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  <front>
    <journal-meta>
      <journal-id journal-id-type="nlm-ta">Arq Bras Cardiol</journal-id>
      <journal-id journal-id-type="publisher-id">abc</journal-id>
      <journal-title-group>
        <journal-title>Arquivos Brasileiros de Cardiologia</journal-title>
        <abbrev-journal-title abbrev-type="publisher">Arq. Bras. Cardiol.</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">0066-782X</issn>
      <issn pub-type="epub">1678-4170</issn>
      <publisher>
        <publisher-name>Sociedade Brasileira de Cardiologia - SBC</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id" specific-use="scielo-v3">PRqyQLMs4BG7FztLdCcGdBS</article-id>
      <article-id pub-id-type="publisher-id" specific-use="scielo-v2">S0066-782X2019000200180</article-id>
      <article-id pub-id-type="publisher-id" specific-use="previous-pid">S0066-782X2018005021102</article-id>
      <article-id pub-id-type="doi">10.5935/abc.20180263</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Original Article</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Evaluation of Collagen Fibers, MMP2, MMP9, 8-OHdG and Apoptosis in the Aorta of Ovariectomized LDL Knockout Mice Submitted to Aerobic Exercise</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Maifrino</surname>
            <given-names>Laura Beatriz M.</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Lima</surname>
            <given-names>Nathalia E. A. de</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Marques</surname>
            <given-names>Mara R.</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Cardoso</surname>
            <given-names>Clever G.</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Souza</surname>
            <given-names>Lidiane B. de</given-names>
          </name>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Tom&#233;</surname>
            <given-names>Tabata de Carvalho</given-names>
          </name>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Quintana</surname>
            <given-names>Hananiah Tardivo</given-names>
          </name>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Oliveira</surname>
            <given-names>Flavia de</given-names>
          </name>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0001-9930-7747</contrib-id>
          <name>
            <surname>Reis</surname>
            <given-names>Beatriz da Costa Aguiar Alves</given-names>
          </name>
          <xref ref-type="aff" rid="aff4">4</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Fonseca</surname>
            <given-names>Fernando Luiz Affonso</given-names>
          </name>
          <xref ref-type="aff" rid="aff4">4</xref>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <label>1</label>
        <institution content-type="orgname">Universidade S&#227;o Judas Tadeu</institution>
        <addr-line>
          <city>S&#227;o Paulo</city>
          <state>SP</state>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">Universidade S&#227;o Judas Tadeu, S&#227;o Paulo, SP - Brazil</institution>
      </aff>
      <aff id="aff2">
        <label>2</label>
        <institution content-type="orgname">Universidade Federal de Goi&#225;s</institution>
        <addr-line>
          <city>Goi&#226;nia</city>
          <state>GO</state>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">Universidade Federal de Goi&#225;s, Goi&#226;nia, GO - Brazil</institution>
      </aff>
      <aff id="aff3">
        <label>3</label>
        <institution content-type="orgname">Universidade Federal de S&#227;o Paulo</institution>
        <institution content-type="orgdiv1">Departamento de Bioci&#234;ncias</institution>
        <addr-line>
          <city>S&#227;o Paulo</city>
          <state>SP</state>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">Departamento de Bioci&#234;ncias da Universidade Federal de S&#227;o Paulo, S&#227;o Paulo, SP - Brazil</institution>
      </aff>
      <aff id="aff4">
        <label>4</label>
        <institution content-type="orgname">Faculdade de Medicina do ABC</institution>
        <addr-line>
          <city>Santo Andr&#233;</city>
          <state>SP</state>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">Faculdade de Medicina do ABC, Santo Andr&#233;, SP - Brazil</institution>
      </aff>
      <author-notes>
        <corresp id="c1"><bold>Mailing Address: Beatriz da Costa Aguiar Alves Reis,</bold> Av. Pr&#237;ncipe de Gales, 821. Postal Code 09060-650, Santo Andr&#233;, SP - Brazil. E-mail: <email>bcaalves@uol.com.br</email>
				</corresp>
        <fn fn-type="con">
          <p>
            <bold>Author contributions</bold>
          </p>
          <p>Conception and design of the research: Maifrino LBM, Souza LB, Quintana HT, Fonseca FLA; acquisition of data: Maifrino LBM, Lima NEA, Cardoso CG, Souza LB, Oliveira F, Fonseca FLA; analysis and interpretation of the data: Lima NEA, Cardoso CG, Souza LB, Tom&#233; TC, Oliveira F, Reis BCAA; statistical analysis: Marques MR, Quintana HT, Oliveira F; obtaining funding: Maifrino LBM; writing of the manuscript: Maifrino LBM, Lima NEA, Marques MR, Souza LB, Oliveira F, Reis BCAA; critical revision of the manuscript for intellectual content: Maifrino LBM, Marques MR, Cardoso CG, Tom&#233; TC, Reis BCAA, Fonseca FLA.</p>
        </fn>
        <fn fn-type="conflict">
          <p>
            <bold>Potential Conflict of Interest</bold>
          </p>
          <p>No potential conflict of interest relevant to this article was reported.</p>
        </fn>
      </author-notes>
      <pub-date pub-type="epub">
        <day>17</day>
        <month>12</month>
        <year>2018</year>
      </pub-date>
      <pub-date pub-type="collection">
        <month>02</month>
        <year>2019</year>
      </pub-date>
      <volume>112</volume>
      <issue>2</issue>
      <fpage>180</fpage>
      <lpage>188</lpage>
      <history>
        <date date-type="received">
          <day>09</day>
          <month>12</month>
          <year>2017</year>
        </date>
        <date date-type="rev-recd">
          <day>04</day>
          <month>05</month>
          <year>2018</year>
        </date>
        <date date-type="accepted">
          <day>23</day>
          <month>07</month>
          <year>2018</year>
        </date>
      </history>
      <permissions>
        <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/" xml:lang="en">
          <license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited</license-p>
        </license>
      </permissions>
      <abstract>
        <title>Abstract</title>
        <sec>
          <title>Background:</title>
          <p>In menopause, there is greater cellular exposure to oxidative stress, related to the decreased antioxidative effects of estrogen. These metabolic changes favor the progression of cardiovascular diseases, such as atherosclerosis. Abnormal function of the aorta - the most important artery - is associated with many cardiovascular diseases. Collagen, especially types I and III, is one of the most important aortic wall components and it can be affected by many factors, including menopause. The 8-OHdG is one of the main markers of DNA oxidative damage induced by reactive oxygen species (ROS).</p>
        </sec>
        <sec>
          <title>Objective:</title>
          <p>We aimed to investigate effects of moderate aerobic training on the ascending aorta of LDL-knockout (LDL-KO) and ovariectomized female mice.</p>
        </sec>
        <sec>
          <title>Methods:</title>
          <p>A total of 15 C57BL/6 mice and 15 LDL-KO mice were divided into experimental groups. The thickness and volume density of types I and III collagen fibers were performed by morphoquantitative analysis, whereas the MMP-2 and MMP-9 and 8-OHdG were detected by immunohistochemistry and apoptosis was detected by the TUNEL assay. The significance level for all tests was p &lt; 0.05.</p>
        </sec>
        <sec>
          <title>Results:</title>
          <p>Exercise causes an increase in the thickness of the aorta in LDL-KO groups, particularly accentuated in the ovariectomized groups. The type I collagen fibers showed an increase in volume density influenced by training in both Control groups and in the LDL-KO group. Type III collagen density decreased in both groups. The MMP-2 showed moderade immunostaining in the tunica media in LDL-KO groups, which did not occur in the control groups and the MMP-9 stained irregularly in all tissues. The marker 8-OhdG was stronger in the exercise training groups. Additionally, the ovariectomy, the exercise training and the LDL-KO treatments increased apoptosis.</p>
        </sec>
        <sec>
          <title>Conclusion:</title>
          <p>These results suggest that moderate-intensity aerobic exercise in ovariectomized mice associated to an increase in LDL rate possibly increases oxidative stress and apoptosis induction.</p>
        </sec>
      </abstract>
      <kwd-group xml:lang="en">
        <title>Keywords:</title>
        <kwd>Rats</kwd>
        <kwd>Cardiovascuar Diseases</kwd>
        <kwd>Menopause</kwd>
        <kwd>Fibrillar Collagens/analysis</kwd>
        <kwd>Ovariectomy</kwd>
        <kwd>Exercise</kwd>
        <kwd>Cholesterol, LDL</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec sec-type="intro">
