Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-04-01T12:01:10Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) ZILMA ANJOS.pdf: 965838 bytes, checksum: 562afc25b2650739b531bde86e398a7b (MD5) / Made available in DSpace on 2016-04-01T12:01:11Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) ZILMA ANJOS.pdf: 965838 bytes, checksum: 562afc25b2650739b531bde86e398a7b (MD5) Previous issue date: 2014-12-04 / Ficolinas são moléculas de reconhecimento do sistema complemento capazes de promover opsonização, fagocitose e destruição de patógenos mediado pela ativação da via das lectinas. Polimorfismos de nucleotídeo único (SNPs) nos genes FCN1 e FCN2, que codificam as ficolinas 1 e 2, têm sido relacionadas com a susceptibilidade a doenças infecciosas e autoimunes. Nosso estudo teve como objetivo investigar a associação funcional dos polimorfismos de base única (SNPs) ou tagSNPs entre FCN1 e FCN2 e o desenvolvimento de diabetes mellitus tipo 1 (DM1). Dois SNPs no gene FCN1, rs2989727 e rs1071583 e três no FCN2, rs17514136, rs3124954 e rs7851696 foram estudados em 204 crianças e adolescentes com diagnóstico de DM1 e 193 indivíduos saudáveis do Nordeste do Brasil. Não encontramos associações diretas com o desenvolvimento do DM1 ou com a insurgência de doenças relacionadas com DM1, como doença celíaca (DC) e tireoidite autoimune (AIDT). No entanto, o genótipo T / T (rs1071583) da FCN1 foi associado com uma idade precoce quando do diagnóstico DM1 em comparação com C / C ou genótipos C / T (p = 0,02), em torno de dois anos de diferença. Assim, se a hipótese de que o genótipo T / T (rs1071583) não está diretamente envolvido nas etapas iniciais de DM1 início, mas, após o gatilho induzir DM1, os indivíduos com este genótipo podem aumentar / acelerar a resposta autoimune contra células – do pâncreas. Apesar dos nossos resultados indicarem importância de FCN1 no contexto do DM1, estudos adicionais de réplicas devem ser realizados para esclarecer o papel da ficolina no DM1. / Ficolins are innate immune proteins able to activate the complement system by the lectin pathway. Single nucleotide polymorphisms (SNPs) of FCN1 and FCN2 genes, encoding for ficolin 1 and 2, have been related with susceptibility to infectious and autoimmune diseases. Our study aims at investigating the association between FCN1 and FCN2 functional of single nucleotide polymorphisms (SNPs) or tagSNPs and the development of type 1 diabetes mellitus (T1D). Two SNPs at FCN1, rs2989727 and rs1071583 and three at FCN2, rs17514136, rs3124954 and rs7851696 were studied in 204 children diagnosed with T1D and 193 healthy individuals all from the Brazilian Northeast. No direct associations were found with the T1D onset or with the insurgence of T1D related celiac disease (CD) and autoimmune thyroiditis (AIDT). However, the genotype T/T (rs1071583) of FCN1 was associated with an early age at T1D diagnosis compared with C/C or C/T genotypes (p = 0.02), around two years of difference Thus, we hypothesize that the T/T genotype (rs1071583) is not directly involved in the initial steps of T1D onset, but, after the trigger inducing T1D, individuals carrying this genotype could increase/accelerate the pancreatic autoimmune response. Despite our results indicate some importance of FCN1 in the context of T1D, additional replica studies should be performed to clarify the role of ficolins in T1D.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Chronic hepatitis C has been associated with non-organ-specific autoantibodies (NOSA) production. Despite of increasing number of researches about this subject, there is no agreement among the authors of which autoantibodies are produced during combinated therapy of interferon and ribavirin or the clinical relevance of NOSA in patientâs organism. Our aim was to evaluate the profile of NOSA in patients with chronic hepatitis C who attended to Walter CantÃdio Hospital (HUWC) and received combinated antiviral therapy (interferon-ribavirin). A total of 34 patients with hepatitis C were studied. Anti-nuclear antibody (ANA), anti-smooth muscle antibody (SMA), anti-liver/kidney microsomal antibody type 1 (LKM-1) and anti-mitochondrial antibody (AMA) were detected by indirect immunofluorescence. The presence of NOSA was related to clinical and epidemiological variables and to the outcome of antiviral combination therapy with interferon-alfa and ribavirin. Patients were classified as nonresponders, relapsers or long-term responders depending on the outcome of treatment. In our study, before therapy, 23 patients were NOSA positive (SMA was detected in 6 patients, SMA and AMA in 10 and SMA, AMA and ANA in 7). On the 24th week of treatment, 24 patientes were NOSA positive (SMA was detected in 4 patients, SMA and AMA in 10, ANA and SMA in 1, ANA and AMA in 1 and SMA, AMA and ANA in 8). NOSA behavior did not show significant variation during treatment. The overall rate of long-term response was 26,5% (9/34). Long-term response occurred in 17,4% (4/23) of NOSA positive patients and 45,5% (5/11) of NOSA negative patients. Positivity of autoantibodies was not associated with gender, age, viral genotype or aminotransferase levels. In conclusion, ANA was the only NOSA associated with treatment outcome. The absence of NOSA might indicate a significantly higher chance for viral clearance in response to combination therapy for chronic hepatitis C infection. / A hepatite crÃnica pelo vÃrus C tem sido associada à produÃÃo de autoanticorpos nÃo-ÃrgÃo especÃficos (NOSA). Apesar do aumento do nÃmero de pesquisas