Os mecanismos etiopatogênicos que levam ao desenvolvimento dos nódulos e tumores da tireoide ainda não são bem conhecidos. É fato estabelecido que a prevalência dessas lesões é maior nas mulheres. Dessa forma, o que nos motivou a realizar esta Tese foi avaliar se os hormônios sexuais femininos tem efeito direto sobre as células de tireoide humanas normais podendo contribuir para a sua etiopatogenia. Este estudo teve como objetivos padronizar um modelo de cultura primária de células foliculares de tireoide humana normal e nesse modelo validar um gene normalizador após tratamento com estradiol e progesterona, avaliar os efeitos da progesterona na expressão dos genes NIS, TG e TPO bem como avaliar a expressão gênica e proteíca e a possível localização intracelular do receptor de membrana GPR30 nestas células. Em nosso modelo de cultura primária em monocamada, as células foliculares mantiveram sua morfologia cubóide característica e permaneceram diferenciadas o que foi evidenciado pela dosagem de tireoglobulina e T4 livre, no sobrenadante do meio de cultura, e pela identificação das proteínas TG e TPO por imunocitoquímica. A estimulação com progesterona aumentou a expressão dos genes NIS, TG e TPO, respectivamente, 1.78 (p=0.003), 1.50 (p=0.034) e 1.64 (p=0.018) vezes, quando comparadas ao grupo tratado somente com TSH. Essa estimulação da progesterona foi inibida por mifepristona sugerindo que a progesterona tem efeito direto nas células foliculares da tireoide e que esse efeito é mediado por seu receptor nuclear. A normalização da expressão gênica foi realizada pelo gene β-actina, o qual demonstrou uma maior estabilidade entre os grupos analisados. Demonstramos também que as células normais da tireoide expressam tanto o gene como a proteína do receptor de membrana GPR30 com possível localização na membrana celular e no espaço perinuclear. / The mechanisms leading to the development of thyroid nodules and tumors are not well established. As these lesions are more common in women, female sex hormones could be involved in the pathogenesis of these disorders. The objectives of this study were to establish a model of primary culture of normal human thyroid follicular cells, to validate a normalizing gene for qRT-PCR after treatment with estradiol and progesterone, to evaluate the effects of progesterone on the expression of genes NIS, TG and TPO, and to evaluate the GPR30 gene and protein expression as well as its possible intracellular location, in these cells. In our model of primary monolayer culture, follicular cells maintained their characteristic cuboid differentiated morphology; and had evidence of differentiated thyroid function: the production of thyroglobulin and free T4, and identification of TG and TPO proteins by immunocytochemistry . Adding progesterone to TSH increased NIS, TG and TPO mRNA, respectively, 1.78 (p=0.003), 1.50 (p=0.034) and 1.64 (p=0.018) folds, compared to the group treated with only TSH. This stimulation was inhibited by mifepristone, suggesting that progesterone has a direct effect on the thyroid follicular cells. Normalization of gene expression was performed using β-actin as reference gene. We have also demonstrated that normal thyroid cells expressed GPR30 gene and protein, which is possibly localized in the plasma membrane and the perinuclear region.

A infertilidade é uma condição clínica que acomete até 15% dos casais em idade reprodutiva. Como forma de tratamento para essa parcela da população a Medicina Reprodutiva dispõe de várias técnicas de Reprodução Assistida que visam auxiliar o casal na obtenção da gestação. O primeiro passo para obtenção de sucesso na Medicina Reprodutiva é o correto diagnóstico da infertilidade e, do ponto de vista didático, as causas de infertilidade podem ser classificadas em: feminina, masculina, mista ou desconhecida. A causa feminina de infertilidade apresenta como importante fator o ovariano, representado, principalmente, por alterações no processo de maturação do oócito e/ou no processo de foliculogênese. Com relação à maturação do oócito, um dos possíveis tratamentos oferecidos pela Medicina Reprodutiva é a aplicação da técnica de maturação in vitro (MIV). Infelizmente a MIV não apresenta resultados animadores, e um dos motivos é a falta de um método adequado de seleção dos gametas de humanos que podem ser destinados à ela. No entanto, várias técnicas de seleção de oóticos já foram descritas para espécies animais; dentre elas destaca-se a coloração dos complexos cumuli-oócitos com o corante Azul Cresil Brilhante (BCB). A sua aplicação na espécie humana permanece com ressalvas, uma vez que a comunidade científica preocupa-se com os possíveis efeitos tóxicos dessa substância. Nesta Tese, conseguimos demonstrar, através da avaliação de ensaios de viabilidade e de proliferação celular, e da expressão gênica e proteica, a inocuidade dessa substância para o modelo de cultura primária de células foliculares ovarianas luteinizadas, indicando que o protocolo de coloração com BCB é seguro para a espécie humana. Adicionalmente, conseguimos caracterizar e padronizar o cultivo dessas células, que são amplamente utilizadas em estudos na área da Medicina Reprodutiva. Com relação ao outro fator ovariano de infertilidade (o processo de foliculogênese), sabe-se que a depleção acelerada dos folículos ovarianos pode provocar falência ovariana precoce (FOP), uma condição clínica que acomete até 1% das mulheres em idade reprodutiva e leva à infertilidade. Uma das causas da FOP é a alteração no gene Fragile X Mental Retardation 1 (FMR1) e consequentemente em sua proteína (FMRP). Muito do conhecimento do controle dessa proteína provem de experimentos em neurônios, onde o seu controle já foi elucidado. Nesta Tese, conseguimos demonstrar que o controle dessa proteína nas células ovarianas de humanos é similar ao controle que ocorre nos neurônios, envolvendo a via de sinalização S6K. / Infertility is a clinical condition that affects up to 15% of couples of reproductive age. Reproductive medicine applies many assisted reproductive technologies (ARTs) in order to help them to achieve pregnancy. The first step for infertility treatment success is the correct infertility diagnosis, which is divided into four categories: female, male, mixed or unknown. Female infertility is chiefly represented by ovarian dysfunctions, which are generally related to oocyte maturation and/or folliculogenesis. With regard to oocyte maturation, in vitro oocyte maturation (IVM) is one ART that can be applied but, unfortunately, nowadays it does not present suitable results, since we do not have an effective method of selecting competent human oocytes. On the other hand, in animal reproduction brilliant cresyl blue (BCB) staining has already been described as an appropriate method for oocyte selection. However its clinical applicability to humans is some away off, owing to concerns about its safety. In this thesis we have demonstrated (through many cellular viability and proliferation assays and gene and protein expression), that BCB staining, applying the correct protocol, seems to be safe for use in humans (using the primary culture of human ovarian follicular cells as an experimental model). Additionally, we have characterized and standardized the primary culture of human ovarian follicular cells, and this experimental model is widely applied in reproductive medicine experiments. With regard to folliculogenesis, it is well known that premature ovarian failure/insufficiency (POF/POI) is one condition that can be caused by follicle depletion (when folliculogenesis occurs too fast). This condition affects about 1% of females of reproductive age, causing infertility. Genetic alterations, such as in the fragile X mental retardation 1 (FMR1) gene and its protein FMRP, are considered as one cause of POF/POI. Most of our knowledge about FMRP cellular control comes from studies on neurons, and in these cells we have a clue about its control. In this thesis, we have shown that FMRP control on human granulosa cells is similar to its control on neurons, and this involves the S6K pathway.

