京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21017号 / 医博第4363号 / 新制||医||1028(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 椛島 健治, 教授 濵﨑 洋子, 教授 杉田 昌彦 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Antikörper, die gegen eine klinisch relevante Gruppe von Rezeptoren innerhalb der Tumornekrosefaktor-Rezeptor-Superfamilie (TNFRSF) gerichtet sind, darunter CD40 und CD95 (Fas/Apo-1), benötigen ebenfalls eine Bindung an Fc-Gamma-Rezeptoren (FcγRs), um eine starke agonistische Wirkung zu entfalten. Diese FcγR-Abhängigkeit beruht weitgehend auf der bloßen zellulären Verankerung durch die Fc-Domäne des Antikörpers und benötigt dabei kein FcγR-Signalling. Ziel dieser Doktorarbeit war es, das agonistische Potenzial von αCD40- und αCD95-Antikörpern unabhängig von der Bindung an FcγRs durch die Verankerung an Myelomzellen zu entfalten. Zu diesem Zweck wurden verschiedene Antikörpervarianten (IgG1, IgG1-N297A, Fab2) gegen die TNFRSF-Mitglieder CD40 und CD95 genetisch mit einem einzelkettig kodierten B-Zell-aktivierenden Faktor (scBaff) Trimer als C-terminale myelom-spezifische Verankerungsdomäne fusioniert, welche die Fc-Domäne-vermittelte FcγR-Bindung ersetzt. Diese bispezifischen Antikörper-scBaff-Fusionsproteine wurden in Bindungsstudien und funktionellen Assays mit Tumorzelllinien untersucht, die einen oder mehrere der drei Baff-Rezeptoren exprimieren: BaffR, Transmembran-Aktivator und CAML-Interaktor (TACI) und B-Zell-Reifungsantigen (BCMA). Zelluläre Bindungsstudien zeigten, dass die Bindungseigenschaften der verschiedenen Domänen innerhalb der Antikörper-scBaff-Fusionen gegenüber der Zielantigene vollständig intakt blieben. In Ko-Kulturversuchen von CD40- und CD95-responsiven Zellen mit BaffR-, BCMA- oder TACI-exprimierenden Verankerungszellen zeigten die Antikörper-Fusionsproteine einen starken Agonismus, während in Ko-Kulturen mit Zellen ohne Expression von Baff-interagierenden Rezeptoren nur eine geringe Rezeptorstimulation beobachtet wurde. Die hier vorgestellten αCD40- und αCD95-Antikörper-scBaff-Fusionsproteine zeigen also Myelom-spezifische Aktivität und versprechen im Vergleich zu herkömmlichen CD40- und CD95-Agonisten geringere systemische Nebenwirkungen. / Antibodies that target a clinically relevant group of receptors within the tumor necrosis factor receptor superfamily (TNFRSF), including CD40 and CD95 (Fas/Apo-1), also require binding to Fc gamma receptors (FcγRs) to elicit a strong agonistic activity. This FcγR dependency largely relies on the mere cellular anchoring through the antibody's Fc domain and does not involve the engagement of FcγR signaling. The aim of this doctoral thesis was to elicit agonistic activity from αCD40 and αCD95 antibodies in a myeloma cell anchoring-controlled FcγR-independent manner. For this purpose, various antibody variants (IgG1, IgG1-N297A, Fab2) against the TNFRSF members CD40 and CD95 were genetically fused to a single-chain-encoded B-cell activating factor (scBaff) trimer as a C-terminal myeloma-specific anchoring domain substituting for Fc domain-mediated FcγR binding. These bispecific antibody-scBaff fusion proteins were evaluated in binding studies and functional assays using tumor cell lines expressing one or more of the three receptors of Baff: BaffR, transmembrane activator and CAML interactor (TACI) and B-cell maturation antigen (BCMA). Cellular binding studies showed that the binding properties of the different domains within the fusion proteins remained fully intact in the antibody-scBaff fusion proteins. In co-culture assays of CD40- and CD95-responsive cells with BaffR, BCMA or TACI expressing anchoring cells, the antibody fusion proteins displayed strong agonism while only minor receptor stimulation was observed in co-cultures with cells without expression of Baff-interacting receptors. Thus, the herein presented αCD40 and αCD95 antibody fusion proteins display myeloma cell-dependent activity and promise reduced systemic side effects compared to conventional CD40 and CD95 agonists.

