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.

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No. of bitstreams: 1 sandrabertelliribeirodecastro.pdf: 21642592 bytes, checksum: ba2c7d8539f06b1e9a8e8f3ca1c34c08 (MD5) Previous issue date: 2011-12-08 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico / FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais / A Esclerose Múltipla (EM) caracteriza-se por ser uma doença inflamatória crônica desmielinizante do Sistema Nervoso Central (SNC), que afeta aproximadamente um milhão de pessoas em todo o mundo. Entre os agentes terapêuticos aprovados atualmente para o tratamento da EM podemos citar o interferon beta (IFN-β) e o acetato de glatirâmer, entretanto, estes agentes não promovem a cura da doença ou a recuperação total dos pacientes que estão em fase avançada. Diversos estudos demonstram a propriedade que os hormônios sexuais, como o estradiol e progesterona possuem em diminuir a gravidade da Encefalomielite Autoimune Experimental (EAE). Estruturalmente, as isoflavonas compartilham muitas similaridades com os estrógenos endógenos. Estudos realizados com genisteína mostram os efeitos benéficos deste isoflavonóide na EAE. Entretanto, alguns fatores limitam sua aplicação clínica, como por exemplo, sua rápida excreção e declínio dos níveis séricos, sendo que estas características podem estar relacionadas à sua estrutura química. Dentro deste contexto, este trabalho teve por objetivo avaliar o efeito de sete derivados lipofílicos da genisteína na modulação da resposta in vitro de macrófagos murinos J774.A1 ativados com lipopolissacarídeo e IFN-g, e verificar a atuação de um análogo selecionado na etapa in vitro na modulação da resposta imune in vivo no modelo de EAE. Na etapa in vitro foi avaliada a citotoxicidade dos compostos, no sobrenadante da cultura foram dosados óxido nítrico, IL-12 e TNF-α. Na etapa in vivo foi investigado o uso do derivado da genisteína 3 (7-Otetradecanoil-genisteína – TDG) na evolução da EAE induzida em camundongos C57Bl/6 através da aplicação do MOG35–55. No 14° dia após a indução com o MOG, os camundongos foram tratados com TDG por sete dias. No 21° dia após a indução, as porcentagens de células mononucleares isoladas de cérebro expressando marcadores de superfície (CD4+, CD3+ e CTLA-4) e produzindo citocinas IL- 17+CD4+, IL-10+CD4+ ou fator de transcrição Foxp3+CD4+ foram determinadas por citometria de fluxo. A concentração de IL-6, IFN-γ e IL-10 em macerado de cérebro e medula foram determinadas por ELISA. As análises histológicas de cérebro e medulas foram realizadas por coloração de Hematoxilina e Eosina. Os resultados apresentados indicam que a modificação estrutural da genisteína originou derivados não citotóxicos, com elevada capacidade de inibir a concentração de IL-12. Entretanto, estes derivados da genisteína não foram capazes de inibir TNF-α. A produção de NO foi significativamente inibida pelos derivados monoésteres (2,3) e monoéter (6,7) de maneira dose-dependente. Os dados obtidos in vivo indicam que o tratamento com o TDG melhora os sinais clínicos da EAE e isto pode ser correlacionado com uma redução na porcentagem de células produzindo IL-17 e um aumento de células Foxp3+CD4+ no cérebro. Além disso, o tratamento com o TDG aumentou a liberação de IL-10 e a expressão de CTLA-4 além de reduzir a liberação de IFN-γ e IL-6. Desta forma, os dados sugerem um papel imunomodulatório do TDG na EAE e possivelmente na EM / Multiple Sclerosis (MS) is a severe and disabling chronic autoimmune inflammatory demyelinating disease of the central nervous system (CNS), that affect around one million people at entire world. Among the therapeutic agents currently approved for the treatment of MS can be cited the interferon beta (IFN-β) and the glatiramer acetate, however, these agents do not promote the cure or full recovery of patients in advanced stages. Several studies showed that hormones, such as estradiol and progesterone, could reduce the severity of experimental autoimmune encephalomyelitis (EAE). The isoflavones share many structural similarities with endogenous estrogens. Studies with genistein showed the beneficial effects of isoflavones in EAE. However, the chemical structure of genistein has characteristics that limit its clinical application, such as rapid excretion and decreased serum levels. This study aimed evaluate the effect of seven lipophilic derivatives of genistein in the modulation of in vitro response of murine J774A.1 macrophages activated with lipopolysaccharide and IFN-g, and verify the performance of one in vitro selected analogue on modulating in vivo the immune response in EAE. The lipophilic derivatives were evaluated in LPS+IFN-g-activated J774A.1 macrophage cultures to their effects on cytotoxicity and nitric oxide, IL-12 and TNF-α production. The effects of the selected genistein derivative 3 (7-O-genistein-tetradecanoil - TDG) on the development of EAE induced in C57BL/6 mice immunized with MOG35-55 were performed. At 14th day after induction, mice were treated with TDG for seven days. At 21st day the percentage of mononuclear cells isolated from brains expressing CD4+, CD3+, CTLA-4+ and Foxp3+ and producing IL-17+ and IL-10+ were determined by flow cytometry. The concentration of IL-6, IFN-g and IL-10 in brain and spinal cord were determined by ELISA. Histological analysis of brain and spinal cord were performed by hematoxylin and eosin staining. The results showed that the modification of genistein enables the generation of non-cytotoxic compounds with increased IL-12 inhibition, despite of failed TNF-α inhibition. The NO production was inhibited by the monoester (2,3) and monoether (6,7) compounds in a dose-dependent manner. The in vivo data indicated that treatment with TDG improved the clinical signs of EAE which can be correlated with a reduction in the percentage of cells producing IL-17 and the increment of Foxp3+CD4+ cell population at brain. Furthermore, treatment with TDG increased the release of IL-10 and expression of CTLA-4 and reduced the release of IFN-g and IL-6. Altogether, the data suggest an immunomodulatory role of the TDG in EAE and possibly MS.