nessa Ãrea, ainda nÃo existe um consenso entre quais autoanticorpos tÃm seus nÃveis elevados devido ao tratamento combinado de interferon e ribavirina, nem sua influÃncia no desfecho do mesmo ou a relevÃncia clÃnica da presenÃa desses autoanticorpos no organismo do pacientes. O objetivo do presente estudo foi avaliar o perfil de NOSA em pacientes com hepatite C crÃnica atendidos no Hospital UniversitÃrio Walter CantÃdio (HUWC) e submetidos à terapia combinada de interferon-alfa e ribavirina. Para isso, um total de 34 pacientes com hepatite C foram estudados. Os anticorpos anti-nuclear (FAN), anti-mÃsculo liso (SMA), anti-microssomal de fÃgado e rim do tipo 1 (LKM-1) e anti-mitocÃndria (AMA) foram detectados atravÃs de imunofluorescÃncia indireta. A presenÃa de NOSA foi relacionada a variÃveis clÃnicas e epidemiolÃgicas e à resposta ao tratamento. Os pacientes foram classificados, em relaÃÃo à resposta ao tratamento, como nÃo respondedores, recidivantes ou respondedores (resposta virolÃgica sustentada). Em nosso estudo, 23 pacientes foram NOSA reagentes (SMA foi detectado em 6 pacientes, SMA e AMA em 10 e SMA, AMA e FAN em 7). Na 24 semana de tratamento, 24 pacientes foram NOSA reagentes (SMA foi detectado em 4 pacientes, SMA e AMA em 10, FAN e SMA em 1, FAN e AMA em 1 e SMA, AMA e FAN em 8). A variaÃÃo dos tÃtulos dos autoanticorpos durante o tratamento nÃo foi significativa. O percentual total de respondedores foi de 26,5% (9/34). A resposta virolÃgica sustentada foi obtida por 17,4% (4/23) dos pacientes NOSA reagentes e 45,5% (5/11) dos pacientes nÃo reagentes para NOSA. A presenÃa de autoanticorpos nÃo foi associada a gÃnero, idade, genÃtipo viral ou nÃveis de transaminases. Conclui-se que o FAN foi o Ãnico NOSA significativamente associado à resposta à terapia. A ausÃncia de NOSA indica uma tendÃncia à resposta virolÃgica sustentada no tratamento da hepatite C crÃnica.

Introdução: Os linfócitos T regulatórios CD4+CD25+Foxp3+ (Tregs) desempenham um papel fundamental na manutenção da tolerância aos antígenos próprios e no controle da magnitude da resposta imunológica. Alterações quantitativas ou funcionais foram descritas em diversos distúbios auto-imunes. O pênfigo foliáceo endêmico (PFE) é uma doença bolhosa cutânea de natureza auto-imune, que compartilha características clínicas e imunopatológicas com o pênfigo foliáceo clássico, mas apresenta achados epidemiológicos próprios. Auto-anticorpos circulantes e teciduais da classe IgG dirigidos contra caderinas desmossômicas (desmogleína 1), levam à perda de adesão entre os queratinócitos. Objetivo: O objetivo deste estudo foi avaliar se a perda de tolerância é associada com alterações quantitativas nos linfócitos Tregs CD4+CD25+Foxp3+ na pele de pacientes com PFE. Métodos: Amostras de pele de 22 pacientes e 10 controles saudáveis foram submetidos à análise imunoistoquímica com anti-CD4, anti-CD25 e anti-Foxp3. Fotomicrografias foram obtidas de campos consecutivos ao longo de toda epiderme e derme. A seguir, foi realizada quantificação dos linfócitos Foxp3+, CD4+, CD25+, CD4+Foxp3+ e CD25+Foxp3+ em cada compartimento, considerando-se a respectiva área de cada campo (m2). Valores significantemente estatísticos foram considerados como p<0,05. Resultados: Encontramos um infiltrado epidérmico aumentado de linfócitos imunomarcados CD25+(p=0,003), Foxp3+(p=0,04) e CD25+Foxp3+ (p=0,007), em comparação com os controles. O infiltrado dérmico exibiu uma maior expressão de linfócitos CD4+ (p<0,001) e CD25+ (p=0,008) em amostras de pele de pacientes com PFE, quando comparados aos controles. Conclusões: Nossos achados sugerem que a quebra de tolerância imunológica periférica nos pacientes com PFE não se correlaciona com uma diminuição dos linfócitos T reg CD4+CD25+Foxp3+ na pele afetada. Entretanto, uma maior expressão de linfócitos CD25+Foxp3+ no infiltrado epidérmico poderia representar outra população de linfócitos com atividade regulatória, a ser definida. / Background: CD4+CD25+Foxp3+ regulatory T cells (Tregs) play a crucial role in the maintenance of self tolerance and control of the magnitude of the immune response. Their quantitative or functional impairment has been reported in several autoimmune disorders. Endemic pemphigus foliaceus (EPF) is an autoimmune organ-specific blistering skin disorder that shares many clinical and immunopathological features with classic pemphigus foliaceus, but with unique epidemiological features. Circulating and tissue-bound IgG auto-antibodies react against desmosomal cadherins (desmoglein 1), causing loss of adhesion between keratinocytes. Aims: The purpose of this study was to evaluate whether the loss of tolerance is associated with impairment of CD4+CD25+Foxp3+ Tregs in the skin of EPF patients. Methods: Skin samples from 22 patients and 10 controls were submitted to immunohistochemistry with anti-CD4, CD25 and Foxp3. Photomicrographs were obtained from consecutive fields along epidermis and dermis; quantification of Foxp3+, CD4+, CD25+, CD4+Foxp3+ and CD25+Foxp3+ cells were performed in each compartment, taking into account the respective field area (m2). Significance was set at p<0.05. Results: We found an enhanced epidermal infiltrate of CD25+(p=0.003), Foxp3+(p=0.04) and CD25+Foxp3+(p=0.007) immunostained T cells in EPF patients, when compared to controls. Dermal infiltrate exhibited a higher expression of CD4+ (p<0.001) and CD25 p=0.008) T cells in EPF skin samples than in controls. Conclusions: Our findings suggest that the break of peripheral immunologic tolerance in EPF patients did not correlate with an impairment of CD4+CD25+Foxp3+ Treg cells present in the affected skin. However, higher expression of CD25+Foxp3+ cells in the epidermal infiltrate could be a counterpart of a diverse population of T cells, previously described as exerting a regulatory activity, yet to be defined

