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International audience; This study has shown that murine monocytes/macrophages (Mo/Ma) can be labeled simply and efficiently with large, green-fluorescent, micrometer-sized particles of iron-oxide (MPIO). Neither size nor proliferation rate of the Mo/Ma is significantly affected by this labeling. The labeled Mo/Ma have been administered intravenously to rats that had developed a glioma following stereotactic injection of C6 cells. The labeled Mo/Ma were shown to target the brain tumors, a process that could be monitored non-invasively using T2*-weighted MRI. MRI observations were confirmed by Prussian blue staining, lectin staining and fluorescence histology. Overall, the results of this study suggest that the use of Mo/Ma may be envisaged in the clinic for vectorizing therapeutic agents toward gliomas.

Knowledge of the molecular mechanisms that underlie neuron death after stroke is important to allow the development of effective neuroprotective strategies. In this study, we investigated the contribution of death receptor signaling pathways to neuronal death after ischemia using in vitro and in vivo models of ischemic injury and transgenic mice that are deficient in tumor necrosis factor receptor I (TNFRI KO) or show neuron-specific overexpression of the long isoform of cellular Fas-associated death domain-like interleukin-1-beta-converting enzyme-inhibitory protein (FLIP(L)). Caspase 8 was activated in brain lesions after permanent middle cerebral artery occlusion (pMCAO) and in cortical neurons subjected to glucose deprivation (GD) and was necessary for GD-induced neuron death. Thus, neurons treated with zIETD-FMK peptide or overexpressing a dominant-negative caspase 8 mutant were fully protected against GD-induced death. The presence of the neuroprotective TNFRI was necessary for selectively sustaining p50/p65NF-kappaB activity and the expression of the p43 cleavage form of FLIP(L), FLIP(p43), an endogenous inhibitor of caspase 8, in pMCAO lesions and GD-treated neurons. Moreover, TNF pretreatment further upregulated p50/p65NF-kappaB activity and FLIP(p43) expression in neurons after GD. The knock-down of FLIP in wild-type (WT) neurons using a short hairpin RNA revealed that FLIP(L) is essential for TNF/TNFRI-mediated neuroprotection after GD. Furthermore, the overexpression of FLIP(L) was sufficient to rescue TNFRI KO neurons from GD-induced death and to enhance TNF neuroprotection in WT neurons, and neuron-specific expression of FLIP(L) in transgenic mice significantly reduced lesion volume after pMCAO. Our results identify a novel role for the TNFRI-NF-kappaB-FLIP(L) pathway in neuroprotection after ischemia and identify potential new targets for stroke therapy.

Bone-marrow-derived mesenchymal stem cells (MSCs) constitute an interesting cellular source to promote brain regeneration after neurodegenerative diseases. Recently, several studies suggested that oxygen-dependent gene expression is of crucial importance in governing the essential steps of neurogenesis such as cell proliferation, survival and differentiation. In this context, we analysed the effect of the HIF-1 (hypoxia inducible factor-1) activation-mimicking agent CoCl2 on MSCs. CoCl2 treatment increased the expression of the anti-proliferative gene BTG2/PC3 and decreased cyclin D1 expression. Expression of HIF-1α and its target genes EPO, VEGF and p21 was also upregulated. These changes were followed by inhibition of cell proliferation and morphological changes resulting in neuron-like cells, which had increased neuronal marker expression and responded to neurotransmitters. Echinomycin, a molecule inhibiting HIF-1 DNA-binding activity, blocked the CoCl2 effect on MSCs. Additionally, by using Y-27632, we demonstrated that Rho kinase (ROCK) inhibition potentiated CoCl2-induced MSC differentiation in particular into dopaminergic neuron-like cells as attested by its effect on tyrosine hydroxylase expression. Altogether, these results support the ability of MSCs to differentiate into neuron-like cells in response to CoCl2, an effect that might act, in part, through HIF-1 activation and cell-cycle arrest, and which is potentiated by inhibition of ROCK.

