La glomérulonéphrite mésangioproliférative (GNMP) se caractérise par une inflammation locale et la prolifération et l’apoptose des cellules mésangiales (CM). La protéine apparentée à l’hormone parathyroïdienne (PTHrP) a été impliquée dans ces processus dans divers types cellulaires. Nous avons analysé les effets de la PTHrP sur ces processus dans les CM. Nous montrons que la PTHrP majore la prolifération des CM par voie intracrine et diminue leur apoptose par voie paracrine. La PTHrP stimule les voies de l’AMPc/PKA et PI3-K/Akt conduisant à l’activation du NFkB et à la majoration de la cyclooxygénase-2 (Cox-2). La Cox-2 était responsable de la survie des CM par la PTHrP. Par ailleurs, l’IL-1beta et le TNF-alpha majorent l’expression de la PTHrP dans les CM, et la PTHrP elle-même induisait l’expression de cytokines et chimiokines. L’expression des cytokines (IL-17, IL-16), était brève (pic à 2h). L’expression des chimiokine (RANTES, MIP-2, TARC et I-TAC) était plus prolongée (4h). Dans un modèle murin de GNMP, la PTHrP était surexprimée à J1 dans les glomérules malades. Elle pourrait contribuer à l’inflammation locale, à la prolifération et à la survie des CM. / Mesangial proliferative glomerulonephritis (MPGN) is characterized by mesangial cells (MC) inflammation, proliferation and apoptosis. The parathyroid hormone-related protein (PTHrP) is known to influence these processes in many cell types. In this work we analyzed the effects of PTHrP on MC proliferation, apoptosis and inflammation. Our results show that PTHrP induced MC proliferation through the intracrine pathway while it promoted their survival through the paracrine one. PTHrP activating its receptor PTH1R, led to the activation of cAMP/PKA and PI3-K/Akt pathways, which induced NF-kappaB, and upregulated the cyclooxygenase-2 (Cox-2). We have shown that the Cox-2 was responsible of the anti-apoptotic effect of PTHrP on MC. Otherwise, IL-1beta and TNF-alpha importantly upregulated the PTHrP in MC and PTHrP itself led to an overexpression of many cytokines and chemokines. The overexpression of cytokines (IL-17 and IL-16) was brief (2h) while that of chemokines was extended (4h). In a mouse model of MPGN, PTHrP was upregulated in the injured glomeruli at day 1. PTHrP may then contribute to the inflammation, the proliferation and the survival of MC.

La sécrétion d'aldostérone par la glande surrénale est principalement contrôlée par le système rénine-angiotensine circulant (SRA) et la kaliémie. La synthèse de l'aldostérone est également influencée par les facteurs paracrines intra-surrénaliens, y compris les neuropeptides. En particulier, les tachykinines, comme la substance P (SP), peuvent être libérées par les terminaisons nerveuses dans le cortex surrénalien. Le rôle de la SP dans la régulation de la fonction surrénalienne a été évalué chez l'animal mais rarement étudié chez l'homme. Le but de la présente étude est d'explorer le rôle de la SP dans le contrôle de la synthèse des minéralocorticoïdes dans la glande surrénale humaine. Des expériences in vitro conduites dans des échantillons surrénaliens normaux révèlent l'expression de SP codée par TAC1 qui est détecté par immunohistochimie dans des fibres nerveuses non-adrénergiques non-cholinergiques dans la zone glomérulée. Les fibres SP-positives établissent des contacts étroits avec des cellules productrices d'aldostérone qui expriment le récepteur NK1 (NK1R), récepteur de la SP. La SP stimule la production d'aldostérone à partir de cellules corticosurrénales cultivées, un effet qui est inhibé par l'aprépitant, antagoniste NK1R. L'action de la SP est relayée par la voie ERK et implique une régulation à la hausse de plusieurs gènes codant pour des enzymes de la stéroïdogénèse. Le rôle physiologique de la SP dans la régulation de la sécrétion d'aldostérone a été évalué à l'aide d'un essai clinique prospectif, contrôlé par placebo, de l'impact de l'aprépitant sur les concentrations plasmatiques et urinaires d'aldostérone chez des volontaires sains. L'aprépitant a réduit la production quotidienne d'aldostérone et la concentration plasmatique d'aldostérone (CPA) dans le décubitus, mais n'a pas modifié les CPA en position debout. Ces données montrent que la SP exerce un tonus stimulant sur la production d'aldostérone chez l'homme. / Aldosterone secretion by the adrenal gland is principally under control of the circulating renin-angiotensin system (RAS) and kalemia. Aldosterone synthesis is also influenced by intra-adrenal paracrine factors including neuropeptides. Especially, tachykinins, like substance P (SP), can be released by nerve endings in the adrenal cortex. The role of SP in the regulation of the adrenal function has been evaluated in animals but only scarcely investigated in humans. The aim of the present study is to explore the role of SP in the control of mineralocorticoid synthesis in the human adrenal gland. In vitro experiments conducted in normal adrenal samples reveal expression of the TAC1 encoding SP which is detected by immunohistochemistry in non adrenergic non cholinergic nerve fibres in the zona glomerulosa. SP-positive fibres establish close contacts with aldosterone-producing cells which express the SP receptor, i.e. the NK1 receptor (NK1R). SP stimulates aldosterone production from cultured adrenocortical cells, an effect which is inhibited by the NK1R antagonist aprepitant. The action of SP is mediated by the ERK pathway and involves upregulation of several genes encoding steroidogenic enzymes. The physiological role of SP in the regulation of aldosterone secretion was further assessed through a prospective clinical placebo-controlled trial investigating the impact of aprepitant on plasma and urine aldosterone levels in healthy volunteers. Aprepitant reduced daily aldosterone production and plasma aldosterone concentration (PAC) in recumbency but did not modify PAC in upright position. These data show that SP exerts a stimulatory tone on aldosterone production in man.

