La photochimiothérapie extracorporelle (PCE) est une immunothérapie autologue, basée sur la réinjection de cellules photochimiquement modifiées. La PCE a démontré son efficacité dans le traitement des formes avancées du CTCL, dans la GvHD ainsi que dans d’autres pathologies médiées par la présence de lymphocytes T pathogènes (rejets de greffes d’organes, pathologies auto-immunes), sans provoquer d’immunossupression généralisée. Bien qu’utilisée depuis de nombreuses années, les mécanismes d’action de la PCE restent peu connus. L’objectif de ma thèse était de les étudier et de mettre en place un modèle chez la souris pour permettre une optimisation des protocoles cliniques. Deux hypothèses ont été testées pour expliquer l’efficacité de la PCE : la mort « tolérogène » où l’effet obtenu serait lié à la génération de lymphocytes T régulateurs et la mort « immunogène » où l’effet pourrait s’expliquer par la génération de lymphocytes T cytotoxiques.L’utilisation de cellules mononucléées humaines obtenues chez des donneurs sains nous a permis de générer des lymphocytes T alloréactifs activés et de montrer que les lymphocytes T traités PUVA émettaient une partie des molécules dites de danger (DAMPs), décrites comme immunogènes, telles que la Calréticuline ou encore le HMGB1. Ces cellules sont phagocytées par les macrophages et les moDCs, mais ne sont pas capables d’induire leur maturation, ce qui n’engendre donc pas de stimulation du système immunitaire.L’utilisation d’un modèle murin de polyarthrite rhumatoïde (CIA) nous a permis de montrer l’efficacité de la PCE dans le traitement de cette pathologie. De plus, nos résultats montrent que l’efficacité du traitement repose sur la présence de lymphocytes T issus de souris « arthritique » dans l’échantillon traité.En conclusion, les mécanismes d’action de la PCE ne semblent pas être associés au concept de mort immunogène. Le modèle de polyarthrite rhumatoïde induite par le collagène chez la souris permettra de poursuivre l’étude des mécanismes d’action et d’optimisation de la PCE. / Extracorporeal photopheresis (ECP) is an autologous immunotherapy based on the reinfusion of photochemical modified mononuclear cells. ECP efficacy is demonstrated in treatment of CTCL, in GvHD and in others T-cell mediated diseases (organ transplant rejection and auto-immune diseases). ECP does not generate generalized immunosuppression. Although it has been used for years, mechanisms of action of ECP are not totally understood. The objective of my thesis was to study these mechanisms of action and set up a murine model to allow an optimization of the clinical protocols. Two hypotheses have been tested to explain the effectiveness of ECP: “Tolerogenic” cell death where the effect would be related to the generation of regulatory T lymphocytes and "immunogenic" death where the effect could be explained by the generation of cytotoxic T lymphocytes.The use of human mononuclear cells obtained from healthy donors enabled us to generate activated alloreactive T cells and to show that the PUVA-treated T-cells emitted a part of the danger molecules (DAMPs), described as immunogenic, such as Calreticulin or HMGB1. These cells are phagocytosed by macrophages and moDCs but do not induce their maturation, which does not therefore generate any stimulation of the immune system.The use of a murine model of rheumatoid arthritis (CIA) allowed us to show the effectiveness of PCE in the treatment of this pathology. Moreover, our results show that the effectiveness of the treatment is based on the presence of T lymphocytes derived from "arthritic" mice in the treated sample.In conclusion, the mechanisms of action of PCE do not seem to be associated with the concept of immunogenic death. The model of collagen-induced rheumatoid arthritis in mice will allow further study of the mechanisms of action and optimization of PCE.

