A tuberculose (TB) é um grave problema de saúde pública. Somente no ano de 2004, cerca de 9 milhões de pessoas desenvolveram TB ativa e mais de 2 milhões de pessoas morreram da doença. O desenvolvimento de novos modelos experimentais de TB seriam de grande utilidade para para elucidar mecanismos fisiopatológicos da doença e testar esquemas terapêuticos para a prevenção e contenção da doença. Além disso, o desenvolvimento de novas vacinas torna-se indispensável como ferramenta de prevenção e controle da TB. A TB no sistema nervoso central (SNC), assim como em outros tecidos do organismo, promove a ativação de células inflamatórias. No SNC a micróglia desempenha este papel, sendo capaz de produzir ou ser influenciada por mediadores solúveis. Vários mediadores estão envolvidos nos mecanismos moleculares decorrentes da infecção e inflamação causados pela TB, entre eles: NFB, iNOS e VEGF. A ativação do NFB, um fator de transcrição citoplasmático que sob estímulo migra para o núcleo celular, tem íntima relação com a indução da iNOS e de VEGF. A resistência intracelular a patógenos, inclusive ao Mycobacterium tuberculosis, parece estar associada a expressão de iNOS em macrófagos. O óxido nítrico (NO) tem papel importante na comunicação intercelular, estimulando a síntese de mediadores inflamatórios, como as citocinas, e regulando sua própria produção endógena. Estas citocinas por sua vez também podem induzir a atividade do NFB e a expressão da iNOS e VEGF. O VEGF é um potente ativador de permeabilidade vascular e de angiogênese, envolvido na ruptura da barreira hemato-encefálica. Neste estudo, mostramos a caracterização morfológica e imuno-histoquímica de um modelo murino de TB no SNC, com a indução da doença pela inoculação de BCG. Com este modelo experimental obtivemos importantes resultados que podem esclarecer mecanismos envolvidos na fisiopatologia da neuro-TB humana. A indução de meningite e tuberculomas foi possível através da inoculação de 104 cfu de BCG no cerebelo de camundongos, por estereotaxia, e esta indução foi dependente do tempo. A confirmação do diagnóstico foi feita pela detecção de bacilos álcool-ácido resistentes (BAAR), nas lesões tuberculosas. Observamos, ao longo do tempo (1 a 6 dias; 1, 2, 4 e 8 semanas) o recrutamento de diferentes populações gliais (micróglia e astrócitos) no sítio de injeção. Houve aumento de produção e ativação NFB nas lesões tuberculosas, caracterizada pela translocação da molécula do citoplasma para o núcleo celular. Houve expressão de iNOS restrita às lesões tuberculosas, além do aumento de expressão de VEGF nestas lesões. Além disso, camundongos imunizados com a vacina gênica hsp65, contra a TB, não expressam VEGF em suas lesões. Esta vacina parece conferir um efeito protetor em nosso modelo experimental, reduzindo a expressão de VEGF, e consequentemente reduzindo seu efeito angiogênico decorrente do processo inflamatório. O recrutamento glial, e a produção de mediadores solúveis (NFB, iNOS e VEGF) pelo hospedeiro, em resposta à invasão do patógeno no SNC, parecem estar envolvidos na fisiopatologia da neurotuberculose, como demonstrado neste modelo experimental. Nosso modelo permitirá investigar fatores possivelmente responsáveis pelo desenvolvimento e manutenção de lesões tuberculosas no SNC. O objetivo final seria elucidar a fisiopatologia desta grave doença e compreender eventos moleculares envolvidos na produção de lesões. O conhecimento gerado poderá permitir o delineamento de terapias específicas e efetivas. / Tuberculosis (TB) is a serious public health problem; in 2004, 9 million people developed active TB and the disease killed 2 million patients. Development of experimental models and new vaccines are essential both to elucidate physiopathological mechanisms and to control the disease. This infection in the central nervous system (CNS), as in other tissues of the organism, activates inflammatory cells. In CNS, this role is performed by the microglia, which is capable of producing or be influenced by soluble mediators. Several mediators are involved in the molecular mechanisms of the infection and inflammation by mycobacteria , such as NFB, iNOS and VEGF. NFB activation, a cytoplasmic transcriptional factor that migrates to the cellular nucleus under stimuli, is involved with the iNOS and VEGF induction of expression. The intracellular resistance to Mycobacterium tuberculosis has been associated with iNOS expression in macrophage cells. Nitric oxide (NO) is crucial in intercellular communication, modulating the synthesis of mediators of inflammation, such as cytokines, and modulation itself. These cytokines induces NFB activity, and induces iNOS and VEGF expression. VEGF is a potent activator of vascular permeability and of angiogenesis and it is a factor involved in the breakdown of the blood brain-barrier in tuberculous meningitis. In this study, we showed the morphologic and immunohistochemistry characterization of an experimental model of TB in the CNS, with inoculation of BCG in mice. In this model we elicited important outcome that can elucidate mechanisms involved in the physiopathology of human neuron-TB. Induction of meningitis and tuberculomas were possible with stereotaxic inoculation of 104 cfu of BCG in mice cerebellum, in a time-dependent way. Diagnostic was confirmed by detection of alcohol-acid resistant bacilli (BAAR), in tuberculous lesions. We observed, the time-course (1 to 6 days; 1, 2, 4 e 8 weeks) of the recruitment of different glial populations (microglia and astrocytes) in the injection site. There was increased production and activation of NFB in the tuberculous lesions, it was characterized by its nuclear translocation from cytoplasm. There was iNOS expression only in the tuberculous lesions, and expression increased of VEGF in these lesions. Furthermore, mice immunizated with vaccine DNA-hsp65 there was no expression of VEGF in its lesions. This vaccine seems confer a protector effect in our experimental model, reducing the expression of VEGF, and then reducing its angiogenic effect derived from inflammatory process. Glial recruitment, and the soluble mediators production (NFB, iNOS e VEGF) by the host, producing in response to invasion of the pathogen in the CNS, has been involved in the pathophysiology of the neuro-TB, such as demonstrated in this experimental model. Our model will allow investigate possible factors responsible for the development and maintenance of tuberculous lesions in the CNS. The final aim is to elucidate the physiopathology of this serious illness and understand the molecular events involved in the production of the lesions. The knowledge created may permit to pave the way to delineate specific and effective therapies.