The epicardium is a single layer of epithelial (mesothelial) cells that covers the entire heart surface, but whose function in adult mammals is poorly understood. Defining the role of epicardial cells during homeostasis, growth and injury has potential to provide new treatment strategies for human diseases that result in heart failure, due to extensive loss of viable cardiac tissue. We hypothesized that epicardial cells contribute to repair as transplantable progenitor cells for cellular regeneration and as a source of secreted growth factors for cell protection after myocardial infarction. Adult epicardial cells were prospectively isolated as uncommitted epithelial cells using epithelial-specific beta-4 integrin (CD104). These cells underwent epithelial to mesenchymal transformation in culture to generate epicardial cell derivatives (EPDCs). We demonstrate that the C-terminal peptide from Connective Tissue Growth Factor (CTGF-D4), when combined with insulin, effectively primes EPDCs for robust cardiac engraftment in rats and contributes to improvement in cardiac function at one month after MI. Furthermore, we define a signaling axis comprised of CTGF-D4, low density lipoprotein receptor-related protein 6 (LRP6), sex determining region Y-box 9 (Sox9) and Endothelin Receptor B (ETBR) that controls several key processes that impact EPDC graft success: cell survival, proliferation and migration. Interestingly, conditional deletion of ETBR using epicardial-specific transgenic mice prevented epicardial cell proliferation and migration into myocardium after MI. We therefore observed a congruence in the signals and signaling pathways that control the proliferation and migration of endogenous EPDCs after MI and EPDCs that can be generated in cell culture and grafted back to the heart. To gain additional insight into the cellular contribution of the epicardium, we utilized a non-injurious running exercise model to evaluate epicardial activity as a consequence of cardiac hypertrophy (i.e. myocardial growth model). We employed an inducible lineage-tracing system to specifically label and track epicardial cells by GFP expression. Prolonged exercise resulted in a significant number of GFP-positive proliferating epicardial cells and epicardial-derived GFP-positive endothelial cells and few GFP-positive smooth muscle cells in the heart. These observations highlight the cellular plasticity of the adult epicardium and its function as a cardiac progenitor cell niche, maintaining a source of replacement cells. To investigate the paracrine properties of adult epicardial cells for their role in cell protection after MI and reperfusion, human epicardial cells were isolated from donor atrial tissue explants. We predicted that medium conditioned by cultured epicardial cells (EPI CdM) contained secreted reparative factors that would promote endothelial cell survival. Administration of EPI CdM promoted endothelial cell survival in culture and in vivo, 24 hours after ischemia-reperfusion injury. By screening EPI CdM, we detected protein complexes containing hepatocyte growth factor (HGF) with polyclonal IgG that imparted vascular protection in vivo in a manner similar to EPI CdM. Overall, the studies presented here illustrate the unique biology of epicardial cells, their signaling networks, and their contribution to cardiac cell protection and regeneration. Importantly, these properties have the potential to be exploited in translational applications for cardiac repair.

