Cancer immunotherapy has gained attention in recent years for its successes in potentiating immune responses that can elicit tumor control. In particular, adoptive cell therapy (ACT), which involves the autologous/allogeneic transplant of ex vivo-cultivated tumor-specific T lymphocytes, can mediate potent tumor recognition and killing; however, durable clinical responses are often difficult to obtain in solid tumors. Solid tumors and their unique microenvironments have the capacity to evade and suppress antitumor immune responses and represent significant hurdles for effective ACT. Recently, we have discovered that chemical inhibition of histone deacetylases via MS-275 (Entinostat) during ACT can subvert tumor resistance to foster potent, broad-spectrum antitumor immunity. Overall, the work described supports the efficacy of ACT in the treatment of immunosuppressive, solid tumors; however, consistency in durable clinical outcomes can only be achieved through the concurrent therapeutic targeting of tumor resistance mechanisms. This thesis uses pre-clinical models to describe how tumor resistance to ACT can manifest, and demonstrates that concurrent MS-275 delivery drives extensive immunomodulation to promote sustained tumor clearance. This includes: 1) The polarization of tumor-infiltrating myeloid cells into cytotoxic effectors with the ability to reject immune escape variants 2) The inflammatory remodeling of the tumor microenvironment to potentiate epitope spreading against secondary tumor antigens 3) The transcriptional reprogramming of adoptively transferred T cells to overcome tumor-burden-dependent exhaustion We expect that the results will help facilitate the development of next-generation ACT platforms that will feature strategies for multi-mechanistic perturbation of tumor resistance. / Thesis / Doctor of Philosophy (PhD) / The host immune system has the ability to recognize and destroy tumor cells. Therapeutic platforms that leverage antitumor immune cells, specifically T cells, have shown potency in the elimination of cancer. In the clinic, cancer immunotherapies have demonstrated early success against hematological malignancies; however, are unreliable in the treatment of solid tumors. Solid tumors utilize intrinsic and adapted mechanisms of resistance to mitigate the effectiveness of cancer immunotherapy. This thesis pursues research questions aimed at understanding how tumors resist immunotherapy, what mechanisms are utilized, and how to overcome these obstacles. We anticipate that these results will contribute to the development and incorporation of strategies to subvert tumor resistance and potentiate T cells against solid tumors.

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Remarkable advances have been made in the treatment of cardiovascular diseases (CVD), however, CVD still accounts for the most deaths in industrialized nations. Ischemic heart disease (IHD) can lead to acute coronary syndrome (ACS) (myocardial infarction [MI]). The standard of care is reperfusion therapy followed by pharmacological intervention to attenuate clinical symptoms related to the MI. While survival from MI has dramatically increased with the implementation of reperfusion therapy, these individuals will inevitably suffer progressive pathological remodeling leaving them predispose to develop heart failure (HF). HF is a clinical syndrome defined as the impairment of the heart to maintain organ perfusion at rest and/or during times of exertion (i.e. exercise intolerance). Clinically, this is accompanied by dyspnea, pulmonary or splanchnic congestion and peripheral edema. Physiologically, there is neurohormal activation through the classical β–adrenergic and PKA–dependent signalin / Physiology

