BPS/IC (Bladder Pain Syndrome/Interstitial Cystitis) ist ein sehr schweres und noch weitgehend unverstandenes Krankheitsbild in der Urologie. Viele Frauen sind im Alltag durch den ständigen Harndrang und die Schmerzen stark eingeschränkt und von Depressionen betroffen. Die Aufklärung der Pathogenese ist deshalb sehr wichtig, um eine adäquate Therapie für die Betroffenen zu entwickeln und die Krankheit möglichst frühzeitig diagnostizieren zu können. Das Schwangerschaftshormon hCG (humanes Choriongonadotropin) besitzt differenzierende und wachstumsfördernde Eigenschaften und eine Rolle in der Urothelregeneration und – stabilisierung scheint möglich. Daher ist das Ziel dieser Arbeit seinen Rezeptor, den LHCGR (Luteinizing-Hormone/Choriogonadotropin Rezeptor), in der Harnblase nachzuweisen und die urothelialen und muskulären Charakteristika zwischen gesunden und an BPS/IC erkrankten Harnblasen zu vergleichen. Die Darstellung des LHCGR erfolgte auf Proteinebene mittels indirekter Immunfluoreszenz und auf mRNA-Ebene durch Standard-PCR. Es zeigten sich im Urothel von Harnblase und Ureter 5 unterschiedliche Verteilungsmuster des Rezeptors hinsichtlich seiner Expression in verschiedenen Zellschichten und seiner subzellulären Lokalisation. Je nach Urothelzustand und zwischen den Entitäten Kontroll- bzw. BPS/IC-Harnblase variierten diese Muster in ihrer Häufigkeit. In anderen Epithelien, wie dem Vaginalepithel, änderte sich die zelluläre Verteilung des LHCGR in Abhängigkeit vom Differenzierungsgrad der Zellen. Es scheint möglich, dass auch die Rezeptorexpression in Urothelzellen deren verschiedene Differenzierungszustände widerspiegelt. Dies unterstützt den für hCG vermuteten Einfluss auf die Epithelregeneration. Ein Vergleich der urothelialen Fluoreszenzintensitäten zwischen weiblichen Kontroll – und BPS/IC-Harnblasen zeigte eine signifikant stärkere Expression des Rezeptors bei erkrankten Patienten. Dem gegenüber war kein Unterschied im Detrusor, weder zwischen Kontroll – und BPS/IC-Harnblasen noch im geschlechtsspezifischen Vergleich, festzustellen. Damit scheint der Rezeptor seine Hauptaufgabe vorrangig im Urothel zu entfalten. Die Korrelationsanalysen ergaben keinen signifikanten Zusammenhang zwischen dem Erkrankungsalter (Zeitpunkt der Diagnosestellung und Biopsieentnahme) und der LHCGR-Immunfluoreszenz. Ein endokrinologischer Einfluss auf die Rezeptorexpression wurde dadurch unwahrscheinlich und unterstützt die immer akzeptiertere Auffassung, dass BPS/IC nicht mehr mit der Menopause assoziiert ist. Neben dem Urothel und Detrusor zeigten auch Lamina propria und Gefäße von Harnblase und Ureter die Expression des LHCGR in der Immunhistochemie. Unterschiedliche Clustermuster des Rezeptors im Detrusor ließen auf die Oligomerisierung des Rezeptors schließen. Die Bedeutung dieser Zusammenschlüsse ist jedoch noch unklar, wobei unterschiedliche funktionelle Zustände des Rezeptors vermutet werden. Orientierung bieten andere Rezeptoren, die durch Dimerisierung verschiedener Rezeptorvarianten ihre Funktionalität verbessern oder verschlechtern konnten. Obwohl für keine bisher entdeckte Variante des LHCGR eine definitive Aufgabe ermittelt werden konnte, scheinen doch viele Varianten auch unterschiedliche Funktionen wahrnehmen zu können. Besonders auf der Regulierbarkeit des Rezeptors mittels interagierender Splicevarianten sollte das Augenmerk zukünftiger Studien liegen. Ob durch Komplexbildung verschiedener Varianten oder Bildung nichtfunktioneller trunkierter Rezeptoren, die Kontrollmöglichkeiten sind vielfältig und können auch auf Liganden wirken. Letztlich ließ der Nachweis des LHCGR in allen Schichten von Harnblase und Ureter eher eine globale Rolle des Rezeptors im Harntrakt des Menschen vermuten. Dazu passten auch die bereits nachgewiesenen Einflüsse seiner Liganden auf die Blasenfunktion von Hunden. Die hier vorgelegte Arbeit untersuchte zum ersten Mal die Expression des LHCGR mittels PCR und Immunhistochemie in humanen Harnblasen und Ureteren. Dabei löste sie sich von den sonst üblichen Vorstellungen einer Beziehung des Rezeptors zu Blasentumoren, Schwangerschaft oder Inkontinenz. Diagnose und Therapie von BPS/IC sind zur Zeit noch ständigen Wandlungen unterworfen und dabei entgehen viele Patienten der (frühen) Diagnosestellung und einer adäquaten Behandlung. Diese Studie sollte dazu beitragen neue Einblicke in die Pathophysiologie der Erkrankung zu erlangen, um eine kausale Therapie entwickeln zu können. Zukünftig könnten diese Ergebnisse dabei helfen die Anwendung einer sensitiven und vor allem spezifischen Diagnostik auf molekularer Ebene (mRNA - oder Proteinnachweis) zu ermöglichen.

