Orientador: Mario Jose Abdalla Saad / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-13T16:18:01Z (GMT). No. of bitstreams: 1 Aquino_NiltonSergiode_M.pdf: 666411 bytes, checksum: 2c02dd4742835246669966068bdac040 (MD5) Previous issue date: 2009 / Resumo: Diversos estudos epidemiológicos realizados indicam a ligação, tanto da obesidade quanto do DM tipo 2, a um estado de inflamação sub-clínico, onde encontramos elevação do nível sérico de diversas citocinas pró-inflamatórias. TLR4 é uma subclasse dos TLR's e estão localizados em vários tecidos e células do organismo dos mamíferos, incluindo aqueles insulino sensíveis. A sua ativação pela exposição a ácidos graxos livres (AG) e lipopolissacarídeos (LPS), derivado da membrana externa das bactérias Gramnegativas, causa um aumento do nível sérico de diversas citocinas pró-inflamatória e resistência à insulina. Assim esses receptores emergem como candidatos a intermediar o processo inflamatório sub-clínico e a resistência à insulina. Recentes estudos demonstraram que um grupo de derivados da ciclohexanona inibe, de forma específica, o TLR4. Dentre os derivados com atividade inibidora de citocinas destaca-se o (6R)-6-[N-(2-cloro-4-fluorfenil)sulfamoil]-ciclohex-1-ene-1-carboxilato de etila, designado pelo FDA para estudos clínicos como TAK-242 e que apresenta uma potente capacidade supressora na produção de NO, IL-6 e TNF-a. No presente estudo, sintetizamos e investigamos o efeito do tratamento crônico com TAK-242 por via oral na transdução do sinal da insulina, estado de inflamação subclínico e na sensibilidade à insulina em camundongos tratados com dieta hiperlipídica. Tais animais, após quatorze dias de tratamento, demonstraram significante melhora na sensibilidade à insulina, na tolerância à glicose e aumento na capacidade de sinalização da insulina no tecido adiposo, fígado e músculo através da via da Akt. A administração de TAK-242 também diminuiu a resistência à insulina em nosso modelo de choque séptico induzido por LPS de bactérias Gram-negativas com uma alta taxa de sobrevida dos animais. Assim, novos derivados da ciclohexanona, como o TAK-242, podem oferecer uma nova abordagem terapêutica para as doenças cuja patogenicidade envolve o TLR4, como o processo inflamatório sub-clínico e a resistência à insulina. / Abstract: Insulin resistance and type 2 diabetes are associated with obesity and a state of abnormal inflammatory response. TLR4 detects Gram-negative bacteria through recognition of the lipid A moiety of lipopolysaccharide (LPS) and has an important role in inflammation and immunity. Since it is activated by LPS and saturated fatty acids, which are inducers of insulin resistance, TLR4 appears as a candidate for participation in the cross-talk between inflammatory and metabolic signals. We investigated, herein, in vivo efficacy and associated molecular mechanisms by TAK 242, a small-molecule selective TLR4 inhibitor, improved diabetes control and insulin action. The effect of TAK 242 was investigated on insulin sensitivity, insulin signaling and activity in tissues of high-fat dietfed mice. Moreover, these mice showed significantly improved insulin sensitivity, improved glucose tolerance and enhanced insulin signaling capacity in adipose tissue, muscle and liver as compared to control mice during high fat feeding. TAK 242, in our endotoxin shock model, by oral administration, also demonstrated efficacy against the LPSinduced cytokines with a high survival rate and improved insulin sensibility in mice. In conclusion, we demonstrated that TAK-242, a small-molecule selectively suppresses TLR4-signaling, improves glucose tolerance and insulin action in high-fat dietfed mice. Manipulation of TLR4 pathways is considered to have great therapeutic potential. Cyclohexene derivatives, like TAK-242, represent a novel therapeutic approach to the treatment of human obesity, insulin resistance and type 2 diabetes. / Mestrado / Biologia Estrutural, Celular, Molecular e do Desenvolvimento / Mestre em Fisiopatologia Médica