Les cellules dendritiques plasmacytoïdes sont les productrices majeures d’IFN de type I dans l’organisme humain. Durant les infections virales chroniques, telles que l’infection par le Virus de l’Hépatite C, les pDCs sont fonctionnellement altérées. L’efficacité dans plus de 50% des cas du traitement par IFN-α, utilisé jusqu’à récemment, suggère que la modulation de la fonction des pDCs serait une cible intéressante pour le traitement HCV. Les pDCs reconnaissent l’ARN du HCV par les récepteurs Toll-like, et disposent de plus d’un set de récepteurs dits régulateurs qui régulent la production d’IFN-I. L’activation de ces RR inhibe la production d’IFN-I par les pDCs stimulées par les agonistes de TLR7/9. Nous montrons ici que la glycoprotéine d’enveloppe E2 du HCV est un nouveau ligand des RR BDCA2 et DCIR des pDCs, et que cette liaison est responsable de l’inhibition d’IFN-I via l’activation de la voie de signalisation BCR-like. Nous avons ensuite voulu restaurer la production d’IFN-I dans les pDCs en ciblant les kinases décrites de la voie BCR-like, Syk et Mek. En inhibant Syk, l’IFN-I n’a été que partiellement restauré par les concentrations subliminales de l’inhibiteur; les concentrations élevées de cet inhibiteur ont bloqué la production d’IFN-I, suggérant l’implication de Syk dans la voie TLR7/9 comme montré pour l’activation des TLR dans les macrophages. En inhibant MEK, la restauration d’IFN-I est efficace. Les mécanismes de cette restauration sont explorés. Le ciblage pharmacologique de la signalisation BCR-like constituerait une nouvelle approche intéressante pour étudier les mécanismes de modulation de l’activation des pDCs dans les conditions physiopathologiques. / Plasmacytoid dendritic cells are major producers of type I IFN in human organism. During chronic viral infections, such as Hepatitis C Virus infection, pDCs are functionally impaired. More than 50% efficiency of IFN-α treatment, until recently used, suggested that modulation of pDC function could be an important target for HCV treatment. pDCs recognize HCV RNA by Toll-like receptors, and dispose of a set of so-called regulatory receptors that regulate IFN-I production. Crosslinking of these RR such as BDCA-2 and ILT7 has been shown to inhibit IFN-I production by pDCs stimulated with TLR7/9 agonists. In this work we show that HCV envelope glycoprotein E2 is a novel ligand of pDC RR, BDCA-2 and DCIR, and that this binding is responsible for IFN-I inhibition via the activation of the BCR-like pathway. Then we assayed to restore IFN-I in pDCs with crosslinked RR by targeting well-known kinases of BCR-like pathway, Syk and Mek. When inhibiting Syk, IFN-I was only partially restored by subliminal concentrations of Syk inhibitor; high concentrations of Syk inhibitor effectively blocked IFN-I production, suggesting involvement of Syk in the TLR7/9 pathway as it was already demonstrated in TLR activation in macrophages. When inhibiting MEK, the restoration of type I IFN was effective. The underlying mechanisms leading to the restoration are further explored. Pharmacological targeting of BCR-like signaling may constitute an attractive new approach to study mechanisms of modulation of pDC activation in pathophysiological conditions.

La mucoviscidose est une pathologie pulmonaire causée par un dysfonctionnement du canal CFTR et caractérisée par un mucus visqueux, une susceptibilité accrue aux infections chroniques et une inflammation excessive. Une première partie de ma thèse a eu pour objectif d’étudier les mécanismes inflammatoires impliqués dans le développement de la pathologie. Nous avons plus particulièrement analysé le rôle de l’IL-1β et de l’IL-17 dans la réponse à l’infection par Pseudomonas aeruginosa, dans le modèle murin ΔF508 de mucoviscidose. La seconde partie de ma thèse a porté sur l’étude de la malaria pulmonaire et cérébrale, une complication létale de l’infection à P. falciparum. Nous avons mis en évidence l’importance de trois voies d’activation des lymphocytes T CD8+ cytotoxiques dans le développement de la neuropathologie induite par Plasmodium berghei ANKA chez la souris : la protéine PKC-θ, la sous-unité β2 du récepteur à l’IL-12 et le récepteur des IFN de type I, mais qui ne semblent pas impliquées dans l’inflammation pulmonaire associée. / Cystic fibrosis is a pulmonary pathology, caused by the CFTR channel dysfunction, and characterized by high mucus viscosity, increased sensitivity to chronic infections and excessive inflammation. The aim of my thesis was first to study the inflammatory mechanisms involved in this lung pathology. Indeed, we analyzed the role of IL-1β and IL-17 in response to Pseudomonas aeruginosa infection, in the ΔF508 mouse model of cystic fibrosis. In the second part of my thesis, I studied pulmonary and cerebral malaria, a lethal complication of P. falciparum infection. We showed the importance of three pathways implicated in cytotoxic CD8+ T lymphocytes activation during the Plasmodium berghei ANKA-induced neuropathology development in mice: PKC-θ protein, β2 subunit of IL-12 receptor and type I IFN receptor, which did not seem essential for the associated lung inflammation.

