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La barrière hémato-encéphalique (BHE) protège le système nerveux central (SNC) des fluctuations plasmatiques des molécules endogènes, mais aussi exogènes, et notamment des molécules à potentiel thérapeutique. L’imperméabilité de la BHE est compensée par la présence de mécanismes qui assurent le transport transendothélial des nutriments nécessaires au tissu nerveux, parmi lesquels la transcytose relayée par différents récepteurs. Dans le but d’améliorer le transfert d’agents thérapeutiques à travers la BHE, nous développons des « vecteurs » qui se lient à certains de ces récepteurs. Au cours de notre thèse, nous avons développé et optimisé des modèles in vitro de BHE et barrière sang-moelle épinière (BSME) syngéniques de rats et souris, basés sur la co-culture de cellules endothéliales microvasculaires (CEMs) cérébrales (CEMCs) ou spinales (CEMSs) et d'astrocytes. Parmi les récepteurs étudiés, nous montrons que le LDLR est exprimé à la membrane plasmique apicale des CEMCs et qu’il est impliqué dans la transcytose du LDL tout en évitant le compartiment lysosomal, confirmant l’intérêt de son ciblage dans nos approches. Nous montrons que nos vecteurs, conjugués à une molécule organique ou à un cargo protéique, sont endocytés par les CEMCs de façon LDLR-dépendante, évitent le compartiment lysosomal et franchissent la monocouche de CEMCs. Nous avons également mis en place des modèles in vitro de BHE et BSME enflammés, sachant que l’inflammation des CEMs est associée à de nombreuses pathologies du SNC. Ces modèles seront utiles pour évaluer des stratégies de vectorisation ciblant préférentiellement les structures du SNC en situation pathologique. / The blood-brain barrier (BBB) protects the central nervous system (CNS) from plasma fluctuations of endogenous, but also exogenous molecules, including therapeutic molecules. The BBB’s restrictive properties are compensated by the presence of different mechanisms that provide transport of nutrients across the BBB, including transcytosis of endogenous ligands mediated by receptors. Our objective is to improve drug delivery across the BBB and we developed “vectors” that target different recpetors. During our thesis we developed and optimized cellular tools and approaches, in particular syngeneic in vitro models of the BBB and blood-spinal cord barrier (BSCB) from both rat and mouse, based on the co-culture of brain (BMECs) or spinal cord (SCMECs) microvascular endothelial cells (MECs) and astrocytes. Among the receptors we studied, we show that the LDL receptor (LDLR) is expressed at the apical plasma membrane of BMECs and confirmed that it is involved in transcytosis of LDL through the vesicular compartment, while avoiding the lysosomal compartment, further establishing its interest as a target receptor. We show that our vectors conjugated to an organic molecule or to a protein cargo are endocytosed by BMECs in a LDLR-dependent manner, avoid the lysosomal compartment and cross the BMEC monolayers. Finally, we developed BBB and BSCB in vitro models in inflammatory conditions, considering that MECs inflammation is associated with many CNS lesions and pathologies. These models will be useful to better understand the inflammatory processes of CNS endothelial cells and to evaluate vectorization strategies preferentially targeting CNS structures in pathological condition.

Proprotein Convertase Subtilisin/Kexin 9 (PCSK9) is the ninth member of the Ca+2-dependent mammalian proprotein convertase super family of serine endoproteases that is structurally related to the bacterial subtilisin and yeast kexin enzymes. It plays a critical role in the regulation of lipid metabolism and cholesterol homeostasis by binding to and degrading low-density lipoprotein-receptor (LDL-R) which is responsible for the clearance of circulatory LDL-cholesterol from the blood. Owing to this functional property, there is plenty of research interest in the development of functional inhibitors of PCSK9 which may find important biochemical applications as therapeutic agents for lowering plasma LDL-cholesterol. The catalytic domain of PCSK9 binds to the EGF-A domain of LDL-R on the cell surface to form a stable complex and re-routes the receptor from its normal endosomal recycling pathway to the lysosomal compartments leading to its degradation. Owing to these findings, we propose that selected peptides from PCSK9 catalytic domain, particularly its disulphide (S-S) bridged loop1 323-358 and loop2 365-385, are likely to exhibit strong affinity towards the EGF-A domain of LDL-R. Several regular peptides along with corresponding all- dextro and retro-inverse peptides as well as the gain-of-function mutant variants were designed and tested for their regulatory effects towards LDL-R expression and PCSK9-binding in human hepatic HepG2 and mouse hepatic Hepa1c1c7 cells. Our data indicated that disulfide bridged loop1-hPCSK9323-358 and its H357 mutant as well as two short loop2-hPCSK9372-380 and its Y374 mutant peptides modestly promote the LDL-R protein levels. Our study concludes that specific peptides from the PCSK9 catalytic domain can regulate LDL-R and may be useful for development of novel class of therapeutic agents for cholesterol regulation.