Seres humanos dependem incessantemente de um sistema de reconhecimento efetivo contra infecções para sobreviver. Dentre as diversas proteínas que compõem a resposta imune inata estão os receptores do tipo Toll (TLR Toll-like Receptors), que possuem a função de reconhecer padrões moleculares associados a patógenos e dar início a uma resposta imune adequada. O carcinoma do colo uterino é uma das principais causas de morte de mulheres por câncer mundialmente, sendo o terceiro tipo de câncer mais comum entre mulheres. Este tipo de neoplasia é vinculada etiologicamente à infecção pelo Papilomavírus humano (HPV). Dentre as principais proteínas virais, E6 e E7 são responsáveis pela manipulação dos processos celulares para promover ciclo viral, sendo essenciais no processo de transformação celular. Nesse contexto, o objetivo deste trabalho foi investigar a importância da via de sinalização de TLRs sobre a infecção por HPV. O polimorfismo rs5743836, na região promotora de TLR9, capaz de alterar a expressão deste receptor, foi estudado quanto à influência sobre a história natural da infecção por HPV em uma coorte de mulheres brasileiras; nenhuma associação relevante foi encontrada, indicando que este polimorfismo não interfere significativamente na resposta à infecção e risco de desenvolvimento de lesões no colo do útero causadas por HPV. Proteínas componentes da via de TLRs demonstraram serem alvos de interação com E6 de HPV16; dentre elas, o notável adaptador MyD88 e IKKε, enzima ativadora de importantes transfatores do sistema imune. Estas interações foram aqui estudadas. A interação de E6 com MyD88 resultou em estabilização da proteína viral, o que parece não depender do sítio LxxLL presente em MyD88, como ocorre com outros parceiros moleculares de E6. O sítio de interação de E6 com IKKε coincide com a região onde se localiza o sítio catalítico desta enzima, sugerindo a ação de E6 na ativação de proteínas alvo de IKKε. Esta interação foi observada em queratinócitos, células alvo das infecções por HPV. A produção de citocinas foi afetada por E6 de HPV16, resultando num aumento da quantidade de IL-8 e IL-6; a indução desta citocina poderia ser explicada pela ativação de IKKε. Estes resultados apontam para a capacidade do HPV16 de interferir com o sistema imune, contribuindo para o processo de carcinogênese. / Humans constantly rely on an effective recognition system against infections in order to survive. Among various proteins that compose the innate immune response, Toll-like Receptors (TLRs) have the role to recognize pathogen associated molecular patterns and initiate a proper immune response. The cervical cancer is one of the main causes of women death worldwide, being the third most common cancer type among women. This type of neoplasia is etiologically associated with the Human papillomavirus (HPV) infection. E6 and E7, two main viral proteins, are responsible for manipulating the cellular processes to promote the virus\' life-cycle, being essential to the cellular transformation process. In the context, the objective of this work was to investigate the relevance of the TLR signaling pathway on the HPV infection. The rs5743836 polymorphism, in the TLR9 promoter region, capable of altering this receptor\'s expression, was studied regarding its influence on the natural history of HPV infection in a Brazilian women cohort; no relevant association was found, indicating that this polymorphism does not interfere significantly in the infection response and risk of developing cervix lesions caused by HPV. Component proteins of TLR pathway were shown to be interaction targets of HPV16 E6; among them, the notable adaptor MyD88 and IKKε, enzyme that activates important immune system transfactors. These interactions were studied in this work. The interaction of E6 with MyD88 resulted in the stabilization of the viral protein, which seems independent of the LxxLL site present on MyD88, as in other E6 molecular partners. The interaction site on IKK with E6 matches with the region containing the enzyme\'s catalytic site, suggesting an influence of E6 in the activation of IKKε target proteins. This interaction was observed in keratinocytes, natural targets of HPV infections. The cytokines production was altered by HPV16 E6, resulting in an increase of IL-8 and IL-6 concentration; the induction of the latter could be explained by the activation of IKKε. These results point to the ability of HPV16 of interfering with the immune system, contributing to the carcinogenesis process.