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-09-26T20:24:00Z No. of bitstreams: 1 katiabatistadoamaral.pdf: 5840188 bytes, checksum: bc96f4a6457a961cca6e272ba1aaaa5d (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-09-26T20:29:35Z (GMT) No. of bitstreams: 1 katiabatistadoamaral.pdf: 5840188 bytes, checksum: bc96f4a6457a961cca6e272ba1aaaa5d (MD5) / Made available in DSpace on 2016-09-26T20:29:35Z (GMT). No. of bitstreams: 1 katiabatistadoamaral.pdf: 5840188 bytes, checksum: bc96f4a6457a961cca6e272ba1aaaa5d (MD5) Previous issue date: 2015-12-11 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O roedor Nectomys squamipes, também conhecido como rato d’água, é considerado o mais importante reservatório silvestre do parasito Schistosoma mansoni no Brasil, contribuindo para a epidemiologia da esquistossomose mansônica humana. Além disso, quando infectado, não apresenta sinais clínicos da doença, apresentando lesões teciduais extremamente brandas decorrentes da infecção. Parâmetros relacionados à infecção esquistossomótica em modelos murinos de infecção experimental já foram bem documentados; porém, em modelos de infecção natural, ainda são pouco conhecidos. A relação parasito-hospedeiro neste modelo de infecção natural é de grande relevância e motivou o desenvolvimento deste trabalho. Foi realizado estudo comparativo da esquistossomose mansônica em N. squamipes naturalmente infectado pelo parasito S. mansoni e no camundongo Swiss experimentalmente infectado, nas fases aguda e crônica da infecção, através de análises histopatológicas, bioquímicas e ultraestruturais, objetivando obter uma melhor compreensão de como o rato d’água lida com o parasitismo pelo S. mansoni. Foram realizadas análises de frequências e tipos de granulomas, suas áreas médias e do comprometimento tecidual dos órgãos alvos da infecção (fígado e intestinos), nos dois modelos experimentais. A participação dos eosinófilos durante a resposta inflamatória granulomatosa também foi avaliada, visto que estas células estão presentes em grandes números nos granulomas. Dosagens bioquímicas das transaminases hepáticas auxiliaram na avaliação do dano hepatocelular. Além disso, a influência da esteatose hepática neste modelo de infecção natural foi estudada, visto que seus efeitos não são conhecidos em animais silvestres. Assim, dosagens séricas de glicose, colesterol total e triglicerídeos foram importantes para avaliar o perfil glicêmico e lipídico dos animais estudados. Os tecidos hepáticos dos animais foram submetidos à espectroscopia Raman, para avaliar o grau de insaturação presente. Finalmente, análises ultraestruturais ajudaram a aprofundar o conhecimento sobre os papéis dos eosinófilos e dos corpúsculos lipídicos presentes nos hepatócitos nestes dois modelos de esquistossomose mansônica. Os resultados revelaram que N. squamipes apresentou excelente modulação das lesões teciduais no fígado, com baixo comprometimento tecidual neste órgão e uma reação granulomatosa mais exacerbada no intestino delgado, favorável à eliminação dos ovos do parasito nas fezes. Além disso, os níveis séricos das transaminases não se alteraram em decorrência da infecção neste roedor silvestre, ao contrário do que ocorreu no camundongo Swiss. N. squamipes infectados e não infectados apresentaram os maiores graus de insaturação presentes nos tecidos hepáticos. Características ultraestruturais intrigantes dos eosinófilos de N. squamipes foram observadas por MET. Através dos dados obtidos, concluímos que o rato d’água apresenta uma relação ecológica bem estabelecida com o parasito S. mansoni, sendo que esta adaptação ao parasitismo pode estar relacionada ao metabolismo lipídico deste reservatório silvestre. / The rodent Nectomys squamipes, also known as water rat, is considered the most important wild reservoir of the parasite Schistosoma mansoni in Brazil, contributing to the epidemiology of human schistosomiasis. Furthermore, when infected, it shows no clinical signs of the disease with extremely soft tissue injuries resulting from infection. Parameters related to the infection in murine models of experimental infection have been well documented; however, in natural infection models, they are still largely unknown. The host-parasite relationship in this model of natural infection is highly relevant and motivated the development of this work. So, It was conducted a comparative study of schistosomiasis in N. squamipes naturally infected by the parasite Schistosoma mansoni and in Swiss experimentally infected mice, at the acute and chronic phases of the infection through histological, biochemical and ultrastructural analysis, aiming to gain a better understanding of how the water rat handles with parasitism by S. mansoni. Analysis of frequencies and types of granulomas were held, their average areas and tissue impairment of the target organs of infection (liver and intestines) in both experimental models. The involvement of eosinophils during granulomatous inflammatory response was also evaluated, as these cells are present in large numbers in the granulomas. Biochemical testing of liver transaminases contributed to the evaluation of hepatocellular damage. Furthermore, the influence of hepatic steatosis in the natural infection model was studied, since their effects are not known in wild animals. Thus, serum levels of glucose, total cholesterol and triglycerides were important to assess the glycemic and lipid profile of the animals studied. The liver tissues of animals were subjected to Raman spectroscopy, to assess the degree of unsaturation. Finally, ultrastructural analysis helped to deepen understanding of the roles of eosinophils and lipid bodies present in hepatocytes in these two models of schistosomiasis. The results revealed that N. squamipes showed excellent modulation of tissue lesions in the liver, with low tissue impairment and a more exacerbated granulomatous reaction in the small intestine, favoring the elimination of the parasite eggs in feces. Furthermore, serum transaminases levels did not change as a result of the infection in wild rodents, unlike what occurred in Swiss mice. N. squamipes infected and uninfected showed the highest degree of unsaturation present in liver tissue. Intriguing ultrastructural characteristics of N. squamipes eosinophils were observed by TEM. Through the data obtained, we concluded that the water rat has a wellestablished ecological relationship with the parasite Schistosoma mansoni, and this adaptation to parasitism may be related to lipid metabolism of this wild reservoir.

