In this study, we have used genetic, cell biological and transcriptomic methods in the nematode C. elegans as a model to examine the impact of glucose supplementation during development. We show that a glucose-supplemented diet slows the rate of developmental progression (termed "glucose-induced developmental delay" or GIDD) and induces the mitochondrial unfolded protein response (UPRmt) in wild-type animals. Mutation in the insulin receptor daf-2 confers resistance to GIDD and UPRmt in a daf-16-dependent manner. We hypothesized that daf-2(e1370) animals alter their metabolism to manage excess glucose. To test this, we used RNA-sequencing which revealed that the transcriptomic profiles of glucose-supplemented wildtype and daf-2(e1370) animals are distinct. From this, we identified a set of 27 genes which are both exclusively upregulated in daf-2(e1370) animals fed a glucose-supplemented diet and regulated by daf-16, including a fatty acid desaturase (fat-5), and two insulin-like peptides (ins-16 and ins-35). Mutation of any of these genes suppresses the resistance of daf-2(e1370) to GIDD. Additionally, double mutation of ins-16 and ins-35 in a daf-2(e1370) background results in an increase in constitutive dauer formation which is suppressed by glucose supplementation. Further investigation of the insulin-like peptides revealed that ins-16 mutation in a wild-type background results in upregulation of ins-35 and DAF-16 nuclear translocation regardless of diet; however, unlike daf-2(e1370), this translocation is not associated with resistance to GIDD. Taken together, these data suggest that glucose-supplemented daf-2(e1370) animals maintain developmental trajectory in part through upregulation of specific insulin-like peptide genes and fatty acid desaturation and contribute to a deeper understanding of the mechanisms underlying the resistance of daf-2(e1370) animals to GIDD. We also showed another fascinating aspect of GIDD: it becomes more pronounced in subsequent generations exposed to a glucose-supplemented diet, suggesting that the parental glucose diet has an impact on the developmental progression of their offspring.

Yes / The DNA Damage Response (DDR) pathways sense DNA damage and coordinate robust DNA repair and bypass mechanisms. A series of repair proteins are recruited depending on the type of breaks and lesions to ensure overall survival. An increase in glucose levels was shown to induce genome instability, yet the links between DDR and glucose are still not well investigated. In this study, we aimed to identify dysregulation in the transcriptome of normal and cancerous breast cell lines upon changing glucose levels. We first performed bioinformatics analysis using a microarray dataset containing the triple-negative breast cancer (TNBC) MDA-MB-231 and the normal human mammary epithelium MCF10A cell lines grown in high glucose (HG) or in the presence of the glycolysis inhibitor 2-deoxyglucose (2DG). Interestingly, multiple DDR genes were significantly upregulated in both cell lines grown in HG. In the wet lab, we remarkably found that HG results in severe DNA damage to TNBC cells as observed using the comet assay. In addition, several DDR genes were confirmed to be upregulated using qPCR analysis in the same cell line. Our results propose a strong need for DDR pathways in the presence of HG to oppose the severe DNA damage induced in cells. / Wellcome Trust

Thesis (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Background - Although acute hyperglycemic episodes are linked to lower glucose uptake, underlying mechanisms driving this process remain unclear. We hypothesized that acute hyperglycemia triggers reactive oxygen species (ROS) production and increases non-oxidative glucose pathway (NOGP) activation, i.e. stimulation of advanced glycation end products (AGE), polyol pathway (PP), hexosamine biosynthetic pathway (HBP) and protein kinase C (PKC) activation. These mechanisms attenuate cellular function, and may indeed decrease insulin-mediated cardiac glucose uptake. The role of the pentose phosphate pathway (PPP) under high glucose/diabetic conditions is a subject of contention. Activation of the PPP enzyme transketolase (TK) (by benfotiamine/BFT or thiamine) reduces flux via the other four NOGPs, and is associated with beneficial outcomes. Our aim was therefore to evaluate the effects of acute hyperglycemia on insulin-mediated glucose uptake in a cardiac-derived cell line. Specifically, we aimed to elucidate the role of ROS and NOGP induction under these conditions. Methodology - H9c2 cardiomyoblasts were exposed to 25 mM glucose for 24 hr vs. 5.5 mM glucose controls ± modulating agents during last hour of glucose exposure: a) antioxidant #1 for mitochondrial ROS (250 μM 4-OHCA), b) antioxidant #2 for NADPH oxidase-generated ROS (100 μM DPI), c) NOGP inhibitors – 100 μM aminoguanidine (AGE), 5 μM chelerythrine (PKC); 40 μM DON (HBP); and 10 μM zopolrestat (PP). We also employed BFT (50 and 100 μM) in vitro, while the effects of in vivo thiamine administration were assessed in hearts of an obese/diabetic rat model of pre-diabetes and diabetes, the OLETF strain. We evaluated insulin sensitivity by glucose uptake assay (flow cytometry), GLUT4 translocation (transfection of HA-GLUT4-GFP construct) and protein kinase B (Akt) activity assay. ROS levels (mitochondrial, intracellular) were measured by flow cytometry analysis of specific fluorescent probes. Markers of each NOGP were also assessed. Results - Acute hyperglycemia elevated ROS, activated NOGPs and blunted glucose uptake. However, TK activity (marker of PPP) did not change. Respective 4-OHCA and DPI treatment blunted ROS production, diminished