The overall goal of my thesis research was to understand better the mechanisms that control antigen processing and presentation by class II MHC molecules. Towards this goal I investigated ways in which the physical structure and post-translational modifications of the class II MHC alpha and beta chains and associated molecules might serve to regulate antigen processing and presentation. Specifically, I investigated (1) a hypothesis that Ii might aid binding of foreign antigenic peptides to the class II MHC foreign antigen binding site (desetope), and the application of this hypothesis to the prediction of class II-presented peptides; (2) the proteolytic cleavage of Ii to p25; (3) the proteolytic cleavage of the class II MHC alpha and beta chains, and (4) the phosphorylation of Iiand the alpha and beta chains. In exploring the hypothesis that amphipathic alpha helical peptides digested from foreign antigen, bind to the class II MHC desetope, to be presented to T cell receptors, we found such an extended, amphipathic helix in Ii (Phe146-Val164). A hypothesis was developed that this amphipathic alpha helix of Ii bound to the desetope of class II MHC molecules, and remained there from time of synthesis until catalyzing the charging of the desetope with a foreign peptide. This region of Iicould then be considered to be the prototypic T cell-presented peptide and the "strip-of-helix" algorithm was developed to search the sequences of proteins for similar amphipathic alpha helices. Such peptides might bind to the class II MHC desetope and have a high probability to be presented to the T cell. The strip-of-helix algorithm calculated the mean hydrophobicity (from Kyte-Doolittle values; Kyte and Doolittle, 1982) of sets of amino acids in axial strips down sides of helices for 3 to 6 turns, at positions n, n+4, n+7, n+11, n+14, and n+18. Peptides correlating well with T cell responsiveness had: (1) 12 to 19 amino acids (4-6 turns of an alpha helix), (2) a strip with highly hydrophobic residues, (3) adjacent, moderately hydrophilic strips, and (4) no prolines to break the helix. This algorithm predicted 10 of 12 T cell-presented peptides in 7 well-studied proteins. In a study of the post-translational modifications of Ii, an early proteolytic pathway of the destruction of Ii, resulting in the generation of p25, was described. This 25,000 dalton protein, seen in immunoprecipitates with antibodies to class II MHC molecules or to Ii, was shown to be a C-termina1 fragment of a high mannose form of Ii. The evidence for this conclusion includes the following results. [35S]methionine-1abe1ed Ii and associated molecules were immunoprecipitated, denatured, resolubi1ized and subjected to a second immunoprecipitation with various antibodies. Two antisera to C-termina1 peptides of Ii (183-193 and 192-211), but not an antiserum to an N-termina1 peptide (12-28), immunoprecipitated p25. A monoclonal antibody (mAb) to Ii immunoprecipitated [35S]methionine-1abe1ed p25 but not [35S]cysteine-1abe1ed p25, consistent with the loss of a portion of Ii containing the only cysteine in Ii, Cys28. [35S]methionine pulse-chase labeling demonstrated the maximal appearance of p25 at 20-40 min chase times. p25 molecules were reduced to about 10.5 kD by treatment with endoglycosidases F and H. p25 was, therefore, generated from a high mannose form of Ii in the ER or cis-Golgi. This finding could either implicate that site for class II MHC desetope charging with foreign peptides or reflect a mechanism for degradation of "excess" Ii molecules in the ER. Digestion of class II MHC antigen-Ii complexes with various proteases yielded fragments, migrating at and near p25 in 2-D electrophoretic gels, which were relatively resistant to further digestion. This observation was consistent with the presence of relatively protease-resistant secondary structures (domains) and a relatively protease-sensitive (IgG hinge-like) region in Iinear its insertion into the membrane. In a study of the post-translational modifications of the class II MHC alpha and beta chains, well conserved pairs of basic amino acids in the sequences of these molecules were observed. It was hypothesized these could be sites for proteolytic cleavage, as precedented in other systems (i.e.proinsulin processing). These potential cleavage sites fall in significant locations with respect to the deduced structure of the class II MHC desetope, supporting the hypothesis that these cleavages might either aid or destroy antigen presenting functions. To test this hypothesis we looked for remnant polypeptides of the alpha and beta chains. Polypeptides were observed in gels of immunoprecipitated class II MHC complexes. To identify if such polypeptides were derived from the alpha and beta chains, immunoblotting to electrotransferred polypeptides was attempted, with antisera made to synthesized peptides that mimicked eight regions of the alpha and beta chains. These antisera were produced and characterized by dot blotting, ELISA, western blotting, and immunoprecipitation of native and denatured material. One antiserum, to an alpha chain peptide (77-88), blotted to a polypeptide immunoprecipitated by anti-class II MHC antiserum. This observation supported the hypothesis that the alpha and beta chains undergo proteolytic cleavages, possibly in the control of antigen presentation. It was also demonstrated that Ii and the alpha and beta chains can be phosphorylated under varying culture conditions, but this project was not pursued.