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.:I Inhaltsverzeichnis................................................................I II Bibliographische Beschreibung....................................................................IV III Abkürzungsverzeichnis...................................................................................V 1 Einleitung...........................................................................................................01 1.1 Die T-Zell-vermittelte Immunität..................................................................01 1.1.1 Die verschiedenen Klassen der T-Lymphozyten................................ 01 1.1.2 Interferon-gamma als proinflammatorisches Zytokin......................... 04 1.1.3 Interleukin-17............................................................................................. 04 1.2 Die Nierentransplantation........................................................................... 05 1.2.1 Einführung.................................................................................................. 05 1.2.2 Besonderheiten der Lebendnierenspenden........................................ 06 1.3 Therapeutika bei Lebendnierenspenden................................................. 07 1.3.1 Calcineurininhibitoren............................................................................... 07 1.3.2 Prednisolon.................................................................................................. 08 1.3.3 Mycophenolat-Mofetil................................................................................. 09 1.4 Komplikationen bei Transplantationen....................................................... 10 1.4.1 Opportunistische Infektionen..................................................................... 10 1.4.2 Kardiovaskuläre und metabolische Erkrankungen................................ 11 1.4.3 Maligne Tumore.............................................................................................11 1.5 Transplantatrejektion........................................................................................ 12 1.5.1 Akute Abstoßungsreaktion............................................................................12 1.5.2 Chronische Transplantatnephropathie......................................................13 1.6 Zielsetzung der Arbeit.......................................................................................15 I2 Materialien und Methoden................................................................................. 16 2.1 Studiendesign.................................................................................................... 16 2.2 Materialien.......................................................................................................... 17 2.3 Methoden............................................................................................................ 19 2.3.1 Blutentnahmen................................................................................................ 19 2.3.2 Lymphozytenseparation.................................................................................19 2.3.3 Bestimmung der Zellzahl............................................................................... 20 2.3.4 Kryokonservierung der Zellen...................................................................... 20 2.3.5 Auftauen von kryokonservierten Zellen...................................................... 20 2.3.6 Bestrahlung von Zellen...................................................................................21 2.3.7 Stimulanzien.................................................................................................... 21 2.3.8 Durchflusszytometrie...................................................................................... 22 2.3.9 Elispot-Assay.................................................................................................... 23 3 Ergebnisse............................................................................................................... 29 3.1 Charakteristika der Patienten............................................................................ 29 3.2 Medikamentöse Therapieschemata nach Nierentransplantationen.......... 32 3.3 Versuche zur Etablierung des Elispot-Verfahrens......................................... 33 3.3.1 Vorversuche zum Nachweis von IFN-γ........................................................ 34 3.3.2 Vorversuche zum Nachweis von IL-17........................................................ 36 3.3.3 Versuche mit FKS-freiem Medium.................................................................37 3.3.4 Vitalitätsmessung in der Durchflusszytometrie.......................................... 38 3.4 Vergleich von Buffy Coats mit Patientenproben im Elispot-Assay..............38 3.5 Elispot-Assays der Spender-Empfänger-Paare............................................ 39 3.5.1 Ergebnisse der Elispot-Assays zum Nachweis von IFN-γ........................40 3.5.2 Ergebnisse der Elispot-Assays zum Nachweis von IL-17....................... 45 II3.6 Elispot-Ergebnisse unter Berücksichtigung der HLA-Kompatibilität........49 4 Diskussion............................................................................................................... 50 4.1 Bewertung der Methoden.................................................................................. 51 4.1.1 Patientenauswahl und -akquirierung........................................................... 51 4.1.2 Durchflusszytometrie....................................................................................... 51 4.1.3 Elispot-Assay..................................................................................................... 52 4.2 Vitalitätsmessung................................................................................................. 53 4.3 Elispot-Ergebnisse............................................................................................... 53 4.3.1 Vergleich der unbestrahlten und bestrahlten Elispot-Assays................... 53 4.3.2 Elispot-Assays der Patienten.......................................................................... 54 4.3.2.1 IFN-γ-Elispot-Assay........................................................................................ 54 4.3.2.2 IL-17-Elispot-Assay.........................................................................................56 4.3.2.3 IFN-γ-Elispot-Assay und IL-17-Elispot-Assay im Vergleich.................... 