La mucoviscidose (ou cystic fibrosis, CF) est une maladie caractérisée par une inflammation pulmonaire chronique qui contribue à la dégradation progressive de l’épithélium des voies aériennes des patients. Les glucocorticoïdes (GC) représentent un outil essentiel pour le traitement du patient mais leur efficacité et leur rapport bénéfice/risque restent cependant controversés. Les effets secondaires provoqués par l’administration de ces molécules pourraient être diminués par l’utilisation de leur protéine d’adressage, la corticosteroid-binding globulin (CBG). L’objectif de ce travail était d’étudier l’expression de la CBG chez les patients CF, afin d’optimiser leur traitement anti-inflammatoire par GC. Nous avons montré, dans un premier temps, que la synthèse hépatique de CBG était augmentée, tandis que son taux plasmatique était conservé chez les patients CF, comparé aux patients non-CF. Dans un second temps, nous nous sommes intéressés à l’expression de la CBG au niveau pulmonaire. L’inflammation chez les patients CF étant principalement pulmonaire, l’expression locale de CBG à ce niveau pourrait moduler l’efficacité du GC, en le recaptant. Nos données montrent que l’expression de cette CBG pulmonaire est diminuée chez les patients CF. Les études sur des modèles in vitro hépatiques et pulmonaires n’ont pas permis d’expliquer les résultats obtenus et ont souligné la limite des modèles et des outils à disposition. Le maintien de la concentration plasmatique de CBG et la diminution de la CBG pulmonaire chez les patients CF suggèrent ainsi que la CBG pourrait être utilisée comme outil thérapeutique dans le contexte de la mucoviscidose, afin d’optimiser le traitement par GC. / Cystic fibrosis (CF) is characterized by a chronic pulmonary inflammation, responsible of the progressive degradation of the airways epithelium. In CF, glucocorticoids (GC) are widely used but their efficiency and benefit/risk ratio are still discussed. The side effects, caused by the administration of these molecules, might be decreased by the use of their delivery protein, corticosteroid-binding globulin (CBG). The aim of the work was to study the expression of CBG in CF patients, in order to optimise their anti-inflammatory treatment by GC. First, we showed that the hepatic synthesis of CBG was increased while its plasmatic level was preserved in CF patients, compared to non-CF. Second, we were interested by the expression of CBG at the pulmonary level. The inflammation in CF patients being primarely pulmonary, the local expression of CBG in the lung could modulate the efficiency of GC through recapture. Our data showed that this expression of this pulmonary CBG was decreased in CF patients. The studies conducted in vitro on hepatic and pulmonary models did not explained our results and highlighted the limit of the models and tools at our disposal. The maintained plasmatic concentration of CBG and the decrease of pulmonary CBG in CF patients suggest that CBG might be useful as a therapeutic tool in the CF context, in order to optimise the GC treatment.

During fetal development, the lung is filled with fluid that is secreted by an active Cltransport promoting lung growth. The basolateral Na+,K+,2Cl- cotransporter (NKCC1) participates in Cl- secretion. The apical Cl- channels responsible for secretion are unknown but studies suggest an involvement of the cystic fibrosis transmembrane conductance regulator (CFTR). CFTR is developmentally regulated with a high expression in early fetal development and a decline in late gestation. Perinatal lung transition is triggered by hormones that stimulate alveolar Na+ channels resulting in fluid absorption. Little is known on how hormones affect pulmonary Cl- channels. Since the rise of fetal cortisol levels correlates with the decrease in fetal CFTR expression, a causal relation may be assumed. The aim of this study was to analyze the influence of glucocorticoids on pulmonary Cl- channels. Alveolar cells from fetal and adult rats, A549 cells, bronchial Calu-3 and 16HBE14o- cells, and primary rat airway cells were studied with real-time quantitative PCR and Ussing chambers. In fetal and adult alveolar cells, glucocorticoids strongly reduced Cftr expression and channel activity, which was prevented by mifepristone. In bronchial and primary airway cells CFTR mRNA expression was also reduced, whereas channel activity was increased which was prevented by LY-294002 in Calu-3 cells. Therefore, glucocorticoids strongly reduce CFTR expression while their effect on CFTR activity depends on the physiological function of the cells. Another apical Cl- channel, anoctamin 1 showed a glucocorticoid-induced reduction of mRNA expression in alveolar cells and an increase in bronchial cells. Furthermore, voltage-gated chloride channel 5 and anoctamine 6 mRNA expression were increased in alveolar cells. NKCC1 expression was reduced by glucocorticoids in alveolar and bronchial cells alike. The results demonstrate that glucocorticoids differentially modulate pulmonary Clchannels and are likely causing the decline of CFTR during late gestation in preparation for perinatal lung transition.