      <title>Introduction</title>
      <p>Menopause is a period during which women suffer changes in metabolic profile due to decreased production of hormones such as estrogen.<xref ref-type="bibr" rid="B1">1</xref><sup>-</sup><xref ref-type="bibr" rid="B3">3</xref> These metabolic changes favor the progression of cardiovascular diseases, such as atherosclerosis.<xref ref-type="bibr" rid="B4">4</xref> Abnormal function of the aorta - the most important artery - is associated with many cardiovascular diseases. Collagen, especially types I and III, is one of the most important aortic wall components and it can be affected by many factors, including menopause.<xref ref-type="bibr" rid="B5">5</xref>
			</p>
      <p>Physical exercises are recommended for preventing cardiovascular diseases during menopause.<xref ref-type="bibr" rid="B6">6</xref><sup>,</sup><xref ref-type="bibr" rid="B7">7</xref> However, moderate-to-high intensity physical activity causes increased oxidative stress in cells and tissues, raising the risk of cardiovascular disease.<xref ref-type="bibr" rid="B8">8</xref><sup>-</sup><xref ref-type="bibr" rid="B10">10</xref> The adaptation of the body to oxidative stress may be impaired in individuals with low levels of estrogen, which binds to specific cellular receptors and accelerate the production of various antioxidants by cells.</p>
      <p>Little is known about the effects of physical activity on the development of atherosclerosis and metabolic changes that are characteristic of menopause. Relevant data for the elucidation of these effects have been obtained with the use of markers such as 8-hydroxydeoxyguanosine (8-OHdG), metalloproteinases (MMPs), apoptosis detection and quantification of collagen types III and I. 8-OHdG is one of the main markers of DNA oxidative damage induced by reactive oxygen species (ROS).<xref ref-type="bibr" rid="B11">11</xref><sup>,</sup><xref ref-type="bibr" rid="B12">12</xref> MMPs play key roles in the function of various tissues during growth, development and aging of the organism.<xref ref-type="bibr" rid="B13">13</xref><sup>-</sup><xref ref-type="bibr" rid="B17">17</xref> The excessive or unbalanced MMP activity is associated with the pathogenesis of many diseases.<xref ref-type="bibr" rid="B18">18</xref><sup>,</sup><xref ref-type="bibr" rid="B19">19</xref> among them cardiovascular diseases, such as atherosclerosis.<xref ref-type="bibr" rid="B20">20</xref>
			</p>
      <p>The detection of apoptosis in tissues is a marker related to mitochondrial injury, reactive oxygen species production, and oxidative stress. In apoptosis, DNA breakage results in several fragments with free 3&#8217;-OH ends. The identification of cells undergoing the process of apoptosis consists in detecting enzymatically the free 3&#8217;-OH ends with the addition of nucleotides modified by the TdT enzyme (terminal deoxynucleotidyl transferase).</p>
      <p>Thus, we aimed to verify the effects of moderate aerobic training on the ascending aorta of, low-density lipoprotein receptor LDL knockout and ovariectomized female mice.</p>
    </sec>
    <sec sec-type="methods">
      <title>Methods</title>
      <sec>
        <title>Animals and group formation</title>
        <p>The experiments were performed in 15 female mice C57BL/6 and 15 of low-density lipoprotein receptor knockout female mice (LDL-KO) weighing 20-25g, from the Animal House of the S&#227;o Judas Tadeu University, S&#227;o Paulo, Brazil. The mice received the standard laboratory chow and water <italic>ad libitum</italic>. The animals were placed in cages in a room with controlled temperature (22&#176;C) and a 12-h light-dark cycle. All surgical procedures and protocols were approved by the Experimental Animal Use Committee of Universidade S&#227;o Judas Tadeu (058/2007). After a simple randomization, the mice were divided into six groups (n = 5): sedentary control (S-C), ovariectomized sedentary control (OS-C), ovariectomized trained control (OT-C), sedentary LDL KO (S-LDL KO), ovariectomized sedentary LDL KO (OS-LDL KO) and ovariectomized trained LDL KO (OT-LDL KO). The animals were separated physically and randomly between the groups / boxes.</p>
        <p>The sample size definition was performed according to previous data from other authors,<xref ref-type="bibr" rid="B21">21</xref><sup>-</sup><xref ref-type="bibr" rid="B23">23</xref> which were based on the instructions of CONCEA (Conselho Nacional de Controle de Experimenta&#231;&#227;o Animal) Normative Instruction N&#176;. 27 and determined by the formula n = (2&#945;/2&#948;) 2/E<xref ref-type="bibr" rid="B24">24</xref> was used, where n stands for sample size; (2&#945;)<xref ref-type="bibr" rid="B2">2</xref> stands for a critical value that corresponds to the desired degree of confidence, &#948; stands for the population standard deviation and E stands for the margin of error (difference between the sample mean and the mean of the true population).</p>
      </sec>
      <sec>
        <title>Ovariectomy</title>
        <p>At nine months of age, the animals were anesthetized (ketamine 120 mg/kg + xylazine 20 mg/kg), and a small abdominal incision was performed where the ovaries and oviducts were found, sectioned and removed. Then, the skin and muscle wall were sutured.<xref ref-type="bibr" rid="B25">25</xref><sup>,</sup><xref ref-type="bibr" rid="B26">26</xref> The efficacy of the ovariectomy was determined by observation of vaginal secretions during four consecutive days.</p>
      </sec>
      <sec>
        <title>Training protocol</title>
        <p>Seven days after the ovariectomy, all animals were adapted on the treadmill for ten minutes during three days before initiating the training. The maximal exercise test was performed in all groups at the beginning and at the ending of the training program, providing the basis for the prescription of physical training, and with the purpose to evaluate the physical capacity of the trained animals.</p>
        <p>The trained groups were submitted to a moderate physical training protocol on a treadmill, with progressive speed and load (1 hour a day/5 days a week at 50-60% of maximum effort speed) during 4 weeks, as previously described.<xref ref-type="bibr" rid="B27">27</xref>
				</p>
      </sec>
      <sec>
        <title>Histological procedures</title>
        <p>At the end of the experiment, the animals were weighed and subsequently euthanized by decapitation. Thoracotomy was performed by cutting the ascending aorta at the heart base. The aorta samples were washed (PBS - phosphate buffered saline 0.1M, pH 7.4) and fixed in 10% formaldehyde for 24 hours. Then, they were dehydrated, cleared and embedded in paraffin. The aorta was sectioned transversely (5 &#181;m thick), and the samples were stained in H&amp;E for histomorphometric analysis.<xref ref-type="bibr" rid="B7">7</xref> In order to analyze the effects of aerobic training on the whole aorta, the tunica intima was not separated from the tunica media. Picrosirius staining was used for classification of collagen fibers I and III. The images were captured at 4 points, at 0&#186;, 90&#186;, 180&#186; and 270&#186;, with x10 magnification to measure the aorta thickness, and x40 for other evaluations, and transferred to an image analysis program (Axion Visio Software, Zeiss<sup>&#174;</sup>). To analyze the volume density of types I and III collagen fibers, the images were captured by light microscope with polarized light, analyzed using a test system of 252 points, and the values were expressed as percentages.</p>
      </sec>
      <sec>
        <title>Immunohistochemical analysis: 8-OHdG, MMP-2 and MMP-9</title>
        <p>Five 4-&#181;m cross-sections, mounted on previously silanized slides, were used to show the expression of 8-OHdG, MMP-2 and MMP-9. The slides were then deparaffinized, cleared, hydrated and washed in running water. Then, endogenous peroxidase activity was blocked with 0.3% hydrogen peroxide, protein blocking was performed with 0.3% skim milk diluted in PBS and the slides were incubated overnight with anti-8-OHdG (SC66036 Santa Cruz&#174; Biotechnology, CA, USA) primary antibody, titrated 1:100, and MMP2/72KDa and MMP9/KDa (SC-10436 Santa Cruz&#174; Biotechnology, CA, USA; SC-6840 Santa Cruz<sup>&#174;</sup> Biotechnology, CA, USA), titrated 1:150 in PBS-BSA 0.1%. All slides were then placed in a humid chamber at 4&#176;C overnight. The material was washed with PBS buffer and incubated with biotinylated secondary antibody. For revelation, the 3-3&#180;diaminobenzidine chromogenic substrate was used at a ratio of 0.06 g per 100 mL of PBS, and 1 mL of 20-volume H<sub>2</sub>O<sub>2</sub> for five minutes at 37&#176;C and counter-stained with Mayer&#8217;s hematoxylin for 3 minutes. Finally, the slides were mounted with cover slips and entellan&#174; for analysis under light microscopy.</p>
      </sec>
      <sec>
        <title>Investigation of the apoptotic cell death by TUNEL immunocytochemistry</title>
        <p>TUNEL staining was performed using the ApopTag Peroxidase In Situ Apoptosis Detection Kit (Millipore<sup>&#174;</sup>, Germany) according to the manufacturer&#8217;s instructions.</p>
      </sec>
      <sec>
        <title>Quantification of apoptotic cells</title>