Os tecidos periodontais estão em confronto continuo com microorganismos capazes de disparar mecanismos da resposta imune inata, dando origem ao infiltrado inflamatório. Estudos recentes mostraram a importancia dos receptores do tipo Toll (TLRs) na fase inicial de reconhecimento de diferentes patogenos. A participação de receptores tipo Toll (TLRs) na resposta de neutrófilos e macrófagos frente a periodontopatógenos precisa ser determinada. Nesse estudo procuramos caracterizar o infiltrado inflamatório presente no peritônio de animais deficientes de TLR4-/-, avaliar a atividade fagocítica, bem como a produção de óxido nítrico (NO) e a atividade de mieloperoxidase (MPO) no curso da infecção por Aggregatibacter actinomycetemcomitans. A ausência de TLR4 não influenciou a quimiotaxia de neutrófilos e macrófagos para o local da infecção, a produção de óxido nítrico, a atividade de MPO e a viabilidade celular. No entanto, neutrófilos e macrófagos de animais TLR4-/- apresentaram menor atividade fagocítica quando comparado ao grupo controle (camundongos WT). Em relação a doença periodontal induzida experimentalmente com Aggregatibacter actinomycetemcomitans em camundongos deficientes de TLR4, os resultados mostraram que 100% dos animais deficientes de TLR4 sobreviveram a infecção durante o período de observação. Em relação a análise de perda óssea, os dados revelaram uma menor perda progressiva de osso alveolar na região dos molares de animais deficientes de TLR4. A ausência do receptor interferiu na disseminação da bactéria, uma vez que se observou um grande número de bacilos no linfonodo e baco dos animais que não expressaram TLR4, diferente do observado para os animais selvagens (WT). Os resultados indicam a importância da sinalização via TLR4 durante a resposta imune contra Aggregatibacter actinomycetemcomitans. / Aggregatibacter actinomycetemcomitans is an oral gram negative bacteria that contributes to periodontitis progression. Isolated antigens from A. actinomycetemcomitans could be activating innate immune cells through Toll-like receptors (TLRs), molecules that recognize structural components conserved among microorganisms. In this study, we evaluated the role of TLR4 in the recognition of Aggregatibacter actinomycetemcomitans. Neutrophils and macrophage from TLR4 deficient mice and WT mice were collected and used for the subsequent assays. The phagocytosis of leukocytes against A. actinomycetemcomitans and the presence of apoptotic cells were determined by flow cytometry. The in vivo and in vitro production of NO and MPO was evaluated 24h after A. actinomycetemcomitans challenge. In addition, we examined the mechanisms that modulate the outcome of A. actinomycetemcomitans-induced periodontal disease in TLR4-/- mice. The results show that inflammatory cells influx in peritoneal cavity of TLR4-/- mice was similar to that observed into their littermate controls. The phagocytic activity was diminished by cells from TLR4-/- mice. In addition, we did not observe difference in NO and MPO production and the frequency of apoptotic cells between cells from TLR4-/- and WT mice. The results showed that TLR4-deficient mice developed less severe periodontitis after A. actinomycetemcomitans infection, characterized by significantly lower bone loss and inflammatory cell migration to periodontal tissues. Together, these data demonstrate the role TLR4 signals for neutrophils activation after A. actinomycetemcomitans infection and development of periodontal disease.

The opportunistic fungus, Aspergillus fumigatus, is a leading cause of morbidity and mortality among the immunocompromised population. Experimental and clinical findings have established that phagocytic defenses are critical in the recognition and clearance of A. fumigatus. Previous studies found that Toll-like receptors (TLRs), specifically TLR2 and TLR4, were essential in the detection of the mold. Furthermore, one study found that mice deficient in TLR9 lived longer than their wild-type counterparts following challenge with A. fumigatus. We sought to determine the role of TLR9 during A. fumigatus infection. Our results show that A. fumigatus contains unmethylated CpG DNA, the natural ligand of TLR9. Furthermore, A. fumigatus DNA stimulates a potent pro-inflammatory response in mouse bone marrow derived dendritic cells (BMDCs) and human plasmacytoid dendritic cells (pDCs). A genome wide analysis showed that A. fumigatus DNA contains 87 human and 23 mouse putative immunostimulatory motifs. The response to A. fumigatus DNA is TLR9-dependent, as BMDCs from TLR9-/- mice were unresponsive to the fungal DNA. In addition, HEK293 cells cotransfected with human TLR9 and NFκB driven Luciferase conferred responsiveness to A. fumigatus CpG-rich sequences found in the fungal DNA. Our results show that TLR9 detects A. fumigatus DNA, resulting in the secretion of proinflammatory cytokines. While pDCs secrete IFNα in response to A. fumigatus DNA, these cells have been mainly described to play critical roles in the antiviral