Introdução: Os anticorpos anticitoplasma de neutrófilos (ANCA) são classificados em três padrões observados na imunofluorescência indireta (IFI) utilizando neutrófilos humanos fixados em etanol e formaldeído como substrato. O c-ANCA apresenta forte associação com a enzima neutrofílica proteinase 3 (PR3), enquanto o p-ANCA está fortemente associado à mieloperoxidase (MPO). Na hepatite autoimune (HAI), colangite esclerosante primária (CEP) e doença inflamatória intestinal (DII) é observado outro padrão de IFI classificado como p-ANCA atípico que não apresenta reatividade contra as enzimas PR3 e MPO. Objetivo: Determinação da frequência dos diferentes padrões de ANCAs na CEP com ou sem DII concomitante (CEP/DII+, CEP/DII-), em três subtipos de hepatite autoimune (HAI-1 com anticorpo antimúsculo liso padrão tubular; HAI-2 com anticorpo antimicrossoma de fígado e rim tipo 1; HAI antiantígeno hepático solúvel/fígado e pâncreas, na colangite biliar primária (CBP) e em controles saudáveis. O anticorpo antinúcleo poderia estar presente em todos os subtipos. Os resultados dos ANCAs foram comparados com os do ELISA para verificação de concordância entre os padrões e as reatividades antigênicas. Metodologia: Foram estudados 249 pacientes (42 CEP/DII+; 33 CEP/DII-; 31 HAI-1; 30 HAI-2; 31 HAI-3; 52 CBP; 30 indivíduos saudáveis). As amostras de soro desses pacientes foram processadas pelos ensaios comerciais INOVA: ANCA Etanol, Quanta LiteTM MPO ELISA, Quanta LiteTMPR3 ELISA, Quanta LiteTM FAN HEp-2; e em lâminas com neutrófilos humanos fixados em etanol preparadas in house. Para as análises estatistícas foram utilizados os testes de Fisher com correção de Holm, os testes kappa e de McNemar. Resultados: O p-ANCA esteve presente em 4 (1,6%), o c-ANCA em 3 (1,2%), o p-ANCA atípico em 62 (24,9%), o c-ANCA atípico em dois (0,8%) e o padrão inconclusivo em 14 (5,6%) de 249 amostras testadas. O p-ANCA atípico foi mais frequentemente detectado na CEP/DII+ (52,4%; IC 95% = 37,7-66,6) em relação à CEP/DII- (21,2; IC 95% = 10,4-38,0), p=0,005. Não houve diferença significante na frequência do p-ANCA atípico na CEP/DII- em relação a CBP (15,38%, IC 95% = 7,83-27,89), p=0,501. O p-ANCA atípico foi significantemente mais positivo na HAI-1 (45,2%, IC 95% = 29,15-62,24, p < 0,001) e HAI-3 (32,3%, IC = 18,46-49,97, p=0,012) em comparação a HAI-2 (3,3%, IC 95% = 0-18,09). Não foi detectada diferença entre a HAI-1 e a HAI-3 (p=0,434). Ao considerarmos todos os padrões conjuntamente, persistiram as mesmas diferenças significantes entre a CEP/DII+ versus CEP/ DII- (p=0,037) e entre a HAI-2 versus HAI-1 (p=0,011) e versus HAI-3 (p=0,024). A reatividade do anti-PR3 foi encontrada em 25 das 249 amostras, sendo mais frequente na CEP/DII+ (31,0% IC 95%: 22,94 - 50,88) do que na CEP/ DII- (12,1%, IC 95%: 4,52-29,46, p = 0,025). Anticorpos anti-MPO foram identificados em oito de 249 amostras (3,2%). Das 25 amostras positivas para o anti-PR3 apenas uma apresentou c-ANCA; outras duas amostras positivas para o c-ANCA foram negativas para o anti-PR3. As oito amostras positivas para o anti-MPO não apresentaram reatividade para o p-ANCA e as quatro que tinham esse padrão não foram reativas para o anti-MPO. Entre as 62 amostras reativas para o p-ANCA atípico 49 não apresentaram reatividade para o anti-PR3 e anti-MPO. Das treze amostras positivas para o p-ANCA atípico e que exibiram reatividade ao ELISA, doze apresentaram positividade para o anti-PR3 e uma para o anti-MPO e para o anti-PR3. Conclusões: 1) Do ponto de vista de reatividade dos ANCAs e do anti-PR3 a CEP/DII+ teve comportamento diferente da CEP/ CEP/ DII - que que que que teve comportamento semelhante ao da CBP, o que pode sugerir que a maior frequência do p-ANCA atípico e do anti-PR3 esteja mais associada à DII do que à CEP; 2) Quanto à reatividade dos ANCAs, pacientes com HAI-1 e HAI-3 tiveram características semelhante entre si e diferente do da HAI-2; 3) Não houve concordância entre os resultados da IFI para os padrões c-ANCA e p-ANCA clássicos e os do ELISA anti-PR3 e anti-MPO; 4) A melhor concordância de leitura dos padrões do ANCA foi para o p-ANCA atípico, porque a maioria dos soros com esse padrão não teve reatividade nem para o anti-PR3 nem para o anti-MPO por ELISA; 5) Para doenças do aparelho digestivo (DII, CEP e HAI) é difícil relacionar os padrões do ANCA obtidos na imunofluorescência indireta com a reatividade observada nos ELISAs comerciais / Background: The antineutrophil cytoplasmic antibodies (ANCA) has 3 main subtypes according to the pattern observed by indirect immunofluorescence (IIF) on ethanol and formalin fixed human neutrophils. The cANCA has a strong association to a neutrophil enzyme proteinase 3 (PR3), while the classical pANCA has a strong association to myeloperoxidase (MPO), catepsin G, elastase, lactoferrin, lysozyme. Autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD), shows another pattern called atypical pANCA that does not react to the enzymes PR3 and MPO. Aims: Determine the frequency of different types of ANCA in PSC, with or without association to IBD (PSC/IBD+, PSC/IBD-); 3 AIH subtypes (AIH type 1, with antismooth muscle antibody (ASMA) with the tubular pattern and with or without antinuclear antibody (ANA); AIH type 2, with anti-LKM1 antibody; AIH anti-Soluble liver antigen/liver pancreas antigen (anti-SLA/LP), with or without ANA associated); primary biliary cholangites (CBP) and healthy controls. Methods: we studied 249 patients (42 PSC/IBD+; 33 PSC/IBD-; 31 AIH-1; 30 AIH-2; 31 HAI antiSLA/LP; 52 CBP; 30 healthy controls). The serum sample of these patients were processed with the INOVAÒ commercial kits: ANCA Etanol, Quanta LiteTM MPO ELISA, Quanta LiteTM PR3 ELISA, Quanta LiteTM FAN HEp-2; and human neutrophil slides ethanol fixed in house. Statistical analysis were performed using the Fisher Test, with Holm correction when nedeed, McNemar and Kappa Test. Results: The classical pANCA were present in 1.9% (IC 95%: 0 - 11.07) CBP patients and 7.1% (IC 95%: 1.77 - 19.7) of PSC/IBD+ patients. There were no statistical significance between groups. The atypical pANCA were