Estudos recentes têm revelado que a maior parte dos transcritos gerados em células humanas é composta por RNAs não-codificadores de proteínas (ncRNAs). Uma parte desses ncRNAs compreende a classe de RNAs curtos, que possuem menos que 200 nucleotídeos. Os micro-RNAs (miRNAs) fazem parte dessa classe e têm sido alvo de grande interesse, pois são preditos como possíveis reguladores de mais de 60% dos RNAs mensageiros (mRNAs) humanos. Outra classe dos ncRNAs é composta por ncRNAs longos (lncRNAs, com mais de 200 nucleotídeos), que são transcritos a partir de regiões intergênicas e intrônicas do genoma humano e possuem várias funções, muitas delas relacionadas ao controle da expressão de mRNAs. Recentemente, os lncRNAs têm sido caracterizados quanto à sua estrutura e função. No entanto, muito pouco se sabe sobre os mecanismos pelos quais os lncRNAs são regulados. Este trabalho teve como objetivo avaliar se lncRNAs são regulados por miRNAs em células humanas. Para tanto, identificamos lncRNAs ligados ao complexo de silenciamento induzido por RNA (RISC) em células da linhagem HeLa, utilizando um método aqui desenvolvido de geração de bibliotecas de cDNA direcionadas para sequenciamento em larga escala na plataforma 454/Roche. Em paralelo, sequenciamos os miRNAs ligados ao RISC nestas mesmas células. Os resultados obtidos mostram que centenas de lncRNAs de diversas classes se ligam ao RISC em células HeLa, juntamente com milhares de mRNAs e várias centenas de miRNAs. Entre os miRNAs, encontramos 37 que são preditos como alvejando os lncRNAs detectados. Estes miRNAs constituem possíveis reguladores dos lncRNAs e, portanto, nosso trabalho estabelece um mapa experimental de interações diretas entre lncRNAs e miRNAs. Dentre os lncRNAs identificados ligados ao RISC neste trabalho, destaca-se o TUG1, lincRNA sabidamente envolvido na regulação de genes relacionados à apoptose e ao ciclo celular. Mostramos por ensaio de super-expressão de miRNAs e qPCR que TUG1 é regulado pelo miRNA-148b, um dos miRNAs por nós detectados que possui um sítio alvo altamente conservado em mamíferos localizado na extremidade 3\' de TUG1. Em conjunto, este trabalho contribui para o entendimento da regulação dos níveis de expressão de lncRNAs em células humanas e abre perspectivas para a modulação de miRNAs como estratégia de regulação dos níveis e das funções de lncRNAs. / Recent studies have revealed that the largest fraction of the transcripts generated in human cells is composed of non-protein coding RNAs (ncRNAs). A portion of these RNAs encompasses the class of short RNAs, which are less than 200 nucleotides in length. Micro-RNAs (miRNAs) are part of this class and are of great interest, as they are predicted to target over 60% of the human messenger RNAs (mRNAs). Another class of ncRNAs is composed of long ncRNAs (lncRNAs, longer than 200 nucleotides), which are transcribed from intergenic and intronic regions of the human genome and have several functions, many of them related to the control of the mRNA expression. Recently, the structure and function of lncRNAs have been characterized. However, little is known about the mechanisms involved in lncRNA regulation. This work aimed to evaluate whether lncRNAs are regulated by miRNAs in human cells. For this purpose, we identified lncRNAs bound to the RNA-induced silencing complex (RISC) in HeLa cells using a method developed here for the generation of strand-specific cDNA libraries for large scale RNA-sequencing in the 454/Roche plataform. In parallel, we sequenced the miRNAs bound to RISC in these cells. Our results show that hundreds of lncRNAs from diverse classes are bound to RISC in HeLa cells, along with thousands of mRNAs and several hundred miRNAs. Among the miRNAs we identified 37 that are predicted to target the detected lncRNAs. These miRNAs are possible regulators of the lncRNAs, and therefore our work establishes an experimental map of direct interactions between lncRNAs and miRNAs. The lncRNA TUG1, a lincRNA involved in the regulation of genes related to apoptosis and cell cycle, was identified among the lncRNAs bound to RISC. We showed by miRNA over-expression and qPCR that TUG-1 is regulated by the miRNA-148b, which is one of the miRNAs detected in our sequencings and has a binding site highly conserved in mammals located at the TUG1 3` end. Taken together, our results contribute to the understanding of the regulation of the lncRNA expression levels in human cells and open perspectives for the modulation of miRNAs as a strategy to regulate the levels and functions of lncRNAs.

