Orientador: Sergio A.R. de Paiva / Resumo: A deficiência/insuficiência de vitamina D tem aumentado nos últimos anos e tornou-se problema mundial de saúde pública. Além do raquitismo, a deficiência de vitamina D também está associada com maior risco de desenvolver câncer, doenças imunológicas e, inclusive, doenças cardiovasculares. Estes fatores têm incentivado o uso indiscriminado da suplementação de vitamina D na população saudável. Suplementação de vitamina D, em altas doses, promove estresse oxidativo, inflamação, apoptose, altera o metabolismo energético, morfologia e função cardíaca. Adicionalmente, esta suplementação aumenta a concentração sérica de fósforo, que pode estimular a liberação do fator de crescimento de fibroblasto-23 (FGF-23). Esta maior concentração sérica de FGF-23 pode estar associada à remodelação cardíaca. Outros autores sugerem que a ação do FGF-23 no coração ocorre por meio da via de sinalização calcineurina/fator nuclear das células T ativadas (NFAT). Desta maneira, a menor fosfatemia, promovida pelo uso de sevelamer, poderia atenuar as alterações cardíacas provocadas pela suplementação de vitamina D. Assim, o objetivo deste trabalho é verificar se o tratamento com sevelamer diminui a concentração de FGF-23 e, consequentemente, atenua a remodelação cardíaca, decorrente da suplementação de vitamina colecalciferol, em altas doses. Foram utilizados 169 ratos machos da raça Wistar alocados em seis grupos: 1) Grupo controle alimentado com ração padrão (C, n=27); 2) Grupo controle + 3% de sevelame... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Vitamin D deficiency/insufficiency has increased in recent years and has become a worldwide public health problem. In addition to rickets, vitamin D deficiency is also associated with increased risk of developing cancer, immune diseases and even cardiovascular diseases. These factors have encouraged the indiscriminate use of vitamin D supplementation in the healthy population. High-dose of vitamin D supplementation promotes oxidative stress, inflammation, apoptosis, changes in energy metabolism, morphology and cardiac function. In addition, this supplementation increases the serum phosphorus concentration which can stimulate the release of fibroblast growth factor-23 (FGF-23). Higher serum concentration of FGF-23 can be associated with cardiac remodeling. Other authors suggest that the action of FGF-23 in heart occurs through the signaling pathway calcineurin/nuclear factor of activated T cells (NFAT). Thus, decrease in phosphatemia, promoted by the use of sevelamer, can attenuate the cardiac changes promoted by vitamin D supplementation. The aim of this study is to verify whether treatment with sevelamer decreases the concentration of FGF-23 and, consequently, attenuates cardiac remodeling, due to supplementation of cholecalciferol vitamin, in high doses. 169 male Wistar rats were allocated in six groups: 1) Control group fed standard chow (C, n=27); 2) Control group + 3% sevelamer (C+S, n=26); 3) Group supplemented with 3,000 IU cholecalciferol/kg of chow (VitD 3, n=29); 4)... (Complete abstract click electronic access below) / Doutor

La coronaropathie est une cause majeure de mortalité, motivant la recherche de stratégies limitant le remodelage cardiaque ou stimulant la néovascularisation après un infarctus du myocarde (IDM). Ce travail vise à étudier chez la souris adulte le rôle, sur la fonction cardiaque, de gènes régulant l'angiogenèse et le métabolisme cellulaire en modulant leur expression endothéliale en conditions basales ou en post-IDM (après ligature coronaire) : PPARβ/δ, Wt1, Cyp51 et Dnmt2. Les paramètres échocardiographiques ont été mesurés pré et post-IDM, des analyses histochimiques réalisées, et l’expression de gènes cibles comparée selon le génotype. La surexpression de PPARβ/δ stimule l'angiogenèse basale, causant une hypertrophie ventriculaire gauche (VG). En post-IDM, elle induit un remodelage VG pathologique et majore la taille de l'IDM, posant la question des interactions entre endothélium et cardiomyocytes. En post-IDM, l'invalidation de Wt1 limite l'angiogenèse coronaire, majore le remodelage VG et la taille de l'IDM. A l'état basal, l'invalidation de Cyp51 est à l'origine d'une insuffisance cardiaque dilatée, via une perméabilité vasculaire accrue et une activation endothéliale. La modification de la composition membranaire en stérols peut expliquer la dysfonction de l'endothélium, modifiant ses interactions avec les cardiomyocytes. Ainsi, Cyp51 possède un rôle essentiel dans la structure et la fonction cardiaque, ouvrant le champ de son étude en post-IDM. Enfin, l'expression de Dnmt2 est indispensable pour limiter l'hypertrophie cardiaque, via le contrôle de l'activité de l'ARN polymérase II par la méthylation de l’ARN non codant Rn7sk. / Coronary heart disease is a major cause of mortality, explaining the increasing interest in therapeutics targeting cardiac remodeling and neovascularization after myocardial infarction (MI). Using endothelial expression modulation in adult mice in basal or post-MI conditions (after coronary artery ligation), this work studied several genes involved in angiogenesis and cardiac metabolism, PPARβ/δ, Wt1, Cyp51 and Dnmt2, and their role in cardiac function. Echocardiographic structural and functional parameters were measured before and after MI, histochemistry analyses performed, and target genes expression compared between different genotypes. PPARβ/δ basal overexpression resulted in an increased angiogenesis and cardiac hypertrophy. After MI, it caused MI expansion through increased cardiac remodelling. This discrepancy raises the issue of communication between endothelial cells and cardiomyocytes. Endothelial Wt1 expression is essential for cardiac repair after MI : deletion was responsible for neovascularization impairment, poorer cardiac remodeling and MI enlargement. Endothelial Cyp51 expression is necessary for basal cardiac structure and function. After Cyp51 deletion, membrane and cell junction disorganization caused increased vascular permeability and endothelium activation, resulting in dilated cardiomyopathy. The accumulation of toxic oxysterols or lack of cholesterol might account for endothelial dysfunction, through abnormal endothelial cells to cardiomyocytes signalling. Dnmt2 deletion caused cardiac hypertrophy. through methylation of non-coding RNA Rn7sk and control of RNA polymerase II activity.

