As Doenças Inflamatórias Intestinais (DII) são caracterizadas por resposta inflamatória exacerbada na mucosa intestinal, com desbalanço entre mecanismos pró-inflamatórios e reguladores. Entretanto, até o momento, nenhuma terapia é curativa e vários pacientes são refratários ou intolerantes a elas, necessitando de intervenções cirúrgicas para combater as complicações da doença. Sendo assim, é evidente que novas terapias são necessárias para o controle da progressão das DII. Dessa forma, como a saliva de insetos hematófagos constitui uma fonte importante de moléculas com potencial farmacológico, o objetivo desse trabalho foi avaliar a atividade terapêutica do extrato de glândula salivar (EGS) do Aedes aegypti e suas frações na colite experimental. Para tal, camundongos C57BL/6 foram submetidos à indução de colite pela administração de água contendo 3% de dextran sulfato de sódio (DSS). Os resultados demonstraram melhora na condição clínica e no escore pós-morte dos camundongos tratados com o EGS i.v. ou i.p. Essa melhora foi acompanhada de redução de leucócitos no sangue periférico, principalmente quando os animais foram tratados i.v. Além disso, redução do infiltrado inflamatório e das citocinas patogênicas IL-12, IFN-?, TNF-?, IL- 1? e IL-5, no intestino, foi também associada ao tratamento. Ademais, houve diminuição da frequência de linfócitos TCD4+ produtores de IFN-?, IL-17 e IL-4 no baço e nos linfonodos mesentéricos (LNM) dos animais tratados com EGS. Ainda, uma menor frequência de células CD11b+ no baço e CD49b+ nos LNM também foi detectada nos animais com inflamação intestinal tratados com o EGS. De forma interessante, quando expostos por dois ciclos ao DSS, o tratamento precoce com EGS (1o ciclo) protegeu os camundongos do desenvolvimento da colite após nova indução da inflamação intestinal (2o ciclo), sugerindo que a saliva do A. aegypti possui componentes com capacidade de retardar o aparecimento e a gravidade da recidiva da doença. A melhora na condição clínica associada ao tratamento com EGS parece também estar associada à modulação de populações bacterianas no intestino com características supostamente colitogênicas (Pseudomonas monteilii) e protetoras (Ruminococus champanelensis e Turicibacter sanguinis). De fato, o transplante de microbiota de camundongos tratados com EGS para animais que sofreram indução da colite levou à aparente melhora do escore pós-morte e à redução de leucócitos circulantes. Além disso, o transplante diminuiu a expressão de RNAm das citocinas inflamatórias IFN-? e IL-1?, indicando que alterações na microbiota intestinal podem ser um dos mecanismos pelos quais o EGS modula a colite experimental. Finalmente, experimentos utilizando a cromatografia líquida de alta performance (HPLC) sugerem que uma fração (F3) do extrato bruto da saliva, pode ser a responsável pela melhora observada nos sinais clínicos da doença. De forma geral, o EGS e seus componentes parecem representar uma fonte importante de moléculas imunomoduladoras com potencial terapêutico no tratamento da inflamação intestinal induzida experimentalmente / Inflammatory Bowel Disease (IBD) is an inflammatory disorder characterized by an imbalance between inflammatory and regulatory immune responses at the gut mucosa. However, current therapies are not totally effective and a plenty of patients require repeated surgeries to control disease complications. So, it is clear that novel therapies are still needed to control IBD progression. Thereby, since saliva from bloodsucking arthropods is a rich source of pharmacologically bioactive molecules, the aim of this study was to evaluate the therapeutic activity of Aedes aegypti total (SGE) and fractionated saliva in the treatment of experimental colitis. For this purpose, C57BL/6 male mice were exposed to 3% dextran sulfate sodium (DSS) in drinking water. The results showed an improvement in clinical disease outcome and postmortem scores after SGE treatment, regardless the route of administration used (i.p. or i.v.). This amelioration was accompanied by the systemic reduction in peripheral blood lymphocytes, especially when the i.v route was used. Furthermore, a reduction in the inflammatory area together with a local diminishment of IFN- ?, TNF-?, IL-1? and IL-5 cytokines were observed in the colon of SGE-treated mice. Similarly, a reduction of the frequency of TCD4+ lymphocytes producing IFN-?, IL-17 and IL-4 was observed in spleen and mesenteric lymph nodes (MLN) of SGE-treated mice. A lower frequency of CD11b+ cells in spleen and CD49b+ in MLN was also observed after SGE treatment. Interestingly, early treatment with SGE led to mice protection from a late DSS rechallenging, indicating that the mosquito saliva may present components able to prevent disease relapse. Clinical improvement due to SGE therapy seems to be also related to the modulation of intestinal bacterial population with different characteristics. Thus, SGE-therapy managed to a diminishment of colitogenic (Pseudomonas monteilii) and improvement of protective (Ruminococus champanelensis e Turicibacter sanguinis) bacteria. In fact, microbiota transplantation from SGE-tretaed mice to mice exposed to DSS-colitis improved postmortem scores and induced systemic diminishment in peripheral blood lymphocytes. Additionally, a reduced mRNA levels for the inflammatory cytokines IFN-? and IL-1?, was observed in transplanted mice, pointing to the effects of SGE-therapy in the modulation of gut microbes as one of the mechanisms related to the improvement of disease outcome. Finally, high performance liquid chromatography (HPLC) experiments suggested a major SGE pool fraction (F3) able to ameliorate disease signs. In conclusion, SGE and its components might represent a source of important immunomodulatory molecules with promising therapeutic activity for experimentally induced intestinal inflammation.

