Existe un grupo de enteropatía conocidas como AVSN que pueden simular enfermedad celíaca. Objetivo: El objetivo de este estudio es describir los hallazgos histológicos y de inmunohistoquímica en pacientes con enfermedad celíaca y AVSN. Material y métodos: 15 biopsias de pacientes con enfermedad celíaca y 19 biopsias con AVSN fueron reexaminados. Se estudió características histológicas tales como atrofia severa, hiperplasia de criptas, número de células plasmáticas, número de eosinófilos y presencia de neutrófilos. Asimismo, a través de inmunohistoquímica se estudió la presencia de linfocitos CD4, CD8, CD3, CD56. Resultados: Se encontró diferencia significativa en la mayor presencia de hiperplasia de criptas (p=0,0348) y mayor número de células plasmáticas (p=0,0348) en las biopsias de enfermedad celíaca que en las catalogadas como AVSN. El número de linfocitos CD8, CD4, CD56 y su distribución fue similar en ambos grupos. El porcentaje de linfocitos intraepiteliales CD3 positivos (p=0,0144) fue mayor en pacientes con AVSN. Conclusión: Los hallazgos histológicos e inmunohistoquímicos muestran más similitudes que diferencias. La diferencia hallada en nuestro estudio sugiere mayor respuesta inmune humoral en pacientes con enfermedad celiaca que en AVSN. / There is a group of enteropathies recently known as seronegative villous atrophy (SNVA), which can simulate celiac disease. Objective: The aim of this study was to describe histological and immunohistochemical differences between a group of Celiac disease and SNVA patients. Material and methods: Microscopy reexamination and Immunohistochemistry study were performed for a group of 15 celiac patients and 19 SNVA patients. Histological features as severe atrophy, crypt hyperplasia, plasma cells number, eosinophils number, neutrophils presence were studied; CD4, CD8, CD3, and CD56 markers were studied through immunohistochemistry. Results: There was a significant difference between the frequency of observation of crypt hyperplasia (p=0.0348) and plasma cells (p=0.0348) in celiac disease patients than SNVA patients. In celiac disease was bigger. The number and distribution of CD 8, CD4 and CD56 lymphocytes was similar in both groups. The percentage of CD3 positive intraepithelial lymphocytes (p=0.0144) was higher in SNVA. Conclusion: Histological and immunohistochemical evaluation shows more similarities than differences. The differences found in this study suggest more humoral immune response in celiac disease than in SNVA.

Monocytes are no longer regarded as a homogenous cell population but can be divided, both phenotypically and functionally, into different subsets. In rheumatoid arthritis, the subpopulation of CD14bright/CD16+ monocytes is expanded and prone towards generation of Th17 cells. CD56+ monocytes represent a different subpopulation, which is also expanded in conditions associated with autoimmunity like inflammatory bowel diseases. The aim of the study was the quantification and functional characterization of the CD56+ monocyte subset in rheumatoid arthritis (RA). The work at hand shows that the frequency of CD56+ monocytes is also expanded in RA; moreover, this subpopulation seems to increase with age in healthy controls. This age association is completely lost in patients suffering from RA. Further functional investigations could demonstrate a dysregulated cytokine response to lipopolysaccharide (LPS) with an increased production of pro-inflammatory cytokines like TNFα as well as an increased spontaneous reactive oxygen intermediate (ROI) production. A longitudinal treatment study using Etanercept as an established TNFα-blocking agent revealed a decrease of the frequency of that cell population under therapy. This decrease was more pronounced in patients with a good treatment response as judged by the reduction of the disease activity score (DAS) 28. Summing up those results, the CD56+ monocyte subset might be involved in immunosenescence as well as in the pathogenesis of RA.

