Sildenafil, a selective phosphodiesterase type 5 (PDE5) inhibitor, is registered for the treatment of male erectile dysfunction (Viagra®) and pulmonary hypertension (Revatio®) in the United States. PDE5 is found in the endothelium of blood vessels in the penile corpus cavernosum, pulmonary vessels and also brain and other peripheral tissue. Sildenafil crosses the blood brain barrier, leading to side-effects such as headache and dizziness, as well as behavioural manifestations including depression, anxiety and aggression (Milman & Arnold, 2002). According to the Food and Drug Administration (2001), 12378 adverse events were reported after the use of sildenafil and 274 of these reports implicated sildenafil in neurologic, emotional, or psychological disturbances between January 1998 and 21 February 2001. In addition, in vivo studies in rats indicate that sildenafil has anxiogenic and stressogenic actions (Harvey et al., 2005; Volke et al., 2003). This is a clear indication that sildenafil influences neurological processes in the brain and may influence various signalling systems, which play major roles in the neural circuitry of the above-mentioned disturbances. Recent in vitro studies in our laboratory suggest that sildenafil may potentiate cholinergic muscarinic receptor signalling (Eager, 2004). These results suggest potential depressogenic actions, since an increase in acetylcholine is associated with depression-like symptoms (El- Yousef et al., 1973). It was therefore postulated that sildenafil may in fact possess antidepressant activity that is masked by a cholinergic-driven depressogenic activity. In a study conducted by Muller and Benkert in 2000, patients reported a decrease in depression-like symptoms when treated with sildenafil for erectile dysfunction. This implied that sildenafil not only had a direct effect on erectile function in about 50-80% of men with erectile dysfunction (Langtry and Markham, 1999; Padma-Nathan, 1999) but might also improve anhedonia and depression. The substantial correlation between the International Index of Erectile Function and Epidemiologic Studies-Depression Scale scores supported this assumption (Muller & Benkert, 2000). In addition, Raffaele et al. (2002) reported an indirect improvement in depressive-like symptoms in patients treated for erectile dysfunction with idiopathic Parkinson's disease. Aims: The current study investigated the behavioural and neuroreceptor properties of sildenafil in a rat model of depression. We also investigated a hypothesis that sildenafil displays antidepressant-like properties, but which are masked by its potentiation of the cholinergic system. Methods: The experimental layout was divided into three pilot studies. Pilot Study 1 validated the FST under our laboratory conditions, Sprague-Dawley rats received saline intraperitoneally (i.p.) for 7 days, whereafter half of the rats were pre-exposed to a 15 minute swim trial, while the remaining rats were not pre-exposed. All rats were then evaluated 24 hours later in the 5 minute scored swim trial. In Pilot Study 2 Sprague-Dawley rats were treated for 3, 7 or 11 days with vehicle (control) or 20 mg/kg fluoxetine to establish the time-dependency of the onset of antidepressant-like effects in a rat model of depression. We measured immobility in the rat forced swim test (FST), as well as changes in P-adrenergic receptor (P-AR) concentration in rat frontal cortex. In pilot study 3, rats were treated for 7 days with vehicle (control), 20 mg/kg fluoxetine, 10 mg/kg sildenafil, 1 mg/kg atropine or various combinations of these drugs. Again we employed the FST and measured cortical p-AR concentration. Results: In the FST pre-exposure to a 15 minute swim trial 24 hours before the scored swim trial significantly increased immobility. Fluoxetine inhibited this development of increased immobility in FST and decreased P-AR concentration after 7 and 11 days of treatment with fluoxetine, but not after 3 days. Seven days of treatment with atropine and sildenafil alone did not exert any changes in immobility in the FST or changes in p-AR concentration. However, a combination of atropine and sildenafil exerted a significant antidepressant-like behavioural effect, comparable with fluoxetine. Moreover, the combination of atropine and fluoxetine as well as the a triple combination of fluoxetine, sildenafil and atropine was superior to fluoxetine alone. Conclusion: Muscarinic cholinergic mechanisms mask the antidepressant-like properties of sildenafil in a rat model of depression. The antidepressant properties of the combination of sildenafil and atropine are comparable to that of fluoxetine in an animal model of depression. The combination of fluoxetine with atropine, and atropine and sildenafil enhances the antidepressant-like properties of fluoxetine. / Thesis (M.Sc. (Pharmacology))--North-West University, Potchefstroom Campus, 2007.

