L’allogreffe de cellules souches hématopoïétiques (CSH) reste à l’heure actuelle la seule thérapie curative de nombreuses hémopathies malignes. Les lymphocytes T (LT) du donneur constituent une immunothérapie contre les cellules de la leucémie (ou lymphome) appelé effet « GVL » pour « Graft versus Leukemia ». Malheureusement cet effet est intimement lié à la maladie du greffon contre l’hôte appelée « GVH » pour « Graft versus Host » (destruction des cellules saines du receveur par les LT du donneur). L’allogreffe de CSH est de plus en plus souvent réalisées avec des greffons mobilisés par du G-CSF. Quelques publications identifient des cellules immunosuppressives avec un phénotype peu précis CD11b+ Gr1+ induites par le G-CSF pouvant regrouper plusieurs sous-types cellulaires et sans trouver de contre-partie humaine ou avec un mécanisme d’action peu clair. Nous avons démontré que le G-CSF mobilise chez l’homme, dans la fraction CD34+ du greffon, une population monocytaire. Lorsqu’elle représente plus de 12% des CD34+, les receveurs ont une incidence moindre de la GVH aiguë. Cette même population est phénotypiquement et fonctionnellement conservée chez la souris. En réponse à l’IFN-γ relargué par les LT allogéniques, elle produit de l’Oxyde Nitrique capable d’induire l’apoptose de ces LT in vitro. In vivo, nous avons pu décortiquer (chez la souris uniquement) les mécanismes de régulation de la GVH aiguë. Les LT apoptotiques phagocytés par les macrophages capables alors de devenir tolérogènes en produisant du TGF-β et ainsi d’induire des LT régulateurs. Dans le modèle murin d’allogreffe de CSH, le transfert adoptif de cette population purifiée protège le receveur de la GVH aiguë. Nous pensons que si cette population peut être cultivée et expandue ex vivo, elle pourrait être une thérapie cellulaire préventive contre la GVH. / Allogeneic Hematopoietic Stem Cell Transplantation (Allo-HSCT) is the most effective immunotherapy for acute leukemia, due to the development of graft-versus-leukemia (GVL) effect mediated by alloreactive donor T cells. However, donor T cells specific for recipient alloantigens are also responsible for graft-versus-host disease (GVHD), a life-threatening complication that frequently occurs after allo-HSCT. The administration of Granulocyte colony stimulating factor (G-CSF) is routinely performed to collect Peripheral Blood Stem Cells (PBSC) from healthy donors for allo-HSCT. Few studies identified that G-CSF can induce myeloid suppressive cells in mice (CD11b+ Gr1+) with no human counterpart. We demonstrated in our study that G-CSF can induce a new population named CD34+Monocyte. The cumulative incidence of acute grade II to IV GVHD following allo-HSCT was lower in patients receiving grafts containing CD34+ monocyte frequencies above 12% of the CD34+ population. In mice, we demonstrated that G-CSF mobilized a highly conserved CD34+ monocyte population. CD34+Monocytes require T cell-mediated IFN-γ to produce Nitric Oxide that inhibits T cell activation and proliferation. In vivo, we report that CD34+ monocyte-derived NO regulates the alloreactive response by inducing T cell apoptosis and subsequently, the induction of regulatory T cells. In fact, uptake of apoptotic T cells by macrophages triggers them to produce high levels of TGF-β that drives the expansion of Tregs and induces immune tolerance. Such tolerogenic monocytes could represent a good candidate for the development of novel immunoregulatory and therapeutic cellular therapies.

