Note: Portions of this abstract have been previously published in the journal Blood, Basiorka et al. Blood. 2016 Oct 13, and has been reproduced in this manuscript with permission from the publisher. Myelodysplastic syndromes (MDS) are genetically diverse hematopoietic stem cell malignancies that share a common phenotype of cytological dysplasia, ineffective hematopoiesis and aberrant myeloid lineage maturation. Apoptotic cell death potentiated by inflammatory cytokines has been considered a fundamental feature of MDS for over two decades. However, this non-inflammatory form of cell death cannot account for the inflammatory nature of these disorders. We report that a hallmark of lower-risk (LR) MDS is activation of the NLRP3 inflammasome, which drives clonal expansion and pyroptosis, a caspase-1-dependent programmed cell death induced by danger-associated molecular pattern (DAMP) signals. Independent of genotype, MDS hematopoietic stem and progenitor cells (HSPC) overexpress pyroptosis-related transcripts, inflammasome proteins and manifest activated NLRP3 inflammasome complexes that direct caspase-1 activation, IL-1β and IL-18 maturation and pyroptotic cell death. Using the S100A9 transgenic (S100A9Tg) mouse model that phenocopies human MDS, we demonstrated that forced expression of S100A9 was sufficient to drive pyroptosis in vivo, implicating pyroptosis as the principal mechanism of HSPC cell death in S100A9Tg mice. The lytic cell death releases intraceullar contents that include alarmins and catalytically active ASC specks, which can propagate bystander inflammation. Notably, MDS mesenchymal stromal cells (MSC) and stromal-derived linages were found to predominantly undergo pyroptosis, with marked activation of caspase-1 and NLRP3 inflammasome complexes. These findings may account for the clusters of both HSPC and stromal cell death previously described in the bone marrows of patients with MDS. Mechanistically, pyroptosis is triggered by the alarmin S100A9 that is found in excess in MDS HSPC and bone marrow (BM) plasma. Further, both somatic gene mutations and S100A9-induced signaling activate NADPH oxidase (NOX), generating reactive oxygen species (ROS) that initiate cation influx, cell swelling and β-catenin activation. Accordingly, ROS and active β-catenin were significantly increased in MDS BM mononuclear cells (BM-MNC) and S100A9Tg mice compared to normal controls, as well as in human cell lines harboring gene mutations and in murine models of gene mutation knock-in or gene loss. ROS and β-catenin nuclear translocation were significantly reduced by NLRP3 or NOX inhibition, indicating that S100A9 and somatic gene mutations prime cells to undergo NOX1/4-dependent NLRP3 inflammasome assembly, pyroptosis and β-catenin activation. Together, these data explain the concurrent proliferation and inflammatory cell death characteristic of LR-MDS. Given that loss of a gene-rich area in del(5q) disease results in derepression of innate immune signaling, we hypothesized that this genetic deficit would trigger assembly of the NLRP3 inflammasome complex, akin to the pathobiological mechanism characteristic of non-del(5q) MDS. To this end, we utilized two distinct murine models of del(5q) disease, namely in the context of Rps14 haploinsufficiency and concurrent loss of mDia1 and microRNA (miR)-146a. In both models, pyroptosis was not evident in the HSPC compartment; however, early erythroid progenitors displayed high fractions of pyroptotic cells. This was associated with significant increases in caspase-1 and NLRP3 inflammasome activation, ROS and nuclear localization of β-catenin, which was extinguished by inflammasome or NOX complex inhibition. These data suggest that early activation of the inflammasome drives cell death and prevents terminal maturation of erythroid precursors, accounting for the progressive anemia characteristic of del(5q) disease, whereby hematopoietic defects are primarily restricted to the erythroid compartment. Importantly, these data implicate a similar pathobiological mechanism in del(5q) MDS as is observed in non-del(5q) patients. The identification of the NLRP3 inflammasome as a pathobiological driver of the LR non-del(5q) and del(5q) MDS phenotype allows for novel therapeutic agent development. Notably, knockdown of NLRP3 or caspase-1, neutralization of S100A9, and pharmacologic inhibition of NLRP3 or NOX suppresses pyroptosis, ROS generation and nuclear β-catenin in MDS, and are sufficient to restore effective hematopoiesis. In del(5q) murine models, inhibition of the NLRP3 inflammasome significantly improved erythroid colony forming capacity by a mechanism distinct from that of lenalidomide, highlighting the translational potential for targeting this innate immune complex in this subset of MDS. Thus, alarmins and founder gene mutations in MDS license a common redox-sensitive inflammasome circuit, which suggests new avenues for therapeutic intervention. Furthermore, aggregated clusters of the NLRP3 adaptor protein ASC [apoptosis-associated speck-like protein containing a caspase activation and recruitment domain (CARD)] are referred to as ASC specks. During pyroptosis, ASC specks are released from dying cells and function as DAMP signals that propagate inflammation. In this way, specks are a surrogate marker for NLRP3 inflammasome activation and pyroptotic cell death. Given that pyroptosis is the predominant mechanism of cell death in MDS and ASC specks are readily quantified by flow cytometry, we hypothesized that BM or peripheral blood (PB) plasma-derived ASC specks may be a biologically rational biomarker for the diagnosis of MDS. The percentage of ASC specks were significantly increased in MDS BM plasma compared to normal, healthy donors, which was validated by confocal microscopy. PB plasma-derived ASC specks were significantly greater in LR- versus HR-MDS, consistent with the greater extent of cell death and myeloid-derived suppressor cell (MDSC) expansion in LR disease. As hyperglycemia induces NLRP3 inflammasome activation, plasma glucose levels were measured to adjust for this confounding variable. Subsequently, the percentage of glucose-adjusted, PB plasma-derived ASC specks was measured in a panel of specimens of varied hematologic malignancies. The corrected percentage of ASC specks was significantly increased in MDS compared to normal donors and to each other malignancy investigated, including other myeloid and lymphoid leukemias, myeloproliferative neoplasms and overlap syndromes, like chronic myelomonocytic leukemia (CMML). These data indicate that the glucose-adjusted ASC speck percentage is MDS-specific and may be a valuable diagnostic biomarker. At a cutoff of 0.039, the biomarker minimizes misclassification error and achieves 95% sensitivity and 82% specificity in classifying MDS from normal donors, other hematologic malignancies and T2D. Lastly, the biomarker declined with treatment response to lenalidomide in LR-MDS patients, but not to erythropoietin stimulating agent (ESA) or hypomethylating agent (HMA) therapy. As such, the percentage of ASC specks represents the first biologically rational, diagnostic biomarker for MDS that can be implemented with current diagnostic practices to reduce diagnostic error.