        <p>For the quantification of immunostained cells for apoptosis, 30 images of the intima-media layer were captured (10 images/animal; n = 3 animals/group; with x10 magnification to measure the aorta thickness, and x40 for other evaluations, and transferred to an image analysis program (Axion Visio Software, Zeiss<sup>&#174;</sup>) for each experimental group. For each image, the total number of immunostained cells was obtained as a relative frequency (%) in relation to the total number of cells. The light microscope coupled to a digital camera (Zeiss, Germany) was used to obtain the images, and the photomicrographs were scanned with the AxioVision software (Zeiss&#174;, Germany).</p>
      </sec>
      <sec>
        <title>Statistical analysis</title>
        <p>The results were presented as mean and standard deviation. Analysis of variance (ANOVA) and Tukey&#8217;s post-hoc tests were properly applied in data analysis. The significance level for all tests was p &lt; 0.05. The data were evaluated using the software Stata 7.0. All continuous variables were normally distributed (Shapiro-Wilk test). To evaluate the normality of the data, the Shapiro-Wilk calculation was used, which found that the data were allocated within the Gaussian curve. Considering a level of significance of 5%, the test assumed the normality hypothesis for the variable with normal distribution.</p>
      </sec>
    </sec>
    <sec sec-type="results">
      <title>Results</title>
      <sec>
        <title>Histopathological and histomorphometric analysis</title>
        <p>The histopathological analysis showed that the animals from the control groups (S-C, OS-C and OT-C) did not exhibit changes in the elastic fiber arrangement and thickness pattern. However, the dyslipidemic groups (S-LDL KO, OS-LDL KO and OT-LDL KO), showed greater spacing between elastic fibers (<xref ref-type="fig" rid="f1">Figure 1</xref>).</p>
        <p>
          <fig id="f1">
            <label>Figure 1</label>
            <caption>
              <title>Mouse aorta cross-sections showing the arrangement of elastic fibers. The control groups showed a similar pattern of arrangement and thickness of the elastic fibers. The LDL KO groups showed more spaced fibers and thicker vessel walls compared to the controls. Photomicrographs, H&amp;E. Calibration Bar = 100 &#181;m. Sedentary control (S-C), ovariectomized sedentary control (OS-C), ovariectomized trained control (OT-C), sedentary LDL KO (S-LDL KO), ovariectomized sedentary LDL KO (OS-LDL KO) and ovariectomized trained LDL KO (OT- LDL KO). </title>
            </caption>
            <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf01.jpg"/></fig>
        </p>
      </sec>
      <sec>
        <title>Thickness of the tunica media - intima (&#181;m)</title>
        <p>We observed a significant increase in the thickness of the tunica media and intima in dyslipidemic animals, when compared to the control group animals. The ovariectomy and the exercise in the LDL KO groups were a determining factor for the increase of this variable. In both control and LDL KO groups the training exercise did not reverse this process (<xref ref-type="fig" rid="f1">Figures 1</xref> and <xref ref-type="fig" rid="f2">2</xref>).</p>
        <p>
          <fig id="f2">
            <label>Figure 2</label>
            <caption>
              <title>Thickness of the tunica media-intima (&#181;m) in the studied groups. Values are expressed as M &#177; SD *p &lt; 0.05 vs. S-C; #p &lt; 0.05 vs. OS- C; +p &lt; 0.05 vs. OT-C; &#185;p &lt; 0.05 vs S-LDL KO; 2p &lt; 0.05 vs OS-LDL KO. </title>
            </caption>
            <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf02.jpg"/></fig>
        </p>
      </sec>
      <sec>
        <title>Volume density of types I and III collagen fibers in the intima-media and adventitia tunica</title>
        <p>Similar behavior of the type III collagen fiber was observed between the intima-media and adventitia tunica. We observed a significant decrease in the volume density of the type III collagen fiber in the LDL KO groups, when compared to the S-C (<xref ref-type="fig" rid="f3">Figure 3</xref>).</p>
        <p>
          <fig id="f3">
            <label>Figure 3</label>
            <caption>
              <title>Volume density of types I and III collagen fibers (Vv[cf]) in Intima-Media and Adventitia Tunica of ascendant aorta. Values are expressed as M &#177; SD. *p &lt; 0.05 vs. S-C; #p &lt; 0.05 vs. OS-C; +p &lt; 0.05 vs. OT-S.</title>
            </caption>
            <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf03.jpg"/></fig>
        </p>
        <p>The type I collagen fibers of the tunica adventitia and media-intima showed increase in volume density, influenced by training in the Control groups. The dyslipidemia induces an increase in type I collagen fibers in the LDL KO groups when compared to the Control groups and did not undergo any change by ovariectomy, or by training (<xref ref-type="fig" rid="f3">Figure 3</xref>).</p>
      </sec>
      <sec>
        <title>Immunohistochemical analysis</title>
        <p><xref ref-type="fig" rid="f4">Figure 4</xref> shows the tissue staining caused by the oxidative stress marker 8-OHdG. Note that the immunoexpression of the marker occurred in all groups. The staining was moderate for LDL KO and Control groups, both the Sedentary and the Ovariectomized Sedentary groups. However, for the Ovariectomized and trained groups, the observed staining was intense.</p>
        <p>In all control groups (S-C, OS-C and OT-C) the immunoexpression of MMP-2 occurred both in the tunica intima (arrow) and in the tunica adventitia (arrowhead) of the ascending aorta. The LDL groups, in general, showed MMP-2 immunoexpression beyond the tunica intima and adventitia, but also in the tunica media of the aorta (although very slightly), which was not observed in any groups of control animals (<xref ref-type="fig" rid="f5">Figure 5</xref>). The MMP-9 was expressed in all layers of the ascending aorta of all groups; however, the distribution was heterogeneous (<xref ref-type="fig" rid="f6">Figure 6</xref>).</p>
        <p>
          <fig id="f4">
            <label>Figure 4</label>
            <caption>
              <title>Photomicrographs of cross-sections of the aorta of mice submitted to immunohistochemical reaction for 8-OHdG. The immunoexpression of 8-OHdG was observed in all investigated groups. The staining was moderate for LDL KO and Control groups, both the S and the OS. However, for the O and T groups, the observed staining was intense. Calibration bar = 100 &#181;m.</title>
            </caption>
            <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf04.jpg"/></fig>
        </p>
        <p>
          <fig id="f5">
            <label>Figure 5</label>
            <caption>
              <title>Photomicrographs of cross-sections of the ascending aorta of mice submitted to immunohistochemical reaction for MMP-2. Note the presence of MMP-2 immunoexpression in the tunica intima (arrow) and adventitia (arrowhead) in all control groups (S-C, OS-C and OT-C). In general, the MMP-2 immunoexpression in the LDL KO groups was observed in the intima and adventitia layers, as well as in the middle layer of the aorta (*), which did not occur in any animal of the control groups. Calibration bar: 100 &#181;m.</title>
            </caption>
            <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf05.jpg"/></fig>
        </p>
        <p>
          <fig id="f6">
            <label>Figure 6</label>
            <caption>
              <title>Photomicrographs of cross-sections of the ascending aorta of mice submitted to immunohistochemical reaction for MMP-9. Note the presence of immunoexpression in all layers, heterogeneously, in all groups. Calibration bar: 100 &#181;m.</title>
            </caption>
            <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf06.jpg"/></fig>
        </p>
        <p>Apoptotic cells were distributed in the media-intima layer of the ascending aorta in all studied groups. The comparation of relative frequency showed that Ovariectomy statistically increased apoptosis in +12,6% in the sedentary group (OS-C) and +19% in physical training group (OT-C) when compared to the apoptosis of the sedentary control group (S-C) (<xref ref-type="fig" rid="f7">Figure 7</xref>). Among the knockout groups, apoptosis rates were higher than the respective controls, regardless if the mice were ovariectomized or not. Thus, the knockout sedentary group increased apoptosis frequency in +28,8% when compared with the control group. Ovariectomy and knockout statistically increased the apoptosis in +24,5% in the sedentary (OS-LDL KO) and +32,3% in the physical training (OT-LDL KO) groups, when compared to the sedentary control group (S-C). No significant change was observed when comparing the knockout sedentary group (S-LDL-KO) to knockout ovariectomy sedentary (OS-LDL KO) or physical training (OT-LDL KO) groups, with decreased apoptosis in -4,3% and improved apoptosis in +3,5%, respectively. However, the relative frequency of ovariectomy, sedentary and physical training knockout groups showed to be statistically increased in +7,8% (<xref ref-type="fig" rid="f7">Figure 7</xref>).</p>
        <p>
          <fig id="f7">
            <label>Figure 7</label>
            <caption>