Coronary artery disease remains the leading cause of death in the United States with over 1 million acute coronary events predicted to take place in 2019 alone. Heart failure, a common and deadly sequela of myocardial infarction (MI), is attributed to adverse ventricular remodeling driven by cardiomyocyte death, inflammation, and mechanical factors. Despite strong evidence suggesting the importance of myocardial mechanics in driving cardiac remodeling, many <i>in vivo</i> MI studies still rely on 2D analyses to estimate global left ventricular (LV) function and approximate strain using a linear definition. These metrics, while valuable in evaluating the overall impact of ischemic injury on cardiac health, do not capture regional differences in myocardial contractility. The objective of this work is therefore to expand upon existing ultrasound studies by enabling regional analysis of 3D myocardial strain. By integrating our recently developed four-dimensional ultrasound (4DUS) imaging technique with a direct deformation estimation algorithm for 3D strain, we identified unique remodeling patterns and regional strain differences between two murine models of MI with different infarct severities. By constructing 3D strain maps of the remodeling LVs, we were able to capture strain heterogeneity and characterize a sigmoidal strain profile at infarct border zones. Finally, we demonstrated that the maximum principal component of the 3D Green-Lagrange strain tensor correlates with LV remodeling severity and is predictive of final infarct size. Taken together, the presented work provides a novel and thorough approach to quantify regional 3D strain, an important component when assessing post-MI remodeling.

