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The liver is responsible for lipid and glucose metabolism, protein and bile synthesis and the biotransformation of xenobiotics. These functions, performed by hepatocytes, are dependent on heterotypic interactions with other liver cell types and the stratified microarchitecture of the organ. In vitro liver models provide insights into the role of each cell type and perturbations upon external stimuli. Despite the dissimilarities to in vivo and rapid dedifferentiation, most liver studies utilize hepatocyte monocultures. These models lack heterotypic interactions causing inaccurate assessments of toxicity and disease. Only a limited number of 3D hepatic models incorporate the major liver cell types, and these cultures primarily focus on the hepatocyte response. We have developed 3D liver models that include all major hepatic cell types and recapitulate the layered architecture of the organ. These models maintain hepatic functions for up to four weeks and can be used to isolate the role and response of each cell type. We used these models to study two critical aspects of the organ -- acute hepatotoxicity and liver fibrosis. There are tens of thousands of chemicals with undetermined effects on the human body. High concentrations of xenobiotics can cause acute liver damage and failure. Liver impairment can result in multiple organ failure, hepatic encephalopathy and death. Therefore, it becomes critically important to investigate hepatotoxicity in a time, cost and resource effective manner. Our 3D liver models were validated for hepatotoxicity testing with acetaminophen, a prototypic drug. We then adapted and optimized the models for high-throughput hepatotoxicity testing with automated procedures and primary human hepatic cells. Liver fibrosis and cirrhosis are well-established consequences of chronic chemical exposure, infection and alcoholism. The initiating factors, end stages and resolution of fibrosis have been extensively studied. However, there is minimal information on the role of the local microenvironment in the progression of the disease from diseased to healthy tissue. We designed 3D liver cultures with a mechanical gradient to gradually model this transition through spatial and temporal perspectives. These findings demonstrate the versatility and accuracy of these 3D hepatic models in the investigation of liver toxicity and fibrosis. / Ph. D.

O sulindaco é um antiinflamatório não esteroidal (AINE) classificado quimicamente como ácido carboxílico, da classe dos acetatos, que inibe de forma não seletiva a cicloxigenase 1 e 2. Terapeuticamente, é utilizado como agente analgésico e antiinflamatório para o tratamento de sintomas da artrite reumatóide aguda e crônica, osteoartrite e espondilite anquilosante, no entanto, seu uso não está restringido somente a estas patologias, pois apresenta atividade quimiopreventiva, sendo atualmente também utilizado para este fim, apesar de inúmeros relatos de toxicidade gastrointestinal e hepática terem sido relatados na literatura. Ele é ingerido como um pró-fármaco, e por reações de biotransformação hepática origina um metabólito reduzido (sulindaco sulfeto, ativo farmacologicamente) e outro oxidado (sulindaco sulfona, inativo). Para avaliar os efeitos do sulindaco e seus metabólitos, foram realizados estudos in vitro em mitocôndrias isoladas de fígado de rato, para explorar aspectos mecanísticos de toxicidade mitocondrial, e ensaios com linhagem celular de hepatoma humano HepG2, para avaliar seus efeitos após metabolização, uma vez que estas células mantém enzimas responsáveis pelas reações de biotransformação de fase I e II. Nossos resultados demonstram que o sulindaco sulfeto estimula a respiração de estado 4 e promove a liberação de cálcio pré-acumulado pela organela de maneira concentração-dependente, sendo evidente o efeito desacoplador sobre a fosforilação oxidativa, refletidos na diminuição da viabilidade celular em associação com a diminuição do conteúdo de ATP, provocado pela dissipação do potencial de membrana mitocondrial, sugerindo um mecanismo