Orientador: Áureo Evangelista Santana / Banca: Mirela Tinucci Costa / Banca: Ana Paula Massae Nakage Canesin / Banca: Maura Rosane Valério Ikoma / Banca: Paulo César Ciarlini / Resumo: Considerando a importância da origem celular do linfoma e as alteragOes decorrentes da evolugäo desta neoplasia e aquelas ocorridas corn o emprego da quimioterapia, avaliaram-se 27 câes corn diagnOstico de linfoma, que foram submetidos indugäo da remiss5o, corn o protocolo de Madison-Wisconsin. No momento do diagnOstico e uma semana apOs cada uma das oito sessOes quimioterapicas, realizou-se hemograma e analise citomètrica das subpopulagOes linfocitarias CD5+CD4+, CD5+CD8+ e CD45+CD21+ no sangue periferico e, na medula Ossea as avaliagOes foram realizadas antes e apOs o tratamento. Observou-se um major nOmero de animais machos, das ragas Rottweiler e sem raga definida, de meia idade e grande porte, que apresentaram com major freqUéricia, linfoma multicêntrico em estadio Vb. Com relagäo a origem celular do linfoma, notou-se predominancian de linfoma B. No eritrograma, observou-se anemia normocitca normocrOmica na maioria dos animais durante todo o tratamento. No leucograma, notou-se em alguns animais, no momento do diagnOstico, a presenga de leucocitose por neutrofilia. Alem disso, houve uma consideravel deplegâo de linfOcitos no sangue circulante, assim como das subpopulagOes CD5+CD8+ e CD45+CD21+, durante todo o tratamento e, observou¬se tambem, com menor intensidade, uma deplegäo da subpopulagâo CD5+CD4+. Na medula Ossea observou-se deplegâo da subpopulagäo CD45+CD21+. Assim, a imunidade humoral e imunidade mediada por calulas ficam prejudicadas corn a evolugao do linfoma e corn o emprego da quimioterapia. / Abstract: Considering the importance of the lymphoma cellular origin and the decurrent alterations of the evolution of this neoplasia and those occured ones with the chemotherapy, was evaluated 27 dogs with diagnosis of lymphoma. that they were submitted to the induction of remission, with the protocol of Madison-Wisconsin. At the moment of the diagnosis and one week after each one of the eight chemotherapic sessions, became fullfilled hemogram and citometric analysis of CD5+CD4+, CD5+CD8+ e CD45+CD21+ lymphocyte subpopulations in peripheral blood and, bone marrow evaluations were carried through before and after the treatment. Was observed a bigger number of male animals, Rottweiler breeder and without defined race, of half age and big tall, that had presented more frequently, multicentric lymphoma in Vb stage. With regard to the lymphoma cellular origin, the B cell lymphoma was noticed. In the eritrogram, was observed in the majority of the animals anemia normocitic normocromic during the treatment. In the leucogram, was noticed in some animals, at the moment of the diagnosis, the presence of leukocitosis with neutrofilia. Moreover, had a considerable depletion of lymphocytes in circulating blood, as well as of CD5+CD8+ e CD45+CD21+ subpopulations, during all the treatment and, it was also observed , with lesser intensity, a depletion of CD5+CD4+ subpopulation. In the bone marrow was observed depletion of CD45 +CD21+ subpopulation. Thus, the humoral immunity and immunity mediated for cells are harmed with the evolution of lymphoma and the use of chemotherapy. / Doutor

Introdução: A micose fungóide foliculotrópica (MFF) é subtipo de linfoma cutâneo de células T que atinge especialmente o folículo piloso e parece ter prognóstico mais reservado. Informações clínicas sobre a população acometida por linfomas cutâneos no Brasil são escassas. O fenômeno de imunoprivilégio (IP) diz respeito à habilidade de alguns órgãos em permanecer protegidos contra reações inflamatórias. Tem sido sugerido que o folículo piloso normal represente um local de IP. Nesse estudo aventou-se a possibilidade de haver uma quebra no equilíbrio desse fenômeno na MFF, com alteração na expressão de moléculas do complexo maior de histocompatibilidade (MHC) e na expressão de MHC não-clássicos (HLA-G), com algum papel no mecanismo do foliculotropismo. Os objetivos foram: descrever o perfil clínico-epidemiológico de paciente com MFF, descrever a histologia e imunofenótipo dos casos de MFF e investigar os mecanismos envolvidos na predileção dos linfócitos atípicos pelo folículo piloso. Metodologia: Os prontuários de pacientes com diagnóstico de MFF provenientes do ambulatório de Linfomas Cutâneos da Faculdade de Medicina da Universidade de São Paulo (FMUSP) foram revisados (n=33). O material histológico de biópsias de pele dos pacientes com MFF provenientes dos ambulatórios de Linfomas Cutâneos da FMUSP e da Northwestern University foi analisado por meio de escala semi-quantitativa (n=43). Na coloração de hematoxilina-eosina foram avaliados os seguintes parâmetros: infiltrado neoplásico epidérmico, infiltrado neoplásico dérmico, presença de acantose/espongiose, de mucinose folicular, de fibroplasia do tecido conjuntivo, de eosinófilos, de plasmócitos, o tamanho celular e o grau de dano folicular. Analisou-se a positividade do infiltrado neoplásico para os seguintes marcadores celulares: CD1a, CD56, TIA-1 e CD117. As expressões do complexo de histocompatibilidade HLA-G e do MHCII no infiltrado celular e no epitélio folicular foram investigadas no grupo de pacientes com MFF e comparadas com o grupo de pacientes com micose fungóide clássica (MFC) e pele normal. A expressão do complexo de histocompatibilidade MHCII também foi investigada na epiderme. Resultados: A mediana das idades ao diagnóstico foi de 46 anos com 61% dos pacientes classificados como portadores de estágio avançado. A proporção entre homens e mulheres foi de 1,54 e a mediana de duração de doença antes do diagnóstico foi de três anos. Ao final de três anos de acompanhamento, 67% dos casos estavam vivos com a doença. O prurido foi relatado em 82% dos casos. Histologicamente, encontrou-se associação entre a presença de eosinófilos