Die Nierentransplantation ermöglicht Patienten die Wiederherstellung der Nierenfunktion. Aufgrund der begrenzten Verfügbarkeit an Organen nimmt dabei die Zahl der Transplantationen von einem lebenden Spender stetig zu. Zudem ermöglichen die präzisen und genauen Vorbereitungen und Abläufe bei Lebendnierenspenden eine bessere 5-Jahres-Überlebensrate als bei Kadaverspenden. Die genetische Verschiedenheit zwischen Spender und Empfänger bedingt jedoch eine lebenslange immunsuppressive Therapie, um Abstoßungsreaktionen und damit das Scheitern einer Organtransplantation zu verhindern. An den Universitätskliniken Leipzig und Halle/Saale besteht diese Therapie aus einer Dreifachkombination von Tacrolimus, Mycophenolat-Mofetil und Prednisolon, wobei mögliche Nebenwirkungen wie opportunistische Infektionen, kardiovaskuläre und metabolische Erkrankungen sowie Tumore in Kauf genommen werden. Zudem besteht für den immunsupprimmierten Organismus die ständige Gefahr einer Abstoßungsreaktion. Diese Aspekte führen bei den Empfängern zu einer massiven Einschränkung der Gesundheit und Lebensqualität. Inwieweit die ausgeprägte Immunsuppression notwendig ist, bleibt unklar und muss individuell festgelegt werden. Bisher existiert kein geeignetes Verfahren für ein Immunmonitoring, weshalb in vielen Fällen eine umfangreiche und überdosierte Immunsuppression in Kauf genommen wird. Im Rahmen dieser Arbeit wurde ein geeignetes Testverfahren, der Elispot-Assay, für die Expression der beiden proinflammatorischen Zytokine IFN-γ und IL-17 erstellt. Dafür wurden die PBMC der Spender und Empfänger aus Vollblut separiert, um sie anschließend sowohl separat als auch in einer Lymphozytenmischreaktion zu untersuchen. Die Darstellung von IL-17 konnte nur aufgrund einer zusätzlichen Stimulation mit OKT3 gelingen, während der IFN-γ-Elispot sowohl im Leerwert als auch unter Stimulation mit IL-2 zu ausreichenden Spotanzahlen führte. Die Spotanzahlen der Spender-PBMC wurden mit Hilfe von γ-Strahlung signifikant reduziert (IFN-γ: p=0,047 | IFN-γ + IL-2: p=0,007 | IL-17: p = 0,001), um in den Lymphozytenmischreaktionen die alleinige Zytokinausschüttung der Empfänger-PBMC messen zu können. Die Spender- PBMC fungierten dabei nur als Antigene. Insgesamt konnten zwischen 2009 und 2012 zwölf von siebzehn Patientenpaaren in die Studie eingeschlossen werden. Die Spotanzahlen der Paare wurden dabei sowohl im IFN-γ- als auch im IL-17-Elispot-Assay zu vier unterschiedlichen Zeitpunkten gemessen (vor Transplantation | 21±3 d postoperativ | 28±3 d postoperativ | 75±15 d postoperativ). In den meisten Fällen zeigte sich vor Transplantation eine erhöhte Spotanzahl im Vergleich zu den drei postoperativen Werten. Zudem stiegen die Spotanzahlen sowohl für IFN-γ als auch für IL-17 nach niedrigen Messergebnissen kurz nach der Transplantation im postoperativen Verlauf wieder an und erreichten in einigen Fällen die Spotanzahl der präoperativen Ausgangswerte. Ein signifikanter Unterschied konnte aufgrund der geringen Fallzahl nicht erreicht werden. Die kurzfristige Reduktion der Spotanzahlen postoperativ ist dabei aller Wahrscheinlichkeit nach auf die hohen Dosen an immunsuppressiven Medikamenten zurückzuführen. Insgesamt zeigten die Verläufe der IFN-γ- und der IL-17- Elispot-Assays ähnliche Verläufe. Daraus lässt sich schlussfolgern, dass der IL-17-Elispot- Assay in Bezug auf mögliche Abstoßungsreaktionen eine ähnliche Aussagekraft besitzen könnte wie der bereits vielfach untersuchte IFN-γ-Elispot-Assay. Weiterhin wurden die Messergebnisse mit der Serumkreatininmolarität verglichen. Diese zeigte präoperativ höhere Molaritäten als postoperativ, wobei die postoperativen Molaritäten im Verlauf, im Gegensatz zu den Elispot-Messungen, abnahmen, was das Einsetzen der Nierenfunktion widerspiegelt. Unter den zwölf Patientenpaaren gab es keine einzige nachgewiesene akute Abstoßungsreaktion, der Verlauf der Serumkreatininmolaritäten war bei allen zwölf Empfängern vergleichbar. Demzufolge konnten die Werte der Elispot-Assays nicht herangezogen werden, um an ihnen eine Abstoßungsreaktion der transplantierten Nieren erkennen zu können. Das präoperative