Made available in DSpace on 2014-06-11T19:35:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2005Bitstream added on 2014-06-13T18:46:34Z : No. of bitstreams: 1 nogueira_mfg_dr_botfmvz.pdf: 892396 bytes, checksum: 471e1cec0bdbf86073d92bc94c87f460 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Em células da teca e da granulosa, de folículos bovinos, foram detectados quatro transcritos alternativos do receptor do hormônio luteinizante (LHR). Apenas dois deles são traduzidos em proteínas funcionais com afinidades distintas em relação aos ligantes. Em humanos e símios, a isoforma completa (full-length) tem afinidade pelo LH e hCG, enquanto que a isoforma que apresenta deleção do exon 10 tem afinidade somente pelo hCG. Além disso, isoformas com deleção do exon 3 foram observadas em ratos, embora nenhum outro estudo tenha investigado essa região do gene bovino. Objetivouse com este trabalho caracterizar o padrão da expressão do gene do LHR nas células da teca e da granulosa de folículos antrais bovinos. Ovários foram coletados em matadouro, os folículos (5-14 mm) foram dissecados e as células da teca e da granulosa separadas para extração de RNA total com Trizol. As concentrações de esteróides no fluido folicular foram determinadas por radioimunoensaio (RIE). A expressão gênica do LHR foi mensurada por RTPCR semiquantitativo com oligonucleotídeos iniciadores (primers) específicos para amplificar o fragmento entre o final da região extracelular e o final da intracelular (LHRBC; primers posicionados nos exons 9 e 11). A ocorrência de transcritos alternativos oriundos do início da região extracelular (LHRA; primers posicionados nos exons 2 e 9) foi investigada mediante amplificação por RT-PCR. Como controle interno no PCR, utilizou-se a expressão da GAPDH. Paralelamente, células da granulosa cultivadas in vitro foram tratadas com 1 ou 10 ng de FSH no meio de cultura. Mediante RT-PCR, foi investigada a expressão das isoformas do LHRBC nas células da granulosa cultivadas e tratadas com FSH... / Growth of dominant follicle in the absence of circulating FSH and the events following the LH surge that culminate in ovulation, are dependent on the interaction between LH and its receptor (LHR). Four LHR alternative transcripts were described in theca and granulosa cells from bovine follicles. Only two of them can be translated to functional proteins (receptors coupled with G protein) with different affinities to their ligands. In humans and marmosets, the full-length isoform has affinity to both LH and hCG molecules, whereas the isoform with deletion of only exon 10 has affinity to hCG exclusively. Additionally, isoforms with deletion of exon 3 were observed in rats, although no previous report have investigated this region of the bovine gene. The objective of this study was to characterize the pattern of gene expression of the LHR in theca and granulosa cells from bovine antral follicles. Additionally, LHR expression was determined in cultured granulosa cells under FSH treatment. From ovaries collected in abattoir, antral follicles were dissected (5 to 14mm of diameter), and samples of theca and granulosa cells were obtained to total RNA extraction (Trizol protocol). Steroids concentrations in the follicular fluid were determined by RIA. Gene expression of LHR was measured by semiquantitative RT-PCR with specific primers to amplify part of extracellular region (LHRA; primers annealing on exons 2 and 9) and the fragment from the end of extracellular region, including the transmembrane domain and finishing near the end of intracellular region (LHRBC; primers annealing on exons 9 and 11). As internal control of the PCR, it was used GAPDH expression. Cultured granulosa cells were treated with 0, 1 or 10 ng of FSH (3 replicates each dose). As in vivo and positive control, theca cell sample was utilized to comparison... (Complete abstract, access undermentioned electronic address)