responses. The role of pDCs during fungal infections remains to be elucidated. Our data show that CD304+ peripheral blood pDCs challenged with A. fumigatus hyphae secrete large concentrations of IFNα and TNFα in response to infection. Furthermore, the response appears to be TLR9- independent. However, pDCs spread over the hyphae and inhibit fungal growth. Furthermore, pDCs undergo cell lysis upon incubation with A. fumigatus. The antifungal activity of the pDCs was retained in the cell lysates, suggesting that this response was mediated by an intracellular factor. Addition of exogenous Zn2+, but not Fe3+, partially restores hyphal growth. In addition, western blot of pDC lysates show that these cells have the Zn2+-binding protein calprotectin. Over 60% cell death is observed in the pDC population following a 2 hour incubation with A. fumigatus. The observed pDC cell death can be partially attributed to gliotoxin, as pDCs challenged with A. fumigatus stains deficient in production of the mycotoxin result in decreased pDC cytotoxicity. Furthermore, pDC cell death occurs independent of contact with the mold, confirming that pDC cell death is mediated by a secreted fungal factor. In addition, our results show that pDCs are required for the host response against A. fumigatus. Mice depleted of their pDCs are more susceptible to A. fumigatus infection than the control counterparts, suggesting that pDCs play a role in the antifungal response. Also, we observe a 5-fold increase in the pDC population in the lungs of infected mice. Therefore, the possibility of these cells playing a role in recruiting and communicating with other immune cells cannot be eliminated. Upon maturation, pDCs acquire characteristics of conventional DCs (cDCs) such as upregulation of major histocompatability complex (MHC) and becoming more phagocytic. Whether mature pDCs are involved in the detection of and responses against fungal pathogens remains to be determined. Here we show that mature pDC secrete IFNα and TNFα in response to A. fumigatus conidia as early as 6 hours post-challenge. While cytokine secretion of mature pDCs against A. fumigatus does not require opsonization, it requires for A. fumigatus being alive and growing. Furthermore, supernatants from conidial growth induced cytokine secretion by the mature pDCs. The work presented in this thesis establishes that the nucleic acids in A. fumigatus serve as a pathogen associated molecular pattern (PAMP) that can induce a TLR9- dependent response. Furthermore, I show that pDCs secrete cytokines and induce an antifungal response against A. fumigatus conidia and hyphae. While the pDC population in the blood appears to be small, our work shows that these cells could be intimately involved in the antifungal responses against A. fumigatus.

Stress, either physical or psychological, can have a dramatic impact on our immune system. There has been little progress, however, in understanding chronic stress-induced immunosuppression. Naive CD4+ T cells could modulate immune responses via differentiation to T helper (Th) cells. In this study, we showed that stress promotes the release of the Th1 cytokines interferon (IFN)-γ and tumor necrosis factor (TNF)-α, the Th2 cytokines interleukin (IL)-4 and IL-10 and the Th17 cytokine IL-17 of splenic naive CD4+ T cells. This suggests that stress promotes the differentiation of naive CD4+ T cells to Th1, Th2 and Th17 cells. Knockout strategies verified that TLR2 might modulate the differentiation of Th1/Th2 cells by inhibiting p38 mitogen-activated protein kinase (MAPK). Taken together, our data suggest that chronic stress induces immune suppression by targeting TLR2 and p38 MAPK in naive CD4+ T cells.

Toll-like receptor 4 (TLR4), a key member of the TLR family, has been well characterized by its function in the induction of inflammatory products of innate immunity. However, the involvement of TLR4 in a variety of apoptotic events by an unknown mechanism has been the focus of great interest. Our investigation found that TLR4 promoted apoptotic signalling by affecting the glycogen synthase kinase-3β (GSK-3β) pathway in a serum-deprivation- induced apoptotic paradigm. Serum deprivation induces GSK-3β activation in a pathway that leads to subsequent cell apoptosis. Intriguingly, this apoptotic cascade is amplified in presence of TLR4 but greatly attenuated by β-arrestin 2, another critical molecule implicated in TLR4-mediated immune responses. Our data suggest that the association of β-arrestin 2 with GSK-3β contributes to the stabilization of phospho-GSK-3β, an inactive form of GSK-3β. It becomes a critical determinant for the attenuation of TLR4-initiated apoptosis by β-arrestin 2. Taken together, we demonstrate that the TLR4 possesses the capability of accelerating GSK-3β activation thereby deteriorating serum-deprivation-induced apoptosis; β-arrestin 2 represents an inhibitory effect on the TLR4-mediated apoptotic cascade, through controlling the homeostasis of activation and inactivation of GSK-3β.