Candidate: Nikola Juríková1 Supervisor: prof. RNDr. Jiří Vlček, CSc.1 Consultant: doc. MUDr. Tomáš Soukup, PhD.2 1 Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University 2 2nd Department of Internal Medicine - Gastroenterology, University Hospital in Hradec Králové Title of the master thesis: Effect of pulse glucocorticoid therapy on ECG Glucocorticoid pulse therapy (PT) is used to terminate acute exacerbations of immunologically mediated diseases. The aim of this thesis was to analyze the influence of methylprednisolone (MP) PT on ECG changes, mainly on QT interval, as prolonged QT interval may induce ventricular arrhythmias and to identify other risk factors (RF) for QT prolongation. Data were gained retrospectively from medical records of patients hospitalized at II. Internal Gastroenterology Clinic of University Hospital Hradec Králové. QT was corrected to QTc using Bazzet (QTcB) and Fridericia (QTcF) formula, QTc >450 ms (men) and QTc >460 ms (women) was considered prolonged. QTc changes before and after pulse therapy were determined as ∆QTc. 325 pulses of MP were administered to 277 patients (66,0 % women), ECG was available in 94,2 % (n=306 from 325). After PT there was significant ∆QTcF 14,6 ms (p <0,001) and ∆QTcB 5,6 ms (p <0,001)....

No description available.

In order to adapt to changing external conditions, organisms developed the endogenous biological clock for predicting daily alterations. This so-called circadian system drives functions and processes in the whole body with an approximately 24h period. The central oscillator, located in hypothalamic suprachiasmatic nuclei (SCN), is synchronized by light and subsequently sends the information about the time of the day to the rest of the body. Even in the ontogenesis, the functional SCN clock is crucial for proper development as well as health later in life. Since the maturation of embryonic SCN is not completed before birth, maternal signals seem to play a fundamental role in setting and synchronizing the fetal clock. During my PhD studies, we focused on elucidating the nature of maternal signals and their diverse impact on fetal SCN of rat and mouse models. We have revealed that developing SCN is able to sense distinct signals related to various maternal behavioral regimes. Importantly, we have discovered eminent role of glucocorticoids in synchronizing the fetal SCN, along with their ability to accelerate SCN development. These observations point out the importance of regular daily routine and noxious effect of stress during pregnancy. Since the mother communicates with the fetus through placenta...

In the present study, we examined the possible effect of chronic treatment with glucocorticoids on the morphology of the rat brain and levels of endogenous agmatine and arginine decarboxylase (ADC) protein, the enzyme essential for agmatine synthesis. Seven-day treatment with dexamethasone, at a dose (10 and 50 μg/kg/day) associated to stress effects contributed by glucocorticoids, did not result in obvious morphologic changes in the medial prefrontal cortex and hippocampus, as measured by immunocytochemical staining with β-tubulin III. However, 21-day treatment (50 μg/kg/day) produced noticeable structural changes such as the diminution and disarrangement of dendrites and neurons in these areas. Simultaneous treatment with agmatine (50 mg/kg/day) prevented these morphological changes. Further measurement with HPLC showed that endogenous agmatine levels in the prefrontal cortex and hippocampus were significantly increased after 7-day treatments with dexamethasone in a dose-dependent manner. On the contrary, 21-day treatment with glucocorticoids robustly reduced agmatine levels in these regions. The treatment-caused biphasic alterations of endogenous agmatine levels were also seen in the striatum and hypothalamus. Interestingly, treatment with glucocorticoids resulted in a similar change of ADC protein levels in most brain areas to endogenous agmatine levels: an increase after 7-day treatment versus a reduction after 21-day treatment. These results demonstrated that agmatine has neuroprotective effects against structural alterations caused by glucocorticoids in vivo. The parallel alterations in the endogenous agmatine levels and ADC expression in the brain after treatment with glucocorticoids indicate the possible regulatory effect of these stress hormones on the synthesis and metabolism of agmatine in vivo.

