Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2006. / Härtill 3 uppsatser.

Thesis (Ph. D.)--University of Virginia, 2006. / Includes bibliographical references. Also available online through Digital Dissertations.

La maladie d'Alzheimer est devenue le désordre neurodégénérarif le plus important chez les personnes âgées chez qui elle se manifeste par un déclin cognitif. Cette maladie se caractérise par l'accumulation dans le cerveau de peptides amyloïdes, particulièrement le peptide Aβ42, qui s'avère être le plus toxique. Ce peptide doit être éliminé du cerveau et le transporteur P-glycoprotéine présent dans la Barrière Hémato Encéphalique (BHE) a été proposé comme intervenant dans ce processus. L'objectif essentiel de cette thèse, était de savoir si le peptide Aβ42 est pris en charge par la P-gp. Nos résultats suggèrent que ce transport semble ne pas être possible. Dans le but d'explorer quels sont les changements conduisant à la mort neuronale lors de la maladie d'Alzheimer, une étude sur la modification de deux paramètres contribuant à la vie cellulaire a été aussi réalisée, a savoir : le potentiel membranaire et la concentration intercellulaire des ions chlorure. Des altérations dans ces deux paramètres ont été observées lors de l'incubation des cellules neuronales avec Aβ42. Finalement afin de mieux comprendre l'interaction des molécules avec la P-gp pouvant aboutir à la conception de nouveaux traitements pour la maladie d'Alzheimer, une étude sur l'effet inhibiteur de différentes molécules sur la P-gp parachève cette thèse. Les résultats obtenus lors de ces trois études portent une contribution à la compréhension dans le domaine du développement de cette maladie. / Alzheimer's disease has become the most important degenerative disorder in elderly people, being cognitive decline its main result for patients who exhibit such medical condition. A hallmark of this disease is the brain accumulation of amyloïd peptides, particulary Aβ42 peptide, wich is revealed to be the most toxic. This peptide must be eliminated of brain, and the transporter P-glycoprotein at the blood brain barrier (BBB) has been proposed for this process. The principal aim of this thesis was to know if Aβ42 is transported by P-gp. Our results suggested that such transport mechanism di not seem to be possible.In order to explore the underlying changes that drive neuronal death in Alzheimer's disease, a study of variations in two parameters importants for cell survival (membrane potential and intracellular concentration of chloride) has been made. Alterations in theses parameters were observed in neuronal cells incubated in the presence of Aβ42 . Finally, a study on inhibitor effect of different molecules on P-gp activity completes this thesis, to accomplish the aim understanding molecules interactions with P-gp, so as to establish some possible guidelines related with new treatments for Alzheimer's disease. The overall results obtained in the three studies herein contribute to understand the development of this disease.

Asthma is a multi-faceted chronic inflammatory disease accompanied by loss of airway epithelial integrity leading to remodeling of the airways. Perturbations to the lung redox environment, including alterations in glutathione (GSH) content, have been reported in asthma. GSH can be conjugated to protein cysteines, controlling protein function in an oxidant-dependent process known as protein S-glutathionylation (PSSG). The thioltransferase, glutaredoxin-1 (Glrx1), deglutathionylates proteins under physiological conditions, restoring sulfhydryl groups of target proteins. Glrx1 is emerging as a critical player in settings of allergic airway disease, but its function in regulating epithelial cell responses to asthma-relevant cytokines has not been examined. Furthermore, the role of Glrx1 in controlling the extent of airway remodeling in response to house dust mite (HDM) in vivo is still not well understood. Interleukin-17A (IL-17A) is a potent cytokine that stimulates epithelial cells to produce pro-inflammatory mediators, in part by activating the nuclear factor kappaB (NF-κB) pathway, a key regulator of inflammation. We demonstrate that interleukin-17A (IL-17A) induces rapid activation of both classical and alternative NF-κB, while simultaneously resulting in protein oxidation and PSSG. In particular, we show IL 17A induces S-glutathionylation of RelA (RelA-SSG) and IKKα (IKKα-SSG), which is enhanced following siRNA-mediated knockdown of Glrx1. We also demonstrate that absence of Glrx1 leads to increased nuclear content of RelA and RelB and enhanced production of NF-κB-driven pro-inflammatory genes, KC and CCL20 while decreasing IL-6 expression. Finally, we show that siRNA-mediated knockdown of IKKα attenuates nuclear RelA and RelB and dampens pro-inflammatory gene production. Together, these data indicate a crucial role for the Glrx1/PSSG axis in controlling RelA-SSG, IKKα-SSG and epithelial cell responsiveness to IL-17A. Mice lacking Glrx1 were previously shown to display enhanced resolution of allergic airway disease induced by ovalbumin (Ova) challenge. In this study, we determined the role of Glrx1 in a HDM model of allergic airway disease. Wild type (WT) mice and Glrx1 deficient (Glrx1-/-) mice demonstrated similar total lung cell counts, but Glrx1-/- mice displayed fewer neutrophils than WT mice. Conversely, mice overexpressing Glrx1 specifically in CCSP positive cells in the lung (Epi-Glrx1) showed attenuated total lung cell counts and lung eosinophils compared to control mice. Immunohistological analysis of remodeling markers revealed that Glrx1-/- mice displayed increased HDM-induced mucus metaplasia, α smooth muscle actin (αSMA) positivity and collagen staining compared to WT mice. Evaluation of total lung collagen showed that Glrx1-/- mice had significantly higher collagen content compared to WT mice. In Epi-Glrx1 mice, attenuation of mucus metaplasia, αSMA content and collagen staining was observed compared to control mice. Furthermore, Epi-Glrx1 mice also demonstrated significantly impaired collagen production compared to control mice. We also demonstrate that Glrx1 absence results in decreased expression of the epithelial cell marker, E-cadherin, and increased expression of αSMA, a mesenchymal marker. Together, these studies demonstrate a critical role for Glrx1 in controlling epithelial cell responses to IL-17A and in mediating in vivo collagen production in response to chronic allergen exposure.

Type 1 diabetes affects around 0.5% of the population in developed countries and the incidence rates have been rising over the years. The destruction of beta cells is irreversible and the current therapy available to patients only manages the symptoms and does not prevent the associated pathological manifestations. The patients need lifelong therapy and intensive research is being carried out to identify ways to eliminate autoimmune responses directed against pancreatic beta cells and to replace or regenerate beta cells. The work presented herein aimed at analyzing the role of the Th17 T cell subset, characterized by secretion of the pro- inflammatory cytokine IL-17A, in autoimmune diabetes and also at generating a beta cell reporter mouse line in the NOD background, the most widely- used mouse model for type 1 diabetes. We generated IL- 17A knockdown (KD) NOD mice, using RNAi in combination with lentiviral transgenesis. We analyzed diabetes frequency in IL-17A deficient mice and found that the loss of IL-17A did not protect the transgenic mice from diabetes. Based on these observations, we believe that Th17 cells do not play a critical role in type 1 diabetes through the IL-17A pathway, though they might still be involved in the disease process through alternate pathways. We also generated NOD and NOD-SCID mice with a transgene that drives the beta cell specific expression of a luciferase reporter gene. We used a lentiviral construct, which combined a luciferase sequence and a short- hairpin RNA (shRNA) expression cassette, allowing gene- knockdown under the beta cell specific rat insulin promoter (RIP). These mice will be of use in studying beta cell phenotypes resulting from the knockdown of target genes, using