Made available in DSpace on 2016-12-23T13:56:00Z (GMT). No. of bitstreams: 1 dissertacao de mestrado Tatiana Co.pdf: 1118842 bytes, checksum: f75eb8302dbe7252582bc592b702c3f7 (MD5) Previous issue date: 2006-09-28 / The cellular immune response probably plays a pivotal role in determining the clinical outcome after exposure to Mycobacterium tuberculosis (MTB). This immune response is mediated by Th1 cells, with production of IFN-g, the major cytokine in macrophage activation and mycobacteria eradication. Several factors can be related to tuberculosis resistance. We investigated the role of intestinal helminth infection on M. tuberculosis specific immune response during active tuberculosis in patients with concomitant tuberculosis and intestinal helminth infection at the time of diagnosis and during tuberculosis therapy. Forty patients with newly diagnosed tuberculosis were enrolled in this study. Twenty-seven percent of these patients were co-infected with at least one intestinal helminth (TB+Helminths patients). Concomitant intestinal helminth infection and tuberculosis had a negative impact on absolute numbers of total lymphocytes, B cells, T cells (CD4+ and CD8+), and NKT cells. These alterations were also accompanied by lower IFN-g and elevated and sustained IL-10 levels in whole blood cultures from TB+Helminths patients as compared to TB patients. In addition to a depressed anti-MTB immunity, TB+Helminths patients also presented more severe radiological pulmonary disease, with significant difference in the number of involved lung zones at the end of tuberculosis treatment. The data from this study indicated that intestinal helminth infection can disturb the protective immune response in patients with tuberculosis. / A resposta imune celular tem um papel fundamental na evolução clínica do hospedeiro após a exposição ao Mycobacterium tuberculosis (MTB). Essa resposta imune é mediada por uma resposta do tipo Th1, com a produção de IFN-g, principal citocina na ativação do macrófago e, conseqüentemente, na eliminação do bacilo. Vários fatores podem estar relacionados com a resistência a tuberculose. Neste trabalho, foi avaliado o papel da infecção helmíntica na resposta imune MTB-específica durante a tuberculose ativa em pacientes portadores de tuberculose, co-infectados por helmintos intestinais, no momento do diagnóstico e durante a terapia antituberculose. Para isso, foram arrolados 40 pacientes, com diagnóstico recente de tuberculose pulmonar. Desses pacientes, 27% eram portadores de pelo menos uma espécie de helminto intestinal (grupo TB+Helminto). A presença de helmintos intestinais nos pacientes portadores de tuberculose levou a um efeito negativo nos números absolutos de linfócitos totais, linfócitos B, linfócitos T (CD4+ and CD8+) e células NKT. Essas alterações nos números de células estavam acompanhadas de uma diminuição na produção de IFN-g e de elevados e prolongados níveis de IL-10 em sobrenadantes de cultura de sangue total no grupo TB+Helminto, quando comparado ao grupo nãoinfectado por helmintos intestinais. Adicionalmente à supressão da imunidade anti-MTB, os pacientes do grupo TB+Helminto apresentaram doença pulmonar mais grave (avaliada pelo exame radiográfico), com uma diferença significativa no número de zonas pulmonares envolvidas ao final do tratamento antituberculose. Os resultados desse trabalho sugerem que a infecção helmíntica intestinal pode prejudicar a resposta imune protetora nos pacientes portadores de tuberculose.

