Submitted by Nadir Basilio (nadirsb@uninove.br) on 2016-05-17T20:42:43Z No. of bitstreams: 1 Gabriela Gomes Cardoso Rodrigues.pdf: 623885 bytes, checksum: 3da3d1230fd77beffc9c12f00be889bb (MD5) / Made available in DSpace on 2016-05-17T20:42:43Z (GMT). No. of bitstreams: 1 Gabriela Gomes Cardoso Rodrigues.pdf: 623885 bytes, checksum: 3da3d1230fd77beffc9c12f00be889bb (MD5) Previous issue date: 2015-02-04 / Chronic kidney disease (CKD) is characterized by progressive and irreversible loss of renal function and often progresses with a muscular weakness, whose set of signs and symptoms is generally referred to as uremic myopathy. Possible risk factors for the uremic myopathy are the uremic toxins. Among uremic toxins, indoxyl sulfate (IS) is a derivative of tryptophan metabolism by intestinal bacteria. Because skeletal muscle tissue undergo constant remodeling due differentiation of myoblasts in myotubes, it is possible that uremic toxins have a deleterious effect to influence this process, exacerbating the uremic myopathy. Low level laser therapy (LLLT) is regarded as a growth promoter feature widely used in the treatment of chronic diseases and has shown positive effects on the modulation of skeletal muscle repair process and also in the process of inflammation. However, in the context of CKD, the LLLT has not yet been explored. The aim of this study was to evaluate the effects of the IS on cell viability and on oxidative stress on cellular differentiation in cultured C2C12 myoblasts. In addition, to verify the action of the LLLT as a protective alternative to the cells. The C2C12 myoblasts were cultured in DMEM culture medium containing 10% fetal bovine serum and were induced to differentiation process by adding 2% horse serum. Three different IS concentrations were used to mimic the plasma concentrations of normal individual, CKD patients with moderate uremia and CKD patients with advanced uremia (0.6 mg/l and 53 mg/l and 236 mg/l, respectively), at different times of incubation (24 h, 48 h and 72 h). Subsequently, the cells were subjected to treatment with LLLT GaAlAs 780 nm (output power 10 mW, 20 seconds application time and energy density of 0.5 J / cm2). In terms of analysis, we used MTT method to assess the viability of the cells, flow cytometry to assess the viability/cell death and oxidative stress, nitrite dosing to evaluate nitric oxide production and real-time PCR to analyze IL-6, myogenin and MyoD expression (inflammation and cell differentiation markers). The results demonstrate that the IS at the maximum concentration was toxic to C2C12 cells, because it significantly decreased cell viability by MTT and by flow cytometry and by increasing the percentage of necrosis. This effect was present throughout the three incubation periods. With respect to oxidative stress, was not any conclusion, probably by the time the samples, but do not rule out the possibility of IS induce this type of stress. Although the IS has induced death to C2C12 cells, the remaining had no change in cell differentiation markers. Treatment with BPL the IS sensitized cells, reducing cell viability. We conclude that the IS acts directly on C2C12 myoblasts with toxic effect and may be the one factor responsible for uremic myopathy. Treatment with LLLT was not effective in protecting the cells. / A doença renal crônica (DRC) é caracterizada pela perda progressiva e irreversível da função renal e que frequentemente cursa com um quadro de fraqueza muscular, cujo conjunto de sinais e sintomas é globalmente designado como miopatia urêmica. Possíveis fatores predisponentes para a miopatia urêmica são as toxinas urêmicas. Dentre as toxinas urêmicas, o indoxil sulfato (IS) é uma derivada do metabolismo do triptofano presente em bactérias intestinais. Devido ao fato do tecido muscular esquelético sofrer constante remodelação graças à diferenciação de mioblastos em miotubos, é possível que toxinas urêmicas tenham um efeito deletério por influenciar este processo, agravando a miopatia urêmica. A terapia