O carcinoma epidermóide de cabeça e pescoço (CECP) representa 6ª malignidade mais comum no mundo. Para melhor entender os mecanismos envolvidos na iniciação tumoral, progressão e metástase, é necessária a elucidação dos eventos moleculares que guiam esses processos. É também importante a investigação da interação e modulação das células tumorais e seu microambiente. A participação de agentes inflamatórios no desenvolvimento e manutenção do CECP pode ser resumida na superexpressão da cicloxigenase 2 (COX-2) e na secreção de prostaglandina E2 (PGE2) pelas células tumorais. A PGE2 ativa seus receptores EP1-4 que são ligados a proteínas G. As proteínas G ativam outras vias de sinalização responsáveis por processos celulares como proliferação e angiogênese. Embora a participação do EP2 no câncer de cólon seja bem estabelecida, o papel dos receptores de PGE2 no CECP ainda permanece incerto. Este trabalho teve como objetivo avaliar o papel da PGE2 e de seus receptores na proliferação celular em linhagens celulares de CECP, bem como a expressão dos receptores em tissue microarrays de CECP. Inicialmente as linhagens de CECP foram utilizadas para analisar o padrão de expressão da COX-2 e dos receptores EP1-4 por meio da técnica de western blotting. A inibição da secreção da PGE2 pelos inibidores de COX-2 foi mensurada por meio da técnica de ELISA. A expressão dos receptores EP1-3 e da COX-2 foi também avaliada por meio da imuno-histoquímica em dois diferentes tissue microarray. A fim de esclarecer a indução da proliferação celular pela PGE2 e de apontar um de seus receptores como responsável pelo processo, duas PGE2 sintéticas, um antagonista do EP2 e um antagonista do EP3 foram utilizados para estimular a proliferação celular. Foi realizado o bloqueio do receptor EP2 por meio da interferência de RNA. Seus efeitos sobre a proliferação foram avaliados por meio do ensaio de incorporação de timidina. Os resultados mostraram que o CECP expressa constitutivamente a COX-2, o EP1, o EP2 e o EP3; e que é capaz de secretar PGE2. Os inibidores de COX-2 inibiram a secreção de PGE2 em baixas concentrações, mas não foram capazes de inibir a proliferação. A COX-2 e os receptores EP1-3 foram amplamente expressos nos tissue microarrays. Foi observada correlação entre EP1 e EP2; EP1 e EP3; e EP2 e EP3 (p<0,05). Somente o EP1 mostrou correlação com a COX-2 (p<0,05). A PGE2 induziu a proliferação por meio da indução da síntese de DNA nas linhagens celulares de CECP. O agonista de EP3 também induziu a síntese de DNA, sugerindo sua participação na proliferação dos CECPs. Os efeitos do siRNA para EP2 sobre a síntese de DNA não foram conclusivos. As proteínas ativadas por segundos mensageiros do EP2 também não foram afetadas pelo bloqueio do mesmo. Este estudo indica três importantes achados: 1. a PGE2 é secretada por linhagens de CECP; 2. a COX-2 é superexpressa nos CECPs; 3. os receptores de PGE2 são constitutivamente expressos nos CECPs. No entanto, esse trabalho mostra que esta via inflamatória parece ser independente aos mecanismos indutores da proliferação nos CECPs. / Head and neck squamous cell carcinoma (HNSCC) is the 6th most common malignant lesion worldwide. To better understand the mechanisms of tumor initiation, progression, and metastasis a better understanding of the molecular networks that guides these process is needed. Towards this goal, it is important to investigate the interaction and modulation of cancer cells over its surrounding microenvironment. The involvement of inflammatory agents in HNSCC development and maintenance can be resumed in the overexpression of cycloxygenase 2 (COX-2) and secretion of prostaglandin E2 (PGE2) by tumor cells. Prostaglandin E2 activates its receptors EP1-4 which are coupled to G proteins. G protein activates other pathways responsible for cellular processes such as proliferation and angiogenesis. The participation of EP2 in colon cancer is well established however the role of PGE2 receptors in HNSCC is still poorly understood. This work aims to investigate the role of PGE2 and its receptors in cellular proliferation in HNSCC cell lines and the clinical relevant expression pattern in HNSCC tissue microarrays. HNSCC cell lines were initially used to access the expression pattern of COX-2 and EP1-4 by using western blotting technique. The ability of selective COX-2 inhibition to block PGE2 secretion was measured by ELISA antibody specific assay. Also, EP1, EP2, EP3 and COX-2 expression were evaluated by immuno-histochemistry in two different sets of HNSCC tissue microarrays. To address the question about PGE2 inducted cell proliferation and which PGE2 receptor are involved in the process, two synthetic PGE2, an EP2 agonist and an EP3 agonist were used to stimulate cell proliferation. Finally, the knockdown of EP2 receptor was performed by siRNA transfection assay and its effect was evaluated in cell proliferation by radioactive thymidine incorporation assay. The results presented here shows that HNSCC constitutively express COX-2, EP1, EP2 and EP3 and that they are able to secret PGE2. COX-2 selective inhibitors are able to suppress PGE2 secretion in lower