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Mathematical modeling is an important tool in improving the understanding of complex biological processes. However, mathematical models are often faced with challenges that arise due to the limited knowledge of the underlying biological processes and the high number of parameters for which exact values are unknown. The method of generalized modeling is an alternative modeling approach that aims to address these challenges by extracting information about stability and bifurcations of classes of models while making only minimal assumptions on the specific functional forms of the model. This is achieved by a direct parameterization of the Jacobian in the steady state, introducing a set of generalized parameters which have a biological interpretation. In this thesis, the method of generalized modeling is extended and applied to different problems from cell biology. In the first part, we extend the method to include also the higher derivatives at the steady state. This allows an analysis of the normal form of bifurcations and thereby a more specific description of the nearby dynamics. In models of gene-regulatory networks, it is shown that the extended method can be applied to better characterize oscillatory systems and to detect bistable dynamics. In the second part, we investigate mathematical models of bone remodeling, a process that renews the human skeleton constantly. We investigate the connection between structural properties of mathematical models and the stability of steady states in different models. We find that the dynamical system operates from a stable steady state that is situated in the vicinity of bifurcations where stability can be lost, potentially leading to diseases of bone. In the third part of this thesis, models of the MAPK signal transduction pathway are analyzed. Since mathematical models for this system include a high number of parameters, statistical methods are employed to analyze stability and bifurcations. Thereby, the parameters with a strong influence on the stability of steady states are identified. By an analysis of the bifurcation structure of the MAPK cascade, it is found that a combination of multiple layers in a cascade-like way allows for additional types of dynamic behavior such as oscillations and chaos. In summary, this thesis shows that generalized modeling is a fruitful alternative modeling approach for various types of systems in cell biology. / Mathematische Modelle stellen ein wichtiges Hilfmittel zur Verbesserung des Verständnisses komplexer biologischer Prozesse dar. Sie stehen jedoch vor Schwierigkeiten, wenn wenig über die zugrundeliegende biologischen Vorgänge bekannt ist und es eine große Anzahl von Parametern gibt, deren exakten Werte unbekannt sind. Die Methode des Verallgemeinerten Modellierens ist ein alternativer Modellierungsansatz mit dem Ziel, diese Schwierigkeiten dadurch anzugehen, dass dynamische Informationen über Stabilität und Bifurkationen aus Klassen von Modellen extrahiert werden, wobei nur minimale Annahmen über die spezifischen funktionalen Formen getätigt werden. Dies wird erreicht durch eine direkte Parametrisierung der Jacobimatrix im Gleichgewichtszustand, bei der neue, verallgemeinerte Parameter eingeführt werden, die eine biologische Interpretation besitzen. In dieser Arbeit wird die Methode des Verallgemeinerten Modellierens erweitert und auf verschiedene zellbiologische Probleme angewandt. Im ersten Teil wird eine Erweiterung der Methode vorgestellt, bei der die Analyse höherer Ableitungen im Gleichgewichtszustand integriert wird. Dies erlaubt die Bestimmung der Normalform von Bifurkationen und hierdurch eine spezifischere Beschreibung der Dynamik in deren Umgebung. In Modellen für genregulatorische Netzwerke wird gezeigt, dass die so erweiterte Methode zu einer besseren Charakterisierung oszillierender Systeme sowie zur Erkennung von Bistabilität verwendet werden kann. Im zweiten Teil werden mathematische Modelle zur Knochenremodellierung untersucht, einem Prozess der das menschliche Skelett kontinuierlich erneuert. Wir untersuchen den Zusammenhang zwischen strukturellen Eigenschaften verschiedener Modelle und der Stabilität von Gleichgewichtszuständen. Wir finden, dass das dynamische System von einem stabilen Zustand operiert, in dessen Nähe Bifurkationen existieren, welche das System destabilisieren und so potentiell Knochenkranheiten verursachen können. Im dritten Teil werden Modelle für den MAPK Signaltransduktionsweg analysiert. Da mathematische Modelle für dieses System eine hohe Anzahl von Parametern beinhalten, werden statistische Methoden angewandt zur Analyse von Stabilität und Bifurkationen. Zunächst werden Parameter mit einem starken Einfluss auf die Stabilität von Gleichgewichtszuständen identifizert. Durch eine Analyse der Bifurkationsstruktur wird gezeigt, dass eine kaskadenartige Kombination mehrerer Ebenen zu zusätzliche Typen von Dynamik wie Oszillationen und Chaos führt. Zusammengefasst zeigt diese Arbeit, dass Verallgemeinertes Modellieren ein fruchtbarer alternativer Modellierungsansatz für verschiedene zellbiologische Probleme ist.

Le remodelage cardiaque est un élément central dans le développement et la progression de l'insuffisance cardiaque, une cause majeure de morbi/mortalité dans le monde. Il est défini par les changements structurels, métaboliques et fonctionnels du ventricule gauche qui se manifestent cliniquement par des modifications de taille et de forme du cœur dans diverses situations pathologiques telles que l'hypertension, l'infarctus du myocarde ou l'obésité. Il s'agit donc d'un procédé complexe et dynamique qui implique une hypertrophie des cardiomyocytes, une production massive de radicaux libres (ROS) et une perte importante de cardiomyocytes par apoptose/nécrose. Cette perte cellulaire induit l'activation des fibroblastes cardiaques et le développement progressif d'une fibrose interstitielle conduisant à l'insuffisance cardiaque. Mon projet de thèse est centré sur l'étude du rôle de la kinase PIKfyve dans le remodelage ventriculaire et l'insuffisance cardiaque. PIKfyve est une lipide kinase conservée au cours de l'évolution qui régule de nombreuses fonctions cellulaires fondamentales. Par des approches in vitro et in vivo sur des modèles murins d'insuffisance cardiaque, mes travaux de thèse identifient PIKfyve et son produit le phosphatidylinositol 5-phosphate comme acteurs clés de l'altération du statut cardiométabolique et de l'intégrité mitochondriale en conditions pathologiques. L'inhibition pharmacologique et épigénétique de l'enzyme préserve l'intégrité mitochondriale, réduit le stress oxydant, l'apoptose cardiomyocytaire, et culmine par l'amélioration des fonctions cardiaques dans un modèle d'insuffisance cardiaque liée à l'obésité. De plus, mes travaux identifient un nouveau mécanisme de régulation de la réponse au stress cellulaires par PIKfyve qui implique une voie de la désacétylase mitochondriale SIRT3.[...] / Cardiac remodeling is a key process in the development and the progression of heart failure, one of the leading causes of morbi/mortality in modern societies. It is defined as a combination of structural, metabolic and functional modifications that clinically manifest as changes in size and shape of the heart, and under the influence of risk factors such as hypertension, myocardial infarction and obesity. Cardiac remodeling is a complex and dynamic process characterized by cardiomyocyte hypertrophy, excessive reactive oxygen species (ROS) generation leading to a massive loss of cardiomyocytes by apoptotic/necrotic cell death. Altogether, these events trigger the differentiation of cardiac fibroblasts into myofibroblasts and the progressive development of interstitial fibrosis leading to cardiac dysfunction. My thesis work focuses on the role of the lipid kinase PIKfyve in cardiac remodeling and heart failure. PIKfyve is the product of an evolutionary conserved single-copy gene and is known to regulate pleiotropic cellular functions. Combining in vitro and in vivo studies in mouse models of cardiac remodeling, my work identifies PIKfyve and its product phosphatidylinositol 5-phosphate as master regulators of the cardiometabolic status and mitochondrial integrity under pathological conditions. Pharmacological or epigenetic inhibition of the enzyme preserves mitochondrial integrity, reduces oxidative stress, myocyte apoptotic death and culminates with improved cardiac function in a mouse model of obesity induced heart failure. These effects are mediated by the mitochondrial deacetylase SIRT3. My work also demonstrates that PIKfyve is a necessary factor in the differentiation of cardiac fibroblasts into myofibroblasts during cardiac remodeling, regulating the TGF-beta/Smad pathway. Altogether, my thesis work unravels a novel role for PIKfyve in myocardial remodeling and paves the way for alternative therapies as a new molecular target for the treatment of cardiometabolic and fibrotic diseases.