Les maladies cardiovasculaires (MCV) demeurent au tournant de ce siècle la principale cause de mortalité dans le monde. Parmi les facteurs de risque, l’hypercholestérolémie et l’obésité abdominale sont directement liées au développement précoce de l’athérosclérose. L’hypercholestérolémie familiale, communément associée à une déficience des récepteurs des lipoprotéines de basse densité (LDLR), est connue comme cause de maladie précoce d’athérosclérose et de calcification aortique chez l’humain. La subtilisine convertase proprotéine/kexine du type 9 (PCSK9), membre de la famille des proprotéines convertases, est trouvée indirectement associée aux MCV par son implication dans la dégradation du LDLR. Chez l'humain, des mutations du gène PCSK9 conduisent soit à une hypercholestérolémie familiale, soit à une hypocholestérolémie, selon que la mutation entraîne un gain ou une perte de fonction, respectivement. Il demeure incertain si les individus porteurs de mutations causant un gain de fonction de la PCSK9 développeront une calcification aortique ou si des mutations entraînant une perte de fonction provoqueront une obésité abdominale. Dans cette étude, nous avons examiné : 1) l’effet d’une surexpression de PCSK9 dans le foie de souris sur la calcification aortique ; 2) les conséquences d’une déficience en PCSK9 (Pcsk9 KO), mimant une inhibition pharmacologique, sur le tissu graisseux. Nous avons utilisé un modèle de souris transgénique (Tg) surexprimant le cDNA de PCSK9 de souris dans les hépatocytes de souris et démontrons par tomographie calculée qu’une calcification survient de façon moins étendue chez les souris PCSK9 Tg que chez les souris déficientes en LDLR. Alors que le PCSK9 Tg et la déficience en LDLR causaient tous deux une hypercholestérolémie familiale, les niveaux seuls de cholestérol circulant ne parvenaient pas à prédire le degré de calcification aortique. Dans une seconde étude, nous utilisions des souris génétiquement manipulées dépourvues de PSCK9 et démontrons que l’accumulation de graisses viscérales (adipogenèse) apparaît régulée par la PCSK9 circulante. Ainsi, en l’absence de PCSK9, l’adipogenèse viscérale augmente vraisemblablement par régulation post-traductionnelle des récepteurs à lipoprotéines de très basse densité (VLDLR) dans le tissu adipeux. Ces deux modèles mettent en évidence un équilibre dynamique de la PCSK9 dans des voies métaboliques différentes, réalisant un élément clé dans la santé cardiovasculaire. Par conséquent, les essais d’investigations et d’altérations biologiques de la PCSK9 devraient être pris en compte dans un modèle animal valide utilisant une méthode sensible et en portant une attention prudente aux effets secondaires de toute intervention. / Cardiovascular disease (CVD) is the leading cause of death in the 21st century. Among risk factors, hypercholesterolemia and abdominal obesity are directly linked to premature development of atherosclerosis. Familial hypercholesterolemia, commonly due to low-density lipoprotein receptor (LDLR) deficiency, is known to cause premature atherosclerosis and aortic calcification in humans. Proprotein convertase subtilisin/kexin 9 (PCSK9), a member of the proprotein convertase family, is indirectly associated with CVD through enhanced LDLR degradation. Mutations in the human PCSK9 gene lead to either familial hypercholesterolemia or hypocholesterolemia, depending on whether the mutation causes a gain or a loss of function, respectively. It is uncertain if individuals carrying mutations causing a gain-of-function of PCSK9 will develop aortic calcification or whether loss-of-function mutations will lead to abdominal obesity. In this thesis, we investigated: 1) the effect of PCSK9 overexpression on aortic calcification; 2) the consequences of PSCK9 deficiency, mimicking pharmacological inhibition of PCSK9 on fat tissue. We employed a transgenic (Tg) mouse model overexpressing mouse PCSK9 and illustrated by micro-computerized tomography that calcification occurs to a lesser extent in PCSK9 Tg mice than in LDLR-deficient mice. While both PCSK9 Tg and LDLR deficiency caused familial hypercholesterolemia, circulating cholesterol levels alone could not dictate the degree of aortic calcification. In another study, we used genetically modified mice lacking PCSK9 and demonstrated that visceral fat accumulation (adipogenesis) is regulated by circulating PCSK9. Thus in the absence of PCSK9, visceral adipogenesis increases likely via post-translational regulation of very-low-density lipoproteins receptors (VLDLR) in the adipose tissue. In conclusion, these two studies highlight the dynamic balance of PCSK9 in different metabolic pathways, making it a key element in cardiovascular health. Consequently, attempts to survey and/or alter PCSK9 biology should be performed in a valid animal model using sensitive methods and with careful attention to side effects of any given intervention.

