Surface modification of biomaterials for conjugation with human fetal osteoblasts.

Surface functionalization of hydroxyapatite (HA) and beta-tricalcium phosphate (TCP) bioceramics with chemical ligands containing a pyrrogallol moiety was developed to improve the adhesion of bone cell precursors to the biomaterials. Fast and biocompatible copper-free click reaction with azido-modified human fetal osteoblasts resulted in improved cell binding to both HA and TCP bioceramics, opening the way for using this methodology in the preparation of cell-engineered bone implants.

Plasma and cerebrospinal fluid population pharmacokinetics of temozolomide in malignant glioma patients

RESUME : Objectif: Le glioblastome multiforme (GBM) est la tumeur cérébrale maligne la plus agressive qui conduit au décès de la majorité des patients moins d'une année après le diagnostic. La plupart des agents chimiothérapeutiques actuellement disponibles ne traversent pas la barrière hémato¬encéphalique et ne peuvent par conséquent pas être utilisés pour ce type de tumeur. Le Temozolomide (TMZ) est un nouvel agent alkylant récemment développé pour le traitement des gliomes malins. A ce jour, très peu d'informations sont disponibles sur la pénétration intra-cérébrale de cet agent. Au cours d'une étude pilote de phase II menée auprès de 64 patients atteints de GBM, l'administration précoce de TMZ combinée à une radiothérapie standard (RT) afin d'intervenir au plus tôt dans l'évolution de la maladie, a permis de prolonger la survie de ces patients, résultat qui pu être confirmé par la suite lors de l'étude randomisée de phase III. L'objectif de cette étude a été de déterminer les paramètres pharmacocinétique du TMZ dans le plasma et le liquide céphalo-rachidien (LCR), d'évaluer l'influence de certains facteurs individuels (âge, sexe, surface corporelle, fonction rénale/hépatique, co-médications, RT concomitante) sur ces différents paramètres, et enfin d'explorer la relation existant entre l'exposition au TMZ et certains marqueurs cliniques d'efficacité et de toxicité. Matériel et Méthode: Les concentrations de TMZ ont été mesurées par chromatographie liquide à haute performance (HPLC) dans le plasma et le LCR de 35 patients atteints de GBM nouvellement diagnostiqués (étude pilote) ou de gliomes malins en récidive (étude récidive). L'analyse pharmacocinétique de population a été réalisée à l'aide du programme NONMEM. L'exposition systémique et cérébrale, définie par les AUC (Area Under the time-concentration Curve) dans le plasma et le LCR, a été estimée pour chaque patient et corrélée à la toxicité, la survie ainsi que la survie sans progression tumorale. Résultats: Un modèle à 1 compartiment avec une cinétique d'absorption et de transfert Kplasma -> LCR de ordre a été retenu afin de décrire le profil pharmacocinétique du TMZ. Les valeurs moyennes de population ont été de 10 L/h pour la clairance, de 30.3 L pour le volume de distribution, de 2.1 h pour la 1/2 vie d'élimination, de 5.78 hE-1 pour la constante d'absorption, de 7.2 10E4 hE-1 pour Kplasma->LCR et de 0.76 hE-1 pour KLCR plasma. La surface corporelle a montré une influence significative sur la clairance et le volume de distribution, alors que le sexe influence la clairance uniquement. L'AUC mesurée dans le LCR représente ~20% de celle du plasma et une augmentation de 15% de Kplasma->LCR a été observée lors du traitement concomitant de radiochimiothérapie. Conclusions: Cette étude est la première analyse pharmacocinétique effectuée chez l'homme permettant de quantifier la pénétration intra-cérébrale du TMZ. Le rapport AUC LCR/AUC Plasma a été de 20%. Le degré d'exposition systémique et cérébral au TMZ ne semble pas être un meilleur facteur prédictif de la survie ou de la tolérance au produit que ne l'est la dose cumulée seule. ABSTRACT Purpose: Scarce information is available on the brain penetration of temozolomide (TMZ), although this novel methylating agent is mainly used for the treatment of ma¬lignant brain tumors. The purpose was to assess TNIZ phar¬macokinetics in plasma and cerebrospinal fluid (CSF) along with its inter-individual variability, to characterize covari¬ates and to explore relationships between systemic or cere¬bral drug exposure and clinical outcomes. Experimental Design: TMZ levels were measured by high-performance liquid chromatography in plasma and CSF samples from 35 patients with newly diagnosed or recurrent malignant gliomas. The population pharmacoki¬netic analysis was performed with nonlinear mixed-effect modeling software. Drug exposure, defined by the area un¬der the concentration-time curve (AUC) in plasma and CSF, was estimated for each patient and correlated with toxicity, survival, and progression-free survival. Results: A three-compartment model with first-order absorption and transfer rates between plasma and CSF described the data appropriately. Oral clearance was 10 liter/h; volume of distribution (VD), 30.3 liters; absorption constant rate, 5.8 hE-1; elimination half-time, 2.1 h; transfer rate from plasma to CSF (Kplasma->CSF), 7.2 x 10E-4hE-1 and the backwards rate, 0.76hE-1. Body surface area signifi¬cantly influenced both clearance and VD, and clearance was sex dependent. The AU CSF corresponded to 20% of the AUCplasma. A trend toward an increased K plasma->CSF of 15% was observed in case of concomitant radiochemo-therapy. No significant correlations between AUC in plasma or CSF and toxicity, survival, or progression-free survival were apparent after deduction of dose-effect. Conclusions: This is the first human pharmacokinetic study on TMZ to quantify CSF penetration. The AUC CSF/ AUC plasma ratio was 20%. Systemic or cerebral exposures are not better predictors than the cumulative dose alone for both efficacy and safety.