Les neutrophiles participent à la défense de l'hôte en phagocytant les agents pathogènes et en les détruisant via notamment la production de formes réactives de l'oxygène (FRO). Les FRO sont produites par un complexe multi- protéique :la NADPH oxydase (NOX2). Celle-ci peut s’assembler à la membrane du phagosome lors de la phagocytose mais aussi à la membrane plasmique lors de la stimulation des neutrophiles par des agents bactériens ou des médiateurs de l’inflammation. La NADPH oxydase est une arme à double tranchant; une activation excessive ou inappropriée de la NADPH oxydase génère un stress oxydant, facteur aggravant des nombreuses pathologies. Cette enzyme doit donc être finement régulée. La NADPH oxydase est activée lorsque les sous-unités cytosoliques de NOX2 (p67phox, p47phox, p40phox) et la petite GTPase Rac s’assemblent avec les sous-unités membranaires (p22phox et gp91phox) à la membrane phagosomale ou plasmique. P67phox régule le flux d'électrons qui transite via gp91phox du NADPH à O2.-. Des travaux récents indiquent que les phospholipides anioniques contribueraient à la régulation de la NADPH oxydase. De plus, Les protéines organisatrices p40phox et p47phox possèdent des domaines de liaison à ces phosphoinositides : p40phox peut se lier au phosphatidylinositol 3-phosphate (PI(3)P) et p47phox au phosphatidylinositol 3,4-bisphosphate (PI(3,4)P2). Nous avons donc voulu comprendre le rôle des ces phospholipides dans la régulation de la NADPH oxydase. Dans un premier temps nous nous sommes intéressés au rôle du PI(3)P, présent au phagosome après la fermeture de celui-ci, dans l’activation de la NADPH oxydase. Nos données indiquent que p40phox fonctionne comme un adaptateur, PI(3)P dépendant, permettant de maintenir p67phox dans le complexe de la NADPH oxydase. Le PI(3)P agit comme un « timer » pour l'activation de la NADPH oxydase au phagosome. Nous avons ensuite voulu examiner le rôle du PI(3,4)P2 dans la régulation de la NADPH oxydase à la membrane plasmique. Ce lipide est formé à la membrane plasmique par phosphorylation du PI(4)P par la PI3K de classe I lors de l’activation des neutrophiles. Nous avons montré que, l'activité PI3K de classe I est nécessaire pour maintenir l’activation, intégrine-dépendante, de la NADPH oxydase à la membrane plasmique. / The NADPH oxidase of the professional phagocyte is essential for the immune system. The phagocyte NADPH oxidase, NOX2, catalyze the reduction of molecular oxygen to superoxide. Superoxide is transformed rapidly into other reactive oxygen species (ROS) which play a critical role in the killing of pathogens in host defense. Indeed neutrophils, the first cells that arrive at the site of infections, engulf pathogens in a process called phagocytosis. The production of reactive oxygen species is then triggered by the NADPH oxidase in the phagosome. The importance of ROS production is demonstrated by the recurrent bacterial and fungal infections that face patients who lack functional NADPH oxidase as in the rare genetic disorder known as the chronic granulomatous disease (CGD). Upon stimulation by bacterial peptide or in some pathological conditions, NADPH oxidase can also be activated at the phagocyte plasma membrane producing ROS in the extracellular medium. So, an excessive or inappropriate NADPH oxidase activation generates oxidative stress involve in chronic inflammation, cardiovascular disease and neurodegenerative disease. The NADPH oxidase activity should be tightly regulated. The activity of the enzyme is the result of the assembly of cytosolic subunits (p47phox, p67phox, p40phox and Rac2) with membranous subunits (gp91phox and p22phox). P67phox regulates the electron flow through gp91phox from NADPH to oxygen leading to the formation of superoxide. Recent data indicate that the anionic phospholipids are important for the NADPH oxidase regulation. Moreover, p40phox and p47phox bear a PX domain that binds respectively phosphatidylinositol3-phosphate (PI3P) and phosphatidylinositol (3,4)-bisphosphate(PI(3,4)P2). Our objective was to decipher the importance of these phosphoinositides on the NADPH oxidase activity. We first examined the role of PI3P, which is present on the cytosolic leaflet of phagosome after its sealing, in NADPH oxidase activation. Our data indicate that p40phox works as a late adaptor controlled by PI3P to maintain p67phox in the NADPH oxidase complex. Thus, PI3P acts as a timer for NADPH oxidase assembly. We then examined the role of PI(3,4)P2 in the activation of the NADPH oxidase assembled at the plasma membrane. PI(3,4)P2 and PI(3,4,5)P3 are formed at the plasma membrane, upon neutrophil activation, by phosphorylation by Class I PI3K of respectively PI4P and PI(4,5)P2. We found that class I PI3K activity is required to maintain the integrin-dependent activation of NADPH oxidase at the plasma membrane.