Sildenafil, a selective phosphodiesterase type 5 (PDE5) inhibitor, is registered for the treatment of male erectile dysfunction (Viagra®) and pulmonary hypertension (Revatio®) in the United States. PDE5 is found in the endothelium of blood vessels in the penile corpus cavernosum, pulmonary vessels and also brain and other peripheral tissue. Sildenafil crosses the blood brain barrier, leading to side-effects such as headache and dizziness, as well as behavioural manifestations including depression, anxiety and aggression (Milman & Arnold, 2002). According to the Food and Drug Administration (2001), 12378 adverse events were reported after the use of sildenafil and 274 of these reports implicated sildenafil in neurologic, emotional, or psychological disturbances between January 1998 and 21 February 2001. In addition, in vivo studies in rats indicate that sildenafil has anxiogenic and stressogenic actions (Harvey et al., 2005; Volke et al., 2003). This is a clear indication that sildenafil influences neurological processes in the brain and may influence various signalling systems, which play major roles in the neural circuitry of the above-mentioned disturbances. Recent in vitro studies in our laboratory suggest that sildenafil may potentiate cholinergic muscarinic receptor signalling (Eager, 2004). These results suggest potential depressogenic actions, since an increase in acetylcholine is associated with depression-like symptoms (El- Yousef et al., 1973). It was therefore postulated that sildenafil may in fact possess antidepressant activity that is masked by a cholinergic-driven depressogenic activity. In a study conducted by Muller and Benkert in 2000, patients reported a decrease in depression-like symptoms when treated with sildenafil for erectile dysfunction. This implied that sildenafil not only had a direct effect on erectile function in about 50-80% of men with erectile dysfunction (Langtry and Markham, 1999; Padma-Nathan, 1999) but might also improve anhedonia and depression. The substantial correlation between the International Index of Erectile Function and Epidemiologic Studies-Depression Scale scores supported this assumption (Muller & Benkert, 2000). In addition, Raffaele et al. (2002) reported an indirect improvement in depressive-like symptoms in patients treated for erectile dysfunction with idiopathic Parkinson's disease. Aims: The current study investigated the behavioural and neuroreceptor properties of sildenafil in a rat model of depression. We also investigated a hypothesis that sildenafil displays antidepressant-like properties, but which are masked by its potentiation of the cholinergic system. Methods: The experimental layout was divided into three pilot studies. Pilot Study 1 validated the FST under our laboratory conditions, Sprague-Dawley rats received saline intraperitoneally (i.p.) for 7 days, whereafter half of the rats were pre-exposed to a 15 minute swim trial, while the remaining rats were not pre-exposed. All rats were then evaluated 24 hours later in the 5 minute scored swim trial. In Pilot Study 2 Sprague-Dawley rats were treated for 3, 7 or 11 days with vehicle (control) or 20 mg/kg fluoxetine to establish the time-dependency of the onset of antidepressant-like effects in a rat model of depression. We measured immobility in the rat forced swim test (FST), as well as changes in P-adrenergic receptor (P-AR) concentration in rat frontal cortex. In pilot study 3, rats were treated for 7 days with vehicle (control), 20 mg/kg fluoxetine, 10 mg/kg sildenafil, 1 mg/kg atropine or various combinations of these drugs. Again we employed the FST and measured cortical p-AR concentration. Results: In the FST pre-exposure to a 15 minute swim trial 24 hours before the scored swim trial significantly increased immobility. Fluoxetine inhibited this development of increased immobility in FST and decreased P-AR concentration after 7 and 11 days of treatment with fluoxetine, but not after 3 days. Seven days of treatment with atropine and sildenafil alone did not exert any changes in immobility in the FST or changes in p-AR concentration. However, a combination of atropine and sildenafil exerted a significant antidepressant-like behavioural effect, comparable with fluoxetine. Moreover, the combination of atropine and fluoxetine as well as the a triple combination of fluoxetine, sildenafil and atropine was superior to fluoxetine alone. Conclusion: Muscarinic cholinergic mechanisms mask the antidepressant-like properties of sildenafil in a rat model of depression. The antidepressant properties of the combination of sildenafil and atropine are comparable to that of fluoxetine in an animal model of depression. The combination of fluoxetine with atropine, and atropine and sildenafil enhances the antidepressant-like properties of fluoxetine. / Thesis (M.Sc. (Pharmacology))--North-West University, Potchefstroom Campus, 2007.

Thesis (M.Sc.)--Memorial University of Newfoundland, Faculty of Medicine, / Typescript. Bibliography: leaves 44-68.