Les nanoparticules (NP) ont été introduites en médecine pour développer des médicaments intelligents ou des agents d'imagerie. En raison de leur petite taille (<200 nm), les NP permettent la mise en place de thérapies ciblées, augmentent la diffusion et l’efficacité des drogues, tout en facilitant les modes d’administration et en diminuant les couts de santé publique. Malgré les promesses que présentent les NP pour la médecine, les risques potentiels pour la santé humaine associés à une exposition aux NP restent mal documentés ; en particulier en ce qui concerne leurs effets sur le système immunitaire. Les cellules présentatrices d’antigène (CPA) (comprenant les macrophages et les cellules dendritiques) sont recrutées au site d’inflammation induite par des pathogènes et constituent une ligne de défense majeure pour notre organisme. Les CPA sont dotées d’une activité de phagocytose et endocytose conduisant à une forte internalisation des NP. Ainsi, ces cellules seront parmi les plus affectées par une exposition aux NP et sont un modèle expérimental pertinent pour l’étude du devenir cellulaire des NP et de leurs effets sur l’hôte.Dans cette étude, nous avons étudié si les fonctions de ces cellules pourraient être modifiées par une exposition aux NP. Comme modèles de NP, nous avons choisi l'or (AuNP) et le gadolinium-polysiloxane (GdSi) utilisés comme agent de contraste ou de théranostique, le poly lactic-co-glycolic acid (PLGA) et une nano émulsion lipidique (LNP) développés comme plateforme de délivrance d’antigènes ou de médicaments. Tout d'abord, en utilisant des microsphères fluorescentes comme sonde, nous avons montré que toutes les NP testées n'altèrent pas la capacité de phagocytose de la lignée cellulaire de macrophages J774. Ensuite, l’activation des cellules a été analysée par cytométrie de flux, basée sur l'expression des marqueurs de surface CD-86 et MHC-II. Nous avons établi que l'exposition aux NP n'active pas les cellules dendritiques dérivées de la moelle osseuse (BMDC). Dans le même sens, aucune de ces NP n’induit par elle-même de sécrétions de cytokines par les BMDC. En outre, l’activation de ces cellules par des activateurs connus, tels que le lipopolysaccharide bactérien (LPS) n'est pas modifiée par les NP. Cependant, l'exposition aux AuNP diminue l'expression des cytokines IL-6, IL-12 et IL-23 par les BMDC activées par LPS. Or, ces cytokines sont impliquées dans la polarisation des lymphocytes T CD4 + vers le phénotype T helper approprié (Th). Nous avons analysé si ces modifications de cytokines pourraient modifier la réponse Th. Dans un modèle in vitro de présentation d'antigène, les BMDC ont été incubés avec un antigène modèle (ovalbumine (OVA)) et co-cultivés avec des cellules T spécifiques de l'OVA. L'exposition aux AuNP a conduit à une augmentation des cytokines spécifiques des lymphocytes T: IL-13 (indiquant un déplacement de la balance Th1 / Th2 classique vers Th2) et IL-17 (permettant de diriger les cellules T vers Th17). L'exposition des BMDC aux autres NP de l'étude ne modifie que très faiblement leurs sécrétions de cytokines inflammatoires, et n'a donc pas d'impact sur le destin des lymphocytes T après la présentation de l'antigène.L’ensemble de ces résultats démontrent que GdSi, PLGA et LNP ne modifient pas la phagocytose, l'activation des DC et la présentation antigénique. Cependant, l'exposition aux AuNP modifie les réponses inflammatoires des DC et le devenir des cellules T vers les phénotypes Th2 et Th17. Ces modifications pourraient entraver la physiologie du système immunitaire et contribuer aux maladies chroniques ou à l'auto-immunité. / Nanoparticles (NP) have been introduced in medicine to develop intelligent drugs or imaging agents. Due to their small size (<200 nm), NPs allow the development of targeted therapies, increase drug diffusion and effectiveness while facilitating modes of administration and decreasing public health costs. Nevertheless, the potential risks for human health associated to NP exposure remain poorly documented; especially about their effects on the immune system. Antigen-presenting cells (APC) (including macrophages and dendritic cells) are recruited at the site of pathogen-induced inflammation and constitute to the maintenance of body integrity, engulfing pathogens and delivering signals to other components of the immune system. Due to their internalization abilities, APC accumulate NP in their cytoplasm. Thus, these cells will be among the most affected by exposure to NP and constitute a relevant experimental model for the study of the cellular fate of NP and their effects on the host.In this study, we investigated whether the functions of these cells could be modified by an exposure to NP. As models of NP, we selected gold (AuNP) and gadolinium-polysiloxane (GdSi) used as contrast agent for therapeutic and diagnostic applications, and poly lactic-co-glycolic acid (PLGA) and lipid nano emulsion (LNP) developed as a platform for the delivery of antigens or drugs.First, using fluorescent microspheres as probe, we have shown that all of the tested NP did not alter the phagocytosis capacity of the J774 macrophage cell line. Then, cell activation was analyzed by flow cytometry, based on the expression of the surface markers CD-86 and MHC-II. We have established that NP exposure did not activate bone marrow derived dendritic cells (BMDC). In this way, none of these NP induced cytokine secretions by the BMDC. Furthermore, activation of these cells by known activators, such as bacterial lipopolysaccharide (LPS) was not modified by NP.However, in this case, the cytokine response was altered by AuNP exposure, showing reduced inflammatory cytokine production such as IL-6, IL-12 and IL-23. Interestingly, these cytokines are involved in the polarization of CD4 + T lymphocytes to the appropriate T helper phenotype (Th). In a model of antigen presentation in vitro, this cytokine profile resulted into an altered development of specific immune responses. AuNP exposure increased T cell specific cytokines: IL-13 and IL-4 (indicating a shift of classical Th1/Th2 balance towards Th2) and IL-17 (standing for an alteration of T-cell fate towards Th17). The exposure of BMDC to the other NP of the study only very slightly altered their inflammatory cytokine secretions and therefore did not affect the fate of T lymphocytes after antigen presentation.All together, these results demonstrate that GdSi, PLGA and LNP do not modify phagocytosis, DC activation and antigen presentation. However, exposure to AuNP alters the DC induced inflammatory responses and polarizes the T cell fate towards Th2 and Th17 phenotypes. These changes could impair the physiology of the immune system and contribute to chronic diseases or autoimmunity.

