Submitted by Neusa Fagundes (neusa.fagundes@unioeste.br) on 2018-09-12T14:40:58Z No. of bitstreams: 2 Gabrielle_Custódio2018.pdf: 1773314 bytes, checksum: 2eea15a0ee541c0d86fb3e257f910aeb (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-09-12T14:40:58Z (GMT). No. of bitstreams: 2 Gabrielle_Custódio2018.pdf: 1773314 bytes, checksum: 2eea15a0ee541c0d86fb3e257f910aeb (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-07-13 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Fundação Araucária de Apoio ao Desenvolvimento Científico e Tecnológico do Estado do Paraná (FA) / The oral administration of insulin stands out as the most convenient, simple and compatible way for patients, since it provides comfort and it can control the glucose homeostasis. This study produced and evaluated a polymer-lipid nanotransporter for the oral delivery of insulin by double emulsion and solvent emulsification/evaporation using ethyl palmitate and hyaluronic acid (HA) of 13 and 55 kDa. The nanoparticles showed an average diameter of 300 nm, negative surface charge, encapsulation efficiency of 35% and they were thermally stable when analyzed by differential scanning calorimetry. The in vitro release with simulated gastrointestinal fluids demonstrated the protection ability to encapsulated insulin. The nanoparticles have shown to be safe at potential therapeutic concentrations, since they did not cause cytotoxicity to intestinal epithelial cells. Finally, the permeability of nanoencapsulated insulin through Caco-2 monolayers and Caco-2/HT29-MTX model correlated with the slow release rates and did not show differences between them. These results indicated that the molar weight of HA did not show differences in both the characterization and the therapeutic response of the prepared nanoparticles, which could be considered as a good carrier for the oral administration of insulin. / A administração oral da insulina destaca-se como o modo mais conveniente, simples e compatível com o paciente, pois proporciona conforto e é capaz de controlar a homeostase glicídica. Neste estudo foi produzido e avaliado um nanotransportador lipídico polimérico para a entrega oral da insulina por meio de dupla emulsão e emulsificação/evaporação do solvente utilizando etilpalmitato e ácido hialurônico (HA) de 13 e 55 kDa. As nanopartículas apresentaram diâmetro médio em torno de 300nm, carga superficial negativa, eficiência de encapsulação de 35% e apresentaram-se estáveis termicamente quando analisadas pela calorimetria diferencial de varredura. A liberação in vitro com fluidos gastrointestinais simulados demonstrou a capacidade de proteção à insulina encapsulada. As nanopartículas mostraram-se seguras em potenciais concentrações terapêuticas, uma vez que não originaram citotoxicidade para as células epiteliais intestinais. Por último, a permeabilidade da insulina nanoencapsulada através de monocamadas Caco-2 e modelo Caco-2:HT29-MTX correlacionaram-se com as taxas de liberação lenta e não apresentam diferenças entre si. Esses resultados indicaram que o peso molar do HA não apresentou diferenças tanto na caracterização quanto na resposta terapêutica das nanopartículas preparadas, podendo estas serem consideradas como um bom transportador para administração oral de insulina.

Métodos in vitro utilizando epitélio intestinal animal são importantes ferramentas para avaliar a permeabilidade de fármacos, propriedade que é um importante parâmetro de biodiosponibilidade. Considerando que o maior objetivo na indústria farmacêutica é desenvolver novos fármacos com boa biodisponibilidade oral, o projeto teve como objetivo padronizar o modelo de permeação com membrana de intestino de rã (Rana catesbeiana) em células de Franz, comparando seus resultados com ensaios de células Caco-2. Os fármacos modelo utilizados foram os antivirais zidovudina e aciclovir. A quantidade de fármaco permeado foi determinada por método de eletroforese capilar para o método com intestino de rã touro e por HPLC-UV para os ensaios com células Caco-2. O parâmetro de permeação foi o coeficiente de permeabilidade aparente (Papp) dos fármacos para ambos modelos experimentais. Para estabelecimento do protocolo experimental dos estudos de permeabilidade intestinal de rã, foi proposto um projeto fracionado 24-1 com 4 ensaios adicionais usando o software Minitab, e as variáveis foram: secção intestinal, pH da solução de Ringer e temperatura. A análise