La destruction des cellules ciliées de la cochlée entraine des surdités sensorielles. Chez les mammifères ces cellules ne se régénèrent pas et les déficits auditifs occasionnés sont définitifs. Aucune thérapie visant à remplacer les cellules ciliées détruites n'est actuellement proposée.L'objectif de cette thèse est de contribuer au développement d'une thérapie cellulaire basée sur la greffe de cellules souches / progénitrices cochléaires et destinée à promouvoir la régénération des cellules ciliées.Au cours de nos travaux, nous avons isolé une population de cellules souches cochléaires chez des souris néonatales appartenant à la « side population » (Savary et al. 2007). Nous avons également montré, par des expériences de perte et de gain de fonction in vitro, que la voie de signalisation Notch est nécessaire pour l'auto-renouvellement et la différenciation de ces cellules (Savary et al., 2008). Des lignées de souris transgéniques exprimant la GFP sous le promoteur de la GFAP et de la Nestine nous ont permis de suivre l'expression de ces marqueurs de cellules souches dans des cochlées de souris P3 et adultes. En étudiant l'expression combinée d'autres marqueurs comme Sox2 et Abcg2, nous avons montré que les cellules progénitrices cochléaires sont réparties différemment chez les souris néonatales et les souris adultes (Smeti, Savary et al 2010).Nos expériences préliminaires de transplantation in vitro dans un modèle murin de surdité génétique humaine de type DFNA15 démontrent que les cellules souches / progénitrices greffées sont capables d'intégrer l'épithélium sensoriel lésé et de se différencier en cellules exprimant un marqueur de cellules ciliées. / The destruction of cochlear hair cells causes sensory deafness. In Mammals these cells do not regenerate and damages are irreversible. Currently, there is no proposed therapy to replace the destroyed hair cells.The focus of this thesis is to develop a novel cell therapy based on transplantation of cochlear progenitor cells in order to promote regeneration of hair cells.We first isolated a population of cochlear stem cells from neonatal mice by using the side population analysis technique (Savary et al. 2007). Then, we showed, by in vitro loss and gain of function experiments, that the Notch signaling pathway is necessary for cellular self-renewal and differentiation (Savary et al., 2008).Transgenic mice strains expressing GFP under the control of GFAP and Nestin promotors allowed us to monitor the expression of these markers of stem cells in the P3 and adult mice cochleae. By studying the combined expression of other stem cells markers such as Sox2 and ABCG2, we showed that the niches of cochlear progenitor cells are differently distributed in neonatal and adult mice (Smati, Savary et al 2010).Our preliminary in vitro transplantation experiments in a mouse model that mimics human genetic deafness DFNA15 show that the transplanted stem / progenitor cells are able to migrate to the lesion site, to integrate the damaged sensory epithelium and to differentiate into cells expressing a marker of hair cells.

Infarction irreversibly damages the heart, with formation of an akinetic scar that may lead to heart failure. Endogenous cardiac stem cells (CSCs) are a promising candidate cell source for restoring lost tissue and thereby preventing heart failure. CSCs would be most beneficial if administered soon after infarction, thus the aim of this project was to optimize CSC culture conditions to enhance their therapeutic potential for myocardial infarction. CSCs were isolated and expanded in vitro via the formation of cardiospheres to give cardiosphere-derived cells (CDCs). Neonatal rat CDCs were found to be heterogenous, containing cells expressing the cardiac stem cell marker, c-Kit, pluripotent cell markers, Oct-4, Sox 2, Klf-4 and Nanog, and early cardiac specific differentiation markers, Nkx 2.5 and GATA 4. Administration of CDCs to the infarcted rat heart increased the cardiac ejection fraction by 9%, capillary density by 9% and reduced scar volume by 33%, compared to the non-treated group. The proliferation rates and the expression of c-Kit were significantly decreased in CSCs isolated from aged rats and after extended culture in vitro, so, CSC culture was optimized using hypoxic preconditioning. Under hypoxia, CDC proliferation rates were 1.7-fold greater, and larger cardiosphere clusters were formed. Hypoxic CDCs had an increased cardiac stem cell population, in that c-Kit was increased by 220% and CD90 and CD105 were decreased by 55% and 35%, respectively, compared to normoxic CDCs. Further, hypoxia induced the expression of CXCR-4 (~3.2-fold), EPO (~3.0-fold) and VEGF (~1.5-fold), indicating that hypoxic preconditioning may stimulate stem cell homing and neovascularization in the infarcted myocardium. Notably, hypoxic CDCs were able to switch to anaerobic glycolytic metabolism and had approximately 80% lower oxygen consumption, suggesting that they may be better adapted to survive within the hypoxic infarct scar, compared with normoxic CDCs. Culture of CDCs with hypoxia-mimicking prolyl-4-hydroxylase inhibitors (PHDIs) using DMOG, BIC and a novel compound, EDBA, induced similar effects to hypoxic culture by increasing c-Kit, EPO, VEGF, CXCR-4, decreasing CD90 and CD105 and increasing glycolytic metabolism. However, PHDI treatment for 24 hours did not alter CDC proliferation rates and cells died after 24 hours. In conclusion, CDCs are a potential cell source for therapy after myocardial infarction and their therapeutic potential can be enhanced using hypoxia or PHDI-preconditioning techniques.

