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Les mécanismes de réponse à l'inflammation chronique dans le foie stéatosique et les conséquences sur l'homéostasie cellulaire et la cancérogénèse

Abstract : Liver is a an essential to life organ in all mammals. It plays a central role in energy and drug metabolism. Liver is constantly challenged by damaging compounds such as viruses, alcohol and chemicals from food intake or from the environment. It can also undergo some deep pathological transformations, e.g. in diabetes or obesity. Liver steatosis has been known for many years, it is defined as an accumulation of triglycerides vesicles generating an inflammatory response in hepatocytes. A « two step hypothesis » has been proposed for the genesis of Non Alcoholic Steatohepatitis (NASH). The first step is the fat accumulation, the second step involves the generation of an oxidative stress and the release ofcytokines. NASH is one of the pathological consequences of metabolic syndrome, when insulin resistance occurs in the tissues.The composition of accumulated fat in NASH has been recently described and reveals the presence of free cholesterol and different fatty acids metabolites with a high but variable toxicity. Surprisingly, a new hypothesis tends to emerge about the protective effects of some types of lipides.Triglyceride storage in vesicles could indeed be a survival mechanism for cells (Neuschwander-Tetri, 2010). It is assumed that it would mainly result in an tolerance to cell death by necrosis orapoptosis. In this context, (activation of) autophagy would play a key-role and necrosis, usually an uncontrolled mechanism, would become accurately regulated. Similarly to oncogenesis, recent experimental data in NASH suggest that energy metabolism,systemic and tissular inflammatory response and subcellular alterations such as impaired mitochondria and ER are connected in a complex network of molecular interactions. Ischemic preconditioning (IP) is a surgical technique consisting of brief periods of vascular occlusion which confer protection against subsequent ischemia/reperfusion via endogenous protective mechanisms. We investigated the survival mechanisms set up by steatotic hepatocytes during I/R, with or without IP. In the following two situations, warm ischemia during partial hepatectomy and cold ischemia during liver transplantation, we pointed out that autophagy can play a central role in steatotic hepatocytes protection. However, an autophagy dysfunction might result in the generation of cellular impairments such as genomic instabilities, typical features of oncogenic transformation. Therefore, the balance between cell survival or death depends on the integration of a complex signaling, taking into account the cellular energetic state, the cell response to transient stress and its adaptation to chronical stress. In that context, autophagy seems to play a central role in the integration of stress response (Kroemer et al Mol Cell 2010), which could promote, directly or indirectly the malignant cell transformation.Therefore, it seems essential to improve the understanding of mechanisms involved in tolerance and survival of lipid-full hepatocytes in response to an inflammatory, ischemic or ER stress. Indeed, this would help developing new therapeutical strategies to improve patients care, increase the number of available grafts for transplants, and prevent cancer risks in liver.
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Submitted on : Thursday, December 15, 2011 - 8:58:19 PM
Last modification on : Thursday, March 4, 2021 - 9:36:06 AM
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Davide Degli Esposti. Les mécanismes de réponse à l'inflammation chronique dans le foie stéatosique et les conséquences sur l'homéostasie cellulaire et la cancérogénèse. Sciences agricoles. Université Paris Sud - Paris XI, 2011. Français. ⟨NNT : 2011PA114809⟩. ⟨tel-00652594⟩

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