INTRODUÇÃO: A Síndrome de Sézary (SS) é um linfoma cutâneo de células T (LCCT), caracterizado por eritrodermia, linfadenopatia generalizada e presença de células tumorais na pele, linfonodos e sangue periférico. Os linfócitos TCD8+ têm papel fundamental na resposta imune antitumoral, entretanto, há escassos estudos evidenciando seu perfil fenotípico e funcional. Considerando que a resposta imunológica do paciente com SS está suprimida, estratégias para potencializar a imunidade inata e adaptativa com agonistas de receptores Toll-like (TLRs) têm sido exploradas. OBJETIVO: Caracterizar o perfil de marcadores de ativação/inibição das células TCD8+, seus estágios de diferenciação, capacidade de resposta a IL-7/IL-15 e ao agonista de TLR7/TLR8 de pacientes com SS. METODOLOGIA: Foram selecionados 15 pacientes com SS (7 homens e 8 mulheres) com 48-85 anos do Ambulatório de Linfomas Cutâneos, do HC-FMUSP, e um grupo de controle com 24 indivíduos sadios. A análise de marcadores de ativação/inibição e diferenciação celular em células TCD4/TCD8+ do sangue periférico foi realizada por citometria de fluxo. A expressão de marcadores extracelulares e citocinas intracelulares em células mononucleadas do sangue periférico (CMN) após estimulação com o agonista de TLR7/TLR8 foi analisada por citometria de fluxo. Além disto, o efeito de IL-7 e IL-5 em células T foi avaliado pela fosforilação de STAT5, na capacidade de proliferação mitogênica e expressão de BCL-2 em CMNs, como também pelos níveis séricos de IL-7 por citometria de fluxo. RESULTADOS: Os pacientes com SS mostram perfil fenotípico de ativação crônica nos linfócitos TCD8+ periféricos, decorrente do elevadopercentual de células TCD8+ CD38+, redução percentual de TCD8+ CD127+ (IL-7R) e da população naive. Além disso, ocorreu aumento de expressão de PD-1 na população naive de células TCD8+. O marcador de ativação, CD26, até então apenas relacionado com linfócitos TCD4, foi detectado em reduzida percentagem de linfócitos TCD8. A resposta para IL-7/IL-15 parece estar funcionalmente presente tanto nos linfócitos TCD4 quanto nos linfócitos TCD8. Contudo, foi encontrado um perfil diferenciado e heterogêneo de fosforilação de STAT5 assim como de expressão de BCL-2 nos linfócitos TCD8+ de pacientes com SS. O nível sérico de IL-7 reduzido dos pacientes com SS foi inversamente correlacionado com o número absoluto de linfócitos TCD4+. CONCLUSÃO: Os linfócitos TCD8+ dos pacientes com SS encontram-se reduzidos em números absolutos, e possuem um perfil alterado de diferenciação celular e expressão de marcadores extracelulares. A redução percentual da população de TCD8+ naive associada com a presença de moléculas de ativação crônica mostra um perfil de imunosenescência. As células TCD8+ exibem baixa capacidade de resposta aos ligantes de TLR intracelulares, provavelmente devido ao perfil de ativação crônica. Além disso, há resposta parcial dos linfócitos TCD8+ às citocinas ligantes do receptor yc. Nossos resultados evidenciam alterações em linfócitos TCD8+ que debilitam a resposta imune antitumoral e que pode contribuir com a patogênese da síndrome de Sézary / INTRODUCTION: Sézary syndrome (SS) is a cutaneous T cell lymphoma (CTCL), characterized by erythroderma, generalized lymphadenopathy and the presence of tumor cells in the skin, lymph nodes and peripheral blood. The TCD8+ lymphocytes play a key role in anti-tumor immune response, whereas, there are few studies showing its phenotypic and functional profile in SS. Considering that the immune response of SS patient is suppressed, strategies to enhancing the innate and adaptive immunity by Toll-like receptors (TLRs) agonists have been explored. OBJECTIVE: To characterize the profile of activation/inhibition markers of CD8+ T cells, their stages of differentiation, ability of response to IL-7/IL-15 and TLR7/TLR8 agonist of patients with SS. METHODOLOGY: Fifteen SS patients were enrolled (7 men and 8 woman) with 48-85 years from the Clinic of Cutaneous Lymphomas, HC-FMUSP, and a control group of 24 healthy individuals. Analysis of activation/inhibition markers and cellular