protonoforético de desacoplamento, responsável pela toxicidade deste antiinflamatório. Além disso, foi observado o inchamento das mitocôndrias em meio energizado, condição que ocorre independente de cálcio presente no meio reacional. Este evento foi parcialmente sensível a ciclosporina A e Mg2+, teve prevenção total com a adição de BHT e insensibilidade a outros moduladores, como ADP, ATP, DTT e NEM. Os resultados não condizem com a transição de permeabilidade mitocondrial clássica, uma vez que é dependente de cálcio, e o mecanismo de prevenção deste efeito obtida com a adição de BHT é desconhecido, pois não foi observada a indução de formação de radicais livres nos dois modelos experimentais utilizados. No entanto, a indução de intumescimento mitocondrial pode contribuir para seus efeitos tóxicos. O sulindaco e o sulindaco sulfona não apresentaram quaisquer efeitos descritos para o sulindaco sulfeto, indicando que somente o metabólito farmacologicamente ativo é responsável pelos efeitos tóxicos observados. A biotransformação por reações de Fase I e II podem contribuir para a toxicidade in vivo, por originarem o metabólito reduzido, e como o sulindaco é utilizado em terapias que envolvem uso por tempo prolongado, é prudente realizar um monitoramento da função hepática antes e durante o período de tratamento, no sentido de prevenir complicações do uso na terapia convencional / Sulindac is a nonsteroidal anti-inflammatory drug (NSAID) known to inhibit non-selectively ciclooxygenases (COX) 1 and 2. Sulindac is therapeutically used as anti-inflammatory and analgesic in the symptomatic treatment of acute and chronic rheumatoid arthritis, osteoarthritis, and ankylosing spondylits. In addition to this property, a role in the prevention/regression of colonic carcinogenesis, has been described for both sulindac and metabolites. Nevertheless, its therapeutic use has been limited because of its toxicity to the gastrointestinal tract and liver, reported in the literature. Sulindac is a prodrug that is ?in vivo? metabolized to its pharmacological active metabolite, sulindac sulfide and its pharmacological inactive one, sulindac sulfone. In order to assess the effects of sulindac and its metabolites, we used ?in vitro? studies with isolated rat liver mitochondria, to evaluate the aspects of its toxicity in mitochondria; and studies with human hepatoma cell line (HepG2), to evaluate its affects after biotransformation. The present study shows that sulindac sulfide, but not sulindac sulfone or sulindac itself, cause mitochondrial uncoupling, releasing pre-accumulated Ca2+ from the organelle, and decrease Hep-G2 cell viability in an apparent association with cellular ATP depletion resulted from mitochondrial uncoupling-associated membrane potential dissipation. We therefore propose mitochondrial uncoupling by sulindac sulfide as a potential mechanism for the well established toxicity of sulindac, at least to the liver in humans. It was also observed a mitochondrial swelling in energized media that can occur without dependence on the calcium present in the media. This event was partial inhibited by CsA and Mg2+, and completely inhibited with the addition of BHT. It did not show any inhibition with the addition of ADP, ATP, DTT or NEM. These results can not be associated to the classical mitochondrial permeability transition that is dependent to calcium, and the mechanism of inhibition observed with BHT is not known, since it was not observed any production of free radicals in our models, but the swelling observed can also contribute to the toxic effects observed. The sulindac itself and the sulfone metabolite did not show any toxic effect observed for the sulfide form, indicating that just the pharmacological active metabolite is responsible for the toxic effects. The biotransformation (phase I and II reactions) can contribute to sulindac toxicity, because they generate the reduced form. Sulindac is also used in long term treatment, so it is necessary the monitoring of the hepatic function is necessary before and during the treatment, in order to prevent any further complication.