Au cours de ce travail de thèse nous avons proposé une stratégie de ciblage des macrophages alvéolaires afin d’y vectoriser des glucocorticoïdes. Une prodrogue de budésonide, le palmitate de budésonide (BP) a été synthétisée dans le but de prolonger sa demi-vie dans les poumons après inhalation. Des nanoparticules PEGylées de BP ont été développées et étudiées pour obtenir une formulation stable avec des caractéristiques physico-chimiques appropriées et un taux de charge élevé pour pénétrer dans les macrophages alvéolaires, cellules centrales dans l'inflammation pulmonaire. Des tests in vitro sur les macrophages RAW 264.7 ont confirmé l'activité anti-inflammatoire et l'absence de cytotoxicité des nanoparticules. Celles-ci ont ensuite été séchée au sein de microparticules Troyennes obtenues par atomisation-séchage afin de faciliter leur administration pulmonaire sous forme de poudres et libérer les nanoparticules à proximité des alvéoles pulmonaires. Les microparticulessphériques creuses contenant de 0 % à 20 % de nanoparticules de BP présentent des diamètres aérodynamiques et une fraction de particules fines appropriés pour la délivrance pulmonaire. Les études pharmacocinétiques in vivo montrent des concentrations élevées et prolongées de budésonide dans les poumons, avec de faibles concentrations plasmatiques. Dans la deuxième partie de cette thèse, une autre stratégie de ciblage des macrophages a été évaluée par la décoration de la surface des nanoparticules avec du mannose. Après la synthèse d'un lipide mannosylé, des nanoparticules ont été formulées et caractérisées, démontrant un taux de charge élevé et une bonne stabilité jusqu'à 30 jours. Des tests in vitro sur les macrophages RAW 264.7 ont montré que la présence du mannose à la surface augmente l'internalisation des nanoparticules d’un facteur 2 après 48 h d'incubation, par rapport aux nanoparticules PEGylées. / This work focuses on strategies to target glucocorticoids to alveolar macrophages. We have synthesized a budesonide prodrug, budesonide palmitate (BP), increasing its lipophilicity to extend drug half-life in the lungs. BP PEGylated nanoparticles were developed and studied to obtain a stable formulation with suitable physicochemical characteristics and high drug loading to enter alveolar macrophages, key players in lung inflammation. In vitro tests on RAW 264.7 macrophages confirmed the anti-inflammatory activity and absence of cytotoxicity of nanoparticles. These were then encapsulated into Trojan microparticles obtained by spray-drying to facilitate their delivery to the lung as dry powders and release nanoparticles directly to the pulmonary alveoli. Spherical hollow microparticles containing from 0 % to 20 % of BP nanoparticles presented suitable aerodynamic diameters and fine particle fraction for lung delivery. In vivo pharmacokinetic studies demonstrated high and extended budesonide concentrations in the lungs, with low plasma concentrations. In the second part of this thesis, another macrophage targeting strategy was assessed by decoration of nanoparticle surface with mannose. After synthesis of a mannosylated lipid, nanoparticles were formulated and characterized, demonstrating high drug loading and stability up to 30 days. In vitro tests on RAW 264.7 macrophages showed that the presence of mannose on the surface increases nanoparticles internalization 2 fold after 48 h incubation, as compared with PEGylated nanoparticles.