identified in 62 out of 249 samples (24.9%). It were more frequently detected in PSC/IBD+ (52.4%, IC 95%: 37.72-66.6) then in PSC/IBD- (21.2%, IC 95%: 10.38 - 38.05), p = 0.005. The Fisher test did not show statistical significance between PSC/IBD+ and CBP for atypical pANCA reactivity (21.2%, IC 95%: 10.38-38.05 versus 15.4%, IC 95%: 7.74 - 27.79), p = 0.56. However, there was statistical significance for atypical pANCA between AIH subtypes, p < 0,001. Among AIH subtypes, the atypical pANCA were more frequent in AIH-1 than in AIH-2 (45.2%, IC 95%: 29.15 - 62.24 versus 3.3%, IC 95%: 0 - 18.09, p < 0.001) and more frequent in AIH-3 than in AIH-2 (32.3%, IC 95%: 18.46-49.97 versus.3.3%, IC 95%: 0 - 18.09, p = 0.012). There were no statistical diference between AIH-1 e a AIH-3 (p = 0.434).None of the 30 healthy controls showed the atypical pANCA pattern. The classical cANCA were present in just 3 of 249 patient samples (1.2%), 1 CBP, 1 PSC/IBD+ and 1 AIH-1. The atypical cANCA is rarely described in the literature. We identified just 2 samples with the atypical cANCA of 249 samples (0.8%), one PSC/IBD+ patient and another AIH-2 patient. 14 out of 249 samples (5.6%), showed a positive fluorescence on ethanol fixed slides, even though we couldn\'t define a ANCA pattern because of the ANA interference. However, the Fisher test did not show a statistical significance between the studied groups (among AIH subtypes, p= 0.207 and PSC/IBD+ versus PSC/IBD-, p = 0.945). Antibodies against proteinase-3, that is considered the classical cANCA target, we detected 25 out of 249 samples (10.0%). The anti-PR3 were more frequent in PSC/IBD+ (31.0%, IC 95%: 22.94-50.88) than in PSC/IBD- (12.1%, IC 95%:4.52-29.46), p = 0,025. Antibodies against antimyeloperoxidase, one of the target antigens of the classical pANCA, were identified in 8 out of 249 samples (3.2%). The overall ELISA results, adding the anti-PR3 and anti-MPO, show that this autoantibodies were more frequent in PSC among the other groups, mainly PSC/IBD+ (p= 0.002). It is worth mentioning that PSC/IBD+ 2 patients showed simultaneously anti-PR3 and anti-MPO reactivity. If we consider atypical pANCA as atypical pANCA by IIF and negative ELISA (anti-MPO and anti-PR3), 49 out of 249 samples (19.7%), The Fisher test showed a difference statistical significance in atypical pANCA IIF+/ELISA- between PSC/IBD+ (35.7%, IC 95%: 22.94 - 50.88) and PSC/IBD- (12.1%, IC 95%:4.21 - 27.93), p = 0,018. The Fisher test did not show significant difference between PSC/IBD- and CBP (13.5%, IC 95%: 6.37 - 25.58), p = 1. The same test showed statistical significance reactivity of ANCA IIF+/ELISA- among AIH subtypes (p=0,001), been more frequent in AIH-1 then in AIH-2 (p = 0.001) and among AIH-3 versus AIH-2 (p = 0.025). There was no statistical difference among AIH-1 versus AIH-3, p = 0,426. Conclusion:SC/IBD+ had a different serological pattern compared with PSC/IBD-, since atypical p-ANCA and anti-PR3 antibodies were significantly more frequent in the former. According to the ANCA profile, PSC/IBD- had a similar behavior to PBC which may suggest that atypical p-ANCA and anti-PR3 antibodies are more associated with IBD than with PSC. Patients with ASMA AIH and with anti-SLA/LP had higher frequency of atypical p-ANCA than anti-LKM1 AIH; There was no concordance between the results of indirect immunofluorescence and those of ELISA. Then, the results of ANCA by immunofluorescence are completely observer-dependent

A hantavirose (infecção por Hantavírus) é uma das zoonoses que vem preocupando as autoridades sanitárias de todo o mundo. Sua ocorrência se deve principalmente os distúrbios ecológicos é transmitida ao homem através de inalação de partículas virais contida na excreta de roedores. São conhecidas duas doenças humanas distintas causadas pelo Hantavírus: a Febre Hemorrágica com Síndrome Renal (FHSR) e a Síndrome Pulmonar e Cardiovascular (SPCVH). O objetivo deste estudo foi verificar a ocorrência de anticorpos IgG anti-hantavírus, através do ELISA, em populações da Amazônia e Sudeste brasileiro, que vivem em contato com os roedores silvestres, utilizando a proteína recombinante do vírus Araraquara expressa em Escherichia coli. Do total de estudados 1308 soros humanos estudados, na Amazônia (1078) encontramos 59 soros positivos (5%). Na cidade Machadinho do OesteRO os soros coletados durante o ano 2003, foram analisados 638, onde foram encontrados 20 soros positivos (4,5%); e no Rio Machado RO. foram analisados 435 soros da população ribeirinha onde foram encontrados 39 (5%) soros positivos, respectivamente. Após análise realizada em 151 soros humanos provenientes do Vale do Ribeira, em 2007; e 84 no Pontal do Paranapanema, em 2008, foram observados 14 positivos (9%) e 6 (7%) das amostras, respectivamente. / The genus Hantavirus of the family Bunyaviridae includes a large number of rodent-borne viruses that are distributed worldwide. The occurrence is due mainly to ecological disturbances and it is transmitted to the humans through inhalation of virus particles contained in the excreta of wild rodents. Two different human diseases known to be caused by Hantavirus: are Hemorrhagic Fever with Renal Syndrome (HFRS) and Hantavirus Cardiopulmonary Syndrome (HPS). The main objective of this study was detected antibody against hanatavirus (IgG) by ELISA, in Amazon region and Brazilian Southwest populations who live in contact with the wild rodents, using recombinant protein (antigen) of the Araraquara virus expressed in Escherichia coli. We study 1308 human sera (1078 from Amazon region) and there were found 59 (5%) positive sera. From the city of Machadinho do Oeste RO (2003 year), 633 sera were analysed, where there were found to be 20 positive (4.5%) serums. In Machado river RO (2005 year), 435 sera of the river-dwelling population were analysed where there were found 39 (5%) positive sera, respectively. After analysis was accomplished for 151 human sera coming from the Vale do Ribeira - SP, in 2007, and 84 from the Pontal do Paranapanema - SP, in 2008, 14 (9%) and 6 (7%) of the samples were observed to be positive, respectively.

