles produced also showed good ability to encapsulate GHRL with an encapsulation rate of 98%, but micelles of DSPE-PEG failed to increase the GHRL diffusion through epithelial layer. This step is essential in order to obtain high GHRL levels in the brain. The formulation containing DSPE-PEG micelles has thus been abandoned.Still in the goal of combining lipid excipients with hydrophilic polymer, another formulation strategy based on liposomes coated with chitosan has been considered. Since GHRL has a positive charge at physiological pH, anionic liposomes have been developed to get a high loading. Three types of liposomes have been produced: anionic, neutral and cationic. The objective was to evaluate the influence of the liposomes charge on GHRL encapsulation. By working with anionic liposomes, the loading could be 46% higher than that obtained from the cationic liposomes. In order to evaluate a potential relation between the amount of GHRL that was encapsulated in the liposomes and the amount of GHRL that could potentially be degraded in the presence of enzyme, the three types of liposomes were exposed to trypsin. Following enzyme exposure, anionic liposomes showed enzymatic protection 4 times higher than cationic liposomes. These anionic liposomes have also shown high GHRL protection in the presence of another enzyme with another mechanism of digestion, namely, carboxylesterase-1. Subsequently, isothermal titration calorimetry tests were performed to better understand the interaction mechanisms between GHRL and anionic liposomes. This technique showed that hydrophobic interactions between both compounds were predominant. The coating of anionic liposomes by chitosans was performed and confirmed by an increase of the mean diameter (+48 nm) and charge (+6 mV) as well as by the modification of the morphology of the liposomes. This coating of liposomes with chitosans was supposed to confer additional properties to the formulation such as mucoadhesion and permeation enhancement. These both effects can be obtained thanks to the positive charge of chitosans which allows adhering to the mucins of the mucus, on the one hand, and thanks to the opening of the epithelial tight junctions that enhances drug permeation, on the other hand. The chitosan coating allowed increasing the fixation of the liposomes to mucins by about twenty percent compared to uncoated liposomes. In addition, the "absorption promoter" effect of chitosans was confirmed on cells culture. Then, the formulation was introduced into two distinct nasal devices intended for the administration of liquid nasal sprays, namely, the VP3 device from Aptar Pharma and the SP270 device from Nemera. The aerosols produced by each device allowed generating droplets characterized by a mean diameter higher than 10µm, leading to potential satisfactory impaction onto the olfactory region instead of diffusion throughout posterior region of the nasal cavities. In the second part of the work, a dry formulation was produced by spray-drying from the liquid dispersion of coated liposomes. The objective was to increase the stability of GHRL during storage as well as to enhance its remanence and diffusion through the olfactory epithelium. The optimized parameters allowed producing a powder characterized by a mean diameter higher than 10 μm with an acceptable yield. The powder produced exhibited a low residual moisture and showed good homogeneity in terms of GHRL content. Then, a comparative study was carried out between the powder and the liquid formulation to compare the GHRL stability over time during storage at different temperatures (4°C and 25°C) but also their ability to fix mucins. In both cases, the dry powder showed better results The powder was also re-dispersed in aqueous phase to evaluate the ability of the liposomes to be reconstituted without modifying their physicochemical properties (e.g. size distribution, charges, stability). It was demonstrated that the majority of the initial properties could be preserved after reconstitution (i.e. rate of encapsulation). Similarly to the liquid formulation, the powder was loaded into a specific device developed for the nasal administration of powders that allows targeting the olfactory region to optimize the nose-to-brain transfer. The device, "UDS - Unit Dose System " from Aptar Pharma, has shown excellent properties in terms of particle size distribution in the aerosol but also in terms of targeting the olfactory zone. The latest was studied by means of "nasal cast" that is a 3-printed model of artificial nasal cavities. After impaction in the different cavities of the cast, it was possible to quantify the amount of GHRL that was deposited in the olfactory zone. Using our optimized formulation in combination with the device developed by Aptar, it was shown that 52% of the powder was impacted onto the area corresponding to the olfactory region. Such data demonstrated the relative difficulty to target this section of the nasal cavities.Finally, the formulation loaded with fluorescent GHRL was intranasally administered in mice. It was demonstrated that GHRL could reach the brain after intranasal administration of the formulation and that the formulation was essential to allow this transfer to the brain.The administration of such biopharmaceutical by nose-to-brain with this formulation seems to be an interesting alternative to exploit. However, additional studies to quantify this transfer more precisely, to better define its kinetics and also to evaluate the efficacy of the treatment should be carried out. / Doctorat en Sciences biomédicales et pharmaceutiques (Pharmacie) / info:eu-repo/semantics/nonPublished