Les cellules dendritiques plasmacytoïdes (pDCs) font le lien entre l'immunité innée et l'immunité adaptative en produisant de l'interféron de type 1 en grandes quantités ainsi qu'en induisant l'activation et la prolifération des cellules T naïves de manière antigène-spécifique. Les pDCs expriment à haut niveau les récepteurs TLR7 et TLR9 et détectent ainsi les acides nucléiques d'origine virale. Les TLRs 7 et 9, localisés dans le réticulum endoplasmique (RE) à l'état basal, sont relocalisés vers les endosomes tardifs, lors de l'activation, pour initier la signalisation. Ce processus est dépendant de la protéine chaperon UNC93B1. Au cours de ma thèse, j'ai caractérisé une nouvelle molécule de la famille des protéines membranaires associées aux lysomes (LAMP), nommée BAD-LAMP. Cette protéine est, au sein du système immunitaire humain, exprimée spécifiquement dans les pDCs. Contrairement aux autres membres de la famille, BAD-LAMP n'est pas détectée dans les lysosomes mais est retenue dans le RE. J'ai également démontré que BAD-LAMP est régulée négativement lors de l'activation des pDCs induite par un ligand de TLR9. L'utilisation d'un système de cellules HeLa tranfectées et de différents mutants de BAD-LAMP avec des défauts de localisation m'ont permis d'établir que BAD-LAMP et UNC93B1 sont capables d'influencer mutuellement les adressage, par un mécanisme restant à identifier. BAD-LAMP pourrait aussi remplir un rôle de chaperon du complexe UNC93B1-TLR9 et moduler la réponse TLR9. L'étude d'un tel mécanisme de contrôle permettrait de mieux comprendre la régulation fine de la réponse immunitaire. / Plasmacytoid dendritic cells (pDCs) link innate and adaptative immunity by producing large amounts of type-1 interferon and inducing naive T cell activation and proliferation in an antigen-specific manner. pDCs express high levels of TLR7 and TLR9 and thereby sense viral nucleic acids. TLRs 7 and 9, which rest in the endoplamic reticulum (ER) at steady-state, are re-localized to the late endosomal compartment upon activation for signaling. this process is dependent of the interaction between TLRs and the chaperone UNC93B1. During my thesis, I characterized a new molecule of the lysosome-associated membrane protein (LAMP) family, named BAD-LAMP. In the human immune system, this protein is exclusively expressed in pDCs. BAD-LAMP is not detected in lysosomes, as opposed to the other LAMP family members, but is retained in the ER compartment. I also demonstrated that BAD-LAMP is down-regulated after pDCs activation by a TLR9 ligand. Using trnasfered HeLa cells and several mutant forms of BAD-LAMP with localization defects, I etablished that BAD-LAMP and UNC93B1 can influence reciprocally their intercellular trafficking by a yet uncharacterize mechanism. BAD-LAMP could therefore act as a chaperone of UNC93B1-TLR9 complex and moduate the TLR9 response. The study of such a regulatory mechanism could help to understand better the fine tuning of the immune response.