Abschätzen einer möglichen Abstoßungsreaktion anhand der Elispot-Assays konnte aufgrund fehlender Abstoßungsreaktionen ebenfalls nicht untersucht werden. Zusätzlich wurde bei den Patienten eine HLA-Typisierung vorgenommen, wobei der Bereich von optimalen bis maximal ungünstigen Konstellationen reichten (HLA-Mismatch: 0-0-0 bis 2-2-2). Auch hier konnten die Ergebnisse nicht mit möglichen Abstoßungsreaktionen verglichen werden. In der vorliegenden Arbeit wurden zahlreiche Varianten untersucht, die das Abschätzen einer Immunreaktion nach Nierentransplantation (Immunmonitoring) ermöglichen könnten. Aufgrund fehlender Abstoßungsreaktionen bei den Empfängern konnte das Testverfahren nicht an den klinischen Verläufen validiert werden. Mit dem in dieser Arbeit entwickelten Messverfahren kann jedoch eine neue und größer angelegte Studie erfolgen, die in Zukunft ein Immunmonitoring bei Patienten nach Nierentransplantation ermöglicht. / Introduction Since the first kidney transplantation in the 1950ies, kidney transplantation is still being challenged by graft dysfunction and complete graft failure. Permanent immunsuppressive treatment is mandatory to avoid an unfavourable outcome. The treatment with Prednisolone, Tacrolimus and Mycophenolat-Mofetil may cause toxic side effects resulting in Diabetes mellitus, hypertension, infections and cancer. In the present study we tried to demonstrate that the amount of spots in the Enzyme linked immunospot assay (Elispot-Assay) of IFN-γ and IL-17 correlates with the probability of graft dysfuction and complete graft failure. We also compared the results to clinical parameters. Methods Between the years 2009 and 2012, twelve pairs of related living kidney transplantations were included in this study. From each pair blood samples were taken at four time points (before transplantation, and at 21±3, 28±3 and 75±15 days after kidney transplantation, respectively). After establishing the technique of IFN-γ- and IL-17-Elispot-Assays, we separated the periphale blood mononuclear cells (PBMC) and performed follow up examinations at the four time points mentioned above. The PBMC of each donor and each recipient were examined separatly, and in addition together in a lymphocyte mixed reaction. We stimulated the PBMC of the IFN-γ-Elispot with Interleukin-2 (IL-2) and the PBMC of the IL-17-Elispot with OKT3 to get significant characteristics. PBMC of the donors were irradiated with 30 Gy before mixing them with the PBMC of the recipients. We also took the HLA-matches and serum creatinine molarity to compare important clinical parameters with the results of the Elispot-Assays. Results Sufficient spots were measured using the unstimulated and stimulated IFN-γ-Elispot and the stimulated IL-17-Elispot. Radiation was significant at all three tests (IFN-γ: p=0,047 | IFN-γ + IL-2: p=0,007 | IL-17: p = 0,001). All twelve recipients showed a high number of spots before transplantation in both types of Elispot-Assays and most of them an increasing number of spots after a minimal turning point three weeks after transplantation. Due to the small number of cases, no significant results could be obtained at follow up. Non recipient developed a graft rejection as proven by biopsy or graft failure. The molarity of serum creatinine was permanently reduced whereas it was high before transplantation. Because of the abscence of any rejection episodes, HLA matches could not be compared. Discussion Due to the absence of rejection episodes or graft failure, no prediction for rejection by the IFN-γ- and IL-17-Elispot was possible. The low number of cases of living related kidney transplantation demonstrated the challange of the investigation of living related kidney transplantation. Although we could prove a significant effect of the irradiation of PBMC, there was no significant result in the follow up investigations. A higher number of cases are needed in future investigations. The established method of the IFN-γ- and IL-17-Elispot can be used in a future study with an extended number of cases and a longer follow up of time.

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.