Orientador: Irene Gyongyver Heidemarie Lorand Metze / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T03:04:45Z (GMT). No. of bitstreams: 1 Reis-Alves_SuiellenCarvalho_D.pdf: 1989355 bytes, checksum: c49ffc9bdc49263faef580e3f36d751a (MD5) Previous issue date: 2014 / Resumo: A imunofenotipagem é reconhecida como uma importante ferramenta para o diagnóstico das síndromes mielodisplásicas (SMD). O sistema de pontuação por citometria de fluxo descrito recentemente (FCSS) é útil para o diagnóstico diferencial, bem como para o prognóstico de SMD. Avaliamos se a inclusão de valores quantitativos de expressões anormais em células CD34+ e monócitos nesta pontuação poderia melhorar o seu valor diagnóstico. O FCSS modificado (FCSS -R) abrange 9 alterações granulocíticas, 8 monocíticas e 6 de células CD34+. A análise imunofenotípica foi realizada em células de medula óssea (MO) de 56 pacientes com SMD (76% com blastos na medula óssea <5%), 33 casos de citopenias reacionais e 41 doadores de medula óssea saudáveis de transplante alogênico (controles normais). As duas pontuações foram aplicadas em todos os casos. Embora tenhamos encontrado o desvio à esquerda assíncrono na maturação dos granulócitos, a diminuição das hematogônias e o aumento de monócitos CD16+, bem como casos isolados de co-expressões anormais no amadurecimento de precursores mielomonocíticos em citopenias reacionais, alterações qualitativas e quantitativas nos sub tipos de células mielóides CD34+ foram mais específicas de SMD. Ambas as pontuações permitiram discriminar SMD de citopenias reacionais, mas, de acordo com a área sob a curva ROC, o FCSS -R foi mais sensível (53% para FCSS e 94% para FCSS -R). Ambas as pontuações apresentaram especificidade de 100%. A inclusão de valores quantitativos de expressões anormais nas células CD34+ e monócitos em FCSS melhorou a sensibilidade de FCSS-R para o diagnóstico diferencial entre SMD e citopenias periféricas reacionias / Abstract: Immunophenotyping has been recognized as an important tool for diagnosis of myelodysplastic syndromes (MDS). The recently described flow cytometry scoring system (FCSS) is useful for the differential diagnosis as well as prognosis of MDS. We examined if the inclusion of quantitative values of abnormal expressions in CD34+ cells and monocytes in this score could improve its diagnostic value. The modified FCSS (FCSS-R) covers 9 granulocytic, 8 monocytic and 6 CD34+ cell abnormalities. Immunophenotypic analyzes were performed on bone marrow (BM) cells of 56 patients with MDS (76% with bone marrow blasts <5%), 33 cases of reactive cytopenias and 41 healthy bone marrow donors for allogeneic BM transplantation (normal controls). The two scores were applied in all cases. Although asynchronous shift to the left in the maturing granulocytes, decrease in hematogones and increase in CD16+ monocytes as well as isolated cases of abnormal co-expressions in maturing myelomonocytic precursors could be found in reactive PB cytopenias, the most important differences with MDS were seen in the subsets of myeloid CD34+ cells. Both scores allowed to discriminate MDS from reactive cytopenias, but, according to the area under the ROC curve FCSS-R was more sensitive (53% for FCSS and 94% for FCSS-R). Both scores had a specificity of 100%. The inclusion of quantitative values of abnormal expressions in CD34+ cells and monocytes in FCSS improved the sensibility of FCSS for the differential diagnosis between MDS and reactive peripheral cytopenias / Doutorado / Clinica Medica / Doutora em Clínica Médica

Malgré leur efficacité pour réduire la réplication du VIH, les traitements antirétroviraux ne s’accompagnent pas systématiquement de la restauration du compartiment des lymphocytes T CD4+ périphériques. L’espérance et la qualité de vie des individus en échec immunologique sont grandement impactées. Concomitante avec les anomalies périphériques, une atteinte des progéniteurs hématopoïétiques rend compte des fréquentes cytopénies observées au cours des stades tardifs de l’infection. Si l’infection directe des progéniteurs CD34+ reste marginale, les études qualitatives menées in vitro évoquent la perturbation du potentiel de différenciation de ces cellules.Nous avons sélectionné et apparié les patients infectés par le VIH à chaque extrême quand au profil de leur restauration immunitaire et un groupe de donneurs non infectés. Les répondeurs (IR) et non répondeurs immunologiques (INR) traités depuis plus de 8 ans présentaient les caractéristiques similaires pour chaque paramètre pouvant impacter la magnitude de la reconstitution du système immunitaire. Les INR montraient l’activation chronique du système immunitaire, l’inflammation persistante et les signes de l’atteinte de la thymopoïèse. La fréquence des progéniteurs