Abstract Diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) are two of the most common lymphomas in the Western world. DLBCL is an aggressive disease with a good response to treatment; about 75% of patients achieve permanent remission after first-line treatment. In patients with relapses or primary refractory disease, prognosis is dismal; only 10–20% of them can be cured, even with aggressive treatments. FL is an indolent lymphoma with a very good response to treatment and slow progression. Median survival with modern treatments is over 15 years. Nevertheless, some patients have short remissions and succumb to disease. Oxidative stress, TP53 mutations, and translocations of MYC, Bcl-2 and Bcl-6 have been linked in many neoplasms to aetiology and poor prognosis. This thesis concerns oxidative stress and redox-state-regulating enzymes in DLBCL and FL, and TP53 mutations and translocations of MYC, Bcl-2 and Bcl-6 in DLBCL. High expression levels of the antioxidant enzyme thioredoxin and a marker of oxidative stress, nitrotyrosine, were related to poor prognosis in DLBCL. In FL, high-level expression of peroxiredoxin was associated with good prognosis. TP53 mutations in specific regions LSH and L3 and concurrent translocation of Bcl-2 were associated with poor prognosis in DLBCL. Not all TP53 mutations predicted survival. High expression levels of Bcl-2 and MYC were associated with poor prognosis in DLBCL. Based on the results presented here, antioxidant function may have protective roles, but also may cause resistance to treatment. TP53 mutations have prognostic roles in DLBCL, but should be further defined. Novel therapies could be developed in connection with these mechanisms. / Tiivistelmä Diffuusi suurisoluinen B-solulymfooma (DLBCL) ja follikulaarinen lymfooma (FL) ovat kaksi yleisintä lymfoomaa länsimaissa. DLBCL on aggressiivinen syöpä, joka reagoi hyvin hoitoihin, jopa 75 % paranee. Kuitenkin potilailla, joilla syöpä uusiutuu hoitojen jälkeen tai etenee hoidon aikana, on erittäin huono ennuste, noin 10-20 % näistä potilaista voidaan parantaa. FL on hyväennusteinen lymfooma, joka yleensä reagoi hyvin hoitoihin. Mediaani elossaoloaika kaikilla FL potilailla on yli 15 vuotta taudin toteamisesta. Osalla potilaista FL kuitenkin on aggressiivisempo. Oksidatiivinen stressin, TP53- mutaatioiden, MYC, Bcl-2 ja Bcl-6 -translokaatioiden on todettu olevan huonoon ennusteeseen yhteydessä olevia tekijöitä monissa syövissä, kuten lymfoomissa. Tämä väitöskirja tutki oksidatiivisen stressin ja hapetus-pelkistys reaktioon liittyvien entsyymien osuutta R-CHOP-hoidetuissa DLBCL:ssa ja FL:ssa immunohistokemian (IHC) avulla. DLBCL:ssa tutkittiin lisäksi TP53 mutaatioita, MYC, Bcl-2 ja Bcl-6 translokaatioiden roolia taudin kulussa. Korkea ekspressio oksidatiivisen stressin merkkiainetta nitrotyrosiinia ja antioksidantti thioredoksiinia olivat yhteydessä huonoon ennusteeseen DLBCL:ssa. FL:ssa runsas ilmentyminen antioksidativiisiin entsyymeihin kuuluvia peroksiredoksiineja olivat yhteydessä hyvään ennusteeseen. TP53 mutaatiot LSH ja L3 alueella ja Bcl-2 -translokaatiot yhdessä olivat yhteydessä huonoon ennusteeseen DLBCL:ssa. Kaikki TP53-mutaatiot eivät olleet assosioituneet huonoon ennusteeseen. DLBCL:ssa Bcl-2 ja MYC –proteiinien runsas ilmentyminen IHC:llä arvioituna liittyi huonoon ennusteeseen. Tulosten perusteella solujen hapetus-pelkistystilaa säätelevillä entsyymeillä voi olla dualistinen rooli, osittain suojeleva ja osittain vahingoittava lymfoomissa. TP53 -mutaatioilla voi olla ennusteellista merkitystä, mutta tämä vaatii lisää tutkimuksia.

