In the last 150 years, tremendous headway has been made in our understanding of the human immune system. Pioneers in the field such as Paul Ehrlich, Elie Metchnikoff, Louis Pasteur, Robert Koch and Walter Reed carried out seminal studies that established the groundwork for our understanding of humoral and cellular immunity in humans. However, this direct line of evidence into human immunology was diverted in the mid-20th century with the adoption of a model which allowed for investigators to use a reductionist-approach with the promise to resolve immunity at a molecular level. This revolutionary model was the scientific commercialization of various inbred strains of mice. It seems inconceivable how a four-legged nocturnal rodent managed to become the focus of billions of dollars of research to improve our understanding of human immunity. Nevertheless, this strange surrogate for human immunity did provide us with major conceptual advances in areas, such as identification of dendritic cell population heterogeneity, T cell help for B cell antibody production, MHC-restricted recognition of virusinfected cells, and even the discovery of cell types like NKT cells. However, these prior advances have now been prefaced with decades-worth of disappointing, non-translational findings. The best examples of such disappointments are in murine models of autoimmunity, cancer immunotherapy, and vaccinology where numerous studies have revealed promising outcomes in mice but were met with failure or limited success upon translation into humans. We do not look at this as a failure of the murine model; rather we consider it a call to arms to innovate in vitro surrogates to examine human immunity when otherwise bound by ethical limitation from working directly in humans. To overcome these challenges, we developed a system to interrogate novel immunogens that begins by generating human dendritic cells (DCs), a cell type necessary to mounting a protective immune response. DCs for research and clinical applications are typically derived from purified blood monocytes that are cultured in a cocktail of cytokines for a week or more. Because it has been iv suggested that these cytokine-derived DCs may be deficient in some important immunological functions and might not accurately represent antigen presenting cell (APC) populations found under normal conditions in vivo, there is an interest in developing methods that permit the derivation of DCs in a more physiologically relevant manner in vitro. Here, we describe a simple and reliable technique for generating large numbers of highly purified DCs that is based on a one-way migration of blood monocytes through a layer of human umbilical vein endothelial cells (HUVECs) that are cultured to confluency in the upper chamber of a Transwell device. The resultant APCs, harvested from the lower Transwell chamber, resemble other cultured DC populations in their expression of major histocompatibility (MHC) and costimulatory molecules, ability to phagocytose protein antigens and capacity to trigger primary antigen-specific T cell responses. This technique offers several advantages over the standard method of in vitro cytokine-driven DC development, including: (1) the rapidity of this approach, as DC differentiation occurs in only 2 days, (2) the differentiation process itself, which is more akin to the development of DCs under physiologic conditions and (3) the cost effectiveness of the system, since no monocyte pre-selection is required and DC development occurs in the absence of expensive recombinant cytokines. Taken together, this approach allows for the exploration of novel immunogens utilizing a physiologically representative population of APCs enriched from circulating blood. The outbreak of the swine-origin H1N1 influenza in the spring of 2009 took epidemiologists, immunologists, and vaccinologists by surprise and galvanized a massive worldwide effort to produce millions of vaccine doses to protect against this single virus strain. Of particular concern was the apparent lack of pre-existing antibody capable of eliciting cross-protective immunity against this novel virus, which fueled fears this strain would trigger a particularly far-reaching and lethal pandemic. Given that disease caused by the swine-origin virus was far less severe than expected, we hypothesized v cellular immunity to cross-conserved T cell epitopes might have played a significant role in protecting against the pandemic H1N1 in the absence of cross-reactive humoral immunity. We collaborated with bioinformaticians to develop an immunoinformatics approach to predict CD4+ T cell epitopes conserved between the 2008-2009 seasonal H1N1 vaccine strain and pandemic H1N1 (A/California/04/2009) hemagglutinin proteins that could act as novel immunogens and function as potential vaccine candidates or compliments to current vaccine formulations. We examined these peptides using T cells from human donors not exposed to the pandemic virus demonstrating that pre-existing CD4+ T cells can elicit