Une des stratégies pour limiter les neutropénies induites par la chimiothérapie est l’utilisation de granulocyte-colony stimulating factor (G-CSF). Nous avons développé, par une approche de population, un nouveau modèle pharmacocinétique/pharmacodynamique capable de décrire la cinétique des neutrophiles des patients traités au carboplatine, qu’ils aient ou non reçu du G-CSF. Les simulations réalisées à partir de ce modèle ont montré que le G-CSF n’était pas bénéfique chez tous les patients et que la formulation à action longue semblerait plus efficace que les autres formulations. Nous avons également établi des règles de décision permettant d’une part de prédire le risque de neutropénie sévère, et d’autre part d’identifier précocement les patients pour lesquels le G-CSF peut avoir un effet bénéfique. / Granulocyte colony-stimulating factor (G-CSF) is often used in cancer patients receiving cytotoxic drugs to prevent or reduce high grade neutropenia. We developed a new population pharmacokinetic/pharmacodynamic model to describe neutrophil time-course in carboplatin-treated patients, whether or not they received G-CSF. Model simulations showed that G-CSF was not as beneficial as expected in some patients and that the onceper- cycle formulation was more efficient than other formulations. Model-based decision rules were also built to anticipate prolonged high grade neutropenia and early identify patients for whom G-CSF was beneficial.

L’immunologie de la reproduction englobe les principes de l’immunologie générale et les aspects spécifiques de la reproduction et du développement. Les Colony Stimulating Factors (CSFs) sont une illustration de l'application médicale de ce domaine. Dans la famille des CSFs, le Granulocyte-Colony Stimulating Factor (G-CSF) apparaît aujourd'hui comme une thérapie innovante dans divers cas d'échec de la reproduction, bien que ses cibles et ses effets ne soient pas encore clairement établis. Dans ce travail, à travers une revue sur les CSFs dans la reproduction, une étude consacrée aux gènes cibles du G-CSF dans l'endomètre humain, et une étude consacrée aux effets de la supplémentation systémique en G-CSF sur l’implantation embryonnaire murine, nous avons essayé d'approcher certains mécanismes d'action possibles pour cette cytokine. Dans les modèles murins fertiles et pro-abortifs, la supplémentation systémique en G-CSF, ciblant spécifiquement l’endomètre préimplantatoire, modifie les taux d’implantation embryonnaire. Dans l’endomètre humain, certaines dérégulations préimplantatoires de gènes cibles du G-CSF ont également été observées chez les patients infertiles. L'influence du G-CSF sur ces gènes cibles a été également illustrée dans un modèle ex-vivo de culture endométriale. Ces cibles dont l’expression est influencée par le G-CSF sont décrites comme des molécules clés dans le processus implantatoire, intervenant sur l’adhésion embryonnaire, la migration cellulaire, le remodelage des tissus et l'angiogenèse locale. Ces données suggèrent des possibilités de diagnostic préventif et pré-conceptionnel de certains échecs de reproduction, considérés jusqu’à maintenant comme idiopathiques, et de thérapies innovantes orientées, afin d’optimiser la réceptivité du biosenseur endométrial afin de permettre une implantation embryonnaire harmonieuse et une grossesse évolutive. / Reproductive Immunology involves general immunology principles and special aspects of reproduction and development. Colony Stimulating Factors (CSFs) are an illustration of the medical application of this domain. In the CSF family, Granulocyte-Colony Stimulating Factor (G-CSF) appears today as a promising therapy in various cases of reproductive failure although its targets and effects are not clearly established. In this work, through a review on CSFs in reproduction, a study dedicated to human endometrial targets of G-CSF, and a study dedicated to systemic G-CSF supplementation effects on murine embryo implantation, we tried to approach some possible mechanisms of action of this cytokine. In the considered non-abortive and abortion-prone murine models, the timed systemic G-CSF supplementation, targeting specifically the pre implantation endometrium, influenced the embryo implantation process. Some pre conceptual human endometrial dysregulations of G-CSF target genes were also observed in infertile patients. The endometrial influence of G-CSF on these target genes was also illustrated in an ex-vivo model. These molecules under G-CSF influence are described as critically involved in embryo implantation process, by influencing embryo adhesion, cell migration, tissue remodelling and angiogenesis. These data suggest possible pre-conceptual preventive diagnosis of such reproductive failures and future orientated therapies to optimise the endometrial biosensor and the further embryo implantation and ongoing pregnancy.

