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[ES] En este trabajo se ha realizado la detección de analitos implicados en el sector sanitario (trombina) e industria alimentaria (alérgenos y patógenos), mediante el uso de un sistema de biosensado fotónico. Este sistema desarrollado por el equipo de LUMENSIA Sensors, emplea la tecnología de chips fotónicos de nitruro de silicio (Si3N4), basados en estructuras de anillos resonantes (RR). Las estrategias de funcionalización química e inmovilización de biomoléculas como aptámeros (fragmentos de ADN de cadena sencilla) y anticuerpos, se han realizado sobre superficies planas de Si3N4 para la detección de analitos, como paso previo a las medidas fotónicas. Por tanto, estas estrategias se han implementado en la preparación del chip fotónico para las medidas en un entorno de laboratorio (set-up). En cuanto a la estrategia aplicada, ésta consiste en la activación química de la superficie del sensor. Después sobre los RR del chip, cuyo tamaño es del orden de las micras, se inmoviliza la sonda de captura (anticuerpo o aptámero), siendo ésta la encargada de reconocer específicamente al analito de interés (trombina, alérgeno o patógeno). En los resultados obtenidos de trombina, se ha elaborado un estudio para la detección de trombina en el seno de diferentes matrices biológicas sobre superficies planas de Si3N4, además del control sobre la activación de una muestra de sangre mediante el uso de factor tisular (TF) y cloruro de calcio (CaCl2). Estos resultados han servido como un estudio preliminar a la optimización del aptámero empleado como sonda de captura, específico de la trombina para su detección sobre chips fotónicos. En lo referente a la detección de alérgenos, se han empleado dos estrategias claramente diferenciadas. Por un lado, la utilización de aptámeros como sondas de captura en la detección del Ovomucoide (OVO) y la Gliadina (GLN) sobre superficies planas Si3N4. Por otro lado, la implementación de anticuerpos monoclonales como moléculas biológicas de captura sobre chips fotónicos, se ha llevado a cabo en la detección de los alérgenos Gliadina (GLN) y caseína (CAS), cuyos resultados han dado lugar a una recta de calibrado. Asimismo, se ha realizado un ensayo para la detección de GLN en muestra real, procedente de un extracto cárnico con gluten de trigo. En cuanto a la detección de patógenos, se han utilizado dos tipos de estrategias, al igual que para los alérgenos. En primer lugar, el uso de aptámeros como sondas de captura han dado como resultado la detección de dos cepas de carácter no patogénico de la bacteria E.coli (Origami y XL1BLUE) sobre superficies planas de Si3N4. En segundo lugar, la utilización de un anticuerpo policlonal como sonda de captura, se ha inmovilizado sobre la superficie del chip fotónico para la detección del Circovirus Porcino tipo 2 (PCV2) en un estudio realizado sobre la dosis dependencia del virus a diferentes factores de dilución. Finalmente, el desarrollo de una plataforma de sensado para la detección de los analitos (trombina, alérgenos y patógenos) y donde se vayan a implementar los diferentes biosensores está en proceso. / [CA] En aquest treball s'ha realitzat la detecció d'anàlits implicats en el sector sanitari (trombina) i indústria alimentària (al·lergògens i patògens), mitjançant l'ús d'un sistema de biosensat fotònic. Aquest sistema desenvolupat per l'equip de LUMENSIA Sensors, empra la tecnologia de xips fotònics de nitrur de silici (Si3N4), basats en estructures d'anells ressonants (RR). Les estratègies de funcionalització química i immobilització de biomolècules com aptàmers (fragments d'ADN de cadena senzilla) i anticossos, s'han realitzat sobre superfícies planes de Si3N4 per a la detecció d'anàlits, com a pas previ a les mesures fotòniques. Per tant, aquestes estratègies s'han implementat en la preparació del xip fotònic per a les mesures en un entorn de laboratori (set-up). Quant a l'estratègia aplicada, aquesta consisteix en l'activació química de la superfície del sensor. Després sobre els RR del xip, la grandària del qual és de l'ordre de les micres, s'immobilitza la sonda de captura (anticòs o aptàmer), sent aquesta l'encarregada de reconèixer específicament a l'anàlit d'interés (trombina, al·lergogen o patogen). En els resultats obtinguts de trombina, s'ha elaborat un estudi per a la detecció de trombina en el si de diferents matrius biològiques sobre superfícies planes de Si3N4, a més del control sobre l'activació d'una mostra de sang mitjançant l'ús de factor tissular (TF) i clorur de calci (CaCl2). Aquests resultats han servit com un estudi preliminar a l'optimització del aptàmer empleat com sonda de captura, específic de la trombina per a la seua detecció sobre xips fotònics. Referent a la detecció d'al·lergògens, s'han emprat dues estratègies clarament diferenciades. D'una banda, la utilització de aptàmers com sondes de captura en la detecció del Ovomucoide (OVO) i la Gliadina (GLN) sobre superfícies planes Si3N4. D'altra banda, la implementació d'anticossos monoclonals com a molècules biològiques de captura sobre xips fotònics, s'ha dut a terme en la detecció dels al·lergògens Gliadina (GLN) i caseïna (CAS), els resultats de la qual han donat lloc a una recta de calibrat. Així mateix, s'ha realitzat un assaig per a la detecció de GLN en mostra