Afin de se répliquer et de se propager efficacement, les virus ont développé de multiples stratégies leur permettant d’échapper au système de défense innée : le système IFN de type I. Ce travail de thèse a alors consisté à étudier les interactions entre protéines virales et protéines de ce système de défense afin de mieux comprendre les mécanismes de subversion virale et d’identifier d’éventuelles cibles cellulaires thérapeutiques. La reconstruction d’un réseau d’interactions entre ces protéines nous a permis d’identifier des stratégies différentielles de subversion pour 4 familles virales et de montrer un ciblage massif et significatif des protéines du système IFN de type I par les virus. Les protéines en interaction directe avec ces protéines sont également fortement touchées par les virus et sont de potentiels modulateurs du système IFN de type I. Parmi ces modulateurs, le processus biologique sur-représenté est le transport nucléocytoplasmique et la protéine KPNA1 impliquée dans ce processus a retenu notre attention. L’étude fonctionnelle de l’interaction entre la protéine KPNA1 et la protéine NS3 du VHC a montré que la protéine NS3 associée à son cofacteur NS4A inhibe partiellement la réponse IFN de type I en empêchant l’import nucléaire de STAT1. Ce phénotype pourrait résulter de la dégradation de KPNA1 par NS3/4A. Par ailleurs, l’identification de nouveaux inter-acteurs de la protéine NS1 du virus influenza par criblage double-hybride levure a révélé la protéine induite par les IFN de type I, ADAR1, comme partenaire de la protéine NS1 de multiples souches virales et nous avons montré qu'ADAR1 est un facteur pro-viral dont la fonction editing est activée par NS1 / To replicate and propagate efficiently, viruses have developed multiple strategies allowing them to escape the innatedefense system: the type I IFN system, This work of thesis then consisted in studying the interactions between viralproteins and proteins of this defence system in order to understand better the mechanisms of viral subversion andidentifY possible therapeutic cellular tatgets. The reconstruction of a network of interacting proteins involved in the typeI IFN system allowed us to identifY differentiai subversion strategies for 4 viral families and to show a massive andsignificant targeting of proteins of the type I IFN system by viruses. Proteins directly interacting with the type Iinterferon system network are also strongly targeted by viruses and are potential modulators of the type I IFN system.Among these modulators, the most tatgeted function conesponds to the transport of NLS-bearing substrates to thenucleus and the KPNAI protein involved in this process held our attention. The functional study of the interactionbetween KPNA1 and NS3 protein of the HCV showed that NS3 protein associated with its cofactor NS4A inhibitsprutially the type I IFN response by preventing the nuclear translocation of ST A Tl. This phenotype could result fromthe degradation of KPNAI by NS3/4A. Besides, the identification of new cellular prutners ofNS 1 prote in of influenzavirus by yeast two-hybrid screens revealed ADARI, an interferon-stimulated prote in, as partner of NS 1 of ali testedvirus strains and we showed that ADARI is an essential host factor for viral replication and its editing function isactivated by NS 1 protein

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O número de mulheres jovens infectadas pelo HIV-1 vem crescendo desde o início da epidemia da aids, principalmente nos países em desenvolvimento, onde a frequência de gravidez é elevada. O desenvolvimento de estratégias para evitar a transmissão vertical tem aumentado o número de recém-nascidos não infectados nascidos de gestantes portadora do vírus. O objetivo da presente tese foi avaliar, in vivo e in vitro, o perfil de citocinas de neonatos não infectados, porém nascidos de mulheres infectadas pelo HIV-1. Os resultados demonstraram elevados níveis de citocinas pró-inflamatórias relacionadas ao fenótipo Th17, associadas à baixa produção de IL-10, tanto nos plasmas quanto nos sobrenadantes das culturas de células T ativadas obtidas do sangue do cordão umbilical de neonatos nascidos de gestantes infectadas pelo HIV-1 com cargas virais plasmáticas(PVL) detectáveis. De modo interessante, um perfil similar pró-inflamatório foi observado em amostras de sangue periférico de suas respectivas mães. Por outro lado, níveis elevados de IL-10, associados à reduzida produção de citocinas inflamatórias, foram dosados no sangue e nos sobrenadantes das culturas de células T ativadas de gestantes que controlavam a PVL, assim como de seus neonatos. Com relação à caracterização fenotípica das células T maternas produtoras de IL-10, a análise por citometria de fluxo demonstrou que essa citocina é majoritariamente produzida por células