As células-tronco isoladas a partir do tecido adiposo (ADMSCs) se tornaram promissoras para o tratamento de diversas doenças autoimunes devido a suas propriedades imunomoduladoras. O objetivo deste estudo foi avaliar o potencial terapêutico das ADMSCs em modular a resposta imune no diabetes autoimune experimental em camundongos NOD. ADMSC alogênicas foram administradas em camundongos NOD diabéticos (glicemia > 240 mg/dl) nos dias 0, 7 e 14 sendo então a glicemia monitorada por 12 semanas. A administração de ADMSCs resultou na reversão da hiperglicemia em 78% dos animais por 8 semanas após o tratamento. O tratamento com ADMSCs pôde melhorar de forma efetiva o diabetes autoimune em camundongos NOD pela atenuação da resposta autoimune envolvida concomitante a expansão de células T reguladoras, provendo o desenvolvimento futuro de novas perspectivas de estratégias terapêuticas de terapia celular para o DMT1. / Adipose-derived mesenchymal stem cells (ADMSCs) display immunosuppressive properties representing a promising therapeutic approach for several autoimmune diseases. The aim of this study was to investigate the immune regulatory properties of allogeneic ADMSCs therapy in T cell-mediated experimental autoimmune diabetes in NOD mice. Diabetic NOD mice (blood glucose > 240 mg/dl) were treated or not with ADMSC at days 0, 7 and 14 and blood glucose was monitored once a week for 12 weeks after treatment. ADMSC reversed the hyperglycemia levels of early onset T1D in 78% of diabetic-treated mice for 8 weeks after treatment. ADMSC therapy efficiently ameliorates T1D pathogenesis in diabetic NOD mice by attenuating the Th1 immune response concomitantly with the expansion of Treg cells, thereby contributing to maintenance of functional -cells. This study may thus provide a new therapeutic perspective for the development of ADMSC-based cellular therapies for T1D.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-06-27T18:12:44Z No. of bitstreams: 1 alyriateixeiradias.pdf: 10088679 bytes, checksum: 54e2cba2e92e9707b5c8813c456ca1cb (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-06-28T12:50:27Z (GMT) No. of bitstreams: 1 alyriateixeiradias.pdf: 10088679 bytes, checksum: 54e2cba2e92e9707b5c8813c456ca1cb (MD5) / Made available in DSpace on 2016-06-28T12:50:27Z (GMT). No. of bitstreams: 1 alyriateixeiradias.pdf: 10088679 bytes, checksum: 54e2cba2e92e9707b5c8813c456ca1cb (MD5) Previous issue date: 2012-03-01 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A esclerose múltipla (EM) é uma doença autoimune que acomete o sistema nervoso central (SNC) promovendo inflamação, desmielinização e subsequente comprometimento neurológico. A encefalomielite autoimune experimental (EAE) é o modelo animal mais amplamente utilizado para o estudo da EM, podendo ser induzida por uma grande diversidade de protocolos. Porém, o resultado da doença pode ser diferente em cada modelo, dependendo das características genéticas dos animais utilizados, da fonte e concentração do material antigênico e do modo de aplicação do antígeno, refletindo, em parte, a heterogeneidade encontrada nas diversas formas clínicas da EM. Portanto, devido à diversidade de modelos de indução de EAE, vários fatores relacionados à resposta imunológica, permanecem pouco conhecidos. O presente trabalho buscou avaliar a diferença entre duas concentrações antigênicas, utilizadas na indução, sobre o desenvolvimento clínico da EAE e em diversos parâmetros da resposta imunológica. Para isto, a EAE foi induzida em camundongos da linhagem C57BL/6, utilizando-se a glicoproteína mielínica de oligodendrócitos (MOG35-55), em duas concentrações diferentes (100 ou 300 μg do peptídeo MOG35-55) e mantendo-se as concentrações de Mycobacterium tuberculosis (4 mg/mL) e toxina pertussis (300 ng) constantes. Foi então acompanhado o curso clínico da doença, nos dois protocolos utilizados, durante um período de 58 dias. Além disso, parâmetros da resposta imunológica, como avaliação do infiltrado celular no cérebro e dosagem de citocinas e quimiocinas no SNC e linfonodos inguinais foram acompanhados no 7°, 10°, 14°, 21° e 58° dias após a indução. Observou-se que embora não tenha ocorrido diferença significativa entre os grupos de animais imunizados em relação à pontuação do escore clínico, ocorreram diferenças importantes entre estes dois protocolos no que diz respeito ao perfil de citocinas, quimiocinas e infiltrado celular no cérebro. O aumento das citocinas pró-inflamatórias e quimiocinas no SNC ocorreu de forma precoce no grupo imunizado com 100 μg do peptídeo MOG35-55, que também exibiu infiltrado celular precoce e mais intenso do que o grupo imunizado com 300 μg do peptídeo MOG35- 55. Além disso, o nível das quimiocinas CCL5 e CCL20 e das citocinas de perfil Th1 e Th17 foram, de forma geral, mais elevados no grupo imunizado com 100 μg do peptídeo MOG35-55. Os resultados sugerem que somente a variação na concentração antigênica do MOG35-55, no momento da indução, não é capaz de induzir diferentes cursos clínicos de EAE e que a concentração mais elevada do antígeno (300 μg do peptídeo MOG35-55) parece promover algum mecanismo regulador ou de tolerância, que deve ser melhor estudado. / Multiple sclerosis (MS) is an inflammatory