Experimental autoimmune encephalomyelitis (EAE) is the rodent model of multiple sclerosis (MS), a chronic autoimmune neuroinflammatory disease that has a devastating impact on various neurological functions of the patients. The hallmarks of both, MS and EAE, are neuroinflammation, demyelination and neuroaxonal degeneration. Various types of lymphoid and myeloid cells were shown to infiltrate the central nervous system and to participate in disease pathology. However, the role of eosinophil granulocytes has been less explored thus far. An early study showed that eosinophils infiltrate into the spinal cord of EAE mice and suggested their role in the disease progression. Recently, it was reported that eosinophils can play a protective role against EAE when mice are treated with an extract from helminths. Furthermore, it was shown that EAE development is not altered in mice deficient for interleukin-5, an important eosinophil pro-survival factor. Taken together, the role of eosinophils in EAE is currently unclear and needs to be investigated in detail. In the present study, we use the active model of EAE, whereby we immunized the C57BL/6 mouse strain with MOG35-55 peptide emulsified in the complete Freund’s adjuvant, in order to study a possible contribution of eosinophils to the disease pathology. Using the flow cytometry and RT-qPCR analysis of the spinal cord, we show that eosinophils infiltrate into the tissue in the course of EAE. The infiltration is likely driven by eosinophil chemoattractants, such as eotaxin-1, as the concentration of the latter was increased in the spinal cord during EAE, as shown on mRNA and protein level. Moreover, detailed flow cytometry analysis of spinal cord eosinophils revealed that they show signs of activation, namely an increase in CD11b and decrease in CCR-3 surface expression. Furthermore, we observed signs of degranulation of spinal cord eosinophils in EAE which was measured as a decrease of the side scatter parameter and an upregulation of CD63 surface expression. These data suggest a potential role of eosinophils in the pathology of EAE. In order to elucidate whether eosinophils are important for the disease development, eosinophil-deficient mice were subjected to EAE and the clinical development of the disease was observed. For this purpose, we used two independent models of eosinophil deficiency - ΔdblGATA1 and interleukin-5-depleted mice. ΔdblGATA1 mice are a genetically manipulated mouse strain bearing a deletion in GATA1 promoter that causes a specific depletion of eosinophils. Interestingly, clinical development of EAE was not affected in these mice when compared to their wild-type controls. As a next step, we depleted eosinophils by injecting wild-type mice with an antibody against the eosinophil pro-survival factor interleukin-5 in order to reduce eosinophil numbers in the effector phase of EAE. In accordance with the result from the experiment with ΔdblGATA1 mice, EAE progression was not altered in the eosinophil-depleted mice when compared to mice that were injected with an isotype control antibody. Further, we analyzed the neuroinflammation and demyelination in the spinal cord of 4ΔdblGATA1 mice subjected to EAE. Specifically, the infiltration of inflammatory cell populations, including CD4 and CD8 T cells, neutrophils and macrophages, was assessed by flow cytometry. In agreement with the unchanged clinical EAE development, inflammatory cell infiltration was not affected in ΔdblGATA1 mice. Furthermore, we analyzed expression of pro-inflammatory cytokines in the spinal cord of ΔdblGATA1 mice subjected to EAE in order to better characterize the inflammatory status. No significant changes were detected further confirming that eosinophils do not contribute to neuroinflammation in EAE. Finally, we assessed the demyelination in the spinal cord of ΔdblGATA1 EAE mice using luxol fast blue staining to detect myelin. In accordance with the unaffected clinical development and inflammatory status, we did not observe any difference in the spinal cord demyelination in ΔdblGATA1 mice when compared to their wild-type littermates. Taken together, although eosinophils infiltrate into the spinal cord of EAE mice and are activated and degranulate therein, they are dispensable for EAE development.