57 4.4 HLA-Merkmale und Serumkreatininmolarität...................................................58 4.5 Schlussfolgerung und Ausblick...........................................................................59 5 Zusammenfassung...................................................................................................62 6 Abstract...................................................................................................................... 65 7 Literaturverzeichnis................................................................................................. 67 8 Tabellenverzeichnis.................................................................................................83 9 Abbildungsverzeichnis........................................................................................... 84 10 Erklärung über die eigenständige Verfassung der Arbeit............................. 85 11 Lebenslauf..............................................................................................................86 12 Danksagung.......................................................................................................... 87 / 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.:I Inhaltsverzeichnis................................................................I II Bibliographische Beschreibung....................................................................IV III Abkürzungsverzeichnis...................................................................................V 1 Einleitung...........................................................................................................01 1.1 Die T-Zell-vermittelte Immunität..................................................................01 1.1.1 Die verschiedenen Klassen der T-Lymphozyten................................ 01 1.1.2 Interferon-gamma als proinflammatorisches Zytokin......................... 04 1.1.3 Interleukin-17............................................................................................. 04 1.2 Die Nierentransplantation........................................................................... 05 1.2.1 Einführung.................................................................................................. 05 1.2.2 Besonderheiten der Lebendnierenspenden........................................ 06 1.3 Therapeutika bei Lebendnierenspenden................................................. 07 1.3.1 Calcineurininhibitoren............................................................................... 07 1.3.2 Prednisolon.................................................................................................. 08 1.3.3 Mycophenolat-Mofetil................................................................................. 09 1.4 Komplikationen bei Transplantationen....................................................... 10 1.4.1 Opportunistische Infektionen..................................................................... 10 1.4.2 Kardiovaskuläre und metabolische Erkrankungen................................ 11 1.4.3 Maligne Tumore.............................................................................................11 1.5 Transplantatrejektion........................................................................................ 12 1.5.1 Akute Abstoßungsreaktion............................................................................12 1.5.2 Chronische Transplantatnephropathie......................................................13 1.6 Zielsetzung der Arbeit.......................................................................................15 I2 Materialien und Methoden................................................................................. 16 2.1 Studiendesign.................................................................................................... 16 2.2 Materialien.......................................................................................................... 17 2.3 Methoden............................................................................................................ 19 2.3.1 Blutentnahmen................................................................................................ 19 2.3.2 Lymphozytenseparation.................................................................................19 2.3.3 Bestimmung der Zellzahl............................................................................... 20 2.3.4 Kryokonservierung der Zellen...................................................................... 20 2.3.5 Auftauen von kryokonservierten Zellen...................................................... 20 2.3.6 Bestrahlung von Zellen...................................................................................21 2.3.7 Stimulanzien.................................................................................................... 21 2.3.8 Durchflusszytometrie...................................................................................... 22 2.3.9 Elispot-Assay.................................................................................................... 23 3 Ergebnisse............................................................................................................... 29 3.1 Charakteristika der Patienten............................................................................ 29 3.2 Medikamentöse Therapieschemata nach Nierentransplantationen.......... 32 3.3 Versuche zur Etablierung des Elispot-Verfahrens......................................... 33 3.3.1 Vorversuche zum Nachweis von IFN-γ........................................................ 34 3.3.2 Vorversuche zum Nachweis von IL-17........................................................ 36 3.3.3 Versuche mit FKS-freiem Medium.................................................................37 3.3.4 Vitalitätsmessung in der Durchflusszytometrie.......................................... 38 3.4 Vergleich von Buffy Coats mit Patientenproben im Elispot-Assay..............38 3.5 Elispot-Assays der Spender-Empfänger-Paare............................................ 39 3.5.1 Ergebnisse der Elispot-Assays zum Nachweis von IFN-γ........................40 3.5.2 Ergebnisse der Elispot-Assays zum Nachweis von IL-17....................... 45 II3.6 Elispot-Ergebnisse unter Berücksichtigung der HLA-Kompatibilität........49 4 Diskussion............................................................................................................... 50 4.1 Bewertung der Methoden.................................................................................. 51 4.1.1 Patientenauswahl und -akquirierung........................................................... 51 4.1.2 Durchflusszytometrie....................................................................................... 