cross-reactive effector responses against the pandemic H1N1 virus. As well, we showed the computational tools created by our collaborators were 80-90% accurate in predicting CD4+ T cell epitopes and their HLA-DRB1-dependent response profiles in donors that were chosen at random for HLA haplotype. Combined, these results confirm the power of coupling immunoinformatics to define broadly reactive CD4+ T cell epitopes with a highly sensitive in vitro model to verify these in silico predictions as a means to understand human cellular immunity, including cross-protective responses, and to define CD4+ T cell epitopes for potential vaccination efforts against future influenza viruses and other pathogens. It is thought that utilizing highly conserved peptides as novel immunogens of cellular immunity for future vaccination strategies may require an adjuvant for efficacy. However, the FDA has approved the use of only two adjuvant compounds (Alum or MPL®) which may not be compatible or offer effective immune enhancement in novel vaccine preparations, thereby soliciting the need for novel adjuvants. Nanoparticles have since been a topic of adjuvant potential. Nanoparticles harbor great potential because they possess unique physicochemical properties compared to their larger counter parts as a result of quantum-size effects and their inherent large surface area to volume ratio. These physicochemical properties govern how a nanoparticle will behave in its environment. However, vi researchers have only just begun to catalogue the biological effect these properties illicit. Moreover, little is known about the interaction between the immune system and NPs. However, in light of the recent development in new adjuvants that involves composites and coatings of polymers, lipids, ligands, TLR agonist, the ability of a simple metal oxide nanopowder to effectively induce or couple immunomodulation would provide researchers a basic alternative to costly and complex adjuvant development. Considering the evidence suggesting NPs can act as immunopotentiators, we questioned whether these materials can act not only as innate adjuvants, but as novel immunogens to cellular immunity. To accomplish this, we under took a set of studies to investigate any nanoparticle size-induced effects using TiO2, one of the most widely manufactured nanoparticles, as a model. We explored titanium dioxide synthesized into its three most commonly nanoarchitectures: anatase (7-10 nm), rutile (15-20 nm), and nanotube (10-15 nm diameters, 70-150 nm length) in comparison to a micron-sized formulation. We used the fully human autologous MIMIC® immunological construct has been utilized as a predictive, nonanimal alternative to diagnose nanoparticle immunogenicity. Cumulatively, treatment with titanium dioxide nanoparticles in the MIMIC® system led to elevated levels of proinflammatory cytokines and increased maturation and expression of costimulatory molecules on dendritic cells. Additionally, these treatments effectively primed activation and proliferation of naïve CD4+ T cells in comparison to dendritic cells treated with titanium dioxide microspheres, characteristic of an in vivo inflammatory response, providing evidence of a size induced difference between the nano-sized and micron-sized material, revealing novel immune cell recognition and activation by a crystalline nanomaterial in a size-dependent manner. Having identified nanomaterial size as a contributing feature of nanoparticle induced immunopotentiation, we became interested if additional physicochemical properties such as surface vii reactivity or catalytic behavior could also be immunostimulatory. Moreover, because we witnessed a stimulatory effect to dendritic cells following nanoparticle treatment, we were curious how these nanoparticle-touched dendritic cells would impact adaptive immunity. Since TiO2 acts as an oxidant we chose an antioxidant nanoparticle, CeO2, as a counterpart to explore how divergent nanoparticle surface reactivity impacts innate and adaptive immunity. We focused on the effect these nanoparticles had on human dendritic cells and TH cells as a strategy towards defining their impact to cellular immunity. Combined, we report that TiO2 nanoparticles potentiate DC maturation inducing the secretion of IL- 12p70 and IL-1B, while treatment with CeO2 nanoparticles induced IL-10, a hallmark of suppression. When delivered to T cells alone TiO2 nanoparticles induced stronger proliferation in comparison to CeO2 which also stimulated TReg differentiation. When co-cultured in allogeneic T cell assays, the materials directed alternate TH polarization whereby TiO2 drives largely a TH1 dominate response, whereas CeO2 drove a TH2 bias. Combined, we report a novel immunomodulatory capacity of nanomaterials with catalytic activity. While unintentional exposure to these nanomaterials could pose a serious health risk, development and targeted use of such immunomodulatory nanoparticles could provide researchers with new tools for novel adjuvant strategies or therapeutics.

