Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Background-Previously we found that smooth muscle cell (SMC)-specific knockout of miR-17 similar to 92 attenuates hypoxia-induced pulmonary hypertension. However, the mechanism underlying miR-17 similar to 92-mediated pulmonary artery SMC (PASMC) proliferation remains unclear. We sought to investigate whether miR-17 similar to 92 regulates hypoxia-inducible factor (HIF) activity and PASMC proliferation via prolyl hydroxylases (PHDs). Methods and Results-We show that hypoxic sm-17 similar to 92(-/-) mice have decreased hematocrit, red blood cell counts, and hemoglobin contents. The sm-17 similar to 92 (-/-) mouse lungs express decreased mRNA levels of HIF targets and increased levels of PHD2. miR-17 similar to 92 inhibitors suppress hypoxia-induced levels of HIF1 alpha, VEGF, Glut1, HK2, and PDK1 but not HIF2 alpha in vitro in PASMC. Overexpression of miR-17 in PASMC represses PHD2 expression, whereas miR-17/20a inhibitors induce PHD2 expression. The 3'-UTR of PHD2 contains a functional miR-17/20a seed sequence. Silencing of PHD2 induces HIF1a and PCNA protein levels, whereas overexpression of PHD2 decreases HIF1 alpha and cell proliferation. SMC-specific knockout of PHD2 enhances hypoxia-induced vascular remodeling and exacerbates established pulmonary hypertension in mice. PHD2 activator R59949 reverses vessel remodeling in existing hypertensive mice. PHDs are dysregulated in PASMC isolated from pulmonary arterial hypertension patients. Conclusions-Our results suggest that PHD2 is a direct target of miR-17/20a and that miR-17 similar to 92 contributes to PASMC proliferation and polycythemia by suppression of PHD2 and induction of HIF1 alpha.

No description available.

Abstract Oxygen is vital for human survival. To ensure its sufficient supply, the body has an intricate system, which involves the circulatory, respiratory and neuroendocrine systems. When oxygen is lacking, a state of hypoxia occurs, and adaptive changes in gene expression increase oxygen delivery to promote survival. The key regulator of the transcriptional hypoxia response is hypoxia-inducible factor (HIF) which targets over 1000 genes. The HIF prolyl 4-hydroxylases (HIF-P4Hs) govern the stability of HIF in an oxygen-dependent fashion. In our studies we investigated whether activation of the hypoxia response through inhibition of either of two distinct HIF-P4Hs, HIF-P4H-2 or P4H-TM would reduce atherosclerosis in mice. We found that inhibition of HIF-P4H-2 led to reductions in numbers of atherosclerotic plaques, and levels of serum cholesterol and inflammation in white adipose tissue and aortic plaques. In addition, HIF-P4H-2 deficient mice had elevated levels of modified LDL-targeting, atheroprotective circulating autoantibodies. The P4H-TM knockout mice also had reduced numbers of atherosclerotic plaques and increased levels of atheroprotective autoantibodies in their sera, but in contrast to the HIF-P4H-2 deficient mice, they also showed a reduction in serum triglyceride levels. To determine how hypoxia alters maternal glucose and lipid metabolism in pregnancy, we studied pregnant mice that were predisposed to a hypoxic condition (15% ambient O2). We found that they had enhanced glucose metabolism due to reduced insulin resistance and an increased flux of glucose to maternal tissues. The hypoxic dams also failed to gain weight and store adipose tissue in the anabolic phase to the same extent as normoxic control dams. These results implicate HIF-P4H inhibition as a novel therapeutic mechanism for atherosclerosis, and suggest that the small molecule HIF-P4H inhibitors currently in clinical trials for renal anemia may have further possible therapeutic applications. In addition, greater understanding of the changes in maternal metabolism that underly reduced fetal growth in hypoxic conditions, and the development of targeted interventions may allow the preservation of fetal growth in cases of maternal hypoxia. / Tiivistelmä Happi on ihmiselle elintärkeää. Tämän vuoksi meille on kehittynyt pitkälle jalostunut verenkierto-, hengitys- ja neuroendokriininen