Master of Science in Medicine (by research) / Assisted reproductive technologies (ARTs) are very efficient in producing embryos, however many of these embryos have poor viability. No more than 50% of IVF embryos complete preimplantation development (Hardy et al. 2001). The poor viability is manifested as a reduced rate of cell proliferation and increased rates of apoptosis in the early embryo, resulting in high rates of embryo mortality (Hardy et al. 2001). The reduced viability occurs as a response to a range of cellular stressors that are a consequence of embryo culture (Hardy et al. 2001). The stress of culture disrupts some survival signalling pathways, metabolism of substrates and induces redox stress (Hardy et al. 2001). The cellular stress sensor p53 is expressed in the early embryo but is normally kept at very low levels (Li et al. 2005). This latency may be breached in IVF embryos following culture of zygotes in vitro for 96 hours, resulting in the up-regulation and nuclear accumulation of p53 (Li et al. 2005). Activation of the p53 stress-sensing pathway in the early mouse embryo by culture in vitro causes a marked loss of their developmental competence (Li et al. 2005). This study aimed to establish whether benefits could be obtained by culturing mice IVF embryos in the presence of p53 protein inhibitors. IVF zygotes were cultured individually in 10µl drops of 1.25, 2.5, 5 or 10µM Pifithrin-a (PFTa) in 0.05% DMSO for 96 hours. On day 5 the development stage was assessed. Embryos reaching the blastocyst stage were fixed and stained with Hoechst 33342 for total cell count and the proportion of nuclei with normal and abnormal morphology. There was an increase in the blastocyst rate, total cell count and the proportion of nuclei in a blastocyst with normal nuclei in 10µM-treated embryos. This study also aimed to determine whether benefits could be obtained by incubating mouse IVF sperm with p53 protein inhibitors during IVF. IVF sperm was treated with 1.25, 2.5, 5 or 10µM of PFTa in 0.05% DMSO during incubation with oocytes for 6 hours. Resulting zygotes were cultured for 96 hours individually in 10µl drops of MODHTFM. On day 5 the development stage was assessed. Embryos reaching the blastocyst stage were fixed and stained with Hoechst 33342 for total cell count and the proportion of nuclei with normal and abnormal morphology. There was a reduction in the proportion of fragmented nuclei in blastocysts derived from 1.25 and 10µM-treated sperm. 10µM treated sperm increased the total cell count, the proportion of normal nuclei in a blastocyst and the blastocyst development rate. IVF sperm incubated with 1.25µM PFTa during insemination of oocytes increased the fertilisation rate. Another aim of this study was to establish whether p53 siRNA could inhibit p53 mRNA in mice IVF embryos and if so, whether this would improve embryo viability in culture. IVF zygotes were transfected with 15nM p53 small inhibiting RNA (siRNA) and 0.8% Oligofectamine Reagent immediately, 24 h, 48 h and 72 h after IVF then cultured individually in 10µl drops of MOD-HTFM for a total of 96 hours. On day 5 the blastocyst rate was assessed and immunofluorescence performed probing for p53. There was no significant reduction in p53 expression and no improvement in blastocyst rate at any of the transfection times. However, there was a decrease in the proportion of nuclei which expressed p53 when p53 siRNA was transfected 72 hours after IVF. Also, it was determined that siRNA was efficiently being delivered into the preimplantation embryo with Oligofectamine Reagent. Lastly, this study aimed to determine whether mice sperm with p53 gene deletions have a selective advantage in fertilising the oocyte compared to their wild-type counterparts. p53+/- males were mated with p53+/+ females and the resulting zygotes genotyped after 24 hours of culture. More than 50% of offspring had a p53+/+ genotype. There was no selective advantage for p53 null sperm to fertilise the oocyte, there was actually a disadvantage. The selective disadvantage for p53 null sperm to fertilise the F1 hybrid oocyte in IVF compared to its wild-type counterparts may imply that p53 null sperm are not as viable and may have a survival disadvantage. The reduction in fertility of p53 null sperm in vitro infers that p53 function may be important for the fertility of the mouse sperm in vitro. The results of this thesis could establish means of improving human embryo viability in ART, some examples being P53 protein inhibition in preimplantation embryos during culture prior to transfer to the uterus, or P53 protein inhibition in IVF sperm. The use of the new technology, p53 siRNA was not effective in inhibiting p53 expression, although the build-up experiments determined that siRNA is efficiently delivered into the preimplantation embryo with Oligofectamine Reagent. The demonstration that p53 null sperm has a selective disadvantage in fertilising the oocyte compared to their wild-type counterparts does not indicate a positive selection pressure for naturally occurring mutations to this gene. And so, there is no concern regarding the genetic and epigenetic risks to progeny arising from assisted reproductive technologies with respect to sperm.