Orientador: Gilberto de Nucci / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-10T06:11:56Z (GMT). No. of bitstreams: 1 Lorenzetti_Raquel_D.pdf: 2089930 bytes, checksum: f6ed8b98e678ffdfc6051c645efc8b4b (MD5) Previous issue date: 2007 / Resumo: No presente trabalho foi padronizado um novo método para a dosagem da atividade de fosfodiesterase in vitro, por HPLC-MS/MS. Este novo método conseguiu apresentar exatidão, precisão, sensibilidade e rapidez nas análises; monitorando os nucleotídeos (AMP, GMP, AMPc e GMPc). O desenvolvimento de novos fármacos derivados de um protótipo aponta para a obtenção de moléculas com um melhor perfil farmacocinético ou uma melhor relação estrutura-atividade. Atualmente o sildenafil é considerado o principal fármaco para o tratamento de disfunção erétil. Neste trabalho, avaliaram-se novos compostos denominados análogos de sildenafil (carbonato de lodenafil, dímero uréia e dímero uretana). Os análogos foram analisados quanto à atividade em PDE5 e agregação plaquetária humana, in vitro. Foi determinada a estabilidade destes compostos, em meio ácido e plasma humano, in vitro, além de seus possíveis metabólitos em microssomas e hepatócitos de rato in vitro, e os seus parâmetros farmacocinéticos via intravenosa e oral, em cão, in vivo. Os resultados mostraram que os análogos de sildenafil inibem a atividade de PDE e não inibem a agregação plaquetária do mesmo modo que o sildenafil in vitro, no entanto potencializam a ação do doador de NO (SNP). Os análogos de sildenafil foram estáveis em meio ácido e em plasma humano. No ensaio de metabolização, os dímeros uréia e uretana não foram metabolizados, entretanto o carbonato de lodenafil foi metabolizado principalmente em lodenafil, in vitro. O carbonato de lodenafil é rapidamente biotransformado em lodenafil, após administração v.i. e v.o. em cão. Concluiu-se que este trabalho apresenta um novo método de dosagem de PDEs e uma nova perspectiva terapêutica para a disfunção erétil, representada pelo carbonato de lodenafil, o qual inibe concentração-dependente a atividade de PDE5 / Abstract: In the present work a new method for the dosage of the activity of phosphodiesterase was standardized in vitro, for HPLC-MS/MS. This new method obtained to present exactness, precision, sensitivity, and rapidity in the analyses; monitoring the nucleotides (AMP, GMP, cAMP and cGMP). The development of new drug derived from an archetype points with respect to the molecule attainment with one better pharmacokinetic profile or one better relation structure-activity. Currently the sildenafil is considered the main drug for the treatment of erectile dysfunction. In this work, we evaluate new analogous called composites of sildenafil (carbonate of lodenafil, dimer urea and dimer uretana). The analogous ones had been analyzed how much the activity in PDE5 and platelet aggregation human being, in vitro. The stability of these composites was determined, in human acid way and plasma, in vitro, beyond its possible metabolites in microsomes and hepatocytes of rat in vitro, and its pharmacokinetic profile after intravenous and oral, in dog, in vivo. The results had shown that the analogous of sildenafil inhibit the activity of PDE and they do not inhibit the platelet aggregation in a similar way that the sildenafil in vitro, however potencializam the action of the giver of NO (SNP). The analogous ones of sildenafil are presented steady in human acid way and plasma. In the metabolization assay, metabolization of dimer urea and dimer uretana was not observed, however the lodenafil carbonate was metabolizado mainly in lodenafil, in vitro. The lodenafil carbonate quickly is biotransformation in lodenafil, after administration v.i. and v.o. in dog. We conclude that this work presents a new method for analyze activity of PDEs and a new therapeutically perspective for the erectile dysfunction, represented for lodenafil carbonate, which inhibits concentration-dependent the activity of PDE5 / Doutorado / Doutor em Farmacologia