Orientador: Flávio Henrique Caetano / Banca: Hércules Menezes / Banca: Ricardo José Gomes / Resumo: Quando um tecido ou órgão é alvo de algum tipo de injúria, dá-se início ao processo de inflamação tecidual. As reações celulares e humorais que tomam parte desta reação são evocadas a fim de exterminar ou neutralizar o agente infeccioso e seus produtos, permitindo que o reparo tecidual se dê da melhor forma possível. Contudo, algumas vezes o resultado desta ação pode ser prejudicial, levando ao comprometimento ou a perda das funções do tecido ou órgão em questão, com conseqüências que podem afetar a saúde do indivíduo como um todo. Em contrapartida, a atividade física moderada tem sido apontada como um grande aliado no combate à várias doenças, potencializando a ação do sistema imune e reduzindo os possíveis danos e minimizando os efeitos nocivos das respostas inflamatórias. Desta forma, nos propomos a verificar os efeitos da atividade física moderada no processo inflamatório e de reparação tecidual, comparando 10 ratos Wistar que realizaram exercícios físicos moderados com 10 sedentários, por meio da análise numérica (microscopia de luz) e ultra-estrutural (microscopia eletrônica de transmissão) de mastócitos, macrófagos e fibroblastos, células muito importantes para tais fenômenos. O modelo de estudo escolhido foi o implante subcutâneo de esponjas de PVC, que mimetiza situações clínicas importantes como, por exemplo, implantes de marcapasso. Nossos resultados indicam que as células do grupo treinado respondem de maneira mais ágil (precoce) e efetiva à injúria, que o número de cada tipo celular foi significativamente maior neste grupo e ainda que, para quaisquer dos grupos, os tipos celulares em estudo agem estreitamente interrelacionados...(Resumo completo, clicar acesso eletrônico abaixo) / Abstract: When a tissue or organ is target of some offense, it feels beginning to the process of tissue inflammation. Cellular and humoral reactions that participate of this reaction are evoked to exterminate or to neutralize the infectious agent and your products, allowing the tissue repair to feel in the best possible way. However, the result of this action can sometimes be harmful, taking to the compromising or the loss of the functions of the tissue or organ in subject, with consequences that can affect the individual's health as a completely. On the other hand, the moderate physical activity has been pointed as a great ally in the combat to several diseases, improving the action of the immune system and reducing the possible damages and minimizing the noxious effects of the inflammatory answers. Thus, we intend to verify the effects of the moderate physical activity in the inflammatory and tissue repair process, comparing 10 Wistar rats that had carried through moderate physical exercises with 10 sedentary ones, through the numeric analysis (light microscopy) and ultrastructural (transmission electronic microscopy) of mast cells, macrophages and fibroblasts, which are very important cells for such phenomena. The model of chosen study was the subcutaneous implantation of PVC sponges, that simulates important clinical situations as, for instance, implant of pacemaker. Our results indicate that the cells of the trained group answer in a more agile (precocious) and effective way to the offense, that the number of each cellular type was significantly larger in this group and although, for any of the groups, the cellular types in study act narrowly interrelated. Therefore, we ended in our work that the moderate physical activity can contribute positive and significantly for the inflammation and tissue repair process, making possible that the homeostasis is reestablished more easily and, like this, avoiding larger damages to the individual. / Mestre

Made available in DSpace on 2014-06-11T19:22:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-04-20Bitstream added on 2014-06-13T19:49:27Z : No. of bitstreams: 1 rodrigues_rf_me_rcla.pdf: 5396854 bytes, checksum: 53dc5df0dd553ffb8f11bf6074d163cc (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Quando um tecido ou órgão é alvo de algum tipo de injúria, dá-se início ao processo de inflamação tecidual. As reações celulares e humorais que tomam parte desta reação são evocadas a fim de exterminar ou neutralizar o agente infeccioso e seus produtos, permitindo que o reparo tecidual se dê da melhor forma possível. Contudo, algumas vezes o resultado desta ação pode ser prejudicial, levando ao comprometimento ou a perda das funções do tecido ou órgão em questão, com conseqüências que podem afetar a saúde do indivíduo como um todo. Em contrapartida, a atividade física moderada tem sido apontada como um grande aliado no combate à várias doenças, potencializando a ação do sistema imune e reduzindo os possíveis danos e minimizando os efeitos nocivos das respostas inflamatórias. Desta forma, nos propomos a verificar os efeitos da atividade física moderada no processo inflamatório e de reparação tecidual, comparando 10 ratos Wistar que realizaram exercícios físicos moderados com 10 sedentários, por meio da análise numérica (microscopia de luz) e ultra-estrutural (microscopia eletrônica de transmissão) de mastócitos, macrófagos e fibroblastos, células muito importantes para tais fenômenos. O modelo de estudo escolhido foi o implante subcutâneo de esponjas de PVC, que mimetiza situações clínicas importantes como, por exemplo, implantes de marcapasso. Nossos resultados indicam que as células do grupo treinado respondem de maneira mais ágil (precoce) e efetiva à injúria, que o número de cada tipo celular foi significativamente maior neste grupo e ainda que, para quaisquer dos grupos, os tipos celulares em estudo agem estreitamente interrelacionados... / When a tissue or organ is target of some offense, it feels beginning to the process of tissue inflammation. Cellular and humoral reactions that participate of this reaction are evoked to exterminate or to neutralize the infectious agent and your products, allowing the tissue repair to feel in the best possible way. However, the result of this action can sometimes be harmful, taking to the compromising or the loss of the functions of the tissue or organ in subject, with consequences that can affect the individual's health as a completely. On the other hand, the moderate physical activity has been pointed as a great ally in the combat to several diseases, improving the action of the immune system and reducing the possible damages and minimizing the noxious effects of the inflammatory answers. Thus, we intend to verify the effects of the moderate physical activity in the inflammatory and tissue repair process, comparing 10 Wistar rats that had carried through moderate physical exercises with 10 sedentary ones, through the numeric analysis (light microscopy) and ultrastructural (transmission electronic microscopy) of mast cells, macrophages and fibroblasts, which are very important cells for such phenomena. The model of chosen study was the subcutaneous implantation of PVC sponges, that simulates important clinical situations as, for instance, implant of pacemaker. Our results indicate that the cells of the trained group answer in a more agile (precocious) and effective way to the offense, that the number of each cellular type was significantly larger in this group and although, for any of the groups, the cellular types in study act narrowly interrelated. Therefore, we ended in our work that the moderate physical activity can contribute positive and significantly for the inflammation and tissue repair process, making possible that the homeostasis is reestablished more easily and, like this, avoiding larger damages to the individual.