T CD4+Foxp3-. Curiosamente, a replicação viral in vitro do HIV-1 foi inferior nas culturas das gestantes infectadas pelo HIV-1 e foi relacionada aos efeitos inibitórios da IL-10 sobre a produção de TNF-α. Por fim, os neonatos não infectados expostosin utero à terapia antirretroviral (ART) apresentaram um menor peso ao nascer, e este achado foi inversamente correlacionado com os níveis periféricos maternos de TNF-α. Em conclusão, nossos achados sugerem que gestantes que conseguem controlar a PVL, e o incremento na produção de IL-10 materna possam favorecer a expansão das células Tr-1, as quais podem auxiliar em reduzir o risco de transmissão vertical do HIV-1 por reduzir a taxa de replicação viral. Por outro lado, outros resultados também apresentados aqui, apesar de preliminares, revelaram efeitos adversos da replicação viral e da ART em gestantes infectadas pelo HIV-1 no desenvolvimento funcional das células T de neonatos não infectados. Esses dados podem ajudar a explicar por que algumas dessas crianças apresentam elevado risco à morbidade e mortalidade devido a um estado basal de hipersensibilidade patológica. / The number of HIV-1-infected young women has been increasing since the beginning of the AIDS epidemic, mainly in developing countries, where the frequency of pregnancy among them is also elevated. The development of strategies for vertical transmission avoidance has enhanced the number of uninfected neonates born from infected mothers. The objective of the present study was to evaluate, in vivo and in vitro, the cytokine profile of uninfected neonates born from pregnant women infected with HIV-1.The results demonstrated high levels of proinflammatory cytokines related to Th17 phenotype associated with low IL-10 production, in plasma as well as in culture supernatants of activated T cells obtained from umbilical cord blood of neonates born from mothers infected with HIV -1 with plasma viral load (PVL) detectable.Interestingly, a similar pro-inflammatory cytokine profile was observed in peripheral blood samples from their respective mothers.On the other hand, high levels of IL-10 associated to reduced production of inflammatory cytokines were measured in blood and in the supernatants of activated T cells culturesfrom women that controlled the PVL, as well as their neonates.Regarding the phenotypic profile of pregnant women infected of HIV-1, the main T lymphocyte subset involved in producing IL-10 was CD4+Foxp3-. Interestingly, the in vitro HIV-1 replication was lower in cell cultures from pregnant patients, and it was related to the inhibitory effects of IL-10 on the production of TNF-α. Finally, ART-in utero-exposed neonates showed to be born with lower weight, and it was inversely correlated with maternal peripheral TNF-α level. In conclusion, the results suggest that pregnant women that are able to control the PVL, and the increment in the production of IL-10 may favor maternal Tr-1 cell expansion, which could help to reduce the risk of vertical transmission of HIV-1 by reducing the rate of viral replication.However, other results also presented here, although preliminary, have revealed adverse effects of viral replication, as well as the use of ART by pregnant women infected with HIV-1 in the development of functional T cells from uninfected newborns.These data may help to explain why some of these children have elevated risk of clinical morbidity and mortality due to a baseline state of pathological hypersensitivity.

No description available.

Made available in DSpace on 2015-03-03T15:38:43Z (GMT). No. of bitstreams: 1 PedroPAS_TESE_1-70.pdf: 4719637 bytes, checksum: 8f16cb0e2326a80cfc947b1ea2b89641 (MD5) Previous issue date: 2012-02-28 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Myofibroblasts are cells that exhibit a hybrid phenotype, sharing the morphological characteristics of fibroblasts and smooth muscle cells, which is acquired during a process called differentiation. These cells then start to express -SMA, a marker that can be used for their identification. Studies suggest that myofibroblasts are related to the aggressiveness of different tumors and that TGF-1 and IFN- play a role in myofibroblast differentiation, stimulating or inhibiting this differentiation, respectively. The objective of this study was to investigate the role of myofibroblasts in epithelial odontogenic tumors, correlating the presence of these cells with the aggressiveness of the tumor. Immunohistochemistry was used to evaluate the expression of TGF-1 and IFN- in myofibroblast differentiation, as well as the expression of MMP-13, which is activated by myofibroblasts, and of EMMPRIN (extracellular matrix metalloproteinase inducer) as a precursor of this MMP. The sample consisted of 20 solid ameloblastomas, 10 unicystic ameloblastomas, 20 odontogenic