HINTERGRUND: Eine inadäquate Aktivierung von Typ-1-IFN kann in der Entstehung von Autoimmunität und Autoinflammation resultieren. Die einer solchen dysregulierten Typ-1-IFN-Achse zu Grunde liegenden Störungen werden primär über das angeborene Immunsystem vermittelt. Krankheitsbilder, die durch eine chronische Typ-1-IFN-Aktivierung bedingt sind, werden daher unter dem Begriff Typ-1-Interferonopathien zusammengefasst. Diese Gruppe seltener, genetisch bedingter Erkrankungen zeichnet sich durch eine große symptomatische Bandbreite aus, wobei vor allem neurologische und kutane Manifestationen im Vordergrund stehen. Bisher aufgeklärte Pathomechanismen dieser systemisch-entzündlichen Erkrankungen haben einen Einblick in neue zellintrinsische Mechanismen gegeben, die zu einer Typ-1-IFN-Aktivierung führen und auf Störungen im Metabolismus und der immunologischen Erkennung intrazellulärer Nukleinsäuren beruhen. Daraus ergeben sich auch Erkenntnisse hinsichtlich des Einsatzes einer immunmodulatorischen Therapie zur kausalen Behandlung von Typ-1-Interferonopathien. FRAGESTELLUNG: Typ-1-Interferonopathien gehören zu den genetisch bedingten, seltenen Erkrankungen. Eine Diagnosestellung ist jedoch aufgrund mangelnder Kenntnisse über die Krankheitsursache häufig nicht möglich, sodass kausale Therapieansätze für viele Patienten nicht existieren. Die Aufklärung der genetischen Ursache solcher Erkrankungen ist demnach von essentieller Bedeutung. Auch die hier untersuchten Familien leiden an bisher nicht molekulargenetisch diagnostizierten Krankheiten, deren Phänotyp jedoch eine Typ-1-Interferonopathie vermuten lässt. Vor diesem Hintergrund war es das Ziel dieser Arbeit, bisher unbekannte Gene zu identifizieren und zu charakterisieren, welche Krankheitsbilder mit chronischer Typ-1-IFN-Aktivierung verursachen. MATERIAL UND METHODEN: Anhand klinischer Daten wurden zunächst die Krankheitsbilder der zwei betroffenen Familien charakterisiert und hinsichtlich der Gemeinsamkeiten mit bekannten Typ-1-Interferonopathien untersucht. Zudem wurde das Vorliegen einer chronischen Typ-1-IFN-Aktivierung bei den erkrankten Familienmitgliedern untersucht. Mit Hilfe von Exomanalysen und anschließenden bioinformatischen Analysen wurde nach dem ursächlichen Krankheitsgen gesucht. Die in diesem Rahmen in der Familie 1 nachgewiesene STING-Mutation wurde unter Verwendung von molekularbiologischen sowie zellbiologischen Analysen eingehend untersucht und zudem ihre Konsequenzen auf die IFN-Achse und die Stabilität des STING-Dimers mittels Strukturmodellierungen charakterisiert. Hinsichtlich der Aufklärung der genetischen Ursache der Erkrankung der Familie 2 wurde ebenfalls eine Exomanalyse durchgeführt. Da dabei jedoch keine Mutation identifiziert werden konnte, erfolgte eine Analyse differentiell exprimierter Transkripte mit Hilfe von Transkriptomdaten von Fibroblasten gesunder Kontrollen im Vergleich zu erkrankten Familienmitgliedern der Familie 2. ERGEBNISSE: Im Verlauf dieser Arbeit konnte in der Familie 1 mit einem familiären Chilblain Lupus eine kausale heterozygote Mutation im STING-Gen identifiziert werden. Diese bisher nicht beschriebene Mutation bedingt den Aminosäureaustausch Gly166Glu (G166E) im hochkonservierten Dimerinterface des STING-Proteins. Strukturmodelle ergaben Hinweise auf strukturverändernde Eigenschaften der Mutation G166E, die das STING-Dimer konstitutiv aktivieren. Dies konnte experimentell bestätigt werden, da in den peripheren Blutzellen der Patienten eine erhöhte IFN-Signatur nachgewiesen werden konnte und Patientenfibroblasten eine erhöhte Produktion von IFN-β sowie eine vermehrte Phosphorylierung von IRF3 zeigten. Um den Einfluss einer therapeutischen Immunmodulation über eine JAK-Inhibition zu untersuchen, wurden zwei Erkrankte der Familie 1 mit dem JAK-Inhibitor Tofacitinib über einen Zeitraum von 17 Tagen behandelt. Es konnte dabei in vivo eine signifikant reduzierte IFN-Signatur nachgewiesen werden. Mit Hilfe der Exomanalyse konnte in der konsanguinen Familie 2 mit einem AGS-ähnlichen Phänotyp keine kausale Mutation identifiziert werden. Es zeigte sich zudem, dass in den Patientenzellen keine erhöhte IFN-Signatur