autoimmune disease of central nervous system (CNS) that causes demyelination and neurological deficit. The experimental autoimmune encephalomyelitis (EAE) is the most common model for study this disease. The EAE can be induced by different protocols and the score of the disease is related to the genetic background of the animals, the concentration of antigen and the way of induction, reproducing the heterogeneity of the MS. Thus, due to the diversity of EAE induction, different factors related to immune response are still unclear. The aim of this study was evaluate the difference between two antigen concentrations in the development of EAE and the parameters of immune response. The EAE was induced in C57BL/6 female mice with the myelin oligodendrocyte glycoprotein (MOG35-55) in two different concentrations (100 or 300μg of MOG35-55), but keeping the same concentrations of Mycobacterium tuberculosis (4 mg/mL) and pertussis toxin (300 ng). The disease clinical signs were followed until the 58th day after induction in both protocols, and the immunological parameters, such as cellular infiltrate at brain and levels of cytokines and chemokines at CNS and lymph nodes, were evaluated at 7th, 10th, 14th, 21st and 58th days post induction. In relation to the clinical score, were not observed significant differences between the different protocols, however the cytokines, chemokines and cellular infiltrate profile at brain showed interesting results. The release of Th1 and Th17 cytokines and the CCL5 and CCL20 chemokines at CNS occurred early and more intense at 100μg MOG35-55 group, in accordance with the earlier and intense cellular infiltrate than 300μg MOG35- 55 group. In conclusion, the results suggest that only the differences in the MOG35-55 concentration at induction, is not capable of induce different clinical signs of EAE and that the 300 μg of MOG35-55 seems to promote a regulatory or tolerance mechanism that deserves further studies.

Le modèle murin le plus utilisé pour le diabète de type 1 est la souris NOD. L’activation des lymphocytes T autoréactifs vis à vis des cellules béta nécessite la reconnaissance par le TCR de l’auto antigène présenté par le CMH ainsi que des signaux de co stimulation. Nous apportons la preuve que la voie de costimulation ICOS/ICOSL est indispensable au développement du diabète chez la souris NOD. En effet, les souris invalidées pour le gène Icos ou IcosL sont protégées du diabète. Nous avons démontré que cette protection est liée à un défaut d’activation des LT diabétogènes. De façon inattendue, nous avons observé chez ces souris ICOS-/- et ICOSL-/- une neuromyopathie. Cette pathologie se développe parallèlement au diabète chez la souris ICOSL+/+. Sur le plan histologique, le muscle strié périphérique et le nerf périphérique est envahi par un infiltrat lymphocytaire et par des cellules présentatrices d’antigène. Nous avons démontré par des expériences de transfert adoptif que la neuromyopathie est une maladie auto-immune données, nous avons étudié les souris NOD ICOSL-/- CIITA-/-. Ces souris sont dépourvues de lymphocytes T -CD4+ et ne développent pas de neuromyopathie ni de diabète. De même, nous avons étudié les souris NOD ICOSL-/- béta2m-/-. Ces souris sont dépourvues de lymphocytes T-CD8+ et développent une neuromyopathie. Cette déviation de l’auto-immunité est liée à l’interaction entre les LT et les lymphocytes B via le signal ICOS/ICOSL. Nous avons prouvé via des expériences de transfert et de chimères que l’absence de signal ICOS/ICOSL entre les lymphocytes T et les lymphocytes B oriente l’auto-immunité vers le système nerveux périphérique et le muscle strié. Enfin, l’analyse du spectre de spécificité des anticorps présent chez la souris ICOSL-/- par western blot puis par spectrométrie de masse a précisé les cibles antigéniques de la myopathie. L’invalidation de la voie ICOS/ICOSL conduit donc à une déviation de l’auto-immunité du pancréas vers le muscle et le système nerveux périphérique. Ces données prouvent que la voie ICOS/ICOSL est indispensable à l’initiation du diabète, mais aussi au contrôle de l’auto-immunité / Costimulation pathways are described as central in T cell activation and the control of autoimmune responses. We previously reported that NOD mice that are deficient for the icosl gene are protected from diabetes, but instead develop a spontaneous autoimmune neuromyopathy. The general phenotype of the neuromyopathy observed in ICOSL-/- NOD mice is globally similar to that observed in ICOS-/- and ICOS-/-ICOSL-/- double knockout NOD mice. The neuromyopathy is observed in 100% of female mice by the age of 35 weeks. The neuropathy remains limited to the peripheral nerve tissue. The disease is characterized by an infiltration of immune cells: CD4+ T cells, CD8+ T cells, dendritic cells and B lymphocytes, but does not extend to the central nervous system. A similar infiltrate is seen in muscles. Autoimmune neuromyopathy can be transfer to naive recipients by T lymphocytes. Transfer is achieved in NOD.scid recipient mice by CD4+ T-cells, although not by CD8+ T-cells, isolated from 35 week old ICOSL-/- NOD. The predominant role of CD4+T-cells is further demonstrated in this model by the observation that CIITA-/-ICOSL-/- NOD mice do not developed the neuromyopathy. By contrast, ȕ2m-/-ICOSL-/- NOD mice develop a neuromyopathy. We obtained evidence (in chimeric mice) that the interaction between antigen-presenting cells (APC) and T lymphocytes via ICOS/ICOSL is a prerequisite to the development of diabetes, while the loss of the interaction between T lymphocytes and APC play a key role in the development of nervous and muscular autoimmunity. Finally, the spectrum analysis of antibodies specificity in mouse ICOSL-/- with Western blot and mass spectrometry indicated the antigenic targets of myopathy. Altogether, our data indicate that the deviation of autoimmunity in NOD mice from the pancreas to muscles and the peripheral nervous system in the absence of ICOS/ICOSL signal is dependent on the loss of the physiological interaction between T cells and APC

