As lesões periapicais são induzidas por uma infecção crônica da polpa dental. Antígenos microbianos estimulam a resposta imune específica e inespecífica nos tecidos apicais. Como consequência desse processo, diante da incapacidade das defesas do hospedeiro para erradicar a infecção, uma lesão periapical é formada, com o objetivo de restringir a invasão microbiana. O desenvolvimento da periodontite apical crônica depende de uma fina regulação da ativação dos linfócitos. A ativação das células T requer dois sinais, um mediado pelo complexo TCR, após o reconhecimento do antígeno, e o outro mediado pela interação dos receptores coestimulatórios. CD28 é um receptor coestimulatório, enquanto CTLA-4 e PD-1 induzem um sinal inibitório para a ativação de células T. Para compreender o envolvimento de células T na periodontite apical crônica, avaliamos a presença destas células na lesão periapical e os fatores coestimulatórios, citocinas e espécies reativas do oxigênio que estas células estariam produzindo. As amostras analisadas foram de tecido gengival para o grupo controle (n = 20) e lesões periapicais para o grupo com periodontite apical crônica (n = 20). Quanto ao perfil celular das lesões periapicais, os resultados mostraram que linfócitos T (59,3 ± 3,7%) foram as células predominantes, sendo a subpopulação CD4+ (72,7 ± 3,4%) a mais encontrada. A seguir, verificou-se a expressão de moléculas de superfície em células T. Observou-se que a expressão de CD28 (0,5 ± 0,5%) foi significativamente mais baixa em amostras de lesões periapicais que no grupo controle principalmente para linfócito T CD8+. Já CTLA-4 foi identificado em altos níveis para pacientes com periodontite apical tanto para CD3+CD4+ (86,1 ± 2,6%) quanto para CD3+CD8+ (59,8 ± 8,6%). PD-1 (73,5 ± 5,6%) e PD-L1 (59,8 ± 8,6%) apresentaram alta positividade para CD3+CD4+. Esses resultados indicaram um possível envolvimento da via de sinalização de PD-1 e PD-L1 na modulação da resposta de células T de pacientes com periodontite apical crônica. A dosagem de citocinas revelou alta positividade para todas as citocinas investigadas (TGF-; TNF-; IFN- e IL-10). Óxido Nítrico e mieloperoxidase produzidas por neutrófilos e responsáveis pela degradação tecidual também foram detectadas em altas doses nas amostras de pacientes com periodontite apical. O conhecimento sobre o papel das moléculas coestimulatórias na imunopatogênese da periodontite apical crônica servirá de base para o direcionamento de novas estratégias de prevenção, assim como o desenvolvimento de novos procedimentos terapêuticos. / Periapical lesions are induced by the chronic infection of dental pulp. Microbial antigens stimulate both non-specific and specific immune response in periapical tissue. As a consequence of these processes and the inability of host defense mechanisms to eradicate infection, chronic periapical lesion are formed, with the aim of restricting microbial invasion. Negative co-stimulatory signals mediated via cell surface molecules such as cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and programmed death-1 (PD-1) play a critical role in down- modulation immune responses and maintaining peripheral tolerance. Both CTLA-4 and PD-1 are induced on actived T cell, and these are involved in the immunophatogenesis of periapical lesions. Inhibitory signals mediated via molecules such as programmed-death-1 (PD-1) play a critical role in down-modulating immune responses and maintaining peripheral tolerance. We investigated the involvement of cytokines and PD-1 engagement in mediating the T cell activation in chronic periapical diseases. Gingival samples from healthy individuals (n= 20) and patients with chronic periapical periodontitis (n= 20) were collected and used for the subsequent assays. The leukocytes in the lesion site were evaluated using flow cytometry. The production of cytokines interferon-gamma (IFN-), interleukin (IL)-10, tumor necrosis factor-alpha (TNF-) and transforming growth factor-beta (TGF-) was evaluated by ELISA. We observed a significant increase in the total number of leukocytes from periapical lesions as compared with healthy group. Our results for the composition of infiltrating cell in periapical lesion showed that the predominant cells were lymphocytes T (59,3 ± 3,7%) and contained a higher proportion of CD4+ cells (72,7 ± 3,4%). T cells from patients with periapical lesions expressed significantly higher levels of PD-1 (73,5 ± 5,6%) and PD-L1 (59,8 ± 8,6%). The levels of CTLA-4 were higher in CD3+CD4+ (86,1± 2,6%) and CD3+ CD8+ (59,8 ± 8,6%) cells, but in contrast the expression of CD28 was lower than control group. In addition, CD4+ and CD8+ T cells expressing PD-1 accumulate in lesions with chronic periapical periodontitis. Moreover, PD-L1 expression was intense in macrophage from patients. Our data clearly showed that lesions samples contained elevated amounts of TGF-, IL-10, TNF- and IFN- when compared with healthy gingival tissue from control individuals. These data show that PD-1 and CTLA-4 engagement could be involved in the modulation of T cells activation in patients with chronic periapical periodontitis.

