A ulceração aftosa recorrente (UAR) é considerada a doença ulcerativa mais frequente da cavidade bucal. Sua etiopatogenia ainda não está plenamente esclarecida, embora inúmeros fatores locais e sistêmicos já tenham sido a ela associados. Recentemente, a resposta imune anormal do tipo celular tem sido considerada a responsável pela lesão bucal na UAR, favorecendo uma resposta imunológica pró-inflamatória do tipo Th1, em conjunto com alterações em linfócitos T regulatórios. Sendo assim, o objetivo do presente estudo foi realizar análise da expressão gênica da FOXP3, MIP-3? e Interleucinas 2, 10 e 35 em pacientes com ulceração aftosa recorrente, por meio de estudo caso-controle. Os pacientes do grupo caso apresentavam quadros frequentes de UAR com pelo menos um ano de manifestação de surtos ulcerativos e história negativa de condições sistêmicas ou locais interferentes com a expressão das UAR. Estes foram submetidos a biópsia de lesão ulcerativa recente para a análise molecular. Os pacientes do grupo controle apresentavam história negativa de UAR, mucosa clinicamente saudável, e doaram voluntariamente fragmento de mucosa saudável para análise molecular, quando submetidos a procedimentos cirúrgicos como exodontia de terceiros molares ou biópsias ósseas. Todos os pacientes foram incluídos no grupo de pesquisa apenas após anuência com termo de consentimento livre e esclarecido. Submeteram-se a exame clínico, realizaram exames complementares para controle da saúde geral e suporte diagnóstico. Onze pacientes UAR e três controles voluntários compuseram a casuística estudada, sendo submetidos a biópsia de lesões de UAR ou de mucosa de revestimento sadia. As amostras de tecido bucal foram submetidas aos procedimentos laboratoriais de extração do RNA e análise da expressão gênica da FOXP3, MIP-3? e Interleucinas 2, 10 e 35 por meio da técnica de RT-PCR em tempo real. Não houve diferença significativa na expressão dos genes estudados entre as amostras de portadores de UAR e controles sadios. Concluímos que os genes aqui avaliados não parecem desempenhar papel distintivo na fase ulcerativa inicial das UAR, entretanto estudos adicionais são recomendados a fim de se verificar a real participação desses agentes da inflamação na expressão da doença. / Recurrent aphthous ulcers (RAU) is the most common ulcerative disease of the oral cavity. Its pathogenesis is poorly understood yet, although numerous local and systemic factors have been associated with it. Recently, abnormal immune response of cellular type has been considered responsible for the RAU oral lesions, promoting a pro-inflammatory immune response Th1-type, in conjunction with changes in regulatory T cells. Thus, the aim of this study was to analyze the gene expression of FOXP3, MIP-3? and interleukins 2, 10 and 35 in patients with recurrent aphthous ulceration through a case-control study. The case group of patients presented frequent RAU bouts with at least one year of manifestation of ulcerative outbreaks and negative history of local or systemic conditions interfering with the RAU expression. These patients were submitted to a biopsy procedure of a recent ulcerative lesion for molecular analysis. Patients in the control group presented no history of RAU, and agreed with a donation of a healthy mucosa fragment for molecular analysis when undergoing surgical procedures such as extraction of third molars or bone biopsies. All patients were included in the research group only after agreement with an informed consent. All subjects underwent clinical examination and were submitted to additional lab tests to check overall health and support diagnosis. Eleven RAU patients and three control volunteers composed the sample size and undergone biopsy of RAU lesions or healthy mucosal lining. The oral tissue samples were submitted to the laboratory procedures of RNA extraction and analysis of gene expression of FOXP3, MIP-3? and interleukins 2, 10, 35 by real time RT-PCR. There was no significant difference in gene expression between the studied samples of patients with RAU and healthy controls. It was concluded that the genes evaluated do not seem to play distinctive role in the initial ulcerative phase of RAU, however further studies are recommended in order to verify the actual participation of these inflammation agents in RAU expression.