do planejamento experimental feita pela estimativa dos parâmetros da regressão obtidos através dos resultados do modelo fatorial possibilitou a determinação dos coeficientes da equação matemática que definiu a influência das variáveis sobre o coeficiente de permeabilidade aparente dos fármacos. Os efeitos das variáveis pH e temperatura interpretados conjuntamente apresentaram interferência leve, porém as variáveis fármaco e secção intestinal interpretados juntos tiveram interferência importante, mostrando maior permeação dos fármacos através da secção inicial do intestino da rã. Os resultados de Papp foram: para o metoprolol, pelo método das células Caco-2 foi de 28 x 10-6 cm/s, valor que está de acordo com demais dados de células Caco-2 na literatura e o valor obtido com células de Franz que mais se adequada a estes resultados e demais disponíveis provenientes de outras técnicas na literatura, foi de 28,1 x 10-6 cm/s, em uma das condições do planejamento estatístico utilizando segmento final da membrana epitelial da rã. No caso do aciclovir, o resultado de Papp de 0,48 x 10-6 cm/s também obtido em uma das condições envolvendo segmento intestinal final da rã foi exatamente igual a o valor 0,48 x 10 - 6 cm/s, encontrado com células Caco-2 no presente estudo e estão de acordo com outros valores disponíveis na literatura por Trapani e colaboradores, 2004 e também com células Caco-2. Para zidovudina o valor de Papp obtido em uma das condições utilizando segmento intestinal inicial da rã, de 13 x 10-6 cm/s, foi a que mais se assemelhou ao obtido pela técnica de células Caco-2, 13,6 x 10-6 cm/s, e também está de acordo com demais dados da literatura. / There are lots of different in vitro technics in the literature using animal intestinal epithelium to estimate permeability of drugs, property that is an important parameter of bioavailabity. Considering that the main objective of Pharmaceutical Companies is the development of new drugs with good oral bioavailabity, the aim of this work was to standardize the permeability of antivirals using in vitro/ex vivo method of intestinal epithelium of Rana catesbeiana in Franz cells and compare these results to those obtained from studies using Caco-2 cells. Zidovudine and Acyclovir were selected as model drugs. The amount of drug permeated will be determined by the method of capillary electrophoresis for assays using Rana Catesbeiana and HPLC-UV for studies with Caco-2 cells. The permeation parameter determined was the apparent permeability coefficient (Papp) of drugs for both experimental models. To establish the experimental protocol to studies of intestinal permeability of frog, it was proposed a fractional 24-1 design with 4 additional tests using Minitab software and the variables were: intestinal section, pH of Ringer solution and temperature. The analysis of the experimental design made by the estimate of the regression parameters obtained from the factorial model results allowed the determination of the coefficients of the mathematical equation that defines the influence of the variables on the apparent permeability coefficient of acyclovir and zidovudine. The effects of pH and temperature interpreted jointly presented a slight interference, but the variables drug and intes tinal section interpreted together had major interference, showing greater permeation of drugs through the initial section of the intestine of the frog . The results of Papp were: for metoprolol, with the method of Caco-2 cells was 28 x 10-6 cm/s, a value which is consistent with other data of Caco-2 cells provided in the literature and the condition obtained with Franz cells that are most suitable for these and other results obtained from other techniques available in the literature, was 28.1 x 10-6 cm/s, provided with the final intestinal segment using frog epithelial membrane. In the case of acyclovir, the result of Papp of 0.48 x 10-6 cm/s obtained in one condition with final frog intestinal segment was exactly equal to the value of 0.48 x 10-6 cm/s, found with Caco-2 cells in the present study and are in agreement with other values available in the literature for Trapani and colegues, 2004 and also with Caco-2 cells. The Papp value for zidovudine obtained with the initial gut segment of frog, 13 x 10-6 cm /s was which more resembled that obtained by the technique of Caco-2 cells, 13.6 x 10-6 cm/s and is also consistent with other literature data.

