Both CD200 and its receptor(s), CD200R(s), are type I membrane glycoproteins belonging to the immunoglobulin (Ig) supergene family. CD200:CD200R(s) interaction manipulates host immunity in multiple models, including those exploring allograft rejection, autoimmune disease, tumor development, spontaneous fetal loss, infection/inflammation, and virus infection. The studies described in this thesis were focused on investigation possible mechanism(s) involved in CD200-mediated regulation, using transgenic mice over-expressing CD200, and exploring models of skin allograft rejection and LPS-induced abortion in mice. A Tet-on system was chosen to create CD200tg mice (rtTA CD200tg animal line), in which transgenic expression of CD200 is induced by the presence of doxycycline (Dox-treated mice). Splenocytes from Dox-treated transgenic mice, used as either responder cells or stimulator cells in mixed leukocyte cultures, showed antigen-specific suppressed lymphocyte proliferation and induction of CTL. Although enhanced survival of skin allografts was achieved in Dox-treated transplanted CD200tg mice (BALB/c to BL/6 Tg), all grafts were rejected by 28 days post transplantation (see chapter 2). A superior “second generation” Tet-on system was used to create a new CD200tg animal referred to as rtTA2s-M2 CD200tg mice. Transgenic overexpression of CD200 in this mouse was stably induced at much lower Dox concentrations, with less (or no) “leaky” expression of the transgene in the absence of Dox. Using these mice in an LPS-induced murine abortion model, transgenic expression of CD200 was found to reduce the LPS-induced abortion rate from ~49% to 6% (see chapter 3). Long term increased survival of grafted tissues (of both cardiac and skin allografts) was achieved using the rtTA2s-M2 CD200tg mice as recipients. To explore the potential molecular mechanism(s) involved in this allograft tolerance, a commercial microarray kit focusing on detecting altered expression of genes related with T-cell anergy/tolerance was used to investigate the gene expression profile in grafted tissue of mice with transgenic expression of CD200. Expression of genes associated with Foxp3+ regulatory T-populations (Foxp3, CTLA4 and GITR) and type 2 cytokine genes showed increased expression in CD200tg recipients. With particular note in regards to Foxp3+ regulatory T cells, expression of the gene encoding chemokine receptor CCR4, reported to play a key role in attracting Foxp3+ regulatory T cells to grafted tissues and DLNs, was found to be increased in Dox-treated CD200tg recipients, along with genes encoding chemokines CCL22/17, the ligands for CCR4. Immunochemistry staining also showed increased numbers of Foxp3+ cells in both grafted skin tissues and the DLNs of transplant at day 14 post transplantation. Using CCR4-shRNA lentivirus administered to Dox-treated CD200tg recipients to block expression of CCR4, the transgene-induced increased presence of regulatory T cell populations in grafted tissues and DLNs was attenuated, along with loss of enhanced skin graft survival and the histological appearance of graft acceptance (see chapter 4). These data provide support for a model suggesting that altered migration of Treg mediated through a CCR4:CCL17/22 pathway is an important mechanism underlying increased allograft acceptance following CD200tg expression.