The formation of the mRNP complex is a critical component of translational regulation and mRNA decay. Both the 5 ' and 3 ' UTRs of CSF-1 mRNA are involved in post-transcriptional regulation. In CSF-1 mRNA, a small hairpin loop structure is predicted to form at the extreme 5 ' end (2-21 nt) of the 5 ' UTR. Nucleolin binds the hairpin loop structure in the 5 ' UTR of CSF-1 mRNA and enhances translation, while removal of this hairpin loop nucleolin binding element dramatically represses translation. Thus in CSF-1 mRNA, the hairpin loop nucleolin binding element is critical for translational regulation. In addition, nucleolin interacts with the 3 ' UTR of CSF-1 mRNA and facilitates the miRISC formation which results in poly (A) tail shortening. The overexpression of nucleolin increases the association of CSF-1 mRNA containing short poly (A)(n), <= 26, with polyribosomes. Nucleolin both forms an mRNP complex with the eIF4G and CSF-1 mRNA, and is co-localized with the eIF4G in the cytoplasm further supporting nucleolin's role in translational regulation. The distinct foci formation of nucleolin in the cytoplasm of ovarian and breast cancer cells implicates the translational promoting role of nucleolin in these cancers.

In under a century, melioidosis, the infection due to Burkholderia pseudomallei, has emerged from Whitmore’s series of glanders-like infections amongst the morphia addicts in Burma to a major cause of mortality in northeastern Thailand and northern Australia. Also endemic in other parts of south-east Asia, melioidosis may have varied presentations ranging from severe, overwhelming infection to chronic, low grade disease. Observational evidence had suggested that granulocyte colony stimulating factor (G-CSF), a naturally occurring substance produced by the body in response to infection, may have been useful in reducing the high mortality associated with the more severe forms of this infection. Other observations linked the occurrence of this disease to various environmental factors, such as contamination of drinking water and the annual rainfall. This thesis explores and attempts to quantify these associations. There are three parts to this thesis. In the first part, I reviewed the epidemiology and management of patients with melioidosis. The use of G-CSF and meropenem was associated with a fall in mortality, although other factors may have at least partially contributed to this effect. In the second part, I progressed towards a clinical trial of G-CSF. There was no other evidence supporting the use of G-CSF in severe sepsis and ethical issues precluded a trial in Darwin. There was not evidence from laboratory models of G-CSF action in melioidosis to support the use of G-CSF in patients, although there remained some doubt regarding the applicability of such models to human disease. I examined clinical methods to identify patients at high risk of death from melioidosis. A simple scoring system based on clinical and laboratory parameters was developed and externally validated. However, clinical definitions of severe sepsis appeared to be better predictors of mortality. A clinical trial based on clinical definitions was commenced in Thailand. In the final part, I explored the question of whether different strains or B. pseudomallei or different environmental conditions caused different patterns of infection. There was no evidence that strain types of this bacterium determine the pattern or severity of disease, but weather conditions appeared to influence the distribution of disease in northern Australia.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a multipotent cytokine involved in the production and function of hematopoietic cells, and GM-CSF plays in particular a major role in responses to infection and physiological and pathological inflammatory processes. GM-CSF is produced in many cell types, and increases in the intracellular Ca2+ concentration are, like in many other systems, of major importance in the intracellular signaling that determines GM-CSF expression after receptor stimulation of the cells. Previous studies have shown that the Ca2+/calmodulin-dependent phosphatase calcineurin (CN) mediates stimulation of GM-CSF transcription in response to Ca2+. This thesis shows that Ca2+ signaling also regulates GM-CSF transcription negatively through Ca2+/calmodulin-dependent kinase II (CaMK II) phosphorylation of serines in the autoinhibitory domain for DNA binding of the transcription factor Ets1. Mutation of the CaMK II target serines increased transactivation of the GM-CSF promoter/enhancer and decreased the sensitivity to inhibition by increased Ca2+ or constitutively active CaMK II. The Ca2+-dependent phosphorylation of Ets1 was also shown to reduce the binding of Ets1 to the GM-CSF promoter in vivo. RUNX1, also known as acute myeloid leukemia 1 (AML1), is one of three mammalian RUNX transcription factors and has many essential functions in hematopoiesis. RUNX1 has also many important roles in the immune system, and RUNX1 is the most frequent target for chromosomal translocation of genes in acute human leukemias. This thesis shows that RUNX1 directly interacts with both subunits of CN and that the strongest interaction is localised to the regulatory CN subunit and the DNA binding domain of the RUNX protein. Constitutively active CN was shown to activate the promoter/enhancer of GM-CSF synergistically with RUNX1, RUNX2 or RUNX3, and the Ets1 binding site of the promoter was shown to be essential for the synergy between RUNX1 and CN in Jurkat T cells. The analysis suggests that Ets1 phosphorylated by the protein kinase glycogen synthase kinase-3β is the target of RUNX1-recruited CN phosphatase at the GM-CSF promoter. Transforming growth factor-β (TGF-β) is another multipotent cytokine that often has a role opposite to that of GM-CSF in inflammatory responses since it is a potent suppressor of immune cells and therefore is anti-inflammatory. This thesis shows that TGF-β can decrease transcription from a GM-CSF promoter/enhancer. Certain constitutively active TGF-β receptors and the TGF-β activated transcription factor Smad3 could also repress GM-CSF transcription, whereas several other Smad proteins did not have this inhibitory effect. The inhibition required intact DNA binding ability of Smad3, and the 125 bp upstream of the transcription initiation site, which was sufficient for the inhibition, contains several weak Smad binding sites near the TATA box next to an Ets1 site of the promoter. Smad3 was able to bind to the promoter DNA together with Ets1 and could also be in complex with Ets1 in the absence of DNA. Surface plasmon resonance analysis revealed that Ets1 interacted with the DNA binding domain of Smad3, and the binding constant of this interaction was about 1 µM. The results identify a negative regulation of the GM-CSF promoter by TGF-β signaling through direct Smad3 binding and indicate that the mechanism is by Smad3 interaction with Ets1 and perhaps other proteins around the TATA box of the promoter. This thesis also identifies a novel transactivation domain in the N-terminal of RUNX1 including the N-terminal α-helix in the DNA binding domain. The domain was also required for RUNX2 and RUNX3 transactivation. Despite this, the N-terminal domain of RUNX1 was not essential for RUNX1 function in megakaryocytopoiesis in vitro from mouse embryonic stem cells.