hématopoïétiques circulants n’étant pas différente entre les deux groupes de patients, nous avons analysé le potentiel de ces cellules aux stades pré-thymiques de la différenciation.En utilisant un système de co-culture des progéniteurs hématopoïétiques avec une lignée stromale OP9-DL1 (différenciation T) ou MS5 (différenciation B et NK) avec un cocktail cytokinique approprié, nous avons mis en évidence l’altération du potentiel de différenciation T des cellules issues de patients INR impactant leur restauration périphérique. Ce n’était pas le cas chez les patients IR qui étaient similaires aux donneurs non-VIH. En revanche, le potentiel NK était impacté chez tous les patients infectés en comparaison aux donneurs. Finalement aucune anomalie de potentiel B n’était révélée.En étudiant les voies moléculaires de l’engagement des précurseurs T (Notch), de leur prolifération (IL-7/IL7R) et leur survie (Fas/FasL, TNFR, caspase-1, P2X7) nous avons constaté une diminution de la viabilité des progéniteurs hématopoïétiques chez les patients VIH+ qui présentaient d’avantage d’activation de la caspase-1 qui orchestrait la mort cellulaire par pyroptose. De plus, l’expression de certains gènes-cibles de Notch était clairement Notch-indépendante. Néanmoins, les différences dans le profil transcriptionnel de BCL11B entre les patients IR et INR nous ont permis de proposer un modèle selon lequel la différenciation T était promue chez les patients IR au dépit de celle des précurseurs NK. Enfin, les progéniteurs CD34+ de patients INR présentait la surexpression du P2X7 (récepteur à l’ATP extracellulaire) et l’absence de l’ectonucléotidase CD73 (hydrolyse de l’ATP) ce qui suggérait leur susceptibilité accrue aux nucléotides extracellulaires.L’ensemble de données nous permet de postuler qu’il existe un microenvironnement hautement inflammatoire dans la niche médullaire des progéniteurs hématopoïétiques chez les patients VIH+ qui perturbe leur survie et différenciation. Cette mortalité accrue des cellules CD34+ et probablement des cellules voisines amplifie l’inflammation locale. Ce processus est compensé chez certains patients par la meilleure différenciation T des progéniteurs CD34+ et la réponse immunologique qui s’en suit. Quand ce n’est pas le cas l’atteinte de la lymphopoïèse est importante et l’absence de la reconstitution de la population des lymphocytes T CD4+ périphériques est observée. Ainsi, nous pensons avoir identifié une population de patients infectés par le VIH pour qui les interventions ponctuelles avec les médicaments anti-inflammatoires (par exemple, les antagonistes du P2X7) peuvent s’avérer d’un bénéfice clinique irréfutable. / Despite the efficient reduction of the HIV replication, the administration of combination antiretroviral therapy (c-ART) is not systematically accompanied by the restoration of the peripheral T CD4+ lymphocyte compartment. The life expectancy and quality are severely impacted in individuals with immunological failure. Together with peripheral abnormalities, an alteration of CD34+ hematopoietic progenitor may explain the frequency of the cytopenia observed in the latest stages of the disease. While a direct infection of CD34+ progenitors is thought to be extremely rare, quantitative studies performed in vitro have highlighted the impairment of the differentiation potential of these cells.We selected and matched individuals infected with HIV presenting extremely opposite immunological profile in response to c-ART as well as non-infected donors. The Immune Responders (IR) and Immune Non Responders (INR) treated since more than 8 years, presented similar characteristics for each parameter known to be involved in poor reconstitution of immune system. INR patients showed chronic immune activation, persistent inflammation and thymic regeneration failure. The frequency of circulating CD34 hematopoietic progenitors being not different between both groups of patients, we analyzed the differentiation potential of these cells at pre-thymic stages of lymphopoiesis.Using a co-culture system of hematopoietic progenitors with stromal cell lines OP9-DL1 (T-cell assay) or MS5 (B- and NK-cells assay) with appropriate cytokines, we highlighted an alteration of T-cell differentiation potential in INRs impacting their peripheral restoration. This was not observed in IRs who were similar to non-HIV donors. On the other hand, NK-cell differentiation potential was impaired in both groups of patients in comparison to non-HIV donors. Lastly, no abnormalities in B-cell potential were revealed.Studying molecular pathways involved in T-cell specification (Notch), proliferation (IL-7/IL7R) and survival (Fas/FasL, TNFR, caspase-1, P2X7) we observed the decreased viability of hematopoietic progenitors in HIV patients with