sowie keine erhöhte IFN-β Produktion nachweisbar waren. Die vergleichende Transkriptomanalyse ergab keine auffällige differentielle Expression von Genen des Aminosäure-Metabolismus, der Seneszenz, des Zellzyklus, der DNA-Schadensantwort und DNA-Reparatur sowie von Genen immunologischer Prozesse. Allerdings wurde die vollständig fehlende Expression der Gene COL6A1 und COL6A2 in den Patientenzellen nachgewiesen. SCHLUSSFOLGERUNG: Die identifizierte STING-Mutation der Familie 1 führt zu einer chronischen Aktivierung der Typ-1-IFN-Achse und ist folglich als Gain-of-function Mutation anzusehen. Die Behandlung mit dem immunmodulierenden JAK-Inhibitor Tofacitinib führt zu einer Verminderung der IFN-Signatur und bietet somit einen vielversprechenden Ansatz für eine kausale Therapie. Weiterführende Untersuchungen, vor allem bezüglich der Langzeiteffekte, sind hier jedoch noch erforderlich. Die Erkrankung der Familie 2 ist dagegen vermutlich nicht den Typ-1-Interferonopathien zuzuordnen. Vielmehr scheint es zum jetzigen Zeitpunkt wahrscheinlich, dass eine Mutation innerhalb eines regulatorischen Elements, das die Expression der Gene COL6A1 und COL6A2 reguliert, für den Phänotyp der Erkrankten verantwortlich ist. Weiterführende Untersuchungen sind hier zukünftig von großem Interesse.

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective therapeutic option for many malignant diseases. However, the efficacy of allo-HSCT is limited by the occurrence of destructive graft-versus-host disease (GVHD). Since allogeneic T cells are the driving force in the development of GVHD, their activation, proliferation, and differentiation are key factors to understanding GVHD pathogenesis. On the other hand, antigen-presenting cells (APCs) are essential for allogeneic T-cell priming and the development of GVHD. The T-box transcription factor T-bet is a master regulator for IFN-γ production and Th1 differentiation. T-bet also regulates the functions of APCs including dendritic cells (DCs) and B cells. Therefore, we investigated the role of T-bet in T cell responses, as well as on APC functions, in acute GVHD (aGVHD) using murine models of allogenic bone marrow transplantation (allo-BMT). In Chapter 2, we evaluated the roles of T-bet and IFN-γ in T-cell responses. T-bet-/- T cells induced significantly less GVHD compared with either wild-type (WT) or IFN-γ-/- counterparts in CD4-driven major histocompatibility complex (MHC)- or minor histocompatibility antigen (miHA)-mismatched models. We defined several T-bet-dependent but IFN-γ-independent molecules that may account for this distinct outcome. Further study indicates that T-bet also controls the optimal activity of Th17 cells to induce GVHD. Moreover, the compromised graft-versus-leukemia (GVL) effect of T-bet-/- T cells could be essentially reversed by IL-17 neutralization. Thus, targeting T-bet or regulating its downstream effectors independent of IFN-γ may be a promising strategy to control GVHD in the clinic. In Chapter 3, we evaluated the role of T-bet on APCs and found that T-bet-/- recipients developed much milder GVHD than their WT counterparts in MHC-mismatched or CD4-depedent miHA-mismatched models. As the functional readout of APCs, allogeneic donor T cells, particular CD4 subpopulation, significantly reduced IFN-γ production, proliferation and migration, and caused less damage in liver and gut in T-bet-/- recipients. We further observed that T-bet on recipient hematopoietic APCs, particular DCs, was primarily responsible for donor T-cell response and pathogenicity in GVHD. In fact, Trail/DR5 interaction served as a major signaling pathway responsible for donor T-cell apoptosis and impaired GVHD development in T-bet-/- recipients. Furthermore, T-bet expression on the host is largely dispensable for the GVL effect. Taken together, we propose that T-bet is a potential therapeutic target for the control of GVHD through regulating T cells as well as APCs. We believe further exploration and understanding of the immunobiology of T-bet in controlling the activities of T cells and APCs in GVHD will expand therapeutic options for the continuing success of allo-HSCT.

