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Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Une petite population de lymphocytes T exprimant les deux corécepteurs CD4 et CD8 et appelée double positive (DP), a été détectée dans le sang périphérique de donneurs sains et de patients atteints de diverses pathologies dont la sclérose en plaques (SEP). Nous avons émis l’hypothèse qu’il s’agissait de lymphocytes T hautement activés pouvant contribuer à l’inflammation chronique présente dans la SEP. Nous avons comparé les cellules T DP obtenues du sang de donneurs sains et de patients atteints de la SEP et non traités. La fréquence des cellules DP était similaire chez les patients et les donneurs sains. La proportion de lymphocytes T DP qui exprimaient les chaines du récepteur de l’interleukine-15 (IL-15) était plus élevée que pour les autres populations lymphocytaires. Des mesures d’induction de la phosphorylation du STAT5 (signal transducer and activator of transcription) ont démontré que les cellules DP ont répondu à des doses plus faibles et pour de plus longues périodes à l’IL-15 comparativement aux autres lymphocytes T. Le pourcentage de lymphocytes T DP ayant la capacité de produire l’interféron-gamma et des enzymes lytiques était élevé chez les témoins sains mais ces niveaux étaient significativement réduits chez les patients atteints de la SEP. La caractérisation phénotypique de cellules DP a suggéré que ces cellules ont des propriétés similaires aux lymphocytes T activés. Bien qu’il ne s’agisse que d’une caractérisation partielle, il semble que les lymphocytes T DP perdent une partie de leurs propriétés chez les patients atteints de la SEP. / A small population of T lymphocytes expressing both CD4 and CD8 called double positive (DP) T lymphocytes has been detected in the peripheral blood of healthy donors and patients affected by different pathologies such as multiple sclerosis (MS). We hypothesize that these cells represent a highly activated T lymphocyte subset that could contribute to the characteristic inflammation found in MS. Thus, we compared DP T cells from healthy donors to those from untreated MS patients. We found similar frequencies of DP T lymphocytes between both groups. A higher percentage of DP T lymphocytes expressed the IL-15R (interleukin 15 receptor) than other T cell populations. Moreover, IL-15 triggered the phosphorylation of STAT5 in a greater proportion of CD4+CD8+ T lymphocytes compared to other T cells. A greater percentage of CD4+CD8+ T lymphocytes can produce interferon gamma and lytic enzymes compared with other T cell subsets. However, those levels were drastically lower in MS patients. The phenotypic characterization of the DP cells suggests they have similar properties as activated T cells. Even though the characterization process is still in its infancy, it appears that the DP T cells may lose some of their properties in MS patients.

INTRODUÇÃO: A vacina contra febre amarela é a principal forma de prevenção da doença, e é raramente associada a eventos adversos graves, para os quais pessoas que vivem com o vírus da imunodeficiência humana (HIV) teoricamente possuem risco aumentado. Nessa população, estudos sugerem que a imunogenicidade da vacina é inferior, e fatores associados à resposta vacinal são pouco conhecidos. Neste estudo, avaliamos a imunogenicidade e reatogenicidade da vacina contra febre amarela em pessoas infectadas por HIV e controles, comparando os títulos de anticorpos neutralizantes, ocorrência de viremia pelo vírus vacinal e eventos adversos após a vacinação, e investigamos potenciais preditores da resposta vacinal. Avaliamos ainda o grau de conhecimento a respeito da febre amarela e a adesão às recomendações de vacinação entre pessoas que vivem com HIV. MÉTODOS: No Estudo 1, indivíduos com infecção por HIV e controles com indicação de receber a vacina foram incluídos em uma coorte prospectiva com um ano de acompanhamento, com avaliação periódica de eventos adversos, viremia pelo vírus vacinal e títulos de anticorpos neutralizantes específicos contra febre amarela após a vacinação. No Estudo 2, indivíduos com infecção por HIV sob tratamento antirretroviral e controles com uma única dose da vacina contra febre amarela no passado foram incluídos