differentiation in CD4/CD8 T cells from peripheral blood were assessed by flow cytometry. The expression of extracellular markers and intracellular cytokines in mononuclear cells in the peripheral blood (CMN) were evaluated by flow cytometry. Moreover, the effect of IL-7 and IL-15 stimulation in T cells was assessed by the STAT5 phosphorylation, proliferative mitogenic capacity, BCL-2 expression in CMNs as well as serum IL-7 levels by flow cytometry. RESULTS: Patients with SS show a phenotypic CD8 T peripheral lymphocytes profile of chronic activation, due to the high percentage of CD8+CD38+ T cells, reduced percentage of CD8+CD127+ (IL-7R) and naïve population. Furthermore, it was observed an increased PD-1 expression in the naïve CD8+ T cells. The activation marker CD26, previously only associated with CD4 T lymphocyte, was detected at decreased percentage in CD8 T lymphocytes. The TLR7/TLR8 agonist did not affect the IFN-? and TNF secretion of CD8 T lymphocytes of SS patients, in contrast to the control group. The response to IL-7/IL-15 appears to be functional in both CD4 and CD8 T lymphocytes. However, it was founded a differentiated and heterogeneous profile of STAT5 phosphorylation and Bcl-2 expression in the CD8 T lymphocytes in SS patients. The reduced IL-7 serum of patients with SS was inversely correlated with the absolute number of CD4 T lymphocytes. CONCLUSION: CD8 T lymphocytes of patients with SS are reduced in absolute numbers, and show an altered cellular differentiation profile and extracellular markers expression. The reduced percentage of CD8 naïve population associated with chronic activation of molecules reveals an immunosenescence profile. The CD8 T cells exhibit low ability to ligands of intracellular TLR receptors, probably due to chronic activation profile. In addition, there are partial response of CD8 T lymphocytes to the cytokine receptor ?c. Our results show disturbance in CD8 T lymphocytes that may impair the anti-tumor response contributing to the pathogenesis of Sézary syndrome

INTRODUÇÃO: A Síndrome de Sézary (SS) é um linfoma cutâneo de células T (LCCT), caracterizado por eritrodermia, linfadenopatia generalizada e presença de células tumorais na pele, linfonodos e sangue periférico. Os linfócitos TCD8+ têm papel fundamental na resposta imune antitumoral, entretanto, há escassos estudos evidenciando seu perfil fenotípico e funcional. Considerando que a resposta imunológica do paciente com SS está suprimida, estratégias para potencializar a imunidade inata e adaptativa com agonistas de receptores Toll-like (TLRs) têm sido exploradas. OBJETIVO: Caracterizar o perfil de marcadores de ativação/inibição das células TCD8+, seus estágios de diferenciação, capacidade de resposta a IL-7/IL-15 e ao agonista de TLR7/TLR8 de pacientes com SS. METODOLOGIA: Foram selecionados 15 pacientes com SS (7 homens e 8 mulheres) com 48-85 anos do Ambulatório de Linfomas Cutâneos, do HC-FMUSP, e um grupo de controle com 24 indivíduos sadios. A análise de marcadores de ativação/inibição e diferenciação celular em células TCD4/TCD8+ do sangue periférico foi realizada por citometria de fluxo. A expressão de marcadores extracelulares e citocinas intracelulares em células mononucleadas do sangue periférico (CMN) após estimulação com o agonista de TLR7/TLR8 foi analisada por citometria de fluxo. Além disto, o efeito de IL-7 e IL-5 em células T foi avaliado pela fosforilação de STAT5, na capacidade de proliferação mitogênica e expressão de BCL-2 em CMNs, como também pelos níveis séricos de IL-7 por citometria de fluxo. RESULTADOS: Os pacientes com SS mostram perfil fenotípico de ativação crônica nos linfócitos TCD8+ periféricos, decorrente do elevadopercentual de células TCD8+ CD38+, redução percentual de TCD8+ CD127+ (IL-7R) e da população naive. Além disso, ocorreu aumento de expressão de PD-1 na população naive de células TCD8+. O marcador de ativação, CD26, até então apenas relacionado com linfócitos TCD4, foi detectado em reduzida percentagem de linfócitos TCD8. A resposta para IL-7/IL-15 parece estar funcionalmente presente tanto nos