Orientador: Maria Izabel Souza Camargo / Resumo: O presente trabalho teve como objetivo avaliar o efeito tóxico e terapêutico do extrato da glândula salivar (EGS) de fêmeas de carrapatos Rhipicephalus sanguineus senso lato (Acari: Ixodidae), alimentadas por 2 dias em hospedeiros, em diferentes concentrações, por meio de injeções intraperitoneais em ratas Wistar. Os resultados clínicos mostraram que na concentração de 10 μg/μL houve aumento da frequência de neutrófilos e diminuição da de linfócitos. Na análise histológica do fígado, observou-se que o extrato nessa concentração causou alguns efeitos tóxicos como vacuolização citoplasmática nos hepatócitos e desorganização estrutural dos cordões celulares. Nas concentrações de 40 e 80 μg/μL, as ratas ganharam peso corporal e tiveram o peso relativo do fígado diminuído, evidenciandoo que essas concentrações causaram toxicidade sistêmica. Nesse trabalho foi também analisado o efeito do EGS apenas na concentração de 0,04μg/μL, sobre lesões pré-neoplásicas (LPN) no fígado de ratos Wistar e observou-se aumento no peso relativo apenas do fígado nos animais dos grupos LPN e LPN+EGS quando comparados ao controle. A histologia mostrou que os animais LPN, antes da injeção do extrato, foram os que tiveram o tecido hepático com maiores danos (desorganização dos cordões, aumento de tecido conjuntivo, vacuolização citoplasmática, células apoptóticas e aumento na frequência de células de Kupffer, células de defesa deste órgão) os quais foram reduzidos quando os ratos receberam o EGS. No pres... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This study aimed to evaluate the toxic and pharmacological effect of salivary gland extract (SGE) of female ticks Rhipicephalus sanguineus in different concentrations through intraperitoneal injections in Wistar rats. Clinical results showed that at the concentration of 10 μg/μL there was an increase in neutrophil frequency and a decrease in lymphocytes. It was also observed that in the liver histological analysis, the extract at this concentration caused some toxic effects: cytoplasmic vacuolization in the hepatocytes and structural disorganization in the cellular cords. At concentrations of 40 and 80 μg/μL, rats body weight increased, and relative liver weight decreased, showing that these concentrations caused systemic toxicity. In this study, was analysed the effect of SGE in the concentration of 0.04 μg/μL on the pre-neoplasic lesions (PNL) in the liver of Wistar rats, and there was an increase in the relative weight of the liver in the groups PNL and PNL + SGE. The histology showed that the PNL animals had the hepatic tissue with the biggest damage (cord disorganization, increase of connective tissue, cytoplasmic vacuolization, apoptotic cells and increased Kupffer cell quantity, indicating immune response), those alterations were reduced when the mice received the SGE as treatment. In the study about the in vitro evaluation of the acaricides effect of thymol and carvacrol on RML-15 cells from R. sanguineus s.l. ticks were carried out. Thymol at all tested concentration... (Complete abstract click electronic access below) / Doutor

Conselho Nacional de Desenvolvimento Científico e Tecnológico / The family Cactaceae comprises about 1900 species in 125 genera. Nopalea cochenillifera (L.) Salm-Dyck occurs from Mexico to Panama and has been adapted in several countries. It is a shrubby plant that reaches 3-4 m tall, has cylindrical trunk and cladodes that are flat and fleshy. This species is known by names such as palma doce, palma-muida, nopal and nopalitos. It is used in traditional medicine as anti-inflammatory, analgesic, antimicrobial and diuretic. The cladodes of N. cochenillifera are present flavonoids, saponins, tannins and anthraquinones, and highlighted the occurrence of -sitosterol. Pharmacobotanical study shows that N. cochenillifera presents phylloclades with areolae composed of three straight and hyaline spines. The uniseriate epidermis has parallelociytic stomata and mucilage cells, followed by an annular collenchyma and parenchyma palisade, on average, with eight layers of cells. The vascular region consists of isolated bundles of the open colateral type, and the central cylinder, consists of a parenchyma medulla. The structures of mucilage and calcium oxalate druzes occur both in the cortical region as in the central cylinder and are more numerous near the vascular bundles, and the druze also occur in the first layer of collenchyma. These morphoanathomical characteristics, when taken together, are consistent in botanical modelo of control of quality of this plant species. The evaluation of anti-inflammatory activity of N. cochenillifera in induction of granulomatous tissue shows that animals treated with ethanol extract shows 53.5% inhibition of the formation of granulomatous tissue, while those treated with nimesulide has 58.5%, confirming significant antiinflammatory activity. With the same animals was performed the serum AST, ALT, albumin, creatinine and urea, which showed a lack of renal toxicity and suggest liver toxicity. / A família Cactaceae compreende aproximadamente 1900 espécies distribuídas em 125 gêneros. Nopalea cochenillifera (L.) Salm-Dyck ocorre do México ao Panamá e encontra-se aclimatada em diversos países. É uma planta arbustiva que atinge 3 a 4 m de altura, possui tronco cilíndrico e com artículos denominados cladódios que são achatados e carnosos. Esta espécie é conhecida por denominações como palma-doce, palmamiúda, nopal e nopalito. É utilizada na medicina tradicional como antiinflamatória, analgésica, antimicrobiana e diurética. Nos cladódios de N. cochenillifera estão presentes, flavonóides, saponinas, taninos e antraquinonas, sendo destacada a ocorrência de -sitosterol. Estudo farmacobotânico, demonstra que N. cochenillifera apresenta filocladódio com aréolas composta por três espinhos retos e hialinos. A epiderme unisseriada possui estômatos paralelocítico e células mucilaginosas, seguido por um colênquima anelar e parênquima paliçádico, em média, com oito camadas de células. A região vascular é constituída de feixes isolados do tipo colateral aberto e, o cilindro central, é composto por uma medula parenquimática. As estruturas de mucilagem e as drusas de oxalato de cálcio ocorrem tanto na região cortical como no cilindro central e estão em maior número próximo aos feixes vasculares, sendo que as drusas também ocorrem na primeira camada do colênquima. Estas características morfoanatômicas, quando tomadas em conjunto, são consistentes no controle botânico de qualidade desta espécie vegetal. A avaliação da atividade antiinflamatória de N. cochenillifera em modelo de indução de tecido granulomatoso demonstra que os animais tratados com extrato etanólico apresentam 53,5% de inibição da formação de tecido granulomatoso enquanto que os tratados com nimesulida apresentam 58,5%, confirmando significativa atividade antiinflamatória. Com os mesmos animais foi realizada a dosagem sérica de AST, ALT, albumina, creatinina e uréia, onde demonstraram ausência de toxicidade renal e sugerem toxicidade hepática.

