Vascular stiffening is defined as the reduced ability of the blood vessels to expand in response to an increase in blood pressure. Vascular stiffening is often not appreciated as a disease in and of itself but is important to recognize because it is considered a predictor of many cardiovascular disease states. Mechanisms of vascular stiffening remain largely unknown; however the immune system has been found to play major roles in cardiovascular disease and arterial remodeling. This dissertation therefore seeks to illustrate the role of the adaptive immune system in vascular stiffening. This has been done by modeling vascular stiffness in transgenic mice lacking an adaptive immune system as well as immunosuppression in normal mice using a novel method to stimulate regulatory T cells with a cytokine immune complex. We have found that inhibition of the immune system by the use of a genetic knockout (RAG 1 ⁻/⁻ mice) or suppression of an existing immune system with an IL-2/anti-IL-2 complex reduces the development of angiotensin II-induced vascular stiffening. This dissertation supports the role of the adaptive immune system, and particularly CD4⁺T cells, in the development of vascular stiffening as well as the protective roles of Tregs in the disease. It also highlights the use of the IL-2/anti-IL-2 complex as a new potential therapy for vascular stiffness. Therapeutics that suppress adaptive immune function may be beneficial in the treatment of vascular stiffening.

Thesis (M.Sc (Clinical Pathology))--Mahidol University, 1982.

The aim of cancer immunotherapy is to eradicate tumours by inducing a tumour-specific immune response. This thesis focuses on how antibodies and peptides can improve antigen presentation and the subsequent tumour-specific T cell response. Tumour recognition by the immune system can be promoted through delivery of antigen in the form of a vaccine. One example is the development of a therapeutic peptide vaccine containing both CD4+ and CD8+ T cell epitopes. So far, peptide vaccinations have shown limited success in clinical trials and further improvements are needed, such as choice of adjuvant and T cell epitopes, as well as targeted delivery of peptides and adjuvants to the same DC. In paper I, we describe the development of a peptide-peptide conjugate (with a tumour T cell epitope) that, via immune complex formation and FcγR binding, enhance antigen uptake and activation of DCs. The conjugate consists of three tetanus toxin-derived linear B cell epitopes (MTTE) that were identified based on specific IgG antibodies in human serum. Three MTTE peptide sequences were conjugated to a synthetic long peptide (SLP) that consists of a T cell epitope derived from the desired target tumour. In paper II, the conjugate was evaluated in a modified Chandler loop model containing human blood, mimicking blood in circulation. The conjugate was internalised by human monocytes in an antibody-dependent manner. A conjugate containing the model CMV-derived T cell epitope pp65NLV generated recall T cell responses dependent on MTTE-specific antibodies and the covalent conjugation of the three MTTE with the SLP. In paper III, a CD40-specific antibody was characterised for local treatment of solid tumours. The antibody eradicated bladder tumours in mice and induced T cell-mediated immunological memory against the tumour. In paper IV, we characterised the Chandler loop model (used in paper II) for its potential use in predicting cytokine release syndrome (CRS) in response to monoclonal antibodies (mAbs). Superagonistic antibodies (e.g., OKT3) induced rapid cytokine release whereas no cytokine release was induced by antibodies (e.g., cetuximab) associated with low incidence of CRS in the clinic. In conclusion, this thesis work demonstrates proof-of-concept of improved strategies for antibody- and peptides-based cancer immunotherapies and their potential use in multiple cancer indications.

This post-positivist research study explored the possible relationship between Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) and the presence of underlying psychological and emotional issues. An exploratory design with naturalistic methods of inquiry was utilized to investigate whether the presence, or absence, of these issues had any impact on the overall disease process.