Evaluation of monoenergetic imaging to reduce metallic instrumentation artifacts in computed tomography of the cervical spine.

OBJECT Monoenergetic imaging with dual-energy CT has been proposed to reduce metallic artifacts in comparison with conventional polychromatic CT. The purpose of this study is to systematically evaluate and define the optimal dual-energy CT imaging parameters for specific cervical spinal implant alloy compositions. METHODS Spinal fixation rods of cobalt-chromium or titanium alloy inserted into the cervical spine section of an Alderson Rando anthropomorphic phantom were imaged ex vivo with fast-kilovoltage switching CT at 80 and 140 peak kV. The collimation width and field of view were varied between 20 and 40 mm and medium to large, respectively. Extrapolated monoenergetic images were generated at 70, 90, 110, and 130 kiloelectron volts (keV). The standard deviation of voxel intensities along a circular line profile around the spine was used as an index of the magnitude of metallic artifact. RESULTS The metallic artifact was more conspicuous around the fixation rods made of cobalt-chromium than those of titanium alloy. The magnitude of metallic artifact seen with titanium fixation rods was minimized at monoenergies of 90 keV and higher, using a collimation width of 20 mm and large field of view. The magnitude of metallic artifact with cobalt-chromium fixation rods was minimized at monoenergies of 110 keV and higher; collimation width or field of view had no effect. CONCLUSIONS Optimization of acquisition settings used with monoenergetic CT studies might yield reduced metallic artifacts.

Convenient synthesis of heterobifunctional poly(ethylene glycol) suitable for the functionalization of iron oxide nanoparticles for biomedical applications.

A straightforward route is proposed for the multi-gram scale synthesis of heterobifunctional poly(ethylene glycol) (PEG) oligomers containing combination of triethyloxysilane extremity for surface modification of metal oxides and amino or azido active end groups for further functionalization. The suitability of these PEG derivatives to be conjugated to nanomaterials was shown by pegylation of ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles (NPs), followed by functionalization with small peptide ligands for biomedical applications.

Covalent cell surface functionalization of human fetal osteoblasts for tissue engineering.