Objetivos: Este estudo foi desenvolvido para avaliar o diâmetro transverso da alça intestinal exteriorizada como fator preditor de resultado adverso, nas gestações com gastrosquise fetal isolada. Métodos: Estudo retrospectivo envolvendo 94 gestações únicas. Foi realizada a medida do diâmetro transverso da alça intestinal (DTA) herniada, por meio da ultrassonografia antenatal, até 3 semanas antes do parto. Foi considerado resultado perinatal adverso: óbito intra-útero, óbito neonatal e complicações intestinais. Resultados: a última medida ultrassonográfica do DTA foi realizada com 35,6 ± 1,6 semanas e o tempo médio do intervalo entre a última medida e o parto foi de 6,2 ± 5,0 dias. Ocorreram 10 (10,6%) casos de óbitos intraútero e neonatal; foram observadas complicações intestinais em 8 (8,5%) casos. DTA 15, 20, 25 e 30 mm foram identificadas em 87, 46, 13 e 4% das gestações com prognóstico favorável, respectivamente. O DTA 25 mm apresentou valores de sensibilidade de 38%, e, valores preditivo positivo e preditivo negativo de 38% e 87%, na predição de resultados adversos. Para o DTA 30 mm, os valores foram: 19, 50 e 85%. A área sob a curva ROC do valor observado/esperado do DTA para cada idade gestacional foi de 0,67, sendo o melhor ponto-de-corte em 1,39; e, seus valores preditivos foram semelhantes aos do DTA 25 mm. Dilatação intestinal esteve significantemente associada com baixa taxa de fechamento primário da parede abdominal, longo período para iniciar a dieta via oral e internação hospitalar prolongada. Conclusões: Dilatação intestinal demonstrada até 3 semanas antes do parto é preditora de complicações intestinais e está associado a baixa taxa de fechamento primário da parede abdominal, longo período para iniciar a dieta via oral e de internação hospitalar / Objectives: Evaluate bowel diameter as a predictor of adverse outcome in isolated fetal gastroschisis. Methods: Retrospective study involving 94 singleton pregnancies. Ultrasound measurements of herniated bowel transverse diameter (BTD) were performed up to 3 weeks before delivery. Adverse outcome was intrauterine/ neonatal death and/or bowel complications. Results: Last BTD was recorded at 35,6 ± 1,6 weeks and mean interval to delivery was 6,2 ± 5,0 days. Intrauterine/ neonatal death occurred in 10 (10,6%) cases; bowel complications were observed in 8 (8,5%). BTD 15, 20, 25 and 30mm were found in 87, 46, 13 and 4% of pregnancies with a favorable outcome, respectively. BTD 25 mm sensitivity was 38%, positive and negative predictive values, 38% and 87%. For BTD 30 mm, the values were: 19, 50 and 85%. Observed/expected BTD ROC curve showed an area of 0,67, with best cut-off at 1,39; prediction values were similar to those for BTD 25 mm. Bowel dilatation was also significantly associated with lower rate of primary surgical closure, longer period to full oral feeding and prolonged hospital stay. Conclusions: Bowel dilatation demonstrated up to 3 weeks before delivery is a predictor of intestinal complications and is associated with lower rate of primary surgical closure, longer period to achieve full oral feeding and hospital stay

Introduction : L’inflammation intestinale observée dans les maladies inflammatoires chroniques de l’intestin (MICI) est essentiellement située au niveau du côlon et peut sur le long terme provoquer l’apparition du cancer colorectal (CCR). Cette inflammation est étroitement régulée par les cellules immunitaires de la muqueuse intestinale qui sont majoritairement représentées par les macrophages. Ces derniers jouent un rôle clé dans la pathogenèse des MICI et contribuent au maintien de l’inflammation intestinale. A l’heure actuelle, les traitements disponibles proposés pour traiter ces pathologies visent surtout à diminuer l’inflammation. Les travaux menés au cours de cette thèse, s’inscrivent dans ce contexte. En effet, des expériences précédentes réalisées par notre laboratoire avaient montré que des surnageants de biofilms du probiotique Lactobacillus induisaient une réponse anti-inflammatoire chez les macrophages humains. Il avait également été remarqué que l’immunodéplétion de GroEL (une protéine de choc thermique) du surnageant bactérien abrogeait de manière dose-dépendante ces propriétés anti-inflammatoires. Méthodes : Par conséquent, au cours de ce travail de thèse nous nous sommes intéressés aux effets bénéfiques que pourrait exercer GroEL sur l’inflammation intestinale via son action au