Les relations hôte-parasite sont complexes et soumettent les deux protagonistes à un ensemble de compromis aussi bien plastiques qu’évolutifs. D'un côté, bien que l’immunité soit indispensable pour la lutte contre les parasites, elle peut aussi causer de nombreux dégâts à l’hôte lors de la réponse et mener à des maladies inflammatoires. De l’autre côté, les parasites, bien que dotés de mécanismes d'évasion, vont être affectés par l'environnement inflammatoire de l'hôte. Cela pose la question des coûts et bénéfices que l'interaction entre ces deux protagonistes va avoir sur chacun d'eux lors de l'apparition de troubles inflammatoires chez l'hôte. Grâce à différentes approches expérimentales et bibliographiques nous avons pu montrer que l’immunopathologie est un trait qui perdure vraisemblablement grâce aux bénéfices de la réponse immunitaire dans la lutte contre les parasites. Par ailleurs, j’ai pu mettre en évidence qu’une inflammation altérait positivement les traits d’histoire de vie du parasite Heligmosomoides polygyrus aussi bien de façon plastique que lors de processus de sélection. Cependant, le parasite investit davantage dans l’immunomodulation et le camouflage lorsqu'il est confronté à cet environnement, laissant planer la question du coût de cette inflammation à long terme et sur plusieurs générations. / Host-parasite interactions are characterized by trade-offs that involve both plastic and microevolutionary responses. On one hand, while immunity is essential to fight parasites, it can also cause damage to the host, leading to autoimmunity and inflammatory diseases. On the other hand, parasites have to cope with the immune environnement provided by the host. This raises the question of the costs and benefits of the inflammatory response for the two partners of the interaction. With different experimental and literature-based approaches, I showed that immunopathology is a trait that likely persists because of the immediate benefits of the immune response in terms of protection against parasites. Furthermore, I was able to show that inflammation positively altered the life history traits of the gastrointestinal nematode Heligmosomoides polygyrus both plastically or after experimental evolution. However, the parasite invested more in immunomodulation and camouflage when facing an inflammatory environment, leaving open the question of the costs associated with an inflammatory environment over the entire lifespan of the parasite and/or across generations.

Chronic obstructive pulmonary disease (COPD) including emphysema is a devastating condition, increasing in prevalence in the US and worldwide. There remains no cure for COPD, rather only symptomatic treatments. Due to unique challenges of the lung, translation of therapies for acute lung injury to target chronic lung diseases like COPD has not been successful. We have been investigating lung derived extracellular matrix (ECM) hydrogels as a novel approach for delivery of cellular therapies to the pulmonary system. During the course of this work we have developed and characterized a lug derived ECM hydrogel that exhibits “injectability,” allowing cells or dugs to be delivered in a liquid and encapsulated at body temperature. The hydrogel self assembles in <5 minutes and achieves mechanical stiffness similar to other soft tissue ECM hydrogels. The hydrogel can support 3D cell growth and encapsulated cell viability. Encapsulated hMSCs can also still be activated by simulated inflammatory environments. Naïve mouse macrophages exposed to the fully formed gel were not significantly induced to express markers for pro or anti-inflammatory polarized phenotypes, but increased expression for several secreted inflammatory mediators was observed. We also investigated a novel approach for preparing and solubilizing the isolated ECM proteins, using digestion time as a variable for controlling hydrogel density (interconnectivity), mechanical stiffness, component protein size distribution, and cell behavior on fully formed gels. The potential future impact for the presented research includes optimization for future animal studies, expansion to additional applications, and the development of new derivative materials.

Diversos estudos tem demonstrado que as células-tronco mesenquimais (CTM) são imbuídas de uma forte atividade imunossupressora in vitro, no entanto, os resultados de imunoterapias utilizando CTM têm sido variáveis até o momento. Nossa hipótese para tal variação são interações que devem ocorrer entre as CTM e fragmentos de patógenos circulantes nos pacientes, resultando na modulação da atividade imunossupressora. Para avaliar a ocorrência deste fenômeno em CTM de medula óssea, inicialmente foi avaliado a presença de diversos TLR através da marcação com anticorpos e posterior quantificação por citometria de fluxo, sendo observada a presença dos TLR2, TLR3, TLR4 e TLR9. No intuito de avaliar alterações no potencial imunossupressor, linfócitos T ativados e marcados a nível intracelular foram co-cultivados com CTM estimuladas com LPS, POLY IC e oligonucleotídeos com motivos CpG: DSP30, CpG-A e CpG-B, sendo sua proliferação quantificada por citometria de fluxo. Como resultados, foi observado que a estimulação com LPS e