Apesar dos avanços sobre a efetiva participação das células T reguladoras (Treg) na resposta imune antitumoral, ainda existem vários pontos que precisam ser esclarecidos. Visto que, os fatores que controlam a migração destas células para o microambiente tumoral ainda não estão totalmente definidos, o esclarecimento dos mecanismos de migração de células Treg no contexto do câncer poderia fornecer novos alvos para o desenvolvimento de terapias mais específicas. Diversos modelos de estudo demonstraram que o recrutamento preferencial de células Treg ao invés de outros tipos de células T pode ser explicado pela expressão diferencial de receptores de quimiocinas como o CCR5. Assim, é de extrema importância estabelecer qual é o papel de CCR5 na migração de células Treg em tumores induzidos quimicamente e seu envolvimento no desenvolvimento tumoral. Baseado no exposto, o presente estudo analisou o envolvimento de CCR5 na migração de células Treg e a sua correlação com o desenvolvimento de carcinoma espinocelular (CEC) induzido quimicamente. Os resultados obtidos demonstraram que camundongos geneticamente deficentes de CCR5 (CCR5KO) apresentaram baixo número de células Treg nas lesões e foram menos suscetíveis ao desenvolvimento de carcinoma espinocelular. Na fase de progressão tumoral verificou-se o desenvolvimento de CEC in situ por animais CCR5KO em combinação com a maior infiltração leucocitária, enquanto camundongos do grupo controle (WTCEC) apresentaram lesões de CEC bem diferenciado associado à elevada frequência de células Treg no microambiente tumoral e menor infiltração leucocitária. Interessantemente, a transferência adotiva de células Treg CCR5+ para animais CCR5KO (CCR5CEC Treg) resultou no acúmulo destas células no microambiente tumoral, elevado nível de CCL4, CCL17 e CCL22, e aumento da suscetibilidade desses animais à carcinogênese química. Verificou-se o desenvolvimento de CEC indiferenciado por animais CCR5CEC Treg e este foi associado à elevada frequência de macrófagos, células mielóides e dendríticas, linfócitos CD19+, T CD4+, T CD8+ e células Treg na fase de progressão tumoral. Outro aspecto relevante de nosso estudo foi à observação de que a transferência adotiva de células T CD4+CD25-CCR5+ para animais CCR5KO (CCR5CEC CD4+) induziu o desenvolvimento de CEC moderadamente diferenciado com características intermediárias as lesões observadas em animais WTCEC e CCR5CEC Treg. A transferência adotiva de células T CD8+CCR5+ para animais CCR5KO (CCR5CEC CD8+) promoveu o aparecimento precoce de papilomas e inibiu a progressão de papilomas para o CEC. A menor suscetibilidade à carcinogênese química de animais CCR5CEC CD8+ foi associada ao alto número de macrófagos, células mielóides, linfócitos B e T CD8+, células NK detectado nas lesões destes animais. Dessa forma, os resultados descritos estabelecem que a quimiotaxia de células Treg para o microambiente tumoral é dependente de CCR5 e estas células regulam aspectos críticos desta doença, sugerindo que o bloqueio da migração de células Treg CCR5+ seria uma importante estratégia imunoterapêutica no combate deste tipo de câncer. / Considering the advances on the effective participation of regulatory T cells (Treg) in the antitumor immune response, there are still several points that need to be clarified. The mechanisms that control the Treg cells migration to the tumor microenvironment are not completely defined, for these reason, establish these mechanisms could provide new targets for the development of more specific therapies. Several study models have demonstrated that preferential recruitment of Treg cells rather than other types of T cells can be explained by the differential expression of chemokine receptors such as CCR5. Thus, the present study examined the involvement of CCR5 in the migration of Treg cells and their correlation with the development of squamous cell carcinoma (SCC) chemically induced. The results showed that CCR5 knockout mice (CCR5KO) showed a low number of Treg cells in the lesions and these animals were less susceptible to the development of squamous cell carcinoma. SCC in situ was developed in CCR5KO mice and associated with high leukocytes infiltration, whereas the development SCC well differentiated in the control group (WTSCC) was associated with a high number of Treg cells and lower leukocyte infiltration in the tumor microenvironment. Interestingly, adoptive transfer of CCR5+Treg cells to CCR5KO mice (CCR5SCC Treg) resulted in the accumulation of these cells, high levels of CCL4, CCL17 and CCL22 in the tumor microenvironment and increased susceptibility to chemical carcinogenesis. CCR5SCCTreg mice developed SCC undifferentiated associated with a higher incidence of macrophages, myeloid and dendritic cells, CD19+, CD4+ T, CD8+ T lymphocytes, and Treg cells in the stage of tumor progression. Another relevant aspect of our study was the observation that adoptive transfer of CD4+CD25-CCR5+ T cells to CCR5KO animals (CCR5SCC CD4+) induced the development of SCC moderately differentiated with intermediate features observed in the WTSCC and CCR5SCC Treg mice. The adoptive transfer of CD8+CCR5+ T cells to CCR5KO mice (CCR5SCC CD8+) promoted the early incidence of papillomas and inhibited the progression to SCC. Reduced susceptibility to skin carcinogenesis in CCR5SCC CD8+ mice was associated with high frequency of macrophages, myeloid cells, B lymphocytes, CD8+ T lymphocyte and NK cells. In this study we showed that the migration of Treg cells to the tumor microenvironment is CCR5 dependent and that it regulates critical aspects of tumor development. The development of drugs that blocks CCR5+ Treg cells migration could be an important immunotherapeutic strategy to control this type of cancer.