concentrations but not to inhibit cell proliferation. Also, COX-2, EP1, E2 and EP3 are widely expressed in HNSCC tissue microarrays. A correlation between EP1 and EP2; EP1 and EP3; and EP2 and EP3 (p<0.05) was observed. Only EP1 showed correlation with COX-2 in tissue microarrays (p<0,05). PGE2 was able to induce cell proliferation as it induces DNA synthesis in HNSCC cell lines. EP3 agonist also induced DNA synthesis addressing its role in cell proliferation induction in HNSCC. The siRNA for EP2 effects in DNA synthesis was not conclusive and the downstream proteins activated by EP2 second messenger were not affected following its expression knockdown. This study indicates three important findings. First, PGE2 is secreted by HNSCC. Second, COX-2 is found to be overexpressed in HNSCC; and third, PGE2 receptors are found to be constitutively expressed in HNSCC. Most interesting, we show here that this inflammatory pathway seems to be independent of the mechanisms that induce HNSCC proliferation.

No description available.

En dépit du nombre croissant d’études cliniques sur le canal artériel (CA), des failles méthodologiques entretiennent plusieurs incertitudes concernant l’efficacité et la sécurité des traitements chez les bébés nés prématurés. L’objectif de cette recherche était de comparer les concentrations de prostaglandine E2 (PGE2) et les mesures du flux mésentérique par échographie Doppler chez les enfants nés prématurément et ayant un canal artériel traité à l’ibuprofène par voie intraveineuse ou entérale, en utilisant la méthodologie randomisée contrôlée et à double insu. Dans notre étude pilote, 20 nouveau-nés prématurés de moins de 34 semaines ayant un CA symptomatique confirmé par échocardiographie, furent randomisés au traitement à l’ibuprofène par voie intraveineuse ou entérale. La voie d’administration fut maintenue à l’insu de l’équipe traitante, des cardiologues et des investigateurs. Des dosages des prostaglandines plasmatiques ont été mesurés avant le début du traitement ainsi que 3, 24 et 48 h après le début du traitement. Les mesures du flux mésentérique ont été effectuées avant le traitement à l’ibuprofène ainsi que 1 h et 3 h après le traitement. Nous avons démontré à partir de nos observations que les niveaux plasmatiques de prostaglandines E2 diminuent chez les patients ayant répondu au traitement à l’ibuprofène, indépendamment de la voie d’administration. Nous n’avons pas observé de changement dans l’évolution des dosages de PGE2 chez les patients qui n’ont pas répondu au traitement. Les paramètres mesurés par échographie Doppler au niveau de l’artère mésentérique supérieure n’étaient pas affectés par la voie d’administration du traitement à l’ibuprofène, intraveineuse ou entérale. La présente étude suggère ainsi que le traitement du CA par ibuprofène intraveineux ou entéral n’influe pas sur le flux sanguin mesuré par échographie Doppler. La baisse de la prostaglandine E2 coïncide avec la fermeture du CA, et son dosage pourrait jouer un rôle dans la gestion du traitement. Nous avons démontré la faisabilité d’une étude clinique randomisée à double insu dans le traitement du canal artériel; une méthodologie qui devrait désormait être employé dans la recherche clinique sur les traitements de la persistance du CA. / Despite the growing body of research on the patent ductus arteriosus (PDA), issues with clinical research methodology impairs much of our understanding regarding treatment efficacy and safety in the preterm population. The purpose of this study was to determine plasma prostaglandin E2 (PGE2) concentrations in preterm infants with symptomatic persistence of the ductus arteriosus treated with IV and oral ibuprofen, and measure Doppler flow parameters in the superior mesenteric artery, utilizing randomized controlled and double-blind methodology. Twenty patients age < 34 wks with a symptomatic PDA confirmed by echocardiography randomized to oral vs intravenous ibuprofen regimen. Treating physician, cardiologists and study investigators were blinded to treatment allocation. Plasma PGE2 levels were measured prior to ibuprofen treatment and at 3, 24 and 48 h after treatment. Mesenteric Doppler measurements were taken prior to ibuprofen treatment, and 1 h and 3 h after treatment. Our results showed that plasma PGE2 levels decreased over time in patients that exhibited ductal closure after IV or oral ibuprofen treatment; no time-dependent changes in PGE2 were seen in subjects that failed to respond to ibuprofen. Superior mesenteric artery Doppler flow measurements were not affected by ibuprofen treatment (IV or oral), regardless of efficacy on ductal closure and of PGE2 changes. We conclude that treatment with oral or intravenous ibuprofen does not impact on superior mesenteric artery blood flow measured by Doppler ultrasound. Decreases in plasma PGE2 concentrations coincide with ibuprofen efficacy, and may be more cost-effective to monitor than ultrasound. This study also demonstrated the successful use of double blinded randomized controlled research methodology, which should be more strictly applied in future clinical research on PDA treatment.

Le virus de l’hépatite C (VHC) est l’une des causes majeures de cirrhose du foie et de carcinome hépatocellulaire. Au courant de la première partie de ma thèse, nous nous sommes intéressés à caractériser plus en détail le rôle de SR-BI dans l’infection par le VHC. Bien que les mécanismes impliquant SR-BI dans la liaison du virus à l’hépatocyte aient été partiellement caractérisés, le rôle de SR-BI dans les étapes suivant la liaison du VHC reste encore largement méconnu. Afin de mieux caractériser le rôle de l’interaction VHC/SR-BI dans l’infection par le VHC, notre laboratoire à généré une nouvelle classe d’anticorps monoclonaux anti-SR-BI inhibant l’infection virale. Nous avons pu démontrer que SR-BI humain jouait un rôle dans le processus d’entrée du virus à la fois lorsde l’étape de liaison du virus à la cellule hôte mais aussi au cours d’étapes suivant cette liaison. Ainsi il serait intéressant de cibler cette fonction de SR-BI dans le cadre d’une stratégie antivirale pour lutter contre l’infection parle VHC. Dans la seconde partie de ma thèse, nous avions pour but de caractériser les mécanismes moléculaires intervenant dans la réinfection du greffon lors de la transplantation hépatique (TH). Nous avons ainsi identifiés 3 mutations adaptatives dans la glycoprotéine d’enveloppe E2 responsables de l’entrée virale augmentée du variant hautement infectieux. Ces mutations influent sur la dépendance au récepteur CD81 du VHC résultant en une entrée virale accrue. L’identification de ces mécanismes va nous permettre une meilleure compréhension de la pathogénèse de l’infection par le VHC, et est un premier pas pour le développement d’une stratégie préventive antivirale ou vaccinale. / Hepatitis C virus (HCV) is a major cause of liver cirrhosis and hepatocellular carcinoma. In the first part of my PhD, we aimed to further characterize the role of scavenger receptor class B type I (SR-BI) in HCV infection. While the SR-BI determinants involved in HCV binding have been partially characterized, the post-binding function of SR-BI remains remained largely unknown. To further explore the role of HCV-SR-BI interaction during HCV infection, we generated a novel class of anti-SR-BI monoclonal antibodies inhibiting HCV infection. We demonstrated that human SR-BI plays a dual role in the HCV entry process during both binding and post-binding steps. Targeting the post-binding function of SR-BI thus represents an interesting antiviral strategy against HCV infection. In the second part of my PhD, we aimed to characterize the molecular mechanisms underlying HCV re-infection of the graft after liver transplantation (LT). We identified threeadaptive mutations in envelope glycoprotein E2 mediating enhanced entry and evasion of a highly infectious escape variant. These mutations markedly modulated CD81 receptor dependency resulting in enhanced viral entry. The identification of these mechanisms advances our understanding of the pathogenesis of HCV infection and paves the way for the development of novel antiviral strategies and vaccines.