järjestelmä sekä sellaisten geenien ilmentymisen muutoksia, jotka joko lisäävät hapen kuljetusta tai auttavat selviytymään hypoksisissa oloissa, jotta taataan riittävä hapen saanti. Hapen puutteessa hypoksiavaste, jonka tärkein säätelijä on hypoksiassa indusoituva transkriptiotekijä (HIF), aktivoituu. HIF:lla on yli 1000 kohdegeeniä joiden kautta sen vaikutukset välittyvät. HIF-prolyyli-4-hydroksylaasit (HIF-P4H:t) säätelevät HIF:n stabiilisuutta hapesta riippuvaisesti. Tutkimuksessamme selvitimme, vähentääkö hypoksiavasteen aktivointi HIF-P4H-2:n tai P4H-TM:n inhibition kautta ateroskleroosia hiirillä. Tuloksena oli, että HIF-P4H-2:n inhibitio vähensi ateroskleroottisia plakkeja, seerumin kolesterolia ja inflammaatiota valkoisessa rasvakudoksessa sekä plakeissa. Lisäksi hiirillä, joilta puuttui HIF-P4H-2, oli lisääntynyt määrä ateroskleroosilta suojaavia muokattua LDL:ää sitovia autovasta-aineita seerumissa. P4H-TM-poistogeenisillä hiirillä todettiin vastaavasti vähemmän ateroskleroottisia plakkeja ja lisääntynyt määrä ateroskleroosilta suojaavia autovasta-aineita seerumissa. Poiketen HIF-P4H-2-puutteisista hiiristä, niillä oli matalammat seerumin triglyseridi-tasot. Tutkimme raskaina olevia hiiriä, jotka altistimme hypoksisille olosuhteille (15% O2), jotta pystyisimme määrittämään, kuinka hypoksia vaikuttaa äidin sokeri- ja rasva-aineenvaihduntaan. Hypoksiassa raskaana olevilla hiirillä todettiin tehostunut sokeriaineenvaihdunta, joka oli seurausta alentuneesta insuliiniresistenssistä sekä lisääntyneestä sokerin sisäänotosta äidin kudoksiin. Hypoksiassa eivät raskaana olevien hiirten paino eivätkä rasvavarastot lisääntyneet samassa suhteessa normoksiassa raskaana olevien hiirten kanssa. Nämä tulokset tarjoavat uusia mahdollisuuksia HIF-P4H-inhibition käyttämiseen terapeuttisena vaihtoehtona ateroskleroosin hoidossa ja ehkäisemisessä. Kliinisissä kokeissa munuaisperäisen anemian hoidossa olevat HIF-P4H-estäjät voisivat näin ollen saada lisää indikaatioita. Lisäksi korkean ilmanalan aiheuttaman pienipainoisuuden takana olevien aineenvaihdunnan muutoksien ymmärtäminen voi mahdollistaa sikiön kasvun turvaamisen spesifein interventioin.

O núcleo motor do trigêmeo (Mo5) está cercado por um anel de neurônios pré-motores localizados na região h. Estudos demonstram que neurônios que inervam o Mo5 estão distribuídos no tronco encefálico e no prosencéfalo. Após implante de traçador retrógrado no Mo5, verificamos células retrogradamente marcadas no núcleo mesencefálico do trigêmeo (Me5), na região h e em núcleos prosencefálicos como o central da amígdala (CeA), a área hipotalâmica lateral (LH) e o parasubtalâmico (PSTh). Para confirmação, realizamos injeção de traçador anterógrado e investigamos, também, a neuroquímica das projeções. Neurônios do CeA que se projetam para o Mo5 recebem inervação de fibras imunorreativas ao fator liberador de corticotrofina (CFR-ir) e/ou à tirosina hidroxilase (TH-ir); alguns neurônios da LH que se projetam para o Mo5 são imunorreativos à orexina (ORX) e alguns neurônios do PSTh que se projetam para o Mo5 são innervados por fibras TH-ir. O Me5 recebe grande inervação do CeA e moderada da LH e do PSTh, possuindo grande aferência de fibras imunorreativas ao CRF, ORX e TH / The trigeminal motor nucleus (Mo5) is surrounded by a ring of premotor neurons defined as the h region. Studies have shown that neurons innervating the Mo5 are located in brainstem and in forebrain nuclei. Through the injection of the retrograde tracer cholera toxin b subunit/CTb in the Mo5, we found retrograde labeled neurons in the brainstem including the h region and the mesencephalic trigeminal nucleus (Me5), and in forebrain nuclei such as the central nucleus of amygdala (CeA), the lateral hypothalamic area (LH) and the parasubthalamic nucleus (PSTh). As control, we injected the anterograde tracer biotin dextran amine and found that these areas project direct or indirectly via the h region or the Me5 to the Mo5. Some CeA neurons that project to the Mo5 receive corticotrophin releasing factor (CRF) and tyrosine hydroxylase (TH) innervation, some LH neurons that project to Mo5 express orexin, and PSTh neurons that project to the Mo5 receive TH innervation. The Me5 is also innervated by CeA, LH and PSTh neurons and by CRF, orexin and TH immunoreactive fibers