Planar supported, polymerized phospholipid bilayers (PPBs) composed of 1,2-bis[10-(2’,4’-hexadienoyloxy)decanoyl]-sn-glycero-3-phosphocholine (bis-SorbPC or BSPC) were generated by a redox polymerization method. The PPBs were supported by a silicon substrate. The PPBs were characterized and tested for uniformity and stability under physiological conditions. The PPBs were analyzed in vitro with murine derived cells that are pertinent to the host response. Cellular attachment and phenotypic changes in RAW 264.7 macrophages and NIH 3T3 fibroblasts were investigated on PPBs and compared to bare silicon controls. Fluorescent and SEM images were used to observe cellular attachment and changes in cellular behavior. The PPBs showed much lower cellular adhesion for both cell lines than bare silicon controls. Of the cells that attached to the PPBs, a very low percentage showed the same morphological expressions as seen on the controls. The hypothesis generated from this work is that defects in the PPBs mediated the cellular attachment and morphological changes that were observed. Finally, a layer-by-layer (LbL) deposition of a poly(acrylic acid) (PAA) and poly(N-vinylpyrrolidone) (PNVP) alternating bilayer was attempted as a proof of concept for future modification of this system.

Francisella tularensis is a gram-negative bacterium that is the cause of the serious and sometimes fatal disease, tularemia, in a wide range of animal species and in humans. The response of cells of the mouse macrophage cell line J774 to infection with Francisella tularensis LVS was analyzed by means of a DNA microarray. It was observed that the infection conferred an oxidative stress upon the target cells and many of the host defense mechanisms appeared to be intended to counteract this stress. The infection was characterized by a very modest inflammatory response. Tularemia caused by inhalation of F. tularensis subspecies tularensis is one of the most aggressive infectious diseases known. We used the mouse model to examine in detail the host immune response in the lung. After an aerosol challenge all mice developed clinical signs of severe disease, showed weight loss by day four of infection, and died the next day. Gene transcriptional changes in the mouse lung samples were examined on day one, two, and four of infection. Genes preferentially involved in host immune responses were activated extensively on day four but on day one and two, only marginally or not at all. Several genes upregulated on day four are known to depend on IFN-gamma or TNF-alpha for their regulation. In keeping with this finding, TNF-alpha and IFN-gamma levels were found to be increased significantly in bronchoalveolar lavage on day four. We undertook an analysis of the transcriptional response in peripheral blood during the course of ulceroglandular tularemia by use of Affymetrix microarrays. Samples were obtained from seven individuals at five occasions during two weeks after the first hospital visit and convalescent samples three months later. In total 265 genes were differentially expressed. The most prominent changes were noted in samples drawn on days 2-3 and a considerable proportion of the upregulated genes appeared to represent an IFN-gamma-induced response and also a pro-apoptotic response. Genes involved in the generation of innate and acquired immune responses were found to be downregulated, presumably a pathogen-induced event. A logistic regression analysis revealed that seven genes were good predictors of the early phase of tularemia. Recently, a large number of methods for the analysis of microarray data have been proposed but there are few comparisons of their relative performances. We undertook a study to evaluate established and novel methods for filtration, background adjustment, scanning, and censoring. For all analyses, the sensitivities at low false positive rates were observed together with a bias measurement. In general, there was a trade off between the analyses ability to identify differentially expressed genes and their ability to obtain unbiased estimators of the desired ratios. A commonly used standard analysis using background adjustment performed poorly. Interestingly, the constrained model combining data from several scans resulted in high sensitivities. For experiments where only low false discovery rates are acceptable, the use of the constrained model or the novel partial filtration method are likely to perform better than some commonly used standard analyses.