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2013-11-06T14:31:55Z No. of bitstreams: 1 Jaqueline Franca Costa Aspectos imunopatogênicos da leishmaniose cutanêa...pdf: 1509776 bytes, checksum: 2d3824cc711f84d908e61378ac3d4a8c (MD5) / Made available in DSpace on 2013-11-06T14:31:55Z (GMT). No. of bitstreams: 1 Jaqueline Franca Costa Aspectos imunopatogênicos da leishmaniose cutanêa...pdf: 1509776 bytes, checksum: 2d3824cc711f84d908e61378ac3d4a8c (MD5) Previous issue date: 2013 / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / A progressão crônica da LCD é atribuída à falta da imunidade mediada por células específica para antígeno de Leishmania e predominância de uma resposta do tipo Th2. Neste sentido, tanto fatores do parasita quanto do hospedeiro podem atuar na desativação da resposta imune favorecendo a replicação da Leishmania. Inicialmente avaliamos o papel da exposição de fosfatidilserina na infecção de macrófagos murinos com Leishmania amazonensis isolados de pacientes com LCD. Para isso, macrófagos peritoneais de camundongos F1(BALB/c x C57BL/6) foram infectados com os diferentes isolados obtidos de pacientes com LCD e LCL. Os isolados obtidos de pacientes com LCD apresentaram maior expressão de PS do que os isolados de pacientes com LCL após 24 horas de infecção. Em seguida, avaliamos a infectividade dos diferentes isolados. As amastigotas de pacientes com LCD apresentaram maior porcentagem de macrófagos infectados e índice de infecção, quando comparados com amastigotas de pacientes com LCL. Quanto ao mecanismo, o grupo infectado com os isolados de pacientes com LCD apresentou um aumento na relação TGF-β/TNF-α e IL-10/TNF-α em relação ao grupo LCL. A análise de correlação revelou que a porcentagem de macrófagos infectados, o índice de infecção, os índices de TGF-β/TNF-α e IL-10/TNF-α, bem como o tamanho dos vacúolos estão diretamente associados a maior exposição de PS. Além disso, o número de lesões e o tempo de doença dos pacientes com LCD também estão associados á exposição de PS. O reconhecimento de PS tem como consequência a produção de TGF, IL-10, IL-4 e PGE2, que ativam a via da enzima arginase e consequentemente a produção de poliaminas. Por isso buscamos investigar a participação de tais mediadores em pacientes com LCD. Os níveis da arginase I, ODC e TGF-β no plasma de pacientes com LCD estava elevados quando comparado com os pacientes com LCL ou o controle saudável da área endêmica. Por outro lado, os níveis de TNF-α, IL-12, MCP-1 e CXCL-10 estavam reduzidos no plasma de pacientes com LCD comparado aos pacientes com LCL. Os níveis de arginase apresentaram correlação positiva com ODC, TGF-β e PGE e correlação negativa com TNF-α, IL-12, MCP-1 e CXCL-10. A produção da arginase e ODC também foi avaliada nas lesões dos pacientes através de imunohistoquímica. As lesões dos pacientes com LCD apresentaram uma marcação mais intensa e difusa do que as de LCL. Além disso, a expressão da cicloxigenase 2 também estava aumentada nas lesões de LCD. A expressão do mRNA das enzimas fosfolipase A2, COX-2, prostaglandina sintase, espermina e espermidina sintase apresentaram uma relação positiva com a enzima arginase, indicando que esta interfere diretamente no metabolismo dos mediadores lipídicos e na via de síntese das poliaminas. A inibição das enzimas arginase e ODC com nor-NOHA e DFMO, respectivamente, reduziu a carga parasitária de macrófagos humanos infectados com L. amazonensis após 72 h de infecção. Além disso, os inibidores reduziram a produção de TGF e PGE2 no sobrenadante das culturas. Em conjunto, nossos dados sugerem que a liberação local e sistêmica de prostaglandinas e poliaminas associadas à via da arginase em pacientes com LCD deve estar associada com a inabilidade em montar uma resposta imune eficiente contra a infecção por Leishmania proporcionando um ambiente favorável para a replicação do parasita e disseminação da doença. Nossos resultados mostram também que este ambiente imunossuprimido pode ser induzido pela exposição de PS na superfície de L. amazonensis deflagrando uma resposta anti-inflamatória nos pacientes com LCD. / The chronic progression of DCL is attributed to the lack of specific cell-mediated immunity to Leishmania antigen and predominance of a Th2-type response. In this sense, both factors of the parasite and the host can act in the deactivation of immune response, favoring parasite replication. Initially we evaluate the role of phosphatidylserine exposure in murine macrophages infected with L. amazonensis isolated from patients with DCL. First, peritoneal macrophages of mice F1 (BALB/c x C57BL/6) were infected with different isolates from patients with DCL and LCL. The DCL isolates showed higher PS expression than the LCL