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Cellule interstitielle de valve et sténose aortique : impact de la voie du facteur tissulaire

Abstract : Defined as the narrowing of the aortic valve, aortic stenosis (AS) is the third cardiovascular pathology in industrialized countries. Affecting mainly people aged over 65 years, AS represents a major public health problem because of the aging of the population. After initially been considered as a passive degenerative process, it is now established that AS is an "atherosclerosis-like " disease characterized by the processes of inflammation, fibrosis, neo-angiogenesis and calcification. Some proteins of the coagulation pathway such as tissue factor (TF) are known to have a pro-fibrotic role and actively participate in the development of atherosclerotic lesions. Their implication in AS seems, therefore, probable and remain to be identified.Prevalent cellular component of the aortic valve, VICs have five distinct subpopulations: embryonic progenitor cells (EPCs), progenitor cells (pVICs) quiescent (qVICs), activated (aVICs) and osteoblastic (obVICs). During the valvulogenesis, EPCs allow the cellularization of the valve, differentiating into qVICs. These cells maintain the valvular homeostasis and, in case of damage, are activated (aVICs) to effectively repair the valve tissue. The valvular inflammation and VICs activation initiate the secretion of pro-calcifying proteins inducing the differentiation of aVICs into obVICs. Finally, pVICs, naturally present within the valve (called resident) or from the blood circulation (called hematopoietic), seem to promote cell renewal and may be involved in the angiogenic and osteoblastic processes.Although described, these subpopulations have never been studied longitudinally, in respect to their behavior in vitro. Our first objective was to perform this investigation. Our second objective was to study the potential role of TF pathway in the deleterious mechanisms of AS.As part of the longitudinal follow-up of VICs from control and pathological human aortic valves to the in vitro culture performed on plastic and collagen, we first showed that different subpopulations were present in these valves with different locations and proportions according to the pathophysiological state of the tissue. After enzymatic digestion, all subpopulations are found but, in culture, hematopoietic pVICs disappeared, whichever the support. Thus, we validated the primary culture model of VICs while highlighting its limitations: lack of hematopoietic pVICs, spontaneous osteoblastic differentiation and activation of VICs in culture.As part of the study the involvement of FT in the AS development, we showed its colocalization with thrombin and calcifications of pathological valves. We showed that the expression and activity of TF were constitutively more important in VICs from fibrocalcified valves than control ones and that IL-1β for pathological VICs and that its expression could be induced by IL1 beta. In addition, TF activation in the by its ligand FVII, induced, directly and via the PAR-2 receptor, different signaling pathways involved in cell proliferation and the processes of fibrosis and calcification. Thus, our findings suggest that the FT expressed by VICs mediates fibrocalcific processes of aortic stenosis.
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Submitted on : Friday, September 28, 2018 - 5:38:32 PM
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Anais Arbesu y Miar. Cellule interstitielle de valve et sténose aortique : impact de la voie du facteur tissulaire. Médecine humaine et pathologie. Université du Droit et de la Santé - Lille II, 2015. Français. ⟨NNT : 2015LIL2S062⟩. ⟨tel-01883825⟩



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