Le glaucome est une maladie neurodégénérative qui se définit par une perte progressive en fibres nerveuses rétiniennes et un rétrécissement du champ visuel. Il s’agit de la première cause de cécité irréversible dans le monde et le principal facteur de risque est la pression intraoculaire (PIO). L’étude ALIENOR (Antioxydants, Lipides Essentiels, Nutrition et maladies OculaiRes) est une étude épidémiologique qui a pour but de déterminer l’incidence des différentes pathologies oculaires liées à l’âge avec les facteurs nutritionnels, démographiques ou environnementaux dans une population représentative de la région de Bordeaux. En 2009-2010, 624 sujets âgés de plus de 74 ans ont bénéficié d’un examen ophtalmologique complet incluant un examen du nerf optique en rétinophotographie et en tomographie à cohérence optique spectral-domain (SD-OCT), d’une mesure la PIO au tonomètre à air et d’une évaluation des propriétés biomécaniques de la cornée. Une mesure de l’accumulation cutanée de produits de glycation avancée a été réalisée par autofluorescence. Le diagnostic de glaucome a été réalisé en utilisant les critères de la classification ISGEO (International Society for Epidemiologic and Geographical Ophthalmology). Les paramètres biomécaniques de la cornée étaient modifiés avec l’âge et chez les sujets ayant une histoire résidentielle à des latitudes plus exposées aux ultraviolets ambiants. L’épaisseur de cornée était plus élevée chez les sujets anciennement fumeurs. L’autofluorescence cutanée ≥ 2.7 UA (Unité Arbitraire) était indépendamment associée au glaucome. Les paramètres d’épaisseur en fibres nerveuses rétiniennes du SD-OCT présentaient de bonnes performances diagnostiques pour discriminer les sujets glaucomateux des témoins et la base normative présentait de bonnes performances discriminatives lorsqu’au moins un des paramètres était considéré comme anormal. Notre étude apporte des résultats originaux en termes de facteurs de risque de glaucome ou de déterminants des facteurs de risque de glaucome. De plus les performances diagnostiques du SD-OCT pourraient fournir des informations utiles pour optimiser les stratégies de dépistage du glaucome dans une population générale âgée. / Glaucoma is a neurodegenerative disease defined by a progressive loss of optic nerve axons and retinal ganglion cells resulting in a characteristic enlargement of the optic nerve head cup and associated visual field defects. It remains the first cause of irreversible blindness worldwide and intraocular pressure (IOP) is the main risk factor. The ALIENOR (Antioxydants, Lipides Essentiels, Nutrition et maladies OculaiRes) study is a population-based study. It aims to assess the associations of age-related eye diseases with nutritional, demographic and environmental factors in a representative population of the Bordeaux area. In 2009-2010, 624 subjects, aged 74 years or more, underwent a complete eye examination, including an optic nerve head evaluation using retinophotography and a spectral-domain optical coherence tomography (SD-OCT), an IOP measurement using air-puff tonometry and an evaluation of biomechanical properties of the cornea. A measurement of skin accumulation of advanced glycation end-products was performed using an autofluorescence reader. Glaucoma diagnosis was made using ISGEO (International Society for Epidemiologic and Geographical Ophthalmology) criteria. Biomechanical properties of the cornea were modified by increasing age and in subjects having a higher lifetime ambient ultraviolet exposure. Central corneal thickness was thicker in former smokers. Skin autofluorescence values ≥ 2.7 AU (Arbitrary Unit) were independently associated with glaucoma. SD-OCT retinal nerve fiber layer thickness parameters had good diagnostic performances for discriminating glaucoma and control subjects and the normative database had good diagnostic performances if at least one parameter was considered abnormal by the machine. Our study provides new insights on glaucoma risk factors and determinants of glaucoma risk factors. Furthermore diagnostic performances of SD-OCT may provide valuable information in a screening strategy to optimize glaucoma detection in a general population of elderly people.

