Mécanismes impliqués dans les effets du récepteur à la (pro)rénine sur le développement de l'obésité et de ses complications cardiométaboliques associées

Obesity is a disease associated with multiple complications such as type 2 diabetes, hypertension and cancer. Nowadays, lifestyle modifications, such as eating habits and physical activity, are simply not enough to counter the deleterious effects of obesity. Pharmacotherapy is used as an alternative treatment although beneficial effects are temporary and cannot be maintained in the long run. The current medical need for a treatment with long term beneficial outcomes devoid of side effects is unmet. Best known for its role in blood pressure regulation, the renin-angiotensin system has recently been attributed a role in favouring fat storage. The prorenin and renin receptor is a component of renin-angiotensin system that amplifies its activation. Thus, the prorenin and renin receptor might play a key role in gaining fat mass. The aim of this thesis is to investigate the role of the prorenin and renin receptor in the development of obesity and its complications in mice using a combination of high-fat and high carbohydrate diet and the handle region peptide, a blocker of the prorenin and renin receptor.   After a period of 10 weeks, we have found that the prorenin and renin receptor is increased specifically in subcutaneous and visceral adipose tissue of obese mice. When administered simultaneously with a high-fat and high-carbohydrate diet, the handle region peptide reduced body weight gain in mice with similar decrease in visceral fat mass. Decreased expression of the enzyme catalyzing the last step of lipogenesis could be responsible for the reduction in visceral fat mass. In the same animals, the expressions of several adipokines were also decreased in adipose tissue suggesting reduced insulin resistance, inflammation and macrophage infiltration locally in subcutaneous and visceral fat. Increased expression of a marker of adipogenesis in subcutaneous adipose tissue could suggest higher adipocyte number. This would buffer excess circulating free fatty acid since we have noticed a reduction in the latter in mice on a high-fat and high-carbohydrate diet and treated with the peptide. We hypothesized that a futile cycle could be activated in subcutaneous fat because we have observed increased expression of several enzymes implicated in lipogenesis and lipolysis. « Beiging » is defined as the presence of brown-like adipocytes in adipose tissue which is characterized by high mitochondrial density and thermogenesis. Increased expression of markers for « beiging » and mitochondrial biogenesis in subcutaneous fat suggests that « beiging » could also be activated in this fat pad. Insulin sensitivity in these animals could be improved as suggested in the circulation by decreased insulin, similar glucose, increased glucose on insulin ratio as well as a possible change in the correlation between mouse body weight and circulating adiponectin levels.   Our work suggests that the handle region peptide could increase the capacity of subcutaneous adipose tissue to metabolize circulating lipids with a potential activation of a futile cycle and « beiging ». This would prevent ectopic deposition of fat in visceral compartments as suggested by the reduction in visceral fat mass in mice on high-fat and high-carbohydrate diet and treated with the peptide. Using a mice model, this study demonstrates the pharmacological potential of the handle region peptide as a novel treatment to prevent obesity.

Keyphrases: Handle region peptide, Adipokine, Obesity, Renin-angiotensin system, Prorenin and renin receptor, Adipose tissue, Insulin resistance, Futile cycle, Beiging