Considerando que processos cruciais de diferenciação e maturação das células dendríticas (DCs) são regulados pelo fator de transcrição nuclear kappa B (NF-&#954;B), nos propusemos a estudar esta via em DCs derivadas de monócitos de pacientes com câncer de mama, partindo da hipótese de que alterações desta via contribuam, nesses indivíduos, para a geração de DCs com fenótipo e função alterados, levando ao escape tumoral. A análise da presença de NF-&#954;B no núcleo de monócitos, DCs imaturas (iDCs) e maduras indicou que as pacientes falham em modular tal fator de transcrição, de modo que a quantidade de NF-&#954;B no núcleo de iDCs de pacientes supera os níveis encontrados em controles, fenômeno possivelmente decorrente de alterações nas proteínas inibidoras do NF-&#954;B em pacientes. Observou-se menor frequência de células CD86+, CD83+ e HLA-DR+ (p < 0,05) ao final das culturas das pacientes, e aumento na concentração de IL-8 no sobrenadante das culturas. Coletivamente, estes dados corroboram a hipótese formulada. / Considering that crucial processes of differentiation and maturation of dendritic cells (DCs) are regulated by nuclear factor kappa B (NF-&#954;B), we proposed to study this pathway in monocyte-derived DCs from breast cancer patients, based on the hypothesis that alterations in such pathway may contribute in these individuals to the generation of DCs having phenotypic and functional changes, leading to tumor escape. The analysis of the presence of NF-&#954;B in the nucleus of monocytes, immature and mature DCs indicated that patients fail to modulate this transcription factor, so that the amount of NF-&#954;B in the nucleus of iDCs from patients exceeds levels found in controls, a phenomenon possibly due to alterations in inhibitory proteins of NF-&#954;B in patients. It was also observed diminished frequency of CD86+, CD83+ and HLA-DR+ cells (p <0.05) at the end of the patients cultures, as well as increased IL-8 concentration in the culture supernatants. Collectively, these data support the hypothesis previously formulated.

A Cardiomiopatia Chagásica Crônica (CCC) é uma cardiomiopatia de natureza inflamatória, que ocorre em cerca de 30% dos indivíduos infectados pelo protozoário Trypanosoma cruzi 5-30 anos após infecção. Na doença de Chagas crônica e na CCC, há importante produção de citocinas próinflamatórias do padrão Th1 e quimiocinas, mesmo na ausência de disfunção ventricular. Foi demonstrado que células mononucleares que infiltram o tecido cardíaco de pacientes CCC produzem algumas dessas citocinas inflamatórias. Entretanto, os fatores que determinam a composição do infiltrado inflamatório e contribuem para a migração e acúmulo das células inflamatórias dentro do tecido cardíaco na CCC são ainda desconhecidos. Sabendo-se que a CCC apresenta pior prognóstico que as cardiomiopatias dilatadas de natureza não inflamatória, é possível hipotetizar que diversos mediadores inflamatórios produzidos localmente estejam envolvidos no pior prognóstico. Dentro deste contexto, nosso objetivo no presente trabalho foi avaliar a expressão gênica de citocinas do padrão próinflamatório/Th1, quimiocinas envolvidas na migração de células T de memória e seus receptores e quimiocinas envolvidas na migração diferencial de linfócitos Th1/Th2 e seus receptores em amostras de miocárdio de pacientes com CCC e outras cardiomiopatias. Para isso, utilizamos a técnica de qRT-PCR e imunofluorescência com microscopia confocal para esses mediadores/receptores em amostras de miocárdio (ventrículo esquerdo) de pacientes CCC, portadores de cardiomiopatia não inflamatória (CNI) e doadores saudáveis, obtidos durante o procedimento de transplante. Observamos a expressão gênica aumentada da citocina pró-inflamatória IL-18, das quimiocinas CCL3/MIP-1, CCL4/MIP-1, CCL5/RANTES, CXCL9/Mig, CXCL10/IP-10, CCL17/TARC e CCL19/ELC e dos receptores CXCR3, CCR5 e CCR4 em amostras de miocárdio de pacientes com CCC quando comparadas com amostras de miocárdio de pacientes com CNI ou tecido cardíaco controle. Entretanto, observamos a expressão diminuída ou ausente de genes como TGF-, Foxp3, IL-4 e IL-13 , sugerindo a ausência de células T regulatórias ou células Th2 funcionais. Adicionalmente, a presença de células mononucleares CXCR3+, CCR5+ e CCR4+ foi observada em amostras de miocárdio de pacientes com CCC utilizando imunofluorescência confocal. As quimiocinas CCL5/RANTES e CXCL9/Mig foram detectadas em células mononucleares do infiltrado inflamatório de tecido cardíaco de pacientes com CCC. A expressão diferencial dos genes aqui estudados permitiu obter um quadro panorâmico dos mediadores inflamatórios produzidos no miocárdio de pacientes com CCC. A expressão gênica aumentada de IL-18 e de quimiocinas e seus receptores no miocárdio de pacientes com CCC contribuem para a migração e acúmulo de células de CCR5+, CXCR3+ de perfil Th1 e as correlações observadas entre esses mediadores e receptores sugerem um feedback positivo atuando na manutenção e amplificação do processo inflamatório, possivelmente em associação com outros mediadores expressos no miocárdio. A resposta inflamatória intensa e predominantemente Th1 com a expressão aumentada de diversos mediadores inflamatórios no miocárdio de pacientes com CCC pode ocorrer pela ausência de células T regulatórias Foxp3+ ou TGF-+, e a expressão de alguns mediadores como IL-18 e CCL21/SLC pode estar associada ao desenvolvimento de hipertrofia e fibrose, sugerindo