Mesenchymal stem cells (MSC) possess a multilineage differentiation potential and have the ability to regulate reactivity of the immune system. They are usually isolated and expanded from the bone marrow, adipose tissue or umbilical cord. MSC represent promising cell population for the treatment of some severe diseases, such as amyotrofic lateral sclerosis (ALS), due to the combination of regenerative and immunomodulatory properties. The aim of this study is to compare MSC from ALS patients and healthy donors in their phenotype, proliferative activity and mainly their immunomodulatory properties. The assessment of impact of the disease on the properties of MSC is important for their autologous use in clinical trials. In this study we used MSC isolated from bone marrow of 14 ALS patients and 15 patients undergoing mostly orthopedic surgery as control group. We also used MSC stimulated for 24 hours by poinflammatory cytokines. Cells were compared in terms of immunophenotype, differentiation in adipocytes and osteoblasts, metabolic activity, expression of selected genes for immunomodulatory molecules and for inhibition of lymphocyte proliferation. Further experiments were focused on evaluation of immunomodulatory properties of MSC. The effect of MSC on peripheral blood mononuclear cells stimulated...

Les faibles capacités régénératives intrinsèques du système nerveux central, après la survenue de lésions traumatiques ou l'apparition de maladies neuro-dégénératives, ont orienté les recherches vers des thérapies basées sur l'utilisation de cellules souches dans le but de régénérer le tissu cérébral. Cependant, des limitations éthiques et techniques associées aux cellules souches embryonnaires, fœtales ou neurales chez l'adulte restreignent leur utilisation en clinique humaine. À la recherche d'une source alternative, nous nous sommes intéressés à des cellules souches adultes peu connues, provenant du chorion d'un tissu nerveux périphérique en perpétuel renouvellement : les cellules souches de la lamina propria olfactive, localisée dans la cavité nasale. Ces cellules multipotentes ont été décrites comme un sous-type de cellules souches mésenchymateuses, présentant de fortes capacités prolifératives et neurogéniques. En utilisant un premier modèle murin d'amnésie induit par lésion excito-toxique des hippocampes, nous avons montré que des cellules souches olfactives humaines, greffées dans les zones lésées ou dans le liquide céphalo-rachidien, i) s'installent et adoptent un phénotype neuronal, ii) rétablissent la circulation d'informations au sein des réseaux neuronaux défectueux et iii) permettent une récupération des capacités d'apprentissage et de mémorisation. Suite à ces résultats très encourageants, le premier objectif de cette thèse a été de mieux faire connaître ces cellules souches adultes auprès de la communauté scientifique. / The brain displaying poor regenerative capacities, exogenous stem cell-based therapy has been proposed as an attractive strategy to regenerate cerebral tissue after acute injuries or neurodegenerative disorders. However, ethical and technical issues, associated with embryonic, fetal or adult neural stem cells, limit their use in human medicine. In search of alternative candidates, we focused our attention on adult stem cells, located in a peripheral nervous tissue: the nasal stem cells sited in the olfactory lamina propria. These multipotent stem cells have been characterized as a member of the mesenchymal stem cell superfamily, displaying strong proliferative and neurogenic properties. Recently, using a mouse model of amnesia induced by excito-toxic lesions of hippocampal neurons, we demonstrated that olfactory stem cells, grafted in lesioned areas or into the cerebrospinal fluid, i) migrate and differentiate into neuron-like cells, ii) contribute to the restoration of local neuronal networks and iii) promote recovery of learning and memory abilities. In line with these promising results, the first aim of the current thesis was to promote the use of these adult stem cells by the scientific community. For this purpose, we published an article and a book chapter in which we demonstrated that they are suitable for autologous cell therapy in humans. Using an audiovisual document, we showed that these cells i) can be safely obtained in humans, under local anesthesia, without any loss of smell and ii) are easily and quickly amplifiable in vitro.

