Cerebrovascular diseases are by far the largest causes of death in the UK, as well as one of the leading causes of adult disability. The brain's healthy function depends on a steady supply of oxygen, delivered through the microvasculature. Cerebrovascular diseases, such as stroke and dementia, can interrupt the transport of blood (and hence oxygen) rapidly, or over a prolonged period of time. An interruption in flow can lead to ischaemia, with prolonged interruptions leading to tissue death and eventual brain damage. The microvasculature plays a key role in the transport of oxygen and nutrients to brain tissue; however, its role in diseases such as dementia is poorly understood, primarily due to the inability of current clinical imaging techniques to resolve microvessels, and due to the complexity of the underlying microvasculature. Therefore, in order to understand cerebrovascular diseases, it is necessary to be able to resolve and understand the microvasculature. In particular, generating large-scale models of the human microvasculature that can be linked back to contemporary clinical imaging is important in helping plug the current imaging gap that exists. A novel statistical model is proposed here that generates such large-scale models efficiently. Homogenization theory is used to generate a porous continuum capillary bed (characterised by its permeability) that allows for the efficient scaling up of the microvasculature. A novel order-based density-filling algorithm is then developed which generates morphologically accurate penetrating arterioles and venules, also demonstrating that the topology of the vessels only has a minor influence on CBF compared to diameter. Finally, the capillary bed and penetrating vessels are coupled into a large voxel-sized model of the microvasculature from which pressure and flux variations through the voxel can be analysed. A decoupling of the pressure and flux, as well as a layering of flow, was observed within the voxel, driven by the topology of the penetrating vessels. Micro-infarctions were also simulated, demonstrating the large local effects they have on the pressure and flux, whilst only causing a minor drop in CBF within the voxel.

One of the greatest obstacles to clinical translation of bone tissue engineering is the inability to effectively and efficiently vascularise scaffolds. This limits the size of defects that can be repaired, as blood perfusion is necessary to provide nutrient and waste exchange to tissue at the core of scaffolds. The goal of this work was to systematically explore whether architecture, at a scale of hundreds of microns, can be used to direct the growth of microvessels into the core of scaffolds. A pipeline was developed for the production of hydroxyapatite surfaces with controlled architecture. Three batches of hydroxyapatite were used with two different particle morphologies and size distributions. On sintering, one batch remained phase pure and the other two batches were biphasic mixtures of α-tricalcium phosphate (α-TCP) and hydroxyapatite. Sample production methods based on slip casting of a hydroxyapatite-gelatin slurry were explored. The most successful of these involved the use of curable silicone to produce moulds of high-resolution, three dimensional (3D) printed parts with the desired design. Parts were dried and sintered to produce patterned surfaces with higher resolution than obtainable through conventional 3D printing techniques. Given the difficulties associated with the structural reproducibility of concave pores architectures in 3D reported in the literature, in this work, a 2.5D model has been developed that varies architectural parameters in a controlled manner. Six contrasting architectures consisting of semi-circular ridges and grooves were produced. Grooves and ridges were designed to have widths of 330 μm and 660 μm, with periodicities, respectively, of 1240 μm and 630 μm. Groove depth was varied between 150 μm and 585 μm. Co-cultures of endothelial cells and osteoblasts were optimised and used to grow microcapillary-like structures (referred to as "microvessels") on substrates. Literature shows that these precursors to microcapillaries contain lumina and can produce functional vasculature, demonstrating their clinical promise. The effects of the composition and surface texture of grooved samples on microvessel formation were studied. It was found that surface microtopography and phase purity (α-TCP content) did not affect microvessel formation. However, hydroxyapatite architecture was found to significantly affect microvessel location and orientation. Microvessels were found to form predominantly in grooves or between convexities. Two metrics - the degree of alignment (DOA) and the degree of containment (DOC) - were developed to measure the alignment of endothelial cell structures and their localisation in grooves. For all patterned samples, the CD31 (an endothelial cell marker) signal was at least 2.5 times higher along grooves versus perpendicular to grooves. In addition, the average signal was at least two times higher within grooves than outside grooves for all samples. Small deep grooves had the highest DOA and DOC (6.13 and 4.05 respectively), and individual, highly aligned microvessels were formed. An image analysis method that compares sample X-ray microtomography sections to original designs to quantify architectural distortion was developed. This method will serve as a useful tool for improvements to architectural control for future studies. This body of work shows the crucial influence of architecture on microvessel self-assembly at the hundreds of micron scale. It also highlights that microvessel formation has a relatively low sensitivity to phase composition and microtopography. These findings have important implications for the design of porous scaffolds and the refinement of fabrication technologies. While important results were shown for six preliminary architectures, this work represents a toolkit that can be applied to screen any 2.5D architecture for its angiogenic potential. This work has laid the foundations that will allow elucidating the precise correspondence between architecture and microvessel organisation, ultimately enabling the "engineering" of microvasculature by tuning local scaffold design to achieve desirable microvessel properties.