京都大学 / 0048 / 新制・課程博士 / 博士(生命科学) / 甲第20533号 / 生博第375号 / 新制||生||50(附属図書館) / 京都大学大学院生命科学研究科高次生命科学専攻 / (主査)教授 杉田 昌彦, 教授 米原 伸, 教授 清水 章 / 学位規則第4条第1項該当 / Doctor of Philosophy in Life Sciences / Kyoto University / DFAM

Glucocorticoids are the most widely prescribed medications due primarily to their anti-inflammatory and immunosuppressive actions, however, their use is not without side effects. Among these, glucocorticoids cause profound muscle atrophy, yet paradoxically are used as the first line of treatment for muscle wasting disorders such as Duchenne Muscular Dystrophy (DMD) and inflammatory myopathies. In DMD patients, glucocorticoid treatment can improve muscle strength during the first 6 months of treatment and can delay loss of muscle function by up to three years. While recent advancements have been made to understand the effect of glucocorticoids (GCs) on the myofiber, the impact of GCs on skeletal muscle stem cells (MuSCs), the adult stem cells responsible for muscle regeneration, and their role in myogenic differentiation, are relatively unknown. To study the role of glucocorticoid signalling during muscle repair, I developed a conditional null mouse (GRMuSC-/-) model in which glucocorticoid receptor (GR) expression is knocked out specifically in MuSCs (GRMuSC-/-). One-week following acute muscle injury, WT and GRMuSC-/- mice both underwent robust repair assessed by myofiber cross-sectional area (CSA) analysis. However, the GR-/- MuSCs failed to return to quiescence following repair resulting in a significant increase in average myofiber CSA at 28- and 42- days post-injury, as compared to controls. Loss of the GR led to a significant increase in the percentage of PAX7+Ki67+ cycling cells in GRMuSC-/- mice (as compared to controls) at 42 days post injury. In the uninjured contralateral limb, I observed significantly fewer MuSCs in GRMuSC-/- mice with a concomitant increase in fibers with centrally located nuclei, indicating that these PAX7+ MuSCs progressed to differentiation in the absence of direct injury. In an uninjured model, two weeks following loss of GR expression there was an increase in the percentage of BrdU+ and Ki67+ cycling cells in resting GRMuSC-/- tibialis anterior muscles as compared to WT, suggesting that the GR acts to maintain MuSC quiescence. Consistent with this, immunostaining of single EDL myofiber fibers at T2h post-dissociation revealed that loss of GR in MuSCs lead to precocious activation and subsequent proliferation of MuSCs as compared to controls. Bulk RNA-sequencing from in situ fixed MuSCs in resting muscle revealed that the gene signature of GR-/- MuSCs was consistent with cells that have exited from the quiescent state and are activated for differentiation. Despite precocious activation, GR-/- myoblasts differentiate and fuse normally, however the myotubes produced had abnormal morphology and aberrant myonuclear placement in regenerated muscle fibers in vivo.

Background: Rats exposed to chronic predator scent stress mimic the phenotype of complex post-traumatic stress disorder (PTSD) in humans, including altered adrenal morphology and function. High- and low-anxiety phenotypes have been described in rats exposed to predator scent stress (PSS). This study aimed to determine whether these high- and low-anxiety phenotypes correlate with changes in adrenal histomorphology and corticosteroid production. Methods: Rats were exposed to PSS for ten days. Thirty days later, the rats’ anxiety index (AI) was assessed with an elevated plus-maze test. Based on differences in AI, the rats were segregated into low- (AI ≤ 0.8, n = 9) and high- (AI > 0.8, n = 10) anxiety phenotypes. Plasma corticosterone (CORT) concentrations were measured by ELISA. Adrenal CORT, desoxyCORT, and 11-dehydroCORT were measured by high-performance liquid chromatography. After staining with hematoxylin and eosin, adrenal histomorphometric changes were evaluated by measuring the thickness of the functional zones of the adrenal cortex. Results: Decreased plasma CORT concentrations, as well as decreased adrenal CORT, desoxyCORT and 11-dehydroCORT concentrations, were observed in high- but not in low-anxietyphenotypes. These decreases were associated with increases in AI. PSS led to a significant decrease in the thickness of the zona fasciculata and an increase in the thickness of the zona intermedia. The increase in the thickness of the zona intermedia was more pronounced in low-anxiety than in high-anxiety rats. A decrease in the adrenal capsule thickness was observed only in low-anxiety rats. The nucleus diameter of cells in the zona fasciculata of high-anxiety rats was significantly smaller than that of control or low-anxiety rats. Conclusion: Phenotype-associated changes in adrenal function and histomorphology were observed in a rat model of complex post-traumatic stress disorder.