No / Gerard Egan's problem management and opportunity development model is currently in use training prospective counsellors, social workers, nurses, managers, etc. the skills of helping. This essay attempts, experimentally, to depict in three different ways Egan's work and its relationship to operations of power: (1) from a relatively uncritical stance, (2) from a personal experience stance, and (3) from a social constructionist perspective. The whole piece, taken together, attempts to tackle the issue of theory as practice ¿ to ground/unmask/make present the ways in which we are socialised into a profession and the problems inherent in that process. Two themes run through the work: the double bind created for a student on a counselling course which makes some claim to train around Rogers' core conditions, and which is also assessed/accredited; the connections between theory, training and practices.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第24994号 / 医博第5028号 / 新制||医||1069(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 上野 英樹, 教授 椛島 健治, 教授 濵﨑 洋子 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Le respect de l’équilibre entre lymphocytes T effecteurs auto-réactifs et lymphocytes T régulateurs (LTreg) est primordial dans le maintien de la tolérance aux antigènes du soi. Les partenaires cellulaires et les mécanismes moléculaires impliqués dans la rupture de l’équilibre de cette balance ne sont pas ou peu connus dans les maladies auto-immunes. Ainsi, les travaux décrits dans cette thèse portent sur le dérèglement de la balance T effecteurs/ Treg dans deux modèles de maladies auto-immunes chez l’homme: le lupus érythémateux systémique et l’anémie hémolytique auto-immune (AHAI). Nous montrons une augmentation de l’expression de la molécule de costimulation OX40L (CD252, TNFSF4) à la surface des cellules présentatrices d’antigène circulantes et infiltrant les tissus chez les patients lupiques. Cette augmentation est corrélée à l’activité de la maladie chez l’adulte comme chez l’enfant. Elle a pour conséquence l’induction de lymphocytes T effecteurs de type Tfh (T follicular helper) et le blocage des fonctions suppressives des Treg, deux acteurs majeurs dans la physiopathologie du lupus. Dans le second projet, nous montrons une augmentation de la proportion de T8reg circulants chez les patients affectés d’une AHAI à anticorps chauds en phase de rémission. Ces Treg expriment le CD25, le FoxP3 et exercent leur fonction suppressive par un mécanisme faisant intervenir l’IL10. De faibles doses d’IL-2 permettent l’expansion de cette population cellulaire in vitro. Ces résultats apportent de nouvelles connaissances dans la physiopathologie de ces deux maladies et offrent des perspectives thérapeutiques potentielles. / Respect of the balance between autoreactive T cells and regulatory T cells (LTreg) is important to maintain tolerance to self-antigens. Cellular partners and molecular mechanisms involved in the disruption of this balance are not or little known in autoimmune diseases.Thus, the work described in this thesis focuses on the disruption of the T effector/ Treg balance in two models of human autoimmune diseases: systemic lupus erythematosus and autoimmune hemolytic anemia (AIHA). We show an increased expression of the OX40L (CD252, TNFSF4) costimulatory molecule at the surface of both circulating and tissues-infiltrating antigen presenting cells in SLE patients. OX40L expression is correlated with disease activity in adults and in children and results in Tfh (follicular helper T) effector cells induction and Treg suppressive functions inhibition, two key mechanisms in the pathogenesis of lupus. In the second project, we show an increase of the circulating T8reg proportion in patients with a warm AIHA in a non-active state. These Treg express CD25, FoxP3 and exert their suppressive function by a mechanism involving IL-10. Low-dose IL-2 allows the expansion of this cell population in vitro. These results provide new insights into the pathophysiology of these diseases and offer potential therapeutic perspectives.