Dans un contexte de vieillissement de la population et d’accroissement des maladies chroniques liées à l’âge comme le diabète, de nouveaux biomarqueurs de l’état de santé à long terme doivent être étudiés. Les produits de glycation avancée (AGE) sont des molécules témoins de la charge métabolique accumulée au cours du temps, dénommée "mémoire métabolique". Les AGE jouent un rôle important dans les lésions à long terme dans le diabète et dans le déclin du métabolisme global lié au vieillissement. L’accumulation cutanée des AGE peut être mesurée par autofluorescence (AF) de manière instantanée et non invasive grâce à l’AGE-READER. Les objectifs de cette thèse étaient d’évaluer la valeur de l’AF cutanée des AGE en tant que marqueur de mémoire métabolique chez des personnes âgées de la cohorte des 3-Cités et parallèlement d’évaluer la valeur pronostique de l’AF pour les complications du diabète chez des patients porteurs de diabète de type 1. Chez les personnes âgées, nous avons montré que l’AF reflétait les statuts glycémique et rénal 10 ans avant la mesure. Chez les patients atteints de diabète de type 1, l’AF était associée à la présence d’une neuropathie 4 ans plus tard. De plus, dans cette même population, nous avons décrit l’évolution de l’AF sur 4 ans de suivi. Nous avons montré que les principaux déterminants de son évolution étaient la fonction rénale et le traitement par pompe à insuline. Enfin nous avons trouvé que l’augmentation de l’AF sur 4 ans de suivi était associée à la survenue de la maladie rénale. Ces travaux soulèvent de nouvelles perspectives de recherche quant à l’intérêt de l’AF à différents âges clés de la vie en tant que biomarqueur de pathologies qui évoluent sur des dizaines d’années. / In the context of the ageing of the population and the increase of age related diseases such as diabetes, new biomarquers of the long-term health status should be considered. Advanced glycation end products (AGE) are molecules indicators of the metabolic burden over time, called “metabolic memory”. AGE play an important role in long term diabetes injuries and in the global decline of the metabolism related to ageing. Skin accumulation of AGE can be measured by autofluorescence instantly and non-invasivly with a tool called AGE-READER. The objectives of my dissertation were to evaluate the value of the skin autofluorescence (sAF) of AGE as marker of metabolic memory in elderly people from the 3-City cohort and in parallel, in patients with type 1 diabetes, evaluate the prognostic value of sAF for diabetes complications. In the elderly population, we showed that sAF reflected glycemic and renal status of 10 years before. In patients with type 1 diabetes, sAF was associated to the presence of neuropathy 4 years later. Moreover, in this same population, we described the evolution of sAF in 4 years of follow-up and we showed that the principal determinants of the evolution of sAF were kidney function and insulin pump therapy. Finally, we also found that increase of sAF in 4 years was associated with the occurrence of kidney disease. This work rises new research opportunities about the interest of sAF at differents key ages as biomarker of pathologies which evolve in several decades.

Hemodialysis (HD) is the most frequently used treatment for end-stage renal disease. Despite all efforts to improve the outcomes, the mortality of patients on HD is still high, and this especially is related to cardiovascular diseases (CVD). Glucose degradation products accumulate in plasma and tissue as a result of oxidative stress in these patients. Such accumulation is strongly related to the risk of developing CVD. Tissue deposits of advanced glycation end products (AGE) can be easily assessed by a skin autofluorescence (SAF) technique. SAF is one of the strongest prognostic markers of mortality in HD patients. The aim of this thesis is to examine whether intervention on HD treatment can reduce the load of AGE of these patients. The aim of the first study was to investigate whether changes in SAF appear after a single HD session and if they might be related to changes in plasma AF. Skin and plasma AF (PAF) were measured before and after HD in 35 patients on maintenance HD therapy. Median dialysis time was 4 h (range 3-5.5). SAF was measured noninvasively with an AGE Reader, and plasma AF was measured before and after HD. The HD patients had on average a 65% higher SAF value than age-matched healthy persons (P < 0.001). PAF was reduced by 14% (P < 0.001), whereas SAF was not changed after a single HD treatment. No significant influence of the reduced PAF on SAF levels was found. This suggests that the measurement of SAF can be performed during the whole dialysis period and is not directly influenced by the changes in plasma AF during HD. In study 2 different dialysis filters were compared to clarify whether using a high-flux (HF) dialyzer favors plasma or SAF removal compared to low-flux (LF) dialyzer. Twenty-eight patients were treated with either an HF-HD or LF-HD but otherwise unchanged conditions in a cross-over design. SAF was measured non-invasively