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective therapeutic option for many malignant diseases. However, the efficacy of allo-HSCT is limited by the occurrence of destructive graft-versus-host disease (GVHD). Since allogeneic T cells are the driving force in the development of GVHD, their activation, proliferation, and differentiation are key factors to understanding GVHD pathogenesis. On the other hand, antigen-presenting cells (APCs) are essential for allogeneic T-cell priming and the development of GVHD. The T-box transcription factor T-bet is a master regulator for IFN-γ production and Th1 differentiation. T-bet also regulates the functions of APCs including dendritic cells (DCs) and B cells. Therefore, we investigated the role of T-bet in T cell responses, as well as on APC functions, in acute GVHD (aGVHD) using murine models of allogenic bone marrow transplantation (allo-BMT). In Chapter 2, we evaluated the roles of T-bet and IFN-γ in T-cell responses. T-bet-/- T cells induced significantly less GVHD compared with either wild-type (WT) or IFN-γ-/- counterparts in CD4-driven major histocompatibility complex (MHC)- or minor histocompatibility antigen (miHA)-mismatched models. We defined several T-bet-dependent but IFN-γ-independent molecules that may account for this distinct outcome. Further study indicates that T-bet also controls the optimal activity of Th17 cells to induce GVHD. Moreover, the compromised graft-versus-leukemia (GVL) effect of T-bet-/- T cells could be essentially reversed by IL-17 neutralization. Thus, targeting T-bet or regulating its downstream effectors independent of IFN-γ may be a promising strategy to control GVHD in the clinic. In Chapter 3, we evaluated the role of T-bet on APCs and found that T-bet-/- recipients developed much milder GVHD than their WT counterparts in MHC-mismatched or CD4-depedent miHA-mismatched models. As the functional readout of APCs, allogeneic donor T cells, particular CD4 subpopulation, significantly reduced IFN-γ production, proliferation and migration, and caused less damage in liver and gut in T-bet-/- recipients. We further observed that T-bet on recipient hematopoietic APCs, particular DCs, was primarily responsible for donor T-cell response and pathogenicity in GVHD. In fact, Trail/DR5 interaction served as a major signaling pathway responsible for donor T-cell apoptosis and impaired GVHD development in T-bet-/- recipients. Furthermore, T-bet expression on the host is largely dispensable for the GVL effect. Taken together, we propose that T-bet is a potential therapeutic target for the control of GVHD through regulating T cells as well as APCs. We believe further exploration and understanding of the immunobiology of T-bet in controlling the activities of T cells and APCs in GVHD will expand therapeutic options for the continuing success of allo-HSCT.