Les applications des cellules souches pluripotentes humaines (CSP) dans le domaine biomédical sont particulièrement prometteuses, aussi bien au niveau expérimental qu’au niveau clinique. Leur utilisation comme source inépuisable de cellules permettant de tester et développer de nouvelles molécules thérapeutiques (notamment par modélisation de pathologies in vitro, criblage haut-débit et tests de cytotoxicité) s’ajoute à l’important potentiel qu’elles présentent en médecine régénérative et en thérapie cellulaire. Utilisables comme matériel biologique permettant de restaurer partiellement ou totalement un organe ou un tissu défaillant, il reste essentiel de vérifier l’intégrité génétique des lignées cellulaires utilisées afin de garantir une utilisation sécurisée pour le patient. Parmi les facteurs responsables de l’apparition d’anomalies génétiques chez les CSP, les conditions cultures jouent un rôle essentiel. Des techniques de culture inadaptées peuvent facilement provoquer l’émergence d’une instabilité génomique. Toute altération doit être détectée et documentée afin de pouvoir définir des critères d’acceptation préalable à leur utilisation clinique.Les CSP sont des cellules particulièrement sensibles au stress qui peut résulter de techniques de repiquage inappropriées. La dérive génétique qui découle de ce stress peut être précoce et apparaître dès les premiers passages des lignées cultivées. Notre équipe a pu tester de nombreuses méthodes de repiquage sur différentes lignées cellulaires pluripotentes. Nous avons notamment observé que des anomalies génétiques majeures caryotypiques (trisomies) et infra-caryotypiques (SNPs) ainsi que des changements phénotypiques (survie augmentée, acquisition de mobilité) apparaissaient rapidement suite à l’utilisation de techniques de repiquage basées sur l’utilisation d’enzyme de dissociation (TryPLE). Ces altérations apparaissent dans des lignées qui s’adaptent progressivement à la dissociation en cellules uniques (dissociation « single-cell ») provoquées par ces enzymes.Notre équipe étudie les conséquences cellulaires liées à ce phénomène d’adaptation des CSP provoquée par la dissociation « single-cell ». Grâce à des techniques de séquençage dernière génération (RNA-Seq), nous avons comparé les profils transcriptomiques de CSP repiquées par des techniques standard (comme le passage mécanique) et par des techniques basées sur la dissociation « single-cell » (comme le passage enzymatique par TryPLE). Cette comparaison a montré au niveau transcriptionnel une surexpression spectaculaire d’ARNs non codants appartenant à une classe récemment décrite : les longs ARNs non codants (lncRNAs).L’objectif principal de ce travail de thèse a été d’évaluer le niveau d’implication de ces lncRNAs dans le processus d’adaptation des CSP en culture, et leur rôle fonctionnel potentiel. Nous avons ainsi dans un premier temps déterminé in silico quels lncRNAs étaient différentiellement exprimés dans les CSP adaptées, et après validation expérimentale par biologie moléculaire des candidats les plus prometteurs, nous avons utilisé des tests fonctionnels (notamment par RNA interférence (siRNA)) afin de déterminer le rôle de ces lncRNAs dans la machinerie cellulaire et la pluripotence des CSP. Autour de ce projet principal, nous avons essayé de comprendre les mécanismes régissant les changements phénotypiques et comportementaux provoquées par la dissociation « single-cell ». Nous avons notamment pu suggérer la mise en place d’un phénomène de transition épithélio-mésenchymateuse (EMT) chez des CSP dissociées. Enfin, l’attractivité que représente un sujet d’étude récent comme les lncRNAs et la disponibilité croissante de publications les concernant nous ont poussé à publier une revue approfondie ainsi qu’une méta-analyse sur l’implication des longs ARN non codants dans le développement précoce de l’embryon et dans les cellules souches pluripotentes. / The actual and future applications of human pluripotent stem cells (PSC) in the biomedical field are highly promising. Their use for the discovery of new therapeutic drugs through the development of high-throughput screening tests, cytotoxicity tests and in vitro disease modeling has been added to their tremendous interests in regenerative medicine and cellular therapy. As a source of biological material that can be used to restore partially or totally the lost functions of a damaged organ or tissue, or as a source of normal cells to study human development or test putative new drugs, their genomic integrity has to be thoroughly assessed. Therefore, an effective optimization of their culture conditions has to be considered, in order to control the absence of genomic instability and prevent their potential emergence. Any genetic or epigenetic alteration resulting from cell culturing must be detected in order to define and characterize acceptance criteria for scientific and medical purposes.PSC are particularly sensitive to stress resulting from unappropriated passaging techniques, which cause rapid genetic drift. Indeed, our team observed that many genomic abnormalities arise from aggressive single cell, enzymatic based, passaging