Organic nitrates, such as nitroglycerine (NTG), are widely used for their potent vasodilator capacity in the management of coronary artery disease and heart failure. Unfortunately, their beneficial effect is rapidly lost due to the development of nitrate tolerance, which is translated by an impaired vasorelaxation to NTG and an increased oxidative stress production. Although the mechanisms of the development of nitrate tolerance are still not fully elucidated, much interest has been focused in treating nitrate-receiving patients together with other drugs in order to overcome the development of nitrate tolerance. The Nitric Oxide generating enzyme, eNOS, and the superoxide anion generating enzyme, NAD(P)H oxidase, have been suggested to play a role in the development of nitrate tolerance. The aim of this study was to analyse the underlying mechanism by which ramipril, an ACE inhibitor and rosuvastatin, a new molecule of the statin class, are able to protect against the development of nitrate tolerance in the aortas isolated from rats, wild-type (wt) and eNOS-/- mice. <p>These results show that ramipril as well as rosuvastatin are able to protect against the development of nitrate tolerance in the wt and eNOS-/- mice aortas suggesting that eNOS is not necessary for their protective effect. The aortas from nitrate tolerant rats and mice showed a significant increase in the NAD(P)H oxidase activation compared to the aortas from the control and from the co-treated ramipril+NTG or rosuvastatin+NTG animals. In line with these findings were the results obtained by RT-PCR analysis: the mRNA expression of the different subunits of the NAD(P)H oxidase, such as gp91phox, p22phox, were significantly decreased after rosuvastatin or ramipril treatment in wt and eNOS-/- mice aortas. Apocynin, the NAD(P)H oxidase inhibitor was also able to inhibit the development of nitrate tolerance in the rat and mouse aortas. <p>In conclusion, these results suggest that rosuvastatin and ramipril are able to protect against the development of nitrate tolerance by counteracting the nitrate-induced oxidative stress. The mechanism of protection involves a direct interaction with the NAD(P)H oxidase pathway and seems to be completely independent of the eNOS pathway. <p> / Doctorat en sciences pharmaceutiques / info:eu-repo/semantics/nonPublished

Grundlage der vorgelegten Arbeit sind die bei der Alzheimerschen Erkrankung beobachtbaren pathologischen Merkmale, wie die progressive Akkumulation von β-Amyloid-Plaques, cholinerger Dysfunktion und zerebrovaskuläre Abnormalitäten. Die in englischer Sprache verfasste Dissertation ist eine tierexperimentelle Studie, die versucht, den Zusammenhang von β-Amyloid, cholinerger Neurotransmission und zerebralem Gefäßsystem bei der Alzheimerschen Erkrankung näher zu charakterisieren. An Hirnmaterial aus der transgenen Maus Tg2576, die die schwedische Mutation des humanen Amyloidpräkursorproteins als Transgen trägt und ab dem 10. Lebensmonat durch humane β-Amyloid-Plaqueablagerungen in der Hirnrinde imponiert, wurden im Altersverlauf (4 bis 18 Monate) immunhistochemische Untersuchungen zur morphologischen Integrität der zerebralen Mikrogefäße, der kortikalen cholinergen Nervterminalen und der intrazerebralen cholinergen neurovaskulären Innervation durchgeführt. Am somatosensorischen Kortex werden beispielhaft die Expression des Glukosetransporters 1 oder Solanum tuberosum Lektin als Kapillarmarker und des vesikulären Acetylcholintransporters als Marker für cholinerge Fasern mittels