niveau des macrophages. Pour ce faire, nous avons étudié les effets de GroEL provenant de la souche Lactobacillus reuteri sur des modèles in vitro (macrophages humains), ex vivo (explants tissulaires de côlon) et in vivo (modèles murins d’inflammation intestinale et de polypose). Résultats : Nous avons démontré que la protéine GroEL provenant de la souche L. reuteri prévient la polarisation des macrophages vers un phénotype M1 (pro-inflammatoire) tout en favorisant la polarisation des macrophages vers un phénotype M2 (anti-inflammatoire). De façon similaire, le traitement des macrophages par cette protéine a permis de diminuer l’inflammation et le stress oxydant induits par le LPS. Ces expériences ont été confirmées sur des explants tissulaires de côlon, où le traitement par GroEL a permis de réduire l’inflammation, l’apoptose et le stress oxydant provoqués par le LPS. Par ailleurs, l’effet anti-inflammatoire de GroEL de L. reuteri a pu être démontré sur un modèle murin d’inflammation intestinale induite par le DSS. Dans ce modèle, l’administration intra-rectale de GroEL de L. reuteri a permis de prévenir le raccourcissement du côlon, la dégradation de la muqueuse intestinale et la perte de poids provoqués par le DSS. Enfin, nous avons également remarqué que GroEL de L. reuteri pouvait agir comme un agent prophylactique étant donné que les souris APCMin/+ traitées avec cette protéine présentaient une diminution significative du nombre de polypes sporadiques situés au niveau du côlon. Conclusion : La protéine GroEL de L. reuteri, par ses propriétés anti-inflammatoires, pourrait être un complément thérapeutique intéressant aux traitements disponibles dans la prise en charge des MICI et la prévention du CCR.Mots clés : GroEL, inflammation du côlon, probiotiques, MICI et CCR. / Introduction : Intestinal inflammation observed in inflammatory bowel disease (IBD) is mainly located in the colon and could lead to the onset of colorectal cancer (CRC). This inflammation is tightly regulated by the immune cells of the intestinal mucosa which are predominantly represented by macrophages. These cells play a key role in the pathogenesis of IBD and contribute to the maintenance of intestinal inflammation. Currently, available treatments proposed to treat these pathologies are aimed primarily at reducing inflammation. The work carried out during this thesis is part of this context. Indeed, previous experiments performed by our laboratory showed that supernatants of probiotic Lactobacillus biofilms induced an anti-inflammatory response in human macrophages. It was also noted that this effect was abrogated upon immunodepletion of the stress protein GroEL (a heat shock protein). Methods : Therefore, during this thesis work we have been interested in the beneficial effects that GroEL could exert on intestinal inflammation via its action on human macrophages. In order to do this, we used GroEL from the Lactobacillus reuteri strain and its effect in vitro (in human macrophages isolated from buffy coats), ex vivo in colon human explants and in vivo in two different models was analyzed (murine models of intestinal inflammation and polyposis). Results : We found that Lactobacillus reuteri GroEL inhibited the polarization of macrophages towards a M1-like phenotype (pro-inflammatory) while facilitating the polarization of macrophages towards an M2-like phenotype (anti-inflammatory). As a consequence, macrophages treated with L. reuteri GroEL presented a decrease in inflammation and oxidative stress induced by LPS. This was confirmed in colon tissues from biopsies, where L. reuteri GroEL was able to decrease inflammation, apoptosis and oxidative stress induced by LPS. Besides, the beneficial anti-inflammatory effect of Lactobacillus GroEL was demonstrated in a mice model of DSS-induced intestinal inflammation. Rectal administration of L. reuteri GroEL prevented colon shortening and degradation of intestinal mucosa. Further, it abrogated the drastic weight loss induced by DSS. We also showed the potential role of GroEL as a prophylactic agent since APCMin/+ mice treated with L. reuteri GroEL exhibited a significant decrease in the number of sporadic colonic polyps. Conclusion : L. reuteri GroEL protein, by its anti-inflammatory properties, could be an interesting adjunct therapy to the available treatments in the care of IBD and the prevention of CRC.Keywords : GroEL, colonic inflammation, probiotics, IBD and CRC.