In this work, bispecific antibodies were produced by coupling TNFR-specific antibodies with checkpoint inhibitors, tested for their functionality and compared with each other. This combination should enable a targeted TNFR activation in tumor tissue, where a high PDL1 expression is frequent and therefore the formation of oligomeric transactivating (TNFSF3-TNFRSF3)2 complexes should only occur there by binding to PDL1-expressing cells. These receptor-ligand complexes are a prerequisite for the agonistic activity of the antibodies. / In dieser Arbeit wurden bispezifische Antikörper durch Kopplung von TNFR-spezifischen Antikörpern mit Checkpoint-Inhibitoren hergestellt, auf ihre Funktionalität getestet und miteinander verglichen. Diese Kombination sollte eine gezielte TNFR-Aktivierung im Tumorgewebe ermöglichen, wo eine hohe PDL1-Expression häufig ist und daher die Bildung oligomerer transaktivierender (TNFSF3-TNFRSF3)2-Komplexe nur dort durch Bindung an PDL1-exprimierende Zellen erfolgen sollte. Diese Rezeptor-Liganden-Komplexe sind eine Voraussetzung für die agonistische Aktivität der Antikörper.

Le CD154 joue un rôle crucial dans l’activation des cellules présentatrices d’antigènes. Il a été démontré que le CD154 est incorporé à la surface du VIH-1 et que de tels virus activent des lymphocytes B. Nous avons vérifié s’ils ont également la capacité d’activer des macrophages humains. Nous avons observé une augmentation de la production d’IL-8 par les macrophages dérivés de monocytes (MDM), mais celle-ci varie grandement en fonction des différentes productions virales et des donneurs utilisés. L’induction de la sécrétion d’IL-8 est spécifique au CD154 puisqu’une forme mutée ne l’induit pas et est indépendante de la gp120. L’expression des MMP-1 et -2 est influencée par le CD154 sur les cellules 293T, mais l’effet spécifique de CD154 est perdu lorsque des virus sont utilisés. L’ensemble de ces résultats suggère que l’incorporation de CD154 par le virus pourrait être un moyen additionnel d’attirer des cellules cibles au site d’infection et ainsi favoriser la réplication virale. / CD154 interacts with CD40 found on antigen-presenting cells such as macrophages and plays a crucial role in activating these cells and initiating immune responses. We have previously reported that CD154 is incorporated within HIV-1 envelope and is effective at activating primary B lymphocytes. In this study, we tested if such CD154-bearing virions are also effective in activating human monocyte-derived-macrophages (MDM). We observed an increase in IL-8 secretion, but it is highly variable depending on viral productions and donors used. The induction of IL-8 production is specific to CD154 since a mutant form does not induce it and is independent of gp120. The production of MMP-1 and -2 is influenced by CD154 on 293T cells but the specificity is lost when viral particles are used. These results suggest a possible way used by the virus to attract target cells to the site of infection and thereby favour its own replication.

No description available.

Le virus de l’immunodéficience humaine (VIH) cause quotidiennement 14 000 nouvelles infections et 8 000 décès (1). Certes, les antirétroviraux actuels aident le système immunitaire des porteurs du VIH à contenir le virus. Néanmoins, ils sont inefficaces pour guérir l’infection vu l’intégration du génome viral dans celui de la personne infectée. Ainsi, la prévention de l’infection demeure, en ce moment, la meilleure arme dont nous disposions contre ce rétrovirus. La connaissance du cycle de réplication du VIH-1 constitue la pierre angulaire de la conception de médicaments et d’outils de prévention. C’est pourquoi nous en étudions des étapes encore peu définies comme le bourgeonnement, et plus particulièrement l’incorporation de molécules d’origine cellulaire dans l’enveloppe virale. Les résultats présentés dans cette thèse montrent que des isolats cliniques du VIH-1 acquièrent les molécules HLA-DR, ICAM-1, CD40, CD86 et CD40L des cellules qu’ils infectent dans des modèles de culture de cellules reflétant au mieux la réalité du corps humain, telles des cultures ex vivo de portions d’amygdales palatines. Par le fait même, nous sommes les premiers à mentionner la présence de CD40L dans l’enveloppe du VIH-1. Également, nos résultats relatifs à l’appropriation des protéines cellulaires HLA-DR et CD40L par ce virus prouvent que celle-ci découle d’un mécanisme indépendant des glycoprotéines de l’enveloppe virale. Nos résultats démontrent aussi que les lymphocytes B d’amygdales palatines sont activés suite à la sollicitation de leur récepteur CD40 par la molécule CD40L insérée dans l’enveloppe du VIH-1. Ainsi, la