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<dc:title xml:lang="fr">Évaluation de la sénescence endothéliale et leucocytaire dans le choc septique</dc:title>
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<dc:subject xml:lang="fr">Sepsis</dc:subject>
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<dc:subject xml:lang="fr">Complications cardio-vasculaires</dc:subject>
<dc:subject xml:lang="fr">Sénescence</dc:subject>
<dc:subject xml:lang="fr">Immunosénescence</dc:subject>
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<dc:subject xml:lang="en">Septic shock</dc:subject>
<dc:subject xml:lang="en">Cardiovascular complications</dc:subject>
<dc:subject xml:lang="en">Senescence</dc:subject>
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<dcterms:abstract xml:lang="fr">Parmi les conséquences à long terme du sepsis (également appelé "syndrome post-sepsis"), l'augmentation du risque de développer des complications cardiovasculaires inexpliquées et/ou un épisode infectieux récurrent sont des préoccupations émergentes. Ces complications expliquent en grande partie la morbi-mortalité chez les survivants d’un choc septique. Récemment, la sénescence, définie comme l’arrêt irréversible du cycle cellulaire, a été identifiée comme un mécanisme de dysfonction cellulaire qui perdure dans le temps. Habituellement liée à l’âge lorsqu’il s’agit de sénescence réplicative, elle peut aussi être « induite » de manière « prématurée » par un stress majeur. Ainsi,une sénescence prématurée induite par le choc septique au niveau du système cardio-vasculaire et immunitaire pourrait en partie contribuer à la physiopathologie et aux conséquences à long terme du syndrome post-sepsis. Ce travail de thèse a pour objectif d’appréhender les relations potentielles entre le sepsis et la sénescence prématurée induite (ou sénescence accélérée). En particulier, les mécanismes cellulaires clés contribuant aux infections récurrentes et aux événements cardiovasculaires chez des patients convalescents déjà lourdement affectés par un choc septique. Les principaux résultats de nos travaux sont que le sepsis induit un dysfonctionnement artériel avec une acquisition in situ, dépendante du temps, d'un phénotype d'inflammation et de sénescence dans les artères de conduction et de résistance, ce qui indique un effet systémique persistant pouvant expliquer en partie la physiopathologie des conséquences cardio-vasculaires à long terme.</dcterms:abstract>
<dcterms:abstract xml:lang="en">Among the long-term consequences of sepsis (also called "post-sepsis syndrome"), the increased risk of developing unexplained cardiovascular complications and/or a recurrent infectious episode are emerging concerns. These complications account for much of the morbidity and mortality in survivors of septic shock. Recently, senescence, defined as irreversible cell cycle arrest, has been identified as a mechanism of cell dysfunction that persists over time. Usually linked to age when it is replicative senescence, it can also be "induced" in a "premature" way by a major stress. Thus, premature senescence induced by septic shock at the level of the cardiovascular and immune system could partly contribute to the pathophysiology and long-term consequences of the post-sepsis syndrome.The aim of our work is to understand the potential relationship between sepsis and induced premature senescence (or accelerated senescence). In particular, the key cellular mechanisms contributing to recurrent infections and cardiovascular events in convalescent patients already heavily affected by sepsis. The main finding of our work is that sepsis induced arterial dysfunction with a time dependent in situ acquisition of inflammation and senescence phenotype in both conductance and resistance arteries, therefore pointing at a systemic long-lasting effect that may partly explain the pathophysiology of long-term cardiovascular consequences.</dcterms:abstract>
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