non- invasive bioimaging. We believe that the generation of these reporter mouse lines for diabetes studies will prove valuable in future investigations. Furthermore, the demonstration that the loss of IL-17A does not alter susceptibility to type 1 diabetes should help clarify the controversial involvement of Th17 cells in this disease. / In Industrieländern erkranken etwa 0,5 % der Bevölkerung an Typ-1-Diabetes und die Krankheitsrate ist in den letzten Jahren angestiegen. Die dabei stattfindende Zerstörung der insulinproduzierenden Beta-Zellen ist irreversibel und die derzeitig verfügbaren Therapien behandeln lediglich Symptome, verhindern die pathologischen Auswirkungen aber nicht. Patienten benötigen daher eine lebenslange Therapie und es wird intensiv daran gearbeitet, Wege zu identifizieren, die die autoimmune Antwort gegen pankreatische Beta-Zellen unterbinden, oder aber Beta-Zellen ersetzen, beziehungsweise regenerieren lassen. Die vorliegende Arbeit hat zum Ziel, die Rolle der Th17 T-Zellen, welche durch die Sekretion des proinflammatorischen Zytokins IL-17A gekennzeichnet sind, in Typ-1- Diabetes zu analysieren. Zusätzlich wurden Reportermauslinien im NOD Hintergrund, dem am weitesten verbreiteten Mausmodell für Typ-1-Diabetes, generiert. Durch RNAi, in Kombination mit lentiviraler transgener Technologie, wurden IL-17A Knockdown (KD) NOD Mäuse generiert. Die Diabeteshäufigkeit in IL-17A defizienten Mäusen wurde mit dem Ergebnis untersucht, dass der Verlust von IL-17A die transgenen Mäuse nicht vor Diabetes schützt. Von dieser Beobachtung ausgehend wurde gefolgert, dass Th17 Zellen zumindest über den IL-17A Signalweg keine entscheidende Rolle bei Typ-1-Diabetes spielen, diese allerdings durch alternative Signalwege durchaus im Krankheitsprozess beteiligt sein könnten. Außerdem wurden NOD und NOD-SCID Mäuse mit einem Transgen, das die Beta-Zell spezifische Expression eines Luciferasereporters steuert, generiert. Hierbei wurde ein lentivirales Konstrukt genutzt, welches sowohl die Luciferase, als auch eine short-hairpin RNA (shRNA) Expressionssequenz beinhaltet, um einen Genknockdown unter Kontrolle des spezifischen Insulinpromotors der Ratte (RIP) zu erlauben. Diese Mäuse werden bei zukünftigen nicht-invasiven bildgebenden Untersuchungen des Beta-Zell Phänotyps, der aus dem Knockdown von Zielgenen resultiert, von großem Nutzen sein. In zukünftigen Untersuchungen wird sich die Generierung dieser Reportermauslininien für Diabetesstudien sicherlich als wertvoll erweisen. Des Weiteren sollte die Erkenntnis, dass der Verlust von IL-17A die Anfälligkeit für Typ-1-Diabetes nicht verändert, zu einem besseren Verständnis der kontrovers diskutierten Beteiligung der Th17 Zellen führen.

In the present study, we investigated the functional differences between cluster of differentiation (CD)14++CD16- and CD14+CD16+ monocytes during anti-Candida host defense. CD14++CD16- are the "classical" monocytes and represent the majority of circulating monocytes in humans, while CD14+CD16+ monocytes patrol the vasculature for maintenance of tissue integrity and repair. Both monocyte subsets inhibited the germination of live Candida albicans, and there was no difference in their capacity to phagocytose and kill Candida. Although production of IL-6 and IL-10 induced by C. albicans was found to be similar between monocyte subsets, IL-1β and prostaglandin E2 (PGE2) production was higher in CD14++CD16- compared with CD14+CD16+ monocytes. In line with the increased production of IL-1β and PGE2, central mediators for inducing Th17 responses, CD14++CD16- monocytes induced greater Th17 responses upon stimulation with heat-killed C. albicans yeast. The percentage of cells that expressed mannose receptor (MR) was higher in the CD14++CD16- monocyte subset, and MR-specific stimulation induced higher Th17 responses only in co-cultures of CD14++CD16- monocytes and CD4 lymphocytes. In conclusion, both monocyte subsets have potent innate antifungal properties, but only CD14++CD16- monocytes are capable of inducing a potent Th17 response to C. albicans, an important component of antifungal host defense.