Both CD200 and its receptor(s), CD200R(s), are type I membrane glycoproteins belonging to the immunoglobulin (Ig) supergene family. CD200:CD200R(s) interaction manipulates host immunity in multiple models, including those exploring allograft rejection, autoimmune disease, tumor development, spontaneous fetal loss, infection/inflammation, and virus infection. The studies described in this thesis were focused on investigation possible mechanism(s) involved in CD200-mediated regulation, using transgenic mice over-expressing CD200, and exploring models of skin allograft rejection and LPS-induced abortion in mice. A Tet-on system was chosen to create CD200tg mice (rtTA CD200tg animal line), in which transgenic expression of CD200 is induced by the presence of doxycycline (Dox-treated mice). Splenocytes from Dox-treated transgenic mice, used as either responder cells or stimulator cells in mixed leukocyte cultures, showed antigen-specific suppressed lymphocyte proliferation and induction of CTL. Although enhanced survival of skin allografts was achieved in Dox-treated transplanted CD200tg mice (BALB/c to BL/6 Tg), all grafts were rejected by 28 days post transplantation (see chapter 2). A superior “second generation” Tet-on system was used to create a new CD200tg animal referred to as rtTA2s-M2 CD200tg mice. Transgenic overexpression of CD200 in this mouse was stably induced at much lower Dox concentrations, with less (or no) “leaky” expression of the transgene in the absence of Dox. Using these mice in an LPS-induced murine abortion model, transgenic expression of CD200 was found to reduce the LPS-induced abortion rate from ~49% to 6% (see chapter 3). Long term increased survival of grafted tissues (of both cardiac and skin allografts) was achieved using the rtTA2s-M2 CD200tg mice as recipients. To explore the potential molecular mechanism(s) involved in this allograft tolerance, a commercial microarray kit focusing on detecting altered expression of genes related with T-cell anergy/tolerance was used to investigate the gene expression profile in grafted tissue of mice with transgenic expression of CD200. Expression of genes associated with Foxp3+ regulatory T-populations (Foxp3, CTLA4 and GITR) and type 2 cytokine genes showed increased expression in CD200tg recipients. With particular note in regards to Foxp3+ regulatory T cells, expression of the gene encoding chemokine receptor CCR4, reported to play a key role in attracting Foxp3+ regulatory T cells to grafted tissues and DLNs, was found to be increased in Dox-treated CD200tg recipients, along with genes encoding chemokines CCL22/17, the ligands for CCR4. Immunochemistry staining also showed increased numbers of Foxp3+ cells in both grafted skin tissues and the DLNs of transplant at day 14 post transplantation. Using CCR4-shRNA lentivirus administered to Dox-treated CD200tg recipients to block expression of CCR4, the transgene-induced increased presence of regulatory T cell populations in grafted tissues and DLNs was attenuated, along with loss of enhanced skin graft survival and the histological appearance of graft acceptance (see chapter 4). These data provide support for a model suggesting that altered migration of Treg mediated through a CCR4:CCL17/22 pathway is an important mechanism underlying increased allograft acceptance following CD200tg expression.

Le Demodex, petit acarien vivant dans les follicules pilo-sébacés de tous les humains adultes, est reconnu responsable des démodécies chez l’homme mais n’est considéré dans la rosacée, au plus, que comme un facteur aggravant potentiel d’une inflammation préexistante. Toutes nos observations, depuis 1983, convergent vers la confirmation de son rôle pathogène dans la rosacée, et suggèrent des liens physiopathologiques clairs entre rosacées avec papulopustules (RPP) avec ou sans érythème permanent, rosacée érythématotélangiectasique (RET), pityriasis folliculorum et autres démodécies. (1) Dans les biopsies cutanées, le Demodex est associé à l’inflammation périfolliculaire. (2) Le concept de densité en Demodex a été introduit et une méthode de prélèvement standardisée permettant de mesurer cette densité a été développée, puis perfectionnée. (3) Elle a permis de montrer que cette densité était nettement supérieure chez les patients atteints de démodécie et de RPP, que chez ceux avec peau saine et ceux atteints d’autres dermatoses faciales, les patients avec RPP sans prolifération en Demodex étant exceptionnels. (4) Un test diagnostique hautement spécifique et sensible, utilisable facilement en consultation a été élaboré et validé. (5) Des signes cliniques discrets de ces dermatoses ont été mis en évidence, de même que la grande fréquence des démodécies en consultation de dermatologie (alors qu’elles sont très peu diagnostiquées). (6) L’effet acaricide sur le Demodex de six traitements topiques a été comparé in vivo et les meilleures molécules ont été utilisées pendant une vingtaine d’années :sur base des résultats collectés, l’efficacité du traitement