Throughout history, human populations have continuously been challenged by new and emerging infectious diseases. For the past 26 years, sub-Saharan Africa and other countries around the world have been dealing with a pandemic caused by a relatively new pathogen called the human immunodeficiency virus (HIV). Although antiretroviral (ARV) therapies effectively reduce morbidity and mortality rates, the long term use in those who have access to treatment inevitably leads to drug-related toxicity and resistance. Even with a strong commitment from governments to expand and finance prevention and treatment programs, transmission rates continue to outpace the benefits of these efforts. Therefore to effectively eradicate the disease, research is focusing on the design of protective and therapeutic vaccines. The first major step in designing these alternative therapies is to define correlates of immune protection. / The research presented in this thesis focuses on characterizing the quantitative and qualitative features of T cell immune responses in individuals who spontaneously control viral replication and exhibit a benign course of disease while remaining off ARV therapy. A comprehensive analysis of HIV-specific IFN-gamma secreting immune responses revealed that neither the breadth nor the magnitude of responses directed against the entire HIV proteome accurately predicts the viral load or rate of CD4 decline. Subsequent analyses showed that the preferential targeting of Gag was associated with reduced rates of CD4 decline and was later confirmed in a cohort of individuals in primary infection whereby the relative breadth and magnitude of Gag p24 was inversely correlated with viral load set point. / The maintenance of polyfunctional immune responses in HIV-infected subjects with a benign course of disease prompted us to develop a method that could comprehensively assess the breadth, magnitude and specificity of three functionally distinct subsets of HIV-specific lymphocytes (single IFN-gamma, single IL-2 and dual IFN-gamma/IL-2 secretors). Survey of immune responses in chronically infected individuals revealed that only the breadth and magnitude of dual IFN-gamma/IL-2 secreting lymphocytes correlated with reduced viral loads and increased CD4 counts suggesting that secretion of IFN-gamma alone was a poor correlate of protection. We also showed that the contribution of polyfunctional lymphocytes to the total response was greater for epitopes restricted by major histocompatibility complex (MHC) class I alleles associated with slow disease progression compared to those restricted by alleles associated with rapid or neutral rates of HIV disease progression. / Taken together, this work supports the view that immune monitoring of infected and vaccinated individuals should include methodologies capable of detecting both IFN-gamma and IL-2 secretion from responding T lymphocytes. The studies presented here have furthered our understanding of what constitutes protection from disease progression emphasizing that both specificity and polyfunctionality are features of effective control of viral replication.

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A proposta principal deste estudo foi de avaliar o efeito da prática regular de atividade física por longos anos na imunossenescência, isto é, nas alterações que o sistema imune sofre com o envelhecimento. Para tal, comparou-se os resultados dos exames imunológicos de 20 idosos praticantes de corrida (idade média = 67 anos) aos de 20 idosos sedentários (idade média = 66 anos) e 10 jovens sedentários (idade média = 26 anos). Os idosos corredores eram praticantes da modalidade em média nos últimos 23 anos e vinham percorrendo uma distância semanal média de 39 quilômetros. O consumo máximo de oxigênio (VO2 max) deles foi 52% maior do que o dos idosos sedentários, atingindo valores similares aos dos jovens. Os parâmetros imunológicos analisados foram: contagem de linfócitos e seus subtipos, resposta proliferativa dos linfócitos T a mitógenos, atividade citotóxica das células natural killer e produção de citocinas (interleucinas 2, 3, 4, 6, 10 e 12). A dosagem das mesmas citocinas no soro também foi realizada, porém somente nos dois grupos de idosos. Os idosos corredores apresentaram resposta proliferativa dos linfócitos T a OKT-3 e produção de interleucina-2 significativamente maiores do que as dos idosos sedentários. Eles apresentaram também uma produção de interleucina-3 significativamente menor do que a dos seus pares sedentários. Por outro lado, não apresentaram diferença significativa destes parâmetros em relação aos jovens. Os níveis séricos das interleucinas 3, 6 e 12 dos idosos corredores foram significativamente menores do que os dos idosos sedentários. A influência da prática de atividade física regular sobre os níveis séricos do hormônio de crescimento, da testosterona e da dehidroepiandrosterona sulfato (DHEAS), que sofrem redução com o envelhecimento (\"endocrinossenescência\"), também foi estudada. Não houve diferença significativa entre os níveis séricos destes hormônios anabólicos dos idosos corredores e dos idosos sedentários. O efeito da atividade física regular sobre a beta-endorfina também foi avaliado. Os idosos corredores não apresentaram diferença significativa nos níveis séricos deste neuropeptídeo em relação aos idosos sedentários. Em virtude do possível envolvimento do sistema endócrino na imunossenescência, avaliou-se a correlação entre os hormônios anabólicos e as citocinas. Não se constatou correlação relevante entre eles, especialmente entre a DHEAS e a interleucina-6. Os resultados indicam que a prática regular de atividade física por longos anos tem o potencial de desacelerar a imunossenescência / The main objective of this study was to assess the effect of regular practice of physical activity on immunosenescence, that is, the changes that occur when the immune system is affected by aging. The results of immune tests conducted on 20 elderly runners (mean age = 67 years) were compared to those of 20 elderly sedentary individuals (mean age = 66 years) and to those of 10 young sedentary individuals (mean age = 26 years). On average, the elderly runners had practiced this activity for the last 23 years, running a mean weekly distance of 39 kilometers. Their maximum oxygen consumption (VO2 max) was 52% higher than that of sedentary elderly group, and similar to that of the group of younger individuals. The immune parameters studied were: lymphocyte and lymphocyte subtype counts, the proliferative