Background and Aims: Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) remains a poorly understood condition, shrouded in uncertainty and dispute. Research suggests this context to have a profound bearing on those touched by the condition, impacting significantly on their experience and the narratives constructed thereof. However, no studies examining the narratives of partners of individuals affected by CFS/ME appear to have been carried out to date. Based upon this gap in the literature, this study sought to hear the narratives of partners of adults living with CFS/ME, giving particular consideration to the ways in which these narratives were told to an outsider, and how the outsider may have influenced the narrative. Methodology: This study drew on a qualitative approach. A purposive sample of six partners of adults affected by CFS/ME (4 men and 2 women) was recruited. Individual interviews were conducted that were audio-recorded and transcribed. Narrative analysis was used to analyse the transcripts, focusing principally on how participants narrated their accounts, as well as on the content of narratives and the narrative and discursive features that shaped the telling of the accounts. Analysis and Findings: Multiple readings of the narratives identified two areas of collective focus within participants' accounts - 'stories from then' and 'stories from now'. Some similarities in how 'stories from now' were told were seen to emerge down gender lines. Notably participants' storytelling could be seen to represent a form of response to wider narratives that purvey around CFS/ME, with participants' being observed to construct particular meanings around CFS/ME, as well as particular 'identities' of themselves, their partner, their relationship and 'others' who had played a key role in their story of living with the condition. The findings are discussed in terms of their potential bearing for clinical practice and future research endeavours. In addition, the strengths and the limitations of the research are considered.

D.Ed. (Nursing) / This research aims at the description of a therapeutic approach relevant to the youth suffering from chronic fatigue syndrome and includes his family, school and peer group. According to relevant literature it appears that chronic fatigue impacts negatively upon the total functioning of the youth. The physical demands of the condition leads to continual school-absenteeism, dysfunctional socialising and variable familial relationships. The condition is not easily diagnosed in youth as symptoms are often ascribed to school-phobia, deviant behaviour and/or psychological problems. In view of the fact that the researcher is of the opinion that the condition of the youth is not readily understood by his peers, family and school, the researcher aims at examining the experience of the youth who manifests chronic fatigue syndrome. The youth forms part of a specific system which is also affected by the chronic-fatigue-syndrome. Thus the research is aligned to a systemic approach. The researcher has decided to follow a qualitative research approach, with the deliberate choice of two youths subjected to the utilisation of multiple data-gathering sources. Multiple data-gathering includes interviews, document analysis and observation. The data has been analysed with the assistance of two independent coders and central themes have been established. Case study reports have been complied according to processed data. Hereafter a literature-control was applied to compare the results of this research with other available research and to point out new insights into chronic-fatigue syndrome gained from this research.

The data presented within this thesis shows the generation and characterisation of a complete-, macrophage/granulocyte- and T cell-specific IFNγR2 deficient mouse mutant. This mutant mouse is a valuable tool in dissecting the mechanism of action of the pleiotrophic cytokine IFNγ.The global mutant mouse was tested in three models in vivo - DSS induced colitis, Trichuris muris infection and EAE. The aim of the DSS-induced colitis model was to test the role of IFNγ in the innate immune system and, despite previous reports demonstrating IFNγ deficient mice are protected from DSS-colitis, our IFNγR2 deficient mice displayed equal or more severe colitis than control mice. We hypothesise that this discrepancy is due to differences in the gut microbiota.The Trichuris muris model was utilised as a method of examining the role of IFNγ in the adaptive immune system. The complete IFNγR2 mutant was resistant to a low dose T. muris infection; however, neither the T cell specific nor the macrophage/granulocyte specific mutant duplicated the resistant phenotype observed in the global knock-out mice. Analysis of a double conditional T cell and macrophage/granulocyte specific IFNγR2 mutant produced inconsistent results. Initial experiments suggested that, in combination, these deficiencies are sufficient to duplicate the resistant phenotype observed in the global mutant mice, but this was not reproducible.The final in vivo model that we used to analyse IFNγR2 mutant mice was EAE. This model was chosen as, for a long time, the mechanism of action and the involvement of IFNγ in EAE has been a matter of uncertainty. These results demonstrated that global IFNγR2 mutant mice demonstrate an atypical phenotype, with no signs of recovery. In contrast, control mice develop classical EAE symptoms with almost complete recovery prior to the termination of the experiment. The IFNγ receptor mutant mouse generated will be of great value to the scientific community as IFNγ has been demonstrated to play a role in multiple diseases and this tool allows the mechanism of action of this cytokine to be unravelled.