NK cell based anti-tumour therapies demonstrate high efficacy in targeting hematological malignancies, however, treatments for advanced solid tumours face challenges. The immunosuppressive environment produced by tumours prevents NK cells from maintaining cytotoxic activity and reducing tumour burden. Enhancing NK cell activation is essential to improve their function against solid tumours. Genetic manipulation of primary NK cells with viral and non-viral methods has seen a drastic improvement in recent years. Lentiviral vectors are being used to generate CAR-NK cells ex vivo, while refinement of electroporation protocols has allowed for the generation of stable gene knockouts in primary NK cells. To establish and validate the generation of a stable knockout in primary human NK cells we focused on targeting the NCAM-1 (CD56) surface adhesion molecule. The high surface expression of CD56 in NK cells makes it a suitable target to establish the knockout protocol. Furthermore, despite its levels of expression being correlated to different functional phenotypes, the role of CD56 in NK cell function is not understood. Here we have shown that current lentiviral transduction protocols are not viable methods to deliver the sgRNA/Cas9 system into primary NK cells. However, we found that nucleofection of the sgRNA/Cas9 complex into NK cells is an efficient method to generate gene knockouts. Using newly generated CD56KO NK cells we have shown that the expression of CD56 has no effect on NK cell cytotoxicity, cytokine production, proliferation, and in vivo tissue trafficking. In parallel, we have also identified an intracellular pathway that is active in the tumour microenvironment and could inhibit NK cell function. Recent studies on the intracellular signaling of the E3 ubiquitin-protein ligase Cbl-b have highlighted its role in inhibiting NK cell tumour lytic and anti-metastatic activity. Immunosuppressive factors produced by tumours activate the Cbl-b pathway, leading to the targeted degradation of signaling proteins required for NK cell activation. We have shown that Cbl-b is upregulated in ex vivo expanded NK cells cultured with GAS6 or ovarian cancer ascites. Therefore, the generation of human primary Cbl-bKO NK cells could be a beneficial asset to enhance NK cell cancer immunotherapy. / Thesis / Master of Science (MSc)

Monocytes are no longer regarded as a homogenous cell population but can be divided, both phenotypically and functionally, into different subsets. In rheumatoid arthritis, the subpopulation of CD14bright/CD16+ monocytes is expanded and prone towards generation of Th17 cells. CD56+ monocytes represent a different subpopulation, which is also expanded in conditions associated with autoimmunity like inflammatory bowel diseases. The aim of the study was the quantification and functional characterization of the CD56+ monocyte subset in rheumatoid arthritis (RA). The work at hand shows that the frequency of CD56+ monocytes is also expanded in RA; moreover, this subpopulation seems to increase with age in healthy controls. This age association is completely lost in patients suffering from RA. Further functional investigations could demonstrate a dysregulated cytokine response to lipopolysaccharide (LPS) with an increased production of pro-inflammatory cytokines like TNFα as well as an increased spontaneous reactive oxygen intermediate (ROI) production. A longitudinal treatment study using Etanercept as an established TNFα-blocking agent revealed a decrease of the frequency of that cell population under therapy. This decrease was more pronounced in patients with a good treatment response as judged by the reduction of the disease activity score (DAS) 28. Summing up those results, the CD56+ monocyte subset might be involved in immunosenescence as well as in the pathogenesis of RA.