The group A beta-haemolytic streptococcus is known to be the aetiologic agent in acute rheumatic fever, but the exact pathogenesis remains obscure. A review of the histopathology of the Aschoff body suggests that the cardiac pathology is a granulomatous hypersensitivity reaction. However the streptococcus has not been found in the lesions, and the agent responsible for the granuloma has not yet been identified. Circulating immune complexes have previously been measured in some children with acute rheumatic fever. The normal or raised complement components measured by some workers in acute rheumatic fever suggests that the immune complexes may not be complement fixing. Considering that the usual assays for measuring immune complexes depend on complement fixation, the failure of the immune complexes to fix complement might produce false negative results. A physical, non-complement fixing assay (polyethylene glycol precipitation - PEG), was therefore used to measure circulating immune complexes. Results were expressed as total IgG precipitated (g/L), or as a percentage of serum IgG. Immune complexes were also measured by two complement dependent assays, a Clq binding assay (ClqBA), and conglutinin binding assay (CBA). Complexes were assayed in 15 children with acute rheumatic carditis (ARC), 11 with non-active, chronic rheumatic heart disease (CRHD), 13 with acute poststreptococcal glomerulonephritis (APSGN), and 15 normal children and adults (NORMAL). Total haemolytic complement, complement components as well as the complement breakdown product C3d, were measured.

abstract: Influenza is a deadly disease that poses a major threat to global health. The surface proteins of influenza A, the type most often associated with epidemics and pandemics, mutate at a very high frequency from season to season, reducing the efficacy of seasonal influenza vaccines. However, certain regions of these proteins are conserved between strains of influenza A, making them attractive targets for the development of a ‘universal’ influenza vaccine. One of these highly conserved regions is the ectodomain of the influenza matrix 2 protein (M2e). Studies have shown that M2e is poorly immunogenic on its own, but when properly adjuvanted it can be used to induce protective immune responses against many strains of influenza A. In this thesis, M2e was fused to a pair experimental ‘vaccine platforms’: an antibody fusion protein designed to assemble into a recombinant immune complex (RIC) and the hepatitis B core antigen (HBc) that can assemble into virus-like particles (VLP). The two antigens were produced in Nicotiana benthamiana plants through the use of geminiviral vectors and were subsequently evaluated in mouse trials. Mice were administered three doses of either the VLP alone or a 1:1 combination of the VLP and the RIC, and recipients of both the VLP and RIC exhibited endpoint anti-M2e antibody titers that were 2 to 3 times higher than mice that received the VLP alone. While IgG2a:IgG1 ratios, which can suggest the type of immune response (TH1 vs TH2) an antigen will elicit, were higher in mice vaccinated solely with the VLP, the higher overall titers are encouraging and demonstrate a degree of interaction between the RIC and VLP vaccines. Further research is necessary to determine the optimal balance of VLP and RIC to maximize IgG2a:IGg1 ratios as well as whether such interaction would be observed through the use of a variety of diverse antigens, though the results of other studies conducted in this lab suggests that this is indeed the case. The results of this study demonstrate not only the successful development of a promising new universal influenza A vaccine, but also that co-delivering different types of recombinant vaccines could reduce the total number of vaccine doses needed to achieve a protective immune response. / Dissertation/Thesis / Masters Thesis Molecular and Cellular Biology 2019