um papel fisiopatológico adicional para a expressão desses mediadores no grupo de pacientes com CCC. / Chronic Chagas disease Cardiomyopathy (CCC) is an inflammatory cardiomyopathy that affects around 30% of individuals infected by the protozoan Trypanosoma cruzi and happens 5-30 years after the infection. In Chronic Chagas disease and CCC, there is a significant production of proinflammatory Th1 cytokines and chemokines even in the absence of ventricular dysfunction. Mononuclear cells inflitrating the heart tissue of CCC patients produce some of these inflammatory cytokines. However, the factors that determine the composition of the inflammatory infiltrate and contribute to the migration, accumulation and distribution of inflammatory cells inside heart tissue in the CCC are still unknown. Considering that CCC has worse prognosis than dilated cardiomyopathy of non-inflammatory etiology, we hypothesized that the production of several inflammatory mediators in situ could be involved in the worse prognosis of CCC. Taking this into consideration, our aim in the present study was to analyze the gene expression of pro-inflammatory/Th1 cytokines, chemokines involved in cell T memory migration and its receptors and chemokines involved in Th1/Th2 lymphocyte migration and its receptors. qRT-PCR and immunofluorescence with confocal microscopy were employed to detect the expression these mediators/receptors in left ventricular free wall samples from end-stage CCC patients, patients with non-inflammatory cardiomyopathy (NIC) and healthy donors, obtained upon transplantation. We observed a significant increase in the expression of pro-inflammatory cytokine IL-18, chemokines CCL3/MIP- 1, CCL4/MIP-1, CCL5/RANTES, CXCL9/Mig, CXCL10/IP-10, CCL17/TARC and CCL19/ELC and its receptors CXCR3, CCR5 and CCR4 in the samples of CCC patients compared to NIC patients and control heart samples. On the other hand, we observed absence of expression or downregulation or of TGF-, Foxp3, IL-4 and IL-13, suggesting the absence of regulatory T cells and functional Th2 cells. In addition, the presence of mononuclear CXCR3+, CCR5+ and CCR4+ cells was observed in myocardium of CCC patients using immunofluorescence with confocal microscopy. The chemokines CCL5/RANTES and CXCL9/Mig were detected in mononuclear cells of inflammatory infiltrates of heart tissue CCC patientes. The differential gene expression observed in this study allowed us to elaborate a global profile of inflammatory mediator production in the myocardium CCC patients. The up-regulated gene expression of IL-18 and chemokines and its receptors in the myocardium CCC patients contribute to the migration and accumulation of CCR5+, CXCR3+ Th1 cells and the correlation observed between these mediators and their receptors suggest a positive feedback contributing to the maintenance and amplification of inflammatory process, possibly in association with another mediators expressed in the myocardium. The intense Th1 inflammatory response with the up-regulated expression of various inflammatory mediators in the myocardium of CCC patients could be enhanced by the absence of Foxp3+ or TGF-+, regulatory T cells and the expression of mediators as IL-18 and CCL21/SLC could play a role in the development of hypertrophy and fibrosis suggesting an additional pathophysiologic role of expression of these mediators in CCC patients.

Introdução: A endometriose, condição inflamatória prevalente, associa-se a alterações da reposta imune na cavidade peritoneal e no útero. Evidências sugerem participação de mediadores inflamatórios, como as células Natural Killer e T-reguladoras na patogênese desta doença. A resposta destas células pode ser controlada pela atividade de algumas quimiocinas. O objetivo deste estudo foi avaliar a expressão gênica das quimiocinas reguladoras das células Natural Killer e T-reguladoras em endométrio tópico em lesões endometrióticas de pacientes com endometriose. Pacientes e Métodos: A expressão gênica das quimiocinas reguladoras da atividade das células Natural Killer (CXCL9, 10, 11, CXCL12, XCL1 e CX3CL1) e T reguladoras (CCL17 e CCL21) foi avaliada por meio de RTPCR no endométrio tópico e lesão endometriótica de 22 pacientes com endometriose de retossigmóide; 10 pacientes com endometriose retrocervical e no endométrio tópico de 32 mulheres sem endometriose comprovada por laparoscopia para laqueadura tubária. Resultados: Dentre as quimiocinas relacionadas às células Natural Killer, encontramos diferença estatística significativa na CX3CL1 e CXCL12, as quais foram mais expressas no foco de endometriose intestinal e retrocervical, quando comparadas ao endométrio tópico das pacientes e controles (p < 0,05). Das relacionadas às células T-reguladoras, a CCL17 foi mais expressa no endométrio tópico de pacientes com lesão em retossigmóide quando comparada aos demais grupos (p < 0,05). Conclusões: As quimiocinas CX3CL1 e CXCL12 foram mais expressas nos focos de endometriose intestinal e a CCL17 foi mais expressa no endométrio tópico de pacientes com lesão de retossigmóide. Estes resultados sugerem que as quimiocinas CX3CL1, CXCL12 e CXCL17 participam da resposta inflamatória que ocorre na endometriose pélvica / Objective: Endometriosis is a highly prevalent inflammatory condition associated with an altered immune response in the peritoneal cavity and uterus. Evidence suggests a participation of inflammatory mediators such as natural killer (NK) and