51 4.1.3 Elispot-Assay..................................................................................................... 52 4.2 Vitalitätsmessung................................................................................................. 53 4.3 Elispot-Ergebnisse............................................................................................... 53 4.3.1 Vergleich der unbestrahlten und bestrahlten Elispot-Assays................... 53 4.3.2 Elispot-Assays der Patienten.......................................................................... 54 4.3.2.1 IFN-γ-Elispot-Assay........................................................................................ 54 4.3.2.2 IL-17-Elispot-Assay.........................................................................................56 4.3.2.3 IFN-γ-Elispot-Assay und IL-17-Elispot-Assay im Vergleich.................... 57 4.4 HLA-Merkmale und Serumkreatininmolarität...................................................58 4.5 Schlussfolgerung und Ausblick...........................................................................59 5 Zusammenfassung...................................................................................................62 6 Abstract...................................................................................................................... 65 7 Literaturverzeichnis................................................................................................. 67 8 Tabellenverzeichnis.................................................................................................83 9 Abbildungsverzeichnis........................................................................................... 84 10 Erklärung über die eigenständige Verfassung der Arbeit............................. 85 11 Lebenslauf..............................................................................................................86 12 Danksagung.......................................................................................................... 87

Einleitung Zytokine bewirken maßgeblich die Kommunikation und Koordination der zellulären und humoralen Effektorsysteme der angeborenen und erworbenen Immunität. Die Immunzellen stellen selbst die Hauptproduzenten der Zytokine dar. Pro- und anti-inflammatorische Zytokine nehmen nicht nur innerhalb der Zellkommunikation ablaufender Immun- und Entzündungsreaktionen eine Schlüsselrolle ein, sondern sind somit ebenso am Ablauf von Pathogenesen zahlreicher Erkrankungen beim Pferd beteiligt. Trotz verschiedener Studien anhand unterschiedlicher Modelle existiert keine einheitliche Datenlage zu validierten, vergleichbaren in vivo-nahen Zellkultursystemen, die es erlauben die Kinetiken equiner Zytokine als Grundlage zur weiterführenden Erforschung von Zytokinwechselwirkungen sowie zur Testung potentieller Arzneimittel abzubilden. Aktuell werden insbesondere Glukokortikoide weiterhin aufgrund ihrer anti-inflammatorischen und immunmodulatorischen Eigenschaften häufig, aber in Bezug auf Zytokine unspezifisch zur Therapie equiner Erkrankungen eingesetzt. Ziele der Untersuchung Das Ziel der vorliegenden Studie bestand darin, eine einfache, schnelle, günstige und reproduzierbare Methodik zur ex vivo-Messung von Zytokinen (Tumornekrosefaktor-alpha [TNF-α], Interleukin-1 Rezeptor-Antagonist [IL-1Ra] und Interferon gamma [IFN-γ]) und deren zeit- und konzentrationsabhängige Freisetzung in der equinen Vollblutzellkultur zu entwickeln. Anhand dessen sollte weiterführend der Effekt der Glukokortikoide Dexamethason (DEX) und Hydrocortison (HC) auf die Produktion von TNF-α, IL-1Ra und IFN-γ im equinen Vollblut untersucht werden. Zurzeit sind Zytokine, ihre Freisetzung sowie das Eintreten ihrer vermittelten Effekte Gegenstand der gegenwärtigen Forschung, mit dem Ziel spezifische Wechselwirkungen aufzuzeigen und somit zielgerichtete Therapeutika etablieren zu können. Insbesondere Pferde, die eine Anfälligkeit gegenüber mit Sepsis einhergehenden Erkrankungen oder für equines Asthma aufweisen, könnten davon profitieren. Material und Methoden Hierfür wurde Pferdevollblut, in den Verdünnungen zu 10%, 20% und 50% eingesetzt und mit Lipopolysaccharid (LPS), einer Kombination aus Phytohämagglutinin, Concanavalin A, Pokeweed-Mitogen und LPS (PCPwL) oder equinem rekombinantem TNF-a (erTNF-α) zur Zytokinfreisetzung stimuliert. Zur Erstellung der Zytokinkinetiken wurden Zellkulturüberstände zu verschiedenen Zeitpunkten gesammelt und die Konzentrationen von TNF-α, IL-1Ra und IFN-γ mit spezifischen enzyme-linked immunosorbent assays (ELISA) analysiert. In weiterführenden Versuchen wurden in der etablierten equinen Vollblutzellkultur DEX und HC in Konzentrationen von 10-12 - 10-5 M eingesetzt, um die LPS- oder PCPwL- induzierte Zytokinfreisetzung zu modulieren. Statistische Analysen erfolgten über die Berechnungen der Mittelwerte mit den dazugehörigen Standardfehlern. Signifikanzen wurden über ein- und zweifaktorielle ANOVA bestimmt. Ergebnisse Die durchgeführten Untersuchungen ergaben, dass die optimale Detektion der Zytokine in equinen Vollblutzellkulturen mit einem Blutanteil von 20% durchgeführt werden kann. TNF-α, IL-1Ra und IFN-γ wurden zeitabhängig freigesetzt und zeigten unterschiedliche Freisetzungskinetiken. Die PCPwL- induzierte TNF-α- und IL-1Ra-Freisetzung stiegen jeweils kontinuierlich über 24 - 48 Stunden an. In ähnlicher Weise erreichte die LPS- stimulierte TNF-α-Konzentration ein Maximum zu Zeitpunkten zwischen 8 - 12 Stunden und begann daraufhin abzufallen, wohingegen die Konzentration von IL-1Ra 24 Stunden später gipfelte und vielmehr fortgeführt über 48 Stunden hinaus akkumulierte. Equines rekombinantes TNF-α konnte ebenso die IL-1Ra-Freisetzung induzieren. Die PCPwL-induzierte IFN-γ-Freisetzung begann zeitversetzt und verlief kontinuierlich ansteigend über 48 - 72 Stunden. In weiterführenden konzentrationsabhängigen Untersuchungen konnte anhand der equinen Vollblutzellkultur eine stärkere Suppression der LPS-induzierten TNF-α- und IL-1Ra-Produktion sowie der PCPwL-induzierten IFN-γ-Produktion durch DEX als durch HC nachgewiesen werden. DEX hemmte die Zytokinfreisetzung mit einer mittleren inhibitorischen Konzentration (IC50) von 0,09 μM (TNF-α), 0,453 μM (IL-1Ra) und 0,001 μM (IFN-γ), während HC IC50 Werte von 1,45 μM (TNF-α), 2,96 μM (IL-1Ra) und 0,09 μM (IFN-γ) aufwies. Schlussfolgerungen Schlussfolgernd kann zusammengefasst werden, dass sich das Model der equinen Vollblutzellkultur hervorragend eignet, um nach erfolgreicher Mitogenstimulation den zeitabhängigen Freisetzungsverlauf von Zytokinen evaluieren zu können. Somit bietet das Model der equinen Vollblutzellkultur