A Escherichia coli enteropatogênica (EPEC) é um dos principais agentes etiológicos da diarréia infecciosa tanto em crianças no primeiro ano de vida, como em adultos. As infecções por EPEC são prevalentes nos países em desenvolvimento, principalmente nas populações de baixo nível sócio-econômico, como as encontradas no Brasil. A resposta imune na infecção por EPEC permanece pobremente caracterizada. O uso das novas tecnologias no desenvolvimento de vacinas vem reforçar à importância de se levar em consideração a via natural de infecção do patógeno e utilizá-la como tema de estudo, quando se pretende estudar a resposta imune a um determinado agente infeccioso. O objetivo deste trabalho foi efetuar o estudo da resposta imune em animais inoculados com bactérias vivas ou mortas, por meio de diferentes vias de imunização. As bactérias em estudo foram: a cepa de E. coli O86:H34 e a cepa protótipo de E. coli O127:H6. A cepa de E. coli pertencente ao sorotipo O86:H34 foi isolada de fezes de crianças com diarréia. Foram empregadas as cepas : E2348/69, DH5&#945; e as mutantes E2348/69 flic-, E2348/69 &#916;tir, E2348/69 EscN-, CVD 206 &#916;eaeA, UMD 872 &#916;EspA, UMD 864 &#916;EspB, UMD 870 &#916;EspD. No presente estudo os camundongos BALB/c foram inoculados pela via intragástrica com a cepa de E. coli O86:H34 viva ou cepas O86:H34 e O127:H6 mortas por formol, que foram utilizadas nas imunizações pela via intragástrica e pela via intramuscular. Por meio de ELISA foram determinados os níveis de anticorpos específicos dos isotipos IgG, IgA e IgM, assim como o direcionamento da resposta imune para importantes antígenos que participam do mecanismo de patogenicidade da bactéria. De acordo com o perfil de reatividade no Immunoblot foi avaliada a especificidade dos anticorpos presentes nos soros imunes obtidos, frente aos antígenos de \"whole cells\" ou complexo de membrana externa bacteriana, empregados na técnica de \"immunoblotting\". A resposta imune a proteínas, como EspA, EspB, Tir, intimina, flagelos e BFP observada em camundongos, tem um importante papel no esclarecimento da infecção por este patógeno .Pela primeira vez foi realizado um estudo utilizando diferentes vias de imunização por EPEC em camundongos. Este estudo permitiu a análise de antígenos de E. coli reconhecidos pelos anticorpos produzidos pelas inoculações de bactérias vivas ou mortas por meio de vias intragástrica e intramuscular em camundongos, em comparação com aqueles reconhecidos na infecção natural ou experimental humana. Por conseguinte, os dados obtidos poderão auxiliar no esclarecimento desse complexo mecanismo de patogenicidade e orientar na seleção de peptídeos a serem utilizados no preparo de produtos vacinais específicos. / Enteropathogenic Escherichia coli is one of the major ethiologic agent that causes infectious diarrhoea in both infants and adults individuals. EPEC infections are prevalent in developing countries, mainly in low social-economic populations, as those found in Brazil. The immune response of this infection is still insufficiently known. Use of new technologies in the development of vaccines has been reinforced the importance of taking in account the natural route of infeccion of pathogens and use of it in investigation on immune response to be elicited against a certain to infectious agent. The aim of the present investigation was to study the immune response in mice inoculated with dead or alive bacteria, by means of diverse immunization routes. E. coli O86:H34 strain and E. coli O127:H6 prototype were employed for immunization. E. coli strain belonging to O86:H34 serotype was isolated from faeces from infants with diarrhoea. The strains: E2348/69, DH5 &#945; and the mutants strains E2348/69 flic-, E2348/69 &#916;tir, E2348/69 EscN-, CVD 206 &#916;eaeA, UMD 872 &#916;EspA, UMD 874 &#916;EspB, UMD 870 &#916;EspD were employed. BALB/c mice were inoculated by intragastric route with alive E. coli O86:H34 strain or formalin-killed O86:H34 and O127:H6 strains intragastric and intramuscular immunization routes. The specific antibodies of isotypes IgA, IgG and IgM were determinated by means of ELISA and the course of the immune response for important antigens that participate in the patogenicity mechanism of bacteria could be analysed. By means of reactivity profile on immunobloting, the specificity of antibodies present in obtained sera against whole cells or the outer membrane complex of the bacteria were analysed. Immune response to proteins like EspA, EspB, Tir, intimin, flagelin and BFP in immunized mice may have an important meaning for elucidation of infection in this pathogen At the first time a research using different routes of immunization with EPEC strains in mice has been conducted. This study allowed to compare antigens from E. coli recognized in natural or experimental human infection, and consequentently these data may help in the elucidation of this complex mechanism of pathogenicity, and also to orientate the selection of peptides to be used in preparation of specific vaccines.

