Vaccinia virus (VACV) is primarily known as a vaccine against its relative variola virus, the causative agent of smallpox. In the seventies of the 20th century, the vaccination campaign with VACV led to eradication of smallpox. Consequently, vaccination of the general population was stopped. Currently, the vaccination was reintroduced, namely among army and healthcare professionals. However, vaccination with VACV is accompanied with a high incidence of vaccination-related complications, namely among immunocompromised individuals. One of the complications is eczema vaccinatum, occuring in patients with atopic dermatitis. The laboratory of Dr. Melkova has focused on development of a model of eczema vaccinatum in mice Nc/Nga and on studies of pathogenesis of this complication. The goal of my diploma thesis is to contribute to characterization of imunopathogenesis of eczema vaccinatum in mice Nc/Nga infected either with VACV strain Western Reserve (WR) or with a recombinant VACV with the integrated cDNA for IRF-3 (Interferon Regulatory Factor 3; WR-IRF3). IRF-3 regulates the expression of interferon type I in response to viral infection. This recombinant virus has been constructed in the laboratory of Dr. Melková. The objective of my work was to verify the expression of the integrated cDNA for IRF-3 and to...

Orientador: Luiz Henrique de Araújo Machado / Resumo: Dermatite atópica (DA) canina é uma enfermidade alergoinflamatória de caráter crônico, da pele e orelha externa, geralmente de cães adultos jovens, induzida por distintos alérgenos. A afecção tem etiopatologia complexa e ainda não totalmente elucidada, dificilmente atingindo cura. Porém, há hoje, várias opções medicamentosas para o seu controle. O oclacitinib faz parte da recente remessa de medicamentos para tratamento e controle do prurido dos cães atópicos, com poucos efeitos colaterais. É um fármaco inibidor de janus quinase, com rápida ação e que age na ligação das citocinas aos receptores JAKs. Este trabalho teve como intuito avaliar a resposta inflamatória da pele de animais atópicos, antes e 30 dias após o tratamento com Oclacitinib comercial (Apoquel®), através da mensuração das interlucinas IL-1, IL-4, IL-6, IL-10, IL-17, IL-31, TNF-, IFN- e filagrina, pela técnica de imuno-histoquímica, além da resposta clinica ao tratamento pela avaliação do CADESI-4 e escore do prurido. Os 10 cães utilizados no estudo são provenientes do atendimento dermatológico do HV da UNESP-Botucatu e clínica particular de Sorocaba-SP. Apenas os escores do CADESI-4, do prurido e da IL-1, citocina inflamatória chave da imunidade inata e na patogênese da DA, apresentaram redução na análise estatística. Concluise que a IL-1 pode ter um papel importante na farmacocinética do oclacitinib e maiores estudos são necessários para confirmar a ação do oclacitinib sobre a produção e ligação da IL-1 aos ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Canine atopic dermatitis (DA) is a chronic inflammatory alergo disease of the skin and external ear, usually of young adult dogs, induced by distinct allergens. The disease has complex and still not fully elucidated etiopatology, hardly reaching cure. However, there are today several drug options for your control. Oclacitinib is part of the recent consignment of medications for treatment and control of the itching of atopic dogs, with few side effects. It is an inhibitor drug of Janus Kinase, with rapid action and acting in the binding of cytokines to jaks receptors. The objective of this work was to evaluate the inflammatory response of the skin of atopic animals before and 30 days after treatment with commercial oclacitinib (Apoquel®), through the measurement of interlukines il-1, IL-4, IL-6, IL-10, IL-17, IL-31, TNF-α, IFN-γ and Filagrin, by immunohistochemistry technique, in addition to clinical response to treatment by evaluation of Cadesi-4 and pruritus score. The 10 dogs used in the study are from the dermatological treatment of HV of UNESP-Botucatu and private Clinic of Sorocaba-SP. Only the scores of Cadesi4, pruritus and IL-1, the key inflammatory cytokine of innate immunity and the pathogenesis of DA, showed a reduction in the statistical analysis. It is concluded that IL-1 may play an important role in the pharmacokinetics of oclacitinib and further studies are needed to confirm the action of oclacitinib on the production and binding of IL-1 to cutaneous receptors... (Complete abstract click electronic access below) / Mestre