Several studies have shown cellular replacement therapy as a treatment strategy of myocardial infarction but results have been limited. Therefore, enhancing the therapeutic potential of stem cells injected into ischemic microenvironments by novel preconditioning (PC) techniques is critical for improving cellular therapy. Recent studies have shown that inhibition of phosphodiesterase-5 (PDE-5) is a powerful strategy to precondition the heart and cardiomyocytes against ischemia/reperfusion injury. We therefore tested the hypothesis that inhibition of PDE-5 with sildenafil (Viagra®) or selective knockdown with a silencing vector in adipose derived stem cells (ASCs) would improve their survival after ischemia/reoxygenation in vitro and enhance cardiac function following myocardial implantation in vivo. ASCs were treated with sildenafil or infected with PDE-5 silencing vector shRNA (shRNAPDE-5). The cells were subjected to simulated ischemia (SI) and reoxygenation (RO). Both sildenafil and shRNAPDE-5 significantly reduced cell injury, as shown by improved viability, decreased lactate dehydrogenase, and apoptosis. The preconditioned ASCs also demonstrated an increase in the release of growth factors including VEGF, b-FGF, and IGF. The protective effect against SI/RO injury was abolished by inhibition of protein kinase G (PKG) using both a pharmacological inhibitor and selective knockdown with shRNAPKG1α suggesting a PKG-mediated mechanism. To show the effect of preconditioned ASCs in vivo, adult male CD-1 mice underwent myocardial infarction (MI) by occlusion of the left descending coronary artery, followed by direct injection of PBS (control), non-preconditioned ASCs, or preconditioned ASCs (4x105) ASCs into the left ventricle (LV). Preconditioned ASC-treated hearts showed consistently superior cardiac function by all measures as compared with PBS and non-preconditioned ASCs after 4 weeks of treatment. Post-mortem histological analysis demonstrated that preconditioned ASC-treated mice had significantly reduced fibrosis, increased vascular density and reduced resident myocyte apoptosis as compared to mice receiving non-preconditioned ASCs or PBS. VEGF, b-FGF, and Ang-1 were also significantly elevated 4 weeks after cell therapy with preconditioned ASCs. Our data suggests that genetic or pharmacological inhibition of PDE-5 is a powerful new approach to improve stem cell therapy following myocardial infarction.

Pang Yefei. / "August 2001." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (p. 161-197). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Heart failure accounts for more deaths in the United States than any other pathology. Unfortunately, repairing the heart after pathological injury has become an overwhelming task for physicians and researchers to overcome. Fortunately, cellular cardiomyoplasty has emerged as a promising solution for sufferers of heart failure. Such a therapy is limited in efficacy due to poor engraftment efficiencies, however. To address this issue, we have developed a tissue engineered vehicle for cell delivery. Use of a "cardiac patch" resulted in localized and efficient delivery of human mesenchymal stem cells (hMSC) to infarcted myocardium. Application of a cardiac patch also attenuated adverse remodeling. Additionally, the culture of stem/progenitor cells within three dimensional collagen constructs led to modulations in cell function, which did not promote enhanced angiogenesis in vitro or in vivo. Despite enhanced neovessel formation, hMSC patches were more beneficial at augmenting myocardial repair compared to directly injected hMSC. Lastly, although hMSC represent an effective cell source option for enhancing cardiac repair they require additional purification and expansion steps which inherently delay the turnover before treatment. Therefore, suitable cell alternative are being sought. Human embryonic stem cell derived mesenchymal (B4) cells display several phenotypic similarities to hMSC. B4 progenitor cells responded similarly to hMSC in 3D culture. In addition B4 progenitor cell patch application to infarcted myocardium resulted in similar indices of repair compared to hMSC. Thus, a tissue engineering approach represents an effective cell delivery strategy and induces modulations in cell function which may demonstrate pathological significance.

Current cartilage repair methods are ineffective in restoring the mechanical and biological functions of native hyaline cartilage. Therefore, using the paracrine actions of stem cell therapies to stimulate endogenous cartilage regeneration has gained momentum. Adipose stem cells (ASCs) are an attractive option for this endeavor because of their accessibility, chondrogenic potential, and secretion of factors that promote connective tissue repair. In order to use the factors secreted by ASCs to stimulate cartilage regeneration, the signaling pathways that affect postnatal cartilage development and morphology need to be understood. Next, approaches need to be developed to tailor the secretory profile of ASCs to promote cartilage regeneration. Finally, delivery methods that localize ASCs within a defect site while facilitating paracrine factor secretion need to be optimized. The overall objective of this thesis was to develop an ASC therapy that could be effectively delivered in cartilage defects and stimulate regeneration via its paracrine actions. The general hypothesis was that the secretory profile of ASCs can be tailored to enhance cartilage regeneration and be effectively delivered to regenerate cartilage in vivo. The overall approach used the growth plate as an initial model to study changes in postnatal cartilage morphology and the molecular mechanisms that regulate it, different media treatments and microencapsulation to tailor growth factor production, and alginate microbeads to deliver ASCs in vivo to repair cartilage focal defects.