Introduction: Canadian First Nations experience a significantly higher rate of Mycobacterium tuberculosis (MTB) infection than non-Indigenous Canadians. Th17 cells are a subset of CD4+ T cells that are distinguished by their production of Interleukin-17A (IL-17A), an important cytokine for defense against mycobacteria. IL-17 is a primary contributor to the formation and stabilization of the lung granuloma, a biological containment vessel to protect the host from tuberculosis (TB). Past research with First Nations people has identified single nucleotide polymorphisms (SNPs) in the Th1 and Th2 immune pathways may affect their disease risk. However, SNPs in key Th17 related genes and the P2RX7 gene have not been explored in First Nations despite their important role against infectious diseases. Hypothesis: This research hypothesizes that distinct First Nations groups (Dene, Cree and Saulteaux) will have a different frequencies of SNPs in the key Th17 immunity related genes (IL-17A, IL-17AR, IL-23R, and IFN-γR) and the P2RX7 gene, as compared to a non-Indigenous Canadian group. Methods: SNP profiles (IL-17A rs2275913, IL-17RA rs4819554, IL-23R rs10889677, IFN-γR rs2234711 and P2RX7 rs3751143) were identified through literature research and the NCBI database was used for identifying gene motifs, primer locations and Restriction Enzyme cut sites. Polymerase Chain Reaction and Restriction Fragment Length Polymorphism analysis was performed on and visualized on agarose gel to determine specific allele frequencies. Four different Manitoba First Nations communities; the Northern Dene (Dene 1 N=69. Dene 2 N=52), Central Cree (N=46), and Southern Saulteaux (N=56), participated in this research and their SNP profiles were compared to a non-Indigenous Canadian cohort (N=99). Results: Allele frequencies for IL-17A were statistically different for every First Nation community when compared to the non-Indigenous cohort (Dene 1 p=0.0043, Dene 2 p=0.0000, Cree p=0.0001, Saulteaux p=0.0000). Allele frequencies for IL-17RA were statistically different for every First Nation community except Saulteaux when compared to the non-Indigenous cohort (Dene 1 p=0.0000, Dene 2 p=0.0028, Cree p=0.0000). Allele frequencies for IL-23R were statistically different for Dene 1 and Saulteaux community when compared to the non-Indigenous cohort (Dene 1 p=0.0002, Saulteaux p=0.0000). Allele frequencies for IFN-R were statistically different for Cree community when compared to the non-Indigenous cohort (Cree p=0.0026). Allele frequencies for P2RX7 were statistically different for both Dene communities when compared to the non-Indigenous cohort (Dene 1 p=0.0000, Dene 2 p=0.0000). Conclusions: An effective Th17 response is required to bring Th1 cells to infected tissues and to balance inflammatory responses. Functional SNPs may compromise an appropriate immune response and contribute to disease. This study demonstrate that the non-Indigenous population maintained a significantly different genetic profile when compared to the First Nations populations. / October 2016

Diabetes Mellitus tipo 1A (DM1A), doença autoimune clássica, decorrente da quebra de tolerância imune por fatores ambientais em indivíduos geneticamente predispostos, é caracterizada pela infiltração pancreática de linfócitos T e B, macrófagos e células dendríticas. As células T auxiliadoras 17 (Th17) são células potentes, altamente inflamatórias, que produzem a interleucina 17A (IL-17A), citocina mediadora de várias desordens imunológicas como, artrite reumatóide, esclerose múltipla, encefalite experimental autoimune, psoríase e asma, e em animais, o diabetes autoimune. No entanto, seu papel na patogênese do DM1A em humanos não está definido O objetivo de nosso estudo foi avaliar a influência da IL-17A na predisposição ao DM1A através da identificação de variantes alélicas no gene da IL-17A (por sequenciamento automático) e da determinação dos níveis séricos de IL-17A (por ELISA) e da expressão do seu receptor em linfócitos T periféricos (por citometria de fluxo). Foram analisados 103 pacientes com DM1A (idade 15,15 ± 10,38) e 102 controles