DSP30 levaram a perda e acentuação da capacidade supressora, respectivamente, enquanto o estímulo simultâneo com LPS e DSP30 resultou em sua manutenção. Tais modulações na imunossupressão foram corroboradas ao serem avaliadas modulações na expressão gênica, tendo em vista que o estímulo por LPS e DSP30 induziram no aumento da expressão de IL1 e TGF, respectivamente. Em seguida, foi avaliado o efeito das mesmas condições experimentais na indução a proliferação das CTM, ao ser mensurada alterações na quantidade de células em um equipamento de High content Screening (HCS). Como resultados, foi possível observar que somente o tratamento com DSP30 foi capaz de aumentar significativamente a quantidade de células, fenômeno corroborado ao ser mensurada a síntese de DNA, através da utilização de um produto comercial, seguido de análise por citometria de fluxo. No intuito de avaliar possíveis modulações na via NF-B, CTM estimuladas com LPS ou DSP30 foram sujeitas ao ensaio de imunoprecipitação de cromatina, utilizando anticorpos específicos a subunidades de RelA e RelB, sendo o DNA imunoprecipitado sujeito a PCR quantitativo com primers específicos para a regiões promotoras do gene VCAM-1. Como resultados, foi observado que o estímulo com LPS aumentou a atividade do RelA, enquanto não foram observados efeitos após o estímulo com DSP30. No entanto, o estímulo simultâneo com ambos os ligantes levou ao aumento de atividade de RelA e RelB. Ao serem avaliadas estas condições em um ensaio de imunofluorescência analisado em HCS, foi possível observar maiores níveis da proteína RelB no citoplasma das células tratadas com DSP30, sugerindo um aumento da sua formação. Apesar dos mecanismos moleculares subjacentes aos resultados observados ainda necessitarem de maior elucidação, nosso trabalho indica que a estimulação das CTM com DSP30 pode trazer benefícios no sentido de potencializar a imunossupressão e proliferação celular, além de impedir a perda da imunossupressão, decorrente da interação com LPS. Tais resultados poderão servir como diretrizes para o aprimoramento de imunoterapias utilizando CTM de medula óssea, principalmente em casos de pacientes com infecções por patógenos. / Several studies have shown that mesenchymal stem cells (MSCs ) are imbued with a strong immunosuppressive activity in vitro , however , the results of immunotherapies using CTM has been mixed so far. Our hypothesis for this variation are interactions that must occur between the CTM and fragments of circulating pathogens in patients , resulting in the modulation of the immunosuppressive activity. To evaluate the occurrence of this phenomenon in bone marrow MSCs was initially evaluated the presence of various TLR by staining with antibodies and subsequent quantification by flow cytometry , the presence of TLR2 , TLR3 , TLR4 and TLR9 was observed . To assess changes in the immunosuppressive , activated T lymphocytes and labeled intracellularly potential were co-cultured with MSC stimulated with LPS , poly IC and oligonucleotides with CpG motifs : DSP30 , CpG - A and CpG - B , and their proliferation measured by flow cytometry. As a result , it was observed that stimulation with LPS and DSP30 led to loss of stress and suppressing ability , respectively, while simultaneous stimulation with LPS and DSP30 resulted in maintenance. Such modulations in immunosuppression were corroborated when assessing modulations in gene expression , given that the stimulus induced by LPS and DSP30 in increased expression of TGFb and IL1 , respectively. Then , the effect of the same experimental conditions inducing proliferation of MTC to be measured changes in the amount of cells in a High Content Screening equipment (HCS ) was measured . As a result , it was observed that only the DSP30 treatment was able to significantly increase the amount of cells, phenomenon to be measured supported DNA synthesis through the use of a commercial product followed by analysis by flow cytometry . In order to evaluate possible modulations in NF-kB pathway , CTM stimulated with LPS or DSP30 were subjected to chromatin immunoprecipitation assay , using antibodies specific to subunits RelA and RelB , and the immunoprecipitated DNA subjected to quantitative PCR with primers specific to the promoter regions of VCAM-1 gene. As a result , it was observed that stimulation with LPS increased the activity of RelA , while effects were not observed after stimulation with DSP30 . However , simultaneous stimulation with both ligands led to increased activity of RelA and RelB . When these conditions are evaluated in an assay in HCS immunofluorescence analysis , we observed higher levels of RelB protein in the cytoplasm of cells treated with DSP30 , suggesting an increase in their formation. Although the molecular mechanisms underlying the observed results still require further elucidation , our work indicates that stimulation of MSC with DSP30 can bring benefits in terms of enhancing immunosuppression and cell proliferation , and prevent loss of immunosuppression resulting from the interaction with LPS . These results can serve as guidelines for the improvement of immunotherapies using CTM bone marrow , especially in cases of patients with infections caused by pathogens.