Os mecanismos etiopatogênicos que levam ao desenvolvimento dos nódulos e tumores da tireoide ainda não são bem conhecidos. É fato estabelecido que a prevalência dessas lesões é maior nas mulheres. Dessa forma, o que nos motivou a realizar esta Tese foi avaliar se os hormônios sexuais femininos tem efeito direto sobre as células de tireoide humanas normais podendo contribuir para a sua etiopatogenia. Este estudo teve como objetivos padronizar um modelo de cultura primária de células foliculares de tireoide humana normal e nesse modelo validar um gene normalizador após tratamento com estradiol e progesterona, avaliar os efeitos da progesterona na expressão dos genes NIS, TG e TPO bem como avaliar a expressão gênica e proteíca e a possível localização intracelular do receptor de membrana GPR30 nestas células. Em nosso modelo de cultura primária em monocamada, as células foliculares mantiveram sua morfologia cubóide característica e permaneceram diferenciadas o que foi evidenciado pela dosagem de tireoglobulina e T4 livre, no sobrenadante do meio de cultura, e pela identificação das proteínas TG e TPO por imunocitoquímica. A estimulação com progesterona aumentou a expressão dos genes NIS, TG e TPO, respectivamente, 1.78 (p=0.003), 1.50 (p=0.034) e 1.64 (p=0.018) vezes, quando comparadas ao grupo tratado somente com TSH. Essa estimulação da progesterona foi inibida por mifepristona sugerindo que a progesterona tem efeito direto nas células foliculares da tireoide e que esse efeito é mediado por seu receptor nuclear. A normalização da expressão gênica foi realizada pelo gene β-actina, o qual demonstrou uma maior estabilidade entre os grupos analisados. Demonstramos também que as células normais da tireoide expressam tanto o gene como a proteína do receptor de membrana GPR30 com possível localização na membrana celular e no espaço perinuclear. / The mechanisms leading to the development of thyroid nodules and tumors are not well established. As these lesions are more common in women, female sex hormones could be involved in the pathogenesis of these disorders. The objectives of this study were to establish a model of primary culture of normal human thyroid follicular cells, to validate a normalizing gene for qRT-PCR after treatment with estradiol and progesterone, to evaluate the effects of progesterone on the expression of genes NIS, TG and TPO, and to evaluate the GPR30 gene and protein expression as well as its possible intracellular location, in these cells. In our model of primary monolayer culture, follicular cells maintained their characteristic cuboid differentiated morphology; and had evidence of differentiated thyroid function: the production of thyroglobulin and free T4, and identification of TG and TPO proteins by immunocytochemistry . Adding progesterone to TSH increased NIS, TG and TPO mRNA, respectively, 1.78 (p=0.003), 1.50 (p=0.034) and 1.64 (p=0.018) folds, compared to the group treated with only TSH. This stimulation was inhibited by mifepristone, suggesting that progesterone has a direct effect on the thyroid follicular cells. Normalization of gene expression was performed using β-actin as reference gene. We have also demonstrated that normal thyroid cells expressed GPR30 gene and protein, which is possibly localized in the plasma membrane and the perinuclear region.

INTRODUÇÃO: Os carcinomas papilífero e folicular são neoplasias malignas primárias da glândula tireóide. Em conjunto, recebem o nome de carcinoma bem diferenciado. Determinar o risco individual da ocorrência de metástase nesses casos auxilia na seleção da terapêutica que é atualmente baseada na classificação de acordo com fatores prognósticos, aos quais pode ser associada a pesquisa de marcadores biológicos. Dentre eles, destaca-se a galectina-3, cujas funções exercidas nos compartimentos celulares foram descritas em uma variedade de neoplasias. Entretanto, seu papel no carcinoma tireóideo permanece controverso. Com o intuito de investigar se a galectina-3 pode auxiliar na predição do risco individual da ocorrência de metástase e se está associada aos critérios de malignidade do carcinoma bem diferenciado, a presente pesquisa objetivou verificar as seguintes hipóteses: 1) se há diferença da imunoexpressão da galectina-3 nos compartimentos do tireócito maligno entre os doentes com e sem metástase e se é possível predizer o risco de metástase em função da quantificação digital desse marcador; 2) se há diferença da imunoexpressão da galectina-3 entre o tecido tireóideo maligno e o não neoplásico; conforme a presença de invasão tecidual; e conforme a sobrevivência; 3) se há indício do envolvimento da galectina-3 com apoptose, indução da proliferação celular e angiogênese. MÉTODO: Trata-se de estudo retrospectivo de caso-controle que envolveu 109 doentes operados por carcinoma bem diferenciado da tireóide e seguidos por mais de cinco anos, distribuídos em dois grupos equivalentes: com e sem metástase. Foram feitos coleta de dados clínicos, avaliação anátomo-patológica e análise imunohistoquímica digital dos biomarcadores galectina-3, Ki-67, caspase-3 e CD-34. RESULTADOS: 1) A média do índice de positividade nucleolar da galectina-3 foi maior no grupo de doentes com metástase linfática cervical (1,78 ± 0,41 nucléolos/CGA contra 0,35 ± 0,13, p=0,004). A expressão nucleolar da galectina-3 apresentou especificidade de 75% para identificação da ocorrência de metástase e foi fator independente associado à ocorrência metástase linfática (p=0,01). A equação logística obtida permitiu calcular o risco individual de desenvolvimento de metástase linfática cervical que é próximo a 100% quando a galectina-3 está imunoexpressa em quatro ou mais nucléolos por campo microscópico de grande aumento. 2) não houve expressão da galectina-3 no tireócito não neoplásico; o índice de expressão citoplasmático foi fator independente associado à presença de invasão linfática (p=0,013) e a média desse índice foi maior nos casos com extensão extratireóidea (52,7 ± 3,9 uo/µm2 contra 41,0 ± 4,0, p=0,037); não houve associação dos índices de imunoexpressão da galectina-3 e sobrevivência; 3) no grupo de doentes com metástase, a expressão nucleoplasmática da galectina-3 correlacionou-se de forma positiva com o índice de positividade do Ki-67 e, nos dois grupos, a expressão citoplasmática com o índice de expressão da caspase-3. CONCLUSÕES: Foi possível predizer o risco individual da ocorrência de metástase linfática cervical em função da quantificação digital da imunoexpressão nucleolar da galectina-3. O presente estudo sugere que alta expressão citoplasmática está associada com algumas características de invasão local. Houve indícios do envolvimento da galectina-3 com indução da proliferação celular e apoptose no grupo de doentes com metástase. / INTRODUCTON: Papillary and follicular carcinomas are primary malignant neoplasias of the thyroid gland and are classified as well-differentiated carcinoma. In these cases, determination of