Les phosphoantigènes (P-Ag) de P. falciparum (P.f.) induisent une forte activation et une expansion des lymphocytes T (LT) Vγ9Vδ2 par un mécanisme encore mal décrit. Les LT Vγ9Vδ2 actives inhibent le cycle sanguin de P. f. par des médiateurs cytotoxiques solubles, inhibant ainsi la capacité invasive des mérozoites. Il a été montre in vitro que des LT Vγ9Vδ2 activés par les P-Ag peuvent présenter des antigènes et activer les LT αβ, agissant ainsi comme des cellules présentatrices d’antigènes (APC). Cette fonction n’a cependant pas été démontrée dans un contexte physiopathologique. Le but de ce projet est i) d’étudier les mécanismes d’activation des LT Vγ9Vδ2 par les stades sanguins P. f. et ii) d’evaluer le potentiel APC des LT Vγ9Vδ2 stimules par P. f. Nous montrons que l’activation des LT Vγ9Vδ2 par des globules rouges parasites par P. f. (GRP) intacts ne dépend ni d’un contact cellulaire, ni de l’expression de butyrophiline par le GRP. Les LT Vγ9Vδ2 sont activés par des molécules contenues dans les surnageants de culture de GRP, ayant les caractéristiques de P-Ags et étant libérées lors de la rupture des GRP. In vitro, les LT Vγ9Vδ2 stimules par les GRP expriment des marqueurs de surface associés à un rôle d’APC et cross-présentent un antigène modèle à une lignée T CD8 spécifique. In vivo, nous montrons une expression augmentée des marqueurs APC à la surface de LT Vγ9Vδ2 de patients infectés par P. falciparum. L’ensemble de ces données suggèrent que les P-Ag libérés par les GRP dans le milieu extracellulaire pourraient activer les LT Vγ9Vδ2 à distance, et ouvrent de nouvelles perspectives quant au rôle des LT Vγ9Vδ2 dans la réponse immunitaire adaptative anti-palustre. / P. falciparum derived phosphoantigens (P‐Ag) induce potent activation and expansion of Vγ9Vδ2 T-cells by a poorly described mechanism. Activated Vγ9Vδ2 T cells inhibit the Plasmodium falciparum blood cycle through soluble cytotoxic mediators, abrogating merozoite invasion capacity. In vitro, P-Ag activated Vγ9Vδ2 T lymphocytes have been shown to present antigens and induce αβ T lymphocyte responses, i.e. to act as an antigen presenting cell (APC). Whether this activity can be involved in a pathophysiological context is unknown. The aim of this PhD project is to a) investigate the mechanisms of Vγ9Vδ2 T cell activation by blood stage P. falciparum and b) assess the potential of P. falciparum activated Vγ9Vδ2 T cells to display APC functionality. We show that Vγ9Vδ2 T-cell activation by intact iRBCs is independent of iRBC contact and butyrophilin expression. Blood stage culture supernatants can potently activate Vγ9Vδ2 T-cells and bioactivity is found to be attributable to P-Ags released at the time of parasite egress from the RBC. In vitro iRBC stimulated Vγ9Vδ2 T cells up-regulate surface expression of APC associated markers and can cross-present a model antigen to specific CD8 T cell responders. In vivo we demonstrate an increase in surface expression of APC makers on Vγ9Vδ2 T cells from P. falciparum infected patients.Altogether, these data outline a framework whereby P‐Ag release by iRBC into extracellular milieu can promote activation of distant Vγ9Vδ2 T cells, and opens the door to a new aspect of Vγ9Vδ2 T cell contribution to P. falciparum adaptive immune responses.

Microchimerism arises from the exchange of cells between genetically distinct individuals. The coexistence of genetically distinct cell populations within a single organism has possible effects on health and functioning of individuals immune systems, but the exact mechanisms of action are often not yet known. With the development of microscopic technologies and software for data analysis, the possibilities of detection and phenotyping of these rare cell populations are expanding. My intention in this work is to find maternal microchimerism in embryonic tissues (E13) and intestines of breastfed pups using MHCII/EGFP knock-in mouse model. Several different technologies potentially suitable for the detection of maternal microchimeric cells in offspring tissues (light sheet fluorescent microscopy - LSFM, virtual slide microscopy and flow cytometry) were selected. Advanced analysis of the obtained samples from the light sheet microscopy using the creation of a neural network was used here. The presence of maternal microchimerism was not demonstrated by flow cytometry. Using LSFM, image data were obtained from intestinal samples of suckling pups, which were processed by the neural network method. Data analysis of embryos (E13) obtained by the same method did not allow data analysis due to high...

Tolerance to self proteins is largely dependent upon the deletion of immature, self-specific T and B cells in the thymus and bone marrow. Although highly efficient, the elimination of these self-reactive lymphocytes is dependent on the expression of their target antigen in these primary lymphoid organs. Many proteins, however, such as hormones, are developmentally regulated and expressed at different stages of life, while other proteins are expressed outside the thymus and marrow. To ensure self-tolerance, other mechanisms must exist to inactivate or prevent the activation of mature, potentially self-reactive lymphocytes and maintain peripheral tolerance. T cell activation requires direct recognition of a specific protein fragment, presented on the surface of an antigen presenting cell (APC), as well as the interaction between various T cell and APC surface molecules. In the absence of the costimulatory signals provided by these ligand-pair interactions and lymphokines, antigen recognition leads to T cell inactivation and tolerance to the protein. Since many autoimmune disorders appear to be based upon the aberrant activation of mature T lymphocytes, it is important to identify and understand the mechanisms of peripheral tolerance. The obvious importance of the APC in initiating the T cell immune response has led our lab to examine one of the many antigen-processing cells, the B lymphocyte. Our studies have shown that B cells are highly efficient APC and can present antigen at very low doses to cultured T cell lines. In addition, we have found that we can induce tolerance, as measured by a reduced antibody response to an immunogenic form of the protein, in naive, normal mice by targeting a foreign protein to their B cells for antigen processing and presentation. Tolerance in the treated mice can be traced to a lesion in the T cell compartment of the animals, thus suggesting that B cells can act as tolerizing APC for peripherally