methods, and that substantial phenotypical changes such as increased survival after cell dissociation and variation in cell shape can then occur.In order to understand the mechanisms governing the emergence of those adverse alterations, the team focused on the consequences resulting from the adaptation of PSC to single-cell dissociation. By using new generation sequencing techniques as RNA-Seq, we compared transcriptomics of PSC passaged by standard techniques (such as mechanical passaging) versus single-cell enzymatic dissociation (such as TRyPLE-based single-cell passaging). This comparison showed that the most striking difference in the gene expression pattern between adapted and non adapted cells concerned the dramatic overexpression of RNAs from a recently discovered class: long non-coding RNAs (lncRNAs).The aim of this thesis work was to determine to which extent some of these lncRNAs were functionally linked to adaptation of PSC. In order to address this matter, we first investigated in silico which lncRNAs were upregulated by single-cell dissociation, and after experimental validation of lncRNA candidates by molecular biology, we performed functional in vitro analysis (notably by siRNA-mediated loss of function) and sought their cellular localization in order to decipher their role in the cellular machinery and their level of implication. Beside this main project, other auxiliary projects were grafted. The observation of major changes in cell phenotype and behavior led to the investigation of the global mechanisms governing these modifications, underlining the potential role of epithelial-to-mesenchymal transition provoked by single-cell dissociation. Finally, the global attractiveness of lncRNAs and the emergence of exponential documentation concerning non-coding RNAs prompted the writing of an extensive review and meta-analysis concerning the implications of lncRNAs during embryo development and in pluripotent stem cells.

Chimpanzee is the closest living species to modern humans. Although the differences in phenotype are striking between these two species, the difference in genomic sequences is surprisingly small. Species specific changes and positive selection have been mostly found in proteins, but ncRNAs are also involved, including the largely uncharacterized class of long ncRNAs (lncRNAs). A notable example is the Human Accelerated Region 1 (HAR1), the region in the human genome with the highest number of human specific substitutions: 18 in 118 nucleotides. HAR1 is located in a pair of overlapping lncRNAs that are expressed in a crucial period for brain development. Importantly, structural rather then sequence constraints lead to evolution of many ncRNAs. Different methods have been developed for detecting negative selection in ncRNA structures, but none thus far for positive selection. This motivated us to develop a novel method: the SSS-test (Selection on the Secondary Structure test). This novel method uses an excess of structure changing changes as a means of identifying positive selection. This is done using reports from RNAsnp, a tool that quantifies the structural effect of SNPs on RNA structures, and by applying multiple correction on the observations to generate selection scores. Insertions and deletions (indels) are dealt with separately using rank statistics and a background model. The scores for SNPs and indels are combined to calculate a final selection score for each of the input sequences, indicating the type of selection. We benchmarked the SSS-test with biological and synthetic datasets, obtaining coherent signals. We then applied it to a lncRNA database and obtained a set of 110 human lncRNAs as candidates for having evolved under adaptive evolution in humans. Although lncRNAs have poor sequence conservation, they have conserved splice sites, which provide ideal guides for orthology annotation. To provide an alternative method for assigning orthology for lncRNAs, we developed the 'buildOrthologs' tool. It uses as input a map of ortholog splice sites created by the SpliceMap tool and applies a greedy algorithm to reconstruct valid ortholog transcripts. We applied this novel approach to create a well-curated catalog of lncRNA orthologs for primate species. Finally, to understand the structural evolution of ncRNAs in full detail, we added a temporal aspect to the analysis. What was the order of mutations of a structure since its origin? This is a combinatorial problem, in which the exact mutations between ancestral and extant sequences must be put in order. For this, we developed the 'mutationOrder' tool using dynamic programming. It calculates every possible order of mutations and assigns probabilities to every path. We applied this novel tool to HAR1 as a case study and saw that the co-optimal paths that are equally likely to have occured share qualitatively comparable features. In general, they lead to stabilization of the human structure since the ancestral. We propose that this stabilization was caused by adaptive evolution. With the new methods we developed and our analysis of primate databases, we gained new knowledge about adaptive evolution of human lncRNAs.