Die Tryptophanhydroxylase (TPH) katalysiert den geschwindigkeitsbestimmenden Schritt der Synthese des wichtigen Neurotransmitters Serotonin. Kürzlich wurde ein zweites TPH-Isozym, die TPH2, entdeckt. Es stellte sich heraus, dass dieses Isozym für die Serotoninsynthese im Zentralnervensystem verantwortlich ist, wohingegen die TPH1 lediglich der Ausgangspunkt der Serotoninsynthese in den peripheren Geweben ist. Da Störungen im Serotoninstoffwechsel mit einer Vielzahl von psychiatrischen Erkrankungen in Verbindung gebracht werden, rückt nun die als neuronales Enzym identifizierte TPH2 in den Fokus der Forschung. In dieser Arbeit konnte gezeigt werden, dass TPH1 und 2 sich nicht nur in ihren Expressionsorten sondern auch in ihren grundlegenden biochemischen Eigenschaften voneinander unterscheiden. Die TPH1 stellte sich als aktiveres der beiden Enzyme heraus. Der N- und C-Terminus der TPH2 konnten als auf die Aktivität des Enzyms inhibierend bzw. aktivierend wirkende Strukturen identifiziert werden und stellen damit interessante Angriffspunkte für die pharmakologische Beeinflussung dar, wobei der N-Terminus als TPH2-spezifische Struktur eine gezielte Beeinflussung des serotonergen Systems im Zentralnervensystem ohne Auswirkungen auf das periphere System ermöglichen würde. In weiteren Projekten konnte die Existenz von mindestens zwei, die Enzymaktivität nicht beeinflussenden Proteinkinase A-Phosphorylierungsstellen in der TPH2 nachgewiesen werden, es konnte ein auf einem fluorometrischen Prinzip basierender High-Throughput-Assay zur Bestimmung der TPH-Aktivität entwickelt werden, Tubulin beta2A wurde als Interaktionpartner der TPH2 identifiziert, die Auswirkungen eines in vitro aktivitätssenkenden Tph2-SNPs auf die Serotoninlevel und das Verhalten verschiedener Mausstämme konnte durch die Generierung und Untersuchung von congenen Mäusen als unbedeutend eingestuft werden und die Expression von TPH1-mRNA wurde als Marker für endometriale Karzinome identifiziert. / Tryptophan hydroxylase (TPH) catalyzes the rate limiting step of the synthesis of the important neurotransmitter serotonin. Recently a new TPH isoenzyme, TPH2, was discovered. It turned out that this isoenzyme is responsible for the serotonin synthesis within the central nervous system, whereas the TPH1 is merely the starting point of serotonin synthesis in peripheral tissues. Since dysfunction in the metabolism of serotonin is related to a large number of psychiatric diseases, the neuronal TPH2 moved into the centre of interest. As a basis for the pharmacological manipulation of the central nervous serotonergic system, without influencing the periphery, the identification of differences between the two isoenzymes is essential. In this thesis it was shown that TPH1 and 2 not only differ in their expression sites but also in their basic biochemical characteristics. TPH1 turned out to be the more active enzyme. Furthermore it was shown that the N- and C-termini of TPH2 have an inhibitory respectively activating influence on the enzymatic activity. Therefore they became interesting targets for pharmacological interference, whereas the N-terminus as a TPH2 specific structure would facilitate the manipulation of the central nervous serotonergic system without exerting influence on the peripheral system. In further projects the existence of at least two protein kinase A phosphorylation sites could be verified, whereas the phosphorylation doesn’t seem to have any influence on the enzymatic activity, a high throughput assay for determination of TPH activity, based on a fluorometric principle, was developed, Tubulin beta2A was identified as a TPH2 interaction partner, the effect of a SNP in the Tph2 gene that decreases the TPH2 activity in vitro on the serotonin level and the behaviour of different mouse strains could be rated as insignificant by the generation of congenic mice und the expression of TPH1 mRNA was identified as a marker for endometrial cancer.