Made available in DSpace on 2015-04-11T13:54:31Z (GMT). No. of bitstreams: 1 Claudia Maria de Melo Silva.pdf: 2215806 bytes, checksum: c9afeecd5c357af061e1b38a8a31df56 (MD5) Previous issue date: 2014-04-28 / FAPEAM - Fundação de Amparo à Pesquisa do Estado do Amazonas / Tuberculosis (TB) is a chronic infection caused by Mycobacterium tuberculosis complex and remains a major worldwide public health problem, leading to almost 1.45 million deaths annually. The state of Amazonas has a high rate incidence of TB, about 68.3/100,000 inhabitants in 2012. Only 5 to 10% of infected individuals develop active TB. It has been suggested that host factors determine the immune response to pathogen. Thus, many immunogenetic researches have demonstrated TB associated genes, but in the north region, research in this field is still rare. This fact motivated the investigation of polymorphisms for IFNG, IL12B, CD80 and CD86 genes, which codify proteins for cellular immune response. Furthermore, IFN- concentration and its relation with genotypes found have been verified. A total of 177 patients and 224 controls (159 contacts and 65 non-contacts) were included in this study and DNA sequencing was performed for genes IFNG (SNP +874A/T and microsatellite +875), IL12B (SNPs +1030C/T, +1188A/C and +1254T/G), CD80 (SNPs -454 C/A, -387 T/C, -232 G/A, -79 C/G, -7T/C, +5C/A and an indel polymorphism -557_-561insCATGA) and CD86 (SNPs +1057G/A and +1079G/A). The IFN-y concentration was determined by enzyme-linked immunoassay. At IFNG, the presence of the allele +874A and the allele with 15 CA repeats were associated with susceptibility to pulmonary TB, while the allele +874T and the allele with 12 CA repeats were associated with protection from pulmonary TB. In addition, an association between genotype CC (SNP +1188A/C at IL12B) and increased risk of pulmonary TB was found. Furthermore, a significant difference between IFN- concentration and genotypes of SNP +1188A/C at IL12B and microsatellite at IFNG was observed, with decrease of IFN-at genotype CC and 15 CA repeats respectively. These outcomes lead to a better understanding of the immune response regulation for TB and help to determine the genetic profile of the Amazon population. Future researches are still needed for a better understanding of the role of other genes involved in the immune response to M. tuberculosis and their influence at the production of citokines like IFN-. / A Tuberculose (TB) é uma infecção crônica causada pelo complexo Mycobacterium tuberculosis sendo um importante problema de saúde pública mundial, levando a aproximadamente 1,45 milhões de mortes a cada ano. O estado do Amazonas possui uma alta incidência desta doença, atingindo 68,3 casos por 100 mil habitantes em 2012. Dos indivíduos infectados pelo bacilo, cerca de 5 a 10% desenvolvem a Tuberculose ativa, sugerindo que há fatores associados ao hospedeiro que determinam o destino da resposta imune ao patógeno. Neste contexto, diversos estudos em imunogenética têm demonstrado genes associados à TB, mas na região norte ainda são raras as pesquisas nesta área, fato que motivou a investigação da frequência dos polimorfismos nos genes IFNG, IL12B, CD80 e CD86, que codificam para proteínas fundamentais na resposta imune celular. Além disso, foi verificado se a concentração de IFN- está relacionada com o genótipo encontrado. Foram incluídas amostras de 177 pacientes e 224 controles (159 contatos e 65 não contatos) e realizado sequenciamento de DNA para os genes IFNG (SNP +874A/T e microssatélite +875), IL12B (SNPs +1030C/T, +1188A/C e +1254T/G), CD80 (SNPs -454 C/A, 454 C/A, 454 C/A, 454 C/A, -387 T/C, 387 T/C, 387 T/C, -232 G/A, 232 G/A, 232 G/A, -79 C/G, 79 C/G, 79 C/G, -7T/C e 7T/C e 7T/C e 7T/C e +5C/A+5C/A +5C/A e um polimorfismo indel -557_-561insCATGA) e CD86 (SNPs +1057G/A e +1079G/A). A determinação das concentrações de IFN-foi realizada através de ensaio imunoenzimático. Foi verificada uma associação do gene IFNG, entre a presença do alelo +874A e 15 repetições CA, como fator de risco para TB pulmonar assim como a presença do alelo +874T e 12 repetições CA como fatores de proteção contra TB pulmonar. Também foi encontrada uma associação do genótipo CC, do SNP +1188A/C no gene IL12B, como fator de risco ao desenvolvimento da TB pulmonar. Houve diferença significativa na concentração de IFN-entre os genótipos do SNP +1188A/C no gene IL12B e o microssatélite no gene IFNG, com menor produção no genótipo CC e 15 repetições CA respectivamente. Estes resultados contribuem para o melhor entendimento da regulação na resposta imune à TB e auxilia na determinação do perfil genético da população da região Amazônica. Estudos futuros são necessários para uma melhor compreensão do papel de outros genes envolvidos na resposta imunológica a M. tuberculosis e influência nos níveis de produção de citocinas como IFN-.

Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory tract infection in young children worldwide, accounting for an estimated 33.8 million cases of respiratory disease, over 3 million of which require hospitalization, and between 66,000 and 199,000 deaths in this susceptible population. Additionally, severe RSV infection early in life is associated with an increased risk of wheeze and other airway disorders later in life. Despite this, there is currently no vaccine or economically reasonable prophylactic regimen to prevent infection. While disease is typically more severe in infancy RSV can infect throughout the lifespan repeatedly as the body does not develop protective immunity during primary or subsequent infection. The mechanisms behind this incomplete immunity are unclear. RSV has been reported to infect numerous extra-epithelial cell types. Interestingly, viral infection in human mesenchymal stem cells (MSCs) has been reported, but the consequences are poorly understood. MSCs are an immune regulatory cell population present in nearly every organ including the nasal mucosa and the lung. They play a role in regulating immune responses and mediating tissue repair. In the following studies we sought to determine whether RSV infection of MSCs enhances their immune regulatory functions and contributes to RSV-associated lung disease. RSV was shown to replicate in human MSCs by fluorescence microscopy, plaque assay, and expression of RSV transcripts. RSV-infected MSCs showed differentially altered expression of cytokines and chemokines such as IL-1β, IL-6, IL-8 and SDF-1 compared to normal human bronchial epithelial cells. Notably, RSV-infected MSCs exhibited significantly increased expression of IFN-β (~100-fold) and indoleamine-2,3-dioxygenase (IDO) (~70-fold) compared with mock-infected MSCs. IDO was identified in cytosolic protein of infected cells by Western blots and enzymatic activity was detected by tryptophan catabolism assay. Treatment of PBMCs with culture supernatants from RSV-infected MSCs reduced their proliferation in a dose dependent manner. This effect on PBMC activation was reversed by treatment of MSCs with the IDO inhibitors 1-methyltryptophan and vitamin K3 during RSV infection. We also demonstrated the pathway leading to IDO expression in RSV infected MSCs. Neutralizing IFN-β prevented IDO expression and activity indicating its role as a viral response factor perhaps “high jacked” by the virus in immune escape. Treatment of MSCs with an endosomal TLR, but not a RIG-I, inhibitor prevented IFN-β and IDO expression. Additionally, TLR3/dsRNA complex inhibitor was able to block IFN-β stimulation, while a TLR7/8/9 inhibitory ODN did not, suggesting that endosomal TLR3 detection of RSV dsRNA was leading to IFN-β and IDO expression. Together, these findings indicate that RSV infection of MSCs triggers their immune regulatory function via TLR3 recognition of dsRNA, upregulating IFN-β expression and IDO activity, ultimately affecting immune cell proliferation. This finding may account for the lack of protective RSV immunity and consequent repeated infections throughout one's lifetime.