Les adénovirus humains (HAdVs) provoquent généralement une infection bénigne chez l'hôte sain. En revanche, chez les patients immunodéprimés et immunocompétents, ils peuvent causer des infections sévères à létales. Les vecteurs HAdVs sont couramment utilisés dans les domaines de la thérapie génique et de la vaccination. L'immunité pré-existante de l’hôte protège généralement contre les infections de type sauvage mais peut entraîner des effets indésirables lors du relargage des virus tel que l’induction de processus inflammatoire locale ou général. Après l'infection, l'inflammation va principalement entraîner le recrutement de cellules dendritiques (DCs), de monocytes et de neutrophiles. Les DCs ont la capacité unique de présenter l'antigène et d’activer les cellules T, qui, par la suite, aideront les cellules B à produire des anticorps. En plus de leurs activités phagocytaires, des peptides antimicrobiens dérivés des neutrophiles (AMPs) jouent un rôle central dans l'immunité innée. Les AMPs peuvent neutraliser les microbes infectieux et / ou activer différents types de cellules immunitaires. Dans ce contexte, nous avons étudié l'interaction ex vivo entre le facteur hôte (anticorps anti-HADV et AMPs) contre les HAdVs dans les DCs ainsi que le rôle des DCs activés indirectement (indir-DCs) lors de la réponse immunitaire. Nous avons caractérisé le profil des cytokines et des chimiokines sécrétées par les DCs stimulées par différents HAdVs, AMPs et les combinaisons qui en découlent. Enfin, nous avons constaté que l’opsonisation d’HAdV5 par les IgG accroît la capacité de capture antigénique des MoDCs (cellules dendritiques dérivées de monocytes) et induit la mort cellulaire par pyroptose. Je me suis donc concentrée sur les caractéristiques et la fonction des indir-DCs dans l’immunité contre les HAdVs. Afin de mieux comprendre les propriétés et les phénotypes des indir-DCs et DCs activés directement (dir-DCs), nous avons caractérisé leurs profils de maturation, les facteurs influençant cette maturation, et leur capacité fonctionnelle de recruter les leucocytes. Ainsi nous avons pu mettre en évidence que les dir-DCs empêchent le recrutement leucocytaire tandis que les indir-DCs favorisent la migration des monocytes. L’ensemble de ces données contribue à comprendre comment l'immunité pré-existante contre les HAdVs peut impacter l’efficacité des traitements contre les maladies HAdVs ainsi que la conception de vaccins. / Human adenoviruses (HAdV) generally cause mild infection in healthy host, but in immunocompromised and immunocompetent patients, they cause severe on lethal infections. HAdV vector are also commonly used for gene transfer and vaccination. We know that pre-existing immunity can protect from wild type infection and cause adverse effects during vector delivery including local and system inflammation. Following HAdV infection on vector use, inflammation leads to the recruitment of dendritic cells (DCs), monocyte and neutrophils. DCs have the unique ability to present antigens and activate T cells, that subsequently aid B cells to produce antibodies. In addition to their phagocytic activities, neutrophil-derived antimicrobial peptides (AMPs) play a central role in innate immunity. AMPs can kill invading microbes and/or activate various cell types. Here I studied the ex vivo interaction between host factor (anti-HAdV antibodies and AMPs) to HAdV in DCs and the role of indirect-activated DC (indir-DCs) in immune response. I characterized the profile of cytokines and chemokines of DC stimulated with different HAdV, AMPs and their combination. We recently found that IgG-oposonization of HAdV5 increase the update by MoDCs (monoctyes-derived dendritic cells) and induced pyroptotic cell death. I therefore focused on the characteristic and function of indir-DCs in anti-HAdV immunity. To better understand the properties and phenotypes of indir-DCs and direct-activated DCs (dir-DCs), we characterize their maturation profile, the factors influencing their maturation, and the functional ability to recruit leukocyte. We found that dir-DC prevent leucocyte recruitment while indir-DC increases monocyte migration. These data contribute to understand how the pre-existing immunity to HAdV impacts treatment for HAdV diseases and vaccine design.