Master of Science in Medicine (by research) / Assisted reproductive technologies (ARTs) are very efficient in producing embryos, however many of these embryos have poor viability. No more than 50% of IVF embryos complete preimplantation development (Hardy et al. 2001). The poor viability is manifested as a reduced rate of cell proliferation and increased rates of apoptosis in the early embryo, resulting in high rates of embryo mortality (Hardy et al. 2001). The reduced viability occurs as a response to a range of cellular stressors that are a consequence of embryo culture (Hardy et al. 2001). The stress of culture disrupts some survival signalling pathways, metabolism of substrates and induces redox stress (Hardy et al. 2001). The cellular stress sensor p53 is expressed in the early embryo but is normally kept at very low levels (Li et al. 2005). This latency may be breached in IVF embryos following culture of zygotes in vitro for 96 hours, resulting in the up-regulation and nuclear accumulation of p53 (Li et al. 2005). Activation of the p53 stress-sensing pathway in the early mouse embryo by culture in vitro causes a marked loss of their developmental competence (Li et al. 2005). This study aimed to establish whether benefits could be obtained by culturing mice IVF embryos in the presence of p53 protein inhibitors. IVF zygotes were cultured individually in 10µl drops of 1.25, 2.5, 5 or 10µM Pifithrin-a (PFTa) in 0.05% DMSO for 96 hours. On day 5 the development stage was assessed. Embryos reaching the blastocyst stage were fixed and stained with Hoechst 33342 for total cell count and the proportion of nuclei with normal and abnormal morphology. There was an increase in the blastocyst rate, total cell count and the proportion of nuclei in a blastocyst with normal nuclei in 10µM-treated embryos. This study also aimed to determine whether benefits could be obtained by incubating mouse IVF sperm with p53 protein inhibitors during IVF. IVF sperm was treated with 1.25, 2.5, 5 or 10µM of PFTa in 0.05% DMSO during incubation with oocytes for 6 hours. Resulting zygotes were cultured for 96 hours individually in 10µl drops of MODHTFM. On day 5 the development stage was assessed. Embryos reaching the blastocyst stage were fixed and stained with Hoechst 33342 for total cell count and the proportion of nuclei with normal and abnormal morphology. There was a reduction in the proportion of fragmented nuclei in blastocysts derived from 1.25 and 10µM-treated sperm. 10µM treated sperm increased the total cell count, the proportion of normal nuclei in a blastocyst and the blastocyst development rate. IVF sperm incubated with 1.25µM PFTa during insemination of oocytes increased the fertilisation rate. Another aim of this study was to establish whether p53 siRNA could inhibit p53 mRNA in mice IVF embryos and if so, whether this would improve embryo viability in culture. IVF zygotes were transfected with 15nM p53 small inhibiting RNA (siRNA) and 0.8% Oligofectamine Reagent immediately, 24 h, 48 h and 72 h after IVF then cultured individually in 10µl drops of MOD-HTFM for a total of 96 hours. On day 5 the blastocyst rate was assessed and immunofluorescence performed probing for p53. There was no significant reduction in p53 expression and no improvement in blastocyst rate at any of the transfection times. However, there was a decrease in the proportion of nuclei which expressed p53 when p53 siRNA was transfected 72 hours after IVF. Also, it was determined that siRNA was efficiently being delivered into the preimplantation embryo with Oligofectamine Reagent. Lastly, this study aimed to determine whether mice sperm with p53 gene deletions have a selective advantage in fertilising the oocyte compared to their wild-type counterparts. p53+/- males were mated with p53+/+ females and the resulting zygotes genotyped after 