Das Monozyten chemotaktische Protein-1 (MCP-1) ist ein CC-Chemokin, das in seiner Rolle als Chemoattraktor auf Monozyten in der Genese von Malignomen eine wesentliche Rolle spielt. Dabei kann es sowohl zur lokalen Tumorabwehr als auch zur Tumorgenese, Tumor-angiogenese und Metastasierung beitragen. Die vorliegende Arbeit untersucht die MCP-1-Inhibition und die Stimulation durch MCP-1 auf die Koloniebildung und die Zytokinexpression von Plattenepithelkarzinomen der Kopf-Hals-Region (HNSCC) im FLAVINO-Assay. Dieser ist ein klonogener, qualitätskontrollierter Ex-vivo-Koloniebildungsassay, der an der Klinik für Hals-Nasen-Ohrenheilkunde der Universität Leipzig etabliert und patentiert wurde und unter flavinschützenden Bedingungen durchgeführt wird. Weiterhin wird die Eignung von MCP-1, Interleukin-6 (IL-6), Interleukin-8 (IL-8) und des Vascular endothelial growth factor (VEGF) als Biomarker in HNSCC, die mithilfe von ELISA in Seren und Kulturüberständen quantifiziert wurden, untersucht. Durch die Stimulation durch MCP-1 und dessen Blockade sowie durch in vivo tolerierbare Konzentrationen von Cisplatin, Docetaxel, Cilengitide und Temsirolimus wurde die Expression der untersuchten Zytokine in den Kulturüberständen der HNSCC unterschiedlich moduliert. Cisplatin und MCP-1 supprimierten die Koloniebildung signifikant, während unter Docetaxel und Temsirolimus eine insignifikante Reduktion und durch Cilengitide eine insignifikante Stimulation der Koloniebildung beobachtet wurde. Die MCP-1-Blockade durch einen Anti-MCP-1-Antikörper führte zu keiner signifikanten Modulation der Koloniebildung. MCP-1 und der Anti-MCP-1-Antikörper senkten die Zytokinexpression, während bis auf Cisplatin alle Zytostatika die Zytokinexpressionen steigerten. Bezüglich der kombinierten Testung der Zytostatika und der MCP-1-Blockade bzw. Stimulation unterschieden sich die Proben, sodass additive, synergistische und antagonistische Effekte resultierten. Da durch MCP-1 gesteuerte tumorassoziierte Makrophagen das Mikromilieu eines Tumors wesentlich beeinflussen, gebührt diesen ebenfalls eine besondere Aufmerksamkeit. In dieser Arbeit wurden unter MCP-1 antitumoröse Effekte beobachtet, sodass weitere klinische Testungen der antitumorösen Wirkung des MCP-1 auf HNSCC lohnenswert erscheinen. Die individuelle Chemoresponse-Testung kann dabei helfen, das biologisch heterogene Verhalten der HNSCC besser zu verstehen. In diesem Sinne wäre die klinische Validierung solcher Testsysteme wertvoll.

Einleitung Zytokine bewirken maßgeblich die Kommunikation und Koordination der zellulären und humoralen Effektorsysteme der angeborenen und erworbenen Immunität. Die Immunzellen stellen selbst die Hauptproduzenten der Zytokine dar. Pro- und anti-inflammatorische Zytokine nehmen nicht nur innerhalb der Zellkommunikation ablaufender Immun- und Entzündungsreaktionen eine Schlüsselrolle ein, sondern sind somit ebenso am Ablauf von Pathogenesen zahlreicher Erkrankungen beim Pferd beteiligt. Trotz verschiedener Studien anhand unterschiedlicher Modelle existiert keine einheitliche Datenlage zu validierten, vergleichbaren in vivo-nahen Zellkultursystemen, die es erlauben die Kinetiken equiner Zytokine als Grundlage zur weiterführenden Erforschung von Zytokinwechselwirkungen sowie zur Testung potentieller Arzneimittel abzubilden. Aktuell werden insbesondere Glukokortikoide weiterhin aufgrund ihrer anti-inflammatorischen und immunmodulatorischen Eigenschaften häufig, aber in Bezug auf Zytokine unspezifisch zur Therapie equiner Erkrankungen eingesetzt. Ziele der Untersuchung Das Ziel der vorliegenden Studie bestand darin, eine einfache, schnelle, günstige und reproduzierbare Methodik zur ex vivo-Messung von Zytokinen (Tumornekrosefaktor-alpha [TNF-α], Interleukin-1 Rezeptor-Antagonist [IL-1Ra] und Interferon gamma [IFN-γ]) und deren zeit- und konzentrationsabhängige Freisetzung in der equinen Vollblutzellkultur zu entwickeln. Anhand dessen sollte weiterführend der Effekt der Glukokortikoide Dexamethason (DEX) und Hydrocortison (HC) auf die Produktion von TNF-α, IL-1Ra und IFN-γ im equinen Vollblut untersucht werden. Zurzeit sind Zytokine, ihre Freisetzung sowie das Eintreten ihrer vermittelten Effekte Gegenstand der gegenwärtigen Forschung, mit dem Ziel spezifische Wechselwirkungen aufzuzeigen und somit zielgerichtete Therapeutika etablieren zu können. Insbesondere Pferde, die eine Anfälligkeit gegenüber mit Sepsis einhergehenden Erkrankungen oder für equines Asthma aufweisen, könnten davon profitieren. Material und Methoden Hierfür wurde Pferdevollblut, in den Verdünnungen zu 10%, 20% und 50% eingesetzt und mit Lipopolysaccharid (LPS), einer Kombination aus Phytohämagglutinin, Concanavalin A, Pokeweed-Mitogen und LPS (PCPwL) oder equinem rekombinantem TNF-a (erTNF-α) zur Zytokinfreisetzung stimuliert. Zur Erstellung der Zytokinkinetiken wurden Zellkulturüberstände zu verschiedenen Zeitpunkten gesammelt und die Konzentrationen von TNF-α, IL-1Ra und IFN-γ mit spezifischen enzyme-linked immunosorbent assays (ELISA) analysiert. In weiterführenden Versuchen wurden in der etablierten equinen Vollblutzellkultur DEX und HC in Konzentrationen von 10-12 - 10-5 M eingesetzt, um die LPS- oder PCPwL- induzierte Zytokinfreisetzung zu modulieren. Statistische Analysen erfolgten über die Berechnungen der Mittelwerte mit den dazugehörigen Standardfehlern. Signifikanzen