linfócitos TCD4 quanto nos linfócitos TCD8. Contudo, foi encontrado um perfil diferenciado e heterogêneo de fosforilação de STAT5 assim como de expressão de BCL-2 nos linfócitos TCD8+ de pacientes com SS. O nível sérico de IL-7 reduzido dos pacientes com SS foi inversamente correlacionado com o número absoluto de linfócitos TCD4+. CONCLUSÃO: Os linfócitos TCD8+ dos pacientes com SS encontram-se reduzidos em números absolutos, e possuem um perfil alterado de diferenciação celular e expressão de marcadores extracelulares. A redução percentual da população de TCD8+ naive associada com a presença de moléculas de ativação crônica mostra um perfil de imunosenescência. As células TCD8+ exibem baixa capacidade de resposta aos ligantes de TLR intracelulares, provavelmente devido ao perfil de ativação crônica. Além disso, há resposta parcial dos linfócitos TCD8+ às citocinas ligantes do receptor yc. Nossos resultados evidenciam alterações em linfócitos TCD8+ que debilitam a resposta imune antitumoral e que pode contribuir com a patogênese da síndrome de Sézary / INTRODUCTION: Sézary syndrome (SS) is a cutaneous T cell lymphoma (CTCL), characterized by erythroderma, generalized lymphadenopathy and the presence of tumor cells in the skin, lymph nodes and peripheral blood. The TCD8+ lymphocytes play a key role in anti-tumor immune response, whereas, there are few studies showing its phenotypic and functional profile in SS. Considering that the immune response of SS patient is suppressed, strategies to enhancing the innate and adaptive immunity by Toll-like receptors (TLRs) agonists have been explored. OBJECTIVE: To characterize the profile of activation/inhibition markers of CD8+ T cells, their stages of differentiation, ability of response to IL-7/IL-15 and TLR7/TLR8 agonist of patients with SS. METHODOLOGY: Fifteen SS patients were enrolled (7 men and 8 woman) with 48-85 years from the Clinic of Cutaneous Lymphomas, HC-FMUSP, and a control group of 24 healthy individuals. Analysis of activation/inhibition markers and cellular differentiation in CD4/CD8 T cells from peripheral blood were assessed by flow cytometry. The expression of extracellular markers and intracellular cytokines in mononuclear cells in the peripheral blood (CMN) were evaluated by flow cytometry. Moreover, the effect of IL-7 and IL-15 stimulation in T cells was assessed by the STAT5 phosphorylation, proliferative mitogenic capacity, BCL-2 expression in CMNs as well as serum IL-7 levels by flow cytometry. RESULTS: Patients with SS show a phenotypic CD8 T peripheral lymphocytes profile of chronic activation, due to the high percentage of CD8+CD38+ T cells, reduced percentage of CD8+CD127+ (IL-7R) and naïve population. Furthermore, it was observed an increased PD-1 expression in the naïve CD8+ T cells. The activation marker CD26, previously only associated with CD4 T lymphocyte, was detected at decreased percentage in CD8 T lymphocytes. The TLR7/TLR8 agonist did not affect the IFN-? and TNF secretion of CD8 T lymphocytes of SS patients, in contrast to the control group. The response to IL-7/IL-15 appears to be functional in both CD4 and CD8 T lymphocytes. However, it was founded a differentiated and heterogeneous profile of STAT5 phosphorylation and Bcl-2 expression in the CD8 T lymphocytes in SS patients. The reduced IL-7 serum of patients with SS was inversely correlated with the absolute number of CD4 T lymphocytes. CONCLUSION: CD8 T lymphocytes of patients with SS are reduced in absolute numbers, and show an altered cellular differentiation profile and extracellular markers expression. The reduced percentage of CD8 naïve population associated with chronic activation of molecules reveals an immunosenescence profile. The CD8 T cells exhibit low ability to ligands of intracellular TLR receptors, probably due to chronic activation profile. In addition, there are partial response of CD8 T lymphocytes to the cytokine receptor ?c. Our results show disturbance in CD8 T lymphocytes that may impair the anti-tumor response contributing to the pathogenesis of Sézary syndrome

No description available.