As células-tronco de pluripotência induzida (iPSC) representam uma fonte de maior disponibilidade para obtenção de células estromais mesenquimais (MSC). Além disso, as células mesenquimais derivadas de iPSC, as MSC-like, demonstram in vitro uma atividade parácrina e uma taxa de proliferação que as apontam como uma candidata em potencial à terapia celular. Em paralelo, a terapia celular dispõe das propriedades terapêuticas das células estromais mesenquimais do cordão umbilical (UC-MSC), uma população celular de fácil isolamento, rendimento notável, alta capacidade de proliferação e ausência de tumorigenecidade. Assim, perante a relevância das iPSC como fonte alternativa para obtenção de MSC e do desempenho in vitro demonstrado pelas MSC-like, tornou-se necessário a comparação destas com as UC-MSC. Para tanto, iPSC reprogramadas a partir de células mononucleares do sangue periférico (iPS-PBMC) foram diferenciadas em MSC-like e estas por sua vez foram caracterizadas, segundo à aderência ao plástico, expressão de genes e proteínas de pluripotência, expressão de antígenos de superfície CD73, CD90, CD105, CD14, CD19, CD34, CD45 e HLA-DR; capacidade de diferenciação in vitro em adipócitos e osteócitos e posteriormente comparadas as UC-MSC frente a capacidade de proliferação e imunomodulação. As MSC-like obtidas mostraram-se aderentes ao plástico, não pluripotentes e com morfologia fibroblastoide. Demonstraram um perfil imunofenotípico negativo (menos de 2% de células positivas) para marcadores hematopoéticos e HLA-DR, mais de 90% para CD73 e CD90 e menos de 80% para CD105. Ademais, exibiram capacidade de diferenciação osteogênica e adipogênica. Quando comparadas às UC-MSC, em relação à capacidade de proliferação, as MSC-like apresentaram uma taxa de proliferação duas vezes menor. A comparação da capacidade imunomodulatória entre as duas linhagens demonstrou que as UC-MSC foram capazes de conter a proliferação de linfócitos T CD8+ mas não de linfócitos T CD4+. As MSC-like não foram capazes de conter a proliferação de ambas as populações de linfócitos. Os resultados indicam que o protocolo de indução utilizado foi capaz de gerar MSC-like com antígenos de superfície clássico em mesenquimais, baixa expressão de marcadores de pluripotência, hematopoéticos e HLA-DR e com habilidade de se diferenciar em linhagens mesodérmicas, porém, com menor capacidade de proliferação e ausência de propriedades imunomodulatórias. A funcionalidade das MSC-like geradas neste trabalho pode ser proveniente de fatores genéticos e epigenéticos do doador e pelas metodologias de reprogramação da célula somática à iPSC, bem como pela indução da iPSC à MSC. A investigação futura destes fatores pode contribuir para a obtenção de MSC-like funcionalmente semelhante às UC-MSC. / Induced pluripotent stem cells (iPSC) are an easily available mesenchymal stromal cell (MSC) source. Moreover, iPSC-derived mesenchymal cells (MSC-like) demonstrated an in vitro proliferation rate and paracrine activity that make them a potential candidate for cell therapy. Currently the cell therapy uses the therapeutic properties of umbilical cord-derived mesenchymal cells (UC-MSC), an effortlessly isolated cell population with remarkable yield, high proliferation capacity, and absence of tumorigenecity. Thus, considering the iPSC relevance as an alternative MSC source and their in vitro performance, it has become necessary to compare them with UC-MSC. The iPSC reprogrammed from peripheral blood mononuclear cells (iPS-PBMC) were differentiated in MSC-like and these cells were characterized according their adherence to plastic; pluripotency genes and proteins expression; surface antigens expression such CD73, CD90, CD105, CD14, CD19, CD34, CD45, and HLA-DR; in vitro differentiation capacity into adipocytes and osteocytes; and were compared with the UC-MSC proliferation and immunomodulation capacity. The obtained MSC-like were adherent to plastic, not pluripotent, and with fibroblastoid morphology. They demonstrated an immunophenotypic profile with less than 2% hematopoietic and HLA-DR positive cell markers, over 90% of CD73 and CD90, and less than 80% were CD105 positives. They also exhibited osteogenic and adipogenic differentiation capacity. When proliferation rate was compared between the two cell lineages, MSC-like showed a proliferation rate twice smaller than UC-MSC. The UC-MSC immunomodulatory activity contained the proliferation of T CD8+ lymphocytes but did not of T CD4+. MSC-like did not show immunomodulatory activity in the proliferation of CD4+ and CD8+. These results allow the assumption that the applied induction protocol was able to generate MSC-like with the classic mesenchymal surface markers, low pluripotency, hematopoietic, and HLA-DR surface markers expression and with mesodermal lineage differentiation potential, however, with lower proliferation rate and absence of immunomodulatory properties. The MSC-like functionality could be influenced by donor genetic and epigenetic factors as well as by as well as the methodologies of reprogramming of somatic cells to the iPSC and the induction of iPSC to the mesenchymal phenotype. These influential factors should be investigated in deep detail in order to make the generated MSC-like functionally similar to UC-MSC.