Heterotrimeric Gi proteins play a role in signalling activated by lipopolysaccharide (LPS), Staphylococcus aureus (SA) and group B streptococci (GBS), leading to production of inflammatory mediators. We hypothesized that genetic deletion of Gi proteins would alter cytokine and chemokine production induced by LPS, SA and GBS stimulation. LPS-induced, heat-killed SA-induced and heat-killed GBS-induced cytokine and chemokine production in peritoneal macrophages from wild-type (WT), Gαi2-/- or Gαi1/3-/- mice were investigated. LPS induced production of tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-10 and interferon-γ-inducible protein-10 (IP-10); SA induced TNF-α, and IL-1β production; and GBS induced TNF-α, IL-6, IL-1β, macrophage inflammatory protein-1α (MIP-1α) and keratinocyte chemoattract (KC) production were all decreased (P < 0.05) in Gαi2-/- or Gαi1/3-/- mice compared with WT mice. In contrast to the role of Gi proteins as a positive regulator of mediators, LPS-induced production of MIP-1α and granulocyte-macrophage colony-stimulating factor (GM-CSF) were increased in macrophages from Gαi1/3-/- mice, and SA-induced MIP-1α production was increased in both groups of Gαi protein-depleted mice. LPS-induced production of KC and IL-1β, SA-induced production of GM-CSF, KC and IP-10, and GBS-induced production of IL-10, GM-CSF and IP-10 were unchanged in macrophages from Gαi2-/- or Gαi1/3-/- mice compared with WT mice. These data suggest that Gi2 and Gi1/3 proteins are both involved and differentially regulate murine inflammatory cytokine and chemokine production in response to both LPS and Gram-positive microbial stimuli.

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[ES] El consumo de altas cantidades de etanol durante en un corto período de tiempo, conocido también como consumo en atracón, causa importantes alteraciones en el sistema nervioso central del adolescente, activando la respuesta innata inflamatoria, que puede causar muerte neuronal y alteraciones a nivel estructural y de la conducta. Esta respuesta se produce mediante la activación de los receptores de membrana Toll-like, y específicamente por los receptores TLR4, localizados en células gliales. Cuando dicho receptor se une a su ligando y dimeriza, desencadena una cascada de señalización que finaliza con la translocación al núcleo del factor de transcripción NF-κB, donde se promueve la síntesis y liberación de citoquinas y quimioquinas pro-inflamatorias al medio extracelular. Entre los mecanismos que podrían participar en la amplificación de la respuesta neuroinflamatoria se encontrarían un tipo de vesículas extracelulares (VEs), denominadas exosomas. Los exosomas son micropartículas de 30-150 nm de tamaño con un contenido de carácter bioactivo, formado por proteínas, lípidos y ácidos nucleicos, y que cumplen un papel importante en la comunicación intercelular. Por tanto, la hipótesis que planteamos en esta tesis doctoral es que las VEs ejercen un papel en el mantenimiento y propagación de la neuroinflamación causada por el consumo de alcohol en forma de atracón. Utilizando VEs de cultivos primarios de astrocitos demostramos que el etanol induce una mayor secreción de VEs y altera los niveles de determinadas proteínas y microARNs (miARNs) asociados con la neuroinflamacion. Además, demostramos que cuando las neuronas corticales en cultivo se incuban con VEs procedentes de los astrocitos WT tratados con etanol, se inducen marcadores inflamatorios en las neuronas y presentan mayores niveles de apoptosis. Durante el proceso de biogénesis exosomal, se ha demostrado la participación de una familia de enzimas, llamadas esfingomielinasas, que estarían relacionadas con la biogénesis y secreción de las VEs. Estudios previos de este laboratorio han demostrado que el etanol es capaz de activar las esfingomielinasas, aunque el mecanismo por el cual esto ocurre se desconoce. En este proyecto de tesis proponemos a las membranas asociadas a mitocondrias (MAM) como mecanismo regulador de la secreción de VEs mediada por esfingomielinasas. Mediante el análisis de la actividad de transferencia de fosfolípidos, marcador de actividad de MAM, observamos que el etanol, tanto a nivel tisular como en cultivo, es capaz de activar MAM. Además, demostramos que, inhibiendo la actividad tanto de MAM como de las esfingomielinasas, se revierte el aumento en secreción de VEs causado por el tratamiento con etanol. Estos resultados sugieren que el etanol promueve una mayor liberación de