Regulatory T cells (Treg) represent a crucial CD4 T cells subset involved in maintenance of immune-tolerance. Since their first description important efforts have been undertaken to better understand their biology, their development and their mechanisms of action. However, little is known about factors controlling Treg peripheral homeostasis. The aim of this thesis work was to better define mechanisms involved in governing Treg homeostasis and to investigate the eventual contribution of perturbation of Treg homeostasis in human disease. In the first part of this thesis work we tried to define in the murine system the role played by IL-7 in governing Treg homeostasis. We showed that Treg surface expression of CD127, the IL-7 receptor alpha chain, is finely regulated as it depends on their activation as well as on their tissue localization. More importantly, we demonstrated that Treg do express functional levels of CD127, identifying these cells as potential target of IL-7. Using both genetically modified murine models of altered IL-7 signaling and adoptive transfer models, we obtained definitive evidence for a direct role of IL-7 in governing Treg cell numbers. Finally, we demonstrated that IL-7 signaling in Treg optimizes their capacity to react to IL-2 an important cytokine regulating Treg homeostasis. In the second part of this work we investigated Treg homeostasis in the context of HIV infection. Employing for the first time in HIV infection a novel consensus Treg identification strategy and applying it to different groups of HIV infected patients, including primary infected patients and HIV controllers, we showed that HIV infection is characterized by an early and long lasting alteration of Treg homeostasis. In particular we demonstrated that effector rather than naive Treg are affected by HIV infection. Moreover, we showed that effector Treg numbers inversely correlated with HIV specific CD8 T cells responses, providing ex vivo evidence of Treg involvement in HIV immunity.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed June 6, 2008). Includes bibliographical references.

Des progrès majeurs dans l'espérance et la qualité de vie ont étéenregistrés dans la lutte contre le VIH et le SIDA avec l'introduction des traitementsantirétroviraux combinés. De nos jours, cette thérapie réduit nettementla charge virale après quelques semaines de traitement chez la plupart des patients.Ceci conduit généralement à une reconstitution satisfaisante du nombrede cellules CD4+, mais ce n'est pas toujours le cas. Cette thèse est focaliséesur les patients ayant une réponse immunitaire insuffisante malgré une chargevirale indétectable, après au moins 6 mois de thérapie antirétrovirale combinée.A ce moment, l'Interleukine 7 (une cytokine secrétée par la moelle épinièreet le thymus) est une thérapie prometteuse pour restaurer le système immunitairedans une telle situation. Pendant ce travail de thèse, nous avons contribuéà l'analyse des études INSPIRE 2 & 3, ou 107 patients présentant une faibleréponse immunitaire ont reçu des cycles (3 injections) répétés de r-hIL-7 (Inter-leukine 7 recombinée humaine).Nous avons utilisé des modèles dynamiques basés sur des systèmes d'équationsdifférentielles pour analyser l'effet de la r-hIL-7 exogène sur les cellules CD4+lors des trois études INSPIRE. Un modèle mathématique, avec un modèle àeffets mixtes appliqué sur les paramètres biologiques et un \modèle pour les observations"forment la structure de notre travail. Une estimation par maximumde vraisemblance basée sur une méthode de type Newton est combinée avec uneestimation du maximum a posteriori dans un contexte semi-Bayésien / Fight against HIV and AIDS has shown major improvements inlife expectancy and quality of life of HIV-infected people since the introductionof the cART. Today, viral load dramatically decreases a few weeks after startingantiretroviral therapy, and it becomes undetectable after 6 months for most ofpatients. This usually leads to an adequate reconstitution of CD4+T cells pool,but this is not necessarily always true. This thesis is focalised on these \lowimmunological responder" patients, who have not reached acceptable levels ofCD4+ T cells count despite undetectable viral load 6 months after having startedthe cART therapy.Today, Interleukin 7 (a cytokine naturally secreted in the bone marrow andthe thymus) is considered as one of the rare potential solution to boost the immunesystem in this situation. During this thesis work, we have collaborated toanalyze data from the INSPIRE 2 & 3 trials, where repeated cycles (3 subcutaneousinjections) of recombinant human Interleukin 7 have been administeredto a total of 107 of these \low responder patients".We have used dynamical models based on systems of ordinary differentialequations to study the ffect of the exogenous Interleukin 7 on CD4+ T cellsthrough the three INSPIRE studies. A mathematical model together with amixed effects model applied on the biological parameters of the ODE systemand a \model for the observations" make up the structure of our work. Amaximum likelihood approach based on an adaptation of a Newton-like methodis combined with a maximum a posteriori estimation in a semi-Bayesian context.