Les hépatopathies médicamenteuses survenant sur un mode idiosyncrasique représentent un obstacle majeur au développement de médicaments et sont à l’origine du retrait du marché de nombreux d’entre eux. Un des mécanismes mis en cause est lié à la survenue d’un épisode inflammatoire aigu qui, lors d’un traitement médicamenteux, sensibiliserait le foie pour les effets indésirables des médicaments, mettant en évidence leur toxicité idiosyncrasique. A l’heure actuelle, la détection précoce de médicaments potentiellement hépatotoxiques dans un contexte inflammatoire avant leur mise sur le marché, reste encore difficile et leurs mécanismes sous-jacents ne sont pas clairement élucidés. Dans ce contexte, notre travail s’articule sur 3 axes : 1) Développer un nouveau modèle cellulaire in vitro humain, adaptable au criblage à haut débit prédictif d'hépatotoxicité idiosyncrasique liée à un stress inflammatoire, basé sur l’exposition synergique des cellules HepG2 cultivées dans des conditions particulières exposées à des médicaments potentiellement idiosyncrasiques et des médiateurs pro-inflammatoires(LPS et TNF- ).2) Elucider les mécanismes sous jacents de la toxicité de 4 médicaments idiosyncrasiques connus (trovafloxacine, nimésulide, télithromycine et néfazodone), en mettant l'accent sur le stress oxydatif, la stéatose et la cholestase 3) Etudier les mécanismes moléculaires sous-jacents de la mort cellulaire observée lors d’une hépatotoxicité idiosyncrasique liée à un stress inflammatoire. Ainsi, nous avons développé un modèle cellulaire humain prédictif d’hépatotoxicité idiosyncrasique liée à un stress inflammatoire sensible, spécifique et applicable au criblage en haut débit d’un grand nombre de médicaments. Pour cela, nous avons étudié dans ce modèle, les effets toxiques de quatre médicaments testés et élucidé leurs mécanismes. La trovafloxacine exerce un effet cholestatique par diminution de l’expression et de l’activité de MDR1 et MRP2. Le nimésulide favorise l'accumulation intracellulaire de radicaux superoxydes en plus de son potentiel cholestatique par inhibition de l’activité MRP2. La télithromycine favorise une hépatotoxicité principalement via un mécanisme cholestatique impliquant l’inhibition de MDR1. La néfazodone favorise l'accumulation des radicaux superoxydes en plus de son potentiel stéatosique important et de son effet inhibiteur sur les deux transporteurs MDR1 et MRP2. Bien que chaque médicament idiosyncrasique testé présente un mécanisme de toxicité différent, ils ont tous entraîné une mort hépatocellulaire amplifiée en présence de LPS et TNF- , via la voie apoptotique intrinsèque pour la trovafloxacine, extrinsèque pour la néfazodone et les deux voies de l'apoptose pour le nimésulide et la télithromycine. Le potentiel apoptotique amplifié des quatre médicaments s'est avéré être médié par la surexpression de Bax et de caspase 8 via un mécanisme dépendant de ERK ½. Nos résultats indiquent que notre modèle peut être utilisé non seulement comme un outil préclinique pour l'identification de nouveaux médicaments qui pourraient être potentiellement hépatotoxiques lors d’un stress inflammatoire, mais aussi pour l'élucidation de leurs mécanismes. / Idiosyncratic adverse drug reactions (IADRs) are considered as an important subset of ADRs, accounting for approximately 13% ofall acute liver failure cases and representing one of the leading causes for post-marketing drug withdrawal (Shaw et al. 2010). The lack of effective in vitro or in vivo models able to predict the hepatotoxic potential of idiosyncratic drugs before being approved formarketing on one hand, and the ambiguity of the mechanisms underlying their hepatic pathogenesis on the other hand render IADRs a perplexing human health problem (Shaw et al. 2010). Accordingly, the work presented in this thesis was based on three main objectives: 1) Development of a high throughput human-based cellular model for the prediction of inflammation associated idiosyncratic drug-induced hepatotoxicity; based on the synergistic exposure of HepG2 cells to potentially hepatotoxic drugs and proinflammatory mediators (LPS and TNF- ). 