Yes / Governance perspective plays a vital role in the success of Quality Management in Healthcare Environment (QMHE). In fact QMHE has adopted and applied different quality tools and models in recent times, with some even developing their own quality‐based initiatives. This paper will present an original and novel approach (KB/ES coupled with GAP analysis) to evaluate the effectiveness of governance body in QMHE. The KB system inserts GAP for benchmarking and evaluating the current practices with the desired ones. The KB system will benchmark the current position of governance perspective as part of QMHE with the ideal benchmark one. The results will help healthcare practitioners to improve the governance boy’s gaps and take the correct decisions. / Sultan Qaboos University, Oman

No / A novel function of NF-KB in the development of most ectodermal appendages, including two types of murine pelage hair follicles, was detected in a mouse model with suppressed NF-KB activity (CI¿B¿¿N). However, the developmental processes regulated by NF-¿B in hair follicles has remained unknown. Furthermore, the similarity between the phenotypes of CI¿BA¿N mice and mice deficient in Eda A1 (tabby) or its receptor EdaR (downless) raised the issue of whether in vivo NF-KB regulates or is regulated by these novel TNF family members. We now demonstrate that epidermal NF-KB activity is first observed in placodes of primary guard hair follicles at day E14.5, and that in vivo NF-KB signalling is activated downstream of Eda A1 and EdaR. Importantly, ectopic signals which activate NF-KB can also stimulate guard hair placode formation, suggesting a crucial role for NF-KB in placode development. In downless and CI¿B¿¿N mice, placodes start to develop, but rapidly abort in the absence of EdaR/NF-KB signalling. We show that NF-KB activation is essential for induction of Shh and cyclin D1 expression and subsequent placode down growth. However, cyclin D1 induction appears to be indirectly regulated by NF-KB, probably via Shh and Wnt. The strongly decreased number of hair follicles observed in CI¿B¿¿N mice compared with tabby mice, indicates that additional signals, such as TROY, must regulate NF-KB activity in specific hair follicle subtypes.

Yes / Designing and implementing Performance Measurement System (PMS) is an integral part of management control systems. This paper presents an original and novel approach to designing and benchmarking of PMSs for a manufacturing environment through a hybrid framework which overcomes the shortcomings of earlier models. A detailed review was taken of previous models and their limitations were identified. The present hybrid PMS model seeks to improve the earlier research models by the following novel approach: implementation of a Knowledge Based (KB) expert system, Gauging Absences of Pre-requisite (GAP) analysis and Analytic Hierarchy Process (AHP) methodology in an integrated KBPMS. The paper has shown that the present hybrid (KB-AHP-GAP) approach to developing a KBPMS model is a realistic methodology. The combination of the KB-AHP-GAP approach allows detailed benchmarking of the PMS existing within a manufacturing organisation. Furthermore, this approach can assist in identifying and prioritising the key decisions that need to be actioned to overcome the existing PMS shortcomings.

No description available.