Orientador: Ciro Moraes Barros / Resumo: Em células da teca e da granulosa, de folículos bovinos, foram detectados quatro transcritos alternativos do receptor do hormônio luteinizante (LHR). Apenas dois deles são traduzidos em proteínas funcionais com afinidades distintas em relação aos ligantes. Em humanos e símios, a isoforma completa ("full-length") tem afinidade pelo LH e hCG, enquanto que a isoforma que apresenta deleção do exon 10 tem afinidade somente pelo hCG. Além disso, isoformas com deleção do exon 3 foram observadas em ratos, embora nenhum outro estudo tenha investigado essa região do gene bovino. Objetivouse com este trabalho caracterizar o padrão da expressão do gene do LHR nas células da teca e da granulosa de folículos antrais bovinos. Ovários foram coletados em matadouro, os folículos (5-14 mm) foram dissecados e as células da teca e da granulosa separadas para extração de RNA total com Trizol. As concentrações de esteróides no fluido folicular foram determinadas por radioimunoensaio (RIE). A expressão gênica do LHR foi mensurada por RTPCR semiquantitativo com oligonucleotídeos iniciadores ("primers") específicos para amplificar o fragmento entre o final da região extracelular e o final da intracelular (LHRBC; "primers" posicionados nos exons 9 e 11). A ocorrência de transcritos alternativos oriundos do início da região extracelular (LHRA; "primers" posicionados nos exons 2 e 9) foi investigada mediante amplificação por RT-PCR. Como controle interno no PCR, utilizou-se a expressão da GAPDH. Paralelamente, células da granulosa cultivadas in vitro foram tratadas com 1 ou 10 ng de FSH no meio de cultura. Mediante RT-PCR, foi investigada a expressão das isoformas do LHRBC nas células da granulosa cultivadas e tratadas com FSH... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Growth of dominant follicle in the absence of circulating FSH and the events following the LH surge that culminate in ovulation, are dependent on the interaction between LH and its receptor (LHR). Four LHR alternative transcripts were described in theca and granulosa cells from bovine follicles. Only two of them can be translated to functional proteins (receptors coupled with G protein) with different affinities to their ligands. In humans and marmosets, the full-length isoform has affinity to both LH and hCG molecules, whereas the isoform with deletion of only exon 10 has affinity to hCG exclusively. Additionally, isoforms with deletion of exon 3 were observed in rats, although no previous report have investigated this region of the bovine gene. The objective of this study was to characterize the pattern of gene expression of the LHR in theca and granulosa cells from bovine antral follicles. Additionally, LHR expression was determined in cultured granulosa cells under FSH treatment. From ovaries collected in abattoir, antral follicles were dissected (5 to 14mm of diameter), and samples of theca and granulosa cells were obtained to total RNA extraction (Trizol protocol). Steroids concentrations in the follicular fluid were determined by RIA. Gene expression of LHR was measured by semiquantitative RT-PCR with specific primers to amplify part of extracellular region (LHRA; primers annealing on exons 2 and 9) and the fragment from the end of extracellular region, including the transmembrane domain and finishing near the end of intracellular region (LHRBC; primers annealing on exons 9 and 11). As internal control of the PCR, it was used GAPDH expression. Cultured granulosa cells were treated with 0, 1 or 10 ng of FSH (3 replicates each dose). As in vivo and positive control, theca cell sample was utilized to comparison... (Complete abstract, access undermentioned electronic address) / Doutor

L'expression anormale de récepteurs hormonaux couplés aux protéines Gs (RCPG) a été mise en évidence dans des tumeurs cortico-surrénaliennes. Ces récepteurs contrôlent la sécrétion du cortisol, mais leur rôle dans la formation tumorale n'a pas été démontré. Nous avons utilisé un modèle de tumorigenèse cortico-surrénalienne permettant l'expression des gènes de deux récepteurs, le GIPR et le LHR, dont l'implication dans les manifestations cliniques d'hypercortisolisme a été bien établie. La formation de tissus hyperprolifératifs et hyperfonctionnels, d'aspect tumoral bénin, démontre pour la première fois que l'expression ectopique d'un seul gène de RCPGs (le GIPR ou le LHR) a un rôle initiateur de la tumorigenèse cortico-surrénalienne. Nous avons également caractérisé in vivo et in vitro un cas clinique de syndrome de Cushing sensible aux catécholamines, secondaire à une hyperplasie surrénalienne où nous avons démontré la surexpression du récepteur β2-adrénergique. La sécrétion de cortisol était aussi dépendante d'autres médiateurs tels que la 5-HT, l'AVP et l'ACTH sécrété localement de façon ectopique. En conclusion, l'expression d'un RCPG suffit pour induire la formation d'une tumeur bénigne cortico-surrénalienne. Des anormalités mixtes peuvent être présentes dans ce type de tumeur. Ce modèle permettra d'étudier les étapes de progression tumorale cortico-surrénalienne ainsi que l'effet d'autres types de GPCR et les alternatives thérapeutiques dans ce type de pathologie.