International audience; After cerebral ischemia, angiogenesis, by supplying for the deficient perfusion, may be a beneficial process for limiting neuronal death and promoting tissue repair. In this study, we showed that the combination of Ang-1 and vascular endothelial growth factor (VEGF) provides a more adapted therapeutic strategy than the use of VEGF alone. Indeed, we showed on a focal ischemia model that an early administration of VEGF exacerbates ischemic damage, because of its effects on blood-brain barrier (BBB) permeability. In contrast, a coapplication of Ang-1 and VEGF leads to a significant reduction of the ischemic and edema volumes by 50% and 42%, respectively, in comparison with VEGF-treated mice. We proposed that Ang-1 blocks the BBB permeability effect of VEGF in association with a modulation of matrix metalloproteinase (MMP) activity. Indeed, we showed on both ischemic in vivo and BBB in vitro models that VEGF enhances BBB damage and MMP-9 activity and that Ang-1 counteracts both effects. However, we also showed a synergic angiogenic effect of Ang-1 and VEGF in the brain. Taken together, these results allow to propose that, in cerebral ischemia, the combination of Ang-1 and VEGF could be used early to promote the formation of mature neovessels without inducing side effects on BBB permeability.

Alteration of the extracellular matrix (ECM) is one of the major events in the pathogenesis of brain lesions following ischemic stroke. Heparan sulfate mimetics (HSm) are synthetic pharmacologically active polysaccharides that promote ECM remodeling and tissue regeneration in various types of lesions. HSm bind to growth factors, protect them from enzymatic degradation and increase their bioavailability, which promotes tissue repair. As the ECM is altered during stroke and HSm have been shown to restore the ECM, we investigated the potential of HSm4131 (also named RGTA-4131®) to protect brain tissue and promote regeneration and plasticity after a stroke. Methods: Ischemic stroke was induced in rats using transient (1 h) intraluminal middle cerebral artery occlusion (MCAo). Animals were assigned to the treatment (HSm4131; 0.1, 0.5, 1.5, or 5 mg/kg) or vehicle control (saline) groups at different times (1, 2.5 or 6 h) after MCAo. Brain damage was assessed by MRI for the acute (2 days) and chronic (14 days) phases post-occlusion. Functional deficits were evaluated with a battery of sensorimotor behavioral tests. HSm4131-99mTc biodistribution in the ischemic brain was analyzed between 5 min and 3 h following middle cerebral artery reperfusion. Heparan sulfate distribution and cellular reactions, including angiogenesis and neurogenesis, were evaluated by immunohistochemistry, and growth factor gene expression (VEGF-A, Ang-2) was quantified by RT-PCR. Results: HSm4131, administered intravenously after stroke induction, located and remained in the ischemic hemisphere. HSm4131 conferred long-lasting neuroprotection, and significantly reduced functional deficits with no alteration of physiological parameters. It also restored the ECM, and increased brain plasticity processes, i.e., angiogenesis and neurogenesis, in the affected brain hemisphere. Conclusion: HSm represent a promising ECM-based therapeutic strategy to protect and repair the brain after a stroke and favor functional recovery.

The partial pressure in oxygen remains challenging to map in the brain. Two main strategies exist to obtain surrogate measures of tissue oxygenation: the tissue saturation studied by magnetic resonance imaging (StO2-MRI) and the identification of hypoxia by a positron emission tomography (PET) biomarker with 3-[18F]fluoro-1-(2-nitro-1-imidazolyl)-2-propanol ([18F]-FMISO) as the leading radiopharmaceutical. Nonetheless, a formal validation of StO2-MRI against FMISO-PET has not been performed. The objective of our studies was to compare the two approaches in (a) the normal rat brain when the rats were submitted to hypoxemia; (b) animals implanted with four tumour types differentiated by their oxygenation. Rats were submitted to normoxic and hypoxemic conditions. For the brain tumour experiments, U87-MG, U251-MG, 9L and C6 glioma cells were orthotopically inoculated in rats. For both experiments, StO2-MRI and [18F]-FMISO PET were performed sequentially. Under hypoxemia conditions, StO2-MRI revealed a decrease in oxygen saturation in the brain. Nonetheless, [18F]-FMISO PET, pimonidazole immunohistochemistry and molecular biology were insensitive to hypoxia. Within the context of tumours, StO2-MRI was able to detect hypoxia in the hypoxic models, mimicking [18F]-FMISO PET with high sensitivity/specificity. Altogether, our data clearly support that, in brain pathologies, StO2-MRI could be a robust and specific imaging biomarker to assess hypoxia.