Quatro décadas de pesquisas mostraram que muitos mecanismos inflamatórios estão intrinsecamente ligados ao desenvolvimento e manutenção do câncer, e ainda, que as citocinas inflamatórias exercem papel primordial nessa relação. Os anti-inflamatórios não esteroides (AINEs) podem reduzir o desenvolvimento neoplásico por afetar a produção de citocinas inflamatórias pelas células neoplásicas. No entanto, até o momento não foi bem definido se o tratamento com AINEs é capaz de modular a expressão de citocinas inflamatórias por células do carcinoma epidermoide oral (CEO). O objetivo deste trabalho foi avaliar a expressão de citocinas inflamatórias em linhagens celulares de CEO após tratamento com ácido acetilsalicílico (AAS) e celecoxibe (CLX). Foi realizado screening da expressão de 84 citocinas e quimiocinas, através de PCR array, das linhagens SCC4, 9 e 25 tratadas com doses de AAS e CLX próximas às concentrações plasmáticas dos fármacos em humanos. Os resultados mostraram que AAS e CLX modularam a expressão de citocinas e que as linhagens responderam de maneira diferente aos tratamentos. Observou-se aumento de expressão de citocinas pró-inflamatórias como a IL-1?, IL-8 e TNF na SCC9 e 25, assim como diminuição de expressão de ACKR4 e CXCL10 na SCC4 e 9. / Four decades of research have shown that many inflammatory mechanisms are intrinsically linked to the development and maintenance of cancer and that inflammatory cytokines play pivotal role in this association. Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce neoplastic growth on affecting the production of inflammatory cytokines by the neoplastic cells. So far, it is not well established if the treatment with NSAIDs can modulate the expression of inflammatory cytokines by OSCC cells. The objective of this study was to evaluate the expression of inflammatory cytokines by OSCC cell lines after treatment with acetylsalicylic acid (ASA) and celecoxib (CLX). Eighty-four cytokines and chemokines mRNA expression were screened by PCR array on SCC4, 9 and 25 cell lines treated with ASA and CLX at plasma concentrations in humans. The results showed that ASA and CLX modulate the expression of cytokines with all cell lines responding differently to the treatments. Increased expression of proinflammatory cytokines such as IL-1?, IL-8 and TNF in SCC9 and 25, and reduced expression of ACKR4 and CXCL10 in SCC4 and 9, was observed. Thus it follows that the treatments of lines SCC4, SCC9 and SCC25 with ASA and CLX at the next plasma concentrations in humans are able to modulate the gene expression of inflammatory cytokines.

Na cidade de São Paulo, cerca de 50 mil pessoas são portadoras do HTLV-1. O HTLV-1 é o agente causador da paraparesia espástica tropical/mielopatia associada com o HTLV-1 (TSP/HAM) e os mecanismos desta patogênese são obscuros. A TSP/HAM é considerada uma doença imuno-mediada e algumas citocinas, podem estar associadas, com a desmielinização da membrana de mielina da coluna espinhal, provavelmente, estimuladas pela presença de antígenos virais. A PCR em tempo real é uma técnica utilizada para a detecção de citocinas e apresenta maior sensibilidade na expressão de mRNA e carga proviral do HTLV-1. Objetivos: Detecção de citocinas pelas técnicas sorológicas e de biologia molecular (PCR em tempo real) que auxiliaram no aconselhamento e avaliação de pacientes infectados pelo HTLV-1, além de uma avaliação da carga proviral dos pacientes com infecção pelo HTLV-1. Casuística: Grupo I: indivíduos soronegativos para HCV, HIV-1 e HTLV-1 (Controle); Grupo II: pacientes HTLV-1 assintomáticos; Grupo III: pacientes com TSP/HAM. Observamos que o INF-<font face=\"symbol\">g apresenta-se alterado na infecção HTLV-1, sendo um dos fatores mais importantes da evolução para TSP/HAM, ambos os ensaios apresentaram o mesmo resultado. A carga proviral pode ser um marcador de progressão para a TSP/HAM. A interação complexa existente entre o HTLV-1 e as células responsáveis pela liberação de citocinas e <font face=\"symbol\">b-quimiocinas pró-inflamatórias, assim como elementos de ativação celular, resultam na ativação imunológica. Isto, lentamente, pode levar ao processo inflamatório crônico que atua diretamente no micro ambiente neuronal e/ou membrana de mielina da coluna espinhal, em alguns portadores de HTLV-1. Com a persistente ativação do sistema imunológico, este processo provocará destruição das células gliais e dos neurônios, dando início ao processo de desmielinização. / In São Paulo, about 50 thousand people are HTLV-1 carriers. HTLV-1 is the agent that causes tropical spastic paraparesis and HTLV-1 associated myelopathy (TSP/HAM) despite the mechanisms of this disease are still unclear. TSP/HAM is considered an immune mediated illness and some cytokines might be involved with axonal damage and demyelination, most pronounced in the midthoracic spinal cord, probably stimulated by the presence of viral antigens. Real Time PCR is a used technique to cytokine detection and shows higher sensitivity on mRNA expression and HTLV-1 proviral load. Objectives: cytokine detection through molecular biology (Real time PCR) and serologic techniques that helped on advising and assessment of HTLV-1 infected patients and also on their proviral load. Casuistic: Group I: seronegative individuals for HCV, HIV-1 and HTLV-1 (control); Group II: asymptomatic HTLV-1 infected patients; Group III: TSP/HAM patients. We\'ve been observed that <font face=\"symbol\">g-interferon presents changing on the HTLV-1 infection, being one of the most important factors to TSP/HAM progression, both essays showed the same results. The proviral load may be an important marker for TSP/HAM development.