NOGP activation and normalized glucose uptake. NOGP inhibitory studies identified PKCβII as a key downstream player in lowering insulin-mediated glucose uptake. When we employed BFT (known to shunt flux away from NOGPs and into the PPP), it decreased ROS generation and NOGP activation, and restored glucose uptake under acute hyperglycemic conditions. In vivo thiamine administration reduced markers of the other NOGP, while it attenuated (mainly in the pre-diabetic phase) the metabolic dysfunction observed in the OLETF rats. Conclusions - This study demonstrates that acute hyperglycemia elicits a series of maladaptive events that function in tandem to reduce glucose uptake, and that antioxidant treatment and/or attenuation of NOGP activation (PKC, polyol pathway) may limit the onset of insulin resistance. / AFRIKAANSE OPSOMMING: Agtergrond – Alhoewel akute hiperglisemie voorvalle gekoppel is aan verlaagde glukose opname, is die onderliggende meganismes wat die proses dryf steeds onduidelik. Ons hipotetiseer dat akute hiperglisemie aanleiding gee tot die produksie van reaktiewe suurstofspesies (RSS) en toename in nie-oksidatiewe glukose weg (NOGW) aktivering, i.e. stimulering van gevorderde glukasie eindprodukte (GGE), poliolweg (PW), heksosamien biosintetiese weg (HBW) en proteïenkinase C (PKC) aktivering. Hierdie meganismes verminder sellulêre funksie, en mag inderdaad insulien-bemiddelde kardiêre glukose opname verlaag. Die rol van die pentosefosfaatweg (PFW) onder hoë glukose/diabetiese kondisies is ‘n onderwerp van stryd. Aktivering van die PFW ensiem transketolase (TK) (deur benfotiamien/BFT of tiamien) verminder fluks deur die ander vier NOGWë, en is geassosieer met voordelige uitkomste. Ons doel was dus om die effekte van akute hiperglisemie op insulien-bemiddelde glukose opname te evalueer in ‘n kardiaal-afkomstige sellyn. Meer bepaald het ons gepoog om die rol van RSS en NOGW induksie onder hierdie kondisies te verstaan. Metode – H9c2 kardiomioblaste is aan 25 mM glukose vir 24 h blootgestel vs. 5.5 mM glukose kontroles ± moduleeragente tydens die laaste uur van glukose blootstelling: a) anti-oksidant #1 vir mitochondriese RSS (250 μM 4-OHCA), b) anti-oksidant #2 vir NADPH oksidase-gegenereerde RSS (100 μM DPI), c) NOGW inhibeerders – 100 μM aminoguanidien (GGE), 5 μM cheleritrien (PKC); 40 μM DON (HBW); en 10 μM zopolrestaat (PW). Ons het ook BFT (50 en 100 μM) in vitro aangewend, terwyl die effek van in vivo tiamien aanwending geassesseer is in die harte van ‘n vetsugtige/diabetiese rotmodel van pre-diabetes en diabetes, die OLETF lyn. Ons het insuliensensitiwiteit deur ‘n glukose opname toets (vloeisitometrie), GLUT4 translokasie (transfeksie van HA-GLUT4-GFP konstruk) en proteïenkinase B (Akt) aktiwiteitstoets, geëvalueer. RSS vlakke (mitochondries, intrasellulêr) is gemeet deur vloeisitometriese analise van spesifieke fluoresserende peilers. Merkers van elke NOGW is ook geassesseer. Resultate - Akute hiperglisemie het RSS verhoog, NOGWë geaktiveer en glukose opname versag. TK aktiwiteit (merker van PFW) het egter nie verander nie. Onderskeidelike 4-OHCA en DPI behandeling het RSS produksie versag, NOGW aktivering verminder en glukose opname genormaliseer. NOGW onderdrukking studies het PKCβII geïdentifiseer as ‘n sleutel deelnemer in verlaging van insulien-bemiddelde glukose opname. Die aanwending van BFT (bekend vir die wegvoer van fluks vanaf NOGWë na die PFW), het RSS skepping en NOGW aktivering verlaag, en glukose opname herwin onder akute hiperglisemiese kondisies. In vivo tiamien toediening het merkers van die ander NOGW verlaag, terwyl dit die metaboliese disfunksie waargeneem in die OLETF rotte (hoofsaaklik in die pre-diabetiese fase) verminder het. Gevolgtrekking – Hierdie studie demonstreer dat akute hiperglisemie ‘n reeks van wanaangepaste voorvalle ontlok wat gesamentlik funksioneer om glukose opname te verlaag, en dat anti-oksidant behandeling en/of vermindering van NOGW aktivering (PKC, poliolweg), die aanvang van insulien weerstand mag beperk.

Thesis (PhD (Physiological Sciences))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: OBJECTIVE – Oxidative stress increases flux through the hexosamine biosynthetic pathway (HBP) resulting in greater O-GlcNAcylation of target proteins. Since increased oxidative stress and HBP flux are associated with insulin resistance, we hypothesized that its activation leads to greater O-GlcNAcylation of BAD (pro-apoptotic) and increased myocardial apoptosis. RESEARCH DESIGN AND METHODS – To investigate our hypothesis, we employed two experimental models: 1) H9c2 cardiomyoblasts exposed to high glucose (33 mM glucose) ± HBP modulators ± antioxidant treatment vs. matched controls (5.5 mM glucose); and 2) a rat model of high fat diet-induced insulin resistance and hyperglycemia. We evaluated apoptosis in vitro by Hoechst nuclear staining, Annexin-V staining, caspase activity measurements and immunoblotting while in vivo apoptosis was assessed by immunoblotting. In vitro reactive oxygen species (ROS) levels were quantified by H2DCFDA staining (fluorescence microscopy, flow cytometry). We determined overall and BAD O-GlcNAcylation, both by immunoblotting and immunofluorescence microscopy. As BAD-Bcl-2 dimer formation enhances apoptosis, we performed immunoprecipitation analysis and immunofluorescence microscopy (co-localization) to determine BAD-cl-2 dimerization. In vivo overall O-GlcNAcylation, BAD O-GlcNAcylation and BAD-Bcl-2 dimerization was determined by immunoprecipitation and immunoblotting. 4 RESULTS – High glucose treatment of cells significantly increased the degree of apoptosis as revealed by Hoechst nuclear staining (54 ± 9%, p<0.01 vs. 5.5 mM), Annexin-V staining (43 ± 5%), caspase activity assay (26 ± 2%) and immunoblotting. In parallel, overall OGlcNAcylation (p<0.001 vs. 5.5 mM), BAD O-GlcNAcylation (p<0.05 vs. 5.5 mM) and ROS levels were increased (fluorescence microscopy – p<0.05 vs. 5.5 mM; flow cytometry – p<0.001 vs. 5.5 mM). HBP inhibition using DON and antioxidant treatment (α-OHCA) attenuated these effects while HBP activation by PUGNAc exacerbated it. Likewise, insulin resistant rat hearts exhibited significantly higher caspase-3 (p<0.05 vs. controls), overall O-GlcNAcylation (p<0.05 vs. controls) and BAD O-GlcNAcylation levels (p<0.05 vs. 5.5 mM). BAD-Bcl-2 dimer formation was increased in cells exposed to hyperglycemia [immunoprecipitation analysis and co-localization] and in insulin resistant hearts. CONCLUSIONS - Our study identified a novel pathway whereby hyperglycemia results in greater oxidative stress, resulting in increased HBP activation and increased BAD OGlcNAcylation. We also found greater BAD-Bcl-2 dimerization increasing myocardial apoptosis, suggesting that this pathway may play a crucial role in the onset of the diabetic cardiomyopathy. / AFRIKAANSE OPSOMMING: DOELWIT – Oksidatiewe stres verhoog fluks deur die heksosamien biosintetiese weg (HBW) wat in „n groter O-GlcNAsetilering van teiken proteïene resulteer. Weens die feit dat verhoogde oksidatiewe stres en HBW fluks verband hou met insulienweerstandigheid, hipotetiseer ons dat die aktivering hiervan tot groter O-GlcNAsetilering van BAD (pro-aptoptoties) en verhoogde miokardiale apoptose lei. NAVORSINGS ONTWERP EN METODES – Om die hipotese te ondersoek het ons twee modelle ontplooi: 1) H9c2 kardiomioblaste is blootgestel aan hoë glukose konsentrasie (33mM glucose) ± HBW moduleerders ± antioksidant behandeling vs. gepaarde kontrole (5.5mM glucose); en 2) „n hoë vet dieetgeïnduseerde insulienweerstandige rotmodel en hiperglukemie. Ons het apoptose in vitro deur middel van Hoescht nukleuskleuring geëvalueer, kasapase aktiwiteit bepalings en immunoblotting terwyl apoptose in vivo getoets is deur immunoblotting. Reaktiewe suurstofspesie (RSS) vlakke is deur middel van H2DCFDA verkleuring (fluoresensie mikroskopie, vloeisitometrie) bepaal. Algehele en BAD O-GlcNAsetilering is beide deur immunoblotting en immunofluoresensie mikroskopie bepaal. BAD-Bcl-2 dimeervorming bevorder apoptose, om BAD-cl-2 dimerisasie te bepaal is daar van immunopresipitering analise en immunofluoresensie mikroskopie (ko-lokalisasie) gebruik gemaak. In vivo is algehele OGlcNAsetiliering, BAD O-GlcNAsetiliering en BAD-Bcl-2 dimerisasie deur immunopresipitasie en immunoblotting bepaal. 6 RESULTE – Hoë glukose behandeling van selle het die graad van apotpose betekenisvol verhoog soos blootgelê deur Hoechst nukleuskleuring (54 ± 9%, p<0.01 vs. 5.5 mM), Annexin-V kleuring (43 ± 5%), kaspase aktiviteit assay (26 ± 2%) en immunoblotting. In parallel, algehele OGlcNAsetilering (p<0.001 vs. 5.5 mM), BAD O-GlcNAsetilering (p<0.05 vs. 5.5 mM) en RSS vlakke is verhoog (fluoresensie mikroskopie– p<0.05 vs. 5.5 mM; vloeisitometrie– p<0.001 vs. 5.5 mM). HBW inhibering deur van DON en van antioksidant behandeling gebruik te maak (α- OHCA) het hierdie effekte verlaag terwyl HBW aktivering deur PUGNAc dit verhoog het. Netso, het insulienweerstandige rotharte betekenisvolle hoë kaspase -3 (p<0.05 vs. kontrole), algeheel O-GlcNAsetilering (p<0.05 vs. kontrole) en BAD O-GlcNAsetiliering vlakke (p<0.05 vs. 5.5 mM) getoon. BAD-Bcl-2 dimeervorming is verhoog in hiperglukemies blootgestelde selle [immunopresipitering analise en ko-lokalisering] en in insulienweerstandige harte. GEVOLGTREKKINGS – Ons studie het „n nuwe weg geïdenifiseer waar hiperglukemie in groter oksidatiewe stres resulteer wat weer HBW aktivering verhoog en BAD O-GlcNAsetilering verhoog het. Ons het verder bevind dat groter BAD-Bcl-2 dimerisasie miokardiale apoptose verhoog wat voorstel dat hierdie weg „n belangrike rol in diabetiese kardiomiopatie speel.

Le diabète maternel est un facteur de risque majeur pour le développement de malformations congénitales. Dans le syndrome de l’embryopathie diabétique, l’exposition prolongée du fœtus à de hautes concentrations ambientes de glucose induit des dommages qui peuvent affecter plusieurs organes, dont les reins. Les malformations rénales sont la cause de près de 40 pourcent des cas d’insuffisance rénale infantile. L’hyperglycémie constitue un environnement utérin adverse qui nuit à la néphrogenèse et peut causer l’agenèse, la dysplasie (aplasie) ou l’hypoplasie rénale. Les mécanismes moléculaires par lesquels les hautes concentrations ambientes de glucose mènent à la dysmorphogenèse et aux malformations demeurent toutefois mal définis. Le diabète maternel prédispose aussi la progéniture au développement d’autres problèmes à l’âge adulte, tels l’hypertension, l’obésité et le diabète de type 2. Ce phénomène appelé ‘programmation périnatale’ a suscité l’intérêt au cours des dernières décennies, mais les mécanismes responsables demeurent mal compris. Mes études doctorales visaient à élucider les mécanismes moléculaires par lesquels le diabète maternel ou un environnement in utero hyperglycémique affecte la néphrogenèse et programme par la suite la progéniture a développer de l’hypertension par des observations in vitro, ex vivo et in vivo. Nous avons utilisé les cellules MK4, des cellules embryonnaires du mésenchyme métanéphrique de souris, pour nos études in vitro et deux lignées de souris transgéniques (Tg) pour nos études ex vivo et in vivo, soient les souris HoxB7-GFP-Tg et Nephrin-CFP-Tg. Les souris HoxB7-GFP-Tg expriment la protéine fluorescente verte (GFP) dans le bourgeon urétérique (UB), sous le contrôle du promoteur HoxB7. Les souris Nephrin-CFP expriment la protéine fluorescente cyan (CFP) dans les glomérules, sous le contrôle du promoteur nephrin spécifique aux podocytes. Nos études in vitro visaient à déterminer si les hautes concentrations de glucose modulent l’expression du gène Pax2 dans les cellules MK4. Les cellules MK4 ont été traitées pendant 24h avec du milieu contenant soit 5mM D-glucose et 20mM D-mannitol ou 25mM D-glucose et avec ou sans antioxydants ou inhibiteurs de p38 MAPK, p44/42 MAPK, PKC et NF-kB. Nos résultats ont démontré que le D-glucose élevé (25mM) augmente la génération des espèces réactives de l’oxygène (ROS) dans les cellules MK4 et induit spécifiquement l’expression du gène Pax2. Des analogues du glucose tels le D-mannitol, L-glucose ou le 2-Deoxy-D-glucose n’induisent pas cette augmentation dans les cellules MK4. La stimulation de l’expression du gène Pax2 par le D-glucose dans les cellules MK4 peut être bloquée par des inhibiteurs des ROS et de NF-kB, mais pas par des inhibiteurs de p38 MAPK, p44/42 MAPK ou PKC. Ces résultats indiquent que la stimulation de l’expression du gène Pax2 par les concentrations élevées de glucose est due, au moins en partie, à la génération des ROS et l’activation de la voie de signalisation NF-kB, et non pas via les voies PKC, p38 MAPK et p44/42 MAPK. Nos études ex vivo s’intéressaient aux effets d’un milieu hyperglycémique sur la morphogenèse de la ramification du bourgeon urétérique (UB). Des explants de reins embryonnaires (E12 à E18) ont été prélevés par micro-dissection de femelles HoxB7-GFP gestantes. Les explants ont ensuite été cultivés dans un milieu contenant soit 5mM D-glucose et 20mM D-mannitol ou 25mM D-glucose et avec ou sans antioxydants, catalase ou inhibiteur de PI3K/AKT pour diverses durées. Nos résultats ont démontré que le D-glucose stimule la ramification du UB de manière spécifique, et ce via l’expression du gène Pax2. Cette augmentation de la ramification et de l’expression du gène Pax2 peut être bloquée par des inhibiteurs des ROS et de PI3K/AKT. Ces études ont démontré que les hautes concentrations de glucose altèrent la morphogenèse de la ramification du UB via l’expression de Pax2. L’effet stimulant du glucose semble s’effectuer via la génération des ROS et l’activation de la voie de signalisation Akt. Nos études in vivo visaient à déterminer le rôle fondamental du diabète maternel sur les défauts de morphogenèse rénale chez la progéniture. Dans notre modèle animal, le diabète maternel est induit par le streptozotocin (STZ) chez des femelles HoxB7-GFP gestantes (E13). Les souriceaux ont été étudiés à différents âges (naissants et âgés de une, deux ou trois semaines). Nous avons examiné leurs morphologie rénale, nombre de néphrons, expression génique et les événements apoptotiques lors de cette étude à court terme. La progéniture des mères diabétiques avait un plus faible poids, taille et poids des reins, et possédait des glomérules plus petits et moins de néphrons par rapport à la progéniture des mères contrôles. La dysmorphogenèse rénale observée est peut-être causée par l’augmentation de l’apoptose des cellules dans la région du glomérule. Nos résultats ont montré que les souriceaux nés de mères diabétiques possèdent plus de podocytes apoptotiques et plus de marquage contre la caspase-3 active dans leurs tubules rénaux que la progéniture des mères contrôles. Les souriceaux des mères diabétiques montrent une augmentation de l’expression des composants du système rénine angiotensine (RAS) intrarénal comme l’angiotensinogène et la rénine, ainsi qu’une augmentation des isoformes p50 et p65 de NF-kB. Ces résultats indiquent que le diabète maternel active le RAS intrarénal et induit l’apoptose des glomérules, menant à une altération de la morphogenèse rénale de la progéniture. En conclusion, nos études ont permis de démontrer que le glucose élevé ou l’environnement in utero diabétique altère la morphogenèse du UB, qui résulte en un retard dans la néphrogenèse et produit des reins plus petits. Cet effet est dû, au moins en partie, à la génération des ROS, à l’activation du RAS intrarénal et à la voie NF-kB. Nos études futures se concentreront sur les mécanismes par lesquels le diabète maternel induit la programmation périnatale de l’hypertension chez la progéniture adulte. Cette étude à long terme porte sur trois types de progénitures : adultes nés de mères contrôles, diabétiques ou diabétiques traitées avec insuline pendant la gestation. Nous observerons la pression systolique, la morphologie rénale et l’expression de divers gènes et protéines. Nous voulons de plus déterminer si la présence d’un système antioxydant (catalase) peut protéger la progéniture des effets néfastes des ROS causés par l’environnement in utero hyperglycémique. Les souris Catalase-Tg expriment la catalase spécifiquement dans les tubules proximaux et nous permettrons d’explorer notre hypothèse sur le rôle des ROS dans notre modèle expérimental de diabète maternel. / Maternal diabetes is a major risk factor for congenital malformations. When the fetus is exposed to high, sustained, ambient glucose levels, widespread fetal damage may affect multiple organs, including the kidneys, evoking diabetic embryopathy syndrome. Renal malformations account for up to 40% of childhood renal failure cases. Hyperglycemia constitutes an adverse in utero environment that dynamically impairs nephrogenesis, resulting in renal agenesis, dysplasia, aplasia or hypoplasia. However, the molecular mechanisms by which high, ambient glucose levels lead to renal dysmorphogenesis and birth defects have not yet been delineated. Maternal diabetes also programs the offspring to develop other problems later in life, such as hypertension, obesity and type 2 diabetes. This phenomenon, called ‘perinatal programming’, has attracted worldwide attention in recent decades, yet the mechanisms by which it occurs are incompletely understood. My PhD studies are designed to elucidate the underlying molecular pathways by which maternal diabetes or hyperglycemic environments in utero impair nephrogenesis and subsequently make the offspring develop perinatal programming of hypertension in vitro, ex vivo and in vivo. We employed mouse embryonic metanephric mesenchyme cells, namely MK4 cells, for our in vitro experiments, and 2 transgenic (Tg) mouse lines, Hoxb7-GFP-Tg and Nephrin-CFP-Tg mice, for ex vivo and in vivo investigations. Hoxb7-GFP-Tg mice specifically express green fluorescent protein (GFP) in ureteric buds (UB), driven by the Hoxb7 promoter. Nephrin-CFP-Tg mice express cyan fluorescent protein (CFP) in glomeruli, driven by the podocyte-specific nephrin promoter. In our in vitro studies, we examined whether high glucose alters Pax2 gene expresson in MK4 cells. The cells were treated with either 5 mM D-glucose plus 20 mM D-mannitol or 25 mM D-glucose media with or without reactive oxygen species (ROS) blockers (DPI, rotenone), and inhibitors of p38 mitogen-activated protein kinase (MAPK) (SB203580), p44/22 MAPK (PD98059), protein kinase C (PKC) (GF109203X), or nuclear factor kappa B (NK-kB) (PDTC) for 24-hr incubation. Our data showed that high D-glucose (25 mM) increased ROS generation and specifically induced Pax2 gene expression, but not other glucose analogs such as D-mannitol, L-glucose or 2-deoxy-D-glucose in MK4 cells. The stimulatory effect of high D-glucose on Pax2 gene expression could be blocked by ROS and NF-kB inhibitors in MK4 cells but not by inhibitors of p38 MAPK (SB203580), p44/22 MAPK (PD98059), and PKC (GFX) in MK4 cells. These data indicated that the stimulatory effect of high glucose on Pax2 gene expression is mediated, at least in part, via ROS generation and activation of NF-κB, but not via the PKC, p38 MAPK and p44/42 MAPK signalling pathways. In our ex vivo studies, we investigated the influence of a high-glucose milieu on UB branching morphogenesis. Kidney explants (E12 to E18) were microdissected from timed-pregnant Hoxb7-GFP mice and cultured with either 5 mM D-glucose plus 20 mM D-mannitol or 25 mM D-glucose media with or without ROS blockers (DPI, rotenone), catalase and phosphoinositide-3-kinase (PI3K)/AKT inhibitor at different time points, depending on the experiment. We found that high D-glucose specifically stimulated UB branching in a time-dependent manner. High D-glucose stimulation of UB branching morphogenesis was mediated via Pax2 gene expression. High D-glucose-induced UB branching and Pax2 gene expression could be blocked by ROS and PI3K/AKT inhibitors. These studies demonstrated that high glucose alters UB branching morphogenesis via Pax2 gene and protein expression. The stimulatory effect of high glucose seems to be mediated via ROS generation and activation of the AKT signalling pathway. In our in vivo studies, we explored the fundamental role of maternal diabetes on renal morphogenesis impairment in offspring. In our experimental model, maternal diabetes was induced by streptozotocin in pregnant Hoxb7-GFP mice at embryonic day 13. The offspring were examined at several time points after birth (neonatal, 1 week, 2 weeks, and 3 weeks) with follow-up of kidney morphology, nephron number, gene expression, and apoptotic events in this short-term postnatal experiment. We observed that the offspring of diabetic mice had lower body weight, body size, kidney weight, small volume of glomeruli and a reduced number of nephrons in comparison to non-diabetic control offspring. Renal dysmorphogenesis may have been the result of increased cell apoptosis in glomeruli. Our findings showed that the offspring of diabetic mice displayed significantly more apoptotic podocytes as well as augmented active caspase-3 immunostaining in renal tubules compared to control mice offspring. Diabetic mice offspring presented heightened expression of intrarenal renin-angiotensin system (RAS) components, such as angiotensinogen and renin, with upregulation of p50 and p65 NF-kB isoforms. These data indicated that maternal diabetes activates the intrarenal RAS and induces glomerular apoptosis, resulting in impairment of renal morphogenesis in diabetic offspring. In conclusion, our findings indicated that a high-glucose milieu in utero or maternal diabetic alters UB morphogenesis, culminating in retardation of nephrogenesis with smaller kidney size. The underlying mechanism(s) is mediated, at least in part, via ROS generation and activation of the intrarenal RAS and NF-kB pathways. In the future, we aim to investigate the underlying mechanism(s) of how maternal diabetes induces perinatal programming of adult hypertension in offspring in vivo. This long-term postnatal study will be undertaken in 3 groups: adult offspring (20 weeks) of control mice, adult offspring of diabetic pregnant mice, and adult offspring of insulin-treated, diabetic, pregnant mice. We will follow-up by tracking hypertension, kidney morphology, and gene expression. Furthermore, we also plan to determine whether an antioxidant system (catalase) can protect against an hyperglycemic environment in utero that affects embryonic organogenesis via an increase in ROS generation. Catalase-Tg mice that specifically overexpress catalase in proximal tubules will be tested. Such Tg mice with catalase overexpression represent a model for exploring our hypothesis on the role of ROS in gestational diabetes.