No description available.

La maladie de Chagas est une maladie parasitaire causée par le protozoaire Trypanosoma cruzi et transmise par des insectes hématophages . Elle est composée de 2 phases : la phase aiguë et la phase chronique. Parmi les individus infectés, 30 % développent la forme chronique de la maladie. Les patients présentent des atteintes cardiaques, digestives (œsophage, côlon) et cardiodigestives. Notre étude a été focalisée sur les patients atteints de cardiomyopathie chagasique (CCC). Notre objectif est d’identifier des gènes de susceptibilité pouvant être impliqués dans le développement des formes chroniques. Notre étude a permis de mettre en évidence une variation d’expression de certains gènes entre les CCC et les contrôles. Nous nous sommes également intéressés aux processus épigénétiques pouvant réguler l’expression des gènes. Une étude de la méthylation de l’ADN croisée avec l’étude du transcriptome nous ont permis d’identifier des gènes présentant à la fois des variations d’expression et de méthylation. Pour certains de ces gènes, nous avons démontré que la méthylation est responsable de la variation d’expression observée. Enfin, nous avons étudié un ARN long non-codant, MIAT. Nous avons démontré qu’il est surexprimé chez les CCC par rapport aux contrôles et dans un modèle murin infecté par T. cruzi. De plus, l’analyse de l’expression de micro-ARNs couplée à une analyse de transcriptome nous a permis d'identifier plusieurs micro-ARNs indispensables à la régulation de l’expression des gènes. Enfin, une étude protéomique nous a permis de mettre en évidence une augmentation de la production de protéine pour certains gènes, en lien avec l’augmentation de l’expression observée. / Chagas disease is a parasitic disease caused by the protozoan Trypanosoma cruzi and transmitted by the hematophagous insects. The disease is composed by acute and chronic phases. Among the infected individuals, 30 % develop chronic form. They suffer from heart, digestive (esophagus, colon) and cardiodigestives injury. Our study was focused on patients with dilated chagasic cardiomyopathy (CCC). Our goal is to identify susceptibility genes that may be involved in the development of chronic forms. Our study revealed a variation in the expression of certain genes between CCC group and controls. We are also interested in epigenetic processes that can regulate the expression of genes. A study of the DNA methylation crossed with the transcriptome allowed us to identify genes presenting both variations in expression and methylation. For some of these genes we demonstrated that methylation is responsible for the expression variation observed. Finally, we studied a long non-coding RNA called MIAT. Our study demonstrated that it is overexpressed in CCC compared to controls and in a murine model infected by T. cruzi. Furthermore, the analysis of the expression of micro-RNAs crossed with transcriptome analysis allowed us to identify several micro-RNAs whose functions are essential in the regulation of gene expression. Finally, a proteomic study allowed us to demonstrate an increase in the production of protein for certain genes, correlated with the increase in expression levels observed.