A injúria ao epitélio intestinal é uma das mais importantes complicações da sepse, associada à perda da integridade da barreira epitelial intestinal pela alteração da expressão de proteínas constituintes das tight junctions (TJ). Os dois subtipos de receptores de estrógeno são normalmente expressos na mucosa intestinal, sendo responsável pela manutenção da arquitetura do epitélio intestinal. Além disso, diversos modelos experimentais fisiopatológicos têm atribuído um papel imunomodulador ao estradiol. O objetivo do presente estudo foi avaliar a participação do estradiol na modulação da resposta inflamatória e na proteção da barreira epitelial intestinal durante a inflamação sistêmica induzida por lipopolissacarídeo (LPS; 1,5 mg/kg, i.v.) em ratas. As ratas foram ovariectomizadas e mantidas para recuperação durante 10-12 dias antes do experimento. Por três dias consecutivos, as ratas foram tratadas com cipionato de estradiol (50 ou 100 µg/kg, s.c.) ou óleo. Após 6h da indução da endotoxemia, foram avaliadas a permeabilidade intestinal pela injeção de dextrana FITC no íleo ou cólon, a translocação bacteriana nos linfonodos mesentéricos e as citocinas no plasma e na mucosa intestinal. Adicionalmente, a infiltração de mastócitos e neutrófilos foi avaliada no íleo e no cólon, a integridade das TJ e junções aderentes (JA) foi determinada por microscopia eletrônica de transmissão, e expressão das proteínas (ocludina, claudina-1, JAM-A, E-caderina) bem como suas localizações. Nossos resultados demonstraram que o estradiol reduziu a permeabilidade intestinal bem como preveniu a translocação bacteriana nos linfonodos mesentéricos induzidas pela administração de LPS. Em ratas endotoxêmicas tratadas com estradiol, as concentrações das citocinas pró-inflamatórias (TNF?, IL-6, IFN-? e IL-1?), migração de neutrófilos (atividade da mieloperoxidase) e degranulação dos mastócitos no íleo e no cólon foram reduzidas. O estradiol também reverteu a disfunção da barreira epitelial induzida pelo LPS, aumentando a expressão das proteínas das TJ, reduzindo a abertura das TJ e JA e atenuando os danos histológicos. Em conjunto, os resultados sugerem um papel protetor do estradiol, prevenindo a disfunção da barreira epitelialintestinal induzida pela inflamação sistêmica, possivelmente modulando a resposta inflamatória e a liberação de proteases de mastócitos. / Intestinal injury is one of the most important complications of sepsis, associated with the loss of integrity of the intestinal epithelial barrier due to the alteration of the expression of proteins that constitute the tight junctions (TJ). The two subtypes of estrogen receptors are normally expressed in the intestinal mucosa, being responsible for maintaining the architecture of intestinal epithelium. Moreover, several experimental pathophysiological models have been attributed the immunomodulatory role for the estradiol. The aim of the present study was to evaluate the role of estradiol in the modulation of the inflammatory response and the protection of the intestinal epithelial barrier during systemic inflammation induced for lipopolysaccharide (LPS, 1.5 mg / kg, i.v.) in rats. The female rats were ovariectomized and allowed to recover for 10-12 days before the experiment. For three consecutive days, rats were pretreated with estradiol cypionate (50 or 100 µg/kg, subcutaneous) or corn oil. At 6h after of endotoxemia induction, were evaluated the intestinal permeability by injecting FITC dextran into the ileum or colon, bacterial translocation in the mesenteric lymph nodes and plasma and intestinal mucosa cytokines levels. In addition, the infiltration of mast cells and neutrophils was evaluated in the ileum and colon, the integrity of the TJ and adherent junctions (JA) integrity was determined by transmission electron microscopy, and the protein expression (occludin, claudin-1, JAM-A, E-cadherin) as well as their localization. Our results demonstrated that estradiol reduced intestinal permeability as well as prevented bacterial translocation in the mesenteric lymph nodes induced by the LPS administration. In the endotoxemic rats treated with estradiol, the concentration of proinflammatory cytokines (TNF?, IL-6, IFN-? e IL-1?), neutrophil infiltration (myeloperoxidase activity), and mast cells degranulation were reduced in the ileum and colon. Estradiol also reverted the LPS-induced epithelial barrier dysfunction, increasing the expression of the TJ proteins, reducing TJ and AJ opening and attenuating the histological damages. Together, these results suggest a protective role for estradiol, attenuating damage to the intestinal epithelium induced by systemic inflammation, possibly due to modulation of the inflammatory response and the release of mast cells proteases.

Le développement de nanomédicaments capables de contrecarrer les propriétés biopharmaceutiques défavorables de l'amphotéricine B (AmB) représente un enjeu important. L'AmB est en effet une molécule très efficace pour le traitement des infections fongiques systémiques et aussi pour la leishmaniose, mais difficile à formuler efficacement, quelle que soit la voie d'administration. Cette molécule particulièrement hydrophobe souffre de limitations importantes en raison de sa tendance prononcée à l'agrégation dans les conditions physiologiques. La première partie de cette thèse a consisté à vérifier l'hypothèse selon laquelle le degré d'agrégation de l'AmB pourrait avoir un fort impact sur certaines de ses propriétés biopharmaceutiques et pharmacocinétiques. Dans cet objectif, l'albumine a été utilisée pour produire avec l'AmB des complexes de taille contrôlée. Les