VEs mediante la activación de las enzimas esfingomielinasas a través de MAM. Además, puesto que las VEs tienen la capacidad de cruzar la barrera hematoencefálica (BBB) y tener estabilidad en la circulación, se han considerado como posibles candidatos a biomarcadores de situaciones patológicas. Uno de los elementos presentes en las VEs, que se ha utilizado recientemente como biomarcador en diversos estudios, son los miARNs, moléculas de ARN no codificante de cadena corta implicados en la regulación génica. Se ha descrito que, en pacientes con enfermedades neurodegenerativas como el Alzheimer, Parkinson u otras, se detectan patrones de expresión diferencial de miARNs en las VEs circulantes, en comparación con pacientes control. En este estudio demostramos que el etanol es capaz de alterar los perfiles de miARNs relacionados con la inflamación presentes en VEs circulantes de jóvenes con intoxicación etílica aguda (IEA). Estos efectos presentan diferencias de género, siendo las mujeres/hembras más vulnerables a los efectos del alcohol, ya que la expresión de marcadores inflamatorios en cerebro y en VEs circulantes son más elevadas en mujeres/hembras que en hombres/machos. Estos resultados ponen de manifiesto que las VEs circulantes y sus perfiles de miARNs son posibles candidatos a biomarcadores de la neuroinflamación asociadas con el abuso de alcohol. / [CA] El consum d'elevades quantitats d'alcohol durant un curt període de temps, conegut també com a consum en afartament, causa importants alteracions en el sistema nerviós central de l'adolescent, activant la resposta innata inflamatòria, que pot causar mort neuronal i alteracions a nivell estructural i de conducta. Aquesta resposta es produeix mitjançant l'activació dels receptors de membrana Toll-like, i específicament pels receptors TLR4, localitzats en cèl·lules glials. Quan aquest receptor s'uneix al seu lligant i dimeritza, desencadena una cascada de senyalització que finalitza amb la translocació al nucli del factor de transcripció NF-κB, on es promou la síntesi i alliberament de citoquines i quimioquines pro-inflamatòries al medi extracel·lular. Dins dels mecanismes que podrien participar en l'amplificació de la resposta neuroinflamatòria es trobarien un tipus de vesícules extracel·lulars (VEs), denominades exosomes. Els exosomes són micropartícules de 30-150 nm de grandària amb un contingut de caràcter bioactiu, format per proteïnes, lípids i àcids nucleics, i que compleixen un paper important en la comunicació intercel·lular. Per tant, la hipòtesi que plantegem en aquesta tesi doctoral és que les VEs exerceixen un paper en el manteniment i propagació de la neuroinflamació causada pel consum d'alcohol en forma d'afartament. Utilitzant VEs de cultius primaris d'astròcits demostràrem que l'etanol indueix una major secreció de VEs i una alteració dels nivells de determinades proteïnes i microARNs (miARNs) associats amb la neuroinflamació. A més a més, també observàrem que quan les neurones corticals en cultiu s'incubaben amb VEs procedents dels astròcits WT tractats amb etanol, s'induïen marcadors inflamatoris en les neurones i aquestes presentaven majors nivells d'apoptosi. Durant el procés de biogènesi exosomal, s'ha demostrat la participació d'una família d'enzims, anomenats esfingomielinases, que estarien relacionats amb la biogènesi i secreció de les VEs. Estudis previs d'aquest laboratori han demostrat que l'etanol és capaç d'activar les esfingomielinases, encara que el mecanisme pel qual això passa es desconeix. En aquest projecte de tesi proposem a les membranes associades a mitocòndries (MAM), juntament amb les esfingomielinases com el mecanisme regulador de la secreció de VEs induïda pel consum d'alcohol. Mitjançant l'anàlisi de l'activitat de transferència de fosfolípids, marcador d'activitat de MAM, observàrem que l'etanol, tant a nivell tissular com en cultiu, era capaç d'activar MAM. A més, demostràrem que inhibint l'activitat tant de MAM com de les esfingomielinases, revertiem l'augment en la secreció de VEs causat pel tractament amb etanol. Aquests resultats suggereixen, que l'etanol promou una major alliberament de VEs mitjançant l'activació dels enzims esfingomielinases a través de MAM. A més, ja que les VEs tenen la capacitat de creuar la barrera hematoencefàlica (BBB) i ser estables en circulació, s'han considerat bons candidats a biomarcadors de situacions patològiques. Un dels elements presents en les VEs que s'ha utilitzat recentment com a biomarcador en