Cellular and tissue characteristics are results of dynamic regulation of gene expression. DNA wrapped into proteins, referred to as chromatin, requires involvement of mechanisms guiding accessibility of specific sequences. In higher organisms, chromatin remodeling proteins are indispensable in regulating chromatin structure including ISWI ATPase SMARCA5. SMARCA5 is involved in almost any transaction on DNA including transcription, however precise in vivo role of SMARCA5 in these processes remains unknown. To advance understanding of specific role of SMARCA5 in the development of chromatin structure during transcription we devised cellular model in which SMARAC5 level is manipulated while chromatin structure development and transcriptional response are monitored. Our data indicate that the transfected DNA template that is transcribed is enriched with histone H3 and its specific methylation of Histone H3 lysine (K) 4, a mark of active chromatin structure. Overexpression of SMARCA5 results within the reporter gene coding sequence in ~2,5-3 fold increase of both H3 occupancy an its modification H3K4Me3. Increased DNA template commitment into chromatinization is associated with repression of reporter gene expression. These results are supported by studies indicating dynamic development of nucleosomal...

Dilated cardiomyopathy (DCM) is the second leading cause of heart failure. The pathophysiology in DCM is still poorly understood, partly because of currently limited research tools. We investigated whether cardiovascular magnetic resonance (CMR), using novel imaging techniques, could be used for in vivo assessment of some key pathophysiological mechanisms related to DCM. In addition, we evaluated whether the pathological findings on CMR would predict clinically relevant functional and morphological improvement of the left ventricular (LV) function - the LV reverse remodeling (LVRR). CMR together with endomyocardial biopsy, echocardiography, cardiopulmonary exercise testing and a thorough assessment of cardiac biomarkers was performed in 44 patients with new-onset DCM (<6 months of duration). The imaging was repeated after 12 months of clinical follow-up. Endomyocardial biopsy revealed myocardial inflammation in 34 % of the patients. LVRR at 12 months occurred in 45 % of the patients. Presence of late gadolinium enhancement (LGE) in the left ventricle was a sensitive but unspecific sign of myocardial inflammation because it was also a feature of hemodynamic stress related to the heart failure. The baseline extent of LGE was an independent predictor of future LVRR and also a predictor of adverse clinical...

Osteopontin, also called cytokine Eta-1, is a multifunctional protein containing Arg-Gly-Asp-Ser (RODS) cell-binding sequence. It interacts with αvβ1, αvβ3 and αvβ5 integrins and CD44 receptors. OPN is suggested to play a role during inflammation via the recruitment and retention of macrophages and T-cells to inflamed sites. OPN regulates the production of inflammatory cytokines and nitric oxide in macrophages. In this review, we will discuss diverse roles of OPN related to cardiovascular diseases, including atherosclerosis, valvular stenosis, hypertrophy, myocardial infarction and heart failure.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19401号 / 医博第4052号 / 新制||医||1012(附属図書館) / 32426 / 京都大学大学院医学研究科医学専攻 / (主査)教授 髙田 穣, 教授 平岡 眞寛, 教授 松本 智裕 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM