L'infection par le virus de l'hépatite C (VHC) est un problème de santé publique majeur car en absence de vaccin et de thérapie suffisamment efficace, l’infection peut dégénérer en carcinome hépatocellulaire. Il est alors important d’identifier de nouvelles cibles thérapeutiques et de développer de nouveaux antiviraux. Ainsi, nous avons étudié l'activité anti-VHC de différents composés : l'arbidol (Arb), la silymarine (SM) et les molécules la composant, notamment la silibinine (SbN). Ces composés ont l'avantage d'être déjà utilisés en médecine humaine depuis de nombreuses années et ont ainsi prouvé leur innocuité. Ils présentent un large spectre antiviral et inhibent plusieurs étapes du cycle viral, dont la fusion membranaire. Cette étape du cycle est intéressante à cibler car le virus serait bloqué précocement, avant de provoquer des dommages cellulaires.Nous avons approfondi notre connaissance du mécanisme d'inhibition de la fusion par Arb en montrant par différentes stratégies qu'il s'associe avec les phospholipides à l'interface membranaire et interagit avec des résidus aromatiques. Cela suggère que Arb pourrait former durant le processus de fusion un complexe entre glycoprotéine virale et membrane, permettant d'inhiber les changements conformationnels de la glycoprotéine, nécessaires à la fusion. De même SM et ses composés inhibent la fusion de pseudoparticules de HCV, probablement en stabilisant les membranes impliquées dans le processus. Enfin, nous avons observé une activité antivirale et anti-inflammatoire très différente entre deux formulations de SbN. Tous ces résultats sont discutés dans le contexte actuel d'un arsenal thérapeutique anti-HCV qui reste limité. / Infection by the hepatitis C virus (HCV) is a major public health problem since the infection can lead to hepatocellular carcinoma in the current absence of vaccine and effective treatment. It is therefore important to identify new therapeutic targets and to develop novel antiviral drugs. Here we studied the anti-HCV activity of two compounds : arbidol (Arb), the herbal extract silymarin (SM) and molecules therein, including silibinin (SbN). These compounds are already in use in human medicine for several years and have proven safety. They display a broad antiviral spectrum and inhibit several steps of the virus life cycle, including membrane fusion. This step is very interesting to target, since the virus could be blocked upstream the cellular damages it could induce. Using different biophysical strategies, we showed that Arb associates with phospholipids at the membrane interface and interacts with aromatic residues. This suggests that Arb could form during the fusion process a complex between viral glycoprotein(s) and membrane, leading to the inhibition of the conformational changes within the glycoprotein that are required during the fusion process. SM and its components inhibit fusion of HCV pseudoparticles, probably by stabilizing the membranes involved in this process. Finally, we observed different antiviral and anti-inflammatory activities between two different formulations of SbN. Knowledge of these antiviral mechanisms should lead to innovative therapeutic strategies against HCV.

Hepatitis C virus (HCV) is a worldwide spread pathogen infecting up to 3 % of the human population. Nowadays, research of new drugs against this virus is focused on the individual steps in its life cycle, including the translation initiation. In the case of HCV translation initiation is dependent on the internal ribosome entry site (IRES). Besides of components of the translational machinery also other components of the cell, so called IRES trans-acting factors (ITAF), contribute to its proper progress. This work continues in previous research of our laboratory focused on searching for new ITAF. In order to search for potential ITAF increasing HCV IRES activity new recombinant plasmid vectors and reference strains were prepared and selection conditions of the selection system were optimized. The differences in the growth characteristics of the reference strains were analyzed and quantified under selective and non-selective conditions. A set of pilot high efficiency transformations of the yeast strain pJ69-4A carrying bicistronic construct with HCV IRES were conducted using human expression cDNA library in order to optimize the efficiency of transformation and selection conditions and to attempt to identify new ITAF. Several dozens of randomly selected clones from these transformations obtained under...