              <title>Relative frequency (%) of apoptotic cells in the ascending aorta of the control sedentary group (S-C) vs. the different evaluated groups as evidenced by the TUNEL assay. *p &lt; 0,05 vs. S-C, #p &lt; 0,05 vs. OS-C, +p &lt; 0,05 vs. OS-LDL-KO. Values are expressed as mean &#177; SD (p &lt; 0,05).</title>
            </caption>
            <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf07.jpg"/></fig>
        </p>
      </sec>
    </sec>
    <sec sec-type="discussion">
      <title>Discussion</title>
      <p>The main objective of this study was to verify the effects of moderate aerobic training on the ascending aorta of ovariectomized female mice, knockout for the low-density lipoprotein receptor LDL through the analyses of types I and III collagen fibers, the expression of 8-OHdG oxidative stress markers of MMP-2 and MMP-9 metalloproteinases.</p>
      <p>Collagen and elastin are major structural and functional components of the arterial wall. These components actively participate in arterial wall remodeling in response to hemodynamic alterations and during atherogenesis.</p>
      <p>The histopathological analysis did not show any morphological changes in the control group. However, the LDL KO group showed increased thickness and larger spacing between the elastic fibers. Some studies have demonstrated an association between an increase in intima-media thickness and the occurrence of cardiac events,<xref ref-type="bibr" rid="B28">28</xref> which confirmed the existence of the association between increased intima-media thickness of the carotid and the presence of cardiovascular risk factors, including infection and inflammation markers. Collagen I is mostly a structural collagen; collagen III, in turn, is more frequent in pathological processes. Our results have shown that the number of cells in apoptosis were significantly lower in the control group and remained constant in the Control groups (OS-C and OT-C) and the LDL knockout groups (S-LDL KO, OS-LDL KO and OT-LDL KO), without significant differences in the percentage of apoptotic cells between the Control or LDL Knockout groups for each parameter used. However, the apoptosis process was greater in animals of LDL knockout groups, when compared with animals of the control groups, regardless if they were ovariectomized or not. This suggests that ovariectomy was not a major factor in the processes of apoptosis induction in the aorta.</p>
      <p>The high levels of LDL in the bloodstream may have been the apoptosis-inducing factor in the endothelium and the tunica media of the ascending aorta in LDL knockout groups. The endothelial dysfunction induced by LDL oxidation (ox-LDL) has been associated to the pathogenesis of atherosclerosis and other vascular disorders. It is known that the ox-LDL activates ROS release and has been associated to apoptosis and endothelium damage.<xref ref-type="bibr" rid="B29">29</xref> The apoptosis of vascular smooth muscle cells (VSMC) is associated with the occurrence of vascular diseases. In atherosclerosis, cell apoptosis induction has been associated with atherosclerotic plaque rupture, clotting, vessel remodeling, tunica media atrophy, aneurysm formation and calcification.<xref ref-type="bibr" rid="B30">30</xref> Furthermore, in various human diseases such as Marfan syndrome and cystic necrosis of the tunica media (CMN), the apoptotic processes results in higher breakage of the elastic fibers, abnormal extracellular matrix deposition and tunica media expansion.<xref ref-type="bibr" rid="B31">31</xref> In this environment, the release of interleukin IL1&#945; and IL8, as well as the chemoattractant protein expression of monocytes (MCP-1) occurs during the VSMC apoptosis, which have causes infiltrating macrophages <italic>in vivo</italic>, increasing the observed tissue damage.<xref ref-type="bibr" rid="B32">32</xref>
			</p>
      <p>The animals of the OT-C group showed a higher number of apoptotic cells compared to the OS-C and S-C groups (p &lt; 0,05). Physical activity has been associated with increased apoptosis levels in rats&#8217; thymocyte, mice skeletal muscle and lymphocytes.<xref ref-type="bibr" rid="B33">33</xref><sup>,</sup><xref ref-type="bibr" rid="B34">34</xref> Oxidative stress resulting from metabolism in physical activities has been largely associated to apoptosis. In patients with cardiovascular diseases, the deficiency in nitric oxide (NO) production, associated with oxidative stress, results in a decline of NO bioavailability, inducing apoptosis of endothelial cells and therefore, resulting in endothelial dysfunction.<xref ref-type="bibr" rid="B35">35</xref> The ovariectomized animals showed a higher percentage of apoptotic cells than the trained and sedentary control groups (OT-C and OS-C). This suggests that decreased hormone production may be related to a reduction in antioxidative effects on the body.</p>
      <p>8-OHdG is one of the main oxidative products of DNA, which is considered a reliable marker of oxidative DNA damage. Thus, 8-OHdG has been widely used as a sensitive biomarker of oxidative stress.<xref ref-type="bibr" rid="B36">36</xref> The immunohistochemical analysis of 8-OHdG showed staining in all groups; however, the trained groups showed higher intensity staining. Goto et al.,<xref ref-type="bibr" rid="B9">9</xref> found that high-intensity exercise increases 8-OHdG levels in the plasma, which explains the higher degree of staining in the trained groups.</p>
      <p>There were differences in MMP-2 expression, and the control group showed staining in the intima and adventitia layers, while the LDL KO group showed staining in the tunica media. According to Sakalihasan et al.,<xref ref-type="bibr" rid="B37">37</xref> this occurs because the atherosclerotic lesion causes the migration of MMP-2 at the ends and at a lower quantity in normal tissue, for the tunica media, i.e., the formation of atherosclerotic plaques activates a set of chain reactions, which can increase the amount of MMP-2 present in the tissue. With regard to the MMP-9 expression, all groups showed tissue staining, but without a pattern. No evidence explaining this heterogeneous staining was found.</p>
    </sec>
    <sec sec-type="conclusions">
      <title>Conclusion</title>
      <p>The experimental model analyzed shows histomorphometric changes with increased expression of 8-OHdG in trained groups. An increase in the apoptosis rate was observed in the trained groups and the LDL KO ovariectomized group. The groups stained with MMP-2 showed migration and its increased expression in the tunica media of LDL KO groups. However, the MMP-9 staining appeared in all groups, but did not follow a homogeneous pattern. Finally, studies on the expression of metalloproteinases in cardiac muscle tissues with atherosclerosis are very scarce, suggesting the need for further studies to investigate the issue. Thus, the results described herein suggest that moderate-intensity aerobic exercise in ovariectomized mice associated to an increase in LDL rates possibly increases oxidative stress and apoptosis induction. </p>
      <p>The evaluation of the parameters under study (MMPs, apoptosis and 8-OHdG) was performed by immunohistochemistry. However, other more sensitive technologies (such as molecular biology ones) could be used in these assessments, leading to more precise results and interpretations.</p>
    </sec>
  </body>
  <back>
    <fn-group>
      <fn fn-type="financial-disclosure">
        <p>
          <bold>Sources of Funding</bold>
        </p>
        <p>There were no external funding sources for this study.</p>
      </fn>
      <fn fn-type="other">
        <p>
          <bold>Study Association</bold>
        </p>
        <p>This study is not associated with any thesis or dissertation work.</p>
      </fn>
      <fn fn-type="other">
        <p>
          <bold>Ethics approval and consent to participate</bold>
        </p>
        <p>This study was approved by the Ethics Committee on Animal Experiments of the Universidade de S&#227;o Judas Tadeu under the protocol number 058/2007.</p>
      </fn>
    </fn-group>
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  <sub-article article-type="translation" id="s1" xml:lang="pt">
    <front-stub>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Artigo Original</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Avalia&#231;&#227;o de Fibras de Col&#225;geno, MMP2, MMP9, 8-OH-Dg e Apoptose na Aorta de Ratas LDL Nocaute Ovariectomizadas Submetidas a Exerc&#237;cio Aer&#243;bico</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Maifrino</surname>
            <given-names>Laura Beatriz M.</given-names>
          </name>
          <xref ref-type="aff" rid="aff5">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Lima</surname>
            <given-names>Nathalia E. A. de</given-names>
          </name>
          <xref ref-type="aff" rid="aff5">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Marques</surname>
            <given-names>Mara R.</given-names>
          </name>
          <xref ref-type="aff" rid="aff6">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Cardoso</surname>
            <given-names>Clever G.</given-names>
          </name>
          <xref ref-type="aff" rid="aff6">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Souza</surname>