diversos estudis, són els miARNs, molècules d'ARN no codificant de cadena curta implicats en la regulació gènica. S'ha descrit que, en pacients amb malalties neurodegeneratives, com l'Alzheimer o Parkinson, es detecten patrons d'expressió diferencial de miARNs a les VEs circulants, en comparació amb pacients control. A aquest estudi demostrem que l'etanol és capaç d'alterar els perfils de miARNs relacionats amb la inflamació presents en VEs circulants de joves amb intoxicació etílica aguda (IEA). Aquests efectes presenten diferències de gènere, sent les dones / noies més vulnerables als efectes de l'alcohol, ja que l'expressió de marcadors inflamatoris en cervell i en VEs circulants són més elevades en noies que en nois. / [EN] Heavy alcohol intake during a short period of time, also known as binge drinking, has been proved to produce negative effects on the individual's central nervous system by activating an inflammatory response that can lead to neuronal death and structural and behavioral alterations. This response is produced by glial cells, the main component of the neuroimmune system, through the activation of TLR4, a transmembrane receptor of the TLR family. When TLR4 binds to its ligand and dimerizes, it triggers a signaling cascade that ends up with the translocation of NF-κB to the nucleus, acting as a transcription factor, where it promotes the synthesis and release of pro-inflammatory cytokines and chemokines to the extracellular milieu. Among the mechanisms responsible for the transmission and amplification of this neuroinflammatory response, one candidate could be a kind of extracellular vesicles (VEs) called exosomes. Exosomes are microparticles of 30-150 nm in size, with a bioactive content, composed mostly by proteins, lipids and nucleic acids, which play an important role in intercellular communication. Therefore, the hypothesis of this thesis is that VEs play an important role in the transmission of the neuroinflammatory response caused by ethanol binge drinking. Using VEs from primary cultures of astrocytes, we show that ethanol is able to induce a higher secretion of VEs and alters their composition of inflammatory related protein and microRNAs (miARNs). Furthermore, incubation of these VEs in primary cultures of neurons lead to the development of inflammatory protein and gene markers, and higher apoptosis levels. Exosomal release has been shown to be partly regulated by a family of enzymes called sphingomyelinases, since inhibition of these enzymes resulted in a reduction of secreted VEs. Previous studies from this laboratory have shown that ethanol is able to activate sphingomyelinases, but the mechanism involved in the process is currently unknown. We propose membrane-associated mitochondria (MAM), along with sphingomyelinases, as the responsible for the increased VEs release after ethanol intake. We show that ethanol is capable of increasing phospholipid transfer activity, a marker of MAM activity. Moreover, MAM and sphingomyelinase inhibition resulted in depleted VEs secretion. These results suggest that ethanol promotes increased release of VEs by activating sphingomyelinase enzymes through MAM. VEs display certain biological characteristics, like the ability to cross the blood-brain barrier (BBB) or their high stability in serum, which make them good candidates for biomarkers of pathological situations. One of the elements present in VEs that has recently been used as a biomarker in various studies are miARNs, which are short-chain non-coding RNA molecules involved in gene regulation. It has been described that differential expression patterns of miARNs in circulating VEs can be detected in patients with neurodegenerative diseases, such as Alzheimer's, Parkinson's or others, when compared to healthy patients. In this study we demonstrate that ethanol is able to alter the inflammatory-related miARNs expression patterns in circulating VEs of young people with acute alcohol intoxication (IEA). Notably, the alterations in miARNs are dependent on the patient's gender, being women/females more affected by alcohol than men/males, since women/females showed lower presence of anti-inflammatory miARNs and a higher expression of inflammatory markers in brain tissue than men/males. / Ibáñez Cabanes, F. (2021). Papel de las vesículas extracelulares en la propagación y mantenimiento de la neuroinflamación inducida por el consumo de alcohol en la adolescencia [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/174214