expressed antigens. To further explore this idea and find more direct evidence for the role of B cells in establishing peripheral tolerance, we developed a model system that would more closely resemble in vivo conditions. This thesis tests and provides additional evidence for the hypothesis that B cells are tolerizing antigen presenting cells for peripherally expressed protein antigens. Tolerance to the foreign protein human μ chain, is induced in normal recipient mice by the transfusion of splenocytes from transgenic mice that express the membrane-bound form of μ on their B cells. Tolerance is antigen-specific since the transfused recipients' antibody production to the irrelevant protein chicken IgG is not compromised. Only viable transgenic spleen cells are tolerogenic and even when human μ chain is accessible to other APCs for presentation, tolerance can be induced by the transfusion of live μ transgenic splenoctyes. These data suggested that the transfused μ chain-expressing B cells are the tolerizing APCs which was confirmed by experiments that compared the tolerizing abilities of purified B and T cells from the transgenic mice. Adoptive transfer experiments showed that the recipients' T cell response to human μ was impaired but an analysis of the isotypes produced by tolerized mice did not indicate that either helper T cell subset was specifically compromised. Splenocytes from human μ chain-secreting transgenic B cells also induce tolerance to human μ in nontransgenic mice. Although human μ chain-expressing B cells were not detected in transfused mice, the presence of measurable levels of human IgM in the sera of mice transfused with μ chain-secreting spleen cells suggests that the transfused transgenic B cells persist in their new host. In addition, the tolerizing ability of both resting and activated membrane-bound μ chain B cells was compared. Lipopolysaccharide (LPS)-activated transgenic spleen cells do not tolerize, nor do they prime for antibody to human μ, thus suggesting that the induction of costimulatory molecules on the transgenic B cells inhibits tolerance induction. To more specifically address this, human μ chain-expressing mice were bred to transgenic mice that express the costimulatory molecule, B7-1 (CD80), on their B cells. Double transgenic splenocytes, in which the B cells bear both human μ and B7-1, did not induce tolerance to human μ chain, a result that supports the idea that activated B cells are not tolerogenic. Together the data in this thesis show that resting B cells can process and present a foreign endogenous antigen in a tolerogenic manner to the immune system and suggest a role for the B cell in the maintenance of peripheral tolerance.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Histopathologic examination of the tumor microenvironment demonstrates the presence of a vast repertoire of infiltrating lymphocytes and antigen presenting cells (APC’s). Recent studies establish a strong correlation between the tumor microenvironment cell composition and prognostic value in terms of cell type, location and ratio, referred to as a tumor’s immunoscore. More specifically, the relationship between T regulatory (Treg) cell to T effector (Teff) cell percentage predominates as a mechanism of tumor immune evasion. Further investigation of the factors influencing the development of Treg and Teff cells is therefore warranted. Gammainterferon‐inducible lysosomal thiol reductase (GILT) acts to influence antigenic processing and presentation by MHC class II cells, ultimately impacting lymphocyte development. Evaluation of the role of GILT expression in MHC class II+ APC’s with respect to Treg and Teff cell development in primary melanoma lesions, to our knowledge, has not been reported. Therefore our investigation focuses on elucidating a plausible relationship between GILT presence and Treg to Teff cell ratio. The aim of our study is to examine a possible association between GILT expression in APC’s and Treg:Teff cell ratio. We hypothesized GILT expression in melanoma cells would result in a decreased Treg to Teff ratio or an enhanced T cell‐mediated response. Our study included 17 de‐identified primary melanoma specimens previously stained and scored for Treg, Teff, CD8, MHC class II and GILT. Scoring was performed through identification of four areas per specimen with highest Treg and Teff cell density. These four areas were then averaged with ± standard deviation (SD). With use of landmark association, these four areas were identified and scored for MHC class II and GILT in APC’s and tumor cells with consideration to presence/absence, intensity and frequency of staining. Statistical significance was not reached relative to our hypothesized relationship of a decreased Treg to Teff cell ratio in the presence of GILT+ MHC class II. Similarly, we did not reach statistical significance when comparing individual cell types to GILT, MHC class II and GILT + MHC class. In our study, we were unable reach statistical significance relative to our proposed correlation between MHC class II and GILT presence leading to a decreased Treg to Teff cell ratio or enhanced T‐cell mediated immune response. A major limitation of our study included the small sample size leading to a probable type II error, prompting the need for further investigation of the factors influencing the Treg to Teff cell ratio within the melanoma tumor microenvironment on a larger scale.

Antigen presentation during which antigen fragments in complex with MHC glycoproteins are recognized by T cell antigen-specific receptors is necessary for the initiation of adaptive immune response. During this process, immunological synapse is assembled at the site of contact between the T cell and the antigen-presenting cell (APC). This leads to the activation of receptors on the surface of both cells followed by triggering of multiple signaling pathways. However, our knowledge about the signaling occurring at the APC-side of the IS is limited in comparison to the T cell side. Here, we analyze role of Src family kinases in the APC signaling pathways. For this purpose, constructs targeting Csk kinase to the plasma membrane of APCs were prepared to inhibit SFKs there. We show that expression of these constructs inhibits activation of SFKs, calcium mobilization and cell activation of K46 B cell line. Further, expression of these constructs in hematopoietic progenitors attenuates their differentiation into dendritic cells which then results in their decreased ability to stimulate T cells.

