Yes / Induction of the antioxidant enzyme heme oxygenase-1 (HO-1) affords cellular protection and suppresses proliferation of vascular smooth muscle cells (VSMCs) associated with a variety of pathological cardiovascular conditions including myocardial infarction and vascular injury. However, the underlying mechanisms are not fully understood. Over-expression of Cav3.2 T-type Ca2+ channels in HEK293 cells raised basal [Ca2+]i and increased proliferation as compared with non-transfected cells. Proliferation and [Ca2+]i levels were reduced to levels seen in non-transfected cells either by induction of HO-1 or exposure of cells to the HO-1 product, carbon monoxide (CO) (applied as the CO releasing molecule, CORM-3). In the aortic VSMC line A7r5, proliferation was also inhibited by induction of HO-1 or by exposure of cells to CO, and patch-clamp recordings indicated that CO inhibited T-type (as well as L-type) Ca2+ currents in these cells. Finally, in human saphenous vein smooth muscle cells, proliferation was reduced by T-type channel inhibition or by HO-1 induction or CO exposure. The effects of T-type channel blockade and HO-1 induction were non-additive. Collectively, these data indicate that HO-1 regulates proliferation via CO-mediated inhibition of T-type Ca2+ channels. This signalling pathway provides a novel means by which proliferation of VSMCs (and other cells) may be regulated therapeutically. / This work was supported by the British Heart Foundation.

Die Schwangerschaft ist ein komplexes Phänomen, bei dem es zu einer Interaktion zwischen dem mütterlichen Immunsystem und dem Fetus kommt. An der feto-maternalen Grenze kommt es zur Auslösung einer inflammatorischen Reaktion, die für eine normale Implantation und Schwangerschaft notwendig ist. Allerdings kann eine exzessive Entzündungsreaktion zu Schwangerschaftskomplikationen wie dem immunologisch vermittelten Sponatanabort füh-ren. Das zytoprotektive Enzym Hämoxygenase-1 (HO-1) spielt eine sehr wichtige Rolle bei der Kontrolle inflammatorischer Reaktionen. Inwiefern HO-1 für das Gelingen und Bestehen einer Schwangerschaft unabdingbar ist, wurde bisher nicht untersucht. Unsere Hypothese ist, dass HO-1 eine bedeutsame Rolle während der Schwangerschaft spielt. Die Beantwortung dieser wichtigen Frage ist deshalb Hauptziel dieser Dissertation. Es konnte gezeigt werden, dass eine spezifische Hochregulation des HO-1 Moleküls mittels Gentherapie in einem Mausmodell für Spontanabort zur signifikanten Reduktion der Abortra-te führte. Dieser protektive Effekt war mit einer erhöhten Th2/Th1 Zytokinen-Ratio und mit verminderter Apoptose assoziiert. Ein weiteres Teilziel dieser Arbeit bestand darin, die Rolle des HO-1 Moleküls während der Plazentation zu untersuchen. Dafür wurde eine Trophoblastenstammzelllinie benutzt, die in der Lage ist, zu Riesenzellen zu differenzieren. Die mittels Zinkprotoporphyrin (ZnPPIX) induzierte Expressionssuppression von HO-1 führte zur Verminderung der Überlebensrate von Trophoblastenstammzellen und zur Hemmung von deren Ausdifferenzierung in Trophoblastenriesenzellen. Um die Rolle des HO-1 Moleküls in anderen Schwangerschaftsprozessen zu untersuchen, wurden Hämoxygenase-1 defiziente (Hmox1-/-) Mäuse benutzt. Da die Verpaarung von Hmox1-/- Mäuse zu keinem erfolgreichen Abkömmling führt, war ein weiteres Teilziel dieser Arbeit gewesen, den zu Grunde liegenden Mechanismus aufzuklären. Es zeigte sich, dass Hmox1-/- Weibchen im Vergleich zu den Hmox1+/+ Weibchen weniger Oozyten produzieren. Auch konnten die Hmox1-/- Oozyten weniger erfolgreich als die Hmox1+/+ Oozyten fertili-ziert werden. Verschiedene Verpaarungsexperimente mit Hmox1+/+, Hmox1+/- und Hmox1-/- Mäusen ergaben einen indirekt proportionalen Zusammenhang zwischen HO-1 Expression und Aborthäufigkeit. Die hier gewonnenen Daten deuten daraufhin, dass HO-1 eine entscheidene Rolle in der Schwangerschaft spielt. Die gewonnenen Erkenntnisse tragen zum Verständnis der Pathologie des immunologisch vermittelten Spontaborts bei und können darüber hinaus helfen neue Be-handlungsstrategien gegen diese gefürchtete Schwangerschaftskomplikation zu