Introdução: Considerando a prevalência, a importância social dos tratamentos de alta complexidade de mulheres inférteis e o contexto atual da literatura que atribui relevância aos polimorfismos dos genes reguladores do desenvolvimento inicial e crescimento folicular, entre eles o FSHR, LH, LHR, AMH, AMHR, BMP15 e GDF9; torna-se imprescindível o melhor conhecimento e a quantificação desses fatores. Com isso poderemos individualizar e abordar de forma mais racional a investigação e o tratamento destas mulheres submetidas à fertilização in vitro (FIV). Objetivos: Avaliar se os polimorfismos dos genes do LH (Trp8Arg e Ile15Thr), AMH (Ile49Ser), BMP15 (673C/T, 9C/G, IVSI+905A/G), GDF9 (546G>A, 398C>G, 447C>T e 646G>A), e dos receptores do FSH (Ser680Asn), do LH (18isnILQ) e do AMH (Ile49Ser), estão relacionados a diferentes desfechos reprodutivos em pacientes submetidas à fertilização in vitro. Métodos: Realizamos dois estudos em mulheres submetidas à indução ovulatória para FIV: (1) um estudo caso-controle entre pacientes normo respondedoras e má respondedoras, (2) um estudo transversal em pacientes jovens submetidas à indução ovulatória para fertilização in vitro (FIV). Foi extraído DNA das pacientes submetidas à indução ovulatória para FIV a partir do sangue periférico para realização de polymerase chain reaction, com o objetivo de detectar os polimorfismos dos referidos genes e as respectivas relações com os resultados obtidos na estimulação ovariana, no Laboratório de Terapia Gênica do HCPA/UFRGS. Resultados: Foi evidenciado que a presença do polimorfismo 398C>G no gene GDF9 está associada à má resposta em pacientes inférteis submetidas à estimulação ovariana para fertilização in vitro (68% em má respondedoras versus 23% normo respondedoras, OR: 4.01, 95% IC:1.52-10.60). Além disso, o genótipo mutante para o polimorfismo G447C>T no gene do GDF9 foi encontrado em 50% nas pacientes má respondedoras versus 19% nas pacientes normo respondedoras (OR: 2.88, 95% IC:1.19-6.04), evidenciando uma forte associação destes polimorfismos com a má resposta ovariana à estimulação. Encontramos, também, que as mulheres portadoras do alelo mutante do gene 447C>T do GDF9 tiveram um número menor de folículos entre 12-14 mm no dia do hCG (1,62 versus 2,46, P = 0,007). As mulheres com o alelo mutante do gene do GDF9 398C>G tiveram um menor número de folículos maiores que 17 mm no dia do hCG (4,33 versus 6,49, P = 0,001), menor número de folículos entre 12 e 14 milímetros no dia do hCG (1,42 versus 2,25, P= 0,017), um menor número de folículos no dia do hCG (7,33 versus 10,11 versus, P = 0,007), e redução total de oócitos MII coletados (5,38 versus 8,84 P = 0,017). Conclusão: Concluímos que polimorfismos no gene do GDF9 têm uma influência significativa no desenvolvimento do oócito, uma vez que a presença dos alelos mutantes 447C>T e 398C>G diminui o número total de folículos maduros e o número total de oócitos coletados de tais pacientes, além deste último estar associado à má resposta ovariana em pacientes submetidas à indução da ovulação para fertilização in vitro. Isso mostra que este membro da família TGFβ além de atuar nas fases iniciais da foliculogênese também tem influência importante sobre a fase final do desenvolvimento do oócito. / Introduction: Given the prevalence, the social importance of high complexity treatments of infertile women and the current context of the literature assigns relevance to polymorphisms of genes regulating early follicle growth and development, including LH, AMH, BMP15, GDF9, FSHR, LHR and AMHR; become essential to better understanding and quantification of these factors. With this we can individualize and address more rationally research and treatment of these women undergoing IVF. Objectives: Evaluate the relationship of polymorphisms of LH (Trp8Arg andIle15Thr), AMH (Ile49Ser), BMP15 ( 673C/T, 9C/ G, IVSI+905A/ G) and GDF9 (546G>A, 398C>G, 447C>Tand646G>A) genes, and FSH (Ser680Asn), LH (18isnILQ) and AMH (Ile49Ser) receptors genes, related to different reproductive outcomes in patients undergoing IVF. Methods: Our study consisted of two phases: the first conducted a case-control study among patients with normal responders and poor responders, and the second a cross-sectional study in young patients undergoing ovulation induction for in vitro fertilization. DNA was extracted from peripheral blood for performing polymerase chain reaction (PCR) and analyzed at the Laboratory of Gene Therapy HCPA/UFRGS, with the objective of detecting polymorphisms of these genes and their relationships to the results obtained in ovarian stimulation. Results: It was shown that the presence of polymorphism 398C>G in GDF9 gene is associated with poor response in infertile patients undergoing controlled ovarian stimulation for in vitro fertilization (68% in poor responders versus 23% in normal responders). Furthermore, the genotype GDF9 447C>T mutant polymorphism was found in 50% and 19%, respectively, in poor and normal responders patients, showing a strong association with this polymorphism and a poor response in ovarian stimulation. Women carrying the GDF9 398C>G mutant allele had a smaller number of follicles between 12-14 mm on the day of r-hCG (1.62 vs. 2.46, respectively P=0.007). Women with GDF9 398C>G mutant allele had a smaller number of follicles larger than 17 mm on the r-hCG day (4.33 vs. 6.49, P=0.001), a smaller number of follicles between 12 and 14mm on the r-hCG day (1.42 vs. 2.25, P=0.017), a smaller number of follicles on the r-hCG day (7.33 vs. 10.11, P=0,007), and a reduced overall number of MII oocytes collected (5.38 vs. 8.84 ,P=0.017). Conclusion: We conclude that GDF9 polymorphisms in the gene have a significant influence on the development of the oocytes, since the presence of the mutant alleles 447C>T and 398C>G decreases the total number of mature follicles, total number of oocytes collected, and are associated a poor ovarian response in patients undergoing ovulation induction for in vitro fertilization. This shows that this member of the TGFβ family besides acting in the early stages of folliculogenesis also has important influence on the final stage of oocytes development.