No description available.

Stickstoffmonoxid (NO) spielt eine bedeutende Rolle in der Regulation des Blutdruckes, es ist ein starker Vasodilatator. Mäuse mit genetisch inaktivierter endothelialer Stickstoffmonoxidsynthase (eNOS-/-) haben einen Bluthochdruck. Mäuse mit fehlender neuronaler NO-Produktion (nNOS-/-) zeigen einen erniedrigten Blutdruck in Narkose. Im Gegensatz dazu konnte in der Literatur eine Hemmung der Katecholaminfreisetzung durch neuronal gebildetes NO gezeigt werden. Es war deshalb das Ziel dieser Studie, die Kreislaufparameter von eNOS-/- und nNOS-/- Mäusen im wachen Zustand in Ruhe und unter Stress zu untersuchen. Außerdem wurde untersucht, ob nNOS die Expression des Schlüsselenzyms der Katecholaminsynthese, Tyrosinhydroxylase (TH), hemmt und die hämodynamische Antwort auf Stress abschwächt. Acht nNOS-/-, neun eNOS-/- und neun Wildtypkontrollmäuse (WT) erhielten einen Femoralarterienkatheter. Blutdruck und Herzfrequenz sowie die Körperkerntemperatur wurden 24h nach der Operation unter wachen Bedingungen in Ruhe und bei Erhöhung der Umgebungstemperatur aufgezeichnet. Die Tyrosinhydroxylase-mRNA-Expression und -Proteingehalt der Nebennieren wurden mittles RT-PCR und Western Blot bestimmt. In Ruhe zeigten eNOS-/- und nNOS-/- Mäuse einen signifikant erhöhten mittleren und diastolischen Blutdruck im Vergleich zu Wildtypkontrollen. Während des Hitzestresses war der initiale Blutdruckabfall bei den eNOS-/- Mäusen signifikant vermindert. Der stressinduzierte Anstieg von Blutdruck und Herzfrequenz war deutlich verstärkt bei nNOS-/- Mäusen im Vergleich zu WT und eNOS-/- Mäusen. Die TH-mRNA-Expression war zehnfach erhöht bei nNOS-/- Mäusen im Vergleich zu WT. Auch der Proteingehalt der Nebennieren war dreifach erhöht in nNOS-/- im Vergleich zu WT. Diese Ergebnisse zeigen, dass endothelial gebildetes NO hauptsächlich an der thermoregulatorischen Vasodilatation der Hautgefäße beteiligt ist. Weiterhin konnte gezeigt werden, dass neuronal gebildetes NO die TH-Expression hemmt und die sympathisch vermittelte Stressantwort vermindert. / Nitric oxide (NO) plays an important role in the circulatory regulation, it is a very potent vasodilator. Mice deficient of a functional endothelial NO synthase (eNOS-/-) exhibit hypertension. Mice lacking a functional neuronal NO production (nNOS-/-) were observed to be hypotensive under anaesthesia. In contrast, evidence from the literature suggests an inhibition of catecholamine release by NO derived from nNOS. Therefore it was the aim of this thesis to evaluate the circulatory parameters in eNOS-/- and nNOS-/- under conscious conditions at rest and in reponse to stress. Additionally, it was tested if nNOS inhibits the expression of the key enzyme of the catecholamine synthesis, tyrosine hydroxylase, and thereby reduces the hemodynamic responses to stressful stimuli. Eight nNOS-/-, nine eNOS-/-, and nine wild type controls (WT) were chronically instrumented with femoral artery catheters. 24h after surgery,resting blood pressure and heart rate were measured and then mice were exposed to an elevated ambient temperature. Arterial blood pressure together with heart rate and core temperature were recorded in conscious animals. Tyrosine hydroxylase mRNA expression and protein content in the adrenal gland were measured by RT-PCR and western blotting, respectively. At rest, eNOS-/- and nNOS-/- exhibited a significantly elevated mean and diastolic blood pressure compared to WT. During heat stress, the initial decrease in blood pressure seen in WT and nNOS-/- was significantly blunted in eNOS-/-. The stress-induced acceleration of heart rate and increase in blood pressure were much stronger in nNOS-/- compared to WT and eNOS-/- . TH mRNA expression was ten times larger in nNOS-/- than in WT. Correspondingly, protein content in the adrenal gland was increased threefold in nNOS-/- compared to WT. The results of this thesis indicate that endothelial derived NO predominantly mediates the thermoregulatory vasodilatation. Furthermore, it shows that neuronally derived NO inhibits TH expression and, therefore, limits the sympathetically-mediated responses to stressful stimuli, such as heat stress.