This study focused on HIV-positive domestic helpers and the constructions of their experiences in their employing families. A literature survey established the primary theoretical assumption for the study that acknowledges the domestic helper as an integral part of the extended family of the employer. The study sought to generate grounded theory through content analysis, qualitative research methods and the constructivist-interpretative paradigm. Semi-structured interviews with open questions were conducted with 14 HIV-positive domestic helpers. Responses captured in audio recordings were transcribed and analysed. The textual data was then analysed and interpreted based on open, axial and selective coding. From this coding process four themes emerged as the ways in which HIV-positive domestic helpers construct their experiences within the families. The results from this study indicate that they construct their experiences around: <ul> <li> the HIV&AIDS diagnosis, </li> <li> their HIV&AIDS status, </li> <li> their emotions and </li> <li> their needs. </li></ul> A particularistic scrutiny of the data and research results indicate that participants experience that visible symptoms of HIV&AIDS may forewarn employers when domestic helpers are HIV-positive. These domestic helpers experience negative attitudes, reduction of job content and retrenchment with concomitant financial repercussions. However, the participants in this study indicated that the attitude of employers' children towards them remain positive after diagnosis. In terms of the way in which they construct their experience around emotion, results indicate that they experience complex emotions including shock, uncertainty, loneliness, unworthiness, guilt, rejection, concern, anger, shamefulness and depression. Yet, they also present high levels of acceptance and spiritual growth. In terms of needs, they indicate the need for HIV-friendly workplaces and medical care. They specifically desire employers to help care for their children when they pass away. A comprehensive appraisal of the research results points towards two key aspects: the lack of agency that is prevalent in this group of participants and the silences that is evident from their narratives. The narratives of the HIV-positive domestic helpers indicate that they easily negate agency of their lives to their employers and concomitantly that the lack of agency hampers their ability to retain a sense of worthiness and responsibility for their lives. The results from this study also ensconce silences in many guises. Silences were reflected: <ul> <li> through semantic values and linguistic nuances,</li> <li> regarding acts or omissions of employers,</li> <li> regarding communications,</li> <li> regarding needs and</li> <li> regarding reduction of job content</li> </ul> In rare instances, the construction of experiences of some participants confirmed the ability of HIV-positive domestic helpers to accept agency of their circumstances. In summary, HIV-positive domestic helpers in this study experienced a lack of agency, they report narratives of silences, but they also reflect elements of healing, growth and spiritual deepening when they construct their experiences of HIV&AIDS in their families of employment. Copyright 2004, University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. Please cite as follows: Barnard, JP 2004, MIV-positiewe huiswerksters se konstruering van hul ervarings van MIV en VIGS binne die werkgewersgesin (Afrikaans), PhD thesis, University of Pretoria, Pretoria, viewed yymmdd < http://upetd.up.ac.za/thesis/available/etd-03112005-080007 / > / Thesis (PhD (Educational Psychology))--University of Pretoria, 2006. / Educational Psychology / unrestricted

Indiana University-Purdue University Indianapolis (IUPUI) / Germinal Centers (GCs) are transient lymphoid structures that arise in lymphoid organs in response to T cell-dependent antigen. Within the GC, follicular T helper (TFH) cells promote GC B cell differentiation and in turn the proper antibody production to protect us from invading pathogens. We wished to study the regulation of this process by transcription factors STAT3 and Bcl6. STAT3 is important for both TFH cell differentiation and IL-4 production by Th2 cells. IL-4 is a major functional cytokine produced by TFH cells. To dissect the role of STAT3 in IL-4 production by TFH cells, we generated T cell-specific conditional STAT3 knockout mice (STAT3KO). Compared to WT mice, TFH cell differentiation in STAT3KO mice was partially impaired, both in spleen following sheep red blood cells (SRBC) immunization and in Peyer's patches (PPs). In STAT3KO mice, the numbers of splenic GC B cells were markedly decreased, whereas PP GC B cells developed at normal numbers and IgG1 class switching was greatly increased. Unexpectedly, we found that STAT3 intrinsically suppressed the expression of IL-4 and Bcl6 in TFH cells. Mechanistically, in vitro repression of IL-4 expression in CD4 T cells by Bcl6 required STAT3 function. Apart from TFH cells, the GC reaction is also controlled by regulatory follicular T helper (TFR) cells, a subset of Treg cells. To study the mechanism of how TFR cells regulate the GC reaction, we generated mice specifically lacking TFR cells by specifically deleting Bcl6 in Treg cells. Following immunization, these "Bcl6FC" mice developed normal TFH and GC B cell populations. However, Bcl6FC mice produced altered antigen-specific antibody responses, with reduced titers of IgG and increased IgA. Bcl6FC mice also developed IgG antibodies with significantly decreased avidity to antigen in an HIV-1 gp120 "prime-boost" vaccine model. Additionally, TFH cells from Bcl6FC mice produced higher levels of Interferon-γ, IL-10 and IL-21. Loss of TFR cells therefore leads to highly abnormal TFH and GC B cell responses. Overall, our studies have uncovered unexpected regulatory roles of STAT3 in TFH cell function as well as the novel regulatory roles of TFR cells on cytokine production by TFH cells and on antibody production.