Les estrogènes confèrent aux femmes une protection cardiovasculaire jusqu’à la ménopause. En effet, la perte des fonctions ovariennes engendre plusieurs désordres du profil lipidique qui s’accompagnent d’une accumulation de triglycérides au foie appelée stéatose hépatique. Le retrait des estrogènes perturbe de nombreuses voies de contrôle de la cholestérolémie, provoquant simultanément une hypercholestérolémie et une stéatose hépatiques. Toutefois, à ce jour, les mécanismes d’action du retrait des estrogènes sur le métabolisme du cholestérol favorisant le stockage de triglycérides au foie demeurent imprécis. À cet égard, les travaux de cette thèse visaient à clarifier l’ensemble des effets du retrait des estrogènes sur le métabolisme du cholestérol pouvant mener à la pathogenèse de la stéatose hépatique. Lors de la première étude, l’ovariectomie (Ovx) chez la rate, un modèle bien établi de la stéatose, avait permis d’identifier la voie d’assemblage des lipoprotéines à très faible densité (VLDL) comme élément contributif à la stéatose. La voie des VLDL reliant étant également une voie de transport du cholestérol, l’étude suivante a été réalisée afin de comprendre le rôle du cholestérol alimentaire sur les lipides hépatiques. Dans cette deuxième étude, le modèle de la diète riche en lipides et en cholestérol (HFHC), aussi reconnu pour induire une stéatose hépatique, a permis d’établir des liens étroits entre le métabolisme du cholestérol et celui des lipides hépatiques. Étonnamment, de manière similaire à l’Ovx, la diète HFHC perturbait la voie d’assemblage des VLDL. En outre, les données recueillies au cours de ces travaux indiquaient qu’une dysrégulation du métabolisme des acides biliaires avait contribué à la sévérité de la stéatose hépatique induite par cette diète HFHC. Dans la continuité de ces deux premiers projets, nous nous sommes intéressés aux effets concomitants du retrait des estrogènes et d’une diète HFHC sur la stéatose hépatique. De manière intéressante, lorsque combinés, l’Ovx et la diète HFHC potentialisaient non seulement l’accumulation de lipides hépatiques, mais également les perturbations moléculaires des voies sous-jacentes à la stéatose, dont l’assemblage des VLDL et de la sécrétion d’acides biliaires. Dans l’ensemble, les données présentées dans la revue de littérature et dans les trois études reliées à cette thèse indiquent qu’une dysrégulation du métabolisme du cholestérol en réponse au retrait des estrogènes entraîne des complications favorisant l’accumulation de lipides dans le foie. / Estrogens confer to women a cardiovascular protection until menopause. Indeed, the loss of ovarian functions leads to several lipid disorders along with hepatic triglycerides accumulation called hepatic steatosis. Estrogen withdrawal disrupts several cholesterol metabolism pathways that results in both hypercholesterolemia and hepatic steatosis. However, to date, the precise mechanisms by which estrogen withdrawal affect cholesterol metabolism pathways that favour lipid storage in the liver are unclear. In this regard, works in the present thesis aimed at elucidate the effects of estrogen withdrawal on cholesterol metabolism involved in hepatic steatosis pathogenesis. In the first study, estrogen withdrawal by ovariectomy (Ovx), a well established model for hepatic steatosis and hypercholesterolemia, had enabled the identification of very low density lipoprotein (VLDL) pathway as a contributory element for hepatic steatosis. Since the VLDL pathway relates lipids and cholesterol metabolism, we conducted the second study to explore the role of dietary cholesterol on hepatic lipids. In the second study, the high fat/high cholesterol (HFHC) diet, also recognized as a model for hepatic steatosis development, was used to explore links between cholesterol metabolism and hepatic fat accumulation. Surprisingly, HFHC diet also disrupted the VLDL pathway. Additionally, data provided in this study indicated that a dysregulation of bile acids metabolism might have contributed to the severity of hepatic steatosis induced by the HFHC diet. As a continuation of these projects, we were interested in the concomitant effects of estrogen withdrawal and HFHC diet on hepatic lipid accretion. Interestingly, when combined, Ovx and HFHC diet not only potentiated hepatic lipid accumulation but also molecular disruptions involved in underlying pathways for hepatic steatosis including the VLDL pathway and bile acid secretion. Overall, data presented in the review of litterature and provided by the three studies related to the present thesis indicate that cholesterol metabolism dysregulation following estrogen withdrawal result in complications that favour hepatic lipid accumulation.