<p>Uvod: Hronična HCV infekcija je povezana sa nizom ekstrahepatičnih manifestacija, uključujući pojavu depresivnih i anksioznih simptoma, zamora, bolova u mi&scaron;ićima i zglobovima koji su povezani sa smanjenjem kvaliteta života u vezi sa zdravljem (HRQOL). Ciljevi istraživanja: Proceniti različite aspekte kvaliteta života bolesnika sa hroničnim hepatitisom C koji nisu na terapijskom tretmanu interferonom; Sagledati učestalost određenih psihosocijalnih obeležja (depresivnost, anksioznost, radni status, stepen obrazovanja) i njihovu povezanost sa kvalitetom života bolesnika sa hroničnim hepatitisom C koji nisu na terapijskom tretmanu, kao i ispitati povezanost osnovnih demografskih obeležja (starost, pol, bračno stanje) i kvaliteta života bolesnika sa hroničnim hepatitisom C; Ispitati povezanost osnovnih medicinskih obeležja vezanih za oboljenje (način prenosa infekcije, dužna infekcije, prisustvo ciroze) i kvaliteta života bolesnika sa hroničnim hepatitisom C. Materijal i metode: Istraživanje je sprovedeno kao prospektivna studija u periodu od aprila 2013. do aprila 2015. godine na Klinici za infektivne bolesti Kliničkog centra Vojvodine u Novom Sadu, Infektivnom odeljenju i u Službi za transfuziju krvi Op&scaron;te bolnice ,,Dr Radivoj Simonović&rdquo; u Somboru. Ispitano je 150 osoba, oba pola, obolelih od hroničnog hepatitisa C koji su činili studijsku grupu obolelih. U kontrolnoj grupi ispitano je ukupno 150 zdravih osoba, oba pola, uzrasta iznad 18 sličnih socio-demografskih karakteristika. Kvalitet života ispitan je pomoću upitnika: SF-36, CLDQ i HADS. Putem op&scaron;teg upitnika prikupljni su socio-demografski podaci o ispitanicima, kao i odeđena obeležja vezana za oboljenje. Rezultati: Sagledavanjem skorova upitnika SF-36 razlika u kvalitetu života između obolelih od hroničnog hepatitis C i kontrolne grupe je statistički značajna na svakom od pojedinačnih domena, ukupnom skoru SF-36 upitnika, Fizičkom kompozitnom skoru i Mentalnom kompozitnom skoru (p&lt; 0,000). Oboleli od hroničnog hepatitisa C pokazuju statistički značajno izraženiju depresivnost (t=3,37; p&lt;0,01) i anksioznost (t=2,35; p&lt;0,05) u odnosu na kontrolnu grupu. Multiplom regresionom analizom utvrđeno je da se visok procenat depresivnosti (72%) može objasniti sa skupom prediktora koji su činili domeni kvaliteta života sa upitnika SF-36. Najveći parcijalni doprinos pojavi depresivnosti imaju tri domena kvaliteta života: Fizičko funkcionisanje, Vitalnost i Mentalno zdravlje. Univarijantnom analizom utvrđen je nezavisan efekat bračnog statusa na promene u kvalitetu života kod obolelih od HHC. Lo&scaron;iji kvalitet života kod osoba koje boluju od hroničnog hepatitisa C če&scaron;će je prisutan kod onih koji žive u braku ili vanbračnoj zajednici i onih starosti 30-50 godina, dok oni koji su zaposleni imaju bolji kvalitet. Zaključak: S obzirom na lo&scaron;iji kvalitet života osoba obolelih od hroničnog hepatitisa C i če&scaron;će prisustvo depresivnih i anksioznih obeležja potrebno je proceniti kvalitet života obolelih nakon postavljanja dijagnoze, kao i tokom kliničkog praćenja i lečenja.</p> / <p>Background: Chronic HCV infection is associated with a variety of extrahepatic manifestations, including the occurrence of depressive and anxiety symptoms, fatigue, muscle pain and joint pain associated with a reduction in quality of life related to health (HRQOL). Objectives: Assess the different aspects of quality of life in patients with chronic hepatitis C who are not on interferon therapy treatment; Consider the frequency of certain psychosocial characteristics (depression, anxiety, employment status, education level) and their association with the quality of life of patients with chronic hepatitis C who have not on therapeutic treatment, as well as examine the relationship between basic demographic characteristics (age, sex, marital status) and quality of life in patients with chronic hepatitis C; To analyze the association of basic medical characteristics related to disease (mode of transmission of infection, responsible for the infection, the presence of cirrhosis) and quality of life of patients with chronic hepatitis C. Materials and Methods: The study was conducted as a prospective study from April 2013 to April 2015 at the Clinic for Infectious Diseases of the Clinical Center of Vojvodina in Novi Sad, Department of Infectious Diseases and the Blood Transfusion General Hospital ,,Dr Radivoj Simonovic&ldquo; Sombor . The study has included 150 patients with chronic hepatitis C who have done a study group, both sexes. In the control group, has included 150 healthy subjects of both sexes, aged over 18 years, similar socio-demographic characteristics. Quality of life was tested using a questionnaire SF-36, HADS and CLDQ. Through a general questionnaire have collected the socio-demographic data on the respondents, as well as the diseases characteristics. Results: By reviewing the scores of SF-36 difference in quality of life between patients with chronic hepatitis C and control group was statistically significant in each of the individual domains, the total score of the SF-36 questionnaire, Physical and Mental composite score (p &lt;0.000). Patients