a été démontrée, non seulement sur la densité en Demodex mais également sur les symptômes cliniques, tant parmi les démodécies que dans la RPP, ce qui prouve indirectement que la prolifération en parasites n’est pas un épiphénomène mais est bien la cause de la maladie. (7) Parmi les modalités comparées, les plus intenses ont une efficacité plus rapide et une meilleure compliance. (8) La RET peut correspondre à une démodécie subclinique et est probablement un facteur favorisant la prolifération des parasites, tout comme le sont probablement l’hyperplasie sébacée et l’hypothyroïdie, tandis que la cortisone semble limiter leur prolifération quand celle-ci est excessive. (9) Les similarités et les confusions nosologiques entre les démodécies et les différentes formes de rosacée ont été mises en évidence, afin de montrer que ces dermatoses ne sont vraisemblablement que des phénotypes d’une seule et même maladie :ce sont toutes des démodécies. (10) Trois systèmes d’attribution d’une cause à une maladie convergent pour confirmer le rôle pathogène du Demodex dans la RPP. Nos observations doivent être confirmées par des études longitudinales et des études contrôlées, mais d’ores et déjà, ajoutées aux données actuelles de la littérature, elles nous semblent suffisantes pour reconnaître le rôle pathogène du parasite en médecine humaine et dans la rosacée en particulier. Cette reconnaissance donnerait une définition principalement étiologique à la rosacée, la classerait parmi les démodécies, et en faciliterait la prise en charge et le traitement. Nous proposons une hypothèse physiopathologique originale où le Demodex se trouve au centre d’un réseau causal « en toile d’araignée », la RPP étant considérée comme une infection chronique s’accompagnant d’épuisement lymphocytaire. / Demodex folliculorum and Demodex brevis are small mites living in the pilosebaceous follicles of all adult humans. They are known to be responsible for demodicosis in humans but in rosacea are generally considered only as a potential aggravating factor of pre-existing inflammation. However, our observations since 1983 converge towards a pathogenic role of the Demodex mite in rosacea, and suggest clear pathophysiological links between rosacea with papulopustules (PPR) with or without persistent erythema, erythematotelangiectatic rosacea (ETR), pityriasis folliculorum and other demodicoses. Summarising our findings: (1) In skin biopsies, Demodex is statistically associated with perifollicular inflammation. (2) The concept of Demodex density was introduced and a method to measure it using two consecutive standardized skin surface biopsies was developed and refined. (3) It was shown that Demodex density was significantly higher in patients with demodicosis and PPR than in those with healthy skin and with other facial dermatoses; patients with PPR without Demodex proliferation detected are rare, and the few cases that do occur likely correspond to false negative results linked to proliferation of the mites deep in the pilosebaceous follicles, thus not detected by the sampling method. (4) A highly specific and sensitive diagnostic test based on the results from two consecutive standardized skin surface biopsies was developed and validated and can be easily used during clinical consultation. (5) Less well-known clinical signs of these dermatoses were highlighted, as well as the high frequency of demodicoses in dermatologic consultations (although they are under-diagnosed). (6) The acaricidal effect of six topical treatments on Demodex was compared in vivo and the best molecules were used for about 20 years in our practice. From data collected from our patients during this time period, the efficacy of the treatment was demonstrated, not only on Demodex density but also on clinical symptoms, both in demodicosis and in PPR, indirectly showing that parasite proliferation is not an epiphenomenon, but is the cause of the disease. (7) Of the treatment modalities compared, those that were more intense worked more rapidly and had better compliance. (8) ETR may correspond to subclinical demodicosis and is probably a condition that favours parasite proliferation, as are sebaceous hyperplasia and hypothyroidism; cortisone seems initially to favour mite proliferation, but to limit it when Demodex density is very high. (9) The similarities and nosological confusion between demodicosis and the different forms of rosacea were highlighted, showing that these dermatoses are probably phenotypes of one and the same disease: they are all demodicoses. (10) Three systems used to attribute disease causality converge to confirm the pathogenic role of Demodex in PPR. Our observations need to be confirmed by longitudinal and controlled studies, but, combined with current data in the literature, they seem sufficient to recognise the pathogenic role of the parasite in human disease and in rosacea in particular. This recognition would enable a mainly aetiological definition to be given to rosacea, would classify it among the demodicoses, and would facilitate its management and treatment. We propose an original pathophysiological hypothesis in which Demodex is at the centre of a causal network, with PPR being considered a chronic infection accompanied by lymphocyte exhaustion. / Doctorat en Sciences médicales (Médecine) / info:eu-repo/semantics/nonPublished