Yes / Quercetin is reported to reduce blood pressure in hypertensive but not normotensive humans, but the role of endothelial redox signaling in this phenomenon has not been assessed. This study investigated the effects of physiologically obtainable quercetin concentrations in a human primary cell model of endothelial dysfunction in order to elucidate the mechanism of action of its antihypertensive effects. Angiotensin II (100 nM, 8 h) induced dysfunction, characterized by suppressed nitric oxide availability (85 ± 4% p<0.05) and increased superoxide production (136 ± 5 %, p<0.001). These effects were ablated by an NADPH oxidase inhibitor. Quercetin (3 μM, 8 h) prevented angiotensin II induced changes in nitric oxide and superoxide levels, but no effect upon nitric oxide or superoxide in control cells. The NADPH oxidase subunit p47(phox) was increased at the mRNA and protein levels in angiotensin II-treated cells (130 ± 14% of control, p<0.05), which was ablated by quercetin co-treatment. Protein kinase C activity was increased after angiotensin II treatment (136 ± 51%), however this was unaffected by quercetin co-treatment. Physiologically obtainable quercetin concentrations are capable of ameliorating angiotensin II-induced endothelial nitric oxide and superoxide imbalance via protein kinase C-independent restoration of p47(phox) gene and protein expression. / Innovate UK and Boots Pharmaceuticals

No description available.

It is known that African American ethnicity is an independent risk factor for exaggerated oxidative stress which is intricately intertwined with inflammation, hypertension (HT), and cardiovascular disease (CVD). The purpose of this dissertation study was to examine the racial differences that exist between African Americans and Caucasians in oxidative stress levels at the molecular level using an in vitro model of Human Umbilical Vein Endothelial Cells (HUVECs). African American HUVECs were found to have significantly higher baseline levels of oxidative stress in vitro compared to Caucasian HUVECs. In order to establish proof of concept, three preliminary studies were conducted. The first preliminary study, an acute exercise protocol was conducted in young healthy adults in order to measure plasma oxidative stress markers in response to a single moderate intensity treadmill exercise bout. In this study, it was found that the treadmill exercise did not elicit a race-dependent responses, but that African American adults had higher level of oxidative stress at all sample times when compared to the Caucasians. A second preliminary study was conducted using a parallel cell culture design to measure basal oxidative stress levels in African American and Caucasian HUVECs without stimulation. These data were shown in relation to the plasma levels of oxidative stress in resting African American and Caucasian adults. This was done in order to show that the common oxidative stress markers measured in human plasma can also be measured in cell culture supernatant and lysate. It was found that both African American adults and HUVECs had heightened oxidative stress and inflammatory markers when compared to their Caucasian counterparts. The third preliminary study was conducted using tumor Necrosis Factor-#945; (TNF-#945;) as an inflammatory stimulant and measuring the oxidative stress response in both African American and Caucasian HUVECs. This was done in order to show that cells of different race respond differently to stimuli. It was found that the response to TNF-α was blunted in African American HUVECs. The final step was to use laminar shear stress (LSS) as an exercise mimetic in order to examine whether HUVECs from different race respond differently. HUVECs from both race were harvested under static condition (no LSS), with low LSS at 5 dyne/cm2, and with a moderate level of LSS at 20 dyne/cm2. It was found that despite the fact that African American HUVECs had higher levels of oxidative stress under static conditions, when LSS was applied, protein expressions and oxidative stress biomarkers adjusted to levels that were similar to the Caucasian HUVEC adaptations to LSS. From this, it appears that African American HUVECs have a larger response to LSS stimulus indicating that aerobic exercise prescriptions may be valuable for this population since the potential exists for large improvements in oxidative stress levels for this population. / Kinesiology

O sistema NADPH oxidase é um complexo enzimático gerador de ânion superóxido formado pelas subunidades gp91-phox e p22-phox, p47-phox, p67-phox e p40-phox. O eixo IL-12/23-IFN-g é crítico para a ativação dos fagócitos e controle de infecções. Defeitos na ativação deste eixo resultam em infecções recorrentes e à MSMD, e podem levar à diminuição da expressão do componente gp91-phox. Em minha Dissertação de Mestrado (Aragão-Filho, 2009), vimos que as subunidades 1 e 2 do receptor do IFN-g são necessárias para a expressão dos genes NCF1 e NCF2 e para a ativação do sistema NADPH oxidase humano nos modelos experimentais de células humanas por nós utilizados. Assim, no presente trabalho de doutorado, continuamos a investigar o papel dos defeitos no eixo IL-12/23-IFN-g sobre o sistema NADPH oxidase utilizando novas linhagens celulares de pacientes com defeitos no eixo IL-12/23-IFN-g. Verificamos que há defeito secundário da ativação da NADPH oxidase em pacientes com defeitos no eixo IL-12/23-IFN-g, o que representa um novo mecanismo imunopatológico envolvido na MSMD. / The NADPH oxidase system is an enzymatic complex that generates superoxide anion, it is formed by gp91-phox, p22-phox, p47-phox, p67-phox and p40-phox subunits. The IL-12/23-IFN-g axis is critical for the phagocytes activation and infection control. Defects in this axis activation result in recurrent infections and MSMD, and can lead to decreased expression of gp91-phox component. In my Master Thesis (Aragão-Filho, 2009), we found that the subunits 1 and 2 of the IFN-g receptor are required for NCF1 and NCF2 gene expression and activation of human NADPH oxidase system in human experimental cell models that we used. Therefore, in the present doctoral work, we continue to investigate the role of IL-12/23-IFN-g axis defects on NADPH oxidase system using new cell lines from patients with IL-12/23-IFN-g axis defects. We verify that there is a secundary defect in the activation of the NADPH oxidase from patients with IL-12/23-IFN-g defects, what represents a new immunopathological mechanism involved in MSMD.