Orientador: Liana Maria Cardoso Verinaud / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-27T08:18:08Z (GMT). No. of bitstreams: 1 Zanucoli_FabiodosSantosMachado_M.pdf: 3072241 bytes, checksum: 66a7959825671f33da79f21f4dbeda55 (MD5) Previous issue date: 2015 / Resumo: A esclerose múltipla (EM) é uma doença inflamatória crônica de origem autoimune que afeta o sistema nervoso central (SNC), provocando disfunções neurológicas em decorrência de desmielinização axonal, principalmente na substância branca dos órgãos do SNC. A doença acomete mais de 2 milhões de pessoas no mundo todo e não tem cura. As abordagens terapêuticas utilizadas com sucesso consistem na aplicação de anticorpos monoclonais, citocinas imunomoduladoras e fármacos antiinflamatórios. Ainda assim, tais estratégias são dependentes de produtos de alto custo e toxicidade. A utilização de fármacos antimaláricos no tratamento da Encefalomielite Autoimune Experimental (EAE, modelo experimental de EM), como cloroquina e diidroartemisinina, tem apresentado resultados promissores na atenuação do quadro clínico dos camundongos; entretanto, os efeitos tóxicos dessas substâncias constituem um importante fator limitante para a utilização clínica. Neste sentido, o presente trabalho teve por objetivo caracterizar os efeitos terapêuticos da primaquina (PQ), um fármaco antimalárico análogo à cloroquina mas com toxicidade reduzida, na EAE emvcamundongos C57BL/6. Para tanto, camundongos foram tratados com PQ por via intraperitoneal (i.p.) por cinco dias consecutivos e os efeitos da administração direta foram avaliados sobre as subpopulações de linfócitos T esplênicos. Semelhantemente, camundongos portadores de EAE foram tratados com PQ como acima e o desenvolvimento da doença foi avaliado. Os resultados obtidos mostraram uma redução significativa na severidade da EAE em camundongos tratados com primaquina em comparação com animais pertencentes ao grupo controle. A melhora no quadro clínico se correlacionou com (i) aumento na expressão de genes de citocinas anti-inflamatórias e decréscimo na expressão de genes de citocinas inflamatórias, (ii) redução na ativação de micróglia e (iii) diminuição da reatividade glial no SNC de camundongos tratados com PQ em relação aos não tratados. Também se verificou um aumento na frequência de células T reguladoras em baços de camundongos tratados com PQ. Posteriormente, células T reguladoras (Treg, CD4+CD25+) e células T efetoras (CD4+CD25- ) foram isoladas de baços de camundongos tratados com PQ e transferidas adotivamente a camundongos portadores de EAE. Foi observada uma redução na severidade da EAE em camundongos recipientes de células Treg em comparação com camundongos recipientes de células T efetoras. De forma semelhante ao observado em camundongos tratados diretamente com PQ, a menor severidade da EAE se correlacionou com redução na expressão de mediadores inflamatórios e de reatividade glial no SNC. A capacidade imunossupressora de PQ foi avaliada também. Neste sentido, células dendríticas (DCs) diferenciadas a partir de precursores de medula óssea foram tratadas com PQ e avaliadas quanto ao seu perfil fenotípico e funcional. Observou-se uma redução na expressão de marcadores de maturação de DCs tratadas com PQ (DC-PQ) em comparação às células não tratadas (DC-PBS). A transferência adotiva de DC-PQ resultou na redução do quadro clínico de EAE. Os resultados obtidos nesse trabalho permitem concluir que a primaquina é um fármaco eficaz na atenuação dos sintomas da EAE por meio da modulação de componentes celulares e moleculares do sistema imune / Abstract: Multiple sclerosis (MS) is an autoimmune chronic inflammatory disease that affects the central nervous system (CNS) causing neurological disorders arised from axonal demyelination, particularly in the white matter of the CNS organs. The disease affects more than 2 million people worldwide and still has no cure. The successfully used therapeutic approaches consist in the application of monoclonal antibodies, immunomodulatory cytokines and anti-inflammatory drugs. Still, such strategies are dependent on expensive and toxic drugs. The use of antimalarial drugs in the treatment of experimental autoimmune encephalomyelitis (EAE, experimental model of MS), such as chloroquine and dihydroartemisinin, has shown promising results in attenuation of the clinical signs of mice; however, the toxic effects of these substances are an important limiting factor for clinical use. In this sense, this study aimed to characterize the therapeutic effects of primaquine (PQ), an antimalarial drug analog to chloroquine but with reduced toxicity, in EAE in C57BL / 6 mice. To this end, mice were treated with PQ intraperitoneally (i.p.) for five consecutive days, and the effects of direct administration were evaluated on spleen T lymphocyte subpopulations. Similarly, mice bearing EAE were treated with PQ as