wurden über ein- und zweifaktorielle ANOVA bestimmt. Ergebnisse Die durchgeführten Untersuchungen ergaben, dass die optimale Detektion der Zytokine in equinen Vollblutzellkulturen mit einem Blutanteil von 20% durchgeführt werden kann. TNF-α, IL-1Ra und IFN-γ wurden zeitabhängig freigesetzt und zeigten unterschiedliche Freisetzungskinetiken. Die PCPwL- induzierte TNF-α- und IL-1Ra-Freisetzung stiegen jeweils kontinuierlich über 24 - 48 Stunden an. In ähnlicher Weise erreichte die LPS- stimulierte TNF-α-Konzentration ein Maximum zu Zeitpunkten zwischen 8 - 12 Stunden und begann daraufhin abzufallen, wohingegen die Konzentration von IL-1Ra 24 Stunden später gipfelte und vielmehr fortgeführt über 48 Stunden hinaus akkumulierte. Equines rekombinantes TNF-α konnte ebenso die IL-1Ra-Freisetzung induzieren. Die PCPwL-induzierte IFN-γ-Freisetzung begann zeitversetzt und verlief kontinuierlich ansteigend über 48 - 72 Stunden. In weiterführenden konzentrationsabhängigen Untersuchungen konnte anhand der equinen Vollblutzellkultur eine stärkere Suppression der LPS-induzierten TNF-α- und IL-1Ra-Produktion sowie der PCPwL-induzierten IFN-γ-Produktion durch DEX als durch HC nachgewiesen werden. DEX hemmte die Zytokinfreisetzung mit einer mittleren inhibitorischen Konzentration (IC50) von 0,09 μM (TNF-α), 0,453 μM (IL-1Ra) und 0,001 μM (IFN-γ), während HC IC50 Werte von 1,45 μM (TNF-α), 2,96 μM (IL-1Ra) und 0,09 μM (IFN-γ) aufwies. Schlussfolgerungen Schlussfolgernd kann zusammengefasst werden, dass sich das Model der equinen Vollblutzellkultur hervorragend eignet, um nach erfolgreicher Mitogenstimulation den zeitabhängigen Freisetzungsverlauf von Zytokinen evaluieren zu können. Somit bietet das Model der equinen Vollblutzellkultur durch die Vorteile einer einfachen, günstigen Durchführung im in vivo-nahen, physiologischen Milieu, die Möglichkeit den Zytokinstatus gesunder sowie kranker Pferde zu beurteilen und stellt seinen Nutzen und die Verlässlichkeit unter Beweis potentielle Arzneimittel und immunologische Zusammenhänge des Pferdes untersuchen zu können.:INHALTSVERZEICHNIS I ABBILDUNGSVERZEICHNIS III TABELLENVERZEICHNIS III ABKÜRZUNGSVERZEICHNIS IV 1 EINLEITUNG 1 2 LITERATURÜBERSICHT 3 2.1 Allgemeine wissenschaftliche Hintergründe 3 2.1.1 Das Blut und das Immunsystem des Pferdes 3 2.1.1.1 Zusammensetzung des equinen Blutes 3 2.1.1.2 Allgemeiner Aufbau des Immunsystems 4 2.1.2 Zytokine und Entzündungsreaktionen - Mediation der Immunantwort durch Zytokine und Chemokine 14 2.1.2.1 Pro-inflammatorische Zytokine: Tumornekrosefaktor-α und Interferon-γ 17 2.1.2.2 Anti-inflammatorische Zytokine: Interleukin-1 Rezeptor-Antagonist 19 2.2 Therapeutische Beeinflussung der Zytokin- und Mediator-Freisetzung 21 2.2.1 Inhibition der Zytokinfreisetzung durch Glukokortikoide 21 2.2.2 Inhibition der Zytokinfreisetzung durch weitere Pharmaka und Substanzen 23 2.2.2.1 NSAID 23 2.2.2.2 Small molecules und Anti-Zytokinantikörper 24 2.3 Equine Zellkulturmodelle zur Zytokindetektion 25 2.3.1 Stimulation der Zytokinfreisetzung 26 2.3.2 Vollblutzellkultursysteme und Systeme mit isolierten Zellen 27 2.4 Fragestellung der Dissertation 30 3 PUBLIKATIONEN 31 3.1 Freisetzungskinetik von TNF-α und IL-1Ra im equinen Vollblut 32 3.2 Modulation der Freisetzung von TNF-α, IL-1Ra und IFN-γ in der equinen Vollblutzellkultur durch Glukokortikoide 40 4 DISKUSSION 45 4.1 Zytokinfreisetzung im equinen Vollblut 46 4.2 Der Einfluss von Glukokortikoiden auf die Zytokinfreisetzung 52 4.3 Schlussfolgerungen 56 4.4 Ausblick 56 5 ZUSAMMENFASSUNG 58 6 SUMMARY 60 7 LITERATURVERZEICHNIS 62 8 ANHANG 72 8.1 Freisetzungskinetik von IFN-γ 72 8.2 Konzentration von TNF-α, IL-1Ra und IFN-γ in der equinen Vollblutzellkultur 72 9 DANKSAGUNG 74 / Introduction The communication and coordination between the cellular and humoral effector compartments of the innate and adaptive immunity were mainly accomplished by cytokines. Immunocompetent cells themselves represent the main source for cytokines. Pro- and anti-inflammatory cytokines not only play a pivotal role within the cell signaling of expiring immune- and inflammatory reactions but also take part in the pathogenesis of several equine diseases. Despite various studies based on different experimental setups no uniform availability of data about validated, comparable in vivo cell culture systems exists which enables the description of the kinetically time course of cytokines as foundation of further investigations of cytokine interactions as well as the testing of potential drugs. These days especially glucocorticoids are still frequently used for treatment of equine diseases because of their anti-inflammatory and immunomodulatory, but with respect to cytokines unspecific properties. Objectives of the investigations The aim of the study was to develop an easy, quick, cheap and reproducible ex vivo method for measuring cytokines (tumor necrosis factor alpha [TNF-α], interleukin-1 receptor antagonist [IL-1Ra] and interferon gamma [IFN-γ]) and their time- and concentration-dependent release in the equine whole blood cell culture. Whereby the impact of the glucocorticoids dexamethasone (DEX) and hydrocortisone (HC) on production of TNF-α, IL-1Ra and IFN-γ should be investigated subsequently. Currently, cytokines, their release and eventuation of their mediated effects are objects of actual research with the aim to reveal