entwickeln. / Mammalian pregnancy is a parabiotic union of two genetically different individuals, the fetus and the mother. At the feto-maternal interface, inflammatory processes can occur due to an immune reaction against alloantigens. It is known that some degree of systemic or uterine inflammation is necessary for both normal implantation and pregnancy. However, if this in-flammation becomes too excessive it can cause pregnancy complications such as abortion. Heme oxygenase-1 (HO-1), the enzyme responsible for the degradation of free heme, plays a key role in inflammatory processes. Viewing pregnancy mainly as an inflammatory process had led us to the idea that HO-1 may play an important role in pregnancy. Therefore, the main aim of this work was to analyze the role of HO-1 in the different processes related to preg-nancy by means of functional studies employing in vivo as well as in vitro models. First, we could show that a specific up-regulation of HO-1 in abortion-prone animals by means of an adenoviral vector is able to reduce the abortion rate. This HO-1 up-regulation improved pregnancy outcome by up-regulating the Th2/Th1 cytokines ratio and protecting tissues from apoptosis, suggesting an important role of HO-1 in pregnancy. In a second part of the work, we aimed to analyze the role of HO-1 in placentation. For that, a trophoblast stem cell line capable of differentiate into trophoblast giant cells was used. Inter-estingly, a down-regulation of HO-1 by means of ZnPPIX led to diminished survival of the trophoblast stem cells. Furthermore, these cells were unable to differentiate into trophoblast giant cells in the absence of HO-1, strongly suggesting a crucial role of HO-1 in placentation. Finally, a closer look into the role of HO-1 in pregnancy was performed by using heme oxy-genase-1 deficient mice (Hmox1-/- mice). Interestingly, Hmox1-/- females produce much less oocytes than wild type females. Analyses of the ovaries of both types of females showed dif-ferences in follicle development. Furthermore, when fertilized in vitro, a significant diminu-tion in the fertilization rate of Hmox1-/- oocytes when compared to Hmox1+/+ oocytes was found. Since the mating of Hmox1-/- mice does not yield progeny, we also aimed to clarify whether this is due to problems in the female, in the male or in both. For this, different mating combinations of mice partially or totally deficient in Hmox1 were performed. The analysis of the pregnancy outcome showed that, the less HO-1 in the combination, the higher the fetal rejection. In summary, a central role of HO-1 in different processes of reproduction could be demon-strated in this work which helps understanding the mechanisms behind pregnancy success.

Le système de l’hème oxygenase-1 (HO-1) constitue un système essentiel pour la vie grâce à ses activités anti-inflammatoire et anti-oxydante lui conférant une capacité de protection importante face à une multitude de pathologies. Les produits de dégradation de l’hème par l’hème oxygénase, essentiellement le CO, participent activement dans la protection procurée par le système de l’HO-1. Par conséquence, l’exploitation pharmacologique de ce système s’est montrée d’un intérêt particulier pour une application clinique potentielle. Dans ce contexte, le but de ce travail était la caractérisation de nouvelles molécules qui activent ce système de protection.Tout d’abord, CORM-401, une nouvelle molécule ayant le Mn comme métal et qui libère 3CO/mole de la molécule, a été caractérisée dans un contexte cardiovasculaire. CORM-401 a induit une relaxation significative et immédiate des anneaux aortiques pré-contractés avec de l’épinéphrine. En parallèle, CORM-401 s’est montré sensible au stress oxydant et la libération du CO par CORM-401 s’est accélérée significativement en présence des oxydants comme H2O2, ce qui s’est traduit par une relaxation plus poussée des anneaux aortiques. En plus, CORM-401 a induit la migration des cellules endothéliales EA.hy926, l’augmentation d’expression de différents facteurs angiogéniques ainsi que la phosphorylation de p38 MAPK et Akt. P38 MAPK et HO-1 