2) Elucidation of the hepatotoxic mechanisms underlying four known idiosyncratic drugs (trovafloxacin, nimesulide, telithromycin and nefazodone) with emphasis on oxidative stress, steatosis and cholestasis.3) Investigation of the molecular mechanisms underlying drug-inflammation synergistic induction of hepatocellular death Firstly, the results attained in this thesis demonstrated that the developed model is sensitive, specific and applicable to high throughputtoxicity screening of different categories of drugs. Secondly, our results demonstrated that the inflammation associated hepatotoxicpotentials of the four tested idiosyncratic drugs are mediated as follows: trovafloxacin exerts a cholestatic potential that involves thedown-regulation of both MDR1 and MRP2. Nimesulide promotes the intracellular accumulation of superoxide anions in addition topotently inhibiting MRP2. Telithromycin promotes hepatotoxicity predominately via a cholestatic mechanism that involves the downregulation of MDR1. Nefazodone favors the accumulation of superoxide anions in addition to its prominent steatotic potential and inhibitory effect on both MDR1 and MRP2. Although each of the idiosyncratic drugs exhibited a different mechanism of toxicity they all induced amplified hepatocellular death in presence of LPS and TNF- , which proved to be mediated via the intrinsic apoptotic pathway for trovafloxacin, the extrinsic for nefazodone and both apoptotic pathways for nimesulide and telithromycin. The amplified apoptotic potential of the four drugs proved to be based on the up-regulation of Bax and caspase 8 via an ERK½-dependent mechanism. These results indicate that the presented drug-inflammation model constitute an effective pre-clinical tool not only for the detection of inflammation-associated hepatotoxic drugs but also for the elucidation of their underlying mechanisms.

O sulindaco é um antiinflamatório não esteroidal (AINE) classificado quimicamente como ácido carboxílico, da classe dos acetatos, que inibe de forma não seletiva a cicloxigenase 1 e 2. Terapeuticamente, é utilizado como agente analgésico e antiinflamatório para o tratamento de sintomas da artrite reumatóide aguda e crônica, osteoartrite e espondilite anquilosante, no entanto, seu uso não está restringido somente a estas patologias, pois apresenta atividade quimiopreventiva, sendo atualmente também utilizado para este fim, apesar de inúmeros relatos de toxicidade gastrointestinal e hepática terem sido relatados na literatura. Ele é ingerido como um pró-fármaco, e por reações de biotransformação hepática origina um metabólito reduzido (sulindaco sulfeto, ativo farmacologicamente) e outro oxidado (sulindaco sulfona, inativo). Para avaliar os efeitos do sulindaco e seus metabólitos, foram realizados estudos in vitro em mitocôndrias isoladas de fígado de rato, para explorar aspectos mecanísticos de toxicidade mitocondrial, e ensaios com linhagem celular de hepatoma humano HepG2, para avaliar seus efeitos após metabolização, uma vez que estas células mantém enzimas responsáveis pelas reações de biotransformação de fase I e II. Nossos resultados demonstram que o sulindaco sulfeto estimula a respiração de estado 4 e promove a liberação de cálcio pré-acumulado pela organela de maneira concentração-dependente, sendo evidente o efeito desacoplador sobre a fosforilação oxidativa, refletidos na diminuição da viabilidade celular em associação com a diminuição do conteúdo de ATP, provocado pela dissipação do potencial de membrana mitocondrial, sugerindo um mecanismo protonoforético de desacoplamento, responsável pela toxicidade deste antiinflamatório. Além disso, foi observado o inchamento das mitocôndrias em meio energizado, condição que ocorre