caractéristiques morphologiques des objets colloïdaux formés ont été déterminées par spectroscopie UV-Vis et par dichroïsme circulaire. Ainsi, l'impact de l'état de l'agrégation sur la perméabilité intestinale d'une part et la reconnaissance éventuellement des agrégats par le système immunitaire d'autre part a été étudié. La deuxième partie de ce travail a été axée sur le développement des micro et nanotransporteurs destinés à surmonter la barrière d'absorption élevée contre AmB après son administration orale. À cet effet, des micro- et nano-émulsions chargées en AmB ont été préparée afin d'estimer leur capacité à améliorer la perméabilité de l'AmB au travers de l'épithélium digestif de rat. Le modèle de la Chambre d’Ussing a été utilisé à cet effet. Aucun passage de l’AmB n'a pu être détecté dans chacune des conditions expérimentales testées. Toutefois, les données électrophysiologiques ont montré une diminution de la viabilité des tissus, attribuable à la grande toxicité de l'AmB, et dépendante de l'état d'agrégation de l'AmB lorsque ces objets sont au contact avec le tissu. Ces essais de perméation menés sur des tissus sains au niveau jéjunal suggèrent que le transport de l'AmB par les voies paracellulaire et/ou transcellulaire est sans doute marginal. Cependant, la littérature rapporte que qu'une absorption par voie orale de l'AmB, bien que peu importante, peut être observée in vivo. Ceci suggère donc que d'autres voies d'absorption pourraient être mises en oeuvre, parmi lesquelles la capture d'agrégats d'AmB au niveau des plaques de Peyer et l'accès à la voie lymphatique pourraient représenter des voies d'absorption alternatives. Enfin, l'emploi d'un autre système de transporteur conçu pour atteindre le colon et assurer la délivrance colonique grâce à l'action enzymatique bactérienne locale a été envisagé. Dans cet objectif, un biopolymère naturel et dégradable par des enzymes, le xylane, a été sélectionné. Le xylane est un polysaccharide présent dans les grains, de céréales et de plantes angiospermes qui est spécifiquement dégradé dans la région du côlon, grâce à l'action enzymatique du microbiote. Pour cela, un procédé original de préparation de particules a été mis en oeuvre consistant tout d'abord à produire une émulsion eau-dans-eau de xylane en présence de PEG, suivie d'une phase de réticulation du xylane au moyen du trimétaphosphate de trisodium. La méthode a permis la production de nano et de microparticules allant de 380 nm à 4,5 μm et les paramètres contrôlant le processus ont été identifiés. Ce processus, respectueux de l'environnement et ne nécessitant pas l'emploi de solvants organiques, pourrait être appliqué à la délivrance colonique de AmB. / This thesis is part of the development and evaluation of nanomedicines potentially able to overcome unfavorable biopharmaceutical properties of amphotericin B (AmB), a highly effective molecule used for the treatment of systemic fungal infections and leishmaniasis, but difficult to formulate efficiently, whatever the route of delivery. It is believed that this hydrophobic molecule suffers from severe limitations due to its prounounced tendency to aggregate under physiological conditions. The first part of the thesis was driven on the hypothesis that the degree of aggregation of AmB could have a strong impact on some of its pharmacokinetics properties. For this purpose albumin has been used to produce controlled complexes between albumin and AmB in order to control AmB aggregation states. The morphological characteristics of the resulting colloidal objects have been carefully characterized by UV-Vis spectroscopy and circular dichroism. Furthermore, the impact of aggregation state on both the intestinal permeability and a possibly expected recognition of the aggregates by the immunological system were investigated. The second part of this work was focused on the development of micro- and nanocarriers intended to overcome the absorption barrier raised against AmB after oral delivery. For this purpose, AmB was loaded into micro- and nanoemulsions to evaluate a possible permeability enhancement effect through the intestinal membrane, which was evaluated in ratas using the Ussing chamber model. No detectable permeation was seen in any of the experimental conditions. However, the electrophysiological data showed tissue viability losses due to the strong toxicity of AmB, that were dependent on the agregation state of AmB when in contact with the tissue. It was also concluded from detailed permeation experiments in healthy tissues that paracellular and transcellular routes were likely to be only marginal pathways when oral absorption are observed in vivo, as reported in the literature. The likeness of other possible absorption pathways, including Peyer's patches capture and lymphatic pathway implication for agregated particles has been discussed. Finally, another particulate system intended for colonic delivery and based on xylan, a natural and enzymatically degradable biopolymer, has been investigated. Xylan is a polysaccharide present in grains, cereals and angiosperm plants that is specifically degraded on colon region, by the microbiota. An original process consisting in a water-in-water emulsion of xylan in presence of PEG followed by a crosslinking phase using trisodium trimetaphosphate has been developed, making possible the production of xylan-based biocompatible micro- and nanospheres ranging from 380 nm to 4.5 μm, depending on the parameters in the process. This eco-friendly process is free of harmful solvents and has potential application for the delivery of AmB at the colonic level.