Macrophages are leukocytes of the innate immune system that display great phenotypic plasticity to mediate diverse functions. The ontogeny of tissue resident macrophages has been debated in recent decades. It is now recognised that tissue macrophages can be replenished from embryonically-derived precursors, and/or monocyte intermediates in a tissue specific manner. Interferon Regulatory Factor 5 (IRF5) is a transcription factor that promotes a pro-inflammatory phenotype in macrophages in vitro and in vivo. Indeed, IRF5 contributes to the pathogenesis of experimental inflammatory arthritis, lupus, and obesity via recruitment and activation of effector cells. Research described here as part of this thesis, involves the profiling of the intestinal Mononuclear Phagocyte system to investigate the role of IRF5 in the development of monocyte-derived macrophages in the Colonic Lamina Propria (cLP) which are exclusively replenished by adult Ly6C^hi monocytes. Using Mixed Bone Marrow Chimaeras (MBMCs) we showed that in shared environment Wild-Type (WT) cLP macrophages dominated IRF5-deficient (Irf5^-/-) cLP macrophages in both steady state and inflammation. The development of in vitro bone marrow derived macrophages, and the reconstitution of the haematopoietic compartment in bone marrow of MBMCs were not significantly affected by IRF5 deficiency. IRF5 promoted the accumulation of WT monocytes in the cLP of MBMCs in a process possibly dependent on the CCL2/CCR2 axis. Furthermore, IRF5 expression committed Ly6C^hi monocytes to a pro-inflammatory macrophage fate in the inflamed cLP, characterised by protein expression of the cytokines IL1β, and TNFα, and the expression of Ccl4 and Ccl8 transcripts, whilst loss of IRF5 favoured accumulation of CD11b⁺ IRF4-dependent Dendritic Cells. Of significance, IRF5 expression might have prevented further differentiation of inflammatory macrophages into tissue-resident macrophages, thus supporting an inflammatory state. Irf5-/- mice were protected from Helicobacter hepaticus + αIL10R colitis. Intriguingly, protection from colitis may also be conferred by the presence of Irf5-/- haematopoietic cells, evidenced by WT:Irf5-/- MBMCs . Modulation of IRF5 activity may therefore be a viable therapeutic strategy. RNA sequencing identified that C1q, Cd81, and Ccl8 were upregulated in WT macrophages from MBMC, which may prove therapeutic targets.

A doença inflamatória intestinal (DII) e a esclerose sistêmica (ES) são doenças inflamatórias crônicas de difícil diagnóstico e tratamento. A etiologia da DII e da ES ainda não é completamente compreendida, mas sabe-se que fatores genéticos, imunológicos e ambientais estão envolvidos na sua patogênese. A DII possui dois principais subtipos clínicos: a doença de Crohn (DC) e a retocolite ulcerativa (RCU), caracterizados pela inflamação do intestino delgado e/ou cólon. Evidências sugerem que o aumento do estresse oxidativo desempenha um papel importante na fisiopatologia da DII. A ES é uma doença inflamatória autoimune rara, caracterizada pela fibrose progressiva da pele e de órgãos internos. A hipótese de que o aumento do dano oxidativo pode iniciar o dano vascular e desencadear os eventos patológicos observados na ES vem sendo investigada. Genes e enzimas envolvidos na metabolização (Fase I) e detoxificação (Fase II) de xenobióticos são utilizados como marcadores de susceptibilidade para o desenvolvimento de doenças que possuem fatores ambientais como fatores de risco. Em uma reação de Fase I, as enzimas do Citocromo P450 (CYP) inserem um átomo de oxigênio em um substrato deixando-o eletrofílico e reativo, criando um sítio para posterior conjugação pelas enzimas de Fase II. As enzimas Glutationa S-tranferases (GST) de Fase II catalisam a conjugação da glutationa com uma grande variedade de compostos eletrofílicos, detoxificando substâncias endógenas e exógenas. A atividade catalítica aumentada das enzimas CYP, bem como a falha na detoxificação de metabólitos pelas GST pode contribuir para o aumento do estresse oxidativo. O objetivo deste estudo foi investigar o papel de polimorfismos nos genes que codificam enzimas de metabolização (CYP1A*2C e CYP2E1*5B) e detoxificação (GSTT1 nulo, GSTM1 nulo e GSTP1 Ile105Val) na susceptibilidade a estas doenças. O grupo de pacientes com DII era constituído por 235 indivíduos e o grupo controle por 241 indivíduos, todos eurodescendentes. Na ES, 122 pacientes (99 eurodescendentes e 23 afrodescendentes) e 329 controles (241 eurodescendentes e 87 afrodescendentes) foram analisados. Os polimorfismos CYP foram genotipados por PCR-RFLP, enquanto que os polimorfismos em GSTT1 e GSTM1 foram genotipados por PCR multiplex e PCR-RFLP para GSTP1. As frequências alélicas e genotípicas foram comparadas entre pacientes e controles usando o teste de Qui-Quadrado. A respeito dos resultados das análises em DII, as frequências alélicas e genotípicas dos polimorfismos CYP1A1*2C, CYP2E1*5B e GSTP1 Ile105Val, bem como as frequências genotípicas do polimorfismo de presença/ausência de GSTM1, foram similares nos três grupos de pacientes (DII, DC e RCU) quando comparados ao grupo controle (P>0,05). Observouse uma frequência significativamente aumentada do genótipo nulo de GSTT1 no grupo de pacientes com DII quando comparado ao grupo controle [0,28 vs 0,18; χ² com Yates P=0,02; OR=1,71 (IC 95% 1,09 –2,71)]. Quando separamos o grupo de pacientes em DC ou RCU, esta frequência permaneceu significativamente