Interleukin-7 (IL-7) is an essential cytokine for lymphocyte growth that has the potential for promoting proliferation and survival. While the survival and proliferative functions of IL-7 are well established, the identities of IL-7 signaling components in pathways other than JAK/STAT, that accomplish these tasks remain poorly defined. To this end, we used IL-7 dependent T-cells to examine those components necessary for cell growth and survival. Our studies revealed two novel signal transducers of the IL-7 growth signal: BimL and JunD. IL-7 promoted the activity of JNK (Jun N-terminal Kinase), and that JNK, in turn, drove the expression of JunD, a component of the Activating Protein 1 (AP-1) transcription factors. Inhibition of JNK/JunD blocked glucose uptake and HXKII gene expression, indicating that this pathway was responsible for promoting HXKII expression. After a bioinformatics survey to reveal possible JunD-regulated genes activated early in the IL-7 signaling cascade, our search revealed that JunD could control the expression of proteins involved in signal transduction, cell survival and metabolism, including Pim-1. Pim-1, an IL-7 induced protein, was inhibited upon JNK or JunD inhibition. Our hypothesis that JunD positively regulated proliferation was confirmed when the proliferation of primary CD8+ T-cells cultured with IL-7 was impaired upon treatment with JunD siRNA. These results show that the IL-7 signal is more complex than the JAK/STAT pathway, activating JNK and JunD to induce rapid growth through the expression of metabolic factors like HXKII and Pim-1. When metabolic activities are inhibited, cells undergo autophagy, or cell scavenging, to provide essential nutrients. Pro-apoptotic Bim was evaluated for its involvement in autophagy. Bim is a BH3-only member of the Bcl-2 family that contributes to T-cell death. Partial rescue of iv T-cells occurs when Bim and the interleukin-7 receptor are deleted, implicating Bim in IL-7- deprived T-cell apoptosis. Alternative splicing results in three different isoforms: BimEL, BimL, and BimS. To study the effect of Bim deficiency and define the function of the major isoforms, Bim-containing and Bim-deficient T-cells, dependent on IL-7 for growth, were used. Loss of Bim in IL-7-deprived T-cells delayed apoptosis, but blocked the degradative phase of autophagy. The conversion of LC3-I to LC3-II was observed in Bim-deficient T-cells, but p62, which is degraded in autolysosomes, accumulated. To explain this, BimL, was found to support acidification of lysosomes associated with autophagic vesicles. Key findings showed that inhibition of lysosomal acidification accelerated death upon IL-7 withdrawal only in Bimcontaining T-cells, indicating that in these cells autophagy was protective. IL-7 dependent Tcells lacking Bim were insensitive to inhibition of autophagy or lysosomal acidification. BimL co-immunoprecipitated with dynein and Lamp1-containing vesicles, indicating BimL could be an adaptor for dynein to facilitate loading of lysosomes. In Bim deficient T-cells, lysosometracking probes revealed vesicles of less acidic pH. Over-expression of BimL restored acidic vesicles in Bim deficient T-cells, while other isoforms, BimEL and BimS, associated with intrinsic cell death. These results reveal a novel role for BimL in lysosomal positioning that may be required for the formation of functional autolysosomes during autophagy

Dans les cas de lymphopénie, les lymphocytes T résiduels prolifèrent exagérément dans un phénomène appelé «expansion homéostatique périphérique» (HPE), qui est efficace pour la régénération des T CD8+, mais inefficace pour les T CD4+. L’interleukine-7 (IL7) est une cytokine homéostatique utilisée afin d’augmenter les comptes lymphocytaires T des patients lymphopéniques. Toutefois, la raison de l’expansion préférentielle des lymphocytes T CD8+ par l’IL7 demeure toujours inconnue. Nous montrons que cette expansion est due au fait que l’IL7 induit une prolifération efficace des T CD8+ périphériques (CD8+PERI) ainsi que des émigrants thymiques CD8+ (CD8+RTEs). Par contre, l’effet prolifératif de l’IL7 est restreint presqu’uniquement aux CD4+RTEs même si les CD4+PERI survivent mieux que les CD4+RTEs. De plus faibles doses d’IL7 sont nécessaires aux CD4+RTEs afin de phosphoryler STAT5 ou de proliférer comparativement aux CD4+PERI et nous démontrons que les contacts TCR/CMHII sont nécessaires à la prolifération induite par l’IL7 des CD4+RTEs en périphérie. De fait, augmenter au Flt3 ligand le nombre de cellules dendritiques périphériques d’une souris donneuse, avant de transférer ses TPERI dans des souris receveuses traitées à l’IL7 induit une prolifération significative