Upon viral infection, host cells produce type I interferon (IFN), which activates the JAK-STAT signaling pathway and induces the expression of hundreds of interferon-stimulated genes (ISGs) to establish an antiviral state. In West Nile virus (WNV)-infected cells, the JAK-STAT signaling pathway is blocked by viral proteins. However, the expression of a subset of ISGs, which includes 2¢-5¢-oligoadenylate synthetase 1a (Oas1a), Oas1b, interferon regulatory factor 7 (Irf7), Mx1, and interferon-induced proteins with tetratricopeptide repeats 1 (Ifit1), is still upregulated by an IFN-independent mechanism in WNV-infected mouse embryonic fibroblasts (MEFs). Studies in cells with one or more components of RNA-sensing pathway knocked out showed that the alternative ISG upregulation is activated through RIG-I or MDA5, and the downstream adaptor IPS-1. In cells with IRF3, 5 and 7 knocked out, the alternative ISG upregulation by WNV infection is reduced but not eliminated. As an initial means of discovering the transcription factors involved in this non-canonical ISG upregulation, the critical regulatory regions in the promoters of two representative ISGs, Oas1b and Ifit1, were mapped using a dual luciferase assay system with a NanoLuc luciferase promoter reporter in WNV-infected Ifnar1-/- MEFs. The region from -299 to -28 in the Oas1b promoter, and the region from -192 to -50 in the Ifit1 promoter were identified as being important for upregulating non-canonical gene expression after WNV infection. Fine mapping identified enhancer and repressor sub-regions as well as transcription factor binding sites (TFBSs) putatively involved in the IFN-independent antiviral mechanism. Mutation of one identified TFBS in the ISG promoters reduced Oas1b and Ifit1 promoter activities. In electrophoretic mobility shift assays (EMSAs), a unique band, which was detected in WNV-infected but not in mock-infected Ifnar1-/- MEF nuclear extracts, was not observed when a probe with the identified TFBS mutated was used, suggesting that a unique complex forms at the identified TFBS when it is in the context of the adjacent flanking regions. The unique complex appears to contain NF-κB components and IRF3, IRF5 or IRF7. Our findings provide new insights into the mechanism involved in non-canonical upregulation of ISGs after WNV infection.

>Magister Scientiae - MSc / Tuberculosis (TB) is a disease that results from infection by Mycobacterium tuberculosis, which is regarded the most common infecting organism. TB has killed countless numbers of people particularly in underdeveloped countries. TB bacteria can remain inactive or in dormant state for years without causing symptoms or spreading to other subjects, but as soon as the immune system of the host becomes weakened, the bacteria become active and infect mainly the lungs along with other parts of body. TB cases are further aggravated by other illnesses that affect the immune system, such as human immune virus (HIV), which is very prevalent in resource-poor countries. Interferon-gamma (IFN-γ) is a TB biomarker that has found to have all the qualities that are needed to help and cure Tuberculosis disease. Early diagnosis and treatment are essential measures for effectively controlling the disease. Traditional microbial culture-based tests are the most common methodologies currently used. Usually, these methods involve cell culture, cell counts, and cell enrichment, but this process is time-consuming and laborious, especially for the slow-growing bacteria like M. tuberculosis. Sputum smear is one of the methods currently used to detect acid fast bacilli (AFB) in clinical specimens or fluorescent staining. It is a cost-effective tool for diagnosing patients with TB and to monitor the progress of treatment especially in developing countries. The traditional method of inoculating solid medium such as Lowerstein-Jensen (L-J) or 7H10/7H11 media is also used currently it is slow and takes 6-8 weeks of incubation to diagnose the infection and further more time to determine the susceptibility patterns. The microscopic observation drug susceptibility (MODS) assay they are also used currently they rely on light microscopy to visualize the characteristic cording morphology of M. tuberculosis in liquid culture. MODS has shorter time to culture positivity (average 8 days) compared with LJ medium (average ~26 days), they are very expensive. The Gen-Probe assay specific for M. tuberculosis complex is a rapid detection that is also used, nucleic acid amplification (NAA) test results can be obtained as fast as in two hours (provided if a positive culture is present); it also has a high sensitivity of 99% and specificity of 99.2%. It holds the disadvantage of needing of positive culture that can take several