Imiquimod é uma imidazoquinolina, agonista do TLR-7, ativador de células dendríticas (DC) e indutor da transcrição de diversas citocinas. O objetivo deste estudo é avaliar o crescimento tumoral, a formação de metástases em órgãos internos, a atividade do sistema imune e o tipo de morte celular induzido devido ao tratamento tópico. Camundongos foram inoculados com células de melanoma murino B16F10. O fármaco, na dose de 5mg, foi aplicado no local da inoculação uma vez por dia até o fim do experimento. Foram estudados quatro grupos experimentais, dois inoculado com células tumorais, sendo um tratado e outro não, e outros dois grupos, um recebeu somente o tratamento com o fármaco e o outro não recebeu tratamento. Os animais foram pesados e seus tumores medidos periodicamente. Exemplares dos grupos foram sacrificados em quatro tempos diferentes, imediatamente submetidos à necropsia para a análise de massas tumorais por citometria de fluxo com caspase-3 e anexina-v para investigar a indução de apoptose e/ ou necrose tumoral, e remoção do tumor, pele, Baço, linfonodo e pulmão, que foram fixados, inclusos em parafina, cortados e corados com HE, para análise histológica. / Imiquimod is a TLR-7 agonist and activator of dendritic cells (DC), and induces transcription of several cytokines. This study`s objective is to evaluate tumor growth, development of metastasis within internal organs and the immune system`s function, due to the topical treatment. Two groups of C57BL/6J mice were inoculated with B16F10 melanoma cells subcutaneously, and only one of the groups was treated, applied topically at the injection site once a day, followed by a second round of two groups, one treated and the other as a healthy group. Every two tumors and weight were measured. In order to observe the tumor progression and treatment effects, groups of animals were sacrificed on four days apart and immediately submitted to necropsy for a tumor analysis by flow cytometry, to evaluate the induction of apoptosis and necrosis, and to macroscopically observe the tumor development within internal organs, vascularization and posterior inclusion of the organs in paraffin for histological analysis. Tumor, skin, spleen, limph node and lung were colored with HE for histological analysis of migrating immune system cells and tumoral cells in the organs and describing its integrity.

Os macrófagos são células fagocíticas derivadas dos monócitos sanguíneos produzidos pela medula óssea e estão diretamente envolvidos em um conjunto de processos biológicos vitais. Durante o repasto sanguíneo, fêmeas do mosquito Aedes aegypti inoculam saliva na pele de seu hospedeiro vertebrado e, devido sua localização estratégica nos tecidos, os macrófagos estão dentre as primeiras células residentes a ser exposta a saliva. Apesar dessa evidência fisiológica, pouco se sabe sobre os efeitos imunomoduladores da saliva desse mosquito sobre os macrófagos. Assim, o objetivo deste projeto foi avaliar o papel dos componentes salivares de A. aegypti em macrófagos murinos ativados por LPS+IFN-&#947; e o potencial efeito de uma proteína salivar no desenvolvimento da encefalomielite autoimune experimental (EAE), um modelo experimental para estudo da esclerose múltipla. Em conclusão, o EGS de A. aegypti apresenta efeito imunomodulatório sobre macrófagos peritoneais ativados com LPS e IFN-&#947;. Além disso, nossos resultados sugerem que a proteína identificada com possível inibidor da IL-6 produzida por macrófagos ativados pode ser capaz de diminuir a polarização de respostas Th1 e Th17, afetando assim o desenvolvimento da EAE. / Macrophages are phagocytic cells derived from blood monocytes produced by the bone marrow and are directly engaged in a set of vital biological processes. During blood feeding, Aedes aegypti female mosquitoes inoculate saliva into the skin of their vertebrate hosts and, due to its strategic location in the tissues, macrophages are possibly among the first resident cells to be exposed to saliva. Despite this physiological evidence, little is known about the immunomodulatory effects of this mosquitos saliva on macrophages. Thus, the aim of this study was to evaluate the role of A. aegypti salivary components in LPS/IFN-&#947;-activated murine macrophages and the potential effect of a salivary protein on the development of experimental autoimmune encephalomyelitis (EAE), an experimental model for multiple sclerosis studies. In conclusion, A. aegypti SGE presents immunomodulatory effect on peritoneal macrophages activated by LPS/IFN-&#947;. Furthermore, our results suggest that the protein identified as a putative inhibitor of IL-6 produced by activated macrophages may be able to down modulate the polarization of Th1 and Th17 responses, thus affecting the development of EAE.