Central giant cell granuloma (CGCG) is an uncommon pathology of the maxillary bones, which has diverse clinical behavior. It can be treated either by surgical removal or by conservative methods such as systemic daily application of calcitonin and intralesional injections of corticosteroids. Recurrence of lesions seems to vary according to its clinical behavior, location and treatment modality. The aim of this study was to evaluate the recurrence rate of the CGCG of the jaws and its associated factors through a systematic review and meta-analyses. An electronic search in PubMed and Scopus databases was conducted in order to identify observational studies, published in English, that reported the recurrence rate of CGCG of the jaws regardless of treatment modality. In addition, a hand search of cross-references was also carried out identify additional studies. We excluded studies that did not report the main outcome of interest, with less than five cases and studies not available for full text review. Twenty-one studies, published between 1973 and 2011 met eligibility criteria and were included in this review. We observed a global recurrence rate of 13.4% (8.4%-19.1%, 95% CI). Surgical curettage showed the higher recurrence rate (15.8%, 10.7 – 21.7 95%CI), followed by calcitonin administration (9.7%, 0.0 – 31.8 95% CI) and surgical resection (0.16%, 0.0 – 0.07 95%CI). Lesion location was not associated with a higher risk of recurrence (RR = 1.7, 0.97 – 2.9, 95% CI). The results of this systematic review showed a high risk of lesion recurrence of aggressive CGCG treated with surgical curettage. / A lesão central de células gigantes (LCCG) é uma patologia incomum dos maxilares que apresenta comportamento clínico bastante variável. As modalidades terapêuticas para esta lesão variam desde tratamentos conservadores, com o uso de calcitonina e corticosteróides, a abordagens cirúrgicas mais radicais. As taxas de recidiva parecem variar de acordo com o comportamento clínico das lesões, tratamento indicado e localização. O objetivo deste trabalho foi, através de uma revisão sistemática com metanálise, avaliar as taxas de recidiva da LCCG dos maxilares e seus fatores associados. A revisão sistemática da literatura foi conduzida utilizando-se de busca eletrônica pelas bases de dados PubMed e Scopus. A lista de referências de todos os estudos elegíveis foi manualmente analisada para identificar estudos adicionais a serem incluídos. Foram incluídos estudos observacionais, publicados em língua inglesa, que relataram a taxa de recidiva da LCCG dos maxilares independente do tipo de tratamento realizado. Foram excluídos os estudos com menos de 5 casos, aqueles em que o desfecho de interesse não foi relatado e os artigos não disponíveis para leitura na íntegra. A heterogeneidade estatística entre os estudos foi analisada através do teste Q de Cochran e do índice I2 de Higgins e Thompson. As taxas de recidiva foram calculadas através de um modelo de efeitos randômicos após transformação do tipo Freeman-Tukey. O risco relativo para recidiva de acordo com comportamento clínico e localização das lesões foi calculado pelo método de Mantel-Haenszel. Foram incluídos 21 estudos observacionais, publicados entre 1973 e 2011. Foi observada uma taxa global de recidiva de 13.4% (IC 95% 8.4-19.1). Os pacientes tratados através de curetagem, ressecção cirúrgica e calcitonina tiveram taxas de recidiva de 15.8% (IC 95% 10.7-21.7), 0.16% (IC 95% 0.0-0.07) e 9.7% (0.0-31.8%), respectivamente. As lesões de comportamento agressivo tiveram um risco relativo para recidiva de 3.1 (IC 95% 1.7-5.7). Não foi observado aumento do risco em relação à localização da lesão (RR = 1.7; IC 95% 0.97-2.9). Desta forma, os resultados desta meta-análise indicam um risco elevado de recidiva em LCCG de comportamento agressivo e tratadas através de curetagem.