T-regulatory (T-reg) cells in the pathogenesis of this disease while the response of these cells may be controlled by the activity of some chemokines. Patients and Methods: Gene expressions of the chemokines that regulate the activity of NK (CXCL9, CXCL10, CXCL11, CXCL12, XCL1 and CX3CL1) and T-reg cells (CCL17 and CCL21) were evaluated using real time polymerase chain reaction (PCR) in the eutopic and ectopic endometrium of 22 patients with bowel endometriosis, 10 patients with retrocervical endometriosis and 32 controls. Results: Of the chemokines associated with NK cells, the expression of CX3CL1 and CXCL12 was significantly greater in the foci of endometriosis (p < 0.05). Of those associated with T-reg cells, significant differences between groups were found in CCL17. In addition, CCL17 was expressed to a higher degree in the eutopic endometrium of the patients with rectosigmoid lesions when compared to the other groups (p < 0.05). Conclusions: Chemokines CX3CL1 and CXCL12 were more expressed in intestinal endometriosis and CCL17 expression was higher in eutopic endometrium of the patients with rectosigmoid lesions. These results suggest that those chemokines participate in the inflammatory response that occurs in pelvic endometriosis

Une fois activées, les cellules dendritiques (DCs) migrent dans les organes lymphoïdes ou elles exercent leur rôle de cellules présentatrices d’antigène professionnelles. Elles sont capables d’activer et d’induire la différenciation des lymphocytes T naïfs en différentes sous-populations de lymphocytes T auxiliaires. L’ajustement de la réponse lymphocytaire T au type d’inflammation est assuré par les DCs à deux niveaux. Premièrement, grâce à leur plasticité, les DCs adaptent leur comportement en fonction de la combinaison de signaux issus du microenvironnement inflammatoire. Deuxièmement, il existe différentes sous-populations de cellules dendritiques ayant de différentes spécialisations fonctionnelles.Mon travail de thèse s’est concentré sur l’étude de la diversité des réponses des sous-populations de cellules dendritiques humaines suite à la stimulation par la cytokine lymphopoïetine stromale thymique (TSLP). Cette cytokine est secrétée par les cellules épithéliales et la peau au cours de l’inflammation. La TSLP active principalement les DCs myéloïdes, induisant celles-ci à secréter les chimiokines inflammatoires CCL17 et CCL22. Les DCs activées par la TSLP (TSLP-DCs) induisent une réponse inflammatoire de type Th2, et sont impliquées dans le développement de l’allergie. La comparaison systématique de la réponse à la TSLP par les sous-populations de DCs du sang, BDCA1+ et BDCA3+, nous a permis de montrer que ces deux sous-populations sont activées par la TSLP. Toutefois, nos résultats montrent que la TSLP, en synergie avec le TGF-β, induit la différenciation des DCs BDCA-1+ en cellules de Langerhans, mais pas celle des DCs BDCA-3+. De plus, la TSLP induit la migration cellulaire et la sécrétion de chimiokines seulement chez la sous-population de DCs BDCA-1+. Des analyses complémentaires des mécanismes impliqués dans la migration des DCs BDCA-1+ en réponse à la TSLP révèlent que, d’une part la TSLP est indispensable à l’induction de la migration et d’autre part, qu’un récepteur de chimiokines, sensible à la Toxine Pertussique serait impliqué. Au final, nos résultats révèlent (i) de nouvelles capacités des DCs en tant que cellules précurseurs, (ii) de différentes propriétés fonctionnelles des sous-populations de DCs en réponse à la stimulation par la TSLP, (iii) et démontrent la complexité des mécanismes impliqués dans la migration des DCs induite par la TSLP. / Once activated, Dendritic Cells (DCs) migrate to the lymphoid organs and exert their role as professional antigen presenting cells. They are able to induce the activation and differentiation of naïve T cells into different types of T helper cells. The T cell response must be suited to the type of inflammation. This is ensured by DCs at two levels. First DCs are functionally plastic. This means that their behavior is subdued to the integrated signals coming from the inflammatory microenvironment. Secondly, the DC population is diverse. Indeed, different DC subsets have different functional specializations. My thesis was focused on the differential response of human DC subsets to Thymic stromal lymphopoietin (TSLP). This cytokine is secreted by inflamed skin and epithelia, and strongly activates myeloid DCs. The TSLP-activated DCs secrete the inflammatory chemokines CCL17 and CCL22, prime an inflammatory Th2 response, and have been involved in the pathogenesis of allergic inflammation. By systematically comparing the response of human blood BDCA-1+ and BDCA-3+ DCs to TSLP stimulation we found that both of these DC subsets get activated by TSLP. However TSLP synergizes with TGF-β to induce the differentiation of blood BDCA-1+ and not BDCA-3+ DCs into Langerhans Cells. Moreover, TSLP induces cell migration and chemokine secretion only on the blood BDCA-1+ subset. Further analysis of the mechanisms implicated in TSLP-induced DC migration revealed that TSLP is required to induce DC migration, but this effect is dependent on the expression of a PTX-sensitive chemokine receptor. Overall our results reveal new precursor capacities of blood DC subsets, different functional properties of blood DC subsets stimulated by TSLP and highlight intricate mechanisms underlying TSLP-induced DC migration.