a laser de baixa potência (LBP) é considerada como um recurso bioestimulante amplamente utilizado no tratamento de doenças crônicas e tem demonstrado efeitos positivos sobre a modulação do processo de reparo muscular esquelético e também no processo da inflamação. Entretanto, no contexto de DRC, o LBP não foi ainda explorado. O objetivo do presente estudo foi avaliar dos efeitos do IS sobre a viabilidade celular, sobre o estresse oxidativo e sobre a diferenciação celular em cultura de mioblastos C2C12. Além disso, verificar a ação do LBP como forma de proteção às células. Os mioblastos C2C12 foram cultivados em meio de cultura de DMEM, contendo 10% de soro fetal bovino e foram induzidos ao processo de diferenciação por meio da adição de 2% soro de cavalo. Três diferentes concentrações de IS foram usadas para mimetizar as concentrações plasmáticas de indivíduo normal, paciente DRC com uremia moderada e paciente DRC com uremia avançada (0,6 mg/l; 53 mg/l e 236 mg/l, respectivamente), em diferentes períodos de incubação (24 h, 48 h e 72 h). Posteriormente, as células foram submetidas ao tratamento com laser de baixa potência AsGaAl 780 nm (potência de saída de 10 mW, tempo de aplicação de 20 segundos e densidade de energia de 0,5 J/cm2). Como análise, foi utilizado o método MTT para acessar a viabilidade das células, citometria de fluxo para avaliar a viabilidade/mortalidade das células, bem como o estresse oxidativo, dosagem de nitrito para avaliar a produção de óxido nítrico e PCR em tempo real para analisar a expressão de IL-6, miogenina e MyoD (marcadores de inflamação e diferenciação celular). Os resultados demonstram que o IS na concentração máxima foi tóxico para as células C2C12, pois diminuiu significativamente a viabilidade das células, tanto por MTT como por citometria de fluxo, aumentando a porcentagem de necrose. Este efeito foi presente nos três períodos de incubação. Com relação ao estresse oxidativo, não foi possível nenhuma conclusão, provavelmente pelo tempo das amostras , porém não descartamos a possibilidade do IS induzir este tipo de estresse. Embora o IS tenha induzido morte às células C2C12, as remanescentes não tiveram alteração dos marcadores de diferenciação celular. O tratamento com LBP sensibilizou as células ao IS, diminuindo a viabilidade das células. Concluímos que o IS age diretamente sobre mioblastos C2C12 com efeito tóxico, podendo ser um dos responsáveis pela miopatia urêmica. O tratamento com LBP não foi eficiente na indução de proteção às células.

Patients with kidney failure (KF) have a high incidence of cardiovascular (CV) disease, partly driven by insufficient clearance of uremic toxins. Recent investigations have questioned the accepted effects of adverse lipid profile and CV risk in uremic patients. Therefore, we related a panel of uremic toxins previously associated with CV morbidity/mortality to a full lipid profile in a large, tri-national, cross-sectional cohort. Total, high-density lipoprotein (HDL), non-HDL, lowdensity lipoprotein (LDL), and remnant cholesterol, as well as triglyceride, levels were associated with five uremic toxins in a cohort of 611 adult KF patients with adjustment for clinically relevant covariates and other patient-level variables. Univariate analyses revealed negative correlations of total, non-HDL, and LDL cholesterol with all investigated uremic toxins. Multivariate linear regression analyses confirmed independent, negative associations of phenylacetylglutamine with total, non-HDL, and LDL cholesterol, while indole-3 acetic acid associated with non-HDL and LDL cholesterol. Furthermore, trimethylamine-N-Oxide was independently and negatively associated with non-HDL cholesterol. Sensitivity analyses largely confirmed findings in the entire cohort. In conclusion, significant inverse associations between lipid profile and distinct uremic toxins in KF highlight the complexity of the uremic milieu, suggesting that not all uremic toxin interactions with conventional CV risk markers may be pathogenic.