with chronic hepatitis C show significantly more pronounced depression (t = 3.37; p &lt;0.01) and anxiety (t = 2.35; p &lt;0.05) compared to the control group. Multiple regression analysis showed that a high percentage of depression (72%) can be explained by a set of predictors consisted of the domain of quality of life questionnaire SF-36. The greatest partial contribution occurs depression have three domains of quality of life: Physical functioning, Vitality and Mental health. Univariate analysis identified the independent effect of marital status on changes in the quality of life in patients with HHC. Worse quality of life in patients suffering from chronic hepatitis C often present in those living in married or common-law marriage and those aged 30-50 years, while those who are employed have better quality. Conclusion: Due to the inferior quality of life of patients suffering from chronic hepatitis C and frequent presence of depressive and anxiety traits it is necessary to assess the quality of life of patients after diagnosis and during clinical follow-up and treatment.</p>

Le virus de l'hépatite C (HCV) infecte environ 180 millions de personnes à travers le monde. De nouveaux antiviraux ont récemment été mis sur le marché mais ils présentent des effets indésirables. La recherche de nouvelles cibles thérapeutiques reste donc d'actualité. Mes principaux travaux ont consisté à développer des approches de biochimie et d'imagerie sur cellules vivantes pour étudier les mécanismes moléculaires d'action des antiviraux silibinine (SbN) et arbidol (ARB) sur HCV. Nous avons montré que SbN et ARB inhibent des vésicules entourées de clathrine et ne sont pas délivrés aux endosomes précoces. SbN et ARB inhibent également l'infection d'autres virus entrant par endocytose clathrine-dépendante, ce qui expliquerait leur activité à large spectre. J'ai également contribué à un projet initié depuis quelques mois au sein de l'équipe. L'hypothèse était qu'un élément présent dans le microenvironnement hépatique (MEH) jouerait un rôle essentiel dans l'infection par HCV. Nous nous sommes intéressés au syndécan-1 (SDC1) car il est fortement exprimé à la surface des hépatocytes. Nos travaux montrent que la déplétion de SDC1 diminue fortement l'infection. SDC1 colocalise à la surface des hépatocytes non infectés avec CD81, un récepteur connu de HCV. Dans les jours suivant l'infection, cette colocalisation est perturbée. Ces données suggèrent que SDC1 serait un co-facteur d'entrée de HCV, agissant en combinaison avec CD81, et que l'infection réorganiserait les molécules du MEH, ce qui pourrait à long terme contribuer à la persistance de l'infection / Hepatitis C virus (HCV) is a global health concern infecting 170 million people worldwide. New antivirals recently received the approval for the treatment against HCV infection but they display many side effects. Research for new therapeutic targets therefore remains an important topic. My main work was to develop approaches in biochemistry and live cell imaging to study the molecular mechanisms of action of antivirals silibinin (SbN) and arbidol (ARB) on HCV infection. We show that SbN and ARB alter clathrin-mediated endocytosis. Viral particles are trapped in clathrin-positive structures and cannot be delivered to the early endosomal compartment, thereby preventing infection. SbN and ARB also prevent cell infection by viruses that enter through clathrin-mediated endocytosis, which could explain their broad spectrum activity. I also contribute to a project initiated for a few months in the lab. We hypothsized that a molecule present in the immediate surrouding of the hepatocyte microenvironment could play a role in HCV infection. We focused on the syndecan-1 (SDC1) because it is essentially anchored on the surface of hepatocytes. We show that SDC1 depletion leads to a drastic decrease of the viral infectivity. SDC1 colocalizes on the unfected hepatocyte surface with the already identified HCV recptor CD81. This colocalization vanished within days in infected cells. These data suggest that SDC1 could act as a cellular co-factor for HCV entry, in combination with CD81; thus infection could reorganized molecules of the hepatocyte microenvironment and contribute to HCV hepatotropism and the peristence of infection

As hepatites virais estão entre as mais importantes pandemias mundiais da atualidade. Existem várias causas de hepatite, entre elas, o vírus da hepatite B (HBV), o vírus da hepatite C (HCV) e o vírus da Hepatite Delta (HDV). Da mesma forma, o vírus GB-C (GBV-C) é importante na coinfecção com outros vírus, como o HIV. Nesse estudo, várias regiões da América do Sul foram analisadas. Na Colômbia, os estados do Amazonas e Magdalena foram encontradas como regiões hiperendêmicas para HBV. O genótipo F3 (75%) foi o mais prevalente. Determinou-se que o subgenótipo F3 é o mais antigo dos subgenótipos F. No estado de Chocó, encontrou-se o subgenótipo A1 (52,1%) como o mais prevalente. Surpreendentemente, nesse mesmo estado foram encontrados nove casos autóctones de infecção pelo genótipo E (39,1%). Para o HCV, em Bogotá, encontrou-se o subtipo 1b (82,8%) como o mais prevalente. Da mesma