Background and Purpose— Despite uncontroversial benefit from its thrombolytic activity, the documented neurotoxic effect of tissue plasminogen activator (tPA) raises an important issue: the current emergency stroke treatment might not be optimum if exogenous tPA can enter the brain and thus add to the deleterious effects of endogenous tPA within the cerebral parenchyma. Here, we aimed at determining whether vascular tPA crosses the blood–brain barrier (BBB) during cerebral ischemia, and if so, by which mechanism. Methods— First, BBB permeability was assessed in vivo by measuring Evans Blue extravasation following intravenous injection at 0 or 3 hours after middle cerebral artery electrocoagulation in mice. Second, the passage of vascular tPA was investigated in an in vitro model of BBB, subjected or not to oxygen and glucose deprivation (OGD). Results— We first demonstrated that after focal permanent ischemia in mice, the BBB remains impermeable to Evans Blue in the early phase (relative to the therapeutic window of tPA), whereas at later time points massive Evans Blue extravasation occurs. Then, the passage of tPA during these 2 phases, was investigated in vitro and we show that in control conditions, tPA crosses the intact BBB by a low-density lipoprotein (LDL) receptor-related protein (LRP)-dependent transcytosis, whereas OGD leads to an exacerbation of tPA passage, which switches to a LRP-independent process. Conclusion— We evidence 2 different mechanisms through which vascular tPA can reach the brain parenchyma, depending on the state of the BBB. As discussed, these data show the importance of taking the side effects of blood-derived tPA into account and offer a basis to improve the current thrombolytic strategy.

Hypoxia is one of the main causes of resistance to treatments in glioblastoma, the worst primary brain tumor in term of survival. Two targeted vectorization strategies directed against hypoxia are presented in this thesis work. The first strategy was designed to inhibit hypoxia-induced erythropoietin through the use of macrophages. Macrophages were genetically engineered to overexpress a truncated form of the erythropoietin receptor resulting in a decrease in the tumor volume in a hypoxic model of glioblastoma in vivo. Hypoxia-inducible constructs were then developed. The second strategy aimed to use nanozeolites carrying hyperoxic gases as a tool to specifically reoxygenate the tumor. Results show that these microporous nanoparticles have no adverse effects in vitro and in vivo. The incorporation of iron in the zeolites significantly increases their oxygen transport capacity and the gadolinium allows their use as a contrast agent for magnetic resonance imaging. In addition, nanozeolites carrying CO2/O2 accumulate specifically in the tumor tissue and locally increase the blood volume/oxygenation. Thus, the two strategies developed during this thesis demonstrate the potential to fight against hypoxia specifically in glioblastoma.; L’hypoxie est l’une des principales causes de résistance aux traitements dans les glioblastomes. Des stratégies permettant de lever l’hypoxie ou de limiter ses effets sont de ce fait nécessaires. Ces travaux de thèse s’intéressent à deux stratégies de vectorisation ciblée agissant contre l’hypoxie. La première stratégie vise à lutter contre les effets de l’hypoxie par une approche combinée de vectorisation cellulaire et moléculaire ciblant une protéine à action pro-tumorale : l’érythropoïétine. Des macrophages ont ainsi été modifiés génétiquement pour leur permettre de surexprimer une forme tronquée de récepteur à l’érythropoïétine conduisant à un ralentissement de la croissance d’un modèle de glioblastome. Les constructions moléculaires ont ensuite été modifiées pour rendre la surexpression inductible par l’hypoxie. La deuxième stratégie vise à réoxygéner spécifiquement la tumeur en se basant sur des nanozéolithes vectrices de gaz hyperoxiques. Les résultats montrent que ces nanoparticules microporeuses ne présentent pas d’effets toxiques majeurs in vitro et in vivo. L’incorporation de fer dans les zéolithes augmente significativement la capacité de transport d’O2 et le gadolinium permet leur utilisation comme agent de contraste en imagerie par résonance magnétique. D’autre part, les nanozéolithes vectrices de CO2/O2 s’accumulent spécifiquement dans le tissu tumoral et augmentent localement le volume sanguin et la quantité d’oxygène. Ainsi, les deux approches développées au cours de cette thèse démontrent le potentiel des stratégies ciblées dirigées contre l’hypoxie dans les glioblastomes.