with an AGE reader before and after HD. PAF was determined as total and non-protein-bound fractions. Corrections for hemoconcentrations by volume changes were made using the change in serum albumin. Paired and non-paired statistical analyses were used. The different treatments did not change SAF after LF- and HF-dialysis. Total, free, and protein-bound PAF were reduced after a single LF-HD by 21%, 28%, and 17%, respectively (P<.001). After HF-HD total and free PAF was reduced by 5% and 15%, respectively (P<.001), while protein-bound values were unchanged. The LF-HD resulted in a more pronounced reduction of PAF than did HF-HD (P<.001). Serum albumin correlated inversely with PAF in HF-HD. There was no significant change in SAF after dialysis, either with LF or with HF dialysis. Although only limited reductions in PAF were observed, these were more pronounced when performing LF dialysis. These data are not in overwhelming support of the use of HF dialysis in the setting used in this study. In the third study the effect on SAF was investigated using either glucose-containing or glucose-free dialysate. SAF and PAF were measured in patients on HD during standard treatment with a glucose-containing dialysate (n=24). After that, the patients were switched to a glucose-free dialysate for a 2 week period, and new measurements were performed on PAF and SAF. There was an increase of pre-dialysis SAF measured at the beginning of the study compared with the values one month later (as in study 4). By comparing pre- and post-dialysis values there was a significant decrease of SAF only when using glucose-free dialysate. Free PAF decreased independently whether glucose-containing or glucose-free dialysate was used. The important finding was that increase in SAF seemed possible to slow down using glucose-free dialysate. Study 4 was performed to investigate whether there are seasonal variations in SAF on a HD population. SAF was measured non-invasively with an AGE Reader in patients on HD at different seasonal periods during one year such as February-May (N=31), May–August (N=28), August–March (N=25). SAF was measured before HD. Paired statistical analyses were performed between each two periods.  Unexpectedly there was at a median 6% increase in SAF during the winter (p=0.004) and a 11% decrease from 4.0 to 3.5 arbitrary units of the SAF during the summer (p<0.001). The study concluded that SAF shows seasonal variation. The cause of these changes could not be clarified. A beneficial effect may be due to extended exposure to sunlight during the summer and/or to different dietary intakes during the seasons. In conclusion, these interventional studies confirmed that PAF is lowered by dialysis. SAF was only decreased by HD when using glucose-free dialysate. SAF was not influenced by a single HD, with glucose-containing dialysate, independent of using HF or LF filters. These data favor glucose-free dialysate as a possible measure to slow down the progress of tissue AGE compared to glucose-containing dialysate. Longitudinal studies will help to clarify this issue further.

Les pathologies cardio-vasculaires (CVD) représentent la principale cause de morbidité et demortalité dans le monde. Le risque de CVD augmente avec l’âge, le tabagisme, le diabète, les dyslipidémies, l’obésité et l’insuffisance rénale. L’incidence et la prévalence des CVD nécessitent le développement de stratégies de prévention et de traitement, et la recherche de nouveaux biomarqueurs. Le récepteur aux produits de glycation avancée (RAGE) est impliqué dans plusieurs pathologies métaboliques ou inflammatoires. L’activation du RAGE par ses multiples ligands, i.e. produits de glycation avancée (AGE), protéines de la famille S100 et amphotérine (HMGB1) induit une cascade pro-inflammatoire. La forme soluble du RAGE (sRAGE) a été proposée comme biomarqueur du risque vasculaire, de la sévérité et du devenir des CVD, particulièrement chez les patients diabétiques ou insuffisants rénaux. Cependant, les données sont contradictoires et des corrélations positives et négatives sont observées pour une même pathologie. L’importance de l’axe ligand-RAGE dans les processus pathologiques et le large éventail de molécules se liant au RAGE (des protéines proinflammatoires aux auto-anticorps), justifient le présent travail. Au cours du présent travail, dans un premier temps, nous avons d’abord étudié les effets des ligands du RAGE et des auto-anticorps anti-sRAGE récemment décrit, sur la quantification du sRAGE en ELISA. Nous supposons que l’interaction entre le sRAGE et ces molécules pourrait perturber le dosage du sRAGE. Dans un deuxième travail, nous avons évalué les variations du taux de sRAGE et des auto-anticorps anti-sRAGE après chirurgie bariatrique d’une obésité morbide. Les ligands du RAGE (Nε-carboxyméthyllysine, S100A6, S100A12, S100B, HMGB1 et peptide β-amyloïde) se fixent au sRAGE en différents sites et pourraient potentiellement interférer dans sa quantification par l’intermédiaire d’un masquage d’épitope. Nous avons incubé ces ligands, à des concentrations physiologiques et pathologiques, avec du sRAGE