e de plasmócitos com fibroplasia do tecido conjuntivo. Observou-se diminuição da expressão do HLA-G no epitélio folicular nos grupos MFF e MFC em relação à pele normal. Observou-se aumento da expressão do MHCII no epitélio folicular na MFF em comparação à pele normal e na epiderme na MFC quando comparada à MFF. Conclusões: Dados clínicos da população estudada assemelharam-se aos dados da literatura como estágio avançado ao diagnóstico e prognóstico reservado. Cerca de metade dos casos de MFF foi positiva para o marcador citotóxico TIA-1. Demonstrou-se haver um provável colapso do imunoprivilégio folicular nos linfomas cutâneos com expressão diminuída de moléculas HLA-G em comparação à pele normal. O aumento da expressão do MHCII poderia relaciona-se com o foliculotropismo na MFF e com o epidermotropismo na MFC / Introduction: Folliculotropic mycosis fungoides (FMF) is a subtype of cutaneous T cells lymphoma affecting mainly the hair follicle and seems to have a less favorable prognosis. Clinical information on the population affected by cutaneous lymphomas in Brazil is scarce. The immune privilege (IP) phenomenon involves the ability of some body sites remaining protected from inflammatory reactions. It has been suggested that normal hair follicle represents an IP location. We hypothesized that a collapse of this phenomenon would occur in FMF, with changes in the expression of classical major histocompatibility molecules (MHC) and in the expression of nonclassical MHC molecules (HLA-G) with a role in folliculotropism mechanism. The objectives of this study were to describe the clinical and epidemiological profile of patients with MFF, describe the histology and immunophenotype of cases of MFF and investigate the expression of MHC molecules. Methods: The medical records of patients from the outpatient Cutaneous Lymphoma Clinic of the University of Sao Paulo Medical School (FMUSP) diagnosed with MFF were reviewed (n = 33). The histological material from skin biopsies of patients with MFF from the Cutaneous Lymphomas Clinic of FMUSP and Northwestern University was stained and evaluated by semi-quantitative scale. In hematoxylin-eosin staining the following parameters were evaluated: epidermal neoplastic infiltrate, dermal neoplastic infiltrate, acanthosis/spongiosis, follicular mucinosis, connective tissue fibroplasia, presence of eosinophils and plasma cells, cell size and degree of follicular damage. We analyzed the positivity of the neoplastic infiltrate for the following cellular markers: CD1a, CD56, TIA-1, and CD117. Finally, the expression of histocompatibility complex HLA-G and MHC II in the neoplastic infiltrate and the follicular epithelium was investigated in MFF group and compared to patients with classical mycosis fungoides (CMF) and to normal skin. MHCII expression in the epidermis was also investigated. Results: The median age at diagnosis was 46 years, with 61% classified as advanced stage disease. The ratio between men and women was 1.54, the median disease duration before diagnosis was three years. After a median time of follow-up of three years, 67% of the cases were alive with disease. Pruritus was reported in 82% of the cases. Histologically, an association between the presence of eosinophils and plasma cells with fibroplasia of collagen was found. There was a decrease of HLA-G expression in the follicular epithelium in MFF and CMF groups compared to normal skin. There was an increase of MHCII expression in the follicular epithelium in FMF group compared to normal skin. There was an increased MHCII expression in the epidermis in CMF compared to FMF. Conclusions: Clinical data from the studied population were similar to the previous literature in relation to advanced stage at diagnosis and prognosis. There was a relationship between the presence of eosinophils and plasma cells in neoplastic infiltrate and the connective tissue fibrosis. Near half of the cases of FMF was positive for the cytotoxic marker TIA-1. A possible hair follicle immune privilege collapse was suggested by a decreased expression of HLA-G molecules in FMF and CMF compared to normal skin. Increased MHCII expression appears to be involved in the folliculotropism of FMF and epidermotropism of CMF

INTRODUÇÃO: As células-tronco mesenquimais são capazes de regenerar diferentes tipos de tecidos, no entanto, a maioria dos métodos para sua obtenção são invasivos. Recentemente, foi descoberta a existência destas células no sangue menstrual. OBJETIVO: Padronizar as técnicas de coleta e transporte do fluido menstrual, bem como a caracterização, isolamento, expansão e criopreservação de células-tronco do fluido menstrual e avaliar a disponibilidade de células tronco mesenquimais no fluido menstrual. MÉTODOS: No período de agosto de 2011 a março de 2012 foram selecionadas 20 voluntárias com ciclo menstrual regular, sem doença ginecológica. O fluido menstrual foi coletado no dia de maior fluxo e submetido a imunofenotipagem e cultivo celular. Foram realizadas duas passagens em meio de cultura até atingir semi-confluência das células-tronco, as quais foram, em seguida, criopreservadas. RESULTADOS: Os parâmetros analisados apresentaram os seguintes valores médios: volume de fluido menstrual 6,90±5,60mL; tempo de transporte 17,20±5,50h; número de células totais 3,95 x106±3,88 x106 com 76,05%±24,57 de células viáveis. Após a cultura, as células mesenquimais aumentaram de 0,14%±0,26 para 96,19%±2,14. Na primeira passagem de cultura, após 15 a 21 dias, as colônias formaram grupos que atingiram a confluência, que a partir da segunda passagem ocorreu em cerca de 3 dias. As células-tronco mesenquimais criopreservadas eram viáveis. CONCLUSÃO: As células-tronco do fluido menstrual podem ser obtidas sem métodos invasivos. O fluido menstrual pode ser transportado em condições ideais de temperatura até 24 horas após a coleta. As células tronco mesenquimais podem ser