Chemokines are chemotactic cytokines which play an important role in the migration of immune cells to distant tissues or compartments within tissues. These proteins have also been demonstrated to play a major role in cancer metastasis. The C-C chemokine receptor type 7 (CCR7) is a member of the chemokine receptor family. CCR7 along with its ligands CCL19 and CCL21 plays an important role in innate immune response by trafficking of lymphocytes. In cancer, tumour cells expressing CCR7 migrate to lymphoid organs and thus disseminate to other organs. Neutralizing the interactions between CCL21/CCR7 would therefore be expected to inhibit the progression and metastasis of many different types of cancer to regional lymph nodes or distant organs. Our objective was to identify a potent small molecule antagonist of CCR7 as a prelude to the investigation of the role of this axis in cancer metastasis. In this study, we provided a brief description of chemokines and their role in health and disease with an emphasis on the CCR7/CCL19/CCL21 axis, as well as identification of a CCR7 antagonist “hit”. The potency of the CCR7 antagonist “hit” was optimised by synthesizing different CCR7 antagonist analogues. The “hit” optimization process has led to discover the most active compound amongst a series of different analogues which have the ability to bind and block CCR7 receptor. The efficacy of the most active compound and other analogues were evaluated in vitro using a calcium flux assay which is based on detecting fluorescent light emitted upon release of calcium ions. To identify a suitable cell line, which expresses CCR7 and capably respond to it, amongst a panel of cell lines for in vitro assessment of potency of synthesised compounds, we used Western blot assay and later by flow cytometry assay. The activity and selectivity of the most effective compound against CCR7 receptor was evaluated in vitro by other functional assays such as “configured agarose spot assay” and scratch assay. We first configured the existing under agarose assay to fulfil our requirements and then used it to assess activity and selectivity of compounds. The configured agarose spot assay also describes the application of the agarose spot for evaluation of cells chemotactic response to multiple chemokines under identical experiment conditions.

INTRODUÇÃO: A endometriose é uma doença crônica de natureza benigna e de alta prevalência, definida pela presença de tecido endometrial fora da cavidade uterina. Dentre os principais sintomas, destacam-se a dor pélvica crônica, dismenorreia e infertilidade. Clinicamente, apresenta-se de três formas distintas: endometriose peritoneal ou superficial, endometriose ovariana - endometrioma - e endometriose profunda (EP). A EP apresenta um padrão de comportamento semelhante ao das doenças malignas, com capacidade de crescimento infiltrativo e destrutivo em diferentes sítios. Lesões endometrióticas já foram identificadas em linfonodos pélvicos, evidenciando a disseminação linfática das células endometrióticas. Em neoplasias malignas, as quimiocinas e seus receptores desempenham papel soberano no processo de metástase e na disseminação linfática das células tumorais. OBJETIVOS: 1) avaliar a expressão das quimiocinas que no câncer estão relacionadas ao processo de metástase - CXCL12-CXCR4, CCL19/CCL21-CCR7 - na EP do compartimento posterior da pelve e nos respectivos linfonodos-sentinela (LS); 2) avaliar a concentração dessas quimiocinas no líquido peritoneal (LP) de pacientes com e sem endometriose; 3) avaliar a expressão da proteína BAF250a, relacionada à transformação maligna, na endometriose, com ênfase na EP do compartimento posterior da pelve. MÉTODOS: 123 pacientes foram incluídas neste estudo. Nós realizamos a coloração imuno-histoquímica para avaliar a expressão das quimiocinas - ligantes e receptores - nas lesões de EP retovaginal/do compartimento posterior da pelve (n=27), nos respectivos LS (n=27) e no endométrio de pacientes-controle sem endometriose (n=20); a concentração das quimiocinas no LP foi avaliada por meio da tecnologia multiplex - Luminex® xMAP® Technology - em um subgrupo de pacientes com (n=36) e sem (n=27) endometriose; a possibilidade de transformação maligna também foi avaliada por meio da imuno-histoquímica para analisar a expressão da proteína BAF250a dentre as lesões de endometriose - EP retovaginal (n=30), lesões de endometriose nos LS (n=7), endometriose ovariana (n=20), sarcoma do estroma endometrial extragenital (SEEE) de intestino (n=2) e no endométrio de pacientes sem endometriose (n=20). RESULTADOS: o padrão de coloração IHQ das quimiocinas relacionadas à metástase no câncer foi caracterizado pela primeira vez na EP do compartimento posterior da pelve e nas lesões de endometriose acometendo os LS; a expressão de CXCR4 foi diretamente relacionada ao tamanho da lesão de EP; CCL19, CCL2 e CXCL8 apresentaram concentrações no LP estatisticamente maiores em mulheres com endometriose comparadas aos controles sem doença e a associação delas aumentou a probabilidade de identificar pacientes com endometriose; além disso, nós identificamos a perda clonal da expressão da BAF250a em 36% (9/25) dos casos de EP, 40% (2/5) das lesões de endometriose nos LS, 30% (6/20) dos endometriomas e em 25% (5/20) no endométrio tópico das pacientes-controle. CONCLUSÕES: quimiocinas parecem estar envolvidas no mecanismo de disseminação da endometriose e algumas mostraram potencial para serem utilizadas como marcadores da doença; a perda clonal da expressão da proteína BAF250a na EP possa talvez representar um marcador de risco para transformação maligna nessas lesões. O valor desses achados precisa ser ainda esclarecido em futuras análises / INTRODUCTION: Endometriosis is a chronic disease of benign nature and of high