Tanto a invasão local como o comprometimento de linfonodos cervicais tem grande impacto na sobrevida de pacientes portadores de carcinomas epidermóides de cabeça e pescoço. Em nosso trabalho nós primeiramente determinamos a expressão dos receptores de quimiocinas de CXCR1 a CXCR5, além de CCR7 e CX3CR1 pelo método do ensaio de proteção à ribonuclease (RPA) em 98 fragmentos de tumores primários, 91 fragmentos de mucosas adjacentes e 26 linfonodos comprometidos e correlacionamos estes dados com parâmetros anátomo-patológicos e sobrevida. CXCL12 ligante do receptor CXCR4 e CCL19 e CCL21 ambos ligantes de CCR7 foram determinados em 38 fragmentos de tumores, 33 mucosas adjacentes e 25 linfonodos comprometidos pela técnica de real-time PCR. Os tumores primários apresentam expressão aumentada do mRNA de CXCR1 (P=0.013), CXCR3 (P=0.008) e CXCR4 (P=0.025). Não observamos correlações entre status linfonodal ou tamanho de tumor. Os linfonodos comprometidos expressam mais mRNA dos receptores de quimiocinas CXCR4, CXCR5, CCR7 e CX3CR1 (todos com P<0.0001) em comparação aos tumores comprometidos. Observamos um aumento de sobrevida (P=0.048) e uma tendência a aumento de sobrevida livre de doença (P=0.074) nos pacientes negativos para a expressão de CX3CR1 (n=17) em comparação aos pacientes positivos (n=21) somente no subgrupo de pacientes portadores de carcinomas da cavidade oral. O mesmo foi observado com os pacientes CCR7 negativos também no subgrupo de pacientes portadores de carcinomas da cavidade oral, tanto em sobrevida global (P=0.024) como para sobrevida livre de doença (P=0.049). Em relação aos ligantes de quimiocinas observamos um aumento do mRNA de CCL21 em linfonodos comprometidos em relação aos tumores primários (P=0.059). Concluímos que a interação quimiotática entre CCR7 e de seu ligante CCL21, poderia ser um mecanismo de atração de células tumorais para os linfonodos em tumores de cavidade oral, além disso a negatividade da expressão do mRNA de CCR7 e CX3CR1 são candidatos marcadores de uma melhor sobrevida em carcinomas epidermóides de cavidade oral. / Local invasion and lymph nodal spread impact in the outcome of Head and Neck squamous cell carcinoma (HNSCC) patients (pts). We determined CXCR1-5, CCR7 and CX3CR1 mRNA expression by means of RNAse protection assay in 98 HNSCC primary tumors and 91 adjacent mucosa and 26 metastatic lymph nodes, correlating this data with outcome. CXCL12 and CCL19/CCL21, ligands for CXCR4 and CCR7, were determined in 38 tumor fragments, 33 adjacent mucosas and 25 de metastatic lymph nodes, by means of Quantitative Real-Time PCR. Tumors presented higher CXCR1 (P=0.013), CXCR3 (P=0.008) and CXCR4 mRNA (P=0.025) expression as compared to mucosa. No correlations are observed neither lymph nodal status nor tumor size impacted on chemokine receptor expression. Metastatic lymph nodes expressed more CXCR4, CXCR5, CCR7 and CX3CR1 (P<0.0001) as compared to matched tumors. We found a longer overall survival (OS) (P=0.048) and a trend toward longer disease free survival (DFS) (P=0.074) in CX3CR1 negative (n=17) as compared to positive pts (n=21) only in oral subgroup. The same occurred for CCR7 negative oral SCC, in terms of OS (P=0.024) and DFS (P=0.049). We conclude that, of the chemokine receptors here studied, CCR7 and CX3CR1 mRNA expression seems to better reflect outcome in oral subsite only. In addition, CCL21, a CCR7 ligand mRNAs is more expressed in metastatic lymph nodes than tumors (P=0.059). Further studies are warranted to confirm these results.

