Individual-level models are a class of complex statistical models, often fitted within a Bayesian Markov chain Monte Carlo framework, that have been effectively used to model the spread of infectious diseases. The ability of these models to incorporate individual-level covariate information allows them to be highly flexible, and to account for such characteristics as population heterogeneity. However, these models can be subject to inherent uncertainties often found in infectious disease data. As well, their complex nature can lead to a significant computational expense when fitting these models to epidemic data, particularly for large populations. An individual-level model that incorporates a latent grouping structure into the modeling procedure, based on some heterogeneous population characteristics, is investigated. The dependence of this latent conditional individual-level model on a discrete latent grouping variable alleviates the need for explicit, although possibly unreliable, covariate information. A simulation study is used to assess the posterior predictive ability of this model, in comparison to individual-level models that utilize the full covariate information, or that assume population homogeneity. These models are also applied to data from the 2001 UK foot-and-mouth disease epidemic. When attempting to compare complex models fitted within the Bayesian framework, the identification of appropriate model selection tools would be beneficial. The use of deviance information criterion (DIC) as model comparison tool, particularly for the latent conditional individual-level models, is investigated. A simulation study is used to compare five variants of the DIC, and the ability of each DIC variant to select the true model is determined. Finally, an investigation into methods to reduce the computational burden associated with individual-level models is carried out, based on an individual-level model that also incorporates population heterogeneity through a discrete grouping variable. A simulation study is used to determine the effect of reducing the overall population size by aggregating the data into spatial clusters. Reparameterized individual-level models, accounting for the aggregation effect, are fitted to the aggregated data. The effect of data aggregation on the ability of two reparameterized individual-level models to identify a covariate effect, as well as on the computational expense of the model fitting procedure, is explored.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common disorders of childhood. It is theorized to be caused by catecholamine dysfunction in the striatum (Str) and frontal cortex (FC). The spontaneously hypertensive rat (SHR) has been used as a model for ADHD because of its attention deficits, impulsiveness, and hyperactivity. Prior studies of dopamine (DA) in the Str and FC have revealed conflicting results in the SHR compared to control, indicative of a need for a better understanding of DA dynamics in this model. In addition to the DA hypothesis, studies have begun implicating glutamate in the etiology of ADHD. Previous evaluations of the SHR model of ADHD found that the SHR have increased α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor activity and elevated calcium levels in the FC, suggesting that altered glutamatergic neurotransmission exists in the SHR. The first set of studies presented here suggest that increased surface expression of DA transporters may exist in the SHR model of ADHD, lowering basal DA levels. Second, we discovered that the glutamate system in the FC of the SHR model of ADHD is hyperfunctional, thus raising the possibility that targeting glutamate dysfunction in the FC could lead to the development of novel therapeutics for the treatment of ADHD. The third and fourth set of studies explored glutamate signaling in the awake rodent to fully understand glutamate neurotransmission as well as the effects of methylphenidate (MPH) on glutamate signaling in the prelimbic cortex, a region heavily implicated in ADHD. The SHR displayed similar phasic glutamate signaling compared to control; however, in the SHR but not the WKY control, chronic treatment with MPH lowered phasic glutamate amplitude. Additionally, intermediate treatment with MPH increased tonic glutamate in the SHR only, whereas chronic MPH treatment increased tonic levels in both the SHR and WKY compared to saline. Taken together, this body of work characterizes DA and glutamate signaling in the anesthetized SHR model of ADHD. Additionally, glutamate dynamics and the effects of the stimulant medication MPH were explored in the awake animal, providing evidence that glutamate is a likely target for future neuropharmacology for the treatment of ADHD.