individual risk of metastasis allows offering an adequate treatment. Nowadays therapy is chosen based on classification according to prognostic factors and biomarkers can be associated with them. Galectin-3 is one of these markers and has been thoroughly studied. A wide range of functions that it carries out in the subcellular compartments have been described in several neoplasms. However, its role in thyroid carcinomas remains controversial. In order to investigate if galectin-3 can be used to predict the individual risk of metastasis and if this marker is associated with malignant criteria of well-differentiated carcinoma, this study was proposed to verify the following hypotheses: 1) if galectin-3 immunostaining in subcellular compartments of the malignant thyrocyte is different when comparing patients with and without metastasis and if it is possible to predict the individual risk of metastasis based on digital quantification of the galectin-3 immunostaining; 2) if galectin-3 immunoexpression is different from malignant and benign thyroid tissue; according to tissue invasion and survival; 3) if there are indications that galectin-3 plays a role in apoptosis and cell proliferation or angiogenesis induction. METHODS: It was performed a retrospective case-control study involving 109 patients treated for well-differentiated thyroid carcinoma and followed up for more than five years. They were divided into two equivalent groups: with and without metastasis. The search of clinical data, morphological evaluation and digital immunohistochemical analysis with galectin-3, Ki-67, caspase-3 and CD-34 antibodies were done. RESULTS: 1) the average of the nucleolar galectin-3 positive index was higher in lymph node metastasis group (1.78 ± 0.41 nucleoli/HPF versus 0.35 ± 0.13, P=.004). Nucleolar staining was an independent factor associated with lymph node metastasis (P=.01) and its specificity to identify metastasis was 75%. The logistic model allowed predicting the individual risk of cervical lymph node metastasis. It was almost 100% for carcinomas displaying more than four galectin-3 immunostained nucleoli by microscopic high power field. 2) There was no galectin-3 immunostaining in non-neoplasic thyrocyte; the cytoplasmic galectin-3 expression index was an independent factor associated with lymphatic invasion (P=.013) and these index average was higher in cases with extrathyroidal extension (52.7 ± 3.9 uo/µm2 versus 41.0 ± 4.0, P=.037); there was no association of galectin-3 immunostaining indexes with survival; 3) in the metastasis group, there was positive correlation between nucleoplasmic staining of galectin-3 and Ki-67 positive index; there was positive correlation between cytoplasmic staining of galectin-3 and caspase-3 positive index in both groups. CONCLUSION: It was possible to predict the individual risk of cervical lymph node metastasis based on digital quantification of the nucleolar galectin-3 immunostaining. This study suggests that there is association of high cytoplasmic expression with local tissue invasion. In the metastasis group there were indications that galectin-3 plays a role in cell proliferation and apoptosis induction.

MSCAGR (Animal Science) / Department of Animal Science / The main purpose of this study was to assess the efficiency of ultrasonography in monitoring reproductive organs, pregnancy diagnosis, and foetal gender identification and to verify its reliability by laparoscopy and laparotomy, where applicable. Reproductive organs, pregnancy diagnosis and gender of the foetus were examined by A-mode ultrasound using 3.0 - 8.0 MHz trans-rectal transducer. A Sony Olympus Model laparoscope with a camera transducer was used to monitor the reproductive organs and pregnancy diagnosis. In monitoring the follicular dynamics, daily ultrasonography (ULTS) scanning was done for 17 days in sheep and for 21 days in both goats and cattle. Follicles of diameter ≥ 3 mm were selected for analysis of growth, ovulation and regression. For determining the efficiency of the techniques, laparoscopy (LAPSC) and laparotomy (LAPT) were used on days 3 and 10 of the goats and sheep oestrous cycle. The follicles were grouped into three categories according to their diameter as 3 - 4.9 mm, 5 - 7.9 mm and ≥ 8 mm, whereas the follicles of cattle were grouped as 3 - 4.9 mm, 5 - 9.9 mm and ≥ 10 mm. Early pregnancy diagnosis examinations were carried out from day 18 post insemination until pregnancy was confirmed. Foetal gender examinations were conducted from day 40 of pregnancy until the day the gender of the foetus was confirmed. Follicular development was accompanied by the occurrence of waves of follicular growth at different period of the oestrous cycle. The first follicular wave emerged on day 1.0 ± 0.4 in goats, 1.2 ± 0.4 in sheep and 2.2 ± 0.4 in cattle. The maximum diameter of the dominant follicles of observed follicular waves in goats was 7.3 ± 0.4 mm, 6.6 ± 0.2 mm, 7.3 ± 0.2 mm; in sheep was 6.4 ± 0.4 mm, 6.6 ± 0.4 mm and 6.7 ± 0.7 mm and in cattle was 13.1 ± 0.8 mm, 14.2 ± 0.6 mm and 15.7 ± 0.6 mm in wave 1, 2 and 3, respectively. However, the maximum size of the dominant follicle of the ovulatory wave in cattle was larger than the dominant follicles of both first and second waves, but in goats and sheep the dominant follicles were of similar size throughout the waves. In cattle, the ovulatory wave was shorter (p ˂ 0.05) than the duration of the first and second waves, while in sheep and goats were similar throughout the waves. In goats the total number of follicles counted in right and left ovaries under category 3 - 4.9 mm was lower with ULTS and LAPSC than with LAPT method (p ˂ 0.05). In sheep the mean number of follicles between 3 - 4.9 mm category in both right and left ovaries were different (p ˂ 0.05) between ULTS and LAPT. However, for categories 5 - 7.9 mm and ≥ 8 mm in both goats and sheep the mean numbers of follicles observed by all techniques were similar (p ˃ 0.05). In goats, pregnancy diagnosis accuracy improved from zero percent on day 18 to 100% on day 26 - 28, in sheep pregnancy diagnosis was 40% on day 18 and improved to 100% on day 20 - 22 vi of gestation. In cattle accuracy of pregnancy diagnosis was not possible at day 18 and gradually increased to 100% on day 30 - 32 of gestation. Out of 5 (100%) goat’s foetuses whose gender was determined, the diagnosis was correct in 100% (3/3) of the male foetuses and 100% (2/2) of the female foetuses. In sheep two foetuses were sexed as males while the other three were sexed as females and were both 100%. Out of 60% (3/5) of foetuses examined in cattle, 1 (100%) was identified as male and the remaining 2 (100%) were identified as females. The results obtained confirmed that the accuracy for foetal gender by ultrasonography was 100% in all foetuses observed. The current study demonstrated that trans-rectal ultrasonography examination is an efficient method for monitoring follicular dynamics, diagnosing pregnancy and foetal gender identification and that it is as reliable as laparoscopy and laparotomy where they were applied together. / NRF