L’autophagie est un processus catabolique lié aux lysosomes, essentiel à la l’homéostasie cellulaire notamment dans les lymphocytes. Elle est impliquée dans la pathogenèse de nombreuses maladies et pourrais jouer un rôle dans le développement de maladies auto-immunes. Nous avons voulu étudier son rôle in vivo dans les lymphocytes B et T. Nous avons généré des souris déficientes en autophagie spécifiquement dans ces cellules et montré que l’autophagie n’est pas essentielle au développement des LB, mais que dans un contexte auto-immun la persistance de plasmocytes et la production d’autoanticorps été diminuée. Cela démontre un rôle de l’autophagie dans les réponses à long terme. Les réponses humorales à long-terme T dépendantes sont également impactées. De plus des souris transplantées avec des LT CD4+ déficients en autophagie montrent une réponse humorale mémoire diminuée. Nous nous sommes également intéressé aux voies de signalisation conduisant à l’induction de l’autophagie en réponse à une stimulation du TCR dans des LT normaux et pathologiques. Nos résultats préliminaires montrent une implication de la voie calcique. / Autophay is a catobolic lysosomal process essentail for cellular maintenance and fucntion such as lymphocyte homeosatsis. The generation of mice models with an Atg5 conditional knock-out in B and T cells respectively, have allowed us to study autophagy requirements of those immune cells in vivo. We have demonstrated that autophagy was dispensable for B cell development but that in autoimmune settings B cell autophagy was required for the maintenance of long-lived plasma cells and for the production of autoantibodies. In mice deficient for autophagy in T cells, long-term tumoral response to a T-dependent antigen is decreased. We also showed that in mice adoptively transferred with autophagy deficient CD4 T cells, the antigen specific memory humoral immune response was impaired. We also investigated the signaling pathways leading to autophagy induction upon TCR stimulation in normal and lupus T cells and showed that the calcium signaling is highly involved.

Systemic lupus erythematosus (SLE) is a systemic inflammatory disease. Clinically, the distinction between ongoing inflammation attributed to SLE, and organ damage due to medication or co-morbidities remains challenging. In addition, SLE is a heterogeneous disease where the various disease phenotypes complicate the search for biomarkers that adequately reflect disease activity and/or signs of increasing organ damage. The aim of the thesis was to investigate and evaluate potential new biomarkers of disease activity and/or organ damage in SLE patients. High mobility group box protein-1 (HMGB1) is a nuclear non-histone protein that can shuttle to the cytoplasm, become secreted extracellularly, and participate in systemic inflammation. Administration of monoclonal anti-HMGB1 antibodies has been reported both to attenuate and intensify disease in animal models of arthritis and lupus. In Paper I of the thesis, circulating anti-HMGB1 was found in 23% of the SLE patients and correlated with disease activity variables. The biological role of these autoantibodies remains to be elucidated. As a consequence of massive circulating levels of cellular debris and immune complexes, SLE patients have insufficient capacity to remove such material via the reticuloendothelial system. Pentraxin 3 (PTX3) may possibly protect against lupus flares due to classical complement activation, opsonization of apoptotic cells, and cytokine induction. In Paper II, circulating PTX3 was found to be inhibited or exhausted by interferon (IFN)-α, a key cytokine of SLE pathogenesis, and serum levels of PTX3 in SLE patients were inversely related to IFN-α levels. Suppressed PTX3 levels may contribute to a vicious circle resulting in impaired waste clearance, autoantigen exposure and autoantibody production, and sustained disease activity. Osteopontin (OPN), a protein known to influence cell signaling and apoptosis, has been proposed as a marker of organ damage in pediatric lupus. In a Swedish cross-sectional study, circulating OPN levels were found to be raised in SLE (Paper III). In patients with recent-onset disease, OPN reflected disease activity, while in established disease, OPN appeared to mirror damage accrual and cardiovascular damage. In Paper IV, OPN was instead analyzed in an international longitudinal multi-center study based on patients with recent-onset SLE and follow-up data. OPN turned out to be a poor predictor of organ damage, but significant associations were observed between OPN and disease activity both at disease onset, as well as over 5 years of follow-up. In conclusion, increased anti-HMGB1 antibody and decreased PTX3 levels could potentially sustain the impaired waste-disposal. Of the molecules analyzed in this thesis, OPN seems to be the best marker of disease activity. Further studies of these proteins may help to better understand SLE pathogenesis and to optimize treatment of patients.