des CD4+PERI. Nos résultats indiquent donc que l’abondance des contacts TCR/CMHII reçus dans le thymus semble contrôler la sensibilité à l’IL7 des CD4+RTEs. Finalement, l’observation que les CD8+PERI et CD8+RTEs prolifèrent pareillement pendant la thérapie à l’IL7, alors que la prolifération des T CD4+ est largement restreinte aux RTEs expliquerait pourquoi, dans les cas de lymphopénie, la régénération des T CD4+ est aussi dépendante de la thymopoïèse. / In lymphopenic settings, residual T lymphocytes typically undergo exaggerated proliferation via homeostatic peripheral expansion (HPE). While HPE efficiently regenerates CD8+ T cells, it is unable to normalize CD4+ T-cell counts. Interleukin-7 (IL7) is a homeostatic cytokine, currently used in trials in order to increase T-cell counts in lymphopenic humans. Nowadays, it is still not known why IL7 therapy is more effective toward the expansion of CD8+ T cells rather than CD4+ T cells. Here we show that CD8+ T cells preferential expansion is due to IL7-induced efficient proliferation of peripheral CD8+ T cells (CD8+PERI) and CD8+ recent thymic emigrants (CD8+RTEs). In contrast, the proliferative action of IL7 is largely restricted to CD4+RTEs although CD4+PERI survive better than CD4+RTEs. Interestingly, CD4+RTEs require lower concentrations of IL7 in order to phosphorylate STAT5 or proliferate when compared to CD4+PERI, and we demonstrate the requirement for TCR/MHCII contacts to support the IL7-induced HPE of CD4+RTEs in the periphery. Furthermore, augmenting the number of MHCII expressing cells in the periphery of donor mice by treating them with Flt3 ligand (Flt3L) prior transferring their TPERI cells in IL7 therapy-treated recipients, significantly enhances the IL7-induced proliferation of CD4+PERI. Our results indicate so far that the abundance of TCR triggering occurring inside the thymus drives IL7 responsiveness of CD4+RTEs. Moreover, the observation that CD8+PERI and CD8+RTE proliferate similarly during IL7 therapy, while proliferation of CD4+ T cells is largely restricted to RTEs, may explain why CD4+ T cells regeneration in lymphopenic settings is highly dependent on thymopoiesis.

La transplantation allogénique de cellules souches hématopoïétiques (ASCT) est couramment utilisée pour traiter différents cancers hématologiques. Malheureusement, l’effet bénéfique de cette technique est limité par la réaction du greffon contre l’hôte (GVHD) qui demeure la cause principale de mortalité post-greffe. La GVHD endommage différents organes et retarde la reconstitution immunitaire des lymphocytes T (LT) ce qui augmente les risques d’infection et de rechute. Le développement de nouveaux traitements permettant d’accélérer la reconstitution immunitaire augmenterait donc les chances de survie des patients greffés. Il existe deux façons de régénérer des LT: via la thymopoïèse qui consiste à produire de nouveaux LT, ou par la prolifération homéostatique (PH) qui implique l’expansion rapide des LT matures retrouvés dans le greffon. La PH requiert deux signaux essentiels: l’interleukine-7 (IL-7) et la présentation d’antigènes du soi par les cellules dendritiques (DC) via le complexe majeur d’histocompatibilité (CMH) I pour les LT CD8+ et le CMH II pour les LT CD4+. Dans un contexte d’ASCT, la chimiothérapie et la GVHD endommagent le thymus rendant la thymopoïèse inefficace. Par conséquent, la reconstitution immunitaire repose presque entièrement sur la PH des LT. L’objectif de cette thèse était de comprendre comment la GVHD affecte la reconstitution des LT. Grâce à un modèle murin, nous avons démontré que la PH des LT CD4+ est absente durant la GVHD et ce, dû à de faibles niveaux d’IL-7 et une diminution du nombre de DC. La perte des DC est en grande partie causée par des niveaux réduits de stromal derived factor-1α (SDF-1α) et par l’absence de progéniteurs de DC dans la moelle osseuse des souris en GVHD. Le traitement des souris en GVHD avec du SDF-1α permet d’augmenter le nombre de DC, et lorsqu’administré avec l’IL-7, améliore significativement la PH des LT CD4+. Contrairement aux LT CD4+, l’administration d’IL-7 seule est suffisante pour restaurer la PH des LT CD8+ durant la GVHD et ce, même en absence des DC. Ces différences s’expliquent pour deux raisons : 1) l’expression du CMH I, contrairement au CMH II, n’est pas limitée aux DC mais est également exprimée par les cellules stromales du receveur ce qui est suffisant pour induire la PH des LT CD8+ et 2) les LT CD8+ répondent à des concentrations plus faibles d’IL-7 systémique comparativement aux LT CD4+. En conclusion, l’ensemble de ces résultats permettra de mettre en place des études translationnelles sur le potentiel thérapeutique