Planar supported, polymerized phospholipid bilayers (PPBs) composed of 1,2-bis[10-(2’,4’-hexadienoyloxy)decanoyl]-sn-glycero-3-phosphocholine (bis-SorbPC or BSPC) were generated by a redox polymerization method. The PPBs were supported by a silicon substrate. The PPBs were characterized and tested for uniformity and stability under physiological conditions. The PPBs were analyzed in vitro with murine derived cells that are pertinent to the host response. Cellular attachment and phenotypic changes in RAW 264.7 macrophages and NIH 3T3 fibroblasts were investigated on PPBs and compared to bare silicon controls. Fluorescent and SEM images were used to observe cellular attachment and changes in cellular behavior. The PPBs showed much lower cellular adhesion for both cell lines than bare silicon controls. Of the cells that attached to the PPBs, a very low percentage showed the same morphological expressions as seen on the controls. The hypothesis generated from this work is that defects in the PPBs mediated the cellular attachment and morphological changes that were observed. Finally, a layer-by-layer (LbL) deposition of a poly(acrylic acid) (PAA) and poly(N-vinylpyrrolidone) (PNVP) alternating bilayer was attempted as a proof of concept for future modification of this system.

As lesões periapicais são induzidas por uma infecção crônica da polpa dental. Antígenos microbianos estimulam a resposta imune específica e inespecífica nos tecidos apicais. Como consequência desse processo, diante da incapacidade das defesas do hospedeiro para erradicar a infecção, uma lesão periapical é formada, com o objetivo de restringir a invasão microbiana. O desenvolvimento da periodontite apical crônica depende de uma fina regulação da ativação dos linfócitos. A ativação das células T requer dois sinais, um mediado pelo complexo TCR, após o reconhecimento do antígeno, e o outro mediado pela interação dos receptores coestimulatórios. CD28 é um receptor coestimulatório, enquanto CTLA-4 e PD-1 induzem um sinal inibitório para a ativação de células T. Para compreender o envolvimento de células T na periodontite apical crônica, avaliamos a presença destas células na lesão periapical e os fatores coestimulatórios, citocinas e espécies reativas do oxigênio que estas células estariam produzindo. As amostras analisadas foram de tecido gengival para o grupo controle (n = 20) e lesões periapicais para o grupo com periodontite apical crônica (n = 20). Quanto ao perfil celular das lesões periapicais, os resultados mostraram que linfócitos T (59,3 ± 3,7%) foram as células predominantes, sendo a subpopulação CD4+ (72,7 ± 3,4%) a mais encontrada. A seguir, verificou-se a expressão de moléculas de superfície em células T. Observou-se que a expressão de CD28 (0,5 ± 0,5%) foi significativamente mais baixa em amostras de lesões periapicais que no grupo controle principalmente para linfócito T CD8+. Já CTLA-4 foi identificado em altos níveis para pacientes com periodontite apical tanto para CD3+CD4+ (86,1 ± 2,6%) quanto para CD3+CD8+ (59,8 ± 8,6%). PD-1 (73,5 ± 5,6%) e PD-L1 (59,8 ± 8,6%) apresentaram alta positividade para CD3+CD4+. Esses resultados indicaram um possível envolvimento da via de sinalização de PD-1 e PD-L1 na modulação da resposta de células T de pacientes com periodontite apical crônica. A dosagem de citocinas revelou alta positividade para todas as citocinas investigadas (TGF-; TNF-; IFN- e IL-10). Óxido Nítrico e mieloperoxidase produzidas por neutrófilos e responsáveis pela degradação tecidual também foram detectadas em altas doses nas amostras de pacientes com periodontite apical. O conhecimento sobre o papel das moléculas coestimulatórias na imunopatogênese da periodontite apical crônica servirá de base para o direcionamento de novas estratégias de prevenção, assim como o desenvolvimento de novos procedimentos terapêuticos. / Periapical lesions are induced by the chronic infection of dental pulp. Microbial antigens stimulate both non-specific and specific immune response in periapical tissue. As a consequence of these processes and the inability of host defense mechanisms to eradicate infection, chronic periapical lesion are formed, with the aim of restricting microbial invasion. Negative co-stimulatory signals mediated via cell surface molecules such as cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and programmed death-1 (PD-1) play a critical role in down- modulation immune responses and maintaining peripheral tolerance. Both CTLA-4 and PD-1 are induced on actived T cell, and these are involved in the immunophatogenesis of periapical lesions. Inhibitory signals mediated via molecules such as programmed-death-1 (PD-1) play a critical role in down-modulating immune responses and maintaining peripheral tolerance. We investigated the involvement of cytokines and PD-1 engagement in mediating the T cell activation in chronic periapical diseases. Gingival samples from healthy individuals (n= 20) and patients with chronic periapical periodontitis (n= 20) were collected and used for the subsequent assays. The leukocytes in the lesion site were evaluated using flow cytometry. The production of cytokines interferon-gamma (IFN-), interleukin (IL)-10, tumor necrosis factor-alpha (TNF-) and transforming growth factor-beta (TGF-) was evaluated by ELISA. We observed a significant increase in the total number of leukocytes from periapical lesions as compared with healthy group. Our results for the composition of infiltrating cell in periapical lesion showed that the predominant cells were lymphocytes T (59,3 ± 3,7%) and contained a higher proportion of CD4+ cells (72,7 ± 3,4%). T cells from patients with periapical lesions expressed significantly higher levels of PD-1 (73,5 ± 5,6%) and PD-L1 (59,8 ± 8,6%). The levels of CTLA-4 were higher in CD3+CD4+ (86,1± 2,6%) and CD3+ CD8+ (59,8 ± 8,6%) cells, but in contrast the expression of CD28 was lower than control group. In addition, CD4+ and CD8+ T cells expressing PD-1 accumulate in lesions with chronic periapical periodontitis. Moreover, PD-L1 expression was intense in macrophage from patients. Our data clearly showed that lesions samples contained elevated amounts of TGF-, IL-10, TNF- and IFN- when compared with healthy gingival tissue from control individuals. These data show that PD-1 and CTLA-4 engagement could be involved in the modulation of T cells activation in patients with chronic periapical periodontitis.

Diarrheal disease caused by attaching and effacing pathogens, such as enteropathogenic E. coli (EPEC), is a worldwide health concern. As the second leading cause of diarrheal-related death in young children, new investigations into host defense against EPEC, as well as future therapeutics, is greatly needed. To elucidate the host immune responses to these enteric pathogens, the attaching and effacing (A/E) murine pathogen, Citrobacter rodentium, has been widely used. It is well understood that C. rodentium infection induces a robust Th1 response within the host. Yet how these pleiotropic IFNγ immune responses are initiated, propagated, and the accessory immune cell types involved remains poorly understood. In this thesis, I investigated how innate immune cell types such as natural killer cells, which are significant producers of IFNγ, mediate these Th1 directed responses. This work identified that both NK and NK-like innate lymphoid type 1 cells (ILC1s) are capable of producing IFNγ in response to C. rodentium, and NK cells rapidly increase in numbers within the colon during the early stages of infection. Depletion of these cell types causes a delayed Th1 CD4+ T cell response within the colon, resulting in increased bacterial load, and greater degree of colonic pathology at later time points. Additionally, depletion of these cells results in decreased CXCL9 chemokine expression in mice. I later determined that CXCL9 exhibited direct antimicrobial action against Citrobacter in vitro. Depletion of this chemokine in vivo, in the absence of adaptive immune responses, or its receptor CXCR3, results in increased mortality rates, elevated bacterial loads, greater degree of pathology, and deeper penetration of bacteria within the colonic crypts. These data indicate a potential direct antimicrobial role for this IFNγ-induced chemokine, independent of its known properties for the homing of T cells to the site of infection. These findings demonstrate the importance of accessory IFNγ-producing immune cells in not only mediating Th1 CD4+ T cells responses, but also other innate host defense mechanisms against A/E pathogens. / Thesis / Doctor of Philosophy (PhD)

No description available.