aumentada somente no grupo de pacientes com RCU comparado ao grupo controle [0,29 vs 0,18; χ² com Yates P=0,035; OR=1,84 (IC 95% 1,03 –3,24)]. Com relação aos resultados das análises na ES, uma frequência significativamente aumentada do genótipo *1A/*1A (P=0,03; 0,74 vs. 0,61) e do alelo *1A (P=0,013; 0,86 vs 0,78; OR=0,57, IC 95% 0,36–0,90) do polimorfismo CYP1A1*2C foi observada entre os indivíduos controles eurodescendentes. Em contrapartida, a frequência do alelo *2C estava significativamente aumentada entre os pacientes de mesma etnia (P=0,013; 0,22 vs 0,14; OR=1,75, IC 95% 1,11–2,74). Com relação às frequências alélicas e genotípicas dos polimorfismos CYP2E1*5B e GSTP1 Ile105Val, e as frequências genotípicas do polimorfismo de presença/ausência de GSTM1, nenhuma diferença significativa foi observada quando os grupos de pacientes de ambas as etnias foram comparados aos grupos controle (P>0,05). Uma frequência significativamente aumentada do genótipo nulo de GSTT1 [0,29 vs 0,18; χ² com Yates P=0,035; OR=1,85 (IC 95% 1,03–3,29)], bem como uma alta frequência da dupla deleção de GSTT1/GSTM1 [0,19 vs 0,08; χ² com Yates P=0,007; OR=2,62 (IC 95% 1,25 –5,46)], foi observada no grupo de pacientes comparado aos controles (eurodescendentes). Estas associações não se repetiram entre indivíduos afrodescendentes. Concluindo, nossos resultados sugerem que o genótipo nulo de GSTT1 está associado à susceptibilidade a DII e pode influenciar na definição do curso da doença para a RCU. Além disso, o genótipo nulo de GSTT1 sozinho ou em combinação com o genótipo nulo de GSTM1 é um fator genético de susceptibilidade para a ES, enquanto que o genótipo *1A/*1A ou a presença do alelo *1A do polimorfismo CYP1A1*2C pode exercer um papel protetor contra o desenvolvimento da ES em indivíduos eurodescendentes. / Inflammatory bowel disease (IBD) and systemic sclerosis (SSc) are chronic inflammatory diseases of difficult diagnosis and treatment. The etiology of IBD and SSc is not completely understood but it is known that genetic, immunologic and environmental factors are involved in its pathogenesis. Crohn’s disease (CD) and ulcerative colitis (UC) are the two major subtypes of IBD, characterized by inflammation of the small intestine and/or colon. Evidences suggest that the increase of oxidative stress plays an important role in the pathophysiology of IBD. SSc is a rare autoimmune inflammatory disease of the connective tissue characterized by progressive fibrosis of the skin and internal organs. The hypothesis that the increase of oxidative stress can initiate vascular damage and triggers the pathological events in SSc has been investigated. Genes and enzymes involved in metabolism (Phase I) and detoxification (Phase II) of xenobiotics are used as markers of susceptibility to the development of diseases that have environmental factors as risk factors. In a Phase I reactions, the Cytochrome P450 (CYP) enzymes insert an oxygen atom in a substrate that making it more electrophilic and reactive, and creating a site for subsequent conjugation by Phase II enzymes. Phase II Glutathione S-transferases (GSTs) enzymes catalyze the conjugation of glutathione with a variety of electrophilic compounds, detoxifying endogenous and exogenous substances. A higher catalytic activity of CYP enzymes, as well as the failure in detoxifying of metabolites by GST enzymes may to contribute for the increase of oxidative stress. The aim of this study was investigated the role of polymorphisms in genes coding Phase I enzymes (CYP1A*2C and CYP2E1*5B) and Phase II (GSTT1 null, GSTM1 null and GSTP1 Ile105Val) in susceptibility to these diseases. IBD group was constituted by 235 patients and the control group by 241 individuals, all European-derived. In SSc group, 122 patients (99 European-derived and 23 African-derived) and 329 controls (241 European-derived and 87 African-derived) were analyzed. The CYP polymorphisms were genotyped by PCR-RFLP, whereas polymorphisms in GSTM1 and GSTT1 were genotyped by multiplex PCR and PCRRFLP for GSTP1. Allelic and genotypic frequencies were compared between patients and controls using the Chi-square test. Concerning IBD, allelic and genotypic frequencies of CYP1A1*2C, CYP2E1*5B and GSTP1 Ile105Val polymorphisms, as well as genotypic frequencies of GSTM1 presence/absence polymorphism were similar in all groups patients (IBD, CD, and UC) and controls (P>0.05). We observed a significantly increased frequency of GSTT1 null genotype in IBD group as compared to controls [0.28 vs. 0.18, χ ² with Yates P=0.02, OR=1.71 (95% CI 1.09 – 2.71)]. When patients were classified in CD or UC group, this frequency remained significantly increased only among UC patients [0.29 vs. 0.18, χ ² with Yates P=0,035, OR=1.84 (95% CI 1.03 – 3.24)] as compared to controls. Regarding results in SSc, a frequency significantly increased of *1A/*1A genotype (P=0.03; 0.74 vs. 0.61) and *1A allele (P=0.013; 0.86 vs 0.78; OR=0.57, 95% CI 0.36–0.90) from CYP1A1*2C polymorphism was observed among European-derived controls. On the other hand, the frequency of *2C allele was significantly increased among patients of same ethnic group (P=0.013; 0.22 vs 0.14; OR=1.75, 95% CI 1.11–2.74). The allelic and genotypic frequencies of CYP2E1*5B and GSTP1 Ile105Val polymorphisms, as well as genotypic frequencies of GSTM1 presence/absence polymorphism were similar between SSc patients and controls of both ethnic groups (P>0.05). We observed a