Orientador: Heitor Moreno Junior / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-06T19:55:16Z (GMT). No. of bitstreams: 1 Melo_SilviaElainedeSousaFerreiraCarvalhode_D.pdf: 6801672 bytes, checksum: d5d157af717b53ac33305c8ec554a2d0 (MD5) Previous issue date: 2005 / Resumo: O óxido nítrico (NO) é um mediador biológico multifuncional que serve como molécula chave em muitos processos fisiopatológicos, sintetizado nas células endoteliais em resposta a estímulos fisiológicos ou patológicos. Sua síntese se dá a partir da clivagem do terminal nitrogênio-guanidina do aminoácido L-arginina, em uma reação catalizada pela enzima óxido nítrico sintase (NOS). Há três isoformas de NOS: a NOS endotelial (eNOS), a NOS neuronal (nNOS) e a NOS induzível (iNOS). A eNOS e a nNOS são isoformas expressas constitutivamente nas células endoteliais vasculares e nas células neuronais, respectivamente; e a iNOS que a forma induzível, expressa em células inflamatórias após a indução por citocinas e outros mediadores inflamatórios. Após sua síntese o NO se difunde para as células do músculo liso vascular ativando a enzima guanilato ciclase solúvel (GCs), que converte guanosina-tri-fostato (GTP) em guanosina-3¿,5¿-monofosfato cíclica (GMPc), um segundo mensageiro para seus diversos efeitos biológicos, dentre os quais o relaxamento da musculatura lisa vascular. A síntese de NO pode ser inibida por vários compostos análogos à L-arginina, como L-NMMA, L-NAA, L-NAME e L-NIO de forma dose-dependente. A inibição crônica da síntese de óxido nítrico pela administração crônica de L-NAME é um modelo complexo e bem estabelecido de hipertensão arterial e miocardiopatia hipertensiva. É caracterizado por elevação da pressão arterial (PA) de forma severa, redução na freqüência cardíaca, no fluxo coronário e débito cardíaco (DC), aumento da resistência vascular periférica total (RVPT), diminuição do relaxamento vascular e alterações na contratilidade cardíaca, hipertrofia cardíaca, aumento do tamanho cardiomiócito, remodelamento miocárdico e microvascular com fibrose perivascular, sendo que o índice peso cardíaco/peso corporal e peso ventricular esquerdo/peso corporal estão usualmente aumentados. As fosfodiesterases são enzimas que degradam os nucleotídeos cíclicos GMPc e AMPc nas suas formas inativas. São conhecidas 11 famílias de enzimas (PDE1 ¿ PDE11) que diferem com relação ao padrão distribuição, especificidade de substrato, regulação pelas PKs e proteínas ligantes. Estão envolvidas em diversos processos fisiológicos e patológicos, tais como ereção peniana, asma, hipertensão pulmonar, aterosclerose, insuficiência cardíaca e diabetes. Consequentemente, os inibidores seletivos de PDE são interessantes e promissores alvos farmacológicos. Os inibidores das PDEs inpedem a degradação do AMPc, GMPc, elevando seus níveis intracelulares. Esses inibidores mimetizam as estruturas do AMPc e GMPc, mas não são degradados. Sildenafil é um inibidor seletivo da PDE5 induzindo o e relaxamento do músculo vascular liso e têm sido utilizados com sucesso no tratamento da disfunção erétil. A base racional para este projeto é a hipótese de que o sildenafil, por inibir de forma seletiva a PDE5 e conseqüentemente aumentar a disponibilidade de GMPc, possa ter efeitos cardiovasculares benéficos na inibição crônica da síntese de NO que reduz os níveis de GMPc no músculo cardíaco e vascular. Para isso foram estudados 4 grupos experimentais divididos aleatoriamente em: CONTROLE, L-NAME, SILDENAFIL e SILDENAFIL + L-NAME, durante 8 semanas de tratamento. Analisamos as alterações hemodinâmicas através das medidas da pressão arterial média, débito cardíaco, freqüência cardíaca e resistência vascular. As análises histológicas foram feitas através de técnicas morfométricas para determinação do diâmetro de miócito, lesões miocárdicas e espessura da camada média vascular e análises imunohistológicas. Nossos resultados demonstraram que a administração crônica de sildenafil altera os padrões hemodinâmicos e histolólgicos do modelo de miocardiopatia hipertensiva induzida pela inibição da síntese de NO por L-NAME. A inibição da PDE5 restaurou parcialmente os padrões hemodinâmicos, avaliados através da PA, DC e RVPT, além de protege parcialmente o miocárdio e músculo vascular liso contra as lesões e remodelamento cardiovascular característicos deste modelo experimental. A biodisponibilidade de GMPc, nos animais do grupo L-NAME + sildenafil, foi totalmente restaurada após 8 semanas de tratamento e a expressão das enzimas PDE3 e PDE5 estavam modificadas no músculo vascular liso e nos discos intercalares dos miócitos. Dessa forma, concluimos que o sildenafil, através da inibição da PDE5, aumentando a biodisponibilidade do GMPc, resulta em um efeito cardioprotetor e antiproliferativo contra as alterações cardiovasculares descritas no modelo de miocardiopatia hipertensiva induzida pela inibição crônica da síntese de NO em ratos Wistar / Abstract: Many of the physiological responses to nitric oxide (NO) are mediated by cyclic 5'-guanosine monophosphate (cGMP), the intracellular levels of which are regulated by phosphodiesterase type 5 (PDE5). In situations of reduced NO formation, the inhibition of PDE5 by selective inhibitors such as sildenafil could be beneficial in restoring physiological functions by enhancing the intracellular levels of cGMP. In this study, we