normais (idade 18,29 ± 10,83). O estudo da expressão do receptor da IL-17A em linfócitos T periféricos bem como o da proteína sérica foram conduzidos em 24 pacientes com DM1A recente (duração inferior a 6 meses) e 23 controles normais. Resultados: Nos 3 exons da IL-17 A analisados, a freqüência das 14 variantes alélicas já descritas em bancos de dados e de três novas variantes alélicas na região não codificadora do exon 3 (3UTR) não diferiu entre diabéticos e controles. Detectamos, pela primeira vez, diminuição estatisticamente significativa da expressão proporcional do receptor de IL-17A em células TCD3+ (p = 0,041) e TCD4+ (p = 0,0019) periféricas de pacientes com DM1A de início recente quando comparados com controles normais. As concentrações séricas de IL-17A foram menores nos diabéticos. Não observamos correlação entre a expressão dos receptores com a resposta humoral (níveis de autoanticorpos pancreáticos anti-GAD65 e anti-IA2) ou com variáveis metabólicas (glicemia e HbA1c). Nossos resultados sugerem que mutações ou polimorfismos no gene da IL-17A não estão implicadas na predisposição ao DM1A em humanos. A reduzida expressão dos receptores de IL-17A em linfócitos T CD3+ e CD4+ periféricos e das concentrações séricas de IL-17A nos pacientes diabéticos não indicam a participação ativa da via Th17 na periferia na patogênese do DM1A em humanos. No entanto, não descartamos a possibilidade de que, ao estudarmos variáveis na periferia e não do local de agressão imune (as ilhotas pancreáticas), tenhamos obtido valores que não expressem o processo adequadamente. Um eventual mecanismo de regulação negativa da via Th17, na tentativa de proteção do organismo contra o processo inflamatório autoimune, poderia explicar a diminuição de expressão de IL-17RA nos linfócitos periféricos / Type 1A diabetes mellitus (T1AD), a classical autoimmune disease related to the loss of immune tolerance is determined by environmental factors in genetically predisposed individuals. Pancreatic infiltration of T and B lymphocytes, macrophages and dentric cells characterize the process. T helper 17 (Th17) cells are potent, highly inflammatory cells, which initiate tissue inflammation and induce infiltration of other inflammatory cells in target organs. They produce the Interleukin 17A (IL-17A), considered a mediator of various immune disorders such as rheumatoid arthritis, multiple sclerosis, experimental autoimmune encephalitis, psoriasis and asthma, and in animals, autoimmune diabetes. However, its role in T1AD pathogenesis in humans is not defined. The aim of our study was to evaluate the influence of IL-17A in T1AD predisposition in humans. The allelic variants of IL-17A gene (by automatic sequencing), the expression of IL-17A receptors in peripheral lymphocytes (by flow cytometry assay) and the serum levels of IL-17A (by ELISA) were analyzed. Our casuistic was composed of 103 patients with T1D (15,15 ± 10,38 years) and 102 normal controls (18,29 ± 10,83 years). The expression of IL-17A receptor in peripheral lymphocytes and the serum concentration of IL-17A were determined in a subgroup of 24 recent-onset T1D (less than 6 months) and 23 normal controls. Results: The frequency of the 14 allelic variants on the 3 exons of IL- 17A gene already described on data bases did not differ between patients with diabetes and controls. We detected three new allelic variants at the final non-coding region of exon 3. Their frequency was also similar between patients and controls. We detected for the first time a statistically significant decrease in the proportional expression of the receptor of IL-17 on CD3+ (p=0,041) and CD4+ (p=0,0019) T lymphocytes in patients with recent-onset type 1A diabetes. IL- 17A serum concentrations were also lower in patients. There was no correlation between the expression of IL-17A receptor and titles of pancreatic autoantibodies (anti-GAD65 or anti-IA2) or metabolic variables (glucose and HbA1c levels). Our results suggest that mutations or polymorphisms of IL-17A gene are not implicated in the pathogenesis of T1AD in humans. The reduced expression of IL-17A receptors in peripheral T lymphocytes and of IL-17A serum concentrations in patients with diabetes did not indicate a role of Th17 via at the periphery in the autoimmune process. There is however the possibility that by studying the peripheral and not the local immune aggression (pancreatic islets) we have obtained values that do not adequately express the process. A possible mechanism of negative regulation of receptors in an attempt to protect the organism against autoimmune inflammatory process could explain the decrease of IL-17A levels and of IL-17RA expression in peripheral lymphocytes