PCSK9 est un régulateur clé du métabolisme du cholestérol par le foie à travers la dégradation lysosomiale du récepteur aux LDL (low-density lipoprotein). Alors que les mutations gain de fonction (GOF) de PCSK9 induisent une hypercholestérolémie autosomique dominante, les mutations pertes de fonctions (LOF) entraînent un taux spontanément bas de LDL-cholestérol, ainsi qu’un protection cardiovasculaire. Du fait des limitations inhérentes aux modèles d’études, tels que les lignées cellulaires transfectées ou des animaux transgéniques, les fonctions de PCSK9 restent encore mal connues. Ainsi, nous avons utiliser des cellules souches pluripotentes induites (hiPSC) spécifiques de patients pour les différencier en hépatocytes et modéliser la physiopathologie liée aux mutations de PCSK9 GOF-S127R et LOF-R104C/V114A. Nous avons démontré que les hépatocytes obtenus récapitulaient la physiopathologie liés aux mutations de PCSK9. De plus, les cellules portant la mutation S127R ont montré une importante réponse au traitement par les statines, qui est corrélée à la réponse clinique des patients portant cette même mutation. Enfin, notre étude nous a permis de mettre à jour une fonction inattendue de PCSK9 dans les hiPSC et pendant leur différenciation. Elle montre que PCSK9 affecterait la prolifération des hiPSC ainsi qu’une voie de signalisation clé du développement régulée par NODAL. Cette régulation se ferait à travers une interaction directe entre PCSK9 et DACT2, un régulateur intracellulaire de la voie de signalisation de NODAL. En conclusion, les hiPSC s’avèrent être un modèle cellulaire translationnel pertinent pour mettre à jour de nouvelles fonctions hépatiques de PCSK9. / PCSK9 has been identified as a key regulator of cholesterol metabolism by the liver through inducing lysosomal degradation of the low-density lipoprotein receptor (LDLR). While PCSK9 gain-of-function (GOF) mutations induced autosomal dominant hypercholesterolemia and increased cardiovascular risk, loss-of-function (LOF) mutations are associated with low LDL-cholesterol levels and cardiovascular protection. Due to limitations inherent to current models including animal and human cells lines transfected with DNA constructs or transgenic animal models, PCSK9 functions are not fully understood. Therefore, we took advantage of patient related somatic cells reprogramming intoinduced pluripotent stem cells (hiPSC) to generate hepatocyte-like cells (HLC) and model the pathophysiology of PCSK9 mutations in dyslipidemia through focusing on two intracellular mutation forms; GOF (S127R) and LOF (R104C/V114A). We showed that HLC could recapitulate the key pathophysiological features of PCSK9 mutations. Moreover, HLC with the S127R mutation displayed an increased uptake of LDL upon statin treatment, which was correlated with the original patient clinical response. In parallel, this model enabled us to unravel a new unexpected role of PCSK9 in hiPSC and during differentiation. PCSK9 was found to affect the proliferation of hiPSC and regulate a key developmental signaling pathway mediated by NODAL. This regulation might occur by a direct interaction between PCSK9 and DACT2, an intracellular attenuator of NODAL signaling pathway. In conclusion, hiPSC provide a pertinent translational model to decipher PCSK9 hepatic functions and a novel cellular environment to highlight new functions.

京都大学 / 0048 / 新制・課程博士 / 博士(医科学) / 甲第22699号 / 医科博第114号 / 新制||医科||8(附属図書館) / 京都大学大学院医学研究科医科学専攻 / (主査)教授 影山 龍一郎, 教授 妻木 範行, 教授 長船 健二 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Untreatable gonorrhea, caused by fully antimicrobial resistant Neisseria gonorrhoeae (GC), is a major global health threat. While a vaccine would greatly help address this crisis, development of a GC vaccine is complicated by the lack of lab models of symptomatic gonorrhea. We hypothesized that overt disease in animal models of gonorrhea is limited by the human-restriction of gonococcal virulence factors, and the impact of the reproductive hormone cycle (estrus and diestrus phases). We tested these hypotheses by examining the host response to infection in transgenic mice expressing targets of bacterial adhesion, human carcinoembryonic antigen-related cell adhesion molecules (hCEACAMs), in uterine versus vaginal infections, and in different phases of the reproductive cycle (estrus and diestrus phases). hCEACAM expression most impacted estrus phase infections, prolonging colonization in vaginal infection and inducing greater inflammation in uterine. Reproductive phase greatly influenced host response to uterine infection as diestrus infection was more inflammatory than estrus. Phase differences in uterine infection were driven by greater activation of a chemokine-centric common anti gonococcal response and unique induction of type 1 interferons in diestrus. These findings suggest that symptomatic uterine and vaginal GC infection can be modeled by transcervically infected wild-type diestrus mice and transgenic, vaginally-infected estrus mice, respectively. A novel approach to GC vaccine development is also needed. Mono-antigenic vaccines have failed to produce immunity suggesting a poly-antigenic antigen, like natural outer membrane vesicles (nOMVs) may be necessary. It has been shown that any GC vaccine must lack the bacterioprotective antigen, reduction modifiable protein (RMP), and no such nOMV has been previously described. Here we report successful isolation of RMP-deficient nOMVs through sequential size and weight restrictive filtration. Vesicle morphology, proteomics, and bioactivity was characterized via various methods. nOMVs were found to be consistent in size, shape and antigenic load. As antigens, nOMVs induced high serum titers and measurable vaginal levels of antigen and GC specific IgG that recognized several nOMV immunogens supporting the vaccine potential of GC nOMVs. These findings lay the groundwork for protective studies of nOMV vaccines in novel models of active gonorrhea moving the field closer to discovering the mechanism of protective anti-gonococcal immunity.