Dermatite atópica (DA) é uma dermatose inflamatória, de caráter crônico e recidivante, com alta prevalência mundial, caracterizada por eczema localizado ou generalizado, xerose cutânea e prurido intenso, mais comum em crianças, porém podendo acometer adultos, muitas vezes prejudicando de forma considerável a qualidade de vida dos pacientes e seus familiares. O diagnóstico de alergia inclui testes in vivo (testes cutâneos de hipersensibilidade imediata ou prick test) e testes in vitro com mensuração de anticorpos IgE no sangue. Está disponível método para detecção de alergia baseado no princípio de diagnóstico por componentes, o ImmunoCAP Immunosorbent Allergen CHIP (ImmunoCAP-ISAC) que marca a transição para o diagnóstico molecular de alergia. No presente estudo, tivemos por objetivos determinar o perfil de resposta IgE a alérgenos purificados, naturais ou recombinantes, em pacientes adultos com DA e comparar o valor do diagnóstico de alergia por componentes com métodos diagnósticos existentes. Foram selecionados 39 pacientes adultos com DA dentre aqueles Atendidos nos Ambulatórios de Alergia e Dermatologia do HCFMRP-USP. A idade dos pacientes variou de 14-66 anos (média ± DP 34,3 ± 2.1 anos), 64% mulheres. O tempo médio de doença foi de 16 anos. SCORAD médio foi de 36,6 (2-90). Média geométrica (MG) de IgE total foi 1,963 kU/L (24-63,000 kU/L). Alérgenos de ácaros foram dominantes, com sensibilização a Der p1 e a Der f1, Der p2 e Der f2 em 82% e 85% dos pacientes, com MG 27,6; 50; 39,2; 45,4 ISU-E respectivamente, seguidos de gato (38%), cachorro (36%) e pólen de gramíneas (36%). IgE para alérgenos de baratas, fungos, pólen de árvores, látex e veneno de insetos foi encontrada em menos de 20% dos pacientes em baixos níveis. Sensibilização para castanhas (33%) e camarão (31%) foram os alérgenos mais prevalentes entre os alimentos, enquanto a reatividade IgE para leite e ovo esteve presente em 10% ou menos dos pacientes, com baixos níveis de anticorpos IgE na maioria dos casos. Apenas 6 pacientes (15,4%) apresentaram IgE para o panalérgeno tropomiosina, e 3/39 (7,7%) foram negativos para todos os 112 componentes de alérgenos testados no ImmunoCAP-ISAC, com níveis de IgE total de 24, 38,7 e 156 kU/L. Concluímos que o perfil de sensibilização IgE entre os pacientes adultos com dermatite atópica difere daquele entre os pacientes com alergiarespiratória, apresentando menos sensibilização para baratas e para o panalérgeno tropomiosina, e difere ainda do perfil presente em crianças com DA, com predomínio de sensibilização IgE a castanhas e camarão, e baixa taxa de sensibilização a alérgenos de leite de vaca e ovo. / Atopic dermatitis (AD) is an inflammatory, chronic, relapsing dermatosis with a high global prevalence characterized by localized or generalized eczema, cutaneous xerosis and intense pruritus, more common in children, but it can affect adults, often causing considerable damage to the quality of life of patients and their families. The diagnosis of allergy includes in vivo tests (skin tests of immediate hypersensitivity or prick test) and in vitro tests with measurement of IgE antibodies in the blood. An allergy detection method based on the principle of component diagnosis is available, ImmunoCAP Immunosorbent Allergen CHIP (ImmunoCAP-ISAC), and marks the transition to the molecular diagnosis of allergy. In the present study, we aimed to determine the IgE response profile to purified, natural or recombinant allergens in adult patients with AD and to compare the value of component allergy diagnosis with existing diagnostic methods. Thirty-nine adult patients with AD were selected from among those attending the Outpatient Clinic of Allergy and Dermatology at HCFMRP-USP. The age of the patients ranged from 14-66 years (mean ± SD 34,3 ± 2.1 years), 64% women. The mean duration of illness was 16 years. SCORAD mean was 36,6 (2- 90). Geometric mean (GM) of total IgE was 1,963 kU / L (24-63,000 kU / L). Mite allergens were dominant, with sensitization to Der p1 and Der f1, Der p2 and Der f2 in 82% and 85% of the patients, with GM 27,6; 50; 39.2; 45.4 ISU-E respectively, followed by cat (38%), dog (36%) and grass pollen (36%). IgE for cockroach, fungus, tree pollen, latex and insect venom allergens was found in less than 20% of patients at low levels. Sensitization to nuts (33%) and shrimp (31%) were the most prevalent allergens among foods, while IgE reactivity to milk and egg was present in 10% or less of the patients, with low levels of IgE antibodies in most cases. Only 6 patients (15.4%) presented IgE for the pan-allergen tropomyosin, and 3/39 (7.7%) were negative for all 112 allergen components tested on ImmunoCAP-ISAC, with total IgE levels of 24; 38,7 and 156 kU / L. We concluded that the IgE sensitization profile among adult patients with atopic dermatitis differs from that among patients with respiratory allergy, presenting less sensitization to cockroaches and to the pan-allergen tropomyosin, andalso differs from the profile present in children with AD, with a predominance of IgE sensitization to nuts and shrimp, and low sensitization rate to cow\'s milk and egg allergens.