O timo é o órgão linfóide primário responsável pelo estabelecimento inicial de um repertório funcional de células T. A via de sinalização Notch é essencial para o desenvolvimento de células T a partir de células-tronco hematopoiéticas, e a distribuição de seus receptores e ligantes no timo humano ainda é desconhecida. A expressão de AIRE é crucial para a seleção de um repertório de receptores de linfócitos T (TCR) sem autorreatividade. Neste estudo, analisamos o padrão de expressão de AIRE e a distribuição de Notch em timos pacientes com cardiopatias congênitas, parte dos quais com síndrome de Down. Descrevemos a localização intratímica e os tipos celulares capazes de expressar os diferentes receptores e ligantes Notch. A expressão de AIRE em células epiteliais medulares foi significantemente reduzida em timos de crianças com síndrome de Down, deficiência esta que pode explicar a alta incidência de doenças autoimunes nesta cromossomopatia. / The thymus is a primary lymphoid organ which is essential for the initial establishment of a functional repertoire of T cells. Notch signaling is crucial for T-cell lineage development from hematopoietic stem cells; however, distribution of Notch ligands and receptors in human thymus is still unknown. AIRE is crucial for the selection of a T-cell-receptor (TCR) repertoire purged of self-reactive specificities. In this study, we analyzed the expression patterns of AIRE and Notch in human thymuses from children with congenital cardiopathies that undergo heart surgery, part of whom with Down syndrome. We described the intra-thymic localization and the cell types that express Notch receptors and ligands. AIRE expression in medullary epithelial cells is significantly decreased in Down syndrome patients. This deficiency could explain higher incidence of autoimmune disease in Down syndrome.

Background: CD4+ T cells are central players of the adaptive immune response. They mediate inflammation via clonal expansion, differentiation into specific response subtypes and production of inflammatory signals that promote cytotoxicity and antibody production by other immune cells. CD4+ T cells may also differentiate into regulatory T cells (Treg) that control autoimmune responses and promote tolerance. Loss of CD4+ T cell tolerance to autoantigen leads to unwanted T cell responses and autoimmunity. Immunomodulation therapies that affect CD4+ T cells have become a paradigm to reverse T cell mediated autoimmunity, either by blocking T cell activation signals (Chamian et al., 2007; Keymeulen et al., 2005; Scheinfeld, 2005) or by enhancing tolerogenic function (Hartemann et al., 2013; Marcovecchio et al., 2020). Some of these single drug therapies are now used in trials or in practice to treat patients with autoimmune diseases. However, their true immunomodulating capacity on CD4+ T cell phenotype is unclear. Scientific Question: The aim of my thesis is to identify immunomodulators that modify the transcriptional profile of antigen-responsive human CD4+ T cells toward anergy or tolerance. I selected compounds targeting critical pathways of T cell activation that have relevance to autoimmunity in type 1 diabetes. I examined the in vitro effect of immunomodulation on naïve and memory CD4+ T cell proliferation upon stimulation with model antigens. Responsiveness of immunomodulated cells to subsequent antigen stimulation was also investigated. Single cell transcriptomic analyses were performed on proliferating and non-proliferating CD4+ T cells stimulated with model antigens in the presence of immunomodulation to detect potential alterations in their profile in comparison to untreated cells. Materials and Methods: CD4+ T cell responses to antigen stimulation were assessed using proliferation assays in the presence of absence of immunomodulating drugs. The drugs assessed were the JAK inhibitor Tofacitinib, the natural phenol Resveratrol, an anti-human IFN-αR monoclonal antibody, the anti-IL-6R monoclonal antibody Tocilizumab, the proteasome inhibitor Bortezomib, the IgG1-CTLA-4 fusion protein Abatacept, a DHODH inhibitor (Compound A) and a RORγT inverse agonist (Compound B). The effects on human peripheral blood memory CD4+ T cells were examined using the recall antigens Flu and Tetanus Toxoid and the superantigen SEB at a concentration that stimulated TCRVβ17+ cells. The effects on naïve CD4+ T cells were assessed using SEB. Responses were measured using flow cytometry. Re-stimulation of inhibited cells in the absence of immunomodulator was performed to examine the legacy of immunomodulated CD4+ T cells post-treatment. For the transcriptomic analyses, single cells were sorted with FACS and their transcriptome was sequenced with RNAseq. For memory CD4+ T cells stimulated with recall antigens, the proliferated responsive cells in cultures with and without immunomodulatory drug were examined and compared. For memory and naïve CD4+ T cells stimulated with SEB, the non-proliferated TCRVβ17+ CD4+ T cells in cultures with and