Tesis por compendio / [ES] Aproximadamente 57 millones de adultos sufren insuficiencia cardíaca en todo el mundo y el trasplante cardíaco sigue siendo el tratamiento de referencia, en ausencia de contraindicaciones, en pacientes con insuficiencia cardíaca avanzada. A pesar de las mejoras en el tratamiento inmunosupresor, uno de los principales eventos tras el trasplante es el rechazo agudo (rechazo celular agudo (RCA) y el rechazo mediado por anticuerpos (RMA). La biopsia endomiocárdica (BEM) es la técnica estándar para monitorizar el rechazo, pero presenta importantes limitaciones, como su carácter invasivo. Por lo tanto, la identificación de métodos no invasivos para reducir o eliminar la BEM es un campo de estudio abierto. La biopsia líquida es una alternativa potencial menos invasiva debido a su capacidad para reflejar los cambios fisiopatológicos producidos en los órganos durante un evento. Los enfoques ómicos han permitido el descubrimiento de moléculas libres circulantes en sangre como biomarcadores de enfermedad, destacando el potencial de los ARNs por su papel en procesos inflamatorios, especificidad tisular y estabilidad en fluidos biológicos. Por ello, esta Tesis Doctoral se ha centrado en identificar ARNs libres circulantes alterados en el torrente sanguíneo tras un trasplante de corazón desde un enfoque transcriptómico y estudiar la capacidad diagnóstica para su uso como biomarcadores de rechazo cardíaco (RCA [no rechazo (0R), leve (1R) y moderado-grave (≥2R)] y RMA [no rechazo (pRMA0) y rechazo histopatológico e inmunopatológico (pRMA2)]). Los resultados obtenidos en esta Tesis Doctoral mostraron una desregulación en varios biotipos de ARNs libres circulantes tras el trasplante cardíaco en condiciones de rechazo. Observamos alteraciones en genes relacionados con el sarcómero; y el gen que codifica la alfa-actina cardiaca (ACTC1) mostró la mejor capacidad diagnóstica (≥2R área bajo la curva (AUC)=1,000, p<0,0001). Además, determinamos los niveles de la proteína ACTC1 en una cohorte mayor de pacientes, corroborando los hallazgos previos (AUC=0,702, p<0,05). Además, identificamos varios miARNs alterados en el suero de pacientes con RCA, concretamente miR-144-3p mostró los mejores resultados. En la fase de validación tuvo una capacidad diagnóstica excelente para el rechazo ≥2R (AUC=0,801, p<0,0001); sin embargo, su capacidad para detectar el rechazo 1R fue limitada (AUC=0,631, p<0,01). Así pues, analizamos y validamos la combinación de miR-144-3p y miR-652-3p, otro miARN identificado en la fase de descubrimiento. La combinación mejoró el poder diagnóstico (≥2R AUC=0,892, p<0,0001; 1R AUC=0,794, p<0,0001). Además, analizamos por primera vez la presencia en suero de otros biotipos de ARNs no codificantes tras un trasplante cardíaco. En concreto, identificamos 5 lncARNs (AC008105.3, AC006525.1, AC011455.8, AL359220.1, y AC025279.1) con capacidad diagnóstica excelente para la detección de los grados ≥2R (AUC de 0,850 a 1,000) y 1R (AUC de 0,750 a 0,854). Por otro lado, identificamos 7 piARNs (piR-169894, piR-181318, piR-1981088, piR-2479902, piR-380748, piR-398377 y piR-401292) con un perfil de expresión coincidente en suero y BEM. A continuación, validamos la combinación de estos piARNs en una cohorte mayor independiente (≥2R AUC=0,819, p<0,0001; 1R AUC=0,721, p=0,001). Además, nuestro panel de piARNs mostró un excelente poder diagnóstico de RMA (AUC=0,967, p<0,0001). Nuestros resultados demuestran la existencia de alteraciones en la expresión de ARNs libres circulantes (mARN, miARN, lncARN y piARN) en pacientes con rechazo cardíaco tras un trasplante, demostrando además una potente capacidad diagnóstica para los diferentes grados de RCA, incluso para el grado de rechazo leve. Además, una adecuada combinación de ARNs libres circulantes muestra mayor precisión para el diagnóstico del RCA que la detección individual de cada molécula, mostrando una excelente capacidad de diagnóstico del RMA y permitiendo monitorizar la respuesta al tratamiento. / [CA] Aproximadament 57 milions d'adults patixen insuficiència cardíaca a tot el món i el trasplantament cardíac continua sent el tractament de referència en absència de contraindicacions en pacients amb insuficiència cardíaca avançada. Malgrat les millores en el tractament immunosupressor, un dels principals esdeveniments