A aterosclerose é uma doença crônica onde duas características marcantes são observadas: retenção de lipídios e inflamação. Compreender as interações entre as células do sistema imunológico e as lipoproteínas envolvidas na aterogênese são desafios urgentes, uma vez que as doenças cardiovasculares são a principal causa de morte no mundo. Os macrófagos são cruciais para o desenvolvimento de placas ateroscleróticas e para a perpetuação da inflamação em tais lesões; estas células também estão diretamente envolvidas na ruptura de placa instável. Recentemente diferentes populações de macrófagos estão sendo identificadas nas lesões ateroscleróticas. Embora macrófagos M2 tenham sido identificados, a função destas células na aterosclerose ainda não está definida. Neste projeto, avaliamos se a adição de LDLox altera a função de macrófagos M2. Resultados: 1- Foi possível observar que os M2 se mantem viáveis após o estímulo com as lipoproteínas. 2- Quando avaliamos a expressão de moléculas co-estimulatórias, receptores Scavenger, lectinas e integrinas na superfície das células, observamos que a adição de LDLn ou LDLox em 2 concentrações diferentes (5 e 50ug/ml), por diferentes períodos de tempo não alterou a expressão de nenhum dos marcadores avaliados. A presença de LDL também não alterou outra função primordial dos M2, a capacidade de fagocitose. 3- Quando investigamos a presença de citocinas no sobrenadante das culturas estimuladas ou não com as lipoproteínas, identificamos um aumento na secreção de IL-8, uma citocina pró-inflamatória, na presença de LDLox, semelhante ao observado com a população de macrófagos M1. 4- Avaliamos se os macrófagos M2 estimulados ou não com LDL mantem sua capacidade de favorecer a angiogênese. Observamos que nas culturas estimuladas com o sobrenadante das culturas dos M2 mantidos na presença de LDLox houve uma inibição significativa da formação de túbulos pelas HUVECs. 5- Observamos que na presença do meio condicionado dos M2 estimulados com LDLox ocorreu uma intensa degradação dos filamentos de matriz extracelular produzida por MEFs. 6- Avaliamos a expressão gênica de componentes de matriz, membrana basal, moléculas de adesão, proteases e também inibidores de protease nestas células. Dos 96 genes avaliados, observamos que a adição de LDLox reduziu a expressão de 10 genes de maneira significativa, entre eles: beta-Actina (ACTB), Colágeno 6A2 (Col6A2), Integrina alfa 6 (ITGA6), Metaloproteinase 15 (MMP15), molécula de adesão celular endotelial plaquetária (PECAM) e Inibidor de metalopeptidase 2 (TIMP2). A adição de LDLox aumentou significativamente somente a expressão de trombospondina (TSP1). A adição de LDLn não alterou a expressão de nenhum gene de forma significativa. 7- A adição de LDLox induziu aumento da expressão da TSP1 e redução da expressão de colágeno 6, quando comparadas aos macrófagos M2 sem estímulo. Nossos resultados indicam que a adição de LDLox altera diversas funções dos macrófagos M2 in vitro. Em especial detectamos uma inibição significativa na angiogênese e também a secreção de mediadores que induzem a degradação da matriz extracelular. A adição de LDLox também inibiu a expressão de genes envolvidos com a estabilização da matriz extracelular. Nossos resultados sugerem que esta população de células pode contribuir para a perpetuação do processo inflamatório e degradação tecidual observados na lesão dos pacientes. Assim, acreditamos que este projeto contribuiu para o esclarecimento da participação dos M2 na patologia da aterosclerose / Atherosclerosis is a chronic disease where two key characteristics are observed: lipid retention and inflammation. Understanding the interactions between the cells of the immune system and the lipoproteins involved in atherogenesis are urgent challenges, since cardiovascular diseases are the leading cause of death in the world. Macrophages are crucial for the development of atherosclerotic plaques and for the inflammation in such lesions; These cells are also directly involved in unstable plaque rupture. Recently different populations of macrophages are being identified in atherosclerotic lesions. Although M2 macrophages has been identified, the function of these cells in atherosclerosis has not yet been defined. This project, we evaluated whether the addition of OxLDL alters the function of M2 macrophages. Results: 1- M2 macrophages remain viable after stimulation with the lipoproteins. 2- When evaluated the expression of co-stimulatory molecules, Scavenger receptors, lectins and integrins on the surface of the cells. We observed that the addition of LDLn or OxLDL at 2 different concentrations (5 and 50 ?g / ml) for different time periods did not alter the expression of any of the evaluated markers. 3- The presence of LDL also did not alter other primordial function of M2 cells, phagocytosis. 4- Was observed that cultures stimulated with conditioned medium of OxLDL-stimulated M2 there was a significant inhibition of tubule formation by HUVECs. 5- We observed that in the presence of OxLDL-stimulated M2 cells conditioned médium an intense degradation of the matrix filaments occurred. 