A infecção do sítio cirúrgico (ISC) é complicação frequente que pode acometer o paciente cirúrgico e acarretar incremento de morbimortalidade, readmissão, prolongamento da permanência no serviço de saúde e custos. A presente investigação teve como objetivos estimar as taxas de incidência (bruta e densidade) de infecção de sítio cirúrgico em pacientes submetidos à cirurgia abdominal, identificar os fatores de risco ou proteção e identificar o efeito independente da hiperglicemia perioperatória sobre a incidência de infecção de sítio cirúrgico. Trata-se de estudo de coorte. A amostra foi composta de 484 pacientes submetidos à cirurgia abdominal, os quais foram acompanhados durante o período de 30 dias após a cirurgia. Para a coleta das informações, utilizou-se instrumento padronizado, pré-codificado e submetido à validação aparente e de conteúdo (cinco juízes). A coleta de dados foi realizada na admissão do paciente, no dia da cirurgia, no primeiro dia de pós-operatório até a alta hospitalar, no 30º dia após a cirurgia e nos casos de reinternação. A hiperglicemia perioperatória foi avaliada em três momentos, a saber: na sala de recepção do centro cirúrgico, ao final da cirurgia e 12 horas após o término da cirurgia. A incidência bruta de ISC foi de 20,25%, a maioria dos pacientes era do sexo feminino (54,34%), classificados na categoria ASA II (58,47%), e mais de 15% com diagnóstico prévio de diabetes mellitus e neoplasia. A duração média da cirurgia foi de 117,62 minutos e da anestesia de 144,15 minutos. Com relação ao potencial de contaminação da ferida, 63,64% foram classificadas em potencialmente contaminadas e 62,81% dos pacientes apresentaram hipotermia (<= 5vezes). Ao final da cirurgia, a média da temperatura da sala de operação foi 23,92ºC e a umidade do ar foi de 54,50kg/m3. A hiperglicemia perioperatória esteve presente em 17,77% dos pacientes ao final da cirurgia e 12 horas após o término do procedimento cirúrgico. Com relação à gravidade da hiperglicemia, 24,38% da amostra apresentou tal condição em uma das aferições e 5,79% duas ou mais vezes. As medidas de associação brutas (modelos univariados) indicaram que pacientes expostos à hiperglicemia têm maior risco de desenvolvimento de ISC (RR >2,5), quando comparados aos não expostos. A fração atribuível indicou que a ISC não ocorreria em mais de 60% dos casos se a hiperglicemia pudesse ser evitada. No modelo multivariado, as variáveis, potencial de contaminação da ferida (cirurgia contaminada), hipotermia e gravidade da hiperglicemia, permaneceram independentemente associadas à ISC. A variável hiperglicemia foi fator de risco independente associada ao desfecho em todos os modelos, exceto na sala de recepção do centro cirúrgico. A temperatura da sala de operação foi associada independentemente ao desfecho, exceto 12 horas após o final da cirurgia (fator protetor). As evidências geradas podem contribuir para a prevenção e controle de ISC, uma vez que o conhecimento pelos profissionais de saúde, sobre os fatores de risco, especialmente, a hiperglicemia perioperatória, pode promover o planejamento e implementação de ações direcionadas para a redução deste tipo de infecção / Surgical site infection (SSI) is a frequent complication that may affect the surgical patient, leading to an increase in morbidity and mortality, readmission, prolonged stay in the health service and costs. This study aimed to estimate the incidence rates (gross and density) of surgical site infection in patients submitted to abdominal surgery, to identify the risk or protection factors and to identify the independent effect of perioperative hyperglycemia on the incidence of infection of surgical site. It is a cohort study; the sample was composed of 484 patients submitted to abdominal surgery, who were followed during the period of 30 days after surgery. For the information collection, a standardized, pre-coded instrument was used and it was submitted to the apparent and content validation (five judges). Data collection was performed at the patient\'s admission, in the day of surgery, from the first postoperative day to the hospital discharge, on the 30th day after surgery, and in cases of rehospitalization. The perioperative hyperglycemia was evaluated in three moments, as following: in the reception room of the surgical center, at the end of the surgery and 12 hours after the end of the surgery. The gross incidence of SSI was 20.25%, the majority of the patients were female (54.34%), classified as ASA II (58.47%), and more than 15% with previous diagnosis of diabetes mellitus and neoplasia. The average duration of surgery was 117.62 minutes and of anesthesia was 144.15 minutes. Regarding the potential for contamination of the wound, 63.64% of them were classified as potentially contaminated, and 62.81% of the patients presented hypothermia (<= 5 times). At the end of the surgery, the average operating room temperature was 23.92ºC and the air humidity was 54.50kg/m3. Perioperative hyperglycemia was present in 17.77% of the patients at the end of the surgery and 12 hours after the end of the surgery. Regarding the severity of hyperglycemia, 24.38% of the sample presented such condition in one of the measurements and 5.79% in two or more times. Measures of gross association (univariate models) indicated that patients exposed to hyperglycemia had a higher risk of developing SSI (RR>2.5) when compared to those not exposed. The attributable fraction indicated that SSI would not occur in more than 60% of cases if hyperglycemia could be avoided. In the multivariate model, the potential variables of wound contamination (contaminated surgery), hypothermia and severity of hyperglycemia remained independently associated to SSI. The variable hyperglycemia was an independent risk factor associated to the outcome in all models, except in the reception room of the surgical center. The operating room temperature was independently associated to the outcome, except 12 hours after the end of surgery (protective factor). The evidence found may contribute to the prevention, control of SSI, since the knowledge of health professionals about the risk factors, especially perioperative hyperglycemia, may promote the planning, and implementation of actions aimed at reducing this type of infection

O diabetes mellitus é considerado um dos problemas de saúde globalmente mais desafiadores do século 21. De acordo com as estimativas recentes do International Diabetes Federation - IDF, cerca de 382 milhões de pessoas são diabéticas e esse número tende a aumentar para além de 592 milhões em menos de 25 anos. Para melhor compreensão do Diabetes mellitus e suas complicações torna-se necessário buscar novos marcadores para a doença. O DM promove estresse oxidativo, inflamação e a formação de produtos avançados de glicação não enzimática (AGES), o que leva a dano tecidual no paciente diabético. Marcadores de dano oxidativo em proteínas e lipídeos na vigência do DM têm sido amplamente abordados na literatura, no entanto o estudo de lesões em DNA ainda requer mais atenção em modelos in vivo. Este trabalho teve como objetivo avaliar o dano oxidativo e resultante de glicação avançada em rim, fígado, cerebelo, sangue e urina de animais diabéticos, assim como a modulação do dano por diferentes períodos de tratamento com insulina, a fim de verificar se o controle da glicemia nos animais diabéticos protege contra a indução dos danos em biomoléculas. Para a indução do DM nos ratos Sprague-Dawley foram administrados 40 mg de STZ por kg de peso corpóreo por via intravenosa. Os níveis de MDA e 5-metildC foram avaliados por HPLC-DAD. A quantificação de HbA1c e dos adutos 1,N2-&#949;dGuo, 1,N6-&#949;dAdo, 8-oxodG e CEdG foi realizada por sistema HPLC-ESI-MS/MS. Os níveis de nitrito sérico foram determinados por leitura da absorbância em espectrofotômetro e a concentração de creatinina plasmática foi determinada por analisador bioquímico. Os resultados mostraram que as alterações metabólicas desencadeadas pela condição de hiperglicemia persistente não são prontamente revertidas após o controle da glicemia. Os níveis glicêmicos e de HbA1c apresentam diferença significativa entre os grupos de animais hiperglicêmicos e sadios, sendo observada uma queda dos valores de HbA1c somente a partir do tratamento com insulina por 6 semanas. Em plasma, rim e fígado as concentrações de MDA seguem o perfil de concentração de hemoglobina glicada (HbA1c), indicando