A Síndrome Hemolítica Urêmica (SHU) é a principal doença associada à infecção com linhagens de Escherichia coli produtoras de toxina de Shiga (Stx), doença para qual não há uma vacina ou tratamento específico. A toxina Stx é formada por uma subunidade A enzimaticamente ativa e uma B pentamérica responsável pela ligação da toxina na célula hospedeira. Neste trabalho propomos o uso de Bacillus subtilis, uma bactéria não patogênica e formadora de esporos, como veículo vacinal para a expressão de formas atóxicas da Stx2, sob o controle de um promotor induzível por estresse (PgsiB). Camundongos BALB/c imunizados com células vegetativas ou esporos das linhagens vacinais de B. subtilis, por diferentes vias, induziram baixos níveis de anticorpos anti-Stx em soro (IgG) e fezes (IgA). Avaliamos também o potencial imunogênico da Stx gerada em linhagens recombinates de E. coli, mas os anticorpos gerados não foram capazes de neutralizar a toxina nativa. Os resultados indicam que formas alternativas de expressão e/ou o uso de adjuvantes são necessárias para gerar formulações vacinais eficazes contra a SHU. / The Hemolytic Uremic Syndrome (HUS) is the main disease associated with infections with Shiga toxin (Stx) - producing Escherichia coli strain and no effective vaccine or treatment exist. The Stx toxin consist of an enzymatically active A subunit and a pentameric B subunit responsible toxin binding to host cells. In this work we propose the use of Bacillus subtilis, a harmless spore form bacteria as a vaccine vehicle for the expression atoxic forms of Stx2, under the control of stress inducible (PgsiB) promoter. BALB/c mice immunized with vegetative cells and spores of the B. subtilis vaccine strain using different immunization routes elicited low specific antibody levels at serum (IgG) or fecal extracts (IgA). We also investigated the immunogenic potencial of StxB purified from recombinant E. coli strain, but the induced anti-StxB antibodies did not neutralize the native toxin. The results indicate that alternative expression system or the incorporation of the adjuvants are required for the generation of vaccine formulation active against HUS.

Resorcinarenes can be functionalized at their upper and lower rims. In this work, the upper rim of a resorcinarene was functionalized with glutamic acids and the lower rim was functionalized with either methyl or undecyl alkyl groups. The cavitands were characterized by nuclear magnetic resonance (NMR), mass spectrometry (MS), UV-vis spectroscopy, dynamic light scattering (DLS) and electron microscopy. The binding of resorcinarene with amine guests was studied in DMSO by UV-vis titration. The obtained binding constants (K values) were in the range of 12,000-136000 M-1. The resorcinarenes were shown to form aggregates in a variety of solvents. The aggregates were spherical as confirmed by DLS, SEM and TEM experiments. Dynamic light scattering (DLS) experiments revealed the size of the aggregates could be controlled by cavitand concentration, pH, and temperature. The resorcinarene with undecyl alkyl group were adsorbed onto 55% cross-linked styrene-divinylbenzene resin to prepare a new stationary phases for ion chromatography (IC) columns. The new column packing material was applied in determination of uremic toxins and water contaminants. The new IC column afforded separation of the five uremic toxins : guanidinoacetic acid, guanidine, methylguanidine, creatinine, and guanidinobenzoic acid in 30 minutes. Detection and quantification of uremic toxins helps diagnose kidney problems and start patient care. Gradient elutions at ambient temperature with methanesulfonic acid (MSA) as eluent resulted in detection levels in water from 10 to 47 ppb and in synthetic urine from 28 to 180 ppb. Trace levels of creatinine (1 ppt) were detected in the urine of a healthy individual using the columns. The new IC stationary phase separated cationic pharmaceuticals including a group of guanidine compounds in surface water. Detection limits in the range of 5 - 32 µg L-1 were achieved using integrated pulsed amperometric detection (IPAD) for guanidine (G), methylguanidine (MG), 1,1-dimethylbiguanidine (DMG), agmatine (AGM), guanidinobenzoic acid (GBA) and cimetidine (CIM). Suppressed conductivity (CD) and UV-vis detection resulted in limits of detection similar to IPAD, in the range of 1.7 - 66 µg L-1, but were not able to detect all of the analytes. Three water sources, river, lake, and marsh, were analyzed and despite matrix effects, sensitivity for guanidine compounds was in the 100 µg L-1 range and apparent recoveries were 80-96 %. The peak area precision was 0.01 - 2.89% for IPAD, CD and UV-vis detection.