6- We evaluated the gene expression of matrix components, basement membrane, adhesion molecules, proteases and also protease inhibitors in these cells. Of the 96 evaluated genes, we observed that the addition of OxLDL significantly reduced the expression of 10 genes, among them: Actin-beta (ACTB), Collagen 6A2 (Col6A2), Integrin alfa 6 (ITGA6), Metaloproteinase 15 (MMP15), Platelet endothelial cell adhesion molecule (PECAM) and metallopeptidase 2 inhibitor (TIMP2). The addition of OxLDL significantly increased only the expression, thrombospondin-1 (TSP1). Addition of LDLn did not significantly alter the expression of any gene. 7- That OxLDL addition induced increased TSP1 expression and reduced collagen 6 expression, when compared to M2 macrophages without stimulation. Our results indicate that the addition of OxLDL alters several M2 macrophages functions in vitro. In particular we detected a significant inhibition in angiogenesis and also the secretion of mediators that induce the degradation of the extracellular matrix. The addition of OxLDL also inhibited the expression of genes involved in extracellular matrix stabilization. Our results suggest that this cell population may contribute to the perpetuation of the inflammatory process and tissue degradation observed in the lesion of the patients. Thus, we believe that this project contributed to better understand the participation of M2 in the pathology of atherosclerosis

A enzima Paraoxonase-1 (PON1) possui atividades paraoxonase, arilestearase e lactonase, entre outras. É a mais estuda da família das PONs que é composta pela PON1, PON2 e PON3. Sugere-se, que todas atuam inibindo o processo de peroxidação lipídica de moléculas como a lipoproteína de baixa densidade (LDL) e alta densidade (HDL), caracterizando assim um possível papel anti-aterogênico. O gene da PON1 apresenta dois sítios polimórficos, com a troca de uma Gln192Arg (Q/R) e Met55Leu, que estão associados com diferenças na atividade e concentrações séricas da enzima. Por sua vez, indivíduos soropositivos para o HIV-1 apresentam alterações do metabolismo lipídico, que poderiam estar associados a alterações na atividade da PON1 e a terapia antirretroviral (TARV) com inibidores de protease (IP). O objetivo do estudo foi determinar as atividades séricas da PON1 e da arilestearase (ARE), e as freqüências alélicas dos polimorfismos genéticos da PON1 192QR e 55LM, e ainda, avaliar a correlação destes parâmetros com as alterações lipídicas em indivíduos soropositivos para o HIV-1 tratados com IP. No período de Setembro de 2009 até Junho de 2012, 174 indivíduos soropositivos e 46 soronegativos para o HIV-1 foram estudados. Foi realizada a genotipagem dos polimorfismos da PON1 192QR e 55LM através de PCR-RFLP. A atividade sérica da PON1/ARE foi avaliada por espectrofotometria empregando-se como substratos o paraoxon e o fenilacetato, respectivamente. O RNA-HIV-1 foi quantificado pelo método NASBA, e os linfócitos T-CD4+ e T-CD8+ por citometria de fluxo. Os níveis séricos de colesterol total, HDL, LDL, triglicérides (TG), ApoA1 e ApoB100 foram determinados e os anticorpos IgG anti-oxLDL por ELISA. A atividade sérica da PON1 foi inferior nos grupos de soropositivos, p<0,05, porém, a atividade ARE não apresentou diferenças entre os grupos estudados, p>0,05. Ambas as atividades não apresentaram relação com os genótipos PON1 192QR e 55LM, e estes genótipos apresentaram uma freqüência alélica semelhante ao grupo de soronegativos. Os níveis séricos de TG foram superiores nos grupos de soropositivos com TARV, p<0,05, enquanto o grupo tratado com IP apresentou níveis séricos de HDL e Apo-A1 inferiores aos demais grupos, p<0,05. Níveis séricos de Apo-B100, IgG anti-oxLDL, e o índice de risco aterogênico foram superiores no grupo tratado com IP, p<0,05. Concluí-se, que indivíduos soropositivos para o HIV-1 apresentaram alterações no metabolismo lipídico, principalmente nos tratados com IP, que adicionalmente apresentaram um maior índice de risco aterogênico e maiores níveis de anticorpos IgG anti-oxLDL. Estas alterações não apresentaram relação com os polimorfismos PON1 192QR e 55LM da PON1, e demonstraram que a atividade da enzima PON-1 esta diminuída em indivíduos soropositivos para o HIV-1 / The enzyme Paraoxonase-1 (PON1) has paraoxonase (PON), arylesterase (ARE) and lactonase activities, among others. It is the most studied member of PON family which is composed of PON1, PON2 and PON3. It is suggested that all members acts by inhibiting the peroxidation of lipid molecules as the low-density lipoprotein (LDL) and high-density lipoprotein (HDL), characterizing a potential anti-atherogenic effect. The PON1 gene has two mainly polymorphic sites, with an exchange of Gln192Arg (Q/R) and Met55Leu (L/M), which are associated with differences in activity and serum concentrations of the enzyme. In turn, seropositive individuals for HIV-1 show changes in lipid metabolism, which could be associated with changes in the activity of PON1 and highly active antiretroviral therapy (HAART) with protease inhibitors (PI). The aim of this study was to determinate the serum PON and ARE activities of PON1, the allele frequencies of PON1 192QR and PON1 55LM genetic polymorphisms and evaluate the correlation between these parameters and lipid abnormalities in seropositive patients for HIV-1 treated with IP. In the period from September 2009 until June 2012, 174 seropositive individuals and 46 soronegative individuals for HIV-1 were studied. We performed PON1 192QR and 55LM genotyping by PCR-RFLP. Serum activities PON and ARE of PON1 were