Immunfluoreszenz und Laser-Scanning Mikroskopie erfasst, einer semiquantitativen Computer-gestützten Bildanalytischen Auswertung unterzogen und mit dem Ausmaß der kortikalen Plaquebeladung korreliert. So konnte gezeigt werden, dass die Dichte der Blutgefäße und cholinergen Fasern im somatosensorischen Kortex von transgenen Tieren mit dem Alter im Vergleich zu nichttransgenen Kontrolltieren abnimmt, was mit einer Reduktion der perivaskulären cholinergen Innervation einhergeht. Die erhobenen Befunde stützen die von J.C. de la Torre und T. Mussivand schon im Jahre 1993 formulierte „vaskuläre Hypothese“, wonach bei der sporadischen Form der Alzheimerschen Erkrankung alters- und Lebensstil-bedingte Schädigungen des zerebralen Gefäßsystems eine zentrale Rolle bei der Manifestierung der Erkrankung spielen.

Grundlage der vorgelegten Arbeit sind die bei der Alzheimerschen Erkrankung beobachtbaren pathologischen Merkmale, wie die progressive Akkumulation von β-Amyloid-Plaques, cholinerger Dysfunktion und zerebrovaskuläre Abnormalitäten. Die in englischer Sprache verfasste Dissertation ist eine tierexperimentelle Studie, die versucht, den Zusammenhang von β-Amyloid, cholinerger Neurotransmission und zerebralem Gefäßsystem bei der Alzheimerschen Erkrankung näher zu charakterisieren. An Hirnmaterial aus der transgenen Maus Tg2576, die die schwedische Mutation des humanen Amyloidpräkursorproteins als Transgen trägt und ab dem 10. Lebensmonat durch humane β-Amyloid-Plaqueablagerungen in der Hirnrinde imponiert, wurden im Altersverlauf (4 bis 18 Monate) immunhistochemische Untersuchungen zur morphologischen Integrität der zerebralen Mikrogefäße, der kortikalen cholinergen Nervterminalen und der intrazerebralen cholinergen neurovaskulären Innervation durchgeführt. Am somatosensorischen Kortex werden beispielhaft die Expression des Glukosetransporters 1 oder Solanum tuberosum Lektin als Kapillarmarker und des vesikulären Acetylcholintransporters als Marker für cholinerge Fasern mittels Immunfluoreszenz und Laser-Scanning Mikroskopie erfasst, einer semiquantitativen Computer-gestützten Bildanalytischen Auswertung unterzogen und mit dem Ausmaß der kortikalen Plaquebeladung korreliert. So konnte gezeigt werden, dass die Dichte der Blutgefäße und cholinergen Fasern im somatosensorischen Kortex von transgenen Tieren mit dem Alter im Vergleich zu nichttransgenen Kontrolltieren abnimmt, was mit einer Reduktion der perivaskulären cholinergen Innervation einhergeht. Die erhobenen Befunde stützen die von J.C. de la Torre und T. Mussivand schon im Jahre 1993 formulierte „vaskuläre Hypothese“, wonach bei der sporadischen Form der Alzheimerschen Erkrankung alters- und Lebensstil-bedingte Schädigungen des zerebralen Gefäßsystems eine zentrale Rolle bei der Manifestierung der Erkrankung spielen.:CHAPTER 1: INTRODUCTION 1.1 Alzheimer’s disease 1 1.2 APP processing and β-amyloid production 2 1.3 Cholinergic dysfunction in Alzheimer’s disease 5 1.4 Cerebrovascular abnormalities in Alzheimer’s disease 8 1.5 Cholinergic innervation of intracortical cerebral microvessels 9 1.6 Transgenic Tg2576 mouse model of Alzheimer’s disease 11 1.7 Aim of study 14 CHAPTER 2: MATERIALS AND METHODS 2.1 Materials 15 2.1.1 Chemical reagents used 15 2.1.2 Biological reagents used 15 2.1.3 Preparation of solutions and buffers 15 2.1.4 Antibodies and reagents used for immunohistochemistry 17 2.1.5 Transgenic animals 19 2.2 Methods 20 2.2.1 Tissue preparation and sampling of sections 20 2.2.2 Immunohistochemistry 20 2.2.2.1 Protocol of immunofluorescent