O processo de diferenciação e ativação de osteoclastos, essencial para a manutenção da homeostasia do tecido ósseo e também envolvido na patogênese de diversas patologias caracterizadas pela atividade osteolítica, depende de um sistema central de controle que envolve a ligação das moléculas RANK/RANKL. Além do sistema RANK/RANKL, moléculas co-estimulatórias de osteoclastos, tais como os complexos DAP-12, TREM-2 e SIRP1, e FcR, OSCAR e PIR-A, também apresentam um papel importante na geração e ativação de osteoclastos. Entretanto, a possível contribuição de tais moléculas para a progressão da doença periodontal (DP) permanece desconhecida, assim como o possível impacto de citocinas na modulação de sua expressão no microambiente periodontal. Nosso objetivo foi investigar, por RealTimePCR, o padrão de expressão de moléculas co-estimulatórias de osteoclastos (DAP-12, TREM-2 e SIRP1, e FcR, OSCAR e PIR-A) na periodontite crônica em humanos, além de avaliar a cinética de expressão destas moléculas e a sua modulação por citocinas (TNF-, IFN-, IL-17 e IL-10) ao longo do curso da DP em camundongos em camundongos C57Bl/6 wild-type (WT) e geneticamente modificados (TNFp55KO, IFNKO, IL17KO, IL10KO. Nossos resultados demonstram que nas lesões periodontais crônicas a expressão de todas as moléculas co-estimulatórias de osteoclastos apresentaram-se significativamente aumentadas quando comparadas às amostras controle. Com relação à periodontite experimental, verificamos que todas as moléculas co-estimulatórias alvo apresentavam aumento em sua expressão após a indução de doença quando comparado aos controles. Nos camundongos para TNFp55KO, IFNKO e IL17KO, observamos uma redução na severidade da DP (reabsorção óssea e quantidade de células inflamatórias) e na expressão de moléculas co-estimulatórias, ao contrário do observado nos camundongos IL10KO. Entretanto, ao normalizarmos os níveis de expressão das moléculas co-estimulatórias de osteoclastos pelo número de células inflamatórias, verificamos que TNF- e IL-17 se mostram associados a uma maior expressão de moléculas co-estimulatórias, enquanto IFN- e IL-10 parecem regular negativamente a expressão de tais moléculas. Em termos gerais, demonstramos que a expressão de moléculas co-estimulatórias de osteoclastos se mostra aumentada na DP humana e experimental, e que citocinas parecem modular sua expressão por mecanismos diretos e indiretos, tais como a migração de células inflamatórias para os sítios de doença periodontal. / The osteoclast differentiation and activation are essential to bone tissue homeostasis and in the development of bone pathologies, which RANK/RANKL signaling molecules are the major osteoclastogenic factor. However, osteoclast co-stimulatory molecules, such as DAP-12, TREM-2, SIRP1, FcR, OSCAR and PIR-A, also present an important role in the osteoclastogenesis. However, the exact role and regulation of these molecules in human and mice periodontal diseases (PD) development have not completely known. Our aim was to investigate the pattern of osteoclast co-stimulatory expression (DAP-12, TREM-2, SIRP1, FcR, OSCAR and PIR-A) in human chronic periodontitis (CP), apart from analyze the kinetic of these molecules and their regulation by cytokines (TNF-, IFN-, IL-17 and IL-10) in the development of experimental periodontal disease in mice C57Bl/6 and knockout. Our results demonstrated that all osteoclast co-stimulatory molecules presented highly expressed in CP patients when compared with control. Similar results are presented about experimental PD, where all co-stimulatory molecules was presented highly expressed in infected mice when compared with control mice. We observed in TNFp55KO, IFNKO and IL17KO mice a decrease in PD scores and co-stimulatory molecules expression, the opposite of IL10KO mice. However, when we standardized the co-stimulatory molecules levels by the number of inflammatory cells, we found that TNF- and IL-17 are associated with increased expression of co-stimulatory molecules, while IFN- and IL-10 appear to negatively regulate the expression of such molecules. In conclusion, we demonstrated that osteoclast co-stimulatory molecules shown increased in human and experimental PD, and cytokines appear to modulate their expression by direct and indirect mechanisms, such as inflammatory cells migration to the PD infected tissue.