Processos celulares que governam as NADPH oxidases vasculares em condições patológicas não estão claros ainda. Como os processos redox são parte intrínseca da resposta da célula ao estresse, temos investigado se o estresse oxidativo pode convergir com outros tipos de estresse via Nox(es). No presente estudo, focamos na inibição do proteasoma como uma condição relevante de estresse. A incubação de células musculares lisas com concentrações não apoptóticas de inibidores do proteasoma, MG132 e lactacistina, promoveu aumento na produção basal de superóxido e na atividade da NADPH oxidase, diminuição da atividade da SOD e da razão GSH/GSSG. Por outro lado, a inibição do proteasoma diminui a atividade da Nox após estímulo com Angiotensina II ou Tunicamicina, conhecido estressor do retículo endoplasmático. Em condições basais, MG132 induz a expressão de mRNA da Nox1, entretanto o aumento de Nox1 induzido por Angiotensina II foi diminuído na presença de MG132. O mesmo efeito ocorre com a indução de Nox4 pela Tunicamicina, que nesse caso foi drasticamente reduzida na presença de MG132. Além disso, tanto Angiotensina II quanto Tunicamicina induziram a atividade lítica do proteasoma 20S. A seguir, investigamos as conseqüências fisiológicas do MG132 na sinalização do estresse do RE, uma conhecida resposta mediada por Nox4. Células vasculares incubadas com MG132 induzem a expressão de marcadores do estresse do RE, GRP78 e XBP1, e também os marcadores mais tardios ATF4 e o próapoptótico CHOP/GADD153. Resultados similares ocorrem também com a Tunicamicina. Entretanto, a co-incubação de Tunicamicina e MG132 diminui e a sinalização do estresse do RE. AKT e p38 MAPK foram ativados por MG132, possivelmente como resposta ao estresse induzido pela inibição do proteasoma. Assim, a inibição do proteasoma bloqueia a NADPH oxidase, com aumento da atividade basal e expressão da Nox1 versus forte inibição da ativação e expressão da Nox4 frente ao estímulo. A inibição da Nox4 associa-se e pode contribuir para a inibição pelo MG132 da sinalização do estresse do RE. Portanto, o proteasoma parece exercer papel na integração de estresses celulares envolvendo a NADPH oxidase. A inibição do proteasoma pode ter papel na terapia de doenças associadas a estresse do RE. / Cellular processes governing vascular Nox family NADPH oxidases in disease conditions are unclear. Since redox processes are intrinsic to cell stress response, we asked whether oxidative stress merges with other types of stress via Nox(es). We focused on proteasome inhibition as a relevant stress condition. Vascular smooth muscle cells (VSMC) incubation with non-apoptotic concentrations of proteasome inhibitors MG132 or lactacystin promoted increased baseline superoxide generation (HPLC/DHE products) and NADPH oxidase activity, decreased SOD activity and GSH/GSSG ratio. Conversely, proteasome inhibitors decreased by Nox response to Angiotensin II (AngII) and abrogated Nox response to endoplasmic reticulum (ER) stressor tunicamycin. With MG132, basal Nox1 mRNA levels were increased, while Nox1 response to AngII was blunted. Moreover, MG132 abolished Nox4 mRNA levels TN-induced. Both AngII and TN (at 2 and 4 hs) promoted increased 20S proteasome lytic activity. We next assessed physiological consequences of MG132 in ER stress signaling, a known Nox4- mediated response. VSMC incubation with MG132 alone enhanced expression of the ER stress markers Grp78 and XBP1 and late markers such as ATF4 and proapoptotic CHOP/GADD153. Similar results occurred with the known ER stressor TN. However, co-incubation of TN and MG132 decreased Grp78, Grp94 and CHOP/GADD153, indicating that proteasome inhibition interrupts ER stress. AKT and p38 are activated by MG132 as response to stress and recover to survival. Thus, proteasome inhibition disrupts NADPH oxidase, with increased baseline activity and Nox1 expression vs. strong inhibition of stimulated Nox1 and Nox4 activation/expression. The later effect may underlie MG132-mediated inhibition of ER stress signaling. (Support: FAPESP, CNPq Milênio Redoxoma)

A principal função da glândula tireoide é a produção dos hormônios T3 e T4, que promovem a regulação do consumo energético no organismo. O hipotireoidismo congênito (HC) é um distúrbio metabólico sistêmico, onde a produção de T3 e T4 no período neonatal é insuficiente. O HC por disormonogênese é uma doença causada por erros inatos na síntese de T3 e T4, com herança autossômica recessiva. Já foram descritas mutações nos genes NIS, SLC26A4, DUOX2, DUOXA2, TPO, TG e DEHAL-1. O defeito na organificação do iodeto (DOI) é o mais comum na disormonogênese, sendo a falha mais frequente na TPO, seguida pelas proteínas DUOX2 e DUOXA2. A TPO é responsável pela oxidação do iodeto, pela iodação da tireoglobulina e pelo acoplamento das tirosinas iodinizadas. Já foram descritas 70 mutações ao longo de todo o gene TPO. Por ser uma heme peroxidase, a TPO requer H2O2 para sua função. O principal núcleo catalítico gerador de H2O2 na tireoide é o complexo DUOX2/DUOXA2. Foram descritas 25 mutações no gene DUOX2 e uma única mutação