24 hours of culture. More than 50% of offspring had a p53+/+ genotype. There was no selective advantage for p53 null sperm to fertilise the oocyte, there was actually a disadvantage. The selective disadvantage for p53 null sperm to fertilise the F1 hybrid oocyte in IVF compared to its wild-type counterparts may imply that p53 null sperm are not as viable and may have a survival disadvantage. The reduction in fertility of p53 null sperm in vitro infers that p53 function may be important for the fertility of the mouse sperm in vitro. The results of this thesis could establish means of improving human embryo viability in ART, some examples being P53 protein inhibition in preimplantation embryos during culture prior to transfer to the uterus, or P53 protein inhibition in IVF sperm. The use of the new technology, p53 siRNA was not effective in inhibiting p53 expression, although the build-up experiments determined that siRNA is efficiently delivered into the preimplantation embryo with Oligofectamine Reagent. The demonstration that p53 null sperm has a selective disadvantage in fertilising the oocyte compared to their wild-type counterparts does not indicate a positive selection pressure for naturally occurring mutations to this gene. And so, there is no concern regarding the genetic and epigenetic risks to progeny arising from assisted reproductive technologies with respect to sperm.

Le terme d’« hypertension artérielle pulmonaire » (HTAP) décrit une maladie vasculaire pulmonaire caractérisée par une augmentation progressive des pressions artérielles pulmonaires (PAP), définie par une PAP moyenne supérieure ou égale à 25 mmHg au repos et dont le principal symptôme est un essoufflement à l’effort. Un remodelage artériel pulmonaire intense conduisant à une obstruction des petits vaisseaux pulmonaires est responsable de la maladie. C’est une maladie rare mais néanmoins grave car pouvant aboutir à une insuffisance ventriculaire droite et entraîner le décès du patient.Le cadre général de notre étude est l’amélioration de la compréhension des mécanismes physiopathologiques de l’HTAP afin d’identifier de nouvelles cibles thérapeutiques potentielles. Nous nous sommes intéressés plus particulièrement au phénotype « pseudo-tumoral » des cellules musculaires lisses des artères pulmonaires (CML-AP) des patients atteints d’HTAP qui jouent un rôle primordial dans le remodelage vasculaire pulmonaire de l’HTAP et qui présentent des caractéristiques communes avec les cellules cancéreuses, notamment une hyper-prolifération, une résistance à l’apoptose, des désordres métaboliques et une instabilité génomique. Etant donné que la protéine p53, un des plus importants suppresseurs de tumeur, est largement décrite comme inactivée dans la plupart des cancers, nous avons émis l’hypothèse qu’elle pourrait également jouer un rôle important dans le développement de l’HTAP. Les résultats des études in vitro menées sur des CML-AP de patients atteints d'HTAP idiopathiques (HTAPi) versus des sujets contrôles semblent indiquer que la protéine p53 n’est pas altérée dans les CML-AP HTAPi. En effet, la séquence codante du gène TP53 ne présente pas de mutation dans les CML-AP HTAPi, les expressions génique et protéique de p53 (et de certaines de ses protéines cibles) ne semblent pas être différentes entre contrôles et HTAPi, ni à l’état basal ni en réponse à différents stress cellulaires inducteurs de p53 (étoposide et H2O2). Cependant, la régulation de p53 semble altérée puisque nous avons observé une augmentation du taux protéique de MDM2, principal régulateur de p53, dans les CML-AP HTAPi. Ce résultat peut être considéré comme une des caractéristiques « pseudo-tumorales » des CML-AP HTAPi mais également être un élément déterminant du mécanisme d’action de la Nutlin-3a, qui a montré des effets anti-prolifératifs accrus dans les CML-AP