després del trasplantament és el rebuig agut (rebuig cel·lular agut (RCA) i rebuig mediat per anticossos (RMA)). La biòpsia endomiocàrdica (BEM) és la tècnica estàndard per a monitorar el rebuig agut. No obstant això, la BEM presenta importants limitacions, com el seu caràcter invasiu. Per tant, la identificació de mètodes no invasius per a reduir o eliminar la BEM és un camp d'estudi obert. La biòpsia líquida és una alternativa potencial per a substituir a la BEM a causa de la seua capacitat per a reflectir els canvis fisiopatològics produïts en els òrgans durant un rebuig. Els enfocaments òmics han permés el descobriment de molècules lliures circulants en el torrent sanguini com biomarcadors de malaltia, destacant el potencial dels ARNs pel seu paper en processos inflamatoris, especificitat tissular i estabilitat en fluids biològics. Per això, esta Tesi Doctoral s'ha centrat en identificar ARNs lliures circulants alterats en sang després d'un trasplantament de cor des d'un enfocament transcriptòmic i estudiar la capacitat diagnòstica per al seu ús com biomarcadors de rebuig cardíac (RCA [no rebuig (0R), lleu (1R) i moderat-greu (≥2R)] i RMA [no rebuig (pRMA0) i rebuig histopatològic i immunopatològic (pRMA2)]). Els resultats obtinguts en esta Tesi Doctoral van mostrar desregulació en diversos biotips d'ARN lliures circulants després del trasplantament cardíac en condicions de rebuig. Observem alteracions en gens relacionats amb el sarcòmer; i el gen que codifica l'alfa-actina cardíaca (ACTC1) va mostrar la millor capacitat diagnòstica (≥2R: àrea baix la corba (AUC)=1,000, p<0,0001). A més, determinàrem els nivells de proteïna ACTC1 en una cohort major de pacients, corroborant les troballes prèvies (AUC=0,702, p<0,05). A més, identificàrem alguns miARNs alterats en el sèrum de pacients amb RCA, concretament miR-144-3p va mostrar els millors resultats. En la fase de validació va tindre una capacitat diagnòstica excel·lent per al rebuig ≥2R (AUC=0,801, p<0,0001); no obstant això, la seua capacitat per a detectar el rebuig 1R va ser limitada (AUC=0,631, p<0,01). Així doncs, analitzàrem i validàrem la combinació de miR-144-3p i miR-652-3p, un altre miARN identificat en la fase de descobriment. La combinació va millorar el poder diagnòstic (≥2R AUC=0,892, p<0,0001 i 1R AUC=0,794, p<0,0001). A més, analitzem per primera vegada la presència en sèrum d'altres biotips de ARN no codificant després d'un trasplantament cardíac. En concret, identificàrem 5 lncARNs (AC008105.3, AC006525.1, AC011455.8, AL359220.1, i AC025279.1) amb capacitat diagnòstica excel·lent per a la detecció de graus ≥2R (AUC de 0,850 a 1,000) i 1R (AUC de 0,750 a 0,854). D'altra banda, identificàrem 7 piARNs (piR-169894, piR-181318, piR-1981088, piR-2479902, piR-380748, piR-398377, i piR-401292) amb un perfil d'expressió coincident en sèrum i BEM. A continuació, validàrem la combinació d'estos piARNs en una major cohort independent (≥2R AUC=0,819, p<0,0001 i 1R AUC=0,721, p=0,001). A més, el nostre panell de piARN va mostrar un excel·lent poder diagnòstic de RMA (AUC=0,967, p<0,0001). Els nostres resultats demostren l'existència d'alteracions en l'expressió de ARNs lliures circulants (mARN, miARN, lncARN i piARN) en pacients amb rebuig cardíac després d'un trasplantament, demostrant a més una potent capacitat diagnòstica per als diferents graus de RCA, fins i tot per al grau de rebuig lleu. A més, una adequada combinació de ARNs lliures circulants mostra major precisió per al diagnòstic del RCA que la detecció individual de cada molècula, mostrant també una excel·lent capacitat de diagnòstic del RMA i permetent monitorar la resposta al tractament. / [EN] Approximately 57 million adults globally suffer heart failure and heart transplantation remains the gold standard therapy, in the absence of contraindications, in advanced heart failure patients. Despite improvements in immunosuppressive treatment one of the main events after transplant is acute rejection (acute cellular rejection (ACR) and antibody-mediated rejection (AMR)). Endomyocardial biopsy (EMB) is the standard technique for monitoring acute rejection, but EMB presents important limitations such as its invasive nature. Therefore, the identification of non-invasive methods to reduce or eliminate surveillance EMB is an important and necessary open field of