prevalence, defined by the presence of endometrial tissue outside the uterine cavity. Among the main symptoms are highlighted chronic pelvic pain, dysmenorrhea and infertility; clinically, it may appear in three distinct ways: peritoneal endometriosis, ovarian endometriosis - endometriomas - and deep infiltrating endometriosis (DIE). DIE presents a behavioral pattern in many ways similar to that of malignancies, as capacity of infiltrative and destructive growth in different sites. Endometriotic lesions have already been identified in pelvic lymph nodes, showing the possibility of lymphatic dissemination of endometriotic cells. In malignancies, chemokines play a sovereign role in the process of metastasis and lymphatic spread of tumor cells. OBJECTIVES: 1) to evaluate the expression of cancer-related chemokines - CXCL12-CXCR4, CCL19/CCL21-CCR7 - in rectovaginal DIE (or endometriosis of the posterior compartment of the pelvis) and the respective pelvic sentinel lymph node (PSLN); 2) to evaluate the concentration levels of those chemokines in the peritoneal fluid (PF) of patients with and without endometriosis; 3) to evaluate the expression of protein BAF250a, related to malignant transformation, in endometriosis, with emphasis in rectovaginal DIE. METHODS: 123 patients were enrolled in this study. We performed immunohistochemical staining to assess the expression of all chemokines - ligands and receptors - in rectovaginal DIE (n=27), PSLN (n=27) and eutopic endometrium (EE) from patients without endometriosis as controls (n=20); chemokine concentration in the PF was assessed with multiplexing technology - Luminex® x-MAP® Technology - in a subgroup of patients with (n=36) and without (n=27) endometriosis; the possibility of malignant transformation was also assessed by means of immunohistochemistry to evaluate the expression of BAF250a protein among endometriosis lesions - rectovaginal DIE (n=30), compromised PSLN (n=7), ovarian endometriosis (n=20), extragenital endometrial stromal sarcoma (EESS) affecting the bowel (n=2) and EE from controls without the disease (n=20). RESULTS: the staining pattern of cancer metastasis-related chemokines was characterized for the first time in rectovaginal DIE and lesions compromising the PSLN; CXCR4 expression was directly correlated with the size of the DIE lesions; CCL19, CCL2 and CXCL8 presented higher statistically significant PF concentrations in women with endometriosis compared with controls and their association improved the likelihood of identifying patients with endometriosis; furthermore, we identified the clonal loss of BAF250a expression in 36% (9/25) of DIE, 40% (2/5) of endometriotic lesions in the PSLN, 30% (6/20) of endometriomas and in 25% (5/20) of EE from controls. CONCLUSIONS: chemokines might be involved in the mechanism of dissemination of endometriosis and some have shown potential to be used as markers of the disease; clonal loss of protein BAF250a in DIE might represent a marker for malignant transformation in these lesions. The value of these findings needs to be clarified in further analysis

Apesar dos avanços sobre a efetiva participação das células T reguladoras (Treg) na resposta imune antitumoral, ainda existem vários pontos que precisam ser esclarecidos. Visto que, os fatores que controlam a migração destas células para o microambiente tumoral ainda não estão totalmente definidos, o esclarecimento dos mecanismos de migração de células Treg no contexto do câncer poderia fornecer novos alvos para o desenvolvimento de terapias mais específicas. Diversos modelos de estudo demonstraram que o recrutamento preferencial de células Treg ao invés de outros tipos de células T pode ser explicado pela expressão diferencial de receptores de quimiocinas como o CCR5. Assim, é de extrema importância estabelecer qual é o papel de CCR5 na migração de células Treg em tumores induzidos quimicamente e seu envolvimento no desenvolvimento tumoral. Baseado no exposto, o presente estudo analisou o envolvimento de CCR5 na migração de células Treg e a sua correlação com o desenvolvimento de carcinoma espinocelular (CEC) induzido quimicamente. Os resultados obtidos demonstraram que camundongos geneticamente deficentes de CCR5 (CCR5KO) apresentaram baixo número de células Treg nas lesões e foram menos suscetíveis ao desenvolvimento de carcinoma espinocelular. Na fase de progressão tumoral verificou-se o desenvolvimento de CEC in situ por animais CCR5KO em combinação com a maior infiltração leucocitária, enquanto camundongos do grupo controle (WTCEC) apresentaram lesões de CEC bem diferenciado associado à elevada frequência de células Treg no microambiente tumoral e menor infiltração leucocitária. Interessantemente, a transferência adotiva de células Treg CCR5+ para animais CCR5KO (CCR5CEC Treg) resultou no acúmulo destas células no microambiente tumoral, elevado nível de CCL4, CCL17 e CCL22, e aumento da suscetibilidade desses animais à carcinogênese química. Verificou-se o desenvolvimento de CEC indiferenciado por animais CCR5CEC Treg e este foi associado à elevada frequência de macrófagos, células mielóides e dendríticas, linfócitos CD19+, T CD4+, T CD8+ e células Treg na fase de progressão tumoral. Outro aspecto relevante de nosso estudo foi à observação de que a transferência adotiva de células T CD4+CD25-CCR5+ para animais CCR5KO (CCR5CEC CD4+) induziu o desenvolvimento de CEC moderadamente diferenciado com características intermediárias as lesões observadas em animais WTCEC e CCR5CEC Treg. A transferência adotiva de células T CD8+CCR5+ para animais CCR5KO (CCR5CEC CD8+) promoveu o aparecimento precoce de papilomas e inibiu a progressão de papilomas para o CEC. A menor suscetibilidade à carcinogênese química de animais CCR5CEC CD8+ foi associada ao alto número de