HTAPi.Dans des études in vivo menées chez le rat, la protéine p53 semble jouer un rôle dans l’initiation de la pathogénèse d’une HTAP. En effet, les taux protéiques pulmonaires de p53, de sa cible p21 et de son régulateur (mais également cible transcriptionnelle) MDM2 sont diminués lors de la première semaine dans un modèle d’induction d’HTAP par mono-injection de monocrotaline (MCT) chez le rat, au cours duquel la pathologie se développe à partir de la 2ème semaine. De plus, l’administration quotidienne à des rats d’un inhibiteur de l’activité transcriptionnelle de p53, le pifithrin-α (PFT), conduit au développement d’une HTAP en 14 jours, au même titre qu’une mono-injection de MCT, et aggrave l’HTAP induite par la MCT. Des effets pro-prolifératifs et anti-apoptotiques du PFT révélés sur des CML-AP indiquent que l’inhibition de l’activité transcriptionnelle de p53 est à l'origine d'une prolifération exagéree et une résistance à l'apoptose, deux composantes clés dans le remaniement vasculaire pulmonaire et le développement de l'HTAP.En conclusion, ces résultats mettent en évidence l’implication de l’inactivation de la voie de p53 lors de la phase initiatrice du développement de l’HTAP, alors qu’aux stades tardifs et sévères de la maladie, il semble il y avoir une normalisation de p53. En revanche, l’augmentation de l’expression de son principal régulateur MDM2 observée dans les CML-AP de patients HTAP semble être une cible thérapeutique potentiellement intéressante. / Pulmonary artery hypertension (PAH) is a severe pulmonary vascular disease characterized by a progressive increase of the pulmonary arterial pressure (PAP), defined by a mean PAP greater than or equal to 25 mmHg at rest. The main symptom is a shortness of breath. An intense pulmonary arterial remodeling that leads to an obstruction of the small pulmonary vessels is responsible of the disease. PAH is a rare but severe disease that develops into right ventricular cardiac failure leading to the patient's death.The general framework of our study was to improve the understanding of the pathophysiology of PAH in order to identify new potential therapeutic targets and improve the clinical management of patients. In particular, we were interested in the “cancer-like phenotype” of PAH patient pulmonary arterial smooth muscle cells (PA-SMCs). PA-SMCs play a key role in the pulmonary vascular remodeling of PAH. These cells share characteristics with cancerous cells, such as: exaggerated proliferation, apoptosis resistance, metabolic disorders and genomic instability. Owing to the growth-suppressive and pro-apoptotic functions of p53 protein and its inactivation largely described in cancer, we hypothesized that the p53 pathway could also be altered during PAH development in PA-SMCs.The results of in vitro studies on PA-SMCs of late stage patients with idiopathic PAH (iPAH) versus control patients suggest that the p53 protein nor pathway is not altered in iPAH PA-SMCs. Indeed, the coding sequence of the TP53 gene presented no mutations in iPAH PA-SMCs. Analysis of mRNA and protein levels of p53 and its target proteins showed no difference between controls and iPAH PA-SMCs, neither in a basal state or in response to various cellular stresses such as etoposide and H2O2. However, regulation of p53 may be altered in iPAH PA-SMCs as we observed an increase of the MDM2 (the main p53 regulator) protein level compared to control. This last result may be considered as a “cancer-like” characteristic of iPAH PA-SMCs and also be a determining factor in the mechanism of action of Nutlin-3a, which had more important anti-proliferative effects in iPAH PA-SMCs than in control cells.In vivo studies in rats revealed, however, that the p53 pathway may play a role in the initiation stage of PAH pathogenesis. Indeed, kinetics evaluation of p53 lung expression in