du SDF-1α et de l’IL-7 dans la reconstitution immunitaire des patients greffés. / Hematological cancers are currently treated with allogeneic hematopoietic stem cell transplantation (ASCT). Unfortunately, graft-versus-host disease (GVHD) greatly limits the health benefits of this procedure, as it is the main cause of mortality post-ASCT. GVHD damages various organs and delays the immune reconstitution of T lymphocytes (TL), which increases the risk of infections and relapse. Thus, developing new treatments modulating the immune reconstitution following ASCT would greatly enhance survival of the transplanted patients. TL can be regenerated by two ways: de novo production of TL by thymopoiesis; or homeostatic proliferation (HP), which consists of rapidly expanding mature TL already present in the graft. HP requires two crucial signals: interleukin-7 (IL-7) and self-antigen presentation by dendritic cells (DC) via the major histocompatibility complex (MHC) I for CD8+ TL and MHC II for CD4+ TL. During ASCT however, chemotherapy and GVHD induce damage to the thymus making thymopoiesis inefficient, and thus immune reconstitution relies almost entirely on HP of TL. The objective of this thesis was to understand how GVHD affects TL reconstitution. Using a mouse model, we demonstrate that CD4+ TL fail to undergo HP when transferred in GVHD hosts due to low levels of IL-7 and reduced numbers of DCs. Moreover, the loss of DCs is mostly caused by reduced levels of Stromal Derived Factor-1 alpha (SDF-1α) and the absence of DC progenitors in the bone marrow of mice suffering from GVHD. Treating GVHD hosts with SDF-1α resulted in increased DC counts and, when administered in combination with IL-7, significantly improved HP of CD4+ TL. Unlike CD4+ TL, administration of IL-7 alone was sufficient to restore HP of CD8+ TL in GVHD mice and this, regardless of the presence of DCs. These differences could be explained by two reasons: 1) MHC I expression is not limited to DCs but is expressed by stromal cells from the recipient, which is sufficient to promote HP in CD8+ TL and 2) CD8+ TL respond to lower doses of systemic IL-7 in comparison to CD4+ TL. In conclusion, these results can lead to future translational studies on the therapeutic potential of SDF-1α and IL-7 in the immune reconstitution of grafted patients.

O Diabetes Mellitus tipo 1 (DM1A) é uma doença autoimune caracterizada pela infiltração pancreática de linfócitos T e B, macrófagos e células dendríticas, levando à perda progressiva da capacidade de secreção de insulina pelas células beta pancreáticas. A homeostase das células T, ou seja, o desenvolvimento e manutenção apropriados dos números e funções das células T são essenciais para a integridade do sistema imune. Classicamente acreditava-se que as células T CD4+ poderiam se subdividir em duas populações efetoras distintas, T helper 1 e T helper 2. Recentemente, foram descritas duas novas vias de ativação de linfócitos T CD4+: a via Th17, que tem papel fundamental na autoimunidade; a via T regulatória, onde células T CD4+CD25+ high são essenciais na tolerância periférica e proteção contra autoimunidade. As Interleucinas (IL) de cadeia gama comum agem em várias etapas desta diferenciação linfocítica. A IL-21 é o membro mais recente desta família de citocinas, que inclui também: IL-2, IL-4, IL-7 , IL-9 e IL-15. A IL-21 atua através da interação com seu receptor, o IL-21R, apresentando ações pleiotrópicas e, como regra, pró-inflamatórias. Em estudos com modelos animais de diabetes autoimune verificou-se que a IL-21 e seu receptor são essenciais para o desenvolvimento da doença, porém ainda não há estudos sobre a ação desta interleucina no DM1 em humanos. O objetivo de nosso estudo foi avaliar o papel dos receptores das interleucinas de cadeia gama comum na patogênese do DM1A através da determinação da expressão da proteína de superfície e do RNA mensageiro destes receptores em pacientes com DM1A de início recente, em comparação com indivíduos controles normais, e da correlação destes valores com títulos de autoanticorpos pancreáticos. Estudamos a expressão da proteína de superfície do IL-21R, IL-2R (CD25), IL-2R (CD122), IL-4R (CD124) e IL-7R (CD127) em linfócitos T periféricos de 35 pacientes com DM1 e 25 controles sadios utilizando citometria de fluxo. O tempo médio de diagnóstico do DM1 foi de 3 meses, e todos os pacientes estavam em uso de insulina no momento da coleta de sangue. Auto-anticorpos pancreáticos (anti-GAD65 e anti-IA2) foram dosados através de radioimunoensaio. A expressão do RNAm de IL-21R, IL-2R e IL-2R foi quantificada por PCR em tempo real em 23 dos pacientes portadores de DM1A. Detectamos, pela primeira vez, diminuição