Local invasion and lymph nodal spread impact in the outcome of Head and Neck squamous cell carcinoma (HNSCC) patients (pts). We determined CXCR1-5, CCR7 and CX3CR1 mRNA expression by means of RNAse protection assay in 98 HNSCC primary tumors and 91 adjacent mucosa and 26 metastatic lymph nodes, correlating this data with outcome. CXCL12 and CCL19/CCL21, ligands for CXCR4 and CCR7, were determined in 38 tumor fragments, 33 adjacent mucosas and 25 de metastatic lymph nodes, by means of Quantitative Real-Time PCR. Tumors presented higher CXCR1 (P=0.013), CXCR3 (P=0.008) and CXCR4 mRNA (P=0.025) expression as compared to mucosa. No correlations are observed neither lymph nodal status nor tumor size impacted on chemokine receptor expression. Metastatic lymph nodes expressed more CXCR4, CXCR5, CCR7 and CX3CR1 (P<0.0001) as compared to matched tumors. We found a longer overall survival (OS) (P=0.048) and a trend toward longer disease free survival (DFS) (P=0.074) in CX3CR1 negative (n=17) as compared to positive pts (n=21) only in oral subgroup. The same occurred for CCR7 negative oral SCC, in terms of OS (P=0.024) and DFS (P=0.049). We conclude that, of the chemokine receptors here studied, CCR7 and CX3CR1 mRNA expression seems to better reflect outcome in oral subsite only. In addition, CCL21, a CCR7 ligand mRNAs is more expressed in metastatic lymph nodes than tumors (P=0.059). Further studies are warranted to confirm these results. / Bone tissue alterations and vascular calcification (VC) are commonly found in patients with chronic renal failure (CKD). The importance of phosphorus (P) and parathyroid hormone (PTH) is not clear, yet. An in vitro study showed that inorganic phosphate was able to transform vascular smooth muscle cells (VSMC) into calcifying cells confirmed for up-expression of Runx2 in these cells. Besides, it has been demonstrated the in vivo expression of Runx2 in intimal and medial VSMC in calcified arteries of CKD patients. We evaluated the effect of phosphorus (P) and parathyroid hormone (PTH) on bone remodeling and on the expression of bone proteins (Runx2, Osteoprotegerin, type I Collagen, Osteocalcin, Osteopontin and NF?B) in aortic valve and heart in experimental uremia. Wistar rats were submitted to parathyroidectomy, nephrectomy (Nx) and continuous infusion of 1-34 rat PTH in physiologic or 5 times the normal values. The diet was identical, however the P content was low (LP: 0,2%) or high (HP: 1,2%). We performed biochemical, histomorphometric, imuno-histochemistry and RT-PCR analysis. Rats submitted to Nx developed renal failure. The P overload contributed to loss bone volume independent of uremia. Besides Nx animals that received high PTH doses bone loss was slight probably because of the anabolic effect of PTH, which was attenuated by the phosphorus overload toxic. VC was only observed in Nx animals that received high PTH doses independently of P overload. However, the P overload with physiologic PTH doses induced phenotypic changes in VSMC that was confirmed for the up-expression of Runx2 on aorta of these animals. The high concentrations of P and PTH promoted histological changes on expression of osteoprotegerin and type I Collagen in calcified arteries and heart. This study does not established ideal levels of PTH sufficient for the maintenance of the bone integrity and also to prevent VC when animal are submitted to different P overload.

A leptospirose é uma zoonose causada por bactérias do gênero Leptospira. A patogênese da doença em humanos é observada principalmente no pulmão, fígado e rins. Neste trabalho, foi avaliado o papel da resposta imune inata na proteção contra a leptospirose usando camundongos como modelo experimental. Os animais foram infectados com L. interrogans e o desenvolvimento da doença foi acompanhado, observando-se a morte de animais C3H/HeJ, enquanto C3H/HePas apresentou icterícia e BALB/c não apresentou sintomas. O perfil de mRNA foi medido por qPCR nas amostras de rim, fígado e pulmão e as concentrações de proteinas TNF-<font face=\"Symbol\">&#945;, TGF-<font face=\"Symbol\">b, MCP-1, MIP-1<font face=\"Symbol\">&#945;, MIP-2 e IL-8 foram analisadas por ELISA em extratos dos tecidos e no soro. Os resultados demonstraram que L. interrogans estimula a expressão prematura de TNF-<font face=\"Symbol\">&#945;, TGF-<font face=\"Symbol\">b, MCP-1, MIP-1<font face=\"Symbol\">&#945;, MIP-2 e IL-8 na linhagem BALB/c resistente à infecção. A análise histológica indica que estes mediadores podem estar relacionados com o influxo de diferentes células do sistema imune desempenhando importantes funções na proteção contra leptospirose. / Leptospirosis is a worldwide zoonosis caused by Leptospira. The pathogenesis in humans is mainly observed in lungs, livers and kidneys. In this work the role of innate immune response in protection against leptospirosis is being studied using different mice models. The animals were infected intraperitoneally with virulent cells of L. interrogans serovar Copenhageni and the development of the disease was followed, being observed mortality of C3H/HeJ mice, whereas C3H/HePas presented jaundice and BALB/c mice remained asymptomatic. Samples of liver, kidney, lungs and sera were analyzed following the profiles of mRNA and protein of the cytokines TNF-<font face=\"Symbol\">&#945; and TGF-<font face=\"Symbol\">b and chemokine MCP-1, MIP-1<font face=\"Symbol\">&#945;, MIP-2 and CXCL1/IL-8. We showed that Leptospira infection stimulates early expression of cytokine TNF-<font face=\"Symbol\">&#945; and TGF-<font face=\"Symbol\">b and chemokine MCP-1, MIP-1<font face=\"Symbol\">&#945;, MIP-2 and IL-8 in the resistant mice strain BALB/c. Histological analysis indicates that the expression of those molecules can be related to the influx of distinct immune cells, which play a role in the naturally acquired protective immunity.