Ongoing advances in tissue engineering with the goal to address the clinical shortage of donor organs have encouraged the design and development of biomaterials to be used in tissue-engineered scaffolds. Furthermore, biomaterials have been used as delivery vehicles for vaccines that aim to enhance the protective immunity against pathogenic agents. These tissue-engineered constructs or vaccines are usually combination products that combine biomaterial and biological (e.g. cells, proteins, and/or DNA) components. Upon introduction into the body, the host response towards these products will be a combination of both a non-specific inflammatory response towards the biomaterial and an antigen-specific immune response towards the biological component(s). Recently, the biomaterial component was shown to influence the immune response towards a co-delivered antigen. Specifically, poly(lactic-co-glycolic acid) (PLGA), but not agarose, scaffolds or microparticles (MPs) enhanced the humoral response to a model antigen, ovalbumin. This in vivo result echoed with the in vitro study that PLGA, but not agarose, supported a mature phenotype of dendritic cells (DCs), the most potent antigen-presenting cells. Therefore, it is hypothesized that the effect of biomaterials on DC phenotype may influence the adaptive immunity against a co-delivered antigen. Understanding how biomaterials affect DC response will facilitate the selection and design of biomaterials that direct a desired immune response for tissue engineering or vaccine delivery applications. The objectives of this research were to elucidate the correlations between material properties and DC phenotype, develop predictive models for DC response based on material properties, and uncover the molecular basis for DC response to biomaterials. Well-defined biomaterial systems, including clinical titanium (Ti) substrates and two polymer libraries, were chosen to study induced DC phenotype. Due to the time-consuming nature of conventional methods for assessing DC phenotype, a high-throughput (HTP) method was first developed to screen for DC maturation based on surface marker expression (CHAPTER 4). A 96-well filter plate-based HTP methodology was developed and validated for the assessment of DC response to biomaterials. A "maturation factor", defined as CD86/DC-SIGN and measured by immunostaining, was found to be a cell number-independent metric for DC maturation and could be adapted to screen for DC maturation in a microplate format. This methodology was shown to reproducibly yield similar results of DC maturation in response to biomaterial treatment as compared to the conventional flow cytometric method upon DC treatment in 6-well plates. In addition, the supernatants from each treatment could easily be collected for cytotoxicity assessment using glucose-6-phosphate dehydrogenase (G6PD)-based assay and cytokine profiling using multiplex technology. In other words, the 96-well filter plate-based methodology can generate three outcomes from one single cell culture: 1) maturation marker expression, 2) cytotoxicity, and 3) cytokine profile. To examine which material properties were critical in determining DC phenotype, a set of three clinical titanium (Ti) substrates with well-defined surfaces was used to treat DCs (CHAPTER 5). These Ti substrates included pretreatment (PT), sand-blasted and acid-etched (SLA), and modified SLA (modSLA), with different roughness and surface energy. DCs responded differentially to these substrates. Specifically, PT and SLA induced a mature DC (mDC) phenotype, while modSLA-treated DCs remained immature based on surface marker expression, cytokine production profiles and cell morphology. Both PT and SLA induced higher CD86 expression as compared to iDC control, while modSLA maintained CD86 expression at a level similar to iDC. PT- or SLA-treated DCs exhibited dendritic processes associated with a mDC phenotype, while modSLA-treated DCs were rounded, a morphology associated with an iDC phenotype. Furthermore, PT induced increased secretion of MCP-1 by DCs compared to iDCs, indicating that PT promoted a pro-inflammatory environment. SLA induced higher IL-16 production, which is a pleiotropic cytokine, by DCs, most likely as a pro-inflammatory response due to the enhanced maturation of DCs induced by SLA. In contrast, modSLA did not induced enhanced production of any cytokines examined. Principal component analysis (PCA) were used to reduce the multi-dimensional data space and confirmed these experimental results, and it also indicated that the non-stimulating property of modSLA co-varied with certain surface properties, such as high surface hydrophilicity, % oxygen and % titanium of the substrates. In contrast, high