response of T-lymphocytes to mitogens, cytotoxic activity of natural killer cells and production of cytokines (interleukins 2, 3, 4, 6, 10 and 12). The same cytokines were measured in serum, but only in the two groups of elderly people. Elderly runners presented a significantly higher proliferative response of T-lymphocytes to OKT-3 as well as interleukin-2 production than the sedentary group. The production of interleukin-3 was also significantly lower in the group of runners. On the other hand, the results of these parameters did not differ significantly from those of young subjects. Serum levels of interleukins 3, 6, and 12 were significantly lower in elderly runners than in sedentary individuals. The impact of regular physical activity on serum levels of growth hormone, testosterone, and dehydroepiandrosterone sulfate (DHEAS), which are affected by aging (\"endocrinosenescence\"), was also studied. The serum levels of these anabolic hormones did not differ significantly between the groups of elderly runners and the elderly sedentary individuals. When the impact of regular physical activity on beta-endorphin was studied, again no significant difference in the serum levels of this neuropeptide was found between the two elderly groups. Owing to the possible involvement of the endocrine system in immunosenescence, the correlation between anabolic hormones and cytokines was assessed. No relevant correlation was found, especially between DHEAS and interleukin-6. The results indicate that the regular practice of physical activity for several years may delay immunosenescence

A proposta principal deste estudo foi de avaliar o efeito da prática regular de atividade física por longos anos na imunossenescência, isto é, nas alterações que o sistema imune sofre com o envelhecimento. Para tal, comparou-se os resultados dos exames imunológicos de 20 idosos praticantes de corrida (idade média = 67 anos) aos de 20 idosos sedentários (idade média = 66 anos) e 10 jovens sedentários (idade média = 26 anos). Os idosos corredores eram praticantes da modalidade em média nos últimos 23 anos e vinham percorrendo uma distância semanal média de 39 quilômetros. O consumo máximo de oxigênio (VO2 max) deles foi 52% maior do que o dos idosos sedentários, atingindo valores similares aos dos jovens. Os parâmetros imunológicos analisados foram: contagem de linfócitos e seus subtipos, resposta proliferativa dos linfócitos T a mitógenos, atividade citotóxica das células natural killer e produção de citocinas (interleucinas 2, 3, 4, 6, 10 e 12). A dosagem das mesmas citocinas no soro também foi realizada, porém somente nos dois grupos de idosos. Os idosos corredores apresentaram resposta proliferativa dos linfócitos T a OKT-3 e produção de interleucina-2 significativamente maiores do que as dos idosos sedentários. Eles apresentaram também uma produção de interleucina-3 significativamente menor do que a dos seus pares sedentários. Por outro lado, não apresentaram diferença significativa destes parâmetros em relação aos jovens. Os níveis séricos das interleucinas 3, 6 e 12 dos idosos corredores foram significativamente menores do que os dos idosos sedentários. A influência da prática de atividade física regular sobre os níveis séricos do hormônio de crescimento, da testosterona e da dehidroepiandrosterona sulfato (DHEAS), que sofrem redução com o envelhecimento (\"endocrinossenescência\"), também foi estudada. Não houve diferença significativa entre os níveis séricos destes hormônios anabólicos dos idosos corredores e dos idosos sedentários. O efeito da atividade física regular sobre a beta-endorfina também foi avaliado. Os idosos corredores não apresentaram diferença significativa nos níveis séricos deste neuropeptídeo em relação aos idosos sedentários. Em virtude do possível envolvimento do sistema endócrino na imunossenescência, avaliou-se a correlação entre os hormônios anabólicos e as citocinas. Não se constatou correlação relevante entre eles, especialmente entre a DHEAS e a interleucina-6. Os resultados indicam que a prática regular de atividade física por longos anos tem o potencial de desacelerar a imunossenescência / The main objective of this study was to assess the effect of regular practice of physical activity on immunosenescence, that is, the changes that occur when the immune system is affected by aging. The results of immune tests conducted on 20 elderly runners (mean age = 67 years) were compared to those of 20 elderly sedentary individuals (mean age = 66 years) and to those of 10 young sedentary individuals (mean age = 26 years). On average, the elderly runners had practiced this activity for the last 23 years, running a mean weekly distance of 39 kilometers. Their maximum oxygen consumption (VO2 max) was 52% higher than that of sedentary elderly group, and similar to that of the group of younger individuals. The immune parameters studied were: lymphocyte and lymphocyte subtype counts, the proliferative response of T-lymphocytes to mitogens, cytotoxic activity of natural killer cells and production of cytokines (interleukins 2, 3, 4, 6, 10 and 12). The same cytokines were measured in serum, but only in the two groups of elderly people. Elderly runners presented a significantly higher proliferative response of T-lymphocytes to OKT-3 as well as interleukin-2 production than the sedentary group. The production of interleukin-3 was also significantly lower in the group of runners. On the other hand, the results of these parameters did not differ significantly from those of young subjects. Serum levels of interleukins 3, 6, and 12 were significantly lower in elderly runners than in sedentary individuals. The impact of regular physical activity on serum levels of growth hormone, testosterone, and dehydroepiandrosterone sulfate (DHEAS), which are affected by aging (\"endocrinosenescence\"), was also studied. The serum levels of these anabolic hormones did not differ significantly between the groups of elderly runners and the elderly sedentary individuals. When the impact of regular physical activity on beta-endorphin was studied, again no significant difference in the serum levels of this neuropeptide was found between the two elderly groups. Owing to the possible involvement of the endocrine system in immunosenescence, the correlation between anabolic hormones and cytokines was assessed. No relevant correlation was found, especially between DHEAS and interleukin-6. The results indicate that the regular practice of physical activity for several years may delay immunosenescence