Avec 42 000 nouveaux cas diagnostiqués en 2012, le cancer colorectal (CCR) représente en France le troisième cancer en termes d’incidence. Les métastases, qui surviennent principalement au niveau du foie et des poumons, en constituent la principale cause de décès. Malgré les progrès récents de la chimiothérapie et des agents ciblés, le taux de survie à 5 ans des patients présentant un CCR métastasé reste faible. Aujourd’hui, la résection chirurgicale est le seul traitement curatif, cependant moins de 20% des patients porteurs de métastases sont opérables. Il existe donc un grand nombre de patients présentant un CCR métastasé pour lequel aucun traitement curatif ne peut être proposé. La formation des métastases à partir d’une tumeur primaire résulte d’une longue série d’étapes séquentielles liées les unes aux autres. L’issue de ce processus dépend à la fois des propriétés intrinsèques des cellules tumorales et de la réponse de l’hôte. Il a récemment été montré que les couples chimiokines/récepteurs interviennent dans le contrôle des différentes étapes de la progression tumorale.Le projet de recherche développé au cours de mon travail de thèse avait pour objectif d’utiliser les chimiokines et leurs récepteurs dans de nouvelles stratégies thérapeutiques pour bloquer et/ou éradiquer les métastases hépatiques et pulmonaires des CCRs. Le travail s’est articulé selon deux axes dans lesquels nous avons montré d’une part que, le blocage du récepteur de chimiokines CXCR7 permet de limiter les métastases pulmonaires de CCRs et d’autre part que, le transfert de gène codant CX3CL1 au niveau du foie entraîne une réponse anti-tumorale efficace dans les métastases hépatiques de CCRs. / With 42 000 newly-diagnosed patients in 2012, the colorectal cancer (CRC) represents the third type of cancer in terms of incidence in France. The leading cause of death from CRC is the development of metastases and these metastases will occur mostly within the liver (50% of the patients) and within the lungs (15%). Despite recent progress, notably in the chemotherapies now used and the targeted agents, the rate of 5-years survival for late stage CRC remains low. Nowadays, the surgical resection is the only curative treatment proposed to patients with metastatic CRC, however less than 20% of them have an operable tumour. There is therefore a high number of patients for whom no cure is currently available. A primary tumour’s dissemination to a second organ is the result of a long process made of numerous cross-linked steps. The final outcome of this process depends on the intrinsic properties of tumour cells as well as the host response. Recently, it has been shown that the chemokine-chemokine receptor pairs (initially described as regulating the leukocyte migration) play crucial roles in the various stages involved in tumour progression. The aim of the research project developed during my PhD was to assess the use of the chemokines and their receptors in new therapeutic strategies to block and/or eradicate the hepatic and pulmonary metastases of CRC. Our work has been organized along two main lines of approach. We have shown that the blockage of the CXCR7 chemokine receptor enables the limitation of the CRC metastases within the lungs and that the CX3CL1 gene transfer into the hepatocytes leads to an efficient anti-tumor response in the CRC metastases within the liver.

Heart transplantation (HTx) is now an established therapy for end-stage cardiac failure not responding to medical treatment. Recent decades have seen improved outcome following HTx due to more effective and targeted immunosuppressive therapy. However, acute and chronic rejection remains a major cause of morbidity and mortality. At the same time, immunosuppressive strategies are associated with significant side effects, including development of tumours. Hence, the induction of immunologic tolerance to alloantigen is considered the “holy grail” of transplant research. T regulatory cells (Tregs) are a subset of T cells that appear to suppresscytotoxic cell and initiate tolerance to foreign tissues. The Tregs suppresscytotoxic cells through specific cytokine pathways and cell-cell contact. In-vivo T reg migration has been a matter of debate in recent years. Treg trafficking is governed by chemokines, which are small secreted proteins, acting via their distinct trans-membrane serpentine receptors. Experimental work has demonstrated an involvement of distinct chemokine pathways in Tregs migration and localization following cardiac transplantation; however, there is paucity of data in humans. I investigated the effects of chemokines on Tregs in heart transplant recipients through a series of observational studies. My study demonstrated that acute rejection following heart transplantation is associated with a significant elevation of peripheral blood Th1 chemokine levels. I hereby further show that peripheral blood Treg counts in stable heart transplant recipients are not affected by immunosuppression but are significantly lower in patients taking statins. I have demonstrated via in-vitro chemotaxis assays a specific pattern of chemotactic response for Tregs and the effector T cells. Using double immunofluorescence staining and immunostaining, I show for the first time that Tregs may migrate to the allograft under the influence of CCL17.

No description available.