keratocysts, and 20 adenomatoid odontogenic tumors. For evaluation of myofibroblasts, anti- -SMA-immunoreactive cells were quantified in connective tissue close to the epithelium. Immunoexpression of TGF-1, IFN-, MMP-13 and EMMPRIN was evaluated in the epithelial and connective tissue components, attributing scores of 0 to 4. The results showed a higher concentration of myofibroblasts in solid ameloblastomas (mean of 30.55), followed by odontogenic keratocysts (22.50), unicystic ameloblastomas (20.80), and adenomatoid odontogenic tumors (19.15) (p=0.001). No significant correlation between TGF-1 and IFN- was observed during the process of myofibroblast differentiation. There was also no correlation between the quantity of myofibroblasts and MMP-13 expression. Significant correlations were found between MMP-13 and TGF-1 (r=0.087; p=0.011), between MMP- 13 and IFN- (r=0.348; p=0.003), as well as between EMMPRIN and MMP-13 (r=0.474; p<0.001) and between EMMPRIN and IFN- (r=0.393; p=0.001). The higher quantity of myofibroblasts observed in solid ameloblastomas, odontogenic keratocysts and unicystic ameloblastomas suggests that these cells are one of the factors responsible for the more aggressive biological behavior of these tumors, although the myofibroblast population was not correlated with TGF-1, IFN-, MMP-13 or EMMPRIN. The correlation between MMP- 13 and TGF-1 suggests that the latter induces the expression of this metalloproteinase. The present results also support the well-established role of EMMPRIN as an inducer of MMP-13. Furthermore, the relationship between EMMPRIN and IFN- and between MMP-13 and IFN- suggests synergism in the antifibrotic effect of these markers / Os miofibroblastos s?o c?lulas que apresentam um fen?tipo h?brido exibindo caracter?sticas morfol?gicas de fibroblastos e de c?lulas musculares lisas, sendo a aquisi??o de tal fen?tipo denominada diferencia??o, passando ent?o a expressar a -SMA, a qual ? importante na identifica??o dessas c?lulas. Estudos t?m sugerido que os miofibroblastos apresentam rela??o com a agressividade de diversas les?es e que o seu processo de diferencia??o estaria relacionado ? express?o do TGF- 1 e do IFN- atuando, respectivamente, no est?mulo e na inibi??o dessa diferencia??o. O objetivo deste trabalho foi investigar o papel dos miofibroblastos em les?es odontog?nicas epiteliais, relacionando-os ? agressividade das les?es e analisar por meio da imuno-histoqu?mica, a express?o do TGF- 1 e IFN- no processo de diferencia??o, al?m da an?lise da MMP-13 que ? ativada por miofibroblastos e do indutor de metaloproteinases de matriz (EMMPRIN) como precursor desta MMP. A amostra foi constitu?da por 20 ameloblastomas s?lidos, 10 ameloblastomas unic?sticos, 20 ceratocistos odontog?nicos e 20 tumores odontog?nicos adenomat?ides. Para a avalia??o dos miofibroblastos, foram quantificadas as c?lulas imunorreativas ao anticorpo - SMA presentes no tecido conjuntivo, pr?ximo ao tecido epitelial. As express?es de TGF- 1, IFN- , MMP-13 e EMMPRIN, foram avaliadas no componente epitelial e no conjuntivo, estabelecendo-se o percentual de imunorreatividade e atribuindo-se escores de 0 a 4. A an?lise dos miofibroblastos evidenciou maior concentra??o nos ameloblastomas s?lidos (m?dia de 30,55), seguido pelos ceratocistos odontog?nicos (22,50), ameloblastomas unic?sticos (20,80) e tumores odontog?nicos adenomat?ides (19,15) com valor de p= 0,001. N?o foi encontrada correla??o significativa entre TGF- 1 e IFN- no processo de diferencia??o dos miofibroblastos, bem como na rela??o entre a quantidade de miofibroblastos e a express?o da MMP-13. Constatou-se, correla??o estat?stica entre MMP-13 e TGF- 1 (r= 0,087; p= 0,011) al?m de significante correla??o entre MMP-13 e IFN- (r=0,348; p=0,003). Entre EMMPRIN e MMP-13 verificou-se signific?ncia (r= 0,474; p<0,001) assim como entre EMMPRIN e IFN- (r=0,393; p=0,001). A maior quantidade de miofibroblastos evidenciada nos ameloblastomas s?lidos, ceratocistos odontog?nicos e ameloblastomas unic?sticos sugere que estas c?lulas podem ser um dos fatores respons?veis para um comportamento biol?gico mais agressivo destas les?es, embora a popula??o de miofibroblastos n?o tenha apresentado correla??o com TGF- - 1, IFN- ,MMP-13 e EMMPRIN. Quanto a correla??o evidenciada entre MMP-13 e TGF- 1, isto pode sugerir um papel indutor do TGF- 1 para a express?o da MMP-13, assim como os resultados deste estudo refor?am a rela??o bem estabelecida do EMMPRIN como indutor da MMP-13. Constatou-se tamb?m rela??o entre EMMPRIN e IFN- assim como entre MMP-13 e IFN- sugerindo, dessa forma, um sinergismo na a??o anti-fibr?tica desses marcadores