INTRODUÇÃO: O objetivo do estudo foi avaliar o perfil de marcadores imuno-histoquímicos relacionados às células NK em biópsias de aloenxertos renais com diagnóstico anatomopatológico de rejeição aguda (mediadas por células T ou anticorpos) e estabelecer relações desses marcadores com parâmetros morfológicos de lesão à microcirculação e sobrevida do enxerto. MÉTODOS: Estudo retrospectivo histórico que revisou 74 biópsias realizadas entre janeiro de 2009 e dezembro de 2012, de pacientes com rejeição aguda mediada por células T (n=36), rejeição aguda mediada por anticorpos com expressão positiva (n=19) ou negativa (n=19) para o marcador C4d, juntamente com levantamento de dados clínicos e laboratoriais pertinentes ao estudo. Foram realizadas reações imuno-histoquímicas, para os marcadores CD56, CD57, CD16, CD68, CD3, CD8 e CD4 com ênfase para os marcadores CD56 e CD16. Foi feita análise das células positivas em toda a cortical da biópsia nos compartimento intersticial, glomerular e vascular. Testes estatísticos foram aplicados conforme os pressupostos definidos no objetivo da pesquisa. RESULTADOS: No compartimento intersticial, células CD56+ (P = 0,004) e CD57+ (P < 0,001) foram expressas em maior quantidade em biópsias negativas para dosagem sérica de anticorpos específicos anti-doador (DSA) com diagnóstico de rejeição aguda mediada por células T. CD56 intersticial foi associado estatisticamente com presença de glomerulite (g >= 1) (P = 0,02) e ausência / leve capilarite peritubular (ptc <= 1) (P = 0,003). Células intersticiais positivas para o marcador CD56 com média superior a 0,56 céls/mm2 tiveram uma pior sobrevida do enxerto renal (P = 0,028). Biópsias com contagem inferior ou igual a 0,56 cél/mm2 tiveram associação estatisticamente significante para ausência ou leve capilarite peritubular (P = 0,012) e com contagem superior a 0,56 céls/mm2, foram associadas à presença de glomerulite (P = 0,002). Foi observado maior número de células positivas para o marcador CD16 no compartimento glomerular em biópsias positivas para dosagem sérica de DSA com diagnóstico de rejeição aguda mediada por anticorpos (P = 0,03) e em biópsias com presença de glomerulite (P = 0,009). Presença de maior número de células CD16+ no compartimento intersticial associou-se com capilarite peritubular (P = 0,0001). CONCLUSÕES: Maior expressão de células CD56 positivas no compartimento intersticial das biópsias foi significantemente associada com escores relacionados à lesão na microcirculação, especialmente glomerulite, com rejeição aguda mediada por células T e pior sobrevida do enxerto renal. Células CD16 positivas, no compartimento glomerular foram associadas com rejeição aguda mediada por anticorpos e glomerulite. As variações na expressão dos marcadores de células NK nos diferentes compartimentos da biópsia renal podem sugerir presença de envolvimento das células NK em diferentes vias do sistema imune nas rejeições agudas de aloenxertos renais / INTRODUCTION: The aim of this study was to investigate the immunohistochemical profile of markers related to NK cells from renal allograft biopsies with morphological diagnosis of acute rejection (T-cells or antibodies mediated rejection) and to study associations of those markers with types of rejection, microcirculation injury morphological parameters and graft survival. METHODOLOGY: Historical retrospective study that reviewed 74 biopsies performed between January 2009 and December 2012 in patients with acute T-cell-mediated rejection (n=36) and acute antibody-mediated rejection with (n=19) or without evident C4d deposition (n=19). The study was performed with relevant clinical and laboratory data. Immunohistochemical reactions were performed for CD56, CD57, CD16, CD68, CD3, CD8 and CD4 markers with highlights for CD56 and CD16. Counting of positive cells throughout cortical biopsy was performed in glomerular, interstitial and vascular compartments. Statistical tests were applied according to assumptions set out the goal of the study.RESULTS: DSA-negative biopsies-from patients with acute T-cell mediated rejection (aTCMR) had an increased expression of CD56+ and CD57+ cells (P = 0.004 and P < 0.001) in the interstitial compartment in comparison with donor-specific antibodies ( DSA)-positive biopsies from patients acute antibody-mediated rejection with and without C4d deposition. Interstitial CD56+ cells had an increased expression for presence of glomerulitis (g >= 1) (P = 0.02) and peritubular capillaritis (ptc >= 2) (P = 0.003). Interstitial CD56 + cells with mean superior to 0.56cells/mm2 had worse allograft survival (P = 0.028). CD56+ cells in the interstitial compartment with mean inferior or equal to 0.56cells/mm2 associated with absence or mild peritubular capillaritis (P = 0.012) and mean superior to 0.56cells/mm2 was associated with presence of glomerulitis (P = 0.002). CD16+ cells was increased in the glomerular compartment in DSA-positive biopsies (P = 0.03) and in the presence of glomerulitis (P = 0.009). Interstitial CD16+ cells associated with peritubular capillaritis (P = 0.0001).CONCLUSION: CD56+ cell infiltrates in the interstitial compartment were significantly associated with microcirculation injury scores, especially glomerulitis, acute T-cell mediated rejection and clinical outcomes. CD16+ cell infiltrates in glomerular compartment was associated with acute antibody-mediated rejection and glomerulitis. Our findings showed variations in expression of NK cells markers in renal biopsy different compartments which might suggest the involvement of NK cells in different immune system pathways in acute renal allograft rejection