The chemical functionalization of cell-surface proteins of human primary fetal bone cells with hydrophilic bioorthogonal intermediates was investigated. Toward this goal, chemical pathways were developed for click reaction-mediated coupling of alkyne derivatives with cellular azido-expressing proteins. The incorporation via a tetraethylene glycol linker of a dipeptide and a reporter biotin allowed the proof of concept for the introduction of cell-specific peptide ligands and to follow the reaction in living cells. Tuning the conditions of the click reaction resulted in chemical functionalization of living human fetal osteoblasts with excellent cell survival.

Cell surface expression of a functional rubella virus E1 glycoprotein by addition of a GPI anchor.

Rubella virus (RV) envelope glycoproteins E1 and E2 are targeted to the Golgi as heterodimers. While E2 contains a transmembrane Golgi retention signal, E1 is arrested in a pre-Golgi compartment in the absence of E2, and appears to require heterodimerization in order to reach the Golgi. Various forms of E1 with deletions in the ectodomain or lacking the cytoplasmic (CT) and transmembrane (TM) domains, as well as the 29 C-terminal amino acid residues of the ectodomain were also retained intracellularly. We therefore investigated the possibility of targetting E1 to the plasma membrane by addition of a glycosylphosphatidylinositol (GPI) anchor. We found that E1GPI was transported to the cell surface where it retained the hemadsorption activity characteristic of the wild-type E1/E2 heterodimer. Furthermore, coexpression of a mammalian GPI-specific phospholipase D (GPI-PLD) resulted in the release of E1GPI and in constitutive expression of a soluble form of E1. This study thus demonstrates that the GPI anchor has a dominant effect over the E1 pre-Golgi retention signal and that E1 is sufficient for hemadsorption.

Mutational analysis of cysteine-rich domains of the epithelium sodium channel (ENaC). Identification of cysteines essential for channel expression at the cell surface.

One of the characteristic features of the structure of the epithelial sodium channel family (ENaC) is the presence of two highly conserved cysteine-rich domains (CRD1 and CRD2) in the large extracellular loops of the proteins. We have studied the role of CRDs in the functional expression of rat alphabetagamma ENaC subunits by systematically mutating cysteine residues (singly or in combinations) into either serine or alanine. In the Xenopus oocyte expression system, mutations of two cysteines in CRD1 of alpha, beta, or gamma ENaC subunits led to a temperature-dependent inactivation of the channel. In CRD1, one of the cysteines of the rat alphaENaC subunit (Cys158) is homologous to Cys133 of the corresponding human subunit causing, when mutated to tyrosine (C133Y), pseudohypoaldosteronism type 1, a severe salt-loosing syndrome in neonates. In CRD2, mutation of two cysteines in alpha and beta but not in the gamma subunit also produced a temperature-dependent inactivation of the channel. The main features of the mutant cysteine channels are: (i) a decrease in cell surface expression of channel molecules that parallels the decrease in channel activity and (ii) a normal assembly or rate of degradation as assessed by nondenaturing co-immunoprecipitation of [35S]methionine-labeled channel protein. These data indicate that the two cysteines in CRD1 and CRD2 are not a prerequisite for subunit assembly and/or intrinsic channel activity. We propose that they play an essential role in the efficient transport of assembled channels to the plasma membrane.

The mechanisms of inflammation in gout and pseudogout (CPP-induced arthritis).

Recent advances have stimulated new interest in the area of crystal arthritis, as microcrystals can be considered to be endogenous "danger signals" and are potent stimulators of immune as well as non-immune cells. The best known microcrystals include urate (MSU), and calcium pyrophosphate (CPP) crystals, associated with gout and pseudogout, respectively. Acute inflammation is the hallmark of the acute tissue reaction to crystals in both gout and pseudogout. The mechanisms leading to joint inflammation in these diseases involve first crystal formation and subsequent coating with serum proteins. Crystals can then interact with plasma cell membrane, either directly or via membrane receptors, leading to NLRP3 activation, proteolytic cleavage and maturation of pro-interleukin-1β (pro-IL1β) and secretion of mature IL1β. Once released, this cytokine orchestrates a series of events leading to endothelial cell activation and neutrophil recruitment. Ultimately, gout resolution involves several mechanisms including monocyte differentiation into macrophage, clearance of apoptotic neutrophils by macrophages, production of Transforming Growth Factor (TGF-β) and modification of protein coating on the crystal surface. This review will examine these different steps.