labeling 20 2.2.2.2 Protocol of immunoperoxidase labeling (ABC technique) 21 2.2.2.3 Combination of primary and secondary antibodies 22 2.2.2.4 Protocol of β–amyloid immunolabeling (Formic acid epitope retrieval method) 23 2.2.3 Histochemistry 23 2.2.3.1 Thioflavin S staining 23 2.2.3.2 Nissl staining 23 2.2.3.3 Solanum Tuberosum Lectin (STL) staining 24 2.2.4 Double and triple-coloured immuno-/ histochemical staining of brain sections 24 2.2.5 Microscopy and digital image processing 25 2.2.6 Morphological and morphometric analyses 25 2.2.6.1 Cortical microvessels 25 2.2.6.2 Cortical cholinergic innervation 27 2.2.6.2.1 Total density of VAChT-immunoreactivity 27 2.2.6.2.2 Estimation of the density of varicosities on cholinergic fibres 29 2.2.6.3 Estimation of cholinergic perivascular innervation of cortical microvessels 29 2.2.6.4 Three-dimensional-imaging of vessels innervation 30 2.2.7 Statistical analysis 30 CHAPTER 3: RESULTS 3.1 Developmental and amyloid plaque-related changes in cerebral cortical capillaries in transgenic Tg2576 Alzheimer mice 31 3.1.1 Morphological distribution of brain vessels in the cerebral cortex of wild type mice 31 3.1.2 Microvessel density under plaque burden 33 3.2 Developmental and amyloid plaque-related changes in cholinergic neurotransmission in cholinoceptive target regions of transgenic Tg2576 mice 39 3.2.1 Visualisation of cholinergic nerve terminals in mouse brain 39 3.2.2 VAChT-Expression in wild type and transgenic Tg2576 mice 40 3.3 Role of cholinergic system in β-amyloid-related changes in the cerebrovascular system of transgenic Tg2576 mice 46 3.3.1 Solanum tuberosum lectin (STL) histochemistry in visualisation of brain vessels, β-amyloid, and microglia 46 3.3.1.1 Solanum tuberosum lectin and brain vessels 46 3.3.1.2 Solanum tuberosum lectin and β-amyloid plaques 47 3.3.1.3 Solanum tuberosum lectin staining to visualize glial cells 48 3.3.2 Cholinergic perivascular innervation of cerebral cortical microvessels in transgenic Tg2576 and wild type mice 50 CHAPTER 4: DISCUSSION 4.1 β-Amyloid and brain vascular system: the vascular hypothesis of Alzheimer’s disease 55 4.1.1 Evidences of a role of vascular mechanisms in Alzheimer’s disease 55 4.1.2 Effect of β-amyloid on brain vascular system 57 4.1.3 Effect of ischemia and hypoperfusion on APP processing 59 4.1.4 Effect of β-amyloid on cholinergic function in brain vascular system 59 4.2 Aim of study and main results obtained 61 4.3 Age-related changes in cerebral cortical microvessels in the presence and absence of β-amyloid plaque load 62 4.4 Age-related changes of cholinergic terminals in cholinoceptive target regions in the presence and absence of β-amyloid plaque load 64 4.4.1 VAChT – a reliable marker for detection of cholinergic terminals in cerebral cortex 64 4.4.2 The barrel field of the somatosensory cortex 1 (S1BF) as a model region to reveal age-related changes in cholinergic innervation 65 4.4.3 VAChT expression: morphological and morphometric studies 66 4.5 Age-related changes in cholinergic innervation of cerebral cortical microvessels in the presence and absence of β-amyloid plaque load 69 4.5.1 STL – a mono-marker for detection of cortical vessels, senile amyloid plaques and activated microglia in cerebral cortex 69 4.5.2 Cholinergic perivascular innervation of cerebral cortical microvessels in transgenic Tg2576 mice 70 4.5.3 Quantitation of cholinergic input on cerebral microvessels of mouse brain 71 4.6 Summary and conclusions 75 REFERENCES 77