isolates after 24 hours of infection.. The DCL-amastigotes patients showed a higher percentage of infected macrophages and the infectivity index when compared with patients with LCL- amastigotes. Regarding the mechanism, the group infected with isolates from patients with LCD showed an increase in TGF/TNF and IL-10/TNF when compared with LCL group. Correlation analysis revealed that the percentage of infected macrophages, the infectivity index, the rate of TGF/TNF and IL-10/TNF as well as the size of the vacuoles are directly associated with higher PS exposure. Moreover, the number of lesions and disease duration of DCL patients are also associated with PS exposure. Recognition of PS results in the production of TGF, IL-10, IL-4 and PGE2, molecules with anti-inflammatory role that activate the enzyme arginase and consequently the polyamines production. Therefore, we investigated the involvement of these mediators in patients with DCL. The plasma of DCL patients showed high levels of arginase, ODC and TGF compared to the LCL patients or healthy control from endemic area. On the other hand, the levels of TNF, IL-12, MCP-1 and CXCL-10 were reduced in the DCL patients plasma compared to patients with LCL. Arginase levels were positively correlated with ODC, TGF and PGE and negatively correlated with TNF, IL-12, MCP-1 and CXCL-10. The production of arginase and ODC was also evaluated in the lesions of patients by immunohistochemistry. The DCL lesions showed a more intense and diffuse staining than LCL lesions. Furthermore, the expression of cyclooxygenase-2 was also increased in lesions of DCL. The mRNA expression of the enzymes phospholipase A2, COX-2, prostaglandin synthase, spermine synthase and spermidine synthase showed a positive relationship with the arginase enzyme, indicating that it directly interferes with the metabolism of lipid mediators and in synthesis of polyamines. The inhibition of the enzyme arginase and ODC with nor-NOHA and DFMO, respectively, reduced the parasite load of L. amazonensis human infected macrophages 72 h after infection. Moreover, NOHA and DFMO reduced TGF and PGE2 production in the supernatant of cultures. Together, local and systemic release of prostaglandins, arginase and polyamines pathways in DCL should be associated with the inability of these patients to mount effective immune response against infection by Leishmania providing a favorable environment for replication and spread of the parasite disease. Our results also show that this immunosuppressed environment can be induced by PS exposure on the L. amazonensis surface triggering anti-inflammatory response in DCL patients.

Diese Arbeit verdeutlicht die Wirkung von Chondroitinsulfat auf die Synthese von Prostaglandin E2 in humanen mesenchymalen Stromazellen in Abhängigkeit ihres Sulfatierungsgrades. MSC zeichnen sich durch ihre antiinflammatorischen Eigenschaften aus und haben damit einen modulierenden Effekt auf Wundheilungsprozesse. Als Vorläuferzellen von Osteoblasten sind sie direkt an der Knochenneubildung beteiligt. Eine persistierende Entzündung hat eine kontinuierliche Freisetzung von Zytokinen, wie IL-1 zur Folge. Es konnte gezeigt werden, dass IL-1 in hMSC zu einer Freisetzung von PGE2 führt. Unter kurzzeitiger Wirkung stimuliert PGE2 die Knochenneubildung. Eine langanhaltende Präsenz leitet dagegen die Bildung des Faktors RANKL, einen die Osteoklastogenese stimulierenden Faktor, ein. Seit langem ist der positive Effekt von Chondroitinsulfat in chronischen Entzündungsprozessen, wie Rheumatoider Arthritis, bekannt. Zudem werden sie in aktuellen Studien als Beschichtungsbestandteile von Knochenimplantaten verwendet. Sie führten hier zu einer besseren Bioinduktivität und Biokonduktivität. Bisher ist dennoch der molekulare Wirkmechanismus nicht genau beschrieben. Die Schwierigkeit besteht darin, dass die molekularen Signalkaskaden für die einzelnen Kulturmoldelle Unterschiede aufweisen und kein ubiquitärer Mechanismus dargestellt wird. In hMSC führte die Stimulation mit IL-1 unter vorheriger Zugabe von Chondroitinsulfat zu einer Reduktion der PGE2 Freisetzung. Der Effekt des hochsulfatierten sCS3 war gegenüber dem nativen C4S verstärkt. Die reduzierende Wirkung von C4S setzte verzögert ein. Es ist bereits bekannt, dass die negative Ladung der CS zu einer Bindung von Zytokinen führt. Dadurch wird eventuell die Konzentration der Zytokine, wie IL-1 im Bereich der Zellrezeptoren erniedrigt und führt zu einer verringerten Stimulation der Zelle. Denkbar ist auch die Beeinflussung der intrazellulären Signaltransduktionskaskade durch die Bindung der CS an einen speziellen, bisher unbekannten, Membranrezeptor. Die entscheidenden Enzyme der PGE2 Synthese sind die Cyclooxygenase-2 (Cox-2) und