without immunomodulatory drug were examined and compared. The differentially expressed genes were examined and further processed using the Ingenuity Pathway Analysis. Results: All the selected compounds consistently reduced the frequencies of proliferating memory CD4+ T cells responding to recall antigens, with the exception of the anti-IFN-αR and Tocilizumab. Re-stimulation in the absence of inhibitor showed a persistent loss of responsive capacity to the recall antigen for cells that had been exposed to Resveratrol and to the RORγT inverse agonist. The transcriptome of isolated single CD4+ CD25+ T cells that proliferated in the presence of these compounds was comparable to that of not treated proliferative cells, showing minor and inconsistent across PBMC samples differences in gene expression. These data suggest that the immunomodulators induced little change in memory CD4+ T cell phenotype. Resveratrol, the DHODH inhibitor and a RORγT inverse agonist, but none of the other compounds successfully inhibited proliferation of responsive to SEB naïve and memory TCRV17+ cells, without affecting their viability. Responsiveness of these inhibited cells to SEB was restored in the absence of immunomodulators. The transcriptome of isolated non-proliferating TCRV17+ cells exposed to SEB in the absence of immunomodulators was characteristic of stimulated T cells with upregulated pathways related to TCR signaling, anabolic biosynthetic processes and chromosomal replication. Non-proliferating cells that were stimulated but inhibited by the three compounds had a transcriptional profile consistent with downregulation of response to SEB. Resveratrol had the strongest downregulating effect in both naïve and memory cells. The inhibited pathways that were commonly affected by all compounds were associated with cell cycle control of chromosomal replication, tRNA charging, spliceosomal cycle and necroptosis, demonstrating the role of these pathways in the CD4+ T cell response to SEB. The transcriptomic data of immunomodulated dividing or not dividing CD4+ T cells did not provide evidence of an induced Treg phenotype. Conclusions: The established in vitro models identified six inhibitors of memory antigen-specific CD4+ T cell response and three that were additionally able to inhibit memory and naïve response to SEB. The transcriptomic data suggest that the primary effect of the tested immunomodulators is on the T cell responsiveness to antigen and not on the T cell phenotype. I conclude that while the majority of immunomodulators can severely inhibit CD4+ T cell response, none of the tested immunomodulators have a combined capacity to inhibit and shift antigen-responsive CD4+ T cells toward tolerogenic phenotypes in vitro. I interpret these data as indicating that successful therapeutic application is likely to require chronic administration. / Hintergrund: CD4+ T-Zellen sind zentrale Koordinatoren der adaptiven Immunantwort. Sie vermitteln Entzündung durch klonale Expansion, durch Ausdifferenzierung in Subtypen der spezifischen Antwort und durch Produktion von Entzündungssignalen, die wiederum die Zytotoxizität und Antikörperproduktion durch andere Immunzellen fördern. CD4+ T-Zellen können sich auch in regulatorische T-Zellen (Treg) differenzieren, die Autoimmunantworten kontrollieren und die Toleranz fördern. Der Verlust der Toleranz von CD4+ T-Zellen gegenüber Autoantigenen führt zu unerwünschten T-Zell-Reaktionen und Autoimmunität. Immunmodulationstherapien, die CD4+ T-Zellen beeinflussen, sind zum Musterbeispiel geworden, um T-Zell-vermittelte Autoimmunität, entweder durch Blockierung von T-Zell-Aktivierungssignalen (Chamian et al., 2007; Keymeulen et al., 2005; Scheinfeld, 2005) oder durch Verbesserung der tolerogenen Funktion (Hartemann et al., 2013; Marcovecchio et al., 2020), umzukehren. Einige dieser auf einzelnen Medikamenten basierenden Therapien werden jetzt in Studien oder in der Praxis zur Behandlung von Patienten mit Autoimmunerkrankungen eingesetzt. Ihr tatsächlicher immunmodulierender Einfluss auf den CD4+ T-Zell-Phänotyp ist jedoch unklar. Fragestellung/Hypothese: Das Ziel meiner Doktorarbeit ist es, Immunmodulatoren zu identifizieren, die das Transkriptionsprofil humaner Antigen-responsiver CD4+ T-Zellen in Richtung Anergie oder Toleranz verändern. Hierzu wählte ich Substanzen aus, die auf maßgebliche Signalwege der T-Zell-Aktivierung wirken und für die Autoimmunität bei Typ-1-Diabetes von Bedeutung sind. Ich untersuchte den in vitro Effekt der Immunmodulation auf die Proliferation von naiven und CD4+ Gedächtnis-T-Zellen nach Stimulation mit Modellantigenen. Das Ansprechverhalten immunomodulierter Zellen auf nachfolgende Antigenstimulation wurde ebenfalls untersucht. Einzelzell-Transkriptomanalysen wurden an proliferierenden und nicht-proliferierenden CD4+ T-Zellen durchgeführt, die mit Modellantigenen in Gegenwart der Immunmodulation stimuliert wurden, um mögliche Veränderungen in ihrem Profil im Vergleich zu unbehandelten Zellen