Since Shiga-toxigenic Escherichia coli (STEC) strains are not considered to be enteroinvasive, the mechanism(s) by which Shiga toxin (Stx) gains access to the circulation and to target tissues expressing its target receptor Gb3 is crucial to the disease process. There is increasing evidence that by facilitating translocation of Stx across the intestinal epithelium and by transporting bound toxin to remote sites such as the renal endothelium, polymorphonuclear leucocytes (PMNs) play a key role in the pathogenesis of serious STEC disease. Plasma levels of PMN-attracting CXC chemokines such as IL-8 also appear to correlate in humans with the severity of disease. Thus, the capacity of STEC strains to elicit CXC chemokine responses in intestinal epithelial cells may be a crucial step in pathogenesis. In order to determine which STEC factor(s) are responsible for the induction of CXC chemokine responses by intestinal epithelial (HCT-8) cells, a real-time reverse transcription PCR assay was developed to quantitatively measure relative expression of chemokine mRNA for IL-8, ENA-78, GCP-2, MGSA, MIP-2α and MIP-2β. Similarly, a commercially available sandwich ELISA was used to measure levels of IL-8 protein secreted by HCT-8 cells in response to infection with STEC. When HCT-8 cells were infected with the wellcharacterised locus of enterocyte effacement (LEE)-negative O113:H21 strain 98NK2 or the LEE-positive STEC strain EDL933, there were significant differences in the levels of chemokine mRNA and IL-8 protein expression. In particular, the LEE-negative strain 98NK2 induced significantly higher and earlier levels of chemokine mRNAs, including IL-8, MIP-2α and MIP-2β at 1 and 4 h, and ENA-78 at 4 h. However, EDL933 elicited no significant upregulation of any of the chemokine mRNAs at 1 h, and only modest increases in IL-8, MIP-2α and MIP-2β by 4 h, post-infection. These results were confirmed by IL-8 ELISA which showed that 98NK2 elicited significant levels of IL-8 protein by 2 h post-infection, and remained high until 4 h post-infection. In comparison, EDL933 did not elicit significant IL-8 induction over that of control cells, even at 4 h post-infection. When a range of STEC isolates from clinical samples were tested for their capacity to induce chemokine production in HCT-8 cells, highly significant differences were observed between the strains. Infection of HCT-8 cells with a range of LEE-negative STEC strains isolated from patients with severe STEC disease resulted in significantly higher and earlier upregulation of IL-8 and MIP-2α mRNA than that elicited by several LEE-positive STEC strains. Similarly, levels of IL-8 protein in LEE-negative STEC-infected HCT-8 culture supernatants were significantly higher than in LEE-positive STEC-infected culture supernatants. Only one LEE-positive strain, an O26 strain 95ZG1, was capable of inducing chemokine responses comparable to that induced by infection with the LEE-negative STEC strains. These results were also shown not to be attributable to differences in the adherence, initial doses or growth of the strains during the assay, or to a loss of viability of the HCT-8 cells. These results, therefore, suggest that there may be interesting differences in the ability of STEC strains to induce chemokine production in intestinal epithelial cells. The factor(s) that contribute to chemokine induction by epithelial cells in response to STEC were then examined. The difference in responses could not be attributed to the expression or non-expression of LEE genes, the presence or absence of an STEC megaplasmid or to differences in O serogroup. Although purified Stx1 and Stx2 were able to induce IL-8 and MIP-2α mRNA, and IL-8 protein, the levels of chemokine induction in response to wild-type STEC did not correlate with the type or amount of Stx produced by these strains in vitro. Similarly, deletion of the single stx2 gene