caracterizadas por imunofenotipagem, isoladas, cultivadas e expandidas e, em seguida, criopreservadas. O fluido menstrual contém células tronco mesenquimais viáveis e apropriadas para cultivo / INTRODUCTION: Mesenchymal stem cells may renovate different tissues, but techniques to obtain these cells are invasive. Recently, those cells were detected in menstrual blood. OBJECTIVE: Patterning techniques of collection, transportation, characterization, isolation, expansion and cryopreservation of stem cells in menstrual fluid. METHODS: From August 2011 to March 2012 twenty volunteers were selected with regular menstrual cycle without gynecological diseases. They collected menstrual fluid on the most intense flux day to analysis by immunophenotyping and cellular culture. Culture was made in 2 stages until reached semi-confluence of stem cells and these cells were cryopreserved. RESULTS: Average of menstrual fluid volume was 6,90±5,60mL, transportation time was 17,20±5,50h, and total number of cells was 3,95 x106±3,88 x106 witch 76,05%±24,57 were viables. After culture, mesenchymal stem cells increased from 0,14%±0,26 to 96,19%±2,14. After 15 to 21 days of culture in first passage, colonies formed clusters that reached confluence. In second passage, it happens after 3 days of culture and stem cells were cryopreserved. CONCLUSION: Stem cells of menstrual fluid may be easily obtained without invasive methods. Menstrual fluid can be transported in good conditions of temperature up to 24 hours of collection. Mesenchymal stem cells of menstrual fluid may be characterized by immunophenotyping, as well as it is possible to isolated, cultivate and cryopreserved them. Menstrual fluid has viable and proper for culture mesenchymal stem cells

Orientador: Edgard Graner / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-19T22:05:51Z (GMT). No. of bitstreams: 1 Almeida_LucianaYamamotode_M.pdf: 2240916 bytes, checksum: ea05e547ca468707eb304c81344a3fbf (MD5) Previous issue date: 2012 / Resumo: A enzima ácido graxo sintase (FASN), responsável pela síntese endógena de ácidos graxos, está presente em grande quantidade em diversas neoplasias malignas e lesões pré-malignas. Sua inibição farmacológica parece estar relacionada com a morte celular seletiva de células tumorais. Orlistat (Xenical®), uma droga anti-obesidade, que possui também propriedades anti-neoplásicas por inibir irreversivelmente FASN, sendo estes efeitos claramente demonstrados em cânceres de mama, próstata, estômago e melanoma. Embora as propriedades antitumorais do Orlistat ocorram devido a um efeito direto sobre as células malignas, até o momento, possíveis mecanismos indiretos sobre o sistema imunológico não foram estudados. Células imunes, como linfócitos T CD8+ (LTCD8+), células natural killer (NK) e células dendríticas (CD), estão envolvidas no processo de defesa antitumoral, por promover a morte de células neoplásicas. Como não há informações na literatura sobre uma possível relação entre FASN e o sistema imunológico, nosso trabalho teve como objetivo principal estudar o efeito da inibição da enzima FASN com Orlistat sobre o fenótipo e porcentagem de LTCD8+, células NK e CDs presentes nos tumores primários e suas respectivas metástases para linfonodos mediastínicos, em modelo de melanoma murino (B16-F10 / C57/Bl6). Adicionalmente, avaliou-se o estado de ativação das CDs CD11c+ presentes nos linfonodos mediastínicos metastáticos, através da expressão de MHC I (complexo maior de histocompatibilidade de classe I) e das moléculas co-estimulatórias CD80 e CD86 na superfície destas células. Através de citometria de fluxo, foram analisadas as porcentagem de LTs CD3+CD8+, células NK CD3-CD49b+ e CDs CD11c+ nos tumores e metástases. A ativação dos LTCD8+ e células NK foi avaliada pela expressão de granzima b e perforina em RNA total obtido dos linfonodos mediastínicos metastáticos, através da reação em cadeia da polimerase em tempo real (qRT-PCR). Além disso, as células NK presentes nas metástases linfonodais também foram avaliadas quanto à expressão do receptor inibitório Ly49A, através de citometria de fluxo. Após o tratamento com Orlistat, houve redução de cerca de 30 % na quantidade de metástases, em comparação com os grupos controle. Os tumores primários do grupo controle apresentaram um baixo percentual de LTs CD3+CD8+ (0,36%) e de células NK CD3-CD49b+ (0,27%). No grupo tratado, não foi possível detectar a presença destas células na massa tumoral, sugerindo uma supressão desta população pelo Orlistat. Além disso, CDs CD11c+ não puderam ser avaliadas nestes tumores. Nos linfonodos mediastínicos metastáticos, houve um discreto aumento de CDs CD11c+, acompanhado de menor expressão das proteínas de superfície MHC I, CD80 e CD86, além de uma redução percentual das células T CD3+CD8+ e NK CD3-CD49b+. A expressão de RNAs mensageiros para granzima b e perforina também foi menor no grupo de camundongos tratados. Finalmente, em relação a Ly49A, sua expressão foi maior nas NKs dos linfonodos metastáticos de animais tratados. Em conjunto, nossos resultados indicam que a inibição de FASN com Orlistat interfere no fenótipo, porcentagem e estado de ativação das células imunológicas intratumorais e dos linfonodos metastáticos, sugerindo possível atividade imunossupressora / Abstract: Fatty acid synthase (FASN), the enzyme responsible for the endogenous synthesis of fatty acids, is highly expressed in several malignant neoplasms and premalignant lesions. Its pharmacological inhibition promotes apoptosis in tumor cells. Orlistat (Xenical ®), an anti-obesity drug, has anti-neoplastic properties by irreversibly inhibiting FASN, which were demonstrated in malignant neoplasms from breast, prostate and stomach and melanoma. Although the known antitumor properties of Orlistat are consequence of a direct effect on malignant cells, indirect mechanisms on the immune system were not described. Immune cells, such as CD8+ T lymphocytes (CD8+ TL), natural killer (NK) and dendritic cells (DC) are involved in the defense against cancer cells. Since there is no information in literature about a relationship between FASN activity and the immune system, our work aimed to study the effect of Orlistat on the phenotype and percentage of CD8+TL, NK and DC present in the primary tumors and their metastases to mediastinal lymph nodes in a experimental model of spontaneous melanoma metastasis (B16-F10 / C57/Bl6). Additionally, we evaluated the activation of CD11c+ DCs present in the metastatic mediastinal lymph nodes, through the expression of MHC I (major histocompatibility complex class I) and costimulatory molecules CD80 and CD86 on cell surface. By using flow cytometry, we analysed the effects of Orlistat on the percentage of CD3+CD8+ TLs, CD3-CD49b+ NK cells, and CD11c+ DCs in primary tumors and lymph node metastases. Activation of CD8+ TLs and NK cells was evaluated through the expression of granzyme b and perforin in the metastatic mediastinal lymph nodes by quantitative RT-PCR. In addition, NK cells present in lymph node metastases were also evaluated regarding the expression of Ly49A by flow cytometry. Orlistat was able to reduce in aproximately 30% the number of metastatic lymph nodes. Control primary tumors had a low percentage of CD3+CD8+ TLs (0.36%) and CD3-CD49b+ (0.27%), which were not detected in the treated tumors, suggesting a supression of this population. In addition, CD11c+ DCs could not be assessed in both treated and control tumors. Regarding metastatic lymph nodes, there was a slight increase of CD11c+ DCs, associated with a lower expression of the surface proteins MHC I, CD80 and CD86. CD3+CD8+ TLs and CD3-CD49b+ NK cells were reduced in the metastases from the treated animals. Moreover, the expression of granzyme b and perforin was lower in the metastases of treated mice. Finally, the expression of of Ly49A on NK cells was higher in metastatic lymph nodes of treated animals. Taken together, our results indicate that inhibition of FASN with Orlistat changes the phenotype, percentage and activation state of intratumoral and lymph node immune cells, suggesting a immunosuppressive activity / Mestrado / Estomatologia / Mestre em Estomatopatologia

Le myélome multiple (MM) est une hémopathie maligne caractérisée par la prolifération d’un clone plasmocytaire tumoral dans la moelle osseuse et d’une accumulation d’une immunoglobuline monoclonale dans le sérum et/ou les urines. La diversité des anomalies cytogénétiques, rendant la maladie plus ou moins agressive, et la variabilité de la réponse au traitement font du MM une maladie hétérogène. Le MM reste incurable dans la majorité des cas avec une médiane de survie de 5 à 7 ans. La rechute après traitement est due à la persistance de cellules tumorales au sein de la moelle osseuse, appelée maladie résiduelle ou en anglais « Minimal Residual Disease » (MRD). La cytométrie en flux multiparamétrique (CFM) est une technique sensible, simple et rapide qui permet d’identifier et de caractériser des cellules d’intérêt dans un échantillon biologique. C’est dans le but de simplifier le suivi de la MRD du MM que nous avons développé une solution complète basée sur la CFM. Cette solution comprend (i) la conception d’un panel à 5 couleurs, composés des anticorps (Ac) anti-CD38, anti-kappa et anti-lambda pour identifier les plasmocytes totaux et de deux pools d’Ac couplés au même fluorochrome (anti-CD19/anti-CD27, pool négatif et anti-CD56/anti-CD117/anti-CD200, pool positif) pour détecter les plasmocytes tumoraux ; (ii) le développement d’un préparateur afin d’automatiser l’ensemble des étapes de préparation de l’échantillon ; et (iii) l’automatisation de l’analyse des résultats de CFM grâce à un logiciel que nous avons créé. Cette solution simple et entièrement automatisée permet d’augmenter la reproductibilité et la productivité, de diminuer le coût du test, sans altérer la sensibilité ou la spécificité. En parallèle de ces travaux, nous avons construit un score de risque simple basé sur l’expression de gènes codant pour des protéines de surface (CD24, CD27, CD36 et CD302) permettant de prédire la survie des patients atteints de MM au diagnostic ainsi qu’à la rechute. / Multiple myeloma (MM) is a hematological malignancy characterized by clonal plasma cell proliferation in bone marrow and abnormal monoclonal immunoglobulin accumulation in the serum and/or urine. The heterogeneity of the disease is partly due to the cytogenetic abnormalities diversity making the disease more or less aggressive. MM is incurable in the majority of cases with a median survival between 5 and 7 years. The persistence of abnormal plasma cells in bone marrow after treatment is called minimal residual disease (MRD) and leads to the patient relapse. Multiparametric flow cytometry (MFC) is a sensitive, simple and fast technique to identify and characterize cells of interest in biological samples. In order to simplify MRD follow-up we have developed a complete solution based on MFC. This solution includes (i) the 5-color panel design, composed of anti-CD38, anti-kappa and anti-lambda antibodies (Ab) to identify total plasma cell population and two pools of Ab paired to the same fluorophore (anti-CD19/anti-CD27, negative pool and anti-CD56/anti-CD117/anti-CD200, positive pool) to detect abnormal plasma cells; (ii) the development of a device used to automatically prepare biological samples before MFC; and (iii) the analysis automation of MFC results using a homemade software. This fully automated solution increases reproducibility and productivity, decreases processing and analyzing time as well as test cost, without affecting sensibility and specificity. In parallel, we have built a simple risk score based on gene expression encoding surface proteins (CD24, CD27, CD36 and CD302) providing MM patient outcome at diagnostic and MRD follow-up.