Diabetes Mellitus tipo 1A (DM1A), doença autoimune clássica, decorrente da quebra de tolerância imune por fatores ambientais em indivíduos geneticamente predispostos, é caracterizada pela infiltração pancreática de linfócitos T e B, macrófagos e células dendríticas. As células T auxiliadoras 17 (Th17) são células potentes, altamente inflamatórias, que produzem a interleucina 17A (IL-17A), citocina mediadora de várias desordens imunológicas como, artrite reumatóide, esclerose múltipla, encefalite experimental autoimune, psoríase e asma, e em animais, o diabetes autoimune. No entanto, seu papel na patogênese do DM1A em humanos não está definido O objetivo de nosso estudo foi avaliar a influência da IL-17A na predisposição ao DM1A através da identificação de variantes alélicas no gene da IL-17A (por sequenciamento automático) e da determinação dos níveis séricos de IL-17A (por ELISA) e da expressão do seu receptor em linfócitos T periféricos (por citometria de fluxo). Foram analisados 103 pacientes com DM1A (idade 15,15 ± 10,38) e 102 controles normais (idade 18,29 ± 10,83). O estudo da expressão do receptor da IL-17A em linfócitos T periféricos bem como o da proteína sérica foram conduzidos em 24 pacientes com DM1A recente (duração inferior a 6 meses) e 23 controles normais. Resultados: Nos 3 exons da IL-17 A analisados, a freqüência das 14 variantes alélicas já descritas em bancos de dados e de três novas variantes alélicas na região não codificadora do exon 3 (3UTR) não diferiu entre diabéticos e controles. Detectamos, pela primeira vez, diminuição estatisticamente significativa da expressão proporcional do receptor de IL-17A em células TCD3+ (p = 0,041) e TCD4+ (p = 0,0019) periféricas de pacientes com DM1A de início recente quando comparados com controles normais. As concentrações séricas de IL-17A foram menores nos diabéticos. Não observamos correlação entre a expressão dos receptores com a resposta humoral (níveis de autoanticorpos pancreáticos anti-GAD65 e anti-IA2) ou com variáveis metabólicas (glicemia e HbA1c). Nossos resultados sugerem que mutações ou polimorfismos no gene da IL-17A não estão implicadas na predisposição ao DM1A em humanos. A reduzida expressão dos receptores de IL-17A em linfócitos T CD3+ e CD4+ periféricos e das concentrações séricas de IL-17A nos pacientes diabéticos não indicam a participação ativa da via Th17 na periferia na patogênese do DM1A em humanos. No entanto, não descartamos a possibilidade de que, ao estudarmos variáveis na periferia e não do local de agressão imune (as ilhotas pancreáticas), tenhamos obtido valores que não expressem o processo adequadamente. Um eventual mecanismo de regulação negativa da via Th17, na tentativa de proteção do organismo contra o processo inflamatório autoimune, poderia explicar a diminuição de expressão de IL-17RA nos linfócitos periféricos / Type 1A diabetes mellitus (T1AD), a classical autoimmune disease related to the loss of immune tolerance is determined by environmental factors in genetically predisposed individuals. Pancreatic infiltration of T and B lymphocytes, macrophages and dentric cells characterize the process. T helper 17 (Th17) cells are potent, highly inflammatory cells, which initiate tissue inflammation and induce infiltration of other inflammatory cells in target organs. They produce the Interleukin 17A (IL-17A), considered a mediator of various immune disorders such as rheumatoid arthritis, multiple sclerosis, experimental autoimmune encephalitis, psoriasis and asthma, and in animals, autoimmune