evaluated by spectrophotometry using paraoxon and phenylacetate, respectively, as substrates. The HIV-1-RNA was quantified by the NASBA method, and lymphocytes T-CD4+ and T-CD8+, by flow cytometry. Serum levels of total cholesterol, HDL, LDL, triglycerides (TG), apoA1 and ApoB100 were determined. IgG anti-oxLDL antibodies were quantified by ELISA. The serum PON1 activity was lower in the seropositive group, p<0.05, however, ARE activity did not differ between groups, p>0.05. Both activities had no relation with the PON1 192QR and PON1 55LM genotype, and these individuals showed an allele frequency similar to the seronegative group. Serum levels of TG were higher in groups of HIV-positive with HAART, p<0.05, while the IP-treated group showed serum levels of HDL and ApoA1 lower than other groups, p <0.05. Serum levels of ApoB100, IgG anti-oxLDL antibodies, and atherogenic risk indices were higher in the group treated with PI, p<0.05. It was concluded that individuals HIV-1-infected showed changes in lipid metabolism, especially in those treated with IP, which additionally showed a higher rate of atherogenic risk and higher levels of IgG anti-oxLDL antibodies. These changes did not correlated with PON1 192QR and 55LM polymorphisms and demonstrated that the activity of PON1enzyme is decreased in individuals seropositive for HIV-1

No advento dos antirretrovirais potentes, os indivíduos infectados pelo vírus da imunodeficiência humana (HIV) começaram a apresentar risco maior para o desenvolvimento de doença cardiovascular (DCV). Este aumento do risco cardiovascular pode ser associado tanto à infecção viral quanto ao tratamento antirretroviral (TARV), que provocam mudanças pró-aterogênicas como o aumento do colesterol total e da lipoproteína de baixa densidade (LDL), além da diminuição da lipoproteína de alta densidade (HDL). A ativação imune e as alterações lipídicas são mecanismos associados com a infecção pelo HIV e com o risco de DCV. Este trabalho utilizou ensaios imunoenzimáticos para a determinação plasmática de biomarcadores emergentes de risco cardiovascular relacionados com modificações da lipoproteína de baixa densidade, a saber: LDL eletronegativa [LDL(-)] e formas oxidadas da LDL, ou seja, LDL-oxi (resíduos lisina da apolipoproteína B100 modificados com malondialdeído), LDL-HNE (resíduos lisina da ApoB100 modificados com 4-hidroxinonenal) e LDL-CML (resíduos lisina da ApoB100 modificados por carboximetila), além de biomarcadores relacionados com a resposta imune-inflamatória, ou seja, autoanticorpos IgG e IgM anti-LDL(-), imunocomplexo de LDL(-) [IC-LDL(-)], proteína amiloide sérica A (SAA) e mieloperoxidase (MPO). Também foram determinadas as concentrações séricas dos biomarcadores de risco relacionados às apolipoproteínas: apolipoproteína A-I (ApoA-I), apolipoproteína B (ApoB) e apolipoproteína E (ApoE). A população estudada incluiu indivíduos com infecção pelo HIV, tratados (HIV-TARV) e não tratados (HIV-NT) com terapia antirretroviral e indivíduos sem infecção pelo HIV (controle). Não foram identificadas diferenças para as concentrações de LDL(-), IC-LDL(-), anti- LDL(-)-IgM, SAA, ApoA-I, ApoB e ApoE entre os grupos estudados (HIV-TARV, HIV-NT e controle). A ApoA-I correlacionou-se positivamente com ApoB e ApoE (rs= 0,418 e rs= 0,347, Spearman, p<0,01) e a ApoB com a ApoE (rs= 0,286, Spearman, p<0,01). Verificou-se correlação inversa entre as concentrações de LDL(-) e IC-LDL(-) (rs= -0,214, Spearman, p<0,05). Os níveis de anti-LDL(-)-IgG correlacionaram-se positivamente com IC-LDL(-) e anti-LDL(-)-IgM (rs= 0,240, Spearman, p<0,05 e rs= 0,348, Spearman, p<0,01). As concentrações de LDL-CML correlacionaram-se positivamente com LDL(-), LDL-oxi, LDL-HNE e IC-LDL(-) (rs= 0,212, Spearman, p<0,05; rs= 0,214, Spearman, p<0,05; rs= 0,573, Spearman, p<0,01 e rs= 0,219, Spearman, p<0,05). O grupo HIV-NT apresentou níveis mais elevados de anticorpos anti-LDL(-)-IgG comparado ao grupo controle (Kruskal-Wallis, p<0,01). Em contraste, observou-se no grupo HIV-NT diminuição das concentrações de MPO, LDL-HNE e LDL-CML em relação ao grupo controle (Kruskal-Wallis, p<0,01). A comparação dos grupos HIV-NT e HIV-TARV demonstrou que o TARV promoveu diminuição das concentrações dos anticorpos anti-LDL(-)-IgG e aumentou os níveis de LDL-oxi (Kruskal-Wallis, p<0,01). O grupo HIV-TARV apresentou aumento das concentrações de LDL-oxi e diminuição dos níveis de MPO, LDL-HNE e LDL-CML em relação ao controle (Kruskal-Wallis, p<0,01). Em conclusão, a infecção pelo HIV modificou o biomarcador de inflamação MPO e o perfil de biomarcadores relacionados às modificações da LDL (menor formação de LDL-HNE e LDL-CML), além aumentar a resposta imune-humoral à LDL eletronegativa [anti-LDL(-)-IgG], enquanto o tratamento com antirretrovirais inibiu esta resposta. Os outros biomarcadores estudados não foram modificados pela infecção viral ou pelo tratamento antirretroviral. / In the advent of potent antiretroviral therapy, individuals infected with human immunodeficiency virus (HIV) have showed an increased risk for developing cardiovascular disease (DCV). Studies have discussed that the increased risk may be related to both the disease and antiretroviral treatment (TARV), that produced pro-atherogenic changes such as increased of total cholesterol and low density lipoprotein (LDL) and decreased high density lipoprotein. The