L’avènement des multi-thérapies antirétrovirales a permis une réduction importante de la mortalité associée au VIH en induisant notamment la chute de la charge virale à moins de 50 copies/mL et une récupération progressive du nombre de lymphocytes T CD4+ (LT-CD4). Cependant, certains patients définis comme mauvais répondeurs immunologiques (MRI) ne parviennent pas à récupérer un taux de CD4 généralement considéré comme « protecteur » (>500cellules/µL). L’interleukine-7 (IL-7), cytokine essentielle à la thymopoïèse et à l’homéostasie lymphocytaire T, a été utilisée en étude clinique afin de restaurer et maintenir le taux de LT-CD4 chez les patients MRI. La première partie de mon travail de thèse visait à évaluer l’impact d’une telle thérapie sur le réservoir viral circulant. Dans l’essai clinique sur lequel nous avons travaillé (INSPIRE 3, Cytheris), des cycles d’administration d’IL-7 ont induit une augmentation significative du nombre de LT-CD4 et CD8 circulants, avec une expansion majoritaire des populations naïves et centrales mémoires. Nous avons montré qu’un cycle d’injections d’IL-7 induisait une augmentation significative de la quantité de cellules infectées circulantes 28 jours et 3 mois post-injection. Cependant, malgré l’accroissement de la fréquence de LT-CD4 infectés 28 jours post-injection, nous avons observé une diminution significative de la charge virale ADN par million de LT-CD4 chez la majorité des patients 3 mois après l’initiation de la thérapie, suggérant une élimination partielle de cellules infectées. Suite au second cycle d’injections, nous n’avons pas observé d’évolution de la quantité de cellules infectées circulantes ni de la fréquence de LT-CD4 infectés, suggérant un impact différent des 2 cycles d’injections sur la dynamique du réservoir viral périphérique. Enfin, certains patients ayant développé des anticorps neutralisants anti-IL-7 (Nab) suite au second cycle d’injections d’IL-7, nous avons cherché à identifier des facteurs prédictifs de l’apparition de ces anticorps ainsi que leurs conséquences physiologiques in vivo. Le seul paramètre caractérisant ces patients est l’amplitude de la reconstitution T-CD4 au cours du premier cycle d’injections d’IL-7. Il semble donc qu’une meilleure réponse à l’IL-7 ait pour conséquence de faciliter le développement de la réponse immune contre cette cytokine. Cependant, ces anticorps ne sont détectables que de façon transitoire chez les patients. De plus, nous avons observé une diminution significative, mais transitoire, de la prolifération des thymocytes chez les patients présentant des Nab, démontrant un impact fonctionnel de ces anticorps sur l’activité biologique de l’IL-7 endogène. L’injection systémique d’IL-7 induit la migration des cellules circulantes vers différents compartiments tissulaires lymphoïdes et non lymphoïdes. Dans une seconde partie de mon travail de thèse, j’ai étudié le pouvoir adjuvant de cette cytokine administrée localement par pulvérisation à la surface de la muqueuse vaginale. Dans le modèle macaque rhésus, nous avons mis en évidence une augmentation de la production d’un large spectre de chimiokines dans le chorion et l’épithélium vaginal des animaux 48 heures après l’administration vaginale d’IL-7. Cette surexpression de chimiokines s’accompagne d’une migration massive de LT-CD4, CD8, macrophages, cellules dendritiques et cellules NK dans cette muqueuse, suggérant l’augmentation de la vigilance immunologique. L’effet adjuvant de cette cytokine a été confirmé par l’analyse de la réponse humorale muqueuse de macaques vaccinés par pulvérisation vaginale d’antigènes 48h après l’administration du spray d’IL-7. Dans les lavages cervicovaginaux (CVL) des animaux traités à l’IL-7, nous avons mis en évidence des réponses spécifiques de type IgA et IgG plus rapides, plus fortes et plus durables que chez les animaux contrôles, démontrant la capacité de l’IL-7 à préparer la muqueuse vaginale à répondre à une stimulation antigénique locale. / Highly Active Antiretroviral Therapy (HAART) has led to significant reduction of HIV-associated mortality by maintaining an undetectable viral load and inducing progressive CD4-T cell restoration. However, some patients, defined as poor immunological responders (PIR), fail to restore their CD4 counts to 500cells/µL during treatment, a threshold considered as the protective against AIDS related or non AIDS related malignancies, opportunistic infections and cardiovascular events. Interleukin-7 (IL-7), an essential cytokine for thymopoïesis and T cell homeostasis has been used in clinical trials aimed at restoring and maintaining CD4 counts in PIR patients. The first part of my thesis project aimed at assessing the impact of IL-7 therapy on circulating HIV reservoir. In the clinical study we worked on (INSPIRE 3, Cytheris), cycles of IL-7 injections led to a significant increase of the number of circulating CD4 and CD8 T-cells, with a predominance of naïve and central memory T cell expansion. We have shown that one cycle of IL-7 injections induced a significant increase in the number of circulating infected cells 28 days and 3 months post-injections. However, despite a significant increase in the frequency of infected CD4 T-cells 28 days post-injections, we observed a significant decrease of HIV-DNA load in CD4 T-cells in the majority of