Os neutrófilos são os leucócitos mais abundantes na circulação sanguínea, sendo recrutados rapidamente para os locais de infecção e inflamação. Em condições fisiológicas, os neutrófilos circulantes possuem tempo de vida curto, de cerca de 6 a 8 horas, mas a sua sobrevida pode aumentar em condições inflamatórias. O papel dos neutrófilos em diversas doenças foi negligenciado por muito tempo, em parte devido àsdificuldades em seu estudo e manipulação, pois os mesmos são facilmente ativados e difíceis de serem mantidos em cultura. Nos últimos anos, o advento de novas técnicas e o aprimoramento de condições laboratoriais têm possibilitado uma investigação mais ampla da fisiopatologia dos neutrófilos e revelado a diversidade de funções e interações dessas células. Para dar continuidade aos estudos visando o entendimento de como as funções efetoras dos neutrófilos podem ser moduladas por produtos naturais e sintéticos, e a aplicação desse conhecimento no tratamento de patologias nas quais tais leucócitos participam, o presente trabalho estabeleceu, primeiramente, as condições experimentais para a cultura de neutrófilos humanos. As células mantiveram-se viáveis e em estado de repouso por até 24 horas, tanto em solução balanceada de Hank\'s quanto em meio RPMI. A funcionalidade dos neutrófilos foi avaliada através da sua capacidade de produzir espécies reativas de oxigênio (ERO), medida por quimioluminescência dependente de luminol (QLlum). Diferentemente do meio RPMI, a solução balanceada de Hank\'s não interferiu no ensaio de QLlum, possibilitando a análise da funcionalidade das células. Durante o período de cultura celular de 24 horas, os neutrófilos mantiveram a sua capacidade de produzir ERO em quantidades suficientes para serem detectadas e permitirem a avaliação do efeito inibitório de substâncias antioxidantes. Em seguida, este trabalho avaliou o efeito de dois antioxidantes - a 3-fenilcumarina 6,7-diidroxi-3-(3\',4\'-metilenodioxifenil)-cumarina (C13) e o flavonol galangina - na produção de ERO pelos neutrófilos. Ambas as substâncias inibiram esta função efetora dos neutrófilos durante todo o período de cultura analisado, indicando que as mesmas não foram degradadas a ponto de perderem a sua atividade antioxidante. As condições de cultura padronizadas possibilitaram também a avaliação do efeito da galangina e da C13 na viabilidade celular. Na maior concentração analisada (20 ?M), ambas as substâncias não alteraram a porcentagem de células viáveis (aproximadamente 80%), mas modularam os estágios de sobrevivência dos neutrófilos, reduzindo a porcentagem de células em apoptose e aumentando a porcentagem de células em necrose, principalmente após 18 horas de cultura. Portanto, a solução balanceada de Hank´s é adequada para manter neutrófilos humanos em cultura por até 24 horas, possibilitando a avaliação do efeito de substâncias antioxidantes na produção de ERO por estas células e na sua viabilidade. / Neutrophils are the most abundant leukocytes in blood, which are rapidly recruited to sites of infection and inflammation. Circulating neutrophils have a short lifetime of about 6 to 8 hours under physiological conditions, but their survival can be increased under inflammatory conditions. The role that neutrophils play in various diseases was long neglected, partially due to the difficulties to study and manipulate these cells, which are easy to activate and hard to maintain in culture. In recent years, the development of new techniques and improvement of laboratory conditions have broadened the investigation of neutrophil physiopathology and revealed the variety of functions and interactions of these cells. To continue the studies to understand how the effector functions of neutrophils can be modulated by natural and synthetic products, and to apply such knowledge to treat diseases in which these leukocytes participate, the first part of the present work established the experimental conditions to culture human neutrophils. Cells cultured in either Hank\'s balanced solution or RPMI medium remained viable and in the resting state for up to 24 hours. Neutrophil functionality was evaluated through its ability to produce reactive oxygen species (ROS), assessed by the luminol-enhanced chemiluminescence assay (CL-lum). In contrast to RPMI medium, Hank\'s balanced solution did not interfere in the CL-lum assay and thereby allowed analysis of neutrophil functionality. During the 24-hour cell culture period, neutrophils maintained their capacity to produce ROS in detectable amounts that were sufficient to assess the inhibitory effect of antioxidant compounds. Next, this work examined the effect of two antioxidants - the 3-phenylcoumarin 6,7-dihydroxy-3-[3\',4\'-methylenedioxyphenyl]-coumarin (C13) and the flavonol galangin - on ROS production by neutrophils. Both compounds suppressed this effector function of neutrophils during the whole culture period studied, indicating that they were not degraded to the point of losing their antioxidant activity. The standardized culture conditions also allowed assessing whether galangin and C13 affected cell viability. At the highest concentration tested (20 ?M), both compounds did not alter the cell viability percentage (around 80%) but modulated the neutrophil survival stages by reducing the percentage of apoptotic cells and increasing the percentage of necrotic cells, particularly after 18 hours of culture. Therefore, Hank\'s balanced solution is suitable to culture human neutrophils for up to 24 hours, and enables to assess the effect of antioxidant compounds on neutrophil ROS production and viability.