O perfil de ativação do NF-B foi avaliado em biópsias de 47 pacientes com diagnóstico clínico e laboratorial de hanseníase, seguidos no Ambulatório de Hanseníase do Centro de Referência Nacional em Dermatologia Tropical com Ênfase em Hanseníase do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo. O índice de ativação NF-B foi calculado de acordo com a porcentagem de positividade na histoquímica Southwestern. Índice de ativação NF-B >1 foi considerado representativo de ativação. Trinta e seis por cento dos pacientes apresentaram NF-B ativado na biópsia, o que foi mais frequente em multibacilares (54,6%) que em paucibacilares (20%), p=0,018. Hanseníase tuberculóide esteve associada com ausência de NF-B ativado (p=0,039). Forma dimorfa e neural pura estiveram associadas com ativação de NF-B, com odds ratio de 44 (p=0,014) e 30 (p=0,029), respectivamente. A ativação correlacionou-se com detecção in situ de fator de necrose tumoral por imuno-histoquímica (p=0,0064). Observou-se grande variação da ativação do NF-B nas formas clínicas de hanseníase. Ativação foi nula em granulomas de hanseníase tuberculóide, que representa a reação inflamatória mais efetiva contra o M. leprae. A ativação do NF-B ocorreu predominantemente em formas clínicas com maior suscetibilidade (multibacilares) e instabilidade imunológica (dimorfa), indicando condição favorável à infecção pela ativação do NF-B, por seus efeitos antiapoptóticos, visto que o bacilo depende das funções celulares para sobreviver. / NF-B activation profile was evaluated in cutaneous biopsies from 47 patients with clinical and laboratorial diagnosis of leprosy followed at a referral center for treatment of leprosy, the leprosy outpatient clinic of the Hospital of Clinics of Faculty of Medicine of Ribeirão Preto University of São Paulo. NF-B activation index (ranging from 0 to 4) was calculated according to the percentage of positivity in Southwestern histochemistry. Activation index >1 was considered representative of activation. Thirty-six percent of patients presented activated NF-B, which was more frequent in multibacillary (54,6%) than in paucibacillary (20%), p=.018. Tuberculoid leprosy was associated with absence of activated NF-B (p=.039). Borderline and pure neural leprosy clinical forms were associated with NF-B activation, with odds ratio of 44 (p=.014) and 30 (p=.029), respectively. NF-B activation was correlated with in situ detection of tumor necrosis factor- by immunohistochemistry (p=.0064). Great variation of NF-B activation was found in clinical forms of leprosy. Activation was absent in tuberculoid leprosys granulomas, which represent effective inflammatory reaction pattern against M. leprae. NF-B activation was present in clinical forms with increased susceptibility (multibacillary) and immunological instability (borderline), which suggests favorable conditions towards infection, probably due to the anti-apoptotic effects of NF-B, since bacillary survival is dependent of cellular functions.