above, and disease development was evaluated. The results showed a significant reduction in the severity of EAE in mice treated with primaquine compared to animals in the control group. Amelioration of the clinical signs was correlated with (i) an increase in gene expression of anti-inflammatory cytokines and decrease in gene expression of inflammatory cytokines, (ii) reduction in microglia activation and (iii) the decreased CNS glial reactivity in mice treated with PQ compared to untreated group. There was also an increase in the frequency of regulatory T cells in the spleens of mice treated with PQ. Subsequently, regulatory T cells (Tregs, CD4+CD25+ ) and effector T cells (CD4+CD25-) were isolated from spleens of mice treated with PQ, and adoptively transferred to mice with EAE. It was observed a reduction in the severity of EAE in mice recipients of Treg cells compared to mice recipients of effector T cells. Similarly to what was observed in mice directly treated with PQ, the lower severity of EAE was correlated with a reduction in the expression of inflammatory mediators and glial reactivity in the CNS. The immunosuppressive capacity of PQ was evaluated as well. In this regard, dendritic cells (DCs) differentiated from bone marrow precursors were treated with PQ and assessed for phenotypic and functional profile. It was observed a reduction in the expression of DC maturation markers treated with PQ (DC-PQ) compared to untreated cells (DC-PBS). The adoptive transfer of DC-PQ resulted in the reduction of the clinical signs of EAE. The results of this work have shown that primaquine is an effective drug in ameliorating the symptoms of EAE through modulation of cellular and molecular components of the immune system / Mestrado / Imunologia / Mestre em Genética e Biologia Molecular

Orientador: Alexandre Leite Rodrigues de Oliveira / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-27T11:24:09Z (GMT). No. of bitstreams: 1 Silva_GleidyAnaAraujo_M.pdf: 28585855 bytes, checksum: aaac289d72ca956b0b61eb90ac8c228e (MD5) Previous issue date: 2013 / Resumo: A esclerose múltipla se caracteriza por gerar uma inflamação esmielinizantecrônica e de caráter autoimune no sistema nervoso central, gerando uma série desinais e sintomas clínicos. Um modelo experimental para estudo da esclerosemúltipla é a encefalomielite autoimune experimental (EAE). Durante o curso da EAE, observa-se no SNC, perda de contatos sinápticos, bem como aumento da gliose reativa, envolvendo tanto astrócitos quanto células microgliais. Assim, a amenização dessas alterações, por tratamentos farmacológicos, pode ser útil no tratamento dos sintomas da EM. Neste sentido, o emprego da pregabalina, um ligante da proteína ?2-? associada a canais de cálcio voltagem-dependentes em neurônios, pode se constituir numa estratégia para o controle dos sintomas da doença. Assim, o presente estudo investigou o efeito da pregabalina sobre o curso da EAE, através da análise clínica de ratos Lewis imunizados com MBP e avaliação imunoistoquímica da medula espinal, utilizando marcadores para sinapses, astrogliose e reação microglial. Adicionalmente, através de RT-PCR, avaliou-se a expressão gênica de interleucinas pró e anti-inflamatórias, bem como a recuperação motora nos grupos placebo e tratado, foi avaliada pelo walking track test (CatWalk System). Os resultados demonstraram que o tratamento com pregabalina foi capaz de atrasar e amenizar os sinais clínicos e morfológicos da EAE, bem como reduzir a perda sináptica e a reação astroglial na medula espinal. Ainda, o tratamento resultou numa regulação positiva de genes anti-inflamatórios. De forma similar, a administração desse fármaco permitiu um mais rápido restabelecimento de parâmetros de marcha. Os resultados do presente estudo indicam que a pregabalina apresenta características neuroprotetoras e antiinflamatórias que refletem positivamente na amenização da doença, mostrando potencial para o uso clínico, em associação aos imunomoduladores atualmente empregados / Abstract: The multiple sclerosis (MS) is an autoimmune disease and neurodegenerative that affects young adults. It is characterized by generating a chronic demyelinating autoimmune inflammation in the central nervous system. An experimental model for the study of multiple sclerosis is the experimental autoimmune encephalomyelitis (EAE), induced by immunization with antigenic proteins of myelin of the central nervous system, dissolved in adjuvants. The present study investigated the evolution of the disease in pregabalin treated animals up to the remission phase. The results demonstrated a delay on the onset of the disease with statistical differences at the 10th and the 16th day after immunization For the gait evaluation, the walking track test (CatWalk) was used to evaluate different parameters related to motor function. Although no difference between groups was obtained for the