forma, estimou-se que esse subtipo foi introduzido por volta de 1950 e se propagou exponencialmente entre 1970 a 1990. O HDV foi identificado em casos de hepatite fulminante do estado de Amazonas, todos classificados como genótipo 3. Se determinou que o HDV/3 se espalhou exponencialmente a partir de 1950 a 1970 na América do Sul e depois desta época, esta infecção deixou de aumentar, provavelmente devido a introdução de vacinação contra o HBV. GBV-C foi procurado em doadores de sangue colombianos infectados com HCV e/ou HBV de Bogotá e em povos indígenas com infecção pelo HBV no Amazonas. A análise filogenética revelou a presença do genótipo 2a como o mais prevalente entre os doadores de sangue e o 3 nos povos indígenas estudados. A presença do genótipo 3 na população indígena foi previamente relatada na região de Santa Marta, na Colômbia e nos povos indígenas da Venezuela e da Bolívia. No Chile, foi realizado um estudo com 21 pacientes cronicamente infectados pelo HBV sem tratamento antiviral prévio. Todas as sequências obtidas eram do subgenótipo F1b e se agrupavam em quatro diferentes grupos, sugerindo que diferentes linhagens desse subgenótipo estão circulando no Chile. No Brasil, no estado de Rondônia, para o HCV, encontramos o subtipo 1b (50,0%) como o mais frequente. Esse foi o primeiro relato sobre os genótipos do HCV neste estado. Para o HBV, o subgenótipo A1 (37,0%) foi o mais frequente. Os resultados do estado de Rondônia são consistentes com outros estudos no Brasil, mostrando a presença de vários genótipos do HBV, refletindo a origem mista da população Brasileira. Estudando o estado do Maranhão, avaliamos a frequência da infecção pelo HBV e seus genótipos. Foram encontradas 4 sequencias genótipo A1 que agruparam com outras sequências reportadas do Brasil. Em outro estudo, caracterizamos os subgenótipos do HBV em 68 pacientes com hepatite crônica B em Pernambuco, encontrando 78,7% de presença do subgenótipo A1. Finalmente, em um estudo realizado com amostras da cidade de São Paulo, encontramos um caso de HBV genótipo C em um brasileiro nativo, sendo essa a primeira sequência completa do genoma de HBV/C2 notificados no Brasil / Viral hepatitis are among the major pandemics in the world nowadays. There are many causes of hepatitis, including hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis delta virus (HDV). Similarly, GB virus C (GBV-C) is a relevant agent in co-infection with HIV. In this study, several regions of South America were studied. In Colombia, the states of Amazonas and Magdalena were identified as highly endemic areas for HBV. Genotype F3 (75%) was the most prevalent. It was determined that subgenotype F3 is the oldest among all F subgenotypes. In the state of Chocó, subgenotype A1 (52.1%) was the most prevalent. Surprisingly, nine indigenous cases of infection by genotype E (39.1%) were found in this state. For HCV, in Bogotá, subtype 1b (82.8%) was the most frequent. Likewise, it was estimated that this subtype was introduced around 1950 and spread exponentially from 1970 to 1990. HDV has been identified in cases of fulminant hepatitis in the state of Amazonas, all of them classified as genotype 3. It was determined that the HDV/3 spread exponentially from 1950 to 1970 in South America and after this time, this infection stopped to increase, probably due to introduction of vaccination against HBV. GBV-C was sought in Colombian blood donors infected with HCV and/or HBV in Bogotá and indigenous peoples with HBV infection in the Amazon. The phylogenetic analysis revealed the presence of genotype 3 as the most prevalent among blood donors and in three studied indigenous people. The presence of genotype 3 in the indigenous population has been previously reported in the region of Santa Marta, Colombia, and in the indigenous peoples of Venezuela and Bolivia. In Chile, a study was carried out with 21 patients chronically infected with HBV without any prior antiviral treatment. All sequences obtained belonged to subgenotype F1b and clustered into four different groups, suggesting that different strains that are circulating in Chile. In Brazil, the state of Rondônia, we found HCV subtype 1b (50.0%) as the most frequent. This was the first report on HCV genotypes in this state. For HBV, subgenotype A1 (37.0%) was the most frequent. The results of the state of Rondônia are consistent with other studies carried out in Brazil, showing the presence of several HBV genotypes, reflecting the mixed origin of the Brazilian population. Studying the state of Maranhão, we evaluated the frequency of HBV infection and its genotypes and we found 4 genotype A1 sequences that grouped with other sequences reported in Brazil. In another study, we characterized HBV subgenotypes in 68 patients with chronic hepatitis B in Pernambuco and we found subgenotype A1 in 78.7% cases. Finally, in a study of samples from São Paulo, we found a case of HBV genotype C in a native Brazilian patient and this is the first complete genome sequence of HBV/C2 reported in Brazil