significativa na expressão proporcional de IL-21R, CD25 e CD122 em linfócitos TCD3+ e TCD4+, além de diminuição na expressão de CD124 em linfócitos T CD4+ e CD127 em linfócitos T CD3+. Verificamos também redução significativa na quantidade de células TCD4+CD25+high (T regulatórias) nos pacientes DM1A. Não houve correlação entre expressão dos receptores de superfície das interleucinas de cadeia gama comum e títulos de autoanticorpos pancreáticos. Realizamos o PCR em tempo real para quantificar a expressão do RNA mensageiro (RNAm) dos receptores de interleucinas de cadeia gama comum, e avaliar se esta correspondia à expressão das proteínas de superfície obtida através de citometria de fluxo. Comparamos a expressão do RNAm de IL-21R, IL-2R e IL-2R nos pacientes DM1A dividindo-os em tercis de acordo com os valores de expressão de proteína de superfície obtidos por citometria de fluxo em linfócitos T CD3+, e verificamos que não houve diferença entre os 3 grupos na expressão relativa dos genes estudados. Portanto, em nossa casuística a redução da expressão da proteína de superfície dos receptores de interleucinas de cadeia gama comum possivelmente decorreu de alterações posteriores à transcrição do RNA mensageiro / Type 1 diabetes (T1D) is a chronic autoimmune disease characterized by pancreatic infiltration of T and B lymphocytes, macrophages and dendritic cells, leading to a progressive destruction of the insulin-producing -cells. Homeostasis of T cells can be defined as the ability of the immune system to maintain normal T-cell counts and to restore T-cell numbers following T-cell depletion or expansion. It was classically believed that the CD4+ T cells could be activated into two distinct effector populations, T helper1 and T helper2. It was recently described two new pathways of CD4+ T lymphocytes activation: the Th17 pathway, that plays a fundamental role in autoimmunity and the regulatory pathway (Treg), where CD4+CD25+high T cells are essential to maintain peripheral tolerance and therefore protect against autoimmunity. The common gamma chain cytokines interfere with several steps of the CD4+ T lymphocytes differentiation. Interleukin-21 (IL-21) is the most recent member of this family, that also includes IL-2, IL-4, IL-7, IL-9 and IL-15, and has pleiotropic effects on the immune system. Interleukin-21 acts through interaction with its receptor, the IL-21R, which is expressed in a great variety of immune cells. Various studies with animal models of autoimmune diabetes demonstrated that IL-21 and its receptor are essential for the development of the disease, but there are no studies evaluating the role of this interleukin and its receptor in T1DM in humans. The aim of our study was to assess the role of common gamma chain-dependent cytokine receptors in the pathogenesis of T1D, by determining the expression of the surface protein and mRNA of these receptors in recent-onset T1D patients and correlating these values with titles of pancreatic autoantibodies. We studied the surface protein expression of IL-21R, IL-2R (CD25), IL-2R (CD122), IL-4R (CD124) and IL-7R (CD127) in peripheral T lymphocytes of 35 patients with T1D and 25 healthy controls using flow cytometry. Mean T1D duration was 3 months and all patients were using insulin at the time of blood withdraw. Pancreatic autoantibodies (anti-GAD65 and anti-IA2) were assessed by radioimmunoassay. The mRNA expression of IL-21R, IL-2R and IL-2R was quantified by real time PCR in 23 of the T1D patients. We detected for the first time a statistically significant decrease in the proportional expression of IL-21R, CD25 and CD122 on CD3+ and CD4+ T lymphocytes, a decrease in the expression of CD124 on CD4+ T cells and CD127 on CD3+ T lymphocytes. We also observed a significant reduction in the amount of CD4+ CD25+high (T regulatory cells) in T1D patients. There was no correlation between the expression of the surface receptors of common gamma chain cytokines and titles of pancreatic autoantibodies. We performed real-time PCR to quantify RNA expression of common gamma-chain interleukin receptors, and evaluate if these values corresponded to those of surface proteins obtained using flow cytometry. We compared the mRNA expression of IL-21R, IL-2R and IL-2R in T1D patients by dividing them into tertiles according to the expression values of surface protein obtained by flow cytometry in CD3+T lymphocytes. We observed that there was no difference in the relative expression of mRNA among the 3 groups of patients. Therefore, in our study, the reduction of surface protein expression of common gamma chain cytokines receptors was possibly due to alterations that occurred after the transcription of mRNA