from 98NK2 had no significant effect on chemokine induction compared to wild-type 98NK2-infected HCT-8 cells. Interestingly, several of the LEE-negative STEC strains eliciting the strongest chemokine responses belonged to flagellar serotype H21. Incubation of HCT-8 cells with purified H21 flagella elicited IL-8 and MIP-2α mRNA responses similar to those seen in the presence of the most potent LEE-negative STEC strains. Deletion of the fliC gene largely abolished the capacity of 98NK2 to elicit IL-8 and MIP-2α mRNA and IL-8 protein responses in HCT-8 cells. Similarly, deletion of both stx2 and fliC from 98NK2 elicited a response similar to that observed with deletion of fliC alone. Flagella were then purified from the high chemokine-inducing STEC strains 95HE4 (O91:H7) and 95ZG1 (O26:H11). Purified H7 and H11 flagella were similarly able to induce both IL-8 and MIP-2α mRNA, and IL-8 protein, in HCT-8 cells at levels similar to their respective wild-type strains. Deletion of fliC from two other STEC strains, 97MW1 (O113:H21) and 86-24 (O157:H7), confirmed that flagellin was responsible for the majority of chemokine responses in these wild-type strains. However, an inability of EDL933 to induce these responses was unexpected and later found to be due to a lack of expression of H7 flagella by this strain. Purified H21 FliC (His6-FliC) alone was able to induce chemokine production (including IL-8, MIP-2α and MIP-2β at 1 and 4 h, and ENA-78 at 4 h) by HCT-8 cells at similar levels to that observed for 98NK2. Taken together, these data suggest that although Stx is capable of inducing CXC chemokine responses, the elevated responses observed in cells infected with certain STEC strains are largely attributable to the production of flagellin. Purified His6-H21 flagellin was also able to induce p38 MAPK activation in vitro and IL-8 and MIP-2α mRNA were superinduced in the presence of both Stx2 and H21 flagellin. Blockade of the p38 pathway with SB203580 resulted in a down-regulation of IL-8 protein levels (by up to 61%) in response to H21 flagellin, but not IL-8 mRNA, suggesting that this inhibition may occur post-transcriptionally. Blocking the ERK and JNK pathways similarly decreased IL-8 secretion in response to H21 flagellin, suggesting that all three MAPK pathways are involved in this response. Indeed, concurrent inhibition of all three pathways resulted in virtually complete inhibition of IL-8 protein production (98%). Transfected HeLa and MDCK cells stably expressing TLR5 activated p38 in the presence of purified H21 flagellin, whereas dominant-negative (DN) TLR5-expressing cells did not, supporting previous studies that show that flagellin acts via TLR5. These data suggest that TLR5 and the p38, ERK and JNK MAPK pathways all play an important role in the response of intestinal epithelial cells to H21 flagellin from STEC, and that the combined effects of Stx and flagellin on host intestinal epithelial cells may result in an augmented inflammatory response. A role for flagellin in virulence was then investigated. BALB/c mice were orally inoculated with wild-type 98NK2 or 98NK2ΔfliC. Of the 16 mice challenged with the wildtype strain 98NK2, 9 (56%) died during the experiment (median survival time 7.6 days). However, only 3 of 16 mice (19%) challenged with 98NK2ΔfliC died (median survival time > 14 days). The difference in survival rate was statistically significant. No significant differences in the level of intestinal colonisation of 98NK2 or 98NK2ΔfliC were observed. Thus, flagellin directly contributes to the virulence of STEC in streptomycin-treated mice. Since the streptomycin-treated mouse is a model for systemic Stx-mediated pathology, these results suggest that the pro-inflammatory effects of flagellin play an important role in the pathogenesis of Stx-mediated STEC disease in vivo. / Thesis (Ph.D.)--School of Molecular and Biomedical Science, 2004.