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<p>Massive loss of cardiac tissue as a result of myocardial infarction can create a poorly-conducting substrate with impaired contractility, ultimately leading to heart failure and lethal arrhythmias. Recent advances in pluripotent stem cell research have provided investigators with potent sources of cardiogenic cells that may be transplanted into failing hearts to provide electrical and mechanical support. Experiments in both small and large animal models have shown that standard cell delivery techniques suffer from poor retention and engraftment of cells. In contrast, the transplantation of engineered cardiac tissues may provide improved cell retention at the injury site, creating a more localized paracrine effect and yielding more efficient structural and functional repair. However, tissue engineering methodologies to assemble cardiomyocytes or cardiac progenitors into aligned, 3-dimensional (3D) myocardial tissues capable of physiologically relevant electrical conduction and force generation are lacking. The objective of this thesis was thus to develop a methodology to generate highly functional engineered cardiac tissues starting from pluripotent stem cells.</p><p>To accomplish this goal, we first derived purified populations of cardiac myocytes from mouse embryonic stem cells (mESC-CMs) by antibiotic selection driven by an &#945;-myosin heavy-chain promoter. Culture conditions that yielded robust mESC-CM electrical coupling and fast action potential propagation were optimized in confluent cell monolayers. We then developed a microfabrication-based tissue engineering approach to create engineered cardiac tissues ("patches") with uniform 3D cell alignment. We found that, unlike in monolayers, mESC-CMs required a population of supporting cardiac fibroblasts to enable the formation of 3D engineered tissues. Detailed structural, electrical and mechanical characterization demonstrated that engineered cardiac patches consisted of dense, uniformly aligned, highly differentiated and electromechanically coupled mESC-CMs and supported rapid action potential conduction velocities between 22 - 25cm/s and contractile force amplitudes of up to 2mN. </p><p>Next, we sought to circumvent the use of primary cardiac fibroblasts by utilizing a single pluripotent stem cell-derived source, multipotent cardiovascular progenitors (CVPs) capable of differentiating into vascular smooth muscle and endothelial cells in addition to cardiomyocytes. CVPs were derived from mouse embryonic stem cells and induced pluripotent stem (iPS) cells by antibiotic selection driven by an Nkx2-5 enhancer element. Similar to mESC-CMs, CVPs formed highly differentiated cell monolayers with electrophysiological properties that improved with time in culture to levels achieved with pure mESC-CMs. However, unlike mESC-CMs, CVPs formed highly functional 3D engineered cardiac tissues without the addition of cardiac fibroblasts, enabling engineered cardiac tissues to be formed from a single, entirely stem cell-derived source.</p><p>Finally, we explored mechanisms of synergistic cardiac fibroblast/myocyte signaling in 3D engineered tissues by using cardiac fibroblasts of different developmental stages in the settings of direct 3D co-culture as well as in conditioned media studies. When co-cultured with fetal cardiac fibroblasts, mESC-CMs were capable of two-fold faster action potential propagation and 1.5-fold higher maximum contractile force generation than when co-cultured with adult cardiac fibroblasts. These functional improvements were associated with enhanced mESC-CM spreading and upregulation of important ion channel, coupling, and contractile proteins. Conditioned medium studies revealed that compared to adult fibroblasts, fetal cardiac fibroblasts secreted distinct paracrine factors that promoted mESC-CM spreading and spontaneous contractility in 3D engineered tissues and acted via the MEK-ERK pathway. Quantitative gene expression analysis revealed paracrine factor candidates that may mediate this action.</p><p>In summary, this thesis presents methods and underlying mechanisms for generation of highly functional cardiac tissues from pluripotent stem cell sources. These techniques and findings provide foundation for future engineering of human ES and iPS cell-based cardiac tissues for therapeutic and drug screening applications.</p> / Dissertation

The developing chick retina is an extrapituitary site of growth hormone (GH) synthesis and action. GH, GH receptor (GHR) and their mRNAs are present in the neural retina when the neural cells are undergoing proliferation and differentiation during early embryogenesis. It is thus likely that GH acts as an autocrine or paracrine in this location. The present study shows that intra-vitreal injection of a chick GH (cGH) small interfering RNA (siRNA) into the eyes of early embryos [embryonic day (ED) 4] suppresses GH expression in the neural retina and increases the incidence of spontaneous retinal cell death. Our current work also demonstrates a reduction of local IGF-1 expression after retinal GH gene knockdown, suggesting that GH action in retinal cells is regulated through IGF-1 signalling. These results demonstrate that retinal GH is an autocrine/paracrine hormone that acts as a neuroprotective factor in the retina of chick embryos.