Background: Staphylococcus aureus is an important trigger of flares in atopic dermatitis. The exact mechanisms by which S. aureus induces inflammatory responses and cell death in the skin epithelium is unclear. The aim of this thesis was to elucidate the cellular and molecular mechanisms by which S. aureus induces it's pathogenic effects on keratinocyte and fibroblast cell lines. Methods: Human keratinocytes (HEKa), and mouse embryonic fibroblasts (MEF) from the NC/Nga dermatitis prone mouse strain were used to investigate the induction of Th2-promoting cytokines (IL-33 and TSLP) and cell death by S. aureus. Cytokine levels were measured by ELISA and cytotoxicity by flow cytometry. Results: Live, but not killed S. aureus or other staphylococcal species, induced release of Th2-promoting cytokines (IL-33 and TSLP) and necrosis in both human and mouse cell lines. Cytokines were not induced by TLR2 ligands, and anti-TLR2 antibodies did not inhibit release, suggesting that the TLR2 pathway was not involved. By contrast, the release of cytokines was induced by a secreted, heat-labile factor/s and could be blocked by protease and PAR2 inhibitors, suggesting that the protease-PAR2 pathway was critical. NC/Nga mouse fibroblasts that lacked soluble IL-33 (sST2) receptor were more sensitive to the effects of S. aureus than control MEF. Conclusions: S. aureus is unique amongst staphylococcal species in it's ability to induce an inflammatory response and cytotoxicity in human keratinocytes and mouse fibroblasts. The protease-PAR2 pathway is critical to this bioactivity. Development of specific inhibitors of this pathway may provide novel therapies for treating S. aureus -induced eczema flares.

Metagenomics, or genomic sequence of the community of microbiota (bacteria, fungi, virus), enables an investigation of the full complement of genetic material, including virulence, antibiotic resistance, and strain differentiating markers. The granularity to distinguish between closely related strains is important as within one species, these strains possess distinct functions and relationships to a host. To analyze metagenomic samples, I developed a reference-based approach that utilizes both single nucleotide variants and genetic content to assign species and strain-level designations. After refining this approach with complex simulated communities, I utilized it to analyze the microbial communities present in skin samples from healthy and diseased individuals. First, to investigate strain-level heterogeneity in healthy adults, I focused on the common skin commensals Propionibacterium acnes and Staphylococcus epidermidis with well-documented sequence variation. Results indicated that an individual’s strains of P. acnes are shared across multiple sites of his or her body, and that those strains are more similar within than between individuals. For S. epidermidis, in addition to individual site similarities, there were also site-specific strains. Overall these results emphasize that both individuality and site specificity shape our bodies’ microbial communities. Based on longitudinal data, an individual’s strain signatures remain stable for up to a year despite external, environmental perturbations. I then used metagenomic data to explore microbial temporal dynamics in atopic dermatitis (AD; eczema), an inflammatory skin disease commonly associated with Staphylococcal species. Species-level investigation of AD flares demonstrated a microbial dichotomy in which S. aureus predominated on more severely affected patients while S. epidermidis predominated on less severely affected patients. Strain-level analysis determined that S. aureus-predominant patients were monocolonized with distinct S. aureus strains, while all patients had heterogeneous S. epidermidis strain communities. To assess the host immunologic effects of these species, I topically applied patient-derived strains to mice. AD strains of S. aureus were sufficient to elicit a skin immune response, characteristic of AD patients. This suggests a model whereby staphylococcal strains contribute to AD progression through activation of the host immune system. Overall, this strain-level analysis of healthy and disease communities provides previously unexplored resolution of human skin microbiome. / 2018-03-24T00:00:00Z

Purpose To estimate susceptibility to smoking among never-smoking youth globally and identify factors associated with such behavior. Methods Cross-sectional data for 168 countries were obtained from the Global Youth Tobacco Survey. Simple and multiple logistic regression analyses were conducted. Frequencies and proportions for descriptive statistics, and adjusted odds ratios with 95% confidence intervals for logistic regression models were reported. Results Approximately 12.5% of never-smoking youth worldwide were susceptible to smoking worldwide, of which 7.2% were males and 5.3% were females. Compared with youth in the Americas, those in other WHO regions were associated with decreased susceptibility to smoking. Regardless of gender, exposure to parental or peer smoking, secondhand smoke inside or outside home, and tobacco industry promotion was associated with increased smoking susceptibility. In contrast, support for smoke-free policies and school antismoking education was associated with decreased susceptibility to smoking among females. Moreover, exposure to antismoking media messages was associated with increased susceptibility to smoking among never-smoking youth. Conclusions Approximately 1 in 8 never-smoking youth worldwide was found to be susceptible to smoking. A comprehensive approach involving parental and peer education, smoke-free policies, ban on tobacco advertising and promotions, and antismoking education in schools should be developed by policy makers and public health professionals to protect never-smoking youth from being susceptible to smoking and transforming into future regular smokers.