Les maladies artérielles périphériques athéromateuses sont graves : l'atteinte des troncs supra-aortiques est à risque d'accident vasculaire cérébral et l'atteinte des artères des membres inférieurs est à risque d'amputation et de décès cardiovasculaire. Le développement de stratégies innovantes capables d'optimiser le diagnostic précoce et le traitement de ces maladies est un enjeu considérable.Nous montrons une corrélation entre deux biomarqueurs inflammatoires, les microparticules leucocytaires (MPL) et la lipoprotéine phospholipase A2, et l'instabilité de la plaque carotidienne définie histologiquement, dans une population de patients porteurs d'une sténose carotidienne serrée. Les MPL sont élevées de façon significative et indépendante y compris chez les patients asymptomatiques porteurs d'une sténose carotidienne serrée instable. Ainsi, le taux circulant de MPL aider à sélectionner les meilleurs candidats à une chirurgie carotidienne préventive parmi les patients ayant une sténose carotidienne serrée asymptomatique. Deuxièmement, nous montrons que l'administration ex vivo d'érythropoïétine (EPO) améliore les capacités proangiogéniques des progéniteurs endothéliaux circulants tardifs in vitro et in vivo sur un modèle d'ischémie de patte de souris nude. Ces effets semblent médiés par la sous-unité CD131 du récepteur à l'EPO. Si ces résultats se confirment chez l'homme, l'EPO pourrait être utilisée pour améliorer les capacités de revascularisation des progéniteurs endothéliaux circulants tardifs circulants humains avant réinjection autologue comme produit de thérapie cellulaire chez des patients atteints d'ischémie critique des membres inférieurs. / Atherosclerotic peripheral arterial diseases are frequent and severe. They undertake the functional and vital prognosis of patients: lesions of supra-aortic trunks are at risk of stroke and lesions of lower limb arteries are at risk of amputation and cardiovascular death. The development of innovative strategies that optimize early diagnosis and therapeutic management of these diseases is thus a considerable challenge.In this work, we show a correlation between inflammatory biomarkers, leukocyte microparticles and lipoprotein phospholipase A2, and carotid plaque instability defined histologically, in a population of patients with tight carotid stenosis with or without neurological symptoms. Leukocyte microparticles are elevated significantly and independently including asymptomatic patients with tight unstable carotid stenosis. Thus, the circulating levels of leukocyte microparticles could be a tool in the future to select the best candidates for carotid surgery among patients with asymptomatic carotid stenosis tight.Second, we show that ex vivo administration of erythropoietin improves the proangiogenic capacity of late circulating endothelial progenitor in vitro and in vivo in a mouse model of hindlimb ischemia. These effects appear mediated by CD131 subunit of the receptor for erythropoietin. If these results are confirmed in humans, erythropoietin could be used to improve the revascularization capacity of late circulating endothelial progenitor before reinjection as autologous cell therapy product in patients with critical ischemia of the lower limbs.

Les anévrysmes de l'aorte abdominale (AAAs) sont des dilatations artérielles qui exposent le patient au décès par rupture. Ils sont caractérisés notamment par la perte de la monocouche de cellules endothéliales et son remplacement par un épais thrombus mural. Cependant, le lienentre l'accroissement du diamètre anévrysmal, la présence d'un thrombus et la perte en cellules endothéliales reste inexploré. Notre hypothèse est que la perte de l'endothélium contribue au développement des AAAs et que sa restauration par thérapie cellulaire permettrait de stabiliser les AAAs. In vivo, la réparation endothéliale implique le recrutement des cellules endothéliales adjacentes mais également des cellules progénitrices endothéliales (EPCs). Chez l'homme, le nombre et l’activité fonctionnelle des EPCs sont inversement corrélés aux facteurs de risque cardiovasculaire, et très peu de données sont disponibles sur l’activité fonctionnelle des EPCs issues de patients porteurs d'AAA. La présence du thrombus pourrait ainsi diminuer le nombre et les propriétés cicatricielles des EPCs issues de patients porteurs d'AAA. / Summary not transmitted