the PAH model, induced by a single injection of monocrotaline (MCT), revealed a decrease in the p53 protein level during the first week, followed by a normalization by the second week. PAH symptoms are developed in MCT rats after two weeks. Similarly, the protein levels of p21, a p53 target, and MDM2, the major p53 regulator, and also a transcriptional target of p53, decreased during the first week in the MCT-PAH model. In addition, daily treatment in rats with an inhibitor of p53 transcriptional activity, pifithrin-α (PFT), led to the development of PAH in 14 days, similarly to MCT, and worsened the PAH induced by MCT. Pro-apoptotic and anti-proliferative effects of PFT on PA-SMCs indicate that inhibition of p53 transcriptional activity causes an excessive proliferation and an apoptosis resistance, which are two key components of the pulmonary vascular remodeling and development of human and experimental PAH.In conclusion, these results demonstrate the involvement of the p53 pathway inactivation in the initiation stage of PAH development, whereas in late and severe stages of disease, its role seems to be less implicated. In contrast, the increased expression of MDM2 observed in PA-SMCs of PAH patients may be a potential therapeutic target.

The current studies were designed to explore the protective effects of pifithrin-α and melatonin against doxorubicin-induced cardiotoxicity. Doxorubicin was injected at a dose of 22.5 mg/kg (i.p.) in mice to induce cardiotoxic effects. Meanwhile, doxorubicin caused a significant increase of cardiac cell apoptosis following injection (14.2 ± 1.1% for doxorubicin-5 d vs. 1.8 ± 0.12% for control, P < 0.01). Ribonuclease protection assays and Western blot analyses revealed that doxorubicin upregulated the p53-dependent genes Bax, BclxL, and MDM2 at least 2-fold. p53 was phosphorylated at Ser 15 in mouse hearts 1 h following doxorubicin injection, and p38 and ERK1/2 MAPKs mediated the phosphorylation of p53. In addition, caspases-3 and -9 were activated 24 h after doxorubicin injection. A p53 inhibitor, pifithrin-α, inhibited doxorubicin-induced apoptosis when administered at a dose of 2.2 mg/kg. Pifithrin-α abolished p53 transactivation activity, but did not influence doxorubicin-induced phosphorylation at Ser 15. By effectively inhibiting the expression of p53-dependent genes, pifithrin-α blocked doxorubicin-induced activation of caspases-3 and -9, thereby preventing cardiac apoptosis. In addition, pifithrin-α attenuated doxorubicin-induced structural and functional damages, without diminishing its anti-tumor efficacy on p53-null PC-3 cancer cells. The protective effects of melatonin and its metabolite 6-hydroxymelatonin on doxorubicin-induced cardiac dysfunction were evaluated in an isolated perfused mouse hearts and in vivo doxorubicin-treated mice. While perfusion of mouse hearts with 5 μM doxorubicin for 60 min resulted in a 50% suppression of HRxLVDP and a 50% reduction of coronary flow, pre-exposure of hearts to 1 μM melatonin or 6-hydroxymelatonin eased the cardiac dysfunction. In addition, administration of melatonin or 6-hydroxymelatonin (2 mg/kg/d) significantly attenuated doxorubicin-induced cardiac dysfunction, myocardial lesions, and cardiac cell apoptosis. Melatonin and 6-hydroxymelatonin significantly improved the survival rate of doxorubicin-treated mice. Another melatonin analog, 8-methoxy-2-propionamidotetralin, did not show any convincing protection on either animal survival or on in vitro cardiac function, presumably due to its lack of free radical-scavenging activity. Finally, neither melatonin nor 6-hydroxymelatonin compromised the anti-tumor activity of doxorubicin in cultured PC-3 cells. These studies suggest that pifithrin-α and melatonin have significant therapeutic potential for patients suffering doxorubicin-induced cardiotoxicity.