Les kinases régulées par les signaux extracellulaires (ERK1/2) régulent une multitude de processus cellulaires, incluant la prolifération, la survie et la différenciation. Ces kinases représentent l’élément terminal de la voie ERK/MAPK, laquelle est activée dans près de 30% de tous les cancers humains et donc généralement perçue comme étant un effecteur critique de la progression tumorale. Cependant, une accumulation d’observations suggèrent que les kinases ERK pourraient également induire la suppression tumorale. Le but premier de cette thèse est de démontrer comment la signalisation par ERK peut contribuer à la suppression tumorale et de concilier les mécanismes impliqués avec son rôle dans la progression du cancer. Puisque nos travaux ont une incidence sur les bénéfices attendus de certaines thérapies actuellement en développement, le deuxième objectif de la thèse est de proposer de nouvelles stratégies thérapeutiques pour combattre le cancer. Nous avons démontré qu’une hyperactivation des kinases ERK induit la sénescence cellulaire. Le mécanisme implique la dégradation sélective et dépendante du protéasome de nombreuses protéines, ce que nous avons nommé le SAPD (Senescence-Associated Protein Degradation). Ce processus cible des protéines requises pour différentes fonctions cellulaires, incluant la progression du cycle cellulaire, les fonctions mitochondriales et la biogenèse des ribosomes. Ensuite, nos résultats montrent qu’en plus d’inhiber l’établissement de la sénescence, une diminution de la signalisation par les kinases ERK favorise la reprogrammation cellulaire, laquelle permet aux cellules précancéreuses de développer leur tumorigénicité et aux cellules cancéreuses d’acquérir des propriétés attribuables aux cellules souches. Ces observations suggèrent que les mécanismes qui inhibent la voie ERK/MAPK pourraient favoriser l’initiation du cancer, la formation de métastases et la résistance à diverses thérapies. Enfin, nous avons démontré que la metformine, utilisée pour le traitement du diabète, inhibe le facteur de transcription NF-kB. Ce dernier joue un rôle central dans la reprogrammation cellulaire et dans la production de cytokines pro-inflammatoires nocives par les cellules sénescentes. Ainsi, nous émettons l’hypothèse que la metformine pourrait être utilisée en combinaison avec certaines thérapies afin d’éviter les effets secondaires tant d’une inhibition des kinases ERK que d’une hyperactivation. Globalement, les résultats présentés démontrent que l’effet de la voie ERK/MAPK dépend de la force de son activation. Alors qu’une activation modérée peut contribuer à la prolifération de la plupart des cellules, une forte activation induit la sénescence tandis qu’au contraire, une faible activation favorise la reprogrammation des cellules cancéreuses et donc une augmentation de l’agressivité de la tumeur. Cette polyvalence de la voie suggère une certaine prudence face à l’usage des inhibiteurs de la voie ERK/MAPK. Cependant, elle nous motive à travailler au développement de nouvelles stratégies thérapeutiques, lesquelles pourraient inclure la metformine. / The Extracellular Signal-Regulated Kinases (ERK1/2) regulate multiple cellular processes such as proliferation, survival and differentiation. These kinases are the last component of the ERK/MAPK pathway, which is activated in about 30% of all human cancers. Therefore, current thinking proposes that the ERK/MAPK pathway is a critical mediator of tumor progression. However, a steadily growing number of observations suggest that ERK kinases could trigger tumor suppression as well. The first aim of this thesis is to determine how ERK signaling triggers tumor suppression and to try to reconcile these mechanisms with its putative contribution to tumor progression. Since our work has a profound impact on the value of some therapies currently in development, the second aim of the thesis is to propose new strategies to fight cancer. We found that hyperactivation of the ERK kinases induces cellular senescence. Mechanistically, this involves selective proteasome-dependent protein degradation. This “Senescence-Associated Protein Degradation” (SAPD) targets proteins required for several cellular functions, including cell cycle progression, mitochondrial functions and ribosome biogenesis. Furthermore, our results showed that downregulation of ERK signaling not only inhibits the establishment of senescence but promotes cellular reprogramming, thereby allowing precancerous cells to gain tumorigenicity and cancer cells to acquire stem cell-like properties. These results suggest that mechanisms downregulating the ERK/MAPK pathway could promote cancer initiation, metastasis and resistance to multiple therapies. Finally, we demonstrated that the antidiabetic drug metformin targets the transcription factor NF-kB. The latter plays a central role in reprogramming, but also in the generation of deleterious pro-inflammatory cytokines by senescent cells. Hence, we suggest that metformin could be used in combination with other therapies to avoid the side effects of either downregulating or overactivating ERK signaling. Taken together, the results presented in this thesis demonstrate that the outcome of the ERK/MAPK pathway activity depends on signaling strength. While a moderate activation of the pathway may contribute to cell proliferation, a strong activation induces senescence and, conversely, a low activation promotes cancer cell reprogramming. This versatility of the pathway suggests caution with the use of ERK/MAPK pathway inhibitors, but motivates us to develop new therapeutic strategies, which could include metformin.