Final publication is available at http://www.cell.com/cell-stem-cell/abstract/S1934-5909(13)00012-X / 京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19622号 / 医博第4129号 / 新制||医||1015(附属図書館) / 32658 / 京都大学大学院医学研究科医学専攻 / (主査)教授 高橋 淳, 教授 伊佐 正, 教授 YOUSSEFIAN Shohab / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20788号 / 医博第4288号 / 新制||医||1025(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 髙橋 良輔, 教授 高橋 淳, 教授 山下 潤 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医科学) / 甲第21697号 / 医科博第101号 / 新制||医科||7(附属図書館) / 京都大学大学院医学研究科医科学専攻 / (主査)教授 妻木 範行, 教授 影山 龍一郎, 教授 松田 秀一 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

No description available.

Acute myeloid leukemia (AML) is a fatal cancer of the human hematopoietic system characterized by the rapid accumulation of non-functional, immature hematopoietic cells in the bone marrow (BM) and peripheral blood (PB) of affected patients. Limited sources of safe hematopoietic stem/progenitor cells (HSPCs) for transplantation and incomplete mechanistic understandings of disease initiation, progression and maintenance have impeded advances in therapy required for improvement of long-term AML patient survival rates. Toward addressing these unmet clinical needs, the ability to generate induced pluripotent stem cells (iPSCs) from human somatic cells may provide platforms from which to develop patient-specific (autologous) cell-based therapies and disease models. However, the ability to generate iPSCs from human AML patient somatic cells had not been investigated prior to this dissertation. Accordingly, I hypothesized that cellular reprogramming of human AML patient somatic cells to iPSCs is possible and will enable derivation of autologous sources of normal and dysfunctional hematopoietic progenitor cells (HPCs). I first postulated that reprogramming AML patient fibroblasts (AML Fibs) to pluripotency would provide a novel source of normal autologous HPCs. Our findings revealed that AML patient-specific iPSCs devoid of leukemia-associated aberrations found in the matched bone marrow (BM) could be generated from AML Fibs, and demonstrated that this cellular platform allowed for the derivation of healthy HPCs capable of normal differentiation to mature myeloid lineages in vitro. During the tenure of these experiments we also redefined conventional reprogramming methods by discovering that OCT4 transcription factor delivery combined with culture in pluripotent-supportive media was minimally sufficient to induce pluripotency in AML and normal Fibs. Toward capturing and modeling the molecular heterogeneity observed across human AML samples in vitro, we next asked whether reprogramming of AML patient leukemic cells would enable generation of iPSCs and derivative HPCs that recapitulated dysfunctional differentiation features of primary disease. Our results demonstrated that conventional reprogramming conditions were insufficient to induce pluripotency in leukemic cells, but that generation of AML iPSCs could be reproducibly achieved in one AML sample when reprogramming conditions were modified. These AML iPSCs and their derivative HPCs harboured and expressed the leukemia-associated aberration found in the BM leukemic cells and similarly possessed dysfunctional differentiation capacities. Together, this body of works provides the proof of principle that cellular reprogramming can be applied on a personalized basis to generate normal and dysfunctional HPCs from AML patient somatic cells. These foundational findings should motivate additional studies aimed at developing iPSC-based cell therapies and disease models toward improving AML patient quality of life and long-term survival rates. / Thesis / Doctor of Philosophy (PhD)