increased caspase-1 activation involved in cellular death by pyroptosis. Moreover, expression of some Notch target genes was clearly Notch-independent. However, differences in transcriptional profile of BCL11B between IRs and INRs allowed us to postulate that T-cell differentiation is promoted over NK-cell differentiation in IR patients. Finally, CD34+ cells from INRs presented P2X7 overexpression (extracellular ATP receptor) and absence of CD73 ectonucleotidase (ATP hydrolysis) pointing out their increased susceptibility to extracellular nucleotides.Taken together our data, we postulate that highly inflammatory microenvironment of hematopoietic progenitor’s bone marrow niche disturbs their survival and differentiation in HIV patients. Thus, increased cellular death of CD34+ cells and probably neighboring cells amplifies the local inflammation. This is compensated in some patients by enhanced T-cell differentiation of CD34+ progenitors and results in immunological success. When it is not the case, the alteration of lymphopoiesis is important and the absence of reconstitution of peripheral T CD4+ lymphocyte compartment is noted. We believe have identified the population of HIV-infected individuals who will benefit from occasional administration of anti-inflammatory drugs (such as P2X7 antagonists).

Les dommages de l'ADN peuvent s’accumuler dans les cellules souches hématopoïétiques(CSH) suite aux stress externes ou métaboliques et perturber leur fonctionnement et/ou leur maintien.La réparation par excision de nucléotides (NER), initiée par l’arrêt de la transcription (TCR) ou par lareconnaissance de distorsions des régions non transcrites (GGR) de l’ADN, est nécessaire àl’hématopoïèse à long terme. XPC, un facteur clé du système GGR, participe à d’autres réponses austress oxydatif. Le laboratoire a montré que la perte de XPC provoque l’accumulation de mutations, unstress métabolique et la carcinogenèse. Notre objectif est d’évaluer son expression et son rôle dans lemaintien et la différenciation des CSH. Nos résultats montrent qu’il est plus exprimé dans les cellulesimmatures CD34+ que dans les CD34- matures. Aussi, XPC apparaît sous trois poids moléculairesdifférents certainement liés à des modifications post-traductionnelles. Son extinction par ARNinterférence n'affecte ni la prolifération ni la capacité progénitrice in vitro des cellules CD34+.Cependant, les cellules déficientes implantées chez des souris immunodéficientes disparaissentprogressivement suggérant une perte des CSH ou de leur capacité de différenciation. Postulant queles mutations s’accumulent avec le temps, nous avons étudié l’hématopoïèse chez des sourisdéficientes en XPC jeunes et âgées. Les différences décrites dans l’hématopoïèse chez les individusjeunes et âgés sont retrouvées mais, de manière surprenante, aucune différence entre les animauxsauvages et mutés quelque soit l’âge ou le stress génotoxique n’est observée. Les résultats obtenussur les cellules humaines démontrent un rôle potentiel de XPC dans l’hématopoïèse, mais denouvelles investigations sont nécessaires pour mieux comprendre les mécanismes impliqués, et lapossible participation de XPC dans la leucémogenèse. / DNA damage may accumulate in hematopoietic stem cells (HSC) due to external ormetabolic stresses, leading to perturbation in their function and/or maintenance. Nucleotide excisionrepair (NER), initiated in the DNA by the stop of transcription (TCR) or by the recognition of distortionsin transcribed regions (GGR), is necessary for long-term hematopoiesis. XPC, a key factor in GGR, isimplicated in oxidative stress. The laboratory has demonstrated that XPC loss leads to theaccumulation of mutations, metabolic stress and carcinogenesis. Our objective is to evaluate XPCexpression and its role in HSC maintenance and differentiation. Results showed that XPC is highlyexpressed in immature CD34+ cells compared to mature CD34- cells. In addition, XPC appeared withthree different molecular weights, certainly linked to post-translational modifications. XPC silencing byshRNA did not affect the proliferation or the progenitor ability of CD34+ cells in vitro. However, deficientcells transplanted in immunodeficient mice disappeared progressively, suggesting the loss of HSCs ortheir differentiation capacity. Postulating that mutations accumulate with time, we have studiedhematopoiesis in young and aged XPC deficient mice. Differences described in young and agedhematopoiesis systems were found but, surprisingly, no difference was observed between wild typeand mutant mice at any age or genotoxic stress. Data from human cells demonstrate a potential rolefor XPC in HSC but new investigations are necessary to better understand the mechanisms implicatedand if XPC may participate in leukemogenesis.