se sont montrés impliqués dans la signalisation de l’angiogenèse induite par CORM-401.En parallèle, une nouvelle classe de molécule nommée HYCOs a été récemment synthétisée par notre groupe. Ces molécules sont formées par la liaison d’un inducteur de Nrf2/HO-1 à un CO-RM dans le but d’induire une réponse immédiate à la libération du CO et une réponse plus tardive à l’induction de Nrf2/HO-1. Les deux premières molécules de cette classe, HYCO-1 et HYCO-2, ont libéré du CO en solution d’une manière concentration-dépendante et HYCO-1 s’est montré plus efficace que HYCO-2 en termes d’induction de Nrf2 dans différentes lignées cellulaires. HYCO-1 a réduit significativement la production de nitrite par les cellules microgliales BV2 et les macrophages RAW 264.7 stimulées avec du LPS. Par conséquence, ces deux molécules ont prouvé la réussite du concept des HYCOs. / The heme oxygenase-1 (HO-1) pathway has emerged as a vital multifaceted system with important capacities of protection during pathological conditions characterized by oxidative stress and inflammation. The byproducts of this pathway, CO, BV and BR, were shown to contribute actively in mediating these protective effects. Thus the exploitation of the HO-1 pathway by different pharmacological tools seems to have interesting potential in clinical application. In this context, we aimed to characterize the biochemical and pharmacological activities of molecules targeting this pathway.First, a new Mn-based CO-RM named CORM-401 that releases 3CO/mole of compound with a slow kinetic was characterized in a cardiovascular context. CORM-401 induced immediate and significant relaxation in pre-contracted isolated aortic rings. Interestingly, CORM-401 has also shown to be susceptible to an oxidative environment since H2O2 potently enhanced the CO release by this compound and enhanced its vasodilatory effect. In addition, CORM-401 promoted the migration of EA.hy926 endothelial cells and induced the expression of different angiogenic factors along with the phosphorylation of P38 MAPK and Akt. HO-1 and p38 MAPK both participated in mediating the angiogenic effect of CORM-401.In parallel, a new class of hybrid molecules, named HYCOs, was recently synthesized by our group. These molecules were designed to possess an Nrf2 inducer moiety coordinated to a CO-RM in the purpose of inducing a prompt effect by the CO release and a delayed induction of Nrf2/HO-1 by the Nrf2 inducer moiety. HYCO-1 and HYCO-2, the first two compounds of this class, both released CO in solution in a concentration-dependent manner and HYCO-1 was more potent than HYCO-2 in inducing Nrf2 in different cell lines. HYCO-1 also significantly reduced nitrite production in BV2 microglia and RAW 264.7 macrophages stimulated with LPS. With these two molecules, the concept of designing HYCOs has proven its feasibility and its success.

Les statines sont des molécules hypocholestérolémiantes, inhibiteurs compétitifs de l'hydroxyméthylglutaryl-CoA réductase, possédant des propriétés anti-inflammatoires et anti-oxydantes dépendantes et indépendantes de leur capacité à réduire le cholestérol. L'hème-oxygénase-1, une enzyme responsable du catabolisme de l'hème participe à la résolution de l'inflammation, notamment via ses propriétés anti-oxydantes. Le système enzymatique cyclooxygénase-2/prostaglandine synthase-1 microsomale catalyse la transformation de l'acide arachidonique en prostaglandine E2, médiateur biologique important dans la régulation de l'hémostase des vaisseaux, la croissance cellulaire, l'inflammation et la douleur. La cyclooxygenase-2 et l'heme-oxygenase-1 étant des cibles des statines, et jouant un rôle majeur dans l'inflammation et la fibrose, le but de ce travail a été d'élucider les mécanismes moléculaires impliqués dans la régulation de l'expression de ces enzymes par les statines dans les macrophages et les fibroblastes. Dans les fibroblastes, nous avons démontré que l'induction de l'hème-oxygénase-1 par deux statines différentes, la simvastatine et la fluvastatine, est dépendante de la voie du mévalonate et de la géranygéranylation des protéines. Nous