recombinant et du sérum pour évaluer leur effet sur le dosage du sRAGE. Des auto-anticorps anti-sRAGE ont été identifiés et purifiés et leur effet sur le dosage de sRAGE a été évalué. La présence des ligands ou d’autoanticorps anti-sRAGE ne modifie pas le dosage du sRAGE recombinant ou sérique. L’obésité favorise les dyslipidémies, les perturbations glycémiques et l’inflammation, conditions au cours desquelles le RAGE pourrait jouer un rôle important. Nous avons étudié les variations des taux sériques du sRAGE et de ses auto-anticorps et leur évolution avec l’amélioration métabolique des sujets obèses après chirurgie bariatrique. Les patients ont été sélectionnés au sein d’une cohorte déjà établie (Patient présentant une obésité morbide et candidat à une chirurgie de bypass gastrique, ABOS, Lille). Les patients présentant des facteurs pouvant modifier les niveaux de sRAGE, tels qu’un traitement par statines, une insuffisance rénale chronique ou une hypertension,ont été exclus. Comparé au groupe contrôle, les taux de sRAGE et d’auto-anticorps étaientsignificativement plus élevés chez les patients obèses avant la chirurgie. Parallèlement à la baisse de l’indice de masse corporelle, les taux de sRAGE et d’anti-sRAGE ont été significativement diminués un an après la chirurgie. La baisse d’anti-sRAGE a été corrélée à l’augmentation des taux de HDL. Nous démontrons que les variations des taux de sRAGE constatées dans la littérature ne sont, à priori, pas dues à l’interaction des ligands du RAGE avec le sRAGE. D’autres hypothèses, comme la régulation de la formation et de la clairance du sRAGE, sont discutées. Nous avons, pour la première fois, démontré la présence d’auto-anticorps anti-sRAGE chez les patients obèses, et la diminution du taux de ces auto-anticorps après une chirurgie de bariatrique. Ces résultats suggèrent que l’obésité pourrait être responsable d’une réaction auto-immune contre le sRAGE. / Cardiovascular diseases (CVDs) are the leading cause of mortality and morbidity in the world. The risk of CVDs increases with age, tobacco, diabetes, dyslipidemia, obesity and kidney dysfunction. The incidence and prevalence of CVDs demands the development of efficient strategies for prevention and treatment, as well as new biomarkers. The receptor for advanced glycation end-products (RAGE) is implicated in several metabolic and inflammatory disorders. RAGE activation by its multiple ligands, i.e. advanced glycation end-products (AGEs), S100 proteins and amphoterin (HMGB1) induces pro-inflammatory events upon RAGE engagement. The soluble circulating form of RAGE (sRAGE) has been proposed as a biomarker of vascular risk, disease severity and outcome, especially in individuals with diabetes or kidney dysfunction. However, data is controversial since positive and negative correlations are observed for a same disease. Nevertheless, the importance of the ligand-RAGE axis in pathological processes and the wide range of RAGE-binding molecules (from pro-inflammatory proteins to autoantibodies), appreciates the present study.In this thesis, we first investigated effects of RAGE ligands and the recently described anti-sRAGE autoantibodies on sRAGE quantification. We hypothesized that interactions between sRAGE and these molecules could impair sRAGE quantification. On the second part, we evaluated the value of sRAGE and anti-sRAGE autoantibodies as biomarkers of metabolic improvement after bariatric surgery for morbid obesity. Patients were selected from the established cohort ABOS (Lille). RAGE ligands (Nε-carboxymethyllysine, S100A6, S100A12, S100B, HMGB1 and amyloid beta peptide) bind sRAGE at different sites and could potentially impair its quantification through epitope masking. We tested this hypothesis by incubating these ligands, from physiological to pathological concentrations, with recombinant sRAGE and serum to evaluate their effects on sRAGE quantification. Anti-sRAGE autoantibodies were identified and further purified and their effects on sRAGE measurement evaluated. The presence of ligands or anti-sRAGE autoantibodies did not impair recombinant or serum sRAGE quantification. Obesity is a condition of dyslipidemia, glycemia deregulation and inflammation where RAGE is believed to play an important role. We aimed then to investigate the levels of sRAGE and its autoantibodies according to metabolic improvement in obese subjects submitted to weight loss surgery. Patients were highly selected from a well established cohort (morbidly obese patients eligible for gastric bypass, ABOS, Lille). Patients under statins treatment, with kidney dysfunction or hypertension, factors that could affect sRAGE levels, were excluded. In obese patients, significant higher levels of sRAGE and anti-sRAGE autoantibodies were observed before weight-loss surgery. In parallel to body-mass Index, both sRAGE and anti-sRAGE titers were significantly decreased one year after surgery.We demonstrate that the variations of sRAGE levels among the literature are, most likely, not due to an interaction between RAGE ligands and sRAGE. Other hypothesis like the regulation of sRAGE formation and clearance are further discussed. We have, for the first time demonstrated the presence of anti-sRAGE autoantibodies in obese subjects and that their levels decrease after bariatric surgery. Although our data suggest that morbid obese status leads to an autoimmune reactions against sRAGE. Together, our findings argue against sRAGE as a good biomarker but suggest that anti-sRAGE autoantibodies may have a potential implication to evaluate metabolic risk and autoimmunity associated to RAGE