Les microARN (miARN) sont de petits ARN non-codants qui contrôlent l’expression génique, en s’hybridant, le plus souvent, de manière imparfaite à des séquences spécifiques qui se trouvent généralement dans la région non traduite en 3' (3’UTR) de transcrits cibles. Les miARN guident sur l’ARN messager (ARNm) un complexe protéique appelé RNA-induced Silencing Complex (RISC), composé des protéines Argonaute et TNRC6, qui perturbe l’initiation de la traduction et provoque la déadénylation et la dégradation du transcrit. C'est l’interaction entre le RISC et le complexe de pré-initiation de la traduction 43S (composé de la petite sous-unité ribosomique 40S et des facteurs d’initiation associés) qui entraîne la répression traductionnelle de l’ARNm ciblé. Des résultats récents ont démontré que le RISC perturbe le balayage de la région non traduite en 5’ (5’UTR) par le ribosome, étape qui requiert la présence de 2 facteurs d’initiation qui sont eIF4F qui reconnaît et lie la coiffe ainsi que la protéine PABP, fixée le long de la queue poly(A). Toutefois, les miARN peuvent également induire la stimulation de la traduction des transcrits cibles dans les cellules quiescentes, dans un lysat d’embryons de drosophiles ou encore dans les ovocytes de Xénope. Le mécanisme moléculaire de stimulation de l’expression par les miARN est encore mal connu mais requiert l’absence de queue poly(A) en 3’ des ARN cible et de TNRC6 au sein du complexe RISC. Le Virus de l’Hépatite C (VHC) possède en 5’ de son ARNg un site d’entrée interne du ribosome (IRES) qui recrute la petite sous-unité ribosomique 40S, sans nécessiter la reconnaissance de la coiffe par eIF4F, ni la protéine PABP, ni le balayage de la 5’UTR par le ribosome. Ces caractéristiques singulières nous ont conduits à rechercher l'impact du complexe RISC fixé en 3’ de l’ARNm sur l’initiation de la traduction du VHC. Pour cela, nous avons utilisé des transcrits contenant l'IRES du VHC en 5' et des sites d’hybridation du miARN let-7 en 3’. Ces ARNm ont ensuite été transfectés dans des lignées cellulaires hépatocytaires, ou non. A notre grande surprise, nous avons observé que la fixation du miARN let-7 sur la région 3' du transcrit stimulait fortement l’expression dirigée par l’IRES de VHC. Toutefois, l’augmentation de l’expression n’est pas due à la stabilisation du transcrit mais bien à une hausse significative de la synthèse protéique indépendamment d’un quelconque effet de miR-122. En utilisant d’autres IRES dites 'HCV-like', nous avons pu confirmer ces résultats et démontrer que, l’ajout d’une queue poly(A) en 3’ du transcrit, capable de fixer la PABP, annule cet effet stimulateur suggérant que l’absence de cette protéine est nécessaire pour que le complexe RISC stimule la traduction du VHC. / MicroRNAs (miRNAs) are small non coding RNAs which control gene expression by recognizing and hybridizing to a specific sequence generally located in the 3’UTR of targeted messenger RNA (mRNA). miRNAs serve as a guide for the RNA-Induced Silencing Complex (RISC) that is composed by, at least, the Argonaute proteins and TNRC6. Recent studies have suggested that translation inhibition occurs first and is then followed by deadenylation and degradation of the targeted transcript. The miRNA-induced inhibition of protein synthesis occurs at the level of translation initiation during the ribosomal scanning step and it requires the presence of both the initiation factor eIF4G and the poly(A) Binding Protein (PABP). In this process, the RISC interacts with both PABP and 43S pre-initiation complex (composed by initiation factors and ribosome) and it results in the disruption of linear scanning of the ribosome along the 5’ Untranslated Region (5’UTR). In some specific cases, the binding of miRNAs to their target sequences can upregulate translation initiation. This has notably been demonstrated in G0 quiescent cells, drosophila embryos and Xenopus oocytes. Although the molecular mechanism by which upregulation occurs remains to be precisely determined, it appears that the absence of a poly(A) tail and the lack of availability of the TNRC6 proteins are amongst the major determinants. In the particular case of the Hepatitis C Virus (HCV), the genomic RNA is uncapped and non polyadenylated and harbors an Internal Ribosome Entry Site (IRES) which directly binds to the ribosome with no need for cap-recognition, PABP binding and ribosome scanning. These peculiar features of the HCV IRES prompted us to investigate how viral translation can be regulated by the miRNA machinery. In order to do that, we have used a mRNA that contains the HCV IRES in 5’ and 4 let-7 binding sites in its 3’ extremity. To most of our surprise, we have observed a strong stimulation of the expression of the HCV IRES when the construct is bearing the let-7 sites. This effect is not due to any interference with the miR-122 binding sites although the magnitude of stimulation reached the same level. Our data show that it is the presence of the RISC on the 3' end of the transcript that can stimulate internal ribosome entry at the 5' end. By using other HCV-like IRESes, we could confirm these data and further showed that the absence of a poly(A) tail was an absolute requirement for the stimulation to occur. These effects are not due to an increase of mRNA stability and are rather exerted at the level of translation.