A novel neutrophil elastase inhibitor prevents elastase activation and surface cleavage of the epithelial sodium channel expressed in Xenopus laevis oocytes.

The amiloride-sensitive epithelial sodium channel (ENaC) constitutes a limiting step in sodium reabsorption across distal airway epithelium and controlling mucociliary clearance. ENaC is activated by serine proteases secreted in the extracellular milieu. In cystic fibrosis lungs, high concentrations of secreted neutrophil elastase (NE) are observed. hNE could activate ENaC and contribute to further decreased mucociliary clearance. The aims of this study were (i) to test the ability of an engineered human neutrophil elastase inhibitor (EPI-hNE4) to specifically inhibit the elastase activation of ENaC-mediated amiloride-sensitive currents (I(Na)) and (ii) to examine the effect of elastase on cell surface expression of ENaC and its cleavage pattern (exogenous proteolysis). Oocytes were exposed to hNE (10-100 microg/ml) and/or trypsin (10 microg/ml) for 2-5 min in the presence or absence of EPI-hNE4 (0.7 microm). hNE activated I(Na) 3.6-fold (p < 0.001) relative to non-treated hENaC-injected oocytes. EPI-hNE4 fully inhibited hNE-activated I(Na) but had no effect on trypsin- or prostasin-activated I(Na). The co-activation of I(Na) by hNE and trypsin was not additive. Biotinylation experiments revealed that cell surface gamma ENaC (but not alpha or beta ENaC) exposed to hNE for 2 min was cleaved (as a 67-kDa fragment) and correlated with increased I(Na). The elastase-induced exogenous proteolysis pattern is distinct from the endogenous proteolysis pattern induced upon preferential assembly, suggesting a causal relationship between gamma ENaC cleavage and ENaC activation, taking place at the plasma membrane.

GLUT2 surface expression and intracellular transport via the constitutive pathway in pancreatic beta cells and insulinoma: evidence for a block in trans-Golgi network exit by brefeldin A.

The biosynthesis, intracellular transport, and surface expression of the beta cell glucose transporter GLUT2 was investigated in isolated islets and insulinoma cells. Using a trypsin sensitivity assay to measure cell surface expression, we determined that: (a) greater than 95% of GLUT2 was expressed on the plasma membrane; (b) GLUT2 did not recycle in intracellular vesicles; and (c) after trypsin treatment, reexpression of the intact transporter occurred with a t1/2 of approximately 7 h. Kinetics of intracellular transport of GLUT2 was investigated in pulse-labeling experiments combined with glycosidase treatment and the trypsin sensitivity assay. We determined that transport from the endoplasmic reticulum to the trans-Golgi network (TGN) occurred with a t1/2 of 15 min and that transport from the TGN to the plasma membrane required a similar half-time. When added at the start of a pulse-labeling experiment, brefeldin A prevented exit of GLUT2 from the endoplasmic reticulum. When the transporter was first accumulated in the TGN during a 15-min period of chase, but not following a low temperature (22 degrees C) incubation, addition of brefeldin A (BFA) prevented subsequent surface expression of the transporter. This indicated that brefeldin A prevented GLUT2 exit from the TGN by acting at a site proximal to the 22 degrees C block. Together, these data demonstrate that GLUT2 surface expression in beta cells is via the constitutive pathway, that transport can be blocked by BFA at two distinct steps and that once on the surface, GLUT2 does not recycle in intracellular vesicles.