real, procedent d'un extracte carni amb gluten de blat. Quant a la detecció de patògens, s'han utilitzat dos tipus d'estratègies, igual que per als al·lergògens. En primer lloc, l'ús de aptàmers com sondes de captura han donat com a resultat la detecció de dos ceps de caràcter no patogènic del bacteri E.coli (Origami i XL1BLUE) sobre superfícies planes de Si3N4. En segon lloc, la utilització d'un anticòs policlonal com sonda de captura, s'ha immobilitzat sobre la superfície del xip fotònic per a la detecció del Circovirus Porcí tipus 2 (PCV2) en un estudi realitzat sobre la dosi dependència del virus a diferents factors de dilució. Finalment, el desenvolupament d'una plataforma de sensat per a la detecció dels anàlits (trombina, al·lergògens i patògens) i on es vagen a implementar els diferents biosensors està en procés. / [EN] In this work the detection of analytes involved in the health sector (thrombin) and food industry (allergens and pathogens) has been carried out, through the use of a photonic biosensing system. This system, developed by the LUMENSIA Sensors team, uses the technology of silicon nitride (Si3N4) photonic chips, based on resonant ring structures (RR). The strategies of chemical functionalization and immobilization of biomolecules such as aptamers (single chain DNA fragments) and antibodies, have been performed on flat surfaces of Si3N4 for the detection of analytes, as a previous step to photonic measurements. Therefore, these strategies have been implemented in the preparation of the photonic chip for measurements in a laboratory environment (set-up). Refering to the strategy applied, it consists of the chemical activation of the sensor surface. Then on the RR of the chip, whose size is of the order of microns, the capture probe (antibody or aptamer) is immobilized, being the one in charge of specifically recognizing the analyte of interest (thrombin, allergen or pathogen). In the results obtained from thrombin, a study for the detection of thrombin in different biological matrices on flat surfaces of Si3N4 has been developed, in addition to the control on the activation of a blood sample through the use of tissue factor (TF) and calcium chloride (CaCl2). These results have served as a preliminary study to the optimization of the aptamer used as a capture probe, specific for thrombin for detection on photonic chips. Regarding the detection of allergens, two clearly differentiated strategies have been used. On the one hand, the use of aptamers as capture probes in the detection of Ovomucoid (OVO) and Gliadin (GLN) on Si3N4 flat surfaces. On the other hand, the implementation of monoclonal antibodies as biological capture molecules on photonic chips has been carried out in the detection of the allergens Gliadina (GLN) and casein (CAS), whose results have resulted in a calibration line. Likewise, an assay for the detection of GLN in real sample, from a meat extract with wheat gluten, has been carried out. As for the detection of pathogens, two types of strategies have been used, as for allergens. First, the use of aptamers as capture probes has resulted in the detection of two non-pathogenic strains of the E.coli bacteria (Origami and XL1BLUE) on flat surfaces of Si3N4. Secondly, the use of a polyclonal antibody as a capture probe has been immobilized on the surface of the photonic chip for the detection of Porcine Circovirus type 2 (PCV2) in a study on the dose dependence of the virus at different dilution factors. Finally, the development of a sensing platform for the detection of analytes (thrombin, allergens and pathogens) and where the different biosensors are going to be implemented is in process. / Quiero agradecer al Instituto de Salud Carlos III por el contrato i-PFIS concedido / Sánchez Sánchez, C. (2019). Sistema de biosensado fotónico para la detección de trombina, alérgenos y patógenos. funcionalización química de chips fotónicos basados en estructuras de anillos resonantes [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/133060

THESIS SUMMARY Food allergy is one of the frequent disorders and its incidence in paediatric as well as adult population is continuously rising, having doubled in the last two decades. Although wheat belongs to major food allergens and is a staple food in most diets, we have only little knowledge of wheat proteins causing IgE mediated hypersensitivity reaction. Diagnostic approaches of food allergy to wheat have a high sensitivity, but low specificity. Poor predictability and specificity may be associated with the insufficient purity of wheat extracts used in sIgE assays or with the lack of major allergens in these extracts. In the first step, we characterized 19 potential allergens recognised by IgE Abs of allergic patients, using proteomic techniques (1-DE, 2-DE, MALDI-TOF, QTOF and LCQDECA nLC-MS/MS ion trap technique). We identified these IgE-binding molecules such as: α-amylase inhibitors, β-amylase, profilin, serpin, β-D-glucan exohydrolase and 27K protein. To quantify sIgE in patient's sera we developed ELISA using the whole wheat extract and two commercially available α-amylase inhibitors. Second, we developed a procedure that allows isolation of wheat allergens from natural sources using Rotofor cell and HPLC. Twenty-seven potential wheat allergens have been successfully identified; of these, the...