avons pu également démontrer le rôle des facteurs de transcription CCAAT/enhancer-binding protein beta et gamma et upstream stimulatory factor 1 ou 2 dans cette induction, en utilisant des ARN interférants. Dans les macrophages, nous avons mis en évidence que les statines induisent l'hème-oxygénase-1 par un mécanisme dépendant du monoxyde d'azote. La petite protéine G Rho A/C semble être impliquée dans cette régulation ainsi que le facteur de transcription CCAAT/enhancer-binding protein beta. Finalement, nous avons analysé le rôle des statines dans la régulation des cyclooxygénase-2 et la prostaglandine synthase-1 microsomale dans des myofibroblastes hépatiques humains. Nous avons mis en évidence que les statines induisent l'expression de ces deux enzymes, par un mécanisme impliquant la voie de la Rho A/C. La conséquence de cette activation est une libération de la prostaglandine E2 qui inhibe la prolifération des myofibroblastes hépatiques. Au niveau transcriptionnel, l'élément de réponse nuclear factor-kappa B et cAMP response element/E box régions ainsi que GATA les régions riches en GC participent à la régulation des promoteurs de la cyclooxygénase-2 et de la prostaglandine synthase-1 microsomale, respectivement. En resumé, nos travaux confirment que les statines jouent un rôle protecteur dans les macrophages et les fibroblastes en induisant hème-oxygénase-1, la cyclooxygénase-2 et la prostaglandine synthase-1 microsomale, des enzymes qui jouent un rôle majeur dans le contrôle de l'inflammation et la fibrose. / Statins are selective competitive inhibitors of the 3-hydroxy-3-methylglutaryl coenzyme A reductase administered for the treatment of hypercholesterolemia. These molecules have multiple pleiotropic effects in addition to lowering cholesterol such as anti-inflammatory and anti-oxidant properties. Heme-oxygenase-1 is responsible for the catabolism of heme and has important anti-oxidant and anti-inflammatory effects. Cylooxygenase-2, along with microsomal prostaglandin E synthase-1, metabolizes arachidonic acid into prostaglandin E2, a biological mediator with important effects on vascular tone, cell growth, inflammation and pain. Because cyclooxygenase-2 and heme-oxygenase-1 are targets for statins and play a key role in inflammation and fibrosis, we aimed to investigate the molecular mechanisms underlying the regulation of these enzymes by statins in macrophages and fibroblasts.In fibroblasts, simvastatin and fluvastatin induced HO-1 expression in a mevalonate and geranylgeranylated-dependent manner. We further demonstrated a role of the transcription factors CCAAT/enhancer-binding protein beta and gamma and upstream stimulatory factor 1 or 2 in statin-dependent induction of heme-oxygenase-1 using small interfering RNA and dominant-negative constructs.In macrophages, we showed that statins i- increase the level of expression of heme-oxygenase-1 and ii- nitric oxide can play a role in statin-dependent induction of heme-oxygenase-1 , iii- RhoA/C is one of the target of statins, iv- the transcription factor CCAAT/enhancer-binding protein beta is involved in the regulation of heme-oxygenase-1 by statins.Finally, since cyclooxygenase-2 and heme-oxygenase-1 play a role in fibrosis and inflammation, we analyzed the effect of statins in human hepatic myofibroblasts, the fibrogenic cells of the liver. Statins significantly upregulated cyclooxygenase-2 and microsomal prostaglandin E synthase-1 and inhibited cell proliferation in a PGE2-dependent manner via inhibition of RhoA/C activity. Further analysis of the transcription factors involved showed a role for nuclear factor kappa B and cAMP response element/Ebox regions of cyclooxygenase-2 promoter and GATA and GC rich box regions for microsomal prostaglandin E synthase-1.Overall, our thesis results highlight the molecular mechanisms of statin-dependent regulation of two important enzymes in inflammation and fibrosis, in macrophages and fibroblasts. They confirm that some of the protective effects of statins go through the upregulation of heme-oxygenase-1, cyclooxygenase-2 and microsomal prostaglandin E synthase-1.