em um estudo de corte transversal para avaliação dos títulos de anticorpos neutralizantes contra febre amarela. Finalmente, no Estudo 3 pessoas infectadas por HIV foram convidadas a completar um questionário avaliando o grau de conhecimento a respeito da febre amarela e a adesão às recomendações de prevenção. RESULTADOS: Não observamos entre pessoas infectadas por HIV maior risco de viremia pelo vírus vacinal, ocorrência de eventos adversos ou diferença estatisticamente significante nos títulos de anticorpos nos primeiros três meses após a vacinação. Entretanto a persistência de anticorpos foi significantemente inferior entre indivíduos infectados por HIV, e associou-se inversamente à relação CD4+/CD8+, um marcador de ativação imune e inflamação de importância crescente. Nas respostas ao questionário, embora os participantes tenham demonstrado conhecimento a respeito da febre amarela e sua prevenção, a prevalência de discrepância entre as recomendações e o uso da vacina foi de 19%. CONCLUSÕES: Nossos resultados enfatizam a necessidade de novos estudos e intervenções entre pessoas infectadas por HIV a fim de melhorar a adesão às recomendações de uso da vacina, reduzir a ativação imune excessiva associada à pior resposta vacinal, e determinar o intervalo de tempo ideal para administração de reforço vacinal nessa população / INTRODUCTION: The yellow fever vaccine is the main prevention strategy against the disease, and is rarely associated with severe adverse events for which HIV-infected persons present theoretical increased risk. Studies suggest that the immune response to the vaccine is reduced in this population, but predictors of the vaccine immunogenicity are not well known. In this study, we assessed yellow fever vaccine immunogenicity and reactogenicity among HIV-infected persons and controls by comparing yellow fever-specific neutralizing antibody titers, detection of viremia by the vaccine virus and adverse events following vaccination. We also investigated potential predictors of vaccine response. Furthermore, we assessed knowledge and perceptions about yellow fever, and adherence to yellow fever vaccine recommendations among HIV-infected individuals. METHODS: In Study 1, HIV-infected participants and controls with indication to receive yellow fever vaccine were enrolled in a prospective cohort study and followed for one year with serial assessments of adverse events, viremia by the vaccine virus and yellow fever-specific neutralizing antibody titers after vaccination. In study 2, HIV-infected individuals under antiretroviral therapy and controls with a history of a single dose of yellow fever vaccine in the past were enrolled in a cross sectional study to evaluate yellow fever-specific neutralizing antibody titers after vaccination. Finally, in Study 3, HIV-infected persons under clinical follow up were invited to complete a survey assessing knowledge and perceptions about yellow fever and adherence to yellow fever prevention recommendations. RESULTS: We found no increased risk for the occurrence of viremia by the vaccine virus or adverse events, and no significant difference in yellow fever-specific antibody titers among HIVinfected participants in the first three months after vaccination. However, the duration of antibody response was reduced in HIV-infected persons, and was inversely associated to CD4+/CD8+ ratio, a biomarker of immune activation and inflammation of increasing importance. In the survey responses, although participants demonstrated awareness about yellow fever and yellow fever prevention, the prevalence of discrepancy between vaccine recommendation and actual compliance was 19%. CONCLUSIONS: Our results reinforce the need for new studies and interventions among HIVinfected persons to improve adherence to yellow fever vaccine recommendations, reduce excessive immune activation associated with impaired vaccine response, and to determine the ideal interval for a booster vaccination in this population