significantly increased frequency of GSTT1 null genotype [0.29 vs. 0.18, χ ² with Yates P=0.035, OR=1.85 (95% CI 1.03–3.29)], as well as an increased frequency of GSTT1/GSTM1 double-null in SSc patients as compared to controls [0.19 vs. 0.08; χ ² with Yates P=0.007, OR=2.62 (95% CI 1.25 – 5.46)]. These associations were exclusive to European-derived individuals. In conclusion, our results suggest that the GSTT1 null genotype is associated with susceptibility to IBD and may influence in defining the course of the disease for RCU. Furthermore, the GSTT1 null genotype alone or combined with GSTM1 null genotype is a susceptibility genetic factor to SSc, while the *1A/*1A genotype or the presence of *1A allele from CYP1A1*2C polymorphism may plays a protector role in SSc development in Brazilian Europeanderived individuals.

Les maladies inflammatoires chroniques de l'intestin (MICI) se caractérisent par une inflammation sévère de l'intestin grêle et du côlon et comprennent la maladie de Crohn (MC) et la rectocolite hémorragique (RCH). Les MICI sont des maladies complexes faisant intervenir des facteurs génétiques : certains senseurs bactériens, l'autophagie et le stress du réticulum endoplasmique. Un défaut de barrière de l'épithélium digestif est également fortement impliqué dans la physiopathologie du processus inflammatoire. La fonction barrière de l'épithélium digestif est assurée par plusieurs types cellulaires, synthétisant entre autres, des peptides antimicrobiens (PAM) et des mucines. Dans les MICI, une augmentation de la perméabilité intestinale et une perte de muco-sécrétion ont été décrites. Les protéases jouent un rôle fondamental dans la digestion du bol alimentaire mais également dans le maintien de l'homéostasie intestinale en activant ou dégradant divers motifs moléculaires, ou in induisant des signaux spécifiques aux cellules par l'activation de quatre récepteurs : les PARs (Protease-Activated Receptor). Dans les MICI, un excès d'activité protéolytique de type trypsine est observé. L'origine de cette activité est théoriquement attribuée aux cellules immunitaires, à une surproduction pancréatique ou au microbiote, mais les cellules épithéliales intestinales semblent également être une source majeure de protéases. L'objectif de mon projet de thèse visait à étudier l'impact des principales voies impliquées dans les MICI sur l'homéostasie des protéases épithéliales et le rôle de celles-ci dans la déstabilisation de la fonction de barrière. Nos résultats ont confirmé un excès de protéases à sérine dans les cellules épithéliales de patients atteint de MC ou de RCH. In vitro, sur des monocouches de cellules Caco-2, l'induction de l'autophagie diminuait la libération apicale de protéase de type trypsine, alors que le senseur bactériens NOD2 n'avait aucun effet. A l'inverse, une stimulation du Stress du réticulum endoplasmique (SRE) par la Thapsigargin, induisait une libération accrue de protéases actives de type trypsine au pôle apical des cellules. [...] / Crohn's disease (CD) and Ulcerative colitis (UC) are two forms of Inflammatory Bowel Disease (IBD), a chronic inflammatory pathology affecting the digestive tract. Patients suffer from relapsing flares, diarrhea, abdominal pain and bleeding. Although the molecular mechanisms of IBD are poorly understood, recent data suggest that IBD occurs in genetically predisposed individuals developing an abnormal immune response to intestinal microbes after, being exposed to specific environmental triggers. Genetic studies have reported more than 170 polymorphisms susceptible to be involved in IBD pathogenesis. The strongest associations have highlighted three main pathways altered in IBD including bacterial sensing (NOD2, CD), autophagy (ATG16L1 and IRGM, CD) and endoplasmic reticulum stress (ER-Stress) (XBP1, UC). The role of intestinal barrier function is also strongly implicated in IBD pathogenesis, and is modulated by factors present in the lumen derived from microbiota, food or at a molecular level, by factors such as proteases. In IBD pathophysiology, the inflammatory process is characterized by impaired intestinal biology including disruption of tight junctions and leaky gut, decreased amount of Paneth and Goblet cells, and translocation of luminal antigens triggering inflammation. Previous studies have demonstrated an increased level of active serine proteases in the stools and tissues of IBD patients, supposing that proteases originate from infiltrated immune cells, pancreatic secretion or microbiota. However, our team has reported that intestinal epithelial cells are a major source of serine proteases, in particular trypsin-like enzymes, are released by a stressed epithelium in pathogenic context such as irritable bowel syndrome. In this project, we aimed at better understanding whether the three main pathways involved in IBD (Nod2, autophagy, ER-stress) could be linked to an epithelial release of trypsin and reciprocally, if epithelial trypsin is able to induce or modulate these three IBD pathways. We confirmed that trypsin-like activity was significantly higher in biopsies from UC and CD patients compared to healthy controls. In Caco-2 monolayers cultured in transwells, secreted trypsin-like proteolytic activity remained stable upon NOD2 stimulation but decreased under autophagy induction. Thapsigargin (Tg) stimulation a well-known ER-stress inducer, enhanced the apical release of trypsin-like activity in Caco2 cells. [...]