surface % carbon and % nitrogen were more associated with a mDC phenotype. Furthermore, PCA also suggested that surface line roughness (Ra) did not contribute to the expression of CD86, an important maturation marker, suggesting that roughness had little impact on DC response (CHAPTER 5). DC response-material property relationships were also derived using more complex materials from a combinatorial library of polymethacrylates (pMAs) (CHAPTER 6). Twelve pMAs were selected and were found to induce differential DC response using the HTP method described in CHAPTER 4. These pMAs resulted in a trend of increasing DC maturation represented by the metric CD86/DC-SIGN, which was consistent with the trends of the production of pro-inflammatory cytokine, TNF-α, and chemokine, IL-8. Interestingly, this set of pMAs induced an opposite trend of IL-16 production, which is most likely released as an anti-inflammatory cytokine in this situation. These polymers were characterized extensively for a number of material properties, including surface chemical composition, glass transition temperature (Tg), air-water contact angle, line roughness (Ra), surface roughness (Sa), and surface area. Similar to the results from the Ti study, PCA determined that surface carbon correlated with enhanced DC maturation, while surface oxygen was associated with an iDC phenotype. In addition, Tg, Ra, and surface area were unimportant in determining DC response. Partial square linear regression (PLSR), a multivariate modeling approach, was implemented using the pMAs as the training set and a separate polymer library, which contained methacrylate- and acrylate-based terpolymers, as the prediction set. This model successfully predicted DC phenotype in terms of surface marker expression with R2prediction = 0.76. Furthermore, prediction of DC phenotype was effective based on only theoretical chemical composition of the bulk polymers with R2prediction = 0.80 (CHAPTER 6). Nonetheless, one should note that a predictive model can be only as good as what it is trained on and cannot be used to predict the DC response induced by a type of materials different from the training set. Also, this model might not contain all the important material properties such as polymer swelling and cannot predict specific types of immune responses. However, these results demonstrated that a generalized immune cell response can be predicted from biomaterial properties, and computational models will expedite future biomaterial design and selection (CHAPTER 6). From the pMA library, pMAs that induced the two extremes of DC phenotype (mature or immature) were identified for elucidating the mechanistic basis of biomaterial-induced DC responses (CHAPTER 7). Two pMAs, polyhydroxyethylmethacrylate (pHEMA) and poly(isobutyl-co-benzyl-co-terahydrofurfuryl)methacrylate (pIBTMA), were selected because they induced the least and the most mature DC phenotype, respectively. These pMAs were used to elucidate the activation profiles of transcription factors in DCs after biomaterial treatment and were compared to the iDC and mDC controls. In addition, a combined treatment of pHEMA and LPS was also included to determine if pHEMA could maintain an iDC phenotype in the presence of LPS. Interestingly, pIBTMA induced DC maturation primarily through the activation of NF-κB, while pHEMA mediated suppression of DC maturation through multiple TFs, including the activation of ISRE, E2F-1, GR-PR, NFAT, and HSF. GR-PR and E2F-1 have been shown to be associated with the suppression of DC maturation; ISRE, E2F-1, and NFAT are linked to apoptosis induction; HSF regulates the production of heat shock proteins (HSPs) that induce DC maturation and inhibit apoptosis. The activation of HSF by pHEMA was most likely a natural defensive mechanism against the other apoptotic signals. Therefore, pHEMA suppressed DC maturation through the induction of apoptosis. Surprisingly, in the presence of pHEMA, the effect of LPS was completely eliminated, suggesting that biomaterials can override the effect of soluble factors. The morphology and surface marker expression of DCs treated with these different biomaterials or controls were consistent with TF activation profiles (CHAPTER 7). Overall, this research illustrates that biomaterial properties, within the chosen biomaterial space, can be correlated to DC phenotype and more importantly, can be used as predictors for relative levels of DC phenotype. Furthermore, the differential responses induced by different biomaterials were mediated through the distinct activation profiles of transcription factors. Together, these findings are expected to facilitate the design and selection of biomaterials that direct desired immune responses.