evaluated the effects of sildenafil on the hemodynamic and histological alterations induced by the chronic treatment of rats with Nw¿nitro-L¿arginine¿methyl ester (L-NAME). After 8 weeks of concomitant treatment with sildenafil and L-NAME, arterial blood pressure was significantly lower (P<0.05) than in L-NAME treated rats. The fall in blood pressure was associated with a slight reduction in the total peripheral vascular resistance (P<0.05). Sildenafil partially restored the decrease in cardiac output seen in L-NAME-treated rats. Morphologically, sildenafil reduced the total area of the myocardial lesions and attenuated the cardiomyocyte and vascular smooth muscle remodeling seen with L-NAME. These results show that sildenafil reversed the deleterious hemodynamic and morphological alterations associated with L-NAME-induced hypertension. This beneficial effect was probably mediated by an increase in cardiac and vascular cGMP levels as reflected in circulating plasma cGMP levels / Doutorado / Doutor em Farmacologia

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O objetivo do estudo foi verificar os efeitos do carbonato de lodenafil no processo de consolidaÃÃo Ãssea nos fÃmures de ratos reduzidos com fio de Kirshner. Os fatores vasculares sÃo extremamente importantes para a formaÃÃo do calo Ãsseo. O carbonato de lodenafil causa efeitos vasodilatadores, pertence ao grupo dos inibidores da fosfodiesterase seletiva para o tipo 5 (PDE5), enzima que hidrolisa monofosfato de guanosina cÃclico (GMPc). O GMPc induz o relaxamento da musculatura lisa, sendo utilizado no tratamento da disfunÃÃo erÃtil. Foram utilizados 36 ratos machos, adultos, da linhagem Wistar, com o peso mÃdio de 300g. Todos os animais foram submetidos a cirurgia em que era realizada a fratura da diÃfise femoral com uma guilhotina romba. Os animais foram divididos em 2 grupos: o grupo lodenafil, que recebeu, via oral, doses diÃrias de carbonato de lodenafil (10mg/kg) e o grupo controle. Os animais foram sacrificados com 7, 14 e 28 dias de pÃs-operatÃrio. Houve duas mortes, dois falsos trajetos do fio e em trÃs animais nÃo foi estabelecida a fratura. Foram realizados estudo radiogrÃfico com filme de mamÃgrafo para analisar a densidade Ãptica e Ãrea do calo Ãsseo, medida em mm e estudo histolÃgico, utilizando amostras coradas com picrosirius red sob a luz poralizada do microscÃpio, para quantificar a formaÃÃo de colÃgeno tipo I e tipo III na regiÃo cortical prÃxima a fratura e no calo Ãsseo. A densidade de colÃgeno tipo I na regiÃo cortical do fÃmur prÃximo à fratura verificada no grupo lodenafil foi significantemente menor que a observada no grupo controle com 28 dias de consolidaÃÃo Ãssea (**P = 0,0028). Os resultados encontrados nÃo sÃo consistentes o suficiente para afirmar que este fÃrmaco exerce algum efeito na consolidaÃÃo Ãssea. Verificou-se que o Carbonato de lodenafil nÃo influenciou no processo de consolidaÃÃo Ãssea nos fÃmures de ratos reduzidos com fio de Kirshner. / The study was to investigate the effects of Lodenafil Carbonate in the process of bone healing in femurs of rats with reduced KirshnerÂs wire. The vascular factors are extremely important for the formation of callus. Lodenafil Carbonate cause vasodilatory effects, belongs to the group of selective phosphodiesterase type 5(PDE5) inhibitors, that enzyme inhibits cyclic guanosine monophosphate (GMPc) and relaxation of smooth muscles and are used to treat erectile dysfunction. It used 36 male rats, adult male rats, with the average weight of 300g. All animals underwent surgery in which fractures to the femoral shaft with a blunt guillotine. The animals were divided into 2 groups: lodenafil group, wich received oral doses of carbonate lodenafil (10mg/kg) and the control group. The animals were sacrificed at 7, 14 and 28 days postoperatively. There were two deaths, two false paths of the wire and three animals was not established fracture. Were performed radiographic studies with film mammography to analyze the optical density and area of callus, measured in mm  and histological study, using samples stained with picrosirius red under microscope light polarization, to quantify formation of collagen type I and type III in the cortical region near the fracture and callus. The density of type I collagen in the cortical region of the femur near the fracture observed in group lodenafil was significantly lower than that observed in the control group at 28 days of bone (** P = 0.0028). The results are not consistent enough to say that this drug has an effect on bone healing. It was found that the carbonate lodenafil not influence the process of bone healing in femurs of rats with reduced wire Kirshner.

