Hypertension artérielle, dysfonction endothéliale et stress oxydant dans un modèle animal d'apnée du sommeil : rôle protecteur de l'estradiol
|Advisor:||Bairam, Aida; Joseph, Vincent; Pialoux, Vincent|
|Abstract:||Arterial hypertension is a major public health problem, which is at the heart of many diseases. In studying the prevalence of hypertension, we focused in two specific points that we address in this thesis manuscript. The first one is the existence of bidirectional relationship between hypertension and sleep apnea syndrome (SAS), a disease that is still underdiagnosed today. The second is that men are more affected by these two conditions than women, but this trend reverses at the time of menopause, suggesting a protective role of ovarian hormones. The underlying mechanisms of the establishment of hypertension have been studied in various associated diseases (atherosclerosis, obesity, diabetes), but have yet to be studied in SAS in menopausal women. This work aims to understand the mechanisms underlying high blood pressure in postmenopausal women with SAS. For this, we used an animal model of intermittent hypoxia (IH, 21% -10% O2, 10cycles/h, 8h/day). This model presents the same pathophysiological profile observed in apneic patients, in particular with the development of arterial hypertension. The unusual feature of our study is the use of ovariectomized (OVX) female rats, thus allowing to mimic the menopause, contrary to many models of IH which use the male rats. In addition, we have also investigated the role of estradiol (E2) in the development of hypertension and on the underlying mechanisms induced by IH. Our main conclusions are that although IH causes elevation of blood pressure and endothelin- 1 concentration (a vasoconstrictor), it is reversible with E2 treatment. In aorta, OVX generates an increase of oxidative stress, but, again, the supplementation in E2 reverses this effect. The mechanisms of response to E2 are different according to the protocol followed by the animal; after IH, E2 reduces the activity of pro-oxidant enzymes whereas in normoxia condition (21% O2), E2 increases the activity of antioxidant enzymes. In the lungs, IH increases oxidative stress, but OVX has an effect only in female rats exposed to normoxia. The effects of E2 on oxidative stress are tissue-dependent. E2 treatment prevents IH-induced vascular dysfunction and may be clinically relevant in the treatment of SAS in postmenopausal women.|
|Document Type:||Thèse de doctorat|
|Open Access Date:||7 November 2019|
|Collection:||Thèses et mémoires|
All documents in CorpusUL are protected by Copyright Act of Canada.