A desnutrição proteico-energética (DPE) altera a hemopoese e, portanto, a geração de células imunológicas, bem como compromete o sistema imune. Desta forma, indivíduos desnutridos apresentam maior susceptibilidade a infecções. As células tronco mesenquimais (CTMs) possuem propriedades imunomodulatórias e são importantes na formação do estroma medular que sustenta a hemopoese. Visto que a L-glutamina (GLUT) é o aminoácido condicionalmente essencial mais consumido por CTMs, e que também apresenta capacidade imunomoduladora, investigou-se, neste trabalho, se a GLUT exerceria efeito sobre aspectos imunomodulatórios das CTMs em um modelo experimental de DPE. Para tanto, utilizou-se camundongos da linhagem BALB/c, os quais receberam rações normoproteica ou hipoproteica isocalóricas contendo, respectivamente, 12% e 2% de proteína por um período de 5 semanas. Após o isolamento e a caracterização de CTMs provenientes dos grupos controle (CTMct) e desnutrido (CTMdesn), cultivou-se essas células em 0, 0,6, 2 e 10mM GLUT, a fim de determinar a influência deste aminoácido sobre a expressão de fatores de transcrição e produção de citocinas por CTMct e CTMdesn. Adicionalmente, avaliou-se o efeito dos sobrenadantes das culturas de CTMct e CTMdesn sobre a proliferação e produção de citocinas por macrófagos e linfócitos esplênicos. Os animais desnutridos apresentaram anemia, leucopenia, hipoplasia medular e diminuição na concentração de proteínas séricas, albumina e préa-lbumina. A DPE não modificou a morfologia e o fenótipo das CTMs, bem como não alterou a expressão de proteínas reguladoras do ciclo celular. Por outro lado, a expressão de NFkB e STAT-3 e a produção de IL-1&#946;, IL-6, IL-10 e TGF-&#946; por CTMs foram alteradas pela DPE e variaram de acordo com as concentrações de GLUT testadas. O aumento na concentração de GLUT diminuiu a expressão de NFkB e induziu a expressão de STAT-3 por CTMs obtidas de ambos os grupos. Quanto a produção de citocinas por essas células, observou-se uma diminuição nos níveis de IL-&#946; e IL-6 e uma elevação nos níveis de IL-10 e TGF-&#946; com o aumento na concentração de GLUT. Variações na concentração desse aminoácido não alteraram a produção de IL-17 ou IFN-&#947; por CTMct e CTMdesn. Ademais, a concentração de GLUT alterou, de forma diretamente proporcional, a taxa de proliferação das CTMs. Os meios condicionados de CTMct e CTMdesn diminuíram a proliferação de macrófagos e linfócitos esplênicos estimulados com LPS, induziram aumento na produção da citocina antiinflamatória IL-10 por ambos os tipos celulares e diminuíram a produção das citocinas pró-inflamatórias IL-12 e TNF-&#945; por macrófagos e IL-17 por linfócitos. Portanto, conclui-se que a GLUT possui efeito sobre a proliferação das CTMs, bem como a capacidade de imunomodular estas células. / Protein-energy malnutrition (PEM) alters hemopoiesis and, therefore, the generation of immune cells, and compromises the immune system. In this way, malnourished individuals are more susceptible to infections. Mesenchymal stem cells (MSCs) have immunomodulatory properties and are important in the formation of bone marrow stroma that supports hemopoiesis. Since L-glutamine (GLUT) is a conditionally essential amino acid, which is most consumed by MSCs, and present immunomodulatory capacity, this work investigated whether GLUT would have an effect on immunomodulatory aspects of MSCs in a PEM experimental model. For this purpose, BALB/c mice were used, which received isocaloric normoproteic or hypoproteic diets, containing respectively, 12% and 2% of protein for a period of 5 weeks. After isolation and characterization of MSCs from control (MSCct) and malnourished (MSCmaln) groups, these cells were cultured with 0, 0.6, 2 and GLUT 10mM in order to determine the influence of this amino acid on the expression of transcription factors and cytokine production by MSCct and MSCmaln. Besides that, the effect of MSCct and MSCmaln culture supernatants on proliferation and cytokine production by macrophages and splenic lymphocytes was evaluated. Malnourished animals presented anemia, leucopenia, marrow hypoplasia and decreased concentration of serum proteins, albumin and prealbumin. PEM did not change morphology and phenotype of MSCs or altered the expression of cell cycle regulatory proteins. On the other hand, the expression of NFkB and STAT-3 and the production of IL-1&#946;, IL-6, IL-10 and TGF-&#946; by MSCs were modified by PEM and varied according to the tested GLUT concentrations. An increase in GLUT concentration decreased NFkB expression and induced STAT-3 expression by MSCs obtained from both groups. Regarding the production of cytokines by these cells, an increase in GLUT concentration resulted in decreased IL-1&#946; and IL-6 levels and increased IL- 10 and TGF-&#946; levels. Changes in the concentration of this aminoacid did not alter IL- 17 or IFN-&#947; production by MSCct and MSCmaln. Furthermore, the concentration of GLUT changed, in direct proportion, the proliferation of MSCs. The conditioned media MSCct and MSCmaln decreased the proliferation of macrophages and splenic lymphocytes stimulated with LPS, induced an increase in the production of the antiinflammatory cytokine IL-10 by both cell types, and decreased the production of proinflammatory cytokines IL-12 and TNF-&#945; by macrophages and IL-17 by lymphocytes. Therefore, it can be concluded that GLUT has an effect on the proliferation of MSCs and it has the capacity to immunomodulate these cells.