que os eventos de glicação e estresse oxidativo podem estar relacionados. O controle glicêmico também apresentou efeito benéfico para a excreção de CEdG e 1,N6-&#949;dAdo em urina, apesar de ser observado a partir dos níveis de 8- oxodG que a hiperinsulinemia leva a um quadro de estresse oxidativo. As três lesões são geradas por vias distintas: glicação avançada, peroxidação lipídica e ROS. Portanto, além do controle glicêmico, é importante que se desenvolvam estratégias de intervenção nas vias bioquímicas alteradas pela condição de hiperglicemia, a fim de reduzir os riscos das complicações decorrentes do diabetes mellitus. / Diabetes mellitus is generally considered one of the most challenging health problems of the 21st century. According to recent estimates from the International Diabetes Federation - IDF, about 382 million people have diabetes and this number is expected to increase beyond 592 million in less than 25 years. For a better understanding of diabetes mellitus and its complications becomes necessary to search for new biomarkers for the disease. The DM promotes oxidative stress, inflammation and the formation of advanced glycation end products (AGEs), which leads to tissue damage in the diabetic patient. Markers of oxidative damage to proteins and lipids in the presence of DM have been widely discussed in literature, however the study of DNA lesions in vivo models still requires more attention. This study aimed to evaluate the oxidative damage and advanced glycation in the kidney, liver, cerebellum, blood and urine of diabetic animals, as well as damage modulation for different periods of insulin treatment in order to verify that the glycaemic control in diabetic animals protects against induction of biomolecules damage. For induction of diabetes in Sprague-Dawley rats were administered 40 mg STZ per kg body weight intravenously. MDA and 5-metildC were evaluated by HPLC-DAD. The quantification of HbA1c and adducts 1,N2-&#949;dGuo, 1,N6-&#949;dAdo, 8-oxodG and CEdG was performed by HPLC-ESI-MS / MS system. The serum nitrite was determined by reading the absorbance in a spectrophotometer and the plasma creatinine concentration was determined by biochemical analyzer. The results showed that metabolic changes triggered by the condition of persistent hyperglycemia are not readily reversed after glycemic control. Blood glucose and HbA1c levels are significantly different between the groups of hyperglycemic and healthy animals, and was observed a fall in HbA1c only from insulin treatment for 6 weeks. In plasma, kidney and liver concentrations follow the profile of MDA concentration of glycated hemoglobin (HbA1c), indicating that the events of glycation and oxidative stress may be related. Glycemic control also showed beneficial effect for urine excretion of CEdG and 1,N6-&#949;dAdo despite could be seen from 8-oxodG levels that the hyperinsulinaemia leads to a frame of oxidative stress. The three lesions are generated by distinct pathways: advanced glycation, lipid peroxidation and ROS. Therefore, beyond glycaemic control, it is important to develop intervention strategies in biochemical pathways altered by the condition of hyperglycemia in order to reduce the complications risk of diabetes mellitus.

O Diabetes Mellitus é uma das maiores causas de morte no mundo. O desenvolvimento do Diabetes Mellitus tipo 2 (DM2) está relacionado com uma série de fatores genéticos e ambientais, culminando com o desenvolvimento do DM2. Já a hiperglicemia, característica marcante da doença, está associada a uma série de complicações metabólicas e comorbidades. No entanto, nào se sabe a influência de um controle apropriado da doença, com menores níveis glicêmicos. No presente trabalho, foi utilizada a técnica de microarrays para comparar os perfis transcricionais (mRNA e microRNA) de células mononucleares de sangue periférico (PBMCs) em três grupos distintos: um grupo de pacientes DM2 descompensados (DM2-D, n=13); um grupo de pacientes DM2 compensados (DM2-C, n=14), e um grupo controle (n=10). Os dados foram analisados por meio de duas linguagens de programação: R e PERL. Após a extração dos dados utilizando-se o software Feature Extraction, versão 10.7 (Agilent Techonologies), foram realizadas correção do background, exclusão dos outliers, normalização dos dados pelo método quantile e, por fim, o ajuste de variações nãobiológicas. Os dados foram então submetidos a análise estatística rank products, sendo identificados 415 mRNAs diferencialmente expressos no grupo DM2-C relativamente aos controles, 285 no grupo DM2-D em comparação aos controles e 478 em pacientes DM2-D comparados aos DM2-C. Posteriormente, os genes diferencialmente expressos foram submetidos à analise de enriquecimento funcional (DAVID). Foram encontrados 22 e 56 termos biológicos enriquecidos (p-corrigido Benjamini-Hochberg < 0,05) para as comparações DM2-C versus controle e pacientes DM2-D versus DM2-C, respectivamente. Em ambas as comparações, um processo biológico foi considerado de interesse para o presente trabalho: resposta inflamatória. Na análise por GSEA e GSA, foram identificados 110 grupos gênicos diferencialmente expressos na comparação DM2-C versus controle. Já para a comparação DM2-D versus controles foram encontrados 297 grupos gênicos diferencialmente expressos, enquanto que na comparação DM2-D versus DM2-C, 161 grupos gênicos diferencialmente expressos. Dentre os grupos gênicos diferencialmente expressos, três merecem destaque: regulação do reparo do DNA (GO: 0006282), resposta ao superóxido (GO: 0000303) e resposta ao estresse do retículo endoplasmático (GO: 0034976). Ainda, 97 microRNAs foram diferencialmente expressos na comparação DM2-C versus controles, 54 na comparação DM2-D versus controles e 101 na comparação DM2-D versus DM2-C. Assim, diferentes grupos gênicos provavelmente foram modulados pela hiperglicemia, além de terem sido descobertos novos microRNAs relacionados a altos níveis de glicose. / Diabetes mellitus is a major cause of death worldwide. The development of type 2 Diabetes Mellitus (T2D) is associated with a number of genetic and environmental factors, culminating in the development of T2D. Hyperglycemia, a hallmark of the disease, is associated with a number of metabolic complications and comorbidities. However, the influence of a proper control of the disease, with lower glucose levels is unknown. In this study, we used the microarrays technique to compare the transcriptional profiles (mRNA and microRNA) of peripheral blood mononuclear cells (PBMCs) in three distinct groups: a group of patients with uncontrolled T2D patients (T2D-U, n = 13) a group of controlled T2D patients (T2D-C, n = 14) and control group (n = 10). Data were analyzed using two programming languages: R and PERL. After extracting the data using the Feature Extraction software, version 10.7 (Agilent Technologies), background correction, outliers exclusion, data normalization by quantile and adjustmesnt of non-biological variations were performed. The data were then statistically analyzed by the rank products test, which identified 415 differentially expressed mRNAs in T2D-C group compared to controls, 285 in group T2D-U in comparison with controls and 478 when T2D-U and T2D-C are compared. Thereafter, the differentially expressed genes were subjected to functional enrichment analysis (DAVID). 22 and 56 biologically enriched terms were found (Benjamini-Hochberg-corrected p value<0.05), when comparing T2D-C with controls and T2D-U with T2D-C, respectively. In both comparisons, inflammatory response was selected as a biological process of interest. The analysis by GSEA and GSA identified 110 differentially expressed gene sets in comparison T2D-C versus control. As for the comparison T2D-U versus control, 297 gene sets were found differentially expressed, whereas in comparison T2D-U versus T2D-C, 161 differentially expressed gene sets were found. Among the differentially expressed gene sets, three stand out: regulation of DNA repair (GO: 0006282), superoxide response (GO: 0000303) and response to endoplasmic reticulum stress (GO: 0034976). Still, 97 microRNAs were differentially expressed in the T2D-C versus controls comparison, 54 when comparing T2D-U versus controls and 101 in the comparison of T2D-U versus T2D-C. Thus, different gene sets were probably modulated by hyperglycemia, and new microRNAs related to high levels of glucose were discovered.