INTRODUÇÃO: O objetivo do estudo foi avaliar o perfil de marcadores imuno-histoquímicos relacionados às células NK em biópsias de aloenxertos renais com diagnóstico anatomopatológico de rejeição aguda (mediadas por células T ou anticorpos) e estabelecer relações desses marcadores com parâmetros morfológicos de lesão à microcirculação e sobrevida do enxerto. MÉTODOS: Estudo retrospectivo histórico que revisou 74 biópsias realizadas entre janeiro de 2009 e dezembro de 2012, de pacientes com rejeição aguda mediada por células T (n=36), rejeição aguda mediada por anticorpos com expressão positiva (n=19) ou negativa (n=19) para o marcador C4d, juntamente com levantamento de dados clínicos e laboratoriais pertinentes ao estudo. Foram realizadas reações imuno-histoquímicas, para os marcadores CD56, CD57, CD16, CD68, CD3, CD8 e CD4 com ênfase para os marcadores CD56 e CD16. Foi feita análise das células positivas em toda a cortical da biópsia nos compartimento intersticial, glomerular e vascular. Testes estatísticos foram aplicados conforme os pressupostos definidos no objetivo da pesquisa. RESULTADOS: No compartimento intersticial, células CD56+ (P = 0,004) e CD57+ (P < 0,001) foram expressas em maior quantidade em biópsias negativas para dosagem sérica de anticorpos específicos anti-doador (DSA) com diagnóstico de rejeição aguda mediada por células T. CD56 intersticial foi associado estatisticamente com presença de glomerulite (g >= 1) (P = 0,02) e ausência / leve capilarite peritubular (ptc <= 1) (P = 0,003). Células intersticiais positivas para o marcador CD56 com média superior a 0,56 céls/mm2 tiveram uma pior sobrevida do enxerto renal (P = 0,028). Biópsias com contagem inferior ou igual a 0,56 cél/mm2 tiveram associação estatisticamente significante para ausência ou leve capilarite peritubular (P = 0,012) e com contagem superior a 0,56 céls/mm2, foram associadas à presença de glomerulite (P = 0,002). Foi observado maior número de células positivas para o marcador CD16 no compartimento glomerular em biópsias positivas para dosagem sérica de DSA com diagnóstico de rejeição aguda mediada por anticorpos (P = 0,03) e em biópsias com presença de glomerulite (P = 0,009). Presença de maior número de células CD16+ no compartimento intersticial associou-se com capilarite peritubular (P = 0,0001). CONCLUSÕES: Maior expressão de células CD56 positivas no compartimento intersticial das biópsias foi significantemente associada com escores relacionados à lesão na microcirculação, especialmente glomerulite, com rejeição aguda mediada por células T e pior sobrevida do enxerto renal. Células CD16 positivas, no compartimento glomerular foram associadas com rejeição aguda mediada por anticorpos e glomerulite. As variações na expressão dos marcadores de células NK nos diferentes compartimentos da biópsia renal podem sugerir presença de envolvimento das células NK em diferentes vias do sistema imune nas rejeições agudas de aloenxertos renais / INTRODUCTION: The aim of this study was to investigate the immunohistochemical profile of markers related to NK cells from renal allograft biopsies with morphological diagnosis of acute rejection (T-cells or antibodies mediated rejection) and to study associations of those markers with types of rejection, microcirculation injury morphological parameters and graft survival. METHODOLOGY: Historical retrospective study that reviewed 74 biopsies performed between January 2009 and December 2012 in patients with acute T-cell-mediated rejection (n=36) and acute antibody-mediated rejection with (n=19) or without evident C4d deposition (n=19). The study was performed with relevant clinical and laboratory data. Immunohistochemical reactions were performed for CD56, CD57, CD16, CD68, CD3, CD8 and CD4 markers