Glycodelin, a homodimeric glycoprotein belonging to the lipocalin superfamily, is synthesised predominantly by the cells of the reproductive system of certain primates including humans. Of the four different known glycoforms of the molecule, glycodelin A (GdA), secreted by the glandular epithelial cells of the endometrium in response to progesterone, is involved in the immunosuppression of the maternal immune response to the semi-allograft fetus. GdA secretion onsets few days after ovulation. In the absence of fertilization, GdA levels drop, but subsequent to a successful fertilization, the concentrations peak till the 12th week of pregnancy and fall steadily to low levels. The importance of GdA has been implicated in implantation, endometrial receptivity, trophoblast invasion and differentiation, and modulating the functions of almost all immune cells. GdA has profound influence on the activity of T cells. It inhibits the proliferation of T cells, induces apoptosis in activated T cells, inhibits the IL-2 production and leads to skewing of the Th-1/Th-2 balance towards Th-2 type of immune response. Cytotoxic T lymphocytes are more resistant to the induction of apoptosis by GdA, but, it suppresses their cytolytic activity Additionally, GdA induces apoptosis in monocytes and natural killer (NK) cells, inhibits the proliferation of B cells and induces tolerogenic phenotype in dendritic cells. Clinical studies showing that women undergoing recurring spontaneous abortions have low levels of GdA supports its role in prevention of fetus rejection. The immunomodulatory activity of Gd resides in the protein backbone, however, apart from GdA and GdF which have similar oligosaccharide chains, other glycoforms do not possess this activity. Glycosylation seems to dictate the stability, folding and activity of Gd. In absence of glycosylation, the expression of the recombinant Gd is compromised and the protein is improperly folded while over-mannosylation of Gd impairs its immunomodulatory function. Additionally, sialylation seen on the glycan chain regulates the activity. Therefore, in order to obtain adequate amounts of active recombinant Gd (rGd), expression of the protein was attempted in three different systems, insect, yeast and bacteria (Chapter 1). In all of the described systems, the rGd protein was found apoptotically active. The protein expressed in the Sf21 insect cells was demonstrated to be differentially glycosylated compromising the activity. Hence, a genetically modified yeast strain, Pichia pastoris SuperMAN5 was explored for expression. Though presence of a single glycosylated protein species was observed in small-scale cultures, similar to the case of Sf21 cell expression, differentially glycosylated proteins were detected in large-scale fermentation and even the yield was low. Eventually, mutant Gd, modified to increase the stability and aid in proper protein folding, was expressed in E.coli and demonstrated to be able to induce apoptosis in Jurkat cells (T cell leukemia cell line). This active rGd was used for further studies. The immunomodulatory function of GdA during pregnancy protects the semi-allograft fetus from rejection by the maternal immune system. In the process, GdA tweaks the T cell immune response from pro-inflammatory to anti-inflammatory in a specific and localized manner. Allograft rejection seen during mis-match transplantations is basically a pro-inflammatory condition which is mediated by the activation of cellular immune response, NK cell cytotoxicity and antibody-dependent immune response, the same processes that are suppressed for a successful pregnancy. Chapter 2 discusses whether it is feasible to use Gd to prevent allograft rejection. Killing of target graft cells by the cytotoxic T lymphocytes (CTLs) predominantly presides acute graft rejection. GdA treatment has been shown to suppress the cytotoxicity of in vitro generated CTLs. On this basis, the earlier study was translated to in vivo conditions by establishing an allograft nude mouse model. The tumor rejection mediated by the action of in vitro generated cytotoxic alloactivated PBMCs in the nude mouse imitated the allograft rejection. A heterogenous population of immune cells with the predominance of CTLs was chosen to accommodate a more interactive immune response in the tumor microenvironment and enabled the study of other cells which may contribute to the rejection. Reactivation and proliferation of CD4+ and CD8+ T cells following their infiltration in the tumor validated our hypothesis. On treatment with rGd, the cytotoxicity of the alloactivated PBMCs was suppressed, thereby inhibiting the tumor rejection in the nude mouse. Real