independente de cálcio presente no meio reacional. Este evento foi parcialmente sensível a ciclosporina A e Mg2+, teve prevenção total com a adição de BHT e insensibilidade a outros moduladores, como ADP, ATP, DTT e NEM. Os resultados não condizem com a transição de permeabilidade mitocondrial clássica, uma vez que é dependente de cálcio, e o mecanismo de prevenção deste efeito obtida com a adição de BHT é desconhecido, pois não foi observada a indução de formação de radicais livres nos dois modelos experimentais utilizados. No entanto, a indução de intumescimento mitocondrial pode contribuir para seus efeitos tóxicos. O sulindaco e o sulindaco sulfona não apresentaram quaisquer efeitos descritos para o sulindaco sulfeto, indicando que somente o metabólito farmacologicamente ativo é responsável pelos efeitos tóxicos observados. A biotransformação por reações de Fase I e II podem contribuir para a toxicidade in vivo, por originarem o metabólito reduzido, e como o sulindaco é utilizado em terapias que envolvem uso por tempo prolongado, é prudente realizar um monitoramento da função hepática antes e durante o período de tratamento, no sentido de prevenir complicações do uso na terapia convencional / Sulindac is a nonsteroidal anti-inflammatory drug (NSAID) known to inhibit non-selectively ciclooxygenases (COX) 1 and 2. Sulindac is therapeutically used as anti-inflammatory and analgesic in the symptomatic treatment of acute and chronic rheumatoid arthritis, osteoarthritis, and ankylosing spondylits. In addition to this property, a role in the prevention/regression of colonic carcinogenesis, has been described for both sulindac and metabolites. Nevertheless, its therapeutic use has been limited because of its toxicity to the gastrointestinal tract and liver, reported in the literature. Sulindac is a prodrug that is ?in vivo? metabolized to its pharmacological active metabolite, sulindac sulfide and its pharmacological inactive one, sulindac sulfone. In order to assess the effects of sulindac and its metabolites, we used ?in vitro? studies with isolated rat liver mitochondria, to evaluate the aspects of its toxicity in mitochondria; and studies with human hepatoma cell line (HepG2), to evaluate its affects after biotransformation. The present study shows that sulindac sulfide, but not sulindac sulfone or sulindac itself, cause mitochondrial uncoupling, releasing pre-accumulated Ca2+ from the organelle, and decrease Hep-G2 cell viability in an apparent association with cellular ATP depletion resulted from mitochondrial uncoupling-associated membrane potential dissipation. We therefore propose mitochondrial uncoupling by sulindac sulfide as a potential mechanism for the well established toxicity of sulindac, at least to the liver in humans. It was also observed a mitochondrial swelling in energized media that can occur without dependence on the calcium present in the media. This event was partial inhibited by CsA and Mg2+, and completely inhibited with the addition of BHT. It did not show any inhibition with the addition of ADP, ATP, DTT or NEM. These results can not be associated to the classical mitochondrial permeability transition that is dependent to calcium, and the mechanism of inhibition observed with BHT is not known, since it was not observed any production of free radicals in our models, but the swelling observed can also contribute to the toxic effects observed. The sulindac itself and the sulfone metabolite did not show any toxic effect observed for the sulfide form, indicating that just the pharmacological active metabolite is responsible for the toxic effects. The biotransformation (phase I and II reactions) can contribute to sulindac toxicity, because they generate the reduced form. Sulindac is also used in long term treatment, so it is necessary the monitoring of the hepatic function is necessary before and during the treatment, in order to prevent any further complication.

