Mechanism involved in the UCB neurotoxicity on cellular models

Summary This doctoral thesis covers three years period (2006-2008) during which I have investigated the bilirubin neurotoxicity in the neuroblastoma SH-SY5Y cell line, a neuronal cell model widely used in the study of the pathogenesis and in the development of new therapeutic compounds for neurodegenerative diseases. In the first chapter is summarized the current knowledge about bilirubin chemistry and metabolism including disorders of bilirubin metabolism and the neuronal disturbances associated. In addition, the main discoveries in bilirubin toxicity mechanisms are described. Chapter two describes how we have chosen the cellular model to study the unconjugated bilirubin (UCB) damage. We first compared the bilirubin accumulation and cell viability in two neuronal cell lines (2a1 mouse neuronal progenitor cell line and SH-SY5Y cell line) and one non neuronal cell line (HeLa cells). In addition, we performed studies on cellular localization of Mrp1 (involved in UCB extrusion) and mRNA expression. We observed that SH-SY5Y cells show higher accumulation of bilirubin and lower survival than 2a1 and HeLa cells. SH-SY5Y cells shows a clear localization of Mrp1 at membrane level. Based on these observations we selected the SH-SY5Y cell line as our experimental model, and we characterized this cell line for molecular events linked with bilirubin neurotoxicity. Chapter three revises original data published by mainly our group, about †œthe free bilirubin hypothesis†�. It has been suggested that cell injury correlates better with free unconjugated bilirubin (Bf) than total unconjugated bilirubin (BT). To directly test this hypothesis we evaluated cell viability in four cell lines (SH-SY5Y, MEF, HeLa and 2a1 cell lines) after incubation with different Bf/BT ratios, obtained by mixing varied UCB concentrations and albumins with different binding affinities (bovine, fetal calf and human); Bf was measured in each solution by the peroxidase method. Our data show that the loss of viability is dependent on the Bf but not on BT although bilirubin sensitivity varied with the different cell line tested. This in vitro study reinforces the proposal that Bf or Bf combined with total serum bilirubin should improve risk assessment for neurotoxicity in both term and premature infants. Chapter four describes our studies about the biochemical and molecular changes in SH-SY5Y cells exposed to a rather high Bf (140 nM) for 24 hours. Biochemical changes (cell viability, proliferation, cellular redox environment -ROS and GSH content) and gene expression profile were evaluated in the cells which survived after the treatment. Results suggest that the surviving cells become more resistant to a second oxidative exposition (Bf or H2O2) and this was associated with an increases expression of various genes involved both in ER stress response and in the transport system Xc- (cystine-glutamate exchanger). This transport system is of great relevance in maintaining the redox homeostasis within the cell, and together with the ER stress genes may contribute to the activation of an adaptative response to bilirubin damage. Further studies will be necessary to elucidate the molecular mechanisms that confer resistance to bilirubin toxicity; these mechanisms could help understanding the different sensitivity of the cells to bilirubin damage, and why some neuronal cells die (as the Purkinje cells) while others don't. Furthermore, these studies may achieve to the identification of target proteins useful to develop new drugs: this may be the case of the system Xc-.