Systemic hypoxia frequently occurs in patients with cardiopulmonary diseases. Maintenance of vascular reactivity and endothelial viability is essential to preserving oxygen delivery in these patients. The role of matrix metalloproteinase-2 (MMP-2) and heme oxygenase-2 (HO-2) in the vascular response to hypoxia were investigated. In the first part of the thesis, the role of MMP-2 in regulating systemic arterial contraction after prolonged hypoxia was investigated. MMP-2 inhibition with cyclic peptide CTTHWGFTLC (CTT) reduced phenylephrine (PE)-induced contraction in aortae and mesenteric arteries harvested from rats exposed to hypoxia for 7 d. Responses to PE were reduced in MMP-2-/- mice exposed to hypoxia for 7 d compared to wild-type controls. CTT reduced contraction induced by big endothelin-1 (big ET-1) in aortae harvested from rats exposed to hypoxia. Increased contraction to big ET-1 after hypoxia was observed in wild-type controls, but not MMP-2-/- mice. Rat aortic MMP-2 and MT1-MMP protein levels and MMP activity were increased after 7 d of hypoxia. Rat aortic MMP-2 and MT1-MMP mRNA levels were increased in the deep medial vascular smooth muscle. These results suggest that hypoxic induction of MMP-2 activity potentiates contraction in systemic conduit and resistance arteries through proteolytic activation of big ET-1. The second part of the thesis investigated oxygen regulation of HO-2 protein and whether it plays a role in preserving endothelial cell viability during hypoxia. HO-2, but not HO-1, protein level was maintained during hypoxia in human endothelial cells through enhanced translation of HO-2 transcripts. Inhibition of HO-2 expression increased the production of reactive oxygen species, decreased mitochondrial membrane potential, and enhanced apoptotic cell death and activated caspases during hypoxia, but not during normoxia. These data indicate that HO-2 is translationally regulated and important in maintaining endothelial viability and function during hypoxia. In summary, the thesis demonstrates the importance of MMP-2 and HO-2 in preserving vascular function during prolonged systemic hypoxia. These enzymatic pathways may, therefore, represent novel therapeutic targets that may be exploited to ameliorate the effects of hypoxia in patients with cardiopulmonary disease.

Cyanide is a well known toxicant that arises in the environment from both biological and industrial sources. Bacteria have evolved novel coping mechanisms for cyanide and function as principal agents in the biosphere for cyanide recycling. Some bacteria exhibit the unusual ability of growing on cyanide as the sole nitrogen source. One such organism is Pseudomonas fluorescens NCIMB 11764 (Pf11764) which employs a novel oxidative mechanism for detoxifying and assimilating cyanide. A unique complex of enzymes referred to as cyanide oxygenase (CNO) is responsible for this ability converting cyanide to ammonia which is then assimilated. Because one component of the four member CNO complex was previously shown to act on cyanide independent of the other members, its characterization was sought as a means of gaining a better understanding of the overall catalytic mechanism of the complex. Preliminary studies suggested that the enzyme belonged to a subset of nitrilase enzymes known as cyanide dihydratases (CynD), however, a cynD-like gene in Pf11764 could not be detected by PCR. Instead, a separate nitrilase (Nit) linked to cyanide metabolism was detected. The corresponding nit gene was shown to be one of a conserved set of nit genes traced to a unique cluster in bacteria known as Nit1C. To determine whether the previously described CynD enzyme was instead Nit, efforts were undertaken to isolate the enzyme. This was pursued by cloning and expressing the recombinant enzyme and by attempting to isolate the native enzyme. This thesis is concerned with the latter activity and describes the purification of a Nit-like cyanide-degrading nitrilase (NitCC) from Pf11764 to ~95% homogeneity. Purification was greatly facilitated by the discovery that fumaronitrile, as opposed to cyanide, was the preferred substrate for the enzyme (20 versus 1 U/mg protein, respectively). While cyanide was less effective as a substrate, the specificity for cyanide far outweighed that (10,000 fold) of the recombinant enzyme (NitPG) implying that the native NitCC protein purified in this work is different from that of the cloned recombinant. Further evidence of this was provided by molecular studies indicating that the two proteins differ in mass (34.5 and 38 kDa, respectively) and amino acid sequence. In summary, two different Nit enzymes are encoded by Pf11764. While the two share greater than 50% amino acid sequence identity, the results suggest that the native NitCC enzyme purified in this work functions better as a cyanide-degrading nitrilase and is one of four enzyme components comprising CNO required for Pf11764 cyanide assimilation.

No description available.