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O número de mulheres jovens infectadas pelo HIV-1 vem crescendo desde o início da epidemia da aids, principalmente nos países em desenvolvimento, onde a frequência de gravidez é elevada. O desenvolvimento de estratégias para evitar a transmissão vertical tem aumentado o número de recém-nascidos não infectados nascidos de gestantes portadora do vírus. O objetivo da presente tese foi avaliar, in vivo e in vitro, o perfil de citocinas de neonatos não infectados, porém nascidos de mulheres infectadas pelo HIV-1. Os resultados demonstraram elevados níveis de citocinas pró-inflamatórias relacionadas ao fenótipo Th17, associadas à baixa produção de IL-10, tanto nos plasmas quanto nos sobrenadantes das culturas de células T ativadas obtidas do sangue do cordão umbilical de neonatos nascidos de gestantes infectadas pelo HIV-1 com cargas virais plasmáticas(PVL) detectáveis. De modo interessante, um perfil similar pró-inflamatório foi observado em amostras de sangue periférico de suas respectivas mães. Por outro lado, níveis elevados de IL-10, associados à reduzida produção de citocinas inflamatórias, foram dosados no sangue e nos sobrenadantes das culturas de células T ativadas de gestantes que controlavam a PVL, assim como de seus neonatos. Com relação à caracterização fenotípica das células T maternas produtoras de IL-10, a análise por citometria de fluxo demonstrou que essa citocina é majoritariamente produzida por células T CD4+Foxp3-. Curiosamente, a replicação viral in vitro do HIV-1 foi inferior nas culturas das gestantes infectadas pelo HIV-1 e foi relacionada aos efeitos inibitórios da IL-10 sobre a produção de TNF-&#945;. Por fim, os neonatos não infectados expostosin utero à terapia antirretroviral (ART) apresentaram um menor peso ao nascer, e este achado foi inversamente correlacionado com os níveis periféricos maternos de TNF-&#945;. Em conclusão, nossos achados sugerem que gestantes que conseguem controlar a PVL, e o incremento na produção de IL-10 materna possam favorecer a expansão das células Tr-1, as quais podem auxiliar em reduzir o risco de transmissão vertical do HIV-1 por reduzir a taxa de replicação viral. Por outro lado, outros resultados também apresentados aqui, apesar de preliminares, revelaram efeitos adversos da replicação viral e da ART em gestantes infectadas pelo HIV-1 no desenvolvimento funcional das células T de neonatos não infectados. Esses dados podem ajudar a explicar por que algumas dessas crianças apresentam elevado risco à morbidade e mortalidade devido a um estado basal de hipersensibilidade patológica. / The number of HIV-1-infected young women has been increasing since the beginning of the AIDS epidemic, mainly in developing countries, where the frequency of pregnancy among them is also elevated. The development of strategies for vertical transmission avoidance has enhanced the number of uninfected neonates born from infected mothers. The objective of the present study was to evaluate, in vivo and in vitro, the cytokine profile of uninfected neonates born from pregnant women infected with HIV-1.The results demonstrated high levels of proinflammatory cytokines related to Th17 phenotype associated with low IL-10 production, in plasma as well as in culture supernatants of activated T cells obtained from umbilical cord blood of neonates born from mothers infected with HIV -1 with plasma viral load (PVL) detectable.Interestingly, a similar pro-inflammatory cytokine profile was observed in peripheral blood samples from their respective mothers.On the other hand, high levels of IL-10 associated to reduced production of inflammatory cytokines were measured in blood and in the supernatants of activated T cells culturesfrom women that controlled the PVL, as well as their neonates.Regarding the phenotypic profile of pregnant women infected of HIV-1, the main T lymphocyte subset involved in producing IL-10 was CD4+Foxp3-. Interestingly, the in vitro HIV-1 replication was lower in cell cultures from pregnant patients, and it was related to the inhibitory effects of IL-10 on the production of TNF-&#945;. Finally, ART-in utero-exposed neonates showed to be born with lower weight, and it was inversely correlated with maternal peripheral TNF-&#945; level. In conclusion, the results suggest that pregnant women that are able to control the PVL, and the increment in the production of IL-10 may favor maternal Tr-1 cell expansion, which could help to reduce the risk of vertical transmission of HIV-1 by reducing the rate of viral replication.However, other results also presented here, although preliminary, have revealed adverse effects of viral replication, as well as the use of ART by pregnant women infected with HIV-1 in the development of functional T cells from uninfected newborns.These data may help to explain why some of these children have elevated risk of clinical morbidity and mortality due to a baseline state of pathological hypersensitivity.