die mikrosomale Prostaglandin E Synthase 1 (mPGES1). Die mRNA beider Enzyme war unabhängig vom Sulfatierungsgrad der CS reduziert. Dieser Effekt konnte auf Protein-ebene nicht belegt werden. Die produzierte Proteinmenge an mPGES1 wird durch IL-1 induziert, bleibt aber auch durch Zugabe von CS unverändert. Somit kann von einer erhöhten Translationseffizient und mRNA Stabilität der mPGES1 RNA ausgegangen werden. MAPK Kinasen sind entscheidende Schnittstellen bei der Regulation der mRNA Stabilität als auch der Aktivität von Transkriptionsfaktoren. In dieser Studie konnte die MAPK p38 als entscheidendes Enzym bei der Wirkung von CS auf die PGE2 Synthese ermittelt werden. Dabei führten sowohl das natürliche C4S als auch das hochsulfatierte sCS3 zu einer verringerten Aktivierung. Der Transkriptionsfaktor NfkB ist einer von mehreren, die an den Promotorbereichen der beiden induzierbaren PGE2 Enzyme, Cox-2 und mPGES1, binden. Es ist anzunehmen, dass die hier aufgezeigte verringerte Aktivität von NfkB als auch die verhinderte Translokation in den Zellkern eine reduzierte Transkription der jeweiligen mRNA bedingten. Abhängig vom untersuchten Modell und den verwendeten Kulturbedingungen können diese Prozesse moduliert sein. Die Erkenntnisse dieser experimentellen Arbeit liefern einen weiteren wichtigen Baustein zum Verständnis der molekularbiologischen Abläufe während entzündlicher Prozesse. Die Verwendung von Chondroitinsulfat, insbesondere hochsulfatiertes CS, in Kombination mit hMSC kann gezielt zu einer Verringerung der Entzündungsreaktion während der Implantateinheilung führen. Die durch PGE2 hervorgerufenen Symptome, wie erhöhte Gefäßpermeabilität, Schwellung und verstärktes Schmerzempfinden begründen diese positiven Effekte.

Die Ausbildung und der Schweregrad einer Anaphylaxie kann durch verschiedene Co-Faktoren beeinflusst werden. Zu diesen zählen die nichtsteroidalen Antiphlogistika (NSAIDs), die ihre Wirkung über die Inhibition der COX entfalten. Wie NSAIDs den Schweregrad der Anaphylaxie beeinflussen, ist bisher nicht genau bekannt. Interessanterweise zeigen Anaphylaxie-Patienten mit einer NSAID-Hypersensibilität niedrige Konzentrationen des regulatorischen Prostaglandins E2 (PGE2). Zudem zeigen ASA-tolerante und –intolerante Asthma-Patienten variable anaphylaktische Sensitivitäten. Anhand der vorliegenden Arbeit sollte untersucht werden, ob sich eine PGE2-Dysregulation auf die Ausbildung und den Schweregrad der Anaphylaxie auswirkt und ob diese durch genetische Prädispositionen gefördert werden kann. Dazu wurden zunächst die PGE2 Konzentration im Serum von ANA-Patienten und gesunden Individuen gemessen. ANA-Patienten zeigten reduzierte PGE2 Level, die invers mit dem Schweregrad der ANA korrelierten. Unterstützend weisen zwei in der Allergieforschung häufig verwendete Mauslinien, Balb/c und C57BL/6, unterschiedliche PGE2 Level auf, die wiederum invers mit dem ANA-Schweregrad korrelierten. Eine Stabilisierung der PGE2 Konzentration mittels eines pharmakologischen Inhibitors der Hydroxyprostaglandin-Dehydrogenase (15-PGDH-I) in vivo führte zu einer Verbesserung des ANA Schweregrades. Um in diesem Zusammenhang den Einfluss von ASA und PGE2 besser zu verstehen, wurde das Model der systemisch passiven ANA im Mausmodel eingesetzt. ASA verschlimmerte den Schweregrad der ANA durch die Inhibition der COX1/2. PGE2 konnte diese Verschlimmerung über die EP Rezeptoren 2, 3 und 4 reduzieren. Um die zugrundeliegenden Mechanismen der Wirkweise von exogenem PGE2 und EP-Agonisten besser zu verstehen, wurden diese Zusammenhänge in murinen und humanen Mastzellen untersucht. PGE2 reduzierte die Schwere der ANA durch Inhibition der Mastzell-Aktivität in diesem System über die Rezeptoren EP2 und EP4. Anhand der vorliegenden Arbeit konnte gezeigt werden, dass bereits homöostatische PGE2 Konzentrationen die Aktivität der Mastzelle verändern und vor einer schweren ANA schützen. Zudem kann der Grad der ANA und der Einfluss des PGE2 auf die Mastzellantwort durch genetische Prädisposition beeinflusst werden. Die pharmakologische Stabilisierung des PGE2 könnte daher eine vielversprechende, therapeutische wie auch vorbeugende Strategie zur Behandlung risikoreicher ANA- Patienten sein. / The clinical outcome of anaphylaxis (ANA) can be affected by several co-factors. Non-steroidal anti-inflammatory drugs (NSAIDs) are well-known co-factors of ANA acting via COX-inhibition. The NSAIDs-mediated mechanisms altering the severity of ANA are not well-defined. It is reported that patients of ASA (NSAID)-hypersensitivity show low levels of the regulatory prostaglandin E2 (PGE2). Moreover, the effectiveness of PGE2 administration in such patients suggests a critical role of PGE2 in ASA hypersensitivity. In