aufzuspüren. Material und Methoden: Die CD4+ T-Zell-Antworten auf die Antigenstimulation wurden mit Hilfe von Proliferationsassays in An- und Abwesenheit von immunmodulierenden Medikamenten untersucht. Bei den untersuchten Medikamenten handelte es sich um den JAK-Inhibitor Tofacitinib, das natürliche Phenol Resveratrol, einen monoklonalen Anti-IFN-αR-Antikörper, den monoklonalen Anti-IL-6R-Antikörper Tocilizumab, den Proteasominhibitor Bortezomib, das IgG1-CTLA-4-Fusionsprotein Abatacept, einen DHODH-Inhibitor (Substanz A) und einen inversen RORγT-Agonisten (Substanz B). Die Effekte auf CD4+ Gedächtnis-T-Zellen des humanen peripheren Blutes wurden mit den Recall-Antigenen Grippe und Tetanus-Toxoid, sowie mit dem Superantigen SEB in einer Konzentration, die TCRVβ17+ T-Zellen stimuliert, untersucht. Die Auswirkungen auf naive CD4+ T-Zellen wurden mit SEB untersucht. Die Antworten wurden mittels Durchflusszytometrie (FACS) gemessen. Eine Re-Stimulation der gehemmten Zellen in Abwesenheit des Immunmodulators wurde durchgeführt, um die längerfristige Wirkung der immunmodulierten CD4+ T-Zellen nach der Behandlung zu untersuchen. Für die Transkriptom-Analysen wurden einzelne Zellen via FACS sortiert und ihr Transkriptom mit von RNAseq sequenziert. Für CD4+ Gedächtnis-T-Zellen, die mit Recall-Antigenen stimuliert wurden, konnten die proliferierten, Antigen-responsiven T-Zellen in Kulturen mit und ohne Immunmodulator untersucht und verglichen werden. Für CD4+ Gedächtnis-T-Zellen und naive CD4+ T-Zellen, bei den die Stimulation mit SEB erfolgte, wurden nicht-proliferierte TCRVβ17+ CD4+ T-Zellen in Kulturen mit und ohne Immunmodulator analysiert. Die differentiell exprimierten Gene wurden ermittelt und mit Hilfe der Ingenuity Pathway Analyse untersucht. Ergebnisse: Alle ausgewählten Substanzen, mit Ausnahme von Anti-IFN-αR und Tocilizumab, reduzierten durchweg die Häufigkeit der proliferierenden CD4+ Gedächtnis-T-Zellen, die auf Recall-Antigene reagierten. Eine erneute Stimulation in Abwesenheit des Inhibitors zeigte einen anhaltenden Verlust des Ansprechverhaltens auf das Recall-Antigen für Zellen, die mit Resveratrol und dem inversen RORγT-Agonisten inkubiert worden waren. Das Transkriptom isolierter einzelner CD4+ CD25+ T-Zellen, die in Gegenwart dieser Substanzen proliferierten, war mit dem von nicht behandelten, proliferativen Zellen vergleichbar und zeigte geringfügige, und über PBMC-Proben hinweg inkonsistente, Unterschiede in der Genexpression. Diese Daten deuten darauf hin, dass die Immunmodulatoren nur eine geringe Veränderung des Phänotyps der CD4+ Gedächtnis-T-Zellen induzierten. Resveratrol, der DHODH-Inhibitor und ein inverser RORγT-Agonist, aber keine der anderen Substanzen hemmten erfolgreich die Proliferation von SEB-responsiven naiven und TCRVβ17+CD4+ Gedächtnis- T-Zellen, ohne deren Viabilität zu beeinträchtigen. Das Ansprechverhalten dieser gehemmten Zellen auf SEB wurde in Abwesenheit von Immunmodulatoren wiederhergestellt. Das Transkriptom von isolierten nicht-proliferierenden TCRV17+ T-Zellen, die SEB in Abwesenheit von Immunmodulatoren ausgesetzt wurden, war charakteristisch für stimulierte T-Zellen und zeigte hochregulierte Signalwege, die mit T-Zell-Rezeptor-Signaling, anabolen biosynthetischen Prozessen und chromosomaler Replikation zusammenhängen. Nicht-proliferierende Zellen, die stimuliert, aber durch die drei Substanzen gehemmt wurden, hatten ein Transkriptionsprofil, das mit einem Herunterregulieren der Reaktion auf SEB übereinstimmt. Resveratrol hatte den stärksten herunterregulierenden Effekt sowohl in naiven als auch in Gedächtnis-T-Zellen. Die gehemmten Signalwege, die von allen Substanzen gemeinsam beeinflusst wurden, waren mit der Zellzykluskontrolle der chromosomalen Replikation, der tRNA-Ladung, dem Spliceprozess und der Nekroptose assoziiert, was die Rolle dieser Signalwege bei der Reaktion der CD4+ T-Zellen auf SEB zeigt. Die Transkriptionsdaten von immunomodulierten, proliferierenden oder nicht-proliferierenden CD4+ T-Zellen lieferten keine Hinweise auf einen induzierten regulatorischen T-Zell-Phänotyp. Schlussfolgerung: Die etablierten in vitro-Modelle identifizierten sechs Inhibitoren der Antigen-spezifischen CD4+ Gedächtnis-T-Zell-Antwort und drei, die zusätzlich die Gedächtnis- und naive T-Zell-Antwort auf SEB hemmen konnten. Die Transkriptom-Daten legen nahe, dass der primäre Effekt der getesteten Immunmodulatoren auf dem T-Zell-Ansprechverhalten auf das jeweilige Antigen beruht und nicht auf Änderungen des T-Zell-Phänotyps zurückzuführen ist. Ich folgere daraus, dass die meisten Immunmodulatoren zwar die CD4+ T-Zell-Antwort stark hemmen können, aber keiner der getesteten Immunmodulatoren in vitro eine kombinierte Fähigkeit zur Hemmung der Antigen-responsiven CD4+ T-Zellen bei gleichzeitiger Verschiebung in Richtung tolerogener Phänotypen hat. Ich interpretiere diese Daten als Hinweis darauf, dass eine erfolgreiche therapeutische Anwendung dieser Substanzen voraussichtlich einer chronischen Verabreichung bedarf.