time PCR analysis showed that rGd treatment was able to affect the functions of the immune cells in vivo. It decreased the T cell population most probably by inducing apoptosis. As expected, the reduction was more prominent in case of CD4+ T cells than CD8+ T cells. The their expression of key molecules responsible for the cytotoxicity such as IL-2, granzyme B and EOMES, was observed to be downregulated by rGd. Concomitantly, decreased levels of pro-inflammatory cytokines, TNFα and IL-6 were also seen. Expression of Foxp3, marker for regulatory T cells, was upregulated in the tumor infiltrating immune cells suggesting an expansion of the concerned population upon rGd treatment. Overall, rGd seems to suppress the cellular immune response to the tumor by modulating the T cell population and their functions. Since, T cell-dependent immune response is central to allograft rejection, the ability of rGd to regulate it could be of therapeutic use in the management of allograft rejection. NK cells are essential for the maintenance of pregnancy, evident from their abundance (70% of total leukocytes) at the first trimester decidua. The third chapter focuses on how Gd regulates the NK cell function. The cytokine production from CD56bright subset of NK cells and their interaction with the HLA antigens expressed by the trophoblast cells helps in creating a favourable environment for the growth of the fetus. It is important to note that the NK cell population present in the decidua exclusively express Gd, implicating a role of Gd in their differentiation from the peripheral CD56bright cells. However, an increased number of CD56dimCD16+ cells in the peripheral blood dictates a negative outcome for the pregnancy. The study, presented in Chapter 3, demonstrated that rGd treatment induces caspase-dependent apoptosis in the activated CD56dimCD16+ cells and reduces their cytotoxicity by downregulating granzyme B and IFNγ production. Similar effect of rGd is also seen on the NKT cells characterised as CD3+CD56dimCD16-. Furthermore, in YT-Indy cells, an activated NK cell line, it was shown that the induction of apoptosis by rGd involves Ca2+ signalling which could explain why Gd affects activated immune cells only. This study therefore reinforces the role of Gd in modulating the NK cell activity during pregnancy. Cytotoxicity of NK and NKT cells also plays an important role during allograft rejection. Decrease in the mRNA levels of CD56 upon rGd treatment in the allograft mouse model indicates that the effect of Gd on NK cells observed in cell culture system can be translated to in vivo conditions. In conclusion, suppression of the cellular immune response and NK cell mediated cytotoxicity by rGd could potentiate its’ probable use in the management of allograft rejection. .

Les môles hydatiformes sont une prolifération placentaire prétumorale pouvant évolueren tumeur alors traitée par chimiothérapie. Afin de réduire la mortalité et d’optimiser laprise en charge thérapeutique, l’objectif de cette thèse est d’identifier les gènespermettant de prédire la transformation en tumeur post môlaire et la chimiorésistance.Concernant la prédiction de la transformation, l’analyse de l’expression de gènescandidatssur tissu molaire décrit la relocalisation apicale de la Syncytine-1 en cas detransformation maligne, sans modification de transcription de ses récepteurs ni de deuxautres enveloppes rétrovirales placentaires. L’analyse sans à priori du transcriptome par3 méthodes différentes n’a pas permis d’identifier de gène différentiellement expriméselon la transformation. Cela suggère que la variabilité interindividuelle et les diverscritères utilisés pour le diagnostic de tumeur nuisent à l’identification de biomarqueursrobustes.Concernant la prédiction de la chimiorésistance, une approche transcriptomique largespectre sur tissu tumoral de choriocarcinome identifie une réduction de transcriptiond’HLA-G en cas de monochimiorésistance, confirmée au niveau protéique par immunohistochimie. L’analyse en réseaux de l’ensemble des gènes différentiellementexprimés suggère que la monochimiorésistance est associée à une altération de ladifférenciation des lymphocytes T alors que la polychimiorésistance est associée à unealtération de la prolifération des cellules sanguines.In fine, l’objectivation de l’expression trophoblastique du point de contrôle PD-L1 aconduit à évaluer l’efficacité d’un anti PD-L1 chez les patientes chimiorésistantes. Lesrésultats encourageants de cet essai et la possibilité de stratifier les patientes à l’aidedes marqueurs HLA-G et Syncytine-1 incitent à évaluer la place de l’anti PD-L1 associéà une monochimiothérapie en première ligne de traitement des tumeurstrophoblastiques. / Hydatidiform moles are a pretumoral placental proliferation which can turn into a tumorrequiring chemotherapy. In order to reduce mortality and propose an optimal therapeuticmanagement, the aim of this thesis is to identify genes which are predictive of postmolartumor transformation and