L'ingénierie tissulaire est reconnue comme une méthode potentielle pour réparer ou régénérer les tissus endommagés. Malgré de grandes avancées dans l'ingénierie tissulaire, la réussite de la construction de tissus complexes avec des réseaux vascularisés reste un défi. Dans les modèles d'angiogenèse actuels, les cellules endothéliales sont ensemencées au hasard, n'offrant pas de structure organisée. La technologie de bioimpression par laser offre une résolution d'impression précise. Par cette technique, les structures microvasculaires peuvent être construites pour la fabrication d'organes complexes, ou pour modéliser la progression de la maladie ou les modèles de réponse aux médicaments. Dans cette étude, des techniques de bio-impression au laser ont été utilisées pour étudier le guidage de l'angiogenèse in vitro. Deux techniques basées sur le laser, le transfert direct induit par laser (LIFT) et le transfert latéral induit par laser (LIST) sont utilisées. Comparée à LIFT, la technologie LIST offrait des conditions idéales pour l'impression cellulaire telles que la concentration cellulaire requise pour la formation du tubes endothéliaux et l'uniformité du motif désiré. Nous avons réalisé le modelage de la formation de structures de type capillaire dans des motifs organisés via l'impression LIST. Les constructions de type capillaire formées présentent des motifs uniformes. Les structures formées ont été analysées par microscopie confocale et reconstruction d'images 3D. Bien que le développement de la lumière endothéliale soit incomplet, la technique développée possède le potentiel d'atteindre une stabilisation et un développement de la lumière si l'on recrute un deuxième type de cellule tel que les fibroblastes ou les péricytes. / Tissue engineering has been well acknowledged as a potential method to repair or regenerate damaged tissues in the human body, fulfilling the limitations and shortage in autologous and organ transplantations. Despite great advances in engineering tissues with simple geometry and low requirement for oxygen and blood supply such as cartilage, skin and cornea, success in constructing 3D complex tissues with vascularized networks remains a major challenge. Angiogenesis plays an important role in vascular development in vivo. In current angiogenesis models, endothelial cells are seeded randomly not offering precise and desired patterning. Laser-based bioprinting technology offers precise and high cell printing resolution. By using laser-based bioprinting technology, microvascular structures can be constructed as a platform for complex organ fabrication, disease progression and drug response models. In this study, laser-based bioprinting techniques are employed to study angiogenesis guidance in vitro by patterning endothelial cells. Two laser-based techniques, Laser-Induced Forward Transfer (LIFT) and Laser-Induced Side Transfer (LIST) are used as patterning tools. Compared to LIFT, LIST technology provided ideal conditions for cell printing such as required cell concentration for endothelial tube formation and pattern uniformity. In this study, we achieved the guidance of capillary-like structure formation in desired patterns via LIST printing. The formed capillary-like constructs featured precise patterns and uniformity. The structures were analyzed by confocal microscopy, 3D image reconstruction and frozen section procedure. Though lumen development was incomplete, it possesses the potential to attain further stabilization and lumen development if recruiting a second cell type such as fibroblast or pericyte.