patients 3 months after the therapy initiation. These data suggest a partial elimination of HIV infected cells. After the second cycle of IL-7 injections, we did not observed any change in the number or frequency of circulating infected cells, suggesting a differential impact of the two IL-7 injection cycles on the dynamics of circulating HIV-reservoir. Finally, considering that some patients developed anti-IL-7 neutralizing antibodies (Nab) after the second cycle of IL-7 injections, we looked for predictive factors of this immunogenicity and analyzed its physiological consequences in vivo. The only parameter that distinguished Nab and non-Nab patients was the extent of CD4 T-cell reconstitution during the first cycle of therapy. This suggests that a better response to IL-7 also facilitates the development of auto-antibodies to the cytokine. However, these antibodies were only transiently detectable after the second cycle of therapy. Moreover, the appearance of Nab was associated with a significant but transient decrease of thymocyte proliferation, suggesting a functional impact of these antibodies on the endogenous IL-7 function. Systemic injection of IL-7 induces circulating T cells homing from the blood into lymphoid and non-lymphoid tissues. In the second part of my thesis project, I evaluated whether this cytokine could be used as an adjuvant when sprayed on the vaginal mucosa. Ten micrograms of IL-7 directly sprayed in the vaginal tract of rhesus monkeys induced, 48h after administration, the production of a large pattern of chemokines in the vaginal chorion and epithelium. This chemokine expression was accompanied by massive homing of CD4 and CD8-T cells, macrophages, dendritic cells and NK cells in the vaginal mucosa, suggesting an increased immunological vigilance. Finally, the adjuvant potential of this cytokine was confirmed by analyzing local humoral immune response after vaginal administration of antigens 48h following IL-7 spray. In cervicovaginal washes (CVL) of treated animals, we observed a faster, stronger and longer-lasting specific IgA and IgG response than in control animals, highlighting the capacity of IL-7 to prepare the vaginal mucosa response to local antigen stimulation.

Pulmonary arterial hypertension (PAH) is a group of diseases characterized by avascular obstruction leading to a progressive increase of the resistances in the pulmonary blood flow. The recent progress in the understanding of mechanisms at the origin of this disease underlines the role of extrapulmonary cells, such as circulating stem cells and bone marrow-derived progenitor cells in vascular remodeling and in PAH development. In this thesis we have shown implication of the progenitor cells and chemotactic axis in the vascular remodeling in human and experimental PAH. This work could help to develop new therapies allowing more specific and more effective treatments leading to improved survival of PAH patients. / L’hypertension artérielle pulmonaire (HTAP) est un groupe de maladies qui se caractérise par une obstruction vasculaire conduisant à une augmentation progressive des résistances à l’écoulement sanguin. Le remodelage vasculaire qui implique toutes les couches de la paroi du vaisseau est considéré comme un élément clé dans la pathogenèse de l'HTAP. Les progrès récents dans la compréhension des mécanismes à l'origine de cette maladie soulignent le rôle de cellules extrapulmonaires, telles que des cellules souches circulantes et des progéniteurs dérivés de la moelle osseuse, dans le remodelage vasculaire et dans le développement de l’HTAP. Les thérapeutiques ciblées sur la dysfonction endothéliale ne permettent pas à l'heure actuelle de guérir cette maladie, il est donc nécessaire d’identifier d'autres mécanismes physiopathologiques permettant de développer de nouvelles stratégies thérapeutiques. C’est pourquoi nous avons exploré l’implication des cellules progénitrices et des signaux chimiotactiques dans le remodelage vasculaire au cours de l’HTAP humaine et expérimentale. Nous avons mis en évidence un recrutement de cellules c-kit+ (incluant des progéniteurs et des mastocytes) ainsi que l’expansion de vasa vasorum dans les poumons des patients atteints d’HTAP. Grâce à l’utilisation du modèle expérimentale d’HTAP induit par l’hypoxie chez la souris, nous avons montré le rôle central de la chimiokine CXCL12 et de ses deux récepteurs CXCR4 et CXCR7 dans le recrutement des progéniteurs c-kit+. Le traitement combiné par les antagonistes AMD3100 et CCX771, grâce à leurs actions synergiques, inhibe le remodelage vasculaire pulmonaire, l’hypertrophie cardiaque droite, ainsi que le recrutement des progéniteurs c-kit+, induits par l’hypoxie. Par ailleurs, le blocage de c-kit par l’imatinib améliore également les paramètres d’hémodynamique et diminue le recrutement périvasculaire des cellules c-kit+, probablement en inhibant leurs expansion dans la moelle osseuse. Nous avons également mis en évidence une altération d’une population de progéniteurs mésenchymateux d’origine hématopoïétique, appelés fibrocytes, dans le sang des patients souffrant d’HTAP.Ce travail pourrait contribuer à développer des actions thérapeutiques ciblées permettant la mise en place de traitements à la fois plus spécifiques et plus efficaces susceptibles d’améliorer la survie des patients HTAP.