Resumo: O gênero Potyvirus é um dos maiores dentre os vírus de planta com genoma composto por RNA. O genoma dos potyvirus codifica um único polipeptídeo que é processado por três proteinases virais que originam todas as proteínas necessárias para complementar o ciclo da infecção. A proteína HC-Pro (Helper Component proteinase) é uma dessas proteínas multifuncionais que está envolvida na amplificação do genoma, transmissão por afídeo, movimento sistêmico e local, supressão do silenciamento gênico e proteólise. Nesse trabalho, foi realizada a substituição funcional de parte da região codificadora da HC-Pro do Lettuce mosaic virus (LMV) com a porção correspondente à HC-Pro do Potato virus Y (PVY), com o objetivo de melhor compreender os papéis dessa proteína no ciclo de infecção dos potyvirus. O LMV e o PVY diferem tanto em patogenicidade quanto em círculo de hospedeiros. O LMV infecta, principalmente, espécies da família Asteraceae (alface) enquanto o PVY infecta Solanaceae. Para avaliar o efeito de tal substituição na infectividade, dois vírus quiméricos foram construídos: um clone infeccioso de LMV contendo a HC-Pro selvagem do PVY (estendendo-se dos aminoácidos 1 a 352) e um segundo clone contendo a HC-Pro de PVY com mutação no motivo conservado IGN (mutado para RPN). Os vírus recombinantes e o LMV selvagem foram inoculados via biobalística em folhas de plântulas de alface cv. Trocadero (suscetível ao LMV). A presença e a natureza das progênies virais... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The genus Potyvirus is one of the largest genera of plant RNA viruses. The potyvirus genome encodes a single polypeptide that is processed by three viral proteinases to yield all viral proteins needed for the infection cycle. One of these proteins is the multifunctional helper component proteinase (HC-Pro), which is involved in genome amplification, aphid transmission, local and systemic movement, suppression of gene silencing and proteolysis. To gain further understanding of the roles of this protein in the Potyvirus life cycle, the functional replacement of the HC-Pro coding region of Lettuce mosaic virus (LMV) with its corresponding counterpart of Potato virus Y (PVY) was performed. These viruses differ both in pathogenicity and in host range. LMV infects mainly Asteraceae while PVY infects Solanaceae. To assess the functional requirement of a homologous HC-Pro in infectivity, two different chimeric viruses were constructed i. e: a full-length LMV containing a wild type PVY HC-Pro (1aa to 352aa) and a full-length LMV containing a PVY HC-Pro with a mutation in the IGN motif (exchanged to RNP). The chimeras, and wild type LMV, were inoculated by biolistic in young lettuce plants. The presence and nature of viral progenies were checked by RT-PCR amplification followed by sequencing. All recombinant viruses were infectious and displayed systemic infection although the symptoms were weak when compared to the wild type LMV. The viruses accumulation were evaluated by differential cycles in the RT-PCR. The LMV wild type was amplified by 30 cycles while the chimerics viruses needed 40 cycles. Therefore this result indicating that the chimeric viruses titer were lower than LMV wild type. The results 4 described here demonstrated that the main biological functions of HC-Pro can be accomplished by heterologous protein. / Orientador: Marcelo Agenor Pavan / Coorientador: Ivan de Godoy Maia / Banca: Renate Krause Sakate / Banca: José Osmar Gaspar / Banca: João Roberto Spotti Lopes / Banca: Addolorata Colariccio / Doutor

The primary purpose of this study was to craft and validate a set of core competencies necessary for an e-Helper to possess. A review of the literature guided the creation of the initial competencies. Following expert review, the competencies were revised and formatted into an online survey which was sent to respondents in four target groups: (a) school administrators who had adopted telepractice as a service delivery model; (b) SLPs experienced in telepractice within a school setting; (c) current e-Helpers, and (d) scholars experienced in telepractice. Sixty percent (21 out of 35) of the competencies were rated as “important” by 76-100% of respondents. The remaining competencies could be more or less important dependent on workplace requirements.