A leishmaniose visceral causada por Leishmania infantum chagasi à caracterizada pela perda da habilidade do hospedeiro gerar uma resposta imunolÃgica eficaz. Neste estudo, foi investigado o papel da quimiocina CXCL10 no controle da infecÃÃo por L. infantum chagasi in vivo. Grupos de camundongos BALB/c foram tratados ou nÃo com CXCL10 (5 μg/kg) com 1, 3 e 7 dias de infecÃÃo e apÃs 1, 7 e 23 dias do tratamento, alguns parÃmetros foram avaliados: a carga parasitÃria, os nÃveis de IFN-, IL-4, TGF-β e IL-10, e as alteraÃÃes histopatolÃgicas no fÃgado. ApÃs 23 dias de tratamento, CXCL10 induziu, no baÃo, uma reduÃÃo expressiva no nÃmero de parasitos, quando comparado ao grupo controle. No fÃgado, a carga parasitÃria mostrou uma queda no grupo tratado, entre o 7 e 23 dia apÃs o tratamento. Entretanto, o efeito leishmanicida de CXCL10, neste trabalho, nÃo parece ser mediado por NO, uma vez que nÃo houve diferenÃa na produÃÃo de NO entre os grupos. IFN-γ foi induzida de maneira mais significativa no grupo tratado do que nos controles, e atingiu sua produÃÃo mÃxima (100 pg/mL) no 23 dia apÃs o tratamento, correlacionando-se com a queda da carga parasitÃria nos ÃrgÃos-alvo. IL-4 foi produzida em baixas concentraÃÃes, em ambos os grupos, embora os animais tratados com CXCL10 tenham mostrado nÃveis mais elevados do que os controles. Em relaÃÃo Ãs citocinas antiinflamatÃrias, apÃs 23 dias do tratamento, os nÃveis de IL-10 nos animais tratados foram menores do que os do controle. A produÃÃo de TGF-β apÃs 7 dias do tratamento foi 2 vezes menor no grupo tratado quando comparado ao controle, e apÃs 23 dias do tratamento, essa citocina continuou com nÃveis mais baixos do que aqueles observados no controle. Na anÃlise histopatolÃgica do fÃgado apÃs o 1 dia do tratamento, foram encontrados, em ambos os grupos, mais granulomas imaturos (GI), do que infiltrados nÃo granulomatosos (NG) e alguns poucos granulomas maduros (GM) apenas no grupo tratado. ApÃs 7 dias do tratamento, a quantidade de infiltrados NG estava menor e os GI ainda foram os mais encontrados, em ambos os grupos, alÃm disso, foi observado um pequeno aumento de GM no grupo tratado. Em resumo, diante dos resultados encontrados, à possÃvel sugerir um importante papel leishmanicida de CXCL10 em camundongos BALB/c infectados por L. infantum chagasi, que parece ser mediado por uma expressiva produÃÃo de IFN-g e supressÃo das citocinas imunorreguladoras, IL-10 e TGF-β, abrindo a hipÃtese se isto nÃo estaria associado a uma diminuiÃÃo na frequÃncia de cÃlulas T regulatÃrias, induzida por CXCL10, nesses animais. / Visceral leishmaniasis caused by Leishmania infantum chagasi is characterized by the loss of the ability of host to generate an effective immune response. In this study it was investigated the role of CXCL10 chemokine in controlling L. infantum chagasi infection in vivo. Groups of BALB/c mice were treated or not with recombinant CXCL10 chemokine (5 μg/kg) with 1, 3 and 7 days of infection and after 1, 7 and 23 days of treatment, some parameters were evaluated: parasite load, levels of IFN-g, IL-4, TGF-β and IL-10, and the histopathological alterations in the liver. After 23 days of treatment, CXCL10 induced in the spleen a significant reduction on the number of parasites as compared to control group. In the liver, parasite load decreased in treated group between the 7th and 23th day post treatment. However, the antileishmanial effect of CXCL10, in this work, does not seem to be mediated by NO, since there was no difference in the NO production among the groups. IFN-γ was induced most significantly in treated group than in controls, and reached its maximum production (100 pg/mL) on day 23 after treatment, correlating with the reduction in parasite burden in target organs. IL-4 was produced in low doses, in both groups, although treated animals had shown higher levels than control group. Regarding to anti-inflammatory cytokines, after the 23th day of treatment, IL-10 levels in treated animals were smaller than in control group. Production of TGF-β after 7 days of treatment was 2 times lower in treated group when compared to control, and after the 23th day of treatment, this cytokine remained with lower levels than those observed in control. In the histopathological analysis of the liver after the 1st day of treatment, were found in both groups more immature granulomas (GI) than non-granulomatous infiltrate (NG), and some few mature granulomas (GM) were only observed in treated group. After 7 days of treatment, the amount of NG infiltrates was lower, and GI were still the most frequent in both groups, besides a slight increase of GM was observed in treated group. In summary, at the light of the found results, it is possible to suggest an important leishmanicidal role to CXCL10 in BALB/c mice infected by L. infantum chagasi, which seems to be mediated by a significant IFN-g production, and suppression of immunoregulatory cytokines, IL-10 and TGF-β, opening the hypothesis that this would be associated to a decrease in the frequency of regulatory T cells induced by CXCL10 in these animals.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2015-12-10T09:47:46Z No. of bitstreams: 2 Dissertação - Allison Filipe Lopes Martins - 2015.pdf: 3205167 bytes, checksum: 5c24397e18241a8a809af753bb233428 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-12-10T10:03:57Z (GMT) No. of bitstreams: 2 Dissertação - Allison Filipe Lopes Martins - 2015.pdf: 3205167 bytes, checksum: 5c24397e18241a8a809af753bb233428 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2015-12-10T10:03:57Z (GMT). No. of bitstreams: 2 Dissertação - Allison Filipe Lopes Martins - 2015.pdf: 3205167 bytes, checksum: 5c24397e18241a8a809af753bb233428 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2015-03-27 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / The Central Giant Cell Lesion (CGCL) is an intraosseous lesion that can be classified into non aggressive and aggressive. Due to the aesthetic and functional defects of surgical treatment of CGCL, therapies with drugs have been reported, such as glucocorticoid injections and calcitonin. The studies reported in the literature support the use of these drugs through the investigation of the presence of glucocorticoid receptors (RGC) and calcitonin (RCT) in CGCL; however there is no consensus if all lesions express these receptors and if there is any difference between non aggressive and aggressive lesion. In addition, there are no studies that evaluated the bone formation potential through the investigation of Osteocalcin (OC) in aggressive and non-aggressive lesions. The aim of this study was to compare, using immunohistochemistry, the GR and CTR and osteocalcin protein (OC) expression in non aggressive (n = 20) and aggressive (n = 11) CGCL, and the correlation between the OC expression and these receptors determined in both groups of lesions. The number of mononuclear cells in mitosis (MOC), and the number of multinucleated giant cells (MGC) were also investigated using immunohistochemical techniques (hematoxylin and eosin). Our results show that all the cases express the GR and CTR and that there is no difference in the expression of these receptors or the number of mitosis