INTRODUÇÃO: A vacina contra febre amarela é a principal forma de prevenção da doença, e é raramente associada a eventos adversos graves, para os quais pessoas que vivem com o vírus da imunodeficiência humana (HIV) teoricamente possuem risco aumentado. Nessa população, estudos sugerem que a imunogenicidade da vacina é inferior, e fatores associados à resposta vacinal são pouco conhecidos. Neste estudo, avaliamos a imunogenicidade e reatogenicidade da vacina contra febre amarela em pessoas infectadas por HIV e controles, comparando os títulos de anticorpos neutralizantes, ocorrência de viremia pelo vírus vacinal e eventos adversos após a vacinação, e investigamos potenciais preditores da resposta vacinal. Avaliamos ainda o grau de conhecimento a respeito da febre amarela e a adesão às recomendações de vacinação entre pessoas que vivem com HIV. MÉTODOS: No Estudo 1, indivíduos com infecção por HIV e controles com indicação de receber a vacina foram incluídos em uma coorte prospectiva com um ano de acompanhamento, com avaliação periódica de eventos adversos, viremia pelo vírus vacinal e títulos de anticorpos neutralizantes específicos contra febre amarela após a vacinação. No Estudo 2, indivíduos com infecção por HIV sob tratamento antirretroviral e controles com uma única dose da vacina contra febre amarela no passado foram incluídos em um estudo de corte transversal para avaliação dos títulos de anticorpos neutralizantes contra febre amarela. Finalmente, no Estudo 3 pessoas infectadas por HIV foram convidadas a completar um questionário avaliando o grau de conhecimento a respeito da febre amarela e a adesão às recomendações de prevenção. RESULTADOS: Não observamos entre pessoas infectadas por HIV maior risco de viremia pelo vírus vacinal, ocorrência de eventos adversos ou diferença estatisticamente significante nos títulos de anticorpos nos primeiros três meses após a vacinação. Entretanto a persistência de anticorpos foi significantemente inferior entre indivíduos infectados por HIV, e associou-se inversamente à relação CD4+/CD8+, um marcador de ativação imune e inflamação de importância crescente. Nas respostas ao questionário, embora os participantes tenham demonstrado conhecimento a respeito da febre amarela e sua prevenção, a prevalência de discrepância entre as recomendações e o uso da vacina foi de 19%. CONCLUSÕES: Nossos resultados enfatizam a necessidade de novos estudos e intervenções entre pessoas infectadas por HIV a fim de melhorar a adesão às recomendações de uso da vacina, reduzir a ativação imune excessiva associada à pior resposta vacinal, e determinar o intervalo de tempo ideal para administração de reforço vacinal nessa população / INTRODUCTION: The yellow fever vaccine is the main prevention strategy against the disease, and is rarely associated with severe adverse events for which HIV-infected persons present theoretical increased risk. Studies suggest that the immune response to the vaccine is reduced in this population, but predictors of the vaccine immunogenicity are not well known. In this study, we assessed yellow fever vaccine immunogenicity and reactogenicity among HIV-infected persons and controls by comparing yellow fever-specific neutralizing antibody titers, detection of viremia by the vaccine virus and adverse events following vaccination. We also investigated potential predictors of vaccine response. Furthermore, we assessed knowledge and perceptions about yellow fever, and adherence to yellow fever vaccine recommendations among HIV-infected individuals. METHODS: In Study 1, HIV-infected participants and controls with indication to receive yellow fever vaccine were enrolled in a prospective cohort study and followed for one year with serial assessments of adverse events, viremia by the vaccine virus and yellow fever-specific neutralizing antibody titers after vaccination. In study 2, HIV-infected individuals under antiretroviral therapy and controls with a history of a single dose of yellow fever vaccine in the past were enrolled in a cross sectional study to evaluate yellow fever-specific neutralizing antibody titers after vaccination. Finally, in Study 3, HIV-infected persons under clinical follow up were invited to complete a survey assessing knowledge and perceptions about yellow fever and adherence to yellow fever prevention recommendations. RESULTS: We found no increased risk for the occurrence of viremia by the vaccine virus or adverse events, and no significant difference in yellow fever-specific antibody titers among HIVinfected participants in the