1. Einleitung Multipotente mesenchymale Stromazellen (MSC) stellen eine interessante Therapieoption in der regenerativen Medizin verschiedener Erkrankungen dar. Aufgrund ihrer Herkunft aus mesodermalem Gewebe ist ihr Einsatz in der Therapie von Sehnenerkrankungen als günstig anzusehen, wo sie bei Pferden bereits erfolgreich verwendet werden. Da dieser Erkrankungskomplex mit degenerativen Veränderungen der Achillessehne des Menschen vergleichbar ist, wäre eine Translation der gewonnenen Ergebnisse in die Humanmedizin wünschenswert. Die zugrunde liegenden Wirkmechanismen bei der Sehnenregeneration sind allerdings bis zum heutigen Tage noch nicht vollständig geklärt. Unter anderem wird eine tenogene Differenzierung der MSC mit nachfolgender Produktion von extrazellulärer Matrix (EZM) diskutiert. Als Nachweis hierfür wird die Genexpression von Matrixproteinen sowie Transkriptionsfaktoren angesehen. Die Isolation von MSC ist aus verschiedenen Geweben möglich; allerdings haben Untersuchungen deutliche Unterschiede in den in-vitro-Charakteristika zwischen den Zellquellen aufgezeigt. Trotz dieser unterschiedlichen Eigenschaften fasst die International Society for Cellular Therapy (ISCT) seit 2006 humane MSC als plastikadhärente Zellen mit tripotentem Differenzierungspotential sowie einem definierten Antigenprofil zusammen. Um eine Vergleichbarkeit equiner und humaner MSC und somit eine bessere Übertragbarkeit gewonnener Erkenntnisse aus der Pferdemedizin zu erreichen, steht aktuell die Untersuchung der geforderten Antigenexpression noch aus. 2. Ziele der Untersuchung In der vorliegenden Arbeit sollte daher erstmalig eine vollständige Charakterisierung des geforderten Antigenprofils equiner MSC aus fünf verschiedenen Quellen durchgeführt werden, um einen Vergleich mit humanen Zellen zu ermöglichen. Zudem sollte eine vergleichende Darstellung der Sehnenmarkerexpression durchgeführt werden, welche das Wissen um die in-vitro-Eigenschaften von MSC erweitern und in Folge zur Auswahl einer optimal für die Therapie von Sehnenerkrankungen geeigneten Zellquelle beitragen soll. 3. Materialien und Methoden In der ersten Studie wurden equine MSC aus Knochenmark, Fettgewebe, Nabelschnurblut, Nabelschnurgewebe und Sehnengewebe bis zur Passage 3 kultiviert und anschließend mittels Durchflusszytometrie auf das Vorkommen der Antigene CD 29, CD 44, CD 73, CD 90 und CD 105 sowie das Fehlen der Antigene CD 14, CD 34, CD 45, CD 79α und MHC II untersucht. In der zweiten Studie wurde eine Genexpressionsanalyse der Sehnenmarker Kollagen 1A2, Kollagen 3A1, Decorin, Tenascin-C und Skleraxis vergleichend mittels Echtzeitpolymerasekettenreaktion an den isolierten Zellen durchgeführt. In beiden Studien wurde eine Probenzahl von n= 6 für jede Zellquelle untersucht. 4. Ergebnisse Keine der untersuchten Zellquellen erfüllte die MSC-Definition der ISCT bezüglich des Antigenprofils. Insbesondere durch den fehlenden Nachweis CD 73 (< 3,07 %) in allen untersuchten Proben unterscheiden sich equine und humane MSC. Die einzigen stabil exprimierten Antigene sind die zusätzlich untersuchten Proteine CD 29 (37,5 % - 65,42 %) und CD 44 (32,2 % - 97,18 %). Das Vorkommen CD 105 konnte in MSC aus Fett- und Sehnengewebe belegt werden. Zusätzlich war ein Nachweis von CD 90 in MSC aus Fettgewebe möglich, welche somit die größte Ähnlichkeit mit der humanen Zellpopulation aufweisen. Die Studie zur Genexpressionsanalyse weist auf eine Basisexpression von Kollagen 1A2, 3A1 und Decorin in MSC aus verschiedenen Quellen hin, welche über der von nativem Sehnengewebe liegt. Auch hier weisen wiederum MSC aus Fettgewebe die höchste Expression auf. 5. Schlussfolgerungen Die vorliegende Arbeit leistet einen Beitrag zu einer vertiefenden in-vitroCharakterisierung equiner MSC. Das Antigenprofil equiner MSC ist nicht vollständig mit dem humaner identisch. Eine abschließende Beurteilung sollte durch Untersuchungen mit spezies-spezifischen Antikörpern erfolgen. Die Ergebnisse der Genexpressionsanalyse unterstützen die Theorie, dass MSC die Sehnenheilung durch Produktion von extrazellulärer Matrix beeinflussen. Der Einsatz von MSC aus Fettgewebe in der Therapie von Sehnenerkrankungen sollte forciert werden, da ihre hohe Sehnenmarkerexpression einen Hinweis auf eine Verbesserung der Sehnenregeneration darstellt.