O sistema NADPH oxidase é um complexo enzimático gerador de superóxido. O NF-kB é um fator de transcrição envolvido no controle da expressão de diversos genes ligados à resposta inflamatória. Defeitos no eixo IL-12/23-IFN-g resultam em infecções recorrentes e à susceptibilidade mendeliana a micobacterioses, podendo diminuir a expressão do componente gp91-phox da NADPH oxidase. Estudamos qual é a relação direta do NF-kB e de defeitos no eixo IL-12/23-IFN-g na regulação dos genes CYBA, NCF1, NCF2 e NCF4 do sistema NADPH oxidase humano em células U937, células B EBV transformadas provenientes de pacientes com EDA-ID, DGC, ou de pacientes com defeitos no eixo IL-12/23-IFN-g. A expressão dos genes NCF1 e NCF2 foi diminuída em células com defeitos no eixo (IFNGR1 e INFGR2) e em células U937 IkB S32A/S36A. A expressão do gene NCF1 também foi diminuída em células EDA-ID S32I e em células EDA-ID NEMO/IKKg W420X. O NF-kB e os IFNGR1 e INFGR2 são necessários para a expressão dos genes NCF1 e NCF2 e para a ativação do sistema NADPH oxidase humano neste sistema modelo. / The NADPH oxidase system is an enzymatic complex that generates superoxide. The NF-kB is a transcriptional factor involved in the expression of several genes related to the inflammatory response. The IL-12/23-IFN-g axis defects lead to recurrent infections and to the mendelian susceptibility of mycobacterial disease (MSMD), and they can decrease the gp91-phox expression (a NADPH oxidase component). We studied the NF-kB and the IL-12/23-IFN-g axis defects consequences on the regulation of CYBA, NCF1, NCF2 and NCF4 genes of the human NADPH oxidase system in U937 cells, and in B EBV cells from patients with EDA-ID, DGC, or patients with IL-12/23-IFN-g axis defects. The NCF1 and NCF2 gene expression was decreased in IL-12/23-IFN-g axis defects cells (IFNGR1 and INFGR2) and in U937 IkB S32A/S36A cells. NCF1 gene expression was decreased in EDA-ID S32I and in EDA-ID NEMO/IKKg W420X cell lineages. The NF-kB and the IFNGR1 and INFGR2 are necessary for NCF1 and NCF2 gene expression and activation of the human NADPH oxidase in this model system.

O sistema imune dos mamíferos forma uma complexa rede de populações celulares especializadas e vias de sinalização extremamente reguladas. Linfócitos T naïve podem diferenciar-se após encontro com o antígeno em pelo menos duas sub-populações distintas, Th1 ou Th2, sendo que o papel do circuito p38MAPK/MSK1 durante este período inicial de ativação não é completamente entendido. Linfócitos T CD4+ naïve humanos foram estimulados in vitro em condições não-polarizantes (Tnp), Th1 ou Th2, na presença de inibidor específico da p38MAPK. As células ativadas e mantidas em condições diferenciadoras Th1 ou Th2 na presença do inibidor SB203580, apresentaram menor produção de IFN-<font face=\"symbol\">g e maior produção de IL-4. Através do bloqueio do RNAm da MSK1 por siRNA, observamos o mesmo efeito resultante da inibição da p38MAPK, fato que foi confirmado em experimentos com linfócitos T de camundongos MSK1-deficientes. A alteração da produção das citocinas características de cada população parece ser decorrente da alteração da expressão da IL12R<font face=\"symbol\">b2 e IL4R-<font face=\"symbol\">a dos receptores de citocinas da IL-12 e IL-4, respectivamente. Desta forma, os nossos dados sugerem que o circuito p38MAPK/MSK1 participa do processo de ativação dos linfócitos T mantidos em condições diferenciadoras Th1/2. / The mammalian immune system form a complex network of highly regulated signaling pathways and populations of specialized cells. After meeting with the antigen naïve T cells differentiate into at least two distinct sub-populations, Th1 or Th2, and the role of the circuit p38MAPK/MSK1 during this initial period of activation is not completely understood. Human CD4+ T lymphocytes were stimulated in vitro under non-polarized, Th1 or Th2 conditions, in the presence of a specific p38MAPK inhibitor. The cells activated and differentiated under Th1 or Th2 condition in the presence of inhibitor SB203580, had decreased production of IFN-<font face=\"symbol\">g and increased IL-4. By silencing MSK1 through siRNA, we observed the same effect due to inhibition of p38MAPK, an observation that was confirmed in experiments with T lymphocytes from mice deficient of MSK1. The change in the production of cytokines appears to be a result of altered expression of IL12R-<font face=\"symbol\">b2 and IL4R<font face=\"symbol\">a receptors of the cytokines IL-12 and IL-4, respectively. Taken together, our data suggest that the circuit p38MAPK/MSK1 plays a key role in the activation of human T cells maintained under Th1/2 differentiation conditions.