A lesão de isquemia e reperfusão (IRI) continua a ser um problema clínico e o estresse do retículo endoplasmático (ERS) parece ser um importante mediador desse processo. A presença da heme oxigenase-1 (HO-1) ou do monóxido de carbono (CO), parece proteger da IRI. O objetivo do nosso trabalho foi avaliar a papel da HO-1 e CO na IRI renal. A indução da HO-1 em camundongos promoveu uma proteção na IRI renal, com melhora da função renal, menos inflamação e atenuação do ERS. Ao avaliarmos o papel do CO, verificamos que há também uma proteção, mediada por p38, vias purinérgicas, estabilização de HIF-1a e eritropoietina. Há ainda uma melhora do metabolismo energético celular após o tratamento com CO. Enfim, podemos concluir que, na presença da HO-1 ou do CO, há uma melhora da lesão isquêmica, através de uma maior ativação de vias citoprotetoras, com atenuação do ERS, redução da inflamação e consequente melhora da função renal. / Ischemia-reperfusion injury (IRI) remains a clinical problem and endoplasmic reticulum stress (ERS) seems to be an important mediator of this process. The presence of heme oxygenase-1 (HO-1) or carbon monoxide (CO) appears to protect from IRI. The aim of our study was to evaluate the role of HO-1 and CO in renal IRI. The induction of HO-1 in mice promoted protection in renal IRI with improved renal function, less inflammation and attenuation of ERS. When evaluating the role of CO, we found that there is also a protection mediated by p38, purinergic signaling, HIF-1a stabilization and erythropoietin. There is still an improvement of cellular energy metabolism after treatment with CO. Finally, we conclude that, in the presence of HO-1 or CO, there is an improvement of the ischemic lesion, through greater activation of cytoprotective pathways, with reduced ERS, reducing inflammation and consequent improvement in renal function.

Aims There are few proven therapies that can protect against the inevitable ischaemia reperfusion injury (IRI) that occurs during renal transplantation. IRI increases the likelihood of delayed graft function (DGF), which negatively impacts on the long-term survival of a transplanted kidney. One enzyme of interest, heme oxygenase-1 (HO-1), degrades heme and protects against the oxidative stress that occurs secondary to IRI. Clinical renal recipients with higher HO-1 levels have improved graft function post transplant. Heme arginate (HA), a form of hemin, which has been used to treat porphyria for over 30 years, has repeatedly been shown to induce HO-1 in in vivo and in vitro macrophages. It is one of the few HO-1 inducers approved for clinical use and healthy volunteer studies confirmed that HA could also safely induce HO-1 in humans. Prior to the formal start of the MD, the University of Edinburgh successfully applied to NHS Blood and Transplant for funding to investigate whether giving HA to recipients of deceased donor renal grafts prior to transplant could upregulate HO-1 and whether this had any effect on the function and health of the grafts. This MD aims to explain the background behind the proposed study, the process of study approval, planning and trial logistics and protocol. This thesis then describes the methods of sample analysis, the results and future directions for the HOT (Heme Oxygenase-1 in renal Transplantation) study. Methods The HOT study planning and approval process took eight months and the first participant was randomised in January 2012. The study was sponsored by ACCORD, a joint company from University of Edinburgh and NHS Lothian, and recruited patients from the Edinburgh Royal Infirmary Transplant Unit. The protocol was followed to ensure that 40 recipients were randomised blind to either active (two doses 3mg kg-1 HA: pre-operatively, day 2) or placebo (NaCl: same schedule). To ensure that the primary outcome was fulfilled, recipient blood was taken daily for peripheral blood mononuclear cells (PBMC) extraction. After further blinding steps, the PBMCs were analysed for HO-1 protein and mRNA. The secondary outcome measures involved collecting urine for analysis of urinary biomarkers (KIM-1 and NGAL), taking renal graft biopsies pre-op and day 5 for renal HO-1 analysis and collecting renal function data. DGF was calculated daily. To ensure that all adverse event data was captured, the recipients were closely reviewed for 7 days and their renal function was monitored for 90 days. Results The final participant was recruited in May 2013 within the predicted timescale and to budget. This participant completed follow-up in August 2013. Of the 40 participants, three received the infusion but did not receive a transplant and therefore could not give primary outcome data. The remaining 37 did and this was analysed. Adverse events were equivalent between groups and there were no adverse reactions to HA. HA upregulated PBMC HO-1 protein at 24 hours compared to placebo: HA 11.1ng/ml (1.0- 37.0) vs. placebo 0.14ng/ml (-0.7- 0.3)(p= < 0.0001). PBMC HO-1 mRNA was also increased: HA 2.73 fold (1.8- 3.2) vs. placebo 1.41 fold (1.2- 2.2) (p=0.02). HA increased HO-1 protein immunopositivity in day 5 renal tissue compared with placebo: HA 0.21 (-24- 0.7) vs. placebo -0.03 (-76- 0.15) (p=0.02) and the percentage of HO-1 positive renal macrophages also increased: HA 50.8 cells per HPF (40.0- 59.8) vs. placebo 22.3 (0- 34.8) (p=0.012). Renal HO-1 mRNA was also increased in HA group: 2.02 (0.20- 4.03) fold increase compared to 1.68 (0.75- 10.39) fold in the placebo group but it was not significant (p= 0.451). Urinary biomarkers were reduced after HA but not significantly so. Histological injury and DGF rates were similar between the groups. Conclusion HA is safe and effective in renal transplant recipients as reported in this phase II, randomised, placebo controlled, blinded, single-centre study. The primary outcome was achieved and demonstrated for the first time that HA induces HO-1 in peripheral and renal macrophages in kidney transplant recipients. There was also evidence that HA increased HO-1 expression in renal tissue. There was no evidence that HA improved renal function or reduced injury as seen in animal models but it is recognised that the sample size was small and the study was not powered to these endpoints. Larger studies are planned to determine the impact of HO-1 upregulation on clinical outcomes and evaluate the benefit to patients at risk of IRI. The plans for HOT2 are expanded in this thesis.