A forma indeterminada é a fase inicial da hanseníase, que se caracteriza histologicamente pelo infiltrado inflamatório leve, não granulomatoso, de linfócitos e histiócitos ao redor de vasos, anexos e nervos. No local de entrada do M. leprae, as células apresentadoras de antígeno do tipo células dendríticas são as primeiras a encontrar o bacilo. Este, no interior de células dendríticas, desencadeia a produção local de citocinas e quimiocinas, que resultam em proliferação de linfócitos T helper 1 ou T helper 2, assim definindo uma resposta imune celular ou humoral, respectivamente. As lesões tuberculoides mostram predominância das citocinas de padrão Th1 como IL-2, TNF-alfa, IFN-y, IL-12 e IL-18, enquanto que nas lesões virchowianas predominam citocinas de padrão Th2, como IL-4, IL-5, IL-10 e TGF-beta. Na pele, as principais células dendríticas são células dendríticas mieloides, células de Langerhans e alguns dendrócitos dérmicos. São identificadas respectivamente pela expressão imuno-histoquímica de S100, CD1a e Fator XIIIa. Células de Langerhans e dendrócitos dérmicos Fator XIIIa positivos estão aumentados em quantidade nas lesões tuberculoides quando comparadas com lesões virchowianas. Os objetivos do presente estudo foram: 1) caracterizar a inflamação \"in situ\" na hanseníase indeterminada através da quantificação das marcações imuno-histoquímicas de: CD57, CD4, CD8, CD1a, S100, FXIIIa, CD68, Foxp3, CD123, IL-1, IL-2r, IL-4, IL-6, IL-8, IL-10, IL-12, IL-18, IFN-, TNF-alfa, TGF-beta, iNOS, granzima B, receptor Toll-like 2/4, e antígeno BCG, 2) comparar o perfil fenotípico e citocínico das lesões na hanseníase indeterminada entre grupos de reação de Mitsuda positiva e negativa, a fim de investigar se existem padrões que possam prever para qual forma a doença evoluiria, e 3) revisar a histopatologia da forma indeterminada através da análise semiquantitativa das alterações vistas à coloração de hematoxilina/eosina. Foram selecionadas 15 lesões de pacientes com hanseníase indeterminada. Foram usados grupos controles de expressão de Fator XIIIa e CD1a em 10 casos de pele normal. A histopatologia mostrou discretas alterações epidérmicas, como alteração vacuolar e exocitose de linfócitos (33% dos casos cada), apoptose de queratinócitos (26%), atrofia e acantose (06% dos casos cada); infiltrado inflamatório linfomononuclear neural (100%), perivascular superficial (100%), perivascular profundo (93%), peri-écrino (40%) e peri-folículo pilossebáceo (20%), além de melanófagos em 93% dos casos. Esses achados mostraram que nem sempre todos os ambientes estão acometidos por inflamação na histopatologia. Em 66% dos pacientes foi encontrado antígeno bacilar (por Fite-Faraco ou técnica imuno-histoquímica anti-BCG), portanto a forma indeterminada não deve ser considerada sistematicamente como paucibacilar. Não houve diferença significativa de padrões de marcadores entre os grupos Mitsuda positivo e negativo. No microambiente inflamatório das lesões houve expressões significativas de TLR 2/4, Fator XIIIa, CD4, CD8, IL-2r, IL-4, IL-10, iNOS e TGF-beta. A expressão importante de IL-4, IL-10 e TGF- beta nas lesões de hanseníase indeterminada significaram tendência de resposta imune para o polo Th2, um ambiente de tolerância à permanência do bacilo. A baixa expressão de IFN-y colaborou para a inexpresiva resposta Th1. Não houve diferença significativa na expressão de CD1a entre as lesões e pele normal. Fator XIIIa foi expresso em mais que 50 células/mm2 em todos os casos, com quantidades significativamente maiores que outras células dendríticas nas lesões (S100, CD68, CD123) e que a pele normal. Estes achados demonstraram a importância dos dendrócitos dérmicos Fator XIIIa positivos na apresentação de antígeno na fase inicial da hanseníase / The indeterminate form is the initial stage of leprosy, which is characterized histologically by mild inflammatory infiltrate, non granulomatous, with lymphocytes and histiocytes around vessels, nerves and adnexals. When M. leprae enter the host, antigen-presenting cells of dendritic type are the first cells to find the bacillus. Once inside dendritic cells, the bacillus elicits local production of cytokines and chemokines, which result in proliferation of T lymphocytes helper 1 or T helper 2, thereby defining a cellular or humoral immune response, respectively. The tuberculoid lesions show predominance of Th1 cytokines such as IL-2, TNF-alfa, IFN-y, IL-12 and IL-18, whereas in the lepromatous lesions predominate cytokines of Th2 pattern such as IL-4, IL-5 IL-10 and TGF-beta. In the skin, main dendritic cells are myeloid dendritic cells, Langerhans cells, and some dermal dendrocytes. They are identified respectively by immunohistochemical expression of S100, CD1a and Factor XIIIa. Langerhans cells and dermal dendrocytes Factor XIIIa positive are increased in number in tuberculoid lesions compared with lepromatous lesions. The objectives of this study were: 1) to