study. Liquid biopsy is a potential alternative to replace EMB due to its less invasive nature and capability to reflect pathophysiological changes produced in organs during an event. The omics approaches have allowed the discovery of free molecules circulating in the bloodstream as biomarkers of disease, highlighting the potential of RNAs for their role in inflammatory processes, tissue specificity and stability in biological fluids. Therefore, this Doctoral Thesis have focused on identifying altered circulating cell-free mRNAs, miRNAs, lncRNAs, and piRNAs in the bloodstream after heart transplantation from a transcriptomic approach and studying the diagnostic capacity for its use as biomarkers of cardiac rejection (ACR [non-rejection (0R), mild (1R) and moderate-severe (≥2R)], and AMR [non-rejection (pAMR0) and histopathologic and immunopathologic rejection (pAMR2)]). The results obtained in this Doctoral Thesis showed deregulation in several biotypes of cell-free RNAs after heart transplantation in rejection conditions. We observed alterations in genes related to the sarcomere; and the gene that encodes cardiac alpha-actin (ACTC1) showed the best diagnostic capacity (grade ≥2R: AUC=1.000, p<0.0001). Furthermore, we determined ACTC1 protein levels in a larger cohort of patients, corroborating previous findings (AUC=0.702, p<0.05). Moreover, we identified several miRNAs altered in the serum of patients with ACR, specifically miR-144-3p showed the best results. In the validation phase it had excellent diagnostic capacity for moderate-severe rejection (AUC=0.801 p<0.0001); however, its ability to detect mild rejection was limited (AUC=0.631, p<0.01). Thus, we analysed and validated the combination of miR-144-3p and miR-652-3p, another miRNA identified in the discovery phase. The combination improved diagnostic power for moderate-severe rejection (AUC=0.892, p<0.0001) and mild (AUC =0.794, p<0.0001) rejection. Furthermore, we analysed for the first time the presence in serum of other biotypes of ncRNA (lncRNA and piRNA) after heart transplantation. Specifically, we identified 5 lncRNAs (AC008105.3, AC006525.1, AC011455.8, AL359220.1, and AC025279.1) with excellent diagnostic capacity for detection of ≥2R (AUC of 0.850 to 1.000) and 1R (AUC of 0.750 to 0.854) grades. On the other hand, we identified 7 piRNAs (piR-169894, piR-181318, piR-1981088, piR-2479902, piR-380748, piR-398377, and piR-401292) with a coincident expression profile in serum and EMB. Next, we validated the combination of these piRNAs in a large independent cohort (grade ≥2R: AUC=0.819, p<0.0001 and grade 1R: AUC=0.721, p=0.001). Additionally, our piRNA panel showed excellent diagnostic power for AMR (pAMR2: AUC=0.967, p<0.0001). Our results demonstrate the existence of alterations in the expression of circulating free RNAs (mRNA, miRNA, lncRNA and piRNA) in patients with cardiac rejection after transplantation, also demonstrating a powerful diagnostic capacity for different grades of ACR, even for the grade of mild rejection. Besides, an appropriate combination of circulating free RNAs shows greater precision for the diagnosis of ACR than the single detection of each molecule, showing excellent AMR capacity diagnosis and allowing monitoring of the response to treatment. / This work was supported by the National Institute of Health “Fondo de Investigaciones Sanitarias del Instituto de Salud Carlos III” (Projects: PI17/01232, PI20/01469, PI20/00071, CP18/00145 and PMPTA22/00184) co-funded by European Union; Miguel Servet contracts: CP21/00041, CP18/00145 cofunded by European Union, European Social Fund (ESF) “The ESF invests in your future” co-funded by European Union; “Consorcio Centro de Investigación Biomédica en Red” [CIBERCV, under Grant CB16/11/00261]; Ministry of Science and Innovation (MCIN, 10.13039/501100011033) and State Investigation Agency (AEI) (Project CNS2022-135769) co-funded by European Union “Next Generation EU” and the European Recovery, Transformation and Resilience Plan (PRTR); Conselleria de educación, universidades y empleo (Project kuuy8uio, contract CIACIF/2022/429). / Pérez Carrillo, L. (2024). Identification of New Circulating Biomarkers for the Characterization and Non-Invasive Diagnosis of Cardiac Rejection [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/214192 / Compendio