Dans cette thèse nous avons étudié quatre aspects fondamentaux de l’interaction ADN-protéine, notamment : l’affinité, la spécificité, l’accessibilité et la cinétique. En particulier, nous avons adressé les questions suivantes : comment un dimer du facteur de transcription NF-kB reconnait spécifiquement sa séquence d’ADN-cible, quelle est la rapidité de ces interactions, comment NF-kB interagit avec son site de fixation dans le contexte de la chromatine? Récemment, la spécificité de l’interaction NF-kB – ADN a reçu une attention particulière après l’observation que NF-kB peut se lier à des séquences qui n’entrent pas dans la classification de ses motifs « consensus ». Nous avons étudié la spécificité d’interaction de sept de ces motifs avec quatre dimers de NF-kB. Nos résultats montrent que le homo-dimer p50 sont les moins discriminatives et peuvent s’associer spécifiquement avec ces sept séquences. Par contre, les homo-dimers RelA se sont révélés hautement discriminatives ne pouvant pas s’associer spécifiquement avec ces séquences. Pour mesurer l’affinité de l’interaction nous avons utilisés deux méthodes distinctes : le traditionnel gel de retard (EMSA) et une nouvelle technique – « l’empreinte » au laser UV. Nos résultats montrent que le deuxième approche est plus approprié pour la mesure des constantes spécifiques de dissociation.Pour étudier la dynamique de l’interaction NF-kB – ADN, nous avons couplé l’empreinte au laser UV avec un appareil de mélange-rapide à façon. Cette combinaison nous a permis d’atteindre une résolution spatiale d’un nucléotide et temporaire de quelques millisecondes. Nous avons montré que l’homo-dimer p50 s’associe avec sa séquence-cible (MHC) H2 en suivant une cinétique à 2 pas. Le premier, de durée ~100 ms, reflète une reconnaissance initiale rapide, tandis que le deuxième, de durée ~1s, reflète une stabilisation lente du complexe. Nos expériences suggèrent aussi que les séquences voisines du site de reconnaissance jouent aussi un rôle dans la stabilisation du complexe.Finalement, nous avons étudié aussi l’accessibilité du nucléosome pour le NF-kB. Nos données in vitro montre que l’invasion spécifique de l’ADN à l’intérieure du nucléosome par NF-kB nécessite une perturbation majeure de la structure du nucléosome telle que l’éviction d’au moins un dimer d’histones H2A-H2B. / In this thesis we have attempted to study four basic aspects of DNA-protein interactions: Affinity, specificity, accessibility and kinetics. With NF-kB as our model transcription factor, we wanted to investigate how a particular dimer recognizes a specific binding sequence? How fast are these interactions? And finally, how does the NF-kB interact with it binding site in the chromatin context? Specificity of NF-kB-DNA interactions has recently come into focus after it was shown that these dimers can bind to the sequences which do not fall into the NF-kB general consensus motif. We studied seven such sequences for their specificity for four NF-kB dimers. Our results show that p50 homodimers are least discriminative and can bind specifically to all these sequences. While as, RelA homodimers were highly discriminative and did not bind to most of these nontraditional sequences. We used two different methods to measure binding affinities: traditional gel mobility shift assay (EMSA) and a novel technique called as UV laser footprinting. Our results show that UV laser footprinting is the better method to determine the binding constants.For studying the dynamics of NF-kB-DNA binding, we combined UV laser footprinting with stopped flow device. This combination, not only give us one base pair resolution but also milli-second time resolution. Using p50 homodimers as a model transcription factor, we showed that the binding of this factor follows a two-step mechanism. First step involves the fast recognition of the sequence and second step follows a slower kinetics most likely for the stabilization of the complex. Our experiments suggest that flanking sequences play a role in the recognition and stabilization process of the complex formation.Finally, we also studied the accessibility of nucleosomes to NF-kB. Our in vitro data sheds light on the in vivo requirements for the alterations in chromatin structure necessary for the productive binding of NF-kB. These include either a removal of H2A-H2B dimers from the nucleosome and/or chromatin remodeler induced relocation of the histone octamer.Our data sheds light on the in vivo requirements for the alterations in chromatin structure necessary for the productive binding of NF-kB. We hypothesize that some factors like PU.1 might be able to target the chromatin remodeling/dimer eviction machinery to particular nucleosomes and lead to productive binding of NF-kB.