Introdução: Fungos são alérgenos cuja importância nas doenças alérgicas respiratórias é subestimada por falta de extratos alergênicos adequados para diagnóstico, quer através de testes cutâneos, quer através de dosagem de IgE específica. Botucatu possui características próprias por se localizar numa \"cuesta\" e possuir vegetação variada que cobre grande parte da cidade. A partir das plantas os fungos ganham o ar através da esporulação podendo ser inalados e sensibilizar pacientes com alergias respiratórias. Este trabalho se propõe a estudar quais os fungos mais prevalentes em Botucatu e a taxa de sensibilização dos principais gêneros entre os portadores de asma e rinite procedentes dessa região. Casuística e Métodos: Foi desenvolvido um aparelho caça esporos para a captura dos mesmos em quatro pontos da cidade. Foram feitas cinco coletas/ponto/semana durante um ano para contagem e identificação das UFC (unidades formadoras de colônias). Foram selecionados pacientes de Botucatu e região com asma e rinite, nos quais se aplicou testes de puntura para os principais alérgenos, incluindo onze diferentes fungos. Foram também realizados testes intradérmicos com extratos de fungos nos pacientes cujo teste de puntura ao fungo em questão tenha sido negativo. Resultados: Foram identificados 67 gêneros sendo os mais prevalentes: Cladosporium, Epicoccum, Levedura, Aspergillus, Helminthosporium, Nigrospora, Monilia, Fusarium, Hyalodendrum, Penicillium, Curvularia, Humicola, Alternaria, Trichoderma e Sphaerosporium. Foram selecionados 207 pacientes dos quais 118 (57%) apresentaram pelo menos um teste positivo a fungo. O teste intradérmico foi responsável por 88% do diagnóstico de sensibilização A dosagem de IgE específica mostrou baixa sensibilidade (4%). Os fungos mais sensibilizantes foram: Aspergillus, Neurospora, Candida, Penicillium e Cladosporium. Observou-se maior positividade a fungos no grupo de asma grave, sendo que Aspergillus, Neurospora e Candida foram mais prevalentes nesse grupo. Encontrou-se associação positiva entre pacientes com asma atendidos em Pronto-Socorros durante o ano estudado e o total de UFC nesse período. Conclusões: Os fungos mais prevalentes no planeta são também encontrados em Botucatu, embora haja fungos característicos dessa região; a sensibilização a fungos é expressiva na população estudada e guarda relação com maior gravidade da asma; o teste intradérmico foi o melhor meio diagnóstico para sensibilização a fungos / Purpose: Fungi are allergens whose importance has been underestimated due to the absence of reliable extracts for the diagnosis of sensitization in vivo or in vitro. Botucatu has unique characteristics because of its location on a \"cuesta\" and its varied vegetation which cover a large area of the city. The fungi reach the air from the plants through sporulation and they can be inhaled and sensitize patients with allergic diseases. Here we studied the most prevalent fungi in the air of Botucatu and the rate of sensitization to the main fungi genus among patients with asthma and rhinitis. Methods: We developed a spore trap to catch the spores from the air in four points in the city. Five collections were taken weekly during a whole year. Colony forming units (CFU) were counted and the fungi on Petri dishes were classified. Patients with asthma and rhinitis have been selected and submitted to prick tests with the main allergens including eleven different types of fungi. Intradermal tests with fungi extract were also performed in the patients whose prick test to these fungi had been negative. Results: Sixty-seven genus of fungi have been identified and the more prevalent were: Cladosporium, Epicoccum, yeast, Aspergillus, Helminthosporium, Nigrospora, Monilia, Fusarium, Hyalodendrum, Penicillium, Curvularia, Humicola, Alternaria, Trichoderma and Sphaerosporium. Two hundred and seven patients have been selected and 118 (57%) have been at least one positive test to fungus. Intradermal test made the diagnosis in 88% of all diagnostics of sensitization, whereas \"in vitro\" specific IgE had low sensibility (4%). The more sensitizer fungi were: Aspergillus, Neurospora, Candida, Penicillium and Cladosporium. There was a significant correlation between severe asthma and fungi sensitization and the fungi more prevalent in that group of patient were: Aspergillus, Neurospora and Candida. Moreover, there was a positive correlation between the number of asthmatic patients attended in Emergencies and the total of CFU in the study period. Conclusion: We recognize in the air fungi specific to Botucatu although the most prevalent fungi are the same found in other places in the world; the fungi sensitization among patients with allergic respiratory diseases is meaningful and correlated with asthma severity; the intradermal test was the best mean to diagnose fungi sensitization