translocation de NF-κB au noyau de ces cellules est induite, de même que la sécrétion d’anticorps IgG et d’IL-6 et l’adhésion cellulaire homotypique. La molécule CD40L permet au virus de mieux se lier aux lymphocytes B qui le transmettent par ailleurs aux lymphocytes T CD4+. Enfin, caractériser davantage le mécanisme d’acquisition de molécules de l’hôte par le VIH-1 et son impact sur la pathogenèse associée au virus contribuera peut-être à identifier des molécules pouvant être ciblées par une nouvelle thérapie, voire une immunisation. / Ever since mankind faced human immunodeficiency virus (HIV), advances in research have been compromised by many difficulties, some of them being related to the complexity of the virus. Because HIV causes 14 000 new infections and 8 000 deaths daily (1), we must work intensely to fight this pathogen. Although antiretroviral drugs help the immune system of HIV-infected individuals to contain the virus, these drugs are ineffective to cure the infection, considering that the viral genome is integrated within the host genome. Thus, the best way to fight HIV infection at this point is to prevent it. The design of new therapies and prevention tools rely on our knowledge of the replication cycle of HIV. Therefore, we study steps of the viral cycle that are less defined, such as budding, and particularly the incorporation of molecules of cellular origin in the viral envelope. The results we present in this thesis show that host-derived HLA-DR, ICAM-1, CD40, CD86 and CD40L molecules are acquired by clinical isolates of HIV-1 produced in the most natural culture models, such as pieces of palatine tonsils cultured ex vivo. Moreover, we are the first to report the CD40L molecule as being part of HIV-1’s envelope. Also, our results indicate that incorporation of host HLA-DR and CD40L is independent of viral envelope glycoproteins. Furthermore, our results show that B lymphocytes from tonsils are activated following the binding of their CD40 receptor by the CD40L molecule inserted in the envelope of HIV-1. The translocation of NF-κB to the nucleus of cells is then induced, as for the secretion of IgG antibodies, production of IL-6 and homotypic cell-to-cell adhesion. The CD40L protein facilitates binding of virions to B lymphocytes which transfer them to T CD4+ lymphocytes. In the future, further investigation of the mechanism of HIV-1 host molecule incorporation and its impact on HIV-1 pathogenesis may help in the identification of new molecules being able to be targeted by a new therapy or immunization.

Malgré la mise en oeuvre de la leucoréduction systématique, les transfusions plaquettaires restent génératrices de réactions post-transfusionnelles (encore appelées « Effets Indésirables Receveur, EIR »). Nous savons que les plaquettes sanguines relarguent des molécules proinflammatoires (e.g. CD40 ligand soluble ou sCD40L) durant leur préparation et stockage et leurs taux augmentés sont associées aux EIR. Le travail de cette thèse vise à mieux comprendre les mécanismes de survenue des EIR post transfusion plaquettaire, dans le contexte de l’inflammation. La première partie de nos travaux n’a pas retrouvé de polymorphismes génétiques du gène CD40LG qui pourraient modifier l’affinité du couple Récepteur/Ligand, en cas d’EIR. Dans un second temps, une caractérisation haplotypique de CD40LG n’a pas non plus permis de retrouver d’association avec l’apparition d’EIR. Nous avons ensuite tenté d’identifier des marqueurs génétiques de surexpression de sCD40L (et par conséquence, d’EIR). Pour cela, nous avons étendu l’investigation à douze polymorphismes de CD40LG mais aussi des marqueurs génétiques connus comme indépendamment liés à l’expression de sCD40L : au niveau de son récepteur CD40 et d’ITGA2. Ont été retrouvés associés à une modification significative de sécrétion de sCD40L, d’une part le polymorphisme rs126643 (ITGA2), un haplotype étendu de CD40LG et aussi un haplotype interchromosomique (CD40LG–CD40–ITGA2). Toutefois, ces haplotypes n’ont pas pu être retrouvés associés à l’apparition d’EIR. Nous avons également montré que lors du stockage de concentrés plaquettaires (CP) non leucoréduits, les « modificateurs de réponse biologique » (BRM) leucocytaires diffèrent d’une part, dominent et influencent d’autre part les BRM d’origine plaquettaire. Nous nous sommes ensuite intéressés à un autre BRM individualisé dans les produits transfusés : l’ADN mitochondrial, classé comme un signal de danger endogène (ou DAMP) et nous avons retrouvé une augmentation significative de ceux-ci dans les CP ayant induit un EIR. Nous avons alors entrepris une étude protéomique (LC-MS/MS) et transcriptomique (RNA-seq) sur des CP ayant induit ou non un EIR. L’enrichissement des protéines et gènes différentiellement exprimés présente principalement un rôle dans l’activation plaquettaire, la coagulation, l’apoptose et la dégranulation qui représentent des processus en liaison étroite. Le transcriptome plaquettaire a confirmé l’étiologie apoptique par la mise en évidence de la dérégulation calcique mitochondriale. De plus, l’obtention de l’enrichissement de sa voie intrinsèque permet d’expliquer l’abondance des ADNmt retrouvés précédemment dans les CP associés aux EIR. Par ailleurs, l’état d’activation et la dégranulation des plaquettes expliquent l’abondance des BRM retrouvés en cas d’EIR. Ainsi, nous avons identifié de nouveaux marqueurs inflammatoires hautement exprimés dans le groupe EIR. Après validation de ces résultats par des études complémentaires, ces marqueurs pourraient être proposés comme cibles de prévention d’EIR en modifiant, par exemple la préparation des CP / Despite the implementation of systematic leucoreduction, platelet transfusions are still generating transfusion reactions (also called "Adverse Events or AEs"). We know that platelets release proinflammatory molecules during preparation and storage of platelet components (PCs) notably the soluble CD40 ligand or sCD40L and high levels are associated with AEs. In this thesis, we aimed to understand the mechanisms of occurrence of inflammatory platelet transfusion reactions. In the first part, we investigated the genetic polymorphisms of CD40LG. We failed to identify a significant association with AEs but we identified genetic markers of sCD40L overexpression: a CD40LG haplotype and also an interchromosomal haplotype (CD40LG-CD40-ITGA2). However, these haplotypes have not been found to be associated with AEs. In the second part, we showed that, during storage of non leucoreduced PCs, leukocyte-derived "biological response modifiers" (BRMs) dominate and influence the platelet-derived BRMs. Then, we found increased levels of another individualized BRM in PCs involved in AEs: mitochondrial DNA, classified as an endogenous danger-associated molecular pattern (DAMP). In the last part, we performed an integrated proteomic and transcriptomic study by LC-MS/MS and RNA-seq, respectively, to better understand the pathophysiology of AEs in a case-control approach. The biological enrichment of differentially expressed genes revealed a significant association with platelet activation, apoptosis and inflammatory mechanisms which may be involved in platelet transfusion reactions. This study provides novel insights into the molecular mechanisms underlying the occurrence of AEs and could give paths to prevent them

The past two decades have seen an explosive increase of obesity rates worldwide, with more than one billion adults overweight and 300 million of them obese. Obesity and its associated complications have become leading causes of morbidity and mortality in the United States and major contributing factors to the rising costs of national health care. The pathophysiology of obesity and type 2 diabetes in rodents and humans is characterized by low-grade inflammation and chronic activation of immune pathways in adipose tissue and liver. The CD40 receptor and its ligand, CD40L, initiate immune cell signaling promoting inflammation, but conflicting data on CD40L-null mice confound its role in obesity-associated insulin resistance. A clear understanding of how CD40 and its ligand communicate to regulate and sustain the inflammatory environment of obesity is lacking. Here we demonstrate that CD40 receptor deficient mice on a high-fat diet display the expected decrease in hepatic cytokine levels, but paradoxically exhibit liver steatosis, insulin resistance and glucose intolerance compared with their age-matched wild-type controls. Hyperinsulinemic-euglycemic clamp studies also demonstrated insulin resistance in glucose utilization by the CD40-null mice compared with wild-type mice. In contrast to liver, visceral adipose tissue in CD40 deficient animals harbors elevated cytokine levels and infiltration of inflammatory cells, particularly macrophages and CD8+ effector T cells. In addition, ex vivo explants of epididymal adipose tissue from CD40-null mice display elevated basal and isoproterenol-stimulated lipolysis, suggesting a potential increase of lipid efflux from visceral fat to the liver. These findings reveal that 1) CD40-null mice represent an unusual model of hepatic steatosis with reduced hepatic inflammation, and 2) CD40 unexpectedly functions in adipose tissue to attenuate the chronic inflammation associated with obesity, thereby protecting against hepatic steatosis.