Seule une minorité des individus infectés par le virus de l’immunodéficience humaine (VIH) développe une réponse immunitaire capable de contrôler le virus. Chez la plupart des individus, on observe un échappement virologique et un épuisement des lymphocytes T CD8+ spécifiques du VIH. L’infection chronique non-traitée altère également les lymphocytes T CD4+ spécifiques du VIH caractérisé par l’expression accrue des récepteurs co-inhibiteurs et une signature des cellules auxiliaires T folliculaires (Tfh). La thérapie antirétrovirale (TAR) est très efficace pour supprimer durablement la charge virale dans le plasma. Néanmoins, elle ne permet pas une éradication complète du VIH car le virus persiste, intégré dans le génome des cellules réservoirs, desquelles le virus réapparaît lors de l’interruption de la thérapie. Cela démontre que l'immunité adaptive spécifiques du VIH n'est pas restaurée. Les anticorps neutralisants à large spectre (bNAbs) représentent une alternative potentielle à la TAR. En plus de la neutralisation du virus – et contrairement à la TAR – les bNAbs ne limitent pas la disponibilité de l'antigène et peuvent engager le système immunitaire. L'administration de bNAbs à des macaques rhésus induit des réponses immunitaires adaptatives associées à un contrôle prolongé de la virémie, mais cela n’a pas été établi chez l’Homme. Dans cette thèse, nous avons donc exploré la modulation des réponses des lymphocytes T spécifiques du VIH lors d'une TAR standard et d’une immunothérapie utilisant des bNAbs. Dans un premier objectif nous avons analysé la modulation persistante des réponses des lymphocytes T CD4+ spécifiques du VIH chez les individus sous TAR. Nous avons pu démontrer l'expansion persistante des Tfh spécifiques au VIH avec des caractéristiques phénotypiques et fonctionnelles les distinguant des Tfh spécifiques d’antigènes viraux comparatifs (cytomégalovirus, virus de l’hépatite B). Ces caractéristiques ont été induites au cours de l’infection chronique non-traitée, persistaient pendant la TAR et étaient associées au réservoir du VIH compétent pour la traduction. Ces données suggèrent qu’une stimulation antigénique persistante, malgré une TAR efficace, maintient des modifications immunologiques notamment au niveau des Tfh. Dans un second objectif, nous avons caractérisé les réponses T spécifiques du VIH à la suite d’un traitement utilisant des bNAbs et une interruption structurée de la TAR (IST). Des individus inclus dans une étude clinique de phase Ib ont reçu une perfusion d’une combinaison des bNAbs 10-1074 et 3BNC117 et ont démontré une suppression virale prolongée après l’IST. Chez ces participants, nous avons observé une augmentation des réponses immunitaires des lymphocytes T CD8+ et CD4+ spécifiques du VIH due à l'expansion des réponses immunitaires préexistantes et au développement de réponses ciblant de nouveaux épitopes. Cela suggère que la combinaison d’un traitement par bNAbs avec l’IST est associée au maintien de la charge virale plasmatique indétectable et à une intensification de la réponse immunitaire des lymphocytes T spécifiques du VIH. Nos travaux permettent une meilleure compréhension des réponses des lymphocytes T spécifiques du VIH au cours de la TAR et lors d’une immunothérapie. Ils peuvent contribuer au développement de stratégies thérapeutiques plus efficaces visant à contrôler la réplication virale sans la TAR. / Only a small fraction of individuals infected with the human immunodeficiency virus (HIV) develops effective immune responses able to control the virus. In most individuals, the virus escapes the antiviral immune response and HIV-specific CD8+ T cell responses become exhausted. Untreated progressive HIV infection also leads to alterations in HIV-specific CD4+ T cells. This includes increased expression of co-inhibitory receptors and skewing towards a T follicular helper cell (Tfh) signature. Antiretroviral therapy (ART) is highly effective in controlling the HIV viral load at undetectable levels in the plasma. However, ART does not represent a cure as the virus integrates into the genome of infected cells from where the virus rebounds once ART is stopped. This demonstrates that the HIV-specific T cell immunity is not restored. However, the changes that are introduced during progressive infection and that are maintained after viral suppression with ART are poorly known. Broadly neutralizing antibodies (bNAbs) represent a potential alternative to ART. In addition to virus neutralization and unlike ART, bNAbs to do not limit HIV antigen availability and can engage the immune system. bNAb administration elicited adaptive immune responses that were associated with long-lasting viral control in a simian animal model but this has not been established in HIV-infected individuals. In this thesis, we therefore proceeded to study the modulation of HIV-specific T cell responses during standard ART and after an immunotherapeutic intervention using bNAbs. The first objective was to better understand persistent modulation of HIV-specific CD4+ T cell responses in ART-treated individuals. Our results demonstrated the persistent expansion of HIV-specific Tfh cell responses with multiple phenotypic and functional features that differed from Tfh cells specific for comparative viral antigens (cytomegalovirus, hepatitis B virus). These features were induced during chronic untreated HIV infection, persisted during ART and correlated with the translation-competent HIV reservoir. This suggests that persistent HIV antigen expression, despite effective ART, maintains these altered immunological features specifically for Tfh responses. For the second objective, we characterized changes in the HIV-specific CD8+ and CD4+ T cell immunity after bNAb treatment and analytical treatment interruption (ATI). For this, we used samples obtained from participants enrolled in a clinical phase Ib study that received combined infusion of bNAbs 10-1074 and 3BNC117 and demonstrated prolonged viral suppression after ATI. In these individuals, we detected an increase of HIV-specific CD8+ and CD4+ T cell responses during ART interruption when compared to baseline. Increased T cell responses were due to both expansion of pre-existing responses and the emergence of responses to new epitopes. In contrast, HIV-specific T cell responses remained unchanged in ART-treated individuals who did not receive bNAb infusions. This suggests that bNAb treatment and ATI is associated with increased HIV-specific T cell immunity while viral suppression is maintained. Together our results contribute to a better understanding of HIV-specific T cell responses during ART and immunotherapy treatment. Our findings may help to develop more effective HIV treatment strategies to improve the host’s immune system so that HIV can be controlled without the need for ART.