O processo de diferenciação e ativação de osteoclastos, essencial para a manutenção da homeostasia do tecido ósseo e também envolvido na patogênese de diversas patologias caracterizadas pela atividade osteolítica, depende de um sistema central de controle que envolve a ligação das moléculas RANK/RANKL. Além do sistema RANK/RANKL, moléculas co-estimulatórias de osteoclastos, tais como os complexos DAP-12, TREM-2 e SIRP1, e FcR, OSCAR e PIR-A, também apresentam um papel importante na geração e ativação de osteoclastos. Entretanto, a possível contribuição de tais moléculas para a progressão da doença periodontal (DP) permanece desconhecida, assim como o possível impacto de citocinas na modulação de sua expressão no microambiente periodontal. Nosso objetivo foi investigar, por RealTimePCR, o padrão de expressão de moléculas co-estimulatórias de osteoclastos (DAP-12, TREM-2 e SIRP1, e FcR, OSCAR e PIR-A) na periodontite crônica em humanos, além de avaliar a cinética de expressão destas moléculas e a sua modulação por citocinas (TNF-, IFN-, IL-17 e IL-10) ao longo do curso da DP em camundongos em camundongos C57Bl/6 wild-type (WT) e geneticamente modificados (TNFp55KO, IFNKO, IL17KO, IL10KO. Nossos resultados demonstram que nas lesões periodontais crônicas a expressão de todas as moléculas co-estimulatórias de osteoclastos apresentaram-se significativamente aumentadas quando comparadas às amostras controle. Com relação à periodontite experimental, verificamos que todas as moléculas co-estimulatórias alvo apresentavam aumento em sua expressão após a indução de doença quando comparado aos controles. Nos camundongos para TNFp55KO, IFNKO e IL17KO, observamos uma redução na severidade da DP (reabsorção óssea e quantidade de células inflamatórias) e na expressão de moléculas co-estimulatórias, ao contrário do observado nos camundongos IL10KO. Entretanto, ao normalizarmos os níveis de expressão das moléculas co-estimulatórias de osteoclastos pelo número de células inflamatórias, verificamos que TNF- e IL-17 se mostram associados a uma maior expressão de moléculas co-estimulatórias, enquanto IFN- e IL-10 parecem regular negativamente a expressão de tais moléculas. Em termos gerais, demonstramos que a expressão de moléculas co-estimulatórias de osteoclastos se mostra aumentada na DP humana e experimental, e que citocinas parecem modular sua expressão por mecanismos diretos e indiretos, tais como a migração de células inflamatórias para os sítios de doença periodontal. / The osteoclast differentiation and activation are essential to bone tissue homeostasis and in the development of bone pathologies, which RANK/RANKL signaling molecules are the major osteoclastogenic factor. However, osteoclast co-stimulatory molecules, such as DAP-12, TREM-2, SIRP1, FcR, OSCAR and PIR-A, also present an important role in the osteoclastogenesis. However, the exact role and regulation of these molecules in human and mice periodontal diseases (PD) development have not completely known. Our aim was to investigate the pattern of osteoclast co-stimulatory expression (DAP-12, TREM-2, SIRP1, FcR, OSCAR and PIR-A) in human chronic periodontitis (CP), apart from analyze the kinetic of these molecules and their regulation by cytokines (TNF-, IFN-, IL-17 and IL-10) in the development of experimental periodontal disease in mice C57Bl/6 and knockout. Our results demonstrated that all osteoclast co-stimulatory molecules presented highly expressed in CP patients when compared with control. Similar results are presented about experimental PD, where all co-stimulatory molecules was presented highly expressed in infected mice when compared with control mice. We observed in TNFp55KO, IFNKO and IL17KO mice a decrease in PD scores and co-stimulatory molecules expression, the opposite of IL10KO mice. However, when we standardized the co-stimulatory molecules levels by the number of inflammatory cells, we found that TNF- and IL-17 are associated with increased expression of co-stimulatory molecules, while IFN- and IL-10 appear to negatively regulate the expression of such molecules. In conclusion, we demonstrated that osteoclast co-stimulatory molecules shown increased in human and experimental PD, and cytokines appear to modulate their expression by direct and indirect mechanisms, such as inflammatory cells migration to the PD infected tissue.