O glioblastoma (GBM) é o tumor cerebral primário mais comum e o mais grave tumor de células da glia. O GBM é um tumor astrocítico de grau IV caracterizado pela proliferação descontrolada, infiltrado difuso, tendência à necrose, angiogênese, resistência a apoptose e grande heterogeneidade genética. Apesar da terapia abranger a remoção cirúrgica máxima, a radioterapia e a quimioterapia, o tumor torna-se resistente à drogas utilizadas no tratamento levando o paciente a recorrência e morte em menos de 15 meses após o diagnóstico. Uma alternativa para o tratamento do GBM é a imunoterapia, a qual é capaz de estimular o sistema imunológico do próprio paciente a gerar uma resposta específica e duradoura que pode proteger contra a recorrência da doença. Uma dessas alternativas envolve o uso de vacinas de DNA codificando antígenos tumorais e proteínas imunomoduladoras capazes de ativar eficientemente linfócitos B e T específicos aos antígenos presentes no tumor. Nesse contexto, o objetivo do presente trabalho foi construir vacinas de DNA utilizando-se os genes dos antígenos EGFRvIII, cERBB2, MAGE e GLEA de GBM e os genes das proteínas imunomoduladoras hsp65, hsp70, gp96 e gD e avaliar suas respectivas imunogenicidades. Os genes foram avaliados in silico, sintetizados in vitro e utilizados na construção das vacinas de DNA. Ferramentas de biologia molecular e o vetor pVAX foram utilizados para obtenção das vacinas. Elas foram caracterizadas por sequenciamento e western blot e utilizadas na imunização de camundongos C57BL/6. As imunizações foram realizadas com três doses em intervalos de 12 dias combinando um antígeno tumoral e uma proteína imunomoduladora na forma de vacina de DNA. A imunogenicidade foi avaliada 20 dias após a última dose. Os ensaios ex vivo foram realizados com o soro dos animais imunizados para dosagem de anticorpos específicos contra os antígenos tumorais e com as células do baço que foram re-estimuladas com as proteínas EGFRvIII, cERBB2, MAGE e GLEA para identificar a presença de células específicas aos antígenos tumorais. Como resultado, a vacina pVAXgDGLEA foi a única capaz de induzir anticorpos do subtipo IgG2a anti-GLEA. As vacinas pVAXgDGLEA, pVAXgDEGFRvIII e pVAXgDMAGE foram capazes de ativar células específicas aos antígenos que após o re-estímulo responderam rapidamente com produção de IFN-g e IL-10. A proteína imunomoduladora gD foi, portanto, capaz de ajudar na indução de um padrão de resposta Th1, específica aos antígenos de GBM, importante no combate ao tumor e a IL-10 pode favorecer e/ou balancear a resposta no cérebro que deve ser eficaz, mas não exacerbada. / Glioblastoma multiforme (GBM) is the most common form of primary brain cancer and the most severe tumour affecting glia cells. GBM is a grade IV astrocytoma known by uncontrolled proliferation, diffused infiltrate, necrosis tendency, angiogenesis, apoptosis resistance and a wide genetic heterogeneity. The standard of care consists of maximal surgical resection, followed by a combination of radiation and chemotherapy. Despite that, tumour becomes resistant to drugs used to treatment, and the patient experiences recurrence followed by death in less than 15 months after diagnosis. An alternative in GBM treatment could be immunotherapy which aims to stimulate patients immunological system in order to obtain a specific and long-term response that can protect against recurrence. One of these alternatives involves the use of DNA vaccines codifying tumoral antigens and immunomodulatory proteins that can effectively activate tumour antigen specific B and T lymphocytes. In this context, the objective of this work was the construction of DNA vaccines using GBM antigen genes (EGFRvIII, cERBB2, MAGE e GLEA) and immunomodulatory proteins (hsp65, hsp70, gp96 e gD), followed by their immunogenicity evaluation. Genes were evaluated in silico, synthesized in vitro and used in DNA vaccines construction. Molecular biology tools and the pVAX vector were used to obtain the vaccine. They were characterized by sequencing, western blot and were used in the immunization of C57BL/6 mice. Immunizations were performed in 3 doses of a DNA vaccine combining a tumoral antigen and an immunomodulatory protein at each 12 days. Immunogenicity was evaluated 20 days after the last dose. The ex vivo assays were performed with the serum of immunized animals for antibody evaluation and spleen cells were stimulated with EGFRvIII, cERBB2, MAGE e GLEA proteins to assess tumoral antigen specific cells. The pVAXgDGLEA vaccine was the only able to induce IgG2a subtype anti-GLEA antibodies. Vaccines pVAXgDGLEA, pVAXgDEGFRvIII e pVAXgDMAGE were able to activate antigen-specific cells that produced IFN-g e IL-10 quickly after reestimulation. The gD immunomodulatory protein was able to induce a Th1 immune response, specific to GBM antigens, which is important in tumor combat while IL-10 could favor and/or balance the response in brain, which should be effective but not exacerbated.