addition, patients of ASA-tolerant and ASA-intolerant asthma show variable ANA sensitivities suggesting a role of genetic variation in susceptibility. The aim of this thesis was to study whether and how PGE2 dysregulation predisposes to ANA and whether genetic pre-dispositions affect the PGE2 system and therefore ANA susceptibility. First, sera from ANA patients and healthy individuals were analyzed for PGE2 levels. ANA patients were characterized by reduced PGE2 levels which inversely correlated with the severity of ANA. This disparity was confirmed by differential PGE2 levels between Balb/c and BL/6 strains, two genetic mouse strains frequently employed in allergy research. PGE2 levels in these mice were again inversely related with the severity of ANA. Results were confirmed by in vivo PGE2 stabilization using 15-hydroxyprostaglandin dehydrogenase inhibitor (15-PGDH-I). Pharmacological PGE2 stabilization ameliorated ANA severity in mice. A passive systemic ANA (PSA) model was applied to study the impact of ASA on ANA severity and the role of PGE2 in this context. ASA aggravated ANA by inhibiting COX-1/COX-2, while PGE2 reduced the aggravation through EP receptors 2, 3 and 4. To delineate the underlying mechanisms, murine and human mast cells were used to study the impact of exogenous PGE2 and EP agonists. PGE2 attenuated ANA severity by inhibiting MC activation through EP2 and EP4 receptors and interfering with MC signaling. In summary, this thesis demonstrates that homeostatic levels of PGE2 modulate MC activation and protect against ANA severity. The impact of PGE2 on MC responses and ANA susceptibility is governed by genetic variation. Pharmacological stabilization of PGE2 may prove to be a therapeutic or preventive strategy in the management of high-risk ANA patients.

Background: Low-grade chronic inflammation has been implicated as a risk factor in prostate-related pathologies including benign hyperplasia and cancer. Sweet cherry containing the bioactive anthocyanin (ACN), has demonstrated tumor inhibitory action in model systems, specifically inhibition of inflammatory molecules and prostaglandin biosynthesis. Objective: To assess the urinary and plasma concentrations of ACN from the daily consumption of 3 cups of sweet cherries for 4 weeks and test the relationship of ACN levels and cherry consumption to inflammatory biomarkers in an at risk population. Results: Prostaglandin E2 Metabolite (PGEM) levels were reduced with cherry consumption in men with elevated baseline values. Conclusion: We conclude that 1c (142g) of sweet cherries 3 times daily for 4 weeks significantly reduced the COX-2 metabolite, PGEM, in men with elevated baseline levels. This was the first study to examine the chronic effects of daily sweet cherries on COX-2 inhibition in an at risk population.

HCV infects 170 million persons worldwide and is a serious global health problem. Genotype-3a is the dominant genotype in newly diagnosed infections within the UK and has a high response rate to interferon therapy, with up to 70% patients achieving a sustained virological response (SVR). The reason(s) for this are unknown; therefore the aim was to assess host and viral factors that determine treatment outcome of subtype-3a infection. Full-length subtype-3a viral sequence analysis identified 2 novel regions of hypervariability within E2 - HVR495 and HVR575, that are subject to positive selection pressure. A 5 amino-acid insertion found only in subtype-3a and a putative glycosylation site were contained within HVR575. These data suggest that HVR495 and HVR575 may serve as major antigenic sites in subtype-3a HCV infection. Successful treatment of chronic subtype-3a infection was not associated with pre-treatment quasispecies diversity and complexity, PePHD, HVR495 or HVR575 sequence. Different patterns of quasispecies variation were observed in patients that failed treatment. Subtype-3a specific CD8+ T-cell responses in chronic infection target non-structural proteins, in contrast to pre-dominant genotype-1 core-specific CD4+ T-cell responses. SVR was associated with a decline in subtype-3a specific and non-specific T-cell responses, and also total lymphocyte counts, which all recovered after treatment. These data do not support the theory that clearance of subtype-3a is associated with an enhancement of antiviral T-cell responses. Overlapping peptides detected a greater number of subtype-3a T-cell responses compared with peptides representing putative predicted CD8 epitopes. Therefore subtype-3a HCV is distinct from genotype-1 in terms of genome sequence, effect of treatment on quasispecies and subtype-3a specific T-cell responses, further emphasising the importance in understanding this distinct subtype.