L’objectif de ma thèse a été d’étudier l’expression et l’activité de deux récepteurs de chimiokine dans deux désordres immunitaires, CCR1 dans le modèle murin NZB/W de néphrite lupique et CXCR4 dans la Lymphopénie T CD4+ Idiopathique (LCI), un déficit immunitaire rare chez l’Homme. Le Lupus Erythémateux Disséminé est une maladie autoimmune, chronique et inflammatoire dont le développement est caractérisé par une perte progressive de la fonction rénale associé notamment à une infiltration leucocytaire. Je me suis intéressé à la contribution de CCR1 et de ses ligands CCL3/CCL5 au recrutement leucocytaire intra-rénal chez la souris NZB/W néphritique. Nos résultats révèlent une augmentation de l’expression et de la fonction de CCR1 à la surface des cellules T (LT), des phagocytes et des neutrophiles issues de souris néphritiques. Un traitement aigu par un antagoniste non-peptidique de CCR1 administré par voie orale a réduit l’infiltration rénale des LT et des macrophages. L’inhibition de CCR1 à long terme a permis de diminuer l’accumulation rénale des LT CD4+ effecteurs/mémoires, des monocytes inflammatoires Ly6C+ et des macrophages polarisés M1 ou M2, a amélioré les atteintes tubulo-interstitielles et glomérulaires, a retardé l’apparition d’une protéinurie fatale et in fine a prolongé la survie des souris NZB/W. Ainsi, la combinaison d’approches pharmacologiques et fonctionnelles nous a permis de dévoiler un rôle pathogénique de CCR1, dans la progression de la néphrite lupique chez la souris NZB/W. La LCI est un déficit immuno-hématologique hétérogène et d’étiologie inconnue associant un nombre faible et persistant de LT CD4+ circulants et des infections opportunistes sévères en particulier d’origine fongique. Nos analyses multi-paramétriques par cytométrie en flux ont permis de révéler une perte d’expression et de fonction de CXCR4 à la membrane des LT de 17 des 20 patients étudiés. Ces données suggèrent que l’anomalie de CXCR4 constitue un trait biologique commun de la LCI. Notre approche transcriptomique a également permis d’identifier des signatures spécifiques de l’expression de gènes associés au seuil d’activation du TCR et à l’immuno-sénescence dans la LCI. Nos analyses phénotypiques et fonctionnelles ont confirmé ces observations et rapportent pour la première fois que les LT circulants résiduels de patients présentent un profil sénescent (exemple : perte d’expression des molécules de co-stimulation CD27 et CD28), des anomalies de réponse du TCR in vitro et une érosion des télomères. Sur un plan mécanistique, nous avons montré que les anomalies de signalisation intrinsèque aux LT des patients sont causées par l’expression accrue de la DUal-Specific Phosphatase 4 (DUSP4). Par conséquent, nos travaux révèlent une sénescence précoce des LT de patients souffrant de LCI, qui pourrait résulter d’une hyperstimulation chronique. Ce phénomène semble dépendre de la surexpression de DUSP4, dont la modulation pourrait constituer une piste thérapeutique dans la LCI afin d’améliorer les stratégies vaccinales. / My PhD works focused on the expression and function of chemokine receptors in two immune disorders, namely CCR1 in the lupus-prone NZB/W mouse model and CXCR4 in the Idiopathic CD4+ T-cell lymphopenia, a rare human immune defect.Systemic lupus erythematosus is a chronic inflammatory autoimmune disease, the development of which is characterized by a progressive loss of renal function. Such dysfunction is associated with renal leukocyte infiltration. During my PhD, I investigated the role of the CCR1 chemokine receptor in this process during the progression of nephritis in NZB/W mice. We found that peripheral T-cells, mononuclear phagocytes and neutrophils from nephritic NZB/W mice were more responsive to CCR1 ligands than the leukocytes from younger prenephritic mice. Short-term treatment of nephritic NZB/W mice with a orally available CCR1 antagonist decreased renal infiltration by T-cells and macrophages. Longer Ccr1 blockade decreased kidney accumulation of effector/memory CD4+ T-cells, Ly6C+ inflammatory monocytes, and both M1 and M2 macrophages; reduced tubulointerstitial and glomerular injuries; delayed fatal proteinuria; and prolonged animal lifespan. Altogether, these findings highlight a pivotal role for CCR1 in the recruitment of T and mononuclear phagocyte cells to inflamed kidneys of NZB/W mice, which in turn contribute to the progression of renal injury.ICL is heterogeneous immunological syndrome of unclear molecular mechanisms, characterized by a profound and persistent CD4+ T-cell defect and by opportunistic infections in particular of fungal origin. We detected using multiparametric flow-cytometry analyses, reduced levels of CXCR4 expression and chemotactic function on T-cells from 17 of 20 ICL patients. These results suggest that the impaired membrane expression and function of CXCR4 is a common biologic trait of ICL. Using a transcriptomic approach, we also identified an ICL-specific T-cell gene expression signature characteristic of low TCR sensitivity and accelerated T-cell aging. Phenotypic and functional analyses of circulating T cells confirmed these observations and extended them to include an expansion of terminally-differentiated T cells with hallmarks of aging including loss of the co-stimulatory molecules CD27 and CD28, defective in vitro TCR responses, and telomere erosion. Mechanistically, we further showed that intrinsic T-cell signaling defects were caused by higher expression of DUal-Specific Phosphatase 4 (DUSP4). These findings suggest that premature T-cell senescence occurs in ICL as a result of chronic T-cell activation. This is in part due to abnormally high DUSP4 expression in CD4+ T cells, the modulation of which may constitute a novel therapeutic avenue in ICL to improve vaccination strategies.