L’ANS recombinante de Vitis vinifera (VvANS) a été exprimée chez E. coli, et purifiée par chromatographie d’affinité sur colonne Nickel. La production et purification de l'holoenzyme chargée en fer a été mise en point, afin d’éviter les réactions d'oxydation non-enzymatique incontrôlée en présence de sel de Fe(II). Un complexe VvANS-Fe(II) stable est formé en présence d'α- cétoglutarate et d'ascorbate, complexe qui est catalytiquement actif à PO2 ambiante en l'absence de sel de Fe(II). La transformation de la (+)-catéchine par VvANS a été étudiée avec ou sans ascorbate, en utilisant le complexe VvANSFe( II) ou l’holoenzyme co-incubée en présence de sulfate ferreux, afin d’étudier le rôle de l’ascorbate. Aucune activité enzymatique n’a été observée en l'absence d’ascorbate, ce qui indique qu'il s'agit d'un cofacteur indispensable de VvANS. Un adduit covalent ascorbate-cyanidine est produit in vitro, mais seulement en l'absence d'un autre réducteur nucléophile majeur, le glutathion GSH. Les deux stéréoisomères de la leucocyanidine (flavan-diols 3,4-cis et 3,4-trans), substrats potentiels de VvANS, mais non commerciaux, ont été synthétisés par réduction de la dihydroquercétine par NaBH4, puis identifiés par RMN du proton. L'analyse des deux stéréoisomères par spectrométrie de masse en tandem (MS/MS) montre que leurs voies de fragmentation MS/MS sont distinctes et peuvent être utilisées pour les distinguer lors de leur production. Les deux stéréoisomères sont stables en milieu aqueux congelé à -20°C. Douze flavonoïdes de quatre familles distinctes (flavanones, dihydroflavonols, flavan-3-ols et flavan-3,4-diols) ont été testés comme substrats potentiels. Tous les produits enzymatiques ont été purifiés par HPLC en phase inverse, puis identifiés par MS/MS, avec les résultats suivants: 1) Seuls les dihydroflavonols de configuration (2R,3R) sont acceptés comme substrats par VvANS dont l'activité diminue avec le nombre de groupements hydroxyles du cycle B. 2) Seuls les flavan-3-ols ou flavan-3,4-diols de configuration (2R,3S) ayant un catéchol ou trois OH phénoliques vicinaux sur le cycle B sont acceptés comme substrats. 3) La naringénine n'est pas substrat de VvANS, sans doute en raison de l'absence de groupement hydroxyle en C3. […] Le glutathion GSH est un puissant nucléophile, réducteur et piégeur de radicaux libres, qui est abondant dans la baie de raisin. Nous avons donc étudié son effet sur l'activité de VvANS avec tous les substrats identifiés. GSH n’a pas d'effet sur la transformation des dihydroflavonols et des flavan-3,4-diols, mais il modifie considérablement le mode de transformation de la (+)-catéchine et de la (+)-gallocatéchine. En présence de (+)-catéchine et de GSH, on observe deux produits majeurs, la cyanidine et un adduit thioéther cyanidine-glutathion, et le rendement de production est beaucoup plus élevé qu'en l'absence de GSH. De plus, l’adduit covalent ascorbate-cyanidine et le dimère issu de la (+)-catéchine obtenus lors de la réaction réalisée en l'absence de GSH ont disparu. Nos données suggèrent que l'adduit covalent cyanidine-glutathion est un thioéther en C4 qui fait l'objet d'un équilibre de tautomérisation céto-énolique en C3, et se décompose en cyanidine et GSH. En présence de (+)-gallocatéchine, un adduit thioéther similaire delphinidine-glutathion est aussi observé. Pour tester l'éventuelle spécificité de GSH, trois autres mercaptans (thiomalate, cystéine et cystéamine) ont été testés et aucun adduit similaire n’a été observé, ce qui suggère que GSH est un ligand spécifique, et pourrait être un coenzyme de VvANS. Nos résultats suggèrent que les anthocyanidines pourraient être produites in vivo à partir d'un substrat flavan-3-ol (catéchine ou gallocatéchine) via un intermédiaire thioéther de glutathion, alors que le