first three months after vaccination. However, the duration of antibody response was reduced in HIV-infected persons, and was inversely associated to CD4+/CD8+ ratio, a biomarker of immune activation and inflammation of increasing importance. In the survey responses, although participants demonstrated awareness about yellow fever and yellow fever prevention, the prevalence of discrepancy between vaccine recommendation and actual compliance was 19%. CONCLUSIONS: Our results reinforce the need for new studies and interventions among HIVinfected persons to improve adherence to yellow fever vaccine recommendations, reduce excessive immune activation associated with impaired vaccine response, and to determine the ideal interval for a booster vaccination in this population

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

Résumé L’objectif de cette étude était de déterminer les effets de la source de sélénium sur les concentrations de Se et de GSH-Px des vaches de boucherie (n =33) et leurs veaux et sur des paramètres immunitaires des veaux. Deux groupes de vaches ont reçu 3 mg/j/animal de Se organique ou inorganique dans le minéral. Le troisième groupe n'a pas été supplémenté en Se et leurs veaux ont été divisés en deux sous-groupes, l’un des deux a reçu une injection de sélénite de sodium (0,087 mg/Kg) à la naissance. Le Se et la GSH-Px ont été respectivement mesurés par HPLC-UV et par cinétique enzymatique. La phagocytose, la flambée respiratoire et le ratio CD4:CD8ont été évalués par des kits commerciaux et les IgG totales ont été mesurés par immunodiffusion radiale. La supplémentation de Se a augmenté significativement le Se sérique et colostral (P<0,02) et la GSH-Px(P≤0,04) pour les vaches et leurs veaux avec un effet significativement plus élevé pour le Se organique. Le Se du lait a augmenté de façon significative uniquement avec la source organique du Se (P≤0,0007). L’injection du Se chez les veaux a permis une augmentation significative mais temporaire (P<0,0001) du Se sérique. La supplémentation en Se n’a pas influencé les paramètres immunitaires mesurés (P>0,01, non significatif après correction de Bonferroni). Nous concluons que la supplémentation en Se améliore le niveau du Se colostral, lacté et sérique ainsi que la GSH-Px pour les vaches et leurs veaux sans effet sur les paramètres immunitaires mesurés des veaux. Mots clés: Sélénium, veaux de boucherie, phagocytose, flambée respiratoire, anticorps, ratio CD4:CD8, GSH-Px. / Abstract The aims of this study were to determine the effects of selenium (Se) supplementation sources (organic and inorganic) on Se and GSH-Px concentrations of beef cows (n=33) and their calves and on immune parameters of the calves. Two groups of cows were given daily 3 mg of either organic or inorganic Se in mineral supplement starting from 12 weeks before calving until weaning. The third group had no Se added into the diet and their calves were divided into two subgroups either injected or not with 0.087 mg/kg of sodium selenite after birth. Serum Se and whole blood GSH-Px were respectively measured by HPLC-UV and by kinetic-enzymatic technique. Calves immune parameters were evaluated using commercial kits for phagocytosis, respiratory burst and CD4:CD8 ratio and radial immunodiffusion for total IgG concentrations. In cows and calves, Se supplementation increased significantly serum and colostrum Se concentrations (P<.02) with significant higher effect for organic source. However, milk Se concentrations increased significantly only with the organic source (P≤.0007). Se supplementation increased GSH-Px concentrations in cows (P≤.04) and their calves (P≤.0004); organic source induced a higher effect than inorganic one in calves (P≤.0004). Se injection in calves allowed a temporary increase (P<.0001) of serum Se concentrations. No significant differences were noticed throughout the experiment for all of the immune parameters measured (P>.01, not significant after Bonferroni adjustment). Our results showed that Se supplementation improved colostrum, milk and serum Se and GSH-Px concentrations in cows and their calves without effect on the measured immune parameters in calves. Key words: selenium, beef calves, phagocytosis, respiratory burst, antibodies, CD4:CD8 ratio, GSH-Px.