no gene DUOXA2. Em estudo anterior, avaliamos pacientes com HC após os 3 anos de idade para estabelecimento do diagnóstico etiológico, através de dosagem de TG sérica, ultrassonografia, captação e mapeamento da tireoide com 131I. Sete pacientes apresentaram DOI. Nestes pacientes avaliamos o gene TPO e identificamos diversos SNPs já descritos na literatura. Um paciente apresentou a mutação p.Q660E em heterozigose, outro paciente o SNP p.R584Q em homozigose, e um terceiro paciente as alterações p.Q660E e p.584Q em heterozigose composta. Os objetivos deste estudo foram pesquisar mutações dos genes DUOX2 e DUOXA2 nos pacientes com DOI e realizar o estudo funcional da alteração p.R584Q na TPO. Para o estudo molecular, extraímos o DNA de leucócitos periféricos dos pacientes e seus familiares, seguido de amplificação por PCR, e sequenciamento automático, e os resultados comparados com as sequencias normais de cada gene (GenBank). Na análise funcional da alteração p.R584Q na TPO, células HeLa foram transfectadas com plasmídios pcDNA contendo o gene da TPO normal e alterado, e a atividade das proteínas produzidas pelas células foi avaliada pelo sistema AmplexRed. Análises in silico foram realizadas com os programas de bioanálise PolyPhen, MutationTaster, SIFT e PSIPRED. Ao final do estudo molecular, no gene DUOX2, identificamos 20 SNPs previamente descritos, incluindo o SNP funcional p.H678R (rs57659670), presente em heterozigose em 3 pacientes. Também identificamos a nova substituição p.A1087V em heterozigose em um paciente. De acordo com dados dos programas de bioanálise, a alteração p.A1087V é prejudicial e o SNP p.H678R é tolerável. No gene DUOXA2 identificamos 5 polimorfismos previamente descritos e nenhuma mutação. No estudo funcional, verificamos uma diminuição significativa da atividade da TPO portadora da alteração p.R584Q em comparação à proteína normal (5% de atividade residual; p=0,0193). De acordo com os dados dos programas de bioanálise, a alteração p.R584Q é prejudicial. Três pacientes não apresentaram alterações nas regiões estudadas dos genes TPO, DUOX2 e DUOXA2. As revisões dos dados clínicos e laboratoriais sugerem a presença de outras proteínas alteradas, como TG, Pendrina ou receptor do TSH. Um paciente apresentou a nova alteração p.A1087V na DUOX2 em heterozigose e nenhuma outra alteração nas regiões estudadas dos genes avaliados. Cogitamos a presença de alterações em regiões não avaliadas ou ainda a expressão monoalélica de DUOX2. O SNP funcional p.H678R na DUOX2 foi identificado em três pacientes com alterações na TPO: um com a alteração p.R584Q em homozigose, outro com a p.R584Q e a mutação p.Q660E em heterozigose composta. Estes dois pacientes apresentam os dois alelos da TPO alterados, justificando o DOI. O terceiro caso apresentou apenas a mutação p.Q660E em heterozigose, podendo apresentar alterações em regiões não avaliadas ou ainda a expressão monoalélica da TPO. Concluímos que definimos o diagnóstico molecular de 4 dos nossos pacientes, que apresentaram importantes alterações nos genes avaliados, e ressaltamos que a alteração p.R584Q na TPO provoca perda da atividade, causando DOI / The main role of the thyroid gland is to produce T3 and T4, which promote the regulation of body energy intake. Congenital hypothyroidism (CH) is a systemic metabolic disorder where T3 and T4 production during neonatal period is insufficient. CH due to dyshormonogenesis is a disease caused by inborn errors in T3 and T4 synthesis, with autosomal recessive inheritance. Mutations in NIS, SLC26A4, DUOX2, DUOXA2, TPO, TG and DEHAL-1 genes have been described. The iodide organification defect (IOD) is the most common cause of dyshormonogenesis, being the TPO defect the most frequent, followed by defects in DUOX2 and DUOXA2 proteins. TPO is responsible for iodide oxidation, tyrosine iodination and its coupling. Seventy mutations have been described throughout the gene. As a heme peroxidase, TPO requires H2O2 to its regular function. The main catalytic core for H2O2 generation in thyroid is the DUOX2/DUOXA2 complex. Twenty five mutations have been described in DUOX2 gene and only one mutation in DUOXA2 gene. In our previous study, we evaluated patients with CH after 3 years of age to establish their etiologic diagnosis, by combining serum TG, thyroid ultrasound, and radioiodide uptake with 131I. Seven patients were diagnosed with IOD. In these patients, we evaluated TPO gene and identified several already described SNPs. One patient had the p.Q660E mutation in heterozygous state, another patient had the SNP p.R584Q in homozygous state and a third one had p.Q660E and p.584Q in compound heterozygous state. The aims of this study were to search for mutations in DUOX2 and DUOXA2 genes in patients with IOD and perform a functional study of TPO p.R584Q change. For the molecular study, DNA was extracted from peripheral blood leukocytes of each patient and parents, followed by PCR, and automatic sequence, and the results were compared with normal sequences of each gene (GenBank). For functional analysis of TPO p.R584Q, HeLa cells