Typescript (Photocopy) / Bibliography: leaves 170-198. / xx, 198 leaves, 1 leaf of col. plates : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Medicine, 1991

Bibliography: leaves 175-203. / xxix, 203 leaves, [14] leaves of plates : ill. (some col.) ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Investigates whether cytokines influence the development of the embryo prior to implantation. / Thesis (Ph.D.)--University of Adelaide, Depts. of Obstetrics and Gynaecology and Microbiology and Immunology, 1993

Diss. (sammanfattning) Umeå : Univ., 2008. / Härtill 4 uppsatser.

Thesis (Ph. D.)--University of Missouri--Columbia, 2005. / "May 2005." Typescript. Vita. Includes bibliographical references (leaves 139-157). Also issued on the Internet.

Submitted by Priscila Nascimento (pnascimento@icict.fiocruz.br) on 2013-03-22T14:03:31Z No. of bitstreams: 1 Tulio_Queto.pdf: 43727261 bytes, checksum: 24d32a6a536f42194f28e8e2b42a6fe1 (MD5) / Made available in DSpace on 2013-03-22T14:03:31Z (GMT). No. of bitstreams: 1 Tulio_Queto.pdf: 43727261 bytes, checksum: 24d32a6a536f42194f28e8e2b42a6fe1 (MD5) Previous issue date: 2011 / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil. / A provocação por via respiratória com ovalbumina (OVA) em camundongos sensibilizados promove, na medula óssea (MO), eosinopoiese, resposta exacerbada à Interleucina(IL)-5, e mudanças no padrão de resposta em cultura à eotaxina, à IL- 13 e aos antiinflamatórios não esteroidais (NSAIDs). Em cultura de MO, a Prostaglandina (PG) E2 induz apoptose de eosinófilos, por via dependente de NO sintase indutível (iNOS) e ligante de CD95 (CD95L), enquanto a dexametasona (DEXA) promove eosinopoiese, gerando eosinófilos agregados e morfológicamente imaturos e protege contra da apoptose induzida por PGE2, provavelmente por mecanismos que regulem a expressão ou ativação de integrinas. No presente trabalho avaliamos se: a) in vitro, os efeitos dos NSAIDs, da IL-13 e da eotaxina dependem da produção de cisteinil-leucotrienos (CisLT) e da sinalização via receptor 1 de CisLT (CysLT1R); b) in vitro, a DEXA regula expressão de VLA-4, que promoveria a agregação e imaturidade dos eosinófilos, e se PGE2 contrapõe a ação da DEXA; c) in vivo, G-CSF e dietilcarbamazina (DEC) promoveriam eosinopenia medular e sistemica e se inibiriam a inflamação pulmonar alérgica. Resultados: a) NSAIDs, eotaxina e IL-13 potencializam a eosinopoiese via produção de CisLT e sinalização via CysLT1R. Os NSAIDs ainda protegem os eosinófilos da apoptose induzida por PGE2 exógena. b) A interação farmacológica entre PGE2 e DEXA modificam a ação de ambas, de forma estreitamente relacionada sobre a expressão de VLA-4 e, em condições específicas, esses agentes sinergizam gerando quantidades aumentadas de eosinófilos maduros. c) A DEC, inibidor da síntese de LTs, que na filariose experimental possivelmente atua via iNOS, inibe a eosinopoiese e os efeitos da provocação sobre o pulmão e a MO, através da via iNOS-CD95L. O Fator Estimulante de Colônias de Granulócitos (G-CSF), estimulante da neutropoiese, igualmente inibiu a inflamação pulmonar alérgica através da inibição da eosinopoiese. Este trabalho é parte do projeto intitulado "Eosinofilia na Asma Experimental", licenciado pela Comissão de Ética no Uso de Animais (CEUA) da Fiocruz, sob nos L010/04 e L002/09. / Our laboratory has previously shown that airway