between non aggressive and aggressive lesions. The OC expression was rare and higher in non aggressive lesions, however, not statistically significant (p> 0.05). There was a correlation between the CTR expression in MOC and MGC (r = 0.45; p <0.01). Considering the different variants of CGCL, there was a correlation between CTR expression in MOC and MGC in non aggressive lesions (r = 0.66; p <0.01) and between the CTR and OC expression in MGC (r = 0.718; p = 0.01). There was a higher number of MGC in aggressive lesions (p = 0.01). The results indicate that all cases express GR and CTR and that there are no differences between non aggressive and aggressive CGCL lesions of these receptors expression, these results strengthens CGCL treatment with glucocorticoids and calcitonin. Aggressive lesions have a higher number of MGC. The CGCL express glucocorticoid and calcitonin receptors and this finding give biological basis to the CGCL treatment with intralesional glucocorticoid and calcitonin either in non aggressive and aggressive cases. It was also identified osteocalcin positive cells, that may be related to bone repair, it is believed that these cells may also serve as a therapeutic target. / A Lesão Central de Células Gigantes (LCCG) é uma lesão intraóssea que pode ser classificada em não agressiva e agressiva. Devido aos defeitos estéticos e funcionais do tratamento cirúrgico da LCCG, terapias medicamentosas tem sido relatadas, como injeções de glicocorticoide e calcitonina. Há na literatura estudos que suportam o uso desses medicamentos através da investigação da presença de receptores de glicocorticoides (RGC) e de calcitonina (RCT) em LCCG. No entanto não existe consenso se todas as LCCG expressam esses receptores e se existe alguma diferença entre lesões agressivas e não agressivas. Além disso, não existem estudos sobre a avaliação do potencial de formação óssea através da Osteocalcina (OC) em lesões agressivas e não agressivas. O propósito deste estudo foi avaliar comparativamente, por meio de imunohistoquímica, a expressão de RGC e RCT e da OC em LCCG não agressivas (n= 20) e agressivas (n= 11) e a correlação entre a expressão da OC e desses receptores nos dois grupos de lesões estudados. O número de mitoses nas células mononucleares e o número de células gigantes multinucleadas também foram investigados, utilizando técnica histoquímica (hematoxilina e eosina). Nossos resultados mostram que todos os casos analisados expressam o RGC e RCT e que não existe diferença na expressão do RGC, RCT ou do número de mitoses entre lesões não agressivas e agressivas. A expressão de OC em células mononucleares foi rara e maior em lesões não agressivas, no entanto, sem diferenças estatisticamente significantes (p>0,05). Houve correlação entre a expressão do RCT em células mononucleares e células gigantes multinucleadas (r=0,45; p<0,01). Considerando as diferentes variantes foi verificada correlação do RCT entre o componente mononuclear e as células gigantes multinucleadas nas lesões não agressivas (r=0,66; p<0,01) e entre a expressão de OC e RCT em células gigantes multinucleadas (r= 0,718; p=0,01). Houve maior número de células gigantes em lesões agressivas (p= 0,01). Os resultados indicam que todos os casos expressam RGC e RCT e que não há diferenças entre lesões agressivas e não agressivas de LCCG quanto à expressão desses receptores, fortalecendo a recomendação o tratamento da LCCG com o uso de glicocorticoide e calcitonina. Lesões agressivas apresentam maior número de CGM. As células da LCCG expressam o RGC e RCT e esse achado pode fornecer bases biológicas para o tratamento com injeções intralesionais de glicocorticoides e o uso de calcitonina, seja em lesões não agressivas ou agressivas. Adicionalmente, foram identificadas células expressando OC, que podem estar relacionadas ao reparo ósseo, acredita-se que essa linhagem celular também pode se tornar um alvo terapêutico.

One key to the pathogenic potential of the mycobacteria lies in their capacity to resist destruction by infected macrophages and dendritic cells. Robust host immune responses during mycobacterial infection often involve a potent CD4, CD8 and gamma delta T cell mediated effector responses including lysis of mycobacteria infected host cells, secretion of variety of cytokines like IFN-γ etc. However, pathogenic mycobacteria survives for prolonged periods in the phagasomes of infected macrophages within the host in an asymptomatic, latent state and can reactivate years later if the host’s immune system wanes. One of the most devastating consequences of infection with mycobactreia is the formation of caseating granulomas followed by tissue destruction with liquefaction causing cavity formation. Pathogenic mycobacteria reside in these granulomas, which are formed by the accumulation of monocytes, epithelioid and foamy macrophages as well as cytolytic lymphocytes including CD8 T cells around the infection focus. In this regard, rigid balance as well as modulation of inflammatory immune responses by the host upon infection of pathogenic microbes is one of the crucial steps not only in controlling the spread of pathogen from the site of infection to reminder of host organs, but also in mounting an effective memory response so that future exposures/infections by similar pathogen can be effectively controlled. Significantly, despite this complex host response, it remains unclear, that why the immune response controls mycobacteria but does not eradicate infection. Both human and mouse studies have provided ample evidence that even in the face of an adequate immune response, mycobacteria are able to persist inside macrophages. These findings have suggested series of survival strategies employed by Mycobacterium sp. during its infection of host macrophages/dendritic cells which include, blockade of phagosome-lysosome fusion, secretion of ROI antagonistic proteins like superoxide dismutase & catalase, inhibition of processing of its antigens for presentation to T cells, decrease in secretion of proinflammatory cytokines by inducing secretion of immunosuppressive cytokines like IL-10 and TGF-β etc. In view of above-mentioned observations, graulomas in response to pathogenic mycobacterial infections have long been considered host-protective structures formed to contain infection. In this perspective, Matrix metalloproteinase-9 (MMP-9), an important member of Zn2+ and Ca2+ dependent endopeptidases, participates in a significant manner in several aspects of host immune responses to mycobacterial infection such as graunloma formation, matrix (ECM) reorganization, lymphocytes trafficking and infiltrations, inflammation etc. MMP-9 is expressed at various clinical categories of tuberculosis disease like active cavitary tuberculosis, meningitis and pleuritis. Notably, in case of pulmonary tuberculosis, breakdown of ECM by MMP-9 forms an integral part of the granuloma formation. Importantly, Mycobacterium tuberculosis infection in MMP-9 deficient mice revealed defective bacterial proliferation, reduced bacterial burden and reduced lung macrophages recruitment compared to wild-type, in addition, to reduced ability to initiate or maintain well-formed granulomas. In this context, we explored the signaling