A imunodeficiência comum variável (ICV) é uma síndrome heterogênea caracterizada por hipogamaglobulinemia e infecções bacterianas de repetição. As doenças obstrutivas, como a asma, estão presentes em aproximadamente 50% dos pacientes. Os sintomas decorrentes de infecções respiratórias de repetição podem mascarar os sintomas de alergia respiratória. A asma tem alta prevalência no mundo e é observada em aproximadamente 10% da população brasileira. Embora muitos pacientes com ICV apresentem história clínica sugestiva de rinite e/ou asma alérgicas, a participação da atopia não está bem esclarecida e freqüentemente os níveis de IgE total e/ou IgE específica estão baixos. Muitos autores estudam a produção de IgE local e uma correlação entre a concentração de IgE nos fluidos corporais e no soro existe. Os objetivos deste estudo são avaliar a função pulmonar em pacientes com ICV através de: espirometria, provocação brônquica com histamina e com alérgeno; investigar o diagnóstico de asma em pacientes com ICV e realizar a investigação in vivo e in vitro da IgE em pacientes com ICV. Este estudo incluiu 62 pacientes que estavam em acompanhamento ambulatorial no Serviço de Imunologia Clínica e Alergia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. A função pulmonar foi avaliada pela espirometria e pela provocação brônquica com histamina antes e após uma provocação brônquica com Dermatophagoides pteronyssinus (Der p) e a investigação da IgE específica para aeroalérgenos através de teste epicutâneo e avaliação da IgE sérica específica usando ImmunoCAPTM. Vinte e nove (46,7%) tinham história clínica de sugestiva de asma e em relação à atopia, 27 (43,5%) tinham história sugestiva de atopia. Uma associação de asma e atopia no mesmo paciente foi encontrada em 18 pacientes (29%). Nós comparamos o grupo sugestivo de asma alérgica com os outros pacientes pacientes com rinite alérgica ou não-alérgica, asma não-alérgica e pacientes sem sintomas respiratórios. A maioria dos pacientes apresentou níveis séricos de IgE total indetectáveis. Somente dois pacientes apresentaram resultado positivo para IgE específica pelo teste epicutâneo e in vitro. Sessenta e um pacientes realizaram espirometria. Destes, 25 pacientes (41%) apresentaram resultado normal, 29 (47,5%) apresentaram distúrbio ventilatório obstrutivo e 7 (11,5%) apresentaram resultados sugestivos de distúrbio ventilatório restritivo. As provocações brônquicas foram realizadas em 15 pacientes. A provocação brônquica com histamina foi considerada positiva em 3 pacientes com história positiva para asma. Em relação à provocação brônquica com Der p, nenhum paciente apresentou resposta imediata positiva. Entretanto, quando a segunda provocação brônquica com histamina foi realizada (pós-Der p), quatro dos 5 pacientes com história sugestiva de asma alérgica apresentaram resultado positivo, com diminuição de PC20 em relação à primeira provocação vi brônquica com histamina. Uma diferença estatística foi observada nos resultados entre o grupo sugestivo de asma alérgica e os pacientes sem asma alérgica. Ao final do estudo, a asma foi confirmada em 9 pacientes com ICV (14,5%), a atopia foi confirmada em 6 pacientes com ICV (9,7%) e a asma alérgica foi confirmada em 4 pacientes com ICV (6,5%), que correspondeu a 22,2% dos 18 pacientes com suspeita de asma alérgica / Common variable immunodeficiency (CVID) is a heterogenous immunodeficiency syndrome characterized by hypogammaglobulinemia, and recurrent bacterial infections. Obstructive diseases as asthma are present in approximately 50 % of patients. Symptoms due to recurrent respiratory pyogenic infections may mask respiratory allergic symptoms. Asthma has high worldwide prevalence and is observed in approximately 10 % of Brazilian population. Although a number of patients with CVID report a clinical history suggestive of allergic symptoms, the role of atopy is not well established in these individuals; and frequently levels of total IgE and/or specific IgE are low. Local IgE production has been studied and a correlation between IgE concentration in body fluids and serum exists. The objectives of this study are evaluation of