Mechanical and elemental characterization of solder joints and welds using a gold-palladium alloy

Purpose. This study was conducted to determine whether newer infrared or laser welding technologies created joints superior to traditional furnace or torch soldering methods of joining metals. It was designed to assess the mechanical resistance, the characteristics of the fractured surfaces, and the elemental diffusion of joints obtained by four different techniques: (1) preceramic soldering with a propane-oxygen torch, (2) postceramic soldering with a porcelain furnace, (3) preceramic and (4) postceramic soldering with an infrared heat source, and (5) laser welding. Material and methods. Mechanical resistance was determined by measuring the ultimate tensile strength of the joint and by determining their resistance to fatigue loading. Elemental diffusion to and from the joint was assessed with microprobe tracings. Scanning electron microscopy micrographs of the fractured surface were also obtained and evaluated. Results. Under monotonic tensile stress, three groups emerged: The laser welds were the strongest, the preceramic joints ranged second, and the postceramic joints were the weakest. Under fatigue stress, the order was as follows: first, the preceramic joints, and second, a group that comprised both postceramic joints and the laser welds. Inspection of the fractographs revealed several fracture modes but no consistent pattern emerged. Microprobe analyses demonstrated minor diffusion processes in the preceramic joints, whereas significant diffusion was observed in the postceramic joints. Clinical Implications. The mechanical resistance data conflicted as to the strength that could be expected of laser welded joints. On the basis of fatigue resistance of the joints, neither infrared solder joints nor laser welds were stronger than torch or furnace soldered joints.

Pharmacokinetic and pharmacogenetic factors influencing plasma and cellular antiretroviral drug disposition