<p>Patients with systemic lupus erythematosus (SLE) have elevated levels of interferon (IFN)-α in blood and IFN-α-producing cells in tissues. In the present thesis, we investigate the mechanisms behind the upregulated IFN-α-production in SLE and also show that the IFN-α system is activated in primary Sjögren’s syndrome (pSS), with IFN-α-producing cells in the major affected organ, the salivary glands. The IFN-α is a type I IFN, a family of cytokines counteracting especially viral infections, by acting directly on infected cells, and via many immunomodulatory effects. The latter may also contribute to autoimmune processes.</p><p>The type I IFNs are usually produced upon recognition of microbial structures. In SLE, however, DNA-containing immune complexes (ICs) that induce IFN-α production are found. Many autoantibodies in SLE and pSS are directed to nucleic acids or to DNA/RNA-binding proteins. We show that also RNA in complex with autoantibodies from SLE or pSS patients (RNA-IC) induces IFN-α-production. The RNA could be either in the form of RNA-containing material released from apoptotic or necrotic cells or as a pure RNA-containing autoantigen, the U1 small nuclear ribonucleoprotein particle. </p><p>The IFN-α-production induced by RNA-IC occurred in plasmacytoid dendritic cells (PDCs), also termed natural IFN-producing cells (NIPCs), via binding to Fcγ-receptor IIa, endocytosis and triggering of Toll-like receptors (TLRs), probably TLR7 and TLR9. The RNA-IC may also have other effects, and we found that they induce prostaglandin E2 (PGE2) production in monocytes and tumor necrosis factor (TNF)-α in both monocytes and NIPC/PDC. The PGE2 downregulated the IFN-α induction in NIPC/PDC, and the IFN-α induction was increased in monocyte-depleted cell cultures. </p><p>The findings presented in this thesis aids in the understanding of the mechanisms behind the activated IFN-α system in SLE and other autoimmune diseases, and shows that also pSS is one of these diseases.</p>

Patients with systemic lupus erythematosus (SLE) have elevated levels of interferon (IFN)-α in blood and IFN-α-producing cells in tissues. In the present thesis, we investigate the mechanisms behind the upregulated IFN-α-production in SLE and also show that the IFN-α system is activated in primary Sjögren’s syndrome (pSS), with IFN-α-producing cells in the major affected organ, the salivary glands. The IFN-α is a type I IFN, a family of cytokines counteracting especially viral infections, by acting directly on infected cells, and via many immunomodulatory effects. The latter may also contribute to autoimmune processes. The type I IFNs are usually produced upon recognition of microbial structures. In SLE, however, DNA-containing immune complexes (ICs) that induce IFN-α production are found. Many autoantibodies in SLE and pSS are directed to nucleic acids or to DNA/RNA-binding proteins. We show that also RNA in complex with autoantibodies from SLE or pSS patients (RNA-IC) induces IFN-α-production. The RNA could be either in the form of RNA-containing material released from apoptotic or necrotic cells or as a pure RNA-containing autoantigen, the U1 small nuclear ribonucleoprotein particle. The IFN-α-production induced by RNA-IC occurred in plasmacytoid dendritic cells (PDCs), also termed natural IFN-producing cells (NIPCs), via binding to Fcγ-receptor IIa, endocytosis and triggering of Toll-like receptors (TLRs), probably TLR7 and TLR9. The RNA-IC may also have other effects, and we found that they induce prostaglandin E2 (PGE2) production in monocytes and tumor necrosis factor (TNF)-α in both monocytes and NIPC/PDC. The PGE2 downregulated the IFN-α induction in NIPC/PDC, and the IFN-α induction was increased in monocyte-depleted cell cultures. The findings presented in this thesis aids in the understanding of the mechanisms behind the activated IFN-α system in SLE and other autoimmune diseases, and shows that also pSS is one of these diseases.