A systems biology approach was adopted in order to assess various aspects of the disease oral squamous cell carcinoma. Three main aims were addressed; assess the ability of CoCl2 to mimic the hypoxic response in a eukaryotic cell line, assess the role of PDE4D in oral squamous cell carcinoma (OSCC) and the construction of a normoxic/hypoxic mathematical model to identify therapeutic targets.Cancer cells often acquire a revised metabolism which aids in initiation, survival and progression of the tumour. This is predominantly due to the transcription factor HIF-1 which is activated under hypoxic conditions. Certain compounds such as cobalt chloride (CoCl2) have been used extensively to inhibit the degradation of HIF-1α and simulate hypoxia. CoCl2 is likely to have off-target effects on metabolism; these effects were examined when exposing human telomerase reverse transcriptase (hTERT) cells to 100μM CoCl2. Gas chromatography-mass spectrometry (GC-MS), liquid chromatography-mass spectrometry (LC-MS) based metabolomics were utilised in combination with ELISA assays for HIF-1α and ATP. Central metabolism was accurately mimicked when hTERT cells were subjected to 100μM CoCl2, however; it was apparent that this concentration of CoCl2 does not induce an equal extent of hypoxia as 1% oxygen. A number of off-target effects of CoCl2 were observed in secondary metabolism, specifically in lipids and fatty acids. In conclusion, CoCl2 should be used with caution as a hypoxic mimicker with the caveat that interpretation of results should be restricted to its effects on central metabolism.The transcription factor CREB has the ability to regulate approximately 4000 genes, a number of which are associated with cancer initiation and progression. Cyclic adenosine monophosphate (cAMP) is required to activate CREB and is partially regulated through its degradation via the enzyme phosphodiesterase type 4D (PDE4D). A homozygous deletion of PDE4D has been associated with OSCC; however; the exact consequence of this deletion has not been fully elucidated. PDE4D was knocked down in the OSCC cell line BicR16 and cellular proliferation, migration, resistance to ionising radiation and central metabolism was investigated using MTT, scratch, clonogenic and GC-MS, respectively. The knockdown resulted in an increase in proliferation, migration and radiation resistance suggesting the role of PDE4D as a TSG. Amino acids, cholesterol, fatty acids, carbohydrates and TCA intermediates were found to be altered in concentration.A mathematical model of glycolysis, TCA and glutaminolysis under normoxia and hypoxia was constructed through the amalgamation of two established models from the literature. New reactions, parameters and metabolite concentrations were added and unnecessary entities were deleted. COmplex PAthway SImulator (COPASI) was utilised to construct the model before validating the model using experimental data from the literature and steady state and flux analyses. Sensitivity analysis and a reduction in external glucose and glutamine were mimicked and the alterations in hypoxic and normoxic metabolism analysed. The reactions vCSII, vGS, vPGK and vGII were identified as potential therapeutic targets which may affect metabolism in hypoxia only. However, certain validation methods proved unsuccessful and hence the model requires further work before attempting the analyses again.

Les deux nucléotides cycliques, AMPc et GMPc, sont des seconds messagers importants qui régulent une grande variété de fonctions cellulaires, en particulier la fonction contractile cardiovasculaire, la croissance des cardiomyocytaires et la prolifération des cellules musculaires lisses vasculaires. Les phosphodiestérases (PDE) dégradent les nucléotides cycliques et exercent un contrôle local de leur concentration intracellulaire. Une altération de la voie de signalisation des nucléotides cycliques est impliquée dans plusieurs situations pathologiques telles que l’hypertension artérielle systémique ou pulmonaire, l’athérosclérose et l'hypertrophie cardiaque. Ainsi, les PDE constituent de puissantes cibles thérapeutiques pour restaurer un contrôle correct des nucléotides cycliques. Onze familles de PDEs sont actuellement décrites, les PDE1-6 étant les plus étudiées et les PDE 7-11 représentant de nouvelles familles.L'objectif de cette thèse était d'étudier le rôle respectif de 4 familles de PDEs, la PDE1, famille stimulée par le complexe Ca2+/calmoduline, les PDE5 et PDE9 spécifiques du GMPc, et la PDE8 spécifique de l'AMPc, dans le contrôle des concentrations intracellulaires d'AMPc ([AMPc]i) et de GMPc ([GMPc]i) dans les cellules musculaires lisses aortiques de rat (CMLARs) et les myocytes