Abstract: The improvement in antiretroviral drug therapy has transformed HIV infection into a chronic disease. However, treatment failure and drug toxicity are frequent. Inadequate response to treatment is clearly multifactorial and, therefore, dosage individualisation based on demographic factors, genetic markers and measurement of cellular and plasma drug level may enhance both drug efficacy and tolerability. At present, antiretroviral drugs levels are monitored in plasma, whereas only drugs penetrating into cells are able to exert an antiviral activity, suggesting that cellular drug determination may more confidently reflect drug exposure at the site of pharmacological action. The overall objective of this thesis is to provide a better understanding of the Pharmacokinetic and pharmacogenetic factors influencing the plasma and cellular disposition of antiretroviral drugs. To that endeavour, analytical methods for the measurements of plasma and cellular drug levels have been developed and validated using liquid chromatography methods coupled with ultraviolet and tandem mass spectrometry detection, respectively. Correlations between plasma and cellular exposures were assessed during observational and experimental studies. Cytochrome (CYP) 2B6, efflux transporters (ABCB1, ABCC1, ABCC2 and ABCG2) and orosomucoid (ORM) polymorphisms were determined and were related to plasma and cellular exposures, as well as toxicity of antiretroviral drugs. A Pharmacokinetic population model was developed to characterise inter- and intra-patient variability of atazanavir pharmacokinetics, and to identify covariates influencing drug disposition. In that context, a Pharmacokinetic interaction study between atazanavir and lopinavir, both boosted with ritonavir, has beén conducted to assess the safety and pharmacokinetics of this boosted double-protease inhibitors regimen. Well to moderately-correlated cellular and plasma drug levels are .observed or protease inhibitors, whereas for efavirenz and nevirapine these correlations are weak. Cellular exposure, and CYP2B6 genotype (516G>T) are predictors of efavirenz neuropsychological toxicity. Nevirapine plasma exposure is also influenced by CYPZB6 polymorphism. Nelfinavir cellular exposure appears to be significantly associated only with ABCB1 genotype (3435C>T and intron 26 + 80T>C). Indinavir and lopinavir clearance and lopinavir cellular/plasma exposure ratio are influenced by the concentration of the variant S of ORM, suggesting-a specific binding of these drugs to this variant. Nelfinavir and efavirenz are not influenced by ORM concentration and phenotype. The Pharmacokinetic parameters of atazanavir are adequately described by our population model. The atazanavir-lopinavir interaction study indicates no influence on plasma and cellular atazanavir pharmacokinetics, while limited decrease in lopinavir concentrations was observed after atazanavir addition. The residual variability unexplained by the considered variables suggests that other covariates either uncontrolled at present or remaining to be identified, such as genetic and environmental factors influence antiretroviral drug pharmacokinetics, with substantial impact on treatment efficacy and tolerability. In that context, a comprehensive approach taking into account drug pharmacokinetics and patient genetic background is expected to contribute to increase treatment success, and to reduce the occurrence of adverse drug reactions by stratifying patients in an individualised antiretroviral therapy approach. Résumé Facteurs pharmacocinétiques et pharmacogénétiques influençant l'exposition plasmatique et cellulaire des antirétroviraux Les progrès de la thérapie antirétrovirale ont transformé l'infection par le VIH d'une affection mortelle à une maladie chronique. En dépit de ce succès, l'échec thérapeutique et la toxicité médicamenteuse restent fréquents. Une réponse inadéquate au traitement est clairement multifactorielle et une individualisation de la posologie des médicaments qui se baserait sur les facteurs démographiques et génétiques des patients et sur les taux sanguins des médicaments pourrait améliorer à la fois l'efficacité et la tolérance de la thérapie. Par ailleurs, seules les concentrations plasmatiques sont actuellement considérées pour le suivi thérapeutique des médicaments, alors que les taux cellulaires pourraient mieux refléter l'activité de ses médicaments qui agissent au niveau intracellulaire. L'objectif global de cette thèse était de mieux comprendre les facteurs pharmacocinétiques et pharmacocénétiques influençant l'exposition plasmatique et cellulaire des médicaments antirétroviraux. A cet effet, des méthodes pour quantifier les concentrations plasmatiques et cellulaires des antirétroviraux ont été développées et validées en utilisant la chromatographie liquide couplée à la détection ultraviolette et la spectrométrie de masse en tandem, respectivement. La corrélation entre l'exposition cellulaire et plasmatique de ces médicaments a été étudiée lors d'études observationnelles et expérimentales. Les polymorphismes du cytochrome (CYP) 2B6, ainsi que des transporteurs d'efflux (ABCB1, ABCC1, ABCC2 et ABCG2) et de l'orosomucoïde (ORM) ont été déterminés et corrélés avec l'exposition plasmatique et cellulaire des antirétroviraux, ainsi qu'à leur toxicité. Un modèle de pharmacocinétique de population a été établi afin de caractériser la variabilité inter- et intra-individuelle de l'atazanavir, et d'identifier les covariables pouvant influencer le devenir de ce médicament. Dans ce contexte, une étude d'interaction entre l'atazanavir et le lopinavir a été effectuée afin de déterminer la sécurité et le profil pharmacocinétique de ce régime thérapeutique. Des corrélations modérées à bonnes ont été observées entre les taux cellulaires et plasmatiques des inhibiteurs de protéase, alors que pour l'efavirenz et la névirapine ces corrélations sont faibles. L'exposition cellulaire, ainsi que le génotype du CYP2B6 (516G>T) sont des indices de la toxicité neuropsychologique de l'efavirenz. L'exposition plasmatique de la névirapine est également influencée par le polymorphisme du CYPZB6. L'exposition cellulaire du nelfinavir est significativement associée au génotype du ABCB1 (3435C>T et intron 26 + 80T>C). La clairance de l'indinavir et du lopinavir, ainsi que le rapport entre exposition cellulaire et plasmatique du lopinavir sont influencés par la concentration du variant S de l'ORM, suggérant une liaison spécifique de ces médicaments à ce variant. La clairance du nelfinavir et de l'efavirenz n'est pas influencée ni par la concentration ni par le phénotype de l'ORM. Les paramètres pharmacocinétiques de l'atazanavir ont été décrits de façon adéquate par le modèle de population proposé. De plus, le lopinavir n'influence pas les concentrations plasmatiques et cellulaires de l'atazanavir; alors que celui-ci conduit à une baisse limitée des taux de lopinavir. L'importante variabilité pharmacocinétique des antirétroviraux suggère que d'autres facteurs génétiques et environnementaux -qui restent encore à découvrir- influencent également leur disponibilité. Dans un proche futur, une prise en charge qui tienne. compte de la pharmacocinétique des médicaments et des caractéristiques génétiques du patient devrait permettre d'individualiser le traitement, contribuant certainement à une amélioration de la réponse thérapeutique et à une diminution de la toxicité. Résumé grand public Facteurs pharmacocinétiques et pharmacogénétiques influençant l'exposition plasmatique et cellulaire des antirétroviraux Les progrès effectués dans le traitement de l'infection par le virus de l'immunodéficience humaine acquise (VIH), ont permis de transformer une maladie avec un pronostic sombre, en une maladie chronique traitable avec des médicaments de plus en plus efficaces. Malgré ce succès, de nombreux patients ne répondent pas de façon optimale à leur traitement et/ou souffrent d'effets indésirables médicamenteux entraînant fréquemment une modification de leur thérapie. Actuellement, le suivi de la réponse au traitement s'effectue par la mesure chez les patients de la quantité de virus et du nombre des cellules immunitaires dans le sang, ainsi que par la concentration sanguine des médicaments administrés. Cependant, comme le virus se réplique à l'intérieur de la cellule, la mesure des concentrations médicamenteuses au niveau intracellulaire pourrait mieux refléter l'activité pharmacologique au site d'action. De plus, il a été possible de mettre en évidence la grande variabilité des concentrations plasmatiques de médicaments chez des patients prenant pourtant la même dose de médicament. Comme cette variabilité est notamment due à des facteurs génétiques qui sont susceptibles d'influencer la réponse au traitement antirétroviral, des analyses génétiques ont été également effectuées chez ces patients. Cette thèse a eu pour objectif de mieux comprendre les facteurs pharmacologiques et génétiques influençant l'activité et la toxicité des médicaments antirétroviraux afin de réduire la variabilité de la réponse thérapeutique. A cet effet, une méthode de dosage permettant la quantification des médicaments anti-HIV au niveau intracellulaire a été développée. Par ailleurs, nos études ont également porté .sur les variations génétiques influençant la quantité et l'activité des protéines impliquées dans le métabolisme et dans le transport des médicaments antirétroviraux. Enfin, les conséquences de ces variations sur la réponse clinique et la toxicité du traitement ont été évaluées. Nos études ont mis en évidence des associations significatives entre les variations génétiques considérées et la concentration sanguine, cellulaire et la toxicité de quelques médicaments antirétroviraux. La complémentarité des connaissances pharmacologiques, génétiques et virales pourrait aboutir à une stratégie globale permettant d'individualiser le traitement et la dose administrée, en fonction des caractéristiques propres de chaque patient. Cette approche pourrait contribuer à une optimisation du traitement antirétroviral dans la perspective d'une meilleure- efficacité thérapeutique à long terme et d'une diminution des effets indésirables rencontrés.