En raison du manque d'efficacité et de la toxicité des thérapies conventionnelles contre le cancer, la recherche s'est concentrée sur le développement de nouvelles stratégies. Ces efforts ont été à l'origine de l'essor de l'immunothérapie, dont les acteurs les plus récents sont les anticorps monoclonaux ciblant les points de contrôles immunitaires (PCI). Parmi ces inhibiteurs des PCI, on retrouve les anticorps ciblant la protéine de surface « Programmed Cell Death 1 », les anti-PD1, et ceux ciblant son ligand, « Programmed Cell Death Ligand 1 », les anti-PDL-1. Ces anticorps ont démontré une efficacité spectaculaire dans plusieurs types de cancers, et sont aujourd'hui couramment utilisés en clinique comme thérapies dans le mélanome, le cancer du poumon, de la vessie et du rein. Cependant, ces traitements ne profitent pas à tous les patients atteints de cancer, avec en moyenne 60% de résistance innée, et 25% de résistance acquise après une réponse primaire aux anticorps, variable selon le type de tumeur. Les phénomènes impliqués dans la résistance sont à l'heure actuelle peu connus. Ainsi, l'objectif de mon projet de recherche consistait à établir des modèles in vivo de résistance acquise aux anti-PD1 et anti-PDL 1. Pour ce faire, nous avons utilisé des tumeurs syngéniques de rein (RENCA), de vessie (MB49 et MBT-2) et de colon (MC38) et des souris immunocompétentes, que nous avons rendues résistantes aux traitements en les soumettant à des séries de réimplantation de tumeurs et de traitements, induisant une pression de sélection jusqu'à l'obtention d'un phénotype résistant. Le succès du blocage de l'axe PD1/ PDL-1 étant fortement lié à l'état du microenvironnement tumoral, nous avons mis en place un protocole d'immunophénotypage. Nous avons ainsi pu observer les cellules au profil « anti-tumoral », telles que les cellules T, les Natural Killer, et les macrophages M1, mais également les cellules ayant une fonction immunosuppressive, telles que les macrophages M2, les MDSC, les Treg. Enfin, certaines études ayant identifié une sur-régulation des PCI inhibiteurs alternatifs dans les cas de résistance acquise à l'anti-PD1, nous avons également observé l'expression de LAG3, TIM3 et TIGIT en plus de l'expression de PD1 et PDL-1. Nous avons ainsi pu déterminer que la résistance semble très fortement dépendante du modèle tumoral, même si nous avons pu identifier une diminution des macrophages M1 anti-tumoraux dans l'ensemble des modèles résistants à l'anti- PD1, et une augmentation des Treg dans les modèles résistants à l'anti-PDL-1, suggérant un mécanisme commun de résistance propre respectivement à l'anti-PD1 et à l'anti-PDL-1. Suite à l'identification par Zaretsky et al. de gènes impliqués dans la voie interféron dans des cas de résistance acquise de mélanome traité à l'anti- PD1, nous avons également décidé d'étudier le profil moléculaire des tumeurs résistantes. Cela nous a permis d'identifier 5 gènes communs entre les modèles anti- PD1 et anti-PDL-1 résistants, dont SERPINF1 et FCNA qui semblent prometteurs comme cibles à valider. Enfin, en parallèle de l'établissement et de la caractérisation des modèles de résistance acquise, nous avons testé de nouvelles approches thérapeutiques de potentialisation des anticorps anti-PD1 et anti-PDL-1 en combinaison avec des chimiothérapies de référence pour le cancer étudié. Nous avons ainsi démontré une potentialisation dans les modèles sauvages de cancer du côlon MC38 et de la vessie MB49, aucun effet de la combinaison dans le modèle de cancer du sein métastatique 4T1, et une inhibition de l'effet de l'anti-PDL-1 avec la combinaison dans le modèle de vessie MBT-2. L'immunophénotypage nous a permis de constater ici aussi des différences très importantes entre les modèles tumoraux, au niveau basal et après traitement [etc...] / Because of the limited efficacy and the toxicity of conventional therapies to fight cancer, researchers focused on the new trategies. These efforts lead to the emergence of immunotherapies, whose msot recent actors are the monoclonal antibodies targeting immune checkpoint (ICP). Among those ICP inhibitors, we found antibodies targeting the surface protein « Programmed Cell Death 1 », called anti- PD1, and those targeting its ligand, « Programmed Cell Death Ligand 1 », called anti- PDL-1. Those antibodies shown a great efficacy in a wide diveristy of cancers, and are currently used for clinical practice in the case of melanoma, lung cancer, bladder cancer and renal cell carcinoma. However, those treatments don’t benefit to all tumor bearing patients, with a mean of 60% of innate resistance, and 25% of acquired resistance following a primary response, variable according to tumor type. Phenomena involved in resistance are currently poorly described. In this context, the aim of my project was to establish in vivo preclinical models of acquired resistance to anti-PD1 and anti-PDL-1. To do that, we used syngeneic renal cancer (RENCA), bladder cancer (MB49 and MBT-2), and colorectal cancer (MC38), and immunocompetent mice, that we have made resistant by serial reimplantations of tumors pieces and serial treatments, inducing a selection pressure until we obtained a resistant phenotype. The efficiency of PD1/PDL-1 axis blocking is strongly linked to the microenvironment composition, as a result we realized an immunophenotyping protocol. We observed anti-tumor cells as T cells, Natural Killer cells, and M1 macrophages, but also cells harboring immunosuppressive functions, as M2 macrophages, MDSC, and Treg. Moreover, some studies have identified an upregulation of alternatives ICP in the context of acquired resistance to anti-PD1, so we also observed the expression of LAG3, TIM3 and TIGIT besides PD1 and PDL-1 expression. We shown that resistance is strongly dependant to the tumor model, even if we identified a decrease of anti-tumor M1 macrophages is models resistant to anti-PD1, and an increase of Treg in models resistant to anti-PDL-1, suggesting a common mechanism of resistance specific to respectively anti PD1 and anti-PDL-1. Following Zaretsky and al. identification of genes involved in interferon pathway in the case of acquired resistance to anti-PD1 in melanoma, we decided to study the molecular profile of resistant tumors. We identified 5 common genes differently modulated