immune activation and the lipid modifications are well known mechanisms related to HIV infection and the risk of DCV. This study used immunoassays for plasma quantification for emerging biomarkers of cardiovascular risk related to modification of low density lipoprotein: electronegative LDL [LDL(-)] and oxidized forms of LDL, LDL-oxi (lysine residues of apolipoprotein B100 modified by malondialdehyde), LDL-HNE (lysine residues of ApoB100 modified by 4-hydroxynonenal) and LDL-CML (lysine residues of ApoB100 modified by carboxymethyl) and biomarkers associated to immune and inflammatory responses, IgG and IgM autoantibodies anti-LDL(-) and immunecomplexe of LDL(-) [IC-LDL(-)], serum amyloid A protein (SAA) and myeloperoxidase (MPO). Also, were determined serum concentrations of risk biomarkers related to apolipoproteins: apolipoprotein A-I (ApoA-I), apolipoprotein B (ApoB) and apolipoprotein E (ApoE). The studied population included patients with HIV infection, treated (HIV-TARV) and untreated (HIV-NT) with antiretroviral therapy and individuals without HIV infection (controle). No differences were identified for concentrations of LDL(-), ICLDL(-), anti-LDL(-)-IgM, SAA, ApoA-I, ApoB and ApoE between studied groups (HIV-TARV, HIV-NT and controle). The ApoA-I was positively correlated to ApoB and ApoE (rs= 0,418 e rs= 0,347, Spearman, p<0,01) and ApoB to ApoE (rs= 0,286, Spearman, p<0,01). There was an inverted correlation between LDL(-) and IC-LDL(-) (rs= -0.214, Spearman, p<0,05). The levels of anti-LDL(-)-IgG were positively correlated to IC-LDL(-) and antibodies anti-LDL(-)-IgM (rs= 0.240; Spearman; p <0.05 and rs= 0.348; Spearman; p <0.01). The concentrations of LDL-CML were positively correlated to LDL(-), LDL-oxi, LDL-HNE e IC-LDL(-) (rs= 0,212, Spearman, p<0,05; rs= 0,214, Spearman, p<0,05; rs= 0,573, Spearman, p<0,01 e rs= 0,219, Spearman, p<0,05). The HIV-NT group showed higher levels of anti-LDL(-)-IgG compared to Control group (Kruskal-Wallis, p<0,01). In contrast, was observed lower levels for HIV-NT group to MPO, LDL-HNE and LDL-CML when compared to Control group (Kruskal-Wallis, p<0,01). The comparison of HIV-NT and HIV-TARV groups demonstrated that TARV caused a decrease of concentrations of anti-LDL(-)-IgG antibodies and an increased of LDL-oxi levels (Kruskal-Wallis, p <0.01). The HIV-TARV group showed increased LDL-oxi concentrations and decreased at levels of MPO, LDL-HNE e LDL-CML when compared to Control (Kruskal-Wallis, p<0,01). In conclusion, the HIV infection changed the biomarker of inflammation MPO and the profile of biomarkers related to modifications of LDL (lower concentrations of LDL-HNE and LDL-CML), as well as increased the humoral-immune response to electronegative LDL [anti-LDL(-)-IgG], while treatment with antiretroviral therapy inhibited this response. The other studied biomarkers were not modified either by viral infection or antiretroviral treatment.

A aterosclerose é uma doença crônica onde duas características marcantes são observadas: retenção de lipídios e inflamação. Compreender as interações entre as células do sistema imunológico e as lipoproteínas envolvidas na aterogênese são desafios urgentes, uma vez que as doenças cardiovasculares são a principal causa de morte no mundo. Os macrófagos são cruciais para o desenvolvimento de placas ateroscleróticas e para a perpetuação da inflamação em tais lesões; estas células também estão diretamente envolvidas na ruptura de placa instável. Recentemente diferentes populações de macrófagos estão sendo identificadas nas lesões ateroscleróticas. Embora macrófagos M2 tenham sido identificados, a função destas células na aterosclerose ainda não está definida. Neste projeto, avaliamos se a adição de LDLox altera a função de macrófagos M2. Resultados: 1- Foi possível observar que os M2 se mantem viáveis após o estímulo com as lipoproteínas. 2- Quando avaliamos a expressão de moléculas co-estimulatórias, receptores Scavenger, lectinas e integrinas na superfície das células, observamos que a adição de LDLn ou LDLox em 2 concentrações diferentes (5 e 50ug/ml), por diferentes períodos de tempo não alterou a expressão de nenhum dos marcadores avaliados. A presença de LDL também não alterou outra função primordial dos M2, a capacidade de fagocitose. 3- Quando investigamos a presença de citocinas no sobrenadante das culturas estimuladas ou não com as lipoproteínas, identificamos um aumento na secreção de IL-8, uma citocina pró-inflamatória, na presença de LDLox, semelhante ao observado com a população de macrófagos M1. 4- Avaliamos se os macrófagos M2 estimulados ou não com LDL mantem sua capacidade de favorecer a angiogênese. Observamos que nas culturas estimuladas com o sobrenadante das culturas dos M2 mantidos na presença de LDLox houve uma inibição significativa da formação de túbulos pelas HUVECs. 5- Observamos que na presença do meio condicionado dos M2 estimulados com LDLox ocorreu uma intensa degradação dos filamentos de matriz extracelular produzida por MEFs. 6- Avaliamos a expressão gênica de componentes de matriz, membrana basal, moléculas de adesão, proteases e também inibidores de protease nestas células. Dos 96 genes avaliados, observamos que a adição de LDLox reduziu a expressão de 10 genes de maneira significativa, entre eles: beta-Actina (ACTB), Colágeno 6A2 (Col6A2), Integrina alfa 6 (ITGA6), Metaloproteinase 15 (MMP15), molécula de adesão celular endotelial plaquetária (PECAM) e Inibidor de metalopeptidase 2 (TIMP2). A adição de LDLox aumentou significativamente somente a expressão de trombospondina (TSP1). A adição de LDLn não alterou a expressão de nenhum gene de forma significativa. 