            <given-names>Lidiane B. de</given-names>
          </name>
          <xref ref-type="aff" rid="aff7">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Tom&#233;</surname>
            <given-names>Tabata de Carvalho</given-names>
          </name>
          <xref ref-type="aff" rid="aff7">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Quintana</surname>
            <given-names>Hananiah Tardivo</given-names>
          </name>
          <xref ref-type="aff" rid="aff7">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Oliveira</surname>
            <given-names>Flavia de</given-names>
          </name>
          <xref ref-type="aff" rid="aff7">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0001-9930-7747</contrib-id>
          <name>
            <surname>Reis</surname>
            <given-names>Beatriz da Costa Aguiar Alves</given-names>
          </name>
          <xref ref-type="aff" rid="aff8">4</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Fonseca</surname>
            <given-names>Fernando Luiz Affonso</given-names>
          </name>
          <xref ref-type="aff" rid="aff8">4</xref>
        </contrib>
      </contrib-group>
      <aff id="aff5">
        <label>1</label>
        <institution content-type="original">Universidade S&#227;o Judas Tadeu, S&#227;o Paulo, SP - Brasil</institution>
      </aff>
      <aff id="aff6">
        <label>2</label>
        <institution content-type="original">Universidade Federal de Goi&#225;s, Goi&#226;nia, GO - Brasil</institution>
      </aff>
      <aff id="aff7">
        <label>3</label>
        <institution content-type="original">Departamento de Bioci&#234;ncias da Universidade Federal de S&#227;o Paulo, S&#227;o Paulo, SP - Brasil</institution>
      </aff>
      <aff id="aff8">
        <label>4</label>
        <institution content-type="original">Faculdade de Medicina do ABC, Santo Andr&#233;, SP - Brasil</institution>
      </aff>
      <author-notes>
        <fn fn-type="con">
          <p>
            <bold>Contribui&#231;&#227;o dos autores</bold>
          </p>
          <p>Concep&#231;&#227;o e desenho da pesquisa: Maifrino LBM, Souza LB, Quintana HT, Fonseca FLA; obten&#231;&#227;o de dados: Maifrino LBM, Lima NEA, Cardoso CG, Souza LB, Oliveira F, Fonseca FLA; an&#225;lise e interpreta&#231;&#227;o dos dados: Lima NEA, Cardoso CG, Souza LB, Tom&#233; TC, Oliveira F, Reis BCAA; an&#225;lise estat&#237;stica: Marques MR, Quintana HT, Oliveira F; obten&#231;&#227;o de financiamento: Maifrino LBM; reda&#231;&#227;o do manuscrito: Maifrino LBM, Lima NEA, Marques MR, Souza LB, Oliveira F, Reis BCAA; revis&#227;o cr&#237;tica do manuscrito quanto ao conte&#250;do intelectual importante: Maifrino LBM, Marques MR, Cardoso CG, Tom&#233; TC, Reis BCAA, Fonseca FLA.</p>
        </fn>
        <fn fn-type="conflict">
          <p>
            <bold>Potencial conflito de interesses</bold>
          </p>
          <p>Declaro n&#227;o haver conflito de interesses pertinentes.</p>
        </fn>
      </author-notes>
      <abstract>
        <title>Resumo</title>
        <sec>
          <title>Fundamento:</title>
          <p>Na menopausa, h&#225; maior exposi&#231;&#227;o celular ao estresse oxidativo, relacionada &#224; diminui&#231;&#227;o dos efeitos antioxidantes do estrog&#234;nio. Essas altera&#231;&#245;es metab&#243;licas favorecem a progress&#227;o das doen&#231;as cardiovasculares, como a aterosclerose. A fun&#231;&#227;o anormal da aorta - a art&#233;ria mais importante - est&#225; associada a muitas doen&#231;as cardiovasculares. O col&#225;geno, especialmente os tipos I e III, &#233; um dos mais importantes componentes da parede da aorta e pode ser afetado por muitos fatores, incluindo a menopausa. Por sua vez, 8-OHdG &#233; um dos principais marcadores de danos oxidativos do DNA induzidos por esp&#233;cies reativas de oxig&#234;nio (EROS).</p>
        </sec>
        <sec>
          <title>Objetivo:</title>
          <p>Investigar os efeitos do treinamento aer&#243;bico moderado na aorta ascendente de camundongos f&#234;meas, nocaute para LDL (LDL-KO) e ovariectomizadas.</p>
        </sec>
        <sec>
          <title>M&#233;todos:</title>
          <p>Um total de 15 animais C57BL/6 e 15 animais LDL-KO foram divididos em grupos experimentais. A espessura e a densidade de volume das fibras de col&#225;geno tipos I e III foram realizadas por an&#225;lise morfoquantitativa; MMP-2 e MMP-9 e 8-OHdG foram detectadas por imunohistoqu&#237;mica; e a apoptose foi detectada pelo ensaio TUNEL. O n&#237;vel de signific&#226;ncia adotado para todos os testes realizados foi p &lt; 0,05.</p>
        </sec>
        <sec>
          <title>Resultados:</title>
          <p>o exerc&#237;cio causa aumento da espessura da aorta em grupos LDL-KO, particularmente acentuada em grupos ovariectomizados. As fibras de col&#225;geno de tipo I mostraram aumento da densidade de volume influenciado pelo treinamento em animais controle e LDL-KO. A densidade do col&#225;geno tipo III diminuiu em ambos os grupos. A MMP-2 mostrou imunomarca&#231;&#227;o moderada na t&#250;nica m&#233;dia em animais LDL-KO; em grupos controle, a MMP-9 marcou irregularmente em todos os tecidos. O marcador 8-OHdG foi mais forte nos grupos de treinamento de exerc&#237;cios. Al&#233;m disso, a ovariectomia, o treinamento f&#237;sico e os tratamentos de LDL-KO aumentaram a apoptose.</p>
        </sec>
        <sec>
          <title>Conclus&#227;o:</title>
          <p>Esses resultados sugerem que exerc&#237;cios aer&#243;bicos de intensidade moderada em camundongos ovariectomizados associados ao aumento da taxa de LDL, possivelmente, aumentam o estresse oxidativo e a indu&#231;&#227;o da apoptose. </p>
        </sec>
      </abstract>
      <kwd-group xml:lang="pt">
        <title>Palavras-chave:</title>
        <kwd>Ratos</kwd>
        <kwd>Doen&#231;as Cardiovasculares</kwd>
        <kwd>Menopausa</kwd>
        <kwd>Col&#225;genos Fibrilares/an&#225;lise</kwd>
        <kwd>Ovariectomia</kwd>
        <kwd>Exerc&#237;cio</kwd>
        <kwd>LDL-Colesterol</kwd>
      </kwd-group>
    </front-stub>
    <body>
      <sec sec-type="intro">
        <title>Introdu&#231;&#227;o</title>
        <p>A menopausa &#233; um per&#237;odo durante o qual as mulheres sofrem altera&#231;&#245;es no perfil metab&#243;lico devido &#224; diminui&#231;&#227;o da produ&#231;&#227;o de horm&#244;nios como o estrog&#234;nio.<xref ref-type="bibr" rid="B1">1</xref><sup>-</sup><xref ref-type="bibr" rid="B3">3</xref> Essas altera&#231;&#245;es metab&#243;licas favorecem a progress&#227;o de doen&#231;as cardiovasculares, como a aterosclerose.<xref ref-type="bibr" rid="B4">4</xref> A fun&#231;&#227;o anormal da aorta - a art&#233;ria mais importante - est&#225; associada a muitas doen&#231;as cardiovasculares. O col&#225;geno, especialmente os tipos I e III, &#233; um dos mais importantes componentes da parede da aorta e pode ser afetado por v&#225;rios fatores, incluindo a menopausa.<xref ref-type="bibr" rid="B5">5</xref>
				</p>
        <p>Exerc&#237;cios f&#237;sicos s&#227;o recomendados para preven&#231;&#227;o de doen&#231;as cardiovasculares durante a menopausa.<xref ref-type="bibr" rid="B6">6</xref><sup>,</sup><xref ref-type="bibr" rid="B7">7</xref> No entanto, a atividade f&#237;sica de intensidade moderada a alta provoca aumento do estresse oxidativo em c&#233;lulas e tecidos, elevando o risco de doen&#231;a cardiovascular.<xref ref-type="bibr" rid="B8">8</xref><sup>-</sup><xref ref-type="bibr" rid="B10">10</xref> A adapta&#231;&#227;o do corpo ao estresse oxidativo pode estar prejudicada em indiv&#237;duos com baixos n&#237;veis de estrog&#234;nio, que se liga a receptores celulares espec&#237;ficos e acelera a produ&#231;&#227;o de v&#225;rios antioxidantes pelas c&#233;lulas.</p>
        <p>Pouco se sabe sobre os efeitos da atividade f&#237;sica no desenvolvimento da aterosclerose e altera&#231;&#245;es metab&#243;licas caracter&#237;sticas da menopausa. Dados relevantes para a elucida&#231;&#227;o destes efeitos foram obtidos com o uso de marcadores como a 8-hidroxidesoxiguanosina (8-OHdG), metaloproteinases (MMPs), detec&#231;&#227;o de apoptose e quantifica&#231;&#227;o de col&#225;geno tipos III e I. A 8-OHdG &#233; um dos principais marcadores de dano oxidativo do DNA induzido por esp&#233;cies reativas de oxig&#234;nio (EROs).<xref ref-type="bibr" rid="B11">11</xref><sup>,</sup><xref ref-type="bibr" rid="B12">12</xref> As MMPs desempenham pap&#233;is-chave na fun&#231;&#227;o de v&#225;rios tecidos durante o crescimento, desenvolvimento e envelhecimento do organismo.<xref ref-type="bibr" rid="B13">13</xref><sup>-</sup><xref ref-type="bibr" rid="B17">17</xref> A atividade excessiva ou desequilibrada das MMPs est&#225; associada &#224; patog&#234;nese de muitas doen&#231;as,<xref ref-type="bibr" rid="B18">18</xref><sup>,</sup><xref ref-type="bibr" rid="B19">19</xref> dentre elas, doen&#231;as cardiovasculares, como a aterosclerose.<xref ref-type="bibr" rid="B20">20</xref>
				</p>
        <p>A detec&#231;&#227;o de apoptose em tecidos &#233; um marcador relacionado &#224; les&#227;o mitocondrial, &#224; produ&#231;&#227;o de EROs e ao estresse oxidativo. Na apoptose, a quebra do DNA resulta em v&#225;rios fragmentos com terminais 3&#8217;-OH livres. A identifica&#231;&#227;o das c&#233;lulas submetidas ao processo de apoptose consiste em detectar enzimaticamente os terminais 3&#8217;-OH livres com a adi&#231;&#227;o de nucleot&#237;deos modificados pela enzima TdT (terminal desoxinucleotidil transferase).</p>