In verschiedenen Studien konnte eine Korrelation im Auftreten von Übergewicht bzw. Adipositas und Asthma bronchiale sowohl bei Erwachsenen als auch bei Kindern festgestellt werden. Als Hintergrund für diesen Zusammenhang werden aktuell verschiedene Theorien, die die biochemischen, genetischen und Lebensstil-abhängigen Ursachen betrachten, diskutiert. In dieser Arbeit wurden die Ursachen für Übergewicht und Asthma sowie der Zusammenhang zwischen beiden Erkrankungen innerhalb der LISA-Studie untersucht. Hierbei handelt es sich um eine prospektive Geburtskohortenstudie, wobei insgesamt 3097 Neugeborene zwischen 1997-1999 aus 4 verschiedenen deutschen Städten rekrutiert worden sind. In regelmäßigen zeitlichen Abständen wurden mittels standardiesierten Fragebögen Daten zu Lebensbedingungen und Gesundheitszustand der Kinder erhoben. Als statistische Methode wurden vorwiegend logistische Modelle erstellt, sodass Odds Ratios in einem multivariaten Zusammenhang angegeben werden konnten. Ergebnisse: Als signifikante Risikofaktoren für Übergewicht im Alter von 5 Jahren stellten sich heraus: Mütterliches Übergewicht (OR: 2,05; KI:1,22-3,46), väterliches Übergewicht (OR: 1,77; KI: 1,02-3,06). Rauchen der Mutter im 1. Trimenon der Schwangerschaft (OR: 2,10; KI: 1,16-3,80). Geburtsgewicht des Kindes > 90. Perzentile (OR: 2,80; KI: 1,63-4,80). Niedriger Bildungsstand der Eltern (OR: 3,41; KI: 2,04-5,71), Zeitdauer,die pro Tag vor einem Bildschirm verbracht wird, > 1 Stunde (OR: 2,12; KI: 1,23-3,65). Für die Entwicklung eines Asthma bronchiale bis zum 6. Lebensjahre wirkten in der LISA-Studie folgende Faktoren als signifikante Einflüsse: eine positive Familienanamnese (OR: 4,57; KI: 2,69 – 7,77), ein männliches Geschlecht ( OR: 1,70; KI: 1,02 – 2,83), Rauchen während der Schwangerschaft ( OR: 2,05; KI: 1,04 – 4,02), Wohnen an einer Haupstraße bis zum 6. Lebensmonat (OR:1,72; KI:1,02 – 2,95) sowie das Renovieren der Wohnung während der Schwangerschaft und im 1. Lebensmonat (OR: 2,13; KI: 1,03 – 4,39). Anhand unserer Daten konnte insgesamt eher geschlossen werden, dass bei dem besprochenen Zusammenhang Übergewicht bzw. Adipositas den Risikofaktor für Asthma bronchiale darstellen. Bei der Untersuchung im logistischen Modell waren hierbei ein sehr hoher Geburts-BMI (OR: 2,06; KI: 0,95 – 4,47) und Übergewicht im Alter von 5 Jahren (OR: 2,26, KI: 0,93 – 5,50) in der Tendenz als Risikofaktor zu sehen. Für Adipositas mit 5 Jahren konnte auch im logistischen Modell ein signifikanter Einfluss auf die Entwicklung eines Asthma bronchiale gesehen werden (OR: 6,48; KI: 1,91 – 21,96 )

The prevalence of childhood allergic diseases has been increasing in Taiwan. In Taipei area, according to the surveillance of Hsieh KH, the prevalence rate of childhood asthma increased from 1.3% in 1974 to 10.79% in 1994. The other allergic diseases, such as allergic rhinitis, atopic dermatitis and urticaria , have been also increasing in Taipei, Taichung and Tainan city by a serious studies in Western Taiwan. There is no any report of childhood allergic diseases in Eastern Taiwan till now. So, we want to analyze the prevalence of childhood allergic diseases and the common allergens in Eastern Taiwan. From Nov. 2002 to Oct. 2004, all of the primary school children in Yu-Li town in Hualien county were included in this study. (total 2058 children of 12 school). All of them were surveyed with pediatric allergic diseases questionnaire (asthma, allergic rhinitis, atopic dermatitis and urticaria). After the survey, the suspected allergic cases were analyzed for their hypersensitivity to the common allergens by allergen screening test and specific IgE exam of Pharmacia CAP system. 