Le genre Entérovirus (EV) (famille des picornaviridae) est composé de petits virus à ARN non enveloppées classés en 12 espèces dont 7 sont pathogènes pour l'homme : 4 espèces (A-D) d'enterovirus humains (HEV) et trois espèces (A-C) de rhinovirus humains (HRV). Dans le genre enterovirus, les HRV et HEV sont reconnus comme des pathogènes respiratoires fréquemment responsables d'infections des voies aériennes supérieures et inférieures chez l'enfant et l'adulte. Entre 2009 et 2012, de nouveaux génotypes d'HEV à tropisme respiratoire (HEV-68, 104, 109, et le CVA-21) ont été décrits dans des cas isolés ou épidémiques démontrant la capacité des espèces A à D à induire des infections respiratoires basses humaines.La première phase de ce travail de thèse a eu pour objectifs de préciser le rôle étiologique des infections à EVs; d'identifier les génotypes potentiellement responsables des pathologies respiratoires pédiatriques nécessitant une hospitalisation, mais aussi d'analyser et de comparer les caractéristiques cliniques et épidémiologiques entre les différents groupes de génotypes identifiés. Nous avons réalisé une étude rétrospective sur une cohorte de 309 enfants hospitalisés au CHU de Reims entre septembre 2009 et juin 2010 pour une infection respiratoire aiguë non documentée microbiologiquement par la réalisation des tests virologiques et bactériologiques conventionnels. Nos résultats montrent que le génome des EVs (HEV et HRV) est retrouvé dans 60,5% (187/309) des aspirations naso-pharyngées des enfants hospitalisés, distinguant 15 infections à HEV (dont 10 souches HEV-68) et 172 à HRV. Les cas de bronchiolite et d'exacerbation de l'asthme (133/187) positifs pour la détection des souches HEV (12/133) étaient plus âgés (P=0,003) et plus fréquemment associés avec une détresse respiratoire (P=0,01) et un besoin en oxygénothérapie au moment de leur hospitalisation (P=0,01) que les cas infectés par un HRV. De plus, nous avons mis en évidence pour la première fois en France la circulation épidémique de souches d'HEV-68 (10/15 des souches d'HEV détectées) isolées au cours de l'automne 2009 chez des enfants hospitalisés pour une infection respiratoire aiguë. Nos résultats fournissent de nouvelles informations sur ce génotype ré-émergent qui semble présenter un tropisme respiratoire spécifique des voies respiratoires inférieures.La seconde phase de ce travail de thèse s'est intéressée à étudier les mécanismes liés au développent des processus inflammatoires de la muqueuse au cours de l'infection des voies respiratoires basses par HEV. A l'aide d'un modèle in vitro de cellules respiratoires humaines (A549) infectées par HEV-B (CVB5, Mitchell), nous avons observé que l'infection réplicative des HEV dans les cellules A549 induisait une augmentation dose et temps-dépendante des ARNm, et des protéines IL-8, MCP-1 et RANTES.En conclusion, nos résultats obtenus à partir de prélèvements respiratoires dans le cadre de notre étude de cohorte suggèrent que les EVs représentent une cause étiologique fréquente d'infections respiratoires basses chez l'enfant avec une pathogénicité supérieure des HEVs (principalement dans notre étude HEV-68) par rapport aux souches HRVs. De plus, nos résultats obtenus à partir d'expérimentation in vitro démontrent que les HEVs du groupe B sont capables d'induire au cours de l'infection des cellules épithéliales alvéolaires humaines (A459) une sécrétion spécifique d'IL-8, MCP-1 et RANTES. La production de ces chimiokines correspond à une réponse innée de la cellule épithéliale humaine infectée par les HEVs: nous avons montré pour la première fois que ce mécanisme était en partie régulé par l'activation de la voie non canonique de NF-kB via la protéine NIK dans la cellule épithéliale