Le lymphome angioimmunoblastique à cellules T (AITL) est un lymphome périphérique à cellules T agressif dont les symptômes sont la lymphadénopathie et l'hypergammaglobulinémie. Actuellement, les patients atteints du AITL ont des options de thérapeutiques limitées et des résultats cliniques défavorables, avec un taux de survie sur 5 ans d'environ 30%. Les cellules tumorales du AITL proviennent de cellules T CD4+ appelées cellules T auxiliaires folliculaires (Tfh). Les cellules Tfh sont essentielles dans le centre germinatif (GC), où elles facilitent l'expansion et la différentiation des cellules B en plasmocytes. Cette fonction d'aide est soutenue par de nombreuses protéines dérivées des cellules Tfh et des programmes de transcription qui pourraient aussi fonctionner dans les cellules tumorales du AITL. Par conséquent, la perturbation des principaux mécanismes de signalisation soutenant l'identité des cellules Tfh et leurs interactions avec les cellules B pourrait inhiber la croissance du AITL. Des études ont démontré que les cellules hyperactives de type Tfh provoquent une accumulation de cellules immunitaires telles que les cellules B, les plasmocytes et les macrophages dans les tumeurs. Cependant, le microenvironnement du AITL n'a pas été bien étudié et il n'a pas été vérifié si certaines cellules immunitaires pourraient être utilisées pour arrêter la croissance de la tumeur. Bien que l’on trouve des cellules Tfh circulantes dans l’AITL humain, le taux de propagation peut varier d’un patient à l’autre. Ainsi, une possibilité est la présence de mécanismes de surveillance immunitaire s'opposant à la progression de la tumeur. En accord avec cette hypothèse, un signal positif pour la phagocytose nommé SLAMF7 (contrebalancé par la voie inhibitrice CD47-SIRPα) est exprimé dans un sous-ensemble de patients atteints du AITL. Toutefois, la corrélation entre les différents niveaux d'expression du SLAMF7 et l'amélioration des résultats pour les patients n'a pas été étudiée. En utilisant des souris Roquinsan/+, qui développent spontanément l’AITL, nous avons étudié le rôle des mécanismes de signalisation immunitaire dans les cellules tumorales de type Tfh et du microenvironnement tumoral. Nous avons cherché à inhiber les protéines et les voies de signalisation typiques des cellules Tfh dans les tumeurs afin d'évaluer la valeur thérapeutique potentielle. Nous avons aussi étudié le rôle de la phagocytose dépendante des macrophages dans le contexte SLAMF7 et comment la modulation de la signalisation de CD47-SIRPα peut améliorer l'efficacité de la phagocytose des cellules tumorales. Notre hypothèse centrale est qu'en supprimant les programmes fondamentaux des cellules Tfh ou en favorisant l'élimination phagocytaire des cellules tumorales de type Tfh, nous pouvons favoriser la régression de la tumeur. Nous avons démontré que les tumeurs AITL nécessitent des protéines d’identité des cellules Tfh essentielles telles que le facteur de transcription Bcl6 et la protéine adaptatrice SAP, ainsi que la communication entre les cellules T et B (T-B). Même en l'absence de GC classiques, les cellules tumorales de type Tfh ont apporté un soutien aux cellules B. Cela est démontré par des titres élevés d'IgG et l'accumulation de cellules précurseurs des plasmocytes dans les tumeurs. Nous avons trouvé des preuves de l'opposition entre la surveillance immunitaire et l'évasion au sein des tumeurs de type AITL, car les cellules Tfh augmentent l’expression de la molécule inhibitrice CD47 tandis que les macrophages stimulent le niveau de SLAMF7. Les cellules de type AITL ont été phagocytées plus efficacement in vitro quand la signalisation du CD47 était bloquée. En résumé, nous démontrons que les voies de signalisation importantes pour l'identité des cellules Tfh et la communication entre les cellules T et B sont essentielles pour la progression de l’AITL et suggèrent qu’une surveillance immunitaire continue par les macrophages peut influencer l’évolution de la maladie. Des études futures pourraient explorer la possibilité de combiner des inhibiteurs de l'activité des cellules Tfh ou T-B avec des médicaments qui stimulent l'activité phagocytaire antitumorale pour améliorer l'efficacité thérapeutique du traitement. / Angioimmunoblastic T cell lymphoma (AITL) is an aggressive peripheral T cell lymphoma manifesting with symptoms such as generalized lymphadenopathy and hypergammaglobulinemia. Currently, AITL patients have limited treatment options and poor clinical outcomes with a 5-year survival rate around 30%. AITL tumor cells derive from a subset of CD4+ T cell, the T follicular helper (Tfh) cell. Tfh cells are essential in germinal centers (GC), where they facilitate B cell expansion and differentiation into plasma cells. This helper function is supported by numerous Tfh cell-derived proteins and transcriptional programs which may still be operational in AITL tumor cells. Therefore, disrupting key signaling mechanisms sustaining Tfh cell identity and their ability to interact with B cells could inhibit AITL tumor growth. Studies have demonstrated that these hyperactive Tfh-like cells lead to the accumulation of immune cell subsets such as B cells, plasma cells, and macrophages within tumor lymph nodes. Nevertheless, the AITL tumor microenvironment itself has not been well-studied and whether some immune cells could be harnessed to impede tumor growth has not been tested. In human AITL, although circulating Tfh cells have been reported, the rate of tumor spreading can vary between patients. As such, one possibility is the presence of immune surveillance mechanisms opposing tumor progression. In line with this idea, SLAMF7, a positive signal for macrophage-mediated phagocytosis (counterbalanced by the inhibitory CD47-SIRPα pathway), is expressed in a subset of AITL patients. Despite this, whether differing levels of SLAMF7 expression correlates with improved patient outcomes has not been investigated. Using Roquinsan/+ mice, a spontaneous AITL-like mouse model, we addressed the role of immune signaling mechanisms within Tfh-like tumor cells and the surrounding tumor microenvironment that would promote tumor regression. First, we aimed to inhibit signature Tfh cell proteins and downstream signaling pathways in developed AITL-like tumors to evaluate potential therapeutic value. Second, we investigated the role of macrophage-mediated phagocytosis in the context of SLAMF7 and how modulating CD47-SIRPα signaling may enhance the efficiency of AITL tumor cell engulfment. Our central hypothesis is that by removing fundamental Tfh cell supporting programs from tumor cells or by promoting the phagocytic removal of Tfh-like tumor cells we can favour tumor regression and impair future growth. Through this work, we demonstrated that AITL-like tumors continuously require critical Tfh cell identity proteins such as transcription factor Bcl6 and adaptor protein SAP, as well as T cell-B cell (T-B) crosstalk. Importantly, despite the absence of conventional GCs, Tfh-like tumor cells provided functional support to B cells as evidenced by elevated IgG titers and accumulation of plasma cell precursors in tumors. We also found evidence of opposition between immune surveillance and evasion within AITL-like tumors as Tfh-like cells upregulated inhibitory CD47 levels while macrophages increased expression of prophagocytic SLAMF7. Moreover, AITL-like tumor cells were more efficiently phagocytosed in vitro when CD47 signaling was blocked. Taken together, we demonstrate that pathways important for Tfh cell identity and T-B communication are critical for AITL-like disease progression and suggest that ongoing macrophage-mediated immune surveillance may influence disease outcomes. Future studies may explore combining inhibitors of Tfh cell activity or T-B crosstalk along with drugs which boost antitumor phagocytic activity to further improve the therapeutic efficacy of treatment.