stéréoisomère naturel (3,4-cis) de la leucocyanidine n'est pas transformé en cyanidine. / Recombinant anthocyanidin synthase from Vitis vinifera (VvANS) has been expressed in E. coli, and purified by nickel affinity chromatography. The production and purification of the iron-loaded enzyme has been developed in order to avoid uncontrolled nonenzymatic oxidation reactions in the presence of Fe(II) salt. A stable VvANS-Fe(II) complex is formed in the presence of 2-oxoglutarate and ascorbate, and this complex is catalytically active at ambient PO2 in the absence of Fe(II) salt. The transformation of (+)-catechin by VvANS has been studied with and without ascorbate, by using either the VvANSFe( II) complex or the holoenzyme co-incubated with ferrous sulfate, to investigate the role of ascorbate. No enzyme activity has been observed in the absence of ascorbate, which means that it is an essential enzyme cofactor. A covalent adduct ascorbate-cyanidin is produced in vitro, but only in the absence of glutathione (GSH), another major nucleophilic and reducing agent. The two stereoisomers of leucocyanidin (3,4-cis et 3,4-trans flavan-diols) which were expected to behave as substrates of VvANS, are not commercial and were synthesized by reduction of dihydroquercetin by NaBH4, and characterized by proton NMR. The analysis of the two stereoisomers by means of tandem mass spectrometry (MS/MS) shows that their fragmentation pathways are distinct and may be used to distinguish them during their production. The two stereoisomers are stable in frozen aqueous medium at -20°C. Twelve flavonoids of four distinct families (flavanones, dihydroflavonols, flavan-3-ols et flavan-3,4-diols) were tested as potential substrates of VvANS. All enzymatic products were purified by means of reverse-phase HPLC and characterized by MS/MS, with the following results: 1) Only dihydroflavonols of (2R,3R) configuration are accepted as substrates by VvANS, the activity decreasing with the number of hydroxyl groups of ring B. 2) Only flavan-3-ols or flavan-3,4-diols of (2R,3S) configuration having either a catechol or three vicinal phenolic OH on ring B are accepted as substrates. 3) Naringenin is not substrate of VvANS, most likely because a C3 hydroxyl group is missing. […] Glutathione GSH is a powerful nucleophilic and reducing agent as well as a free radical scavenger, which is abundant in grape berries. We therefore studied its effect on VvANS activity with all identified substrates. GSH has no effect on the transformation of dihydroflavonols and flavan-3,4-diols, but it considerably modifies the transformation pattern of (+)- catechin and (+)-gallocatechin. In the presence of (+)-catechin and GSH, we observe two major products, cyanidin and a cyanidin-glutathione thioether, with production yields which are much higher than in the absence of GSH. Moreover, the ascorbate-cyanidin covalent adduct and the (+)-catechin dimer that had been obtained in the absence of GSH have disappeared. Our data suggest that the cyanidin-glutathione adduct is a C4-thioether which is in equilibrium between the two keto-enolic tautomeric forms at C3, and decomposes into cyanidin and GSH. In the presence of (+)-gallocatechin, a similar delphinidin-glutathione thioether adduct is also observed. In order to test the possible specificity of GSH as a cofactor, three other mercaptans (thiomalate, cysteine and cysteamine) were tested, and no similar product was observed, which suggests that GSH is a specific ligand, and might be a coenzyme of VvANS. Our results suggest that anthocyanidins could be produced in vivo from a flavan-3-ol substrate (catechin or gallocatechin) via a glutathione thioether intermediate, whereas the natural 3,4-cis stereoisomer of leucocyanidin is not transformed into cyanidin by VvANS.