1816 children completed the questionnaire (completive rate 88.24%) and 688 (37.88%) children were suspected to have allergic diseases. 151 (8.87%) asthma¡F448 (24.67%) allergic rhinitis¡F70 (3.85%) atopic dermatitis¡F65 (3.58%) urticaria. A total of 623 suspected allergic cases were analyzed for their hypersensitivity to the common allergens. The common allergens were also analyzed. 87.7% allergic to D. pteronyssinus (Dp) ; 83.9% Blomia tropicalis (Bt) ; 35.0% German cockroach; 16.0% Dog dander; 7.5% Cat dander; 8.0% Candida albicans; 11.2% Bermuda grass; 38.6% shrimp; 33.1% crab; 26.6% milk; 14.3% egg white; 6.7% peanuts; 6.1% Cod fish; 5.4% Wheat; 4.7% Soya bean. The prevalence of childhood allergic diseases in Eastern Taiwan is lower than Western Taiwan. The different envelopment and living type may be the major reasons. From this study, we also suggest that Blomia tropicalis (Bt) should be included in the common aeroallergy analysis in Eastern Taiwan.

This thesis presents genetic studies of atopic dermatitis (AD) and IgA deficiency in dogs. AD is a chronic inflammatory and pruritic skin disorder caused by allergic reactions against environmental allergens. Both genetic and environmental factors are involved in the development of Canine AD (CAD) and human AD. In Paper I, we performed genome-wide association studies (GWAS) and identified a locus on chromosome 27 significantly associated with CAD in German shepherd dogs (GSDs). The locus contains several genes and fine-mapping indicated strongest association close to the candidate gene PKP2. In Paper II, we performed additional fine-mapping and identified four highly associated SNPs located in regions with transcriptional regulatory potential in epithelial and immune cells. The risk alleles were associated with increased transcriptional activity and the effect on expression was cell-type dependent. These data indicate that multiple cell-type specific enhancers regulate the expression of PKP2, and/or the neighboring genes YARS2, DNM1L and FGD4, and predispose GSDs to CAD. IgA deficiency is the most common primary immune deficiency disorder in both humans and dogs, characterized by a higher risk of recurrent mucosal tract infections, allergic and other immune-mediated diseases. In Paper III, we performed the widest screening (to date) of serum IgA levels in dog breeds (Ndogs=1267, Nbreeds=22) and defined eight breeds as predisposed to low IgA levels. In Paper IV, we performed GWAS in four of the breeds defined as prone to low IgA levels. We used a novel percentile groups-approach to establish breed-specific cut-offs to perform analyses in a close to continuous manner. In total, 35 genomic loci were suggestively associated (p<0.0005) to IgA levels, and three genomic regions (including the genes KIRREL3 and SERPINA9) were genome-wide significantly associated with IgA levels in GSDs. A ~20kb long haplotype on chromosome 28, significantly associated to IgA levels in Shar-Pei dogs, was positioned within the first intron of the gene SLIT1 overlapping with a possible dog domestication sweep. This thesis suggests novel candidate genes involved in two immune-mediated disorders in the dog. Hopefully, these results will become an important resource for the genetic research of the corresponding human diseases.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2002. / Härtill 5 uppsatser.