were transfected with pcDNA plasmids containing normal and altered TPO gene and the protein activity was assessed by AmplexRed system. In silico analyzes were performed with the bioanalysis programs: PolyPhen, MutationTaster, SIFT and PSIPRED. At the end of the molecular study, in DUOX2 gene we identified 20 previously described SNPs, including the functional p.H678R SNP (rs57659670), present in heterozygous state in 3 patients. We also identified the new p.A1087V change in heterozygous state in one patient. According to bioassay programs datas, p.A1087V change is damage and p.H678R SNP is tolerable. In DUOXA2 gene we identified five previously described polymorphisms and no mutation. In TPO functional study, we observed a significant activity decrease of TPO p.R584Q compared to normal TPO (5% of activity; p=0.0193). According to bioassay programs datas, p.R584Q is damaging. Three patients showed no changes in TPO, DUOX2 and DUOXA2 genes studied regions. A review of clinical and laboratory data suggested the presence of other altered proteins, such as TG, Pendrin or TSH receptor. One patient had the new DUOX2 p.A1087V alteration in heterozygous state and no other changes in the studied regions of evaluated genes, suggesting that there could be changes in other nonevaluated regions or the monoallelic expression of DUOX2. The functional DUOX2 p.H678R SNP was identified in three patients with changes in TPO: one with p.R584Q change in homozygous state and another one with p.R584Q and p.Q660E in compound heterozygous state. These cases have the two alleles of TPO changed, justifying their IOD. A third case showed only the TPO p.Q660E mutation in heterozygous state. We speculate that the patient may present changes in regions nonevaluated or the monoallelic expression of TPO. We conclude that we defined the molecular diagnosis of four patients, that showed significant changes in evaluated genes, and that TPO p.R584Q change is functionally harmful, causing IOD

O consumo crônico de etanol acarreta alterações significativas das funções cardíaca e circulatória, figurando como um importante fator de risco no desenvolvimento de doenças cardiovasculares, como por exemplo a hipertensão arterial. O passo inicial para a disfunção cardiovascular associada ao etanol envolve a formação de espécies reativas de oxigênio (ERO) e redução da biodisponibilidade do óxido nítrico (NO), sendo esse processo mediado pela enzima nicotinamida adenina dinucleótido fosfato (NADPH) oxidase. Baseado nestas observações, a hipótese do estudo é a de que o consumo de etanol aumente a pressão arterial, a geração de ERO e induza a ativação de vias de sinalização redox sensíveis na vasculatura via NADPH oxidase. Portanto, o objetivo desse estudo foi investigar a participação da NADPH no aumento da pressão arterial e estresse oxidativo vascular induzidos pelo consumo crônico de etanol através de sua inibição pela apocinina. O trabalho demonstrou pela primeira vez o envolvimento do estresse oxidativo via ERO geradas pela NADPH oxidase no aumento da pressão arterial induzida pelo consumo crônico de etanol. Houve aumento da contração induzida por fenilefrina em anéis de aorta com e sem endotélio de animais tratados com etanol e foi demonstrada a participação das ERO geradas pela NADPH oxidase nesta resposta, uma vez que o tratamento com apocinina promoveu diminuição da contração observada. O tratamento com etanol aumentou a geração de ERO em tecido aórtico via NADPH oxidase, reduziu a biodisponibilidade de NO plasmático e tecidual e promoveu peroxidação lipídica, visto pela elevação dos níveis de TBARS. Também foi demonstrado que a enzima NADPH oxidase está envolvida no aumento da expressão protéica da PKC ? e SAPK/JNK induzido pelo etanol, e que o tratamento com etanol é capaz de diminuir a atividade enzimática da superóxido dismutase (SOD) e aumentar a expressão protéica especificamente da SOD2, possível resposta adaptativa ao aumento de geração de O2- via NADPH oxidase pelo etanol. Houve aumento da expressão protéica da nNOS em aorta de animais tratados com etanol, sendo esta, uma possível resposta adaptativa intrínseca às alterações promovidas pelo aumento da pressão arterial nestes animais. O tratamento com etanol não alterou os níveis aórticos de peróxido de hidrogênio (H2O2), glutationa reduzida (GSH) e atividades enzimáticas da xantina oxidase (XO), superoxido dismutase (SOD), catalase (CAT) e glutationa peroxidase (GPx). Além disso, a partir da avaliação da translocação citosol/membrana das subunidades organizadoras p47phox e Nox organizer 1 (Noxo1) e expressão protéica das subunidades catalíticas da NADPH oxidase, Nox1, Nox2 e Nox4, foi possível concluir que o aumento da expressão da Nox1 possui importante papel na modulação da geração de ERO pelo etanol, podendo participar do aumento da pressão arterial e estresse oxidativo sistêmico e vascular gerados. Portanto, a partir dos resultados obtidos, o estudo demonstrou que o consumo crônico de etanol induz o aumento da produção de ERO, resposta implicada no aumento da pressão arterial observado nos animais