Résumé L’objectif de cette étude était de déterminer les effets de la source de sélénium sur les concentrations de Se et de GSH-Px des vaches de boucherie (n =33) et leurs veaux et sur des paramètres immunitaires des veaux. Deux groupes de vaches ont reçu 3 mg/j/animal de Se organique ou inorganique dans le minéral. Le troisième groupe n'a pas été supplémenté en Se et leurs veaux ont été divisés en deux sous-groupes, l’un des deux a reçu une injection de sélénite de sodium (0,087 mg/Kg) à la naissance. Le Se et la GSH-Px ont été respectivement mesurés par HPLC-UV et par cinétique enzymatique. La phagocytose, la flambée respiratoire et le ratio CD4:CD8ont été évalués par des kits commerciaux et les IgG totales ont été mesurés par immunodiffusion radiale. La supplémentation de Se a augmenté significativement le Se sérique et colostral (P<0,02) et la GSH-Px(P≤0,04) pour les vaches et leurs veaux avec un effet significativement plus élevé pour le Se organique. Le Se du lait a augmenté de façon significative uniquement avec la source organique du Se (P≤0,0007). L’injection du Se chez les veaux a permis une augmentation significative mais temporaire (P<0,0001) du Se sérique. La supplémentation en Se n’a pas influencé les paramètres immunitaires mesurés (P>0,01, non significatif après correction de Bonferroni). Nous concluons que la supplémentation en Se améliore le niveau du Se colostral, lacté et sérique ainsi que la GSH-Px pour les vaches et leurs veaux sans effet sur les paramètres immunitaires mesurés des veaux. Mots clés: Sélénium, veaux de boucherie, phagocytose, flambée respiratoire, anticorps, ratio CD4:CD8, GSH-Px. / Abstract The aims of this study were to determine the effects of selenium (Se) supplementation sources (organic and inorganic) on Se and GSH-Px concentrations of beef cows (n=33) and their calves and on immune parameters of the calves. Two groups of cows were given daily 3 mg of either organic or inorganic Se in mineral supplement starting from 12 weeks before calving until weaning. The third group had no Se added into the diet and their calves were divided into two subgroups either injected or not with 0.087 mg/kg of sodium selenite after birth. Serum Se and whole blood GSH-Px were respectively measured by HPLC-UV and by kinetic-enzymatic technique. Calves immune parameters were evaluated using commercial kits for phagocytosis, respiratory burst and CD4:CD8 ratio and radial immunodiffusion for total IgG concentrations. In cows and calves, Se supplementation increased significantly serum and colostrum Se concentrations (P<.02) with significant higher effect for organic source. However, milk Se concentrations increased significantly only with the organic source (P≤.0007). Se supplementation increased GSH-Px concentrations in cows (P≤.04) and their calves (P≤.0004); organic source induced a higher effect than inorganic one in calves (P≤.0004). Se injection in calves allowed a temporary increase (P<.0001) of serum Se concentrations. No significant differences were noticed throughout the experiment for all of the immune parameters measured (P>.01, not significant after Bonferroni adjustment). Our results showed that Se supplementation improved colostrum, milk and serum Se and GSH-Px concentrations in cows and their calves without effect on the measured immune parameters in calves. Key words: selenium, beef calves, phagocytosis, respiratory burst, antibodies, CD4:CD8 ratio, GSH-Px.

Les cytokines jouent un rôle essentiel dans la réponse immunitaire ; elles modulent les propriétés et la survie de nombreuses cellules immunitaires. Les lymphocytes T (LT) sont régulés par un large spectre de cytokines. Néanmoins certaines sous-populations de LT restent peu définies à ce jour tout comme l’impact de cytokines sur ces cellules en conditions physiologiques et pathologiques. Une population de LT caractérisée par la double expression des corécepteurs CD4 et CD8 a été identifiée en périphérie chez des donneurs sains et sa fréquence est augmentée chez les patients atteints de certaines pathologies. Cependant, peu d’études ont déterminé le phénotype et les fonctions de ces cellules. Nous avons caractérisé le phénotype ex vivo des LT CD4+CD8+ issus de sujets sains et étudié la réponse de ces cellules à plusieurs cytokines importantes dans l’homéostasie et l’activation des lymphocytes. Notre étude révèle que les LT CD4+CD8+ forment une population hétérogène présentant de nombreuses caractéristiques des cellules mémoires. De plus, notre étude montre que ces cellules ont une capacité accrue de produire des cytokines et enzymes lytiques comparée aux LT CD4 et CD8. Finalement, nous avons observé qu’une plus grande proportion de LT CD4+CD8+ répond aux cytokines IL-2, IL-15 et IL-7 comparée aux LT CD4 et CD8 simples positifs. Plusieurs études ont révélé que certaines cytokines participent à la pathobiologie