specific interactions and thus be able to establish purposeful therapeutic agents. This could be beneficial especially for horses which display a susceptibility to septic diseases or equine asthma. Material and Methods Therefore horse whole blood diluted to 10%, 20% and 50% was stimulated with lipopolysaccharide (LPS), a combination of phytohemagglutinin, concanavalin A, pokeweed mitogen and LPS (PCPwL) or equine recombinant TNF-α (erTNF-α). To generate cytokine kinetics TNF-α, IL-1Ra and IFN-γ were analyzed in culture supernatants, which were collected at different time points using specific enzyme-linked immunosorbent assays (ELISA). In further investigations within the equine whole blood cell culture DEX and HC were applied with concentrations between 10-12 and 10-5 M to modulate LPS- or PCPwL-induced cytokine release. Statistics were performed by calculation of means with associated standard errors. Statistical significances were assessed by one- and two-way analysis of variance. Results The evaluations revealed that cytokines could be detected optimal in whole blood cell cultures with 20% blood volume. TNF-α, IL-1Ra and IFN-γ were released time-dependently and differing kinetics were displayed. PCPwL-induced TNF-α and IL-1Ra release was enhanced continuously over 24 - 48 hours, respectively. Similarly, LPS-stimulated TNF-α was at maximum at time points between 8 - 12 hours and started to decrease thereafter, whereas IL-1Ra peaked 24 hours later and rather continued to accumulate beyond 48 hours. ErTNF-α could induce also the IL-1Ra release. PCPwL- induced IFN-γ release started time displaced and showed a continuously enhanced course over 48 - 72 hours. In subsequent investigations within equine whole blood cell culture, LPS-induced TNF-α and IL-1Ra as well as PCPwL-induced IFN-γ production were more potently suppressed concentration-dependently by DEX than by HC. DEX inhibited cytokine release with the inhibition concentration (IC50) 0.09 μM (TNF-α), 0.453 μM (IL-1Ra) and 0.001 μM (IFN-γ), whereas HC with IC50 values of 1.45 μM (TNF-α), 2.96 μM (IL-1Ra) and 0.09 μM (IFN-γ). Conclusion In conclusion our results could suggest the eminent suitability of equine whole blood cell culture to assess the release of a variety of cytokines following successful mitogen stimulation. Therefore the model of the equine whole blood cell culture provides, because of its advantages including simple and cheap performance in an in vivo close physiological ambient, the opportunity to evaluate the cytokine status of healthy and diseased horses. Furthermore it could give the proof of its benefit and reliability to evaluate potential equine drugs and immunological coherences of the horse.:INHALTSVERZEICHNIS I ABBILDUNGSVERZEICHNIS III TABELLENVERZEICHNIS III ABKÜRZUNGSVERZEICHNIS IV 1 EINLEITUNG 1 2 LITERATURÜBERSICHT 3 2.1 Allgemeine wissenschaftliche Hintergründe 3 2.1.1 Das Blut und das Immunsystem des Pferdes 3 2.1.1.1 Zusammensetzung des equinen Blutes 3 2.1.1.2 Allgemeiner Aufbau des Immunsystems 4 2.1.2 Zytokine und Entzündungsreaktionen - Mediation der Immunantwort durch Zytokine und Chemokine 14 2.1.2.1 Pro-inflammatorische Zytokine: Tumornekrosefaktor-α und Interferon-γ 17 2.1.2.2 Anti-inflammatorische Zytokine: Interleukin-1 Rezeptor-Antagonist 19 2.2 Therapeutische Beeinflussung der Zytokin- und Mediator-Freisetzung 21 2.2.1 Inhibition der Zytokinfreisetzung durch Glukokortikoide 21 2.2.2 Inhibition der Zytokinfreisetzung durch weitere Pharmaka und Substanzen 23 2.2.2.1 NSAID 23 2.2.2.2 Small molecules und Anti-Zytokinantikörper 24 2.3 Equine Zellkulturmodelle zur Zytokindetektion 25 2.3.1 Stimulation der Zytokinfreisetzung 26 2.3.2 Vollblutzellkultursysteme und Systeme mit isolierten Zellen 27 2.4 Fragestellung der Dissertation 30 3 PUBLIKATIONEN 31 3.1 Freisetzungskinetik von TNF-α und IL-1Ra im equinen Vollblut 32 3.2 Modulation der Freisetzung von TNF-α, IL-1Ra und IFN-γ in der equinen Vollblutzellkultur durch Glukokortikoide 40 4 DISKUSSION 45 4.1 Zytokinfreisetzung im equinen Vollblut 46 4.2 Der Einfluss von Glukokortikoiden auf die Zytokinfreisetzung 52 4.3 Schlussfolgerungen 56 4.4 Ausblick 56 5 ZUSAMMENFASSUNG 58 6 SUMMARY 60 7 LITERATURVERZEICHNIS 62 8 ANHANG 72 8.1 Freisetzungskinetik von IFN-γ 72 8.2 Konzentration von TNF-α, IL-1Ra und IFN-γ in der equinen Vollblutzellkultur 72 9 DANKSAGUNG 74

Normalt sett skyddar komplementsystemet kroppen mot infektioner och patogener. Vid vissa typer av njursjukdomar, framför allt vid C3-glomerulopati, förekommer autoantikroppar som kallas ”nephritic factors” (NeF). Sådana antikroppar stabiliserar enzymkomplex (konvertas) i komplementsystemet, vilket leder till destruktiv komplementaktivering via den alternativa vägen. Syftet med studien var att utveckla minst en metod för att analysera C5NeF på kliniska prover.  