pulmonary function in patients with CVID through: spirometry, bronchial challenge with histamine, and with allergen; investigate asthma diagnosis in patients with CVID; perform in vivo and in vitro investigation of IgE in patients with CVID. This study included sixty-two patients, who were being followed at the Service of Clinical Immunology and Allergy of the Hospital das Clínicas of the University of São Paulo Medical School. Pulmonary function was assessed using spirometry and bronchial challenge with histamine before and after a bronchial challenge with Dermatophagoides pteronyssinus (Der p), and investigation of specific IgE for aeroallergens with skin prick test and serum specific IgE evaluation using ImmunoCAPTM. Twenty-nine (46.7 %) had clinical history suggestive of asthma, and in regards to atopy, twenty-seven patients (43.5%) reported atopy suggestive history. An association of asthma and atopy in the same patient was observed in eighteen (29 %) participants. We compared the group of allergic asthma with the other patients patients with allergic or non-allergic rhinitis, non-allergic asthma, and patients without respiratory. Most patients had undetectable levels of total IgE concentration in serum. Only two patients had positive results for specific IgE by prick test and in vitro investigation. All patients, except one, underwent spirometry test for lung function evaluation. Of the sixty-one patients, twenty-five (41 %) had normal spirometry results, twenty-nine (47.5 %) had Obstructive Ventilatory Defect, and seven (11.5 %) had results suggestive of Restrictive Ventilatory Defect. Bronchial challenges were performed in fifteen patients. Bronchial challenge with histamine was considered positive in three patients with a positive history of asthma. Regarding to bronchial challenge with Der p, none presented immediate positive response. However, when the second nonspecific bronchial provocation with histamine was performed (post-Der p), four of the five patients with a history of allergic asthma had positive test results, with lower PC20 than in the first non-specific bronchial provocation with histamine. A statistical difference was noticed in the test results of the group suggestive for allergic asthma and the patients without allergic asthma. viii At the end of this study, asthma had been confirmed in 9 patients with CVID (14.5%), atopy had been confirmed in 6 patients with CVID (9.7%), and allergic asthma had been confirmed in 4 patients with CVID (6.5%), which corresponded to 22.2% of the 18 patients suspected of allergic asthma

Submitted by VINÍCIUS ATHAYDES CANELLO null (vinaocanello@hotmail.com) on 2017-03-16T11:28:58Z No. of bitstreams: 1 Tese Versão Final.pdf: 4376586 bytes, checksum: 13d4cc1c29f43d7c4deb2102a7b48543 (MD5) / Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2017-03-22T16:42:38Z (GMT) No. of bitstreams: 1 canello_va_dr_jabo.pdf: 4376586 bytes, checksum: 13d4cc1c29f43d7c4deb2102a7b48543 (MD5) / Made available in DSpace on 2017-03-22T16:42:38Z (GMT). No. of bitstreams: 1 canello_va_dr_jabo.pdf: 4376586 bytes, checksum: 13d4cc1c29f43d7c4deb2102a7b48543 (MD5) Previous issue date: 2017-02-03 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O grande desafio do sistema de defesa respiratório é a manutenção dos animais em baias. Pois, devido a diversos fatores, acaba por aumentar as chances do desenvolvimento de afecções respiratórias e a qualidade do material utilizado como cama é fator agravante. Diante disto, três grupos com 5 equinos cada foram submetidos a 45 dias sob o mesmo manejo, sendo dois grupos estabulados com diferentes tipos de cama, um com maravalha esterilizada (ME) e o outro com maravalha não esterilizada (MNE), e o terceiro grupo a pasto (Pasto). Foram realizadas análises do lavado broncoalveolar (LBA) (celularidade e marcadores de estresse oxidativo) e hemograma antes do início do manejo (Basal) e posteriormente a cada 15 dias (M15, M30 e M45). Também foi avaliada a presença de gêneros fúngicos nas amostras de cama, e do feno utilizado na alimentação dos animais. Os hemogramas permaneceram dentro dos valores da normalidade. Os valores obtidos de malondialdeído (MDA) e ácido úrico no LBA não apresentaram diferença entre os momentos e grupos avaliados. A vitamina C no LBA apresentou queda em seus valores em M30. Os três grupos apresentaram queda nas concentrações de glutationa reduzida em M30, tendo havido diferença significativas entre os grupos Pasto e MNE. Os grupos ME e MNE apresentaram