Les cellules T folliculaires helper (Tfh) jouent un rôle central dans la mise en place de réponses humorales efficaces. En effet, les Tfh participent à la sélection des lymphocytes B permettant le développement de lymphocytes B mémoires et d’anticorps de haute affinité. Les Tfh représentent ainsi une cible prometteuse pour la mise en place de nouvelles stratégies thérapeutiques, notamment pour augmenter l’efficacité de la vaccination. Ainsi, il apparaît crucial de mieux comprendre les étapes menant à leur développement, en particulier chez l’Homme. L’initiation de la polarisation Tfh se déroule dans les organes lymphoïdes secondaires et met en jeu les cellules myéloïdes mononucléaires (MMC). Les MMC présentes dans les organes lymphoïdes comprennent les macrophages résidents et trois sous populations de DC résidentes : les cDC1 (CD141+), les cDC2 (CD1c+) et les pDC. Nous nous sommes plus particulièrement intéressés au rôle respectif des sous populations de MMC humaines dans l’induction de la polarisation Tfh. Ainsi, les travaux effectués au cours de ma thèse avaient pour objectifs dans un premier temps d’analyser la capacité des différentes populations de MMC à induire la polarisation Tfh, afin de mettre en évidence de potentielles spécialisations fonctionnelles. Dans un second temps, nous nous sommes concentrés sur les mécanismes moléculaires impliqués dans l’induction par les MMC de la polarisation Tfh. Nous avons montré une spécialisation fonctionnelle des cDC2 et des macrophages des amygdales pour la polarisation Tfh. Toutefois, des différences ont été observées entre les cDC2 et macrophages, puisque les macrophages induisent la sécrétion par les lymphocytes T d’une grande quantité de CXCL13 par rapport au cDC2, qui sont plus efficaces pour induire la production d’IL21. Nous avons pu également montrer que les cDC2 et macrophages sécrétaient des cytokines précédemment identifiées comme ayant un rôle dans l’induction des Tfh telles que IL12p70, ActivinA et TGFβ. Afin de confirmer le rôle de ces cytokines dans la polarisation induite par les MMC d’amygdales, nous avons utilisé des anticorps bloquants dans nos expériences de polarisation T helper. Ainsi, nous avons confirmé le rôle de l’IL12p70, de l’Activin A et du TGFβ dans l’induction des Tfh humains. Nos résultats suggèrent également un rôle de l’Activin A et de TGFβ dans l’induction de la sécrétion de CXCL13, alors que l’IL12p70 serait impliqué dans l’induction de la sécrétion d’IL21. Nos résultats suggèrent aussi l’existence de deux sous populations de Tfh caractérisées soit par l’expression d’IL21 soit par l’expression de CXCL13. Les travaux réalisés au cours de ma thèse enrichissent ainsi les connaissances sur la spécialisation fonctionnelle des sous populations de DC et des macrophages humains, et apportent de nouveaux éléments pour la compréhension de la différenciation des Tfh humains. / T follicular helper cells (Tfh) play a key role in the establishment of efficient humoral responses. Indeed, Tfh are involved in B lymphocyte selection allowing the development of high affinity memory B cells and antibodies. Tfh are promising targets for new therapeutic strategies, especially to increase the effectiveness of vaccination. Thus, it is crucial to better understand the stages leading to their development, especially in human. Initiation of Tfh polarisation occurs in secondary lymphoid organs and involves mononuclear myeloid cells (MMC). MMC from secondary lymphoid organs include resident macrophages and three subsets of resident Dendritic Cells (DC): cDC1 (CD141+), cDC2 (CD1c+) and pDC. We were particularly interested in human MMC subsets respective roles in the induction of Tfh polarisation. Thus, the work carried out during my thesis aimed first at analysing the ability of different populations of MMC to induce Tfh polarisation, in order to highlight potential functional specialisations. In a second step, we focused on the molecular mechanisms involved in Tfh polarisation by MMC. We have shown a functional specialisation of cDC2 and tonsillar macrophages for Tfh polarisation. However, differences have been observed between cDC2 and macrophages, since macrophages induce secretion by T cells of a large amount of CXCL13 compared to cDC2, which are more effective in inducing IL21 production. We have also been able to show that cDC2 and macrophages secreted cytokines previously shown to play a role in Tfh induction such as IL12p70, ActivinA and TGFβ. In order to confirm the role of these cytokines in Tfh polarisation induced by tonsil MMCs, we used blocking antibodies in our T helper polarisation experiments. Thereby, we confirmed the role of IL12p70, Activin A and TGFβ in the induction of human Tfh. Our results also suggest a role for Activin A and TGFβ in inducing secretion of CXCL13, whereas IL12p70 would be involved in the induction of IL21 secretion. Besides, our results suggest the existence of two Tfh subsets characterised by expression of either IL21 or CXCL13. The work performed during my thesis broadens the knowledge on the functional specialisation of human DC subsets and macrophages, and provides new insight into the differentiation of human Tfh.