C5NeF In-House ELISA analyserade bindning av C5NeF till C5-konvertas. Analys av C5-klyvning i löslig fas kvantifierade mängden C5a som bildats vid stabilisering av C5-konvertas. Cut-off för analyserna bestämdes genom analys av prover från 20 friska blodgivare. Tolv patientprover med möjlig förekomst av C5NeF analyserades. För att utesluta falskt positiv reaktion i C5NeF in-house ELISA analyserades även förekomst av antikroppar mot specifika enskilda komplementproteiner. Åtta patientprover var positiva i C5NeF In-House ELISA, fem patientprover uppvisade positivt resultat för C3NeF, vilket inte var oväntat utifrån tidigare publikationer som visat att det är vanligt att patienter med C5NeF också ofta är positiva för C3NeF. Tre patientprover erhöll positivt resultat i endast C5NeF In-House ELISA och två av dessa var positiva i analys av C5-klyvning i löslig fas. Studien resulterade i etablering av en metod för analys av C5NeF. / Normally the complement system protects the body from infections and pathogens. In certain types of kidney diseases, mainly C3-glomerulopathy, autoantibodies called ”Nephritic Factors” (NeF) are found. NeFs stabilize enzyme complexes (convertases) in the complement system, an event which leads to destructive complement activation via the alternative pathway. The purpose of this study was to develop at least one method to analyse C5NeF on clinical samples.  C5NeF In-House ELISA analysed binding of C5NeF to C5 convertases. Analysis of C5-cleavage in the soluble phase measured the amount of C5a formed when C5-convertase was stabilized. Cut-off for the analyses was determined through analysis of 20 blood donor samples from healthy individuals. Twelve patient samples with possible C5NeF were analysed. To exclude false positive results in C5NeF In-House ELISA analysis of antibodies against specific single complement factors was performed.  Eight patient samples were positive in C5NeF In-House ELISA, five patient samples showed positive result for C3NeF, a finding which was not unexpected as previous publications have shown that concomitant presence of C3NeF and C5NeF is common in C3-glomerulopathy. Where most patients are positive for both C3NeF and C5NeF. Three patient samples received positive result in only C5NeF In-House ELISA and two of these samples were positive in the analysis of C5-cleavage in soluble phase. In conclusion, in this study a method to examine C5NeF was developed.

The cancer recognition (CARE) antibody (Ab) test is a serologic assay for a specific IgM that is elevated in cancer patients. All tests are measured using an indirect enzyme-linked immunosorbent assay (ELISA) of human serum. The target polypeptide in the CARE Ab test is the IgM binding epitope (LT-11) of the CARE antigen (Ag) consisting of a 16 mer structure that has been produced synthetically. The mean relative concentration (MRC) is determined relative to standard, normalized human plasma. Non-parametric analysis showed median MRC values of healthy volunteers (HVs) with no history of cancer (n=47), family history of cancer (n=126) and a previous cancer history (n=24) to be 26, 34 and 46, respectively. It was determined that there was no significance found among the medians of the three HV groups (P=0.53). The specificity of the HV types was between 87 and 98%. Benign/non-cancer surgical patients (n=27) had a median value of 20 with a specificity of 96%. The cancer patients (n=61) had a median value of 246 with a sensitivity of 89%. There was a significant difference between the HV and cancer patients (P<0.0001) as well as between the benign/surgical non-cancerous group and cancer patients (P<0.0001). The IgM antibody is heat stable at room temperature for two days versus being frozen at -80°C (r2=0.97). Either serum or plasma samples may be used in the CARE Ab test (r2=0.92). The CARE Ab was almost exclusively IgM with no serum conversion to IgG in sequential measurements of patients with cancer over a six-month period. Preliminary data from patients undergoing post-operative cancer treatment showed that decreasing Ab levels revealed patients negative for residual cancer or undergoing remission, while relapsing patients show an increase in Ab levels. A return to a positive Ab level shortly after treatment is a poor prognostic sign while in advanced cancers the Ab levels may be depressed significantly.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

- Einleitung - Coxiella burnetii (C. burnetii) ist der Erreger des Q-Fiebers, einer zoonotischen Erkrankung, welche insbesondere kleine und große Wiederkäuer betrifft. Während Tiere meist asymptomatisch erkranken, kann die Erkrankung beim Menschen von akuten grippeähnlichen Symptomen bis hin zur chronischen Organschädigung führen. Die Diagnostik von Q-Fieber im veterinärmedizinischen Bereich wird durch unspezifische Symptome sowie diagnostische Lücken erschwert: Einerseits ist die direkte Diagnostik aufgrund langer Anzuchtzeiten der Bakterien häufig unpraktikabel. Andererseits weisen die Leistungen der Serodiagnostika in Untersuchungen teilweise inakzeptable Spezifitäten und Sensitivitäten auf. - Ziel der Untersuchungen - Ziel war es, das Potential des rekombinant hergestellten C. burnetii Außenmembran-proteins Com1 als diagnostischen Marker zu bestimmen und darauf aufbauend einen indirekten Enzyme-linked Immunosorbent Assay (ELISA) zu entwickeln, welcher die Grundlage für neue, praxistaugliche und verbesserte Serodiagnostika bieten kann. - Material und Methoden - Hierfür wurde die kodierende Sequenz für Com1 von C. burnetii Nine Mile Phase II RSA 439 unter Ausschluss der Signalsequenz mittels Polymerase-Kettenreaktion amplifiziert. Das Amplifikat com1 wurde in ein Expressionsplasmid kloniert und anschließend mittels Transformation in Escherichia coli (E. coli) als Com1 exprimiert. Das Expressionsprodukt wurde nach der Aufreinigung über Nickel-NTA (Nitrilotriessigsäure) mittels