Conventional prostate MRI, enhanced by diffusion and perfusion sequences, and then named multiparametric, showed high performances for detection of prostate cancer using visual scoring. Indications in stratification, prognosis, treatment planning and follow up are currently under investigations.First part of this work attached itself to describe, elaborate and use a non-rigid image fusion method in 3D between gold standard histology of radical prostatectomy and MRI. Investigations captured the significant differences in shape and volume of in vivo and ex vivo prostate using MRI. The developed multimodality fusion method was applied to a cohort of patients who underwent MRI prior surgery. Results showed a stratified underestimation of cancer volume by MRI. Clinical output resides in detection, stratification and surgical planning.The second part proposed some texture analysis of sequences and quantitative maps. As a multiparametric approach, the Entropy Score is applied in a pilot cohort at time of biopsy and showed some potential usefulness to select MRI targets without compromising detection of significant cancer. By positively correlating with the Gleason Score and the maximal core length of cancer, Entropy Score participates of stratification of cancer.The third part explored application of image registration in the longitudinal follow up of an emergent therapy, said focal (FT). As a conservative approach, FT induces very local deformation of the gland which appears to be appropriately modelled by non-rigid registration, then opening possibilities to guide further control biopsy and radiologic assessment.; Dénommée multiparamétrique par adjonction de séquences fonctionnelle aux conventionnelles, L’IRM de prostate a montré ses performances pour la détection du cancer de prostate par un score radiologique visuel, subjectif. D’autres applications sont en cours d’investigations comme la stratification, le planning thérapeutique ou encore le suivi oncologique.La première partie s’attache à décrire, élaborer et appliquer une méthodologie de recalage non rigide en 3D entre l’histologie du spécimen de prostatectomie totale et les différentes séquences de l’IRMmp. Après avoir capturé une déformation et un changement de volume de la prostate entre les états in vivo et ex vivo par IRM, la méthode de recalage multimodalité appliquée à une population de prostatectomie totale précédée d’une IRM démontre une sous-estimation du volume de cancer par l’IRM, sujette à une stratification. Les implications se trouvent dans la détection, la stratification et le planning thérapeutique. La deuxième partie propose une analyse de texture des différentes séquences et cartographies quantitatives en diffusion et perfusion pour la détection et la stratification du cancer. Cette approche multiparamétrique de « Score d’Entropie » est testée dans une population pilote au moment des biopsies et présente des performances diagnostique pour sélectionner les lésions à biopsier. Ce score d’entropie participe de la stratification du cancer en corrélant positivement avec le score de Gleason et la longueur de cancer biopsique.La troisième partie explore le rôle de l’IRM dans le suivi d’une thérapie émergente, dite focale, du cancer. Il s’agit d’un travail de recalage non-rigide longitudinal sur une cohorte de patients traités par thérapie focale en vue de compenser les déformation focalement induites. Il apparaît que ce type de recalage peut permettre un suivi objectif des résultats d’ablation et potentiellement élaborer une cible biopsique et radiologique dans le suivi oncologique.