Infection is a leading cause of death in hemodialysis patients, partly due to dysfunctional immunity. Frequent dialysis therapy improves patient outcomes and quality of life. We hypothesize that extended home hemodialysis (EHHD) also improves immune function compared to conventional in-hospital hemodialysis (CHD); therefore, we designed a prospective matching-cohort clinical study to assess serum inflammatory markers and the functional capacity of monocyte-derived dendritic cells (MDDCs) and T-lymphocytes. Serum CRP was decreased in EHHD patients suggesting that extended dialysis may decrease inflammatory solute/cytokine levels. Compared to controls, MDDCs from hemodialysis patients had similar endocytic capacity, expression of co-stimulatory molecules, and T-cell activation capacity. However, CHD was associated with the highest expression of CD83 and CD40. Activated T-cells in CHD patients also produced significantly more immunosuppressive IL-10 compared to EHHD patients and controls. Therefore, EHHD may improve immune function by decreasing inflammation, MDDC pre-activation, and synthesis of immunosuppressive cytokines.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-10-13T14:14:46Z No. of bitstreams: 1 michellealvesvicentini.pdf: 761505 bytes, checksum: 2f59d68ce4001875ae7881a93f5e4930 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-10-22T12:56:30Z (GMT) No. of bitstreams: 1 michellealvesvicentini.pdf: 761505 bytes, checksum: 2f59d68ce4001875ae7881a93f5e4930 (MD5) / Made available in DSpace on 2016-10-22T12:56:30Z (GMT). No. of bitstreams: 1 michellealvesvicentini.pdf: 761505 bytes, checksum: 2f59d68ce4001875ae7881a93f5e4930 (MD5) Previous issue date: 2008-03-05 / FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais / As parasitoses intestinais representam um importante problema médico-sanitário, tendo em vista o grande número de pessoas acometidas e as inúmeras alterações orgânicas que podem provocar no hospedeiro. Infecções provocadas por Strongyloides venezuelensis apresentam uma resposta imune local tanto nos pulmões quanto no intestino, predominantemente do tipo Th2, caracterizada pela produção das citocinas IL-4, IL-5, IL-13 e IL-10, resultando em eosinofilia, aumento da produção de muco, mastocitose e altas concentrações de IgE. Por outro lado, infecções provocadas por micobactérias estimulam uma imunidade predominantemente do tipo Th1 caracterizada pela produção de IFN-, IL-12, TNF- e óxido nítrico. A tuberculose, causada pelo patógeno intracelular Mycobacterium tuberculosis, é uma das doenças infecciosas mais importantes, sendo responsável por aproximadamente 2,9 milhões de óbitos e 8 milhões de novos casos por ano. Ainda são escassos os trabalhos envolvendo co-infecções, e devido às complexas relações existentes entre parasitos e entre eles e seu hospedeiro, faz-se necessário observações criteriosas. No presente trabalho avaliou-se o efeito modulatório que o Mycobacterium bovis virulento exerce sobre a resposta imune de camundongos co-infectados com S. venezuelensis. Os resultados demonstraram que o perfil de resposta imune durante a infecção por S. venezuelensis parece ser diretamente influenciado pela presença do M. bovis, uma vez que o perfil de resposta Th2, específico ao verme, esteve diminuído nos animais co-infectados. Tal diminuição pôde ser constatada pelo aumento do número de ovos e vermes nos animais co-infectados quando comparado com os animais infectados somente com S. venezuelensis; assim como a diminuição dos níveis de IgE específica à larva L3 do verme detectada em diferentes pontos da infecção; diminuição dos níveis de IL-10 produzida por células de baço estimuladas in vitro com antígeno da larva L3 do verme; diminuição dos níveis de IL-4, IL-5 e IL-13 no intestino; diminuição da expressão de CD80, CD86 e CD25 em células de baço e linfonodo e aumento da expressão de CD28 em células de linfonodos mesentéricos. Em conjunto, esses resultados sugerem que a infecção por M. bovis, e a conseqüente ativação do perfil de resposta imune do tipo Th1, foi capaz de modular o desenvolvimento do perfil de resposta imune do tipo Th2 contra S. venezuelensis nos animais co-infectados, deixando-os mais susceptíveis à infecção com S. venezuelensis. Esse trabalho é o primeiro a avaliar os mecanismos imunoregulatórios envolvidos na co-infecção S. venezuelensis versus M. bovis. / The intestinal parasites are a major medical-health problem, in view of the large number of people involved and the numerous organizational changes which may result in the host. Infections caused by Strongyloides venezuelensis have a local immune response in both lungs as in the intestine, predominantly from the Th2 type, characterized by the production of cytokines IL-4, IL-5, IL-13 and IL-10, resulting in eosinophilia, increased production of mucus, mastocytosis and high levels of IgE. In addition, infections caused by mycobacteria stimulate predominantly an Th1-type immune response characterized by the production of IFN-, IL-12, TNF- and nitric oxide. Tuberculosis, caused by intracellular pathogen Mycobacterium