A participação dos produtos de glicação avançada (AGEs) nas complicações crônicas relacionadas ao diabetes, têm sido muito investigadas. Entretanto, pouco se sabe sobre a participação direta dos AGEs em relação a homeostase glicêmica, na qual o transportador de glicose GLUT4 (proteína codificada pelo gene SLC2A4 ) desempenha um papel essencial. Portanto o objetivo do presente estudo é investigar o papel dos AGEs tanto in vivo quanto in vitro sobre a expressão do Slc2a4/GLUT4. Nos modelos in vivo e in vitro, os AGEs reduziram a expressão gênica/proteica do Slc2a4/GLUT4 e reduziram a sensibilidade insulínica no modelo in vivo, como também exarcebaram tanto a via inflamatória pelo NFKB quanto a via do estresse de retículo endoplasmático pelas chaperonas. Por fim, estes resultados sugerem os AGEs como um mecanismo repressor da expressão do Slc2a4/GLUT4 no músculo esquelético pelas vias de estresse de retículo e inflamatória. / The participation of advanced glycation end products (AGEs) in the diabetes-related chronic complications has been extensively investigated. However, little is known about AGEs participation in glycemic homeostasis, for which the glucose transporter GLUT4 (Slc2a4 gene) plays a key role. The aim of this study was indentify the effect of AGEs in an in vivo and in vitro models in Slc2a4/GLUT4 expression. In vivo and in vitro models showed decrease of Slc2a4/GLUT4 expression and insulin sensitivity (only on in vivo model). AGEs increase inflammatory and endoplasmic reticulum stress ways by NFKB and chaperones respectively. In sume, The results reveal that AGEs repress Slc2a4/GLUT4 expression in muscle, in a reticulum endoplasmic stress- and inflammatory-mediated way. This effect contributes to impair plasma glucose clearance, highlighting AGEs reduction/inhibition as a target to improve glycemic control in diabetes.

Diabetic symmetrical polyneuropathy is the most common secondary complication of diabetes, with no effective treatment, apart from maintaining tight glycemic control. It is therefore essential to understand the mechanisms underlying the pathogenesis of the disease in order to develop new therapeutic strategies. Biochemical and structural changes are observed in the extracellular matrix (ECM) of the peripheral nerve in diabetes: including increased endoneurial collagen; reduplication of basement membranes around endoneurial capillaries; a thickening of basal lamina; and accumulation of advanced glycation end-products (AGEs). In normal nerves, ischaemic or other damage to distal axons provokes a regenerative response; in diabetes this is abortive and failure of axonal regeneration is a hallmark of clinical and experimental diabetic neuropathy. Matrix metalloproteinases (MMPs) are a large family of zinc-dependent proteolytic enzymes that cleave the protein components of the ECM. MMP-2 and MMP-9 play a central role in Wallerian degeneration and regeneration following nerve injury. This thesis investigates whether MMP-2 and -9 expression and/or activity were altered in the peripheral nerve in diabetes, and could contribute to regenerative failure in diabetic neuropathy. Using an experimental model of diabetes, we have demonstrated that MMP-2, but not MMP-9, is upregulated at gene, protein and activity levels in the rat sciatic nerve 8 weeks post-streptozotocin (STZ). This upregulation was not maintained at later time-points of diabetes. In vitro sciatic nerve cryoculture studies showed that peripheral nerve from STZ-diabetic rats was less supportive for neurite outgrowth from dissociated adult rat sensory neurons than nerve obtained from age-matched control rats. Cyrocultures were pre-treated with either MMP-2 or chondroitinase ABC, remodelling the peripheral nerve ECM, via the removal of inhibitory chondroitin sulfate proteoglycans from the sciatic nerve, and significantly enhanced its ability to support axonal regeneration, and partially restored the diabetes-associated regenerative deficit. However, exogenous MMP-2 or MMP-9 did not directly affect neurite outgrowth of dissociated adult rat sensory neurons. Finally, we assessed the neuroprotective effects of the AGE inhibitors LR90 and pyridoxamine in experimental diabetes, using a number of electrophysiological, behavioural and biochemical endpoints. These inhibitors were effective at preventing the development of some of the functional deficits observed in STZ-diabetes. Sensory nerve conduction velocity deficits and lipid peroxidation in the sciatic nerve were prevented by both LR90 and pyridoxamine. These agents have potential for the treatment of diabetic neuropathy.