Haemopoietic stem and progenitor cells from bone marrow and cord blood are well characterised with respect to their phenotype, growth in clonal assays, responsiveness to cytokine stimulation, receptor profile and their ability to sustain multilineage engraftment of receptive hosts in animal models of transplantation and of course, clinically in the treatment of some haemopoietic and immunological disorders. It is generally accepted that cells bearing the CD34+ phenotype are enriched for the most primitive of haemopoietic stem cells that possess the cardinal features of self-renewal and multipotency. However, the molecular mechanisms, the spectrum of expressed genes that give rise to the physical characteristics of haemopoietic progenitor cells are not well understood. Furthermore, although CD34+ cells from different sources (bone marrow, cord blood, mobilised peripheral blood) share many common features, there are also significant differences. (For complete abstract open document)

Acute myocardial infarction (MI) is the end result of many cardiovascular diseases and is one of the leading causes of death in the western world. Cell therapy, using circulating angiogenic cells (CACs) or CD34+ cells from peripheral blood, is one approach under investigation for restoring blood flow and function to the ischemic heart. However, the numbers of CACs and CD34+ circulating cells are inversely proportional to the severity of cardiovascular disease and age; therefore, there is a need to increase their numbers and/or function for therapy. One possibility is to enhance the therapeutic potential of the cells with the use of a biomaterial. In this study, we used a collagen matrix to culture human CD34+ circulating cells, and evaluated the effect of the matrix on CD34+ cell properties and function. The matrix was able to successfully increase proliferation, migration, CD34+ phenotype and branching in an angiogenesis assay. These functional benefits may be associated with the sonic hedgehog (Shh) pathway. The collagen matrix was previously shown to enhance the function of healthy CACs, but its ability to do the same for CACs from coronary artery disease patients is unknown. In this study, the matrix was shown to enhance the viability, proliferation and angiogenic potential of patient CACs. Furthermore, gene expression for integrins and Shh pathway components in the sub-population of CD34+ cells was similar between patient and healthy donors when isolated from CACs. This work provides insight into the mechanisms for the observed matrix-enhanced function of therapeutic CACs and CD34+ cells from both healthy and CAD patient donors.

Stem cell transplantation is a known treatment for various cancers. Currently most cells transplanted are collected via apheresis. An injection of growth factor is given to the patient to start the proliferation and mobilization of stem cells. Apheresis can be initiated when the patient has a stem cell count of 15 to 20 stem cells/µL of peripheral blood. The standard method with which stem cells are analysed is immune flow cytometry where CD34+ and CD45+ are identified with targeted fluorescent antibodies. This analysis takes more than 45 minutes to perform.     Sysmex XN-9000 analyses samples with flow cytometry by lysing erythrocytes and platelets and staining the leukocytes with fluorescent dye. Analysis of the hematopoietic progenitor cells (HPC) takes less than 4 minutes. The purpose of this study was to investigate ifit is possible to predict the start of the apheresis using XN-9000.     For this study, 43 samples were analysed using both methods. Using the sign test, a p-value was calculated to &lt;0.05, which indicates a significant difference between the results received by the two methods. Spearman’s rank correlation gave an observed ρ-value &gt; the critical ρ-value which revealed a correlation between the methods, although not linear according to Pearson’s correlation coefficient. PPV and NPV were calculated with cut-off at 20, 30 and 40 HPC/µL blood where 20 HPC/µL gave an NPV at 100 %. According to the test made, there is correlation between the two methods, but further samples must be analysed to investigate how the results should be compared.