tuberculosis, is one of the most important infectious diseases, accounting for approximately 2.9 million deaths and 8 million new cases per year. Are still scarce papers involving co-infections, and because of the complex relationship between parasites and between them and their host, it is necessary criterious evaluations. This study evaluated the modulatory effect that the virulent Mycobacterium bovis has on the immune response of mice co-infected with S. venezuelensis. The results showed that the profile of immune response during infection with S. venezuelensis seems to be directly influenced by the presence of M. bovis, because the profile of Th2 response, specific to the worm, was reduced in co-infected animals. This decline could be observed by increasing the number of eggs and worms in animals co-infected when compared with animals infected only with S. venezuelensis, as well as decreased levels of IgE specific to the L3 larvae of the worm detected at different points of infection, decreased levels of IL-10 produced by spleen cells stimulated in vitro with L3 larvae antigen; decreased levels of IL-4, IL-5 and IL-13 in the intestine, reducing the expression of CD80, CD86 and CD25 cells in the spleen and lymph nodes and increased expression of CD28 cells in mesenteric lymph nodes. Together, these results suggest that infection with M. bovis, and the consequent activation of the profile of Th1-type immune response, was able to modulate the development of the profile of Th2 type of immune response against S. venezuelensis in co-infected animals, leaving them more susceptible to infection with S. venezuelensis. This work is the first to evaluate the mechanisms involved in imunoregulatory mechanisms involved in co-infection S. venezuelensis versus M. bovis.

Infection is a leading cause of death in hemodialysis patients, partly due to dysfunctional immunity. Frequent dialysis therapy improves patient outcomes and quality of life. We hypothesize that extended home hemodialysis (EHHD) also improves immune function compared to conventional in-hospital hemodialysis (CHD); therefore, we designed a prospective matching-cohort clinical study to assess serum inflammatory markers and the functional capacity of monocyte-derived dendritic cells (MDDCs) and T-lymphocytes. Serum CRP was decreased in EHHD patients suggesting that extended dialysis may decrease inflammatory solute/cytokine levels. Compared to controls, MDDCs from hemodialysis patients had similar endocytic capacity, expression of co-stimulatory molecules, and T-cell activation capacity. However, CHD was associated with the highest expression of CD83 and CD40. Activated T-cells in CHD patients also produced significantly more immunosuppressive IL-10 compared to EHHD patients and controls. Therefore, EHHD may improve immune function by decreasing inflammation, MDDC pre-activation, and synthesis of immunosuppressive cytokines.

Streptococcus suis est un important pathogène porcin et agent zoonotique responsable de méningites et de septicémies. À ce jour, les mécanismes impliqués dans la réponse immunitaire de l’hôte lors de l’infection par S. suis sont peu connus; et il en est de même pour les stratégies utilisées par S. suis afin de déjouer cette réponse. L’augmentation de l’incidence et de la sévérité des cas humains souligne le besoin d’une meilleure compréhension des interactions entre S. suis et le système immunitaire afin de générer une réponse immunitaire efficace contre ce pathogène. Les cellules dendritiques (DCs) sont de puissantes cellules présentatrices d’antigènes qui stimulent les lymphocytes T et B, assurant la liaison entre l’immunité innée et l’immunité adaptative. L’objectif principal de ce projet était d’évaluer le rôle joué par différents facteurs de virulence de S. suis sur la modulation de la fonction des DCs et de la réponse T-dépendante. Nous avons examiné l’effet des facteurs clés pour la virulence de S. suis, dont la capsule polysaccharidique (CPS), les modifications de la paroi cellulaire (D-alanylation de l’acide lipotéichoïque et N-déacétylation du peptidoglycane) et la toxine suilysine, sur l’activation et la maturation de DCs murines dérivées de la moelle osseuse (bmDCs). Suite à l’infection par S. suis, les bmDCs sont activées et subissent un processus de maturation caractérisé par l’augmentation de l’expression de molécules de co-stimulation et la production de cytokines pro-inflammatoires. La CPS est le principal facteur interférant avec la production de cytokines, même si les modifications de la paroi cellulaire et la suilysine peuvent également moduler la production de certaines cytokines. Enfin, la CPS, les modifications de la paroi cellulaire et la suilysine interfèrent avec la déposition du complément à la surface des bactéries et, en conséquence, avec le « killing » dépendant du complément. Les résultats ont été confirmés à l’aide de bmDCs porcines. Nous avons aussi voulu identifier les récepteurs cellulaires impliqués dans la reconnaissance de S. suis par les DCs. Nous avons démontré que la production de cytokines et l’expression des