respiratoire humaine. / The Enterovirus (EV) genus (picornaviridae family) consists of small non-enveloped positive RNA viruses classified in 12 species of which 7 are pathogenic for humans: four species (A-D) of human enterovirus (HEV) and three species (A-C) of human rhinovirus (HRV). Among the EV genus, HEV and HRV are recognized as leading causes of acute respiratory tract infections (ARTIs) in human. Between 2009 and 2012, new HEV respiratory genotypes (e. g. HEV-68, 104, 109, 117 and CVA-21) have been described in isolated cases or outbreaks supporting the ability HEV species A to D to induce lower respiratory tract infections. This supports the hypothesis of an underestimation of the prevalence and etiological role of EVs in pediatric acute respiratory tract infections (ARTIs) (more specifically bronchitis, bronchiolitis and asthma exacerbation).To assess the etiological role and the clinical characteristics of HRV and HEV infections in pediatric patients hospitalized for ARTIs, we conducted a retrospective study of 309 hospitalized pediatric patients in University Hospital Centre of Reims with microbiologically unexplained ARTIs from September 2009 to June 2010. Among the 309 ARTIs, 15 HEV and 172 HRV strains were identified. Among bronchiolitis and asthma exacerbation cases (n=133), HEV infected cases were older (P=0.003) and were more frequently associated with a respiratory distress (P=0.01) and a need for oxygen therapy at the time of admission (P=0.01) than cases infected by HRV strains. Interestingly, during this retrospective study, we provided evidence that during the fall 2009 in France, HEV-D68 strains were responsible for a low proportion of pediatric cases hospitalized for acute airway diseases including bronchiolitis and asthma exacerbation.To identify the mechanisms that can regulate the development of airway mucosa inflammation during HEV respiratory lower tract infections, we investigated the production of chemokines by HEV infected human alveolar epithelial cells (A549). Using in vitro model A549 cells infected by HEV-B (CVB5, Mitchell), we demonstrated that HEV-B strains isolated from upper respiratory tract of child with bronchiolitis could actively replicate in various human airway epithelial cells, and that this replicative infection induced specific dose and time-dependent increases in mRNA and protein secretion of IL-8, MCP-1 and RANTES, but not of all other CC and CXC human chemokines tested. The protein secretion of these chemokines appeared to be significantly increased at 48 and 72 hours post-infection in culture treated by low-doses of IFN-γ in comparison with mock-infected cells (P <0.001), and was correlated to the viral replication activity. In second time, we explore the pathogenic mechanisms that can regulate inflammatory responses to HEV in lower respiratory airways. We show that HEV infection induced a time-dependent increase of NIK protein accumulation that peaks at 16 hours post-infection (H P-I). NIK protein accumulation mediated the processing of p100 in p52, which association with Rel B was evidenced in nuclear compartment between 16 and 48 H P-I.In conclusion, our findings indicate that EVs are a common cause of lower respiratory tract infections in pediatric patients with a potential higher pathogenicity of HEV strains (mainly HEV-68) by comparison to HRV strains. Moreover, our in vitro results demonstrated that HEV are capable to induce the release of specific chemokines (IL -8, MCP-1 and RANTES) by alveolar epithelial cells during a replicative infection. Finally, we demonstrated for the first time that this innate airway epithelial cell response against HEV infection was partly regulated by the activation of the non-canonical NF-kB via NIK protein.