queda nos valores de glutationa oxidada em M45, já o grupo Pasto apresentou queda constante a partir de M15, com diferença significativa em relação ao grupo ME em M30. A superóxido dismutase apresentou aumento em M30 no grupo MNE, levando a diferença significativa em relação aos grupos Pasto e ME. A glutationa peroxidase no LBA apresentou queda significativa no grupo ME em M45. Quanto a celularidade do LBA a contagem de células nucleadas totais e eosinófilos não apresentaram diferenças significativas. O grupo ME apresentou elevação nos valores de neutrófilos em M30, levando a diferença significativa em relação aos grupos MNE e Pasto, já o grupo MNE apresentou queda significativa em M45. Os grupos ME e MNE apresentaram queda nos valores de linfócitos no LBA em M30, já o grupo Pasto apresentou queda em M15. O grupo Pasto apresentou aumento dos macrófagos no LBA em M15 e M30. As análises das amostras de cama e feno apresentaram baixas porcentagens de gêneros fúngicos. Grande parte das alterações apresentadas ocorreram em M30, momento em que foram registradas as menores temperaturas e maiores velocidades dos ventos durante todo período experimental, o que possivelmente levou a um desequilíbrio oxidativo pontual, com pequenas variações na celularidade do LBA. Acredita-se que o manejo, as boas condições de higiene e ventilação das baias tenham contribuído para que não houvesse o desenvolvimento de alterações inflamatórias no sistema respiratório dos animais avaliados. Deste modo, podemos concluir que não houve diferenças significativas na manutenção dos animais nos diferentes tipos de cama em relação a resposta inflamatória, estresse oxidativo e desenvolvimento fúngico. / The great challenge of the respiratory defense system is the maintenance of animals in stalls, which due to several factors ends up increasing the chances of development of respiratory diseases. The quality of the material used as bed is an aggravating factor. Three groups of 5 horses were submitted to 45 days under the same management, and two groups were housed with different types of beds, one with sterilized wood shaving (ME) and the other with unsterilized wood shaving (MNE), and the third group was maintened in the pasture. Bronchoalveolar lavage fluid (BALF) and hemoglobin analyzes were performed before baseline and then every 15 days (M15, M30 and M45). It was also evaluated the possible presence of fungal genera in bed samples, and in hay used in animal feeding. The hemograms remained within normal values. The values of malondialdehyde (MDA) and uric acid in BALF showed no difference between the moments and groups evaluated. Vitamin C in BALF showed a decrease in M30 values. The three groups showed a decrease in the concentrations of glutathione reduced in M30, and there were significant differences between the groups pasture and MNE. The ME and MNE groups showed a decrease in the values of oxidized glutathione in M45, whereas the pasture group presented a constant drop from M15, with a significant difference in relation to the ME group in M30. Superoxide dismutase increased in M30 in the MNE group, leading to a significant difference in relation to the pasture and ME groups. Glutathione peroxidase in BALF showed a significant decrease in the ME group in M45. As for the cellularity of BALF, total nucleated and eosinophil counts did not showed significant differences. The ME group presented elevation in neutrophil values in M30, leading to a significant difference in relation to the MNE and pasture groups, whereas the MNE group presented a significant decrease in M45. The ME and MNE groups presented a decrease in lymphocyte values in the BALF in M30, whereas the pasture group presented a decrease in M15. The pasture group presented increase of the macrophages in the BALF in M15 and M30. Bed and hay samples showed low percentages of fungal genera. Most of the alterations presented occurred in M30, at which time the lowest temperatures were recorded throughout the experimental period, possibly leading to a punctual oxidative imbalance, with small variations in BALF cellularity. It is believed that management, good conditions of hygiene and ventilation of the boxes contributed to the no development of inflammatory changes in the respiratory system of the animals evaluated. Thus, we can conclude that there were no significant differences in the maintenance of the animals in the different types of bed in relation to the inflammatory response, oxidative stress and fungal development.