No description available.

L’asthme allergique est caractérisé par une inflammation, un remodelage bronchique et une hyperréactivité bronchique (HRB). L’infiltration de fibrocytes, précurseurs des cellules musculaires lisses (CML) et exprimant le CD34, participe à l’hyperplasie du muscle lisse, cause potentielle de l’HRB. Cependant, l’expression du CD34 sur les CML ainsi que son rôle dans leur contraction et la réactivité du système respiratoire (SR) n’ont jamais été étudiés. L’objectif principal de ce projet était d’étudier le rôle du CD34 sur la contractilité des CML et la réactivité du SR dans l’asthme. Une perte de réactivité a été observée chez les souris Cd34-/- dans un modèle d’asthme. Celle-ci n’est pas reliée à une différence de la capacité contractile des CML en l’absence du CD34. Elle semble plutôt influencée par une altération des éléments non-contractiles tels que la production de mucines. Bref, cette étude a permis d’étudier l’importance de l’expression du CD34 dans le développement de l’HRB. / Allergic asthma is a chronic pulmonary disorder characterized by airway inflammation, airway remodeling and airway hyperresponsiveness (AHR). Hyperplasia of smooth muscle cells (SMCs) (potential mechanism of AHR) is influenced by CD34+ fibrocytes, which are known as smooth muscle precursors. However, CD34 expression on SMCs and its role on SMCs contractility have never been studied. The principal aim of this thesis was to study the role of CD34 on SMCs contractility and airway reactivity in the context of allergic asthma. In a mouse model of allergic asthma, a loss of airway reactivity was observed in sensitized Cd34-/- mice, which was not caused by alterations in the contractile capacity of SMCs. Instead, non-contractile elements (such as mucin production) seemed to be involved in this phenotype. Briefly, this study shows the importance of CD34 expression in the development of AHR associated with asthma.

A malária é uma infecção causada por plasmódios, cujo controle depende do baço, o responsável pelo clareamento dos eritrócitos parasitos. O aumento da parasitemia induz uma ampliação do baço para resolver a infecção, onde participam células precursoras que apresentam CCD34+ na sua superfície. Estudamos a distribuição e a quantidade de células CD34+ em baços de roedores durante malárias de roedores, para compreender sua participação na ampliação do baço e no controle da infecção. Camundongos C57Bl/6j infectados com as cepas AJ e CR de Plasmodium chabaudi, e com a cepa ANKA de Plasmodium berghei, tiveram seus baços removidos e encaminhados para histologia e citometria de fluxo. A distribuição das células CD34+ mostrou-se mais intensa no 4º dia p.i. e menos intensa no 8º dia p.i.. As células CD34+ livres, por citometria de fluxo, surgem com uma onda no 4º dia p.i.. Sua quantidade é similar entre os modelos de P. chabaudi, mas diferente no P. berghei. Neste trabalho, o influxo de células CD34+ no baço não se relaciona com o controle da infecção. / Malaria is caused by Plasmodium sp., which control depends on the spleen, responsible for parasite clearing. The increase of parasitemia implies in spleen amplification to control the infection, with participation of CD34+ cells. We studied the distribution and amount of CD34+ cells in spleen during rodent malaria, to define the role of those cells in spleen amplification and infection control. C57Bl/6j mice were infected with strains CR and AJ of Plasmodium chabaudi, and ANKA strain of Plasmodium berghei. The spleen was removed and processed for histology and flow cytometry. Spleen CD34+ cells was increased in 4th day, p.i., and decreases in 8th day p.i. in all models. By flow cytometry, free CD34+ cells appears as a wave in the 4th day p.i.. P. chabaudi models presented the same level of those cells, which was larger in the P. berghei mice. In this work, increase of spleen CD34+ cells do not correlate with infection control.