characterize \"in situ\" inflammation in indeterminate leprosy through the quantification of immunohistochemical markers: CD57, CD4, CD8, CD1a, S100, FXIIIa, CD68, Foxp3, CD123, IL-1, IL-2r, IL-4, IL-6, IL-8, IL-10, IL-12, IL-18, IFN-y, TNF-alfa, TGF-beta, iNOS, granzyme B, Toll-like receptor 2/4, and BCG antigen, 2) compare the phenotypic and cytokinic profile of indeterminate leprosy lesions between positive and negative Mitsuda reaction groups in order to investigate if there are patterns that can predict which way the disease may evolve, and 3 ) review the histopathology of the indetermate form by semi-quantitative analysis of changes seen in hematoxylin / eosin. Fifteen lesions of patients with indeterminate leprosy were selected. There was used control groups of Factor XIIIa and CD1a expression in 10 cases of normal skin. Histopathology showed discrete epidermal changes, such as vacuolar changes and lymphocyte exocytosis (in 33% of cases each), keratinocyte apoptosis (26%), atrophy and acanthosis (in 06% of cases each); neural lymphocytic inflammatory infiltrate (100%), superficial perivascular (100%), deep perivascular (93%), peri-eccrine (40%), peri-pilosebaceous follicle (20%), and melanophages in 93% of cases. These findings showed that not always all environments are affected by inflammation in histopathology. In 66% of patients it was found bacterial antigen (by Fite-Faraco or immunohistochemical technique anti-BCG), so the indeterminate form should not be systematically considered as paucibacillary. There was no significant difference in phenotypic and cytokinic patterns between the positive and negative Mitsuda groups. In the microenvironment of inflammatory lesions there was significant expression of TLR 2/4, Factor XIIIa, CD4, CD8, IL-2r, IL-4, IL-10, TGF-beta and iNOS. The important expression of IL-4, IL-10 and TGF-beta in indeterminate leprosy meant tendency to Th2 immune response pole, an environment of tolerance to permanence of bacillus. Low IFN-? expression contributed to the negligible Th1 response. There was no significant difference in the expression of CD1a between the lesions and normal skin. Factor XIIIa was expressed as greater than 50 cells / mm2 in all cases, with significantly larger quantities than other dendritic cells in lesions (S100, CD68, CD123) and than normal skin. These findings demonstrate the importance of Factor XIIIa positive dermal dendrocytes in antigen presentation at the initial stage of leprosy

A forma indeterminada é a fase inicial da hanseníase, que se caracteriza histologicamente pelo infiltrado inflamatório leve, não granulomatoso, de linfócitos e histiócitos ao redor de vasos, anexos e nervos. No local de entrada do M. leprae, as células apresentadoras de antígeno do tipo células dendríticas são as primeiras a encontrar o bacilo. Este, no interior de células dendríticas, desencadeia a produção local de citocinas e quimiocinas, que resultam em proliferação de linfócitos T helper 1 ou T helper 2, assim definindo uma resposta imune celular ou humoral, respectivamente. As lesões tuberculoides mostram predominância das citocinas de padrão Th1 como IL-2, TNF-alfa, IFN-y, IL-12 e IL-18, enquanto que nas lesões virchowianas predominam citocinas de padrão Th2, como IL-4, IL-5, IL-10 e TGF-beta. Na pele, as principais células dendríticas são células dendríticas mieloides, células de Langerhans e alguns dendrócitos dérmicos. São identificadas respectivamente pela expressão imuno-histoquímica de S100, CD1a e Fator XIIIa. Células de Langerhans e dendrócitos dérmicos Fator XIIIa positivos estão aumentados em quantidade nas lesões tuberculoides quando comparadas com lesões virchowianas. Os objetivos do presente estudo foram: 1) caracterizar a inflamação \"in situ\" na hanseníase indeterminada através da quantificação das marcações imuno-histoquímicas de: CD57, CD4, CD8, CD1a, S100, FXIIIa, CD68, Foxp3, CD123, IL-1, IL-2r, IL-4, IL-6, IL-8, IL-10, IL-12, IL-18, IFN-, TNF-alfa, TGF-beta, iNOS, granzima B, receptor Toll-like 2/4, e antígeno BCG, 2) comparar o perfil fenotípico e citocínico das lesões na hanseníase indeterminada entre grupos de reação de Mitsuda positiva e negativa, a fim de investigar se existem padrões que possam prever para qual forma a doença evoluiria, e 3) revisar a histopatologia da forma indeterminada através da análise semiquantitativa das alterações vistas à coloração de hematoxilina/eosina. Foram selecionadas 15 lesões de pacientes com hanseníase indeterminada. Foram usados grupos controles de expressão de Fator XIIIa e CD1a em 10 casos de pele normal. A histopatologia mostrou discretas alterações epidérmicas, como alteração vacuolar e exocitose de linfócitos (33% dos casos cada), apoptose de queratinócitos (26%), atrofia e acantose (06% dos casos cada); infiltrado inflamatório linfomononuclear neural (100%), perivascular superficial (100%), perivascular profundo (93%), peri-écrino (40%) e peri-folículo pilossebáceo (20%), além de melanófagos em 93% dos casos. Esses achados mostraram que nem sempre todos os ambientes estão acometidos por inflamação na histopatologia. Em 66% dos pacientes foi encontrado antígeno bacilar (por Fite-Faraco ou técnica imuno-histoquímica anti-BCG), portanto a forma indeterminada não deve ser considerada sistematicamente como paucibacilar. Não houve diferença significativa de padrões de marcadores entre os grupos Mitsuda positivo e negativo. No microambiente inflamatório das lesões houve expressões significativas de TLR 2/4, Fator XIIIa, CD4, CD8, IL-2r, IL-4, IL-10, iNOS e TGF-beta. A expressão importante de IL-4, IL-10 e TGF- beta nas lesões de hanseníase indeterminada significaram tendência de resposta imune para o polo Th2, um ambiente de tolerância à permanência do bacilo. A baixa expressão de IFN-y colaborou para a inexpresiva resposta Th1. Não houve diferença significativa na expressão de CD1a entre as lesões e pele normal. Fator XIIIa foi expresso em mais que 50 células/mm2 em todos os casos, com quantidades significativamente maiores que outras células dendríticas nas lesões (S100, CD68, CD123) e que a pele normal. Estes achados demonstraram a importância dos dendrócitos dérmicos Fator XIIIa positivos na apresentação de antígeno na fase inicial da hanseníase / The indeterminate form is the initial stage of leprosy, which is characterized histologically by mild inflammatory infiltrate, non granulomatous, with lymphocytes and histiocytes around vessels, nerves and adnexals. When M. leprae enter the host, antigen-presenting cells of dendritic type are the first cells to find the bacillus. Once inside dendritic cells, the bacillus elicits local production of cytokines and chemokines, which result in proliferation of T lymphocytes helper 1 or T helper 2, thereby defining a cellular or humoral immune response, respectively. The tuberculoid lesions show predominance of Th1 cytokines such as IL-2, TNF-alfa, IFN-y, IL-12 and IL-18, whereas in the lepromatous lesions predominate cytokines of Th2 pattern such as IL-4, IL-5 IL-10 and TGF-beta. In the skin, main dendritic cells are myeloid dendritic cells, Langerhans cells, and some dermal dendrocytes. They are identified respectively by immunohistochemical expression of S100, CD1a and Factor XIIIa. Langerhans cells and dermal dendrocytes Factor XIIIa positive are increased in number in tuberculoid lesions compared with lepromatous lesions. The objectives of this study were: 1) to characterize \"in situ\" inflammation in indeterminate leprosy through the quantification of immunohistochemical markers: CD57, CD4, CD8, CD1a, S100, FXIIIa, CD68, Foxp3, CD123, IL-1, IL-2r, IL-4, IL-6, IL-8, IL-10, IL-12, IL-18, IFN-y, TNF-alfa, TGF-beta, iNOS, granzyme B, Toll-like receptor 2/4, and BCG antigen, 2) compare the phenotypic and cytokinic profile of indeterminate leprosy lesions between positive and negative Mitsuda reaction groups in order to investigate if there are patterns that can predict which way the disease may evolve, and 3 ) review the histopathology of the indetermate form by semi-quantitative analysis of changes seen in hematoxylin / eosin. Fifteen lesions of patients with indeterminate leprosy were selected. There was used control groups of Factor XIIIa and CD1a expression in 10 cases of normal skin. Histopathology showed discrete epidermal changes, such as vacuolar changes and lymphocyte exocytosis (in 33% of cases each), keratinocyte apoptosis (26%), atrophy and acanthosis (in 06% of cases each); neural lymphocytic inflammatory infiltrate (100%), superficial perivascular (100%), deep perivascular (93%), peri-eccrine (40%), peri-pilosebaceous follicle (20%), and melanophages in 93% of cases. These findings showed that not always all environments are affected by inflammation in histopathology. In 66% of patients it was found bacterial antigen (by Fite-Faraco or immunohistochemical technique anti-BCG), so the indeterminate form should not be systematically considered as paucibacillary. There was no significant difference in phenotypic and cytokinic patterns between the positive and negative Mitsuda groups. In the microenvironment of inflammatory lesions there was significant expression of TLR 2/4, Factor XIIIa, CD4, CD8, IL-2r, IL-4, IL-10, TGF-beta and iNOS. The important expression of IL-4, IL-10 and TGF-beta in indeterminate leprosy meant tendency to Th2 immune response pole, an environment of tolerance to permanence of bacillus. Low IFN-? expression contributed to the negligible Th1 response. There was no significant difference in the expression of CD1a between the lesions and normal skin. Factor XIIIa was expressed as greater than 50 cells / mm2 in all cases, with significantly larger quantities than other dendritic cells in lesions (S100, CD68, CD123) and than normal skin. These findings demonstrate the importance of Factor XIIIa positive dermal dendrocytes in antigen presentation at the initial stage of leprosy