with highlights for CD56 and CD16. Counting of positive cells throughout cortical biopsy was performed in glomerular, interstitial and vascular compartments. Statistical tests were applied according to assumptions set out the goal of the study.RESULTS: DSA-negative biopsies-from patients with acute T-cell mediated rejection (aTCMR) had an increased expression of CD56+ and CD57+ cells (P = 0.004 and P < 0.001) in the interstitial compartment in comparison with donor-specific antibodies ( DSA)-positive biopsies from patients acute antibody-mediated rejection with and without C4d deposition. Interstitial CD56+ cells had an increased expression for presence of glomerulitis (g >= 1) (P = 0.02) and peritubular capillaritis (ptc >= 2) (P = 0.003). Interstitial CD56 + cells with mean superior to 0.56cells/mm2 had worse allograft survival (P = 0.028). CD56+ cells in the interstitial compartment with mean inferior or equal to 0.56cells/mm2 associated with absence or mild peritubular capillaritis (P = 0.012) and mean superior to 0.56cells/mm2 was associated with presence of glomerulitis (P = 0.002). CD16+ cells was increased in the glomerular compartment in DSA-positive biopsies (P = 0.03) and in the presence of glomerulitis (P = 0.009). Interstitial CD16+ cells associated with peritubular capillaritis (P = 0.0001).CONCLUSION: CD56+ cell infiltrates in the interstitial compartment were significantly associated with microcirculation injury scores, especially glomerulitis, acute T-cell mediated rejection and clinical outcomes. CD16+ cell infiltrates in glomerular compartment was associated with acute antibody-mediated rejection and glomerulitis. Our findings showed variations in expression of NK cells markers in renal biopsy different compartments which might suggest the involvement of NK cells in different immune system pathways in acute renal allograft rejection

Po pirmosios širdies transplantacijos 1967 metais, ši operacija iš eksperimentinio gydymo tapo šiuolaikiniu, pažangiu sunkių širdies ligų gydymo būdu. Širdis šiuo metu yra trečias pagal dažnumą transplantuojamas organas JAV. UNOS (angl. Unaited Network for Organs Sharing) duomenimis JAV kasmet atliekama 2700 širdies transplantacijos operacijų. Tyrimai rodo, kad pirmuosius metus po operacijos išgyvena apie 85% pacientų, pirmus trejus metus – 75% pacientų. ISHLT (angl. International Society for Heart and Lung Transplantation) registravimo duomenys rodo, kad šiuo metu pasaulyje gyvena apie 50 000 žmonių, turinčių širdies transplantatą [20]. Nepakankamas donorų skaičius skatina mokslininkus ieškoti alternatyvių širdies ligomis sergančių pacientų gydymo būdų. Šiuo metu daug dėmesio skiriama kamieninių ląstelių tyrimams ir galimam jų pritaikymui įvairiom ligom gydyti. Su eksperimentiniais pelių modeliais parodyta, kad kamieninės ląstelės, implantuotos į širdies raumenį, geba diferencijuotis į kardiomiocitus ir kraujagyslių endotelio ląsteles ir atkurti pažeistą raumenį. Taučiau publikuota ir nemažai nesėkmių, susijusių su kamieninių ląstelių terapija, pvz.: neprigyjimas implantuotoje vietoje, nepilna diferencijacija [59]. Žmogaus mezenchiminių kamieninių ląstelių auginimas užtrunka, o gydymo dažnai prireikia tuoj pat [50]. Šios ir daug kitų problemų reikalauja daugybės tyrimų ir eksperimentų, todėl transplantacija kol kas išlieka pagrindiniu gydymo būdu, prailginančiu pacientų... [toliau žr. visą tekstą] / The ame of this work was to evaluate the changes of the expresion of T lymphocyte CD16/56, CD103, CD134 surface markers in the blood of the patients who underwent heart transplantation. For this purpose we collected heparinized blood samples of 21 patients with cardiac transplant and 29 healthy volunteers. 9 patients out of 21 underwent acute cardiac transplant rejection. Blood samples of these patients were tested using flow cytometry 10 days before heart rejection and on the day when rejection was uphold. Our results showed that the expresion of T lymphocyte CD16/56 surface molecule is higher on the rejection day then in controle group. Exspresion of CD103 marker is higher 10 days before rjection than on the rejection day and is lower then in healthy volunteers. Expresion of CD134 marker is higher before transplant rejection and higher then in healthy controles. Monitoring of CD3+CD103+ and CD+CD134+ cells in the blood after heart transplantation could be helpful in prediction of heart transplant rejection.