No description available.

A hiperplasia adrenal congênita (HAC), mais comumente causada por deficiência da 21-hidroxilase (21OH), apresenta um espectro de manifestações clínicas, que varia desde virilização da genitália externa de fetos femininos com perda de sal neonatal até manifestações hiperandrogênicas que se iniciam tardiamente. A forma clássica, de maior gravidade, é subdividida em perdedora de sal (PS) e virilizante simples (VS). A doença é elegível para inclusão em programas de triagem neonatal, e o principal problema enfrentado é a taxa elevada de resultados falso-positivos (FP), de até 1%. Cerca de 50-70% destes são atribuídos ao estresse neonatal por doença, à prematuridade e ao baixo peso ao nascimento (PN). Em 7-17% dos FP, a dosagem da 17OHP no teste confirmatório pelo método de radioimunoensaio (RIE) no soro, um dos mais utilizados em nosso país, permanece alterada. A adição da dosagem de outros esteroides como o 21-deoxicorisol (21-DF) e, sobretudo, a utilização de metodologia mais específica, como a cromatografia líquida com detecção por espectrometria de massas (CL-MS/MS), pode aumentar o valor preditivo positivo (VPP). O estudo molecular do gene CYP21A2 também pode ser útil na confirmação diagnóstica, porém com maior custo e complexidade. No final de 2013, a triagem da HAC-21OH foi incluída no Programa Nacional de Triagem Neonatal (PNTN). A eficácia de dosagens hormonais no soro por diferentes metodologias como teste confirmatório não tem sido estudada na literatura. Objetivos: determinar o esteroide adrenal cuja dosagem oferece maior especificidade como teste confirmatório na triagem neonatal da HAC. Determinar os valores de referência da 17OHP e do 21-DF na população brasileira por CL-MS/MS. Casuística: 708.437 recém-nascidos (RN) submetidos à triagem no laboratório da APAE-São Paulo de janeiro de 2014 a dezembro de 2015. Métodos: os RNs que apresentaram 17OHP neonatal acima do valor de referência para o P99,5 para o PN foram convocados para dosagem dos esteroides no soro (RIE e CL-MS/MS). Os RNs com resultados 17OHP >= 10 ng/ml (CL-MS/MS) no soro foram convocados para estudo molecular do CYP21A2. Resultados: O VPP do teste de triagem no papel de filtro (P99,5) foi 3% e a taxa de FP de 0,037%; 65/252 (25%) resultados permaneceram alterados na dosagem 17OHP/RIE (VPP 30%) e 32/289 (11%) continuaram alterados após o teste confirmatório 17OHP/CL-MS/MS (VPP 49%); 58 casos de HAC clássica foram diagnosticados (47PS; 11VS), 57 pela triagem e 1 falso-negativo (forma VS), resultando em incidência de 1:12.200. Outros 32 casos assintomáticos e com 17OHP/CL-MS/MS elevada (indeterminados) foram acompanhados até normalização ou confirmação diagnóstica da forma não clássica da HAC pelo genótipo do CYP21A2. A relação (17OHP+delta4)/cortisol foi a que apresentou maior área sob a curva ROC, e o ponto de corte >= 9,7 detectou todos os portadores de forma clássica (S=100%). Valores entre 9,7 e 24,8 compreenderam pacientes com a forma VS, forma não clássica (NC) e não afetados e o ponto de corte >= 24,9 apresentou VPP de 100% (E=100%) para as formas clássicas da HAC. Em 10 casos com resultados indeterminados da 17OHP, o estudo molecular permitiu a alta do seguimento neonatal (4 portadores da forma NC; 4 sem mutações identificadas e 2 heterozigotos). Conclusão: A dosagem no soro da 17OHP por CL-MS/MS foi superior à dosagem por RIE. A aplicação dos pontos