Le virus de l'hépatite C (VHC) établit généralement une infection chronique. Néanmoins, environ 20% des sujets vont résoudre spontanément l’infection. Il existe des preuves solides que les cellules T CD8 sont essentielles au contrôle du VHC. Dans la première partie de ma thèse, nous avons identifié un nouveau marqueur de la dysfonction des lymphocytes T, CD39, comme étant régulé positivement au cours de l'infection chronique par le VHC, le VIH et dans un modèle d’infection chronique par LCMV. Dans une deuxième partie, nous avons utilisé une approche d'analyse intégrative pour étudier la régulation transcriptionnelle des cellules T CD8 au cours de la phase aiguë de l'infection par le VHC. Nous avons identifié des changements précoces dans la régulation transcriptionelle d’importantes fonctions effectrices, de voies métaboliques et du nucléosome par les cellules T CD8 des patients souffrant d'une infection persistante. Certains de ces changements corrèlent avec l’absence des cellules T CD4 spécifiques du VHC et sont associés avec l’âge et le sexe du sujet infecté. Nos résultats suggèrent que la dysfonction des lymphocytes T CD8 au cours de l'infection par le VHC est liée à des événements précoces dans la régulation des gènes, non seulement amplifiés par une inflammation chronique et une absence des cellules T CD4 auxiliaires, mais qui pourraient également être influencés par des facteurs de l’hôte tels que l’âge et le sexe. / Infection with Hepatitis C virus typically establishes chronic infection, but about 20% of subjects clear HCV spontaneously. There is strong evidence that functional CD8 T cells are critical for HCV control. In the first part of my thesis we identified a new marker for exhausted T cells, CD39, that we showed to be upregulated in chronic HCV infection, progressive HIV infection and in chronic infection with LCMV. In the second part we used an integrative analysis approach to study transcriptional regulation of CD8 T cells in the acute phase of HCV infection with different outcomes. We found early transcriptional changes in key immune effector pathways as well as metabolic and nucleosomal processes in CD8 T cells from patients with persistent infection. Some of these changes track with a lack of HCV-specific CD4 T cells exhibit associations with subject age and sex. Our findings suggest that CD8 T cell exhaustion in HCV infection is linked to early gene regulatory events that are not only amplified by chronic inflammation and a lack of CD4 help, but might also be influenced by disease-relevant host factors such as patient age and sex.

Garantir la qualité des produits sanguins est crucial. Les lysats plaquettaires (LP) riches en facteurs de croissance (FC) s’imposent comme le complément idéal pour l’expansion ex vivo des cellules souches, et comme produit thérapeutique pour la régénération cellulaire. L’intérêt est croissant pour les microparticules (MPs) extracellulaires, mais l’expression de phosphatidylsérine à leur surface peut induire des effets thrombotiques et inflammatoires. L’autre risque transfusionnel, la transmission de virus, dont le virus de l’hépatite C (VHC), est maîtrisable par traitements de réduction virale par solvant/détergent (S/D), chauffage, ou nanofiltration. Nous avons étudié des technologies de sécurisation des produits sanguins: (a) élimination des MPs par nanofiltration sur filtres de 75 nm et (b) traitements S/D, chauffage à 56°C ou nanofiltration pour inactiver ou éliminer le VHC. Les informations ont été utilisées pour développer des LP utiles en médecine régénérative. L’un d’eux destiné à la neurorégénération, a été préparé en émettant l’hypothèse qu’un lysat de culot plaquettaire (LCP) enrichi en facteurs neurotrophiques et dépourvu de protéines plasmatiques se montrerait efficace contre les maladies neurodégénératives. Nos résultats montrent que la nanofiltration sur des filtres de 75 nm préserve la composition en protéines plasmatiques, et le pouvoir hémostatique. La nanofiltration retire les MPs et évite, in vitro, la génération de thrombine. Par ailleurs le traitement S/D à 31°C pour 30 minutes élimine le pouvoir infectieux du VHC. Pris globalement les traitements de nanofiltration et S/D apparaissent donc comme des méthodes de choix pour l’amélioration de la sécurité du plasma vis à vis de risques thrombogènes et infectieux. Nous avons ensuite préparé un LCP appauvri en protéines plasmatiques (dont le fibrinogène) et enrichi en un mélange pléiotrope physiologique de FC destiné à l’administration cérébrale. Les analyses par ELISA et par protéomique ont montré qu’un chauffage de 56°C pour 30 min réduisait le contenu en protéines et modifiait favorablement la composition relative en facteurs neurotrophiques. Par ailleurs le chauffage améliore l’action neuroprotectrice et, associé aux traitements S/D et de nanofiltration, contribue à l’inactivation du VHC. Ce LCP exerce une