macrófagos, células mielóides, linfócitos B e T CD8+, células NK detectado nas lesões destes animais. Dessa forma, os resultados descritos estabelecem que a quimiotaxia de células Treg para o microambiente tumoral é dependente de CCR5 e estas células regulam aspectos críticos desta doença, sugerindo que o bloqueio da migração de células Treg CCR5+ seria uma importante estratégia imunoterapêutica no combate deste tipo de câncer. / Considering the advances on the effective participation of regulatory T cells (Treg) in the antitumor immune response, there are still several points that need to be clarified. The mechanisms that control the Treg cells migration to the tumor microenvironment are not completely defined, for these reason, establish these mechanisms could provide new targets for the development of more specific therapies. Several study models have demonstrated that preferential recruitment of Treg cells rather than other types of T cells can be explained by the differential expression of chemokine receptors such as CCR5. Thus, the present study examined the involvement of CCR5 in the migration of Treg cells and their correlation with the development of squamous cell carcinoma (SCC) chemically induced. The results showed that CCR5 knockout mice (CCR5KO) showed a low number of Treg cells in the lesions and these animals were less susceptible to the development of squamous cell carcinoma. SCC in situ was developed in CCR5KO mice and associated with high leukocytes infiltration, whereas the development SCC well differentiated in the control group (WTSCC) was associated with a high number of Treg cells and lower leukocyte infiltration in the tumor microenvironment. Interestingly, adoptive transfer of CCR5+Treg cells to CCR5KO mice (CCR5SCC Treg) resulted in the accumulation of these cells, high levels of CCL4, CCL17 and CCL22 in the tumor microenvironment and increased susceptibility to chemical carcinogenesis. CCR5SCCTreg mice developed SCC undifferentiated associated with a higher incidence of macrophages, myeloid and dendritic cells, CD19+, CD4+ T, CD8+ T lymphocytes, and Treg cells in the stage of tumor progression. Another relevant aspect of our study was the observation that adoptive transfer of CD4+CD25-CCR5+ T cells to CCR5KO animals (CCR5SCC CD4+) induced the development of SCC moderately differentiated with intermediate features observed in the WTSCC and CCR5SCC Treg mice. The adoptive transfer of CD8+CCR5+ T cells to CCR5KO mice (CCR5SCC CD8+) promoted the early incidence of papillomas and inhibited the progression to SCC. Reduced susceptibility to skin carcinogenesis in CCR5SCC CD8+ mice was associated with high frequency of macrophages, myeloid cells, B lymphocytes, CD8+ T lymphocyte and NK cells. In this study we showed that the migration of Treg cells to the tumor microenvironment is CCR5 dependent and that it regulates critical aspects of tumor development. The development of drugs that blocks CCR5+ Treg cells migration could be an important immunotherapeutic strategy to control this type of cancer.

INTRODUÇÃO: A endometriose é uma doença crônica de natureza benigna e de alta prevalência, definida pela presença de tecido endometrial fora da cavidade uterina. Dentre os principais sintomas, destacam-se a dor pélvica crônica, dismenorreia e infertilidade. Clinicamente, apresenta-se de três formas distintas: endometriose peritoneal ou superficial, endometriose ovariana - endometrioma - e endometriose profunda (EP). A EP apresenta um padrão de comportamento semelhante ao das doenças malignas, com capacidade de crescimento infiltrativo e destrutivo em diferentes sítios. Lesões endometrióticas já foram identificadas em linfonodos pélvicos, evidenciando a disseminação linfática das células endometrióticas. Em neoplasias malignas, as quimiocinas e seus receptores desempenham papel soberano no processo de metástase e na disseminação linfática das células tumorais. OBJETIVOS: 1) avaliar a expressão das quimiocinas que no câncer estão relacionadas ao processo de metástase - CXCL12-CXCR4, CCL19/CCL21-CCR7 - na EP do compartimento posterior da pelve e nos respectivos linfonodos-sentinela (LS); 2) avaliar a concentração dessas quimiocinas no líquido peritoneal (LP) de pacientes com e sem endometriose; 3) avaliar a expressão da proteína BAF250a, relacionada à transformação maligna, na endometriose, com ênfase na EP do compartimento posterior da pelve. MÉTODOS: 123 pacientes foram incluídas neste estudo. Nós realizamos a coloração imuno-histoquímica para avaliar a expressão das quimiocinas - ligantes e receptores - nas lesões de EP retovaginal/do compartimento posterior da pelve (n=27), nos respectivos LS (n=27) e no endométrio de pacientes-controle sem endometriose (n=20); a concentração das quimiocinas no LP foi avaliada por meio da tecnologia multiplex - Luminex® xMAP® Technology - em um subgrupo de pacientes com (n=36) e sem (n=27) endometriose; a possibilidade de transformação maligna também foi avaliada por meio da imuno-histoquímica para analisar a expressão da proteína BAF250a dentre as lesões de endometriose - EP retovaginal (n=30), lesões de endometriose nos LS (n=7), endometriose ovariana (n=20), sarcoma do estroma endometrial extragenital (SEEE) de intestino (n=2) e no endométrio de pacientes sem endometriose (n=20). RESULTADOS: o padrão de coloração IHQ das quimiocinas relacionadas à metástase no câncer foi caracterizado pela primeira vez na EP do compartimento posterior da pelve e nas lesões de endometriose acometendo os LS; a expressão de CXCR4 foi diretamente relacionada ao tamanho da lesão de EP; CCL19, CCL2 e CXCL8 apresentaram concentrações no LP estatisticamente maiores em mulheres com endometriose comparadas aos controles sem doença e a associação delas aumentou a probabilidade de identificar pacientes