        <p>Assim, nosso objetivo foi verificar os efeitos do treinamento aer&#243;bio moderado na aorta ascendente de camundongos f&#234;meas nocaute para receptor de lipoprote&#237;na de baixa densidade - LDL e ovariectomizados.</p>
      </sec>
      <sec sec-type="methods">
        <title>M&#233;todos</title>
        <sec>
          <title>Animais e forma&#231;&#227;o dos grupos</title>
          <p>Os experimentos foram realizados em 15 camundongos f&#234;meas C57BL/6 e 15 camundongos f&#234;meas nocaute para receptor de lipoprote&#237;na de baixa densidade (LDL-KO), pesando 20-25 g, doo Biot&#233;rio da Universidade S&#227;o Judas Tadeu, S&#227;o Paulo, Brasil. Os camundongos receberam a ra&#231;&#227;o padr&#227;o de laborat&#243;rio e &#225;gua <italic>ad libitum</italic>. Os animais foram colocados em gaiolas em uma sala com temperatura controlada (22&#176;C) e ciclo claro-escuro de 12 horas. Todos os procedimentos e protocolos cir&#250;rgicos foram aprovados pelo Comit&#234; do Uso Experimental de Animais da Universidade S&#227;o Judas Tadeu (058/2007). Ap&#243;s uma randomiza&#231;&#227;o simples, os camundongos foram divididos em seis grupos (n = 5): controle sedent&#225;rio (CS), controle sedent&#225;rio ovariectomizado (CSO), controle treinado ovariectomizado (CTO), LDL KO sedent&#225;rio (S-LDL KO), LDL KO sedent&#225;rio ovariectomizado (SO-LDL KO) e LDL KO treinado ovariectomizado (TO-LDL KO). Os animais foram separados fisicamente e aleatoriamente entre os grupos/caixas.</p>
          <p>A defini&#231;&#227;o do tamanho da amostra foi realizada segundo dados anteriores de outros autores,<xref ref-type="bibr" rid="B21">21</xref><sup>-</sup><xref ref-type="bibr" rid="B23">23</xref> baseada nas recomenda&#231;&#245;es da Instru&#231;&#227;o Normativa n&#186; 27 do CONCEA (Conselho Nacional de Controle de Experimenta&#231;&#227;o Animal) e determinada pela f&#243;rmula n = (2&#945; / 2&#948;) 2 / E,<xref ref-type="bibr" rid="B24">24</xref> onde n representa o tamanho da amostra; (2&#945;)<xref ref-type="bibr" rid="B2">2</xref> representa um valor cr&#237;tico que corresponde ao grau de confian&#231;a desejado, &#948; representa o desvio padr&#227;o da popula&#231;&#227;o e E representa a margem de erro (diferen&#231;a entre a m&#233;dia da amostra e a m&#233;dia da popula&#231;&#227;o verdadeira).</p>
        </sec>
        <sec>
          <title>Ovariectomia</title>
          <p>Aos nove meses de idade, os animais foram anestesiados (cetamina 120 mg/kg + xilazina 20 mg/kg), e uma pequena incis&#227;o abdominal foi realizada, onde os ov&#225;rios e ovidutos foram encontrados, seccionados e removidos. Em seguida, a pele e a parede muscular foram suturadas.<xref ref-type="bibr" rid="B25">25</xref><sup>,</sup><xref ref-type="bibr" rid="B26">26</xref> A efic&#225;cia da ovariectomia foi determinada pela observa&#231;&#227;o das secre&#231;&#245;es vaginais durante quatro dias consecutivos.</p>
        </sec>
        <sec>
          <title>Protocolo de treinamento</title>
          <p>Sete dias ap&#243;s a ovariectomia, todos os animais foram adaptados na esteira por dez minutos durante tr&#234;s dias antes de iniciar o treinamento. O teste de esfor&#231;o m&#225;ximo foi realizado em todos os grupos no in&#237;cio e no final do programa de treinamento, fornecendo a base para a prescri&#231;&#227;o do treinamento f&#237;sico e com o objetivo de avaliar a capacidade f&#237;sica dos animais treinados.</p>
          <p>Os grupos treinados foram submetidos a um protocolo de treinamento f&#237;sico moderado em esteira ergom&#233;trica, com velocidade e carga progressivas (1 hora ao dia / 5 dias por semana a 50-60% da velocidade m&#225;xima de esfor&#231;o) durante 4 semanas, conforme descrito anteriormente.<xref ref-type="bibr" rid="B27">27</xref>
					</p>
        </sec>
        <sec>
          <title>Procedimentos histol&#243;gicos</title>
          <p>Ao final do experimento, os animais foram pesados e subsequentemente submetidos a eutan&#225;sia por decapita&#231;&#227;o. A toracotomia foi realizada cortando-se a aorta ascendente na base do cora&#231;&#227;o. As amostras da aorta foram lavadas (PBS - solu&#231;&#227;o salina tamponada com fosfato 0,1M, pH 7,4) e fixadas em formalde&#237;do a 10% por 24 horas. Eles ent&#227;o foram desidratadas, limpas e embebidas em parafina. A aorta foi seccionada transversalmente (5&#181;m de espessura), e as amostras foram coradas com H&amp;E para an&#225;lise histomorfom&#233;trica.<xref ref-type="bibr" rid="B7">7</xref> Para analisar os efeitos do treinamento aer&#243;bico na aorta inteira, a t&#250;nica &#237;ntima n&#227;o foi separada da t&#250;nica m&#233;dia. A colora&#231;&#227;o de Picrosirius foi utilizada para classifica&#231;&#227;o das fibras de col&#225;geno I e III. As imagens foram capturadas em 4 pontos, a 0&#186;, 90&#186;, 180&#186; e 270&#186;, com amplia&#231;&#227;o de 10x para medir a espessura da aorta e 40x para outras avalia&#231;&#245;es, e transferidas para um programa de an&#225;lise de imagens (Axion Visio Software, Zeiss<sup>&#174;</sup>). Para analisar a densidade volum&#233;trica das fibras col&#225;genas tipos I e III, as imagens foram obtidas em microsc&#243;pio &#243;tico com luz polarizada, analisadas em sistema teste de 252 pontos, e os valores expressos em porcentagens.</p>
        </sec>
        <sec>
          <title>An&#225;lise imunohistoqu&#237;mica: 8-OHdG, MMP-2 e MMP-9</title>
          <p>Cinco se&#231;&#245;es transversais de 4 &#181;m, montadas em l&#226;minas previamente silanizadas, foram utilizadas para demonstrar a express&#227;o de 8-OHdG, MMP-2 e MMP-9. As l&#226;minas foram ent&#227;o desparafinizadas, limpas, hidratadas e lavadas em &#225;gua corrente. Em seguida, a atividade da peroxidase end&#243;gena foi bloqueada com per&#243;xido de hidrog&#234;nio a 0,3%, o bloqueio de prote&#237;nas foi realizado com leite desnatado a 0,3% dilu&#237;do em PBS e as l&#226;minas foram incubadas durante a noite com anticorpo prim&#225;rio anti-8-OHdG (SC66036 Santa Cruz<sup>&#174;</sup> Biotechnology, CA, EUA), titulado a 1:100 e MMP2/72KDa e MMP9/KDa (SC-10436 Santa Cruz&#174; Biotechnology, CA, EUA; SC-6840 Santa Cruz&#174; Biotechnology, CA, EUA),titulado a 1: 150 em PBS-BSA 0,1%. Todas as l&#226;minas foram ent&#227;o colocadas numa c&#226;mara &#250;mida a 4&#176;C durante a noite.</p>
          <p>O material foi lavado com tamp&#227;o PBS e incubado com anticorpo secund&#225;rio biotinilado. Para revela&#231;&#227;o, o substrato cromog&#234;nico 3-3&#8217; diaminobenzidina foi utilizado na propor&#231;&#227;o de 0,06 g por 100 mL de PBS, e 1 mL de H<sub>2</sub>O<sub>2</sub> a 20 volumes por cinco minutos a 37 &#176;C e contra-corado com hematoxilina de Mayer por 3 minutos. Finalmente, as l&#226;minas foram montadas com lam&#237;nula e Entellan<sup>&#174;</sup> para an&#225;lise sob microscopia &#243;tica.</p>
        </sec>
        <sec>
          <title>Investiga&#231;&#227;o da morte celular por apoptose pelo m&#233;todo imunocitoqu&#237;mico de TUNEL</title>
          <p>A colora&#231;&#227;o TUNEL (<italic>Terminal deoxynucleotidyl transferase dUTP nick end labeling</italic>) foi realizada utilizando-se o kit ApopTag Peroxidase <italic>In Situ</italic> Apoptosis Detection (Millipore<sup>&#174;</sup>, Alemanha) de acordo com as instru&#231;&#245;es do fabricante.</p>
        </sec>
        <sec>
          <title>Quantifica&#231;&#227;o de c&#233;lulas apopt&#243;ticas</title>
          <p>Para a quantifica&#231;&#227;o das c&#233;lulas imunomarcadas para apoptose, foram capturadas 30 imagens da camada &#237;ntima-m&#233;dia (10 imagens/animal; n = 3 animais/grupo), com aumento de 10x para medir a espessura da aorta e 40x para outras avalia&#231;&#245;es, e transferidas para um programa de an&#225;lise de imagens (Axion Visio Software, Zeiss<sup>&#174;</sup>) para cada grupo experimental.</p>
          <p>Para cada imagem, o n&#250;mero total de c&#233;lulas imunomarcadas foi obtido como uma frequ&#234;ncia relativa (%) em rela&#231;&#227;o ao n&#250;mero total de c&#233;lulas. O microsc&#243;pio &#243;tico acoplado a uma c&#226;mera digital (Zeiss, Alemanha) foi utilisado para obter as imagens, e as fotomicrografias foram digitalizadas com o software AxioVision (Zeiss<sup>&#174;</sup>, Alemanha).</p>
        </sec>
        <sec>
          <title>An&#225;lise estat&#237;stica</title>
          <p>Os resultados foram apresentados como m&#233;dia e desvio padr&#227;o. A an&#225;lise de vari&#226;ncia (ANOVA) e os testes post-hoc de Tukey foram aplicados adequadamente na an&#225;lise dos dados. O n&#237;vel de signific&#226;ncia para todos os testes foi de p &lt; 0,05. Os dados foram avaliados utilizando-se o software Stata 7.0. Todas as vari&#225;veis cont&#237;nuas estavam distribu&#237;das normalmente (teste de Shapiro-Wilk). Para avaliar a normalidade dos dados, foi utilizado o c&#225;lculo de Shapiro-Wilk, que mostrou que os dados estavam alocados dentro da curva de Gauss. Considerando-se um n&#237;vel de signific&#226;ncia de 5%, o teste assumiu a hip&#243;tese de normalidade para a vari&#225;vel com distribui&#231;&#227;o normal.</p>