tratados com etanol. Além disso, o trabalho evidencia a participação da enzima Nox1/NADPH oxidase neste processo, uma vez que houve aumento da expressão protéica dessa subunidade catalítica na aorta dos animais tratados com etanol / Chronic ethanol consumption results in significant alterations in cardiac and circulatory functions, appearing as an important risk factor responsible for cardiovascular diseases such as hypertension. The initial step for cardiovascular dysfunction associated with ethanol consumption involves the generation of reactive oxygen species (ROS) and reduced bioavailability of nitric oxide (NO), processes mediated by the enzyme nicotinamide adenine dinucleotide phosphate (NADPH) oxidase. Based on the mentioned observations we hypothesized that ethanol consumption increases blood pressure, ROS generation and induces activation of redox-sensitive signaling pathways in the vasculature through NADPH oxidase. Thus, here we investigated the contribution of NADPH oxidase in chronic ethanol consumption-induced hypertension and vascular oxidative stress through its inhibition by apocynin. This study demonstrated for the first time the involvement of oxidative stress via ROS derived from NADPH oxidase in increased blood pressure induced by chronic ethanol intake. The increased contractility of endothelium-intact and endothelium-denuded aortic rings from ethanol-treated rats to phenylephrine was prevented by apocynin. Ethanol consumption increased systemic and vascular oxidative stress and apocynin prevented these responses. The decrease on plasma and vascular nitrate/nitrite (NOx) levels induced by ethanol were not prevented by apocynin. Treatment with ethanol did not affect aortic levels of hydrogen peroxide (H2O2) and reduced glutathione (GSH) as well as the activity of xanthine oxidase (XO), superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx). Ethanol-induced increased protein expression of Nox1, PKC?, nNOS, SAPK/JNK and SOD2 in the rat aorta was prevented by apocynin. No difference on the aortic expression of Nox2, Nox4, p47phox, Nox organizer 1 (Noxo1), eNOS and iNOS was detected after treatment with ethanol. Ethanol treatment did not alter the phosphorylation of SAPK/JNK, p38MAPK, ERK1/2, c-Src, Rac1 or PKC?. The major new finding of our study is that the increased vascular generation of reactive oxygen species (ROS) induced by ethanol is related to the increased vascular Nox1/NADPH oxidase expression. This mechanism is involved on the vascular dysfunction and hypertension induced by ethanol. Additionally, we conclude that ethanol consumption induces the expression of different proteins that regulate vascular contraction and growth and that NADPH oxidase-derived ROS play a role in such response

Acreditava-se inicialmente que a produção de espécies reativas de oxigênio (EROs) estava associada apenas aos danos oxidativos e efeitos deletérios às células. Atualmente, evidências sugerem que as EROs desempenham papel benéfico e estão associadas às adaptações estruturais e funcionais das células, por meio de regulação de vias de sinalizações celulares. Nas células musculares, sabe-se que sua função é dependente do estado redox das mesmas. De fato a produção exacerbada destas EROs é um fator limitante da contração muscular, no entanto, um ambiente celular reduzido também afeta negativamente a função muscular. Além disso, adaptações ao exercício físico parecem ser reguladas por vias de sinalizações sensíveis a oxidação por EROs. A NADPH oxidase é um importante complexo enzimático produtor de EROs no músculo esquelético (ME) e considerada como principal fonte de EROs no citosol durante a contração. Além disso, as proteínas envolvidas na contração muscular são sensíveis e reguladas dependente do estado redox celular, e, a NADPH oxidase esta localizada, aparentemente de forma estratégica, próxima a estas proteínas. Desta forma, tornou-se pertinente o estudo da inibição da NADPH oxidase, com apocinina in vivo, em adaptações ao treinamento físico intervalado intenso (TFII), uma vez que esta enzima tem sua atividade aumentada em estudos de contração muscular in vitro. Para investigar o efeito do TFII associado à administração de apocinina sobre as adaptações estruturais, funcionais e redox do músculo esquelético, foram utilizados ratos wistar (3 meses de idade) distribuídos aleatoriamente em 4 grupos: controle sedentário (CS), controle treinado (CT), apocinina sedentário (AS), e apocinina treinado (AT). O protocolo de TFII foi de corrida em esteira rolante durante 2 meses (1h, 5x/sem) com intensidade intervalada (3min a 60% VO2máx e 4min a 85% VO2máx) em inclinação de 20°. O tratamento com a apocinina (30 mg/kg/dia) foi por gavagem durante 2 meses. Foram avaliadas nos músculos sóleo e EDL, as medidas de capilarização, área de secção transversa (AST), distribuição de tipos de fibra, atividades de enzimas antioxidantes: superóxido dismutase (SOD) e catalase (CAT), o estado redox pela razão GSH:GSSG, e lesões oxidativas pelas concentrações de hidroperóxidos lipídicos e proteínas carboniladas. Os resultados