chemoresistance.Concerning the prediction of transformation, the expression analysis of candidate-geneson molar tissue shows a relocalization of Syncytin-1 at the syncytiotrophoblast apicalborder in moles followed by malignant transformation, without modification oftranscription of its receptors and two other retroviral placental envelopes. A wholetranscriptomeapproach using 3 different microarrays-based methods did not identify anydifferentially expressed gene according to the post molar evolution. This may reflect thatinter-individual variability and the different criteria used for tumor diagnosis impede theidentification of robust biomarkers.Concerning the prediction of chemoresistance, a broad-spectrum transcriptomicapproach on choriocarcinoma tumor tissue identifies a down regulation of HLA-G in case of monochemoresistance, confirmed at the protein level by immunohistochemistry.Pathway analysis of the differentially expressed genes suggests thatmonochemoresistance is associated with impaired T-cell differentiation, whereaspolychemoresistance is associated with impaired proliferation of blood cells.Ultimately, the evidence of trophoblastic ubiquitous expression of the PD-L1 immunecheckpoint led us to the evaluation of the efficacy of PD-L1 blockade in chemoresistantpatients. The encouraging results of this trial and the possibility of stratifying patientswith HLA-G and Syncytin-1 markers encourages the assessment of PD-L1 blockadecombined with monochemotherapy as a first line treatment for trophoblastic tumors.

O vírus Epstein-Barr infecta aproximadamente 95% da população mundial adulta, estabelecendo uma infecção latente e assintomática. Porém, é um vírus associado à neoplasias malignas, tais como carcinomas de nasofaringe, linfomas de Hodgkin, alguns casos de carcinomas gástrico, linfomas T e NK, dentre outras. O EBV também está implicado em doenças não neoplásicas como a leucoplasia pilosa. O fenômeno de imunotolerância está ligado ao potencial de infecção e oncogênico do EBV. Células dendríticas imaturas e linfócitos T reguladores são importantes nesse contexto. Em situações neoplásicas, esse mecanismo impede o reconhecimento e a destruição de células tumorais. O objetivo desse trabalho foi estudar em quatro diferentes situações de infecção pelo EBV, a saber, amigdalite crônica, linfomas de Hodgkin, leucoplasia pilosa e carcinomas de nasofaringe, a presença de células dendríticas imaturas e linfócitos T reguladores, e também o papel da citocina MIP3 no recrutamento dessas células. Foram utilizadas as técnicas de hibridização in situ para detecção do EBV e imunoistoquímica para detecção das células dendríticas, linfócitos T reg e para análise da expressão de MIP3. Em todos os casos de linfoma de Hodgkin, amigdalites e carcinomas de nasofaringe EBV+ observou-se uma forte concentração de células dendríticas imaturas e linfócitos T reg. A expressão de MIP3 mostrou-se intensa nas neoplasias EBV positivas e fraca nos casos de amigdalite crônica. Não foi observada expressão de MIP3 nos casos de leucoplasia pilosa. A concentração de células dendríticas imaturas e linfócitos T reg está intimamente ligada à presença de céulas EBV+ e pela expressão de MIP3 nos linfomas de Hodgkin associados ao EBV e carcinomas de nasofaringe, criando assim um micro-ambiente de imunossupressão nessas lesões. / The Epstein-Barr virus infects approximately 95% of adult world-wilde population, establishing a latent and asymptomatic infection. However it is related to malignant neoplasia, such as nasopharynx carcinomas, Hodgkin disease, some gastric carcinomas, T/NK lymphomas among others. EBV is also implicated in non-neoplasic disease such as hairy leukoplakia. This phenomenon is associated with the EBV infectious and oncogenic potential. Immature dendritic cells and T reg cells are important in this context. In neoplasic situations, this mechanism obstructs recognition and destruction of tumoral cells. The aim of this work was study, in four different situations of EBV infection, to knowledge, chronic tonsillitis, Hodgkins disease, hairy leukoplakia and nasopharynx carcinoma, the presence of immature dendritic cells and T reg cells, and also the role of cytokine MIP3 in the recruitment of these cells. In situ hybridization was performed for EBV detection and immunohistochemistry for dendritic cells and T reg cells detection and also for expression evaluation of MIP3 cytokine. In all the cases of Hodgkins disease, tonsillitis and nasopharynx carcinoma EBV+, a strong concentration of immature dendritic cells and T reg lymphocytes was observed. The MIP3 expression was more intense on EBV positive neoplasia and weak in cases of chronic tonsillitis. No MIP3 expression was observed in hairy leukoplakia. The concentration of immature dendritic cell and T reg lymphocyte is intimately connected with the presence of EBV positive-cells and MIP3 expression in Hodgkin disease associated to EBV and nasopharynx carcinoma, creating a microenvironment of immunosuppression in these neoplasias.