durch die Vorteile einer einfachen, günstigen Durchführung im in vivo-nahen, physiologischen Milieu, die Möglichkeit den Zytokinstatus gesunder sowie kranker Pferde zu beurteilen und stellt seinen Nutzen und die Verlässlichkeit unter Beweis potentielle Arzneimittel und immunologische Zusammenhänge des Pferdes untersuchen zu können.:INHALTSVERZEICHNIS I ABBILDUNGSVERZEICHNIS III TABELLENVERZEICHNIS III ABKÜRZUNGSVERZEICHNIS IV 1 EINLEITUNG 1 2 LITERATURÜBERSICHT 3 2.1 Allgemeine wissenschaftliche Hintergründe 3 2.1.1 Das Blut und das Immunsystem des Pferdes 3 2.1.1.1 Zusammensetzung des equinen Blutes 3 2.1.1.2 Allgemeiner Aufbau des Immunsystems 4 2.1.2 Zytokine und Entzündungsreaktionen - Mediation der Immunantwort durch Zytokine und Chemokine 14 2.1.2.1 Pro-inflammatorische Zytokine: Tumornekrosefaktor-α und Interferon-γ 17 2.1.2.2 Anti-inflammatorische Zytokine: Interleukin-1 Rezeptor-Antagonist 19 2.2 Therapeutische Beeinflussung der Zytokin- und Mediator-Freisetzung 21 2.2.1 Inhibition der Zytokinfreisetzung durch Glukokortikoide 21 2.2.2 Inhibition der Zytokinfreisetzung durch weitere Pharmaka und Substanzen 23 2.2.2.1 NSAID 23 2.2.2.2 Small molecules und Anti-Zytokinantikörper 24 2.3 Equine Zellkulturmodelle zur Zytokindetektion 25 2.3.1 Stimulation der Zytokinfreisetzung 26 2.3.2 Vollblutzellkultursysteme und Systeme mit isolierten Zellen 27 2.4 Fragestellung der Dissertation 30 3 PUBLIKATIONEN 31 3.1 Freisetzungskinetik von TNF-α und IL-1Ra im equinen Vollblut 32 3.2 Modulation der Freisetzung von TNF-α, IL-1Ra und IFN-γ in der equinen Vollblutzellkultur durch Glukokortikoide 40 4 DISKUSSION 45 4.1 Zytokinfreisetzung im equinen Vollblut 46 4.2 Der Einfluss von Glukokortikoiden auf die Zytokinfreisetzung 52 4.3 Schlussfolgerungen 56 4.4 Ausblick 56 5 ZUSAMMENFASSUNG 58 6 SUMMARY 60 7 LITERATURVERZEICHNIS 62 8 ANHANG 72 8.1 Freisetzungskinetik von IFN-γ 72 8.2 Konzentration von TNF-α, IL-1Ra und IFN-γ in der equinen Vollblutzellkultur 72 9 DANKSAGUNG 74 / Introduction The communication and coordination between the cellular and humoral effector compartments of the innate and adaptive immunity were mainly accomplished by cytokines. Immunocompetent cells themselves represent the main source for cytokines. Pro- and anti-inflammatory cytokines not only play a pivotal role within the cell signaling of expiring immune- and inflammatory reactions but also take part in the pathogenesis of several equine diseases. Despite various studies based on different experimental setups no uniform availability of data about validated, comparable in vivo cell culture systems exists which enables the description of the kinetically time course of cytokines as foundation of further investigations of cytokine interactions as well as the testing of potential drugs. These days especially glucocorticoids are still frequently used for treatment of equine diseases because of their anti-inflammatory and immunomodulatory, but with respect to cytokines unspecific properties. Objectives of the investigations The aim of the study was to develop an easy, quick, cheap and reproducible ex vivo method for measuring cytokines (tumor necrosis factor alpha [TNF-α], interleukin-1 receptor antagonist [IL-1Ra] and interferon gamma [IFN-γ]) and their time- and concentration-dependent release in the equine whole blood cell culture. Whereby the impact of the glucocorticoids dexamethasone (DEX) and hydrocortisone (HC) on production of TNF-α, IL-1Ra and IFN-γ should be investigated subsequently. Currently, cytokines, their release and eventuation of their mediated effects are objects of actual research with the aim to reveal specific interactions and thus be able to establish purposeful therapeutic agents. This could be beneficial especially for horses which display a susceptibility to septic diseases or equine asthma. Material and Methods Therefore horse whole blood diluted to 10%, 20% and 50% was stimulated with lipopolysaccharide (LPS), a combination of phytohemagglutinin, concanavalin A, pokeweed mitogen and LPS (PCPwL) or equine recombinant TNF-α (erTNF-α). To generate cytokine kinetics TNF-α, IL-1Ra and IFN-γ were analyzed in culture supernatants, which were collected at different time points using specific enzyme-linked immunosorbent assays (ELISA). In further investigations within the equine whole blood cell culture DEX and HC were applied with concentrations between 10-12 and 10-5 M to modulate LPS- or PCPwL-induced cytokine release. Statistics were performed by calculation of means with associated standard errors. Statistical significances were assessed by one- and two-way analysis of variance. Results The evaluations revealed that cytokines could be detected optimal in whole blood cell cultures with 20% blood volume. TNF-α, IL-1Ra and IFN-γ were released time-dependently and differing kinetics were displayed. PCPwL-induced TNF-α and IL-1Ra release was enhanced continuously over 24 - 48 hours, respectively. Similarly, LPS-stimulated TNF-α was at maximum at time points between 8 - 12 hours and started to decrease thereafter, whereas IL-1Ra peaked 24 hours later and rather continued to accumulate beyond 48 hours. ErTNF-α could induce also the IL-1Ra release. PCPwL- induced IFN-γ release started time displaced and showed a continuously enhanced course over 48 - 72 hours. In subsequent investigations within equine whole blood cell culture, LPS-induced TNF-α and IL-1Ra as well as PCPwL-induced IFN-γ production were more potently suppressed concentration-dependently by DEX than by HC. DEX inhibited cytokine release with the inhibition concentration (IC50) 0.09 μM (TNF-α), 0.453 μM (IL-1Ra) and 0.001 μM (IFN-γ), whereas HC with IC50 values of 1.45 μM (TNF-α), 2.96 μM (IL-1Ra) and 0.09 μM (IFN-γ). Conclusion In conclusion our results could suggest the eminent suitability of equine whole blood cell culture to assess the release of a variety of cytokines following successful mitogen stimulation. Therefore the model of the equine whole blood cell culture provides, because of its advantages including simple and cheap performance in an in vivo close physiological ambient, the opportunity to evaluate the cytokine status of healthy and diseased horses. Furthermore it could give the proof of its benefit and reliability to evaluate potential equine drugs and immunological coherences of the horse.:INHALTSVERZEICHNIS I ABBILDUNGSVERZEICHNIS III TABELLENVERZEICHNIS III ABKÜRZUNGSVERZEICHNIS IV 1 EINLEITUNG 1 2 LITERATURÜBERSICHT 3 2.1 Allgemeine wissenschaftliche Hintergründe 3 2.1.1 Das Blut und das Immunsystem des Pferdes 3 2.1.1.1 Zusammensetzung des equinen Blutes 3 2.1.1.2 Allgemeiner Aufbau des Immunsystems 4 