events modulated by Mycobacterium bovis bacillus Calmette-Gue´rin (BCG) or its novel cell wall antigens during induced expression of MMP-9 or SPI6 in macrophages. Our studies clearly demonstrate that NO, a product of iNOS activity, is responsible for M. bovis BCG-triggered activation of Notch1 in macrophages through direct regulation of Jagged1 expression as well as in generation of activated Notch1. We present the evidence that iNOS activity is a critical factor in TLR2 mediated Notch1 activation as macrophages derived from iNOS knockout (iNOS-/-), but not from wild-type (WT) mice failed to activate Jagged1 expression as well as Notch1 signaling upon M. bovis BCG infection. The loss of TLR2-mediated Jagged1 expression or Notch1 activation in iNOS-/-macrophages could be rescued by treatment with NO donor 3-morpholinosydnonimine (SIN1) or S-nitroso-Nacetylpenicillamine (SNAP). Signaling perturbations strongly implicated the role for cross talk among members of Notch1-PI3 Kinase and MAPK cascades in M. bovis BCG-TLR2– mediated activation of Notch1 target genes MMP-9 or Hes1. Chromatin immunoprecipitation experiments demonstrate that M. bovis BCG’s ability to trigger increased binding of CSL/RBP-Jk to MMP-9 promoter was severely compromised in macrophages derived from iNOS-/-mice compared to WT mice. These results are consistent with the observation that NO-triggered Notch1 signaling-mediated CSL/RBP-Jk recruitment has a positive regulatory role in M. bovis BCG-induced MMP-9 transcription. We show the correlative evidence that this mechanism operates in vivo by immunohistochemical expression analysis of activated Notch1 or its target gene products Hes1 or MMP-9 in brains of WT or iNOS-/-mice that were intracerebrally infected with M. bovis BCG. Further, activation of Notch1 signaling in vivo could be demonstrated only in granulomatous lesions in brains derived from human patients with tuberculous meningitis (TBM) as opposed to healthy individuals, validating the role of Notch1 signaling in mycobacterial pathogenesis. Briefly, we have identified NO as the pathological link between TLR2 and Notch1 signaling, which regulates the relative abundance of various immunopathological parameters including MMP-9 in macrophages. Synopsis Despite mycobacteria elicits robust host T cell responses as well as production of NO, ROI or cytokines like interferon-γ (IFN-γ) that are essential for the control of infection, the mounted immune response contain, but does not eliminate the infection. These findings clearly advocate roles for mycobacteria mediated various immune evasion strategies to modulate the signaling cascades thus leading to macrophage activation. Importantly, TLR2 triggering by mycobacteria elicits the activation of divers sets of anti or pro-apototic genes expression, a balance of which will have strong bearing on the overall cell-fate decisions across many cell types. In this regard, a novel granzyme B inhibitor, SPI6/PI9, can exhibit robust resistance to various cells including dendritic cells or tumor cells from lysis by CD8 cytotoxic T cells (CTL). SPI6/PI9 predominantly functions by inhibiting Granzyme B, an effector protease of cytotoxic granules released by CTL upon its TCR recognition of infected cells such as macrophages, dendritic cells etc. In this context, current investigation attempted to investigate molecular details involved in M. bovis BCG triggered SPI6 expression as well as the involvement of TLR2NO-Notch1 signaling axis in driving induced expression of SPI6, akin to that of MMP-9 expression. We demonstrate that M. bovis BCG trigger SPI6 expression in macrophages and requires critical participation of TLR2-MyD88 dependent NO-Notch1 signaling events. More importantly, signaling perturbations data suggest the involvement of cross talk among the members of PI3 Kinase and MAPK cascades with Notch1 signaling in SPI6 expression. In addition, SPI6 expression requires the Notch1 mediated recruitment of CSL/RBP-Jk and NF-κB to the SPI6 promoter. Functional studies strongly attribute critical involvement of SPI6 and MMP-9 in imparting protection to M.bovis BCG infected macrophages from lysis effectuated by CTL. Macrophages are principal mediators of initiation as well as activation of host inflammatory responses to pathogenic mycobacterial infection. Albeit mycobacteria reside within phagolysosomes of the infected macrophages, envelope glycoconjugates like Lipoarabinomannan (LAM), phosphatidyl-myo-inositol mannosides (PIM), Trehalose 6,6′dimycolate (TDM; cord factor) etc. are released and traffic out of the mycobacterial phagosome into endocytic compartments as well as can gain access to the extracellular environment in the form of exocytosed vesicles. In this perspective, PIM represent a variety of phosphatidyl-myo-inositol mannosides (PIM) 1-6 containing molecules and are integral component of the mycobacterial envelope. A number of biological functions have been credited to PIM2. PIM2 was shown to trigger TLR2 mediated activation of macrophages that resulted in activation of NF-κB, AP-1, and mitogen-activated protein (MAP) kinases. In addition to pulmonary granuloma-forming activities, PIM2 was shown to recruit NKT cells into granulomas. Further, surface associated PIM was suggested to act as adhesins mediating attachment of M. tuberculosis bacilli to non-phagocytic cells. Accordingly, mycobacterial envelope antigen PIM2 could initiate or affect the inflammatory responses similar to mycobacteria bacilli. In this perspective, we explored whether novel cell surface antigen PIM2 similar to whole M. bovis BCG bacilli can contribute to molecular signaling events leading to MMP-9 expression in macrophages. Our current study provides the evidence that PIM2 driven activation of signaling cascades triggers the expression of MMP-9. TLR stimulation by various agonists has been shown to activate Notch signaling resulting in modulation of diverse target genes involved in pro-inflammatory responses in macrophages. In this regard we demonstrated that PIM2 induced expression of MMP-9 involved Notch1 upregulation and activation of Notch1 signaling pathway in a TLR2-MyD88 manner. Enforced expression of the cleaved Notch1 in macrophages induced the expression of MMP-9. Further, PIM2 triggered significant p65 nuclear factor-κB (NF-κB) nuclear translocation that was dependent on activation of PI3 Kinase or Notch1 signaling. Furthermore, MMP-9 expression requires Notch1 mediated recruitment of Suppressor of Hairless (CSL) and NFκB to MMP-9 promoter. Taken together, our observations clearly describe involvement of TLR2/iNOS in activating Notch1 and PI3 Kinase signaling during infection of macrophages with M. bovis BCG, thus effectuating the regulation of specific effector gene expressions, such as SPI6 and MMP-9. These results clearly describe the cross talk of Notch1 signaling with PI3 Kinase and MAPK pathways, thus leading to differential effects of Notch1 signaling. Overall, we believe that our work will extend the current understanding of inflammatory parameters associated with host-mycobacteria interactions which might lead to better design as well as evaluation of therapeutic potential of novel agents targeted at diverse mycobacterial diseases.