A incidência de doenças crônicas não transmissíveis como a diabetes tipo 2 e complicações cardiovasculares tem aumentado significativamente, e tem-se associado principalmente às mudanças nos hábitos alimentares tradicionais. O objetivo do presente estudo foi caracterizar diferentes cultivares de feijão, lupino e grãos da região dos Andes quanto a seus compostos fenólicos antioxidantes, capacidade antioxidante e potencial anti-hiperglicêmico e anti-hipertensivo in vitro. Dependendo do tipo de cultivar, o feijão é uma fonte promissora de taninos condensados, antocianinas, e flavonóis; enquanto que o lupino andino destacou-se pela presença de isoflavonas. Após o tratamento térmico, o feijão e lupino andino inibiram significativamente a enzima conversora da angiotensina I, relevante na prevenção da hipertensão, enquanto o milho roxo andino inibiu a &#945;-glicosidase, relevante na prevenção da hiperglicemia. Uma combinação apropriada de grãos tradicionais como parte da dieta poderia contribuir na modulação dos níveis de glicose e na prevenção das complicações relacionadas ao desequilíbrio óxido-redução. / Incidence of chronic diseases such as diabetes type 2 and related cardiovascular complications has increased significantly due mainly to current changes in traditional food dietary habits. The objective of this study was to characterize several bean and lupin cultivars along with grains from the Andean region in relation to their phenolic compounds, antioxidant capacity and anti-diabetes and anti-hypertension potential using in vitro assays. Depending on the cultivar, beans are interesting sources of condensed tannins, anthocyanins and flavonols, whereas major phenolic compounds in Andean lupins were isoflavones. Following thermal treatment, selected beans and Andean lupins inhibited significantly the hypertension relevant angiotensin I-converting enzyme and among Andean grains, the purple corn inhibited the hyperglycemia relevant &#945;-glucosidase. A good combination of traditional grains as a part of the overall diet can contribute to effective dietary strategies for managing Type 2 diabetes and associated complications linked to unbalanced cellular redox status.

O efeito da hipertrofia induzida por sobrecarga funcional no músculo extensor digital longo (EDL) e sóleo de ratos diabéticos induzidos por estreptozotocina foi avaliado. Ratos Wistar foram induzidos ao estado diabético por dose única de estreptozotocina (65mg/kg peso corporal, i.v.) e mantidos nessa condição durante quatro semanas. Foi então realizada tenotomia do músculo gastrocnêmio ou ablação do músculo tibial anterior. Os conteúdos de Akt e S6 totais e fosforiladas foram avaliados após uma e quatro semanas de sobrecarga nos músculos EDL e sóleo. No EDL, após 7 dias de sobrecarga, ocorreu aumento de fosfo-Akt, fosfo-S6 e S6 total no músculo EDL nos grupos diabético e controle. Os aumentos foram semelhantes entre os grupos. No músculo sóleo, os conteúdos de Akt total e fosfo-Akt aumentaram significativamente, após 7 dias de sobrecarga funcional. A área da secção transversa das fibras, a massa, as forças tetânica e isotônica, absolutas e específicas foram avaliadas nos músculos sóleo e EDL após 4 semanas de sobrecarga e apresentaram aumentos similares em resposta à sobrecarga funcional. A deficiência de insulina por até 4 semanas não afeta de modo significativo a resposta hipertrófica induzida por sobrecarga funcional nos músculos sóleo e EDL de ratos. / The effect of hypertrophy induced by functional overload on extensor digitalis longus (EDL) and soleus muscles of streptozotocin-induced diabetic rats were evaluated. Male Wistar rats were rendered diabetic by a single dose of streptozotocin (65mg/kg b.w., i.v.) and maintained under this condition for four weeks. Then, tenotomy of the gastrocnemius muscle or tibialis anterior ablation were performed. Contents of total and phosphorylated Akt and S6 were evaluated after one and four weeks of overload on EDL and soleus muscles. Phospho-Akt content was increased in control and diabetic animals in hypertrophied muscles. Contents of phospho-S6 and total S6 increased after 7 days of overload either in the control and diabetic groups. In soleus muscle, after 7 days of overload, increases in contents of total Akt and phospho-Akt were observed. Content of phospho-S6 was increased in diabetic group. Fiber cross-sectional area (CSA), muscle mass, and tetanic forces were evaluated after four weeks of overload. Increases in muscle mass and CSA were observed in EDL and soleus muscles of diabetic and control rats. Deficiency of insulin for up to 4 weeks has no significant effect on the hypertrophic response induced by functional overload on the EDL and soleus muscles.