de maladies auto-immunes notamment la sclérose en plaques (SEP). La SEP est une maladie inflammatoire chronique du système nerveux central (SNC) caractérisée par une destruction de la gaine de myéline et une perte axonale à l’origine des symptômes cliniques. L’impact des médiateurs immunitaires dans la destruction et/ou la réparation reste néanmoins à éclaircir. Plusieurs études suggèrent que l’interleukine-27 (IL-27) joue un rôle central dans la SEP : l’IL-27 diminue la sévérité de la maladie dans un modèle murin de la SEP ; la réponse des patients à certaines thérapies corrèle avec des niveaux périphériques élevés d’IL-27. Notre étude avait pour but de déterminer comment l’IL-27 module les LT des patients atteints de SEP. Nous avons observé des niveaux d’IL-27 augmentés à la fois en périphérie et dans le SNC des patients SEP. Nous avons mis en évidence que les effets induits par l’IL-27 sont altérés dans les LT des patients SEP ; notamment l’induction de PD-L1 et la réponse à l’IL-12 sont plus faibles comparées aux LT de sujets sains. La voie de signalisation STAT3 est induite plus fortement en réponse à l’IL 27 dans les cellules de patients SEP en comparaison à celles de sujets sains. Finalement, nous avons démontré que la forme soluble du récepteur à l’IL-27 est présente en plus grande quantité dans le sérum des patients SEP et ces niveaux sont suffisants pour bloquer l’effet de l’IL-27 sur ses cellules cibles. En conclusion, nos résultats permettent de mieux comprendre comment certaines cytokines participent à la régulation des populations lymphocytaires. En condition pathologique, la modulation de ces cytokines pourrait s’avérer efficace dans un but thérapeutique afin de promouvoir et/ou inhiber certaines réponses immunitaires notamment dans la SEP. / Cytokines play an essential role in modulating the immune response. They act on cells from both innate and adaptive immunity by modulating their phenotype and influencing their survival. T cells are highly regulated by a broad spectrum of cytokines. Nevertheless, some subsets of T cells remain ill-defined and a better understanding of cytokine-mediated responses in physiological and pathological conditions requires further investigation. A T cell population characterized by the dual expression of CD4 and CD8 co-receptors has been identified in the periphery of healthy donors and its frequency is notably increased in several pathologies. However, very few studies have determined the phenotype and functions of these cells under physiological conditions. We performed an ex vivo phenotypic characterization of CD4+CD8+ T cells from healthy subjects and analyzed the response of these cells to several important cytokines implicated in homeostasis and activation of immune cells. Our study reveals that CD4+CD8+ T cells are heterogeneous and exhibit many characteristics of memory cells. In addition, our study shows that these cells have an enhanced ability to produce cytokines and lytic enzymes compared to CD4 and CD8 T cells. Finally, we found that a higher proportion of CD4+CD8+ T cells respond to IL-2, IL-15 and IL-7 cytokines compared to CD4 and CD8 counterparts. Numerous studies showed that lymphocyte populations and some cytokines are involved in the development of several autoimmune diseases, including multiple sclerosis (MS). MS is a chronic inflammatory disease of the central nervous system (CNS) characterized by the destruction of the myelin sheath, axonal loss and oligodendrocytic death leading to clinical symptoms. The immune mediators involved in the destruction and/or repair remain to be clarified. Several studies suggest that interleukin-27 (IL-27) plays a central role in MS: IL-27 dampens the severity of the disease in a MS mouse model and in MS patients the response to some therapies correlates with higher levels of peripheral IL-27. The purpose of our study was to determine how IL-27 modulates T cells in MS patients. We observed that IL-27 levels are increased in both periphery and CNS of MS patients. We found that IL-27-mediated effects are impaired in T cells from MS patients in particular PD-L1 induction and IL-12 response that are lower compared to T cells from healthy subjects. IL-27-triggered STAT3 signaling pathway is also enhanced in cells from MS patients compared to healthy subjects. Finally, our study showed that the soluble form of the receptor of IL-27 is present in greater levels in the serum of MS patients and the measured doses are sufficient to block the capacity of IL-27 to act on its target cells. To conclude, our results provide a better understanding of how certain cytokines participate in the regulation of lymphocyte populations. Under pathological conditions, modulation of these cytokines may be effective for therapeutic applications in order to promote and/or inhibit immune responses, particularly in MS.