Les S-nitrosothiols (RSNO) comme le S-nitrosoglutathion (GSNO) sont des donneurs de monoxyde d’azote (NO) prometteurs pour le traitement des maladies cardiovasculaires. Cependant, ce sont des candidats médicaments peu stables. Précédemment, des nanoparticules chargées en GSNO (GSNO-NP) ont été incluses dans une matrice d’alginate/chitosan. Les particules composites ainsi produites avaient une bonne encapsulation et une libération prolongée de GSNO. De plus, leur administration orale à des rats produisait un stock de NO au niveau de la paroi de l’aorte. Elles avaient cependant plusieurs limitations : préparation et caractérisation longues, manque de stabilité et de reproductibilité. Ce travail avait donc trois objectifs : (1) déterminer le mécanisme d’absorption intestinale des RSNO non formulés ; (2) évaluer la capacité des RSNO non formulés à créer un stock vasculaire de NO ; 3) optimiser la formulation de GSNO. Nous avons montré, dans un modèle in vitro de barrière intestinale, que la perméabilité intestinale de GSNO, S-nitroso-N-acétylcystéine (NACNO) et S-nitroso-N-acetylpénicillamine (SNAP) se fait par un mécanisme passif, principalement par voie transcellulaire (également paracellulaire pour SNAP), avec une perméabilité moyenne. Après avoir traversé la barrière intestinale, les RSNO atteindront les vaisseaux sanguins. Pour comparer leur capacité à former un stock vasculaire de NO dans des aortes (avec endothélium intact ou retiré), nous avons quantifié le stock, vérifié sa biodisponibilité pour la vasorelaxation et évalué son impact sur une vasoconstriction induite par la phénylephrine (PHE). L’incubation des aortes avec les RSNO augmente le stock basal de NO par un facteur trois à cinq. Ce stock est mobilisable pour induire la vasorelaxation et efficace pour diminuer la réactivité vasculaire à la PHE (NACNO>GSNO = SNAP), seulement dans les aortes dont l’endothélium a été retiré. Comme la perméabilité intestinale des RSNO est moyenne, l’intégration du GSNO dans une formulation appropriée est nécessaire. Vu l’impossibilité de résoudre les problèmes liés aux particules composites, le protocole de production des GSNO-NP a été modifié pour produire des microparticules (deux types selon l’état liquide ou solide de GSNO dans la phase interne de l’émulsion). Les deux types de microparticules avaient une libération de GSNO ralentie par rapport aux GSNO-NP. Les nano- comme les micro-particules ont pu être stabilisées par lyophilisation, et amélioraient la perméabilité intestinale de GSNO (jusqu’à une forte perméabilité avec les microparticules). Par conséquent, une administration orale de nano/microparticules chargées en GSNO/RSNO pourrait représenter une nouvelle approche thérapeutique pour les maladies cardiovasculaires. / S-nitrosothiols (RSNOs) such as S-nitrosoglutathione (GSNO) are promising nitric oxide (NO) donors for cardiovascular diseases treatment. However, they are poorly stable drug candidates. In previous studies, GSNO-loaded nanoparticles (GSNO-NP) were embedded into an alginate/chitosan matrix. Resulting nanocomposite particles showed high encapsulation and sustained release of GSNO, and led to the formation of a NO store in the wall of aorta after a single oral administration to rats. However, these nanocomposite particles have several limitations such as time-consuming preparation, lack of both stability and reproducibility. This thesis work aimed at: 1) Elucidate the mechanism of free RSNOs intestinal absorption; 2) Evaluate ability of free RSNOs to form a vascular NO store; 3) Optimize the GSNO formulation. In this study, we showed that the intestinal permeability (in vitro model of intestinal barrier) of GSNO, S-nitroso-N-acetylcysteine (NACNO) and S-nitroso-N-acetylpenicillamine (SNAP) was a passive diffusion, following the transcellular pathway (and also the paracellular way for SNAP) and belonging to the medium permeability class. After crossing the intestinal barrier, RSNOs will reach the vasculature. In order to compare the ability of free RSNOs to form a vascular store of NO either in endothelium-intact or endothelium-removed aortae, we quantified the store, verified its bioavailability for vasorelaxation and evaluated its impact on phenylephrine (PHE)-induced vasoconstriction. Incubation with RSNOs increased the basal NO store three to five times. This store is still bioavailable to induce vasorelaxation and efficient to induce vascular hyporeactivity to PHE (NACNO> GSNO = SNAP) only in endothelium-removed aortae. As intestinal permeability of RSNOs was in the medium class, the integration of GSNO into an appropriate delivery system is essential. Limitations of previously developed nanocomposites particles were impossible to bypass so the production process of GSNO-NP was modified (liquid or solid GSNO in the internal phase of the emulsion) to produce microparticles. Both kinds of microparticles exhibited a slower release of GSNO than GSNO-NP. Nano-and micro-particles were stable after lyophilization and presented an enhancement of GSNO intestinal permeability (up to high permeability class for microparticles). Thus, oral administration of GSNO/RSNO loaded nano/micro particles seems to be a promising avenue for the treatment of cardiovascular diseases.