cardiaques de rat en utilisant une approche pharmacologique facilitée par le développement de nouveaux inhibiteurs sélectifs de PDEs. Les activités d'hydrolyse d’AMPc et de GMPc ont été mesurées par dosage enzymatique, tandis que les [AMPc]i et [GMPc]i ont été suivies sur cellules isolées, in situ, en temps réel, grâce à l'utilisation de l'imagerie FRET (Fluorescence Resonance Energy Transfer). Dans les CMLARs en culture, une activité d'hydrolyse des nucléotides cycliques via les PDE1, PDE5 et PDE9 a été observée. Nous avons montré un rôle fonctionnel de la PDE1 non stimulée dans le contrôle de l’augmentation de la [GMPc]i induite par le peptide natriurétique de type C (CNP). Il est intéressant de noter que, lors de l’élévation de la concentration intracellulaire en Ca2+, la PDE1 exerce également un contrôle de la réponse GMPci induite par le monoxyde d’azote (NO) et de la réponse AMPc médiée par la stimulation des récepteurs β-adrénergiques (β-AR). La PDE5 exerce un rôle majeur dans la réponse GMPc provoquée par l'activation de la guanylyl cyclase (GC) soluble par le NO ou des GC membranaires par les peptides natriurétiques, CNP et ANP. En revanche, la PDE9 ne régule que la réponse GMPc induite par le NO dans les RASMC cultivées. Aucune activité ou fonction hydrolytique de l'AMPc n'a été révélée avec l'inhibiteur de la PDE8 dans les CMLARs ou les cardiomyocytes de rat. Dans ces cellules cardiaques, l'activité d'hydrolyse médiée par la PDE1 n'a été détectée que sur la réponse GMPc et uniquement en présence de Ca2 +/Calmoduline. L'inhibiteur de la PDE1 n'a que légèrement affecté la réponse AMPc médiée par les récepteurs β-AR, par augmentation du pic du signal FRET.En conclusion, notre travail démontre que dans les cellules musculaires lisses vasculaires, les PDE1, PDE5 et PDE9 exercent une régulation spécifique et locale des [AMPc]i et [GMPc]i, renforçant le rôle clé des PDEs dans la compartimentation subcellulaire de la signalisation des nucléotides cycliques. / The two cyclic nucleotides cAMP and cGMP are important second messengers that regulate a large variety of cellular functions, in particular cardiovascular contractile function, cardiomyocyte cell growth and vascular smooth muscle cell proliferation. Phosphodiesterases (PDEs) degrade cyclic nucleotides, and exert a fine local control of their intracellular concentration. Alteration of cyclic nucleotides signaling pathway is involved in several pathological situations such as systemic and pulmonary arterial hypertensions, atherosclerotic lesions and cardiac hypertrophy. Thus, PDEs constitute potent therapeutic targets to restore a right cyclic nucleotide function. Eleven families of PDEs are now described, PDE1-6 being the most studied and PDE 7-11 representing the new families.The aim of the present thesis was to investigate the respective role of 4 PDE families, the Ca2+/calmodulin-stimulated PDE1, the cGMP-specific PDE5 and PDE9, and the cAMP-specific PDE8, in controlling intracellular cAMP ([cAMP]i) and intracellular cGMP ([cGMP]i) concentrations in both rat aortic smooth muscle cells (RASMCs) and cardiac myocytes by using a pharmacological approach taken advantage of the development of new selective PDE inhibitors. Cyclic AMP- and cGMP-hydrolyzing activities were measured by enzymatic assay on cell lysate, whereas real-time [cAMP]i and [cGMP]i were followed in situ in isolated cells using Fluorescence Resonance Energy Transfer (FRET) imaging. In cultured RASMCs, PDE1, PDE5 and PDE9 hydrolyzing activities were observed. We showed a functional role of basal PDE1 in controlling [cGMP]i increased by the C-type Natriuretic Peptide (CNP). Interestingly, upon high intracellular Ca2+ concentration, PDE1 also regulated the Nitric Oxide (NO)-mediated [cGMP]i response and the β-adrenoceptor (β-AR)-mediated [cAMP]i response. PDE5 exerted a major role in degrading [cGMP]i produced by the activation of either the soluble guanylyl cyclase (GC) elicited by NO or the particulate GCs by the natriuretic peptides, CNP and ANP. By contrast, PDE9 only regulated NO-induced [cGMP]i increase in cultured RASMCs. No cAMP-hydrolyzing activity or function was revealed with the PDE8 inhibitor in RASMCs or cardiac myocytes. In rat cardiomyocytes, PDE1-mediated hydrolyzing activity was only detected on cGMP in the presence of Ca2+/calmodulin. Unexpectedly, PDE1 inhibition slightly affected the β-AR-mediated [cAMP]i response by increasing the peak of FRET signal.In conclusion, our work underscores the distinct role of PDE1, PDE5, and PDE9 in locally regulating the [cAMP]i and [cGMP]i, in vascular smooth muscle cells, strengthening the concept of PDEs as key actors of cyclic nucleotide subcellular compartmentation.