O vírus Epstein-Barr infecta aproximadamente 95% da população mundial adulta, estabelecendo uma infecção latente e assintomática. Porém, é um vírus associado à neoplasias malignas, tais como carcinomas de nasofaringe, linfomas de Hodgkin, alguns casos de carcinomas gástrico, linfomas T e NK, dentre outras. O EBV também está implicado em doenças não neoplásicas como a leucoplasia pilosa. O fenômeno de imunotolerância está ligado ao potencial de infecção e oncogênico do EBV. Células dendríticas imaturas e linfócitos T reguladores são importantes nesse contexto. Em situações neoplásicas, esse mecanismo impede o reconhecimento e a destruição de células tumorais. O objetivo desse trabalho foi estudar em quatro diferentes situações de infecção pelo EBV, a saber, amigdalite crônica, linfomas de Hodgkin, leucoplasia pilosa e carcinomas de nasofaringe, a presença de células dendríticas imaturas e linfócitos T reguladores, e também o papel da citocina MIP3 no recrutamento dessas células. Foram utilizadas as técnicas de hibridização in situ para detecção do EBV e imunoistoquímica para detecção das células dendríticas, linfócitos T reg e para análise da expressão de MIP3. Em todos os casos de linfoma de Hodgkin, amigdalites e carcinomas de nasofaringe EBV+ observou-se uma forte concentração de células dendríticas imaturas e linfócitos T reg. A expressão de MIP3 mostrou-se intensa nas neoplasias EBV positivas e fraca nos casos de amigdalite crônica. Não foi observada expressão de MIP3 nos casos de leucoplasia pilosa. A concentração de células dendríticas imaturas e linfócitos T reg está intimamente ligada à presença de céulas EBV+ e pela expressão de MIP3 nos linfomas de Hodgkin associados ao EBV e carcinomas de nasofaringe, criando assim um micro-ambiente de imunossupressão nessas lesões. / The Epstein-Barr virus infects approximately 95% of adult world-wilde population, establishing a latent and asymptomatic infection. However it is related to malignant neoplasia, such as nasopharynx carcinomas, Hodgkin disease, some gastric carcinomas, T/NK lymphomas among others. EBV is also implicated in non-neoplasic disease such as hairy leukoplakia. This phenomenon is associated with the EBV infectious and oncogenic potential. Immature dendritic cells and T reg cells are important in this context. In neoplasic situations, this mechanism obstructs recognition and destruction of tumoral cells. The aim of this work was study, in four different situations of EBV infection, to knowledge, chronic tonsillitis, Hodgkins disease, hairy leukoplakia and nasopharynx carcinoma, the presence of immature dendritic cells and T reg cells, and also the role of cytokine MIP3 in the recruitment of these cells. In situ hybridization was performed for EBV detection and immunohistochemistry for dendritic cells and T reg cells detection and also for expression evaluation of MIP3 cytokine. In all the cases of Hodgkins disease, tonsillitis and nasopharynx carcinoma EBV+, a strong concentration of immature dendritic cells and T reg lymphocytes was observed. The MIP3 expression was more intense on EBV positive neoplasia and weak in cases of chronic tonsillitis. No MIP3 expression was observed in hairy leukoplakia. The concentration of immature dendritic cell and T reg lymphocyte is intimately connected with the presence of EBV positive-cells and MIP3 expression in Hodgkin disease associated to EBV and nasopharynx carcinoma, creating a microenvironment of immunosuppression in these neoplasias.