Orientador: Chung Man Chin / Banca: Renato Farina Menegon / Banca: Cleverton Roberto de Andrade / Banca: Eduardo René Perez Gonzalez / Banca: Jean Leandro dos Santos / Resumo: Os glicocorticoides (GCs) são fármacos utilizados amplamente na terapêutica devido suas atividades anti-inflamatória, imunossupressora e antiangiogênica. Possuem a capacidade de reduzir a transcrição de uma série de enzimas/proteínas inflamatórias como a ciclooxigenase-2 (COX-2), lipoxigenases, fosfolipase A2, óxido nítrico sintase induzida (iNOS) e citocinas pró-inflamatórias como o fator de necrose tumoral alfa (TNF-alfa), super expresso em diversas doenças inflamatórias. Porém o seu uso é limitado devido as diversas reações adversas. Derivados ftalimídicos também têm sido relatados na literatura com importante atividade anti-inflamatória. Dessa forma, no presente trabalho, planejou-se através da estratégia de hibridação molecular, novos derivados anti-inflamatórios esteroides moduladores da citocina TNF-alfa, úteis no tratamento de doenças inflamatórias crônicas. Nesse contexto, foram sintetizados e caracterizados seis compostos derivados da prednisolona e budesonida da série Lapdesf GL-FT 1-6. Os compostos finais foram avaliados quanto à atividade anti-inflamatória em modelo de colite ulcerativa distal, atividade imunossupressora e determinação da viabilidade celular necessária para o ensaio de doseamento da citocina TNF-alfa. Além disso, os compostos GLFT 2 e 3 foram avaliados quanto à atividade anti-inflamatória em modelo de edema de pata. No ensaio de colite ulcerativa os compostos Lapdesf GL-FT 5 e 6 foram iguais estatisticamente ao controle negativo e apresentaram at... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Glucocorticoids (GCs) are drugs widely used in therapy due their anti-inflammatory, immunosuppressive and antiangiogenic activities. They have the ability to reduce the transcription of a series of inflammatory enzymes / proteins such as cyclooxygenase-2 (COX2), lipoxygenases, phospholipase A2, induced nitric oxide synthase (iNOS) and proinflammatory cytokines such as tumor necrosis factor alpha (TNF-alpha), over expressed in several inflammatory diseases. However, its use is limited due to the various adverse reactions. Phthalimide derivatives have also been reported in the literature with important antiinflammatory activity. Thus, in the present work, new steroid anti-inflammatory derivatives as TNF-alpha cytokine modulators, useful in the treatment of chronic inflammatory diseases, have been designed through the molecular hybridization strategy. In this context, six compounds prednisolone and budesonide derivatives, Lapdesf GL-FT series, were synthesized and characterized. The final compounds were evaluated for anti-inflammatory activity in a model of distal ulcerative colitis, immunosuppressive activity and cell viability assay required for the TNF-alpha assay. In addition, GLFT 2 and 3 compounds were evaluated for anti-inflammatory activity in paw edema model. In the ulcerative colitis test, Lapdesf GL-FT 5 and 6 compounds were statistically equal to the negative control and showed anti-inflammatory activity with regression of the ulceration caused by the induction with acetic acid. Compound 5 also showed improvement in clinical signs such as weight gain and increased survival of animals and total regression of ulceration in 83.3% of treated animals. GLFT 1 and 3 compounds were statistically different from the positive and negative control groups. They presented antiinflammatory activity with... (Complete abstract click electronic access below) / Doutor

The intestinal mucosa is made up of complex secreted mucus layer consist of mainly mucin 2 (MUC2) and antimicrobial components that defend the underlining cellular barrier from intrusion by luminal microbiota and toxins. In inflammatory bowel diseases (IBD), the mucosal integrity is compromised. This can result from a combination of altered host genetics, gut immune responses and environment factors. However, it is the presence of intestinal bacteria that is central to the pathogenesis of IBD. As part of the dynamic gut microbial flora, mucolytic bacteria produce a wide range of glycosidases that are able to remove the outer oligosaccharide chains of MUC2, which allow other luminal bacteria to further degrade the mucin. We hypothesised that increased mucolytic bacteria will cause excessive degradation of the mucus layer, which in turn, allow more luminal bacteria to be in close proximity to the underlining epithelial cells resulting in inflammation. Consistent with our group’s previous semi-quantitative bacterial 16S rRNA gene clone library analysis, we found increased Ruminococcus gnavus in non-inflamed ulcerative colitis (UC) mucosa. R. gnavus was previously isolated by others based on its mucolytic property. In this study, we quantify total mucosa-associated bacteria and mucolytic bacteria, namely, R. gnavus, R. torques, Akkermansia muciniphila and