        </sec>
      </sec>
      <sec sec-type="results">
        <title>Resultados</title>
        <sec>
          <title>An&#225;lise histopatol&#243;gica e histomorfom&#233;trica</title>
          <p>A an&#225;lise histopatol&#243;gica mostrou que os animais dos grupos controle (CS, CSO e CTO) n&#227;o apresentaram altera&#231;&#245;es no arranjo das fibras el&#225;sticas e no padr&#227;o de espessura. No entanto, os grupos dislipid&#234;micos (S-LDL KO, SO-LDL KO e TO-LDL KO) apresentaram maior espa&#231;amento entre as fibras el&#225;sticas (<xref ref-type="fig" rid="f8">Figura 1</xref>).</p>
          <p>
            <fig id="f8">
              <label>Figura 1</label>
              <caption>
                <title>Cortes transversais de aorta do camundongo mostrando o arranjo das fibras el&#225;sticas. Os grupos controle mostraram um padr&#227;o similar de arranjo e espessura das fibras el&#225;sticas. Os grupos LDL KO mostraram fibras mais espa&#231;adas e paredes dos vasos mais espessas em compara&#231;&#227;o com os controles. Fotomicrografias, H&amp;E. Barra de Calibra&#231;&#227;o = 100 &#181;m. Controle sedent&#225;rio (CS), controle sedent&#225;rio ovariectomizado (CSO), controle treinado ovariectomizado (CTO), grupo sedent&#225;rio LDL KO (S-LDL KO), grupo sedent&#225;rio ovariectomizado LDL KO (SO-LDL KO) e grupo treinado ovariectomizado LDL KO (TO-LDL KO).</title>
              </caption>
              <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf01-pt.jpg"/></fig>
          </p>
        </sec>
        <sec>
          <title>Espessura da t&#250;nica &#237;ntima-m&#233;dia (&#181;m)</title>
          <p>Observamos um aumento significativo na espessura da t&#250;nica &#237;ntima-m&#233;dia em animais dislipid&#234;micos, quando comparados aos animais dos grupos controle. A ovariectomia e o exerc&#237;cio nos grupos LDL KO foram determinantes para o aumento dessa vari&#225;vel. Tanto no grupo controle quanto no grupo LDL KO o exerc&#237;cio de treinamento n&#227;o reverteu esse processo (<xref ref-type="fig" rid="f8">Figuras 1</xref> e <xref ref-type="fig" rid="f9">2</xref>).</p>
          <p>
            <fig id="f9">
              <label>Figura 2</label>
              <caption>
                <title>Espessura da t&#250;nica &#237;ntima-m&#233;dia (&#181;m) nos grupos estudados. Os valores s&#227;o expressos como M &#177; DP * p &lt; 0,05 vs. S-C; #p &lt; 0,05 vs. OS-C; + p &lt; 0,05 vs. OT-C; &lt; p &lt; 0,05 vs S-LDL KO; 2p &lt; 0,05 vs OS-LDL KO.</title>
              </caption>
              <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf02-pt.jpg"/></fig>
          </p>
        </sec>
        <sec>
          <title>Densidade de volume das fibras de col&#225;geno tipos I e III na t&#250;nica &#237;ntima-m&#233;dia e advent&#237;cia</title>
          <p>Comportamento semelhante da fibra de col&#225;geno tipo III foi observado entre a t&#250;nica &#237;ntima-m&#233;dia e a advent&#237;cia. Observamos uma diminui&#231;&#227;o significativa na densidade de volume da fibra de col&#225;geno tipo III nos grupos LDL KO, quando comparados com o CS (<xref ref-type="fig" rid="f10">Figura 3</xref>).</p>
          <p>
            <fig id="f10">
              <label>Figura 3</label>
              <caption>
                <title>Densidade de volume das fibras de col&#225;geno tipos I e III (Vv [fc]) na T&#250;nica &#237;ntima-m&#233;dia e na advent&#237;cia da aorta ascendente. Os valores s&#227;o expressos como M &#177; DP. *p &lt; 0,05 vs. CS; #p &lt; 0,05 vs. CSO; + p &lt; 0,05 vs. STO.</title>
              </caption>
              <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf03-pt.jpg"/></fig>
          </p>
          <p>As fibras de col&#225;geno tipo I da t&#250;nica advent&#237;cia e da &#237;ntima-m&#233;dia apresentaram aumento na densidade de volume, influenciado pelo treinamento nos grupos Controle. A dislipidemia induz a um aumento das fibras de col&#225;geno tipo I nos grupos LDL KO quando comparado aos grupos Controle e n&#227;o sofreram nenhuma altera&#231;&#227;o causada pela ovariectomia ou pelo treinamento (<xref ref-type="fig" rid="f10">Figura 3</xref>).</p>
        </sec>
        <sec>
          <title>An&#225;lise imunohistoqu&#237;mica</title>
          <p>A <xref ref-type="fig" rid="f11">Figura 4</xref> mostra a colora&#231;&#227;o do tecido causada pelo marcador de estresse oxidativo 8-OHdG. Observe que a imunoexpress&#227;o do marcador ocorreu em todos os grupos. A colora&#231;&#227;o foi moderada para os grupos LDL KO e Controle, tanto Sedent&#225;rio quanto Ovariectomizado. No entanto, para os grupos Ovariectomizados e treinados, a colora&#231;&#227;o observada foi intensa.</p>
          <p>
            <fig id="f11">
              <label>Figura 4</label>
              <caption>
                <title>Fotomicrografias de cortes transversais da aorta de camundongos submetidos &#224; rea&#231;&#227;o imuno-histoqu&#237;mica para 8-OHdG. A imunoexpress&#227;o de 8-OHdG foi observada em todos os grupos investigados. A colora&#231;&#227;o foi moderada para os grupos LDL KO e Controle, tanto o S como o SO. No entanto, para os grupos O e T, a colora&#231;&#227;o observada foi intensa. Barra de calibra&#231;&#227;o = 100&#181;m.</title>
              </caption>
              <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf04-pt.jpg"/></fig>
          </p>
          <p>Em todos os grupos controle (CS, CSO e CTO), a imunoexpress&#227;o de MMP-2 ocorreu tanto na t&#250;nica &#237;ntima (seta) quanto na advent&#237;cia (cabe&#231;a de seta) da aorta ascendente. Os grupos LDL, em geral, mostraram imunoexpress&#227;o da MMP-2 al&#233;m das t&#250;nicas &#237;ntima e advent&#237;cia, mas tamb&#233;m na t&#250;nica m&#233;dia da aorta (embora muito levemente), o que n&#227;o foi observado em nenhum grupo de animais controle (<xref ref-type="fig" rid="f12">Figura 5</xref>). A MMP-9 foi expressa em todas as camadas da aorta ascendente de todos os grupos; no entanto, a distribui&#231;&#227;o foi heterog&#234;nea (<xref ref-type="fig" rid="f13">Figura 6</xref>).</p>
          <p>
            <fig id="f12">
              <label>Figura 5</label>
              <caption>
                <title>Fotomicrografias de cortes transversais da aorta ascendente de camundongos submetidos a rea&#231;&#227;o imunohistoqu&#237;mica para MMP-2. Observe a presen&#231;a de imunoexpress&#227;o para MMP-2 nas camadas &#237;ntima (seta) e advent&#237;cia (cabe&#231;a de seta) em todos os grupos de controle (CS, CSO e CTO). Em geral, a imunoexpress&#227;o de MMP-2 nos grupos LDL KO foi observada nas camadas &#237;ntima e advent&#237;cia, bem como na camada m&#233;dia da aorta (*), o que n&#227;o ocorreu em nenhum animal dos grupos controle. Barra de calibra&#231;&#227;o: 100 &#181;m</title>
              </caption>
              <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf05-pt.jpg"/></fig>
          </p>
          <p>
            <fig id="f13">
              <label>Figura 6</label>
              <caption>
                <title>Fotomicrografias de cortes transversais da aorta ascendente de camundongos submetidos a rea&#231;&#227;o imuno-histoqu&#237;mica para MMP-9. Observe a presen&#231;a de imunoexpress&#227;o em todas as camadas, de forma heterog&#234;nea, em todos os grupos. Barra de calibra&#231;&#227;o: 100 &#181;m.</title>
              </caption>
              <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf06-pt.jpg"/></fig>
          </p>
          <p>C&#233;lulas apopt&#243;ticas estavam distribu&#237;das na camada &#237;ntima-m&#233;dia da aorta ascendente em todos os grupos estudados. A compara&#231;&#227;o da frequ&#234;ncia relativa mostrou que a ovariectomia aumentou estatisticamente a apoptose em + 12,6% no grupo sedent&#225;rio (CSO) e + 19% no grupo treinamento f&#237;sico (CTO) quando comparado &#224; apoptose do grupo CS (<xref ref-type="fig" rid="f14">Figura 7</xref>). Entre os grupos nocaute, as taxas de apoptose foram maiores que os respectivos controles, independentemente se os camundongos fossem ovariectomizados ou n&#227;o. Assim, o CSO nocaute apresentou aumento da frequ&#234;ncia de apoptose em + 28,8% quando comparado ao grupo controle. A ovariectomia e nocaute aumentaram estatisticamente a apoptose em +24,5% nos grupos sedent&#225;rio (SO-LDL KO) e + 32,3% no treinamento f&#237;sico (TO-LDL KO), quando comparados ao grupo CS. Nenhuma mudan&#231;a significativa foi observada quando se comparou o grupo sedent&#225;rio nocaute (S-LDL-KO) com os grupos nocaute sedent&#225;rio ovariectomizados (SO-LDL KO) ou com treinamento f&#237;sico (TO-LDL KO), com diminui&#231;&#227;o da apoptose em -4,3% e melhora apoptose em + 3,5%, respectivamente. No entanto, a frequ&#234;ncia relativa de grupos nocaute com ovariectomia, sedentarismo e treinamento f&#237;sico mostrou-se estatisticamente aumentada em +7,8% (<xref ref-type="fig" rid="f14">Figura 7</xref>).</p>
          <p>
            <fig id="f14">
              <label>Figura 7</label>
              <caption>
                <title>Frequ&#234;ncia relativa (%) de c&#233;lulas apopt&#243;ticas na aorta ascendente do grupo controle sedent&#225;rio (CS) versus os diferentes grupos avaliados, conforme evidenciado pelo ensaio TUNEL. * p &lt; 0,05 vs. CS, # p &lt; 0,05 vs. CSO, + p &lt; 0,05 vs. SO-LDL-KO. Os valores s&#227;o expressos como m&#233;dia &#177; DP (p &lt; 0,05).</title>