com endometriose; além disso, nós identificamos a perda clonal da expressão da BAF250a em 36% (9/25) dos casos de EP, 40% (2/5) das lesões de endometriose nos LS, 30% (6/20) dos endometriomas e em 25% (5/20) no endométrio tópico das pacientes-controle. CONCLUSÕES: quimiocinas parecem estar envolvidas no mecanismo de disseminação da endometriose e algumas mostraram potencial para serem utilizadas como marcadores da doença; a perda clonal da expressão da proteína BAF250a na EP possa talvez representar um marcador de risco para transformação maligna nessas lesões. O valor desses achados precisa ser ainda esclarecido em futuras análises / INTRODUCTION: Endometriosis is a chronic disease of benign nature and of high prevalence, defined by the presence of endometrial tissue outside the uterine cavity. Among the main symptoms are highlighted chronic pelvic pain, dysmenorrhea and infertility; clinically, it may appear in three distinct ways: peritoneal endometriosis, ovarian endometriosis - endometriomas - and deep infiltrating endometriosis (DIE). DIE presents a behavioral pattern in many ways similar to that of malignancies, as capacity of infiltrative and destructive growth in different sites. Endometriotic lesions have already been identified in pelvic lymph nodes, showing the possibility of lymphatic dissemination of endometriotic cells. In malignancies, chemokines play a sovereign role in the process of metastasis and lymphatic spread of tumor cells. OBJECTIVES: 1) to evaluate the expression of cancer-related chemokines - CXCL12-CXCR4, CCL19/CCL21-CCR7 - in rectovaginal DIE (or endometriosis of the posterior compartment of the pelvis) and the respective pelvic sentinel lymph node (PSLN); 2) to evaluate the concentration levels of those chemokines in the peritoneal fluid (PF) of patients with and without endometriosis; 3) to evaluate the expression of protein BAF250a, related to malignant transformation, in endometriosis, with emphasis in rectovaginal DIE. METHODS: 123 patients were enrolled in this study. We performed immunohistochemical staining to assess the expression of all chemokines - ligands and receptors - in rectovaginal DIE (n=27), PSLN (n=27) and eutopic endometrium (EE) from patients without endometriosis as controls (n=20); chemokine concentration in the PF was assessed with multiplexing technology - Luminex® x-MAP® Technology - in a subgroup of patients with (n=36) and without (n=27) endometriosis; the possibility of malignant transformation was also assessed by means of immunohistochemistry to evaluate the expression of BAF250a protein among endometriosis lesions - rectovaginal DIE (n=30), compromised PSLN (n=7), ovarian endometriosis (n=20), extragenital endometrial stromal sarcoma (EESS) affecting the bowel (n=2) and EE from controls without the disease (n=20). RESULTS: the staining pattern of cancer metastasis-related chemokines was characterized for the first time in rectovaginal DIE and lesions compromising the PSLN; CXCR4 expression was directly correlated with the size of the DIE lesions; CCL19, CCL2 and CXCL8 presented higher statistically significant PF concentrations in women with endometriosis compared with controls and their association improved the likelihood of identifying patients with endometriosis; furthermore, we identified the clonal loss of BAF250a expression in 36% (9/25) of DIE, 40% (2/5) of endometriotic lesions in the PSLN, 30% (6/20) of endometriomas and in 25% (5/20) of EE from controls. CONCLUSIONS: chemokines might be involved in the mechanism of dissemination of endometriosis and some have shown potential to be used as markers of the disease; clonal loss of protein BAF250a in DIE might represent a marker for malignant transformation in these lesions. The value of these findings needs to be clarified in further analysis

<p>The process of β-cell destruction that leads to type 1 diabetes (T1D) is incompletely understood and it is believed to be a result of both genetic and environmental factors. Enterovirus (EV) infections of the β-cells have been proposed to be involved, however, the effects of EV infections on human β-cells have been little investigated. This thesis summarises studies of three different Coxsackie B4 virus strains that have previously been shown to infect human islets. The effects of infections with these EV were studied <i>in vitro</i> in human islets and in a rat insulin-producing cell line. In addition, a pilot study was performed on isolated human islets to investigate the ability to treat such infections with an antiviral compound.</p><p>It was found that one of the virus strains replicated in human β-cells without affecting their main function for at least seven days, which <i>in vivo</i> may increase a virus’s ability to persist in islets.</p><p>Nitric oxide was induced by synthetic dsRNA, poly(IC), but not by viral dsRNA in rat insulinoma cells in the presence of IFN-γ, suggesting that this mediator is not induced by EV infection in β-cells and that poly(IC) does not mimic an EV infection in this respect.</p><p>All three virus strains were able to induce production of the T-cell chemoattractant interferon-γ-inducible protein 10 (IP-10) during infection of human islets, suggesting that an EV infection of the islets might trigger insulitis <i>in vivo</i>.</p><p>Antiviral treatment was feasible in human islets, but one strain was resistant to the antiviral compound used in this study.</p><p>To conclude, a potential mechanism is suggested for the involvement of EV infections in T1D. If EV infections induce IP-10 production in human islet cells <i>in vivo</i>, they might recruit immune cells to the islets. Together with viral persistence and/or virus-induced β-cell damage, this might trigger further immune-mediated β-cell destruction <i>in vivo</i>.</p>