This review details the manner in which the central nervous system regulates metabolic homeostasis in normal weight and obese rodents and humans. It includes a review of the homeostatic contributions of neurons located in the hypothalamus, the midbrain and limbic structures, the pons and the medullary area postrema, nucleus tractus solitarius, and vagus nucleus, and details how these brain regions respond to circulating levels of orexigenic hormones, such as ghrelin, and anorexigenic hormones, such as glucagon-like peptide 1 and leptin. It provides an insight as to how high intensity exercise may improve homeostatic control in overweight and obese subjects. Finally, it provides suggestions as to how further progress can be made in controlling the current pandemic of obesity and diabetes.

Background. Roux-en-Y gastric bypass (RYGB) is an effective treatment for obesity, where gut peptides such as ghrelin, glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) play an instrumental role in reduced appetite after RYGB. This systematic review and meta-analysis aimed to establish the magnitude of change of ghrelin, GLP-1, PYY and appetite sensation following RYGB. Methods. A systematic search was conducted in Medline Ovid, Embase, Scopus, and Cochrane Central Register of Controlled Trials up until March 2021. Two independent reviewers screened articles for studies that evaluated ghrelin, GLP-1, PYY or appetite sensation via visual analogue scales (VAS) before and after RYGB in adults. Risk of bias was assessed with the quality assessment tool for before-after studies with no control group from the National Heart, Lung and Blood Institute (NHLBI). A multilevel model with random effects for study and follow-up time points nested in study was fit to the data. The model included kilocalorie consumption as a covariate and time points as moderators. Results. Among the 2,559 articles identified, 47 met the inclusion criteria, among which k=19 evaluated ghrelin, k=40 GLP-1, k=22 PYY and k=8 appetite sensation via VAS. Our results indicate that fasting ghrelin levels are decreased 2 weeks post-RYGB (p = .005) but do not differ from baseline from 6 weeks to 1-year post-RYGB. Postprandial ghrelin levels at 6 months and 1-year post-RYGB were not different from pre-surgical values (p = .51). Fasting GLP-1 levels were not different from pre-surgical levels up to 2 years post-RYGB. Postprandial levels of GLP-1 increased significantly from 1 week (p < .001) to 2 years post-RYGB (p < .01) compared to before surgery. Compared to pre-RYGB levels, fasting PYY increased at 6 months (p = .034) and 1 year (p = .0299) post-surgery and postprandial levels were increased up to 1 year (p < .01). Heterogeneity was significant in most analyses. Insufficient data on appetite sensation was available to be meta-analyzed. Conclusion. Our analyses illustrate the magnitude of change of ghrelin, GLP-1 and PYY before and after RYGB surgery. Importantly, between study heterogeneity within the current literature warrants more standardized protocols and studies with longer follow-up periods for better comprehension of changes in gut peptides following RYGB surgery.

The hypothalamic arcuate nucleus (Arc) is a central unit that controls the appetite through the integration of metabolic, hormonal, and neuronal afferent inputs. Agouti-related protein (AgRP), proopiomelanocortin (POMC), and dopaminergic neurons in the Arc differentially regulate feeding behaviors in response to hunger, satiety, and appetite, respectively. At the time of writing, the anatomical and electrophysiological characterization of these three neurons has not yet been intensively explored. Here, we interrogated the overall characterization of AgRP, POMC, and dopaminergic neurons using genetic mouse models, immunohistochemistry, and whole-cell patch recordings. We identified the distinct geographical location and intrinsic properties of each neuron in the Arc with the transgenic lines labelled with cell-specific reporter proteins. Moreover, AgRP, POMC, and dopaminergic neurons had different firing activities to ghrelin and leptin treatments. Ghrelin led to the increased firing rate of dopaminergic and AgRP neurons, and the decreased firing rate of POMC. In sharp contrast, leptin resulted in the decreased firing rate of AgRP neurons and the increased firing rate of POMC neurons, while it did not change the firing rate of dopaminergic neurons in Arc. These findings demonstrate the anatomical and physiological uniqueness of three hypothalamic Arc neurons to appetite control.