              </caption>
              <graphic xlink:href="1678-4170-abc-112-02-0180-80263-gf07-pt.jpg"/></fig>
          </p>
        </sec>
      </sec>
      <sec sec-type="discussion">
        <title>Discuss&#227;o</title>
        <p>O principal objetivo desse estudo foi verificar os efeitos do treinamento aer&#243;bico moderado na aorta ascendente de camundongos ovariectomizados, nocaute para o receptor de lipoprote&#237;na de baixa densidade - LDL, atrav&#233;s da an&#225;lise de fibras de col&#225;geno tipos I e III, a express&#227;o de 8-OHdG e marcadores de estresse oxidativo das MMP-2 e MMP-9.</p>
        <p>O col&#225;geno e a elastina s&#227;o importantes componentes estruturais e funcionais da parede arterial. Esses componentes participam ativamente do remodelamento da parede arterial em resposta a altera&#231;&#245;es hemodin&#226;micas e durante a aterog&#234;nese.</p>
        <p>A an&#225;lise histopatol&#243;gica n&#227;o mostrou altera&#231;&#245;es morfol&#243;gicas no grupo controle. No entanto, o grupo LDL KO apresentou maior espessura e maior espa&#231;amento entre as fibras el&#225;sticas. Alguns estudos demonstraram uma associa&#231;&#227;o entre o aumento da espessura intima-m&#233;dia e a ocorr&#234;ncia de eventos card&#237;acos,<xref ref-type="bibr" rid="B28">28</xref> o que confirmou a exist&#234;ncia da associa&#231;&#227;o entre o aumento da espessura intima-m&#233;dia da car&#243;tida e a presen&#231;a de fatores de risco cardiovascular, incluindo marcadores de infec&#231;&#227;o e inflama&#231;&#227;o. O col&#225;geno I &#233; principalmente um col&#225;geno estrutural; o col&#225;geno III, por sua vez, &#233; mais frequente em processos patol&#243;gicos. Nossos resultados mostraram que o n&#250;mero de c&#233;lulas em apoptose foi significativamente menor no grupo controle e se manteve constante nos grupos Controle (CSO e CTO) e nos grupos nocaute LDL (S-LDL KO, SO-LDL KO e TO-LDL KO), sem diferen&#231;as significativas na porcentagem de c&#233;lulas apopt&#243;ticas entre os grupos controle ou nocaute LDL para cada par&#226;metro utilizado. No entanto, o processo de apoptose foi maior nos animais dos grupos nocaute LDL, quando comparados aos animais dos grupos controle, independentemente de terem sido ovariectomizados ou n&#227;o. Isso sugere que a ovariectomia n&#227;o foi um fator importante nos processos de indu&#231;&#227;o de apoptose na aorta.</p>
        <p>Os altos n&#237;veis de LDL na corrente sangu&#237;nea podem ter sido o fator indutor de apoptose no endot&#233;lio e na t&#250;nica m&#233;dia da aorta ascendente nos grupos nocaute LDL. A disfun&#231;&#227;o endotelial induzida pela oxida&#231;&#227;o da LDL (ox-LDL) tem sido associada &#224; patog&#234;nese da aterosclerose e outros dist&#250;rbios vasculares. Sabe-se que a LDL-ox ativa a libera&#231;&#227;o de EROs e tem sido associada a apoptose e dano ao endot&#233;lio.<xref ref-type="bibr" rid="B29">29</xref> A apoptose de c&#233;lulas musculares lisas vasculares (CMLV) est&#225; associada &#224; ocorr&#234;ncia de doen&#231;as vasculares. Na aterosclerose, a indu&#231;&#227;o da apoptose celular tem sido associada &#224; ruptura da placa ateroscler&#243;tica, coagula&#231;&#227;o, remodela&#231;&#227;o vascular, atrofia da t&#250;nica m&#233;dia, &#224; forma&#231;&#227;o de aneurismas e calcifica&#231;&#227;o.<xref ref-type="bibr" rid="B30">30</xref> Al&#233;m disso, em v&#225;rias doen&#231;as humanas, como a s&#237;ndrome de Marfan e a necrose c&#237;stica da t&#250;nica m&#233;dia (NCM), os processos apopt&#243;ticos resultam em maior quebra das fibras el&#225;sticas, deposi&#231;&#227;o anormal da matriz extracelular e expans&#227;o da t&#250;nica m&#233;dia.<xref ref-type="bibr" rid="B31">31</xref> Nesse ambiente, a libera&#231;&#227;o de interleucina IL-1&#945; e IL-8, assim como a express&#227;o da prote&#237;na quimioatrativa de mon&#243;citos (MCP-1) ocorre durante a apoptose de CMLV, que causa infiltra&#231;&#227;o de macr&#243;fagos <italic>in vivo</italic>, aumentando o dano tecidual observado.<xref ref-type="bibr" rid="B32">32</xref>
				</p>
        <p>Os animais do grupo CTO apresentaram maior n&#250;mero de c&#233;lulas apopt&#243;ticas em rela&#231;&#227;o aos grupos CSO e CS (p &lt; 0,05). A atividade f&#237;sica tem sido associada ao aumento dos n&#237;veis de apoptose em tim&#243;citos de ratos, m&#250;sculo esquel&#233;tico e linf&#243;citos de camundongos.<xref ref-type="bibr" rid="B33">33</xref><sup>,</sup><xref ref-type="bibr" rid="B34">34</xref> O estresse oxidativo resultante do metabolismo em atividades f&#237;sicas tem sido amplamente associado com a apoptose. Em pacientes com doen&#231;as cardiovasculares, a defici&#234;ncia na produ&#231;&#227;o do &#243;xido n&#237;trico (NO), associada ao estresse oxidativo, resulta em um decl&#237;nio da biodisponibilidade do NO, induzindo a apoptose das c&#233;lulas endoteliais e, consequentemente, resultando em disfun&#231;&#227;o endotelial.<xref ref-type="bibr" rid="B35">35</xref> Os animais ovariectomizados apresentaram maior porcentagem de c&#233;lulas apopt&#243;ticas do que os grupos controle treinados e sedent&#225;rios (CTO e CSO). Isso sugere que a diminui&#231;&#227;o da produ&#231;&#227;o de horm&#244;nios pode estar relacionada &#224; redu&#231;&#227;o dos efeitos antioxidantes no organismo.</p>
        <p>O 8-OHdG &#233; um dos principais produtos oxidativos do DNA, que &#233; considerado um marcador confi&#225;vel de danos oxidativos ao DNA. Assim, o 8-OHdG tem sido amplamente utilizado como um biomarcador sens&#237;vel de estresse oxidativo.<xref ref-type="bibr" rid="B36">36</xref> A an&#225;lise imunohistoqu&#237;mica do 8-OHdG mostrou colora&#231;&#227;o em todos os grupos; no entanto, os grupos treinados apresentaram maior intensidade de colora&#231;&#227;o. Goto et al.,<xref ref-type="bibr" rid="B9">9</xref> em 2003, descobriram que o exerc&#237;cio de alta intensidade aumenta os n&#237;veis de 8-OHdG no plasma, o que explica o maior grau de colora&#231;&#227;o nos grupos treinados.</p>
        <p>Houve diferen&#231;as na express&#227;o de MMP-2, e o grupo controle mostrou colora&#231;&#227;o nas camadas &#237;ntima e advent&#237;cia, enquanto o grupo LDL KO mostrou colora&#231;&#227;o na camada m&#233;dia. De acordo com Sakalihasan et al.,<xref ref-type="bibr" rid="B37">37</xref> em 1996, isso ocorre porque a les&#227;o ateroscler&#243;tica causa a migra&#231;&#227;o da MMP-2 nas extremidades e em menor quantidade no tecido normal, para a camada m&#233;dia, ou seja, a forma&#231;&#227;o de placas ateroscler&#243;ticas ativa um conjunto de rea&#231;&#245;es em cadeia, o que pode aumentar a quantidade de MMP-2 presente no tecido. Com rela&#231;&#227;o &#224; express&#227;o da MMP-9, todos os grupos apresentaram colora&#231;&#227;o tecidual, mas sem um padr&#227;o. Nenhuma evid&#234;ncia foi encontrada que explicasse essa colora&#231;&#227;o heterog&#234;nea.</p>
      </sec>
      <sec sec-type="conclusions">
        <title>Conclus&#227;o</title>
        <p>O modelo experimental analisado mostra altera&#231;&#245;es histomorfom&#233;tricas com aumento da express&#227;o de 8-OHdG nos grupos treinados. Um aumento na taxa de apoptose foi observado nos grupos treinados e no grupo ovariectomizado LDL KO. Os grupos corados com MMP-2 mostraram migra&#231;&#227;o e aumento de express&#227;o na t&#250;nica m&#233;dia dos grupos LDL KO. No entanto, a colora&#231;&#227;o de MMP-9 apareceu em todos os grupos, mas n&#227;o seguiu um padr&#227;o homog&#234;neo. Por fim, estudos sobre a express&#227;o de MMPs em tecidos musculares card&#237;acos com aterosclerose s&#227;o muito escassos, sugerindo a necessidade de mais estudos para investigar o assunto. Assim, os resultados aqui descritos sugerem que o exerc&#237;cio aer&#243;bico de intensidade moderada em camundongos ovariectomizados, associado a um aumento nas taxas de LDL, possivelmente aumenta o estresse oxidativo e a indu&#231;&#227;o de apoptose.</p>
        <p>A avalia&#231;&#227;o dos par&#226;metros em estudo (MMPs, apoptose e 8-OHdG) foi realizada por imunohistoqu&#237;mica. No entanto, outras tecnologias mais sens&#237;veis (como as de biologia molecular) poderiam ser utilizadas nessas avalia&#231;&#245;es, levando a resultados e interpreta&#231;&#245;es mais precisos.</p>
      </sec>
    </body>
    <back>
      <fn-group>
        <fn fn-type="financial-disclosure">
          <p>
            <bold>Fontes de financiamento</bold>
          </p>
          <p>O presente estudo n&#227;o teve fontes de financiamento externas.</p>
        </fn>
        <fn fn-type="other">
          <p>
            <bold>Vincula&#231;&#227;o acad&#234;mica</bold>
          </p>
          <p>N&#227;o h&#225; vincula&#231;&#227;o deste estudo a programas de p&#243;s-gradua&#231;&#227;o.</p>
        </fn>
        <fn fn-type="other">
          <p>
            <bold>Aprova&#231;&#227;o &#233;tica e consentimento informado</bold>
          </p>
          <p>Este estudo foi aprovado pela Comiss&#227;o de &#201;tica em Experimenta&#231;&#227;o Animal da Universidade de S&#227;o Judas Tadeu sob o n&#250;mero de protocolo 058/2007.</p>
        </fn>
      </fn-group>
    </back>
  </sub-article>
</article>