between anti-PD1 and anti-PDL-1 resistant models, including SERPINF1 and FCNA which seems to be promising as targets to validate. Lastly, in parallel to establishment and characterization of preclinical models of acquired resistance, we tested new therapeutical approches of anti-PD1 and anti- PDL-1 potentiation in combination with reference chemotherapies. We shown a synergy in wild-type colorectal and bladder cancers (MC38 and MB49), no effect of the combination in metastatic breast cancer 4T1, and an inhibition of anti-PDL 1 effect in bladder cancer MBT-2. Immunphenotyping of tumors allowed us to observe here also high differences between tumor models, both at baseline and after treatments initiation. To conclude, even if our results need a validation with patients samples, we demonstrated that different cellular and molecular modifications could be involved in resistance to anti-PD1 and anti-PDL-1, and that resistance could be bypass with chemotherapy combination, according to tumor type

Maternal obesity has significant consequences on the lifelong health of the developing child and rising global incidences make it one of the most common comorbidities during pregnancy. Offspring of obese mothers are at an increased risk of hospitalization for respiratory infections throughout childhood, which predispose these children to non-communicable respiratory diseases in later life. Animal models of maternal high fat diet (mHFD) feeding have observed common inflammatory outcomes with obesogenic models, but the effect on offspring varies with timing of the nutritional challenge and diet composition across studies. These studies demonstrate significant alterations to circulating and lung specific immune cells but the sequence of events that link maternal diet to these fetal outcomes are unclear, nor have they been tested in the context of a bacterial respiratory infection. Streptococcus pneumonaie is the most common causative pathogen of bacterial pneumonia and meningitis, making it of high clinical relevance. We aimed to investigate the effect of a mHFD (45% kcal from fat) during gestation and lactation, on offspring outcome and recovery from Streptococcus pneumoniae infection. Immunophenotyping, both before and after infection, revealed a hypo-inflammatory phenotype in circulating monocytes of the mHFD offspring with a decreased capacity to both initiate and terminate inflammatory responses. These offspring had significantly higher bacterial counts in lung tissues during infection and sustained cellular inflammation in survivors. In this thesis, we present foundational work on the detrimental influence of excess maternal nutrition on offspring immune function and infection outcomes, which may be involved in susceptibility to inflammatory and chronic disease in later life. A better understanding of this deep and lasting influence of the maternal environment will allow us to target preconception health as a form of harm reduction, informing stake holders and institutions to direct efforts towards DOHaD knowledge translation. / Thesis / Master of Science (MSc)

Primary immunodeficiencies represent a heterogeneous group of hereditary immune system malfunctions with very variable causes and symptoms. Multiparametric flow cytometry has become an important tool in primary immunodeficiency diagnostics and research because it provides detailed information on the phenotype of individual immune cells and their proportions in circulation. We have developed a complex monoclonal antibody panel composed of five eight-color tubes which is designed for immunophenotyping of basic lymphocyte subsets and further analysis of B and T cell subpopulations. We have optimized and standardized the panels so they will identify any changes originating from primary immunodeficiencies and provide comparable data on the level of cooperation between more laboratories. This was achieved by cooperation of six European research facilities which are all parts of the Euroflow consortium. The panels have been validated both on peripheral blood samples from healthy donors and patients with either gentically defined primary immunodeficiency or common variable immunodeficiency. Keywords: T lymphocyte, B lymphocyte, primary immunodeficiency, flow cytometry, immunophenotyping, Euroflow, optimization, standardization

Escorpiões da família Buthidae estão envolvidos na maioria dos envenenamentos em todo o mundo. Tityus é um dos gêneros dessa família, sendo Tityus serrulatus a espécie mais perigosa, por estar envolvida em envenenamentos graves, nos quais as vítimas são crianças, podendo levar a óbito. As manifestações da picada incluem dor local, hipersensibilidade, hipertensão, manifestações cardiovasculares e edema pulmonar. A peçonha do T. serrulatus contem, entre outros componentes, várias toxinas que atuam em canais de K+, Na+ e Ca2+ e que são responsáveis pelos efeitos tóxicos do veneno. Estudos recentes mostraram que a peçonha de T. serrulatus pode ativar macrófagos que são críticos na resposta imune e desempenham papel fundamental na resposta humoral e celular. Entretanto, pouco se conhece sobre os efeitos diretos dessas peçonhas sobre linfócitos humanos. Considerando que a modulação de funções celulares como proliferação, ativação e produção de citocinas pode desempenhar papel importante em envenenamentos, o presente estudo propôs: a) avaliar o efeito citotóxico do veneno bruto de Tityus serrulatus (VTs) sobre células mononucleares do sangue periférico humano (PBMC); b) analisar o efeito do VTs sobre a modulação da expressão de marcadores fenotípicos (CD3, CD4, CD8 e CD19) e de marcadores de ativação celular, incluindo CD69, CD25 e HLA-DR em células T e B; c) avaliar o efeito do VTs sobre a proliferação de linfócitos T; d) avaliar a capacidade do VTs em modular a produção de citocinas pelas PBMC. Ensaios de citotoxicidade foram realizados pela técnica do MTT (3-(4,5-dimethyl-2-thiazolyl-2,5-diphenyl-2H-tetrazolium bromide) e mostraram que as concentrações de 500, 1000 e 2000 ?g/mL do VTs apresentaram citotoxicidade baixa a moderada para PBMC (12,7, 22,2 e 23,7% de redução na viabilidade celular, respectivamente). Concentrações de 25, 50 e 100 ?g/mL não foram citotóxicas. Com base nesses ensaios, estas ultimas concentrações foram utilizadas nos ensaios subsequentes. A