neuroprotection élevée dans des modèles de la maladie de Parkinson (MP) tout à la fois (a) in vitro (cellules LUHMES différentiées en neurones dopaminergiques et exposées au MPP+) et (b) in vivo (souris intoxiquées par MPTP). L’expression de la tyrosine hydroxylase (TH) dans la Substantia nigra pars compacta montre que l’administration intracérébroventriculaire (ICV) ou intranasale (i.n.) apparait comme une option thérapeutique possible des maladies neuro-dégénératives. Les études cellulaires In vitro sur LUHMES et NSC34 ont montré que l’inhibition spécifique des voies signalétiques relayées par AkT et ERK altère l’activité neuroprotectrice du LC. Des événements neuro-inflammatoires pouvant aggraver l’évolution des maladies neurodégénératives, nous avons vérifié que le LCP n’induit pas de marqueurs inflammatoires (COX-2, iNOS) chez des cellules microgliales BV2, et pouvait même diminuer celle de COX-2 après exposition à des lipopolysaccharides. De plus, nous avons identifié que le LCP contenait 1.7 x 1012 MP/mL d’une taille moyenne de 160 nm. Isolées, ces MPs pourraient exercer un rôle neuroprotecteur des cellules LUHMES exposées à des agents neurotoxiques. En conclusion, nos résultats montrent la faisabilité technique à préparer des lysats plaquettaires viro-inactivés pour des usages dans le domaine de la médecine régénérative, y compris comme agent neuroprotecteur du système nerveux central. / Ensuring quality and safety of blood products is crucial. Platelet lysates (PL) rich in growth factors (GFs) have emerged as ideal clinical-grade supplement for ex vivo expansion of mesenchymal stromal cells, and as therapeutic product promote cellular regeneration. Interest for platelet extracellular microparticles (MPs) is growing but expression of phosphatidylserine on their surface may cause thrombotic and inflammatory side effects. Another transfusional risk, transmission of viruses, including hepatitis C virus (HCV), can be fully controlled by dedicated viral reduction methods as solvent/detergent (S/D) or heat treatments, or nanofiltration. We have evaluated technologies to secure therapeutic blood products: (a) removal of MPs by 75nm-nanofiltration and (b) inactivation/removal of HCV by S/D or 56°C heat treatments, or nanofiltration. Data have been used to develop LP of interest for regenerative medicine. In particular, one, targeting neuroregenerative applications, has been prepared based on the hypothesis that a platelet pellet lysate (PPL) enriched in multiple neurotrophic growth factors and depleted of plasma proteins could exert potent neuroprotective actions in neurodegenerative disease models. Our data show that 75 nm-plasma nanofiltration preserved plasma protein biochemical profile, and hemostatic power. Nanofiltration removes MPs and avoids in vitro the generation of thrombin. In addition, the S/D treatment at 31°C for 30 minutes fully inactivates HCV infectivity. Therefore, altogether, nanofiltration and S/D emerge as choice procedures to improve the safety of plasma for thrombogenic and infectious risks. We have then prepared a PPL depleted of plasma proteins (in particular fibrinogen), and rich in a physiological pleiotropic mixture of neurotrophins for brain administration. ELISA and proteomics studies revealed that the heat-treatment at 56°C for 30 min decreased the protein content and favorably modified the relative composition in neurotrophic factors. Heat-treatment improved the neuroprotective activity and, together with S/D and nanofiltration contributed to HCV inactivation. This PPL exerted strong neuroprotective effects in Parkinson’s disease (PD) models (a) in vitro, using LUHMES cells exposed to MPP+ neurotoxin, and (b) in vivo, in mice intoxicated by MPTP neurotoxin. Expression of tyrosine hydroxylase (TH) in the Substantia nigra pars compacta indicated that brain delivery by intracerebroventricular (ICV) or intranasal (i.n.) administration may be a therapeutic option for disease-modifying strategies of neurodegenerative diseases. In vitro studies in LUHMES and NSC34 cells showed that specific inhibition of signal transduction pathways through AkT and ERK influenced PPL neuroprotective function. Since neuro-inflammation detrimentally affects neurodegenerative disorders, we verified that the PPL did not stimulate the release of inflammatory markers (e.g. COX-2, iNOS) by BV2 microglial cells in culture, and could even restrict COX-2 expression when cells were exposed to LPS. In addition, the PPL was found to contain 1.7 x 1012 MP/mL with a mean size of 160 nm. These MPs may exert neuroprotective activity on LUHMES cells exposed to neurotoxins. Altogether, our data demonstrate the technical feasibility of developing virally-safe customized platelet lysate preparations with specific applications for cell therapy and regenerative medicine, in particular as neuroprotective agents of the central nervous system.