SDS-PAGE (Natriumdodecylsulfat-Polyacrylamid-Gelelektrophorese), Coomassie-Blau-Färbung und Western Blot überprüft. Die 96-Well-Mikrotiterplatten wurden mit 1 µg/Well des rekombinanten Proteins beschichtet und 404 Seren von Schafen (111), Ziegen (100) und Rindern (193) auf ihre Reaktion im rekombinanten Com1-ELISA analysiert. Die Seren stammten sowohl aus definierten Ausbrüchen als auch aus Q-Fieber-freien Beständen, geimpften Herden und von Tieren mit fraglichem Infektionshintergrund. Daneben wurden die Seren mit kommerziellen ELISAs getestet und daraufhin in positive und negative Seren eingeteilt. Die OD450-Werte (optische Dichte bei 450 nm) der Seren aus dem rekombinanten Com1-ELISAs wurden in Pivot-Tabellen angeordnet und anschließend in einer ROC-Kurve (receiver operating characteristic) dargestellt, wodurch das Integral als Area under the curve (AUC) berechnet und hinsichtlich der Diskrimination zwischen positiven und negativen Ergebnissen ausgewertet wurde. Nach Festlegung von tierart-spezifischen Cut-off-Werten wurden Sensitivität und Falsch-Positiv-Rate bestimmt. - Ergebnisse - Die ermittelten tierart-spezifischen OD450-Cut-off-Werte betrugen für Schafe 0,32, für Ziegen 0,23 und für Rinder 0,18. Als Spezifität bzw. Sensitivität ergaben sich für Schafe 85 % bzw. 68 %, für Ziegen 94 % bzw. 77 % und für Rinder 71 % bzw. 70 %. Die Diskrimination wurde bei Schafen als „exzellent“, bei Ziegen als „herausragend“ und bei Rindern als „akzeptabel“ eingeschätzt. - Schlussfolgerungen - Die Ergebnisse dieser Studie zeigen, dass das Coxiella-Außenmembranprotein Com1 als Basis für die Entwicklung neuer, sensitiverer und spezifischerer (Schnell)-Diagnostika dienen kann, um weitere Q-Fieber-Epidemien einzudämmen und damit das Risiko einer C. burnetii-Infektion für Mensch und Tier zu minimieren. / - Introduction - Coxiella burnetii (C. burnetii) is the causative agent of Q fever, a zoonotic disease with small and large ruminants as the target hosts. While an infection in ruminants is often symptomless, the disease in humans can lead from acute flu-like symptoms to chronic organ damage. In addition to the non-specific symptoms in the veterinary field, for which reason it is difficult to directly conclude on a Q fever outbreak, the detection of infections with C. burnetii is in need of improvement. On the one hand, direct diagnosis is often impracticable due to long cultivation periods of the bacteria. On the other hand, the performance of serodiagnostics shows partially unacceptable specificities and sensitivities. - Objectives - The aim of the study was to determine the potential of the recombinantly produced C. burnetii outer membrane protein Com1 as a diagnostic marker and, subsequently, to develop an indirect enzyme-linked immunosorbent assay (ELISA), which can provide the basis for the development of new and improved serodiagnostics. - Material and methods - For this purpose, primers for com1 were designed in silico and the open reading frame (ORF) was amplified by polymerase chain reaction (PCR) using phenol-chloroform-isolated DNA (deoxyribonucleic acid) from C. burnetii Nine Mile Phase II RSA 439 without signal sequence. After control by gel electrophoresis, the amplified product was cloned into the two-stage gateway system (Invitrogen) and transformed into Escherichia coli (E. coli) TOP10. The expression vector was cloned into E. coli BL21(DE3) and Com1 was expressed. The protein was analyzed after native purification via Nickel-NTA (nitrilotriacetic acid) by SDS-PAGE (sodium dodecyl sulfate polyacrylamide gel electrophoresis), Coomassie blue staining and Western blot and subsequently concentrated. Microtiter plates were coated with the recombinant protein and 404 sera from sheep (111), goats (100) and cattle (193) were tested for their reaction in the recombinant Com1-ELISA. The sera were derived from 36 different flocks, both from defined outbreaks and from Q fever-free flocks, vaccinated herds and from animals with questionable infection background. In addition, the sera were tested with commercial ELISAs and could thus be divided into positive and negative sera. The OD450 values (optical density at 450 nm) of the sera from the recombinant Com1 ELISAs were arranged in pivot tables and then plotted on a ROC curve (receiver operating characteristic), allowing the integral to be calculated as the area under the curve (AUC) and evaluated regarding the discrimination between positive and negative results. After establishing animal species-specific cut-off values, sensitivity and false positive rate were determined. - Results - The animal species-specific OD450 cut-off values determined were 0.32 for sheep, 0.23 for goats and 0.181 for cattle. Specificity and sensitivity were 85 % and 68 % for sheep, 94 % and 77 % for goats and 71 % and 70 % for cattle. Discrimination was assessed as 'excellent' in sheep, 'outstanding' in goats and 'acceptable' in cattle. - Conclusions - The results of this study suggest that the Coxiella outer membrane protein Com1, together with other immunogenic marker proteins, may serve as a basis for the development of new more sensitive and specific diagnostic tools to contain further Q fever epidemics and thus minimize the risk of C. burnetii infection for humans and animals. Com1 could also lay the foundation for direct rapid diagnostics.

<p>QC 20110615</p>