Introdução: Considerando a prevalência, a importância social dos tratamentos de alta complexidade de mulheres inférteis e o contexto atual da literatura que atribui relevância aos polimorfismos dos genes reguladores do desenvolvimento inicial e crescimento folicular, entre eles o FSHR, LH, LHR, AMH, AMHR, BMP15 e GDF9; torna-se imprescindível o melhor conhecimento e a quantificação desses fatores. Com isso poderemos individualizar e abordar de forma mais racional a investigação e o tratamento destas mulheres submetidas à fertilização in vitro (FIV). Objetivos: Avaliar se os polimorfismos dos genes do LH (Trp8Arg e Ile15Thr), AMH (Ile49Ser), BMP15 (673C/T, 9C/G, IVSI+905A/G), GDF9 (546G>A, 398C>G, 447C>T e 646G>A), e dos receptores do FSH (Ser680Asn), do LH (18isnILQ) e do AMH (Ile49Ser), estão relacionados a diferentes desfechos reprodutivos em pacientes submetidas à fertilização in vitro. Métodos: Realizamos dois estudos em mulheres submetidas à indução ovulatória para FIV: (1) um estudo caso-controle entre pacientes normo respondedoras e má respondedoras, (2) um estudo transversal em pacientes jovens submetidas à indução ovulatória para fertilização in vitro (FIV). Foi extraído DNA das pacientes submetidas à indução ovulatória para FIV a partir do sangue periférico para realização de polymerase chain reaction, com o objetivo de detectar os polimorfismos dos referidos genes e as respectivas relações com os resultados obtidos na estimulação ovariana, no Laboratório de Terapia Gênica do HCPA/UFRGS. Resultados: Foi evidenciado que a presença do polimorfismo 398C>G no gene GDF9 está associada à má resposta em pacientes inférteis submetidas à estimulação ovariana para fertilização in vitro (68% em má respondedoras versus 23% normo respondedoras, OR: 4.01, 95% IC:1.52-10.60). Além disso, o genótipo mutante para o polimorfismo G447C>T no gene do GDF9 foi encontrado em 50% nas pacientes má respondedoras versus 19% nas pacientes normo respondedoras (OR: 2.88, 95% IC:1.19-6.04), evidenciando uma forte associação destes polimorfismos com a má resposta ovariana à estimulação. Encontramos, também, que as mulheres portadoras do alelo mutante do gene 447C>T do GDF9 tiveram um número menor de folículos entre 12-14 mm no dia do hCG (1,62 versus 2,46, P = 0,007). As mulheres com o alelo mutante do gene do GDF9 398C>G tiveram um menor número de folículos maiores que 17 mm no dia do hCG (4,33 versus 6,49, P = 0,001), menor número de folículos entre 12 e 14 milímetros no dia do hCG (1,42 versus 2,25, P= 0,017), um menor número de folículos no dia do hCG (7,33 versus 10,11 versus, P = 0,007), e redução total de oócitos MII coletados (5,38 versus 8,84 P = 0,017). Conclusão: Concluímos que polimorfismos no gene do GDF9 têm uma influência significativa no desenvolvimento do oócito, uma vez que a presença dos alelos mutantes 447C>T e 398C>G diminui o número total de folículos maduros e o número total de oócitos coletados de tais pacientes, além deste último estar associado à má resposta ovariana em pacientes submetidas à indução da ovulação para fertilização in vitro. Isso mostra que este membro da família TGFβ além de atuar nas fases iniciais da foliculogênese também tem influência importante sobre a fase final do desenvolvimento do oócito. / Introduction: Given the prevalence, the social importance of high complexity treatments of infertile women and the current context of the literature assigns relevance to polymorphisms of genes regulating early follicle growth and development, including LH, AMH, BMP15, GDF9, FSHR, LHR and AMHR; become essential to better understanding and quantification of these factors. With this we can individualize and address more rationally research and treatment of these women undergoing IVF. Objectives: Evaluate the relationship of polymorphisms of LH (Trp8Arg andIle15Thr), AMH (Ile49Ser), BMP15 ( 673C/T, 9C/ G, IVSI+905A/ G) and GDF9 (546G>A, 398C>G, 447C>Tand646G>A) genes, and FSH (Ser680Asn), LH (18isnILQ) and AMH (Ile49Ser) receptors genes, related to different reproductive outcomes in patients undergoing IVF. Methods: Our study consisted of two phases: the