demonstraram, que no músculo sóleo, o TFII não alterou a atividade da NADPH oxidase, mas aumentou a capilarização (82%), a atividade da SOD (47%) e a razão GSH:GSSG (52%), e diminuiu a atividade da CAT (-38%). No músculo EDL, o TFII aumentou as atividades das enzimas NADPH oxidase (141%), SOD (36%) e CAT (88%), bem como a capilarização (50%) e mudanças de tipos de fibras. Com isso observou-se que a apocinina não teve efeito sobre a função, estrutura e estado redox do ME de ratos sedentários. No entanto, a apocinina inibiu as adaptações induzidas pelo TFII em ambos os músculos (sóleo e EDL). O TFII aumentou a atividade da NADPH oxidase apenas no músculo EDL mostrando comportamentos diferentes das atividades desta enzima, em resposta a este tipo de treino, entre os músculos de características oxidativas e glicolíticas. Sendo assim, a NADPH oxidase parece participar das vias sinalizadoras para as adaptações induzidas pelo TFII apenas nos músculos glicolíticos. Diante desses resultados, conclui-se que músculos glicolíticos e oxidativos podem ter vias de sinalizações diferentes para as adaptações do ME ao exercício. Isto reforça e também explica a importância da intensidade e duração do exercício em respostas adaptativas, uma vez que estas variáveis influenciam o estado redox e também desencadeiam adaptações diferentes no ME. Futuramente, informações do estado redox muscular podem ser usadas para melhorar a especialização do treinamento físico de atletas / Initially it is believed, the production of reactive oxygen species (ROS) was associated just with oxidative damage and harmful effects on cells. Currently, evidence suggests that ROS play beneficial role and are associated with structural and functional adaptations of the cells by means of regulating cellular signaling pathways. In muscle cells, it is known that its function is dependent on the redox state. In fact, the exacerbated production of ROS is a limiting factor of muscle contraction, however, a reduced cellular environment also adversely affects the muscle function. In addition, adaptations to exercise seems to be regulated by signaling pathways sensitive to oxidation by ROS. The NADPH oxidase is an important enzymatic complex producer of ROS in skeletal muscle (SM) and considered as the main source of ROS in the cytosol during contraction. Besides, the proteins involved in muscle contraction are sensitive and controlled by the cellular redox state. Furthermore, NADPH oxidase is located, apparently in a strategic way, next to these proteins. Thus, it has become relevant to the study, in vivo, the inhibition of NADPH oxidase with apocynin on adaptations to high intense interval training (HIIT), since this enzyme activity has been increased in studies of muscle contraction in vitro. To investigate the effect of HIIT associated with the administration of apocynin on the structural and functional adaptations and the redox state of skeletal muscle, Wistar rats (3 months old) were randomly distributed into 4 groups: sedentary control, trained control, sedentary apocynin, and trained apocynin. The HIIT protocol consisted of treadmill running during two months (1h, 5x / week) with intensity intervals (3min 60% VO2max and 4 min at 85% VO2max) in a inclination of 20 degrees, and the apocynin treatment (30 mg / kg / day) was by gavage during 2 months. Were evaluated in soleus and EDL muscles, the capillarity, cross-sectional area (CSA), the distribution of fiber types, activities of antioxidant enzymes: superoxide dismutase (SOD) and catalase (CAT), the redox state by GSH: GSSG ratio, and oxidative damage by concentrations of hydroperoxides lipid and protein carbonyls levels. The results showed that in the soleus muscle, the HIIT did not increase the NADPH oxidase activity, but increased capillarity (82%), the activity of SOD (47%) and the ratio GSH: GSSG (52%), but decreased CAT activity (-38%). In EDL muscle, the HIFF increased the activity of the NADPH oxidase enzyme (141%), SOD (36%) and CAT (88%), and the capillarity (50%) and the change of fiber types. Thus it was observed that apocynin had no effect on the function, structure and redox state of SM of sedentary rats. However, the apocynin inhibited adaptations HIIT induced in both muscles (soleus and EDL). The HIIT increased the activity of NADPH oxidase only in the EDL muscle showing different behaviors of the activity of this enzyme in response to this type of training, between the oxidative and glycolytic muscles. Therefore, NADPH oxidase appears to participate in the signaling pathways for adjustments HIIT induced only in the glycolytic muscles. Given these results, it is concluded that glycolytic and oxidative muscles may have different pathways for the adjustments to the SM to exercise. This reinforces and also explains the importance of the intensity and duration of exercise in adaptive responses, since these variables influence the redox state and also trigger different adjustments in SM. In the future, muscle redox status information could even be used to improve the expertise of physical training of athletes