Throughout many parts of the world house dust mites (HDM) are considered as a major source of indoor aeroallergens and they are powerful inducers of allergic diseases. Proteolytic HDM allergens are recognised as being able to directly activate respiratory epithelial cells and thereby actively participate in innate immune responses. Although several major HDM allergens lack proteolytic activity, their possible ability to similarly interact with epithelial cells is not known. The overall aim of this thesis was therefore to elucidate if and how major non-proteolytic group 2 allergens from different mite species interact with respiratory epithelial cells. The effects of the structurally related Der p 2, Der f 2 and Eur m 2 from different HDM species as well as the storage mite allergen Lep d 2 were studied in vitro using human respiratory epithelial cells. Also the non-proteolytic, but structurally dissimilar, Fel d 1 from cat, Can f 2 from dog, Bet v 1 from birch and Phl p 5a from timothy were studied. In this thesis evidence that major group 2 mite allergens activate bronchial epithelial cells is presented. Following allergen exposure the secreted amount of the inflammatory mediators G-CSF, GM-CSF, IL-6, IL-8, MCP-1, MIP-3α and sICAM-1 was increased. Surface expression of ICAM-1 was also increased following allergen exposure. Moreover, Fel d 1 and Can f 2 induced secretion of the same mediators from bronchial epithelial cells, representing two additional protein structures being able to directly induce cell activation. In experiments using specific inhibitors and siRNA transfection, it was shown that the mite allergens engage TLR4 and activation through MyD88, MAPK and NF-κB signal transduction pathways. In conclusion, the novel findings in this thesis provide knowledge on how major aeroallergens, in addition to their ability to provoke specific adaptive immune responses, may aggravate a respiratory airway disease by adjuvant-like activation of inflammatory responses in bronchial epithelial cells. This differs from previously reported allergen-induction of epithelial cells by the clear independency of proteolytic activation.

In the present studies we have explored the link between food hypersensitivity and IgA nephropathy (IgAN) and evaluated treatment options in primary and recurrent disease. Approximately one third of our IgAN patients had a rectal mucosal sensitivity to gluten, as demonstrated by increased local mucosal nitric oxide production and/or myeloperoxidase release after gluten challenge. The gluten sensitivity seemed to be an innate immune reaction unrelated to the pathogenesis of celiac disease. Approximately half of the patients had a rectal mucosal sensitivity to soy or cow’s milk (CM). The levels of IgG antibodies to alfa-lactalbumin, beta-lactoglobulin and casein were significantly higher in CM sensitive as compared with non-sensitive IgAN patients, indicating that an adaptive immune response might be involved in addition to the innate immune reaction observed. With the knowledge of gastrointestinal reactivity enteric treatment was considered as a potential new treatment approach of IgAN. A 6-month prospective trial demonstrated proof-of-concept for the use of enteric budesonide targeted to the ileocaecal region of IgAN patients. We observed a modest, but significant reduction in urine albumin, a minor reduction of serum creatinine and a modest increase of eGFR calculated by the MDRD equation. eGFR calculated from the Cockcroft-Gault formula and cystatin C was not changed. In a retrospective study recurrence of IgAN and graft loss was evaluated in Norwegian and Swedish patients having received a primary renal transplant due to IgAN. Adjusting for relevant covariates, a multiple Cox-regression analysis on time to IgAN recurrence showed that use of statins was associated with reduced risk of recurrence and reduced risk of graft loss. The time lag from diagnosis to first transplantation and female gender were also associated with lower risk of recurrence. Improved graft survival was associated with related donor, low donor age and no or low number of acute rejection episodes.