INTRODUÇÃO Produtos intermediários da reação de Maillard e da peroxidação, como os compostos dicarbonílicos, reagem facilmente com grupamentos aminas de proteínas e ácidos nucléicos levando a modificações biológicas que podem resultar em patologias observadas no diabetes, aterosclerose e doenças neurodegenerativas. O consumo de Produtos da Reação de Maillard (PRM) aumentou nas últimas décadas e há evidências de que estas substâncias são absorvidas e podem tomar parte em processos patológicos, embora ainda não haja consenso sobre os possíveis efeitos deletério à saúde a partir do aumento de sua ingestão. Ressalta-se a necessidade de estimar o consumo destes PRMs a partir de dados sobre os conteúdos e a ingestão habitual do alimento em questão como cereais matinais e café. Objetivos: a) validar metodologia para quantificar indicadores da reação de Maillard: hidroximetilfurfural (HMF), furosina (FUR), carboximetilisina (CML) e Compostos Intermediários Fluorescentes (CIF) em cereais matinais (flocos e granola) e café; b) avaliar se há diferenças nos teores desses compostos nas diferentes marcas destes produtos comercializados em São Paulo; METODOLOGIA: Foram analisados dois lotes de três marcas de cereais do tipo flocos, três marcas de cereais do tipo granola e cinco marcas de café presentes em 100 por cento dos hipermercados visitados no município de São Paulo. A validação da metodologia para quantificação, empregando HPLC, consistiu no cálculo da exatidão (recuperação), repetibilidade e sensibilidade para os compostos: HMF e FUR. Foram determinados os teores de CIF por espectrofotometria de fluorescência e os teores de CML por teste imunoenzimático. RESULTADOS: Os métodos de determinação de FUR e HMF foram validados conforme o Instituto Nacional de Metrologia, Normalização e 9 Qualidade Industrial (INMETRO). O teor médio de CIF livre e total foram maiores para as amostras de café, com média de 232CIF/mg e 765CIF/mg respectivamente. Não houve diferença (p>0,05) no teor de CIF livre e total entre os flocos F1 e F2. O mesmo foi observado para a granola marcas. G1, G2 e G3 A granola foi o produto com maior teor médio de HMF (67,5mg/Kg) e furosina (301mg/100g de proteína). A FUR não foi detectado nas amostras de café. Todas as marcas dos alimentos estudados para os indicadores HMF e FUR apresentaram diferença estatisticamente significativa (p<0,05). O café apresentou maior teor médio de CML (1823,5ng/mg de proteína), sem diferença entre as marcas (p>0,05) CONCLUSÕES: Os cereais do tipo flocos contribuem para maior ingestão de PRMs da fase inicial da reação de Maillard (RM), a granola contribui para maior ingestão de PRMs da fase intermediária da RM e o café contribui de forma significativa para maior ingestão de PRMs da fase avançada da RM. O café, por ser submetido a tratamento térmico mais severo apresenta maior concentração de PRMs da fase avançada da reação / INTRODUCTION Maillard reaction products and lipid peroxidation, such as dicarbonyl compounds easily react with amino groups of proteins and nucleic acids leading to biological changes that can result in complications in diseases such as diabetes, atherosclerosis and neurodegenerative. The consumption of Maillard Reaction Products (MRP) has increased in recent decades and there is evidence that these substances are absorbed and can participate in pathological processes, although there is no consensus about the possible harmful health effects from their intake. We highlight the need to identify the consumption of MRP, mainly in vulnerable populations like children and diabetics, in order to establish acceptable daily intakes and guidelines for the food industry. OBJECTIVES: a) validate the methodology to measure indicators of the Maillard reaction: hydroxymethylfurfural (HMF), Furosine (RUF) carboxymethylysine (CML) and fluorescent intermediate compounds (FIC) in breakfast cereals (corn flakes and granola) and coffee, b) to evaluate if there are differences in the levels of these compounds contents among brands commercialized in São Paulo METHODS: two lots of 3 brands of flakes cereal, 3 brands of granola and 5 coffee brands present in 100 per cent of supermarkets visited in the city Sao Paulo were analyzed. HPLC methodology validation was assessed by determining accuracy (recovery), repeatability, and sensibility (linearity, limits of detection and quantitation) for the compounds: HMF and FUR. The contents of the Fluorescent Intermediary compounds (FIC) was measured by spectrophotometric method and the levels of CML by ELISA. RESULTS: Calibration curves