foot print pressure, the regularity index was improved post treatment, indicating a better motor coordination. The immunohistochemical analysis of synapse preservation and glial reactivity revealed that pregabalin treatment improved the overall morphology of the spinal cord. A preservation of circuits was depicted and astroglial reaction was downregulated during the course of the disease. RT-PCR data were in line with the immunolabeling observations and indicated a shift of the immune response towards an anti-inflammatory response. Overall, the present data indicate that pregabalin is efficient for reducing the seriousness of EAE, delaying its course as well as reducing synaptic loss and astroglial reaction / Mestrado / Clinica Medica / Mestra em Clínica Médica

Bakgrund Myalgisk encefalomyelit är en komplex, kronisk, neurologisk sjukdom som kännetecknas av långvarig psykisk och fysisk utmattning. Detta tillsammans med många andra symtom som smärta, yrsel och influensaliknande symtom, där symtomen förvärras vid ansträngning. Sjukdomens etiologi och patofysiologi är fortfarande okänd vilket leder till misstro och missuppfattningar från sjukvården för personen som lever med myalgisk encefalomyelit. Syfte Syftet var att belysa personers erfarenheter av att leva med myalgisk encefalomyelit. Metod Litteraturöversikten är baserad på 18 vetenskapliga kvalitativa och kvantitativa originalartiklar. Dessa återfanns i databaserna CINAHL, PubMed och PsycINFO. De kvalitetsgranskades enligt Sophiahemmet Högskolas bedömningsunderlag modifierat utifrån Berg et al. (1999) och Willman et al. (2011). Dataanalysen gjordes med inspiration från Kristenssons (2014) integrerade analys. Resultat Tre kategorier framträdde i resultatet med utgångspunkt i personernas erfarenhet av: mötet med sjukvården, påverkan på det dagliga livet samt copingstrategier och framtidstro. Resultatet visade att personerna hade erfarenheter av brister i mötet med sjukvården, social isolering och resultatet visade vikten av att ha strategier för att hantera sin vardag. Slutsats Litteraturöversiktens fynd visar vad det innebär för personen att leva med myalgisk encefalomyelit och hur det är att dagligen påverkas av de karaktäristiska symtomen fatigue, smärta och i och med det isolering. Samtidigt har behovet synliggjorts av ökad kunskap, rättvis vård och bättre behandling.

Cannabidiol (CBD), a non-psychotropic phytocannabinoid with structural similarity to Δ 9 -tetrahydrocannabinol (THC), is currently being investigated as a therapeutic for its immunosuppressive effects. One disease for which CBD is extensively researched is multiple sclerosis (MS), a demyelinating, autoimmune disorder, and its murine model counterpart, experimental autoimmune encephalomyelitis (EAE). The focus of this dissertation aimed to analyze the transcriptomic brain pathways in EAE and its comparison to MS in addition to CBD’s immunosuppressive mechanisms in the innate and adaptive immune systems. Evidence presented here showed that transcriptomic signaling pathways in the EAE brain of mice with clinical symptoms were similar to the transcriptome of active lesions from MS patients. The transcriptomic analysis also presented two differentially expressed genes that were increased in CBD-treated, asymptomatic EAE mouse brains: oxytocin and vasopressin. Expression of these genes was also increased in naïve, CBD-treated mouse brains, which may indicate potential as efficacy biomarkers. Subsequently, as disease progression requires input from the innate and adaptive immune systems, the mechanisms of CBD were analyzed under naïve and stimulatory conditions in macrophages and splenocytes. In macrophages, CBD exerted an anti-inflammatory effect by dampening the M1 polarization phenotype, decreasing pro-inflammatory cytokines and chemokines, reducing TNF-α through intracellular TACE retention, and diminishing the translocation of RelA to the nucleus. Notably, similar impact of CBD on TACE was evident in naïve macrophages, suggesting that CBD exerted an effect under naïve conditions. In splenocytes, CBD exhibited a long-term effect on the percentage of various immune populations during naïve and splenic T cell activation (with anti-CD3/anti-CD28) conditions but only provided temporary relief and short-term from TNF-α and IFN-γ cytokine secretion. CBD also increased early mRNA expression of Tnfa in CBD in stimulated splenocytes. In naïve splenocytes, CBD impacted key immune mediators discovered from a transcriptomic re-analysis of human neuroblastoma cells, including decreased early expression of Noxo1 but increased expression of Ctsb. In summary, this dissertation presented evidence that CBD impacts the immune system from the transcriptional level in the brain, the innate and adaptive immune systems at the cellular level, and the overall EAE disease phenotype.

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