Le costimulateur inductible (ICOS) est un récepteur costimulatoire des cellules T crucial pour l’immunité humorale. Chez l’humain, une déficience de ICOS est associée à des infections récurrentes dû à des défauts de différentiation des lymphocytes T auxiliaires folliculaires (Tfh) et un manque d’anticorps protecteurs. Paradoxalement, certains patients déficients en ICOS développent des signes d’autoimmunité causés par des autoanticorps. Ces observations sont en accord avec des résultats suggérant que ICOS joue un double rôle dans la promotion des fonctions de cellules T effectrices et de cellules T régulatrices. L’arthrite rhumatoïde (RA) est une maladie autoimmune caractérisée par l’inflammation articulaire et la destruction progressive des os. Dans la première étude présentée au Chapitre 2, nous avons démontré que ICOS est requis pour l’initiation et la maintenance de l’arthrite induite par le collagène (CIA), un modèle murin de la RA. Nous avons démontré que des événements clés de l’initiation de la CIA incluant la production d’anticorps contre le collagène et la prolifération de cellules T inflammatoires sont dépendants de la voie de signalisation ICOS-PI3K. Aussi, nous avons trouvé que la signalisation par ICOS-PI3K promouvoit le maintien de la CIA. De plus, nous avons établi que l’inhibition de la glycolyse réduit la sévérité de la CIA, ce qui suggère un chevauchement entre la signalisation ICOS-PI3K et le métabolisme du glucose dans la pathogenèse de l’arthrite autoimmune. Dans la deuxième étude présentée au Chapitre 3, nous avons utilisé des souris dont les cellules T régulatrices sont déficientes en ICOS (ICOS FC) pour évaluer l’impact de ICOS dans les cellules Tfr. Nous avons trouvé que les souris ICOS FC possèdent un taux réduit de cellules Tfr, mais aucune diminution des cellules T régulatrices (Treg) précurseurs. De plus, les souris ICOS FC ont un taux élevé de cellules B du centre germinatif (GC) non-spécifiques ainsi qu’une production accrue d’anticorps anti-nucléaires. Nous avons aussi observé une perturbation des réponses anti-virales et de la production d’anticorps spécifiques dans les souris ICOS FC ce qui suggère des rôles non-régulateurs pour les cellules Tfr. Nous avons effectué une analyse de transcriptome de cellule unique avec des Tregs et nous avons observé une accumulation de précurseurs de Tfr dans les souris ICOS FC, ce qui suggère un défaut de la transition Treg à Tfr. Nos données suggèrent que ICOS participe à la différentiation des cellules Tfr en régulant KLF2 et NFAT2, ce qui contribue à l’établissement de traits folliculaires. En résumé, nous avons démontré que ICOS promouvoit le développement de l’arthrite autoimmune en soutenant les fonctions des cellules T inflammatoires par la voie de signalisation ICOS-PI3K. De plus, nos résultats prouvent que ICOS peut prévenir la production d’autoanticorps en supportant la différentiation des cellules Tfr. Notre travail contribue à l’avancement des connaissances en ce qui concerne le rôle double de ICOS dans l’immunité cellulaire et humorale et fournit des paramètres importants à considérer lors de la recherche de nouvelles cibles thérapeutiques. / The inducible costimulator (ICOS) is a T cell costimulatory receptor crucial for humoral immunity. In humans, ICOS deficiency is associated with recurrent infections due to defects in T follicular helper (Tfh) differentiation and lack of protective antibodies. Paradoxically, some ICOS-deficient patients were found to exhibit signs of antibody-mediated autoimmunity. These observations are congruent with findings suggesting that ICOS plays a dual role in promoting T effector and T regulatory cell functions. Due to this ambivalence, the role of ICOS in autoimmunity remains unresolved. Rheumatoid arthritis (RA) is an autoimmune disease characterized by joint inflammation and progressive bone destruction. The number of ICOS+ T cells in the synovial tissues of RA patients was found to be elevated, suggesting a potential involvement of ICOS signaling in the pathogenesis of RA. In the first study presented in Chapter 2, we showed that ICOS is required for the initiation and maintenance of collagen-induced arthritis (CIA), a murine model of RA. We found that key CIA initiation events such as anti-collagen antibody production and inflammatory T cell proliferation were dependent on ICOS-PI3K signaling. Further, we found that ICOS-PI3K signaling promotes maintenance of established CIA. Additionally, we show that glycolysis inhibition ameliorates CIA, thus suggesting potential overlaps between ICOS-PI3K signaling and glucose metabolism in the pathophysiology of autoimmune arthritis. The initiation of autoimmunity depends on the action of autoimmune effector cells, but also on a failure of regulatory cells. Amongst the latter, T follicular regulatory (Tfr) cells are thought to prevent autoantibody production. In the second study presented in Chapter 3, we used regulatory T cell-specific ICOS knockout (ICOS FC) mice to investigate the impact of ICOS signaling in Tfr cells. We found that ICOS FC mice display a significant reduction in Tfr cell numbers, but no depletion of their T regulatory (Treg) precursors. Further, ICOS FC mice exhibited a rise of extraneous germinal center (GC) B cells numbers and increased production of anti-nuclear antibodies. We also observed disruptions of anti-viral responses and antigen-specific antibody production in ICOS FC mice, suggesting non-regulatory roles for Tfr cells. We performed single-cell transcriptome analysis of regulatory T cells and observed an accumulation of Tfr precursors in ICOS FC mice suggestive of a Treg-to-Tfr transition defect. Mechanistically, we found that ICOS participates in Tfr differentiation by regulating KLF2 and NFAT2, thereby contributing to the establishment of follicular T cell traits. In sum, we demonstrate that ICOS promotes the development of autoimmune arthritis by fostering inflammatory T cell responses in a PI3K-dependent manner. In addition, our work shows that ICOS can prevent autoantibody production by supporting Tfr differentiation. Thus, we contribute insights into the dual role of ICOS in the cellular and humoral arms of autoimmunity, providing important parameters to be considered when searching for novel therapeutic targets.