determination coefficient (r 2) were higher than 0,99 for all compounds. Recovery ranged from 84 to 110 per cent and repeatability average was 3,5 per cent. The average content of free and total FIC was higher for coffee 232CIF/mg and 765CIF/mg respectively. The brands of granola and flakes was similar but just brands F1 and F2 was similar between brands (p<0,05). For HMF the higher values were for granola 67,5mg/kg. The presence of dried fruit in these grains may 11 have contributed significantly to the higher rate of this indicator. For indicator FUR average was higher in granola samples (301mg/100g of protein) and it was not possible to quantify the levels of FUR for coffee. All brands analyzed for HMF and FUR was similar (p<0,05). CML average was higher for coffee (1823,5ng/mg of protein). The brands analyzed was similar for all samples (p <0.05). CONCLUSIONS: Flakes contribute to higher intake of MRPs from early stage of the Maillard reaction (MR), the granola contributes to higher intake of MRPs from intermediate phase of MR and coffee contributes significantly to higher intake of final MRPs. Data suggest that coffee has more severe thermal treatment causing a higher concentration of MRPs from the final phase of the MR

Cyclooxygenase (COX) is the rate limiting enzyme that catalyses the production of prostanoids, which are crucial to vascular homeostasis. Evidence suggests that endothelial dysfunction and inflammation play a role in vascular complications in aging and diabetes. Previous animal studies by our laboratory at RMIT University reported enhanced COX expression with aging in rat aortas, platelets and monocytes. Potentially, alteration in COX expression may result in an imbalanced prostanoid production favoring the synthesis of vasoconstrictors and hence increase the risk of cardiovascular events in the aging population. The regulation of altered COX expression in aging, however, is not clear. It has been suggested that histone hyperacetylation may be an important mechanism that regulates COX levels during the aging process as increased histone acetylation has been shown to occur with aging. Thus, we hypothesized that COX expression is modulated by histone hyperacetylati on. This was investigated by measuring COX expression in histone hyperacetylated cultured endothelial cells. In the case of diabetes, studies have reported that the development of diabetes and its complications is associated with persistent inflammatory activity, evident with increased inflammatory markers in the circulation. COX-mediated pathways may be involved in this inflammatory process in diabetes. Furthermore, the formation of advanced glycation end products (AGEs) is accelerated in diabetes. AGEs can bind to receptors for AGEs (RAGE), which has also been suggested to play a role in inflammation in diabetes. We hypothesized that COX- and RAGE-mediated pathways contribute to increased inflammation in diabetes and potentiate the development of diabetic vascular complications. This was investigated by measuring changes in COX-mediated pathways in both rat and human diabetic models. The current thesis reports: 1) in cultured endothelial cells, histone hyperacetylation was associated with increased COX expression; 2) an overall increase in inflammation was observed in diabetes involving COX- and RAGE-mediated pathways. This was supported by increased platelet COX-1 and monocyte COX-2 levels in Zucker rats, increased monocyte COX-2 in human Type 1 diabetes and elevated plasma TXB2 and PGE2 levels in both human Type 1 and Type 2 diabetic subjects. Up-regulation of RAGE expression was further found in platelets and monocytes in both human diabetes types. When treated with NSAIDs, plasma prostanoid levels, COX and RAGE expression were reduced significantly in both platelets and monocytes in human diabetic subjects. 3) It is unclear how COX and RAGE expression was regulated, but histone modifications may be one of the mechanisms. Data from cultured cells indicated that increased COX expression was associated with increased histone acetylation levels induced by TSA. Concurrent increases in histone acetylation and COX-2 levels were also observed in human Type 1 diabetes, but similar findings were not observed in human Type 2 diabetes. In addition, we failed to find an age-dependent increase in monocyte histone H4 acetylation in human Type 2 diabetes despite an age-dependent increase in monocyte COX-2 expression. Thus, whether histone hyperacetylation modulates COX expression and in what conditions require further investigation.