Contexte : La malnutrition aiguë sévère (MAS) est un problème majeur de santé publique dans lemonde et affecte 17 millions d’enfants âgés de moins de 5 ans. La MAS induit une perte de poidsrapide, souvent associée à une dysfonction entérique environnementale (DEE). La DEE se caractérisepar une augmentation de l’inflammation, de la perméabilité intestinale, une diminution de la taille des villosités et de l’absorption des nutriments. La DEE peut ainsi limiter l’efficacité des protocolesde stabilisation et de re-nutrition chez l’enfant dénutri.L’objectif de cette thèse a été de développer un modèle de dénutrition avec entéropathie pour évaluer des laits thérapeutiques enrichis en nutriments ciblant la fonction de barrière intestinale.Résultats : Lors de la phase de développement du modèle, plusieurs approches ont été testées comme la restriction calorique, le régime hypoprotéiné, l’utilisation de lipopolysaccharides et de l’indométacine. Seule la combinaison d’un gavage quotidien d’indométacine pendant une semaine chez des souris dénutries par un régime pauvre en protéines a permis de développer un retard de croissance associé à une entéropathie. Suite à la validation de ce modèle, nous avons évalué la supplémentation du lait thérapeutique F-75 avec de la glutamine, de la leucine, de la gomme arabique et des levures séléniées. La glutamine et la leucine améliorent la fonction de barrière intestinale. Dans nos conditions expérimentales, l’enrichissement du lait thérapeutique avec la glutamine et la leucine combinés a eu des effets limités sur la fonction de barrière. La gomme arabique et les levures séléniées ont des propriétés prébiotiques et probiotiques et exercent des effets bénéfiques sur la barrière intestinale. L’enrichissement du lait thérapeutique avec l’association de ces deux composés permet d’inhiber l’inflammation intestinale et d’augmenter l’abondance de bactéries bénéfiques comme Faecalibacterium prausnitzii.Conclusion : Les travaux réalisés au cours de cette thèse ont permis de développer un nouveau modèle de dénutrition avec entéropathie. Le lait thérapeutique enrichi en gomme arabique et levures séléniées exerce des effets bénéfiques sur la fonction de barrière intestinale dans notre modèle. / Background : Severe acute malnutrition (SAM) is a global health issue affecting 17 million children under the age of 5. SAM induces rapid weight loss and is often associated with environmental enteric dysfunction (EED). EED is characterized by intestinal hyperpermeability and inflammation, villus blunting and nutrient malabsorption. EED might, therefore, limit stabilization and re-nutrition protocol efficacy. Objectives : This thesis aimed to develop an undernutrition model with enteropathy to evaluate the effect of a therapeutic milk enriched with nutrients on gut barrier function. Results : During preclinical model development, several approaches were tested: calorie restriction, low-protein diet, use of lipopolysaccharides and indomethacin. Only daily indomethacin gavage during one week in protein-energy undernourished mice induced growth faltering associated with enteropathy. After preclinical model validation, we evaluated the effect of therapeutic milk supplemented with glutamine, leucine, gum arabic and/or selenium-enriched yeast on gut barrier function. Glutamine and leucine induce beneficial effects on gut barrier function. In ourexperimental conditions, therapeutic milk enriched with a combination of glutamine and leucine had a limited impact on this parameter. Gum arabic and selenium-enriched yeasts have prebiotic and probiotic properties on gut barrier function. Therapeutic milk supplemented with gum arabic and selenium-enriched yeast inhibited intestinal inflammation and enhanced specific bacteria abundance such as Faecalibacterium prausnitzii.Conclusion : The studies conducted during this thesis permitted to develop a new model of undernutrition with enteropathy. Therapeutic milk enriched with arabic gum and selenium-enriched yeast triggered beneficial effects on gut barrier function in our preclinical model.

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The emerging evidence on the interconnectedness between the gut microbiome and host metabolism has led to a paradigm shift in the study of metabolic diseases such as obesity and type 2 diabetes with implications on both underlying pathophysiology and potential treatment. Mounting preclinical and clinical evidence of gut microbiota shifts, increased intestinal permeability in metabolic disease, and the critical positioning of the intestinal barrier at the interface between environment and internal milieu have led to the rekindling of the “leaky gut” concept. Although increased circulation of surrogate markers and directly measurable intestinal permeability have been linked to increased systemic inflammation in metabolic disease, mechanistic models behind this phenomenon are underdeveloped. Given repeated observations of microorganisms in several tissues with congruent phylogenetic findings, we review current evidence on these unanticipated niches, focusing specifically on the interaction between gut permeability and intestinal as well as extra-intestinal bacteria and their joint contributions to systemic inflammation and metabolism. We further address limitations of current studies and suggest strategies drawing on standard techniques for permeability measurement, recent advancements in microbial culture independent techniques and computational methodologies to robustly develop these concepts, which may be of considerable value for the development of prevention and treatment strategies.