diabetes. However, its role in T1AD pathogenesis in humans is not defined. The aim of our study was to evaluate the influence of IL-17A in T1AD predisposition in humans. The allelic variants of IL-17A gene (by automatic sequencing), the expression of IL-17A receptors in peripheral lymphocytes (by flow cytometry assay) and the serum levels of IL-17A (by ELISA) were analyzed. Our casuistic was composed of 103 patients with T1D (15,15 ± 10,38 years) and 102 normal controls (18,29 ± 10,83 years). The expression of IL-17A receptor in peripheral lymphocytes and the serum concentration of IL-17A were determined in a subgroup of 24 recent-onset T1D (less than 6 months) and 23 normal controls. Results: The frequency of the 14 allelic variants on the 3 exons of IL- 17A gene already described on data bases did not differ between patients with diabetes and controls. We detected three new allelic variants at the final non-coding region of exon 3. Their frequency was also similar between patients and controls. We detected for the first time a statistically significant decrease in the proportional expression of the receptor of IL-17 on CD3+ (p=0,041) and CD4+ (p=0,0019) T lymphocytes in patients with recent-onset type 1A diabetes. IL- 17A serum concentrations were also lower in patients. There was no correlation between the expression of IL-17A receptor and titles of pancreatic autoantibodies (anti-GAD65 or anti-IA2) or metabolic variables (glucose and HbA1c levels). Our results suggest that mutations or polymorphisms of IL-17A gene are not implicated in the pathogenesis of T1AD in humans. The reduced expression of IL-17A receptors in peripheral T lymphocytes and of IL-17A serum concentrations in patients with diabetes did not indicate a role of Th17 via at the periphery in the autoimmune process. There is however the possibility that by studying the peripheral and not the local immune aggression (pancreatic islets) we have obtained values that do not adequately express the process. A possible mechanism of negative regulation of receptors in an attempt to protect the organism against autoimmune inflammatory process could explain the decrease of IL-17A levels and of IL-17RA expression in peripheral lymphocytes

Tuberculosis (TB), caused by infection with Mycobacterium tuberculosis (M.tb), remains a global health problem and although BCG offers some protection against childhood disseminated disease and other mycobacterial infections, its efficacy against pulmonary TB varies between 0 and 80%. Modified Vaccinia virus Ankara expressing antigen 85A (MVA85A) is a novel TB vaccine designed to boost mycobacterium-specific CD4+ T cell response primed by BCG. MVA85A induces strong interferon (IFN)-γ responses, a cytokine known to be essential for protection following M.tb infection. A strong IFN-γ response is not a correlate of protection and in terms of the adaptive response, interleukin (IL)-17 is emerging as an important cytokine following vaccination as it is thought to help boost IFN-γ production by CD4+ T cells. This thesis shows that MVA85A induces IL-17 in PBMC and whole blood of human BCG – MVA85A vaccinees. This is replicated in mice receiving BCG – MVA85A intranasally. The administration of cholera toxin (CT) with BCG enhances IL-17 and confers improved protection following M.tb challenge, which is partially dependent on IL-17 and on the mucosal route of administration. Since CT is not a suitable adjuvant in humans, an alternative IL-17-inducing pathway was investigated. In human BCG – MVA85A-vaccinated volunteers, blocking the hydrolysing ability of the CD39, an apyrase responsible for hydrolysing pro-inflammatory ATP, enhances IL-17 production. Challenge of BCG – MVA85A-vaccinated CD39-/- mice with M.tb slightly improved the protective capacity of the vaccine, suggesting that a pathway dependent on ATP-driven inflammation may be a target for improving the immunogenicity of a vaccine against M.tb disease. Overall, this thesis has confirmed the important role of IL-17 in vaccine-induced protection against TB disease and identifies a possible target pathway for improvement of a novel vaccine.