L’arthrose (OA) est une maladie dégénérative et multifactorielle caractérisée par une destruction de cartilage, une formation d’ostéophytes et une inflammation au niveau de la membrane synoviale. Le 4-hydroxynonénal (HNE), un produit final de la peroxydation lipidique, a été identifié récemment comme un facteur catabolique et un médiateur inflammatoire dans le cartilage arthrosique humain. Notre projet vise à étudier l’effet du HNE sur la régulation de la prostaglandine E2 synthase-1 microsomale (mPGES-1) et de la protéine activante 5-lipoxygénase (FLAP)/5-lipoxygénase (5-LOX) dans les chondrocytes arthrosiques humains. Lorsque les cellules sont traitées une seule fois avec 10 µM HNE, les résultats de Western blot et de PCR en temps réel montrent que l’expression de la cyclooxygénase-2 (COX-2) et de la mPGES-1 augmente de manière significative et atteint respectivement le maximum après 8 et 16 heures d’incubation puis diminue graduellement. Cependant, lorsque les cellules sont traitées plusieurs fois avec 10 µM HNE à 2 heures d’intervalle, l’expression de la COX-2 et de la mPGES-1 augmente en fonction du temps sans subir une baisse après 24 heures d’incubation. Le HNE induit l’activité du promoteur de la mPGES-1 via l’activation du facteur de transcription Egr-1. L’investigation de la 2ème voie du métabolisme de l’acide arachidonique, à savoir 5-LOX/FLAP, montre que le HNE induit l’expression de FLAP après 24 heures de stimulation et celle de 5-LOX seulement après 48 heures. Ceci semble survenir à l’étape de transcription au cours de laquelle HNE induit l’expression de l’ARNm et l’activité du promoteur du gène 5-LOX. Nous avons démontré aussi que le niveau de leukotriène B4 (LTB4) augmente et suit le même profil que celui de la 5-LOX. L’étude des mécanismes moléculaires susceptibles d’être impliqués dans la régulation de la 5-LOX/FLAP par le HNE montre que ce dernier stimule leur expression via l’action de prostaglandine E2 (PGE2) et du facteur de croissance transformant-beta 1 (TGF-β1). En conclusion, notre étude démontre que le HNE induit à court-terme d’incubation la voie de COX-2/mPGES-1 puis par la suite stimule celle de FLAP/5-LOX à long-terme d’incubation dans les chondrocytes arthrosiques humains. Ces résultats suggèrent que la mPGES-1 et 5-LOX/FLAP sont des potentielles cibles thérapeutiques intéressantes pour contrôler la production de PGE2 et LTB4 dans OA. / 4-hydroxynonenal (HNE), a lipid peroxidation end-product, is produced abundantly in osteoarthritic (OA) articular tissues. Recently, we reported that HNE-induced cyclooxygenase-2 (COX-2) decreased gradually in human OA chondrocytes after 8 h of incubation. This study aimed to investigate whether COX-2 down-regulation is attributed to HNE depletion and is responsible for the switch from COX-2 to 5-lipoxygenase-activating protein (FLAP)/5-lipoxygenase (5-LOX). Treatment of chondrocytes with 10 µM HNE induced prostaglandin E2 (PGE2) release as well as COX-2 and microsomal prostaglandin E2 synthase-1 (mPGES-1) expression at the protein and mRNA levels, with a plateau reached at 8-16 h of incubation, followed by a subsequent decline. However, 8 repeated treatments with 10 µM HNE prevented the reduction of COX-2 and mPGES-1 expression. We demonstrated that HNE induced mPGES-1 promoter activity mainly through transcription factor Egr-1 activation. On the other hand, when COX-2 expression decreased, leukotriene B4 (LTB4) level rose after a long period of stimulation (48 and 72 h). At the mRNA level, HNE induced FLAP and 5-LOX expression after 24 and 48 h of stimulation, respectively. The addition of a nonspecific COX-2 inhibitor (naproxen) to cultured chondrocytes revealed that FLAP and 5-LOX regulation by HNE required PGE2 production. Furthermore, our data showed that 10 µM HNE significantly induced transforming growth factor-beta 1 (TGF-β1) production. The addition of anti-TGF-β antibody to culture medium reduced HNE-induced 5-LOX/FLAP expression by 40%, indicating the involvement of a TGF-β1-dependent mechanism. Our data demonstrate that the shunt to the FLAP/5-LOX pathway in HNE-induced human OA chondrocytes is attributed to COX-2 inhibition, probably due to HNE depletion. PGE2 and TGF-β1 are suggested to be involved in this regulation. Further experiments are in progress to determine other molecular mechanisms underlying this switch in OA chondrocytes.