Le virus de l’hépatite C (VHC) est un problème mondial. La majorité des personnes infectées (70-85%) développent une infection chronique qui cause des complications hépatiques. Le seul régime thérapeutique approuvé pour le VHC est l'interféron alpha (IFN-α). Ce traitement a un taux de réussite de 50-80% selon le génotype de virus et le moment de l'initiation de la thérapie. Les facteurs régissant la réponse au traitement ne sont pas bien définis. Des études antérieures ont suggéré un rôle potentiel de la réponse immunitaire de l'hôte au succès de la thérapie, toutefois, ces résultats sont controversés. Nous avons émis l'hypothèse que la réponse immunitaire de l’hôte sera plus efficace chez les patients qui commencent la thérapie tôt pendant la phase aiguë de l'infection. En revanche, la réponse immunitaire sera épuisée lorsque le traitement est initié pendant la phase chronique. L'objectif principal de ce mémoire est d’étudier les facteurs immunologiques qui régissent la réponse à la thérapie, et de déterminer si la contribution de la réponse immunitaire de l'hôte peut être influencée par la période de l'infection. Nos résultats démontrent l'efficacité de la restauration de la réponse immunitaire spécifique au VHC lorsque la thérapie par l'interféron est initiée tôt. Ceci est démontré par le sauvetage des cellules T efficaces spécifiques au VHC efficace similaires à celles observées chez les individus qui ont résolu spontanément, suggérant ainsi qu'elles jouent un rôle actif dans la réponse au traitement. Toutefois, cette réponse n'a pas été restaurée chez les patients traités au cours de la phase chronique. Ces résultats ont des implications importantes dans la compréhension des mécanismes sous-jacents à la réponse aux traitements actuels et au développement des nouvelles thérapies. / Hepatitis C virus (HCV) is a major public health problem worldwide. Only 15-30% of infected individuals clear the virus spontaneously, while the majority develops chronic infection that causes liver complications. The only approved therapy for HCV is interferon alpha (IFN-α) based. This therapy has a 50-80% success rate depending on the infecting virus genotype and the timing of initiation of therapy. Factors governing the response to therapy are not well defined. Previous studies have suggested a role for the host immune response in the success of therapy. However, these results were controversial. We hypothesized that host immunity has an effective role in the success of IFN-α therapy when initiated early during the acute phase of HCV infection, while late initiation during the chronic phase minimizes this role. The main objective of this thesis was to dissect the immunological factors governing the differential response to IFN-α therapy, and to determine if the contribution of the immune response to success of therapy might be influenced by the period of infection. Our results demonstrate restoration of efficient HCV-specific immune responses when therapy is initiated early during the acute phase. This is demonstrated by the rescue of functional HCV-specific T cells similar to those observed in spontaneously resolved individuals, suggesting that they may play an active role in response to therapy. However, such responses were not restored following late therapy suggesting irreversible damage to the host’s defence system with chronicity. These findings have important implications in understanding the mechanisms underlying response to current treatments and development of novel therapies.

Hepatitis C virus (HCV) is a major cause of liver cirrhosis and hepatocellular carcinoma. In the first part of my PhD, we aimed to further characterize the role of scavenger receptor class B type I (SR-BI) in HCV infection. While the SR-BI determinants involved in HCV binding have been partially characterized, the post-binding function of SR-BI remains remained largely unknown. To further explore the role of HCV-SR-BI interaction during HCV infection, we generated a novel class of anti-SR-BI monoclonal antibodies inhibiting HCV infection. We demonstrated that human SR-BI plays a dual role in the HCV entry process during both binding and post-binding steps. Targeting the post-binding function of SR-BI thus represents an interesting antiviral strategy against HCV infection. In the second part of my PhD, we aimed to characterize the molecular mechanisms underlying HCV re-infection of the graft after liver transplantation (LT). We identified threeadaptive mutations in envelope glycoprotein E2 mediating enhanced entry and evasion of a highly infectious escape variant. These mutations markedly modulated CD81 receptor dependency resulting in enhanced viral entry. The identification of these mechanisms advances our understanding of the pathogenesis of HCV infection and paves the way for the development of novel antiviral strategies and vaccines.