The aim of this study is to investigate the deterioration in mechanical integrity of the collagen network in bovine bone with aging, which are related to fracture toughness. Age-related changes in collagen molecular structures formed by non-enzymatic glycation were examined and indentation fracture technique was used as a method for measuring the microstructural toughness of cortical bone. Microcrack propagation characteristics of bone for fragility were also studied. Young and old group of bovine cortical bone specimens were grouped into 2 as ribosylated and non-ribosylated which were rested in solutions for four weeks. Series of indentations were made on bone specimen groups for each of five masses 10g, 25g, 50g, 100g and 200g for 10 sec to detect the effect of applied indentation load. The applied load was increased to 300g, 500g, 1000g and 2000g for 10 sec to be able to make microcracks. Series of indentations were made on bone specimen groups for each of five durations 5sec, 10sec, 20sec, 30sec for 100g to study the effect of indentation duration. Specimens were examined in the wet and dry state while studying the factors effecting microhardness measurement. Microhardness values measured by 10g of load for 10sec were indifferent between the ribosylated and non-ribosylated groups in the young and old bovine bone pointing that this load is not indicative of the structural collagen changes. Loads of 25g, 50g, 100g and 200g for 10 sec were able to differ ribosylated bone from non-ribosylated bone for the young and old bovine bones. Degree of microhardness increased with increased incubation period. Microhardness of dry specimens being either ribosylated or non-ribosylated were found to be statistically higher than wet specimens in young and old bone except for 10g for 10sec. It has been shown that the calculated fracture toughness measured by the indentation method is a function of indentation load. Additionally, effect of indentation size might have resulted in a higher toughness measurement for higher indent loads with longer cracks even if the toughness is not actually higher.Methods using indentation technique has difficulty in relating the resistance to crack growth to the Mode I fracture toughness definition.Indentation fracture toughness allows sampling only one point on the R&shy / curve methods and was not considered as successful for assessing materials with rising R&shy / curve. Toughness is ranked incorrectly among riboslated and non-ribosylated bovine bone by this technique. Presence of extrinsic toughening mechanisms including crack bridging due to uncracked ligaments and collagen fibers were directly observed by scanning electron microscope. Ribosylated bone was found to have lower number of collagen bridging compared ton on-ribosylated bovine bone.As a summary, indentation fracture method by Vickers indentation in bone is a method for measuring the fracture toughness.

Traumatic brain injury (TBI) has become an increasingly unmet clinical need due to intense military conflicts worldwide. Directly impacted brain cells suffer massive death, with neighboring cells succumbing to progressive neurodegeneration accompanied by inflammatory and other secondary cell death events. Subsequent neurodegenerative events may extend to normal areas beyond the core of injury, thereby exacerbating the central nervous system’s inflammatory response to TBI. Recently CD-36 (cluster of differentiation 36/fatty acid translocase (FAT), a class B scavenger receptor of modified low-density lipoproteins (mLDLs) in macrophages, has been implicated in lipid metabolism, atherosclerosis, oxidative stress, and tissue injury in cerebral ischemia, and in certain neurodegenerative diseases. Accordingly, we proposed that CD-36 has a pivotal role in the neuroinflammatory cascade that further contributes to the pathology of TBI. First, we explored the neuroinflammatory role of CD-36 after acute and chronic stages of TBI. Second, we employed a neuroinflammatory model to test the therapeutic effect of the soluble receptor of advanced end-glycation product (sRAGE); previously shown to abrogate increased CD-36 expression in stroke. Third, we further examined ameliorating TBI related inflammation as a therapeutic pathway by combination of stem cell therapy and sRAGE. At acute stages of TBI, we observed brain co-localization of CD-36, monocyte chemoattractant protein 1 (MCP-1) and ionized calcium-binding adapter molecule 1 (Iba-1) on impacted cortical areas, significant increases of CD-36 and MCP-1 positive cells in the ipsilateral vs. contralateral hemispheres of TBI animals in acute, but no significant increases of Iba-1 expressing cells over time. In early acute stages of TBI immunoblotting showed overexpression of CD-36 in brain cortex when comparing ipsilateral and contralateral hemispheres vs. sham. Spleen CD-36 protein expression at acute post-TBI stages showed no significant difference between TBI and sham groups. In addition, immunohistochemistry revealed minimal CD-36 detection on the cortical area of impact on our chronic group. Spleen immunohistochemistry also showed co-localization of CD-36 and MCP-1 in the red pulp of spleen in acute stages of TBI animals when compared to sham. Ongoing ischemic and hyperlipidemic rodent models suggest that infiltrating monocytes/macrophages from the periphery are the major source of CD-36 in the post-ischemic brain. Likewise, CD-36 expressing monocytes in the spleen after TBI may suggest its role in peripheral immune response, which may exacerbates the inflammatory response after TBI. Therefore, CD-36 may play a key role as a pathological link between inflammation and TBI. Our results suggest an intimate involvement of CD-36 mediated inflammation in TBI, providing novel insights into the understanding of disease neuroinflammation and as a potent therapeutic target for TBI treatment. The critical timing (i.e., 24-48 hours) of CD-36 expression (from downregulation to upregulation) may signal the transition of functional effects of this immune response from pro-survival to cell death. This observed dynamic CD-36 expression also suggests the therapeutic window for TBI. The detection of CD-36 expression in brain areas proximal, as well as distal, to the site of impacted injury suggests its role in both acute and progressive evolution of TBI. CD-36 neuroinflammatory role has clinical relevance for treating patients who have suffered any TBI condition at acute and chronic stages.