Em estudos anteriores desenvolvidos por este grupo de pesquisa uma expressão mais elevada de alvos transcricionais e componentes da via NF-kB, bem como altos níveis de NOTCH1, foi identificada em células-tronco hematopoéticas (CTH) CD34+ de sangue de cordão umbilical (SCU) quando comparadas às CTH CD34+ de medula óssea (MO). Este grupo verificou ainda, por comparação das células CD34+ com as CD133+ (mais primitivas) que diversos fatores de transcrição (FT) envolvidos com o potencial de hemangioblasto, com a autorenovação das CTH, e com a diferenciação linfóide; como: RUNX1/AML1, GATA3, USF1, TAL1/SCL, HOXA9 e HOXB4 apresentaram-se mais expressos em células mais primitivas. A potencial participação das vias Notch e NF-kB na regulação destes FT tem importância conceitual e prática no entendimento da biologia das CTH, e dos processos envolvidos na diferenciação destas células. Com isto em vista, este projeto teve como objetivo, estudar o papel da via NF-kB e da via Notch na regulação destes FT. Para isso, um modelo experimental in vitro, de diferenciação de CTH CD34+ em linfócitos T, foi utilizado e a influência de fatores agonistas e inibidores farmacológicos destas vias, foram avaliados por citometria de fluxo e PCR em tempo real. Nossos resultados evidenciam o papel da via Notch na regulação transcricional de HOXB4 e GATA3 em células-tronco hematopoéticas CD34+ humanas, o que foi confirmado com base na expressão dos alvos diretos de Notch (HEY1 e HES1). Notamos ainda, que a expressão dos transcritos HES1, GATA3 e HOXB4 é prejudicada pela síntese protéica das CTH, uma vez que quando empregamos o prétratamento com a droga CHX há aumento da transcrição dos mesmos. Também podemos inferir que a ação do TNF- é positiva sobre esses transcritos, já que quando o utilizamos há elevação do nível de expressão desses transcritos, com exceção a HES1. Em relação ao cocultivo das CTH com as células estromais de camundongos, verificamos que apenas a linhagem OP9-DL1 detém a capacidade de promover a diferenciação celular T, e isso foi comprovado pelo surgimento de células comprometidas com a linhagem linfocítica T, através da presença dos marcadores de superfície específico CD7+ e CD1a+. Esses resultados auxiliarão na compreensão dos mecanismos moleculares de regulação transcricional envolvidos não apenas na diferenciação de linfócitos T, mas também na manutenção de um estado mais primitivo das CTH. Este conhecimento pode vir a contribuir com o desenvolvimento ou otimização de protocolos laboratoriais visando à expansão de CTH ou geração de células T para usos terapêuticos. / In previous studies by this research group a higher expression of transcriptional targets and components via NF-kB, as well as high levels of NOTCH1, was identified in hematopoietic stem cells (HSC) CD34 + cells from umbilical cord blood (UCB) compared to CD34 + hematopoietic stem cells from bone marrow (BM). This group also found, by comparing the CD34 + cells with CD133 + (more primitive) that several transcription factors (TF) involved in the potential of hemangioblast, with self-renewal of hematopoietic stem cells and to differentiated lymphocytic; as Runx1 / AML1, GATA3, USF1, TAL1/SCL, HOXB4 and HOXA9 were more expressed in more primitive cells. The potential involvement of Notch signaling pathways and NF-kB in the regulation of FT has conceptual and practical importance in understanding the biology of HSC, and the processes involved in differentiation of these cells. With this in mind, this project aimed to study the role of NF-kB pathway and Notch signaling in the regulation of FT. For this, an experimental model in vitro differentiation of CD34 + hematopoietic stem cells into T lymphocytes, was used and the influence of pharmacological agonists and inhibitors of these pathways were evaluated by flow cytometry and real-time PCR. Our results highlight the role of Notch signaling in the transcriptional regulation of GATA3 and HOXB4 in hematopoietic stem cells CD34 + human, which was confirmed based on the expression of direct targets of Notch (HES1 and HEY1). We also note that the expression of transcripts HES1, GATA3 and HOXB4 protein synthesis is hampered by the HSC, since when we use the pre-treatment with the drug there CHX increased transcription thereof. We can also infer that the action of TNF- is positive about these transcripts, since when we use it for raising the level of expression of these transcripts, except the HES1. In relation to the HSC coculture with stromal cells of mice, we found that only the line-DL1 Op9 has the ability to promote T cell differentiation, and this was evidenced by the appearance of cells committed to the T lymphocyte lineage, through the presence of specific surface markers CD7 + and CD1a +. These results will help understand the molecular mechanisms of transcriptional regulation involved not only in the differentiation of T lymphocytes, but also in maintaining a more primitive state of HSC. This knowledge may contribute to the development or optimization of laboratory protocols aimed at the expansion of HSC or generation of T cells for therapeutic use.