The host response toward biomaterial component of tissue-engineered devices has been extensively investigated. The objective of this research was to understand the response of dendritic cells (DCs) to different biomaterials upon contact and identify biomaterials suitable for use in tissue engineering constructs for rheumatoid arthritis (RA) applications. Differential levels of functional DC maturation were observed depending on the type of biomaterial in 2-dimensional films or 3-dimensional scaffolds used to treat immature DCs; Poly(lactic-co-glycolic acid) (PLGA) or chitosan supported higher levels of DC maturation, as compared to immature DCs. Alginate supported moderate levels of DC maturation. Agarose did not support DC maturation whereas hyaluronic acid inhibited DC maturation. Further, these DCs treated with different biomaterials induced differential phenotype and polarization of autologous T cells upon co-culture of DCs and T cells; DCs treated with PLGA induced T helper type I with immunogenic response while DCs treated with agarose did T helper type II with tolerogenic response. Effect of different biomaterials (PLGA and agarose) was assessed in vivo upon implantation of them into the knee joint of RA-induced rabbit. Total leukocyte concentrations in the peripheral blood or in the joint lavage of the left knees (untreated control) were observed in differential levels depending on the biomaterial implant, possibly due to the systemic circulation of the peripheral blood. Furthermore, cartilage and bone healing progression was differentially observed in the osteochondral defect of the knee joint of RA-induced rabbit, depending on type of biomaterial scaffold implanted into the defect. Collectively, these results demonstrate the multifunctional impacts of inherently different biomaterials on in vitro immunomodulation of phenotype and polarization of DCs and autologous T cells. Furthermore, taken together with these immunomodulatory impacts of biomaterials, in vivo effects of different biomaterial scaffolds on RA environment shown in this study can suggest the criteria of selection and design of biomaterials for orthopedic tissue engineering, which may ultimately be best integrated into the diseased cartilage and bone.

La fièvre boutonneuse Méditerranéenne (FBM) est due à Rickettsia conorii subsp. conorii, bactérie intracellulaire stricte. Cette maladie, initialement décrite comme bénigne, présente actuellement un taux de sévérité de l’ordre de 10% avec une augmentation de cette sévérité décrite dernièrement. Au cours d’une étude clinique rétrospective portant sur 161 cas de FBM, nous avons observé que le traitement par fluoroquinolones était associé à une évolution défavorable, ce qui à ce jour n’avait jamais été rapporté, alors que la doxycycline semble être protectrice. Nous avons également observé cet effet délétère des fluoroquinolones sur un modèle in vitro d’infection cellulaire à R. conorii, effet qui n’a pas été observé avec la doxycycline. Une des hypothèses pouvant expliquer cet effet est l’induction du module toxine-antitoxine par les fluoroquinolones. Ainsi nous avons montré que la ciprofloxacine modulait l’expression des gènes du couple toxine-antitoxine. Nous avons également montré que les statines pouvaient avoir un effet prophylactique au cours de l’infection par R. conorii. Enfin nous avons étudié la réponse de l’hôte au sein de l’escarre d’inoculation par une approche transcriptomique.Cette thèse a mis en évidence que les traitements reçus au cours de la FBM peuvent modifier le pronostic de cette maladie. Le choix des antibiotiques est donc crucial et doit faire l’objet d’études complémentaires. / Mediterranean spotted fever (MSF) is caused by Rickettsia conorii subsp. conorii, a strict intracellular bacterium. The disease initially described as benign presents currently rates of severity around 10% with an increase described recently. In a retrospective clinical study of 161 cases of MSF, we observed that treatment with fluoroquinolones was associated with an unfavourable outcome whereas doxycycline appeared to be protective. We also observed this deleterious effect of fluoroquinolones in vitro in a cellular model of R. conorii infection, which was not observed with doxycycline. One hypothesis that could explain this effect is the induction of toxin-antitoxin module by fluoroquinolones. Thus we have shown that ciprofloxacin modulates the gene expression of toxin-antitoxin module. We have also shown that statins may have a prophylactic effect during infection by R. conorii. Finally, we have studied the host response within the inoculation eschar by a transcriptomic approach. This thesis has shown that the treatment received during the MSF can change the prognosis of this disease. The choice of antibiotics is crucial, and should be subject to further studies.