de corte obtidos pela curva ROC dos diferentes testes confirmatórios no soro permitiria a resolução de 30/32 indeterminados, sendo que a relação (17OHP+delta4)/cortisol foi especialmente útil nestes casos. O estudo molecular foi importante, sobretudo, para elucidação dos casos indeterminados / Congenital adrenal hyperplasia (CAH) is most commonly caused by 21- hydroxylase deficiency and clinical presentation depends on the degree of enzyme activity impairment, varying from virilization of external genitalia in females and neonatal salt loss and hyperandrogenic signs in both genders. The classical form is subdivided in salt-wasting (SW) and simple virilizing (SV). The disease is suitable for neonatal screening programs. The high false-positive (FP) result rate, up to 1%, is the main issue, in most cases attributed to either prematurity or neonatal stress caused by coexistence of stress conditions. In serum confirmatory tests, 17-hydroxy-progesterone (17OHP) levels by radioimmunoassay (RIA), one of the main methodologies performed in our country, remains elevated in 7-17% of cases. The addition of other steroids, such as 21-deoxycortisol (21-DF), and the use of a more specific methodology, liquid chromatography followed by tandem mass spectrometry (LC-MS/MS), increase de positive predictive value (PPV) of confirmatory tests. The CYP21A2 genotyping is also useful in diagnosing CAH, although its higher cost and complexity are potential limitations. Objectives: to determine the adrenal steroid with higher specificity to confirm CAH diagnosis in the newborn screening. To determine the reference values of serum 17OHP and 21-DF by LC-MS/MS in the Brazilian population in neonatal period. Patients: 708,437 newborns (NBs) screened in Laboratório da APAE SÃO PAULO between January 2014 and December 2015. Methods: NBs with neonatal 17OHP (N17OHP) on filter paper above the 99.5th percentile were recalled to serum sample collection and steroids dosage by RIA and LC-MS/MS; Molecular CYP21A2 analysis was offered to those with 17OHP >= 10 ng/ml (LC-MS/MS). Results: FP rate on filter paper was 0.037% and these NBs were recalled for serum tests: 65/252 (25%) results of 17OHP by RIA and 32/289 (11%) of 17OHP by LC-MS/MS remained altered. PPV of RIA and LC-MS/MS were 30% and 49%, respectively. Fifty-eight CAH classical cases were diagnosed (47SW;11SV) and other 32 asymptomatic NBs presented increased serum 17OHP by LC-MS/MS and were followed until diagnostic elucidation. In the ROC curves analyses between false and true-positives, 17OHP/LC-MS/MS had the highest accuracy as a single steroid measurement, for which the 48.3 ng/ml cutoff had 100% sensitivity for classical forms. Serum 21DF was not superior than 17OHP/LC-MS/MS. The product of (17OHP+delta4)/cortisol ratio presented the highest accuracy: the cutoff of 24.9 had a PPV of 100% to detect saltwasting form, while values between 9.7-24.8 comprised FP, NC and SV patients and molecular tests could be useful for differential diagnosis in this latter group. Conclusions: Serum 17OHP by LC-MS/MS was superior than 17OHP by RIA. The efficacy of confirmatory tests was improved using 17OHP by LC-MS/MS and, for the asymptomatic NBs with undetermined results, the (17OHP+delta4)/cortisol ratio presented the highest diagnostic efficacy. The CYP21A2 genotyping was particularly useful in asymptomatic NBs with persistently increased serum 17OHP