7- A adição de LDLox induziu aumento da expressão da TSP1 e redução da expressão de colágeno 6, quando comparadas aos macrófagos M2 sem estímulo. Nossos resultados indicam que a adição de LDLox altera diversas funções dos macrófagos M2 in vitro. Em especial detectamos uma inibição significativa na angiogênese e também a secreção de mediadores que induzem a degradação da matriz extracelular. A adição de LDLox também inibiu a expressão de genes envolvidos com a estabilização da matriz extracelular. Nossos resultados sugerem que esta população de células pode contribuir para a perpetuação do processo inflamatório e degradação tecidual observados na lesão dos pacientes. Assim, acreditamos que este projeto contribuiu para o esclarecimento da participação dos M2 na patologia da aterosclerose / Atherosclerosis is a chronic disease where two key characteristics are observed: lipid retention and inflammation. Understanding the interactions between the cells of the immune system and the lipoproteins involved in atherogenesis are urgent challenges, since cardiovascular diseases are the leading cause of death in the world. Macrophages are crucial for the development of atherosclerotic plaques and for the inflammation in such lesions; These cells are also directly involved in unstable plaque rupture. Recently different populations of macrophages are being identified in atherosclerotic lesions. Although M2 macrophages has been identified, the function of these cells in atherosclerosis has not yet been defined. This project, we evaluated whether the addition of OxLDL alters the function of M2 macrophages. Results: 1- M2 macrophages remain viable after stimulation with the lipoproteins. 2- When evaluated the expression of co-stimulatory molecules, Scavenger receptors, lectins and integrins on the surface of the cells. We observed that the addition of LDLn or OxLDL at 2 different concentrations (5 and 50 ?g / ml) for different time periods did not alter the expression of any of the evaluated markers. 3- The presence of LDL also did not alter other primordial function of M2 cells, phagocytosis. 4- Was observed that cultures stimulated with conditioned medium of OxLDL-stimulated M2 there was a significant inhibition of tubule formation by HUVECs. 5- We observed that in the presence of OxLDL-stimulated M2 cells conditioned médium an intense degradation of the matrix filaments occurred. 6- We evaluated the gene expression of matrix components, basement membrane, adhesion molecules, proteases and also protease inhibitors in these cells. Of the 96 evaluated genes, we observed that the addition of OxLDL significantly reduced the expression of 10 genes, among them: Actin-beta (ACTB), Collagen 6A2 (Col6A2), Integrin alfa 6 (ITGA6), Metaloproteinase 15 (MMP15), Platelet endothelial cell adhesion molecule (PECAM) and metallopeptidase 2 inhibitor (TIMP2). The addition of OxLDL significantly increased only the expression, thrombospondin-1 (TSP1). Addition of LDLn did not significantly alter the expression of any gene. 7- That OxLDL addition induced increased TSP1 expression and reduced collagen 6 expression, when compared to M2 macrophages without stimulation. Our results indicate that the addition of OxLDL alters several M2 macrophages functions in vitro. In particular we detected a significant inhibition in angiogenesis and also the secretion of mediators that induce the degradation of the extracellular matrix. The addition of OxLDL also inhibited the expression of genes involved in extracellular matrix stabilization. Our results suggest that this cell population may contribute to the perpetuation of the inflammatory process and tissue degradation observed in the lesion of the patients. Thus, we believe that this project contributed to better understand the participation of M2 in the pathology of atherosclerosis

Background: Exposure to perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) have been associated with higher circulating concentrations of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C). ApoB is the primary apolipoprotein component of LDL-C, and acts as a ligand for LDL-C receptors in various cells throughout the body. Circulating concentrations of ApoB are considered to be a better indicator of heart disease risk than TC or LDL-C. Objectives: Explore associations of concentrations of PFOA and PFOS with serum ApoB in adults. Methods: We analyzed data from 2744, 20-80 years old participants in the 2005–2006 National Health and Nutrition Examination Survey (NHANES). Linear regression models were used to estimate adjusted predicted means of serum ApoB (in g/L) for quartiles of PFOA and PFOS (in ng/mL) to describe patterns of associations. Results: Adjusted predicted mean concentrations of serum ApoB did not appear to vary meaningfully with increasing concentrations of PFOA (Q1 1.11, Q2 1.02, Q3 1.01, Q4 1.02) or increasing concentrations of PFOS (Q1 1.06, Q2 1.05, Q3 1.07, Q4 0.99) in study participants. Conclusions: Exposure to PFOA or PFOS does not appear to alter Apo B concentrations in adults.