Im medizinischen Alltag steht Gewebeersatz oftmals nicht ausreichend zur Verfügung. Tissue Engineering (TE) bietet eine wertvolle Methode, um aus wenigen Zellen des gewünschten Gewebes größere Strukturen herzustellen. Aber selbst autologe über Tissue Engineering gebildete Gewebe können einer Abstoßung unterliegen. Diese Arbeit befaßt sich daher mit der Immunmodulation von TE-Transplantaten. Chondrocyten wurden aus Ohrknorpel von Neuseeland-Kaninchen enzymatisch isoliert, in Zellkultur vermehrt und wurden a) in allogenem Fibrinkleber oder b) in Agarose suspendiert, dann in ein Scaffold eingebracht. 24 Transplantate wurden zusätzlich mit einer Polyelectrolyt Kapsel versehen. Nativer Ohrknorpel diente als Kontrolle. So entstanden n=84 Transplantate, 14 autologe Transplantate pro Kaninchen: jeweils 2 native, 4 Fibrin-, 4 Agarose- und 4 Kapsel-Transplantate. Die 1cm x 1cm x 0.2 cm großen Transplantate wurden subkutan auf dem Rücken der Kaninchen implantiert. Eine der in zwei Gruppen aufgeteilten Kaninchen erhielt eine 3 wöchige i. m. Gabe von Methylprednisolon. 70 Transplantate wurden in 5 Versuchstiere implantiert. 14 Transplantate wurden in vitro ernährt. 2 Kaninchen wurden nach 6 Wochen getötet und die Transplantate entnommen. 3 Kaninchen wurden nach 12 Wochen getötet. Im Anschluß wurden die Transplantate histologisch untersucht. Die Transplantate der nicht immunmodulierten Tiere konnten zu den Entnahmezeitpunkten 6 und 12 Wochen kaum aus den Implantationsorten entnommen werden: sie waren nur schwer vom umliegenden Gewebe zu unterscheiden. Die Transplantate der immunmodulierten Tiere blieben in ihrer Größe konstant. Histologisch zeigte sich bei den nicht immunmodulierten Tieren nach 6 Wochen massive zelluläre Infiltration, nach 12 Wochen die Einwachsung von Fibrozyten und kaum noch Knorpel- oder Knochengewebe. In der Gruppe der immunmodulierten Tiere konnte keine bis eine geringe Inflammation festgestellt werden. Bis auf die nativen Transplantate, war in dieser Gruppe bei allen Transplantaten vitaler trabekulärer Knochen mit hämatopoetisch aktivem Knochenmark zu beobachten. Der Vergleich der Gruppen Nicht immunmoduliert und Immunmoduliert war hinsichtlich der Immunreaktionen statistisch signifikant (Chi-Quadrat Test nach Pearson). / Tissue replacement is a common need in clinical medicine. And often there is too less tissue available. Tissue Engineering (TE) is a valuable measure to solve this problem: only a few cells of the origin tissue are cultivated and new threedimensional structures are built. But even autologeously built tissues can be rejected by the host. Therefore, this investigation is about immunomodulation of TE-transplants. Chondrocytes of ear cartilage of New Zealand rabbits were enzymatically isolated, amplified and were solved in a) allogenic fibrin glue or b) agaraose. Then they were taken into scaffolds. 24 transplants were encapsulated by a polyelectrolyte-complex membrane. Native cartilage served as control. There were formed n=84 transplants, 14 autologeous transplant per rabbit: each with 2 native, 4 fibrin-, 4 agarose- and 4 capsule-transplants. The tranplants size was 1 cm x 1 cm x 0.2 cm. The rabbits were divided into two groups one of the group has been treated with methylprednisolone IM for 3 weeks. 70 transplants were taken into the ridge of 5 rabbits. 14 transplants were cultivated in vitro. 2 rabbits were sacrificed after 6 weeks and 3 rabbits after 12 weeks. Afterwards the transplants were investigated histologically. The transplants of the non-immunomodulated group could hardly be separated from the surrounding tissue, whereas the transplants of the immunomodulated group remained constant in seize and shape. Histologically, the non-immunomodulated tranplants underwent cellular (granulocytes) infiltration after 6 weeks, respectively ingrowth of fibrocytes after 12 weeks. No cartilage or bone could was evident. In the immunomodulated group no signs of inflammation were identifiable after 6 and 12 weeks. In all transplants of this group bone formation with hematopoietically-active bone marrow was detectable. The native control-cartilage had not become bone, inflammation wasnot evident there. The difference of the two groups non-immunomodulated and immunomodulated was statistically significant concerning th degree of inflammation. (Chi-square-test).