Bovine milk-derived extracellular vesicles (EVs) hold promises as oral drug delivery systems. Since EV bioavailability studies are difficult to compare, key factors regarding EV uptake and intestinal permeability remain little understood. This work aims to critically study uptake and transport properties of milk-derived EVs across the intestinal barrier in vitro by standardization approaches. Therefore, uptake properties were directly compared to liposomes in intestinal Caco-2 cells. Reliable staining results were obtained by the choice of three distinct EV labeling sites, while non-specific dye transfer and excess dye removal were carefully controlled. A novel fluorescence correction factor was implemented to account for different labelling efficiencies. Both EV and liposome uptake occurred mainly energy dependent with the neonatal Fc receptor (FcRn) providing an exclusive active pathway for EVs. Confocal microscopy revealed higher internalization of EVs whereas liposomes rather remained attached to the cell surface. Internalization could be improved when changing the liposomal formulation to resemble the EV lipid composition. In a Caco-2/HT29-MTX co-culture liposomes and EVs showed partial mucus penetration. For transport studies across Caco-2 monolayers we further established a standardized protocol considering the distinct requirements for EVs. Especially insert pore sizes were systematically compared with 3 µm inserts found obligatory. Obtained apparent permeability coefficients (Papp) reflecting the transport rate will allow for better comparison of future bioavailability testing.

L'interleukine IL-18 (IL-18), un membre de la famille de l’IL-1, est une cytokine pro-inflammatoire multifonctionnelle. Elle est produite par les monocytes, les macrophages, les cellules dendritiques, les cellules épithéliales, les kératinocytes et le cortex surrénal dans le corps humain. Cette cytokine est d'abord produite comme une protéine précurseure inactive, qui est par la suite clivée en une forme mature par la caspase-1 activée. La caspase, en elle-même, existe comme précurseur inactif dans les cellules humaines et requiert l'assemblage d'inflammasomes pour son activation. L'IL-18 pour joue un rôle clé dans la médiation des conditions inflammatoires. Notre laboratoire et d'autres ont montré que l'infection par le VIH est accompagnée d'une augmentation des taux circulants d'IL-18 avec une diminution des niveaux de son antagoniste, l'interleukine-18 binding protein (IL-18BP). Dans cette thèse, nous démontrons pour que l'IL-18 est également produite et sécrétée par les plaquettes humaines lors de leur activation. Les plaquettes contiennent des composants de l'inflammasome. Ils assemblent et activent la caspase-1, qui ensuite traite le précurseur de l'IL-18 dans sa forme mature au cours du processus d'activation des plaquettes. La cytokine est synthétisée de novo lors de l'activation des plaquettes. Contrairement à l'IL-18, les plaquettes expriment constitutivement l’IL-18BP, et la libèrent de manière constitutive, ainsi que lors de l'activation. L'IL-18 et l'IL-18BP sont colocalisés avec CD63, un marqueur pour les granules α des plaquettes. L'IL-18 libéré des plaquettes constitue la source principale de cette cytokine dans la circulation humaine chez les individus sains. Nous avons identifié des concentrations faibles de cette cytokine dans les lysats de plaquettes chez les individus infectés par le VIH par rapport à ceux en santé. D'autre part, les concentrations ont été augmentées dans le sérum et le plasma pauvre en plaquettes chez les individus infectés. Des résultats similaires ont été obtenus avec l'IL-18BP dans les lysats de plaquettes d'individus sains et infectés par le VIH. Cependant, des quantités plus faibles de cet antagoniste ont été trouvées dans le sérum et le plasma pauvre en plaquettes d'individus infectés par le VIH par rapport à ceux en santé. Nos résultats ont des implications importantes pour les maladies inflammatoires chroniques dans laquelle une activité accrue de l'IL-18 joue un rôle pathogène. Le VIH est également accompagné par une inflammation intestinale et une diminution de l'intégrité intestinale, mesurée par la réparation de la muqueuse, la régénération et la perméabilité. Cependant, on en sait peu sur la relation entre le niveau élevé de l'IL-18 associé à l'infection au VIH et la perméabilité intestinale: ceci n'a jamais été étudié. Dans cette thèse, nous démontrons le rôle du virus et sa protéine Tat à augmenter la production d'IL-18 chez deux lignées de cellules épithéliales intestinales (HT29 et Caco2) ainsi qu'une diminution de l'IL-18BP. L'IL-18 induit une hyperperméabilité de la barrière épithéliale en perturbant à la fois les jonctions serrées et adhérentes, et ce, en modulant l'expression et la distribution de l'occludine, de claudine-2 et de la bêta-caténine. Une désorganisation de l'actine F a également été observée dans les cellules lors de l'incubation avec l'IL-18. Les mêmes observations ont