molécules de co-stimulation par les DCs sont fortement dépendantes de la signalisation par MyD88, suggérant que les DCs reconnaissent S. suis et deviennent activées majoritairement via la signalisation par les récepteurs de type Toll (TLRs). En effet, on remarque une diminution de la production de plusieurs cytokines ainsi que de l’expression de certaines molécules de co-stimulation chez les DCs TLR2-/- ou TLR2-/- et TLR9-/- double négatives. Finalement, le récepteur NOD2 semblait jouer un rôle partiel dans l’activation des DCs suite à une infection par S. suis.Enfin, nous avons évalué les conséquences de la modulation des fonctions des DCs sur le développement de la réponse T-dépendante. Les splénocytes totaux produisent plusieurs cytokines en réponse à S. suis. Des analyses in vivo et ex vivo ont permis d’observer l’implication des cellules T CD4+ et le développement d’une réponse de type « T helper » 1 (TH1) bien que la quantité de cytokines TH1 produites lors de l’infection in vivo par S. suis demeure assez basse. La CPS de S. suis interfère avec la production de plusieurs cytokines par les cellules T in vitro. Expérimentalement, l’infection induite par S. suis résulte en de faibles niveaux de production d’anticorps anti-S. suis, mais aussi d’anticorps dirigés contre l’ovalbumine utilisée comme antigène rapporteur. Cette interférence est corrélée avec la sévérité des signes cliniques, suggérant que S. suis interfère avec le développement d’une réponse immunitaire adaptative appropriée qui serait requise pour contrôler la progression de l’infection. Les résultats de cette étude mèneront à une meilleure compréhension de la réponse immunitaire de l’hôte lors de l’infection par S. suis. / Streptococcus suis is an important swine pathogen and an emerging zoonotic agent of septicemia and meningitis. Knowledge of host immune responses towards S. suis, and strategies used by this pathogen for subversion of these responses is scarce. Increased severity of S. suis infections in humans underscores the critical need to better understand the interactions between S. suis and the immune system to generate an effective immune response against this pathogen. Dendritic cells (DCs) are powerful antigen-presenting cells. Once activated, they stimulate T cells and B cells, linking innate and adaptive immunity. Thus, the main objective of this project was to evaluate the role of different S. suis virulence factors on the modulation of DC functions and the T cell-dependent response. Initially, we investigated the effect of S. suis key virulence factors, including the capsular polysaccharide (CPS), the cell wall modifications (D-alanylation of the lipoteichoic acid and N-deacetylation of the peptidoglycan) and the toxin suilysin, on the activation and maturation of mouse bone-marrow derived DCs (bmDCs). We observed that following S. suis infection, bmDCs are activated and go through a complex maturation process characterized by the up-regulation of the surface expression of costimulatory molecules and the production of pro-inflammatory cytokines. The CPS is the main virulence factor interfering with cytokine production, even if cell wall modifications and suilysin can also modulate the production of cytokines. Finally, CPS, cell wall modifications and suilysin were shown to interfere with complement deposition on S. suis, and consequently with complement-dependent killing. Results were confirmed using porcine bmDCs. We also aimed to identify the cellular receptors involved in S. suis recognition by DCs. Production of cytokines and expression of co-stimulatory molecules by DCs were shown to strongly rely on MyD88-dependent signaling pathways, suggesting that DCs recognize S. suis and become activated mostly through Toll-like receptor (TLR) signaling. Supporting this fact, TLR2-/- or double negative TLR2-/- and TLR9-/- DCs were severely impaired in the release of several cytokines and the surface expression of certain costimulatory molecules. In addition, NOD2 receptor also seems to play a partial role in DC activation by S. suis. Finally, we evaluated the consequences of the modulation of DC functions on T cell activation. In response to S. suis infection, total splenocytes readily produced several cytokines ex vivo. Ex vivo and in vivo analysis revealed the involvement of CD4+ T cells and development of a T helper 1 (TH1) response. Nevertheless, levels of TH1-derived cytokines during S. suis infection were very low. The bacterial CPS was shown to interfere with the release of several T cell-derived cytokines in vitro. As a consequence, a clinical infection resulted in low levels of not only anti-S. suis antibodies but also of those directed against ovalbumin, used as reported antigen. This interference was correlated with the presence of severe clinical signs of S. suis disease. These data suggest that S. suis impairs the development of an efficient adaptive immune response, which is required to control the infection progress. Overall, these results will permit a better comprehension of the host immune response during S. suis infection.