There are an estimated 2 billion individuals infected with Mtb, and 37.7 million people living with HIV (PLWH) worldwide. HIV/Mtb co-infection increases the risk of developing active tuberculosis by over 20-fold, and 210,000 of 1.5 million deaths from TB were among co-infected PLWH in 2020. Therefore, development of effective TB vaccination, particularly within the vulnerable PLWH population, is an urgent global issue. With limited in vivo models to study co-infection, humanized NRG (huNRG) mice and humanized DRAG-A2 mice (a next-generation of huNRG mice expressing HLA class I and II transgenes with improved human immune reconstitution, huDRAG-A2) are promising tools for HIV and TB reserach as they develop robust human immune cell populations and recapitulate many aspects of HIV or TB clinical disease. HIV/Mtb co-infection was investigated using huNRG and hu-DRAG-A2 mice in separate experiments where intravaginal (with DMPA pre-treatment) or intraperitoneal HIV-1 infection was administered, respectively, and intranasal infection of Mtb was administered 3.5 weeks later. Both huNRG and huDRAG-A2 mice recapitulated hallmark features of HIV/Mtb co-infection such as severe granuloma pathology, hCD4+ T cell depletion in lung and spleen tissue, and human like lung pathology such as Mtb-infected foamy macrophages in the granuloma. Co-infected huDRAG-A2 mice also displayed significantly higher bacterial burden in the lungs, increased extrapulmonary dissemination into spleen and liver, and significantly lower hCD4+ T cells in the peripheral blood post-Mtb infection when compared to the Mtb-only infected group. To investigate TB vaccine immunogenicity, huNRG and huDRAG-A2 mice were immunized with a novel trivalent vaccine, AdCh68MV. Upon intranasal immunization, both models showed trends of developing higher Mtb antigen-specific hCD4+ T cell responses in the lung and spleen. Overall, this project sets the initial stages of a pre-clinical HIV/Mtb co-infection model in huNRG and huDRAG-A2 mice appropriate for immune investigations, therapeutic and vaccination development. / Thesis / Master of Science in Medical Sciences (MSMS) / There are over 2 billion individuals infected with TB and 37.7 million people living with HIV (PLWH) worldwide. When someone is co-infected with both diseases, the risk of death is greatly increased. Research in co-infection and developing effective TB vaccination for PLWH are urgent global issues. Animal studies are currently limited because studying HIV requires human immune cells. Our lab has established humanized mice (hu-mice) that develop many different human immune cells and are useful for HIV/Mtb co-infection research. When hu-mice were co-infected, they showed more dying lung tissue, immune cell loss, and bacteria in the lungs. Hu-mice were also used to study human immune responses to a novel TB vaccine delivered to the lungs. Trends of higher immune responses towards TB were observed in the lung and spleen of immunized hu-mice. Overall, this project shows the utility of hu-mice as pre-clinical models of HIV/Mtb co-infection and Mtb vaccine studies.

<p dir="ltr">Tuberculosis (TB), caused by <i>Mycobacterium tuberculosis</i> (<i>Mtb</i>), and human immunodeficiency virus-1 (HIV) are major public health concerns, individually and in combination. The status of the host immune system, previous <i>Mtb</i> infection and HIV-mediated T cell exhaustion, can have significant impacts on immune dynamics during reinfection. Individuals with asymptomatic latent TB infection (LTBI) may be protected against <i>Mtb </i>reinfection, as demonstrated by animal and <i>in vitro </i>studies. However, the underlying dynamics and protective mechanisms of LTBI are poorly understood. In HIV, long-term infection in children and associated T cell exhaustion leads to weakened immune responses to HIV reinfection. The complexity of these infections, particularly in the context of the heightened vulnerability of HIV+ individuals to TB, underscores the need for novel investigative approaches to study host-pathogen and pathogen-pathogen interactions. To this, we have developed an agent-based model (ABM) as a mechanistic computational tool to simulate the immune response to <i>Mtb </i>and HIV, separately and during coinfection. Our ABM integrates clinical and experimental data; simulates immune cell dynamics between macrophages, CD4+ and CD8+ T cells; and produces emergent granuloma-like structures – a critical response to <i>Mtb</i>. This <i>in silico</i> approach allows us to efficiently explore host-pathogen interactions and their clinical implications. By unraveling the complex interplay of immune cell activation, T cell exhaustion, and pathogen dynamics, our model offers insights that could guide the development of targeted therapies. By quantifying the multifaceted nature of these diseases and their interactions, we highlight the potential of computational approaches in understanding and treating complex diseases, individually and in combination.</p>