2.1.2 Zytokine und Entzündungsreaktionen - Mediation der Immunantwort durch Zytokine und Chemokine 14 2.1.2.1 Pro-inflammatorische Zytokine: Tumornekrosefaktor-α und Interferon-γ 17 2.1.2.2 Anti-inflammatorische Zytokine: Interleukin-1 Rezeptor-Antagonist 19 2.2 Therapeutische Beeinflussung der Zytokin- und Mediator-Freisetzung 21 2.2.1 Inhibition der Zytokinfreisetzung durch Glukokortikoide 21 2.2.2 Inhibition der Zytokinfreisetzung durch weitere Pharmaka und Substanzen 23 2.2.2.1 NSAID 23 2.2.2.2 Small molecules und Anti-Zytokinantikörper 24 2.3 Equine Zellkulturmodelle zur Zytokindetektion 25 2.3.1 Stimulation der Zytokinfreisetzung 26 2.3.2 Vollblutzellkultursysteme und Systeme mit isolierten Zellen 27 2.4 Fragestellung der Dissertation 30 3 PUBLIKATIONEN 31 3.1 Freisetzungskinetik von TNF-α und IL-1Ra im equinen Vollblut 32 3.2 Modulation der Freisetzung von TNF-α, IL-1Ra und IFN-γ in der equinen Vollblutzellkultur durch Glukokortikoide 40 4 DISKUSSION 45 4.1 Zytokinfreisetzung im equinen Vollblut 46 4.2 Der Einfluss von Glukokortikoiden auf die Zytokinfreisetzung 52 4.3 Schlussfolgerungen 56 4.4 Ausblick 56 5 ZUSAMMENFASSUNG 58 6 SUMMARY 60 7 LITERATURVERZEICHNIS 62 8 ANHANG 72 8.1 Freisetzungskinetik von IFN-γ 72 8.2 Konzentration von TNF-α, IL-1Ra und IFN-γ in der equinen Vollblutzellkultur 72 9 DANKSAGUNG 74

Introduction: Canadian First Nations experience a significantly higher rate of Mycobacterium tuberculosis (MTB) infection than non-Indigenous Canadians. Th17 cells are a subset of CD4+ T cells that are distinguished by their production of Interleukin-17A (IL-17A), an important cytokine for defense against mycobacteria. IL-17 is a primary contributor to the formation and stabilization of the lung granuloma, a biological containment vessel to protect the host from tuberculosis (TB). Past research with First Nations people has identified single nucleotide polymorphisms (SNPs) in the Th1 and Th2 immune pathways may affect their disease risk. However, SNPs in key Th17 related genes and the P2RX7 gene have not been explored in First Nations despite their important role against infectious diseases. Hypothesis: This research hypothesizes that distinct First Nations groups (Dene, Cree and Saulteaux) will have a different frequencies of SNPs in the key Th17 immunity related genes (IL-17A, IL-17AR, IL-23R, and IFN-γR) and the P2RX7 gene, as compared to a non-Indigenous Canadian group. Methods: SNP profiles (IL-17A rs2275913, IL-17RA rs4819554, IL-23R rs10889677, IFN-γR rs2234711 and P2RX7 rs3751143) were identified through literature research and the NCBI database was used for identifying gene motifs, primer locations and Restriction Enzyme cut sites. Polymerase Chain Reaction and Restriction Fragment Length Polymorphism analysis was performed on and visualized on agarose gel to determine specific allele frequencies. Four different Manitoba First Nations communities; the Northern Dene (Dene 1 N=69. Dene 2 N=52), Central Cree (N=46), and Southern Saulteaux (N=56), participated in this research and their SNP profiles were compared to a non-Indigenous Canadian cohort (N=99). Results: Allele frequencies for IL-17A were statistically different for every First Nation community when compared to the non-Indigenous cohort (Dene 1 p=0.0043, Dene 2 p=0.0000, Cree p=0.0001, Saulteaux p=0.0000). Allele frequencies for IL-17RA were statistically different for every First Nation community except Saulteaux when compared to the non-Indigenous cohort (Dene 1 p=0.0000, Dene 2 p=0.0028, Cree p=0.0000). Allele frequencies for IL-23R were statistically different for Dene 1 and Saulteaux community when compared to the non-Indigenous cohort (Dene 1 p=0.0002, Saulteaux p=0.0000). Allele frequencies for IFN-R were statistically different for Cree community when compared to the non-Indigenous cohort (Cree p=0.0026). Allele frequencies for P2RX7 were statistically different for both Dene communities when compared to the non-Indigenous cohort (Dene 1 p=0.0000, Dene 2 p=0.0000). Conclusions: An effective Th17 response is required to bring Th1 cells to infected tissues and to balance inflammatory responses. Functional SNPs may compromise an appropriate immune response and contribute to disease. This study demonstrate that the non-Indigenous population maintained a significantly different genetic profile when compared to the First Nations populations. / October 2016

The oxysterol, 25-hydroxycholesterol (25-HC), is important for sterol metabolism and emerging evidence suggests that 25-HC plays a more critical role in immunity and infection. However, the precise antiviral mechanism and the target of 25- HC remains unclear. Here efforts were made to investigate the link between viral infection and the triggering of the 25-HC associated interferon (IFN) response, and how this dynamically alters the endogenous level of 3-hydroxy- 3-methylglutaryl-CoA reductase (HMGCR), a key enzyme that catalyses the production of the precursor of cholesterol and oxysterols. In this thesis I have sought to specifically explore the temporal changes and role of HMGCR in DNA virus (cytomegalovirus) and RNA (Influenza) virus infections. I hypothesise that HMGCR is a target for 25-HC associated IFN-mediated host defence against viral infection. To characterise HMGCR and test this hypothesis, the following objectives were defined: (1). To establish an experimental system to quantitatively study the endogenous HMGCR protein level; (2). To investigate the mechanism of the down-regulation of HMGCR involved in the IFN-mediated innate immune response; (3). To study the behaviour of HMGCR in the influenza virus induced 25-HC associated IFN-mediated innate immune response; (4). To study the behaviour of HMGCR in the cytomegalovirus induced 25-HC associated IFN-mediated innate immune response. Chapter 3, describes establishing an experimental system for the quantification of endogenous HMGCR levels. Different protein detection methods, including a modified western blot protocol and immunostaining, were tested. The results of RNA interference of HMGCR demonstrate that under lipid-deficient condition with the supplementation of mevastatin (an HMGCR inhibitor) the modified western blot protocol specifically detects endogenous HMGCR. This chapter lays the foundational work for the temporal analysis and testing the role of HMGCR in infection. In Chapter 4, the mechanism of the degradation of HMGCR following 25-HC and IFN treatments, in wild-type and Ch25h−/− mouse bone marrow derived macrophages (BMDMs), was investigated. Similar to 25-HC, IFN-γ treatment results in the drop of both the transcript and protein abundance of HMGCR in wild-type