citometria de fluxo foi empregada para avaliação da proliferação celular, da expressão de marcadores fenotípicos e de ativação celular, bem como para a quantificação de citocinas nos sobrenadantes de culturas celulares. As concentrações utilizadas não induziram alterações significativas nas subpopulações de linfócitos e não modificaram a expressão de marcadores de ativação em linfócitos T CD4+, CD8+ e B, após 24h de cultivo. O ensaio de proliferação celular, utilizando marcação concomitante com diacetato carboxifluoresceína succinimidyl ester (CFSE) e anticorpos monoclonais contra marcadores fenotípicos e marcadores de ativação celular, permitiu que se avaliasse não só a proliferação, mas a discriminação das diferentes subpopulações celulares e o estado de ativação das mesmas após 96h de cultivo. Os resultados sugerem que o VTs inibe a proliferação de linfócitos estimulados com fitohemaglutinina (PHA), e em especial a porcentagem de linfócitos T CD8+CD25+ (linfócitos T citotóxicos ativados). O VTs não foi capaz de induzir proliferação celular. Em contraste, o VTs quando adicionado isoladamente à cultura de PBMC, nas concentrações de 50 e 100 ?g/mL, induziu a produção de IL-6 (p<0,05 e p<0,01, respectivamente), uma citocina pró-inflamatória que desempenha papeis importantes nas respostas imunes ii inata e adaptativa. A secreção aumentada de IL-6, portanto, não está vinculada a aumento na proliferação celular. A presença do VTs concomitantemente à PHA apresentou tendência para inibição da produção de citocinas por células estimuladas com a PHA, como IL-10, TNF e IFN-gama. Os resultados sugerem que o VTs é uma fonte potencial de substâncias com ações imunomoduladoras sobre linfócitos T humanos e estimulam novas investigações para o esclarecimento dos mecanismos de ação envolvidos, incluindo estudos que considerem a participação dos canais iônicos de linfócitos T nos fenômenos observados. Essas investigações, juntamente com a identificação dos componentes da peçonha, responsável pela atividades observadas, poderão contribuir para a descoberta de ferramentas para estudo dos mecanismos fisiopatológicos do envenenamento, bem como para a descoberta de novas alternativas de tratamento para doenças mediadas pelo sistema imune. / Scorpions of the Buthidae family are involved in most envenomations worldwide. Tityus is one of the genera of this family, being Tityus serrulatus the most dangerous species, because it is involved in severe envenomation, in which the victims are children and it can lead to death. The manifestations of scorpion sting are classified from mild to severe and its clinical signs include local pain, hypersensitivity, hypertension, cardiovascular manifestations and pulmonary edema. T. serrulatus venom contains, among other components, various toxins that act on K+, Na+ and Ca2+ channels, and are responsible for the toxic effects of the venom Recent studies showed that the venom of T. serrulatus (VTs) can activate macrophages that are critical to immune response and play a key role in the humoral and cellular response. However, little is known about the direct effects of these venoms on human lymphocytes. Considering that the modulation of cellular functions such as proliferation and induction of citokines production may play an important role in envenomation, the study proposed: a) to evaluate the cytotoxic effects of crude venom on peripheral blood mononuclear cells, b) to examine the effect of VTs on the modulation of expression of phenotypic markers (CD3, CD4, CD8 and CD19) and markers of cellular activation, including CD69, CD25 and HLA-DR on T and B cells c) to evaluate the VTs effect on the proliferation of T lymphocytes d) to evaluate the ability of VTs to modulate cytokine production by PBMC. Cytotoxicity assays were performed by the technique of MTT (3 - (4,5-dimethyl-2-thiazolyl-2,5-diphenyl-2Htetrazolium bromide) and showed that VTs concentrations of 500, 1000 and 2000 ?g/mL showed low to moderate cytotoxicity to PBMC (12.7, 22.2 and 23.7% reduction in cell viability, respectively). Concentrations of 25, 50 e 100 ?g/mL were not cytotoxic. Based on these tests, these concentrations were used in subsequent trials. Flow cytometry was used to assess cell proliferation, expression of phenotypic markers and cell activation, as well as for the quantification of cytokines in supernatants of cell cultures. The concentrations used did not induce significant changes in subpopulations of lymphocytes and did not modify the expression of activation markers on CD4+, CD8+ and B cells, after 24 hours of culture. The cellular proliferation assay, using simultaneously diacetate carboxyfluorescein succinimidyl ester (CFSE) and monoclonal antibodies against phenotypic markers and cell activation markers, allowed the evaluation not only of proliferation, but the discrimination of different cell subpopulations and activation state of the same after 96h of culture. The results suggest that VTs inhibits the proliferation of lymphocytes stimulated with phytohemagglutinin (PHA), and in particular the percentage of T lymphocytes CD8+ CD25+ (activated cytotoxic T lymphocytes). The VTs were not able to induce cell proliferation. In contrast, the VTs when added alone to the culture of PBMC at concentrations of 50 and 100 ?g/mL induced production of IL-6 (p <0.05 and p <0.01, respectively), a proinflammatory cytokine that plays important roles in innate and adaptive immune responses. The increased secretion of IL-6, therefore, is not linked to increased cell proliferation. The presence of VTs concurrently with PHA tended to inhibit cytokine production by cells stimulated with PHA, as IL-10, TNF and iv IFN-gamma.The results suggest that the VTs is a potential source of substances with immunomodulatory actions on human T lymphocytes and stimulate further research to elucidate the mechanisms of action involved, including studies to consider the participation of ion channels of T lymphocytes in the phenomena observed. These investigations, along with the identification of the components of the venom responsible for the observed activities may contribute to the discovery of tools to study the pathophysiological mechanisms involved in the envenomation as well as for the discovery of new treatment alternatives for diseases mediated by the immune system.