Au cours des processus de croissance folliculaire et d'ovulation, les cellules stéroïdogéniques, y compris les cellules de granulosa (CG), jouent un rôle crucial dans la maturation et la libération de l'ovocyte. Notre laboratoire a identifié et caractérisé pour la première fois tribbles pseudokinase 2 (TRIB2) dans les CG de follicules ovariens. Des études ont démontré que TRIB2 joue un rôle dans la coordination de la mitose et la morphogenèse chez la drosophile alors que chez la souris, son expression dans les cellules du cumulus serait liée à la maturation ovocytaire. Cependant, le rôle exact de TRIB2 dans la fonction des CG et ses effets sur les voies de signalisation impliquées dans la croissance folliculaire restait à être défini. La présente étude de doctorat avait donc pour but d’étudier la fonction et les partenaires de liaison de TRIB2 dans les CG de follicules ovariens bovins. À l’aide d’un modèle d’étude in vivo consistant en des CG obtenues à partir de follicules à différents stades de développement, nous avons démontré une régulation à la baisse de TRIB2 par l’hormone lutéinisante (LH) et la gonadotrophine chorionique humaine (hCG) aussi bien au niveau du messager que de la protéine. De plus, les analyses utilisant un modèle in vitro de CG en culture ont montré que la FSH stimule l'expression de TRIB2 tandis que l'inhibition de TRIB2 via CRISPR/Cas9 entraîne une réduction significative de la prolifération des CG (P<0,05). Les analyses Western blot ont montré une augmentation des niveaux de phosphorylation d’ERK1/2 (MAPK3/1) et p38MAPK (MAPK14) suite à la surexpression de TRIB2. Ces résultats suggèrent un rôle de TRIB2 dans la croissance folliculaire et la modulation des voies MAPK. Avec l’approche double hybride chez la levure, nous avons identifié CALM1, INHBA, INPPL1, NT5E, SCD, SDHB et RAB14 comme partenaires de liaison de TRIB2. Les analyses RT-PCR ont montré que ces partenaires sont régulés différemment au cours du développement folliculaire et les manipulations de l’expression de TRIB2 (inhibition ou surexpression) résulte en une régulation différente (augmentation ou diminution) de l’expression des partenaires dans les CG. Ces résultats suggèrent un rôle de TRIB2 dans la régulation de cibles effectrices en lien avec la fonction des CG et le développement folliculaire. Enfin, un modèle de CG provenant de vaches en période post-partum a été utilisé pour mieux comprendre le contrôle de l’activité des CG. Des analyses complémentaires avec ce modèle ont révélé une réduction significative de TRIB2 chez les vaches ayant un taux élevé de BHB (>1.4mmol/L) comparé à celles ayant un faible taux de BHB (<1.2mmol/L). Cette réduction était concomitante à une augmentation d’interleukines pro-inflammatoires et une réduction d’interleukines anti-inflammatoires dans les CG. L’ensemble de ces résultats supporte un rôle de TRIB2 dans la modulation de la signalisation MAPK dans les CG, apporte une preuve solide que TRIB2 pourrait agir comme un régulateur de la prolifération et de la fonction des CG et de l’expression de gènes cibles, et suggère que TRIB2 pourrait affecter la stéroïdogenèse au cours du développement folliculaire et lors de la période post-partum. / During the processes of follicular growth and ovulation, steroidogenic cells, including granulosa cells, play a crucial role in the maturation and release of the oocyte. Our lab identified and characterized for the first time tribble pseudokinase 2 (TRIB2) in GC of ovarian follicles. Previous studies have shown that TRIB2 plays a role in the coordination of mitosis and morphogenesis in Drosophila while in mice its expression in cumulus cells is linked to oocyte maturation. However, the exact mechanism of action of TRIB2 as well as its function and effects on signaling pathways in GC during follicular growth remained to be defined. This study aimed therefore to further investigate TRIB2 function and identify its binding partners in GC. TRIB2 inhibition and overexpression experiments were conducted using, respectively, CRISPR/Cas9 technology and the pQE1 system. Using an in vivo model consisting of GC obtained from follicles at different stages of development, we demonstrated a downregulation of TRIB2 by the endogenous luteinizing hormone (LH) and human Chorionic Gonadotropin (hCG) at both the messenger and protein levels. In addition, analyzes using an in vitro model of cultured GC, we showed that FSH stimulates the expression of TRIB2 while inhibition of TRIB2 via CRISPR-Cas9 resulted in a significant reduction in GC proliferation (P<0.05). Western blot analyzes showed an increase in the phosphorylation levels of ERK1/2 (MAPK3/1) and p38MAPK (MAPK14) following TRIB2 overexpression. These results suggested a role of TRIB2 in follicular growth and modulation of MAPK pathways. In the second part of the thesis, we identified CALM1, INHBA, INPPL1, NT5E, SCD, SDHB and RAB14 as binding partners of TRIB2 in GC using the yeast two-hybrid approach. RT-qPCR analyzes showed that all of these partners are present in the dominant follicles but are differently regulated during follicular development. Moreover, TRIB2 manipulation (inhibition or overexpression) results in a different regulation (up- or down-regulation) of these partners expression in GC. These results suggest a role of TRIB2 in the regulation of effector targets genes related to follicular development and GC activity. In the third part of the thesis, a GC model from postpartum cows was also used to better understand the control of GC activity. Further analyses using this model revealed a significant decrease of TRIB2 in cows with high level of BHB (>1.4 mmol/L) as compared to those with a low BHB levels (<1.2 mmol/L). This reduction of TRIB2 was concomitant with an increase in pro-inflammatory interleukins and a reduction in anti-inflammatory interleukins in GC. Overall, these results support a role of TRIB2 in the modulation of MAPK signaling in GC, provide strong evidence that TRIB2 could act as a regulator of GC proliferation and function as well as expression of target genes in GC, and suggests that TRIB2 might affect steroidogenesis during follicular development and during the post-partum period.