The eosinophil is a leukocyte whose intracellular mediators are considered to play a central role in the pathogenesis of allergic diseases, including allergic asthma, allergic rhinitis and atopic dermatitis, and which is also involved in immunological responses to parasites. Eosinophil differentiation and maturation from bone marrow progenitors is regulated by interleukin-5 (IL-5), which may be secreted by T helper 2 (Th2) T lymphocytes, and is consistently upregulated in allergic conditions. Eotaxin is a potent chemoattractant for circulating and tissue eosinophils, and the production of this chemokine promotes eosinophil infiltration and accumulation within sites of allergic inflammation.¶ Eosinophils obtained from inflammatory tissues and secretions display an altered phenotype in comparison to peripheral blood eosinophils, with increased surface expression of major histocompatibility complex (MHC) proteins and adhesion molecules (Hansel et al., 1991), and migration across the microvascular endothelium may also increase their capacity to generate an oxidative burst (Walker et al., 1993; Yamamoto et al., 2000). Eosinophils are phagocytic cells, and have been shown to present simple (no requirement for intracellular processing) and complex antigens to MHC-restricted, antigen-specific T lymphocytes (Del Pozo et al., 1992; Weller et al., 1993). Furthermore, eosinophils express the costimulatory molecules required for effective antigen presentation (Tamura et al., 1996), and ligation of costimulatory molecules on the eosinophil cell surface can induce the release of eosinophil derived cytokines (Woerly et al., 1999; Woerly et al., 2002). Therefore the eosinophil may also regulate immune responses.¶ To date, no studies have demonstrated the ability of eosinophils to modulate activated T lymphocyte function via presentation of relevant antigen in the context of MHC class II (MHC-II), concomitant with Th2 cytokine release. In the experiments described in this thesis, murine eosinophils have been observed to rapidly migrate to sites of antigen deposition within the airways mucosa of naïve mice, suggesting a potential role for this granulocyte in the primary response to inhaled antigen. However, human allergic diseases are often diagnosed after the establishment of allergic responses, and symptom development. Therefore, a murine model of allergic airways disease (AAD) was used to investigate the ability for eosinophils to participate as antigen presenting cells (APCs), and thereby modulate activated T lymphocyte function both in vitro and in vivo. Detailed histological analysis of the pulmonary draining lymph nodes following antigen challenge in sensitised mice revealed a rapid infiltration of eosinophils into this tissue, which preceded the accumulation of eosinophils in bronchoalveolar lavage fluid (BALF). This suggested that eosinophils were preferentially translocating to the draining lymph nodes following antigen challenge, and that the subsequent accumulation of these cells in the BALF was a consequence of continued antigen delivery to the lower airways.¶ Eosinophil trafficking to lymphoid tissue via the afferent lymphatics was substantiated using electron microscopy of lymph node sections and the intravenous (i.v.) transfer of fluorescently labeled eosinophils, which did not traffic to lymph nodes via the blood. During the resolution of AAD, eosinophils were noted for their persistence in the pulmonary draining lymph nodes. These observations suggested a continued modulation of T cell function by lymph node dwelling eosinophils during AAD resolution, particularly in light of recent observations for draining lymph node T cell proliferation following instillation of antigen-pulsed eosinophils into the allergic mouse lung (Shi et al., 2000).¶ To further investigate the antigen presenting capacity, eosinophils were obtained from the BALF of mice with AAD, and their surface expression of MHC class II (MHC-II) proteins and costimulatory molecules confirmed using flow cytometric analysis. The ability to acquire and process complex antigen both in vitro and in vivo was also confirmed using naturally quenching fluorescenated ovalbumin (OVA), which is degraded into fluorescent peptides by the action of intracellular proteases. Thus, eosinophil expression of the surface molecules necessary for effective antigen presentation was confirmed, as was their ability to process complex antigen. Further investigations revealed that eosinophils can present complex OVA antigen to CD4+ T lymphocytes obtained from the allergic mouse, and to in vitro derived OVA-specific Th2 cells. In the presence of exogenous antigen, eosinophils co-cultured with T lymphocytes were able to induce Th2 cytokine production, and demonstrated an ability for eosinophils to modulate T lymphocyte function in vitro.