bifidobacteria. We were able to show quantitatively that total mucosa-associated bacteria were increased in IBD. There was also a population shift in the mucosa-associated mucolytic bacteria, which were increased overall. There was significantly more R. gnavus in non-inflamed IBD biopsies. For the first time, we were also able to demonstrate that R. gnavus can degrade human MUC2 in vitro. To examine whether the numerical association of R. gnavus in IBD does have functional influence on intestinal inflammation and Paneth cell antimicrobial peptide gene expression, we fed mice with R. gnavus. Interestingly, R. gnavus feeding did not result in histological or molecular evidence of gut inflammation; however, it was able to specifically induce Paneth cell cryptdins and lysozyme P genes expression in 3 week old, antibiotic pre-treated C57BL/6 mice. This demonstrated that R. gnavus is not a pathogenic bacterium, which will directly cause colitis. However, the increased Paneth cell response suggested the need for host innate defence when R. gnavus is increased. Other than bacterial degradation, altered host genetics will also influence the mucus barrier. There is evidence to suggest that the MUC2 gene is highly unstable and is susceptible to gene copy number variation (CNV). Therefore, we hypothesised that MUC2 CNV is present, which may result in altered oligomerisation of the MUC2 glycoprotein causing endoplasmic reticulum stress of the goblet cells that appears to be characteristic of UC. Currently, our data partly support the presence of MUC2 CNV. However, further investigation is required to verify the MUC2 CNV identity. Only then can a high throughput methodology be designed to screen a large population for any association with IBD.

<p>The accumulation of eosinophil granulocytes (EOS) at sites of inflammation is a common feature of astma, allergic rhinitis and inflammatory bowel disease. The aim of the present investigation was to study the mechanisms involved in this accumulation.</p><p>Bronchoalveolar lavage (BAL) fluid obtained from patients with birch-pollen allergy lavaged during season exhibited increased eosinophil chemotactic activity compared with pre-season BAL fluid from the same patients. We identified IL-5, IL-8 and RANTES as the main eosinophil chemotactic agents in the BAL fluid. Only EOS from allergic donors responded to IL-8. IL-2 inhibited albumin-stimulated eosinophil migration towards buffer or chemoattractants. EOS from allergic subjects were less sensitive to this inhibition than EOS from normal subjects, and in vitro priming of the EOS with IL-5 prevented the inhibitory effect of IL-2. We therefore hypothesise that IL-2 acts as an autocrine regulator of EOS migration, and that this inhibitory effect may be down-regulated in allergy, resulting in increased migration of EOS towards chemotactic factors. The stimulation of eosinophil migration by albumin is mediated by PI3 kinase. Decreased expression of CD49d and CD49f caused by albumin may decrease the adhesiveness of the EOS, which in turn may facilitate migration. We found a higher chemotactic activity in perfusion fluids from patients with ulcerative colitis than from control patients. The chemotactic activity correlated with the concentrations of eosinophil granule proteins in the perfusion fluids. IL-5 and TNF-α were identified as two of the chemotactic agents in the perfusion fluid that were inhibited by steroid treatment. Agents with steroid-insensitive chemotactic activity remain to be identified.</p>

The main forms of inflammatory bowel diseases (IBD) are Crohns disease and ulcerative colitis. These are chronic diseases, with periods of progression and remission. They are mostly characterized by digestive symptoms such as diarrhea, abdominal pain and weight loss. They affect young individuals and their frequencies have increased for the last decades. The etiology of these pathologies is not well understood, however genetic and environmental factors are involved. The treatment of IBD aims to control the inflammation and to extend periods of clinical remission. Infliximab is an anti-TNF-α antibody, leading to a clear improvement of the symptomatology. However, about 30 % of the patients do not response to this treatment. Genetic factors are certainly involved in these inter-individual differences. The purpose of our work was to find: 1- genetic factors implicated in the response to Infliximab in Crohns disease and 2- genetic factors predisposing to IBD. First we could show that both genes LTA and TNF, which are closely related, are not associated with the answer to Infliximab in Crohns disease. However, different polymorphisms of the ADAM17 gene were associated with a response to the treatment in our Belgian cohort. Second, we could demonstrate an association between an insertion/deletion in the IRF5 gene and IBD. The insertion allele, predisposing to IBD, is expected to create a new binding site for the SP1 transcription factor.