été faites avec la protéine Tat du VIH-1. Après une incubation prolongée, l'IL-18 a causé la mort des cellules intestinales et induit l'apoptose par l'activation de la caspase-1 et la caspase-3. Fait intéressant, les taux plasmatiques de lipopolysaccharides chez trois catégories différentes de patients au VIH (ART-naïf, ART-traitée et contrôleurs élite) sont en corrélation avec les niveaux plasmatiques de l'IL-18. Enfin, nous avons étudié la voie de signalisation à travers laquelle l'IL-18 induit une perméabilité intestinale accrue. En bref, nos études identifient les plaquettes comme une source importante d'IL-18, et leur activation lors d'une infection à VIH contribue à des concentrations accrues de cette cytokine. Le virus entraine également l'augmentation de la production de cytokines par les cellules épithéliales intestinales. L'activité biologique accrue de ces cytokines contribue à la pathogenèse du sida en augmentant la perméabilité intestinale et en causant la mort des cellules intestinales. L'IL-18 pourrait servir de cible moléculaire pour retarder la progression du sida et réduire l'inflammation chronique dans un stade précoce d'une infection à VIH. / Interleukin IL-18 (IL-18), a member of the IL-1 family, is a multifunctional pro-inflammatory cytokine. It is known to be produced by monocytes, macrophages, dendritic cells, keratinocytes and the adrenal cortex in the human body. This cytokine is produced as an inactive precursor protein, which is cleaved into mature form by activated caspase-1. The caspase itself exists as an inactive precursor in human cells and requires inflammasomes assembly for its activation. IL-18 has been shown to play a key role in mediating different inflammatory conditions. Our laboratory and others have shown that HIV infection is accompanied with increased circulating levels of IL-18 along with decreased levels of its antagonist IL-18 Binding Protein (IL-18BP). In this thesis, we show that IL-18 is also produced and secreted by human platelets upon activation. The platelets also contain components of the inflammasome. They assemble and activate caspase-1 and process the precursor IL-18 into its mature form during the platelet activation process. The cytokine is synthesized in platelets de novo upon activation. Contrary to IL-18, the platelets constitutively express pre-formed IL-18BP, and release it constitutively as well as upon activation. Both IL-18 and IL-18BP colocalized with CD63, a marker for the platelet α granules. Platelet-released IL-18 constitutes the main source of this cytokine in the human circulation in healthy individuals. We found decreased amounts of this cytokine in the platelet lysates in HIV-infected individuals as compared to the healthy ones. On the other hand, its concentrations were increased in the serum and platelet-poor plasma in infected individuals. Similar findings were obtained with IL-18BP in platelet lysates from healthy and HIV-infected individuals. However, lower amounts of this IL-18 antagonist were found in the serum and platelet-poor plasma from HIV-infected individuals compared with the healthy ones. Our findings have important implications for chronic inflammatory disease conditions in which increased IL-18 activities play a pathogenic role. HIV is also accompanied by intestinal inflammation and decreased intestinal integrity as measured by mucosal repair, regeneration and permeability. However, little is known concerning the relation between high level of IL-18 associated to HIV infection and intestinal permeability. In this thesis, we demonstrate the role of HIV and its protein Tat in increasing IL-18 production in two intestinal epithelial cell lines (HT29 and Caco2) and decreasing IL-18BP. IL-18 induces epithelial barrier hyperpermeability by disrupting both tight and adherens Junctions by modulating expression and distribution of occludin, claudin-2 and beta-catenin. Disorganization of F-actin was also observed within the cells upon incubation with treated by IL-18. Upon prolonged incubation, IL-18 caused intestinal cells death and induced apoptosis by activating caspase-1 and caspase-3. Interestingly, the plasma levels of lipopolysaccharide in three different categories of HIV-infected patients (ART-naïve, ART-treated and Elite controllers) correlated with their IL-18 plasma levels. Finally we investigated the signaling pathway through which IL-18 induces increased intestinal permeability. Briefly, our studies identified platelets as an important source of IL-18, and their activation in HIV infection contributes to enhanced concentrations of the cytokine. The virus also induces increased production of the cytokine from intestinal epithelial cells. Increased biological activities of the cytokine contribute towards AIDS pathogenesis by increasing intestinal permeability and causing death of intestinal cells. The cytokine may serve as a molecular target for delaying AIDS progression and reducing low-grade chronic inflammation in HIV infection.