Etude de la toxicité et des mécanismes de mort cellulaire induits par les glucocorticoïdes sur les cellules endothéliales

Abstract : Glucocorticoids (GCs) present a major interest in the treatment of numerous pathologies. In the eye, they are injected directly in high doses to treat inflammation, macular edema, and vision-threatening neovascularization. Although spectacular, the beneficial anatomical effects obtained by this treatmentare not still correlated to the functional resultsand the recovery of a normal visual acuteness. These empirical therapeutics (except AMM) showed a corticotoxicity on the cells of the retina and the vessels that assure their viability. A two-fold effort is imperative to mitigate these inconveniences. First, fundamental studies to better understand the mechanisms of toxicity of glucocorticoids are still necessary to be able to propose rational therapeutic plans. Second, the implementation of the skills of pharmaceutical companies, with the development of new molecules, in order to obtain an equivalently efficient therapy using glucocorticoids with fewer side effects on tissues is imperative. From this perspective, the objective of my work was to understandthe mechanisms of cellular toxicity caused by different glucocorticoids on endothelial cellsof the dermic and retinal general microcirculation. I showed that toxicity varies according to the cellular type and that the mechanisms of cells death activated with these drugs are not always the same. The second part of my thesis concerned the confirmation and the evaluation of the preclinical efficiency of a new anti-inflammatory treatment, conceived by a Swiss pharmaceutical company, in the treatment of the inflammatory states in ophthalmology. These works improve our knowledge of the general cellular toxicity of glucocorticoids and provides further insight to the microvascular cytotoxicity associated with this treatment option.
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Ikram El-Zaoui. Etude de la toxicité et des mécanismes de mort cellulaire induits par les glucocorticoïdes sur les cellules endothéliales. Toxicologie. Université René Descartes - Paris V, 2013. Français. ⟨NNT : 2013PA05P640⟩. ⟨tel-01470298⟩

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