days. Enzyme-linked immunosorbent assay (ELISA), is a test that uses antibodies and colour change to identify a substance. ELISA is an assay that uses a solid-phase enzyme immunoassay (EIA) to detect the presence of a substance, usually an antigen, in a liquid sample or wet sample. It can be used to detection of Mycobacterium antibodies in tuberculosis. The Amplified Mycobacterium Tuberculosis Direct Test (AMTDT) is used for the detection of M. tuberculosis it enables the amplification and detection of M. tuberculosis rRNA directly from respiratory specimens. The diagnostic methods employing genetechnology based on the amplification of DNA or RNA are expected to improve the speed, sensitivity, and specificity of Mycobacterium tuberculosis detection. TB rapid cultivation detection technique, such as MB/BacT system, BactecMGIT 960 system and flow cytometry. The BACTEC MGIT960 system (Becton Dickinson, Sparks, MD) performs incubation and reading of the tubes continuously inside the machine using a predefined algorithm to interpret the fluorescent signal and giving the results as positive or negative. When performing DST, the BACTEC MGIT960 interprets the results as susceptible or resistant to the antibiotic under study. Results are available within 8 days. A recent meta-analysis of the published studies found high accuracy and high predictive values associated with the use of BACTEC MGIT960. These methods are more sensitive and rapid than the traditional microbial culture-based methods. However, they cannot provide the detection results in real-time and most of these methods are centralized in large stationary laboratories because complex instrumentation and highly qualified technical staff are required. Recently, Food and Drug Administration (FDA) approved two new assays that were introduced. These two assays detect in vitro a specific immune response to M. tuberculosis. These tests are the QuantiFERON-TB Gold In-Tube (Cellestis/Qiagen, Carnegie, Australia) and the T-SPOT.TB assay (Oxford Immunotec, Abingdon, United Kingdom). Both assays use whole blood from the patient and measure the production of interferon gamma after the whole blood is exposed to specific antigens from M. tuberculosis. These tests are based on the knowledge that IFN-γ is a product of an active cell-mediated immune response induced by M. tuberculosis. However, TB detection remains a major obstacle due to several drawbacks of these methods. To date, the number of diagnosis approaches for TB has increased as the disease continues to be a major public health problem worldwide and most conventional detection technologies present difficulties in recognizing the presence of M. tuberculosis, since they are time consuming, do not provide clinically reliable results and significantly lack of sensitivity. This thesis focusedon developing two binary and one ternary-electrochemically quantum dots, all synthesised at room temperature in aqueous media for detecting (IFN-γ). Copper telluride (CuTe) and Zinc telluride (ZnTe) was prepared to check how does the two quantum dot behave individual and also to check on how they behave when they are combined and formed ternary quantum dots (CuZnTe). The electrochemical studies of the binary CuTe quantum dots, ZnTe quantum dots and the ternary CuZnTe core-shell quantum dots reveal that ternary quantum dots were stable and showed a significant enhancement in the conductivity of CuZnTe core-shell solution compared to that of CuTe and ZnTe, all studied in solution. The three different quantum dots were capped with three different capping reagents which are tetraethyl orthosilicate (TEOS), thioglycolic acid (TGA), (3-mercaptopropyl) trimethoxysilane (MPS). In the study, a label-free electrochemical immunosensor for the detection of interferon gamma (IFN-γ) was prepared for the first time using ternary quantum dots. The biosensor consists of water-soluble silica coated Copper Zinc telluride (CuZnTe core-shell) quantum dots conjugated to a gold electrode. The antibody-antigen were then conjugated on the CuZnTe core-shell QD modified gold electrode. Results from synthesis of two different binary quantum dots are also presented in the study and compared to the results of the CuZnTe core-shell QDs. The CuTe quantum dots had a small average size which was confirmed through HRTEM, SAXS and XRD analysis

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22833号 / 医博第4672号 / 新制||医||1047(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 竹内 理, 教授 濵﨑 洋子, 教授 椛島 健治 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医科学) / 甲第19628号 / 医科博第66号 / 新制||医科||5(附属図書館) / 32664 / 京都大学大学院医学研究科医科学専攻 / (主査)教授 髙折 晃史, 教授 浅野 雅秀, 教授 小柳 義夫 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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