Cancer, historically considered a genetic disease, is currently acknowledged to affect the whole body. Our immune system is one key player that can elicit a response against malignant cells but can also promote tumorigenesis. Tumors avoid immune recognition by creating a suppressive microenvironment and inducing tolerance. T-cells are regarded a major effector cell type in tumor immunotherapy. An important ”switch” needed for T-cell activation involves so-called costimulatory and coinhibitory receptors. In this thesis, experimental tumor models were used to investigate the potential of immunomodulatory antibodies to stimulate immune cells and subsequently eliminate tumors. First, systemic antibody blockade of two negative checkpoint regulators (CTLA-4 and PD-1) present on T-cells was evaluated in combination with local CpG therapy or standard BCG treatment. Indeed, this combinatorial therapy with CpG augmented anti-tumor effects with increased levels of tumor-directed T-cells and reduced tumor-infiltrating Tregs. Secondly, as these immunomodulatory antibodies elicit severe side effects in patients, a local low-dose delivery regimen was explored as an alternative to systemic bolus treatment. Our results demonstrated that an approximately seven times lower dose of aCTLA-4, compared to systemic delivery, could eradicate both primary and distant tumors. CD40-expressing APCs are another potential target in antibody-mediated cancer therapy. CD40-stimulated dendritic cells (DCs) have the capability to activate tumor-directed T-cells to kill tumor cells. We next sought to investigate agonistic CD40 antibody efficacy and in vivo biodistribution when delivered locally compared to the equivalent systemic dose. Anti-tumor effects were dependent on CD8+ T-cells, host CD40 expression and the presence of tumor antigen at the injection site. CD40 antibodies were cleared from the circulation and accumulated in lymphoid organs, where, upon repeated aCD40 dosing, target APC populations increased in numbers and upregulated their surface CD40 expression. Lastly, CD40 agonist antibodies were mixed with nanoparticles to enhance their stimulatory properties. B-cells demonstrated increased proliferative capacity and DCs became more activated when exposed to the cocktail. Further, this combination reduced serum levels of pro-inflammatory cytokines compared to plain antibodies.       The results herein advocate further exploratory studies of the delivery of monoclonal antibodies at the tumor site in order to improve anti-tumor effects and reduce toxicity.

This dissertation represents efforts to determine the functional consequences acquired by vascular smooth muscle cells (SMC) in response to CD40 ligation by activated CD154+ T cells, and to elucidate components of the signaling pathway(s) activated in response to CD40 signaling in both monocytes and SMC. To study the consequences of CD40 stimulation, primary human monocytes and aortic SMC were treated with plasma membranes purified from CD154 + , CD4+ T cells. The results presented in this dissertation demonstrate that SMC, like monocytes/macrophages, are capable of interacting with T cells in a manner that results in reciprocal activation events. SMC were shown to present antigen to, and activate T cells. In turn T cell stimulus resulted in the activation of proinflammatory function in SMC initiated through the CD154:CD40 interaction. CD40 stimulation of SMC resulted in the production of the chemokines interleukin 8 (IL-8) and macrophage chemotactic protein-1 (MCP-1), and the upregulation of intercellular adhesion molecule (ICAM). Examination of the intracellular signaling pathways activated through CD40 signaling revealed the involvement of MAPKs in the pathway leading to induction of proinflammatory activity. Evaluation of CD40 signaling in monocytes demonstrated the activation of the MAPK family members ERK1/2, but not the MAPK family members p38 or c-jun-N-terminal kinase (JNK). In contrast, CD40 signaling in SMC was shown to result in ERK1/2 and p38 activation, and both of these kinases were shown to play a critical role in the induction of chemokine synthesis. An examination of the ability of anti-inflammatory cytokines to modulate CD40 signaling in monocytes and SMC demonstrated that the anti-inflammatory cytokines IL-4 and IL-10 abrogate CD40-mediated induction of inflammatory cytokine production by monocytes. This inhibition was shown to be a result of a negative influence of IL-4 and IL-10 on CD40 mediated ERK1/2, activation in monocytes. However, IL-4 and IL-10 did not inhibit SMC proinflammatory responses indicating a difference in the intracellular responses to these cytokines by the two cell types. (Abstract shortened by UMI.)