¶ The ability for eosinophils to act as antigen presenting cells in vivo was also investigated. Eosinophils obtained from the antigen-saturated lungs of OVA sensitised and challenged mice were transferred to the peritoneal cavities of naïve host mice. When subsequently challenged with aerosolised OVA, eosinophil recipients developed a pulmonary eosinophilia similar to that of OVA sensitised and challenged mice. To validate this finding, the experimental procedure was altered to accommodate the use of non-allergy derived eosinophils, which were pulsed with OVA in vitro, prior to transfer into naïve recipients. When subsequently challenged with aerosolised OVA, eosinophil recipients developed a peripheral blood and pulmonary eosinophilia, and stimulation with OVA induced IL-5 and IL-13 cytokine production from pulmonary draining lymph node cells. Notably, the AAD induced by transfer of antigen pulsed eosinophils did not induce detectable OVA-specific IgG1, which may be attributed to the lack of soluble antigen required for B cell antibody production.¶ During the course of these investigations, an OVA T cell receptor (TCR) transgenic mouse (OT-II) was procured with a view to defining the interaction between eosinophils and activated T lymphocytes (Barnden et al., 1998). Despite having specificity for the OVA323-339 peptide, an immunodominant epitope that skews naïve T cell responses towards Th2 cytokine release (Janssen et al., 2000), T lymphocytes from the OT-II mouse preferentially secreted IFN-γ in response to stimulation with either OVA peptide or OVA. These mice were further characterised in a mouse model of AAD, and found to be refractory to disease induction and progression, which may be attributed to significant IFN-γ secretion by transgenic CD4+ T lymphocytes during antigen sensitisation. Indeed, these cells were noted for their ability to attenuate pulmonary eosinophilia when transferred to OVA sensitised and challenged wild type mice, although serum OVA-specific IgG1, peripheral blood eosinophilia levels and airways response to methacholine challenge remained intact.¶ Knowledge of the biased Th1 phenotype in naïve OT-II provided a unique opportunity to investigate the fate of T lymphocytes bearing high affinity OVA-specific TCRs following neonatal antigen exposure to soluble OVA. In a previous study, subcutaneous (s.c.) administration of soluble OVA to wild type neonatal mice was suspected to have deleted OVA-specific T cells from the T cell repertoire (Hogan et al., 1998a). Using flow cytometry and TCR specific antibody, the delivery of s.c. OVA to OT-II neonates did not alter transgenic T cell populations in adult mice. Instead, it was surprising to find a skewing towards the Th2 phenotype and loss of IFN-γ secretion following OVA sensitisation and challenge in adult mice. A mechanism for this reprogramming of the transgenic T cell from the Th1 to a Th2 phenotype following OT-II neonatal exposure to soluble OVA is proposed, and further experimentation may validate this hypothesis.¶ In conclusion, eosinophils residing in the allergic lung have the capacity to interact with activated T cells, both within this tissue and the draining lymph nodes. Despite their relative inefficiency as antigen presenting cells (Mawhorter et al., 1994), eosinophils may participate en masse in the serial triggering of activated TCRs, and provide appropriate costimulatory signals that modulate T lymphocyte function. Through the elaboration of Th2 cytokines and stimulation of T cell proliferation, antigen presenting eosinophils may transiently prolong or exacerbate the symptoms of allergic diseases. Alternatively, eosinophils presenting relevant antigens may inhibit T cell activity via degranulation, and such activity has recently been observed in a parasite model (Shinkai et al., 2002). Finally, experiments in the OT-II mouse have provided valuable information to suggest that therapies designed to modulate eosinophil numbers in allergic tissues through the secretion of opposing cytokines such as IFN-γ, may be of limited benefit. The results shown here suggest that airways dysfunction remains intact despite significantly reduced pulmonary eosinophilia