La survenue de lésions hépatiques représente une cause majeure de retrait des médicaments au cours de leur développement et après leur mise sur le marché. La manifestation la plus fréquente des effets secondaires liés aux médicaments est lacholestase qui résulte d’un blocage de la sécrétion biliaire. Ils peuvent être prévisibles, généralement dépendants de la dose, ou dans certains cas n’être observés que chez un nombre restreint de patients traités, par exemple avec la chlorpromazine (CPZ), un neuroleptique. Il s’agit alors d’une hépatotoxicité idiosyncratique. Notre travail a eu pour but d’induire une cholestase avec ce médicament et d’étudier les mécanismes impliqués, en présence ou non d’un stress inflammatoire en utilisant comme modèle expérimental les cellules hépatiques différenciées HepaRG dérivées d’un cholangio-hépatocarcinome humain. Nous avons tout d’abord validé ce modèle en montrant que les principaux transporteurs d’influx et d’efflux canaliculaires et basolatéraux sont bien localizes dans les domaines membranaires appropriés, et que les canalicules biliaires sont fonctionnels et fermés comme dans les hépatocytes humains cultivés en sandwich, le modèle de référence. Le traitement par CPZ à une concentration élevée (50μM) entraine après 15min la génération d’un stress oxydant associé à une altération du potentiel membranaire mitochondrial et de la distribution péricanaliculaire des microfilaments de F-actine et à une inhibition de l’efflux canaliculaire de l’acide taurocholique. Après 24h, on observe notamment une inhibition de l’expression des deux principaux transporteurs canaliculaires, BSEP et MDR3, du transporter d’influx NTCP et une surexpression du transporteur basolatéral MRP4. Ces effets suggèrent une réponse compensatrice des cellules face à l’accumulation intracellulaire des acides biliaires. L’inflammation est considérée comme un facteur de susceptibilité dans l’hépatotoxicité idiosyncratique. Nous avons recherché si dans un context inflammatoire induit par l’IL-6 et l’IL-1β, les effets cytotoxiques et cholestatiques de CPZ sont aggravés. Après un prétraitement de 24h par les deux cytokines proinflammatoires, les cellules HepaRG, ont été co-exposées à 20μM CPZ pendant 1 à 5 jours. Bien que les cytokines aient induit un stress inflammatoire et inhibé le métabolisme de la CPZ et les transcrits de CYP3A4 et CYP1A2, deux principaux CYPs impliqués dans le métabolisme de ce médicament, la modulation des effets cytotoxiques et cholestatiques de la CPZ observés est restée limitée, y compris après 5 jours. Une cytotoxicité accrue de 20% et une amplification de l’inhibition des transcrits et de l’activité de NTCP ainsi que la dérégulation de l’expression d’autres gènes liés à la cholestase, ont été constatées suite au co-traitement à CPZ et aux cytokines. Au total, nos résultats montrent qu’il est possible d’induire une cholestase in vitro à partir des cellules HepaRG et que la cholestase induite par CPZ a pour origine l’induction d’un stress oxydant. Ils montrent en outre que l’étude de certains facteurs de susceptibilité peut être envisagée. / Drug-induced liver injury is the major cause of drug withdrawal during development and marketing process. The most common manifestation of adverse drug reactions is cholestasis, which results from alteration of bile flow. Adverse drug reactions are usually classified either as dose-dependent and reproducible (intrinsic) or unpredictable (idiosyncratic) occurring only in certain susceptible patients as observed with chlorpromazine (CPZ), a neuroleptic drug. Our work aimed to induce cholestasis with this drug and to study the mechanisms involved in the presence or absence of an inflammatory stress using differentiated HepaRG liver cells derived from a human cholangio-hepatocarcinoma as an experimental model. We firstly validated this cell model by demonstrating that the major canalicular and basolateral influx and efflux transporters are localized to the appropriate membrane domains, and that the bile canaliculi are functional and closed as in sandwichcultured human hepatocytes, the reference model. Treatment with CPZ at a high concentration (50μM) induces, as early as 15min, generation of oxidative stress which is associated with altered mitochondrial membrane potential, disruption of the pericanalicular F-actin cytoskeleton distribution and inhibition of canalicular efflux of taurocholic acid. After 24-hour treatment with CPZ, mRNA expression of the two main canalicular bile transporters, BSEP and MDR3, and of the main influx transporter, NTCP, was decreased. By contrast, expression of MRP4 mRNA, a basolateral transporter, was increased. These latter events likely represent hepatoprotective responses which aim to reduce intrahepatic accumulation of toxic BA. Inflammation is considered as a factor of susceptibility to idiosyncratic hepatotoxicity. We investigated whether in an inflammatory stress induced by IL-6 and IL-1β, cytotoxic and cholestatic effects of CPZ are exacerbated. After a 24 hour pre-treatment by either pro-inflammatory cytokines, HepaRG cells were co-exposed to 20μM CPZ for 1 to 5 days. Although cytokines have induced inflammatory stress and inhibited the metabolism of CPZ and transcripts of CYP3A4 and CYP1A2, two main CYPs involved in the metabolism of this drug, the modulation of cytotoxic and cholestatic effects of CPZ was limited, even after 5 daily treatments. Increased cytotoxicity by 20 %, amplification of NTCP mRNA and activity inhibition and deregulation of the expression of other genes associated with cholestasis, were observed in CPZ- and cytokine-co-treated cells. Altogether, our results show that it is possible to induce in vitro cholestasis using HepaRG cells and that CPZ-induced cholestasis depends on the generation of oxidative stress. They also show that the certain susceptibility factors may be investigated.