A tuberculose (TB) é um grave problema de saúde pública. Somente no ano de 2004, cerca de 9 milhões de pessoas desenvolveram TB ativa e mais de 2 milhões de pessoas morreram da doença. O desenvolvimento de novos modelos experimentais de TB seriam de grande utilidade para para elucidar mecanismos fisiopatológicos da doença e testar esquemas terapêuticos para a prevenção e contenção da doença. Além disso, o desenvolvimento de novas vacinas torna-se indispensável como ferramenta de prevenção e controle da TB. A TB no sistema nervoso central (SNC), assim como em outros tecidos do organismo, promove a ativação de células inflamatórias. No SNC a micróglia desempenha este papel, sendo capaz de produzir ou ser influenciada por mediadores solúveis. Vários mediadores estão envolvidos nos mecanismos moleculares decorrentes da infecção e inflamação causados pela TB, entre eles: NFB, iNOS e VEGF. A ativação do NFB, um fator de transcrição citoplasmático que sob estímulo migra para o núcleo celular, tem íntima relação com a indução da iNOS e de VEGF. A resistência intracelular a patógenos, inclusive ao Mycobacterium tuberculosis, parece estar associada a expressão de iNOS em macrófagos. O óxido nítrico (NO) tem papel importante na comunicação intercelular, estimulando a síntese de mediadores inflamatórios, como as citocinas, e regulando sua própria produção endógena. Estas citocinas por sua vez também podem induzir a atividade do NFB e a expressão da iNOS e VEGF. O VEGF é um potente ativador de permeabilidade vascular e de angiogênese, envolvido na ruptura da barreira hemato-encefálica. Neste estudo, mostramos a caracterização morfológica e imuno-histoquímica de um modelo murino de TB no SNC, com a indução da doença pela inoculação de BCG. Com este modelo experimental obtivemos importantes resultados que podem esclarecer mecanismos envolvidos na fisiopatologia da neuro-TB humana. A indução de meningite e tuberculomas foi possível através da inoculação de 104 cfu de BCG no cerebelo de camundongos, por estereotaxia, e esta indução foi dependente do tempo. A confirmação do diagnóstico foi feita pela detecção de bacilos álcool-ácido resistentes (BAAR), nas lesões tuberculosas. Observamos, ao longo do tempo (1 a 6 dias; 1, 2, 4 e 8 semanas) o recrutamento de diferentes populações gliais (micróglia e astrócitos) no sítio de injeção. Houve aumento de produção e ativação NFB nas lesões tuberculosas, caracterizada pela translocação da molécula do citoplasma para o núcleo celular. Houve expressão de iNOS restrita às lesões tuberculosas, além do aumento de expressão de VEGF nestas lesões. Além disso, camundongos imunizados com a vacina gênica hsp65, contra a TB, não expressam VEGF em suas lesões. Esta vacina parece conferir um efeito protetor em nosso modelo experimental, reduzindo a expressão de VEGF, e consequentemente reduzindo seu efeito angiogênico decorrente do processo inflamatório. O recrutamento glial, e a produção de mediadores solúveis (NFB, iNOS e VEGF) pelo hospedeiro, em resposta à invasão do patógeno no SNC, parecem estar envolvidos na fisiopatologia da neurotuberculose, como demonstrado neste modelo experimental. Nosso modelo permitirá investigar fatores possivelmente responsáveis pelo desenvolvimento e manutenção de lesões tuberculosas no SNC. O objetivo final seria elucidar a fisiopatologia desta grave doença e compreender eventos moleculares envolvidos na produção de lesões. O conhecimento gerado poderá permitir o delineamento de terapias específicas e efetivas. / Tuberculosis (TB) is a serious public health problem; in 2004, 9 million people developed active TB and the disease killed 2 million patients. Development of experimental models and new vaccines are essential both to elucidate physiopathological mechanisms and to control the disease. This infection in the central nervous system (CNS), as in other tissues of the organism, activates inflammatory cells. In CNS, this role is performed by the microglia, which is capable of producing or be influenced by soluble mediators. Several mediators are involved in the molecular mechanisms of the infection and inflammation by mycobacteria , such as NFB, iNOS and VEGF. NFB activation, a cytoplasmic transcriptional factor that migrates to the cellular nucleus under stimuli, is involved with the iNOS and VEGF induction of expression. The intracellular resistance to Mycobacterium tuberculosis has been associated with iNOS expression in