L'immuno-marquage multiple des lymphocytes T par cytométrie en flux permet d'observer plus de phénotypes que les deux isotypes conventionnels T CD4+ et T CD8+. Ces observations sont basées sur la combinaison de marqueurs habituellement utilisés mais rarement tous associés ainsi que sur le niveau d'expression membranaire. Ces données ne peuvent être reproductibles qu'au prix d'une standardisation rigoureuse de la préparation et des réglages du cytomètre et l'élimination de possibles artefacts. Nous décrivons les lymphocytes T CD4+CD8dim, T CD4dimCD8+, T CD3fort (Tgamma/alpha), T CD8alpha/alpha, T CD8dim et T CD8+CD56+. Les trois derniers sont encore peu détaillés. Seules quelques observations ont déjà été rapportées dans la littérature. Certaines combinaisons (doubles positifs CD4+/CD8+) sont observées sur le thymocyte immature mais, classiquement, pas dans le sang périphérique. Il était donc nécessaire de distinguer les isotypes doubles positifs dans le sang périphérique de formes immatures qui auraient pu s'échapper du thymus. L'expression réduite d'un marqueur (" dim ") peut être induite par l'activation du lymphocyte. Il était donc nécessaire d'éliminer une activation récente. Bien que le travail en l'état se limite à des descriptions phénotypiques, nous avons cherché à connaître la pertinence physiologique possible de ces expressions aberrantes en faisant une courte revue de la littérature sur les étapes de la lymphopoïèse, les mécanismes d'orientation vers une lignée particulière et les processus d'activation lymphocytaire spécifique. L'expression d'un marqueur membranaire étant dépendant de son utilité, nous émettons l'hypothèse que ces isotypes non conventionnels ont une activité immunitaire particulière, soit habituellement minoritaire ou restreinte à certains sites soit induite. Des études fonctionnelles devraient éclaircir ce point. Nos résultats ne permettent pas de préciser si leur émergence est un processus actif (éventuellement chronique) ou est séquellaire d'une sollicitation passée. Certaines populations ont une diversité très restreinte. Nous les avons qualifiées d'oligoclonales à défaut de pouvoir confirmer leur monoclonalité. Compte tenu de la grande diversité du système immunitaire T, il est peu probable que cette restriction soit fortuite. Elle peut être réactionnelle mais doit être distinguée des authentiques syndromes lymphoprolifératifs aux phénotypes parfois proches. Nous situant alors dans la situation frontière entre physiologie et pathologie, nous avons proposé de qualifier ces populations de " dysclonotypie oligoclonale de signification indéterminée " par analogie avec le concept de " dysglobulinémie monoclonale de signification indéterminée ". Des études complémentaires devraient permettre de clarifier cette hypothèse et éventuellement de définir des critères pronostiques.

Dès l'ouverture du laboratoire et la création de cette activité sur le CHU en 1995, notre travail a été centré autour de l'analyse cellulaire. Nous nous sommes plus particulièrement intéressés aux populations lymphocytaires T et aux adénocarcinomes avec deux aspects particuliers : diversité et dynamique de populations hétérogènes, détection et caractérisation d'éléments minoritaires (évènements rares) au sein de cette population. Notre activité hospitalière a été effectuée dans au laboratoire d'Immunologie qui fait partie du Pôle de Biologie-Pathologie du CHU de Saint-Etienne. La partie plus expérimentale ou biotechnologique de nos recherches a été conduite dans le cadre du Groupe d'études sur l'Immunité des Muqueuses et les Agents Pathogènes (GIMAP, EA 3064) et, depuis 2004, dans celui du Centre d'Ingénierie et Santé de l'Ecole Nationale Supérieure des Mines de Saint Etienne (où nous sommes détaché pour 20% de notre temps hospitalier).