La maladie d'Alzheimer est la pathologie neurodégénérative la plus courante affectant les personnes âgées. Cette neuropathologie se caractérise par une étiologie complexe dont le déficit en acétylcholine, les plaques amyloïdes, les dégénérescences neurofibrillaires ou le stress oxydant en sont les principaux acteurs.Au cours de cette thèse, nous nous sommes intéressés à l'application des réactions multicomposants de Ugi et de Passerini, pour la synthèse de nouveaux adduits multi-cibles basées sur différents motifs antioxydants et anticholinestérasiques. Ces réactions permettent d'accéder à une vaste diversité chimique en une étape, ce qui les rend adaptées pour la synthèse rapide de molécules ayant plusieurs pharmacophores d'intérêt et ciblant ainsi différentes cause étiologiques de la maladie d'Alzheimer.Au total, 56 composés finaux, répartis dans cinq séries, ont été synthétisés :les alpha-acylaminocarboxamides prototypes (série A)les hybrides tacrine-acide férulique (série B)les hétérotrimères tacrine-mélatonine-acides antioxydant (série C)> les hybrides donépézil-acide férulique (série D)^ les dérivés chromone (série E)Toutes les séries ont été évaluées pour leur capacité à inhiber les enzymes cholinestérases et leur pouvoir antioxydant. L'hépatotoxicité des séries B et C. portant un motif tacrine, a été évaluée sur les cellules HepG2. Par ailleurs, l'étude de la série B a été complétée par d'autres tests pharmacologiques, physico-chimiques et toxicologiques.Ces différents travaux démontrent et valident l'utilisation des réactions de Ugi et de Passerini dans le développement de molécules multi-cibles pour le traitement potentiel de la maladie d'Alzheimer. / Alzheimer's disease (AD) is thé most common type of dementia affecting elderly people. This neuropathology is characterized by a highiy complex and intricated etiology including cholinergic déficit, amyloid deposits, neurofibrillary tangles and oxidative stress.During this thesis, we sought to apply Ugi and Passerini multicomponent reactions for thé synthesis of new multi-target adducts based on différent antioxidant and anticholinergic scaffolds.Thèse réactions provides access to a broad range of chemical diversity in a one-pot fashion, which makes them suitable for thé expeditious synthesis of molécules having several pharmacophores of interest and hitting différent targets related to thé multifaceted etiology of Alzheimer's disease.A total of 56 final compounds, spread over 5 séries, hâve been synthesized:alpha-acylaminocarboxamides prototypes (A séries)tacrine-ferulic acid hybrids (B séries)tacrine-melatonin-antioxydant acids heterotrimers (C séries)donepezil-ferulic acid hybrids (D séries)Chromone derivatives (E séries)Ail thé séries were tested for their ability to inhibit thé cholinesterases enzymes and for their antioxidant power. Hepatotoxicity of thé B and C séries, bearing a tacrine fragment, was evaluated on HepG2 cells. Moreover, thé study of thé B séries was supplemented by further pharmacological, physicochemical and toxicological tests (NMR conformational study, neuroprotection on SH-SY5Y cells. self-induced Abetai.42 peptide aggregation inhibition, docking ADMET).Such work demonstrated and validated thé use of Ugi and Passerini reactions for thé development of new multi-target directed molécules for thé potential treatment of AD.

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