first conducted a case-control study among patients with normal responders and poor responders, and the second a cross-sectional study in young patients undergoing ovulation induction for in vitro fertilization. DNA was extracted from peripheral blood for performing polymerase chain reaction (PCR) and analyzed at the Laboratory of Gene Therapy HCPA/UFRGS, with the objective of detecting polymorphisms of these genes and their relationships to the results obtained in ovarian stimulation. Results: It was shown that the presence of polymorphism 398C>G in GDF9 gene is associated with poor response in infertile patients undergoing controlled ovarian stimulation for in vitro fertilization (68% in poor responders versus 23% in normal responders). Furthermore, the genotype GDF9 447C>T mutant polymorphism was found in 50% and 19%, respectively, in poor and normal responders patients, showing a strong association with this polymorphism and a poor response in ovarian stimulation. Women carrying the GDF9 398C>G mutant allele had a smaller number of follicles between 12-14 mm on the day of r-hCG (1.62 vs. 2.46, respectively P=0.007). Women with GDF9 398C>G mutant allele had a smaller number of follicles larger than 17 mm on the r-hCG day (4.33 vs. 6.49, P=0.001), a smaller number of follicles between 12 and 14mm on the r-hCG day (1.42 vs. 2.25, P=0.017), a smaller number of follicles on the r-hCG day (7.33 vs. 10.11, P=0,007), and a reduced overall number of MII oocytes collected (5.38 vs. 8.84 ,P=0.017). Conclusion: We conclude that GDF9 polymorphisms in the gene have a significant influence on the development of the oocytes, since the presence of the mutant alleles 447C>T and 398C>G decreases the total number of mature follicles, total number of oocytes collected, and are associated a poor ovarian response in patients undergoing ovulation induction for in vitro fertilization. This shows that this member of the TGFβ family besides acting in the early stages of folliculogenesis also has important influence on the final stage of oocytes development.

Introdução: Considerando a prevalência, a importância social dos tratamentos de alta complexidade de mulheres inférteis e o contexto atual da literatura que atribui relevância aos polimorfismos dos genes reguladores do desenvolvimento inicial e crescimento folicular, entre eles o FSHR, LH, LHR, AMH, AMHR, BMP15 e GDF9; torna-se imprescindível o melhor conhecimento e a quantificação desses fatores. Com isso poderemos individualizar e abordar de forma mais racional a investigação e o tratamento destas mulheres submetidas à fertilização in vitro (FIV). Objetivos: Avaliar se os polimorfismos dos genes do LH (Trp8Arg e Ile15Thr), AMH (Ile49Ser), BMP15 (673C/T, 9C/G, IVSI+905A/G), GDF9 (546G>A, 398C>G, 447C>T e 646G>A), e dos receptores do FSH (Ser680Asn), do LH (18isnILQ) e do AMH (Ile49Ser), estão relacionados a diferentes desfechos reprodutivos em pacientes submetidas à fertilização in vitro. Métodos: Realizamos dois estudos em mulheres submetidas à indução ovulatória para FIV: (1) um estudo caso-controle entre pacientes normo respondedoras e má respondedoras, (2) um estudo transversal em pacientes jovens submetidas à indução ovulatória para fertilização in vitro (FIV). Foi extraído DNA das pacientes submetidas à indução ovulatória para FIV a partir do sangue periférico para realização de polymerase chain reaction, com o objetivo de detectar os polimorfismos dos referidos genes e as respectivas relações com os resultados obtidos na estimulação ovariana, no Laboratório de Terapia Gênica do HCPA/UFRGS. Resultados: Foi evidenciado que a presença do polimorfismo 398C>G no gene GDF9 está associada à má resposta em pacientes inférteis submetidas à estimulação ovariana para fertilização in vitro (68% em má respondedoras versus 23% normo respondedoras, OR: 4.01, 95% IC:1.52-10.60). Além disso, o genótipo mutante para o polimorfismo G447C>T no gene do GDF9 foi encontrado em 50% nas pacientes má respondedoras versus 19% nas pacientes normo respondedoras (OR: 2.88, 95% IC:1.19-6.04), evidenciando uma forte associação destes polimorfismos com a má