allergen challenge in ovalbumin-sensitized mice rapidly induces an increase in bone-marrow (BM) eosinophil production (eosinopoiesis), along with an increased response to Interleukin(IL)-5 in BM culture, changes in the ex vivo responses to cytokines and immunomodulators, including nonsteroidal anti-inflammatory drugs (NSAIDs) and cysteinyl-leukotrienes (CysLT), and colonization of the lungs by eosinophil progenitors. Early in the course of IL-5-induced eosinophil differentiation in BM culture, Prostaglandin E2 (PGE2) induces apoptosis, through a pathway dependent on the inducible isoform of NO synthase (iNOS) and the ligand for CD95 (CD95L). NSAIDs enhance eosinopoiesis and protect eosinophils in this critical period from exogenous PGE2, through a novel mechanism of action at the celular level. In this study, we show that indomethacin and aspirin act through endogenously synthesized CysLT, by establishing the essential roles of 5-lipoxygenase, LTC4 synthase and CysLT1R receptors, as well as the cytoprotective effect of CysLT against exogenous PGE2. The similarity between the effects of NSAIDs and those of eotaxin and IL-13 prompted us to reevaluate the contribution of endogenous CysLT to the effects of these cytokines. We confirmed that eotaxin and IL-13 act through this mechanism, and expand therefore the list of agents that, through CysLT, enhance eosinopoiesis, protecting immature eosinophils from apoptosis induced through the iNOS-CD95L pathway. Dexamethasone promotes BM eosinopoiesis, generating aggregated, cytologically immature eosinophils, which are nevertheless protected from PGE2- induced apoptosis. We examined therefore the possibility that dexamethasone upregulates integrin expression/activation, thereby maintaining an immature celular phenotype in cultured eosinophils, while PGE2 would have opposite effects on both integrin function and cytological maturation. We show that the proapoptotic effects of PGE2 are profoundly modified by its pharmacological interaction with dexamethasone, paralleling the effects of both drugs on integrins, and leading to a synergic generation of increased numbers of mature eosinophils, in very specific experimental conditions. Diethylcarbamazine (DEC) is an antihelminthic drug that blocks leukotriene synthesis, and possibly acts in experimental filarial infection through iNOS. We have examined, for the first time, the effects of DEC in a model of allergic pulmonary inflammation, showing that DEC is very effective in preventing the impact of airway allergen challenge on BM and lungs, through the in vivo operation of the iNOS-CD95L pathway. Granulocyte Colony-stimulating Factor (G-CSF), which stimulates neutropoiesis, mobilizes CD34+ hemopoietic progenitors from BM, and exerts complex immunoregulatory effects, was shown in our study to have a strong impact in a murine model of allergic pulmonary inflammation. Like DEC, G-CSF suppressed BM eosinopoiesis, although through a different mechanism, since DEC suppressed neutrophilia in the lungs with no effect on BM neutrophilia/neutropoiesis, while G-CSF promoted neutropoiesis and induced blood neutrophilia, even though it suppressed eosinopoiesis. This work was part of the Research Project “Eosinophilia in Experimental Asthma”, licensed by the Committee on the Ethical Use of Laboratory Animals (CEUA) at FIOCRUZ, under numbers L010/04 and L002/09.