Peptide modification or blocking of CD8, resulting in weak TCR signaling, can activate CTL for Fas- but not perforin-dependent cytotoxicity or cytokine production.

This study describes a form of partial agonism for a CD8+ CTL clone, S15, in which perforin-dependent killing and IFN-gamma production were lost but Fas (APO1 or CD95)-dependent cytotoxicity preserved. Cloned S15 CTL are H-2Kd restricted and specific for a photoreactive derivative of the Plasmodium berghei circumsporozoite peptide PbCS 252-260 (SYIPSAEKI). The presence of a photoactivatable group in the epitope permitted assessment of TCR-ligand binding by TCR photoaffinity labeling. Selective activation of Fas-dependent killing was observed for a peptide-derivative variant containing a modified photoreactive group. A similar functional response was obtained after binding of the wild-type peptide derivative upon blocking of CD8 participation in TCR-ligand binding. The epitope modification or blocking of CD8 resulted in an &gt; or = 8-fold decrease in TCR-ligand binding. In both cases, phosphorylation of zeta-chain and ZAP-70, as well as calcium mobilization were reduced close to background levels, indicating that activation of Fas-dependent cytotoxicity required weaker TCR signaling than activation of perforin-dependent killing or IFN-gamma production. Consistent with this, we observed that depletion of the protein tyrosine kinase p56(lck) by preincubation of S15 CTL with herbimycin A severely impaired perforin- but not Fas-dependent cytotoxicity. Together with the observation that S15 CTL constitutively express Fas ligand, these results indicate that TCR signaling too weak to elicit perforin-dependent cytotoxicity or cytokine production can induce Fas-dependent cytotoxicity, possibly by translocation of preformed Fas ligand to the cell surface.