resposta ovariana à estimulação. Encontramos, também, que as mulheres portadoras do alelo mutante do gene 447C>T do GDF9 tiveram um número menor de folículos entre 12-14 mm no dia do hCG (1,62 versus 2,46, P = 0,007). As mulheres com o alelo mutante do gene do GDF9 398C>G tiveram um menor número de folículos maiores que 17 mm no dia do hCG (4,33 versus 6,49, P = 0,001), menor número de folículos entre 12 e 14 milímetros no dia do hCG (1,42 versus 2,25, P= 0,017), um menor número de folículos no dia do hCG (7,33 versus 10,11 versus, P = 0,007), e redução total de oócitos MII coletados (5,38 versus 8,84 P = 0,017). Conclusão: Concluímos que polimorfismos no gene do GDF9 têm uma influência significativa no desenvolvimento do oócito, uma vez que a presença dos alelos mutantes 447C>T e 398C>G diminui o número total de folículos maduros e o número total de oócitos coletados de tais pacientes, além deste último estar associado à má resposta ovariana em pacientes submetidas à indução da ovulação para fertilização in vitro. Isso mostra que este membro da família TGFβ além de atuar nas fases iniciais da foliculogênese também tem influência importante sobre a fase final do desenvolvimento do oócito. / Introduction: Given the prevalence, the social importance of high complexity treatments of infertile women and the current context of the literature assigns relevance to polymorphisms of genes regulating early follicle growth and development, including LH, AMH, BMP15, GDF9, FSHR, LHR and AMHR; become essential to better understanding and quantification of these factors. With this we can individualize and address more rationally research and treatment of these women undergoing IVF. Objectives: Evaluate the relationship of polymorphisms of LH (Trp8Arg andIle15Thr), AMH (Ile49Ser), BMP15 ( 673C/T, 9C/ G, IVSI+905A/ G) and GDF9 (546G>A, 398C>G, 447C>Tand646G>A) genes, and FSH (Ser680Asn), LH (18isnILQ) and AMH (Ile49Ser) receptors genes, related to different reproductive outcomes in patients undergoing IVF. Methods: Our study consisted of two phases: the first conducted a case-control study among patients with normal responders and poor responders, and the second a cross-sectional study in young patients undergoing ovulation induction for in vitro fertilization. DNA was extracted from peripheral blood for performing polymerase chain reaction (PCR) and analyzed at the Laboratory of Gene Therapy HCPA/UFRGS, with the objective of detecting polymorphisms of these genes and their relationships to the results obtained in ovarian stimulation. Results: It was shown that the presence of polymorphism 398C>G in GDF9 gene is associated with poor response in infertile patients undergoing controlled ovarian stimulation for in vitro fertilization (68% in poor responders versus 23% in normal responders). Furthermore, the genotype GDF9 447C>T mutant polymorphism was found in 50% and 19%, respectively, in poor and normal responders patients, showing a strong association with this polymorphism and a poor response in ovarian stimulation. Women carrying the GDF9 398C>G mutant allele had a smaller number of follicles between 12-14 mm on the day of r-hCG (1.62 vs. 2.46, respectively P=0.007). Women with GDF9 398C>G mutant allele had a smaller number of follicles larger than 17 mm on the r-hCG day (4.33 vs. 6.49, P=0.001), a smaller number of follicles between 12 and 14mm on the r-hCG day (1.42 vs. 2.25, P=0.017), a smaller number of follicles on the r-hCG day (7.33 vs. 10.11, P=0,007), and a reduced overall number of MII oocytes collected (5.38 vs. 8.84 ,P=0.017). Conclusion: We conclude that GDF9 polymorphisms in the gene have a significant influence on the development of the oocytes, since the presence of the mutant alleles 447C>T and 398C>G decreases the total number of mature follicles, total number of oocytes collected, and are associated a poor ovarian response in patients undergoing ovulation induction for in vitro fertilization. This shows that this member of the TGFβ family besides acting in the early stages of folliculogenesis also has important influence on the final stage of oocytes development.