Introduktion: Psoriasis är en autoimmun hudsjukdom som orsakar fjällande, erytematösa plack på huden. Sjukdomen orsakas av genetiska och miljömässiga faktorer och den är kopplad till andra sjukdomar som psoriasisartrit. Immunceller i kroppen spelar en viktig roll i bildandet av psoriasis, så som T-celler och olika cytokiner, inklusive interleukin-23 (IL-23), IL-12, IL-6 och tyrosine kinase 2 (TYK2). Dessa inflammatoriska faktorer leder till överdriven tillväxt av keratinocyter i huden och bidrar till bildandet av psoriasis. Plackpsoriasis är den vanligaste typen av psoriasis där den uppträder symmetriskt i kroppen. Den kan orsaka torra fjäll och smärtsamma sprickor vilket försämrar patientens livskvalitet. Forskning pågår fortfarande i strävan efter nya läkemedel medbättre effekt och färre biverkningar. Det finns olika orala behandlingar som riktar sig mot immunmolekyler i kroppen och hämmar deras verkan för att lindra symptomen på plackpsoriasis. Apremilast, en oral fosfodiesteras 4 (PDE4) hämmare, har visat en god terapeutisk effekt och säkerhet medan deucravacitinib är en ny oral selektiv TYK2-hämmare som har en god effekt och bra säkerhetsprofil. Syfte: Syftet var att hitta och analysera kliniska studier för att ta reda på om oral behandling med deucravacitinib har bättre effekt och säkerhet än apremilast vid behandling av patienter med medelsvår till svår plackpsoriasis. Metod: Databasen PubMed användes för att hitta fem vetenskapliga artiklar som undersökte effekt och säkerhet på de två läkemedlen i fråga. Studierna analyserades och utifrån analyserna drogs slutaster som besvarar syftet med arbetet. Resultat: De två första studierna hade till syfte att jämföra deucravacitinib med apremilast genom en så kallad ”head to head”. De visade en signifikant överlägsenhet av deucravacitinib över apremilast för att uppnå 75 % förbättring av Psoriasis Area and Severity Index (PASI 75) och Static Physician's Global Assessment score of 0 (clear) or 1 (almost clear) (sPGA 0/1) samt en bra säkerhetsprofil. Medan den tredje och fjärde studien visade att apremilast hade en överlägsen terapeutisk effekt jämfört med placebo. Patienterna nådde PASI 75 och sPGA-värden signifikant med en bra säkerhetsprofil. När det gäller den femte studien så jämförde den deucravacitinib med placebo. Dess resultat överensstämde med resultaten av de två första studierna. Diskussion: De fem artiklarna som analyserades var randomiserade kliniska studier på patienter med plackpsoriasis vilket gav tillförlitliga slutsatser. Det fanns felkällor så som det lilla antalet deltagare i den tredje och femte studien och bristen på tillräcklig etnisk mångfald. Vid jämförelse av PASI-värdena för de fem studierna så hade deucravacitinib bättre terapeutiska värden än apremilast. När det gäller säkerhetsprofilen så minskade kardiovaskulära biverkningar signifikant vid behandling med deucravacitinib. Slutsats: Deucravacitinib har en bättre effekt än apremilast samt bättre säkerhetsprofil vid behandling av patienter med medelsvår till svår plackpsoriasis

Phosphodiesterase Type 5 (PDE5) inhibitors are cardioprotective against ischemia/reperfusion (I/R) injury. However, it remains uncertain if I/R affects PDE5. We hypothesized that generation of reactive oxygen species (ROS) during I/R leads to upregulation of PDE5, which contributes to pathological changes following acute myocardial infarction (AMI). Adult male ICR mice were subjected to 30 minutes of in vivo or ex vivo I/R. To examine the role of ROS, a subset of hearts were perfused with 100 µM hydrogen peroxide (H2O2). Expression and activity of PDE5, pPDE5, and cGMP-dependent protein kinase (PKG) were measured by Western blots and spectrophotometric assay. The results show that ischemia and I/R significantly increased expression of PDE5. H2O2 had no effect on PDE5 expression and activity but significantly increased PKG activity. We conclude that acute cardiac ischemia or I/R upregulate PDE5 independent of oxidant stress in the heart.