Vasopressin-inducible ubiquitin-specific protease 10 increases ENaC cell surface expression by deubiquitylating and stabilizing sorting nexin 3

Adjustment of Na+ balance in extracellular fluids is achieved by regulated Na+ transport involving the amiloride-sensitive epithelial Na+ channel (ENaC) in the distal nephron. In this context, ENaC is controlled by a number of hormones, including vasopressin, which promotes rapid translocation of water and Na+ channels to the plasma membrane and long-term effects on transcription of vasopressin-induced and -reduced transcripts. We have identified a mRNA encoding the deubiquitylating enzyme ubiquitin-specific protease 10 (Usp10), whose expression is increased by vasopressin at both the mRNA and the protein level. Coexpression of Usp10 in ENaC-transfected HEK-293 cells causes a more than fivefold increase in amiloride-sensitive Na+ currents, as measured by whole cell patch clamping. This is accompanied by a three- to fourfold increase in surface expression of alpha- and gamma-ENaC, as shown by cell surface biotinylation experiments. Although ENaC is well known to be regulated by its direct ubiquitylation, Usp10 does not affect the ubiquitylation level of ENaC, suggesting an indirect effect. A two-hybrid screen identified sorting nexin 3 (SNX3) as a novel substrate of Usp10. We show that it is a ubiquitylated protein that is degraded by the proteasome; interaction with Usp10 leads to its deubiquitylation and stabilization. When coexpressed with ENaC, SNX3 increases the channel's cell surface expression, similarly to Usp10. In mCCD(cl1) cells, vasopressin increases SNX3 protein but not mRNA, supporting the idea that the vasopressin-induced Usp10 deubiquitylates and stabilizes endogenous SNX3 and consequently promotes cell surface expression of ENaC

Respective roles of calcitonin receptor-like receptor (CRLR) and receptor activity-modifying proteins (RAMP) in cell surface expression of CRLR/RAMP heterodimeric receptors.

Receptor activity modifying proteins RAMP1, RAMP2, and RAMP3 are responsible for defining affinity to ligands of the calcitonin receptor-like receptor (CRLR). It has also been proposed that receptor activity-modifying proteins (RAMP) are molecular chaperones required for CRLR transport to the cell surface. Here, we have studied the respective roles of CRLR and RAMP in transporting CRLR/RAMP heterodimers to the plasma membrane by using a highly specific binding assay that allows quantitative detection of cell surface-expressed CRLR or RAMP in the Xenopus oocytes expression system. We show that: (i) heterodimer assembly is not a prerequisite for efficient cell surface expression of CRLR, (ii) N-glycosylated RAMP2 and RAMP3 are expressed at the cell surface and their transport to the plasma membrane requires N-glycans, (iii) RAMP1 is not N-glycosylated and is transported to the plasma membrane only upon formation of heterodimers with CRLR, and (iv) introduction of N-glycosylation sites in the RAMP1 sequence (D58N/G60S, Y71N, and K103N/P105S) allows cell surface expression of these mutants at levels similar to that of wild-type RAMP1 co-expressed with CRLR. Our data argue against a chaperone function for RAMP and identify the role of N-glycosylation in targeting these molecules to the cell surface.