BMDMs. Differential temporal analysis of RNA and protein alterations and the use of proteasome inhibitors reveals that both 25-HC and IFN-γ lead to a marked reduction of HMGCR protein via a proteasomal degradation mechanism within early times of treatments. Further, the immediate reduction of HMGCR levels induced by IFN-γ was completely abrogated in Ch25h−/− BMDMs. Hence, the reduction of HMGCR following IFN-γ treatment is due to the de novo synthesis in macrophages of 25-HC. However, the decrease of Hmgcr gene expression was observed in not only wild-type but also Ch25h−/− BMDMs, suggesting additional mechanisms for regulating Hmgcr RNA levels. These results demonstrate the mechanism of the down-regulation of HMGCR resulted from the induction of IFN response during viral infection, is only partially due the de novo synthesis of 25-HC. In chapter 5, influenza A virus was used to investigate the role of HMGCR in the IFN-mediated innate immune response. The inhibition of HMGCR by RNA interference inhibited viral growth, suggesting the requirement of HMGCR for optimal intracellular viral growth. Viral infection in wild-type murine BMDMs reduced the endogenous HMGCR levels. However, the reduction of HMGCR at early times was prevented in Ch25h−/− BMDMs. Intriguingly, the decrease of HMGCR at late time points was still observed in Ch25h−/− BMDMs. These results indicate that the down-regulation of HMGCR with influenza virus infection in BMDMs at early times is completely due to the de novo synthesis of 25-HC; whereas at late times alternative pathways or mechanisms exist. Additionally, human epithelial A549 cells and A549/PIV5-V cells that are deficient in STAT1 were used to study the role of IFN pathway in the down-regulation of HMGCR at late times during viral infection. Results from these studies show that at late times the reduction of HMGCR is due to IFN-independent mechanisms. Chapter 6, extends these investigations to the herpes virus murine cytomegalovirus and infection of BMDMs. HMGCR is known to be essential for cytomegaloviral infections and 25-HC, statin and RNAi inhibition of HMGCR restrict viral growth. 25-HC is shown to reduce HMGCR at immediate early times of infection. However, most notably, the down-regulation of HMGCR was also observed in Ch25h−/− BMDMs at late times with murine cytomegalovirus infected BMDMs. These results confirm that alternative pathways or mechanisms exist, playing roles in the crosstalk between cholesterol metabolism and innate immune response. Collectively, this study characterises the role of HMGCR in the 25-HC associated IFN-mediated host defence against viral infection. Results indicate that, in addition to the IFN-mediated host response, alternative pathways or other mechanisms also result in the down-regulation of HMGCR during viral infection. HMGCR is at the crossroad of different pathways or mechanisms, and is therefore not only targeted by 25-HC. Hence, further questions can be addressed from these results: (1). What are the alternative pathways or mechanisms for the down-regulation of HMGCR? (2). How do these pathways or mechanisms work in hosts’ immune system? Answering these questions can contribute to refining the pathway map of innate immunity and understanding the precise role of HMGCR, or even the sterol biosynthesis pathway, in hosts’ immune response against pathogens.

Le VHB est un problème majeur puisque les 350 millions de porteurs chroniques existant ont un risque accru de développer une cirrhose ou un carcinome hépatocellulaire. Compte tenu du manque de système d'étude du VHB in vitro qui soit facile d'accès et pleinement satisfaisant, l'objectif était d'améliorer l'un de ceux qui utilisent des baculovirus VHB recombinants pour délivrer le génome VHB dans des cellules hépatocytaires. La pertinence de ce système pour réaliser des tests phénotypiques et étudier le « fitness » des mutants résistants aux antiviraux a ensuite été démontrée. Enfin, l'utilisation de ces baculovirus VHB recombinants dans des cellules HepaRG a permis de mettre en évidence une réponse IFN efficace de l'hépatocyte suite à la synthèse des protéines du VHB. Ceci constitue une donnée nouvelle dans l'étude des interactions virus/cellules puisque le VHB était considéré jusqu'à présent comme un virus silencieux vis-à-vis de la réponse innée cellulaire. L'ensemble de ces résultats a des implications importantes dans la compréhension des mécanismes de persistance du VHB et le développement de nouveaux modèles cellulaires d'infection.

<p>Type 1 diabetes is a multifactorial disease resulting from the selective destruction of insulin-producing β-cells within the pancreatic islets of Langerhans. The mechanisms of β-cell death are not fully understood but cytokines are important mediators of this process. In the present study we found that the combination of IL-1β, TNF-α and IFN-γ induced a nitric oxide-dependent disruption of the mitochondrial membrane potential in rat insulin-producing RINm5F-cells, which seems to be a necessary event for both RINm5F-cell apoptosis and necrosis. The antiapoptotic protein Bcl-2 was able to prevent cellular death in RINm5F cells, most probably by counteracting the mitochondrial permeability transition. These results pointed out the potential of such antiapoptotic genes as gene therapy tools, to allow enhanced resistance against autoimmune destruction of β-cells in type 1 diabetes. For this purpose we used a progesterone-antagonist (RU 486)-inducible gene transfer system to achieve an efficient and controlled Bcl-2 overexpression in primary rat β-cells. However, in our experience, prolonged <i>in vitro</i> culture revealed adenoviral-induced islet cell necrosis, a process that was not prevented by Bcl-2 overexpression. Moreover, we observed that specific adenoviral genotypes correlate with differential induction of necrosis in both human and rat pancreatic islet cells. Although human islet cells showed an increased resistance in terms of viral concentrations required for the induction of cell-toxicity, our results showed that they were unable to build up an efficient antiviral response following infection and that their survival was dependent on the exogenous addition of α-interferon.</p><p>In conclusion, adenoviral techniques for overexpression of antiapoptotic proteins in insulin-producing cells may provide useful tools against β-cell directed autoimmune destruction. However, understanding the specific interactions of the viral gene products with cellular proteins and how they are involved in β-cell death regulation is fundamental for an efficient and safe application of gene therapy approaches to type 1 diabetes.</p>