macrophage cells. Nitric oxide (NO) is crucial in intercellular communication, modulating the synthesis of mediators of inflammation, such as cytokines, and modulation itself. These cytokines induces NFB activity, and induces iNOS and VEGF expression. VEGF is a potent activator of vascular permeability and of angiogenesis and it is a factor involved in the breakdown of the blood brain-barrier in tuberculous meningitis. In this study, we showed the morphologic and immunohistochemistry characterization of an experimental model of TB in the CNS, with inoculation of BCG in mice. In this model we elicited important outcome that can elucidate mechanisms involved in the physiopathology of human neuron-TB. Induction of meningitis and tuberculomas were possible with stereotaxic inoculation of 104 cfu of BCG in mice cerebellum, in a time-dependent way. Diagnostic was confirmed by detection of alcohol-acid resistant bacilli (BAAR), in tuberculous lesions. We observed, the time-course (1 to 6 days; 1, 2, 4 e 8 weeks) of the recruitment of different glial populations (microglia and astrocytes) in the injection site. There was increased production and activation of NFB in the tuberculous lesions, it was characterized by its nuclear translocation from cytoplasm. There was iNOS expression only in the tuberculous lesions, and expression increased of VEGF in these lesions. Furthermore, mice immunizated with vaccine DNA-hsp65 there was no expression of VEGF in its lesions. This vaccine seems confer a protector effect in our experimental model, reducing the expression of VEGF, and then reducing its angiogenic effect derived from inflammatory process. Glial recruitment, and the soluble mediators production (NFB, iNOS e VEGF) by the host, producing in response to invasion of the pathogen in the CNS, has been involved in the pathophysiology of the neuro-TB, such as demonstrated in this experimental model. Our model will allow investigate possible factors responsible for the development and maintenance of tuberculous lesions in the CNS. The final aim is to elucidate the physiopathology of this serious illness and understand the molecular events involved in the production of the lesions. The knowledge created may permit to pave the way to delineate specific and effective therapies.

Esse trabalho teve como objetivo estudar os efeitos do glutamato sobre a síntese de melatonina, avaliando a participação dos diferentes tipos de receptores e uma possível interação entre pinealócitos e astrócitos; além de avaliar o papel do fator de transcrição NF-<font face=\"symbol\">kB nos efeitos modulatórios do glutamato. Para tanto, glândulas pineais de ratos foram mantidas em cultura e estimuladas com diferentes concentrações de glutamato e também com diversos agonistas glutamatérgicos. Culturas de pinealócitos isolados e co-culturas de pinealócitos e astrócitos também foram usadas. A melatonina foi quantificada em HPLC com detecção eletroquímica. Para caracterização dos receptores de glutamato foi feita uma análise de RT-PCR, e a ativação do NF-<font face=\"symbol\">kB foi avaliada por ensaio de gel de retardo. Os resultados mostram que o glutamato exerce um efeito inibitório sobre a síntese de melatonina através de uma ação sobre os receptores metabotrópicos dos grupos I e II e ionotrópico do tipo AMPA e que as ações do glutamato são mediadas pela ativação do NF-<font face=\"symbol\">kB dos astrócitos. / The aim of this work was to study the effects of glutamate on melatonin synthesis, investigating the glutamate receptors involved and a possible interaction between the two predominant cell types of the pineal gland, pinealocytes and astrocytes; moreover, it was investigated the involvement of the transcription factor NF-<font face=\"symbol\">kB on the glutamate effects. To accomplish this, pineal glands were kept in culture and stimulated with glutamate or glutamate agonists. Isolated pinealocytes or in association with astrocytes in culture were also stimulated with glutamate. Melatonin was quantified by HPLC with electrochemical detection. Glutamate receptors were characterized by RT-PCR and NF-<font face=\"symbol\">kB activation was evaluated by gel shift assay. The data showed that glutamate has an inhibitory effect on melatonin synthesis that is mediated by groups I and II glutamate metabotropic receptors and AMPA receptor and that this effect involves the activation of astrocytic NF-<font face=\"symbol\">kB.