Les macrophages jouent un rôle dans l'inflammation de certaines pathologies pulmonaires comme l'asthme et la broncho pneumopathie chronique obstructive. Selon la dichotomie Th1 et Th2, les macrophages s'activent en phénotype M1/M2 en fonction du microenvironnement. Sous l'influence du lipopolysaccharide (LPS) les macrophages s'activent en phénotype M1. A l'inverse, l'exposition aux cytokines Th2 (interleukine (IL)-4/IL-13) induit un phénotype M2 des macrophages. Nous avons réalisé une étude transcriptomique des marqueurs de la polarisation M1/M2 des macrophages pulmonaires humains. La polarisation M1 induite par le LPS augmente la production des cytokines (TNF-α, IL-1β, CCL2, 3, 4, 5, CXCL1, 8, 10), de la PGE2 et l'expression du CD38 et CD197. La polarisation M2 induite par l'IL-4/IL-13 augmente l'expression des cytokines (CCL13, 17, 22, 26), de la 15-lipoxygénase (15-LOX) et du CD206. Nous avons évalué l'expression des 15-LOX-1 et 15-LOX-2 et leur rôle dans la régulation de la polarisation des macrophages pulmonaires. Le LPS augmente l'expression de la 15-LOX-2 alors que l'IL-4/IL-13 augmente l'expression de la 15-LOX-1. L'inhibition des 15-lipoxygénases diminue la production des cytokines M1/M2. Enfin, nous avons étudié l'expression et le rôle du récepteur nicotinique α7 dans la polarisation des macrophages pulmonaires humains. Ces derniers expriment les récepteurs nicotiniques α7 dont la stimulation par des agonistes nicotiniques α7 diminue la production des cytokines M1/M2. Ce travail apporte de nouvelles connaissances sur la polarisation des macrophages, dont certaines voies de régulation peuvent être impliquées dans les pathologies inflammatoire pulmonaires / In pulmonary diseases such as asthma and chronic obstructive pulmonary disease, macrophages orchestrate inflammatory reactions. In response to environmental signals, macrophages exhibit a phenotypic polarization that mirrors the Th1/Th2 polarization. Upon exposure to bacterial lipopolysaccharide (LPS), macrophages undergo M1 polarization. In contrast, interleukin (IL)-4/IL-13 induce M2 polarization.In our first study, we characterized the phenotypic differentiation of human lung macrophages (LM) using a whole-transcriptome approach. Cytokines, lipid metabolism and membrane markers were among the most affected genes. LPS-induced M1 polarization was associated with an increase in the production of cytokines (TNF-α, IL-1β, CCL2, 3, 4, 5, CXCL1, 8, 10), in PGE2 signalling and in the expression of CD38 and CD197. IL-4/IL-13-induced M2 macrophages increased expression of cytokines (CCL13, 17, 22, 26), 15-lipoxygenase (15-LOX) and CD206. In the second study, we investigated the expression of 15-LOX-1 and 15-LOX-2 and their roles in regulating the polarization of human LM. LPS increased the expression of 15-LOX-2 whereas IL-4/IL-13 induced the expression of 15-LOX-1. Inhibition of the 15-LOX pathways decreased the production of both M1 and M2 cytokines. The third study investigated the expression of α7 nicotinic receptors (α7nAChR) and their regulating roles in the polarization of LM. Expression of α7nAChR was found in unstimulated LM. Specific α7nAChR agonists decreased the in vitro production of both M1 and M2 cytokines. Our work adds new insights in the macrophage polarization and some of the regulatory pathways that may be involved in pulmonary diseases