Ce travail de thèse porte sur la valorisation de granulats recyclés dans la fabrication de nouveaux liants hydrauliques. Il s’inscrit dans une problématique actuelle de gestion des déchets du BTP, de sauvegarde des ressources naturelles et de réduction des gaz à effets de serre liés à la production de matériaux cimentaires. En quelques chiffres, sur les 260 millions de tonnes de déchets inertes produits annuellement par le secteur du BTP en France, 90 millions sont encore déposés en installations de stockage. C’est ce gisement qu’il convient de réduire pour accentuer la fabrication de granulats recyclés estimée aujourd’hui à 15 millions de tonnes/an. Dans cette perspective, ce travail de recherche a pour double objectif de valoriser des granulats recyclés sous forme de fines (Dmax < 80 µm) comme addition minérale en substitution du ciment pour les mortiers et bétons ou bien comme constituant principal de Liants Hydrauliques Routiers (LHR) pour le traitement des sols en place. Deux matériaux source sont utilisés, à savoir : un béton aux propriétés connues et maitrisées et un granulat issu d’une plateforme de recyclage représentatif d’une filière de production. De ces deux matériaux, des fines sont fabriquées par un protocole couplé de concassage et criblage avec ou sans traitement thermique à haute température puis caractérisées (caractérisation physico-chimique, minéralogique et réactivité hydraulique résiduelle) en vue d’établir une cartographie complète de leur potentiel de valorisation en fonction de leur origine. Le premier objectif intitulé « fabrication d’une addition minérale à base de fines » traite de l’effet de cette addition sur le comportement rhéologique, mécanique et sur les propriétés de durabilité de mortiers. Malgré un verrou normatif lié à l’utilisation de matières non référencées dans les normes des matériaux cimentaires, les résultats de ce travail démontrent la faisabilité d’introduire des fines en substitut d’additions classiques tel que le filler calcaire dans des proportions largement supérieures à celles imposées. Le second objectif intitulé « fabrication de liants hydrauliques routiers à base de fines » traite de la conception de LHR à base de fines pour le traitement des sols en place. C’est à partir d’un sol témoin reconstitué en laboratoire que deux familles de LHR à base de fines traitées et non traitées sont conçues, testées et comparées à des liants hydrauliques routiers commercialisés et enfin optimisées. / This thesis work focuses on the valorization of recycled aggregates as main component for hydraulic binders. This is included in a current issue of waste management, protection of natural resources and environment, reduction of greenhouse gases emissions in cement production. In France, on 260 millions tons of inert wastes produced per year, 90 millions tons are still stored in non-hazardous landfill. This waste deposit has to be reduced to increase the production of recycled aggregates currently estimated at 15 million tons per year. In view of this, this research is aimed to enhance the valorization of recycled aggregates into powder form (Dmax < 80 microns) as a mineral addition in substitution of cement for mortar and concrete or as main constituent of Hydraulic Road Binders (HRB). Two sources of materials are used : a five years old concrete and a recycled aggregates come from a recycling plant. Powders are prepared by crushing and sieving with or without high-temperature heat treatment and characterized (physical, chemical and mineralogical characterizations : residual hydraulic reactivity) to evaluate their potential valorization based on their origin.The first objective, entitled “Conception of mineral addition using powder of recycled aggregates”, deals with of the influence of this new materials on rheological, mechanical and durability properties of mortars. The results of this study allow us to evaluate the benefits of incorporating powder obtained by crushing/sieving of recycled aggregates as cement or limestone substitute used in the composition of a mortar. The second objective, entitled "conception of the Hydraulic Road Binders using powders of recycled aggregates", deals with the design of HRB by a comparative approach with HRB manufactured. The characteristics of binders are tested on mortars and on samples of treated soil and the results show that it's possible to produce an HRB rich in powders of recycled aggregates with or without cement which can efficiently stabilize clayey soils.

This study was an exploration of how language is managed in the subordinate courts of Machakos County in Kenya. It was an investigation into the language policy used in the courts, and whether the languages serve the needs, uses and preferences of the people. Language use in Kenya is constitutional (The Constitution of Kenya, 2010).The national language of the Republic of Kenya is Kiswahili and its official languages are English and Kiswahili. The constitution shall protect and promote indigenous languages of the people of Kenya. The constitution further indicates that there shall be general provisions to the Bill of Rights, fundamental freedoms, and that the authority of courts shall uphold and enforce the Bill of Rights. (The Kenya Constitution, 2010, (Cap 4, entitled “The Bill of Rights” has subcategories ranging from Part 1 to Part 5. Part 1 elaborates on general provisions relating to the Bill of Rights, Part 2 on Rights and fundamental freedoms, Part 3 on specific application of Rights, Part 4 on state of emergency and Part 5 on Kenya National Human Rights and Equality Commission). The study attempts to establish whether or not the subordinate courts adhere to these provisions, which policy makers need to adhere to. This research further explores solutions to the problem of communication during court proceedings. Its aim was to advance scientific information that would inform the formulation of a more accommodating language policy in Subordinate Courts. The background information and the history of the courts language gave an overview of how language in subordinate courts is used according to various scholars. The evaluation of how language is used during court proceedings shed light on the people‟s language needs, uses and preferences. / Linguistics and Modern Languages / D. Litt et Phil. (Linguistics)